ÌÎÇ ÓÊÐÀ¯ÍÈ                                                                                                                         Ìåäè÷íà äîêóìåíòàö³ÿ
 ÍÀÇÂÀ ÓÑÒÀÍÎÂÈ                                                                                                                Ôîðìà N
                                                                                                                                                  Çàòâåðäæåíà ÌÎÇ Óêðà¿íè
 
 
 
 
ÐÎÁÎ×ÈÉ ÆÓÐÍÀË
ì³êðîá³îëîã³÷íèõ äîñë³äæåíü åôåêòèâíîñò³
îáðîáêè ðóê ïåðñîíàëó òà øê³ðè ë³êòüîâèõ çãèí³â äîíîð³â
 
 
 
 Ðîçïî÷àòèé "__"_________200_ ð.                                                                             Çàê³í÷åíèé "__"_________200_ ð.
 
 
 
 Ìåòîäè â³äáîðó ìàòåð³àëó òà ¿õ ëàáîðàòîðí³ äîñë³äæåííÿ ïðîâîäÿòüñÿ çã³äíî ç íîðìàòèâíî-òåõí³÷íîþ äîêóìåíòàö³ºþ:
 1. _________________________
 2. _________________________
 3. _________________________
 
 
Ðåºñòðà-ö³éíèé íîìåð
Äàòà êîíò-ðîëþ
Óñòàíîâà (â³ää³ë)
Ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³ îáñòåæóâàíîãî, ïîñàäà
Îá'ºêò äîñë³ä-æåííÿ
Íàéìåíóâàííÿ äåç³íô³êóþ÷îãî çàñîáó òà éîãî êîíöåíòðàö³ÿ
Ðåçóëüòàòè äîñë³äæåíü
 
ϳäïèñ îñîáè, ÿêà ïðîâîäèëà äîñë³äæåííÿ
 
Äàòà çàê³í÷åííÿ äîñë³äæåííÿ.
Âæèò³ çàõîäè
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