Sample Submission Form for DNA Sequencing

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The Center for Genomic Technologies.
DNA Sequencing Sample Submission Form
Please print the complete sample information
Date:_________________
Sender (last, first name):_________________________Head of the group (PI):________________________
Address (department, institute, city):___________________________________________________________
E-mail address:____________________________________________________________________________
Phone: ______________________________________Cellular phone:_______________________________
Comments_______________________________________________________________________________
No
.
Sample ID
(5 chars)
*
Concentration
(µg/µl)
Primer
ID
(4 chars)
*
Type of DNA
PCR
Plasmid
BAC
Lengh of
PCR
fragment
DS/SS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
* DNA and primers are kept for 2 weeks (mention the sample’s name given by us).
The Institute of Life Sciences, wing 1, 3rd floor, room:1- 313.
The Hebrew University of Jerusalem, Edmond J. Safra Campus, Givat-Ram, Jerusalem
Tel: 02-6585211 Fax: 02-6584048
Comments
(DMSO)
(GC rich)
Office
use only
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