Blood sample ____ -. .heart ....... J ugular ,____ _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______________—— — -—— 
