Gokuldas Hospital: A Glance

Gokuldas hospital is one of the best health care facilities available to

the residents of Indore. It provides the facilities for all the elements with all
the latest technology available in the country.
Under the guidance and chairmanship of Dr.Sanjay Gokuldas and
Mr.Anand Gokuldas, approximately 30 good Doctors, 40 nurses and 45class
IV employees serves Gokuldas Hospital.
Patients know Gokuldas Hospital for its supreme service and good
treatment.
The staffs employed are keen to help with any kind of service. The
management is quick and effective in completing the work in hand.
Beginning from a 35bed capacity, it has now grown to size of 150bedded Hospital, with numerous diagnostic facilities and number of facilities
in various disciplines.

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Aim and Objectives

Aim
To find out the Cost Benefit Ratios of various Tests in Pathology
Department of Gokuldas Hospitals Ltd.

Objectives
To find out the Cost of some particular tests performed in
pathology lab.
To calculate the Revenue generated from those Tests.
To analyze the Cost Benefit Ratio of those particular Tests.
Suggesting measures on cutting down the cost & increasing
revenue generation.

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Methodology
The Methodology used in this Project is Observation for one month of
various procedures of the tests and data collection for six months, regarding
cost of each test, cost of kits, electricity, consumables, etc.
The Information thus collected was analyzed i.e. the cost incurred by
each test to the Hospital is compared against the Revenue Generated by that
particular Test.
The Management of the Hospital was interested in calculating Cost
Benefit Ratio of some particular Tests only, so only those Tests have been
taken up in this Project.

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Introduction of the Department

Pathology is that branch of medicine, which employs methods and
instruments of precision for the examination of secretions and excretions of
the human body and it functions to-:
Diagnose the disease
Follow its course
Aid in its treatment
Ascertain the cause of death and the result of treatment by the means
of autopsies &
Help advance the science of medicine by means of search.

The Pathology is the basic source of analytical information

concerning the patient. Although the term laboratory is in common use, it
is called the Department of Pathology.
The importance of hospital laboratory cannot be underestimated
because the practice of medicine today requires more and more
laboratory examinations and Physicians have need of diagnostic facilities
whether they are private practitioner or hospital based Doctors.
A Hospital laboratory service can be a high-income generating service
and economic asset to the hospital.
In Gokuldas Hospitals Ltd. Pathology department is a state of art
department and one of the most important department of the hospital.
Staffing of Pathology is as follows-:

Pathologist (MD)
Sr.Technicians
Technicians
Ward Boy

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Introduction of the Project

Cost Benefit Analysis is finding out the cost incurred on a particular
thing and the revenue generated by it.
In this Project the Cost Benefit Analysis of the following test have been
analysed in Pathology as required by the Management.
FSH
LH
Prolactin
T3
T4
TSH
PSA
SGOT
SGPT
HIV
HBs Ag
Blood Collection
CBC
VDRL
Lipid Profile
HDL
Cholestrol
Triglyceride
Alpha Feto Protein
Serum Electrolyte
Na+
K+
Hb
T&D
CPK
CPKMb
Pre Operative Profile

Institute of Management Studies

Cost Benefit Analysis

The Cost Benefit Analysis is a tool, which is useful in setting
priorities for various courses of action to meet objectives and provide an
estimate of the net financial value associated with each course of action
(eg. Manpower and labour, material and equipment). All inputs and
outputs have to be converted into monetary terms because all Inputs (i.e.
Costs) and all Outputs (ie. Benefits) are valued in Money terms.
Formula -:
Cost / Test
Revenue Generated / Test
If Cost Benefit Ratio < 1 Profit
If Cost Benefit Ratio = 1 No Profit No Loss
If Cost Benefit Ratio > 1 Loss
After doing this Project the Cost Benefit of various tests were found
out whether they are proving beneficial to the Hospital or not, keeping in
mind their cost to the Hospital.
Purpose of Cost Benefit Analysis
By doing Cost Benefit Analysis it can be known how much
beneficial certain particular tests have been to the management of
the Hospital.
After this Project efforts may be channelized to minimize costs and
maximize outputs.

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Cost and Revenue of the Tests

Calculating Costs of the Tests
The Cost of Tests will include-:
Fixed Cost +Variable Cost

Fixed Cost
Fixed Costs are considered to be the elements of the costs, which do
not vary with the volume of production. These costs are required to be
incurred regardless of the level of output and sales. Depreciation, property,
taxes, Interest, Insurance Premium, Rent, Supervisory and Management
Salaries are typical examples of Fixed Costs.
i)

Cost of the Equipment is the Cost spend by the Hospital to

obtain particular machine.
In this Project the Cost of the Equipment have not been
considered as by one equipment many tests are performed
but we are considering only few particular tests and costs
incurred in obtaining Equipments are considered as one time
investment to the Hospital.

ii)

Maintenance Charge - These charges depend on the Annual

Maintenance Contract (if any) signed by the Hospital and the
Vendor of the machine.
Again this have not been included in the Project

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iii)

Salary of the Staff The Staff Salary is one of the Fixed Cost
As we have been calculating cost of some specific tests only
so the salaries have been taken as-:
Total Salary of the Staff
Average No. of Tests performed in Pathology in a month

Salary (Per Month)

Doctor Rs 15000/Technicians (10) Rs 19505/Ward Boy Rs 1000/-

Total Salary

35505
10,800

= Rs 3.28 / Test

iv)

Insurance Premium Charges- The Premium Charges differ

with policies and have not been taken.

Variable Costs
Variable Costs are those, which vary directly with the actual volume
of production or sale. This makes it clear that the Variable Costs per unit

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of output are found constant and with a change in the output, we find a
proportionate change in the Total Variable Cost.
It generally includes-:
i)

Cost of the Kits-

The costs of the kits used for various tests differ with the supplier of
the kits and the methods of doing the tests and also with the bond with
the supplier of the kits.
ii)

Electricity Charges-

The charges of the electricity have been taken as a whole average

including appliances and instruments as

AC 4
Tubelight
Fan
Refridgerator
Cell Dyn
BRIO Elisa test
Sirio Auto
Tulip Quantimate
EMS (ECS)
Bayer Biochemistry Analyser
Automatic Immunoassay Analyser
Sereological Water Bath
Axsym
Lab Centrifuge
Blood Bag Tube Sealer

The Cost of Electricity have been taken as an average

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Cost of average Electricity Consumed

No. of Tests in Pathology
8000
10,800
=Rs.0.74 / Test

iii)

Cost of Consumables-:
Vaccutainers
Rs 5.80 / Pc
Glass Slides
Cover slips
Syringes

iv) Miscellaneous-:
Detergents
Diluents
Stationary

Total Misc + Consumables = Rs 3.15 per Test

Sources of Revenue Generation

The Sources of Revenue Generation is the amount paid by the patient for
various tests.

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10

Calculations
Calculating Fixed Costs of the Tests

Salary:
35505 / 10800 = Rs 3.28 Per Test
Calculating Variable Costs of the Tests

Electricity:
8000 / 10800 = Rs. 0.74 Per Test

Cost of Kits:
It depends on the Particular test.

Consumables + Miscellaneous:
=Rs 3.15 Per Test

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11

Cost Benefit of the Tests

1. FSH
Kits Cost Rs 50 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 62.97/Revenue Rs 350/Cost / Benefit 0.179

2.LH
Kits Cost Rs 50 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 62.97/Revenue Rs 350/Cost / Benefit 0.179

3.Prolactin
Kits Cost Rs 52.8 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 65.77/Revenue Rs 370/Cost / Benefit 0.178

4.T3
Kits Cost Rs 45 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 57.97/-

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Revenue Rs 250/Cost / Benefit 0.232

5.T4
Kits Cost Rs 56.2 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 69.17/Revenue Rs 300/Cost / Benefit 0.231

