Format Pemeriksaan Penunjang.docx

Nama Pasien:

Tanggal Pemeriksaan DARAH LENGKAP Leukosit (3,8-10,6) Basofil (0-1)% Neutrophil (39,3-73,7) Limfosit (25-40)% Eosinofil ( 2-4)% Monosit (2-8)% Eritrosit (4,40-5,90) Haemoglobin (13,2-17,3) g/dL Hematokrit (40-52)% Indeks Eritrosit MCV (80-100)fL MCH (26,0-34,0) Pg MCHC (32-36)% RDW-CV (11,5-14,5 Trombosit (150-440) MPV (7,2-11,1)fL Serum Elektrolit Natrium (135-147) Kalium (3,5-5,0) Klorida ( 96-105) Fungsi Hepar SGOT (<50) SPGT (<50) Fungsi Ginjal BUN (10-20) Kreatinin (0,62-1,10)

Ruang :

Keterangan

Nama Pasien:

Tanggal Pemeriksaan

Ruangan;

Pemeriksaan Urine lengkap warna urine Kejernihan urine pH urine Specific gravity Nitrit urine Protein urine Glukosa urine Keton urine Urobilinogen urine Lekosit urine Bilirubin urine Blood Mikroskopis urine Eritrosit Lekosit Sel epitel Kristal Bakteri Jamur Parasite Cast Lain-lain

Hasil

Satuan

mg/dL

plp plp plp

Nilai Rujukan Kuning Jernih 5–8 1,005 – 1,030 Negative Negative Negative Negative 3,2 – 16 Negative Negative Negative 0–1 0–1 0–1 Negative Negative Negative Negative Negative Negative

Pemeriksaan Urine lengkap warna urine Kejernihan urine pH urine Specific gravity Nitrit urine Protein urine Glukosa urine Keton urine Urobilinogen urine Lekosit urine Bilirubin urine Blood Mikroskopis urine Eritrosit Lekosit Sel epitel Kristal Bakteri Jamur Parasite Cast Lain-lain

Hasil

Satuan

mg/dL

plp plp plp

Nilai Rujukan Kuning Jernih 5–8 1,005 – 1,030 Negative Negative Negative Negative 3,2 – 16 Negative Negative Negative 0–1 0–1 0–1 Negative Negative Negative Negative Negative Negative