Stock Card for CHWs Name of CHW: Nearest health center: District: Your name here Product Name: Name of the health center you are attached to and the district it is in Name of the medicine or commodity. Use one card for each different product Strength and Dosage Form: Unit: Counting unit of the product (e.g., blister or tablet or sachet) Concentration and presentation of the product (e.g., 20mg tablet) Minimum stock level: Minimum amount that should be on the shelf at any time- this should be calculated by the health center Date Date Each time you give out or receive some product you must write the date it happens Received From/Issued To Where you received medicine from (e.g., the health center) or where you dispensed medicines to (e.g., patients) Quantity Received Quantity of counting units received in an order (e.g., if the unit is blister here you write 1 blister not 6 tablets) Quantity Dispensed Quantity of counting units given out (e.g., if the unit is blister here you write 1 blister not 6 tablets) Balance Amount of counting units remaining in your stock. Expiry Date/Comments The date the product expires. This makes it easier to track. Supervisor can help locate this information. Received from /issued to Quantity received Quantity Dispensed Balance Expiry date /comments