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["Aflatoxinas (B1, B2, G1 y G2)"]
["Metales (As, Cd, Hg, Pb y Cr hexavalente)"]
["NMBA"]
["NDMA"]
["NDBA"]
["NDEA"]
["NDIPA"]
["NEIPA"]
["NMPA"]
["NMEA"]

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[]
[null,null,null,null,null,null,null,null,null,null,null,null,"REMISIÓN DE MUESTRAS - INDUSTRIA FARMACÉUTICA",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FOR-PDA-010"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Versión 1"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Aprobado 2024-02-02"]
[]
[null,"Empresa:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NIT:",null,null,null,null,"Fecha recepción de la muestra:"]
[null,"Dirección: "]
[null,"Persona de contacto:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Teléfono:"]
[null,"Correo persona de contacto:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Consecutivo Micotox:"]
[null,"Correos adicionales para envío de resultados: "]
[]
[null,null,null,null,null,null,null,null,null,"MUESTRA 1",null,null,null,null,null,null,"MUESTRA 2","Muestra 2",null,null,null,null,null,"MUESTRA 3",null,null,null,null,null,null,"MUESTRA 4"]
[null,"Espacios exclusivos MICOTOX ➤",null,null,null,null,null,null,null," ID MICOTOX:",null,null,null,null,null,null," ID MICOTOX:",null,null,null,null,null,null," ID MICOTOX:",null,null,null,null,null,null," ID MICOTOX:"]
[null,null,null,null,null,null,null,null,null," PESO (g):",null,null,null," T ingreso*:\n(°C)",null,null," PESO (g):",null,null,null," T ingreso*:\n(°C)",null,null," PESO (g):",null,null,null," T ingreso*:\n(°C)",null,null," PESO (g):",null,null,null," T ingreso*:\n(°C)"]
[null,"Identificación o nombre de la muestra (escriba el nombre de la muestra como requiera que aparezca en el reporte de resultados)"]
[null,"Análisis solicitados: \n(puede seleccionar varias opciones de la lista desplegable)"]
[null,"Información requerida por BPL:"]
[null,"Origen del material"]
[null,"Composición"]
[null,"DCI (Denominación común internacional)"]
[null,"Marca comercial"]
[null,"Forma farmacéutica"]
[null,"Concentración o contenido"]
[null,"Fabricante"]
[null,"Número de lote"]
[null,"Número de autorización de comercialización (registro sanitario)"]
[null,"Tamaño de la muestra"]
[null,"Razón de la solicitud de análisis"]
[null,"Fecha de toma de muestra"]
[null,"Fecha de vencimiento o fecha de re-análisis "]
[null,"Condiciones de almacenamiento"]
[null,"Especificaciones que se deben aplicar durante el ensayo"]
[null,"Registro de comentarios adicionales: Riesgos o cuidados asociados a considerar"]
[null,"REQUSITOS ADICIONALES :"]
[null,null,null,null,null,null,null,null,null,"OTROS:"]
[null,"*Temperatura aproximada de ingreso: aplica sólo a muestras refrigeradas o congeladas (℃)"]