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					UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 1 of 14
Quality Manual
Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
         Management Manual                                                Non-Patient Specimens
Prepared by: QA Committee                                  Original Date: March 1, 2003
Issued by: Laboratory Manager                              Revision Date: February 20, 2007
Approved by: Laboratory Director                           Annual Review Date: August 15, 2008


                                               Table of Contents

MSH Non-patient Specimens

PMH Non-patient Specimens

TRI Non-patient Specimens

BAYCREST Non-patient Specimens

Infection Control Screen

UHN Non-patient Specimen

Bridgepoint Non-patient Specimen

Midwives Collective of Toronto

Record of Edited Revisions




         UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

 NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
            are not controlled and should be checked against the document (titled as above) on the server prior to use.

D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
      UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 2 of 14
      Quality Manual
      Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
               Management Manual                                                Non-Patient Specimens


 ORIGIN OF SPECIMEN                   MRN#               CASE#           HEALTH           ATTN.         CLINIC/       REPORT REQ. DR.
                                                                          CARD#            DR.           WARD           TO
MSH:
Blood Bank non-patient              111111222      System will              Leave         30849            BTS                  Press
specimens (e.g. ATTest)                            generate or pick         blank                                               <enter> to
                                                   from list.                                                                   copy the
                                                                                                                                 ATT DR
Bone Bank non-patient               999999997          999999997            Leave         25720          BONNB                  Press
specimens (e.g. Spore Strip)                                                blank                                               <enter> to
                                                                                                                                copy the
                                                                                                                                 ATT DR
Cord Blood Program                   CB####             CB####              leave         33578          CTSCP                  Press
                                      as per          same as MRN           blank      Cruickshank                              <enter> to
                                    requisition                                                                                 copy the
                                                                                                                                 ATT DR
Cytogenetics-Lab                    CY999999       Use the receiving        Leave         as per         CYTTH                  Press
                                                   date(yymmdd)             blank       requisition                             <enter> to
                                                   and prefix it with                                                           copy the
                                                   CY E.g. If                                                                   ATT DR
                                                   received on Nov
                                                   21,2000 then
                                                   Case # is
                                                   CY021121
Cystoscopy non-patient              999999994         999999994             leave         CYST           CYST1               Press
specimens (e.g. ATTest)                                                     blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Dentistry non-patient               222222222          222222222            leave         O6460          DENT1               Press
specimens (e.g. ATTest)                                                     blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
ENT non-patient specimens           333333333          333333333            leave         18620          ENTEN               Press
(e.g. ATTest)                                                               blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
EOPS non-patient specimens          555555555          555555555            leave                        EOPS1               Press
(e.g. ATTest)                                                               blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Eye Bank Specimens                  111222222          111222222            leave       Lorna Zilic      EYEBK         BONNB Press
                                                                            blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Eye Clinic Specimens                333333111          333333111            leave      Abuhaleeqa,         EYE
                                                                            blank          K.




               UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

       NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                  are not controlled and should be checked against the document (titled as above) on the server prior to use.

      D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
     UHN/MSH Department of Microbiology                          Policy #MI\SPEC\NONP\v07                     Page 3 of 14
     Quality Manual
     Section: Microbiology Lab Specimen                          Subject Title: Patient Demographic Format for
              Management Manual                                                 Non-Patient Specimens

