Government of Arunachal Pradesh Office of The Medical Superintendent General Hospital Aalo, West Siang

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GOVERNMENT OF ARUNACHAL PRADESH

OFFICE OF THE MEDICAL SUPERINTENDENT


GENERAL HOSPITAL AALO, WEST SIANG

Ref Issue No: 32352 Dated, Aalo the 2nd September 2021

Issue Date: 2021-09-02

To,
___________
DCHC (District Covid Health Centre), GH Aalo, West Siang

Sub:- Issue / Receipt Voucher

Following items are issued to you.

Sl. Name of Program Unit-1 Unit-2 Rate Rate of Issued Batch No. Mfg. Date Exp. Date Total Remarks
No. Drugs Name (inclusive GST Qty. Amount
of GST)
1 Adhesive N/A Spool Materia 135.162 0.12 1 00390IP Mar 2021 Feb 2024 135.162 ---
Tape USP l
(Size : 7.5 Supply
cm X 5 /
mtrs) / Consu
Spool. mables
2 Dispovan N/A Nos. Materia 0 0 50 937101LF Sep 2019 Aug 2024 0 ---

Signature of Recipient: Signature of Issuing Officer:


Name: Name:
Designation: Designation:
Page 1 of 3
Note- This Issue Voucher is generated by DVDMS, so kindly receive through DVDMS Software.
Sl. Name of Program Unit-1 Unit-2 Rate Rate of Issued Batch No. Mfg. Date Exp. Date Total Remarks
No. Drugs Name (inclusive GST Qty. Amount
of GST)
Syringe with l 2
Needle - 10 Supply
ml (Needle /
Size: 21 G, Consu
Length: mables
1/1.5 inch).
3 Dispovan N/A Nos. Materia 0 0 100 G43865 Jan 2021 Dec 2024 0 ---
Syringe with l
Needle - 2 ml Supply
(Needle Size: /
22 G, Consu
Length: 1 mables
inch).
4 N-95 Mask N/A Nos Covid1 0 0 10 NA May 2021 Apr 2025 0 ---
9
Logisti
cs
5 Non Sterile N/A Nos Covid1 0 0 30 2131422 May 2021 Apr 2026 0 ---
Hand Gloves 9 08LPZA
Logisti
cs
6 OT Cap N/A Piece Materia 0 0 20 CAP-20 Sep 2020 Aug 2024 0 ---
(Size: 18) l
(Disposable) Supply
. /
Consu
mables

Signature of Recipient: Signature of Issuing Officer:


Name: Name:
Designation: Designation:
Page 2 of 3
Note- This Issue Voucher is generated by DVDMS, so kindly receive through DVDMS Software.
Sl. Name of Program Unit-1 Unit-2 Rate Rate of Issued Batch No. Mfg. Date Exp. Date Total Remarks
No. Drugs Name (inclusive GST Qty. Amount
of GST)
7 Sterile N/A Pairs Materia 0 0 15 SG-1360 Mar 2021 Feb 2025 0 ---
Surgical l
Gloves (Size: Supply
6.5 Inch). /
Consu
mables
8 Triple Layer Covid19 Nos. Covid1 0 0 15 NA Jan 2021 Dec 2023 0 ---
Mask (3 9
Layer Mask). Logisti
cs
Gross Total (Rs.) 135.162
(One Hundred and Thirty Five )

Signature of Recipient: Signature of Issuing Officer:


Name: Name:
Designation: Designation:
Page 3 of 3
Note- This Issue Voucher is generated by DVDMS, so kindly receive through DVDMS Software.

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