Professional Documents
Culture Documents
REQUEST:
Supply Requisition pc 0.75
Job Order Form pc 0.75
Central Service pc 0.5 100 300
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 100 400
Stock Unit Beg. DELIVERIES
January 2019 Unit
Level Cost Bal. 1st 2nd 3rd 4th 5th
OR Schedule pc 0.5
Report on Gas Use pc 0.5 110
X-Ray Request pc 0.75 300
Returned Meds. Supplies pc 0.5 500
ECG Request pc 0.5 200
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5 200
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 100 200
Prohibited/Regulated Drugs pc 0.5 500
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
ROD's Report pc 0.75
NURSING UNIT FORMS:
Kardex pc 1.5 50 110
Assignment Sheet pc 1.5 50
Record on Gas Use pc 0.5 110
Discharge Checklist pc 1.5 150
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 300
Diet List pc 1.5 200
Evaluation Form pc 0.75 20
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 100 300
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 50 300
blue pc 0.5
orange pc 0.5
yellow pc 0.5 10
pink pc 0.5
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 100 300
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5 10
Orange Card Big (treatment) pc 0.5 240
White Card Big (OF) pc 0.5
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66 1
Scrubbing pad pc 22.65 1
Bottle Brush pc 33.65 1
Vinegar gallon 23.93
Alcohol ml 47 1
Approved By:
100 50 75.00
200
160
50
110
150 150 225.00
10 10 5.00
400
10 10 5.00
240
2 2 12.00
1 4 20.00
2 2 80.00
2 2 70.00
2 3 75.00
-1 1 -30.00 30.00
2 1 120.00
2 2 120.00
4 4 240.00
1 1 20.66
1 1 22.65
1 1 33.65
1 1 47.00
Total: 123.96
Total Cost of Total Cost of
Used Supplies End Balance
REQUEST:
Supply Requisition pc 0.75
Job Order Form pc 0.75
Central Service pc 0.5 200
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 400 300 500
Stock Unit Beg. DELIVERIES
February 2019 Unit
Level Cost Bal. 1st 2nd 3rd 4th 5th
OR Schedule pc 0.5
Report on Gas Use pc 0.5 60
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 300
ECG Request pc 0.5
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 200 300 300
Prohibited/Regulated Drugs pc 0.5 300
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
ROD's Report pc 0.75
NURSING UNIT FORMS:
Kardex pc 1.5
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 400 500
Diet List pc 1.5
Evaluation Form pc 0.75
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 400 200
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 50 300
blue pc 0.5 200
orange pc 0.5 200
yellow pc 0.5
pink pc 0.5 200
green pc 0.5 200
Oral Meds. Ticket, short white pc 0.5 400 500
blue pc 0.5 200
yellow pc 0.5 200
pink pc 0.5 200
green pc 0.5 100 300
Orange Card Big (treatment) pc 0.5 180
White Card Big (OF) pc 0.5 180
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6 1
Albatross pc 20.66 1
Scrubbing pad pc 22.65 1
Bottle Brush pc 33.65 1
Vinegar gallon 23.93
Alcohol ml 47 1 1
Approved By:
500 750.00
50 50 75.00
400
60
50 37.50
300 300 150.00
150 75.00
6 2 4 12.00 24.00
6 3 3 15.00 15.00
4 3 1 120.00 40.00
1 1 50.00
6 3 105.00
7 2 50.00
1 1 30.00
3 2 1 240.00 120.00
4 3 1 180.00 60.00
8 8 480.00
1 1 41.60
1 1 20.66
1 1 22.65
1 1 33.65
2 2 94.00
Total: 212.56
Total Cost of Total Cost of
Used Supplies End Balance
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75 50
Blue pc 0.75 50
White pc 0.75
Linen Request pc 0.5
Stock Unit Beg. DELIVERIES Total No. of
March 2019 Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 200 200
Report on Gas Use pc 0.5
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5
ECG Request pc 0.5
Page 1
MARCH
Medical Specialty Unit Rt. Form pc 0.75 50 50
Osteorized Feeding Request pc 0.5
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5
Prohibited/Regulated Drugs pc 0.5 100 100
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75 150 150
Professional Fee pc 0.5
Diet List pc 1.5
