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    Neelkanth Infertility & I.F.V. Hospital: Requisition Form

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    Neelkanth Infertility
    This document is a requisition form from Neelkanth IVF Hospital in Patna, India dated November 26, 2020. It details a request from the nursing staff of the OT department for various medical supplies including Endokine 300 mcg, surgical gloves, face masks, and disposable caps. The form provides the item descriptions, batch numbers, quantities requested, and totals. It requires signatures from the pharmacist and center head to authorize the request.

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    Neelkanth Infertility & I.F.V. Hospital: Requisition Form

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    Neelkanth Infertility
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    This document is a requisition form from Neelkanth IVF Hospital in Patna, India dated November 26, 2020. It details a request from the nursing staff of the OT department for various medical supplies including Endokine 300 mcg, surgical gloves, face masks, and disposable caps. The form provides the item descriptions, batch numbers, quantities requested, and totals. It requires signatures from the pharmacist and center head to authorize the request.

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    Requisition Form-A4.doc

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    This document is a requisition form from Neelkanth IVF Hospital in Patna, India dated November 26, 2020. It details a request from the nursing staff of the OT department for various medical supplies including Endokine 300 mcg, surgical gloves, face masks, and disposable caps. The form provides the item descriptions, batch numbers, quantities requested, and totals. It requires signatures from the pharmacist and center head to authorize the request.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    52 views1 page

    Neelkanth Infertility & I.F.V. Hospital: Requisition Form

    Uploaded by

    Neelkanth Infertility
    This document is a requisition form from Neelkanth IVF Hospital in Patna, India dated November 26, 2020. It details a request from the nursing staff of the OT department for various medical supplies including Endokine 300 mcg, surgical gloves, face masks, and disposable caps. The form provides the item descriptions, batch numbers, quantities requested, and totals. It requires signatures from the pharmacist and center head to authorize the request.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    NEELKANTH INFERTILITY & I.F.V.

    HOSPITAL
    2ND FLOOR, SURYA HEALTH CARE NEAR HANDLOOM BHAVAN
    RAJENDRA NAGAR, PATNA-16

    REQUISITION FORM

    Date: 26.11.2020 NEELKANTH IVF HOSPITAL, RAJENDRA NAGAR


    Requester Name: MEENU KUMARI Designation: NURSING STAFF

    Department/Laboratory Name: O.T

    S. No. Description of ITEM Batch No. Qty. Total


    (Item name and Specification/Brand)
    1 ENDOKINE 300 MCG 1610047 1 1

    2 SURGICAL GLOVES 01236 2 2 BOX

    3 FACE MASK 065 10 10

    4 DISPO CAP 064 1 1 BOX

    Remarks____________________________________________________

    Signature: _________________________
    NAME OF PHARMACIST- DIVESH MISHRA DATE:- 26.11.2020

    CENTER HEAD SIGNATURE:-…………………………………………………… DATE: 26.11.2020

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