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APPENDIX 6
Document Number MKAKB/BP/BR-10
Issue Number 01
Amendment Number 00
Issue Date 03.04.2016
MAKMAL KESIHATAN AWAM KOTA BHARU
LOT 522, KM 10 JALAN KUALA KRAI
16010 KOTA BHARU KELANTAN
No. Tel : 09-7138000 No. Faksimili : 09-7127115
TRACING RESULT FORM
To :
_________________________
_________________________
_________________________
SENDING
NO PATIENT’S NAME I/C NUMBER DATE TEST REMARK
REQUEST BY :
NAME :
DESIGNATION :
DATE :
