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INSTALASI LABORATORIUM SENTRAL

HASIL PEMERIKSAAN LABORATORIUM


Laboratory Examination Results

NAMA PASIEN : by.ny.hartatik (p) NAMA DOKTER : dr.Salamah sari


Patient's Name Doctor Name

NIK : - TGL. ORDER : 14-07-2023 10:30:20


ID Number Order Date

TANGGAL LAHIR : 08-08-2023 (00 Tahun) TGL. SAMPEL DITERIMA : 03-08-2023 08:12:30


Date of Birth Sample Date Received

ALAMAT : dsn gilis rt/rw 001/001 desa DPJTM : Dr. HARTONO, dr., Sp.PK.,
Address ngliman DPJTM MQIH.
NO. TELEPON : 0812529599123 TGL. VALIDASI : 08-08-2023 09:15:32
Phone Number Validation Date

SID : PK20230803079
a

  JENIS   NILAI  
NO. PEMERIKSAAN HASIL RUJUKAN KETERANGAN
Number Checking Type Result Reference Value Description

1 NEONATAL TSH 3,90 NEGATIF:<9, -


PROGRAM INDETERMINTE:
9-18, POSITIF:
>20 mikro
unit/mL

Diverifikasi oleh DPJTM : Dr. HARTONO, dr., Sp.PK.,


Verified by DPJTM   MQIH.

NIP : 195905311986111001
Employee Identification
Number  

a
Dokumen ini sah dan telah divalidasi secara sistem elektronik sesuai SK Direktur Utama No.
188.4/11483/301/2020
This document is valid and has been electronically validated in accordance with the President Director's Decree No.
188.4/11483/301/2020

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