|
| 1 | Non-schedule forms and register |
| 2 | Report on Medical Legal cases Register Red colour(Each book containing 100 pages) |
| 3 | Report on Medical Legal cases Register Yellow colour(Each book containing 100 pages) |
| 4 | Elisa Test Register |
| 5 | HIV-100 pages |
| 6 | HBV-100 pages |
| 7 | HCV-100 pages |
| 8 | T.T. I. Register -100 pages |
| 9 | Daily Quality Control Register (ABO antisera)-100 pages |
| 10 | Daily Quality Control Register(Anti D sera)-100 pages |
| 11 | Daily Quality Control Register (AI\"IG sera)-100 pages |
| 12 | Daily Quality Control Register(N/S) -100 Pages |
| 13 | Daily Quality Control Register (Dist.Water)-100 pages |
| 14 | Daily Quality Control Register(CuSO,f Sol.)-1.00 pages |
| 15 | Dailv Quality Control Register (Ked Cell Conc.)-100 pages |
| 16 | Daily Quality Control Register (Whole Blood) -100 pages |
| 17 | Daily Quality Control Register(platelet conc.)-100 pages |
| 18 | Daily Quality Control Register(F.F.P.) - 100 pages |
| 19 | Blood Bag Register-100 pages |
| 20 | Purchase Register (General)-100 Pages |
| 21 | Equipment Inventory Register -100 pages |
| 22 | Daily Quality Control Register(Control Red Cell)-100 pages |
| 23 | Cross Matching Register 200 pages |
| 24 | Blood Collection Register (Donor) 200 pages |
| 25 | Donor Master Register 200 pages |
| 26 | Blood Grouping Register (200 pages) patient or Blood bank Recipient |
| 27 | Daily Case Record Book(Each Book Containing 100 pages) |
| 28 | Indent Book Book of 100 Pages |
| 29 | Entry Pass Card (Red & Yellows Colour) |
| 30 | Blood Issue Register 200 pages |
| 31 | Donor Master Register 200 pages |
| 32 | Blood Grouping Register |
| 33 | HIV Testing Register |
| 34 | HBV Rapid TestingRegister 200 pages |
| 35 | HCV Rapid Testing Register 200 pages |
| 36 | Malaria Rapid testingRegister 200 pages |
| 37 | Syphilis Rapid Testing Register 200 pages |
| 38 | X-ray requisition Form |
| 39 | Admission record Form |
| 40 | Case Summary Form |
| 41 | Operation record |
| 42 | Radio-Therapy / Cobalt Therapy form |
| 43 | Physically Handicapped/ Senior Citizen Card |
| 44 | Compatibility Test Report Label Label - AB (White Color) |
| 45 | Label - B (Pink Color) |
| 46 | Label - A (yellow Color) |
| 47 | Label - O (Blue Color) |
| 48 | Consent form for transfusion of Blood/Blood Component |
| 49 | Whole Blood Requisition form |
| 50 | Blood Component Requisition form |
| 51 | Blood Bank Receipt Book (Each book containing 100 page only in duplicate) |
| 52 | Blood Group Sticker |
| 53 | MRI Envelope |
| 54 | CT Envelope |
| 55 | Radiation Therapy Prescription. |
| 56 | Discharge follow up Card |
| 57 | ECG Normal Reporting Form |
| 58 | ECG Abnormal reporting Form |
| 59 | Echo Cardiography & Doppler report |
| 60 | Discharge Certificate and Follow Up record Book let (For Cardiology) |
| 61 | Bone Marrow Report Form |
| 62 | C.S.F. Report Form |
| 63 | Audiomentary Form |
| 64 | Stock Card |
| 65 | Schedule III (Form-I) |
| 66 | R.C Bill Form |
| 67 | CC Bill Form |
| 68 | Bill Extract Form |
| 69 | Assam Schedule III Form No. 61 |
| 70 | Grant in Aid Bill Form |
| 71 | Format T.R. 47 (A) |
| 72 | Annexure –A |
| 73 | Annexure B |
| 74 | Mother New Born Discharge Certificate |
| 75 | Post Mortem Examination Report Form |
| 76 | Examination Report Pad 100 pages |
| 77 | Screening report on the Haemoglobin typing on HPLC Chromatogram |
| 78 | T.R Form No. 9 (Multiple Sheet) |
| 79 | T.R. Form No 9 (Single sheet) |
| 80 | Consent form for Cytology/Core Biopsy |
| 81 | Cheque issue Register 200 pages |
| 82 | JSY Delivery Register 200 pages |
| 83 | Referral Certificate |
| 84 | Medical Certificate for leave |
| 85 | Fitness certificate |
| 86 | Master Stock Book |
