Daily Checklist Sheet (RADIOLOGY STAFF)

Radiology Staff is advised must to fill the respective checklist form on daily basis. At anytime during
visit, form can be checked by Center Incharge, Coordinator and Seniors of company.
Founding unfilled / false check may lead to strict disciplinary action.
Time-In Name: ________________ Month:______________________
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
Cleanliness of Procedure Room | Waste Bin| Couch Sheet | All Instruments| Emergency Tray along with all useful machinary is in working condition.
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
Check the Dusting| Cleanliness of Glass Doors | Waiting area | No Issue with your Instruments and Machines Like ECG, Nebulizers etc.
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
Make Sure availability of Bill Book/Inventory| Undertaking Forms | File Folders| Machinary and Equipments are dustless/ Sterilized.
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
Make sure all Furniture like Couch| Patient Chairs| Air conditioner/Heater| Lights are in well conditioned & automatic airsol is turned on.
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
TV |LCD |Mosquito Killer| Floor lights are turned on| Wall Clocks| Water Dispensor are working well| Hand sanitizers & Tissues are available.
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
Availability of Couch Sheets, Examination sheets and other housekeeping useful things and back-up are available.
Time-Out
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
At the time you leave, See Inventory Check of Instruments, Weight Machines & other Machines are left working & turned off.
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
All Instruments & Machines are Clean, Trays are equiped with emergency drugs, and ECG Machine in working condition.
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
Make sure all Furniture like Troly, Couch & Patient Chair, air conditioner/Heater are in well condition & Turned Off.
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
Pending Appointments are noted down on diary, and has inform to next coming FDO or Concern departments.
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
All entries are done manually & entered into system along with their summaries.
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
Complaint or Damage Report