PATIENT ID{{ Entry.patient.patient_id }}
DOB{{ Entry.patient.dob |date:"m/d/Y" }}
AGE{% if Entry.patient.age %}{{ Entry.patient.age }}{% else %}{{ Entry.patient.how_old }}{% endif %}
GENDER{{ Entry.patient.show_gender_name }}

CLIENT ID {{ Entry.patient.patient_client.client_code }} ATTENDING PHYSICIAN: {{ Entry.physician_name }}

ADDRESS {{ Entry.patient.patient_client.business_address }}{% if Entry.patient.patient_client.business_address2 %} {{ Entry.patient.patient_client.business_address2 }} {% endif %} {{ Entry.patient.patient_client.business_city }}, {{ Entry.patient.patient_client.business_state }}, {{ Entry.patient.patient_client.business_zipcode }}

ACCESSION #:{{ Accession.accession_number }}
COLLECTED:{{ Entry.collection_date |date:"m/d/Y" }}
RECEIVED:{{ Entry.created_date |date:"m/d/Y"}}
REPORTED:{{ Accession.completed_date |date:"m/d/Y" }}

{% if Accession.exam_in.exam_casetype.case_type_id == 1 %}

CLINICAL INFORMATION

Specimen Source: {% if Entry.GYN_Cervix == 1 %} Cervix, {% endif %} {% if Entry.GYN_Vaginal == 1 %}Vaginal, {% endif %} {% if Entry.GYN_Endocervix == 1 %}Endocervix, {% endif %} {% if Entry.GYN_None == 1 %} None given {% endif %}
LMP8/15/2015

Specimen Type: {% if Entry.GYN_speciment_type == 'Conventional' %}Conventional{% else %}Liquid Base PAP{% endif %}
STATUSRegular

Clinical Findings: {% if Entry.GYN_routine == 1 %}Routine {% endif %} {% if Entry.GYN_vaginitis == 1 %}Vaginitis, {% endif %} {% if Entry.GYN_cervicitis == 1 %}Cervicitis, {% endif %} {% if Entry.GYN_condyloma == 1 %}HPV, {% endif %} {% if Entry.GYN_herpes == 1 %}Possible Herpes,{% endif %} {% if Entry.GYN_clinically_suspicious == 1 %}Clinically suspicious, {% endif %} {% if Entry.GYN_abnormal_bleeding == 1 %}Abnormal Bleeding, {% endif %} {% if Entry.GYN_cervical_lesion == 1 %}Cervical Lesion, {% endif %} {% if Entry.GYN_menopausal_syndrome == 1 %}Menopausal Syndrome, {% endif %} {% if Entry.GYN_bleeds_on_contact == 1 %}Bleeds on Contact, {% endif %} {% if Entry.GYN_infection == 1 %}Infection, {% endif %} {% if Entry.GYN_iud == 1 %}IUD, {% endif %} {% if Entry.GYN_discharge == 1 %}Discharge, {% endif %} {% if Entry.GYN_hysterectomy == 1 %}Hysterectomy, {% endif %} {% if Entry.GYN_hysterectomy == 1 %}{% if Entry.GYN_discharge_info == 'Partial' %}Partial {% endif %}{% if Entry.GYN_discharge_info == 'Total' %}Total{% endif %} {% endif %}

OTHER INFO: {% if Entry.GYN_hysterectomy_description %}{{ Entry.GYN_hysterectomy_description }} {% endif %}

RESULTS

SPECIMEN ADEQUACY:

{% for result in Results_in_specimen %} {% if result.code_casetype_result.case_type_id == Accession.exam_in.exam_casetype.case_type_id %} {% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {% if accession.result_in_speciment.all %} {% for res in accession.result_in_speciment.all %} {% if result.code_id == res.code_id %} {% if result.code_result_type == 1 %} {{ result.code_description }}
{% else %}

{% endif %} {% endif %} {% endfor %} {% endif %} {% endif %} {% endfor %} {% endif %} {% endfor %}

INTERPRETATION / RESULTS:

