Submission Form - Deutsches Primatenzentrum
Transcription
Submission Form - Deutsches Primatenzentrum
Infection Biology Unit - Coordination of Viral Diagnostics - Deutsches Primatenzentrum GmbH ■ Kellnerweg 4 ■ 37077 Göttingen Contact Person: Unit: Leibniz-Institut für Primatenforschung Telephone: Telefax: E-Mail: Web: Dr. Artur Kaul Infection Biology +49 551 3851-186 +49 551 3851-184 [email protected] www.dpz.eu Submission Form Sender: ________________________________ ________________________________ ________________________________ Tel-./Fax-no.: ________________________________ Date: __________________ Species/Sex: __________________ Animal no./Chip no.: History: male female ____________________ ____________________________________________________________ ____________________________________________________________ Test for: Herpes B-Virus Serology Retroviruses Hepatitisviruses STLV (serology) Hepatitis A-Virus (serology) SIV (serology) Hepatitis B-Virus (serology) Hepatitis C-Virus (serology) Herpes Simplex-Virus Serology Miscellaneous ___________________________ ___________________________