ALL PAGES OF THE ORDER FORM HAVE TO BE FAXED SPECIAL NOTICES

Transcription

1 ALL PAGES OF THE ORDER FORM HAVE TO BE FAXED SPECIAL NOTICES Notice: Please check the "ship to" address to make sure it is correct. Incorrect shipping addresses will incur a surcharge of $12 per box in addition to the original UPS freight charges. This cost will be passed on to the Ministry as of this notice. Important Documentation Notification: Recently mission teams to Nicaragua and El Salvador have told us of increased government requirements to bring in medicines. Blessings encourages you to research the requirements for drug importation prior to your departure to any country. If you want Blessings to provide additional documentation, we will be glad to do that. We need to charge $2.00 for each document (Proforma, Certificate of Analysis, Gift Certificate, Certificate of Authenticity) to cover our cost. Documents cannot be sent until an order is ready to ship. PRO -- Proforma (signed, stamped and sealed) COQ --Certificate of Quality and Authenticity GC -- Gift Certificate COA--Certificate of Analysis issued by manufacturer (only available on For Export Only products) To order the above Documents check the last page; they are the last items on the order form. Documents cannot be sent until an order is ready to ship. New Items to Blessings order form-(these are not for donation) PAGE Acetaminophen 80mg children's chewable fruit flavored tabs 30 ct Page Chloroquine phosphate tabs 150mg base 3984 Allopurinol 100mg tabs FOR EXPORT ONLY Page Chlorzoxazone 500mg tabs FOR EXPORT ONLY 1046 Phenytoin sodium 100mg caps FOR EXPORT ONLY Page Ketorolac tromethamine 0.5% ophthmic solution;5ml sterile 2997 Naphazoline HCl.01% USP ophthmic solution;15ml sterile{like VISINE -ALLERGY RELIEF] FOR EXPORT ONLY 2397 Tobramycin 0.3%, dexamethasone0.1% ophthalmic 5mL FOR EXPORT ONLY Page I.V. administration set 78" tube-15 drops/ml-1 inject sites Page M Surgical gown reinforced (sterile):contents inculde- 1gown,2 hand towels,(med 1195L Surgical gown reinforced (sterile):contents inculde- 1gown,2 hand towels,(large) 1196XL Surgical gown reinforced (sterile):contents inculde- 1gown,2 hand towels,(x-large) PMTR Patient Medical Treatment Record- in packs of 50 PAGE Thermometer INFRARED forehead scan, guidebook in english & spanish DONATIONS B.I. will donate to you any of the following items that we have in our stock donation inventory. If you need any of these, just mark how many you want on this page, then fax it in with your order. Please note that we have limited stock on items so they will be donated on first come, first serve basis. Like us on facebook! Look for us in your newsfeed regarding product availability updates, surveys, and feedback from other medical mission teams.

2 Description International Pharmaceutical Order Form Quantity Unit Charge Page 2 06/0815 Unit Legend 1M = 1,000 EA= Each IFE=FOR EXPORT ONLY OUT OF STOCK=NOT AVAILABLE FOR THIS TRIP BACKORDER WITH DATE IN BLANK=IS THE DATE BI EXPECTS IT DUE IN (STOCK) IF IT IS STAMPED NOT IN DATE RANGE= MEANS IT IS NOT IN THE DATE RANGE YOU ASKED FOR. Examples: 15M = 15,000 25M = 25,000 Blessings International 1650 North Indianwood Avenue Broken Arrow, OK USA Telephone Fax order@blessing.org Website: Surely blessing I will bless thee.. HEB 6:14 June 2015 These medicines are to be used solely for the ill, needy, or infants. Medicines are not for sale or resale. The handling charge may be changed at any time. Please note all charges are subject to change due to market price fluctuations and availability. We make every attempt to secure the absolute lowest charge. 000 TABLETS AND CAPSULES ANTACIDS AND ANTIFLATULENTS 4607 Calcium carbonate 500mg chewable tabs, asst flavors x 500 $ Calcium carbonate 500mg tabs [LIKE TUMS] x 150 $ U Omeprazole 20mg caps, delayed-release [LIKE PRILOSEC] x 100 $ Omeprazole 20mg caps, D. R.