INTERNATIONAL PHARMACEUTICAL TRIP APPLICATION

1650 N Indianwood Avenue, Broken Arrow, OK 74012 Phone: 918.250.8101 Fax: 918.250.1281 Email: order@blessing.org www.blessing.org INTERNATIONAL PHARMACEUTICAL TRIP APPLICATION *PLEASE FILL OUT COMPLETELY*A NEW APPLICATION IS REQUIRED FOR EVERY TRIP* *PLEASE FILL OUT ACTUAL FOREIGN COUNTRY INFO* FOREIGN COUNTRY INFORMATION Foreign Mission Name Mission Director Address Email Will you be working with a physician from this country? Yes No WE REQUIRE AT LEAST 20 BUSINESS/WORKING DAYS PLUS SHIPPING TIME TO PROCESS YOUR ORDER. ORDERS WILL BE SHIPPED BASED ON PRODUCT AVAILABILITY AND TRIP DEPARTURE DATE. Name Title Address Zip Phone Alt Phone Email Will you be accompanying the team on this trip? Yes No If not, who is responsible for proper distribution of medicine? Name & Position Organization BILLING INFORMATION Organization Name E.I.N. (Federal Tax ID #) - Billing Contact Billing Address Zip Phone Is this a home address or a church/business address? Email *Please note this email will be used to transmit invoices. If there is another person responsible for paying invoices for this account, please indicate below. Alternate Billing Contact Alternate Billing Contact Phone Alternate Billing Contact Email CITY & COUNTRY MEDICINE WILL BE USED IN Is this the fi rst time the above ministry has used our services? DEPARTURE DATE RETURN DATE Yes No LAST DATE YOU CAN ACCEPT BACKORDERS Please tell us how you found about about Blessings SPECIAL INSTRUCTIONS? FIRST TIME USERS, PLEASE SEE OUR INSTRUCTIONS ONLINE. PREPAYMENT AND 501(C)3 LETTER MUST BE SUBMITTED. MEDICAL PROFESSIONAL INFORMATION *PLEASE NOTE SHIPPING ADDRESS MUST MATCH ADDRESS ON Application must be signed by a physician (M.D. or D.O.) Copy of PHYSICIAN S LICENSE. medical license required. Please see our instructions for complete details. SHIPPING OR PICKUP INFORMATION SIGNATURE REQUIRED ON PAGE 2. Please ship order I will pick up order Is this a residential address? Yes No Organization Name Contact Person c/o Business Name Address Zip Phone Alt Phone Email PLEASE SEE PAGE 2 FOR SIGNATURE & ADDITIONAL REQUIREMENTS. INCOMPLETE APPLICATIONS MAY BE DELAYED IN PROCESSING. RECEIPT OF YOUR ORDER WILL BE CONFIRMED VIA EMAIL SENT TO THE BILLING CONTACT PERSON. IF YOU DO NOT RECEIVE AN ORDER ACKNOWEDGE- MENT VIA EMAIL WITHIN 3 BUSINESS DAYS, PLEASE CONTACT US AT 918.250.8101. IT MEANS WE DID NOT RECEIVE YOUR ORDER. Form MED 1 of 11 Pharmaceutical Trip Application Page

INTERNATIONAL PHARMACEUTICAL TRIP APPLICATION - PAGE 2 TO BE FILLED OUT AND SIGNED BY MEDICAL PROFESSIONAL AND RETURNED WITH COPY OF YOUR MEDICAL LICENSE & MINISTRY S 501(C)3 LETTER (IF NOT ALREADY ON FILE) SIGNED COPY MUST BE FAXED BEFORE ORDER CAN BE PROCESSED If your destination country REQUIRES medicine to have a future expiration date, please enter that date here: (mm/dd/yy) Not applicable REQUIREMENTS OF MEDICAL MISSIONS Signature by physician licensed in the state to where the order is being shipped is required for ALL orders. If ordering only vitamins or over-the-counter medicines, signature may be by any person responsible for the order. The following is a list of operational requirements which medical missions must meet and concur with before Blessings International will commence and/or continue shipments of pharmaceuticals and supplies to them. 5. Pharmaceuticals obtained from Blessings International should be used only for the treatment of indigent patients; for short term medical mission teams (those less than 3 months), the medicines are not to be sold or exchanged or transferred for money, property, or services. 1. IMPORT FOR EXPORT DISCLOSURE: All medicine with IMPORT FOR EXPORT or IFE in the description has been formulated for use outside of the USA only. If medicine of this category has been ordered, you hereby agree that it will not be used within the USA or any of its possessions & territories. Additionally, you agree that medicine of this category will not be returned to the USA. Further, you agree that all medicine on the accompanying order will not be used in or returned to the USA. 2. A physician must obtain proper approval to practice medicine in the country where the mission is located, if required. 3. If a clinic or hospital is operated, there must be a permit from the region, state, or province of its location. A permit must be obtained for importation of drugs duty free, if required. 4. A physician must be responsible for the appropriate utilization, dispensation, and safety in storage of all drugs. 6. Pharmaceuticals must not be used in a government operated hospital or clinic except by specifi c permission. 7. Pharmaceuticals will be distributed and employed in a way that glorifi es God. 8. Within 30 days of return from medical mission trip, an original signed Pharmaceutical Feedback Form must be returned to Blessings International. Failure to do so will prevent our ability to serve you in the future. I have read and accept responsibilty to fulfi ll all of the Requirements of Medical Missions as the conditions for the management and distribution of all pharmaceuticals and/or medical supplies obtained through Blessings International. If the person signing below is not accompanying the trip, they agree that the above requirements are met by those who are going. Signature of Medical Professional/*Person Responsible Printed Name of Medical Professional/*Person Responsible Title Date Pharmaceutical Trip Application Page 2 Form MED 2 of 11

