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oqani/el 0 w Y/.;PATIENT NAME
07483
ACCOUNT*
M 9
SEX
AGE
4092300677
LAB WORK *
representation of scaled results
0 1 2 3 oo
TEST
TESTIS) REQUESTED
++*++ '
CHOLESTEROL BILIRUBIN TOTAL
+
TOTAL PROTEIN : i|ALBUMIN
GLOBULIN
A/G RATIO LDH
ALK PHOSPHATASE
+++
1 SGQ-T !PHOSPHORUS
CHLORIDES
SODIUM POTASSIUM CALCIUM TOTAL
4/01/74_____ 4/02/74* 00 105 4/03/74*1 05:39
E DRAWN SAMPLE RECEI RESULTS OUT
WAO" 11
RESULT USUAL CLINICAL RANGE
UNITS
SERUM PROFILE
282 150 - 260
0.8 0.1 - 1.2
MG7
, 7.6; 5.9 - 8.0
GS
j 4*51 3.3*- 5.2 { GS
| ' 3.1. 'l.5?r-3.8 I GS
! 1.4:1! l.l:l-2.5tl! RATIO
615 280 - 700
S-B
1.7 0.6 - 2.5 j B-L
! 62,
52 S-F .
! 2.1! 2.1 - 4.T ! MGS
110* 94 - 110 ; MEQ/L
1 152! 135 *- 150 ^ MEQ/L
4.6 3.0 - 5.0
MEQ/L
10.5 8.8 - 11.0 MGS
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UCC 096041
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PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE
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UCC 096048
ODANI.EU D_W.,, PATIENT NAME
patient 10*
07483
ACCOUNT*
"35-
SEX
4122700709 LAB WORK It
5/01/74 __ 5/02/74, 00:05,, 5/03/74, 03:48
SAMPLE DRAWN SAMPLE RECEIVED RESULTS OUT
PAGE 1 OF 1
representation of scaled results
0 12 3
TEST
TESTIS) REQUESTED
RESULT USUAL CLINICAL RANGE
SERUM PROFILE
+++
CHOLESTEROL
221 150 - 260
MG*'
++++,
BILIRUBIN TOTAL
1.0 0.1 - 1.2
MG*
++++++*
TOTAL PROTEIN
7.7 5.9 - 8.0
G*
..........
V *,
ALBUMIN ! GLOBULIN ; ; A/G RATIO
"^
4.7 i 3.3 5.2 GS
4-0, 1
Gl
* 1.5SI' l.l:t*2.5:l * RATIO
LDH
531 280 - 700
B-B
A-. +++++4--M-++
ALK PHOSPHATASE ;SGO-T I PHOSPHORUS
1.5 0.6 - 2.5 51, UA52
2.8 2.1 - 4.7
B-L S-F
MG*
CHLORIDES
102 94 - 110
MEQ/L
SODIUM
144| 135 - 150
MEQ/L
POTASSIUM
4.9 3.0 - 5.0
MEQ/L
CALCIUM TOTAL
10.5 8.8 - 11.0 MG*
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PRIVILEGED AND CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE
ORDER"
UCC 096049
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SOURCE OF SPECIMEN (Please Specify)*
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PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE
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UCc 096050
VINYL CHLORIDE HISTORY WORKSHEET ~] PateJTf
Name
lx)
_______________ Age
Mailing' add re a /7P? Llj rCs2>t~ J>/? 7?X4S
Craft R+P
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*
1. Years worked in VinyLite Area
'
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(a) Years worked with vinyl chloride (Bldgs. Nos. 110* 115. 117, 119,dS^(S) 174. Tank Areas No. 1
and No. 4 in Vinylite Area)
(b) Years worked with vinyl powder (Bldgs. Nos. 120, 121, 123, 124,Qj>(m)
2. Are you working in the Vinylite Area now?
If "Yes," number of years 3. Number of years since last exposure to vinyl chloride
V
4. Number of years since last exposure to vinyl powder
5. History of hepatitis or other liver trouble? If "Yes," when?
6. Use of alcohol: Estimated No. oz. whiskey per day Estimated No. beers per day Estimated No. glasses wine per day
7. Do you take medication or drugs regularly?
~
Name of drug
Length of time takeiy
(No. of yra.)
(No. of yrs,) _2_________
(No. of yrs.)
(Yes or No) _______
(No. of yrs.) ZJo Ll)
(No. of yrs.) yjo lO
(No. of yrs.) VP
(Yes or No)
(Year (p))
=3
(Yes or No)
8. Have you ever had a blood transfusion?
9. Past history of significant hospitalizations:
Date 6- 7 CL
niagnoaia------ . ^
A& (Yes or No)
PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE
ORDER"
UCC 096051