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Animal Disease Diagnostic Submission Form

The document is a General Sample Collection Form from the Department of Agriculture in the Philippines, specifically for the Regional Animal Disease Diagnostic Laboratory. It includes sections for sample details, submission date, species information, and purpose of submission. The form is intended for various diagnostic and investigative purposes related to animal health.

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themightychondria04
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72 views1 page

Animal Disease Diagnostic Submission Form

The document is a General Sample Collection Form from the Department of Agriculture in the Philippines, specifically for the Regional Animal Disease Diagnostic Laboratory. It includes sections for sample details, submission date, species information, and purpose of submission. The form is intended for various diagnostic and investigative purposes related to animal health.

Uploaded by

themightychondria04
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ENT OR

Republic of the Philippines


AGR DEPARTMENT OF AGRICULTURE
Regional Field Office No. 12
Integrated Laboratory Division General Sample Collection Form
REGIONAL ANIMAL DISEASE DIAGNOSTIC
1098 LABORATORY 12
Tel/Fax No. (083) 553-9324
Date/Time of Submission: Laboratory Accession Number: Purpose**

No. Sample Whole Date of Species Barangay /City/


Serum Age Sex Owner Remarks
1.D. Blood Collection Municipality

**Diagnostics, Disease Investigation, Local Shipment, Imported under Quarantine, Export, Surveillance, Farm Accreditation, Others (specify)

Submitted by: Received by:

DAXII-ILD-RADDL-LF-10 General Sample Submission Form Page /.


Rev. No.: 00
January 03, 2023

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