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Hasil Pemeriksaan Laboratorium Klinik

The document is a medical laboratory test result form from Klinik Dina Trisnawati. It contains the patient's information and the results of several medical tests grouped into categories like hematology, clinical chemistry, immunology, and microbiology/parasitology. The tests performed include complete blood count, urinalysis, blood glucose, liver enzymes, kidney function, lipids, and screening tests for conditions like pregnancy, blood type, malaria, HIV, and syphilis.

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Dina Trisnawati
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217 views1 page

Hasil Pemeriksaan Laboratorium Klinik

The document is a medical laboratory test result form from Klinik Dina Trisnawati. It contains the patient's information and the results of several medical tests grouped into categories like hematology, clinical chemistry, immunology, and microbiology/parasitology. The tests performed include complete blood count, urinalysis, blood glucose, liver enzymes, kidney function, lipids, and screening tests for conditions like pregnancy, blood type, malaria, HIV, and syphilis.

Uploaded by

Dina Trisnawati
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

KLINIK DINA TRISNAWATI

FORMULIR HASIL PEMERIKSAAN LABORATORIUM

Gejala Penyakit: Spesimen :Nilai Nilai


No Jenis Pemeriksaan Hasil
Jenis : No Jenis Pemeriksaan Hasil
Dokter Pengirim : ................................ Rujukan Rujukan
Asal Bahan :
HEMATOLOGI Tgl/Jam Pengambilan sp:
Pengobatan: KIMIA KLINIK
Pasien Petugas :
- Nomor Register : .................................
1 o Hemoglobin (Hb) 1 o Glukosa
- Nama : .................................
2 o Hematokrit o Albumin
2
- Umur : .................................
3 o Hitung Eritrosit 3 o Bilirubin Direk
- Jenis Kelamin : .................................
4 o Hitung Trombosit 4 o SGOT
- Alamat : .................................
5 o Hitung Leukosit 5 o SGPT
6 o Hitung Jenis 6 o Alkali Fosfatase
Leukosit
7 o Laju Endap Darah 7 o Asam Urat
8 o Masa Perdarahan 8 o Urea
Pemeriksa,
9 o Masa Pembekuan 9 o Kreatinin
10 o Trigliserida
URINALISA
1 o Makroskopis 11 o Kolestrol Total
- Warna 12 o Kolestrol HDL
- Kejernihan
- Bau IMUNOLOGI
- Volume
2 o pH 1 o Tes Kehamilan

3 o Berat Jenis 2 o Golongan Darah


4 o Protein 3 o Widal
5 o Glukosa 4 o Anti HIV
6 o Bilirubin 5 o Antigen/Antibodi
Dengue
7 o Urobilinogen 6 oSifilis
8 o Keton
9 o Nitrit MIKROBIOLOGI &
PARASITOLOGI
10 o Leukosit 1 o Malaria
11 o Eritrosit
12 o Sedimen Lain-lain

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