REPUBLIC OF THE PHILIPPINES

Province of Occidental Mindoro

Municipality of Looc
Rural Health Unit

Patient's Name: Age/Sex:

Address: Date/Time:
Date/Time of Collection: Date and Time
Birthday: of Released:
CLINICAL CHEMISTRY
TEST: REFERENCE RANGE: RESULT: REMARKS:

BLOOD URIC ACID Male: 3.1-7.0 mg/dL

Female: 2.5-5.6 mg/dL

REMARKS:

LOUIS ALFRED R. RELLORA, MD, MBA KEZIAH R. POSADA, RMT

MUNICIPAL HEALTH OFFICER/DTTB MEDICAL TECHNOLOGIST
LICENSE NO. 0147467 LICENSE NO. 0075061

* Tarriela St., Brgy. Guitna, Looc, Occidental Mindoro * laboratoryrhulooc@gmail.com