Financial Report of Nursing Service Units' Forms, Office and House

Stock Unit Beg. DELIVERIES

January 2019 Unit
Level Cost Bal. 1st 2nd 3rd 4th 5th
CHART FORMS
TPR Graphic Sheet pc 1.5
Standing Order pc 1.5
Doctors' Order pc 1.5 500
Medication Sheet pc 1.5 600 500
Nurses Progress Notes pc 1.5 100 500
IVF Fluid Sheet pc 1.5
Intake/Output Chart pc 1.5 100
Transfusion of Bld. Comp. pc 1.5
Neurovital Sign Sheet pc 1.5
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 100
Serial Monitoring Sheet pc 1.5
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5 50
Doctors list pc 0.75 200
Newsprint(for outsource medicine) pc 1.5
MICU/SICU Guidelines pc 1.5
Medical Certificate (OP) pc 0.75
CONSENT FORM:
Consent for Operation and Anes pc 1.5
Consent for Bld. Transfusion pc 1.5
Consent for Special Procedures pc 1.5
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Job Order Form pc 0.75
Central Service pc 0.5 100 300
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 100 400
Stock Unit Beg. DELIVERIES
January 2019 Unit
Level Cost Bal. 1st 2nd 3rd 4th 5th
OR Schedule pc 0.5
Report on Gas Use pc 0.5 110
X-Ray Request pc 0.75 300
Returned Meds. Supplies pc 0.5 500
ECG Request pc 0.5 200
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5 200
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 100 200
Prohibited/Regulated Drugs pc 0.5 500
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
ROD's Report pc 0.75
NURSING UNIT FORMS:
Kardex pc 1.5 50 110
Assignment Sheet pc 1.5 50
Record on Gas Use pc 0.5 110
Discharge Checklist pc 1.5 150
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 300
Diet List pc 1.5 200
Evaluation Form pc 0.75 20
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 100 300
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 50 300
blue pc 0.5
orange pc 0.5
yellow pc 0.5 10
pink pc 0.5
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 100 300
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5 10
Orange Card Big (treatment) pc 0.5 240
White Card Big (OF) pc 0.5

Stock Unit Beg. DELIVERIES

January 2019 Unit
Level Cost Bal. 1 st
2nd
3rd 4th 5th
OFFICE SUPPLIES
Pencil pc 6 2
Eraser pc 5 1
Pentelpen pc 40 2
Staple wire box 50
Paste pc 40
Masking tape pc 35 2
Scotch tape pc 25 2
Calculator pc 600
Scissor pc 120
Notebook pc 30
Battery: C+/ 9V pc 120 2
AA" pc 60 2
AAA pc 60 4
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66 1
Scrubbing pad pc 22.65 1
Bottle Brush pc 33.65 1
Vinegar gallon 23.93
Alcohol ml 47 1

Approved By:

Sr. Rowena C. Rodil

Nursing Director
s, Office and Housekeeping Supplies
Total No. of Used End Total Cost of Total Cost of
Supplies Supplies Balance Used Supplies End Balance

500 500 750.00

1100 700 400 1,050.00 600.00
600 600 900.00

100 50 75.00

200

400 400 200.00

500 100 400 50.00 200.00

Total No. of Used End Total Cost of Total Cost of
Supplies Supplies Balance Used Supplies End Balance

110 50 60 25.00 30.00

 300 300 225.00
500
200

200 200 100.00

300 100 200 50.00 100.00

500 500 250.00

160
50
110
150 150 225.00

300 -100 400 -50.00 200.00

200
20 20 15.00

400 400 200.00

350 300 50 150.00 25.00

10 10 5.00

400

10 10 5.00
240

Total: 3,050.00 2,330.00

Total No. of Used End Total Cost of Total Cost of
Supplies Supplies Balance Used Supplies End Balance

2 2 12.00
1 4 20.00
2 2 80.00

2 2 70.00
2 3 75.00
 -1 1 -30.00 30.00
2 1 120.00
2 2 120.00
4 4 240.00

Total: 410.00 327.00

1 1 20.66
1 1 22.65
1 1 33.65

1 1 47.00

Total: 123.96
Total Cost of Total Cost of
Used Supplies End Balance

Grand Total: 3,583.96 2,657.00

 Financial Report of Nursing Service Units' Forms, Office and House
Stock Unit Beg. DELIVERIES
February 2019 Unit
Level Cost Bal. 1st 2nd 3rd 4th 5th
CHART FORMS
TPR Graphic Sheet pc 1.5
Standing Order pc 1.5
Doctors' Order pc 1.5 600 150
Medication Sheet pc 1.5 400 300
Nurses Progress Notes pc 1.5 600 300 300
IVF Fluid Sheet pc 1.5
Intake/Output Chart pc 1.5
Transfusion of Bld. Comp. pc 1.5
Neurovital Sign Sheet pc 1.5
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 50
Serial Monitoring Sheet pc 1.5
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 200 200
Newsprint(for outsource medicine) pc 1.5
MICU/SICU Guidelines pc 1.5
Medical Certificate (OP) pc 0.75
CONSENT FORM:
Consent for Operation and Anes pc 1.5
Consent for Bld. Transfusion pc 1.5
Consent for Special Procedures pc 1.5
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Job Order Form pc 0.75
Central Service pc 0.5 200
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 400 300 500
Stock Unit Beg. DELIVERIES
February 2019 Unit
Level Cost Bal. 1st 2nd 3rd 4th 5th
OR Schedule pc 0.5
Report on Gas Use pc 0.5 60
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 300
ECG Request pc 0.5
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 200 300 300
Prohibited/Regulated Drugs pc 0.5 300
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
ROD's Report pc 0.75
NURSING UNIT FORMS:
Kardex pc 1.5
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 400 500
Diet List pc 1.5
Evaluation Form pc 0.75
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 400 200
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 50 300
blue pc 0.5 200
orange pc 0.5 200
yellow pc 0.5
pink pc 0.5 200
green pc 0.5 200
Oral Meds. Ticket, short white pc 0.5 400 500
blue pc 0.5 200
yellow pc 0.5 200
pink pc 0.5 200
green pc 0.5 100 300
Orange Card Big (treatment) pc 0.5 180
White Card Big (OF) pc 0.5 180

Stock Unit Beg. DELIVERIES

February 2019 Unit
Level Cost Bal. 1 st
2nd
3rd 4th 5th
OFFICE SUPPLIES
Pencil pc 6 2 2 2
Eraser pc 5 4 1 1
Pentelpen pc 40 2 2
Staple wire box 50 1
Paste pc 40
Masking tape pc 35 2 2 2
Scotch tape pc 25 3 2 2
Calculator pc 600
Scissor pc 120
Notebook pc 30 1
Battery: C+/ 9V pc 120 1 2
AA" pc 60 4
AAA pc 60 4 4
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6 1
Albatross pc 20.66 1
Scrubbing pad pc 22.65 1
Bottle Brush pc 33.65 1
Vinegar gallon 23.93
Alcohol ml 47 1 1

