You are on page 1of 1

GSI Lab

Registered Office: Graha Mitra, 4th Floor, Jl. Jend. Gatot Subroto Kav. 21, Jakarta 12930, Indonesia
Lab Address: Jl. RA Kartini No 34, Cilandak Jakarta 12430, Indonesia
Instagram : @gsilab.id Email : helpline@gsilab.id
www.gsilab.id
Keputusan Direktur Jenderal Pelayanan Kesehatan Brought to you by 24/7 Helpline +62-21-8086 6080 & WA +62-821-2233-6080
Nomor: HK.02.02/I/2932/2020

Patient: BONAVENTURA ROSSI C Provider:


Drive Thru GSI by Medika Plaza

Corporate:
GSI WEB Org
Local ID / NIK : 3674061505900006

Date of Birth : 15-May-1990

Telephone : +62081932911063

Email : bonaventura.rcp@gmail.com

Gender : Male

Report # :
Customer Reference # : 1000201328261220

Sample # : 100-024-4442 (242951) Date Received : -


Source : Swab, Naso-Oropharyngeal Date Reported - -
Date Collected - -

Test Result Normal Range Date Approved

PCR SARS-CoV-2 Negative Negative - -


E Gene Negative Negative
E Gene Ct -
RdRp Gene Negative Negative
RdRp Gene Ct -

Approved By : dr. Siskawati Suparmin, Sp.PK.


- -

Page 1 of 1 Print Date: - -

You might also like