Clinic Facilities Form =- Page 3
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Type of alectrical power available Zor operating equipment:
None available
120 voles, 60 Uz AC sower available
Other type aC 2lactrical power (give voltage
Battery powered DC available (give volrage
batteries are recharged)
freguency
) and
[state how
If there is AC power available, describe the source:
mms nr
Has its own generacor in good working condition
Clinic has ics own generacor but not in good working cokdicion
Communicy supplied sower which {is reliable
Clintc supplied power which is unreliable
Other (please describe)
tt oH) et
T7vpe of refrigeraricn:
amare
LS.
None available
AC electric operatcad
Kerosene refrigeration
\
Other type operaced
—
Dimensions of storage spac@ in inches:
.
Height
_—ss
(please describe)
16.
Total number of beds in clinic.
Number of mattresses.
18.
Number of mattresses in good condition.
19.
Number of uattresses in poor condition.
20.
Examination table facilities:
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{ ]
{ ]
None
Plain table wich blanket
Regular examination sable(s)
(describe each on the next page)
toa
Wideh
Depth
)