{% for result in Results_in_interpretation %} {% if result.code_casetype_result.case_type_id == Accession.exam_in.exam_casetype.case_type_id %} {% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {% if accession.result_in_interpretation.all %} {% for res in accession.result_in_interpretation.all %} {% if result.code_id == res.code_id %} {% if result.code_result_type == 1 %} {{ result.code_description }}
{% else %}

{% endif %} {% endif %} {% endfor %} {% endif %} {% endif %} {% endfor %} {% endif %} {% endfor %}

ADDITIONAL FINDINGS:

{% for result in Results_in_additional %} {% if result.code_casetype_result.case_type_id == Accession.exam_in.exam_casetype.case_type_id %} {% if Entry.accession_number.all %} {% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {% if accession.result_in_additional.all %} {% for res in accession.result_in_additional.all %} {% if result.code_id == res.code_id %} {% if result.code_result_type == 1 %} {{ result.code_description }}
{% else %}

{% endif %} {% endif %} {% endfor %} {% endif %} {% endif %} {% endfor %} {% endif %} {% endif %} {% endfor %}

HORMONAL EVALUATION:

{% for result in Results_in_hormonal %} {% if result.code_casetype_result.case_type_id == Accession.exam_in.exam_casetype.case_type_id %} {% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {% if accession.result_in_hormonal.all %} {% for res in accession.result_in_hormonal.all %} {% if result.code_id == res.code_id %} {% if result.code_result_type == 1 %} {{ result.code_description }}
{% else %}

{% endif %} {% endif %} {% endfor %} {% endif %} {% endif %} {% endfor %} {% endif %} {% endfor %}

COMMENTS

{% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {{ accession.GYN_result_comment }} {% endif %} {% endfor %}

{% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {% if accession.GYN_result_photo %}

SPECIMEN IMAGE

{% if accession.GYN_result_caption %}

{% endif %}

{% endif %} {% endif %} {% endfor %}

{% endif %} {% if Accession.exam_in.exam_casetype.case_type_id == 2 %}

CLINICAL INFORMATION

SPECIMEN SOURCE: {% if Entry.Non_GYN_specimen_source %} {% for source in no_gyn_specimen_sources %} {% if source.id == Entry.Non_GYN_specimen_source %}{{ source.name }}{% endif %}{% endfor %}{% endif %}

CLINICAL INFORMATION: {% if Entry.Non_GYN_clinical_info %}{{ Entry.Non_GYN_clinical_info }}{% endif %}

GROSS DESCRIPTION: {% if Entry.Non_GYN_gross_description %}{{ Entry.Non_GYN_gross_description }}{% endif %}

RESULTS

SPECIMENT RECEIVED:

{% for accession in Entry.accession_number.all %}{% if Accession.exam_in.exam_id == accession.exam_in.exam_id %}{{ accession.Non_GYN_result_speciment_received }}{% endif %}{% endfor %}

CLINICAL DATA:

{% for accession in Entry.accession_number.all %}{% if Accession.exam_in.exam_id == accession.exam_in.exam_id %}{{ accession.Non_GYN_result_clinical_data }}{% endif %}{% endfor %}

GROSS DESCRIPTION:

{% for accession in Entry.accession_number.all %}{% if Accession.exam_in.exam_id == accession.exam_in.exam_id %}{{ accession.Non_GYN_result_gross_description }}{% endif %}{% endfor %}

DIAGNOSIS:

{% for accession in Entry.accession_number.all %}{% if Accession.exam_in.exam_id == accession.exam_in.exam_id %}{{ accession.Non_GYN_result_diagnosis }}{% endif %}{% endfor %}

COMMENT:

{% for accession in Entry.accession_number.all %}{% if Accession.exam_in.exam_id == accession.exam_in.exam_id %}{{ accession.Non_GYN_result_comment }}{% endif %}{% endfor %}

{% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {% if accession.Non_GYN_result_photo %}

SPECIMEN IMAGE

{% if accession.Non_GYN_result_caption %}

{% endif %}

{% endif %} {% endif %} {% endfor %}

{% endif %} {% if Accession.exam_in.exam_casetype.case_type_id == 3 %}

CLINICAL INFORMATION:

