DIAGNOSTIC REPORT

CLIENT CODE : C000022247 Cert. No. M-0415

CLIENT'S NAME AND ADDRESS : SRL LIMITED

RUCHI SINGH B-1/12, VIPUL KHAND, GOMTINAGAR
LUCKNOW, 226010
UTTAR PRADESH, INDIA
Tel : 0522 4412121, 4428378, Fax : 0522 - 406 2980
CIN - U74899PB1995PLC045956
Email : customercare.lucknow@srl.in

PATIENT NAME : RUCHI SINGH PATIENT ID : RUCHF13038224A

ACCESSION NO : 0024RD009343 AGE : 36 Years SEX : Female DATE OF BIRTH : 13/03/1982

DRAWN : 27/04/2018 13:11 RECEIVED : 27/04/2018 13:12 REPORTED : 27/04/2018 16:12

REFERRING DOCTOR : DR. MANISH MISHRA CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

FITNESS CARE ADVANCE

25 - HYDROXYVITAMIN D, SERUM
25 - HYDROXYVITAMIN D 29.36 Low Deficiency: < 20.0 ng/mL
Insufficiency: 20.0 - < 30.0
Sufficiency: 30.0 -100.0
Toxicity > 100.0
CALCIUM, SERUM
CALCIUM 7.4 Low 8.5 - 10.1 mg/dL
METHOD : OCPC / CRESOLPHTHALIN

PHOSPHORUS, SERUM
PHOSPHORUS 3.5 2.5 - 4.9 mg/dL
TOTAL IRON BINDING CAPACITY, SERUM
IRON 23 Low 50 - 170 µg/dL
METHOD : FERENE COLORIMETRIC

TOTAL IRON BINDING CAPACITY 229 Low 250 - 450 µg/dL

METHOD : CHOROMOGEN FERENCE

% SATURATION 10 Low 13 - 45 %
METHOD : CALCULATED PARAMETER

SERUM BLOOD UREA NITROGEN

BLOOD UREA NITROGEN 9 6 - 20 mg/dL
METHOD : GLDH / UREASE

CREATININE, SERUM
CREATININE 0.80 0.60 - 1.10 mg/dL

Page 1 Of 6
 DIAGNOSTIC REPORT

CLIENT CODE : C000022247 Cert. No. M-0415

CLIENT'S NAME AND ADDRESS : SRL LIMITED

RUCHI SINGH B-1/12, VIPUL KHAND, GOMTINAGAR
LUCKNOW, 226010
UTTAR PRADESH, INDIA
Tel : 0522 4412121, 4428378, Fax : 0522 - 406 2980
CIN - U74899PB1995PLC045956
Email : customercare.lucknow@srl.in

PATIENT NAME : RUCHI SINGH PATIENT ID : RUCHF13038224A

ACCESSION NO : 0024RD009343 AGE : 36 Years SEX : Female DATE OF BIRTH : 13/03/1982

DRAWN : 27/04/2018 13:11 RECEIVED : 27/04/2018 13:12 REPORTED : 27/04/2018 16:12

REFERRING DOCTOR : DR. MANISH MISHRA CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

METHOD : JAFFE KINETIC METHOD

BUN/CREAT RATIO
BUN/CREAT RATIO 11.25 5.00 - 15.00
METHOD : CALCULATED PARAMETER

URIC ACID, SERUM

URIC ACID 4.4 2.6 - 6.0 mg/dL
METHOD : URICASE/CATALASE UV

TOTAL PROTEIN, SERUM

TOTAL PROTEIN 7.9 6.4 - 8.2 g/dL
METHOD : BIURET

ALBUMIN, SERUM
ALBUMIN 3.2 Low 3.4 - 5.0 g/dL
METHOD : BCP DYE BINDING

* GLOBULIN
GLOBULIN 4.7 High 2.0 - 4.1 g/dL
METHOD : CALCULATED PARAMETER

ELECTROLYTES (NA/K/CL), SERUM

SODIUM 138.1 137 - 145 mmol/L
METHOD : ISE DIRECT

POTASSIUM 4.41 3.6 - 5.0 mmol/L

METHOD : ION SELECTIVE ELECTRODE TECHNOLOGY

CHLORIDE 101.8 98 - 107 mmol/L

Page 2 Of 6
 DIAGNOSTIC REPORT

CLIENT CODE : C000022247 Cert. No. M-0415

CLIENT'S NAME AND ADDRESS : SRL LIMITED

RUCHI SINGH B-1/12, VIPUL KHAND, GOMTINAGAR
LUCKNOW, 226010
UTTAR PRADESH, INDIA
Tel : 0522 4412121, 4428378, Fax : 0522 - 406 2980
CIN - U74899PB1995PLC045956
Email : customercare.lucknow@srl.in

