Date Received
Item
Date Received
date
Batch # or Device Type
Item
Batch # or Device Type
text
Lot #, Serial #, or Model Number(s)
Item
Lot #, Serial #, or Model Number(s)
integer
Received by (staff initials)
Item
Received by (staff initials)
text
Date used
Item
Date used
date
Subject Study ID
Item
Subject Study ID
integer
Dispensed by (staff initials)
Item
Dispensed by (staff initials)
text
Device Position
Item
Device Position
text
Date of final Device Disposition
Item
Date of final Device Disposition
date
Confirmed by (staff initials)
Item
Confirmed by (staff initials)
text
Comments
Item
Comments
text