UIDL Client # * Facility Name * Contact Person * Contact Phone Number * Ship To: Street Address * Department or Room # * City * State * Zip * Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Please select the item(s) you wish to order Complete Transplant Pancreas Biopsy Kit Fed Ex Airbills Complete Transplant Pancreas Biopsy Kit - Specify Quantity Requested Kits (Each kit includes Biohazard Specimen Bag, Fed Ex Box, Fed Ex Large Transport Bag, Pre-Paid Fed Ex Airbill, 10% Buffered Formalin Tissue Vial, Transplant Pancreas Biopsy Requisition, Transplant Pancreas Clinical History Form and Transplant Pancreas Biopsy Instruction Sheet) Fed Ex Airbills - Specify Quantity Requested The UIDL provides Pre-Paid complimentary Fed Ex Overnight Service for our Transplant Pancreas Biopsy customers. First Order Only: Please provide your Fed Ex account number for the UIDL to use to place an order in the Fed Ex system. Your Airbills will be shipped directly to you by Fed Ex in approximately two weeks. Fed Ex Account Number Comment(s): CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.