PA-S-36 (GROUND FLOOR)

JLN. PASIR EMAS, SG. CHUA, PEARL AVENUE

43000 KAJANG, SELANGOR DARUL EHSAN

MORPHOLOGY SCAN DATE:

NAME : ID/IC :
LMP : DOB :
EDD : EDD (U/S) :
GA : GA (U/S) :

FETAL DESCRIPTION

NO. OF FETUS : 1 / 2 / 3 / 4
FETAL POSITION :
FETAL HEART : PRESENT / ABSENT
FETAL MOVEMENT :
PLACENTA :
AMNIOTIC FLUID :
GENDER : BOY / GIRL

BPD : HC :
AC : FL :
EFW :

BRAIN ABDOMEN
LATERAL VENTRICLE ABDOMINAL WALL
CEREBELLUM STOMACH
CISTERNA MAGNA BOWEL
NUCHAL FOLD KIDNEY RT LT
DIAPHRAGM RT LT
CORD INSERTION
FACIAL UMBILICAL ARTERY 2UA SUA
BOD BLADDER
IOL SPINE
OD
NASAL BONE
LIPS / NOSE
NECK

HEART EXTREMITIES
HEART RATE bpm UPPER LIMBS LOWER LIMBS
4 CHAMBERS RT HUMERUS RT FEMUR
LEFT OUTFLOW ULNA TIBIA
RIGHT OUTFLOW RADIUS FIBULA
3 VESSEL VIEW LT HUMERUS LT FEMUR
IVS ULNA TIBIA
AORTIC ARCH RADIUS FIBULA
DUCTAL ARCH

DISCLAIMER:
Singleton alive fetus.
It was explained that a normal morphology scan cannot totally exclude the possibility of all structural anomalies or a
chromosomal anomaly. It was also explained that the septal defects and valvular anomalies may not be detected antenatally.

COMMENTS:

No structural anomaly detected within the limits of this examination

PA-S-36 (GROUND FLOOR)
JLN. PASIR EMAS, SG. CHUA, PEARL AVENUE
43000 KAJANG, SELANGOR DARUL EHSAN

HEALTH SCREENING REPORT

Date:
Name:
IC:

Examination
BP:
HR:
Spo2:
DXT:

Weight:
Height:
BMI:

Otoscopy:

Visual Acquity: Right eye Left eye

Without Glasses / /
With Glasses / /

Ishihara Test for Colour Blindness

Package Add-Ons
Express
Standard
Silver
Gold
Platinum
BASIC BLOOD TEST
RM69.00

FULL BLOOD EXAMINATION 血液检查

Haemoglobin 血红蛋白
Total RBC 红细胞计数
RDW 红细胞体积分布
PCV 细胞堆积体积
MCV 平均红细胞容积
MCHC 平均血红蛋白浓度
Total WBC 白血球分类
Platelet 血小板

DIABETIC SCREEN 血糖检测

Glucose 血糖
HBA1C 糖化血红蛋白
*add on RM30

URINE EXAMINATION 尿液检查

Urine FEME 尿液常规检查
STANDARD BLOOD TEST
RM129.00

FULL BLOOD EXAMINATION 血液检查

Haemoglobin 血红蛋白
Total RBC 红细胞计数
RDW 红细胞体积分布
PCV 细胞堆积体积
MCV 平均红细胞容积
MCHC 平均血红蛋白浓度
Total WBC 白血球分类
Platelet 血小板

DIABETIC SCREEN 血糖检测

Glucose 血糖
HBA1C 糖化血红蛋白
*add on RM30

RENAL FUNCTION TEST 肾脏检测

Urea 尿素
Creatinine 肌酸酐
Uric Acid 尿酸
E-GFR 估算的肾小球滤过率

LIVER FUNCTION TEST 肝功能试验

Albumin 白蛋白
Globulin 球蛋白
Albumin/Globulin Ratio 白蛋白/球蛋白比值
Total Protein 血清总蛋白
Total Bilirubin 总胆红素
Alkaline Phosphatase 碱性磷酸酶
Alkaline Transaminase 谷丙转氨酶
Aspartate Transaminase 天冬氨酸氨基转移酶
Gamma-Glutamyl Transferase 谷酰转肽酶