Approved By:

Sr. Rowena C. Rodil

Nursing Director
s, Office and Housekeeping Supplies
Total No. of Used End Total Cost of Total Cost of
Supplies Supplies Balance Used Supplies End Balance

750 250 500 375.00 750.00

700 350 525.00
1200 600 600 900.00 900.00

-50 50 -75.00 75.00

500 750.00

50 50 75.00

400

200 200 100.00

50 37.50

1200 1000 200 500.00 100.00

Total No. of Used End Total Cost of Total Cost of
Supplies Supplies Balance Used Supplies End Balance

60
 50 37.50
300 300 150.00
150 75.00

-100 100 -50.00 50.00

800 550 250 275.00 125.00

300 300 150.00

-150 150 -225.00 225.00

900 500 400 250.00 200.00

-300 300 -450.00 450.00
250 187.50

600 100 500 50.00 250.00

350 150 200 75.00 100.00

200 150 50 75.00 25.00
200 200 100.00
-10 10 -5.00 5.00
200 200 100.00
200 200 100.00
900 800 100 400.00 50.00
200 200 100.00
200 200 100.00
200 200 100.00
400 200 200 100.00 100.00
180 -20 200 -10.00 100.00
180 100 50.00

Total: 3,185.00 5,242.50

Total No. of Used End Total Cost of Total Cost of
Supplies Supplies Balance Used Supplies End Balance

6 2 4 12.00 24.00
6 3 3 15.00 15.00
4 3 1 120.00 40.00
1 1 50.00

6 3 105.00
7 2 50.00
1 1 30.00
3 2 1 240.00 120.00
4 3 1 180.00 60.00
8 8 480.00

Total: 1,077.00 464.00

1 1 41.60
1 1 20.66
1 1 22.65
1 1 33.65

2 2 94.00

Total: 212.56
Total Cost of Total Cost of
Used Supplies End Balance

Grand Total: 4,474.56 5,706.50

 MARCH

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
March 2019 Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5
Standing Order pc 1.5 500
Doctors' Order pc 1.5 500 350
Medication Sheet pc 1.5 350 600
Nurses Progress Notes pc 1.5 600
IVF Fluid Sheet pc 1.5 50
Intake/Output Chart pc 1.5 50
Transfusion of Bld. Comp. pc 1.5 500
Neurovital Sign Sheet pc 1.5 500
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5 50
Vital Sign Monitoring Sheet pc 1.5 50
Serial Monitoring Sheet pc 1.5
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5
Consent for Bld. Transfusion pc 1.5
Consent for Special Procedures pc 1.5
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75 50
Blue pc 0.75 50
White pc 0.75
Linen Request pc 0.5
Stock Unit Beg. DELIVERIES Total No. of
March 2019 Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 200 200
Report on Gas Use pc 0.5
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5
ECG Request pc 0.5

Page 1
 MARCH
Medical Specialty Unit Rt. Form pc 0.75 50 50
Osteorized Feeding Request pc 0.5
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5
Prohibited/Regulated Drugs pc 0.5 100 100
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75 150 150
Professional Fee pc 0.5
Diet List pc 1.5
Evaluation Form pc 0.75
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 250 250
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5
blue pc 0.5
orange pc 0.5 500 500
yellow pc 0.5
pink pc 0.5 200 200
green pc 0.5 50 50
Oral Meds. Ticket, short white pc 0.5
blue pc 0.5 10 10
yellow pc 0.5
pink pc 0.5
green pc 0.5 100 100
Orange Card Big (treatment) pc 0.5
White Card Big (OF) pc 0.5

Stock Unit Beg. DELIVERIES Total No. of

March 2019s Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6
Eraser pc 5
Pentelpen pc 40
Staple wire box 50
Paste pc 40 4 4
Masking tape pc 35 3 3
Scotch tape pc 25 1 1
Calculator pc 600 1 1
Scissor pc 120
Notebook pc 30 3 3
Battery: C+/ 9V pc 120 2 2
AA" pc 60

Page 2
 MARCH
AAA pc 60
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66
Scrubbing pad pc 22.65
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47

Gra
Approved By:

Sr. Rowena C. Rodil

Nursing Director

Page 3
 MARCH

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

300 200 450.00 300.00

350 525.00
500 100 750.00 150.00
250 375.00
50 75.00

150 225.00

150 225.00

200 150.00

-100 100 -50.00 50.00

-200 200 -100.00 100.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
200 100.00

Page 4
 MARCH

-500 500 -250.00 250.00

100 50.00

-200 200 -300.00 300.00

50 25.00

-50 50 -25.00 25.00

100 75.00

-150 400 -75.00 200.00

50 25.00
-150 150 -75.00 75.00

200 100.00

-100 100 -50.00 50.00

-20 30 -10.00 15.00

50 25.00
-200 200 -100.00 100.00
-200 200 -100.00 100.00

Total: 915.00 2,840.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

-2 2 -12.00 12.00
2 10.00

3 105.00
-1 2 -25.00 50.00

2 240.00
2 120.00

Page 5
 MARCH
-2 2 -120.00 120.00

Total: 188.00 312.00

1 41.60
1 20.66

Total: 41.60 20.66

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 1,144.60 3,172.66

Page 6
 APRIL

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
April 2018 Unit
Level Cost Bal. 1 st
2nd
3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5
Standing Order pc 1.5
Doctors' Order pc 1.5 200 300 200 700
Medication Sheet pc 1.5 200 200
Nurses Progress Notes pc 1.5 100 300 500 900
IVF Fluid Sheet pc 1.5 250 250
Intake/Output Chart pc 1.5
Transfusion of Bld. Comp. pc 1.5
Neurovital Sign Sheet pc 1.5 150 150
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 150 150
Serial Monitoring Sheet pc 1.5
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 200 200
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5
Consent for Bld. Transfusion pc 1.5
Consent for Special Procedures pc 1.5
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 100 100
Laboratory Request pink pc 0.75
Yellow pc 0.75
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 200 300 500 1000

April 2018 Unit Stock Unit Beg. Total No. of

Level Cost Bal. 1st 2nd 3rd 4th 5th Supplies
OR Schedule pc 0.5
Report on Gas Use pc 0.5 300 200 500
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 300 300 600
ECG Request pc 0.5

