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  • Elisa For Hiv

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    Harish Chand
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    The document is an ELISA test form from Life Insurance Corporation of India for testing an individual's blood sample for HIV I and II. It contains fields for the zone, division, branch, proposal number, agent code, name of the life to be assured, and their age and sex. The form is then used to record the examination of the blood for HIV I and II, with results and the testing method. The pathologist signs to confirm the individual was examined and signed in their presence, and that they are not related to the individual or agent.

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    Elisa for Hiv

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    The document is an ELISA test form from Life Insurance Corporation of India for testing an individual's blood sample for HIV I and II. It contains fields for the zone, division, branch, proposal number, agent code, name of the life to be assured, and their age and sex. The form is then used to record the examination of the blood for HIV I and II, with results and the testing method. The pathologist signs to confirm the individual was examined and signed in their presence, and that they are not related to the individual or agent.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    21 views1 page

    Elisa For Hiv

    Uploaded by

    Harish Chand
    The document is an ELISA test form from Life Insurance Corporation of India for testing an individual's blood sample for HIV I and II. It contains fields for the zone, division, branch, proposal number, agent code, name of the life to be assured, and their age and sex. The form is then used to record the examination of the blood for HIV I and II, with results and the testing method. The pathologist signs to confirm the individual was examined and signed in their presence, and that they are not related to the individual or agent.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    of 1

    ANNEXURE II – 10

    LIFE INSURANCE CORPORATION OF INDIA

    Form No. LIC03 - 011

    ELISA FOR HIV

    Zone Division Branch


    Proposal No.
    Agent/D.O. Code: Introduced by: (name & signature)
    Full Name of Life to be assured:
    Age/Sex :

    EXAMINATION OF BLOOD FOR HIV I & II TEST

    HIV I & II :
    RESULT :

    Method :

    I declare that the person examined signed (affixed his/her thumb impression) in the space
    earmarked below, in my presence and I am not related to him/her or the Agent or the
    Development Officer.

    Dated at on the day of 200 at a.m./p.m.

    Signature of the L.A. Signature of the Pathologist

    Pathologist’s name & Address Qualification: LICI Code No:

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