1 : ‫ﺻﻔﺤﻪ‬ ‫ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ ﺍﺳﺘﺎﻥ ﻓﺎﺭﺱ‬

7/17/1403 : ‫ﺗﺎﺭﻳﺦ‬ ‫ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﺩﺭﻣﺎﻧﮕﺎﻩ ﺷﻬﻴﺪ ﻣﻄﻬﺮﻱ ﺷﻴﺮﺍﺯ‬

22:10 : ‫ﺳﺎﻋﺖ‬ 07136121134 ‫ ﻣﻴﺪﺍﻥ ﻧﻤﺎﺯﻱ ﺗﻠﻔﻦ‬-‫ﺷﻴﺮﺍﺯ‬
2294681983 : ‫ﻛﺪ ﻣﻠﻲ‬ ‫ ﻧﺎﺯﺑﺎﻧﻮ ﺍﻣﻴﺮﻱ ﻗﺮﻗﺎﻧﻲ‬: ‫ﻧﺎﻡ ﺑﻴﻤﺎﺭ‬ 31184823 : ‫ﻛﺪ ﻗﺒﺾ‬ L0238 1403/07/14 40 : ‫ﻗﺒﺾ ﭘﺬﻳﺮﺵ‬
‫ ﺯﻥ‬: ‫ﺟﻨﺲ‬ (94612)‫ ﺍﺻﻐﺮ ﺯﺍﺭﻉ‬: ‫ﭘﺰﺷﮏ‬ 20470 : ‫ﺳﺮﻳﺎﻝ‬ : ‫ﻗﺒﺾ ﺩﺭﺧﻮﺍﺳﺖ‬
55 Y : ‫ﺳﻦ‬ 632213 : ‫ﻛﺪ ﺑﻴﻤﺎﺭ‬ L0241 1403/07/14 15:21 : ‫ﻗﺒﺾ ﺟﻮﺍﺏ‬
Serology SampleNo: 3222
Test Result Unit Normal Test Result
RF-Quantitative 4.2 IU/ml 0 - 20
CRP Quantitative 1.2 mg/l 0-6
Reported By : Digitally Signed By :
‫ﺯﻫﺪ ﺯﻫﺮﺍ‬
Mohammad Zadeh.MD Sahand

Immunology SampleNo: 3770

Test Result Unit Normal Test Result
ANA Anti nuclear 1.11 U/ml 0 - 1.2 Negative : < 0.9
antibody Doubtful : 0.9 - 1.1
Positive : > 1.1
HBS Ag Ultra ELISA Negative INDEX 0 - 0.13 Non Reactive : < 0.13
Reactive : > 0.13
HCV Ab ELISA Negative INDEX 0 - 1 Non Reactive : < 1.0
Reactive : > 1.0
Anti CCP 2.0 U/ml 0 - 18 Normal: <= 12
Eqiuvocal: 12-18
Positive: >18
Hormone SampleNo: 6798
Test Result Unit Normal Test Result
TSH L 0.13 µlU/ml 0.34 - 6.1
25 OH Vit D3 50.8 ng/mL 10 - 100 Deficiency: <10
Suboptimal: 10-30
Optimal: 30-70
Overdose: 70-100
Toxic: >100
Reported By : Digitally Signed By :
‫ﺭﺿﺎﻳﻲ ﺩﻭﺳﺖ ﻓﺎﻃﻤﻪ‬
Dehghanian.MD Amirreza

‫ﭘﻨﺠﺸﻨﺒﻪ ﺻﺒﺢ ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﻓﻌﺎﻝ ﺍﺳﺖ‬.‫ﺻﺒﺢ ﻣﻴﺒﺎﺷﺪ‬6 ‫ﺷﺮﻭﻉ ﻛﺎﺭﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﺍﺯﺳﺎﻋﺖ‬