ALL PAGES OF THE ORDER FORM HAVE TO BE FAXED SPECIAL NOTICES Notice: Please check the "ship to" address to make sure it is correct. Incorrect shipping addresses will incur a surcharge of $12 per box in addition to the original UPS freight charges. This cost will be passed on to the Ministry as of this notice. Important Documentation Notification: Recently mission teams to Nicaragua and El Salvador have told us of increased government requirements to bring in medicines. Blessings encourages you to research the requirements for drug importation prior to your departure to any country. If you want Blessings to provide additional documentation, we will be glad to do that. We need to charge $2.00 for each document (Proforma, Certificate of Analysis, Gift Certificate, Certificate of Authenticity) to cover our cost. Documents cannot be sent until an order is ready to ship. PRO -- Proforma (signed, stamped and sealed) COQ --Certificate of Quality and Authenticity GC -- Gift Certificate COA--Certificate of Analysis issued by manufacturer (only available on For Export Only products) To order the above Documents check the last page; they are the last items on the order form. Documents cannot be sent until an order is ready to ship. New Items to Blessings order form-(these are not for donation) Page 2 4564U Naproxen sodium 220mg CAPS BACK IN STOCK Page 3 2744 Chloroquine phosphate tabs 150mg base FOR EXPORT ONLY 3984 Allopurinol 100mg tabs FOR EXPORT ONLY 3817 Terazosin HCl 5mg caps Page 4 1046 Phenytoin sodium 100mg caps FOR EXPORT ONLY 4146 Singulair 4mg (Montelukast) 90ct Page 5 2735 Bacitracin zinc, neomycin sulfate, polymyxin B sulfate ointment 1oz tubes - triple antibiotic ointment 5999 DynaRub pain relieving cream non-greasy 3oz-methyl- sailcylate 30%-menthol 10%- camphor 4% 3282 Zinc oxide 1oz 28.4g ointment tube Page 6 5410 Sodium chloride 0.9%:1000mL in IV bag BACK IN STOCK Page 7 1874 Furosemide 20mg/mL 2ml inj IM/IV:ampoule FOR EXPORT ONLY 3985 Allopurinol 100mg tabs FOR EXPORT ONLY x 50 $5.706009 Coloring Books to help promote good hygiene/africa- printed in Swahili w/crayons 3017 I.V. administration set 78" tube-15 drops/ml-1-2 inject sites 9055 Instant Cold Packs 4"x5" squeeze-knead-apply Page 8 1194M Surgical gown reinforced (sterile):contents inculde- 1gown,2 hand towels,(med 1195L Surgical gown reinforced (sterile):contents inculde- 1gown,2 hand towels,(large) 1196XL Surgical gown reinforced (sterile):contents inculde- 1gown,2 hand towels,(x-large) PMTR Patient Medical Treatment Record- in packs of 50 PAGE 9 9051N Malaria Rapid Detection Test for both falciparum and vivax 2115 Thermometer INFRARED forehead scan, guidebook in english & Spanish 2405 Blood Pressure Monitor w/large cuff & AC adapter, comes w/4aabatteries DONATIONS B.I. will donate to you any of the following items that we have in our stock donation inventory. If you need any of these, just mark how many you want on this page, then fax it in with your order. Please note that we have limited stock on items so they will be donated on first come, first serve basis. 3984 Allopurinol 100mg tabs FOR EXPORT ONLY x 28 EXPIRES 10/2015 Like us on facebook! Look for us in your newsfeed regarding product availability updates, surveys, and feedback from other medical mission teams. Form MED 3 of 11

Description International Pharmaceutical Order Form Quantity Unit Charge Page 2 09/30/15 Unit Legend 1M = 1,000 EA= Each IFE=FOR EXPORT ONLY OUT OF STOCK=NOT AVAILABLE FOR THIS TRIP BACKORDER WITH DATE IN BLANK=IS THE DATE BI EXPECTS IT DUE IN (STOCK) IF IT IS STAMPED NOT IN DATE RANGE= MEANS IT IS NOT IN THE DATE RANGE YOU ASKED FOR. Examples: 15M = 15,000 25M = 25,000 Blessings International 1650 North Indianwood Avenue Broken Arrow, OK 74012 USA Telephone 918-250-8101 Fax 918-250-1281 Email: order@blessing.org Website: www.blessing.org Surely blessing I will bless thee.. HEB 6:14 October 2015 These medicines are to be used solely for the ill, needy, or infants. Medicines are not for sale or resale. The handling charge may be changed at any time. Please note all charges are subject to change due to market price fluctuations and availability. We make every attempt to secure the absolute lowest charge. 000 TABLETS AND CAPSULES ANTACIDS AND ANTIFLATULENTS 4607 Calcium carbonate 500mg chewable tabs, asst flavors x 500 $6.65 3554 Calcium carbonate 500mg tabs [LIKE TUMS] x 150 $2.10 0057U Omeprazole 20mg caps, delayed-release [LIKE PRILOSEC] x 100 $7.45 0054 Omeprazole 20mg caps, D. R.-FOR EXPORT ONLY[LIKE PRILOSEC] x 1M $57.00 1947 Ranitidine 15mg/mL 16oz (75mg/5mL) x 1 $15.00 0090 Ranitidine 150mg tabs FOR EXPORT ONLY x 1M $27.45 ANALGESICS 2644 Acetaminophen 325mg tabs x 1M $6.70 0208 Acetaminophen 500mg tabs (Paracetamol) FOR EXPORT ONLY x 1M $9.95 2125 Acetaminophen 80mg children's chewable fruit flavored tabs x 1M $10.15 1209 Acetaminophen 80mg children's chewable fruit flavored tabs x 30 $1.30 2249 Acetaminophen suppositories 120mg (pediatric) x 12 $3.00 2646 Aspirin 325mg enteric coated tabs x 1M $9.00 4029 Aspirin 81mg enteric coated, adult, DR tabs: not chewable x 1M $6.60 4417 Ibuprofen 200mg, tabs-- FOR EXPORT ONLY x 1M $16.85 4564 Naproxen sodium 220mg CAPS x 100 $7.50 ANTIBIOTICS, ANTIBACTERIALS, ANTIFUNGAL, ANTIVIRAL 1281 Amoxicillin 125mg, dispersible tabs, in 5mL water FOR EXPORT ONLY x 100 $6.00 3946U Amoxicillin 250mg (chewable) tabs x 100 $34.15 0214 Amoxicillin 250mg (chewable) tabs FOR EXPORT ONLY x 1M $59.00 3954U Amoxicillin 250mg (chewable) tabs x 500 $130.00 0215C Amoxicillin 500mg caps FOR EXPORT ONLY x 1M $61.25 3469U Amoxicillin 500mg