-FOR EXPORT ONLY[LIKE PRILOSEC] x 1M $ Ranitidine 15mg/mL 16oz (75mg/5mL) x 1 $ Ranitidine 150mg tabs FOR EXPORT ONLY x 1M $27.45 ANALGESICS 2644 Acetaminophen 325mg tabs x 1M $ Acetaminophen 500mg tabs (Paracetamol) FOR EXPORT ONLY x 1M $ Acetaminophen 80mg children's chewable fruit flavored tabs x 1M $ Acetaminophen 80mg children's chewable fruit flavored tabs x 30 $ Acetaminophen suppositories 120mg (pediatric) x 12 $ Aspirin 325mg enteric coated tabs x 1M $ Aspirin 81mg enteric coated, adult, DR tabs: not chewable x 1M $ Ibuprofen 200mg, tabs-- FOR EXPORT ONLY x 1M $ Naproxen sodium 220mg tabs x 100 $6.55 ANTIBIOTICS, ANTIBACTERIALS, ANTIFUNGAL, ANTIVIRAL 1281 Amoxicillin 125mg, dispersible tabs, in 5mL water FOR EXPORT ONLY x 100 $ U Amoxicillin 250mg (chewable) tabs x 100 $ Amoxicillin 250mg (chewable) tabs FOR EXPORT ONLY x 1M $ U Amoxicillin 250mg (chewable) tabs x 500 $ C Amoxicillin 500mg caps FOR EXPORT ONLY x 1M $ U Amoxicillin 500mg caps x 500 $ Amoxicillin 500mg,clavulanate potassium 125mg, tabs FOR EXPORT ONLY out of stock until JULY x 50 $ Azithromycin 250mg tab FOR EXPORT ONLY x 500 $ Azithromycin 250mg tab FOR EXPORT ONLY x 250 $ U Cephalexin 250mg caps x 100 $ U Cephalexin 250mg caps x 500 $ U Cephalexin 500mg caps [LIKE KEFLEX] x 100 $ U Cephalexin 500mg caps [LIKE KEFLEX] x 500 $ Ciprofloxacin 500mg tabs - FOR EXPORT ONLY [CIPROX] x 500 $ Clindamycin 150mg caps x 100 $ Cloxacillin 500mg caps FOR EXPORT ONLY x 1M $ Doxycycline hyclate 100mg tabs FOR EXPORT ONLY x 1M $ Erythromycin stearate BP 250mgtabs FOR EXPORT ONLY x 500 $ Dicloxacillin sodium 250mg cap x 100 $ Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 100 $ D Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 500 $ C Fluconazole 200mg, caps FOR EXPORT ONLY [LIKE DIFLUCAN] x 100 $ Griseofulvin 125mg tabs FOR EXPORT ONLY x 1M $ D Griseofulvin 500mg tabs FOR EXPORT ONLY x 500 $ Itraconazol 100mg caps FOR EXPORT ONLY x 28 $ Nitrofurantoin 100mg tabs FOR EXPORT ONLY x 500 $ Nystatin 500,00 unit tabs (oral) FOR EXPORT ONLY x 100 $ Minocycline HCl 100mg caps x 50 $ Phenoxymethyl Penicillin 250mg(Pen VK) tabs, FOR EXPORT ONLY x 1M $ C Levofloxacin 500mg tabs FOR EXPORT ONLY x 100 $ Sulfamethoxazole 400mg,trimethoprim 80mg tabs FOR EXPORT ONLY x 1M $37.55 [LIKE BACTRIM OR SEPTRA] 4396 Sulfamethoxazole 800mg, trimethoprin 160mg DS tabs IFE x 500 $33.50 [LIKE BACTRIM SEPTRA] ANTIAMEBICS 4651 Metronidazole 250mg tabs - FOR EXPORT ONLY [LIKE FLAGYL] x 1M $ Tinidazole 500mg tabs FOR EXPORT ONLY x 500 $35.75

3 International Pharmaceutical Order Form Page 3 ANTIVIRALS 0230 Aciclovir 200mg tabs FOR EXPORT ONLY[LIKE ZOVIRAX] x 500 $ U Acyclovir 200mg tabs [LIKE ZOVIRAZ] x 100 $8.65 ANTHELMENTICS 2325 Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 100 $ Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 500 $ Mebendazole 100mg chewable tab FOR EXPORT ONLY [LIKE VERMOX] x 1M $ D Albendazole 400mg chewable tab -- FOR EXPORT ONLY x 500 $53.00 ANTIMALARIALS 0321 Artemether 20mg + Lumefantrine 120mg FOR EXPORT ONLY [Like Coartem] x 24 $ Chloroquine phosphate tabs 150mg base x 100 $3.25 ANTIDIARRHEALS & ANTISPASMOTIC 3430 Bismuth subsaliclate 262mg chewable tabs [LIKE PEPTOBISMAL TABS] x 30 $ Loperamide HCl 2mg caps FOR EXPORT ONLY [LIKE IMMODIUM] x 500 $ Loperamide HCl 2mg caps FOR EXPORT ONLY [LIKE IMMODIUM] x 100 $5.00 ANTIHISTAMINE, DECONGESTANTS, 3100 Chlorpheniramine maleate 4mg tabs x 1M $ Cough drops cherry flavored x 720 $ Cough drops honey lemon flavor x 720 $ Cough drops Menthol flavor x 720 $ Diphenhydramine 50mg, caps [LIKE BENADRYL] x 1M $ Diphenhydramine HCl 25mg caps [LIKE BENADRYL] x 1M $ D Guaifenesin 400mg, tabs USP x 500 $ U Loratadine 10mg tabs [LIKE CLARITIN] x 100 $ Loratidine 10mg tabs, FOR EXPORT ONLY x 500 $ Cetirizine HCI 10mg tab FOR EXPORT ONLY x 500 $ U Cetirizine HCl 10mg tabs ZYRTEC x 100 $ Promethazine HCl 25mg tabs [LIKE PHENERNAN] x 100 $6.00 MISCELLANEOUS 3519 Estradiol 0.5mg tabs x 100 $ Atorvastatin 10mg tabs FOR EXPORT ONLY [LIKE LIPITOR] x 360 $ Estradiol 1mg tabs x 100 $ U Simvastatin 10mg tabs x 90 $ U Simvastatin 10mg tabs x 500 $ U Simvastatin 20mg tabs x 90 $ U Simvastatin 20mg tabs x 1M $ U Simvastatin 20mg tabs x 500 $ U Simvastatin 40mg tabs x 30 $5.05 ANTIHYPERTENSIVES AND DIURETIC 4573U Atenolol 50mg tabs x 100 $ Atenolol 50mg tab FOR EXPORT ONLY x 1M $ Captopril 25mg tabs FOR EXPORT ONLY x 1M $ Chlorthalidone tabs 25mg x 100 $ Enalapril 10mg tabs FOR EXPORT ONLY x 1M $ Furosemide 40mg tabs FOR EXPORT ONLY x 1M $ Hydrochlorothiazide 