LABORATORIUM RUMAH SAKIT FIRDAUS TEST RESULT REPORT. LAPORAN HASIL PENGUJIAN Laboratory/health institution: Firdaus Hospital (Rumah Sakit Firdaus) ‘Nama fasilitas Kesehatan Sample type lenis sampel Date of specimen collection Tanggal pengambilan sampel Nasopharynx /Oropharynx Swab November 5%, 2020 Date of testing + November 6", 2020 Tanggal pengujian Test results + POSITIVE Hasil pengufian Patient's Indentity Sample Code | SARS Cov-2 Information Hdentitas Pasien KodeSampel | RealTime PCR | Keterangan Patient's name : FRANKY AGUS HATMOKO ‘003451 POSITIVE | RT-PCR Method ‘Nama pasien Tage Gases Baton + August 11th, 197 eaeeant : INDONESIAN (Ct 95: Positive Passport number/NIK ID : 3674061108770011 No. passport ‘These results are just a representation of condition when the specimen is collected. If there is a clinical symptom/contact with infected patient after testing, please contact nearest physician/health institution. Hasil tersebut hanya menggambarkan kondisi pengambilan specimen. Jika timbul gejala Kinis/komak dengan pasien terinfeksi setelah pemeriksaan, silahkan menghubungi dokter/fasilitas kesehatan terdekat. Published at + Jakarta Dikeluarkan di Published date + November 6", 2020 Tanggal dikelarkan Approved by, Menyetujui. Person in Charge of Firdaus Hospital PCR Laboratory Penanggung Jawab Laboratoriam PCR Rumah Sakit Firdaus SukopureJoterta 14140 {eto (021) 4407322, 400077 Fx (021) 4400043 ‘email abortyshoe com LIke ee ee ee ED MED-«2 Rov.0 Scanned with CamScanner