ONLINE VALIDATION

REDO Bldg. 951 Remedios cor. San Marcelino sts.,

Malate, Manila 1004 Philippines

COVID-19 RT-PCR TEST RESULT

NAME OF PATIENT : (Lastname, Firstname, Middle Name)

SAMULDE, REY TIMBOL
AGE : SEX : DATE OF BIRTH : NATIONALITY :
39 MALE Jul 24, 1982 FILIPINO
ADDRESS :
LOT 18 BLK 10, ZONE 3, BARANGAY IV (POB.), CITY OF SILAY, NEGROS OCCIDENTAL
DATE OF EXAMINATION :
11/14/2021 DATE AND TIME OF SPECIMEN COLLECTION :
11/14/2021 7:50:38 AM
PASSPORT NUMBER :
P6500579B
PATIENT LOCATION :
WALK IN DATE AND TIME OF SPECIMEN RECEIPT :
11/14/2021 8:30:38 AM
SPECIMEN TYPE :
OROPHARYNGEAL & NASOPHARYNGEAL SWAB
ACCESSION NUMBER :
EML2100197179 DATE AND TIME OF RELEASE OF RESULT :
11/14/2021 3:12:40 PM
LABORATORY NUMBER :
EML2100113939
LABORATORY TEST RESULT
TEST RESULT :
SARS-CoV-2 (Causative Agent of COVID-19) viral RNA : NOT DETECTED 

LABORATORY TEST PERFORMED :

SARS-CoV-2 (Causative Agent of COVID-19) virus detection by Real-Time Polymerase Chain Reaction

INTERPRETATION OF RESULTS WHEN APPROPRIATE :

Final Result Interpretation
SARS-CoV-2 (Causative Agent of COVID-19) viral RNA not Negative for SARS-CoV-2 (Causative Agent of COVID-19)
detected
SARS-CoV-2 (Causative Agent of COVID-19) viral RNA Positive for SARS-CoV-2 (Causative Agent of COVID-19)
detected
Invalid due to specimen quality Negative for test internal control (most likely due to
poor specimen quality)

Remarks: Negative for Nucleic Acid test / COVID-19

Test Performed by:

CHERY MAY SEMILLANO, RMT NIKA CASSANDRA BARBASA, RMT

Molecular Laboratory Scientist Molecular Laboratory Scientist
PRC NO. 0090066 PRC NO. 0091432
Verified by: Validated by:

JEGGER GEMONGALA, RMT EDITH TRIA, MD, FPSP

Chief Molecular Laboratory Scientist Pathologist
PRC NO. 0091903 PRC NO. 0056574

info@ermitamolecular.com www.ermitamolecular.com 0966-904-7989

(02)-8536-4668

EMDLI_QF-6.1/REV.00/DEC20
 2nd Floor REDO Building, 951 San Marcelino cor. Remedios sts., Malate, Manila

CERTIFICATION

Date:11/14/2021

To whom it may concern:

Ermita Molecular Diagnostic Laboratory, Inc., a duly licensed and recognized by

the government of the Philippines, hereby certifies that Mr. SAMULDE, REY
TIMBOL has a Negative for Nucleic Acid test / COVID-19. His details are as follows:

Name : SAMULDE, REY TIMBOL

Gender : MALE
Nationality : FILIPINO
Passport No. : P6500579B
Date Specimen Collected : 11/14/2021 7:50:38 AM
Date Result Released : 11/14/2021 3:12:40 PM
Test Conducted : Nucleic Acid test / COVID-19
Specimen Type : OROPHARYNGEAL & NASOPHARYNGEAL SWAB
Result : NEGATIVE

NOTE: THIS CERTIFICATE IS INVALID WITHOUT THE ATTACHED LABORATORY REPORT.

Revien B. Dela Cruz, M. D.

Physician's Name & Signature
PRC NO. 0094613
Authenticity Verification Date: 11/14/2021

EMDLI_QF-6.2/REV.00/DEC20