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Surat

Keterangan Sehat / Health Certificate


Covid-19 Antigen Test
Nama / Name : Abdullah Syafei
Tanggal Lahir / D.O.B : 04/02/1985
Jenis Kelamin / Sex : Male
Kebangsaan / Nationality : INDONESIAN
Alamat / Address : Jl. Lontar Bawah, Kebon Melati 008/012, Tanah Abang , Jakarta Pusat

HASIL PEMERIKSAAN LABORATORIUM


LABORATORY EXAMINATION RESULTS

Sample Id : 20220202_BLR_TBT_000002 Date Received : 02/02/2022

Source : Swab Naso-Oropharyngeal Date Reported : 02/02/2022

Date Collected : 02/02/2022 10:08
Test Result

Tes / Test Hasil / Result
Antigen Negative

Validasi oleh / Validated by :
Amira Arifa Masiena


Prof. Dr. dr. Pusparini, Sp. PK
Penanggung Jawab Lab / Laboratory in Charge


















Hasil di atas hanya


Jl. Blora No. 21-22 Sudirman Jakarta Pusat

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