OUTPATIENT LABORATRY REQUISITION
Testosterone Total T3, Free T3, Total Free T4 Free T4 Thyroperoxidase Antibody (TPO Ab) TSH, Sensitive Thyroid Testing Total Protein Transferrin Triglycerides - Fast 12 Hr Uric Acid ... (Enter ICD-9 code and/or sign, symptom or complaint in your medical record for tests ordered) ... ................
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