GB2221208A - Form assembly - Google Patents

Abstract

A form assembly of the type used in hospitals, etc. for sending a specimen (e.g. blood, urine, sputum) to a laboratory for analysis comprises a form 1 for the recordal of information partially overlaid by a bag 2 for receiving the specimen to be analysed. The bag is attached adjacent its open end to the form 1 remote from an edge thereof so that there is free area of the form not overlaid by the bag. A strip of adhesive 7 is provided on the free area which may be folded along a line 3 against the bag 2 so as to close the mouth. A line of perforations 4 may be provided so that the portion of the form on which information is recorded is separable. The bag has a lip 2a with adhesive 6 on its rear for attached to the form. Lip 2a also has adhesive Ton its front to close the mouth. <IMAGE>

Description

FORM ASSEWBL The present invention razes to a form assembly of the type used in hospitals, clinics and the like for sending a specimen (eg. blood. urine, sputum, etc.

to a laboratory for analysis.

Such form assemblies are known and generally comprise a paper for, (which may have one or more leaves) on which details of the patient, specimen, analysis required etc are written and bag (generaliy of polythene) which is attached to the form and into which the sample in a suitable closed tube is placed.

It is desirable thet, the bac can be securely closed once the sample has been placed therein and it is therefore an object of the present invention to provide 2 form assembly in which such secure closure may be effected easily.

According to the present invention there is provided a form assembly comprising a form for the recordal of information partially overlaid by bag for receiving a specimen to be analysed attached adjacent its open end to the form remote from an edge thereof so that there is a free area of the form not overlaid by the bag wherein a strip of adhesive is provided on said free area which may be folded against the bag to close the mouth thereof.

In a preferred embodiment of the invention the form has a score line and a perforation both parallel to the open end of the bag, the score line being in said free area and the perforation being in that part of the form overlaid by the bag. The strip of adhesive is provided between the sore line and the adjacent free edge of the fr In this embodiment, the bag is closed by foloincy along the score line such that the adhesive strip a..tOmaticalZy contacts the bag over its open end. The perforation serves for detaching that part of the fornl o which information is recorded from the bag.

Preferably the adhesive strip (which is preferably a continuous strip but may in certain circumstances be discontinuous) is covered by a removable strip of paper or the like until the bag is to be closed.

The invention wili be further described by way of example only with reference to the accompanying drawings, in which Fig. 1 is an exploded perspective view of one embodiment of form assembly in accordance with the invention; Figs. 2 and 3 illustrate stages in the closure of the bag; and Fig. 4 illustrateE aside view of the form assembly with the bag c3osed.

Referring to Fig. I, the illustrated form assembly comprises a paper form 1 and a polythene bag 2, shown with its mouth uppermost, attached to the form 1 in the manner described more fully be.low.

Form 1 (as conventional) is pre-printed to faci5.itate completion with details of the patient, specimen and analysis required. Althopgh not iXlustrated in the drawing, form 1 may comprise two or more layers of carbonless paper so that information written on the front of the form is reproduced on the other leaves.

Outside of the area on which the patient/specin.ien/analysis information may be recorded is a score line j and a perforatlon 4 between which a rectangulal irt 5 of the form is defined.The bag 2 has a projecting per lip 2a and is attached to the form by means of o thin line of adhesive 6 positioned on the reverse side of lip 2c. More particularly, this strip 6 bonded to the for; l on the side of the score line 3 remote crom area 5 It will thus be appreciated that the main body of the bag 2 normally overlies the area of form 1 on which information is recorded (but may easily be turned back' when it is desired to mark the form) and that the mouth of the bag overlies the area 5. Additionally the bag may easily be opened to place a sample therein.

On the side of the score line 3 remote from area 5, is a strip of adhesive 7 provided partly on the form 1 and partly on the front of lip 2a. A paper strip 8 protects adhesive 7 (until required).

A small hole 9 is provided in the form 1 as shown.

Once a specimen (not shown) has been placed in bag 2, the latter may be closed and sealed by the following procedure.

Initially, paper strip 8 is removed from the adhesive 7 (see Fig. 2). The form 1 is now folded along the score line 2 so that the now exposed adhesive 7 may be pressed into contact with the mouth of the bag which overlies area 5. Thus the bag is closed and sealed against leakage The form 1 may now be folded back along the score line 3 so that the form assembly adopts the configuration shown in side view in Fig. 4. That part of the form with information recorded thereon may be detached by tearing along the perforation line 4, and the bag may be hung by means of the hole 9 on a suitable support (not shown).

Claims (11)

1. A form assembly comprising a form for the recordal of information partially overlaid by bag for receiving a specimen to be analysed attached adjacent its open end to the form remote from an edge thereof so that there is a free area of the form not overlaid by the bag wherein a strip of adhesive is provided on said free area which may be folded against the bag to close the mouth thereof.

2. A form assembly as claimed in Claim 1 wherein the form has a fold 1'ne along which said free ,area may be folded so as ,to bring the strip of adhesive against the bag for closing the mouth thereof.

3. A form assembly as claimed in Claim 1 or 2 wherein the bag has a lip formed as an extension of the mouth of the bag, and the bag is attached to the form along the reverse side of the lip.

4. A form assembly as claimed in Claim 3 wherein said adhesive is provided along the free area of the form and aloic the front of said lip.

5. A form assembly as claimed in any one of Claims 1 to 4 wherein said adhesive is a continuous line of adhesive.

6. A form assembly as claimed in any one of Claims 1 to 5 wherein the adhesive is covered by removable protective strip which is removed prior to closure of the strip.

7. A form assembly as claimed in any one of Claims 1 to 6 where a portion of the form on which information may be recorded is readily separable from the remainder of the forn.- when the bag has been closed.

8. A form assembly as claimed in Claim 7 wherein a line of perforations are provided in so that said portion is readily separable.

9. A form assembly as claimed in any one of Claims 1 to 8 wherein the bag is of plastic material.

10. A form assembly comprising a form with a portion thereof for the recordal of information, a bag for receiving a specimen to be analysed attached adjacent its open end to the form remote from an edge thereof so that said portion of the form for recordal of information is overlaid by the bag and there is a free area of the form not overlaid by the bag, a strip of adhesive provided on said free area, a fold line extending parallel to said strip of adhesive along which said free area may be folded to bring the adhesive into contact with the bag to close the mouth thereof, and a line of weakness (eg perforation) between said fold line and said portion for recordal of information permitting the latter to be readily detached.

11. A form assembly substantially as hereinbefore described with reference to the accompanying drawings.