CHINESE GENERAL HOSPITAL AND MEDICAL CENTER

INSTITUTE OF PATHOLOGY
CLINICAL PATHOLOGY DEPARTMENT
286 Blumentritt St., Sta. Cruz, Manila, Philippines
Tel.: (02) 8-711-4141 Loc. 372 / 373
MOLECULAR PATHOLOGY RESULT
Specimen No.: STAT-207225 DateTime Requested: December 23, 2020
Patient Name: BUNGAY, JOEY GAETOS DateTime Collected: December 23, 2020 10:16 AM
Age/Gender: 49 / MALE DateTime Received: December 23, 2020
Date Of Birth: August 9, 1971 DateTime Released: December 23, 2020 04:57 PM
Room: OP Requested By:
Patient Class: STAT CS/OR#:
Hospital / LGU: PHILIPPINE TRANSMARINE CARRIERS INC. Passport Number: P4996788A
Nationality: FILIPINO
EXAMINATION: SARS-CoV-2 *RNA RT-PCR TEST
Qualitative Detection by Real-Time PCR
SPECIMEN: Nasopharyngeal Swab and Oropharyngeal Swab
RESULT:
ASSAY: INTERPRETATION
SARS-Cov-2 NEGATIVE (-)
REMARKS: * Ribonucleic Acid Reverse Transcription-Polymerase Chain Reaction Test. Please correlate the results
of this test with all clinical and imaging findings.
Methodology: Ribonucleic acid extraction was performed using RNA Extraction Kit. SARS-Cov-2 viral N Gene, ORF Gene, E gene or S
PCR amplification and detection were done with Real-Time PCR machines, QuantStudio5, with positive and negative controls
included in each run to confirm validity and accuracy of results.
Significance: This test is intended to be used to achieve qualitative detection of SARS-CoV-2, the causative agent of COVID-19,
extracted from nasopharyngeal swabs, oropharyngeal swabs, sputum and bronchoalveolar lavage specimen of patients.
Limitations: The detection of viral RNA is dependent on the viral load if the specimen was collected very early in the infection.
Pre-analytical variables (i.e. specimen quality, handling/transport condition) may also affect the results. The limit of detection
for this assay is 200 viral copies/ml.
The performance characteristics of this laboratory developed test have been validated at the Institute of Pathology-Molecular
Pathology Section, and is continuously being monitored by the Institute as part of its quality assurance procedures, including
enrolment with external proficiency testing at Research Institute for Tropical Medicine (RITM).

ZENITH ANNE P DURAN | JHONAMARI DAVID DR. DAPHNE C. ANG DR. EVELINA N. LAGAMAYO
MEDICAL TECHNOLOGIST PATHOLOGIST PATHOLOGIST
PRC ID: 80689 | 82984 PRC ID:102523 PRC ID:49241
Print DateTime: 12/23/2020 06:19:28 PM

CLINICAL LABORATORY FOR COVID-19

DOH LICENSE TO OPERATE ISO 9001:2015 CERTIFIED
LAB-SD/FO-42 (1) LICENSE NUMBER 13-0005-2020-CT-2 ISO Certificate # AJA14.0815
Rev. 3 Oct. 15, 2020 15 APRIL 2020 - 31 DECEMBER 2020 Valid Until October 23, 2020
 CHINESE GENERAL HOSPITAL AND MEDICAL CENTER
INSTITUTE OF PATHOLOGY
286 Blumentritt St., Sta. Cruz, Manila, Philippines
Tel.: (02) 8-711-4141 Loc. 372 / 373

Serial Number: STAT-207225 Date: December 23, 2020

CERTIFICATION
To whom it may concern:

This is to certify that Mr/Ms. BUNGAY, JOEY GAETOS is a Filipino

underwent COVID - 19 RT-PCR test on 12/23/2020 at Chinese General Hospital and Medical Center
which is a health institution recognized by the Government of the Philippines (Please see attached result)

Passport No.: P4996788A

Date and Time of Specimen Collection: 12/23/2020 10:16:00 AM
Test Conducted: SARS-COV-2 Ribonucleic Acid Reverse Transcription Polymerase Chain Reaction (RT-PCR)
Test

Remarks and Recommendations:

* NEGATIVE for the presence of SARS-COV-2 Virus at the time of testing
* Continue COVID-19 precautionary measures.

This certificate is issued upon the request of the patient for whatever purpose it may serve
(except for medico-legal purposes).
Thank you.

Evelina N. Lagamayo, MD / Daphne C. Ang, MD

License No. 49241 / 102523

CLINICAL LABORATORY FOR COVID-19

DOH LICENSE TO OPERATE ISO 9001:2015 CERTIFIED
LAB-SD/FO-42A LICENSE NUMBER 13-0005-2020-CT-2 ISO Certificate # AJA14.0815
Rev.2 Oct. 15, 2020 15 APRIL 2020 - 31 DECEMBER 2020 Valid Until October 23, 2020