Republic of the Philippines MM-002-1

Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT
Fund Cluster :
Supplier : DOH DONATION IAR No.:
P.O. No.: P.O. Date: Date:
Requisitioning Office/Dept. : Invoice No.:
Responsibility Center Code : Invoice Date:
Stock /
Description Unit Quantity
Property No.
CARBAMAZEPINE 200mg TABLET TAB 1,929
LOT # S14488 EXP: 9/2020
VALPORATE DISODIUM+VALPORIC ACID 250mg TABLET TAB 2,000
LOT # 71205XP EXP: 11/2018
BIPERIDEN 2mg TABLET TAB 826
LOT # 16P750 EXP: 11/2018
CHLORPROMAZIME 200mg TABLET TAB 3,849
LOT # 06GE17T01 EXP: 12/2019
CHLORPROMAZIME 100mg TABLET TAB 2,227
LOT # 05GE16T01 EXP: 05/2020
CLOZAPINE 25mg TABLET TAB 100
LOT # B345C011 EXP: 07/2018
CLOZAPINE 100mg TABLET TAB 1,494
LOT # SCEH0028 EXP: 10/2019
HALOPERIDOL 5mg TABLET TAB 114
LOT # 24PE16T01 EXP: 5/2020
HALOPERIDOL 20mg TABLET TAB 20
LOT # ARW6B002 EXP: 7/2019
OLANZAPINE 200mg TABLET TAB 285
LOT # 327DE03 EXP: 1/2019
QUETIAPINE 200mg TABLET TAB 50
LOT # QWEH0012 EXP: 4/2019
RISPERIDONE 2mg TABLET TAB 2,690
LOT # 16R750 EXP: 12/2018
RISPERIDONE 4mg TABLET TAB 28
LOT # 16D095 EXP: 4/2018
ESCITALOPRAM 10mg TABLET TAB 60
LOT # 405AF04 EXP: 12/2018
SETRALINE 50mg TABLET TAB 119
LOT # 17B061 EXP: 2/2019
FLUPENTIXOL DECONOATE 20mg/ml, 1ml AMPULE AMP 7
LOT # 2517586 EXP: 8/2020
DOH DONATION
INSPECTION ACCEPTANCE
Date Inspected: 07/28/2017 Date Accepted: 07/28/2017
Inspected, verified and found in order X COMPLETE
as to quantity and specifications
NOLYN V. GUZMAN / MONA JANE R. EUSEBIO HAROLD C. TAMAYAO
 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT
INSPECTION COMMITTEE ADMINISTRATIVE OFFICER III
OIC - MATERIAL MANAGEMENT SECTION
ACETYLCISTEINE 200mg SACHET, FLUIMUCIL GRAN FOR SOL'N.
ACETYLCISTEINE 200mg/ml, 25ml BOT (IV INFUSION), HIDONAC
ACETYLCISTEINE 600mg EFFERVESCENT TAB, EXFLEM, SS PH
ACICLOVIR 400mg TAB, ZYCLOVIR
ADENOSINE 3mg/ml, 2ml VIAL (IV), 50mg/ml, 2ml AMP
ALENDRONATE 70mg TAB (as SODIUM SALT), ALDREN
ALLOPURINOL 300mg TAB, ALPURASE
AMIKACIN 250mcg/ml, 2ml AMP/VIAL (IM,IV) (as SO4), CINMIK
AMINOPHYLLINE 25mg/ml, 10ml AMP (IV), AINOFIL
AMIODARONE 50mg/ml, 3ml AMP (IV) (as HCl), CORDARONE INJ. 150mg
AMLODIPINE 10mg TAB (as BESYLATE), AMSAPINE
AMLODIPINE 5mg TAB (as BESYLATE or CAMSYLATE), AMSAPINE
AMOXICILLIN 250mg/5ml GRANULES/POWDER for SUSP. 60ml (as TRIHYDRATE), MOXYLOR
AMOXICILLIN 500mg/CAP (as TRIHYDRATE), HARBIMOX
AMPICILLIN 1g VIAL (IM,IV) (as SODIUM SALT), AMPITREX
AMPICILLIN 500mg VIAL (IM,IV) (as SODIUM SALT), AMPITREX
AMPICILLIN SULBACTAM (1000mg AMPI. + 500mg SULBAC.) VIAL (IM,IV), (as SODIUM SALT), AMPIMAX
AMPICILLIN SULBACTAM (500mg AMPI. + 250 SULB.) VIAL (IM,IV) (as SODIUM SALT), SILGRAM 750mg
ANTI-TETANUS SERUM (EQUINE) 1500iu/ml, 1ml AMP/VIAL (IM)
ASCORBIC ACID 500mg TAB, VITCEE
ASPIRIN 80mg TAB, ASPITOR
ATRACURIUM BESYLATE 10mg/ml, 2.5ml AMP (IV), ACURIUM
AZITHROMYCIN 500mg TAB (as BASE/as DIHYDRATE), AZEMAX
BIPERIDEN 2mg TAB (as HCL), AKETON
BLOOD TRANSFUSION SET, ORMED, CHINA
BUPIVACAINE 0.5%, 4ml/AMP (SPINAL) w/ 8 DEXTROSE (as HCl), HEAVY HOSPIRA
BUTAMIRATE CITRATE 50mg MR TAB, SINECOD SR
CALCIUM FOLINATE (LEUCOVERIN CALCIUM) 10mg/ml, 5ml AMP/VIAL (IM,IV), CAFONATE
CARBAMAZEPINE 200mg TAB, TEGREPIN
