COVID-19 ANTIGENIC TEST

RESULT

About the patient

Done on 01/02/2023
Family name:
Last name: Stan PHARMACIE DES ARCHIVES - 752041020
First name: Rahela 2 rue des Archives, Paris 75004
Date of birth: 08/08/2003
Mobile phone number: +330651830658
Email: rahelastan98@gmail.com

About the antigenic test

Pharmacist last name: BELLAICHE

Pharmacist first name: PHILIPPE
Title: titulaire
Date of the sample: 01/02/2023 15:31
Brand and reference: 2019-nCov Antigen Test (lateral flow method) W196 - Guangzhou Wondfo Biotech Co
Batch number: W19610858
Expiration date: 19/08/2022

I, the undersigned BELLAICHE PHILIPPE certified that Stan Rahela born on 08/08/2003 benefited from the 01/02/2023 15:31 of the test “SARS-CoV-2 Antigenic
test (code94558-8)”:

• Covid result: NEGATIVE

If the result is negative, you must:
- Keep applying barrier gestures
- Wear a mask
- Maintain social distancing
If the result is positive, you are a confirmed case of Covid 19, you must:
- Isolate yourself immediately
- Wear a surgical mask
- Limit your contacts within your household
- Contact your attending doctor.

#TousAntiCovid
Following your test, you will receive a certificate from SIDEP
allowing you to integrate your result into the TousAntiCovid
application.
If you are positive, directly and anonymously inform people you
have encountered recently.
If you are negative, store your test as a certification.

The data concerning you, collected as part of this screening test or examination, in connection with the Covid-19 epidemic, is recorded in the national
information system called SI-DEP, implemented by the General Directorate of the health of the ministry in charge of solidarity and health, in accordance
with the provisions of article 11 of the law of May 11, 2020 .