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Republic of the Philippines

DEPARTMENT OF HEALTH
ZAMBOANGA PENINSULA - CENTER FOR HEALTH DEVELOPMENT
Upper Calarian, Zamboanga City 7000
Phone : (062) 983-0314, (062) 983-0146, Fax : (062) 991-3380
Email : dohchdzp@yahoo.com, Web : www.doh.gov.ph

REQUISITION AND ISSUE SLIP


Appendix 63
Entity Name : DOH-ROIX Fund Cluster : _________________

Division : _______________________________________________ Responsibility Center Code : _________________


Office : ________________________________________________ RIS No. : ________________________________
Requisition Stock Available? Issue
Stock No. Unit Item's complete descriptions QTY YES NO Unit Cost Total

0.00

0.00
Purpose:

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


Signature :
Printed Name : JOSE NOEL F. TORRES
Designation : Administrative Officer V
Date :
b4-jnft/bml ISO 9001:2015 CERTIFIED QUALITY MANAGEMENT SYSTEM
Shall be filled up by the requesting office or personnel to be approved by his/her Division Chief
Shall be filled up by Supply Section

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