OTC 2-Pack TEST DEVICE INFODevice Lot Number(Required)Example: 42723XXXDevice EXP Year(Required)24252627XXDevice EXP Month(Required)010203040506070809101112XXDevice EXP Day(Required)30312928XXPLEASE CONFIRM: •January, March, May, July, August, October, and December all have 31 Days. • April, June, September, and November have 30 Days • February has 29 days in 2024Number of Individual Tests Devices(Required)Number of 2-Pack Kits Needed(Required)This calculation will be automatic.BUFFER TUBES ASSIGNED TO LOTBuffer Lot Number(Required)Example: 38423XXX or 42623XXXBuffer EXP Year24252627XXBuffer EXP Month(Required)010203040506070809101112XXBuffer EXP Day(Required)30312928XXPLEASE CONFIRM: •January, March, May, July, August, October, and December all have 31 Days. • April, June, September, and November have 30 Days • February has 29 days in 2024OTC 2-PACK HOME KITOTC 2-Pack Lot Number(Required)Example: 42823XXX – Sometimes an over-label is needed in which case, you and an “A” or “B” etc to identify at the end of the LOT number.OTC 2-Pack EXP Year(Required)24252627OTC 2-Pack EXP Month(Required)010203040506070809101112OTC 2-Pack EXP Day(Required)1330312928PLEASE CONFIRM: •January, March, May, July, August, October, and December all have 31 Days. • April, June, September, and November have 30 Days • February has 29 days in 2024SWABSInclude the Lot number for SWABS you plan to include in this lot shipment.SWAB LOT Number(Required)SWAB EXP Date(Required) YYYY dash MM dash DD This field is hidden when viewing the formTotals NeededThis field is hidden when viewing the formNeed to Print – OTC – 2-Pack BoxesThis field is hidden when viewing the formNeed to Print – Buffer LabelsLabel Version – 1888-2This field is hidden when viewing the formNeed to Print – 6-Pack LabelsLabel Version – CL1893-1_6This field is hidden when viewing the formNeed to Print – 10-Pack LabelsLabel Version – CL1893-1_60 SUBMITTED BYName First Last Email
