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Fecalysis Form New 2021

This document is a fecalysis laboratory report from Laguna Provincial Hospital. It includes the patient's identifying information and test results from both macroscopic and microscopic examination of a fecal sample. The microscopic examination notes the presence or absence of parasites, bacteria, and other elements found per high powered field or liters of processed feces. The report is signed by the pathologist and medical technologist in charge of the case.

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973 views1 page

Fecalysis Form New 2021

This document is a fecalysis laboratory report from Laguna Provincial Hospital. It includes the patient's identifying information and test results from both macroscopic and microscopic examination of a fecal sample. The microscopic examination notes the presence or absence of parasites, bacteria, and other elements found per high powered field or liters of processed feces. The report is signed by the pathologist and medical technologist in charge of the case.

Uploaded by

GCMDH
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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LAGUNA PROVINCIAL HOSPITAL LABORATORY RESULT

+ GEN. CAILLES MEMORIAL DISTRICT HOSPITAL


100 Tavera Street, Pakil, Laguna 4017 ● (049) 557 0213 to 15
FECALYSIS
ACCREDITED HEALTHCARE PROVIDER

MACROSCOPIC EXAMINATION: MICROSCOPIC EXAMINATION


PATIENT’S NAME: _________________________________________ Entamoeba histolytica:
Color DATE/TIME: _______________________
Consistency
BIRTHDATE: __________________ AGE/GENDER: ___________ Cyst: CASE NUMBER: ___________________
/hpf
CHEMICAL TEST (OCCULT BLOOD) /hpf
Trophozoites:
 POSITIVE E. coli: /hpf
 NEGATIVE E. nana: /hpf
MICROSCOPIC EXAMINATION: Trichomonas: /hpf
Ascaris lumbricoides: /lpf Others:
Trichuris trichiura: /lpf Pus cells: /hpf
Ancylostoma duodenale /lpf Red blood cells: /hpf
(hookworm):
Strongyloides /lpf Bacteria: /hpf
stercoralis:
Others/Comments: Yeast cells: /hpf
Fat Globules: /hpf
Starch Granules: /hpf
Others:

IMELDA MARIE FREMIELLE F. PALACOL, MD, FPSP __________________________


Pathologist Medical Technologist
PRC License Number 0080292

LAGUNA PROVINCIAL HOSPITAL LABORATORY RESULT


+ GEN. CAILLES MEMORIAL DISTRICT HOSPITAL
100 Tavera Street, Pakil, Laguna 4017 ● (049) 557 0213 to 15
FECALYSIS
ACCREDITED HEALTHCARE PROVIDER

MACROSCOPIC EXAMINATION: MICROSCOPIC EXAMINATION


PATIENT’S NAME: _________________________________________ Entamoeba histolytica:
Color DATE/TIME: _______________________
Consistency
BIRTHDATE: __________________ AGE/GENDER: ___________ Cyst: CASE NUMBER: ___________________
/hpf
CHEMICAL TEST (OCCULT BLOOD) /hpf
Trophozoites:
 POSITIVE E. coli: /hpf
 NEGATIVE E. nana: /hpf
MICROSCOPIC EXAMINATION: Trichomonas: /hpf
Ascaris lumbricoides: /lpf Others:
Trichuris trichiura: /lpf Pus cells: /hpf
Ancylostoma duodenale /lpf Red blood cells: /hpf
(hookworm):
Strongyloides /lpf Bacteria: /hpf
stercoralis:
Others/Comments: Yeast cells: /hpf
Fat Globules: /hpf
Starch Granules: /hpf
Others:

IMELDA MARIE FREMIELLE F. PALACOL, MD, FPSP __________________________


Pathologist Medical Technologist
PRC License Number 0080292

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