Lab Result Forms

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL
City of Tacloban City of Tacloban
Name : Name :
Age/ Sex Hosp. No. Age/ Sex Hosp. No.
Physician: Physician:
WARD OPD WARD OPD
FECALYSIS FECALYSIS
COLOR: COLOR:
CONSISTENCY: CONSISTENCY:
MICROSCOPIC EXAMINATION MICROSCOPIC EXAMINATION
RESULT: RESULT:
NO OVA PARASITE SEEN NO OVA PARASITE SEEN
RBC RBC
PUS CELLS PUS CELLS
OTHERS OTHERS
MED TECH MED TECH

DATE DATE
#1
Cleocita Parilla- Portula, FPSP Cleocita Parilla- Portula, FPSP
Pathologist PRC # 94389 Pathologist PRC # 94389

Name : Name :
WARD OPD WARD OPD
FECALYSIS FECALYSIS
COLOR: COLOR:
RESULT: RESULT:
NO OVA PARASITE SEEN NO OVA PARASITE SEEN
RBC RBC
PUS CELLS PUS CELLS
OTHERS OTHERS
MED TECH MED TECH

DATE DATE
.
Name : Name :
WARD OPD WARD OPD
FECALYSIS FECALYSIS
COLOR: COLOR:
Ascaris Ascaris
Hookworm Hookworm
T. trichuira T. trichiura
E. Histolytica E. Histolytica
RBC RBC
PUS CELLS PUS CELLS
OTHERS OTHERS
MED TECH MED TECH
DATE DATE


Name : Name :
WARD OPD WARD OPD
FECALYSIS FECALYSIS
COLOR: COLOR:
Ascaris Ascaris
Hookworm Hookworm
T. trichuira T. trichuira
E. Histolytica E. Histolytica
RBC RBC
PUS CELLS PUS CELLS
OTHERS OTHERS
MED TECH MED TECH
DATE DATE

A. Lumbricoides
T. trichuira
Hookworm
E. Histolytica
mmalaluan,rmt PRC# 16002

vtmargallo,rmt PRC# 39684
cdtangpuz,rmt PRC# 72196
agnerka,rmt PRC# 79995
lmacaray,rmtPRC# 85730
pjcastilo,rmtPRC#88218
maaldaba,rmtPRC#94055
adelacruz, rmt#94330
vmhidalgo,rmt
mmalaluan,rmt
vtmargallo,rmt
cdtangpuz,rmt
maballena,rmt
mjbrosas,rmt
City of tacloban City of tacloban
Name: Name:
Age/ Sex Hosp No. Age/ Sex Hosp No.
Physician Physician
Ward OPD Ward OPD
LABORATORY EXAMINATION RESULT LABORATORY EXAMINATION RESULT
DRT DRT
DATE mmalaluan,rmt PRC# 16002 DATE 8/22/19

MED TECH MED TECH
Cleocita Parilla-Portula, FPSP Cleocita Parilla-Portula, FPSP

Pathologist prc#94389 Pathologist prc# 94389

Name: Name:
Physician Physician
Ward OPD Ward OPD
BLOOD TYPING BLOOD TYPING
DATE DATE
MED TECH MED TECH

Pathologist prc# 94389 Pathologist prc# 94389
HbsAb
HbsAg
RPR
BLOOD TYPING
UCG
Name: Name:
Physician Physician
Ward OPD Ward OPD
HEMATOLOGY HEMATOLOGY
TEST RESULTS
NORMAL VALUES TEST RESULTS
NORMAL VALUES
PLATELET Count 150 - 450 x 109/L PLATELET Count 150 - 450 x 109/L
HEMATOCRIT Child - 0.38 - 0.44 HEMATOCRIT Child - 0.38 - 0.44
DATE DATE
MED TECH MED TECH


Name: Name:
Physician Physician
Ward OPD Ward OPD
TEST RESULTS NORMAL VALUES TEST RESULTS NORMAL VALUES
DATE DATE
MED TECH MED TECH

