BRAWIJAYA HOSPITAL

Jl. Raya Ciputat Parung, Bojongsari

Depok Jawa Barat 16516
Telp. 021 - 29836640

Patient Name: Noersita Patient ID:

Date of Birth:
by. Ny Rifka Sex:
Physician:

DPOAE Test Report

Right Ear: PASS Tester:
Test Date: 08/04/2022 19:33:06 Protocol: DP 4s Avg Time: 4 Pass Criteria:
Instrument: V114,01 IA3003863 IA2004656 Frequencies for Pass: 3
SNR: 6 dB

F2 L1 L2 DP NF SNR

2,0 65 55 -9,6 -6,0 -3,6

3,0 65 55 -12,9 -18,9 6,0 P
4,0 65 55 -0,7 -20,0 19,3 P
5,0 65 55 -13,1 -19,2 6,2 P

DPOAE Test Report

Left Ear: PASS Tester:
Test Date: 08/04/2022 19:39:16 Protocol: DP 4s Avg Time: 4 Pass Criteria:
Instrument: V114,01 IA3003863 IA2004656 Frequencies for Pass: 3
SNR: 6 dB

F2 L1 L2 DP NF SNR

2,0 68 57 12,6 5,3 7,3 P

3,0 66 58 12,9 1,8 11,1 P
4,0 70 59 ---- -5,1 ---- *
5,0 69 57 10,6 -11,8 22,4 P

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