Philippine Children's Medical Center

Quezon Avenue, cor. Agham Rd., Diliman, Quezon City (+02)85889900 loc. 425

COVID-19 TESTING LABORATORY

Molecular Pathology Result Form

Name of Patient: BROQUEZA, JONNEL REGORIS

(Last Name, First Name, Middle Name)

Age/Sex: 27/M Date of Birth: 07/08/1993

(MM/DD/YYYY)
Patient Location: Address: 1501 MAIN STREET PACO MANILA
OPD
REFERRAL Date of Admission:
INPATIENT (MM/DD/YYYY) N/A
Requisitioner: N/A Accession No:
B1226OP129
Specimen Type: OPS/NPS
Date and Time of Specimen Collection: Date and Time of Specimen Receipt: 12/26/2020
(MM/DD/YYYY HH:MM)
12/26/2020
(MM/DD/YYYY HH:MM) 04:00PM
Date and Time of Release of Result:
(MM/DD/YYYY HH:MM)
12/28/2020 11:00AM
LABORATORY TEST RESULTS

LABORATORY TEST PERFORMED: SARS-COV-2 (causative agent of COVID-19) virus detection by Real-Time
Polymerase Chain Reaction

TEST RESULT: SARS-CoV-2 (causative agent of COVID-19) viral RNA not detected

INTERPRETATION OF RESULTS WHEN APPROPRIATE

FINAL RESULT INTERPRETATION
SARS-CoV-2 (causative agent of COVID-19) Positive for SARS-CoV-2 (causative agent of
viral RNA detected COVID-19)
SARS-CoV-2 (causative agent of COVID-19) Negative for SARS-CoV-2 (causative agent of
viral RNA not detected COVID-19)
Negative for Test Internal Control (most likely due to
Invalid due to specimen quality
poor specimen quality)

This laboratory test result should be interpreted together with the available clinical and epidemiological information
COMMENTS:

Performed by: Verified by: Noted by:

JOVEL ORTEGA RAMOS, R.M.T.

License No.: 0057341
GRIG D. MISIONA, MD, DPSP RAYMUNDO W. LO, MD, FPSP
License No.: 098149 License No.: 0046115

MANUEL SAN DIEGO BAUTISTA JR., R.M.T.

License No.: 0066186