caps x 500 $32.25 0240 Amoxicillin 500mg,clavulanate potassium 125mg, tabs FOR EXPORT ONLY x 50 $29.95 0204 Azithromycin 250mg tab FOR EXPORT ONLY x 500 $143.00 0202 Azithromycin 250mg tab FOR EXPORT ONLY x 250 $71.50 3150U Cephalexin 250mg caps x 100 $6.95 3157U Cephalexin 250mg caps x 500 $39.00 3648U Cephalexin 500mg caps [LIKE KEFLEX] x 100 $11.95 4631U Cephalexin 500mg caps [LIKE KEFLEX] x 500 $45.10 4251 Ciprofloxacin 500mg tabs - FOR EXPORT ONLY [CIPROX] x 500 $45.00 3423 Clindamycin 150mg caps x 100 $11.00 1624 Cloxacillin 500mg caps FOR EXPORT ONLY x 1M $55.55 0225 Doxycycline hyclate 100mg tabs FOR EXPORT ONLY x 1M $41.00 4612 Erythromycin stearate BP 250mgtabs FOR EXPORT ONLY x 500 $49.85 3158 Dicloxacillin sodium 250mg cap x 100 $48.85 0700 Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 100 $20.10 0700D Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 500 $100.55 0291C Fluconazole 200mg, caps FOR EXPORT ONLY [LIKE DIFLUCAN] x 100 $22.80 1253 Griseofulvin 125mg tabs FOR EXPORT ONLY x 1M $42.85 1251D Griseofulvin 500mg tabs FOR EXPORT ONLY x 500 $75.60 1375 Itraconazol 100mg caps FOR EXPORT ONLY OUT OF STOCK x 28 $11.75 3306 Nitrofurantoin 100mg tabs FOR EXPORT ONLY x 500 $22.15 0270 Nystatin 500,00 unit tabs (oral) FOR EXPORT ONLY x 100 $19.85 2942 Minocycline HCl 100mg caps x 50 $14.20 4613 Phenoxymethyl Penicillin 250mg(Pen VK) tabs, FOR EXPORT ONLY x 1M $48.00 0217C Levofloxacin 500mg tabs FOR EXPORT ONLY x 100 $19.00 0275 Sulfamethoxazole 400mg,trimethoprim 80mg tabs FOR EXPORT ONLY x 1M $34.00 [LIKE BACTRIM OR SEPTRA] 4396 Sulfamethoxazole 800mg, trimethoprin 160mg DS tabs IFE x 500 $30.00 [LIKE BACTRIM SEPTRA] ANTIAMEBICS 4651 Metronidazole 250mg tabs - FOR EXPORT ONLY [LIKE FLAGYL] x 1M $35.95 0289 Tinidazole 500mg tabs FOR EXPORT ONLY x 500 $36.65 Form MED 4 of 11

Description International Pharmaceutical Order Form Quantity Unit Charge Page 3 ANTIVIRALS 0230 Aciclovir 200mg tabs FOR EXPORT ONLY[LIKE ZOVIRAX] x 500 $35.60 4313U Acyclovir 200mg tabs [LIKE ZOVIRAZ] x 100 $8.65 ANTHELMENTICS 2325 Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 100 $19.95 2324 Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 500 $95.00 0350 Mebendazole 100mg chewable tab FOR EXPORT ONLY [LIKE VERMOX] x 1M $24.95 4634D Albendazole 400mg chewable tab -- FOR EXPORT ONLY x 500 $50.00 ANTIMALARIALS 0321 Artemether 20mg + Lumefantrine 120mg FOR EXPORT ONLY [Like Coartem] x 24 $4.60 2744 Chloroquine phosphate tabs 150mg base x 100 $3.25 ANTIDIARRHEALS & ANTISPASMOTIC 3430 Bismuth subsaliclate 262mg chewable tabs [LIKE PEPTOBISMAL TABS] x 30 $2.40 2011 Loperamide HCl 2mg caps FOR EXPORT ONLY [LIKE IMMODIUM] x 500 $25.00 2012 Loperamide HCl 2mg caps FOR EXPORT ONLY [LIKE IMMODIUM] x 100 $5.00 ANTIHISTAMINE, DECONGESTANTS, 3100 Chlorpheniramine maleate 4mg tabs x 1M $6.10 4532 Cough drops cherry flavored x 720 $25.95 4034 Cough drops honey lemon flavor x 720 $25.95 4035 Cough drops Menthol flavor x 720 $25.95 4500 Diphenhydramine 50mg, caps [LIKE BENADRYL] x 1M $17.00 2779 Diphenhydramine HCl 25mg caps [LIKE BENADRYL] x 1M $15.25 0450D Guaifenesin 400mg, tabs USP x 500 $22.95 4201U Loratadine 10mg tabs [LIKE CLARITIN] x 100 $7.60 4611 Loratidine 10mg tabs, FOR EXPORT ONLY x 500 $28.00 0415 Cetirizine HCI 10mg tab FOR EXPORT ONLY x 500 $20.50 4213U Cetirizine HCl 10mg tabs ZYRTEC x 100 $5.20 4246 Promethazine HCl 25mg tabs [LIKE PHENERNAN] x 100 $6.00 MISCELLANEOUS 3519 Estradiol 0.5mg tabs x 100 $7.45 3963 Atorvastatin 10mg tabs FOR EXPORT ONLY [LIKE LIPITOR] x 360 $19.95 0602 Estradiol 1mg tabs x 100 $18.75 0612U Simvastatin 10mg tabs x 90 $2.70 0611U Simvastatin 10mg tabs x 500 $18.90 0613U Simvastatin 20mg tabs x 90 $4.10 6614U Simvastatin 20mg tabs x 1M $24.75 6613U Simvastatin 20mg tabs x 500 $16.65 0617U Simvastatin 40mg tabs x 30 $5.05 ANTIHYPERTENSIVES AND DIURETIC 4573U Atenolol 50mg tabs x 100 $2.25 4389 Atenolol 50mg tab FOR EXPORT ONLY OUT OF STOCK x 1M $13.55 4598U Atenolol 50mg tabs (once daily dosing) x 1M $18.40 3826 Captopril 25mg tabs FOR EXPORT ONLY x 1M $21.95 1034 Chlorthalidone tabs 25mg x 100 $4.70 4288C Enalapril 10mg tabs FOR EXPORT ONLY x 100 $2.50 4288 Enalapril 10mg tabs FOR EXPORT ONLY x 1M $21.05 4616 Furosemide 40mg tabs FOR EXPORT ONLY x 1M $12.00 4659 Hydrochlorothiazide 25mg tabs FOR EXPORT ONLY x 1M $9.75 0015M Lisinopril 10 mg tab, FOR EXPORT ONLY x 1M $23.50 0730D Losartan potassium 50mg FOR EXPORT ONLY x 500 $39.40 4220U Losartan potassium 50mg tabs x 90 $4.45 4450 Metoprolol 50mg tabs BID [LIKE LOPRESSOR] x 1M $21.70 4451 Metoprolol 50mg tabs BID [LIKE LOPRESSOR] x 100 $2.65 3817 Terazosin HCl 5mg caps x 100 $5.65 ANTIINFLAMMATORY AND ANTIGOUT 3985 Allopurinol 100mg tabs FOR EXPORT ONLY x 50 $5.70 3717 Diclofenac sodium 50mg tabs (enteric coated) FOR EXPORT ONLY x 1M $16.70 3495U Ibuprofen 400mg, tabs x 500 $19.45 4608 Ibuprofen 400mg, tabs FOR EXPORT ONLY x 1M $26.80 3495U Ibuprofen 400mg tabs x 500 $19.45 0625 Ibuprofen 600mg film coated tabs--for EXPORT ONLY x 1M $42.10 2918U Ibuprofen 600mg film coated tabs x 500 $24.90 3384U Ibuprofen 800mg tabs x 500 $22.35 4009U Meloxicam 7.5mg tabs x 100 $2.25 4012U Meloxicam 7.5 mg tabs x 1M $16.50 4011U Meloxicam 15mg tabs x 100 $2.65 4013U Meloxicam 15 mg tabs x 1M $17.95 0007M Prednisone 10mg tabs FOR EXPORT ONLY x 1M $81.35 0005M Prednisolone 5mg tabs FOR EXPORT ONLY x 1M $28.05 4253 Prednisone 20mg tabs x 100 $20.65 ANTIPSYCHOTICS, ANTIDEPRESSANTS, 4161M Amitriptyline 25mg tabs FOR EXPORT ONLY x 1M $17.50 2030 Fluoxetine 20mg caps PROZAC x 500 $15.85 0901 Sertraline HCL 25mg [LIKE ZOLOFT] x 30 $1.80 0900 Sertraline HCL 25mg [LIKE ZOLOFT] x 90 $5.55 0903 Sertraline HCL 25mg x 500 $28.45 0905U Sertraline HCL 100mg [LIKE ZOLOFT] x 30 $2.55 0906U Sertraline HCL 100mg [LIKE ZOLOFT] x 500 $32.65 3744 Trazodone HCl 150mg tabs [LIKE DESYREL] x 100 $14.25 Form MED 5 of 11

