{"id":14006,"date":"2022-05-30T14:45:10","date_gmt":"2022-05-30T11:45:10","guid":{"rendered":"https:\/\/www.izmiregelab.com\/material-request-form-2\/"},"modified":"2026-09-02T23:28:49","modified_gmt":"2026-09-02T20:28:49","slug":"material-request-form-2","status":"publish","type":"page","link":"https:\/\/www.izmiregelab.com\/en\/material-request-form-2\/","title":{"rendered":"Material Request Form"},"content":{"rendered":"<style>.elementor-14006 .elementor-element.elementor-element-24b1fa93:not(.elementor-motion-effects-element-type-background), .elementor-14006 .elementor-element.elementor-element-24b1fa93 > .elementor-motion-effects-container > .elementor-motion-effects-layer{background-image:url(\"https:\/\/www.izmiregelab.com\/wp-content\/uploads\/2022\/02\/microscopes-in-scientific-laboratory.jpg\");background-position:0px 40%;background-repeat:no-repeat;background-size:cover;}.elementor-14006 .elementor-element.elementor-element-24b1fa93 > 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.jkit-button-wrapper svg{margin-right:10px;}.elementor-14006 .elementor-element.elementor-element-19ae5f5d .jeg-elementor-kit.jkit-button.icon-position-after .jkit-button-wrapper i, .elementor-14006 .elementor-element.elementor-element-19ae5f5d .jeg-elementor-kit.jkit-button.icon-position-after .jkit-button-wrapper svg{margin-left:10px;}.elementor-14006 .elementor-element.elementor-element-35d88cfe > .elementor-widget-container{margin:0px 0px 0px 0px;}.elementor-14006 .elementor-element.elementor-element-35d88cfe .elementor-heading-title{font-size:var( --e-global-typography-6cb29b0-font-size );}.elementor-14006 .elementor-element.elementor-element-5e5f68e4{padding:50px 0px 50px 0px;}}\/* Start custom CSS for form, class: .elementor-element-6584271 *\/.elementor-14006 .elementor-element.elementor-element-6584271 .elementor-field-option label {\n    font-weight: 400;\n}\n\n@media only screen and (max-width:800px) {\n    .malzeme_title, .adet_title {\n        display:none;\n    }\n}\/* End custom CSS *\/<\/style>\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"14006\" class=\"elementor elementor-14006 elementor-7826\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-24b1fa93 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"24b1fa93\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-80322fc\" data-id=\"80322fc\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-27628804 elementor-widget elementor-widget-heading\" data-id=\"27628804\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Material Request Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-19ae5f5d elementor-widget__width-auto elementor-widget elementor-widget-jkit_button\" data-id=\"19ae5f5d\" data-element_type=\"widget\" data-widget_type=\"jkit_button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div  class=\"jeg-elementor-kit jkit-button  icon-position-after jeg_module___6aace47be06bd\" ><a href=\"\" class=\"jkit-button-wrapper\">Home Page<i aria-hidden=\"true\" class=\"fas fa-chevron-right\"><\/i><\/a><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-35d88cfe elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"35d88cfe\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Material Request Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5e5f68e4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5e5f68e4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-wider\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0981351\" data-id=\"0981351\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-91f5c9f elementor-widget elementor-widget-text-editor\" data-id=\"91f5c9f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>* THIS FORM IS VALID FOR INSTITUTIONS RECEIVING MATERIALS UNDER THE AGREEMENT.  <\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6584271 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"6584271\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"materialForm\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"14006\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"6584271\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-kurumadi elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-kurumadi\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOrganization Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[kurumadi]\" id=\"form-field-kurumadi\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefon elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefon\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefon]\" id=\"form-field-telefon\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_825c05e elementor-col-70\">\n\t\t\t\t\t<label class=\"malzeme_title