UHK Activate Spare Equipment

Name of Person Ordering Equipment*

Location*
---Rathass WardMuckross WardAghadoe WardCCU WardScellig WardClonfert WardICU WardReask WardArdagh WardPallative Care UnitA & E WardDenish WardLoher WardAnnagh WardValentia WardCashel WardKells WardMAUAcute Stroke UnitCARRIG WARD

Date of Transfer*: Year202020212022 Month010203040506070809101112 Day01020304050607080910111213141516171819202122232425262728293031

Room Number and Patient Initials*

Product Rental Number* (e.g. OFM1234)

OFM

Return Email

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