LAPORAN HASIL / Laboratory Result

No. Rekam Medis : 13356900 Klinik Asal / :

Medical Record Number Origin Clinic
No. Registrasi Lab : 4929449 / C.101.21.124584 Dok. Pengirim : --
Lab Registration Number Reffering Doctor
Nama Pasien : SIRRIYATUL MAULA Tanggal Swab : 08-11-2021 13:45:00
Patient`s Name Specimen Collection Date 2021-11-08 13:45:00
No.Ident.Kependudukan / : 3525127010990001 Tanggal Diterima : 08-11-2021 16:03:21
Paspor Receiving Date 2021-11-08 16:03:21
Residence ID Number/ Validasi Hasil : 08-11-2021 18:56:46
Passport Validation Date 2021-11-08 18:56:46
Tgl Lahir : 30-10-1999 Cetak Hasil : 08-11-2021
Date of Birth 1999-10-30 Print Out Date 2021-11-08
Jenis Kelamin : PEREMPUAN Debitur / : PASIEN TUNAI
Sex Female Insurance
Alamat / : JLN. SUNAN BONANG Kewarganegaraan / : INDONESIA
Address Nationality

JENIS PEMERIKSAAN/ HASIL/ Keterangan /

Type of Examination Result Other information
SARS CoV-2 Nucleic Acid Testing Negatif Keterangan :
Target Gen N, Gen ORF1ab, dan Gen RNAse-P
(RT-PCR) Negative Hasil Positif jika Nilai CT Gen N dan atau Gen ORF1ab <= 40
Kontrol positif <= 35
Explanation:
The target genes are N-gene, ORF1ab-gene, and RNAse P-gene
Positive Result establish if N-gene and/or ORF1ab-gene CT Value
<= 40
Positive control <= 35

Specimen : Nasopharyngeal and Oropharypheal Swab

Intepretasi Hasil / Result Interpretation

Hasil Negatif atau Tidak Terdeteksi menunjukkan bahwa material genetik SARS-CoV-2 yang dimaksud tidak ditemukan di
dalam spesimen atau kadar spesimen belum dapat terdeteksi oleh alat
Negative or Undetectable Results indicate that the SARS-CoV-2 genetic material in question was not detected in the
specimen or the specimen levels could not be detected by the instrument
Edukasi / Education
Patuhi protokol kesehatan yang berlaku / Always follow the health protocols
Tetap berperilaku bersih dan sehat / Keep a clean and healthy attitude
Untuk konsultasi lebih lanjut dapat menghubungi layanan kesehatan terdekat / For further consultation, please contact the
nearest health service

Sangkalan / Disclaimer
*Hasil pemeriksaan PCR SARS-CoV-2 tidak dapat dibandingkan dengan
laboratorium lain karena terdapat perbedaan: sampel (waktu dan teknis
pengambilan), metode, alat, target gen, limit deteksi, dan faktor lainnya
Hasil CT Value tidak menggambarkan klinis dan beratnya penyakit

*The results of the SARS-CoV-2 PCR examination could not be compared with
other laboratories result because there are differences in samples (time and Dokter Penanggung Jawab,
technique of collection), methods, tools, target genes, detection limits, and other Doctor in Charge
factors
The CT Value could not reflect the clinical and severity of disease

dr. Ferdy Royland M, Sp.PK

Ferdy Royland M. MD.Clinical Pathologist

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