25mg tabs FOR EXPORT ONLY x 1M $ M Lisinopril 10 mg tab, FOR EXPORT ONLY x 1M $ D Losartan potassium 50mg FOR EXPORT ONLY x 500 $ U Losartan potassium 50mg tabs x 90 $ Metoprolol 50mg tabs BID [LIKE LOPRESSOR] x 1M $ Metoprolol 50mg tabs BID [LIKE LOPRESSOR] x 100 $2.65 ANTIINFLAMMATORY AND ANTIGOUT 3984 Allopurinol 100mg tabs FOR EXPORT ONLY x 28 $ Diclofenac sodium 50mg tabs (enteric coated) FOR EXPORT ONLY x 1M $ U Ibuprofen 400mg, tabs x 500 $ Ibuprofen 400mg, tabs FOR EXPORT ONLY x 1M $ U Ibuprofen 400mg tabs x 500 $ Ibuprofen 600mg film coated tabs--for EXPORT ONLY x 1M $ U Ibuprofen 600mg film coated tabs x 500 $ U Ibuprofen 800mg tabs x 500 $ U Meloxicam 7.5mg tabs x 100 $ U Meloxicam 7.5 mg tabs x 1M $ U Meloxicam 15mg tabs x 100 $ U Meloxicam 15 mg tabs x 1M $ Naproxen sodium 550mg tabs x 100 $ Naproxen Sodium 550mg tabs OUT x 500 $ M Prednisone 10mg tabs FOR EXPORT ONLY x 1M $ M Prednisolone 5mg tabs FOR EXPORT ONLY x 1M $ Prednisone 20mg tabs x 100 $20.65 ANTIPSYCHOTICS, ANTIDEPRESSANTS, 4161M Amitriptyline 25mg tabs FOR EXPORT ONLY x 1M $ Amitriptyline 10mg tabs x 1M $ Fluoxetine 20mg caps PROZAC x 500 $ Sertraline HCL 25mg [LIKE ZOLOFT] x 30 $ Sertraline HCL 25mg [LIKE ZOLOFT] x 90 $ Sertraline HCL 25mg x 500 $ U Sertraline HCL 100mg [LIKE ZOLOFT] x 30 $2.55

4 International Pharmaceutical Order Form Page U Sertraline HCL 100mg [LIKE ZOLOFT] x 500 $ Trazodone HCl 150mg tabs [LIKE DESYREL] x 100 $ Trazodone HCI 150mg tabs x 500 $49.90 ANTIEPILEPTIC & ANTIPARKINSON 3286 Carbamazepine 100mg chewable tabs x 100 $ Carbamazepine 200mg tabs FOR EXPORT ONLY [LIKE TEGRETOL] x 1M $ U Gabapentin 100mg caps x 100 $ U Gabapentin 300mg caps x 100 $ U Gabapentin 300mg caps x 500 $ Levetiracetam 250mg tabs [LIKE KEPPRA] x 120 $ Phenytoin sodium 100mg caps FOR EXPORT ONLY x 100 $8.20 ANTISPASMODIC, ANTICHOLENERGIC 4565 Dicyclomine HCl 10mg caps [LIKE BENTYL] x 100 $ Metoclopramide 5mg tabs [LIKE REGLAN] x 500 $ Promethazine 25mg tabs FOR EXPORT ONLY x 100 $9.00 BRONCHIAL DILATORS 3989 Albuterol sulfate 0.083% 2.5mg/3mL inhalation solution x 25 $ D Salbutamol 2mg tabs/(albuterol) FOR EXPORT ONLY x 500 $ D Salbutamol 4mg tabs scored/(albuterol) FOR EXPORT ONLY x 500 $ Singulair 4mg (Montelukast) x 90 $ Beclomethasone.05mg/dose oral inhaler FOR EXPORT ONLY OUT x 1 $ Salbutamol (Albuterol) oral inhaler 0.1mg; 200 doses FOR EXPORT ONLY _OUT x 1 $5.75 CARDIAC GLYCOSIDES, ANTIARRHYMICS, 1250M Amlodipine 5mg tabs [LIKE NORVASC] x 1M $ Clopidogrel 75mg tabs [LIKE PLAVIX] x 30 $ Clopidogrel 75mg tabs [LIKE PLAVIX] x 90 $ Isosorbide Dinitrate 10mg tabs FOR EXPORT x 500 $ Verapamil HCl 80mg tabs x 100 $ Verapamil HCl 80mg tabs x 1M $ Warfarin sodium 5mg tabs [LIKE COUMADIN] x 100 $9.75 DIABETES, HYPOGLYCEMICS 1330 Glibenclamide 5mg tabs (Glyburide) FOR EXPORT ONLY x 1M $ U Glipizide 10mg tabs [LIKE GLUCOTROL] x 500 $ Glipizide 10mg tabs (scored) FOR EXPORT ONLY [LIKE GLUCOTROL] x 1M $ U Glipizide 5mg tabs [LIKE GLUCOTROL] x 500 $ U Glipizide 5mg tabs [LIKE GLUCOTROL] x 1M $ M Metformin 1000mg tabs [LIKE GLUCOPHAGE] FOR EXPORT ONLY x 1M $ Metformin 850mg tabs [LIKE GLUCOPHAGE] x 500 $ U Metformin HCl 850mg tabs [LIKE GLUCOPHAGE] x 100 $ Metformin HCI 500mg tabs FOR EXPORT ONLY [LIKE GLUCOPHAGE] x 1M $ U Metformin HCI 500mg tabs [LIKE GLUCOPHAGE] x 100 $2.25 LAXATIVES 3609 Bisacodyl 5mg delayed-release, tabs x 1M $ Docusate sodium 100mg soft gels x 1M $ Docusate sodium 100mg soft gels x 100 $2.10 MUSCLE RELAXANT, MINOR TRANQUILIZERS 0875 Chlorzoxazone 500mg tabs FOR EXPORT ONLY x 500 $ U Cyclobenzaprine HCl 10mg tabs [LIKE FLEXERIL] x 1M $ Methocarbamol 500mg tabs x 500 $41.50 VITAMINS, MINERALS 2187 Vitamin A 200,000 IU caps FOR EXPORT ONLY x 1M $ Ferrous sulfate 325mg tabs x 1M $ Folic acid 800mcg tab x 1M $ Multivit: Children chewable without iron Vit-A 2500IU;Vit-D3 400IU; x 1M $17.00 Vit-B1 1.05mg; Vit-B2 1.2mg; Vit-B6 1.05mg; Vit-B12 4.5mcg; Vit-C 60mg; Vit-E 15IU;Niacin 13.5mg 2196ZMC1 Multivit: Child chew w/iron,zn: Vit-A 2500IU;Vit-D 400IU; Vit-B1 1.05mg; x 27M+ $ Vit-B2 1.2mg; Vit-B6:1.05mg; Vit-B124.5mcg; Vit-C 60mg; Vit-E 15IU; Niacin 13.5mg; Iron(as ferrous fumarate) 15mg.ZINC [BOX CT IS 27,273] 2196 Multivit: Children chew w/iron: Vit-A 