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  • Set Ok Mata

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    This document is a medical supply checklist for eye surgery. It lists 20 items needed for the procedure, including infusion sets, syringes, eye drapes, medications, and surgical tools. For each item it specifies the quantity, intended use, and whether any were returned after the surgery. The checklist is signed off by both the nurse and pharmacist to confirm the supply count.

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    SET OK MATA

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    This document is a medical supply checklist for eye surgery. It lists 20 items needed for the procedure, including infusion sets, syringes, eye drapes, medications, and surgical tools. For each item it specifies the quantity, intended use, and whether any were returned after the surgery. The checklist is signed off by both the nurse and pharmacist to confirm the supply count.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    6 views1 page

    Set Ok Mata

    Uploaded by

    gqpvsh7qn9
    This document is a medical supply checklist for eye surgery. It lists 20 items needed for the procedure, including infusion sets, syringes, eye drapes, medications, and surgical tools. For each item it specifies the quantity, intended use, and whether any were returned after the surgery. The checklist is signed off by both the nurse and pharmacist to confirm the supply count.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    SET OK MATA

    NAMA PASIEN :
    DOKTER :
    HARI/TANGGAL :

    NO NAMA BARANG JUMLAH PEMAKAIAN RETUR


    1 RL SANBE/WIDA 2
    2 INFUS SET DEWASA 2
    3 ST STERIL 8 2
    4 ST STERIL 7 2
    5 ST STERIL 6,5 2
    6 NURSE CAP 1
    7 DEXAMETHASONE INJ 1
    8 LIDOCAIN INJ 2
    9 SPUIT 10 CC STERA 4
    10 SPUIT 5 CC STERA 4
    11 SPUIT 1 CC STERA 5
    12 CENDO MYDRIATIL MD 1 STRIP
    13 EYE DRAPE 1
    14 APPAVISC 1
    15 RHEX ID/TQM BLUE 1
    16 MIO-CHOL/TQM CHOL 1
    17 MICROSURGICAL STAB KNIFE 15 1
    18 CRESCENT BEVEL 2,6 1
    19 SLIT ANGLED 2,75 1
    20 BENANG T-NYLON 10.0 1

    PERAWAT FARMASI

    SET OK MATA
    NAMA PASIEN :
    DOKTER :
    HARI/TANGGAL :

    NO NAMA BARANG JUMLAH PEMAKAIAN RETUR


    1 RL SANBE/WIDA 2
    2 INFUS SET DEWASA 2
    3 ST STERIL 8 2
    4 ST STERIL 7 2
    5 ST STERIL 6,5 2
    6 NURSE CAP 1
    7 DEXAMETHASONE INJ 1
    8 LIDOCAIN INJ 2
    9 SPUIT 10 CC STERA 4
    10 SPUIT 5 CC STERA 4
    11 SPUIT 1 CC STERA 5
    12 CENDO MYDRIATIL MD 1 STRIP
    13 EYE DRAPE 1
    14 APPAVISC 1
    15 RHEX ID/TQM BLUE 1
    16 MIO-CHOL/TQM CHOL 1
    17 MICROSURGICAL STAB KNIFE 15 1
    18 CRESCENT BEVEL 2,6 1
    19 SLIT ANGLED 2,75 1
    20 BENANG T-NYLON 10.0 1

    PERAWAT FARMASI

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