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To enter more than one report use the same form.

Enter Lipid Profile Report Information * Indicates compulsary fields.

Date Of Checkup*

Normal Range
(Min. - Max.)

Total Cholestrol (Enzymatic)

mgs/dl

High Density Lipid (HDL)

mg/dl

S.Chol. / HDL Chol. Ratio

Triglycerides (Enzymatic)

mg/dl

Low Density Lipid (LDL)

mg/dl

V.L.D.L

mg/dl

Any Other information

Warning: Please find and enter all the fields accurately from your report (Hard Copy)


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