HEMATOCRIT Child - 0.38 - 0.44
HEMATOCRIT F= .30 - 0.40

M= .42 - .47
HEMATOCRIT Infants - 0.35 - 0.40
HEMATOCRIT NB 0.44 - 0.70

Name: Name
Age/Sex Hosp. No. Age/Sex Hosp. No.
Physician Physician:
WARD OPD WARD OPD
WBC 4.0 - 15.0 x 109/L WBC 5 - 10 x 109/L
HEMOGLOBIN Infants 113 - 130 g/L HEMOGLOBIN F= 120 - 140 g/L
M= 130 - 160 g/L
HEMATOCRIT Infants - 0.35 - 0.40 HEMATOCRIT F= .30 - 0.40
M= .42 - .47
SEGMENTERS 0.55 - 0.65 SEGMENTERS 0.55 - 0.60
LYMPHOCYTES 0.40 - 0.48 LYMPHOCYTES 0.20 - 0.35
EOSINOPHILS 0.02 - 0.05 EOSINOPHILS 0.01 - 0.04
MONOCYTES 0.05 - 0.10 BASOPHILS 0.00 - 0.01
STAB MONOCYTES 0.03 - 0.06
PLATELET Count 150 - 450 x 10 /L
9
STAB 0.02 - 0.04
PLATELET Count 150 - 450 x 109/L
DATE DATE
MED TECH MED TECH

Pathologist prc # 94389 Pathologist prc # 94389

Name: Name:
Age/Sex Hosp. No. Age/Sex Hosp. No.
Physician Physician
WARD OPD WARD OPD
WBC 4.0 - 15.0 x 10 /L
9
WBC 4.0 - 15.0 x 109/L
HEMOGLOBIN Child - 115 - 148 g/L HEMOGLOBIN Child - 115 - 148 g/L
SEGMENTERS 0.55 - 0.65 SEGMENTERS 0.55 - 0.65

LYMPHOCYTES 0.40 - 0.48 LYMPHOCYTES 0.40 - 0.48
EOSINOPHILS 0.02 - 0.05 EOSINOPHILS 0.02 - 0.05
MONOCYTES 0.05 - 0.10 MONOCYTES 0.05 - 0.10
STAB STAB
DATE DATE
MED TECH MED TECH
TACLOBAN CITY HOSPITAL
City of tacloban 0-2 NEWBOPRN
Name: CHILDREN INFANTS 2 MOS TO 2 YRS OLD
Age/Sex CHILDREN 3 - 17 YO
Physician ADULT 18 ABOVE
WARD OPD
WBC
WBC 4.0 - 11.0 x 10 /L9
HEMOGLOBIN
HEMOGLOBIN Child - 115 - 148 g/L
HEMATOCRIT
HEMATOCRIT 0.40 Child - 0.38 - 0.44
SEGMENTERS
SEGMENTERS 0.45 - 0.55 LYMPHOCYTES
LYMPHOCYTES 0.38 - 0.45 EOSINOPHILS
EOSINOPHILS 0.02 - 0.05 BASOPHILS
BASOPHILS 0.00 - 0.01 MONOCYTES
MONOCYTES 0.03 - 0.06 STAB
STAB PLATELET Count
PLATELET Count 150 - 450 x 10 /L 9
DATE
MED TECH
Cleocita Parilla-Portula, FPSP

Pathologist prc # 94389
TACLOBAN CITY HOSPITAL WBC 4.0 - 15.0 x 109/L
City of tacloban HEMOGLOBIN Infants 113 - 130 g/L
Name: NEWBORN
Age/Sex Hosp. No. HEMATOCRIT Infants - 0.35 - 0.40
Physician
WARD OPD SEGMENTERS 0.55 - 0.65
HEMATOLOGY LYMPHOCYTES 0.40 - 0.48
TEST RESULTS NORMAL VALUES EOSINOPHILS 0.02 - 0.05
WBC 4.0 - 15.0 x 109/L MONOCYTES 0.05 - 0.10
HEMOGLOBIN NB 150 - 240 g/L STAB
HEMATOCRIT NB 0.44 - 0.70
SEGMENTERS 0.55 - 0.65

