UNIT 01-05, 16-20 G/F LAGUNA CENTRAL BLDG PASEO OUTLETS, GREENFIELD
CITY TAGAYTAY, BALIBAGO ROAD, CITY OF SANTA ROSA, LAGUNA
DATE: 05/03/2025
PATIENT NAME: LOBUSTA, MANNY
TIME: 09:40 AM
AGE/GENDER: 18/MALE
SPECIMEN: HEMATOLOGY/CBC
REQUESTING PHYSICIAN
UNIT 01-05, 16-20 G/F LAGUNA CENTRAL BLDG PASEO OUTLETS, GREENFIELD
CITY TAGAYTAY, BALIBAGO ROAD, CITY OF SANTA ROSA, LAGUNA
DATE: 05/03/2025
PATIENT NAME: LOBUSTA, MANNY
TIME: 09:40 AM
AGE/GENDER: 18/MALE
SPECIMEN:
REQUESTING PHYSICIAN
UNIT 01-05, 16-20 G/F LAGUNA CENTRAL BLDG PASEO OUTLETS, GREENFIELD
CITY TAGAYTAY, BALIBAGO ROAD, CITY OF SANTA ROSA, LAGUNA
DATE: 05/03/2025
PATIENT NAME: LOBUSTA, MANNY
TIME: 09:40 AM
AGE/GENDER: 18/MALE
SPECIMEN: URINALYSIS
REQUESTING PHYSICIAN
URINALYSIS
CLINICAL MICROSCOPY
Complete Urinalysis
Date of Collection 05-13-2025
Time of Collection 1:32 PM
Physical/Macroscopic
Color YELLOW
Transparency CLEAR
Urine Chemical
Sp. Gravity 1.005 1.005-1.025
pH 6.50 5.00-7.00
Protein POSITIVE POSITIVE
Glucose NEGATIVE NEGATIVE
Bilirubin NEGATIVE NEGATIVE
Blood (ERY/Hb) NEGATIVE NEGATIVE
Leukocytes NEGATIVE NEGATIVE
Nitrite NEGATIVE NEGATIVE
Urobilinogen NEGATIVE NEGATIVE
Ketone NEGATIVE
NEGATIVE
Microscopic
/hpf 0-3
RBC 6
0 /hpf 0-5
WBC
Bacteria FEW
NOTE: PAB Accredited test/s.
The results are best interpreted by a healthcare professional and are not intended to be used as the sole means
for diagnosis or management.
Specimen rechecked, result/s verified.
UNIT 01-05, 16-20 G/F LAGUNA CENTRAL BLDG PASEO OUTLETS, GREENFIELD
CITY TAGAYTAY, BALIBAGO ROAD, CITY OF SANTA ROSA, LAGUNA
DATE: 05/03/2025
PATIENT NAME: LOBUSTA, MANNY
TIME: 09:40 AM
AGE/GENDER: 18/MALE
SPECIMEN: FECALYSIS
REQUESTING PHYSICIAN
UNIT 01-05, 16-20 G/F LAGUNA CENTRAL BLDG PASEO OUTLETS, GREENFIELD
CITY TAGAYTAY, BALIBAGO ROAD, CITY OF SANTA ROSA, LAGUNA
DATE: 05/03/2025
PATIENT NAME: LOBUSTA, MANNY
TIME: 09:40 AM
AGE/GENDER: 18/MALE
SPECIMEN:
REQUESTING PHYSICIAN
MEDICAL CERTIFICATE
PAST HISTORY
( ) DIABETES MELLITUS
( ) HYPERTENSION ( ) TYPHOID FEVER
( ) EPILEPSY/EPILEPSIN
( ) MUMPS ( ) HEPATITIS
( ) ALLERGY
( ) MEASLES/GERMAN MEASLES ( ) OTHERS
( ) ASTHMA
( ) PTB ( ) CHICKENPOX
OPERATION/HOSPITALIZATIONS
PRESENT ILLNESS
(X) Headache
(X) Cough (X) Chest Pain
(X) Dizziness
( ) Cold (X) Headache
(X) Burning of Eyes
(X) Difficulty Breathing (X) Abdominal Pain
(X) Difficulty of Hearing
(X) Productive Phlegm (X) Joint Pain
(X) Toothache
(X) Fever (X) Generalized Pain
PHYSICAL EXAMINATION
BP: 110/70
Weight: 67.80 kgs
Height: 5'7"
Visual Acuity: OD 20/20 OS 20/20
SKIN REMARKS
DERMATOSIS NORMAL
PIGMENTATION NORMAL
CONJUNCTIVA NORMAL
REFRACTION NORMAL
OTOSCOPIC NORMAL
NOSE/MUCOSA NORMAL
TEETH NORMAL
NECK EXAMINATION NORMAL
THYROID NORMAL
EFFORT NORMAL
AUSCULTATION OF HEART NORMAL
PERIPHERAL VASCULAR NORMAL
ABDOMINAL EXAM NORMAL
NECK NORMAL
AXILLA NORMAL
URINE NORMAL
SKIN/NAILS NORMAL
DIGITS NORMAL
MENINA NORMAL
RECOMMENDATIONS:
(X) CLASS A. Physically fit for all types of work. No physical defects or disease noted.
( ) CLASS B. Physically fit for all types of work. Has minor defects/ailment.
( ) CLASS C. With abnormal findings not acceptable for employment.
( ) CLASS D. UNEMPLOYABLE
( ) PENDING
Examined by: _________________________
