FORMULIR UNTUK PENGUMPUL DATA

Sensus Harian Indikator Unit Kamar operasi

Indikator : Tidak adanya kejadian operasi salah sisi ( UK 4 ) / Sep 18

Tidak adanya kejadian

NO Tanggal No. Rm Nama pasien operasi salah sisi
Ya Tidak
1 1/9/2018 108130 An M ghatan 1
2 1/9/2018 52488 Tn Muhamad Nur 1
3 1/9/2018 129582 Ny Melva 1
4 1/9/2018 127087 Nn. Rifaa 1
5 1/9/2018 125489 Ny ricka 1
6 3/9/2018 69764 Ny Murdian 1
7 3/9/2018 70188 Ny Yuyun 1
8 3/9/2018 95334 Ny. Sarmi 1
9 3/9/2018 93878 Ny. Opsanih 1
10 3/9/2018 131443 Tn Bambang 1
11 3/9/2018 84244 Ny irvina 1
12 3/9/2018 128582 Ny Eka 1
13 3/9/2018 35531 ny Dea 1
14 4/9/2018 112550 Nn Nabila 1
15 4/9/2018 117466 An Ufati 1
16 4/9/2018 4831 An Karin 1
17 4/9/2018 130716 nnnurul 1
18 4/9/2018 105332 Ny dian 1
19 5/9/2018 131353 Tn Gunung 1
20 5/9/2018 131056 Ny. Shiuta 1
21 6/9/2018 129242 Ny Listari 1
22 6/9/2018 131387 Tn suwaji 1
23 6/9/2018 75205 Ny Vita 1
24 6/9/2018 33268 Ny Ita Y 1
25 7/9/2018 32552 Linda 1
26 7/9/2018 131681 Tn Restu 1
27 7/9/2018 131159 Ny Amaliyah 1
28 7/9/2018 131603 An Syahru 1
29 7/9/2018 131774 Tn Mujur 1
30 7/9/2018 88908 Ny Dewi 1
31 7/9/2018 124811 Ny Cita R 1
32 8/9/2018 129032 Ny Dewi 1
33 10/9/2018 131876 Ny Rosinta 1
34 10/9/2018 131775 Ny Parwi 1
35 10/9/2018 131430 Ny suprianti 1
36 10/9/2018 131573 Tn Robert 1
37 10/9/2018 124536 Ny Putri 1
38 10/9/2018 2694 Tn Yusuf 1
39 10/9/2018 131064 Ny Yuyun 1
40 10/9/2018 56626 Tn Mansur 1
41 12/9/2018 128230 Ny syahlinan 1
42 12/9/2018 131107 Ny doria 1
43 13/9/2018 132049 Ny nani 1
44 13/9/2018 131645 Ny dewi sartika 1
45 13/9/2018 120317 Ny sopiah 1
46 14/9/2018 37986 Ny Madina 1
47 14/9/2018 132285 Ny neni 1
48 14/9/2018 132244 Ny Linda 1
49 16/9/2018 117677 Ny harmila 1
50 17/9/2018 132337 An Nadin 1
51 17/9/2018 109136 Ny sukriah 1
52 17/9/2018 131553 Indrawaty 1
53 17/9/2018 113904 Ny. Veronica 1
54 17/9/2018 132117 Ny siti A 1
55 17/9/2018 102134 Tn Warkum 1
56 17/9/2018 672324 Tn Lukman 1
57 18/9/2018 132150 Tn sanusi 1
58 18/9/2018 132160 Tn ferinand 1
59 18/9/2018 38528 Ny rosita 1
60 29/9/2018 133086 Tn riki 1
60
UL DATA FORMULIR UNTUK VAL

Sensus Harian Indikator Unit Kamar Opaerasi

Indikator : Tidak adanya kejadian operasi salah sisi ( UK

Keterangan NO Tanggal No. Rm

1 1/9/2018 108130
2 3/9/2018 69764
3 4/9/2018 112550
4 4/9/2018 130716
5 5/9/2018 131353
6 6/9/2018 129242
7 7/9/2018 32552
8 7/9/2018 131681
9 8/9/2018 129032
10 10/9/2018 131876
11 12/9/2018 128230
12 13/9/2018 131645
13 16/9/2018 117677
14 17/9/2018 132337
15 18/9/2018 38528
16 29/9/2018 133086
JML
FORMULIR UNTUK VALIDASI DATA

Kamar Opaerasi
dian operasi salah sisi ( UK 4 ) / Sep 18

Tidak adanya kejadian

Nama pasien operasi salah sisi Keterangan
Ya Tidak
An M ghatan 1
Ny Murdian 1
Nn Nabila 1
nnnurul 1
Tn Gunung 1
Ny Listari 1
Linda 1
Tn Restu 1
Ny Dewi 1
Ny Rosinta 1
Ny syahlinan 1
Ny dewi sartika 1
Ny harmila 1
An Nadin 1
Ny rosita 1
Tn riki 1
16
100
 FORMULIR UNTUK PENGUMPUL DATA

