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    Blood Issuing Form

    Uploaded by

    SemeeeJunior
    This document is a blood issuing form containing fields for sample collection time and type, patient information including name, age, identification number, ward, sex, and blood group. It also includes donor blood group, number, pilot number, expiry date, cross match results, and signatures and dates of those who cross matched, reviewed, issued, and received the blood sample.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Blood Issuing Form

    Uploaded by

    SemeeeJunior
    25 views2 pages
    This document is a blood issuing form containing fields for sample collection time and type, patient information including name, age, identification number, ward, sex, and blood group. It also includes donor blood group, number, pilot number, expiry date, cross match results, and signatures and dates of those who cross matched, reviewed, issued, and received the blood sample.

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    mutheei

    Original Title

    mutheei

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    This document is a blood issuing form containing fields for sample collection time and type, patient information including name, age, identification number, ward, sex, and blood group. It also includes donor blood group, number, pilot number, expiry date, cross match results, and signatures and dates of those who cross matched, reviewed, issued, and received the blood sample.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    25 views2 pages

    Blood Issuing Form

    Uploaded by

    SemeeeJunior
    This document is a blood issuing form containing fields for sample collection time and type, patient information including name, age, identification number, ward, sex, and blood group. It also includes donor blood group, number, pilot number, expiry date, cross match results, and signatures and dates of those who cross matched, reviewed, issued, and received the blood sample.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Blood issuing form.

    Time of sample collection---------:-----------Hrs

    Sample type.(WB/SERUM/PLASMA).

    Sample collected by------------------------------------.

    Condition of the sample-------------------------------.

    Name of patient--------------------------------------------------------

    Age---------------yrs

    IP No---------------

    Ward--------------------

    Sex------------------------

    Hb-------------------g/dl.

    Patient’s Blood group------------------

    Donor Blood group------------------------

    Donor Number-------------------------------

    Pilot Number------------------------------------

    Expiry Date-------------------------------

    Cross match Results-----------------------------

    Cross matched by-----------------------------sign--------------------Date----------------


    Reviewed by------------------------------------sign----------------------Date-------------------.

    Issued by---------------------------------------sign-----------------------Date-------------------

    Received by--------------------------------------sign----------------------Date--------------------.

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