Name: Age: Sex: AUTOMATED COMPLETE BLOOD COUNT

Date Collected: Time Released:

CLINICAL CHEMISTRY RESULTS
Test Result Reference Range
Fasting Blood Sugar 70 – 110 mg/dL
Random Blood Sugar Up to 140 mg/dL
HBa1c (EIA) 4.5 – 6.5 %
Creatinine 0.5 – 1.2 mg/dL
Blood Uric Acid M 4.0 – 8.5
F 2.7 – 7.3 mg/ dL
Blood Urea Nitrogen 10 – 20 mg/dL
L I P I D P R O F I L E
Cholesterol; Total 140 – 200 mg/dL
Triglycerides 0 – 200 mg/dL
HDL 40 – 80 mg/dL
LDL 80 – 160 mg/dL
VLDL 2 – 30 mg/dL
Chol/HDL Ratio 1 – 6 mg/dL
L I V E R P R O F I L E
Total Protein 6.0 – 7.8 g/dL
Albumin 3.5 – 5.5 g/dL
Globulin 2.3 – 3.8 g/dL
Albumin/Globulin 0.8 – 2.0 g/dL
Ration
Total Bilirubin 0.1 – 1.2 mg/dL
Direct Bilirubin 0.0 – 0.3 mg/dL
Indirect Bilirubin 0.1 – 1.0 mg/dL
SGPT/ALT M up to 41
F up to 33 U/L
SGOT/AST M up to 40
F up to 32 U/L
Alkaline Phosphatase M 40 – 129
F 35 – 104 U/L
E L E C T R O L Y T E S
Sodium 135 – 145 mmol/L
Potassium 3.5 – 5.0 mmol/L
Total Calcium 9.2 – 11.0 mg/dL
Ionized Calcium 1.1 – 1.3 mmol/L
Chloride 99 – 103 mmol/L
Magnesium 1.6 – 2.6 mg/dL
Name: Age: Sex:
Time of Extraction: Time Released: Date:
RESULT Normal Values
White Cell Count 5,000 – 10,000
Red Cell Count 4.20-5.40 (million)
Hemoglobin 12.0 – 16.0 gm/Dl
Hematocrit 37.0 – 47.0 %
MCV 82 – 92 fL
MCH 27 – 33 pg
MCHC 31 – 38 g/dL
Platelet Count 150,000 – 400,
000 /mm
Clotting Time
Bleeding Time
Reticulocyte
Count
ESR
ABO Typing
DIFFERENTIAL COUNT
Granulocytes 43.4 – 76.2 %
Lymphocytes 17.4 – 48.2 %
Monocytes 4.5 – 10.5%
Eosinophil 0 – 7.0$
Basophil 0 – 2.0 %
Stabs 1.0 – 2.0 %

NMMC FORMAT
NAME: TIME REQUESTED:
AGE/SEX: TIME COLLECTED:
PHYSICIAN: TIME ACCEPTED:
WARD: TIME RELEASED:
BLOOD CHEMISTRY RESULT FORM

Results Reference Values

Blood Urea Nitrogen = 8.4 – 25.7mg/dL

Creatinine = 0.6 – 1.8mg/dL

Electrolytes:
Potassium = 35.5 – 5.3mmol/L

Sodium = 135 – 148mmol/L