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Patient Name Medical Center

ID Number Collection Date

Date of Birth Result Date

Nationality Report No

Phone No HESN No

Test Description ‫صف ا ف ص‬

COVID-19 test by RT-PCR ‫ال ل م راز الم سلسل الل ظ‬ ‫ اس دام‬19 - ‫ف ص ف د‬


Qualitative detection of SARS-COV-2 2 ‫لسارس ف د‬ ‫ل ف ال مض ال‬ ‫الف ص ال‬

Result ‫ا‬

infected (Positive) ) ‫صاب (ا اب‬

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