Name 
Address 
Source 
Identification 
Geographical data 
Color 
Instructions to Laboratory 
Special Instructions 
Sample No. 
Date received 
Roots 
Trunk 
Branches 
Zone 
Altitude 
Priority Status 
Signed 
ame of 
Lab . and Date Delivered to Lab . 
Remarks 
rs 
* I ^ 
r ‘t ^ 
* 
V ; -A, ^ >v 
, .'v . ^ ^ 
. e a.-. 
' .K 
. A fe f i, • , .V - ' 
