RAPHA SPECIALIST HOSPITAL

25,First Avenue (Between Total Filling Station And Ajis Hotel)

Federal Housing Authority, Airport Road, Lugbe-Abuja.
Tl: 08027607175, 08036915724
Email: raconspeclinics@gmail.com DATE:
HEAMATOLOGY AND SEROLOGY
SURNAME FIRST NAME AGE SEX WARD CLINIC
NHIS NO:

TEL:
CLINICAL DIAGNOSIS: SIGNATURE

Date: .....................................................
Genotype AA AS SS Others
FOOL BLOOD COUNT Blood Group:
Total RBC ….................................... X10 g/L (3.50 - 5.50)
12
Cross Matching: ____________________________________
Total Platelet ….................................... X10 9g/L (150-400) __________________________________________________
Total WBC ….................................... X10 9g/L (4.0-11.0) __________________________________________________
PCV ….................................... % (37 - 50) __________________________________________________
MB ….................................... g/dl (11 0 - 16.0) Bleeding Time ….......................................... Min (1-6 min)
MCH ….................................... Pg (27.0-34.0) PT …............................................................ SEC (11 - 18 SEC)
MCHC ….................................... g/L (320-360-50) APPT …........................................................ SEC (30 - 40 SEC)
MCV ….................................... fl (35-56) Cluster Differentation
Differential CD4 ............................................................Cells/L
Neutorphil ….................................... % (50-70) CD3 ........................................................... Cells/L
Lymphocyte …................................... % (20-40) CD4 / CD8 ................................................. Cells/L
Monocyte …...................................... % (3.0-9.0) SEROLOGY
Eosinophil …....................................... % (< 6) HIV Screening ….............................................
Basophil …......................................... % (< 2) HIV Confirmation …........................................
Hbs Ag ….....................................................
Comment HCV ….....................................................
Sickle Cell Hypochromasia VDRL ….....................................................
Hyperchromasia Poikilocytosis PT ….....................................................
Ovalocytosis Anisocytosis WIDAL REACTION
Macrocytosis Microcytosis Antigen Titre
Polychromasia Nucleated RBC O H
S. Tiphi
S. Paratyphi A
ESR: __________________________mm/hr
{<20mm/Hr} S. Paratyphi B
S. Paratyphi C
significant Titre 1:80

MP:

Med Lab. Significant Signature: