180x Filetype XLSX File size 0.03 MB Source: www.humanitarianresponse.info
Sheet 1: Form 1
Distribution of nutrition items under PCA | ||||||||||||||||
Name of Partner: | Form 1 | |||||||||||||||
PCA No: | ||||||||||||||||
Date of start of PCA: | ||||||||||||||||
Date of Expiry: | ||||||||||||||||
Warehouse from where the items would be drawn: | ||||||||||||||||
Item | Code | Pack | Qty under PCA | Jan-14 | Feb-14 | Mar-14 | Apr-14 | May-14 | Jun-14 | Jul-14 | Aug-14 | Sep-14 | Oct-14 | Nov-14 | Dec-14 | TOTAL |
Plumpynut sache CAR/ 92 g-150 | S0000240 | CAR | 0 | |||||||||||||
Amoxillin pdr oral sus 125 mg bot 100 ml | S1505046 | BOT | 0 | |||||||||||||
Amox 250mg tab Pac 10 | S1505045 | PAC | 0 | |||||||||||||
Amox 250mg tb Pac20 | S1505044 | PAC | 0 | |||||||||||||
Weighing trousers pac | S0189000 | PAC | 0 | |||||||||||||
Micronutrients film tab Pac 1000 | S1580100 | PAC | 0 | |||||||||||||
Albendazole 400 mg chew pac 1000 | S1555370 | PAC | 0 | |||||||||||||
Scale inf. Spring | S0557000 | EACH | 0 | |||||||||||||
ReSoMal 42 g Sach Car 100 | S1561125 | CAR | 0 | |||||||||||||
F-100 ther diet sach 1114 g Car 90 | S0000209 | CAR | 0 | |||||||||||||
F-75 ther diet sach 102 g Car 120 | S0000208 | CAR | 0 | |||||||||||||
Portable bay/child L-H Meas | S0114540 | SET | 0 | |||||||||||||
Weighing scale el moth child 150 kg x 25 g | S0141021 | EA | 0 | |||||||||||||
Mebendazole 500 mg chew tab pack 100 | S1555360 | PAC | 0 | |||||||||||||
MUAC child 11.5 red PAC-50 | S0145620 | PAC | 0 | |||||||||||||
MUAC Adult | S0145630 | PAC | 0 | |||||||||||||
Retinol 100 K IU soft gel PAC caps. PAC-500 | S7800001 | PAC | 0 | |||||||||||||
Retinol 200 K IU soft gel PAC caps. PAC-500 | S7800002 | PAC | 0 | |||||||||||||
Portable bay chd L-H meas./SET-2 | S0114530 | SET | 0 | |||||||||||||
Scale infant spring type 25 kg x100g | S0145555 | EA | 0 | |||||||||||||
Fe +folic acid 60+0.4 mg tab/PAC 1000 | S1550025 | PAC | 0 | |||||||||||||
Multiple Micro. Nut pdr | S1580201 | PAC | 0 | |||||||||||||
Port. Baby chd L-H | S01145200 | SET | 0 |
Form 2 | |||||||||||
UNICEF, Juba South Sudan | |||||||||||
Request for Supply | |||||||||||
Name of Partner: Date: | |||||||||||
PCA No: Expiry Date: | |||||||||||
PCA Amendment date Expiry: UNICEF Warehouse: | |||||||||||
Quarter ending: 2014 Location of Supply | |||||||||||
Sr No | Item | Unit | Total units in PCA | Total units collectedtill date | Units utilised till date | Balance stock | Expiry date | No. of units requested | Date up to which will be utilised | Remarks | |
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
0 | |||||||||||
Name and Title of Partner (Designated Focal Official) | |||||||||||
Signatures: | |||||||||||
Recommendation/Remarks of UNICEF Nutrition Specialist. | |||||||||||
To be submitted min. two weeks in advance of expected delivery of items. | |||||||||||
To be submitted as pdf and signed by the focal official and stamp |
Monthly Stock Report of Partners Form 3 | ||||||||
Name of Partner: | ||||||||
PCA No: | ||||||||
Month | ||||||||
Item | Code | Pack | Opening stock | Stock Rceived during the month | Stock used during the monthh | Balance at the end of month | Location of balance stock | Remarks |
Plumpynut sache CAR/ 92 g-150 | S0000240 | CAR | 0 | |||||
Amoxillin pdr oral sus 125 mg bot 100 ml | S1505046 | BOT | 0 | |||||
Amox 250mg tab Pac 10 | S1505045 | PAC | 0 | |||||
Amox 250mg tb Pac20 | S1505044 | PAC | 0 | |||||
Weighing trousers pac | S0189000 | PAC | 0 | |||||
Micronutrients film tab Pac 1000 | S1580100 | PAC | 0 | |||||
Albendazole 400 mg chew pac 1000 | S1555370 | PAC | 0 | |||||
Scale inf. Spring | S0557000 | EACH | 0 | |||||
ReSoMal 42 g Sach Car 100 | S1561125 | CAR | 0 | |||||
F-100 ther diet sach 1114 g Car 90 | S0000209 | CAR | 0 | |||||
F-75 ther diet sach 102 g Car 120 | S0000208 | CAR | 0 | |||||
Portable bay/child L-H Meas | S0114540 | SET | 0 | |||||
Weighing scale el moth child 150 kg x 25 g | S0141021 | EA | 0 | |||||
Mebendazole 500 mg chew tab pack 100 | S1555360 | PAC | 0 | |||||
MUAC child 11.5 red PAC-50 | S0145620 | PAC | 0 | |||||
MUAC Adult | S0145630 | PAC | 0 | |||||
Retinol 100 K IU soft gel PAC caps. PAC-500 | S7800001 | PAC | 0 | |||||
Retinol 200 K IU soft gel PAC caps. PAC-500 | S7800002 | PAC | 0 | |||||
Portable bay chd L-H meas./SET-2 | S0114530 | SET | 0 | |||||
Scale infant spring type 25 kg x100g | S0145555 | EA | 0 | |||||
Fe +folic acid 60+0.4 mg tab/PAC 1000 | S1550025 | PAC | 0 | |||||
Multiple Micro. Nut pdr | S1580201 | PAC | 0 | |||||
Port. Baby chd L-H | S01145200 | SET | 0 | |||||
To be submiited by 10 th of every month for the preceding month |
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