□ Other (please indicate): linen/sterile gauze (available within hospital for burn □ □ 4. E N/A Yes No care) □ □ 5. Pediatric Gowns E 5 Yes No 6. Syringes □ □ □ E 5 1cc Yes No □ □ □ E 5 3 cc Yes No □ □ □ E 5 10 cc Yes No
□ Other (please indicate): 4. linen/sterile gauze (available within hospital for burn care) E N/A □ Yes □ No 5. Pediatric Gowns E 5 □ Yes □ No 6. Syringes □ 1cc E 5 □ Yes □ No □ 3 cc E 5 □ Yes □ No □ 10 cc E 5 □ Yes □ No