FRIENDLY CARE CLINIC

Metrolane cor 20th Avenue Cubao Quezon City

VAT TIN : 640-869-867-000000
Telephone No. (049) 531-01-92

SEROLOGY
AGE: 26
NAME: WILBERT G. EUGENIO GENDER: MALE
REQUESTED BY DATE EXAMINE : APRIL 13, 2024

TEST NAME RESULT

HBsAg Screening NON- REACTIVE

MARIA LOUDES D. CRUZ, RMT HONEYLYN F. CLORES,MD,FPSP

License No. 05482 LICENSE # 054826
MEDICAL TECHNOLOGIST PATHOLOGIST
 FRIENDLY CARE CLINIC
Metrolane cor 20th Avenue Cubao Quezon City
VAT TIN : 640-869-867-000000
Telephone No. (049) 531-01-92

HEMATOLOGY
AGE: 26
NAME: WILBERT G. EUGENIO GENDER: MALE
REQUESTED BY DATE EXAMINE : APRIL 13, 2024

ROUTINE COMPLETE BLOOD COUNT BLOOD TYPING

HEMOGLOBIN 150 110-170 g/L

HEMATOCRIT 0.42 0.35 - 0.55 OTHERS RESULT NORMAL VALUE
RED BLOOD CELLS 5.55 4.0 - 6.20X10X12/L
WHITE BLOOD CELLS 9.8 4.00X10X9/L
BLEEDING TIME 2-4 minutes
PLATELET COUNT 1.50-4.00X10X9/L
DIFFERENTAL COUNT CLOTTING TIME 2-4 minutes
NEUTROPHILS 60 50-80%
RETICULOCYTE 0.5 - 1.5%
LYMPHOCYTES 30 25-50%
MONOCYTES 10 2-10%
EOSINOPHILS 2-5%
ERYTHROCYTE M= 0-10 mm/hr
BASO PHILS 0-1%
SEDIMENTATION RATE F= 0-20 mm/hr

MARIA LOUDES D. CRUZ, RMT HONEYLYN F. CLORES,MD,FPSP

License No. 05482 LICENSE # 054826
MEDICAL TECHNOLOGIST PATHOLOGIST
 FRIENDLY CARE CLINIC
Metrolane cor 20th Avenue Cubao Quezon City
VAT TIN : 640-869-867-000000
Telephone No. (049) 531-01-92

CLINICAL MICROSCOPY
AGE: 26
NAME: WILBERT G. EUGENIO GENDER: MALE
REQUESTED BY DATE EXAMINE : APRIL 13, 2024
URINALYSIS FECALYSIS
MACROSCOPIC EXAMINATION MACROSCOPIC EXAMINATION

COLOR: CLOR : BROWN

yellow TRANSPARENCY : Clear
CONSISTENCY : FORMED
CHEMICAL EXAMINATION
MACROSCOPIC EXAMINATION
pH. 6.0 PROTEIN negative
PUS CELLS :/hpf
SPECIFIC GRAVITY: 1.030 GLOCUSE negative
RED BLOOD CELLS: ;/hpf
MACROSCOPIC EXAMINATION BLOOD CELLS :
FAT GLOBULES:
PUS CELLS: 0-3 BACTERIA:
RED BLOOD CELLS: 3-6 OTHERS
EPITHELIAL CELLS : few RENAL CELLS
BACTERIA : few YEAST CELLS
MUCUS THREADS :few
AMORPHOUS URATES: CASTS
AMORPHOUS PHOSPHATES: COARSELY GRANULAR /lpf RESULT
CALCIUM OXALATE: FINE GRANULAR /lpf
URIC ACID: HYALINE /lpf No ova nor intestinal parasite seen
OTHERS:

MARIA LOUDES D. CRUZ, RMT HONEYLYN F. CLORES,MD,FPSP

License No. 05482 LICENSE # 054826
MEDICAL TECHNOLOGIST PATHOLOGIST
 FRIENDLY CARE CLINIC
Metrolane cor 20th Avenue Cubao Quezon City
VAT TIN : 640-869-867-000000
Telephone No. (049) 531-01-92

RADIOLOGICAL REPORT

NAME OF PATIENT: EUGENIO , WILLBERT GURA

AGE AND GENDER: 26 / MALE
DATE: APRIL 13, 2024
EXAMINATION: CHEST PA
CASE NUMBER: 24-0542

FINDINGS:

There are no active parenchymal opacities in both lungs.

