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Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2017 1 Yuli v
2 Deyanti v
3 Nia v
4 Ai jubaedah v
5 Mursalena v
6 Delma v v
6 1

02/03/2017 7 Yuli v v
8 Siti v v
9 Rina v
10 Ira rahani v
4 1 1

03/03/2017 11 Ira rahani v


12 Reni v v
13 Anis v v
14 Cedina v v
15 Erni v v
16 Yuli v v
17 Halimah v
7 4 1

04/03/2017 18 Ani v
19 Ira rahani v
20 Ani v
21 Jumiati v v
22 Mursalina v
23 Sri v
24 Eli v v
25 Rohayati v v
8 2 1

05/03/2017 26 yani v v
27 Eni v
28 Ratna v
29 Mursalina v
30 Eli v v
31 Rohayati v
6 1 1

06/03/2017 32 Anggi v
33 Eni v
34 Rika v
35 Eli v v
36 Rohayati v v
37 Popon v
38 Ai rohaeti v
7 1 1

07/03/2017 39 Anggi v v
40 Ai rohaeti v v
41 Rika v v
42 Rohayati v
43 Popon v v
44 Euis v
45 Yuyun v v
7 5

08/03/2017 46 Lisdawati v
47 Rani v
48 Fitri v
49 Rossi v v
50 Euis v
5 1

09/03/2017 51 Rossi v v
52 Siti A v v
53 Rani v
54 Rossa v
55 Fitri v v
56 Lisdawati v v
57 Yeni v
58 Didah v
8 4

10/03/2017 59 Sri v
60 Asyifa v
61 Titin v
62 Didah v v
63 Lia v
64 Ira rahani v v
65 Lala v
66 Rossi v v
67 Oky v v
9 4

11/03/2017 68 Halimah v
69 Santi v
70 Lia v
71 Ira rahani v
4
12/03/2017 72 Yani v v
73 Widiasari v v
74 Halimah v v
75 Ika k v
4 3

13/03/2017 76 Siti S v
77 Nengsih v
78 Sintia v v
3 1
14/03/2017 79 Rias v v
80 Siti S V
81 Fitri v v
82 Nengsih v v
83 Titin v
84 Iis v
6 3
15/03/17 85 lia v
86 titin v
87 iis v v
3 1
16/03/17 88 Titin v
89 Septi v
90 Ida v v
91 LIa Soleha v
92 Fitriyani v
5 1
17/03/2017 93 Heni v
94 Purni v
95 Nurdiani v
96 Ida v
97 Lia v
98 Fitriyani v
6
18/03/17 99 ina v
100 rina v v
101 purni v v
102 nurdiani v v
103 ema v
104 oya v
6 3
19/03/2017 105 oya v
1
20/03/2017 106 titin v
107 fitrahulloh v
108 Reni v
3 0
21/03/17 109 titin v v
110 nuraeni v v
111 yuliawati v v
3 3
22/03/17 112 linda v v
113 ani v
114 pika v
115 anggi v v
116 kartika v v
5 3
23/03/17 117 Fani v
118 Silvia v v
119 Diana v
120 Ani M v v
121 Euis v
122 Yulianti v
6 2
24/03/17 123 diana v
124 ani v
125 mala v v
126 febriyani v
127 euis v v
128 yulianti v v
129 yeni v
130 siti n v
8 3
25/03/2017 131 Erniawati v v
132 Yeni v v
133 Fitria v
134 Ani v v v v
135 Siti nur v v
136 Tina v
1 6 4 1

26/03/2017 137 Daryanti v


138 Ani v v v
1 2 1
27/03/2017 139 Daryanti v
140 Ani v v
141 Herawati v
1 3
28/03/17 142 siti jubaedah v
143 siti latifah v v
144 andri v v
145 lia v
4 2
29/3/2017 146 siti rohayati v v
147 rindawati v
148 listini v v
149 nurmaya v
3 3
30/03/2017 150 Febriyyani v
151 Nury v
152 Irma v
153 Ati v
4
31/03/2017 154 Febbriyyanni v
155 Ati v
156 Herni v
157 Ice v v
158 Ary v v
5 2
3 157 59 6

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2017 1 Ice v
2 Herni v
3 Erna v
4 Titin v
5 Ina v
6 Tina v
7 Febbriyyani v
8 Wiwin v v
9 Visa v
9 1

02/04/2017 10 Desi v v
11 Visa v
12 Ulpa v v
13 Sri v
14 Febbriyani v
5 2

03/04/2017 15 Febriyyani v
16 Neti v
17 Visa v
18 Yulia v
19 Sri fuji v
5

04/04/2017 20 Febriyyani v
21 Neti v v
22 Visa v
23 Euis v v
24 Yulia v v
25 Nia v
26 Sinta v
27 Ria v
28 Meti v
9 3
05/04/2017 29 Nita v
30 Febbriyyani v v
31 Lia v
32 Visa v v
33 Asrina v v
34 Eha v
35 Siti aisyah v v
7 4

06/04/2017 36 neni v
37 maryam v
38 nita v
39 rinda v
40 pipit v
41 dede ida v v
42 lia v
43 dede nurmalasari v
44 eha v v
9 2

07/04/2017 45 Neni v v
46 Pipit v
47 Rinda v
3 1

08/04/2017 48 Nining v
49 Siska v
50 Eni v v
51 Kokom v
52 Noneng v
5 1

09/04/2017 53 Siska v v
54 Eni v v
55 Eka v
56 Risa v
4 2

10/04/2017 57 Mala v v
58 Dewi v
59 Tuti v
60 Siska v v
61 Jeni v
5 2

11/04/2017 62 Tuti v v
63 Siska v
64 Jeni v v
65 Nunung v
66 Rosidah v v
67 Heni v v
68 Laela v
69 Nita v
8 4

12/04/2017 70 Mega v
71 Nunung v v
72 Rita v v
73 Mutiara v v
74 Adawiyah v
75 Laela v
76 Susanti v v
7 4
13/04/17 77 nita v
78 siti nugraha v
79 weny v v
80 laela mukti v v
81 mega v v
82 lusy v
83 adawiyah v v
84 caryati v
9 4
14/04/2017 85 Nurfauziah v
86 Siti nugraha v
87 Rusliah v v
88 Weni v
89 Karwati v v
90 Caryati v v
91 Nisa v
7 3
15/04/2017 92 Nurfauziah v
93 Neni v
94 Eneng v v
3 1
16/04/2017 95 Kharimah v
96 Nuraini v
97 Kokom v 1
3 1
17/04/2017 98 Siti n v v
99 Lina k v v
100 Kokom v v
101 Kharimah v
102 Neni y v
103 Halimah v
6 3
18/04/2017 104 Karmila v
105 Reni v
106 Sindi v v
107 Fitriyani v v
108 Lia v v
109 Rani v
6 3
19/04/2017 110 Reni v v
111 Mira v v
112 Risa v v
113 Karmila v
114 Lia v v
115 Heni v
116 Lina v
7 4
20/04/2017 117 Melawatini v
118 Tsuroyo v
119 Tuti s v v
120 Nursiti v
121 Heni v v
122 Sri n v
123 Verawati v
7 2
21/04/2017 124 Melawatini v v
125 Irna v v
126 Dati v
127 Nursiti v
128 Nina v v
129 Lilis v v
130 Tsuroya v
131 Nopi v
132 Irmawati v v
9 5
22/04/2017 133 Siti H v
134 Dati v v
135 Santika v
136 Nopi v v
137 Irmawati v
138 Ina v
139 Reni v
7 2
23/04/2017 140 Dini v v
141 Santika v v
142 Yati v
143 Ina v
144 Haeni v
145 Siti M v
146 Soliha v
147 Reni v
8 2
24/04/2017 148 Yati v
149 Siti m v
150 Soliha v
151 Titin v v
152 Yoke v v
5 2
25/04/2017 153 isma v
154 lia v
155 sindi v
156 yoke v v
4 1
26/04/2017 157 indri v
158 Dewi v
159 Yani v
160 Wati v v
4 1

27/04/2017 161 rani v


162 indri v
163 dewi v
164 yani v
165 rosita v
166 siti sarah v v
167 imas v
168 yuli v
169 agnia v v
9 2
28/04/2017 170 Lela/suhendar v
171 Siti sarah v v
172 Aghnia v v
173 Lela/karso v v
174 Imas siti v
175 Imas romlah v v
6 4
29/04/2017 176 pipih v v
177 mayang v
178 ermawati v
179 elis v
180 lela v
181 fauziah v v
182 aghnia v
7 2
30/04/2017 183 Mumun v v
184 Pipih v v
185 Mayang v
186 Iceu v v
187 Karmilah v v
188 Oya v v
6 5
188 74

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MEI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2017 1 Mayang v
2 Iceu v v
3 Mira v v
4 Dede v v
5 Vera v
6 Lilis v
6 3

02/05/2017 7 Vera v
8 Esih v
9 Lilis v
10 Yeni v
11 Karmilah v
12 Nurhasanah v
5 1
03/05/2017 13 Intan v v
14 Fera v v
15 Esih v v
16 Darti v
17 Siti s v v
18 Rina v
19 Karneti v
7 4
04/05/2017 20 Mega v v
21 Karneti v
22 Siti s v v
23 Diana v v
24 Nurfauziah v
25 Nani v v
26 Darti v v
27 Kartika v v
28 Reni v v
29 Siti sarah v
10 7
05/05/2017 30 Diana v v
31 Nurfauziah v
32 Ika v v
33 Leti v v
34 Siti nuriah v v
35 Siti sarah v v
6 5
06/05/2017 36 Dede v
37 Sari v v
38 Widi v v
39 Siti solehah v
40 Nela v
41 Rosi v v
6 3
07/05/2017 42 Lasmanah v v
43 Siti solihah v
44 Nina v
45 Kokom v
46 Rossi v
5 1
08/05/2017 47 Susi susanti v v
48 Siti fatimah v v
49 Rima v
50 Siti solehah v v
4 3
09/05/2017 51 Yati v v
52 Siti solehah v v
53 Ipah v
54 Yanti v
55 Erni v
56 Rima v v
57 Dede v
58 Tira v
8 3
10/05/2017 59 Nia v
60 Friska v
61 reni v
62 Rina v v
63 Rani v v
64 Siti soleha v
6 2
11/05/2017 65 Wati v v
66 Rina v v
67 Siti solihah v v
3 3
12/05/2017 71 Wati v
72 Rina v v
73 Elma v
74 putri v
75 Fanny v
76 Ipah v
6 1
13/05/2017 77 Hera v
78 Sri m v v
79 Ipah v
80 Yanti v
81 Elma v v
82 Wati v
6 2
14/05/2017 83 Dian v v
84 Aisyah v v
85 Yanti v
86 Wiwin v
87 Sri m v
5 2
15/05/2017 88 Dian v v
89 Hani v
90 Suryani v
91 Yanti v
92 Wiwin v
93 Warinih v
6 1
16/05/2017 94 Dian v v
95 Noni v v
96 Cucu v v
97 Rina v
98 Wiwin v
99 Hani v v
6 4
17/05/2017 100 Rina v
101 Ratih v v
102 Rima v
103 Liya v
104 Sumiati v
105 Meriyani v
6 1
18/05/2017 106 Nunung v
107 Rima v v
108 Sumiati v
109 Kokom v
110 Merryani v
111 Devi v
112 Eros v v
113 Siti m v
114 Erni v
9 2
19/05/2017 115 Erni v v
116 Isma v
117 Iceu v v
118 N. ida v v
119 Nunung v v
120 Tini v
121 Dian v v
7 5
20/05/2017 122 Nurul v
123 Isma v v
124 Cahyati v
125 Dian v v
126 Enong v v
5 3

21/05/2017 127 devi v


128 Ima v v
129 cahyati v
130 yuli v v
131 dian v v
5 3

22/05/2017 132 yuli v v


133 regina v v
134 dian v v
135 ima v v
139 dewi v
140 Ida v
141 jujun v v
142 lilis v
143 suryati v v
9 6
23/05/2017 144 Yuli v v
145 Jujun v v
146 Lilis v
147 Suryati v v
148 Ima v
149 Mira v
150 Welly v v
151 Dian v v
152 Ani v
153 Aam v
10 5
24/05/2017 154 Yuli v v
155 Heli v
156 Mayang v
157 Gea v
158 Ani v
159 Ima v
160 Mira v
161 Yeti v
8 1
25/05/2017 162 Heli v v
163 Ati v
164 Ella v v
165 Rita v v
166 Mayang v v
167 Leni v v
168 Sopiyah v v
7 6
26/05/2017 169 Dini v v
170 Ati v v
171 Mayang v v
172 Salma v
173 Neti v
174 Desi v
175 Suharyati v v
7 4
27/05/2017 176 Dini v
177 Sopia v
178 Dini regina v
179 Salma v
180 Surhayati v v
181 Neti v
182 Irena v v
7 2
28/05/2017 183 Suharyati v
184 Neti v
185 Dini v v
186 Sulastri v v
4 2
29/05/2017 187 Neti v
188 Neng w v
189 Puji arum v
190 Kusyanti v v
191 Sulastri v v
192 Dini v v
6 3
30/05/2017 193 Neti v
194 Pupah v
2
31/05/2017 195 Wiwis v
196 Rina v
197 Nurul v
198 Meli v v
199 Linda v v
200 Ratna v
6 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MEI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2017 1 Mayang v
2 Iceu v v
3 Mira v v
4 Dede v v
5 Vera v
6 Lilis v
6 3

02/05/2017 7 Vera v
8 Esih v
9 Lilis v
10 Yeni v
11 Karmilah v
12 Nurhasanah v
5 1
03/05/2017 13 Intan v v
14 Fera v v
15 Esih v v
16 Darti v
17 Siti s v v
18 Rina v
19 Karneti v
7 4
04/05/2017 20 Mega v v
21 Karneti v
22 Siti s v v
23 Diana v v
24 Nurfauziah v
25 Nani v v
26 Darti v v
27 Kartika v v
28 Reni v v
29 Siti sarah v
10 7
05/05/2017 30 Diana v v
31 Nurfauziah v
32 Ika v v
33 Leti v v
34 Siti nuriah v v
35 Siti sarah v v
6 5
06/05/2017 36 Dede v
37 Sari v v
38 Widi v v
39 Siti solehah v
40 Nela v
41 Rosi v v
6 3
07/05/2017 42 Lasmanah v v
43 Siti solihah v
44 Nina v
45 Kokom v
46 Rossi v
5 1
08/05/2017 47 Susi susanti v v
48 Siti fatimah v v
49 Rima v
50 Siti solehah v v
4 3
09/05/2017 51 Yati v v
52 Siti solehah v v
53 Ipah v
54 Yanti v
55 Erni v
56 Rima v v
57 Dede v
58 Tira v
8 3
10/05/2017 59 Nia v
60 Friska v
61 reni v
62 Rina v v
63 Rani v v
64 Siti soleha v
6 2
11/05/2017 65 Wati v v
66 Rina v v
67 Siti solihah v v
3 3
12/05/2017 71 Wati v
72 Rina v v
73 Elma v
74 putri v
75 Fanny v
76 Ipah v
6 1
13/05/2017 77 Hera v
78 Sri m v v
79 Ipah v
80 Yanti v
81 Elma v v
82 Wati v
6 2
14/05/2017 83 Dian v v
84 Aisyah v v
85 Yanti v
86 Wiwin v
87 Sri m v
5 2
15/05/2017 88 Dian v v
89 Hani v
90 Suryani v
91 Yanti v
92 Wiwin v
93 Warinih v
6 1
16/05/2017 94 Dian v v
95 Noni v v
96 Cucu v v
97 Rina v
98 Wiwin v
99 Hani v v
6 4
17/05/2017 100 Rina v
101 Ratih v v
102 Rima v
103 Liya v
104 Sumiati v
105 Meriyani v
6 1
18/05/2017 106 Nunung v
107 Rima v v
108 Sumiati v
109 Kokom v
110 Merryani v
111 Devi v
112 Eros v v
113 Siti m v
114 Erni v
9 2
19/05/2017 115 Erni v v
116 Isma v
117 Iceu v v
118 N. ida v v
119 Nunung v v
120 Tini v
121 Dian v v
7 5
20/05/2017 122 Nurul v
123 Isma v v
124 Cahyati v
125 Dian v v
126 Enong v v
5 3

21/05/2017 127 devi v


128 Ima v v
129 cahyati v
130 yuli v v
131 dian v v
5 3

22/05/2017 132 yuli v v


133 regina v v
134 dian v v
135 ima v v
139 dewi v
140 Ida v
141 jujun v v
142 lilis v
143 suryati v v
9 6
23/05/2017 144 Yuli v v
145 Jujun v v
146 Lilis v
147 Suryati v v
148 Ima v
149 Mira v
150 Welly v v
151 Dian v v
152 Ani v
153 Aam v
10 5
24/05/2017 154 Yuli v v
155 Heli v
156 Mayang v
157 Gea v
158 Ani v
159 Ima v
160 Mira v
161 Yeti v
8 1
25/05/2017 162 Heli v v
163 Ati v
164 Ella v v
165 Rita v v
166 Mayang v v
167 Leni v v
168 Sopiyah v v
7 6
26/05/2017 169 Dini v v
170 Ati v v
171 Mayang v v
172 Salma v
173 Neti v
174 Desi v
175 Suharyati v v
7 4
27/05/2017 176 Dini v
177 Sopia v
178 Dini regina v
179 Salma v
180 Surhayati v v
181 Neti v
182 Irena v v
7 2
28/05/2017 183 Suharyati v
184 Neti v
185 Dini v v
186 Sulastri v v
4 2
29/05/2017 187 Neti v
188 Neng w v
189 Puji arum v
190 Kusyanti v v
191 Sulastri v v
192 Dini v v
6 3
30/05/2017 193 Neti v
194 Pupah v
2
31/05/2017 195 Wiwis v
196 Rina v
197 Nurul v
198 Meli v v
199 Linda v v
200 Ratna v
6 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JUNI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2017 1 Ratna v v
2 Susi v v
3 Anisah v v
4 Meli v v
5 Echa v v
6 Nur rahmayati v v
7 Ina v
8 Wiwis v v
9 Dwi anggraeni v
10 Dewi siti v
10 7
02/06/2017 11 Nur rahmayati v v
12 Ina fatimah v
13 Windi v v
14 Widia v v
15 Ratna v v
16 Ratna v v
6 5
03/06/2017 17 Septi v
18 Resa v v
19 Kania v
3 1
04/06/2017 20 Rohimah v
21 Septi v v
2 1
05/06/2017 22 Erna v v
23 Lisna v
24 Lena v v
25 Lisnawati v
26 Rika v
27 Fitri v v
28 Novi v v
7 4
06/06/2017 29 Yulianti v
30 Romadona v
31 Irma v v
32 Nia v v
33 Silmi v
34 Lisna v
35 Iis v
36 Ai v v
8 3

07/06/2017 37 evi v v
38 imas v
39 gita v
40 iis v v
41 ega v
42 romadhona v
43 iska v v
44 nia v v
45 puji v
46 ai sumiati v
47 tati v
11 4
08/06/2017 48 Yulianti v v
49 Sri m v v
50 Gita v
51 Ega v
52 Ina v
53 Ai v
54 Yani v
55 Yuni v v
8 3
09/06/2017 56 Susilawati v
57 Widya v v
58 Erna v
59 Lutfiya v
60 Yani v v
5 2
10/06/2017 61 Lilis v v
62 Lutfiya v
63 Erna v
3 1
11/06/2017 64 Ai Siti v
65 Siti S v
66 Lilis v
67 Eti v
68 Rekha v
69 Neng Teti v
6
12/06/2017 70 Ai v
71 Lilis v
72 Neng Yeti v
73 yanti v v
74 siti f V V
5 2
13/06/2017 75 Siti v
76 Elis v v
77 Yanti v v
78 Neng yeti v v
4 3
14/06/2017 79 Yani v
80 Novi v
81 Rosita v v
82 Desi v
83 Yeni v
5 1
15/06/2017 84 Maya v v
85 Siti rosita v v
86 Yani v v
87 Feti v
88 Ida v
5 3
16/06/2017 89 Popy v v
90 Siti julaeha v v
91 Priyanti v
92 Ida rosida v v
93 Lilis v v
94 Rini v v
6 5
17/06/2017 95 Eka v
96 Santi v v
97 Priyanti v v
98 Rohaeni v
99 Lilis v
100 Rini v
101 Siti julaeha v
6 3
18/06/2017 102 Priyanti v
103 Iis v
104 Lilis v
105 Rini v
106 Erna v v
107 Eka v
6 1
19/06/2017 108 Erna v
109 Neni v
110 Yeti v
3
20/06/2017 111 Neni v v
112 Vina v
113 Kokom v v
114 Yeti v v
115 Siti j v
116 Erna v v
117 Eti v
7 4
21/06/2017 118 Vina v v
119 Kokom v v
120 Siti j v
121 Umi v
122 Eti v
5 2
22/06/2017 123 Yanti v v
124 Salma v
125 Tita v
126 Yani v
127 Yuyu v
128 Kokom v
6 1

23/06/17 129 neni v v


130 fitri v
131 yolanda v
132 yulia v v
133 ida v
5 2

24/06/17 134 ela v


135 rina v
136 neni v v
137 yulianti v
138 suati v
5 1

25/06/17 139 siti aminah v v


140 nani v v
141 eni v v
142 nurasiah v v
145 rima v
146 ela v
6 4

26/06/17 147 rima v


148 ela v
149 mimpriasih v
150 nani v
151 eni v v
5 1

27/06/17 152 iis aisyah v


153 dewi v
154 ela v
155 mimpriasih v v
4 1

28/06/17 156 nunung v


157 ela v
158 mimpriasih v v
3 1

29/06/17 0 0
30/06/17 159 fitri v v
160 putri v
2 1
157 67

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JULI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2017 1 Halin v v
2 Santi v v
2 2

02/07/2017 3 Elin v v
4 Halin v
5 Santi v
6 Sri sulastri v v
7 Romadhona v v
8 Wiwik v
9 Dating v v
7 4

03/07/2017 10 Iis v
11 Dating v v
12 Wiwik v
13 Sri sulastri v
14 Romadhona v v
15 Elin v
16 Ranny v v
7 3
04/07/2017 17 Rina v
18 Maryamah v
19 Adytia v v
20 Esih v
4 1
05/07/2017 21 Gina v v
22 Esih v
23 Dina v
3 1
06/07/2017 24 Gina v v
25 Dewi v v
26 Asum v v
27 Lilis v
28 Yani v v
29 Sri v
30 Lia v
31 Aty v
7 5
07/07/2017 32 Gina v v
33 Ela v
34 Aty v v
35 Yuyun v v
36 Anih v
5 3
08/07/2017 37 Mega v v
38 Nunung v v
39 Asti v v
40 Mutia v v
41 Herni v v
42 Yuyun v v
43 Endang v
44 Dian v v
45 Ela v v
9 8
09/07/2017 46 Iik v
47 Yuningsih v
48 Endang v v
49 Milah v v
50 Rini v v
5 3
10/07/2017 51 Yuyun v v
52 Nanda v v
53 Susanti v
54 Ernawati v
55 Tika v
5 2
11/07/2017 56 Neng tuti v
57 Reni v v
58 Susanti v v
3 2
12/07/2017 59 Neng tuti v v
60 Ai r v v
61 Mintarsih v
62 Ratih v
63 Imas v
64 Fitriyanti v v
65 Sani v
7 3
13/07/2017 66 Ai rohayati v v
67 Tanti v v
68 Indah v v
69 Fitriyanti v v
70 Sani v v
71 Imas v v
72 Ai sumiati v
7 6
14/07/2017 73 Nunung v v
74 Fitriyanti v
75 Fitri v
76 Triana v v
4 2
15/07/2017 77 Fitri v
78 Triana v
2
16/07/2017 79 Astri v v
80 Eli v
81 Nurhayati v
3 1
17/07/2017 82 Nia v
83 Risa v
84 Siti solihah v
85 Nurhayati v
86 Eli v v
4 1

18/07/17 87 gerhana v
88 novi v v
89 santi v v
90 Siti solihah v
4 2

19/07/2017 91 ai v v
92 siti aisah v v
93 fitria v
94 tina v v
95 neng juariah v v
96 imas v
97 mira v
7 4
20/07/2017 98 Wahyuni v
99 Mira v v
100 Resya v
101 Sri ulfah v v
102 Eneng yani v v
5 2
21/07/2017 103 Sumiati v v
104 Nurlaela v
105 Resya v v
3 2

22/07/17 106 nunung v v


107 tutie v
108 tika v
109 tini v v
110 yayang v v
111 rita v v
6 4
23/07/2017 112 Cica v
113 Tutie v v
114 Tita v v
115 Yayang v
116 Nina v v
4 4
24/07/2017 117 Nina v v
118 Yayang v
119 Dating v v
2 3
25/07/2017 120 Cica m v
121 Dating v v
122 Siti solihat v
2 2
26/07/17 123 Popy v v
124 Cica v v
125 Detty v
126 Herlina v
127 Dede yati v
5 2
27/07/2017 128 Nina v v
129 Yuni v v
130 Detty v v
131 Nia v v
132 Desi v
133 Dede v v
6 5
28/07/2017 134 Erna v v
135 Dede yati v v
136 Gita v
137 Euis v
138 Wina v
5 2
29/07/2017 139 Erna v
140 Sumiati v v
141 Rina v v
142 Siti s v
143 Dede v v
144 Gita v
6 3
30/07/2017 145 Erna v
146 Yuni rizki v
147 Vinny v v
148 Mintarsih v v
149 Sumiati v
150 Gita astri v
6 2
31/07/2017 151 Yuni rizki v v
152 Nisa v
153 Nia v
3 1

JUMLAH 148 85

FORMAT SURVEY HARIAN PEMAKAIAN ALAT AGUSTUS 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2017 1 Yuliani v
2 Dewi sri v
3 Dini v
4 Evi v
4
02/08/2017 5 Wulan v v
6 Restiawati v v
7 Siti holipah v
8 Susi v
9 Dini v v
10 Siska v
11 Siti romlah v
7 3
03/08/2017 12 Ade pupu v v
13 Susi v v
14 Siti cholifah v v
15 Vina v
16 Pipit v v
17 Eutik v v
6 5
04/07/2017 18 Nuryani v
19 Sri m v
20 Riyah v
21 Cucu v v
22 Rita v v
5 2
05/08/2017 23 Nurvianti v v
24 Nuryani v v
25 Sri mulyani v v
3 3
06/08/2017 26 Suci v
27 Nuryani v
28 Sri mulyani v
29 Cheny v
4 0
07/08/2017 30 Cheny v
31 Suci v v
32 Euis v v
33 Nurhayati v
34 Deti v v
35 Yadianti v
6 3
08/08/2017 36 Nurhayati v v
37 Sani v
38 Rostini v
3 1
09/08/2017 39 Rini v v
40 Sany v v
41 Fitria v
42 Tuti v
4 2
10/08/2017 43 Entin v v
44 Ella v v
45 Neneng v v
46 Tuti v v
4 4
11/08/2017 47 Risnawati v v
48 Reni v
49 Dewi v
50 Sopi v v
51 Dian v
52 Fitri v v
53 Ina v v
7 4
12/08/2017 54 Hasni v
55 Dewi v v
56 Reni v v
57 Ina v v
58 Dian v v
59 Santi v v
60 Dini v
61 Teni v v
8 6
13/08/2017 62 Santi v v
63 Teni v v
64 Ayu v v
65 Sumiati v v
66 Ina v
5 4
14/08/2017 67 Ayu v v
68 Komalasari v
69 Haryati v
70 Ernawati v
71 Maharani v v
72 Kiki v
6 2
15/08/2017 73 Haryati v v
74 Ernawati v v
75 Dede v
76 Uun v
77 Nurvianti v
78 Ai sari v
6 2
16/08/2017 79 Ani v v
80 Herliawati v v
81 Yani v v
82 Susilawati v
83 Nani v
84 Dede v
85 Yani v
86 Ai sari v
87 Nurvianti v
9 3
17/08/2017 88 Nopi v v
89 Herliawati v
90 Yani v v
91 Septi v v
92 Wini v v
93 Maria v v
94 Susilawati v v
95 Fitria v v
96 Fitria v v
9 8
18/08/2017 97 Septi v v
98 Yani v
99 Endah v
100 Uun v v
101 Nurvianti v
102 Nurhasanah v v
6 3
19/08/2017 103 Nurhasanah v v
104 Rizky v
105 Gina v v
106 Nurvianti v
4 2
20/08/2017 107 Nurvianti v
108 Mimin v v
109 Gina v
110 Novriyani v v
4 2
21/08/2017 111 Winda v
112 Riyah v v
113 Sopiah v v
114 Yuyu v v
115 Nurhasanah v v
116 Rina v
117 Dewi v
7 4
22/08/2017 118 Rina v v
119 Dewi v v
120 Rida v v
121 Nurhasanah v v
122 Wida v
123 moslihah v
6 4
23/08/2017 124 Moslihah v
125 Leni v v
126 Rida v v
127 Vadila v v
4 3
24/08/2017 128 Nita v
129 Eka v v
130 Nani v
3 1
25/08/2017 131 Ati v
132 Wiwin v
133 Dessy v v
134 Febi v v
135 Arti v
5 2
26/08/2017 136 Feby v v
137 Karmila v v
138 Susilawati v v
3 3
27/08/2017 139 Evi v
140 Eti v
141 Tina v v
142 Ati v v
143 Dian v
5 2
28/08/2017 144 Ati v v
145 Evi v v
146 Nita v v
147 Dian v
148 Tina v v
149 Weni v
6 4
29/08/2017 150 Ani v
151 Tina v v
152 Nepta v
153 Nurhasanah v v
154 Rita v
5 2

30/08/2017 155 mintarsih v


156 endah v
157 ani s v
158 sani v
160 nia v v
5 1
31/08/2017 161 Mintarsih v
162 Ai dewi v v
163 Rismawati v v
164 Rokhane v v
4 3

JUMLAH 163 89
FORMAT SURVEY HARIAN PEMAKAIAN ALAT SEPTEMBER 2017
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2017 1 Widiawati v v
2 Mintarsih v v
3 Ai sapitri v
4 Gina v v
4 3
02/09/2017 5 Syaibatul v
6 Widiawati v
7 Ai sapitri v
3 0

3/9/2017 8 heni v
9 sumiyanti v
10 lia v
3 0
4/9/2017 11 rina v v
12 intan v
13 yeni v
14 eli v
15 esih v v
5 2
05/09/2017 16 Nunung v
17 Intan v v
18 Dian v v
19 Elis v v
20 Lela v
21 Eneng sri v v
6 4
06/09/2017 22 Ernita v v
23 Yuli v v
24 Imas v
25 Dewi v v
26 Neng v
27 Lela v v
28 Esin v
7 4
07/09/2017 29 Imas v v
30 Dedeh v
31 Esin v
32 Siti k v
4 1
08/09/2017 33 Sri dewi v v
34 Lia v
35 Rospita v
36 Anisa v
37 Dewi p v
5 1
09/09/2017 38 Nila v v
39 Lia m v v
40 Dewi p v v
41 Irma v
42 Ani r v
43 Iis k v
6 3
10/09/2017 44 Dewi p v v
45 Sopi v v
46 Iis v v
47 Ani v
48 Elisah v
49 Diah v
6 3
11/09/2017 50 Devi v v
51 Ani v
2 1
12/09/2017 52 Rika v
53 Esti v
54 Karina v
55 Lisna v
56 Neli v v
57 Rina v
6 1
13/09/2017 58 Dewi v
59 Esti v
60 Suci v
61 Sari v
4 0
14/09/2017 62 Diana v v
63 Suci v v
64 Kurniawati v
65 Yuliyani v
66 Ade sari v
67 Pipih v
6 2
15/09/2017 68 Iis v
69 Diantika v v
70 Iim v
71 Ari v v
4 2
16/09/2017 72 Rosmaya v
73 Rahayu v v
74 Ari v v
75 Siti r v v
76 Iis v v
77 Fitriyanti v
78 Rida v
79 Desi v
80 Ani v
81 Fitri v
10 4
17/09/2017 82 Lina v v
83 Fitriyanti v v
84 Rida v v
85 Lelasari v v
4 4
18/09/2017 86 Lina v v
87 Rida v v
88 Elin v v
89 Sinta v
90 Oom v
91 Rina v
92 Elis v
7 3
19/09/2017 93 Sinta v v
94 Mirawati v v
95 Susanti v
96 Siti komariah v
97 Oom v v
5 3
20/09/2017 98 Widya v v
99 Susanti v
100 Yeni v
101 Mulyani v v
102 Upi v
103 Lia v v
104 Tuti v v
105 Elli v v
106 Ria v v
107 Karlina v
108 Siti k v
11 6
21/09/2017 109 Widya v
110 Yeni v
111 Upi v
112 Elli v
113 Karlina v v
114 Elim v v
115 Siti k v v
7 3
22/09/2017 116 Fanny v
117 Nurjanah v
118 Lina v
3 0
23/09/2017 119 Nurjanah v v
120 Yati v v
121 Lani v v
122 Ayu v
123 Elsa v v
124 Dewi v v
125 Eneng rini v v
126 Evi v
127 Neli v
9 6
24/09/2017 128 Ani v
129 Ayu v v
130 Ratnengsih v v
131 Elsa v v
132 Nurhayati v v
5 4
25/09/2017 133 Elsa v v
134 Dine v v
135 Ari v
136 Dailah v
4 2

26/09/2017 137 Nursiti v


138 Leni v
139 Fitri v
140 Siti Nurhayati v v
141 Elin v v
5 2

27/09/2017 142 Nursiti v


143 Mega v v
144 Risma v
145 Latipah v
146 Siti hamidah v
147 Desi v
148 Wati v
7 1
28/09/2017 149 Nurmayasari v
150 Ani v
151 Ade siti v
152 Siti H v v
153 Neneng v
154 Imas S v
155 Mega v v
7 2
29/09/2017 156 Fifi v v
157 Ade siti v v
158 Neneng v v
159 Ani v v
160 Nurmayasari v v
161 Tin w v
162 M mutiara v
163 Yeni v v
164 Seli v v
9 7
30/09/2017 165 Mila v v
166 Repina v
167 Seli v v
3 2

JUMLAH 167 75

FORMAT SURVEY HARIAN PEMAKAIAN ALAT OKTOBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2017 1 Erna v v
2 Repina v v
3 Heti v
4 Nenden v v
5 Selli v v
6 Nur syarifah v
7 M Mutiara v
8 Linda v v
8 5
02/10/2017 9 Lilis v
10 Lutifiah v
11 Nenden v v
12 Mimin v v
13 Cici v v
14 Nur syarifah v v
6 4
03/10/2017 15 Mira v
16 Lilis v v
17 Lutfiah v v
18 Inayah v
4 2
04/10/2017 19 Lestari v
20 N siti v
21 Risma v
22 Ratnasari v
23 Endah v
24 Yuni v
25 Siti r v v
26 Neng mulyani v
8 1

05/10/17 27 ratnasari v v
28 yuni v
29 susanti v v
30 neng mulyani v v
31 risma v
5 2

06/10/2017 32 elis v
33 linlin v v
34 elis hayati v v
35 iis v
36 derika v
37 paryani v v
38 resna v
7 3
07/10/2017 39 Resna v v
40 Elis v
41 Ani v v
42 Dherika v v
43 Paryani v v
44 Santi v
6 4

08/10/2017 45 iin v v
46 nuryamah v
47 santi v
48 Adilah v
49 wiwin v
5 1

09/10/2017 50 iin v v
51 Adilah v
52 wiwin v
53 Lilis v
54 Anggi v v
55 Iis v
56 Suryani v
7 2
10/10/2017 57 Lilis v v
58 Iis v
59 Aas v
60 Ira v v
61 Rina v v
5 3
11/10/2017 62 Aas v
63 Seni v v
64 Ira v
65 Ani taryani v v
66 Ferawati v v
5 3
12/10/17 67 lisna v
68 rika v
69 kurniawati v
70 dewi n v
71 rina v
72 nelli v
73 esti v
74 karina v
75 ririn v v
9 1

13/10/17 76 sawinah v
77 susiyati v
78 yani v
79 ajeng v v
80 euis v v
81 yayan v v
82 mintarsih v v
83 ani v
84 emi v
9 4

14/10/17 85 mintarsih v v
86 leni v
87 ani v
88 susiyati v v
89 niawati v
90 irma v v
91 noerhayati v
92 siti aisyah v
8 3
15/10/2017 93 Mamah v v
94 Liana v v
95 Irma v v
96 Yuliawati v
97 Aisyah v
98 Rini v
6 3
16/10/2017 99 Liana v v
100 Siti v v
101 Emi v v
102 Rini v v
4 4
17/10/2017 103 Rini v
104 Emi v
105 Imas v
106 Sindy v
107 Lilis v
108 Sandra v v
6 1
18/10/2017 109 Aas v
110 Lilis v v
111 Sindy v
112 Tika v
113 Rani v v
114 Widawati v
115 Emi v
116 Sugiarti v
117 Kusmirah v
118 Siti v
10 2
19/10/2017 119 Tika v v
120 Aas v v
121 Wulansari v v
122 Sugiarti v
123 Putri v v
5 4
20/10/2017 124 Putri v
125 Lilis v
126 Desy v v
3 1
21/10/2017 127 Fitri v
128 Lusy v v
129 Novy v v
130 Rina v
131 Lina v
132 Eka v
133 Ai kania v
7 2
22/10/2017 134 Fitri v
135 Liana v v
2 1
23/10/2017 136 Fitri v
137 Rima v
138 Eva v
3
24/10/2017 139 Tika v v
140 Nawati v v
141 Eva v v
142 Susan v v
4 4
25/10/2017 143 Suminar v v
144 Susan v v
145 Lilis v
146 Nawati v
147 Tita v
148 Nita v v
149 Siti B v
150 Neneng v
151 Febi v v
9 4
26/10/2017 152 Mirna v
153 Sinta v v
154 Reni v
155 Nawati v v
156 Tita v v
157 Sulastri v v
158 Siti barikah v v
158 Rosmaya v
159 Nisa v v
9 6
27/10/2017 160 Sinta v v
161 Reni v v
162 Nurhilaliah v v
163 Neni v
164 Rosmaya v
165 Ricka v v
166 Nuryani v
167 Siti rokayah v v
8 5
28/10/2017 168 Sinta v
169 Rosmaya v
170 Wahyuni v v
171 Ersa v
172 Fenti v
173 Elin v
6 1
29/10/2017 174 Fenti v
175 Mimin v
176 Maudina v
3
30/10/2017 177 Nuri v
178 Maudina v
179 Mimin v
180 Siti f v
181 Elsa v
5
31/10/2017 182 Dian v v
183 Rokayah v v
184 Vany v
3 2

JUMLAH 184 78

FORMAT SURVEY HARIAN PEMAKAIAN ALAT NOVEMBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2017 1 Dian v v
2 Siti Aisyah v
3 Yanti v
4 Resti v v
5 Yuli yulianti v v
6 Devi v v
6 4
02/11/2017 7 Dati v v
8 Siti r v
9 Mulya v
10 Elis v v
11 Siti aisyah v v
12 Ningsih v
6 3
03/11/2017 13 Rini v
14 Siti rohmah v v
15 Elis v
16 Ningsih v v
17 Titin v
18 Ratih v
19 Lima v v
20 Luri v v
8 4
04/11/2017 21 Titin v
22 Ratih v v
23 Elis v v
24 Siti N v v
25 Zaenab v v
5 4
05/11/2017 26 Ratih v v
27 Yani v
28 Siti h v v
3 2
06/11/2017 29 Winda v v
30 Lilis v
31 Ratih v v
32 Rika v v
4 3
07/11/2017 33 Penti v
34 Mumun v
35 Winda v
36 Fitri v
37 Lilis v
38 Dina v
39 Komalasari v
7 0
08/11/2017 40 Komalasari v
41 Wati v
42 Dina v v
43 Nurazizah v
44 Dewi v
45 Santi v
46 Rika v v
47 Rositawati v v
8 3
09/11/2017 48 Intan v v
49 Dewi v
50 Santi v v
51 Yuyun v
52 Rebeca v
53 Wati v v
54 Siti m v
7 3
10/11/2017 55 tina v v
56 rini v
57 nina v v
58 kusmini v v
59 putri v
60 yani v
61 imas v
62 siti v v
63 wina v v
9 5
11/11/2017 64 rini v
65 herlina v v
66 nuryani v v
67 kusmini v
68 wiwin v v
69 putri v
70 siti v
71 isye v
8 3
12/11/2017 72 riani v
73 wiwin v
8 3
13/11/2017 74 Ratih v v
75 Fitri v
76 Sensen v v
3 2
Ruang Nifas 3 MARET 2017
Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 6 1
2 4 1 1
3 7 4 1
4 8 2
5 6 1
6 7 1
7 7 5
8 5 1
9 8 4
10 9 4
11 4
12 4 3
13 3 1
14 6 3
15 3 1
16 5 1
17 6
18 6 3
19 1
20 3
21 3 3
22 5 3
23 6 2
24 8 3
25 1 6 4
26 1 2 1
27 1 3
28 4 2
29 3 3
30 4
31 5 2
JUMLAH 3 157 59 2

Jumlah Pasien Ibu dalam kota 175 orang


Jumlah Pasien Ibu luar kota 27 orang
Jumlah Pasien bayi dalam kota 101 orang
Jumlah Pasien bayi luar kota 16 orang

Ruang Nifas 3 APRIL 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 9 1
2 5 2
3 5
4 9 3
5 7 4
6 9 2
7 3 1
8 5 1
9 4 2
10 5 2
11 8 4
12 7 4
13 9 4
14 7 3
15 3 1
16 3 1
17 6 3
18 6 3
19 7 4
20 7 2
21 9 5
22 7 2
23 8 2
24 5 2
25 6 1
26 3 1
27 9 2
28 6 4
29 7 2
30 6 5
31
JUMLAH 188 74

Jumlah Pasien Ibu dalam kota 187 orang


Jumlah Pasien Ibu luar kota 24 orang
Jumlah Pasien bayi dalam kota 83 orang
Jumlah Pasien bayi luar kota 12 orang

Ruang Nifas 3 MEI 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 6 3
2 5 1
3 7 4
4 10 7
5 6 5
6 6 3
7 5 1
8 4 3
9 8 3
10 6 2
11 3 3
12 6 1
13 6 2
14 5 2
15 6 1
16 6 4
17 6 1
18 9 2
19 7 5
20 5 3
21 5 3
22 9 6
23 10 5
24 8 1
25 7 6
26 7 4
27 7 2
28 4 2
29 6 3
30 2
31 6 2
JUMLAH 193 90

Jumlah Pasien Ibu dalam kota 217 orang


Jumlah Pasien Ibu luar kota 34 orang
Jumlah Pasien bayi dalam kota 111 orang
Jumlah Pasien bayi luar kota 14 orang

Ruang Nifas 3 JUNI 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 10 7
2 6 5
3 3 1
4 2 1
5 7 4
6 8 3
7 11 4
8 8 3
9 5 2
10 3 1
11 6
12 5 2
13 4 3
14 5 1
15 5 3
16 6 5
17 6 3
18 6 1
19 3
20 7 4
21 5 2
22 6 1
23 5 2
24 5 1
25 6 4
26 5 1
27 4 1
28 3 1
29 0 0
30 2 1
31
JUMLAH 157 67
Jumlah Pasien Ibu dalam kota 168 orang
Jumlah Pasien Ibu luar kota 20 orang
Jumlah Pasien bayi dalam kota 84 orang
Jumlah Pasien bayi luar kota 12 orang

Ruang Nifas 3 JULI 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 2 2
2 7 4
3 7 3
4 4 1
5 3 1
6 7 5
7 5 3
8 9 8
9 5 3
10 5 2
11 3 2
12 7 3
13 7 6
14 4 2
15 2
16 3 1
17 4 1
18 3 2
19 4 2
20 5 2
21 3 2
22 6 4
23 4 4
24 2 3
25 2 2
26 5 2
27 6 5
28 5 2
29 6 3
30 6 2
31 3 1
JUMLAH 148 85

Jumlah Pasien Ibu dalam kota 165 orang


Jumlah Pasien Ibu luar kota 29 orang
Jumlah Pasien bayi dalam kota 92 orang
Jumlah Pasien bayi luar kota 18 orang

Ruang Nifas 3 Agustus 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 4
2 7 3
3 6 5
4 5 2
5 3 3
6 4 0
7 6 3
8 3 1
9 4 2
10 4 4
11 7 4
12 8 6
13 5 4
14 6 2
15 6 2
16 9 3
17 9 8
18 6 3
19 4 2
20 4 2
21 7 4
22 6 4
23 4 3
24 3 1
25 5 2
26 3 3
27 5 2
28 6 4
29 5 2
30 6 1
31 5 1
JUMLAH 163 89

Jumlah Pasien Ibu dalam kota 178 orang


Jumlah Pasien Ibu luar kota 26 orang
Jumlah Pasien bayi dalam kota 120 orang
Jumlah Pasien bayi luar kota 18 orang

Ruang Nifas 3 September 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 4 3
2 3 0
3 3 0
4 5 2
5 6 4
6 7 4
7 4 1
8 5 1
9 6 3
10 6 3
11 2 1
12 6 1
13 4 0
14 6 2
15 4 2
16 10 4
17 4 4
18 7 3
19 5 3
20 11 6
21 7 3
22 3 0
23 9 6
24 5 4
25 4 2
26 5 2
27 7 1
28 7 2
29 9 7
30 3 2
31
JUMLAH 167 75

Jumlah Pasien Ibu dalam kota 178 orang


Jumlah Pasien Ibu luar kota 43 orang
Jumlah Pasien bayi dalam kota 85 orang
Jumlah Pasien bayi luar kota 24 orang

Ruang Nifas 3 Oktober 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 8 5
2 6 4
3 4 2
4 8 1
5 5 2
6 7 3
7 6 4
8 5 1
9 7 2
10 5 3
11 5 3
12 9 1
13 9 4
14 8 3
15 6 3
16 4 4
17 6 1
18 10 2
19 5 4
20 3 1
21 7 2
22 2 1
23 3
24 4 4
25 9 4
26 9 6
27 8 5
28 6 1
29 3
30 5
31 3 2
JUMLAH 185 78

Jumlah Pasien Ibu dalam kota 206 orang


Jumlah Pasien Ibu luar kota 27 orang
Jumlah Pasien bayi dalam kota 104 orang
Jumlah Pasien bayi luar kota 18 orang

Ruang Nifas 3 November 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 6 4
2 6 3
3 8 4
4 5 4
5 3 2
6 4 3
7 7 0
8 8 3
9 7 3
10 9 5
11 8 3
12 8 3
13 3 2
14 6 6
15 6 3
16 5 5
17 7 5
18 7 5
19 4 3
20 4 2
21 6 4
22 8 2
23 9 7
24 8 3
25 5 2
26 6 3
27 5 2
28 7 1
29 8 5
30 6
31
JUMLAH 183 97

Jumlah Pasien Ibu dalam kota 191 orang


Jumlah Pasien Ibu luar kota 26 orang
Jumlah Pasien bayi dalam kota 110 orang
Jumlah Pasien bayi luar kota 11 orang

Ruang Nifas 3 DESEMBER 2017


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 2 1
2 7
3 5 3
4 7 4
5 6 5
6 8 4
7 3 2
8 7 3
9 6 3
10 6 3
11 9 7
12 7 4
13 9 6
14 8 4
15 8 4
16 8 4
17 5 3
18 9 3
19 6 4
20 8 4
21 4 2
22 2 1
23 2 2
24 6 0
25 6 2
26 3 1
27 2 1
28 5 3
29 6 3
30 6 2
31 4 3
JUMLAH 180 91

Jumlah Pasien Ibu dalam kota 204 orang


Jumlah Pasien Ibu luar kota 38 orang
Jumlah Pasien bayi dalam kota 145 orang
Jumlah Pasien bayi luar kota 24 orang
Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 8 2
02/04/2016 6 1
03/04/2016 7 2
04/04/2016 1
05/04/2016 6
06/04/2016 9 3
07/04/2016 6 3
08/04/2016 9 3
09/04/2016 8
10/04/2016 4
11/04/2016 7 1
12/04/2016 9 3
13/04/2016 8 2
14/04/2016 11 7 1
15/04/2016 11 6
16/04/2016 7 3
17/04/2016 10 5
18/04/2016 8 5 1
19/04/2016 6 2 1
20/04/2016 4 3
21/04/2016 6 5
22/04/2016 10 6
23/04/2016 6 4
24/04/2016 4 2
25/04/2016 6 1
26/04/2016 4 1
27/04/2016 1
28/04/2016 4
29/04/2016 6 2
30/04/2016 5 1

197 73 2 1

jumlah pasien ibu dalam kota 105 orang


jumlah pasien ibu luar kota 36 orang
jumlah pasien bayi dalam kota 89 orang
jumlah pasien bayi luar kota 25 orang
Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR
01/04/2015 1 NY.NENAH/TN.SOPANDI V
2 NY.HOMSAH/TN.MARHAM V
3 NY.AZIMATUN/TN.KRISTIYANTO V
4 NY.WULAN/TN.UMAR V V
5 NY.TINI/TN.ASEP V V
6 NY.LISNA/TN.EGI V
7 NY.SUGIARTI/TN.AHMAD V
8 NY.HERA/TN.IWAN V
9 NY.DIAH/TN.MUHTAR V V
10 NY.YUNI/TN.YAYANG V
11 NY.EVA/TN.AZMIL V
12 NY.RESTI/TN.YADI V V
13 NY.RISKA/TN.ARI V V
14 NY.NENENG/TN. V
15 NY.ERNI/TN.SUTISNO V V
16 NY.ELI/TN.ALI V
JUMLAH 16 6
02/04/2015 1 NY.RESTI/TN.YADI V
2 NY.IRESTU/TN.DADANG V
3 NY.RISKA/TN.ARI V
4 NY.SITI E/TN.DODI V V
5 NY.ERNI/TN.SUTISNO V
6 NY.TITA/TN.UMAR V V
7 NY.DEWI/TN.DUDI V
8 NY.NENDEN/TN.BUDI V
9 NY.TINI/TN.ASEP V
10 NY.HARTINI/TN.DEDE V
11 NY.DIAH/TN.MOHTAR V
11 2
03/04/2015 1 NY.PATMWATI/TN.WAWAN V V
2 NY.TIKA/TN.PETRUS V
3 NY.SRI/TN.HERU V
4 NY.TINI/TN.ASEP V
5 NY.DIAH/TN.MOHTAR V
6 NY.FARA/TN.APIP V
7 NY.SINTA/TN.ANGGA V
8 NY.SITI.E/TN.DODI V
8 1
04/04/2015 1 NY.WINA/TN.ATO V V
2 NY.ANNISA/TN.HADI V
3 NY.SINTA/TN.ANGGA V
4 NY.YULIANTI/TN.RAMDHANI V
5 NY.SRI/TN.HERU V
6 NY.RINI/TN.NARDI V
6 1
05/04/2015 1 NY.ANNISA/TN.HADI V V
2 NY.PITRIA/TN.ROBI V
3 NY.POPPY/TN.INDRA V
4 NY.RINI/TN.FEBRI V V
5 NY.AAH/TN.AGUS V
6 NY.TITA/TN.AGUS V
7 NY.WAFI/TN.REFI V
8 NY.MELY/TN.YUDI V
9 NY.MAYA/TN.DJADJAT V
10 NY.RENI/TN.ASEP V V
10 2 1
06/04/2015 1 NY.SARSIH/TN.DADANG V
2 NY.WIWIN/TN.NUR.H V
3 NY.YAYAH/TN.AJANG V
4 NY.SRI/TN.HERU V V
5 NY.YUNINGSIH/TN.ARIS V
6 NY.IRMA/NY.ARIS V
7 NY.AAM/TN.JUHRO V
8 NY.POPY/TN.INDRA V V
9 NY.RINI/TN.FEBRI V
10 NY.HERNA/TN.FAJAR V V
11 NY.MUJAHIDIN/TN.SAKIN V V
11 4
07/04/2015 1 NY.AAN/TN.JUHRO V V
2 NY.POPPY/TN.INDRA V
3 NY.NIKEN/TN.UMAR V V
4 NY.HERNA/TN.FAJAR V
5 NY.MUJHIDAH/TN.SAKIM V
6 NY.ILAN/TN.IRSAD V
7 NY.SRI/TN.HERU V V
8 NY.RIRIN/TN.ENCEP V
9 NY.YUNINGSIH/TN.ARIS V V
10 NY.HENI/TN.EDDY V V
10 5 1
08/04/2015 1 NY.ILAN/TN.IRSAD V
2 NY.FELLA/TN.IWAN V
3 NY.SRI/TN.HERU V
4 NY.HENI/TN.EDDY V V
5 NY.WINDI/TN.KURNIAWAN V
6 NY.NANI/TN.ACEP V
7 NY.WINA/TN.FUADL V
8 NY.SUSI/TN.YUDI V
9 NY.TITIN/TN.UTU V
10 NY.AAM/TN.JUHRO V
11 NY.NIKEN/TN.UMAR V
12 NY.MARINA/TN.ANGGI V V
13 NY.LINTANG/TN.BUDI V
14 NY.DINI/TN.ADITYA V
14 2
09/04/2015 1 NY.FITRI/TN.ADE V
2 NY.TRESNA/TN.SOBIRIN V
3 NY.ERNI/TN.SAEFUL V
4 NY.MIRA/TN.RIAN V
5 NY.KOKOM/TN.RUDI V
6 NY.YAYAH/TN.EMAN V V
7 NY.SUMIATI/TN.BAMBANG V
8 NY.LINTANG/TN.BUDI V V
9 NY.SRI/TN.HERI V
10 NY.DINI/TN.YOGI V V
11 NY.TITA/TN.AGUS V V
11 3 1
10/03/2015 1 NY.LINTANG/TN.BUDI V V
2 NY.VENY/TN.SOFYAN V V
3 NY.KOKOM/TN.JEJEN V V V
4 NY.RINA/TN.ASEP V V
5 NY.CACAH/TN.JAENAL V
6 NY.RITA/TN.AGUS V V
7 NY.ISNI/TN.EKO V V
8 NY.TUTI/TN.JAJA V
9 NY.VIKY/TN.CUCU V V
10 NY.ENI/TN.ACE V V
11 NY.DINI/TN.YOGI V V
12 NY.ISNI/TN.EKO V V
13 NY.YAYAH/TN.EMAN V V
13 9 3
11/04/2015 1 NY.MIMIN/TN.JIMI V V
2 NY.YENI/TN.ARIF V
3 NY.ROMIYATI/TN.SAEFUDIN V
4 NY.SANTI/TN.ELSAR V
5 NY.VIKY/TN.CUCU V V
6 NY.ENI/TN.ACE V
7 NY.HANI/TN.AWALUDIN V V
8 NY.ROSMAYANTI/TN.ANDRI V V
9 NY.ADITYA/TN.RINDY V
10 NY.ISNI/TN.EKO V
10 4
12/05/2015 1 NY.ATIK/TN.AYI V
2 NY.SUSANTI/TN.RAJIB V
3 NY.NENG W/TN.MUSBAH V
4 NY.SANTI/TN.ELSAR V V
5 NY.VIKY/TN.CUCU V V
6 NY.ENI/TN.ACE V
7 NY.ROSMAYANTI/TN.ANDRI V
8 NY.IPAH/TN.IHIN V
9 NY.YULI/TN.IWAN V
10 NY.NENG M/TN.DADI V V
10 3
13/04/2015 1 NY.FITRI/TN.UNTUNG V
2 NY.ATIK/TN.AGI V
3 NY.EVA/TN.SOBAR V
4 NY.SITI H/TN.ROHDIANA V V
5 NY.VIKY/TN.CUCU V V
6 NY.ROSMAIDAR/TN.SUHENDRA V V
7 NY.NOPI/TN.SANDRA V
8 NY.YULI/TN.IWAN V V
9 NY.RIA/TN.ADIT V V
10 NY.NENG M/TN.DADI V
11 NY.NOVIASARI/TN.RAMA V
12 NY.SINTA/TN.ANGGA V
13 NY.ANGGI/TN.AAM V
14 NY.NIKEN/TN.UMAR V
14 5
14/04/2015 1 NY.SINTA/TN.ANGGA V
2 NY.ANGGI/TN.AAM V
3 NY.NIKEN/TN.UMAR V
4 NY.FEBI/TN.RUDI V
5 NY.SITI H/TN.ROSDIANA V V
6 NY.VICKY/TN.CUCU V V
7 NY.SUKINAH/TN.IWAN V
8 NY.ROSMAIDAR/TN.SUHENDRA V
9 NY.YULI/TN.IWAN V
10 NY.IPAH/TN.IHIN V V
11 NY.RIA/TN.ADIT V
12 NY.DEDE/TN.ADANG V V
13 NY.KRISTIANA/TN.IVAN V
14 NY.HESTY/TN.SOLIHIN V
15 NY.WIDATI/TN.YUDI V
15 4
15/04/2015 1 NY.ROSMAIDAR/TN.SUHENRA V
2 NY.KRISTIANA/TN.IVAN V
3 NY.HESTY/TN.SOLIHIN V
4 NY.SITI/TN.RIKKY V
5 NY.RIA/TN.ADIT V
6 NY.WIDATI/TN.YUDI V V
7 NY.DEDE/TN.ADANG V
8 NY.SINTA/TN.ANGGA V
9 NY.ANGGI/TN.AAM V
10 NY.NIKEN/NY.UMAR V
11 NY.DWI/TN.SLAMET V
12 NY.SITI/TN.ROHDIANA V
12 1
16/04/2015 1 NY.VIKY/TN.CUCU V V
2 NY.YULIANDAWATI/TN.AGUNG V
3 NY.ADE/TN.ABDUL V
4 NY.NENI/TN.GUGUN V
5 NY.NIKEN/TN.UMAR V
6 NY.YULIANTI/TN.WINDI V
7 NY.NENI/TN.AN'AN V
8 NY.REZKY/TN.IDA V
9 NY.DENNY/TN.AGUS V
10 NY.IMAS/TN.DANI V V
11 NY.NINING/TN.DEDEN V V
12 NY.KRISTIANA/TN.IVAN V
13 NY.HESTY/TN.SOLIHIN V
14 NY.AAN/TN.FERI V V
15 NY.AAN/TN.M KEMAL V V
16 NY.PURWATI/TN.M.JUWANA V V
17 NY.WIDIATI/TN.YUDI V
18 NY.RIVA/TN.RICCO V V
17 7
17/04/2015 1 NY.IMAS/TN.DANI V
2 NY.NINING/TN.DEDEN V
3 NY.KRISTIANA/TN.IVAN V
4 NY.HESTY/TN.SOLIHIN V
5 NY.AAN/TN.FERI V
6 NY.VIKITN.CUCU V
7 NY.PURWATI/TN.M.JUWANA V
8 NY.DEWI/TN.SUHERMAN V V
9 NY.INA/TN.CECEP V
10 NY.YENI/TN.FEBY V V
11 NY.REZKY/TN.IDA V
12 NY.NENI/TN.GUGUN V V
13 NY.NIKEN/TN.UMAR V
14 NY.NENI/TN.AN'AN V
15 NY.HALIMAH/TN.DIKI V V
16 NY.NINA/TN.SUPRIATNA V V
17 NY.ELIS/TN.MULYATI V
16 6
18/04/2015 1 NY.ROSITAWATI/TN.EGY B V V
2 NY.NENI/TN.GUGUN V
3 NY.VIKY/TN.CUCU V V
4 NY.ELIS/TN.MULYATI V V
5 NY.RATIH/TN.SAWALUDIN V
6 NY.NINA/TN.SUPRIATNA V V
7 NY.NIKEN/TN.UMAR V
8 NY.DESSY/TN.IWAN V V
8 5
19/04/2015 1 NY.SURYANI/TN.HARI V
2 NY.RUSMIASIH/TN.HARUN V
3 NY.NINA/TN.SUPRIYATNA V V
4 NY.NIKEN/TN.UMAR V
5 NY.LILIS/TN.IWAN V
6 NY.ROSITAWATI/TN.EGY V
7 NY.RIRI/TN.M SAEPUDIN V V
8 NY.LILIS/TN.IWAN V V
9 NY.RATIH/TN.SAWALUDIN V
9 3
20/04/2015 1 NY.NURKOMALA/TN.AGUS V V
2 NY.AISYAH/TN.NURDIN V
3 NY.LILIS/TN.IWAN V
4 NY.RUSMIASIH/TN.HANIN V
5 NY.ALFIATUS/TN.M KHOLIK V
6 NY.PIPIT/TN.SONA V
7 NY.KARTINI/TN.SUMARDI V V
8 NY.NURHAYATI/TN.DEDI V
9 NY.NIKEN/TN.UMAR V
9 2
21/04/2015 1 NY.VERA/TN.HARDIA V
2 NY.NURKOMALA/TN.AGUS V V
3 NY.NIKEN/TN.UMAR V
4 NY.NIA/TN.DANI V
5 NY.LENI/TN.AHMAD V V
6 NY.NITA/TN.DADANG V V
7 NY.KRISTINA/TN.DARMAWAN V V
8 NY.HENI/TN.AHMAD V V
9 NY.INA/TN.RAHMAT V V
10 NY.TETI/TN.ZULKARNAEN V V
11 NY.RANI/TN.IRVAN V
12 NY.MINAH/TN.DEDE V
13 NY.MICHELLE/TN.GERI V
14 NY.EFFA/TN.DIAN V
15 NY.PIPIT/TN.SONA V
16 NY.NURHAYATI/TN.DEDI V
16 7
22/04/2015 1 NY.INA/TN.RAHMAT V
2 NY.EFFA/TN.DIAN V V
3 NY.PIPIT/TN.SONA V
4 NY.NURKOMALA/TN.AGUS V
5 NY.LENI/TN.AHMAD V
6 NY.NITA/TN.DADANG V
7 NY.KRISTINA/TN.DARMAWAN V
8 NY.ADMINAH/TN.WAHYUDIN V V
9 NY.HENI/TN.AHMAD V
10 NY.NENDAH/TN.RUDIANA V V
11 NY.TIAN/TN.HENDRA V V
11 4
23/04/2015 1 NY.MULYATI/TN.BIDIYONO V V
2 NY.MINAH/TN.DEDE V V
3 NY.MIMIN/TN.NURDIN V
4 NY.SINTA/TN.ANGGA V
5 NY.INA/TN.IKA V
6 NY.YENI/TN.PANJI V
7 NY.EFFA/TN.DIAN V
8 NY.NURKOMALA/TN.AGUS V
9 NY.SITI/TN.INDRA V V
10 NY.SUHARTINI/TN.BAMBANG V V
11 NY.KRISTINA/TN.DARMAWAN V V
12 NY.NENDAH/TN.RUDIANA V
13 NY.ADMINAH/TN.WAHYUDIN V
14 NY.TIAN/TN.HENDRA V
13 6
24/04/2015 1 NY.SITI/TN.INDRA V
2 NY.SUHARTINI/TN.BAMBANG V
3 NY.LULU/TN.YUDI V V
4 NY.MULYATI/TN.BUDIYONO V V
5 NY.TIKA/TN.LUKY V
6 NY.INDRIANI/TN.REDI V
7 NY.INAY/TN.PUJIONO V
8 NY.SINTA/TN.ANGGA V
9 NY.NINA/TN.IKA V
10 NY.YENI/TN.PANJI V
10 2
25/04/2015 1 NY.LULU/TN.YUDI V V
2 NY.HILDA/TN.ARIF V
3 NY.INDRIYANI/TN.REDI V
4 NY.WIDIYAWATI/TN.SANDI V
5 NY.SINTA/TN.ANGGA V
6 NY.YENI/TN.PANJI V
7 NY.NIKEN/TN.UMAR V
8 NY.ENENG/TN.ETANG V
9 NY.MERLIN/TN.ANDRI V
9 1

26/04/2015 1 NY.INDRIANI/TN.REDI V
2 NY.SINTA/TN.ANGGA V
3 NY.YENI/TN.PANJI V
4 NY.ASRI/TN RENDI V V
5 NY MINAH/TN DEDE V V
5

27/04/2015 1 NY ASRI/TN RENDI V


2 NY RENI/TN DODI V
3 NY SINTA/TN ANGGA V
4 NY SITI A/TN WAWAN V V
5 NY SITI S/TN BUDI V V
5 2

28/04/2015 1 NY LILIS/TN AGUS V V


2 NY SHERLY/TN MISLAM V V
3 NY SITI A/TN WAWAN V V
4 NY SITI S/TN BUDI V V V
5 NY PIPIT/TN SONIA V
6 NY DIANA/TN YANA V V
7 NY ERNI/TN DITO V
8 NY RITA/TN GANJAR V
9 NY SINTA/TN ANGGA V
10 NY NUR INDRIANI/TN EMBAR V V
10 6 1

29/04/2015 1 NY PIPIT/TN SONA V


2 NY SUSI/TN INDARWAN V
3 NY RINA/TN YANA V
4 NY SAIRO/TN SANBO V
5 NY SINTA/TN ANGGA V
6 NY LILIS/TN AGUS V
7 NY FITRI/TN CECE V
8 NY SHERLY/TN MISLAM V
9 NY TIKA/TN IWAN V
10 NY NIA/TN ADI V V
11 NY LINDA/TN ERTOGAR V V
12 NY ROSITA/TN IWAN V
12 2

30/04/2015 1 NY FITRI/TN CECE V V


2 NY NIA/TN ADI V V
3 NY RENI/TN KUSNADI V V
4 NY ELIS/TN APEP V
5 NY PIPIT/TN SONA V
6 NY SITI K/TN SUJANA V V
7 NY HIYAROH/TN ADE V V
8 NY IDAH/TN UJANG V
9 NY SINTA/TN ANGGA V
10 NY RIDA/TN ISLAMI V
11 NY IIN/TN JEJEN V
11 5

314 104 3 5

Ruang Nifas 4 Bulan MEI 2015

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR


01/05/2015 1 ny sinta/tn angga v
2 ny rida/tn islami v
3 ny iin/tn jejen v
4 ny lilis/tn agit v
5 ny reni/tn kusnadi v
6 ny siti A/ tn kanana v v
7 ny siti n /tn hidayatuloh v v
jumlah 7 2
02/05/2015 1 ny lilis/tn agit v
2 ny tiansih/tn aceng v
3 ny siti A /tn nana v
4 ny rosita/tn iwan v
5 ny sinta/tn angga v
6 ny rida/tn islami v
7 ny iin/tn jejen v
jumlah 7 0
03/05/2015 1 ny rienaldi/tn ayi v
2 ny sinta/tn angga v
3 ny yuni/tn alexander v
4 ny sari/tn tatang v
5 ny evi/tn firman v
6 ny heti/tn kodir v
jumlah 6 0
04/05/2015 1 ny.ferawati/tn.rona v
2 ny.wati/tn.kusnadi v
3 ny.yeni/tn.asep v
jumlah 3 0
05/05/2015 1 ny.devi/tn.endang v
2 ny.nani/tn.feri v v
3 ny.rosita/tn.iwan v
4 ny.pia/tn.ropik v
5 ny.irma/tn.endang v
6 ny.rismawati/tn.deni v
7 ny.nurjayanti/tn.robiyanto v
8 ny.tia/tn.aditia v v
jumlah 8 0
06/05/2015 1 ny.tini/tn.tian v v
2 ny.ana/tn.arosoki v v
3 ny.rosita/tn.iwan v
4 ny.pia/tn.ropik v
5 ny.yuyun/tn.epi v
6 ny.tia/tn.aditia v v
jumlah 6 3
07/05/2015 1 ny.pipih/tn.nana v
2 ny.kokom/tn.hendra v
3 ny.yusniati/tn.ali v v
4 ny.rosita/tn.iwan v
5 ny.tia/tn.aditya v v
6 ny.santi/tn.marlon v
7 ny.tini/tn.tian v
8 ny.suryamah/tn.iwa v
9 ny.nurjanah/tn.bondan v
10 ny.imas/tn.hendri v v
11 ny.karwati/tn.sutara v v
12 ny.siti a/tn. iwan v
13 ny.tresnawati/tn.budi v v
14 ny.sri d/tn.andri v v
14 5 1
08/05/2015 1 ny.imas/tn.hendri v
2 ny.heni/tn.deden v v
3 ny.sri d/tn.andri v
4 ny.tresnawati/tn.budi v
5 ny.nina/tn.soami v v
6 ny.yosmati/tn.ali v
7 ny.rosita/tn.iwan v
8 ny.tia/tn.aditya v
9 ny.santi/tn.marlan v
9 2
09/05/2015 1 ny.rosita/tn.iwan v
2 ny.ai rina/tn.ujang v
3 ny.silvia/tn.dini v
4 ny.tia/tn.aditia v
5 ny.santi/tn.marln v
6 ny.mariam/tn.dadan v
7 ny.nurendah/tn.dodi v
8 ny.nurjanah/tn.bonbon v
9 ny.nurbayati/tn.ahmad v v
10 ny.heni/tn.deden v
jumlah 10 1

10/05/15n 1 ny rosita/tn iwan v v


2 ny eulis/tn sandi v v
3 ny isyana/tn mustori v v
4 ny mariam/tn dadan v v
5 ny nelli/tn muhajir v v
6 ny nurbayiti/tn ahmad v v
7 ny heni/tn deden v
8 ny rini/tn rizal v v
9 ny ida/tn maryana v v
10 ny yuliani/tnsupriatna v
11 ny siti aisyah/tn atep v v
11 9
11/05/2015 1 ny.ririn/tn.komaryadi v v
2 ny.rosita/tn.iwan v
3 ny.siti rokayah/tn.ugih v
4 ny.yulyani/tn.supriyatna v
5 ny.rini/tn.rizal v
6 ny.yopi/tn.haryadi v
7 ny.lasmayawati/tn.ayi v v
8 ny.elis/tn.jana v
8 1 1
12/05/2015 1 ny.ani/tn.m.sanny v v
2 ny.yuliani/tn.supriyatna v
2 1
13/05/2015 1 ny lasmawati/tn ayi v v
2 n y susilawati/tn santana v
3 ny evi/tn ajat v
4 ny nita/tn adi v
5 ny rini/tn rizal v v
6 ny ratna v
7 ny haapy/tn sugih v
8 ny tresnawati /tn oki v v
9 ny ani/tn sani v
10 ny rodiah/tn deni v v
11 ny yuningsih/tn yanto v
12 ny lia/tn suprianto v v
13 ny nia/tn doni v v
14 ny azfia/tn diaz v v

14 7

14/05/2015 1 ny restiani/tn oki v


2 ny rodiah/tn deni v
3 ny rini/tn rizal v
4 ny kristiarti/tn soni v
5 ny lia/tn suprianto v
6 ny nia/tn doni v v
7 ny azfia/tn diaz v
8 ny kokom/tn hendra v
9 ny lasmawati/tn agi v
10 ny eni/tn furkon v
11 ny yulia/tn agun v
12 ny tinah/tn yayat v v
13 ny elsa/tn gatot v
14 ny yati/tn sudarmanik v v
15 ny susilawati/tn santana v
16 ny evi/tn azat v
17 ny nita/tn adi v
18 ny risma/tn jaka v
18 3

15/05/2015 1 ny lasmawati/tn agi v v


2 ny dian/tn abang v
3 ny titin/tn dani v v
4 ny tita/tn aditya v
5 ny alin/tn asep v v
6 ny pipit/tn soni v
7 ny wulan/tn mujahidin v v
8 ny yeni/tn acep v v
9 ny sri/tn dian v v
10 ny ika/tn tresna v

9 7

16/05/2015 1 NY INDRI/TN RANGGA v


2 ny nurasyiyad/tn syaifulloh v
3 ny ana/tn jeni v
4 ny sundari/tn amin v
5 ny ika/tn tresna v
6 ny yuliawati/tn dede v
7 ny yanti/tn syamsudin v
8 ny wulan/tn muhajidin v v
9 ny yati/tn endang v
10 ny yeni/tn acepny tita/tn aditya v
11 ny titin/tn dani v
12 ny nia/tn agung v v
13 ny sri/tn dian v
14 ny sri/tn gunawan v

13 2 1
17/05/2015 1 ny yati/tn endang v
2 ny titin/tn mimid v v
3 ny tuti/tn dani v
4 ny nia/tn agung v
5 ny sri/tn gunawan v
6 ny ayuni/tn muhamad v
7 ny keke/tn irfan v
8 ny imas/tn rustandi v
9 ny sarah/tn rizki v v
10 ny indri/tn rangga v
11 ny nia/tn agus v
12 ny suryani/tn dedenny dina/tn jejen v
13 ny sundari/tn amin v
14 ny ika/tn tersna v v
15 ny siti/tn aim v
16 ny dina/tn m arif v

16 3

18/05/2015 1 ny sugih/tn suhendi v


2 ny kaka/tn irfan v
3 ny sarah/tn rizki v
4 ny nursyah/tn dwi v
5 ny indri/tn rangga v
6 ny suryani/tn deden v
7 ny nina/tn suherman v
8 ny erni/tn holis v
9 ny rini/tn agus v
10 ny karwati/tn mamat v
11 ny aditya/tn rendi v
12 ny santi/tn febrika v
13 ny titin/tn mimid v v
14 ny cahya/tn angga v

14 1
19/05/2015 1 ny aditya/tn rendi v
2 ny cahya/tn angga v v
3 ny nia/tn sutisna v v
4 ny maria/tn hasan v v
5 ny yeni /tn iim v v
6 ny nursyah/tn dewi v
7 ny rima/tn eni v
8 ny yati/tn endang v
9 ny nina/tn suherman v
10 nu eni/tn holis v
11 ny rini/tn agus v
12 ny rifa/tn hasan v
13 ny karwati/tn mamat v v

13 5
20/05/2015 1 ny irma/tn bangun v
2 ny nursyah/tn dwi v
3 ny rima/tn toni v
4 ny ina/tn ade v
5 ny wina/tn wendi v
6 ny rita/tn hasan v
7 ny karwati/tn mawar v v
8 ny yulia/tn sam v
9 ny aditya/tn rendi v
10 ny erna/tn aris v
11 ny cahya/tn angga v
12 ny maria/tn hasan v
13 ny yeni/tn iim v 1
14 ny susanti/tn lilik v v
15 ny widi/tn supena v

15 2 1

21/05/2015 1 ny aditya/tn rendi v v


2 ny erna/tn aris v
3 ny mimin/tn aep v v
4 ny susanti/tn lilik v
5 ny dedeh/tn sutiyadi v v v
6 ny widi/tn sumpena v
7 ny karwati/tn mamat v v
8 ny yuliana/tn sam v v

8 4 2

22/05/2015 1 ny wina/tn itra v


2 ny isyana/tn waskitu v
3 ny santi/tn febrika v v
4 ny santi/tn dani v
5 ny lenny/tn mak etek v v
6 ny yuliana/tn sam v v
7 ny aditya/tn rendi v
8 ny santi/tn erwan v v
9 ny poppy/tn tubagus v v

8 6

23/05/2015 1 ny dewi/tn edi v


2 ny kartika/tn asep v
3 ny adiya/tn rendi v
4 ny lini/tn pratio v
5 ny santi/tn erwan v
6 nypopi/tn tubagus v
7 ny noor/tn iwa v v
8 ny widia/tn ivan v
9 ny neng hasanah/tn oman v
10 ny wina/tn itra v
11 ny isnaya/tn wasnitu v
12 ny santi/tn febrika v
13 ny susan/tn agus v
14 ny santi/tn yuda v v
15 ny diani/tn solehudin v
16 ny mirawati/tn oki v
17 ny ati/tn rusdian v
18 ny yuliana/tn sani v

18 2

24/05/2015 1 ny wina/tn itra v


2 nyisnaya/tn waskitu v
3 ny santi/tn febriana v v
4 ny santi/tn dani v v
5 ny santi/tn yuda v v
6 ny diani/tn solihin v
7 ny gusmiati/tn imam v v
8 ny noor/tn iwa v v
9 ny idia/tn ipan v
10 ny neng hasanah/tn omon v
11 ny yustina/tn ngara v
12 NY CUCU/TN AGUS V
12 4 1
25/05/2015 1 ny putri/tn ahmad v v
2 ny santi/tn dani v v
3 nn tania v
4 ny diani/tn solehudin v
5 ny santi/tn toni v v v
6 ny yusmiati/tn ali v
7 ny isnaya/tn waskita v
8 ny wiriningsih/tn ajat v
9 ny nurlela/tn gugun v
10 ny dewi/tn gugun v
11 ny siti/tn kusnadi v
12 ny noor/tn iwa v v
13 ny neng itun/tn rosadi v v
14 ny yani/tn dedi v v
15 ny yulianti/tn agus v
16 ny mimin/tn soleh v v

16 7 1

26/05/2015 1 ny yanti/tn dudi v v


2 ny mariska/tn dila v v
3 ny mimin/tn soleh v
4 ny santi/tn toni v v
5 ny seli/tn iyan v v
6 ny dedeh/tn sutiyad v
7 ny ani/tn dadang v v
8 ny erlina/tn solehudin v
9 ny astri/tn ujang v
10 ny herlina/tn arifin v
11 ny R temi/tn ade v
12 ny siti khodijah/tn bambang v v
13 ny isyana/tn waskito v
14 ny wiriningsih/tn ajat v
14 6
27/05/2015 1 ny dedeh/tn sutiyadi v
2 ny indri /tn eri v v
3 ny erlina/tn solehudin v 1
4 ny astri/tn ujang v
5 ny nerlina/tn aryin v
6 ny siti/tn bambang v v
7 ny wiriningsih/tn ajat v
8 ny yanti/tn dudi v
9 ny mariska/tn dila v
10 ny diana/tn zezen v
11 ny pipit/tn heryano v v
12 ny santi/tn toni v v
13 ny seli/tn iyan v v

13 5 1

28/05/2015 1 ny dedeh/tn suyadi v


2 ny indri/tn eri v
3 ny siti/tn abdul v
4 ny lilis/tn maman v
5 ny erlina/tn saepudin v
6 ny neneng/tn atep v
7 ny dina/tn onong v
8 ny siti/tn ari v
9 ny resa/tn haris v
10 ny nina/tn ade v
11 ny santi/tn taofik v
12 ny toti/tn saefudin v v
13 ny rosmala/tn yuni v
14 ny yeni/tn dodi v
15 ny lilis/tn mman v v
16 ny pipit/tn heryo v
17 ny seli/tn iyan v v

17 2 1
29/05/2015 1 ny toti/tn saefudin v
2 ny rosmala/tn yani v
3 ny lilis/tn maman v
4 ny komalasari/tn iwan v v
5 ny neni/tn hendra v
6 ny iis/tn yaya v
7 ny dedeh/tn suhayadi v
8 ny leni/tn didun v
9 ny ane/tn agus v
10 ny indriani/tn redi v
11 ny lena/tn ilpanny nina/tn ade v
12 ny enung/tn hendra v
13 ny febi/tn maryanto v v
14 ny yani/tn yazid v
15 ny heni/tn hikmat v
14 2
30/05/2015 1 ny dinda/tn riony v
2 ny resta/tn jisman v
3 ny heni/tn hikmat v
4 ny lena/tn napiday v v
5 ny aida/tn endang v
6 ny yomita/tn ace v
7 ny mimin/tn nurman v
8 ny tantri/tn mamat v
9 ny melawati/tn muhamad fajar v
10 ny lena/tn elpan v
11 ny siti R /tn rudi v v
12 ny enng/tn hendra v
13 ny yani/tn yazea v
14 ny santi/tn taufik v
15 ny linda/tn nikolasny v
16 ny desi/tn rafael v
17 ny pipit/tn tri v
18 ny rini/tn beni v
19 ny roslina/tn dony v
20 ny iis/tn yaya v
20 2
31/05/2015 1 ny lena/tn napiday v
2 ny tuti/tn iwan v v
3 ny kokom/tn najudin v v
4 ny enung/tn hendra v
5 ny desi/tn rafael v
6 ny linda/tn nikolas v
7 ny lina/tn dedi v v
8 ny rini/tn beni v v

8 4

351 98 10

Ruang Nifas 4 Bulan JUNI 2015

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR


01/06/2015 1 ny evi/tn rohmat v
2 ny meika/tn dana v
3 ny sinta/tn drajat v
4 ny castem/tn nono v v
5 ny kartini/tn dian v v
6 ny tati/tn imang v
7 ny eni/tn dani v v
8 ny lulu/tn gumilar v
9 ny linda/tn nicholas v
10 ny aisyah/tn endang v
11 ny esih /tn sopian v v
12 ny ami/tn viky v v v
13 ny siti/tn ali v v
13 6 1

02/06/2015 1 ny dewi/tn indra v v


2 ny dewi/tn arifin v
3 ny castem/tn nono v v
4 ny kartini/tn diah v v
5 ny eni/tn dani v v
6 ny cucu/tn nandang v
7 ny neli/tn amim v v
7 5
03/06/2015 1 ny neng hayati/tn santoso v v
2 ny omah/tn rohman v
3 ny nining/tn suherman v
4 ny kartini/tn dian v
5 ny eni/tn dani v v
6 ny lina/tn huzaeni v
7 ny hilda/tn nuryono v
8 ny happy/tn sugih v
9 ny wiwin/tn sodaya v
10 ny lusi/tn asep v v
11 ny neli/tn amim v
12 ny anggi/tn giwan v
12 3

04/06/2015 1 ny lina/tn huzaeni v


2 ny hilda/tnnuryono v
3 ny lusi/ tn asep v v v
4 ny anggi/tn giwan v
4 1 1
05/06/2015 1 ny gina/tn ade v
2 ny linda/tn ahmad v v
3 ny fitria/tn ade v
4 ny sri/tn usep v
5 ny yani/tn iman v
6 ny lina/tn huzaeni v
7 ny irma/tn iman v v
8 ny febiyani/tn ahmad v v
9 by tini/tn trisna v
10 ny susi/tn yudi v
11 ny maesaroh/tn wisnu v
12 ny ipah/tn komaludin v v
13 ny yani/tn iman v

13 5
06/06/2015 1 ny linda/tn ahmad v v
2 ny yanti/tn tata v
3 ny hesti/tn agus v
4 ny putria/tn anggi v
5 ny gina/tn ade v
6 ny irma/tn irman v v
7 ny febiyani/tn ahmad v
8 ny rani/tn hanan v
9 ny tisi/tn indra v

9 2
07/06/2015 1 nyrisma/tn agista v
2 ny siti/tn asep v v
3 ny katini/tn jasin v v
4 nygianti/tn usep v v
5 ny cucu/tn heryana v
6 ny hesti/tn agus v
7 ny putria/tn anggi v
7 3
08/06/0115 1 ny ai/tn hendra v
2 ny fitri/tn hamzah v
3 ny kartini/tn jasin v
4 ny fitri/tn asep v v
5 ny dantika/tn adi v
6 ny rika/tn antoni v
7 ny nelis/tn ijan v
8 ny siti/tn tedi v
9 ny tita/tn iyus v
10 ny dinny/tn agung v
11 ny yani/tn dede v v
12 ny darwiyatun/tn kali v
13 ny sri/tn rizal v

13 2
09/06/2015 1 ny mimin/tn sodati v v
2 ny erma/tn suherman v v
3 ny jumila/tn samsul v
4 ny iis/tn wanda v
5 ny dewi/tn reki v
6 ny siti k/tn caca v
7 ny susi/tn burhanidin v
8 ny yani/tn dede v v
9 ny herma/tn agus v v
10 ny herna/tn rahmat v v
11 ny enung/tn rudian v v
12 ny tia/tn firman v v
13 ny yani/tn cecep v
14 ny sinta/tn peri v
15 ny ipah/tn ujang v
16 ny fitri/tn fandi v

16 6 1
10/06/2015 1 ny mimin/tn sodeti v
2 ny neni/tn ii v
3 ny wulan/tn misbah v
4 ny tia/tn firmanny v
5 ny neneng/tn doran v v
6 ny inci/tn herli v v
7 ny dewi/tn agung v v
8 ny nina/tn hilman v
9 ny mira/tn yusuf v
10 ny yuyun/tn eko v v
11 ny susi/tn burhanudin v
12 ny vina/tn agus v
13 ny enung/tn rudian v
14 ny irawati/tn sopian v
15 ny herna/tn agus v
15 4

11/06/2015 1 ny yunita v v
2 ny fitri v
3 ny yati v v
4 ny neneng v
5 ny dewi v
6 ny siti A v v
7 ny inci v
8 ny asti v
9 ny mimin v
10 ny aldinna v
11 ny yuyun v v
12 ny rani v
13 ny ragil v
14 ny herna v v

14 5

12/06/2015 1 ny dian/tn adicita v v


2 ny siti a/tn nunung v
3 ny yunita/tn m farid v
4 ny yati/tn hamdan v
5 ny siti/tn ridwan v
6 ny nining/tn anton v
7 ny mimin/tn sadeli v
8 ny nunung/tn yusup v v
9 ny ratini/tn basuki v
10 ny yuyun/tn eko v v
11 ny yuliawati/tn duek v
12 ny maemunah/tn tomi v v
13 ny herna/tn agus v v
13 5
13/06/2015 1 ny dian/tn adicita v
2 ny hilda/tn nuryono v v
3 ny rina/tn gandi v
4 ny herlina/tn iwan v
5 ny rani/tn hani v
6 ny siti/tn ridwan v v
7 ny nining/tn anton v v
8 ny mimin/tn radeli v
9 ny marlina/tn sansan v
10 ny nisa/tn randi v
11 ny sri/tn agus v
12 ny yuliawati/tn dede v
13 ny maemunah/tn tomi v v
13 2 2
14/06/2015 1 ny mimin/tn radeli v
2 ny rita/tn cepi v
3 ny yuliawati/tn dede v
4 ny hilda/tn nuryono v
5 ny wulan/tn edi v
6 ny sutiani/tn dodih v v
6 1
15/06/2015 1 ny ardian/tn taufik v
2 ny rita/tn cepi v
3 ny erni/tn yaya v
4 ny nikie/tn asep v
5 ny eli/tn rahmat v
6 ny yuliawati/tn dede v
7 ny ria/tn yadi v
8 ny riska/tn iyep v
8 0
16/06/2015 1 ny neneng/tn asep v v
2 ny gina/tn henhen v
3 ny rika/tn dudi v v
4 ny imas/tn agung v v
5 ny yuniar/tn ipan v v
6 ny nenden/tn ica v v
7 ny yuliani/tn hermantoni v v
8 ny kristianti/tn hendar v
8 6
17/06/2015 1 ny nurhayanih/tn agus v v
2 ny cucu/tn agus v v
3 ny rodiah/tn itang v v
4 ny riska/tn iyep v
5 ny neneng/tn asep v v
6 ny imas/tn agung v
7 ny yuyun/tn ahmad v v
8 ny deti/tn m agung v v
9 ny yuniar/tn ipan v
10 ny siti/tn a hasan v v
11 ny yuliani/tn hermantoni v
11 7
18/06/2015 1 ny lasmini/tn ara v
2 ny sinta/tn rukmana v
3 ny nurhayanih/tn agus v v
4 ny neng eli/tn rahmat v
5 ny eni/tn agus v
6 ny dini/tn yoni v v
7 ny lina/tn nono v
8 ny rodiah/tn itang v v
9 ny riska/tn iyep v v v
10 ny neneng/tn asep v v
11 ny eni/tn deni v v
12 ny widya/tn rendi v
13 ny yuyun/tn ahmad v
14 ny deti/tn m agung v
15 ny wida/tn atep v v
16 ny siti/tn a hasan v
17 ny nadina/tn gunawan v v
17 9 1
19/06/2015 1 ny sri/tn irwan v
2 ny eni/tn agus v
3 ny dini/tn yoni v v
4 ny riska/tn iyep v v
5 ny eni/tn deni v
6 ny yayu/tn edi v v
7 ny putri/tn ajat v
8 ny sri/tn hendri v v
8 4
20/06/2015 1 ny dessy/tn rizki v
2 ny neng eli/tn rohmat v
3 ny yulia/tn roni v
4 ny sodiah/tn safii v v
5 ny riska/tn iyep v v
6 ny neneng/tn asep v v
7 ny sri/tn hendri v
8 ny yayu/tn edi v
9 ny priska/tn deni v
10 ny omih/tn agus v v
9 5
21/06/2015 1 ny neni/tn asep v
2 ny siti/tn hans v v
3 ny siti/tn yana v
4 ny desi/tn rizki v
5 ny neng eli/tn rohmat v v
6 ny ristiani/tn deden v v
7 ny cahyati/tn dede v
8 ny heni/tn redi v v
9 ny sodiah/tn safii v v
10 ny intan/tn ridwan v
10 5
22/06/2015 1 ny cahyati v
2 ny henny v v v
3 ny sinta v
4 ny sodiah v
5 ny intan v
6 ny yulianti v
7 ny siti k v v
8 ny neni v v
9 ny elsa v v
10 ny nining v
10 4 1
23/06/2015 1 ny siti k v
2 ny neni v
3 ny cica v v
4 ny putie v v
5 ny sobiyah v v
6 ny sintawati v
7 ny cahyati v
7 3
24/06/2015 1 ny yeni v v
2 ny sintawati v
3 ny darsih v v
4 ny siti a v
5 ny silvia v v
6 ny cica v
7 ny nanny v v
8 ny yusi v v
9 ny sobiyah v
10 ny nisa v
10 5
25/06/2015 1 ny imas v v
2 ny yeni v v
3 ny silvia v
4 ny nani v
5 ny yusi v
6 ny jumila v
6 2
26/06/2015 1 ny usni v
2 ny yati v v
3 ny windi v
4 ny imas v
5 ny yeni v
6 ny neneng v v
7 ny eva v v
8 ny sri v v
8 4
27/06/2015 1 ny siti s v
2 ny neneng v
3 ny iis v v
4 ny neli v v
5 ny yati v v
6 ny eva v
7 ny sri v
8 ny farida v v
8 4
28/06/2015 1 ny budhiarti v v
2 ny iis v
3 ny kokom v v
4 ny neli v
5 ny eva v
6 ny sri v
7 ny farida v
8 ny ai siti v v
9 ny rosita v
10 ny sandri v
11 ny waryati v
12 ny siti n v v
13 ny nursipah v v
13 5
29/06/2015 1 ny budhiarti v v
2 ny siti m v v
3 ny nursipah v v
4 ny rani v v
5 ny novi v v
6 ny ai siti v
7 ny intan v
7 5
30/06/2015 1 ny rani v
2 ny novi v
3 ny intan v v
4 ny shintawati v
5 ny reni v v
6 ny euis v v
7 ny ries v v
8 ny nuraini v
9 ny imas v
10 ny winda v
11 ny ufit v
12 ny sri s v
13 ny yani v
14 ny siti v v
15 ny nursipah v v
15 6 7

Ruang Nifas 4 Bulan JULI 2015

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR


01/07/2015 1 NY SITI AISYAH/TN M AFRINALDI V
2 NY IMAS/TN DODI V
3 NY ARIE/TN TAUFIK V
4 NY WINDA/TN YADI V
5 NY YENI/TN RIZKI V
6 NY TRIA/TN FAUZI V
7 NY WAHIDAH/TN TULUS V
8 NY SITI/TN ROMI V V
9 NY NURSIPAH/TN DAEP V V
10 NY TRESNA/TN AHMAD V
11 NY INTAN/TN ANGGI V
12 NY SINTAWATI/TN DADANG V
13 NY NURLELAWATI/TN HENDI V
14 NY RENI/TN SOPIAN V
15 NY EUIS/TN YUDI V V
16 NY RIES/TN PUTI V
17 NY TRI/TN INDRA V V
17 4
02/07/2015 1 NY WULAN/TN OKA V
2 NY ANI/TN ANDRI V
3 NY IMAS/TN DODI V
4 NY LINA/TN FARHAN V V
5 NY YENI/TN M RIZKI V
6 NY ETI/TN JUNI V
7 NY NURSIPAH/TN DAEP V V
8 NY WIWIN/TN BARJAH V V
9 NY SANTIAWATI/TN M SENDI V V
10 NY TRI/TN INDRA V
10 4
03/07/2015 1 NY MEIS/TN ADEN V
2 NY LINA/TN FARHAN V V
3 NY ROSITA/TN SITA V
4 NY AAM/TN AGUS V
5 NY NURSIPAH/TN DAEP V V
6 NY VICKY/TN AGUS V V
7 NY SANTI/TN MIKARTA V V
8 NY WIWIN/TN BARJAH V V
9 NY SANTIAWATI/TN M SENDI V
9 5
04/07/2015 1 ny tita/tn heru v
2 ny nursanti/tn denni v
3 ny lilis/tn suherman v v
4 ny lina/tn farhan v v
5 ny anisa/tn ahmad v
6 ny sri/tn cecep v
7 ny diani/tn iki v
8 ny wawat/tn hendar v
9 ny kokom/tn yonatan v
10 ny aat/tn dian v v
11 ny nursipah/tn daep v v
12 ny yuli/tn yadi v
13 ny nurkmaila/tn eko v v
14 ny vicki/tn agus v
15 ny titi/tn anjar v
16 ny maya/tn iwan v
17 ny santi/tn mikarna v
18 ny deta/tn gilang v
19 ny lilis/tn ilyas v v
19 6
05/07/2015 1 ny nurkamila/tn eko v
2 ny selvia/tn windi v v
3 ny dede/tn wenda v
4 ny lilis/tn ilyas v v
5 ny rena/tn parulian v
6 ny titin/tn harisny lina/tn farhan v v
7 ny sri/tn cecep v
8 ny aat/tn dian v v
9 ny suci/tn adi v
9 3 1
06/07/2015 1 ny siti/tn dadan v
2 ny ai/tn mahmudin v
3 ny dede/tn wenda v v
4 ny rina/tn deni v v
5 ny lilis/tn sani v v
6 ny tita/tn heru v
7 ny tutik/tn sulaiman v
8 ny neni/tn rosid v
8 3
07/07/2015 1 ny lilis/tn heri v v
2 ny sri/tn muhsoni v v
3 ny dede/tn wenda v
4 ny titin/tn dede v v
5 ny nuni/tn hendra v v
6 ny elly/tn ale v v
7 ny alya/tn sutarso v
8 ny tita/tn heru v
9 ny reni/tn atang v
10 ny wida/tn purwadi v
11 ny neneng/tn tajudin v
11 5
08/07/2015 1 ny ina/tn yadi v
2 ny lilis/tn heri v
3 ny nuni/tn hendra v
4 ny neli/tn franky v v
5 ny dian/tn yudi v v
6 ny melina/tn alfa v v
7 ny elly/tn ale v v
8 ny yayu/tn budi v
9 ny dini/tn wisnu v
10 ny wida/tn purwadi v
10 4
09/07/2015 1 ny nurhalimah/tn triswan v v
2 ny erni/tn koswan v v
3 ny syandra/tn ipan v
4 ny yeni/ v
5 ny neli/tn franky v
6 ny isalora/tn kodir v
7 ny risma/tn eka v
7 2
10/07/2015 1 ny yuyun v
2 ny dina v
3 ny rini v v
4 ny siti m v
5 ny dian v
6 ny eti v
7 ny inomah v v
8 ny rina v v
9 ny yolanda v v
10 ny anisah v
11 ny iis v v
12 ny nurhalimah v
13 ny yulianti v
14 ny erni v
14 5

