Document YreVx2KOe7Q1Qn4MMJo7vXMGN

Name:, Present Age:. Weight:______ Pantasote Inc POLYMER SURVEILLANCE PHYSICAL EXAMINATION ~CT~* Plant Location:. Date of Examination:______ Mrs, Date of Last Examination: C. C . \cSiGr'2-- INTEHVAL HISTORY! Recen^risits j^p\rivata physician and medication if any: A' -2) Recent illnesses in family members:. vnc<--(HFTF-----2Wd. JJi'r Present complaints, if any:. Change in eyesight:. y/^r Headaches:. -O- Dizziness: Shortness of breath:. Chest pains:. -G- Change in bowel or urinary habits:. Change in sleeping habits:. 2? *-4i ^ ** ~0~ PHYSICAL EXAMINATION Skin (color, rash, pigmentation):. Fundi:. E.N.T.: Carotid arteries:. Tsti-f A/i Peripheral adenopathies:. Thyroid gland: Pulse and Blood pressure:. 22 lJ ~ f'/ f# A P" Heart: Lung:. Abdomen (Organomegalies):. Genitalis (optional):. TP" '`C* /Vl Femoral and pedal pulses:. Reflexes inci. vibratory and positional sense: Tumors:. (R*^ ^ Jjl. /. i 'SSIaMINING PHYSICIAN: UCCLEW0432 I Negative polltiv*------- Suspleto*1* Urln|}yste: p-^iJ--GV Laboratory ,3-- V.C. Normal.-- Others Abnormal Allen Test: t Right Hanes U Lett Hand UCCLEW0433 TEST NAME ROUP 781 HCT HGB gag sms MCHC RBC COUNT wec differential: LYMPHS Matlaaal Health UtonlirieiwomuRo 271 SHEFFIELD ST,, MOUNTAINSIDE, NEW JERSEY 07072 PAGE 1 OF COPT- "2` UP' WJTHfN RANGE -' r;~r'^-v.? ~wtQutsTB>v; v.-: HANS TAUBER, M.D. COMPANY PHYSICAL 893 PARK AVE. NEv* YORK NY ACCOUNTNO. TELEPHONING. 8690033 212 737-6856 OUT5IDE RANGE NORMAL VALUE RANGE ROUTE 0 43.0 15.0 x 36.0 4.85 WRk*: .. .; . n>$ T". - "'' * *,,* \?i-: I***-. L M:40-54 F:37-47 .-.Li 'O ' M^: 14-1 8 FC12-1J6 80"-"io0--- 26- - W ' : . 33 - 38 M:46--62 F:4.2--5.4 ORMAtT ' 4*0 -- 11.6 33, 20 -- 40 50 -- 70 1-6 K GM/DL CU .MICRONS P6 ..`..J % MILLION/Nh TH0US/MM3 % % 15. dilfe" isssssar 19. Z$7SI, grorrT'iSr< .-j&rr:. >.B ILI -3aflsoSp-,i6a 4*+dW<r: 0 .2 ALK PHOS 103. %-Mgsk GLOBUL in A/G RATIO E^ScfBr^vv, ,v. 2.5 POTASSIUM CHLORIDE ideIvv mS 'aAv' * * * *. * s **Zi *. '. r PHOSPHATE IRON, TOTAL ^cholesierol. >3rr '' :v- . ' `V 0*7 - 1.4 . .. 10 - 26 .. 9.0 - 24.0 SEE REVERSl^TTT'T:. .*-0 0-45 257, HI 110 - 240 V.A.. V 0.2 -;i.. zr~T';r/ . .. v;. / .; . .-j-* 0.0 - 0.3 SEE REVERSE -vv;,.. 6m AT~ 8**4' 3.5 - *5*1. 2.0 - 3.7 "* * ,v ". - ~*7*7 ; \ .T- **'% 7f; *-.*,i.. . V'. ** : C; . l .1 - 2.1 MS 3.3-9.0 Ff2.`2-7.7 i37 . 3.6-- 5.3 98 - 110 22-- 34 - "V-' 8.5 -- 11*0 2l5"- 4.5 c 40 - 180 SEE REVERSE SEE REVERSE MG/DL, MG/DL MG/DL U/L U/L MG/OL MG/OL U/L GM/DL . GM/OL GM/OL. MG/OL'1 MEQ/L MEQ/L MEQ/L MEQ/L MG/DL * MG/DL MCG/DL MG/OL MG/OL 3A^\MA-GTP RICHARD W. WATSON, JR., PH.D. - LABORATORY DIRECTOR 0. - 40 NOTE: Stated ranges and flagging of results represent only nominal normal ranges. Interpretation ofTest re sults should be considered in the light of patient age and sex together wiih any medications the patient is using. See also important information on reverse side. U/L AERFORMCOAT VIENNA.V .PfAFOAVtO AT PUMNVICW. N UCCLEW0434 MEMICE.JOSEPH 64 - 63 b*K?v:. m TEST NAME RPR SEROLOGY . in/ cotucTtoNOftini/ ../ c05/19/82 r ACCESSION DATE . , J 35/19/82 REPORT DATE-' 05/2 0/82 WITHIN RANGE | NON--REACTIVE OUTSIDE RANGE HANS TAUBER. M.D. COMPANY PHYSICAL 093 PARK AVE. NEW YORK NY ACCOUNT NO. 8690033 TBJEWOHSNO. 212 737-6856 torn G NORMAL VALUE RANGE v.v/ yy. *l Ae.uirA saife * l*'?, * .'_G*\ -SrJL&ZtL-*teUii. 5BSET7IK ...... rT/ A-. j *; . VSw- 'i*: : - l.J- * `U ^ r** 'rr.r/-ipx. *rym.v^yr<. * kVx' Vr?X?"" '"TTT^St ,4t * m L-.\ % Amj >. . tSiuuiV: ,' 'u" IH,^' V Nl fJT>A' JwlttWifr.ij1*. M . Vi *' ` * . * .yTK*.'/ ,'>i_-H' yyr**;/*./*-^> -V*W*Vu^W. i ;* : *&? :i^ .` j~i' : ''.ESsJ.nJi^. s&Z. *rf * /* '/** '* . * if sygx^yj-<-> ............... **"****~* . mV * . *'"'T * o.*'-; j --.j r^rtnaj^ >-4 .r_4. y` 7\ -.1 i .i~'s5sSiVx'. rtt: 1---\; s ; -t V Ae, * -"''c., vi : 'sVew %'~7r**T ' w- * G v. . .