Name: Nana Natascha Gosse Classification Confidential

Date of Birth: April 13, 1964

Passport number/ Identity card number: NW774BL74
Telephone +31 (0) 20 244 06 20
Issue date May 04, 2021

Subject: Test result SARS-CoV-2 PCR test (COVID-19)

Dear Nana Natascha Gosse,

On May 03, 2021 at 11:05 a SARS-CoV-2 PCR test was performed on a nasopharyngeal
(deep nose) and oropharyngeal (throat) swab.

The result of this test is Negative.

This means that at the time of performing the test, no SARS-CoV-2 virus was detected in the
samples taken from your nose and throat.

With regard to your privacy, we request you to share the results of this test only to whom it
may concern.

If you have any additional questions, please do not hesitate to contact us via telephone
number: +31 (0) 20 244 06 20.

Yours sincerely,

KLM HEALTH SERVICES

M.A.R. Driessen, MD Public Health

International Medical Advice

KLM Health Services BV

Schiphol-Oost, Schiphol-Centrum,
Den Haag
klmhealthservices.com
KHS 4000-09.19.3 Trade register Amsterdam nr. 34091331
IBAN: NL35 INGB 0007 2090 12, Swift: INGBNL2A
Medical Report

I hereby declare that:

Name : Nana Natascha Gosse

Date of birth : April 13, 1964
Gender : Female
Sample ID : 210480423701
Sampling date : May 03, 2021 at 11:05
Department : Virology

Test : SARS-CoV-2 Nucleic Acid Amplification Test (NAAT) – RT PCR

Result : Negative
• The SARS-CoV-2 realtime RT-PCR is negative: The coronavirus (RNA)
could not be detected in the clinical sample (throat and nasopharyngeal
swab).

Dr. B.L. Herpers, Clinical Microbiologist | Chief Medical Officer

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