TEAR OUT ACCESSION SHEET 
SUBMIT WITH KNOWN INFORMATION TO: g 
Dr. John C. Harshbarger § 
Registry of Tumors in Lower Animals § 
National Museum of Natural History § 
Smithsonian Institution o 
Washington, D.C. 20560 o 
o 
o 
o 
9999999999999999999999999999999999999999999999999999999999999999999999999999999 
COMMON NAME _ FAMILY _ 
PHYLUM _ GENUS _ 
CLASS _ SPECIES _ 
ORDER _ 
CATEGORY: NEOPLASM _ INFLAMMATION _ INFECTION _ PARASITIC _ TOXIC _ 
DEVELOPMENTAL DEFECT _ TRAUMATIC _ NORMAL _ OTHER _ 
CONTRIBUTOR (NAME & ADDRESS): COLLECTOR (NAME & ADDRESS): 
DATE RECD. _ 
CONTRIBUTOR'S NO. 
RTLA NO. _ 
USNM NO. _ 
NIH HISTOPATH NO. 
ITEMS SUBMITTED (QUANTITY): 
GROSS MATERIAL _ 
SLIDES _ 
BLOCKS _ 
ORIGIN OF ANIMAL: MARINE _ 
WHERE COLLECTED _ 
_ PHOTOGRAPHS _ 
_ REPRINTS _ 
_ OTHER _ 
FRESHWATER ESTAURINE TERRESTRIAL 
DATE COLLECTED _ SEX _ AGE _ STAGE OF LIFE CYCLE 
HOW KILLED _ FIXATION _ 
GROSS DESCRIPTION _ 
MICROSCOPE DX 
COMMENTS (e„g., possible exposure to chemical pollutants or infectious agents, 
incidence and duration of this condition in the population, etc.) 
(Please use reverse side if more space is needed) 