6.TSH
Kits Cost Rs 36 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 48.97/Revenue Rs 300/Cost / Benefit 0.163

7.PSA
Kits Cost Rs 168/ Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 180.97/Revenue Rs 450/Cost / Benefit 0.402

8.SGOT
Kits Cost Rs 11.97 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
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Total Cost Rs 24.94/Revenue Rs 90/Cost / Benefit 0.277

9.SGPT
Kits Cost Rs 11.97 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 24.94/Revenue Rs 90/Cost / Benefit 0.277

10.HIV
Kits Cost Rs 37.44 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 50.41/Revenue Rs 260/Cost / Benefit 0.193

11.HbsAg
Kits Cost Rs 19.2 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 32.17/Revenue Rs 160/Cost / Benefit 0.201

12.CBC
Kits Cost Rs 20 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 32.97/Revenue Rs 70/Institute of Management Studies

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Cost / Benefit 0.471

13.Blood Donation
Kits Cost Rs 28.32 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test + Rs 34/- Per Bag
Total Cost Rs 75.29/Revenue Rs 650/Cost / Benefit 0.116

14.VDRL
Kits Cost Rs 11 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 23.97/Revenue Rs 90/Cost / Benefit 0.267

15.Lipid Profile
Kits Cost Rs 42.91 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 55.88/Revenue Rs 425/Cost / Benefit 0.131

16.Cholesterol
Kits Cost Rs 11.98 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 24.95/Revenue Rs 90/Institute of Management Studies

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Cost / Benefit 0.277

17.HDL
Kits Cost Rs 9.93 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 22.9/Revenue Rs 120/Cost / Benefit 0.191

18.Triglyceride
Kits Cost Rs 26.87 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 39.84/Revenue Rs 125/Cost / Benefit 0.318

19.Alpha Feto Protein

Kits Cost Rs 90 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 102.97/Revenue Rs 450/Cost / Benefit 0.229

20.Serum Electrolytes
Kits Cost Rs 30 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
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=Rs 12.97/ Test

Total Cost Rs 42.97/Revenue Rs 220/Cost / Benefit 0.195

21.Na+
Kits Cost Rs 28 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 40.97/Revenue Rs 90/Cost / Benefit 0.455

22.K+
Kits Cost Rs 26 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 38.97/Revenue Rs 90/Cost / Benefit 0.433

23.CPK
Kits Cost Rs 45 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 57.97/Revenue Rs 275/Cost / Benefit 0.210

24.CPKMb
Kits Cost Rs 65 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
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=Rs 12.97/ Test

Total Cost Rs 77.97/Revenue Rs 375/Cost / Benefit 0.208

25.Hb
Kits Cost Rs 16 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 28.97/Revenue Rs 40/Cost / Benefit 0.724

26.T&D
Kits Cost Rs 17 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 29.97/Revenue Rs 60/Cost / Benefit 0.499

27. Pre Operative Profile

Kits Cost Rs 43 / Test
Other Costs Salary / test + electricity + Consumables +Miscel.
=Rs 12.97/ Test
Total Cost Rs 55.97/Revenue Rs 220/Cost / Benefit 0.254

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Findings
Cost and Revenue of various Tests for a period of six months
(September05 to February06)
1. FSH
i. No. of Tests 42
ii. Costs of Tests Rs 2,644.74
iii. Revenue Generated Rs 14,700
2. LH
i. No. of Tests 36
ii. Costs of Tests Rs 2,266.92
iii. Revenue Generated Rs 12,600
3. Prolactin
i. No. of Tests 48
ii. Costs of Tests Rs 3,156.96
iii. Revenue Generated Rs 17,760

