Report of Findings

Centers for Disease Control and Prevention

National Center for Health Statistics 3311 Toledo Road, MS P08

Hyattsville, Maryland 20782

SAMPLE ROF 2021

Date

Attachment 14g

Participant Name

Address

Dear Participant,

We appreciate your participation in the National Health and Nutrition Examination Survey conducted by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. By taking part in this survey, you have helped add to our knowledge about the health status of people living in the United States. The information we collect is used to evaluate the country's health problems, develop health programs, and improve the quality of medical care.

The examination given to you was not a complete examination and was not intended to be a substitute for visits to your medical care provider. However, the enclosed report contains results of your examination that may be useful to maintaining and promoting your health. You are responsible for securing your test results. If you do not want anyone else to review your results place them in a secure place so no one else can review them.

If you have any questions about the results of your examination, you can reach me on one of our toll-free numbers below between 7:30 AM and 4:30 PM Eastern Time, Monday through Friday.

English:	1-800-452-6115, press "1"
Spanish:	1-800-452-6115, press "2"
Sincerely,

Duong T. Nguyen, D.O. Chief Medical Officer

Enclosure 123456

These measurements were obtained as part of a survey and do not represent a medical diagnosis.

Interpretation of these measurements must be made by a physician.

Date of Examination: DATE

Participant Name: Participant

Participant Age at Interview: xx years

Participant Age at Exam: xx years

Participant Gender: Female

SP ID: 123456

Body Measurements

Height: 5 ft. 4 in.

Weight: 122.9 lbs.

Blood Pressure & Heart Rate

ADULT (ages 18 years and up)		Normal
Systolic Blood Pressure:	118 mm Hg	< 120
Diastolic Blood Pressure:	76 mm Hg	< 80
Resting Pulse Rate:	88
Cuff Size:	Adult

Your blood pressure today is within the normal range based on the American Cardiology Association (ACC) and the American Heart Association (AHA) Hypertension Guidelines for Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. American Journal of Hypertension, 2018; 31 (2):133-135.

CHILD (ages 8-17 years)

Systolic Blood Pressure:	105 mm Hg
Diastolic Blood Pressure:	65 mm Hg
Resting Pulse Rate:	94
Cuff Size:	Child

Your child’s blood pressure today is within the normal range based on the American Academy of Pediatrics (AAP) Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017; 140 (3):e20171904

SP ID, xx years, Female, 123456, Date Page 1

Centers for Disease Control and Prevention, NCHS 3311 Toledo Road, MS P08, Hyattsville, Maryland 20782

Complete Blood Count

White Blood Count	Result 7.0	Units x109 /L	Flag	Reference Range 4.1 - 12.9
Lymphocytes	21.8	%		14.1 - 47.6
Monocytes	4.7	%		3.8 - 11.6
Neutrophils	56.6	%		39.8 - 78.1
Eosinophils	0.6	%		0.6 - 7.3
Basophils	1.4	%		0.1 - 1.7
Red Blood Count	4.7	x1012 /L		3.6 - 5.2
NRBC	0.0	x1012 /L		0.0 - 0.3
Hemoglobin	12.7	g/dL		10.6 - 15.6
Hematocrit	38.0	%		32.0 - 45.9
MCV	80.8	fL		74.6 - 98.2
MCH	26.0	pg		24.3 - 33.8
MCHC	33.4	g/dL		32.1 - 35.3
RDW	14.5	%		11.4 - 16.3
Platelet Count	360	x109 /L		168 - 441

--- Test not done

A/A/A/ Results still pending

<<< Lower than the limit of detection

>>> Above the limit of detection

vvv Delayed results Number of hours fasted prior to blood draw: 22

SP ID, xx years, Female, 123456, Date Page 2

Centers for Disease Control and Prevention, NCHS 3311 Toledo Road, MS P08, Hyattsville, Maryland 20782

Blood Tests

	Result	Units	Flag	Reference Range
Glucose	85	mg/dL		60 - 109
Hemoglobin A1c	4.6	%		< 6.5
ALT	10	IU/L		< 31
AST	11	IU/L		< 31
Alkaline Phosphatase	60	IU/L		39 - 117
Albumin	3.3	g/dL		3.2 - 5.2
Bicarbonate	20	mmol/L	Low	22 - 29
BUN	7	mg/dL		6 - 19
Calcium	10.0	mg/dL		8.4 - 10.2
Cholesterol	182	mg/dL		< 200
CPK	30	IU/L		22 - 199
Triglycerides	87	mg/dL		< 150
HDL	66	mg/dL		> 39
Phosphorus	4.1	mg/dL		2.6 - 4.5
Sodium	136	mmol/L		133 - 145
Potassium	4.00	mmol/L		3.30 - 5.10
Chloride	102	mmol/L		96 - 108
Total Protein	6.9	g/dL		5.9 - 8.4
Uric Acid	3.7	mg/dL		2.4 - 5.7
Bilirubin	0.2	mg/dL		0.0 - 1.0
Serum Folate	48.8	nmol/L		10.5 - 90.7
RBC Folate	1610	nmol/L		640 - 2006
Serum Ferritin	48	µg/L		15 - 150
Iron	63	µg/dL		22 - 163
Total Iron Binding Capacity (TIBC)	344	µg/dL		250 - 450
Transferrin Saturation	18	%	Low	20 - 50
Lead	0.5	µg/dL		0.0 - 10.0
Vitamin A (retinol)	vvv	µg/dL		20 - 100
Vitamin C	vvv	µg/dL
Vitamin D	vvv	µg/dL
Cadmium	0.1	µg/L		0.3 - 1.2
Total Blood Mercury	0.6	µg/L		< 5.7
Testosterone	500	μg/dL		250-1100
Thyroglobulin ng/mL 1.5-29.2	5	ng/ml		1.5-29.2
TSH	4	mIU/dL		0.45-4.12
Follicle Stimulating Hormone	12	mIU/mL		Varies individually
Lutenizing Hormone	15	mIU/mL		Varies individually