LYMPHOCYTES 0.40 - 0.48
EOSINOPHILS 0.02 - 0.05
MONOCYTES 0.05 - 0.10
STAB
DATE
MED TECH
BOPRN
S TO 2 YRS OLD
5 - 10 x 109/L
F= 120 - 140 g/L
M= 130 - 160 g/L
F= .30 - 0.40
M= .42 - .47
0.55 - 0.60
0.20 - 0.35
0.01 - 0.04
0.00 - 0.01
0.03 - 0.06
0.02 - 0.04
150 - 450 x 109/L
Name: Name:
Physician Physician
Ward OPD Ward OPD
Tests Results N.V. Tests Results N.V.
HbA1c 4-7% HbA1c 4-7%
DATE DATE
MED TECH MED TECH


Name: Name:
Physician Physician
Ward OPD Ward OPD
HbA1c 4-7% HbA1c 4-7%
DATE DATE
MED TECH MED TECH
Name: Name:
Age/Sex Hosp. No. Age/ Sex Hosp No.
Physician Physician
WARD OPD Ward OPD
TESTS: TROPONIN I (QUALITATTIVE) TESTS: TROPONIN I (QUALITATIVE)
RESULTS: RESULTS:
INTERPRETATION OF RESULTS INTERPRETATION OF RESULTS
Positive Concentration at 1.0 ng/ml or greater Positive Concentration at 1.0 ng/ml or greater
MED TECH: DATE: MED TECH: DATE:


Name: Name:
Age/Sex Hosp. No. Age/ Sex Hosp No.
Physician Physician
WARD OPD Ward OPD
TESTS: TROPONIN I (QUALITATIVE) TESTS: TROPONIN I (QUALITATIVE)
RESULTS: RESULTS:
INTERPRETATION OF RESULTS INTERPRETATION OF RESULTS
Positive Concentration at 1.0 ng/ml or greater Positive Concentration at 1.0 ng/ml or greater
MED TECH: DATE: MED TECH: DATE:

Name : Name :
WARD OPD WARD OPD
URINALYSIS URINALYSIS
Physical Examination Physical Examination
Color Color
Transparency Transparency
Sp Gravity Sp Gravity
Chemical Examination Chemical Examination
Protein Protein
Glucose Glucose
pH pH
Microscopic Examination Microscopic Examination
WBC WBC
RBC RBC
Epithelial Cells Epithelial Cells
Mucous Threads Mucous Threads
A. Urates A. Urates
Bacteria Bacteria
OTHERS OTHERS
DATE: DATE:
MED TECH: MED TECH:

City of tacloban City of Tacloban
Name : Name :
WARD OPD WARD OPD
Color Color
Protein Protein
Glucose Glucose
pH pH
WBC WBC
RBC RBC
A. Urates A. Urates
Bacteria Bacteria
Casts Casts
Crystals Crystals
OTHERS OTHERS
DATE: DATE:
MED TECH: MED TECH:
Name: Name+H65:
Age/Sex WARD/OPD Age/Sex WARD/OPD
Color Color
Protein Protein
Glucose Glucose
pH pH
WBC WBC
RBC RBC
A. Urates A. Urates
Bacteria Bacteria
Casts Casts
Crystals Crystals
OTHERS OTHERS
DATE: DATE:
MED TECH: MED TECH:


Name: Name:
Age/Sex OPD/WARD Age/Sex WARD/OPD
Color Color
Protein Protein
Glucose Glucose
pH pH
WBC WBC
RBC RBC
A. Urates A. Urates
Bacteria Bacteria
Casts Casts
Crystals Crystals
OTHERS OTHERS
maaldaba, rmt RRC# 94055 DATE: DATE:
MED TECH: MED TECH:
fjocado, rmt prc#94008
dpenalos#88869a,rmt
dpenalosa,rmt#88869
94055
CITY OF TACLOBAN
NAME AGE/ SEX

PHYSICIAN HOSPITAL NO.
WARD ER OPD
URINALYSIS
Physical Examination Chemical Examination

Color pH
Transparency Nitrate
Sp Gravity Glucose
Microscopic Examination Ascorbic acid
WBC Specific Gravity
RBC Blood
Epithelial Cells Protein
Mucous Threads Bilirubin
A. Urates Urobilinogen
Bacteria ketone
Casts Leukocytes
Crystals
OTHERS
MED TECH DATE

