Confocal Microscope
General Facility Project No: GS 03/08
Date
*
-
Month
-
Day
Year
Date
*
Analysis Request Submitted by
Principal Investigator
Student
Research Associate/ Assistant
Kuwait University ID No.
*
Email ID of the PI
*
Use Only Kuwait University Email ID of the PI
Name of the PI
*
First Name
Last Name
Signature of PI
*
Stamp with Signature
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Sample Hazard
*
Pathogenic
Non Pathogenic
Live Cell Imaging
Yes (Please Book Both Slots)
Book Slots for Submitting the sample
*
Brief Description of the Sample & Analysis Required
*
Special Instructions if any
Please collect the samples within 2 weeks after collecting the analysis results
*
I agree to collect the sample within 2 weeks after analysis.
I agree RSPU to dispose the samples after analysis.
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