INVENTARIS ALAT MEDIS

DI RUANG OK
BULAN ......................

SET SC YANG DIPESANKAN

NO ALAT MERK KODE JUMLAH
1 BAK INSTRUMEN BESAR 1

2 BENGKOK 1
3 BLASS SPECULUM SHM 18.378.25 1
4 CANULA SUCTION 1
5 CUCING KECIL 1
6 CUCING SEDANG 1
7 DOEK KLEM SHM 14.111.13 5
8 GUNTING BENANG 1
9 GUNTING JARINGAN
10 HAK TAJAM 2
11 HAND MESS NO. 4 AESCULAP BB084R 1
12 KOCKER AESCULAP BH646R 2
13 KROM BESAR AESCULAP BH447R 2
14 LANGEN BACK SHM 18.131.21 2
15 MIKULIK AESCULAP BJ314R 4
16 NALDFOODER BESAR AESCULAP BM067R 1
17 NALDFOODER KECIL AESCULAP BM035R 1
18 PEAN KECIL AESCULAP BH424R 4
19 PINCET ANATOMIS MANIS AESCULAP FB402R 1
20 PINCET CIRUGIS KECIL AESCULAP BD667R 1
21 PINCET CIRUGIS SEDANG AESCULAP BD560R 2
22 RING TANG AESCULAP BF122R 6
23 RING TANG SHM 16.170.25 1
24 TIMAN / SLEBOR 1

INVENTARIS ALAT MEDIS

DI RUANG OK
BULAN ......................

CHEKLIST INSTRUMEN
SET SC
ALAT MEDIS MERK KODE JUMLAH
NO

1 BAK INSTRUMEN BESAR 1

2 BENGKOK 1
3 CUCING SEDANG 1
4 CUCING KECIL 1
5 BLASS SPEKULUM SHM 18.378.25 1
6 TIMAN SHM 18.187.38 1
7 DOCK KLEM SHM 14.111.13 5
8 LANGEN BACK SHM 18.131.21 2
9 GUNTING BENANG SHM 08.120.16 1
10 RING TANG AESCULAP BF122R 6
11 MIKULIK AESCULAP BJ314R 4
12 KROM BESAR AESCULAP BH447R 2
13 KOCKER BESAR AESCULAP BH646R 2
14 HAK TAJAM AESCULAP BT260R 2
15 HAND MESS NO 4 AESCULAP BB084R 1
16 PEAN KLEM AESCULAP BH424R 4
17 GUNTING JARINGAN AESCULAP BE592R 1
18 NALDFOODER BESAR AESCULAP BM067R 1
19 NALDFOODER KECIL AESCULAP BM035R 1
20 PINCET CIRUGIS AESCULAP BD560R 2
21 PINCET ANATOMIS AESCULAP FB402R 1
22 PINCET CIRUGIS KECIL AESCULAP BD667R 1
23 CANULA SUCTION 1
24 RING TANG SHM 16.702.55 1

INVENTARIS ALAT MEDIS

DI RUANG OK
BULAN ......................

CHEKLIST INSTRUMENT
LAPARATOMY / SC
NO ALAT MEDIS MERK KODE JUMLAH
1 SCALPEL HANDEL NO 4 AESCULAP BB084R 1
2 STANDARD TISSUE FORCEP AESCULAP BD560R 2
3 SEMKER TISSUE FORCEP AESCULAP BD667R 1
4 PINCET ATRAUMATIC AESCULAP FB402R 1
5 NDL HOLDER AESCULAP BM035R 1
6 HAK TAJAM AESCULAP BT260R 2
7 PEAN AESCULAP BH424R 5
8 KOCKER FORCEP AESCULAP BH646R 4
9 MIKULIK AESCULAP BJ314R 4
10 KROM KLEM AESCULAP BH447R 7
11 RINGTANG AESCULAP BF122R 6
12 GUNTING OPERASI AESCULAP BC592R 1
13 GUNTING BENANG SHM 08.120.16 1
14 DOEK KLEM SHM 14.111.15 5
15 LANGEN BACK SHM 18.131.21 2
16 RIGHTANGALE SHM 12.459.28 2
17 MYOM BOOR SHM 70.641.17 1
18 SPATEL LIDAH SHM 18.170.50 1
19 BAB COOL AESCULAP FB936R 2
20 TIMAN KECIL SHM 18.181.22 1
21 TIMAN SEDANG SHM 18.187.50 1
22 TIMAN BESAR SHM 18.187.75 1
23 TROICAR SHM 22.104.00 1
24 BENGKOK MAGNATE STAINLESS 18-8 1
25 CUCING SEDANG MAGNATE STAINLESS 18-8 1
26 CUCING KECIL 1
27 SPERDER SHM 18.746.18 1
28 ALLIS AESCULAP EA020R 2
29 CANULA SUCTION 1
30 NALD FOODER BESAR AESCULAP BM067R 1
31 RINGTANG SHM 16.170.25 1
32 BLASS SPEKULUM SHM 18.378.25 1

