The "x" coordinate discrepancy is due to the the default formatting applied by the DrawString Method. If you apply "System.Drawing.StringFormat.GenericTypographic" as the format this will disappear. As for how you arrived at the "y" coordinate value being less than the requested 200 pts is beyond my comprehension. The Adobe Acrobat screen shot you referenced show the top of the letter at approximately 210; however as Mike Meinz has told you, the top of the letter is not the top of character cell. See
this[
^], for an explanation of the character cell layout.
egraphics.DrawString("A", fReportFont, New SolidBrush(Color.Black), 100, 200, System.Drawing.StringFormat.GenericTypographic)
I suggest that you change the draw point to (72, 72) so that you can see the layout better than trying to interpolate a grid position in Adobe Acrobat.