Page 22 - DIDC SOPS and Guidelinesv as of April 2019

Anti-Malaria Medication Receipt PMO-6018-01-a

Contingency Released Date
Operations 03/06/17 Page 1 of 1

DynCorp International Deployment Center

I, ____________________________________________ received 395 tablets of 100mg

(Name)

Doxycycline on ________/_________/___________.

(mm/dd/yyyy)

(SSN #) (Signature)

Distributed by:

This document contains confidential and proprietary information of DynCorp International (“DI”).
No part of it may be used, circulated, quoted, or reproduced for distribution outside of DI without the prior written approval of DI.