CHEKLIST INSTRUMEN
SET SC
NO ALAT MEDIS MERK KODE JUMLAH
1 BAK INSTRUMEN BESAR 1
2 BENGKOK 1
3 CUCING SEDANG 1
4 CUCING KECIL 1
5 BLASS SPEKULUM SHM 18.378.25 1
6 TIMAN SHM 18.187.38 1
7 DOCK KLEM SHM 14.111.13 5
8 LANGEN BACK SHM 18.131.21 2
9 GUNTING BENANG SHM 08.120.16 1
10 RING TANG AESCULAP BF122R 6
11 MIKULIK AESCULAP BJ314R 4
12 KROM BESAR AESCULAP BH447R 2
13 KOCKER BESAR AESCULAP BH646R 2
14 HAK TAJAM AESCULAP BT260R 2
15 HAND MESS NO 4 AESCULAP BB084R 1
16 PEAN KLEM AESCULAP BH424R 4
17 GUNTING JARINGAN AESCULAP BE592R 1
18 NALDFOODER BESAR AESCULAP BM067R 1
19 NALDFOODER KECIL AESCULAP BM035R 1
20 PINCET CIRUGIS AESCULAP BD560R 2
21 PINCET ANATOMIS AESCULAP FB402R 1
22 PINCET CIRUGIS KECIL AESCULAP BD667R 1
23 CANULA SUCTION 1
24 RING TANG SHM 16.702.55 1
 CHEKLIST INSTRUMENT
LAPARATOMY / SC
NO ALAT MEDIS MERK KODE JUMLAH
1 SCALPEL HANDEL NO 4 AESCULAP BB084R 1
2 STANDARD TISSUE FORCEP AESCULAP BD560R 2
3 SEMKER TISSUE FORCEP AESCULAP BD667R 1
4 PINCET ATRAUMATIC AESCULAP FB402R 1
5 NDL HOLDER AESCULAP BM035R 1
6 HAK TAJAM AESCULAP BT260R 2
7 PEAN AESCULAP BH424R 5
8 KOCKER FORCEP AESCULAP BH646R 4
9 MIKULIK AESCULAP BJ314R 4
10 KROM KLEM AESCULAP BH447R 7
11 RINGTANG AESCULAP BF122R 6
12 GUNTING OPERASI AESCULAP BC592R 1
13 GUNTING BENANG SHM 08.120.16 1
14 DOEK KLEM SHM 14.111.15 5
15 LANGEN BACK SHM 18.131.21 2
16 RIGHTANGALE SHM 12.459.28 2
17 MYOM BOOR SHM 70.641.17 1
18 SPATEL LIDAH SHM 18.170.50 1
19 BAB COOL AESCULAP FB936R 2
20 TIMAN KECIL SHM 18.181.22 1
21 TIMAN SEDANG SHM 18.187.50 1
22 TIMAN BESAR SHM 18.187.75 1
23 TROICAR SHM 22.104.00 1
24 BENGKOK MAGNATE STAINLESS 18-8 1
25 CUCING SEDANG MAGNATE STAINLESS 18-8 1
26 CUCING KECIL 1
27 SPERDER SHM 18.746.18 1
28 ALLIS AESCULAP EA020R 2
29 CANULA SUCTION 1
30 NALD FOODER BESAR AESCULAP BM067R 1
31 RINGTANG SHM 16.170.25 1
32 BLASS SPEKULUM SHM 18.378.25 1

