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  • Bilet de Trimitere La LABORATOR HUMANAMED Cu Header, Footer Si Background

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    This document is a medical test requisition form from the HUMANAMED medical laboratory in Oradea, Romania. It requests various medical tests be performed and lists over 50 potential tests that could be ordered, including common blood tests, hormone levels, tumor markers, infectious disease antibodies, urine analysis, stool samples, and more. The patient's name, address, date of birth, diagnosis, and contact information are to be filled out. The doctor must sign to authorize the requested tests.

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    Bilet de Trimitere La LABORATOR HUMANAMED Cu Header ,Footer Si Background

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    This document is a medical test requisition form from the HUMANAMED medical laboratory in Oradea, Romania. It requests various medical tests be performed and lists over 50 potential tests that could be ordered, including common blood tests, hormone levels, tumor markers, infectious disease antibodies, urine analysis, stool samples, and more. The patient's name, address, date of birth, diagnosis, and contact information are to be filled out. The doctor must sign to authorize the requested tests.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    36 views1 page

    Bilet de Trimitere La LABORATOR HUMANAMED Cu Header, Footer Si Background

    Uploaded by

    hfgiuohipo
    This document is a medical test requisition form from the HUMANAMED medical laboratory in Oradea, Romania. It requests various medical tests be performed and lists over 50 potential tests that could be ordered, including common blood tests, hormone levels, tumor markers, infectious disease antibodies, urine analysis, stool samples, and more. The patient's name, address, date of birth, diagnosis, and contact information are to be filled out. The doctor must sign to authorize the requested tests.

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    © All Rights Reserved
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    of 1

    Laborator analize medicale

    HUMANAMED

    ORADEA , str.Tudor Vladimirescu , Nr.8 , www.humanamed.ro

    tel: 0259/435427
    laborator@humanamed.ro

    BILETDETRIMITERE

    Nume_______________________________________Prenume__________________________________
    Localitatea____________________________________________Judet___________________________
    Str.________________________________________Nr._________Bl._______Ap.______SexF/M
    CNP

    Email:_________________________________________@____________________________________

    *
    Telefon:_________________________________________

    *
    Diagnostic:___________________________________________________________________________

    Altementiuni:_____________________________________________________________________________

    *
    Probeleaufostrecoltateindata____/____/________ora____:____

    Hemoleucograma

    HBGlicozilata,HbA1c,A1C

    LeptospiraIgM

    FSH

    VSH

    Calciu

    TSH

    LH

    TQINR

    Magneziu

    FT3

    Prolactina

    Fibrinogen

    Fier(Sideremie)

    FT4

    Estradiol

    FR

    Fosfatazaalcalina

    Tiroglobulina,TG

    Progesteron

    ASLO

    ALFAAmilaza

    Anti tiroglobulina,AcTG

    Testosteron

    CRP

    H.Pyloriser

    TPOAc

    ToxoplasmaIgG

    Glicemie

    Ex.Urina+Sediment

    AFP

    ToxoplasmaIgM

    Uree

    Ex.Coproparazitologic

    NSE (markerplamani)

    ChlamydiaIgG

    Creatinina

    Ag.Giardiascaun

    Calcitonina

    ChlamydiaIgM

    Bilirubinadirecta

    Ag.H.Pyloriscaun

    CEA (Ag.carcinoembrionar)

    RubellaIgG

    Bilirubinatotala

    Ac.Sifilistestrapid

    PSA

    RubellaIgM

    TGO/ASAT/GOT

    Ac.HCV

    PSAfree

    CMVIgG

    TGP/ALAT/GPT

    AgHBs

    CA153 (markersan)

    CMVIgM

    GamaGT

    HIV1/2

    CA 125 (markerovar)

    ALTEANALIZE:

    ColesterolTotal

    Ag.ROTAVIRUSscaun

    SCC(markercoluterin)

    HDLColesterol

    Hemoragiioculte

    CA199(markertubdigestiv

    LDLColesterol

    SNF

    ACTH

    Aciduric

    Urocultura

    AcidVanilmandelic urina

    Proteinetotale

    Coprocultura

    Cortisol

    Trigliceride

    Secretie

    hGH (STH)

    Data ______/______/____________

    Laborator analize medicale


    HUMANAMED

    ORADEA , str.Tudor Vladimirescu , Nr.8

    Semnaturasiparafamedicului

    www.humanamed.ro

    tel: 0259/435427
    laborator@humanamed.ro

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