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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