INSTITUTE OF HUMAN GENETICS
National Institutes of Health University of the Philippines Manila “The Health Sciences Center”
ISO 9001:2015 Certified
Form No.: BGL-FO-12
Revision No.: 00
Effectivity: 03 Jan 2019
Patient’s Name: |
{{$sample->patient->name}} {{$sample->patient->middle_name}} {{$sample->patient->last_name}} |
Birth Date: |
{{\Carbon\Carbon::parse($sample->patient->dob)->format('M d, Y')}} |
Age/ Sex: |
{{$sample->patient->gender}} |
Address: |
{{$sample->patient->address}} {{$sample->patient->street}} {{$sample->patient->address}} {{$sample->patient->city}} |
Contact No.: |
{{$sample->patient->phone}} |
Test Requested: |
{{$sample->test->name}} |
Date sample collected: |
{{\Carbon\Carbon::parse($sample->collection_date)->format('M d, Y')}} |
Date and time sample received at IHG: |
{{\Carbon\Carbon::parse($sample->lab_receive_date)->format('M d, Y')}} |
The above sample has not conformed the criteria of a good specimen for the test(s) requested. Processing this sample will yield unreliable results. Therefore, the laboratory is unable to process this specimen for the following reason(s):
Reason: |
|
sample_criterias->contains('sample_criteria_id',$criteria['id']) ? 'checked' : ''}} > |
{{$criteria->criteria}} |
{{$sample->rejected_by->last_name}},{{$sample->rejected_by->name}}
Laboratory Staff Name Signature:
{{ is_null($sample->rejected_signed_date) ? '' : date('F d, Y', strtotime($sample->rejected_signed_date)) }}
Date: