PORT TRANSPORT T00142757

DATE 13-Nov-19 13:25

PHARMA DELIVERY RECEIPT

CARTAGE DETAILS PRINTED BY: QUEENCY ALVAREZ
Consignor Consignee
JHUMA S. GUMAYAGAY LORENZO REYES

PTSI- NEGROS ORIENTAL CHEST CLINIC & DISPENSARY NATIONAL TUBERCULOSIS REFERENCE LABORATORY
TALAY DOH COMPOUND,
6200 DUMAGUETE FILINVEST CORPORATE CITY ALABANG
PHILIPPINES 1770 MUNTINLUPA
PHILIPPINES
Phone: 09667646053
CLIENT
PHILIPPINE BUSINESS FOR SOCIAL PROGRESS (PBSP)
PSDC BUILDING, MAGALLANES CORNER
REAL STREETS 1002 INTRAMUROS
MANILA
PHILIPPINES
Phone: +63 2 310 5658 Fax: +63 2 310 5660
GOODS DESCRIPTION ORDER NUMBERS / REFERENCE
SPECIMEN ACCESSTB

PACKAGES TYPE WEIGHT VOLUME LENGTH WIDTH HEIGHT UNDG

1 PLT 0 0 0 M

SHIPPER INSTRUCTION

SHIPPER'S PRINTED NAME SHIPPER SIGNATURE

RECEIVED BY COURIER

Printed Name: Signature: Date/Time:

No. of Boxes: Remarks:

PROOF OF DELIVERY
Please indicate below the number of packages received and if items are received in good condition and in compliance with good quality
standards.

No of Pcs. Received: Delivery Courier Name & Signature

Are the Items Received

in Good Condition? (Yes/No): Consignee's Printed Name:

Remarks: Consignee Signature: Date/Time