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RSU Bunda Jakarta

Jl. Teuku Cik Ditiro No. 21


Menteng - Jakarta Pusat 10350
Indonesia
Call Center : 1-500-799

Clinical Pathologist :
Prof. dr. Siti Boedina, Sp.PK(K)
dr. Dennis Jacobus, Sp.PK
Name : FUAD AJRUL MUKHDI Order Time : 21-10-2021 23:10
Laboratory number : 2110211495AH Sampling Time : 21-10-2021 14:45
Customer ID : 0002211010079 Received Time : 21-10-2021 23:10
Identity : 1306092209020002 Referrer : DIAGNOS PADANG
Birth Date / Age : 22-09-2002 / 19 Year(s) 29 Day(s) Referrer Address :
Gender : Male Doctor : dr. Meri Ponda Sari, SpPK
Address : -- Clinical Information :
Phone / Email : -/

LABORATORY TEST RESULT REFERENCE VALUE UNIT DESCRIPTION

MOLECULAR AND GENOMICS


PCR SARS-CoV-2
Conclusion Negative Negative

Sample type : Nasopharyngeal & Oropharyngeal Swab


Method : Real Time RT-PCR nucleic acid amplification test (real time RT-PCR)

*This document has been electronically validated


Validation Time : 22/10/2021 04:01:07 by Andi Trisnandi, S.Si, M.Si
Result Print Time : 22/10/2021 07:28:35 by Andi Trisnandi, S.Si, M.Si
Page : 1 / 1

"Advanced Innovation, Advanced You" DLU.HO.MAN.SE.FRM.001.02

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