Blood sample * . heart. ... jugular other_ 
Plasma analysis _—Tests: VI. . HI_N 
Plasma virus report VI: negative __positive _virus _ 
HI: ______ 
HI: _ ____ 
HI: ___ _ 
N:_____ 
Blood smear_Stain(s)___ 
Blood smear results_____ 
Remarks __ 
