DINAS KESEHATAN DINAS KESEHA

UPTD PUSKESMAS CIBATU UPTD PUSKESMA

JL. KI HAJAR DEWANTARA NO.10 CIBATU - GARUT JL. KI HAJAR DEWANTARA NO.10

FORMULIR HASIL LABORATORIUM FORMULIR HASIL LAB

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Umur :.................................. Umur :..................................
Alamat :.................................. Alamat :..................................

HEMATOLOGI HASIL ANGKA NORMAL URINALISIS HASIL NILAI NORMAL HEMATOLOGI HASIL ANGKA NORMAL
HB gr/dl l.13-18 p.12-16 WARNA URIN HB gr/dl l.13-18 p.12-16
LEKOSIT mm3 4000-10000/mm3 PH LEKOSIT mm3 4000-10000/mm3
ERITROSIT l.5-6 juta p.4-5 juta KETON ERITROSIT l.5-6 juta p.4-5 juta
LED l.0-18 p.0-15 PROTEIN LED l.0-18 p.0-15
BILIRUBIN
TROMBOSIT mm3 150000-450000/mm3 REDUKSI TROMBOSIT mm3 150000-450000/mm3
HEMATOKRIT % UROBILIN HEMATOKRIT %
DIEF COUNT DIEF COUNT
BASIOFIL % SEDIMEN BASIOFIL %
EOSINOFIL % LEKOCIT LPB EOSINOFIL %
BATANG % ERITROCIT LPK BATANG %
SEGHMEN % EPITEL LPK SEGHMEN %
LIMPOSIT % SEL KANDUNG KENCING LPK LIMPOSIT %
MONOCIT % SEL GINJAL LPK MONOCIT %
KRISTAL LPK
KIMIA KLINIK KIMIA KLINIK
GULA DARAH PUASA mg/dl 70-110 mg/dl DLL GULA DARAH PUASA mg/dl 70-110 mg/dl
2 JAM PP mg/dl <170 mg/dl 2 JAM PP mg/dl <170 mg/dl
GULA SEWAKTU mg/dl 150 mg/dl TES KEHAMILAN GULA SEWAKTU mg/dl 150 mg/dl
KOLESTEROL TOTAL mg/dl 150-210 mg/df KOLESTEROL TOTAL mg/dl 150-210 mg/df
KOLESTEROL HDL mg/dl 40-70 TES NARKOBA KOLESTEROL HDL mg/dl <100
KOLESTEROL LDL mg/dl <130 KOLESTEROL LDL mg/dl >40
ASAM URAT mg/dl p.3,4-5,7 L.3,4-7,0 MIKROBIOLOGI ASAM URAT mg/dl p.3,4-5,7 L.3,4-7,0
SGOT u/i 0-25 U/I BTA SGOT u/i 0-25 U/I
SGPT u/i 0-25 U/I MIKOTEK TB SGPT u/i 0-25 U/I
BILIRUBIN TOTAL mg/dl 0,2-1 mg/dl GO BILIRUBIN TOTAL mg/dl 0,2-1 mg/dl
BIL DIRECT mg/dl 0,4 mg/dl BIL DIRECT mg/dl 0,4 mg/dl
BIL INDIRECT mg/dl <1 mg/dl0,6-1,1 FECES RUTIN BIL INDIRECT mg/dl <1 mg/dl0,6-1,1
KREATININ mg/dl 0,6-1,1 KREATININ mg/dl 0,6-1,1
URIUM mg/dl <50 URIUM mg/dl <50
TRIGLISERID mg/dl <150 mg/dl TRIGLISERID mg/dl <150 mg/dl
PROTEIN TOTAL mg/dl 6-8 g/dl SEROLOGI PROTEIN TOTAL mg/dl 6-8 g/dl
ALBUMIN mgdl 3,5-5,5 g/dl GOLONGAN DARAH ALBUMIN mgdl 3,5-5,5 g/dl
WIDAL
SL TPH
SL TPO
SL PARATYPI CO
SL PARATYPI AH

HBSAG
HIV

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Petugas
 ESEHATAN
SMAS CIBATU
ARA NO.10 CIBATU - GARUT

L LABORATORIUM

URINALISIS HASIL NILAI NORMAL

WARNA URIN
PH
KETON
PROTEIN
BILIRUBIN
REDUKSI
UROBILIN

SEDIMEN
LEKOCIT LPB
ERITROCIT LPK
EPITEL LPK
SEL KANDUNG KENCING LPK
SEL GINJAL LPK
KRISTAL LPK

DLL

TES KEHAMILAN

TES NARKOBA

MIKROBIOLOGI
BTA
MIKOTEK TB
GO

FECES RUTIN
SEROLOGI
GOLONGAN DARAH
WIDAL
SL TPH
SL TPO
SL PARATYPI CO
SL PARATYPI AH

HBSAG

Cibatu, ...................................
Petugas