7543473905

7543473905



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Chart No.--


Clinic No___


NEW YORK POST-GRADUATE ME DI CAL SCUOOL & UOSP1TAL REPOfiTON EXAMINATION OF BLOOD

--------Dr.    ----------------Specimcn takcn

____Room ..JjLŚL___________________Report macic

Clinic



Marne ~~

Erythrocytcs —

Hemoglobin    .....Grams per 100 cc.

Color Indcx___________


per cu. mm


Reticulocyt es-

Platclcts---

Blccding timc__

Coagulation timc Parasites_____


~pcr cu


%


mm:


_____ Age.....(z> -I.......-.....

Lcucocytcs    ____________

Polymorphonuclcar neutrophiles — Polymorphonuclcar eosinophiles ....

Polymorphonuclcar basophiles___

Lymphocytes ~

Monocytcs —



—per cu. mm

-5 7-

........£.

t a


__


Mctamyclocytes Myclocylcs---


.N.......!


E    B

• .................


Morphology of red cclls:

Anisocytosis______

Microcytosis_____________

Macrocytosis_______

Poikilocytosis__________Stippling

Avcragc diameter of red cclls____

REMARKS:


Achromia___

...Polychromasia


Prcmyclocytcs DilTcrcntial count of Normoblasts Megaloblasts Mycloblasts ..


___whitc    cclls

-per 100 whitc cclls ...per 100 whitc cclls ~pcr 100 whitc cclls


micra


Form 0 10M 10—Cl II. S. P.


n Lab. No

Examincd Juow,


{Jz-alSl- JL




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