Test Report: Assay Assay Version Assay Type

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812543-RSUD Lamaddukkelleng-Wajo-Indonesia 04/02/24 11:53:45

Test Report

Patient ID: MAKKASAU_PKM TOSORA


Patient ID 2: 0443
Sample ID: Xpert M 040224095001
Test Type: Specimen
Sample Type:

Assay Information
Assay Assay Version Assay Type
Xpert MTB-RIF Ultra 4 In Vitro Diagnostic

Test Result: MTB NOT DETECTED


-
Analyte Result
No fields selected

User: Wahyuddin
Status: Done Start Time: 04/02/24 09:50:54
Expiration Date*: 11/05/25 End Time: 04/02/24 10:55:41
S/W Version: 5.1 Instrument S/N: 812543
Cartridge S/N*: 629120521 Module S/N: 210074463
Reagent Lot ID*: 55709 Module Name: C4
Notes:
Error Status: OK
-
Errors
<None>

Tech. Initial/Date Supervisor Initial/Date


* indicates that a particular field is entered using a barcode scanner

For In Vitro Diagnostic Use Only.

GeneXpert® Dx System Version 5.1 Page 1 of 7


812543-RSUD Lamaddukkelleng-Wajo-Indonesia 04/02/24 11:53:45

Test Report

Patient ID: HJ. JARNA_PKM TOSORA


Patient ID 2: 0442
Sample ID: Xpert M 040224094937
Test Type: Specimen
Sample Type:

Assay Information
Assay Assay Version Assay Type
Xpert MTB-RIF Ultra 4 In Vitro Diagnostic

Test Result: MTB NOT DETECTED


-
Analyte Result
No fields selected

User: Wahyuddin
Status: Done Start Time: 04/02/24 09:50:31
Expiration Date*: 11/05/25 End Time: 04/02/24 10:55:18
S/W Version: 5.1 Instrument S/N: 812543
Cartridge S/N*: 629120532 Module S/N: 651651
Reagent Lot ID*: 55709 Module Name: C1
Notes:
Error Status: OK
-
Errors
<None>

Tech. Initial/Date Supervisor Initial/Date


* indicates that a particular field is entered using a barcode scanner

For In Vitro Diagnostic Use Only.

GeneXpert® Dx System Version 5.1 Page 2 of 7


812543-RSUD Lamaddukkelleng-Wajo-Indonesia 04/02/24 11:53:45

Test Report

Patient ID: SAHRUL_PKM TOSORA


Patient ID 2: 0441
Sample ID: Xpert M 040224094915
Test Type: Specimen
Sample Type:

Assay Information
Assay Assay Version Assay Type
Xpert MTB-RIF Ultra 4 In Vitro Diagnostic

Test Result: MTB NOT DETECTED


-
Analyte Result
No fields selected

User: Wahyuddin
Status: Done Start Time: 04/02/24 09:50:09
Expiration Date*: 11/05/25 End Time: 04/02/24 10:54:29
S/W Version: 5.1 Instrument S/N: 812543
Cartridge S/N*: 629120542 Module S/N: 210103541
Reagent Lot ID*: 55709 Module Name: C3
Notes:
Error Status: OK
-
Errors
<None>

Tech. Initial/Date Supervisor Initial/Date


* indicates that a particular field is entered using a barcode scanner

For In Vitro Diagnostic Use Only.

GeneXpert® Dx System Version 5.1 Page 3 of 7


812543-RSUD Lamaddukkelleng-Wajo-Indonesia 04/02/24 11:53:45

Test Report

Patient ID: RUSTAN_PKM TOSORA


Patient ID 2: 0440
Sample ID: Xpert M 040224083012
Test Type: Specimen
Sample Type:

Assay Information
Assay Assay Version Assay Type
Xpert MTB-RIF Ultra 4 In Vitro Diagnostic

Test Result: MTB NOT DETECTED


-
Analyte Result
No fields selected

User: Wahyuddin
Status: Done Start Time: 04/02/24 08:31:07
Expiration Date*: 11/05/25 End Time: 04/02/24 09:35:36
S/W Version: 5.1 Instrument S/N: 812543
Cartridge S/N*: 629120535 Module S/N: 662540
Reagent Lot ID*: 55709 Module Name: C2
Notes:
Error Status: OK
-
Errors
<None>

Tech. Initial/Date Supervisor Initial/Date


* indicates that a particular field is entered using a barcode scanner

For In Vitro Diagnostic Use Only.