International Pharmaceutical Order Form Page 4 4548 Trazodone HCI 150mg tabs x 500 $49.90 ANTIEPILEPTIC & ANTIPARKINSON 1048 Carbamazepine 200mg tabs FOR EXPORT ONLY [LIKE TEGRETOL] x 1M $47.50 3675U Gabapentin 100mg caps x 100 $3.00 3676U Gabapentin 300mg caps x 100 $6.85 3061U Gabapentin 300mg caps x 500 $30.20 4466 Levetiracetam 250mg tabs [LIKE KEPPRA] x 120 $15.00 1046 Phenytoin sodium 100mg caps FOR EXPORT ONLY x 100 $8.20 ANTISPASMODIC, ANTICHOLENERGIC 4565 Dicyclomine HCl 10mg caps [LIKE BENTYL] x 100 $7.35 3600 Metoclopramide 5mg tabs [LIKE REGLAN] x 500 $26.35 1056 Promethazine 25mg tabs FOR EXPORT ONLY x 100 $9.00 BRONCHIAL DILATORS 3989 Albuterol sulfate 0.083% 2.5mg/3mL inhalation solution x 25 $3.60 4656D Salbutamol 2mg tabs/(albuterol) FOR EXPORT ONLY x 500 $14.00 4657D Salbutamol 4mg tabs scored/(albuterol) FOR EXPORT ONLY x 500 $16.75 4146 Singulair 4mg (Montelukast) x 90 $17.40 0825 Beclomethasone.05mg/dose oral inhaler FOR EXPORT ONLY x 1 $6.60 1100 Salbutamol (Albuterol) oral inhaler 0.1mg; 200 doses FOR EXPORT ONLY x 1 $5.75 CARDIAC GLYCOSIDES, ANTIARRHYMICS, 1250M Amlodipine 5mg tabs [LIKE NORVASC] x 1M $16.45 3848 Clopidogrel 75mg tabs [LIKE PLAVIX] x 30 $4.55 3846 Clopidogrel 75mg tabs [LIKE PLAVIX] x 90 $8.95 1512 Isosorbide Dinitrate 10mg tabs FOR EXPORT x 500 $26.20 4261 Verapamil HCl 80mg tabs x 100 $6.60 1255 Verapamil HCl 80mg tabs x 1M $58.75 4212 Warfarin sodium 5mg tabs [LIKE COUMADIN] x 100 $13.75 DIABETES, HYPOGLYCEMICS 1330 Glibenclamide 5mg tabs (Glyburide) FOR EXPORT ONLY x 1M $20.75 3965U Glipizide 10mg tabs [LIKE GLUCOTROL] x 500 $15.15 2356 Glipizide 10mg tabs (scored) FOR EXPORT ONLY [LIKE GLUCOTROL] x 1M $37.00 4060U Glipizide 5mg tabs [LIKE GLUCOTROL] x 500 $9.60 4364U Glipizide 5mg tabs [LIKE GLUCOTROL] x 1M $20.65 1111M Metformin 1000mg tabs [LIKE GLUCOPHAGE] FOR EXPORT ONLY x 1M $48.55 4306U Metformin 850mg tabs [LIKE GLUCOPHAGE] x 500 $14.40 4624U Metformin HCl 850mg tabs [LIKE GLUCOPHAGE] x 100 $6.00 0515 Metformin HCI 500mg tabs FOR EXPORT ONLY [LIKE GLUCOPHAGE] x 1M $18.60 4004U Metformin HCI 500mg tabs [LIKE GLUCOPHAGE] x 100 $2.25 LAXATIVES 3609 Bisacodyl 5mg delayed-release, tabs x 1M $8.35 2973 Docusate sodium 100mg soft gels x 1M $16.50 1605 Docusate sodium 100mg soft gels x 100 $2.10 MUSCLE RELAXANT, MINOR TRANQUILIZERS 0875 Chlorzoxazone 500mg tabs FOR EXPORT ONLY x 500 $40.00 3909U Cyclobenzaprine HCl 10mg tabs [LIKE FLEXERIL] x 1M $25.35 3507 Methocarbamol 500mg tabs x 500 $41.50 VITAMINS, MINERALS 2187 Vitamin A 200,000 IU caps FOR EXPORT ONLY x 1M $71.05 3428 Ferrous sulfate 325mg tabs x 1M $10.50 4233 Folic acid 800mcg tab x 1M $9.00 2199 Multivit: Children chewable without iron Vit-A 2500IU;Vit-D3 400IU; x 1M $17.00 Vit-B1 1.05mg; Vit-B2 1.2mg; Vit-B6 1.05mg; Vit-B12 4.5mcg; Vit-C 60mg; Vit-E 15IU;Niacin 13.5mg 2196ZMC1 Multivit: Child chew w/iron,zn: Vit-A 2500IU;Vit-D 400IU; Vit-B1 1.05mg; x 27M+ $545.00 Vit-B2 1.2mg; Vit-B6:1.05mg; Vit-B124.5mcg; Vit-C 60mg; Vit-E 15IU; Niacin 13.5mg; 2196 Iron(as ferrous fumarate) 15mg.ZINC [BOX CT IS 27,273] Multivit: Children chew w/iron: Vit-A 2500IU;Vit-D 400IU; Vit-B1 1.05mg; x 25M $420.00 Vit-B2 1.2mg; Vit-B6 1.05mg; Vit-B124.5mcg; Vit-C 60mg; Vit-E 15IU; Niacin 13.5mg; Iron(as ferrous fumerate) 15mg. 2195 Multivit: Children chew w/iron: (Same content as 51376-0236-25) 51376-0235-10 x 1M $22.00 3076 Multivitamins w/fe & I: VitA w/beta carotene 5000IU; VitD 400IU; VitC x 25M $360.00 60mg; VitB1 1.5mg; VitB2 1.7mg; VitB6 2.0mg; niacinamide 20mg; Ca pantothenate 10mg; folic acid0.4mg;vit-b12 6mcg;Iron as fumarate 3250 18mg;IODI18mg;IODINE 0.225mg RDA VITAMINS W/IRON & IODINE[BOX CT 25,200] Multivitamins w/fe &I: (Same content as 51376-0178-25) RDA x 1M $17.00 VITAMINS/IRON/IODINE 1900B Multivitamins:without IRON & IODINE:VitA 5000IU;VitC60mg; x 25M $360.00 VitD-3 400IU;VitB-1VitB- 21.7mg;Niacin 20mg; VitB-6 2mg;VitB-12 6mcg; 1900 VitE30IU;Foliate 400mcg;Pantothenic Acid 1mg; Multivitamins: without IRON & IODINE :VitA 5000IU;VitC60mg;VitD-3 400IU; x 1M $17.00 VitB-1VitB- 2,1.7mg;Niacin 20mg; VitB-6 2mg;VitB-12 6mcg; VitE30IU;Foliate 400mcg;Pantothenic Acid 1mg; 3199 Prenatal vitamins: (Same content as 51376-0239-14) x 500 $20.00 3173 Prenatal vitamins: Vit-A 4,000IU; Vit-D 400 IU; Vit-E11 IU; Vit-C 100mg; x 16M+ $450.00 Vit-B1 1.84mg; f olic acid 0.8mg;VitB2 1.7mg; niacinamide 18mg; Vit-B6 2.6mg; 1731 Vit-B12 4mcg;Ca 200mg; Fe 60m g (as fumerate); Zn 25mg (as o25mg (as oxide) [BOX CT IS 16,667] Zinc sulfate monohydrate 20mg (DISPERSIBLE) FOR EXPORT ONLY x 100 Form MED 6 of 11 $6.45

