Student Name: _________________________________________________________ Date: __________________ Grade: ________________ Patient Name Anti-A Anti-B Anti-D D Ctrl Wk D Wk D A1 cells B cells Interp. Tech Ctrl Initials ID# Retype Rack # Collection Start IS 37 AHG Check Cells Interpretation Antibody Tech Date Time Completed Date/Time Time Identification Initials S1 S2 S3 S1 S2 S3 S1 S2 S3 S1 S2 S3 Tech Date Time Donor # Anti-A Anti-B Anti-D Interp ABO/D IS 37 AHG Interpretation Initials Completed 1 2 Special Testing DAT Elution Results FBS Tech Date Time Initials Completed Poly IgG C3 Pos Neg Pt Comments Instructor check and comments: ___________________________________________________________________________________________
Student Name: _________________________________________________________ Date: __________________ Grade: ________________ Patient Name Anti-A Anti-B Anti-D D Ctrl Wk D Wk D Ctrl A1 cells B cells Interp. Tech Initials ID# Retype Rack # Collection Date/Time Start Time IS 37 AHG Check Cells Interpretation Antibody Identification Tech Initials Date Time Completed S1 S2 S3 S1 S2 S3 S1 S2 S3 S1 S2 S3 Donor # Anti-A Anti-B Anti-D Interp ABO/D IS 37 AHG Interpretation Tech Initials Date Time Completed 1 2 Special Testing DAT Elution Results FBS Tech Initials Date Time Completed Poly IgG C3 Pos Neg Pt Comments Instructor check and comments: ___________________________________________________________________________________________