2500IU;Vit-D 400IU; Vit-B1 1.05mg; x 25M $ Vit-B2 1.2mg; Vit-B6 1.05mg; Vit-B124.5mcg; Vit-C 60mg; Vit-E 15IU; Niacin 13.5mg; Iron(as ferrous fumerate) 15mg Multivit: Children chew w/iron: (Same content as ) x 1M $ Multivitamins w/fe & I: VitA w/beta carotene 5000IU; VitD 400IU; VitC x 25M $ mg; VitB1 1.5mg; VitB2 1.7mg; VitB6 2.0mg; niacinamide 20mg; Ca pantothenate 10mg; folic acid0.4mg;vit-b12 6mcg;Iron as fumarate 18mg;IODI18mg;IODINE 0.225mg RDA VITAMINS W/IRON & IODINE[BOX CT 25,200] 3250 Multivitamins w/fe &I: (Same content as ) RDA x 1M $17.00 VITAMINS/IRON/IODINE 1900B Multivitamins:without IRON & IODINE:VitA 5000IU;VitC60mg; x 25M $ VitD-3 400IU;VitB-1VitB- 21.7mg;Niacin 20mg; VitB-6 2mg;VitB-12 6mcg; VitE30IU;Foliate 400mcg;Pantothenic Acid 1mg; 1900 Multivitamins: without IRON & IODINE :VitA 5000IU;VitC60mg;VitD-3 400IU; x 1M $17.00 VitB-1VitB- 2,1.7mg;Niacin 20mg; VitB-6 2mg;VitB-12 6mcg; VitE30IU;Foliate 400mcg;Pantothenic Acid 1mg; 3199 Prenatal vitamins: (Same content as ) x 500 $20.00

5 International Pharmaceutical Order Form Page Prenatal vitamins: Vit-A 4,000IU; Vit-D 400 IU; Vit-E11 IU; Vit-C 100mg; x 16M+ $ Vit-B1 1.84mg; f olic acid 0.8mg;VitB2 1.7mg; niacinamide 18mg; Vit-B6 2.6mg; Vit-B12 4mcg;Ca 200mg; Fe 60m g (as fumerate); Zn 25mg (as o25mg (as oxide) [BOX CT IS 16,667] 1731 Zinc sulfate monohydrate 20mg (DISPERSIBLE) FOR EXPORT ONLY x 100 $ Infant Multivitamin drops w/iron: A-1500 IU, D-400 IU,E-5 IU, C-35mg, x 6 $20.25 B1-0.5mg, B2-0.6mg, Niacin 8mg,B6-0.4mg, Iron 10mg/1mL (50mL) 1 2/3oz dropper bottle LIQUID[LIKE POLY-VI-SOL W/IRON] 200 TOPICALS GENERAL TOPICALS 1077 Betamethazone 0.1% cream 15gr (1/2 oz) FOR EXPORT ONLY out of stock until June x EA $ Hemorrhoidal rectal suppositories [LIKE PREPARATION H] x 12 $ Hydrocortisone 0.5% cream 15gm1/2oz tube FOR EXPORT ONLY x 12 $ Hydrocortisone 1% 15mg tube FOR EXPORT ONLY x 10 $ Hydrocortisone cream 1% foil packet x 144 $ Menthol 10%,Methyl salicytate 15%:1oz (90g) [LIKE BEN-GAY] x 6 $ Vitamin A & D ointment foil packs 5g x 144 $ White Petrolatum foil packs 5g x 144 $11.35 ANTIBIOTICS AND ANTISEPTICS 9000 Empty-1/2oz round hinged lid plastic container-can be used to divide up x 30 $7.50 creams/ointments 4392 Bacitracin 500 units ointment 1.0gm foil packets x 144 $ Bacitracin zinc, neomycin sulfate, polymyxin B sulfate ointment 0.9gm x 144 $19.35 foilpackets [TRIPLE ANTIBIOTIC] gm/Bacitracin zinc 400 unitsneomycin sulfate 5mg, polymyxin B ointment x 12 $ /2 oz (14.17gm) tube [TRIPLE ANTIBIOTIC] 2004 Clotrimazole 1% antifungal cream 20gm IFE ONLY [LIKE LOTRIMIN] x 10 $ Miconazole nitrate 2% cream 1oz (30gm) tube [LIKE MICOTIN] x 6 $ X Nystatin ointment 100,000 unit 1oz (30gm) tube, FOR EXPORT ONLY x 10 $ Nystatin ointment 100,000 unit 1oz (30gm) tube, FOR EXPORT ONLY x EA $ Povidone iodine 10% topical solution 128oz (3784mL)gallon x 1 $ Povidone iodine 10% topical solution 16oz (473 ml) pint x 1 $ Silver sulfadiazine 1% cream 50gm tubes [LIKE SILVADENE 1%] x 1 $ Tolnaftate 1% cream 1/2oz (15gm) tube x 6 $10.65 ANTILICE - PEDICULICIDES 2325 Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 100 $ Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 500 $ Lice Shampoo - non-toxic enzyme concentrate 16oz;32 treatments per x 1 $27.00 bottle. Includes instructions BLESSINGS LICE SHAMPOO 4108 Permethrin 5% cream; 60gm tube - FOR EXPORT ONLY x 1 $ Permethrin Lotion 1% 60mL cream rinse-w/lice combs x 2 $ Permethrin Lotion 1% 100mL cream rinse FOR EXPORT ONLY x EA $ Scabies Solution - non-toxic enzyme concentrate 32 oz; 16 treatments x 1 $34.50 per bottle. instructions included. ITCH B GONE OPHTHALMICS & OTICS 8100 Reading Glasses-variety pack assorted powers-from +1/+1.25/+1.5/+1.75/+2/+2.5 x 19 $ Glasses for near-sighted (-1.0 to -4.5)adjustable on side of each ear piece. x EA $ Carbamide peroxide 6.5% ear drops 1/2oz(14.79mL) x EA $ Ciprofloxacin 0.3% sterile ophthalmic solution 10mL x 1 $ Gentamicin sulfate 0.3%-- ophthalmic solution; 5mL FOR EXPORT ONLY x 10 $ Ketorolac tromethamine 0.5% ophthmic solution;5ml sterile x 10 $15.75 FOR EXPORT ONLY 4000 Lubricant eye drops 8 pks of 4 sterile 0.02 fl oz x 32 $ Lubricant eye drops polyvinyl alcohol 1.4%,benzalkonium chloride.01%-5ml- x 