AL FARABI COLLEGE COLLEGE OF DENTISTRY DENTAL PRACTICUM DEPT. RESTO KIT BORROWING SLIP NAME: LEVEL: INSTRUMENTS QNTY.

ALLOY KIT RESTO KIT DATE & TIME: INSTRUCTOR: BORROWED REMARKS RETURNED REMARKS

QNTY.

Double Ended Excavator Amalgam Modeling & Carving Inst. Amalgam Finishing Instrument Filling Instrument Plastic Filling Spatula Amalgam Carver - Enamel Instrument Amalgam Carvers Amalgam Carver Carver MDYSM20 Periodontal Instruments Scalpels Enamel Instrument Filling Instrument Marquette Amalgam Condenser
RUBBER DAM SET MOTOR HANDPIECE LOW SPEED HIGH SPEED

Serial No: Serial No:

CARBIDE BURS DIAMOND BURS COMPOSITE FINISHING BURS FINISHING BURS GLASS SLAB BONDING DISPENSER AMALGUM DISH OTHERS 1. 2. 3. 4. 5. INSTRUMENT/S ISSUED TO NAME SIGNATURE USED INSTRUMENTS RECEIVED BY NAME SIGNATURE
RRM001-2011

REMINDER: TO AVOID PENALTY, ALL INSTRUMENTS MUST BE RETURNED AFTER EACH USE/SESSION

AL FARABI COLLEGE COLLEGE OF DENTISTRY DENTAL PRACTICUM DEPT. PERIO KIT BORROWING SLIP NAME: LEVEL: INSTRUMENTS QNTY. PERIO KIT PROPHY BRUSH PROPHY CUP MOTOR HANDPIECE LOW SPEED HIGH SPEED DATE & TIME: INSTRUCTOR: BORROWED REMARKS RETURNED REMARKS.

QNTY.

Serial No: Serial No:

ANESTHESIA SYRINGE OTHERS 1. 2. 3. 4. 5. INSTRUMENT/S ISSUED TO NAME SIGNATURE USED INSTRUMENTS RECEIVED BY NAME SIGNATURE
RRM002-2011

REMINDER: TO AVOID PENALTY, ALL INSTRUMENTS MUST BE RETURNED AFTER EACH USE/SESSION

AL FARABI COLLEGE COLLEGE OF DENTISTRY DENTAL PRACTICUM DEPT. DIAGNOSIS AND SURGERY BORROWING SLIP NAME: LEVEL: INSTRUMENTS QNTY. DIAGNOSIS KIT ANESTHESIA SYRINGE TRAY ADULT FORCEPS QNTY. UPPER ANTERIOR FORCEPS UPPER PREMOLAR FORCEPS UPPER RIGHT 1ST MOLAR FORCEPS UPPER LEFT 1ST MOLAR FORCEPS UPPER MOLAR FORCEPS UPPER REMAINING ROOT FORCEPS LOWER ANTERIOR FORCEPS LOWER PREMOLAR FORCEPS LOWER MOLAR FORCEPS LOWER REMAINING ROOT FORCEPS PEDO FORCEPS QNTY. UPPER ANTERIOR FORCEPS UPPER MOLAR FORCEPS LOWER ANTERIOR FORCEPS ELEVATORS QNTY. STRAIGHT ELEVATOR STRAIGHT JAMES COUPLAND JAMES L & R CRYER L & R PERIOSTEAL DATE & TIME: INSTRUCTOR: BORROWED REMARKS RETURNED REMARKS

QNTY.

BORROWED REMARKS

QNTY.

RETURNED REMARKS

BORROWED REMARKS

QNTY.

RETURNED REMARKS

BORROWED REMARKS

QNTY.

RETURNED REMARKS

APEXO FLAP RETRACTOR OTHERS 1. 2. 3. 4. 5. INSTRUMENT/S ISSUED TO NAME SIGNATURE NAME SIGNATURE
RRM003-2011

USED INSTRUMENTS RECEIVED BY

REMINDER: TO AVOID PENALTY, ALL INSTRUMENTS MUST BE RETURNED AFTER EACH USE/SESSION AL FARABI COLLEGE COLLEGE OF DENTISTRY DENTAL PRACTICUM DEPT. DIAGNOSTIC KIT BORROWING SLIP NAME: LEVEL: INSTRUMENTS QNTY. DIAGNOSIS KIT ANESTHESIA SYRINGE TRAY ARTICULATING PAPER FORCEPS OTHERS 1. 2. 3. 4. 5. INSTRUMENT/S ISSUED TO NAME SIGNATURE NAME SIGNATURE
RRM003-2011

DATE & TIME: INSTRUCTOR: BORROWED REMARKS RETURNED REMARKS

QNTY.

USED INSTRUMENTS RECEIVED BY

REMINDER: TO AVOID PENALTY, ALL INSTRUMENTS MUST BE RETURNED AFTER EACH USE/SESSION