Get Appendix 2i No Rujukan Makmal Diagnostic Request Form A - Jknns Moh Gov

Filling out the Appendix 2i No Rujukan Makmal Diagnostic Request Form A is crucial for effective diagnostic procedures. This guide provides a step-by-step approach to ensure users can complete the form accurately and efficiently online.

Follow the steps to successfully complete your diagnostic request form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In section A, provide patient information. Fill in the state, hospital or clinic name, the patient's name, identification number, and ethnicity.
3. In section B, document clinical information by marking any symptoms as applicable, such as fever over 38°C, mouth and throat ulcers, maculopapular rashes, or upper respiratory tract infection signs.
4. Section C requires you to specify the clinical specimens needed for testing. Choose from options like rectal swab, mouth ulcer, vesicle swab, or stool.
5. In section D, fill in information about the applicant. Provide your name, official stamp, and signature to authenticate the request.
6. Section E is for laboratory use. Record the specimen condition and types of tests required, including spaces for laboratory personnel’s name and signature, along with their position and lab stamp.
7. Complete any additional notes required for the request. Make sure to fill in extra fields about the district, referral number, age, date of birth, gender, contact numbers, email, and dates pertinent to specimen collection and submission.
8. After reviewing all filled sections for accuracy, you can save changes to the form. Options are available to download, print, or share the completed diagnostic request form once finalized.

Complete your diagnostic request form online today to ensure timely processing.