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Certificate of a NEGATIVE rapid antigen test result for

detecting SARS-CoV-2 Virus

Test center:
Name: CovidTestCenter-Berlin Mitte
Adress: Torstraße 170, 10115 Berlin

Person tested:
Reference number: 9cf4x230124aea12
Surname, Firstname: Watts, Coco
Birthday: 08.05.2000
Address: Schönfliesserstrase 18, 10439 Berlin
ID Number:

Rapid Test:
Test Name: ANTIGEN BÜRGERTEST Rapid Test
Manufacturer: Getein Inc.
Test date / Test time: 24.01.2023 18:40
Test performed by (Name): Walter Patta

Reason: Besucher Krankeneinrichtung oder Ähnlich

Test result: Positive* Negative X

24.01.2023

Date / Signature

Anyone who falsifies this document or falsely certifies a test that has not been performed is liable
to prosecution under Section 267 of the German Criminal Code (StGB) for forgery of documents.
Any violation found will be reported to the police.

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