Final Report

Drs Soldin & Le Roux

Mediclinic Hospital
Joubert Street, Vereeniging Practice No:5200539
016 - 4406300

Report to: Referred by: TRAVEL AUTHORITY

TRAVEL AUTHORITY Copies to: Report For Patient
Verify Results

Requisition No: 606594288 Patient: Guarantor:

Specimen No: 0122:PA00322R MR PIETER JAMES FRASER MR P J FRASER
Collection Date: 22-01-2022 UNK Patient ID No: 7904045083082 Med Aid: SD CORONA
Received Date: 2022-01-22 08:56 Age:Sex:DoB: 42y: M: 1979-04-04 Member No: R500.00 REC:3405-02-
Reported Date: 2022-01-23 00:22 Contact No: 0832004672 327700
Contact No: 0832004672

Clinical Data: COLLECTION TIME NOT SUPPLIED OR UNCLEAR.

Residential Address : 20 STRYDPOORT STR
City : VAALPARK SASOLBURG
Province : Free State
Patient Cell No. : 0832004672
Patient EMail : PIETFRASER790404@GMAIL.COM
Patient Passport Number: M00299907
Passport Expiry Date : 22/05/2029
Vaccinated : Y
Tests requested: URG TRAV/TOUR SARS2
ICD10 code(s): Z76.9
P.C.R. Department
Test Name Result Flag Reference Range
URGENT TRAVEL/TOURIST SARSCoV2 REAL TIME PCR (COVID19)
Specimen Source Respiratory swab
SARS-CoV-2 PCR Negative
SARS Coronavirus 2 RNA was not detected in this sample
using a commercial real-time PCR assay.

PathCare (Dietrich, Voight, Mia & Partners) Laboratories is

a recognized and South African Government approved
laboratory to conduct Nucleic Acid testing for COVID-19 and
is ISO15189:2012 accredited. Refer to www.sanas.co.za for a
list of accredited laboratories and tests.

Authorised on 2022-01-23 00:07:00

For consultation, contact a Clinical Pathologist - +27 82 800 4910
H=High, L=Low, *H=Critically High, *L=Critically Low
~ File [ ] Phone Patient [ ] Appointment [ ] Prescription [ ] Draw File [ ]

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