LABORATORY DEPARTMENT

NAME___________________________________________________ DATE _______________________

AGE___________SEX____________STATUS_____________ PHYSICIAN________________________
HEMATOLOGY NORMAL VALUES RESULTS

BLOOD TYPE

CROSS MATCHING

MAJOR

MINOR

BLEEDING TIME
Duke (1-3 min)

CLOTTING TIME
Lee White (5-15 min)

PLATELET COUNT
(150,000-400,000cu. mm)

A.F.B.

GRAM STAIN


HEMOGLOBIN (gms/dl) M- 13 16 / F- 12 15
HEMATOCRIT (%) M 39 - 48 / F- 36 45
WBC (/cu mm) 5,000 - 10,000
RBC (/cu mm) 4-5M

DIFFERENTIAL COUNT

NEUTROPHILS 40-60% %
LYMPHOCYTES 20-40% %
EOSINOPHILS 1-3% %
STAB CELLS 2-5% %
MONOCYTES 2-5% %
BASOPHILLS 0-1% %


__________________________ _____________________________
Medical Technologist Pathologist

PHIC Accredited Health Care Provider




LABORATORY DEPARTMENT

NAME___________________________________________________ DATE _______________________
AGE___________SEX____________STATUS_____________ PHYSICIAN________________________
HEMATOLOGY NORMAL VALUES RESULTS

BLOOD TYPE

CROSS MATCHING

MAJOR

MINOR

BLEEDING TIME
Duke (1-3 min)

CLOTTING TIME
Lee White (5-15 min)

PLATELET COUNT
(150,000-400,000cu. mm)

A.F.B.

GRAM STAIN



HEMOGLOBIN (gms/dl) M- 13 16 / F- 12 15
HEMATOCRIT (%) M 39 - 48 / F- 36 45
WBC (/cu mm) 5,000 - 10,000
RBC (/cu mm) 4-5M

DIFFERENTIAL COUNT

NEUTROPHILS 40-60% %
LYMPHOCYTES 20-40% %
EOSINOPHILS 1-3% %
STAB CELLS 2-5% %
MONOCYTES 2-5% %
BASOPHILLS 0-1% %


__________________________ _____________________________
Medical Technologist Pathologist

PHIC Accredited Health Care Provider