 |
|  |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Specimen Control: | -- | Hospital No: | -- |
| Name: | -- | ||
| Address: | -- | ||
| Age/Sex: | -- | Contact No: | -- |
| Date of Birth: | -- | Passport No: (if applicable) | -- |
| Specimen Health Facility: | -- | ||
| Specimen Type: | -- | ||
| Date/Time Collection: | -- | ||
| Date/Time Received: | -- | ||
| Date/Time Released: | -- | ||
| Requesting Physician: | -- | ||
| MOLECULAR LABORATORY ASSAY | |||
| REMARKS: | |||
| 1. Testing Method Used: Reverse Transcription Polymerase Chain Reaction (RT-PCR). | |||
| 2. End results can be affected by multiple factors from pre-analytic to analyticphase. Clinical and epidemiologic correlations are advised. | |||
| 3. This result is strictly confidential. Information is intended for patient and physician use. | |||
| **End of Report** | |||