URINE EXAMINATION 尿液检查

Urine FEME 尿液常规检查
SILVER BLOOD TEST
RM219.00

FULL BLOOD EXAMINATION 血液检查 ADDITIONAL TESTS 额外测试

Haemoglobin 血红蛋白 Blood Group (血型)
Total RBC 红细胞计数 Rh (Anti-D) (RH因子)
RDW 红细胞体积分布 HIV Ag/Ab (愛滋病毒抗原/抗體篩檢)
PCV 细胞堆积体积 Rheumatoid Factor (風濕性關節炎因子)
MCV 平均红细胞容积 TSH (甲狀腺刺激素)
MCHC 平均血红蛋白浓度 Free T4 (游離甲狀腺素)
Total WBC 白血球分类 Free T3 (游離三碘甲狀腺胺 酸)
Platelet 血小板

DIABETIC SCREEN 血糖检测 URINE EXAMINATION 尿液检查

Glucose 血糖 Urine FEME 尿液常规检查
HBA1C 糖化血红蛋白
*add on RM30

RENAL FUNCTION TEST 肾脏检测

Urea 尿素
Creatinine 肌酸酐
Uric Acid 尿酸
E-GFR 估算的肾小球滤过率

LIVER FUNCTION TEST 肝功能试验

Albumin 白蛋白
Globulin 球蛋白
Albumin/Globulin Ratio 白蛋白/球蛋白比值
Total Protein 血清总蛋白
Total Bilirubin 总胆红素
Alkaline Phosphatase 碱性磷酸酶
Alkaline Transaminase 谷丙转氨酶
Aspartate Transaminase 天冬氨酸氨基转移酶
Gamma-Glutamyl Transferase 谷酰转肽酶

LIPID PROFILE 脂肪组合测试

Total Cholesterol 总胆固醇
HDL Cholesterol 高密度胆固醇
LDL Cholesterol 低密度胆固醇
Triglycerides 三酸甘油酯
Total/HDL ratio 高密度胆固醇比值
GOLD (MALE)
RM269.00

FULL BLOOD EXAMINATION 血液检查

Haemoglobin 血红蛋白
Total RBC 红细胞计数
RDW 红细胞体积分布
PCV 细胞堆积体积
MCV 平均红细胞容积
MCHC 平均血红蛋白浓度
Total WBC 白血球分类
Platelet 血小板

DIABETIC SCREEN 血糖检测

Glucose 血糖
HBA1C 糖化血红蛋白
*add on RM30

RENAL FUNCTION TEST 肾脏检测

Urea 尿素
Creatinine 肌酸酐
Uric Acid 尿酸
E-GFR 估算的肾小球滤过率

LIVER FUNCTION TEST 肝功能试验

Albumin 白蛋白
Globulin 球蛋白
Albumin/Globulin Ratio 白蛋白/球蛋白比值
Total Protein 血清总蛋白
Total Bilirubin 总胆红素
Alkaline Phosphatase 碱性磷酸酶
Alkaline Transaminase 谷丙转氨酶
Aspartate Transaminase 天冬氨酸氨基转移酶
Gamma-Glutamyl Transferase 谷酰转肽酶

URINE EXAMINATION 尿液检查

Urine FEME 尿液常规检查

TUMOUR MARKERS 肿瘤标志物

AFP 肝胎蛋白質
CEA 胚胎性癌抗原
PSA 前列腺特异性抗原
CA19-9 癌抗原19-9
GOLD (FEMALE)
RM269.00

FULL BLOOD EXAMINATION 血液检查

Haemoglobin 血红蛋白
Total RBC 红细胞计数
RDW 红细胞体积分布
PCV 细胞堆积体积
MCV 平均红细胞容积
MCHC 平均血红蛋白浓度
Total WBC 白血球分类
Platelet 血小板

