RNO 
479 
94? 5R26B (^) 15:49 P.20 
signature (SUBJECT CONSENT) DATF. 
STCiNA'rUKK (WITNESS) DATE 
Investlp aiors Certincaiion 
I declare that 1 have versormlly explained the above information to the patients or the 
patient's legal reprc.scntatlve. 
Investigator's Signature 
Witness Dale 
Patient Initials 
Recombinant DNA Research, Volume 19 
[447] 
