TEAR OUT ACCESSION SHEET 
PLEASE SUBMIT TO: 
Dr. John C. Harshbarger 
Registry of Tumors in Lower Animals 
National Museum of Natural History 
Room W216“A 
Smithsonian Institution 
Washington, D.C., 20560, USA 
COMMON NAME FAMILY __ 
PHYLUM GENUS 
CLASS SPECIES _____ 
order ____________________ 
CATEGORY: NEOPLASM __ INFLAMMATION __ INFECTION ___ PARASITIC __ TOXIC 
DEVELOPMENTAL ___ TRAUMATIC __ NORMAL __ OTHER ___ 
CONTRIBUTOR (NAME & ADDRESS): COLLECTOR (NAME & ADDRESS): 
DATE RECD. __ 
CONTRIBUTOR'S NOo 
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 
COMlffiNTS (e.g,, possible exposure to chemical pollutants or infectious agents, in¬ 
cidence and duration of this condition in the population, etc.) 
(Please use reverse side, if more space is needed) 
