PEMERINTAH KOTA BANDAR LAMPUNG

DINAS KESEHATAN
UPT PUSKESMAS LABUHAN RATU
Jl. Soekarno-Hatta (By Pass) No. 15 A Labuhan Ratu, Telepon 081273481600
BANDAR LAMPUNG, 35143

HASIL PEMERIKSAAN LABORATORIUM

Dokter Pengirim : .................................................... Tgl. : .......................................
Ruang : .................................................... Jenis Spesimen : .......................................
No. Register : .................................................... Asal Bahan : .......................................
Nama : .................................................... Tgl / Jam Pemeriksaan : .......................................
Umur : .................................................... Tgl. Jam Penyerahan Hasil : .......................................
Jenis Kelamin : .......................................
L P
Alamat : ....................................................

HEMATOLOGI URINALIS
HB L 13,5 - 18,0 g/dl Warna
P 12,0 - 18 g/dl PH (,5 - 8,5)
L 4,4 - 5,5 jt/ul BJ (1016 - 1022)
Eritrosit
P 3,5 - 4,5 jt/ul Reduksi
Leukosit 5.000 - 10.000/ul Protein
Trombosit 150 - 400 x 10/ul Bilirubin
L 40 - 45 % Urobilinogen
Hematokrit
P 38 - 47 % Sedimen
Hitungan Jenis Leukosit - Entrosit (0 - 3) / LPB
- Neutrofil - Leukosit (1 - 5) / LPB
- Limphosit - Kristal
- Mixed - Silinder
- Epitel (+)

GDS 70 - 180 mg/dl

GDP 70 - 110 mg/dl
Choleaterol <200 mg/dl
Asam Urat L : 3,4 - 7,0 mg/dl
P : 2,4 - 5,7 mg/dl
PEMERIKSAAN SEROLOGI
Widal Titer O Titer H Lain-lain
SalmoNella Thyphy BTA
S. Parathyphy A Malaria
S. Parathyphy B HbsAg
S. Parathyphy C HIV
Tes Kehamilan Dengue Blod
Golongan Darah IgG
IgM
Sifilis

Pemeriksa,

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