10 $15.00 FOR EXPORT ONLY [llike LIQUITEARS] 2997 Naphazoline HCl.01% USP ophthmic solution;15ml sterilefor EXPORT ONLY x 10 $ Ofloxacin.3% ophthalmic 5 ml-drops-for EXPORT ONLY x 10 $ Prednisolone acetate 1.0% ophthalmic suspension 5ml FOR EXPORT ONLY x 10 $ Tetrahydrozoline HCl Ophthalmic drops 0.05% 1/2oz (15mL) OPTI-CLEAR x 12 $ Timolol Maleate Ophthalmic solution 0.5%: 10mL x 1 $ Tobramycin 0.3%, dexamethasone0.1% ophthalmic 5mL FOR EXPORT ONLY x 10 $11.25 VAGINALS 0700 Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 100 $ D Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 500 $ U Clotrimazole vaginal cm USP 1%antifungal 45gm (1.5 oz) w/app x 1 $ Clotrimazole 100mg vaginal tabw/applicator-6 tabs per box FOR EXPORT ONLY x 6 $ Lubricating jelly sterile 2oz x EA $ S Vaginal specula (small) ready to use - disposable x 10 $ M Vaginal specula (medium) ready to use - disposable x 10 $ L Vaginal specula (large) ready to use-disposable x 10 $ Obsterical Kit:1 pr str gloves1 drape sheet,2 umbilical clamps str,2 O.B. x 1 $9.00 towelettes 1-O.B.Pad str, 1plastic bag for placenta,6 gauze sponges 1 bulb syringe,4 disposable towels 2 nylon tie-offs,scalpel twist ties, rec-ing blanket 2 alcohol preps medium, 400 LIQUIDS tsp child medicine spoon x 10 $ oz empty plastic cough syrup bottles x 10 $3.00

6 International Pharmaceutical Order Form Page tsp oral medicine syringe 5mL x 10 $ Medicine cups 1oz disposable: 100 cups / bag x 100 $1.45 ANTACIDS AND ELECTROLYTES 4120U Magnesium hydroxide 400mg;12oz (Milk of Magnesia) Mint x 1 $ Ranitidine 15mg/mL 16oz (75mg/5mL) x 1 $ Oral rehydration salts- NaCl 3.5g, KCl 1.5g, trisodium Na 2.9g, glucose x 100 $ g, sachet for 1 liter soln. FOR EXPORT ONLY ANALGESIC LIQUIDS, SYRUPS 2437 Acetaminophen drops 80mg 0.8mL; 15mL x 1 $ Acetaminophen drops 80mg/0.8mL 30mL x 1 $ Acetaminophen elixir 160mg/5mL;4 fl.oz. (118mL) x 1 $ Acetaminophen elixir 160mg/5mL; 16oz x 1 $ Ibuprofen o/s 100mg/5mL; 4oz [LIKE MOTRIN] x 1 $4.75 ANTIBIOTICS, LIQUID OR FOR SUSPENSIONS 1281 Amoxicillin 125mg, dispersible tabs, in 5mL water FOR EXPORT ONLY x 100 $ U Amoxicillin 600mg, clavulanate potassium 42.9mg:5mL/125mL for o/s x EA $ Amoxicillin for o/s 125mg/5mL;pwd-100mL FOR EXPORT ONLY x 40 $52.70 THESE ARE IN PLASTIC BOTTLES - WT. 6 lbs PER CASE Amoxicillin for o/s 250mg/5ml;100ml FOR EXPORT ONLY x 10 $19.50 These are in GLASS BOTTLES wt. 3.4 lbs 3171U Amoxicillin for o/s 250mg/5ml;100ml in plastic wt. 2.3lbs x 12 $ U Amoxicillin for o/s 125mg/5mL;100mL x 12 $ Amoxicillin for o/s 400mg/5mL;50mL BID x 6 $ Azithromycin for o/s 200mg/5mL;pwd- 15mL FOR EXPORT ONLY OUT x 10 $ Nystatin 100,000 units/ml oral solution; 30mL FOR EXPORT ONLY 4432 Sulfamethoxazole 200mg, trimethoprim 40mg/5mL;100mL pediatric susp: x x 1 12 $2.35 $21.65 FOR EXPORT ONLY [LIKE BACTRIM OR SEPTRA] ANTIHISTAMINE, DECONGESTANTS, COUGH & 3807 Diphenhydramine HCl elixir 12.5mg/5mL; 16oz [LIKE BENADRYL] x 1 $ Diphenhydramine HCL 12.5mg/5mL 4oz x 1 $ Guaifenesin 100mg dextromethorphan 10mg/5mL expectorant x 12 $16.95 suppressant 4oz [like ROBITUSSIN DM] 3434 Guaifenesin syrup 100mg/5mL; 16oz [LIKE ROBITUSSIN] x 1 $ Guaifenesin 100mg/5mL 4 fl. oz. x EA $ Loratadine 5mg/5ml solution 4 fl.oz. (118ml) x 1 $5.40 ANTIHISTAMINE, NASAL SPRAYS AND ASTHMA 2268 Albuterol sulfate syrup 2mg 5m : 1 pint (473mL) [LIKE VENTOLIN] x 1 $ Nasal saline decongestant spray 15mL [LIKE AFRIN] x 1 $ Nasal saline spray PLAIN (ocean spray)15ml x 1 $1.05 VITAMINS - LIQUID, POWDER AND NUTRITIONAL 3082 Ferrous sulfate elixir 220mg/5mL; 16oz (473mL) x 1 $ Infant Multivitamin drops w/iron: A-1500 IU, D-400 IU,E-5 IU, C-35mg, x 6 $23.40 B1-0.5mg, B2-0.6mg, Niacin 8mg,B6-0.4mg, Iron 10mg/1mL (50mL) 1 2/3oz dropper bottle [LIKE POLY-VI-SOL W/IRON] MISCELLANEOUS 500 INJECTABLES ANTIMALARIALS 0490 Artemether 20mg/1ml s.d.v. ampoule FOR EXPORT ONLY x 1 $ Artemether 60mg/1ml + 1vial of 5% sodium: I.M./I.V. -s.d.v. FOR EXPORT ONLY x 1 $ Artemether 80mg/1ml s.d.v. ampoule FOR EXPORT ONLY x 6 $10.80 ANESTHETICS 3814 Epinephrine inj. 1:1000 1mg/ml1ml s.d.v.