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医疗物资捐赠登记 List of medical supplies donation
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非常感谢您的帮助。众志成城,抗击疫情!
Thank you very much for your help.
Unity is strength, f
ight against the COVID-19 outbreak!
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1.
捐赠人姓名 Donor‘s Name:
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2.
捐赠单位 Name of the organisation:
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3.
联系电话 Contact Number:
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4.
邮箱地址 Email Address:
捐赠物品:医用防护装备
Donated items:
Medical Protection Equipment
5.
3-Ply Disposable
Medical
Masks / 三层一次性医用口罩
捐赠数量 Quantity:
捐赠数量 Quantity:
是否拥有CE / FDA认证?CE / FDA Certified or not?
是否拥有CE / FDA认证?CE / FDA Certified or not?
其他标准认证?Other Specific Requirement?是否是无菌口罩? Sterile Masks or not?
其他标准认证?Other Specific Requirement?是否是无菌口罩? Sterile Masks or not?
6.
3-Ply
Disposable
Surgical Masks / 三层一次性外科口罩
捐赠数量 Quantity:
捐赠数量 Quantity:
是否拥有CE / FDA认证?CE / FDA Certified or not?
是否拥有CE / FDA认证?CE / FDA Certified or not?
其他标准认证?Other Specific Requirement?
其他标准认证?Other Specific Requirement?
7.
N95/FFP2/FFP3 Face Mask / N95级口罩
捐赠数量 Quantity:
捐赠数量 Quantity:
是否拥有CE / FDA认证?CE / FDA Certified or not?
是否拥有CE / FDA认证?CE / FDA Certified or not?
其他标准认证?Other Specific Requirement?
其他标准认证?Other Specific Requirement?
8.
Protective Clothing, Coverall / 防护服
捐赠数量 Quantity:
捐赠数量 Quantity:
是否拥有CE / FDA认证?CE / FDA Certified or not?
是否拥有CE / FDA认证?CE / FDA Certified or not?
其他标准认证?Other Specific Requirement?
其他标准认证?Other Specific Requirement?
9.
Protective Eyes Goggles, Glasses / 护目镜
捐赠数量 Quantity:
捐赠数量 Quantity:
是否拥有CE / FDA认证?CE / FDA Certified or not?
是否拥有CE / FDA认证?CE / FDA Certified or not?
其他标准认证?Other Specific Requirement?
其他标准认证?Other Specific Requirement?
10.
Face Shields / 面罩
捐赠数量 Quantity:
捐赠数量 Quantity:
是否有认证?Any certification?
是否有认证?Any certification?
若有,何种认证?If yes, what certification?
若有,何种认证?If yes, what certification?
11.
Surgical Gown / 手术衣
捐赠数量 Quantity:
捐赠数量 Quantity:
是否有认证?Any certification?
是否有认证?Any certification?
若有,何种认证?If yes, what certification?
若有,何种认证?If yes, what certification?
12.
Long Cuff Latex Gloves / 长袖乳胶手套
捐赠数量 Quantity:
捐赠数量 Quantity:
是否有认证?Any certification?
是否有认证?Any certification?
若有,何种认证?If yes, what certification?
若有,何种认证?If yes, what certification?
13.
Hand sanitiser / 除菌手部清洁液
捐赠数量 Quantity:
捐赠数量 Quantity:
是否有认证?Any certification?
是否有认证?Any certification?
若有,何种认证?If yes, what certification?
若有,何种认证?If yes, what certification?
14.
Other / 其他
捐赠物品 Donated items:
捐赠物品 Donated items:
捐赠数量 Quantity:
捐赠数量 Quantity:
是否有认证?Any certification?
是否有认证?Any certification?
若有,何种认证?If yes, what certification?
若有,何种认证?If yes, what certification?
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15.
捐赠物品
在新西兰还是海外?
在哪个城市?
Donated items i
n New Zealand or overseas?W
hich city?
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