COVID-19 CERTIFICATION TEST

PATIENT DETAILS

NAME : STEFANIE CHONG TSUI LING

NRIC/PASSPORT NO. : 940211105188

DATE OF TEST : 10/04/2021

This is to certify that the above-named patient on the above date has conducted COVID-19 ANTIGEN
SCREENING

SPECIMEN : Nasal swab

TEST METHOD : Rapid Test Kit Antigen
SARS-CoV-2 ANTIGEN (COVID-19) : NEGATIVE

Note: Repeat testing may be required if clinically indicated as a negative result does not exclude the infection with
SARS-Cov-2. A definite diagnosis should be made by an attending physician, in combination with the clinical symptoms,
the result of viral isolation culture test and other test results.
Patient has declared that all the information given in the Health Declaration Form for COVID-19 is true and correct.

Computer Generated Report - No Signature Required Printed on: 10/04/2021

Thank you

Klinik As-salam 24 Jam

No 69-71, Jalan 7/7C,
Seksyen 7, Bandar Baru Bangi,
43650 Bandar Baru Bangi,
Selangor
COVID-19 HOTLINE: 012-7040969