Machine Translated by Google

Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C Kebayoran

Lama South Jakarta Tel. 021-7227728
Fax 021-7291711
Contact Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,

Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

Examination Name Results Unit Reference Value Information

HEMATOLOGY

Complete Hematology
Hemoglobin 15.8 13.2 - 17.3 g/dL Male, Adult
Hematocrit 45.8 40 - 52 % Male, Adult
Erythrocyte 5.37 4.4 - 5.9 10^6/uL Male, Adult
MC values
- MCV 85.3 80 - 100 fL Mature
- MCH 29.4 26 - 34 pg 32 Mature
- MHC 34.5 - 36 g/dL 5 years - Adult

RDW-CV 12.5 11.5 - 14.5 % Mature

*
Platelets 128 150 - 440 10^3/uL Mature
Leukocytes 4.7 3.8 - 10.6 10^3/uL Male, Adult

Count the Types of Leukocytes

- Basophils 0.2 0.0 - 1.0 %

*
- Eosinophils 1.7 2.0 - 4.0 % Mature
- Neutrophils 68.4 50.0 - 70.0 % Mature
*
- Lymphocytes 24.6 25.0 - 40.0 % Mature
- Monocytes 5.1 2.0 - 8.0 % Mature

Absolute Leukocyte Count

- Absolute Basophil 0.01 0.01 - 0.09 10^3/uL
- Absolute Eosinophils 0.08 0.04 - 0.34 10^3/uL
- Absolute Neutrophils 3.20 1.99 - 6.34 10^3/uL
*
- Absolute Lymphocytes 1.15 1.16 - 3.41 10^3/uL
*
- Absolute Monocyte 0.24 0.28 - 0.78 10^3/uL
Neutrophil/Lymphocyte Ratio 2.8
LEDs 5 0 - 15mm/hour Male, < 50 years

Hal : 1 / 8 @ 11-24-2022 10:14:55 by Prodia

The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta
Interpretation of results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it is
advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system
Machine Translated by Google
Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C
Kebayoran Lama South Jakarta Tel.
021-7227728 Fax
021-7291711
Contact Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,
Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

examiner,

Hal : 2 / 8 @ 11-24-2022 10:14:56 by Prodia

The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta The
interpretation of the results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it
is advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system
Machine Translated by Google
Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C
Kebayoran Lama South Jakarta Tel.
021-7227728 Fax
021-7291711 Contact
Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,

Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

Examination Name Results Unit Reference Value Information

HEMATOLOGY

Blood group A
Rhesus Positive

Prothrombin time + INR

- Prothrombin time 13.6 11.5 - 15.0 seconds
-INR 1.06
APTT 38.7 * 28.0 - 38.6 seconds
CHEMICAL

GOT 19 < 33 U/L Male, > 17 years

GPT 20 < 50 U/L Male, Adult
Fasting Glucose 85 < 100 mg/dL Mature, Consensus
Diabetes Control
Mellitus 2011

Glucose 2 hours PP 124 < 140 mg/dL Mature, Consensus

Diabetes Control
Mellitus 2011

HbA1c (NGSP) 5.1 < 5.7 % Method used:

Ion Exchange HPLC, and
has been standardized
NGSP (National
Glycohemoglobin
Standardization
Program).
Diabetes Mellitus control
target: < 7% (individual)

Cut off Diagnosis : -

Diabetes : >=6.5% -
Prediabetes : 5.7 - 6.4 %

HbA1c (IFCC) 32 < 39mmol/mol Control goals

DM : < 53 mmol/mol
Hal : 3 / 8 @ 11-24-2022 10:14:56 by Prodia
The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta The
interpretation of the results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it
is advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system
Machine Translated by Google
Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C
Kebayoran Lama South Jakarta Tel.
021-7227728 Fax
021-7291711 Contact
Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,

Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

Examination Name Results Unit Reference Value Description

(individual)
Diagnostic cut-off :
- Diabetes : >=48
mmol/mol
- Prediabetes: 39 - 46
mmol/mol
*
Total Cholesterol 206 < 200 mg/dL Adult, Desired Lipid Consensus
<200 200 - 239 high limit >=
240 high

142 *
Direct LDL Cholesterol < 100 mg/dL Adults, Lipid Consensus
< 100 : Optimal
100 - 129 : Approaching
Optimal
130 - 159 : High limit
160 - 189 : High
>= 190 : Very high
HDL Cholesterol 51 >= 40 mg/dL < Adults, Lipid Consensus
*
Triglycerides 152 150 mg/dL Adults, Lipid Consensus
< 150 Normal
150 - 199 High Limit
200 - 499 High
>= 500 Very High
Ratio Chol.Total/Chol. HDL 4 <5
Urea N 7 6 - 20 mg/dL 13 18 - 60 years
Urea 15 - 43 mg/dL 0.70 18 - 60 years
Creatinine 0.91 - 1.20 mg/dL Male, Adult
eLFG (CKD-EPI) 113 mL/min/1.73m² • >= 90 mL/min/1.73 m²
normal conditions
• 60 – 89 mL/min/1.73 m²
for >= 3 months
indicative of mildly impaired
renal function
Hal : 4 / 8 @ 11-24-2022 10:14:56 by Prodia
The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta The
interpretation of the results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it
is advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system
Machine Translated by Google
Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C
Kebayoran Lama South Jakarta Tel.
021-7227728 Fax
021-7291711 Contact
Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,

Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

Examination Name Results Unit Reference Value Remarks • <

60 mL/min/1.73 m² for >=
3 months indicates chronic
kidney disease Male,
Adult
Gout 5 < 7 mg/dL
IMMUNO SEROLOGY

HBsAg# Non Reactive Non Reactive Method: CMIA

Anti-HCV
- Anti-HCV # Non Reactive Non Reactive Method: CMIA
- Impression Recommended doing
re-examination of Anti-HCV
two months later
if the patient has a
risk of being infected
with hepatitis C virus in
the last 6 months.
Examination results
need to be correlated
with clinical conditions
and other
examinations
Anti-CMV IgG# Positive Negative AU/mL Method : CMIA
Cons :351.1 Concentration :
< 6.0 AU/mL : Negative
>= 6.0 AU/mL : Positive

Anti-CMV IgM# Negative Negative Method: CMIA

Impression Past exposure to or infection with CMV. Suggestion: anti-CMV IgG avidity check
ENDOCRINOLOGY
TSHs # 1,442 0.350 - 4.940 uIU/mL Mature

T3 (Total) # 1.08 0.58 - 1.59 ng/mL Male, > 20 years

T4 (Total) # 7.83 4.87 - 11.72 ug/dL Adult, > 20 years

Hal : 5 / 8 @ 11-24-2022 10:14:56 by Prodia

The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta
Interpretation of results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it is
advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system
Machine Translated by Google
Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C
Kebayoran Lama South Jakarta Tel.
021-7227728 Fax
021-7291711
Contact Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,
Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

Specimen Collection Time:

Frozen Blood - 23/11/2022 10:14
Frozen Blood 2 Hours PP - 23/11/2022 13:30
Frozen Blood - 23/11/2022 10:14

#: Examination done at Prodia Cab. Jakarta (Prodia Kramat). person in charge dr. Asnawi, Sp. PK

Authorized By

Mubayinah
Quality Validators

Hal : 6 / 8 @ 11-24-2022 10:14:56 by Prodia

The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta The
interpretation of the results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it
is advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system
Machine Translated by Google
Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C
Kebayoran Lama South Jakarta Tel.
021-7227728 Fax
021-7291711
Contact Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,
Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

Examination Name Results Unit

NON LABORATORY
EKG
Findings -

Conclusion Normal
Suggestion -

examiner,

Hal : 7 / 8 @ 11-24-2022 10:14:56 by Prodia

The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta The
interpretation of the results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it
is advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system
 Machine Translated by Google
Artery Pondok Indah, Jl. Sultan Iskandar Muda No. 31 C Kebayoran
Lama South Jakarta Tel. 021-7227728
Fax 021-7291711
Contact Prodia.1500830

Person in Charge: Dr.

Demak L. Tobing, Sp. PK

Doctor : Dr. Eka Kartika

Address : Prodia Artery Jl. Sultan Iskandar Muda No. 31 C,

Kebayoran Lama, Pondok Indah Artery

No. Lab/Date. : 2211230035 / 23-11-2022 Gender : Man

Customer ID : 9999221107437 Date of Birth/Age : 26-01-1993 / 29 Years 9 Months

Patient's name : Mr. Johar manic Phone :

Address : kp. Manjangan cage 004/003 sukajaya

saira
: Lebak Kab.

Examination Name Results

NON LABORATORY

Thorax X-ray • No
X-ray L 134
• Findings PULMO: No infiltrates/electasis/consolidation or SOL. Bronchovascular markings in both lungs appear normal.

PLEURA : No pleural thickening/effusion or pneumothorax was seen.

The contours of the diaphragm appear normal

HEART : Normal heart size and configuration, CTR <50%

MEDIASTINUM : No distortion of the contour of the mediastinum, no elongation or atherosclerotic calcification

in the aorta. No mediastinal shift is seen.

Bony thorax and chest wall soft tissue showed no abnormalities, no fractures or destructive lesions were seen.

• Impressions - Cor-mediastinum within normal limits

- No infiltrates, electasis or SOL were seen in both lungs
• Suggestion -

examiner,

Hal : 8 / 8 @ 11-24-2022 10:14:56 by Prodia

The result is a number using the decimal system with dot separator.
The # * indicates a value above or below a reference value.
sign indicates that the examination was carried out at Prodia Clinical Laboratory Jl. Kramat Raya No. 150, Jakarta
Interpretation of results is only done by doctors/ clinicians. In order to maintain the confidentiality of your results, it is
advisable not to upload them to social media and other public media

This Examination Result Document does not require a wet signature because it has been validated and printed from the laboratory information system

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