ANNEX B Republic of the Philippines DEPARTMENT OF HEALTH NATIONAL CENTER PHARMACEUTICAL ACCESS AND MANAGEMENT RHU DRUG UTILIZATION/STOCKS

INVENTORY REPORT For the DOH Complete Treatment Pack Program

Name of RHU: RHU II BUGALLON Address: MAGTAKING BUGALLON PANGASINAN Number of DOH QUANTITY ON HAND (A) 144 144 235 3 18 8 45 0 0 2 0 268 0 180 Delivery Date Quantity Delivered (Packs)(B) 0 0 135 4 8 5 22 3 34 2 4 156 70 18 TOTAL (A+B) Compacks Dispensed (per month) April May June 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 5 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 1 0 0

Medicines ASPIRIN 80 MG TAB HCTZ 25 MG TAB METROPOLOL 50 MG TAB ERYTHROMYCIN 500 MG TAB LAGUNDI 300 MG TAB SAMBONG 250 MG TAB AMOXICILLIN 500 MG TAB CIPROFLOXACIN 500 MG TAB COTRIMOXAZOLE 800 MG TAB DOXYCYCLINE 100 MG CAP METRONIDAZOLE 500 MG TAB AMLODIPINE 10 MG TAB GLIBENCLAMIDE 5 MG TAB SIMVASTATIN 20 MG TAB

5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013

144 144 370 7 26 13 67 3 34 4 4 424 70 198

ANNEX B Republic of the Philippines DEPARTMENT OF HEALTH NATIONAL CENTER PHARMACEUTICAL ACCESS AND MANAGEMENT RHU DRUG UTILIZATION/STOCKS INVENTORY REPORT For the DOH Complete Treatment Pack Program

Name of RHU: RHU II BUGALLON Address: MAGTAKING BUGALLON PANGASINAN Number of DOH Compacks Dispensed (per month) April May June 12 10 14 3 4 6 5 0 7 0 3 4 0 0 0 4 5 3 2 2 0 0 2 2 5 5 6 0 1 1 0 0 0 0 0 0

Medicines AMOXICILLIN 250 MG SUSP COTRIMOXAZOLE 400 MG SUSP CLOXACILLIN 125 MG SYRUP CLOXACILLIN 500 MG TAB MEBENDAZOLE 30 ML COTRIMOXAZOLE 200 MG SUSP GLICLAZIDE 80 MG TAB METFORMIN 500 MG TAB LOSARTAN 50 MG TAB SALBUTAMOL INHALER ENALAPRIL 10 MG TAB MEBENDAZOLE 500 MG TAB Prepared by: HANJO T. MEJIA R.N NAME/DESIGNATION

Quantity On Hand (A) 152 27 70 0 30 25 144 279 55 27 259 30

Delivery Date 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013 5/21/2013

Quantity Delivered (Packs)(B) 43 17 43 15 16 24 77 300 45 0 0 0 Noted by:

Total (A+B) 195 44 113 15 46 49 221 579 100 27 259 30

DR.JOSE-ISIDRO V.RICO MHO

MENT

Year: 2013 Quarter: 2nd

Region: 1 Total Number of DOH ComPacks Dispensed 0 0 0 0 0 0 13 0 0 0 0 3 0 1 End of Quarter Stocks 144 144 370 7 26 13 54 3 34 4 4 421 70 197

MENT

Year: 2013 Quarter: 2nd

Region: 1 Total Number of DOH ComPacks Dispensed 36 13 12 7 0 12 4 4 16 2 0 0 Approved by: JUMEL ANTHONY ESPINO MUNICIPAL MAYOR

End of Quarter Stocks 159 31 101 8 46 37 217 575 84 25 259 30