Pathologist prc# 94389

CITY OF TACLOBAN
NAME AGE/ SEX

WARD ER OPD
URINALYSIS
Physical Examination Chemical Examination

Color pH
Transparency Nitrate
Sp Gravity Glucose
Microscopic Examination Ascorbic acid
WBC Specific Gravity
RBC Blood
Epithelial Cells Protein
Mucous Threads Bilirubin
A. Urates Urobilinogen
Bacteria ketone
Casts Leukocytes
Crystals
OTHERS
MED TECH DATE

Pathologist prc# 94389
CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD
FBS 82 - 115 mg / dl HDL M 35 - 55 mg/dl

CHOLESTEROL < 200 mg / dl F 45 - 65 mg/dl
TRIGLYCERIDES < 200 mg / dl LDL 0 <150 mg/dl
BUA M 3.6 - 7.7 mg/ dl
F 2.5 - 6.8 mg/ dl SGPT M Up to 40 U/L
BUN 15 - 55 mg/dl F Up to 32 U/L
CREATININE M 61.8 - 123.7 umol/L SGOT M Up to 38 U/L
F 53.0 - 97.2 umol/L F Up to 31 U/L
Medical Technologist Date

Pathologist prc #94389
CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD

BUA M 3.6 - 7.7 mg/ dl
F 53.0 - 97.2 umol/L F Up to 31 U/L

Pathologist prc #94389

CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME SAAC , KENT AGE/ SEX 25/M

PHYSICIAN DR.DELIMA HOSPITAL NO.
WARD OPD X
Tests Results N. V.
Sodium 140 135 - 145 mmol/l

Potassium 3.4 4.10 - 4.90 mmol/l
Medical Technologist agnerka,rmt PRC# 79995 Date 6.15.19
Cleocita Parilla- Portula, FPSP

CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD

TRIGLYCERIDES < 200 mg / dl LDL <150 mg/dl
BUA M 3.6 - 7.7 mg/ dl
F 53.0 - 97.2 umol/L F Up to 31 U/L


CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD

BUA M 3.6 - 7.7 mg/ dl
F 53.0 - 97.2 umol/L F Up to 31 U/L

CREATININE CONVERSION
MG/DL MMOL/L
0.56 49.504
HgbA1c 4-7%
Sodium 135 - 145 mmol/l

Potassium 4.10 - 4.90 mmol/l
iCalcium 1.33 - 2.05 mmol/l
Chloride 89.0 - 101.0 mmol/l
pH 7.080 - 7.200

iCalcium 1.33 - 2.05 mmol/l
Chloride 89.0 - 101.0 mmol/l
pH 7.080 - 7.200
NORMAL VALUE CREATININE ON mg/dl
M 0.7 - 1.3 mg / dl
F 0.6 - 1.1 mg / dl
NORMAL VALUE CREATININE umol/ L

M 61.8 - 123.7 umol/L
F 53.0 - 97.2 umol/L
CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD NP

BUA M 3.6 - 7.7 mg/ dl
F 53.0 - 97.2 umol/L F Up to 31 U/L


CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD NP

BUA M 3.6 - 7.7 mg/ dl
F 53.0 - 97.2 umol/L F Up to 31 U/L

Pathologist prc 3 94389

CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX
WARD ER OPD 973334

BUA M 3.6 - 7.7 mg/ dl
F 53.0 - 97.2 umol/L F Up to 31 U/L


CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD

BUA M 3.6 - 7.7 mg/ dl
CREATININE M 61.8 - 123.7 umol/L F Up to 32 U/L
53.0 - 97.2 umol/L SGOT M Up to 38 U/L
F Up to 31 U/L


CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX
WARD ER OPD
Tests Results N.V.
CBG 82-115 mg/Dl

Pathologist

CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD
Tests Results N.V.

Pathologist

CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX
WARD ER OPD
Tests Results N.V.