--- Test not done

A/A/A/ Results Still Pending

<<< Lower than the limit of detection

>>> Above the limit of detection

vvv Delayed Results Number of hours fasted prior to blood draw: 22

SP ID, xx years, Female, 123456, Date Page 3

Centers for Disease Control and Prevention, NCHS 3311 Toledo Road, MS P08, Hyattsville, Maryland 20782

Blood Test

Result Reference Range

COVID 19 Antibody Positive Negative

Urine Tests

	Result	Units	Flag	Reference Range
Albumin Creatinine Ratio - 1st Collection	7.17	mg/g		< 30.00
Total Arsenic	---	µg/L
Urinary Nickel	---	µg/L

Kidney Health

Your kidneys filter your blood and help control blood pressure. We checked how healthy your kidneys are by calculating your estimated glomerular filtration rate (eGFR). This is not a meaningful test if you are very muscular.

Your estimated glomerular filtration rate (eGFR) was 120 mL/min/1.73m²

This indicates normal function

This value is not meaningful for pregnant women, individuals with acute kidney failure, people with extreme body size or muscle mass (such as individuals who are bodybuilders, extremely obese or severely malnourished), and people on vegetarian or low-meat diets or taking creatine dietary supplements.

Balance

You performed a Modified Romberg test for balance during your examination. This screening test is listed by the Centers for Medicare and Medicaid (CMS) Physician Quality Reporting System for fall risk assessment.

Based on the Modified Romberg screening test, you passed. 

.

--- Test not done

A/A/A/ Results Still Pending

<<< Lower than the limit of detection

>>> Above the limit of detection vvv Delayed Results

SP, xx years, Female, 123456, Date Page 4

Centers for Disease Control and Prevention, NCHS 3311 Toledo Road, MS P08, Hyattsville, Maryland 20782

Body Composition

The whole body scan provides information on your percent body fat.

The body composition exam results showed that your total body fat is ___%.

We do not know exactly what percent body fat is considered healthy for your age and gender.

Researchers are working to define the healthy ranges for the public. You may want to discuss this result

and your body measurement findings (page 1) with your doctor to find out what they mean for you. Too

much body fat can increase a person's risk of getting diabetes or heart disease.

Liver Elastography

Liver elastography measures the stiffness of your liver. In general, having liver stiffness may indicate liver damage.

Information from your liver ultrasound exam showed a value of 3.60 kiloPascals (kPa).

A scoring system (1), was used to interpret your result. Using this recommended scoring system, the result showed you have little or no liver stiffness. No additional follow-up regarding this test is recommended at

this time.

1. Published in GASTROENTEROLOGY 2005;128:343–350.

SP, xx years, Female, 123456, Date Page 5

Centers for Disease Control and Prevention, NCHS 3311 Toledo Road, MS P08, Hyattsville, Maryland 20782

Laboratory Information

The following CLIA-certified laboratories performed the named tests on biologic specimens

NHANES Mobile Examination Center Laboratory National Center for Health Statistics 3311 Toledo Road, MS P08 Hyattsville, Maryland 20782	Complete blood count
Diabetes Diagnostic Laboratory University of Missouri - Columbia 1 Hospital Drive Room M765 Columbia, MO 65212	Glucose and hemoglobin A1c
Centers for Disease Control and Prevention National Center for Environmental Health Nutritional Biomarkers Branch Laboratory 4770 Buford Highway, NE MS F-55 Atlanta, GA 30341	Serum ferritin, serum folate, RBC folate, vitamin A(retinol), vitamin C and vitamin E
Centers for Disease Control and Prevention NCEH / DLS / IRAT 4770 Buford Hwy. Building 103, Labs 1117, 1119, 1103 Mailstop F-18 Atlanta, GA 30341-3724	Total urinary arsenic, blood lead, cadmium, manganese, total blood mercury, selenium, inorganic blood mercury and urinary nickel
Microalbumin Laboratory University of Minnesota 515 Delaware Street SE Room 13-219 - MOOS Tower Minneapolis, MN 55455	Urine albumin/creatinine ratio
University of Minnesota Advanced Research and Diagnostic Laboratory 1200 Washington Ave S Suite 175 Minneapolis, MN 55415	Glucose, CPK, estimated glomerular filtration rate, iron binding, transferrin saturation, iron, ALT, AST, alkaline phosphatase, albumin, bicarbonate, BUN, calcium, cholesterol, triglycerides, HDL, LDL, serum creatinine, GGT, LDH, phosphorus, sodium, potassium, chloride, total protein, uric acid and bilirubin

SP, xx years, Female, 123456, Date Page 6

Centers for Disease Control and Prevention, NCHS 3311 Toledo Road, MS P08, Hyattsville, Maryland 20782