Medical Supply Receiving Checklist

Receiving Details
Date Received:
Received By:
Vendor/Supplier:
Delivery Reference / PO Number:
Supplies Checklist
Item Description Quantity Ordered Quantity Received Unit Condition (Check) Expiry Date Remarks
General Inspection
Packaging Intact:
Correct Items Delivered:
Expiry Dates Checked:
Temperature Requirements Met:
Notes / Additional Remarks
Receiver Signature