CLINICAL Form Code

LABORATORY LCH -CL-QMSOP-

Form 61
Legazpi Ctiy Hospital Rev. 0
Tel No. Effectivity
Email Add: Revision

SEMEN ANALYSIS
Name: MARK CLIMACOSA Ward/Room No.: Date: 7/19/2021
Age: Gender: MALE Diagnosis/Procedure:

Test Result UNITS NORMAL RANGE

PHYSICAL EXAMINATION
TIME OF SPECIMEN 1:50 PM

TIME OF EXAMINATION 1:50 PM

DURATION OF ABSTINENCE 3 DAYS 3-5 DAYS

LIQUIFACTION AT 37°C 30 MINUTES 30-60 MINUTES

VOLUME >1.5 mL >1.5

APPEARANCE VISCOID OPAQUE
COLOR WHITISH
VISCOSITY +1
Ph 9.0 7.2-7.4
MICROSCOPIC EXAMINATION
TOTAL SPERM CONCENTRATION >15 MILLION/mL >15
PERCENTAGE MOTILITY 40% % >40 ( GRADE A +B )
GRADE A ( PROGRESSIVE MOTILE ) 40% % >32 ( LOW REFERENCE )
GRADE B ( NON PROGRESSIVE MOTILE ) 0% %

GRADE B ( IMMOBILE ) 60% %

AGGLUTINATION NEGATIVE NEGATIVE

PUS CELLS NEGATIVE /HPF NIL
RED BLOOD CELLS NEGATIVE /HPF NIL
EPITHELIAL CELLS NEGATIVE /HPF NIL
MORPHOLOGY
NORMAL MORPHOLOGY 99 % >40%
ABNORMAL
MORPHOLOGY
1 %

(a) Head Defects 0 %

(b) Neck and Midpiece 0 %

(a) Tail Defects 1 %

Done By: Noted By:

CARLO SIMEON D. ALVARADO RMT
LIC. NO. 0039880 RAYMUNDO B. IBARRIENTOS MD, FPSP
Medical Technologist Pathologist
License No: 0078995
 CLINICAL Form

LABORATORY Code
LCH -CL-QMSOP- Form 61
Legazpi Ctiy Hospital Rev. 0
Tel No.
Effectivi
Email Add:
Revisio
ty
n

CHEMISTRY
Name:ANTE,MARIA LUISA Ward/Room No.: OPD Date:
Age: 46 Gender: FEMALE Diagnosis/Procedure:
L = Low
N = Normal
Test Result H = High
NORMAL RANGE
NA= Not Applicable

Fasting Blood Sugar 7 mmol/L High 4.11 - 6.05

Cholesterol 5.18 mmol/L Normal up to 5.18

Triglycerides 1.70 mmol/L Normal up to 1.7
HDL 1.55 mmol/L Normal up to 1.55
LDL 7.00 mmol/L High up to 3.34
Blood Urea Nitrogen (BUN) 7 mmol/L Normal 2.76 - 8.07
Creatinine 44.0 umol/L Normal (Male) 62 - 106 (Female) 44 - 80

Blood Uric Acid (BUA) 7.0 umol/L Low (Male)202.3 - 416.5 (Female)142.8 - 339.2

SGPT/ALT 7.0 U/L Normal (Male) up to 41 (Female) up to 33

SGOT/AST 33.0 U/L High (Male) up to 40 (Female) up to 32
Sodium 136 mmol/L Normal 136 - 145
Potassium 4 mmol/L Normal 3.6 - 5.1
Chloride 4 mmol/L Normal 97 - 111

Done By: Noted By:

CARLO SIMEON D. ALVARADO RMT
LIC. NO. 0039880 RAYMUNDO B. IBARRIENTOS MD, FPSP
Medical Technologist Pathologist
License No: 0078995
 LCH -CL-QMSOP- Form 61
Rev. 0

7/4/2019

NORMAL RANGE

4.11 - 6.05
up to 5.18
up to 1.7
up to 1.55
up to 3.34
2.76 - 8.07
(Male) 62 - 106 (Female) 44 - 80

ale)202.3 - 416.5 (Female)142.8 - 339.2

(Male) up to 41 (Female) up to 33
(Male) up to 40 (Female) up to 32
136 - 145
3.6 - 5.1
97 - 111

ARRIENTOS MD, FPSP

hologist
No: 0078995