Virology Test

Enter patient details and report values. Out-of-range results are flagged in red but do not block printing.

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Patient Information

Patient Name

Serial Number

PP Number

Examination Date

Age

Gender

Address

Nature of Specimen

Sample Type

Test Component	Result	Units	Reference Range
HIV 1&2 Ag/Ab Combo Test (4th Gen)	Show on report	index/mL	< 1 index/mL
HIV Interpretation	Show on report
HBsAg	Show on report	index/mL	< 6 index/mL
HBsAg Interpretation	Show on report
Anti-HCV	Show on report	AU/mL	< 20 AU/mL
Anti-HCV Interpretation	Show on report
TPHA/SYPHILIS	Show on report	mIU/mL	< 1 mIU/mL
TPHA Interpretation	Show on report
VDRL	Show on report	titre	< 1.8 titre
VDRL Interpretation	Show on report
Clinical Observations & Remarks Show on report