Northern Virginia Doctors Hospital serology and urinalysis lab forms for Jack Coffelt

Document date 13 December 1971

Part 86page 621 pageDB Cooper-37906

Open in FBI Vault (Part 86, page 62 of the PDF)
Report a problem

Email this to [email protected]

Id: Cooper-Part-86:062-062

Subject: Cooper Files: Cooper-Part-86:062-062

Document: Northern Virginia Doctors Hospital serology and urinalysis lab forms for Jack Coffelt
Id: Cooper-Part-86:062-062
Page: https://cooper.theunsolved.net/documents/Cooper-Part-86%3A062-062

What is wrong (title, date, type, which pages belong together, copies)?


What does the scan show?

Open in email app

A person reads every report. Corrections are made by hand, to the data — titles, dates, names, which pages belong together — never to the scans, and they can take a while to appear.

FBI 164-81, Vault Part 86 p. 62 (DB Cooper-37906), Form, dated 13 Dec 1971 — cooper.theunsolved.net/documents/Cooper-Part-86%3A062-062

COFFELT, JACK EMP.

NORTHERN VIRGINIA DOCTOR'S HOSPITAL DEPARTMENT OF PATHOLOGY SEROLOGY I

DATE: 12-13-71

☐ Direct Coombs ☐ Indirect Coombs ☑ Admission Serology mn [guess: reactive] ☐ Rh Titer ☐ Pre Marital Serology ☐ Monospot VDRL Slide Test ☐ Heterophile ☐ VDRL Quantitative ☐ ASO-Titer ☐ FTA - ABS ☐ R. A. Test (Latex) ☐ Febrile Agglutinations ☐ C-Reactive Protein

[Handwritten notation at bottom right]: 5.12.7 [guess: K]

---

COFFELT, JACK EMP.

NORTHERN VIRGINIA DOCTORS HOSPITAL DEPARTMENT OF PATH[OLOGY] URINALYSIS

DATE: 12-13-71

SPECIMEN TAKEN BY ☐ Cath [guess: Avoid] Clean ☐ Catch ☐ ADMISSION URINALYSIS ☐ Repeat Urinalysis Appearance ________ Reaction ________ Specific Gravity ________ ☑ Albumin ☑ Sugar ☐ Acetone ________ ☐ Diacetic Acid ________ ☐ Bilirubin ________ ☐ Urobilinogen ________

Leukocytes ________ Erythrocytes ________ Casts: Hyaline ________ Finely Granular ________ Coarsely Granular ________ Cellular ________ Waxy ________ Epithelium ________ Crystals ________ Mucus ________ Miscel: ________ ☐ Occult Blood ________ ☐ Glitter Cell ________

☐ Bence Jones ________ Protein ☐ Sulkowitch ________ (urinary calcium) ☐ Porphobilinogen ________ ☐ Phenylpyruvic ________ Acid ☐ Serotonin (5HIAA)

24 HOUR SPECIMENS: ☐ VMA ________ ☐ 17 Ketosteroids ________ ☐ Catecholamines ________ ☐ 17 Ketogenicsteroids ________

TECH [stamp/initials] DATE Nurses Signature 12-13-71

---

CHART

DB Cooper-37906