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Republic of the Philippines

Department of Health
Regional Office IV - MIMAROPA
CULION SANITARIUM AND GENERAL HOSPITAL
Brgy. Tiza, Culion, Palawan 5315
Contact No.: 0909-560-7350
Email Address: doh_culsan@yahoo.com.ph
Website: culionsanitariumandgeneralhospital.com
CONSIGNMENT-RIS
Division: Responsibilty Center
C-RIS No: Date:
Office: 13-001-14-00034-03-
Requisition ISSUANCE
Stock No. Unit Description Quantity Quantity Consignor

Purpose:
Requested By: Approved by: Issued by: Received by:

ARTURO C. CUNANAN JR. MD,MPH,MHA,FPLS,CSEE,PhD.


Medical Center Chief I
CSGH-HOPSS-SPU-F-003 Rev. 0 Effectivity Date: July 20, 2018

Republic of the Philippines


Department of Health
Regional Office IV - MIMAROPA
CULION SANITARIUM AND GENERAL HOSPITAL
Brgy. Tiza, Culion, Palawan 5315
Contact No.: 0909-560-7350
Email Address: doh_culsan@yahoo.com.ph
Website: culionsanitariumandgeneralhospital.com
CONSIGNMENT-RIS
Division: Responsibilty Center
C-RIS No: Date:
Office: 13-001-14-00034-03-
Requisition ISSUANCE
Stock No. Unit Description Quantity Quantity Consignor

Purpose:
Requested By: Approved by: Issued by: Received by:

ARTURO C. CUNANAN JR. MD,MPH,MHA,FPLS,CSEE,PhD.


Medical Center Chief I
Republic of the Philippines
Department of Health
Regional Office IV - MIMAROPA
CULION SANITARIUM AND GENERAL HOSPITAL
Brgy. Tiza, Culion, Palawan 5315
Contact No.: 0909-560-7350
Email Address: doh_culsan@yahoo.com.ph
Website: www.culionsanitariumandgeneralhospital.com

PURCHASE REQUEST
Fund Cluster:
Department: MCCO P.R. No. Date: 24-May-21
Office/Section: Reproduction Responsibility Center Code 13-001-14-00034-
Stock / Property
Unit Item Description QTY. Unit Cost Total Cost
No.
box GESTETNER,COPYPRINTER INK 15 1,080.24 16,203.60
DX 2430

TOTAL 16,203.60
Purpose: For reproduction of Hospital forms. (good for 3 months)

Approved by:

RODOLFO P. PACULDAS ARTURO C. CUNANAN, JR., MD, MPH, FPLS, CSEE, PhD
OIC - Supply Unit Medical Center Chief I

CSGH-HOPSS-SPU-F-011 Rev. 0 Effectivity Date: July 20, 2018

Republic of the Philippines


Department of Health
Regional Office IV - MIMAROPA
CULION SANITARIUM AND GENERAL HOSPITAL
Brgy. Tiza, Culion, Palawan 5315
Contact No.: 0909-560-7350
Email Address: doh_culsan@yahoo.com.ph
Website: www.culionsanitariumandgeneralhospital.com

PURCHASE REQUEST
Fund Cluster:
Department: MCCO P.R. No. Date: 24-May-21
Office/Section: Reproduction Responsibility Center Code 13-001-14-00034-03-
Stock / Property
Unit Item Description QTY. Unit Cost Total Cost
No.
box GESTETNER,COPYPRINTER INK 15 1,080.24 16,203.60
DX 2430 0.00

TOTAL 16,203.60
Purpose: For reproduction of Hospital forms. (good for 3 months)

Approved by:

RODOLFO P. PACULDAS ARTURO C. CUNANAN, JR., MD, MPH, FPLS, CSEE, PhD
OIC - Supply Unit Medical Center Chief I

CSGH-HOPSS-SPU-F-011 Rev. 0 Effectivity Date: July 20, 2018


v
Republic of the Philippines
Department of Health
Regional Office IV - MIMAROPA
CULION SANITARIUM AND GENERAL HOSPITAL
Brgy. Tiza, Culion, Palawan 5315
Contact No.: 0909-560-7350
Email Address: doh_culsan@yahoo.com.ph
Website: www.culionsanitariumandgeneralhospital.com

REQUISITION AND ISSUE SLIP


Fund Cluster: ___________________
Division : MCCO Responsibility Center Code: 13-001-14-00034-0101
Office : Reproduction RIS No.
Stock
Requisition Issue
Available?
Stock No. Unit Description Quantity Yes No Quantity Remarks
ream Legal size Bond Paper 20

Purpose: For Hospital Use


Requested by: Approved by: Issued by: Received by:

Timothy Kris R. Yap ARTURO C. CUNANAN, JR.,MD,MPH,MHA,FPLS,CSEE,PhD


Date:6/2/2021 Medical Center Chief I Date: Date:

CSGH-HOPSS-SPU-F-012 Rev. 0 Effectivity Date: July 20, 2018

Republic of the Philippines


Department of Health
Regional Office IV - MIMAROPA
CULION SANITARIUM AND GENERAL HOSPITAL
Brgy. Tiza, Culion, Palawan 5315
Contact No.: 0909-560-7350
Email Address: doh_culsan@yahoo.com.ph
Website: www.culionsanitariumandgeneralhospital.com

REQUISITION AND ISSUE SLIP


Fund Cluster: ___________________
Division : MCCO Responsibility Center Code: 13-001-14-00034-0101
Office : Reproduction RIS No.
Stock
Requisition Issue
Available?
Stock No. Unit Description Quantity Yes No Quantity Remarks
ream Legal size Bond Paper 20

Purpose: For Hospital Use


Requested by: Approved by: Issued by: Received by:

Timothy Kris R. Yap ARTURO C. CUNANAN, JR.,MD,MPH,MHA,FPLS,CSEE,PhD


Date:6/2/2021 Medical Center Chief I Date: Date:

CSGH-HOPSS-SPU-F-012 Rev. 0 Effectivity Date: July 20, 2018

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