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Pre-Flight Assesment Report

To Whom It May Concern,

Medical Resume

The undersigned confirms that :

Name : Mr. Baek Harkhyun

Gender : Male

Age : 51 yo

Date of birth : 20/ 09/ 1970

Working diagnose

Confirmed positive Sars - Cov 2 ( covid 19)

Level of consciousness :

 Compos mentis : GCS : E4M6V5


 Blood pressure : 110/80 mmhg
 HR : 74x bpm
 RR : 20 -22 x / min
 Temp : 37.5 0C
 Spo2 : 95 room air

Few days ago patient has covid symptoms, mild dyspnea, Feel weak, mild Fever. Patient has been
treated at home since 10 July 2021 the day when PCR result confirmed positive. He was treated in
a Clinic in Kemang and received 3 ampul extrace and Neurobion drip into NaCL 500ml on 13
and 14 July 2021.

Labs for PCR Sars - Cov (attached)

Roseville Soho& Suite #1612, sunburst CBD lot 1.1 BSD City Indonesia
Current medications started on 13 July 2021:

 Paracetamol 3x1

 Ambroxol 3x1

 Domperidone 3x1

 Amoxclav 3x1

 Famotidine 2x1

Jakarta, July 15th 2021

Flight doctor

dr. Cannes Nobel Wingardi


No SIP : 0003/2.28.1/31.73.05.1001/1.779.3/2015

Roseville Soho& Suite #1612, sunburst CBD lot 1.1 BSD City Indonesia

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