回复：you do not need to, but you'd better do or you will get RE

what is the "REF" means? so you think I should send them altogeter? but I already send I-485 without medical examination, what should I do next?Will I send the medical examination with I-485 receipt? or I will waitin for the notice to do the medical examination?I receive the FP notice but never receive medical examination notice? Thank you very much!