Pemeriksa/Investigator : Pahmi Firmansyah, A.Md.

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Dokter/Doctor
No. Reg/Reg. No
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Nama/Name
NIK/ID No.
Tanggal Lahir/DOB
Jenis Kelamin/Sex
Waktu Sampling/Date Collected
Waktu Periksa/Check Date
Waktu Selesai/Result Date
Alamat / Address
: dr. Indah Susanti W,Sp.PK
: SPB774842778 dffffffffffffffffffffffffffffffff
: NETTY FETRIYANI dffffffffffffffffffffffffffffffff
: 1601225111000005
Kewarganegaraan/Nationality : WNA
: 2000-11-11
No. Passport / Passport No : -
: Perempuan/Female
Faskes Asal / Health Facility : Pasar Rebo
: 27 March 2021
Kota / City : South Jakarta
: 27 March 2021
Instansi / Institution : General
: 27 March 2021
: Blok F Dusun Iii Rt 008/003 Kel Markisa Kec Lubuk Batang

Pemeriksaan/Test Hasil/Result Batas Normal / Normal Range Metode / Method

PCR SARS-CoV-2

2019-nCoV
VIC/n Gene Negative Negative (Cut off CT value 35) RT-PCR
FAM/ORF1ab Negative Negative (Cut off CT value 35) RT-PCR
Interpretasi Result RT-PCR SARS-CoV-2 : Negative
Rekomendasi

Disclaimer

Catatan:
1. Hasil pemeriksaan dikerjakan dengan metode RT-PCR dan hanya menggambarkan kondisi saat pengambilan spesimen.
2. Hasil PCR Negatif tidak selalu berarti pasien tidak terinfeksi oleh pathogen, namun hanya menunjukan bahwa material genetik pathogen tidak
ditemukan di dalam sample
3. Jika hasil PCR positif atau timbul gejala klinis setelah pemeriksaan, silahkan hubungi dokter atau fasilitas kesehatan terdekat.
4. Hasil PCR tidak dapat dibandingkan antar satu laboratorium dengan laboratorium lain, karena perbedaan alat dan target gen yang digunakan.
5. Surat ini dikirim dan ditandatangani secara elektronik

Note :
1. The above examination results were carried out using the RT-PCR method and only described then condition at the time of specimen
collection
2. A negative PCR result does not necessarly mean that the patien is not infected with the pathogen, but only indicates that phatogenic genetic
material is not pressent in the sample
3. If the PCR result is positive or clinical symptoms appear after the examination, please contact the doctor or the nearst health facility.
4. PCR results cannot be compared between one laboratory and another, due to differences in then tools and target genes used.
5. The letter is sent and signed electronicaly

NETTY FETRIYANI South Jakarta, 27 March 2021

Dokter Pemeriksa / Physician Examiner

dr. Indah Susanti W,Sp.PK

info@quicktest.id
021-2138999 (for result)
https://quicktest.id
Jln. Prof Dr. Soepomo 33 A, Tebet, Jakarta Selatan