Date: Location:
Test Result Date Collected (if not today)
01. CD4 Count
02. CD4%
03. VDRL
04. ALT
05. Creatinine
06 (a). HIV Viral Load
06 (b). HIV Viral Load(LDL)
07. HIV DNA PCR
08. Hemoglobin
09. Urinalysis
10. Malaria Smear