ANNEX B Republic of the Philippines DEPARTMENT OF HEALTH NATIONAL CENTER PHARMACEUTICAL ACCESS AND MANAGEMENT RHU DRUG UTILIZATION/STOCKS

INVENTORY REPORT For the DOH Complete Treatment Pack Program

Name of RHU: RHU I BUGALLON Address: POBLACION BUGALLON PANGASINAN Number of DOH QUANTITY ON HAND (A) 239 287 280 8 14 15 45 9 65 4 9 287 0 80 Delivery Date 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 Quantity Delivered (Packs)(B) 240 287 287 3 8 5 43 5 34 2 5 155 66 97 TOTAL (A+B) Compacks Dispensed (per month) April May June 1 2 0 40 0 0 6 19 0 0 0 3 0 0 0 0 0 0 0 0 0 0 2 0 0 14 0 0 0 0 0 0 0 17 24 3 0 0 0 3 7 2

Medicines ASPIRIN 80 MG TAB HCTZ 25 MG TAB METROPOLOL 50 MG TAB ERYTHROMYCIN 500 MG TAB LAGUNDI 300 MG TAB SAMBONG 250 MG TAB AMOXICILLIN 500 MG TAB CIPROFLOXACIN 500 MG TAB COTRIMOXAZOLE 800 MG TAB DOXYCYCLINE 100 MG CAP METRONIDAZOLE 500 MG TAB AMLODIPINE 10 MG TAB GLIBENCLAMIDE 5 MG TAB SIMVASTATIN 20 MG TAB

479 574 567 11 22 20 88 14 99 6 14 442 66 177

ANNEX B Republic of the Philippines DEPARTMENT OF HEALTH NATIONAL CENTER PHARMACEUTICAL ACCESS AND MANAGEMENT RHU DRUG UTILIZATION/STOCKS INVENTORY REPORT For the DOH Complete Treatment Pack Program

Name of RHU: RHU I BUGALLON Address: POBLACION BUGALLON PANGASINAN Number of DOH Compacks Dispensed (per month) April May June 0 1 0 0 0 0 0 0 8 0 4 7 0 0 0 11 4 0 0 0 0 6 4 4 5 4 6 0 0 0 0 1 3 0 0 0

Medicines AMOXICILLIN 250 MG SUSP COTRIMOXAZOLE 400 MG SUSP CLOXACILLIN 125 MG SYRUP CLOXACILLIN 500 MG TAB MEBENDAZOLE 30 ML COTRIMOXAZOLE 200 MG SUSP GLICLAZIDE 80 MG TAB METFORMIN 500 MG TAB LOSARTAN 50 MG TAB SALBUTAMOL INHALER ENALAPRIL 10 MG TAB MEBENDAZOLE 500 MG TAB Prepared by: CARLO GIORGIO CEREZO R.N NAME/DESIGNATION

Quantity On Hand (A) 60 24 45 9 32 15 153 145 75 15 264 16

Delivery Date 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013

Quantity Delivered (Packs)(B) 23 11 43 15 16 24 76 310 45 8 275 15 Noted by:

Total (A+B) 83 35 88 24 48 39 229 455 120 23 539 31

DR.JOSE-ISIDRO V. RICO MHO

MENT

Year: 2013 Quarter: 2nd

Region: 1 Total Number of DOH ComPacks Dispensed 3 40 25 3 0 0 0 2 14 0 0 44 0 12 End of Quarter Stocks 476 534 542 8 22 20 88 12 85 6 14 398 66 165

MENT

Year: 2013 Quarter: 2nd

Region: 1 Total Number of DOH ComPacks Dispensed 1 0 8 11 0 15 0 14 15 0 4 0 Approved by: JUMEL ANTHONY ESPINO MUNICIPAL MAYOR

End of Quarter Stocks 82 35 80 13 48 24 229 441 105 23 535 31