ffi Lahmffi,t'*

Loboroioiium Klinik Kimic Farmo

Jl. Diponegoro f.lo.40 B*ndung

Dokier Fena n ggun s r owab,,j,1'311,ft ;X'fi:?,:ffi

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SA RS-C*Y-? l{ tiA LI TATI f I e {:A }_ [ T;fiTI,E SA]IS-{ o1r-Z

?a*ggal Swabi ;08-05-2021

S*mplirug D*te
NamalP*tieytt N*me : paul Thanorie Silaban
Jenis Kelami*lGender taki-laki lMcle
${Dlf.ab lil : C.,138.64067
elarnat/Adriress
:

TarzggaUl)*te
: Haur pancuh ii No B_5 &i;&"rv
:08-05-2021
CC2/0C4 Lebak Gede Kec
Pex,6;tr;i,illefe*i*g : Lab KF Ilipcnegcrc
!*b rangg*!Leki/*s* l,t;i,-*rt
{dd-mrn-y5ty)
Jenis Sampel : Nasopharyngea! and
lspecbnew oropharyngeii s:vab

.-lenrs
Peutrikraxn Itesimpulan I R.esri.it Sistern I Protercol
S.\RS-CoV-j SARS-CoV-2 : positif I p;;tue fuleiocie : ,i.lt:rhod, mBioCr:V-ltr;tf f,Cn *t
Hualrtatrl (ctoRF 1b:37,CtRdRF_) Detoksi I *etecti*n: Gen ORFIB and Gen RdRp
.ct < 40: Positif / Posititre
c Ct > 40 : Negatif I Neg*tive

Catatan i Netes :

- Mlai at yang {ercd#xturn p*da hasi! positif hanya berlaku

urctuk hasil pCR sARS-col,-2 dari Lolotottsrium
Foftffr' Nilai tersehut tir!*k dapat tiibandingkan dengen Ct kesrt pCR Klinik Kir*ia
SARS-CilT-Z dari Lsborritoriuin laire.
ab$ve onfy *pply in Kriia Farma clinicel Laboratory.
This vatue cannot be compared wirh otker
*r";:;;;:ted
n"u* rnembereta nzenextuksn wekt* diiake**nr4t* swab *asofarins utaxs urztuk
fr:#:-#*:;;:f;-;X:,r,3:
ct value can be usecl.{or deterwining nasopharymgear sw,ab pcR
sARS_co{-2 eysluatian.

Be.:rdung. \4a,1, {JB,i- :{12 }

i / Ya{id*tert by,

Peil arrggrutE J a-a air I <- i i n i r it i i.) c: ; i.i r; i o g i ; i

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Lcboroiotium Klinik Kirriia F*rma

ffi hxbxffi*il-**
Jl. DiPonegoro No.4O Bcndung
Telpl Fo.x : *22-2*542249
Dokter Penanggung Jowab : dr. Dewi Rinakanti' Sp-PK

I.I A SII- FESI *:RII{SAAft* I t "".1 R {} fi il T 0 Rt' {: E R T I r; I { A 7' E

SARS-{:oY-? il{jA!-l-fATIp ! Otj.Al-tTAIIl'? SARS-CoY-2

TanggalSwab/ :08-05-202i NamaiPn#errt Nsrne : Patriesia Elis*irhet S

Surnpling Date Jenis KelaminlGender : Perea.rpuan I ?ernilJe
til
STl.iLab : C.438.64056 HlasadAddrcss : Haur Pancuh ii ivo 1J-5 RtRr.r'
Ta*ggaAD** :08-*5-2021 il02i$O4 Lebal Ccde Ke*
T/^+ aaudiuurr5
A L^-.1,--^
?**gtrtrnl*efsrring ; Lab ts*F Dip+negcr+ i\iii
'1-o^oool I ol".)r/t){)R : 21-0?-1995
I.ryb
{dd-mm-jy1y)
Jenis Sampel : Nascpharl,ngeal ard
lSpectune*t Oropharyngeal Swab

"lenis Kesimpulan I {iesult Sis{ern i Proktc*i

Penr*riksa*u
SARS-Co\r-2 SARS-CoV-Z : Positif I Posiiive Metode I Method : mBi*CoY-Ig RT FCR Kit
Kualita.til icr OltF 1b:31, Ct RdRF34) Deteksi I Detcctiorz. Gen ORI1B and Gerr RdRp
.Ct < 40 : P+sitif,r' Ptssitive
.Ct > 40 : l{egatif I Negat*e

