UNIVERSITY OF MISSOURI HOSPITALS LABORATORY

BLOOD EXAMINATION

pe ~ ee Room No.
Name of Patient: 7 hp ee Physician: Loe Case No.

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35,000 woe [oO 177 v

Time

 

 

 

 

Count number

 

Coagulation time

 

Bleeding time

 

 

Leucocytes per c mm.
: —

 

Differential Count

 

P. M. Neutrophils

 

 

P. M. Eosinophils

 

P. M. Basophils

 

Large Mononuclears

 

Lymphocytes

 

 

Lymphoblasts

 

Myelocytes

 

Myeloblasts

 

Immature P. M. Ns.

 

 

Unclassified

 

Erythrocytes per c mm,

 

Hemoglobin (Method)

 

Color index

 

 

Anisocytosis

 

Poikilocytosis

 

Polychromatophilia

 

Granular degeneration

 

 

Nucleated forms

 

 

 

 

 

 

 

 

Reticulocytes

 

Blood Donor Group

 

Plasmodium Malariae

 

 

Wassermann

 

Widal

 

Culture

 

Blood sugar

 

 

Blood urea

 

Blood N. P. N.

 

Icterus Index

55% Remarks: “Ye

Leucocytes per c mm Neutrophils ExaMitied bY tosses conn ct oe aekd ee nade le eo ee

 

 

 

 

 

 

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