rial Requisition Form

MR Date 5/4/2022
Expected Date/Month when Required : May Month Request
Client Name/Code KIRTI NAGAR HUB
Client Address F54 KIRTI NAGAR NEAR KOTAK MAHINDRA BANK
Requested By Logistics
Harpreet singh 9599293754

Last
S.No SKU Code SKU Description Uom Month In Hand Req.Qty
Sample Qty
Load
1 CON000076 STERILE COTTON SWAB STICK-PW005-1-Nos NIL 0
2 CON000091 Sharp Container 800 ML NIL 0
3 CON000096 Hand Gloves - Medium ( Powder Free Nitrile) NIL 0
5 CON000110 ALCOHOL SWABS - 100 Each NIL 0
6 CON000111 Cotton 400 Grams NIL 0
7 CON000114 Tournicate NIL 10
8 CON000129 Mask - 3Ply NIL 0
9 CON000141 BACTEC PLUS 442192- AEROBIC - 50 - Bottle NIL 0
10 CON000142 BACTEC PLUS 442194 - PAEDIATRIC - 50 - Bottle NIL 0
11 CON000155 SODIUM FLUORIDE VACUTAINER -367587-100-Each NIL 0
13 CON000196 ICE COLD/COOL PACK-(1 x 150 g)-1-PACK NIL 0
14 CON000219 THERMACOL BOX - NO:2 (200X125X150/30) NIL 0
15 CON000226 URINE CONTAINER-STERILE (50ml) NIL 0
16 CON000254 LBC-VIAL-PRESERVCYT SOLN-20ML NIL 0
17 CON000255 LBC-CERVEX BRUSH NIL 0
18 CON000365 Transport Swabs w Amies Medium w/o charcoal-MS684 NIL 0
19 CON000461 BAND AID -150NOS (HANSA PLAST) NIL 1000
20 CON000698 EMRALD SYRINGE 3ML WITH 23G NEEDLES NIL 0
21 CON000854 Krivida Gel and Clot Activator Tube 5ml NIL 0
22 CON001026 PASTURE PIPETTE 3ML NIL 0
23 CON001061 PLASTIC CONTAINERS- 24 HRS -URINE NIL 0
24 CON001088 PPE kit for COVID testing NIL 0
25 CON001231 SYRINGE 5 ML+NEEDLE (23x1 Disc 300852/3 NIL 0
26 CON001239 SYRINGES 10 ML WITH NEEDLES (NSG)(100) NIL 0
27 CON001279 THERMACOL BOX NO.200 L X 165 W X 80 H (M NIL 0
28 CON001346 VACUTAINER CITRATE -BLUE 2ML -454321-BD NIL 0
29 CON001348 VACUTAINER TUBE-GREEN (LETHUM HEP.)-BD NIL 0
30 CON001349 VACUTAINER TUBE-SODIUM HAPERIN - BD NIL 0
31 CON001395 Seafa Microsafe Hand Rub 500Ml NIL 10
32 CON001428 KN 95 MASK NIL 0
33 CON001433 DISPOSABLE GOWNS NIL 0
34 CON001439 ZIP LOCK BAG 5"x9.25" WITH PRINITNG(COVE NIL 3000
35 CON001449 BARCODE LABELWITH RIBBON-60MM*20MM-2000p NIL 0
36 CON001450 Barcode Ribbon 65MM*74MTR NIL 0
37 CON001529 Krivida Sodium Citrate 9 NC (3.2%) 2.7ml KV-SSC-V NIL 0
38 REG000332 BACTEC MYCO F LYTIC (442288) 50 BOTTLES-50-Test NIL 0
39 REG000333 BACTEC PEDS PLUS/F (442194) (50 BOTTLES)-50-Test NIL 0
40 REG001708 HiPurA Viral RNA Purifucation Kit -250-Test-Himedia NIL 0
41 REG002042 CHROM VIRAL TRANSPORT KIT (CHRG-P-VTM-01 NIL 0
42 RED BAG NIL 0
43 YELLOW BAG NIL 0
44 RAGISTER NIL 0
 45 PEN NIL 5
46 MARKER NIL 5
47 STAPLES NIL 2
48 WHITE PAPER A 4 SIZE NIL 2
49 Reporting Paper with NABL Logo NIL 0
50 Reporting Paper NIL 4000
51 TRF NIL 3000
52 Report Envelope NIL 1500

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Prepared By Approved By Received By
Issue Qty
(To Be Remarks
done)
 ……………………………….
d By