OUR LADY OF MT.

CARMEL MEDICAL CENTER

Km.78 Mc. Arthur Highway, Brgy. Saguin, City of San Fernando, 2000 Pampanga
Trunk Line: (045) 860-1265, (045) 860-0993, (045) 435-2421, (045) 435-2420
Fax No.: (045) 455-1416 | email:molecularlaboratory.olmcmc@gmail.com

MOLECULAR LABORATORY DEPARTMENT

PATIENT NAME ACCESSION NUMER

CORTADO, FLORA PADILLA ML2100001252
DATE OF BIRTH AGE / SEX NATIONALITY DATE/TIME COLLECTED
07/29/1937 83Y / Female FILIPINO 2/2/2021 10:05:28 AM
PATIENT ADDRESS DATE/TIME RECEIVED
BLK 12 LOT 20 A, SANTOL RD, CALIBUTBUT, BACOLOR, PAMPANGA 2/2/2021 10:54:26 AM
DATE/TIME RELEASED
CONTACT NUMBER 2/2/2021 11:14:55 PM
09179940971 REQUESTING PHYSICIAN
N/A
WARD / Out-Patient In-Patient Referral

MOLECULAR LABORATORY TEST RESULT

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
RESULT INTERPRETATION
SARS-CoV-2 (causative agent of COVID-19) viral RNA detected Positive for SARS-CoV-2 (causative agent of COVID-19)

SARS-CoV-2 (causative agent of COVID-19) viral RNA not detected Negative for SARS-CoV-2 (causative agent of COVID-19)

INVALID due to specimen quality Negative for test internal control (most likely due to poor specimen quality)

This test result should be interpreted in correlation with the available clinical epidemiological information.

Remarks: N/A

Performed by: Verified by: Noted by:

MA. KATRINA D. LAXAMANA, RMT CIELO MARIE R. RAMOS, RMT GIAN CARLO S. VILLANUEVA, RMT KATHRYNA LESLEY T. AYRO, MD, FPSP
Medical Technologist Medical Technologist Medical Technologist Pathologist
PRC No.: 0093527 PRC No.: 0091803 PRC No.: 0041523 PRC No.: 0079384

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THIS IS A COMPUTER GENERATED REPORT

 OUR LADY OF MT. CARMEL MEDICAL CENTER

CERTIFICATION

To whom it may concern,

This is to certify that Mr./Ms. CORTADO, FLORA PADILLA underwent COVID-19 testing
using RT-PCR on 2/2/2021 11:14:55 PM at Our Lady of Mt. Carmel Medical Center an institution
recognized by the Government of the Philippines.

Date & Time of Specimen Collection: 2/2/2021 10:54:26 AM

Test Conducted: SARS-CoV-2 (causative agent of COVID-19) virus detection by Real-Time
Polymerase Chain Reaction Test

Remarks and Recommendations

·                                                                    
SARS-CoV-2 (causative agent of COVID-19) viral RNA not detected
·     Continue COVID-19 precautionary measures

This certificate is issued upon the request of the patient for whatever purpose it may serve.
Thank you.

NOTE: NOT FOR MEDICO-LEGAL PURPOSES

AUTHENTICITY VALIDATION

KATHRYNA LESLEY T. AYRO, MD, FPSP

Pathologist
PRC No. : 0079384

Km. 78 Mc. Arthur Brgy. Saguin, City of San Fernando, Pampanga

(045) 860-1265, (045) 860-0093, (045) 435-2421, (045) 435-2420
molecularlaboratory.olmcmc@gmail.com

THIS IS A COMPUTER GENERATED RESULT.