elementor-field-label\">Materials<\/label>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_e922304 elementor-col-30\">\n\t\t\t\t\t<label class=\"adet_title elementor-field-label\">Period<\/label>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-2ml_edtali_tup_mor_kapak elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"2-ml EDT tube (purple cap) (1 package = 100 pieces)  \" id=\"form-field-2ml_edtali_tup_mor_kapak-0\" name=\"form_fields[2ml_edtali_tup_mor_kapak]\"> <label for=\"form-field-2ml_edtali_tup_mor_kapak-0\">2-ml EDT tube (purple cap) (1 package = 100 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-2ml_edtali_tup_mor_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[2ml_edtali_tup_mor_adet]\" id=\"form-field-2ml_edtali_tup_mor_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-2ml_heparinli_tup_yesil_kapak elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"2-ml heparin-coated tube (green cap) (1 package = 100 pieces)  \" id=\"form-field-2ml_heparinli_tup_yesil_kapak-0\" name=\"form_fields[2ml_heparinli_tup_yesil_kapak]\"> <label for=\"form-field-2ml_heparinli_tup_yesil_kapak-0\">2-ml heparin-coated tube (green cap) (1 package = 100 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-2ml_heparinli_tup_yesil_kapak_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[2ml_heparinli_tup_yesil_kapak_adet]\" id=\"form-field-2ml_heparinli_tup_yesil_kapak_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-6ml_kirmizi_kapakli elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"6 mL tube with a red cap and no gel\" id=\"form-field-6ml_kirmizi_kapakli-0\" name=\"form_fields[6ml_kirmizi_kapakli]\"> <label for=\"form-field-6ml_kirmizi_kapakli-0\">6 mL tube with a red cap and no gel<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-6_ml_kirmizi_kapakli_jelsiz_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[6_ml_kirmizi_kapakli_jelsiz_adet]\" id=\"form-field-6_ml_kirmizi_kapakli_jelsiz_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_25972c0 elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"2-ml tube with oxalate (gray cap) (1 package = 100 pieces)  \" id=\"form-field-field_25972c0-0\" name=\"form_fields[field_25972c0]\"> <label for=\"form-field-field_25972c0-0\">2-ml tube with oxalate (gray cap) (1 package = 100 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-2ml_oksalalti_gri_kapak elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[2ml_oksalalti_gri_kapak]\" id=\"form-field-2ml_oksalalti_gri_kapak\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-2ml_sodyum_sitratli_tup_mavi_kapak elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"2-ml tube containing sodium citrate (blue cap) (1 package = 100 tubes)  \" id=\"form-field-2ml_sodyum_sitratli_tup_mavi_kapak-0\" name=\"form_fields[2ml_sodyum_sitratli_tup_mavi_kapak]\"> <label for=\"form-field-2ml_sodyum_sitratli_tup_mavi_kapak-0\">2-ml tube containing sodium citrate (blue cap) (1 package = 100 tubes)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-2ml_sodyum_sitratli_tup_mavi_kapak_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[2ml_sodyum_sitratli_tup_mavi_kapak_adet]\" id=\"form-field-2ml_sodyum_sitratli_tup_mavi_kapak_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-5ml_jelli_tup_sari_kapak elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"5-ml gel tube (yellow cap) (1 package = 100 pieces)  \" id=\"form-field-5ml_jelli_tup_sari_kapak-0\" name=\"form_fields[5ml_jelli_tup_sari_kapak]\"> <label for=\"form-field-5ml_jelli_tup_sari_kapak-0\">5-ml gel tube (yellow cap) (1 package = 100 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-5ml_jelli_tup_sari_kapak_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[5ml_jelli_tup_sari_kapak_adet]\" id=\"form-field-5ml_jelli_tup_sari_kapak_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-21g_yesil_igne_ucu elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"21g green needle tips (1 pack = 100 pieces)  \" id=\"form-field-21g_yesil_igne_ucu-0\" name=\"form_fields[21g_yesil_igne_ucu]\"> <label for=\"form-field-21g_yesil_igne_ucu-0\">21g green needle tips (1 pack = 100 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-21g_yesil_igne_ucu_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[21g_yesil_igne_ucu_adet]\" id=\"form-field-21g_yesil_igne_ucu_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_9b6ade4 elementor-col-100\">\n\t\t\t\t\t<div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-steril_idrar_kabi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sterile urine collection container\" id=\"form-field-steril_idrar_kabi-0\" name=\"form_fields[steril_idrar_kabi]\"> <label for=\"form-field-steril_idrar_kabi-0\">Sterile