International Pharmaceutical Order Form Page 5 3968 Infant Multivitamin drops w/iron: A-1500 IU, D-400 IU,E-5 IU, C-35mg, x 6 $20.25 B1-0.5mg, B2-0.6mg, Niacin 8mg,B6-0.4mg, Iron 10mg/1mL (50mL) 1 2/3oz dropper bottle LIQUID[LIKE POLY-VI-SOL W/IRON] 200 TOPICALS GENERAL TOPICALS 1077 Betamethazone 0.1% cream 15gr (1/2 oz) FOR EXPORT ONLY x EA $1.35 5999 DynaRub pain relieving cream non-greasy 3oz-methyl- sailcylate x EA $2.70 30%-menthol 10%- camphor 4% 4499 Hemorrhoidal rectal suppositories [LIKE PREPARATION H] x 12 $1.80 3488 Hydrocortisone 0.5% cream 15gm1/2oz tube FOR EXPORT ONLY x 12 $13.50 1071 Hydrocortisone 1% 15mg tube FOR EXPORT ONLY x 10 $13.85 1751 Hydrocortisone cream 1% foil packet x 144 $14.25 2338 Vitamin A & D ointment foil packs 5g x 144 $15.10 2342 White Petrolatum foil packs 5g x 144 $11.35 3282 Zinc oxide 1oz 28.4g ointment tube x ea $0.80 ANTIBIOTICS AND ANTISEPTICS 9000 Empty-1/2oz round hinged lid plastic container-can be used to divide up x 30 $7.50 creams/ointments 4392 Bacitracin 500 units ointment 1.0gm foil packets x 144 $15.50 2211 Bacitracin zinc, neomycin sulfate, polymyxin B sulfate ointment 0.9gm x 144 $17.00 foilpackets [TRIPLE ANTIBIOTIC] 1999 15gm/Bacitracin zinc 400 unitsneomycin sulfate 5mg, polymyxin B ointmentout OF STOCK x 12 $23.35 1/2 oz (14.17gm) tube [TRIPLE ANTIBIOTIC] 2735 Bacitracin zinc, neomycin sulfate, polymyxin B sulfate ointment 1oz tubes - x EA $2.95 triple antibiotic ointment 2004 Clotrimazole 1% antifungal cream 20gm IFE ONLY [LIKE LOTRIMIN] x 10 $10.70 2173 Miconazole nitrate 2% cream 1oz (30gm) tube [LIKE MICOTIN] x 6 $13.95 3902X Nystatin ointment 100,000 unit 1oz (30gm) tube, FOR EXPORT ONLY x 10 $21.45 3902 Nystatin ointment 100,000 unit 1oz (30gm) tube, FOR EXPORT ONLY x EA $2.15 3368 Povidone iodine 10% topical solution 128oz (3784mL)gallon x 1 $23.50 4469 Povidone iodine 10% topical solution 16oz (473 ml) pint x 1 $3.51 0950 Silver sulfadiazine 1% cream 50gm tubes [LIKE SILVADENE 1%] x 1 $3.35 2181 Tolnaftate 1% cream 1/2oz (15gm) tube x 6 $10.65 ANTILICE - PEDICULICIDES 2325 Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 100 $19.95 2324 Ivermectin 6mg tabs, scabies treatment 2 tabs per/ adult FOR EXPORT ONLY x 500 $95.00 4202 Lice Shampoo - non-toxic enzyme concentrate 16oz;32 treatments per x 1 $27.00 bottle. Includes instructions BLESSINGS LICE SHAMPOO 4108 Permethrin 5% cream; 60gm tube - FOR EXPORT ONLY x 1 $9.95 4502 Permethrin Lotion 1% 60mL cream rinse-w/lice combs x 2 $13.50 4002 Permethrin Lotion 1% 100mL cream rinse FOR EXPORT ONLY x EA $6.80 4125 Scabies Solution - non-toxic enzyme concentrate 32 oz; 16 treatments x 1 $34.50 per bottle. instructions included. ITCH B GONE OPHTHALMICS & OTICS 8100 Reading Glasses-variety pack assorted powers-from +1/+1.25/+1.5/+1.75/+2/+2.5 x 19 $14.25 2020 Glasses for near-sighted (-1.0 to -4.5)adjustable on side of each ear piece. x EA $13.50 2291 Carbamide peroxide 6.5% ear drops 1/2oz(14.79mL) x EA $1.40 2424 Ciprofloxacin 0.3% sterile ophthalmic solution 10mL x 1 $7.05 3794 Gentamicin sulfate 0.3%-- ophthalmic solution; 5mL FOR EXPORT ONLY x 10 $15.00 2994 Ketorolac tromethamine 0.5% ophthmic solution;5ml sterile x 10 $15.75 FOR EXPORT ONLY 4000 Lubricant eye drops 8 pks of 4 sterile 0.02 fl oz x 32 $15.00 3346 Lubricant eye drops polyvinyl alcohol 1.4%,benzalkonium chloride.01%-5ml- x 10 $15.00 FOR EXPORT ONLY [llike LIQUITEARS] 2997 Naphazoline HCl.01% USP ophthmic solution;5ml sterilefor EXPORT ONLY x 10 $13.25 4700 Ofloxacin.3% ophthalmic 5 ml-drops-for EXPORT ONLY x 10 $17.50 3045 Prednisolone acetate 1.0% ophthalmic suspension 5ml FOR EXPORT ONLY x 10 $17.50 3207 Tetrahydrozoline HCl Ophthalmic drops 0.05% 1/2oz (15mL) OPTI-CLEAR x 12 $19.65 4625 Timolol Maleate Ophthalmic solution 0.5%: 10mL x 1 $3.30 2397 Tobramycin 0.3%, dexamethasone0.1% ophthalmic 5mL FOR EXPORT ONLY x 10 $12.70 VAGINALS 0700 Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 100 $20.65` 0700D Fluconazole 150mg, tab FOR EXPORT ONLY [LIKE DIFLUCAN] x 500 $100.55 3194U Clotrimazole vaginal cm USP 1%antifungal 45gm (1.5 oz) w/app x 1 $4.15 0750X Clotrimazole 500mg vaginal tab NO APPLICATOR FOR EXPORT ONLY x 10 $4.15 0749 Clotrimazole 100mg vaginal tabw/applicator-6 tabs per box FOR EXPORT ONLY _OUT x 6 $3.50 3245 Lubricating jelly sterile 2oz x EA $1.20 9090S Vaginal specula (small) ready to use - disposable x 10 $5.00 9090M Vaginal specula (medium) ready to use - disposable x 10 $5.00 9090L Vaginal specula (large) ready to use-disposable x 10 $5.00 3300 Obsterical Kit:1 pr str gloves1 drape sheet,2 umbilical clamps str,2 O.B. x 1 $9.00 towelettes 1-O.B.Pad str, 1plastic bag for placenta,6 gauze sponges 1 bulb syringe,4 disposable towels 2 nylon tie-offs,scalpel twist ties, rec-ing blanket 2 alcohol preps medium, 400 LIQUIDS 9001 2 tsp child medicine spoon x 10 $3.70 4491 2oz empty plastic cough syrup bottles x 10 $3.00 Form MED 7 of 11

International Pharmaceutical Order Form Page 6 8999 1tsp oral medicine syringe 5mL x 10 $5.00 4575 Medicine cups 1oz disposable: 100 cups / bag x 100 $1.45 ANTACIDS AND ELECTROLYTES 4120U Magnesium hydroxide 400mg;12oz (Milk of Magnesia) Mint x 1 $2.85 1947 Ranitidine 15mg/mL 16oz (75mg/5mL) x 1 $19.90 4055 Oral rehydration salts- NaCl 3.5g, KCl 1.5g, trisodium Na 2.9g, glucose x 100 $15.00 20g, sachet for 1 liter soln. FOR EXPORT ONLY ANALGESIC LIQUIDS, SYRUPS 2437 Acetaminophen drops 80mg 0.8mL; 15mL x 1 $2.35 3509 Acetaminophen drops 80mg/0.8mL 30mL x 1 $2.85 3314 Acetaminophen elixir 160mg/5mL;4 fl.oz. (118mL) x 1 $1.50 3239 Acetaminophen elixir 160mg/5mL; 16oz x 1 $5.10 3931 Ibuprofen o/s 100mg/5mL; 4oz [LIKE MOTRIN] x 1 $4.75 ANTIBIOTICS, LIQUID OR FOR SUSPENSIONS 1281 Amoxicillin 125mg, dispersible tabs, in 5mL water FOR EXPORT ONLY x 100 $6.00 4205U Amoxicillin 600mg, clavulanate potassium 42.9mg:5mL/125mL for o/s x EA $9.75 0650 Amoxicillin for o/s 125mg/5mL;pwd-100mL FOR EXPORT ONLY x 40 $52.70 THESE ARE IN PLASTIC BOTTLES - WT. 6 lbs PER CASE. 0655 Amoxicillin for o/s 250mg/5ml;100ml FOR EXPORT ONLY x 10 $19.50 These are in GLASS BOTTLES wt. 3.4 lbs 3171U Amoxicillin for o/s 250mg/5ml;100ml in plastic wt. 2.3lbs x 12 $36.00 3677U Amoxicillin for o/s 125mg/5mL;100mL x 12 $27.00 4650 Amoxicillin for o/s 400mg/5mL;50mL BID x 6 $10.00 0675 Azithromycin for o/s 200mg/5mL;pwd- 15mL FOR EXPORT ONLY x 10 $30.50 4445 4432 Nystatin 100,000 units/ml oral solution; 30mL FOR EXPORT ONLY Sulfamethoxazole 200mg, trimethoprim 40mg/5mL;100mL pediatric susp: x x 1 12 $2.35 $21.65 FOR EXPORT ONLY [LIKE BACTRIM OR SEPTRA] ANTIHISTAMINE, DECONGESTANTS, COUGH & 3807 Diphenhydramine HCl elixir 12.5mg/5mL; 16oz [LIKE BENADRYL] x 1 $3.75 1673 Diphenhydramine HCL 12.5mg/5mL 4oz (118mL) x 1 $1.45 1117 Guaifenesin 100mg dextromethorphan 10mg/5mL expectorant x 12 $16.95 suppressant 4oz [like ROBITUSSIN DM] 3434 Guaifenesin syrup 100mg/5mL; 16oz [LIKE ROBITUSSIN] x 1 $6.10 2773 Guaifenesin 100mg/5mL 4 fl. oz. x EA $1.45 3187 Loratadine 5mg/5ml solution 4 fl.oz. (118ml) x 1 $6.00 ANTIHISTAMINE, NASAL SPRAYS AND ASTHMA 2268 Albuterol sulfate syrup 2mg 5m : 1 pint (473mL) [LIKE VENTOLIN] x 1 $5.00 4516 Nasal saline decongestant spray 15mL [LIKE AFRIN] x 1 $1.35 4454 Nasal saline spray PLAIN (ocean spray)15ml x 1 $1.05 VITAMINS - LIQUID, POWDER AND NUTRITIONAL 3082 Ferrous sulfate elixir 220mg/5mL; 16oz (473mL) x 1 $4.05 3968 Infant Multivitamin drops w/iron: A-1500 IU, D-400 IU,E-5 IU, C-35mg, x 6 $23.40 B1-0.5mg, B2-0.6mg, Niacin 8mg,B6-0.4mg, Iron 10mg/1mL (50mL) 1 2/3oz dropper bottle [LIKE POLY-VI-SOL W/IRON] MISCELLANEOUS 500 INJECTABLES ANTIMALARIALS 0491 Artemether 80mg/1ml s.d.v. ampoule FOR EXPORT ONLY x 6 $10.80 ANESTHETICS 3814 Epinephrine inj. 1:1000 1mg/ml1ml s.d.v.-for EXPORT ONLY x 10 $19.25 4572 Epinephrine 1:1000(1mg/mL) 30 ml x EA $9.70 2310 Lidocaine 1% w/epinephrine 10mg/mL;50mL x 1 $4.45 5104 Lidocaine 2% w/ epinephrine 10mg/ml:30ml (MDV) x 1 $6.50 3640 Lidocaine HCl 1% inj. 10mg/mL;50mL m.d.v. x EA $4.45 3599 Lidocaine HCl 2% inj. 20mg/mL;50mL m.d.v. x EA $1.95 DENTAL 3891 Lidocaine 2% 1:100,000 w/epinephrine 1.7mL per cartridge -dental cartridges x 50 $47.05 2802 Needle 27g x 1" DENTAL disposable, sterile x 100 $15.20 2803 Needle 30g x 1/2" DENTAL disposable, sterile x 100 $15.20 1687 Toothbrushes,pre pasted x 20 $ 5.00 1688 Toothpaste w/flouride 1.5oz x 12 $ 3.20 ANTIBIOTIC 4632 Ceftriaxone sodium 1gm str pdr for IM or IV, 6mL s.d.v. [LIKE ROCEPHIN] x EA $6.40 0590 Ceftriaxone sodium 1gm str pdrfor IM or IV, 6ml s.d.v. FOR EXPORT ONLY x 10 $20.00 [LIKE ROCEPHIN] 4645 Ceftriaxone sodium 250mg str pdr for IM or IV, 6mL s.d.v. [LIKE ROCEPHIN] x EA $2.05 0591 Ceftriaxone sodium 250mg str pwd/ IM or IV, 6ml s.d.v. IFE [LIKE ROCEPHIN] x 10 $10.74 3577 Ceftriaxone sodium 500mg pwd for IM or IV, 6mL s.d.v. [LIKE ROCEPHIN] x EA $3.00 MISCELLANEOUS, VITAMINS 2947 Bacteriostatic 0.9% sodium chloride inj.(not for newborns)sterile 30ml m.d.v. x EA $1.60 1150 Cyanocobalamin 1mg/ml inj:1ml FOR EXPORT ONLY x 10 $7.85 3836 Dexamethasone inj. 4mg/mL; 30mL m.d.v. x EA $30.35 2506 Diphenhydramine HCl inj. 50mg/mL 1mL m.d.v. [LIKE BENADRYL] x EA $1.70 1874 Furosemide 20mg/mL 2ml inj IM/IV:ampoule FOR EXPORT ONLY x 10 $4.75 4067 Promethazine HCl 25mg/ml; 1mL s.d.v.:ampoule [LIKE PHENERGAN] x EA $2.35 4574 Promethazine HCL 50mg/ml 1ml [LIKE PHENERGAN] x EA $3.25 3967 Phenytoin sodium inj 100mg/2mL x 1 $1.90 Form MED 8 of 11

International Pharmaceutical Order Form Page 7 4497 Sodium chloride 0.9% inj. 10mL s.d.v. x EA $1.30 5410 Sodium chloride 0.9%:1000mL in IV bag x 1 $8.25 600 PERSONAL PROTECTION BOOKS 4252 A Comprehensive Guide To Missions / Karen Bean, RN. book, written by x 1 $35.00 a missionary vast experience, is designed to be a practical manual 6013 for anyone involved in foreign missions. Coloring Books to help promote burn safety/central America printed in Spanish x 1 $1.50 w/crayons. 6014 Coloring Books to help promote good hygiene/central America printed in x 1 $1.50 Spanish w/crayons x 1 $1.50 6009 Coloring Books to help promote good hygiene/africa- printed in Swahili x 1 $1.50 6011 w/crayons Coloring Books to help promote good hygiene/africa- printed in English x 1 $1.50 6012 w/crayons. Coloring Books to help promote good hygiene/haiti- printed in Creole w/crayons x 1 $1.50 PERSONAL PROTECTION PRODUCTS 6200 Water purification tabs (Potable Aqua) 2 tabs = 1qt. / 1 bottle = 6 gals x 50 $3.00 4068 Water purifier Outback bucket system, 5-gallon pour through, gravity- x 1 $280.00 feed unit. No water pressure required Purifies 1,500gallons at 8 gal/hr. 4152 OutBack bucket purification replacement cartridge x 1 $121.50 4363 OutBack bucket-water sediment filter (prefilter) 30 micron replacement x 1 $21.00 700 BANDAGES & SURGICAL SYRINGES, TAPE, GAUZE, MISC. 3195 Adhesive bandage 1" x 3" sterile non-stick [LIKE BAND-AIDS] x 100 $2.50 3732 Adhesive flexible fabric bandage 3/4"x3" sterile non-stick [LIKE BAND- x 100 $2.70 4464 Alcohol prep pads 200/box x 200 $1.95 2277 Benzalkonium chloride, 0.13% antiseptic cleansing towelette 5"x7" x 100 $2.05 4563 Butterfly wound closures (M) 3/8x1 7/8 (medium) x 100 $1.90 4562 Butterfly wound closures (LG)1/2x2 3/4 (large) x 100 $2.95 4517 Cap Nurse's blue x 100 $7.60 4593 Catheter foley, silicone coated, retention 5cc, 12 Fr x 10 $18.00 4594 Catheter foley, silicone coated, retention 5cc, 14 Fr x 10 $21.40 4595 Catheter foley, silicone coated, retention 5cc, 16 Fr x 10 $18.00 4596 Catheter foley, silicone coated, retention 5cc, 18 Fr x 10 $20.50 4506 Cotton tip applicators 6" non-sterile x 100 $0.60 7100 Elastic bandage 2" x 5 yds. x 10 $10.25 4513 Elastic bandage 3" x 4.5 yds. x 10 $7.15 4512 Elastic bandage 4" x 4.5 yds. x 10 $7.37 3209 Face mask ear loop x 50 $4.25 7181 N95 Respirater mask w/nose cushion & tan straps (SMALL) x 20 $25.70 