Page 7
 APRIL
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 500 400 500 1400
Prohibited/Regulated Drugs pc 0.5 200 200
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 200 200 400
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 50 100 150
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 50 400 500 950
Diet List pc 1.5
Evaluation Form pc 0.75 100 100
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 400 300 700
Blood Component Ticket pc 0.5 50 50
IV Meds. Ticket, long White pc 0.5 150 200 350
blue pc 0.5
orange pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 100 300 300 700
blue pc 0.5 30 30
yellow pc 0.5
pink pc 0.5
green pc 0.5 50 50
Orange Card Big (treatment) pc 0.5 200 60 260
White Card Big (OF) pc 0.5 200 200

Stock Unit Beg. DELIVERIES Total No. of

April 2018 Unit
Level Cost Bal. 1 st
2nd
3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 2 2 1 5
Eraser pc 5 2 2
Pentelpen pc 40 2 2 4
Staple wire box 50
Paste pc 40
Masking tape pc 35 2 2 4
Scotch tape pc 25 2 2
Calculator pc 600
Scissor pc 120
Notebook pc 30
Battery: C+/ 9V pc 120 2 2
AA" pc 60 2 2

Page 8
 APRIL
AAA pc 60 2 3 8 13
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66 1 1 1 3
Scrubbing pad pc 22.65 1 1 2
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47 1 1 2

Gra
Approved By:

Sr. Rowena C. Rodil

Nursing Director

Page 9
 APRIL

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

150 225.00
75 112.50
600 100 900.00 150.00
180 20 270.00 30.00
700 200 1,050.00 300.00
100 150.00

200 150.00

100 150.00
100 150.00
100 150.00

80 120.00

300 150.00
100 75.00
100 75.00

1000 500.00
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 25.00
400 100 200.00 50.00

500 100 250.00 50.00

Page 10
 APRIL
200 150.00
50 25.00
200 100.00
400 200.00
200 100.00

150 225.00

100 300 150.00 450.00

50 100 25.00 50.00

850 100 425.00 50.00

300 450.00
150 112.50

100 600 50.00 300.00

100 50.00
150 200 75.00 100.00
50 25.00
200 100.00
300 150.00
100 50.00

700 350.00

100 50.00

160 100 80.00 50.00

100 50.00

Total: 4,625.00 4,650.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

5 30.00

4 160.00
1 50.00

2 2 70.00 70.00
1 25.00

2 240.00

Page 11
 APRIL
13 780.00

Total: 1,280.00 145.00

3 61.98
1 1 22.65 22.65

2 94.00

Total: 178.63 22.65

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 6,083.63 4,817.65

Page 12
 MAY

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
May 2018 Unit
Level Cost Bal. st
1 2nd
3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 150 150
Standing Order pc 1.5 75 75
Doctors' Order pc 1.5 100 100
Medication Sheet pc 1.5 20 20
Nurses Progress Notes pc 1.5 200 300 500
IVF Fluid Sheet pc 1.5 100 100
Intake/Output Chart pc 1.5
Transfusion of Bld. Comp. pc 1.5
Neurovital Sign Sheet pc 1.5
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5 150 150
Vital Sign Monitoring Sheet pc 1.5
Serial Monitoring Sheet pc 1.5
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 200 200
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5 100 100
Consent for Bld. Transfusion pc 1.5 100 100
Consent for Special Procedures pc 1.5 100 100
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5 80 80
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 300 300 200 800
Laboratory Request pink pc 0.75 100 100
Yellow pc 0.75 100 100
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 500 200 700
Stock Unit Beg. DELIVERIES Total No. of
May 2018 Unit
Level Cost Bal. st
1 2nd
3rd 4th 5th Supplies
OR Schedule pc 0.5 50 50
Report on Gas Use pc 0.5 100 300 200 600
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 100 300 200 600
ECG Request pc 0.5

Page 13
 MAY
Medical Specialty Unit Rt. Form pc 0.75 200 200
Osteorized Feeding Request pc 0.5 50 300 300 650
In Patient Prescription pc 0.5 200 200
Out Patient Prescription pc 0.5 600 200 800
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 150 150
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 300 200 500
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 100 100
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 100 300 400
Diet List pc 1.5 300 300
Evaluation Form pc 0.75 150 150
Daily Work Sheet pc 0.75 200 200

TICKETS:
IVF Ticket pc 0.5 600 300 300 1200
Blood Component Ticket pc 0.5 100 100
IV Meds. Ticket, long White pc 0.5 200 200 400
blue pc 0.5 50 200 250
orange pc 0.5 200 200
yellow pc 0.5 300 300
pink pc 0.5 100 100
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 200 200
blue pc 0.5 200 200
yellow pc 0.5 100 100
pink pc 0.5 200 200
green pc 0.5
Orange Card Big (treatment) pc 0.5 100 180 280
White Card Big (OF) pc 0.5 100 100 200

Stock Unit Beg. DELIVERIES Total No. of

May 2018 Unit
Level Cost Bal. st
1 2nd
3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 2 1 3
Eraser pc 5
Pentelpen pc 40 2 2
Staple wire box 50 1 1
Paste pc 40
Masking tape pc 35 2 2 2 6
Scotch tape pc 25 1 1 2
Calculator pc 600
Scissor pc 120 1 1
Notebook pc 30 1 1
Battery: C+/ 9V pc 120
AA" pc 60 2 2

Page 14
 MAY
AAA pc 60 4 4
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 41.6
Albatross pc 20.66 1 1 2
Scrubbing pad pc 22.65 1 1 1 3
Bottle Brush pc 33.65 1 1 2
Vinegar gallon 23.93
Alcohol ml 47
Carbon Paper pc 2

Gra
Approved By:

Sr. Rowena C. Rodil

Nursing Director

Page 15
 MAY

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

140 210.00
75 112.50
200 300.00

350 150 525.00 225.00

100 150.00

40 60.00

50 75.00

150 225.00
100 150.00
90 135.00

300 225.00

80 120.00
75 112.50
70 105.00

70 105.00

700 100 350.00 50.00

70 52.50
80 60.00

600 100 300.00 50.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
40 20.00
540 60 270.00 30.00

400 200 200.00 100.00

Page 16
 MAY
100 100 75.00 75.00
625 25 312.50 12.50
250 125.00
700 100 350.00 50.00

