ANNEX G-6

PURCHASE REQUEST
GERONIMA CABRERA NATIONAL HIGH SCHOOL
Riverside, Kolambugan, Lanao del Norte

Department: PR No. ____________ Date: ________________

Section _____________________________________ SAI No. ____________ Date:________________
OS No. ________________________ Date:________________
Unit of Stock Estimated Estimated
Qty. Issue Item Description No. Unit Cost Cost
100 tabs Biogesic 0.00
50 tabs Hyoscine N-Butylbromide 0.00
50 tabs Dicycloverine 0.00
50 tabs Cetirizine 0.00
100 tabs Carbocisteine 0.00
100 cap Mefenamic Acid 250mg 0.00
50 tabs Aluminum Magnesium OH 0.00
50 tabs Salbutamol 0.00
100 tabs Neozep 0.00
100 bot Mefenamic Acid 500mg 0.00
30 tabs captopril 25mg 0.00
50 tabs Diatabs 0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

0.00

Purpose:

Requested By: Approved By:

Signature:
Printed Name VILMA V. MANGUBAT
Designation: SSP I