PRAKTEK UMUM dr.

KUSYAERI Pengirim
Alamat : Pulosaren 46 Losari Brebes TLP. (0231)831374 PRAKTEK UMUM dr. KUSYAERI
Alamat : Pulosaren 46 Losari Brebes TLP. (0231)831374 PRAKTEK UMUM dr. KUSYAERI
Nama / umur Tgl. Alamat : Pulosaren 46 Losari Brebes TLP. (0231)831374
Alamat Diagnosa Nama / umur Tgl.
Alamat Diagnosa Nama / umur Tgl.

HEMATOLOGI KIMIA KLINIK Alamat Diagnosa

 Hematologi rutin  SGOT HEMATOLOGI KIMIA KLINIK

 Hemoglobin  SGPT  Hematologi rutin  SGOT HEMATOLOGI KIMIA KLINIK
 Lekosit  Bilirubin Direk  Hemoglobin  SGPT  Hematologi rutin  SGOT
 LED  Bilirubin Total  Lekosit  Bilirubin Direk  Hemoglobin  SGPT
 Hitung jenis  Alkali Phospatase  LED  Bilirubin Total  Lekosit  Bilirubin Direk
 Hematokrit  Ureum  Hitung jenis  Alkali Phospatase  LED  Bilirubin Total
 Trombosit  Creatinin  Hematokrit  Ureum  Hitung jenis  Alkali Phospatase
 Eritrosit  Asam Urat  Trombosit  Creatinin  Hematokrit  Ureum
 Eosinofil  Cholesterol total  Eritrosit  Asam Urat  Trombosit  Creatinin
 Nilai MC  HDL – C  Eosinofil  Cholesterol total  Eritrosit  Asam Urat
 Gambaran darah tepi  LDL – C  Nilai MC  HDL – C  Eosinofil  Cholesterol total
 Masa Perdarahan  Trigliserida  Gambaran darah tepi  LDL – C  Nilai MC  HDL – C
 Masa Pembekuan  Glukosa Puasa  Masa Perdarahan  Trigliserida  Gambaran darah tepi  LDL – C
 Glukosa 2 jam PP  Masa Pembekuan  Glukosa Puasa  Masa Perdarahan  Trigliserida
URINALISA  Glukosa sewaktu  Glukosa 2 jam PP  Masa Pembekuan  Glukosa Puasa
URINALISA  Glukosa sewaktu  Glukosa 2 jam PP
 Urin Rutin
 Glukosa IMUNO SEROLOGI  Urin Rutin URINALISA  Glukosa sewaktu
 Protein  Widal  Glukosa IMUNO SEROLOGI  Urin Rutin
 Bilirubin  Rematoid Atritis  Protein  Widal  Glukosa IMUNO SEROLOGI
 Urobilinogen  HbsAg  Bilirubin  Rematoid Atritis  Protein  Widal
 Keton  HbsAb  Urobilinogen  HbsAg  Bilirubin  Rematoid Atritis
 Nitrit  Tes Kehamilan  Keton  HbsAb  Urobilinogen  HbsAg
 pH  Nitrit  Tes Kehamilan  Keton  HbsAb
 Berat jenis PENGECETAN  pH  Nitrit  Tes Kehamilan
 Sedimen Mikroskopis  Gram  Berat jenis PENGECETAN  pH
 BTA  Sedimen Mikroskopis  Gram  Berat jenis PENGECETAN
FAECES  Kandida  BTA  Sedimen Mikroskopis  Gram
 Faeces Rutin  Trichomonas FAECES  Kandida  BTA
 Amoeba  GO  Faeces Rutin  Trichomonas FAECES  Kandida
 Kista  Amoeba  GO  Faeces Rutin  Trichomonas
 Lemak ANALISA LAIN  Kista  Amoeba  GO
 Telur Cacing  Analisa Sperma  Lemak ANALISA LAIN  Kista
 Telur Cacing  Analisa Sperma  Lemak ANALISA LAIN
Keterangan ……….………,………..2023  Telur Cacing  Analisa Sperma
 Puasa dan dilarang merokok 8-12 Keterangan ……..………,………..2023
jam  Puasa dan dilarang merokok 8-12
Keterangan ………….……,………..2023
 Persiapan pemeriksaan hub lab jam
………………….……….  Persiapan pemeriksaan hub lab
 Puasa dan dilarang merokok 8-12
Pengirim …………….……………. jam
 Persiapan pemeriksaan hub lab
…….…….…………….
Pengirim