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Laboratory and tool inspections

The general analysis of a blood

Date

Hb

Er

The Central Committee

L

Е

Bs

J

П

С

Мм

Lf

SOYA

Group of a blood _______________ Rh _____________ Reaction Wasserman’s______________________

Blood sugar ________________________________________________________________________________

________________________________________________________________________________________________

Bilirubin:

The general{common} ________________________ conjugated ___________________________ non-conjugated __________________________

__________________________________________ NUCLEAR HEATING PLANT ______________________________________

Urea _________________________________________________________________________________

Creatinine ________________________________________________________________________________

Electrolytes ______________________________________________________________________________

________________________________________________________________________________________

Protein______________________________________________________________________________

________________________________________________________________________________

Coagulogram ____________________________________________________________________________

Alkaline phosphotase _____________________________________________________________________

Amylase urine____________________________________________________________________________

Urine sugar______________________________________________________________________________

The general analysis of urine

Date

Color

Transparency

Ph

specific gravity

Sugar

Protein

Epithelial

Erythrocytes

Leucocytes

Salts

The analysis of a feces on eggs a worm _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Other analyses ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Roenthgenograhy, Roenthgenoscopy lungs ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Electrocardiogram ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Other inspections ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Consultations of experts ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Data of pathological data with an explanation of the diagnosis ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The clinical diagnosis

The basic ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Complications ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Accompanying _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Choice of a method of treatment

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Signature _________________________________