CARBOPLATIN 450mg VIAL, KEMOCARB 10mg/ml, 45ml (IV, INJ.)
CARVEDILOL 25mg TAB, KARVIL
CARVEDILOL 6.25mg TAB, KARVIL
CEFALEXIN 500mg CAP (as MONOHYDRATE), DIACEF
CEFEPIME 1g VIAL (IM,IV) (as HCl), SEFPIME
CEFEPIME 500mg VIAL (IM,IV) (as HCl), AXERA
CEFOXITIN 1g VIAL (IM,IV) (as SODIUM SALT), MONOWEL
CEFTRIAXONE 1g VIAL (as DISODIUM/ SODIUM SALT)
CEFUROXIME 750mg VIAL (IM,IV) (as SODIUM SALT)
CELECOXIB 200mg CAP, COXIDIA
CELECOXIB 400mg CAP, COXIDIA
CHLORPROMAZINE 200mg TAB (as HCl), ZYCLORAN
CIPROFLOXACIN 500mg TAB (as HYDROCHLORIDE), CIPROSAN
CLARITHROMYCIN 125mg/5ml, 70ml GRANULES/POWDER FOR SUSP., KLARYTH
CLINDAMYCIN 150mg/ml, 4ml AMP (IM,IV) (as PO4), DALACIN
CLOBETASOL CREAM 0.05%, 5g TUBE (as PROPIONATE), DERMOVATE
CLONIDINE 75mcg TAB (as HCL), CATAPIN
CLOPIDOGREL 75mg TAB, NORKLOT
CO-AMOXICLAV 625mg TAB (as TRIHYDRATE), AUGET
COBRA ANTIVENOM 800mu / 4.8ml, 1ml (for IV INFUSION)
COTRIMOXAZOLE 200mg/40mg/5ml SUSP. 60ml
CO-TRIMOXAZOLE 800mg/160mg CAP/TAB, DIAZOLE
DEXAMETHASONE 4mg/ml, 2ml AMP/VIAL (IM,IV)(as SODIUM PHOSPHATE), METACORT
DEXTROSE 10% in WATER, 500ml (D10 WATER)
DEXTROSE 5% 0.3 NaCl, 500ml (D5 0.3 NaCl)
DEXTROSE 5% BALANCE MULTIPLE MAINTENANCE SOL'n 1000ml, EUROSOL - M (D5 NM)
DEXTROSE 5% BALANCE MULTIPLE MAINTENANCE SOL'n 500ml, EUROSOL - IMB, (D5 IMB - EURO-ION)
DEXTROSE 5% BALANCE MULTIPLE REPLACEMENT SOL'n. 1000ml, EUROSOL - R (D5 NR)
DEXTROSE 5% in 0.9 NaCl 1000ml (D5 NSS)
DEXTROSE 5% in LACTATED RINGERS 1000ml (D5 LRS), GENERIC
DEXTROSE 5% in WATER 1000ml (D5 WATER 1000ml)
DEXTROSE 5% in WATER 500ml (D5 WATER 500ml)
DEXTROSE 50% in WATER 50ml (D50-50)
DEXTROSE 50% in WATER, 50ml
DICLOFENAC SODIUM 25mg/ml, 3ml (IM,IV), MEDCLOF
DIGOXIN 250mcg (0.25mg) TAB, LANOXIN
DILOXANIDE FUROATE 500mg TAB, DILFUR
DILTIAZEM 60mg TAB (as HCl), NOVOPTIN
DOBUTAMINE 12.5mg/ml, 20ml (IV) (as HCl)
DOPAMINE 200mg/250ml D5W (Pre-Mixed) (IV) (as HCl), HOSPIRA
DOXYCYCLINE 100mg/CAP (as HYCLATE)
DYDROGESTERONE 10mg/TAB, DUPHASTON
EPINEPHRINE 1:1000 1mg/ml, 1ml AMP (IM,SC) (as HYDROCHLORIDE), GENERIC
EPOETIN ALFA 4,000iu/0.4ml, PREFILLED SYRINGE IV, SC, (RECOMBINANT HUMAN ERYTHROPOETIN), RENOGENP.SYRINGE
ERYTHROMYCIN OPTHALMIC OINTMENT 0.5%, 3.5g TUBE, ERYZIN
FENTANYL 50mcg/ml, 2ml AMP (IV) (as CITRATE), HOSPIRA
FLUCONAZOLE 200mg CAP, FUNZELA
FLUOXETIN 20mg DISPERSAL TAB/CAP, DRAFZIN
FOLIC ACID 5mg TAB, FOLINC
FONDAPARINUX 2.5mg/0.5ml SOL'N (as SODIUM SALT), ARIXTRA P.SYRINGE
GABAPENTINE 300mg CAP, CALMPENT
HYDROCORTISONE 125mg/ml, 2ml VIAL (IV) (as SODIUM SUCCINATE) ACT o VIAL, SOLU-CORTEF AOV
HYDROXYZINE 25mg TABLET (As DIHYDROCHLORIDE), ITEREX
HYOSCINE 10mg TAB (as N-BUTYL BROMIDE), HYOSPAN
HYOSCINE 20mg/ml, 1ml AMP (IM,IV,SC) (as N-BUTYL BROMIDE), BUSCOPAR
HYOSCINE 5mg/5ml, 60ml SYRUP (as N-BUTYL BROMIDE), HYOSPAN
IBUPROFEN 100mg/5ml, 60ml SUSP. BOTTLE, FEVERFREE
INFUSION ADMINISTRATION SET (MACROSET), 20 Drops/ml, EURO VACOSET
INFUSION ADMINISTRATION SET (MICROSET), 60 Drops/ml, EURO VACOSET
IPRATROPIUM + SALBUTAMOL UDV 2.5ml/ UNIT DOSE, COMBIVENT UDV
ISOFLURANE 100ml BOTTLE, FLORANE
ISOSORBIDE-5-MONONITRATE 60mg TAB/CAP, VASOTRATE 60-OD
ISOXSUPRINE 10mg TAB (as HCl), DUVAL
IV CANNULA G-18 w/ WINGS and INJ. PORT, DELTA-VEN
IV CANNULA G-20 w/ WINGS & INJ. PORT, DELTA-VEN
