(5) A prepared DA Form 3875, Bulk Drug Order Form, shown in figure 3-10,
illustrates items ordered for reissue to individual patients. These items have been
ordered for issue to individual patients and each item has a UCA value of 0.6. This
TMC is not part of the hospital pharmacy's TDA and issuance of supplies to this work-
center generates a UCA count. Each box of "Cepacol" represents a unit of issue
containing multiple doses; however, each box has a UCA value of 0.6. Notice that on
item 6 (Mylanta Liquid), calculations are based on the number of bottles rather than the
number of cases ordered.
Figure 3-10. DA Form 3875, Bulk Drug Order Form (items ordered for reissue to
individual patients) with UCA calculations (continued).
MD0812
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