50 100 75.00 150.00

300 200 450.00 300.00

40 20.00

100 300 50.00 150.00

300 450.00
60 45.00
200 150.00

900 300 450.00 150.00

25 12.50
300 100 150.00 50.00
190 60 95.00 30.00
300 150.00
290 145.00
50 25.00

100 100 50.00 50.00

100 100 50.00 50.00
60 30.00
200 100.00

230 50 115.00 25.00

160 40 80.00 20.00

Total: 4,422.50 4,562.50

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

2 1 12.00 6.00
1 5.00
1 1 40.00 40.00
1 50.00

6 210.00
2 50.00

1 120.00
1 30.00

2 120.00

Page 17
 MAY
4 240.00

Total: 822.00 101.00

2 41.32
3 67.95
2 67.30

Total: 176.57

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 5,421.07 4,663.50

Page 18
 JUNE

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
June 2019 Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 140 140
Standing Order pc 1.5 75 75
Doctors' Order pc 1.5 200 200
Medication Sheet pc 1.5
Nurses Progress Notes pc 1.5 150 150
IVF Fluid Sheet pc 1.5 100 100
Intake/Output Chart pc 1.5
Transfusion of Bld. Comp. pc 1.5
Neurovital Sign Sheet pc 1.5
Partograph pc 1.5
Pre-Operative Checklist pc 1.5 40 40
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5 50 50
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 100 100
Serial Monitoring Sheet pc 1.5 90 90
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 300 300
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5 80 80
Consent for Bld. Transfusion pc 1.5 75 75
Consent for Special Procedures pc 1.5 70 70
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5 70 70
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 100 100
Laboratory Request pink pc 0.75 70 70
Yellow pc 0.75 80 80
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 100 100
Stock Unit Beg. DELIVERIES Total No. of
June 2019 Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 40 40
Report on Gas Use pc 0.5 60 60
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 200 200
ECG Request pc 0.5 100 100

Page 19
 JUNE
Medical Specialty Unit Rt. Form pc 0.75 100 100
Osteorized Feeding Request pc 0.5 25 25
In Patient Prescription pc 0.5 250 250
Out Patient Prescription pc 0.5 100 100
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 100 100
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 200 200
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 40 40
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 300 300
Diet List pc 1.5 300 300
Evaluation Form pc 0.75 60 60
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 300 300
Blood Component Ticket pc 0.5 25 25
IV Meds. Ticket, long White pc 0.5 100 100
blue pc 0.5 60 60
orange pc 0.5 300 300
yellow pc 0.5 290 290
pink pc 0.5 50 50
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 100 100
blue pc 0.5 100 100
yellow pc 0.5 60 60
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5 50 50
White Card Big (OF) pc 0.5 40 40

Stock Unit Beg. DELIVERIES Total No. of

June 2019 Unit
Level Cost Bal. 1 st nd
2 3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 1 1
Eraser pc 5 1 1
Pentelpen pc 40 1 1
Staple wire box 50 1 1
Paste pc 40
Masking tape pc 35
Scotch tape pc 25
Calculator pc 600
Scissor pc 120
Notebook pc 30
Battery: C+/ 9V pc 120
AA" pc 60

Page 20
 JUNE
AAA pc 60
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66
Scrubbing pad pc 22.65
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47

Gra
Approved By:

Sr. Rowena C. Rodil

Nursing Director

Page 21
 JUNE

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

100 150.00
50 75.00
100 100 150.00 150.00

50 100 75.00 150.00

30 45.00

5 45 7.50 67.50

50 50 75.00 75.00
80 120.00

150 112.50

70 105.00
60 90.00
60 90.00

60 90.00

50 50 25.00 25.00
70 50 52.50 37.50
50 37.50

60 40 30.00 20.00
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
10 30 5.00 15.00
20 10.00

100 100 50.00 50.00

100 50.00

Page 22
 JUNE
50 37.50
-75 100 -37.50 50.00
100 150 50.00 75.00
-100 200 -50.00 100.00

45 67.50

180 20 270.00 30.00

20 10.00

-150 450 -75.00 225.00

600 900.00
20 40 15.00 30.00

250 50 125.00 25.00

20 5 10.00 2.50
-100 200 -50.00 100.00
30 30 15.00 15.00
150 150 75.00 75.00
100 190 50.00 95.00
25 25 12.50 12.50

-50 150 -25.00 75.00

50 50 25.00 25.00
60 30.00

30 20 15.00 10.00
20 20 10.00 10.00

Total: 905.00 3,565.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

1 6.00
-1 2 -5.00 10.00
1 40.00
1 50.00

-3 3 -105.00 105.00
-1 1 -25.00 25.00

Page 23
 JUNE

-135.00 236.00

-1 1 -33.65 33.65

Total: -33.65 33.65

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 736.35 3,834.65

Page 24
 JULY

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
July 2019 Unit
Level Cost Bal. st
1 nd
2 3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 100 100
Standing Order pc 1.5 50 50
Doctors' Order pc 1.5 100 500 600
Medication Sheet pc 1.5 500 500
Nurses Progress Notes pc 1.5 100 500 600
IVF Fluid Sheet pc 1.5 200 200
Intake/Output Chart pc 1.5 300 300
Transfusion of Bld. Comp. pc 1.5 600 600
Neurovital Sign Sheet pc 1.5 500 500
Partograph pc 1.5
Pre-Operative Checklist pc 1.5 30 300 330
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5 45 500 545
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 50 500 550
Serial Monitoring Sheet pc 1.5 80 80
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 150 200 350
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5 70 70
Consent for Bld. Transfusion pc 1.5 60 300 360
Consent for Special Procedures pc 1.5 60 60
WAIVER:
Authorization of Release Body pc 1.5 350 350
HAMA Form pc 1.5 60 300 360
Refusal of Treatment pc 1.5 300 300

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 50 500 550
Laboratory Request pink pc 0.75 50 50
Yellow pc 0.75 50 50
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 40 500 540
Stock Unit Beg. DELIVERIES Total No. of
July 2019 Unit
Level Cost Bal. st
1 nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 30 30
Report on Gas Use pc 0.5 20 20
X-Ray Request pc 0.75 500 500
Returned Meds. Supplies pc 0.5 100 500 600
ECG Request pc 0.5 100 100

Page 25
 JULY
Medical Specialty Unit Rt. Form pc 0.75 50 300 350
Osteorized Feeding Request pc 0.5 100 100
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5 200 500 700
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 45 45
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 20 500 520
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 20 20
Discharge Checklist pc 1.5 400 400
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 450 500 950
Diet List pc 1.5 600 500 1100
Evaluation Form pc 0.75 40 40
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 50 500 500 1050
Blood Component Ticket pc 0.5 5 300 305
IV Meds. Ticket, long White pc 0.5 200 500 700
blue pc 0.5 30 300 330
orange pc 0.5 150 200 350
yellow pc 0.5 190 200 390
pink pc 0.5 25 300 200 525
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 150 500 650
blue pc 0.5 50 300 350
yellow pc 0.5 60 100 160
pink pc 0.5 100 100
green pc 0.5 100 100
Orange Card Big (treatment) pc 0.5 20 500 520
White Card Big (OF) pc 0.5 20 300 320

