SHIPPING CONTAINER TALLY 1234856789 10 1112 13 14°15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 oe OF/6. REQUISITION NUMBER lia, VOUCHER NUMBER AND DATE b, VOUCHER NUMBER AND DATE REQUISITION AND INVOICE / /SHIPPING DOCUMENT "& REQ (CONTINUATION SHEET) ITEM NO. PMETS N1012 7338 B000XXX 53 quantity FEDERAL STOCK NUMBER, DESCRIPTION. AND CODING OF MATERIEL AND/OR SERVICES 16 CUTTER, Cast, DNA Prop. No. 0331M _ 18 REGUL‘TOR, Air Tank, DNA Prop No. 0333M, 0334M, 0506M — 20 STAND, I.V., DNA Prop No. 500M 19 21 22 23 24 25 26 27 28 Ea HYFRECATOR, DNA Prop No. 0332M STERILIZER, Water Bath, DNA Prop No. 0499M IRON, Sealing, DNA Prop. No. 0046 TABLE, Emergency, DNA Prop No, 0502M WHEEL CHAIR, DNA Prop No. 0501M WHEEL CHAIR, DNA Prop No. 7038 CABINET, Medicine, 2 Door, SS, DNA Prop No. 0331 CABINET, Medicine, Narcotic, SS, DNA Prop No. 0332 BED, Hospital, Adjustable, DNA Prop No. NONE STAND, Hospital Bed, DNA Prop No. NONE ACTION |w2u|,cOX, pus — on EA UNIT PRICE TOTALCOST _ $35.00 |$ 85.00 y > SPESSSSES SE 17 supery 5°% REQUESTED 115.00 100.00 125.00 50.00 214.00 185,00 “85,00 104,00 300,00 400,00 115.00 300,00 125.00 50.00. 214.00 185.00 785.00 104,00 300, 00 400.00 40.00 40,00 150,00 1 150.00 /x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/x/xLAST ITEM [x]xf k/Alx]x/x/4/x]x/x/x¥xfxlxhx/x/x/xfxf x]x/xfx]xf (Yarbro) Krara Lx) "I CERTIFY THAT THE ABOVE LISTED ITEMS ARE IN THE CUSTODY OF TH USAF CLIWIC, ENEWETAK." CHARLES D. ROTH, TSGT, 3SN 205~74-2217 NCOIC, USAF CLINIC ENEWETAK APPROVED: - S D JOHN R. SITTEN OF LOGISTICS NA/JTG ENEWETAK ATOLL, M.I. 4 — FORM , athlhay, D i marso ; V4 9e phe me $2153.00 ‘ 149: y SHEET TOTAL 4 4 51 52 5354 55 56 57 58 59 60 61 62 63 64 65 66 67 6869 70 71 72 73 747576 77 7879 80 81 O2 B3 64 85 BG 87 88 89 90 9) 92 93 94 95 96 97 MOY CO REPLACES EDITION OF 1 MAY 58 WHICH MAY BE USED 4