Evaluation Form pc 0.75
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 250 250
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5
blue pc 0.5
orange pc 0.5 500 500
yellow pc 0.5
pink pc 0.5 200 200
green pc 0.5 50 50
Oral Meds. Ticket, short white pc 0.5
blue pc 0.5 10 10
yellow pc 0.5
pink pc 0.5
green pc 0.5 100 100
Orange Card Big (treatment) pc 0.5
White Card Big (OF) pc 0.5
Page 2
MARCH
AAA pc 60
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66
Scrubbing pad pc 22.65
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47
Gra
Approved By:
Page 3
MARCH
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
150 225.00
150 225.00
200 150.00
Page 4
MARCH
50 25.00
100 75.00
200 100.00
50 25.00
-200 200 -100.00 100.00
-200 200 -100.00 100.00
-2 2 -12.00 12.00
2 10.00
3 105.00
-1 2 -25.00 50.00
2 240.00
2 120.00
Page 5
MARCH
-2 2 -120.00 120.00
1 41.60
1 20.66
Page 6
APRIL
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 100 100
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 200 300 500 1000
Page 7
APRIL
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 500 400 500 1400
Prohibited/Regulated Drugs pc 0.5 200 200
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 200 200 400
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 50 100 150
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 50 400 500 950
Diet List pc 1.5
Evaluation Form pc 0.75 100 100
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 400 300 700
Blood Component Ticket pc 0.5 50 50
IV Meds. Ticket, long White pc 0.5 150 200 350
blue pc 0.5
orange pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 100 300 300 700
blue pc 0.5 30 30
yellow pc 0.5
pink pc 0.5
green pc 0.5 50 50
Orange Card Big (treatment) pc 0.5 200 60 260
White Card Big (OF) pc 0.5 200 200
Page 8
APRIL
AAA pc 60 2 3 8 13
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66 1 1 1 3
Scrubbing pad pc 22.65 1 1 2
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47 1 1 2
Gra
Approved By:
Page 9
APRIL
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
150 225.00
75 112.50
600 100 900.00 150.00
180 20 270.00 30.00
700 200 1,050.00 300.00
100 150.00
200 150.00
100 150.00
100 150.00
100 150.00
80 120.00
300 150.00
100 75.00
100 75.00
1000 500.00
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 25.00
400 100 200.00 50.00
Page 10
APRIL
200 150.00
50 25.00
200 100.00
400 200.00
200 100.00
150 225.00
700 350.00
100 50.00
5 30.00
4 160.00
1 50.00
2 2 70.00 70.00
1 25.00
2 240.00
Page 11
APRIL
13 780.00
3 61.98
1 1 22.65 22.65
2 94.00
Page 12
MAY
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 300 300 200 800
Laboratory Request pink pc 0.75 100 100
Yellow pc 0.75 100 100
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 500 200 700
Stock Unit Beg. DELIVERIES Total No. of
May 2018 Unit
Level Cost Bal. st
1 2nd
3rd 4th 5th Supplies
OR Schedule pc 0.5 50 50
Report on Gas Use pc 0.5 100 300 200 600
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 100 300 200 600
ECG Request pc 0.5
Page 13
MAY
Medical Specialty Unit Rt. Form pc 0.75 200 200
Osteorized Feeding Request pc 0.5 50 300 300 650
In Patient Prescription pc 0.5 200 200
Out Patient Prescription pc 0.5 600 200 800
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 150 150
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 300 200 500
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 100 100
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 100 300 400
Diet List pc 1.5 300 300
Evaluation Form pc 0.75 150 150
Daily Work Sheet pc 0.75 200 200
TICKETS:
IVF Ticket pc 0.5 600 300 300 1200
Blood Component Ticket pc 0.5 100 100
IV Meds. Ticket, long White pc 0.5 200 200 400
blue pc 0.5 50 200 250
orange pc 0.5 200 200
yellow pc 0.5 300 300
pink pc 0.5 100 100
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 200 200
blue pc 0.5 200 200
yellow pc 0.5 100 100
pink pc 0.5 200 200