4. T3
i. No. of Tests 192
ii. Costs of Tests Rs 11,130.24
iii. Revenue Generated Rs 48,000
5. T4
i. No. of Tests 264

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ii. Costs of Tests Rs 18,260.88

iii. Revenue Generated Rs 79,200

6. TSH
i. No. of Tests 402
ii. Costs of Tests Rs 19,685.94
iii. Revenue Generated Rs 1,20,600
7. PSA
i. No. of Tests 30
ii. Costs of Tests Rs 5,429.1
iii. Revenue Generated Rs 13,500
8. SGOT
i. No. of Tests 186
ii. Costs of Tests Rs 4,638.84
iii. Revenue Generated Rs 16,740
9. SGPT
i. No. of Tests 1026
ii. Costs of Tests Rs 25,588.44
iii. Revenue Generated Rs 92,340

10.HIV
i. No. of Tests 120
ii. Costs of Tests Rs 6,049.2
iii. Revenue Generated Rs 31,200
11.HBs Ag
i. No. of Tests 96
ii. Costs of Tests Rs 3,088.32
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iii. Revenue Generated Rs 15,360

12.CBC
i. No. of Tests 1248
ii. Costs of Tests Rs 41,146.56
iii. Revenue Generated Rs 87,360
13.Blood Donations
i. No. of Tests 1212
ii. Costs of Tests Rs 91,251.48
iii. Revenue Generated Rs 7,87,800
14.VDRL
i. No. of Tests 6
ii. Costs of Tests Rs 143.82
iii. Revenue Generated Rs 540
15.Lipid Profile
i. No. of Tests 234
ii. Costs of Tests Rs 13,075.92
iii. Revenue Generated Rs 99,450
16.Cholesterol
i. No. of Tests 18
ii. Costs of Tests Rs 449.1
iii. Revenue Generated Rs 1,620
17.HDL
i. No. of Tests 72
ii. Costs of Tests Rs 1,648.8
iii. Revenue Generated Rs 8.640
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18.Triglyceride
i. No. of Tests 30
ii. Costs of Tests Rs 1,195.2
iii. Revenue Generated Rs 3750
19.Alpha Feto Protein
i. No. of Tests 6
ii. Costs of Tests Rs 617.82
iii. Revenue Generated Rs 2,700
20.Serum Electrolyte
i. No. of Tests 306
ii. Costs of Tests Rs 13,148.82
iii. Revenue Generated Rs 67,320
21.Na+
i. No. of Tests 714
ii. Costs of Tests Rs 29,252.58
iii. Revenue Generated Rs 64,260
22.K+
i. No. of Tests 780
ii. Costs of Tests Rs 30,396.6
iii. Revenue Generated Rs 70,200

23.CPK
i. No. of Tests 12
ii. Costs of Tests Rs 695.64
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iii. Revenue Generated Rs3,300

24.CPKMb
i. No. of Tests 18
ii. Costs of Tests Rs 1,403.46
iii. Revenue Generated Rs 6,750

25.Hb
i. No. of Tests 2,478
ii. Costs of Tests Rs 71,787.66
iii. Revenue Generated Rs 99,120

26.T&D
i. No. of Tests 2442
ii. Costs of Tests Rs 73,186.74
iii. Revenue Generated Rs 1,46,520

27.Pre Operative Profile

i. No. of Tests 408
ii. Costs of Tests Rs 22,835.76
iii. Revenue Generated Rs 89.760

