Analytical Service Requisition Form

* Indicates a required field
Name of Teacher/Person requesting for the service sdfdsf* :
Department/Institute/Address * :
Laboratory * : Genetic Engineering and Biotechnology Research Laboratory
Service Name * : Centrifuge (4500 rpm) (-10 to 4oC) ( per 15 min) (GEBR Lab)
Sample ID * :
Sample Name * :
Number of Samples * :
Name of elements (if applicable) :
Purpose of the work * :
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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