green pc 0.5
Orange Card Big (treatment) pc 0.5 100 180 280
White Card Big (OF) pc 0.5 100 100 200
Page 14
MAY
AAA pc 60 4 4
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 41.6
Albatross pc 20.66 1 1 2
Scrubbing pad pc 22.65 1 1 1 3
Bottle Brush pc 33.65 1 1 2
Vinegar gallon 23.93
Alcohol ml 47
Carbon Paper pc 2
Gra
Approved By:
Page 15
MAY
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
140 210.00
75 112.50
200 300.00
40 60.00
50 75.00
150 225.00
100 150.00
90 135.00
300 225.00
80 120.00
75 112.50
70 105.00
70 105.00
Page 16
MAY
100 100 75.00 75.00
625 25 312.50 12.50
250 125.00
700 100 350.00 50.00
40 20.00
2 1 12.00 6.00
1 5.00
1 1 40.00 40.00
1 50.00
6 210.00
2 50.00
1 120.00
1 30.00
2 120.00
Page 17
MAY
4 240.00
2 41.32
3 67.95
2 67.30
Total: 176.57
Page 18
JUNE
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 100 100
Laboratory Request pink pc 0.75 70 70
Yellow pc 0.75 80 80
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 100 100
Stock Unit Beg. DELIVERIES Total No. of
June 2019 Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 40 40
Report on Gas Use pc 0.5 60 60
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 200 200
ECG Request pc 0.5 100 100
Page 19
JUNE
Medical Specialty Unit Rt. Form pc 0.75 100 100
Osteorized Feeding Request pc 0.5 25 25
In Patient Prescription pc 0.5 250 250
Out Patient Prescription pc 0.5 100 100
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 100 100
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 200 200
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 40 40
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 300 300
Diet List pc 1.5 300 300
Evaluation Form pc 0.75 60 60
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 300 300
Blood Component Ticket pc 0.5 25 25
IV Meds. Ticket, long White pc 0.5 100 100
blue pc 0.5 60 60
orange pc 0.5 300 300
yellow pc 0.5 290 290
pink pc 0.5 50 50
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 100 100
blue pc 0.5 100 100
yellow pc 0.5 60 60
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5 50 50
White Card Big (OF) pc 0.5 40 40
Page 20
JUNE
AAA pc 60
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66
Scrubbing pad pc 22.65
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47
Gra
Approved By:
Page 21
JUNE
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
100 150.00
50 75.00
100 100 150.00 150.00
30 45.00
5 45 7.50 67.50
50 50 75.00 75.00
80 120.00
150 112.50
70 105.00
60 90.00
60 90.00
60 90.00
50 50 25.00 25.00
70 50 52.50 37.50
50 37.50
60 40 30.00 20.00
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
10 30 5.00 15.00
20 10.00
Page 22
JUNE
50 37.50
-75 100 -37.50 50.00
100 150 50.00 75.00
-100 200 -50.00 100.00
45 67.50
20 10.00
30 20 15.00 10.00
20 20 10.00 10.00
1 6.00
-1 2 -5.00 10.00
1 40.00
1 50.00
-3 3 -105.00 105.00
-1 1 -25.00 25.00
Page 23
JUNE
-135.00 236.00
-1 1 -33.65 33.65
Page 24
JULY
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 50 500 550
Laboratory Request pink pc 0.75 50 50
Yellow pc 0.75 50 50
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 40 500 540
Stock Unit Beg. DELIVERIES Total No. of
July 2019 Unit
Level Cost Bal. st
1 nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 30 30
Report on Gas Use pc 0.5 20 20
X-Ray Request pc 0.75 500 500
Returned Meds. Supplies pc 0.5 100 500 600
ECG Request pc 0.5 100 100
Page 25
JULY
Medical Specialty Unit Rt. Form pc 0.75 50 300 350
Osteorized Feeding Request pc 0.5 100 100
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5 200 500 700
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 45 45
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 20 500 520
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 20 20
Discharge Checklist pc 1.5 400 400
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 450 500 950
Diet List pc 1.5 600 500 1100