PATIENT NAME : RUCHI SINGH PATIENT ID : RUCHF13038224A

ACCESSION NO : 0024RD009343 AGE : 36 Years SEX : Female DATE OF BIRTH : 13/03/1982

DRAWN : 27/04/2018 13:11 RECEIVED : 27/04/2018 13:12 REPORTED : 27/04/2018 16:12

REFERRING DOCTOR : DR. MANISH MISHRA CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

METHOD : ISE DIRECT

* TOTAL TSH, SERUM

TSH 3RD GENERATION 2.700 0.55 - 4.78 µIU/mL
ALANINE AMINOTRANSFERASE, SERUM
ALANINE AMINOTRANSFERASE (ALT/SGPT) 38 High < 34.0 U/L
METHOD : UV WITH PYRIDOXAL-5 PHOSPHATE

ASPARTATE AMINOTRANSFERASE, SERUM

ASPARTATE AMINOTRANSFERASE (AST/SGOT) 44 High 15 - 37 U/L
METHOD : UV WITH PYRIDOXAL-5 PHOSPHATE

BILIRUBIN, TOTAL, SERUM

BILIRUBIN, TOTAL 0.63 0.2 - 1.0 mg/dL
METHOD : DIAZO WITH SULPHANILIC ACID

COMPLETE BLOOD COUNT, BLOOD

RED BLOOD CELL COUNT 2.79 Low 3.8 - 4.8 mil/µL
METHOD : ELECTRONIC IMPEDANCE

HEMOGLOBIN 9.5 Low 12.0 - 15.0 g/dL

METHOD : PHOTOMETRIC

HEMATOCRIT 30.0 Low 36 - 46 %

METHOD : ELECTRONIC IMPEDANCE/CALCULATION

MEAN CORPUSCULAR VOLUME 107.6 High 83.0 - 101.0 fL

METHOD : CALCULATED PARAMETER

MEAN CORPUSCULAR HEMOGLOBIN 33.8 High 27.0 - 32.0 pg

METHOD : CALCULATED PARAMETER

MEAN CORPUSCULAR HEMOGLOBIN 31.5 31.5 - 34.5 g/dL

CONCENTRATION
METHOD : CALCULATED PARAMETER

RED CELL DISTRIBUTION WIDTH 15.4 High 11.6 - 14.0 %

METHOD : ELECTRONIC IMPEDANCE

PLATELET COUNT 207 150 - 410 thou/µL

METHOD : ELECTRONIC IMPEDANCE

MEAN PLATELET VOLUME 10.1 6.8 - 10.9 fL

METHOD : ELECTRONIC IMPEDANCE

WHITE BLOOD CELL COUNT 9.7 4.0 - 10.0 thou/µL

METHOD : ELECTRONIC IMPEDANCE

WBC DIFFERENTIAL COUNT

NEUTROPHILS 82 High 40 - 80 %
EOSINOPHILS 01 1-6 %
LYMPHOCYTES 13 Low 20 - 40 %

Page 3 Of 6
 DIAGNOSTIC REPORT

CLIENT CODE : C000022247 Cert. No. M-0415

CLIENT'S NAME AND ADDRESS : SRL LIMITED

RUCHI SINGH B-1/12, VIPUL KHAND, GOMTINAGAR
LUCKNOW, 226010
UTTAR PRADESH, INDIA
Tel : 0522 4412121, 4428378, Fax : 0522 - 406 2980
CIN - U74899PB1995PLC045956
Email : customercare.lucknow@srl.in

PATIENT NAME : RUCHI SINGH PATIENT ID : RUCHF13038224A

ACCESSION NO : 0024RD009343 AGE : 36 Years SEX : Female DATE OF BIRTH : 13/03/1982

DRAWN : 27/04/2018 13:11 RECEIVED : 27/04/2018 13:12 REPORTED : 27/04/2018 16:12

REFERRING DOCTOR : DR. MANISH MISHRA CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

MONOCYTES 04 2 - 10 %
BASOPHILS 00 <1-2 %
BAND (STAB) CELLS 00 %
DIFFERENTIAL COUNT PERFORMED ON: EDTA SMEAR
MORPHOLOGY
RBC PREDOMINANTLY NORMOCYTIC NORMOCHROMIC WITH MILD
ANISOCYTOSIS.
WBC WBCS ARE NORMAL IN NUMBER WITH NEUTROPHILIA & LYMPHOPENIA.
PLATELETS PLATELETS ARE ADEQUATE IN NUMBER

