Government of People’s Republic of Bangladesh

Institute Name: Department of Microbiology

Khulna Medical College
Address: Boyra, Khulna - 9000

Laboratory Test report

Laboratory Test Performed by: Real Time PCR for COVID-19

Specimen: Nasal Swab, Throat Swab, Others

Name of Sample Collection Mobile

Patient Name Age Sex
Hospital/Facility/Center/Booth Number

Rupsha Upazilla Health Complex Md Abdul Mannan 01712757534 52 Male

Upazila/ Date of Sample Date of

Address District Sample ID
Thana Collection Test

31/60 Ansnagor 16-04-

Khulna Khulna 12-04-2021 KMC-89785
Boyra 2021

Comment: Positive

This Report Is Issued By Competent Authority Based On Lab Result.

This Is A Computer Generated Document Required No Signature.