The monthly return form is used at the end of each month to collect data for the medical store. This data will help the medical store to assess monthly consumption in the health centre and determine the future purchases at the health centre. This financial progress of the dispensary in relation to attendance at the health centre can also be assessed with the data. The information on the monthly return form (Diagram 16) is:
• Cash collected for the month (as in the FRB),
• Total number of patients that attended the health centre. Information provided by the head of the health centre,
• Quantities of each drug dispensed for the month (refer to daily use record or the daily use/cash record sheet.
Diagram 16 Example of Dispensary Monthly Return Form
Dispensary: ________________________________ Month and Year: ______________
Monthly turnover (in local currency): _________________________________(Refer to FRB)
Health centre attendance for month: _____________________________________________
Items sold during the month |
Quantity |
Acetylsalicylic acid 500 mg tab |
|
Acetyl salicylic acid 250 mg tab |
|
Benzyl benzoate 25% lotion |
|
Chloroquine 100 mg tablet |
|
Diethyl carbamazine 100 mg tablet |
|
Folic acid 5 mg tablet |
|
Name of health worker:_____________________________________________________
Signature of health worker: __________________________________________________
Date:___________________________________________________________________