11/07/2015 1 ny husnul v v
2 ny nuryani v
3 ny yolanda v
4 ny dewi v v
5 ny anin v
6 ny iromah v
7 ny rini v v
8 ny endah v
9 ny aan v
10 ny yani v
11 ny iis v
11 3

12/07/2015 1 ny rini v v
2 ny aan v
3 ny iis v
4 ny husnul v
5 ny yani v v
6 ny dewi v v
6 2 1
13/07/2015 1 ny ane v v
2 ny euis v
3 ny anggi v
4 ny ai v
5 ny ela v v
6 ny lia v
7 ny siti v
8 ny rosi v
9 ny herni v v
10 ny neni v
11 ny heni v v
12 ny yayah v v
13 ny susi v
14 ny ani v
15 ny wiwin v v
15 6

14/07/2015 1 ny anisa v
2 ny wulan v
3 ny riska v v
4 ny euis v v
5 ny dewi v
6 ny anggi v
7 nyela v v
8 ny undari v v
9 ny siti v
10 ny herni v
11 ny nani v
12 ny heni v
13 ny nenden v v
14 ny ani v v
15 ny octaviani v v
16 ny pontiawati v
17 ny neni v
18 ny wiwin v
18 7

15/07/2015 1 ny eka v
2 ny debbi v v
3 ny ari v
4 ny atikah v
5 ny holis v
6 ny nuryawati v
7 ny euis v v
8 ny rini v
9 ny widaniah v v
10 ny shalma v
11 ny nurfuji v
12 ny nenden v
13 ny eulis v v
14 ny ani v
15 ny octaviani v
15 4

16/07/2015 1 ny desi v
2 ny nenden v
3 ny eulis v
4 ny debby v
5 ny ani v
6 ny cheny v
7 ny holis v
8 ny rofina v
9 ny neuls v
10 ny ratna v v

10 1

17/07/2015 1 ny debby v
2 ny ratna v v
3 ny rosi v
4 ny supriatin v
5 ny sofia v v
5 2
18/07/2015 1 ny yanti v
2 ny yuliani v
3 ny intan v
4 ny iis v
5 ny tuti v v
6 ny heni v
7 ny rupinah v v
8 ny supriati v
8 2
19/07/2015 1 ny nurfaridah v
2 ny yayah v
3 ny heni v
4 ny rupinah v v
5 ny wisty v v
6 ny ida v v
6 3
20/07/2015 1 ny sri v
2 ny dewanti v
3 ny sintia v
4 ny heni v
5 ny ai v v
6 ny hani v

6 1
21/07/2015 1 ny anita v
2 ny sumarni v v
3 ny ai v v
4 ny romlah v
5 ny yusi v v
6 ny utari v
7 ny santi v v
7 4
22/07/2015 1 ny yessi/tn dasep v v v
2 ny aan v
3 ny nursipah v v
4 ny santi/tn dzulkifli v
4 2 1

23/07/2015 1 ny nursipah v
2 ny sari v
3 ny irni v v
4 ny mahyati v v
5 ny rini v
6 ny yessi v
7 ny siti v
6 3

24/07/2015 1 ny yani v v
2 ny novia v
3 ny isma v
4 ny sumarni v
5 ny ati v
6 ny santi v
7 ny fitria v v
8 ny irni v
9 ny mahyati v
9 2
25/07/2015 1 ny ai v
2 ny devi v
3 ny siti khodariah v
4 ny ria v
5 ny siti murohmah v v
6 ny fitria v
7 ny novi v
8 ny nurdiani v
9 ny rina v
9 1
26/07/2015 1 ny siti nurohmah v
2 ny ai siti v v
3 ny teti v
4 ny lilis v
4 1
27/07/2015 1 ny mega v
2 ny rakanita v
3 ny anggi v
4 ny tintin v v
5 ny lilis v
6 ny leni v
7 ny asri v
8 ny risa v
9 ny christina v v
10 ny nunung v v
10 3
28/07/2015 1 ny deane v
2 ny nurholifah v v
3 ny christina v
4 ny nurlaela v
5 ny wina v
6 ny lina v
7 ny mega v
8 ny novi v
9 ny anggi v
10 ny euis v
11 ny tintin v
12 ny riska v
12 1
29/07/2015 1 ny eno v
2 ny siti H v v
3 ny neng yamah v
4 ny risneu v
5 ny nurholifah v v
6 ny supiah v v
6 3
30/07/2015 1 ny nurholifah v
2 ny supiah v
3 ny rina v v
4 ny yona v
5 ny eni v
6 ny siti n v v
7 ny avrie v
8 ny edah v v
9 ny fanny v
10 ny ernawati v
10 3
31/07/2015 1 ny silvi v
2 ny fanny v
3 ny ernawati v
4 ny sriningsih v
5 ny esti v v
6 ny nurholifah v
7 ny rina v
8 ny rini v v
9 ny stefani v
10 ny yona v v
10 2 1

Ruang Nifas 4 Bulan AGUSTUS 2015

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR


01/08/2015 1 ny runa/tn tatang v v
2 ny rustiana/tn wahyudin v
3 ny siti kh v
4 ny silvi v
5 ny esti/tn ahmad v
6 ny siti s/tn ari v v
7 nn nurholifah v
8 ny novia/tn dadan v v
9 ny rini/tn nurdin v
10 ny stevani/tn maralus v
10 3
02/08/2015 1 ny yunih/tn fikri v
2 ny wiwi/tn dodih v v
3 ny siti s/tn ari v v
4 ny ipah/tn tino v
5 ny siti s/tn m ridwan v
6 ny witri/tn solihin v
7 ny yani/tn haerudin v v
8 ny ai/tn supriyanto v
9 ny fitri v
10 ny tika/tn iqbal v
10 2 1
03/08/2015 1 ny ratna/tn ahmad v
2 ny wiwi/tn dodih v
3 ny warsiti/tn irman v v
4 ny tineu/tn indra v
5 ny wulan/tn oka v v
6 ny tati/tn koswara v v
7 ny budhiarti/tn tugio v v
8 ny daryani/tn teguh v
8 4
04/08/2015 1 ny sri rahayu/tn ari v v v
2 ny yuli/tn agung v
3 ny hetty/tn pipih v v
4 ny erna/tn dandi v v
5 ny wiwi/tn dadih v
6 ny euis/tn herdi v
7 ny rodiah/tn asep v v
8 ny warsiti/tn irman v v
9 ny wulan/tn oka v
10 ny tati/tn koswara v
10 5 1
05/08/2015 1 ny kadewi/tn ade v v
2 ny rodiah/tn asep v
3 ny susi/tn ahmad v
4 ny yuli/tn agung v
5 ny sofia/tn tia v
5 1
06/08/2015 1 ny susi/tn ahmad v
2 ny euis/tn cece v
3 ny sumarni/tn turiyo v
4 ny kadewi/tn ade v
5 ny neng supartini/tn rahayu v v
5 1
07/08/2015 1 ny susanti/tn yusuf v v
2 ny reni/tn risyanto v
3 ny mira/tn tristan v v
4 ny neng supartini v
4 2
08/08/2015 1 ny nikeu/tn luki v
2 ny rita/tn wawan v
3 ny kiki/tn rizal v v
4 ny susanti/tn yusuf v
5 ny wenny/tn acep v
6 ny mira/tn tristan v
7 ny euis/tn hasan v v
7 2
09/08/2015 1 ny kiki/tn rizal v
2 ny euis/tn hasan v
3 ny siti iim/tn dedi v
4 ny fauziah/tn supriatno v
5 ny yunita/tn nofian v v
5 1
10/08/2015 1 ny alis/tn aden v
2 ny mulyani/ tn aceng v
3 ny desi/ tn yudis v
4 ny fauziah /tn supriatna v
5 ny nikeu / tn luki v
6 ny yunita / tn nofiah v v
7 ny rantinah / tn irwan v
8 ny endah / tn kurnia v
9 ny suryani / tn samson v v
10 ny anisa / tn samsul v v
11 ny desi/tn kiki v v
11 4
11/08/2015 1 ny ane / tn abdul v
2 ny nina/tn trisna v
3 ny elis / tn umar v
4 ny dian / tn heri v
5 ny yunita / tn nofiah v v
6 ny novi/tn ranto v v
7 ny pipih / tn martindo v v
8 ny teungku / tn aris v

8 3
12/08/2015 1 ny dian / tn hery v
2 ny yuliana / tn ali v
3 ny cici / tn acep v v
4 ny pipih / tn martindo v v
5 ny tita / tn rudi v v
5 3
13/08/2015 1 ny rina/ tn taryadi v
2 ny dian / tn heri v
3 ny cici/tn ayep v v
4 ny risna/tn ahmad v
5 ny haryani / tn asep v v
6 ny nurul / tn agus v
7 ny vety/tn agus v v
7 3
14/08/2015 1 ny selvia/tn wendi v
2 ny evi / tn haryanto v v
3 ny haryani/tn asep v v
4 ny iis/tn patuan v v
5 ny veti/tn agus v v
6 ny hani/tn helmi v v
7 ny rini/tn doni v v
7 6
15/08/2015 1 ny iis/tn patuan v
2 ny vety/tn agus v
3 ny heni/tn helmi v
4 ny rini/tn doni v v
5 ny selvia/tn windi v
6 ny sri/tn agus v v
7 ny fera/tn dede v
8 ny silma/tn gunawan v
9 ny evi/tn hendrayana v
9 2
16/08/2015 1 ny gita/tn indra v
2 ny mia/tn adang v
3 ny rokayah v v
4 ny yeni/tn andri v v
5 ny eka / tn wawan v
6 ny sri/tn agus v
7 ny nurlaeni/tn encep v v
8 ny ati/tn rasian v v
8 4

17/08/2015 1 ny nurhalimah/tn acep v


2 ny lia/m falul v
3 ny dewi/tn yeyep v
4 ny heppy/tn sutarno v v
5 ny amanda/tn deni v
6 ny desi/tn gunawan v v
7 ny gina/tn riki v v
8 ny desi/tn ikbal v
9 ny gita/ tn indra v
10 ny mia/tn adang v
11 ny kiki/tn jajang v
12 ny rokayah /tn iing v v
13 ny kiki/tn wawan v
14 ny eka/tn wawan v v
14 5
18/08/2015 1 ny amanda/tn deni v
2 ny tini/ tn nandang v
3 ny teti/tn agus v
4 ny else/tn limping v
5 ny dede/tn hendi v
6 ny eka/tn wawan v
7 ny suwarni/tn mustadin v
8 ny sri/tn subarnah v v
9 ny leni/tn pandraugan v v
10 ny fani/tn injar v
11 ny dewi/tn yadi v
12 ny mia/tn andri v v
12 3
19/08/2015 1 ny suwarni/tn mustadin v v
2 ny aprilina/tn alex v
3 ny sri/tn sukarnah v
4 ny leni/tn pandaugan v
5 ny mia/tn andri v
6 ny maemunah/tn rizky v
7 ny eka/tn apriyadi v
8 ny teti/tn agus v
9 nydede/tn pendi v
9 1
20/08/2015 1 ny suwarni/tn mustadin v
2 ny aprilina/tn alex v
3 ny mira/tn ahmad v v
4 ny reni/tn devi v v
5 nydede/tn pendi v
5 2
21/08/2015 1 ny ervi/tn januar v
2 ny dela/tn rasim v
3 ny neli/tn deni v
4 ny mira/tn ahmad v
5 ny nurmalasari/tn saepudin v
6 ny reni/tn devi v v
7 ny sumaryani/tn heru v
8 ny satinem/tn witono v v
9 ny dian/tn atep v v
9 2 1
22/08/2015 1 ny elis/tn asep v
2 ny rosmanah/tn dedi v
3 ny avriyani/tn indra v
4 ny triayu/tn supriyatno v v
5 ny yusi v
6 ny evy/tn hendro v
7 ny nurmayanti/tn oni v v
8 ny erlin/tn teten v
9 ny suwarni/tn galih v v
10 ny tuti/tn rahmat v v
11 ny satinem/tn witono v
12 ny dian/tn atep v
12 4
23/08/2015 1 ny ratna/tn vehara v
2 ny nurmayanti/tn oni v
3 ny suwarni/tn galih v
4 ny siti/tn cecep v
5 ny tuti/tn rahmat v
6 ny siti r/tn faizal v v
7 ny suminar/tn agung v v
8 ny avriyani/tn indra v
9 ny triayu/tn supriyatno v v
9 3
24/08/2015 1 ny julaeha/tn ahmad v
2 ny sartika/tn pahlawi v
3 ny avriyani/tn indra v
4 ny triayu/tn supriyatno v v
5 ny siti yuliani v
6 ny kristi/tn hendi v v
7 ny qurotul/tn hendra v v
8 ny reni/tn devi v v
9 ny suminar/tn agung v v
9 4 1
25/08/2015 1 ny desi/tn asep v
2 ny nia/tn tatang v v
3 ny teti/tn memet v
4 ny herni/tn uud v v
5 ny kristi/tn hendi v
6 ny iis/tn iyan v
7 ny qutrotul/tn hendra v
8 ny reni/tn deni v
9 ny meri/tn kumia v
10 ny siti/tn ahmad v
10 2

26/08/2015 1 ny dita/tn rudi v


2 ny iis/tn iyan v
3 ny yuyun/tn dedi v v
4 ny siti/tn ahmad v
5 ny nia/tn tatang v v
6 ny tiara/tn edi v
7 ny apriliani v
8 ny neng kiki/tn arif v
9 ny warmi/tn dekman v
9 2

27/08/2015 1 ny efi/tn hendrayana v


2 ny siti k/tn arditya v
3 ny tati/tn bambang v
4 ny dini/tn sendi v
5 ny amilah/tn dian v
6 ny yunengsih/tn deni v v
7 ny laela/tn mulia v
8 ny imas/tn apu v v
9 nn apriliani v
10 ny neng kiki/tn arif v
11 ny warmi/tn dokman v
12 ny heni/tn farizal v v
13 ny neng neri/tn toni v
14 ny jenis/tn budi v
15 ny ejah/tn deni v
16 ny yuyun/tn dedi v
17 ny tita/tn riyan v v
28/08/2015 17 4
1 ny yeni/tn dani v
2 ny yeni/tn deni v
3 ny tati/tn bambang v
4 ny nurhayati/tn memed v
5 ny imas/tn apu v v
6 ny heni/tn ferizal v v
7 ny neng neri/tn toni v v
8 ny jenis /tn budi v v
9 ny ejah/tn deni v v
10 ny yuyun/tn deni v v
11 ny tita/tn riyan v v
12 ny luke/tn imam v
12 7
29/08/2015 1 ny maela/tn dimas v v
2 ny erma/tn saeful v v
3 ny luke/tn imam v
4 ny esih/tn alan v v
5 ny yunita/tn nofem v
6 ny yeni/tn deni v
7 ny rizka/tn munawar v
8 ny nia/tn yogi v v
9 ny lelasari/tn syahrul v
9 4
30/08/2015 1 ny nia/tn yogi v
2 ny lelasari/tn syahrul v v
3 ny maela/tn dimas v
4 ny erma/tn saeful v
5 ny esih/tn alan v
5 1
31/08/2015 1 ny lia/tn edward v
2 ny elis/tn rizal v
3 ny eli/tn irfan v v
4 ny nurhayati v v
5 ny suprihatin v
6 ny lelasari/tn syahrul v
7 ny esih/tn alan V V
7 2 1

Ruang Nifas 4 Bulan SEPTEMBER 2015


Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR
01/09/2015 1 ny juju/tn suyadi v v
2 ny eli/tn irfan v v
3 ny nurhayati/tn handoyo v v
4 ny cici/tn budhi v v
5 ny evi/tn dadan v
6 ny siti j/tn hedi v
6 3 1
02/09/2015 1 ny ati/tn asep v
2 ny juju/tn suyadi v v
3 ny yuli/tn dadan v v
4 ny martinah/tn gunadi v v
5 ny cici/tn budhi v v
6 ny siti j/tn hedi v v
7 ny ai/tn agus v
8 ny dedeh/tn sandi v
9 y yayah/tn tri v
9 5

03/09/2015 1 ny juju/tn suyadi v v


2 ny yuli/tn dadan v
3 ny siti desi/tn dian v v
4 ny dedeh/tn hasan v v
5 ny martinah/tn gunadi v
6 ny neng elis/tn ishak v v
7 ny ida/tn komarudin v v
8 ny neneng/tn dede v
9 ny kiki/tn irman v
10 ny ati/tn mulyawati v v
11 ny susan/tn herman v
11 6
04/09/2015 1 ny noni/tn sanni v
2 ny tarisah/tn m amran v v
3 ny siti desi/tn dian v
4 ny risma/tn iwan v v
5 ny dedeh/tn hasan v v
6 ny esih/tn dodi v v
7 ny yuliani/tn ujang v v
8 ny wahyu/tn waras v
9 ny yeni/tn denny v
10 ny sukesi/tn m zaenudin v
11 ny neda/tn bambang v
12 ny susan/tn herman v
12 5

05/09/2015 1 ny eka/tn tata v v


2 ny tarisah/tn amran v
3 ny imas/tn apu v v
4 ny yuliani/tn ujang v v
5 ny risma/tn iwan v
5 3

06/09/2015 1 ny eka/tn tata v


2 ny imas/tn apu v v
3 ny fitri/tn danu v v
4 ny rose/tn danu v v
5 ny citra/tn r.m aziz v v
6 ny deninta/tn munif v
6 4
07/09/2015 1 ny fitri/tn danu v
2 ny rose/tn danu v
3 ny widarini/tn memed v v
4 ny santi/tn yudi v v
5 ny rosmalasari/tn sandi v v
6 ny aisyah/tn aziz v
7 ny deninta/tn munif v
8 ny triayu/tn supriyanto v
9 ny neni/tn alex v
9 3
08/09/2015 1 ny siti r/tn sopyan v v
2 ny rifda/tn muhasti v v
3 ny ati/tn hadi v v
4 ny deninta/tn munif v
5 ny triayu/tn supriyanto v v
6 ny ai/tn herman v
7 ny dewi/tn iwan v
8 ny widarini/tn memed v
9 ny santi/tn yudi v
9 4
09/09/2015 1 ny dian/tn yudistira v
2 ny dewi/tn abdul v
3 ny asmara/tn suryadi v
4 ny deninta/tn munif v
5 ny rifda/tn muhasti v
6 ny triayu/tn supriyanto v v
7 ny siti r/tn hani v
7 1
10/09/2015 1 ny wati/tn nur risman v
2 ny elis/tn gatot v
3 ny triayu/tn supriyanto v
4 ny vivi/tn dadang v
5 ny debby/tn imanuel v v
5 1
11/09/2015 1 ny kurniasari/tn yuda v
2 ny ai/tn asep v v v
3 ny wati/tn tedi v
4 ny debby/tn imanuel v
5 ny lilis/tn asep v v
6 ny resti/tn imanuel v
7 ny ita/tn dadang v
8 ny sumiati/tn dadang v
9 ny eviana/tn yusman v
10 ny desi/tn setiawan v
11 ny elis/tn gatot v
12 ny vivi/tn dadang v
12 2 1

12/09/2015 1 ny astuti/tn asep v v


2 ny ai/tn asep v v
3 ny vivie/tn ismail v v
4 ny titin/tn frengki v
5 ny lusiana / tn hasan v v
6 ny sumiati /tn asep v
7 ny cici /tn cecep v v
8 ny syarifah/tn nasrul v
9 ny vivi/tn dadang v v
9 6

13/09/2015 1 ny sumiati/tn asep v


2 ny cici / cecep v v
3 ny vivie/tn ismail v
4 ny ai/tn asep v
3 2
14/09/2015 1 ny ai/tn asep v
2 ny mia/tn ruhyana v
3 ny deti/tn degi v v
4 ny anggraeni/tn adi v
5 ny tri/tn kiki v
4 2
15/09/2015 1 ny chitra v
2 ny iis v
3 ny endang v
4 ny sumiati v
5 ny reni v
6 ny seni v
7 ny neng mita v v
8 ny mia v
9 ny deti v
9 1
16/09/2015 1 NY neng mila v v v
2 ny siti aisyah v v
3 ny lilis/tn mulyanto v v
4 ny euis/tn nova v
5 ny citra/tn arriya v
6 ny tati/tn adi v v
7 ny siti/tn soni v
8 ny sumiati/tn asep v
9 ny reni/tn dadan v v
10 ny eneng/tn juhana v v
11 ny weni/tn deni v
11 6 1

17/09/2015 1 ny mia/tn rohyana v


2 ny lilis/tn mulyanto v v
3 ny dedeh/tn basri v v
4 ny chitra/tn m arya v v
5 ny tati/tn adi v
6 ny tita/tn yudi v
7 ny lilis/tn hendra v
8 ny eneng/tn yuhana v v
9 ny wati/tn andri v v
10 ny elsya/tn ari v v
11 ny lusi/tn fauzi v v
12 ny yuliani/tn zamal v v
12 8

18/09/2015 1 ny wati/tn andri v v v


2 ny gita/tn rahmat v v
3 ny ani/tn maman v v
4 ny rini/tn nandang v v
5 ny lusi/tn fauzi v v
6 ny rina/tn enjan v v
7 ny ai/tn tatang v v
8 ny nenden/tn edi v
9 ny yanti/tn darto v v
10 ny muji/tn posman v
11 ny maryani/tn hermansyah v
12 ny eni/tn sumadi v
13 ny citra/tn arya v
14 ny tati/tn adi v v
15 ny een/tn amin v
16 ny neneng/tn yuhana v v

16 9 2
19/09/2015 1 ny neden/tn edi v
2 ny yanti/tn indarto v v
3 ny siti/tn tia v
4 ny scitra/tn arya v v
5 ny dita/tn dayat v v
6 ny yuni/tn saripudin v v
7 ny gita/tn rahmat v v
8 ny ani/tn maman v v
9 ny rini/tn nandang v v
10 ny aam/tn asep v v
11 ny astri/tn agus v v
12 ny ai/tn tatang v
12 9
20/09/2015 1 ny tuti/tn yayan v
2 ny chitra/tn arya v
3 ny nia/tn taufik v
4 ny neneng/tn ali v
5 ny dita/tn dayat v v
6 ny astri/tn agus v
7 ny yuni/tn saripudin v
8 ny aam/tn asep v
8 1
21/09/2015 1 ny nia/tn taufik v
2 ny neneng/tn ali v
3 ny martaulina/tn petrus v v
3 1
22/09/2015 1 ny ida/tn mahdar v v
2 ny nurhayati/tn dadang v v
3 ny detty/tn samsam v v
4 ny ika/tn erik v v
5 ny juju/tn suyadi v v
5 5
23/09/2015 1 ny juju/tn suyadi v v
2 ny yunengsih/tn didin v v
3 ny fitri/tn yadi v
4 ny santi/tn ahmad v
5 ny ida/tn mahdar v
6 ny nurhayati/tn dadang v
7 ny detty/tn samsam v
8 ny ika/tn erik v
9 ny nanih/tn asep v v
10 ny eva/tn rohmat v v
11 ny imas/tn wahyu v v
11 5
24/09/2015 1 ny ine/tn deni v
2 ny gita/tn haris v
3 ny yayu v
4 ny dewi v
5 ny yunengsih/tn didin v v
6 ny fitri/tn yadi v v
7 ny lilis v
8 ny nanih/tn asep v
9 ny eva/tn rohmat v
10 ny linne/tn doni v
11 ny rosi/tn iman v
11 1 1
25/09/2015 1 ny ernawati/tn dede v v
2 ny imas/tn iran v
3 ny kurniawati/tn gandi v
4 ny nima/tn dedi v
5 ny sunari/tn rendi v
6 ny dewi v 1
7 ny lilis v
7 1 1
26/09/2015 1 ny ernawati/tn dede v
2 ny ani/tn rudi v
3 ny lilis v
4 ny nia/tn dian v
5 ny novianti v
6 ny theresa v
7 ny sri/tn dodi v v
8 ny nurhasanah/tn sandi v v
8 2
27/09/2015 1 ny metty v
2 ny vitria v
3 ny sri/tn dodi v
4 ny nurhasanah/tn sandi v v
5 ny cici v
6 ny lasmi v
7 ny mira v
8 ny sumi v
8 1
28/09/2015 1 ny ana v
2 ny fanny v
2

29/09/2015 1 ny siska v
2 ny suryani v
3 ny santi/tn soni v v
4 ny ecin/tn dadi v v
5 ny harlly v v
6 ny yessita v v
7 ny erma/tn yudi v v
7 5
30/09/2015 1 ny santi/tn soni v
2 ny ecin/tn dadi v
3 ny annisa v v
4 ny tating v
5 ny harlly v
6 ny yessita v
7 ny erma/tn yudi v
8 ny asni v
9 ny ani v v
10 ny nurhasanah v
10 2

Ruang Nifas 4 Bulan oktober 2015


Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR
01/10/2015 1 ny gapri/tn aji v v
2 ny ani/tn roni v v
3 ny lils/tn suyitno v
4 ny nova/tn roni v
5 ny wida/tn deri v v
6 ny ira/tn iman v
7 ny rosidah/tn rohaedin v v
8 ny sumarni/tn oped v v
9 ny anisa/tn julian v v
10 ny nurul/tn dendi v v
10 8

02/10/2015 8 ny eri/tn robi v v


2 ny neng rina/tn mamat v v
3 ny teti/tn nindi v v
4 ny nurul/tn dendi v
5 ny widiani/tn wahyudin v
6 ny santi/tn ali v
7 ny martaria/tn roymartin v v
8 ny wida/tn deri v v
8 5

03/10/2015 1 ny yuliani/tn bambang v


2 ny martaria/tn bambang v v
3 ny uun/tn iwan v v
4 ny nunik/tn toni v v
5 ny pipit/tn maman v v
6 ny eri/tn robi v v
7 ny neng rina/tn mamat v v
8 ny tian/tn rahmanto v
9 ny sri wulan/tn tenten v
9 6
04/10/2015 1 ny hikmat/tn yusuf v
2 ny tian/tn rahmat v
3 ny pupuh /tn hoerudin v v
4 ny indriyani/tn anton v v v
5 ny susilawati/tn adi v v
6 ny yuliani/tn bambang v
7 ny nunik/tn toni v v
8 ny pipit/tn maman v
8 4 1

05/10/2015 1 ny dian/tn nuryaman v


2 ny susi/tn andri v
3 ny roos/tn salimin v v v
4 ny dini/tn aziz v
5 ny ester/tn tri v
6 ny pipit/tn mman v
7 ny titi/tn maulana v v
7 2 1

06/10/2015 1 ny leni/tn aep v


2 ny titi/tn maulana v
3 ny siti/tn taufik v
4 ny ytuni/tn asep v
5 ny roos/tn salimin v v
6 ny desi/tn adi v v
7 ny euis/tn eman v v
8 ny rita/.tn sandi v
9 ny nirma/tn opa v
10 ny iis/tn suryadi v
11 ny dian/tn nuryaman v
12 ny susi/tn andri v
13 ny dini/tn abdul v
13 3
07/10/2015 1 ny sri/tn irpan v
2 ny tintin/tn dedi v
3 ny yuni/tn asep v
4 ny desi/tn adi v v
5 ny ros/tn salimin v
6 ny evi/tn sapto v
7 ny nirma/tn opa v
7 1

08/10/2015 1 ny sri/tn irpan v


2 ny noni/tn bagus v
3 ny sri/tn hendi v v
4 ny tintin/tn dedi v v
5 ny ratih/tn satiman v
6 ny enar/tn uje v
7 ny ipah/tn enjangny v
8 ny tini/tn yana v v
9 ny nirma/tn opa v
10 ny neng kiki/tn arif v
11 ny endah/tn asep v
12 ny neneng/tn atep v
13 ny titing/tn dadan v
13 3

09/10/2015 1 ny widaningsih/tn iskandar v


2 ny amirah/tn mujio v
3 ny nia/tn taopik v
4 ny neneng/tn atep v
5 ny titing/tn dadan v
6 ny sri/tn hendi v
7 ny lisna/tn ebta v v
8 ny enar/tn uje v v

8 2
10/10/2015 1 ny reni/tn dasikin v
2 ny ani/tn suparno v
3 ny dewi/tn beni v v
4 ny dinar/tn m rizal v
5 ny lisna/tn ebta v
6 ny tika/tn anggi v v
7 ny nurhayati/tn nandang v v
7 3
11/10/2015 1 ny dewi/tn beni v
2 ny tika/tn anggi v
3 ny nurhayati/tn nandang v
4 ny reni/tn dasikin v
5 ny meliana/tn asep v v
5 1
12/10/2015 1 ny reni/tn dasikin v
2 ny meliana/tn asep v v
3 ny imas/tn rusmana v
4 ny lina/tn bina v
5 ny siti/tn dadang v v
6 ny piana/tn iwan v
7 ny lina/tn eko v v
8 ny irma/tn uti v
9 ny siti m /tn yoka v
10 ny nuryeni/tn david v
11 ny novia/tn purnomo v v
11 4
13/10/2015 1 ny tanti/tn asep v
2 ny siti/tn dadang v
3 ny lina/tn eko v
4 ny novia/tn purnomo v
4
14/10/2015 1 ny rita/tn agus v
2 ny meyda/tn nizar v
3 ny intan/tn yudi v
4 ny nina/tn sugiono v
5 ny novia/tn purnama v
6 ny wati/tn andri v
7 ny tini/tn agus v
8 ny tintin/tn agus v
8
15/10/2015 1 ny imas/tn ade v
2 ny eni/tn didi v
3 ny tanti/tn asep v
4 ny rita/tn agus v v
5 ny faria/tn damrom v v
5 2
16/10/2015 1 ny rohati/tn ferry v v
2 ny yeni/tn erry v v
3 ny rita/tn agus v
4 ny faria/tn damrom v
5 ny herawati/tn andri v v
6 ny halimah/tn ramdan v v
7 ny syurtiah/tn alimudin v
8 ny yustika/tn atep v
9 ny yuli/tn ade v
10 ny eni/tn didi v
11 ny siti ningrat/tn asep v v
11 5
17/10/2015 1 ny enur/tn riki v
2 ny marwah/tn adang v
3 ny neng riska/tn irfan v v
4 ny desi/tn adi v
5 ny popy/tn hilman v
6 ny neng koni/tn alif v
7 ny rohati/tn ferry v
8 ny yeni/tn erry v
9 ny ita/tn jajan v v
10 ny herawati/tn andri v
11 ny halimah/tn ramdan v v
12 ny ida/tn rudi v
12 3 1
18/10/2015 1 ny ita/tn jajan v
2 ny halimah/tn ramdan v v
3 ny popy/tn iman v v
4 ny sri/tn yadi v v
5 ny desi/tn adi v
5 3
19/10/2015 1 ny mujiati/tn candra v
2 ny sri/tn yadi v
3 ny yayu/tn septyan v v
3 1
20/10/2015 1 ny yuli/tn kurniawan v v
2 ny yayu/tn septyan v
3 ny umi/tn tendi v
3 1
21/10/2015 1 ny ita/tn mulyadi v
2 ny ening/tn heru v
3 ny yuli/tn kurniawan v v
4 ny herni/tn ali v
5 ny wiwin/tn tatang v v
5 2
22/10/2015 1 ny lilis/tn muchlisin v v
2 ny lulu/tn dani v v
3 ny wiwin/tn tatang v
4 ny sugiarti/tn rona v
4 2
23/10/2015 1 ny dian/tn iyep v v
2 ny elsa/tn saeful v v
3 ny lilis/tn muchlisin v
4 ny lulu/tn dani v
5 ny hamidah/tn husen v v
6 ny erni/tn sutisna v
7 ny kokom/tn dadang v v
8 ny mariam/tn irwan v v
9 ny nuning/tn dadan v
9 5
24/10/2015 1 ny dian/tn iyep v v
2 ny cica/tn saeful v
3 ny marfina/tn frans v v
4 ny dini/tn asep v
5 ny hamidah/tn husen v
6 ny aas/tn undang v
7 ny eni/tn didi v v
7 3
25/10/2015 1 ny eni/tn didi v v
2 ny fuji/tn dede v
3 ny uniyati/tn agus v v
4 ny neng Aminah/tn heri v
5 ny rina/tn usup v v
5 3
26/10/2015 1 ny maesaroh/tn asep v
2 ny rina/tn usup v
3 ny uniyati/tn agus v v
4 ny dewi/tn indra v v
5 ny sri m/tn didin v v
6 ny mega/tn feri v v
7 ny fujiyanti/tn suwandi v
8 ny cicih/tn odo v
9 ny neng Aminah/tn heri v
9 4
27/10/2015 1 ny ratnasri/tn destiana v
2 ny uun/tn andri v
3 ny riska/tn asep v v
4 ny cicih/tn odo v
5 ny melliyana/tn asep v v
6 ny sri/tn dedi v v
7 ny ai neni/tn iwan v
7 3
28/10/2015 1 ny adah/tn undang v v
2 ny riska/tn asep v
3 ny cicih/tn oda v
4 ny mellyana/tn asep v
4 1
29/10/2015 1 ny meta/tn anshar v
2 ny adah/tn undang v v
3 ny sari/tn olih v
4 ny ririn/tn heri v
5 ny ani/tn saning v
6 ny dewi/tn riju v v
7 ny cicih/tn oda v
7 2
30/10/2015 1 ny titi/tn suhada v
2 ny eros/tn ali v
3 ny susan/tn soni v
4 ny sinta/tn eka v
5 ny nadia/tn asep v
5 0
31/10/2015 1 NY YAYU/tn rizal v v
2 ny diana/tn hendra v
3 ny wiji/tn asep v v
4 ny racmawati/tn supriyadi v
5 ny titi/tn suhada v
6 ny nurhayati/tn asep v
7 ny ikeu/tn mikhael v v
8 ny sinta/tn eka v
9 ny ani/tn saring v
10 ny yayan/tn ahmad v
11 ny isyeu/tn kurniawan v v
12 ny tita/tn supriyatna v
13 ny suryati/tn adi v
13 4 1 2

Ruang Nifas 4 Bulan November 2015

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2015 1 ny isyeu/tn kurniawan v v
2 ny yayu/tn rizal v v
3 ny wiji/tn aep v
4 ny nurhayati/tn asep v
5 ny lina/tn henrda v v
6 ny ikeu/tn mikhael v
6 3
02/11/2015 7 ny kurniasih/tn ali v v
8 ny heni/tn dadang v
9 ny supianti/tn agus v v
10 ny rani/tn rizki v v
4 3 1
03/11/2015 11 ny anisa/tn ardi v v
12 ny ika/tn wawan v v
13 ny supianti/tn agus v
14 ny hellen/tn aldi v
15 ny usti/tn anugrah v
16 ny rusmala/tn tabroni v
17 ny sariah/tn tatang v v
6 4
04/11/2015 18 ny supena/tn idrus v v
19 ny sinta/tn angga v v
20 ny usti/tn anugrah v
21 ny siti n/tn irman v
22 ny irene/tn gilang v v
23 ny lela/tn suhendi v v
24 ny sariah/tn tatang v
25 ny viny/tn ian v
26 ny ating/tn aziz v
27 ny wiwi/tn dodih v
28 ny eneng/tn iwan v
29 ny siti h/tn iwan v v
30 ny widayanti/tn suriadi v
31 ny anisa/tn ardi v v
32 ny supianti/tn agus v
33 ny hellen/tn aldi v
15 7
05/11/2015 34 ny supena/tn idrus v
35 ny sinta/tn angga v
36 ny siti n/tn irman v v
37 ny lela/tn suhendi v
38 ny teti/tn m nurdin v
39 ny anisa/tn ardi v v
40 ny agustini/tn hasanudin v v
7 3
06/11/2015 41 ny sri/tn dira v v
42 ny imas/tn mamad v v
43 ny agustini/tn hasanudin v v
44 ny ane/tn cecep v
45 ny desi/tn mardian v v
5 4
07/11/2015 46 ny setiani/tn nurman v
47 ny lena/tn dadang v
48 ny risma/tn hendi v
49 ny desi/tn mardian v v
50 ny hertati/tn parmonangan v v
51 ny ani/tn hasanudin v
52 ny siti h/tn iwan v
53 ny sri/tn dira v
54 ny imas/tn mamad v
55 ny eli/tn sugiarto v
56 ny agustini/tn hasanudin v v
57 ny ani/tn wahyadi v
12 3
08/11/2015 58 ny reni/tn liston v
59 ny sri r/tn yangki v v
60 ny nurul/tn azmi v
61 ny juju/tn kasman v
4 1
09/11/2015 62 ny teni/tn henok v
63 ny siti r/tn dede v v
64 ny nadia/tn m irfan v
65 ny nurlela/tn bahanni v v
66 ny nurhayati/tn yusuf v v
67 ny darti/tn mukharor v
68 ny hana/tn agus v v
69 ny sri r/tn yangki v v
8 5
10/11/2015 70 ny hana/tn agus v
71 ny siti r/tn dede v
72 ny novianti/tn andri v v
73 ny tri/tn arif v v
74 ny yuli/tn aditya v v
75 ny nurlela/tn bahanni v
6 3
11/11/2015 76 ny r mira/tn hadi v
77 ny winda/tn luki v
78 ny wiblik/tn walma v
79 ny srilawati/tn dian v
80 ny neneng/tn riki v
81 ny dhini/tn yogi v v
82 ny elin/tn dede v v
83 ny tri/tn arif v
84 ny yuli/tn adithya v
9 2
12/11/2015 85 ny dhini/tn yogi v v
86 ny rani/tn adi v v
87 ny elin/tn dede v
88 ny siti m/tn m riza v
89 ny shendy/tn dominggos v
90 ny nindi/tn adang v
91 ny herlinawati/tn ikin v
92 ny dumyanti/tn sugito v
93 ny dwi/tn suisman v
94 ny sulaetin/tn apipudin v
10 2
13/11/2015 95 ny rani/tn adi v
96 ny neng hernawati/tn nurjaman v
97 ny neng pipih v
98 ny any/tn daus v v
99 ny iis/tn asep v v
100 ny nuraeni/tn irfan v v
101 ny harianti v v
102 ny yuyuk/tn koswara v
103 ny siti n/tn tatang v
104 ny febiani/tn asep v
105 ny dini/tn asep v
105 ny sulaetin/tn apipudin v
12 4
14/11/2015 106 ny nelly/tn haidar v
107 ny reni/tn jejen v
108 ny ernawati/tn sulaeman v v
109 ny sulaetin/tn apipudin v v
110 ny lusi/tn rendra v
111 ny yuyuk/tn kuswara v v
112 ny any/tn daus v
7 3
15/11/2015 113 ny yuyuk/tn kuswara v
114 ny sulaetin/tn apipudin v
115 ny triyanti/tn perdiansyah v
116 ny nurhayati/tn asep v
117 ny sri/tn cecep v
118 ny nelly/tn m haedar v
119 ny ernawati/tn sulaeman v
120 ny saniya/tn saprudin v v
121 ny erin/tn agus v
122 ny nurul/tn indra v
10 1
16/11/2015 123 ny tini/tn - v v
124 ny sari/tn asep v v
125 ny suhaetin/tn afirudin v v
3 3

17/11/2015 126 ny tini/tn - v v


127 ny sari/tn asep v v
128 ny meyantiny v v
129 ny tanti/tn asep v
4 3
18/11/2015 130 ny ria/tn hendra v
131 ny tanti/tn asep v
132 ny aan/tn yanto v v
133 ny ana/tn rahman v v
134 ny neng cica/tn firman v
135 ny dewi/tn dodi v v
136 ny eulis/tn udin v
137 ny tini/tn - v v
138/ ny eva/tn ade v
139 ny meyantiny v v
140 ny ani/tn dudung v
11 5
19/11/2015 141 ny meyantiny v v v
142 ny ani/tn dudung v
143 ny tanti/tn asep v
144 ny aan/tn yanto v
145 ny ana/tn rahman v
146 ny nurazizah/tn funai v v
147 ny santi/tn cep r v v
148 ny chandra/tn robi v v
149 ny tini/tn - v v
9 5 1
20/11/2015 150 ny tanti/tn asep v
151 ny nina/tn reza v
152 ny lia/tn maman v v
153 ny siti/tn agus v v
154 ny nurazizah/tn funai v
155 ny santi/tn cep r v
156 ny chandra/tn robi v
157 ny maesaroh/tn ferri v
158 ny resma/tn dendi v
159 ny dewi/tn asep v
160 ny meyantiny v v
11 3
21/11/2015 161 ny gustiani/tn iip v
162 ny herna/tn joko v v
163 ny susanti v
164 ny aneu/tn heri v
165 ny meyantini v v
166 ny safitri/tn khoeroni v v
6 3
22/11/2015 167 ny opi/tn ade v
168 ny rumiyati/tn joko v v
169 ny lisda/tn jaenudin v v
170 ny dolis/tn mulyana v
171 ny winda v v
172 ny aat/tn arif v v
173 ny safitri/tn khoeroni v
174 ny rini/tn ahmad v
175 ny meyantini v
176 ny herna/tn joko v
177 ny ruri/tn abdul v
178 ny titin/tn jaja v v
12 5
23/11/2015 179 ny titin/tn jaja v
180 ny opi/tn ade v
181 ny lisda/tn jaenudin v v
182 ny helma/tn iin v v
3 2 1
24/11/2015 183 ny riane/tn rohman v
184 ny lisda/tn jaenudin v
185 ny yeni/tn arif v v
186 ny anna/tn kinkin v v
187 ny kori/tn yusuf v v
4 4
25/11/2015 188 ny ani/tn dudung v
189 ny dawiyah/tn nurohman v v
190 ny lisda/tn jaenudin v
191 ny anna/tn kinkin v v
192 ny kori/tn yusuf v
193 ny iyus/tn hendi v v
194 ny imas/tn reka v v
195 ny triyati/tn sumardi v v
196 ny nining/tn bugi v v
197 ny arni/tn iing v
9 7
26/11/2015 198 ny vina/tn indra v
199 ny sri/tn sam v v
200 ny tjin lien/tn harun v v
201 ny triyati/tn sumardi v v
202 ny tina/tn rosen v v
203 ny ani/tn dudung v
204 ny rupiyati/tn jevi v v
205 ny sri/tn wirid v
8 5
27/11/2015 206 ny muryati/tn masberdi v
207 ny ani/tn dudung v
208 ny yeti/tn tatang v v
209 ny rumiyati/tn joko v v
210 ny puji/tn azmi v v
211 ny sri/tn sam v
212 ny tjin lien/tn harun v
213 ny elis/tn nana v v
214 ny tina/tn rosen v
9 4
28/11/2015 215 ny neni/tn devi v
216 ny yeti/tn tatang v v
217 ny fitri/tn restu v
218 ny titin/tn jaja v v
219 ny puji/tn azmi v
220 ny elis/tn nana v
6 2
29/11/2015 221 ny rian/tn indra v
222 ny eka/tn yahya v
223 ny nining/tn yadi v
224 ny fitri/tn restu v v
225 ny titin/tn jaja v v
226 ny reni/tn didin v v
227 ny yanti/tn didi v v
7 4
30/11/2015 228 ny heni/tn aan v
229 ny nuryandwi/tn herdiana v
230 ny rani/tn agus v v
231 ny rohaeni/tn anwar v
232 ny ade/tn nizar v v
233 ny annisa/tn wahyudin v v
6 3

Ruang Nifas 4 Bulan Desember 2015

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2015 1 ny anissa/tn wahyudin v
2 ny ririn/tn cahyadi v v
3 ny tuti/tn ridwan v
4 ny yuli/tn guntur v v
5 ny novi/tn anggi v v
6 ny lia/tn rido v
7 ny nuryan/tn herdiana v
8 ny santi/tn saripudin v
9 ny nani/tn nandang v v
10 ny neneng/tn demo v v
10 5
02/12/2015 11 ny tutin/tn ade v
12 ny nani/tn nandang v v
13 ny siska/tn andre v
14 ny putik/tn taufan v
15 ny ririn/tn cahyadi v
16 ny novi/tn anggi v
17 ny messi/tn fikri v v
18 ny rosita/tn ade v v
19 ny iyus/tn hendi v v
9 4
03/12/2015 20 ny maryanti/tn resa v
21 ny messi/tn fikri v
22 ny nurani/tn mulyadi v
23 ny titin/tn suryadi v
24 ny rumanah/tn - v
25 ny evi/tn reni v
26 ny nani/tn nandang v v
27 nn susi v
8 1
04/12/2015 28 ny meyzha/tn den v v
29 ny melur/tn Andi v v
30 ny leni/tn dudun v
31 ny yati/tn among v
32 ny silvi/tn arif v
33 ny ipah/tn heri v v
6 3
05/12/2015 34 ny sumiati/tn samsudin v
35 ny nita/tn erwin v v
36 ny marwati/tn wandi v
37 ny iis/tn andi v
38 ny meyzha/tn den v
39 ny irma/tn asep v
40 ny bernike/tn ridwan v v
41 ny tri imma v
42 ny ipah/tn heri v
9 2
06/12/2015 43 ny marwati/tn wandi v
44 ny iis/tn andi v
45 ny atin/tn supriyanto v
46 ny nita/tn erwin v
47 ny sri/tn m muchtar v v
48 ny dewi/tn dede v
49 ny bernike/tn ridwan v
7 1
07/12/2015 50 ny siti r/tn saeful v v
51 ny nunung/tn rahmat v
52 ny marwati/tn wandi v
53 ny pitriyani/tn enden v v
54 ny atin/supriyanto v v
55 ny nena/tn andrian v
56 ny sri/tn muchtar v v v
7 3 2
08/12/2015 57 ny ratih/tn liyan v v
58 ny fitri/tn sahrum v
59 ny triyati/tn sumardi v v
3 2
09/12/2015 60 ny triyati/tn sumardi v v
61 ny ratih/tn liyan v
62 ny hujan/tn nurkholis v
63 ny nurhayati/tn luki v
64 ny nurhayati/tn joni v
5 1
10/12/2015 65 ny rita/tn fery v
66 ny tina/tn hilma v
67 ny yanti/tn cep tantan v v
3 1
11/12/2015 68 ny tita/tn ipan v
69 ny yanti/tn cep tantan v
70 ny ira/tn deni v v
71 ny yesita/tn deni v v
4 2
12/12/2015 72 ny ria/tn cahyadi v
73 ny ira/tn deni v
74 ny rinrin/tn dikdik v
75 ny oktaviani/tn irvan v
4 0
13/12/2015 76 ny desi/tn agus v
77 ny oktaviani/tn irvan v
78 ny siti/tn defri v
79 ny elsa/tn saripudin v
4 0
14/12/2015 80 ny diah/tn barkah v v
81 ny endah/tn ishak v v
82 ny yanti/tn harto v v
83 ny lina/tn ahum v v
84 ny khafianah v
85 ny atik/tn ade v
86 ny susanti/tn asep v
87 ny sarah/tn nendi v
88 ny epi/tn ajad v v
9 5
15/12/2015 89 ny iis/tn andi v v
90 ny keti/tn iyan v
91 ny atik/tn ade v
92 ny devi/tn adie v v
93 ny diah/tn barkah v v
94 ny endah/tn ishak v
95 ny yanti/tn harto v
96 ny ibut/tn dadan v v
8 3 1
16/12/2015 97 ny devi/tn adie v
98 ny nuryati/tn rodian v
99 ny ibut/tn dadan v v
100 ny dewi/tn iman v
101 ny herlina/tn pringatan v
5 1
17/12/2015 102 ny imas/tn iwan v
103 ny siti r/tn dadan v
104 ny yati/tn sutiya v
105 ny iin/tn ary v
106 ny siti f/tn didi v
107 ny santi/tn sartino v v
108 ny neni/tn yana v v
7 2
18/12/2015 109 ny desi laela/tn jaenudin v v
110 ny tuti/tn hermawan v
111 ny saadah/tn isan v
112 ny pipih/tn mahmud v
113 ny siti f/tn didi v
5 1
19/12/2015 114 ny suanti/tn ajat v
115 ny tuti/tn hermawan v v
116 ny asri/tn yeremia v
117 ny saadah/tn isan v
118 ny amanda/tn asep v
119 ny kartini/tn saefulloh v
120 ny neng anah/tn ramli v
7 1
20/12/2015 121 ny eli/tn yogi v v
122 ny tuti/tn hermawan v v
123 ny nani/tn triyono v v
3 2 1
21/12/2015 124 ny kartika/tn suyitno v v
125 ny ela/tn safrilus v v
126 ny tanti/tn ujang v
127 ny nani/tn triyono v v
128 ny evi/tn yani v
5 3
22/12/2015 129 ny evi/tn yani v
130 ny kartika/tn suyitno v
131 ny ela/tn safrilus v
3 0
23/12/2015 132 ny resa/tn gingin v
133 ny nani/tn triyono v
134 ny helwi/tn beni v v
135 ny rosi/tn agus v
4 1
24/12/2015 136 ny helwi/tn beni v
137 ny ati/tn asep v
138 ny erni/tn nanang v
139 ny leni/tn suhendar v
4
25/12/2015 140 ny erni/tn nanang v
141 ny rd aceng/tn aceng v
142 ny ai nurma v v
143 ny wina/tn erwin v v
144 ny pipit/tn taruna v v
145 ny eni v v
146 ny nopi/tn hendra v v
147 ny iva/tn defi v v
8 5 1
26/12/2015 148 ny wina/tn erwin v v
149 ny pipit/tn taruna v v
150 ny eni v v
151 ny iva/tn defi v
152 ny kamelia/tn hilman v
153 ny erni/tn nanang v
154 ny ai/tn elinus v v
155 ny sheli v
7 4 1
27/12/2015 156 ny pipit/tn taruna v
157 ny rita/tn asep v v
158 ny diah/tn asnin v
159 ny romlah/tn sujamro v
160 ny irma/tn anbiya v
161 ny titin/tn iman v
6 1
28/12/2015 162 ny selvy/tn beni v v
163 ny mawarni/tn sandi v v
164 ny evania/tn deri v v
165 ny sumiati/tn kasmuri v
166 ny nenden/tn ebi v
167 ny siti/tn dodi v v
168 ny yani/tn mamat v v
7 5
29/12/2015 169 ny selvy/tn beni v
170 ny yani/tn mamat v v
171 ny mawarni/tn sandi v
172 ny siti h/tn dodi v
173 ny evania/tn deri v
174 ny dede v
6 1
30/12/2015 175 ny lela/tn lindo v
176 ny ana/tn sutisna v
177 ny ely/tn ayi v v
178 ny e rodiatus/tn agus v v
179 ny penny/tn nunu v v
180 ny santi/tn hendra v v
181 ny siti h/tn edi v
182 ny yani/tn mamat v
183 ny kiki/tn mawardi v
184 ny arin/tn rahmat v v
10 5
31/12/2015 185 ny shanty/tnn agusman v
186 ny santi/tn hendra v
187 ny siti h/tn edi v
188 ny nina/tn harly v
189 ny yully v
190 ny efriana/tn sutrisno v v
191 ny putri/tn fajar v
192 ny tini/tn didin v
193 ny santi/tn ganjar v v
194 ny penny/tn nunu v v
195 ny dian/tn ricky v v
11 4

Ruang Nifas 4 Bulan Januari 2016

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2016 1 ny siti m/tn lukman v
2 ny efriana/tn sutrisno v v
3 ny erni/tn asep v
4 ny penny/tn nunu v v
5 ny eloi/tn yonatan v
6 ny siti h/tn edi v
7 ny dian/tn dicky v
8 ny santi/tn ganjar v
8 1 1
02/01/2016 9 ny endah/tn cepi v
10 ny mala/tn ali usman v
11 ny widi/tn tatan v
12 ny eli siti/tn budi v v
4 1
03/01/2016 13 ny eli siti/tn budi v
14 ny pipih/tn andri v v
15 ny iah/tn tedy v
16 ny ema/tn yonan v
17 ny e rodiatus/tn agus v v
5 2
04/01/2016 18 ny royati/tn asep v
19 ny ema/tn yonan v
20 ny sofiani/tn ritanto v v
21 ny pipih/tn andri v
22 ny euis/tn dodi v
5 1
05/01/2016 23 ny juliah/tn edi v
24 ny dedeh/tn adang v
25 ny iah/tn tedi v
26 ny sri/tn rendi v v
27 ny sofiani/tn ritanto v
28 ny ida/tn jajang v v
29 ny evie/tn agustinus v v
30 ny lenny/tn anwar v v
8 4
06/01/2016 31 ny ida/tn jajang v
32 ny susan/tn hedi v v
33 ny lenny/tn anwar v
34 ny imas/tn ari v v
35 ny kinanti/tn yopi v
36 ny ai rosi/tn arif v v
37 ny sri/tn rendi v
38 ny fitri/tn eka v v
39 ny nuryani/tn herman v
9 4
07/01/2016 40 ny imas/tn ari v
41 ny ai rosi/tn arif v
42 ny fitri/tn eka v
43 ny novel/tn m nasrul v v
44 ny wina/tn deden v v
45 ny dewi/tn yadi v
46 ny susan/tn hedi v
47 ny mia/tn dikdik v v
48 ny rusi/tn firman v
49 ny irma/tn ahmad v
10 3
08/01/2016 50 ny wina/tn deden v
51 ny r nana/tn bobi v
52 ny hestini/tn supendi v
3 0
09/01/2016 53 ny atin/tn ariyadita v
54 ny wati v
55 ny nurafiza/tn akmal v v
56 ny diah/tn roni v
57 ny tunik/tn amin v v
5 2
10/01/2016 58 ny cucu/tn cepi v
59 ny lasmanah v
60 ny eti/tn jua v
61 ny nurafida/tn akmal v
4 0
11/01/2016 62 ny lasmanah v v
63 ny rifa/tn deden v v
64 ny dewi/tn deni v v
3 3
12/01/2016 65 ny lasmanah v
66 ny sumiati v
67 ny evi v v
68 ny dewi/tn dedi v
69 ny kartika v
70 ny neng mariam v
6 1
13/01/2016 71 ny megawati/tn deni v
72 ny hera/tn m ridwan v
73 ny ai/tn jidan v
74 ny leni/tn tantan v
75 ny ihat/tn dani v
76 ny mia/tn deni v v
77 ny mursidah/tn yayat v
78 ny evi v
79 ny nuridawati v v
80 ny eni v
81 ny desi/tn mulya v v
11 3
14/01/2016 82 ny cucu/tn amat v
83 ny siti aisyah/tn ade v
84 ny megawati/tn deni v
85 ny leni/tn tantan v
86 ny mia/tn deni v v
87 ny evi v
88 ny nuridawati v
89 ny irma v v
8 2
15/01/2016 90 ny asti/tn mukhlis v
91 ny evi/tn baenudin v v
92 ny irma/tn yohanis v
93 ny iin/tn muslim v
94 ny tini/tn ihan v v
95 ny partini/tn wasirin v v
96 ny rina/tn doni v v
97 ny heni/tn deni v
98 ny eka/tn komar v
99 ny cucu/tn adi v
100 ny yanti/tn nurhadi v
101 ny jeni/tn iwan v
12 3 1
16/01/2016 102 ny rina/tn doni v v
103 ny sinta/tn insan v v
104 ny jeni/tn iwan v
105 ny iin/tn gusti v v
106 ny tini/tn ihan v
5 2 1
17/01/2016 107 ny mulyati/tn firman v
108 ny sinta/tn insan v
2
18/01/2016 109 ny reti/tn yana v
110 ny pratiwi/tn taufik v
111 ny siti n/tn suryana v
3
19/01/2016 112 ny nova/tn dede v
113 ny yeni/tn andrian v
114 ny siti n/tn suryana v
3
20/01/2016 115 ny yani yuli/tn indra v v
116 ny yeni/tn andrian v
117 ny rahma v
118 ny ratih/tn riki v
119 ny ilah/tn agus v
120 ny irma/tn haris v v
6 2
21/01/2016 121 ny yani yuli/tn indra v
122 ny nunik/tn deni v
123 ny pujiati/tn stevi v
124 ny yeni/tn andrian v
125 ny yanti/tn dadang v v
126 ny sri/tn m muhtar v v
127 ny suwartini/tn suparno v v
128 ny rahma v
129 ny husaenah v v
130 ny minar/tn deni v v
131 ny irma/tn haris v
132 ny rita/tn tatan v
12 5
22/01/2016 133 ny suwartini/tn suparno v
134 ny desti/tn yudi v
135 ny rahma v
136 ny minar/tn deni v
137 ny wiwin/tn toto v v
138 ny iin/tn lutfi v
139 ny erna/tn andrianto v
140 ny sri/tn m muhtar v
141 ny mia/tn deni v v
142 ny lisa/tn yanto v
10 2
23/01/2016 143 ny yeni/tn andrian v
144 ny triyani v
145 ny leni/tn asep v
146 ny tita/tn irfan v
147 ny hajar v
148 ny wiwin/tn toto v
149 ny halida/tn gerry v
150 ny mia/tn deni v v
8 1
24/01/2016 151 ny nurfitri/tn ali v
152 ny halida/tn gerry v
153 ny mia/tn deni v v
3 1
25/01/2016 154 ny suci/tn hari v
155 ny mia/tn deni v v
2 1
26/01/2016 156 ny suci/tn hari v
157 ny cici/tn soni v v
158 ny yuyun/tn yepi v
159 ny astrid v
160 ny yumi v
5 1
27/01/2016 161 ny dewi/tn dadang v v
162 ny tri/tn andriyana v
163 ny cici/tn soni v v
164 ny sri/tn hendra v
165 ny dian/tn sudirman v
166 ny meyle/tn hali v
167 ny irawati/tn budi v
168 ny berna/tn dili v v
8 3
28/01/2016 169 ny cica/tn nani v v
170 ny lisnawati v
171 ny rita v
172 ny berna v
173 ny dewi/tn dadang v
174 ny yeni v
175 ny tri/tn andriyana v
176 ny aryani/tn hendra v
8 1
29/01/2016 177 ny sara v v
178 ny beti v
179 ny tri/tn andriyana v
180 ny aryani/tn hendra v
181 ny rosi/tn eka v v
182 ny riska/tn mahdan v
6 2
30/01/2016 183 ny indri/tn andri v
184 ny betty/tn dedi v v
185 ny tri/tn andriyana v
186 ny aryani/tn hendra v
187 ny lina/tn ahmad v v
188 ny kasmia v
189 ny ati/tn sardi v v
190 ny ayu v v
191 ny anisa/tn gagan v v
192 ny riska v
10 4 1

31/01/2016 193 ny reni v


194 ny ayu v
195 ny dini v v
196 ny enti v
197 ny kasmia v
5 1

Ruang Nifas 4 Bulan fEBRUARI 2016

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2016 1 ny yuni wahyuni v v
2 ny yati/tn aep v
3 ny reni v
4 ny tita/tn andri v
5 ny dini/tn shahrur v v
6 ny wike v
7 ny ida/tn prima v v
7 3
02/02/2016 8 ny reni v
9 ny gina/tn asep v
10 ny siti khoeratun v
11 ny aam v
12 ny suhartiningsih v
13 ny dini v v
14 ny siti setiawati v
15 ny w mustikarani v v
16 ny yuni wahyuni v
9 2
03/02/2016 17 ny astiningsih v
18 ny w mustikarani v
19 ny gifanny v
20 ny mawar/tn dian v v
21 ny siti/tn farid v
22 ny dini v
6 1
04/02/2016 23 ny imas/tn eri v
24 ny nenny/tn herry v v
25 ny mawar/tn dian v
26 nu siti aliah/tn dian v v
27 ny kuswati v v
5 3
05/02/2016 28 ny gianti v
29 ny mira v
30 ny nenny/tn herry v v
31 ny nurul/tn doni v
32 ny anggi/tn andri v v
33 ny rani v
34 ny kuswati v v
35 ny poppy/tn oki v
8 3
06/02/2016 36 ny nurul/tn doni v v
37 ny duri/tn uus v v
38 ny ika/tn edi v v
39 ny reni/tn julian v
40 ny sutinem/tn untung v
41 ny wida/tn dani v
6 3
07/02/2016 42 ny novi/tn irfan v
43 ny tika/tn prediana v
44 ny pipih v
45 ny muthiah/tn zen v v
46 ny supriatin v
47 ny duri/tn uus v
6 1
08/02/2016 48 ny fitri/tn enjang v v
1 1
09/02/2016 49 ny siti/tn trisno v
50 ny fitri/tn enjang v v
51 ny elpinawati v v v
52 ny riska/tn kenken v v
53 ny ratih/tn riki v v
54 ny nisa v v
6 5 1
10/02/2016 55 ny fitri/tn enjang v
56 ny elpinawati v v
57 ny cucu/tn sukemi v
58 ny ratna/tn wahyudi v
59 ny riska/tn kenken v
60 ny ratih/tn riki v
61 ny nisa/tn yono v
62 ny yeni/tn suryana v v
63 ny rika/tn asep v v
64 ny nunung v
10 3
11/02/2016 65 ny ratna/tn wahyudi v
66 ny yeni/tn suryana v v
67 ny rika/tn asep v
68 ny fitria/tn andri v
69 ny nita/tn iyus v v
70 ny rini/tn dadan v v
71 ny nunuy v v
72 ny elpinawati v
7 5
12/02/2016 73 ny nofi/tn doni v
74 ny tita/tn sutejo v v
75 ny yanti/tn dedi v v
76 ny yeni/tn suryana v
77 ny fitria/tn andri v
78 ny nita/tn iyus v
79 ny rini/tn dadan v
80 ny nunuy v
7 3

13/02/2016 81 ny elis/tn dandy v


82 ny wiwik v
83 ny erni/tn dian v v
84 ny tita/tn sutejo v
85 ny yanti/tn dedi v
86 ny nina/tn ahmad v
87 ny ita v
88 ny yeni/tn suryana v
7 2
14/02/2016 89 ny tina/tn asep v
90 ny dewi/tn irfan v
91 ny erni/tn dian v v
ny yeni/tn suryana v
3 2
15/02/2016 92 ny dewi/tn irfan v
93 ny yeni/tn suryana v
94 ny funi/tn ganjar v
95 ny elly/tn saepudin v
96 ny tintin/tn dede v
97 ny dita/tn alex v v
98 ny kartini v v
99 ny erni/tn dian v
100 ny kokom/tn karmizi v v
101 ny erni/tn suparman v
9 4
16/02/2016 102 ny wulan/tn agus v v
103 ny rosmiati v
104 ny kokom/tn karmizi v v v
105 ny erni/tn suparman v
106 ny rida/tn irfan v v
107 ny yeni/tn suryana v
108 ny tintin/tn dede v
109 ny dita/tn alex v
7 4 1
17/02/2016 110 ny rida/tn irfan v
111 ny yeni/tn suryana v
112 ny tintin/tn dede v
113 ny dita/tn alex v
114 ny wulan/tn agus v
115 ny dewi/tn asep v
116 ny resa/tn hoki v v
117 ny kokom/tn karmizi v v
118 ny yati/tn agus v v
8 4
18/02/2016 119 ny wiwin/tn deni v
120 ny eli/tn enjang v
121 ny yati/tn agus v v
122 ny kokom/tn karmizi v v
123 ny rani/tn rosad v v
5 3
19/02/2016 124 ny jumrotun v
125 ny yati/tn agus v
126 ny ani v v
127 ny dita/tn alex v
128 ny mulyati/tn firman v
5 1
20/02/2016 129 ny nanan v
130 ny ani v
131 ny yuga v v
132 ny iis v v
4 2
21/02/2016 133 ny gita/tn yopi v
134 ny iis v v
135 ny tiara v
136 ny dewi v
4 1
22/02/2016 137 ny dewi v v
138 ny reni/tn irwan v v
139 ny rossa/tn azam v
140 ny isni/tn deri v
141 ny neni/tn abidin v v
142 ny iis/tn handiyan v
143 ny efani v v
7 4
23/02/2016 144 ny kaci/tn rikardo v
145 ny dewi v
146 ny reni v
147 ny fitriani v
148 ny uhen v
149 ny sri/tn uus v v
6 1
24/02/2016 150 ny neni/tn abidin v v
151 ny sri/tn uus v v
152 ny iis v
153 ny yuni v
154 ny lisna/tn dodi v v
155 ny ismi/tn yusuf v v
6 4
25/02/2016 156 ny lisna/tn dodi v
157 ny ismi/tn yusuf v
158 ny teti/tn indra v
159 ny neni/tn abidin v v
160 ny erine/tn aris v
5 1
26/02/2016 161 nu nuraeni v v
162 ny cucu/tn yudi v
163 ny sukarsih v
164 ny maelasari/tn bayu v v
165 ny tintin/tn dede v v
166 ny dini v
6 3
27/02/2016 167 ny siti n v
168 ny nuraeni v v
169 ny cucu/tn yudi v
170 ny elly/tn hadia v v
171 ny ufay/tn rudi v
172 ny tati v
173 ny rima/tn zamzam v v
174 ny maelasari v
175 ny saripah v v
9 4
28/02/2016 176 ny rima/tn zamzam v
177 ny saripah v
178 ny siti n v
179 ny sri kartini v
180 ny cucu v
181 ny dewi v
182 ny elly v
183 ny ufay v
8 0
29/02/2016 184 ny dwi v
185 ny neti v
186 ny ina/tn eris v v
2 1 1
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
04/01/2016 1 NY.PITRI v v v - - -
05/01/2016 2 NY.PITRI V V - -
8/1//2016 3 NY.NUR AFIDA V V - -
09/01/2016 4 NY.NUR AFIDA V V - -
11/01/2016 5 NY.DESI V V - -
12/01/2016 6 NY.DESI V V - -
13/01/2016 7 NY.DESI V V - -
23/01/2016 8 NY.ROSSA V V - -
24/01/2016 9 NY.ROSSA V V - -
26/01/2016 10 NY.NELLY V V - -
27/01/2016 11 NY.NELLY V V - -
28/01/2016 12 NY.NELLY V V - -
29/01/2016 13 NY.NELLY V V - -
29/01/2016 14 NY.SANTI V V V - -
30/01/2016 15 NY.SANTI V V - -
31/01/2016 16 NY.SANTI V V - -
2 16 16
jml pasien 6

FORMAT SURVEY HARIAN PEMAKAIAN ALAT FEBRUARI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2016 1 ny.santi v v - - - - -
09/02/2016 2 NY.RISKA v v - - - - -
09/02/2016 3 NY RATIH v v - - - - -
10/02/2016 4 NY.RISKA v v - - - - -
10/02/2016 5 NY RATIH v v - - - - -
11/02/2016 6 NY.MELASARI v v - - - - -
12/02/2016 7 NY.MELASARI v v - - - - -
19/02/2016 8 NY.LILIS v v - - - - -
20/02/2016 9 NY.LILIS v v - - - - -
23/02/2016 10 NY NENI v v - - - - -
24/02/2016 11 NY NENI v v - - - - -
25/02/2016 12 NY MIRA V v v - - - - -
25/02/2016 13 NY.TITIN v v - - - - -
26/02/2016 14 NY MIRA V v v - - - - -
26/02/2016 15 NY.TITIN v v - - - - -
26/02/2016 16 NY MIRA V v v - - - - -
3 16 16
jml os= 8

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MARET 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2016 1 ny.nenden v v - - - - -
02/03/2016 2 ny.nenden v v - - - - -
03/03/2016 3 ny.nenden v v - - - - -
04/03/2016 4 ny.heni v v - - - - -
04/03/2016 5 ny.NENENG v v - - - - -
05/03/2016 6 ny.neneng v v - - - - -
06/03/2016 7 ny.yayah v v v - - - -
07/03/2016 8 ny.yayah v v v - - - -
11/03/2016 9 NY.WIWIN v v - - - - -
12/03/2016 10 NY.WIWIN v v - - - - -
13/03/2016 11 NY.WIWIN v v v - - - -
14/03/2016 12 NY.WIWIN v v - - - - -
16/03/2016 13 NY.MARIAM v v - - - - -
17/03/2016 14 NY.MARIAM v v - - - - -
18/03/2016 15 NY.MARIAM v v - - - - -
20/03/2016 16 NY.AI v v - - - - -
21/03/2016 17 NY.AI v v - - - - -
22/03/2016 18 NY.AI v v - - - - -
23/03/2016 19 NY.AI v v - - - - -
31/03/2016 20 NY.SINTA v v - - - - -
jml os= 8 20 20 3

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
07/04/2016 1 NY.IMAS K V v v - - - - -
20/04/2016 2 ny.gina V v v - - - - -
20/04/2016 3 ny.santi V v v - - - - -
21/04/2016 4 ny.santi V v v - - - - -
JUMLAH : 3 4 4 4

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MEI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2016 1 NY.SITI Z V v v - - - - -
02/05/2016 2 NY.SITI Z - v v - V - - -
03/05/2016 3 NY.SITI Z - v v - - - - -
04/05/2016 4 Ny. Yuli Supriati V v v - - - - -
13/05/2016 5 NY.HAMIDAH V v v - - - - -
14/05/2016 6 NY.HAMIDAH - v v - - - - -
15/05/2016 7 NY.HAMIDAH - v v - V - - -
24/05/2020 8 ny.yuningsih - v v - - - - -
25/05/2020 9 ny.yuningsih - v v - - - - -
27/05/2016 10 ny.tati karyati - v v - - - - -
28/05/2016 11 ny.tati karyati - v v - - - - -
29/05/2016 12 ny.tati karyati - v v - - - - -
29/05/2016 13 ny.Ike - v v - - - - -
30/05/2016 14 ny.tati karyati - v v - - - - -
30/05/2016 15 ny.Ike - v v - - - - -
jumlah=6 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JUNI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2016 1 ny.dewi sartika v v v - -
02/06/2016 2 ny.dewi sartika v v v - -
03/06/2016 3 ny.dewi sartika v v v - -
11/06/2016 4 ny.nunung - v v - -
12/06/2016 5 ny.nunung - v v - -
12/06/2016 6 ny.susilawati - v v - -
13/06/2016 7 ny.susilawati - v v - -
21/06/2016 8 NY.nani v v v - -
22/06/2016 9 NY.nani v v v - -
23/06/2016 10 NY.nani - v v - -
23/06/2016 11 NY SETIAWATI - v v - -
24/06/2016 12 ny.setiawati - v v - -
26/06/2016 13 ny.sugiarni v v v - -
29/06/2016 14 ny.yulimah - v v - -
30/06/2016 15 ny.yulimah - v v - -
6 15

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JULI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
`11/7/2016 1 ny.deti susilawati v v
`12/7/2016 2 ny.deti susilawati v v
30/07/2016 3 NY.elya v v
31/07/2016 4 NY.elya v v
pasien= 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT AGUSTUS 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
2/8/2016 1 Ny.nurrika v v
3/8/2016 2 Ny.nurrika v v
09/08/2016 3 ny.dede aas v v
10/08/2016 4 ny.dede aas v v
10/08/2016 5 ny.susi v v
11/08/2016 6 ny.susi v v
15/8/2016 7 ny.lela V v/v v
15/8/2016 8 NY.YUNI v v
16/8/2016 9 ny.lela V v/v v
16/8/2016 10 NY.YUNI V v
17/8/2016 11 ny.lela V v/v v
17/8/2016 12 NY.YUNI V v
18/8/2016 13 ny.lela v v/v v
19/8/2016 14 ny.lela v v/v v
20/8/2016 15 ny.lela v v/v v
21/8/2016 16 ny.lela v/v v
22/8/2016 17 ny.lela v v
23/8/2016 18 ny.lela v v
24/8/2016 19 ny.lela v v
25/8/2016 20 ny.lela v v
26/8/2016 21 ny.lela v v
30/8/2016 22 NY.CARI AYU v v
31/8/2016 23 NY.CARI AYU v v

PASIEN=6 6 23/7 23

FORMAT SURVEY HARIAN PEMAKAIAN ALAT SEPTEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/9/2016 1 NY.CARI AYU v v v
2/9/2016 2 NY.CARI AYU v v
05/09/2016 3 NY.LINA v v
06/09/2016 4 NY.LINA v v
7/9/2016 5 NY.LINA v v
8/9/2016 6 ny.lala v v
9/9/2016 7 ny.lala v v
10/9/2016 8 ny.lala v v
11/9/2016 9 ny.lala v v
16/9/2016 10 Ny. Restianti Syifa L v v
19/09/2016 11 Ny. Herlina v v
20/09/2016 12 Ny. Herlina v v
21/09/2016 13 Ny. Herlina v v
26/09/2016 12 Ny. Intan Kurnia v v
27/09/2016 13 Ny. Intan Kurnia v v
28/09/2016 14 Ny. Intan Kurnia v v
28/09/2016 15 Ny. Elis Mintarsih v v
29/09/2016 16 Ny. Elis Mintarsih v v
16 16
jml psn 7 org

FORMAT SURVEY HARIAN PEMAKAIAN ALAT OKTOBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
3/10/2016 1 ny.titin v v
4/10/2016 2 ny.titin v v
4/10/2016 3 ny.widayanti v v
5/10/2016 4 ny.titin v v
5/10/2016 5 ny.widayanti v v
6/10/2016 6 Ny.Widayanti v v
8/10/2016 7 NY RINI v v
9/10/2016 8 NY RINI v v
10/10/2016 9 Ny.Rini v v
11/10/2016 10 Ny. Nana Nurjana v v
12/10/2016 11 Ny. Nana Nurjana v v
20/10/2016 12 Komala Sari v v v
21/10/2016 13 Komala Sari v v
25/10/2016 14 NY.WIWIN v v
26/10/2016 15 NY.WIWIN v v
31/10/2016 16 Ny.Tati v v
pasien=7 ett:1 16 16

FORMAT SURVEY HARIAN PEMAKAIAN ALAT NOVEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/11/2016 1 ny.Tati v v
14/11/2016 2 Ny. Rosida v v tampon balon
14/11/2016 3 Ny.Masitoh v v
15/11/2016 4 Ny.Rosida v v tampon balon bakrie
15/11/2016 5 Ny.Masitoh v v
25/11/2016 6 Ny.Fitri v v tampon balon
25/11/2016 7 Ny.Suci v v tampon balon
26/11/2016 8 Ny.Fitri v v tampon balon
9 Ny.Suci v v tampon balon
PASIEN 5 9 9

FORMAT SURVEY HARIAN PEMAKAIAN ALAT DESEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
5/12/2016 1 NY.RATNA SARI v v
6/12/2016 2 ny.RATNA SARI v v
6/12/2016 3 ny. Liya Silviyana v v
7/12/2016 4 ny. Liya Silviyana v v
8/12/2016 5 ny. Liya Silviyana v v
NY Della Wulansari
11/12/2016 6 v v
NY Della Wulansari
12/12/2016 7 v v
NY Della Wulansari
13/12/2016 8 v v
14/12/2016 9 Ny. Rossy v v
15/12/2016 10 Ny. Rossy v v
19/12/2016 11 NY.YUYUN V V V
19/12/2016 12 Ny. Iis Amelia v v
20/12/2016 13 Ny. Iis Amelia v v
20/12/2016 14 Ny. Leli Marliani v v
21/12/2016 15 Ny. Leli Marliani v v

pasien 7 1 15 15
FORMAT SURVEY HARIAN PEMAKAIAN ALAT JANUARI 2017
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
05/01/2017 1 Ny. Imas v v
6/1/2017 2 Ny. Imas v v v
7/1/2017 3 Ny.Deti Kusmawati v v
8/1/2017 4 Ny.Deti Kusmawati v v
8/1/2017 5 Ny.Vika Siti M. v v
9/1/2017 6 Ny.Vika Siti M. v v
10/1/2017 7 Ny.Vika Siti M. v v
10/1/2017 8 Ny. Karsih v v
11/1/2017 9 Ny. Karsih v v
Ny. Julaeha
12/01/2017 10 v v v
24/1/2017 11 NY.LAELA v v
25/1/2017 12 NY.LAELA v v
25/1/2017 13 NY.RICA v v
26/1/2017 14 NY.LAELA v v
26/1/2017 15 NY.RICA v v
27/1/2017 16 NY.RICA v v
31/1/2017 17 NY.SRI v v
8 pasien 1 17 17 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT FEBRUARI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/2/2017 1 NY.SRI v v
1/2/2017 2 NY.TITA v v
Epidural kateter
2/2/2017 3 NY.TITA v v
3/2/2017 4 NY.TITA v v
16/2/2017 5 ny.santi v v v
17/2/2017 6 ny.santi v v v
18/2/2017 7 ny.santi v v v
19/2/2017 8 ny.sumiati v v
20/2/2017 9 ny.sumiati v v
28/02/2017 10 ny.Erni v v v v

5 pasien 4 10 10 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MARET 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/3/2017 1 ny.Erni v v epidural kateter
6/3/2017 2 ny.Rohayati v v
7/3/2017 3 ny.Rohayati v v
8/3/2017 4 ny.Rohayati v v
8/3/2017 5 ny.susi v v v
9/3/2017 6 ny.susi v v
13/3/2017 7 ny.gustina v v
21/3/2017 8 Ny. solihatun v v
22/3/2017 9 Ny. solihatun v v
30/03/2017 10 Ny.Deviyanti v v
31/03/2017 11 Ny.Deviyanti v v
6 pasien 11 11 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT April 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
5/4/2017 1 Ny. Engkim v v
6/4/2017 2 Ny. Engkim v v v
12/4/2017 3 Ny.Sri Yulianti v v
13/4/2017 4 Ny.Sri Yulianti v v
14/4/2017 5 Ny.Sri Yulianti v v
14/4/2017 6 Ny.Sari v v v
15/4/2017 7 Ny.Sari v v v
16/4/2017 8 Ny.Sari v v v v kultur dahak
17/4/2017 9 Ny.Sari v v v
18/4/2017 10 Ny.Sari v v v
19/4/2017 11 Ny.Sari v v v
20/4/2017 12 Ny.Sari v v v
20/4/2014 13 ny.yulia v v
21/4/2017 14 Ny.Sari v v v kultur darah
21/4/2014 15 ny.yulia v v
22/4/2017 16 Ny.Sari v v v
23/4/2017 17 Ny.Sari v v v
v v
24/4/2017 18 ny.ERNI v v
26/4/2017 19 ny.hani v v
27/4/2017 20 Ny. Fauziah v v
27/4/2017 21 Ny. Yati v v
28/4/2017 22 Ny. Fauziah v v
28/4/2017 23 Ny. Yati v v
28/4/2017 24 NY.WATI v v
29/4/2017 25 NY.WATI v v
30/4/2017 26 ny. wati v v 1
jml os= 9 org 10 26 26 1

FORMAT SURVEY HARIAN PEMAKAIAN MEI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/5/2017 1 ny. wati v v
3/5/2017 2 ny.mia v v
4/5/2017 3 ny.mia v v
16/5/2017 4 ny.devi v v
17/5/2017 5 ny.devi v v
18/5/2017 6 ny.kurniasih v v
19/5/2017 7 ny.kurniasih v v
26/5/2017 8 ny.rustini v v
27/5/2017 9 ny.rustini v v
29/5/2017 10 ny.neng eros v v
30/5/2017 11 ny.neng eros v v
31/5/2017 12 ny.neng eros v v
pasien : 6 12 12

FORMAT SURVEY HARIAN PEMAKAIAN JUNI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
3/5/2017 1 Ny. Erna indriyanti v v
4/6/2017 2 Ny. Erna indriyanti v v
12/6/2017 3 ny.rani nurhabibah v v
13/6/2017 4 ny.rani nurhabibah v v
16/6/2017 5 ny.iis v v
17/6/2017 6 ny.iis v v
17/6/2017 7 Ny. Ela v v
18/6/2017 8 Ny. Ela v v
21/6/2017 9 ny.neneu v v
22/6/2017 10 ny.neneu v v
28/6/2017 11 Ny. Fitri Yuliana v v
29/6/2017 12 Ny. Fitri Yuliana v v
pasien : 6 12 12

FORMAT SURVEY HARIAN PEMAKAIAN JULI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
4/7/2017 1 NY.MARYAMAH v v
5/7/2017 2 NY.MARYAMAH v v
5/7/2017 3 Ny.Wiwi Septiana v v
6/7/2017 4 Ny.Wiwi Septiana v v
6/7/2017 5 Ny.Nunung v v
7/7/2017 6 Ny.Nunung v v
15/7/2017 7 Ny.Nia v v
16/7/2017 8 Ny.Nia v v
17/7/2017 9 Ny. Nia v v
24/7/2017 10 Ny.Novi Puspitasari v v
25/7/2017 11 Ny.Novi Puspitasari v v
26/7/2017 12 ny.Nurhayati v v
27/7/2017 13 ny.Nurhayati v v

PASIEN = 6 13 13

FORMAT SURVEY HARIAN PEMAKAIAN AGUSTUS 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
15/8/2017 1 NY.UUN v v
16/8/2017 2 NY.UUN v v
17/8/2017 3 NY.UUN v v
18/8/2017 4 Ny. Elsa Sutisna v v
24/8/2017 5 Ny.Atik Sumiati v v
25/8/2017 6 Ny.Atik Sumiati v v
25/8/2017 7 ny.ati rahmawati v v
26/8/2017 8 Ny.Atik Sumiati v v
26/8/2017 9 ny.ati rahmawati v v
27/8/2017 10 Ny.Atik Sumiati v v
27/8/2017 11 ny.ati rahmawati v v
28/8/2017 12 Ny.Atik Sumiati v v
28/8/2017 13 ny weni v v v
29/8/2017 14 Ny.Atik Sumiati v v
29/8/2017 15 ny weni v v v
30/8/2017 16 Ny.Atik Sumiati v v
30/8/2017 17 ny weni v v v v
31/8/2017 18 Ny.Atik Sumiati v v

pasien 5 3 18 18 1
FORMAT SURVEY HARIAN PEMAKAIAN SEPTEMBER 2017
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/9/2017 1 Nenah Nurjanah v v
2/9/2017 2 Nenah Nurjanah v v
5/9/2017 3 Nunung v v
5/9/2017 4 ny.tina v v
6/9/2017 5 Nunung v v
6/9/2017 6 ny.tina v v
7/9/2017 7 Nunung v v
7/9/2017 8 ny.windy v v
7/9/2017 9 ny. herlina v v
8/9/2017 10 ny.windy v v
8/9/2017 11 ny. herlina v v
9/9/2017 12 ny. herlina v v
10/09/2017 13 Ny.Herlina v v
11/09/2017 14 Ny.Herlina v v
12/09/2017 15 Ny.Herlina v v
13/09/2017 16 Ny.Herlina v v
14/09/2017 17 Ny.Herlina v v
15/09/2017 18 Ny.Herlina v v
16/09/2017 19 Ny.Herlina v v
17/09/2017 20 Ny.Herlina v v
18/09/2017 21 Ny.Herlina v v
20/9/2017 22 ny.tuti masroah v v
21/9/2017 23 ny.tuti masroah v v
22/9/2017 24 ny.tuti masroah v v
29/09/2017 25 Ny.Mutiara v v v
30/09/2017 26 Ny.Mutiara v v

Pasien 7 1 26 26

FORMAT SURVEY HARIAN PEMAKAIAN OKTOBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
12/10/2017 1 ny.siti aisah v v
13/10/2017 2 ny.siti aisah v v
15/10/2017 3 ny. Any suminar v v
15/10/2017 4 ny.yeni v v
16/10/2017 5 ny.yeni v v
16/10/2017 6 ny. Any suminar v v
17/10/2017 7 ny.yeni v v
17/10/2017 8 ny. Any suminar v v
18/10/2017 9 ny.suminah v v
19/10/2017 10 ny.suminah v v
23/10/2017 11 Ny.Suminar v v
pasien 6 11 11

FORMAT SURVEY HARIAN PEMAKAIAN NOVEMBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
2/11/2017 1 NY.SANTI SUSANTI V v v
2/11/2017 2 NY.ENENG LISNAWATI v v
3/11/2017 3 NY.SANTI SUSANTI V v v
3/11/2017 4 NY.ENENG LISNAWATI v v
4/11/2017 5 NY.ENENG LISNAWATI v v
4/11/2017 5 NY.SANTI SUSANTI v v
5/11/2017 6 NY.ENENG LISNAWATI v v
5/11/2017 6 ny.fitri v v balon bakrie
5/11/2017 7 ny.eni v v balon bakrie
6/11/2017 8 ny.eni v v
6/11/2017 9 ny.fitri v v
9/11/2017 10 ny.melis v v
10/11/2017 11 ny melis v v
12/11/2017 12 ny.erika V v v
13/11/2017 13 ny.erika V v v
14/11/2017 14 ny.erika V v v cvp
15/11/2017 15 Ny. Erika v v v cvp
15/11/2017 16 Ny. Cantika YN v
16/11/2017 17 Ny. Erika v v v cvp
16/11/2017 18 Ny. Cantika YN v
17/11/2017 19 Ny. Erika v v v cvp
17/11/2017 20 ny.wawang v v
18/11/2017 21 Ny. Erika v v v cvp
18/11/2017 22 ny.wawang v v
19/11/2017 23 Ny. Erika v v
19/11/2017 24 ny.nurmayanti v v
20/11/2017 25 Ny. Erika v v
20/11/2017 26 ny.nurmayanti v v
20/11/2017 27 ny.rohayati v v v
21/11/2017 28 ny.nurmayanti v v
21/11/2017 29 ny.rohayati v v

FORMAT SURVEY HARIAN PEMAKAIAN DESEMBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/12/2917 1 ny.sri mulyati v v
2/12/2017 2 ny.sri mulyati v v
8/12/2017 3 Ny. Dini Noviyani v v
9/12/2017 4 Ny. Dini Noviyani v v v
27/12/2017 5 Nn.siti nuraeni v v
28/12/2017 6 Nn.siti nuraeni v v
pasien = 3 6 6 1
Formulir Survey Harian Pemakaian Alat
Ruang ICU - RSKIA - JANUARI - 2018

Tanggal No Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/1/2018 1 ny.imas yani v v
2/1/2018 2 ny.imas yani v v
3/1/2018 3 NY.AYU v v
4/1/2018 4 ny.ayu v v
5/1/2018 5 ny.yuli v v
6/1/2018 6 ny.yuli v v
10/1/2018 7 ny.helis v v
10/1/2018 8 ny rina v v v
11/1/2018 9 ny.helis v v
11/1/2018 10 ny rina v v
12/1/2018 11 ny rina v v
14/1/2018 12 ny.ani v v
15/1/2018 13 ny.ani v v
24/1/2018 14 ny.julaeha v v
25/1/2018 15 ny.julaeha v v
1 15 15

Formulir Survey Harian Pemakaian Alat


Ruang ICU - RSKIA - FEBRUARI - 2018

Tanggal No Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
12/2/2018 1 ny.restu v v
13/2/2018 2 ny.restu v v
13/2/2018 3 ny.neulis v v
14/2/2018 4 ny.restu v v v
14/2/2018 5 ny.neulis v v
14/2/2018 6 ny.ai.rosita v v
15/2/2018 7 ny.restu v v
15/2/2018 8 ny.ai.rosita v v
16/2/2018 9 Ny. Restu v v
17/2/2018 10 Ny. Restu v v
18/2/2018 11 NY.Judariah v v
19/2/2018 12 NY.Judariah v v
20/1/2018 13 NY.Judariah v v
20/1/2018 14 NY.dedeh v v
21/1/2018 15 NY.dedeh v v
21/2/2018 16 ny.tati v v
22/1/2018 17 ny.tati v v v
23/1/2018 18 ny.tati v v v
24/1/2018 19 ny.tati v v v
25/1/2018 20 ny.tati v v v
26/1/2018 21 ny.tati v v v
26/2/2018 22 NY.NENI v v v
27/1/2018 23 ny.tati v v v
27/1/2018 24 NY.NENI v v v
28/2/2018 25 ny.tati v v v
28/2/2018 26 NY.NENI v v v
PASIEN =7 10 26 26

Formulir Survey Harian Pemakaian Alat


Ruang ICU - RSKIA - MARET - 2018

Tanggal No Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/3/2018 1 ny.tati v v v
1/3/2018 2 Ny.neni v v v
2/3/2018 3 ny.tati v v v
2/3/2018 4 Ny.neni v v v
3/3/2018 5 ny.tati v v v
3/3/2018 6 Ny.neni v v v
4/3/2018 7 ny.tati v v v
4/3/2018 8 Ny.neni v v v
5/3/2018 9 ny.tati v v v
5/3/2018 10 Ny.neni v v v
6/3/2018 11 ny.tati v v v
6/3/2018 12 Ny.neni v v v
7/3/2018 13 ny.tati v v v
7/3/2018 14 Ny.neni v v v
8/3/2018 15 ny.tati v v v kultur darah dan sputum hasil negatif
8/3/2018 16 Ny.neni v v v
9/3/2018 17 ny.tati v v v
9/3/2018 18 Ny.neni v v v
10/3/2018 19 ny.tati v v v
10/3/2018 20 Ny.neni v v v
11/3/2018 17 ny.tati v v v
11/3/2018 18 Ny.neni v v v
12/3/2018 19 ny.tati v v v
12/3/2018 20 Ny.neni v v v V Pneumonia kultur darah,sputum hasil + hasil kultur luka oprasi : raoultella ornithinolitica
13/3/2018 21 ny.tati v v v
13/3/2018 22 Ny.neni v v v
14/3/2018 23 ny.tati v v v
14/3/2018 24 Ny.neni v v v
15/3/2018 25 ny.tati v v v
15/3/2018 26 Ny.neni v v v rujuk cibabat 16/3/2018 jam 07
16/3/2018 27 ny.tati v v v
17/3/2018 28 ny.tati v v v
17/3/2018 29 ny.nengsih v v
18/3/2018 30 ny.tati v v v
18/3/2018 31 ny.nengsih v v
19/3/2018 32 ny.tati v v v
19/3/2018 33 ny.nengsih v v
20/3/2018 34 ny.tati v v v meninggal jam 00.10
20/3/2018 35 ny.nengsih v v
21/3/2018 36 ny.nengsih v v
22/3/2018 37 ny.nengsih v v
27/3/2018 38 ny.nani v v
28/3/2018 39 ny.nani v v
pasien =4 31 39 39

Formulir Survey Harian Pemakaian Alat


Ruang ICU - RSKIA - APRIL - 2018

Tanggal No Nama ETT IVL / CPP UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
5/4/2018 1 FITRI V V
6/4/2018 2 FITRI V V
7/4/2018 3 NY.ANI V V
8/4/2018 4 NY.ANI V V
8/4/2018 5 NY.TITIN V V
9/4/2018 6 NY.TITIN V V
10/4/2018 7 NY.TITIN V V
17/4/2018 8 NY.TITIN V V
18/4/2018 9 NY.TITIN V V
19/4/2018 10 NY.TITIN V V
22/4/2018 11 ny.gania v v
23/4/2018 12 ny.gania v v
25/4/2018 13 Ny. Pipih v v
25/4/2018 14 Ny. Sariah v v
26/4/2018 15 Ny. Pipih v v kultur darah tgl 26/4/2018
26/4/2018 16 Ny. Sariah v v
26/4/2018 17 Ny. Saripah v v v meninggal,pindaghan dari OK, 5 menit di icu
27/4/2018 18 Ny. Tuti Handayani v v
01/05/2018 19 Ny. Tuti Handayani v v
02/05/2018 20 ny.nopi v v
03/05/2018 21 Ny. Nopi v v
pasien 8 21 21

