Appx A

ANNUAL STOCK TAKING BOARD FOR THE YEAR OF 2010 2011 LIST OF MAJ MED EQPTHELD BY ECHS POLYCLINIC (TYPE-D) NAGAPATTINAM
Sr. No 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. PVSM No 250104 250111 160297 160415 N Nomenclature Auth Held Installed 01 01 01 01 01 01 01 01 01 01 01 01 01 01 01 01 01 01 01 01 01 02 01 01 01 01 01 01 01 01 01 01 01 Not installed --

50270 N 40017 280047 50008 280053 60008 70167 160427 NIV/9516 1640430 NIV/9626 NIV/9598 NIV/9798 NIV/9792 NIV/9798 NIV/9795 NIV/9329 NIV/9794 NIV/7931 NIV/9616 NIV/9797 NIV/9796

Apparatus X-ray radiographic 160mA 01 Automatic film processor 01 Microscope complete (Binocular) 01 Semi Auto Analyzer 01 Stream Sterilizer 01 Pantographic, Multi programmable 01 Dental chair DGAFMS PROCUREMENT Outfit resuscitation Ambu MK III 01 Oxygen concentrator 01 Syringe and needle destroyer 01 ECG Machine 01 Suction Apparatus portable 01 Neubuliser 01 Lamp operating shadow less 01 Auroscope set complete with 01 Ophthalmoscope 02 Sterilizer hot air 01 Dental X-ray system orlix with 01 complete processing unit mounted on Still automatic liter electric 220V 01 complete Ultrasonic scalar 01 Amalgamator 01 Glass bead sterilizer 01 Set of plastic filling instrument 02 Set of exodontias forceps, elevator 01 01 01 01 01 01 01 01 01 01 01

---

--------

-----

Cabinet for instruments (min 80) Ultraviolet storage cabinet Electrical boiling water sterilizer Ultrasonic cleaner (for instruments) Water distiller Instrument table folding with two Matrix retainer with SS bands (Ivory & toffelemire) 160039 Bath water universal 66x30.5cm with lid and tray electrically heated 230 1100110 Front loading table top autoclave with minimum three castes NIV/9793 Endo box

----Upper molar forceps broken - - - - - - -

----

Presiding Offr:________________ Appx B

ANNUAL STOCK TAKING BOARD FOR THE YEAR OF 2010 2011 LIST OF MINOR MED EQPT HELD BY ECHS POLYCLINIC NAGAPATTINAM
Sr. No 1 2 3 Section No 4 4 4 PVMS No 40183 40057 40061 Nomenclature Respirator intermittent positive pressure manual bellows inflating bag complete Cylinder O2 1246 ltr Cylinder O2 bull nose fitting fine adjustment valve with pressure guage and boobin flowmeter with double walled tube for Cylinder O2 key spanner for Cylinder O2 flush type key spanner for Cylinder O2 stand Forceps artery curved on flat 12.5cm Forceps artery (Spencer wells) straight box joint 13cm Forceps dissecting 15cm Forceps dissecting toothed 13cm Forceps dissecting toothed 18cm Forceps sinus Forceps sterilizer (Cheatle) Knife, Bard parker, Blade size 1 fitting (commercial no 11) pkt of 6 Knife, Bard parker, Blade size 1 fitting (commercial no 12) pkt of 6 Knife, Bard parker, Blade size 1 fitting (commercial no 15) pkt of 7 1 fitting (commercial no 03 for use with commercial blade no 10,11,12,15) Needle holder (Mayo), 19 box joint Precursor (Babinski) Scissors, dressing, sharp and blunt, 14cm long SS Scissors, dressing both point sharp 12.4cm Scissor Sprit lamp aluminum with screw cap 60ml Tape messure linen 1.5M Tourniquet Auth Held Remarks 01 01 01 01 01 01

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

4 4 4 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5

40062 40063 40064 50090 50095 50104 50107 50108 50116 50120 50163 50164 50165 50169 50186 50221 50258 50259 50261 50286 50304 50307

