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CLINIC REQUEST FORM

3/10/2017

DESCRIPTION QTY DATE NEEDED MUST REPLENISH EVERY MONTH


Medicine
Alaxan 10 38
Bonamine 10 47 RED - OUT OF STOCK
Bioflu 20 41
Carbocistein 20 47
Clonidine 150 mg 0 90
Ceterizine 5 37
Loratadine 5 40
Loperamide 5 50
Hyoscine ( Buscopan) 5 20
Gaviscon sachet 5 17
Kremil-S 5 37
Motilium 10mg 5 49
Mefenamic acid 9 PCS ASAP 10 31
Neozep forte 20 103
Serc 24mg 0 21
Sinecod forte 5 43
Salbutalmol 2mg 0 13
Strepsils 2 sachets ASAP 6 11
Paracetamol 100 ASAP 20 12 12
Ventolin Nebules 1mg 10 ASAP 0 0
Others
salonpas 5 sachets ASAP 5
Bed sheet 1
Pillow case 1
blanket 1
Brown bag (small for bag breathing)
Nebulizer kit
ADDITIONAL REQUESTS:
Serc 8 mg 10 PCS *as dicussed
Calmoseptine cream 3 sachets *as observed we have cases of allergies (ITCHINESS) that can't relieved immediately by tablets. This cream a
Hot/cold compress 2 *most of the bags are missing. Employees who borrowed it did not even return.
ately by tablets. This cream aids the itchiness in just only a short period of time.

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