DIABETIC SCREEN 血糖检测

Glucose 血糖
HBA1C 糖化血红蛋白
*add on RM30

RENAL FUNCTION TEST 肾脏检测

Urea 尿素
Creatinine 肌酸酐
Uric Acid 尿酸
E-GFR 估算的肾小球滤过率

LIVER FUNCTION TEST 肝功能试验

Albumin 白蛋白
Globulin 球蛋白
Albumin/Globulin Ratio 白蛋白/球蛋白比值
Total Protein 血清总蛋白
Total Bilirubin 总胆红素
Alkaline Phosphatase 碱性磷酸酶
Alkaline Transaminase 谷丙转氨酶
Aspartate Transaminase 天冬氨酸氨基转移酶
Gamma-Glutamyl Transferase 谷酰转肽酶

URINE EXAMINATION 尿液检查

Urine FEME 尿液常规检查

TUMOUR MARKERS
AFP 肝胎蛋白質
CEA 胚胎性癌抗原
CA12-5 癌抗原12-5
CA15-3 癌抗原15-3
CA19-9 癌抗原19-9
PLATINUM BLOOD TEST
RM449.00

FULL BLOOD EXAMINATION 血液检查 ADDITIONAL TESTS 额外测试

Haemoglobin 血红蛋白 Blood Group (血型)
Total RBC 红细胞计数 Rh (Anti-D) (RH因子)
RDW 红细胞体积分布 HIV Ag/Ab (愛滋病毒抗原/抗體篩檢)
PCV 细胞堆积体积 Rheumatoid Factor (風濕性關節炎因子)
MCV 平均红细胞容积 TSH (甲狀腺刺激素)
MCHC 平均血红蛋白浓度 Free T4 (游離甲狀腺素)
Total WBC 白血球分类 Free T3 (游離三碘甲狀腺胺 酸)
Platelet 血小板

DIABETIC SCREEN 血糖检测 URINE EXAMINATION 尿液检查

Glucose 血糖 Urine FEME 尿液常规检查
HBA1C 糖化血红蛋白
*add on RM30

RENAL FUNCTION TEST 肾脏检测

Urea 尿素
Creatinine 肌酸酐
Uric Acid 尿酸
E-GFR 估算的肾小球滤过率

LIVER FUNCTION TEST 肝功能试验

Albumin 白蛋白
Globulin 球蛋白
Albumin/Globulin Ratio 白蛋白/球蛋白比值
Total Protein 血清总蛋白
Total Bilirubin 总胆红素
Alkaline Phosphatase 碱性磷酸酶
Alkaline Transaminase 谷丙转氨酶
Aspartate Transaminase 天冬氨酸氨基转移酶
Gamma-Glutamyl Transferase 谷酰转肽酶

LIPID PROFILE 脂肪组合测试

Total Cholesterol 总胆固醇
HDL Cholesterol 高密度胆固醇
LDL Cholesterol 低密度胆固醇
Triglycerides 三酸甘油酯
Total/HDL ratio 高密度胆固醇比值

TUMOUR MARKERS
BASIC BLOOD TEST
RM69.00

FULL BLOOD EXAMINATION

Haemoglobin
Total RBC
RDW
PCV
MCV
MCHC
Total WBC
Platelet 血小板

DIABETIC SCREEN
Glucose
HBA1C
*add on RM30

URINE EXAMINATION
Urine FEME
STANDARD BLOOD TEST
RM129.00

FULL BLOOD EXAMINATION

Haemoglobin
Total RBC
RDW
PCV
MCV
MCHC
Total WBC
Platelet

DIABETIC SCREEN
Glucose
HBA1C
*add on RM30

RENAL FUNCTION TEST

Urea
Creatinine
Uric Acid
E-GFR

LIVER FUNCTION TEST

Albumin
Globulin
Albumin/Globulin Ratio
Total Protein
Total Bilirubin
Alkaline Phosphatase
Alkaline Transaminase
Aspartate Transaminase
Gamma-Glutamyl Transferase

URINE EXAMINATION
Urine FEME
SILVER BLOOD TEST
RM219.00

FULL BLOOD EXAMINATION ADDITIONAL TESTS

Haemoglobin Blood Group
Total RBC Rh (Anti-D)
RDW HIV Ag/Ab
PCV Rheumatoid Factor
MCV TSH
MCHC Free T4
Total WBC Free T3
Platelet

