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CBC Form New 2021

This document contains the results of a complete blood count (CBC) test from the laboratory of Laguna Provincial Hospital. The test results include white blood cell count, percentages of granulocytes, lymphocytes, monocytes, eosinophils and basophils. It also includes measurements of red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red blood cell distribution width, platelet count, mean platelet volume, clotting time and bleeding time. Reference ranges are provided for each test. Patient identifying information and the medical professionals who analyzed and reviewed the results are listed at the bottom.

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309 views1 page

CBC Form New 2021

This document contains the results of a complete blood count (CBC) test from the laboratory of Laguna Provincial Hospital. The test results include white blood cell count, percentages of granulocytes, lymphocytes, monocytes, eosinophils and basophils. It also includes measurements of red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red blood cell distribution width, platelet count, mean platelet volume, clotting time and bleeding time. Reference ranges are provided for each test. Patient identifying information and the medical professionals who analyzed and reviewed the results are listed at the bottom.

Uploaded by

GCMDH
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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- LAGUNA PROVINCIAL HOSPITAL

+ GEN. CAILLES MEMORIAL DISTRICT HOSPITAL LABORATORY RESULT


CBC
100 Tavera Street, Pakil, Laguna 4017 ● (049) 557 0213 to 15

ACCREDITED HEALTHCARE PROVIDER


TEST RESULT UNIT REFERENCE TEST RESULT UNIT REFERENCE
2wk-2mos 5.0-21.0
3mos-5mos 6.0-18.0 Mean Corpuscular
fL
6-mos-6yr 6.0-15.0 Volume (MCV) 79.2 - 91.2
White Blood Cell 10 /L
9
7yr-12yr 4.5-13.5
Count (WBC)
ADULT 5.0-10.0
Mean Corpuscular
39 - 59 Hemoglobin (MCH)
Granulocyte % pg 28.5 - 32.5
Mean Corpuscular
Lymphocyte % 34 - 54 Hemoglobin g/L 328 - 388
Concentration (MCHC)
RBC Distribution
Monocyte % 3-9 % 7.2 - 17.2
Width (RDW)
Eosinophil % 1- 3
140 - 440
Platelet (PLT) 109/L
Basophil % 0-1
Red Blood Cell Mean Platelet Volume
1012/L 3.93 - 4.33 fL 5.3 - 8.3
(RBC) (MPV)
M 120 - 160
Hemoglobin (Hgb) g/L Clotting Time mins/secs 2-5
F 110 - 140
% M 40 - 54
Hematocrit (Hct) Bleeding Time mins/secs 2-4
F 37 - 47

BLOOD TYPE:___________Rh:_____________

PATIENT’S NAME: ___________________________________________ DATE/TIME: _______________________


BIRTHDATE: __________________ AGE/GENDER: ___________ CASE NUMBER: ____________________

IMELDA MARIE FREMIELLE F. PALACOL, MD, FPSP ________________________________


Pathologist Medical Technologist
PRC License Number 0080292

LAGUNA PROVINCIAL HOSPITAL


+ GEN. CAILLES MEMORIAL DISTRICT HOSPITAL
LABORATORY RESULT
CBC
100 Tavera Street, Pakil, Laguna 4017 ● (049) 557 0213 to 15

ACCREDITED HEALTHCARE PROVIDER


TEST RESULT UNIT REFERENCE TEST RESULT UNIT REFERENCE
2wk-2mos 5.0-21.0
3mos-5mos 6.0-18.0 Mean Corpuscular
fL
9 6-mos-6yr 6.0-15.0 Volume (MCV) 79.2 - 91.2
White Blood Cell 10 /L
7yr-12yr 4.5-13.5
Count (WBC)
ADULT 5.0-10.0
Mean Corpuscular
39 - 59 Hemoglobin (MCH)
Granulocyte % pg 28.5 - 32.5
Mean Corpuscular
Lymphocyte % 34 - 54 Hemoglobin g/L 328 - 388
Concentration (MCHC)
RBC Distribution
Monocyte % 3-9 % 7.2 - 17.2
Width (RDW)
Eosinophil % 1- 3
140 - 440
Platelet (PLT) 109/L
Basophil % 0-1
Red Blood Cell Mean Platelet Volume
1012/L 3.93 - 4.33 fL 5.3 - 8.3
(RBC) (MPV)
M 120 - 160
Hemoglobin (Hgb) g/L Clotting Time mins/secs 2-5
F 110 - 140
% M 40 - 54
Hematocrit (Hct) Bleeding Time mins/secs 2-4
F 37 - 47

BLOOD TYPE:___________Rh:_____________

PATIENT’S NAME: ___________________________________________ DATE/TIME: _______________________


BIRTHDATE: __________________ AGE/GENDER: ___________ CASE NUMBER: ____________________

IMELDA MARIE FREMIELLE F. PALACOL, MD, FPSP _________________________________


Pathologist Medical Technologist
PRC License Number 0080292

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