NAI ZINDAGI GLOBAL FUND ROUND 9 COPY 1 R.I.V.

No:

REQUISITION AND ISSUE VOUCHER (RIV)

City: Organization:
S/No. Items Required Item Code 003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 34 35 Strength Consumption for last month (Last 30 Days) Stock in Hand

Date Submitted: Date Required:

New Demand Approved Quantity Issued Quantity Batch Number Expiry Date Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Syringes Syringes Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large)
Bacitracin Zinc - Neomycin Sulfate

5cc 3cc Male latex 150-175 syringe capacity (Approx.) 20-19mm x 72mm 70% Isopropyl Alcohol 5cm x 3m 10cm x 3m 15cm x 3m 10g 300gm 50ml 2.5cmx3.5m 450ml 60ml (15cm x15cm x 8ply) (10cm x 10cm x 8 Ply) 15ml HIV/RDT Diagnostic KIT HIV/RDT Diagnostic KIT 500ml 20gm

Cotton Roll Chloroxylenol 4.8% Medical Tape Povidone- Iodine 7.5% Povidone- Iodine 7.5% Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid VCT Kit (1st Test) VCT Kit (2nd Test) Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu

Not available in stock at this time Not available in stock at this time

CoPC Store In Charge Name / Siganture Requested By (CoPc): Checked by:

CoPC Site Manager Name / Signature

Name
Approval By (PR): Dispatched By (WH): Received By (CoPC):

Title / Code

Date

Signature

Note: COPY-1 reatined by CoPC Site generating demand. COPY 2-3-4 forwarded to PSM Department PR-NZ for approval

NAI ZINDAGI GLOBAL FUND ROUND 9 COPY 2 R.I.V. No: 0

REQUISITION AND ISSUE VOUCHER (RIV)

City: Organization:
S/No. Items Required Item Code 003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 34 35 0

0 0
Strength Consumption for last month (Last 30 Days) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Stock in Hand 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Date Submitted: Date Required:

New Demand 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Approved Quantity Issued Quantity

January 0, 1900 January 0, 1900

Batch Number Expiry Date Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Syringes Syringes Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large) Bacitracin Zinc - Neomycin Sulfate Cotton Roll Chloroxylenol 4.8% Medical Tape Povidone- Iodine 7.5% Povidone- Iodine 7.5% Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid VCT Kit (1st Test) VCT Kit (2nd Test)

5cc 3cc Male latex 150-175 syringe capacity (Approx.) 20-19mm x 72mm 70% Isopropyl Alcohol 5cm x 3m 10cm x 3m 15cm x 3m 10g 300gm 50ml 2.5cmx3.5m 450ml 60ml (15cm x15cm x 8ply) (10cm x 10cm x 8 Ply) 15ml HIV/RDT Diagnostic KIT HIV/RDT Diagnostic KIT 500ml 20gm 0

Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin 22 Zinc 250 iu 0

Not available in stock at this time Not available in stock at this time 0 0 0 CoPC Site Manager Name / Signature Checked by:

CoPC Store In Charge Name / Siganture Requested By (CoPc):

Name
Approval By (PR): Dispatched By (WH): Received By (CoPC):

Title / Code

Date

Signature

Note: COPY-2-3-4 to be received at WH after approval by PSM Department for dispatch. COPY 2 to be retained by WH.

NAI ZINDAGI GLOBAL FUND ROUND 9 COPY 3 R.I.V. No: 0

REQUISITION AND ISSUE VOUCHER (RIV)

City: Organization:
S/No. Items Required Item Code 003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 34 35 0

0 0
Strength Consumption for last month (Last 30 Days) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Stock in Hand 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Date Submitted: Date Required:

New Demand 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Approved Quantity Issued Quantity

January 0, 1900 January 0, 1900

Batch Number Expiry Date Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Syringes Syringes Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large) Bacitracin Zinc - Neomycin Sulfate Cotton Roll Chloroxylenol 4.8% Medical Tape Povidone- Iodine 7.5% Povidone- Iodine 7.5% Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid VCT Kit (1st Test) VCT Kit (2nd Test) Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu 0