-for EXPORT ONLY x 10 $ Epinephrine 1:1000(1mg/mL) 30 ml x EA $ Lidocaine 1% w/epinephrine 10mg/mL;20mL x 1 $ Lidocaine 2% w/ epinephrine 10mg/ml:30ml (MDV) x 1 $ Lidocaine HCl 1% inj. 10mg/mL;50mL m.d.v. x EA $ Lidocaine HCl 2% inj. 20mg/mL;50mL m.d.v. x EA $1.95 DENTAL 3891 Lidocaine 2% 1:100,000 w/epinephrine 1.7mL per cartridge -dental cartridges x 50 $ Needle 27g x 1" DENTAL disposable, sterile x 100 $ Needle 30g x 1/2" DENTAL disposable, sterile x 100 $ Toothbrushes,pre pasted x 20 $ Toothpaste w/flouride 1.5oz x 12 $ 3.20 ANTIBIOTIC 4632 Ceftriaxone sodium 1gm str pdr for IM or IV, 6mL s.d.v. [LIKE ROCEPHIN] x EA $ Ceftriaxone sodium 1gm str pdrfor IM or IV, 6ml s.d.v. FOR EXPORT ONLY x 10 $20.00 [LIKE ROCEPHIN] 4645 Ceftriaxone sodium 250mg str pdr for IM or IV, 6mL s.d.v. [LIKE ROCEPHIN] x EA $ Ceftriaxone sodium 250mg str pwd/ IM or IV, 6ml s.d.v. IFE [LIKE ROCEPHIN] x 10 $ Ceftriaxone sodium 500mg pwd for IM or IV, 6mL s.d.v. [LIKE ROCEPHIN] x EA $3.00 MISCELLANEOUS, VITAMINS 2947 Bacteriostatic 0.9% sodium chloride inj.(not for newborns)sterile 30ml m.d.v. x EA $ Cyanocobalamin 1mg/ml inj:1ml FOR EXPORT ONLY x 10 $ Dexamethasone inj. 4mg/mL; 30mL m.d.v. x EA $ Diphenhydramine HCl inj. 50mg/mL 1mL m.d.v. [LIKE BENADRYL] x EA $ Promethazine HCl 25mg/ml; 1mL s.d.v.:ampoule [LIKE PHENERGAN] x EA $ Promethazine HCL 50mg/ml 1ml [LIKE PHENERGAN] x EA $3.25

7 International Pharmaceutical Order Form Page Phenytoin sodium inj 100mg/2mL x 1 $ Sodium chloride 0.9% inj. 10mL s.d.v. x EA $ PERSONAL PROTECTION BOOKS 4252 A Comprehensive Guide To Missions / Karen Bean, RN. book, written by x 1 $35.00 a missionary vast experience, is designed to be a practical manual for anyone involved in foreign missions Handbook of Medicine in Developing Countries by: Palmer, DO & Wolf x 1 $39.00 MD, vast experience, is designed to be a practical manual for anyone involved in foreign missions. Third Edition 6013 Coloring Books to help promote burn safety/central America printed in Spanish x 1 $1.50 w/crayons Coloring Books to help promote good hygiene/central America printed in Spanish x 1 $1.50 w/crayons x 1 $ Coloring Books to help promote good hygiene/africa- printed in English x 1 $1.50 w/crayons Coloring Books to help promote good hygiene/haiti- printed in Creole w/crayons x 1 $1.50 PERSONAL PROTECTION PRODUCTS 6200 Water purification tabs (Potable Aqua) 2 tabs = 1qt. / 1 bottle = 6 gals x 50 $ Water purifier Outback bucket system, 5-gallon pour through, gravity- x 1 $ feed unit. No water pressure required Purifies 1,500gallons at 8 gal/hr OutBack bucket purification replacement cartridge x 1 $ OutBack bucket-water sediment filter (prefilter) 30 micron replacement x 1 $ BANDAGES & SURGICAL SYRINGES, TAPE, GAUZE, MISC Adhesive bandage 1" x 3" sterile non-stick [LIKE BAND-AIDS] x 100 $ Adhesive flexible fabric bandage 3/4"x3" sterile non-stick [LIKE BAND- x 100 $ Alcohol prep pads 200/box x 200 $ Benzalkonium chloride, 0.13% antiseptic cleansing towelette 5"x7" x 100 $ Butterfly wound closures (M) 3/8x1 7/8 (medium) x 100 $ Butterfly wound closures (LG)1/2x2 3/4 (large) x 100 $ Cap Nurse's blue x 100 $ Catheter foley, silicone coated, retention 5cc, 12 Fr x 10 $ Catheter foley, silicone coated, retention 5cc, 14 Fr x 10 $ Catheter foley, silicone coated, retention 5cc, 16 Fr x 10 $ Catheter foley, silicone coated, retention 5cc, 18 Fr x 10 $ Cotton tip applicators 6" non-sterile x 100 $ Elastic bandage 2" x 5 yds. x 10 $ Elastic bandage 3" x 4.5 yds. x 10 $ Elastic bandage 4" x 4.5 yds. x 10 $ Face mask ear loop x 50 $ N95 Respirater mask w/nose cushion & tan straps (SMALL) x 20 $ N95 Respirater mask w/nose cushion & tan straps (Medium) x 20 $ Gauze-sterile 2x2x8ply (2 sponges/env)sterile x 50 $ Gauze sponge 2x2x8 ply in ready to sterilize bag x 200 $ Gauze sponge 4x4x8 ply in read to sterilize bag x 200 $ Gauze sponge 4x4x8 ply sterile bag(2 sponges/env) x 50 $ Gauze sponge 4x4x8 ply sterilize bag(2 sponges/env) x 25 $ Gauze sterile 4.5" x 147" 6 ply roll krinkled x 1 $ Gloves latex powder free small x 100 $ Gloves light powder latex (XS)x-small x 100 $ Gloves light powder latex (S) small x 100 $ Gloves light powder latex (M) medium x 100 $ Gloves light powder latex (L) large x 100 $ Gloves powder free Nitrile (S)SMALL x 100 $ Gloves powder free Nitrile (M) medium x 100 $ Gloves powder free Nitrile (L) large x 100 $ Gloves latex surgical sterile (pairs) size 6 1/2 x 50 $ Gloves latex surgical sterile (pairs) size 7 x 50 $ Gloves latex surgical sterile (pairs) size 7 1/2 x 50 $ Gloves latex surgical sterile (pairs) size 8 x 50 $ Gloves latex surgical sterile (pairs) size 8 1/2 x 50 $ Hand Sanitizer w/moisturizing kills 99% germs-4oz flip top x 1 $ Medicine cups 1oz disposable: 100 cups / bag x 100 $ I.V. catheter/needle unit; 20G x 1" [NEEDLES ONLY] x EA $ I.V. catheter/needle unit; 22G X 1" [NEEDLES ONLY] x EA $ I.V. administration set 105"tube length-60 drops/ml-2 inject sites x EA $ IV Start Kit:1/tourniquet- 2/gauze sponge(2x2-8ply)-1/id label-1/transparent dress x 1 $1.25 1/tape (3/4x18)-1/PVP pad- 1/alcohol pad 7140 Needle ONLY 25G x 1" x 100 $ Needle ONLY 18G x 1.5" x 100 $ Needle ONLY 21G x 1.5" x 100 $ Needle only 25G x 5/8" x 100 $ Obsterical Kit:1 pr str gloves1 drape sheet,2 umbilical clamps str,2 O.B. x 1 $9.00 towelettes 1-O.B.Pad str, 1plastic bag for placenta,6 gauze sponges 1 bulb syringe,4 disposable towels 2 nylon tie-offs,scalpel twist ties, rec-ing blanket 2 alcohol preps medium,

8 International Pharmaceutical Order Form Page Povidone Iodine prep pads x 100 $ Povidone iodine 10% topical solution 128oz (3784mL)gallon x 1 $ Povidone iodine 10% topical solution 16oz (473 ml) pint x 1 $ M Surgical gown reinforced (sterile):contents inculde-)1gown,2 hand towels,(med x EA $ L Surgical gown reinforced (sterile):contents inculde- ) x EA $3.75 1gown,2 hand towels,(large) 1196XL Surgical gown reinforced (sterile):contents inculde- x EA $3.75 1gown,2 hand towels,(x-large) 1781 Sterilization Pouch 7.5x13 self-sealing (if you need more deals please call office) x 200 $ Scalpel #10 blade sterile x 100 $ Scalpel #10 blade sterile with attached to handle x 10 $ Scalpel #11 blade sterile x 100 $ Scalpel #11 blade sterile attached to handle x 10 $ Scalpel #15 blade sterile x 100 $ Scalpel #15 blade sterile attached to handle x 10 $ Syringe 10cc 20Gx1 1/2" L/L x 100 $ Syringe 10cc without needle x 100 $ Syringe 1cc 25Gx5/8" L/L x 100 $ Syringe 1cc 27G x 1/2" x 100 $ Syringe 1cc without needle x 100 $ Syringe 3cc 21G x 1 1/2" L/L x 100 $ Syringe 3cc 22Gx1 1/2" L/L x 100 $ Syringe 3cc 23G x 1" L/L x 100 $ Syringe 3cc 23Gx 1 1/2" L/L x 100 $ Syringe 3cc 25g x 1" x 100 $ Syringe 3cc without needle x 100 $ Syringe 5cc 21G x 1 " L/L x 100 $ Syringe 5cc 22G x 1 1/2" L/L x 100 $ Syringe 5cc without needle x 100 $ SPLINT 36"-lightweight, reusable, waterproof, compact, radiolucent, versatile, x 1 $6.00 longitudinal bend to give the splint strength. works for double layer wrist splintsugar tong arm - splint ankle stirrup splint c-curve to create 3783 Tape, adhesive surgical paper 1"x10 yards hypo allergenic x 12 $ Tongue depressor blades adult 6" x 3/4" x 500 $ Tongue depressor blades junior x 500 $ Towel Drape disposable, sterile x 50 $ Unna Boot Bandage x 1 $ PICTURE DOSING LABELS ONLY/same design that's on 3x4 baggies- x 10 $ labels to unit 4257 Zip lock bags 3"x4"x2mil; with picture dosing & white block for writing x 100 $2.50 FDA approved materials 4542 Zip lock bags 3"x5"x2mil; plain double bagged will hold up 120mL liquid x 100 $3.00 SUTURES & SUTURE NEEDLES 7202 Suture synth(braided & coat polyglycolic acid) 2 x 70cm FOR EXPORT ONLY x 36 $ Suture needles assorted sizes, cutting point(needles ONLY)FOR EXPORT ONLY x 12 $ Suture needles assorted sizes, round body FOR EXPORT ONLY x 12 $ Suture catgut chromic 2/0 1x150cm FOR EXPORT ONLY x 36 $ Suture synth abs 3/0 70cm 1/2rb needle 18.5mm FOR EXPORT ONLY x 36 $ EQUIPMENT & MISCELLANEOUS EQUIPMENT & MISCELLANEOUS tsp oral medicine syringe 5mL x 10 $ tsp child medicine spoon x 10 $ oz empty plastic cough syrup bottles x 10 $ Empty-1/2oz round hinged lid plastic container-can be used to divide up x 30 $7.50 creams/ointments 9008 Empty-plastic 60cc bts w/lids and labels x 10 $ PICTURE DOSING LABELS ONLY/same design that's on 3x4 baggies- x 10 $ labels to unit 9006 Asthma Mentor-peak flow meter adult or pediatric x 1 $ Blood glucose monitor; include monitor, manual, battery, carrying case, x 1 $2.00 [MONITOR IS A TRUE TRACK] 9002 Blood glucose test strips; for TrueTrack x 50 $ Lancets; for use with