SampleDetails

ServiceRequestforAntimicrobial Susceptibility Testing (AST)using VITEK

National Centre for Microbial Resource

ForNCMRUseOnlyPRN:

ForNCMRUseOnlySealoftheInstitute Date&SignatureofPrincipleInvestigator

MCC_SD_Form_020 v.1/2019 

Thisisa illablePDF ile.Youcantypeinformationdirectlyintothis ile.IMPORTANT:Pleasereadall‘Guidelines’carefullybeforesendingthesamples.Pleasereferto illedsampleformavailableonourwebsitetocompletethisform;foranyassistancefeelfreetocalluson+912025329043/26/27(10.00to17.00hrs,IST).DetailsoftheInvestigator

PaymentDetails

(Optional)IauthoriseNCMRtoaccessionthecultureanddeposititin’GeneralDeposit’.Iunderstandthatculturewillbemadeavailabletopublicthereafter.(Pleasesee‘GeneralGuidelines’formoredetails*).

DemandDraftNo. Date Amount BankDetails

NameofInvestigator:PostalAddress:

EmailAddress:ContactNumber:DateofDispatch:

Sr.* Straindesignation Gram Nature and Morphology11.2.3.4.

MediaName: Manufacturer&Cat.No.

OptimumGrowthParameters:pH: Temperature(°C): IncubationPeriod:OxygenRequirement: Aerobic Anaerobic Microaerophilic

Composition^(ifcustommade):

Datereceived: Acknowledgementsenton:Sub‐culturedOn: Viable/Non‐Viable:Resultsveri iedby: Reportsenton:Remarks,ifany:

by:Pure/Mixed:

*Attach separate sheet formore strains, if required. 1 Gram –ve rods, Gram –ve cocci, Gram + ve non spore forming rods or cocci, Gram Positive spore forming rod, (Bacillus), Anaerobic, Coryneform or Yeast.

PIN Code:

Growth Parameters and Media

5.6.

1. Samplesmustbesubmitted in ‘pureandviable’formonagarplates,slantsormediastabs.TheymustbelabelledproperlywithisolateIDanddateofinoculation.Pleasenotethatwedonotacceptcon‐taminatedculture(s).Pleaseshiptheculturesonlyaftertheirvisi‐blegrowthhasappeared.

2. Seal the agar plate/ slant tube/ stab vial with laboratory paraf inilmandpack themappropriately toprevent anydamageduringtransportation. It is important for biosafety reasons.Please notethatwedonotacceptdamagedconsignment.Youarerequestedtoensurethoroughpackagingofcultures.Itisimportantthatyouusea shipper that provides tracking facility and is known for timelydeliveries.

3. We accept cultureswhich can be handled under BSL‐1 and BSL‐2facilityonly.YouarerequestedtovisitABSA,WHOandLPSNweb‐siteformoredetails.

4. Culturesfromprivateaddresseswillnotbeaccepted.Itisrequestedtosend thecultures throughproperchannelandmustbesignedbythedepartmentheadoradvisor.

5. Ifyouhavesubmittedsameculture(s) forotherservicesofferedatMCC,pleasenotethatseparatecommunicationwillbemaintainedby respective section in‐chargeunderseparateProcessingRefer‐enceNumber(PRN).

6. Pleaseencloseaprinted illed‐incopyofthisformalong with yoursamplesandDemandDraftforappropriatefeesincludinganyservicetax.See‘FeeStructure’detailsonNCMRwebsite. 

7. For post‐receipt sample status, please contact assigned section in‐chargeandincludetheProcessingReferenceNumber(PRN)oftheculture(s) asmentioned in the acknowledgment email sent byServicecoordinator,NCMR. CommunicationrelatedtoPRN(statusorsendingresults)willbedoneonlywithemailprovidedintheform.

8.*If youhave opted for authorisingNCMR to accession the culture anddeposit it in ’GeneralDeposit’; Youmay need to ill the separatelyavailable ‘General Deposit’ form. However, section in‐Charge(mentionedintheacknowledgementemail)willcontactyouthroughemailforrequiredinformationandfurtherguidelines.

National Centre for Microbial Resource

AnationalfacilityfundedbytheDepartmentofBiotechnology(DBT),GovernmentofIndia.

Anaf iliatememberoftheWorldFederationforCultureCollec‐

tions(WFCC).RegisteredwiththeWorldDataCentreforMicroorganisms(WDCM,registrationnumber

773).RecognizedbytheWorldIntel‐lectualPropertyOrganization(WIPO),Geneva,SwitzerlandasanInternationalDepositoryAu‐thority(IDA)sinceApril,2011.MinistryofEnvironmentand

Forests,GovernmentofIndiahasnominatedNCMRasaDesignatedNationalRepositoryformicroor‐ganismsundertheBiologicalDiversityAct2002sinceJuly

2013.

PleasevisitNCMRwebsiteformoredetailsonotherdepositservices,suchasGeneral’,'Safe'and

'Patent'(underIDA)andidenti icationservicessuchasDNASequencing,FAME,DDHandmore!

National Centre for Microbial Resource

NationalCentreforCellScience,SaiTrinityComplex,SusRoad,

Pashan,Pune411021Maharashtra,INDIA

Phone:+912025329000Fax:+912025329001E‐mail:mcc@nccs.res.inwww.nccs.res.in

GeneralGuidelinesforSendingtheCulturesforPhenotypicCharacterisation using API:

Sample DetailsService Request for Phenotypic Characterisation of Bacteria, Archaea or FungiMicrobial Culture CollectionPRN:Details of the InvestigatorPayment DetailsGrowth Parameters and Media Microbial Culture Collection A national facility funded by the Department of Biotechnology (DBT), Government of India. An affiliate member of the World Federation for Culture Collections (WFCC). Registered with the World Data Centre for Microorganisms (WDCM, registration number 773). Recognized by the World Intellectual Property Organization (WIPO), Geneva, Switzerland as an International Depository Authority (IDA) since April, 2011. Ministry of Environment and Forests, Government of India has nominated MCC as a Designated National Repository for microorganisms under the Biological Diversity Act 2002 since July 2013.Microbial Culture Collection

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