IV CANNULA G-22 w/ WINGS & INJ. PORT, DELTA-VEN
IV CANNULA G-24 w/ WINGS & INJ. PORT, DELTA-VEN
IV CANNULA G-26 w/ WINGS & INJ. PORT, DELTA-VEN
KETAMINE HCl 50mg/ml, 10ml VIAL (IM,IV)
KETOROLAC 30mg/ml, 1ml (IM,IV) (as TROMETAMOL), KETORIGHT
LACTULOSE 3.3g/5ml (66% SYRUP), 120ml, LILAC
LEVOFLOXACIN 5mg/ml SOL'N FOR IV INFUSION, 100ml VIAL, LOXEVA
LIDOCAINE 2%, 5ml POLYAMP (as HCl), EUROCAINE
LORATIDINE 10mg TAB, RINITYN
LOSARTAN + HYDROCHLOROTHIAZIDE 100mg + 25mg TAB, CO-NORMOTEN
LOSARTAN + HYDROCHLOTOTHIAZIDE 50mg + 12.5mg TAB, LOSACAR-H
LOSARTAN 100mg TAB (as POTASSIUM SALT), LOSACAR
LOSARTAN 50mg TAB (as POTASSIUM SALT), LOSACAR
MAGNESSIUM SULFATE 250mg/ml, 20ml AMP (IM,IV) (as HEPTAHYDRATE)
MEROPENEM 1g VIAL (IV) (as TRIHYDRATE), MEROP
MEROPENEM 500mg VIAL (IV) (as TRIHYDRATE), MEPENEM
METFORMIN 500mg TAB/FILM COATED TAB (as HCl), ADIAC
METHIMAZOLE 5mg TABLET, TAPAZOLE
METHYLERGOMETRINE MALEATE 200mcg/ml, 1ml AMP (IM,IV), (as HYDROGEN MALEATE or MALEATE), UTERGIN
METOCLOPROMIDE 5mg/ml, 2ml AMP (IM,IV) (as BASE & HCl), CLOPRIMED
METRONIDAZOLE 5mg/ml, 100ml VIAL IV INFUSION, ZOLEMET
MONTELUKAST 10mg TAB (as SODIUM), MONTEZYD
MORPHINE 30mg CR TAB (as SULFATE), MST CONTINOUS MODIFIED RELEASE TAB
MOTRONIDAZOLE 5mg/ml, 100ml VIAL IN INFUSION, ZOLEMET
MUPIROCIN 2%, 5g TUBE, FOSKINA
NALBUPHINE 10mg/ml, 1ml AMP (IM,IV,SC) (as HCl), NUKAINE
NALOXONE 20mcg/ml, 2ml AMP (IM,IV,SC) (as HCl), HOSPIRA
NEOSTIGMINE 500mcg/ml, 1ml AMP (IM,IV,SC) (as METHYLSULFATE), PROSTIGMINE
NICARDIPINE 1mg/ml, 10ml AMP (IV) (as HCl), PERDIPINE
NIMODIPINE 30mg TAB, NIMOTOP
NOREPINEPHRINE 1mg/ml, 2ml AMP (IV INFUSION) (as BITARTRATE), (as SULFITE FREE), LEVOPHED, IV INFUSION
OMEPRAZOLE 20mg CAP, AZIBLOC
OMEPRAZOLE 40mg + 10ml SOLVENT AMP/VIAL (IV), OMEPRON
ONDANSETRON 2mg/ml, 4ml AMP (IM,IV), EMISTOP
PARACETAMOL 150mg/ml, 2ml (IM,IV), FEBRINIL
PARACETAMOL 500mg TAB, FEBRILE FREE
PENICILLIN G BENZATHINE (BENZATHINE BENZYL PENICILLIN) 1.2M UNITS VIAL, ZALPEN
PENICILLIN G CRYSTALLINE (BENZYLPENICILLIN) 5M "u" VL (IM,IV) (as SODIUM), HARBIPEN
PHENOBARBITAL 130mg/ml, 1ml AMP (IM,IV) (as SODIUM), LUMINAL (IM,IV,SC)
PHENYTOIN 50mg/ml, 2ml AMP (IV) (as SODIUM SALT)
PHYTOMENADIONE (PHYTONADIONE, VIT. K1) 10mg/ml, 1ml AMP (IM,IV), HEMA K
PIPERACILLIN + TAZOBACTAM (4g PIPE. + 500mg TAZO.) per VIAL (IV INFUSION), (as SODIUM SALT), PIPTAZ, SS P
PIPERACILLIN + TAZOBACTAM (4g PIPERACILLIN + 500mg TAZOBACTAM), per VIAL (IV INFUSION) (as SODIUM SALT), PIPTAZ
PLAIN LACTATED RINGER'S SOL'n 1000ml (PLRS)
PLAIN NSS 1000ml (PNSS), GENERIC
PREDNISONE 5mg TAB, PREDSONE
PROPOFOL 10mg/ml, 20ml AMP/VIAL IV (OIL in WATER EMULSION), PROFOGEN
RANITIDINE 25mg/ml, 2ml AMP (IM,IV, IV INFUSION) (as HCl), RA BLOC, ZANTOL
RISPERIDONE 2mg TAB, RISPONDZ
SALBUTAMOL 2mg/5ml, 60ml SYRUP (as SULFATE), ASMACAIRE
SAMBONG 250mg
SERTRALINE 50mg TAB (as HCl), SERENATA
SILVER SULFADIAZINE CREAM 1% 500mg JAR (MICRONIZED), SILVEDERMA
SODIUM BICARBONATE 1mEq, 50ml AMP/VIAL, IV INFUSION GENERIC
SOLUSET, 100ml, EURO
STREPTOMYCIN 1g VIAL IM (as SULFATE), STREPTOCIN
SUCRALFATE 1g TAB, ISELPIN
TAMSULOSIN 200mcg CAP/TAB (as HCl), HARNAL D 200mcg TAB
TETANUS IMMUNE GLOBULIN HUMAN (TIG) 250 "u"/ml, 2ml VIAL