DIABETIC SCREEN URINE EXAMINATION

Glucose Urine FEME
HBA1C
*add on RM30

RENAL FUNCTION TEST

Urea
Creatinine
Uric Acid
E-GFR

LIVER FUNCTION TEST

Albumin
Globulin
Albumin/Globulin Ratio
Total Protein
Total Bilirubin
Alkaline Phosphatase
Alkaline Transaminase
Aspartate Transaminase
Gamma-Glutamyl Transferase

LIPID PROFILE
Total Cholesterol
HDL Cholesterol
LDL Cholesterol
Triglycerides
Total/HDL ratio
GOLD (MALE)
RM269.00

FULL BLOOD EXAMINATION

Haemoglobin
Total RBC
RDW
PCV
MCV
MCHC
Total WBC
Platelet

DIABETIC SCREEN
Glucose
HBA1C
*add on RM30

RENAL FUNCTION TEST

Urea
Creatinine
Uric Acid
E-GFR

LIVER FUNCTION TEST

Albumin
Globulin
Albumin/Globulin Ratio
Total Protein
Total Bilirubin
Alkaline Phosphatase
Alkaline Transaminase
Aspartate Transaminase
Gamma-Glutamyl Transferase

URINE EXAMINATION
Urine FEME

TUMOUR MARKERS
AFP
CEA
PSA
CA19-9
GOLD (FEMALE)
RM269.00

FULL BLOOD EXAMINATION

Haemoglobin
Total RBC
RDW
PCV
MCV
MCHC
Total WBC
Platelet

DIABETIC SCREEN
Glucose
HBA1C
*add on RM30

RENAL FUNCTION TEST

Urea
Creatinine
Uric Acid
E-GFR

LIVER FUNCTION TEST

Albumin
Globulin
Albumin/Globulin Ratio
Total Protein
Total Bilirubin
Alkaline Phosphatase
Alkaline Transaminase
Aspartate Transaminase
Gamma-Glutamyl Transferase

URINE EXAMINATION
Urine FEME

TUMOUR MARKERS
AFP
CEA
CA12-5
CA15-3
CA19-9
PLATINUM BLOOD TEST
RM449.00

FULL BLOOD EXAMINATION ADDITIONAL TESTS

Haemoglobin Blood Group
Total RBC Rh (Anti-D)
RDW HIV Ag/Ab
PCV Rheumatoid Factor
MCV TSH
MCHC Free T4
Total WBC Free T3
Platelet

DIABETIC SCREEN URINE EXAMINATION

Glucose Urine FEME
HBA1C
*add on RM30

RENAL FUNCTION TEST

Urea
Creatinine
Uric Acid
E-GFR

LIVER FUNCTION TEST

Albumin
Globulin
Albumin/Globulin Ratio
Total Protein
Total Bilirubin
Alkaline Phosphatase
Alkaline Transaminase
Aspartate Transaminase
Gamma-Glutamyl Transferase

LIPID PROFILE
Total Cholesterol
HDL Cholesterol
LDL Cholesterol
Triglycerides
Total/HDL ratio

TUMOUR MARKERS
 Blood Test Bottles
BLOOD TEST BOTTLES

Package In house Out source (BP lab):

Basic Purple Bottle X 1 X
Urine Bottle X 1 X
Standard Purple Bottle X 1 X
Blue Bottle X 1 X
Urine Bottle X 1 X
Silver Purple Bottle X 1 Purple Bottle X 1
Blue Bottle X 1 Yellow Bottle X 1
Urine Bottle X 1
Lipid Panel X 1
Gold Purple Bottle X 1 Yellow Bottle X 1
Blue Bottle X 1
Urine Bottle X 1
Platinum Purple Bottle X 1 Purple Bottle X 1
Blue Bottle X 1 Yellow Bottle X 1
Urine Bottle X 1
Lipid Panel X 1

Page 15
PA-S-36 (GROUND FLOOR)
JLN. PASIR EMAS, SG. CHUA, PEARL AVENUE
43000 KAJANG, SELANGOR DARUL EHSAN

LIST OF NAMES FOR BLOOD DONATION

No. Name IC Contact No.

1

10

11

12

13

14

15

16

17

18

19

20
D DONATION

Hx of transfusion/donation
Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N