Form-Haematology

Request form

1. Please use correct form.

2. Please completely fill the request form with patients demography data, clinical history and physical examination, drugs history, name of test ordered, date and time of sample collection, Doctor's signature and identification.

3. Illegible handwriting can cause transcription error.

4. Consent form (if required) must be filled and signed. For paediatric patient, parents or guardian signature is required.