Genetic Material Collection Chain of Custody Record
Case Information
Case/Reference Number:
Date of Collection:
Collected By:
Location of Collection:
Subject Name/ID:
Sample Details
Type of Sample:
Description/Notes:
Sample Container/ID:
Sealed by:
Date & Time Sealed:
Chain of Custody
Date & Time
Released By (Name/Signature)
Received By (Name/Signature)
Purpose of Transfer
Location
Remarks
Final Disposition
Disposed By:
Date & Time of Disposal:
Method/Location of Disposal:
Witness (if any):