Scribd
Upload
763 views

Supplier Delivery Note - Form

This document appears to be a supplier delivery note template used for recording deliveries of medical supplies from a central medical store. The template includes spaces to record the delivery note number, date, customer details, order details including item descriptions, quantities, unit prices and total prices. It also includes spaces to record the names and dates of those who packed, checked, delivered and received the delivery.

Uploaded by

hrstga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
763 views

Supplier Delivery Note - Form

This document appears to be a supplier delivery note template used for recording deliveries of medical supplies from a central medical store. The template includes spaces to record the delivery note number, date, customer details, order details including item descriptions, quantities, unit prices and total prices. It also includes spaces to record the names and dates of those who packed, checked, delivered and received the delivery.

Uploaded by

hrstga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 1

TITLE OF FORM:

Number of pages: Procedure Number


Prepared by: Date: Approved by: Date:
Designation Designation

Supplier Delivery Note

DELIVERY NOTE

CENTRAL MEDICAL STORE

Invoice/Delivery Note Number: ____________ Date: __________________

Customer Name and address: __________________

Customer Order/Requisition Number: ___________________ Order Date: __________

Line Quantity Item description Unit of Unit price Total price


issue
1. 100 Acetylsalicylic acid 1000 tabs 40.00 4000.00
500 mg tab
1,000 tab
2. 20 Magnesium trisilicate
100 tab
3. 5 Chloroquine
100 mg b
1,000 tab
4. 150 ORS sachets
50 sachets
5. 50 Benzyl penicillin vial
1 vial
Total Invoice

Comments: ____________________________

____________________________

Packed by: _______________ Date: __________

Checked by: _______________ Date: __________

Delivered by: _______________ Date: __________

Received by: _______________ Date: __________

Review Date:
Date Reviewed:
Signature:
SOP from EPNs online Centre of Excellence - www.epnetwork.org

You might also like