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HEALTH SCREENING REPORT

CONFIDENTIAL
No. Medical Record : 23782/2482/IX/PCR/21

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PERSONAL DATA
Identity No. / Passport No. : 1207055306980003
Name : RIDA RAZKITA
Birthday/Gender : 13 June 1998 / Female
Address : KP SALAK RT 8 RW 3 NO 50 MUKA KUNING, BATAM

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LABORATORY REPORT
Test Name Result Unit Reference Range
Method: REAL TIME RT-PCR (REVERSE TRANSCRIPTASE - POLYMERASE CHAIN REACTION)
MOLECULAR
SARS-CoV-2 RNA (N, ORF1ab Gene)
Specimen : Nasopharynx & Oropharynx Swab
SARS-CoV-2 RNA N Gene : Not Detected Not Detected
SARS-CoV-2 RNA ORF1ab Gene : Not Detected Not Detected
Reference Laboratory : KLINIK MEDILAB, BATAM, INDONESIA

Date of Exam : 09 September 2021

Taman Niaga Sukajadi Blok J No.3A - 6 Batam Centre, Batam - 29433, Kepri, Indonesia Telp. 08117701188, 0778-7372022 Fax. 0778-7372024
Email: customercare@medilab-clinic.com