CHEKLIST INSTRUMENT
SET SC / LAPARATOMY + TAMBAHAN
NO ALAT MEDIS MERK KODE JUMLAH
1 BAK INSTRUMEN 1
2 BENGKOK 1
3 CUCING SEDANG 2
4 CUCING KECIL 1
5 RINGTANG AESCULAP BF122R 6
6 KOCKER AESCULAP BH646 5
7 HAND MESS NO 4 AESCULAP BB084R 1
8 PEAN KECIL AESCULAP BH424R 7
9 PINCET CIRUGIS SEDANG AESCULAP BD560R 2
10 PINCET CIRUGIS KECIL AESCULAP BD667R 1
11 PINCET ANATOMIS AESCULAP FB402R 1
12 HAK TAJAM AESCULAP BT260R 2
13 KROM BESAR AESCULAP BH447R 7
14 MIKULIK AESCULAP BJ314R 4
15 NALD FOODER BESAR AESCULAP BM067R 1
16 NALD FOODER KECIL AESCULAP BM035R 1
17 GUNTING JARINGAN AESCULAP BC592R 1
18 GUNTING JARINGAN AESCULAP BC284R 1
19 HAK TAJAM AESCULAP BT124R 2
20 KOGEL TANG AESCULAP EO110R 2
21 ELIS KLEM AESCULAP EA020R 2
22 NEEDLE AESCULAP BL212N 12
23 BENGKOK FB936R 2
24 DARM KLEM AESCULAP EA140R 3
25 KROM BESAR AESCULAP BJ041R 4
26 BIOPSI TANG AESCULAP ER070R 1
27 MYOMA BOOR SHM 70.641.17 1
28 LANGEN BACK BESAR SHM 18.135.25 2
29 BLASS SPEKULUM SHM 18.378.25 1
30 RING TANG SHM 16.170.25 1
31 CANULA SUCTION 1
32 PINCET ANATOMIS SMICS 1
33 DOEK KLEM SHM 14.111.13 5
34 LANGEN BACK SHM 18.131.21 2
35 GUNTING BENANG SHM 08.165.17 1

INVENTARIS ALAT MEDIS

DI RUANG OK
BULAN ......................

CHEKLIST INSTRUMENT
SET SC / LAPARATOMY + TAMBAHAN
NO ALAT MEDIS MERK KODE JUMLAH
1 BAK INSTRUMEN 1
2 BENGKOK 1
3 CUCING SEDANG 2
4 CUCING KECIL 1
5 RINGTANG AESCULAP BF122R 6
 6 KOCKER AESCULAP BH646 5
7 HAND MESS NO 4 AESCULAP BB084R 1
8 PEAN KECIL AESCULAP BH424R 7
9 PINCET CIRUGIS SEDANG AESCULAP BD560R 2
10 PINCET CIRUGIS KECIL AESCULAP BD667R 1
11 PINCET ANATOMIS AESCULAP FB402R 1
12 HAK TAJAM AESCULAP BT260R 2
13 KROM BESAR AESCULAP BH447R 7
14 MIKULIK AESCULAP BJ314R 4
15 NALD FOODER BESAR AESCULAP BM067R 1
16 NALD FOODER KECIL AESCULAP BM035R 1
17 GUNTING JARINGAN AESCULAP BC592R 1
18 GUNTING JARINGAN AESCULAP BC284R 1
19 HAK TAJAM AESCULAP BT124R 2
20 KOGEL TANG AESCULAP EO110R 2
21 ELIS KLEM AESCULAP EA020R 2
22 NEEDLE AESCULAP BL212N 12
23 BENGKOK FB936R 2
24 DARM KLEM AESCULAP EA140R 3
25 KROM BESAR AESCULAP BJ041R 4
26 BIOPSI TANG AESCULAP ER070R 1
27 MYOMA BOOR SHM 70.641.17 1
28 LANGEN BACK BESAR SHM 18.135.25 2
29 BLASS SPEKULUM SHM 18.378.25 1
30 RING TANG SHM 16.170.25 1
31 CANULA SUCTION 1
32 PINCET ANATOMIS SMICS 1
33 DOEK KLEM SHM 14.111.13 5
34 LANGEN BACK SHM 18.131.21 2
35 GUNTING BENANG SHM 08.165.17 1
 KETERANGAN

ADA
ADA

ADA
ADA

ENTARIS ALAT MEDIS

DI RUANG OK
ULAN ......................

