Indiana University Health Center

600 N. Jordan Ave. Rm. 208

pb; 812-855-8371 flt: 812-855-5872
Bloomington, IN 47405
CUA JD# l5D0035454

PATIENT NAME/DOB FAST AGE SEX PR
l ___ 4)_. _ F __
I SOCIAL SEC# SAMPLE ID ORAW OATE I DELIVERY DATE RESULTS APPROVEiJTRESULTS REPORTED PAGE
! 2954749 411112014 9:06 AM !411112014 9:06 AM 4/ll/2014 9:35 AM I 4/ll/2014 9:35 AM I
04/11/14 9:35 AM A copy of this report will be faxed to: IOBCAth
04/11/14 9: 06 AM draw and hold EBV, run if mono neg
WBC
RBC
HGB
HCT
MCV
MCH
MCHC
RDW
PLT
MANUAL DIFF INDICATED?
Neutronhil
Band
Lymphocyte
Monocyte
Awical
RBC Morphology
Platelet Estimate
Mono Screen
Sample ID: 295474911
END OF REPORT (Final)
11.85 (H)
4.47
13.0
38.5
86.l
29.1
33.8
13.5
175
YES
37 (L)
Q_(fil
25
12
N.(fil
Nonna!
Normal
Positive IA\
K/uL 3.80-10.50
M/uL 3.93-5.22
gldL 11.4-15.7
% 34.144.9
lL 80.0-97.0
pg 27.0-32.0
g/dL 32.0-36.0
% ll.0-14.5
K/uL 140-440
% 42-75
% 0-5
% 18-45
% 2-12
% 0-10
Normal
Negative

Indiana University Health Center
600 N. Jordan Ave. Rm. 208
ph: 812-855-8371 fx: 812-855-5872
Bloomington, IN 47405
CUA ID# I 5D0035454

PATIENT NAME/DOB FAST PATIENT ID PHONE AGE SEX PROVIDER
j__ )---- No 19 F
I
soc1AL sEc #] SAMPLE 1D - -iJR"Aw oArr---r oELwERvolirE -fRE:suLTSAPPRovED[REsui_ Ts REPORTED PAGE
2954748 4/11/2014 9:07 AM 14/11/2014 9:07 AM 14/11/2014 9:30 AM j 4111/2014 9:30 AM I
04/11/14 9:30 AM A copy of this report will be faxed to: IOSCAth
Rapid Strep
Sample ID: 2954748/1
END OF REPORT (Final)
Negative Negative
Reviewed