Formulir Survey Harian Pemakaian Alat


Ruang ICU - RSKIA - MEI - 2018

Tanggal No Nama ETT IVL / CPP UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
2/5/2018 1 novi setiawati V V
3/5/2018 2 novi setiawati V V
5/5/2018 3 Yani Haryani V V V Meninggal dari OK, pindahan dari OK, 15 menit di ICU
7/5/2018 4 yane komalasari v v
8/5/2018 5 yane komalasari v v
9/5/2018 6 yane komalasari v v
24/5/2018 7 Khinanti v v
25/5/2018 8 Khinanti v v
25/5/2018 9 Wihartini v v
30/5/2018 10 Dinda v v
31/5/2018 11 Dinda v v

Formulir Survey Harian Pemakaian Alat


Ruang ICU - RSKIA - JUNI - 2018

Tanggal No Nama ETT IVL / CPP UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
9/6/2018 1 pipih gustini V V V Periksa kultur darah tanggal 9/6/2018
10/6/2018 2 pipih gustini v v v
11/6/2018 3 pipih gustini v v v
12/6/2018 4 pipih gustini v v v
20/6/2018 5 Dewi siti nurjana v v v
21/06/2018 6 Dewi siti nurjana v v v
igd
]]h
RUANG : IRNA 3 - RSKIA

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2015 1 ny. siti R V
2 ny. Ira V V
3 ny. Esa V
4 ny. Heni V V
5 ny. Lia V V
6 ny. Rodiah V
7 ny. Farida V V
8 ny. Sari V V
9 ny. Ferawati V
10 ny. Linda V
11 ny. Ade Rita V
12 ny. Dewi V
13 ny. Siti Aisyah V V
Jumlah 13 5 1

02/02/2015 1 ny. siti R V


2 ny. Ira V V
3 ny. Esa V 1
4 ny. Lia V
5 ny. Aprianti V
6 ny. Ferawati V
7 ny. Nurhayati V
8 ny. Linda V
9 ny. Ade Rita V V
10 ny. Dewi V V
11 ny. Lia V
12 ny. Tati V V
Jumlah 12 4

03/02/2015 1 ny. Yuke V V


2 ny. Febri V
3 ny. Euis V V
4 ny. Daeni V
5 ny. Leni V
6 ny. Nurhayati V V
7 ny. Iis V
8 ny. Ade Rita V
9 ny. Lia V
9 3

04/02/2015 1 NY.Yuke V V
2 NY.Euis V V
3 NY.Pebri V
4 NY.Nina V V
5 NY.Mei V
Jumlah 5 3
05/02/2015 1 NY.Tika V
2 NY.Noneng V V
3 NY.Tri V
3 1
06/02/2015 1 NY.Noneng V V
2 NY.Ema V
3 NY.Dedeh V
3 1
07/02/2015 1 NY.Djuariyah V
2 NY.Ina V V
3 NY.Novy V
4 NY.Ema V V
4 2
08/02/2015 1 Ny.Ina V V
2 Ny.Nuraeni V
3 Ny.Novy V
4 NY.Lenni V
5 Ny.Rika V V
5 2
09/02/2015 1 Ny.Nuraeni V
2 Ny.Novy V V
3 Ny.Leni V
4 Ny. Tris V
5 Ny.Sri V V
5 1
10/02/2015 1 Ny.Putri V
2 Ny.Sri V V
3 ny.Ani V
4 ny.Rostinah V
4 1
11/02/2015 1 ny.Ani V
2 NY.Reni V
3 Ny.Saenah V
4 Ny.Elis V V
5 Ny.Ema V V
5 2
12/02/2015 1 ny.Ani V V
2 ny.Tita V
3 ny.Yayang V
4 ny.Elis V
5 ny.Sumiati V
5 1
13/02/2015 1 ny.Nurhayati V
2 ny.Yayang V
3 ny.Siti F V
4 ny.Ririn V
5 ny Sumiati V
6 ny Lia V
7 ny Sumi Jumiati V
7
14/02/2015 1 ny.Nurhayati V
2 ny.Vini V
3 ny.Yayang V
4 ny.Ririn V
5 ny.Vina V
6 ny.Kurnia V V
7 ny.Desi V
7 1
15/02/2015 1 Ny.Nurhayati V
2 Ny.Vini V
3 NY Vina V
4 Ny Santi V
4
16/02/2015 1 Ny.Nurhayati V
2 Ny.Iis V V V
3 Ny.Sari V
4 Ny.Hanipah V
5 Ny.Sri V V
5 2 1
17/02/2015 1 Ny.Nurhayati V
2 NY Neni V
3 Ny Euis V V
4 Ny.Iis V
5 Ny.Sari V
6 Ny Sri V
6 2
18/02/2015 1 Ny.Nurhayati V
2 Ny.Euis V
3 Ny.Iis V
4 Ny.Sari V
5 Ny.Ani V V
6 Ny.Halimah V
7 Ny.Yuyu V V
8 NY.Rahmawati V V
9 NY.Dera V V
10 Ny.Yanti V
9 3 1 1
19/02/2015 1 Ny.Sari V
2 Ny.Ani V
3 NY.Rika V V
4 Ny.Yati V V
4 2
20/02/2015 1 Ny.Eka V
1
21/02/2015 1 Ny.Idawati V V
2 NY. Irma V
3 Ny.Lina V
3 1
22/02/2015 1 NY.Ida V V
1 1
23/02/2015 1 Ny.Murlensis V
2 NY.Ida V V
3 Ny.Winarti V
4 NY.Dian V
4 1
24/02/2015 1 NY.Ida V
2 Ny.Winarti V
3 Ny.Elis V V
4 Ny Siti H V V
5 Ny Niat V V
6 Ny Ita V
6 3
25/02/2015 1 Ny.Euis V
2 Ny.Misaroh V
3 Ny.Elis V V
4 Ny.Maryamah V
5 Ny.Imas V
6 Ny.Niat V
7 Ny.Ita V
7 1
26/02/2015 1 Ny.Euis V
2 Ny.Nurhayati V V
3 Ny.Mira V
4 Ny.Ani V
5 Ny Soraya V V
6 Ny.ina V
7 ny.Ridianis V
6 2
27/02/2015 1 NY.Nurhayati V V
2 NY.Eris V
3 Ny.Soraya V V
2 2
28/02/2015 1 NY.Nurhayati V V
2 NY.Ina Lina V V
3 Ny Sumiati V
4 Ny Ani R V V
5 NY. Rusmini V
6 Ny. Dewi V
7 Ny AI Yayah V V
7 4
TOTAL
152 46 7 1

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2015 1 ny. siti R V
2 ny. Ira V V
3 ny. Esa V
4 ny. Heni V V
5 ny. Lia V V
6 ny. Rodiah V
7 ny. Farida V V
8 ny. Sari V V
9 ny. Ferawati V
10 ny. Linda V
11 ny. Ade Rita V
12 ny. Dewi V
13 ny. Siti Aisyah V V
Jumlah 13 5 1

02/02/2015 1 ny. siti R V


2 ny. Ira V V
3 ny. Esa V
4 ny. Lia V
5 ny. Aprianti V
6 ny. Ferawati V
7 ny. Nurhayati V
8 ny. Linda V
9 ny. Ade Rita V V
10 ny. Dewi V V
11 ny. Lia V
12 ny. Tati V V
Jumlah 12 4

03/02/2015 1 ny. Yuke V V


2 ny. Febri V
3 ny. Euis V V
4 ny. Daeni V
5 ny. Leni V
6 ny. Nurhayati V V
7 ny. Iis V
8 ny. Ade Rita V
9 ny. Lia V
9 3

04/02/2015 1 NY.Yuke V V
2 NY.Euis V V
3 NY.Pebri V
4 NY.Nina V V
5 NY.Mei V
Jumlah 5 3
05/02/2015 1 NY.Tika V
2 NY.Noneng V V
3 NY.Tri V
3 1
06/02/2015 1 NY.Noneng V V
2 NY.Ema V
3 NY.Dedeh V
3 1
07/02/2015 1 NY.Djuariyah V
2 NY.Ina V V
3 NY.Novy V
4 NY.Ema V V
4 2
08/02/2015 1 Ny.Ina V V
2 Ny.Nuraeni V
3 Ny.Novy V
4 NY.Lenni V
5 Ny.Rika V V
5 2
09/02/2015 1 Ny.Nuraeni V
2 Ny.Novy V V
3 Ny.Leni V
4 Ny. Tris V
5 Ny.Sri V V
5 1
10/02/2015 1 Ny.Putri V
2 Ny.Sri V V
3 ny.Ani V
4 ny.Rostinah V
4 1
11/02/2015 1 ny.Ani V
2 NY.Reni V
3 Ny.Saenah V
4 Ny.Elis V V
5 Ny.Ema V V
5 2
12/02/2015 1 ny.Ani V V
2 ny.Tita V
3 ny.Yayang V
4 ny.Elis V
5 ny.Sumiati V
5 1
13/02/2015 1 ny.Nurhayati V
2 ny.Yayang V
3 ny.Siti F V
4 ny.Ririn V
5 ny Sumiati V
6 ny Lia V
7 ny Sumi Jumiati V
7
14/02/2015 1 ny.Nurhayati V
2 ny.Vini V
3 ny.Yayang V
4 ny.Ririn V
5 ny.Vina V
6 ny.Kurnia V V
7 ny.Desi V
7 1
15/02/2015 1 Ny.Nurhayati V
2 Ny.Vini V
3 NY Vina V
4 Ny Santi V
4
16/02/2015 1 Ny.Nurhayati V
2 Ny.Iis V V V
3 Ny.Sari V
4 Ny.Hanipah V
5 Ny.Sri V V
5 2 1
17/02/2015 1 Ny.Nurhayati V
2 NY Neni V
3 Ny Euis V V
4 Ny.Iis V
5 Ny.Sari V
6 Ny Sri V
6 2
18/02/2015 1 Ny.Nurhayati V
2 Ny.Euis V
3 Ny.Iis V
4 Ny.Sari V
5 Ny.Ani V V
6 Ny.Halimah V
7 Ny.Yuyu V V
8 NY.Rahmawati V V
9 NY.Dera V V
10 Ny.Yanti V
9 3 1 1
19/02/2015 1 Ny.Sari V
2 Ny.Ani V
3 NY.Rika V V
4 Ny.Yati V V
4 2
20/02/2015 1 Ny.Eka V
1
21/02/2015 1 Ny.Idawati V V
2 NY. Irma V
3 Ny.Lina V
3 1
22/02/2015 1 NY.Ida V V
1 1
23/02/2015 1 Ny.Murlensis V
2 NY.Ida V V
3 Ny.Winarti V
4 NY.Dian V
4 1
24/02/2015 1 NY.Ida V
2 Ny.Winarti V
3 Ny.Elis V V
4 Ny Siti H V V
5 Ny Niat V V
6 Ny Ita V
6 3
25/02/2015 1 Ny.Euis V
2 Ny.Misaroh V
3 Ny.Elis V V
4 Ny.Maryamah V
5 Ny.Imas V
6 Ny.Niat V
7 Ny.Ita V
7 1
26/02/2015 1 Ny.Euis V
2 Ny.Nurhayati V V
3 Ny.Mira V
4 Ny.Ani V
5 Ny Soraya V V
6 NyIna V
7 ny.Ridianis V
6 2
27/02/2015 1 NY.Nurhayati V V
2 NY.Eris V
3 Ny.Soraya V V
2 2
28/02/2015 1 NY.Nurhayati V V
2 NY.Ina Lina V V
3 Ny Sumiati V
4 Ny Ani R V V
5 NY. Rusmini V
6 Ny. Dewi V
7 Ny AI Yayah V V
7 4
TOTAL
152 46 7 1

FORMULIR SURVEI HARIAN PEMAKAIAN ALAT


NIFAS 3 BULAN MARET 2015
TANGGAL NO NAMA ETT IVL UC VAP ISK FLEBITIS HASIL KULTUR KET
01/03/2015 1 NY.Erni V
2 NY .Ika V
3 NY.Sumiati V
4 NY.Siti N V
5 NY. Dewi V
Jumlah 5
02/03/2015 1 Ny.Dona V
2 NY. Cica V V
3 NY. Sumiati V V
4 NY. Fitri V
Jumlah 4 2
03/03/2015 1 NY.Nurhayani V
2 NY. Ani V
3 NY. Fitri V
4 Ny.Martini V V V
5 Ny.Elan V
6 Ny.Lisna V
7 NySri M V
Jumlah 7 1 1
04/03/2015 1 NY.Ida V
2 NY.Yuli V
3 NY.Nurhayani V
4 NY.Anis V
5 NY.Suryatiningsih V
6 Ny.Elah V
7 Ny.Aminah V
Jumlah 7
05/03/2015 1 Ny. Ida V V
2 NY. Yanti V
3 Ny Yuli V
4 Ny Dede V
4 1
06/03/2015 1 Ny.Ida V V
2 Ny.Yanti V
3 Ny.Desta V V
4 Ny Irma V V
4 3
07/03/2015 1 Ny.Ida V V
2 Ny.Ratnaningsih V V
3 Ny.Santi V V
4 NY.Fitri V
5 Ny.Nenden V V
6 Ny Neneng V
7 Ny Nuraeni V
8 NY Irma V V
8 4 1
08/03/2015 1 Ny.Ratnaningsih V V
2 NY.Santi V V
3 Ny.Fitri V
4 Ny.Nenden V V
5 Ny Neneng V V
6 Ny.Meti V
7 Ny.Nuraeni V
7 4
09/03/2015 1 Ny.Chintya V
2 Ny.Ratnaningsih V V
3 Ny.Yunengsih V
4 ny.Nuraeni V
4 1
10/03/2015 1 Ny.Chintya V
2 NY.Cucu V
3 Ny.Yunengsih. V
4 NY.Marcella V
5 Ny.Siti S V V
5 1
11/03/2015 1 NY Rita V V
2 Ny.Yuli V
3 Ny.Sri V
4 Ny.Neneng V
5 Ny.Marcela V
6 Ny SIti S V V
7 Ny Neli V V
7 3
12/03/2015 1 NY.Widaningsih V
2 NY.Bunga V
3 Ny.Leni V V
4 Ny.Yuli V
5 NY.Nurhernawati V V
6 Ny.Eliah V
7 Ny.Wiwin V
8 Ny.Nuraeni V
8 2
13/03/2015 1 Ny.Elis V V
2 NY.Bunga V
3 Ny.Leni V V
4 Ny.Yuli V
5 Ny.Sri V
6 Ny Siti N V V
7 Ny Nia V
7 3
14/03/2015 1 Ny.Rita V
2 Ny.Sopiani V
3 NY.Sri V
4 NY.Iyan V V
5 NY.Sherly V
6 Ny.Fitri V
6 1
15/03/2015 1 Ny.Rita V V
2 Ny.Yeti V
3 Ny.Nurjannah V
4 Yuliasih V
5 Ny Sri V
6 Ny Iyam V V
7 Ny.Fitria V
6 2 1
16/03/2015 1 Ny. Titim V V
2 NY.Dedeh V
3 NY.Wulan V
4 NY.Rosdy V
5 NY.Widi V

6 NY Sri V
7 NY.Diana V
8 Ny.Holoria V
9 Ny IYam V V
8 2 1
17/03/2015 1 Ny.Dedeh V
2 Ny.WUlan V
3 NY.Neni V V
4 Ny.Rosmawati V
5 Ny Sri V
6 Ny Kodijah V
7 Ny.Iyam V
8 Ny.Dede V
9 Ny.Elin V
8 2
18/03/2015 1 Ny Yanti V
2 Ny.Nevi V
3 NY.Wulan V
4 Ny.Yuyun V
5 NY.Mita V V
6 Ny.Sri V
7 NY.Khodijah V
8 NY.IYam V
9. Ny.Elin V
10. NY.Heni V
19/03/2015 9 2
1 Ny.Yati V
2 NY.YAnti V
3 Ny.NEpi V
4 Ny.Yuyun V
5 Ny.Ratnawati V V
6 Ny.Iyam V
7 Ny.Upit V
8 Ny.Yunengsih V
9 Ny Heni V
10 NY Sriwenda V V
11 Ny.Nani V
10 3
20/03/2015 1 ny.Tiktik V
2 Ny.Siti Umbari V
3 Ny.Heni V
4 Ny.Sri Wenda V
5 NY.Nani V V
5 1
21/03/2015 1 NY.Siti Sarah V V
2 NY.Tiktik V
3 Ny.Siti UMbara V V
4 NY Sri V
5 Ny Nani V V
22/03/2015 1 NY.Dede V V
2 Ny.Siti Sarah V V
3 Ny.Sri V
4 Ny.Cucu V
4 2
23/03/2015 1 Ny.Sri V
1
24/03/2015 1 NY.Misdiani V
2 Ny Titin V
3 NY.Siska V V
4 Ny.Sri V
5 Ny.Rita V
6 NY.Rohayati V
7 NY.Euis V
8 NY.Imas V V
25/03/2015 8 2
1 NY.Atin V V
2 NY.Titin V
3 NY.Siska V V
4 NY.Rita V
5 NY.teti/Tn.Franciskus V V
5 3
26/03/2015 1 NY.Atin V
2 NY.Siska V V V
3 NY.Rita V V
4 Ny.Teti/Tn.Kunkun V
5 Ny.Euis V
6 Ny. Siti H V
7 Ny.Lilis V V
8 Ny.Elis V
8 2 2
27/03/2015 1 NY.Atin V
2 NY.Enok V
3 NY.Siska V V
4 NY.Rita V
5 Ny. Siti H V
6 Ny.Elis V
6 1
28/03/2015 1 NY.Atin V
2 NY.Enok V
3 NY.Ani V
4 NY.Rita V
5 NY.Siti V
6 NY.Rusmini V
7 NY.Yanti V
8 NY.Neneng V
8
29/03/2015 1 Ny.Atin V
2 Ny.Rita V
3 NY.Siti S V V
4 Ny.Yati V
5 Ny.Ai V
6 Ny Rusmini V
7 NY.Wiwin V
8 Ny.YAnti V
9 Ny.Neneng V V
10 Ny.Rita V V
10 3
30/03/2015 1 Ny.Atin V
2 Ny.Siti N V
3 Ny.Lita V
4 NY.Rita V
5 NY.Siti S V V
6 NY.Mulyani V
7 Ny.Sumiati V
8 NY.Heni V V
9 Ny.Ambar V V
9 3
31/03/2015 1 NY.Asri V
2 NY.Rita V
3 Ny.Mulyani V V
4 Ny.Iim V
5 NY.Emay V
6 NY.Heni V
7 Ny.Ambar V V
8 NY.Rima V
8 2

264 59 6

FORMULIR SURVEI HARIAN PEMAKAIAN ALAT


NIFAS 3 BULAN APRIL 2015
TANGGAL NO NAMA ETT IVL UC VAP ISK FLEBITIS HASIL KULTUR KET
01/04/2015 1 ny.Asri v
2 ny.Noneng v
3 ny.Rita v
4 ny.Wiwin v
5 ny.Emay v
6 ny.Rima v v
6 1
02/04/2015 1 ny.Noneng v v
2 ny.Siti Nurhidayah v
3 ny.Iim v
4 ny.Imas v
5 ny.Nina v
6 ny.Dewi v
6 0
03/04/2015 1 ny.Siti Nurhidayah v
2 ny.Iim v
3 ny.Rita v
4 ny.Imas v
5 ny.Ratih v
6 ny.Dewi v v
6 1
04/04/2015 1 NY.Nita v
2 NY.Rita v
2 0
05/04/2015 1 NY.Fera v
2 NY.Neni v
3 NY.Merisa v
4 Ny.Nita v
5 NY.Ema v v
6 Ny.Rita v
7 NY.Siti S v v
7 2
06/04/2015 1 Ny.Ema v
2 Ny.Rita/Tn.Cecep v
3 NY. Siti S v v
4 Ny.Ipah v
5 Ny.Sari v
6 Ny.Hamidah v
7 Ny.Ni Putu Sinar v
8 Ny.Megawati v
8 1
07/04/2015 1 Ny.Nani v v
2 Ny.Sari v
3 Ny.Rita/Tn.Cecep v
4 Ny.Ni Putu Sinar v
5 Ny.Diah v
6 Ny.Rita/Tn.Ade v
7 Ny.Iin v
8 Ny.Dini v
8 0
08/04/2015 1 NY.Siti N v
2 NY.Nani v v
3 NY.Sari v
4 NY.Diah v v
5 NY.Rita/Tn.Cecep v
6 Ny.Rita/Tn.Ade v
6 2
09/04/2015 1 Ny.Siti N v
2 Ny.Sari v
3 Ny.Eli v
4 Ny.Rita v
5 Ny.Marcella v
6 Ny.Diah v v
7 Ny.Nani v
7 1
10/04/2015 1 Ny.Imas v
2 Ny.Mirawati v v
3 Ny.sari v
4 Ny.leni v
5 Ny.Cici v
6 Ny.Arche v
7 Ny.Diah v v
8 Ny.Yunita v
9 Nn. Anisa v v
10 Ny.Noni v
10 2
11/04/2015 1 Ny.Imas v
2 NY.Sari v v
3 Ny.Leni v
4 Ny.Siti Komala v v
5 Ny.Diah v
6 Ny.Cacih v v
7 Ny.Rochayati v
8 Ny.Finli v
9 Nn.Anisa v v v
9 4 1
12/04/2015 1` Ny.Siti Mulyati v
2 Ny.Siti Komala v
3 Ny.Diah v
4 Ny.Cacih v v
5 Ny.Irma v
6 Ny.IIn v
6 1
13/04/2015 1 Ny.Ema v
2 Ny.Sariningsih v
3 Ny.Imas v
4 NY.Cacih v v
5 Ny.Siti Nurwendah v
6 Ny.Iin v
6 1
14/04/2015 1 Ny.Yuliana v
2 Ny.Efin v
3 N y.Ema v
4 Ny.Sariningsih v
5 Ny.Cacih v v
6 Ny.Siti Nurwendah v v
6 2
15/04/2015 1 Ny.Entin v v
2 NY.Yuliana v
3 NY.Ema v
4 Ny.Susan v
5 Ny.Sariningsih v
6 NY.Deti v
7 Ny.Dewi v
7 1
16/04/2015 1 Ny.Dewi v v
2 Ny.Mega v v
3 NY.Kartika v v
4 Ny.Evi v
5 Ny.Heni v
6 Ny.Dewi v
6 3
17/04/2015 1 Ny.Onih v v
2 Ny.Dini/Tn.Ramdan v
3 Ny.Tiktik v
4 Ny.meriam v
5 Ny.Cucu v v
5 1
18/04/2015 1 NY.Ratna v
2 Ny.Onih v v
3 Ny.Dini/Tn.Ramdan v
4 NY.Nani v
5 Ny.Ernawati v
6 Ny.Sopiah v v
7 Ny.Tiktik v
8 Ny.Meriam v v
9 Ny.Cucu v v
9 4
19/04/2015 1 Ny.Suhandini v
2 Ny.Dini/Tn.Ramdan v
3 NY.Iim v v
4 Ny.Susan v
4 1
20/04/2015 1 Ny.Elis/Tn.Heri v
2 Ny.Imas/Tn.Gunawan v
3 Ny.Sumartini v
4 Ny.Rizki v
5 Ny.IYam v
5
21/04/2015 1 Ny.Mei Risa v
2 Ny.Imas/Tn.Gunawan v
3 Ny.Rizki v
4 Ny.Santi v v
5 NY.Juju v
6 Ny.Nurhayati v
7 Ny.Erni v v
6 3
22/04/2015 1 Ny.MeiRIsa v v
2 Ny.Susanti v
3 Ny.Annisa v
4 Ny.Wiwi v v
5 Ny.Meri v
6 Ny.Linda v
7 Ny.Sani v
8 Ny.Vina v
8 2
23/04/2015 1 Ny.Mulyati v
2 Ny.Siti J v
3 Ny.Wiwi v
4 Ny.Dian/Tn.Soni v
5 Ny.Eni v
6 Ny.Rohayati v
7 Ny.Nining v v
8 Ny.Siti Saripah v v
9 Ny.Lili v
9 1 1
24/04/2015 1 Ny.Mulyati v
2 Ny.Wiwi v
3 Ny.Dian/Tn.Soni v v
4 Ny.Siti Saripah v v
4 1 1
25/04/2015 1 Ny.Retno v
2 Ny.Ani v
3 Ny.Deasy v
3
26/04/2015 1 Ny.Eli v
2 Ny.Neneng v v
3 Ny.Liya v
4 Ny.Fitri v v
5 Ny.Nurazizah v
6 Ny.Yunengsih v
27/04/2015 6 2
1 Ny.Neneng v
2 Ny.Yanti v
3 Ny.Rina v
4 Ny.Nurazizah v
5 Ny.Entang v
6 Ny.Nia mArtini v
7 Ny.Enah v
8 Ny.NIa v v
9 Ny.Neng Liah v
9 1
28/04/2015 1 Ny.Rosita v
2 Ny.Yanti v
3 Ny.Nia v v
4 NY.Neng Liah v
5 ny.wiwin v v
6 ny.nina v v
7 ny.irmawanti v v
8 ny.wanti v
8 4
29/04/2015 1 ny.wikeu v v
2 ny.endah v v
3 ny.santi v v
4 ny.suhandini v
4 3
30/04/2015 1 ny.ropa v v
2 ny.yuniasih v
3 ny.deti v v
4 ny.santi v v
5 ny.teti v
6 ny.heti v v
6 4
193 48 3

FORMULIR SURVEI HARIAN PEMAKAIAN ALAT


NIFAS 3 BULAN MEI 2015

TANGGAL NO NAMA ETT IVL UC VAP ISK FLEBITIS HASIL KULTUR KET
01/05/2015 1 ny.deti/tn.hadi v
2 ny.ai kiki v
3 ny.santi v v
4 ny.sri v v
5 ny.meri v
6 ny.elis v
7 ny.eros v v
7 3
02/05/2015 1 ny.rika v v
2 ny.nuri v v
3 ny.anita v
4 ny.tesa v
5 ny.yunengsih v
5 2
03/05/2015 1 ny.Mimi v
2 Ny.Elis v
2 0
04/05/2015 1 Ny.Juju v
2 Ny.Mimi v v
3 Ny.Siti M v
4 Ny.Sutiah v
4 1
05/05/2015 1 NY.Juju v
2 NY.Mimi v
3 NY.Siti R v
4 Ny.Elis v
5 Ny.Yani v
6 Ny.Dini v
7 Ny.Heni v
7
06/05/2015 1 NY.Rani v
2 Ny.ELis v
3 Ny.Ipah v
3
07/05/2015 1 NY.Rani v
2 NY.Sri W v
3 Ny.Elis v
4 NY.Diah v
5 Ny.Rita v
6 NY.Iin v
7 Ny.Dini v
7
08/05/2015 1 NY.Nia v
2 NY.Dede v
3 Ny.Ila v
4 Ny.Khayatin v
5 Ny.Diah v
6 Ny.Rita v
6
09/05/2015 1 Ny.Nia v
2 Ny.Linda v
3 Ny.Khayatin v
4 Ny.Cucu v
5 Ny.Eti v
5
10/05/2015 1 Ny.Tri v
2 Ny.Yani v v
2 1
11/05/2015 1 Ny.NurAzizah v
2 NY.Tri v
3 Ny.MIla v v
4 Ny.Roilah v
5 Ny.Siti Romlah v
4 1 1
12/05/2015 1 Ny.Siti Mahmudah v
2 Ny.Ai Siti v
3 Ny.NurAzizah v
4 Ny.Mila v v
5 Ny.Roilah v
6 Ny.Mimi v
7 Ny.Nina v
8 Ny.Siti Romlah v v v
7 2 1 1
13/05/2015 1 Ny.SitI M v
2 Ny.Ai Siti v
3 Ny.Siti Khodijah v
4 Ny.NuAzizah v
5 NY.Mila v v
6 Ny.Imas Reni v
7 NY.Roilah v
8 Ny.Mimi v
9 Ny.Nina v
8 1 1
14/05/2015 1 Ny.Yani v
2 Ny.Juju v
3 Ny.Siti R/Tn.Irva v v v
4 Ny.MIla v
5 Ny.Imas v
6 Ny.Roilah v
5 2 1
15/05/2015 1 Ny.Juju v
2 Ny.Mila v
3 Ny.Imas v
4 Ny.Nina v v
3 2
16/05/2015 1 Ny.MAryani v
2 Ny.Wartini v
3 Ny.Lestari v v
4 Ny.Juju v
5 Ny.Santi v
5 1
17/05/2015 1 Ny.Imas v
2 Ny.Cucu v
3 Ny.Wartini v
4 Ny.Juju v
5 Ny.Titin v
6 Ny.Mila v
5 1
18/05/2015 1 Ny.Elis v
2 Ny.Cucu v
3 Ny.Lilis. v v
4 Ny.Juju v
5 Ny.Dedeh v
6 Ny.Saimah v
6 1
19/05/2015 1 Ny.Neni v
2 Ny.Iis v
3 Ny.Lena v
4 Ny.Yani/Tn.Iyan v
5 Ny.Saimah v v
5 1
20/05/2015 1 Ny.Imas/Tn.Endang v
2 Ny.Warsiti v
3 Ny.Iis v v
4 Ny.Lena v
5 Ny.Yani/Tn.Dedi v
6 Ny.Mariah v
7 Ny.Endang v
8 Ny.Fani v
9 Ny.Cici v v
9 1 1
21/05/2015 1 Ny.Reni v
2 Ny.Dewi v
3 Ny.Muslaini v
4 Ny.Warsiti v v
5 Ny.Yuni v
6 Ny.Yani v
7 Ny.Rida v
7 1
22/05/2015 1 Ny.Reni v
2 Ny.Dewi v v
3 Ny.Riani v
4 Ny.Heryani v
5 Ny.Yuni v
6 Ny.Nurazizah v
7 Ny.Rida v
8 Ny.MImi v
8 1
23/05/2015 1 Ny.Dewi v
2 Ny.Riani v
3 NY.Amilah v
4 Ny.Siti Jenab v
5 Ny.NurAzizah v
6 Ny.Endang v v
7 Ny.Nurlaeli v
7 1
24/05/2015 1 Ny.Dewi v v
2 Ny.Amilah v
3 Ny.Ida v
4 NY. Siti S v
5 Ny.Nurazizah v
6 Ny.Mimi v
7 Ny.Mimin v v
8 Ny.Yayu v
8 1
25/05/2015 1 NY.Novitasari v
2 Ny.Iis v
3 Ny.Siti Ajeng v
4 Ny.Ai v
5 Ny.Dewi v
6 Ny.Nurazizah v
7 Ny.Tita v
8 Ny.Hamidah v
8
26/05/2015 1 Ny.Ait v
2 Ny.Rikawati v
3 Ny.Dewi v
4 Ny.Siti Aisyah v
5 Ny.Nurazizah v
6 Ny.Rini v
6
27/05/2015 1 Ny.Euis v v
2 Ny.Ait v v
3 Ny.Evi v v
4 Ny.Siti F v
5 Ny.Siti Aisyah v
6 Ny.Nurazizah v
7 Ny.Siti /Tn.Yohan v
8 Ny.Gina v
9 Ny.Rini v
9 2
28/05/2015 1 Ny.Tita v
2 Ny.Evi v
3 Ny.Nurazizah v
4 Ny.Hayati v
5 Ny.Gina v
6 Ny.Hamidah v
6
29/05/2015 1 Ny.Siti Khodijah v v
2 Ny.Tita v v
3 Ny.Masripah v
4 Ny.Evi v v
5 Ny.Yuyun v v
6 Ny.Hayati v
6 4
30/05/2015 1 NY.Fitri v
2 Ny.Evriana v
3 Ny.Nur R v
4 Ny.Yuyun v v
5 Ny.Mimi v
6 Ny.Rika v
7 Ny.Diana v v
6 3
31/05/2015 1 Ny.Nunuk v
2 NY.Ria v
3 Ny.Nur R v
4 NY.Yuyun v v
5 Ny.Mimi v
6 Ny.Dewi v
6 1
182 34 2 2

FORMULIR SURVEI HARIAN PEMAKAIAN ALAT


NIFAS 3 BULAN JUNI 2015

TANGGAL NO NAMA ETT IVL UC VAP ISK FLEBITIS HASIL KULTUR KET
01/06/2015 1 ny.Ria v v
2 ny.Yuyun v
3 ny.Elis v
3 1
02/06/2015 1 ny. Pipin v
2 ny.Jamilah v v
3 ny.Siti FItri v
4 ny.Tati v
5 Ny.Eka v
6 Ny.Lina v
6 1
03/06/2015 1 ny.Siti Fitri v
2 Ny.Rani v
3 Ny.Jamilah v
4 Ny.Nina v v
5 Ny.Meli v v
6 Ny.Rita v
6 2
04/06/2015 1 Ny.Siti H v
2 Ny.Siti Fitri v
3 Ny.Wina v
4 NY.Melly v
5 Ny.Rita v
6 Ny.Atin v
6
05/06/2015 1 Ny.Tina v
2 Ny.Siti Fitri v
3 Ny.Wina v
4 Ny.Rita v
5 Ny.Atik v
5
06/06/2015 1 Ny.Siti Fitri v
2 Ny.DAnilah v
2
07/06/2015 1 Ny.Santi v
2 Ny.Novi v v
3 Ny.Dewi v v
4 Ny.MArtini v v
5 Ny.Cicah v v
6 Ny.Susanti v v
7 Ny.Siti F v
7 5
08/06/2015 1 Ny.Della v
2 Ny.Imas v
3 Ny.Nurlela v
4 Ny.Eneng SIti v 1
4
09/06/2015 1 Ny.Yanti v
2 Ny.Linda/Tn.Ajhari v
3 Ny.LINda/Tn.Ahmad v v
4 Ny.Evi v
5 Ny.Lastri v
6 Ny.Nenden v v
7 Ny.Wiwin v
8 Ny.Yeni v
9 Ny.Yuyu v
10 Ny.Hani v v
10 3
10/06/2015 1 Ny.Yanti v
2 Ny.LInda/Tn.Ajhari v v v
3 Ny.LInda/Tn.Ahmad v
4 Ny.Evi v
5 Ny.Lastri v
6 Ny.MAesarah v
7 Ny.Ria v
8 Ny.Yuyun v
8 1 1
11/06/2015 1 Ny.Yuli v
2 Ny.Yanti v
3 Ny.Linda/Tn.Ahmad v
4 Ny.Indri v
5 Ny.Wawat v
6 Ny.Maesarah v
7 Ny.Imas v
8 Ny.Ria v
9 Ny.Rosita v
10 Ny.Yati v
10
12/06/2015 1 Ny.Wati v
2 Ny.Yuli v
3 Ny.Sintia v
4 NY.Roslina v
5 Ny.Imas v
6 Ny.Ria v
6
13/06/2015 1 Ny.Wati v
2 Ny.Sintia v
3 Ny.Roslina v
4 Ny.Norma v
5 Ny.Nurlela v
6 Ny.Elismawati v
6
14/06/2015 1 Ny.Sintia v
2 Ny.Saila v
3 Elismawati v
3
15/06/2015 1 Ny.Dati v
2 Ny.WIwin v
3 Ny.Nining v
4 Ny.Saila v
5 Ny.Erlina v
5
16/06/2015 1 Ny.Nengsih v
2 Ny.Castem v
3 Ny.Nisa v v
4 Ny.Wiwin v
5 Ny.Sumarni v
6 Ny.saila v
7 Ny.Neneng v v
8 Ny.Diana v
9 Ny.Hendrayani v v
10 Ny.Erlina v
11 Ny.Erna v
12 Ny.Dede v
13 Ny.Siti M v v
13 3 1
17/06/2015 1 Ny.Nisa v v
2 Ny.Wiwin v
3 Ny.Diana v
4 Ny.Hendrayani v
5 NY.Erlina v
6 Ny.Etty v
7 Ny.Dewi v
8 Ny.Telsyanisa v
8 1
18/06/2015 1 Ny.Castem v
2 Ny.Ratih v v
3 Ny.Sumiyati v
4 Ny.Ade v
5 Ny.Linda v
6 Ny.Etty v
6 1
19/06/2015 1 Ny.Komalasari v v
2 Ny.Ratih v
3 Ny.Sumiati v
4 Ny.Santika v v
5 Ny.Fenti v
6 NY.Sainem v v
7 Ny.LIdya v
7 2
20/06/2015 1 Ny.Gina v
2 Ny.Ratih v v
3 Ny.Sumiati v
4 NY.Santika v v
5 Ny.Nining v
6 NY.Elis v v
6 3
21/06/2015 1 Ny.Rismawati v
2 Ny.Lilis v
3 NY.Elis v v
4 Ny.Martini v v
4 2
22/06/2015 1 Ny.Fitriawati v
2 Ny.SintaBela v
3 Ny.Iis v v
4 Ny.Herna v
5 Ny.Elis v
5 1
23/06/2015 1 Ny.Rodiah v
2 NY.Fitriawati v
2
24/06/2015 1 Ny.Siti J v
2 Ny.Rodiah v
3 Ny.Siti M v
4 Ny.Mirna v v
5 Ny.Lina v v
6 Ny.Santika v v
7 Ny.Diana v
8 Ny.Yuri v
6 5
25/06/2015 1 Ny.Sri Fuji v
2 Ny.Juaningsih v
3 Ny.Lina v v
4 Ny.Omih v v
5 Ny.Diana v
6 Ny.Yuri v
4 4
26/06/2015 1 Ny.Sendi v
2 Ny.Yuliana v
3 Ny.Juaningsih v
4 Ny.Lina v v
5 Ny.Siti A v
6 Ny.Omih v v
7 Ny.Leni v
8 Ny.Diana v
9 Ny.Yuri v
7 4
27/06/2015 1 ny.juwangsih v
2 ny.seni v
3 ny.sendi v
4 ny .wiwin v
5 ny. lina v v
6 ny siti A v v
6 2
28/06/2015 1 NY.wiwin v
2 Ny.Seny v v
3 Ny.Niawati v
3 1
29/06/2015 1 Ny.Onih v v
2 Ny.Yuliawati v v
3 Ny.Eni v
4 Ny.Lina v
4 2
30/06/2015 1 Ny.Onih v
2 Ny.Maya v
3 NY.Lina v
4 Ny.Yuliawati v
5 NY.Arti v
6 Ny.Istiqomah v
7 Ny.Noneng v v
7
175 45 1 1

jumlah pasien dalam dan luar :197 orang

FORMULIR SURVEI HARIAN PEMAKAIAN ALAT


NIFAS 3 BULAN JULI 2015

TANGGAL NO NAMA ETT IVL UC VAP ISK FLEBITIS HASIL KULTUR KET
01/07/2015 1 Ny. elli v
2 ny Anin v v
3 ny euis v
4 ny. cucu v v
5 ny. maya v v
6 ny. eneng ratmi v
7 ny. herawati v v
8 ny. noneng v
9 ny anggi v v
10 ny.heni v
10 5

02/07/2015 1 ny anggi v
2 ny ani v v
3 ny yuli v v
4 ny anin v
5 ny euis v
6 ny cucu v
7 ny maya v v
8 ny liis v v
9 ny dede v
10 ny dini v v
10 5 1

03/07/2015 1 ny ani v
2 ny eva v
3 ny yuli v
4 ny cucu v v
5 ny euis v v
6 ny maya v v
7 ny lilis v v
8 ny dini v v
7 6

04/07/2015 1 ny ani v
2 ny cucu v
3 ny euis v v
4 ny dini v v
5 ny lilis v v
4 4
05/07/2015 1 Ny.Lilis v
2 Ny.Ani v
3 Ny.Fitri v v
2 2

06/07/2015 1 ny cici v
2 ny ani v
3 ny tati v
4 ny elis v v
5 ny aan v v
6 ny anin v
7 ny hani v
8 ny siti aminah v
7 3

07/07/2015 1 ny cici v
2 ny ani v
3 ny sinta v v
4 ny elis v
5 ny anisa v v
6 ny nuraeni v v
7 ny meta v v
8 ny lilis v v
9 ny agustina v v
10 ny siti aminah v
9 7
08/07/2015 1 ny nuraeni v
2 ny meta v
3 ny lilis v v
4 ny agustina v
5 ny winda v v
6 ny ayi v
7 ny sinta v
8 ny mimi v v
8 3
09/07/2015 1 ny.Widiyati v
2 ny.Ani v
3 ny.Winda v
4 ny.Mimi v v
5 ny.Desri v
5 1
10/07/2015 1 ny.Wdiyati v
2 ny.LInda v
3 ny.Sundari v
4 ny.Imas/Tn.Maman v
5 ny.Desri/Tn.Asep v
5
11/07/2015 1 ny.Rianti v
2 ny.Ade v
3 ny.Iis v
4 ny.Linda v
5 ny.Arah v v
6 ny.Ida v
7 ny.Fiska v
7
12/07/2015 1 ny rosita v v
2 ny sri n v v
3 ny indah v
4 ny yayu v v
5 ny ami v v
6 ny arah v v
7 ny viska v
7 5

13/07/2015 1 ny yayu v
2 ny ami v
3 ny arah v
4 ny nova v
5 ny lina v v
6 ny sri v v
7 ny indah v
7 2

14/07/2015 1 ny siti v
2 julaeha v v
3 ny lina v v
4 ny sri v v
5 ny imas v
6 ny indah v
7 ny heni v v
8 ny lia v
8 4

