Name : BAMBANG SURYANTO Lab.

Number : 7702704
Date Of Birth : 19-06-1973 Med. Record : 202101077702704
KTP/Passport : 3171081906730010 Order Entry : 08-01-2021
Sex : MALE Date of Exam : 09-01-2021
Nationality : INDONESIA Company : APS

LABORATORY RESULT
EXAMINATION RESULT NORMAL RANGE
PCR Test (Swab)
Sample Nasopharyngeal and Oropharyngeal
SARS-COV-2 Negative Negative

Molekular
SARS_CoV-2
Cycle threshold : >40 lU/mL

Clinical Analysis :
Hasil pemeriksaan Negatif tidak menyingkirkan kemungkinan infeksi
SARS-COV2(COVID-19), Kemungkinan penyebab / A Negative result does not
rule out the possibility of Covid 19 infection:
a) Tidak terinfeksi SARS-COV2 / Not currently infected with SARS-CoV-2
or Covid-19
b) Tidak ditemukan materi genetic SARS-COV2 pada sample / No Genetic
material of Virus SARS-CoV-2 or Covid-19 was found in the specimen of
this patient

Doctor :

dr.Anne Harun Sp.PK

Verified By : M. Faiz Ardiansyah, Amd.AK

Name : FEBRIYANI ANUGRAHINI Lab. Number : 7702705
Date Of Birth : 18-02-1977 Med. Record : 202101077702705
KTP/Passport : 3171085802770004 Order Entry : 08-01-2021
Sex : FEMALE Date of Exam : 09-01-2021
Nationality : INDONESIA Company : APS

LABORATORY RESULT
EXAMINATION RESULT NORMAL RANGE
PCR Test (Swab)
Sample Nasopharyngeal and Oropharyngeal
SARS-COV-2 Negative Negative

Molekular
SARS_CoV-2
Cycle threshold : >40 lU/mL

Clinical Analysis :
Hasil pemeriksaan Negatif tidak menyingkirkan kemungkinan infeksi
SARS-COV2(COVID-19), Kemungkinan penyebab / A Negative result does not
rule out the possibility of Covid 19 infection:
c) Tidak terinfeksi SARS-COV2 / Not currently infected with SARS-CoV-2
or Covid-19
d) Tidak ditemukan materi genetic SARS-COV2 pada sample / No Genetic
material of Virus SARS-CoV-2 or Covid-19 was found in the specimen of
this patient

Doctor :

dr.Anne Harun Sp.PK

Verified By : M. Faiz Ardiansyah, Amd.AK

Name : AZKA DWI KHAERANI Lab. Number : 7702706
Date Of Birth : 03-06-2007 Med. Record : 202101077702706
KTP/Passport : 3171084306070004 Order Entry : 08-01-2021
Sex : MALE Date of Exam : 09-01-2021
Nationality : INDONESIA Company : APS

LABORATORY RESULT
EXAMINATION RESULT NORMAL RANGE
PCR Test (Swab)
Sample Nasopharyngeal and Oropharyngeal
SARS-COV-2 Negative Negative

Molekular
SARS_CoV-2
Cycle threshold : >40 lU/mL

Clinical Analysis :
Hasil pemeriksaan Negatif tidak menyingkirkan kemungkinan infeksi
SARS-COV2(COVID-19), Kemungkinan penyebab / A Negative result does not
rule out the possibility of Covid 19 infection:
e) Tidak terinfeksi SARS-COV2 / Not currently infected with SARS-CoV-2
or Covid-19
f) Tidak ditemukan materi genetic SARS-COV2 pada sample / No Genetic
material of Virus SARS-CoV-2 or Covid-19 was found in the specimen of
this patient

Doctor :

dr.Anne Harun Sp.PK

Verified By : M. Faiz Ardiansyah, Amd.AK

Name : ARMIYA FILDZAH Lab. Number : 7702707
Date Of Birth : 25-04-1992 Med. Record : 202101077702707
KTP/Passport : 3173086504920004 Order Entry : 08-01-2021
Sex : FEMALE Date of Exam : 09-01-2021
Nationality : INDONESIA Company : APS

LABORATORY RESULT
EXAMINATION RESULT NORMAL RANGE
PCR Test (Swab)
Sample Nasopharyngeal and Oropharyngeal
SARS-COV-2 Negative Negative

Molekular
SARS_CoV-2
Cycle threshold : >40 lU/mL

Clinical Analysis :
Hasil pemeriksaan Negatif tidak menyingkirkan kemungkinan infeksi
SARS-COV2(COVID-19), Kemungkinan penyebab / A Negative result does not
rule out the possibility of Covid 19 infection:
g) Tidak terinfeksi SARS-COV2 / Not currently infected with SARS-CoV-2
or Covid-19
h) Tidak ditemukan materi genetic SARS-COV2 pada sample / No Genetic
material of Virus SARS-CoV-2 or Covid-19 was found in the specimen of
this patient

Doctor :

dr.Anne Harun Sp.PK

Verified By : M. Faiz Ardiansyah, Amd.AK