LABORATORY RESULT REPORT

Clinical Pathologist : dr. Helen Christin Tarigan, Sp.PK

dr. Anastasia Venna, Sp.PK
Passport No. : - ID Number : 3603174811950002
Reg. No. : 2101020260B Phsycian : Dr DIANNA V.A SAROISONG

Med. Rec. No. : MYPD.0000487290

Patient Name : ANNISA NOVIANI Reg. Date : 02-Jan-2021 13:17

DOB / Age : 08-11-1995 / 25 Year 1 Month 24 Day Finish Date : 03-Jan-2021 14:17
Gender : Female Print Date : 03-Jan-2021 14:18
Address : Perum Binong Permai Blok H 13 No. 11-12 Rt 003 Rw 015 Curug -
Location : POLI

REQUESTED TEST RESULT REFERENCE VALUE UNITS METHOD

IMMUNOLOGY
SILVER PCR PACKAGE C-19
PCR SARS-Cov-2 (Covid-19) Positive Negative Real Time
RT-PCR
Notes:
- The PCR result is not always parallel with the clinical symptoms.
- Results from One's laboratory can NOT be compared to other laboratories' result due to possible differences in method, analyzer and reagents.
Suggestions: It is recommended to get doctor's consultations. The diagnosis should be determined based on comprehensive clinical, diagnostics (laboratory and
radiology). Continue to follow Clean and healthy life style with Good nutrition.

Swab Date 02/01/2021

Sample (PCR SARS-Cov-2) Nasopharyngeal
and Oropharyngeal

- Specimen :

Authorized by,

( Hasbi )

Validated by :
1/ Decimal point is interpreted with dot (.) & thousands with blank space.
2/ The exact interpretation of the results can only be given by the physician who holds all examination data.
3/ The Rapid test are as screening only (temporary) and still need to be confirmed by more estabilished tests.

Printed by : Hasbi Page :1/1