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    Ap. 5 Bukti Form Rujukan Melalui Laboratorium Rs.

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    IT Thursina
    This document is a laboratory test request form from R.S Thursina Hospital. It requests laboratory tests be performed on a patient named Iman, a male born in 1979, with medical record number 00202717. The anamnesis or patient history noted is "diabetes". The form lists several blood tests, urine tests, and microbiology culture tests to be performed. It requests test results be confirmed to the referring laboratory after completion.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Ap. 5 Bukti Form Rujukan Melalui Laboratorium Rs.

    Uploaded by

    IT Thursina
    236 views2 pages
    This document is a laboratory test request form from R.S Thursina Hospital. It requests laboratory tests be performed on a patient named Iman, a male born in 1979, with medical record number 00202717. The anamnesis or patient history noted is "diabetes". The form lists several blood tests, urine tests, and microbiology culture tests to be performed. It requests test results be confirmed to the referring laboratory after completion.

    Original Description:

    form rujukan

    Original Title

    AP. 5 BUKTI FORM RUJUKAN MELALUI LABORATORIUM RS.

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    This document is a laboratory test request form from R.S Thursina Hospital. It requests laboratory tests be performed on a patient named Iman, a male born in 1979, with medical record number 00202717. The anamnesis or patient history noted is "diabetes". The form lists several blood tests, urine tests, and microbiology culture tests to be performed. It requests test results be confirmed to the referring laboratory after completion.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    236 views2 pages

    Ap. 5 Bukti Form Rujukan Melalui Laboratorium Rs.

    Uploaded by

    IT Thursina
    This document is a laboratory test request form from R.S Thursina Hospital. It requests laboratory tests be performed on a patient named Iman, a male born in 1979, with medical record number 00202717. The anamnesis or patient history noted is "diabetes". The form lists several blood tests, urine tests, and microbiology culture tests to be performed. It requests test results be confirmed to the referring laboratory after completion.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    RIiMAH SAKIT THURSIIIA
    Jalan thq Tuah 15 93 Telp. 0765-597782 Feu..0765-59T113 IXni - Riau
    Email : rs.thunirmlmail.com

    St. RAT RT JJTiKAN PE NTERI KSAAN I,A BOR.{TORITI}I

    Yth. Laboratorium pradra Oun

    Di Duri
    l anggal Penginman :

    Mohon dilakukan pemeriksaan labor sesuai dengan lampiran pemeriksaan berikut ini.
    Nama Pasien : fiman
    Jenis Kelamin ' Llu -la4
    Tgl.Lahir :q.oT't579
    No. MR : O\nol 'll
    Alamat : p,a,;,atan Mua.&Uet^ t
    No HP / Telp :

    Anamness ,61ag,C$?

    Demikian suat rujukan ini kami kirim, atas perhatian dan keda sama bapak r ibu kami
    ucapkan terima kasih

    H Karni

    n'i )
    Petugas Laboratorium

    NB: Setelah hasil selesai, harap konfirmasi ke laboratoirum yang merujuli (0813-5{b3-1229)

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    Masa Pendarahan ,/ KULTURYBIAKAN
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    Reuaksi Bekuan Gula Darah ! Kultur untuk Gonococcus
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    I oolongan Darah tr D.J. P.n Kultur Diptheri


    f] Morfologi Sel ! Ranoom Kultur Jamur

    fl uataria n sensitivit) test


    URINE tr
    SEROLOGI I IMUNOSEROLOCI
    E Udne Rutin
    I Pemeriksaan widal
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    ! sitirulin
    Pemeriksaan HBsAg
    fl urotittn TYROID
    ! scaiment T T3 Pcmcriksaan Anti HBs
    Pemeriksaan Aslo
    FESES Pemeriksaan Syphylis
    tr Makoskopis E TSH
    tr F13 E Pemeriksaan HIV
    tr Mikoskopis
    D FT4 fl Pemeriksaan CRP Kualitalif

    E Pcmqifs.er CRP Kurntitatif

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