5cc 3cc Male latex 150-175 syringe capacity (Approx.) 20-19mm x 72mm 70% Isopropyl Alcohol 5cm x 3m 10cm x 3m 15cm x 3m 10g 300gm 50ml 2.5cmx3.5m 450ml 60ml (15cm x15cm x 8ply) (10cm x 10cm x 8 Ply) 15ml HIV/RDT Diagnostic KIT HIV/RDT Diagnostic KIT 500ml 20gm

Not available in stock at this time Not available in stock at this time 0 0 0 CoPC Site Manager Name / Signature Checked by:

CoPC Store In Charge Name / Siganture Requested By (CoPc):

Name
Approval By (PR): Dispatched By (WH): Received By (CoPC):

Title / Code

Date

Signature

Note: COPY-3-4 received by CoPC site. COPY 3 reatined COPY 1 destroyed. COPY 4 back to WH as confirmation of receiving.

NAI ZINDAGI GLOBAL FUND ROUND 9 COPY 4 R.I.V. No: 0

REQUISITION AND ISSUE VOUCHER (RIV)

City: Organization:
S/No. Items Required Item Code 003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 34 35 0

0 0
Strength Consumption for last month (Last 30 Days) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Stock in Hand 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Date Submitted: Date Required:

New Demand 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Approved Quantity Issued Quantity

January 0, 1900 January 0, 1900

Batch Number Expiry Date Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Syringes Syringes Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large) Bacitracin Zinc - Neomycin Sulfate Cotton Roll Chloroxylenol 4.8% Medical Tape Povidone- Iodine 7.5% Povidone- Iodine 7.5% Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid VCT Kit (1st Test) VCT Kit (2nd Test) Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu 0

5cc 3cc Male latex 150-175 syringe capacity (Approx.) 20-19mm x 72mm 70% Isopropyl Alcohol 5cm x 3m 10cm x 3m 15cm x 3m 10g 300gm 50ml 2.5cmx3.5m 450ml 60ml (15cm x15cm x 8ply) (10cm x 10cm x 8 Ply) 15ml HIV/RDT Diagnostic KIT HIV/RDT Diagnostic KIT 500ml 20gm

Not available in stock at this time Not available in stock at this time 0 0 0 CoPC Site Manager Name / Signature Checked by:

CoPC Store In Charge Name / Siganture Requested By (CoPc):

Name
Approval By (PR): Dispatched By (WH): Received By (CoPC):

Title / Code

Date

Signature

Note: COPY 4 to be sent to NZ Central Warehouse as confirmation of receiving items.

NAI ZINDAGI GLOBAL FUND ROUND 9 COPY-1

STOCK TRANSFER NOTE (STN)

FROM: TO:

City: Organization: Prepared by: Signature: Date:

Sr. No. 1 2
3 4 5 6 7 8 9 10 11 12 13 14 15

City: Organization: Received by: Signature: Date:

Material Description Item Code Strength UoM Quantity to Batch Expiry Date be returned Number R.I.V. No. R.I.V. Date Qty Received COMMENTS

Syringes Syringes Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large)
Bacitracin Zinc - Neomycin Sulfate

003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 34 35

5cc 3cc Male latex

150-175 syringe capacity (Approx.) 20-19mm x 72mm 70% Isopropyl Alcohol 5cm x 3m 10cm x 3m 15cm x 3m

10g
300gm

Cotton Roll Chloroxylenol 4.8% Medical Tape Povidone- Iodine 7.5% Povidone- Iodine 7.5% Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid VCT Kit (1st Test) VCT Kit (2nd Test) Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu

50ml 2.5cmx3.5m 450ml 60ml

(15cm x15cm x 8ply) (10cm x 10cm x 8 Ply)

16

17 18 19 20 21 22

15ml HIV Diagnostic KIT HIV Diagnostic KIT

500ml

20gm Title / Code Date Signature

Sending: CoPC In charge Receiving: WH / CoPC

Note: COPY-1 retained by sending CoPC Site. COPY 2-3 forwarded to receiving CoPC Site / NZ Central Warehouse

NAI ZINDAGI GLOBAL FUND ROUND 9 COPY-2

STOCK TRANSFER NOTE (STN)

FROM: TO:

City: Organization: Prepared by: Signature: Date:

Sr. No. 1 2
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

0 0 0

City: Organization: Received by: Signature:

0 0 0

0
Material Description Syringes Syringes Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large) Bacitracin Zinc - Neomycin Sulfate Cotton Roll Chloroxylenol 4.8% Medical Tape Povidone- Iodine 7.5% Povidone- Iodine 7.5% Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid VCT Kit (1st Test) VCT Kit (2nd Test) Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 34 35 Item Code 003 004 002 001 Strength 5cc 3cc Male latex 150-175 syringe capacity (Approx.) 20-19mm x 72mm 70% Isopropyl Alcohol 5cm x 3m 10cm x 3m 15cm x 3m 10g 300gm 50ml 2.5cmx3.5m 450ml 60ml (15cm x15cm x 8ply) (10cm x 10cm x 8 Ply) 15ml HIV Diagnostic KIT HIV Diagnostic KIT 500ml 20gm UOM

Date:
Quantity Sent
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0
Expiry Date
1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900

R.I.V. No.

R.I.V. Date
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Qty Received

COMMENTS

22

1/0/1900

Name
Sendiong: CoPC In charge Receiving: WH / CoPC

Title / Code

Date

Signature

Note: COPY-2 retained by receiving CoPC Site / NZ Central Warehouse. COPY 3 sent back to sending CoPC Site as confirmation of receiving.

NAI ZINDAGI GLOBAL FUND ROUND 9 COPY-3

STOCK TRANSFER NOTE (STN)

FROM: TO:

City: Organization: Prepared by: Signature: Date:

Sr. No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

0 0 0

City: Organization: Received by: Signature:

0 0 0

0
Material Description Syringes Condoms Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large) Bacitracin Zinc - Neomycin Sulfate Cotton Roll Chloroxylenol 4.8% Medical Tape Povidone- Iodine 7.5% Povidone- Iodine 7.5% Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid VCT Kit (1st Test) VCT Kit (2nd Test) Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu Item Code 003 003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 34 Strength 5cc 3cc Male latex 150-175 syringe capacity (Approx.) 20-19mm x 72mm 70% Isopropyl Alcohol 5cm x 3m 10cm x 3m 15cm x 3m 10g 300gm 50ml 2.5cmx3.5m 450ml 60ml (15cm x15cm x 8ply) (10cm x 10cm x 8 Ply) 15ml HIV Diagnostic KIT HIV Diagnostic KIT 500ml 20gm UOM

Date:
Quantity Sent
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0
Expiry Date
00-Jan-00 1/0/1900 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00 00-Jan-00

R.I.V. No.

R.I.V. Date
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Qty Received

COMMENTS

Name
Sendiong: CoPC In charge Receiving: WH / CoPC

Title / Code

Date

Signature

Note: COPY-3 retained by CoPC site for record and COPY-1 destroyed. Important:1 copy of STN with all signatures forwarded to WH and PSM Manager for record updation and reconciliation.

NAI ZINDAGI GLOBAL FUND ROUND 9 DAILY DEMAND FORM (ORW)

City: Origanization:
S/No.

Bahawalnagar Nai Zindagi

Items Description Item Code 004 003 002 001 012 005 Consumption for previous day

Date Submitted: Date Required:

Stock in Hand New Demand Issued Quantity (Approved) Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

Syringes 3cc Syringes 5cc Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab

Name Requested By: Approval By (CoPC Incharge): Issued by Store Incharge CoPC: Received:

Title / Code

Date

Signature

Tahir Majeed M. Waqar Javed

63-69-SM 63-59-AAC

Note: NO DAILY DEMAND WILL BE ISSUED WITH OUT APPROVAL OF CoPC INCHARGE

NAI ZINDAGI GLOBAL FUND ROUND 9 DAILY DEMAND FORM (F-ORW)

City: Origanization:
S/No. Items Description Item Code 002 Consumption for previous day

Date Submitted: Date Required:

Stock in Hand New Demand Issued Quantity (Approved) Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

Condoms

Name Requested By: Approval By (CoPC Incharge): Issued by Store Incharge CoPC: Received:

Title / Code

Date

Signature

Note: NO DAILY DEMAND WILL BE ISSUED WITH OUT APPROVAL OF CoPC INCHARGE

NAI ZINDAGI GLOBAL FUND ROUND 9 DAILY DEMAND FORM (Mobile Medical Team)
City: Origanization:
S/No. Items Description / Item Code Item Code
003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 34 35

