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