Scribd Logo
Upload

Welcome to Scribd!

  • GDOH-LAB-SAF-305 Stool Analysis Form

    Uploaded by

    drabdulrabb
    17 views1 page
    This document is a stool analysis form from a hospital in the Kingdom of Saudi Arabia. It collects information about a patient such as their name, age, gender, nationality, medical record number, and date of birth. It documents the character, color, and presence of substances like blood, pus, mucus, or fat in the patient's stool sample. The form is used to request a routine, urgent, or pre-operative stool analysis and includes spaces for clinical comments, the requester's information, and test results which are examined, checked, and signed by medical professionals.

    Original Description:

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a stool analysis form from a hospital in the Kingdom of Saudi Arabia. It collects information about a patient such as their name, age, gender, nationality, medical record number, and date of birth. It documents the character, color, and presence of substances like blood, pus, mucus, or fat in the patient's stool sample. The form is used to request a routine, urgent, or pre-operative stool analysis and includes spaces for clinical comments, the requester's information, and test results which are examined, checked, and signed by medical professionals.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    17 views1 page

    GDOH-LAB-SAF-305 Stool Analysis Form

    Uploaded by

    drabdulrabb
    This document is a stool analysis form from a hospital in the Kingdom of Saudi Arabia. It collects information about a patient such as their name, age, gender, nationality, medical record number, and date of birth. It documents the character, color, and presence of substances like blood, pus, mucus, or fat in the patient's stool sample. The form is used to request a routine, urgent, or pre-operative stool analysis and includes spaces for clinical comments, the requester's information, and test results which are examined, checked, and signed by medical professionals.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    KINGDOM OF SAUDI ARABIA

    MRN: :‫رقم الملف الطبي‬


    Name: :‫االســم‬
    Nationality: :‫الجنسية‬
    ‫سنة‬ ‫شهر‬ ‫يوم‬
    Age: Years Months Days :‫العمر‬
    Hospital: :‫مستشفى‬

    Region: :‫المحافظة‬/‫المنطقة‬ Date of Birth: / / 14 H / / 20 :‫تاريخ الميالد‬

    Dept./Unit: :‫الوحدة‬/‫القسم‬ Gender: Male Female :‫الجنس‬

    STOOL ANALYSIS FORM ‫نموذج فحص البراز‬


    Routine Urgent Pre-operative

    Clinical Comments:

    Requested by: Stamp&Signature: Date:____/____/______

    Character: Fluid Semifluid Soft Formed Hard Yellow Brown

    Green Black Tarry Red Clay Mucus ( )

    Pus ( ) Blood ( ) Fat ( )


    Occult Blood: Neutral Fat
    Fatty Acid Parasites and Ova
    Amoeba: Starch
    Others:

    Results

    Examined by: Stamp&Signature: Date:____/____/______

    Checked by: Stamp&Signature: Date:____/____/______

    GDOH-LAB-SAF-305 ISSUED DATE:09/02/2013 1 OF 1 SN

    You might also like