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Name – T W

Personal Id Number (PIN):

Information

Name:

Date of Birth:

Health Number:

Gender:

Language Spoken:

T W

05/03/2020

123456

Male

English

Height / Weight / BMI

Cardiac Data

Height (inches):

Weight (lbs):

Body Mass Index (BMI)

70

186

1.88

Resting Heart Rate:

Systolic Pressure (mmHg):

Diastolic Pressure (mmHg):

55

125

95

Cholesterol

Blood Glucose

Total Cholesterol (mg/dL):

HDL Cholesterol (mg/dL):

LDL Cholesterol (mg/dL):

161

35

126

Blood Glucose (mg/dL):

10

Hemotology

Haemoglobin (gr/dL):

Hematocrit (%):

White Cell Count (per mm3):

Platelets Count (per mm3):

Red Blood Cell Count (per mm3):

Bodycomposition

Triceps (mm):

Subscapular (mm):

Chest/Pectoral (mm):

Suprailiac (mm):

Abdominal (mm):

11

24

10

18

23

Waist (cm):

Hips (cm):

Thigh (cm):

Calf (cm):