OFFICE OF THE MEDICAL OFFICER IN CHARGE ,

TATA STEEL COVID-19 HOSPITAL , JAJAPUR

TEST REPORT OF COVID-19
It is to certify that,Shri/Smt/Ms.............................................
(M/F/Other)...........................Aged....................S/C/D/W/O.........................................Village/
Ward...........................................................Dist/City.................................................was tested
for COVID-19 as per the sample collected on the date.........................SL
No....................found ............................for COVID-19. Antigen Test.

He/She has been advised home quarantine for.................days.

Authorized Sign & Seal

Designation:Medical Officer I/C

Date:..........................................

Place: