‫آزﻣﺎﯾﺷﮕﺎه ﻣرﮐزي ﭘﺎﺗوﺑﯾوﻟوژي‬

٠٢/٠٨/٢٠ :‫ﭘذﯾرش‬ 02-246978 :‫ﺷﻣﺎره‬

‫ ﺧﺎﻧم ﺷﯾرﯾن ﺳﺎﻋت‬:‫ﻧﺎم ﺑﯾﻣﺎر‬
١٣٩٩۶١٠ ‫ﺑﺎﯾﮕﺎﻧﻲ‬ ‫ ﺳﺎل‬٣٩ :‫ﺳن ﺑﯾﻣﺎر‬
‫دﮐﺗر اﺑواﻟﻔﺿل ﻋﺑداﻟﮫ زاده‬ :‫ﭘزﺷك‬

Hematology Approved By: Hemato2

Test Name Result Units Reference Range WBC Differential (%)

WBC 4.99 10^3/uL 4.4 - 11.0 Neutrophil 56.7

RBC 4.70 10^6/uL M : 4.1 - 5.7 Lymphocyte 33.3
F : 3.8 - 5.2 Monocyte 7.6

Hemoglobin 13.0 g/dL 11.7-15.5 F(18-44 yr) Eosinophil 1.8

Hematocrit 38.7 % 35-45 F(18-44 yr) Basophil 0.6
MCV 82.3 fL 81 - 100 (F:18y - 44y)
MCH 27.7 pg/cell 27 - 34 (F:18y - 44y)
MCHC 33.6 g/dl 32 - 36
RDW - CV 13.8 % 11.6 - 15
Platelets 231.0 10^3/uL 150 - 450
PDW 14.5 %
MPV 11.2 fL 8 - 12.7
-----------------------------------------
-----------------------------------------
Sedimentation Rate
ESR (1hr) 15 mm Up to 20 ( Female < 50y )

Signed By : Dr Z Alavi MD, APCP

٢٢۶۶۶۵۶١-٣:‫ﺗﻠﻔن‬-١٧‫ﭘﻼک‬-‫ﺧﯾﺎﺑﺎن ﻗرﻧﻲ‬-‫ﺑﺎﻻﺗر از ﺗﻘﺎطﻊ ﭼﻣران‬-(‫ﺧﯾﺎﺑﺎن وﻟﻲ ﻋﺻر)ﻋﺞ‬-‫ﺗﮭران‬: ‫آدرس‬

Website: www.path-lab.com email: info@path-lab.com
 ‫آزﻣﺎﯾﺷﮕﺎه ﻣرﮐزي ﭘﺎﺗوﺑﯾوﻟوژي‬ 2

٠٢/٠٨/٢٠ ‫ ﺳﺎل‬٣٩ ‫ﺷﯾرﯾن ﺳﺎﻋت‬ 02-246978

Continued...

Urine analysis Approved By: ‫ﺑﮫﺒﻮدي ﻓﺮ‬

Specimen Urine(02/08/30)
Macroscopic Microscopic

Color Yellow WBC /hpf 18-20

Appearance Cloudy RBC /hpf 0-1
Blood (RBC) # Negative Epithelial Cells Mod. squamous
Urobilinogen Negative Casts /lpf None
Bilirubin Negative Crystals None
Protein$ Negative Bacteria Mod.
Nitrite Negative Mucus Sl. amount
Ketones Negative
Glucose Negative
Reaction PH 5
Specific Gravity 1.020
Leukocytes # (+)
--
$Total protein with turbidimetric method: Negative

Note: #The minimum sensitivity of the strip is 5 – 10 erythrocytes

and 10 – 25 leukocytes / µl urine

Note: Interfering factors such as pH, drugs, proteases and

bacterial contamintation with test strip, can lead to
false negative or false positive results.

Blood Biochemistry Approved By: Bi-5

Test Result Units Reference Range

Glucose (Fasting) 86 mg/dl Adult : 74 -100

Hb.A1C 5.3 %Hb. 4.8-5.9
Urea 22 mg/dl Adult: 13 - 43
Creatinine 0.82 mg/dl Female(18-60 years): 0.50-1.00
eGFR (CKD-EPI 2021 Creatinine) 93 ml/min Normal GFR : 90-120
Mild decrease in GFR : 60-89
Moderate decrease in GFR : 30-59
Sever decrease in GFR : 15-29
Kidney failure : <15
Note: Limitations of eGFR include: Change of eGFR with variable
muscle mass, protein rich diet ,malnutrition, Traumatic
muscle damage, muscle atrophy or dystrophy, etc.
Equations based on the combination of Creatinine and
Cystatin C provide more accuracy and precision than
either alone, especially in elderly patients.