HEKLIST INSTRUMEN
SET SC
MINGGU KETERANGAN
1 2 3 4
ENTARIS ALAT MEDIS
DI RUANG OK
ULAN ......................

EKLIST INSTRUMENT
LAPARATOMY / SC
1 2 3 4 KETERANGAN
 DI SINGLE, DI PACKING

DI PACKING

KETERANGAN
 KETERANGAN

DI SINGLE, DI PACKING

DI PACKING

KETERANGAN
 DI KELUARKAN
1 DI KELUARKAN

3 KELUAR UNTUK SC 1

ENTARIS ALAT MEDIS

DI RUANG OK
ULAN ......................

EKLIST INSTRUMENT
APARATOMY + TAMBAHAN
1 2 3 4 KETERANGAN
DI KELUARKAN
1 DI KELUARKAN

3 KELUAR UNTUK SC 1
 INVENTARIS ALAT MEDIS
DI RUANG OK
BULAN ......................

NO ALAT MEDIS MERK KODE JUMLAH KALIBRASI

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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
MEDIS

.....

EXP. DATE KETERANGAN NO

Tgl. Masuk Tgl. Keluar Kondisi
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
 INVENTARIS ALAT MEDIS
DI RUANG OK
BULAN ......................

ALAT MEDIS MERK KODE JUMLAH MINGGU

1 2 3
MEDIS

.......

NGGU KALIBRASI EXP. DATE KETERANGAN

4 Tgl. Masuk Tgl. Keluar Kondisi
 INVENTARIS ALAT MEDIS
DI RUANG RAWAT INAP RSIA KENDANGSARI MERR

NO ALAT MEDIS MERK KODE JUMLAH KALIBRASI EXP. DATE KETERANGAN

TGL. MASUK TGL. KELUAR
1 STETOSCOP DEWASA 2
2 STETOSCOP ANAK 2
3 TENSI DIGITAL 2
4 TENSI RAKSA 1
5 TERMOMETER DIGITAL 2
6 TERMOMETER MANUAL 2
7 TERMOMETER RECTAL 2
8 TORNIQUET 2
9 BENGKOK STENLIS 3
10 BENGKOK PLASTIK 2
11 ULTRASONIC GEL 2
12 STANDART INFUS 3
13 PISPOT PLASTIK 3
14 PISPOT STENLES 5
15 GELAS UKUR URINE 2
16 BASKOM SEKA 4
17 TROLI BASKOM SEKA 2
18 TROLI STENLESS 3
19 PEN LIGHT 2
20 KORENTANG 2
21 TEMPAT KORENTANG 2
22 BAK INSTRUMENT 3
23 BAK INJEKSI 1
24 CUCING 3
25 KOM * 3
26 GUNTING EPISIOTOMI 1
27 PINSET ANATOMIS 5
28 PINSET CIRUGIS 5
29 BAKI STENLESS 2
30 GUNTING AJ 4
31 PISPOT UNTUK LAKI-LAKI 5
32 KURSI RODA 1
33 MANSET TENSI ANAK 2
34 O2 TRANSPORT 1
35 HUMIDIFIRE 1
36 FLOW METER 1
37 TROLI O2 TRANSPORT 1
38 NEBULAIZER 1
 INVENTARIS ALAT MEDIS
DI RUANG RAWAT INAP RSIA KENDANGSARI MERR
BULAN ...............

