[ver] 4 [sty] [files] [charset] 82 ANSI (Windows, IBM CP 1252) [revisions] 0 [prn] PostScript Printer [port] LPT2: [lang] 1 [desc] MS service submission form 793928473 8 782173759 167 1 0 0 0 0 1 [fopts] 0 1 0 0 [lnopts] 2 Body Text 1 [docopts] 5 2 [GramStyle] [tag] Body Text 2 [fnt] Times New Roman 220 0 49152 [algn] 1 1 0 0 0 [spc] 33 259 1 0 0 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 0 1 1 0 0 0 0 [nfmt] 280 1 2 . , $ Body Text 4 1 792 1 2160 1 5130 1 6480 0 [tag] Body Single 3 [fnt] TimesNewRomanPS 240 0 49152 [algn] 1 1 0 0 0 [spc] 33 273 1 0 0 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 0 1 1 0 0 0 0 [nfmt] 280 1 2 . , $ Body Single 0 0 [tag] Bullet 4 [fnt] TimesNewRomanPS 240 0 49152 [algn] 1 1 0 288 288 [spc] 33 273 1 0 0 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 <*0> 360 1 1 0 0 0 0 [nfmt] 272 1 2 . , $ Bullet 0 0 [tag] Bullet 1 5 [fnt] TimesNewRomanPS 240 0 49152 [algn] 1 1 288 288 288 [spc] 33 273 1 0 0 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 <*5> 0 1 1 0 0 0 0 [nfmt] 280 1 2 . , $ Bullet 1 0 0 [tag] Number List 6 [fnt] TimesNewRomanPS 240 0 49152 [algn] 1 1 360 360 360 [spc] 33 273 1 0 0 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 <*:>. 360 1 1 0 16 0 0 [nfmt] 272 1 2 . , $ Number List 0 0 [tag] Subhead 7 [fnt] TimesNewRomanPS 240 0 49155 [algn] 1 1 0 0 0 [spc] 33 273 1 72 72 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 2 0 1 1 0 0 0 0 [nfmt] 272 1 2 . , $ Subhead 0 0 [tag] Title 8 [fnt] Arial MT 360 0 16385 [algn] 4 1 0 0 0 [spc] 33 446 1 144 72 1 100 [brk] 16 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 1 0 1 1 0 0 0 0 [nfmt] 272 1 2 . , $ Title 0 0 [tag] Header 9 [fnt] TimesNewRomanPS 240 0 49152 [algn] 1 1 0 0 0 [spc] 33 273 1 0 0 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 0 1 1 0 0 0 0 [nfmt] 280 1 2 . , $ Header 0 0 [tag] Footer 11 [fnt] TimesNewRomanPS 240 0 49152 [algn] 1 1 0 0 0 [spc] 33 273 1 0 0 1 100 [brk] 4 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 0 1 1 0 0 0 0 [nfmt] 280 1 2 . , $ Footer 0 0 [tag] bodytext2 12 [fnt] Times New Roman 220 0 49152 [algn] 1 1 0 0 0 [spc] 33 259 1 0 0 1 100 [brk] 36 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 0 1 1 0 0 0 0 [nfmt] 280 1 2 . , $ bodytext2 5 1 792 49153 4140 1 5130 49153 8496 49153 9360 0 [tag] line 0 [fnt] Times New Roman 240 0 49152 [algn] 1 1 0 0 0 [spc] 33 288 1 0 0 1 100 [brk] 36 [line] 8 0 1 0 1 1 1 10 10 1 [spec] 0 0 0 1 1 0 0 0 0 [nfmt] 280 1 2 . , $ line 1 49153 9348 0 [lay] Standard 513 [rght] 15840 12240 1 1440 1080 1 1080 1440 0 1 0 1 0 2 1 1440 10800 12 1 720 1 1440 1 2160 1 2880 1 3600 1 4320 1 5040 1 5760 1 6480 1 7200 1 7920 1 8640 [hrght] [lyfrm] 1 11200 0 0 12240 1080 0 1 3 1 0 0 0 0 0 0 0 0 1 [frmlay] 1080 12240 1 1440 72 1 792 1440 0 1 0 1 1 0 1 1440 10800 2 2 4680 3 9360 [txt] > [frght] [lyfrm] 1 13248 0 14760 12240 15840 0 1 3 1 0 0 0 0 0 0 0 0 2 [frmlay] 15840 12240 1 1440 792 1 14832 1440 0 1 0 1 1 0 1 1440 10800 2 2 4680 3 9360 [txt] > [elay] [l1] 0 [pg] 1 48 128 41 1025 0 0 0 65535 65535 Standard 65535 0 0 0 0 0 0 0 0 0 65535 0 0 65535 0 0 0 0 0 [edoc] <+B><:S+-2><:#388,9360><:f220,2TimesNewRomanPS,0,0,0><+#>Application For Mass Spectrometric Analysis<-#> <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>Washington University Resource for Biomedical and Bio-organic Mass Spectrometry <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>Department of Medicine <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>Division of Metabolism