Catatan l Nates :

- Nilai Ct ycsstg tercentunt p*da hasi! positif kanya berlabu unzuk lwsit PCR SAR.9-{sl/-2 dtii l*boratoriuw Klivsik Ki*ei*
{ayw.ct. Niiai tersehut ticlab dap*t diba*dingka* deiigax Ct hasil PCR SAF*S-{*V-Z dari Lab*r*totiurtt l*irt"
Ct v*lues sk$ed *bove o*ly eqply in Kimis Farme Cliytical laboratoiy. TLtis value e*nn*r be cawpared wit?t other
Jabawtories.
- Sel*in eytrlz:ssi kliwis, rziioi Ct dapct menzb*ntu r*enexlrak{tn waktu dii*!*tkttnx.,** :t*-ab x*sq{aring utaxg utttuk
pe *ee rik*saax P{JR"
SAFS-Ca Y- 2.
C{ vatue ca* be usedfor determining nasapharyngeal swab PCR SAR$-CoV-2 ev*.luctia*.

i}**dung. tuIay 0$tt':*? I

P**anggun g i aw ab ! (' ii n i':' i: ! I] oth r; i r; g,i.r t

 &rmraf,af,ffi
Laboreiorium Kiinik Kimia Formo
Jl. Diponegoro No.40 Bondung
Telp/ lc:x I Q22-2a54224?
Dokter Fenonggung Jowob : dr- Dewi Rinokanti, $p-PK

ITASX I, FES{ER I KSA;IIi ! L4 B {}RA T{.T RY {: E RTT F I {: A T E

SA RS-C*V-? KI.rA[, I1'ATI F: I {i{i A L l TA ? 7 t't SA }lS-Cotr' -?

Tanggai Sr.vab,. : 08-05-2021 I i No-a, |'*riant Nemte l T'heresia Rumondans Sihornbins

Sampling Date | ! Jenis K*lamiriGe*der : Ferempuan i Female
SIDll,a& /,: C.438.*t065 I I p,lxnatlAddress : HaurFancuh ii No B-5 RlrRrv
Ta*ggallD*te : 08-05-2$21 II II 0*2/0*4 L.ebak Gede Kec. cobl
jD--^;.i-lB4{brpiqq
rrLll' {ri6 .I LE l-ri4^44<!^r -r^+ 41---.1,.*..
lii5iirril r r rrou
^1- !u uiyuriEsuru i i l\ul nudiuuiiB
.l:1
L{!b ! I T."r***! }.s1:ir1.r}fi8 : ?6-1 ?6 1

ftld-mnt-yryy)
Sampel
Jenis : Nasopharyngeal and
lSpeciment fircpharyngeai Swab

.,1elr rs
Ilonrprikrq *x
Kesirnpulan i Rcsuil Sistem t Protocot
5-:*(5-t rt V --i SARS-C*V-2: Positrf;'Ilcsrri:c ilL.tcde .',..it:ihaLl rnBioCcV-l9Itl1PCIdKit
liuairtatif (Ct ORF 1b17,Ct RdRP:29) | Deteksi I Detecti*yt: Gen ORFIB and Ger: RdRp
. Ct < 4B: Pcsitif / Pasiti"-e
r Ct > 40 : Negatif I Neg*tive

Catatan I Notes :

- Niloi Ct yang tercanfam pada kasil positif hanya berlaku untilk hasil PCR SARS-Colt-2 dari lsboratorium Klinik Kirxia
Fsrm*. Nilai tersehut tidak dapr$ diba*dingka* detegan Ct hasit PCR SARS-Cctl-7 dari Laborstorium lain-
Ct values sfaled above only xpply in Kinzia Farffia Clinicsl Lcborator-t. This value cannot be campared tyith otlter
laborciories.
- Selsin evaluasi klinis, nikti Ct dapat rnewbantu menenlttkan waktx.t dil{}kukennya swsb *ast$aring wlawg untuk
peme ri kas a* n Pt R SARS-{al'- 2.
Ct value can be used-frsr determining nasopharymge$l swab ?CR SARS-CoY-2 evaluation.

Ba:nchmg. &{a}, 08'h 102 1

Pe;rang-u,unu Jawab i ( )f tnimi lj{tlfualogist