REQUEST AND ISSUE SLIP (RIS)

BCMDDC

LGU Office Responsibility Center Code RIS No. Date :

BCMDDC 4411 SAI No. Date :

REQUISITION ISSUANCE
Stock No. Unit DESCRIPTION QTY. QTY. Remarks

***nothing follows***
Purpose

Requested by: Approved by: Issued by: Received by:

DR. JEROME B. PROFETANA ROWEL L. BATHAN

MEDICAL OFFICER V PROPERTY CUSTODIAN
Date: Date: Date: Date:
 REQUEST AND ISSUE SLIP (RIS)
BCMDDC

LGU Office Responsibility Center Code RIS No. Date :

BCMDDC 4411 SAI No. Date :

REQUISITION ISSUANCE
Stock No. Unit DESCRIPTION QTY. QTY. Remarks

Purpose:

Requested by: Approved by: Issued by: Received by:

_______________________ __DR. JEROME B. PROFETANA__ __JOMAR ARVIN T. CANTERO__ _________________________

MEDICAL OFFICER V PROPERTY CUSTODIAN
Date: / / Date: / / Date: / / Date: / /