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CHECK LIST PERHITUNGAN KASA DAN INSTRUMENT

Tanggal : No. RM :
Nama : Ruangan :
SET PEDIATRIK

JUMLAH
NO NAMA ALAT KETERANGAN
SEBELUM SESUDAH
1 Pincet Anatomis 2
2 Pincet Cirurgis 2
3 Bengkok 2
4 Cucing 3
5 Skapell No. 3 1
6 Ringtang 3
7 Elis 4
8 Needle Holder (Nald Puder) 2
9 Gunting Jaringan 1
10 Gunting Benang 2
11 Klem 12
12 Kocher Lurus 2
13 Doek Klem 6
14 Hak S 1
15 Kanul Suction 1
16 Hak Gigi 4 Kecil 2
17 Gaas
18 Darem Gaas

Instrumen On Loop

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