Sensus Harian Indikator Unit Kamar operasi

Indikator : Tidak adanya kejadian operasi salah sisi ( UK 4 ) / Okto 18
Tidak adanya
kejadian operasi
NO Tanggal No. Rm Nama pasien Keterangan
Yasalah sisi
Tidak
1 1/10/2018 13.30.98 Tn Samsul 1
2 1/10/2018 13.29.65 Tn Achmad 1
3 1/10/2018 13.31.45 Tn Adih 1
4 2/10/2018 13.31.57 Tn Winarso 1
5 3/10/2018 13.24.03 Ny Fitri 1
6 3/10/2018 05.57.40 Ny Putri 1
7 3/10/2018 11.38.73 Ny Tuti 1
8 3/10/2018 12.12.96 Ny Riska 1
9 4/10/2018 02.15.30 Tn Sukarno 1
10 4/10/2018 13.30.47 Nn Putri 1
11 4/10/2018 08.67.73 Ny Ana 1
12 5/10/2018 13.33.21 Tn Abdul Gofar 1
13 5/10/2018 06.23.74 Tn Indra 1
14 6/10/2018 13.22.96 Nn Nurhidayah 1
15 6/10/2018 08.46.01 Ny Neneng 1
16 8/10/2018 12.16.61 Ny Luanggun 1
17 8/10/2018 13.33.20 Tn Koster 1
18 8/10/2018 13.35.86 An Rizki 1
19 8/10/2018 08.28.29 Nn Novi 1
20 9/10/2018 06.07.78 Ny Corina 1
21 9/10/2018 13.30.29 Tn Udin kecil 1
22 9/10/2018 13.35.74 Tn Agustus 1
23 10/10/2018 11.03.26 Tn Ahmad Sofyan 1
24 10/10/2018 13.30.93 Ny Rahmi Febriani 1
25 10/10/2018 03.78.23 Ny Lani 1
26 11/10/2018 13.29.91 Ny darmunah 1
27 11/10/2018 08.98.45 Tn Yordan 1
28 12/10/2018 13.29.77 Ny Mariskha 1
29 12/10/2018 06.91.42 Ny Nia 1
30 12/10/2018 13.38.24 Ny Sumarni 1
31 12/10/2018 06.99.67 Tn M Rizki 1
32 13/10/2018 08.06.53 Ny Imelda 1
33 13/10/2018 10.84.14 Ny Sigit 1
34 15/10/2018 13.36.98 Ny Dian 1
35 15/10/2018 13.39.23 An M Daniar 1
36 15/10/2018 09.16.43 Ny Reiva 1
37 15/10/2018 01.47.50 Tn Gabriel 1
38 16/10/2018 13.39.75 Tn Mahal 1
39 16/10/2018 13.10.14 Ny Hanum 1
40 17/10/2018 10.02.27 Ny Ria 1
41 17/10/2018 07.99.23 Ny Aminah 1
42 17/10/2018 13.39.84 Tn Andreas 1
43 17/10/2018 12.13.29 Tn Imam 1
44 18/10/2018 05.67.53 Ny Siti 1
45 19/10/2018 12.67.63 Ny Armi 1
46 19/10/2018 13.03.13 An Rafael 1
47 19/10/2018 13.28.87 Tn Yusus 1
48 20/10/2018 13.42.13 Ny Ika 1
49 20/10/2018 05.92.10 Ny Siti 1
50 22/10/2018 13.29.51 An Santi 1
51 22/10/2018 13.41.37 Ny Yulfia 1
52 23/10/2018 13.36.78 Tn Shapiy 1
53 24/10/2018 07.09.58 An Assya 1
54 24/10/2018 10.11.21 Ny Dede 1
55 24/10/2018 06.00.68 Ny Gramsari 1
56 24/10/2018 12.73.59 Tn Moch arie 1
57 25/10/2018 09.57.13 Ny Widihastuti 1
58 26/10/2018 13.46.95 Ny Hilda 1
59 27/10/2018 09.91.48 Nn Athaya 1
60 27/10/2018 13.41.47 Ny Endah 1
60
 FORMULIR UNTUK VALIDASI DATA

Sensus Harian Indikator Unit Kamar Opaerasi

Indikator : Tidak adanya kejadian operasi salah sisi ( UK 4 ) / Okto 18
Tidak adanya
kejadian operasi
NO Tanggal No. Rm Nama pasien Keterangan
Yasalah sisi
Tidak
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
JML
0
 FORMULIR UNTUK PENGUMPUL DATA FOR

