Source: WHO/UNICEF

VACCINE ARRIVAL REPORT (VAR)1




COUNTRY

Tanzania




REPORT No.



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 airway bill (AWB)

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


AWB Number

Airport of destination

Flight No

ETA as per notification

Actual time of arrival

Date

Time

Date

Time

{{ 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 }}



Vaccine

Lot Number

Number of boxes

Number of vials

Expiry date

{{ packageDetails.lotnumber }}

{{ numberOfBoxes(packageDetails.packaging.dosespervial,packageDetails.packaging.vialsperbox,packageDetails.numberofdoses) }}


{{packageDetails.expiredate | date:'yyyy-MM-dd'}}

(Continue on separate sheet if necessary)



Status

Comments

Was quantity received as per shipping notification?



If not, were details of short-shipment provided prior to vaccine arrival?




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.


PART IV — DOCUMENTS ACCOMPANYING THE SHIPMENT


Invoice

Packing list

Release certificate

Vaccine Arrival Report

Other

Yes

Yes

Yes No

Yes


Comments




PART V — STATUS OF SHIPPING INDICATORS


Total number of boxes inspected:



Coolant type:

{{ package.collant_type }}

Temperature monitors present:

{{ package.temp_monitor }}



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

>=450C

>=300C

>=100C

<=-0.50C

A

B

C

D












(Continue on separate sheet if necessary)


PART VI — GENERAL CONDITIONS OF SHIPMENT


What was the condition of boxes on arrival?


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 }}