No.Rekam Medis : 02085608 No.

Laboratorium : 0424007187 / 2402220309

Medical Record Number Laboratory Number
Nama Pasien : Lutfi Hakim ulumuddin L Tanggal Order : 22-02-2024 09:18:00
Patient Name M Order Date
Tanggal Lahir : 23-09-1977 /46 Th 4 Bl 30 Hr Dokter Pengirim :
Date of Birth 46 Year 4 Month 30 Day Referring Doctor
Alamat : jl serdako usman ali b1 no 44 Rujukan : Laboratorium Phlebotomy PM
Address Referee

HASIL LABORATORIUM / LABORATORY RESULT

Jenis Pemeriksaan Hasil Satuan/Unit Nilai Normal Metode

Test Result Unit Reference Range Method

HEMATOLOGY
HEMA 3 (Hema 2 + LED)
Hemoglobin 15.7 g/dL 13.2 - 17.3 Colorimetric
Hematokrit 48.7 % 40 - 52 Calculation
Leukosit 10.6 10³/µL 3.8 - 10.6 Flow Cytometry
Trombosit 346 10³/µL 150 - 440 Impedance
Eritrosit 5.4 juta/µL 4.4 - 5.9 Impedance
MCV 89.7 fL 80 - 100 Calculation
MCH 28.8 pg 26 - 34 Calculation
MCHC 32.2 g/dL 32 - 36 Calculation
RDW-CV 13.3 % 11.7 - 15.3
Hitung Jenis
Basofil 0.1 % 0 - 1.0
Eosinofil 2.9 % 2.0 - 4.0
Neutrofil 60.7 % 50.0 - 70.0
Limfosit 30.2 % 25.0 - 40.0
Monosit 6.1 % 2.0 - 8.0
Laju Endap Darah H 28 mm <= 10 Westergreen
HEMOSTASIS
Bleeding Time (BT) 3'30'' menit 1-6
Clotting Time 13'00'' menit 9 - 15
BLOOD CHEMISTRY
Random Glucose 86 mg/dL <140 Hexokinase
Ureum 19 mg/dL 17 - 43 Urease GLDH
Creatinine 0.85 mg/dL 0.8 - 1.3 Enzymatic
eLFG (CKD-EPI) 109 mL/mnt/1.73m² >= 90 Calculation

Date and Time Specimen :

Serum : 22-02-2024 11:00
EDTA : 22-02-2024 11:00
Darah : 22-02-2024 10:09

Interpretasi hasil pemeriksaan laboratorium harus oleh dokter yang bersangkutan

The interpretation of laboratory result must be carried out by the doctor concerned Page: 1/2

Authorized by: Retno Wulandari Validated by: Devinta Dwi Lestari Print by:

22-02-2024 11:39:00 22-02-2024 11:39:00 22-02-2024 11:41

No.Rekam Medis : 02085608 No. Laboratorium : 0424007187 / 2402220309
Medical Record Number Laboratory Number
Nama Pasien : Lutfi Hakim ulumuddin L Tanggal Order : 22-02-2024 09:18:00
Patient Name M Order Date
Tanggal Lahir : 23-09-1977 /46 Th 4 Bl 30 Hr Dokter Pengirim :
Date of Birth 46 Year 4 Month 30 Day Referring Doctor
Alamat : jl serdako usman ali b1 no 44 Rujukan : Laboratorium Phlebotomy PM
Address Referee

HASIL LABORATORIUM / LABORATORY RESULT

Jenis Pemeriksaan Hasil Satuan/Unit Nilai Normal Metode

Test Result Unit Reference Range Method

Note :
Clinical Pathologist : dr. Diana Susanto, Sp.PK

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This is a Computer Generated Report, No Signature Required

Interpretasi hasil pemeriksaan laboratorium harus oleh dokter yang bersangkutan

The interpretation of laboratory result must be carried out by the doctor concerned Page: 2/2

Authorized by: Retno Wulandari Validated by: Devinta Dwi Lestari Print by:

22-02-2024 11:39:00 22-02-2024 11:39:00 22-02-2024 11:41