 ORIGIN OF SPECIMEN                   MRN#               CASE#           HEALTH           ATTN.         CLINIC/       REPORT REQ. DR.
                                                                          CARD#            DR.           WARD           TO
Infection Control                   111111112          111111112           leave          INFCT         ENVMS                Press
Environmental Specimens                                                    blank                                             <enter> to
ONLY                                                                                                                         copy the
                                                                                                                              ATT DR
Microbiology (eg. ATTest,           777777777          777777777            leave         30734          MICRO               Press
sheep/horse blood)                                                          blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Microbiology TML site (eg.          777777776          777777776            leave         30734          MICRO               Press
ATTest)                                                                     blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Nuclear Medicine non-patient        999999999          999999999            leave       MANZUR           NUCLM               Press
specimens (e.g. ATTest)                                                     blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
OR non-patient specimens            666666666          666666666            leave        Cohen,Z         ENVOR               Press
(e.g. ATTest)                                                               blank         22788                              <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Pathology non-patient               111222111          111222111            leave         21597          RESCH               Press
specimens (e.g. ATTest)                                                     blank        Pritzker                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Pharmacy Main Floor Out-            444111111          444111111            leave        PHAR1           PHAMA               Press
patient                                                                     blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Pharmacy Prenatal & NICU            444444111          444444111            leave        PHAR1           PHARM               Press
                                                                            blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Pharmacy-main In-patient            444444444          444444444            leave        PHAR1           PHAIN               Press
                                                                            blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Radiology                           999999666          999999666            leave         24730          RDSP1               Press
                                                                            blank                                            <enter> to
                                                                                                                             copy the
                                                                                                                              ATT DR
Research                            111111111          111111111            leave     pick Dr. from      RESCH               Press
                                                                            blank     F2 list OR                             <enter> to
                                                                                      * then type in                         copy the
                                                                                      name if not                             ATT DR
                                                                                      found.
Research – PLM Room 602B            111222333          0000000284           leave         SELTE          REPLM                  Press
Teresa Selander’s Lab                                                       blank                                               <enter> to
                                                                                                                                copy the
                                                                                                                                 ATT DR
               UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

       NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                  are not controlled and should be checked against the document (titled as above) on the server prior to use.

     D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
      UHN/MSH Department of Microbiology                           Policy #MI\SPEC\NONP\v07                     Page 4 of 14
      Quality Manual
      Section: Microbiology Lab Specimen                           Subject Title: Patient Demographic Format for
               Management Manual                                                  Non-Patient Specimens

 ORIGIN OF SPECIMEN                     MRN#               CASE#           HEALTH           ATTN.         CLINIC/       REPORT REQ. DR.
                                                                            CARD#            DR.           WARD           TO
Respiratory Therapy non-              999999993          999999993           leave                         RESP1               Press
patient specimens (e.g.                                                      blank                                             <enter> to
ATTest)                                                                                                                        copy the
                                                                                                                                ATT DR
SPD (e.g. ATTest)                     888888888          888888888            leave          SPDI            SPD               Press
                                                                              blank                                            <enter> to
                                                                                                                               copy the
                                                                                                                                ATT DR
Staff without ID#                   Enter last           system will          leave                          OHS               Press
(try to obtain ID# from OHS         name follow           generate            blank                                            <enter> to
first)                              by first name                                                                              copy the
                                    or up to 9                                                                                  ATT DR
                                    digits. If name
                                    exist in system
                                    alter the entry
                                    by using 1 or 2
                                    letters. DO
                                    NOT use an
                                    old entry.
PMH:
14A non-patient specimens             T14A14A           T14A14A001            leave         INFCT          PENVP                  Press
(e.g. Water)                                                                  blank                                               <enter> to
                                                                                                                                  Copy the
                                                                                                                                  ATT DR
14B non-patient specimens             T14B14B           T14B14B001            leave         INFCT          PENVP                  Press
(e.g. Water)                                                                  blank                                               <enter> to
                                                                                                                                  Copy the
                                                                                                                                  ATT DR
17A non-patient specimens             T17A17A          T17A17A0010            leave         INFCT          PENVP                  Press
(e.g. Water)                                                                  blank                                               <enter> to
                                                                                                                                  Copy the
                                                                                                                                  ATT DR
Bone Marrow
Transplant Patients:                As per ADT        10-digit number      download     Download             BMT                  Press
                                    download          i.e. T######00#.     from ADT     from ADT or                               <enter>to
Donor:                              T# as per         If only a 7-digit    or leave     as per                                    copy the
                                    requisition       number appear,       blank.       requisition.                              Att. Dr.
                                    TDDONOR#          F1 to create a new                                                          DO NOT
                                    or                STAY and type in                                                            CHANGE
                                    TDDONOR           T# + extension
                                    SURNAME           and change
Recipient:                          T# as per         patient type to I
                                    requisition.      or O. R Same as
                                                      MRN# if no T#
                                                      exist.




                 UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

         NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                    are not controlled and should be checked against the document (titled as above) on the server prior to use.

