E 18 Address: 9 EAST 71ST STREET 44 EAST 67TH STREET NEW YORK, NY 10021 NEW YORK, NY 10065 D.Q.B.: 01/20/1953 Ordering Sub/altar Provider: WOODSON C MERRELL MO Record IMUGEN Account *: MERW Patient 2018013061 Antibody Capture Enzyme Immunoassay Test Date: 0917/2018 Antigen Antibody Retype Result

18 Address: 9 EAST 71ST STREET 44 EAST 67TH STREET NEW YORK, NY 10021 NEW YORK, NY 10065 D.O.B.: 01/20.'1953 Ordering Submitter Provider: WOODSON C MERRELL MO Record ft. IMUGEN Account*: MERW Patient it: 20180.13061 Antibody Capture Enzyme Immunoassay Test Date: 09117/2018 Antigen Antibody Isoty