HASIL PEMERIKSAAN LABORATORIUM

LABORATORY EXAMINATION RESULT

No. Reg/Reg. No. : SP111802202210281114296 Instansi/Institution : Umum/General

Nama/Name : YOGI YOGI NIK/ID No. : 3304040404980005
Tanggal Lahir/DOB : Apr, 04 1998 Passpor No. :
Jenis Kelamin/Sex : Laki-laki / Male Kewarganegaraan/Nationality. : Indonesia
Waktu Pengambilan Sampel : 18/02/2022 Alamat/Address : PT LERINDRO INTERNASIONAL
Sampling Time Faskes Asal/Health Facility : SPEEDLAB INDONESIA
Waktu Pemeriksaan Sampel : 18/02/2022 Kota/City : Jakarta
Sample Check Time
Dokter Pemeriksa : dr. Donatila Mano S, SpMK
Waktu Selesai : 18/02/2022
Date Reported
Jenis Sampel/Sample Type : ,Orofaring & Nasofaring

NILAI
PEMERIKSAAN/TEST HASIL/RESULT RUJUKAN/NORMAL METODE/METHOD KETERANGAN
RANGE
2019-NCOV Negative Negative Real Time RT-PCR Within Normal Limits

FAM / ORF1AB Undetection Undetection >= 40 Real Time RT-PCR Within Normal Limits

VIC / N GENE Undetection Undetection >= 40 Real Time RT-PCR Within Normal Limits

ROX / S GENE Undetection Undetection >= 40 Real Time RT-PCR Within Normal Limits
Kesan : Negative Sars-CoV-2
Catatan :
• Hasil ini hanya menggambarkan kondisi saat pengambilan spesimen, Jika timbul Gejala klinis atau kontak dengan pasien terindikasi setelah pemeriksaan, silahkan menghubungi Dokter /
Fasilitas Kesehatan terdekat. Pemeriksaan Ulang dapat dilakukan berdasarkan rekomendasi dokter.
• Hasil PCR tidak dapat dibandingkan antar alat dan gen yang berbeda.
• Pemeriksaan dikerjakan di Speedlab Indonesia yang sudah termasuk dalam Jejaring Laboratorium Pemeriksa Covid - 19 dengan Nomor C.456, sesuai dengan surat keputusan KMK No.
HK.01.07/Menkes/4642/2021.
Note :
• These results only describe the conditions at which the specimen was collected, if clinical symptoms or patient contact occurred indicated after the examination, please contact the nearest
doctor / health facility. Re-checking can be done on the recommendation of a doctor.
• PCR Results cannot be compared between different instruments and genes.
• The Test was performed at Speedlab Indonesia, which Is a part of The National Covid - 19 Laboratory network with No. C.456 as stated in the Decree of Health Minister KMK No.
HK.01.07/Menkes/4642/2021.

Petugas Pemeriksa/Investigator : Jeffry Bromo Ageng P.

Jakarta, 18 Februari 2022
QRCODE RESULT Dokter Pemeriksa/Physician Examiner

dr. Donatila Mano S, SpMK