客户服务登记表(
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1、CST FORM(WESTERN BLOTTING)Form: CSF1Ref. No.:Gene Company LimitedDate:Customer Service Form ( Reagent )客户服务登记表( 试剂 )*THE DATA IN THIS REPORT WILL BE USED FOR STATISTICAL PURPORS ES, PLEASECOMPLETE CAREFULLY*.ForCustomejseOnly (由客户填写；或客户详述个案，由公司的代表填写.)Customer IdentityName:Tel:Fax:_e-mail:Dept: Orga
2、nizati on:Address :Product InformationManufacturer:Cat. No.:QuantityProduct Name:Lot No.:ExpiryDate:DeliveryDate:InvoiceNo.:ContractNo.DetailsProtocol : Manufacturers Modified Manufacturers (Please attach protocol) Private(Please attach protocol)Problem Descriptions and Results Interpretation:Genera
3、l Questions1. Customer Name:2. Catalog Number:3. Assay Date printed on tube:4. Lot Number printed on tube:5. How long has the customer had the product?6. At what temperature was the product stored?口 NoSample Information1. What cell type was used for the sample lysate? 口 Cell Line口 Primary Cells口 Who
4、le Tissue口 Other: 2. What is the sample species:口 Human口 Mouse口 Rat口 Other: 3. Please state the induction/drug treatment used: 4. Please state the concentration of the drug used: 5. Please state the time points of induction: 6. Please state the positive control used: 7. Please select the lysis buffe
5、r used:口 SDS Sample Buffer口 CST Cell Lysis Buffer 口 CST Chaps Buffer 口 RIPA Buffer 口 Other: 8. What specific phosphatase inhibitors, if any, were included in the lysis buffer?9. Were the samples sonicated?口 Yes口 No10. Please select the amount of protein lysate 口 20 microgramsloaded per well:口 Other:
6、 11. Please state the date of lysate preparation: 12. Please select the lysate storage temperature: 口 4C口 -20C口 -80C Other:13. Has this antibody previously worked on口 Yesthese samples? NoProtocol Information1. Please state the % acrylamide in the gel: 2. Please select the membrane used: Nitrocellulo
7、se PVDF Nylon Other: 3. What is the pore size of the membrane being used for transfer?Blocking1. Please state the components of the blocking buffer:2. Please state the blocking time: Primary Antibody Incubation1. Please state the primary antibody source: 2. Please state the primary antibody dilution
8、: 3. Please state the components of the primary antibody dilution buffer: 4. Please state the incubation time for the primary antibody: 5. Please state the washing buffer and time after primary antibody incubation:Secondary Antibody Incubation1. Please state the secondary antibody source: 2. Please
9、state the secondary antibody dilution: 3. Please state the components of the secondary antibody dilution buffer:4. Please state the incubation time for the secondary antibody: 5. Please state the washing buffer and time after seconday antibody incubation:Detection1. Please select the detection syste
10、m used:口 Horseradish Peroxidase (HRP)口 Alkaline Phosphatase (AP)口 Other: 2. Please state the supplier of the detection system: 3. Please state the length of time for film exposure:4. Please describe the appearance of the exposed and developed film:For Company/Region Use Only (由 公司 / 分区 的代表填写)Sec/Sal
11、es Rep:HK Sales Order No:HK Invoice No.: HK ContractNo.:Problem:Forwarder/Damage during the transportation-claim insurance immediately.V)lume/Quantity/Expiry/Missing- complete form CSF4 and pass to Shipping Dept.Technical-fill in Ref. No., and pass this form to TSCN.For TSCN & TSHK Use Only (由 TSCN & TSHK 填写)Solution: Lab Test (RMB/USD) Co. AdviceCo. Replacement(RMB/USD) Manufacturer Advice Manufacturer Replacement Other:Manu facturer: PO. No.:In voice No.:Arrival Date:Supervisor: (Block) (Signature) Closi ng Date:
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