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CeGaT GmbH Paul-Ehrlich-Str. 23 D-72076 T bingen Germany Tel 49 7071 565 44 55 Fax 49 7071 565 44 56 info cegat. Phone 49 7071 565 44 55 Email diagnostic-support cegat. de Doctor Surname First name Doctor Date Signature Doctor s stamp / Barcode D CeGaT is accredited by DAkkS according to DIN EN ISO 15189 2014 and by the College of American Pathologists CAP. Order Form Exome Custom Panel General Information Patient Sender / Clinic Surname First name Date of birth Institution Sex q male...
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