Sample characterization request form for Confocal Raman Microscope

Fields marked with * are required Submission Guidelines

Sample Details:

Sample Name* Sample Constitution/Composition*
No of samples* Usage hours (if known)
Sample State*

Measurement Details: Sample requirement guideline Measurement Type* :

Raman Spectra:

Wavenumber range* : Excitation Laser* :
Power* : (Up To 25mW-0.1%, 1%, 10%, 25%, 50%, 100%)
Acquisition Time (If known in sec ) : Accumulation (If known in cycles) :
Raman Spectra with Mapping:

Spectral Lines to be mapped : No. of Points :

Mode of data delivery : email

Samples are to be returned* : Are you coming in person?* :
If Yes & Samples to be sent by post, Charges Rs 70 will be extra
Any other Information

I hereby declare that above information is correct to my knowledge and no further claim shall be made other than the above mentioned. I also declare that the samples submitted or their by-products obtained during the measurement are not toxic / inflammable/radioactive/ biologically hazardous. Samples are liable to be destroyed /disposed off after measurements and if to be returned, they have to be collected in person.

I agree to acknowledge the facility If the data are used in publications or thesis in the format, ‘CeNS, Bangalore is acknowledged for providing Confocal Raman Microscope’.

I have read the Submission Guidelines & Sample requirement guidelines

User Details:
User Category* Contact No*
User Name* Email*
Designation* Signature*
Official Address* Address for Receipt
(Billing Address)*