01 01 01 01 01 01 01 01 01 01 01 01 01 02 02 02 01 01 01 01 03 01

-01 01 01 01 01 01 01 01 01 01 01 01 02 -02 01 01 01 01 03 01

Presiding Offr:________________ Appx B Sr. No 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Section No 5 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 15 15 27 27 28 3 3 14 14 5 PVMS No 50158 Nomenclature Auth Held Remarks 01 01 01 01 02 01 01 01 01 01 01 02 01 02 03 01 02 01 01 01 01 01 01 01 01 01 01 01 01 01 01 08 10 10 03 01 01 01 01 02 01 01 01 01 01 01 02 01 02 03 01 02 01 01 01 01 01 01 01 01 01 01 01 01 01 01 08 10 10 03

Instrument regimental pannier roll of complete 140001 Bag, ice head IR 20cm 140002 Bottle hot water IR 30x20cm with 2 spare washes 140003 Bottle hot water IR 30x20cm with 2 spare washes cover for 140004 Bowl, SS 10cm 140005 Bowl, SS 20cm 140006 Bowl, SS 25cm 140007 Bowl, SS 35cm 140008 Body meter for height 140028 Inhaler nelson 700ml size 1 140042 Mattress foam rubber 140043 Mattress foam rubber cover for 140050 Pan bed EI slipper shaped medium size fixed with vertical handle 140057 Sheeting water proof thin 110cm wide (Mtr) 140058 Sheeting water proof thin 110cm wide (Mtr) 140061 N Spittoon mug 140062 Thermometer oral clinical 140064 Try EI deep size 45x35cm 140065 Try, SS kidney shaped 25cm 140067 Try, EI, shallow, size 35x30cm 140071 Tube, rectal, flatus size 18 English catheter gauge 140072 Tube, rectal, flatus size 19 length 1 meter 140073 Tube stomach 140079 Urinal EI male 150063 Funnel EI 60ml 150071 Gallipots flat bottomed, nest of 4 270509 Out fit venesection set of complete (For components see Appx) 270719 Stand transfusion metal (UK pattern) 280052 Infra red lamp NIV/4/DG/ Nebulizer 365 30165 Receiver soiled dressing 30200 Studs India rubber for 140040 Mask operation nurses 140041 Mask operation surgeon 50287 Stethoscope

Presiding Offr:________________ Appx B Sr. No 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 Section No 5 6 5 5 6 6 6 6 6 6 7 7 7 25 25 25 25 25 25 25 25 25 25 25 25 25 PVMS No 50305 60142 50279 50278 60081 60082 60345 60346 60143 60144 70263 70262 70265 250206 250207 250212 250213 250214 250218 250221 250222 250223 250225 250236 250249 250250 250205 250208 250209 16003906 150148 150149 150191 150212 160257 160034 160040 Nomenclature Examination torch Tuning forks 1024 Sphygmomanometer mercury Sphygmomanometer aneroid Tongue depressor 1.9cm wide Tongue depressor 1.25cm wide Nasal speculum 3cm Nasal speculum 5cm Tuning forks 256 Tuning forks 512 Snellens chat board type Near vision chart Colour vision chart Box viewing Box viewing negative with fluorescent tube Cassette 43.18x35.5cm Cassette 38.10x30.5cm Cassette 30.5x25.40cm Gloves lead rubber Hanger developing 25.4x20.32cm Hanger developing 30.5x25.4cm Hanger developing 38.10x30.5cm Hanger developing Mat rubber, shock protective (91.5x91.5) Stand chest wall type Supporting frame stand chest for Box lead lined Bracket film hanger on Brush fixer developing solution Thermometer bath in cardboard case (-10 C) to 110 Mortar composition size 3 Mortar composition size 3 Rod glass stirring Slap ointment graduated or ungraduated 20cm Spirit lamp Basket wire for washing test tubes (size 15cm high 10.5x10.5 inside) Blood sedimentation rate pipette (Wester grend) graduated from 0 200mm in 1mm division Auth Held Remarks 03 01 02 01 02 01 01 01 01 01 02 02 01 02 01 01 02 02 01 06 06 06 06 01 01 01 01 04 01 01 01 01 01 01 02 02 02 03 -02 01 02 01 01 01 01 01 02 02 01 02 01 01 02 02 01 06 -06 06 01 01 01 -04 01 01 01 01 01 01 02 02 02

