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First Aid Kit Inspection Check List Form

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RST AID KIT INSPECTION CHECK LIST FOR FI

KIT NO 01 02 03 04 05 06
LOCATION WORKSHOP WORKSHOP WORKSHOP WORKSHOP WORKSHOP WORKSHOP Remarks

AVAILABLE ITEMS
01 BAND AID PLASTER
02 BURN CREAM
03 PANADOL
04 BETADINE
ANTISEPTIC SOLON
05 GAUZE SWAB (5CM
X 5CM)
06 GAUZE SWAB
(7.5CM X 7.55CM)
07 GAUZE BANDAGE
(5CM X 5CM)
08 GAUZE BANDAGE
(7.5CM X 7.5CM)
09 MUSCULAR PAIN
SPRAY
10 COTTON
11 LEUKOPLAST/LEUK
O FIX
12 FORCEP
13 SCISSOR
14 EYE PAD
15 ALCHOAL PADS
16 FIRST AID BOX
(CABINET)
17 EYE REFRESHER
:INSPECTED MONTH

:Inspected By :Verified By
:Date :Date
:Sign :Sign

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