15/07/2015 1 ny julaeha v v
2 ny suryati v v
3 ny lina v v
4 ny sri v v
5 ny heni v v
6 ny enung v v
7 ny ika v
7 6
16/07/2015 1 ny.Suryati v
2 ny.Sri v
3 ny.Rose v
4 ny.Romaida v
5 ny.Nurohmah v v
6 ny.Erma v
6 1
17/07/2015 1 ny.Nurohmah v v
1 1
18/07/2015 1 ny.Rini v
2 ny.Nurohmah v
2
19/07/2015 1 ny.Rini v
2 ny.Intan v
2
20/07/2015 1 ny widyastuti v v
2 ny yani v v
3 ny gilang v
4 ny rini v
5 ny henni v
6 ny syafitri v
7 ny nurliana v v
8 ny nurwita v v
7 5
21/07/2015 1 ny.Henny v
2 ny.Syafitri v
3 ny.Nurliana v v
4 ny.Nurwita v
2 2
22/07/2015 1 ny.Ade v
2 ny.Lina v
3 ny.Nurliana v v
4 ny.Anisa v v
4 2
23/07/2015 1 ny ade v v
2 ny lina v
3 ny nurliana v v
4 ny dede v v
5 ny mira v
6 ny nuraeni v v
7 ny diah v v
7 5
24/07/2015 1 ny.Maya v
2 ny.Nenden v
3 ny.Dede v
4 ny.Ai E Kurnia v v
5 ny.Diah v v
5 2
25/07/2015 1 ny desi v
2 ny santi v v
3 ny neli v
4 ny tina v
5 ny santi/tn empah v v
5 2
26/07/2015 1 ny.Siska v
2 ny.Suyatun v v
3 ny.NIta v
4 ny.Santi/Tn.KArnaya v
5 ny.LIna/Tn.Farhan v v
6 ny.Santi/Tn.Empah v
7 ny.Febiyani v
7 2
27/07/2015 1 Ny.Erni v v
2 Ny.Suyatun v v
3 Ny.Lilis v
4 Ny.Desi v
5 Ny.Lina/Tn.Farhan v
6 Ny.Enung v
6 2
28/07/2015 1 Ny.Reni v
2 Ny.Ani v
3 Ny.Erni v v
4 Ny.Lilis v
5 Ny.Desi v
5 1
`````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````
29/07/2015 1 Ny.Saeri v
2 Ny.Rani v
3 Ny.Lilis v
4 Ny.Nuraeni v
4
30/07/2015 1 Ny.Eem v v
2 Ny.Risma v
3 Ny.Nuning v v
4 Ny.Mila v v
5 Ny.Nurhalimah v
5 3
31/07/2015 1 Ny.Risma v
2 Ny.Nurhalimah v
3 Ny.Neng Anih v v
4 Ny.Sriningsih v v
4 2
175 83 1
TOTAL PASIEN:180 (D)+169 (L)=349

Formulir Survey Harian Pemakaian Alat


Ruang IRNA 3 - RSKIA - AGUSTUS 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2015 1 ny.Erna V
2 ny.Seniangsih V V
3 ny.Linda V
4 ny.Neng Anih V V
5 ny.Iim V
6 ny.Rina V
7 ny.Nurhayati V
8 ny.Eulis V
9 ny.Sriningsih V
8 3
02/08/2015 1 ny jejeh v
2 ny erna v
3 ny sumiyati v
4 ny linda v v
5 ny iim v
6 ny rinawati v
7 ny nurhayati v
6 2

03/08/2015 1 ny pitriyani v
2 ny anis v v
3 ny erna v
4 ny enok v
5 ny sumiyati v
4 2
04/08/2015 1 ny.Anita v
2 ny.Sumiyati v
2
05/08/2015 1 ny.Sri R v
2 ny. Castem v
3 ny.Siti N v v
4 ny.Lilis v
5 ny.Ema v
6 ny.Elis v
7 ny.Rini v
8 ny.Neni v
9 ny.Linda v v
9 3
06/08/2015 1 ny sri v
2 ny suyatun v v
3 ny elis v
4 ny rini v
5 ny sandra v v
6 ny tina v v
5 4

07/08/2015 1 ny neng anih v v


2 ny suyatun v v
3 ny rini v
4 ny anastasia v
5 ny tina v v
5 3
08/08/2015 1 Ny.Neng Anih v v v
2 Ny.Lia v
3 Ny.Anastasia v
2 2 1
09/08/2015 1 Ny.Rusmayani v
2 Ny.Neng Anih v
3 Ny.Eros v
4 Ny.Dede v v
4 1
10/08/2015 1 ny rismayani v
2 ny desi v v
3 ny ecin v v
4 ny anawati v v
5 ny ani v
5 3
11/08/2015 1 ny anawati v v
2 ny jeni v
3 ny roiyah v v
4 ny cucu v v
5 ny midah v
6 ny susanti v v
7 ny desi v
8 ny marini v v
9 ny dedeh v
9 5

12/08/2015 1 ny santi v v
2 ny susanti v v
3 ny mina v
4 ny martini v v
5 ny dini v
6 ny nasiyah v
7 ny rina v
8 ny ai n v
9 ny cucu v
9 3

13/08/2015 1 ny purwantinah v v
2 ny nasiyah v
3 ny ai sumarni v v
4 ny santi v
5 ny uli v v
5 3

14/08/2015 1 ny komariah v
2 ny dini v
3 ny siti r v v
4 ny purwantinah v
5 ny ai sumarni v v
6 ny siti n v v
7 ny omah v
8 ny cucu v v
8 4

15/08/2015 1 ny siti n v v
2 ny omah v
3 ny ayu v v
4 ny haryati v
5 ny astri v v
6 ny siti. r v v
6 4
16/08/2015 1 ny.Eros v
2 ny.Eli v
3 ny.Euis v v
3 1
17/08/2015 1 ny.Henny v
2 ny.Omah v
3 ny.Keulis v
4 ny.Euis v
5 ny.Supiah v v
6 ny.Dara v
7 ny.Ai v
7 1
18/08/2015 1 ny.Omah v
2 ny.Dara v
3 ny.Nia v
3
19/08/2015 1 Ny.Halimah v
2 Ny.Dede v
3 Ny.Omah v
3
20/08/2015 1 Ny.Dede v v
2 Ny.Ela v
3 Ny.Omah v
4 Ny.Sumaryati v v
5 Ny.Cindy v
5 2
21/08/2015 1 Ny.Dede v
2 Ny.Rica v
3 Ny.Rosita v
4 Ny.Yulian v v
5 Ny.Cindy v
6 Ny.Winarsih v
6 1
22/08/2015 1 Ny.Siti N v
2 Ny.Enung v
3 Ny.Nunung v
4 Ny.Rosita v
5 Ny.Yulian v
6 Ny.Evi v
5 1
23/08/2015 1 Ny.Enung v
2 Ny.Nunung v
3 Ny.Eka v v
4 Ny.Dewi v v
3 3
24/08/2015 1 ny nunung v
2 ny anggraeni v v
3 ny ratnasih v
4 ny lilah v v
5 ny gina v
4 3

25/08/2015 1 ny nurmayani v v
2 ny nunung v
3 ny nurjanah v
4 ny elsa v
5 ny tintin v
4 2
26/08/2015 1 ny.Nurmayani v
2 ny.Widayati v v
3 ny.Elsa v
4 ny.Imas v
5 ny.Titin v
6 ny.Anggraeni v
6 1

27/08/2015 1 ny widayanti v v
2 ny rohani v v
3 ny fatimah v
4 ny teti v
5 ny imas v v
6 ny dede v
7 ny nenden v
8 ny soinah v v
9 ny rani v v
9 5

28/08/2015 1 ny rosita v v
2 ny ela v
3 ny rise v v
4 ny lia v v
5 ny neulis v v
6 ny nurlela v v
7 ny nina v v
8 ny eni v v
9 ny dewi v v
10 ny tini v
11 ny ai v v
11 9

29/08/2015 1 ny nuelaela v v
2 ny nina v v
3 ny dewi siti v v
4 ny tini v v
5 ny ai v v
6 ny ela v
7 ny rise v v
8 ny lia v v
9 ny neulis v v
9 8
30/08/2015 1 ny.Ela/Tn.Handi v
2 ny.Rini/Tn.Didin v
3 ny.Rise/Tn.Saeful v v
3 1
31/08/2015 1 ny.Laila/Tn.Dian v
1
169 80 1

Formulir Survey Harian Pemakaian Alat


Ruang IRNA3 September 2015- RSKIA

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2015 1 Ny.Nisha/Tn.Irwan v
2 Ny.Darmi/Tn.Zulfikar V
3 NY.Rise/Tn.Saeful v v
4 Ny. Siti v
4 1
02/09/2015 1 Ny.Widi/Tn.Sandi v
2 Ny.Darmi/Tn.Zulfikar v
3 Ny.Eliyana/Tn.Rima v
4 Ny.Ipah/Tn.Abdul v
5 Ny.Mirawati/Tn.HatmaQ v
6 Ny.Neneng/Tn.Tedi v
7 Ny.Nurhayati/Tn.Yudi v
8 Ny.Bening/Tn.Deni v
9 Ny.Resti/Tn.Deni v
10 Ny.Riseu/Tn.Saeful v v v
9 2 1
03/09/2015 1 Ny.Darmi/Tn.zulfikar v
2 Ny.Eliyana/Tn.Rima v
3 NY.Didah/ v
4 Ny.Ipah/Tn.Abdul v v
5 Ny.Mirawati/Tn.HatmaQ v v
6 Ny.Ria/ v
7 Ny.Eli v
8 Ny.Nurhayati/Tn.Yudi v
9 Ny.Resti/Tn.Deni v
10 Ny.Riseu/Tn.Saeful v v v
10 3 1
04/09/2015 1 Ny.Lilis v
2 Ny.Dewi v
3 Ny.Dida v v
4 Ny.Tia v
5 Ny.Sumiyati v
6 Ny.Nurhayati/Tn.Yudi v v
7 Ny.Risye v v
8 ny.Titin v
6 4 1

05/09/2015 1 ny dewi v
2 ny yuliana v
3 ny fatimah v
4 ny risma v
5 ny marliza v v
6 ny tintin v
5 2
06/09/2015 1 ny.Dewi v
2 ny.Siti R v v
3 ny.Dena v
4 ny.Risma v
5 ny.Siti Nur v
6 ny.Karwati v v
5 3
07/09/2015 1 ny.Dewi v
2 ny.Dena v
3 ny.Shanti v v
4 ny.Siti Nur v
3 2
08/09/2015 1 ny.Seli v v
2 ny.Dewi v
3 ny.Anawati v
4 ny.Santi v v
5 ny.Nani v
6 ny.Heni v
7 ny.Nunung v
6 3
09/09/2015 1 ny.Seli v v
2 ny.Sri v v
3 ny.Dewi v
4 ny.Saidah v v
5 ny.Lia v
6 ny.Santi v v
7 ny.Nani v v
8 ny.Nunung v
7 6
10/09/2015 1 ny seli v v
2 ny sri v v
3 ny saidah v
4 ny mira v v
5 ny lia v
6 ny siti h v
6 3
11/09/2015 1 ny.Elis v
2 ny.Seli v v
3 ny.Maskupah v
4 ny.Ai Sadiah v
5 ny.Nuraeni v
6 ny.Wawang v
7 ny.Ana v
6 2
12/09/2015 1 ny.Elis v
2 ny.Dede v
3 ny.Heni v
4 ny.MAskipah v
5 ny.Nuraeni v
6 ny.Rohaeni v v
7 ny.Wawang v
8 ny.Arin v
9 ny.Emi v v
9 2
13/09/2015 1 ny.Santi v v
1 1
14/09/2015 1 NY.Rise v
2 Ny.Ati v
3 Ny.Maryati v
4 Ny.Darmi v
4
15/09/2015 1 Ny.Sutini v v
2 Ny.Masfuah v
3 Ny.Maryati v
4 Ny.Darmi v
4 1
19/09/2015 1 Ny.Heni v
2 Ny.Juaningsih v
3 Ny.Rise v kultur urin + (raoutella terrigena)th/Ciprofloxacin
2 1
17/09/2015 1 Ny.Ucu v
2 Ny.Naisah v
3 Ny.Widya v
4 Ny.Lilis v v
5 Ny.Heni v
5 1
18/09/2015 1 Ny.Santi v v
2 Ny.Wiwin v
3 Ny.Sani v
4 Ny.Sutanti v
5 Ny.Lia v
6 Ny.Adinda v
6 1
19/09/2015 1 Ny.Lina v v
2 Ny.Syarifah v
3 Ny.Lina/Tn.Supriatna v v
4 Ny.Lia v
5 Ny.Yani v
6 Ny.Adinda v
6 2
20/09/2015 1 Ny.Syarifah v v
2 Ny.Siti N v
3 Ny.Dede v
4 Ny.Ernasari v v
5 Ny.Rini v v
5 3
21/09/2015 1 Ny.Siti N v
2 Ny.Mevi v v
3 NY.Erni v
3 1

22/09/2015 1 ny eka v
2 ny siti r v v
3 ny heni v v
4 ny sinta v
5 ny erni v
5 2
23/09/2015 1 ny nuraidah v
2 ny sinta v v
3 ny sari v
4 ny shanti v v
4 2
24/09/2015 1 ny.Riska v
2 ny.Rohani v
3 ny.Intansari v
4 ny.Siti F v
5 ny.Nining v
6 ny.Entin v v
7 ny.Sari v
8 ny.Shanti v
8 1
25/09/2015 1 NY.Riska v
2 Ny.Rohaeni v
3 Ny.Intan v
4 Ny.Entin v v
4 1
26/09/2015 1 ny karnia v
2 ny dewi v v
3 ny sumiati v
4 ny ai n v v
5 ny turimah v
6 ny riska v v
7 ny mariam v
8 ny rohani v
9 ny ai v v
10 ny endah v v
10 5

27/09/2015 1 ny mariam v
2 ny ai v
3 ny deti v v
4 ny endah v v
5 ny rindiani v v
6 ny kania v v
7 ny dewi v v
8 ny ai siti v
9 ny desi v v
9 6
28/09/2015 1 ny mariam v
2 ny ai v
3 ny deti v
4 ny hasanah v
5 ny lia v
5 0
29/09/2015 1 ny.Sumiati v
2 ny.Diah v v
3 ny.Shanti v v
4 ny.Sumiati/tn.Rahmat v v
5 ny.Hasanah v v
5 ny.Lia v
5 3 1
30/09/2015 1 ny.Sumiati v
2 ny.Diah v
3 ny.Santi v v
4 ny.Ratih v
5 ny.Ai v
6 ny. Entin v
7 ny. Sumiati v v
8 ny.Masfuah v
8 2
170 66 1 D:199 L:16 Total :215
Formulir Survey Harian Pemakaian Alat
Ruang IRNA3 OKTOBER 2015- RSKIA
Tanggal No. Nama pasien ETT IVL uc ISK Flebitis VAP Hasil kultur Keterangan
01/10/2015 1 Ny.sarah wati/tn.dedi v v
2 Ny.icah/tn.hendra v
3 Ny.ening v
4 Ny.erni v v v
5 Ny.ratih v
6. Ny.Ai v
7 Ny.entin v
8 Ny.Sumiati v v
9 Ny.silvi v
10 Ny.vera v v
11 Ny.shinta v
12 Ny.maspuah v
12 4 1
02/10/2015 13 ny.sarah wati/tn.dedi v
14 wulansari v v
15 erni v
3 1
03/10/2015 16 ny.Wulan v v
17 ny.Erni v
18 ny.Katiana v
19 ny.Ela v v
4 2
04/10/2015 20 ny.Rita v
21 ny.Asri v
22 ny.Iis v
23 ny.Katiana v
24 ny.Feni v
5
05/10/2015 25 ny.Dian v
26 ny.Elly v v
27 ny.Pipit v
28 ny.Nia v
29 ny.Iis v
30 ny.Reni v
31 ny.Sri v
7 1
06/10/2015 32 ny dian v
33 ny imas v v
34 ny rima v v
35 ny iis v
36 ny resti v v
37 ny rohaeni v
6 3
07/10/2015 38 ny sri v
39 ny iis v
40 nofiyanti v
41 ny rima v
42 ny riska v v
43 ny sumi v v
44 ny siti hodijah v v
45 ny siti n v v
46 ny guntiati v
47 ny rohaeni v
10 4
08/10/2015 48 ny rosmaya v v
49 ny sri v
50 ny riska v v
51 ny sumi v
52 ny siti rokayah v v
53 ny siti hodijah v v
54 ny siti n v v
7 5
09/10/2015 55 ny.Siti F v v
56 ny. Yuliawati v v
57 ny.Dede v
58 ny.Lina v v
59 ny.Katiana v v
60 ny.Parmi v v
61 ny.Halimah v v
62 ny.Sriyanti v
8 6
10/10/2015 63 ny.Siti F v v
64 ny. Yuliawati v v
65 ny.Ai KarIminah v v
66 ny.Lina v v
67 ny.Pitri v
68 ny.Halimah v v
69 ny.Sriyanti v
70 ny.Widaningsih v
8 5
11/10/2015 71 ny.siti Fadalih v
72 ny.Enah v
73 ny.Siti N v
74 ny.Siti Z v
75 ny.Pitri v
76 ny.Widaningsih v v
6 1
12/10/2015 77 ny.Lina v v
1 1
13/10/2015 78 ny. Rosa v v
79 ny.LIan v
80 ny. Eulis v v
3 2
14/10/2015 81 ny.Nina v v
82 ny. Rosa v
83 ny. Eros v
84 ny.LIan v v
85 ny. Neng Riri v v
5 2 1
15/10/2015 86 ny.Irah v v
87 ny.Ina v
88 ny.Livi v v
89 ny.Santi v v
4 3
16/10/2015 91 ny.Evi v v
92 ny.Titin v
93 ny.Irawati v
94 ny. Rosita v v
95 ny.Ade v
5 2
17/10/2015 96 ny.Endah v
97 ny.Sri S v
98 ny. Ade v
99 ny. Tanti v v
4 1
18/10/2015 100 ny. Cucu v
101 ny. Wiwin v
102 ny. Tanti v v
2 2
19/10/2015 103 ny.Ika v v
104 ny. Cucu v
105 ny. Wiwin v
106 ny.Nurjannah v
107 ny. Siti Saleha v v
108 ny. Tanti v v
109 ny.Shinta v v
110 ny. Siti Y v
7 5
20/10/2015 111 ny. Marasari v
112 ny. Tri v
113 ny.Yeni v
114 ny.Yuli v
115 ny.Shinta v
5
21/10/2015 116 ny nurjanah v
117 ny lilis v
118 ny yuli v
119 ny depi v
120 ny shinta v v
121 ny siska dewi v
122 ny destri v
123 ny widaningsih v
8 1
22/10/2015 124 ny. Siti v
125 ny. Yanti v v
126 ny. Nurjannah v
127 ny. Ira v
128 ny.Lilis v
129 ny. Sophia v
130 ny.Depi v
131 ny. Siska Dewi v
132 ny. Destri v
133 ny. Neni v
10 1
23/10/2015 134 ny. Siti v
135 ny.Yanti v v
136 ny.Mustaqimatun v
137 ny. Lilis v
138 ny. Yohana v v
139 ny. Nelia v
140 ny. Ai v
141 ny.Susi v
142 ny.Neni v
9 2
24/10/2015 143 ny. Lintang v
144 ny.Kristina v
145 ny.Nelia v v
146 ny.Ai v
147 ny.Nia v
148 ny. Elis v v
6 2
25/10/2015 149 ny lintang v v
150 ny santi v
151 ny yanti v
152 ny resna v
153 ny seni v v
154 ny rini v
6 2
26/10/2015 155 ny resna v v
156 ny rini v v
157 ny yani v
158 ny iis v
159 ny siti kurniasih v
160 ny rena v
161 ny santi v
7 2
27/10/2015 162 ny yani v v
163 ny fani v
164 ny rena v
165 ny salamah v
166 ny maya v v
167 ny enung v
168 ny mimih v
169 ny euis v v
170 ny heni v
9 3

28/10/2015 171 ny kristina v


172 ny juariah v
173 ny sri v v
174 ny yanti v v
175 ny sri A v v
176 ny hana v
6 3
29/10/2015 177 ny. Ida v
178 ny. Santi v v
179 ny. Sri v
3 1
30/10/2015 180 ny.IIs v
181 ny. Yanti v v
182 ny.Fitri v
183 ny.Rinrin v
184 ny. Imas v
185 ny. Sri A v
186 ny.Puji v
7 1
31/10/2015 187 ny. Rinrin v
188 ny.Imas v
189 ny.Puji v
190 ny. Hani v v
4 1
68 3

Ruang IRNA 3 Bulan November 2015


Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/11/2015 1 Ny.Dina/Tn.Yana v v
2 Ny.Mala/Tn.Andi v
3 Ny.Leni/Tn. Dede v v
3 2
02/11/2015 4 Ny.Sinta/Tn.Ujang v
5 Ny.Dina/Tn.Yana v v
6 Ny.Eha/Tn.Aceng v
7 Ny.Epi/Tn.Wawan v
8 Ny.Yulianti/Tn.Dadang v v
9 Ny.Sri/Tn.Azwardi v
10 Ny.Noviyanti/Tn.Diki v v
11 Ny.Mala/Tn.Ardi v
8 2
03/11/2015 12 Ny.Sinta/Tn.Ujang v
13 Ny.Rini/Tn.Ade v
14 Ny.Dina/Tn.Yana v
15 Ny.Wanti/Tn.abdul v
16 Ny.Santi/Tn.Dani v
17 Ny.Neni/Tn.Rahmat v v
18 Ny.Cucu/Tn.Wahyu v v
19 Ny.Yani/Tn.Bambang v
20 Ny.Siti S/Tn.Lasdi v v
21 Ny.Novianti/Tn.Gumilar v v
10 4
04/11/2015 22 Ny.Rini/Tn.Ade v
23 Ny.Dina/Tn.Yana v v
24 Ny.Eli/Tn. Sudanti v
25 Ny.Fitri/Tn.Saeful v
26 Ny.Dian/Tn.Iman v
27 Ny.Sani/Tn.Rohmat v
28 Ny.Cucu/Tn. Wawan v
29 Ny.Yani/Tn.Bambang v
30 Ny.Atin/Tn.Yadi v
31 Ny.Tati/Tn.Ridwan v v
10 2
04/11/2015 32 Ny.Rini/Tn. v
33 Ny. Sutiawati v v
34 Ny. Dian v v
35 Ny.Suparmi v v
36 Ny.Sani v v
37 Ny.Lina v
38 Ny.Yani v
39 Ny. Atin v
40 Ny. Nurhayati v v
9 3 2
05/11/2015 41 ny neng rini v v
42 ny rini v
43 ny sutiawati v
44 ny dian v v
45 ny suparmi v v
46 ny sani v
47 ny lina v v
48 ny yani v
49 ny atin v
50 ny nurhayati v
10 4

06/11/201551 51 ny lina v v
52 ny dewi v v
53 ny fikriatul v
54 ny rini v
55 ny sumiarsih v v
56 ny santi v v
57 ny suparmi v
6 5

07/11/2015 58 ny sani v
59 ny lina v
60 ny dewi v v
61 ny fikriatul v
62 ny dewi a v v
63 ny sumiarsih v v
64 ny santi v v
6 5

08/11/2015 65 ny sani v
66 ny dewi v v
67 ny fikriatul v
68 ny santi v v
3 3

09/11/2015 69 ny sani v
70 ny melli v
71 ny ema v
72 ny dewi v
73 ny fikriatul v
74 ny desi v
75 ny dini v
6 1

10/11/2015 76 ny titin v
77 ny atin v v
78 ny hasanah v
79 ny dini v
80 ny aas v
81 ny meli v
82 ny fikriatul v
6 2
11/11/2015 83 ny.Titin v
84 ny.Ria v
85 ny.Nita v v
86 ny.Ellyana v
87 ny.Lia v v
88 ny.Fikri v
89 ny.Ani v v
6 4
12/11/2015 90 ny.Ria v
91 ny. Nita v v
92 ny.Lia v v
93 ny.Surmi'ah v v
94 ny.Yanti v v
5 4
13/11/2015 95 ny.Nita v v
96 ny.Vera v
97 ny.Patniasih v v
98 ny.Lia v
99 ny.Yanti v
5 2
14/11/2015 100 ny.Yuyun v
101 ny.Siti Anisah v v
102 ny.Irma v
103 ny.Vera v
4 1
15/11/2015 104 ny.Yuyun v
105 ny.Mimin v
106 ny.Siti Anisah v v
107 ny.Ai v
108 ny.Irah v v
109 ny. Livi v v
110 ny.Santi v v
7 4
16/11/2015 111 ny.Siti Anisah v
112 ny.Ai v
113 ny. Ade v
114 ny.Irma v
115 ny.Ade v
5
17/11/2015 116 ny.Ai v v
117 ny.Sri Susilawati v v
118 ny.Ade v
3 1 1
18/11/2015 119 ny.Hamidah v v
120 ny rina v v
121 ny aas v
122 ny yati v
123 ny mei v
124 ny hamidah v v
125 ny setiawati v v
126 ny diana v v
127 ny erlita v v
128 ny cucu v v
10 7

19/11/2015 129 ny tita v v


130 ny hamidah v
131 ny setiawati v
132 ny diana v
133 ny hera v v
134 ny sukses v v
135 ny enung v v
136 ny nuraeni v
137 ny aas v
138 ny giwang v v
139 ny siti rohimah v v
140 ny widaningsih v
141 ny melly v
13 5

20/11/2015 142 ny cucu v


143 ny dewi v v
144 ny giwang v v
145 ny siti r v v
146 ny widaningsih v v
147 ny melly v
148 ny tita v v
149 ny hamidah v v
150 ny elmadita v v
151 musrifah v
152 ny hera v
153 ny sukses v v
154 ny enung v
13 8

21/11/2015 155 ny kusuma v


156 ny elmadita v v
157 ny cucu v v
158 ny dewi v v
159 ny ambar v
160 ny giwang v v
161 ny siti r v
162 ny wida v v
163 ny madeniati v v
9 6

22/11/2015 164 ny madaniati v v


165 ny dewi v v
2 2

23/11/2015 166 ny tini v v


167 ny handayani v v
168 ny dewi v v
169 ny jeje v
4 3
24/11/2015 170 ny tini v v
171 ny handayani v
172 ny dewi v
173 ny evi v
174 ny susilawati v
5 1
25/11/2015 175 ny.Sinta v
176 ny. Evi v
177 ny. Imar v
178 ny.Susilawati v
4
26/11/2015 179 ny. Sinta v
180 ny. Via v v
181 ny.Titi v v
182 ny.Dianawati v
183 ny.Titin v
5 1 1
27/11/2015 184 ny.Nuraeni v
185 ny.Rini v
186 ny.Ening v
28/11/2015 187 ny.Sugianti v
188 ny. Eneng v
189 ny.Rohani v
190 ny.Nyai v
191 ny.Imas v
192 ny.Rini v
193 ny.Ninik v v
7 1
29/11/2015 194 ny.Sugianti v
195 ny.IIp v
196 ny.Sri N v
197 ny. Siti N v
198 ny.Septy v
5
30/11/2015 199 ny.Teti v
200 ny.Nining/Tn.Agus v
201 ny.Nining/Tn.Sutia v
202 ny. Iip v
203 ny. Astri v v
204 ny. Sri N v
205 ny. Yeni v
206 ny. Siti N v
8 1 0 0

total 206 82 0 4

Ruang IRNA 3 Bulan Desember 2015


Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/12/2015 1 Ny.Teti v v
2 Ny.Eva v
3 Ny.Lela v
4 Ny.Astri v
5 Ny.Evi v
6 Ny. Giwang v v
7 Ny.Nurhayati v
8 Ny. Tini v
9 Ny.Rani v
9 1 1
02/12/2015 10 ny rina v v
11 ny tuti v v
12 ny yeni v v
13 ny yani v v
14 ny imas v v
15 ny iip v
6 5
03/12/2015 16 ny nuraliyah v v
17 ny tuti v
18 ny rina v v
19 ny rina/tn budi v v
20 ny santi v v
21 ny yeni v v
6 5

04/12/2015 22 ny diana v
23 ny mimin v v
24 ny olis v v
25 ny rina/tn andi v v
26 ny rina/tn budi v v
27 ny santi v
28 ny imas v v
29 ny nurhayati v v
30 ny mona v
31 ny nuraliyah v
10 7

05/12/2015 32 ny nurhayati v
33 ny mona v
34 ny nurhayati v v
35 ny rina v v
36 ny imas v v
37 ny olis v v
6 4

06/12/2015 38 ny olis v v
39 ny titi v v
40 ny rina v
41 ny nurhayati v
4 2

07/12/2015 42 ny kiki v v
43 ny yanti v
44 ny rina v
45 ny rika v v
46 ny ai v v
47 ny olis v v
48 ny sinta v v
7 5

08/12/2015 49 ny hani v v
50 ny sinta v
51 ny rika v
52 ny dewi v v
53 ny kiki v v
54 ny yanti v
55 ny ai v v
56 ny rina v
8 4
09/12/2015 57 ny.yanti v
58 ny.Sinta v
59 ny. Ai H v v
60 ny.Rina v
61 ny.Nendah v
62 ny.Dewi v
63 ny. Imas v
7 1
10/12/2015 64 ny. Elis v v
65 ny. Mariah v v
66 ny. Nina v v
67 ny. Deti v
68 ny.Rosita v
69 ny. Sri v
70 ny. imas v v
7 4
11/12/2015 71 ny. Marina v v
72 ny. Via v
73 ny. Enung v
74 ny.Kania v
75 ny.Elis v
4
12/12/2015 76 ny. Mega v v
77 ny. Tita v v
78 ny.Yuni v
79 ny. Sari v
80 ny.Kania v
81 ny. Rohati v v
82 ny. Epi v v
7 4
13/12/2015 83 ny iin v v
84 ny epi v
85 ny mega v
86 ny marlina v
87 ny mila v v
88 ny yuni v
89 ny sari v
90 ny ratna v v
91 ny hani v
8 4
14/12/2015 92 ny hani v
93 ny ratna v
94 ny sri v v
95 ny iin v v
96 ny epi v
4 3
15/12/2015 97 ny.Nani v v
98 ny. Sri v
99 ny. Irma v
100 ny.Siti N v
101 ny. Rohati v
102 ny. Yuli v
103 ny. Neng Siti v
104 ny. Epi v
8 1
16/12/2015 105 ny. Dewi v
106 ny. Sri v
107 ny.Irma v
108 ny.Sumiati v
109 ny. Siti N v
110 ny.Rohati v
111 ny. Epi v
7
17/12/2015 112 ny. Dewi v
113 ny. Siti R v
114 ny. Ina v
115 ny. E cacih v v
116 ny. Sumiati v
117 ny. Rosita v
118 ny. Neng Ratna v
119 ny. Yuyun v
120 ny. Rina v
121 ny. Epi v
10 1
18/12/2015 122 ny. Ismi v
123 ny. Dewi v
124 ny. E Cacih v v
125 ny. N Ratna v
126 ny.Rina v
5 1
19/12/2015 127 ny ismi v
128 ny wiwik v
129 ny lilis v
130 ny tina v v
131 ny nengsih v
132 ny rinawati v v v
5 3 1
20/12/2015 133 ny.Lilis v
134 ny.Penny v
135 ny.Tina v v
136 ny. Rohati v
137 ny. Nengsih v
138 ny. Dewi v
139 ny. Rini v
140 ny.Yuyun v v
6 4
21/12/2015 141 ny. Mira v
142 ny. Lusi v v
143 ny. Teni v
144 ny.Nengsih v
145 ny.Komariah v
146 ny.Rini v
147 ny. Yuyun v v
6 3
22/12/2015 148 ny.Lusi v
149 ny. Tenny v
150 ny. Hani v
151 ny. Rohati v
152 ny. Nengsih v
153 ny. Yati v v
154 ny. Istiqomah v
155 ny.Mega v
8 1
23/12/2015 156 ny. Trisni v
157 ny. Hani v
158 ny. Diana v
159 ny. Nengsih v
160 ny. Istiqomah v
161 ny. Santi v
162 ny. Karisma v
163 ny. Rini v
164 ny. Rismawati v
8 1
24/12/2015 165 ny. Sri v
166 ny. Diana v
167 ny. Nengsih v
168 ny. Santi v
169 ny. Karisma v
4 1
25/12/2015 170 ny. Sri v
171 ny. Enung v
172 ny. Ai Rani v
3
26/12/2015 173 ny. Siti Nuryeni v
174 ny. Siti Rahmawati v
175 ny. Sri v
176 ny. Tati v
177 ny. Haryani v
178 ny. Airani v
179 ny. Asmanah v
7
27/12/2015 180 nn.Yuni v
181 Ny.IIn v
182 Ny.Sri v
183 Ny. Intan Novianti v
184 ny. Reni v
185 ny. Tati v
6
28/12/2015 186 ny. Yuni v
187 ny. Hartini v
188 ny. Ani v v
189 ny. Intan v v
190 ny.Uun v
191 ny.Risma v
6 2
29/12/2015 192 ny. Santi v
193 ny. Yuni v
194 nn.Yuni v
195 ny.Ratih v
196 ny. Intan v
197 ny.Iis v
198 ny. Rosita v
199 ny. Sugandini v
200 ny.Rosita v
9
30/12/2015 201 ny. Yuni v
202 ny. Murtiyati v
203 ny. Santi v
204 ny. Eulis v
205 ny.Yeni v
206 ny.Vivi v
207 ny.Yati v v
7 1
66

1 3

31/12/2015 208 ny eulis v


209 ny yulianti v v
210 ny vivi v
211 ny neng sukmawati v v
212 ny eva v
213 ny rini v v
214 sugandini v v
215 ny wulandari v v
216 ny komalasari v v
217 ny ika v
218 ny santi v
11 6
Ruang Nifas 3 JANUARI 2019
Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 4 2
2 4 2
3 4 3
4 4 1
5 3 1
6 4 2
7 5 3
8 4 4
9 6 1
10 7 5
11 4 3
12 5 3
13 3 3
14 3 2
15 1 0
16 4 2
17 2 2
18 1 1
19 4 3
20 7 1
21 0 0
22 4 3
23 4 1
24 4 3
25 2 2
26
27
28
29
30
31
JUMLAH

Jumlah Pasien Ibu dalam kota orang


Jumlah Pasien Ibu luar kota orang
Jumlah Pasien bayi dalam kota orang
Jumlah Pasien bayi luar kota orang
Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2016 1 ny siti m/tn lukman v
2 ny efriana/tn sutrisno v v
3 ny erni/tn asep v
4 ny penny/tn nunu v v
5 ny eloi/tn yonatan v
6 ny siti h/tn edi v
7 ny dian/tn dicky v
8 ny santi/tn ganjar v
8 1 1
02/01/2016 9 ny endah/tn cepi v
10 ny mala/tn ali usman v
11 ny widi/tn tatan v
12 ny eli siti/tn budi v v
4 1
03/01/2016 13 ny eli siti/tn budi v
14 ny pipih/tn andri v v
15 ny iah/tn tedy v
16 ny ema/tn yonan v
17 ny e rodiatus/tn agus v v
5 2
04/01/2016 18 ny royati/tn asep v
19 ny ema/tn yonan v
20 ny sofiani/tn ritanto v v
21 ny pipih/tn andri v
22 ny euis/tn dodi v
5 1
05/01/2016 23 ny juliah/tn edi v
24 ny dedeh/tn adang v
25 ny iah/tn tedi v
26 ny sri/tn rendi v v
27 ny sofiani/tn ritanto v
28 ny ida/tn jajang v v
29 ny evie/tn agustinus v v
30 ny lenny/tn anwar v v
8 4
06/01/2016 31 ny ida/tn jajang v
32 ny susan/tn hedi v v
33 ny lenny/tn anwar v
34 ny imas/tn ari v v
35 ny kinanti/tn yopi v
36 ny ai rosi/tn arif v v
37 ny sri/tn rendi v
38 ny fitri/tn eka v v
39 ny nuryani/tn herman v
9 4
07/01/2016 40 ny imas/tn ari v
41 ny ai rosi/tn arif v
42 ny fitri/tn eka v
43 ny novel/tn m nasrul v v
44 ny wina/tn deden v v
45 ny dewi/tn yadi v
46 ny susan/tn hedi v
47 ny mia/tn dikdik v v
48 ny rusi/tn firman v
49 ny irma/tn ahmad v
10 3
08/01/2016 50 ny wina/tn deden v
51 ny r nana/tn bobi v
52 ny hestini/tn supendi v
3 0
09/01/2016 53 ny atin/tn ariyadita v
54 ny wati v
55 ny nurafiza/tn akmal v v
56 ny diah/tn roni v
57 ny tunik/tn amin v v
5 2
10/01/2016 58 ny cucu/tn cepi v
59 ny lasmanah v
60 ny eti/tn jua v
61 ny nurafida/tn akmal v
4 0
11/01/2016 62 ny lasmanah v v
63 ny rifa/tn deden v v
64 ny dewi/tn deni v v
3 3
12/01/2016 65 ny lasmanah v
66 ny sumiati v
67 ny evi v v
68 ny dewi/tn dedi v
69 ny kartika v
70 ny neng mariam v
6 1
13/01/2016 71 ny megawati/tn deni v
72 ny hera/tn m ridwan v
73 ny ai/tn jidan v
74 ny leni/tn tantan v
75 ny ihat/tn dani v
76 ny mia/tn deni v v
77 ny mursidah/tn yayat v
78 ny evi v
79 ny nuridawati v v
80 ny eni v
81 ny desi/tn mulya v v
11 3
14/01/2016 82 ny cucu/tn amat v
83 ny siti aisyah/tn ade v
84 ny megawati/tn deni v
85 ny leni/tn tantan v
86 ny mia/tn deni v v
87 ny evi v
88 ny nuridawati v
89 ny irma v v
8 2
15/01/2016 90 ny asti/tn mukhlis v
91 ny evi/tn baenudin v v
92 ny irma/tn yohanis v
93 ny iin/tn muslim v
94 ny tini/tn ihan v v
95 ny partini/tn wasirin v v
96 ny rina/tn doni v v
97 ny heni/tn deni v
98 ny eka/tn komar v
99 ny cucu/tn adi v
100 ny yanti/tn nurhadi v
101 ny jeni/tn iwan v
12 3 1
16/01/2016 102 ny rina/tn doni v v
103 ny sinta/tn insan v v
104 ny jeni/tn iwan v
105 ny iin/tn gusti v v
106 ny tini/tn ihan v
5 2 1
17/01/2016 107 ny mulyati/tn firman v
108 ny sinta/tn insan v
2
18/01/2016 109 ny reti/tn yana v
110 ny pratiwi/tn taufik v
111 ny siti n/tn suryana v
3
19/01/2016 112 ny nova/tn dede v
113 ny yeni/tn andrian v
114 ny siti n/tn suryana v
3
20/01/2016 115 ny yani yuli/tn indra v v
116 ny yeni/tn andrian v
117 ny rahma v
118 ny ratih/tn riki v
119 ny ilah/tn agus v
120 ny irma/tn haris v v
6 2
21/01/2016 121 ny yani yuli/tn indra v
122 ny nunik/tn deni v
123 ny pujiati/tn stevi v
124 ny yeni/tn andrian v
125 ny yanti/tn dadang v v
126 ny sri/tn m muhtar v v
127 ny suwartini/tn suparno v v
128 ny rahma v
129 ny husaenah v v
130 ny minar/tn deni v v
131 ny irma/tn haris v
132 ny rita/tn tatan v
12 5
22/01/2016 133 ny suwartini/tn suparno v
134 ny desti/tn yudi v
135 ny rahma v
136 ny minar/tn deni v
137 ny wiwin/tn toto v v
138 ny iin/tn lutfi v
139 ny erna/tn andrianto v
140 ny sri/tn m muhtar v
141 ny mia/tn deni v v
142 ny lisa/tn yanto v
10 2
23/01/2016 143 ny yeni/tn andrian v
144 ny triyani v
145 ny leni/tn asep v
146 ny tita/tn irfan v
147 ny hajar v
148 ny wiwin/tn toto v
149 ny halida/tn gerry v
150 ny mia/tn deni v v
8 1
24/01/2016 151 ny nurfitri/tn ali v
152 ny halida/tn gerry v
153 ny mia/tn deni v v
3 1
25/01/2016 154 ny suci/tn hari v
155 ny mia/tn deni v v
2 1
26/01/2016 156 ny suci/tn hari v
157 ny cici/tn soni v v
158 ny yuyun/tn yepi v
159 ny astrid v
160 ny yumi v
5 1
27/01/2016 161 ny dewi/tn dadang v v
162 ny tri/tn andriyana v
163 ny cici/tn soni v v
164 ny sri/tn hendra v
165 ny dian/tn sudirman v
166 ny meyle/tn hali v
167 ny irawati/tn budi v
168 ny berna/tn dili v v
8 3
28/01/2016 169 ny cica/tn nani v v
170 ny lisnawati v
171 ny rita v
172 ny berna v
173 ny dewi/tn dadang v
174 ny yeni v
175 ny tri/tn andriyana v
176 ny aryani/tn hendra v
8 1
29/01/2016 177 ny sara v v
178 ny beti v
179 ny tri/tn andriyana v
180 ny aryani/tn hendra v
181 ny rosi/tn eka v v
182 ny riska/tn mahdan v
6 2
30/01/2016 183 ny indri/tn andri v
184 ny betty/tn dedi v v
185 ny tri/tn andriyana v
186 ny aryani/tn hendra v
187 ny lina/tn ahmad v v
188 ny kasmia v
189 ny ati/tn sardi v v
190 ny ayu v v
191 ny anisa/tn gagan v v
192 ny riska v
10 4 1

31/01/2016 193 ny reni v


194 ny ayu v
195 ny dini v v
196 ny enti v
197 ny kasmia v
5 1

Ruang Nifas 4 Bulan fEBRUARI 2016

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2016 1 ny yuni wahyuni v v
2 ny yati/tn aep v
3 ny reni v
4 ny tita/tn andri v
5 ny dini/tn shahrur v v
6 ny wike v
7 ny ida/tn prima v v
7 3
02/02/2016 8 ny reni v
9 ny gina/tn asep v
10 ny siti khoeratun v
11 ny aam v
12 ny suhartiningsih v
13 ny dini v v
14 ny siti setiawati v
15 ny w mustikarani v v
16 ny yuni wahyuni v
9 2
03/02/2016 17 ny astiningsih v
18 ny w mustikarani v
19 ny gifanny v
20 ny mawar/tn dian v v
21 ny siti/tn farid v
22 ny dini v
6 1
04/02/2016 23 ny imas/tn eri v
24 ny nenny/tn herry v v
25 ny mawar/tn dian v
26 nu siti aliah/tn dian v v
27 ny kuswati v v
5 3
05/02/2016 28 ny gianti v
29 ny mira v
30 ny nenny/tn herry v v
31 ny nurul/tn doni v
32 ny anggi/tn andri v v
33 ny rani v
34 ny kuswati v v
35 ny poppy/tn oki v
8 3
06/02/2016 36 ny nurul/tn doni v v
37 ny duri/tn uus v v
38 ny ika/tn edi v v
39 ny reni/tn julian v
40 ny sutinem/tn untung v
41 ny wida/tn dani v
6 3
07/02/2016 42 ny novi/tn irfan v
43 ny tika/tn prediana v
44 ny pipih v
45 ny muthiah/tn zen v v
46 ny supriatin v
47 ny duri/tn uus v
6 1
08/02/2016 48 ny fitri/tn enjang v v
1 1
09/02/2016 49 ny siti/tn trisno v
50 ny fitri/tn enjang v v
51 ny elpinawati v v v
52 ny riska/tn kenken v v
53 ny ratih/tn riki v v
54 ny nisa v v
6 5 1
10/02/2016 55 ny fitri/tn enjang v
56 ny elpinawati v v
57 ny cucu/tn sukemi v
58 ny ratna/tn wahyudi v
59 ny riska/tn kenken v
60 ny ratih/tn riki v
61 ny nisa/tn yono v
62 ny yeni/tn suryana v v
63 ny rika/tn asep v v
64 ny nunung v
10 3
11/02/2016 65 ny ratna/tn wahyudi v
66 ny yeni/tn suryana v v
67 ny rika/tn asep v
68 ny fitria/tn andri v
69 ny nita/tn iyus v v
70 ny rini/tn dadan v v
71 ny nunuy v v
72 ny elpinawati v
7 5
12/02/2016 73 ny nofi/tn doni v
74 ny tita/tn sutejo v v
75 ny yanti/tn dedi v v
76 ny yeni/tn suryana v
77 ny fitria/tn andri v
78 ny nita/tn iyus v
79 ny rini/tn dadan v
80 ny nunuy v
7 3

13/02/2016 81 ny elis/tn dandy v


82 ny wiwik v
83 ny erni/tn dian v v
84 ny tita/tn sutejo v
85 ny yanti/tn dedi v
86 ny nina/tn ahmad v
87 ny ita v
88 ny yeni/tn suryana v
7 2
14/02/2016 89 ny tina/tn asep v
90 ny dewi/tn irfan v
91 ny erni/tn dian v v
ny yeni/tn suryana v
3 2
15/02/2016 92 ny dewi/tn irfan v
93 ny yeni/tn suryana v
94 ny funi/tn ganjar v
95 ny elly/tn saepudin v
96 ny tintin/tn dede v
97 ny dita/tn alex v v
98 ny kartini v v
99 ny erni/tn dian v
100 ny kokom/tn karmizi v v
101 ny erni/tn suparman v
9 4
16/02/2016 102 ny wulan/tn agus v v
103 ny rosmiati v
104 ny kokom/tn karmizi v v v
105 ny erni/tn suparman v
106 ny rida/tn irfan v v
107 ny yeni/tn suryana v
108 ny tintin/tn dede v
109 ny dita/tn alex v
7 4 1
17/02/2016 110 ny rida/tn irfan v
111 ny yeni/tn suryana v
112 ny tintin/tn dede v
113 ny dita/tn alex v
114 ny wulan/tn agus v
115 ny dewi/tn asep v
116 ny resa/tn hoki v v
117 ny kokom/tn karmizi v v
118 ny yati/tn agus v v
8 4
18/02/2016 119 ny wiwin/tn deni v
120 ny eli/tn enjang v
121 ny yati/tn agus v v
122 ny kokom/tn karmizi v v
123 ny rani/tn rosad v v
5 3
19/02/2016 124 ny jumrotun v
125 ny yati/tn agus v
126 ny ani v v
127 ny dita/tn alex v
128 ny mulyati/tn firman v
5 1
20/02/2016 129 ny nanan v
130 ny ani v
131 ny yuga v v
132 ny iis v v
4 2
21/02/2016 133 ny gita/tn yopi v
134 ny iis v v
135 ny tiara v
136 ny dewi v
4 1
22/02/2016 137 ny dewi v v
138 ny reni/tn irwan v v
139 ny rossa/tn azam v
140 ny isni/tn deri v
141 ny neni/tn abidin v v
142 ny iis/tn handiyan v
143 ny efani v v
7 4
23/02/2016 144 ny kaci/tn rikardo v
145 ny dewi v
146 ny reni v
147 ny fitriani v
148 ny uhen v
149 ny sri/tn uus v v
6 1
24/02/2016 150 ny neni/tn abidin v v
151 ny sri/tn uus v v
152 ny iis v
153 ny yuni v
154 ny lisna/tn dodi v v
155 ny ismi/tn yusuf v v
6 4
25/02/2016 156 ny lisna/tn dodi v
157 ny ismi/tn yusuf v
158 ny teti/tn indra v
159 ny neni/tn abidin v v
160 ny erine/tn aris v
5 1
26/02/2016 161 nu nuraeni v v
162 ny cucu/tn yudi v
163 ny sukarsih v
164 ny maelasari/tn bayu v v
165 ny tintin/tn dede v v
166 ny dini v
6 3
27/02/2016 167 ny siti n v
168 ny nuraeni v v
169 ny cucu/tn yudi v
170 ny elly/tn hadia v v
171 ny ufay/tn rudi v
172 ny tati v
173 ny rima/tn zamzam v v
174 ny maelasari v
175 ny saripah v v
9 4
28/02/2016 176 ny rima/tn zamzam v
177 ny saripah v
178 ny siti n v
179 ny sri kartini v
180 ny cucu v
181 ny dewi v
182 ny elly v
183 ny ufay v
8 0
29/02/2016 184 ny dwi v
185 ny neti v
186 ny ina/tn eris v v
2 1 1

Ruang Nifas 4 Bulan MARET 2016

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2016 1 ny sri/tn uus v v
2 ny mawadah v v
3 ny ilham v
4 ny rina/tn yogi v v
5 ny yuyun v v
6 ny ina/tn eris v
5 5
02/03/2016 7 ny lenny/tn iman v v
8 ny setia v
9 ny elly/tn dadi v v
10 ny mawadah v v
11 ny rina/tn yogi v
12 ny teti/tn haerudin v
13 ny yuyun v
7 3
03/03/2016 14 ny riva v
15 ny nurhayani v
16 ny mawadah v v
17 ny siti nurjanah v
18 ny yeyen v
19 ny maira v v
20 ny lenny v
21 ny elly v
22 ny yuni v
23 ny surtini v v
24 ny siti munirah v
11 3
04/03/2016 25 ny nurdianah v v
26 ny enok v
27 ny sri hayati v v
28 ny teti/tn iyep v v
29 ny dewi/tn rahmat v
30 ny maira v v
31 ny neneng v
32 ny surtini v v
33 ny miranti v
9 5
05/03/2016 34 ny surtini v v
35 ny miranti v
36 ny rani/tn cecep v v
37 ny sri/tn sandi v v
38 ny nia/tn iwan v
39 ny suryani v
40 ny astri v
41 ny yeni/tn deden v
8 3
06/03/2016 42 ny hani/tn bambang v
43 ny yuliana v
44 ny atit v
45 ny siti s/tn angga v
46 ny evi/tn agus v
47 ny rani/tn cecep v v
6 1
07/03/2016 48 ny eva/tn hery v
49 ny malia/tn asep v
50 ny yuliana/tn iman v
51 ny siti nurjanah/tn iman v v
52 ny siti s/tn angga v
53 ny santi/tn diat v
54 ny reni/tn sofian v v
7 2
08/03/2016 55 ny ema v
56 ny santi v
57 ny reni/tn sofian v
58 ny sansan/tn aris v v
59 ny dewi/tn wawan v
5 1
09/03/2016 60 ny nuryani/tn sudarma v
61 ny lina/tn surya v v
62 ny eviana v
63 ny bela/tn ajang v
64 ny ani/tn arie v
65 ny ari/tn tri v v
6 2
10/03/2016 66 ny kartika v
67 ny nuryani/tn sudarma v
68 ny lina/tn surya v v
69 ny elsa v v
70 ny yuliani/tn rizal v v
5 3
11/03/2016 71 ny yanti/tn suhendra v
72 ny elsa v v
73 ny yuliani/tn rizal v v
74 ny selvi v v
4 3
12/03/2016 75 ny erni/tn deni v v
76 ny lutfi/tn riki v v
77 ny yayuk v
78 ny desi/tn saeful v
79 ny santi/tn ramli v v
80 ny marlina v
81 ny yusnita v v
82 ny iin/tn frandy v v
8 5
13/03/2016 83 ny erni/tn deni v
84 ny lutfi/tn riki v
85 ny refti v
86 ny sri v
87 ny desi/tn saeful v
88 ny santi/tn ramli v
89 ny april/tn rizki v v
90 ny ismi/tn indra v
91 ny yusnita v v
92 ny iin/tn frandy v v
93 ny lina/tn holid v
94 ny rifani v
95 ny santi/tn diyat v
13 3
14/03/2016 96 ny nisa v
97 ny rifani v
98 ny santi/tn diyat v
99 ny santi/tn faisal v
100 ny refti v
101 ny rini v
102 ny sari v
103 ny muhajiroh v
104 ny ismi/tn indra v
9
15/03/2016 105 ny reni/tn asep v
106 ny siti masitoh v
107 ny gina/tn devi v
108 ny dinny v
109 ny tuti/tn gunawan v
5
16/03/2016 110 ny suryani v v
111 ny uliyah v
112 ny novi v
113 ny nita v
114 ny kusmulyani v v
115 ny lina/tn sodikin v v
116 ny tuti/tn gunawan v
7 2 1
17/03/2016 117 ny lina/tn sodikin v v
118 ny tuti/tn gunawan v
2 1
18/03/2016 119 ny lina/tn sodikin v v
120 ny nisa hasanah v
2 1
19/03/2016 121 ny rahelya v
122 ny siti kamila v
123 ny nurlela v
124 ny rindi v v
125 ny marlinda v v
5 2
20/03/2016 126 ny ebeh v v
127 ny siti kamila v
128 ny fitriani v
129 ny rindi v
4 1
21/03/2016 130 ny siti kamila v
131 ny rumyati v
132 ny desi v
133 ny ai nuri v
134 ny yuniati v
5
22/03/2016 135 ny.feni v
136 ny.titin v
137 ny.hernita v
138 ny.siska v
139 ny.desi v
5
23/03/2016 140 ny.rosita v v
141 ny.anita v v
142 ny.wini v v
3 3
24/03/2016 143 ny.selawati v
144 ny.juniani v v
145 ny.sri rejeki v
146 ny.isma v v
147 ny.yanti v
148 ny.aristina v v
149 ny.shanti v v
150 ny.eva v
8 4
25/03/2016 151 ny.isma v
152 ny.yanti v
153 ny.aristina v
154 ny.windi v
155 ny.rita v
156 ny.ani v v
157 ny.erfini v v
158 ny.elin v
8 2
26/03/2016 159 ny.eulis v v
160 ny.ani v
161 ny.dewi v
3 1
27/03/2016 162 ny.mita v
163 ny.reni v v
164 ny.yuliani v v
3 2
28/03/2016 165 ny.yuliani v
166 ny.siti h v v
167 ny.reni v
168 ny.tini v v
4 2
29/03/2016 169 ny.nining v v
170 ny.marina v
171 ny.tuti v v
172 ny.titin v
173 ny.nurlela v v
174 ny.adlita v v
175 ny.siti h v
176 ny.reni v v
177 ny.fajar v
9 5
30/09/2016 178 ny.nurlela v v
179 ny.fajar v v
180 ny.cici v v
181 ny.sri puji v v
182 ny.tuti v
183 ny.nursanti v v
6 5

31/03/2016 184 ela v v


185 mira v v
186 tuti v v
187 nursanti v
188 sari v
189 euis v
190 roslindawati v v
191 fajar v
8 4

191 185 74 1

total pasen=

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 1 Rina v v
2 Diana v
3 Atri v v
4 Yosi v
5 Erlina v
6 Yani v
7 mira v
7 2
02/04/2016 8 yeni v
9 neng lisda v v
10 lisnawati v
11 yantri v v
12 eniwati v
13 yesi v v
6 3
03/04/2016 14 yantri v
15 yesi v
16 vincentia v v
17 evi v v
18 novi v
19 ismi v
20 amelia v
7 2
04/04/2016 21 fitriyani v v
22 vincentia v
23 evi v v
24 dedeh v
25 surtini v v
5 3
05/04/2016 26 sri n v v
27 epi marlina v
28 surtini v v
29 santi v
30 santi/ahmad v v
5 2 1
06/04/2016 33 leli almawati v v
34 mila v
35 fitri v
36 surtini v
4 1
07/04/2016 37 sri v
38 wini v v
39 mira v
40 widoeri v v
4 2
08/04/2016 41 sri v
42 haryati v v
43 petranela v v
44 widoeri v v
45 ropikoh v v
46 fitria v v
47 cahyati v v
48 iis v v
49 tria v v
50 enung v v
10 9
09/04/2016 51 iis v
52 tria v v
53 enung v v
54 yulia v v
55 yanti s v
56 petranela v
57 widoeri v v
58 fitria v
8 4
10/04/2016 59 yani v
60 uus v
61 yanti v
62 nety v
63 enung v
64 yulia v
6
11/04/2016 65 nita v
66 yulia/yaya v
67 yanti v
68 oom v
4
12/04/2016 69 marlia v v
70 nisa v v
71 rina v v
72 amelia v
73 nita v
74 tika v v
75 iim v
76 tiarni v v
77 lusi v v
9 6
13/04/2016 78 tika v
79 tri desi v
80 tiah v
81 neng hesti v v
82 nisa v
5 1
14/04/2016 83 erna v v
84 sugiarni v v
85 nuryati v v
86 imas v v
87 rosita v
88 rika v
89 tri desi v
7 4
15/04/2016 90 anggun v
91 eka v
92 nuryati v v
93 imas v
94 rosita v v
95 lina v v
96 ponirah v v
97 sunni v v
98 erna v
99 herna v v
100 neni v
101 widoeri v v
102 tri m v
103 sugiarni v v
14 8
16/04/2016 104 yani v
105 ropikoh v
106 sunni v v
107 elza v v
108 friska v
109 tri m v
110 weni v
111 atikah v v
112 teti v
9 3
17/04/2016 113 sri v
114 r lia v
115 widia v
116 desi v
117 atikah v
118 ropikoh v
119 widoeri v v v
7 1 1
18/04/2016 120 ropikoh v
121 hanny v v
122 sariwati v
123 desi v
4 1
19/04/2016 124 hasanah v v
125 ningsih v v
126 sri mulyati v v
127 eva v v
128 neng hani v
129 mursalina v
130 yani v
131 lilis v v
132 neng yati v v
133 hanny v v
134 santi v v
135 vina v
12 8
20/04/2016 136 yani v
137 nurkisah v
138 sri mulyati v v
139 eva v
140 yeni v v
5 2
21/04/2016 141 elih v
142 diana v
143 rossi v
144 sri mulyati v v
145 ai v v
146 eulis v
147 yani v
6 2 1
22/04/2016 148 yani v
149 lilis v v
150 desi v
151 lastriana v v
152 minati v v
153 sri wahyuni v
154 eulis v
155 siti v
8 3
23/04/2016 156 nina v
157 lastriana v
158 rantika v
159 erijuni v
160 lilis v
161 elis h v
162 desi y v
163 mimin v v
8 1
24/04/2016 164 sani v
165 ulfah v v
166 nursaidah v v
167 nuraeni v
168 acah v
5 2
25/04/2016 169 maharani v
170 nursaidah v
171 marita v
172 tuti v
173 yuliawati v
174 acah v
175 nining v
176 meta v
8
26/04/2016 177 dian v
178 nining v
179 meta v v
180 nurlinah v v
181 efi v v
182 tuti v
183 endang v
184 yuliawati v
185 ningsih v v
9 4
27/04/2016 186 dian/asep v
187 yani/ihwan v
188 setiawati v v
189 efi/icang v v
190 ningsih v
5 2
28/04/2016 191 devvy/beni v v
192 tita/nana v
193 yani/ihwan v
194 setiawati v v
195 kartika/setia v v
196 kashnia/iman v v
197 winarti v v
7 5
29/04/2016 198 wiwin/mulyana v v
199 rinaningsih/didin v
200 devvy/beni v
201 dini/edi v v
202 yanti/yayat v v
203 rengganis v
6 3
30/04/2016 204 windi/deden v v
205 ambar v
2 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MEI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2016 1 wiwin v
1
02/05/2016 2 lina v
3 ema v
4 neni v
5 resnawati v
6 jubaedah v v
5 1
03/05/2016 7 neni v
8 ayi v v
9 lani v v
3 2
04/05/2016 10 ayi v v
11 lani v
12 wiranti v
13 nia v
14 windi v
5 1
05/05/2016 15 ani v
16 ayi v v
17 rosi v v
18 ani rohaeni v
19 lala v
20 lani v v
6 2 1
06/05/2016 21 dila v
22 kiki v
23 nursanti v v
24 nina v
25 rina v
26 uci sulastri v
6 1
07/05/2016 27 yanti v v
28 nina v
29 siti dida v
30 uci sulastri v
31 entin v v
32 reyniza v v
6 3
08/05/2016 33 fitria v v
34 nina v v
35 siti dida v
36 sri elawati v v
37 rd elgy v
5 2 1
09/05/2016 38 sheni v
39 siti dida v
2
10/05/2016 40 sri v
41 ai v v
42 dewi v
43 sheni v
44 gina v
45 wida v
46 sinta v v
7 2
11/05/2016 47 nurjanah v
48 nency v
49 nenden v
50 sinta v v
51 santi n v
52 desi v
6 1
12/05/2016 53 nurjanah v
54 dine v
55 debora v v
56 andenia v v
57 nurkisah v
58 siti endah v
59 ai setiawati v
8 3
13/05/2016 60 dewi ayu v
61 siti endah v
62 yuyun s v v
63 lia v v
64 tati v
5 2
14/05/2016 65 lia v
66 yeni v v
67 dewi ayu v
68 didah v
69 defi j v
70 wida v
6 1
15/05/2016 71 sugiarni v v
72 rini sumarni v v
73 rani v v
74 mia v
4 3
16/05/2016 75 rani v v
76 siti komariah v
77 kenia v v
78 siti hamidah v
79 ida v
80 sugiarni v v
81 rini sumarni v v
7 4
17/05/2016 82 rini v v
83 siti m v
84 tisa v
85 yuliana v v
86 siti k v
87 ida v
88 rina v v
89 nunung v
7 3
18/05/2016 90 ida v
91 rina v v
92 yanti v
93 ida farida v
94 tisa v
95 lisna v
6 1
19/05/2016 96 dedeh v v
97 marlia v v
98 upiah v v
99 rina v v
100 sinta v v
4 5 1
20/05/2016 101 taryati v
102 salimah v v
103 ani r v v
104 lilis v v
105 marlia v
106 selvia v
5 4
21/05/2016 107 sugiarni v v
108 intan v v
109 euis v
110 firna v v
111 lilis v
112 marlia v
113 lina v v
114 suminar v
7 5
22/05/2016 115 siti sadiah v
116 emah v
117 suminar v
118 sugiarni v
119 lina v v
120 siti sadiah v
6 1
23/05/2016 121 sugiarni v
122 tita v v
123 siti sadiah v
124 heni v
125 utami v
126 leni v
6 1
24/05/2016 127 nency v v
128 mira v
129 neneng v
130 santi v
131 aidah v
132 sugiarni v
133 rismi v
134 debora v
8 1
25/05/2016 135 mega indah v
136 rima v
137 anisa v
138 tena v
139 ema v v
140 santi v
141 siti n v
142 sugiarni v v
143 vera v
9 2
26/05/2016 144 siti n v
145 sugiarni v v
146 kiki v v
147 sriningsih v
148 ipah v v
5 3
27/05/2016 149 ayu v
150 astri v
151 resdi v
3
28/05/2016 152 siska y v
153 siska d v v
154 bundari v v
155 sarah v
156 astri v v
5 2 1
29/05/2016 157 yutmiyeh v
158 farah v
159 reni v
160 feni v
161 dewi v
162 siti sadiah v
6
30/05/2016 163 marta v
164 rohayati v v
165 peni v
166 ulfa v
167 devi v v
168 siti s v
6 2
31/05/2016 169 siti s v
170 imas v v
171 dewi v v
172 via v v
173 devi v
174 yanti v
175 siti f v v
176 eneng nurfadilah v v
8 5

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JUNI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2016 1 eneng v
2 rina v
3 heni v
4 wilma v
5 sugiarni v
5
02/06/2016 6 rina v
7 sinta v
8 esih v
9 chyntia v
10 santi v v
11 norma v v
5 2 1
03/06/2016 12 rina v
13 norma v
14 sandra v
15 dewi ayu v
16 santi v
4 1
04/06/2016 17 nina v
18 chyntia v
2
05/06/2016 19 vina v
20 syahrita v
2
06/06/2016 21 emiliyawati v
1
07/06/2016 22 ela v
23 sinta v v
24 nina v v
25 aliya v
26 tina v v
27 rohimah v
6 3
08/06/2016 28 upit v
29 eneng v v
30 sinta v
31 nina v
32 ema v
33 ai bentang v
34 wangsih v
7 1
09/06/2016 35 eneng v v
36 ade v
37 yeni v
3 1
10/06/2016 38 eneng v v
1 1
11/06/2016 39 maria v
40 siti aisyah v
41 viska v
3 1
12/06/2016 42 nurhasanah v
43 ai susilawati v
44 sona v v
45 riana v
46 suwanti v
47 oni v
48 rodiah v
7 1
13/06/2016 49 dea sabila v
50 siti fatimah v
51 neni v
52 selvia v v
53 anggraeni v
54 endah v
55 riane v v v
56 kurnia v
57 riana v
58 suwanti v
10 2 1
14/06/2016 59 tri v
60 riane v v
61 nur siti v
62 riana v
63 noor afni v v
64 selvia v
65 endah v
7 2
15/06/2016 66 dini v v
67 riane v
1 2
16/06/2016 68 ine v
69 riane v
70 sartini v v
71 yeni v
72 nunung v v
73 andini v v
74 enur v
75 hacim v v
76 vitta v v
77 anggi v v
9 7
17/06/2016 78 suminar v v
79 elin v v
80 andini v
81 eli v
4 2
18/06/2016 82 tisa v
83 elin v
2
19/06/2016 84 ita v
85 wiwin v
86 nimah v
3
20/06/2016 87 ida farida v v
88 wulansari v
2 1
21/06/2016 89 wulansari v
1
22/06/2016 90 wiwin v v
91 setiawati v v
92 ilza v
93 siti maryam v
94 dina v
95 widaningsih v v
96 nevi v
7 3
23/06/2016 97 wiwin v
98 riana dian v
99 setiawati v
100 elisa v v
101 teti ernawati v
102 ria oktora v v
103 arvi v v
7 3
24/06/2016 104 ria oktora v v
105 sulastri v
106 risa v v
107 vinnie v
108 arvi v v
5 3
25/06/2016 109 wulansari v
110 risa v
111 selvira v v
3 1
26/06/2016 113 arista v
114 rela v
115 erna v
116 arvi v
117 riska v
5
27/06/2016 118 arista v
119 erna v
120 desta v v
121 sri v
122 sugiarni v v
123 wulansari v
124 yossi v
125 lisda v
8 2
28/06/2016 126 resi v
127 reni v v
128 wulansari v
129 ria v
130 yossy v
5 1
29/06/2016 131 evi v v
132 eka v
133 reni v v
134 rina v
135 yanti v v
136 eti v v
137 setyo v
138 ai darwati v
8 4
30/06/2016 139 nurhilfah v
140 lia yuliawati v
141 reni v
142 eni yuna v v
143 yanti v
144 elis v v
145 siti irma v
146 eti v
8 2

146 46 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JULI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2016 1 martini v
2 farida v v
3 melia v
3 1
02/07/2016 4 farida v v
5 nur juwita v
6 lina v v
7 irmayanti v
8 amalia v
9 melia v
10 sinta devi v
7 2
03/07/2016 11 lina v v
12 irmayanti v
13 arni v
14 anisa v
4 1
04/07/2016 15 aida v
16 fenti v
2
05/07/2016 17 juaningsih v v
18 elis v
2 1
06/07/2016 19 yani v v
20 juaningsih v v
21 resa v
22 risnawati v
23 atin v
5 2
07/07/2016 24 haryanti v
25 herlina v
26 yani v v
3 1
08/07/2016 27 tia v
28 nunung v v
29 kurnia v v
3 2
09/07/2016 30 rika v
31 winda v
32 wiwin v
3
10/07/2016 33 penti v
34 oneng v
2
11/07/2016 35 demi v
1
12/07/2016 36 haraidah v
37 neni v
38 lia v
39 demi v
40 jumanah v
5
13/07/2016 41 dewi v
42 jumanah v
43 elsya v
44 yuniarti v
45 ika v v
46 indresyawari v v
47 neulis v
7 2
14/07/2016 48 roli v v
49 idah v
50 puja v
51 imas v v
52 mela v
5 2
15/07/2016 53 ani v
54 fitri v
55 pipit v
56 anisa v
57 imas v
58 fitriani v
59 mela v
60 roli v
61 imas ahmad v
9
16/07/2016 62 eros v
63 nenden deti v
64 tugi v
65 reni v
4
17/07/2016 66 nenden deti v
67 erna v v
68 reni v v v
69 iyan yanti v
70 alifa v v
5 3 1
18/07/2016 71 alifa v
72 yani v v
73 nenden deti v
74 rokhimah v v
75 neni v v
76 iyan yanti v
6 3
19/07/2016 77 neni v
78 ance v
79 novaviatun v v
3 1
20/07/2016 80 prila v v
81 dewi v
82 novaviatun v v
83 rosita v
84 ance v
5 2
21/07/2016 85 rosita v
86 selvi v
87 putri v v
88 wiwin v v
89 prila v
90 yeni v
6 2
22/07/2016 91 putri v
92 wantini v
93 imas v
94 sastari v
95 nurlela v v
96 erika v
97 nuramelia v
98 wulan v
8 1
23/07/2016 99 wartini v v
100 nurlela v
101 erika v v
102 risa v v
103 santi v
4 3 1
24/07/2016 104 kasmiatun v v
105 wartini v
106 yani v
107 risa v v
108 riska v
4 2 1
25/07/2016 109 riska v
110 yani v
111 evi v
112 risa v
113 iis v
5
26/07/2016 114 andi v
115 lani v
116 delly v v
117 yani v
118 anastasya v
119 evi v
120 nengsih v v
7 2
27/07/2016 121 sinta v
122 andi v
123 neng rohimah v
124 lilis v
125 delly v v
126 siti chodijah v
6 1
28/07/2016 127 lisbet v
128 ema v v
129 gian v
130 delly v v
131 siti chodijah v v
5 3
29/07/2016 132 eli setia v v
133 rika v v v
134 neti v v
135 ema v v
4 4 1
30/07/2016 136 dewi snta v
137 reni v
138 umiyati v
3
31/07/2016 139 rohmatun v
140 eni v
141 yeni v v
142 nurrika v v
143 rita v
144 santi v
6 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT AGUSTUS 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2016 1 nani v
2 anny v
3 ani nuraeni v
4 heni v
5 yeni v v
6 nurika v v
7 andi v
8 wiwin v v
9 santi v
9 3
02/08/2016 10 rahmayani v v
11 andi v
12 dini v
13 isti v
14 nurika v v
15 ema v
6 2
03/08/2016 16 iis aisah v v
17 dewi v
18 ema v
19 rahmayani v
20 devi v v
21 delly v v
6 3
04/08/2016 22 ani v
23 puji v v
24 febiyani v
25 tastianty v v
26 iis aisah v
27 sri v
28 nursaodah v
29 yeni v v
30 ema v
9 3
05/08/2016 31 utami v
32 yanti v v
33 yeni v v
34 rani v
35 rosmiati v
36 melina v
6 2
06/08/2016 37 resti v v
38 melina v
39 nuni v
40 ira v v
41 neulis v
42 ruhlianti v
6 2
07/08/2016 43 ruhlianti v
44 lia v
2
08/08/2016 45 rika v v
46 wawat v v
47 dina v
48 sontauli v
49 siti v
50 cucu v
51 lilis v
52 heni v
53 hotmaida v v
9 3
09/08/2016 54 cucu v
55 titin v
56 lilis v
57 dewi v
58 nurazizah v
59 hotmaida v
6
10/08/2016 60 sri h v
61 kokom v
62 lia v
63 jeinplay v v
64 kartika v
5 1
11/08/2016 65 vena v v
66 erwin v v
67 nopi v
68 laela v
69 eva v
70 siti v
71 iis v v
7 3
12/08/2016 72 nia v
73 tia v v
2 1
13/08/2016 74 nia v
75 julaeha v
76 tia v v
77 rini v v
78 nurul v
79 marisha v
6 2
14/08/2016 80 sri wendah v v v
81 yuni v
82 nunung v
83 neng ade v
4 1 1
15/08/2016 84 yuni v v
85 pipih v v
86 neng ade v
87 sri wendah v v
88 nunung v
89 mulyani v
6 3
16/08/2016 90 desy v v v
1 1 1
17/08/2016 91 lilis v
92 santi v
2
18/08/2016 93 lia v
94 santi v
95 hani v
3
19/08/2016 96 tia v v
97 fitria v v
98 hani v v
3 3
20/08/2016 99 yuni v
100 lena v v
101 ade v v
3 2
21/08/2016 102 yuni v
103 dini v
2
22/08/2016 104 surati v
105 ema v
106 ratna v v
107 dina v
108 anggi v
5 1
23/08/2016 109 roslina v v
110 ratna v
111 yuni v
112 eneng v v
113 ade rita v v
114 imas v v
6 4
24/08/2016 115 yuni v
116 desi v
117 santi v v
118 yani v v
119 eneng v
120 gusrinawati v
121 ade rita v v
122 teni v
123 rina v
9 3
25/08/2016 124 yuni v
125 umiati v v
126 ade rita v v
127 eka v
4 2
26/08/2016 128 yuni v
129 cucu v
130 sri hayani v v
131 umiyati v v
132 mina v
133 siti kamsiyah v v
134 hermin v
135 eka v
136 rina v
137 lela v v
138 nia v
139 eneng v v
12 5
27/08/2016 140 lilis v
141 debora v
142 hermin v
143 lela v
144 nia v v
145 eneng v v
146 yuni v v
147 cucu v
148 novie v v
149 tri rahayu v v
10 5
28/08/2016 150 yuni v v
151 novie v
152 tri rahayu v
153 hanivah v
154 nia v v
5 2
29/08/2016 155 ita v v
156 lieswati v
157 rahmi v v
158 nia v v
159 rani v v
160 yuni v v
161 lina v v
162 dini v v
8 7
30/08/2016 163 novi v v
164 nursaodah v
165 dini v
166 anabela v
167 mirna v
168 karlinda v
169 saelinawati v v
170 fitri v v
171 rina v v
172 nia v v
173 rani v v
11 6
31/08/2016 174 ai n v v
175 saelinawati v v
176 ratna v
177 novi v
178 setiawati v
5 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT SEPTEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2016 1 ai nurhasanah v v
2 fenni v v
2 2
02/09/2016 3 khristina v v
4 yesi v v
5 fita v
6 ernita v
7 erna v
8 nirmala v
9 siti v
7 2
03/09/2016 10 yesi v v
11 fita v
2 1
04/09/2016 12 pitri v
13 nauli v
14 siti novisah v v
15 leni v v
16 resti v
5 2
05/09/2016 17 yati v v
18 leni v v
2 2
06/09/2016 19 nurlaela v
20 dina v
21 budiarti v v
22 erna v
23 hermin v
5 1
07/09/2016 24 ayu v
25 tri mulyati v v
26 febrianti v v
27 cucu v
28 budiarti v
29 eneng v
30 hermin v
7 2
08/09/2016 31 fatazah v
32 imas v
33 eneng v v
34 selvi v
35 ayu v
5 1
09/09/2016 36 sinta v
37 fatazah v v
38 euis v v
39 imas v
40 farida v v
5 3
10/09/2016 41 euis v
42 ecin v
2
11/09/2016 43 ingdea v v
44 intan v
45 cahyani v v
3 2
12/09/2016 46 leni v v
47 sri v v
48 ditia v
3 2
13/09/2016 49 ayu dewi v
50 cucu v
51 sri h v
3
14/09/2016 52 elfa v
53 ida v
54 sri v v
55 nia v v
56 alin v v
5 2 1
15/09/2016 57 shanty v
58 silvi v
59 siti k v
60 elfa v v
61 ida v
62 lilis v
63 sri v
64 laily v
65 nia v v
9 2
16/09/2016 66 awang v
67 ippita v
68 dian v v
69 nia v v
70 shanty v
71 lusi v v
72 ayu dwi v
73 nuri v v
74 silvi v v
9 5
17/09/2016 75 ippita v
76 ageung v
77 restianti v v
78 kania v v
79 shanty v
80 lusi v v
81 yesi v
7 3
18/09/2016 82 ratna v
83 syifa v
84 yesi v
85 maya v
4
19/09/2016 86 yesi v
87 hartiningsih v
88 hani v v
89 ratna v
4 1
20/09/2016 90 winarti v
91 hani v
92 yesi v
93 hartiningsih v
4
21/09/2016 94 marni v
95 euis v v v
96 yani v
97 pipin v
98 intan v
99 rina v v
100 nita v
101 een v
102 dewi v
103 yesi v
104 candra v v
11 3 1
22/09/2016 105 maya v
106 yesi v
107 euis v
108 intan v
109 sri m v v
110 rina v
111 nurmala v
5 3
23/09/2016 112 sinta v
113 euis v
114 neneng v
2 1
24/09/2016 115 marpati v v v
116 aryani v
117 rani v
118 euis v v
119 reni v v
120 imat v
121 neneng v
6 3 1 1
25/09/2016 122 nurwita v
123 rohani v
124 marpati v v
125 aryani v
126 fineu v
127 wida v
128 rani v
7 1
26/09/2016 129 erna v v
130 rasy v
131 novie v
132 titin v
4 1
27/09/2016 133 alinda v v
134 hani v v
135 dian v
136 rasy v
137 sity v
5 2
28/09/2016 138 hani v v
139 ratih v v
140 rosmawati v v
141 endah v v
142 tia v
143 naning v
144 rasy v
145 siti nuryani v
8 3 1
29/09/2016 146 rika v v v
147 tia v v
148 rika tania v
149 yesi v
150 fineu v
5 2 1
30/09/2016 151 rina v v
152 harningsih v
153 elis v
154 fineu v
155 sri v v
156 siti anisa v
157 siska v
158 lesa v
159 ria v
9 2

159 51 2 4

FORMAT SURVEY HARIAN PEMAKAIAN ALAT OKTOBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2016 1 siska V V
2 anisa v
3 rina v v
4 harningsih v
5 beti v v
6 imas v v
6 4
02/10/0206 7 siska V V
8 rina v
9 harningsih v
10 beti v
11 yanti v
12 nunung v
13 ida v
14 Mitha / Deni v
8 1

03/10/2016 15 elis v v
16 sumiyati v v
17 kurniawati v
18 ine v
19 selly v v
20 dwi v v
6 4

04/10/2016 21 sarah v
22 neng ranti v
23 evi v v
24 deti v
25 selly v v
26 ratih v
27 susan v
28 yuli v
29 dea v
9 2
05/10/2016 30 nining v
31 ruwah v
32 dedeh v v
33 dewi v
34 rina v v
5 2
06/10/2016 35 yosi v
36 eka v v
37 rina v
38 widaeni v v
39 atikah v
40 amelia v
41 ruwah v v
42 lusi v
8 3
07/10/2016 43 sumarti v
44 fitriani v v
45 heni v v
46 rika v v
47 iin v
48 yosi v v
49 widaeni v
50 atikah v
51 amelia v
9 4

08/10/2016 52 santi v v
1 1

09/10/2016 53 ria v
54 santi v v
2 1

10/10/2016 55 esih v v
56 hana v
57 nurwita v
58 tri v
59 ririn v
5 1
11/10/2016 60 dewi v v
61 lina v v
62 ririn v v
63 risa v
64 lupy v
5 3

12/10/2016 65 siska v
66 yulia v
67 esih v
68 nani v v
69 wahidah v
5 1
13/10/2016 70 inne v v
71 shilvia v v
72 siska v
73 dewi v
74 devi v v
5 2

14/10/2016 75 nurhalimah v v
76 euis v
77 devi v v
78 hartini v
79 dheana v v
80 kenny v v
81 elizabeth v
6 4 1

15/10/2016 82 leni v v
83 rahmawati v
84 dheana v v
85 titin v
86 elizabeth v v
87 mutia v v
88 siska v
89 yeni v
8 4

16/10/2016 90 rahmawati v v
91 indri v v
92 titin v
3 2

17/10/2016 93 khopipah v
94 ati v
95 euis v v
96 seni v
97 sriyana v
98 pipih v
6 1

18/10/2016 99 sri h v
100 khopipah v v
101 mini v
102 ati v
103 ai v
5 1
19/10/2016 104 mini v
105 yuli v
106 siti patimah v
107 ida v
108 tia v v
109 efa v v
120 sri herminah v
7 2
20/10/2016 121 teti v
122 aan v v
123 iis v
124 yuli v
4 1
21/10/2016 125 maesaroh v v
126 nadiyan v
127 lina v v
3 1 1
22/10/2016 128 lina v v
129 santi v v
130 sekar v
131 sandra v
132 komalasari v v
133 lindarti v
134 nita v
135 sari v
136 derika v
137 susmiyati v
138 neneng v
11 3
23/10/2016 139 yeni v v
140 nurlela v
141 pipih v
142 nurul v
143 debora v v
144 ai wardah v v
6 3
24/10/2016 145 lilis v
146 yeni v
147 fitriyani v
148 debora v v
4 1
25/10/2016 149 camela v
150 etik v
51 susilawati v
152 fitriani v v
4 1
26/10/2016 153 riana v
154 tati v
155 widiastuti v
156 neneng v v
157 etik v
158 gia v
6 1
27/10/2016 159 riana v v
160 anisa v
161 neneng v v
162 sumiati v
163 etik v
5 2

28/10/16 164 lia v


165 titik v
166 komah v
167 anisa v
168 sumiati v
169 neneng v v v
170 cicah v
7 1 1
29/10/16 171 esin v v
172 neneng v
1 2
30/10/16 173 neneng v
174 nova v
175 ade irma v v
176 lina v
177 anisa v
178 susanti v
5 2
31/10/16 179 kiki v
180 santi v v
181 cucu v
182 neneng v
183 neng hanisah v
4 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT NOVEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2016 1 cucu v v
2 rima v
3 santi v v
3 2
02/11/2016 4 santi v
5 dewi v
6 yuli v v
7 nurlina v
8 lilis v
9 uswatun v v
10 afifah v
7 2
03/11/2016 11 yuli v v
12 cucun v
13 rita v v
14 emin v
15 fini v
5 2
04/11/2016 16 sumiati v
17 novita v
18 cucun v
19 iis v
20 sulastri v v
21 triana v
22 ellina v
23 emin v v
24 fini v
9 2
05/11/2016 25 triana v v
26 ellina v v
27 sumiati v
28 hani v v
29 novita v v
30 cucun v
31 eneng v
32 risma v
33 ani v
9 4
06/11/2016 34 sumiati v
35 cucun v v
36 eneng v
37 pina v
4 1
07/11/2016 38 sumiati v v
39 tintin v
40 cucun v
41 elin v
42 siti rukmini v
43 lilis v
44 iis v
7 1
08/11/2016 45 lilis v v
46 hanilah v
47 cucun v
48 trisyanti v
4 1
09/11/2016 49 shanti v
50 teti v v
51 indah v v
52 cucun v
53 imas v
54 gilang v v
55 watini v
7 3
10/11/2016 56 hima v
57 santi v
58 nuraida v
59 rika v
60 mira v
5
11/11/2016 61 titin v
62 ai cahyati v
63 diana v v
64 nita v
65 hima v v
66 christine v v
6 3
12/11/2016 67 christine v v
68 della v v
2 2
13/11/2016 69 yuli v
70 ana v v
71 nina v
72 linda v v
73 neulis v
74 della v v
6 3
14/11/2016 75 noneng v
76 tati v v
77 nina v
78 sulimah v
79 teti v
80 ifah v
81 erni v v
7 2
15/11/2016 82 elis v v
83 teti v
84 ifah v v
85 sri s v
86 isma v
4 2 1
16/11/2016 87 nurasiah v
88 yanti v
89 elis v
90 mutiara v v
91 olivia v
4 2
17/11/2016 92 sandra v v
93 mutiara v v
94 natalia v v
95 olivia v
96 yanti v
97 elis v
5 4
18/11/2016 98 novi v
99 carolyn v
100 rostini v v
101 hutriani v v
102 natalia v v
5 3
19/11/2016 103 suhaemi v
104 eulis v
105 yulia v
106 suhaema v v
4 1
20/11/2016 107 herlina v
108 nursidah v v
2 1
21/11/2016 109 yuyun v
110 juanengsih v
111 budiharti v
3
22/11/2016 112 siti nuryani v
113 ela v
114 evi v v
115 yuyun v
116 liya v
117 banny v
118 eti sulastri v
119 juanengsih v
120 budiharti v v
121 nani v
10 2
23/11/2016 122 resti v
123 banny v v
124 yeni v
125 juriah v v
126 neng mulyani v v
127 poppy v
128 hapsa v
129 yuyun v
8 3
24/11/2016 130 gita v v
131 hapsa v v
132 yeni v v
133 sumiati v v
4 4
25/11/2016 134 halimah v v
135 santi v
136 lilis v
137 susi v
138 risma v
5 1
26/11/2016 139 oci v
140 neng sumarni v
141 ernawati v
142 tina v v
143 wida v v
144 Siti Nurlinda v
6 2
27/11/2016 144 Eneng Merawati v v
145 Wida v v
146 Eulis v
147 Neng Sumarni v
148 Ernawati v
149 Ema v
6 2
28/11/2016 150 Resa v
151 Teti v v
152 Wida v
153 Tati v v
154 Dwi v v
155 Kiki v
156 siti robiah v v
7 4
29/11/2016 157 Tati v v
158 Dwi v v
159 Tika v v
160 Rita v
161 Siti Robiah v
5 3
30/11/2016 162 rosy v
163 shinta v v
164 nuraisyah v
165 dorganda v v
166 siti rohmawati v v
167 siti aisah v
168 tika v
169 sania v
170 nurlaelasari v
171 rita v v
172 Susi v v
173 sumiati v
174 Rahmawati v
13 5

FORMAT SURVEY HARIAN PEMAKAIAN ALAT DESEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2016 1 Shinta v v
2 Esty v
3 Siti Khodijah v
4 Herda v
5 Lucy v v
6 Rizkia v
7 Sania v v
8 Dian v v
9 Dewi ayu v
10 Uun v v
10 5
2/12/2016 11 Siti Khodijah v
12 Shinta v
13 Anisa v
14 Avturi v v
15 Rizkia v
16 Dian v v
17 uun v v
7 2 1
3/12/2016 18 Reni v
19 Eneng R v
20 Anisa v
21 Lisna v v
4 1
4/12/2016 22 riska p v
23 ine v
24 rd rainy v
25 nurwasiah v
26 ana v v
5 1
5/12/2016 27 ine v
28 ernawati v
29 supriani v
30 riska p v
4
6/12/2016 31 wiwin v
32 supriani v v
33 desie v
3 1
7/12/2016 34 Erna v v
35 Eka v
36 Ana v v v
37 Linda v v
38 Ai siti v v
39 Susi v
6 4 1
8/12/2016 40 marini v
41 sri asiah v
42 lia amalia v
43 susi v
44 erna v
45 Liya v
6
9/12/2016 46 ratu v
47 marini v
48 sri asiah v
49 Ai Yuliawati v v
4 1
10/12/2016 50 Deti v v
51 Nurhasanah v v
52 Marini v
53 Trianti v
54 Nurasiah v v
55 Nurfadilah v v
56 Siti M v
57 Ratu v
58 Yuliana v v
59 Ai Yulianti v
60 Nuasiah v
11 4 1
11/12/2016 61 nurhasanah v
62 sariah v
2
12/12/2016 64 Masiyem v
65 Rita v
66 Ai N v v
67 Leni v v
68 Santi v
69 Elina v v
70 Leti v
7 3
13/12/2016 71 Reni v v
72 Ai N v v
73 Ranti v v
74 Leni v
75 Merry v
76 della v
6 3
14/12/2016 77 Ai Purnawati v
78 Ai N v v
79 Reni v
80 Alin v
81 Tania v
82 Della v
83 imas v
84 Tita v
85 Anisa v v
86 Ikatri v
87 Riska v v
9 3
15/12/2016 88 Tita v
89 Anisa v
90 Diana v
91 Riska v v
92 Sani v
93 Rossy v v
94 Nisa v
95 Tri ambaryani v
8 2
16/12/2016 96 Rossy v
97 Wita v
98 Dede v
99 Tri ambaryani v
100 Tita v
101 Siti Puspita v
102 Grace v
103 Yeni v v
104 Diana v
9 1
17/12/2016 105 Dewi v
106 Nopi v
107 Lena v v
108 Wiwin v v
109 Dini v
110 Dewi v
111 Grace v
112 Tioria v
113 Enok v
114 Endah v
115 Tri ambaryani v
11 2
18/12/2016 116 Rodiah v v
117 Cucu v
118 Novi v v
119 Dini v
120 Nurmala v v
121 Leli v
122 Yulianti v v
123 Ai N v v
8 5
19/12/2016 124 Risma v v
125 Rodiah v v
126 Cucu v
127 Novi v
128 Nalatresna v v
129 Nurmala v v
130 Leli v
131 Eem v
132 Dena v
133 Yulianti v v
134 Ai N v v
135 Sri v
136 Yuyun v v
137 Sukirah v
14 7
20/12/2016 138 Risma v v
139 Rodiah v v
140 Neli v v
141 Cucu v v
142 Nalatresna v v
143 Yuyun v v
144 Nurmala v v
145 Ika v
146 Zuliyati v v
147 Titi v v
148 Irmayanti v v
11 10
21/12/2016 149 Irmayanti v v
150 Erna v v
151 Fitri v
152 Erniyati v v
153 Leli v v
154 Wati v v
155 Eneng v
156 Elis v
157 Sari v
158 Leli marliani v v
159 Nelly v v
160 Kiki v v
161 Zuliyati v
162 Erniyati v v
14 9
22/12/2016 163 erna v v
164 Feni v
165 Leli v v
166 wati v v v
167 Rokhayani v
168 Elis v
169 leli marliani v v
170 Kiki v v
171 Wita v v
172 Ani v v
173 Mayang v
11 7 1
23/12/2016 174 Wita v
175 Ani v v
176 Putri v
177 Pipih v
178 Leli v
179 Teti v
180 Mayang v
181 Ratu v v
8 2
24/12/2016 182 ratu v v
183 novi v v
184 mayang v
3 2
25/12/2016 185 tati v v
1 1
26/12/2016 186 Ida v v
Yulia v
2 1
27/12/2016 187 gustina v v
188 Dewi Rosyani v
189 ida v v v
3 1 2
28/12/2016 190 ovi v
191 yenny v v
192 teni v v
193 gustina v
194 mimin v
195 lina v v
196 Cucu v
197 Mia v
8 3
29/12/2016 198 Lina v
199 Yayah v v
200 Sri v v
201 ici v
202 yenny v v
203 meli v
204 anne v
7 3
30/12/2016 205 ici v
206 neng tati v
207 Lisnawati v
3 0
31/12/2016 208 Lika v v
209 Maryati v
210 Utami v
211 Susanti v v
4 2
Formulir Survey Harian Pemakaian Alat
FOMULIR SURVEY PEMAKAIAN ALAT HARIAN Ruang IGD - RSKIA BULAN JANUARI 2017
Ruang IGD - RSKIA BULAN OKTOBER 2017
01/01/2017 1 MUTIA MULYANI INFUS DC
2 IRMA YULIANTI INFUS DC 01/10/2017 1 CUCU SOLIHAH INFUS DC
3 NENI SUMARNI INFUS 2 RAHMAT INFUS
4 NILA INFUS DC 3 NIA KANIA INFUS
5 KHOTIJAH INFUS DC 4 LILIS INFUS DC
6 M MILIAN INFUS 5 HADIMAH INFUS
7 SOPINAH INFUS 6 NELINCE INFUS
02/01/2017 8 LIRA INFUS 7 YULIATI INFUS DC
9 YANTI INFUS DC 8 ELI SUMINAR INFUS
10 SABRINA INFUS 9 MIMIN INFUS DC
11 YUNIARTI INFUS 10 YANI MULYANI INFUS
12 AWANG SETIAWANG INFUS 11 HERNA INFUS
13 KOKOM INFUS 02/10/2017 12 MIRA ROSMAWATI INFUS
14 RANI KARLINA INFUS DC 13 ENDAH ISWANTI INFUS
15 RANI KARLINA INFUS 14 MIMIN SITI AMINAH INFUS
16 YUYUM INFUS DC 03/10/2017 15 INAYATI HAKIM INFUS
17 AI RINA INFUS 16 LESTARI SUDIANA INFUS
18 SULASMINI INFUS 17 TINA NURHAYATI INFUS DC
19 SITI RODIAAH INFUS DC 18 NENG MULYANI INFUS
03/01/2017 20 SARI ISTIQOMAH INFUS 19 SRI HANDAYANI INFUS
21 ENENG AISAH INFUS 20 VANIA PUSPITA INFUS
22 RINI INFUS 21 ERLIYANA INFUS
23 RUMIYATI INFUS DC 22 SITI ROKAYAH INFUS
24 TITIN INFUS 04/10/2017 23 SITI FATIMAH INFUS
25 ROSMAWATI INFUS 24 M FIRKHAN INFUS
26 DIAR INFUS 25 BY NY ANI SULISTIYANINGSIH
INFUS OGT
27 FATIH INFUS 26 SUSANTI PUJI ASTUTIINFUS
28 NOVI INFUS 27 AMI AMINAH INFUS
29 JESSIKA INFUS 28 YULI KAMELIANTI INFUS
30 YUNIAWATI INFUS 29 SANTI ANDRIANI INFUS
04/01/2017 31 PIPIH MAS PUPAH INFUS 05/10/2017 30 PUNGKI TRISNAWATIINFUS
32 SERLY INFUS 31 NENENG ANGGRAENIINFUS
33 HUTAMI FABRIATI INFUS 32 ELIS HAYATI INFUS DC
34 NONENG HARYATI INFUS DC 33 NENG LELA INFUS
35 LINA MARLINA INFUS 06/10/2017 34 ANI NURJANAH INFUS DC
36 M AGIL SETIAWAN INFUS 35 BUNGA SALSABILA INFUS
37 NYAYU MARWIAH INFUS DC 36 IRANINGSIH INFUS
05/01/2017 38 RITA INFUS 07/10/2017 37 TETI SETIATI INFUS
06/01/2017 39 RANI INFUS 38 IIN INFUS DC
40 RINA REGINA SIHOMBING INFUS 39 NENENG INFUS
41 ADI MISTIAH INFUS DC 40 NURUL INFUS
42 ANA ROSANA INFUS 41 SARI INFUS
43 WATI INFUS 42 WIWIN INFUS
44 LISI SITI ROKAYAH INFUS 08/10/2017 43 RANI SARININGSIH INFUS
45 FITRI INFUS 44 NADIRA INFUS
46 RINI ASTUTI INFUS DC 45 AVELINO PUTRA INFUS
47 NENG TUTI INFUS 46 SABIR SETIA INFUS
48 ARSYA INFUS 47 DYILAN INFUS
49 SHILA ANINDITA INFUS 48 ANGGI INFUS
07/01/2017 50 DETI KUSMAWATI INFUS DC 49 IIS H INFUS
51 NENENG TINI INFUS 50 MARLIANA INFUS
52 LILIS KOMARIAH INFUS DC 51 HASANAH INFUS
53 MAYMUNAH ISNANI INFUS 09/10/2017 52 NOVA OLIVIA INFUS
54 WULANDARI INFUS 53 RUBI APRILIO INFUS
55 SITI KARMILAH INFUS 54 NAZHIRA INFUS
56 ATIN GANJARWATI INFUS 55 YUYUN YUNIARTI INFUS
08/01/2017 57 KARSIH INFUS 56 IRA JUHARIAH INFUS
58 SULYSTIOWATI INFUS 57 RINA ROSITA INFUS
59 M ZABRAN INFUS 10/10/2017 58 LENI MARLINA INFUS
09/01/2017 60 KOKOM KOMARIAH INFUS 59 PARYANI INFUS DC
61 VIKA SITI MADINAH INFUS 60 ANI SETIANI INFUS DC
62 IDA WAHIDA INFUS 61 RIRIN NURAENI INFUS
63 ASRI INFUS 62 SANGADAH MELLIYANTIINFUS
64 DIAH WIDAYANTI INFUS 63 WINA KURNIA INFUS
65 IRMA APRIYANI INFUS 64 LENI LENIYATI INFUS
66 NENG SUKAESIH INFUS 65 RA HANA LAILAN INFUS
67 KIKI WARIAH INFUS 66 NENG ELLA WATI INFUS
68 NURHASANAH INFUS 67 LANI TAPLIA INFUS
69 DINI INFUS 68 WIWIN INFUS
70 NAURA INFUS 11/10/2017 69 DEWI A INFUS
10/01/2017 71 FAUZIYAH INFUS 70 YATI SURYATI INFUS
72 ELISABETH INFUS 71 RINI SUNDARI INFUS
73 RANI INFUS 72 EUIS MULYANIE INFUS
74 FITHRI FADHILLAH INFUS 73 YANI INFUS DC