TETANUS TOXOID 0.5ml AMP (IM), GENERIC
TOBRAMYCIN OPTHALMIC DROPS 0.3%, 3.5g BOTTLE, TOMRACIN
TRAMADOL 50mg CAPSULE (as HCL), GESITRAM
TRAMADOL 50mg/ml, 2ml AMP (IM,IV,SC) (as HCl), GENERIC
TRANEXAMIC ACID 100mg/ml, 5ml AMP (IM,IV), HEMOTREX
VERAPAMIL 2.5mg/ml, 2ml AMP (IV)(as HCl), ISOPTIN
WATER FOR INJECTION (TRIPPLE DISTILLED WATER), 50ml VIAL, STERILE WATER FOR INJECTION
SUXAMETHONIUM (SUCCINYL CHOLINE) 20mg/ml, 10ml VIAL IV (As Choride), QUELICIN (IM,IV)
SACHET
BOT
TAB
TAB
VIAL
TAB
TAB
AMP/VIAL
AMP
AMP
TAB
TAB
BOT
CAP
VIAL
VIAL
VIAL
VIAL
AMP/VIAL
TAB
TAB
AMP
TAB
TAB
PC
AMP
TAB
AMP/VIAL
TAB
VIAL
TAB
TAB
CAP
VIAL
VIAL
VIAL
VIAL
VIAL
CAP
CAP
TAB
TAB
BOT
AMP
TUBE
 TAB
TAB
TAB
AMP
BOT
TAB
AMP/VIAL
BOT
BOT
BOT
BOT
BOT
BOT
BOT
BOT
BOT
VIAL
VIAL
AMP
TAB
TAB
TAB
VIAL
BOT
CAP
TAB
AMP
P.SYRINGE
TUBE
AMP
CAP
CAP
TAB
P.SYRINGE
CAP
TAB
TAB
TAB
AMP
BOT
BOT
PC
PC
NEB
BOT
 TAB
TAB
PC
PC
PC
PC
PC
VIAL
AMP
BOT
VIAL
AMP
TAB
TAB
TAB
TAB
TAB
VIAL
VIAL
VIAL
TAB
TAB
AMP
AMP
VIAL
TAB
TAB
VIAL
TUBE
AMP
AMP
AMP
AMP
TAB
AMP
CAP
AMP/VIAL
AMP
AMP
TAB
VIAL
VIAL
AMP
TAB
AMP
 VIAL
VIAL
BOT
BOT
TAB
AMP/VIAL
AMP
TAB
BOT
TAB
TAB
JAR
AMP/VIAL
PC
VIAL
TAB
CAP/TAB
VIAL
AMP
BOT
CAP
AMP
AMP
AMP
VIAL
VIAL
ACETYLCISTEINE 200mg SACHET, FLUIMUCIL GRAN FOR SOL'N. METRO
AMLODIPINE 10mg TAB (as BESYLATE), AMSAPINE
AMPICILLIN 1g VIAL (IM,IV) (as SODIUM SALT), AMPITREX
AMPICILLIN 500mg VIAL (IM.IV) (as SODIUM SALT)
AMPICILLIN SULBACTAM (1000mg AMPICILLIN + 500mg SULBACTAM VIAL (IM.IV)
AMPICILLIN SULBACTAM (500mg AMPICILLIN + 250mg SULBACTAM) VIAL (IM.IV
ASPIRIN 300mg TABLET
ASPIRIN 80mg TABLET
BIPERIDEN 2mg/TABLET (as HCI)
BLEOMYCIN SULFATE 15 UNITS VIAL
BUTORPHANOL 2mg/m,l 1mL amp (IM,IV) (as TARTRATE)
CALCIUM FOLINATE (LEUCOVERIN CALCIUM) 10mg/ml, 5ml AMP/VIAL (IM,IV), CAFONATE
CARBAMAZEPINE 200mg TAB, TEGREPIN
CARVEDILOL 25mg TAB, KARVIL
CARVEDILOL 6.25mg TAB, KARVIL
CASTOR OIL USP GRADE 60mL
CEFEPIME 1g VIAL (IM,IV) (as HCl), SEFPIME
CEFEPIME 500mg VIAL (IM,IV) (as HCl), AXERA
CEFUROXIME 250mg TABLET (as AXETIL)
CELECOXIB 200mg CAPSULE
CHLORPHENIRAMINE 10mg/mL, vial (IM.IV) (as Maleate)
CIPROFLOXACIN 2mg/mL 100mL vial (as Lactate) IV INFUSION
CIPROFLOXACIN 500mg TABLET (as HYDROCHLORIDE)
CISPLATIN 50mg vial (IV)
CLARITHROMYCIN 125mg/5mL, 70mL GRANULES/POWDER FOR SUSPENSION
CLARITHROMYCIN 500mg OD MR TABLET
CLARITHROMYCIN 500mg TABLET AS BASE TAB
CLONAZEPAM 2mg TABLET
CLOPIDOGREL 75mg TABLET
CLOZAPINE 100mg TABLET
CO-AMOXICLAV 250mg/62.5mg/5mL/60mL GRANULES/POWDER FOR SUSPENSION
CO-AMOXICLAV 625mg TABLET (as Trihydrate)
COMBINED AMINO ACIDS + SORBITOL SOLUTION (IV INFUSION) 500mL BOTTLE
CO-TRIMOXAZOLE 400mg/800mg/5mL SUSPENSION 60mL
CYCLOPHOSPHAMIDE 1g vial (IV)
CYCLOPHOSPHAMIDE 500mg vial (IV)
DACARBAZINE 200mg vial
DACTINOMYCIN 500mcg vial
DEXAMETHASONE 4mg TABLET
DEXAMETHASONE 4mg/mL, 2mL amp/vial (IM,IV) (as Sodium Phosphate)
DIAZEPAM 5mg/mL, 2mL (IM,IV)
DICLOFENAC SODIUM 25mg/mL, 3mL (IM,IV)
DICLOFENAC SODIUM 50mg cap/tab (as Sodium os potassium salt)
DIGOXIN 250mcg (0.25mg) tablet
DILTIAZEM 60mg tablet (as Hydrochloride)
DIPHENHYDRAMINE HCI 50mg capsule
DIPHENHYDRAMINE HCI 50mg/Ml, 1mL amp, (IM,IV)
DOBUTAMINE 12.5mg/mL, 20mL (IV) (as HCI)
DECETAXEL 20mg/2mL, vial
DECETAXEL 80mg/8mL, vial