Interpretation(s)
25 - HYDROXYVITAMIN D, SERUM-
Note: Our Vitamin D assays is standardized to be in alignment with the ID-LC/MS/MS 25(OH)vitamin D Reference Method Procedure (RMP), the reference procedure for the
Vitamin D Standardization Program (VDSP). The VDSP, a collaboration of the National Institutes of Health Office of Dietary Supplements, National Institute of Technology and
Standards, Centers for Disease Control and Ghent University, is an initiative to standardize 25(OH)vitamin D measurement across methods
CALCIUM, SERUM-Commom causes of decreased value of calcium (hypocalcemia) are chronic renal failure, hypomagnesemia and hypoalbuminemia.

Hypercalcemia (increased value of calcium) can be caused by increased intestinal absorbtion (vitamin d intoxication), increased skeletal reasorption (immobilization),
or a combination of mechanisms (primary hyperparathyroidism). Primary hyperparathyroidism and malignancy accounts for 90-95% of all cases of hypercalcemia.

Values of total calcium is affected by serum proteins, particularly albumin thus, latter’s value should be taken into account when interpreting serum calcium
levels. The following regression equation may be helpful.
Corrected total calcium (mg/dl)= total calcium (mg/dl) + 0.8 (4- albumin [g/dl])*
because regression equations vary among group of patients in different physiological and pathological conditions, mathematical corrections are only
approximations. The possible mathematical corrections should be replaced by direct determination of free calcium by ISE (available with srl) a common and
important source of preanalytical error in the measurement of calcium is prolonged torniquet application during sampling. Thus, this along with fist clenching
should be avoided before phlebotomy.
TOTAL IRON BINDING CAPACITY, SERUM-Total iron binding capacity (TIBC) measures the blood’s capacity to bind iron with transferrin and thus is an indirect way of
assessing transferrin level.
Taken together with serum iron and percent transferrin saturation this test is performed when they is a concern about anemia, iron deficiency or iron deficiency anemia.
However, because the liver produces transferrin, alterations in liver function (such as cirrhosis, hepatitis, or liver failure) must be considered when performing this test.
Increased in:
- iron deficiency
- acute and chronic blood loss
- acute liver damage
- progesterone birth control pills
Decreased in:
- hemochromatosis
- cirrhosis of the liver
- thalassemia
- anemias of infection and chronic diseases
- nephrosis
- hyperthyroidism
The percent Transferrin saturation = Serum Iron/TIBC x 100
Unsaturated Binding Capacity (UIBC)=TIBC - Serum Iron.
Limitations: Estrogens and oral contraceptives increase TIBC and Asparaginase, chloramphenicol, corticotropin, cortisone and testosterone decrease the TIBC level.

Reference:
1.Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, edited by Carl A Burtis, Edward R.Ashwood, David E Bruns, 4th Edition, Elsevier publication, 2006, 563,
1314-1315.
2. Wallach’s Interpretation of Diagnostic tests, 9th Edition, Ed Mary A Williamson and L Michael Snyder. Pub Lippincott Williams and Wilkins, 2011, 234-235.
SERUM BLOOD UREA NITROGEN-Causes of Increased levels
Pre renal
• High protein diet, Increased protein catabolism, GI haemorrhage, Cortisol, Dehydration, CHF Renal
• Renal Failure
Post Renal
• Malignancy, Nephrolithiasis, Prostatism

Causes of decreased levels

• Liver disease

Page 4 Of 6
 DIAGNOSTIC REPORT

CLIENT CODE : C000022247 Cert. No. M-0415

CLIENT'S NAME AND ADDRESS : SRL LIMITED

RUCHI SINGH B-1/12, VIPUL KHAND, GOMTINAGAR
LUCKNOW, 226010
UTTAR PRADESH, INDIA
Tel : 0522 4412121, 4428378, Fax : 0522 - 406 2980
CIN - U74899PB1995PLC045956
Email : customercare.lucknow@srl.in

PATIENT NAME : RUCHI SINGH PATIENT ID : RUCHF13038224A

ACCESSION NO : 0024RD009343 AGE : 36 Years SEX : Female DATE OF BIRTH : 13/03/1982

DRAWN : 27/04/2018 13:11 RECEIVED : 27/04/2018 13:12 REPORTED : 27/04/2018 16:12

REFERRING DOCTOR : DR. MANISH MISHRA CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

