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Mod.PR 11. H/ENG Rev. 06TEST REQUISITION FORM PATIENT DETAILS Protocol no. (internal use only): ___ Name___ Surname___ Date of birth___ Place of birth___ VAT no. ___ORDERING LABORATORY / CLINICIANAddress:___ Date
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How to fill out guidance on patient sample

01
Ensure that all necessary information is provided on the patient sample form, such as patient name, date of birth, and medical record number.
02
Collect the patient sample using sterile technique to prevent contamination.
03
Label the sample with the patient's information and the date and time of collection.
04
Store the sample according to the specific requirements outlined by the testing facility.
05
Complete any additional paperwork or documentation required by the testing facility before submitting the sample.

Who needs guidance on patient sample?

01
Medical professionals collecting patient samples for diagnostic testing
02
Laboratory technicians processing patient samples for analysis
03
Healthcare administrators responsible for ensuring accurate record-keeping and documentation

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