Pathologist

CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME ENDERES, JUANCHO AGE/ SEX 50/m

WARD MM ER OPD
Tests Results N.V.
Sodium 139 135 - 145

Potassium 4.5 3.5 - 5.1
Calcium 1.07 1.70 - 1.90
Medical Technologist cdtangpuz, rmt Date 6/16/2018

Pathologist

CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD
Tests Results N.V. Tests Results
FBS 82 - 115 mg / dl SGPT
CHOLESTEROL < 200 mg / dl
TRIGLYCERIDES < 200 mg / dl SGOT
BUA M 3.6 - 7.7 mg/ dl
F 2.5 - 6.8 mg/ dl Total Bilirubin
BUN 15 - 55 mg/dl Direct Bilirubin
CREATININE M 61.8 - 123.7 umol/L Total protein
F 53.0 - 97.2 umol/L Albumin
A/G Ratio
HDL M 35 - 55 mg/dl Alkaline Phosphatase
F 45 - 65 mg/dl Sodium
LDL 0 <150 mg/dl Potassium
HbA1c 4-7% Calcium

Pathologist
CITY OF TACLOBAN
BLOOD CHEMISTRY
NAME AGE/ SEX

WARD ER OPD
Tests Results N.V. Tests Results
FBS 82 - 115 mg / dl SGPT
CHOLESTEROL < 200 mg / dl
TRIGLYCERIDES < 200 mg / dl SGOT
BUA M 3.6 - 7.7 mg/ dl
F 2.5 - 6.8 mg/ dl Total Bilirubin
BUN 15 - 55 mg/dl Direct Bilirubin
CREATININE M 61.8 - 123.7 umol/L Total protein
53.0 - 97.2 umol/L Albumin
HDL M 35 - 55 mg/dl A/G Ratio
F 45 - 65 mg/dl Alkaline Phosphatase
LDL 0 <150 mg/dl Sodium
HbA1c 4-7% Potassium
Calcium

Pathologist
CREATININE CONVERSION
MG/DL MMOL/L
1.23 108.732
N.V.
M Up to 40 U/L
F Up to 32 U/L
M Up to 38U/L
F Up to 31 U/L
up to 18.81 umol/L
up to 4.27 umol/L
6.6- 8.3 g/dl
3.5 - 5.0 g/dl
0.8-2.0
98 - 279 U/L
135 - 145
3.5 - 5.1
1.70 - 1.90
N.V.
M Up to 40 U/L
F Up to 32 U/L
M Up to 38U/L
F Up to 31 U/L
up to 18.81 umol/L
4.27 umol/L
6.6- 8.3 g/dl
3.5 - 5.0 g/dl
0.8-2.0
98 - 279 U/L
135 - 145
3.5 - 5.1
1.70 - 1.90
CITY OF TACLOBAN
LABORATORY RESULTS
NAME AGE/ SEX
WARD ER OPD
TESTS: TYPHI DOT

RESULTS: NEGATIVE
INTERPRETATION OF RESULTS
Score Result Interpretation Guide
Does not indicate current typhoid fever
0 to 2 NEGATIVE infection
Repeat the test, If still inconclusive repeat
>2 or >4 INCONCLUSIVE sampling at a later date
The higher score the stronger is the
indication of current typhoid fever
4 to 10 POSITIVE infection
Medical technologist Date


CITY OF TACLOBAN
LABORATORY RESULTS
NAME AGE/ SEX
WARD ER OPD
TESTS: TYPHI DOT

RESULTS:
INTERPRETATION OF RESULTS
Score Result Interpretation Guide
Does not indicate current typhoid fever
0 to 2 NEGATIVE infection
Repeat the test, If still inconclusive repeat
>2 or >4 INCONCLUSIVE sampling at a later date
The higher score the stronger is the
indication of current typhoid fever
4 to 10 POSITIVE infection
Medical technologist Date

Republic of the Philippines
REQUEST FOR EXCHANGE OF DUTY
UNIT DEPT: Ancillary

DATE: 3/14/2016 TIME:
REQUESTING EMPLOYEE: Virginia M. Hidalgo
SIGNATURE:
POSITION: Med. Tech. II
REASON FOR EXCHANGE OF SCHEDULE
Went to DWU Hospital for CP Clearance.
3-15-16
Hidalgo 7-3
APPROVED SCHEDULE Margallo 3-11
Hidalgo 3-11
SCHEDULE REQUESTED Margallo 7-3
COMFORME: (Employee on the
requested schedule)
PRINTED NAME AND Verdy T. Margallo, RMT
SIGNATURE
RECOMMENDING APPROVAL:
DIRECT DUPERVISOR
APPROVED BY:
UNIT SUPERVISOR Karen Cudelia C. Go, MD, DPCAM
NOTED BY;
CHIEF OF HOSPITAL Jaime M. Opinion Jr, MD
Republic of the Philippines
REQUEST FOR EXCHANGE OF DUTY
UNIT DEPT: Ancillary

