NOM DEMANDEUR M. Mekaouche Mourad NOM ... - CRN2M
NOM DEMANDEUR M. Mekaouche Mourad NOM ... - CRN2M
NOM DEMANDEUR M. Mekaouche Mourad NOM ... - CRN2M
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PLATE FORME INTRAGENEORLEANS – VILLEJUIFFEUILLE D’ENREGISTREMENT ET D’ACCOMPAGNEMENT EN PCRCS-FOR-008-0214/05/09Page 1 / 1<strong>NOM</strong> <strong>DEMANDEUR</strong> M. <strong>Mekaouche</strong> <strong>Mourad</strong><strong>NOM</strong> ORGANISME D'APPARTENANCE<strong>CRN2M</strong> UMR 7286 CNRSPlates-Formes de de Recherche en Neurosciences, Fac de Médecine Nord de MarseilleADRESSE BD. Pierre Dramard 13 916 Marseille cedex 20<strong>NOM</strong> ET ADRESSED'ENVOI DES RESULTATSN° BON DE COMMANDE<strong>NOM</strong> DU COMPTABLEtél 04 91 69 87 08/ 06 77 03 34 91 fax 04 91 69 87 08 mourad.mekaouche@univ-amu.fridemExamens : BPV Helico sp Helico hepaticus Helico bilis PneumoCONTRÔLE SANITAIRE Date de contrôle : 20/06/2012FAUX FAUX FAUX FAUXNombre contrôlé : 1 Spécification de demande :Helico sp Helico H Helico Bilis PneumoEspèce Souche Sexe Age Code Test? +/-? Test? +/-? Test? +/-? Test? +/-?Rat Wistar Femelle 6m 2658IDENTIFICATION DES ANIMAUX( LIGNEE, <strong>NOM</strong>BRE, SEXE)
SexCodeEncephalitozoon cuniculiKilham rat virusHantavirusClostridium piliformeKilham rat virusMycoplasma pulmonisPneumonia virus of miceRCV / SDARat parvovirus (rNS-1)Sendai virusToolan's H-1 virusMouse adenovirus FLMouse adenovirus K87Reovirus type 3CAR bacillusEctromelia virusLCMVMinute virus of miceMycoplasma arthritidisTMEV (GD VII)Toxoplasma gondiiKilham rat virusToolan's H-1 virusserology (viruses and other agents)RAT PROFILEIFAELISAHAIsubmission form / health monitoring reportQM Diagnostics, UMC St RadboudGeert Grooteplein 29, 6525 EZ Nijmegen, The NetherlandsT.:+31(0)24 3615433 F.:+31(0)24 3616375 E-m.: qmdiagnostics@mmb.umcn.nlMore information available at www.qmdiagnostics.orgDate ofsampleStraing.m.aAgeNumbersenderZone of originNumber QM20/06/12 Wistar F 6m 2658 M. <strong>Mekaouche</strong>g.m.a (geneticTo be completed by sender:modified animal)Virology / serologyY = yesFELASA:N = noMicrobiology (bact/par/path)3 month}CodeBothannually1 = isolatorOther (mark boxes of agents of interest)2 = barrièreyes no3 = conventionalSera are diluted 1:54 = otherSender: CDTA / CNRS @: ctrl-sanitaire@cnrs-orleans.fr3B Rue de la Férollerie45 071 ORLEANS CEDEX 2, FranceTel: 33 2 38 25 54 52 - Fax: 33 2 38 25 54 35I declare that these animals/specimens do not contain any potential human healthhazardsSigned:Date: 20/06/12Laboratory comments:Date receipt of samples:Checked:+±-TCANTDate of signature:Signature:FELASA 3 monthly screeningAdditional in FELASA annuallyExtraPositive reactionBorderline reactionNegative reactionNon-specific reactionSerum agglutinates red blood cellsLack of serumversion 2011-1