LABORATORY SERVICES

Patient Name Lab No

UHID Sample Date
Age/Gender Receiving Date
Referred By Report Date
Report Status

Test Name Result Unit Reference Range

MICROBIOLOGY
CSF FOR CYTOLOGY
Appearance
Microscopic Examination
Total WBC Count
Total RBC Count
Staining (Leishman’s)
Neutrophil
Lymphocytes
AFB Staining
Grams Staining
 (CT SCAN UNIT)
SPIRAL (HELICAL) CT SCAN REPORT

ID. No : ____________ Receipt No : _________ Date :___________

Patient’s Name : ____________________ Age :________ Sex :__________
Part Scanned : ___________________ Enhancement agent :____________
Referred By :________________________________________________

Thank you for the courtesy of this referral

 No focal or diffuse lesion is noted in brain parenchyma.

 No midline shift is noted.
 Ventricles are dilated. Extraventricular CSF spaces are not widened.
 Thalamus, internal capsule and basal ganglia appear normal.
 Sellar, suprasellar and parasellar regions are normal.
 Cerebellum, CP angle and brain stem appear normal.
 Skull bones appear normal.
 Cerebral blood vessels appear normal.

Comment
 Patient ID :.......................................................... Receipt No:.................. Date:.............

Patient Name :.................................................................... Age:................ Sex:..................

Parts Scanned :.......................................................................................................................

OPD/Word-Bed/Cabin/Refd. By:....................................................... Reg. No:.....................

Thank you for the courtesy of this referral.

REPORT

Findings:

 Bilateral moderate pleural effusion.

 Superior mediastinum widened, containing lobulated masses.
 Trachea is encased.
 Ground glass opacity: Multiple focal patchy ground glass opacities are seen in almost
all segments of both lungs, predominantly, peripheral & basal distribution.
 Consolidation: Not seen.
 Crazy paving: Not seen.
 Reverse halo sign: Not seen.
 Subpleural linear fibrotic shadows: Seen in both lower lobes.
 Heart, great, vessels & esophagus are unremarkable.
 Bony thorax & overlying soft tissue appear normal.

Impression:
 (CT SCAN UNIT)
SPIRAL (HELICAL) CT SCAN REPORT

ID. No : ____________ Receipt No : _________ Date :___________

Patient’s Name : ____________________ Age :________ Sex :__________
Part Scanned : ___________________ Enhancement agent :____________
Referred By :________________________________________________

Thank you for the courtesy of this referral

 No focal or diffuse lesion is noted in brain parenchyma.

 No midline shift is noted.
 Ventricles are dilated. Extraventricular CSF spaces are not widened.
 Thalamus, internal capsule and basal ganglia appear normal.
 Sellar, suprasellar and parasellar regions are normal.
 Cerebellum, CP angle and brain stem appear normal.
 Skull bones appear normal.
 Cerebral blood vessels appear normal.
ID No. ................................................................................................... Date: ............................
Name: ............................................................................. Age: .................... Yrs, Sex: ...............
Parts Scanned/Exammed: ................................................... Refd. by..........................................
OPD/Ward/Cabin ...................................... Bed ................. Reg. No. ........................................
Thank you for the courtesy of this referral
REPORT
Sequences:
Axial T1WI, T2WI & T1WI contrast, Coronal T2WI, T1WI contrast.
Sagittal T1WI & T1WI contrast.
Findings:
T1WI is to hyper, T2FI & FLAIR hyperintense lesion with surrounding hypointense rim
along with perilesional hyperintense signal (representing oedema) measuring about
8.6 mm in CC, 12.2 mm in TD & 10.0 mm in AP is noted at posterior aspect of right
frontal lobe & adjacent parietal lobe. The lesion shows variable degrees or restriction
on DWI. After IV contrast (Gd-DTPA) administration: Strong peripheral enhancement
of the lesion is noted.
Complementary MRS kof the lesion shows: Lactate peak (at 1.3 ppm) is increased.

The ventricles are of normal size, configuration and position for a patient of this age.
The normal flow voids are demonstrated within the major cerebral vessels.
Extra ventricular CSF spaces and basal cisterns are unremarkable.
The brain stem, cerebellum, sella and parasellar structures revealed no abnormality.
No evidence of any abnormality in paranasal sinuses in shown.

The globes, optic nerves and extra ocular muscles are normal.
Retro orbital fat is maintained.
Lacrimal apparatus is intact on both sides.

