RSU Bunda Jakarta

Jl. Teuku Cik Ditiro No. 21

Menteng - Jakarta Pusat 10350
Indonesia Call Center : 1-500-799

Clinical Pathologist :
Prof. dr. Siti Boedina, Sp.PK(K)
dr. Dennis Jacobus, Sp.PK
Name : AAKE SOEREN LAX Order Time : 10-11-2023 11:05
Laboratory number : 2311100123A1 Sampling Time : 10-11-2023 11:00
Customer ID : Received Time : 10-11-2023 11:48
Identity : 3175041510495001 Medical Record : 00-41-08-00
Birth Date / Age : 15-10-1949 / 74 Year(s) 26 Day(s) Location : LABORATORY
Gender : Male Doctor : dr. Agus Rizal Ardy H, Hamid , Sp,U(K)PhD
Address : TELUKAWUR RT-001/001 Clinical Information :-
59427
Jawa Tengah -
Phone / Email : 62816909354, 6282152394830 /

LABORATORY TEST RESULT REFERENCE VALUE UNIT DESCRIPTION

RESPIRATORY TRACT INFECTION
RT-PCR SARS-CoV-2
Conclusion Negative Negative

Sample type : Nasopharyngeal & Oropharyngeal Swab

Method : Real Time RT-PCR nucleic acid amplification test (real time RT-PCR)

*This document has been electronically validated Dot (.) is used as decimal separator for numeric test results.
Validation Time : 10/11/2023 15:15:19 By Andi Trisnandi, S.Si, M.Si
Result Print Time : 10/11/2023 16:10:57 By Andi Trisnandi, S.Si, M.Si
Page : 1 / 1