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    Lab - Result Form

    Uploaded by

    Errol Llanes
    The document contains medical test results for an individual from the Municipal Health Office in San Ildefonso, Bulacan, Philippines. It includes blood type, hematocrit, hemoglobin, blood sugar, urinalysis results, pregnancy test results, syphilis test results, and screening results for HIV, hepatitis B, dengue, and other clinical chemistry tests. The tests were performed by Patricia Glynn V. Sanchez, a licensed medical technologist.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Lab - Result Form

    Uploaded by

    Errol Llanes
    33 views5 pages
    The document contains medical test results for an individual from the Municipal Health Office in San Ildefonso, Bulacan, Philippines. It includes blood type, hematocrit, hemoglobin, blood sugar, urinalysis results, pregnancy test results, syphilis test results, and screening results for HIV, hepatitis B, dengue, and other clinical chemistry tests. The tests were performed by Patricia Glynn V. Sanchez, a licensed medical technologist.

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    lab- result form

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    The document contains medical test results for an individual from the Municipal Health Office in San Ildefonso, Bulacan, Philippines. It includes blood type, hematocrit, hemoglobin, blood sugar, urinalysis results, pregnancy test results, syphilis test results, and screening results for HIV, hepatitis B, dengue, and other clinical chemistry tests. The tests were performed by Patricia Glynn V. Sanchez, a licensed medical technologist.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    33 views5 pages

    Lab - Result Form

    Uploaded by

    Errol Llanes
    The document contains medical test results for an individual from the Municipal Health Office in San Ildefonso, Bulacan, Philippines. It includes blood type, hematocrit, hemoglobin, blood sugar, urinalysis results, pregnancy test results, syphilis test results, and screening results for HIV, hepatitis B, dengue, and other clinical chemistry tests. The tests were performed by Patricia Glynn V. Sanchez, a licensed medical technologist.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 5

    Republic of the Philippines

    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    NAME:________________________________________ AGE:________ SEX:__________


    ADDRESS:______________________________________ DATE ISSUED:_______________
    BLOOD TYPE:______________ HEMATOCRIT:____________ HEMOGLOBIN:_________g/dL
    BLOOD SUGAR:_______________ mg/dL __ FBS __ RBS

    URINALYSIS
    COLOR:________________________ WBC:_________/HPF
    TRANSPARENCY:_________________ RBC:__________/HPF
    PROTEIN:_______________________ CAST:_________________________
    GLUCOSE:______________________ BACTERIA:_____________________
    PH:____________________________ EPITHELIAL CELLS:_______________
    SPECIFIC GRAVITY:________________ CRYSTALS:______________________
    OTHERS:________________________
    PREGNANCY TEST:_____________________________
    SYPHILIS TEST:________________________________
    HIV TEST/ SD BIOLINE HIV 1/ 2:__________________
    HEPATITIS B SCREENING(HBSAg):______________

    PATRICIA GILYN V. SANCHEZ,RMT


    License No. 0070715
    Medical Technologist

    Republic of the Philippines


    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    NAME:________________________________________ AGE:________ SEX:__________


    ADDRESS:______________________________________ DATE ISSUED:______________
    BLOOD TYPE:______________ HEMATOCRIT:____________ HEMOGLOBIN:_________g/dL
    BLOOD SUGAR:_______________ mg/dL __ FBS __ RBS

    URINALYSIS
    COLOR:________________________ WBC:_________/HPF
    TRANSPARENCY:_________________ RBC:__________/HPF
    PROTEIN:_______________________ CAST:_________________________
    GLUCOSE:______________________ BACTERIA:_____________________
    PH:____________________________ EPITHELIAL CELLS:_______________
    SPECIFIC GRAVITY:________________ CRYSTALS:______________________
    OTHERS:________________________

    PREGNANCY TEST:_____________________________
    SYPHILIS TEST:________________________________
    HIV TEST/ SD BIOLINE HIV 1/ 2:__________________
    HEPATITIS B SCREENING(HBSAg):______________

    PATRICIA GILYN V. SANCHEZ,RMT


    License No. 0070715
    Republic of the Philippines
    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    Medical Technologist
    DATE ISSUED:______________

    NAME:_______________________________
    ADDRESS: SAN ILDEFONSO, BULACAN____
    AGE/GENDER:________

    CLINICAL CHEMISTRY
    NORMAL RANGE RESULT
    BLOOD SUGAR
    ___ FBS ___RBS 70-104 mg/dL mg/dL
    MALE: 3.0-7.2 mg/dL mg/dL
    179-438 umol/L umol/L
    BLOOD URIC ACID
    FEMALE: 2-6 mg/dL mg/dL
    119-357 umol/L umol/L