SPECIMEN SOURCE: {% if Entry.MP_speciment_source == 'Vaginal' %}Vaginal swab, {% endif %}  {% if Entry.MP_speciment_source == 'Urethral' %}Urethral swab, {% endif %} {% if Entry.MP_speciment_source == 'Urine' %}Urine, {% endif %}  {% if Entry.MP_speciment_source == 'Liquid-based' %}Liquid based, {% endif %} {% if Entry.MP_speciment_source == 'PAP' %}PAP{% endif %}

RESULTS

COMMENT:

{% for accession in Entry.accession_number.all %}{% if Accession.exam_in.exam_id == accession.exam_in.exam_id %}{{ accession.MP_result_comment }}{% endif %}{% endfor %}

CHLAMYDIA TRACHOMATIS EVALUATION

{% for result in Results_in_interpretation %} {% if result.code_casetype_result.case_type_id == case.exam_casetype.case_type_id %} {% for accession in Entry.accession_number.all %} {% if case.exam_id == accession.exam_in.exam_id %} {% if accession.result_in_molecular_CHlamydia_trachomatis.all %} {% for res in accession.result_in_molecular_CHlamydia_trachomatis.all %} {% if result.code_id == res.code_id %} {% if result.code_result_type == 1 %} {{ result.code_description }}
{% else %}

{% endif %} {% endif %} {% endfor %} {% endif %} {% endif %} {% endfor %} {% endif %} {% endfor %}

NEISSERIA GONORRHOEAE EVALUATION

{% for result in Results_in_interpretation %} {% if result.code_casetype_result.case_type_id == case.exam_casetype.case_type_id %} {% for accession in Entry.accession_number.all %} {% if case.exam_id == accession.exam_in.exam_id %} {% if accession.result_in_molecular_Neiseria_gonorroeae.all %} {% for res in accession.result_in_molecular_Neiseria_gonorroeae.all %} {% if result.code_id == res.code_id %} {% if result.code_result_type == 1 %} {{ result.code_description }}
{% else %}

{% endif %} {% endif %} {% endfor %} {% endif %} {% endif %} {% endfor %} {% endif %} {% endfor %}

{% for accession in Entry.accession_number.all %} {% if case.exam_id == accession.exam_in.exam_id %} {% if accession.MP_result_photo %}

SPECIMEN IMAGE

{% if accession.MP_result_caption %}

{% endif %}

{% endif %} {% endif %} {% endfor %}

{% endif %} {% if Accession.exam_in.exam_casetype.case_type_id == 4 %}

CLINICAL INFORMATION

{{ Entry.SP_clinical_info }}

{% if Entry.test_in_entry.all %}  {% for exam in Entry.test_in_entry.all %} {% if Accession.exam_in.exam_casetype.case_type_name == exam.exam_casetype.case_type_name %} {% for i in exam.get_cut_range %} 

Specimen Source Part # {{ forloop.counter }}: {% if forloop.counter == 1 %}{{ Entry.SP_specimen_source_1 }}{% elif forloop.counter == 2 %}{{ Entry.SP_specimen_source_2 }}{% elif forloop.counter == 3 %}{{ Entry.SP_specimen_source_3 }}{% elif forloop.counter == 4 %}{{ Entry.SP_specimen_source_4 }}{% elif forloop.counter == 5 %}{{ Entry.SP_specimen_source_5 }}{% elif forloop.counter == 6 %}{{ Entry.SP_specimen_source_6 }}{% elif forloop.counter == 7 %}{{ Entry.SP_specimen_source_7 }}{% elif forloop.counter == 8 %}{{ Entry.SP_specimen_source_8 }}{% elif forloop.counter == 9 %}{{ Entry.SP_specimen_source_9 }}{% elif forloop.counter == 10 %}{{ Entry.SP_specimen_source_10 }}{% elif forloop.counter == 11 %}{{ Entry.SP_specimen_source_11 }}{% elif forloop.counter == 12 %}{{ Entry.SP_specimen_source_12 }}{% endif %}

