Professional Documents
Culture Documents
No. Registrasi
Nama Pasien Lab
: I KADEK SUPARTA : 791/UCLAB/131222/A259290
Patient's Name Lab Registration
Number
Kewarganegaraan
: INDONESIA
Nationality
Pengirim /
Tanggal Lahir Rumah Sakit
: June 11th, 2002 : UNICARE UBUD
Date of Birth Physician /
Hospital
Jenis Kelamin Spesimen NASOPHARYNGEAL &
: MALE :
Gender Specimens OROPHARYNGEAL
No. RM
Tanggal SWAB
Medical Record : - : December 13th, 2022 (02:00 PM)
SWAB Date
Number
No. Indent.
Tanggal Diterima
Kependudukan : E0441217 : December 13th, 2022
Receive Date
Residence ID Number
BR DINAS MANIKAJI,
Alamat Cetak Hasil
: DESA BAN,KUBU, : December 13th, 2022
Address Print Out Date
KARANGASEM
Doctor in charge