75 NINA ROSMIATI INFUS DC 74 ELSA INFUS
76 AFRIZA NIARTI INFUS 75 HALIMAH INFUS DC
77 MEGA INFUS 12/10/2017 76 DEDEH INFUS DC
78 AI SYAMSIH INFUS 77 IHAT SOLIHAT INFUS
79 NENTI INFUS 78 AJENG INFUS DC
80 KHOR0TUNISA INFUS 79 RIKE INFUS
11/01/2017 81 NURAENI INFUS 80 SELVY ANDRIANI INFUS
82 EROS INFUS 81 EUIS INFUS DC
83 LELI NURAENI INFUS 82 DEWI SUPRIATIN INFUS
84 ELI HALIMAH INFUS 83 EEN SUHAENAH INFUS
85 ROSMIATI INFUS 84 CINDY ANGGRAENI INFUS
86 TANTI INFUS 13/10/2017 85 MINTARSIH INFUS DC
87 ANTARYANI INFUS 86 IRMA MARIA ULFA INFUS DC
88 RISKA INFUS 87 IDA FARIDA INFUS DC
89 TRINJANI INFUS 88 FANY INFUS
90 ZAMZAM INFUS 89 AISYAH INFUS
12/01/2017 91 DEWI INFUS 90 KAUTSARRAZKY INFUS
92 RINA SAHARA INFUS 91 FATHAN INFUS
93 DERA SUPRIANTI INFUS 14/10/2017 92 RINI APRILIA INFUS
94 MAS IYAM INFUS 93 CELINE FELICIA INFUS
95 ELIN INFUS 94 NURDINI FITRIANI INFUS
96 RANI INFUS 95 IKE PANCAWATI INFUS
97 DEDEH SITI ROHMAH INFUS 96 YENI INFUS DC
98 SUSILAWATI INFUS 15/10/2017 97 LELI INFUS
99 SITI AISAH INFUS 98 AINUN INFUS
100 TANTI MARYAM INFUS 99 IIN INFUS DC
101 AMELIA INFUS DC 100 SITI NURLELA INFUS
102 HADIAN KUSMAYANTI INFUS 101 ANY INFUS DC
103 ENENG DARLIAH INFUS 102 RUSMINI INFUS
104 EUIS AISAH INFUS DC 16/10/2017 103 SITI MAESAROH INFUS DC
105 MIMIN INFUS 179 RIZAL AHMAD INFUS
106 MUTIA INFUS 104 RINRIN RUKMAYANI INFUS DC
107 M ALIF INFUS 105 PETRA INFUS
13/01/2017 108 SILFI INFUS 106 JIBRIL INFUS
109 M. RANGGA INFUS 107 KETHI INFUS
110 HABIL INFUS 108 PITRIANI INFUS
111 DIVA INFUS 109 LILIS JUARIAH INFUS
14/01/2017 112 YUYUN YUNINGSIH INFUS DC 110 SUMINAH INFUS DC
113 SULINAR OKTAVIANI INFUS 111 NELLI RUSMIYATI INFUS
15/01/2017 114 SRI ASTRIYANI INFUS DC 17/10/2017 112 MAYA FEBRIANTI INFUS
115 TANTI GUSTIANTI INFUS 180 ALIF MUHAMMAD AZKANANTA
INFUS
116 KIAGUS INFUS 181 KAYLA NUR ASYIFA INFUS
117 KOMALA INFUS 113 RANI KANIA DEWI INFUS
118 HARYUTI INFUS DC 114 VIA YULIANA INFUS
119 HANI ROHAENI INFUS 115 FEMMY LUSIANA RAHAYU
INFUS
120 WINA INFUS 116 RINI SETIANI INFUS
121 LINA PUSPITA INFUS 117 SARI ASIH INFUS
16/01/2017 122 INDRI CAHYANI INFUS 118 LUSIANA PRATIWI INFUS
123 DESIANA INFUS 119 EMI IRAWANTI SASKIAINFUS
124 NOVI NURSANTI INFUS 120 RINI LASMINI INFUS
125 NONI AMELIA INFUS 18/10/2017 121 SURYANI INFUS
126 ELIS HOTIAH INFUS 182 SHAQIL HAFIZH AL THAFURRAHMAN
INFUS
127 ERNA INFUS 122 WULAN SARI INFUS
128 TITIN INFUS 123 LENI MARYANI INFUS
129 RANI INFUS DC 124 ATI KURNIATI INFUS
130 DESI INFUS 125 PUTRI ARDI INFUS
131 ALBY INFUS 19/10/2017 126 AI ATIKAH INFUS
17/01/2017 132 YANTI DC 183 KAYLA PUTRI AGUSTININFUS
133 PARWATI INFUS 127 ENTIN INFUS
134 RENI MARYANI DC 128 RISTI INFUS
135 RINA KURNIAWATI INFUS DC 129 NOVY INFUS
136 LINA HERLINA INFUS 130 NUR HAENI INFUS
137 NENG SUKAESIH INFUS 20/10/2017 131 MASRIVA INFUS
138 LOLA PITALOKA INFUS 184 RASYA INFUS
139 GRACE MOSSEMBEKKER INFUS 185 FAUZAN INFUS
140 DINA INFUS 186 ZAHRA AULIA INFUS
141 RADITYA HAKIM INFUS 187 RIZKI AABDULROSID INFUS
18/01/2017 142 EULIS HAYATI INFUS 132 IDA FARIDA INFUS DC
143 VIVI AMELIA INFUS 133 DIDAH INFUS
144 MIKAYLA INFUS 134 FITRI INFUS
145 HANI HADIANTI INFUS 135 YANTI INFUS
146 SITI SARAH INFUS 21/10/2017 136 PUTRI ARDI INFUS
147 ENENG CITRA PRADILA INFUS 137 LIANA SONIAWATI INFUS
148 AMELIA RIZA INFUS 138 UPIT WIDANENGSIH INFUS DC
149 YENI ANGGRAENI INFUS 139 TINA DEWI INFUS
150 TATI NOVIYANTI INFUS 22/10/2017 140 NENDAH OKTAVIANI INFUS
151 YANI MULYANI INFUS 188 ASILA NUR SALSABILAINFUS
152 ROHAENI INFUS DC 23/10/2017 142 SUMINAR INFUS
19/01/2017 153 DAIS SUPRIATIN INFUS DC 189 ALIFA SACHI KAYANAINFUS
154 LETISHA FELICIA INFUS 190 M ARAFA ASYSYAUQIINFUS
155 RINA FARLINA INFUS DC 191 AFZA FARHANA INFUS
156 MULYANTI INFUS 143 RIKA NURANI INFUS
157 DESI SETIANI INFUS 144 ENUR INFUS
158 NIA MULYATI INFUS 145 LISDIANA FEBRIANI INFUS
159 JULAEHA INFUS 146 NITA AMBARWATI INFUS
20/01/2017 160 WANTI INFUS 24/10/2017 147 NENENG CITRAWATIINFUS
161 TANTRI PUJI A INFUS 148 RINA KRISTINA INFUS
162 SOLEHATI INFUS 149 LILIS KARMINI INFUS
163 PENI ALVIANI INFUS 150 RINI RUSMIATI INFUS
164 MAYA NURHAYATI INFUS 25/10/2017 151 ANITA OKTAVIANI INFUS
165 NURLELA INFUS 192 M ARFAN INFUS
166 ANDARSIH INFUS DC 193 M AFNAN INFUS
167 DEWI ANIH INFUS DC 194 PUTRI NAYLA INFUS
168 ISRAMI INFUS 152 SINTA MARLINA INFUS
21/01/2017 169 GITA INFUS DC 26/10/2017 153 SANIAH INFUS
170 BUNGA OGT 195 YEHEZKIEL HOPE DAREEN
INFUS
171 HERNA HERAWATI INFUS DC 155 SITI SUMIATI INFUS
172 RIKA IRIANI INFUS DC 156 MELI NOVIANTI INFUS
173 INSIYAH INFUS 157 NURHILALIAH INFUS
174 WANTI INFUS 158 RINA RAHMAWATI INFUS
175 NURHIDAYAH INFUS 159 SITI ROKAYAH INFUS DC
176 JUMINAH INFUS 160 EVI APRIANI INFUS
177 RIMA SAPYUTI INFUS 27/10/2017 161 FENTI INFUS
22/01/2017 178 FANI INFUS DC 196 ABDAN INFUS
179 HEPI INFUS 163 WINDRIYANI INFUS
180 TITI HERDIANTI INFUS 164 WAHYUNI SRI HARTATIINFUS
23/01/2017 181 RANI INFUS 165 ELIN INFUS
182 FITRIA SRI INDRIANI INFUS 166 UTAMI WIDIARTI INFUS
183 IMAS INFUS 28/10/2017 167 MIMIN ROSMIATI INFUS
184 SRI SULASTRI INFUS 168 WIWIN WINARSIH INFUS
185 SANTI MARDIANTI INFUS 169 LILIANAWATI INFUS
24/01/2017 186 PIPI AYU INFUS DC 170 MAUDINA INFUS
187 KEYLA AGUSTINA AZAHRA INFUS 171 DWINTA INFUS
188 SITI KHODIJAH INFUS 29/10/2017 172 WIWIN WINARSIH INFUS
189 ZUHAIR INFUS OGT 198 M DAFA INFUS
190 FILA RAHAYU INFUS 174 ELSA SILVIA INFUS
191 BY NY NOVI HARUM INFUS 175 RUKMINI INFUS
192 LARASWATI INFUS 30/10/2017 176 RISMA SAFITRI INFUS
193 WIDAYANTI INFUS DC 177 YHETI INFUS
194 RICA HENDRIYANI INFUS 178 DIAN INFUS DC
25/01/2017 195 EVI ERIKASARI INFUS 30/10/2017 199 HASBI INFUS
196 ABDULLAH INFUS 200 RAFFA INFUS
197 SABILA INFUS 201 LILIS HERNI INFUS
198 ERNA RAHAYU INFUS 30/10/2017 202 LILIS INFUS DC
199 MIA RASWATI INFUS 203 ROKAYAH INFUS
200 NURSYAMSIAH INFUS 204 VANY MATHOVANI INFUS
201 ANTI INFUS 205 SUSILAWATI INFUS
202 ELIS SURYANI INFUS 206 DEWI INFUS
203 SALAMAH INFUS 31/10/2017 207 INDRA SYAMSUDIN INFUS
204 GITA INFUS 208 DEVI APRILIANI INFUS
205 DEWI FATMAWATI INFUS 209 YULI YULIANTI INFUS
26/01/2017 206 DAIS SUPRIATIN INFUS DC 210 MELIA SUSILAWATI INFUS DC
207 LENI YULIANI INFUS 211 HASNI PEBRIANTI INFUS
208 DEDEH INFUS 212 M.ARIFIN INFUS
209 AI LASMINI INFUS 213 M.HAFIZ INFUS
210 MARISHA KRASIWI INFUS TOTAL 213 30 1
211 KOMALASARI INFUS JUMLAH PASIEN 857
212 SHENI INFUS
27/01/2017 213 PUTRI INDRIANI INFUS
214 TINI SUMANTRI INFUS Formulir Survey Harian Pemakaian Alat
215 TUTI SETIAATI INFUS Ruang IGD - RSKIA BULAN NOVEMBER 2017
216 YANI MULYANI INFUS
217 RAMADHABNI PUTRA F INFUS
27/01/2017 218 AMELIA PITRI INFUS 01/11/2017 1 ENENG SUMIATI INFUS
219 HARYUTI INFUS 2 RINI ROHAENI INFUS DC
28/01/2017 220 SUKMA RAHAYU INFUS 3 UUN INFUS DC
221 MARSYA RETA WAHYU INFUS 02/11/2017 4 SUSANTI INFUS
222 LIS SETIOWATI INFUS 5 M AKMAL INFUS
223 DERI RITA FEBI INFUS 6 NAYSILA INFUS
224 ENUNG NURHASANAH INFUS 7 IRMA SAWITRI INFUS DC
225 LUSI SUSILAWATI INFUS 8 ENENG LISNAWATI INFUS DC
226 ERISTA INFUS 9 SANTI SUSANTI INFUS DC
227 YATI MULYATI INFUS 10 LURI RAHAYU INFUS
228 WIWIT SUSANTI INFUS 11 MINTARSIH INFUS
229 ENENG MARYATI INFUS 12 SITI NAFISAH INFUS
230 LATIFAH INFUS 13 NIA ASTIA NINGSIH INFUS DC
29/01/2017 231 NINA RATNASARI INFUS DC 03/11/2017 14 SITI NURJANAH INFUS
232 INTAN NURHAYATI INFUS 15 ZAENAB KARBALA INFUS
233 ROKAYAH INFUS 16 IQ SHOFIA INFUS
234 RISNAWATI INFUS 17 M RAFA INFUS
235 DESI INFUS DC 18 NURIVA INFUS
236 INTAN NUR SILVIANTI INFUS 19 ENI INFUS
237 IMAS TUTI INFUS 20 AZKA ABDILLAH INFUS
238 LISNA SETIANI INFUS 04/11/2017 21 SITI HODIJAH INFUS
237 IMAS TUTI INFUS 22 FITRI RASMAWATI INFUS DC
240 NIA SUSANTI INFUS 23 ALFI INFUS
241 MILDA INFUS 24 HARIS INFUS
242 ROSMIATI INFUS 25 HESTI INFUS DC
243 GITA INFUS 26 YANI ROHAENI INFUS
30/01/2017 244 FITRI INFUS 27 TITI ROHAET INFUS
245 FITRI RAMADHANYANTI INFUS DC 28 BINTANG INFUS
246 SONIA INFUS 05/11/2017 29 EUIS INFUS
247 FITRIANA INFUS 30 RIKA INFUS DC
30/01/2017 248 NUNUNG NURYASIH INFUS 31 MIMIN INFUS DC
249 YULI PRIATIN INFUS 32 RIDA INFUS
250 DINI SULPIANI INFUS 06/11/2017 33 RIDA NURUL INFUS
251 LILIS KOMARIAH INFUS 34 RANI NUJRAENI INFUS
252 SURYATI INFUS DC 35 DIAN ISMAYANTI INFUS
253 MESYA MARYAM INFUS 36 LILIS SUMARNIK INFUS
254 JIDAN MAULANA INFUS 37 KOMALASARI INFUS
255 AI ROSMAYANTI INFUS 38 HOLLIS SOHNA INFUS
31/01/2017 256 SITI SOLIHAH INFUS DC 39 NIZMA INFUS
257 ERNA SETIANA INFUS DC 40 MUMUN INFUS
258 IMAS KOMALASARI INFUS 41 FITRIANI INFUS
259 DEVI ROSYANI INFUS 42 BY NY. IQ SHOFIA INFUS U
260 ITA ROSITA INFUS DC 07/11/2017 43 LENI HERLIANI INFUS
261 SILMI NURJANAH INFUS 44 ROSITAWATI INFUS
262 RINI INGGRIANI INFUF DC 45 NINING TRI WAHYUNIINFUS
263 NOVY MARIA YUANA INFUS 46 ERNI LESTARI INFUS
TOTAL 263 46 2 47 HERNI ISKANDAR INFUS
JUMLAH PASIEN IGD 712 48 M. HAMDI INFUS
49 ARKA GIBRAN G INFUS
Formulir Survey Harian Pemakaian Alat 50 ANI SRI INFUS
Ruang IGD - RSKIA BULAN FEBRUARI 2017 51 ASRY SILVIA INFUS
01/02/2017 1 INE MAGDALENA INFUS 08/11/2017 52 YULIAWATI INFUS
2 AMELIA INFUS 53 SITI MUNIRAH INFUS
3 ICEU INFUS 54 NENENG SUHAETI INFUS
4 AWANG NURHAYATI INFUS 55 YUYUN YUNENGSIH INFUS
5 NAZHIRA NUR F INFUS 56 RENTI RAHAYU INFUS
6 DEWI MUNTIA INFUS 57 INTAN PURNAMA SARIINFUS
02/02/2017 7 NIA KURNIASIH INFUS 58 SITI SAADAH INFUS
8 NIZMA FADILAH INFUS 59 DIANY INFUS
9 YANTI YULIANTI INFUS 60 SITI JUARIAH INFUS
10 DINAWATI INFUS 61 ANITA INFUS
11 MARINI INFUS 62 DEDEH INFUS
12 FITRI INFUS 63 SRI INFUS
13 ERNAWATI INFUS 64 NINA INFUS
14 LENI MARLINA INFUS 09/11/2017 65 FITRI INFUS
15 IKE SURYANI INFUS DC 66 YUYUN INFUS
16 ROSITA INFUS 67 MELIS FATHONAH INFUS
17 LILIS INFUS DC 68 JESNITA INFUS
18 NUR SINTA INFUS 69 DESI WULANDARI INFUS
19 INTAN ASIH LESTARI INFUS 70 NURYANTI PRATAMAINFUS
20 ALIKA PUTRI ANGGRAENI INFUS 10/11/2017 71 ENDANG NURJANAHINFUS
21 WULAN NURAENI INFUS 72 RINI ANGRAENI INFUS
22 BEMBI YULIANA INFUS 73 ELIS SITI INFUS
03/02/2017 23 YUYUN INFUS 74 CUCU JUARIAH INFUS
24 NURROFIQOH INFUS 75 SITI HABIBAH INFUS
25 DEDEH HANDAYANI INFUS 76 HERLINA INFUS
26 FANI MELANI INFUS 77 ISYE NURHAYATI INFUS
27 NENI YANUARSIH INFUS 78 FITRI RATNASARI INFUS
28 KARTINI INFUS 79 SINTA SORAYA INFUS
29 KARTIKA INFUS 11/11/2017 80 NIA KURNIASARI INFUS
30 FARISHA INFUS 81 RIANI PERTIWI INFUS
31 RANDIKA PRATAMA INFUS 82 IDA FARIDA INFUS
32 AZMI AZMA AL FARIZI INFUS 83 NOVA OKTAVIA INFUS
33 AI SITI KURNIAWATI INFUS DC 84 FADLY INFUS
34 NYAI KARWATI INFUS 12/11/2017 85 TIKA KARTIKA INFUS
04/02/2017 35 UUM SUMIASIH INFUS 86 ERIKA AMBARWATI INFUS
36 SITI HASANAH INFUS DC 87 ALKA INFUS
37 ERLIN MARLINA INFUS 88 AZKA RIZKY PRATAMAINFUS
38 NANI INFUS 89 DARIL INFUS
39 DEBI INFUS 90 RATIH INFUS
40 RASYID INFUS 91 MUTIARA AYU INFUS
05/02/2017 41 IIS INFUS 92 RATNA NENGSIH INFUS
42 ALBI INFUS 13/11/2017 93 RATIH INDRIATI INFUS
43 RASYID INFUS 94 LISNAWATI INFUS
05/02/2017 44 MISKIYAH INFUS 95 SITI NURHASANAH INFUS
45 DIYANI INFUS 96 ENTIN KARTINI INFUS
46 HERSA MUSTIKA INFUS 97 AYUNDA SEKAR INFUS
47 ERNI HENDRAWATI INFUS 98 SANTI PARINA INFUS
48 IMAS ROHAENI INFUS 99 JERDINO RAISAN INFUS
49 RANI ROSDIANI INFUS 100 M ZAKA DIYAVRAHMANINFUS
50 NENI HARYANI INFUS DC 101 DESSY ASTARI INFUS
06/02/2017 51 LUSIANA DANTI INFUS 102 IIN KOMALA INFUS
52 IQMAL INFUS 14/11/2017 103 IDA INFUS
53 NINA INFUS 104 FATIMAH INFUS
54 WIDIA INFUS 105 TUTI NURMALA INFUS
55 LINA MARLINA INFUS DC 106 RENI ANGGRAENI INFUS
56 IIS INFUS 107 LILIS JUARIAH INFUS
57 SUSANTI INFUS 108 TATING CAHYANI INFUS
07/02/2017 58 TANTI FEBRIANTI INFUS 109 TINI INFUS
59 ASRIANTI INFUS 110 RISKA RENATA INFUS
60 WINDU WULAN INFUS 111 CANTKA YULIANTI INFUS
61 ALISA FAHRANI INFUS 112 CITRA AUNDRY SANTHIKA
INFUS
62 RISKA KOMALASARI INFUS 113 SUSI SUKAESIH INFUS
63 DIAR HADIANA INFUS 114 KARTINI INFUS
08/02/2017 64 NENI INFUS 115 AZMIA LASHIRA INFUS
65 EVI NURHAYATI INFUS 116 NADHIRA AZMI INFUS
66 NENG YURI INFUS DC 117 WIDI NUR FITRI INFUS
67 SITI WIDA INFUS 118 YULIANA INFUS
68 SINTA INFUS 15/11/2017 119 RENATA NADA INFUS
69 ANGGRAENI INFUS 120 ERVAN FADHIL PRATAMA
INFUS
70 ELIS INFUS 121 AKMAL EL AZZAM INFUS
71 DEWI ROHMAWATI INFUS 122 IRAWATI INFUS
72 RISNA DEWI INFUS 123 SUCI SINTA INFUS
73 ERNI KUSMIATI INFUS 124 BELLA NURAENI INFUS
09/02/0107 74 ANI ROHAENI INFUS 125 SITI MASITOH INFUS
75 ARYAL INFUS 126 RATIH INDRIATI INFUS
76 KEYSHA ALAMANDA INFUS 127 SUMINI INFUS
77 ANISA ANJAR ANDRIANI INFUS 128 NENI INFUS
78 NELLY INFUS 16/11/2017 129 BY NY.SUKERI INFUS
79 MIRA INFUS 130 DEWI NURAPRIYAN IINFUS
80 DIAN INFUS 131 RINA RAHMAWATI INFUS
10/02/2017 81 SITI MARYAM INFUS DC 132 NENI INFUS
82 MIRA PIRMAWATI INFUS DC 133 KARTIKA INFUS
83 HODIJAH INFUS 17/11/2017 134 TATI INFUS
84 RODIAH INFUS 135 RODIAH INFUS
85 FITHRI FADHILLAH NUGRAHAINFUS 136 MIMIN WIDIARMI INFUS
86 ERNA ALFIANI INFYS 137 SIFA PUSPTA HERLIANA
INFUS
87 YANI MULYANI INFUS 138 WAWANG SUWANGSIH INFUS
88 OOM KOMARIAH INFUS DC 139 DAYANI INFUS
89 THANIA NATASYA INFUS 140 YOSI HERLINA INFUS
10/02/2015 90 KARTIKA INFUS 141 DEWI WINARNI INFUS
11/02/2017 91 RIKA MITIA INFUS 18/11/2017 142 SETIYANINGSIH INFUS
92 IKHSAN INFUS 143 RIFA A INFUS
93 ELIS NIAERNIATI INFUS DC 144 SANTI WINDARTI INFUS
94 PUPU PURNAMA INFUS 145 TRI UTAMI INFUS
95 MIRAYANTI INFUS 146 IMAS NURASIYAH INFUS
96 NANI INFUS 147 MELIS FATHONAH INFUS
97 ELA HERAWATI INFUS 148 RISA ROSALINA INFUS
98 WATI DC 149 RINA SUHARTINI INFUS
99 PONSIYATI INFUS 150 NISA RAHAYU INFUS
100 NENG RANTI INFUS 151 AZIZAH SYALSABILA INFUS
101 NOVIYANTI INFUS 152 JAKA MUHAMAD FAUZ INFUS
102 SITI MAESAROH INFUS 153 FAUZIA LATIFAH INFUS
103 SELVI INDRAWATI INFUS 154 LIZA FRASISKA INFUS
12/02/2017 104 MAE KUSMIATI INFUS 19/11/2017 155 ERLIN MARLINA INFUS
105 SITI SELVI INFUS 156 HANA HUSNI INFUS
106 REHAN INFUS OGT 157 SHINTA INFUS
107 DHELIA PAUZIAH INFUS 158 NURMAYANTI INFUS
108 DEDEH MEDIAWATI INFUS 159 ITA KARTINI INFUS
13/02/2017 109 TESA APRILIANTI INFUS 160 ELIS WIANTI INFUS
110 EROS INFUS 161 TITING YENI INFUS
111 FITRIANI INFUS 20/11/2017 162 ALBHI LUCFI INFUS
112 AKBAR KHALID INFUS 163 KALISHA ALYSIA INFUS
113 SINTA NUR SHOLIHAH INFUS 164 VITO CAHYA PURNAMAINFUS
114 INTAN MEILANI INFUS 165 ROHAYATI INFUS
14/02/2017 115 IKA KARTIKA INFUS 166 RODIAH INFUS
116 NANI SURYANI INFUS 167 NUR UVIYANA INFUS
117 SITI ROSITA INFUS 21/11/2017 168 CHANDRA DHAWI INFUS
118 IIS SITI AISYAH INFUS 169 FATTAN ZIKRI INFUS
119 TITA INFUS 170 FATIR RADITA RAHAYU
INFUS
120 ONENG INFUS 171 RISKI INFUS
15/02/2017 121 NENG RITA INFUS 172 lina rostiawati INFUS
122 LISNAWAROH INFUS 173 FITRI RATNASARI INFUS
123 AI RINI INFUS 174 IDAH NURAIDAH INFUS
124 WULAN SEPTINI INFUS 175 ANNISA LAUMARCIA INFUS
125 MUHAMMAD AKBAR INFUS 176 NOPIYANTI INFUS
126 AFDAN NABIL INFUS 177 DINI NOVIYANI INFUS
127 M.YURA INFUS 178 ERNI LESTARI INFUS
15/02/2017 128 NURHAYATI INFUS DC 179 WARTINI INFUS
129 ETI ROHAETI INFUS 180 ISMA HARYANI INFUS
130 ANI CAHYANI INFUS DC 22/11/2017 181 SUCI EVITA INFUS
131 NI WAYAN INFUS 182 SUSI SUSANTI INFUS
132 DESI MIRAWATI INFUS 183 LILIS SURYANI INFUS
133 PANCA OKTARA INFUS 184 FITRI ALVIANI INFUS
134 LOVELIA INFUS 185 EVI ROSITA INFUS
135 SITI NURAENI INFUS 186 EMAWATI INFUS
16/02/2017 136 ANNA ROSDIANA INFUS 187 DEWI ANDRIYANI INFUS
137 DESTI INFUS 188 FITRI MUTIARASARI INFUS
138 SANTI AGUSTINA INFUS DC 189 LOVELLY AUDREY INFUS
139 MULYANI INFUS 190 SERLINA INFUS
140 NENG ROHAYATI INFUS DC 191 TINA MEDISTA INFUS
141 ARVA INFUS 23/11/2017 192 MAEMUNAH INFUS
142 GINI SARIWI INFUS DC 193 RIA INFUS
17/02/2017 143 NENI APRIANI INFUS 194 TITIN SUPRIATIN INFUS
144 SENTRI INFUS 195 IDA ROYANI INFUS
145 RINI DEWI INFUS 196 KIKI MARYANA INFUS DC
146 TENI SUSANTI INFUS 197 KOMALASARI INFUS
147 DESTIANTI FARIDA INFUS 198 YANI HRLINA INFUS
148 WIWIN INFUS 199 MAUDIANA INFUS
149 RENI AGUSTINI INFUS DC 200 NENI HANDAYANI INFUS
150 YUSI YANTI GUNAWAN INFUS 201 SITI MULYATI INFUS DC
151 M AZKAMULYA INFUS 202 M ARFIRO INFUS
152 NUR AISAH INFUS 203 LUSI CAHYANI INFUS DC
18/02/2017 153 DELYA HERVIATI INFUS 24/11/2017 204 CUCUN INFUS
154 AMELIAWATI ASTUTI INFUS 205 STARLA INFUS
155 SUMIATI INFUS 206 RINI YULIANTI INFUS
156 KIKI INFUS 207 YATI ROSMIATI INFUS
157 TITA ROSMAWATI INFUS 208 ROSMAYA INFUS
18/02/2017 158 AISHA NAMURI HUMAIRA INFUS 209 DINI DESTIANTI INFUS
159 M EL FATIH KAMALUDIN INFUS 25/11/2017 210 SABINA INFUS
160 BY NY YANI INFUS 211 KHALIQA NADIA D INFUS
19/02/2017 161 IMAS INFUS 212 ASSYFA INFUS
20/02/2017 162 IMAS SANTI INFUS 213 NURAINI INFUS
163 SYAKILA INFUS 214 SITI RAYANI INFUS
164 ARKA INFUS 215 WIWIN WINARTI INFUS
165 CACIH INFUS 216 DWI INFUS DC
166 ANISA INFUS 217 YOLA YOLANI INFUS
167 SITI HAJAR INFUS 218 NENG RANI INFUS DC
168 YEYEH INFUS 26/11/2017 219 TUTI ASTUTI INFUS DC
169 UMI USWATUN INFUS 220 NOVI OKTAVIANI INFUS
170 NURYANI INFUS 221 EMA AMALIA S INFUS
21/02/2017 171 HERAWATI INFUS 222 NENG SULASTRI INFUS
172 ARIN NUR MUJAHADAH INFUS 223 YANI INDRAWATI INFUS
173 ANISA INFUS 224 KIKI INFUS
174 KUSMIYATI INFUS 225 LIA MARLIANA INFUS
175 SANTI INFUS 226 IMAS CAHYANI INFUS
176 LIA YULYANTI INFUS 27/11/2017 227 HESTI INFUS
22/02/2017 177 ADE CUCU INFUS 228 SYAKIRA INARA INFUS
178 YULI PURNAMASARI INFUS 229 RIANTI NUR SUGIARTIINFUS
179 SITI SOLIHAH INFUS DC 230 ISA AMELIAWATI INFUS
180 POPON INFUS DC 231 BERLIANA NURALAMINFUS
181 DIAN INFUS DC 232 TITIN INFUS DC
182 DEASY SAFARINA INFUS 233 PENI PERAWATI INFUS
183 ANISSA DINA INFUS 28/11/2017 234 DEVI SUSANTI INFUS
23/02/2017 184 RESTI WULANDARI INFUS 235 MAYA INFUS
185 CICA SURYANI INFUS 236 PUTTY INFUS
186 TUTI INFUS 237 MIA INFUS
187 NOVI MULYANTI INFUS 29/11/2017 238 EMAWATI INFUS DC
188 NIA NURLIANI INFUS 239 ASARIA BR SIRAIT INFUS
189 SITI JUMRAH INFUS 240 NURHAYATI AGUSTINAINFUS DC
190 NANIH INFUS 241 WINA YUNI PRATIWI INFUS
191 RIKA NURLATIFAH INFUS 242 EUIS SUMILI INFUS
192 LINDAWATI INFUS 30/11/2017 243 NURLATIFAH INFUS
193 DEKE WINDIYANE INFUS 244 CICIH INFUS
194 WIWIN WIDIAWATI INFUS 245 LILIS MARYAM INFUS
195 ALIF INFUS 246 YULIANI INFUS DC
196 FARISTA INFUS 247 DESI INFUS
24/02/2017 197 WINDA INFUS 248 ASTI ANGGRAENI INFUS
198 RIKA GUSTIKA INFUS 249 SRI MULYATI INFUS DC
199 ITA JUWITA INFUS 250 LUTFI INFUS
200 FATIMAH LUBIS INFUS TOTAL 250 21
201 NITA ANGGRAENI INFUS JUMLAH PASIEN IGD 821
202 NENI RINGIANI INFUS
203 SRI MULYATI INFUS Formulir Survey Harian Pemakaian Alat
204 ANEU INFUS Ruang IGD - RSKIA BULAN DESEMBER 2017
205 SUSILAWATI INFUS DC
206 DESI APRIANTI INFUS 01/12/2017 1 AYU SILVI INFUS
207 IIS WIDIAN INFUS 2 LINA MARLINA INFUS
208 SITI FITRIAH INFUS 3 LILIS SUGIARTI INFUS
209 INDAH BAYU INFUS 4 SUDARSIH INFUS DC
25/02/2017 210 NANI YUNINGSIH INFUS DC 02/11/2017 5 AI KANIA INFUS
211 RANI NOVIANTI INFUS 6 RIKA INFUS
212 NIA MARIANI INFUS 7 REZA INFUS
213 YA YATININGSIH INFUS 8 SUGIYANI INFUS
214 RATNA KOMALA INFUS 9 OPI INFUS
215 RASY JATANUNNISA INFUS 10 SARI NURLELA INFUS DC
216 RAJENDRA PRIANDA KAMIL INFUS 03/12/2017 11 NIKEN FILANDARI INFUS
217 M.FAHMI GHUSAN INFUS 12 CHALISTA INFUS
26/02/2017 218 ANILA BENDITA INFUS 13 GANGAN INFUS
219 EKA SILVIA INFUS 14 PATIMAH INFUS
220 TUNIA ARYANI INFUS 15 DINI NOVIYANI INFUS DC
221 SISKA SETIA INFUS 16 NINING E
222 NURA BUDIANA INFUS 17 SUSYANTI INFUS DC
223 THANIA NATASA INFUS 18 YULINAR INFUS
224 NIA KUSMIATI INFUS 04/12/2017 19 SEPTIRIYANI INFUS
27/02/2017 225 RANI RAHAYU INFUS 20 DEVI S INFUS
226 YAYAH RODIAH INFUS 21 SARI APRIANTI INFUS
227 KHAYRA FIRZA INFUS 22 NENDEN SUHAETI INFUS
228 YAYAH RODIAH INFUS 23 ANI MULYANI INFUS
229 WENNY BR SIREGAR INFUS 24 ARSEN INFUS
230 ANITA INFUS 25 FUJI INFUS
231 FITRI MARYATI INFUS 26 ARSEN KIAN DERMAWAN
INFUS
232 AI JUBAEDAH INFUS 27 AHMAD BAIHAQI INFUS
233 SANDI SETIAWAN INFUS 05/12/2017 28 RINI YULIANTI INFUS
234 MULYANTI INFUS 29 RAKA INFUS
28/02/2017 235 WIWIN INFUS 30 REYHAN INFUS
236 ENUNG INFUS 31 MIMIN INFUS
238 SUKAESIH INFUS 32 ANY INFUS
239 RITA SONI IMFUS 33 YUYUN INFUS
240 DEWI MUSTIKA NINGRUM INFUS 06/12/2017 34 SUSI INFUS
241 RINA INFUS 35 NAZRIL INFUS
242 SITI MAEMUNAH INFUS 36 SUSI YANUARTI INFUS
243 NIA MARIANI INFUS 37 WIWIN NURYANI INFUS
TOTAL 243 24 38 NIA KURNIASIH INFUS
TOTAL PASIEN IGD 482 39 SARININGSIH INFUS DC
40 SITI HAFSOH INFUS
Formulir Survey Harian Pemakaian Alat 41 NOVIA RAHMAYANTIINFUS
Ruang IGD - RSKIA BULAN MARET 2017 42 SANTI SUNDARI INFUS DC
01/03/2017 1 IIN SAKINAH INFUS 43 INDAH KHAIRUUNISAINFUS
2 NENI INFUS 44 FITRIA INFUS
3 RINA MARLINA INFUS 07/12/2017 45 SARAH FRANSISKA INFUS
4 NANI HASANAH INFUS 46 ARIQ INFUS DC
5 IRA HANI INFUS DC 47 SITI HATIFAH RANI INFUS
6 WIDI MARDOTILAH INFUS 48 DINI TRI RAMDHANI INFUS
7 BY NY.PENI INFUS 49 YULIA NUR ANGGRAENI
INFUS
8 BARLEY MATHEO INFUS 50 UCU KARTIKA INFUS
9 SARAH INFUS 51 HERTI INFUS DC
02/03/2017 10 ANI INFUS DC 52 IFTITAH INFUS DC
11 YUSI MEDIA INFUS 53 DINI NOVIYANI INFUS DC
12 ANI SUMARNI INFUS 54 NITA YUNITA DEWI INFUS DC
13 TATI INFUS DC 55 DIAN TRIANDINI INFUS
14 CEDINA NOVIANA INFUS 56 WULAN SRI INFUS DC
03/03/2017 15 SUMIATI INFUS 08/12/2017 57 IRMA RIMJANI INFUS DC
16 M RASSEL INFUS 58 NENI NIAWATI INFUS
17 LILI SOLIHAH INFUS 59 FANI DWI ANDINI INFUS
18 MURSALINA INFUS 60 HOLIS SURYANI INFUS
19 SALIA RAMDAN INFUS DC 61 NENENG KARMILA INFUS
20 MUDRIKAH INFUS 62 YULIA SETIAWATI INFUS
21 ELI DAJIAH INFUS 63 AFRIANA INFUS
22 YANI ASTIANI INFUS 64 NURHAENI INFUS
23 MURSALINA INFUS 65 RISNA FERBAITA INFUS
24 KHAIRIL MARTIN INFUS 09/12/2017 66 SITI NURMALA INFUS
25 SALIA RAMDAN INFUS 67 SARI PUJIYANTI INFUS
26 MUDRIKAH INFUS 68 IDA FITRIANI INFUS
27 ELI DAJIAH INFUS 69 SITI ADELIA INFUS
28 ERNA ALFIANI INFUS 70 YANI SUMARYANI INFUS DC
29 JUMIATI INFUS 71 YUSTINA INFUS
30 SITI ARYANI INFUS DC 72 PENNI INFUS
04/03/2017 31 RATNA HODIJAH INFUS DC 10/12/2017 73 DINI INFUS
32 NUR ANGGRAENI INFUS 74 ERLIN INFUS DC
33 M RAZIQ INFUS 75 SITI SAIDAH INFUS
34 ENUNG NINGSIH INFUS 76 RITA ANDRIANI INFUS
35 IIS ISMAYANI INFUS 77 YOIS INFUS DC
36 ENI SUPRIATINI INFUS 78 LIA DAHLIA INFUS
37 TITIN INFUS 79 ELIN HERLINA INFUS
38 PESTI SULASTRI INFUS 11/12/2017 80 SITI AISYAH INFUS DC
05/03/2017 39 ROTUPA SITANGGANG INFUS 81 LISNAWATI INFUS
40 KAYLA INFUS 82 LIA MULYANI INFUS
41 AI ROHAETI INFUS 83 RENI HERAWATI INFUS DC
42 KONIJAH INFUS 84 SYIFA ASYIFA INFUS
43 SRI DEVI INFUS 85 DEWI DANIATI INFUS DC
06/03/2017 44 ENENG VERA INFUS 86 TETI HERAWATI INFUS DC
45 WIWIN INFUS 87 TITIN SURYATIN INFUS
46 EVI INFUS 88 TINA LIYAWATI INFUS
47 RATNA KARTIKA INFUS 89 YULI YANTI INFUS
48 ASIH INFUS 12/12/2017 90 TINI KARTINI INFUS
49 LENA SUHAENA INFUS 91 MEI ROSITA INFUS DC
50 DANISHA ASRI INFUS 13/12/2017 92 SRI WULAN INFUS
51 YUYUN INFUS 93 SITI NURAENI INFUS
07/03/2017 52 M. NIZAM INFUS 94 ARTI NURAENI INFUS DC
53 ROSSI ROSMAYANTI INFUS 95 IDA INFUS
54 SITI ALIYAH INFUS 96 NADIA INFUS
55 ERNI PURNAMASARI INFUS 97 YULIA PERMATASARIINFUS DC
56 EKA UMIATI INFUS 14/12/2017 98 DEWI NURSAIDAH INFUS
57 SARAH INFUS 99 YANI MULYANI INFUS
58 SUSI SUPRIYATIN INFUS 100 ZITTA FEBRIAN INFUS
59 RANI INFUS 101 TITA ROSPITA INFUS
60 M NIZAM ALFAHRI INFUS 102 NENI INFUS
61 NIZAR AFKAR RISMANTO INFUS 103 DEDEH INFUS
62 DIYAN INFUS 15/12/2017 104 NENGSIH INFUS
08/03/2017 63 EKAWATI INFUS 105 ESA SATRIA INFUS
64 MIMA MAWARNI INFUS 106 TETEH EMA SURYANIINFUS DC
65 WIWIN INFUS 107 RIKEU ANDRINA INFUS DC
66 DIDAH INFUS 108 TRIANI INFUS
67 FITRI YULIANI INFUS 109 CYNTIA MARCIANI INFUS DC
68 NATASYA INFUS 110 WINDI PUSPA INFUS
69 DANISHA INFUS 111 YULIA INFUS
70 RATNA HODIJAH INFUS DC 112 NYAI NURHAYATI INFUS
71 TITIN HENDRIYATI INFUS DC 113 SRI LESTARI INFUS
09/03/2017 72 SRI SUWARSINI INFUS 114 NURSEHA INFUS DC
73 DESI REGITA INFUS DC 16/12/2017 115 ARNI INDRIANI INFUS DC
74 ENENG ROHAENI INFUS 116 M AZKA INFUS
75 CITRA DELIA INFUS 117 SITI AISAH INFUS DC
76 YATI SUPRIYATIN INFUS 118 NELI SUMINAR INFUS
77 ELIS SUMIATI INFUS DC 119 SANTINI INFUS
78 SRI INFUS 120 IMA INFUS
79 LIA SETIAWATI INFUS 17/12/2017 121 KARMILA INFUS
80 INTAN NURWATI INFUS 122 ZAMZAM INFUS
81 OKY FARIDA INFUS 123 KHAIRUL AZAM INFUS
82 IRA HANI INFUS DC 124 DEWI INFUS DC
10/03/2017 83 RIKA INFUS 125 AISAH INFUS
84 DINI ANDRIANI INFUS 126 YESHY HERMAYANTI INFUS DC
85 SISKA INFUS 127 HERAWATI INFUS
86 SANTI INFUS 128 INDRI NURIANSYSAHINFUS
87 VIKA KARTIKA INFUS 129 ROSMAYANTI INFUS
88 IPAH MASRIPAH INFUS 18/12/2017 130 DESI KURNIATIN INFUS
89 ANGGI DWI INFUS 131 ATIK INFUS
90 DAFA INFUS 132 YUNI YUNINGSIH INFUS
91 RAFIKA INFUS 133 NINGRUM YULIAWATI INFUS
92 RIAN INFUS 134 ROSDIANI INFUS
93 AAS NURASIAH INFUS 135 ADELIA PUTRI INFUS
11/03/2017 94 YANNITA INFUS 136 SITI MUFLIHAH INFUS
95 YANI NURYANI INFUS DC 137 YOIS NURBAYANTI INFUS DC
96 NENGSIH INFUS 138 IMAS RODIAH INFUS
97 RAFADHAN INFUS 139 LILIS INFUS DC
98 PUPUT INFUS 19/12/2017 140 RISA ROSALINA INFUS
99 ASIH INFUS 141 NENG HANI INFUS DC
100 CANTI CAHYATI INFUS 142 DINAR WINDRIANI INFUS DC
101 EEM KURNIASIH INFUS 143 ASTRI ANGGRAENI INFUS DC
102 IKA KARTIKA INFUS 144 JUHAERIYAH INFUS
12/03/2017 103 SITI SUMIATI INFUS 145 SELIN MIRANTI INFUS
104 BY.NY.MIA INFUS OGT 146 DETI KURNIA INFUS
105 ARKAN INFUS 147 SANTI INFUS
106 AJENG RESTU INFUS 20/12/2017 148 DEWI INFUS
107 RISKA KRISTIANI INFUS 149 WIDANINGSIH INFUS
108 YULIANTI INFUS 150 DIAN SRI MULYANI INFUS
109 MIMIN INFUS 151 HERAWATI INFUS
110 CAHYA TRISARI INFUS 152 SARI INFUS
111 SINTIA INFUS 153 NANI INFUS
112 CHRISTELLA INFUS 154 RINA INFUS
113 JUJU INFUS 21/12/2017 155 NINA SANTYANA OKTAVIA
INFUS DC
13/03/2017 114 MIRA SARI INFUS DC 156 SADIAH INFUS
115 EKA RUSTIKA INFUS 157 ROSSI ROSMIYATI INFUS
116 HANIS INFUS 158 WIWIN INFUS
117 FITRI INFUS 22/12/2017 159 RINI INFUS
118 RIAS SRI WULAN INFUS 160 HAZNA INFUS
119 ALFARO INFUS 161 SOPIAH NURAENI INFUS DC
120 ADAM INFUS 162 TESA ANGGRAINI INFUS
121 RAZQA INFUS 163 RINI INFUS
122 NUHYANI SANDI ARIYANTI INFUS 23/12/2017 164 AYUDYA RIMA INFUS
123 NOVI ARYANTI INFUS 165 NENI RAHAYU INFUS
124 TIZZA RAHMAVI INFUS DC 166 EFA KRISNAWATI INFUS
125 RINA YULIANA INFUS DC 167 HENI ROCHAENI INFUS
126 TITIN INFUS 168 CINDI EKA INFUS
127 ARIN NURFADILAH INFUS 169 SHADIRA INFUS DC
128 SEPTI MALINDA INFUS 170 NANI INFUS DC
14/03/2017 129 INDRIYANI INFUS 171 YANTI INFUS
130 AI HAYANTI INFUS 172 DARSINI INFUS
131 LIA INFUS 173 ASTRI INFUS
132 MARYAM INFUS 24/12/2017 174 ELIS SUPINI INFUS
133 ELLY M INFUS 175 ALFAN INFUS
134 AI SULASTRI INFUS 176 IIS KOMALASARI INFUS
135 NANI KANIA INFUS 177 SANNTI INFUS
136 DENA ARKAF INFUS 178 MELANI INFUS
137 YATI RUSMAYATI INFUS DC 179 RATNA INFUS
138 NANI NURAENI INFUS DC 25/12/2017 180 FITRIYANI INFUS
15/03/2017 139 LIS RINRIN INFUS 181 MEYLIS INFUS
140 DERI INFUS 182 YULIANTI DEWI LESTARI
INFUS
141 FITRIANI INFUS 183 HERLINA INFUS DC
142 TITIN SUPRIATIN INFUS 184 IDAH INFUS
143 RUNITI INFUS 185 MAYA INFUS
144 SANTI INFUS 186 NAZRIL INFUS
145 DESI SOFIANAI INFUS 187 KARINA INFUS
146 ANNISA FITRI INFUS 26/12/2017 188 YANTI INFUS DC
147 SENA ANISA INFUS 189 RESTU SUJAYANTI PUTRI
INFUS
148 M RIZKY INFUS 190 YANYAN NURYANI INFUS
149 M FAUZI INFUS 191 HANI HANDAYANI INFUS
150 MITA SUSILAWATI INFUS 27/12/2017 190 IIS ROSITA INFUS
151 HENI INFUS 191 YATI MULYATI INFUS
16/03/2017 152 ROWIYATI INFUS 192 SITI NURAENI INFUS DC
153 RATNA RAHAYU INFUS 193 SUSILAWATI INFUS DC
154 DAFA FAHMI INFUS 194 NYI MAS NENI SUTAENI
INFUS
155 IRA WIDYANINGSIH INFUS 195 MARISSA TIO MINARINFUS DC
156 YULIANI INFUS 196 IIS ISMAYANI INFUS
157 IRA HANI INFUS DC 197 ERNI TRI WULANDARIINFUS
17/03/2017 158 NABILA SRI PUTRI INFUS 198 WIDYA INFUS DC
159 INA NURSAENAH INFUS DC 199 RIMBUN INFUS
160 NENI SUMARNI INFUS 200 TIKTIK INFUS
161 RINA SUNDARI INFUS 27/12/2017 201 MAELANI INFUS DC
162 EULIS ROHAYATI INFUS 202 YEYEN YENI INFUS
163 OYA ROHANA INFUS 203 HANA MARDIANA INFUS
164 MELISYA INFUS 204 NINING SUNINGSIH INFUS DC
165 FATIH INFUS 28/12/2017 205 DEDE NENI INFUS DC
18/03/2017 166 ANING MARYATI INFUS 206 RIKA SANTIKA INFUS
167 YETI SRI R INFUS 207 IMAS RODIAH INFUS
19/03/2017 168 MIRA INFUS 208 WIWI WIARSIH INFUS
169 AI IRMA INFUS 209 YANTI INFUS
170 ARKAN INFUS 29/12/2017 210 NINA INFUS
171 NAJWAN INFUS 211 M REZA INFUS
172 SALWA INFUS 212 RANI SETIAWATI INFUS
173 NUR HASANAH INFUS 213 RIMA NUNIK AULILLAHINFUS
174 SUSILAWATI INFUS 214 NIA NURNIASIH INFUS
175 FITRAHTULLAH INFUS 30/112/2017 215 NENI ROSMINI INFUS
176 RENI HANDAYANI INFUS 216 JEAN AMANDA INFUS
177 ANI NUR INFUS 217 SRI YULIANTI INFUS DC
20/03/2017 178 YANNITA FUZYARTI INFUS 218 LAILI SUCI HARYANI INFUS
179 ELIS ROSMAWANTI INFUS 219 FAJAR INFUS
180 ARENI INFUS 220 AINA INFUS
181 NURAENI INFUS DC 31/12/2017 221 N NENI INFUS DC
182 M AKMAL INFUS 222 IMAS YANI INFUS
183 RAFI INFUS 223 UCU INFUS
184 TRIANA INFUS 224 INDRI INFUS
185 LAELASARI INFUS TOTAL 224 51
186 RANA INFUS JUMLAH PASIEN IGD 884
187 ELLA NURLELA INFUS
188 ELLA NURLEALA INFUS
189 ULVA TANTI INFUS
190 JASMAINI INFUS
21/03/2017 191 DESI INFUS
192 SOLIKHATUN INFUS
193 HANIN AGYA INFUS
194 FATHAN INFUS
195 RATU BINTANG QIANA D INFUS
196 M.LUTFI INFUS
197 RSMAYANTI INFUS
198 ERNA ERMAWATI INFUS
199 LILIS SURYANI INFUS DC
200 LINDA INFUS
201 IKEU KARTIKA INFUS DC
202 SURYANI INFUS
22/03/2017 203 NIA MARIANA INFUS DC
204 IMAS INFUS
205 FANI ALFIANTI INFUS
206 ANGGI SAFITRI INFUS DC
207 SINTA OKTAVIANI INFUS
208 M AKMAL INFUS NGT
23/03/2017 209 ASTUNI INFUS
210 KEYLA NURASYIFA INFUS
211 RYUKEM TAKBIR INFUS
212 RITA INFUS
213 SRI MAELASARI INFUS DC
214 EULIS EMA KARMILA INFUS
215 FEBRIYYANI INFUS DC
216 MALA SURYANA INFUS
217 FELICIA INFUS
218 YUNI INFUS
219 NIKI INFUS DC
24/03/2017 220 TINA MARTRIANI INFUS DC
221 BAYU SUKMA ALANSYAH INFUS
222 ENENG ROSITA INFUS
223 WINARNI INFUS
224 LENI MARYANI INFUS
225 YOLANDA INFUS
226 ERNIAWATI INFUS
227 NURMAYA INFUS
228 EMAH NURHAYATI INFUS
25/03/2017 229 ERISNAWATI INFUS
230 RAKA PUTRA PRATAMA INFUS
231 CITRA INDAH MULYANTI INFUS
232 KHALIQA AZZALEA INFUS
233 CICAH NURJANAH INFUS
234 DEDEH IRWANTI INFUS DC
26/03/2017 235 EPA KARTINI INFUS
236 NIA MARIANA INFUS
237 KRISTIA OKTAVIANTI INFUS DC
238 TINI SUHARTINI INFUS DC
239 SRI YUNI INFUS
27/03/2017 240 SANTI INFUS
241 HERAWATI INFUS
242 RIA ROSDIANA INFUS DC
243 RANI INFUS
244 MARCELLA INFUS
245 ANDRI NURAENI INFUS
246 LIA ARDIANI INFUS
247 SITI LATIFAH INFUS
248 TATI INFUS
249 NIA INFUS
250 INDRIYANI INFUS
28/03/2017 251 SRI MULYATI INFUS
252 RINDAWATI INFUS
253 DIANA NURMAWATI INFUS
254 AGUS INFUS
255 AHMAD INFUS
256 ASYIFA INFUS
257 AZAM INFUS
258 R AGAM INFUS
259 HENI ROHAYATI INFUS DC
29/03/2017 260 NUR ALIYAH INFUS DC
261 RAFIF ALFARO INFUS
30/03/2017 262 RESTI APRILIANI INFUS
263 ERNI HENDIYANI INFUS
264 DEVI YANTI INFUS
265 NURMALA INFUS
266 AISAH HESTIANI INFUS
267 NENG YAYANG INFUS
268 ARY WISNUNINGSIH INFUS
269 RENI OKTAVIANI INFUS
31/03/2017 270 NINA INFUS DC
271 OKTA INFUS
272 FAIREL INFUS
273 TINA AGUSTIN INFUS
274 RIDHA FRIDAYANTI INFUS DC
275 IIS YANI INFUS
276 NUR KHALIMAH INFUS
277 WIWIN INFUS DC
278 FAYASKA INFUS
279 M FATIR INFUS
JUMLAH 279 37 2
TOTAL PASIEN IGD 680
Formulir Survey Harian Pemakaian Alat
Ruang IGD - RSKIA BULAN APRIL 2017
01/04/2017 1 VISA PUSPITAWATI INFUS
2 KARMILA INFUS
3 KOKOM KOMARIAH INFUS DC
4 DESI INFUS DC
5 TITING INFUS
6 TUTI MARYATI INFUS DC
7 JUWITA INFUS
8 NINA HAYATI INFUS
9 PUTRI NAZWA INFUS
10 SITI INFUS
11 SITI NURHASANAH INFUS
12 NELI PUSPITA INFUS
02/04/2017 13 NOPI SURYANI INFUS
14 KEVIN INFUS
15 RAFFI INFUS
16 SRI FUJI INFUS
17 SITI SARIPAH INFUS
18 SRI PUJIASTUTI INFUS
03/04/2017 19 ETI INFUS
20 DEVI NOVIANTI INFUS
21 SYARIFAH NUR AISYAH INFUS
22 WATI YUNIARTI INFUS
04/04/2017 23 SUMIATI INFUS
24 ELIN DEWI MARLIANA INFUS
25 PRICILLA INFUS
26 ASRINA INFUS
27 NITA INFUS
04/04/2017 28 SITI AISYAH INFUS
29 SUMIATI INFUS
30 YANI MULYANI INFUS
31 LIA NOPIANTI INFUS
32 HANA SUHAYA INFUS
33 RESTI INFUS
34 RINDA INFUS
05/04/2017 35 DEDE INFUS DC
36 NURSYIFA INFUS
37 AHMAD INFUS
38 VAMELIA INFUS
39 AHMAD MUJAHID TAJUDDIN
INFUS
40 ALTHAFUNNISA INFUS
41 ASSYAM SURYA SATRIA INFUS
42 NENG LINDA INFUS
06/04/2017 43 NONENG ROHAETI INFUS
44 FITRI ANDINI INFUS
45 RANI INFUS
46 EMA RATNAPURI INFUS
47 KEYLA AGUSTIN INFUS
48 ENI NURAENI INFUS
49 NURHAYATI INFUS
07/04/2017 50 NETTI SONIANGSIH INFUS
51 WILDAN INFUS
52 FITRI JAUARIANTI INFUS DC
53 ELVA INFUS DC
54 KOKOM KOMALA INFUS DC
55 SALY INFUS
08/04/2017 56 RASMAWANTI INFUS
57 IRNIA EKA PUTRI INFUS
58 YULI YULIANTI INFUS
59 RISA YULIANTI INFUS
60 DAYANI INFUS
61 ADE MARIYA INFUS
62 JUMIDAH INFUS
09/04/2017 63 NUR AZIZAH INFUS
64 M BINTANG INFUS
65 INARA INFUS
66 HANI INFUS
67 INTAN PERMATASARI INFUS
68 SATMA IDA INFUS
10/04/2017 69 MARIA INFUS
70 KINARA INFUS
71 M FAISAL INFUS
72 ROSIDAH INFUS
73 FITRI INFUS
74 MAYA SAPTADEWI INFUS
75 RITA INFUS
76 ELSA APRILIA INFUS
77 LAELA MUKTI INFUS
78 NISA INFUS DC
79 NITA INFUS
11/04/2017 80 TANTI NOVIANTI INFUS
81 NISA INDRI INFUS
82 AL-HAZZUL INFUS
11/04/2017 83 MISAROH INFUS
84 ELLY MARYAM INFUS
85 RENI INFUS DC
86 SISKA YULIANA INFUS DC
87 NURAZIZAH INFUS
88 SUSANTI NURJANAH INFUS
89 VINA PRATIWI INFUS
90 SANTY NURHASANAH INFUS DC
91 NAFISA INFUS
92 LINDRI ELSERA INFUS
12/04/2017 93 LUSY NURANI INFUS DC
94 ROSWITA INFUS
95 AMALIA INFUS
96 SUSAN NURHASANAH INFUS
97 WENY INFUS DC
98 SRI YULIANTI INFUS DC
99 ERNI INDAHWATI INFUS
100 AISYAH INFUS
13/04/2017 101 FATMA INFUS
102 ALIFIANDRA INFUS
103 YANI MULYANI INFUS
104 KARWATI INFUS DC
105 SANI RAHAYU INFUS
106 DIAN INFUS
107 NURFAUZIAH INFUS
108 MIRA DIAH INFUS
109 NENI ROHANI INFUS
14/04/2017 110 GENTA INFUS
111 M ARIFIN INFUS
112 HANIFAH INFUS
113 YANI NURJANAH INFUS
114 GITA INFUS
115 ENENG NURHAYATI INFUS
116 NIA GINAWATI INFUS
117 ANI KARWATI INFUS
118 WINA KARINA INFUS
119 MIRNA SEPRINA INFUS
15/04/2017 120 M REGA INFUS
121 ANA SURYANA INFUS
122 HILDA ROSTANTIA INFUS
123 TINA INFUS
124 DEA INFUS
125 SITI INFUS
126 LINA INFUS DC
127 YANI INFUS DC
16/04/2017 128 SRI JANAH TOBIBAH INFUS
129 FITRI SITI SOESAN INFUS DC
130 RENI NURFAHMI INFUS
131 SITI NURHASANAH INFUS
132 RATNA DEWI YUNITA INFUS
133 YANI SUKMAWATI INFUS DC
134 VINA HANAPIAH INFUS
135 NENI YULIANI INFUS
136 MIA AGUSTINA INFUS
137 NENG SITI FATHONAH INFUS
138 MIRA SUSANTI INFUS
17/04/2017 139 RANI NISRINA INFUS
140 KARMILA INFUS
141 ELI MERINA INFUS
142 FITRIYANI INFUS
143 RENI ANGRAENI INFUS
144 RANI TRISNAWATI INFUS
145 LIA APRIANTI INFUS
146 YULIA INFUS
147 MARYAM INFUS
148 HESTI RIZKIYANTI INFUS
149 RISSA MEGA INFUS DC
18/04/2017 150 RINA ROHMAWATI INFUS DC
151 MURSALINA ULVA INFUS
152 DEDEH INFUS DC
153 SITI FATIMAH INFUS
154 RIA PURI ANGGRAENI INFUS
155 RENI HERLINA INFUS DC
156 NINIK INFUS
157 VERAWATI INFUS
19/04/2017 158 TSUROYYA NAIMATUL TZ INFUS
159 MAYA ROHAYATI INFUS
160 NURSITI INFUS
161 KIRANA INFUS
162 RIZKI INFUS
19/04/2017 163 NENG LIDIYA INFUS DC
164 YULIA INFUS DC
20/04/2017 165 NINA MULYATI INFUS DC
166 LILIS INFUS
167 KEYLA INFUS
168 NENNI ROSDIANA INFUS
169 AGUSTINA INFUS
170 CUCU ANDANI INFUS DC
21/04/2017 171 HENI ASTUTI INFUS
172 NURSYAMSIAH INFUS
173 SITI HOERIAH INFUS
174 DIAN RACHMAWATI INFUS
175 RANI INFUS
176 CUCU MIRA INFUS
177 KARTIKA BUDIARTI INFUS
22/04/2017 178 APIPAH INFUS
179 YATI INFUS
180 YENI NURAENI INFUS
181 KOKOM KOMALA INFUS DC
182 ADARA INFUS
183 RADITYA INFUS
184 SABILA INFUS
185 SOLIHA RIZKIKA INFUS
186 ERNI ANGGRAENI INFUS DC
187 DEA INFUS
188 RIKA YANTI INFUS
23/04/2017 189 SRI MARDIANA INFUS
190 KALISA INFUS
191 ELI SOLIHAH INFUS
192 NIA GINAWATI INFUS
193 YANTI INFUS
194 YOKE INFUS
195 SUSI SUSANTI INFUS
196 TITIN INFUS DC
24/04/2017 197 YATI SUMIATI INFUS
198 ATIN INFUS
199 WENI INFUS
200 SRI YULIANTI INFUS DC
25/04/2017 201 ALIS INFUS DC
202 STEFAN INFUS
203 INDRI INFUS
204 SITI ROBIAH INFUS
205 LUSIA INFUS
206 WATI INFUS DC
26/04/2017 207 AJENG PUJI INFUS
208 KINAYA INFUS OGT
209 AZAHRA INFUS
210 ROSITA INFUS
211 YULI YULIANTI INFUS
212 SITI SARAH INFUS
213 REVI NOVIARITA INFUS
214 RANI TRISNAWATI INFUS
215 SITI AISAH INFUS
216 SUSILAWATI INFUS
217 IMAS SUKAESIH INFUS
218 SITI MASITOH INFUS
219 AGHNIA INFUS DC
220 INDAH AYU INFUS
27/04/2017 221 RISMA DIANTI INFUS
222 DARSI DUSILAWATI INFUS DC
223 CUCU KOMARIAH INFUS DC
224 FELISYA INFUS
225 MIMIN MINTARSIH INFUS
226 YULI NURLELA INFUS
28/04/2017 227 FATIH RABIATUL INFUS
228 ANI MUJIATI INFUS
229 YAYU YULIANTI INFUS
230 NUR APRILIANI INFUS
231 ICEU KURNIAWATI INFUS DC
232 PIPIH SETIANI INFUS DC
233 MAYANG FEBRIANI INFUS
234 ANNISA FAUZIAH INFUS DC
235 IRMAYANTI INFUS
29/04/2017 236 MUMUN MULYANI INFUS
237 YULIANINGSIH INFUS
238 DEDE INFUS
239 FITRI INFUS
240 ENENG INFUS
241 RINA INFUS
242 WINDI SULISTIANI INFUS DC
243 SRI LESTARI INFUS DC
244 HANI ROHAYANI INFUS
245 BY NY DINI INFUS OGT
246 M LATIEF HAKIM INFUS
247 MONICA INFUS
30/04/2017 248 LUSI INFUS
249 NIA INFUS
250 YENI SASMITA INFUS
251 MIRA SRI REJEKI INFUS
252 DEDE AISYAH INFUS
253 MIRA KUMAYANTI INFUS
254 IYA SONIA INFUS
255 LILIS INFUS DC
256 GINA INFUS
JUMLAH 256 42 2
TOTAL PASIEN 789

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN MEI 2017
01/05/2017 1 FERA INFUS DC
2 ANDRIYANI INFUS
3 NINING SUPRAPTI INFUS DC
4 YULIYANTI INFUS
5 INTAN R INFUS
02/05/2017 6 CUCU SUMIATI INFUS
7 ARYA INFUS
8 SITI SOLIHAH INFUS
9 KARNETI INFUS
10 UFAIRAH INFUS
11 HOIRUN NISA INFUS
12 MOCHAMAD IQBAL MAULIDIA
INFUS
13 DIAN ABRIANTI INFUS
14 RENI MARLIANI INFUS DC
15 MIA ROSMIAWATI INFUS
16 IIS SUMIATI INFUS
17 MEGA ASTUTI INFUS
03/05/2017 18 DEDEH INFUS
19 KARTIKA BUDHIANI INFUS
20 DIANA KURNIASIH INFUS DC
21 ALIFAH INFUS
22 FADLULLAH INFUS
23 IIM PATIMAH INFUS
24 RENI MUTIARA INFUS
25 YENNY INFUS
26 MIRA SRI REZEKI INFUS
27 MIRNA PURWANI INFUS
28 ITA RATNA KOMALA INFUS DC
04/05/2017 29 SUGIYANTI INFUS
30 LETI INFUS DC
31 SANTI NURBAYANTI INFUS
32 EVI ULIN INFUS
33 WIDIA INFUS
34 FELLY NUR ARIFAH INFUS DC
35 LINA MARYANA INFUS
36 META AGUSTIN INFUS
37 ADIVA INFUS
05/05/2017 38 PARTEM INFUS
39 SARI YULIANA INFUS
40 SARI AISAH INFUS
41 WIDI UTARI INFUS
42 SONA APRILINA INFUS
43 NENG LINDA INFUS
44 ZAYAN MUHAMAD INFUS
45 SITI SOLIHAH INFUS
06/05/2017 46 SRI MULYANI INFUS
47 NINING SUPRAPTI INFUS
48 YUNIATI INFUS
49 SUSI SUSANTI INFUS
50 HARIYATNA INFUS
07/05/2017 51 WIDI UTAMI INFUS
52 IIS NENIH NURYANI INFUS
53 ERLIN INFUS
54 SITI FATIMAH INFUS DC
55 ARTI INFUS
56 WINA NINGSIH INFUS
57 NILA INFUS
08/05/2017 58 MEIKE VERONIKA INFUS
59 YANTI SUSANTI INFUS
60 NADIA INFUS
61 ADRIEL INFUS OGT
62 NIA SANDRAYANI INFUS
63 IPAH CASTIPAH INFUS
64 EUIS INFUS
65 ANNE NUR ELVIANE INFUS DC
09/05/2017 66 NENDEN HOLIPAH INFUS DC
67 SITI NURAISAH INFUS
68 PRISKA INFUS
69 IMAS INFUS
70 RANI NOVITASARI INFUS
71 SUSWATI INFUS DC
72 ATI ROHAYATI INFUS
73 FEBRIANI CAHYA INFUS
74 RINA SUSANTI INFUS DC
10/05/2017 75 HANI SUKMAWATI INFUS DC
76 WINDA SARI INFUS
77 NIKI WULANDARI INFUS DC
11/05/2017 78 PUTRIPUSPITA ASRI INFUS
79 FATUROHMAN INFUS
80 NENG MULYANI INFUS
81 NACITA INFUS
82 CUCU NURHASANAH INFUS DC
83 IPAH CASTIPAH INFUS
84 HENI INFUS
12/05/2017 85 LISNAWATI INFUS DC
86 DEWI JUNIRAHAYU INFUS
87 M AKBAR INFUS
88 JUANINGSIH INFUS DC
89 REKA AMALIA INFUS
90 NOVY FRANSISKA INFUS
91 FRISKA NOVFRIANI INFUS
92 SRI MULYATI INFUS DC
93 HERA INFUS
94 YANTI INFUS
13/05/2017 95 DESI INFUS
96 DIAN RACHMAWATI INFUS DC
97 AQIFA INFUS
98 WIWIN INFUS
99 NIKI WULANDARI INFUS DC
100 NUNUNG INFUS DC
101 CICIH INFUS
102 AISAH HESTIANI INFUS DC
14/05/2017 103 SRI PUJIANTI INFUS
104 SADIAH KOMALASARI INFUS
15/05/2017 105 CUCU KURNIAWATI INFUS
106 M FADIL INFUS
107 NURHASANAH INFUS
108 NONI ANDRIANI INFUS
109 MELISA INFUS
110 IMAS INFUS
111 JUBAEDAH INFUS
112 SITI SOIMATUN INFUS
113 DELA INFUS
16/05/2017 114 HERAWATI INFUS
115 RATIH APRILIANI INFUS
116 RATIH APRILIANI INFUS
117 AKBAR INFUS
118 RATNA SITI KHODIJAH INFUS
119 IRMA IMEILDA INFUS
120 DEVI NURBANI INFUS
121 DEWI PURWASIH INFUS
122 MERRYANI INFUS
123 RAISA INFUS
124 HADAD HASANUDIN INFUS
125 SANTI WIANTI INFUS
17/05/2017 126 DESI AGNIWATI INFUS
127 EROS ROSMAYA INFUS DC
128 NURFATIMAH INFUS
129 DIANA INFUS DC
130 N IDA FARIDA INFUS DC
131 ICEU INFUS DC
132 SITI SOLIHAH INFUS
133 RENI ANDRIANI INFUS
18/05/2017 134 SUSI SUNDARI INFUS
135 YULIATI INFUS
136 DIAN RACHMAWATI INFUS DC
19/05/2017 137 LESSY LESMAWATI LESMANA
INFUS
138 ELIA PUTRI INFUS DC
139 AL HAZZUL TAMYIZI INFUS
140 ESHAN GHANY F INFUS
141 NINING INFUS
20/05/2017 142 YULI TALIWONGSO INFUS DC
143 DEVI KUSUMAWATY INFUS DC
144 EVA NURDIAN INFUS
145 YULIANTI INFUS
146 REGINA INFUS
147 HANI INFUS
148 HARMONI PUTRA ALAMI INFUS DC
21/05/2017 149 FRANSISKA INFUS DC
150 IMA INFUS DC
151 DEWI INFUS DC
152 NIA CHAIRUNISA INFUS DC
153 IDA INFUS DC
154 TRI WAHYU UTARI INFUS
155 SURYATI INFUS
156 JUJUN INFUS DC
157 KARMILA INFUS DC
22/05/2017 158 GINA RATIH INFUS
159 NENG LILIS INFUS
160 NAZWAN HAKIM INFUS
161 AZRIL INFUS
162 WELLY MARYETI INFUS
163 ANI AGUSTIN INFUS
164 CUCU NURHASANAH INFUS
165 IIS YULIANTI INFUS DC
166 WINNA INFUS
167 YAYUK INFUS
168 ENI JULFAH FITRIA INFUS DC
169 GEA GUSTIYAN SEPTIANI INFUS
23/05/2017 170 MULYA ALPIANTI INFUS
171 SITI NURHASANAH INFUS
172 RIZKY INFUS
173 YAYAN SARTIKA INFUS
174 MAYANG FEBRIANI INFUS
175 PUTRI AHDIANI INFUS
24/05/2017 176 DESI RISMAWATI INFUS
177 WENNY KIRANA INFUS
178 LAELA INFUS
179 ELLA P INFUS
180 ZULPIAN INFUS
181 RITA ROSMAYANTI INFUS DC
26/05/2017 182 KRISTIN INFUS
183 ANANDIA INFUS
184 AUDI SHERIL INFUS
185 ASSYAM INFUS
186 SIFA INFUS DC
187 SUTEMI INFUS
188 TETI MISRIANI INFUS
189 MULYATIN INFUS
27/05/2017 190 DEVI INFUS
191 GALIH INFUS
192 AAN KURNIASIH INFUS
193 IIS DESTIANI INFUS
194 ANE INFUS
195 SULASTRI INFUS
196 REGINA INFUS
28/05/2017 197 MILA INFUS
198 KUSYANTI INFUS
199 FITRI INFUS
200 ZHAFARUNADIRIN INFUS
201 LALA AISYAH INFUS DC
202 NENG EROS INFUS
29/05/2017 203 LALA AISYAH INFUS DC
204 YUNIARTI INFUS
205 DEWI SITI JAMILAH INFUS DC
206 LIA KANIAWATI INFUS
207 ENENG WIDIAWATI INFUS
30/05/2017 208 AI ROHAENI INFUS
209 SITI HASANAH INFUS DC
210 ZIBRAN MORENO INFUS
211 LINDA INFUS DC
212 MELI ANISA INFUS
213 FATMA KARTIKA SARI INFUS
214 ECHA INFUS
31/05/2017 215 NUR RAHMA ISLAMI INFUS DC
216 MUKIDATUN INFUS
217 RIRIN INFUS
218 NOPI SUSANTI INFUS
219 KUSTINI INFUS
220 TITA JUWITA INFUS
221 DWI A INFUS
222 AJI SULASTRI INFUS
223 SITI MAE INFUS
TOTAL 223 48 1
JUMLAH PASIEN IGD 764

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN JUNI 2017
01/06/2017 1 INA FATIMAH INFUS
2 SUSAN SUSANTI INFUS DC
3 RINA AGUSTIANI INFUS
4 ALEA INFUS
01/06/2017 5 RINA SUSANTI INFUS
6 TRI PUDIYASTUTI INFUS
7 YUNI YULIANI INFUS
8 IMAS ROHAYATI INFUS
02/06/2017 9 SIX MARIA MARGARETA INFUS
10 RESA MARSELA INFUS
11 DANIA INFUS DC
12 ELSA SOPIANTI INFUS
13 ROHANI INFUS DC
14 MIRAWATI INFUS
15 SINTA MUSTIKA INFUS
16 KANIA SUKMAWATI INFUS
17 SUSILAWATI INFUS
03/06/2017 18 DETI MULYANI INFUS
19 ERNA INDRIYANTI INFUS DC
20 ROHIMAH INFUS
21 NINDI INFUS
04/06/2017 22 IROS ROSITA INFUS
23 FITRI PERTIWI INFUS
24 ANITA NOVIYANTI INFUS
25 NOVI ROSMAYANTI INFUS
26 NUR CAHYATI INFUS
27 HOTNI SITOHANG INFUS
28 LISNA ISMAYA SARI INFUS
29 AI SUMIATI INFUS
30 AULIA KHOERUNISA INFUS
05/06/2017 31 ARNI SUHERDIANI INFUS
32 SILLVIA INFUS DC
33 IKA SUPARTIKA INFUS
34 PARISA HAKIM INFUS
35 ARKA INFUS
36 ROMADHONA YUNI INFUS DC
37 NIA INFUS
38 UNING INFUS
39 IRMA YUNITA INFUS
40 SITI NURUL SARI INFUS
41 SILMI INFUS
42 TIKA WININGSIH INFUS
43 IRMAWATI INFUS DC
44 SYLMI INFUS
45 FITRIYANI INFUS
46 DARYANTI INFUS
06/06/2017 47 ISKA INFUS DC
48 WIWIN WIDIANTI INFUS
49 NURYANTI INFUS
50 YESI INFUS
51 TATI INFUS DC
52 EVI SETIAWATI INFUS
53 PUJI RAHAYU INFUS
54 AULIA TIFANI INFUS
55 IN IN NURDINI INFUS
07/06/2017 56 YUNI HARIANI INFUS DC
57 MIRA UTAMI INFUS DC
58 FAUZI ISLAMI ALAWIYAH INFUS
59 IDA FITRIANI INFUS
60 ENAH INFUS DC
61 ARKA INFUS
62 AULIA KHOERUNISA INFUS
63 INA M INFUS
64 RINA INFUS
07/06/2017 65 SRI MUYANI INFUS DC
66 MELANY INFUS
08/06/2017 67 WINA MUHARI INFUS
68 WIDYA PUJI ASTUTI INFUS
69 MILDA INFUS DC
70 ERNA INFUS
71 LUTFIYA NINGRUM INFUS
72 RINI INFUS
73 SYIFA INFUS DC
74 RUSEL RAMDANI INFUS
75 SYIFA INFUS DC
09/06/2017 76 WAHYUNI INFUS
77 ANING INFUS DC
78 LILIS YULIAWATI INFUS DC
79 ALFATHAN INFUS
80 ELLY MARLIYA INFUS DC
10/06/2017 81 LILIS INFUS
82 SITI SUWAESTI INFUS
83 NENG YETI INFUS
84 AI SITI HASANAH INFUS
85 NENI HARYANTI INFUS
86 NADIRA INFUS
87 NOVIAWATI INFUS
88 REKHA INFUS
89 YULI INFUS
90 RATU ULFAH INFUS
11/06/2017 91 ETI SURYATI INFUS
92 SITI FATIMAH INFUS
93 RANI NURHABIBAH INFUS
94 YANTI INFUS
12/06/2017 95 NENG HARTINI INFUS
96 RAKHA INFUS
97 NADIRA INFUS
98 ISE INFUS
99 RISMAWATI INFUS
100 ELIS DARSINAH INFUS
101 SITI ROMLAH INFUS
102 DEWI INFUS
13/06/2017 103 VANNY INFUS DC
104 PIPIN PITRIH INFUS
105 M ALFARIZY INFUS
106 ZYAN INFUS
107 ROSITA INFUS
108 ANASTAYA RINATULI INFUS
109 AMI INFUS
110 DESI ARYANTI INFUS DC
111 SITI MASITOH INFUS
14/06/2017 112 IDA ROSIDA INFUS DC
113 EKA PUJIANI INFUS DC
114 WINDA SRIWIDARI INFUS
115 SITI ROSITA INFUS DC
116 YOHANITA INFUS
117 SARI NIVIANTIKA INFUS
118 TITA TRISNAWATI INFUS
119 IIS SITI RUBIAH INFUS
120 POPI HADIANTI INFUS DC
121 M FAEYZA INFUS
122 ALARRIC AZZAHIDI INFUS
123 ARSILA NUR SIDQIA INFUS
124 IPAH INFUS
125 SITI JULAEHA IMFUS DC
15/06/2017 126 LILIS INFUS
127 SANTI AMELIA INFUS DC
128 NURHAYATI INFUS
129 AJENG INFUS
130 SANTI SARIPAH INFUS
131 LIA MEIDAWATI INFUS
132 RINI PERMATASARI INFUS
133 NENG WIDA NENGSIH INFUS
DHAFA ARYA INFUS
16/06/2017 134 SHABRINA S INFUS DC
135 IIS NURYATI INFUS
136 RAISA FEBRIAN INFUS DC
137 ROHAENI INFUS
138 EKA NURHAYATI INFUS
139 YUNIARTI INFUS
140 MEGA NURAINI INFUS
141 YULINDA DEVIYANTI INFUS
142 HIRMAWATI INFUS DC
143 DEDE RODIAH INFUS DC
144 VERA SETIAWATI INFUS
17/06/2017 145 ELA INFUS
146 ROMADHONA YUNI INFUS
147 YANTI INFUS
148 LILIS MULYANI INFUS
149 BY NY AI SOLIHAH INFUS
150 TIFANI INFUS
151 YUNI MINTARSIH INFUS DC
18/06/2017 152 NENI INFUS
153 TRI ASTUTI INFUS
154 YETI INFUS
155 ELI SUMINAR INFUS
156 UMI ISTIKOMAH INFUS
19/06/2017 157 HERLINA INFUS DC
158 KARTIKA NURLAELA INFUS
159 DETTI SULASTRI INFUS
160 CARTINAH INFUS
161 VINA NOVIANA INFUS DC
162 RANTIANA INFUS
163 KOKOM KOMARIAH INFUS DC
20/06/2017 164 TATI RAHMAYANTI INFUS
165 ETI SUKAESIH INFUS
166 TITIN NURHAYATI INFUS DC
167 SITI MAEMUNAH INFUS
168 SITI SADIAH INFUS
169 DEWI YULIANTI INFUS
170 YANTI INFUS
171 FITRI MELIYANA INFUS DC
21/06/2017 172 MAYA ENDAH INFUS DC
173 YANTI NUR SHOLEHAH INFUS
174 EVI EVIPAH INFUS
175 NENG SHALU INFUS
176 NANAY APRIYANTI INFUS
177 NENNEU SUWARNI INFUS DC
178 YUYU YULIANTI INFUS
179 VANNY INFUS DC
180 POPON SUMYATI INFUS
181 KOKOM KOMARIAH INFUS
182 DESI WIDIARTI INFUS DC
183 SYIFA NURSANDI INFUS
22/06/2017 184 FITRI INFUS
185 YULIA DEWI INFUS
186 BY NY YUNI INFUS
187 HASAN MUGHNI INFUS
188 JUAN AKTA INFUS
189 ARSYLA INFUS
190 ASTRI INFUS DC
23/06/2017 191 YULIANTI INFUS
192 SITI ROHMAH INFUS
193 AAS RAHMAWATI INFUS
24/06/2017 194 NENG SITI INFUS
195 ENI INFU S
25/06/2017 196 SITI AMINAH INFUS DC
197 KLEDIS INFUS
198 NURASIAH INFUS
199 NANI ROHAENI INFUS
200 ITA ROSITA INFUS
201 SRI WAHYUNI INFUS
26/06/2017 202 IDA FARIDA INF
203 MARA MITRA KUTRI INFUS
27/06/2017 204 NENG FAUZIAH INFUS
205 RINA INFUS
206 FITRI INFUS DC
207 ILIN INFUS DC
28/06/2017 208 PUTRI INFUS
209 RENA INFUS
210 ARVINO INFUS
211 GITA INFUS
29/06/2017 212 MITA INFUS
213 MAESAROH INFUS
214 ATI SUSILAWATI INFUS
215 ALIN INFUS
30/06/2017 216 ATI SUSILATI INFUS
217 DESTA INFUS DC
218 NURIAH INFUS DC
219 ERNA MARYANTI INFUS
220 SUPARTINI INFUS DC
221 SETIAWATI INFUS
222 RAYSYA INFUS OGT
JUMLAH 222 48 1
JUMLAH PASIEN IGD 700

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN JULI 2017
01/07/2017 1 PIPIT INFUS DC
2 TITIN SITI FATIMAH INFUS DC
3 ELIN HERLINA INFUS DC
4 DINI ARYANI INFUS
5 ROMADHONA INFUS
6 SARI DEWI INFUS
7 SRI SULASTRI INFUS
02/07/2017 8 SITI KHODIJAH INFUS
9 DATING INFUS
10 AYU TAMARA INFUS
11 DESTA KAMELIA INFUS
12 MIRA ROSDIANA INFUS
13 RINA INFUS
03/07/2017 14 SARI DEWI INFUS
15 SITI SRI SUMARYATI INFUS
16 SITI HAMIDAH INFUS
17 YUNIA WULANDARI INFUS
18 ADYTIA SITI DAMAYANTI INFUS
19 MARYAMAH INFUS
20 SAQILA PUTRI BILQIS INFUS
21 RISYA INFUS
22 ADRIAN PRATAMA INFUS
04/07/2017 23 LIA MULYASARI INFUS
24 M ARDIANSYAH INFUS
25 IRENE INFUS
26 ANASYA INFUS
27 LENI INFUS
28 WIWI LESTARI INFUS
29 GINA INFUS
05/07/2017 30 FELISYA INFUS
31 DEWI INFUS
32 ASUM SUMIAATI INFUS
33 WIWI SEPTIANA INFUS
34 IIS SITI FATIMAH INFUS
35 ELIS INFUS
36 ROMADHONA INFUS DC
37 KUSNI INFUS
38 NAOMI RUSMAYANTI INFUS
06/07/2017 39 IDA WATI INFUS
40 SRI SULASTRI INFUS
41 NUNUNG HAYATI INFUS
42 SUMINAH INFUS
43 USWAH PAUZIAH INFUS
44 YUYUN INFUS
45 MUTIA INFUS
46 ASTI YULIANTI INFUS
07/07/2017 47 WITA PUSPASARI INFUS
48 DIDA EKA PUSPITASARI INFUS
49 HERNI RAHMAWATI INFUS
50 MEGA PANTI SARI INFUS
51 DIAN MARYANI INFUS DC
52 ANGGI INFUS
08/07/2017 53 EKA CITRA PUTRI INFUS
54 YENI NURHAYATI INFUS
55 ANNY SRI WAHYUNI INFUS DC
56 RENI SARA INFUS
57 NENI INFUS DC
58 MILAH INFUS
59 AMANDA INFUS DC
09/07/2017 60 TINA TRESNAWATI INFUS
61 TIKA INFUS DC
62 ERNAWATI INFUS
63 ELI RATNA INFUS
64 DIAN PUSPITA INFUS
65 SIDQIA INFUS
10/07/2017 66 ELAH INFUS
67 RAZKA INFUS
68 AIRA INFUS
69 AI ROHAYATI INFUS
70 INE INDRIANI INFUS
11/07/2017 71 CUHYATI INFUS
72 DEVIKA INFUS OGT
73 MEISYA PUTRI INFUS
74 DIMAS ROMADHON INFUS
75 ENGKUN KUNAH INFUS
76 HOLISOH INFUS DC
77 NOVITA DC
78 AAM AMALIA INFUS DC
79 RINI INFUS
80 SANI AGUSTIANI INFUS DC
81 REZA AULIA ZAHRA INFUS
12/07/2017 82 RIKE INFUS
83 RENI KUSMAWATI INFUS
84 ADAH INFUS
85 YENI SULASTRI INFUS
86 TANTI HANDAYANI INFUS
87 JATUYUNI INFUS
88 INDAH DIAN INFUS
89 RINA ROSANTI INFUS
90 LIANTI SOLIHAT INFUS
13/07/2017 91 ROSMANAH INFUS DC
92 PARIDA INFUS
93 DIAN WANDIANTI INFUS
94 NINA ANGRAENI INFUS DC
95 SINDI NURYANTI INFUS
14/07/2017 96 TANISAH INFUS
97 YOKEU INFUS DC
98 MIMIN INFUS
99 IRA JUNIARTI INFUS
100 BY. NY MELLY MELVIRA INFUS
101 NIA INFUS DC
15/07/2017 102 YANTI SUSANTI INFUS
103 ZEIN SEKELKHATABI INFUS
104 SUCI NURAJIJAH INFUS
105 ASTRI WIDIA GUNA INFUS
106 SONA ARIFANI INFUS
107 KUSMIRAH INFUS
108 RINRIN INFUS
16/07/2017 109 NURHAYATI INFUS
110 PUTRIANI DEWI INFUS
111 NEULIS INFUS DC
17/07/2017 112 NOVI ENDAH LESTARI INFUS
113 ARKHANA INFUS
114 NUR RIYATAN INFUS
115 SANTI SAPUTRI INFUS DC
116 SINTA INFUS
117 RIKAWATI INFUS DC
118 EGA NURHABIBAH INFUS
119 ELIS INFUS
18/07/2017 120 ENENG JUHARIAH INFUS
121 DEWI DAMAYANTI INFUS
122 TINA ANGGRAENI INFUS
123 WULAN WIHARNINGSIH INFUS
124 AI YUNENGSIH INFUS DC
125 WIWIT FURWATI INFUS
19/07/2017 126 VERAWATI INFUS
127 RAISYA MUHAMAD ATAYAINFUS
128 M. HISYAM NASUTIO INFUS
129 YUDA FERDIANSYAH INFUS
130 SITI AISIAH INFUS
131 NITA YUNITA INFUS
132 HANIRAHMAWATI INFUS
133 ENENG YANI INFUS
134 SUMIATI INFUS DC
135 NURLAELASARI INFUS DC
136 SUCI NOPIANTI INFUS
20/07/2017 137 TANTI SRI ARYANTI INFUS
138 LINDA PERMATASARI INFUS
139 INTAN APRILIANI INFUS
140 IIS NANI LATIFAH INFUS
141 SITI MAEMUNAH INFUS
142 SITI NURJANAH INFUS DC
143 ANGGI INFUS DC
144 RINI DIRGAHAYU INFUS DC
21/07/2017 145 ARPI PERTIWI INFUS
146 ETHAN MARTIN INFUS
147 TINI KARTINI INFUS DC
148 TITA SUCIHATI INFUS
22/07/2017 149 YAYANG INDRI INFUS
150 AZMI IRAWAN INFUS
151 M.RASYID INFUS
152 IIT INFUS DC
153 MIA INFUS
154 MULYANAH INFUS
155 SITI ROMLAH INFUS DC
23/07/2017 156 RINI SUMIYATI INFUS
157 SABRINA INFUS
158 DATING SOLIHAT INFUS DC
24/07/2017 159 DEDE FATIMAH INFUS
160 GINRAN INFUS
161 ANANDA INFUS
162 POPY SRI INFUS
163 ANI INFUS
164 INES INFUS
165 SITI SOLIHAT INFUS DC
166 TITIN HAERANI INFUS
167 DEWI ASIH INFUS
25/07/2017 168 NINA MARLINA INFUS DC
169 NURWINDA INFUS
170 RINA INFUS DC
171 DEDE YATI INFUS
172 ANITA NURTIANI INFUS
26/07/2017 173 PUJI UTAMI INFUS
174 RAFA INFUS
175 ELFINA INFUS
176 LISNA INFUS DC
177 NIA AGUSTINA INFUS DC
178 DWI SRI WULAN INFUS DC
27/07/2017 179 NENI TRIANA INFUS
180 STEFAN INFUS
181 FATIMAH INFUS
182 WIDAWATI INFUS
28/07/2017 183 TETI ROHAETI INFUS
184 NAJWAN INFUS
185 ERNA NUR DARISMAWATIINFUS
186 KOMALASARI INFUS
187 SUMIATI INFUS DC
188 NIA INFUS DC
189 RINA INFUS
29/07/2017 190 VINNY INFUS DC
191 MINTARSIH INFUS
192 NENG MIRA INFUS
193 ANDRIANI INFUS
194 NIA INFUS
195 WINDA NOPIYANTI INFUS
196 KAKA REFKI INFUS
197 SITI FATIMAH INFUS
30/07/2017 198 SATIAWATI INFUS
199 SANDY DJAJA INFUS
200 AI ROHAYATI INFUS DC
31/07/2017 201 GINA GARNEWI INFUS DC
202 KOMALAWATI INFUS
203 IKA FADILAH INFUS
JUMLAH 203 41 1
TOTAL PASIEN IGD 563

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN AGUSTUS 2017
01/08/2017 1 JUJU JUWITA INFUS
2 SYIFA AL MUDHALIFAH INFUS
3 ASTRI MAWATI INFUS
4 SHAQUEENA ARETHA MECCA
INFUS
5 NADIA ARSY INFUS
6 FATIH INFUS
7 NIA AFNI INFUS
8 TITA INFUS
9 VIRNA ERTIANA INFUS
10 ULFA FATIMAH INFUS
02/08/2017 11 NURAENI INFUS
12 ROHAENI INFUS
13 PIPIT SUPRIATIN INFUS DC
14 LILIS KHOIRUNISA INFUS
15 SITI JULAEHA INFUS
03/08/2017 16 ROHAYATI INFUS DC
17 NENDI RAMDANI INFUS
18 FAUZAN INFUS
19 M FAREL AL FARIZI INFUS
20 ALZAIDAN INFUS
21 RAHMI INFUS
22 NURVIANTI INFUS
04/08/2017 23 ROSMANA INFUS
24 ANING LASMINI INFUS
25 RISKA NUER ENDAH INFUS
26 TANTI OCTAVIANI INFUS DC
27 WARIAH INFUS
28 SITI SARININGSIH INFUS
29 ELI NURAENI INFUS
05/08/2017 30 RISKA HERLY INFUS
31 AURA HUMAIRA INFUS
32 LENNY MEGAWATI INFUS DC
33 CHENY YASIARANTI INFUS
34 ROSMAYANTI INFUS
06/08/2017 35 KANIA INFUS
36 YOSI INFUS
37 VINA INFUS
38 LINA KARLINA INFUS
39 DETI HANDAYANI INFUS
07/08/2017 40 RISTINA INFUS
41 ARZIEKY INFUS
42 ARSILA INFUS
43 YANI SURYANI INFUS DC
44 IMAS JUBAEDAH INFUS DC
08/08/2017 45 ILAH HALIMAH INFUS
46 EVI INFUS DC
47 ENTIN INFUS
48 WIDIAWATI INFUS
49 SITI RUMAENI INFUS
50 ANI JULAENI INFUS DC
51 ELA INFUS
52 SITI HARYANI INFUS
53 NENENG INFUS
09/08/2017 54 NURHAYANI INFUS
55 MARK VALENTINO INFUS
56 MUHAMMAD KAYSYAR INFUS
10/08/2017 57 MEHRI JANITRA INFUS
58 NAKIA APRILIA INFUS
59 ELI SITI NUEATI INFUS
60 LINDA INFUS
61 RENI HARYANI INFUS
11/08/2017 62 HARYATI INFUS
63 DEVI FITRIA INFUS
64 TENI MUNAWAROH INFUS
65 SANTI NURMALASARI INFUS
66 DINI GUSTI ANJANI INFUS
67 TRIANA AGUSTINA INFUS
68 ROSTINI INFUS
69 SUMIATI INFUS DC
70 RISNA HENDRAYANI INFUS DC
12/08/2017 71 DUSTI INFUS DC
72 IRMA INFUS DC
73 RADIKA RAMDANI INFUS
74 IRMA INFUS DC
13/08/2017 75 GABRIELLE FRISYLIANA INFUS
76 MAHARANI INFUS DC
77 WIDA INFUS
14/08/2017 78 EMIL INFUS
79 KHANSA SYAWALI INFUS
80 M AL AZAM INFUS
81 DEDEH JUANINGSIH INFUS
82 UUN UNENGSIH INFUS DC
83 FRIANI MALINIA INFUS
84 DEDE INFUS DC
85 FILDA INFUS
86 YANI INFUS
87 NINING INFUS
88 AI SARI INFUS
15/08/2017 89 CANDRA WULAN INFUS
90 ANI AERANI INFUS
91 YANI MARYANI INFUS
92 DINAR ROKAYAH INFUS
93 TITA MINTARSIH INFUS
94 INTAN ALMAIDAH INFUS
95 HERLIAWATI INFUS
96 ERLIN INFUS
97 NOPI INFUS
16/08/2017 98 MAYA RACHMAWATI INFUS
99 ROS ENROS INFUS
100 ATIH HANDAYANI INFUS
101 DEASY TRESNAWATI INFUS
102 YUSI HELVINA INFUS
103 FITRIA INFUS
104 RIN RIN ANDRY YANI INFUS
105 MARIA ULFAH INFUS
106 WINI WINIARTI INFUS
107 CASMINI INFUS
108 SISKA INFUS
17/08//2017 109 LENI INFUS
110 IN IN INFUS DC
111 DEDEH INFUS
112 RITA PURNAMASARI INFUS
113 ANI MULYANI INFUS
18/08/2017 114 EULIS NURHAYATI INFUS
115 INARA ADYA INFUS
116 M SHAQIEL KURNIAWAN INFUS
117 NENTI INFUS
118 LINDIANI URDIAN INFUS
119 MAYA OKTARIA INFUS
120 RISKI AMALIA INFUS
121 DINA FARADILA INFUS
122 RIYAH INFUS DC
123 DEWI INFUS DC
124 PURWANTI INFUS
19/08/2017 125 SUSI LAWATI INFUS
126 NAKIA APRILIA INFUS
127 ALESYA INFUS
128 DEDE INFUS
129 SOLIHAH INFUS
130 NURANI YURIDASARI INFUS DC
131 MOSLIHAH INFUS DC
132 IMAS MASRIAH INFUS DC
133 ROS ENROS INFUS
20/08/2017 134 ENDAH INFUS DC
135 NURHOFIFAH INFUS
136 NOVAL INFUS
137 WINDA DAMAYANTI INFUS
138 ATIK SUMIATI INFUS DC
139 FINA SEPTIANA INFUS
140 YUYU YUNINGSIH INFUS DC
141 SOPIAH INFUS DC
142 MIA RATNA INFUS
143 ERMA INFUS
144 PANI INFUS
21/08/2017 145 TITA SRI HARTATI INFUS
146 M GALANG INFUS
147 YENI MULYANI INFUS
22/08/2017 148 LENI INFUS
149 RATNA DILA INFUS
150 VADILA TRISKI INFUS
151 RIVI ARTA INFUS DC
152 KARTINI INFUS
153 CANDRA KIRANA INFUS DC
154 LINA UMAR INFUS
23/08/2017 155 INDRI SUSANTI INFUS
156 RADITYA INFUS
157 RENI RESNALAWATI INFUS
158 NITA SURYANI INFUS
159 LENI SEPTIANI INFUS
160 FEBY NOVIANTI INFUS
24/08/2017 161 ARTI MELLANI INFUS DC
162 GILANG RAMADAN INFUS
163 NURHAMALIN INFUS DC
164 NINA INFUS DC
165 RINI MARYANI INFUS
166 LAELATUL MUNAWAROH INFUS
25/08/2017 167 NINA PURNAWATI INFUS DC
168 SRI RAHAYU SOPIAH INFUS
169 MILA KARMILA INFUS
170 DAHLIA NURIATI SIPAYUNGINFUS DC
171 HESTY INFUS
172 SRI SARBINI INFUS
173 TITA ROSITA INFUS
174 YENI NURAENI INFUS
26/08/2017 175 RINAWATI INFUS DC
176 YAFIE SALAMUH INFUS
177 DEWI KURAESIN INFUS
178 EFI FARDIYATI INFUS
179 TINA INFUS DC
180 DIAN INFUS
27/08/2017 181 RATU INFUS
182 ANI MARYANI INFUS
183 WARLIANI RIZKA INFUS DC
28/08/2017 184 RINA INFUS
185 AISYAH SILMI AFIQO INFUS
186 GIORGIO ARBANI RAMADHANINFUS
187 MUHAMMAD RADIX ABRAR INFUS
188 NATHANAEL INFUS
189 ARSYAKA VIRENDRA SYADIDINFUS
190 IMAS NURAENI INFUS
191 ANAH HASANAH INFUS
192 ANI SYAMSIAH INFUS
193 RATIH NEVIANY INFUS
194 SANI APRIANI INFUS
195 NURHASANAH INFUS DC
196 ILAH KARMILAH INFUS DC
197 RITA DJUWITA INFUS
198 IDA PARIDA INFUS DC
29/08/2017 199 IKARINA SRI HASANAH INFUS
200 ROSSA HUMAIRA AGUSTININFUS
201 NIA KURNIAWATI INFUS
202 PARIDA EKA JULIATI INFUS
203 IMAS SITI INFUS
204 EVI DAMAYANTI INFUS
205 REFI INFUS
206 TUSIYANTI INFUS
30/08/2017 207 DEDE INFUS DC
208 RISMAWATI INFUS
209 ABRARUZ INFUS
210 LAYANA HAURA INFUS
211 AI DEWI INFUS
212 PASKA JUDIKA INFUS
213 WINNI INFUS
214 ROKHANE BASIROH INFUS
215 DEWI SRI MULYATI INFUS
216 IMAS INFUS
217 HANI NUR HALIMAH INFUS
218 INTAN HOLISOH INFUS
219 TINI SULASTRI INFUS
31/08/2017 220 HILDA WINA INFUS
221 SITI HANI INFUS
222 TATI KARYATI INFUS
223 REMI INFUS DC
224 IDA NURHASANAH INFUS
225 ARTHA YUDA INFUS
JUMLAH 225 41
TOTAL PASIEN IGD 691

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN SEPTEMBER 2017
01/09/2017 1 CUCU SOLIHAH INFUS DC
2 NENAH INFUS DC
3 SYAIBATUL NURUL FAZRIAHINFUS
4 SRI INFUS DC
5 NOVA INFUS DC
6 RITA INFUS
7 SUMIYANTI INFUS
8 LUTFIAH MAULIDA INFUS
9 KENZIE INFUS
10 INARA INFUS
11 M AL AZAM INFUS
02/09/2017 12 SEPTI ANDIYANTI INFUS
13 KURNIA INDRIATI INFUS
03/09/2017 14 DEDEH SARTIKA INFUS
15 M.HISYAM NASUTION INFUS
16 ARIFA ADRIYANY INFUS
17 MIKAIL INFUS
18 ANISA ARYANTI INFUS
19 ESIN INFUS
20 TINI SULASTRI INFUS
04/09/2017 21 ILIS MAWATI INFUS
22 ELIS MARLIHAH INFUS
23 LILIS NURLAELA INFUS
24 RENI INFUS
05/09/2017 25 SINTA MARDIANA INFUS
26 RIDWAN INFUS
27 SARAH INFUS
28 TUTI INFUS
29 FOPI ASHARI INFUS
30 NENI INFUS DC
06/09/2017 31 ERNITA INFUS DC
32 ABHIZAR PUTRA DARMAWAN INFUS
33 M ADSHAN INFUS
34 INDAH JUBAEDAH INFUS DC
35 ANISA FITRIANI INFUS
36 SITI AISYAH INFUS DC
37 CUCU KURNIASIH INFUS
38 SUKAESIH INFUS
39 IIS YUNENGSIH INFUS
40 NILA INFUS DC
07/09/2017 41 IIS SOPIANTI INFUS
42 SRI DEWI INFUS
43 SARI KURNIASARI INFUS
44 YAYU NOPIANTI INFUS
45 MIDAULYNA INFUS DC
46 LUSI P INFUS
47 HERLINA NOVIANTI INFUS DC
48 NIA NURLATIFAH INFUS DC
49 SUSANTI INFUS DC
50 DANNYA MEGA INFUS
08/09/2017 51 YANI MULIASARI INFUS
52 SULASTRI INFUS
53 IRMA YUSNITA INFUS
54 RIZKA INFUS
09/09/2017 55 IIS KOMALASARI INFUS
56 SOPI INFUS DC
57 FITRI INFUS
58 RINDA SEPTIANI INFUS
10/09/2017 59 DIAH INFUS
60 KRISTINA INFUS
61 IMAS MASITOH INFUS
62 TIA SRI INFUS
63 RAKA SURYA ADZAKI INFUS
64 SULASTRI INFUS
11/09/2017 65 NENI HAYATI INFUS
66 CHANDRA PRATAMA INFUS
67 RINA ANGGRAENI INFUS
68 ESTI UTAMI INFUS
69 LISNA SONIA INFUS
12/09/2017 70 RIKA SETIAWATI INFUS
71 KURNIAWATI INFUS
72 SITI KOMARIAH INFUS
73 HENI INFUS
74 SITI SULIYAH INFUS
75 RD AJENG HADAMI INFUS
76 IRAWATI INFUS
13/09/2017 77 NINDA INFUS
78 YULIYANI KUSNIAWATI INFUS
79 WULAN SETIANI INFUS DC
80 DIANA ERDIYANI INFUS
81 ELA NURLAELA INFUS
82 ADE SARI INFUS
83 LETHISA INFUS
14/09/2017 84 ASTRI FITRIANI INFUS
85 YANTI NURHAYATI INFUS
86 WIWIN SITI INFUS
87 DIANTIKA ANISA INFUS DC
15/09/2017 88 RAHAYU INFUS
89 RANI RAHMAWATI INFUS
90 YANI RAHAYU INFUS DC
91 KIKI RAHMAWATI INFUS
92 SITI ROHMAH INFUS
93 DIVIA INFUS
94 SITI KULSUM INFUS
95 RIDA ANA SIHALOHO INFUS
96 FITRI SEPTIATI INFUS
97 ANI RATNAWATI INFUS
98 DESI RIZKY INFUS
99 DINI APRIANI INFUS
16/09/2017 100 ICHA FARICHA INFUS DC
101 JUARIAH INFUS
102 ELIS MARLIHAH INFUS
103 IRNI INFUS DC
17/09/2017 104 ELIN KARLINA INFUS
105 SHELLY SHANDIKA INFUS
106 IA LASTRI INFUS
107 RAIHAN SAPUTRA INFUS
108 KERENHAPUKH ABIGAIL INFUS
18/09/2017 109 ALRADYA QIANDRA PUTRIINFUS
110 MIRAWATI INFUS
111 ADINDA INFUS
112 RANI SUKMARINI INFUS
19/09/2017 113 SYAKILLA RIANI NUR AGNIA
INFUS
114 ELI ERNAWATI INFUS DC
115 MULYANI INFUS DC
116 HELMI INDRAWATI INFUS
117 RIA AMELIA INFUS
118 KURNIA INFUS
119 OOM KOMARIAH INFUS DC
120 TUTI MASRUROH INFUS DC
121 LIA RAHMADANI INFUS DC
122 NENI INFUS
123 M KIAN DAFA INFUS
21/09/2017 124 ZIYAD INFUS
125 TISA INFUS
126 AI KULSUM INFUS
127 DEWI SETIAWATI INFUS
22/09/2017 128 ARPAN INFUS
129 LENA MARLENA INFUS
130 ANI SULISTIANINGSIH INFUS
131 YATI MARYATI INFUS
132 NENENG JULAEHA INFUS
133 LANI SUSAN INFUS
134 ENENG RINI INFUS
23/09/2017 135 ATHALLA INFUS
136 SABELAGEOVANI INFUS
137 NELI INFUS
138 LINA INFUS
139 NURHAYATI INFUS
140 LINA INFUS
24/09/2017 141 AQILLA ZAHRA INFUS
142 DAFFA NUR ALAMSYAH INFUS
143 ZULFI INFUS
144 SRI NURYANTI INFUS
145 AI SARI INFUS DC
146 HERLINA INFUS DC
147 ANGEL OLIVIA INFUS
148 MERRY MULYANI INFUS
149 DINE TRISNIAWATI INFUS
150 SITI NURHAYATI INFUS DC
151 ELIN INFUS DC
25/09/2017 152 LENI JULAENI MARLINA INFUS
153 SANTI HAYATI INFUS
154 NUR SITI INFUS
155 WIWIN INFUS DC
177 ALMA INFUS
178 M.AHLAN INFUS
179 FADHIL INFUS
26/09/17 156 SITI NURLAENI INFUS
157 WATI INFUS DC
158 YUNINGSIH INFUS
159 YENI ANDARI INFUS DC
160 WINNA INFUS
161 MEGA INFUS
162 FANNY INFUS
163 SITI HAMIDAH INFUS
164 DESI INFUS
165 ROSWELIYAH INFUS
166 M AHLAN INFUS
27/09/2017 167 SILMI PILHAN INFUS DC
168 IYAM INFUS
169 EMILIA INFUS
170 REVA MELLAWATI INFUS
171 KHANZA INFUS
172 FADIL INFUS
28/09/17 173 SITI MARYAM INFUS
174 SANTI INFUS
175 FIFI OKTAVIA INFUS
176 NYIMAS LIA INFUS
177 SANTI DAMAYANTI INFUS
178 NURBAYANI INFUS
179 SELI RAMDANI INFUS
180 RATIH NOVITASARI INFUS
181 TIN WARTINI INFUS
182 PIPIH SUPIAH INFUS
183 IMAS KARMINI INFUS
184 RIDA ANA SIHALOHO INFUS
185 M ANDIKA INFUS
29/09/2017 186 LALA KARMILA INFUS
187 MILA INFUS
188 LINDA HERLIANA INFUS DC
189 ANI BUDIASIH INFUS
190 NENI MARYANI INFUS
191 M RIZKIAN INFUS
192 MANAF INFUS
30/09/2017 193 LINA MARLINA INFUS
194 TIK TIK NURBAYATI INFUS
195 ERNA NUR DARISMAWATIINFUS
196 MAESAROH INFUS
197 SUSI SUSANTI INFUS
198 SITI KULSUM INFUS
199 DIANA PURNAMASARI INFUS
200 INEU IKLIMA INFUS
201 NOPI INFUS
202 NENDEN INFUS
203 NURHAYATI INFUS
204 GERY FIT PURNAMA INFUS
JUMLAH 204 33
TOTAL PASIEN IGD 823

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN
Ruang IGD - RSKIA BULAN PEBUARI

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2015 1 NY SRI INFUS
01/02/2015 2 NY SRI INFUS
01/02/2015 3 NY SRI INFUS
01/02/2015 4 NY SRI INFUS
01/02/2015 5 NY SRI INFUS
01/02/2015 6 NY MIA INFUS
01/02/2015 7 NY KUSTIA INFUS
01/02/2015 8 NY DIANE INFUS
01/02/2015 9 NY LENI INFUS
01/02/2015 10 BY. AULIA INFUS
01/02/2015 11 BY. M. ALAN INFUS
01/02/2015 12 AN. M. RAFFA INFUS
12

02/02/2015 13 NY TATI HAYATI INFUS


02/02/2015 14 NY LENI INFUS
02/02/2015 15 NY ANI INFUS