urine collection container<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-steril_idrar_kabi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[steril_idrar_kabi_adet]\" id=\"form-field-steril_idrar_kabi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-non_steril_idrar_kabi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Non-sterile urine collection container\" id=\"form-field-non_steril_idrar_kabi-0\" name=\"form_fields[non_steril_idrar_kabi]\"> <label for=\"form-field-non_steril_idrar_kabi-0\">Non-sterile urine collection container<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-non_steril_idrar_kabi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[non_steril_idrar_kabi_adet]\" id=\"form-field-non_steril_idrar_kabi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_e4e8d90 elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Gel-free swab\" id=\"form-field-field_e4e8d90-0\" name=\"form_fields[field_e4e8d90]\"> <label for=\"form-field-field_e4e8d90-0\">Gel-free swab<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-jelsiz_swab_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[jelsiz_swab_adet]\" id=\"form-field-jelsiz_swab_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-jelli_swab elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Gel swab\" id=\"form-field-jelli_swab-0\" name=\"form_fields[jelli_swab]\"> <label for=\"form-field-jelli_swab-0\">Gel swab<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-jelli_swab_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[jelli_swab_adet]\" id=\"form-field-jelli_swab_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-yetiskin_kan_kultur_sisesi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Adult blood culture bottle\" id=\"form-field-yetiskin_kan_kultur_sisesi-0\" name=\"form_fields[yetiskin_kan_kultur_sisesi]\"> <label for=\"form-field-yetiskin_kan_kultur_sisesi-0\">Adult blood culture bottle<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-yetiskin_kan_kultur_sisesi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[yetiskin_kan_kultur_sisesi_adet]\" id=\"form-field-yetiskin_kan_kultur_sisesi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-pediatri_kan_kultur_sisesi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Pediatric blood culture bottle\" id=\"form-field-pediatri_kan_kultur_sisesi-0\" name=\"form_fields[pediatri_kan_kultur_sisesi]\"> <label for=\"form-field-pediatri_kan_kultur_sisesi-0\">Pediatric blood culture bottle<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-pediatri_kan_kultur_sisesi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[pediatri_kan_kultur_sisesi_adet]\" id=\"form-field-pediatri_kan_kultur_sisesi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-12x75_tup elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"12x75 tube\" id=\"form-field-12x75_tup-0\" name=\"form_fields[12x75_tup]\"> <label for=\"form-field-12x75_tup-0\">12x75 tube<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-12x75_tup_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[12x75_tup_adet]\" id=\"form-field-12x75_tup_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-12x75_tup_kapagi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"12x75 tube cap\" id=\"form-field-12x75_tup_kapagi-0\" name=\"form_fields[12x75_tup_kapagi]\"> <label for=\"form-field-12x75_tup_kapagi-0\">12x75 tube cap<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-12x75_tup_kapagi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[12x75_tup_kapagi_adet]\" id=\"form-field-12x75_tup_kapagi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-16x100_tup_dibi_konik elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"16x100 tube (tapered bottom)\" id=\"form-field-16x100_tup_dibi_konik-0\" name=\"form_fields[16x100_tup_dibi_konik]\"> <label for=\"form-field-16x100_tup_dibi_konik-0\">16x100 tube (tapered bottom)<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-16x100_tup_dibi_konik_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[16x100_tup_dibi_konik_adet]\" id=\"form-field-16x100_tup_dibi_konik_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-gaita_kabi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Feces container\" id=\"form-field-gaita_kabi-0\" name=\"form_fields[gaita_kabi]\"> <label for=\"form-field-gaita_kabi-0\">Feces container<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-gaita_kabi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[gaita_kabi_adet]\" id=\"form-field-gaita_kabi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_63365a0 elementor-col-100\">\n\t\t\t\t\t<div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-30ml_10lu_formaldehitli_patoloji_kabi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"30 