borrower's slip
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Republic of the PhilippinesNEGROS ORIENTAL STATE UNIVERSITY
Main Campus I & II, Dumaguete CityNegros Oriental, Philippines 6200
COLLEGE OF NURSING, DENTISTRY, PHARMACY AND ALLIED HEALTH SCIENCES
NURSING DEPARTMENTBORROWER’S SLIP
Date : _____________________________
Subject : _____________________________
EQUIPMENT Borrowed Quantity Unit
1. __________________________________________ _________ ________2. __________________________________________ _________ ________3. __________________________________________ _________ ________4. __________________________________________ _________ ________5. __________________________________________ _________ ________6. __________________________________________ _________ ________7. __________________________________________ _________ ________8. __________________________________________ _________ ________9. __________________________________________ _________ ________10. __________________________________________ _________ ________11. __________________________________________ _________ ________12. __________________________________________ _________ ________
By:
________________________________Student’s Name & Signature
Noted By:
____________________________Instructor’s Name & Signature _____________________________
Date/Time ReleasedReceived By:
Camad C. Ali, Jr. _____________________________Laboratory Assistant Date/Time Returned
Republic of the PhilippinesNEGROS ORIENTAL STATE UNIVERSITY
Main Campus I & II, Dumaguete CityNegros Oriental, Philippines 6200
COLLEGE OF NURSING, DENTISTRY, PHARMACY AND ALLIED HEALTH SCIENCES
NURSING DEPARTMENTBORROWER’S SLIP
Date : _____________________________
Subject : _____________________________
EQUIPMENT Borrowed Quantity Unit
13. __________________________________________ _________ ________14. __________________________________________ _________ ________15. __________________________________________ _________ ________16. __________________________________________ _________ ________17. __________________________________________ _________ ________18. __________________________________________ _________ ________19. __________________________________________ _________ ________20. __________________________________________ _________ ________21. __________________________________________ _________ ________22. __________________________________________ _________ ________23. __________________________________________ _________ ________24. __________________________________________ _________ ________
By:
________________________________Student’s Name & Signature
Noted By:
____________________________Instructor’s Name & Signature _____________________________
Date/Time ReleasedReceived By:
Camad C. Ali, Jr. _____________________________Laboratory Assistant Date/Time Returned
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