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ANNEX 7 Ordering Sheet

The document is a vaccine ordering sheet used by health facilities to track vaccine orders, including details such as the county, health facility, and population demographics. It includes sections for recording the amount of various vaccines to be stocked, current stock levels, and details of previous orders. Additionally, it requires signatures from the requesting officer and the issuing authority for accountability.

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ATEYA JOHN
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686 views1 page

ANNEX 7 Ordering Sheet

The document is a vaccine ordering sheet used by health facilities to track vaccine orders, including details such as the county, health facility, and population demographics. It includes sections for recording the amount of various vaccines to be stocked, current stock levels, and details of previous orders. Additionally, it requires signatures from the requesting officer and the issuing authority for accountability.

Uploaded by

ATEYA JOHN
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ANNEX 7 : VACCINE ORDERING SHEET

EVEL: CENTRAL REGIONAL SUB COUNTY HEALTH FACILITY

NAME OF THE COUNTY :…………………………………………..SUB COUNTRY ……………………………….. HEALTH FACILITY ……………………….. STAMP

DATE OF LAST ORDER:…………………………………………….. DATE OF THIS ORDER:……………………………………. EXPECTED DATE OF NEXT ORDER:……………………………

TOTAL POPULATION
CHILDREN AGED 0-11 MONTHS (UNDER 1 YEAR)
PREGNANT WOMEN
ANTIGEN AMOUNT TO BE STOCKED NUMBER OF STOCK AVAILABLE ORDERED AMOUNT AMOUNT
IN DOSES CHILDREN RECEIVED
VACCINATED AMOUN BATCH EXPIRY AMOUNT BATCH EXPIRY VV
MINIMUM MAXIMUM SINCE THE LAST T IN NUMBER DATE IN DOSES NUMBER DATE STA
ORDER DOSES
Pneumococcal
Dpt-hepB-HiB
HPV Vaccine
Td
IPV
Rotavirus
BCG
Measles Rubella
Oral Polio
BCG Diluents
MR Diluents

OFFICER REQUESTING :………………………………………………..DESIGNATION:…………………………………. DATE:…………………………. SIGNATURE:………………………..

ISSUED BY:………………………………………………………………….. DESIGNATION:…………………………………. DATE:…………………………. SIGNATURE:………………………..

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