HASIL PEMERIKSAAN LABORATORIUM

LABORATORY TEST RESULT

No. Reg/Reg. No. : SPC100820210537 Instansi/Institution : KLINIK IBUKU

Nama/Name : KEMAS MUHAMAD ARDIAN NIK/ID No. : 3174081008860009
Tanggal Lahir/DOB : Aug, 10 1986 No. Passport/Passport No. :
Jenis Kelamin/Sex : Male Kewarganegaraan/Nationality. : Indonesia
Waktu Sampling/Date Collected : Aug, 10 2021 Alamat/Address : JL. GURU ALIP NO 18
Waktu Periksa/Date Received : Aug, 10 2021 Faskes Asal/Health Facility : Speedlab Indonesia
Waktu Selesai/Date Reported : Aug, 11 2021 Kota/City : South Jakarta
Jenis Sample/Sample Type
1. Orofaring & Nasofaring
2. Sputum
3. Saliva
DALAM KISARAN DILUAR KISARAN NILAI
PEMERIKSAAN/TEST RUJUKAN/VALUES RUJUKAN/VALUE RUJUKAN/NORMAL METODE/METHOD
WITHIN RANGE OUTSIDE RANGE RANGE
SARS-CoV-2
2019-nCoV Negative Negative Real Time RT-PCR
VIC / N gene Undetection Undetection / Ct>=35 Real Time RT-PCR
FAM / ORF1ab Undetection Undetection / Ct>=35 Real Time RT-PCR

Catatan:
- Hasil ini hanya menggambarkan kondisi saat pengambilan spesimen, Jika timbul Gejala klinis atau kontak dengan pasien terindikasi setelah pemeriksaan, silahkan menghubungi Dokter / Fasilitas
Kesehatan terdekat. Pemeriksaan Ulang dapat dilakukan berdasarkan rekomendasi dokter.
- Hasil PCR tidak dapat dibandingkan antar alat dan gen yang berbeda.

Note :
- These results only describe the conditions at which the specimen was collected, if clinical symptoms or patient contact occurred indicated after the examination, please contact the nearest doctor /
health facility. Re-checking can be done on the recommendation of a doctor.
- PCR Results cannot be compared between different instruments and genes.

Petugas Pemeriksa/Investigator : MITHUN SINAGA Jakarta Selatan, 23 Juli 2021

QRCODE RESULT Dokter Pemeriksa/Physician Examiner

dr. Donatila Mano S, SpMK