This form is for collection centres / labs to enter details of the samples being tested for Covi-19. It is mandatory to fill this form for each and every sample being tested. It is essential that the collection centres/ labs exercise caution to ensure that correct information is captured in the form.
(These fields to be filled for all patients including foreigners)
Please Note:- Hospital form is required for the patients visiting OPD, IPD and Emergency and Community form is required for patients under containment zone / Non-containment Area / Point of Entry / Testing on Demand.
Cat 1: All symptomatic (ILI symptoms) cases.Containment Zone Non-containment area Testing on demand Point of entry.Cat 2: All asymptomatic high-risk individuals (Any individual who falls under Section B2).Cat 3: All symptomatic (ILI symptoms) individuals with history of international travel in the last 14 days Cat 4: All individuals who wish to get themselves tested.
*Fields marked with asterisk are mandatory to be filled.
Please Note: Section B1 and B2 need to be filled for both Community and Hospital settings. Section B3 needs to be filled only for Hospital Settings.