Pemeriksaan Laboratorium

Nama : No. RM :Tanggal Lahir : DPJP :Diagnosa :

Pemeriksaan Lab

Hasil

WBC

RBC

HGB

HCT

PLT

LED I/II / / / / / / / / / / / /

PT

INR

APTT

GDS

Ureum

Creatinin

SGOT

SGPT

Alkali Fosfatase

Protein Total

Albumin

Globulin

Bilirubin Total

Bilirubin Direk

Gamma GT

Asam Urat

CEA

Ca-125

Natrium

Kalium

Klorida

Fe

TiBC

Ferritin

Coomb’s Test

Sel LE

HbA1c

HbsAg

Anti-HCV

Foto thorax

USG Abdomen

CT-scan Abdomen