7182 N95 Respirater mask w/nose cushion & tan straps (Medium) x 20 $25.70 2098 Gauze-sterile 2x2x8ply (2 sponges/env)sterile x 50 $2.15 3208 Gauze sponge 2x2x8 ply in ready to sterilize bag x 200 $1.80 3361 Gauze sponge 4x4x8 ply in read to sterilize bag x 200 $2.80 4494 Gauze sponge 4x4x8 ply sterile bag(2 sponges/env) x 50 $4.15 4337 Gauze sponge 4x4x8 ply sterilize bag(2 sponges/env) x 25 $2.30 3141 Gauze sterile 4.5" x 147" 6 ply roll krinkled x 1 $1.15 4418 Gloves latex powder free small x 100 $6.60 1756 Gloves light powder latex (XS)x-small x 100 $7.50 4527 Gloves light powder latex (S) small x 100 $5.95 4528 Gloves light powder latex (M) medium x 100 $7.50 4529 Gloves light powder latex (L) large x 100 $7.50 4525 Gloves powder free Nitrile (S)SMALL x 100 $7.50 4524 Gloves powder free Nitrile (M) medium x 100 $7.50 4523 Gloves powder free Nitrile (L) large x 100 $7.50 4543 Gloves powder free Nitrile (XL) X-large x 100 $7.50 4588 Gloves latex surgical sterile (pairs) size 6 1/2 x 50 $27.65 4589 Gloves latex surgical sterile (pairs) size 7 x 50 $25.22 4590 Gloves latex surgical sterile (pairs) size 7 1/2 x 50 $27.29 4591 Gloves latex surgical sterile (pairs) size 8 x 50 $25.22 4592 Gloves latex surgical sterile (pairs) size 8 1/2 x 50 $25.22 3221 Hand Sanitizer w/moisturizing kills 99% germs-4oz flip top x 1 $1.35 4575 Medicine cups 1oz disposable: 100 cups / bag x 100 $1.45 9055 Instant Cold Packs 4"x5" squeeze-knead-apply x 1 $0.45 3012 I.V. catheter/needle unit; 20G x 1" [NEEDLES ONLY] x EA $2.00 3013 I.V. catheter/needle unit; 22G X 1" [NEEDLES ONLY] x EA $2.00 3017 I.V. administration set 105"tube length-60 drops/ml-2 inject sites x EA $4.40 3560 IV Start Kit:1/tourniquet- 2/gauze sponge(2x2-8ply)-1/id label-1/transparent dress x 1 $1.25 1/tape (3/4x18)-1/PVP pad- 1/alcohol pad 7140 Needle ONLY 25G x 1" x 100 $6.30 7135 Needle ONLY 18G x 1.5" x 100 $6.60 7139 Needle ONLY 21G x 1.5" x 100 $6.35 7141 Needle only 25G x 5/8" x 100 $6.30 3300 Obsterical Kit:1 pr str gloves1 drape sheet,2 umbilical clamps str,2 O.B. x 1 $9.00 Form MED 9 of 11

Description International Pharmaceutical Order Form Quantity Unit Charge Page 8 towelettes 1-O.B.Pad str, 1plastic bag for placenta,6 gauze sponges 1 bulb syringe,4 disposable towels 2 nylon tie-offs,scalpel twist ties, rec-ing blanket 2 alcohol preps medium, 4468 Povidone Iodine prep pads x 100 $4.75 3368 Povidone iodine 10% topical solution 128oz (3784mL)gallon x 1 $23.50 4469 Povidone iodine 10% topical solution 16oz (473 ml) pint x 1 $3.51 1194M Surgical gown reinforced (sterile):contents inculde-)1gown,2 hand towels, x EA $3.75 1195L Surgical gown reinforced (sterile):contents inculde- ) x EA $3.75 (MED) 1gown,2 hand towels,(large) 1196XL Surgical gown reinforced (sterile):contents inculde- x EA $3.75 1gown,2 hand towels,(x-large) 1781 Sterilization Pouch 7.5x13 self-sealing (if you need more deals please call office) x 200 $19.45 7500 Scalpel #10 blade sterile x 100 $14.65 2118 Scalpel #10 blade sterile with attached to handle x 10 $8.80 3140 Scalpel #11 blade sterile x 100 $15.75 2122 Scalpel #11 blade sterile attached to handle x 10 $6.90 3139 Scalpel #15 blade sterile x 100 $15.55 2121 Scalpel #15 blade sterile attached to handle x 10 $6.60 4509 Syringe 10cc 20Gx1 1/2" L/L x 100 $26.10 7127 Syringe 10cc without needle x 100 $15.00 4439 Syringe 1cc 25Gx5/8" L/L x 100 $17.80 7130 Syringe 1cc 27G x 1/2" x 100 $12.15 7125 Syringe 1cc without needle x 100 $11.20 3391 Syringe 3cc 21G x 1 1/2" L/L x 100 $9.20 4440 Syringe 3cc 22Gx1 1/2" L/L x 100 $9.15 3387 Syringe 3cc 23G x 1" L/L x 100 $12.60 4495 Syringe 3cc 23Gx 1 1/2" L/L x 100 $12.20 7128 Syringe 3cc 25g x 1" x 100 $9.45 7126 Syringe 3cc without needle x 100 $10.65 3975 Syringe 5cc 21G x 1 " L/L x 100 $18.15 4121 Syringe 5cc 22G x 1 1/2" L/L x 100 $27.30 7129 Syringe 5cc without needle x 100 $18.15 1684 SPLINT 36"-lightweight, reusable, waterproof, compact, radiolucent, versatile, x 1 $6.00 longitudinal bend to give the splint strength. works for double layer wrist splintsugar tong arm - splint ankle stirrup splint c-curve to create 3783 Tape, adhesive surgical paper 1"x10 yards hypo allergenic x 12 $6.00 3364 Tongue depressor blades adult 6" x 3/4" x 500 $4.65 1161 Tongue depressor blades junior x 500 $4.75 4467 Towel Drape disposable, sterile x 50 $16.00 1785 Unna Boot Bandage x 1 $5.85 4300 PICTURE DOSING LABELS ONLY/same design that's on 3x4 baggies- x 10 $0.75 4257 10 labels to unit Zip lock bags 3"x4"x2mil; with picture dosing & white block for writing x 100 $2.50 4542 FDA approved materials Zip lock bags 3"x5"x2mil; plain double bagged will hold up 120mL liquid x 100 $3.00 SUTURES & SUTURE NEEDLES 7201 Suture needles assorted sizes, round body FOR EXPORT ONLY x 12 $3.85 7202 Suture synth(braided & coat polyglycolic acid) 2 x 70cm FOR EXPORT ONLY x 36 $132.80 7211 Suture catgut chromic 0 1x150cm FOR EXPORT ONLY x 36 $85.70 7239 Suture silk 2/0 45cm 3/8 rc needle 24.5mm FOR EXPORT ONLY x 36 $18.30 7245 Suture synth abs 2/0 70cm 1/2rb needle 26mm FOR EXPORT ONLY x 36 $74.80 7249 Suture synth abs 3/0 45cm 3/8rc needle 18.5mm FOR EXPORT ONLY x 36 $62.40 7258 Suture synth abs 3/0 70cm 1/2rb needle 18.5mm FOR EXPORT ONLY x 36 $74.80 900 EQUIPMENT & MISCELLANEOUS EQUIPMENT & MISCELLANEOUS 8999 1tsp oral medicine syringe 5mL x 10 $5.00 9001 2 tsp child medicine spoon x 10 $3.60 4491 2oz empty plastic cough syrup bottles x 10 $3.00 9000 Empty-1/2oz round hinged lid plastic container-can be used to divide up x 30 $7.50 creams/ointments 9008 Empty-plastic 60cc