• SIADH.
CREATININE, SERUM-Higher than normal level may be due to:
• Blockage in the urinary tract
• Kidney problems, such as kidney damage or failure, infection, or reduced blood flow
• Loss of body fluid (dehydration)
• Muscle problems, such as breakdown of muscle fibers
• Problems during pregnancy, such as seizures (eclampsia)), or high blood pressure caused by pregnancy (preeclampsia)

Lower than normal level may be due to:

• Myasthenia Gravis
• Muscular dystrophy
URIC ACID, SERUM-Causes of Increased levels
Dietary
• High Protein Intake.
• Prolonged Fasting,
• Rapid weight loss.
Gout
Lesch nyhan syndrome.
Type 2 DM.
Metabolic syndrome.

Causes of decreased levels

• Low Zinc Intake
• OCP’s
• Multiple Sclerosis

Nutritional tips to manage increased Uric acid levels

• Drink plenty of fluids
• Limit animal proteins
• High Fibre foods
• Vit C Intake
• Antioxidant rich foods
TOTAL PROTEIN, SERUM-Serum total protein,also known as total protein, is a biochemical test for measuring the total amount of protein in serum..Protein in the plasma is
made up of albumin and globulin

Higher-than-normal levels may be due to: Chronic inflammation or infection, including HIV and hepatitis B or C, Multiple myeloma, Waldenstrom''''s disease
Lower-than-normal levels may be due to: Agammaglobulinemia, Bleeding (hemorrhage),Burns,Glomerulonephritis, Liver disease, Malabsorption, Malnutrition, Nephrotic
syndrome,Protein-losing enteropathy etc.
ALBUMIN, SERUM-Human serum albumin is the most abundant protein in human blood plasma. It is produced in the liver. Albumin constitutes about half of the blood serum
protein. Low blood albumin levels (hypoalbuminemia) can be caused by: Liver disease like cirrhosis of the liver, nephrotic syndrome, protein-losing enteropathy, Burns,
hemodilution, increased vascular permeability or decreased lymphatic clearance,malnutrition and wasting etc.
ELECTROLYTES (NA/K/CL), SERUM-ELECTROLYTES (NA/K/CL), SERUM

Sodium levels are Increased in dehydration, cushing''''s syndrome, aldosteronism & decreased in Addison''''s disease, hypopituitarism,liver disease. Hypokalemia (low K) is
common in vomiting, diarrhea, alcoholism, folic acid deficiency and primary aldosteronism. Hyperkalemia may be seen in end-stage renal failure, hemolysis, trauma,
Addison''''s disease, metabolic acidosis, acute starvation, dehydration, and with rapid K infusion.Chloride is increased in dehydration, renal tubular acidosis (hyperchloremia
metabolic acidosis), acute renal failure, metabolic acidosis associated with prolonged diarrhea and loss of sodium bicarbonate, diabetes insipidus, adrenocortical hyperfuction,
salicylate intoxication and with excessive infusion of isotonic saline or extremely high dietary intake of salt.Chloride is decreased in overhydration, chronic respiratory acidosis,
salt-losing nephritis, metabolic alkalosis, congestive heart failure, Addisonian crisis, certain types of metabolic acidosis, persistent gastric secretion and prolonged vomiting,
TOTAL TSH, SERUM-Comment: The Biological Reference Interval of TSH-3rd Generation Ultra [TSH3-UL] is not established for age less than 2 years.

Below mentioned are the guidelines for Pregnancy related reference ranges for TSH.
---------------------------------------------------------------------------------------------------------
Levels in TSH
Pregnancy (µIU/mL)

First Trimester 0.1 - 2.5

.
2nd Trimester 0.2 – 3.0
.
3rd Trimester 0.3 – 3.0
-------------------------------------------------------------------------------------------------------
ALANINE AMINOTRANSFERASE, SERUM-Alanine aminotransferase (ALT) test measures the amount of this enzyme in the blood. ALT is found mainly in the liver, but also in
smaller amounts in the kidneys, heart, muscles, and pancreas. It is commonly measured as a part of a diagnostic evaluation of hepatocellular injury, to determine liver
health. . AST levels increase during acute hepatitis, sometimes due to a viral infection, ischemia to the liver, chronic hepatitis, obstruction of bile ducts, cirrhosis.
ASPARTATE AMINOTRANSFERASE, SERUM-Aminotransferase (AST) is an enzyme found in various parts of the body .AST is found in the liver, heart, skeletal muscle, kidneys,
brain, and red blood cells, and it is commonly measured clinically as a marker for liver health. AST levels increase during chronic viral hepatitis, blockage of the bile duct,
cirrhosis of the liver, liver cancer, kidney failure, hemolytic anemia, pancreatitis, hemochromatosis. AST levels may also increase after a heart attack or strenuous activity.
BILIRUBIN, TOTAL, SERUM-Bilirubin is a yellowish pigment found in bile and is a breakdown product of normal heme catabolism. Bilirubin is excreted in bile and urine, and

