Sultan Qaboos University
Central Analytical and Applied Research Unit
SAMPLE SUBMISSION FORM INTERNAL
Genetic Analyzer
Doc. No.
Issue Date
Revision No
Revision date
Doc. Page No
:
:
:
:
:
CAARU/F/003
01.05.2014
00
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1/1
General Information
Name
Supervisor
E Mail
College
Department
Phone/Extn/GSM
O
O
O
O
O
Funding Source
ABI Big Dye V3.1
O Student Project
Department Budget
Others/Grants(Please Specify the ):__________________________________
O
Full Service
DNA Extraction Only
O
PCR, PCR Purification & Gel Electrophoresis
Sequence Reaction and Sequence Purification
Run Plate Only
(Note:- Primers Should be provided)
Source of Genomic DNA:
O Plasmid O PCR Product O Others:_______________________________
Storage Temperature :
O RT O 4ºC O -20ºC O -80ºC
Sample
Information
Biohazard Samples :
O Yes
O No
S.No.
Sample ID
Sample Description
Quantity
Remarks
1
2
3
4
5
6
Brief Description of Experiment: (You may attach any additional information/details on separate sheet)
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Note
-
-
All Coloured samples are unaccepted
We DO NOT accept any samples with potential biohazard
Label and print clearly (Unclear information will cause delay in processing)
Submit all samples in a plastic bag with clear identification information
Number of
Samples
Head/Advisor Signature
Test Request No.: CAARU/
Sample Condition :
Job Allotted To :
Appointment Schedule (Date/Time)
Comments:
Appointment Schedule (Date/Time): DD/MM/YEAR
O 9 AM
O 1 PM
Date
For Laboratory Use
Sample Received By:
Received Date :
Reported on:
Central Analytical And Applied Research Unit, Sultan Qaboos University
Post Box:50, Al Khoudh, Muscat 123, Sultanate Of Oman
Email: caaru@squ.edu.om, Tel : +968-24146801, Fax: +968-24146810
http://wwwdev.squ.edu.om/science/Units/CAARU.aspx