DINAS KESEHATAN KABUPATEN PATI DINAS KESEHATAN KABUPATEN PATI

PUSKESMAS GUNUNGWUNGKAL PUSKESMAS GUNUNGWUNGKAL

JL. RAYA GUNUNGWUNGKAL NO 56 TELP : (0295)4590113 EMAIL : puskgnwkl@gmail.com JL. RAYA GUNUNGWUNGKAL NO 56 TELP : (0295)4590113 EMAIL : puskgnwkl@gmail.com

PERMINTAAN PEMERIKSAAN LABORATORIUM PERMINTAAN PEMERIKSAAN LABORATORIUM

NAMA : NAMA :
UMUR : UMUR :
JENIS KELAMIN : JENIS KELAMIN :
ALAMAT : ALAMAT :
NO INDEKS : NO INDEKS :
NO JAMINAN : NO JAMINAN :

HEMATOLOGI KIMIA KLINIK URINE ANALISA HEMATOLOGI KIMIA KLINIK URINE ANALISA
Haemoglobin GDS Urin Rutin Haemoglobin GDS Urin Rutin
Leukosit GDP Protein urine Leukosit GDP Protein urine
Erytrosit GD2PP Erytrosit GD2PP
LED Jam 1 Umum FAECES LED Jam 1 Umum FAECES
LED Jam 2 Creatinin Faeces Rutin LED Jam 2 Creatinin Faeces Rutin
Trombosite Urid Acid Trombosite Urid Acid
Hitung Jenis Triglicerida IMMUNOSERROLOGY Hitung Jenis Triglicerida IMMUNOSERROLOGY
BT Cholesterol total HBSAG BT Cholesterol total HBSAG
CT LDL Anti HBSAG CT LDL Anti HBSAG
Golongan Darah HDL Widal Golongan Darah HDL Widal
Malaria SGOT BTA SPUTUM Malaria SGOT BTA SPUTUM
SGPT Test Kehamilan SGPT Test Kehamilan
Gama GT Lain lain Gama GT Lain lain
Protein Total Protein Total
Albumin Albumin
Globulin Globulin
Bilirubin total Bilirubin total

Gunungwungkal, 2019 Gunungwungkal, 2019

Pengirim Pengirim
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