02/02/2015 16 NY TITIN INFUS
02/02/2015 17 NY LIA INFUS DC
02/02/2015 18 NY RIA INFUS
02/02/2015 19 NY FLORENCIA INFUS
02/02/2015 20 NY NENG NURJANAH INFUS
02/02/2015 21 AN. M. SABIQ INFUS
9 1

03/02/2015 22 NY EUIS ROHAYATI INFUS


03/02/2015 23 NY IPAH SARIPAH INFUS
03/02/2015 24 NY YUKE INFUS
03/02/2015 25 NY ELIS INFUS
03/02/2015 26 NY MELIA INFUS
03/02/2015 27 NY NOVI INFUS
03/02/2015 28 NY ELAH INFUS
03/02/2015 29 NY SELI INFUS
03/02/2015 30 NY FEBRI INFUS
03/02/2015 31 NY NOVIANI INFUS DC
03/02/2015 32 NY WANDA INFUS
03/02/2015 33 NY GEUIS INFUS DC
03/02/2015 34 NY.SITI AMINAH INFUS
03/02/2015 35 NY.NENENG INFUS
03/02/2015 36 NY.MEI ROHIMAH INFUS
03/02/2015 37 AN. RISKA INFUS
03/02/2015 38 AN TRIANDRA INFUS
03/02/2015 39 AN. ALIF INFUS
18 2

04/02/2015 40 NY ISHA INFUS


04/02/2015 41 NY NUNING INFUS
04/02/2015 42 NY SARASWATI INFUS
04/02/2015 43 NY NISNAENI INFUS
04/02/2015 44 NY YUNENGSIH INFUS DC
04/02/2015 45 NY EUIS INFUS
04/02/2015 46 NY SUSI INFUS
04/02/2015 47 NY SITI HAJAR INFUS
04/02/2015 48 NY MILDA INFUS
04/02/2015 49 BY. M. RIZKI INFUS
04/02/2015 50 BY. CIKA INFUS
04/02/2015 51 BY. GILMAN INFUS
04/02/2015 52 BY. NY. NANILI INFUS
13 1

05/02/2015 53 NY WINDA INFUS


05/02/2015 54 NY LILSIS INFUS DC
05/02/2015 55 NY MARI MARIAH INFUS
05/02/2015 56 NY DEDEH INFUS DC
05/02/2015 57 NY.WULAN INFUS
05/02/2015 58 AN M RIZKI INFUS
6 2

06/02/2015 59 NY.YUAN INFUS


06/02/2015 60 NY UMMUL INFUS
06/02/2015 61 NY NUNUNG INFUS
06/02/2015 62 NY ERLY INFUS
06/02/2015 63 NY SITI ROHAENI INFUS
06/02/2015 64 NY INA INFUS
06/02/2015 65 NY DJUARIAH INFUS
06/02/2015 66 AN. DEMIAN INFUS
06/02/2015 67 AN RACHMAWATI INFUS
9

07/02/2015 68 NY MAELASARI INFUS


07/02/2015 69 NY RINA INFUS
07/02/2015 70 NY. KIKI INFUS DC
07/02/2015 71 NY. ANITA INFUS DC
07/02/2015 72 NY RIKA INFUS DC
07/02/2015 73 NY LINDA INFUS DC
07/02/2015 74 NY THIA INFUS DC
07/02/2015 75 NY LENI INFUS DC
07/02/2015 76 NY YULIANTI INFUS
07/02/2015 77 NY NURAENI INFUS
07/02/2015 78 NY PUJI INFUS
07/02/2015 79 NY RIMA INFUS
07/02/2015 80 BY HADI INFUS
07/02/2015 81 AN NAILA INFUS
14 6

08/02/2015 82 NY.NANI SUMARNI INFUS DC


08/02/2015 83 NY. YUPI INFUS
08/02/2015 84 NY. SRI INFUS
08/02/2015 85 NY.OOM INFUS
4 1

09/02/2015 86 ny.rostinah Iinfus DC


09/02/2015 87 NY.NURHAYATI Iinfus DC
09/02/2015 88 NY.ENUNG Iinfus DC
09/02/2015 89 NY.WINE Iinfus DC
09/02/2015 90 NY.INNE Iinfus DC
09/02/2015 91 NY. RONASIH Iinfus
09/02/2015 92 NY.YENI Iinfus DC
09/02/2015 93 BY. AAS Iinfus
8 6

10/02/2015 93 NY. ANI Iinfus


94 NY. ITA Iinfus
95 NY.INDAH Iinfus
96 NY. NENG FARIDA Iinfus
97 NY. DWI S Iinfus
5

11/02/2015 98 NY.NELLIS Iinfus


99 NY.RENI Iinfus
100 NY. ELIS Iinfus
101 NY.YULIA Iinfus
102 NY. HENI Iinfus
103 NY.SANDRA K Iinfus DC
104 NY. SUMYATI Iinfus
105 BY.M. IKSAN Iinfus
106 NY.SITI JUBAEDAH Iinfus
107 BY.ZASKIA Iinfus
108 NY.SRI ARYANI Iinfus
11 1

12/02/2015 109 NY..YAYANG JUBAEDAH Iinfus


110 NY. SILMI Iinfus
111 NY.SUMI Iinfus
112 NY.ASTRI Iinfus
113 NY. SITI GINA Iinfus
114 NY. WAWANG Iinfus
115 BY. M. ZAKI Iinfus
7
13/02/2015 116 NY EEM INFUS
13/02/2015 117 NY. SRI INFUS
13/02/2015 118 NY. RANI INFUS
13/02/2015 119 NY. URUH INFUS
13/02/2015 120 NY. TITIN INFUS
13/02/2015 121 AN. BIMTANG INFUS
13/02/2015 122 NY. MIMIN INFUS
13/02/2015 123 NY. NURLELA INFUS
8
14/02/2015 124 NY. VINI INFUS
14/02/2015 125 NY. NISA INFUS
14/02/2015 126 NY. YOHANA INFUS
14/02/2015 127 NY. SUMIATI INFUS
14/02/2015 128 NY. RIA INFUS DC
14/02/2015 129 NY. WINDA INFUS
14/02/2015 130 NY. IIS INFUS DC
14/02/2015 131 NY.DENITA INFUS DC
14/02/2015 132 NY TINI INFUS
14/02/2015 133 NY DIANA INFUS DC
14/02/2015 134 NY DILIA DWIKA INFUS
14/02/2015 135 NY EUIS INFUS
14/02/2015 136 NY ESA INFUS
14/02/2015 137 AN. FAIZA INFUS
14/02/2015 138 BY.NY NURHAYATI INFUS
15 4
15/02/2015 139 NY SINTA KHOTIMAH INFUS
15/02/2015 140 NY NONOK KARMINI INFUS
15/02/2015 141 NY HANIPAH INFUS DC
15/02/2015 142 NY. HAMIDAH INFUS
15/02/2015 143 NY.SRIWATI INFUS
15/02/2015 144 NY.SRI SULASTRI INFUS
15/02/2015 145 AN. TIARA INFUS
15/02/2015 146 NY.RIA INFUS DC
15/02/2015 147 NY. DIAN INFUS
15/02/2015 148 AN. ANISA INFUS
15/02/2015 149 NY SARI JUWITA INFUS
11 2
16/02/2015 150 NY IIN INFUS
16/02/2015 151 NY SITI INFUS
16/02/2015 152 NY. ANITA INFUS DC
16/02/2015 153 NY. SRI INFUS DC
16/02/2015 154 ANOMIA INFUS
16/02/2015 155 NY. NENI INFUS DC
16/02/2015 156 NY. IRA INFUS DC
16/02/2015 157 AN. DANIS INFUS
16/02/2015 158 NY. LINA INFUS DC
16/02/2015 159 NY. IKA INFUS
16/02/2015 160 NY. SITI NURLELA INFUS
16/02/2015 161 NY NENG SUTINAH INFUS
16/02/2015 162 NY TIA INFUS DC
13 6
17/02/2015 163 NY. EUIS CUCU INFUS DC
17/02/2015 164 NY. OMAH INFUS
17/02/2015 165 NY.NENI INFUS DC
17/02/2015 166 NY RENI INFUS
17/02/2015 167 NY AMALIA INFUS
17/02/2015 168 NY ANI MARYANI INFUS
17/02/2015 169 NY CINTA NFUS
17/02/2015 170 NY ERNAWATI INFUS
17/02/2015 171 NY RISA INFUS DC
17/02/2015 172 NY. YATI INFUS
17/02/2015 173 NY. DEWI INFUS
17/02/2015 174 NY. FITRI INFUS DC
17/02/2015 175 AN.RIZKI INFUS
17/02/2015 176 AN.CHISTIANO INFUS
14 4
18/02/2015 177 NY. TANJIBAH INFUS
18/02/2015 178 NY. MEGA INFUS
18/02/2015 179 NY. TINA INFUS
18/02/2015 180 NY. NINA INFUS
18/02/2015 181 NY. LILIS INFUS
18/02/2015 182 NY. DWI INFUS
18/02/2015 183 NY. QONITA INFUS
18/02/2015 184 NY. NURHAYATI INFUS
18/02/2015 185 NY. NURBAYATI INFUS DC
18/02/2015 186 NY. SITI JUBAEDAH INFUS
18/02/2015 187 NY RIKA NURANI INFUS DC
18/02/2015 188 NY RENI MULYANI INFUS
18/02/2015 189 AN. RAYI INFUS
13 2
19/02/2015 190 NY EKA NURLAELA INFUS
19/02/2015 191 NY SITI FATIMAH INFUS
19/02/2015 192 NY NENG RINA INFUS
19/02/2015 193 AN.ZHANIRA INFUS
4
20/02/2015 194 NY.LINA INFUS
20/02/2015 195 NY.TITA INFUS DC
20/02/2015 196 NT.YULIANTI INFUS
20/02/2015 197 NY IMAS infus
20/02/2015 198 AN. M DWI infus
5 1
21/02/2015 199 NY CUCU INFUS DC
21/02/2015 200 NY IRMA INFUS
21/02/2015 201 NY HENDAYANA INFUS
21/02/2015 202 NY NURHERNAWATI INFUS
21/02/2015 203 NY YANI INFUS
21/02/2015 204 NY SRI SUSANTI INFUS
21/02/2015 205 NY YULIANTI INFUS
21/02/2015 206 AN. M isya INFUS
8 1

22/02/2015 207 NY AJENG INFUS


22/02/2015 208 NY IRMA INFUS
22/02/2015 209 NY LISNAWATI INFUS
22/02/2015 210 NY IMAS INFUS
22/02/2015 211 NY SUSI INFUS
22/02/2015 212 NY.MURLESIS INFUS
22/02/2015 213 NY.SITI.K INFUS
22/02/2015 214 NY.WINARTI INFUS
22/02/2015 215 NY SRI SUSANTI INFUS
22/02/2015 216 NY KOMARIAH INFUS DC
22/02/2015 217 BY. WILDAN INFUS
22/02/2015 218 AN. M LESYA INFUS
12 1
23/02/2015 219 NY NADIA INFUS
23/02/2015 220 NY HILDA INFUS
23/02/2015 221 NY BANIAH INFUS DC
23/02/2015 222 NY RENI INFUS
23/02/2015 223 NY EHAN HANIFAH INFUS
23/02/2015 224 NY.MIA MARLIANA INFUS
23/02/2015 225 NY IPAH INFUS
23/02/2015 226 NY SRI RAHAYU INFUS
23/02/2015 227 NY NIYAT INFUS
23/02/2015 228 NY RIBUT INFUS DC
23/02/2015 229 NY SUPRIATIN INFUS DC
23/02/2015 230 NY SHINTA INFUS
23/02/2015 231 NY ADEL INFUS
13 3

24/02/2015 232 NY SITI ROMLAH INFUS


24/02/2015 233 NY NINA INFUS
24/02/2015 234 NY IMAS INFUS
24/02/2015 235 NY AGUSTIANA INFUS
24/02/2015 236 NY DEDE INFUS DC
24/02/2015 237 NY RATIH
24/02/2015 238 NY SRIYANTI INFUS
24/02/2015 239 NY IRMA INFUS
24/02/2015 240 NY EUIS INFUS DC
24/02/2015 241 NY.NURHAYATI INFUS DC
24/02/2015 242 AN. BY ZIDAN INFUS
11 3

25/02/2015 243 NY.DINI INFUS


25/02/2015 244 NY RADIANIS INFUS
25/02/2015 245 NY DEWI INFUS DC
25/02/2015 246 NY TINA INFUS
25/02/2015 247 AN..HAFIZ INFUS
25/02/2015 248 AN. NURIZAL INFUS
6 1

26/02/2015 249 NY. FITRIANI INFUS


26/02/2015 250 NY. WINARTI INFUS
26/02/2015 251 NY. SUNARTI INFUS
26/02/2015 252 NY. NURAHMAYA INFUS
26/02/2015 253 NY. ENENG INFUS
26/02/2015 254 NY. ROHMADE INFUS
26/02/2015 255 NY. IRMA INFUS
26/02/2015 256 NY DINI INFUS
26/02/2015 257 BY. HAFIZ INFUS
9

27/02/2015 258 NY SINTA INFUS


27/02/2015 259 NY DEWI INFUS
27/02/2015 260 NY RINA INFUS
27/02/2015 261 NY SUNDARI INFUS
27/02/2015 262 NY ANI INFUS
27/02/2015 263 NY SUMIATI INFUS
27/02/2015 264 NY RUSMINI INFUS
27/02/2015 265 NY LASTINA INFUS
27/02/2015 266 NY SEPTI INFUS
27/02/2015 267 AN. RAISYA INFUS
27/02/2015 268 NY.LILA INFUS DC
11 1
28/02/2015 269 NY LELA INFUS DC
28/03/2015 270 NY NEGKI INFUS
28/03/2015 271 NY NENG RUKMINI INFUS
28/03/2015 272 NY WA ODE INFUS DC
28/03/2015 273 NY SITI NURLAELA INFUS
05/03/2015 274 NY IKA INFUS
06/03/2015 275 NY NITA INFUS
07/03/2015 276 NY ERNI INFUS
08/03/2015 277 NY SITI NURJANAH INFUS
09/03/2015 278 NY LASWATI INFUS
10/03/2015 279 NY MINAH INFUS DC
11 3

TOTAL 266 58
TOTAL PASIEN 707

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN MARET
01/03/2015 1 NY KRISTIANI INFUS
01/03/2015 2 NY LEAH INFUS DC
01/03/2015 3 NY DONA INFUS
01/03/2015 4 NY RINA INFUS
01/03/2015 5 NY SRI MARIAM INFUS
01/03/2015 6 NY SITI MAEMUNAH INFUS
01/03/2015 7 NY HENI INFUS
01/03/2015 8 NY SINTA INFUS
8 1

02/03/2015 1 NY LISNAWATI INFUS


02/03/2015 2 NY MARTINI INFUS
02/03/2015 3 NY RHINA INFUS
02/03/2015 4 NY YAYAH INFUS
02/03/2015 5 NY YOYOH INFUS
02/03/2015 6 NY DESSY INFUS
02/03/2015 7 NY ROSMAYANTI INFUS
02/03/2015 8 NY NIA INFUS
02/03/2015 9 NY ELI INFUS
02/03/2015 10 NY ANI INFUS
02/03/2015 11 NY NURHAYANI INFUS
02/03/2015 12 NY LISNA INFUS
02/03/2015 13 NY MELATI INFUS
02/03/2015 14 NY NENG TIKA INFUS
02/03/2015 15 NY JUJU INFUS DC
02/03/2015 16 NY EVA INFUS
02/03/2015 17 NY SASI INFUS
02/03/2015 18 NY ATHINA INFUS
02/03/2015 19 NY DEDEH INFUS DC
02/03/2015 20 AN YOGA INFUS
02/03/2015 21 AN KHAIRIANSYAH ARYA W INFUS
21 2

03/03/2015 1 NY EUIS INFUS


03/03/2015 2 NY SARTIYAH INFUS
03/03/2015 3 NY OKE INFUS
03/03/2015 4 BY RAYI INFUS
03/03/2015 5 BY MISEL INFUS
03/03/2015 6 AN NESYA INFUS
6

04/03/2015 1 NY LINA INFUS


04/03/2015 2 NY YAYAH INFUS
04/03/2015 3 NY IIS INFUS
04/03/2015 4 NY SUHAEMA INFUS
04/03/2015 5 NY LILIS INFUS
04/03/2015 6 NY YANTI INFUS
04/03/2015 7 NY NOVITA INFUS
04/03/2015 8 NY SURIANI INFUS
04/03/2015 9 NY ELIS INFUS
04/03/2015 10 NY DEDEH INFUS
04/03/2015 11 NY NENG TIKA INFUS
04/03/2015 12 NY TETI INFUS
04/03/2015 13 NY NOFI INFUS
04/03/2015 14 NY CUCU INFUS
04/03/2015 15 NY VINA INFUS
04/03/2015 16 NY WENI INFUS
04/03/2015 17 NY INE INFUS
04/03/2015 18 AN NAZWA INFUS
04/03/2015 19 AN ANDIKA INFUS
04/03/2015 20 AN AULIA INFUS
20

05/03/2015 1 NY NIRAWATI INFUS


04/03/2015 2 NY DESTA INFUS
05/03/2015 3 NY FEBY INFUS
05/03/2015 4 NY WILLY INFUS
05/03/2015 5 NY WINI INFUS
05/03/2015 6 NY AAN INFUS
05/03/2015 7 NY FITRI INFUS
0503/2015 8 NY MARLINA INFUS
05/03/2015 9 NY MIRA INFUS DC
9 1

06/03/2015 1 NY YULI SUGIARTI INFUS


06/03/2015 2 NY EVI INFUS DC
06/03/2015 3 NY CUCU INFUS DC
O6/03/2015 4 NY YUYUN INFUS
06/03/2015 5 NY ANA INFUS DC
06/03/2015 6 NY SITI ROHMAH INFUS
06/03/2015 7 NY AAS INFUS
06/03/2015 8 NY AI KARYAWATI INFUS
06/03/2015 9 AN RANI INFUS
06/03/2015 10 BY VIRZHA INFUS
06/03/2015 11 AN KHAIRIANSYAH ARYA W INFUS
11 3

07/03/2015 1 NY LINA INFUS


07/03/2015 2 NY METTY INFUS
07/03/2015 3 NY HANA PRATIWI INFUS
07/03/2015 4 NY ANITA INFUS
07/03/2015 5 NY ENI INFUS DC
07/03/2015 NY YUPI INFUS DC
07/03/2015 6 NY SUMIYATI INFUS
07/01/1900 7 BY ISMIA INFUS
7 1

08/03/2015 NY RIA INFUS


08/03/2015 NY AIDA SUROYA
08/03/2015 1 SITI SOPIAH INFUS DC
08/03/2015 2 NY RIA INFUS
08/03/2015 3 NY ISYE KOMATIAH INFUS
08/03/2015 4 NY IRMA INFUS
08/03/2015 5 NY IMAS INFUS
08/03/2015 6 NY MISTEM INFUS
08/03/2015 7 NY SRI BEKTI INFUS
08/03/2015 8 NY ATIN INFUS
08/03/2015 9 BY RISTIANI INFUS
9 1

09/03/2015 1 NY ENI INFUS DC


09/03/2015 2 NY FITRI INFUS
09/03/2015 3 NY.MARCELA INFUS
09/03/2015 4 NY MIMIN INFUS
09/03/2015 5 NY DEWI INFUS
09/03/2015 6 NY DELVI INFUS
09/03/2015 7 NY NINA INFUS
09/03/2015 8 NY ATIKAH INFUS
09/03/2015 9 NY EVI INFUS
09/03/2015 10 NY R KARTINI INFUS
09/03/2015 11 NY NEFI INFUS
09/03/2015 12 NY NELI AMALIA INFUS
09/03/2015 13 NY LIA YULIA INFUS DC
09/03/2015 14 BY.AKMAL INFUS
14 2

10/03/2015 1 NY DESI MERLIANI INFUS


10/03/2015 2 NY ANITA INFUS
10/03/2015 3 NY WULAN SUPRIANI INFUS DC
10/05/2015 4 NY ESTI PUJIANTI INFUS
10/05/2015 5 NY TATI SULASTRI INFUS
10/03/2015 6 NY IIS SIMIANTI INFUS DC
10/03/2015 7 NY DARMIYATI INFUS
10/03/2015 8 NY RITA INFUS
10/03/2015 9 NY NENI INFUS DC
10/03/2015 10 NY ROTUPA INFUS
10/03/2015 11 NY SARIFAH INFUS
10/03/2015 12 NY VINI INFUS
10/03/2015 13 AN NISVI INFUS
13 3

11/03/2015 1 NY NIA INFUS DC


11/03/2015 2 NY NUR ASHRIAN INFUS DC
11/03/2015 3 NY NENI INFUS
11/03/2015 4 NY.AMINAH INFUS
11/032015 5 NY.LENI INFUS
11/03/2015 6 AN ZIHAN INFUS
11/03/2015 7 AN WELSEN INFUS
7 2

12/03/2015 1 NY ADE ERNI INFUS


12/03/2015 2 NY ELIS INFUS DC
12/03/2015 3 NY JULAIKAH INFUS DC
12/03/2015 4 NY SITI NURHASANAH INFUS DC
12/03/2015 5 AN KATRUL INFUS
12/03/2015 6 BY NAUFAL INFUS
12/03/2015 7 BY IBRAHIM INFUS
7 3

13/03/2015 1 NY IMAS INFUS DC


13/03/2015 2 NY IYAM INFUS
13/03/2015 3 NY SHERLY INFUS
13/03/2015 4 NY FITRIA INFUS
13/03/2015 5 NY VERA INFUS
13/03/2015 6 NY RINA INFUS DC
13/03/2015 7 NY LINDA INFUS
13/03/2015 8 NY.HANA INFUS DC
13/03/2015 9 NY RISA INFUS
13/03/2015 9 NY ENDAH INFUS
13/03/2015 10 NY TITIN INFUS DC
10 3

14/03/2015 1 NY FADIAH INFUS


14/03/2015 2 NY RENI INFUS
14/03/2015 3 NY CITRA INFUS
14/03/2015 4 NY YULIASIH INFUS
14/03/2015 5 NY.NOVI PUSPA INFUS
14/03/2015 6 NY.ATIK INFUS
6

15/03/2015 1 NY.NOVITA SARI INFUS DC


15/03/2015 2 NY.ROSMAULINA INFUS
15/03/2015 3 NY EMI INFUS
15/03/2015 4 NY HOLORIA INFUS
15/03/2015 5 NY SINTA INFUS
15/03/2015 6 NY KUSTINAH INFUS
15/03/2015 7 NY ANIS INFUS DC
15/01/2015 8 AN. M ANSHORI INFUS
8 2

16/03/2015 1 NY ATIN INFUS


16/03/2015 2 NY NENI INFUS DC
16/03/2015 3 NY ROSMAWATI INFUS
16/03/2015 4 NY DEWI INFUS DC
16/03/2015 5 NY SARI MARLIANI INFUS DC
16/03/2015 6 NT RINI INFUS
16/03/2015 7 NY SRI RAHAYU INFUS
16/03/2015 8 BY NIZAM INFUS
16/03/2015 9 AN NAUFAL INFUS
16/03/2015 10 AN DIMAS INFUS
16/03/2015 11 BY M AR RASYID INFUS
16/03/2015 12 BY M AHDAN INFUS
12 3

17/03/2015 1 NY SUMANAH INFUS DC


17/03/2015 2 NY TRESNA INFUS
17/03/2015 3 NY YUYUN INFUS
17/03/2015 4 NY NINGRUM INFUS
17/03/2015 5 NY TUTI IRAWATI INFUS
17/03/2015 6 NY WATI INFUS
17/03/2015 7 NY NEPI INFUS
17/03/2015 8 BY BANU INFUS
8 1

18/03/2015 1 NY HENI INFUS DC


18/03/2015 2 NY TIA INFUS
18/03/2015 3 NY SANTI INFUS DC
18/03/2015 4 NY YUNENGSIH INFUS
18/03/2015 5 NY TINTIN INFUS DC
18/03/2015 6 NY LENI INFUS DC
18/03/2015 7 NY RATNAWATI INFUS DC
18/03/2015 8 NY TITA INFUS DC
18/03/2015 9 NY ELIZA INFUS
18/03/2015 10 BYSINTIA INFUS
18/03/2015 11 AN IRPAN INFUS
11 6

19/03/2015 1 NY MAS IIN VIRZAN INFUS


19/03/2015 2 NY.RINA INFUS
19/03/2015 3 NY N WITRI INFUS
19/03/2015 4 NY ELIS INFUS
19/03/2015 5 NY TINI INFUS
19/03/2015 6 NY NOVITASARI INFUS
19/03/2015 7 AN ARSAKA INFUS
19/03/2015 8 BY BAGUS INFUS
19/03/2015 9 BY ALFAN INFUS
9

20/03/2015 1 NY SOFIA INFUS


20/03/2015 2 NY PAUDJIAH INFUS
20/03/2015 3 NY CUCU INFUS
20/03/2015 4 NY IMAS INFUS DC
20/03/2015 5 NY ELIS INFUS
20/03/2015 6 NY ELA SUMIATI INFUS
20/03/2015 7 NY NUNUNG INFUS
20/03/2015 8 NY SANI ADAWIYAH INFUS DC
20/03/2015 9 NY YAYANG INFUS
20/03/2015 10 NY.RINA INFUS
10 2

21/03/2015 1 NY JUJU INFUS


21/03/2015 2 NY SANTI NURYANTI INFUS
21/03/2015 3 NY KURAESIN INFUS DC
21/03/2015 4 NY FITRI INFUS DC
21/03/2015 5 NY SETIATI INFUS
21/03/2015 6 NY WINDA INFUS
21/03/2015 7 NY DEWI INFUS
21/03/2015 8 NY IDA INFUS
21/03/2015 9 AN ADYASA INFUS
9 2

22/03/2015 1 NY ANE INFUS


22/03/2015 2 NY ANI INFUS
22/03/2015 3 NY AAN INFUS
22/03/2015 4 NY SUSI INFUS
22/03/2015 5 NY RINI INFUS
22/03/2015 6 NY TINI INFUS
22/03/2015 7 NY RINI INFUS
22/03/2015 8 NY SUPRIATI INFUS
22/03/2015 9 BY HADFINNA INFUS
22/03/2015 10 AN M BILAL INFUS
10

23/03/2015 1 NY TETI INFUS


23/03/2015 2 NY ELA INFUS
23/03/2015 3 NY ELAH INFUS
23/03/2015 4 NY SITI INFUS
23/03/2015 5 NY EUIS CUCU INFUS
23/03/2015 6 NY INDRI DEDRI INFUS DC
23/03/2015 7 AN SELFA INFUS
7 1

24/03/2015 1 NY AYU INFUS


24/03/2015 2 NY NINA INFUS
24/03/2015 3 NY RAHMAWATI INFUS
24/03/2015 4 NY LILIS INFUS
24/03/2015 5 NY.NURHASANAH INFUS
24/03/2015 6 NY.IIM INFUS
24/03/2015 7 NY SUMIATI INFUS
24/03/2015 8 BY.SINTA INFUS
8

25/03/2015 1 NY RUMONDANG INFUS


25/03/2015 2 NY CAHYATI INFUS
25/03/2015 3 NY ETIN INFUS
25/03/2015 4 NY SRI INFUS
25/03/2015 5 NY SITI MARIAM INFUS
25/03/2015 6 NY SITI HALIMAH INFUS DC
25/03/2015 7 NY LILIS INFUS
25/03/2015 8 NY SITI NINGRUM INFUS
25/03/2015 9 NY LILIS SOLIHAT INFUS
25/03/2015 10 NY AAN INFUS DC
25/03/2015 11 NY LINDA INFUS
25/03/2015 12 AN GALANG INFUS
25/03/2015 13 AN FAHMI INFUS
25/03/2015 14 BY AHMAD INFUS
14 2

26/03/2015 1 NY TINTIN INFUS


26/03/2015 2 NY SARI MANDASRI INFUS
26/03/2015 3 NY.IRMA INFUS
26/03/2015 4 AN RAFARDAN INFUS
4

27/03/2015 1 NY LAELA INFUS DC


27/03/2015 2 NY LINA INFUS
27/03/2015 3 NY.DEWI INFUS
27/03/2015 4 NY.YULIANTI INFUS
27/03/2015 5 NY NANI INFUS
27/03/2015 6 BY JAKA INFUS
6 1

28/03/2015 1 NY WIWIN INFUS


28/03/2015 2 NY AI NURJANNAH INFUS
28/03/2015 3 NY HUBBA INFUS
28/03/2015 4 NY SRI INFUS
28/03/2015 5 NY ELIZA INFUS
28/03/2015 6 NY IMAS INFUS
28/03/2015 7 NY FISCHA INFUS
28/03/2015 8 NY. DETI INFUS
09/01/1900 9 AN WAFA INFUS
9

29/03/2015 1 NY.KHASANAH INFUS DC


29/03/2015 2 NY.SITI NUR INFUS
29/03/2015 3 NY.HERNI INFUS
29/03/2015 4 NY.ELI INFUS
29/03/2015 5 NY.WIWIN INFUS
29/03/2015 6 NY.SUMIATI INFUS
29/03/2015 7 NY.SITI NURDIANTI INFUS DC
29/03/2015 8 NY.DEVI INFUS
29/03/2015 9 NY HENI INFUS
29/03/2015 10 NY SELI INFUS
10 2

30/03/2015 1 NY ANNISA INFUS


30/03/2015 2 NY DEWI INFUS DC
30/03/2015 3 NY YANTI INFUS
30/03/2015 4 NY TITA INFUS DC
30/03/2015 5 NY AZIMATUT INFUS
30/03/2015 6 NY NURHASANAH INFUS
30/03/2015 7 NY SRI MARYATI INFUS
30/03/2015 8 NY IIM INFUS
30/03/2015 9 NY ERNI INFUS DC
30/03/2015 10 AN RAINDRA INFUS
10 3

31/03/2015 1 NY YULIANTI INFUS


31/03/2015 2 NY RINI INFUS
31/03/2015 3 NY NENENG INFUS
31/03/2015 4 NY NONENG INFUS
31/03/2015 5 NY ISAH INFUS
31/03/2015 6 NY ELI INFUS
31/03/2015 7 NY AI RUKMINI INFUS
31/03/2015 8 NY TATI INFUS
31/03/2015 9 NY DIAH INFUS DC
9 1
jumlah total 302

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN APRIL

01/04/2015 1 NY HOMSAH INFUS DC


01/04/2015 2 NY IIM INFUS
01/04/2015 3 NY TITA INFUS
01/04/2015 4 NY NINA INFUS
01/04/2015 5 NY TIKA INFUS
01/04/2015 6 NY DEWI LAELA INFUS DC
01/04/2015 7 NY. IRESTU INFUS
01/04/2015 8 NY. TUTI INFUS
01/04/2015 9 Ny. SITI N INFUS
9 2

02/04/2015 1 NY. HARTINI INFUS


02/04/2015 2 NY. MALA INFUS
02/04/2015 3 NY RATIH INFUS
02/04/2015 4 NY SINTA INFUS
02/04/2015 5 NY WINNY INFUS
5

03/04/2015 1 NY SANTI INFUS


03/04/2015 2 NY ANNISA INFUS
03/04/2015 3 by ny yeti INFUS
03/04/2015 4 NY NURLELA INFUS
4

04/04/2015 1 NY.MERISA INFUS


04/04/2015 2 NY.TITA INFUS DC
04/04/2015 3 NY SITI SARAH INFUS
04/04/2015 4 NY EMA SUKAEMA INFUS DC
04/04/2015 5 NY RIKA INFUS
04/04/2015 6 NY NENI INFUS
04/04/2015 7 NY MAYA INFUS
04/04/2015 8 NY IPAH LATIFAH INFUS
04/04/2015 9 NY IRMA INFUS
04/04/2015 10 AN SYAFA INFUS
04/04/2015 11 AN SELVI INFUS
04/04/2015 12 BY RAFA INFUS
12 2

05/04/2015 1 NY YUNINGSIH INFUS


05/04/2015 2 NY RIRIN INFUS
05/04/2015 3 NY SARSIH INFUS
05/04/2015 4 NY MEGAWATI INFUS
05/04/2015 5 NY SRI YULIANTI INFUS
05/04/2015 6 AN QILLA INFUS
6

06/04/2015 1 NY NI PUTU SINAR INFUS


06/04/2015 2 NY SARI INFUS
06/04/2015 3 NY HAMIDAH INFUS
06/04/2015 4 NY EVI INFUS DC
06/04/2015 5 NY.DIAH INFUS DC
06/04/2015 6 NY.IIN INFUS DC
06/04/2015 7 NY.DINI INFUS DC
06/04/2015 8 NY.ILAN INFUS
8 4

07/04/2015 1 NY.YUNYUN INFUS


07/04/2015 NY.SINTA INFUS
07/04/2015 3 NY.DINI INFUS DC
07/04/2015 4 NY.SUSI INFUS
4 1

08/04/2015 1 NY.YANTI INFUS


08/04/2015 2 NY.DESI INFUS
08/04/2015 3 NY.ELI INFUS
08/04/2015 4 NY.RISMA INFUS
08/04/2015 5 NY.LILIS INFUS
08/04/2015 6 NY.YUNITA INFUS
08/04/2015 7 NY.MULYANI INFUS DC
08/04/2015 8 NY.KOKOM INFUS DC
08/04/2015 9 NY.SUMIATI INFUS
08/04/2015 10 NY SURYAMAH INFUS
08/04/2015 NY KOMARIAH INFUS
08/04/2015 11 NY FITRI INFUS
08/04/2015 12 NY IMAS INFUS DC
12 3

09/04/2015 1 NY ANNISA INFUS


09/04/2015 2 NY ENI ROHAENI INFUS
09/04/2015 3 BY RAMA INFUS
09/04/2015 4 BY FAIZ INFUS
4

10/04/2015 1 NY HANI INFUS DC


10/04/2015 2 NY VIKI INFUS DC
10/04/2015 3 NY IPAH LATIFAH INFUS DC
10/04/2015 4 NY CACIH INFUS
10/04/2015 5 NY ROSMAYANTI INFUS
10/04/2015 6 NY SITI KOMALA INFUS
10/04/2015 7 NY SANTI INFUS DC
10/04/2015 8 BY RENNO INFUS
8 4

11/04/2015 1 NY NITA INFUS


11/04/2015 2 NY RANI INFUS DC
11/04/2015 3 NY RIRIN AGUSTINI INFUS
11/04/2015 4 NY.DAHLIA INFUS
11/04/2015 5 NY. MILA INFUS
11/04/2015 6 NY.DESI INFUS
11/04/2015 7 NY. RINA INFUS
11/04/2015 8 NY. SENI INFUS
11/04/2015 9 NY.SITI M INFUS
11/04/2015 10 NY FITRI INFUS
11/04/2015 11 AN FARHAM INFUS
11 1

12/04/2015 1 NY NOPI INFUS


12/04/2015 2 NY NENG MULYANI INFUS
12/04/2015 3 NY IMAS INFUS DC
12/04/2015 4 NY EMA INFUS
12/04/2015 5 NY EVA INFUS
12/04/2015 6 NY MARIANA INFUS
6 1

13/04/2015 1 NY. SARININGSIH INFUS


13/04/2015 2 NY RIKA INFUS
13/04/2015 3 NY NOVIASARI INFUS
13/04/2015 4 NY ANGGI INFUS DC
13/04/2015 5 NY AI ELI MULIAWATI INFUS DC
13/04/2015 6 NY.NIKEN INFUS
13/04/2015 7 NY.KRISTIANA INFUS
13/04/2015 8 BY M RIZKI INFUS
8 2

14/04/2015 NY ETIN INFUS DC


14/04/2015 1 NY HESTI INFUS
14/04/2015 2 NY NOVIANI INFUS
14/04/2015 3 NY.HESTI INFUS
14/04/2015 4 NY.SITI JUBAEDAH INFUS DC
14/04/2015 5 NY.DEWI INFUS DC
14/04/2015 6 NY.WIDATI INFUS
14/04/2015 7 NY.YENI INFUS
14/04/2015 8 NY.ANI INFUS
14/04/2015 9 NY.DWI INFUS
14/04/2015 10 NY ERAT INFUS
14/04/2015 11 NY IMAS INFUS
14/04/2015 12 NY ROSIAN INFUS
14/04/2015 13 NY KARTIKA SANTI INFUS
14/04/2015 14 NY DEVI INFUS
14/04/2015 15 AN RIDWAN INFUS
14/04/2015 16 AN RAIA INFUS
16 3

15/04/2015 1 NY.SUNARTI INFUS


15/04/2015 2 NY MEGA INFUS
15/04/2015 3 NY MASRIAH INFUS DC
15/04/2015 4 NY YULIYANTI INFUS
15/04/2015 5 NY RIVA INFUS DC
15/04/2015 6 NY EVI INFUS
15/04/2015 7 NY ADE INFUS
15/04/2015 8 NY YENI INFUS
15/04/2015 9 NY SYAMSIAH INFUS
15/04/2015 10 NY VICKY INFUS
10 2

16/04/2015/ 1 NY DENNY INFUS


16/04/2015 2 NY NANI INFUS DC
16/04/2015 3 NY SOPIAH INFUS DC
16/04/2015 4 NY ONIH INFUS
18/04/2015 5 NY CUCU INFUS DC
16/04/2015 6 NY RATIH INFUS
16/04/2015 7 NY WIWIN INFUS
16/04/2015 8 NY RIRI INFUS
16/04/2015 9 NY.NINA INFUS DC
16/04/2015 10 NY.DESSY INFUS
16/04/2015 11 NY.ASRI INFUS
16/04/2015 12 AN RESTY INFUS
12 4

17/04/2015 1 NY ELIS INFUS DC


17/04/2015 2 NY IIM INFUS
17/04/2015 3 NY RUMIYATI INFUS
17/04/2015 4 NY LIANI INFUS
17/04/2015 5 AN NOEL IFUS
5 1

18/04/2015 1 NY. NURHATATI INFUS DC


18/04/2015 2 NY. SUSAN INFUS DC
18/04/2015 3 NY AISYAH INFUS
18/04/2015 4 NY ERTI INFUS
18/04/2015 5 NY NENDEN INFUS
18/04/2015 6 NY LILIS INFUS
18/04/2015 7 NY DENNY INFUS
18/04/2015 8 NY ROSI INFUS
18/04/2015 9 NY IYAM INFUS
9 2

19/04/2015 1 ALFIATUS INFUS


19/04/2015 2 NY NURKOMALA INFUS
19/04/2015 3 NY RUSMIASIH INFUS DC
19/04/2015 4 NY NIA KURNIASIH INFUS
19/04/2015 5 AN RAINA INFUS
19/04/2015 6 AN REISA INFUS
6 1

20/04/2015 1 NY DESTI INFUS DC


20/04/2015 2 NY SITI JUBAEDAH INFUS DC
20/04/2015 3 NY SUMARTINI INFUS
20/04/2015 4 NY PIPIT FATIMAH INFUS
20/04/2015 5 NY KURNIA INFUS
20/04/2015 6 NY SANTI INFUS DC
20/04/2015 7 NY NENG NURYANI INFUS DC
20/04/2015 8 NY JUJU INFUS DC
20/04/2015 9 NY NIA INFUS DC
20/04/2015 10 NY TETI INFUS DC
10 7

21/04/2015 1 NY RANI INFUS


21/04/2015 2 NY MINAH INFUS
21/04/2015 3 NY INA WAHYUNI INFUS
21/04/2015 4 NY FINA INFUS DC
21/04/2015 5 NY ANEU YULIAWATI INFUS
21/04/2015 6 NY.SANI INFUS
21/04/2015 7 NY.NENDAH INFUS
21/04/2015 8 BY M FAUZAN INFUS
8 1

22/04/2015 1 NY.YULIA INFUS


22/04/2015 2 NY.TIAN INFUS
22/04/2015 3 NY PAUW HUI TJING INFUS
22/04/2015 4 NY SUNDARININGSIH INFUS
22/04/2015 5 NY DIAN INFUS
22/04/2015 6 AN M FAKHRI INFUS
6

23/04/2015 1 NY MULYATI INFUS


23/04/2015 2 NY HARTINI INFUS
23/04/2015 3 NY RENI WULANDARI INFUS
23/04/2015 4 NY SUHARTINI INFUS
23/04/2015 5 NY NINA INFUS
23/04/2015 6 NY INAY INFUS
23/04/2015 7 NY ANGGI INFUS
23/04/2015 8 NY LULU INFUS
23/04/2015 9 AN SERLI INFUS
9

24/04/2015 1 NY LIA INFUS


24/04/2015 2 NY RETNO INFUS DC
24/04/2015 3 NY DIASI INFUS
24/04/2015 4 NY INDRI INFUS
24/04/2015 5 NY YUNENGSIH INFUS
24/04/2015 6 NY WIDIAWATI INFUS
24/04/2015 7 NY NENG MEDIANA INFUS
24/04/2015 8 AN NUR ALMIRA INFUS
24/04/2015 9 BY NURAHMA INFUS
9 1

25/04/2015 1 NY RENI INFUS


25/04/2015 2 NY MARLIA INFUS
25/04/2015 3 NY HILDA INFUS
25/04/2015 4 NY SITI SARIPAH INFUS DC
25/04/2015 5 NY YAYAH INFUS DC
25/04/2015 6 NY MULYATI INFUS
25/04/2015 7 NY NURJANAH INFUS
25/04/2015 8 NY ELI ROSMAYANTI INFUS
25/04/2015 9 NY NURHAYATI INFUS
25/04/2015 10 NY RINA INFUS
25/04/2015 11 NY LINDA INFUS
25/04/2015 12 NY FITRI INFUS DC
25/04/2015 13 NY RIKA INFUS
13 3

26/04/2015 1 NY ULFATHANI INFUS


26/04/2015 2 NY ENTANG INFUS DC
26/04/2015 3 NY RINI INFUS
26/04/2015 4 NY RENI INFUS
26/04/2015 5 NY SULASTRI INFUS
26/04/2015 6 NY SRI SUNARTI INFUS DC
26/04/2015 7 NY SITI AISYAH INFUS
26/04/2015 8 NY NORMA ANDRIANI INFUS
26/04/2015 9 NY YANI HANDAYANI INFUS
26/04/2015 10 NY YANI SULFIANITA INFUS
26/04/2015 11 AN.M ALVIN INFUS
26/04/2015 12 AN AHMAD JAELANI INFUS
12 2

27/04/2015 1 NY.ROSITA INFUS DC


27/04/2015 2 NY.NUR INDRIYANI INFUS DC
27/04/2015 3 NY.AI LINDA INFUS DC
27/04/2015 4 NY.YENNY INFUS
27/04/2015 5 AN SALSABILA INFUS
27/04/2014 6 NY. SITI ROHANAH INF
27/04/2014 7 NY. IMAS INF
27/04/2014 8 NY. ONA SUDIANGSIH INF
27/04/2014 9 NY. NOVIANTI INF
27/04/2014 10 NY. II YULIANTI INF
27/04/2014 11 NY. IKRIMA INF
27/04/2014 12 NY. NURAENI INF
27/04/2014 13 NY. TITIH INF
27/04/2014 14 NY. RIKA INF
27/04/2014 15 NY. RENI INF
27/04/2014 16 NY. WARNINGSIH INF
27/04/2014 17 NY. ANA INF
27/04/2014 18 AN AFIQAH infus
27/04/2014 19 AN. KAYLA infus
19 3
28/04/2014 1 NY. TIA INF
28/04/2014 2 NY. DINA INF
28/04/2014 3 NNISLAMI INF
28/04/2014 4 NY.HENI INF
28/04/2014 5 NY NURUL INF
28/04/2014 6 NY HASANAH INF
28/04/2014 7 NY IMAS SITI INF
28/04/2014 8 NY NENG YUYUN INF
28/04/2014 9 NY SRI H INF
28/04/2014 10 NY METI INF
28/04/2014 11 BY IKLIMA infus
28/04/2014 12 AN WILDAN infus
12

29/04/2014 1 NY SANTI INF


29/04/2014 2 NY M ISNAINI INF
29/04/2014 3 NY.ISMAWATI INF
29/04/2014 4 NY.ARUM RUMDANI INF
29/04/2014 5 NY LENI KARTIKA INF
29/04/2014 6 NY RISTA INF
29/04/2014 7 NY.SANTI INFUS
29/04/2014 8 NY REMANIAR INFUS
29/04/2014 9 NY AISYAH NURHASANAH INFUS
29/04/2014 10 AN NAYSHA R. ANAK
10

30/04/2014 1 AN AGUNG R ANAK


30/04/2014 2 NY ELIH INFUS
30/04/2014 3 NY SANTI INFUS
30/04/2014 4 NY ANI OKTAPIANI INFUS
30/04/2014 5 NY DESI INFUS
30/04/2014 6 NY NURHAYATI INFUS
30/04/2014 7 NY LINA INFUS
30/04/2014 8 NY SIPA INFUS
30/04/2014 9 NY MIRA INFUS
30/04/2014 10 NY SUMINAR INFUS
30/04/2014 11 NY EUIS SUPARTINI infus
11

total 275 50

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN MEI
01/05/2015 1 NY.DETI INFUS
01/05/2015 2 NY.SRI INFUS DC
01/05/2015 3 NN SITI ADAWIYAH INFUS DC
01/05/2015 4 NY NURI INFUS
01/05/2015 5 NY YUNENGSIH INFUS
01/05/2015 6 NY YUNI INFUS DC
6 3

02/05/2015 1 NY.EVI INFUS DC


02/05/2015 2 NY.HETI INFUS DC
02/05/2015 3 NY NANI HERNAWATI INFUS DC
02/05/2015 4 NY MIMI INFUS DC
02/05/2015 5 NY ELIS INFUS
02/05/2015 6 NY LASMINI INFUS
02/05/2015 7 NY DEDEH INFUS
02/05/2015 8 AN SITI MARWAH INFUS
02/05/2015 9 BY GALANG INFUS
9 4

03/05/2015 1 NY IIS NURHAYATI INFUS DC


03/05/2015 2 NY SITI MARIAH INFUS
03/05/2015 3 NY.ETIN INFUS
3 1
04/05/2015 1 NY.INE INFUS
04/05/2015 2 NY.YENI INFUS
04/05/2015 3 NY DINI INFUS DC
04/05/2015 4 NY YANI INFUS DC
04/05/2015 5 NY AJENG INFUS
04/05/2015 6 NY RISMAWAWI INFUS DC
04/05/2015 7 BY AXCEL INFUS
7 3

05/05/2015 1 NY PIA APRIANI INFUS


05/05/2015 2 NY TIA INFUS
05/05/2015 3 NY TITA ROSKA INFUS DC
05/05/2015 4 NY SANTI INFUS
05/05/2015 5 NY ANA SEPTIANA INFUS DC
05/05/2015 6 NY NENG ANIS INFUS
05/05/2015 7 NY RANI INFUS DC
05/05/2015 8 NY HAFIFAH INFUS
8 3

06/05/2015 1 NY SANTI INFUS


06/05/2015 2 NY KARWATI INFUS DC
06/05/2015 3 NY.ANITA INFUS
06/05/2015 4 NY.ROHAMI INFUS DC
06/05/2015 5 NY.NURJANAH INFUS DC
06/05/2015 6 NY.DEWI INFUS
06/05/2015 7 NY RINA INFUS
06/05/2015 8 NY SITI AISYAH INFUS
06/05/2015 9 NY YUSMIATI INFUS
06/05/2015 10 NY SRI DEWI INFUS
06/05/2015 11 NY KOKOM INFUS
06/05/2015 12 NY SITI INFUS
12 3

07/05/2015 1 NY MULYATI INFUS DC


07/05/2015 2 NY RINI INFUS
07/05/2015 3 NY OOM INFUS
07/05/2015 4 NY NANI INFUS DC
07/05/2015 5 NY TRESNAWATI INFUS
07/05/2015 6 NY.NINA INFUS
07/05/2015 7 NY.RATIH INFUS
07/05/2015 8 NY.LISNAWATI INFUS
07/05/2015 9 NY ATIN INFUS
07/05/2015 10 BY.DENDY INFUS
07/05/2015 11 AN M.AL-KHALIFI INFUS
11 2
08/05/2015 1 AN NEHA ZEIN INFUS
08/05/2015 2 AN.INDAH INFUS
08/05/2015 2 NY RENI
08/05/2015 3 NY IMAS INFUS
08/05/2015 4 NY RIRIN N INFUS DC
08/05/2015 5 NY. ELIS INFUS DC
08/05/2015 6 NY. NURBAETI INFUS DC
08/05/2015 7 NY. YANTI INFUS
7 3
09/05/2015 1 NY. YANI INFUS DC
09/05/2015 2 NY IDA PARIDAH INFUS
09/05/2015 3 NY TRI HARYANI INFUS
09/05/2015 4 NY SITI NURELAH INFUS
09/05/2015 5 NY.RASTI INFUS
09/05/2015 6 NY FANI INFUS
6 1

10/05/2015 1 NY SUPINAH INFUS


10/05/2015 2 NY YULIANI INFUS
10/05/2015 3 NY SITI SOLIHAH INFUS
10/05/2015 4 NY SITI ROHAYAH INFUS DC
10/05/2015 5 NY YULIS INFUS DC
10/05/2015 6 NY.YOPI INFUS
10/05/2015 7 NY.ANI MULYANI INFUS DC
10/05/2015 8 AN SINTIANI INFUS
10/05/2015 9 BY DAVINA INFUS
10/05/2015 10 AN RAFA INFUS
10 3

11/05/2015 1 NY.SANTI INFUS


11/05/2015 2 NY.SISKA INFUS
11/05/2015 3 NY YUNENGSIH INFUS
11/05/2015 4 NY ELIS SAADAH INFUS
11/05/2015 5 NY ROLLAH INFUS
11/05/2015 6 NY IKA SARTIKA INFUS
11/05/2015 7 NY SITI M INFUS
11/05/2015 8 NY AZMI INFUS
11/05/2015 9 NY EVI INFUS DC
11/05/2015 10 NY NUNIK INFUS
11/05/2015 11 NY YUNENGSIH INFUS DC
11/05/2015 12 NY DEWI SARI INFUS
11/05/2015 13 NY SITI ROSITA INFUS DC
11/05/2015 14 NY LENI SUHARTINI INFUS
11/05/2015 15 NY YANI INFUS
11/05/2015 16 NY SUMIATI INFUS
11/05/2015 17 NY IMAS RENI INFUS DC
11/05/2015 18 NY JUARIAH INFUS
11/05/2015 19 AN WILDAN INFUS
19 4
12/05/2015 1 NY IRMA INFUS
12/05/2015 2 NY NITA INFUS
12/05/2015 3 NY TINAH INFUS DC
12/05/2015 4 NY.YULIA INFUS DC
12/05/2015 5 NY.JUJU INFUS
12/05/2015 6 NY.MARYAM INFUS
12/05/2015 7 NY.YATI INFUS DC
12/05/2015 8 AN ALISYA INFUS
8 3
13/05/2015 1 NY ANA SEPTIANA INFUS
14/05/2015 1 NY DIAN INFUS
14/05/2015 2 NY NINING INFUS
14/05/2015 3 NY LESTARI INFUS
14/05/2015 4 NY ROSI INFUS
14/05/2015 5 NY.PIPIT INFUS
14/05/2015 6 NY.TITA INFUS
14/05/2015 7 NY.NINA INFUS DC
14/05/2015 8 AN NANDA INFUS
8 1
15/05/2015 1 NY.WARTINI INFUS
15/05/2015 2 NY TITIN SUPRAPTIN INFUS DC
15/05/2015 3 NY SUNDARI INFUS
15/05/2015 4 NY YATI INFUS
15/05/2015 5 NY NURHAYATI INFUS
15/05/2015 6 NY HENNY INFUS
15/05/2015 7 NY DATI INFUS
15/05/2015 8 BY REIHAN INFUS
8 1
16/05/2015 1 NY.SRI RAHAYU INFUS
16/05/2015 2 NY.DINA INFUS
16/05/2015 3 NY.TUTI INFUS
16/05/2015 4 NY.NIA INFUS
16/05/2015 5 NY.INDRI INFUS
16/05/2015 6 NY.SITI SAMSIAH INFUS
16/05/2015 7 NY SURYANI INFUS
16/05/2015 8 NY SUHAYATI INFUS
16/05/2015 9 NY DINA INFUS
16/05/2015 10 NY NURYANTI INFUS
16/05/2015 11 NY CUCU INFUS
16/05/2015 12 NY IMAS INFUS
16/05/2015 13 NY KEKE INFUS
16/05/2015 14 BY.RIFAL INFUS
16/05/2015 15 AN SYAIFUL INFUS
15
17/05/2015 1 NY DEDEH INFUS
17/05/2015 2 NY.LILIS INFUS
17/05/2015 3 NY.NANI INFUS
17/05/2015 4 NY.SARAH INFUS
17/05/2015 5 NY.SANTI INFUS
17/05/2015 6 NY.SAIMAH INFUS DC
17/05/2015 7 NY RINI INFUS
17/05/2015 8 NY ROSDIANA INFUS
8 1
18/05/2015 1 NY ERNI INFUS
18/05/2015 2 NY.LENA INFUS
18/05/2015 3 NY.RITA INFUS
18/05/2015 4 NY.FANI INFUS
18/05/2015 5 NY IMAS INFUS
18/05/2015 6 NY NIA KURNIASIH INFUS DC
18/05/2015 7 NY YATI INFUS
18/05/2015 8 NY IIS NURHAYATI INFUS DC
8 2
19/05/2015 1 NY ENDANG INFUS
19/05/2015 2 NY EPON INFUS
19/05/2015 3 NY RIMA INFUS
19/05/2015 4 NY.WINA INFUS
19/05/2015 5 NY.BELA INFUS
19/05/2015 6 NY.YULIANA INFUS DC
19/05/2015 7 AN.LUTFI INFUS
7 1
20/05/2015 1 NY.EMPU MARPUAH INFUS DC
20/05/2015 2 NY.MAE KUSMIATI INFUS
20/05/2015 3 NY CUCU INFUS DC
20/05/2015 4 NY ATIK INFUS
20/05/2015 5 NY LISTIATI INFUS
20/05/2015 6 NY.DEDEH INFUS DC
20/05/2015 7 NY LENI SUHARTINI INFUS DC
20/05/2015 8 NY SHINTA INFUS
20/05/2015 9 NY MIMIN INFUS
20/05/2015 10 NY SURYANI INFUS
20/05/2015 11 NY SITI MARYAM INFUS
20/05/2015 12 BY NY YATI INFUS
20/05/2015 13 BY RAFI INFUS
13 4
21/05/2015 1 NY. SANTI INFUS
21/05/2015 2 NY.RANI INFUS
21/05/2015 3 NY. MUMUN INFUS DC
21/05/2015 4 NY POPY INFUS
21/05/2015 5 NY.NURSIAH INFUS
21/05/2015 6 NY.WINA INFUS
6 1
22/05/2015 1 NY ROHANI INFUS
22/05/2015 2 NY SANTI INFUS DC
22/05/2015 3 NY NURLAELI INFUS
22/05/2015 4 NY AMILAH INFUS
22/05/2015 5 NY DIANI INFUS
22/05/2015 6 NY NENG MUTIARA INFUS
22/05/2015 7 NY SUSAN INFUS
22/05/2015 8 NY NENG HASANAH INFUS
22/05/2015 9 AN DESI INFUS
22/05/2015 10 AN NAURA INFUS
22/05/2015 11 AN ZULFA INFUS
22/05/2015 12 BY ARYA INFUS
12 1

23/05/2015 1 NY SANTI SARIYANTI INFUS


23/05/2015 2 NY YANI INFUS
23/05/2015 3 NY YANI INFUS
23/05/2015 4 NY ITUN INFUS
23/05/2015 5 NY DEWI INFUS
23/05/2015 6 NY NENENG INFUS
23/05/2015 7 NY NOVITASARI INFUS
7

24/05/2015 1 NY SANTI SARIYANTI INFUS DC


24/05/2015 2 NY YANI INFUS DC
24/05/2015 3 NY YANI INFUS
24/05/2015 4 NY ITUN INFUS DC
24/05/2015 5 NY DEWI INFUS DC
24/05/2015 6 NY RISTI INFUS DC
24/05/2015 7 NY NURLELA INFUS
24/05/2015 8 NY TITA INFUS DC
24/05/2015 9 NY PUTRI INFUS DC
24/05/2015 10 NN TANIA INFUS DC
24/05/2015 12 NY HAMIDAH INFUS
24/05/2015 13 NY RIKA WATI INFUS
24/05/2015 14 NY AIT KARTINI INFUS
24/05/2015 15 NY MIMIN INFUS
15 8
25/05/2015 1 NY.NINA INFUS
25/05/2015 2 NY.YUNI WULANSARI INFUS
25/05/2015 3 NY.RIKA SELVIANI INFUS
25/05/2015 4 NY YUNI WULANDARI INFUS DC
25/05/2015 5 NY TENI INFUS DC
25/05/2015 6 NY RINI ROSMIYATI INFUS
25/05/2015 7 NY SITI KARMILAH INFUS DC
25/05/2015 8 NY SRI TAMI INFUS
25/05/2015 9 NY SITI HODIJAH INFUS
9 3
26/05/2015 1 NY SITI KARMILAH INFUS DC
26/05/2015 2 NY.ERNI INFUS DC
26/05/2015 3 NY.SITI FITRI INFUS
26/05/2015 4 NY.NILA INFUS
26/05/2015 5 NY.HERLINA INFUS
26/05/2015 6 NY SELY INFUS
26/05/2015 7 NY INDRI INFUS DC
26/05/2015 8 NY PIPIT INFUS
26/05/2015 9 NY INA RUSTIANI INFUS DC
26/05/2015 10 NY HOLIS INFUS DC
26/05/2015 11 NY NONENG INFUS DC
26/05/2015 12 NY SITI MAEMUNAH INFUS
26/05/2015 13 AN BINTANG INFUS
13 6

27/05/2015 1 NY TATI INFUS DC


27/05/2015 2 NY TOTI INFUS
27/05/2015 3 NY IMA INFUS
27/05/2015 4 NY ETI INFUS
27/05/2015 5 AN.ALISHA INFUS
5 1

28/05/2015 1 NY SANTI INFUS


28/05/2015 2 NY ANEU INFUS
28/05/2015 3 NY DINI INFUS DC
28/05/2015 4 NY SITI N INFUS
28/05/2015 5 NY ROSMALA DEWI INFUS
28/05/2015 6 NY NENI INFUS
28/05/2015 7 NY YANI INFUS DC
7 2

29/05/2015 1 NY LENI INFUS DC


29/05/2015 2 NY TATI ROHAETI INFUS
29/05/2015 3 NY RISKI INFUS
29/05/2015 4 NY ROSLINA INFUS
29/05/2015 5 NY LULU INFUS DC
29/05/2015 6 NY RINI INFUS
29/05/2015 7 NY AIDA INFUS DC
29/05/2015 8 NY KOKOM INFUS DC
29/05/2015 9 NY SITI INFUS DC
9 5
30/05/2015 1 NY.TUTI SUSANTI INFUS
30/05/2015 2 NY.EVI INFUS
30/05/2015 3 NY.DEWI NESTRIAN INFUS
30/05/2015 4 NY.RIA INFUS
30/05/2015 5 NY.ELISMAWATI INFUS
30/05/2015 6 NY.LENA INFUS
30/05/2015 7 NY.SITI UMU INFUS
30/05/2015 8 NY.HAERANI INFUS DC
30/05/2015 NY OMAH INFUS
30/05/2015 9 NY AMI MARYAMI INFUS
30/05/2015 10 NY WARTINI INFUS DC
10 2

31/05/2015 1 NY ESIH INFUS


31/05/2015 2 NY MARTINI INFUS
31/05/2015 3 NY UMDATUL IZZAH INFUS
31/05/2015 4 NY TUTI INFUS
31/05/2015 5 NY SITI HODIJAH INFUS DC
31/05/2015 6 NY MEITA INFUS
31/05/2015 7 NY CASTEM INFUS DC
31/05/2015 8 AN EVAN INFUS
8 2
jumlah 274 58
total pasien 600

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN JUNI

01/06/2015 NY TITIN INFUS


01/06/2015 NY PIPIH INFUS DC
01/06/2015 NY.IRMA INFUS DC
01/06/2015 NY. NIKA INFUS
01/06/2015 NY. LINA INFUS
01/06/2015 NY.JAMILAH INFUS DC
01/06/2015 NY. DEDE INFUS
01/06/2015 NY EKA INFUS
01/06/2015 NY CUCU INFUS
01/06/2015 NY. DEWI SRI INFUS DC
01/06/2015 NY. DEWI INFUS
01/06/2015 BY NY.EKA INFUS
01/06/2015 AN SAHAD PRADANA INFUS
13 4

02/06/2015 NY.LUSI INFUS DC


02/06/2015 NY.RITA INFUS
02/06/2015 NY.NINA INFUS
02/06/2015 NY NENG HAYATI INFUS DC
02/06/2015 NY LINDAWATI INFUS
02/06/2015 NY MELI SULASTRI INFUS
02/06/2015 NY ANGGI INFUS DC
02/06/2015 NY PERONIKA INFUS DC
8 4

03/06/2015 NY SITI NUR ANDINI INFUS


03/06/2015 NY SANTI INFUS DC
03/06/2015 NY ITA ROSITA INFUS
03/06/2016 NY WIWIN INFUS
03/06/2015 NY AYU SRI R INFUS
03/06/2015 NY WINA INFUS DC
6 2

04/06/2015 NN RANI INFUS


04/06/2015 NY YANI INFUS
04/06/2015 NY FITRIA INFUS
04/06/2015 NY SUSI INFUS
04/06/2015 NY TINI INFUS
04/06/2015 NY SRI SARBINI INFUS
6

05/06/2015 NY IRMA INFUS


05/06/2015 NY LINDA INFUS DC
05/06/2015 NY.NURHAYATI INFUS
05/06/2015 NY.IIS SUNENDAR INFUS DC
05/06/2015 NY.FEBIYANI INFUS DC
05/06/2015 NY.SANTI INFUS
05/06/2015 NY NOVI INFUS DC
05/06/2015 NY RANI INFUS DC
05/06/2015 NY GANTINI INFUS DC
05/06/2015 NY DIAN MAYASARI INFUS
05/06/2015 NY PUTRIA INFUS
05/06/2015 NY SILPI INFUS
05/06/2015 NY YANTI INFUS
05/06/2015 NT IMA INSUS
14 6

06/06/2015 NY WAWAT INFUS


06/06/2015 NY SILPI INFUS
06/06/2015 NY CICAH INFUS
06/06/2015 NY SITI SARIFAH INFUS
06/06/2015 NY SUSANTI INFUS DC
06/06/2015 NY UCU SITI INFUS
06/06/2015 NY RISMA INFUS
06/06/2015 NY YANI SRI INFUS
8 1

07/06/2015 NY ENENG SITI INFUS


07/06/2015 NY DANTIKA INFUS
07/06/2015 NY KATINI INFUS DC
07/06/2015 NY AI SITI INFUS
07/06/2015 NY NEULIA INFUS
07/06/2015 NY DELLA INFUS DC
07/06/2015 NY DARWIYATUN INFUS
07/06/2015 NY FITRI MARDIANI INFUS
07/06/2015 NY EUIS INFUS
07/06/2015 NY ERMA PIPIT INFUS DC
07/06/2015 NY NENDEN INFUS
07/06/2015 BY.M DERI INFUS
07/06/2015 BY.RIZKI INFUS
07/06/2015 AN.NAZWA INFUS
07/06/2015 BY.NABILA INFUS
07/06/2015 AN.ROHMAN INFUS
16 3
08/06/2015 NY HANI INFUS DC
08/06/2015 NY YENI INFUS
08/06/2015 NY LINDA INFUS
08/06/2015 NY SINTA INFUS
08/06/2015 AN M ZIDAN INFUS
5 1

09/06/2015 NY NINA INFUS


09/06/2015 NY YANI INFUS
09/06/2015 NY IRAWAN INFUS
09/06/2015 NY ENUNG INFUS
09/06/2015 NY RIA INFUS
09/06/2015 NY SARIFAH INFUS
09/06/2015 NY NINA INFUS
09/06/2015 NY ANDI INFUS
09/06/2015 NY WULAN INFUS
09/06/2015 NY YUYUN INFUS DC
09/06/2015 AN RENDI INFUS
11 1

10/06/2015 NY YATI INFUS DC


10/06/2015 NY.ROSTIKA INFUS DC
10/06/2015 NY.NIA INFUS
10/06/2015 NY YUNITA INFUS
10/06/2015 BY FATHIR RADITYA INFUS
5 2

11/06/2015 NY NENG MARYANA INFUS


11/06/2015 NY SITI INFUS
11/06/2015 NY ROSLINA INFUS DC
11/06/2015 NY RATINI INFUS
11/06/2015 NY MAEMUNAH INFUS
11/06/2015 NY IRAWATI INFUS
6 1

12/06/2015 NY ADE INFUS


12/06/2015 NY.SYLMI INFUS
12/06/2015 NY.ERNA INFUS
12/06/2015 NY.MERTINA INFUS
12/06/2015 NY.HERLINA INFUS DC
12/06/2015 NY WIDA INFUS
12/06/2015 NY NURLELAH INFUS DC
12/06/2015 NY EKA INFUS DC
12/06/2015 NY HILDA INFUS
12/06/2015 NY NISA INFUS
12/06/2015 NY RAINA INFUS
12/06/2015 NY DEDE INFUS
12/06/2015 AN.ZHENIRA INFUS
12/06/2015 AN DANIS INFUS
14 3

13/06/2015 NY AI HARTATI INFUS


13/06/2015 NY ENI INFUS
13/06/2015 NY LINTANG INFUS
13/06/2015 NY NINING INFUS DC
13/06/2015 NY IRA INDRIYANI INFUS
13/06/2015 NY SUTIANI INFUS
13/06/2015 NY RITA INFUS
13/06/2015 AN M FADLI INFUS
13/06/2015 AN REVANYA INFUS
9 1
14/06/2015 NY WIWIN INFUS
14/06/2015 NY SAILA INFUS
14/06/2015 NY HENDRAYANI INFUS
14/06/2015 NY ERLINA INFUS
14/06/2015 NY IKA INFUS
14/06/2015 NY ANI SUMARNI INFUS
14/06/2015 NY.SUHERNI INFUS
14/06/2015 NY NIKIE INFUS
14/06/2015 NY RISKA INFUS
14/06/2015 NY NENG ELI INFUS
10

15/06/2015 NY SITI N INFUS


15/06/2015 NY IRMA INFUS
15/06/2015 NY NENENG INFUS DC
15/06/2015 NY ERNI INFUS
15/06/2015 NY RIKA INFUS
15/06/2015 NY NENDEN INFUS DC
15/06/2015 NY KRISTIANTI INFUS
15/06/2015 NY NENGSIH INFUS
15/06/2015 NY.YULI INFUS
15/06/2015 NY. ROCMANIA INFUS
15/06/2015 NY. DIANA INFUS
15/06/2015 NY. SITI MULYATI INFUS DC
15/06/2015 NY CASTEM INFUS
15/06/2015 NY DEWI INFUS
15/06/2015 NY IIM HASANAH INFUS
15/06/2015 NY YULIANI INFUS
15/06/2015 NY ROSITA INFUS
15/06/2015 BY M FIRGHI INFUS
18 3

16/06/2015 NY FITRIYANI INFUS


16/06/2015 NY RODIAH INFUS
16/06/2015 NY NURHAYANIH INFUS
16/06/2015 NY TELSI INFUS DC
16/06/2015 NY DADAH INFUS
16/06/2015 NY GINA INFUS
16/06/2015 NY SOFIYATUN INFUS
16/06/2015 NY JUARIAH INFUS
16/06/2015 NY DETI INFUS
16/06/2015 NY SITI MAEMUNAH INFUS
16/06/2015 NY CUCU INFUS
16/06/2015 AN KIKI INFUS
16/06/2015 BY NY PRITA INFUS
16/06/2015 AN BELANTARA INFUS
14 1

17/06/2015 NY.SUMIYATI INFUS


17/06/2015 NY.LINA INFUS
17/06/2015 NY.LIA INFUS
17/06/2015 AN ASTIE SIDQIA INFUS
4
18/06/2015 NY KOMALASARI INFUS
18/06/2015 NY DINI INFUS DC
18/06/2015 NY WIDI SRI MUTIA INFUS
18/06/2015 NY EJA INFUS
18/06/2015 NY PUTRI INFUS
18/06/2015 NY E.WIDANINGSIH INFUS
18/06/2015 AN ALIF INFUS
18/06/2015 BY M ALBY INFUS
8 1

19/06/2015 NY SAINEM INFUS DC


19/06/2015 NY.LIA MARLINA INFUS DC
19/06/2015 NY.KEKE INFUS
19/06/2015 NY.PRISKA INFUS
19/06/2015 NY.ELSA INFUS DC
19/06/2015 NY SODIAH INFUS DC
19/06/2015 NY.ELIS MARYANI INFUS DC
19/06/2015 BY AL MUSHORIF INFUS
8 5

20/06/2015 NY UMU INFUS DC


20/06/2015 NY SITI INFUS
20/06/2015 NY MARTINI INFUS DC
20/06/2015 NY LILIS INFUS
20/06/2015 NY RISTIANI INFUS
20/06/2015 NY CAHYATI INFUS
20/06/2015 NY DEANE INFUS
20/06/2015 NY INTAN INFUS
20/06/2015 NY FITRIANI INFUS
20/06/2015 NY RISMAWATI INFUS DC
20/06/2015 NY SITI HANDAYANI INFUS
20/06/2015 NY FATIMAH INFUS DC
20/06/2015 NY IIS HOLISOH INFUS DC
20/06/2015 BY NY ANI INFUS
13 5
21/06/2015 NY ANNE DIANAWATI INFUS
21/06/2015 NY HENI INFUS
21/06/2015 NY PUTRI INFUS
21/06/2015 NY YULIATI INFUS DC
21/06/2015 NY LINA INFUS
21/06/2015 NY WIDA INFUS
21/06/2015 NY ERNA INFUS
21/06/2015 NY CUCU INFUS
8 1

22/06/2015 NY WINA INFUS


22/06/2015 NY FITRIAWATI INFUS
22/06/2015 NY RINI INFUS
22/06/2015 NY RODIAH INFUS DC
22/06/2015 NY PUTIE INFUS
22/06/2015 NY SANTI INFUS
22/06/2015 NY SHINTAWATI INFUS
22/06/2015 NY SRI WINARTI INFUS DC
22/06/2015 NY LINA KARLINA INFUS DC
22/06/2015 NY SITI JUBAEDAH INFUS DC
22/06/2015 AN.FADIL INFUS
11 4

23/06/2015 NY SITI AISYAH INFUS


23/06/2015 NY YANI INFUS
23/06/2015 NY MELIA INFUS
23/06/2015 NY SITI MARYATI INFUS
23/06/2015 NY DARSIH INFUS
23/06/2015 NY.NURALIN INFUS
23/06/2015 NY.YETI INFUS
23/06/2015 NY.AI SUSI SUSANTI INFUS
23/06/2015 NY YENI SEPTIANI INFUS
23/06/2015 NY MIRNANINGSIH INFUS DC
23/06/2015 NY NANI INFUS DC
23/06/2015 NY NOVITA INFUS
12 2

24/06/2015 NY SITI MAEMUNAH INFUS


24/06/2015 NY SANTIKA INFUS DC
24/06/2015 NY LUSI INFUS
24/06/2015 NY.POPON INFUS
24/06/2015 NY NENG ATIKAH INFUS
24/06/2015 NY OMIH INFUS
24/06/2015 NY ERNI INFUS
24/06/2015 NY FITRIA INFUS
24/06/2015 AN FRILI INFUS
9 1

25/06/2015 NY SITI MARIAH INFUS


25/06/2015 NY JUWANGSIH INFUS
25/06/2015 NY YENI ARIESTINI INFUS
25/06/2015 NY ENENG SARIPAH INFUS
25/06/2015 NY YATI INFUS
25/06/2015 NY NENENG INFUS
25/06/2015 NY SRI MULYANI INFUS DC
25/06/2015 NY SENI INFUS
25/06/2015 NY RENI INFUS
25/06/2015 NY LENI INFUS DC
25/06/2015 NY YULIANA INFUS DC
25/06/2015 NY RANIKA INFUS
12 3

26/06/2015 NY NELI INFUS


26/06/2015 NY FARIDA INFUS
26/06/2015 AN NURUL INFUS OGT
3 1

27/06/2015 NY ONIH INFUS


27/06/2015 NY LANI INFUS
27/06/2015 NY SITI NURHAFIDOH INFUS
27/06/2015 NY AI SITI SOLIHAT INFUS
27/06/2015 NY SANDRI SRI INFUS
5

28/06/2015 NY YULIAWATI INFUS


28/06/2015 NY ERNA INFUS
28/06/2015 NY WARYATI INFUS
28/06/2015 NY NURSIPAH INFUS
28/06/2015 NY ENI HARYANI INFUS
28/06/2015 NY ROSITA INFUS
28/06/2015 NY RINA INFUS
28/06/2015 NY INTAN INFUS
28/06/2015 AN ARGANTA INFUS
28/06/2015 AN ARGANTA INFUS
28/06/2015 AN ABYAN INFUS
28/06/2015 AN FAJAR RIZKI INFUS
12

29/06/2015 NY ANI INFUS DC


29/06/2015 NY ANISA INFUS
29/06/2015 NY REGITA INFUS
29/06/2015 NY IMAS INFUS
29/06/2015 NY WINDA INFUS
29/06/2015 NY NENG RATNI INFUS DC
29/06/2015 NY NURAINI INFUS
29/06/2015 NY IMAS SUPARTIKA INFUS
29/06/2015 NY MAYA INFUS
9 2

30/06/2015 NY HERAWATI INFUS DC


30/06/2015 NY ARIE YULIANTI INFUS
30/06/2015 NY NIA INFUS
30/06/2015 NY EUIS INFUS
30/06/2015 NY NURLELAWATI INFUS
5 1

JUMLAH TOTAL 743 ETT 1


JUMLAH INFUS 282 OGT 1
JULAH DC 76
Formulir Survey Harian Pemakaian Alat
Ruang IGD - RSKIA BULAN JULI
01/07/2015 NY CUCU INFUS DC
01/07/2015 NY TRI MELIYATI INFUS DC
01/07/2015 NY PERA INFUS
01/07/2015 NY.YENI INFUS
01/07/2015 NY.FITRI INFUS
01/07/2015 NY NENG YENI INFUS
01/07/2015 NY ETI ROHAETI INFUS
01/07/2015 NY YULI INFUS DC
01/07/2015 AN SAILA NURUL INFUS
01/07/2015 BY SYAMIL INFUS
01/07/2015 BY TASLIM INFUS
01/07/2015 BY RAFFI INFUS
12 3

02/01/2015 NY FITRI INFUS


02/01/2015 NY TRESTI INFUS
02/01/2015 NY TANTRI INFUS
02/01/2015 NY HERNI INFUS
02/01/2015 NY DINI INFUS DC
02/01/2015 NY ANI MULYANI DC
02/01/2015 NY MEIS INFUS
7 2

03/07/2015 NY AAM INFUS


03/07/2015 NY TITI INFUS
03/07/2015 NY DETA INFUS
03/07/2015 NY DIAH INFUS DC
03/07/2015 NY NURSANTI INFUS
03/07/2015 NY DIANI INFUS
03/07/2015 NY LILIS INFUS DC
03/07/2015 NY SRI HAYATI INFUS
03/07/2015 NY AAT INFUS DC
9 3

04/07/2015 NY I HARYATI INFUS


04/07/2015 NY TITA INFUS
04/07/2015 NY RETTA INFUS
04/07/2015 NY ANEU INFUS
04/07/2015 NY NITA INFUS
04/07/2015 BY ADZAN INFUS
6

05/07/2015 NY AAN INFUS


05/07/2015 NY RIMA INFUS
08/07/2015 NY TITIN INFUS
05/07/2015 NY ELIS INFUS
05/07/2015 NY SITI MAULLIDA INFUS
05/07/2015 NY SITI KAMILAH INFUS
05/07/2015 NY TUTIK INFUS
05/07/2015 BY M DZAKI INFUS
05/07/2015 BY PUTRI AYU INFUS
9

06/07/2015 NY RINA INFUS


06/07/2015 NY ANISA INFUS
06/07/2015 NY LILIS INFUS
06/07/2015 NY DINA INFUS
06/07/2015 NY SRI LESTARI DC
06/07/2015 NY ELLY INFUS
06/07/2015 NY FERA INFUS
06/07/2015 NY IMAS INFUS
06/07/2015 NY SRI HARTI INFUS DC
9 2

07/07/2015 NY LILIS INFUS


07/07/2015 NY NUNI INFUS DC
07/07/2015 NY ROKHILAH INFUS DC
07/07/2015 NY II INFUS
07/07/2015 NY DEWI SUPRIATIN INFUS
07/07/2015 NY MIMIN INFUS
07/07/2015 NY HELFIANI INFUS
07/07/2015 NY WIWIN INFUS
07/07/2015 NY SANTI INFUS DC
07/07/2015 NY ZAENAL INFUS DC
07/07/2015 NY YENI INFUS
07/07/2015 AN YULIAN INFUS
07/07/2015 AN AL FATIR INFUS
14 4

08/07/2015 NY IIS NURHAYATI INFUS


08/07/2015 NY ISALORA INFUS
08/07/2015 NY RISMA INFUS
08/07/2015 NY NENI INFUS
08/07/2015 NY AI HAYATI INFUS
08/07/2015 NY SYANDRA NURUL INFUS
08/07/2015 NY WIDIATI INFUS
08/07/2015 NY SILVI INFUS
08/07/2015 BY BEMBI MUHAMMAD INFUS
8

09/07/2015 NY ETI ROHAETI INFUS


09/07/2015 NY ERNI INFUS DC
09/07/2015 NY DESI YULIANI INFUS
09/07/2015 NY NURHALIMAH INFUS
09/07/2015 NY DINA INFUS
09/07/2015 NY IMAS INFUS DC
09/07/2015 NY LINDA INFUS DC
09/07/2015 NY RINA INFUS DC
09/07/2015 NY TIARA MITA LIANI INFUS
09/07/2015 ny. RINI LIDIYA INFUS
09/07/2015 NY NURYANTI INFUS
09/07/2015 AN HILMAN INFUS
09/07/2015 AN DIANDRA INFUS
09/07/2015 AN ILHAM INFUS
14 4

10/07/2015 NY YUYUN INFUS


10/07/2015 NY IIS INFUS
10/07/2015 NY HUSNUL INFUS
10/07/2015 NY ROSITA INFUS DC
10/07/2015 NY ARAH INFUS DC
10/07/2015 NY SRI WAHYUNI INFUS
10/07/2015 NY RIKA INFUS
7 2

11/07/2015 NY YENI INFUS


11/07/2015 NY DEWI INFUS DC
11/07/2015 NY SARINENGSIH INFUS
11/07/2015 NY YANI INFUS
11/07/2015 NY AAN SUSILAWATI INFUS
11/07/2015 NY IMAS CICIH INFUS DC
11/07/2015 NY YAYUK INFUS
7 2

12/07/2015 NY SUSI SUSILAWATI INFUS DC


12/07/2015 NY EUIS INFUS
12/07/2015 NY SITI SUWAEDAH INFUS
12/07/2015 NY ROSSI INFUS DC
12/07/2015 NY GITA PERTIWI INFUS
12/07/2015 NY SITI NURJANAH INFUS DC
12/07/2015 NY. INDAH INFUS
12/07/2015 NY NOVA INFUS
12/07/2015 NY NENI NURAENI INFUS
12/07/2015 NY ELA INFUS DC
12/07/2015 NY MULIANA INFUS
12/07/2015 NY YAYAH INFUS
12/07/2015 NY RISKA INFUS DC
12/07/2015 AN FRISKA INFUS
15 5

13/07/2015 NY HENI INFUS DC


13/07/2015 NY ANNE INFUS DC
13/07/2015 NY HENI INFUS DC
13/07/2015 NY SITI HALIMAH INFUS
13/07/2015 NY JULAEHA INFUS
13/07/2015 NY LIA INFUS
13/07/2015 NY PONIAWATI INFUS DC
13/07/2015 NY WIDANINGSIH DC
13/07/2015 NY ELIS INFUS
13/07/2015 NY LENI INFUS DC
13/07/2015 NY HENI INFUS DC
11 7

14/07/2015 NY NURYAWANTI INFUS


14/07/2015 NY DEWI INFUS
14/07/2015 NY NURFUJI INFUS
14/07/2015 NY OKTAVIANI INFUS DC
14/07/2015 NY ENUNG INFUS DC
14/07/2015 NY EMA INFUS
14/07/2015 NY R SHALMA INFUS DC
14/07/2015 NY ATIKAH INFUS
14/07/2015 NY SYURYATI INFUS DC
14/07/2015 NY ELIS MARJAN INFUS
14/07/2015 NY NELIS INFUS
14/07/2015 NY YAYANG INFUS
14/07/2015 NY SANTI INFUS
13 4

15/076/2015 NY HOLIS HASANAH INFUS


15/076/2015 NY ARI HAYATI INFUS
15/076/2015 NY EKA TAMAYA INFUS
15/076/2015 NY SITI SALMA INFUS
15/076/2015 NY HENDRAYANI INFUS DC
15/076/2015 NY ROSE HERMAYANTI INFUS
15/076/2015 NY EROS INFUS DC
15/07/2015 NY ERNA INFUS
15/07/2015 NY JULAEHA INFUS
15/07/2015 NY ROMAIDA INFUS
15/07/2015 NY DESSI INFUS
15/07/2015 NY NUR ROHMAH INFUS
15/07/2015 NY REXXA INFUS
15/07/2015 NY RATNA INFUS
15/07/2015 AN REVIN INFUS
15 2

16/07/2015 NY SENDY INFUS


16/07/2015 NY DINAR INFUS
16/07/2015 NY AI NURHAYATI INFUS
16/07/2015 NY NURAENI INFUS
16/07/2015 NY SOFIA INFUS DC
5 1

17/07/2015 NY SUMIATI INFUS


17/07/2015 NY INA INFUS
17/07/2015 NY RUPINAH INFUS DC
17/07/2015 NY SUPRIATIN INFUS
17/07/2015 NY LILIS SUHARTINI INFUS
17/07/2015 NY GATY PUTRI INFUS
17/07/2015 NY WISTI INFUS
17/07/2015 NY TUTI INFUS DC
17/07/2015 NY YULIANI INFUS
9 2

18/07/2015 NY HENI INFUS DC


18/07/2015 NY RINI ANGGRAENI INFUS DC
18/07/2015 NY IKE INFUS
18/07/2015 NY IDA AIDA INFUS
18/07/2015 NY NURFARIDA INFUS
18/07/2015 NY ISRAMI INFUS
18/07/2015 NY ROSI INFUS
18/07/2015 NY NURAZIZAH INFUS
18/07/2015 NY SOSILOWATI INFUS
18/07/2015 NY GILANG INFUS DC
18/07/2015 NY IDA AIDA INFUS
18/07/2015 AN M LATIF INFUS
12 3

19/07/2015 NY EVA INFUS


NY ENTIN INFUS
NY RITA INFUS
NY NURLIANA INFUS
NY YANI INFUS
NY HANI INFUS DC
NY AI FATONAH INFUS DC
AN RIZKY INFUS
8 2

20/07/2015 SINTIA INFUS


20/07/2015 ROMLAH INFUS
20/07/2015 DEWANTI INFUS
20/07/2015 NY YUSI INFUS DC
20/07/2015 NY NURWITA INFUS DC
20/07/2015 NY SANTI INFUS
20/07/2015 NY WIDYASTUTI INFUS
20/07/2015 NY NIA INFUS
20/07/2015 NY UTARI INFUS
20/07/2015 NY SUMARNI INFUS
20/07/2015 AN BILQIS INFUS
11 2

21/07/2015 NY AAN INFUS


21/07/2015 NY SARI INFUS DC
21/07/2015 NY ANISA INFUS DC
21/07/2015 AN ANANDA INFUS
4 2

22/07/2015 NY RINA INFUS


22/07/2015 NY YESSI INFUS
22/07/2015 NY NURAENI INFUS
22/07/2015 NY ELI NURLAELI INFUS
22/07/2015 NY SITI SUMINAR INFUS
22/07/2015 NY DIAH INFUS DC
6 1

23/07/2015 NY MAHYATI INFUS


23/07/2015 NY AI E KURNIASIH INFUS DC
23/07/2015 NY YANI INFUS DC
23/07/2015 NY SANTI INFUS
23/07/2015 NY CUCU INFUS
23/07/2015 NY NENDEN INFUS
BY NADIA INFUS ETT
8 2 1

24/07/2015 NY FITRIA INFUS DC


NY FITRI INFUS DC
NY NOVI INFUS
NY SITI INFUS
NY YULI INFUS
NY SISKA INFUS
NY ELLY INFUS
NY SANTI INFUS
NY SOTCA INFUS
AN CINTA INFUS
BY NY IMAS INFUS
11 2

25/07/2015 NY RATNA INFUS


NY ENENG INFUS
NY DEVI INFUS
NY SITI CHOTIMAH INFUS
NY FEBRIANI INFUS
NY NITA INFUS
NY RATIH INFUS DC
NY SUYATUN INFUS
NY LILIS INFUS
NY SEPTIANI INFUS
NY LENI INFUS
NY TETI INFUS
AN SYIFA INFUS
AN SYLA INFUS
AN SAPNA INFUS
15 1

26/07/2015 NY ASRI INFUS DC


NY ENI INFUS
NY AI NURHASANAH INFUS
NY ERNI INFUS
NY RODIAH INFUS
NY NOVI INFUS DC
NY RISA INFUS DC
NY TINTIN INFUS DC
NY DEDE INFUS
NY ANGGI INFUS
NY IRMA INFUS
11 4

27/07/2015 NY EUIS INFUS


NY LILIS INFUS
NY DINNY INFUS
NY NUNUNG INFUS
NY MEGA INFUS
NY RENI INFUS
NY SITI MASITOH INFUS
NY DEWI INFUS
NY E RISNEU INFUS
NY NETI INFUS DC
NY NURAENI INFUS
BY NY EVI INFUS
12 1

28/07/2015 NY NURHOLIFAH INFUS


NY NENG YAMAH INFUS
NY NINA INFUS
NY TIARA INFUS
NY IRMAYANTI INFUS
5

29/07/2015 NY SITI NURJANAH INFUS DC


NY SITI HALIMAH INFUS DC
NY YONA INFUS
NY NUNING INFUS
NY EDAH INFUS DC
NY SINTA INFUS DC
AN RAYA INFUS
7 4

30/07/2015 NY NURHALIMAH INFUS DC


NY MERI INFUS
NY NURSOLIHAT INFUS
AN RIZKI INFUS
AN AL KHALIQ INFUS
3 1

31/07/2015 NY IKA INFUS


NY RINA INFUS DC
NY EULIS INFUS
NY RUSTIANA INFUS
NY JEJEH INFUS DC
NY NOVIA INFUS DC
NY SENIANINGSIH INFUS DC
NY LINDA INFUS DC
NY ERNA INFUS
NY MARIAM INFUS
YN SITI AISYAH INFUS DC
NY NURHAYATI INFUS DC
NY ENI INFUS
13 7 1
JUMLAH TOTAL : 296 69
jUMLAH PASIEN 743
Formulir Survey Harian Pemakaian Alat
Ruang IGD - RSKIA BULAN AGUSTUS
01/08/2015 NY EMA ROHIMAH INFUS
NY WITRI INFUS
NY MULYANI INFUS
NY AI YETI INFUS
AN FABIAN INFUS
5

02/08/2015 NY WIWI NURHAYATI INFUS


NY YANI MULYANI INFUS DC
NY WETI INFUS
NY YUNITA INFUS
NY PITRIYANI INFUS
NY SUSANA INFUS
NY ANIS INFUS DC
NY.TATI SULASTRI INFUS
NY.RABIATUL INFUS
AN NAURA INFUS
10 2

03/08/2015 NY RENI INFUS


NY ANITA INFUS
NY ERNA INFUS
NY HETY INFUS
AN FAHRIZAL INFUS
5
04/08/2015 NY SITI NURHAFIDAH INFUS DC
NY RODIAH INFUS
NY SOFIA INFUS
NY IDA INFUS DC
NY EUIS INFUS
NY YULI INFUS
6 2
05/08/2015 NY KARTINI INFUS
NY SUSI INFUS
NY RANI INFUS
NY IIN SUMARNI INFUS DC
NY NENI INFUS
NY YUNINGSIH INFUS
NY RITA INFUS DC
NYELIN INFUS
8 2
06/08/2015 NY IMAS INFUS
NY DEDE ITA INFUS
NY KIKI RIZKI INFUS DC
3 1
07/08/2015 NY LIA INFUS DC
NY EUIS INFUS
NY ERYULIATI INFUS
NY SITI INFUS
NY INE INFUS
NY HARDAMANIK INFUS DC
NY AYI MARYAM INFUS
7 2
09/08/2015 NY TUTI LIAWATI INFUS
NY.DESI INFUS DC
NY.YUNITA INFUS DC
NY N.SURYANI INFUS DC
NY ECIN INFUS
5 3
10/08/2015 NY ANAWATI INFUS DC
NY DESI NURSIVA INFUS DC
NY RANTINAH INFUS
NY WIENY INFUS DC
NY IMELDA INFUS
NY VINA INFUS
NY TENGKU VERA INFUS
NY ROHIMAH INFUS
NY DEDEH INFUS
NY ANE INFUS
NY JENI INFUS
NY ROIYAH INFUS
NY YULIANTI INFUS
NY NINA INFUS
NY MARINI INFUS
NY NOVI INFUS DC
16 4
11/08/2015 NY IDA ROHIMAH INFUS
NY DIAN INFUS
NY.ULI INFUS DC
NY.ELIS INFUS
NY.DINI INFUS DC
NY.CICI INFUS DC
6 3
12/08/2015 NY.YURI INFUS
NY.MEGA INFUS
NY.MINA INFUS
NY AI NURHAYATI INFUS DC
NY ENTIN INFUS DC
NY SANTI INFUS DC
NY PIPIH INFUS
NY AI SUARNI INFUS DC
NY RISNA INFUS
NY KETHI INFUS
10 4
13/08/2015 NY EGA INFUS
NY SRI NENGSIH INFUS
NY RINNY INFUS DC
NY.ELLIS INFUS
4 1
14/08/2015 NY OMAH INFUS
NY SITI INFUS
NY SELVIA INFUS
NY NUR INFUS
NY HANI INFUS DC
NY SILMA INFUS
NY EPI INFUS
NY AYU INFUS
NY HARYATI INFUS
NY SUSANTI INFUS
10 1
15/08/2015 NY YANI INFUS DC
NY NURHALIMAH INFUS
NY RINI INFUS DC
NY NURLAENI INFUS
NY EROS INFUS
NY MIA INFUS
NY ATI INFUS
NY MULYATI INFUS
NY YENI INFUS
9 2
16/08/2015 NY PIAH INFUS
NY EUIS INFUS
NN KEMALA INFUS
NY ROKAYAH INFUS
NY EKA PARIDA INFUS
NY HENNY INFUS
NY FANI INFUS
NY SITI INFUS
NY DESI WULANDARI INFUS
NY DEWI INFUS
NY AI MAESAROH INFUS
NY NIA AMIATI INFUS
NY HAPPY INFUS
NY SUPIAH INFUS
14
17/08/2015 NY OMAH INFUS
NY DESI INFUS
NY DERA INFUS
NY AI MARYAM INFUS
NY DEWI RATNA INFUS
NY LIA YULIANI INFUS
NY WIDAYANTI INFUS
NY TETI INFUS
NY WINA INFUS
NY TINI INFUS
10
18/08/2015 NY ETI INFUS
NY RIKASARTI INFUS
NY HALIMAH INFUS DC
NY DEDE INFUS
NY ICHA INFUS
NY SUWARNI INFUS
NY PERAWATI INFUS
7 1
19/08/2015 NY APRILINA INFUS
NY ELLA INFUS
NY ENENG INFUS
NY MURNIATI INFUS
4
20/08/2015 NY MULYANI INFUS
NY UMI INFUS
ny winarsih INFUS
ny NURMALA SARI INFUS
NY SUMARYANI INFUS
NY SUNARTI INFUS DC
NY SUPARTINI INFUS
NY YULIANTI INFUS DC
NY SATINEM INFUS
9 2
21/08/2015 NY MIA INFUS DC
21/08/2015 NY SITI INFUS
21/08/2015 NY.LILIS INFUS
21/08/2015 NY EVI INFUS
21/08/2015 NY SITI FARIDAH INFUS
21/08/2015 NY DIAN INFUS
21/08/2015 NY ROSMANAH INFUS
21/08/2015 BY RIZKI INFUS
8 1

22/08/2015 NY NURMAYANTI INFUS


22/08/2015 NY INEU INFUS DC
22/08/2015 NY VANI FEBRIAN INFUS
22/08/2015 NY TRIAYU INFUS
22/08/2015 NY NURYULIANTI INFUS
22/08/2015 NY DEWI INFUS
22/08/2015 NY LISNA INFUS
22/08/2015 NY GESTI INFUS
22/08/2015 AN MARSHANDA INFUS
9 1

23/08/2015 NY SESILIA INA INFUS


23/08/2015 NY POPON INFUS
23/08/2015 NY SITI NUR INFUS
23/08/2015 NY YAYU SRI RAHAYU INFUS
23/08/2015 NY TIKA INFUS
23/08/2015 NY LUY YUNIATI INFUS
23/08/2015 NY NUNI SUNDARI INFUS
7

24/08/2015 NY DEWI INFUS


24/08/2015 NY TITIN INFUS DC
24/08/2015 NY EKA INFUS
24/08/2015 NY TINTIN INFUS DC
24/08/2015 NY MIRAWATI INFUS
24/08/2015 NY NURMAYANI INFUS
24/08/2015 NY KARMINI INFUS
24/08/2015 NY IIS SOLIHAH INFUS DC
24/08/2015 NY MERI INFUS
24/08/2015 NY RINA INFUS DC
24/08/2015 NY HERNI INFUS
24/08/2015 BY NY GHIANI INFUS
24/08/2015 BY M RIFAL INFUS
13 4

25/08/2015 NY DESI INFUS


25/08/2015 NY SITI INFUS DC
25/08/2015 NY SUMIATI INFUS
25/08/2015 NY EMA INFUS
25/08/2015 NN APRILIANTINI INFUS
25/08/2015 NY SOINAH INFUS DC
25/08/2015 BY ALFAREL INFUS
25/08/2015 BY M REGA INFUS
8 2

26/08/2015 NY ROHANI INFUS DC


26/08/2015 NY IMAS INFUS
26/08/2015 NY EFI INFUS
26/08/2015 NY DINI INFUS
26/08/2015 NY LAILA INFUS
5 1

27/08/2015 NY ROSIDA INFUS DC


27/08/2015 NY IIS SOLIHAH INFUS DC
27/08/2015 NY DEWI INFUS DC
27/08/2015 NY NEULIS INFUS DC
27/08/2015 NYYENI INFUS
27/08/2015 NY EJAH INFUS
27/08/2015 NY YENI INFUS
27/08/2015 NY LIA INFUS DC
27/08/2015 NY ENI F INFUSS DC
27/08/2015 NY NINA SURYINA INFUSS DC
27/08/2015 AN M DEANDRA INFUS
27/08/2015 AN SALAVIA INFUS
27/08/2015 BY M ALFAREZKY INFUS
27/08/2015 AN GALANG FARID INFUS
14 7

28/08/2015 NY AI FATONAH INFUS DC


28/08/2015 NY NURLELA INFUS DC
28/08/2015 NY TINI SUMARTINI INFUS DC
28/08/2015 NY RISE INFUS DC
28/08/2015 NY YUNITA INFUS DC
28/08/2015 BY.FAHMI INFUS
28/08/2015 NY. LELASARI INFUS
7 5
29/08/2015 NY MIRNA INFUS
29/08/2015 NY ELI INFUS
29/08/2015 NY LAILA INFUS DC
29/08/2015 AN HAFIZ INFUS
4 1

30/08/2015 NY LIA INFUS


30/08/2015 NY SUSANTI INFUS DC
30/08/2015 NY YUYUN INFUS
30/08/2015 AN NAILA INFUS
30/08/2015 AN M BILAL INFUS
5 1

31/08/2015 NY SUSI INFUS DC


31/08/2015 NY NISHA INFUS DC
31/08/2015 NY SAIDAH INFUS
31/08/2015 NY DEWI INFUS
31/08/2015 NY ELIS INFUS
5 2

228 55

01/09/2015 NY RISE INFUS DC


01/09/2015 NY DARMI INFUS
01/09/2015 NY RADEN INFUS
01/09/2015 NY WIDI SUSANTI INFUS
01/09/2015 NY JUJU MULYANI INFUS DC
01/09/2015 NY FITRI LAELASARI INFUS
01/09/2015 NY NADIA INFUS
01/09/2015 NY ELIANA INFUS
01/09/2015 NY DEDEH INFUS
01/09/2015 NY DARA INFUS
01/09/2015 FUSIN INFUS
01/09/2015 NY.ATI INFUS DC
01/09/2015 NY RISMA INFUS DC
01/09/2015 NY DIDAH INFUS
14 4
02/09/2015 NY DEDEH INFUS
02/09/2015 NY SUSAN INFUS
02/09/2015 NY NURUL INFUS
02/09/2015 NY ESIH INFUS DC
02/09/2015 NY HISNY INFUS
02/09/2015 NY WENI INFUS
02/09/2015 NY IDA F INFUS DC

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN SEPTEMBER
01/09/2015 NY NOVI INFUS DC
01/09/2015 NY YULIA INFUS
01/09/2015 NY DARMI INFUS
01/09/2015 NY RADEN INFUS
01/09/2015 NY WIDI SUSANTI INFUS DC
01/09/2015 NY JUJU MULYANI INFUS
01/09/2015 NY NENENG INFUS
01/09/2015 NY GINA INFUS
01/09/2015 NY ELIANA INFUS
9 2

02/09/2015 NY SANTIA INFUS


02/09/2015 NY.YANI INFUS
02/09/2015 NY.TIA INFUS DC
02/09/2015 NY RISKA INFUS DC

02/09/2015 NY SITI INFUS


02/09/2015 NY DIDAH INFUS
02/09/2015 NY SITI AMINAH INFUS DC
02/09/2015 NY ESIH INFUS
02/09/2015 NY HISNY INFUS
02/09/2015 NY WENI INFUS DC
02/09/2015 BY.KANATAN INFUS
02/09/2015 AN AZIS INFUS
12 4

03/09/2015 NY SIFA INFUS


03/09/2015 NY EKA INFUS DC
03/09/2015 NY AI SADIAH INFUS
03/09/2015 NY VIVIE INFUS
03/09/2015 NY TINTIN INFUS
03/09/2015 NY NEDA INFUS
03/09/2015 BY NOVIA INFUS
03/09/2015 BY RUBI INFUS
03/09/2015 AN.ZAHIYA INFUS
03/09/2015 BY.TAUFIK INFUS
10 1
04/09/2015 NY LINDA INFUS
04/09/2015 NY.WAHYU INFUS
04/09/2015 NY.ROSITA INFUS DC
04/09/2015 NY.IMAS INFUS
04/09/2015 NY.SUKESI INFUS
04/09/2015 NY PATIMAH INFUS
04/09/2015 NY LINDAWATI INFUS
04/09/2015 NY IIS INFUS
04/09/2015 NY ELIN INFUS
04/09/2015 NY MARLIZA INFUS DC
04/09/2015 NY NURUL INFUS
04/09/2015 NY WIDIA INFUS DC
04/09/2015 12 3

05/09/2015 NY SUSI INFUS


05/09/2015 NY D VERAWATI INFUS DC
05/09/2015 NY KARWATI INFUS DC
05/09/2015 NY SITI RODIAH INFUS DC
05/09/2015 NY MIRA INFUS
05/09/2015 NY ANI INFUS DC
05/09/2015 NY FITRI LAELASARI INFUS DC
05/09/2015 NY SITI INFUS
05/09/2015 NY CHITRA INFUS DC
05/09/2015 NY DINI INFUS DC
05/09/2015 NY ROSE INFUS
05/09/2015 NY AAY INFUS DC
05/09/2015 NY FESTY INFUS DC
13 9

06/09/2015 NY YENI INFUS


06/09/2015 NY ATI INFUS DC
06/09/2015 NY ROSMALASARI INFUS
06/09/2015 NY MARSINAH INFUS
06/09/2015 NY TRI AYU INFUS DC
06/09/2015 NY DENINTA INFUS
06/09/2015 AN M AMRY INFUS
06/09/2015 AN RADITYA INFUS
8 2

07/09/2015 NY SANTIKA INFUS


07/09/2015 NY SUMIATI INFUS
07/09/2015 NY SITI R INFUS DC
07/09/2015 NY ANAWATI INFUS
07/09/2015 NY FITRI KURNIA INFUS
07/09/2015 NY EUIS INFUS
07/09/2015 NY ENI INFUS
07/09/2015 NY TINI INFUS
07/09/2015 NY HERMIN INFUS
07/09/2015 AN ALISAKIR INFUS
07/09/2015 NY NANI INFUS
07/09/2015 NY.CAHYATI INFUS
07/09/2015 NY SELI 12 1

08/09/2015 NY CAHYATI INFUS


08/09/2015 NY DEWI INFUS
08/09/2015 NY DIAN EKA INFUS
08/09/2015 NY EUIS INFUS
08/09/2015 NY LIA INFUS
08/09/2015 NY SITI HAFIROH INFUS
6

09/09/2015 NY RINA INFUS


09/09/2015 NY.RINI INFUS
09/09/2015 NY.DESI INFUS
09/09/2015 NY.RUNI INFUS
09/09/2015 NY. ELIS INFUS
5

10/09/2015 NY INA INFUS


10/09/2015 NY SITI INFUS DC
10/09/2015 NY YETI INFUS
10/09/2015 NY WATI INFUS
4 1

11/09/2015 NY AI SARTIKA INFUS


11/09/2015 NY WATI INFUS
11/09/2015 NY LILIS INFUS
11/09/2015 NY MASKUPAH INFUS DC
11/09/2015 NY KURNIASARI INFUS
11/09/2015 NY RATNA INFUS
11/09/2015 NY WAWANG INFUS
11/09/2015 NY RITA INFUS
11/09/2015 NY SUMIATI INFUS
11/09/2015 NYY RESTI INFUS
11/09/2015 NY EMI DANIATI INFUS DC
11/09/2015 NY SOFIA INFUS
11/09/2015 NY SANTI INFUS DC
11/09/2015 NY SYARIFAH INFUS
11/09/2015 NY. HENI INFUS
11/09/2015 NY. DEDE INFUS
11/09/2015 NY. ROHAENI INFUS DC
11/09/2015 NY. VIVIE INFUS
18 4

12/09/2015 NY. CICI INFUS DC


12/09/2015 NY.ANGGRAENI INFUS DC
12/09/2015 NY WULAN INFUS
12/09/2015 NY SITI ROIKAYAH INFUS
12/09/2015 AN.DESYA INFUS
12/09/2015 AN REVAN 6 2

13/09/2015 NY SUCI INFUS


13/09/2015 NY MIA Y INFUS
13/09/2015 NY RATIH INFUS
13/09/2015 NY NANDAN INFUS
13/09/2015 NY DEVA INFUS
13/09/2015 NY SILVI INFUS
13/09/2015 NY TRI LESTARI INFUS
13/09/2015 NY MARYATI INFUS
13/09/2015 NY LINA INFUS
13/09/2015 NY EVIANA INFUS
13/09/2015 NY RENI INFUS
13/09/2015 NY MASPUAH INFUS
13/09/2015 BY RENALDI INFUS
13/09/2015 AN HAFIDZ INFUS
13/09/2015 BY DINA INFUS
15
14/09/2015 NY DARMI INFUS
14/09/2015 NY NENG HANIVIA INFUS
14/09/2015 NY WULAN INFUS
14/09/2015 NY HENI INFUS DC
14/09/2015 NY NANI INFUS
14/09/2015 NY SUMIATI INFUS
14/09/2015 NY SUSANTI INFUS DC
14/09/2015 NY.SITI AISYAH INFUS DC
14/09/2015 NY.LILIS SARTIKA INFUS DC
14/09/2015 NY.SANTI INFUS
14/09/2015 NY.DEDEH INFUS DC
14/09/2015 NY WINA INFUS DC
14/09/2015 NY EUISRATNA INFUS
14/09/2015 NY SITI KULSUM INFUS
14 6

15/09/2015 NY HENI INFUS


15/09/2015 NY NANI INFUS DC
15/09/2015 NY SUSANTI INFUS DC
15/09/2015 NY.NURYANTI INFUS DC
15/09/2015 NY.SITI AISYAH INFUS
15/09/2015 NY.LILIS SARTIKA INFUS DC
15/09/2015 NY.WINA WULANSARI INFUS DC
15/09/2015 NY ITA INFUS
15/09/2015 NY RISMA INFUS
15/09/2015 NY SITI KULSUM INFUS DC
10 6

16/09/2015 NY EVI CHRISTIN INFUS


16/09/2015 NY.ENENG HASANAH INFUS DC
16/09/2015 NY. ELSYA INFUS
16/09/2015 NY.TITA INFUS
16/09/2015 NY NUNUNG INFUS
5 1

17/09/2015 NY SUTANTI INFUS


17/09/2015 NY ANI ROHAENI INFUS
17/09/2015 NY ANI INFUS
17/09/2015 NY YULI INFUS
17/09/2015 NY NURWILIS INFUS
17/09/2015 NY ANI JUMIRAH INFUS
17/09/2015 NY ADINDA INFUS DC
17/09/2015 NY SANTI INFUS DC
17/09/2015 NY LIA INFUS DC
17/09/2015 NY RINI INFUS
17/09/2015 NY MUJI R INFUS
17/09/2015 NY NENDEN INFUS
17/09/2015 AN M RIZKI INFUS
13 3

18/09/2015, NY RINA INFUS DC


18/09/2015, NY ANING INFUS
18/09/2015, NY TANTI INFUS DC
