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:
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: