e @Laboratoriym linik Utama precisiow Ruko Golden Boulevard Blok W2-No. 15, J. Pablawan Seribu, BSD City, ‘Tangerang Selatan 15322 No. Registration Spesimen Received Print out Physician Nama : MUHAMMAD RIZKY RIZALDY Name NIK/ Passport + 3603122308030001 !ONumber ‘TTL Jenis Kelamin : TANGERANG, 23-08-2003 / LAKI-LAKI DOB/ Sex RDT - Ag COVID - 19 Penanggung jawab Klinik : dr. Yunus Tango, MD PhD c-25062021.00403 +: 25-06-2021 20:15:20 5-06-2021 20:40:28 Tenis Pemeriksaan Wasi Matode Test item’ Results Method SARS— COV ~2 Ag-ROT NEGATIVE Negative “Sandwich lateral flow immunoassay Bahan/ spesimen : Nasal or Nasopharyngeal swab sits ereritsan stat, enggambarkan toni sat pengambian specimen ‘ais memerukan pemerisaan anjten dopa skudanfelomendas da lst *Pemerisaan slang dapat diakukanberdaarkn ekomends doiter diotorisasi oleh, KLINIKUTARA, BOE Wans Quality Validator Dokter Patologi Kiinil af. Else Mutiara Sihotang, Sp. PK@ce, RDT -Ag © Laboratorium Utema = 1 9 Drectsiow coup Ruko Golden Boulevard Blok W2-No. 15, JI, Palawan Seribu, BSD City, Tangerang Selatan 15322 Penanggung jawab kiinik: dr. Yunus Tanggo, MD PhO PC-25062021.00402 No. Registration Spesimen Received Print out Physician Nama UNDA FARIDAH NURUL SOBAH Nome NIK/ Passport 1 3603125911740001 1DNumber TTY Jenis Kelamin ; TANGERANG, 19-11-1974 / PEREMPUAN 208/ sex Tenis Pemeritsaan Teal Tila) Rujakan Metode Test tem Results Reference Range Method _ * ‘Sandwich lateral flow SARS~ COV ~2 Ag-RDT Positive Negative lee a Bahan/ spesimen : Nasal or Nasopharyngeal swab di otorisasi leh, KLINIG UTAMA Tir DAN GOUNARD BORAT 5:0. BINGEN seus ‘Quality Validator stax perertsan cata, menegenbartan fendi sat pengambilan specimen ‘fn memerutan emeriaanfanetendopataakukanrekomendis! dar kins! “penerinsan lane copa iakutanberdosarkan rekomendasdokter Dokter Patologi Kinik: dr Else Mtiara Sihotang, Sp. PR@c, RDT-Ag ¢ ©Laboratoriym ian . 1 9 Drecisiow GovIp Ruko Golden Boulevard Blok W2-No. 15, 41, Pahlawan Seribu, B50 city, Tangerang Selatan 15322 7 Penanggung jawab Kink: dr Yunus Tanggo, MO PP + PC-25062021.00402 No. Registration Spesimen Received Print out : Physician z Nama :YUNITA DEW! Nome NIK/Passport __ 3603125408960002 ID Number TTL/Jenis Kelamin : TANGERANG, 14-08-1996 | PEREMPUAN DOB/ Sex Jenis Pemeriksaan Hasil Nilai Rujukan Metode Test Item Results Reference Range Method ‘Sandwich lateral flow SARS— CoV -2 Ag-ROT Positive Negative immunoassay Bahan/ spesimen : Nasal or Nasopharyngeal swab di otorisasi oleh, KLINIK UTAMA “Waoepioereoum ae VATS Eovtnseunctuan Quality Validator ‘Dokter Patologi Klinik: dr Else Mutiara Sihotang, Sp. PK ee