An Autonomous Institute of Dept. of Biotechnology, Ministry of Science and Technology, Govt. of India

Array System / Bio Plex-200

Name of the Institute and Organisation

Name of the User

Designation of the user

Name of the Chief Investigator

Designation of the Chief Investigator

Signature

Mobile No. of the User

Email. of the User

Address of Institute and Organisation

Details of work requested

Type of Sample

Any other information that is useful for analysis

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