workers jun 11 may 11 apr 11 mar 11 feb 11 jan 11 dec 10 nov 10 oct 10 sep 10 aug 10 jul 10 pup tent chairman s monthly report military order of the cootie of the

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workers jun 11 may 11 apr 11 mar 11 feb 11 jan 11 dec 10 nov 10 oct 10 sep 10 aug 10 jul 10 pup tent chairman s monthly report military order of the cootie of the Powered By Docstoc
					                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  JULY          Year:       2010
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  AUG.          Year:       2010
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  SEP.          Year:       2010
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  OCT.          Year:       2010
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  NOV           Year:       2010
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  DEC.          Year:       2010
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  JAN.          Year:       2011
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
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                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  FEB.          Year:       2011
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month: MARCH                          Year:       2011
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month: APRIL                          Year:       2011
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month:                  MAY           Year:       2011
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                                                   PUP TENT CHAIRMAN'S MONTHLY REPORT
                                      MILITARY ORDER OF THE COOTIE OF THE UNITED STATES
                                                                             "The Honor Degree of the Veterans of Foreign Wars"
                                                                             "KEEP 'EM SMILING IN BEDS OF WHITE"
Name of Pup Tent:                                 MAENG DAS                                        Pup Tent Number: 6     Month: JUNE                           Year:       2011
Location: City                                     THAILAND                                                State: Pacific
               2010 MEMBERSHIP                            39                           QUOTA $ 10,335.00

    Day                                                                        Kind                 Mileage                 No.of    Total                  General Expense Report
     of        Where Visit                            Kind of                   of             RoundTrip    Total    No.of Patients Hrs All       Mileage                 Gifts          Total
    Visit      Made                                Entertainment               Gifts           Per Cootie   Miles   Cooties Visited Cooties          $      Hours $         $             $
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
                                                                                                                                              $        -    $      -                 $           -
Total Visits                                                                                    Totals:       0        0          0    0      $        -    $      -    $     -      $           -


Email this report to the Grand Hospital Chairman no later than the 28th of                                 Respectfully submited by
each month. The report should include all visits made from the 26th of the                                 HOSPITAL CHAIRMAN: ______________________________
previous month through the 25th of the current month                                                       Email:    _________________________________________
                    HOSPITAL WORKER RECORDS - PT #6
                    FOR JULY 2010 THROUGH JUNE 2011
                      ENTER NUMBER OF VISITS EACH MONTH BY EACH COOTIE

                                            TOTAL                                     TOTAL
                                            THRU                                      THRU
COOTIE NAME   JUL   AUG   SEP   OCT   NOV   NOV   DEC   JAN   FEB   MAR   APR MAY JUN JUNE
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0
                                                0                                         0

				
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