Department of Clinical Microbiology Phone: + 385 1 4696 316 Fax: + 385 14678 006 E-mail: mikrobiologija.covid19@stampar.hr prof. Jasmina Vranes, MD, PhD - Head HBB ¢ ANDRA STAMPAR Hl ¢ Ml TEACHING INSTITUTE ol OF PUBLIC HEALTH Creating a Healthier Future Medical Certificate This is to certify that (name) RICKOVIC MARIO born on __ 15.08.1981. in has been tested on__ 24.12.2021. _for the presence of SARS-CoV-2. Status report of infection on the date of the test RT-PCR SARS-CoV-2 positive _ negative EX von 24.12.2024. Signature and seal of the certiying medical doctor Ci Mark with X where applicable