B. Braun Avitum Philippines, Inc.

2nd Flr., JMT Corporate Center, ADB Ave., Pasig City, Philippines
Telephone: (632) 633-7284 to 95 Fax: (632) 633-7596

Sales Order No:

Customer Number:

20517482

PO No:

Customer Name:

Vizcaya Nephrocare Dialysis Center Inc.

DPO / SMR No:

Delivery Address:

National Highway, Bonfal Proper, Bayombong, Nueva Vizcaya

DPO / SMR Date:

Terms:

Special Note:

Please deliver on December 20 in ELJ Cabanatuan (completion onl PHR:

Please have invoice delivered

Product Description

Article No.

Quantity

TPI6100B

Treatment Package

1,400

Treatment Package Composition

Item Description
HD Plus 144A
Sodium Bicarbonate Plain Powder 4.2kg
Renax or Nipro
Diacan FW Art G16
Diacan FW Ven G16
Normal Saline Solution
AMIHEPA 1000IU
Sterile Dressing Kit with tray
Subclavian Dressing Kit
5106A PERACETIC ACID TEST STRIP
5105 RESIDUAL PEROXIDE TEST STRIP

Qty

Article No.
3615488
SD-G05
7023004N
7023018N
EMED007
AMIHEPA 1000IU
SDK-035
SDK017
5106A
5105

Per Set
0.3
0.1
1.0
1.0
1.0
2.0
1.5
1.0

MDT-PAA-4
72035410
72035500
72035680

MDT PLUS 4 COLD STERILANT (5 LIT/BOTTLE)

LOPS 15
LOPS 18
LOPS 20

Prepared By:

Ryan A. Malamanig

Approved By:

RAP / JSS / MML

ACL

ines, Inc.
City, Philippines

Sales Order No:

Date: 2016-12-19

VNDCI 12132016
DPO / SMR No:
DPO / SMR Date:

Ryan A. Malamanig

Unit Price

Gross Amount

Qty
Total

*kindly deliver Nipro if Renax is unavailable

*any NSS

8 pcs undelivered last November

11 Pls deliver Peradesin if M 5 pcs undelivered last November

48

16 pcs completion from November Delivery

TOTAL

PHP 0.00

ELR