Medical Diagnostic Center "Modus Vivendi" HEALTH OF THE REPUBLIC OF MOLDOVA MEDICAL DOCUMENTATION F - 19-01 80 Burebist Street, Chisinau, tel. (022) 556 165, tel / fax (022)556 129 Mb. 79402472, 67444006 Who sent TEST RESULTS M249794 10:20:20 04.10.2021 10:20:20 04.10.2021 Time pick-up date Time of Testing Date of Testing Name, Surname Mosiiciuc Vitalie Date of Birth 1986.01.28 ID 2002042112129 insurance No. Address r.Moldova Institution Department room Sector № medical history Immunological determination of antigens Investigation name Control Interpretation Test method 1 2 3 4 SARS-COV-2 Express-Test Antigen Negativ Immunochromatographi c Lateral Flow Assay Manufactured by: RapiGEN,INC. Republic of Korea CE IVD Sensitivity : 90,2 % Specificity : 100 % date of issue 04.10.2021 10:38:56 Signature of Rotaru Mihaela date of issue 04.10.21