      D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
      UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 5 of 14
      Quality Manual
      Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
               Management Manual                                                Non-Patient Specimens

 ORIGIN OF SPECIMEN                   MRN#               CASE#           HEALTH          ATTN.          CLINIC/       REPORT REQ. DR.
                                                                          CARD#           DR.            WARD           TO
Blood Bank - PMH                     3366083           As per HIS          leave         HEMBB            GRP                Press
                                                       download            blank                                             <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Brachytherapy Department             3187132           As per HIS           leave        BRACH             GRP               Press
non patient specimens                                  download             blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Colposcopy Clinic non                3186871           As per HIS           leave        COLCL             GRP               Press
patient specimens                                      download             blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Dentistry non patient                3186873           As per HIS           leave        PMDEN             GRP               Press
specimens                                              download             blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                              ATT DR
Environmental                       T11111112          T11111112            leave         INFCT          PENVP               Press
                                                                            blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Lodge non-patient specimens         TLODGE           TLODGE0001             leave         INFCT          PENVP               Press
(e.g. Water)                                                                blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Nuclear Medicine/                   T99999999          T99999999            leave        Ballinger       RAPHA               Press
Radiology/Radiopharmacy                                                     blank         James                              <enter> to
non patient specimens                                                                                                        Copy the
                                                                                                                             ATT DR
OR non-patient specimens             3186892           As per HIS           leave        ORPMH             GRP               Press
                                                       download             blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Pharmacy                             3185759           As per HIS           leave        PHARM             GRP               Press
                                                       download             blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Pharmacy Daycare                     3186893           As per HIS           leave        PMHDC             GRP               Press
                                                       download             blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                             ATT DR
Prostate Ultrasound Clinic           3186896           As per HIS           leave        PUCLN             GRP               Press
non patient specimens                                  download             blank                                            <enter> to
                                                                                                                             Copy the
                                                                                                                              ATT DR
Research                            T11111111 F1for new stay &              leave     enter Dr.          RESPM               Press
                                              let system                    blank     name per                               <enter> to
                                              generate new case                       requisition                            Copy the
                                              number.                                                                        ATT DR

               UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

       NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                  are not controlled and should be checked against the document (titled as above) on the server prior to use.

      D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
       UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 6 of 14
       Quality Manual
       Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
                Management Manual                                                Non-Patient Specimens

 ORIGIN OF SPECIMEN                    MRN#               CASE#           HEALTH           ATTN.         CLINIC/       REPORT REQ. DR.
                                                                           CARD#            DR.           WARD           TO
Staff without ID# (try to          enter T then         system will          "                             OHS                Press
obtain ID# from OHS first)         last name             generate                                                             <enter> to
                                   follow by first                                                                            Copy the
                                   name for up to                                                                             ATT DR
                                   9 digits. If
                                   name exist in
                                   system alter
                                   the entry by
                                   using 1 or 2
                                   letters. DO
                                   NOT use an
                                   old entry.
STC non-patient specimens            TSTCSTC          TSTCSTC001             leave         INFCT          PENVP                  Press
(e.g. Water)                                                                 blank                                               <enter> to
                                                                                                                                 copy the
                                                                                                                                 ATT DR
Water Tank                           TWTANK           TWATER0001             leave         INFCT          PENVP                  Press
                                                                             blank                                               <enter> to
                                                                                                                                 copy the
                                                                                                                                 ATT DR

TRI:
Chiropody-Dunn non-patient          QED555444          QED555444             leave       WELTZ,S          CHIRO                  Press
specimens (e.g. ATTest)                                                      blank                                               <enter> to
                                                                                                                                 copy the
                                                                                                                                 ATT DR
Dentistry-Dunn non-patient          QED222222          QED222222             Leave     COLOPAUGH,R        DENT2                  Press
specimens (e.g. ATTest)                                                      blank                                               <enter> to
                                                                                                                                 copy the
                                                                                                                                 ATT DR
Dentistry-University non-           QEU222222          QEU222222             leave      GOMBOS,E          DENT3                  Press
patient specimens (e.g.                                                      blank                                               <enter> to
ATTest)                                                                                                                          copy the
                                                                                                                                 ATT DR
Hemodialysis Water – TRI              3190720           As per HIS           Leave           GIP          TGHEM                  Press
                                                        dowonload            blank                                               <enter> to
                                                                                                                                 copy the
                                                                                                                                 ATT DR
Patient clinics-Dunn non-           QED555555          QED555555             leave         REN,A          AMBCC                  Press
patient specimens (e.g.                                                      blank                                               <enter> to
ATTest) Ambulatory Care                                                                                                          copy the
Services                                                                                                                         ATT DR
Patient clinics-University          QEU555555          QEU555555             leave       PATIENT           QUDP                  Press
non-patient specimens                                                        blank        CLINIC                                 <enter> to
Specialty Clinics                                                                                                                copy the
                                                                                                                                 ATT DR



                UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

        NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                   are not controlled and should be checked against the document (titled as above) on the server prior to use.

