This COVID-19 Test Form is for collection centers/ labs to enter details of the samples being tested for Covid-19. It is mandatory to fill this form for each and every sample being tested. It is essential that the collection centers/ labs exercise caution to ensure that correct information is captured in the form.
In this article, we’ll provide you COVID-19 Test Form PDF in English Format, available to download from the official website at tmc.gov.in or download using the direct link below.
Here You Download COVID-19 Test Form PDF in English
- Category: Government
- Format: PDF
- Size: 0.23 MB
- Pages: 2
- Source: tmc.gov.in
- Language: English
This PDF Alternate Link: Download
COVID-19 Test Form
ICMR Specimen Referral Form for COVID-19 (SARS-CoV2)
● Inform the local / district/state health authorities, especially surveillance officer for further guidance
● Seek guidance on requirements for the clinical specimen collection and transport from the nodal officer
● This form may be filled in and shared with the IDSP and forwarded to a lab where testing is planned
COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.
- dry cough
Less common symptoms:
- aches and pains
- sore throat
- loss of taste or smell
- a rash on the skin, or discoloration of fingers or toes
Details to be Mentioned in COVID-19 Test Form
- Patient Personal Details
- Specimen Information Form Referring Agency
- patient Category
- Medical Information
- Hospitalization Details
- And any other details.
Download the COVID-19 Test Form in PDF format using the link given above.
Alternate link for COVID-19 Test Form PDF in English
You can also visit the official / source website to download the PDF from following links: https://maxlab.co.in/covid19-testing/uploads/ICMR_COVID19.pdf
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