02 UNSV

14 15 15 15 15 16 16 16

Presiding Offr:________________

Appx B Sr. No 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 Section No 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 16 PVMS No 160041 160042 160047 160048 160049 160050 160077 160081 160082 160145 160163 160175 160178 160191 160192 160193 10194 160354 160418 160419 160430 160433 160463 160466 Nomenclature Blood sedimentation rate pipette stand to hold 6 pipette Blood sedimentation rate pipettes rubber buffers for Bottle flat narrow mouth glass Bottle flat narrow mouth glass Bottle flat narrow mouth glass Bottle flat narrow mouth 50, 100, 200ml size rubber Centrifuge DC/AC electric 230V complete (For components Clip staining for 10 slides Clip staining jar glass for (for use with PV 16250) Flask, conical with ground glass stopper 50ml Forceps, bent fine point Glass cover microscopic 18mm sure 0.10mm thick for dark ground work pkt of 14g Glass urine conical 300ml Hemocytometer (Neubauer) with bright line complete (for components see appendix of) Haemometer for hemoglobin estimation by acid hematic Haemometer pipette capillary Haemometer round caparison tube graduated Pencil marking Slide microscope Slide microscope Still automatic liter electric 220 volts complete Still automatic liter electric element for complete with washers Tube test 100x12mm rimless Tube wintop be graduated 0 10cm in 1mm divisions downwards for sedimentation 160603 rate and upwards for determining haematocrite value Tube wintrope stand to hold 12 tubes for Urine test case for Urino meter with graduated cylinder (for components see appx of PVSM section 16) Auth 01 02 02 02 01 10 01 01 01 02 01 01 12 02 01 02 02 01 150 150 01 01 04 02 Held 01 02 02 02 01 10 01 01 01 01 01 0.5 12 02 01 02 02 -150 110 01 01 -02 Remarks

122 123 124

16 16 16

160467 160495 160496

01 01 01

01 -01

Presiding Offr:________________ Appx B 125 126 127 128 129 130 16 16 16 16 16 16 160516 160280 NIV/16 NIV/16 NIV/24/14 8 160055 Wire nichrome 24 SWG Marking pen Heamoglobino meter, shali complete in case (for components see appendix of PVMS section 16) Rubber teat Nuebear chamber Burner bunsen 15 01 02 01 01 01 15 ----01

General Items Minor oral surgery items:

Sr. No 131 132 133 134 135 136 137 138 139 140 141 142 Section No PVMS No 50089 50092 50105 50185 50176 100519 50264 100588 100551 100511 NIV/10/11 100534 Nomenclature Artery forceps st and curved (14cm/12.5cm) Mosquito forceps Dissection forceps serrated 13cm Needle holder BP knife handle Periosteal elevator Scissors surgical st and curved Syringe hypodermic cartridge type Ronguers hangers Surgical curettes double ended Sub gingival curettes set File alveolectomy Auth 02 01 01 01 01 01 02 03 01 01 01 01 Held 02 01 01 -01 01 02 03 01 01 01 -Remarks

Miscellaneous items:
Sr. No 143 144 145 146 147 148 149 150 151 152 153 154 Section No PVMS No 40211 50127 100154 100145 100148 100572 NIV/10/ 20 100185 100193 100394 100408 100430 Nomenclature Sterilizer high pressure steam drums shallow & deep Forceps towel holding pair Spirit lamp Dappen glass Cotton holder Wire cutter Inspection set (Probe, mirror& tweezers) Waste receiver Spatula steel double ended Mandrels & polishing tip holders set of 3 Pliers pin bending and roughening Scissors crown and collar Auth 01 01 01 04 01 01 04 01 02 01 01 01 Held -01 01 04 01 01 04 01 02 01 01 01 Remarks

