Doc. No.

:
Rev. No.:
Date:
Page:

First Aid Kit Inspection List

First Aid Kit Reference Number: ____________________________________

Location of First Aid Kit: _________________________________________

Sr 2018
First Aid Item
.# Jan Feb March Apr May June July Aug Sep Oct Nov Dec
Gauze pads (at least 4 x 4
1
inches)

Two large gauze pads (at least 8

2
x 10 inches)

Box adhesive bandages (band-

3
aids)/ Box Saniplast bandages

One package gauze roller

4
bandage at least 2 inches wide

5 Two triangular bandages

Wound cleaning agent such as

6 sealed moistened towelettes/
Pyodine

7 Scissor

9 Tweezer

10 Adhesive tape

11 Latex gloves

Resuscitation equipment such as

12 resuscitation bag, airway, or N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
pocket mask

13 Two elastic wraps/ Crepe

bandage

14 Splint

Signature

Inspected By