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    Pemantauan Troli Emergency Ok

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    isbiyantoro toro
    This document is a monitoring form from RSIA "Harapan Bunda", a maternal and child hospital in Pringsewu, Indonesia. It tracks the condition of emergency trolleys in the operating room/delivery room over several months, including whether they are in good condition or damaged, locked or unlocked, and whether medical supplies have been used. Staff signatures are included to verify the log each month.

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    © All Rights Reserved
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    Pemantauan Troli Emergency Ok

    Uploaded by

    isbiyantoro toro
    26 views10 pages
    This document is a monitoring form from RSIA "Harapan Bunda", a maternal and child hospital in Pringsewu, Indonesia. It tracks the condition of emergency trolleys in the operating room/delivery room over several months, including whether they are in good condition or damaged, locked or unlocked, and whether medical supplies have been used. Staff signatures are included to verify the log each month.

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    Original Title

    PEMANTAUAN TROLI EMERGENCY OK

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    © © All Rights Reserved

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    This document is a monitoring form from RSIA "Harapan Bunda", a maternal and child hospital in Pringsewu, Indonesia. It tracks the condition of emergency trolleys in the operating room/delivery room over several months, including whether they are in good condition or damaged, locked or unlocked, and whether medical supplies have been used. Staff signatures are included to verify the log each month.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    26 views10 pages

    Pemantauan Troli Emergency Ok

    Uploaded by

    isbiyantoro toro
    This document is a monitoring form from RSIA "Harapan Bunda", a maternal and child hospital in Pringsewu, Indonesia. It tracks the condition of emergency trolleys in the operating room/delivery room over several months, including whether they are in good condition or damaged, locked or unlocked, and whether medical supplies have been used. Staff signatures are included to verify the log each month.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 10

    RUMAH SAKIT IBU DAN ANAK (RSIA)

    “HARAPAN BUNDA”
    Izin No: 440 / 162 / D.02 / P / VI / 2014
    Alamat: Jl. KH. Dewantara No.1269 Pringsewu Kabupaten Pringsewu
    E-mail : [email protected] Telp / Fax. (0729) 23186

    PEMANTAUAN TROLY EMERGENCY OK/KAMAR OPERASI


    BULAN...........................TAHUN...............

    Kondisi Troli Kondisi Kunci Pemakaian Obat/ Alkes


    Tanggal Dinas PJ Obat Paraf
    Baik Rusak Terkunci Terbuka Ya Tidak
    Shif 1
    1. Shif 2
    Shif 3
    Shif 1
    2. Shif 2
    Shif 3
    Shif 1
    3. Shif 2
    Shif 3
    Shif 1
    4. Shif 2
    Shif 3
    Shif 1
    5. Shif 2
    Shif 3
    Shif 1
    6. Shif 2
    Shif 3
    Shif 1
    7. Shif 2
    Shif 3
    Shif 1
    8. Shif 2
    Shif 3
    Shif 1
    9. Shif 2
    Shif 3
    Shif 1
    10. Shif 2
    Shif 3
    Shif 1
    11. Shif 2
    Shif 3
    Shif 1
    12. Shif 2
    Shif 3
    Shif 1
    13. Shif 2
    Shif 3
    Shif 1
    14. Shif 2
    Shif 3
    Shif 1
    15. Shif 2
    Shif 3
    Shif 1
    16. Shif 2
    Shif 3
    Shif 1
    17. Shif 2
    Shif 3
    18. Shif 1
    Shif 2
    Shif 3
    Shif 1
    19. Shif 2
    Shif 3
    Shif 1
    20. Shif 2
    Shif 3
    Shif 1
    21. Shif 2
    Shif 3
    Shif 1
    22. Shif 2
    Shif 3
    Shif 1
    23. Shif 2
    Shif 3
    Shif 1
    24. Shif 2
    Shif 3
    Shif 1
    25. Shif 2
    Shif 3
    Shif 1
    26. Shif 2
    Shif 3
    Shif 1
    27. Shif 2
    Shif 3
    Shif 1
    28. Shif 2
    Shif 3
    Shif 1
    29. Shif 2
    Shif 3
    Shif 1
    30. Shif 2
    Shif 3
    Shif 1
    31. Shif 2
    Shif 3

    Pringsewu, Agustus 2018

    Mengetahui,
    Penanggung Jawab Obat/ Alkes Kepala Ruang OK

    ISBIYANTORO,S.Si.Apt PUTRI DESTIANA,Amd.Kep


    RUMAH SAKIT IBU DAN ANAK (RSIA)
    “HARAPAN BUNDA”
    Izin No: 440 / 162 / D.02 / P / VI / 2014
    Alamat: Jl. KH. Dewantara No.1269 Pringsewu Kabupaten Pringsewu
    E-mail : [email protected] Telp / Fax. (0729) 23186

