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BB ID NUMBER: RPZ9946 BB ID NUMBER: RPZ9946


Patient Name: MOORE CHERYL Patient Name: MOORE CHERYL
DOB: 01041961 Age: 62 Gender: F DOB: 01041961 Age: 62 Gender:
Account #: 10482912 MR #: 11683 Account #: 10482912 MR #: 11683
Admit Date: 022323 Room: 204 Admit Date: 022323 Room: 204
Physican: HUGHES L Physican: HUGHES L
Patient Type: A Positive Patient Type: A Positive
Antibody Screen: Negative Antibody Screen: Negative
Component Packed Red Blood Cells Component Packed Red Blood Cells
Unit Number: W0352 23 401724 Unit Number: W0352 23 425439
Unit Type: A Positive Unit Type: A Positive
Special Testing: Special Testing:
Unit Expiration Date/Time: 03-21-2023 Unit Expiration Date/Time: 03212023
Crossmatch Result: Compatible Crossmatch Result: Compatible
Crossmatch Expiration Date: 2-27-2 Time: 2245 Crossmatch Expiration Date: 022723 Time:
Complete Date 022323 Time: 2245 Tech: ;R Complete Date 022323 Time: 2245 Tech:
Comment: Comment:

BB ID NUMBER: RPZ9946 BB ID NUMBER: RPZ9946


Patient Name: MOORE CHERYL Patient Name: MOORE CHERYL
DOB: 01041961 Age: 62 Gender: F DOB: 01041961 Age: 62 Gender:
Account #: 10482912 MR #: 11683 Account #: 10482912 MR #: 11683
Admit Date: 022323 Room: 204 Admit Date: 022323 Room: 204
Physican: HUGHES L Physican: HUGHES L
Patient Type: A Positive Patient Type: A Positive
Antibody Screen: Negative Antibody Screen: Negative
Component Component
Unit Number: Unit Number:
Unit Type: Unit Type:
Special Testing: Special Testing:
Unit Expiration Date/Time: Unit Expiration Date/Time:

https://10.15.0.202/x/efloadform.cbx?COMMAND=PRINTALL&PRINTTYPE=0&CSN... 2/23/2023
Electronic Form Page 2 of 2

Crossmatch Result: Crossmatch Result:


Crossmatch Expiration Date: Time: Crossmatch Expiration Date: Time:
Complete Date 022323 Time: 2245 Tech: LR Complete Date 022323 Time: 2245 Tech:
Comment: Comment:

https://10.15.0.202/x/efloadform.cbx?COMMAND=PRINTALL&PRINTTYPE=0&CSN... 2/23/2023

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