 2 : ‫ﺻﻔﺤﻪ‬ ‫ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ ﺍﺳﺘﺎﻥ ﻓﺎﺭﺱ‬

7/17/1403 : ‫ﺗﺎﺭﻳﺦ‬ ‫ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﺩﺭﻣﺎﻧﮕﺎﻩ ﺷﻬﻴﺪ ﻣﻄﻬﺮﻱ ﺷﻴﺮﺍﺯ‬

22:10 : ‫ﺳﺎﻋﺖ‬ 07136121134 ‫ ﻣﻴﺪﺍﻥ ﻧﻤﺎﺯﻱ ﺗﻠﻔﻦ‬-‫ﺷﻴﺮﺍﺯ‬
2294681983 : ‫ﻛﺪ ﻣﻠﻲ‬ ‫ ﻧﺎﺯﺑﺎﻧﻮ ﺍﻣﻴﺮﻱ ﻗﺮﻗﺎﻧﻲ‬: ‫ﻧﺎﻡ ﺑﻴﻤﺎﺭ‬ 31184823 : ‫ﻛﺪ ﻗﺒﺾ‬ L0238 1403/07/14 40 : ‫ﻗﺒﺾ ﭘﺬﻳﺮﺵ‬
‫ ﺯﻥ‬: ‫ﺟﻨﺲ‬ (94612)‫ ﺍﺻﻐﺮ ﺯﺍﺭﻉ‬: ‫ﭘﺰﺷﮏ‬ 20470 : ‫ﺳﺮﻳﺎﻝ‬ : ‫ﻗﺒﺾ ﺩﺭﺧﻮﺍﺳﺖ‬
55 Y : ‫ﺳﻦ‬ 632213 : ‫ﻛﺪ ﺑﻴﻤﺎﺭ‬ L0246 1403/07/14 12:09 : ‫ﻗﺒﺾ ﺟﻮﺍﺏ‬
Hematology SampleNo: 7673
Test Result Unit Normal Test Result
CBC Diff -----------
W.B.C 5.6 10^3/ul 4.5 - 11 Neutrophils 46
R.B.C H 6.15 10^6 /ul 4.2 - 5.4 Lymphocyte 45
Hb 13.3 g/dL 12 - 16 Monocyte 7
HCT 41.6 % 38 - 47 Eosinophil 2
M.C.V L 67.6 fL 80 - 96
M.C.H L 21.6 pg 27 - 32
M.C.H.C 32.0 g/dL 32 - 36
R.D.W H 16.3 % 11.5 - 14.5
Platelets 346 10^3/ul 150 - 450
M.P.V 9.8 fl 8.6 - 12.6
E.S.R 4 m.m/h 0 - 30
Reported By : Digitally Signed By :
‫ﺑﻮﺳﺘﺎﻧﻲ ﻣﺴﺘﻮﺭﻩ‬
Mohammad Zadeh.MD Sahand

Chemistry SampleNo: 8140

Test Result Unit Normal Test Result
FBS 97 mg/dL 70 - 99 (Impaired Fasting Glucose: 100-125)
BUN 19 mg/dL 8 - 23
Creatinine 0.9 mg/dL 0.6 - 1.3
AST (SGOT) 26 u/L 1 - 40
ALT (SGPT) 15 u/L 1 - 40
Alkaline Phosphatase 267 u/L 80 - 306
Albumin 4.1 g/dL 3.5 - 5.2
Bilirubin -----------
Total Bilirubin 0.67 mg/dL 0.1 - 1.3
Direct Bilirubin 0.20 mg/dL 0 - 0.4
Reported By : Digitally Signed By :
‫ﺭﺿﺎﻳﻲ ﺩﻭﺳﺖ ﻓﺎﻃﻤﻪ‬
Dehghanian.MD Amirreza

‫ﭘﻨﺠﺸﻨﺒﻪ ﺻﺒﺢ ﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﻓﻌﺎﻝ ﺍﺳﺖ‬.‫ﺻﺒﺢ ﻣﻴﺒﺎﺷﺪ‬6 ‫ﺷﺮﻭﻉ ﻛﺎﺭﺁﺯﻣﺎﻳﺸﮕﺎﻩ ﺍﺯﺳﺎﻋﺖ‬