| 87 | ENT O.T Register 100 pages |
| 88 | ENT OPD Register 100 Pages |
| 89 | Maternal Death Review Form Annexure-I |
| 90 | Paediatrics OT Admission register (for operation) Book of 200 pages |
| 91 | Form A (National Centre of Disease Control for COVID-19 |
| 92 | Home Qurantine Form |
| 93 | Schedule of HBA/HUDCO/ MOTOR Car Advance |
| 94 | History Sheet10 pages Copier paper 3 pages back &back printing 7 nos. of pages only one side printing (Psychiatry Deptt.) |
| 95 | Money Receipt BookHospital Management Society, Assam Medical College Hospital, Dibrugarh Dual Numbering, Book Number and Receipt Number Book of 200 pages |
| 96 | Requisition for Ultrasound & Other Radiological examination form book (Book of 100 pages in duplicate) infant/pregnent |
| 97 | Bio-Chemistry/Pathology/Microbiological Lab. Form Book (book of containing 100 pages) infant/pregnant |
| 98 | OPD Card (colour) |
| 99 | OPD Slip Form (Colour) |
| 100 | Art Paper 1/8 size for OPD |
| 101 | a. White |
| 102 | b. Pink |
| 103 | Laboratory requisition Master |
| 104 | X-ray requisition Form |
| 105 | History of Patient |
| 106 | Doctor\"s Order |
| 107 | Nurses daily record |
| 108 | Grapic T.R.C.Chart |
| 109 | Operation record |
| 110 | Blood Requisition Form |
| 111 | Pathology Lab. Form |
| 112 | Cadaver report form |
| 113 | Discharge Certificate form |
| 114 | Eye Deptt. Prescription form |
| 115 | Diet Slip Form |
| 116 | Casualty Registration Card |
| 117 | Investigation Chart |
| 118 | Casualty ML Registration Card |
| 119 | Ante natal record form |
| 120 | MRD OPD Receipt Book Yellow Colour (Each book containing 100 pages only in duplicate) |
| 121 | Donner Questionnaire report form |
| 122 | X-Ray /Ultrasound/CT/MRI report form |
| 123 | MRI requisition form |
| 124 | Nutrition and Growth Summary |
| 125 | Drug & Treatment Form |
| 126 | Daily NICU Nursing Care Plan |
| 127 | Neonatal Proforma |
| 128 | Neurological Examination Sheet |
| 129 | Neonatal Summary |
| 130 | Identifying High Risk, New Boarn (New Ballard Score) |
| 131 | Blood R/E Form |
| 132 | Urine R/E Form |
| 133 | Histopathological/Cytological Report Form |
| 134 | Haematology report form |
| 135 | Feeding Chart |
| 136 | IV Fluid Chart |
| 137 | Consolidated Drug Issue Chart |
| 138 | Schedule II-4-A |
| 139 | Form No. 24 |
| 140 | Schedule II (Sec.I) Form No. 64 |
| 141 | T.R. FormNo.9 |
| 142 | T.R. Form No.10 |
| 143 | Assam Schedule of recoveries of Festival Advance |
| 144 | TE Bill Form |
| 145 | Pay Bill Form |
| 146 | Lab. Report form for Culture of Blood & Body Fluids by versatrek Automated system |
| 147 | Trop-I Form |
| 148 | Lab. Report form (Microbiology) |
| 149 | Dengue case Investigation Form |
| 150 | Antibiogram report form |
| 151 | Seorology/Immunology report Form |
| 152 | Encephalitic syndrome case Investigation Form |
| 153 | J.E Laboratory Request &Report Form |
| 154 | Endoscopy Report form (Medicine/Surgery) |
| 155 | MRD Bill Form |
| 156 | Form for reporting Sex Crime Case |
| 157 | Requisition form for X-ray examination |
| 158 | Malaria , Hbs Ag, HCV etc. report form |
| 159 | Culture & Sensitivity report form |
| 160 | Microbiology Investigation form |
| 161 | Microbiology Investigation form |
| 162 | Census Form |
| 163 | CCL Form |
| 164 | Japanese Encephalities Lab Request & Report Form |
| 165 | Final opinion report form |
| 166 | Chemical Analysis of viscera report form |
| 167 | Fitness certificate |
| 168 | USG Gravid Uteras |
| 169 | Consent Form |
| 170 | MR Imaging and Angiography Form |
| 171 | Consent Form for Hemodialysis |
| 172 | Audiometric record sheets |
| 173 | ENT History cum case record |
| 174 | Maternal Death Review Form Annexure-6 |
| 175 | Blood Stock Register 200 Pages |