either all monitors requiring 28g x 100 $ Cauterie disposable fine tip, high temperature,4 year shelf life x 1 $ Ear Syringe 1oz x 1 $ HIV 1 & 2 Test Kits for 1 and 2:results in 20 mins-for EXPORT ONLY x 25 $78.40 PMTR Patient Medical Treatment Record- in packs of 50 x 50 $ Reading Glasses-variety pack assorted powers-from +1/+1.25/+1.5/+1.75/+2/+2.5 x 19 $ Glasses for near-sighted (-1.0 to -4.5)adjustable on side of each ear piece. x EA $ N Malaria RDT for plasmodia falciparuma :results in 15 mins; x 25 $45.60 includes 25 individually sealed test, lancets, alcohol swab, sample applicator, pipette s, developing buffer store at 6 to 45 degree C 9095 Mosquito Nets: treated w/ deltamethrin-130cmx180cmx150cm(rectangular) x 1 $ Nebulizer handheld AC adapter included x 1 $ Nebulizer handheld AC adapter Pediatric-Margo-Moo portable red barn x 1 $57.75 carrying case 3666D Nebulizer handheld AC adapter Pediatric-Digger Dog w/dog House carrying bag-5ml x 1 $45.00 Medicine cup, angled mouthpiece, 7" air tubing, child mask, and instructions in Spanish 2301R Otoscope economy x 1 $111.00

9 International Pharmaceutical Order Form Page A Otoscope Disposable Ear specula Adult x 100 $ C Otoscope Disposable Eat specula Child x 100 $ Ophthalmoscope/Otoscope w/eurolight (E10) requires 2 " C" batteries x 1 $ [KaWe] 2330 Pregnancy test, one step, simple to read x EA $ Pregnancy HCG test; quick stick one step FOR EXPORT ONLY x 25 $ Pill Crush, crash tablets into powder x 1 $ Sharps- container red large 10qt (biohazard waste) x 1 $ Sphygmomanometer adult precision aneroid nylon cuff x 1 $ Sphygmomanometer child (precision aneroid) w/ blue nylon cuff x 1 $ Sphygmomanometer infant (precision aneroid) w/ blue nylon cuff x 1 $ Sphygmomanometer XL adult precision aneroid nylon cuff x 1 $ Stethoscope fetal 29" black vinyl Y-tubing x 1 $ Stethoscope spectrum dual head x 1 $ Stethoscope spectrum nurse, black x 1 $ Tablet cutter x 1 $ Tablet/Pill, tray counter w/spa x 1 $ Thermometer INFRARED forehead scan, guidebook in english & spanish x 1 $ Thermometer DIGISCAN multi-function ear &forehead scan-talking x 1 $25.00 in,english & Spanish (no probe covers with this one) -(probe covers # 4332) 3707 Thermometer DIGITAL w/beeper, memory, and fever alarm, x 1 $5.65 battery included.(probe covers #3153) 4332 Thermometer probe covers DIGITAL EAR disposable TENDER TEMP x 40 $6.25 PROBE COVERS 3153 Thermometer probe covers DIGITAL oral disposable x 50 $ Lubricating jelly sterile 2oz x EA $ S Vaginal specula (small) ready to use - disposable x 10 $ M Vaginal specula (medium) ready to use - disposable x 10 $ L Vaginal specula (large) ready to use-disposable x 10 $ Urine dip test strips: 10 PARAMETERS-glucose, protein, nitrite, ph, blood, and x 100 $29.25 leukocytes; Uroblinogen Specific Gravity: Ketone: Bilirubin: visual testing PRO Proforma (signed, stamped and sealed) in box only x 1 $2.00 Proforma will be to the address (that you) provide for us x 1 $4.00 address: COQ Certificate of Quality and Authenticity x 1 $2.00 GC Gift Certificate x 1 $2.00 COA Certificate of Analysis issued by manufacturer for every IFE product x per item $2.00 on your order. (only available on For Export Only products and ndc's) IF YOU DO NOT RECEIVE AN ORDER ACKNOWLEDGEMENT IN 3 BUSNIESS DAYS PLEASE CALL OUR OFFICE. We have not received your order if you have not received an from us. Due to the increased volume of orders and our turnaround time from our suppliers you will see BK(back orders) on some of your orders. Please mark in the blank below the latest date you can receive a BK (back order) item or NO if you do not wish to have back orders shipped to you. Date: Blessings cannot guarantee that you will get your BK but with this date we will do everything we can. If a date is written in the blank on the packing list of your original order that is the day that we expect to ship it to you. PLEASE FAX ALL PAGES OF THE ORDER FORM TO INSURE WE HAVE THE COMPLETE ORDER. IFE=FOR EXPORT ONLY OUT OF STOCK=NOT AVAILABLE FOR THIS TRIP BACKORDER WITH DATE IN BLANK=IS THE DATE BI EXPECTS TO RECEIVE THIS ITEM BACK IN STOCK. IF IT IS STAMPED NOT IN DATE RANGE=THIS MEANS THE PRODUCT IS NOT IN THE DATE RANGE YOU REQUESTED.