ANGAN MINGGU
NO ALAT MEDIS MERK KODE JUMLAH KALIBRASI
KONDISI 1 2 3 4
1 STETOSCOP DEWASA 2
2 STETOSCOP ANAK 2
3 TENSI DIGITAL 2
4 TENSI RAKSA 1
5 TERMOMETER DIGITAL 2
6 TERMOMETER MANUAL 2
7 TERMOMETER RECTAL 2
8 TORNIQUET 2
9 BENGKOK STENLIS 3
10 BENGKOK PLASTIK 2
11 ULTRASONIC GEL 2
12 STANDART INFUS 3
13 PISPOT PLASTIK 3
14 PISPOT STENLES 5
15 GELAS UKUR URINE 2
16 BASKOM SEKA 4
17 TROLI BASKOM SEKA 2
18 TROLI STENLESS 3
19 PEN LIGHT 2
20 KORENTANG 2
21 TEMPAT KORENTANG 2
22 BAK INSTRUMENT 3
23 BAK INJEKSI 1
24 CUCING 3
25 KOM * 3
26 GUNTING EPISIOTOMI 1
27 PINSET ANATOMIS 5
28 PINSET CIRUGIS 5
29 BAKI STENLESS 2
30 GUNTING AJ 4
31 PISPOT UNTUK LAKI-LAKI 5
32 KURSI RODA 1
33 MANSET TENSI ANAK 2
34 O2 TRANSPORT 1
35 HUMIDIFIRE 1
36 FLOW METER 1
37 TROLI O2 TRANSPORT 1
38 NEBULAIZER 1
39 SUCTION 1
 KETERANGAN
EXP. DATE
TGL. MASUK TGL. KELUAR KONDISI
 INVENTARIS ALAT MEDIS
DI RUANG VK
BULAN ......................

MINGGU
NO ALAT MEDIS MERK KODE JUMLAH
1
1 GUNTING EPISIOTOMI SHM 08.901.18 2
2 GUNTING EPISIOTOMI SHM 08.560.14 3
3 GUNTING TALIPUSAT SHM 08.551.16 5
4 KLEM KOKER 10
5 KLEM PANJANG SHM 16.230.26 1
6 GUNTING BENANG SHM 08.120.16 5
7 SETENGAH KOKER SHM 70.559.26 4
8 CUCING 10
9 NALDFOODER PANJANG SHM 24.190.20 3
10 NALDFOODER PENDEK SHM 24.170.14 5
11 CATETER LOGAM 1
PINSET ANATOMI PANJANG AESCULAP FB402R
12 PINSET ANATOMI PENDEK SHM 10.110.16 12
13 PINSET CIRUGIS AESCULAP BD561R 6
14 BAK INSTRUMEN KECIL 4
15 BAK INSTRUMEN BESAR 2
16 KOM SAFLON + TUTUP 1
17 KOM TANPA TUTUP 2
18 SPEKULUM L SHM 70.241.03 2
19 SPEKULUM L SHM 70.211.02 1
20 SPEKULUM U SHM 70.291.00 2
21 SPEKULUM U SHM 70.291. 3
22 SONDE UTERUS 3
23 SOENDOK KURET 15
24 SENDOK KURET BOLAK BALIK AESCULAP ER585R 1
23 TENAKULUM AESCULAP EO110R 2
24 TENAKULUM SHM 70.502.25 2
25 TAMPONTANG SHM 16.231.26
26 TAMPONTANG SHM 16.233.26 3
27 RING TANG AESCULAP BF122R 1
28 RING TANG SHM 16.170.25 1
29 BUSI SHM 70.425.08
BUSI SHM 70.405.14
30 BUSI SHM 84.190.25 22
31 ABORTUS TANG SHM 72.244.02 4
SPEKULUM COCOR BEBEK SHM 70.140.03 4
32 SPEKULUM COCOR BEBEK SHM 70.140.02 2
SPEKULUM COCOR BEBEK SHM 70.140.01 2
HAND MESS SHM 06.103.00 2
34 SELANG VAKUM PANJANG 1
35 SELANG VAKUM PENDEK 1
36 VAKUM SILICON 1
37 VAKUM BESI + CUP 3
38 PENGAIT 1
39 FILTER BESAR 4
40 FILTER SEDANG 6
41 FILTER KECIL 5
42 POMPA 1
43 TABUNG VAKUM 1
44 TROMOL KECIL 3
45 KORENTANG 3
46 TEMPAT KORENTANG 2
47 BENGKOK 3
48 DOPLER 2
49 TROLI 4
50 STANDAR INFUS 2
51 TENSI RAKSA 1
52 TENSI DIGITAL 2
53 STETOSKOP DEWASA 2
54 STETOSKOP BAYI 1
55 TIMBANGAN BAYI 1
56 TIMBANGAN DEWASA 1
57 INFANT WARMER 1
58 LAMPU SOROT 3
59 LAMPU TINDAKAN *
60 O2 TRANSPORT 1
61 HUMIDIFIRE 3
62 FLOW METER 3
63 TROLI O2 TRANSPORT 1
64 HAMMER REFLEK
65 USG PORTABLE 1
 ARIS ALAT MEDIS
I RUANG VK
N ......................