18/09/2015, NY LINA INFUS
18/09/2015 NY FITRI INFUS
18/09/2015 NY ROSITI INFUS
18/09/2015 NY IIN INFUS
18/09/2015 NY ASTRI INFUS
18/09/2015 AN M RIZKI INFUS
9 2
19/09/2015 NY LILI INFUS
19/09/2015 NY SUHANAH INFUS
19/09/2015 NY HALIMAH INFUS
19/09/2015 NY SITI NURLIA INFUS
19/09/2015 NY DEDE INFUS
19/09/2015 NY DESTRI INFUS
19/09/2015 NY MARTAULINA INFUS
19/09/2015 NY ELIS INFUS
19/09/2015 NY RANI INFUS
19/09/2015 NY SAIROH INFUS DC
19/09/2015 AN.NUGI INFUS
11 1

20/09/2015 NY SANTI INFUS DC


20/09/2015 AN ALIFA INFUS
20/09/2015 AN BUNGA INFUS
3 1
21/09/2015 NY MEVI INFUS
21/09/2015 NY YULI INFUS
21/09/2015 NY WENNY INFUS
21/09/2015 NY DEWI INFUS
21/09/2015 NY INFUS
5

22/09/2015 NY NENDEN INFUS


22/09/2015 NY JUJU MULYANI INFUS
22/09/2015 NY IMAS INFUS DC
22/09/2015 NY ROSI INFUS
22/09/2015 NY HADIDAWATI INFUS DC
22/09/2015 NY SHANTI INFUS DC
22/09/2015 NY YUNINGSIH INFUS DC
22/09/2015 NY FITRI INFUS
22/09/2015 BY AQLAN INFUS
22/09/2015 BY MIKAILA INFUS
10 4

23/09/2015 NY NINING INFUS DC


23/09/2015 NY MUTMAINAH INFUS
23/09/2015 NY PUTRI DEWI INFUS
23/09/2015 NY DEWI NURSAIDAH INFUS
23/09/2015 NY YAYU RAHAYU INFUS DC
23/09/2015 NY SITI FATIMAH INFUS
23/09/2015 NY NURLAELASARI INFUS
23/09/2015 NY ENTIN INFUS
23/09/2015 NY ROHANI INFUS
23/09/2015 NY SISKA INFUS
23/09/2015 NY INTAN SARI INFUS
23/09/2015 NY NELI INFUS
23/09/2015 NY IMAS INFUS
23/09/2015 AN FAUZAN INFUS
23/09/2015 AN AHDAN INFUS
23/09/2015 BY DHIYAKSA INFUS
23/09/2015 AN FAUZAN INFUS
23/09/2015 AN AHDAN INFUS
23/09/2015 BY DHIYAKSA INFUS
19 2

24/09/2015 NY MAESAROH INFUS


24/09/2015 NY ANI SURYANI INFUS
24/09/2015 NY KURNIAWATI INFUS
24/09/2015 NY SUNARI INFUS
24/09/2015 NY NIMA INFUS
24/09/2015 NY RIZKI F INFUS
24/09/2015 AN ABBAD INFUS
24/09/2015 BY M FITRA INFUS
24/09/2015 AN.PUTRI ALESHA INFUS
24/09/2015 AN.ARIF INFUS
24/09/2015 AN BENZEMA INFUS
11

25/09/2015 NY RIKA INFUS


25/09/2015 NY NY AI INFUS DC
25/09/2015 NY SUMIATI INFUS
25/09/2015 NY.SITI AISYAH INFUS
25/09/2015 NY EVI SESILIA INFUS
25/09/2015 NY NOVIYANTI INFUS DC
25/09/2015 NY DEWI INFUS DC
25/09/2015 NY ANI INFUS
25/09/2015 NY NIA KANIA INFUS
25/09/2015 NY TERESA INFUS DC
25/09/2015 NY ELA INFUS
25/09/2015 NY YENI SETIAWATI INFUS DC
25/09/2015 AN NAURA INFUS
25/09/2015 BY NY YANTI INFUS
25/09/2015 AN.M.ARKAN INFUS
15 5

26/09/2015 NY CICI WARNISAH INFUS DC


26/09/2015 NY.AI YUNAENI INFUS
26/09/2015 NY.ATI INFUS
26/09/2015 NY.MEGA INFUS
26/09/2015 NY.DESI INFUS DC
26/09/2015 NY.DEWI INFUS
26/09/2015 NY.LASMI INFUS
26/09/2015 NY RINDIANI INFUS
26/09/2015 NY DEUIS INFUS
26/09/2015 NY SARIAH INFUS
26/09/2015 AN.RAFFI INFUS
11 2

27/09/2015 NY FANI INFUS


27/09/2015 NY.NENG ANI INFUS DC
27/09/2015 NY.AI SITI INFUS
27/09/2015 NY.DETI GUSTIANI INFUS
27/09/2015 NY SUNIANGINGSIH INFUS
27/09/2015 NY HASANAH INFUS
27/09/2015 NY MASPUAH INFUS
27/09/2015 NY EMA INFUS
27/09/2015 NY ANA INFUS
27/09/2015 NY.WITA INFUS
27/09/2015 NY.SANTI INFUS DC
27/09/2015 AN REYHAN INFUS
27/09/2015 BY.ANINDIA INFUS
13 2

28/09/2015 NY SRI MULYANI INFUS


28/09/2015 NY NUNUNG INFUS
28/09/2015 NY SRI MULYATI INFUS
28/09/2015 NY ERNAWATI INFUS
28/09/2015 NY SUMIATI INFUS DC
28/09/2015 NY SUMIATI INFUS DC
28/09/2015 NY PUJI INFUS DC
28/09/2015 BY.MUHAMMAD RIDO INFUS
28/09/2015 BY.KYRAN AKBAR INFUS
28/09/2015 AN MOH AWALUDIN INFUS
10 3

29/09/2015 NY AYU ASSARI INFUS DC


29/09/2015 NY.WAWANG NAWANGSIH INFUS DC
29/09/2015 NY.RENI KUMAWATI INFUS DC
29/09/2015 NY NINA INFUS
29/09/2015 NY AI SARIPAH INFUS
29/09/2015 NY NURUL INFUS
29/09/2015 NY.WIWIN INFUS
29/09/2015 AN FATIMAH INFUS
29/09/2015 BY PASHA INFUS
29/09/2015 AN KAYLA LUBNA INFUS
10 3

30/09/2015 NY.ERNI INFUS DC


30/09/2015 NY.ICAH INFUS DC
30/09/2015 NY.GAPRI INFUS
30/09/2015 NY.IMAS INFUS
30/09/2015 NY.YANTI INFUS
30/09/2015 NY LIA INFUS
30/09/2015 AN MUHAMMAD FITRA iNFUS
7 2
TOTAL 306 72

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN OKTOBER
01/10/2015 1 TN.DERY INFUS DC
2 TN.TONI INFUS DC
3 TN.DIAN INFUS
4 TN.WAHYUDIN INFUS DC
5 TN ADE INFUS DC
5 4
02/10/2015 6 TN DADAN INFUS
7 TN.MAMAT RUKIMAT INFUS DC
8 TN.DEDI INFUS
9 TN.ROBI INFUS
10 TN IWAN INFUS DC
11 TN KHAIRUL INFUS
12 TN JECHRY INFUS
7 2
03/10/2015 13 TN ANTON INFUS
14 TN IWAN INFUS
15 TN AGUS INFUS
16 TN MAMAH INFUS
17 TN ADI INFUS DC
18 TN YUSUF INFUS
19 TN ANTOR INFUS
20 TN DASIKIN INFUS
21 TN IMAN INFUS DC
22 TN YADI INFUS
23 TN AJIS INFUS DC
24 AN ALFATIH INFUS OGT
25 BY NY NIAR INFUS OGT
13 3 oGT 2

04/10/2015 26 NY IKE NENCY INFUS


27 NY TIKTIK INFUS DC
28 NY RITA INFUS
29 NY DIAN INFUS
30 NY SRI MARYATI INFUS
31 NY DINI INFUS
32 NY ESTER INFUS
33 NY DIAN INFUS
34 AN NABILA INFUS
35 AN M RIYU INFUS
36 AN VERO INFUS
37 AN HELMI INFUS
12 1

05/10/2015 38 NY NURUL AINI INFUS


39 NY IMAS INFUS
40 NY TIKA INFUS
41 NY PUPUNG INFUS
42 NY.EUIS INFUS
43 NY DEDE INFUS
44 NY IIS INFUS DC
45 NY LILIS INFUS
46 NY NOVIANTI INFUS
47 NY RITA INFUS
10 1

06/10/2015 48 NY.NILA INFUS DC


49 NY.YUNI MULYANI INFUS
50 NY IIS INFUS
51 NY EVI NUR INFUS DC
52 NY MIRANTI INFUS
53 NY SUMI TRISNAWATI INFUS DC

54 AN.KAHFI INFUS

55 BY.ZAHRA INFUS

56 AN.BANYU INFUS
9 3

07/10/2015 57 NY.SHERESTA INFUS DC


58 NY ENAR INFUS
59 NY SITI HOTIJAH INFUS DC
60 NY RISKA INFUS DC
61 NY SITI ROKAYAH INFUS
62 NY TINI SOLIHAH INFUS DC
63 NY SRI MULYATI INFUS
64 NY ROSMAYA INFUS

65 BY.SIFA KIRMA INFUS


9 4

08/10/2015 66 NY RINI INFUS


67 NY DERA INFUS
68 NY.PARNI INFUS
69 NY YULIAWATI INFUS
70 NY LISNA INFUS
71 NY YULIANTI INFUS
72 NY LIA INFUS
73 AN SYAKIRA INFUS
74 NY DINAR INFUS DC
9 1

09/10/2015 75 NY.LINA INFUS DC


76 NY DINAR INFUS
78 NY YULI INFUS DC
3 2

10/10/2015 79 NY ANI ERWIN INFUS DC


80 NY SITI NURHAYATI INFUS DC
81 AN FIRDAN INFUS
82 NY ENAH INFUS DC
83 NY SITI ZAKIAH INFUS DC
84 NY LINA INFUS
85 NY YOYOH INFUS
7 4

11/10/2015 86 NY MELLYANA INFUS DC


87 NY SRI R INFUS
88 NY IRMA INFUS
89 NY ANI INFUS DC
90 NY IRMA INFUS
91 NY.SITI MALIKHA INFUS
92 NY.INDRA INFUS
93 NY.INE INFUS DC
94 AN ALKINDI INFUS
9 2

12/10/2015 95 NY ROSA LESMANA INFUS DC


96 NY CITRA INFUS
97 NY NENI ROSITA INFUS
98 NY NIA INFUS
99 NY EUIS FATIMAH INFUS DC
100 NY HERAWATI INFUS
101 NY TINI SUHARTINI INFUS
102 NY EROS INFUS
103 NY NINIK INFUS
9 2
13/10/2015 104 NY NURHAYATI INFUS
105 NY TANTI INFUS
106 NY.NENG RIRI INFUS
107 NY. RITA AVIANTI INFUS
108 INFUS
109 NY ALENA INFUS
110 NY RIRIN INFUS
111 NY NINA INFUS
112 NY MEYDA INFUS
113 NY LOMRAH INFUS
114 NY NATALIA INFUS
11
14/10/2015 115 NY POPI INFUS
116 NY.SANTI INFUS
117 NY.LIVI INFUS
118 NY.NURCAHYATI23 INFUS
119 NY.ANI INFUS
120 NY IRAH INFUS
121 NY.INA INFUS
122 AN QAIRIN INFUS
8
15/10/2015 123 NY IMAS INFUS
124 NY EVI NUR INFUS
125 NY PURI INFUS DC
126 NY SELLY INFUS
127 NY NENI INFUS
128 NY WANTI INFUS
129 NY.ADE AISYAH INFUS
130 NY TITIN INFUS
131 NY RESTI INFUS
132 NY TANTI INFUS DC
133 AN BONI INFUS
134 AN REVEERA SUN INFUS
12 2
16/10/2015 135 NY SYURTIAH INFUS
136 NY YUSTIKA INFUS
137 NY ENUNG INFUS
138 NYDEVI KARMILA INFUS
139 NY SRI INFUS
140 NY IDA INFUS
141 NY RIA ANGGRAENI INFUS
142 NY.YAYU INFUS
143 NY ERICHA INFUS
9
17/10/2015 144 NY ERICHA INFUS
145 NY.WETI ALIA INFUS
146 NY.ENUNG INFUS
147 NY IKE INFUS
148 NY MUJIATI INFUS
149 NY SITI YULIAWATI INFUS
150 NY POPI INFUS DC
7 1
18/10/2015 151 NY SHINTA INFUS DC
152 NY NURJANAH INFUS
153 NY IKA INFUS
154 NY YULI INFUS DC
155 NY LENI INFUS
156 NY NELA INFUS
157 NY MEIDAWATI INFUS
158 NY TRI RAHAYU INFUS
159 NY LINLIN INFUS DC
160 NY SILVI INFUS
161 NY MARA SARI INFUS
162 NY NURLELA INFUS
12 3
19/10/2015 163 NY LEVI INFUS
164 NY HERLIN INFUS
165 NY MEIELISA INFUS
166 NY LISE INFUS DC
167 NY YENI INFUS
168 NY ERNAWATI INFUS
169 NY YULI INFUS
170 NY.UMI INFUS
171 AN M AZKA INFUS
9 1
20/10/2015 172 NY.YULI INFUS
173 NY.NURJANAH INFUS
174 NY.WIDANINGSIH INFUS
175 NY FITRI INFUS
176 NY DIAN INFUS
177 NY LILIS SURYANI INFUS
178 NY NY SRI INFUS
179 NY LIA INFUS
180 NY LILIS SULASTRI INFUS
181 NY DESTRI INFUS
182 NY MIRA INFUS
183 NY SISKA INFUS
184 NY DEVI INFUS
185 NY SITI JENAB INFUS
186 NY NANI INFUS
187 NY ENING INFUS
188 AN.ILHAM INFUS
189 BY.SHAKILA INFUS
190 AN AZKA INFUS
191 NY ITA INFUS
192 NY WIWIN INFUS
21 0
21/10/2015 193 NY YANTI INFUS DC
194 NY DINI INFUS DC
195 NY RIKA AMALIA INFUS DC
196 NY SITI R INFUS
197 NY HAYATI INFUS
198 NY YOHANA INFUS DC
199 NY IRNA INFUS
7 4
22/10/2015 200 NY DESI DAMAYANTI INFUS
201 NY EKI INFUS DC
202 NY MARIAM INFUS DC
203 NY SITI KHODIJAH INFUS
204 NY KOKOM INFUS DC
205 NY MUSTAQIMATUN INFUS
206 NY WIWIN INFUS
207 NY DIAN INFUS
208 NY AI YUNAENI INFUS DC
209 AN CHANDRA INFUS
210 AN FAZIYAH INFUS
211 AN ELSEN RIZKY ARRASYID INFUS
12 4
23/10/2015 212 NY DEWI INFUS
213 NY SITI ROHMAH INFUS
214 NY TATI INFUS
215 NY MASRUFAH INFUS
216 NY MARFINA INFUS DC
217 NY KRISTINA INFUS
218 NY NIA INFUS
219 NY LINDA INFUS
220 NY DIAS INFUS
221 AN.REGINA INFUS
10 1
24/10/2015 222 NY NENG AMINAH INFUS
223 NY YANTI INFUS
224 NY DEDEH INFUS
225 NY SUMIYATI INFUS
226 AN NAURAL INFUS
5
25/10/2015 227 NY RESNA INFUS
228 NY NOVI INFUS
229 NY FUJI INFUS
230 NY RINA ANGGRAENI INFUS
231 NY LENSA INFUS DC
232 NY NENI INFUS DC
233 NY UNIYATI INFUS DC
234 NY.SITI UMMAMAH INFUS
235 NY.SALAMAH INFUS DC
236 NY.MEGANA'ATI INFUS DC
237 AN.FAJAR INFUS
11 5
26/10/2015 238 NY.EUIS INFUS
238 NY.MIMIH INFUS DC
238 NY CICIH INFUS
238 NY AYU INFUS
238 NY AI NENI INFUS DC
238 NY MELLYANA INFUS DC
238 NY FANI INFUS
238 NY MAYA INFUS
238 NY RISKA INFUS
238 NY HENI INFUS
238 NY MUSTAQI INFUS
238 NY RISTINA INFUS
238 NY SRI SUHARTINI INFUS
238 NY MIRANTI INFUS
238 NY MITRIYATI INFUS DC
238 AN PUTRI INFUS
16 4
27/10/2015 239 NY TIAN SEPTIAN INFUS
240 NY WIWIN INFUS
241 NY TRISNAWATI INFUS DC
242 NY LISTIANI INFUS DC
243 NY HANA INFUS DC
5 3
28/10/2015 244 NY YANTI INFUS DC
245 NY WULAN INFUS
246 NY KRISTINA INFUS
247 NY RENA INFUS
248 NY LESTARI INFUS
249 NY AMI INFUS
250 NY DEWI INFUS
251 NY ANI INFUS
252 NY WINA INFUS
253 AN M NAZRIL INFUS
10 1
29/10/2015 254 NY IIS ROSMA iNFUS
255 NY SARI iNFUS
256 NY SINTA INFUS
257 NY FITRI INFUS DC
258 NY DESI INFUS
259 NY NADIA INFUS
260 NY TITI INFUS
261 NY RINA INFUS
8 1
30/10/2015 262 NY.RUSMALA INFUS DC
30/10/2015 263 NY.HANI INFUS DC
264 NY CICIH INFUS
265 NY ISYE INFUS DC
4 3

31/10/2015 266 NY FITRIYANI INFUS


267 NY WIJI INFUS DC
268 NY SURYATI INFUS
269 NY SUPIANTI INFUS
270 NY LYNNA INFUS DC
271 NY DINA SUPRIATIN INFUS DC
272 NY.MALA INFUS
273 AN KIRANA INFUS
8 3

jumlah total pasien bulan oktober 2015 651


Formulir Survey Harian Pemakaian Alat
Ruang IGD - RSKIA BULAN NOVEMBER 35
01/11/2015 1 NY YULIANTI INFUS DC
2 NY SRI MULYANI INFUS
3 NY UKE INFUS
4 NY RANI INFUS DC
5 NY DANIA INFUS
6 NY YUNIAR INFUS
7 BY ARKAN INFUS
7 2

02/11/2015 1 NY NENI INFUS DC


2 NY DEPI INFUS
3 NY NOVIANTI INFUS
4 NY YULIANTI INFUS
5 NY TRI SULISTYOWATI INFUS
6 NY RINI INFUS
7 NY RUSMALA INFUS DC
8 NY SITI SOLEHAH INFUS DC
9 AN M DAMAR INFUS
10 AN HADI INFUS
10 3

03/11/2015 1 NY CUCU INFUS DC


2 NY ANISA INFUS DC
3 NY TATI INFUS DC
4 NY FITRI INFUS DC
5 NY ATIN INFUS
6 NY IMAS INFUS DC
7 NY NENG RINI INFUS DC
8 NY SITI HAMIDAH INFUS DC
9 AN ZIVANA INFUS
9 8

04/11/2015 1 NY LELA NURLELA


2 NY NURHAYATI INFUS
3 NY DIAH INFUS DC
4 NY LILIS INFUS
5 NY SUPARMI INFUS DC
6 NY.LINA INFUS DC
7 NY.HANISAH INFUS
7 3

05/11/2015 1 NY NENDEN INFUS


2 NY AGUSTINI INFUS DC
3 NY.ANE SUSILA INFUS
4 NY.ANE SUSILA INFUS DC
5 NY.AGUSTIN INFUS DC
6 NY. ANNE SUSILAWATI INFUS DC
7 NY.RISMAWATI INFUS
8 NY.SRI YUYLIANTI INFUS
9 NY.ANI KARTIKA INFUS
10 AN ALMYDINA INFUS
10 4

06/11/2015 1 NY.DESI MULYANI INFUS DC


2 NY DIAH INFUS
3 NY SANTI INFUS
4 NY SUMIARSIH INFUS
5 NY DEWI INFUS DC
6 NY SHENI INFUS
7 NY LENDA INFUS
8 NY ELI INFUS DC
9 NY RISA INFUS
9 3

07/11/2015 1 AN.MITA INFUS


2 AN QAIRA INFUS
3 NY ZAHARA INFUS
3

08/11/2015 1 NY TIANI INFUS


2 AN YASFIANI INFUS
3 NY.TIANA INFUS
4 NY.SRI INFUS DC
5 NY.RENI INFUS
6 NY.NADIA INFUS DC
7 NY. MELLY YANTI INFUS
8 NY.RATNA INFUS
9 NY. NURLELA INFUS DC
10 NY.IEMMA
11 NY NURLELA INFUS DC
11 4

09/11/2015 1 NY ATIN INFUS DC


2 NY DOMO INFUS DC
3 NY AAS INFUS
4 NY HASANAH INFUS
5 AN NIZAR INFUS
6 ny.NOVIANTI INFUS DC
7 NY.WIWIN INFUS DC
8 NY. EMMA AMELIA INFUS
9 NY. PUTRI INFUS DC
9
10/11/2015 1 NY.SITI AMELIA INFUS DC
2 NY. ANNI NURMALASARI INFUS DC
3 NY.LINA INFUS
4 NY.DINI INFUS DC
5 NY.NITU INFUS DC
6 NY. NIA INFUS
7 NY.ENTIN INFUS
7 4

11/11/2015 1 AN. RAISA INFUS


2 NY NONENG DEVI INFUS
3 NY SENDI INFUS
4 NY EVA INFUS
5 BY.GIAN INFUS
5

12/11/2015 1 NY SALAETIN INFUS


2 NY NENIH INFUS
3 NY SITI NURLELA INFUS
4 NY NUR AENI INFUS DC
5 NY YUYUK INFUS
6 NY FEBRIANI INFUS
6 1

13/11/2015 1 BY.SHAZIA INFUS


2 NY.MAE SITI INFUS
3 NY. SITI ANISAH INFUS
4 NY IIS INFUS
5 NY ERNAWATI INFUS DC
6 NY ERIN INFUS
7 AN KHAILANI INFUS
8 AN.FADLY INFUS
9 AN.ARSYL INFUS
9 1

14/11/2015 1 NY SONYA INFUS


2 NY SRI INFUS
3 NY FITRI INFUS
4 NY DINA INFUS
5 NY EKA INFUS
6 NY IMAS INFUS
7 NY AI TRISNAWATI INFUS DC
8 BY. DINDA INFUS
9 AN. M ARFA INFUS
9 1

15/11/2015 1 NY TRIYATNI INFUS


1

16/11/2015 1 NY SARI SUSILAWATI INFUS DC


2 NY MEI INFUS
3 NY DEWI SARTIKA INFUS
4 NY YATI INFUS
5 NY AAS ATIKAH INFUS
6 BY NY VERA INFUS
6 1

17/11/2015 1 NY HAMIDAH INFUS DC


2 NY.SETIAWATI INFUS
3 NY SITI SOLIHAH INFUS
4 NY RIA JUARIAH INFUS
5 NY DEWI A INFUS DC
6 NY HANI INFUS
7 NY CUCU INFUS DC
8 NY SITI NURHAENI INFUS
9 NY SITI SOLIHAH INFUS DC
10 NY DINI INFUS
11 NY NENG CICA INFUS
11 4

18/11/2015 1 NY MEGA INFUS


2 NY ENUNG INFUS
3 NY IMAS INFUS DC
4 NY SUSI INFUS
5 NY.SISKA INFUS
6 NY.HANISAH INFUS
7 NY.NUR AZIZAH INFUS DC
8 NY.CUCU APRIYANI INFUS DC
9 NY.ENENG LASMANAH INFUS
10 NY.SUKSES INFUS DC
11 NY HERA NOVIYANTI INFUS
11 4

19/11/2015 1 NY.NUR AZIZAH INFUS DC


2 NY.CUCU APRIYANI INFUS DC
3 NY.ENENG LASMANAH INFUS
4 NY MIRA INFUS DC
5 NY NINA INFUS DC
6 NY RESMA INFUS
7 NY SAFITRI INFUS DC
7 5

20/11/2015 NY MAYA INFUS DC


NY YUNI INFUS
NY. DEWI INFUS DC
NY. MUSRIFAH INFUS
NY MADANIATI INFUS DC
NY WINDA INFUS DC
NY SUSANTI INFUS
NY MILA M INFUS
BY ARDANA INFUS
BY SESIL INFUS DC
10 5

21/11/2015 NY AAT KARWATI INFUS DC


NY IRAYANTI INFUS DC
NY TETI INFUS
NY OPI H INFUS
NY DHEA NITA INFUS
NY YUYUN INFUS
NY ROSTATI INFUS
NY RUMIYATI INFUS
NY LISDA INFUS
NY SITI SUANGSIH INFUS
10 2

22/11/2015 NY SUSI SUSILAWATI INFUS


NY TITIN INFUS DC
NY DOLIS INFUS
NY TRI RAHAYU INFUS
NY TITIN ROSTINI INFUS
NY HELMA INFUS
6 1

23/11/2015 NY KORI INFUS DC


NY ARMI INFUS
NY IMAR INFUS DC
NY EUIS INFUS DC
NY IYUS INFUS
AN GENDIS INFUS
AN ARSYAKA INFUS
7 3

24/11/2015 NY TITIN INFUS DC


NY.ANISA INFUS
NY.TITI INFUS DC
NY ARNI INFUS
NY TRIYATI INFUS
5 2

25/11/2015 NY ELIN INFUS


NY SITI JAENAB INFUS
NY ANI FITRIANI INFUS
NY TJIEN LIEN INFUS
NY TINA INFUS
NY NURYATI INFUS DC
NY RUPIYATI INFUS DC
NY SRI INFUS
8 2

26/11/2015 NY NURVIA INFUS


NY NURAINI INFUS
NY SARIAH INFUS
NY FITRI INFUS
NY RUMIYATI INFUS DC
NY DATI INFUS
NY ENING INFUS DC
7 2

27/11/2015 NY YETI INFUS DC


NY PUTRI INFUS
NY FITRIA INFUS
NY IMAS NURLELASARI INFUS
NY.IMAS INFUS DC
NY.ROHANI INFUS DC
NY.NYAI SARIKAH INFUS DC
NY ENENG WATI INFUS DC
NY LIA INFUS
NY NINIK INFUS
10 5

28/11/2015 NY RIAN INFUS


NY IIP INFUS
NY SITI NURYANI INFUS
NY SRI INFUS
NY SEPTY INFUS
NY CUCU INFUS
NY YATI INFUS
NY SANTI INFUS
NY NUNUNG INFUS
NY RENI INFUS DC
NTY TITIN INFUS
11 1

29/11/2015 NY YENI INFUS


NY YANTI INFUS
NY ROHAENI INFUS DC
NY DAHLIA INFUS
NY ZANUS INFUS
NY NINING INFUS
NY ATIK INFUS
NY NENG SUSANTI INFUS
NY NINING INFUS
AN ANJARSARI INFUS
NY RANI INFUS DC
NY ASTRI INFUS
12 2

30/11/2015 NY MESI ARSITA INFUS


NY LELA INFUS
NY ADE HAPIT INFUS DC
NY ADE RITA INFUS
NY TUTI INFUS DC
NY GIWANG INFUS
NY SUSI INFUS
NY EVI INFUS
NY DESSI INFUS
NY SANTI INFUS
NY DEPI INFUS
NY YANI INFUS DC
NY RISMAWATI INFUS
NY EVA INFUS
NY YULI INFUS DC
NY KOKOM INFUS
NY NENENG INFUS
17 4
250 77
JML OS
579

FORMULIR SURVEY HARIAN PEMAKAIAN ALAT


RUANG IGD - RSKIA BULAN DESEMBER 2015

01/12/2015 1 HARLINA INFUS


2 RANI INFUS
3 METI INFUS
4 BY DIAZ INFUS
5 PUTIK INFUS
6 IIP INFUS DC
7 WIWIN INFUS DC
8 AN IBRAHIM INFUS
9 NY IYUS INFUS
10 NY ROSITA INFUS DC
11 NY ETIN INFUS
11 3

02/12/2015 1 AN KHALIFA INFUS


2 NY YENI INFUS DC
3 NY RINA INFUS DC
4 NY MARIYANA INFUS
5 NY SANTIKA INFUS
6 NY DEVI INFUS
7 NY IDA INFUS
8 NY IMAS INFUS
8 2
03/12/2015 1 NY LILIS INFUS
2 NY IIS INFUS
3 NYSILVI INFUS
4 NY MONA INFUS DC
5 NY DIANA INFUS
6 NY ANITA INFUS
7 NY RODIAH INFUS
8 NY MEIZHA INFUS
9 NY HENI INFUS
10 NY YULI INFUS
11 NY MELUR INFUS
12 NY SUPRI INFUS
12 1

04/12/2015 1 NY SUMIATI INFUS


2 NY FERAYANTI INFUS
3 NY SITI AISYAH INFUS
4 NY YANI INFUS DC
5 AN SABRINA INFUS
6 NY TRI IMMA INFUS
7 NY KULSUM INFUS
8 NY MILA INFUS DC
8 2

05/12/2015 1 NY NITA INFUS DC


2 NY RINA INFUS
3 NY NURHAYATI INFUS
4 NY OLIS INFUS DC
5 NY DEWI INFUS DC
6 NYTITI INFUS
7 NY DEWI INFUS
8 NY RIKA INFUS
9 AN AISYAH INFUS
10 NY LINA INFUS
11 NY IRMA INFUS
12 NY FITRIANI INFUS
12 3

06/12/2015 1 NY SRI SUPRIATI INFUS DC


2 NYSITI ROHIYANI INFUS
3 NY IDA NURAIDA INFUS
4 NY FERAWATI INFUS DC
5 NY NUNUNG INFUS DC
6 NY ATIN INFUS
7 NY RINA INFUS
8 NY AI HIKMAH INFUS DC
9 NY TRIYATI INFUS DC
10 NY SITI INFUS DC
11 NY LILIS INFUS
11 6

07/12/2015 1 NY LINGGA INFUS


2 NY SUPRIHANI INFUS DC
3 NY KIKI INFUS DC
4 AN IZZATU INFUS
5 NY SRI YULIANTI INFUS
6 NY AI RUKMINI INFUS
7 NY RATIH INFUS DC
7 3

08/12/2015 1 NY PUTRI INFUS


2 NY IMAS INFUS
3 NY NOVI INFUS
4 NY YANI INFUS
5 NY NURI INFUS
6 NY NURHAYATI INFUS
7 NY NENDAH INFUS
8 NY NINA INFUS DC
9 NY MARIAH INFUS
9 1

09/12/2015 1 NY TINA INFUS


2 AN M FAREL INFUS
3 AN SYAKILA INFUS
4 NY WINDA INFUS DC
5 NY SITI INFUS
6 NY ELIS INFUS
7 AN M RADITHA INFUS
7 1

10/12/2015 1 NY YANTI INFUS


2 NY YESITA INFUS
3 NY ERNAWATI INFUS
4 NY LISNAWATI INFUS
5 NY YULI INFUS
6 NY MARINA INFUS DC
7 NY TITA INFUS
8 NY VIA INFUS DC
9 NY HENI INFUS
10 NY KANIA INFUS
10 2

11/12/2015 1 NY ROHATI INFUS


2 NY LIA INFUS
3 NY NURJANAH INFUS DC
4 NY TITA INFUS DC
5 NY EPI INFUS
6 NY RIA INFUS
7 NY OKTAVIYANI INFUS
8 NY RINA INFUS
9 NY NOVIA INFUS
9 2

12/12/2015 1 NY MEGA INFUS


2 NY NOVI INFUS
3 NY SITI INFUS
4 AN. M. ALAFAT INFUS
5 NY ELSA INFUS
6 NY MILASARI INFUS DC
7 NY MARLINA INFUS
8 NY SOPIAH INFUS
9 NY RATNA INFUS
10 NY IIN INFUS DC
11 NY ENUNG INFUS
12 NY DESI INFUS
12 2

13/12/2015 1 NY ENDAH MAYASARI INFUS


2 NY. DIAH INFUS
3 NY EUIS INFUS
4 NY SARAH INFUS DC
4 1

14/12/2015 1 NY ELI INFUS DC


2 NY ATIK INFUS DC
3 NY LINA INFUS
4 NY SUSANTI INFUS
5 NY TRISNI INFUS
6 NY AI INFUS
7 NY SEPTI INFUS
8 NY DEVI INFUS
9 NY IRMA INFUS
10 NY LINA INFUS
11 NY YENI INFUS
11 2

15/12/2015 1 NY.FITRI ANA INFUS


2 NY IRA ASTUTI INFUS DC
3 NY.HERLINA INFUS DC
4 NY SUMIATI INFUS
4 2

16/12/2015 1 NY NURYATI INFUS


2 NY ANISA INFUS
3 NY.PIPIH INFUS DC
4 NY.SITI.R INFUS
5 NY.NENG RTANA INFUS
6 NY.ROSITA INFUS
7 NY.SUSI RAHAYU INFUS DC
8 NY.YATI HARTATI INFUS
8 2

16/12/2015 1 NY.LAELA INFUS


2 NY.RINA INFUS
3 NY.SOFIAYATUL INFUS DC
4 NY.YUYUN INFUS DC
5 NY.SI TI ROHIMAH INFUS
6 NY.DESI INFUS
7 NY.SITI.R INFUS
7 2

17/12/2015 1 NY.SRI RAHAYU INFUS


2 NY.TRIYANTI INFUS DC
3 NY SANTI INFUS
4 NY DESI INFUS DC
5 NY DESI LAELA INFUS
6 NY NENGSIH INFUS DC
7 NY TUTI INFUS
10 NY SAADAH INFUS
11 NY IRMA INFUS
9 3

18/12/2015 1 NY RISNAWATI INFUS


2 NY SITI SALAMAH INFUS
3 NY ISMI INFUS DC
4 NY AMANDA INFUS
5 NY RINAWATI INFUS DC
6 NY TINA MARTINA INFUS DC
7 NY KARTINI INFUS
7 3

19/12/2015 1 NY.WINA INFUS


2 NY WIWIT INFUS
3 NY DEWI INFUS
4 NY NANI INFUS
5 NY MIRA INFUS
6 WIWIT INFUS
7 PENNY ERMAYANTI INFUS
8 RATIH KANIA INFUS
8

20/12/2015 1 RINI INFUS


2 NURIATI INFUS
3 AAN ROHANAH INFUS
4 LUSI INFUS
4

21/12/2015 1 RINA MEI INFUS DC


2 MEGA NUR INFUS
3 NY ENI INFUS
4 NY JUNITA INFUS
5 HANI INFUS
6 ISTIQOMAH INFUS
7 GITA INFUS
7 1

22/12/2015 1 EGA INFUS DC


2 LILIS CAHYANI INFUS DC
3 ENTANG INFUS DC
4 TRISNI INFUS DC
5 RISMAWATI INFUS DC
6 YANTI INFUS
6 5

23/12/2015 1 ENDAH INFUS


2 ESIH INFUS
3 RESA INFUS
4 YATI INFUS DC
5 SITI NURJANAH INFUS
6 SANTI INFUS
7 LENI INFUS
7 1

24/12/2015 1 ERNI INFUS


2 WINDANINGSIH INFUS DC
3 ENUNG INFUS DC
4 AI RANI INFUS
5 IRMA INFUS
6 AI N INFUS DC
7 HARYANI INFUS
8 WINA INFUS
8 3

25/12/2015 1 M RIAN INFUS


2 IVA INFUS
3 ENI INFUS DC
4 SITI NURYENI INFUS
5 ASMANAH INFUS
6 TATI INFUS
7 DESI INFUS
8 SHELI INFUS DC
9 UNUNG INFUS
9 2

26/12/2015 1 SITI RAHMAWATI INFUS


2 IMAS INFUS
3 LILAH SARI INFUS DC
4 WAFA INFUS
5 IIN INFUS DC
6 SITI SOFINGAH INFUS
7 ROMLAH INFUS
8 ELIS INFUS DC
9 YANI INFUS
10 REYHAN INFUS
11 TITIN INFUS
12 RITA INFUS DC
13 NOVIYANTI INFUS DC
14 RENI INFUS
15 DIAH INFUS
16 UUN INFUS DC
16 6

27/12/2015 1 ELI HAYATI INFUS


2 YANTI INFUS
3 ADITYA INFUS
4 DEWI INFUS
5 ENDANG INFUS DC
6 YANI INFUS DC
7 NENDEN INFUS
8 YUNI INFUS
9 NENENG DEDEH INFUS
9 2

28/12/2015 1 IIS INFUS


2 IMAS INFUS DC
3 IIM INFUS DC
4 SANTI INFUS
5 SRI INFUS
6 DEWI INFUS
7 TINA INFUS
8 RISMA INFUS
9 DEWI INFUS DC
10 KHITY INFUS
11 DEDE INFUS
12 DEDE INFUS
13 SUGANDINI INFUS
13 3

29/12/2015 1 AFNAN INFUS


2 SANTI INFUS
3 YATI INFUS
4 HENI INFUS
5 RINA INFUS
6 EMA INFUS
7 HASANAH INFUS
8 SITI HODIJAH INFUS
9 EVA INFUS DC
10 ARIN INFUS DC
10 2

30/12/2015 1 TENI INFUS DC


2 ENDAH INFUS DC
3 PENNY INFUS DC
4 RINI INFUS
5 SANTI INFUS DC
6 NINA INFUS
6 4

31/12/2015 1 NINING INFUS DC


2 WULANDARI INFUS DC
3 ELOI INFUS DC
4 M. RIZKI INFUS
5 EVA INFUS
6 ERNI INFUS
7 LILIS INFUS
7 3

JUMLAH 276 73

FORMULIR SURVEY HARIAN PEMAKAIAN ALAT


RUANG IGD - RSKIA - BULAN JANUARI 2016

01/01/2016 1 SITI WAHYUNINGSIH INFUS


2 KANIATI INFUS
3 RISMAWATI INFUS
4 M.MAHARDIKA INFUS
4

02/01/2016 1 NURUL INFUS


2 ELI SITI MASLIAH INFUS DC
3 WIDI INFUS
4 PITRI ARYANTI INFUS DC
5 IMAS INFUS
6 EUIS NURJANAH INFUS
7 DASRI INFUS
8 ERNI INFUS
9 JALI SARIAH INFUS
10 SEGI DAMAYANTI INFUS
10 2
03/01/2016 1 PIPIH LIYANTI INFUS
2 EMA RAHMAWATI INFUS
3 E RADIATUS INFUS DC
4 MARYAMAH INFUS DC
5 SITI AISAH INFUS DC
6 CRYSTINE INFUS
6 3

04/01/2016 1 DEDEH INFUS DC


2 DEDEH HERAWATI INFUS
3 YANI INFUS DC
4 ANISA INFUS
5 EVI INFUS
6 SITI FAUZIAH INFUS
7 RENI INFUS
8 EVIE INFUS
9 RINI INFUS DC
10 ATE INFUS
11 RESTI INFUS DC
12 SRI INFUS DC
12 5

05/01/2016 1 LELA INFUS


2 IMAS INFUS
3 RAMDHAN INFUS
4 RADITIAN INFUS
4

06/01/2016 1 NURHAENI INFUS


2 MIMIN INFUS
3 LENI MARLIANI INFUS DC
4 SUSANTI INFUS
5 MIA INFUS DC
6 ROSITA INFUS DC
7 ENUNG SITI INFUS DC
8 ENUNG SAHADAH INFUS
9 R. NANA NURJANAH INFUS
10 ALVIANA INFUS
11 IMAM ROPII INFUS
11 4

07/01/2016 1 KASMIYATI INFUS


2 UUN MAEMUNAH INFUS
3 SUSILAWATI INFUS
4 HESTINE INFUS
5 TUNIK INFUS
6 INA ROHANAH INFUS DC
7 WIDYA INFUS
8 ISMI INFUS
8 1

08/01/2016 1 EPON INFUS DC


2 DIAH INFUS
3 NUR AFIDA FAUZIA INFUS
4 WINDANINGSIH INFUS
5 ENENG NURHAYATI INFUS
6 UPIT INFUS DC
7 RINDI SAZKIA INFUS
7 2

09/01/2016 1 INA ROSMALINA INFUS DC


2 MIA LESMIATI INFUS
3 OLIS INFUS DC
3 HANI INFUS DC
4 REZTY INFUS DC
5 ARIS INFUS
6 SEPTIA INFUS
7 WIWIN INFUS
8 YANTI INFUS
9 IIS INFUS
9 4

10/01/2016 1 MIRNAWATI INFUS


2 LASMANAH INFUS
3 NOLIS INFUS
4 YULIANUR INFUS DC
5 RIFA INFUS DC
6 RANI ANGGRAENI INFUS
7 ROHIMAH INFUS DC
8 DEWI ROHMAH INFUS DC
9 NEPI NURLEGI 9 4

11/01/2016 1 RISMA SITI WAHYUNI INFUS


2 FARIDAH INFUS DC
3 YULI YULIANA INFUS
4 MURSIDAH INFUS
5 EVI SUSANTI INFUS
6 EVI PURNAMA DEWI INFUS
7 NENG MARIAM INFUS
8 IHAT SOLIHAT INFUS
9 SUMIATI INFUS DC
9 2

12/01/2016 1 ENI SUHAENI INFUS DC


2 DODE INFUS DC
3 DINI INFUS
4 HANI INFUS DC
5 PITRIAH INFUS DC
6 IMAS MULYANI INFUS DC
7 HERA INFUS DC
8 INTAN CAHYA IKA INFUS DC
9 LENI MARLIANI INFUS DC
10 ALSHAB INFUS
10 8

13/01/2016 1 ENTIN INFUS DC


2 LISMAWATI INFUS DC
3 YAYANG ANGGRAENI INFUS
4 WIDANINGSIH INFUS DC
5 MAYA INFUS
6 ADIFA INFUS
6 3

14/01/2016 1 RINA HELYANI INFUS DC


2 FITRI NIRMALA INFUS
3 YATI SURYATI INFUS
4 YANTI SUMINAR INFUS DC
5 NINA NURHASANAH INFUS
6 NURHASANAH INFUS
7 PUTRI INFUS DC
8 ANNE INFUS
9 JENI INFUS DC
10 PARTINI INFUS DC
10 5

15/01/2016 1 IIN MARYATI INFUS


2 HENI WATI INFUS DC
3 TIAWATI INFUS DC
4 FITRI ANIRA INFUS
5 M.RIFKI INFUS
6 KHALIFA INFUS
7 NADIRA INFUS
8 RIFKI INFUS
9 NURHASANAH INFUS
10 NINA INFUS
11 PUTI ERMA INFUS
12 ABIDZAR INFUS
13 ANEU INFUS
14 JENI INFUS
15 PARTINI INFUS DC
15 3

17/01/2016 1 SITI SADIAH INFUS


2 MULYATI INFUS
3 LAELASARI INFUS
4 PARSIAH INFUS DC
5 NITA INFUS
6 WAWAT INFUS
6 1

17/01/2016 1 ILA INFUS


2 ERNA INFUS
3 DONA INFUS DC
4 PRATIWI INFUS DC
5 M IBRAHIM INFUS
6 SUSILAWATI INFUS
7 SITI NURLAELA INFUS
7 2

18/01/2016 1 LINA NOVIANTI INFUS


2 NANI JUARSIH INFUS
3 FAUZIAH INFUS DC
4 NOVA INFUS DC
5 SINDI INFUS DC
6 RAHAYU INFUS
7 TATI HARYATI INFUS DC
8 NANI JUARSIH INFUS DC
9 CUCU SUPARTIN INFUS DC
10 FITRI HANDAYANI INFUS
11 CUCU INFUS DC
12 ISMI LESTARI INFUS DC
13 ISNAENI INFUS
14 HANI NOVIANI INFUS DC
15 BY NY SANTI INFUS
16 BY NY SANTI INFUS
17 MILA INFUS
17 9

19/01/2016 1 MIA LESMIATI INFUS


2 SRI SUPRIYATI INFUS DC
3 SANTI INFUS
4 YUFI INFUS
5 SITI JULAEHA INFUS
6 DEDEWATI INFUS
7 NINA NOVIANTI INFUS
8 IMA SARTIKA INFUS
9 HURIYA INFUS DC
10 ELIN HARTINI INFUS DC
10 3

20/01/2016 1 SRI INDRA INFUS DC


2 ILAH INFUS DC
3 PUJIYATI INFUS
4 HUSAENANAH INFUS
5 SUWARTINI INFUS DC
6 TUTI NURHAYATI INFUS
7 RITA HERAWATI INFUS
8 NUNIK HERAWATI INFUS DC
9 SALMA INFUS
10 ANANDITA KEYZA ZAHRA INFUS
11 QUEISHA INFUS
11 4

21/01/2016 1 IIN MARIYAM INFUS


2 TINI KURNIAWATI INFUS
3 SUTIAH INFUS DC
4 SANTI INFUS
4 1

22/01/2016 1 LENA MARDIANA INFUS


2 HAJAR RIZKI INFUS
3 SUTIJAH INFUS
4 TITA INFUS
5 MASRIYAH INFUS
6 NELY ROSIYANA INFUS DC
7 TRIYANI INFUS
8 YENI INFUS
9 RINI HERLINA INFUS
10 LILIS INFUS
10 1

23/01/2016 1 HALIDA INFUS


2 IDA ROYANTI INFUS
3 CUCU LASMANAH INFUS
4 SITI ROYAKAH INFUS
5 TIKA APRIANI INFUS
6 WIWIN INFUS
7 m zaki INFUS
7

24/01/2016 1 MINTARSIH INFUS


2 YUFI INFUS
3 IIS ISMAWATI INFUS
4 TINI INFUS
5 IIS ISMAWATI INFUS DC
6 TITA INFUS
7 SUCI PUSPA INFUS
8 SUSI INFUS
9 PIXIE INFUS
10 VINA INFUS
11 SHINTA INFUS
11 1

25/01/2016 1 IMAS INFUS


2 SISKA INFUS
3 CICI INFUS DC
4 RENATA INFUS
5 LULU INFUS DC
6 TINTIN INFUS
7 NOVI INFUS
7 2

26/01/2016 1 SIFAWATI INFUS


2 SUGIARTI INFUS
3 NELI INFUS
4 DEDAH INFUS DC
5 MELLY INFUS DC
6 ERNAWATI INFUS DC
7 E. CACIH INFUS
8 MIKAYLA INFUS
9 IMAS INFUS
10 ATI INFUS DC
11 LISNAWATI INFUS
11 4

27/01/2016 1 SITI FATIMAH INFUS DC


2 IIM INFUS DC
3 SISKA INFUS
4 IDA HAMIDAH INFUS
5 ISAN INFUS
6 METI INFUS
7 CICA INFUS DC
8 ARYANI INFUS
9 KOKOM INFUS
10 ERNA INFUS
11 SANTI INFUS DC
12 SUTIAH INFUS DC
13 SABILA INFUS
14 YOKI INFUS
15 SARA INFUS DC
15 6

28/01/2016 1 SITI PUPU INFUS


2 SITIKORIAH INFUS DC
3 RISMIATI INFUS DC
4 BETI INFUS
5 VISKA INFUS
6 ROSI INFUS DC
7 MIA INFUS DC
8 LINA INFUS
9 AYU SRI INFUS
10 LILIS INFUS
10 4

29/01/2016 1 LILIS INFUS


2 KASNIAH INFUS
3 RINI INFUS DC
4 RIRIN INFUS
5 SANTI INFUS DC
6 MASRIAH INFUS DC
6 INDRI INFUS DC
7 MILKI INFUS
8 RAFA INFUS
9 NELY INFUS
10 SRI R INFUS DC
11 NENG SITI INFUS
12 ATI SUMIATI INFUS DC
13 TATI HAYATI INFUS
14 TINTIN INFUS
14 5

30/01/2016 1 IDA INFUS DC


2 FITRI INFUS
3 MIRA INFUS
4 RANI INFUS DC
5 SUSI INFUS DC
6 DINIYATI INFUS
7 RENI INFUS DC
8 SOLIHAH INFUS
8 4

31/01/2016 1 KHUSNUL INFUS


2 FITRI INFUS
3 TIKA INFUS
4 TITA INFUS
5 DENOVIAN INFUS
5

TOTAL 279 93
TOTAL PASIEN 567

FORMULIR SURVEY HARIAN PEMAKAIAN ALAT


RUANGAN -IGD-RSKIA-PEPUARI 2016

01/02/2016 1 SITI H INFUS


2 YUNI INFUS DC
3 REJA INFUS
4 UMAR INFUS
5 SITI SYARIFAH INFUS
6 NURAINUN INFUS
7 EMMA INFUS
8 SITI MARYANI INFUS
9 GINA INFUS
10 WASINI INFUS

10 1

02/02/2016 1 SITI MARYAM INFUS


2 DINI INFUS
3 ANNA AMELIA INFUS
4 GIFANNY INFUS
5 JENI RATNAWATI INFUS DC
6 ARI PURWANTI INFUS
7 NI WAYAN SUTAMI INFUS DC
8 NELLY NURINI INFUS
9 LELA INFUS
10 MAWAR INFUS DC
11 ELA NURLAELA INFUS
12 SETIAWANTI IMFUS
13 ADEEVA INFUS
14 NIZAAR AUFA RIFKI INFUS
14 3

03/02/2016 1 VERA YULIANI INFUS


2 IRMAWATI NFUS
3 OSIH KARTIKA INFUS
4 SHERLY AMELIA INFUS
5 IMAS ANISAH INFUS
6 TRI SOLIAH INFUS
7 YULIAWATI INFUS
8 KUSWATI INFUS DC
9 KANZA INFUS
10 M. ALIF INFUS
10 1

04/02/2016 1 RIYAN MARLIAN INFUS


2 SITI ALIAH INFUS
3 SELVIA OKTAVIANI INFUS DC
4 LILIS INFUS
5 DESI MARSITA INFUS
6 ANGGI PRASTIAN INFUS DC
7 ELI INFUS
8 MIRA INFUS
9 POPPY INFUS DC
10 IHAT INFUS
11 FAREWL INFUS
11 3

05/02/2016 1 DINA INFUS


2 FINA INFUS
3 BIDA INFUS
4 EUIS INFUS
5 WIDA WIDAWATI INFUS
6 RENI APRIANI INFUS
7 ANNISA INFUS
8 M AGUNG INFUS OGT
8 1

06/02/2016 1 IKA MUSTIKA INFUS DC


2 RITANTI INFUS DC
3 SUPRIHATIN INFUS
4 ATRI INFUS
5 SITI ROHMAH INFUS
6 DELIA SOPRISTA INFUS
7 RISNAWATI INFUS
9 RINI ROYANI INFUS
10 NENG FITRI INFUS
11 DESI NOVITASARI INFUS
12 ELPINAWATI INFUS
13 DESI INFUS
13 2

07/02/2016 1 SIFA SAFAAH INFUS


2 NUR ROSIDAH INFUS
3 MEGAWATI INFUS
4 ANISA INFUS
5 AZIZAH INFUS
6 M.KAILAN INFUS
6

08/02/2016 1 MIMIN INFUS


2 YENI INFUS DC
3 FITRI INFUS
4 TUTI INFUS
5 NISA INFUS
6 AZLEA INFUS
7 M WIKKI INFUS
7 1

09/02/2016 1 FITRI ARIESTIANTI INFUS


2 ADRIAN BAGU DERMAWANINFUS
3 SABRINA DINANTI INFUS
4 vita INFUS
5 sintia INFUS
6 yeyen INFUS DC
7 ALBIAN INFUS
8 IMIH INFUS DC
8 2

10/02/2016 1 MIMIN INFUS DC


2 MEGA INFUS DC
3 NUNUY INFUS DC
4 SRI BAGJA INFUS
5 SAMIRAN INFUS DC
6 IMAS CUCU INFUS
7 NAYA INFUS
8 USI,M INFUS
9 ROSI INFUS
10 ANNI INFUS
11 4

11/02/2016 1 EUIS INFUS


2 RINI INFUS
3 LISNA INFUS
4 SINTIA INFUS
5 WATI INFUS DC
6 TIKA RESKAWATI INFUS
7 KUSINAH INFUS DC
8 MELASARI INFUS DC
9 SUGIARTI INFUS DC
10 NOVI INFUS DC
10 5

12/02/2016 1 ERNA INFUS


2 YANTI INFUS DC
3 MEYSA INFUS
4 IPAH INFUS
5 ERNI INFUS
6 EVI INFUS
8 SALSABILA INFUS
9 ELIS INFUS DC
10 FUNI INFUS
11 SITI ROHAMI INFUS
11 2

13/02/2016 1 NOVI INFUS


2 INA SUMINAR INFUS DC
3 RADITYA INFUS
4 AISYAH INFUS
4 1

14/02/2016 1 FATMA INFUS


2 LIS NURAENI INFUS
3 RIZKIYA INFUS
4 SITI ROSITA INFUS
5 NENDEN INFUS DC
6 MEGA R INFUS
7 KOKOM INFUS
7 2

15/02/2016 1 DITA APRODITA INFUS DC


2 DEWI R INFUS
3 ANIS HANI INFUS
4 YULIANTI INFUS
5 ELIS INFUS
6 PUPUN MASTUHAH INFUS DC
7 AYU PAULA INFUS
8 YANTI INFUS
9 TUBAGUS RADITYA INFUS
10 KAHFI INFUS
11 KIKI 11 2

16/02/2016 1 DEWI AENI INFUS


2 TITIN INFUS
3 RENI INFUS
4 YETI INFUS DC
5 YATI INFUS DC
6 RESA INFUS DC
7 ZAHRA AMAN INFUS
7

17/02/2016 1 EVI MARYATI INFUS DC


2 MARIA SEFIA SEPTIAN INFUS
3 ELISAH INFUS DC
4 SISKA NURSALAM INFUS
5 SRI WAHYUNI INFUS
6 MALA INFUS
7 SARAH INFUS
8 QONITA INFUS
9 BINTANG INFUS
10 AKILA INFUS
10 2

18/02/2016 1 DITA APRODITA INFUS DC


2 YENI ROSMAYANTI INFUS
3 RIMELDA INFUS
4 ROSIDA INFUS DC
5 MULYATI INFUS
6 DESI NATALIA INFUS DC
7 KARYATI INFUS
8 RAHMAWATI INFUS
9 YENI NOFITASARI INFUS
10 RITA PERAWATI INFUS
11 LENA INFUS
12 JAFIER INFUS
12 3
19/02/2016 1 RUNI KARUNIA INFUS
2 NANAN INFUS
3 NENAH RODIAH INFUS DC
4 TINI ANGGRAENI INFUS
5 LILIS INFUS
6 IIS INFUS
7 IDA INFUS
8 STEPHANIE INFUS
9 GITA INFUS
10 RIMA INFUS DC
11 RINA INFUS
12 RENALDI INFUS
13 SITI NURFAJILAH INFUS
14 RISMA INFUS
14 2

20/02/2016 1 RIMA INFUS


2 RINA INFUS DC
3 NENI ROHANI INFUS
4 TIARA INFUS
5 YANTI INFUS
5 1

21/02/2016 1 DEWI SYARIFAH INFUS


2 ROSMAYATI INFUS
3 LINDAWATI INFUS
4 HENI INFUS
5 RENI INFUS
6 NINA JUHANDI INFUS
7 GINA INFUS
7

22/02/2016 1 CHINDY FITRIA INFUS


2 IIS FITRIANI INFUS
3 SRI NURJANAH INFUS
4 KACI INFUS
5 TANTRI INFUS DC
6 SITI ROKAYAH INFUS DC
7 FITRIANI INFUS
8 UHEN INFUS
9 VINA INFUS
10 SRI WAHYUNI INFUS DC
11 IPAH SARIPAH INFUS
11 3

23/02/2016 1 ETI SUMIYATI INFUS DC


2 CICI SULASTRI INFUS
3 LILIS HERMAWATI INFUS
4 LINA INFUS
5 SUMARTI INFUS
6 MIMI INFUS
7 RAISA INFUS
8 NOVAN RIZKI INFUS
8 1

24/06/2016 1 RATNA WULAN INFUS


2 IIS ANITA INFUS
3 ASTRI KURNIATI INFUS
4 LINDA ALMIRA INFUS
5 YUYU YUNIA INFUS
6 HENI INFUS
7 YANI INFUS
8 IKBAL INFUS
9 REZKY RAFFA INFUS
9

25/02/2016 1 NINING INFUS


2 LINDA APISTA INFUS
3 DINI INFUS DC
4 TINA INFUS
5 TINTIN INFUS DC
6 RAHMA WIYANTINA INFUS
7 TUTI HARYANTI INFUS DC
8 R. MIEKE INFUS
9 DIAN ANGGRAENI INFUS DC
10 SUKARSIH INFUS DC
11 INSAN INFUS
11 5

26/02/2016 1 LIA SRI MULYANI INFUS DC


2 MELI PERTIWI INFUS DC
3 CUCU INFUS
4 NURAENI INFUS DC
5 LINA HANDAYANI INFUS
6 DEPI SONDARI INFUS DC
7 TANTI ROHMANTIKA INFUS
8 WINA ROSWATI INFUS
9 NELLY INFUS
10 ADE MIMIN INFUS
11 IIS NURHASANAH INFUS
12 TATAT INFUS
13 NENG ANI INFUS
`14 SITI NURJANAH INFUS
15 FITRIANI INFUS DC
16 PUTRI LENI HANANI INFUS
17 ALUNA INFUS
18 M. NIZAM INFUS
18 5

27/02/2016 1 SONATA INFUS


3 DEWI KARTINI INFUS
4 DEWI INDRIYANI INFUS
5 AGUSTIN INFUS
6 DWI KURNIA WATI INFUS
7 SARIPAH INFUS
8 RINA INFUS
9 SITI UMAELAH INFUS
10 SYFIQ ALGHAZALI.F INFUS
11 M.ADTYA RAMADHAN INFUS
11

28/02/2016 1 YAYANG INFUS


2 EFNI WATI INFUS
3 NURSANTI INFUS
4 EMA INFUS
5 MIMIN INFUS
6 RANGGA NAILUN INFUS
6

29/02/2016 1 NENI ROHANI INFUS


2 ELIS INFUS
3 RINI ANGGRAENI INFUS
4 ITA PURNAWATI INFUS
5 SRI WAHYUNI INFUS DC
6 ILHAM NADIA INFUS DC
6 2

TOTAL 276 57
TOTAL PASIEN IGD 560

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN MARET 2016
01/03/2016 1 YULLY MULYANI INFUS
2 NENDEN INFUS DC
3 YETI KURNIASIH INFUS DC
4 CUCU BADRIAH INFUS
5 TATI IRAWATI INFUS DC
6 ARNI INFUS
7 ANISA RAHMA INFUS
7 3

02/03/2016 1 ROSITA INFUS


2 YEYEN ANGGRAENI INFUS DC
3 SURYANI INFUS DC
4 SITI NURJANAH INFUS
5 YUBI RUSIANA INFUS
6 MIA INFUS DC
7 SITI MUNIRAH INFUS
8 SRI MULYATI INFUS
9 RAZKA INFUS
10 DANIAN PUTRA I INFUS
10 3

03/03/2016 1 RINA M INFUS


2 SURTINI INFUS DC
3 DANISMAR INFUS DC
4 SRI HARYATI INFUS DC
5 NUR HENTI RISMA INFUS
6 LASTRI INFUS
7 YULI YUULIANDINI INFUS
8 YENI RAHMAN INFUS DC
9 NURDIANA INFUS
10 WAWAT PARWATI INFUS DC
11 TITIN SUTINAH INFUS DC
12 DEWI ROSMAYANTI INFUS DC
13 EGI KANIA INFUS
14 NENG DESTY INFUS
15 FITRI INFUS DC
16 NIA INFUS
17 NENENG SRI RAHAYU INFUS
18 MIMIN MINTAERSIH INFUS
19 HENI INFUS DC
20 TETI NURHAYATI INFUS
21 ENOK INFUS
22 FADHIL SAID INFUS
22 9

04/03/2016 1 MIRANTI INFUS


2 VERA KARINA FEBRIANTI INFUS
3 YUYUN INFUS
4 SRI OKTAVIANI INFUS
5 NUR AISAH INFUS
6 ERNA SUSANA INFUS
7 KARA ASYIFA NURYAN INFUS
8 ALYA PUTRI INFUS
8

05/03/2016 1 VINA HANAPIAH PUTRI INFUS DC


2 YULI YANTI INFUS
3 VIVI AMALIA INFUS
4 YAYAH INFUS DC
5 EVI INFUS
6 YULIANA INFUS
7 RATNA INFUS DC
8 YANTI INFUS
9 GENDIS INFUS
10 INESAN INFUS
11 GALANG INFUS
12 AZKA ALFARO INFUS
12 3

06/03/2016 1 ROHAENI INFUS


2 ENUNG INFUS DC
3 EMMA RAMAYANTI INFUS
4 MELI PERTIWI INFUS
5 ISOH INFUS
5 1

07/03/2016 1 SANTI NURNANINGSIH INFUS


2 DAEMAH INFUS
3 SANSAN PURWATI INFUS DC
4 ANISA NURUL INFUS
5 NOVIYANTI INFUS DC
6 SITI HALIMAH INFUS
7 DEWI GARDIANI INFUS
8 MULIDIANA INFUS
8 2

08/03/2016 1 OKLI INFUS


2 OON INFUS
3 ERNAWATI INFUS
4 AJENG INFUS
5 AVON R INFUS
6 ERNI INFUS
7 DEWI INFUS
8 TITIN INFUS
9 REHAIN INFUS
10 ARI INFUS
11 NURYANI INFUS
12 M. ALBIANSYAH INFUS
12

09/03/2016 1 MIRNA YULIANI INFUS


2 KARTIKA INFUS
3 RIFA INFUS
4 YULIYANI INFUS DC
5 ELSA SELVIANI INFUS DC
5 2

10/03/2016 1 DEWI MAY NURDIANTINI INFUS


2 SARTIKA INFUS
3 RIKA INFUS
4 TITIN INFUS
5 PITRI INFUS
6 ADELVA FEBRIANZA INFUS
7 NENI NURJANAH INFUS DC
8 YANTI INFUS
9 YELFITRI INFUS
10 FAISAL INFUS
11 DIMAS INFUS
11 1

11/03/2016 1 YELFITRI INFUS


3 BETRI JULIANI INFUS
4 LIA DAHLIA INFUS
5 ANTI INFUS
7 MARLINA INFUS
8 RENI INFUS
9 NUAISYAH INFUS
10 WIWIN INFUS DC
11 DESI INFUS
12 RENI GANTINI INFUS
13 KANIA INFUS
14 KALISA INFUS
15 NAJWA INFUS
15 1

12/03/2016 1 ASTRI INFUS DC


2 ERNI KARTIKA INFUS DC
3 YAYU RAHMAWATI INFUS DC
4 REFTI KURNIAWAN INFUS
5 KOKOM KOMALA INFUS DC
6 PATIMAH INFUS DC
7 IIS ISTIKOMAH INFUS
8 NINA SRI INFUS
9 AISYAH INFUS DC
10 APRIL INFUS DC
10 7

13/03/2016 1 JUARIAH INFUS DC


2 AI KARTIKA INFUS DC
3 RINI SUSILAWATI INFUS
4 MUHAJIROH INFUS DC
5 TINAH SUTINAH INFUS
6 NISA INFUS
7 RENI INFUS
8 KOKOM INFUS
9 YENI NURAENI INFUS DC
10 YENI INFUS DC
11 M HAIKAL INFUS
12 NURLIA INFUS DC
12 8

14/03/2016 1 RIKA INFUS DC


2 MARLINA INFUS
3 RINI ALIANI INFUS DC
4 WINDA INFUS
5 AGNES INFUS
6 NINA INFUS DC
7 IKA INFUS DC
8 M. FADLAN INFUS
9 GINA INFUS
10 IRMA INFUS
11 SHINTA INFUS
11 4

15/03/2016 1 KUSMULYATI INFUS DC


2 RINA INFUS
3 NEVI INFUS
4 LINA INFUS
5 RODIYAH INFUS
6 TUTI INFUS
7 FITRI JAMILAH INFUS
8 KOMALASARI INFUS
9 SITI KOMARIAH INFUS
10 DINA INFUS
11 DESI INFUS
12 ANI HANDAYANI INFUS
13 LATIFAH INFUS
14 SITI MARYAM INFUS
14 1

16/03/2016 1 HANI INFUS DC


2 NOVIANTI A INFUS
3 MARIAM INFUS DC
4 YULI YUULIANDINI INFUS
5 NENDEN INFUS
6 ENDANG INFUS DC
7 NADYLA INFUS
8 ALSYA INFUS
9 NAIRA INFUS
9 3

17/03/2016 1 ANISA INFUS


2 FITRIYANI INFUS
3 RIA INFUS
4 SRI NINGSIH INFUS
5 INTAN INFUS
6 DALIL INFUS
6

18/03/2016 1 SITI MERLINA INFUS


2 SUPRIATI INFUS
3 YENI INFUS
4 YULI INFUS DC
5 RAHELYA TARIGAN INFUS
6 AAT SOLIHAT INFUS
7 EMA NURAJIJAH INFUS
8 NURLAELA INFUS
9 SILVI APRILIANI INFUS
10 MARLINDA INFUS
10 1

19/03/2016 1 NURLELA SARI INFUS


2 SITI KAMILA INFUS
3 RINI PUJI ASTUTI INFUS DC
4 FITRIANI INFUS DC
5 NURHAYATI INFUS DC
6 LANI INFUS
7 SRI DEWI INFUS
8 ADELIA INFUS
9 NADINE INFUS
10 FIKRI AHMAD F INFUS
10 3

20/03/2016 1 SUSANTI INFUS


2 MIRA INFUS
3 EBEH INFUS
4 SITI NURMALA INFUS
5 IMAS SARILAH INFUS
6 AI KARYATI INFUS DC
7 AI.NURI INFUS DC
8 LILIS INFUS
9 ATRI INFUS DC
10 HANA HARYATI INFUS DC
11 RAYHAN PRATAMA INFUS
12 M ADHWA HABIBIE INFUS
13 ENZHA KHARISMA INFUS
13 4

21/03/2016 1 GINA INFUS DC


2 SITI ALAMAH INFUS DC
3 RISNAWATI INFUS
4 EVA ROSDIANA INFUS
5 HERNITA INFUS
6 YANTI INFUS
7 KARTINI INFUS
8 DEWI INFUS
9 HANI INFUS
10 RIKA INFUS DC
11 WULANSARI INFUS
12 DELFA YENI INFUS
13 RIMA INFUS
21/03/2016 14 M AFIZHAM IBNU INFUS
14 3

22/03/2016 1 DEWI INFUS DC


2 WINI WIRASANTI INFUS
3 DEWI HENDRAYANI INFUS
4 ROSITA INFUS
5 NAZWA ALVIN F INFUS
5 1

23/03/2016 1 SITI KAMILA INFUS


2 JUNIARTI INFUS
3 SHANTY VELLYNEA INFUS DC
4 ERLLY ROSAWATI INFUS
5 SELAWATI INFUS
6 RITA INFUS
7 IBNU AISAR INFUS
8 ANINDITA INFUS
9 IRSYAD INFUS
9 1

24/03/2016 1 ERPINI RAHMAWATI INFUS DC


2 EVA NISA INFUS
3 YULAN INFUS DC
4 ELA NURHAYATI INFUS
5 NIDES WIRA INFUS
6 RINI INFUS
7 N JUNARIYAH INFUS
8 IRMA INFUS
9 JANISAH INFUS
10 ISMA NUR AFIFAH INFUS
11 TRI ENDAH INFUS
12 IIN RAPINAH INFUS
13 SAFFA INFUS
14 RAPLY ADITYA INFUS
15 BY NY IRMA INFUS
15 2

25/03/2016 1 DINIA SUSILAWATI INFUS


2 SITI NURMALASARI INFUS
3 TESA ARDYANTI INFUS
4 DESSY INFUS
5 DEWI INFUS
6 RATNA SARI DEWI INFUS DC
7 RAMDHAN INFUS
7 1

26/03/2016 1 INDRI MULYADI INFUS


2 SUSI ERLIN INFUS DC
3 ANA MARDIANAH INFUS
4 ANING INFUS
5 RENI INFUS
6 MITA MEIDA NURISTOPA INFUS
7 HAMLAN INFUS
7 1

27/03/2016 1 NINA HERLINA INFUS DC


2 HERAWATI INFUS
3 HAMIDAH INFUS
4 RINI INFUS DC
5 NINGSIH INFUS
6 TINI INFUS DC
7 ROSARI INFUS
8 SAFA NURSY INFUS
8 3

28/03/2016 1 PUTRI DEWI INFUS


2 YENI NURAENI INFUS
3 ASNAWATI INFUS
4 PUJI PRANESTI INFUS DC
5 FITRI AMALIA INFUS DC
6 AZKA SADAM INFUS
7 ABDUL ROPI INFUS
8 FARAH INFUS
9 PUTRA ARYA INFUS
9 2

29/03/2016 1 MARINA INFUS


2 LINDA INFUS
3 NENI INFUS
4 FENI INFUS
5 TITIN INFUS
6 SRI PUJI NURINDAH INFUS
7 ROSANAH INFUS
8 ROHITA INFUS
9 AMELIA RILLIA DEWI INFUS
10 NOPI YULIANTI INFUS
11 NURSANTI INFUS
11

30/03/2016 1 NURHAYATI INFUS


2 RINA INFUS
3 NURHAYATI INFUS DC
4 LINDAWATI INFUS
5 TATI INFUS DC
6 VINA INFUS
7 YANTI INFUS DC
8 YENI INFUS
9 by ny iit INFUS
10 yulianti INFUS
11 FITRIYANI INFUS
12 ELIS INFUS
13 DASMILAN INFUS
14 SINTA INFUS DC
15 ELA INFUS DC
15 5
31/03/2016 1 WIDI INFUS DC
2 SUNAENGSIH INFUS
3 MIRA INFUS
4 NENDEN INFUS
5 ERLINA INFUS
6 RINA INFUS DC
7 YULIANTI INFUS
8 RIZKIA INFUS
9 SHIFA INFUS
10 YANI INFUS
11 RISNA INFUS
11 2

TOTAL 321 77

TOTAL PASIEN IGD 559

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN APRIL 2016

01/04/2016 1 SRI ARNIYATI INFUS DC


2 SUSANTI INFUS DC
3 YESI GUSMAN INFUS
4 AI NANI R INFUS
5 AI SUMIYATI INFUS
6 IIS MARYATI INFUS
7 YENI NUR MALAENI INFUS DC
8 FUJI PERTIWI INFUS
8 3
02/04/2016 9 NENG LISDA INFUS
10 IDA INFUS
11 EVA INFUS
12 FEBI FITRIANI INFUS
13 NOVI INFUS
14 RAHAYU INFUS
15 AMELIA INFUS
16 VINA NOVIANI INFUS DC
17 VINCENTIA NGADINEM INFUS
18 EVI INFUS DC
19 YULI YULIANTI INFUS
20 SETIAWATI INFUS
21 AYUB INFUS
13 2
03/04/2016 22 MIRA INFUS
23 MIRA WANTINI INFUS
24 FITRIYANI INFUS DC
25 RIA INFUS
26 NURHAYATI INFUS DC
27 HESTI APRILIA INFUS
28 HAMIMAH INFUS DC
29 IQBAL INFUS
8 3
04/04/2016 30 NIA CARANIA INFUS
31 ALGIE INFUS
32 SURTINI INFUS DC
33 SANTI YULIANTI INFUS
34 ENJNG HENDAYANI INFUS
35 TINI AWANGSIH INFUS DC
36 AYU RAHMAWATI INFUS
37 ASTRI STRIANI INFUS
38 SSANTI FITRIANA INFUS
39 RINI INDRIYANI INFUS
40 SITI LESTARI INFUS
41 AYU INFUS
42 TIKA PEBRIANTI INFUS
43 EPI MARLINA INFUS
44 HANI INFUS
45 SRI NINGSIH INFUS
46 IYOM INFUS
47 M AKMAL INFUS
48 ABYAN INFUS
19 2
05/04/2016 49 SITI MASITOH INFUS DC
50 RATNA SULASTRI INFUS
51 RATNA SARI INFUS
52 IIN INFUS
53 RATNA SARI INFUS
54 SARTIKASARI INFUS DC
55 KRISNA AULIA INFUS
56 STEFHANI WIJAYA INFUS
57 NOVI SUSILAWATI INFUS
58 ALFIANSYAH INFUS
59 SYAKILA INFUS
11 2
06/04/2016 60 PRISKA NOVAYADIN INFUS
61 RESTI HERMAYANTI INFUS
62 NENI KOMALASARI INFUS
63 NOORAINI INFUS
64 SURTINI INFUS DC
65 EMPU INFUS
66 NENENG INFUS
67 SUKAESIH INFUS
68 WINI INFUS
69 DEDE KOMALASARI INFUS
70 YENI NURAENI INFUS DC
71 MIRA INFUS
72 SRI ANDRIANI INFUS
73 MIMI INFUS
74 TINI NURAENI INFUS
75 SANTI INFUS
76 MULYADI INFUS
77 HENDI INFUS
18 2
07/04/2016 79 ELITA SATI INFUS
80 IIS MARYATI INFUS DC
81 LINDA INFUS
83 MAURA SALSABILA INFUS DC
84 HARYATI INFUS
85 NELLY INFUS
86 INTAN WIDIAWATI INFUS
87 KEVIN INFUS
88 SATRIA INFUS
08/04/2016 89 JUJU INFUS
90 SITI NUR JAMILAH INFUS
91 NOVI MASTRINA INFUS DC
92 KARNATI INFUS
93 MEGA SOPIA INFUS
94 YUYUN INFUS
95 SULASNI INFUS
96 UUS PUTRIA INFUS
09/04/2016 97 FITRI INFUS
98 RIKA RIYANI INFUS
99 LINDA SETIAWATI INFUS
100 LIA NATALIA INFUS
101 ANI SINA OKTA BESAN INFUS
102 NETY INFUS
103 ENIS INFUS
104 NETY INFUS
105 WNNI INFUS
106 AKBAR SYAIDUL INFUS NGT
107 ZAFRAN INFUS NGT
108 TASYA INFUS
10/04/2016 109 SONA INFUS
110 TIAH LISANTI INFUS
111 IRENE INFUS
112 IIM ROHAETI INFUS DC
113 YANTI KOMALA INFUS
114 YULIA YULIANTI INFUS
115 EVA SEPTIYANI INFUS
116 ARGYA INFUS
117 DANIEL ILHAM INFUS
118 RAYA GIRI INFUS
119 ARSENIO INFUS OGT
11/04/2016 120 LUSI SUSANTI INFUS DC
121 MARLIA INFUS DC
122 EKA SEKARYATI INFUS
123 ASTRI HERDIANTI INFUS DC
124 TIARNI INFUS
125 YENI RAHMAH INFUS DC
126 KARTIKA INTAN INFUS DC
127 NANI NURAENI INFUS
128 IMAS SULASTRI INFUS
129 SITI NURHAYATI INFUS
130 RINA TRESNAWATI INFUS
131 NOPI YANTI INFUS DC
132 RIKA INFUS DC
133 DIAN NUR INFUS
134 MIRZA INFUS
12/04/2016 135 SITI NURLIAH INFUS DC
136 FITRI INFUS
137 NENG HESTI INFUS
138 FiTRI LUTFIANI INFUS
139 GALUH INFUS
13/04/2016 140 DEWI SARTIKA INFUS
141 LISA INFUS
142 ANGGI INFUS DC
143 TARSIAH INFUS
144 FINI MAHARANI INFUS
145 NURYATI INFUS DC
146 FITRIA INFUS
147 ERNA MARYANTI INFUS
148 SUGIARNI INFUS
149 RIMAYANTI INFUS DC
150 HERAWATI INFUS
151 POPY INFUS
152 NAYA AULIA INFUS
153 RAZKA INFUS
154 RIKA INFUS
155 SRI MULYATI INFUS
156 NURTIYAH INFUS
157 SUGIARNI INFUS DC
158 RIMAYANTI INFUS
159 HERAWATI INFUS
160 NAYA INFUS
161 RAZKA INFUS
162 GALUH INFUS
14/04/2016 163 NENI INFUS DC
164 YULI YULIANTI INFUS DC
165 DEBI DC
166 WATI SUMIYATI INFUS
167 SRI ENDANG LAELASARI INFUS DC
168 NUR AFRILIA INFUS
169 LINA JUNAEDI INFUS
170 HERNA DWIYANTI INFUS DC
171 WIDA WIDANINGSIH INFUS
172 PONIRAH INFUS
173 YULIANTI INFUS DC
174 ERNI INFUS
175 SAMSIAH INFUS
176 ABYAN AHNAF INFUS
177 ABIDZAR INFUS
178 AZKA/BY NY ENUNG INFUS
15/04/2016 179 ELZA SYLVI INFUS
180 AI ATIKAH INFUS
181 YANI INFUS
182 DEWI INFUS
183 SULASTRI INFUS
184 DESI SOPIANTI INFUS
185 NENI HANDAYANI INFUS
186 INARA AYUDIA INFUS
187 NUR REYSA INFUS
16/04/2016 188 KOKOM KOMALASARI INFUS
189 SRI ANDRIANI INFUS
190 R LIA YULIANTI INFUS
191 DESI INFUS
192 SITI SAROH INFUS
193 AJENG SRI INFUS DC
194 WIDIA DAMAYANTI
195 NENG SULASTRI INFUS DC
196 LIANA ANGELISIA INFUS DC
197 HASBY HIBATULLOH INFUS
198 YANI INFUS
17/04/2016 199 TINI MARTINI INFUS DC
200 YULIA AGUSTINA INFUS
18/04/2016 201 RENI ANGGRAENI INFUS
202 NINGSIH INFUS DC
203 IMAS S INFUS
204 HERAWATI INFUS
205 YANI KURAESIN INFUS
206 EFI ASTARI INFUS DC
207 APRILIA INFUS
208 VINA SULASTRI INFUS
209 SURYA INFUS
19/04/2016 210 RIKA KARTIKA INFUS
211 ROSITI INFUS
212 GHINA INFUS
213 ARSAD INFUS
20/04/2016 212 ANNA INFUS
213 LEADYA INFUS DC
214 ELIH SOLIHAH INFUS
215 DIANA KH INFUS
216 MARDELIATI INFUS
217 ALVARO INFUS
21/04/2016 218 YANTI YULIANTI INFUS
219 MINATI GOSAH INFUS DC
220 OLA INFUS DC
221 DESI YUNIAWATI INFUS
222 RIKA MULYATI INFUS
22/04/2016 223 SRI WAHYUNI INFUS
224 CICIH INFUS
225 SITI NURHASANAH INFUS
226 ELIS ROMLAH INFUS
227 ERNA MARYANA INFUS
228 AIDA NINGSIH INFUS
229 MIMIN INFUS
230 ARFAN INFUS
231 NADIA INFUS
23/04/2106 232 AMALIA INFUS
233 RANTIKA INFUS
234 ULFAH NURSAIDAH INFUS
235 ERNA YUNINGSIH INFUS
236 RIPALDI INFUS
24/04/2016 237 ACAH INFUS
238 LILIS RACHMAWATI INFUS DC
239 MARITA INFUS
240 RINI ROSDIYANTI INFUS DC
241 YULIAWATI INFUS

25/04/2016 242 DIAN INFUS DC


243 ISMI NURHAYATI INFUS
244 RINI SURYANI INFUS
245 FITRIA INFUS
246 LILIS INFUS
247 NENENG INFUS
248 TITA INFUS
249 DEWI NUR ASYIFA INFUS
250 NURLINAH INFUS
251 M.FIKRI ABDUL INFUS
252 AZANA INFUS
253 ADINDA INFUS

26/04/2016 254 DIAN TRIYANA INFUS


255 IRMA INFUS
256 EKA INFUS
257 SUHAENI INFUS
258 HENDRIYANI INFUS

27/04/2016 259 AMELIA ZAHRA INFUS DC


260 ALIF RAINA INFUS

28/04/2016 261 YULIANTI INFUS


262 SITI NURHAYATI INFUS
263 RENGGANIS INFUS
264 EMA INFUS
265 RINANINGSIH INFUS
266 LILI INFUS
267 WIWI INFUS DC
268 DINI APIANTI INFUS
269 AI ROHAETI INFUS
270 M.AGIS SIDIQ INFUS
271 SINTIYA INFUS

29/04/2016 272 YANTI YULIANTI DC


273 IRA INFUS DC
274 WIDIA INFUS
275 DEWI SARTIKA INFUS
276 AMBAR UTAMI INFUS
277 DETI SETIAWATI INFUS
278 TUMINEN INFUS
279 DEWI NURDIANTI INFUS
280 WINDI NURBAYATI INFUS
281 IRA SESI AMELIA INFUS
282 DESTIA INFUS
283 M. IDWAN INFUS

30/04/2016 284 SELLY RAHMA INFUS DC


285 AAS SUMIATI INFUS
286 SANTI DURMAYANTI INFUS
287 FITRIA AGUSTIN INFUS
288 JUHARIYAH INFUS DC
289 ANISA INFUS
290 SANTI DURMAYANTI INFUS
291 IVA INFUS
292 KENDI INFUS
293 SAFITRI INFUS
294 NURHASANAH INFUS
295 SRI AJENG INFUS
296 SITI LASNUL INFUS
297 AI DARIAH INFUS
298 SUSILAWATI INFUS

TOTAL 298 54 3

TOTAL PASIEN IGD 699

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN MEI 2016

01/05/2016 1 RESNAWATI INFUS


2 MURSALINA ULVA INFUS
3 NELLY INFUS
4 NIK-NIK INFUS DC
5 EMMA MAESAROH INFUS
6 NENI INFUS
7 LINA HERLINA INFUS
8 TITIN RUSTINI INFUS
9 JUBAEDAH INFUS
10 SHINTA INFUS
10 1

02/05/2016 11 RITA INFUS


12 MELITA INFUS
13 ELIN INFUS
14 NURBAETI INFUS
15 DELVIA SINTIA INFUS DC
16 IMAS MAESAROH INFUS DC
17 DESI JESIKA INFUS DC
18 NENI NURAENI INFUS DC
19 YAHYA INFUS

03/05/2016 20 PUJINIATI INFUS DC


21 NITA INFUS
22 M.MIFTAH INFUS
23 SITI ULFAH INFUS
24 NIA KURNIASIH INFUS DC
25 WINDI RIZKYA H INFUS
26 LINA INFUS
27 ANI INFUS DC
28 NELLY INFUS DC
29 MIFTAH INFUS
30 ARSAD INFUS
31 REZA INFUS
32 ZIA INFUS
04/05/2016 33 CHRISTIANA INFUS
34 NANI INFUS DC
35 RISKA INFUS
36 HALIMAH INFUS
37 INA ROSDIYANA INFUS DC
38 WINDA SUSANTI INFUS DC
39 ANI.ROHAENI INFUS

05/05/2016 40 LUSI LUSIANA INFUS


41 RAVIKHA MELLA INFUS
42 SITI AMINAH INFUS
43 NENI NURHAYATI INFUS
44 ROSA SONIA ANTIKAWATI INFUS
45 IDA SOPIAH INFUS DC
46 DILA INFUS
47 NINA INFUS
48 KIKI INFUS
49 NURSANTI INFUS
50 WIDYA INFUS

06/05/2016 51 DEVI INDRI INFUS


52 INES ANNISA INFUS
53 SITI NURANI INFUS
54 NINA INFUS
55 SITI DIDA INFUS
56 DEDE INFUS DC

07/05/2016 57 YANTI INFUS DC


58 RISMAWATI INFUS DC
59 ULFA GANDARI INFUS
60 NOVITA SARI INFUS
61 FITRIA INFUS DC
62 MAYA PERMATA SARI INFUS
63 RADEN ELGY NURMANDHANI
INFUS
64 ELIS NENI SURYANI INFUS
65 YESI NOFIANTI INFUS
66 ALVARO ANDRIANA INFUS
67 IBNU SAFUTRA INFUS
68 HARY RAMDAN INFUS

08/05/2016 69 ELA INFUS DC


70 ASTRI INFUS
71 ENENG CUCU INFUS
72 IIS MARDIANA INFUS
73 SUMIARTI INFUS
74 SHENI UTAMI INFUS
75 ALKALIFI INFUS
76 ZAHRA YUSRIYYAH INFUS
77 DIAN INFUS

09/05/2016 78 ANNISA FATIMAH INFUS


79 PIPIH SITI SOPIAH INFUS
80 SULISTIANI INFUS
81 WIDA INFUS
82 ATI SUMIATI INFUS
83 SANTI INFUS
84 ELIS DEWI CAHYATI INFUS

10/05/2016 85 NENDEN INFUS


86 GINA RATNA SARI INFUS
87 SATMAWATI INFUS DC
88 DESI INFUS
89 MEGA INFUS
90 NENCY INFUS
91 NUNUR INFUS
92 FITRI INFUS
93 ROSITA INFUS
94 DINE RAHMAWATI INFUS

11/05/2016 95 GINA SANTIKA INFUS


96 SINDI INFUS
97 AI SETIAWATI INFUS
98 RIZQIANI INFUS
99 TETI ROHAYATI INFUS DC
100 ELIS INFUS
101 TATI INFUS DC

12/05/2016 102 FITRI INFUS DC


103 SITI AISYAH INFUS
104 LINDA INFUS
105 LIA INFUS DC
106 EUIS INFUS
107 YESSI INFUS
108 EW3 INFUS
109 SITI ENDAH INFUS
110 RIKA KARTIKA INFUS
111 YENI LESTARI INFUS
112 YUYUN KURNIATI INFUS
113 NURY NURHAYATI INFUS
114 SITI ROHIMAH INFUS

13/05/2016 115 YENI SAPTARIANI INFUS


116 DEWI AYU INFUS
117 ARIE SUMARTINI INFUS
118 NURSARIPAH INFUS
119 FILANI INFUS DC
120 DIDAH INFUS DC

14/05/2016 121 YENI NURAENI INFUS


122 TINA NURTIANA INFUS
123 ARI ANGGRAENI INFUS DC
124 IRMAWATI INFUS
125 ELSA INFUS
126 SUGIARNI INFUS DC
127 MIA HERYANI INFUS
128 SUHARTINI INFUS
129 SITI NURJANAH INFUS
130 SITI YANIE INFUS
131 NUR AENI INFUS
132 RINI SUMARNI INFUS
133 RANI INFUS DC

15/05/2016 134 SEPTI ARYANTI INFUS


135 TITA KARTIKA INFUS
136 NENG CAHYATI INFUS
137 NENI INFUS DC
138 LINA INFUS DC
139 KENIA INFUS DC
140 PARJILAH INFUS DC

16/05/2016 141 AAS ASTUTI INFUS DC


142 SITI KOMARIAH INFUS
143 IMAS HODIJAH INFUS DC
144 IDA FARIDA INFUS
145 RINA INFUS DC
146 YULIANA INFUS
147 ENDAH INFUS
148 YULIANA INFUS
149 TISA NADIA INFUS
150 KARTIKA INFUS
151 DENA INFUS
152 ERNAWATI INFUS
153 NELIS INFUS DC

17/05/2016 154 DINNY INFUS DC


155 YANTI INFUS
156 LISNA INFUS
157 AI ROHAYATI INFUS
158 SANTI INFUS DC
159 DEDEH YUNINGSIH INFUS
160 HOTLIN INFUS

18/05/2016 161 ERA MUKAROMAH INFUS


162 RINA INFUS DC
163 IIS INFUS
164 DIANTI INFUS
165 ENON INFUS DC
166 YANTI INFUS DC
167 MARYAM INFUS
168 MELLI AMELIA INFUS
169 SUSAN INFUS
170 YUNINGSIH INFUS
171 RINA INFUS
172 AZZAHRA INFUS
173 INARA AYUDIA INFUS

19/05/2016 174 ANI ROHAENI INFUS DC


175 SELVIA GUNAWAN INFUS
176 SUMARNI INFUS
177 EVI OCTIANY INFUS
178 TIA SUTIANI INFUS DC
179 SARI INFUS DC
180 ELLY INFUS
181 SUGIARNI INFUS DC
182 M.RIAN INFUS
183 ANUGRAH INFUS
184 RIHANATUL JANAH INFUS

20/05/2016 185 SUGIARNI INFUS DC


186 LATIKA SARI INFUS
187 EUIS NUR SARIFAH INFUS
188 RISMA INFUS
189 LINA INFUS DC
190 RINI SUMARNI INFUS DC
191 SALSABILA LESMANA INFUS

21/05/2016 192 SUMINAR INFUS


193 RIKE RATIKA INFUS
194 SELLY INFUS
195 SARI INFUS
196 NOVA INFUS
197 EMAH INFUS
198 ANEU INFUS DC
199 HANY INFUS
200 SHINTA NURLELA INFUS
201 ENTIN INFUS
202 MEGA TRI UTAMI INFUS
203 LIA YULIANTI INFUS
204 RIKA A INFUS
205 VINA VEBRIANI INFUS
206 AFIQAH INFUS
207 RENALDI INFUS

22/05/2016 208 SITI NURHAYATI INFUS


209 YULIANI INFUS
210 MAESAROH INFUS
211 TUTI INFUS
212 ELIS INFUS DC
213 YUYU YUHANA INFUS
214 RISMA RESTIAWATI INFUS
215 UTAMI FAUJIYAH INFUS
216 RANI INFUS
217 REYHAN INFUS
218 CITRA AZZAHRA INFUS
219 ASTI AURA L INFUS

23/05/2016 220 EDAH INFUS


221 TITIN INFUS
222 AIDAH INFUS
223 ANGGUN INFUS
224 SANTI YANI INFUS
225 KARTIKA CANDRA INFUS DC
226 DEBORAH INFUS
227 LILIS ROHAENI INFUS

24/05/2016 228 YUNINGSIH INFUS DC


229 RIMA PUSPITA INFUS
230 DIANA RISTI INFUS DC
231 MEGA INDAH INFUS
232 SITI MEI INFUS
233 MUNAROH INFUS
234 ANISA INFUS
235 EUIS INFUS
236 NAYLA INFUS
237 RASYA ABDUDL INFUS
238 NADA PUTRI INFUS

25/05/2016 239 SEPTI ARYANTI INFUS


240 NURAENI INFUS DC
241 KIKI SITI INFUS
242 NENG YUNI ARYANTI INFUS
243 ENENG FATIMAH INFUS
244 NUNUNG INFUS
245 SITI NURHUSAENI INFUS
246 MIRA ANGGRAENI INFUS

26/05/2016 247 RESDI SITANGGANG INFUS


248 TENI GUSTIANI INFUS
249 INFUS DC
250 SITI INFUS
251 PRISKA NOVITA INFUS
252 NINA INFUS

27/04/2016 253 WINDARI INFUS DC


254 DEWI SARTIKA INFUS DC
255 ASTRI INFUS
256 TATI INFUS
257 SEPTI INFUS DC
258 TATI SUPARTI INFUS
259 TITA JUWITA INFUS
260 KIKI infus
261 SISKA INFUS
262 IMAS INFUS
263 MUHAMMAD FATAN ALJABAR
INFUS
264 SHAQILLA ALFHIRA INFUS

28/05/2016 265 SUTIRAH INFUS DC


266 YUTMIYEH INFUS
267 CUCUN INFUS
268 DEWI HANIFAH INFUS
269 MARHAMAH INFUS
270 YUTMIYEH INFUS
271 EVITA HANDRIANI INFUS
272 SITI SADIAH INFUS
273 MAJIMA INFUS

29/05/2016 173 NARTI INFUS


174 IMAS INFUS
175 ROHAYATI INFUS
176 LALAH INFUS
177 DEWI SARTIKA INFUS DC

30/05/2016 178 YANTI YULIANTI INFUS


179 ULFA INFUS
180 LILIS INFUS
181 DEVI ARIYANTHI INFUS
182 FIA AFIAH INFUS
183 ELITA.R INFUS
184 JUBAIDAH INFUS
185 DEVI OKTAVIYANI INFUS
186 ENENG NURFADILAH INFUS
187 DEWI NURAENI INFUS
188 RISMAWATI INFUS
189 SINTIA INFUS
190 NOVI INFUS

TOTAL 697
INFUS 188
DC 62

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN JUNI 2016
01/06/2016 1 LENI BUDIYARTI INFUS
2 SUNARTI INFUS DC
3 DEWI SARTIKA INFUS DC
4 TIKA INFUS
5 ANGGI INFUS
6 NUNI INFUS
6 2

02/06/2016 7 SINTA INFUS


8 RINATI INFUS
10 ELIS NENI INFUS DC
11 RINA OKTARINA INFUS
12 SANTI INFUS DC
13 SITI KURNIASIH INFUS
14 LASMANAH INFUS
15 NINA ROSDIANA INFUS
16 RATNA INFUS
17 NINA INFUS
10 2
03/06/2016 18 DEWI AYU INFUS DC
19 IRMA INFUS
20 FITRI INFUS SKINTES
21 SHALMA INFUS
22 LESA SARI INFUS SKINTES
23 CUCUN INFUS
24 NAHL QONITA INFUS
25 NAUFALIA INFUS
26 SITI NURAINI INFUS
27 M.TAUFIQUR INFUS
28 ENENG SUSANTI INFUS
30 NINA OKTAVIANI INFUS DC
31 IIS ARNI INFUS DC
13 3
04/06/2016 32 ENENG SUSANTI INFUS
33 NINA OKTAVIANI INFUS DC
34 CYNTHIA KRISTIANA INFUS DC
35 IRMA ROSMIATI INFUS
36 SRI MULYANI INFUS SUNTIK
37 ARDA INFUS

05/02/2016 38 IKA KARTIKA INFUS SUNTIK DC


39 EGA NURLELAH INFUS SUNTIK
40 MARIA YULIANA INFUS DC
41 AYI MARYAM INFUS SUNTIK DC
42 EMELIYAWATI INFUS SUNTIK

06/06/2016 41 SUMARNI INFUS SUNTIK


42 HENI INFUS
43 GINA RATNASARI INFUS
44 TIARA MARTIANA INFUS SUNTIK DC
45 DEWI MULYANTI INFUS
46 MARTINI INFUS DC
47 ALIYA INFUS DC
48 AI BENTANG INFUS SUNTIK DC
49 NINA INFUS SUNTIK
50 ALIT ANI INFUS
51 RYANTI INFUS
52 M GALANG SETIAWAN INFUS
53 MULYADI INFUS
54 ARSENIO INFUS

07/06/2016 55 SELI INFUS


56 YANTI KOMALA INFUS
57 ENENG NUR INFUS
58 UFIT FARIDA INFUS SUNTIK
59 LIAH INFUS
60 ENENG INFUS DC
61 DIAN INFUS DC
62 AKBAR INFUS
63 MUHAMAD ABIYAN INFUS

08/06/2016 64 CYNTIA DEVI INFUS SUNTIK


65 WULAN SARI INFUS
66 KOKOM KOMARIAH INFUS DC
67 ERNA INFUS
68 REZI OKVI INFUS
69 NIA KURNIASIH INFUS
70 WANDA NADIRA INFUS

09/06/2016 71 SELLA HAPSAH INFUS DC


72 IMAS HASANAH INFUS
73 AAS RINA INFUS
74 NUNUNG INFUS
75 HUSAIN INFUS
76 RIZQIA MAKAYLA INFUS

10/06/2016 77 DEWI NURAENI INFUS DC


78 KURNIASIH INFUS
79 SRI WAHYUNI INFUS SUNTIK
80 ANGGRAENI INFUS
81 NURAENI INFUS SUNTIK
82 DEASI SRI INFUS
83 RODIAH INFUS
84 SISKA INFUS SUNTIK
11/06/2016 85 DELISA NUR INFUS
86 SITI PATIMAH INFUS
87 DEA AMELIA INFUS

12/06/2016 88 NEYLA INFUS


89 M.SUGIH INFUS
90 M.ADRIAN INFUS
91 NURHASANAH INFUS
92 RIANA DIAN ANDARI INFUS
93 RISMA DELIMA INFUS
94 SUSILAWATI INFUS
95 EUIS INFUS
96 SURYATI INFUS
97 SELVIA INFUS
98 RIANE INFUS
99 HANNY YUNA KOMALA INFUS

13/06/2016 100 JESSELYN OGT


101 PUTRI FIRGIE INFUS
102 BY NY. RENI DWI INFUS
103 DINI ANDRIANI INFUS
104 NUR SITI NURJANAH INFUS
105 TUTI HANDAYANI INFUS
106 DINI YULIANI INFUS

14/06/2016 107 SITI MASITOH INFUS


108 IMAS ATIKAH INFUS
109 YENI ROSALINDA INFUS
110 VITTA PUSPITASARI INFUS DC
111 AISAH INFUS
112 KOZINAH INFUS
113 NENG YANTI INFUS
114 MUNIROH INFUS

15/06/2016 115 EUIS INFUS


116 NOVA INFUS
117 LIA INFUS
118 TITIN INFUS DC
119 ANGGI INFUS
120 HACIM INFUS
121 ANDINI INFUS
122 ENUR NURHAYATI INFUS
123 WARLIA INFUS
124 SARTINI INFUS DC
125 YULI INFUS

16/06/2016 126 PIA SOPIA INFUS DC


127 YENI INFUS
128 EMA MULYANI INFUS
129 AMI INFUS
130 DIAN INFUS

17/06/2016 131 ELI IRMAWATI INFUS


132 NIMAH INFUS
133 BISMI MAGFIRAH INFUS
134 FER YULI INFUS
135 YETI INFUS
136 IIN INFUS
137 NIDZAR IHYA INFUS

18/06/2016 138 DINA ANGGRAENI INFUS


139 JUWENDAH INFUS
140 ITA PUSPA INFUS
141 ITA PUSPA HAYATI INFUS
142 KARTINI INFUS

19/06/2016 143 WULAN SARI INFUS


144 ARI ROSITASARI INFUS

20/06/2016 145 IDA FARIDA INFUS DC


146 SARI ROSMAWATI INFUS
147 DINA ANGGRAENI INFUS
148 AQILLA INFUS

21/06/2016 149 RINI KARTINI INFUS DC


150 NENG DEWI INFUS
151 LINAWATI INFUS
152 WAWAT SUMIATI INFUS
153 NANI INFUS
154 SETIAWATI INFUS DC

22/06/2016 155 MEILANI WATI iNFUS


156 ANI iNFUS
157 NENDEN DAMYASTI INFUS
158 HERNA INFUS DC
159 ELISA INFUS
160 ARVI YANJANI INFUS
161 SITI NURAENI INFUS
162 SAPTA INFUS

23/06/2016 163 YETTI INFUS


164 ENENG ATIKA INFUS
165 YANTISULASTRI INFUS
166 CUCU INFUS
167 SRI DEVI INFUS
168 NENI KURNIASIH INFUS
169 EROS ROSIDAH INFUS
170 SITI JUBAEDAH INFUS
171 LALAS INFUS
172 MARYATI INFUS
173 ELIN WAHYUNI INFUS
174 ANNY INFUS
175 DEDE INFUS
176 IKA KARTIKA INFUS
177 DAYLAN INFUS
178 REFKI

24/06/2016 178 SRI MULYATI INFUS


179 DESY DESTIYANI INFUS
180 DITHA PARAMITHA INFUS DC
181 RISA YULIAWATI INFUS
182 DESTA FEBRIANI INFUS
183 SANTI SOMANTRI INFUS
184 SITI NURYULIANTI INFUS
185 MUTIARA INFUS
186 MOC RAFA INFUS
187 KATUMIRI INFUS

25/06/2016 188 FITRIANI INFUS


189 ERNA SETIAWATI INFUS
190 AMI SITI AMINAH INFUS
191 SUYANTI INFUS
192 ATIK KARTIKA INFUS DC
193 MIRA SITI SUMIRAH INFUS
194 ITA JUWITA INFUS
195 WULANSARI INFUS DC
196 ENENG NURLAENI INFUS
197 EDAH INFUS
198 ARISTA INFUS DC
199 RINDA YULIA DEWI INFUS
200 RELA DIAH NURANI INFUS
201 ERNA K INFUS
202 SRI YULIANTI INFUS DC
203 DESI NURHAYATI INFUS
204 NENG SITI INFUS DC

26/06/2016 205 ENTI INFUS


206 ASTI PIDIAWATI INFUS
207 IDA FARIDA INFUS
208 FITRIYANI INFUS DC
209 SITI FITRI TRIHANITA INFUS
210 SAIDAH INFUS
211 YAYAH INFUS
212 ALPIN INFUS

27/06/2016 213 RATMI INFUS


214 SRI MARYATI INFUS
215 PUTRI AYU INFUS
216 M.FIRGI INFUS
217 GYLBI INFUS

28/06/2016 218 RAHAYU INFUS


219 SETYO WAHYUNI iNFUS
220 IIS NURJANAH INFUS
221 EKA SURTIKA INFUS
222 EVI MARIA INFUS
223 ADE SUMINAR INFUS

29/06/2016 224 YULIMAH INFUS


225 FARIDA INFUS DC
226 SUSILAWATI INFUS
227 IDA WIJAYANTI INFUS
228 ELIS SUPRIATINI INFUS
229 ENI YUNA SELA INFUS
230 DEWI NURHAYATIN INFUS DC
231 LENI ALFIYANI INFUS
232 WULAN SARI INFUS
233 ALQIS INFUS
234 NAZTINA INFUS
235 FATIR INFUS

30/06/2016 236 ENDAH INFUS DC


237 AI SUKARSIH INFUS
238 MARTINI INFUS
239 ITA JUWITA INFUS DC
240 WINA M INFUS
241 ALI INFUS
242 M. ADIL INFUS

TOTAL 242 37
TOTAL IGD 568

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN JULI 2016
01/07/2016 1 REVA AMALIA INFUS DC
2 RATNA YUNINGSIH INFUS
3 MAS AIT INFUS
4 NENI RISTIANI INFUS
5 AMALIA INFUS
6 RAHAYU INFUS
7 ARSA DIANDRA INFUS
8 DETI INFUS
9 SINTA DEVI INFUS
02/07/2016 10 WINA INFUS
11 BINTANG AZZAHRA INFUS
12 RIKA RAHMAWATI INFUS
13 AI SRI NURYANI INFUS
14 SYAFITRIYANTI INFUS
15 ARNI SUHERDIANI INFUS
16 INDHIRA INFUS
17 TITIN INFUS
03/07/2016 18 TINA GUSTIAWATI INFUS
19 SRI SULISTIAWATI IINFUS DC
20 SITI MALIASYAROH INFUS
21 SITI KOMARIAH INFUS
22 AIDA FITRAH INFUS
23 LINDA NOVITA INFUS
24 RADITYA INFUS
25 HUSNA INFUS
04/07/2016 26 SELFIA INFUS
27 GUSPINA INFUS
28 LILIS NURJANAH INFUS
29 YANI WAHYUNI INFUS
30 PIPIT INFUS
31 DWI SUSILOWATI INFUS
32 AKBAR NGT
33 ELIS INFUS
05/07/2016 34 JUANINGSIH INFUS DC
35 SRI NUROHIMAH INFUS
36 RIA INFUS
37 AJENG INFUS
38 KOKOM INFUS DC
39 YANI INFUS DC
40 RESHA INFUS
06/07/2016 41 DEDEH DAHLIANA INFUS
42 NENG ROHAETI INFUS
43 RIKA ASTUTI INFUS
44 SANDRA FITRIANA INFUS DC
45 IYEN MINGGARIA INFUS
46 LENI ALFIYANI INFUS DC
47 HERLINA INFUS
07/07/2016 48 WARSITI INFUS DC
49 IIN RATNA DEWI INFUS DC
50 DEDAH INFUS
51 KURNIA INFUS
52 IKEN INFUS
53 NURHAYATI INFUS
54 ELIS INDAH INFUS
08/07/2016 55 RATNA WATI INFUS DC
56 DEDE INFUS DC
57 RENI MARYANI INFUS DC
58 RIANSRI PUTRI INFUS
59 WINDA INFUS
60 AI SUKARMI INFUS
61 IKA WAHYUNI INFUS
62 SUGIYANTI INFUS DC
63 NINDI DWI TRESNA SARI INFUS DC
64 M ZULKARNAIN INFUS OGT
65 RIKA INFUS
09/07/2016 66 RIKA INFUS
67 WIWIN INFUS
68 JUJU INFUS
69 PENTI NURHAYATI INFUS
70 RIKA MULYANI INFUS
71 SRI MEGAWATI INFUS
72 m zulkarnaen INFUS
73 M RASID INFUS
10/07/2016 74 DEWI YULIANTI INFUS
75 EVA ELIA INFUS
76 DEMI RAHMAWATI INFUS
77 SITI HASANAH INFUS
78 DEVITA INFUS
11/07/2016 79 KALIMAH INFUS
80 ROMAULI RUMAPEA INFUS
81 RINA MARLINA INFUS
82 YUNI INFUS
83 DETI SUSILAWATI INFUS
84 NENI INFUS
85 FITRI YANI INFUS
86 NENGRIPNI INFUS
87 NINA MARIA INFUS
88 ALYA DWI PUTRI INFUS
89 GHAIDA AULIA A INFUS
12/07/2016 90 NEULIS SULASTRI INFUS
91 JUMANAH INFUS
92 RUHLIANTI INFUS
93 MARYATI INFUS
94 IKA SETYORINI INFUS
95 TETI ARYATI INFUS
96 YUNIARTI INFUS
97 NELI MARLINA INFUS
98 PUTRI SULISTIANI INFUS
13/07/2016 99 TAMI DWI A INFUS
100 SARININGSIH INFUS
101 IRMA KURNIASIH INFUS
102 RAMADIAN INFUS
103 AI SUPRIATIN INFUS
104 INTEN H INFUS
105 MELA FERANI INFUS
106 DEFIRA INFUS
107 ROSMIATI INFUS
108 IMAS INFUS
14/07/2016 109 IDAH INFUS
110 MUSLIHAH INFUS
111 FITRIYANI INFUS
112 ANI INFUS
113 TRIYANA RAHMAWATI INFUS
114 FITRI LESTARI INFUS
115 PIPIT PATMAWATI INFUS
116 RESTI NURAENI INFUS
117 RINA HERLINA INFUS
118 ELSA LAELASASRI INFUS
119 NYIMAS SITI INFUS
120 RENI INFUS
121 KEYLA NNAFI INFUS
15/07/2016 122 NENDEN DETI INFUS
123 NENG SITI INFUS
124 LIS IDA KOMRA INFUS
125 PIPIT INFUS
126 M.TRIA MAULANA INFUS
16/07/2016 127 AI ROHAETI INFUS
128 TITIN INFUS
129 IYAN YANTI INFUS
130 ATIH HARYATI INFUS
131 NANI SUMIATI INFUS
17/07/2016 132 GIGIN INFUS
133 MILLAH INFUS
134 YANI INFUS
18/07/2016 135 C.CEFITRIANI INFUS
136 YULI ARLIANTI INFUS
137 RENI INFUS
138 NOVAVIATUN INFUS
139 DEWI NOVIA INFUS
140 FATIMAH INFUS
141 SRI KESUMA ASTUTI INFUS
142 ALFAT INFUS
19/07/2016 144 SATRI INFUS
145 JUHAERIAH INFUS
146 IMAS DARMAWATI INFUS
147 LILIS INFUS DC
148 DEWI SUPRIYANTI INFUS
149 ARIESCA MARSELINA INFUS DC
150 NENENG NURHAYATI INFUS
151 NAZARI INFUS
152 NARAYA INFUS
20/07/2016 153 PRILA AVIANTI INFUS
154 DEDEH DAHLIANA INFUS
155 SELVI ERPIANA INFUS
156 MARIA SAFITRI INFUS
157 ANNE INFUS
158 WIWIN WINARTI INFUS
159 PUTRI LESTARI INFUS
160 INA DASIMA INFUS` DC
161 MELDA HANDAYANA INFUS
162 IRMA SALAMAH INFUS
163 RINI ANISA INFUS
164 BERDIKARI JAYA PARDO INFUS
21/07/2016 165 SARININGSIH INFUS DC
166 RINA INFUS
167 SRI ENDAH INFUS
168 NENA INFUS
169 SASTARI INFUS
170 YUYUN INFUS
171 IMAS INFUS
172 NURLELA INFUS DC
173 KOKOM INFUS DC
174 WANTINI INFUS
175 AZKA INFUS
176 NADHIRA HASANAH MAULIDA
INFUS
177 NAZAR M ILHAM INFUS
22/07/2016 178 SANTI DUMARYANTI INFUS DC
179 DINA INFUS
180 RISA INFUS DC
181 MIA MULYATI INFUS DC
23/07/2016 182 DEWI ROSMIATI INFUS DC
183 FITRI ROSIDAH INFUS DC
184 ROSITA DEWI INFUS
185 KASMIATUN INFUS
186 NUNUN INFUS DC
187 TIKA INFUS
188 YANI INFUS DC
189 CICIN INFUS
190 TUTI RUSMIATI INFUS
24/07/2016 191 SITI HAJAR INFUS
192 LILIS INFUS
193 IIS INFUS
194 SITI KANARI INFUS DC
195 ITA JUWITA INFUS DC
196 NUNU NURAINI INFUS
197 NYIMAS SITI INFUS DC
198 CUCU INFUS
199 NURLELA INFUS
200 M.SYAFIQ INFUS
25/07/2016 201 SUHARNI INFUS
202 ANI MARYANI INFUS
203 IYAN YANTI INFUS
204 ALIF INFUS
205 QWENI INFUS
26/07/2016 206 NATAN INFUS
207 DIANA FEBRIANITA INFUS DC
208 DELLY INFUS DC
209 DIANA FEBRIANITA INFUS DC
210 CIAH INFUS DC
211 DEWI ANDRIANI INFUS
212 NENGSIH INFUS
