| Full Name: | Client Name |
| Client No: | 999 |
| Normal | Monitor | Action | Notes | |
| Dehydration: | ||||
| Bacteria Load: | ||||
| Parasite Load: | ||||
| Shape of Red Blood Cells | ||||
| Anemia Signs: | ||||
| Clumping/Clotting: | ||||
| Crystals (Uric etc): | ||||
| Rouleaux (Stacked): | ||||
| White Cell Count: | ||||
| White Cell Motility: |
Pictures
| Notes |
| Intracellular pathogens seen |
