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LABORATORIUM

PUSKESMAS BAKUNG
JL. KAMBOJA NO 1 BAKUNG TBB BANDAR LAMPUNG

PERMOHONAN PEMERIKSAAN LABORATORIUM

Nama :......................................................................
Umur :......................................................................
Alamat :......................................................................
Dokter pengirim :......................................................................
No. BPJS/PPKM :......................................................................
No. Rekam medis :......................................................................
Tanggal :......................................................................

HEMATOLOGI
 Hemoglobin
 Erytrosit
 Lekosit
 Thrombosit
 Gol. Darah / RH

KIMIA DARAH
 Cholesterol
 Glukosa puasa
 G2 jam PP
 G sewaktu
 Unc Acid

URINALISASI
 Warna
 PH
 BJ
 Protein
 Reduksi
 Urobilin
 Bilirubin
 Lekosit
 Eritrosit

PARASITOLOGI
 Malaria

BAKTERIOLOGI
 BTA

SEROLOGI
 PP . Test
 Hbs AG
 Widal
 Igg/IgM Dengue

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