This form is for collection centres/ labs to enter details of the samples being tested for Covid-19. It is
mandatory to fill this form for each and every sample being tested.
INSTRUCTIONS
Inform the local / district / state health authorities, especially surveillance officer for further guidance
Seek guidance on requirements for the clinical specimen collection and transport from nodal officer
This form may be filled in and shared with the IDSP and forwarded to a lab where testing is planned
Fields marked with asterisk (*) are mandatory to be filled