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Form Hasil Lab

This document contains the results of various medical lab tests for an unnamed patient. The tests include hematology, clinical chemistry, bacterioscopy, urinalysis, and serology. The results are provided for tests such as hemoglobin, white blood cell count, glucose, cholesterol, liver enzymes, urinalysis sediment and others. Normal ranges are also listed for comparison to the patient's results. The lab technician from Puskesmas Jatibarang Health Center in Brebes, Indonesia signed off on the results.

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79 views2 pages

Form Hasil Lab

This document contains the results of various medical lab tests for an unnamed patient. The tests include hematology, clinical chemistry, bacterioscopy, urinalysis, and serology. The results are provided for tests such as hemoglobin, white blood cell count, glucose, cholesterol, liver enzymes, urinalysis sediment and others. Normal ranges are also listed for comparison to the patient's results. The lab technician from Puskesmas Jatibarang Health Center in Brebes, Indonesia signed off on the results.

Uploaded by

zihanmwb
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PEMERINTAH KABUPATEN BREBES

DINAS KESEHATAN
PUSKESMAS JATIBARANG
Jalan Raya Timur No. 72 Telp. (0283) 3309433 Kec.Jatibarang 52261

HASIL PEMERIKSAAN LABORATORIUM


Nama
P
Umur

Jenis Kelamin

L /

:
...
No.RM
:
...
No.BPJS/JKM/ASKES :
...
Ruang
:
...
Alamat
:
.
..
JENIS
PEMERIKSAAN
HEMATOLOGI
a. Hemoglobin
b. Hematokrit
c. Lekosit
d. Eritrosit
e. Laju endap darah
f. Trombosit
g. Golongan darah
KIMIA KLINIK
a. Glukosa puasa
b. Glukosa 2 jam PP
c. Glukosa sewaktu
d. Cholesterol
e. Cholesterol HDL
f. Cholesterol LDL
g. Trigliserida
h. SGPT ( ALT )
i. SGOT ( AST )
j. Ureum
k. Kreatinin
l. Asam urat
BAKTERIOSKOPIS
a. Sputum ( BTA )
b. Sekreta urethra
c. Sekreta vagina
URINALISA
a. Warna / kejernihan
b. PH
c. Protein
d. Glukosa
e. Bilirubin
f. Sedimen
Lekosit
Eritrosit
Epitel
Cylinder
Kristal
SEROLOGIS
a. Widal
-Sel Typhi O
-Sel Typhy H
b. Anti-HIV
c. PP Test

HASIL
.
gr %
.
vol %
.
/mm
.
jt/mm
.
mm/jam
.
/mm

.
mg/dl
.
mg/dl
.
mg/dl
.
mg/dl
.
mg/dl
.
mg/dl
.
mg/dl
.
U/L
.
U/L
.
mg/dl
.
mg/dl
.
mg/dl

...

...

...

NILAI NORMAL
L = 14-18 gr %
P = 12-14 gr %
A
= 11-13 gr %
L = 40-48 Vol %
P = 37-43 Vol %
D = 4000-10.000 /mm
A = 6000-13.000 /mm
L = 4,5-6,5 jt/mm P = 3,8-5,8 jt/mm A = 4-5,5 jt/mm
0-10 mm/jam
>20 mm/jam
150.000 500.000 /mm

75 100 mg/dl
60 90 mg/dl
80 110 mg/dl
< 200 mg/dl
Xxx mg/dl
xxx mg/dl
60 150 mg/dl
L = < 37 U/L
L = < 37 U/L
L = 10 50 mg/dl
L = 0,6 1,1 mg/dl
L = 3,4 7,2 mg/dl

P = < 31 U/L
P = < 31 U/L
P = 0,5 0,9 mg/dl
P = 2,4 5,7 mg/dl

Negatif
Negatif
Negatif

Negatif
Negatif

Normal = 0 5 / LPB
Normal = 1 3 / LPB
Negatif

Negatif
Negatif
Non Reaktif


...

...

...

...

...
.
/ LPBl
.
/ LPB

...

...

...

...

...

...

...

Jatibarang,
Petugas Laboratorium
Puskesmas Jatibarang Kab. Brebes

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