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Graphical Representation

Cost & Revenue of Tests

800000
700000
600000
500000
Amount 400000
300000
200000
100000
0

Cost
Revenue

Tests

SGPT
CBC
Na+
K+

1
2
3
4
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Hb
T&D
Blood

5
6
7

Graphical Representation

Cost & Revenue of Tests

140000
120000
100000
Amount

80000
60000

Cost
Revenue

40000
20000
0

Tests

Lipid Pro
TSH
S.Elec
T3
T4

1
2
3
4
5

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Pre Op P

Graphical Representation

Cost & Revenue of Tests

35000
30000
25000
Amount

20000
Cost
Revenue

15000
10000
5000
0
1

Tests

FSH
LH
Prolactin
HIV

1
2
3
4

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HbsAg
SGOT
PSA

5
6
7

Graphical Representation

Costs & Revenue of Tests

9000
8000
7000
6000
5000
Amount
4000
3000
2000
1000
0

Cost
Revenue

Tests

HDL
Alph F P
CPK
CPKMb
VDRL
Cholest

1
2
3
4
5
6

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Trigly

Recommendations
Sample collection Room must be widened to decrease congestion and
blockage by the people.
Records even of previous months must be available with the
Pathology Department.
The Computerized Print from machines must be attached with the lab
Reports to avoid human error in writing reports.
The Disposal of Sample Liquids must be away from the main lab to
avoid Air Bourne Infection.
Soothing Music must be there in Blood Collection Room.
Tie up with other Clinics to get more Tests and Profit: The Hospital
should Tie up with Clinics and Private Practitioners and ask them to
refer cases in Gokuldas Pathology. This will help the Hospital to
utilize the equipments to their fullest.
Due to Profit Margin among various Tests Hospital may also afford to
give concession to very poor patients.
Bulk purchases of kits with other Hospitals may significantly reduce
the cost of the Tests.

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Conclusion
Pathology is one of the major Revenue generating Department of the
Hospital. It is very efficient in working and all the latest technologies are
available in the Laboratory.
Measures are also taken to prevent any kind of Cross Infection. The staff
is also competent in their work.
From this Analysis of various major tests in Pathology, we have taken out
the Cost Benefit Ratio. It is also evident that as the number of Tests increase,
cost per Test to the Hospital decreases resulting in more Profit margins per
Test.
As the Cost Benefit Ratio of all the Tests is Less then one, so each and
every Test is bringing Profit of varying degree to the Hospital.
And on the basis of one month observation, various recommendations
were given to improve efficiency and optimize the benefit from various tests

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Limitations of the Project

The kits used in Pathology for same Test may differ widely in price
due to availability of kits, kits of different companies and bargaining
& bulk purchases. So Kits Costs have been taken as average.
The Cost Benefit Analysis of the Tests have been done on basis of six
month data which may have slight variation from exact (as may be in
those few months patients undergoing those Tests may have increased
or decreased)
The Patients undergoing more then one Test (as T3, T4 or TSH) and
thus receiving concession have been taken as individual cases due to
data retrieval problems.
The cost of electricity used in these Tests, cost of Diluents used in
machinery and various other miscellaneous charges have been taken
as an average.

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Bibliography

Books referred:
BM Sakharkar: Health and Hospital Administration
Francis :Hospital Planning and Management

Websites visited:
www.expresshealthcaremanagement.com
www.google.com

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Appendix
TYPES OF TESTS OBSERVED IN PATHOLOGY
S.No

Name Of Test

S.No Name Of Test

S.No Name Of Test

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34

Amylase
ABO Rh
Alk.Phos
ABG
Albumin
APTT
ADA
Anaemia
Ascitic fluid
ASO Titre
Blood Grp.
BTCT
Billirubin
BUN
Blood sugar
Blood Bags
Creatinine
Cholesterol
CBC
CSF
CRP
Ca+
Cross Match
CPK MB
Chloride
Culture sensitive
ESR
Electrolyte
Electrophoresis
FSH
FNAC lung
G6PD
Haemocystin
Hb

39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72

77
78
79
80
81
82
83
84

Herpes Virus
LDH
LFT
Ig for TB
Ketone
MP by QBC
MT
MCV
Platelets
PCV
Protein
PT
Pap Smear
Plural Fluid
Pregnancy test
PSA
Prolactin
RBC
Renal profile
RA Factor
Rectic count
Semen
SGPT&SGOT
Stool
Sputum-AFB
Synovial Fluid
T&D
Thyroid
TCBC
Triglyceride
TropT
Toxic Grnules
TDMP
Urine

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Testesteron
HDL
LDL
VLDL
MCH
MCHC
Toxic Granules
Glycosynate

32

35
36
37
38

HbsAg
HIV
Histopathin
HCV

73
74
75
76

Uterus-HPE
VDRL&Widal
Health Checkup
Band Cell

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