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3 101/27/2016 THYROXINE, FREE(FT4) TNP 0.80-1.73 ng/dL Test Not Performed: Specimen rejected for testing dut to moderate or marked heaolysis. FREE T4 INDEX TNP 1.5-3.8 T3(THYRONINE), TOTAL TNP 72-180 ng/dL Test Not Performed: Specimen rejected for testing due to moderate or marked hemolysis

lucose, Urine NEGATIVE NEGATIVE Ketone, Urine NEGATIVE NEGATIVE Urobilinogen Urine 0.2 0.2 - 1.0 mg/dL sioReference Laboratories, Inc. 481 Edward H. Ross Dr I Elmwood Park, N3 07407 I (800) 2: lames Weisberger, M.D. Clinical Page 2 of 6 9-5227 Laboratory Director Printed 07/25/2016 07:01 g abed 4£9

OXINE, FREE(FT4) TNP Test Not Performed: Specimen rejected for testing due hemolysis. 0.80-1.73 ng/dL to moderate or marked 0.93 101/27/2016 FREE T4 INDEX TNP 1.5-3.8 1.8 01/27/2016 T3(THYRONINE), TOTAL TNP Test Not Performed: Specimen rejected for testing due hemolysis. 72-180 ng/dl. t

rol 13 Evaluation: ABOVE AVG.(MDDERATE RISK) >14 K 17 01/27/2016 Chol/HDL Ratio 7.5 <7.4 I 6.0 101/27/2016 BioReference Laborator1e 481 Edward H. Ross Dr James meisberger, Laboratory Director Clinical Page 1 of 6 Printed 07/25/2016 07:01 abed VE91986Z12l. iPsH AsJeH WALE:GO 9102 60 6NV EFTA002829

OXINE, FREE(FT4) TNP lest Not Performed: Specimen rejected for testing due hemolysis. 0.80-1.73 ng/dL to moderate or marked 0.93 101/27/2016 FREE T4 INDEX TNP 1.5-3.8 1.8 01/27/2016 113(THYRONINE), TOTAL TNP Test Not Performed: Specimen rejected for testing due hemolysis. 72-180 ng/dL t

13 Evaluation: ABOVE AV6.(MODERATE RISK) >14 X 17 01/27/2016 Chol/HDL Ratio 7.5 <7.4 6.0 01/27/2016 BioReference Laboratories, Inc. 481 Edward H. Ross Dr Elmwood Park, N7 07407 I (800) 2 9-5227 lames 4eisberger, Laboratory Director Clinical Page 1 of 6 Printed 07/25/2016 07:01 p gad b£91.886ZLZ1

/dL TNP 08/30/2017 ill UPTAKE (13U) 31.0 24.3-39.0 TNP 08/30/2017 rffirmodat, FREE (aT4Y • 3.11 — 6710--1.71r ng/d1 TNP 08/30/2017 • : FREE T4 INDEX 2.3 1.5-3.8 . . TNP 98/30/2017 --14NP 1T3 (THYRONINE), TOTAL -IgM 127 -180 r&dL B/30/1017 • HEP: A Ab:,. Non- Non-Reactive .•• .

7-32 mg/di Aa, avaiiiiii7 tote- ot/30/2e0 esini2015 • • " (._.Can't CaLc 108/39/2017 ...._... . •-- BioReference Laboratories, Inc. 481 Edward H. Ross Dr I Elammod Park, NO B7407 I James Weisberger M.D. Page 1 of Laboratory Director 'rioted i,9/22/2917 89:57 EFTA00299765 BioReference LABoRAToRi