Format No 13.02.

05/F-04/R1
LOCATION & CHECKLIST
FOR FIRST AID BOX
Revision Dt. 19.11.2020

Project / Office / Manufacturing Unit Name: Checked On:

Location of First Aid Box (FAB):
Sl. No. FAB No. Location of FA Box Under the responsibility of Phone number

Checklist of First Aid Box (FAB): FAB No.:

Sl. Quantity of Expiry Availability Remarks if
Description of First Aid Kit (FAK)
No. FAK Date Yes / No / NA any
1 Eye wash bottles f illed with distilled water. 1 (500cc)
2 4 % xylocaine eye drops. Suf f icient No.
3 Boric Acid Eye drops. Suf f icient No.
4 Soda Bicarbonate. Suf f icient No.
5 Small Sterilised Dressings. 24
6 Medium sized Sterilised Dressings. 12
7 Large size Sterilised Dressings. 12
8 Large size Sterilized Burn Dressings. 12
9 Packets of Sterilised Cotton wool (15cm). 12
Certimide Solution (1 %) or Suitable Antiseptic
10 1 (200ml)
Solution.
11 Mercurochrome (2 %) solution in water. 1 (200ml)
Salvolatile having the doses and mode of
12 1 (120ml)
administration indicated on the label.
13 Scissors. 2
14 Roll of Adhesive Plaster (6 cm x 1 metre). 1 (6 cm x 1 in)
15 Rolls of adhesive plaster (2 cm x 1 metre). 2 (6 cm x 1 in)
16 Sterilised Eye Pads in separate sealed packets. 12
17 Aspirin or any other Analgesic Tablet (each 305 mg). 100
18 Roller bandages 10 cm wide. 12
19 Roller bandages 5 cm wide. 12
20 Tourniquet. 1
21 Suitable splints. Suf f icient No.
22 Saf ety Pins (packets). 3
23 Kidney Tray. 1
24 Snake Bite Lancet. 1
30 ml bottle containing Potassium Permanganate
25 1
Crystals.
26 First-Aid Leaf let issued by the Directorate General. 1
27 Triangular Bandages. 6
28 Suitable, Sterilised, Latex hand gloves (Pairs). 2
Note: Schedule Drugs prohibited in First Aid box.
Requirement as per Regulation:
Schedule 3 of BOCW Act 1996, Suf f icient number of First Aid Boxes to be kept.
Section 45. First Aid Appliances, The Factories Act, 1948, 1 box/150 Employees.
Dock Workers (Saf ety, Health & Welf are) Regulations 1990, 1 box f or every 200 meters.
Mines Act 1952 1 box/150 Employees.