| 176 | Donor Counseling Register 200 pages |
| 177 | Free Cases Entry Register 200 pages |
| 178 | Questionnarie for Screening of Patients Suspected of nCOV-19 |
| 179 | ICMR Specimen Referral Form for COVID-19 |
| 180 | RAT Requisition Form COVID-19 |
| 181 | RAT Test report for COIV-19 |
| 182 | Blood Donor Record Register, 200 pages |
| 183 | Donor Deferral Register, 200 pages |
| 184 | Transfusion Reaction Register, 200 pages |
| 185 | Daily Stock Register for Blood and its components, 200 pages |
| 186 | NRHM, Private, Thalassemia (Plain Copy 3), 200 pages |
| 187 | Recors of Component supplied, 200 pages |
| 188 | Master Records for Blood & its components, 200 pages |
| 189 | Bounded registers (Size 10,20,30,40,50), 200 pages |
| 190 | Donor Reaction Register, 200 pages |
| 191 | AMCH revenue free Cases Entry Register, 200 pages |
| 192 | Classic Executive long Book line(2) (size 50,40,20,10), 200 pages |
| 193 | Revenue free receipt |
| 194 | Classic Executive long Book line, 200 pages |
| 195 | Article department of Blood center AMCH, Dibrugarh |
| 196 | Register for diagnostic Kits and reagents used, 200 pages |
| 197 | Record of purchase of diaposable needle, syringe and blood centre, 200 pages |
| 198 | Register for Records of ACD/CPD/CPDA/Sagm, 200 pages |
| 199 | Peon Book, 200 pages |
| 200 | Attendance Register, 200 pages |
| 201 | Blood Discard Register, 200 pages |
| 202 | Donor Referral Register, 200 pages |
| 203 | TTI Registers (HBV, HCV,HIV,MALARIA,Syphilis), 200 pages |
| 204 | Leather binding register (long size,medium size,small size)(10,20,30,40,50) |
| 205 | Label (A,B,AB,O) |
| 206 | Blood Donor Questionnair & Consent form |
| 207 | Appreciation certificate (Assam & English) for voluntary donors |
| 208 | EEG Form |
| 209 | Psychological Intervention Report Form |
| 210 | Psychological Testing/Assessment Report Form |
| 211 | Requisition fromof psychosocial assessment/therapy |
| 212 | File Cover with printing & ribbon |
| 213 | Form F for PC PNDT 4 pages printing on A4 Paper along with shorting & pinup |
| 214 | Acquiantance Roll Register 300 pages |
| 215 | Laboratory report from (serology/Immunology section) |
| 216 | Laboratory report from for Dengue |
| 217 | Laboratory Form (Deptt. of Microbiology) |
| 218 | WHO SEARO JE NETWORK LABORATORY |
| 219 | Laboratory Report Form |
| 220 | CSSD Quality Control Record Form |
| 221 | Laboratory Report Form for culture of Blood and Body fluids by versatrek automated system |
| 222 | Case Report Form |
| 223 | Laboratory report form for Mycology section repoty form |
| 224 | Ophthalmology Glass Paper |
| 225 | Advice Slip |
| 226 | Advice slip (yellow colour) |
| 227 | Daily Census report |
| 228 | OPD Card(ML Cases) |
| 229 | Blood Requisition |
| 230 | AESF-4 |
| 231 | AESF-5 |
| 232 | Endoscopy Requisition cum Consent Form |
| 233 | TPR Chart |
| 234 | Medico-Legal Register for Casualty (Large size) |
| 235 | Medico-Legal Report Book Yellow Colour (for outdoor cases) |
| 236 | Medico-Legal Report Book Pink Colour(For Indoor Cases) |
| 237 | Check list for enviromentaland surface cleaning of adult ICU\"s |
| 238 | SSI SURVELLANCE FORM |
| 239 | CAUTI SURVELLANCE FORM |
| 240 | VAP SURVELLANCE FORM |
| 241 | Check list for enviromental and surface cleaning of OT\"s |
| 242 | Police Surgeon form |
| 243 | AMC,Dibruugah and Police Surgeon,Dibrugarh form |
| 244 | AMCH-Post Mortem Histopathology requisition form |
| 245 | Form for Despatching Viscera to the Chemical Examiner |
| 246 | Identification Form |
| 247 | Sex crime (accused) examination reporting form |
| 248 | Sex crime case (victim) form |
| 249 | Drunkenness examination form |
| 250 | Age Estimation form |
