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Pemeriksa/Investigator : Pahmi Firmansyah, A.Md.

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Dokter/Doctor : dr. Indah Susanti W,Sp.PK
No. Reg/Reg. No : 654408 dffffffffffffffffffffffffffffffff
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Nama/Name : ABDUL HALIM BIN ASHARI dffffffffffffffffffffffffffffffff
NIK/ID No. : 3174070404540009
Kewarganegaraan/Nationality : MALAYSIA
Tanggal Lahir/DOB : 04/04/1954
No. Passport / Passport No : A53175085
Jenis Kelamin/Sex : Laki-laki/Male
Faskes Asal / Health Facility : Quicktest Pusat
Waktu Sampling/Date Collected : 17 November 2021
Kota / City : South Jakarta
Waktu Periksa/Check Date : 17 November 2021
Instansi / Institution : VAXA ANTIGEN
Waktu Selesai/Result Date : 17 November 2021
Alamat / Address : Jl Lamandau Iii No 19 Kramat Pela Kebayoran Baru Jakarta Selatan

Pemeriksaan/Test Hasil/Result Batas Normal / Normal Range Metode / Method

PCR SARS-CoV-2

2019-nCoV
ORF 1 AB Negative Negative (Cut off CT value 40) RT-PCR
GEN N Negative Negative (Cut off CT value 40) RT-PCR
GEN S Negative Negative (Cut off CT value 40) RT-PCR
Interpretasi Result RT-PCR SARS-CoV-2 : Negative
Rekomendasi

Disclaimer

Catatan:
1. Hasil pemeriksaan dikerjakan dengan metode RT-PCR dan hanya menggambarkan kondisi saat pengambilan spesimen.
2. Hasil PCR Negatif tidak selalu berarti pasien tidak terinfeksi oleh pathogen, namun hanya menunjukan bahwa material genetik pathogen tidak
ditemukan di dalam sample
3. Jika hasil PCR positif atau timbul gejala klinis setelah pemeriksaan, silahkan hubungi dokter atau fasilitas kesehatan terdekat.
4. Hasil PCR tidak dapat dibandingkan antar satu laboratorium dengan laboratorium lain, karena perbedaan alat dan target gen yang digunakan.
5. Surat ini dikirim dan ditandatangani secara elektronik

Note :
1. The above examination results were carried out using the RT-PCR method and only described then condition at the time of specimen
collection
2. A negative PCR result does not necessarly mean that the patien is not infected with the pathogen, but only indicates that phatogenic genetic
material is not pressent in the sample
3. If the PCR result is positive or clinical symptoms appear after the examination, please contact the doctor or the nearst health facility.
4. PCR results cannot be compared between one laboratory and another, due to differences in then tools and target genes used.
5. The letter is sent and signed electronicaly

Abdul Halim Bin Ashari South Jakarta, 17 November 2021


Dokter Pemeriksa / Physician Examiner

dr. Indah Susanti W,Sp.PK

info@quicktest.id
021-2138999(for result)
https://quicktest.id
Jalan Prof. Dr. Soepomo no 33A, Jakarta Selatan, DKI Jakarta 12810

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