Gross description Part # {{ forloop.counter }}: {% if forloop.counter == 1 %}{{ Entry.SP_gross_description_1 }}{% elif forloop.counter == 2 %}{{ Entry.SP_gross_description_2 }}{% elif forloop.counter == 3 %}{{ Entry.SP_gross_description_3 }}{% elif forloop.counter == 4 %}{{ Entry.SP_gross_description_4 }}{% elif forloop.counter == 5 %}{{ Entry.SP_gross_description_5 }}{% elif forloop.counter == 6 %}{{ Entry.SP_gross_description_6 }}{% elif forloop.counter == 7 %}{{ Entry.SP_gross_description_7 }}{% elif forloop.counter == 8 %}{{ Entry.SP_gross_description_8 }}{% elif forloop.counter == 9 %}{{ Entry.SP_gross_description_9 }}{% elif forloop.counter == 10 %}{{ Entry.SP_gross_description_10 }}{% elif forloop.counter == 11 %}{{ Entry.SP_gross_description_11 }}{% elif forloop.counter == 12 %}{{ Entry.SP_gross_description_12 }}{% endif %}

{% endfor %} {% endif %}  {% endfor %}  {% endif %}

RESULTS

{% if Entry.test_in_entry.all %} {% for exam in Entry.test_in_entry.all %} {% if Accession.exam_in.exam_casetype.case_type_name == exam.exam_casetype.case_type_name %} {% for i in exam.get_cut_range %}

Part # {{ forloop.counter }} - Results : {% for accession in Entry.accession_number.all %}{% if Accession.exam_in.exam_id == accession.exam_in.exam_id %}{% if forloop.counter == 1 %}{{ accession.SP_result_part_1 }}{% elif forloop.counter == 2 %}{{ accession.SP_result_part_2 }}{% elif forloop.counter == 3 %}{{ accession.SP_result_part_3 }}{% elif forloop.counter == 4 %}{{ accession.SP_result_part_4 }}{% elif forloop.counter == 5 %}{{ accession.SP_result_part_5 }}{% elif forloop.counter == 6 %}{{ accession.SP_result_part_6 }}{% elif forloop.counter == 7 %}{{ accession.SP_result_part_7 }}{% elif forloop.counter == 8 %}{{ accession.SP_result_part_8 }}{% elif forloop.counter == 9 %}{{ accession.SP_result_part_9 }}{% elif forloop.counter == 10 %}{{ accession.SP_result_part_10 }}{% elif forloop.counter == 11 %}{{ accession.SP_result_part_11 }}{% elif forloop.counter == 12 %}{{ accession.SP_result_part_12 }}{% endif %}{% endif %}{% endfor %}

{% endfor %} {% endif %} {% endfor %} {% endif %}

{% for accession in Entry.accession_number.all %} {% if Accession.exam_in.exam_id == accession.exam_in.exam_id %} {% if accession.SP_result_photo %}

SPECIMEN IMAGE

{% if accession.SP_result_caption %}

{% endif %}

{% endif %} {% endif %} {% endfor %}

{% endif %} {% if Accession.exam_in.exam_casetype.case_type_id == 3 %}

This test was processed using the Aptima Combo2 Assay on the Panther System.

{% endif %}

SCREENED BY: Carlos Lovera, CT (ASCP)

FINAL REPORT

{{ Entry.patient.full_name }}

{{Entry.patient.patient_client.business_legal_name }}

{{ Accession.exam_in.exam_casetype.case_type_name |upper}}

CLINICAL INFORMATION

RESULTS

SPECIMEN ADEQUACY:

INTERPRETATION / RESULTS:

ADDITIONAL FINDINGS:

HORMONAL EVALUATION:

COMMENTS

SPECIMEN IMAGE

CLINICAL INFORMATION

RESULTS

SPECIMENT RECEIVED:

CLINICAL DATA:

GROSS DESCRIPTION:

DIAGNOSIS:

COMMENT:

SPECIMEN IMAGE

CLINICAL INFORMATION:

RESULTS

COMMENT:

CHLAMYDIA TRACHOMATIS EVALUATION

NEISSERIA GONORRHOEAE EVALUATION

SPECIMEN IMAGE

CLINICAL INFORMATION

RESULTS

SPECIMEN IMAGE