Annex C: Daily Logistic Supply and Return Form District: Health facility: Name of site: Type of site: Vaccination date: Cholera Cold Vaccine Waste Sharps Forceps Marker Pen Table Chair Banner Vaccine Box carrier Bag container Vials No. Supply received No. Used No. Returned Signature of vaccinator:
Annex C: Daily Logistic Supply and Return Form District: Name of site: Vaccination date: Health facility: Type of site: Cholera Vaccine Vials Cold Box Vaccine carrier Waste Bag Sharps container Forceps Marker Pen Table Chair Banner No. Supply received No. Used No. Returned Signature of vaccinator:
daily_logistic_supply_and_return_form_0.docx