DOMPERIDONE 10mg tablet
DOPAMINE 200mg/250mL D5W (premixed) (IV) (as HCI)
DOXORUBICIN POWDER 10mg vial (IV) (as HCI)
DOXORUBICIN POWDER 50mg vial (IV) (as HCI)
DOXYCYCLINE 100mg/cap
EPOETIN ALPHA 4,000 iu/0.4mL, perfilled syringe (IV,SC)
ESCITALPRAM 10mg tablet (as oxalate)
ETOPOSIDE 20mg/ml, 5ml ampulE (IV)
FELODIPINE 10mg MR tablet
FENOFIBRATE 160mg tablet
FENOFIBRATE 200mg tablet
FERROUS FUMARATE TABLET 500mg (100mg elemental iron) + B-Complex
FLUCONAZOLE 150mg tablet
FLUCONAZOLE 200mg capsule
FLUCONAZOLE 2mg/ml, 100mL vial (IV infusion)
FLUOROURACIL 25mg/ml 10mL vial (IV,IV infusion)
FLUOROURACIL 50mg/ml 10mL amp/vial (IV, IV infusion)
FONDAPARINUX 2.5mg/0.5ml SOL'N (as SODIUM SALT), ARIXTRA
FUROSEMIDE 10mg/Ml 2mL amp, (IM,IV)
FUROSEMIDE 40mg tablet
GABAPENTIN 100mg capsule
GABAPENTIN 300mg capsule
GEMCITABINE 1g vial
GLIBENCLAMIDE 5mg tablet
HALOPERIDOL 5mg/ml, 1mL amp (IM)
HEPARIN STANDARD 1000IU/ml, 5mL (IV as SODIUM SALT)
HUMAN ALBUMIN 20%, 50mL
HYDROCORTISONE 125mg/ml, 2mL vial (IV) (as SODIUM SUCCINATE ) act o vail
HYDROCORTISONE 50mg/ml, 2mL vial (IV) (as SODIUM SUCCINATE ) act o vail
HYDROXYUREA 500mg tablet
HYOSCINE 20mg/mL 1mL amp (IM, IV, SC) (as N-BUTYL BROMIDE)
HYOSCINE 5mg/5mL 60mL syrup (as N-BUTYL BROMIDE)
IPRATROPIUM + SALBUTAMOL MDI X 200 DOSES
IPRATROPIUM + SALBUTAMOL UDV 2.5ML/ UNIT DOSE
ISONIAZID + RIFAMPICIN + PYRAZINAMIDE 75mg +150mg tablet
ISONIAZID + RIFAMPICIN 75mg +150mg tablet
ISONIAZID 200mg/5mL,120mL syrup
ISOSORBIDE 5- MONONITRATE 60mg MR TABLET/CAPSULE
ISOSORBIDE DINITRATE 10mg TABLET
ISOSORBIDE DINITRATE 1mg/mL 10mL amp (IV)
KETOPROFEN 100mg TABLET
KETOPROFEN 50mg/mL 2mL amp (IM)
KETOROLAC 30mg/ml 1mL (IM,IV) (as TROMETAMOL)
LACTULOSE 3.3g/5mL (66% SYRUP) 120mL BOTTLE
LEVOFLOXACIN 5mg /Ml SOLUTION FOR IV INFUSION, 100mL VIAL
LEVOFLOXACIN 750mg TABLET
LEVOTHYROXINE 50mcg/tab (as ANHYDROUS SODIUM)
LEVOTHYROXINE 100mcg/tab (as ANHYDROUS SODIUM)
LIDOCAINE HCI IN 4mg/ml 250ml D5W (PREMIXED) (IV) (as HCI)
LIDOCAINE SPRAY 10%, 50mL (as HCI)
LORATADINE 5mg/5mL SYRUP, 30mL
LOSARTAN +HYDROCHLOROTHIAZIDE 100mg + 25mg TABLET
LOSARTAN +HYDROCHLOROTHIAZIDE 50mg + 12.5mg TABLET
LOSARTAN 100mg TABLET (as POTASSIUM SALT)
MAGNESIUM SULFATE 250mg/ml, 20mL amp (IM,IV) (as HEPTAHYDRATE)
MANNITOL 20% 500mL BOTTLE (IV)
MEBENDAZOLE 100mg/ml SUSPENSION 30mL
MEBENDAZOLE 500mg/ml TABLET/ CHEWABLE TABLET
MECOBALAMINE 500mcg/ml ampule (IM,IV)
MEDROXYPROGESTERONE ACETATE 5mg TABLET
MEFENAMIC ACID 250mg CAP/TAB
MEFENAMIC ACID 500mg CAP/TAB
MEROPENEM 1g VIAL (IV) (as TRIHYDRATE)
METFORMIN 500mg tab/fil COATED TAB (as HCI)
METHIMAZOLE 5mg TABLET
METHROTREXATE 25mg/ml 2mL amp/vial (IM,IV, INTRATHECAL) (as BASE)
METHYLDOPA 250mg TABLET
METHYLERGOMETRINE MALEATE 125mcg tablet (as HYDROGEN MALEATE OR MALEATE
METHYLERGOMETRINE MALEATE 200mcg/ml, 1mL amp (IM,IV) tablet (as HYDROGEN MALEATE OR MALEATE
METHYLPREDNISOLONE 125mg/ml, 2mL vial + diluent vial (IM,IV) IV INFUSION (as SODIUM)
METHYLPREDNISOLONE 16mg tablet
METOCLOPRAMIDE 5mg/ml, 2mL (IM,IV) (as BASE & HCI)
METROPOLOL 100mg tablet (as TARTRATE)
METRONIDAZOLE 125mg base/5mL SUSPENSION 60mL
METRONIDAZOLE 500mg TABLET
METRONIDAZOLE 5mg/Ml ,100mL vial IV INFUSION
MIDAZOLAM 5mg/ml, 3mL amp (IM,IV)