Date Submitted: Date Required:

Consumption for previous day Stock in Hand New Demand Issued Quantity (Approved) Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Syringes 5cc Syringes 3cc Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (Small) Cotton Bandage (Medium) Cotton Bandage (Large)

Bacitracin Zinc - Neomycin Sulfate (Cicatrin)

Cotton Roll Chloroxylenol 4.8% (Dettol) Medical Tape Povidone- Iodine 7.5% (Large) Povidone- Iodine 7.5% (Small) Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (small) Salicylic Acid (15ml) Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu

Not available in stock at this time Not available in stock at this time Title / Code Date

Name Requested By: Approval By (CoPC Incharge): Issued by Store Incharge CoPC: Received:

Signature

Note: NO DAILY DEMAND WILL BE ISSUED WITH OUT APPROVAL OF CoPC INCHARGE

NAI ZINDAGI GLOBAL FUND ROUND 9 DAILY DEMAND FORM (VCCT)

City: Origanization:
S/No. Items Description Item Code 033 031 002 012 005 001 Consumption for previous day

Date Submitted: Date Required:

Stock in Hand New Demand Issued Quantity (Approved) Comments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

VCT Kit (1st Test) VCT Kit (2nd Test) Condoms First Aid Plaster Alcohol Swab / Spirirt Swab Sharp Bins Hair Covers Gun Mask Lancet Gloves

Name Requested By: Approval By (CoPC Incharge): Issued by Store Incharge CoPC: Received:

Title / Code

Date

Signature

Note: NO DAILY DEMAND WILL BE ISSUED WITH OUT APPROVAL OF CoPC INCHARGE

NAI ZINDAGI GLOBAL FUND ROUND 9 INVENTORY REPORT (18 to 30/September/2013)

Location: Monthly Consumption (1st day of the month to last day of the month) Organization:

Sr. No

Item Code

Item Description

Stock as per Bin Card A

Physical Physical Total Stock with Stock in Physical Mobile Store Stock Teams B C B+C

Comments

Sign

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

003 004 002 001 012 005 022 021 020 009 019 014 013 007 018 026 027 011 033 031 034 035

Syringes 5cc Syringes 3cc Condoms Sharp Bins First Aid Plaster Alcohol Swab / Spirirt Swab Cotton Bandage (small) Cotton Bandage (Medium) Cotton Bandage (Large) Bacitracin Zinc - Neomycin Sulfate (10g) Cotton Roll (Large) Chloroxylenol 4.8% (50ml) Medical Tape (2.5cmx3.5m) Povidone- Iodine 7.5% (450ml) Povidone- Iodine 7.5% (60ml) Guaze Swabs/ Sponges (Large) Guaze Swabs/ Sponges (Small) Salicylic Acid (15ml)
VCT Kit (1st Test) VCT Kit (2st Test)

Ethanol Solution 70% Neomycin Sulfate 3.3g+Bacitracin Zinc 250 iu

PREPARED BY: Designation: VERIFIED BY: Designation: Date:

Date:

NAI ZINDAGI GLOBAL FUND ROUND 9 STOCK VARIANCE REPORT

Location: Organization:

Sr. No

Item Code

Item Description

Stock as per Bin Physical Stock Variance in Comments Card in Store Stock A B B-A

Sign

PREPARED BY: Designation: VERIFIED BY: Designation: Date:

Date:

NAI ZINDAGI GLOBAL FUND ROUND 9

BIN CARD
STOCK LOCATION
ITEM NAME: First Aid Plaster 1 ITEM CODE: EXPIRY DATE: 12 Jul-17

U.O.M: (Unit of Measurement / Packing Size)

Stock Level Indicators

MINIMUM STOCK: MAXIMUM STOCK:
4000 20000

RE-ORDER LEVEL: LEAD TIME:

20% Buffer Zone Ten days

DATE
17-09-2013

Ref R.I.V / P.O

BN0001

FROM
WH ISB

TO
COPC+ BWN

Batch Number
500313

Qty RECEIPT
20000

ISSUE

BALANCE
20000

Expiry Date SIGNATURE

Jul-17

COMMENTS

NOTE: THIS RECORD IS NOT TO BE DESTROYED