Source:
WHO/UNICEF
COUNTRY |
Tanzania |
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REPORT No. |
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Date of report |
{{date | date:'yyyy-MM-dd'}} |
Place, date and time of inspection |
Name of cold store, date and time vaccines entered into cold store |
National Warehouse |
National Warehouse |
PART I — ADVANCE NOTICE
MAIN DOCUMENTS |
Date received by consignee |
Copy of packing list |
Copy of invoice |
Copy of release certificate |
|||||
Shipping notification |
{{date | date:'yyyy-MM-dd'}} |
Yes |
Yes |
Yes |
Yes |
PART II — FLIGHT ARRIVAL DETAILS
Date |
Time |
Date |
Time |
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{{ data.shipping_number }} |
Nyerere Airport |
AWB478 |
2015-09-29 |
1645 |
2015-09-29 |
1645 |
NAME OF CLEARING AGENT: _____________________________ ON BEHALF OF: _______________________________
PART III — DETAILS OF VACCINE SHIPMENT
Purchase Order No. |
Consignee |
Vaccine description (Type and doses/vial) |
Manufacturer |
Country |
{{ packageDetails.shipmentnumber }} |
MSD |
{{ getVaccineName(packageDetails.productid) }} |
{{ packageDetails.packaging.manufacturename }} |
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Vaccine |
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Lot Number |
Number of boxes |
Number of vials |
Expiry date |
{{ packageDetails.lotnumber }} |
{{ numberOfBoxes(packageDetails.packaging.dosespervial,packageDetails.packaging.vialsperbox,packageDetails.numberofdoses) }} |
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{{packageDetails.expiredate | date:'yyyy-MM-dd'}} |
(Continue on separate sheet if necessary)
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Status |
Comments |
Was quantity received as per shipping notification? |
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If not, were details of short-shipment provided prior to vaccine arrival? |
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1 Adopted from the Standard UNICEF Vaccine Arrival Report from WHO Guidelines on the international packaging and shipping of vaccines (WHO/IVB/05.23)
No. = Number
WHO recommends all UN agencies, countries and non-governmental organizations procuring vaccines adopt this report.
Report No. |
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PART IV — DOCUMENTS ACCOMPANYING THE SHIPMENT
Invoice |
Packing list |
Release certificate |
Vaccine Arrival Report |
Other |
Yes |
Yes |
Yes No |
Yes |
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Comments |
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PART V — STATUS OF SHIPPING INDICATORS
Total number of boxes inspected: |
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PROVIDE BELOW DETAILS OF STATUS ONLY WHEN PROBLEMS ARE OBSERVED
(in addition fill in ALARM REPORTING FORM if there are any ALARMS in electronic devices):
Box Number |
LOT NO |
Alarm in electronic device |
Cold-chain monitor |
Date/time of inspection |
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>=450C |
>=300C |
>=100C |
<=-0.50C |
A |
B |
C |
D |
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(Continue on separate sheet if necessary)
PART VI — GENERAL CONDITIONS OF SHIPMENT
What was the condition of boxes on arrival? |
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Were necessary labels attached to shipping boxes? |
{{ package.labels }} |
Other comments including description of alarms in electronic devices: |
{{ package.comments }} |
PART VII — NAME AND SIGNATURE
Authorized Inspection Supervisor DATE Central store or EPI Manager DATE
For Procurement Agency office use only
Date received by the office: {{date | date:'yyyy-MM-dd'}} Contact person: {{ current_user.name }} |