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LAB REPORT COVID-19 IN THE O/O DSU, IDSP OFFICE

Patient RT PCR Name Name of Name of Name of Zone Name Age Sex Addres Mobile Name Date of Date of Date of Result Date of Lab ID Month Death Asso Travel
ID App Srf of District CHC/SD PHC s No of the Admissi Sample Dischar Result No. ciated in Last
No. Labort H refferal on Collecti ge Risk 14
ory hospital on Facto Days
(Admitt r
ed
Case)
164045 6063001 MAMC Hisar RATIA RATIA HARY JYOTI 28 F RATIA 883778 GH 12/03/2 NEGATI 15/03/20 1220/18 March No No No
73792 Agroha ANA RANI 7053 RATIA 021 VE 21 76 Chroni Travel
D/O c History
SUBHA Disea
SH se
CHAND

Note : If the above report is required for any official/legal purposes then the same may got be verified and duly signed by respective health official/officers.

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