DATE: TIME:
REQUESTING EMPLOYEE:
SIGNATURE:
POSITION:
REASON FOR EXCHANGE OF SCHEDULE
APPROVED SCHEDULE
SCHEDULE REQUESTED
COMFORME: (Employee on the
requested schedule)
PRINTED NAME AND
SIGNATURE
RECOMMENDING APPROVAL:
DIRECT DUPERVISOR
APPROVED BY:
UNIT SUPERVISOR Karen Cudelia C. Go, MD, DPCAM
NOTED BY;
CHIEF OF HOSPITAL Jaime M. Opinion Jr, MD
CITY OF TACLOBAN
LABORATORY RESULTS
NAME MANAHON , MARCO AGE/ SEX 9/M
PHYSICIAN DR.HERNANDEZ HOSPITAL NO.
WARD P-3 ER OPD
TESTS: DENGUE RAPID TEST

RESULTS:
POSITIVE Ns1 Antigen
NEGATIVE IgM Antibody
NEGATIVE IgG Antibofy
REMARKS:
IgM POSITIVE:indicates the possibility of primary infection
IgG POSITIVE: indicates the possibility of secondary infection or past infection
IgG and IgM POSITIVE: indicate the possibility of late primary or early secondary infection
NS1 POSITIVE: indicates possibility of primary dengue infection
Medical technologist Date 7/11/2019


CITY OF TACLOBAN
LABORATORY RESULTS
NAME ALVIOR, DAVID JOHN AGE/ SEX 9/M
WARD FS ER OPD
TESTS: DENGUE RAPID TEST

RESULTS:
POSITIVE Ns1 Antigen
NEGATIVE IgM Antibody
NEGATIVE IgG Antibofy
REMARKS:
IgM POSITIVE:indicates the possibility of primary infection
IgG POSITIVE: indicates the possibility of secondary infection or past infection
IgG and IgM POSITIVE: indicate the possibility of late primary or early secondary infection
NS1 POSITIVE: indicates possibility of primary dengue infection
Medical technologist lmacaray,rmtPRC# 85730 Date 7.8.19

st infection
ndary infection
st infection
ndary infection
CITY OF TACLOBAN
LABORATORY RESULTS
NAME ROSTATA, ANGELIE MARIE AGE/ SEX 5/12/ F
WARD ER OPD OPD
TESTS: PERIPHERAL SMEAR RESULT

RESULTS:
Red Blood Cells: NORMOCHROMIC NORMOCYTIC
White Blood Cells: NO ABNORMAL CELLS SEEN HOWEVER, THERE IS
A SLIGHT INCREASE OF EOSINOPHILS
Platelelet: : ADEQUATE
Cleocita Parilla-Portula,FPSP Date 9.20.18

CITY OF TACLOBAN
CROSSMATCHING RESULT
NAME ASTORGA, EXEQUIL AGE/SEX 66 / M

WARD NAME MM
Patients ABO Blood Group:
"A"
Rh Type:
POSITIVE
Blood Component:
PACKED RBC
Donor's ABO Blood Group:
"A"
Rh Type:
POSTIVE
Source of Blood:
Blood Bag Serial Number:

181149
Blood Bag Collection Date:
Blood Bag Expiration Date:01 - 0 1 - 19
Result:
COMPATIBLE
Medical Technologist agnerka,rmt PRC# 79995 Date 12/11/2019

Pathologist

CITY OF TACLOBAN
NAME AGE / SEX

WARD NAME
Rh Type:
Blood Component:
Rh Type:
Source of Blood:

Blood Bag Expiration Date:
Result:

Pathologist

CITY OF TACLOBAN
NAME AGE/SEX
WARD NAME
Rh Type:
Blood Component:
Rh Type:
Source of Blood:

Result:

Pathologist

CITY OF TACLOBAN
NAME AGE / SEX

WARD NAME
Rh Type:
Blood Component:
Rh Type:
Source of Blood:

Result:

Pathologist
computation HDL Cholesterol LABKIT Conversion mmol/L to mg/dl
Cholesterol HDl Triglycerides LDL mmol/L conversion mg/dl

