Ver. 0.1
'*' means required field. Required field cannot be left blank.
Patient ID
*
Patient Age
*
Patient Sex
*
Male
Female
Screening Date
*
1
2
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6
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10
11
12
1
2
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Test
*
Test Gene
*
APC
EPCAM
MLH1
MLH3
MSH2
MSH6
MUTYH
PMS1
PMS2
Test Result
*
Positive
Negative
Mutation
Test
*
Test Gene
*
APC
EPCAM
MLH1
MLH3
MSH2
MSH6
MUTYH
PMS1
PMS2
Test Result
*
Positive
Negative
Mutation
Example : MLH1 - c.-4864C>A, c.-269C>G