Information required

Present (n)

%

Name of patient

Age

Sex

Hospital number

Address

Occupation

Type of specimen

Date of specimen collection

Time of collection

Investigation requested

Diagnosis

Clinical history

Location of the patient

Name of clinician

Signature of clinician

289

284

288

289

14

12

244

276

243

282

248

43

280

280

279

100

98.3

99.7

100

4.8

4.2

84.4

95.5

84.1

97.6

85.8

14.9

96.9

96.9

96.5