Ectoparasite virus report 
Blood sample .. :._ heart 
papular 
other 
Plasma analysis 
Tests* VI 
m 
j 
Plasma virus report VI: negative 
... -...positive _____ 
vims 
HI:__ _ 
HI:__ 
HI: __ 
N:___ 
Blood smear_Stain(s) 
Blood smear results_ 
Remarks_ 
