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  • I T E M S: Storage/Dispensing Requisition and Issue Slip

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    Karl Angelo Montano
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    This document is a requisition and issue slip from the Central Sterile Supply Department of the Southern Philippines Medical Center. It tracks stock levels and consumption of medical items in wards and clinics, and is used to request additional quantities of specific items and record the items dispensed, along with details of the requesting party, dispensing personnel, and receiving party.

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    10 SPMC-F-CSSD-10 revised

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    This document is a requisition and issue slip from the Central Sterile Supply Department of the Southern Philippines Medical Center. It tracks stock levels and consumption of medical items in wards and clinics, and is used to request additional quantities of specific items and record the items dispensed, along with details of the requesting party, dispensing personnel, and receiving party.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    13 views2 pages

    I T E M S: Storage/Dispensing Requisition and Issue Slip

    Uploaded by

    Karl Angelo Montano
    This document is a requisition and issue slip from the Central Sterile Supply Department of the Southern Philippines Medical Center. It tracks stock levels and consumption of medical items in wards and clinics, and is used to request additional quantities of specific items and record the items dispensed, along with details of the requesting party, dispensing personnel, and receiving party.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Southern Philippines Medical Center

    Central Sterile Suppy Department


    STORAGE/DISPENSING REQUISITION AND ISSUE SLIP

    Ward/Clinic:__________________________

    STOCK BALANCE REQUESTED


    I T E M S UNIT
    LEVEL
    CONSUMPTION
    ON HAND
    QUANTITY
    (end of 24 hrs.)

    Requested by: _________________________ Dispensed By: _________________________


    Print Name & Signature CSSD Personnel
    Designation: _____________________ Time Started: ________________
    Date/Time : _____________________ Time Ended : ________________
    Date: ________________
    SPMC-F-CSSD-10 EFFECTIVITY: Febuary 1, 2017
    P

    Date:________________________
    Type of supply stock
    RIS NO. :
    QUANTITY W-ward stock (weekly

    48-72 hrs (MWF)


    ISSUED REMARKS
    E-Emergency

    Received by:____________________________________
    Print Name & Signature
    Designation: _____________________
    Date/Time : _____________________

    REV. 1

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