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Dаtе оf lD пumЬеr // - о
Dziшlis (-usi) identifit<,йci.!as ýr.
Paoients apliecina, ka ir rrodevis savu urТпа analTzi un vi8am ir darTts zinams раr
alkohola uп narkotisko vielu klЕtbtltnes parbaudi organismЕ.

Раrаk-чts Datums

pencyclidin. &jЕGДТFУА (cut off чаIuе 25ngirn{-)

Mentlramphetamine r{ЕGАТýVА (cut offvalue 100* ngimL)

Amphetamines trЖGДТfr'.lЯ,е (cut offvalue i000 ng/ml)

h{Dlv{,{ ffiЕ,ý&т=Rrд (cut offvalue 500пg/ml-)

cocaine ýtЕЭ_:; ;;д (сшt off ,,;alrre З00 nglmI-)

opiate fчЕ Э_:; i:ц (cut offvalr,re З00 пgЛтrl-)

Моцэhiпе jlц (cut oflf rlalue ЗС0 пglпй)

'ЧЕЗЛ
Cannabinoids ttсЕЭ-;:-л (cut off value 50 ng/rril,)

ВагЬirttrаtеS ГтЁз-i,.:.уl, (cut off value З00 пg/mtr )

BenzoxiazePines т;:--: (ctrt оff vaiue З00 nglml,)

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Alcohol ГtЁз:_-,: i;,,я

Result of screening for drшg аЬшsе usig ACON Мuiti-Drug test.

(ACO},I Lпboratories, USA). Ргеlimiпаry testing only.
positive results nrust Ье сопfirmеd with aiteniative method.

Date of test
теstёёапаs datums
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е

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I-aboratorij as vadTtaj а
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