Stock Unit Beg. DELIVERIES Total No. of

July 2019 Unit
Level Cost Bal. st
1 nd
2 3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 1 2 2 5
Eraser pc 5 2 1 2 5
Pentelpen pc 40 1 2 2 5
Staple wire box 50 1 1
Paste pc 40
Masking tape pc 35 3 2 2 7
Scotch tape pc 25 1 2 2 5
Calculator pc 600
Scissor pc 120
Notebook pc 30 1 1
Battery: C+/ 9V pc 120
AA" pc 60 6 6

Page 26
 JULY
AAA pc 60 4 4 8
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6
Albatross pc 20.66 1 1
Scrubbing pad pc 22.65 1 1
Bottle Brush pc 33.65 1 1 2
Vinegar gallon 23.93
Alcohol ml 47 2 2

Gra
Approved By:

Sr. Rowena C. Rodil

Nursing Director

Page 27
 JULY

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

50 75.00
20 30.00
500 100 750.00 150.00
500 750.00
500 100 750.00 150.00
200 300.00
100 150.00
600 900.00
500 750.00

320 10 480.00 15.00

35 52.50

15 22.50
150 225.00

200 150 150.00 112.50

20 50 30.00 75.00
30 45.00
20 30.00

350 525.00
50 75.00
300 450.00

500 50 250.00 25.00

25 18.75
20 15.00

100 150 50.00 75.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
10 5.00
15 7.50
500 375.00
500 100 250.00 50.00
100 50.00

Page 28
 JULY
20 15.00
95 5 47.50 2.50
150 75.00
650 50 325.00 25.00

15 22.50

470 50 705.00 75.00

80 40.00

450 200 225.00 100.00

400 150 600.00 225.00
10 7.50

900 150 450.00 75.00

300 5 150.00 2.50
660 40 330.00 20.00
300 30 150.00 15.00
200 150 100.00 75.00
290 100 145.00 50.00
510 15 255.00 7.50

300 150 150.00 75.00

350 175.00
130 30 65.00 15.00
100 50.00
100 50.00
150 100 75.00 50.00
305 15 152.50 7.50

Total: 10,960.00 2,433.75

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

1 4 6.00 24.00
3 2 15.00 10.00
3 2 120.00 80.00
1 50.00
3 120.00
6 1 210.00 35.00
4 1 100.00 25.00

1 30.00
1 120.00
6 360.00

Page 29
 JULY
8 480.00

1,321.00 464.00

1 75.00

1 20.66
1 22.65
1 1 33.65 33.65

2 94.00

Total: 150.30 129.31

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 12,431.30 3,027.06

Page 30
 AUGUST

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
August 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 50 200 250
Standing Order pc 1.5 20 20
Doctors' Order pc 1.5 100 500 400 1000
Medication Sheet pc 1.5 600 500 1100
Nurses Progress Notes pc 1.5 100 400 500 1000
IVF Fluid Sheet pc 1.5
Intake/Output Chart pc 1.5 100 300 400
Transfusion of Bld. Comp. pc 1.5 200 200
Neurovital Sign Sheet pc 1.5 500 500
Partograph pc 1.5
Pre-Operative Checklist pc 1.5 10 400 410
Diabetic Flowsheet pc 1.5 200 200
Medico-Legal Form pc 1.5 35 35
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 15 300 315
Serial Monitoring Sheet pc 1.5 150 150
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 150 150
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5 50 50
Consent for Bld. Transfusion pc 1.5 30 200 230
Consent for Special Procedures pc 1.5 20 20
WAIVER:
Authorization of Release Body pc 1.5 100 100
HAMA Form pc 1.5 50 100 100 250
Refusal of Treatment pc 1.5 200 200

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 50 800 200 1050
Laboratory Request pink pc 0.75 25 500 525
Yellow pc 0.75 20 600 620
Green pc 0.75
Blue pc 0.75 100 100
White pc 0.75
Linen Request pc 0.5 150 500 400 1050
Stock Unit Beg. DELIVERIES Total No. of
August 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 10 10
Report on Gas Use pc 0.5 15 500 200 715
X-Ray Request pc 0.75 300 300
Returned Meds. Supplies pc 0.5 100 500 400 1000
ECG Request pc 0.5 100 100 200

Page 31
 AUGUST
Medical Specialty Unit Rt. Form pc 0.75 20 600 620
Osteorized Feeding Request pc 0.5 5 300 305
In Patient Prescription pc 0.5 150 300 450
Out Patient Prescription pc 0.5 50 400 500 950
Prohibited/Regulated Drugs pc 0.5 300 300
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 15 100 300 415
Pedia pc 1.5 300 350 650
NURSING UNIT FORMS:
Kardex pc 1.5 50 500 200 750
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 80 80
Discharge Checklist pc 1.5 400 400
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 200 400 500 1100
Diet List pc 1.5 150 350 500 1000
Evaluation Form pc 0.75 10 10
Daily Work Sheet pc 0.75 100 100

TICKETS:
IVF Ticket pc 0.5 150 300 200 650
Blood Component Ticket pc 0.5 5 600 605
IV Meds. Ticket, long White pc 0.5 40 300 400 740
blue pc 0.5 30 200 200 430
orange pc 0.5 150 150
yellow pc 0.5 100 100
pink pc 0.5 15 15
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 150 500 500 1150
blue pc 0.5
yellow pc 0.5 30 30
pink pc 0.5
green pc 0.5 200 200
Orange Card Big (treatment) pc 0.5 100 800 240 1140
White Card Big (OF) pc 0.5 15 800 180 15

Stock Unit Beg. DELIVERIES Total No. of

August 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 4 1 2 7
Eraser pc 5 2 1 3
Pentelpen pc 40 2 1 2 5
Staple wire box 50 1 1
Paste pc 40
Masking tape pc 35 3 2 2 7
Scotch tape pc 25 1 2 2 5
Calculator pc 600
Scissor pc 120
Notebook pc 30 1 1
Battery: C+/ 9V pc 120 1 1
AA" pc 60 4 4

Page 32
 AUGUST
AAA pc 60 4 4
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6 2 2
Albatross pc 20.66 1 1
Scrubbing pad pc 22.65 1 1 2
Bottle Brush pc 33.65 1 1
Vinegar gallon 23.93
Alcohol ml 47 1 1

Gra
Approved By:

Sr. Rowena C. Rodil

Nursing Director
]

Page 33
 AUGUST

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

200 50 300.00 75.00

5 7.50
800 200 1,200.00 300.00
150 225.00
800 200 1,200.00 300.00

350 525.00
75 112.50
500 750.00

200 300.00
35 52.50

200 300.00

100 75.00

50 75.00
10 15.00
10 15.00

100 150.00
40 60.00
200 300.00

950 100 475.00 50.00

515 10 386.25 7.50
605 15 453.75 11.25

100 75.00

800 250 400.00 125.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
-40 50 -20.00 25.00
70 35.00
300 225.00
900 100 450.00 50.00

Page 34
 AUGUST
10 7.50
105 200 52.50 100.00
300 150 150.00 75.00
800 150 400.00 75.00
300 150.00

80 120.00
50 75.00

650 100 975.00 150.00

50 25.00
400 600.00

900 200 450.00 100.00

850 150 1,275.00 225.00
10 7.50
100 75.00

600 300.00
455 150 227.50 75.00
240 500 120.00 250.00
200 100.00
100 50.00
100 50.00
300 150.00

750 400 375.00 200.00

200 100.00
10 5.00
350 175.00
200 100.00
900 240 450.00 120.00
5 10 2.50 5.00

Total: 12,047.50 4,981.25

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

3 4 18.00 24.00
3 15.00
2 3 80.00 120.00
1 50.00

4 3 140.00 105.00
3 2 75.00 50.00

1 30.00
1 120.00
4 240.00

Page 35
 AUGUST
4 240.00

993.00 314.00

1 75.00

-1 2 -20.66 41.32
1 1 22.65 22.65
1 33.65

Total: 76.99 97.62

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 13,117.49 5,392.87

Page 36
 SEPTEMBER

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
September 2019 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 50 50
Standing Order pc 1.5 5 5
Doctors' Order pc 1.5 200 200
Medication Sheet pc 1.5 150 300 100 550
Nurses Progress Notes pc 1.5 200 200
IVF Fluid Sheet pc 1.5
Intake/Output Chart pc 1.5 350 350
Transfusion of Bld. Comp. pc 1.5 75 75
Neurovital Sign Sheet pc 1.5
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5 35 35
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 200 200
Serial Monitoring Sheet pc 1.5 350 350
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 100 100
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5 50 50
Consent for Bld. Transfusion pc 1.5 10 10
Consent for Special Procedures pc 1.5 10 10
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5 40 40
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 100 100
Laboratory Request pink pc 0.75 10 10
Yellow pc 0.75 15 15
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 250 400 300 950
Stock Unit Beg. DELIVERIES Total No. of
September 201 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
OR Schedule pc 0.5 50 50
Report on Gas Use pc 0.5 70 70
X-Ray Request pc 0.75
Returned Meds. Supplies pc 0.5 100 300 400
ECG Request pc 0.5

Page 37
 SEPTEMBER
Medical Specialty Unit Rt. Form pc 0.75 10 10
Osteorized Feeding Request pc 0.5 200 200
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5 150 500 300 950
Prohibited/Regulated Drugs pc 0.5
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5 80 80
Pedia pc 1.5 50 50
NURSING UNIT FORMS:
Kardex pc 1.5 100 100
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 50 50
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 200 400 500 1100
Diet List pc 1.5 150 150
Evaluation Form pc 0.75 10 10
Daily Work Sheet pc 0.75 100 100

TICKETS:
IVF Ticket pc 0.5 600 600
Blood Component Ticket pc 0.5 150 300 200 650
IV Meds. Ticket, long pc 0.5 500 200 100 800
blue pc 0.5 200 100 300
orange pc 0.5 100 100 200 400
yellow pc 0.5 100 300 400
pink pc 0.5 300 300
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 400 200 300 900
blue pc 0.5 200 100 300
yellow pc 0.5 10 100 110
pink pc 0.5 350 350
green pc 0.5
Orange Card Big (treatment) pc 0.5 240 180 420
White Card Big (OF) pc 0.5 10 180 190

Stock Unit Beg. DELIVERIES Total No. of

September 2019 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 4 4
Eraser pc 5 3 3
Pentelpen pc 40 3 3
Staple wire box 50
Paste pc 40
Masking tape pc 35 3 1 1 5
Scotch tape pc 25 2 1 1 4
Calculator pc 600
Scissor pc 120
Notebook pc 30
Battery: C+/ 9V pc 120
AA" pc 60

Page 38
 SEPTEMBER
AAA pc 60 16 16
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75
Powder/Detergent packs 3 41.6
Albatross pc 20.66 2 2
Scrubbing pad pc 22.65 1 1
Bottle Brush pc 33.65 1 1 2
Vinegar gallon 23.93
Alcohol ml 47

Gra
Prepared By: Approved By:

Sr. Rowena C. Rodil

Acting Head Nurse Nursing Director

Page 39
 SEPTEMBER

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

50 75.00
5 7.50
-50 250 -75.00 375.00
500 50 750.00 75.00
450 150 225.00

100 250 150.00 375.00

-45 120 -67.50 180.00
-25 25 -37.50 37.50

35 52.50

100 100 150.00 150.00

350 525.00

100 75.00

-100 150 -150.00 225.00

-20 30 -30.00 45.00
10 15.00

40 60.00

40 60 20.00 30.00
10 7.50
15 11.25

-40 40 -30.00 30.00

800 150 400.00 75.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
50 25.00
20 50 10.00 25.00
-100 100 -75.00 75.00
355 45 177.50 22.50

Page 40
 SEPTEMBER
10 7.50
200 100.00
150 75.00
600 350 300.00 175.00
50 25.00

80 120.00
50 75.00

50 50 75.00 75.00

50 25.00

900 200 450.00 100.00

150 225.00
-70 80 -52.50 60.00
30 70 22.50 52.50

350 250 175.00 125.00

650 325.00
600 200 300.00 100.00
300 150.00
400 200.00
400 200.00
290 10 145.00 5.00

650 250 325.00 125.00

300 150.00
110 55.00
350 175.00

370 50 185.00 25.00

190 95.00

Total: 5,380.00 3,381.25

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

-1 5 -6.00 30.00
2 1 10.00 5.00
1 2 40.00 80.00

2 3 70.00 105.00
3 1 75.00 25.00

Page 41
 SEPTEMBER
16 960.00

1,149.00 245.00

-1 1 -75.00 75.00
-1 1 -41.60 41.60
1 1 20.66 20.66
1 22.65
2 67.30

Total: -28.64 159.91

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 6,500.36 3,786.16

Page 42
 OCTOBER

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
October 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 50 50
Standing Order pc 1.5
Doctors' Order pc 1.5 250 200 100 550
Medication Sheet pc 1.5 50 300 350
Nurses Progress Notes pc 1.5 150 300 150 600
IVF Fluid Sheet pc 1.5
Intake/Output Chart pc 1.5 250 250
Transfusion of Bld. Comp. pc 1.5 120 120
Neurovital Sign Sheet pc 1.5 25 25
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 100 100
Serial Monitoring Sheet pc 1.5
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 100 100
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5 150 150
Consent for Bld. Transfusion pc 1.5 30 30
Consent for Special Procedures pc 1.5
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 60 100 160
Laboratory Request pink pc 0.75 10 10
Yellow pc 0.75 15 15
Green pc 0.75
Blue pc 0.75 40 40
White pc 0.75
Linen Request pc 0.5 150 500 100 750
Stock Unit Beg. DELIVERIES Total No. of
October 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5 300 300
Report on Gas Use pc 0.5 50 50
X-Ray Request pc 0.75 100 100
Returned Meds. Supplies pc 0.5 45 300 345
ECG Request pc 0.5