MINGGU KETERANGAN
KALIBRASI EXP. DATE
2 3 4 Tgl. Masuk Tgl. Keluar Kondisi
DI PINJAM UGD 1

BELUM ADA
 INVENTARIS ALAT MEDIS
DI RUANG VK
BULAN ......................

NO ALAT MEDIS MERK KODE JUMLAH

1 GUNTING EPISIOTOMI SHM 08.901.18 2

2 GUNTING EPISIOTOMI SHM 08.560.14 3
3 GUNTING TALIPUSAT SHM 08.551.16 5
4 KLEM KOKER 10
5 KLEM PANJANG SHM 16.230.26 1
6 GUNTING BENANG SHM 08.120.16 5
7 SETENGAH KOKER SHM 70.559.26 4
8 CUCING 10
9 NALDFOODER PANJANG SHM 24.190.20 3
10 NALDFOODER PENDEK SHM 24.170.14 5
11 CATETER LOGAM 1
12 PINSET ANATOMI PANJANG AESCULAP FB402R
13 PINSET ANATOMI PENDEK SHM 10.110.16 12
14 PINSET CIRUGIS AESCULAP BD561R 6
15 BAK INSTRUMEN KECIL 4
16 BAK INSTRUMEN BESAR 2
17 KOM SAFLON + TUTUP 1
18 KOM TANPA TUTUP 2
19 SPEKULUM L SHM 70.241.03 2
20 SPEKULUM L SHM 70.211.02 1
21 SPEKULUM U SHM 70.291.00 2
22 SPEKULUM U SHM 70.291. 3
23 SONDE UTERUS 3
24 SOENDOK KURET 15
25 SENDOK KURET BOLAK BALIK AESCULAP ER585R 1
26 TENAKULUM AESCULAP EO110R 2
27 TENAKULUM SHM 70.502.25 2
28 TAMPONTANG SHM 16.231.26
29 TAMPONTANG SHM 16.233.26 3
30 RING TANG AESCULAP BF122R 1
31 RING TANG SHM 16.170.25 1
32 BUSI SHM 70.425.08
33 BUSI SHM 70.405.14
34 BUSI SHM 84.190.25 22
35 ABORTUS TANG SHM 72.244.02 4
36 SPEKULUM COCOR BEBEK SHM 70.140.03 4
37 SPEKULUM COCOR BEBEK SHM 70.140.02 2
38 SPEKULUM COCOR BEBEK SHM 70.140.01 2
39 HAND MESS SHM 06.103.00 2
40 SELANG VAKUM PANJANG 1
41 SELANG VAKUM PENDEK 1
42 VAKUM SILICON 1
43 VAKUM BESI + CUP 3
44 PENGAIT 1
45 FILTER BESAR 4
46 FILTER SEDANG 6
47 FILTER KECIL 5
48 POMPA 1
49 TABUNG VAKUM 1
50 TROMOL KECIL 3
51 KORENTANG 3
52 TEMPAT KORENTANG 2
53 BENGKOK 3
54 DOPLER 2
55 TROLI 4
56 STANDAR INFUS 2
57 TENSI RAKSA 1
58 TENSI DIGITAL 2
59 STETOSKOP DEWASA 2
60 STETOSKOP BAYI 1
61 TIMBANGAN BAYI 1
62 TIMBANGAN DEWASA 1
63 INFANT WARMER 1
64 LAMPU SOROT 3
65 LAMPU TINDAKAN *
66 O2 TRANSPORT 1
67 HUMIDIFIRE 3
68 FLOW METER 3
69 TROLI O2 TRANSPORT 1
70 HAMMER REFLEK
71 USG PORTABLE 1
IS ALAT MEDIS
UANG VK
....................

