Here's a couple more possible additions (either in a future version, or by the end user):

1) A small piece of wet/dry sandpaper, for use as a knife sharpener

2) Replace the tiny pencil with a normal-thickness pencil cut to length, or a golf pencil. That makes a useable handle for the scalpel blade if nothing else is handy for that. Extra credit: carve a notch in the pencil ahead of time when a decent knife is handy, or even drill a small hole through it, to give an attachment point for the blade.