Page 43
 OCTOBER
Medical Specialty Unit Rt. Form pc 0.75 300 300
Osteorized Feeding Request pc 0.5 200 200
In Patient Prescription pc 0.5 150 150
Out Patient Prescription pc 0.5 350 500 200 1050
Prohibited/Regulated Drugs pc 0.5 50 50
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 50 50
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 500 100 600
Discharge Checklist pc 1.5 150 150
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 300 300
Diet List pc 1.5 150 150
Evaluation Form pc 0.75 80 80
Daily Work Sheet pc 0.75 70 100 170

TICKETS:
IVF Ticket pc 0.5 250 300 200 750
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 200 300 500
blue pc 0.5
orange pc 0.5
yellow pc 0.5
pink pc 0.5 10 10
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 250 300 200 750
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5 50 240 290
White Card Big (OF) pc 0.5 300 300

Stock Unit Beg. DELIVERIES Total No. of

October 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 5 5
Eraser pc 5 1 1
Pentelpen pc 40 2 2
Staple wire box 50
Paste pc 40
Masking tape pc 35 3 2 1 6
Scotch tape pc 25 1 2 1 4
Calculator pc 600
Scissor pc 120
Notebook pc 30 1 1
Battery: C+/ 9V pc 120
AA" pc 60

Page 44
 OCTOBER
AAA pc 60 16 16
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6 1 1
Albatross pc 20.66 1 1
Scrubbing pad pc 22.65 1 1 2
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47 1 1

Gra
Prepared By: Approved By:

Sr. Rowena C. Rodil

NSO Secretary Nursing Director

Page 45
 OCTOBER

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

50 75.00

450 100 675.00 150.00

330 20 495.00 30.00
480 120 180.00
-50 50 -75.00 75.00
100 150 150.00 225.00
120 180.00
-75 100 -112.50 150.00

-75 75 -112.50 112.50

100 150.00
-180 180 -270.00 270.00

50 50 37.50 37.50

-10 160 -15.00 240.00

-90 120 -135.00 180.00

125 35 62.50 17.50

-40 50 -30.00 37.50
15 11.25

40 30.00

600 150 300.00 75.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
300 150.00
-25 75 -12.50 37.50
25 75 18.75 56.25
295 50 147.50 25.00

Page 46
 OCTOBER
300 225.00
150 50 75.00 25.00
50 100 25.00 50.00
800 250 400.00 125.00
50 25.00

-50 100 -75.00 150.00

570 30 285.00 15.00

150 225.00

100 200 50.00 100.00

150 225.00
80 60.00
170 127.50

450 300 225.00 150.00

300 200 150.00 100.00

-50 50 -25.00 25.00

-40 50 -20.00 25.00

500 250 250.00 125.00

210 80 105.00 40.00

250 50 125.00 25.00

Total: 3,631.25 3,400.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

1 4 6.00 24.00
1 5.00
-1 3 -40.00 120.00

4 2 140.00 70.00
2 2 50.00 50.00

1 30.00

Page 47
 OCTOBER
14 2 840.00 120.00

1,026.00 389.00

1 75.00
1 41.60
-1 2 -20.66 41.32
2 45.30
-1 1 -33.65 33.65

1 47.00

Total: -12.71 242.27

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 4,644.54 4,031.27

Page 48
 NOVEMBER

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
November 2019 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 50 50
Standing Order pc 1.5
Doctors' Order pc 1.5 100 200 300
Medication Sheet pc 1.5 20 20
Nurses Progress Notes pc 1.5 120 300 420
IVF Fluid Sheet pc 1.5 50 50
Intake/Output Chart pc 1.5 150 150
Transfusion of Bld. Comp. pc 1.5
Neurovital Sign Sheet pc 1.5 100 100
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5 75 75
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5 100 100
Serial Monitoring Sheet pc 1.5 180 180
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 50 50
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5 160 160
Consent for Bld. Transfusion pc 1.5 120 120
Consent for Special Procedures pc 1.5
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 35 35
Laboratory Request pink pc 0.75 50 50
Yellow pc 0.75 15 15
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 150 500 650
Stock Unit Beg. DELIVERIES Total No. of
November 2019 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
OR Schedule pc 0.5
Report on Gas Use pc 0.5 75 75
X-Ray Request pc 0.75 75 75
Returned Meds. Supplies pc 0.5 50 50
ECG Request pc 0.5

Page 49
 NOVEMBER
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5 50 50
In Patient Prescription pc 0.5 100 100
Out Patient Prescription pc 0.5 250 500 750
Prohibited/Regulated Drugs pc 0.5 50 50
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 100 100
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5 30 30
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 200 400 600
Diet List pc 1.5 150 150
Evaluation Form pc 0.75 80 80
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 300 400 700
Blood Component Ticket pc 0.5
IV Meds. Ticket, long White pc 0.5 200 200
blue pc 0.5 50 50
orange pc 0.5
yellow pc 0.5
pink pc 0.5 50 50
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 250 400 650
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5 80 300 380
White Card Big (OF) pc 0.5 50 50

Stock Unit Beg. DELIVERIES Total No. of

November 2019 Unit
Level Cost Bal. 1st
2nd
3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 4 2 6
Eraser pc 5 1 1
Pentelpen pc 40 3 1 4
Staple wire box 50
Paste pc 40
Masking tape pc 35 2 2 4
Scotch tape pc 25 2 2 4
Calculator pc 600
Scissor pc 120
Notebook pc 30
Notebook pc 120
AA" pc 60

Page 50
 NOVEMBER
AAA pc 60 2 4 6
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6
Albatross pc 20.66 2 2
Scrubbing pad pc 22.65 2 2
Bottle Brush pc 33.65 1 1
Vinegar gallon 23.93
Alcohol ml 47 1 1 2

Gra
Prepared By: Approved By:

