Analytical Service Requisition Form for Elemental (C,H,N & S) Service

* indicate a required field
Name of Teacher/Person requesting for the service * :
Department/Institute/Address * :
Laboratory * : Environment and Analytical Chemistry Research Laboratory
Service Name * : C,H,N,S analyzer
Sample information:
Sample ID * :
Sample Composition (Expected) * :
Sample Type * :
Metal Content Approximate % * :
Kindly select if your sample contains :
Results of the analysis will be provided * :
Category for Billing Purpose * :
For Contact:
Student/Person (For category A & B)* :
Mobile No * :
Email * (Notification will be send to this email) :
Terms and Condition * :
Captcha * :

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