    BLOOD CHOLESTEROL <200 mg/dL mg/dL


    <5.2 mmol/L mmol/L

    PATRICIA GILYN S. ANABO,RMT


    License No. 0070715
    Medical Technologist

    Republic of the Philippines


    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    DATE ISSUED:______________

    NAME:_______________________________
    ADDRESS: SAN ILDEFONSO, BULACAN____
    AGE/GENDER:________

    CLINICAL CHEMISTRY
    NORMAL RANGE RESULT
    BLOOD SUGAR mg/dL
    ___ FBS ___RBS 70-104 mg/dL
    MALE: 3.0-7.2 mg/dL mg/dL
    179-438 umol/L umol/L
    BLOOD URIC ACID
    FEMALE: 2-6 mg/dL mg/dL
    119-357 umol/L umol/L

    BLOOD CHOLESTEROL <200 mg/dL mg/dL


    <5.2 mmol/L mmol/L

    PATRICIA GILYN S. ANABO,RMT


    License No. 0070715
    Republic of the Philippines
    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    Medical Technologist

    DATE ISSUED:______________

    NAME:_______________________________
    ADDRESS: SAN ILDEFONSO, BULACAN____
    AGE/GENDER:________

    FECALYSIS
    COLOR:________________________
    CONSISTENCY:__________________
    WBC:_____________/HPF
    RBC:_____________ /HPF
    INTESTINAL PARASITE: NO INTESTINAL PARASITE SEEN
    OVA SEEN: __________________________

    OTHERS:________________________

    PATRICIA GILYN S. ANABO,RMT


    License No. 0070715
    Medical Technologist

    Republic of the Philippines


    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    DATE ISSUED:______________

    NAME:_______________________________
    ADDRESS: SAN ILDEFONSO, BULACAN____
    AGE/GENDER:________

    FECALYSIS
    COLOR:________________________
    CONSISTENCY:__________________
    WBC:_____________/HPF
    RBC:_____________ /HPF
    INTESTINAL PARASITE: NO INTESTINAL PARASITE SEEN
    OVA SEEN: __________________________

    OTHERS:________________________

    PATRICIA GILYN S. ANABO,RMT


    License No. 0070715
    Medical Technologist
    Republic of the Philippines
    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    DATE ISSUED:______________

    NAME:_______________________________
    ADDRESS: SAN ILDEFONSO, BULACAN____
    AGE/GENDER:________

    DENGUE TEST

    DENGUE NS1 ANTIGEN:________________________


    DENGUE DUO IgG:__________________
    IgM:__________________

    PATRICIA GILYN S. ANABO,RMT


    License No. 0070715
    Medical Technologist

    Republic of the Philippines


    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    DATE ISSUED:______________

    NAME:_______________________________
    ADDRESS: SAN ILDEFONSO, BULACAN____
    AGE/GENDER:________

    DENGUE TEST

    DENGUE NS1 ANTIGEN:________________________


    DENGUE DUO IgG:__________________
    IgM:__________________

    PATRICIA GILYN S. ANABO,RMT


    License No. 0070715
    Medical Technologist
    Republic of the Philippines
    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    NAME:________________________________________ AGE:________ SEX:__________


    ADDRESS:______________________________________ DATE ISSUED:______________
    BLOOD TYPE:______________ HEMOGLOBIN:____________ HEMATOCRIT:___________
    BLOOD SUGAR:_______________ mg/dL __ FBS __ RBS

    URINALYSIS
    COLOR:________________________ pH:_____________________
    TRANSPARENCY:________________ BLOOD:_________________
    LEUKOCYTES:__________________ SPECIFIC GRAVITY:_________
    NITIRTE:______________________ KETONE:_________________
    UROBILINOGEN:_______________ BILIRUBIN:________________
    PROTEIN:_____________________ GLUCOSE:_________________

    NS1 ANTIGEN:___________________

    PATRICIA GILYN V. SANCHEZ,RMT


    License No. 0070715
    Medical Technologist

    Republic of the Philippines


    Province of Bulacan
    Municipal Government of San Ildefonso
    MUNICIPAL HEALTH OFFICE

    NAME:________________________________________ AGE:________ SEX:__________


    ADDRESS:______________________________________ DATE ISSUED:______________
    BLOOD TYPE:______________ HEMOGLOBIN:____________ HEMATOCRIT:___________
    BLOOD SUGAR:_______________ mg/dL __ FBS __ RBS

    URINALYSIS
    COLOR:________________________ pH:_____________________
    TRANSPARENCY:________________ BLOOD:_________________
    LEUKOCYTES:__________________ SPECIFIC GRAVITY:_________
    NITIRTE:______________________ KETONE:_________________
    UROBILINOGEN:_______________ BILIRUBIN:________________
    PROTEIN:_____________________ GLUCOSE:_________________

    NS1 ANTIGEN:___________________

    PATRICIA GILYN V. SANCHEZ,RMT


    License No. 0070715
    Medical Technologist

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