MONTELUKAST 10mg tablet (as SODIUM)
NALBUPHIINE 10mg/ml amp (IM,IV,SC) (as HCI)
NEOSTIGMINE 500mcg/ml,1mL AMPULE (IM,IV,SC) (as METHYLSULFATE)
NICARDIPINE 1mg/ml, 10mL amp (IV) (as HCI)
NIFEDIPINE 30mg MR TABLET
NIMODIPINE 30mg TABLET
NYSTATIN 100,000 "u"/ml, 30mL SUSPENSION
OFLOXACIN 0.3%, 5mL BOTTLE EYEDROPS SOLUTION
OFLOXACIN 2mg/ml, 100mL vial (IV INFUSION)
OFLOXACIN 400mg TABLET
OFLOXACIN OPTHALMIC DROP 0.3%, 5mL BOTTLE SOLUTION
OMEPRAZOLE 20mg CAPSULE
OMEPRAZOLE 40mg + 10mL SOLVENT amp/vial (IV)
ONDANSETRON 2mg/ml, 4mL AMPULE (IM,IV)
OSELTAMIVIR 75mg CAPSULE (as PHOSPHATE)
OXANTEL PYRANTEL (100mg OXANTEL + 100mg PYRANTEL) 5mL SUSPENSION 10mL (as EMBO)
PACLITAXEL 100mg vial
PACLITAXEL 30mg vial
PARACETAMOL 150mg/ml, 2mL (IM,IV)
PHENOXYMETHYL PENICILLIN (PENICILLIN IV) 250mg/5mL GRANULES/POWDER SUSP. 60
PHENYTOIN 100mg CAPSULE (as SODIUM SALT)
PHENYTOIN 500mg/ml, 2mL amp (IV) (as SODIUM SALT)
PNEUMOCOCCAL VACCINE
POTASSIUM 750mg DURULES (APPROX, EQUIV. TO 10 mEq)
POTASSIUM CHLORIDE 2mEq/ml, 20mL vial (IV INFUSION)
PREDNISOLONE EYE DROPS SUSPENSION 0.5%, 5mL (as ACETATE)
PREDNISONE 10mg/5mL SUSPENSION, 60mL
PRIMAQUINE 15mg BASE TAB (as DIPHOSPHATE)
PROPHYLTHIOURACIL 50mg TABLET
PROPOFOL 10mg/ml, 20mL amp/vial IV (OIL IN WATER EMULTION)
PROPANOLOL 10mg TABLET (as HCI)
PROPANOLOL 40mg TABLET (as HCI)
PYRAZINAMIDE 250mg/5mL,120mL SUSPENSION BOTTLE
QUININE 300mg/ml, 1mL AMPULE IV (as diHCI)
QUININE SULFATE 300mg (325) TABLET (as SULFATE)
RABBIES VACCINE (0.5% OF 4% SODIUM CHLORIDE) AMPULE
RANITIDINE 150mg TABLET (as HCI)
RANITIDINE 25mg/ml, 2mL amp (IM,IV,IV INFUSION) (as HCI)
RANITIDINE 300mg TABLET (as HCI)
RIFAMPICIN 200mg/5mL SUSPENSION 120mL BOTTLE
RISPERIDONE 2mg TABLET
ROPIVACAINE 7.5mg/ml, 10mL AMPULE (IV)
ROSIGLITAZONE 4mg TABLET (as MALEATE)
SALBUTAMOL MDI 100mcg/dose x 200 doses (as SO4)
SALBUTAMOL NEBULES 2mg/ml, 2.5mL (UNIT DOSE) (as SULFATE)
SETRALINE 50mg TABLET (as HCI)
SEVOFLURANE 250mL BOTTLE
SIMVASTATIN 20mg TABLET
SIMVASTATIN 40mg TABLET
SODIUM BICARBONATE 1mEq/ml, 50mL amp/vial (IV INFUSION)
SOMASTATIN 250mcg/amp (IV, IV INFUSION)
SOMASTATIN 3mg amp/vial (IV, IV INFUSION)
SPIRONOLACTONE 100mg TABLET
SPIRONOLACTONE 50mg TABLET
SUCRALFATE 1g TABLET
SULFADOXINE / PYRIMETHAMINE 500mg/25mg TABLET
TAMOXIFEN 20mg TABLET (as CITRATE)
TOBRAMYCIN OPTHALMIC OINTMENT 0.3%, 3.5g TUBE
TRAMADOL 50mg CAPSULE (as HCI)
TRAMADOL 50mg/ml, 2mL AMPULE (IM,IV,SC) (as HCI)
VALPROATE DISODIUM/ VALPROIC ACID 250mg/tab (as DISODIUM SALT OR VALPROIC)
VANCOMYCIN 500mg vial (IV) (as HCI)
VERAPAMIL 180mg TABLET (as HYDROCHLORIDE)
VERAPAMIL 2.5mg/ml, 2mL AMPULE (IV) (as HYDROCHLORIDE)
VERAPAMIL 240mg TABLET (as HYDROCHLORIDE)
VINBLASTIN 10mg/10ml
VINCRISTINE 1mg/1mL vial (IV) (as SULFATE)
VINCRISTINE 2mg/2mL vial (IV) (as SULFATE)
VITAMIN B COMPLEX 100mg + 100mg + 1mg per 3mL AMPULE (IV)
WARFARIN 2.5mg TABLET
ZINC 10mg/ml DROPS
ZINC 20mg/5mL SYRUP
DEXTROSE 5% 0.3 NaCI 500mL
DEXTROSE 5% BALANCE MULTIPLE MAINT. SOLUTION 500mL
DEXTROSE 5% IN WATER 1000mL
PLAIN NSS 1000mL
WATER FOR INJECTION (TRIPLE DISTILLED WATER) 50mL vial
BLOOD TRANSFUSION SET
SOLUSET
IV CANNULA G18
IV CANNULA G20
OR MALEATE
 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT

Fund Cluster : BUSINESS TYPE INCOME
Supplier : METRO DRUG, INC. IAR No.: DM-17-150
P.O. No.: 2017-07-0492 P.O. Date: 07/03/2017 Date:
Requisitioning Office/Dept. : PHARMACY Invoice No.: 1001927336, 1001927212
Responsibility Center Code : Invoice Date: 07/26/2017
Stock /
Description Unit Quantity
Property No.
AZITHROMYCIN 500mg TAB (as BASE/as DIHYDRATE), AZEMAX TAB 1,998
LOT # 7A098A EXP: 01/31/2019
DOMPERIDONE 10mg TABLET, TORDON TAB 2,000
LOT # B227C003 EXP: 7/31/2019
ISOSORBIDE-5-MONONITRATE 60mg TAB/CAP, VASOTRATE 60-OD TAB 1,470
LOT # BQ68D002 EXP: 12/31/2019
LEVOFLOXACIN 5mg/ml SOL'N FOR IV INFUSION, 100ml VIAL, LOXEVA TAB 300
LOT # TCLT7-018 EXP: 9/30/2018
**************************************

INSPECTION ACCEPTANCE
Date Inspected: 07/31/2017 Date Accepted: 07/31/2017

Inspected, verified and found in order X INCOMPLETE

as to quantity and specifications
Partial (pls. specify quantity)

UNDELIVERED: BISACODYL 5mg PEDIATRIC SUPPOSITORY, DULCULAX 1500 SUPP.

GLICLAZIDE 30mg MR TABLET, AZUKON MR 500 TAB

IPRATROPIUM+SALBUTAMOL 60mg MR TABLET/CAPSULE, VASOTRATE 60-0D 3000 NEB

NOLYN V. GUZMAN / MONA JANE R. EUSEBIO HAROLD C. TAMAYAO

INSPECTION COMMITTEE ADMINISTRATIVE OFFICER III
 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT

OIC - MATERIAL MANAGEMENT SECTION
 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT

Fund Cluster : BUSINESS TYPE INCOME
Supplier : METRO DRUG, INC. IAR No.: DM-17-186
P.O. No.: 2017-08-0683 P.O. Date: 08/09/2017 Date:
Requisitioning Office/Dept. : PHARMACY Invoice No.: 1001964079, 1001962129
Responsibility Center Code : Invoice Date: 08/26/2017
Stock /
Description Unit Quantity
Property No.
ACETYLCISTEINE 200mg SACHET, FLUIMUCIL GRAN FOR SOL'N. SACHET 480
LOT # 346976 EXP: 10/31/2019
AZITHROMYCIN 500mg TAB (as BASE/as DIHYDRATE), AZEMAX TAB 999
LOT # 7A09BA EXP: 01/31/2019
LEVOFLOXACIN 5mg/ml SOL'N FOR IV INFUSION, 100ml VIAL, LOXEVA VIAL 50
LOT # C167604 EXP: 9/30/2018
LOSARTAN 50mg TAB (as POTASSIUM SALT), LOSACAR TAB 980
LOT # M700534 EXP; 12/31/2017
CHLORPROMAZINE 200mg TAB (as HCl), ZYCLORAN TAB 15,000
LT # 160550 EXP: 5/31/2017
***************************************

INSPECTION ACCEPTANCE
Date Inspected: 08/30/2017 Date Accepted: 08/30/2017

Inspected, verified and found in order X INCOMPLETE

as to quantity and specifications
Partial (pls. specify quantity)

