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Identification #:
Customer Institution:
Date of Request:
Hematoxylin & Eosin
Recut(s), H&E
Serial Sections, H&E
Unstained sections
Deeper Level(s), H&E
Section at __ microns *
Return blocks
Special Stains
Acid Fast (Niehl-Neelsen)
Calcium (Von Kossa)
Iron (Gomori)
Acid Fast (Fite)
Carbohydrates (PAS)
Giemsa
Acid Mucopolysaccharide (Alcian Blue)
Collagen (Gomori Trichrome)
Mucin (Mayer mucicarmine)
Acid Mucopolysaccharide (Collodial Iron)
Elastic (Verhoeff EVG)
Pneuemocystis (GMS)
Amyloid (Bennhold Cogo Red)
Fat (Oil Red O)
Reticulum (Chandler)
Argetaffin (Fontana-Masson)
Fungus (PAS)
Spirochetes (Warthin_Starry)
Bacteria (Gram Stain)
Fungus (GMS)
Blood Smears (Wright Giemsa)
Glycogen(PAS)
Glycogen (PAS) with diastase
Other *
Immunohistochemistry
CD3
AE1 Karatin
Calretinin
CD5
AE3 Keratin
CEA
CD10
Pan Keratin
Chromogranin
CD20
PIN4
MART-1
CD30
Cytokeratin7
Synaptophysin
CD34
Cytokeratin20
S-100
CD56
Actin HHF-35
Vimentin
* Please list the # of microns or the "other" stain in the comment area. Thank you.
Comments:
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