04 Mirror, 01tweezers broken

Presiding Offr:________________ Appx B Sr. No 155 156 157 158 159 160 161 162 163 164 165 166 167 168 Section No PVMS No 100191 NIV/10/27 100931 NIV/10/33 50257 NIV/10/33 100114 100687 100835 100113 100194 100151 100152 140034 Nomenclature Mixing slab glass Set hand sclaers Amalgam carrier X-ray hanger dental Scissors large Plugger root canal Brush bur wire brass Impression trays assorted U&L for partially endentulous cases Impression trays assorted U&L for partially endentulous cases Rubber bowl Plaster mixing spatula Plaster knife Wax knife Jug measuring plastic graduated 1000ml Auth 01 01 01 01 01 01 01 01 01 01 01 01 01 01 168 Held 01 -01 -01 -01 01 01 01 01 01 -01 153 Remarks

Total

Presiding Offr:________________

Appx C

ANNUAL STOCK TAKING BOARD FOR THE YEAR OF 2010 2011 LIST OF ORDNANCE HELD BY ECHS POLYCLINIC NAGAPATTINAM
Sr . No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Cat. part No KI7165000025 K53740000076 ICC8530 000024 K3 7210 000029 K3 7210 000027 CD8430 00539-42 CE 8415 000260 CE 8415 000013 BK NIV 09 K2 6530 000007 K3 7210 000023 7210 000026 7105 0000010 A4 6530 000017 K3 7220 000012 K3 7210 000008 Nomenclature Standard measuring height Spray hand anti insects Safety razor and blade Towel hand Slip pillow Slipper rubber Aprons water proof Gown operating Mattress rubberized coir sheet Bed stead iron hospital Pillow hospital Sheet cotton hospital Boxes ice small Stretcher folding light weight Mat door Blanket hospital Auth 01 01 02 16 08 02 01 02 02 01 04 06 01 01 06 02 Held 01 01 02 16 08 02 01 08 02 01 04 06 01 01 06 02 Qty Balance Exp

08 02

08 Nil

Presiding Offr:________________

Appx D

ANNUAL STOCK TAKING BOARD FOR THE YEAR OF 2010 2011 LIST OF MES SCALE OF FURNITURE AND NON-MEDICAL EQUIPMENTS FOR ECHS POLYCLINIC NAGAPATTINAM
Sr. No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 Nomenclature Table bed side Stool steel Step two tier Chair non folding without arms PVC Table 90x60cm SS on caster Screen movable Patient trolley stretcher Revolving stool Receptacle large 75 lts Receptacle small 35 lts Examination couch Board notice Lateral filing cabinet 3 drawer Rack adjustable closed on 3 sides 6 tiers Rack adjustable open Side rack with three trays wooden 3 sides Chair CB (with out on stackable visitor) Chair CBA (visitor with padded arm) Chair CB elevated and rotating Chair executive revolving low back with Computer chair with arm on castors Computer chair without arm on castors Chair folding multi seater set of three Table 150x75x75cm Table 100x75x75cm Alamirah large Alamirah medium Computer table set IV fluids stand Cylinder trolley Refrigerator 310 lts Water cooler with aqua guard Rechargeable light Auth 01 01 02 01 01 02 02 07 04 10 03 02 02 02 02 03 01 04 02 05 02 01 08 04 02 01 02 03 02 01 01 01 02 Held -01 -01 ----04 10 -02 02 02 02 03 -04 -07 02 01 03 04 02 01 02 03 --01 01 02 Remarks

UNSV

Presiding Offr:________________

Appx - H

STORES ARE REQUIRED TO BE CHARGED OFF (EXPENDABLE STORES OF AFV WELFARE FUND, PUBLIC FUND, PETTY CASH & ORD STORES)
LIST OF ITEMS EXPENDABLE STORES PURCHASED OUT OF AFV WELFARE FUND ECHS POLYCLINIC (TYPE-D) NAGAPATTINAM Sr No 1. Nomenclature
Floor mat plastic (Spreaded on the floor)

