Laboratory Req para Kato-Katz Jan 20

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Integrated Sciences Laboratory Facilities

Requisition Form
(For Faculty)

Reminder: This form is to be requested at least five days prior to the experiment.

Faculty Name: Dr. Sherwin Toriano Date Requested: Jan. 13, 2023
Date Needed: Jan. 20, 2023
Subject/Course: Clinical Parasitology
Time Needed: 8:00AM - 11:00AM
Expt. Title /Activity: Kato-Katz technique and Cellulose tapeNo. of Students: 20

Apparatus/Materials/Equipment Needed
Quantity Capacity Apparatus/Materials/Equipment Needed Remark/s Returned Remark/s

10 Microscopes

Reagent/Materials Needed per Group/Student


Quantity Conc./Specs Reagent/Materials Remark/s Returned Remark/s

10 mL glycerine

Perishable / Consumable Goods Needed per Group/Student


Quantity Unit Description Remark/s
30 pcs cellophane , soaked in glycerine/ green
30 pcs template
10 pcs gauze (cut)
30 pcs applicator stick
30 pcs strainer
1 box slides

Requested by: For Laboratory Custodian and Supervisor Only

Dr. Sherwin B. Toriano Received by: Prepared by:


____________________
Faculty signature over
__________________ ______________________
printed name / Date
Faculty signature over Custodian’s signature over
Printed name / Date printed name / Date

R-2.0-MHA ISLF-RF2022

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