Maria Angelica Javier Sr. Rowena C. Rodil, SPC

Headnurse Nursing Director

Page 51
 NOVEMBER

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

50 75.00

200 100 300.00 150.00

-30 50 -45.00 75.00
300 120 180.00
50 75.00
150 225.00

100 150.00

-5 80 -7.50 120.00

100 150.00
180 270.00

-70 120 -52.50 90.00

160 240.00
120 180.00

-15 50 -7.50 25.00

50 37.50
14 1 10.50 0.75

600 50 300.00 25.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

25 50 12.50 25.00
25 50 18.75 37.50
-50 100 -25.00 50.00

Page 52
 NOVEMBER

50 25.00
100 50.00
725 25 362.50 12.50
50 25.00

100 150.00

30 15.00

480 120 240.00 60.00

30 120 45.00 180.00
65 15 48.75 11.25

500 200 250.00 100.00

-50 50 -25.00 25.00
200 100.00
30 20 15.00 10.00

50 25.00

500 150 250.00 75.00

380 190.00
50 25.00

Total: 3,423.00 1,527.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

4 2 24.00 12.00
1 5.00
4 160.00

2 2 70.00 70.00
3 1 75.00 25.00

Page 53
 NOVEMBER
4 2 240.00 120.00

569.00 232.00

1 75.00
-11 11 -457.60 457.60
2 41.32
2 45.30
1 33.65

2 94.00

Total: -243.33 532.60

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 3,748.67 2,291.60

Page 54
 DECEMBER

Financial Report of Nursing Service Units' Forms, Office and Housekeeping S

Stock Unit Beg. DELIVERIES Total No. of
December 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
CHART FORMS
TPR Graphic Sheet pc 1.5 50 50
Standing Order pc 1.5
Doctors' Order pc 1.5 100 200 300
Medication Sheet pc 1.5 50 50
Nurses Progress Notes pc 1.5 120 200 320
IVF Fluid Sheet pc 1.5
Intake/Output Chart pc 1.5
Transfusion of Bld. Comp. pc 1.5
Neurovital Sign Sheet pc 1.5
Partograph pc 1.5
Pre-Operative Checklist pc 1.5
Diabetic Flowsheet pc 1.5 80 80
Medico-Legal Form pc 1.5
Illustration of injuries pc 1.5
Physical Therapy Notes pc 1.5
Consultation Sheet pc 1.5
Vital Sign Monitoring Sheet pc 1.5
Serial Monitoring Sheet pc 1.5
Charge Nurse Worksheet #1 pc 1.5
Charge Nurse Worksheet #2 pc 1.5
Doctors list pc 0.75 120 120
Newsprint(for outsource medicine) pc 1.5
CONSENT FORM:
Consent for Operation and Anes pc 1.5
Consent for Bld. Transfusion pc 1.5
Consent for Special Procedures pc 1.5
WAIVER:
Authorization of Release Body pc 1.5
HAMA Form pc 1.5
Refusal of Treatment pc 1.5

REQUEST:
Supply Requisition pc 0.75
Central Service pc 0.5 50 50
Laboratory Request pink pc 0.75
Yellow pc 0.75 1 1
Green pc 0.75
Blue pc 0.75
White pc 0.75
Linen Request pc 0.5 50 300 350
Stock Unit Beg. DELIVERIES Total No. of
December 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OR Schedule pc 0.5
Report on Gas Use pc 0.5 50 50
X-Ray Request pc 0.75 50 50
Returned Meds. Supplies pc 0.5 100 100
ECG Request pc 0.5

Page 55
 DECEMBER
Medical Specialty Unit Rt. Form pc 0.75
Osteorized Feeding Request pc 0.5 50 50
In Patient Prescription pc 0.5
Out Patient Prescription pc 0.5 25 300 325
Prohibited/Regulated Drugs pc 0.5 50 50
Canteen Request pc 0.5
BLOOD TRANSFUSION FORMS:
Blood Request Form adult pc 1.5
Pedia pc 1.5
NURSING UNIT FORMS:
Kardex pc 1.5 100 100
Assignment Sheet pc 1.5
Record on Gas Use pc 0.5
Discharge Checklist pc 1.5
Patients Room Checklist pc 0.75
Professional Fee pc 0.5 120 300 420
Diet List pc 1.5 120 120
Evaluation Form pc 0.75 15 15
Daily Work Sheet pc 0.75

TICKETS:
IVF Ticket pc 0.5 200 300 500
Blood Component Ticket pc 0.5 50 50
IV Meds. Ticket, long White pc 0.5 300 300
blue pc 0.5 20 20
orange pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Oral Meds. Ticket, short white pc 0.5 150 300 450
blue pc 0.5
yellow pc 0.5
pink pc 0.5
green pc 0.5
Orange Card Big (treatment) pc 0.5
White Card Big (OF) pc 0.5

Stock Unit Beg. DELIVERIES Total No. of

December 2019 Unit
Level Cost Bal. 1st nd
2 3rd 4th 5th Supplies
OFFICE SUPPLIES
Pencil pc 6 2 2
Eraser pc 5 1 1
Pentelpen pc 40
Staple wire box 50
Paste pc 40
Masking tape pc 35 2 2 4
Scotch tape pc 25 1 2 3
Calculator pc 600
Scissor pc 120
Notebook pc 30 1 1
Battery: C+/ 9V pc 120
AA" pc 60

Page 56
 DECEMBER
AAA pc 60 2 2
Clear Book(for Directory)

HOUSEKEEPING SUPPLIES:
Hand Soap (liquid, beautiful) liters 75 1 1
Powder/Detergent packs 3 41.6 11 11
Albatross pc 20.66
Scrubbing pad pc 22.65
Bottle Brush pc 33.65
Vinegar gallon 23.93
Alcohol ml 47

Gra
Prepared By: Approved By:

Maria Angelica Javier Sr. Rowena C. Rodil

Headnurse Nursing Director

Page 57
 DECEMBER

eeping Supplies
Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

50 75.00

200 100 300.00 150.00

-50 100 -75.00 150.00
20 300 450.00

80 120.00

-100 100 -150.00 150.00

120 90.00

50 25.00

1 0.75

200 150 100.00 75.00

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance
-50 50 -25.00 25.00
50 25.00
50 37.50
-50 150 -25.00 75.00

Page 58
 DECEMBER

50 25.00

175 150 87.50 75.00

50 25.00

75 25 112.50 37.50

320 100 160.00 50.00

120 180.00
15 11.25

250 250 125.00 125.00

50 25.00
300 150.00
10 10 5.00 5.00

150 300 75.00 150.00

-200 200 -100.00 100.00

Total: 1,041.25 1,955.75

Used Supplies End Balance Total Cost of Total Cost of
Used Supplies End Balance

1 6.00
-2 2 -10.00 10.00
1 2 40.00 80.00

4 160.00
3 105.00

1 120.00

-2 4 -120.00 240.00

Page 59
 DECEMBER
1 2 60.00 120.00

361.00 450.00

1 75.00
11 457.60

-3 3 -67.95 67.95
-3 3 -100.95 100.95

-1 1 -47.00 47.00

Total: 316.70 215.90

Total Cost of Total Cost of

Used Supplies End Balance

Grand Total: 1,718.95 2,621.65

Page 60