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Hospital Name:
Date:
Ph / Fax / No Order:
Ideal Inventory
Days
to
Expire
Expiration
Day/Month O+ A+ B+ AB+ O= A= B= AB=
Days
to
Expire
Expiration
Day/Month O A B AB
1 1
2 2
3 3
4 4
5 O A B AB Any
6 TCP Orders (CMV Any)
7 TCP Orders (CMV =)
8 Irradiated TCP Orders
9 Acrodose Orders (CMV Any)
10 Acrodose Orders (CMV =)
11 Irradiated Acrodose Orders
12
13 CRYO Inventory Order
POOLED
CRYO Inventory Order
14 OO
2-3 weeks AA
3+ weeks BB
O+ A+ B+ AB+ O= A= B= AB= Any Any
Inventory Totals
Critical Inventory Pedi Pedi Order FFP Inventory Order
O+ O
O= A
B
Pedi Split Pedi Split Order AB
O+
O=
FFP Split FFP Split Order
AB
Special Notes
LifeSouth Community Blood Centers
Daily Blood Inventory / Order Report
Red Blood Cells Platelets
HS.1.1 / HIM.1.1
May 2011
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