Ni Luh Yuliantari PDF

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Rumah Sakit Umum Daerah Kab.

Klungkung
Jl. Flamboyan, No.40, Semarapura Klungkung - Bali Telp. (0366)21172
Website : www.rsud.klungkungkab.go.id

Penanggung Jawab Laboratorium : dr. I Komang Parwata, Sp. PK


(Head Of Laboratory Department)

HASIL PEMERIKSAAN RT-PCR COVID-19


(COVID-19 TEST RESULT)

ID SAMPEL : C.425.22.017720/PB/RSUD-KLK
ID OF SAMPLE

KODE/CM : PB18251
MEDICAL RECORD

NAMA : NI LUH YULIANTARI


NAME

NIK : 5107045407990005
ID CARD NUMBER

TANGGAL LAHIR : 14 Jul 1999 J. KELAMIN : PEREMPUAN


DATE OF BIRTH GENDER : FEMALE

ALAMAT : BR. DINAS BUGBUG SAMUH , Kel. BUGBUG , Kec. KARANGASEM , KARANGASEM , BALI
ADDRESS

KOTA : KARANGASEM
CITY

ASAL INSTITUSI : KLINIK UTAMA PADMA BAHTERA MEDICAL CENTRE


INSTITUTION

JENIS SPESIMEN : NASO&OROPHARYNGEAL SWAB SPESIMEN KE : 1


SPECIMENT OF SPECIMENT NUMBER

TANGGAL SWAB : 25 Nov 2022 JAM PENGAMBILAN : 12:00 WITA


DATE OF SWAB TIME

TANGGAL DIPERIKSA : 25 Nov 2022


DATE OF TESTED

JENIS PEMERIKSAAN HASIL NILAI RUJUKAN METODE


TEST RESULT REFFERENCE RANGE METHODE

SARS-CoV-2 Negative Negative Real Time-PCR

Semarapura, 25 Nov 2022


VALIDATOR
(VALIDATE BY)

dr. I Komang Parwata, Sp.PK


NIP. 197701152005011008

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