Egelab

Material Request Form

Material Request Form

* THIS FORM IS VALID FOR INSTITUTIONS RECEIVING MATERIALS UNDER THE AGREEMENT.

Organization Name
5 mL Gel Biochemistry Tube (Yellow Cap)
8 mL Gel Biochemistry Tube (Yellow Cap)
2 mL EDT-Containing Hemogram Tube (Purple Cap)
21 GR GREEN NEEDLE TIP
1.8 mL Citrate PTZ Tube
SEDIMENTATION TUBE
HEPARIN-COATED TUBE (GREEN CAP)
2 mL GLUCOSE TUBE (GRAY CAP)
NON-STERILE URINE COLLECTION CONTAINER
STERILE URINE CULTURE CONTAINER (WITH BAG)
JELLI SWAP
NO-GEL SWAP
12*75 PLASTIC TUBE (SEROLOGICAL)
12*75 PLASTIC TUBE CAP (SEROLOGICAL)
STOOL CONTAINER
YELLOW PIPETTE TIP
ADULT BLOOD CULTURE TUBE
PEDIATRIC BLOOD CULTURE VIAL
COTTON
INJECTION STRIP
Please list any items not included in the list and any other requests you may have.