UNDELIVERED:IPRATROPIUM + SALBUTAMOL UDV 2.5ml/ UNIT DOSE, COMBIVENT UDV (3,000 TAB)

NOLYN V. GUZMAN / MONA JANE R. EUSEBIO HAROLD C. TAMAYAO

INSPECTION COMMITTEE ADMINISTRATIVE OFFICER III
OIC - MATERIAL MANAGEMENT SECTION
 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT

Fund Cluster : BUSINESS TYPE INCOME
Supplier : EURO-MED LABORATORIES IAR No.: DM-17-198
P.O. No.: 2017-07-0535 P.O. Date: 07/13/2017 Date:
Requisitioning Office/Dept. : PHARMACY Invoice No.: SA020041
Responsibility Center Code : Invoice Date: 09/25/2017
Stock /
Description Unit Quantity
Property No.
DEXTROSE 5% in WATER 500ml BOT 4,800
LOT # 0120124 EXP: 07/2022
*****************************************

INSPECTION ACCEPTANCE
Date Inspected: 09/26/2017 Date Accepted: 09/26/2017

Inspected, verified and found in order X INCOMPLETE

as to quantity and specifications
Partial (pls. specify quantity)
UNDELIVERED:METOCLOPROMIDE 5mg/ml 120 AMP 500 AMP

DEXTROSE 50% in WATER, 50ml 1240 VIAL

WATER FOR INJECTION (TRIPPLE DISTILLED WATER), 50ml VIAL 2000 VIAL

NOLYN V. GUZMAN / MONA JANE R. EUSEBIO HAROLD C. TAMAYAO

INSPECTION COMMITTEE ADMINISTRATIVE OFFICER III
OIC - MATERIAL MANAGEMENT SECTION
 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT

Fund Cluster : BUSINESS TYPE INCOME
Supplier : PHIL PHARMAWEALTH, INC. IAR No.: DM-17-252
P.O. No.: 2017-10-0786 P.O. Date: 10/02/2017 Date:
Requisitioning Office/Dept. : PHARMACY Invoice No.: 43210
Responsibility Center Code : Invoice Date: 10/28/2017
Stock /
Description Unit Quantity
Property No.
DEXTROSE 5% in LACTATED RINGERS 1000ml (D5 LRS), GENERIC BOT 600
LOT # 17012022, 17012321 EXP: 12/2019
PENICILLIN G CRYSTALLINE (BENZYLPENICILLIN) 5M "u" VL (IM,IV) (as BOT
500
SODIUM), HARBIPEN
LOT # 160311501, 160311501 EXP: 3/2019
*************************************

INSPECTION ACCEPTANCE
Date Inspected: 10/30/2017 Date Accepted: 10/30/2017

Inspected, verified and found in order X INCOMPLETE

Partial (pls. specify quantity)

UNDELIVERED:ACICLOVIR 400mg TAB, ZYCLOVIR ( 500 TAB)

AMIKACIN 250mcg/ml, 2ml AMP/VIAL (IM,IV) (as SO4), CINMIK ( 500 AMP)
DEXTROSE 5% in LACTATED RINGERS 1000ml (D5 LRS), GENERIC ( 1,800 BOT)
EPINEPHRINE 1:1000 1mg/ml, 1ml AMP (IM,SC) (as HYDROCHLORIDE), GENERIC ( 1, 992 AMP)

MEROPENEM 500mg VIAL (IV) (as TRIHYDRATE), MEPENEM (410 VIAL)

NOLYN V. GUZMAN / MONA JANE R. EUSEBIO HAROLD C. TAMAYAO

 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT

INSPECTION COMMITTEE ADMINISTRATIVE OFFICER III
OIC - MATERIAL MANAGEMENT SECTION
 Republic of the Philippines MM-002-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan

MATERIAL MANAGEMENT SECTION

INSPECTION AND ACCEPTANCE REPORT

Fund Cluster : BUSINESS TYPE INCOME
Supplier : ZUELLIG PHARMA CORPORATION-MULTICARE IAR No.: DM-17-257
P.O. No.: 2017-10-0885 P.O. Date: 10/20/2017 Date:
Requisitioning Office/Dept. : PHARMACY Invoice No.: 1034471516
Responsibility Center Code : Invoice Date: 10/27/2017
Stock /
Description
Property No.
Ofloxacin 0.3%, 5ml ear drops solution, DIZOFLOX ( 30 DROPS 30
LOT # 7C18A1 EXP: 09/30/2019
Ofloxacin Ophthalmic Drop 0.3%, 5ml solution, DIZOFLOX ( 50 DROPS) DROPS 50
LOT # 6A30A1 EXP: 06/30/2019
Tobramycin Ophthalmic drops 0.3%, 3.5g, MYTOCIN ( 50 BOT) BOT 50
LOT # 7A48A1 EXP: 02/28/2019

******************************************

INSPECTION ACCEPTANCE
Date Inspected: 11/03/2017 Date Accepted: 11/03/2017

Inspected, verified and found in order X INCOMPLETE

as to quantity and specifications
Partial (pls. specify quantity)
UNDELIVERED:Dacarbazine 200mg, ARZI-200 ( 50 VIAL)
Prednisolone eye drops suspension 0.5%,5ml(as acetate), VENPRED ( 50 BOT)
Salbutamol 2mg/ml, 2.5ml (unit dose) (as Sulfate), PROVEXEL ( 3,000 NEB)

NOLYN V. GUZMAN / MONA JANE R. EUSEBIO HAROLD C. TAMAYAO

INSPECTION COMMITTEE ADMINISTRATIVE OFFICER III
OIC - MATERIAL MANAGEMENT SECTION