Qty exp
25

Balance
Nil

LIST OF ITEMS NON EXPENDABLE STORES PURCHASED OUT OF AFV WELFARE FUND ECHS POLYCLINIC (TYPE-D) NAGAPATTINAM Sr No 1. Nomenclature
Regulator

Qty exp
01

Balance
01

LIST OF NON-EXPENDABLE STORES PURCHASED OUT OF PUBLIC FUND (363/02) ECHS POLYCLINIC NAGAPATTINAM (TYPE-D) Sr No 1.
CD

Nomenclature

Qty held
10

Qty exp
05

Balance
05

LIST OF NON-EXPENDABLE STORES OF (PETTY CASH - 366/00) ECHS POLYCLINIC NAGAPATTINAM (TYPE-D) FOR THE YEAR Sr No 1. 2. 3. Nomenclature
Disposal colour coded bio wastage bin Brush CGHS Rate book

Qty held
04 Nos 01 No 01 No

Qty exp
04 Nos 01 No 01 No

Balance
Nil Nil Nil

LIST OF ITEMS EXPENDABLE STORES ORD STORE ECHS POLYCLINIC (TYPE-D) NAGAPATTINAM
SR No 1 2 Cat. Part NO K3 7210 000029 CD 8430 000539-42 Nomenclature Towel hand Slipper rubber Qty held 16 02 Qty exp 08 02 Qty balance 08 Nil

Appx - J

LIST OF ITEMS UNSV

Sr Store No 1. MES 2. Minor Med eqpt LP public 3. fund Non exp 4. SITL PVMS No
-50279

Nomenclature
Rechargeable light Sphygmomanometer mercury Compaq Presario computer (includes MSP 245 printer, UPS, CPU, keyboard and monitor)*** TVS proton printer and UPS declared (BER) UNSV by emp comptr firm i.e. Avaice Computers

Qty held
02 02

--

01 set

--

01

LIST OF BROKEN ITEMS

LIST OF ITEMS PROCURED BY AFMSD MUMBAI: ECHS POLYCLINIC (TYPE-D) NAGAPATTINAM Sr No 1. 2. PVMS No Nomenclature Qty Remarks held 04 04 Mirror, 01 tweezers broken
01 Upper molar forceps broken

NIV/10/ Inspection set (Probe, mirror& 20 tweezers) NIV/9798 Set of exodontias forceps, elevator

LIST OF ITEMS PROCURED BY DGLP MH CHENNAI: ECHS POLYCLINIC (TYPE - D) NAGAPATTINAM Sr No 1. 2. 3. Nomenclature
Lead R&L mark Lead letter (A-Z) Small size Lead Nos (0-9) small size

Qty held
06 10 10

Qty exp
02 02 02

Balance
04 08 08

Appx-G LIST OF ITEMS UNDER REPAIR PURCHASED OUT OF AFV WELFARE FUND ECHS POLYCLINIC (TYPE - D) NAGAPATTINAM 2010 - 2011 Sr No 1. Nomenclature
Water purifier reverse osmosis system

Qty held 01

LIST OF ITEMS UNDER REPAIR PURCHASED OUT OF PUBLIC FUND (363/02) ECHS POLYCLINIC (TYPE - D) NAGAPATTINAM 2010 - 2011 Sr No 1. 2. Nomenclature
Panasonic thermal paper FAX machine Laser printer/FAX/Colour scanner

Qty held
01 01

Appx - K

CERTIFICATE
1. It is certified that ASTB for the FY 2010-2011 was carried out and found all stores recd and procured from various sources and code heads incl welfare fund have been taken on ledger charge. 2. The stores have been physically verified on ground with ledgers and found correct. There is no deficiency/discrepancy and details of the stores are att as appces from A to J to this bd proceedings.

Presiding Offr

:_________________________
(Lt Col (Retd) S Mahalingam OIC ECHS Polyclinic, Tiruchirappalli) :_________________________ (JC 569515N, Sub, Ramdas Hade 8 (TN) Bn NCC Kumbakonam) :________________________ (Mrs Kavitha, Lab Asst ECHS Polyclinic, Nagapattinam)

Members

1.

