Free laboratory form
Chemical Withdrawal Form (ใบเบิกสารเคมี)
A chemical withdrawal form is the slip a laboratory member fills in to draw chemicals from the store: what, how much, for which work, and who issued it. The free Excel file below carries the form and an issue log, with a separate row for each chemical and lot issued to update the stock register. No signup and no email required.
Bilingual Thai and English, landscape A4. Two working sheets: the withdrawal form (department, project, date, requester and store keeper header; line rows with grade, CAS, pack size, quantity requested and issued, lot and balance after issue; three signature lines) and an issue log (one row per chemical and lot issued, the same figures the stock register needs), each with a worked example row. Free to use and adapt.
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What a chemical withdrawal form is
The store holds the laboratory’s chemicals under the stock register; the bench needs some of them today. The withdrawal form is the record of that hand-over: the requester states the chemical, grade and quantity, the store keeper issues it, notes the lot and the balance left, and both sign. One form per request, filed in order, is the paper trail behind every change in the register.
Laboratory assessments such as ESPReL and quality systems such as ISO/IEC 17025 expect chemicals to be traceable from receipt to use. The form is how a withdrawal becomes a dated, signed record instead of a bottle that went missing from the shelf. It does not replace the register; it feeds it.
Withdrawal form vs chemical stock register
The two records are kept together and confused often. They answer different questions:
| Withdrawal form (ใบเบิกสารเคมี) | Stock register (ทะเบียนสารเคมี) | |
|---|---|---|
| One document per | Request, on the day it is made | Container received, for its whole life |
| Records | Who asked, who issued, how much, for which work | What the store holds: lot, expiry, location, balance |
| Answers | Where did this quantity go, and who signed for it? | What do we hold, and how much remains? |
| Changes when | A member draws chemicals from the store | Stock is received, withdrawn or disposed of |
| Fails when | Forms are filled in after the fact, or not at all | Balances are updated from memory instead of forms |
Keep both. The form is the evidence for each movement; the register is the running total. In the issue log, record each chemical and lot issued on a separate row. Repeat the form number for every line from the same form, then update the matching stock-register entry.
What to record on every line
The line columns, and why each one is there:
Chemical name, grade and CAS
The store may hold three grades of one solvent. The CAS number and the grade say which bottle is meant, so the issuer does not guess.
Pack size and unit
Whether the request is for one bottle or 500 ml out of one matters for the balance. Naming the unit on the line avoids the arithmetic argument later.
Quantity requested and quantity issued
Two columns on purpose. The store may issue less than asked when stock is short, and the difference is what the requester has to chase.
Lot or batch number
The lot ties the withdrawal to a specific container and its certificate, which is what an investigation asks for when a result looks wrong.
Balance after issue
Written by the issuer from the register. It is the figure the register is updated to, and the first place a stock count finds a mismatch.
Requester, issuer and approver signatures
Three lines because three people are accountable: the one who needs it, the one who hands it over, and the one who allows it. A form with one signature is a note, not a record.
Three habits that keep the store reconciled
- 1
Fill the form before the bottle leaves
A form written afterwards records what someone remembers, not what happened. The store keeper issues against the form, never ahead of it.
- 2
Log every issued line the same day
Use one issue-log row per chemical and lot issued, with the balance after issue. Repeat the form number for a form with several lines, then update each matching stock-register entry.
- 3
Count against the log, not from scratch
When the monthly count disagrees with the register, the log shows which withdrawal was missed. Without it, the only fix is a new starting figure.
When the balance after issue is close to zero
The form is where a laboratory first sees that a chemical is about to run out. The stock register carries the reorder point, and the SDS register holds the hazard sheet for anything new the next order brings in. Both pair with this form.
Free chemical stock register (ทะเบียนสารเคมี) template·Free SDS register (ทะเบียน SDS) template
Common questions
What is a chemical withdrawal form?
An internal form a laboratory member fills in to draw chemicals from the store. It records the chemical, grade, CAS number, quantity requested and issued, lot number and balance after issue, with signatures from the requester, the issuer and the approver. Each chemical and lot issued becomes a separate issue-log row linked by the form number, for updating the matching stock-register entry.
Do I need a withdrawal form if I already keep a stock register?
The register is the running total; the form is the evidence for each change to it. Without forms, the balance column is updated from memory and the monthly count has nothing to reconcile against. Laboratory assessments such as ESPReL expect chemicals to be traceable from receipt to use, and the form is the record of use.
Who signs a chemical withdrawal form?
Three people: the requester who needs the chemical, the store keeper who issues it, and the approver, usually the laboratory head or a delegate. A small laboratory where one person holds two roles crosses out the line it does not use.
What goes in the issue log sheet?
One row per chemical and lot issued: date, form number, chemical, grade, lot, quantity issued, unit, balance after issue, requester, issuer and the project or job. Repeat the form number when the form contains several lines. Use the log to update the matching stock-register entries and reconcile stock counts.
Is the download really free? Do I need to register?
Yes, it is free, and no. There is no signup and no email form. Download the file, put your laboratory’s name on it, and adapt the columns to your procedures.