KALIBRASI EXP. DATE KETERANGAN

Tgl. Masuk Tgl. Keluar Kondisi
DI PINJAM UGD 1

BELUM ADA
 INVENTARIS ALAT MEDIS
DI RUANG BAYI
BULAN ......................

NO ALAT MEDIS MERK KODE JUMLAH

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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
MEDIS
YI
.......

KALIBRASI EXP. DATE KETERANGAN NO

Tgl. Masuk Tgl. Keluar Kondisi
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
 INVENTARIS ALAT MEDIS
DI RUANG BAYI
BULAN ......................

ALAT MEDIS MERK KODE JUMLAH MINGGU

1 2 3
AT MEDIS
BAYI
............

INGGU KALIBRASI EXP. DATE KETERANGAN

4 Tgl. Masuk Tgl. Keluar Kondisi
 INVENTARIS ALAT MEDIS
DI RUANG NICU
BULAN ......................

NO ALAT MEDIS MERK KODE JUMLAH KALIBRASI

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
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S

EXP. DATE KETERANGAN NO

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 INVENTARIS ALAT MEDIS
DI RUANG NICU
BULAN ......................

ALAT MEDIS MERK KODE JUMLAH MINGGU

1 2 3
EDIS

.....

INGGU KALIBRASI EXP. DATE KETERANGAN

4 Tgl. Masuk Tgl. Keluar Kondisi
 INVENTARIS ALAT MEDIS
DI RUANG POLI DAN IGD
BULAN....

KETERANGAN MINGGU
NO ALAT MEDIS MERK CODE JUMLAH
Kondisi 1
1 BAK INSTRUMEN BESAR 4
2 BAK INSTRUMEN SEDANG 4
3 CUCING 15
4 BENGKOK 4
5 KORENTANG + TEMPAT 4
6 SPEKULUM KECIL SHM 7029101 10
7 SPEKULUM KECIL SHM 7012001 11
8 SPEKULUM SEDANG SHM 7012002 10
9 SPEKULUM BESAR SHM 7012003 10
10 TAMPON TANG SHM 1623126 11
11 SONDE 10
12 PINSET CIRUGIS KECIL SHM 4282010 6
13 PINSET ANATOMIS KECIL SHM 4290209 4
14 TANAKULUM SHM 7050425 11
15 BIOPSI TANG SHM 7062404 2
16 CROCODILE SHM 4623103 3
17 GUNTING AJ SHM 812016 11
18 GUNTING MACEMBUNG ( IUD ) SHM 816523 1
19 PINCET ANATOMI BESAR SHM 1012014 7
20 PINCET CIRUGIS BESAR SHM 1011016 5
21 KLEM SHM 2417015 2
22 TROMOL KECIL 1
23 TROMOL BESAR 2
24 BAK INSTRUMEN KECIL 1
25 KOM TUTUP
26 AFF IUD 3
27 STETOSKOP BESAR ONEMED 3
28 STETOSKOP KECIL RIESTAR 3
29 TERMOMETER DIGITAL THERMOMED 5
30 TERMOMETER RAKSA 1
31 PEN LIGHT MAGIC STAR 3
32 TABUNG O2 1
33 ECG 1
34 SUCTION 1
35 NEBULAIZER OMRO 1
36 TENSI DIGITAL OMRO 3
37 TENSI MANUAL RIESTAR 1
38 TIMBANGAN BAYI LAICA 3
39 TIMBANGAN DEWASA 2
40 O2 TEMPEL MANUVER 2
41 GUNTING HEATING YAMACO 1
42 STANDAR INFUS 2
43 MATLINE 2
44 PENGUKUR PANJANG BADAN 1
45 LAMPU GINEK 2
46 USG 2
47 BED OBGYN 2
48 MEJA GINEK 1
49 THERMOMETER TOUCH BERRUER 2