ml pathology vials containing 10% formaldehyde (1 package = 50 vials)  \" id=\"form-field-30ml_10lu_formaldehitli_patoloji_kabi-0\" name=\"form_fields[30ml_10lu_formaldehitli_patoloji_kabi]\"> <label for=\"form-field-30ml_10lu_formaldehitli_patoloji_kabi-0\">30 ml pathology vials containing 10% formaldehyde (1 package = 50 vials)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-30ml_10lu_formaldehitli_patoloji_kabi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[30ml_10lu_formaldehitli_patoloji_kabi_adet]\" id=\"form-field-30ml_10lu_formaldehitli_patoloji_kabi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-smearhpv_kabi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"HPV Smear Collection Container (1 package = 50 units)  \" id=\"form-field-smearhpv_kabi-0\" name=\"form_fields[smearhpv_kabi]\"> <label for=\"form-field-smearhpv_kabi-0\">HPV Smear Collection Container (1 package = 50 units)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-smearhpv_kabi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[smearhpv_kabi_adet]\" id=\"form-field-smearhpv_kabi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-smear_fircasi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Smear brush (1 pack = 50 pieces)  \" id=\"form-field-smear_fircasi-0\" name=\"form_fields[smear_fircasi]\"> <label for=\"form-field-smear_fircasi-0\">Smear brush (1 pack = 50 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-smear_fircasi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[smear_fircasi_adet]\" id=\"form-field-smear_fircasi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-2li_lam_kutusu elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Pack of 2 blades (1 pack = 10 pieces)  \" id=\"form-field-2li_lam_kutusu-0\" name=\"form_fields[2li_lam_kutusu]\"> <label for=\"form-field-2li_lam_kutusu-0\">Pack of 2 blades (1 pack = 10 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-2li_lam_kutusu_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[2li_lam_kutusu_adet]\" id=\"form-field-2li_lam_kutusu_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-1kg_buyuk_boy_patoloji_kabi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"1 kg large pathology container (1 package = 40 pieces)  \" id=\"form-field-1kg_buyuk_boy_patoloji_kabi-0\" name=\"form_fields[1kg_buyuk_boy_patoloji_kabi]\"> <label for=\"form-field-1kg_buyuk_boy_patoloji_kabi-0\">1 kg large pathology container (1 package = 40 pieces)  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-1kg_buyuk_boy_patoloji_kabi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[1kg_buyuk_boy_patoloji_kabi_adet]\" id=\"form-field-1kg_buyuk_boy_patoloji_kabi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-formaldehit_solusyonu elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Formaldehyde solution (1 bottle = 5 liters)\" id=\"form-field-formaldehit_solusyonu-0\" name=\"form_fields[formaldehit_solusyonu]\"> <label for=\"form-field-formaldehit_solusyonu-0\">Formaldehyde solution (1 bottle = 5 liters)<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-formaldehit_solusyonu_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[formaldehit_solusyonu_adet]\" id=\"form-field-formaldehit_solusyonu_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d17f921 elementor-col-100\">\n\t\t\t\t\t<div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-numune_istem_formu elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sample Request Form\" id=\"form-field-numune_istem_formu-0\" name=\"form_fields[numune_istem_formu]\"> <label for=\"form-field-numune_istem_formu-0\">Sample Request Form<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-numune_istem_formu_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[numune_istem_formu_adet]\" id=\"form-field-numune_istem_formu_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-patoloji_istem_formu elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Pathology\/Smear Request Form\" id=\"form-field-patoloji_istem_formu-0\" name=\"form_fields[patoloji_istem_formu]\"> <label for=\"form-field-patoloji_istem_formu-0\">Pathology\/Smear Request Form<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-patoloji_istem_formu_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[patoloji_istem_formu_adet]\" id=\"form-field-patoloji_istem_formu_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-kurye_istem_formu elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Courier Request Form\" id=\"form-field-kurye_istem_formu-0\" name=\"form_fields[kurye_istem_formu]\"> <label for=\"form-field-kurye_istem_formu-0\">Courier Request