COMPLETION OF DA FORM 3161
Use the following instructions to complete a DA Form 3161 for expendable medical
items within a medical facility. Refer to figures 2-14 and 2-15 for the locations of the fields
described below. Refer to figure 2-16 to see the form in its entirety.
a. Information Entry. To order, use these steps. For example, the
Anesthesiology Department at Casey Hospital in Seoul, Korea, needs several expendable
Block issue. Enter "X" for issue.
Block sheet number. Number the sheets consecutively.
Figure 2-14. Sample DA Form 3161 (top portion).
Block number sheet. Enter the total number of sheets included in this
(4) Block 1. Enter the name and address of the SSA, for example, Medical Repair
Detachment, Casey Hospital, Soeul, Korea.
(5) Block 2. Enter the name of the unit making the request, for example,
Anesthesiology Department, Casey Hospital.
(6) Block 3. Enter the document number assigned to request from the
document register, for example, WK4CHA-1012-0201. Refer to paragraph 2-3 and figures 2-2
Block 4. Enter a project code if assigned, or otherwise leave blank.
Block 5. Enter the required date of materiel requested, or leave blank.
Block 6. Leave blank.