       D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
      UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 7 of 14
      Quality Manual
      Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
               Management Manual                                                Non-Patient Specimens

 ORIGIN OF SPECIMEN                   MRN#               CASE#           HEALTH           ATTN.         CLINIC/       REPORT REQ. DR.
                                                                          CARD#            DR.           WARD           TO
SPD                                QED888888          QED888888            leave           SPD           SPD2                Press
                                                                           blank                                             <enter> to
                                                                                                                             copy the
                                                                                                                             ATT DR
BAYCREST:
** At SOURCE Screen, Comment field: enter Baycrest Order # as per
requisition.

Baycrest non-patient               BC1111112           BC1111112            Leave                          BAY                    Press
specimens                                                                   blank                                                 <enter> to
                                                                                                                                  copy the
                                                                                                                                  ATT DR

CENTRE FOR ADDICTION AND MENTAL HEALTH:
Queen St. Mental Health            QS4444444           QS4444444            Leave       PHARMQ         MPHARM            none     Press
Pharmacy                                                                    blank                                                 <enter> to
                                                                                                                                  copy the
                                                                                                                                  ATT DR

INFECTION CONTROL SCREEN:
Canadian Blood Services            CBS111111 system will                    leave         as per         CBSSC           as per Press
                                             generate or pick               blank       requisition                    requisition <enter> to
                                             from list.                                                                            copy the
                                                                                                                                   ATT DR
Patient Screening                             Pick the most
                                  key in as per                       as per      DO NOT                DO NOT        leave blank INFCT
                                  requisition recent one then      requisition     change                change
                                  then F12 to F12 to search        if available default Dr.;             default
                                  search.     with appropriate                    use 51099
                                              patient type (ie. In               (McGeer) if
                                              or out patient)                       none
                                                                                  available
MSH Staff Screening               M+Last Name      M+Last              leave        68323                  OHS        At Room         68323
                                                  Name+001             blank    (Schweigert)                          field: enter Schweigert
                                                                                                                      ward or
                                                                                                                      dept of
                                                                                                                      staff
MSH Patient Relatives               M+Last              M+Last              leave        51099            MREL        At Room        INFCT
Screening                          Name+First          Name+First                       (McGeer)                      field: enter
                                                                                                                      ward of
                                                                                                                      patient
TGH and PMH Staff                    CX#####            From HIS            Leave        HAMH5            GOCC                      HAMH5
Screening                            from HIS                               blank
TWH Staff Screening                  CX#####            From HIS            Leave        HAMH5           WOCC                      HAMH5
                                     from HIS                               blank




               UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

       NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                  are not controlled and should be checked against the document (titled as above) on the server prior to use.

      D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
      UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 8 of 14
      Quality Manual
      Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
               Management Manual                                                Non-Patient Specimens

