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  • Covid Test Form

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    Rogie Contridas Palaran
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    The document contains 3 laboratory miscellaneous reports from Olutanga Municipal Hospital in Zamboanga Sibugay, Philippines. Each report provides the name, age, sex, address, requesting physician, specimen, and COVID-19 antigen test result of a patient. The test results were either negative or positive. The reports were signed by the Chief of Hospital and performed by the hospital pathologist.

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    COVID TEST FORM

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    The document contains 3 laboratory miscellaneous reports from Olutanga Municipal Hospital in Zamboanga Sibugay, Philippines. Each report provides the name, age, sex, address, requesting physician, specimen, and COVID-19 antigen test result of a patient. The test results were either negative or positive. The reports were signed by the Chief of Hospital and performed by the hospital pathologist.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    16 views1 page

    Covid Test Form

    Uploaded by

    Rogie Contridas Palaran
    The document contains 3 laboratory miscellaneous reports from Olutanga Municipal Hospital in Zamboanga Sibugay, Philippines. Each report provides the name, age, sex, address, requesting physician, specimen, and COVID-19 antigen test result of a patient. The test results were either negative or positive. The reports were signed by the Chief of Hospital and performed by the hospital pathologist.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    Republic of the Philippines

    Province of Zamboanga Sibugay


    OLUTANGA MUNICIPAL HOSPITAL
    Bateria, Olutanga Zamboanga Sibugay
    Date:__________
    Age:_____________ Sex:___________
    Name:________________________________________________________________________________
    Address:______________________________________________________________________________
    Requesting Physician:___________________________________________________________________
    Specimen:_____________________________________________________________________________

    LABORATORY MICELLANEOUS REPORT

    COVID 19 Ag Test RESULT: NEGATIVE POSITIVE

    JANICE Q. PEDROSO, M.D., MPH PERFORMED BY:


    Chief of Hospital

    MARY ANN R. TORREGOSA, M.D


    Pathologist (License no. 57674)

    Republic of the Philippines


    Province of Zamboanga Sibugay
    OLUTANGA MUNICIPAL HOSPITAL
    Bateria, Olutanga Zamboanga Sibugay
    Date:__________
    Age:_____________ Sex:___________
    Name:________________________________________________________________________________
    Address:______________________________________________________________________________
    Requesting Physician:___________________________________________________________________
    Specimen:_____________________________________________________________________________

    LABORATORY MICELLANEOUS REPORT

    COVID 19 Ag Test RESULT: NEGATIVE POSITIVE

    JANICE Q. PEDROSO, M.D., MPH PERFORMED BY:


    Chief of Hospital

    MARY ANN R. TORREGOSA, M.D


    Pathologist (License no. 57674)

    Republic of the Philippines


    Province of Zamboanga Sibugay
    OLUTANGA MUNICIPAL HOSPITAL
    Bateria, Olutanga Zamboanga Sibugay
    Date:__________
    Age:_____________ Sex:___________
    Name:_______________________________________________________________________________
    Address:_____________________________________________________________________________
    Requesting Physician:__________________________________________________________________

    Specimen:____________________________________________________________________________

    LABORATORY MICELLANEOUS REPORT

    COVID 19 Ag Test RESULT: NEGATIVE POSITIVE

    JANICE Q. PEDROSO, M.D., MPH PERFORMED BY:


    Chief of Hospital

    MARY ANN R. TORREGOSA, M.D


    Pathologist (License no. 57674)

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