Form<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-kurye_istem_formu_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[kurye_istem_formu_adet]\" id=\"form-field-kurye_istem_formu_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-ornek_gonderme_fisi elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sample Shipping Slip\" id=\"form-field-ornek_gonderme_fisi-0\" name=\"form_fields[ornek_gonderme_fisi]\"> <label for=\"form-field-ornek_gonderme_fisi-0\">Sample Shipping Slip<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-ornek_gonderme_fisi_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[ornek_gonderme_fisi_adet]\" id=\"form-field-ornek_gonderme_fisi_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-buyuk_canta elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Large bag\" id=\"form-field-buyuk_canta-0\" name=\"form_fields[buyuk_canta]\"> <label for=\"form-field-buyuk_canta-0\">Large bag<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-buyuk_canta_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[buyuk_canta_adet]\" id=\"form-field-buyuk_canta_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-kucuk_canta elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Small bag\" id=\"form-field-kucuk_canta-0\" name=\"form_fields[kucuk_canta]\"> <label for=\"form-field-kucuk_canta-0\">Small bag<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-kucuk_canta_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[kucuk_canta_adet]\" id=\"form-field-kucuk_canta_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-numune_poseti elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sample bag\" id=\"form-field-numune_poseti-0\" name=\"form_fields[numune_poseti]\"> <label for=\"form-field-numune_poseti-0\">Sample bag<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-numune_poseti_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[numune_poseti_adet]\" id=\"form-field-numune_poseti_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-bos_barkod elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Blank barcode\" id=\"form-field-bos_barkod-0\" name=\"form_fields[bos_barkod]\"> <label for=\"form-field-bos_barkod-0\">Blank barcode<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-bos_barkod_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[bos_barkod_adet]\" id=\"form-field-bos_barkod_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-yazili_barkod elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"7-digit printed barcode\" id=\"form-field-yazili_barkod-0\" name=\"form_fields[yazili_barkod]\"> <label for=\"form-field-yazili_barkod-0\">7-digit printed barcode<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-yazili_barkod_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[yazili_barkod_adet]\" id=\"form-field-yazili_barkod_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-buz_akusu elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ice battery\" id=\"form-field-buz_akusu-0\" name=\"form_fields[buz_akusu]\"> <label for=\"form-field-buz_akusu-0\">Ice battery<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-buz_akusu_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[buz_akusu_adet]\" id=\"form-field-buz_akusu_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-plastik_klips elementor-col-70\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Plastic Clip\" id=\"form-field-plastik_klips-0\" name=\"form_fields[plastik_klips]\"> <label for=\"form-field-plastik_klips-0\">Plastic Clip<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-plastik_klips_adet elementor-col-30\">\n\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[plastik_klips_adet]\" id=\"form-field-plastik_klips_adet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button type=\"submit\" class=\"elementor-button elementor-size-sm\">\n\t\t\t\t\t\t<span >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\" elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Material Request Form Home Page Material Request Form * THIS FORM IS VALID FOR INSTITUTIONS RECEIVING MATERIALS UNDER THE AGREEMENT.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-14006","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/pages\/14006","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/comments?post=14006"}],"version-history":[{"count":1,"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/pages\/14006\/revisions"}],"predecessor-version":[{"id":14022,"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/pages\/14006\/revisions\/14022"}],"wp:attachment":[{"href":"https:\/\/www.izmiregelab.com\/en\/wp-json\/wp\/v2\/media?parent=14006"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}