On Center Lab Results - Point of Care Testing



On Center Lab Results – Point of Care Testing

Name: ______________________________________ ID#: ______________________________

DOB: _______________________________________ Date: _____________________________

BLOOD

Hemoglobin __________ g/dl and/or Hematocrit __________ %

URINE DIPSTICK

Color/appearance: __________________ Sugar: _____________________________

Specific gravity: _____________________ Ketones: ___________________________

pH: _______________________________ Leukocytes: ________________________

Albumin: __________________________ Nitrite: ____________________________

Blood: _____________________________ Menses: Yes No

URINE PREGNANCY TEST

HCG: Negative Positive LMP date: ___________________________

RAPID STREP TEST

Positive Negative Throat culture sent if Negative: Yes No

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