 ORIGIN OF SPECIMEN                   MRN#                CASE#            HEALTH     ATTN.             CLINIC/        REPORT        REQ. DR.
                                                                            CARD#       DR.              WARD              TO
TRI IC Screen                     MRN# as per         same as MRN#           Leave pick Dr. from      as per          At Room        Press
                                   requisition                               blank F2 list OR *       requisition     field: enter   <enter> to
                                                                                   then type in       and select      ward as per    Copy the
                                                                                   name if not        from F2 list.   requisition    ATT DR
                                                                                   found
Referred in isolates              Enter 2               system will          Leave    REFIN           Hospital           Leave         REFIN
                                  distinct initial       generate            blank                    from F2 list       blank
                                  for hospital
                                  e.g. NW for
                                  Northwest
                                  General + the
                                  referring lab's
                                  number
Toronto Hospital Animal             122222222           122222222           Leave        MOLOB           THARC          55754 Press
Research Centre                                                             blank                                     T Mazzuli <enter> to
                                                                                                                                copy the
                                                                                                                                ATT DR
UHN:
Animal Research Centre-             AR888888         Use the receiving      Leave        MOLOB           ARCTH                       Press
TGH                                                  date(yymmdd)           blank                                                    <enter> to
                                                     and prefix it with                                                              copy the
                                                     the same letters as                                                             ATT DR
                                                     AR E.g. If
                                                     received on Nov
                                                     21,2000 then
                                                     Case # is
                                                     AR021121
ATS Lab Antithermalcyte             AT133333         Use the receiving      Leave         as per         ATSTH                       Press
Serum Lab                                            date(yymmdd)           blank       requisition                                  <enter> to
                                                     and prefix it with                                                              copy the
                                                     AT E.g. If                                                                       ATT DR
                                                     received on Nov
                                                     21,2000 then
                                                     Case # is
                                                     AT021121
Autopsy Suites - TGH                 3188488         Use the receiving      Leave         as per           GRP                       Press
                                                     date(yymmdd)           blank       requisition                                  <enter> to
                                                     AU E.g. If                                                                      copy the
                                                     received on Nov                                                                  ATT DR
                                                     21,2000 then
                                                     Case # is
                                                     AU021121




               UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

       NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                  are not controlled and should be checked against the document (titled as above) on the server prior to use.

      D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
     UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 9 of 14
     Quality Manual
     Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
              Management Manual                                                Non-Patient Specimens

 ORIGIN OF SPECIMEN                  MRN#               CASE#        HEALTH             ATTN.          CLINIC/       REPORT REQ. DR.
                                                                      CARD#              DR.            WARD           TO
Blood Bank - TGH                    3188490       Use the receiving    Leave            HEMBB            GRP                Press
                                                  date(yymmdd)         blank                                                <enter> to
                                                  and prefix it with                                                        copy the
                                                  BBTH E.g. If                                                               ATT DR
                                                  received on Nov
                                                  21,2000 then
                                                  Case # is
                                                  BBTH021121
Cardiovascular                     CR777777                            Leave             as per         CVRTH                  Press
                                                                       blank           requisition                             <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Core Lab Water-TML                  3188493           As per HIS           Leave         CORE             GIP                  Press
                                                      download             blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Rapid Response Lab - TGH            3185753           As per HIS           Leave        TGRRL             GIP                  Press
Water Sterility                                       download             blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Rapid Response Lab - TWH            3188284           As per HIS           Leave        TWRRL             GIP                  Press
Water Sterility                                       download             blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Dentistry - TGH                    DE222222       Use the receiving        Leave         as per         DENTH                  Press
                                                  date(yymmdd)             blank       requisition                             <enter> to
                                                  and prefix it with                                                           copy the
                                                  DE E.g. If                                                                   ATT DR
                                                  received on Nov
                                                  21,2000 then
                                                  Case # is
                                                  DE021121
Diagnostic Dev. Lab - TWH          DDL22222       Use the receiving        Leave         As per         DDLTW                  Press
                                                  date(yymmdd)             blank       requisition                             <enter> to
                                                  and prefix it with                                                           copy the
                                                  DDL E.g. If                                                                  ATT DR
                                                  received on Nov
                                                  21,2000 then
                                                  Case # is
                                                  DDL021121
Endocrinology - TGH                 3363533          266000394                          TGEND             GRP                  Press
                                                                                                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
ENT Clinic - TGH                    3188687           As per HIS           Leave        TGENT             GRP                  Press
                                                      download             blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR

              UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

      NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                 are not controlled and should be checked against the document (titled as above) on the server prior to use.