*,r l Vi^'wifL-Vieix RICHARD W. WATSON, JR., PH.D. LABORATORY DIRECTOR NOTE: Stated ranges and flagging of results represent only nominal normal ranges, interpretation o( test re sults should be considered in the light ol patient age and sex together with any medications the patient is using. See also important information on reverse side. PtmPOAMCO AT VIINNA, V 'PCRFORMCO AT PlAlNVlCW.M UCCLEW0435 VARIABLE NORMAL VALUE RANGES SERUM/PLASMA LIPIDS (MG/DL) Total Beta (LDL) Age (Yrs.) Triglycerides Cholesterol Cholesterol 0-19 20-29 30-39 40-49 50-59 10-140 10-140 10-150 10-150 10-190 120-230 120-240 140-270 150-310 160-330 50-170 60-170 70-190 80-190 80-210 New born 1-3 months 4-6 months 7-12 months 13-24 months 25-36 months 3-5 years SERUM IMMUNOGLOBULINS IgG IgA igM 631-1431 192-688 57-797 223-1099 344-1180 526-1258 473-1385 0-8 15-27 0-64 1-73 2-96 0-145 39-147 1-21 B-52 9-77 8-100 12-104 23-99 20-92 6-8 years 411-1435 9-11 years 654-1594 12-16 years 728-1174 White M. Adult 616-1540 White F. Adult 729-1620 Black M. Adult 724-2090 Black F. Adult 765-2160 HORMONES: Male: * Female; Follicular Phase Mid-Cycle Peak Luteal Phase Menopausal FSH, Serum (MfU/ML) 6-25 5-20 15-30 5-15 50-100 FSH, Urine (IU/24HR) 5-25 5-20 15-30 5-15 50-100 LH, Serum (MIU/ML) 5-20 5-15 30-60 5-15 50-100 LH. Urine (JU/24HR) 5-20 5-45 40-150 6-45 50-100 ALKAUNE PHOSPHATASE (U/L) IgE (Unlts/MU Childhood 60-300 1 year 0-' Puberty 30-165 5 years 0-i Adult <50 yrs. 30-115 10 years O* Adult>50 yrs. 40-135 Adult 0-5 ALPHA-1-ANTITBYPSIN (MQ/DL) IgD (MG/DL) White M Adult: 92-340 White M. Adult (H White F. Adult: 127-414 White F. Adult YH Black M. Adult: 127-373 Black M. Adult 0-5 Black F. Adult: 43-308 Black F. Adult 01- Under SO Yrs.: Over 50 Yrs.: 72-116 MG/DL 84-128 MG/DL GLUCOSE TOLERANCE: 03 Hr.: 30-30 MG/DL above lasting 1.0 Hr.; 30-50 MG/DL above lasting 2.0 Hr.: 5-15 MG/DL above lasting 3.0 Hr. A Greater: Same as lasting SEROLOGICAL TITER EVALUATION: A single serum test result of 'negative" or very low titer establishes that the patient has not previously been Infected with the organism being tested for. it does not rule out a current infection. Tf titers on sera collected 2-4 weeks apart show a 4 fold increase, a retrospective diagnosis of infection by the agent in question has been confirmed ESTRIOL: During pregnancy, fetal well-being is assessed by compering successive estriot values. A drastic drop in estriol levelsduring the course ol pregnancy is an indicator offetal distress. CERULOPLASMIN (MG/DL) White M. Adult: 29-81 White F. Adult: 32-151 Black M. Adult: 41-111 Black F. Adult: 40-1BT, llMPORTANT INFORMATION! COMMENTS ON SPECIMEN CONDITION IMPROPER SEPCIMEN --11 this is the only answer reported, it means that the specimen container used was incorrect and it is impossible forthe laboratory to provide meaningful results. Consult the laboratory test booklet forthe correct specimen! requirements, if this comment accompanies numeric values lor Potassium or LDH. It implies that the results may be elevated because separated serum was not sent to the laboratory. HEMOLYSIS -- Certain results may be invalidated when serum is not promptly removed Irom the clot. Major discrepancies are low Glucose, high Potassium and high LDH. If hemolysis occurs during Initial processing or jf contact with the clot is prolonged, these errors are exaggerated and additional distortions may appear elevations in Cholesterol. Creatinine. Iron. Phosphate. Protein fractions and most enzymes. Calcium will sometimes be depressed. Whenever hemolysis Is so extensive as to prohibit the performance ol the test, this will be the only answer reported NOTE: Errors ol this sort can be minimlied If the following prcautions are observed: (1) 30 minutes after collecting blood from the