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Unit 204 High Pointe Medical Hub, #241 Shaw Blvd.

, Mandaluyong City

SPECIMEN # 20-CVD-460103 RESULT RELEASED 10/30/2020 04:35 PM

REF. INSTITUTION: PRIVATE- DR. JOCELYN COBANKIAT PHYSICIAN

PATIENT NAME ZAMORA, FUENIE FE BANDIOLA DATE OF BIRTH 02/12/1996

CONTACT # 639509388520 AGE 24

ADDRESS 471 ADALLA STREET BARANGAY GENDER Female


GUADALUPE VIEJO MAKATI CITY
NATIONALITY
BARANGAY GUADALUPE VIEJO
PASSPORT #
CITY CITY OF MAKATI

PROVINCE NCR

TEST NAME COVID-19 RT PCR

RESULT SARS-CoV-2 (causative agent of COVID-19) viral RNA NOT ONLINE VALIDATION
detected

INTERPRETATION NEGATIVE FOR SARS-CoV-2 (causative agent of COVID-19)

SPECIMEN Nasopharyngeal swab / Oropharyngeal swab

DATE COLLECTED 10/30/2020 09:39 AM

DATE RECEIVED 10/30/2020 10:15 AM

Disclaimer: This QR code can be scanned to access


your personal information related to your COVID-19
Test. Protect your privacy by protecting this QR code
from being scanned without your consent.

TEST INFORMATION
METHODOLOGY: The Novel Coronavirus (2019-nCoV) Nucleic Acid Diagnostic Kit PCR test is performed for the qualitative detection of
ORF-1ab, N, or E gene of SARS-CoV-2. This test adopts PCR- Fluorescence Probing system technology to detect the
COVID-19 genes in real time PCR assay.

LIMITATION/S: The detection of a mutation is dependent on the number of copies present in the specimen that can be detected, and
may be affected by sample integrity, amout of isolated RNA, the presence of interfering substances or inhibitors, and
processing. The limit of detection for this assay is 200 viral copies/ml.

Test performed by: Verified by:

Mary Joy A. Bagsic, RMT Rachelle Ann Fortuno, RMT

Medical Technologist Laboratory Supervisor


PRC No: 0058146 PRC No: 0063276

*** This is a computer generated form and if issued without any alteration, this does not require a signature ***

Michelle Hernandez Diwa, MD Daphne Chua-Ang, MD

Clinical Pathologist Clinical Pathologist


PRC No: 0096316 PRC No: 0102523

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