Republic of the Philippines

City of Dapitan
C I T HEALTH OFFICE

MISCELLANEOUS

NAME: MARIE FAITH E. DUMPA AGE: 22 SEX: FEMALE DATE: 1/8/2024

ADDRESS: SERGIO OSMIÑA SPECIMEN: URINE

Laboratory Test Performed:Qualitative detection Pregnancy Test using double antibody sandwhich method
and rapid chromatographic immunoassay to test the HCG in urine.

EXAMINATION: PREGNANCY TEST

RESULT: NEGATIVE

REMARKS: PLEASE REFER TO YOUR DOCTOR FOR THE INTERPRETATION OF YOUR RESULTS.

MaryAnn R. Tore0se,MD, DPSP

Pathsius ls
Lic no. 577+
ELENA MAY G. VILLAVERDE, RMT
Head of the Laboratory Medical Technologist II
Lic no. 0041953