    PEMANTAUAN TROLY EMERGENCY OK/ KAMAR OPERASI BULAN


    SEPTEMBER 2018

    Kondisi Troli Kondisi Kunci Pemakaian Obat/ Alkes


    Tanggal Dinas PJ Obat Paraf
    Baik Rusak Terkunci Terbuka Ya Tidak
    Shif 1
    1. Shif 2
    Shif 3
    Shif 1
    2. Shif 2
    Shif 3
    Shif 1
    3. Shif 2
    Shif 3
    Shif 1
    4. Shif 2
    Shif 3
    Shif 1
    5. Shif 2
    Shif 3
    Shif 1
    6. Shif 2
    Shif 3
    Shif 1
    7. Shif 2
    Shif 3
    Shif 1
    8. Shif 2
    Shif 3
    Shif 1
    9. Shif 2
    Shif 3
    Shif 1
    10. Shif 2
    Shif 3
    Shif 1
    11. Shif 2
    Shif 3
    Shif 1
    12. Shif 2
    Shif 3
    Shif 1
    13. Shif 2
    Shif 3
    Shif 1
    14. Shif 2
    Shif 3
    Shif 1
    15. Shif 2
    Shif 3
    Shif 1
    16. Shif 2
    Shif 3
    Shif 1
    17. Shif 2
    Shif 3
    18. Shif 1
    Shif 2
    Shif 3
    Shif 1
    19. Shif 2
    Shif 3
    Shif 1
    20. Shif 2
    Shif 3
    Shif 1
    21. Shif 2
    Shif 3
    Shif 1
    22. Shif 2
    Shif 3
    Shif 1
    23. Shif 2
    Shif 3
    24. Shif 1
    Shif 2
    Shif 3
    Shif 1
    25. Shif 2
    Shif 3
    Shif 1
    26. Shif 2
    Shif 3
    Shif 1
    27. Shif 2
    Shif 3
    Shif 1
    28. Shif 2
    Shif 3

    Pringsewu, September 2018


    Mengetahui,
    Penanggung Jawab Obat/ Alkes Kepala Ruang VK

    ISBIYANTORO,S.Si.Apt PUTRI DESTIANA,Amd.Kep


    RUMAH SAKIT IBU DAN ANAK (RSIA)
    “HARAPAN BUNDA”
    Izin No: 440 / 162 / D.02 / P / VI / 2014
    Alamat: Jl. KH. Dewantara No.1269 Pringsewu Kabupaten Pringsewu
    E-mail : [email protected] Telp / Fax. (0729) 23186

    PEMANTAUAN TROLY EMERGENCY VK/ KAMAR OPERASI BULAN


    OKTOBER 2018

    Kondisi Troli Kondisi Kunci Pemakaian Obat/ Alkes


    Tanggal Dinas PJ Obat Paraf
    Baik Rusak Terkunci Terbuka Ya Tidak
    Shif 1
    1. Shif 2
    Shif 3
    Shif 1
    2. Shif 2
    Shif 3
    Shif 1
    3.
    Shif 2
    Shif 3
    Shif 1
    4. Shif 2
    Shif 3
    Shif 1
    5. Shif 2
    Shif 3
    Shif 1
    6. Shif 2
    Shif 3
    Shif 1
    7. Shif 2
    Shif 3
    Shif 1
    8. Shif 2
    Shif 3
    Shif 1
    9. Shif 2
    Shif 3
    Shif 1
    10. Shif 2
    Shif 3
    Shif 1
    11. Shif 2
    Shif 3
    Shif 1
    12. Shif 2
    Shif 3
    Shif 1
    13. Shif 2
    Shif 3
    Shif 1
    14. Shif 2
    Shif 3
    Shif 1
    15. Shif 2
    Shif 3
    Shif 1
    16. Shif 2
    Shif 3
    Shif 1
    17. Shif 2
    Shif 3
    Shif 1
    18. Shif 2
    Shif 3
    Shif 1
    19. Shif 2
    Shif 3
    Shif 1
    20. Shif 2
    Shif 3
    Shif 1
    21. Shif 2
    Shif 3
    Shif 1
    22. Shif 2
    Shif 3
    Shif 1
    23. Shif 2
    Shif 3
    Shif 1
    24. Shif 2
    Shif 3
    Shif 1
    25. Shif 2
    Shif 3
    Shif 1
    26. Shif 2
    Shif 3
    Shif 1
    27. Shif 2
    Shif 3
    Shif 1
    28. Shif 2
    Shif 3
    Shif 1
    29. Shif 2
    Shif 3
    30. Shif 1
    Shif 2
    Shif 3
    Shif 1
    31.
    Shif 2
    Shif 3

    Pringsewu, Oktober 2018


    Mengetahui,

    Penanggung Jawab Obat/ Alkes Kepala Ruang OK

    ISBIYANTORO,S.Si.Apt PUTRI DESTIANA,Amd.Kep


    RUMAH SAKIT IBU DAN ANAK (RSIA)
    “HARAPAN BUNDA”
    Izin No: 440 / 162 / D.02 / P / VI / 2014
    Alamat: Jl. KH. Dewantara No.1269 Pringsewu Kabupaten Pringsewu
    E-mail : [email protected] Telp / Fax. (0729) 23186