2.

BD PROCEEDINGS: ANNUAL STOCK TAKING (VERIFICATION) OF MEDICAL STORES AND NON - MEDICAL STORES OF ECHS POLYCLINIC (TYPE-D), NAGAPATTINAM Board proceedings of On the day of By the order of For the purpose of : Board of Offrs assembled at ECHS polyclinic (Type-D) Nagapattinam : 01 Apr 11 and subsequent days : Stn Cdr, Stn HQs, Tiruchirappalli vide convening order No 3026/MST/42/ECHS dt 09 Mar 11 : Annual stock checking (verification) of stores held on charge of ECHS Polyclinic (Type-D) Nagapattinam for the year 01 Apr 2010 to 31 Mar 2011 : Lt Col (Retd) S Mahalingam OIC ECHS Polyclinic, Tiruchirappalli 1.
2.

Presiding offr Members

: JC 569515N, Sub, Ramadas Hade 8 (TN) Bn NCC Kumbakonam : Mrs S Kavitha, Lab Asst ECHS Polyclinic, Nagapattinam

1. The bd having assembled pursuant to order proceeds to check annual stock taking (verification) bd for the year 2010-2011. (a) The bd physically checked all the items on ground and tallied the same with the ledger (b) All the stores have been taken on ledger charge as per issue/receipt voucher. (c) There is no surplus/deficiency as per the ledger. (d) The finding of the bd as per various sub heads are as under:(i) Major Medical eqpt (ii) Minor Medical eqpt (iii) Ord stores (iv) MES Stores (v) LP stores (Public fund Non Exp) (vi) LP Stores (AFV Welfare fund non exp) - Appx - A - Appx - B - Appx - C - Appx - D - Appx - E - Appx - F

-2(vii) List of items under repair (viii) Stores are required to be charged off (Expendable stores of AFV Welfare fund, public fund, petty cash) (ix) UNSV and broken items (x) Certificate from BOO - Appx - G - Appx - H - Appx - J - Appx - K

RECOMMENDATION OF THE BD The bd recommended that the items mentioned in Appx - H & J may pl be charged off from the ledger and Appx - G pl be get it repaired.

Presiding offr

:_________________________
Lt Col (Retd) S Mahalingam OIC ECHS Polyclinic, Tiruchirappalli

Members

1.

:_________________________ JC 569515N, Sub, Ramadas Hade 8 (TN) Bn NCC Kumbakonam :________________________ Mrs S Kavitha, Lab Asst ECHS Polyclinic, Nagapattinam

3.

COUNTER SIGNED
Station: Tiruchirappalli Date: 2011

Appx - H

ISSUE/EXPENSE VOUCHER The items enumerated below have been charged off from ledger through this issue/expense voucher for the FY 2010 2011. RV No: 112/ECHS/NAGAI/R&R/01 Sr. No
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29.

Nomenclature
Individual receipt book IAFA 175 receipt book Lab repot form
Floor mat plastic (Spreaded on the floor) Regulator Disposal colour coded bio wastage bin Brush CGHS Rate book CD Towel hand Slipper rubber

A/U
Nos Nos Nos
Mtr Nos Nos No

Qty Held
03 01 01
25 01 04

Qty Expensed
03 01 01
25 01 04

Qty Balance
Nil Nil Nil Nil Nil Nil Nil Nil 05 Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil

No
Nos Nos Pair

01 01
10 16 02

01 01
05 16 02

CD Marker Postal stamp Paint Brush Pad ink & Red ink pad OPD Register Tube light Referral form book Calculator Battery & Eveready cell Tube light starter Hard wares Phenol & Acid Electrical spares Broom & Plastic cleaner, MOP Plastic bucket Distilled water File cover Emulsion paper ECG Bulb

Nos Nos Nos Bott No No Book No No Set Bott No No Nos Bott Nos Nos Nos

10 180 14 02 05 05 30 06 06 02 01 01 08 02 01 15 01 06

10 180 14 02 05 05 30 06 06 02 01 01 08 02 01 15 01 06

Presiding Offr: ____________________