‫‪National Drug Agency‬‬ ‫އ ެ‬

‫ޖނސް‬ ‫ރގް ޭ‬
‫ނލް ޑ ަ‬
‫ޝ ަ‬ ‫ނ ަ‬
‫ޭ‬
‫’‪K. Male‬‬ ‫ކ‪ާ .‬މ ެް‬
‫ލ‬
‫‪Maldives‬‬ ‫ރއ ެ‬
‫ޖް‬ ‫ިދ ެވ ިހ ާ‬

‫ނނ ަ‬
‫ބރ‪434-A/434/2017/3224:‬‬ ‫ަ‬

‫ާތރޚް‪16/11/2017:‬‬

‫ދޭ ފޯމް ‪01 -‬‬

‫ނން ެއ ް‬
‫ދ ަގނ ަ‬
‫ުމ ާް‬
‫‪Purchase Request Form - 01‬‬

‫‪ަ 3‬މ ުހް‬

‫ނންވާ‬
‫ބ ު‬
‫ޭ‬ ‫ޓް‬
‫ކ‬ ‫ސ ޮ‬ ‫ެއ ުދ ު‬
‫ން‬ ‫ދޭ ފ ޯް‬
‫މ‬ ‫ބ ަގ ުތ ަމށް ެއ ް‬ ‫ުމ ާް‬
‫ދ ިލ ި‬
‫ަތފސލް‬ ‫ރ ުވ ު‬
‫ން‬ ‫ން ުކ ެ‬
‫ނ ު‬
‫ބ ު‬
‫ޭ‬ ‫ނންވާ ާތރޙް‬
‫ބ ު‬
‫ޭ‬
‫ދ ުދް‬
‫ައ ަ‬ ‫ާ‬
‫ބކް‬ ‫ސކ ަ‬
‫ޝން‬ ‫ެ‬ ‫ނނ ަ‬
‫ބރ‬ ‫ަ‬
‫ދ ުދް‬
‫ައ ަ‬
‫‪Last 3‬‬
‫‪Quantity‬‬ ‫‪Quantity‬‬ ‫‪Requested‬‬ ‫‪Goods Requisition‬‬
‫‪Description‬‬ ‫‪Months‬‬ ‫‪Required Date‬‬
‫‪Required‬‬ ‫‪in stock‬‬ ‫‪Department‬‬ ‫‪Form No.‬‬
‫‪Usage‬‬

‫‪25‬‬ ‫ދ) ަ‬
‫ރން ‪A1‬‬ ‫ދސް ( ިވ ާް‬
‫ރ ާ‬
‫ސލް ަކ ު‬
‫ރ ަ‬
‫ޕާ ި‬ ‫ައ ިް‬
‫އ‪.‬ޓް‬
‫‪5‬‬ ‫ބޑް ( ެފ ިް‬
‫ހ) ‪A1‬‬ ‫ފޯމް ޯ‬ ‫އ‪.‬ޓް‬‫ައ ިް‬
‫‪01‬‬ ‫ނނ ަ‬
‫ބރ‬ ‫މ ‪ަ 20 -‬‬ ‫ހަް‬ ‫ަކނ ާވ ުް‬
‫ރ ިް‬ ‫ައ ިް‬
‫އ‪.‬ޓް‬
‫ޅ ފ ޮ ިތ ަގނުްޑ ( ފޓް)‬ ‫ަކ ުް‬ ‫އ‪.‬ޓް‬‫ައ ިް‬
‫‪25‬‬ ‫ނބ – ޭް‬
‫އ‪3‬‬ ‫ދ ުް‬ ‫ގ ިލ ަޓރ ޕ ޭ ަޕރ – ަ‬ ‫ައ ިް‬
‫އ‪.‬ޓް‬
‫‪5‬‬ ‫ރޕް ޕ ޭ ަޕރ ‪ެ -‬އ ިކ ުކ ަް‬
‫ލ‬ ‫ކ ެ‬ ‫އ‪.‬ޓް‬‫ައ ިް‬
‫‪100‬‬ ‫ސޓ ިފ ެކޓް ޕ ޭ ަޕރ‬ ‫ެ‬ ‫ައ ިް‬
‫އ‪.‬ޓް‬
‫‪5‬‬ ‫ޓް‬
‫ކ‬ ‫ލސ ި‬ ‫ޅ‪-‬ގ ޫ‬ ‫ރސް ުފ ިް‬‫ެތ ަ‬ ‫ައ ިް‬
‫އ‪.‬ޓް‬
‫‪15‬‬ ‫ޓކް ‪ެ 7‬އމް‪ެ .‬އމް‬
‫ލ ަގން ސ ި‬
‫ގ ޫ‬ ‫ައ ިް‬
‫އ‪.‬ޓް‬
‫ދ ު‬
‫ނބް – ‪10‬‬ ‫މ ަ‬
‫ރލް ިހަް‬
‫ބން ޯ‬
‫ރ ަ‬
‫ި‬
‫‪3‬‬ ‫ައ ިް‬
‫އ‪.‬ޓް‬
‫ެއމް‪ެ .‬އް‬
‫މ‬

‫ނނާްވ ަތ ެކ ިތް‬
‫ބ ު‬
‫ދ ުލ ުވ ަމށް ޭ‬
‫ބއ ަ‬
‫ބއްވ ޭ ަ‬
‫ރ ަމށް ޭ‬
‫އ ުކ ު‬
‫ރ ިވ ުް‬
‫ސއ ަކތް ި‬
‫ރ ަތފސލް ‪ަ : Remarks /‬މ ަ‬
‫ިއ ުތ ުް‬

‫އ ‪Sign /‬‬ ‫ޮ‬

‫ސ ިް‬ ‫ާތރޙް ‪Date /‬‬ ‫ަމ ާ‬
‫ޤމް ‪Designation /‬‬ ‫ަ‬
‫ނން ‪Name /‬‬

‫ކމ ިޕ ުއ ަޓރ‬
‫ނ ައރ ޮ‬
‫ސ ި‬
‫ދﷲ ަ‬
‫ޔމން‬ ‫ައބ ުް‬ ‫ދ ެ‬
‫ދއިްވ ‪Authorized By /‬‬ ‫ުހއ ަ‬
‫ރ ަމރ‬
‫ރގ ާ‬
‫ޕ ޮ‬

‫ްް‬ ‫‪+960 3312018‬‬ ‫ް‬ ‫‪+960 3328184‬‬ ‫‪info@nda.gov.mv‬‬ ‫‪www.nda.gov.mv‬‬