     D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
     UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 10 of 14
     Quality Manual
     Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
              Management Manual                                                Non-Patient Specimens

 ORIGIN OF SPECIMEN                  MRN#               CASE#        HEALTH              ATTN.         CLINIC/       REPORT REQ. DR.
                                                                      CARD#               DR.           WARD           TO
EM Lab – Banting TGH               EM222222       Use the receiving    Leave             as per        EMTTH                Press
Water sterility                                   date(yymmdd)         blank           requisition                          <enter> to
                                                  and prefix it with                                                        copy the
                                                  EM E.g. If                                                                ATT DR
                                                  received on Nov
                                                  21,2004 then
                                                  Case # is
                                                  EM041121
Hemodialysis Water – ES             3186172          As per HIS        Leave            TGHEM             GRP                  Press
Eaton South                                           download         blank                                                   <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Hemodialysis Water – GH             3224008           As per HIS           Leave        TGHEM             GRP                  Press
Gerrard                                               dowonload            blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Hemodialysis Water – Home           3224011           As per HIS           Leave        TGHEM             GRP                  Press
Dialysis                                              dowonload            blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Hemodialysis Water –                3224016           As per HIS           Leave        TGHEM             GRP                  Press
Sheppard Centre                                       dowonload            blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Hemodialysis Water –                3188689           As per HIS           Leave        TGHEM             GRP                  Press
Sussex Centre                                         dowonload            blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Hemodialysis Water – TWH            3188690           As per HIS           Leave        TWHEM             WRP                  Press
                                                      dowonload            blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Hemodialysis Water – TRI            3190720           As per HIS           Leave        TGHEM             GRP                  Press
                                                      dowonload            blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Histopathology Lab – TGH            3188692           As per HIS           Leave        TGPAT             GRP                  Press
                                                      download             blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Infection Control                   3188694           As per HIS           Leave         TGHIC            GRP                  Press
Environmental –TGH                                    download             blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR




              UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

      NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                 are not controlled and should be checked against the document (titled as above) on the server prior to use.

     D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
     UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 11 of 14
     Quality Manual
     Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
              Management Manual                                                Non-Patient Specimens

 ORIGIN OF SPECIMEN                  MRN#               CASE#        HEALTH              ATTN.         CLINIC/       REPORT REQ. DR.
                                                                      CARD#               DR.           WARD           TO
Lipoprotein Study – TGH            LPS11111       Use the receiving    Leave             as per         LPSTH               Press
                                                  date(yymmdd)         blank           requisition                          <enter> to
                                                  and prefix it with                                                        copy the
                                                  LPS E.g. If                                                               ATT DR
                                                  received on Nov
                                                  21,2000 then
                                                  Case # is
                                                  LPS0211211
Maxbell Research Center –           3188697          246001547         Leave            TGMBR             GRP                  Press
TGH                                                                    blank                                                   <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Molecular Lab - TGH                 3188699           246001548            Leave        TGMOL             GRP                  Press
                                                                           blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
OR – TGH                            3188701           246001587            Leave        ORTGH             GRP                  Press
                                                                           blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
P.E.T. Centre Clarke               PC122222       Use the receiving        Leave         as per         PETCT                  Press
Institute                                         date(yymmdd)             blank       requisition                             <enter> to
                                                  and prefix it with                                                           copy the
                                                  PC E.g. If                                                                   ATT DR
                                                  received on Nov
                                                  21,2000 then
                                                  Case # is
                                                  PC021121
Pharmacy Manufacturing -            3188982          246001554             Leave        TGMAN             GRP                  Press
TGH                                                                        blank                                               <enter> to
  Source: EBAG/EVIAL                                                                                                           copy the
                                                                                                                               ATT DR
                                                                                                                               press
Pharmacy – TGH                     PH444444       Use the receiving        Leave         as per         PHATH                  Press
                                                  date(yymmdd)             blank       requisition                             <enter> to
                                                  and prefix it with                                                           copy the
                                                  PH E.g. If                                                                   ATT DR
                                                  received on Nov
                                                  21,2000 then
                                                  Case # is
                                                  PH021121
Pharmacy –TWH                       3194695           24600161             Leave        PHATW             WRP                  Press
                                                                           blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
Radiopharmacy - TGH                 3186889            26600339            Leave          GRP           RAPHA                  Press
 Source: EBAG/EVIAL                                                        blank                                               <enter> to
                                                                                                                               copy the
                                                                                                                               ATT DR
              UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

      NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                 are not controlled and should be checked against the document (titled as above) on the server prior to use.