    PEMANTAUAN TROLY EMERGENCY OK/KAMAR OPERASI BULAN


    November 2018

    Kondisi Troli Kondisi Kunci Pemakaian Obat/ Alkes


    Tanggal Dinas PJ Obat Paraf
    Baik Rusak Terkunci Terbuka Ya Tidak
    Shif 1
    1. Shif 2
    Shif 3
    Shif 1
    2. Shif 2
    Shif 3
    Shif 1
    3. Shif 2
    Shif 3
    Shif 1
    4. Shif 2
    Shif 3
    Shif 1
    5. Shif 2
    Shif 3
    Shif 1
    6. Shif 2
    Shif 3
    7. Shif 1
    Shif 2
    Shif 3
    Shif 1
    8. Shif 2
    Shif 3
    Shif 1
    9. Shif 2
    Shif 3
    10. Shif 1
    Shif 2
    Shif 3
    Shif 1
    11. Shif 2
    Shif 3
    Shif 1
    12. Shif 2
    Shif 3
    13. Shif 1
    Shif 2
    Shif 3
    Shif 1
    14. Shif 2
    Shif 3
    Shif 1
    15. Shif 2
    Shif 3
    Shif 1
    16. Shif 2
    Shif 3
    17. Shif 1
    Shif 2
    Shif 3
    Shif 1
    18. Shif 2
    Shif 3
    Shif 1
    19. Shif 2
    Shif 3
    Shif 1
    20. Shif 2
    Shif 3
    Shif 1
    21. Shif 2
    Shif 3
    Shif 1
    22. Shif 2
    Shif 3
    Shif 1
    23. Shif 2
    Shif 3
    Shif 1
    24. Shif 2
    Shif 3
    Shif 1
    25. Shif 2
    Shif 3
    Shif 1
    26. Shif 2
    Shif 3
    Shif 1
    27. Shif 2
    Shif 3
    Shif 1
    28. Shif 2
    Shif 3
    Shif 1
    29. Shif 2
    Shif 3
    Shif 1
    30. Shif 2
    Shif 3

    Pringsewu, November 2018


    Mengetahui,

    Penanggung Jawab Obat/ Alkes Kepala Ruang OK

    ISBIYANTORO,S.Si.Apt PUTRI DESTIANA,Amd.Kep


    RUMAH SAKIT IBU DAN ANAK (RSIA)
    “HARAPAN BUNDA”
    Izin No: 440 / 162 / D.02 / P / VI / 2014
    Alamat: Jl. KH. Dewantara No.1269 Pringsewu Kabupaten Pringsewu
    E-mail : [email protected] Telp / Fax. (0729) 23186

    PEMANTAUAN TROLY EMERGENCY OK/KAMAR OPERASI BULAN


    DESEMBER 2018

    Kondisi Troli Kondisi Kunci Pemakaian Obat/ Alkes


    Tanggal Dinas PJ Obat Paraf
    Baik Rusak Terkunci Terbuka Ya Tidak
    Shif 1
    1. Shif 2
    Shif 3
    Shif 1
    2. Shif 2
    Shif 3
    Shif 1
    3. Shif 2
    Shif 3
    Shif 1
    4. Shif 2
    Shif 3
    Shif 1
    5. Shif 2
    Shif 3
    Shif 1
    6. Shif 2
    Shif 3
    7. Shif 1
    Shif 2
    Shif 3
    Shif 1
    8. Shif 2
    Shif 3
    Shif 1
    9. Shif 2
    Shif 3
    10. Shif 1
    Shif 2
    Shif 3
    Shif 1
    11. Shif 2
    Shif 3
    Shif 1
    12. Shif 2
    Shif 3
    13. Shif 1
    Shif 2
    Shif 3
    Shif 1
    14. Shif 2
    Shif 3
    Shif 1
    15. Shif 2
    Shif 3
    Shif 1
    16. Shif 2
    Shif 3
    17. Shif 1
    Shif 2
    Shif 3
    Shif 1
    18. Shif 2
    Shif 3
    Shif 1
    19. Shif 2
    Shif 3
    Shif 1
    20. Shif 2
    Shif 3
    Shif 1
    21. Shif 2
    Shif 3
    Shif 1
    22. Shif 2
    Shif 3
    Shif 1
    23. Shif 2
    Shif 3
    Shif 1
    24. Shif 2
    Shif 3
    Shif 1
    25. Shif 2
    Shif 3
    Shif 1
    26. Shif 2
    Shif 3
    Shif 1
    27. Shif 2
    Shif 3
    Shif 1
    28. Shif 2
    Shif 3
    Shif 1
    29. Shif 2
    Shif 3
    Shif 1
    30. Shif 2
    Shif 3

    Pringsewu, Desember 2018


    Mengetahui,

    Penanggung Jawab Obat/ Alkes Kepala Ruang OK

    ISBIYANTORO,S.Si.Apt PUTRI DESTIANA,Amd.Kep

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