Evaluation Form pc 0.75 40 40
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 50 500 500 1050
Blood Component Ticket pc 0.5 5 300 305
IV Meds. Ticket, long White pc 0.5 200 500 700
blue pc 0.5 30 300 330
orange pc 0.5 150 200 350
yellow pc 0.5 190 200 390
pink pc 0.5 25 300 200 525
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 150 500 650
blue pc 0.5 50 300 350
yellow pc 0.5 60 100 160
pink pc 0.5 100 100
green pc 0.5 100 100
Orange Card Big (treatment) pc 0.5 20 500 520
White Card Big (OF) pc 0.5 20 300 320
Page 26
JULY
AAA pc 60 4 4 8
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6
Albatross pc 20.66 1 1
Scrubbing pad pc 22.65 1 1
Bottle Brush pc 33.65 1 1 2
Vinegar gallon 23.93
Alcohol ml 47 2 2
Gra
Approved By:
Page 27
JULY
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 75.00
20 30.00
500 100 750.00 150.00
500 750.00
500 100 750.00 150.00
200 300.00
100 150.00
600 900.00
500 750.00
35 52.50
15 22.50
150 225.00
20 50 30.00 75.00
30 45.00
20 30.00
350 525.00
50 75.00
300 450.00
Page 28
JULY
20 15.00
95 5 47.50 2.50
150 75.00
650 50 325.00 25.00
15 22.50
80 40.00
1 4 6.00 24.00
3 2 15.00 10.00
3 2 120.00 80.00
1 50.00
3 120.00
6 1 210.00 35.00
4 1 100.00 25.00
1 30.00
1 120.00
6 360.00
Page 29
JULY
8 480.00
1,321.00 464.00
1 75.00
1 20.66
1 22.65
1 1 33.65 33.65
2 94.00
Page 30
AUGUST
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 50 800 200 1050
Laboratory Request pink pc 0.75 25 500 525
Yellow pc 0.75 20 600 620
Green pc 0.75
Blue pc 0.75 100 100
White pc 0.75
Linen Request pc 0.5 150 500 400 1050
Stock Unit Beg. DELIVERIES Total No. of
August 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 10 10
Report on Gas Use pc 0.5 15 500 200 715
X-Ray Request pc 0.75 300 300
Returned Meds. Supplies pc 0.5 100 500 400 1000
ECG Request pc 0.5 100 100 200
Page 31
AUGUST
Medical Specialty Unit Rt. Form pc 0.75 20 600 620
Osteorized Feeding Request pc 0.5 5 300 305
In Patient Prescription pc 0.5 150 300 450
Out Patient Prescription pc 0.5 50 400 500 950
Prohibited/Regulated Drugs pc 0.5 300 300
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 15 100 300 415
Pedia pc 1.5 300 350 650
NURSING UNIT FORMS:
Kardex pc 1.5 50 500 200 750
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 80 80
Discharge Checklist pc 1.5 400 400
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 200 400 500 1100
Diet List pc 1.5 150 350 500 1000
Evaluation Form pc 0.75 10 10
Daily Work Sheet pc 0.75 100 100
TICKETS:
IVF Ticket pc 0.5 150 300 200 650
Blood Component Ticket pc 0.5 5 600 605
IV Meds. Ticket, long White pc 0.5 40 300 400 740
blue pc 0.5 30 200 200 430
orange pc 0.5 150 150
yellow pc 0.5 100 100
pink pc 0.5 15 15
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 150 500 500 1150
blue pc 0.5
yellow pc 0.5 30 30
pink pc 0.5
green pc 0.5 200 200
Orange Card Big (treatment) pc 0.5 100 800 240 1140
White Card Big (OF) pc 0.5 15 800 180 15
Page 32
AUGUST
AAA pc 60 4 4
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6 2 2
Albatross pc 20.66 1 1
Scrubbing pad pc 22.65 1 1 2
Bottle Brush pc 33.65 1 1
Vinegar gallon 23.93
Alcohol ml 47 1 1
Gra
Approved By:
Page 33
AUGUST
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
350 525.00
75 112.50
500 750.00
200 300.00
35 52.50
200 300.00
100 75.00
50 75.00
10 15.00
10 15.00
100 150.00
40 60.00
200 300.00
100 75.00
Page 34
AUGUST
10 7.50
105 200 52.50 100.00
300 150 150.00 75.00
800 150 400.00 75.00
300 150.00
80 120.00
50 75.00
50 25.00
400 600.00
600 300.00
455 150 227.50 75.00
240 500 120.00 250.00
200 100.00
100 50.00
100 50.00
300 150.00
3 4 18.00 24.00
3 15.00
2 3 80.00 120.00
1 50.00
4 3 140.00 105.00
3 2 75.00 50.00
1 30.00
1 120.00
4 240.00
Page 35
AUGUST
4 240.00
993.00 314.00
1 75.00
-1 2 -20.66 41.32
1 1 22.65 22.65
1 33.65
Page 36
SEPTEMBER
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 100 100
Laboratory Request pink pc 0.75 10 10
