FKUSK1 F 20 Work Sheet

UPM/FMHS/F 20

WORK SHEET
Laboratory:
Name of Test:

Job No.

: _____________________

Type of sample

: _____________________

Date of test: ____________________

Data of sample:

Calculations/Picture:

Remarks (if any):_________________________________________________________________________

Analysed by:

Checked by / Verified by:

………………………..
Name:
Designation: Competent Personnel
Faculty of Medicine and Health Sciences
UPM
Date:

……………………………
Name:
Designation: DTM / TM / AS
Faculty of Medicine and Health Sciences
UPM
Date: