Physician dr Hendra Koswara Across KBIP Garut J Raya Samaranag Gerut RegNo/ Date 2012100065 / 10-12-2020 Gender Male Patient ID 0815-2012.00107 DOB /Age 01-07-1990 /30 Year 5 Month Patient Name Mr, Ucu Phane Adress Kp, Nangewer RT. 008 RW 004 Selakuray Bayongbeng Gant Result status Parameter Resuit Ref Renge Unit Note MOLECULAR SARS-CaV/-2 RNA Specimen # Nasopharyngeal anc! Oropharyngeal Swab Result Not Detected Net detected Method: RealTime Reverse Transeripton PCR (RT-PCR) Comment # ~ Not Detected result ‘nicates bo absence of SARS-GoV-2 RNA Inpatients sarnple ‘This result describes the condition atthe time ‘of specimen collection. = Correlation with Claical condition, patemts€™s history, and other diagnostic information is needed. Please contact medical ‘octor any cinical Indication appear Not Detected results can be due tothe presence of an inhibitor inthe patient's specimen or the concentration ‘of val nuclei acid 's below the limit of Specimen Collection Time: Nasopharyngeal and Oropharyngeal Swab - 10/12/20 14:53 Ma 1/2@ 2veom x0023 yy habien Susasis Mamie et ned gene separ Ingest val) ot Wh ftom ange {het perarnesin Pode Cleat boatn, Kar aye 150 Jes ‘nerpretaron oss) sou be don anh carcino, OLibortorum Kink Pris @@reds 2d erode Lay wwnnprdinceldRegNo/ Date - 2012100065 10-12-2020 Gender Male Patient ID 0315-2012.00107 DOB! Age 01-07-1990 130 Year 5 Month Patient Name Mr. Uew Phone Parameter Result Ref Range Unit Note Validate by Nabilah Salsabila ( Quality Validator ) Lancgaronna KUNI Authorized By, Ho 2i2@ 1202 inicees vata ot win erence range {te etwas eainea Presa Cina tatordtn Kat Raya 140 deat Ines of wars) rast seus be Sve ony casein care ia it ice alae er etalSURAT KETERANGAN HASIL TES RT-PCR SARS CoV-2 RNA | (Result PCR Statement Letter) | Yang bertenda tangan di bawah ini: dr. | menerangkan bahwa : [the undorigned: dr. LUNIA. ENTE. | Hereby cert base on the idenity below : Nama (Name) uw Tanggal lahir (0.0.8) auly ot, N40 Alamat (Address) TR: Mangener 05 looy .Nesn Salakiney Pekerjaan (Occupation) Neus, eee Noyemberey No.KTP aaa IosrouwrRoeyo /DLaIwSy, ‘Sudah dilakukan pemeriksaan (has been undertake the test of): | RT-PCR SARS CoV-2 RNA dengan hasil (the result): TERDETEKSI (DETECTED) (TIDAK TERDETEKSI (UNDETECTED) |Demikian surat keterangan ini dibuat dengan sebenar-benamya dan dipergunakan| | sebagaimana mestinya sesuai peraturan yang beriaku. This statement letter thus made truthtully and to be used properly based on related regulation. éIP: . | | | | | | | * Lingkarippilih yang sesual