Professional Documents
Culture Documents
Form Checklist Kia Puskesmas Sungai Puar
Form Checklist Kia Puskesmas Sungai Puar
Form Checklist Kia Puskesmas Sungai Puar
Peralatan 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Pita LILA
Metlin
Refleks Patella
Buku Register KB
ANC Terpadu
Resep
Obat-obatan
Suntik KB 3 Bulan
Pil KB Kombinasi
Kondom
Paraf
Nama Pemeriksa
Jumlah
Tanjung Putra,
NIP. 19820808
24 25 26 27 28 29 30 31
Tanjung Putra, Mei 2017
Mengetahui,
Bendahara Barang
Widyastuti, Am.Kep
NIP. 198208082005012009
FORM CHECKLIST RUANG BERSALIN
PUSKESMAS SUNGAI PUAR
May-17
NO Nama Peralatan
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Manual hospital bed 3 crank
2 Meja 1/2 biro
3 Timbangan dewasa/Alat Ukur
4 bak Instrumen
5 Bengkok
6 Kom Kecil
7 Kom Sedang/tertutup
8 lampu Spiritus
9 tong Spatel
10 tornikuet
11 mono Aural
12 tensi meter
13 Tromol/Stalizaer Drum
14 Stetoskop
15 pompa asi
16 Thermometer
17 Auto Klik
18 kom besar
19 celemek
20 timbangan bayi kain
21 Saund time
22 tonometer
23 kaca pembesar
24 Diagnostik penlight
25 Hb Sahli
26 kaca kepala
27 senter
28 stimulasi anak
29 Nasogastik tube
30 murcus
31 Selang oksigen
32 pita lila
33 kateter 12 folley
34 semprit gliserin
35 corong telinga kecil
36 corong telinga sedang
37 corong telinga besar
38 sudip lidah
39 Pinset Anatomi
40 pinset bedah
41 klem
42 klem lurus tampa gigi
43 klem lurus dgn gigi
44 klem lengkung dgn gigi
45 klem lengkung tnp gigi
46 kateter logam
47 Skalple
48 1/2 kocher
49 gunting bedah lurus tajam
50 Gunting bedah lengkung tajam
51 Gunting bedah lengkung tumpul
52 gunting bedah lurus tumpul
53 Gunting pembalut/epis
54 gunting tali pusat
55 Timbangan Pijak
56 Perlak
57 Matras KK
58 Thermometer clinical
59 Sterilizator
60 Partus set
61 - Standar Dressing Forcep 14,5 cm
62 - Standar Dissecting fcps 2:3,14 cm
63 - Mayo hegar TC Needle holder 18 cm
64 - Schrodet tenaculum forceps 24 cm
65 - Forster-B-forcep straight 25 cm
66 - Bround standar Episiotomy scissors 14 cm
67 - Brusch Umbilical cord Scisstor 16 cm
68 - Instrumen BoX with lid 10x16x4cm
69 Kursi
70 Instrumen Cabinet
71 Instumen Trolley
72 Medical Weighing&heihgt measuring
73 - Instrumen tray with cover
74 - Baby Scale
75 - Double bowl stand
76 - Tiang Infus
77 - Stetoscope Double Headscope
78 -Shyngmamometer desk type
79 - Thermometer Clinical
PARAF
NAMA PEMERIKSA
JUMLAH
Apr-17
10 11 12 13 14 15 16 17 18 19
20 21 22 23 24 25 26 27 28 29
Tanjung Putra, April 2017
Mengetahui,
Bendahara Barang
Widyastuti, Am.Kep
NIP. 198208082005012009
30 31