and Endocrinology - Box 8127 <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>Washington University School of Medicine <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>660 S. Euclid Avenue <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>St. Louis, MO 63110 <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>telephone: (314) 362-8190, FAX: (314) 362-8188 <+B><:S+-1><:#259,9360><:f220,2TimesNewRomanPS,0,0,0>PLEASE PROVIDE ALL RELEVANT INFORMATION<:f> <+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> Investigator:<+#> <-#> Bill to:<+#> <-#> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> Address: @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> Telephone: Purchase Order No. <+#> <-#><:f> <+@><:S+-1><:#279,9360><:f240,2TimesNewRomanPS,0,0,0> <+@><:#502,9360><:f,2TimesNewRomanPS,><+#>Type of Analysis (circle one):<-#> <:f200,2TimesNewRomanPS,0,0,0>Low resolution GCMS spectra, <+&>13<-&>CO<+'>2<-'> breath IRMS, <+&>15<-&>N combustion IRMS, <+&>2<-&>H<+'>2<-'><+&>18<-&>O IRMS, GCIRMS tracer/tracee, GCMS tracer/tracee, GCMS quantitation, Other:<+#> <:f> <+@><:#240,9360><+#><:f200,2TimesNewRomanPS,0,0,0> <+B><:#264,9360><+#><:f>FOR GCMS SPECTRA<-#> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,><-#><-#><-#><-#>Sample formula: <+#> <-#><+#> <-#> <+#>Proposed Structure<-#><-#> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Nominal Mol. Wt.: <+#> <-#> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>m.p. or b.p.: <+#> <-#> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Purity: <+#> <-#> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Wt. sample submitted: <+#> <-#> @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Soluble in which solvent? Is sample stable in solution? @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Air sensitive? <+#> <-#> Light Sensitive? @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Moisture sensitive? <+#> <-#> Heat sensitive? @bodytext2@<+@><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Refrigerate? <+#> <-#> Return sample? <:f> <+B><:S+-1><:#259,9360><:f,2TimesNewRomanPS,><+#> <+B><:S+-1><:#259,9360><+#><:f,2TimesNewRomanPS,>FOR IRMS and GCMS TRACER/TRACEE RATIO OR GCMS QUANTITATION:<-#> <+B><:S+-1><:#259,9360><:f><:f,2TimesNewRomanPS,> @bodytext2@<+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Tracer administrated: <+#> <-#> Tracee to analyze for: @bodytext2@<+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Internal Standard Preference: <+#> @bodytext2@<+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Sample matrix: plasma, serum, urine, tissue, Other: <:f> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Sample handling precautions: radioactive, infectious, moiture/heat sensitive. <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> <+#>Patient ID<-#> <+#> Sample date<-#> <+#>Sample time points<-#> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,> <+C><:S+-1><:#259,9360><:f,2TimesNewRomanPS,>Comments, precautions, additional information (Include hazards, handling, helpfull data, questions):<:f> @line@<+@><:S+-1><:#279,9360><:f240,2TimesNewRomanPS,0,0,0><+#> @line@<+@><:S+-1><:#279,9360><+#><:f240,2TimesNewRomanPS,0,0,0> @line@<+@><:S+-1><:#279,9360><:f240,2TimesNewRomanPS,0,0,0><+#> <:f> <+@><:S+-1><:#538,9360><-#><-#><:f240,2TimesNewRomanPS,0,0,0>I<:f220,2TimesNewRomanPS,0,0,0>T IS STRONGLY ADVISED TO CONSALT WITH MASS SPECTROMETRY RESOURCE PERSONNEL PRIOR TO SUBMITTING SAMPLES.<:f> > [Embedded] 00009786