Sensus Harian Indikator Unit Kamar operasi

Indikator : Tidak adanya kejadian operasi salah sisi ( UK 4 ) / Nov 18
Tidak adanya
kejadian operasi
NO Tanggal No. Rm Nama pasien Keterangan
Yasalah sisi
Tidak
1 1/11/2018 08.03.97 Ny Citra 1
2 1/11/2018 13.48.23 Ny Meilinda 1
3 1/11/2018 13.50.56 Ny Meriska 1
4 2/11/2018 11.61.40 Nn Erviela 1
5 2/11/2018 13.49.50 Tn Efendi 1
6 2/11/2018 13.47.56 Ny Eka 1
7 3/11/2018 13.46.11 Tn Yovan 1
8 3/11/2018 10.91.06 Tn Indar 1
9 3/11/2018 13.51.52 Ny Riska 1
10 4/11/2018 13.53.29 Ny Feny 1
11 5/11/2018 13.52.20 Ny Lailyfitria 1
12 5/11/2018 05.18.50 Tn Joni 1
13 5/11/2018 13.52.81 Ny Sri 1
14 6/11/2018 134.9.76 Ny Karwati 1
15 6/11/2018 13.43.73 Ny Zulianti 1
16 7/11/2018 09.42.68 Ny Dheyas 1
17 7/11/2018 13.52.84 Nn Mega 1
18 8/11/2018 13.51.30 Ny Elvira 1
19 8/11/2018 09.59.46 Ny Dina 1
20 8/11/2018 03.17.88 Ny Mulyanah 1
21 8/11/2018 04.04.96 Ny Suryani 1
22 8/11/2018 09.19.66 Ny Wartini 1
23 8/11/2018 06.89.52 An Allico 1
24 9/11/2018 08.72.52 Ny Siti ida 1
25 9/11/2018 06.49.80 Tn Hardian 1
26 9/11/2018 06.46.32 Ny Yenni 1
27 9/11/2018 04.35.50 Ny Maylisa 1
28 9/11/2018 13.24.91 Ny Epon 1
29 10/11/2018 13.56.01 Nn Ratu 1
30 10/11/2018 13.43.31 Ny Umi 1
31 10/11/2018 13.32.42 Ny Siwi 1
32 12/11/2018 10.31.13 Nn Denda 1
33 12/11/2018 13.54.95 Tn Agus 1
34 13/11/2018 13.45.67 Ny Sri R 1
35 14-11-2018 13.46.63 Ny Lies 1
36 15/11/2018 06.90.99 Ny Farisa 1
37 15/11/2018 13.58.84 Ny Tri 1
38 15/11/2018 05.98.64 Ny ima 1
39 15/11/2018 12.29.70 Ny Sopiyah 1
40 16/11/2018 13.53.10 Tn Etdi 1
41 16/11/2018 13.58.82 Tn Ahmad 1
42 16/11/2018 13.52.83 Ny Inayati 1
43 17/11/2018 13.56.82 Tn Firdaus 1
44 17/11/2018 06.25.12 Ny Destu 1
45 17/11/2018 03.21.66 Tn Budhianto 1
46 19/11/2018 13.61.86 Ny Linda 1
47 19/11/2018 06.67.49 Nn Verren 1
48 21/11/2018 01.34.258 Nn Efta 1
49 21/11/2018 13.18.69 Ny Patimah 1
50 22/11/2018 13.31.88 Ny Indah 1
51 1
52 1
53 1
54 1
55 1
56 1
57 1
58 1
59 1
60 1
60
 FORMULIR UNTUK VALIDASI DATA

Sensus Harian Indikator Unit Kamar Opaerasi

Indikator : Tidak adanya kejadian operasi salah sisi ( UK 4 ) / Nov 18
Tidak adanya
kejadian operasi
NO Tanggal No. Rm Nama pasien Keterangan
Yasalah sisi
Tidak
1 1/11/2018 13.50.56 Ny Meriska 1
2 2/11/2018 11.61.40 Nn Erviela 1
3 3/11/2018 13.51.52 Ny Riska 1
4 4/11/2018 13.53.29 Ny Feny 1
5 5/11/2018 13.52.81 Ny Sri 1
6 6/11/2018 134.9.76 Ny Karwati 1
7 7/11/2018 13.52.84 Nn Mega 1
8 8/11/2018 13.51.30 Ny Elvira 1
9 9/11/2018 13.24.91 Ny Epon 1
10 10/11/2018 13.56.01 Nn Ratu 1
11 12/11/2018 13.54.95 Tn Agus 1
12 13/11/2018 13.45.67 Ny Sri R 1
13 14-11-2018 13.46.63 Ny Lies 1
14 15/11/2018 06.90.99 Ny Farisa 1
15 17/11/2018 03.21.66 Tn Budhianto 1
16 19/11/2018 13.61.86 Ny Linda 1
JML 16
100