Signed By : Dr Z Alavi MD, APCP

٢٢۶۶۶۵۶١-٣:‫ﺗﻠﻔن‬-١٧‫ﭘﻼک‬-‫ﺧﯾﺎﺑﺎن ﻗرﻧﻲ‬-‫ﺑﺎﻻﺗر از ﺗﻘﺎطﻊ ﭼﻣران‬-(‫ﺧﯾﺎﺑﺎن وﻟﻲ ﻋﺻر)ﻋﺞ‬-‫ﺗﮭران‬: ‫آدرس‬

Website: www.path-lab.com email: info@path-lab.com
 ‫آزﻣﺎﯾﺷﮕﺎه ﻣرﮐزي ﭘﺎﺗوﺑﯾوﻟوژي‬ 3

٠٢/٠٨/٢٠ ‫ ﺳﺎل‬٣٩ ‫ﺷﯾرﯾن ﺳﺎﻋت‬ 02-246978

Continued...

Blood Biochemistry Approved By: Bi-5

Test Result Units Reference Range

Uric Acid 3.3 mg/dl Female : 2.4-5.7

Cholesterol 180 mg/dl Adult (Desirable): <200
Triglyceride 68 mg/ dl < 150
High Density Lipoprotein 69 mg/ dl Equal to or more than 40
Cholesterol/HDL 2.6 Ratio Low risk : <4.4
Average risk : 4.4-7.1
Moderate risk : 7.1-11.0
High risk : >11.0
Low Density Lipoprotein 105 mg/dl Optimal: <100
Near/Above optimal:100-129
Borderline high: 130-159
High: >160
LDL/HDL 1.5 Ratio Low risk : < 3.0
Moderate risk : 3.0-6.0
High risk : > 6.0
Calcium 9.4 mg/dL Adults: 8.6-10.2
Phosphate 4.3 mg/dl Adult : 2.5-4.5
Magnesium 2.1 mg/dL Adults: 1.6 - 2.6
Zinc 74 ug/dl Women: 70-114

Endocrinology Approved By: EN-4

Test Result Units Reference Range

T3 (CLIA) 1.04 ng/ml 0.6- 1.7 (Adult)

1st Trimester: 1.0 - 2.3
2nd Trimester: 1.29 -2.62
3rd Trimester: 1.3 - 2.62
T4 (CLIA) 7.42 ug/dl 4.5-12.5
1st Trimester: 7.3 - 14.8
2nd Trimester: 7.9 - 16.1
3rd Trimester: 5.55 - 12.9
TSH (ECLIA) 1.87 ulU/ml 0.27 - 4.2 (Adult)
0.17 - 8.9 (>50 years)
1st Trimester: 0.33 - 4.59
2nd Trimester:0.35 - 4.1
3rd Trimester: 0.21 - 3.15

Signed By : Dr Z Alavi MD, APCP

٢٢۶۶۶۵۶١-٣:‫ﺗﻠﻔن‬-١٧‫ﭘﻼک‬-‫ﺧﯾﺎﺑﺎن ﻗرﻧﻲ‬-‫ﺑﺎﻻﺗر از ﺗﻘﺎطﻊ ﭼﻣران‬-(‫ﺧﯾﺎﺑﺎن وﻟﻲ ﻋﺻر)ﻋﺞ‬-‫ﺗﮭران‬: ‫آدرس‬

Website: www.path-lab.com email: info@path-lab.com
 ‫آزﻣﺎﯾﺷﮕﺎه ﻣرﮐزي ﭘﺎﺗوﺑﯾوﻟوژي‬ 4

٠٢/٠٨/٢٠ ‫ ﺳﺎل‬٣٩ ‫ﺷﯾرﯾن ﺳﺎﻋت‬ 02-246978

Continued...

Special Biochemistry Approved By: EN-4

Test Result Units Reference Range

Ferritin (CLIA) 28.8 ng/ml Female<40Y : 5.0-148

Vitamin B12 (CLIA) 253.0 pg/ml 187-883
25(OH)Vit.D Total (CLIA) 27.2 ng/ml Deficiency :<10
Insufficiency :10-30
Sufficiency :30-100
Toxicity :>100
Signed By : Dr Z Alavi MD, APCP

-Neisseria gonorrhoeae- Herpes simplex 1,2-Ureaplasma- Mycoplasma- Chlamydia ‫ ﻋﺎﻣل‬٩ ‫ ﺑﺎ ﺷﻧﺎﺳﺎﯾﻲ‬STD Panel ،‫در اﯾن ﻣرﮐز‬
‫ اﻧﺟﺎم ﻣﻲ ﮔردد‬PCR ‫ ﺑﮫ ﺻورت ھﻣزﻣﺎن ﺑﮫ روش‬Trichomanas ‫ و‬Treponema-Heamophilus

٢٢۶۶۶۵۶١-٣:‫ﺗﻠﻔن‬-١٧‫ﭘﻼک‬-‫ﺧﯾﺎﺑﺎن ﻗرﻧﻲ‬-‫ﺑﺎﻻﺗر از ﺗﻘﺎطﻊ ﭼﻣران‬-(‫ﺧﯾﺎﺑﺎن وﻟﻲ ﻋﺻر)ﻋﺞ‬-‫ﺗﮭران‬: ‫آدرس‬

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