Impression
Track No. :
Laboratory Services Division
Patient ID : Gender :
Patient Name : Age :
Address : Phone :
Ref. by :

CYTOLOGY REPORT
Specimen: CSF
Colour
Apperance
Sediment

Microscopic Examination:
RBC
WBC
Total Leucocyte Count

Differential Count
Lymphocytes :
Neutrophils :
 Laboratory Services Division
Track No. : Collection Date: Delivery Date:
Patient ID : Gender :
Patient Name : Age :
Address : Phone :
Ref. by :

Biochemistry Report

Investigation Results Unit Ref. Values

CSF
Glucose (CSF)
Protein (CSF)
Patient ID : Date
Patient Name :
Age : Gender
Ward No : Bed No Cabin No
Test Name :

X-RAY REPORT

Diaphragm :
Trachea :
Heart :
Lungs :
Bony Thorax :
Impression :
 Laboratory Services Division

DEPARTMENT OF MICROBIOLOGY

Track No. : Collection Date: Delivery Date:

Patient ID : Gender :
Patient Name : Age :
Address : Phone :
Ref. by :

Specimen :
Test :
Staining

Gram Staining :
Zichi-Neelsen Staining :
AFB :
 Biochemical Report
ID No. : Date Received: Date Delivered:
Patient Name : Age: Sex:
Refd. By :
Specimen :
Estimations are carried out by Beckman Coulter AU480/Vitros350 (J&J) / Dade Behring
Dimension RxL Random Access Multibatch Chemistry Analyzer

Test Name Result Unit Reference Range

 Microbiology Report
ID No. : Date Received: Date Delivered:
Patient Name : Age: Sex:
Refd. By :
Specimen :

Laboratory Report

Test Name Result Unit Reference Range

CSF Analysis
Cytology:- Total Leucocyte
Polymorphs
Lymphocyte
RBC (If any)
Biochemical:- Protein
Sugar
Pandey’s Test
Staining:- Gram’s
AFB
Patient Name : Age: Sex:

Name of Examination: ID No:

Protocol: Contrast & non-Contrast: Sagital, Coronal, Axial, T1, T2, Flair.
Findings:
 Multiple conglomerate & small ring enhancing lesions are noted in both cerebrun,
cerebellum, brainstem & basal cisterns, Few lessions show minimal perilesional
edema.
 Sella, suprasellar & parasellar regions normal.
 Ventricles are unremarkable.
 No shift of midline structures detected.
 No lesion detected in CP angle and IAM regions.

Comment:


 Laboratory Services Division

DEPARTMENT OF MICROBIOLOGY

Track No. : Collection Date: Delivery Date:

Patient ID : Gender :
Patient Name : Age :
Address : Phone :
Ref. by :
Specimen :
Test :

Culture and Sensitivity Test

Culture done in aerobic condition at 370C for 72 hours incubation : No Growth of

Pathogenic bacteria is found.
Patient Name : Age: Sex:

Name of Examination: ID No:

Protocol: Contrast & non-Contrast: Sagital, Coronal, Axial, T1, T2, Flair.
Findings:
 Multiple small ring enhancing lesions are noted at both cerebrum, cerebellum, brain
stem and basal cisterns. Some of the lesion show restricted of diffusion on DWI.
 Ventricles are mildly dilated. Basal cisterns are effaced. After I/V contrast
enhancement of basal cisterns and meninges are noted.
 Sella region normal.
 No shift of midline structures detected.
 No lesion detected in CP angle and IAM regions.

Comment:


 Laboratory Services Division
Track No. : Collection Date: Delivery Date:
Patient ID : Gender :
Patient Name : Age :
Address : Phone :
Ref. by :

Biochemistry Report

Investigation Results Unit Ref. Values

CSF
Glucose (CSF)
Protein (CSF)
Invoice No : Invoice Date: Delivery Date: Report No :
Patient Name : Age : Gender :
Referred By : Ward : Bed :

Sample : LAB No. :

Tests : PAID

Test Result
PHYSICAL EXAMINATION
Volume
Color
Appearance
MICROSCOPIC EXAMINATION
Total Cell Count (WBC)
Morphology/Differential Count
Neutrophils
Lymphocytes
Gram Stain
Gram Stain
Z. N. Stain
CSF for AFB
 BIOCHEMISTRY REPORT
Invoice No : Invoice Date: Delivery Date: Report No :
Patient Name : Age : Gender :
Referred By : Ward : Bed :

Sample : LAB No. :

Tests : PAID

Test Result Reference Value

 Magnetic Resonance Imaging
ID No. : Date Delivered:
Patient Name : Age: Sex:
Refd. By :
Specimen :

MRI SCAN OF BRAIN

Clinical History: H/O Vertigo and Imbalance body.

Multiplanar multiecho MRI Scan of the Brain has been performed.

“REPORT DETAILS”
 Small hyperintense foci on T1 and hyperintense on T2/FLAIR images are noted in the
subcortical white matter of right frontal, right parietal, left temporal and centrum
semiovale of left parietal labes not showing restricted diffusion on DWI.


IMPRESSION:
 X-Ray Report
ID No. : Date:
Patient Name : Age: Sex:
Refd. By :
Specimen :

CHEST PA VIEW
TRACHEA :

DIAPHRAGM :

HEART :

LUNGS :

BONY THORAX :

IMPRESSION:
 Magnetic Resonance Imaging
ID No. : Date Delivered:
Patient Name : Age: Sex:
Refd. By :
Specimen :

MRI SCAN OF BRAIN

Clinical History: H/O Vertigo and Imbalance body.

