GOVERNMENT OF BOGOR CITY

PUBLIC HEALTH OFFICE

REGIONAL HEALTH LABORATORY
Jl. R.M. Tirto Adhi Soerjo No. 3 Tanah Sareal Bogor City 16161 Telp/ Fax : (0251) 8385082

LABORATORY RESULT OF THE REGIONAL HEALTH LABORATORY OF THE HEALTH SERVICE

OF BOGOR CITY (C 753 )

Number of report document :

Laboratory ID Number :
Name of Patient :
Pasport Number :
Gender :
Date of Birth :
Country :
Specimen's type :
Sampling Date : Time :
Receiving Date :
Examination Date :
Result Date :

The Result
No. Agent Specification Methode
Conclusion

1 CT Orf1ab  RT-qPCR
2 CT N

Note
The result may only reflect the day when specimen swab was taken, please consult to your physician for follow up
examination

Sincerely yours,
Bogor,…………………..
Head of Laboratory

dr. Selamat Djaya, MKM

NIP : 19720807.200604.1.016