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  • Asset Requisition Form

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    athira
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    The asset requisition form requests additional equipment for the radiology department, including a double power socket, data point, and telephone point. It is signed by the head of department, Dr. Nawal Al Hamar. The document must be approved by various departments before the assets can be procured.

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    The asset requisition form requests additional equipment for the radiology department, including a double power socket, data point, and telephone point. It is signed by the head of department, Dr. Nawal Al Hamar. The document must be approved by various departments before the assets can be procured.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    38 views5 pages

    Asset Requisition Form

    Uploaded by

    athira
    The asset requisition form requests additional equipment for the radiology department, including a double power socket, data point, and telephone point. It is signed by the head of department, Dr. Nawal Al Hamar. The document must be approved by various departments before the assets can be procured.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 5

    ASSET REQUISITION FORM

    Date: _05/04/2018____________ Department:__Radiology_____________


    Ref No: ____________

    New/Additional/
    Item No. existing Requested
    Sr# Asset name & Description Replacement
    Code Unit(s) Unit(s) (N/A/R)

    1 Double Power Socket 1 Additional


    2 Data Point 1 Additional
    3 Telephone point 1 Additional

    REQUESTED BY:_______ Saji Mathew Head of Depart Dr. Nawal Al Hamar

    Biomedical/Engineering Dept: ____________________ CEO: __________________________


    Approval
    Brand specification if any Justification for requirement Remarks Status -
    Yes/No (Y/N)

    for reporting system


    for reporting system
    for reporting system

    Finance: _________________

    HMC: __________________________ BOD: __________________________


    ASSET REQUISITION FORM
    Date: _12/06/2018____________ Department:__Radiology_____________
    Ref No: ____________

    New/Addi Brand
    Item No. existing Requested tional/Rep specific Justification for
    Sr# Asset name & Description Remarks
    Code Unit(s) Unit(s) lacement ation if requirement
    (N/A/R) any
    1 Steel Kidney tray 4 new For biopsy Urgent
    2 Thump Forceps 4 new For biopsy Urgent
    3 Sterile probe cover 4 new For biopsy Urgent
    4 Skin Marker 2 new For biopsy Urgent
    5 Small Steel bowl 8 new For biopsy Urgent
    6 Sterile cotton drape with hole 4 new For biopsy Urgent
    7 Ice Pack 10 new For biopsy Urgent

    REQUESTED BY:_ Saji Mathew Head of Depart Dr. Nawal Al Hamar Finance: _________________

    Biomedical/Engineering Dept: ________________CEO: __________________________ HMC: __ BOD: __________________________


    Approval
    Status -
    Yes/No (Y/N)

    _____________
    ASSET REQUISITION FORM
    Date : 27.09.18 Department:__Radiology_____________
    Ref No: ____________

    Request New/Additional/R Brand Approval


    Item No. existing specifica Status -
    Sr# Code Asset name & Description Unit(s) ed eplacement tion if Justification for requirement Remarks Yes/No
    Unit(s) (N/A/R)
    any (Y/N)

    Drinking Water -1.5 Liters Bottle 0 50Bottles New any CT oral contrast mixing. Urgent
    Sterile Gloves 6.5 0 50 New any Radiology Procedure Urgent
    Slippers 0 2 sets New any For MRI Patients Urgent
    Hangers 0 2 Dozen New any For Radiology Patients Dress Change Urgent
    Steel spoon medium 0 2 nos New any For Barium Power Mixing. Urgent
    Fiber Trolly 1 New any For MRI Room Urgent
    Fiber chair 0 12 Nos New any For patient Urgent

    REQUESTED BY: :Saji M Mathew HOD :Dr. Nawal Al Hamar Finance: _________________

    Biomedical/Engineering Dept: __________________CEO: __________________________ HMC: ____BOD: __________________________

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