Slot Booking Form

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Personal Details

Sample Details

Tomographic details:*



Four Dimensional X-ray Microscopy, IIT Bombay, Mumbai

Non-Dangerous Material Undertaking Form

I undertake that the provided sample (Sample Name ………………… and ID No. ……………..)

fulfills all the below conditions:

- is not biological toxin

- does not contain (whether dead or alive) bacteria, viruses, fungi, and parasites

- is not a part of animal testing

- is not (and cannot be) hazardous

- cannot contaminate equipment/holder

- is not radioactive

- is not poisonous and cannot become poisonous on exposure to heat/atmosphere/water/ x- rays (etc.)

- cannot cause exothermic reactions/evolve gases/liquids/etc. (including fire/explosion/etc.) on exposure to heat/atmosphere/water/ x-rays etc.

Authorized Signatory



(date, place and stamp)

Please confirm the check list given below:

1. Samples

2. External Hard drives

3. Sample Requisition Form

4. Non-Dangerous Material Undertaking Form