Pemeriksa/Investigator : I Gede Semaratika, A.Md.

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Dokter/Doctor : dr. Indah Susanti W,Sp.PK
No. Reg/Reg. No : 1675582 dffffffffffffffffffffffffffffffff
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Nama/Name : RADEN YOGA WIBAWA dffffffffffffffffffffffffffffffff
NIK/ID No. : 3172031808710012
Kewarganegaraan/Nationality : INDONESIA
Tanggal Lahir/DOB : 18/08/1971
No. Passport / Passport No : -
Jenis Kelamin/Sex : Laki-laki/Male
Faskes Asal / Health Facility : Quicktest Tebet
Waktu Sampling/Date Collected : 24 November 2022
Kota / City : Tebet
Waktu Periksa/Check Date : 24 November 2022
Instansi / Institution : PT. MESITECHMITRA PURNABANGUN
Waktu Selesai/Result Date : 24 November 2022
Alamat / Address : Jl, Walang Baru Ii / 54 ,Rt 3/7 , Kel. Tugu
Utara , Kec. Koja , Kota Adm. Jakarta Utara ,
Dki Jakarta

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

PCR SARS-CoV-2

2019-nCoV
FAM / ORF 1 AB Negative Negative (Cut off CT value 40) RT-PCR
VIC / N GEN Negative Negative (Cut off CT value 40) RT-PCR
ROX / S GEN Negative Negative (Cut off CT value 40) RT-PCR
Interpretasi Negative

Disclaimers :

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

Raden Yoga Wibawa Tebet, 24 November 2022

Dokter Pemeriksa / Physician Examiner

dr. Indah Susanti W,Sp.PK

info@quicktest.id
0811-9100-618(for result)
https://quicktest.id
Jalan Prof. Dr. Soepomo no 33A, Jakarta Selatan, DKI Jakarta 12810