PATIENT NAME : Enter Name AGE / SEX : Enter age/sex

REFERRED BY : Enter Ref Name DATE : dd/mm/yy

TEST RESULT NORMAL RANGE

BIO-CHEMISTRY

Blood Sugar (Fasting) ____mg% 70 -110 mg%

Blood Sugar (PP 1 hrs) ____mg% 80 - 140 mg%

PATIENT NAME : Enter Name AGE / SEX : Enter age/sex

REFERRED BY : Enter Ref Name DATE : dd/mm/yy

TEST RESULT NORMAL RANGE

HAEMATOLOGY:

Haemoglobin (Female) ____gm% 12 15 gm%