     D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
     UHN/MSH Department of Microbiology                          Policy #MI\SPEC\NONP\v07                     Page 12 of 14
     Quality Manual
     Section: Microbiology Lab Specimen                          Subject Title: Patient Demographic Format for
              Management Manual                                                 Non-Patient Specimens

 ORIGIN OF SPECIMEN                   MRN#               CASE#         HEALTH             ATTN.         CLINIC/       REPORT REQ. DR.
                                                                        CARD#              DR.           WARD           TO
Research TTH (TG or TW)            U11111111        Use the receiving    Leave            as per         RESTH               Press
Sterility                                            date(yymmdd)        blank          requisition                          <enter> to
                                                    and prefix it with                                                       copy the
                                                       UR E.g. If                                                            ATT DR
                                                    received on Nov
                                                      21,2000 then
                                                        Case # is
                                                       UR021121
Retinoblastoma Solutions –         1111111RS                             Leave           RUSHD           RETSO                  Press
TWH                                                                      blank                                                  <enter> to
                                                                                                                                copy the
                                                                                                                                ATT DR
BRIDGEPOINT:
Central Service Dept.               CS311111Use the receiving               Leave         as per          RHCS                  Press
Bridgepoint                                 date(yymmdd)                    blank       requisition                             <enter> to
                                            and prefix it with                                                                  copy the
                                            CS E.g. If                                                                          ATT DR
                                            received on Nov
                                            21,2000 then
                                            Case # is
                                            CS021121
Dental Clinic - Bridgepoint        RHDC2222 Use the receiving               Leave         as per          RHDC                  Press
                                            date(yymmdd)                    blank       requisition                             <enter> to
                                            and prefix it with                                                                  copy the
                                            RHD E.g. If                                                                         ATT DR
                                            received on Nov
                                            21,2000 then
                                            Case # is
                                            RHD021121
Chiropody Department -             CC111111 Use the receiving               Leave         as per          RHCC                  Press
Bridgepoint                                 date(yymmdd)                    blank       requisition                             <enter> to
                                            and prefix it with                                                                  copy the
                                            CC E.g. If                                                                          ATT DR
                                            received on Nov
                                            21,2000 then
                                            Case # is
                                            CC021121
MIDWIVES COLLECTIVE OF TORONTO:
Midwives Collective of             MCT11111 MCT11111                        Leave     * as per            MCTV                  Press
Toronto ATTest                                                              blank     requisition                               <enter> to
                                                                                                                                copy the
                                                                                                                                ATT DR




               UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

       NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
                  are not controlled and should be checked against the document (titled as above) on the server prior to use.

     D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 13 of 14
Quality Manual
Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
         Management Manual                                                Non-Patient Specimens

                                      Record of Edited Revisions
Manual Section Name: Patient Demographic Format for Non-Patient Specimens
                     Page Number / Item                                           Date of Revision                 Signature of
                                                                                                                    Approval
Page 10 EM Lab TTH added                                                        September 21, 2004                Dr. T. Mazzulli
Annual Review                                                                   September 21, 2004                Dr. T. Mazzulli
PMH Sterility demographics changed                                              July 20, 2005                     Dr. T. Mazzulli
Annual Review                                                                   July 20, 2005                     Dr. T. Mazzulli
Research-PLM Room 602B, Teresa Selander added                                   July 27, 2005                     Dr. T. Mazzulli
Annual Review                                                                   September 5, 2006                 Dr. T. Mazzulli
Updated UHN patients                                                            September 5, 2006                 Dr. T. Mazzulli
Eye clinic (MSH) added                                                          February 20, 2007                 Dr. T. Mazzulli
Annual Review                                                                   August 13, 2007                   Dr. T. Mazzulli
Annual Review                                                                   August 15, 2008                   Dr. T. Mazzulli




         UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

 NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
            are not controlled and should be checked against the document (titled as above) on the server prior to use.

D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc
UHN/MSH Department of Microbiology                         Policy #MI\SPEC\NONP\v07                     Page 14 of 14
Quality Manual
Section: Microbiology Lab Specimen                         Subject Title: Patient Demographic Format for
         Management Manual                                                Non-Patient Specimens

                       Page Number / Item                                         Date of Revision                 Signature of
                                                                                                                    Approval




Record of Edited Revisions.doc




          UHNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY

 NOTE: This is a CONTROLLED document. Any documents appearing in paper form that are not stamped in red "MASTER COPY"
            are not controlled and should be checked against the document (titled as above) on the server prior to use.

D:\Docstoc\Working\pdf\696763cb-c1b2-4320-9a34-371c8172ac22.doc