Multiplanar multiecho MRI Scan of the Brain has been performed.

“REPORT DETAILS”
 Small hyperintense foci on T1 and hyperintense on T2/FLAIR images are noted in the
subcortical white matter of right frontal, right parietal, left temporal and centrum
semiovale of left parietal labes not showing restricted diffusion on DWI.
 Multiple small hyperintense foci on T2/FLAIR images are noted in the subcortieal
white matter of bilateral frontal and parietal lobes as well as in the cortex of both
temperal lobes as matter of bilateral frontal and parietal lobes as well as in the cortex
of both temporal lobes as well as in the pons and right brachium pontis not showing
restricted diffusion on DWL.
 The ventricular system, basal ganglia, thalami and cerebellum appear normal.
 The cranio-vertebral junction appears normal, Visualized intracranial vasculature
reveals normal flow voids, No extra-axial fluid collection or midline shift is seen.
 The pitutary gland and stalk appers normal. Supra-seller and para-seller region is
normal. The optic chiasma and hypothalamic region is unremarkable.
 Both CP angles are unremarkable.
 Visualized paranasal sinuses and the mastoid air cells appears unremarkable.

IMPRESSION:
 Reg ID :

Patient Name : Request No :

Lab No : Age :
Req. Date : Gender :
Req. Doctor : Location :
Received Date :
Technical Information

Specimen Tested :

Test Advised :

Method Used :

Instrument used :

Xpert MTB/RIF report

Result :

Mycobacterium tuberculosis (MTB) DNA :

Note :
Slip Date : Reg ID :
Slip ID : Specimen Receiving Date :
Patient Name : Report Delivery Date :
Ref By : Sex : Age :

Specimen Tested :

Incubation Temp :

Incubation Temp :

Result :
Invoice No : Invoice Date: Delivery Date: Report No :
Patient Name : Age : Gender :
Referred By : PAID

Sample : LAB No. :

Tests :
Test is carried out by automated analyzer: Atellica, Siemens Germany

Test Result Reference Value

CSF-Protein
Glucose
Invoice No : Invoice Date: Delivery Date: Report No :
Patient Name : Age : Gender :
Referred By : Ward : Bed :

Sample : LAB No. :

Tests : PAID

Test Result
PHYSICAL EXAMINATION
Volume
Color
Appearance
MICROSCOPIC EXAMINATION
Total Cell Count (WBC)
Morphology/Differential Count
Neutrophils
Lymphocytes
Gram Stain
Gram Stain
Z. N. Stain
CSF for AFB
Patient Name : Patient ID :
Sex : Age: Date :
Ref. Phys. :

CT Scan of Brain Without Contrast.

Technique : MSCT (64 Slices), Multiplanar images.

Findings:
Small hyperdense lesion (measuring about 15x12x16 mm) surrounded by moderate
perilesional oedema is noted at para sagittal convexity of left frontal lobe. Tiny
calcification is seen within the lesion. Tiny hypodense area is noted at lower part of
right capsulo-ganglionic region.
The brain stem and cerebellum appear normal.
The cerebral ventricles are of normal size and symmetrically arranged.
The interhemispheric fissure is centered on the midline.
No abnormalities are seen in internal capsule, corpus callosum or thalamus.
Sella and pitutary are normal. Parasellar structures are unremarkable.
There is no abnormality in the cerebellopontine angle areas on both sides.
The orbital contents are unremarkable.
There are no abnormalities in the valvarium.

Impression:
 RADIOLOGY SERVICES
MRD No. : RIS No. :
Patient Name : Age/Gender :
Referred By: : Bed No/Ward :
Bill Date : Scan Date :
Report Date : Report Status :

MRI or Brain
Technique: Pre & post contrast Multiple imaging sequences were realized in different
planes.

Clinical information:

 H/O PTB on 2017 and took anti-TB drugs for 6 months.

 H/O Seizure disorder for last 8 months.

Findings:
 Small discrete nodular enhancing T1W iso & T2W-FLAIR hypo to intermediate
signal intensity mass lesion measuring about 1.5x1.5 cm in size with profuse
perilesional edema is noted in right high frontal parafalx region. The lesion also
shows hypointense rim on T2W-FLAIR sequence. Mass effect is evident by mild
compression on adjacent brain parenchyma.
 The ventricles are of normal size and symmetrical with normal CSF flow.
 Pitutary, parasellar areas and optic chiasma appear normal in signal characteristics
and morphology.
 The basal ganglia, internal capsule, corpus callosum and thalami appear normal.
 The brain stem and CP angles are normal.
 Normal basal flow voids are seen.
 Visualized cranial nerves appear normal.

Impression :

