Transgenic Research Center In the Cancer Center

Service Requisition Form

ES cell microinjection for chimeric mice

Which service


Contact Data:

 

Date: Name:
Dept: PI:
Tel:    
Fax:    
E-mail:    
Lab location    

 

Billing Account Information:


Project#  (eg, 1234567)
Task# (eg, 100)
Award (rg, ACAEH)
NCI Funded? 
Name of person who has authorization to the account: 
 

A-PLAC protocol #: 
Animal Housing Location: 


Construct Name (12 character limit): 

is it okay if we include your mice in our mouse database? 

  Name Karyotype Comment
1
2
3
4


 

Project and DNA Construct Description (attach restriction map):

 

Special Requirements:

 

Stanford Medicine Resources:

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