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NARAYA

Medical Center

Lab. Number SBY18774


Name HENDRA
Med. Record 2021062918774
Date Of Birth 01/04/1995
Order Entry 29/06/2021 SURABAYA
KTP/Pa s sport 3518050105950002
Date of Exam 29/06/2021 21:00
Se x MALE
Nationality INDONESIA Company APS

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

Mo1eku1ar
SARS CoV-2
Cycle treshold Gen Orflab & Gen N >35.00

Laboratory Resu1t:
Basi1 pemeriksaan Negatif tidak menyingkirkan kemungkinan infeksi
SARS-COV2(COVID-19), Kemungkinan penyebab / A Negative result does n ot
rule out the possibility of Covid 19 infection:
a) Tidak terinfeksi SARS-COV2 / Not currently infected with SARS -Co V-2
or Covid-19
b) Tidak ditemukan materi genetic SARS-COV2 pada samp1e / No Genetic
material of Virus SARS-CoV-2 or Covid-19 was found in the spe cime n of
this patient
Perneriks a

.
$

Shofiyatul ~ aroh, A.md AK

A laboratory assessment can only be given by a doctor who bas patient clinical data.
This laboratory bas been verified electronically, no signature required

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JI. Sulawesi No.28 , Wonokromo, Surabaya , Jawa Timur 60246


Telp · 0812 3388 6657

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