patient, centrifuge it (2) Following 10-15 minutes' centrifugation, transfer a portion of the serum to a separata tube for transportation to the laboratory (Be careful not to contaminate the serum sample with any cells). NOT FROZEN -- Some blood constituents decompose so rapidly that they must be preserved by freezing the serum or plasma shortly after collection. These tests are specified in the laboratory test booklet. It specimens lor certain sensitive tests arrive at the laboratory unfrozen, thetest cannot be performed. But keep in mind that the substances in question remain stable for days so tong as the specimen Is kept frozen. It is therefore much safer to keep the specimen in your office freezer overnight than to give the lab courier a partially frozen tube. Another importantpoint: be sure to identify any frozen specimens when giving them to the courier, so that he knows to pack them in dry ice for transportation to the laboratory. INADEQUATE DRAW -- For Prothrombin Times, CBCs and other critical hematology testing, results may be totally inaccurate unless sufficient blood is drawn into the collecting tube to properly dilute the anticoagulant chemicals already In the tube. It this comment Is reported, it signifies that the laboratory measured the specimen volume and determined it to be inadequate lor rellble testing. If plasma has been separated from the Prothrombin Time tube, the laboratory cannot access this tnlormation and must decline to test the specimen.. LIPEMIC -- Lipemia can falsely elevate SGOT and SGPT. It may also indicate that the patient did not adequately fast, m which case the Glucose, Triglyceride, Total Up'd and associated LIpoprotem results may be invalidated. The Normal Values listed for these constituents are alt based on fasting conditions. In addition to the above-mentioned, gross lipemia may prevent any possibility ol obtaining a numeric result LOW BILIRUBIN -- Since bilinibin is photodegradable, prolonged exposure ol the specimen to bright sunlight or other ultraviolet light sourceswill produce a lowering of measured results. LOW CAR BON DIOXIDE -- carbon Dioxide tends to escape from blooo In vitro. Therefore. If Carbon Dioxide measurements are not made soon after collection, results will be somewhat reduced. NON-SPECtFtC INHIBITORS OR AGGLUTININS -- Rubella results reported as such mean that the patient's blood contained factors unrelated to R ubella that interfered with the reading of test results. The on ly way around this problem is to repeat the test with a fresh specimen, preferably taken after an overnight fast. SPECIMEN IDENTITY OMITTED --The specimen was not labeled with the patient's name and the laboratory therefore cannot guarantee that the results correspond to your patient. CONFIRMATORY/REPEAT TESTING It, for any of the reasons stated above, the laboratory cannot complete testing on the specimen submitted, the client is requested to re-test with another specimen at no charge. Should confirmation of test results seem advisable, be aware that THE LABORATORY HOLDS MOST SPECIMENS FOR A FEW DAYS. By calling the laboratory, you can have many results checked by repeat analysis, without additional charge. Sera for all RUBELLA AND Rh ANTIBODY testing are retained in the laboratory frozen for at least SEVEN MONTHS. Any client wishing to have sequential specimens tested in company wilh previous sera should notify the laboratory of the ACCESSION NUMBERS and REQUEST DATES of any previous specimens, and parallel testing will be performed. PROTHROMBIN TIMES -- CAUTIONARY NOTE Prothrombin Time measurements ior determining coagulation defects are of no value it specimens are more than a few hours old. For this reason, tests done at the Mountainside laboratory are limited to evaluating anticoagulant therapy ONLY. UCCLEW0436