Yellow pc 0.75 15 15
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 250 400 300 950
Stock Unit Beg. DELIVERIES Total No. of
September 201 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
OR Schedule pc 0.5 50 50
Report on Gas Use pc 0.5 70 70
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 100 300 400
ECG Request pc 0.5
Page 37
SEPTEMBER
Medical Specialty Unit Rt. Form pc 0.75 10 10
Osteorized Feeding Request pc 0.5 200 200
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5 150 500 300 950
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 80 80
Pedia pc 1.5 50 50
NURSING UNIT FORMS:
Kardex pc 1.5 100 100
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 50 50
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 200 400 500 1100
Diet List pc 1.5 150 150
Evaluation Form pc 0.75 10 10
Daily Work Sheet pc 0.75 100 100
TICKETS:
IVF Ticket pc 0.5 600 600
Blood Component Ticket pc 0.5 150 300 200 650
IV Meds. Ticket, long pc 0.5 500 200 100 800
blue pc 0.5 200 100 300
orange pc 0.5 100 100 200 400
yellow pc 0.5 100 300 400
pink pc 0.5 300 300
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 400 200 300 900
blue pc 0.5 200 100 300
yellow pc 0.5 10 100 110
pink pc 0.5 350 350
green pc 0.5
Orange Card Big (treatment) pc 0.5 240 180 420
White Card Big (OF) pc 0.5 10 180 190
Page 38
SEPTEMBER
AAA pc 60 16 16
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66 2 2
Scrubbing pad pc 22.65 1 1
Bottle Brush pc 33.65 1 1 2
Vinegar gallon 23.93
Alcohol ml 47
Gra
Prepared By: Approved By:
Page 39
SEPTEMBER
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 75.00
5 7.50
-50 250 -75.00 375.00
500 50 750.00 75.00
450 150 225.00
35 52.50
100 75.00
40 60.00
40 60 20.00 30.00
10 7.50
15 11.25
Page 40
SEPTEMBER
10 7.50
200 100.00
150 75.00
600 350 300.00 175.00
50 25.00
80 120.00
50 75.00
50 50 75.00 75.00
50 25.00
-1 5 -6.00 30.00
2 1 10.00 5.00
1 2 40.00 80.00
2 3 70.00 105.00
3 1 75.00 25.00
Page 41
SEPTEMBER
16 960.00
1,149.00 245.00
-1 1 -75.00 75.00
-1 1 -41.60 41.60
1 1 20.66 20.66
1 22.65
2 67.30
Page 42
OCTOBER
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 60 100 160
Laboratory Request pink pc 0.75 10 10
Yellow pc 0.75 15 15
Green pc 0.75
Blue pc 0.75 40 40
White pc 0.75
Linen Request pc 0.5 150 500 100 750
Stock Unit Beg. DELIVERIES Total No. of
October 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 300 300
Report on Gas Use pc 0.5 50 50
X-Ray Request pc 0.75 100 100
Returned Meds. Supplies pc 0.5 45 300 345
ECG Request pc 0.5
Page 43
OCTOBER
Medical Specialty Unit Rt. Form pc 0.75 300 300
Osteorized Feeding Request pc 0.5 200 200
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5 350 500 200 1050
Prohibited/Regulated Drugs pc 0.5 50 50
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 50 50
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 500 100 600
Discharge Checklist pc 1.5 150 150
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 300 300
Diet List pc 1.5 150 150
Evaluation Form pc 0.75 80 80
Daily Work Sheet pc 0.75 70 100 170
TICKETS:
IVF Ticket pc 0.5 250 300 200 750
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 200 300 500
blue pc 0.5
orange pc 0.5
yellow pc 0.5
pink pc 0.5 10 10
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 250 300 200 750
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5 50 240 290
White Card Big (OF) pc 0.5 300 300
Page 44
OCTOBER
AAA pc 60 16 16
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6 1 1
Albatross pc 20.66 1 1
Scrubbing pad pc 22.65 1 1 2
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47 1 1
Gra
Prepared By: Approved By:
Page 45
OCTOBER
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 75.00
100 150.00
-180 180 -270.00 270.00
50 50 37.50 37.50
40 30.00
Page 46
OCTOBER
300 225.00
150 50 75.00 25.00
50 100 25.00 50.00
800 250 400.00 125.00
50 25.00
1 4 6.00 24.00
1 5.00
