Mbuma Mission Hospital Laboratory
Urinalysis Result slip
Urine Appearance:
Other comments……………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
Leucocytes………………………………………………..
Nitrites………………………………………………………
Urobilinogen…………………………………………………….
Protein……………………………………………………….
pH…………………………………………………….
Blood……………………………………………………….
Specific gravity……………………………………………
Ketones………………………………………………………..
Bilirubin……………………………………………………
Glucose……………………………………………………………
Date test done………………
Signature………………………….
Done by………………………………..