Scribd Logo
Upload

Welcome to Scribd!

  • Form Perawatan Ambulance

    Uploaded by

    Nuna Nurjanah
    23 views2 pages
    This document is a maintenance checklist for an ambulance at the RSUD Tanah Abang hospital in an unspecified month of 2017. It contains checklists to be completed daily for items such as engine oil, radiator fluid, batteries, belts, and hoses. Additional sections cover mechanical items like brake fluid, steering, and suspension. An electrical section lists lights, starter, charger, siren, and indicators. The final section covers body/interior items such as paint, doors, cleanliness of seats and floors, and emergency equipment. Space is provided for notes and signatures of the driver and coordinator.

    Original Description:

    Form Perawatan Ambulance

    Copyright

    © © All Rights Reserved

    Available Formats

    XLS, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a maintenance checklist for an ambulance at the RSUD Tanah Abang hospital in an unspecified month of 2017. It contains checklists to be completed daily for items such as engine oil, radiator fluid, batteries, belts, and hoses. Additional sections cover mechanical items like brake fluid, steering, and suspension. An electrical section lists lights, starter, charger, siren, and indicators. The final section covers body/interior items such as paint, doors, cleanliness of seats and floors, and emergency equipment. Space is provided for notes and signatures of the driver and coordinator.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    23 views2 pages

    Form Perawatan Ambulance

    Uploaded by

    Nuna Nurjanah
    This document is a maintenance checklist for an ambulance at the RSUD Tanah Abang hospital in an unspecified month of 2017. It contains checklists to be completed daily for items such as engine oil, radiator fluid, batteries, belts, and hoses. Additional sections cover mechanical items like brake fluid, steering, and suspension. An electrical section lists lights, starter, charger, siren, and indicators. The final section covers body/interior items such as paint, doors, cleanliness of seats and floors, and emergency equipment. Space is provided for notes and signatures of the driver and coordinator.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    FORM PERAWATAN AMBULANCE RSUD TANAH ABANG

    BULAN ............. 2017

    Tanggal
    No Item Perawatan Ket
    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 Oli Mesin
    2 Air Radiator
    3 Baterai/Aki
    4 Tali Kipas
    5 Slang Radiator
    Tanggal
    No Mekanikal Ket
    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 Minyak Rem
    2 Rem Tangan/Parking
    3 Kopling
    4 Oli Persenelang
    5 Power Stering
    6 Roda Kemudi
    7 Wiper Kaca
    8 Cairan Wiper
    9 Gemouk Kolong
    10 Suspensi
    11 Tekanan Angin
    Tanggal
    No Elektik Ket
    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 Lampu Utama
    2 Sistem Starter
    3 Sistem Charger Accu
    4 Sistem Sirine
    5 Indikator Suhu
    6 Indikator BBM
    7 Indikator Speedo
    8 Changer HP
    Tanggal
    No Body/Interior Ket
    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 Cat/Warna
    2 Pintu/Kunci
    3 Kebersihan Jok
    4 Kebersihan Karpet
    5 Kebersihan Plafond Cabin
    6 Kebersihan Kemudi
    7 Kebersihan Tandu Pasien
    8 Kesegaran Udara Cabin
    9 Kebersihan Body Mobil
    10 Kebersihan Kolong Mobil
    11 Kesiapan Alat Bantu
    12 Kesiapan Apar
    13 Kesiapan Oksigen

    NB X (Tidak Ada)

    Pelaksana Ceklist Tindak Lanjut

    ( ) (_________________)
    Driver Koordinator

    You might also like