bts w/lids and labels x 10 $2.75 4300 PICTURE DOSING LABELS ONLY/same design that's on 3x4 baggies- x 10 $0.55 10 labels to unit 9006 Asthma Mentor-peak flow meter adult or pediatric x 1 $24.40 9004K Blood glucose monitor; include monitor,manual,battery,carring case, 10 lancets, x 1 $15.00 9004 Lancing device,10 test strips and log book MONITOR IS A TRUE TRACK Blood glucose monitor; include monitor, manual, battery, carrying case, x 1 $2.00 [MONITOR IS A TRUE TRACK] 9002 Blood glucose test strips; for TrueTrack x 50 $30.75 9009 Lancets; for use with either all monitors requiring 28g x 100 $3.65 3740 Cauterie disposable fine tip, high temperature,4 year shelf life x 1 $11.15 4599 Ear Syringe 1oz x 1 $3.35 9054 HIV 1 & 2 Test Kits for 1 and 2:results in 20 mins-for EXPORT ONLY OUT OF STOCK x 25 $78.40 PMTR Patient Medical Treatment Record- in packs of 50 x 50 $5.50 8100 Reading Glasses-variety pack assorted powers-from +1/+1.25/+1.5/+1.75/+2/+2.5 x 19 $14.25 2020 Glasses for near-sighted (-1.0 to -4.5)adjustable on side of each ear piece. x EA $13.50 9052N Malaria RDT for plasmodia falciparuma :results in 15 mins; x 25 $41.90 Form MED 10 of 11

International Pharmaceutical Order Form Page 9 includes 25 individually sealed test, lancets, alcohol swab, sample applicator, pipette s, developing buffer store at 6 to 45 degree C 9051N Malaria Rapid Detection Test for both falciparum and vivax malaria:results in x 25 $45.60 30 mins includes 25 individually sealed test, lancets, alcohol swab, sample applicator, pipette s, developing buffer store at 6 to 45 degree C 9095 Mosquito Nets: treated w/ deltamethrin-130cmx180cmx150cm(rectangular) x 1 $15.00 3664 Nebulizer handheld AC adapter included x 1 $127.00 3666 Nebulizer handhld AC adapter Pediatric-Margo-Moo portable red barn x 1 $57.75 carrying case 3666D Nebulizer handheld AC adapter Pediatric-Digger Dog w/dog House carrying bag-5m x 1 $45.00 Medicine cup, angled mouthpiece, 7" air tubing, child mask, and instructions in Spanish 2301R Otoscope economy (requires 2 C batteries) x 1 $109.00 2301A Otoscope Disposable Ear specula Adult x 100 $12.75 2301C Otoscope Disposable Eat specula Child x 100 $12.45 9080 Ophthalmoscope/Otoscope w/eurolight (E10) requires 2 " C" batteries x 1 $250.00 [KaWe] 2330 Pregnancy test, one step, simple to read x EA $4.00 3822 Pregnancy HCG test; quick stick one step FOR EXPORT ONLY x 25 $15.00 2500 Pill Crush, crash tablets into powder x 1 $4.40 9025 Sharps- container red large 10qt (biohazard waste) x 1 $6.85 2405 Blood Pressure Monitor w/large cuff & AC adapter, comes w/4aabatteries x EA $61.50 2607 Sphygmomanometer adult precision aneroid nylon cuff x 1 $11.00 2307 Sphygmomanometer child (precision aneroid) w/ blue nylon cuff x 1 $15.00 4010 Sphygmomanometer infant (precision aneroid) w/ blue nylon cuff x 1 $20.70 4032 Sphygmomanometer XL adult precision aneroid nylon cuff x 1 $18.00 4343 Stethoscope fetal 29" black vinyl Y-tubing x 1 $18.55 2305 Stethoscope spectrum dual head x 1 $6.60 2304 Stethoscope spectrum nurse, black x 1 $4.85 2552 Tablet cutter x 1 $2.50 4368 Tablet/Pill, tray counter w/spa x 1 $6.55 2115 Thermometer INFRARED forehead scan, guidebook in english & spanish x 1 $60.00 3327 Thermometer DIGISCAN multi-function ear &forehead scan-talking x 1 $25.00 in,english & Spanish (no probe covers with this one) -(probe covers # 4332) 3707 Thermometer DIGITAL w/beeper, memory, and fever alarm, x 1 $5.65 4332 battery included.(probe covers #3153) Thermometer probe covers DIGITAL EAR disposable TENDER TEMP x 40 $6.25 PROBE COVERS 3153 Thermometer probe covers DIGITAL oral disposable x 50 $3.40 3245 Lubricating jelly sterile 2oz x EA $1.20 9090S Vaginal specula (small) ready to use - disposable x 10 $5.00 9090M Vaginal specula (medium) ready to use - disposable x 10 $5.00 9090L Vaginal specula (large) ready to use-disposable x 10 $5.00 4016 Urine dip test strips: 10 PARAMETERS-glucose, protein, nitrite, ph, blood, and x 100 $29.25 leukocytes; Uroblinogen Specific Gravity: Ketone: Bilirubin: visual testing PRO Proforma (signed, stamped and sealed) in box only x 1 $2.00 EMAIL Proforma will be email to the email address (that you) provide for us x 1 $4.00 Email address: ELS Proforma - designed for the country of El Salvador ONL x 1 $5.00 COQ Certificate of Quality and Authenticity x 1 $2.00 GC Gift Certificate x 1 $2.00 COA Certificate of Analysis issued by manufacturer for every IFE product x per item $2.00 on your order.(only available on For Export Only products and 51376 ndc's) IF YOU DO NOT RECEIVE AN EMAIL ORDER ACKNOWLEDGEMENT IN 3 BUSNIESS DAYS PLEASE CALL OUR OFFICE. We have not received your order if you have not received an email from us. Due to the increased volume of orders and our turnaround time from our suppliers you will see BK(back orders) on some of your orders. Please mark in the blank below the latest date you can receive a BK (back order) item or NO if you do not wish to have back orders shipped to you. Date: Blessings cannot guarantee that you will get your BK but with this date we will do everything we can. If a date is written in the blank on the packing list of your original order that is the day that we expect to ship it to you. PLEASE FAX ALL PAGES OF THE ORDER FORM TO INSURE WE HAVE THE COMPLETE ORDER. IFE=FOR EXPORT ONLY OUT OF STOCK=NOT AVAILABLE FOR THIS TRIP BACKORDER WITH DATE IN BLANK=IS THE DATE BI EXPECTS TO RECEIVE THIS ITEM BACK IN STOCK. IF IT IS STAMPED NOT IN DATE RANGE=THIS MEANS THE PRODUCT IS NOT IN THE DATE RANGE YOU REQUESTED. Form MED 11 of 11