GeneXpert® Dx System Version 5.1 Page 4 of 7


812543-RSUD Lamaddukkelleng-Wajo-Indonesia 04/02/24 11:53:45

Test Report

Patient ID: MURTASIA_SAYRA BEDAH


Patient ID 2: 0439
Sample ID: Xpert M 040224082943
Test Type: Specimen
Sample Type:

Assay Information
Assay Assay Version Assay Type
Xpert MTB-RIF Ultra 4 In Vitro Diagnostic

Test Result: MTB NOT DETECTED


-
Analyte Result
No fields selected

User: Wahyuddin
Status: Done Start Time: 04/02/24 08:30:38
Expiration Date*: 11/05/25 End Time: 04/02/24 09:35:22
S/W Version: 5.1 Instrument S/N: 812543
Cartridge S/N*: 629120539 Module S/N: 210074463
Reagent Lot ID*: 55709 Module Name: C4
Notes:
Error Status: OK
-
Errors
<None>

Tech. Initial/Date Supervisor Initial/Date


* indicates that a particular field is entered using a barcode scanner

For In Vitro Diagnostic Use Only.

GeneXpert® Dx System Version 5.1 Page 5 of 7


812543-RSUD Lamaddukkelleng-Wajo-Indonesia 04/02/24 11:53:45

Test Report

Patient ID: NURMI_ASOKA


Patient ID 2: 0438
Sample ID: Xpert M 040224082915
Test Type: Specimen
Sample Type:

Assay Information
Assay Assay Version Assay Type
Xpert MTB-RIF Ultra 4 In Vitro Diagnostic

Test Result: MTB NOT DETECTED


-
Analyte Result
No fields selected

User: Wahyuddin
Status: Done Start Time: 04/02/24 08:30:10
Expiration Date*: 11/05/25 End Time: 04/02/24 09:34:51
S/W Version: 5.1 Instrument S/N: 812543
Cartridge S/N*: 629120553 Module S/N: 651651
Reagent Lot ID*: 55709 Module Name: C1
Notes:
Error Status: OK
-
Errors
<None>

Tech. Initial/Date Supervisor Initial/Date


* indicates that a particular field is entered using a barcode scanner

For In Vitro Diagnostic Use Only.

GeneXpert® Dx System Version 5.1 Page 6 of 7


812543-RSUD Lamaddukkelleng-Wajo-Indonesia 04/02/24 11:53:45

Test Report

Patient ID: SULTAN_ASOKA


Patient ID 2: 0437
Sample ID: Xpert M 040224082853
Test Type: Specimen
Sample Type:

Assay Information
Assay Assay Version Assay Type
Xpert MTB-RIF Ultra 4 In Vitro Diagnostic

Test Result: MTB NOT DETECTED


-
Analyte Result
No fields selected

User: Wahyuddin
Status: Done Start Time: 04/02/24 08:29:46
Expiration Date*: 11/05/25 End Time: 04/02/24 09:34:02
S/W Version: 5.1 Instrument S/N: 812543
Cartridge S/N*: 629120556 Module S/N: 210103541
Reagent Lot ID*: 55709 Module Name: C3
Notes:
Error Status: OK
-
Errors
<None>

Tech. Initial/Date Supervisor Initial/Date


* indicates that a particular field is entered using a barcode scanner

For In Vitro Diagnostic Use Only.

GeneXpert® Dx System Version 5.1 Page 7 of 7

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