Page 5 Of 6
 DIAGNOSTIC REPORT

CLIENT CODE : C000022247 Cert. No. M-0415

CLIENT'S NAME AND ADDRESS : SRL LIMITED

RUCHI SINGH B-1/12, VIPUL KHAND, GOMTINAGAR
LUCKNOW, 226010
UTTAR PRADESH, INDIA
Tel : 0522 4412121, 4428378, Fax : 0522 - 406 2980
CIN - U74899PB1995PLC045956
Email : customercare.lucknow@srl.in

PATIENT NAME : RUCHI SINGH PATIENT ID : RUCHF13038224A

ACCESSION NO : 0024RD009343 AGE : 36 Years SEX : Female DATE OF BIRTH : 13/03/1982

DRAWN : 27/04/2018 13:11 RECEIVED : 27/04/2018 13:12 REPORTED : 27/04/2018 16:12

REFERRING DOCTOR : DR. MANISH MISHRA CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

elevated levels may give yellow discoloration in jaundice.Elevated levels results from increased bilirubin production (eg, hemolysis and ineffective erythropoiesis), decreased
bilirubin excretion (eg, obstruction and hepatitis), and abnormal bilirubin metabolism (eg, hereditary and neonatal jaundice).

An elevated bilirubin level in a newborn may be temporary and resolve itself within a few days to two weeks. However, if the bilirubin level is above a critical threshold or
rapidly increases, an investigation of the cause is needed so appropriate treatment can be initiated.

Source: Wallach"s Interpretation of Diagnostic tests, 9th ed2) Wallach"s interpretation of diagnostic tests, 9th ed
COMPLETE BLOOD COUNT, BLOOD-
Hemoglobin, total leucocyte count and platelate count are stable till 72 hrs. The cell morphology is well preserved for 24hrs. However, between 24 to 72 hrs hrs an increase in
MCV and HCT is observed (MCV - 5.0 - 7.5% and HCT - 5.0 - 6.8%) leading to a decrease in MCHC. A direct smear is recommended for an accurate differential WBC count
and interpretation of RBC morphology.

TEST TECHINQUE: Spectrophotometric/ Electronic Impedence/ Calculation

Pediatric reference ranges represent amalgamated data from published ranges. {Practical Hematology by Dacie & Lewis (10th Edition)}.

References:
Nathan/Oski, Hematolgy of Infancy and Childhood,3rd Ed,1987.
Practical Hematology by Dacie & Lewis (10th Edition).

Dr. Nidhi Awasthi, MD Dr Abhishant Pandey, MD

Pathologist Pathologist
LAB HEAD
CONDITIONS OF LABORATORY TESTING & REPORTING

1. It is presumed that the test sample belongs to the
patient named or identified in the test requisition form.
2. All Tests are performed and reported as per the
turnaround time stated in the SRL Directory of services
(DOS).
3. SRL confirms that all tests have been performed or
assayed with highest quality standards, clinical safety &
technical integrity.
4. A requested test might not be performed if:
a. Specimen received is insufficient or inappropriate
specimen quality is unsatisfactory
b. Incorrect specimen type
c. Request for testing is withdrawn by the ordering
doctor or patient
d. There is a discrepancy between the label on the
specimen container and the name on the test
requisition form
5. The results of a laboratory test are dependent on
the quality of the sample as well as the assay
technology.
6. Result delays could be because of uncontrolled
circumstances. e.g. assay run failure.
7. Tests parameters marked by asterisks are excluded
from the “scope" of NABL accredited tests. (If
laboratory is accredited).
8. Laboratory results should be correlated with clinical
information to determine Final diagnosis.
9. Test results are not valid for Medico- legal purposes.
10. In case of queries or unexpected test results please
call at SRL customer care (Toll free: 1800-222-000).
Post proper investigation repeat analysis may be carried
out.

SRL Limited
Fortis Hospital, Sector 62, Phase VIII,
Mohali 160062

Page 6 Of 6