228.68 58.13 28.93 164.764 Cholesterol 7.3 0.0258 282.9457
N.V less than 150 mg/dl N.V less than 200 mg/dl
mmol/L conversionmg/dl mmol/L conversionmg/dl
Triglycerides 0.327 0.0113 28.93805 HDL - Choles 0.1788 0.0258 6.930233
0.17
N.V. Less than 200 mg/ dl N.V M = 35 to 55 mg/dl

F = 45 - 65 mg/dl
CITY OF TACLOBAN
BLOOD INVENTORY
DATE PATIENTS NAME BLD TYPE SERIAL # RECIV BY

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TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

City of Tacloban City of Tacloban

NO OVA PARASITE SEEN NO OVA PARASITE SEEN

MED TECH MED TECH

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

NO OVA PARASITE SEEN NO OVA PARASITE SEEN

MED TECH MED TECH

Cleocita Parilla- Portula, FPSP Cleocita Parilla- Portula, FPSP

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

Cleocita Parilla- Portula, FPSP Cleocita Parilla- Portula, FPSP

mmalaluan,rmt PRC# 16002

LABORATORY EXAMINATION RESULT LABORATORY EXAMINATION RESULT

DATE mmalaluan,rmt PRC# 16002 DATE 8/22/19

Cleocita Parilla-Portula, FPSP Cleocita Parilla-Portula, FPSP

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

LABORATORY EXAMINATION RESULT LABORATORY EXAMINATION RESULT

BLOOD TYPING BLOOD TYPING

Cleocita Parilla-Portula, FPSP Cleocita Parilla-Portula, FPSP

HEMATOCRIT Child - 0.38 - 0.44 HEMATOCRIT Child - 0.38 - 0.44

Cleocita Parilla-Portula, FPSP Cleocita Parilla-Portula, FPSP

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

HEMATOCRIT Child - 0.38 - 0.44 HEMATOCRIT Child - 0.38 - 0.44

Cleocita Parilla-Portula, FPSP Cleocita Parilla-Portula, FPSP

HEMATOCRIT F= .30 - 0.40

HEMATOCRIT Infants - 0.35 - 0.40

HEMATOCRIT NB 0.44 - 0.70

Cleocita Parilla-Portula, FPSP Cleocita Parilla-Portula, FPSP

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

HEMATOCRIT Child - 0.38 - 0.44 HEMATOCRIT Child - 0.38 - 0.44

SEGMENTERS 0.55 - 0.65 SEGMENTERS 0.55 - 0.65

Cleocita Parilla-Portula, FPSP

SEGMENTERS 0.55 - 0.65

Tests Results N.V. Tests Results N.V.

HbA1c 4-7% HbA1c 4-7%

Cleocita Parilla-Portula, FPSP Cleocita Parilla-Portula, FPSP

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

LABORATORY EXAMINATION RESULT LABORATORY EXAMINATION RESULT

Tests Results N.V. Tests Results N.V.

HbA1c 4-7% HbA1c 4-7%

TESTS: TROPONIN I (QUALITATTIVE) TESTS: TROPONIN I (QUALITATIVE)

INTERPRETATION OF RESULTS INTERPRETATION OF RESULTS

MED TECH: DATE: MED TECH: DATE:

Cleocita Parilla- Portula, FPSP Cleocita Parilla- Portula, FPSP

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

TESTS: TROPONIN I (QUALITATIVE) TESTS: TROPONIN I (QUALITATIVE)

INTERPRETATION OF RESULTS INTERPRETATION OF RESULTS

MED TECH: DATE: MED TECH: DATE:

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

Cleocita Parilla- Portula, FPSP Cleocita Parilla- Portula, FPSP

TACLOBAN CITY HOSPITAL TACLOBAN CITY HOSPITAL

NAME AGE/ SEX

Physical Examination Chemical Examination

MED TECH DATE

Cleocita Parilla-Portula, FPSP

TACLOBAN CITY HOSPITAL

NAME AGE/ SEX

Physical Examination Chemical Examination

MED TECH DATE

NAME AGE/ SEX

Tests Results N.V. Tests Results N.V.

FBS 82 - 115 mg / dl HDL M 35 - 55 mg/dl

Medical Technologist Date