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  • Rhu Matalam Rhu Matalam

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    queen aleianah libatique
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    WALANG LABEL

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    3 views2 pages

    Rhu Matalam Rhu Matalam

    Uploaded by

    queen aleianah libatique

    Copyright:

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

    DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH

    CENTER FOR HEALTH DEVELOPMENT CENTER FOR HEALTH DEVELOPMENT


    SOCCSKARGEN REGION SOCCSKARGEN REGION
    RHU MATALAM RHU MATALAM
    DEPARTMENT OF HEALTH
    CENTER FOR HEALTH DEVELOPMENT GENERIC NAME/ BRAND:________________________ GENERIC NAME/ BRAND:________________________
    SOCCSKARGEN REGION LOT/BATCH NUMBER:__________________________ LOT/BATCH NUMBER:__________________________
    RHU MATALAM EXPIRY DATE:_________________________________ EXPIRY DATE:_________________________________
    DATE COLLECTED:_____________________________ DATE COLLECTED:_____________________________
    GENERIC NAME/ BRAND:________________________ TYPE OF WASTE: ________EMPTY VIALS___________ TYPE OF WASTE: ________EMPTY VIALS___________
    LOT/BATCH NUMBER:__________________________ QUANTITY: ___________20 EMPTY VIALS__________ QUANTITY: ___________20 EMPTY VIALS__________
    EXPIRY DATE:_________________________________
    DATE COLLECTED:_____________________________ VALIDATED BY: VALIDATED BY:
    TYPE OF WASTE: ________EMPTY VIALS___________ NAME & SIGNATURE: ALEIAH JEAN L. LIBATIQUE, RPh_ NAME & SIGNATURE: ALEIAH JEAN L. LIBATIQUE, RPh_
    QUANTITY: ___________20 EMPTY VIALS__________ DESIGNATION: _______DOH- PHARMACIST II_______ DESIGNATION: _______DOH- PHARMACIST II_______
    DATE SIGNED:________________________________ DATE SIGNED:________________________________
    VALIDATED BY:
    NAME & SIGNATURE: ALEIAH JEAN L. LIBATIQUE, RPh_
    DESIGNATION: _______DOH- PHARMACIST II_______
    DATE SIGNED:________________________________

    DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH


    CENTER FOR HEALTH DEVELOPMENT CENTER FOR HEALTH DEVELOPMENT CENTER FOR HEALTH DEVELOPMENT
    SOCCSKARGEN REGION SOCCSKARGEN REGION SOCCSKARGEN REGION
    RHU MATALAM RHU MATALAM RHU MATALAM

    GENERIC NAME/ BRAND:________________________ GENERIC NAME/ BRAND:________________________ GENERIC NAME/ BRAND:________________________


    LOT/BATCH NUMBER:__________________________ LOT/BATCH NUMBER:__________________________ LOT/BATCH NUMBER:__________________________
    EXPIRY DATE:_________________________________ EXPIRY DATE:_________________________________ EXPIRY DATE:_________________________________
    DATE COLLECTED:_____________________________ DATE COLLECTED:_____________________________ DATE COLLECTED:_____________________________
    TYPE OF WASTE: ________EMPTY VIALS___________ TYPE OF WASTE: ________EMPTY VIALS___________ TYPE OF WASTE: ________EMPTY VIALS___________
    QUANTITY: ___________20 EMPTY VIALS__________ QUANTITY: ___________20 EMPTY VIALS__________ QUANTITY: ___________20 EMPTY VIALS__________

    VALIDATED BY: VALIDATED BY: VALIDATED BY:


    NAME & SIGNATURE: ALEIAH JEAN L. LIBATIQUE, RPh_ NAME & SIGNATURE: ALEIAH JEAN L. LIBATIQUE, RPh_ NAME & SIGNATURE: ALEIAH JEAN L. LIBATIQUE, RPh_
    DESIGNATION: _______DOH- PHARMACIST II_______ DESIGNATION: _______DOH- PHARMACIST II_______ DESIGNATION: _______DOH- PHARMACIST II_______
    DATE SIGNED:________________________________ DATE SIGNED:________________________________ DATE SIGNED:________________________________

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