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Surat Keterangan Sehat / Health Certificate

20220120_STT_STTNMP_000002 CoV-2 RT PCR Test


Nama / Name : DHIA HUMAIRA DARMAWAN
Tanggal Lahir / D.O.B : 07/08/2011
Jenis Kelamin / Sex : Female
Kebangsaan / Nationality : INDONESIA
No. KTP / Passport : 3273264708110004
Alamat / Address : CLUSTER BERLIAN VILLAGE A2 , Depok , Jawa Barat

HASIL PEMERIKSAAN LABORATORIUM


LABORATORY EXAMINATION RESULTS

Sample Id : 20220120_STT_STTNMP_000002 Date Received : 20/01/2022


Source : Swab Naso-Oropharyngeal Date Reported : 20/01/2022
Date Collected : 20/01/2022 17:51
Test Result

Test CT Value Normal Range Date Approved Hasil / Result


PCR SARS-Cov-2 Negative 20/01/2022 Negative

Validasi oleh / Validated by :


Amira Arifa Masiena

Prof. Dr. dr. Pusparini, Sp. PK


Penanggung Jawab Lab / Laboratory in Charge

Hasil di atas hanya menggambarkan kondisi saat spesimen diambil / The result above
describes the condition when specimens were taken.

PCR SARS-Cov-2 negatif tidak selalu berarti pasien tidak terinfeksi oleh patogen, namun
hanya menunjukkan bahwa material genetik patogen tidak ditemukan dalam specimen / A
negative PCR SARS-Cov-2 result does not necessarily mean the patient is not infected by the
pathogen, but only shows that the pathogenic genetic material is not found in the specimen.

Swab Station Klinik Nara Medika Pratama

Jakarta

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