LAB REPORT COVID-19 IN THE O/O DSU, IDSP OFFICE
Patient ID 46765
RT PCR App Srf No. 0661900164944
Name of Labortory SHKM
Name of District
Name of CHC/SDH
Name of PHC
Zone
Name HARISH KUMAR
Age 29
Sex Male
Address KATESRA PALWAL
Mobile No 7015490493
Name of the refferal hospital (Admitted
Case)
Date of Admission
Date of Sample Collection 27/05/2021
Date of Discharge
Result NEGATIVE
Date of Result 29/05/2021
Lab ID No.
Month
Death
Associated Risk Factor
Travel in Last 14 Days
Note : 1. If the above report is required for any official/legal purposes
then the same may got be verified and duly signed by
respective health official/officers.
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