Doc. No.

SE/FORM/5-1
SEDINGIN EMBUN SDN BHD (1267411-H) Rev. No. 1
Issue No. 1
No.45, Jalan Cyber Valley 1B/1, Cyber Valley Commercial Centre,
43800 Dengkil, Selangor Darul Ehsan.
Rev. Date 10/01/2023
Tel: 03 - 8768 6528 Fax: 03 - 8768 7528 Email: [email protected] Issue Date 07/2022
Page 1 of 1
FORM
SAMPLE SUBMISSION AND SUPPLIES REQUISITION

LABORATORY USE ONLY

Date Received:
Lab Reference No.:92018-004
Time Received:
CUSTOMER DETAILS
Billing Address: Farm/Owner Name & Address:

Contact Person: Contact Person:

Tel: Tel:
Email: Email:
SAMPLE / ORDER DETAILS
Species: Flock No: Breed:
No Sample Bleeding Age Sample ID/ Marking Quantity Sample Code
Type Date (Lab Use Only)

Remark: Signature:

Sender Name:
Date:
Tel:
LABORATORY USE ONLY
Y N Y N Comment (if no):
Appropriate Sample   Appropriate Test Method  
Competent Personnel   Resources  
Commencement of Work   Received by & Signature:
 ATTACHMENT- PLEASE MARK (X) THE TEST(S) REQUIRED
SEROLOGY
ELISA – POULTRY
Infectious Bronchitis Disease (IBV) EP-01 IDVET EP-19 BIOCHEK EP-28 IDEXX
Newcastle Disease Conventional (ND-CV) EP-02 IDVET EP-20 BIOCHEK
Newcastle Disease (ND-HVT) EP-03 IDVET
Infectious Bursal Disease (IBD) EP-04 IDVET EP-21 BIOCHEK EP-30 IDEXX
Infectious Bursal Disease (IBD-VP2)/IBD PLUS (+) EP-05 IDVET EP-34 PROFLOK
Avian Reovirus (REO) EP-06 IDVET
Mycoplasma gallisepticum (MG) EP-07 IDVET EP-22 BIOCHEK
Mycoplasma synoviae (MS) EP-08 IDVET EP-23 BIOCHEK
Infectious Laryngotracheitis (ILT) EP-09 IDVET
Avian Encephalomyelitis (AE) EP-10 IDVET
Inclusion Body Hepatitis (IBH/FAdV) EP-26 BIOCHEK
Avian Metapneumovirus (AMPV) / Avian Rhinotracheitis (ART) EP-11 IDVET
Egg Drop Syndrome (EDS) EP-12 IDVET
Salmonella Group B & D EP-13 IDVET
Avian Influenza A Nucleoprotein (AI) EP-14 IDVET
Avian Influenza H9 EP-15 IDVET
Chicken Anemia Virus (CAV) EP-31 IDEXX
Pasteurella multocida-Duck (PMS-DUCK) EP-17 IDVET
Pasteurella multocida-Chicken/Turkey (PMS-CHICK) EP-18 IDVET
ALVJ Antigen Capture (Competition) EP-33 IDVET
ELISA - SWINE
Classical Swine Fever E2 (CSF)-Competition ES-01 IDVET
Aujeszky gB-Competition ES-02 IDVET
Aujeszky gE/gI-Competition ES-03 IDVET
Mycoplasma Hypneumoniae (M.HYO) ES-04 IDVET
Porcine Reproductive & Respiratory Syndrome (PRRS) ES-05 IDVET
HAEMAGGLUTINATION INHIBITION TEST
Newcastle Disease HI-01 NDHI
Egg Drop Syndrome HI-02 EDSHI
Avian Influenza H9N2 HI-04 H9N2HI
Extended HI (above titer group 12) HI-05 EXT-HI Disease:
INSULATED ISOTHERMAL PCR (iiPCR) / REAL-TIME PCR (qPCR) / SEQUENCING
POULTRY
iiPCR qPCR iiPCR qPCR
Newcastle Disease-Class I (vaccine virus) PP-01 QPP-01 Salmonella spp. PP-13 QPP-13
Newcastle Disease-Class II (challenge virus) PP-02 QPP-02 Avian Influenza A (AI) PP-14 QPP-14
Newcastle Disease-Lasota (vaccine virus) PP-03 QPP-03 Avian Influenza H5 (AIH5) PP-15 QPP-15
Infectious Bronchitis Disease (IBV) PP-04 QPP-04 Avian Influenza H7 (AIH7) PP-16 QPP-16
Infectious Bursal Disease (IBD) PP-05 QPP-05 Avian Influenza H9 (AIH9) PP-17 QPP-17
Avian Reovirus (REO) PP-06 QPP-06 Avian Leukosis Virus (ALV-J) PP-18 QPP-18
Mycoplasma gallisepticum (MG) PP-07 QPP-07 Infectious Laryngotracheitis (ILT) PP-19 QPP-19
Mycoplasma synoviae (MS) PP-08 QPP-08 Marek’s Disease (MDV)-Sero. 3 PP-20 QPP-20
Avian Metapneumovirus (AMPV) PP-09 QPP-09 IBH 4 PP-21 QPP-21
IBH (general) PP-10 QPP-10 IBV Variant-QX N/A QPP-23
IBH 8b PP-11 QPP-11
Marek’s Disease (MDV)-Sero. 1 PP-12 QPP-12
SWINE
PRRS-CN PS-01 QPS-01 Porcine Circovirus Type 2 (PCV2) PS-04 QPS-05
PRRS-NA PS-02 QPS-02 CSF PS-05 QPS-06
PRRS-EU PS-03 QPS-04
OTHERS
SEQ-01 Conventional PCR, Sequencing & BLAST Analysis (please specify the disease):
MICROBIOLOGY
M-01 Vancomycin-Resistant Enterococcus (VRE) M-06 Escherichia coli Count
M-02 Bacterial Isolation & Identification (for Salmonella only) M-07 Total Plate Count (TPC)
M-04 Coliform Count M-08 McMaster Faecal Egg Count
M-05 Bacterial Isolation & Identification (please specify):
M-09 Antibiotic Sensitivity Test (please specify the bacteria):
Amoxycilin Ampicilin Apramycin Doxycycline Enrofloxacin
Erythromycin Florfenicol Fosfomycin Neomycin Norfloxacin
Tetracycline Sulphamethoxazole /Trimethoprim
CONSUMABLES & SAMPLING MATERIALS
CS-01 Buffered Peptone Water (BPW) (20 ml) CS-04 Centrifuge Tube (50 ml)
CS-02 Phosphate Buffered Saline Solution (PBS) (20 ml) CS-05 FTA Card
CS-03 Eppendorf Tube (2.0 ml) CS-06 Taco Sample Storage Solution (2.0 ml)