<p>Pet LABS Inc. Tel: (330)-220-6435 Diagnostic Laboratories</p><p>Fax: (330)-220-1661 www .p e tl a b s d i ag no sti c s . c o m</p><p>Pag: (216)-625-3121</p><p>Owners Name: D ate: - - Chart Number: Patients Name: Doctor: Hosp it a l : Age: DDays DWeeks DMonths DYears Sex: DM DF Species: DFeline DCanineDEquine DAvian DOther DHemogram(CBC wo/diff) CHEMISTRY DPlatelet Count / Scan DWELLNESS PANELS D Canine Adult Wellness Panel PROFILES DAvian Retic Count DSemi Quantitative Fibrinogen (CBC w/diff, Chemzyme, Profile (AST,CK,UA,Ca,Phos,TP DHeartworm) Canine Wellness Panel ,Alb, Glob,GGT,LDH) DChemzyme (CBC w/diff, Chemzyme, Heartworm, T4) DCanine Adult (Tbil,Gluc,Ca,Chol,Alkp,AL Wellness Panel Plus (CBC w/diff, T,TP Chemzyme, Heartworm, BUN,Alb,Glob,Crea,Phos,Na, K,CL) DELECTROLYTES DUrinalysis) Canine Senior Wellness Panel (Na,K,CL) (CBC w/diff, Chemzyme, AST, DHEPATIC PROFILE GGT, Heartworm) (Tbil,Dbil,GGT,AST,ALT,Alkp,TP DCanine Senior Wellness Panel ,Alb) DLARGE ANIMAL PROFILE Plus (TP,Tbil,Dbil,Gluc,Ca,CL,GGT, (CBC w/diff, Chemzyme, AST, Alkp,AST,BUN,Alb,Crea,Na,K,CL) GGT, DPRE-SURGICAL PROFILE 1 Heartworm, Urinalysis) (CK,GGT,AST,Crea) DFeline Adult Wellness Panel DPRE-SURGICAL PROFILE 2 (CBC w/diff, Chemzyme, (Alkp,ALT,BUN,Crea,Gluc,TP Urinalysis) DFeline Adult ) Wellness Panel Plus (CBC DRENAL PROFILE w/diff, Chemzyme, Urinalysis, (Tbil,Dbil,TP,Alb,Crea,BUN FELV, FIV) DFeline Senior Wellness Panel ) DREPTILE PROFILE (AST,CK,UA,Ca,Phos,TP,Alb, (CBC w/diff, Chemzyme, AST, Glob) DZOO PROFILE GGT, T4) DFeline Senior (AST,ALT,ALP,Gluc,Tbil,Cho Wellness Panel Plus (CBC l, w/diff, Chemzyme, AST, GGT, T4, TP,Alb,BUN,Crea,Phos,Ca,Na,K,CL Urinalysis) DGeriatric Equine Panel ,GGT) (Cortisol, Pre & Post INDIVIDUAL CHEMISTRY DAlbumin DInsulin, T3, T4) Health Panel 1 DALP DALT D(CBC w/diff, Chemzyme) Health Panel 1 (EQ) DAmylase (CBC w/diff, Chemzyme Large DAST DBilirubin, Total DAnimal) Health Panel 2 (EQ) DBilirubin, Direct (CBC w/diff, Chemzyme Large DBile Acid DBile Acid Animal, Semi quantitative , Pre & Post Fibrinogen) DBUN DHealth Panel 2 DCalcium (CBC w/diff, Chemzyme, UA) DCholesterol DHealth Panel 3 DChloride (CBC w/diff, Chemzyme, DCreatine Kinase UA w/culture if indicated) DCreatinine DInsulin Panel 1 DGGT (CBC w/diff, Chemzyme, Insulin) DGlucose DInsulin Panel 2 DPhenobarbital (CBC w/diff, Chemzyme, Insulin, DPhosphorus T4) DPotassium D Pro Heart Panel DProtien, Total (CBC w/diff, ALP, ALT, & DSodium Bilirubin) DTriglyceride DWellness Panel (CBC w/diff, Chemzyme, T4) DUric Acid DZoo Panel 1 DHEMATOLOGY (CBC w/diff, Zoo Chem Profile) CBC w/diff & Platelets DZoo Panel 2 (Mammal) D (Avian/Reptile WBC, Hct, Plt, CBC w/diff & Platelets (Non- Mammal) Parasite scan Zoo Chem DHemoglobin & Hematocrit Profile) D#4 T4, Cortisol URINE CHEMISTRY DUrine Cortisol / Creatinine D#5 T4, T3, TSH D TITRE SCREEN Ratio #6 T4, TSH DBrucella canis D DUrine Creatinine #7 T4, FREE T4, TSH DCanine Herpes DUrine Protien D#8 T4, FREE T4 D DUrine Protein / Creatinine Distem per Ratio DErlich DSEROLOGY Feline Leukemia Virus Antigen ia Endocrinology DFeline Leukemia Virus Antigen DEquine Herpes DCortisol, Baseline & DFIP DCortisol, Pre & Post Feline Immunodeficiency Virus Type 1 DCortisol, Pre & 4H & 8H Antibody DLymes DEstradiol Test D DInsulin (Canine & Equine Only) DHeartworm Parvo Virus DProgesterone (Canine & Feline DRocky Mountain Spotted Fever Only) DTestosterone IMMUN OLOGY DTitre Panel #1 D (Distemper, Parvovirus) THYROID FUNCTION TESTS lgG DT4 Alpaca DTitre Panel #2 DT3 DIgG (Erlichia, Lyme, Rocky Mountain DFREE T4 Equine Spotted Fever) DTSH FLUID </p><p>THYROID PANELS ANALYSIS D#1 T4, T3 DCell Count D#2 T4, FREE T4, T3 DDifferential D#3 T4, FREE T4, T3, TSH Source:</p>