Pulmonary vascular markings is within normal limits.
Heart is not enlarged.
Both hemidiaphragms and sulci are intact.
Bony thorax and soft tissues are unremarkable.

IMPRESSION:

NO SIGNIFICANT CHEST FINDINGS.

JONATHAN DELA CERNA, MD, FPCR, FUSP

RADIOLOGIST

FRIENDLY CARE CLINIC

Metrolane cor 20th Avenue Cubao Quezon City
VAT TIN : 640-869-867-000000
Telephone No. (049) 531-01-92
 FRIENDLY CARE CLINIC
Metrolane cor 20th Avenue Cubao Quezon City
VAT TIN : 640-869-867-000000
Telephone No. (049) 531-01-92
MEDICAL EXAMINATION REPORT
LAST NAME : FIRST NAME: MI AGE SEX
EUGENIO WILBERT G. 26 MALE

CIVIL STATUS : ADDRESS : BIRTHDAY :

SINGLE 139 20th Avenue Cubao Quezon city DECEMBER 18, 1997

BLOOD PRESSURE WEIGHT HEIGHT PULSE RATE COMPANY NAME :

1100/80 53Kg. 5'1 60 bps RED RIBBON

I. MEDICAL HISTORY ( has the applicant suffered from or been told he hand any of following condition )

YES NO YES NO
Choronic Headach Peptic Ulcer / Grastritis
Vertigo / Syncope Renal Problem / UTI
Eye disorders LIVER / Galibladder Disease
Thyroid Problem GIT PROBLEM
Diabetes Infectious Disease

Bronchial Asthma Muscle / Join Diseases

Tubeculosis Neurological Deficits

Heart Disease Hospetalizations
OB-Gyne Surgery

OB Indez ( )

CERTIFICATION
I hereby certify that the answers and statements provided are all true and correct to the best of my knowledge and I understand
that non - disclosure and /or misdeclaration of any of the above items from part of my application and maybe used for any
administrative action.
WILBERT G. EUGENIO APRIL 13, 2024
SIGNATURE OVER PRINTED NAME OF APPLICANT DATE

II. PHYSICAL EXAMINATION ( to be completed by Examing Physician )

HEIGHT : WEIGHT : BLOOD PRESSURE : 110/80 PULSE RATE 60bps Respiration Body Built
(R) 20/20
VISUAL ACUILTY

NORMAL NORMAL
YES NO FINDINGS FINDINGS
YES NO

Hearth
Skin
Abdomen
Head Scalp
Eyes Back / Flank

Ears Hearth

Nose Genitalia

Mouth / Throat Anus / Rectum

Necks Reflexes

Lungs Dental

III. LABORATORY REPORT

A. CHEST X-RAY D. FICALYSIS G. HBsAG SCREENING
FINDINGS N FINDINGS (-) ova parasite seen FINDINGS Non Reactive

B. COMPLETE BLOOD COUNT E. DRUG TESTING H. OTHERS

FINDINGS N FINDINGS N/A FINDINGS N/A

F. ECG
C. URINALYSIS
FINDINGS N/A
FINDINGS N

CLASSIFICATION CLASS A
MEDICAL RECOMMENDATION: FIT TO WORK
AT
Report ID DTO-RO3

FRIENDLY CARE CLINIC

Metrolane cor 20th Avenue Cubao Quezon City
VAT TIN : 640-869-867-000000
Telephone No. (049) 531-01-92
QM920198
90 DRUG TEST REPORT

CCF No: 202406160006 Transaction Date Time : 04/13/2024 10:53:00AM

Name : WILBERTH G. EUGENIO Report Date Time : 04/13/2024 12:34:07PM
Birthdate: 12/18/1997 Age: 26 Gender: M

TEST METHOD TEST KIT

Purpose Requesting Parties

Employment
Result

Drug/Metabolite Result Remarks

METHAMPHETAMINE NEGAVITE PASSED
TETRAHDROCANNABINOL NEGAVITE PASSED

Test Conducted By Approved By

MS. JENNIFER F. TAMAYO DR. ANGELIE ERISTELA L. OROPILLA 65

Analyst Head of Laboratory

Valid Within 12 Month/s from Transaction Date

This is a DOH-DDB IDTOMIS generated report