-1 3 -40.00 120.00
4 2 140.00 70.00
2 2 50.00 50.00
1 30.00
Page 47
OCTOBER
14 2 840.00 120.00
1,026.00 389.00
1 75.00
1 41.60
-1 2 -20.66 41.32
2 45.30
-1 1 -33.65 33.65
1 47.00
Page 48
NOVEMBER
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 35 35
Laboratory Request pink pc 0.75 50 50
Yellow pc 0.75 15 15
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 150 500 650
Stock Unit Beg. DELIVERIES Total No. of
November 2019 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
OR Schedule pc 0.5
Report on Gas Use pc 0.5 75 75
X-Ray Request pc 0.75 75 75
Returned Meds. Supplies pc 0.5 50 50
ECG Request pc 0.5
Page 49
NOVEMBER
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5 50 50
In Patient Prescription pc 0.5 100 100
Out Patient Prescription pc 0.5 250 500 750
Prohibited/Regulated Drugs pc 0.5 50 50
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 100 100
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 30 30
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 200 400 600
Diet List pc 1.5 150 150
Evaluation Form pc 0.75 80 80
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 300 400 700
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 200 200
blue pc 0.5 50 50
orange pc 0.5
yellow pc 0.5
pink pc 0.5 50 50
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 250 400 650
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5 80 300 380
White Card Big (OF) pc 0.5 50 50
Page 50
NOVEMBER
AAA pc 60 2 4 6
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6
Albatross pc 20.66 2 2
Scrubbing pad pc 22.65 2 2
Bottle Brush pc 33.65 1 1
Vinegar gallon 23.93
Alcohol ml 47 1 1 2
Gra
Prepared By: Approved By:
Page 51
NOVEMBER
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 75.00
100 150.00
-5 80 -7.50 120.00
100 150.00
180 270.00
160 240.00
120 180.00
25 50 12.50 25.00
25 50 18.75 37.50
-50 100 -25.00 50.00
Page 52
NOVEMBER
50 25.00
100 50.00
725 25 362.50 12.50
50 25.00
100 150.00
30 15.00
50 25.00
380 190.00
50 25.00
4 2 24.00 12.00
1 5.00
4 160.00
2 2 70.00 70.00
3 1 75.00 25.00
Page 53
NOVEMBER
4 2 240.00 120.00
569.00 232.00
1 75.00
-11 11 -457.60 457.60
2 41.32
2 45.30
1 33.65
2 94.00
Page 54
DECEMBER
REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 50 50
Laboratory Request pink pc 0.75
Yellow pc 0.75 1 1
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 50 300 350
Stock Unit Beg. DELIVERIES Total No. of
December 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5
Report on Gas Use pc 0.5 50 50
X-Ray Request pc 0.75 50 50
Returned Meds. Supplies pc 0.5 100 100
ECG Request pc 0.5
Page 55
DECEMBER
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5 50 50
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 25 300 325
Prohibited/Regulated Drugs pc 0.5 50 50
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 100 100
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 120 300 420
Diet List pc 1.5 120 120
Evaluation Form pc 0.75 15 15
Daily Work Sheet pc 0.75
TICKETS:
IVF Ticket pc 0.5 200 300 500
Blood Component Ticket pc 0.5 50 50
IV Meds. Ticket, long White pc 0.5 300 300
blue pc 0.5 20 20
orange pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 150 300 450
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5
White Card Big (OF) pc 0.5
Page 56
DECEMBER
AAA pc 60 2 2
Clear Book(for Directory)
HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6 11 11
Albatross pc 20.66
Scrubbing pad pc 22.65
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47
Gra
Prepared By: Approved By:
Page 57
DECEMBER
eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 75.00
80 120.00
120 90.00
50 25.00
1 0.75
Page 58
DECEMBER
50 25.00
75 25 112.50 37.50
1 6.00
-2 2 -10.00 10.00
1 2 40.00 80.00
4 160.00
3 105.00
1 120.00
-2 4 -120.00 240.00
Page 59
DECEMBER
1 2 60.00 120.00
361.00 450.00
1 75.00
11 457.60
-3 3 -67.95 67.95
-3 3 -100.95 100.95
-1 1 -47.00 47.00
Page 60