27/07/2016 213 SILVIA INFUS
214 MIKAYLA ALUNA INFUS
215 HENI INFUS
216 LISBET SIANTURI INFUS
217 FIVIH INFUS
218 NURHAYATI INFUS
219 LUSILAWATI INFUS
220 SITI INFUS
221 RAFI INFUS
222 IRMA INFUS
28/07/2016 223 DIAH INFUS
224 DESI RATNASARI INFUS
225 ERNAWATI INFUS
226 RIKA ROSALINA INFUS DC
227 DATI KOMALA INFUS
228 NURAENI INFUS
229 SUMAETI INFUS
230 RAMADHANI INFUS
231 ABRAHAM INFUS
232 NETI INFUS
29/07/2016 234 AINI BAIDURI INFUS
236 ENUNG INFUS
238 NYIMAS SITI INFUS
240 SINTIA DAMAYANTI INFUS
242 DETYA INFUS
244 ANAH MURJANAH INFUS
246 ANGGI INFUS DC
248 REGINA INFUS
250 ELIYA AGUSTIN INFUS DC
252 ARNI HARTATI INFUS DC
30/07/2016 254 NUTI INFUS DC
256 TINI RAHMAWATI INFUS DC
258 SRI HARTATI INFUS
260 MAYA MARIAM.S INFUS
262 NURRIKA SEPTIANI INFUS
264 ENI PURNAMASARI INFUS
266 RIZQI NURSHOLIHAT INFUS
268 IRMA MELATI INFUS
270 TETI INFUS
272 HENI HERLINA INFUS
31/07/2016 274 SRI LARASATI INFUS
276 ROHMATUN INFUS
278 IIS INFUS
280 RIKA INFUS
282 TIKTIK INFUS
284 YULI INFUS
286 RIZKIA INFUS
288 AQILA INFUS
TOTAL 288 40 2
JUMLAH PASIEN IGD 598

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN AGUSTUS 2016
01/08/2016 1 HENIK INFUS
2 DASRI INFUS
3 SYIFA ATIKAH DIYANTI INFUS
4 CUCU KOMALASARI INFUS
5 EMA IKLIMA INFUS
6 LILIS INFUS
7 SENJA ANGGARA INFUS
8 ELSA RAHMA INFUS
9 LILIS INFUS
10 RAHMAWATI INFUS
02/08/2016 11 IMAS PATIMAH INFUS
12 YENI NUARAENI INFUS DC
13 MANIS BUDI INFUS
14 IIS AISAH INFUS DC
15 DELLY HERLIANY INFUS DC
03/08/2016 16 DEVI NOPIANTI INFUS
17 NELA AMELIA INFUS
18 NUR HANDAYANI INFUS
19 PUJI YANTI INFUS
20 FEBIYANI INFUS
21 IIN INFUS
22 SITI NURFADILA INFUS
23 YENI NUARAENI INFUS
04/07/2016 24 EEN SITI SAENAH INFUS DC
25 RINA INFUS
26 EHA INFUS
27 MELINA INFUS
28 UTAMI HEROINA INFUS
29 YANTI SUSANTI INFUS
30 SUPRIATI INFUS
31 NABILA INFUS
32 M RESKY INFUS
33 AZKA INFUS
34 ZAHRA INFUS
35 ROHAYATI INFUS
05/07/2016 36 HENI LISNA INFUS
37 ROSNA SONDARI INFUS
38 IRA PRIMASARI INFUS
39 TATI SRIMULYATI INFUS
40 VIVI INFUS
41 CUCU INFUS
42 LIA DAHLIA INFUS
43 SITI NUR AISYAH INFUS
44 RUHLIANTI INFUS
06/08/2016 45 SITI MAEMUNAH INFUS
46 EVA NURLITA INFUS
47 SITI NURLAELA INFUS
48 ASTI MULYATI INFUS
49 ERNA INFUS
07/08/2016 50 RANI RAHMAYANTI INFUS
51 SONTAULI INFUS
52 DEVI AQILA INFUS
53 GURRY SAFIN INFUS
54 DEWI INFUS
55 CUCU KOMALASARI INFUS
56 SANTI SARI DEVI INFUS
57 HOTMAIDA INFUS
58 MELINA INFUS
59 HENI INFUS
08/08/2016 60 YUNI INFUS
61 LILIS SUMINAR INFUS
62 EEN KOMARIAH INFUS
63 IMARYATI INFUS
64 ANI HARYANI INFUS
65 MAMAH INFUS DC
66 AI GUSTINI INFUS
67 NENDEN INFUS DC
68 HAFIS INFUS
69 REYHAN INFUS
70 JEFRI INFUS
71 TITIN SUHARTINI INFUS DC
09/08/2016 72 DEDE AAS INFUS DC
73 DEA NITA INFUS
74 LINGGAWATI INFUS
75 MIA MARLIANTI INFUS DC
76 IKA INFUS
77 NENG SAWIYAH INFUS
78 AGNES INFUS
79 SUSI LANARYATI INFUS
80 FAHIRA INFUS
81 HANIFAH INFUS
82 HUSNUL KHOTIMAH INFUS
83 WURYANI INFUS DC
84 SAHRILA INFUS
85 NOPI PUSPITA INFUS
10/08/2016 86 NITA GUSTIANY INFUS
87 YANTI INFUS
88 IIS MUNAYA INFUS DC
89 DEDE KURAESIN INFUS DC
90 FATHAN INFUS
91 VENA INFUS
11/08/2016 92 RANI RAY FEBRIANI INFUS
93 INE INFUS
94 DEDEH KURNIASIH INFUS DC
95 ANA YULIANA INFUS DC
96 HENI INFUS DC
12/08/2016 97 NIA KURNIATI INFUS
98 IYAM SITI MARYAM INFUS DC
99 RINI MULYANTI INFUS
100 JULIAH INFUS
101 NONENG SARINAH INFUS
102 NURUL KHADIJAH INFUS
103 TATI ROSITA INFUS
13/08/2016 104 DEDE INFUS
105 MARISHA KHASIWI INFUS
106 DEASY INDAH INFUS
107 SRI WENDAH INFUS
108 NIA ROSMIA INFUS
109 DARI SITI KODARIAH INFUS
110 SARINAH INFUS
111 NENG SAWIYAH INFUS DC
14/08/2016 112 NURUL HANIFAH INFUS
113 MELI INFUS DC
114 REISYA INFUS
115 KHANSA SALSABILA INFUS
116 LELA MAHARANI INFUS DC
117 EGA SADIDAH INFUS DC
15/08/2016 118 RANI FATHONAH INFUS
119 DESY INFUS
120 M RIZKY PRILIYANA INFUS
121 VIVI savitry INFUS
122 YULIDAR INFUS
123 DINI INFUS
16/08/2016 124 TENI ROHAYATI INFUS
125 PIAR PELITA INFUS
126 SANTI FATIMAH INFUS
17/08/2016 127 MELIA INFUS
128 RIDHA AULIA INFUS
129 ARYO infus
130 M.ABDUL FATHIR INFUS
131 HENI INFUS
132 DEASY HERYANTI INFUS
133 ENENG MILSAMA INFUS
18/08/2016 134 YANI INFUS
135 FITRIA KHOERUNISA INFUS DC
136 TIA IRAWANA INFUS DC
137 SUSANTI INFUS
138 EKA INFUS
139 VITRIYANI INFUS
140 TITIN HARTINI INFUS
141 DAFFA NUR ALAMSYAH INFUS
142 M GAZZA GUNAWAN INFUS
143 INTAN MUTIARA INFUS
144 ADE RITA INFUS
19/08/2016 145 SRI HAYANI INFUS
146 SITI HASANAH INFUS
147 IDA DAENAH INFUS
148 SALSABILA INFUS
149 M ADIT INFUS
150 DINI INFUS
151 LIANAWATI INFUS
152 SITI ROHANAH INFUS DC
153 LINDA INFUS
154 YUNI PRIHARTININGSIH INFUS DC
20/08/2016 155 RANI RAHMAYANTI INFUS
156 SITI HAJAR INFUS
157 NOVENTRI INFUS
158 IRMA INFUS
159 SYIFA INFUS
160 NELIS RODIAH INFUS
161 RIKA KARTIKA INFUS
21/08/2016 162 JUWITA DEELI INFUS DC
163 EMA SURYANI INFUS
164 ENDAH SANTIKA INFUS
165 MUTIARA INFUS DC
166 SANTIKA INFUS
167 M PUTRA INFUS
168 ANGGI INFUS
169 DINA INFUS
22/08/2016 170 DEPI FARIDA INFUS
171 YUNI INFUS
172 RIKA KRISTINA INFUS
173 DEVI ROSTIAWATI INFUS
174 ROHMANIA INFUS
175 ASNI FAJRIANI INFUS
176 IMAS INFUS
177 ENENG TANTRI INFUS
178 M RIFAL INFUS
179 AINI INFUS
23/08/2016 180 DIMA SOPHI INFUS
181 ERMA TASYA RENI INFUS
182 MIRNAWATI INFUS DC
183 MANISEM INFUS
184 SANTI DUMARYANTI INFUS
185 SITI FATIMAH INFUS
186 TENI JULIA SOMADI INFUS DC
187 LIA NURLIANA INFUS DC
188 SILVI INFUS
189 YUNI PRIHARTININGSIH INFUS
190 INGEU YULIANTI INFUS DC
24/08/2016 191 LAELA SARI INFUS
192 KUSHARTINI INFUS
193 SALSIAH INFUS
24/08/2016 194 NUR KOMARIAH INFUS
195 DESI RAHMAWATI INFUS
196 SHEVA INFUS
197 HARSA INFUS
198 ZAVANYA INFUS
199 IDA HADAWIYAH INFUS
200 AGNES OKTAVERA INFUS
201 SURYANI INFUS
202 SITI HAJAR INFUS
203 DEWI NURANI INFUS
204 YULIANTI INFUS
25/08/2016 205 MINA INFUS
206 GENDIS INFUS
207 LISNAWATI INFUS
208 CUCU NURELAH INFUS
209 SANTIKA INFUS
210 RINA JUANA INFUS
211 LILIS INFUS
212 HASTINI INFUS DC
26/08/2016 213 CUCU NURELAH INFUS
214 MIA YULIA INFUS
215 NIA KURNIATIN INFUS DC
216 HERMIN INFUS
217 MIRA MARYANI INFUS
218 HERNIZA INFUS
219 SITI SOLIHAH INFUS DC
220 CUCU INFUS DC
221 ENENG DINA KOMALA INFUS
222 NENDEN INFUS
223 SANTI PUJIANTI INFUS
27/08/2016 224 NITA INFUS
225 HENI ROHAENI INFUS DC
226 RADIYA INFUS
227 RANVI INFUS
228 ADITYA INFUS
229 TRIANI INFUS
230 RINA MARLINA INFUS
231 HENI ROHMAYANTI INFUS
232 YUSTI DANIATI INFUS
233 FITRIA NINGSIH INFUS DC
234 SITI AZIZAH INFUS
28/08/2016 235 JUMINAH INFUS DC
236 NITA YULIANTI INFUS
237 PARTINI INFUS
238 NABILA INFUS
28/08/2016 239 AI KURAESIN INFUS
240 SRI RAHAYU INFUS
241 ITA PERMANASARI INFUS
242 RANI RAHMAYANTI INFUS
29/08/2016 243 PANTI INFUS
244 SANA INFUS
245 MIRNAWATI INFUS
246 SITI RUQIATUL INFUS
247 SAELINA WATI INFUS
248 ELDA JULIAH INFUS
249 M ADILA INFUS
250 MITA KARUNIA INFUS
251 RINA FEBRIANI INFUS
30/08/2016 252 NENG RIA AMPIANI INFUS
253 CARI AYU INFUS
254 TINA INFUS
255 ROSITA INFUS
256 AAS INFUS
257 RATNA SARI INFUS
258 YANI MULYANI INFUS
31/08/2016 259 EUIS NURHALIMAH INFUS
260 RIZQI DWI INFUS
261 IDA FARIDA INFUS DC
TOTAL 261 36
JUMLAH PASIEN IGD 702

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN SEPTEMBER 2016

01/09/2016 1 RIMA RAHMAWATI INFUS


2 AYU YULIAN INFUS DC
3 LIA WIDIANI INFUS
4 SUSI INFUS
5 DEWIRATIH INFUS
6 YESI INFUS DC
7 ERNI INFUS DC
8 WINDINING SARI INFUS
9 RANI RAHMAYANTI INFUS DC
02/09/2016 10 RIKA MAYANTI INFUS
11 IRAWATI INFUS DC
12 ALBERTA NOVIA INFUS DC
13 FITA INFUS
14 NENENG INFUS
03/09/2016 15 DALI INFUS
16 NAULI INDAH INFUS
17 SITI MAEMUNAH INFUS
18 LELI NURLAELI INFUS
19 JUMILAH INFUS
20 LENI KUSMIATI INFUS
21 SITI NOVIAH INFUS
22 DESI SRI RAHAYU INFUS
23 PITRI SRININGSIH INFUS
04/09/2016 24 LIA RATNASARI INFUS
25 NENDAH INFUS DC
26 BARA INFUS
27 DEDEH INFUS
28 WINNY INFUS
29 JUMRIYAH INFUS
05/09/2016 30 NURLELA INFUS
31 AI SARINI INFUS
32 ERNAH INFUS
33 LINA SANTOSA INFUS
34 IIS SUMIRAH INFUS
35 ANI INFUS
36 KAMILA INFUS
37 HERMIN INFUS
06/09/2016 38 DINA NURJANAH INFUS
39 AYU INFUS
40 RANI RHOHAENI INFUS
41 KAMILA INFUS
42 DEDEH MAESAROH INFUS
43 WIWIN WINARTI INFUS
44 RITA SUSANTI INFUS
45 TRI MULYATI INFUS
46 FEBRIANTY INFUS
47 ANIRA DANIA INFUS
48 CUCU NURLELA INFUS
49 DEDE INFUS
07/09/2016 50 OCTAVIANTI INFUS DC
51 RIANI PADLI INFUS DC
52 NIA KURNIATI INFUS
53 IMAS INFUS
54 NABIL INFUS
55 NAZWAN INFUS
08/09/2016 56 SITI AISYAH INFUS
57 ROMAENI INFUS
58 ALMEINAS INFUS
59 NENOH INFUS
60 LALA INFUS
61 SYANTY INFUS DC
62 KIKI KARTIKA INFUS
63 RANI INFUS
64 NURSADIAH INFUS
09/09/2016 65 AAS AISYAH INFUS
66 AI SITI RUGAYAH INFUS
67 IMAS SUKIMAH INFUS
68 YUYUN YUNENGSIH INFUS
69 SITI ARIFATULAH INFUS
70 DEWI MULYANI INFUS
71 SRI WENDAH INFUS
72 AI WINARI INFUS
73 M ALDEBRAN INFUS
74 WINNY INFUS
10/09/2016 75 LISNA INFUS
76 SITI ZUAERIAH INFUS
77 DARWATI INFUS
78 ING DEA INFUS
79 LENI KARTIKA INFUS DC
80 CAHYANI INFUS
81 SALWA AZKIA INFUS
82 SINTA SEPTIANI INFUS DC
83 YANTI MARIA INFUS
11/09/2016 84 YULIANA INFUS
85 SITI AISYAH INFUS DC
86 RISNAWATI INFUS
87 RITA SETIA NINGSIH INFUS
88 FAUZIAH INFUS
89 TITING INFUS
12/09/2016 90 YULIA INFUS
91 RANI INFUS
92 RAHMA INFUS OGT
93 ITA INFUS DC
94 CUCU NURYANI INFUS
13/09/2016 95 ELFA INFUS
96 ALIN SRI INFUS
97 ALFA DESIH WIDARSIH INFUS
98 RITA LESTARI INFUS
99 NIA INFUS DC
14/09/2016 100 IMAS RAHMAWATI INFUS
101 NENDEN INFUS
102 SILVI INFUS
103 EVA AGUSTINA INFUS
104 SYANTY SRI DINAWATI INFUS
105 EUIS SETIAWATI INFUS
15/09/2016 106 NUR KOMARIAH INFUS
107 SHANTY INFUS
108 EVA RATNA DEWI INFUS
109 RATNA DEWI YUNITA INFUS
110 HANI YULIANI INFUS
111 INEU KURNIA INFUS
112 RINI LESTARI INFUS
113 ELLY INFUS
114 DIAN SELA OCTAVIA INFUS DC
115 YANTI MARIA INFUS
116 ZIDAN INFUS
117 AYU INFUS
16/09/2016 118 IPPITA INFUS
119 NETI INFUS
120 AWANG INFUS
121 NITA RISKA INFUS
122 LUSI LESTARI INFUS
123 LELA NURLELA INFUS
124 SRI H INFUS
125 IKEU INFUS DC
126 FADLI INFUS
127 AKBAR NGT
128 DEWI INFUS
17/09/2016 129 YESI INFUS DC
130 ANI HANDAYANI INFUS
131 MAYA MAESAROH INFUS
132 SENI RESNA INFUS
133 ALIKA INFUS
134 MAMAH INFUS
18/09/2016 135 RINI INFUS
136 JUBAEDAH INFUS
137 SYIFA WILDAYANI INFUS
138 RATNA SUMINAR INFUS
139 HANY KUSNIATY INFUS
140 NURHAYATI INFUS
141 NENDEN INFUS DC
142 SITI SOLIHAT INFUS
143 IDA ROSIDA INFUS
144 ADNAN INFUS
145 NURYANI INFUS
19/09/2016 146 WINARTI INFUS DC
147 IRNI INFUS
148 ENENG HARTATI INFUS
149 FITRIYANTI INFUS
150 SILVIA AMELIA INFUS
151 MARNI SUMARNI INFUS DC
152 ANNISA NOVIANTY INFUS
153 M GIBRAN INFUS
154 SARI WARISMAN INFUS DC
20/09/2016 155 SITI NURLAELA INFUS DC
156 CANDRA DEWI INFUS
157 ANI SOLIHAT INFUS
158 NENG NURLELA INFUS
159 EEN NURHAYATI INFUS
160 INTAN SRI RAHAYU INFUS
161 ARYA INFUS
162 HAERONI INFUS
21/09/2016 163 ROMLAH INFUS
164 ALIS SUMIATI INFUS
165 IKA PURWATI INFUS
166 TRISTANTI INFUS
167 EVI SETIAWATI INFUS
168 SITI NURLELA INFUS DC
169 MAYA MARIAM INFUS
170 SRI MULYANI INFUS
171 AHMAD INFUS
172 ALESYA INFUS
173 HAIKAL INFUS
174 NURMALA INFUS
22/09/2016 175 NURHAYATI INFUS
176 SITI RODIAH INFUS DC
177 KUKUH INFUS
178 NURANI YURI RAHAYU INFUS DC
179 YANI INFUS DC
180 SANTI INFUS
181 M FAHMI INFUS
182 CEP AHMAD INFUS
183 NENENG SUMIATI INFUS DC
23/09/2016 184 NURMALINDA INFUS
185 IDAH NURAIDAH INFUS
187 WITA INFUS
188 RENI INFUS
189 SINTA SINTIAWATI INFUS
190 SURYANI INFUS
191 RANI INFUS
192 SINTA LAELA INFUS
193 IMAS HOTIJAH INFUS
194 ARYANI INFUS
195 ELSA INFUS
24/09/2016 196 FANI AGUSTIN INFUS
197 SITI NUR AISAH INFUS
198 SISKA NOPIANTY INFUS
199 ROHANI SINAGA INFUS
200 LIA ROSDIANA INFUS
201 RISKA INFUS
25/09/2016 202 LILIS MELISA INFUS
203 YULIANI INFUS
204 RENI W INFUS
205 YENI KOMARIAH INFUS
206 YULI YANTI INFUS DC
207 TITIN NURMALASARI INFUS DC
208 RINI ASTRIANI INFUS
209 INEU FEBRIANTI INFUS DC
210 ALINDA HARTINI INFUS
211 ELINA INFUS
26/09/2016 212 RENI ROSMAYANTI INFUS
213 NIA KURNIATIN INFUS
214 NANAN ROSLIANA INFUS
215 ERNI PUSPITA INFUS
216 WURYANI INFUS
217 RAFA INFUS
218 ELFINA INFUS
219 CUCU INFUS
220 EUIS JUARIAH INFUS
221 SITYFATIHATUL INFUS
27/09/2016 222 NETI RUSMIATI INFUS
223 YOYOYH RUKMINI INFUS
224 TETI ROHAETI INFUS
225 MARYAMAH INFUS
226 ENDAH DAHLIA INFUS
227 RIHMAWATI INFUS
228 RISTINA METIKAWATI INFUS
229 ROSMAWATI INFUS
230 DEWI PURNAMASARI INFUS
28/09/2016 231 RIKA INFUS
232 FINEU SABARIAH INFUS
233 ELIS INFUS
234 ROFI INFUS
235 DESY INFUS
236 YESI INFUS
237 ALGI INFUS
238 HABIBI INFUS
239 YATI INFUS
240 RIKA TANIA INFUS
29/09/2016 241 IIS NURAISYAH INFUS
242 ENI ROHAENI INFUS
243 NURCAHYA INFUS
244 SRI MULYANI INFUS DC
245 NIA KURNIAWATI INFUS
246 YULI YULIAH INFUS
247 SITI ANISA HASANAH INFUS
248 BETI MBISIKMBO INFUS DC
249 NANAN ROSLIANA INFUS
250 RAFI AL GHANI INFUS
251 SELPI ANDRIANA INFUS
30/09/2016 252 LESA MARYATI INFUS
253 PURI PURWANTI INFUS
254 SHENI RESTIANI INFUS DC
255 SUMARNI INFUS
256 DEDE ROHAYATI INFUS
257 ANISA SELVYANA INFUS
258 YANTI PUSPITA INFUS
259 IIS MARYATI INFUS
260 IMAS SARINAH INFUS DC
261 LINDAWATI INFUS
262 MARNI INFUS DC
263 INSANI INFUS
264 RADIKA INFUS
TOTAL 264 35 2
JUMLAH PASIEN IGD 602

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN SEPTEMBER 2016
01/10/2016 1 IDA RIAMA INFUS
2 SITI ROHMAH INFUS
3 NURSIMA INFUS
4 SUMIYATI INFUS
5 ELIS NURJANAH INFUS
6 SURYANI INFUS
7 AYI ROSIFAH INFUS
8 SUMARNI INFUS
9 PUTRA INFUS
10 M MAULANA INFUS
11 RINA INFUS
12 M.SANTI INFUS
02/10/2016 13 ROS HAMIDAH INFUS DC
14 KURNIAWATI INFUS
15 TIA AMELIA INFUS
16 YUNINGSIH INFUS DC
17 INE SITI AISAH INFUS
18 SELLY MEGA INFUS
19 DWI ANGREANI INFUS
20 SYAFIRA INFUS
21 ELMANIA NURAZIZAH INFUS
03/10/2016 22 TITIN SRI WAHYUNI INFUS DC
23 M SANTI INFUS DC
24 SARAH EKA SOPIANA INFUS
25 NENG RANTI RISMAYA INFUS
26 MUAHAMAD AZIZ INFUS
27 FITRI SRI LESTARI INFUS
04/10/2016 28 YULI INFUS DC
29 DEA FITRIYANI INFUS DC
30 DEDEH INFUS
31 SITI FARIDAH INFUS
32 NINING INFUS DC
33 DEWI KARTINI INFUS
34 SUCI RAHAYU INFUS DC
35 EKA AGUSTINA INFUS
36 LIA HASANAH INFUS
37 DINA INFUS DC
38 MEISYARA INFUS
39 NIA KANIATI INFUS
05/10/2016 40 EKA YULIANA INFUS
41 DEWI HALMAH INFUS
42 MAESA RAEHANAH INFUS
43 NADIA ERLIANA INFUS
44 AI SUMARNI INFUS
45 YANTI YULIANTI INFUS
46 KOKOM INFUS
47 AMELIA INFUS
48 HERAWATI INFUS
06/10/2016 49 ATI KUSMIATI INFUS
50 RINI KARTINI INFUS
51 SARI APRIANTI INFUS
52 HENI CAHYANI INFUS
53 ANI HANDAYANI INFUS
54 RITA JUWITA INFUS
55 YULIA YULIANA INFUS
56 SUMARTI INFUS
57 RIKA SARTIKA INFUS
58 HENI MULYANI INFUS DC
59 MERLIN INFUS
60 IIN WIDYA INFUS DC
61 REZA ALFIANDRI INFUS
62 MIFTAH INFUS
63 QIRANI INFUS
07/10/2016 64 SUSI SUSANTI INFUS
65 AAS RODIAH INFUS
66 YULI SUSILAWATI DC
67 NIA NURIANTI INFUS
68 INEU INFUS DC
69 OCKE INFUS
70 DIRGA INFUS
71 NYI YAYAH INFUS
72 ENTIN INFUS
08/10/2016 73 YULIA INFUS
74 WULANDARI INFUS
75 RINI INFUS DC
76 MARYANI INFUS
77 RIA INFUS
09/10/2016 78 OKTI INDRIYANTI INFUS
79 TRI AMBARWATI INFUS
80 RIZKA NOUR INFUS
81 SITI NURAIDA FITRI INFUS
82 NURLELA INFUS
83 SUSANTI PUJI ASTUTI INFUS
84 SITI ANISA H INFUS
85 RINA YULIANTI INFUS
86 DEWI ASIH INFUS
10/10/2016 87 ESIH SUKAESIH INFUS DC
88 ELIN INFUS DC
89 RISA SENTIA INFUS
90 DESMAWATI INFUS
91 SANTIKA INFUS
92 LINA AMELINA INFUS
93 SITI JULAEHA INFUS
94 IDA ZUBAEDAH INFUS
11/10/2016 95 NANI SURYANI INFUS DC
96 INE SITI AISAH INFUS
97 YETI RHAETI INFUS
98 ENDANG DEWI INFUS
12/10/2016 99 MAYA TRISNAWATI INFUS
100 PUJI RAHAYU INFUS
13/10/2016 101 MARYATI ISMALIYA INFUS
102 SUNDARI INFUS
103 DHEANA APRILIA INFUS
104 IIN FATIMAH INFUS
105 KENNY DESRIYANTI INFUS
106 SITI N INFUS
107 AISYAH INFUS
108 EUIS RISMAWATI INFUS
109 ELIN CASRIAH INFUS
110 DINA YULIANIE INFUS
111 KARIM KHATAMI INFUS
112 FINA NURFATIMAH INFUS
113 DESNIAR INFUS
114 ESIN INFUS
14/10/2016 115 SURYANI INFUS DC
116 YENI SUHAEMI INFUS
117 TATI RAHMAWATI INFUS
118 INFUS
119 MUTHIA INFUS DC
120 KIAH INFUS
121 IKEU INFUS
122 DEVINA INFUS
123 WANTI NURBAWANTI INFUS
124 LENI FEBIANTI INFUS DC
125 SRI DINARWATI INFUS DC
126 ADHITA INFUS DC
15/10/2016 127 WIDYA INFUS DC
128 M ARDIAN INFUS
129 FAIZA INFUS
130 ANISA INFUS
131 MELI RAHMAWATI INFUS
132 NUNI JULIANTI INFUS
133 WINA INFUS
134 NANA NURJANA INFUS DC
135 INDRI INFUS
136 RIKA SOLIHAH INFUS
137 NENAH INFUS
138 SANNI NURLINA INFUS
16/10/2016 140 ANIS RIZKI INFUS
141 IMAS INFUS DC
142 PIPIH ARYANTI INFUS
143 NUNUNG INFUS
144 IIS RISMA INFUS
17/10/2016 145 LIA YULIA INFUS
146 SANI INSRIANI INFUS
147 ANA MARYANA INFUS
148 EVA INFUS DC
149 DESI INFUS
150 SRI HERMINAH INFUS
18/10/2016 151 SIFA INFUS
152 SANTIKA INFUS
153 NENG YETI INFUS
154 IDAH ROSIDAH INFUS DC
155 SITI MASITOH INFUS
156 DETI INFUS
157 TIA ASTRIANI INFUS
158 EFA NOVITA INFUS DC
159 HIKMAH INFUS
19/10/2016 160 IMMA NURUL AENI INFUS DC
161 EVI MUSLIMAH INFUS
162 EWIH INFUS
163 YULI YULIANTI INFUS
164 DERIAN INFUS
165 ALDRIK INFUS
166 BENZEMA INFUS
167 RISTINA METIKAWATI INFUS
168 SITI JULAEHA INFUS
169 LINA MARLINA INFUS
170 IMAS MASITOH INFUS
171 YENI INFUS
172 AAN INFUS
173 TETI INFUS
20/10/2016 174 SITI HERDIANTI INFUS
175 HENI MELANI INFUS
176 NADYAN INFUS
177 KOMALASARI INFUS
178 TITIK BUDIYANTI INFUS
179 ANDRIANI ULFAH INFUS
21/10/2016 181 DEWANTI INFUS DC
183 DEWI STIAWATI INFUS DC
185 SANDRA INFUS
187 SANTI INFUS
189 SARI NURLITA INFUS
191 NENENG SITI JUARIAH INFUS
193 SITI SOLIHAT INFUS
195 SISKA INFUS
22/10/2016 197 SSANTI INFUS
199 AI WARDAH INFUS DIOK
201 SEKARTINI INFUS
203 SITI WANDA INFUS
205 HENI ANGRAENI INFUS
207 WIWIN SUPRIATIN INFUS
209 NURUL FATTONAH INFUS
211 ELLY DILLIANTI INFUS
23/10/2016 213 DEBORA INFUS DC
215 RESI OKTAP INFUS
217 ETI SURYATI INFUS
219 LILIS KURAESIN INFUS DC
221 RANI FITRIANI INFUS
223 RANI NURAENI INFUS
225 ANISA JENSAPTIANI INFUS
24/10/2016 227 KHOMSIAH INFUS
229 WIDANINGSIH INFUS
231 ETIK PURWANINGSIH INFUS
233 NENI SURYANI INFUS
235 FITRIANI INFUS
237 VICKY NOVIANI INFUS
239 CAMELA INFUS
25/10/2016 241 RENI INFUS
243 INA MARLINA INFUS
245 LAELA FAUZIAH INFUS
247 MULIANIS INFUS
249 HARYANI INFUS
251 CINDY PUJIANTI INFUS
253 PUTRI SETIAWATI INFUS
255 GIA APRIANI INFUS
257 NENENG SITI JUARIAH INFUS DC
259 RAHMATILLAH INFUS
261 METI HERAWATI INFUS
263 SITI SRI MULYANI INFUS
26/10/2016 265 SUMIATI INFUS
267 ENENG NURJANAH INFUS
269 MULYATI INFUS
271 EVA NOVIANTI INFUS
273 YENI ARYANTI INFUS
275 SENDI INFUS
27/10/2016 277 ARYANI INFUS
279 ALIF ARYA INFUS
281 M SABILUL FAWAZI INFUS
283 ESIN INFUS DC
285 CICAH INFUS
28/10/2016 287 PUTRI LESTARI INFUS
289 NINDA RERITA INFUS DC
291 RINA INFUS
293 WAWAT INFUS
295 TATI INFUS DC
297 ENI INFUS DC
299 SRI MULYATI INFUS
301 FAIZAL INFUS
303 M ALTIC INFUS
305 ZAFIRA INFUS
29/10/2016 307 YAYU NADYA INFUS DC
309 ROSMAWATI INFUS
311 ADE IRMA INFUS DC
313 MIRA NOVIANI INFUS
315 DEA MELIANI INFUS
317 ANI ROHAENI INFUS DC
319 ELVANY ANANDARI INFUS
321 SUSANTI INFUS
323 CITAWATI INFUS
30/10/2016 329 ARMILA INFUS
335 SARYATI INFUS
341 NENG KURNIATI INFUS
347 LASTRI LESTARI INFUS
353 SILTIANTI INFUS
359 YANTI INFUS
365 NENG HANISAH INFUS
371 YULIANTI INFUS
377 ENENG LIA SITI ROBIAH INFUS DC
383 SANTI DAMAYANTI INFUS DC
389 SINTA MARIYAH INFUS
395 SITI NUR KHOLIFAH INFUS
31/10/2016 401 KOKOY ROSLIAH INFUS
407 TAUFIK KURNIADI INFUS
413 JASMIN AURORA PUTRI INFUS
419 YESICA AMELIA INFUS
425 M.TAUFIQURROHMAN INFUS
431 PAPAT INFUS
437 SITI RODIAH INFUS DC
443 MELI NURHASANAH INFUS DC
TOTAL 443 45
JUMLAH PASIEN IGD 603

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN NOVEMBER 2016
01/11/2016 1 RIMA INFUS
2 DWI ANGGRAENI INFUS
3 TUTI INFUS
4 LILIS TRISNAWATI INFUS
5 USWATUN HASANAH INFUS
6 DESI PERMATASARI INFUS
7 TUTI INFUS
8 NURLINA INFUS
9 CIKA INFUS
10 DEDEH INFUS
02/11/2016 11 LIA YULIANTI INFUS
12 EULIS JUNAELIS INFUS
13 CUCUN INFUS
14 RAHMANIA INFUS
15 HIFDIL INFUS
16 NADIA SIPA MUTIARA INFUS DC
03/11/2016 17 AMINAH INFUS
18 SARIPAH INFUS
19 RINA SUMIATI INFUS
20 DEWI KORI HARIANTI INFUS
21 NAISHA INFUS
22 ADFA INFUS
23 RAISA INFUS
24 NURAENI INFUS
04/11/2016 25 NINA ROCHMANIA INFUS
26 FITRIA AFRIALIANI INFUS
27 SANTI SULASTRI INFUS
28 SRI SURYANI INFUS
29 TINA NOPIANA INFUS
30 ANISSA PUTRI INFUS
31 TENI EDYANTI INFUS
32 SARIPAH INFUS
33 NAUFAL INFUS
34 DEWI NURMALASARI INFUS
35 RISMA INFUS
36 SANI INFUS
37 SITI RUKMINI INFUS
38 ENENG NURAENI INFUS
39 IMAS SUKAENAH INFUS
40 HANI INFUS
05/11/2016 41 TITIN INFUS DC
42 WARNITI INFUS DC
43 TINI ROSTINI INFUS
06/11/2016 44 YULIANTI INFUS
45 ENENG INFUS
46 NITA NURYANTI INFUS
47 SANI INFUS
48 YANI SUPARTIKA INFUS DC
07/11/2016 49 TITA SUMIATI INFUS DC
50 DIAS INFUS
51 WIDYAWATI INFUS
52 SITI NURHALIMAH INFUS
53 ENENG WINDI INFUS
54 JULAEHA INFUS
08/11/2016 55 TETI SUNARTI INFUS
56 TINA MUSTINAWATI INFUS
57 IMAS ROHMAYANTI INFUS
58 INDAH B INFUS
59 SITI RODIAH INFUS
60 RISNA ANDRIANI INFUS
61 CHERYL LATISHA INFUS
62 YUSBAR INFUS
63 ILHAM INFUS
64 ALISHA INFUS
65 LINA DASIH INFUS
66 LIA INFUS
09/11/2016 67 SINTA SARI INFUS
68 MIRA MELIASARI INFUS
69 RIKA PERMATASARI INFUS
70 SRIYANTI INFUS
71 YULIANTI INFUS
72 SRIYANTI INFUS
73 TINI GUSTINI INFUS
74 AI SUPRIATIN INFUS DC
75 RANI SEPTIANI INFUS
10/11/2016 76 NENG SUSI INFUS
77 MARINI HERMAWATI INFUS
78 MARWA AZAHRA INFUS
79 TITIN SUSANTI INFUS
80 ARYANI INFUS DC
81 TUNIAH INFUS DC
82 CURYA CAHYATI INFUS
83 SUSILAWATI INFUS
84 MERY RAHAYU INFUS
11/11/2016 85 DEWI LESTARI INFUS
86 LENI SUCIANA INFUS
87 NITA QONITATIN INFUS
88 ELI YULANDARI INFUS
89 SOLIHATI INFUS
90 YENI YEYEN INFUS
12/11/2016 91 SRI RAHAYU INFUS
92 PUTRA ANDARESTA INFUS
93 LINDA INFUS
94 ROSIDA INFUS
95 SISKA RUDIACAHYA INFUS
96 IRMA NURCAHYANA INFUS
97 ANA RATIH INFUS
98 AULIA GUSTINA INFUS
99 NINA ROCHMANIA INFUS
100 NEULIS INFUS
101 LENSI FUJI INFUS
13/11/2016 102 NINA ROCHMANIA INFUS
103 KUSMIATI INFUS
104 SRI HERMINAH INFUS
105 TATI IRAWATI INFUS DC
106 SULIMAH INFUS
107 ERNI ROHAENI INFUS DC
108 DINA INFUS
109 NONENG INFUS DC
14/11/2016 110 KOKOM KOMARIAH INFUS DC
111 SITI MARYAM INFUS
112 INNI INFUS
113 MASITOH INFUS
114 FITRIAH NURSAIDAH INFUS
115 TIKA RAHMAWATI INFUS
116 RINI MARYANI INFUS
117 MILA KURNIA INFUS
118 DESI NURHAYATI INFUS
119 EKA KARTIKA INFUS
120 ISMA RIYANTI INFUS
121 NENI M INFUS
122 PEPY WIDYANTI INFUS
123 EKA INFUS
124 IMAS INFUS
125 SUSILAWATI INFUS
126 SHIFA NUR AZIZAH INFUS
127 IRMA INFUS
15/11/2016 128 OSY ULFAH INFUS DC
129 RISTI INFUS
130 AISYAH KANZA NURYANNI INFUS
131 RIZKY FAUZAN INFUS
16/11/0216 132 ERNI INFUS
133 TITIN INFUS
134 AI DAWIAH INFUS
135 ALIF RAIANA INFUS
136 HUTRIANI INFUS
137 M ASYRAF INFUS
17/11/2016 138 ATIN MULYATIN INFUS
139 TITIN SUPRIATIN INFUS
140 RENNY INFUS
141 RUSTINI INFUS DC
142 KARTINI INFUS DC
143 ANANDITA INFUS
144 GINA RANA WULANDARI INFUS
18/11/2016 145 KOKOM KOMARIAH INFUS
146 DEA KARINA INFUS DC
147 RINA KRISDIANTI INFUS
148 ARFAN INFUS
149 FADIL INFUS
150 ROHMAH INFUS
151 YAYU RAHAYU INFUS
152 YANI SURYANI INFUS
19/11/2016 153 IMAS ROHANAH INFUS DC
154 MIMIN MINTARSIH INFUS DC
155 AA T INFUS
156 ADE AROFAH INFUS
157 INARA INFUS
158 NURSIDAH INFUS
20/11/2016 159 YAYAH TURSIAH INFUS
160 AI NURHASANAH INFUS
161 YUYUN YULIANA INFUS
162 EVI INFUS
163 WULAN INFUS
164 HANI KUSTINI INFUS
165 YUNI INFUS
166 SABRINA INFUS
21/11/2016 167 NANI KURNIA INFUS
168 ETI ROHAETI INFUS
169 SINDI SINTIYA INFUS
170 ETI SULASTRI INFUS
171 MARYATI INFUS
172 CITRA INFUS
22/11/2016 173 SUHARTINI INFUS
174 JURIAH INFUS DC
175 YETI HASTUTI INFUS
176 JEJEH JUBAEDAH INFUS
177 FEBRI TURMA INFUS
178 M HAFIS INFUS
179 SALIMUL ALHAFSI INFUS
180 M.SALIMUL ALHABSY INFUS
181 NURMALA INFUS
23/11/2016 182 SUTINI INFUS
183 ASTRIA INFUS
184 PUTRI SRI NAILA INFUS
185 HALIMAH INFUS DC
186 KURNIA INFUS
187 SRI MULYATI INFUS
188 NURHASANAH INFUS
189 BUDI INFUS
24/11/2016 190 IPAH INFUS
191 NOVA RISMAYANTI INFUS
192 SITI ROHIMAH INFUS
193 CHANDRA INFUS
194 DEDE ROHAYATI INGUS
195 SITI SOPIAH INFUS
196 SANTI INFUS
197 TINA INFUS DC
198 AAT INFUS DC
199 ERNA RATNASARI INFUS DC
25/11/2016 200 CUCU DARLINA INFUS
201 IIS SUMIATI INFUS
202 LILIS INFUS
203 SUCI PEBRIANI INFUS
204 OCI INFUS
205 ENENG MERAWATI INFUS DC
206 NENG SUMARNI INFUS
207 SOLIAH INFUS
208 MAS ENEN INFUS
26/11/2016 209 KOKOM KOMARIAH INFUS
210 DZAKI IQBAL GUNAWAN INFUS
211 YANI INFUS
212 SUNIANGSIH INFUS
213 YANI INFUS
27/11/2016 214 EMA ROSMAWATI INFUS
215 INEU SURYATI INFUS
216 ATIK KOMARIAH INFUS
217 EVA INFUS
218 ALIVIA INFUS
219 M.ZIKRA INFUS
220 YENI FERY INFUS
221 TATI MARYATI INFUS
28/11/2016 222 SURYATI INFUS
223 RATIH INFUS
224 BY NY DEWI INFUS
225 FITRIA FEBRIANI INFUS
29/11/2016 226 TRI UTAMI INFUS DC
229 MEGAWATI INFUS DC
232 SANIA INFUS
235 SHINTA INFUS DC
30/11/2016 238 RAHMAWATI INFUS
241 SUMIATI INFUS
244 AVTURI INFUS
247 VIA INFUS
250 ETI ROSMININGSIH INFUS
TOTAL 250 27
JUMLAH PASIEN IGD 605

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN DESEMBER 2016
01/12/2016 1 DIAN PARWITA INFUS DC
2 BIANA INFUS DC
3 M IKBAL INFUS
4 KHALIFA INFUS
5 SRI MULYATI INFUS DC
6 SITI KHODIJAH INFUS DC
7 NUNUNG SUMARNI INFUS
8 NIA KURNIASIH INFUS
9 ATI INFUS DC
10 ZAKIR INFUS
11 NABILA INFUS
12 ANI INFUS
13 ANISA INFUS
02/12/2016 14 DEDE INFUS DC
15 SITI RODIAH INFUS
16 RIMA INFUS
17 SYIFA INFUS
18 JULIA INFUS DC
19 ENENG INFUS
20 JULIA INFU DC
03/12/2016 21 RISKA INFUS
22 ADELIA INFUS
23 NURWASIAH INFUS
24 NISA AULIA INFUS
25 RUKAYAH INFUS DC
26 ANA HASANAH INFUS DC
27 YULIANTI INFUS
28 ANISA INFUS
29 YULIYANI INFUS
30 ADILA RIZQIANA INFUS
31 DYVIA INFUS
32 MUSTIRAMDANI INFUS
33 NONENG INFUS
04/12/2016 34 IIS SUSILAWATI INFUS
35 INEU INFUS
36 IIS KARMILA INFUS
37 RISKA PURNAMA SARI INFUS
38 RATNA SARI INFUS
39 WAHYU NINGSIH INFUS
40 ENAH INFUS
41 PUJI UTAMI INFUS
42 RITA ROSITA INFUS
43 RISMA ULI INFUS
44 NURHASANAH INFUS
45 YOSI INFUS
46 SITI HAMILAH INFUS
47 SITI USWATUN INFUS
48 LAYLA KAMILA INFUS
49 INNARA INFUS
50 RINA INFUS
05/12/2016 51 ROKHAYATI INFUS
52 EKA PURNAMA INFUS
53 DESIE INFUS
54 DIANA INFUS
06/12/2016 55 ICEU KURNIAWATI INFUS
56 SAFITRI INFUS DC
57 LINDA FATMAWATI INFUS
58 IRMA INFUS DC
59 RAFIF INFUS
60 RANI INFUS DC
61 BY.NY IRMA INFUS
62 BY.NY FITRI INFUS
63 KOKOM KOMARIAH INFUS
07/12/2016 64 RISKA PURNAMA SARI INFUS
65 SUSI SUSANTI INFUS
66 KOKOM KOMARIAH INFUS
67 ERNA RAHAYU INFUS DC
68 SUSI INFUS
08/12/2016 69 MARINI INFUS
70 NURLAELA INFUS
71 NAJWA INFUS
72 KOMARIAH INFUS
09/12/2016 73 RATU MEIGALIA VISTA INFUS
74 RATNA SARI INFUS DC
75 SARIFAH INFUS
76 AI YULIAWATI INFUS
77 MAS IYAM INFUS
78 NURFADILAH INFUS
79 IDA NURAIDA INFUS DC
80 SITI M INFUS
81 LILIS ROHAETI INFUS
82 RISKA NUR CAHYATI INFUS
10/12/2016 83 YULIANA WANDRA INFUS
84 ELIN SURYANI INFUS
85 M FERDIANSYAH INFUS
86 BY.NY AJENG INFUS
11/12/2016 87 NY SARIAH INFUS
88 RATIH DEWI INFUS
89 YULIANI INFUS
90 ELINA WINDIANA INFUS DC
91 RANI RAHAYU INFUS
92 LENI FEBIANTI INFUS DC
12/12/2016 93 LIA NURHAYATI INFUS
94 M ZABRAN INFUS
95 RANTI PURWANTI INFUS
96 AI NURHALIMAH INFUS
97 NURHAYATI INFUS
98 LETI LATIFAH INFUS
13/12/2016 99 FITRI MALASARI INFUS
100 ALIN AFIFAH INFUS
101 RISKA ADITYA INFUS DC
102 SRI INFUS
103 IRA FITRIANI INFUS
104 SYIFA NURAENI INFUS
105 DWI INFUS
14/12/2016 106 NINING SUKAESIH INFUS
107 ROSSY ROSIDAH INFUS DC
108 IDAH ROSIDAH INFUS
109 TITA ERSITA INFUS
110 DAFA INFUS
111 AZMI INFUS
112 NAZWA INFUS
113 AAM AMINAH INFUS
15/12/2016 114 DIANA INDAH INFUS
115 AI FARIDA INFUS
116 TRI AMBAR YANI INFUS
117 MILA KURNIA INFUS DC
118 GRACE SIAHAAN INFUS
119 YENI MARYANI INFUS
120 FAUZIA INFUS
16/12/2016 121 NUR INTAN INFUS
122 TIORIA INFUS
123 LINA MARLINA INFUS
124 WIWIN INFUS
125 NOPI MULYANI INFUS
126 LENA INFUS
127 YUYUN TRISNAWATI INFUS
128 AYU WULANDARI INFUS
129 EUIS RUKMINI INFUS
130 DEWI ROHIMAH INFUS
17/12/2016 131 YULIANTI INFUS
132 ENDAH NURHAYATI INFUS
133 LILIS LISTIANA NURHIDAYAH
INFUS DC
134 YUNI.R INFUS DC
135 RIA NURAENI INFUS
136 ADE JUBAEDAH INFUS
137 NACHITA INFUS
18/12/2016 138 RODIAH INFUS DC
139 CUCU INFUS
140 NOVI SOVIANTI INFUS
141 NURMALA INFUS
142 M.RIFKI FAUZAN INFUS
19/12/2016 143 SRI ANDIYANI INFUS
144 YUYUN YUNARSIH INFUS DC
145 RISKA KAMELIA INFUS
146 IIS AMELIA INFUS
147 ELIS NOVA INFUS
148 ANAH INFUS DC
20/12/2016 149 SANDRA KOMALASARI INFUS
150 KOMALA INFUS DC
151 NENGSIH INFUS
152 WATI INFUS DC
153 ANTI HARDIANTI INFUS
21/12/2016 154 PENI NOVITASARI INFUS
155 RENI ERNAWATI INFUS
156 NENG RIRIN INFUS DC
157 ENI INFUS
22/12/2016 158 WITA JUWITA INFUS
159 RINA ROSMIANTI INFUS
160 RIZKY INFUS
161 MOCH.AL MEINAS INFUS
162 MAYANG INFUS
163 YUYUN YUNINGSIH INFUS
164 WINA INFUS
165 TETI SETIAWATI INFUS
166 ANTI HARDIANTI INFUS
23/12/2016 167 LILIS SUKAENI INFUS
168 NENG NENI SUPRIANTI INFUS
169 YULI YULIANA0 INFUS
24/12/2016 170 LIA MARYATI INFUS
171 RAYYAN PRAMUDIA INFUS
172 TIRTA SURYA M INFUS
173 FIKRI INFUS
174 FITRI RIZKY RAMADANI INFUS
175 YUSI INFUS
176 TATI INFUS DC
177 SANTI INFUS
25/12/2016 178 LENI HERLINA INFUS
179 ELIS INFUS
180 SUSI SUSILAWATI INFUS
181 NOVI INFUS
26/12/2016 182 NOVI ROHAYATI INFUS DC
183 YANTI INFUS DC
184 IDA AIDA INFUS DC
185 IRMA ROSMAWATI INFUS
26/12/2016 186 SANTI RAHAYU INFUS DC
187 ELSA PRATIWI INFUS DC
188 YULIA MAULINA INFUS DC
189 TRI KUSMIATI INFUS
190 YOSI INFUS
191 GUSTINA INFUS
192 EGI INFUS
193 DEWI INFUS
27/12/2016 194 JUJU JUERIAH INFUS
195 ALISYHA INFUS
196 YULI YULIANTI INFUS
197 ULFAH MAYASARI INFUS
198 EMA PURNAMA INFUS
199 TENI DWI YANTINI INFUS DC
200 ROSHAYATI INFUS
201 NAISHA SALSABILA INFUS
28/12/2016 202 IRMA INFUS
203 SRI ANDINI INFUS
204 YAYAH INFUS
205 ICI KURNIAWATI INFUS
206 RIKA INFUS
29/12/2016 207 SITI SOLIHAT INFUS
209 WIWIK WIDIASTUTIK INFUS
210 ROKHAYATI INFUS
211 YANI INFUS DC
212 ADITIA PRATAMA INFUS
213 FABIAN INFUS
214 DESIANA DWI INFUS
30/12/2016 215 YANI INFUS DC
216 ALWI ASYIDIQ INFUS
217 LISNAWATI INFUS
218 SUSANTI INFUS
31/12/2016 219 OPI ARAPIAH INFUS
220 MARYATI INFUS
221 ITA ROSTIANI INFUS
222 TRI WAHYUNI INFUS
223 INA GANTINA INFUS
224 RADEN NOVITA KANIAWATIINFUS
225 RIAN INFUS
226 NURLAELA ASRI INFUS
227 EVA INFUS
228 SITI JULAEHA INFUS
229 NENG DARYANTI INFUS
230 IRMA YULIA INFUS
231 MUHAMAD HANIP INFUS
232 RISKY AVANZA INFUS
233 M RASYA INFUS
234 AMANDA INFUS
TOTAL 234 40
JUMLAH PASIEN IGD 550

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN OKTOBER 2017
1/10/2017 1
FORMAT SURVEY HARIAN PEMAKAIAN ALAT NOVEMBER 2017
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2017 1 Dian v v
2 Siti Aisyah v
3 Yanti v
4 Resti v v
5 Yuli yulianti v v
6 Devi v v
6 4
02/11/2017 7 Dati v v
8 Siti r v
9 Mulya v
10 Elis v v
11 Siti aisyah v v
12 Ningsih v
6 3
03/11/2017 13 Rini v
14 Siti rohmah v v
15 Elis v
16 Ningsih v v
17 Titin v
18 Ratih v
19 Lima v v
20 Luri v v
8 4
04/11/2017 21 Titin v
22 Ratih v v
23 Elis v v
24 Siti N v v
25 Zaenab v v
5 4
05/11/2017 26 Ratih v v
27 Yani v
28 Siti h v v
3 2
06/11/2017 29 Winda v v
30 Lilis v
31 Ratih v v
32 Rika v v
4 3
07/11/2017 33 Penti v
34 Mumun v
35 Winda v
36 Fitri v
37 Lilis v
38 Dina v
39 Komalasari v
7 0
08/11/2017 40 Komalasari v
41 Wati v
42 Dina v v
43 Nurazizah v
44 Dewi v
45 Santi v
46 Rika v v
47 Rositawati v v
8 3
09/11/2017 48 Intan v v
49 Dewi v
50 Santi v v
51 Yuyun v
52 Rebeca v
53 Wati v v
54 Siti m v
7 3
10/11/2017 55 tina v v
56 rini v
57 nina v v
58 kusmini v v
59 putri v
60 yani v
61 imas v
62 siti v v
63 wina v v
9 5
11/11/2017 64 rini v
65 herlina v v
66 nuryani v v
67 kusmini v
68 wiwin v v
69 putri v
70 siti v
71 isye v
8 3
12/11/2017 72 riani v
73 wiwin v
8 3
13/11/2017 74 Ratih v v
75 Fitri v
76 Sensen v v
3 2
14/11/2017 77 Mia v v
78 Ratih v v
79 Fitri v v
80 Sensen v v
81 Siti v v
82 Ayunda v v
6 6
15/11/2017 83 Asri v
84 Sunarsih v
85 Riska v
86 Citra v v
87 Kartini v v
88 Sensen v v
6 3
16/11/2017 89 Sunarsih v v
90 Bella v v
91 Sensen v v
92 Ratih v v
5 5
17/11/2017 93 Cantika v v
94 Sumini v v
95 Sinta v v
96 Choirunissa v
97 Herna v v
98 Popon v
99 Rodiah v v
7 5
18/11/2017 100 Choirunnisa v v
101 Rodiah v v
102 Popon v v
103 Neneng v
104 Mimin v v
105 Dian v v
106 Yosi v
7 5
19/11/2017 107 Rodiah v v
108 Yosi v
109 Dayani v v
110 Neneng v v
4 3
20/11/2017 111 Yosi v
112 Minarni v v
113 Ai patmawati v
114 Ita v v
4 2
21/11/2017 115 Minarni v v
116 Ita v v
117 Reni v
118 Rodiah v v
119 Meri v
120 Riski v v
6 4
22/11/2017 121 Nopiyanti v v
122 Hana v
123 Rodiah v v
124 Riski v
125 Novy v
126 Susilawati v
127 Ela v
128 Nunung v
8 2
23/11/2017 129 Novy v v
130 Ela v v
131 Nunung v v
132 Evi v v
133 Serlina v v
134 Emawati v v
135 Fitri v v
136 Rina v
137 Tina v
9 7
24/11/2017 138 Rina v v
139 Yuniati v
140 Serlina v v
141 Pitri v
142 Emawati v v
143 Fitri v
144 Indri v
145 Komalasari v
8 3
25/11/2017 146 Fitri v
147 Ine siti v
148 Rosmaya v
149 Nurjanah v v
150 Diani v v
5 2
26/11/2017 151 Sabina v
152 Nurul v v
153 N.Aneu v v
154 Rosmaya v
155 Nuraini v v
156 Devi v
6 3
27/11/2017 157 Rosmaya v
158 Yola v v
159 Ema v v
160 Dede v
161 Kiki v
5 2
28/11/2017 162 Yola v
163 Dede v
164 Rani v
165 Rini v
166 Oom v v
167 Enung v
168 Aam v
7 1
29/11/2017 169 Oom v v
170 Rani v
171 Rini v
172 Dewi v
173 Mia v v
174 Maya v v
175 Devi v v
176 Imas v v
8 5
30/11/2017 177 Rani v
178 Cicih v
179 Euis v v
180 Nurlatifah v
181 Tini v
182 Yola v v
6 2

JUMLAH 183 97
FORMAT SURVEY HARIAN PEMAKAIAN ALAT DESEMBER 2017
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2017 1 Nurlatifah v v
2 Asti v
2 1
02/12/2017 3 Asti v
4 Desi v
5 Siti v
6 Yanti v
7 Desy v
8 Sari k v
9 Mesrawani v
7
03/12/2017 10 Karunia v v
11 Sari v
12 Neneng v v
13 Desy v
14 Mesrawani v v
5 3
04/12/2017 15 Sari v
16 Ina v v
17 Siti v
18 Patimah v
19 Yulinar v v
20 Karunia v v
21 Opi v v
7 4
05/12/2017 22 Sri v v
23 Ani v
24 Ina v v
25 Leni v v
26 Susyanti v v
27 Opi v v
6 5
06/12/2017 28 Siti n v v
29 Ani v
30 Mimin v
31 Dewi v
32 Imas v v
33 Dini v
34 Sari v v
35 Fitri v v
8 4
07/12/2017 36 Sariningsih v v
37 Imas v
38 Nia v v
3 2
08/12/2017 39 Fitria v
40 Nita v
41 Ucu v
42 Siti hatifah v v
43 Dini v v
44 Adinda v
45 Iftitah v v
7 3
09/12/2017 46 Dian v v
47 Ucu v
48 Adinda v v
49 Nita v v
50 Afriana v
51 Nurlaela v
6 3
10/12/2017 52 Siti a v
53 Neneng v v
54 Nurlaela v
55 Siti nurjanah v
56 Siti n v v
57 Afriana v v
6 3
11/12/2017 58 Rita r v v
59 Nurlaela v
60 Sopy v v
61 Rita andriyani v v
62 Neza v v
63 Elin h v v
64 Sarifa v v
65 Dini v v
66 Fitri v
9 7
12/12/2017 67 Ima v
68 Deti v
69 Mimin v
70 Fitri v v
71 Dewi v v
72 Lisnawati v v
73 Syifa v v
7 4
13/12/2017 74 Serlina v v
75 Deti v v
76 Yuliyanti v
77 Dewi v v
78 Meli v v
79 Komalasari v
80 Fujiawati v v
81 Popy v
82 Devi v v
9 6
14/12/2017 83 Yayu v
84 Yulinar v
85 Siti s v v
86 Devi v v
87 Fujiawati v v
88 Ani v
89 Nani v
90 Titi v v
8 4
15/12/2017 91 Nila v v
92 Fujiawati v
93 Nani v
94 Ida v v
95 Yayu v v
96 Zitta v v
97 Yulinar v
98 Kingkin v
8 4
16/12/2017 99 Dedeh v v
100 Yulinar v
101 Yuliana v
102 Nurhesa v v
103 Eli siti v
104 Triani v v
105 Windy v
106 Nursumiati v v
8 4
17/12/2017 107 Yulinar v
108 Nurseha v v
109 Siti aisyah v v
110 Yuliana v v
111 Yani v
5 3
18/12/2017 112 Yulinar v
113 Elin v
114 Ima v v
115 Angguni v v
116 Yani v
117 Yanti v v
118 Yuni v
119 Ningrum v
120 Siti zulfa v
9 3
19/12/2017 121 Elin v v
122 Yulinar v v
123 Imas v
124 Ningrum v
125 Ai hasanah v v
126 Yani v v
6 4
20/12/2017 127 ai hasanah v v
128 imas v
129 melianti v
130 astri v v
131 dinar v v
132 neng hani v v
133 ningrum v
134 yulia v
8 4
21/12/2017 135 Meliyanti v
136 Herawati v v
137 Yulia v v
138 Eros v
4 2
22/12/2017 139 Fitri v v
140 Yati v
2 1
23/12/2017 141 sopiah v v
142 nursani v v
2 2
24/12/2017 143 neni v
144 heni v
145 intan v
146 rita v
147 rofiah v
148 laswati v
6 0
25/12/2017 149 heni v
150 nani v v
151 santi v v
6 2
26/12/2017 152 idah v v
153 melani v
154 siti hodijah v
3 1
27/12/2017 155 yanti v v
156 restu v
2 1
28/12/2017 157 yeyen v v
158 tiktik v
159 susilawati v v
160 dede v v
161 yati v
5 3
29/12/2017 162 euis v v
163 dede v v
164 maswati v
165 dian v
166 imas v v
167 eros v
6 3
30/12/2017 168 rani v
169 wiwi v
170 puteri v
171 maswati v
172 nia v
173 nina v v
174 sansan v
6 2
31/12/2017 175 yuli v
176 kakan v v
177 sansan v v
178 nia v
179 neni v
4 3

91
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2017 1 Siti wulan v
2 Neng daryanti v
3 Irma yulia v
4 Annisa v
5 Lika v
6 Rd. Novita v
7 Irma v v
8 Dita v
9 Novi v
9 1
02/01/2017 10 Sopinah v
11 Furi v
12 Rd. Novita v
13 Irma v v
14 Shabrina v v
5 2
03/01/2017 15 Rumyati v v
16 Ai Rina v
17 Sulasmini v
18 Awang v
19 Rini v
20 Shabrina v
21 Diar v
22 Sari istiqomah v v v
23 Rani v v
24 Eneng aisyah v v
25 Lidia v
11 4 1
04/01/2017 26 Fitri v
27 Diar v
28 Sari istiqomah v v
29 Maftuhah v
30 Rini v
31 Rani v v
32 Eneng aisyah v v
33 Rumyati v v
34 Jessica v
35 Nyayu v v
36 Serly v
37 Anias v v
12 6
5/1/2017 38 Hutami v
39 Nyayu v v
40 Tita v v
41 Wulan v v
42 Tri v v
43 Nita v v
44 anias v v
45 Yuliani v
46 Anirah v v
9 7
6/1/2017 47 Rina v v
48 Tintin v v
49 Fitriyanti v
50 Tri v
51 Rani v
52 Nita v v
53 Nok emah v
54 Tita v v
55 Wulan v v
56 Nurul v
57 Kusmawati v
58 Anirah v v
12 5 1
07/01/2017 59 Lilis v v
60 Tintin v
61 Enung v
62 Mia v
63 Vonny v v
5 2
08/01/2017 64 lilis v v
65 karsih v v
66 Kokom v v
3 3
09/01/2017 67 Deti v
68 Karsih v v
69 Heni v v
70 Kokom v
71 ika kartika v
72 Kiki v
73 diah v v
74 Rima v
8 3
10/01/2017 75 Selfi v v
76 Diah v v
77 Elisabeth v
78 Nurhasanah v
79 Karsih v v
80 Vika v v
81 Heni v v
82 Dita v
83 Kiki v
84 Rani v
10 5
11/1/2017 85 Selfi v v
86 Mega putri v
87 Kiki v
88 Rani v
89 neni v
90 karsih v v
91 afriza v v
92 nenti v
8 3
12/01/2017 93 yekti v
94 dewi v
95 novianti v
96 nina v
97 rina sahara v
98 neni mulyani v
99 karsih v
100 tanti v
101 mega v
9

13/01/2017 102 dedeh v v


103 hadian v v
104 mas iyam v
105 neni mulyani v
106 tanti v
107 mega putri v

6 2
14/01/2017 108 dedeh v v
109 euis taryani v v
2 2
15/01/2017 110 tanti v
111 sulinar v
112 haryuti v v
113 carolin v
4 1
16/01/2017 114 haryuti v v
115 yulianti v
116 riska v v
117 tanti v
118 aan v v
119 Lina v
120 Mae v
7 3
17/01/2017 121 noni v v
122 rani v v
123 haryuti v v
124 r riska v v
125 novi v
126 aan v
127 yati v v
128 Tanti v
129 Parwati v
130 Elis v
131 Desiana v
132 Rina v
133 Nining v
134 Hira v v
14 6
18/01/2017 135 Dedeh v v
136 Parwati v
137 Hani v
138 Rika v v
139 Novi v
140 Yati v
141 Fika v
142 Noni v v
143 Hira v
144 Tina v
145 Masfufah v
146 Rani v v
147 Nining v
148 Eulis v
149 Lulu v v
150 Rina v
151 Eneng v
152 Yeni v v
18 6
19/1/2017 153 Rani v v
154 Dedeh v
155 Rika v v
156 Yati v
157 Mira v
158 Nining v
159 Eulis v
160 Lulu v v
161 Riska v
162 Melia v
163 Mulyanti v
11 3
20/1/2017 164 Rani v
165 Dessy v
166 Gracelia v v
167 Fania v
168 Tati v v
169 Mulyanti v
170 Priskila v
171 Andarsih v v
172 Rohaeni v v
9 4
21/1/2017 173 Evi v
174 Peni v
175 Gracelia v
176 Tati v
177 Andarsih v v
178 Rohaeni v v
179 Solehati v v
180 Insiyah v v
181 neng santi v
182 Sri ningsih v
183 Dewi v v
11 5
22/1/2017 184 Putri v
185 Fani v v
186 Solehati v
187 Insiyah v v
188 Andarsih v v
189 Wanti v
190 Rohaeni v
191 Isrami v v
192 Nurhidayah v
193 Rima v
194 Dewi v v
195 Ima v
12 5
23/1/2017 196 Putri v
197 Irma v v
198 Fani v v
199 Insiyah v v
200 Titi v
201 Andarsih v
202 Isrami v v
203 Mimin v
204 Syarifah v v
205 Nurlaela v v
206 Imas v
11 6
24/1/2017 207 Andarsih v
208 Fani v v
209 Insiyah v v
210 Titi v v
211 Santi v
212 Syarifah v
213 Nurlaela v
214 Imas v v
8 2 2
25/1/2017 215 Evi v v
217 Poppy v v
218 Pipi v v
219 Siti sajaah v v
220 Imas v
221 Widayanti v
6 4
26/1/2017 222 dewi v v
223 ai lasmini v
224 dedeh v
225 pipi v v
226 mia v
5 2
27/1/2017 227 marisha v
228 gita v v
229 ai lasmini v
2 1 1
28/1/2017 230 Lis setiowati v v
231 enung v
232 ai lasmini v
233 marisha v
234 komala v
235 Yati mulyati v
5 1
29/1/2017 236 erista v v
237 yati mulyati v
238 lis setiowati v
239 risnawati v
240 wiwit v
241 iMAS v v
6 2
30/1/2017 242 Lis v
243 Risnawati v
244 Imas v
245 Desi v v
246 Anisa v
247 Fitri v
248 Yuli v
249 Sonia v
250 Ririn v
251 Yati v
10 1
31/1/2017 252 Siti solihah v v
253 neng sari v
254 Furi v
255 Suryati v v
256 Siti nuraeni v v
256 ai rosmayanti v v
257 Dewi v
7 4
JUMLAH 255 101 2 3

FORMAT SURVEY HARIAN PEMAKAIAN ALAT FEBRUARI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2017 1 Ita rosita v v
2 Siti nuraeni v
3 Ai rosmayanti v
4 Siti solihah v v
5 silmi v
6 Devi v v
7 Tika v v
8 Ineu v
7 5
02/02/2017 9 rini v v
10 awang v
11 siti solihah v
12 marini v
13 silmi v
14 intan v
15 iceu v v
16 ria v
17 siti w v
18 susan v v
10 2
03/02/2017 19 bembi v
20 intan v
21 marini v
22 dinawati v
4
04/02/2017 23 kartika v
24 bembi v v
25 fani v
26 neni v
27 alya v
28 intan v v
29 ratna v
30 tumirah v
31 ela v v
32 tita v
10 3
05/02/2017 33 ela v v
34 ratna v
35 lilis v
36 debi v
4 1
06/02/2017 37 hersa v v
38 fitri v
39 imas v v
40 ela v v
41 novi v v
42 miskiyah v
43 iis v v
44 erni v
45 rani v v
46 sri wahyuni v
47 iis/iyan v v
11 7
07/02/2017 48 rani v
49 marliah v
50 hersa v v
51 fitri v
52 iis v v
53 iis aisyah v v
54 susanti v
55 ela v
56 novi v
57 imas v v
10 4
8/2/2017 58 eva v v
59 hersa v v
60 iis v v
61 iis aisyah v v
62 ela v
63 venti v v
64 Neng yuri v
65 santi v
66 siti wida v
67 silly v
68 wiwit v
11 5
9/2/2017 69 sinta v
70 ita v
71 neng yuri v v
72 risna v
73 siti wida v
74 silly v
75 eva v v
76 wini v v
77 venty v v
78 siti sarah v v
79 mira v v
10 7
10/2/2017 80 siti mariam v v
81 imas v v
82 mira v
83 risna v
84 imas sumiyati v
85 wini v
86 siti sarah v
87 ita v
88 oom v
89 rodiah v v
90 dewi v
91 siti sarah v
92 thania v
93 mirA kartika v
14 3
11/2/2017 94 imas v
95 nurhayati v
96 elis v v
97 rodiah v
98 ela v v
99 anisa v
100 pupu v v
7 3
12/2/2017 101 asri v v
102 elis v v
103 dhelia v
104 elin v
105 nita v v
106 ela v v
107 pupu v
7 4
13/02/2017 108 siti maesaroh v v
109 noviyanti v v
110 desi v
111 asri v
112 sri v
113 siti solihah v
114 nita v v
115 imas v v
116 ela v
117 ida v v
10 5
14/2/2017 118 siti solihah v
119 eros v v
120 intan v v
121 kharisma v
122 sri wahyuni v
123 imas v v
124 iis v v
125 ida v
126 kurnia v
127 nurwina v
128 rini v
129 nina v v
12 5
15/02/2017 130 erna v v
131 tita v
132 lisnawaroh v
133 rini v
134 oneng v
135 nina v v
136 iis v v
137 ai rini v v
8 4
16/2/2017 138 iis aisyah v v
139 wiwik v v
140 erna v v
141 rini v
142 ni wayan v
143 nina v
144 ai rini v
145 ana v v
146 Desi v
9 4
17/02/2017 147 sheila v v
148 iis aisyah v
149 wiwik v
150 gini v v
151 Nita v
152 rini v
153 desi v
154 Rhesta v
155 bunga v v
156 ana v
10 3
18/02/2017 157 reni v v
158 delya v
159 rini v
160 rita v
161 bunga v
5 1
19/02/2017 162 lusi v
163 tita v
164 ameliawati v v
165 reni v
166 delya v
167 rini v
6 1
20/02/2017 168 rini v
169 tiani v
170 wahyuni v
171 tita v
4
21/02/2017 172 veronika v
173 rini v v
174 sunarsih v v
175 tiani v v
176 wahyuni v v
177 Santi v
5 2
22/02/2017 177 Dede v
178 Rini v
179 Santi v
180 Sunarsih v
181 Aliya v v
182 Lia v
183 Siti s v v
184 Meritta v v
8 3
23/2/2017 185 Annisa siti v v
186 Annisa dina v
187 Deasy v
188 LIa v
189 Rini v
190 ade v
191 Siti S V
192 mERITTA V
193 Aliya v v
194 Siti J V V
195 Rika v v
196 Deke v v
197 Wiwin v
13 5
24/2/2017 198 Deasy v v
199 Resti v v
200 Siti j v
201 Rika v
202 Annisa v v
203 Deke v
204 Rini v
205 Wiwin v
206 ita juwita v
207 susilawati v v
208 Sri mulyati v
209 neni v
12 4
25/2/2017 210 pipih v
211 Rere v v
212 ita juwita v
213 Rani v v
214 Susilawati v v
215 Siti M v
216 wiwin v
217 yeni v v
218 Deasy v v
219 indah v
220 resti v v
11 6
26/2/2017 221 nura v
222 eka v
223 nia v
224 siska v v
225 rani v v
226 susilawati v v
227 siti m v
228 anila v
229 wiwin v
230 komariah v v
231 rasy v
232 ratna v
233 lena v
234 yeni v v
14 5
27/2/2017 235 siska v
236 rani v v
237 susilawati v v
238 siti m v
239 wiwin v
240 yeni v v V
241 komariah v
242 lena v
243 rani v
244 Anita v v
245 nia v
11 4 1
28/2/2017 246 anita v v
247 siti mariam v v
248 sukaesih v
249 mulyanti v v
250 delya v
251 siti m v
252 wiwin v
253 susanti v
8 3
JUMLAH 250 99 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MARET 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2017 1 nining v v
2 yani v v
3 dewi v
4 rita v
5 siti m/iwan v v
6 mulyanti v v
7 yeni v
8 delya v
9 siti m/hengki v v
10 wiwin v
11 susanti v
11 4 1
02/03/2017 12 nining v
13 yani v v v
14 selvi v
15 asih v
16 rohaeni v
17 delya v
18 siti m/hengki v
19 susanti v
20 Tati v
21 Desi v
8 1 1
03/03/2017 22 tati v
23 eneng v v
24 wiwin v
25 rosmawati v v
26 selvi v
27 Desi v
28 Asih v v
29 yanti v v
30 siti julaeha v
31 susanti v
10 3 1
04/03/2017 32 Yanti v v
33 Salia v
34 Mudrikah v v
35 Grizelda v
36 Siti julaeha v
37 Eneng v v
38 Nurani v v
39 Rosmawati v v
40 susi v
41 Iis v v
10 6
05/03/2017 42 IIS V
43 nurani v v
44 Elsa v
3 1
06/03/2017 45 sri devi v v
46 pesti v v
47 Konijah v
48 Lina v
4 2
07/03/2017 50 Ratna v
51 Lina v
52 Rina v v
53 asih v
54 sarah v
55 wiwin v v
56 erni v v
7 3
08/03/2017 57 sarah v
58 rina v v
59 mima v
60 wiwin v v
61 erni v v
62 ratna v v
63 Sylvanni v v
7 5
09/03/2017 64 kamirah v
65 desi v
66 ratna v v
67 Sylvanni v
68 Vicentia v
69 Nurani v
70 Erni v v
71 Susi v v
72 citra v v
73 yunita v
74 elis v v
75 intan v v
12 6
10/03/2017 76 susi v
77 citra v v
78 istriyanti v v
79 intan v
80 erni v
81 desi v
82 ihah v
83 irna v v
8 3
11/03/2017 84 istriyanti v v
85 erni v
86 ipah v v
87 eem v
88 yannita v
89 Aas v v
90 Dina v
91 mala v
8 3
12/03/2017 92 erni v
93 ajeng v v
94 cahya v v
95 asih v
96 eem v
97 yannita v
98 aas v v
7 3
13/03/2017 99 Gustina v v
100 ajeng v
101 cahya v
102 erni v
103 eem v
104 devi v
105 iis v
106 mirasari v
107 eka v
9 1
14/3/2017 108 gustina v v
109 mirasari v v
110 pina v v
111 iis v
112 eka v
113 nuhyani v
114 rina v v
115 Isma v
116 Ai Hayanti v v
117 Tizza v
118 elly v
11 5
15/3/2017 119 Pina v v
120 Desi v
121 Santi v v
122 Ani v
123 Nani v v
124 Sena v
125 Fitriani v
126 Deri v
127 Elly v
9 3
16/03/2017 128 Rowiyati v v
129 Widaningsih v
130 Desi v
131 Santi v v
132 Runiti v
133 Fitriani v v
134 Elly v
135 ira v v
8 4
17/03/2017 136 nabila v
137 ira v v
138 riawati v v
139 neni v v
140 elis v v
141 lisma v v
142 eulis v v
7 6
18/03/2017 143 neni v v
144 lisma v v
145 eulis v v
146 Santi v
147 Riawati v
148 Aneu v
6 3
19/03/2017 149 Putri v v
150 Mira v
151 Nurhasanah v v
152 Jamilah v
4 2
20/03/2017 153 Putri v
154 Ella v
155 Yannita v v
156 Nurhasanah v
157 elis v
158 jusmaini v
159 ulva v
7 1
21/03/2017 160 herni v v
161 ella v
162 ulva v
163 verawati v
164 lilis v v
165 nuraliyah v
166 neng rita v v
167 Tesa v v
168 Yannita v v
169 laelasari v
10 5

22/3/2017 170 Tesa v v


171 Neng Rita v v
172 Ulva v v
173 Tintin v v
174 solihatun v
175 nuraliyah v v
176 Herni v v
177 Lilis v v v
8 7 1
23/3/2017 178 Shopia v
179 Miswen v
180 maryanti v v
181 anggi v v
182 ulva v v
183 Tintin v v v
184 sri maelasari v v
185 astuni v
186 Siti maryam v v
187 nuraliyah v v
188 lilis v v
189 niki v v
12 9 1
24/03/2017 190 maryanti v v
191 anggi v v
192 tintin v v
193 sri maelasari v
194 fitri v
195 astuni v
196 siti maryam v v
197 nuraliyah v v
198 niki v v
199 lilis v v
10 7
25/03/2017 200 astuni v
201 nuraliyah v v
202 lumina v v
203 nani v
204 niki v v
5 3
26/03/2017 205 fitri v v
206 eka v
207 nurmaya v v
208 susilawati v v
209 cicah v
210 astuni v
211 nia v v
7 4
27/03/2017 212 santi v
213 anisyah v
214 fitri v v
215 laela v
216 deti v
217 nurmaya v v
5 2 1
28/03/2017 218 lastini v v
219 ria v
220 nurmaya v
2 2
29/03/2017 221 nuaraliyah v v
222 siti rohayati v v
223 Rindawati v
224 lastini v v
225 dini v v
226 diana v v
227 heni v v
228 nurmaya v
7 7
30/03/2017 229 Ria maryana v
230 nuraliyah v v
231 siti rohayati v
232 syaifani v
233 aisah v v
234 lastini v
235 sarah v v
7 3
31/3/2017 236 aisah v v
237 sarah v v
238 sri p v v
239 Eli v v
240 Nina v v
5 5
234 119 1 5

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2017 1 wati v v
2 kokom v v
3 laily v
4 eli v
5 sri p v
6 ridha v
6 2
02/04/2017 7 titing v
8 wati v v
9 siti nurhasanah v
3 1
03/04/2017 10 siti nuraeni v v
11 tuti v v
12 siti nurhasanah v
13 mutiara v v
14 sri v
15 ela v v
16 eti v v
7 3
04/04/2017 17 mutiara v v
18 liah v
19 eti v v
20 nurendah v v
21 ela v v
22 Ernawati v
23 Laela v
24 nurul v
8 4
05/04/2017 25 noni v v
26 nurul v
27 sri v v
28 rini v v
4 3
06/04/2017 29 noni v v
30 rini v v
31 nurul v
32 vameliA v v
33 hilga v v
34 cucu sopiah v
35 rustini v
36 ema v
8 4
07/04/2017 37 nurul v
38 dian v v
39 hilga v
40 euis v v
41 nurhayati v
42 ai yanti v v
43 netty v v
7 4
08/04/2017 44 dian v
45 euis v
46 ida v
47 elva v v
48 ai yanti v
49 netty v
6 1
09/04/2017 50 tria v
51 ade v
2
10/04/2017 52 nurani v
53 ade v
54 sahiyah v
55 popi v
56 priska v
57 satma v
58 elsa v
6
11/04/2017 59 nurani v v
60 elly v
61 luci v v
62 maria v v
63 maya v v
64 sahiyah v v
65 tanti v
66 anna v
67 elsa v
68 siti v v
69 santy v v
70 reni v v
11 7
12/04/2017 71 wulia v v
72 siska v v
73 maya v v
74 amalia v v
75 roswitasari v v
76 vina v
77 anna v
78 eko v v
79 lindri v
80 siti v v
81 rita v
82 reni v
83 yani v
13 7
13/04/2017 84 rahmi v v
85 amalia v
86 siska v
87 roswitasari v v
88 vina v
89 anna v
90 eko v
91 sani v
8 2
14/04/2017 92 rahmi v v
93 eem v
94 mira v v
95 nia v v
96 trie v v
5 4
15/04/2017 97 eem v
98 nia v
99 trie v
100 safitri v
101 dea v
102 tina v
103 wina v
104 mirna v
105 hilda v v
9 1
16/04/2017 106 dea v
107 safitri v
108 resti v v
109 fitri v v
110 hilda v
111 vina v
6 2
17/04/2017 112 reni v v
113 mia v
114 eli m v v
115 neng siti v v
116 hesti v
117 fitri v v
118 vina v
119 yulia v
8 4
18/04/2017 120 reni A v v
121 Ela v v
122 hesti v
123 eli m v v
124 neng siti v v
125 yulia v
126 ninik v v
7 5
19//4/2017 127 yulia v
128 ria v
129 ninik v
130 nesya v
131 heni v
132 ela v v
133 hesti v
134 siti v v
8 2
20/04/2017 135 heni v
136 nelis v
137 putri v v
138 siti v v
139 maya v
140 rini v
141 agnia v
7 2
21/04/2017 142 rd utary v v
143 rini v v
144 neng lidiya v v
145 agnia v v
146 dede v
147 heni v v
148 astri v
149 nelis v
150 neneng v
151 cucu v v
10 6
22/04/2017 152 nursyamsiah v
153 neni v
154 ria atikah v v
155 triana v
156 dian v v
157 erni v v
158 asri v
159 dian v
160 yeni v v
161 Kokom v v
10 5
23/04/2017 160 yeni v
161 kokom v v
162 dian v
163 ade v v
164 yuanti v v
5 3
24/04/2017 165 wiwin v v
166 weni v
167 ikeu v
168 jeane v
169 sri v v
170 dian v v
171 ade v v
7 4
25/04/2017 172 reni v v
173 yulia v v
174 alis v v
175 dian v v
4 4
26/04/2017 176 reni v v
177 dian v v
178 alis v
179 winda v v
180 reni v v
181 lucia v
182 revi v v
183 imas v
184 siti v
9 5
27/04/2017 185 siti v v
186 winda v
187 reni v v
188 imas v
189 riska v v
190 darsi v v
191 indah v
192 khoerani v v
193 nela v v
194 ade rani v
10 5 1
28/04/2017 195 Lia v
196 riska v v
197 khoerani v v
198 nela v v
199 ani v
200 ade rani v
201 felisya v
7 3
29/04/2017 202 risma v v
203 irmayanti v
204 siti maemunah v
205 felisya v
206 yulianingsih v v
207 winda v
6 2
30/04/2017 208 ipah v
209 anisa v v
210 miniyati v
211 hani v v v
212 yulianingsih v
213 risma v
214 eneng v v
7 3 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2017 1 mira v
2 evi v
3 gina v
4 ipah v
5 miniyati v
6 hani v v
7 neneng v
8 iya sonia v
8 1
02/05/2017 9 mira v
10 widia v
11 silvi v
12 evi v
13 gina v
14 ipah v
15 nining v v
7 1
03/05/2017 16 widia v
17 atika v v
18 suryamah v
19 komalasari v v
20 nining v v
21 wulan v
22 reni v
23 tanti v
24 iim v v
25 tita v
26 tati v v
27 yenny v v
28 mamah v v
13 7
04/05/2017 29 mispa v v
30 ariyanti v
31 risma v v
32 iim v v
33 tita v
34 tati v
35 atika v
36 yenny v v
37 mamah v v
38 komalasari v v
39 lina v v
40 imas v
12 7
05/05/2017 41 elis v
42 lina v v
43 tituk v v
44 felly v v
45 mia v v
46 risma v v
47 imas v
48 tita v
49 mispa v v
50 yanti v v
51 evi v
52 sona v v
12 8
06/05/2017 53 elis v
54 towingah v v
55 lina v v
56 tituk v
57 felly v v
58 mia v
59 imas v
60 yeni v v
61 nely v v
62 yanti v v
63 sona v
11 6
07/05/2017 64 widi v v v
65 felly v v
66 irma v
67 yeni v v
68 suharyati v v
69 dini v
70 nely v v
71 ira v
72 erlin v
9 5 1
08/05/2017 73 wina v v
74 widi v
75 iis nenih v v
76 suharyati v v
77 imas v
78 meike v
79 novia v v
80 erlin v
6 5 1
09/05/2017 81 wina v
82 rya v v
83 euis v v
84 imas v
85 iis v v
86 nenden v v
87 suswati v
88 meike v
89 pitrawati v v
90 nia v v
91 novia v v
11 6 1
10/05/2017 92 suswati v
93 shanti v v
94 susi v
95 rya v v
96 nenden v
97 febryanti v
98 pitrawati v v
98 nia v v
99 niki v
100 sukiyem v v
10 5
11/05/2017 101 niki v
102 Febriyanti v
103 putri v
104 titin v v
105 shanty v v
106 sukiyem v v
107 wilan v
108 ratna v
8 3
12/05/2017 109 niki v
110 titin v
111 heni v v
112 ratna v
113 dewi v v
114 novy v v
115 juaningsih v v
116 lisnawati v v
8 5
13/05/2017 117 dewi v v
118 novy v
119 Lia aqilah v
120 niki v v
121 cicih v
122 desi v v
123 heni v
124 ratna v
125 lisnawati v v
126 omsiatun v
10 4
14/05/2017 127 cicih v
128 sifa v
129 niki v
130 nunung v v
131 desi awaliyah v
132 sri pujiyanti v v
6 2
15/05/2017 133 melisa v
134 eni v v
135 anne v v
136 nunung v v
137 nurhasanah v v
138 sri pujiyanti v v
6 5
16/05/2017 139 melisa v
140 eni v v
141 anne v
142 rani v v
143 dela v
144 herawati v
145 susilawati v v
146 nurhasanah v v
147 ratna v v
9 5
17/05/2017 148 irma v v
149 ratna k v v
150 arnima v v
151 rani v v
152 diana v v
153 susilawati v v
154 ratna v v
155 nurfatimah v
156 siti mustinah v
157 dewi v
158 winda v v
159 reni v v
160 liya v v
13 10
18/05/2017 161 irma v v
162 ratna v v
163 arnima v v
164 diana v v
165 siti mustinah v
166 rohaeni v
167 nurfatimah v
168 winda v v
169 reni v v
170 liya v v
171 lian v v
172 rika v
173 susi v v
174 yuliati v v
14 10
19/05/2017 175 susi v v
176 lian v v
177 irma v v
178 ema v v
179 yuliati v
180 nurfatimah v
6 4
20/05/2017 181 elis v
182 ega v v
183 irma v
184 rini v
185 rina v
186 nurfatimah v
6 1
21/05/2017 187 dewi utari v v
188 nurfatimah v v
189 franciska v
190 yani v
191 Nia v v
5 2
22/05/2017 192 dewi utari v v
193 Nia v v
194 Tuti v
195 tri wahyu v
196 Yani v
197 nurfatimah v
198 Fitriawati v v
199 Gina v v
200 karmila v v
9 5
23/05/2017 201 winna v
202 yayuk v
203 fitriawati v v
204 gina v v
205 karmila v v
206 nia v v
207 tina v v
208 mulya v
209 tri wahyu v
210 yunita v
10 5
24/05/2017 211 Yayan v
212 siti aisah v v
213 nurazizah v
214 tina v
215 siti nurhasanah v
216 yunita sari v v
217 dedah v v
218 laela v
219 putri v v
220 nursanti v v
221 rosmini v v
11 6
25/05/2017 222 yayan v
223 siti aisah v v
224 nurazizah v
225 devi v
226 karmila v v
227 yunita v
228 putri v
229 nursanti v
230 rosmini v v
231 arina v
10 3
26/05/2017 232 ani v
233 rustini v
234 iis v v
235 sifa v v
236 kristin v
237 devi v
238 herly v v
7 3
27/05/2017 239 aan v v
240 rustini v
241 wiwi v v
242 iis v v
243 sifa v v
244 rumiatun v v
245 vina v
246 sutemi v
247 herly v
248 eneng dewi v v
10 6
28/05/2017 249 aan v
250 wiwi v
251 mila v
252 sifa v v
253 sutemi v
254 eneng dewi v v
6 2
29/05/2017 255 fitri v
256 dastini v
257 anne v
258 diyanita v v
259 dedeh v v
260 Alin v v
6 3
30/05/2017 261 diyanita v v
262 dedeh v v
263 alin v v
264 herawati v
265 yulianti v
266 shinta v v
267 dewi v v
268 fatma v
8 5
31/05/2017 269 deasy v v
270 Risa v v v
271 dewi v v
272 lina v
273 haerani v
274 shinta v v
275 fatma v
276 eneng v
277 Dini v v
9 5 1

276 145 2 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JUNI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2017 1 fatma v
2 Rina v
3 Yosi v v
4 imas v
5 Risa v v
6 dini v v
7 kustini v v
8 asri v v v
9 rina v v
9 6 1
02/06/2017 10 yosi v
11 imas v
12 risa v v
13 rina v v
14 ina v
15 asri v v
16 Sinta v v
17 siti v
18 yuni v v
19 elsa v v
10 6
03/06/2017 20 sinta v
21 imas v
22 nurhadini v v
23 yosi N v
24 siti v
25 yuni v v
26 elsa v v
27 deti v
28 asri v
9 3
04/06/2017 29 leni v v
30 ina v v
31 deti v v
32 nindi v v
33 rahmawati v v
34 anita v v
35 Hotni v v
7 6 1
05/06/2017 36 anita v
37 ina v
38 siti v v
39 yayuk v v
40 arni v
41 susanti v v
42 Hotni v
43 siti N v v
44 parisa v v
45 kanny v
46 uning v
47 sylmi v v
48 sillvia v v
13 7
06/06/2017 49 yayuk v v
50 susanti v v
51 siti N v
52 parisa v
53 siti M v v
54 sylmi v v
55 sillvia v v
7 5
07/06/2017 56 neng nuraeni v
57 daryanti v v
58 dinarsih v v
59 elis v
60 siti h v
61 sylmi v
6 2
08/06/2017 62 ida v
63 dinarsih v
64 siti h v v
65 siti saadah v v
66 mira v v
67 enah v v
68 neng nuraeni v
7 4
09/06/2017 69 anisa v
70 neng nuraeni v
71 rini v
72 milda v
73 rora v v
74 ida v
75 dinarsih v v
76 rina v v
8 2 1
10/06/2017 76 milda v
77 rora v
78 rina v
79 elly v v
80 astari v v
81 yuli v v
82 fitri v
7 3
11/06/2017 83 noviawati v
84 ratu v v
85 astari v
86 fitri v v
87 yuli v
5 2
12/06/2017 88 neni v
89 nia v v
2 1
13/06/2017 90 yanti v
91 iis v
93 neni v
94 dewi v v
95 nia v v
96 michelia v
97 fatma v
98 apriliana v
99 rani v v
100 vanny v v
101 arlis v
11 4
14/06/2017 102 eka v v
103 neni v
104 michelia v v
105 siti masitoh v
106 dewi v v
107 winda v v
108 anisah v
109 rosi v
110 sari v v
111 fatma v v
112 anastasia v
11 6
15/06/2017 113 neni v
114 heni v v
115 sari v v
116 ajeng v
117 santi v v
118 gina v
119 neng wida v
120 lia v v
121 fatma v v
122 apriliiana v v
123 wina v v
124 michelia v v
12 8
16/06/2017 125 shabrina v v
126 neng wida v
127 lia v v
128 santi v
129 heni v v
130 wina v v
131 nur rohyani v v
132 ida v
133 raisa v v
9 6
17/06/2017 134 hirmawati v v
135 sabrina v v
136 romadhona v
137 dede v v
138 asmanah v v
139 raisa v v
140 nur rohyani v v
7 6
18/06/2017 141 sabrina v v
142 rita v
143 romadhona v
144 dede v v
145 asri v v
146 asmanah v
147 tri astuti v v
148 ipah v
149 yuni v v
9 5
19/06/2017 150 sabrina v
151 romadhona v
152 yuli v
153 nurwulan v
154 cartinah v v
155 tri astuti v
156 yuyu v v
7 2
20/06/2017 157 sabrina v
158 rezania v
159 romadhona v
160 yuli v
161 cartinah v
162 lia v v
163 kurnia v
164 tri astuti v
165 titin v v
9 2
21/06/2017 166 sabrina v v
167 romadhona v
168 iin v v
169 feni v v
170 titin v v
171 marina v
172 yanti v
7 4
22/06/2017 173 desi v v
174 shifa v v
175 iin v v
176 feni v v
177 dina v
178 yusi v v
179 fitri v
180 esty v v
181 neuneu v v
8 7 1
23/06/2017 182 desi v
183 shifa v
184 feni v v
185 yusi v
186 esty v
187 desy v
188 astri v v
6 3
24/06/2017 189 shifa v
190 ernawati v v
191 siti R v v
2 3
25/06/2017 192 Shifa v
193 ernawati v
1 1
26/06/2017 194 Sri W v v
195 Neti v v
195 masripah v v
196 Desi v
3 3 1
27/06/2017 197 Sari dewi v
198 sri w v
199 neti v
200 masripah v
3 1
28/06/2017 201 Sari dewi v
202 neng fauziah v v
203 ilin v v
204 Cucu v v
205 rima v v
5 4
29/06/2017 206 neng fauziah v
207 ilin v
208 wiwin v
3
30/06/2017 209 ilin v
210 erna v v
2 1
110 3 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JULI 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2017 1 dewi v
2 ilin v
3 Erna v
4 Nuriah v
5 ade siti v
6 desta v v
7 Ai damilah v v
8 Dini v v
8 3
02/07/2017 9 Yulianti v
10 Ai damilah v
11 Erna v
12 mira v v
13 titin v v
14 siti hadijah v
15 Dini v
16 Desta v v
8 3
03/07/2017 17 siti sri v v
18 siti hamidah v
19 sari v
20 mira v
21 titin v v
22 siti hadijah v v
23 ria v v
24 desta v v
8 5
04/07/2017 25 siti sri v
26 Gina v v
27 ria v
28 Desta v v
29 sri h v
5 2
05/07/2017 30 gina v
31 reni v
32 wiwi v v
3 1
06/07/2017 33 idawati v v
34 romadhona v
35 naomi v
36 virna v
37 cici v
38 leah v
39 reni v
7 1
07/07/2017 40 naomi v v
41 neng leni v
42 uswah v v
43 wiwi v v
44 wita v v
5 4
08/07/2017 45 rd temmy v
46 anggi v v
47 wita v
48 dina v
49 dede v v
50 dida v
51 dini v
7 2
09/07/2017 52 anny v v
53 yeni v v
54 dede v v
55 neni v v
56 uswah v
57 anggi v v
58 rini v
59 amanda v v
60 imas v v
9 7
10/07/2017 61 Hilda v
62 imas v
63 uswah v
64 anggi v v
65 sterra v v
66 rini v
67 amanda v v
7 3
11/07/2017 68 Holisoh v
69 ine v
70 siti H V
71 Uswah v
72 mulyani v v
73 stera v
74 linda v
75 rhima v v
76 amanda v v
9 3
12/07/2017 77 Reza v
78 Mulyani v
79 mulyati v
80 uswah v
81 sylmi v v
82 Rhima v
83 anna v v
7 2
13/07/2017 84 ana sahana v v
85 syilmy v v
86 siti s v v
87 ana yuliana v
88 sindi v
89 rosmanah v
90 nina v v
91 alfiah v
8 4
14/07/2017 92 ana sahana v
93 nina v v
94 liya v
95 ira v v
96 ila v v
5 3
15/07/2017 97 erni v
98 nina v v
99 ila v v
100 ira v
101 evi v v
5 3
16/07/2017 102 sona v
103 evi v
imas v
2
17/07/2017 104 nurriyatan v
105 hety v v
106 sinta v
107 agita v v
108 sona v
109 elis v v
110 putriani v
111 rikawati v v
7 4 1
18/07/2017 112 dewi v v
113 hety v v
114 wulan v
115 agita v
116 sona v v
117 elis v v
118 rikawati v v
6 5 1
19/07/2017 119 yulianti v v
120 dewi v
121 wulan v
122 amanda v v
123 sona v
124 dina v v
6 3
20/07/2017 125 suci v
126 yulianti v v
127 verawati v v
128 hani v v
129 mira v
130 wiwin v v
131 wiwit v v
132 dina v v

7 6 1
21/07/2017 133 anggi v v
134 tita v
135 wiwit v
136 dina v
137 imas santi v
138 citra v v v
139 annisa v
7 2 1
22/07/2017 140 dewi v
141 annisa v
142 dina v
143 citra v v
144 desi v
145 nia v v
6 2
23/07/2017 146 siti romlah v v
147 nia v
148 silvia v
149 shelly v
150 rini v
5 1
24/07/2017 151 siti romlah v v
152 novi v v
153 rini v
3 2
25/07/2017 154 novi v v
155 sri v
156 halimah v
157 ani v v
158 hilda v
159 rini v
160 annisa v
161 dwi v v
7 3 1
26/07/2017 162 sesi v
163 dewi v v
164 mariati v v
165 sri v
166 halimah v v
167 lia v
6 3
27/07/2017 168 nunung v
169 anita v v
170 anggi v
171 neni v
172 dwi v
173 siska v v
174 euis v
6 3
28/07/2017 175 christine v
176 siti v
177 nisa v
178 lisna v v
179 kurnia v
180 nurhayati v
181 nurul v v
7 2
29/07/2017 182 neng mira v v
183 siti v
184 ranny v v
185 meity v
186 aas v v
187 tika v
188 dies ave v v
189 yayah v

8 4
30/07/2017 190 lupi v v
191 neng mira v
192 ranny v v
193 aas v v
194 winda v v
5 4
31/07/2017 195 imas v
196 leli v v
197 ai rohayati v
198 lupi v
199 ranny v
200 aas v
201 winda v
7 1
196 93 4 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT AGUSTUS 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2017 1 astri v
2 ai rohayati v v
3 imas v
4 nia v
5 endang v v
6 syifa v
7 nurhasanah v v
8 ika v
9 leli v v
9 4
02/08/2017 10 komalawati v
11 ai rohayati v v
12 nia v
13 rohaeni v v
14 endang v v
15 pera v v
16 tita v v
17 elis v
18 sesi v v
19 monica v
20 nurhasanah v v
21 ika v
12 7
03/08/2017 22 ami nunung v v
23 rohaeni v
24 perni v v
25 endang v v
26 pipit v
27 rohayati v v
28 nuraeni v v v
29 siti julaeha v
30 sesi v v
31 darwati v
32 ruliane v
33 neni v v
12 7 1
04/08/2017 34 ami nunung v
35 perni v
36 riska v v
37 rohayati v v
38 nuraeni v
39 siti julaeha v
40 siti mulyani v v
41 tanti v v
6 4
05/08/2017 42 rosmana v v
43 riska/rudi v
44 riska v
45 rohayati v v
46 tanti v v
5 3
06/08/2017 47 lenny v v
48 nuraisah v v
49 neldawati v
3 2
07/08/2017 50 cintia v v
51 rena v
52 ristina v v
3 2
08/08/2017 53 widyanti v v
54 eni v
55 rani v
56 cintia v
57 nurani v
5 1
09/08/2017 58 widyanti v
59 linggam v v
60 titin v v
61 ira v v
62 evi v v
63 ani v v
6 5
10/08/2017 64 widyawati v
65 ira v v
66 eli/beni v v
67 fenty v v
68 eli/asep v v
69 titin v v
70 ai m v
71 linda v v
8 6
11/08/2017 72 eli/beni v
73 fenty v v
74 eli/asep v v
75 ai m v v
76 anggie v v
77 koningah v
78 linda v v
79 teni v v
80 tina v
81 vini v v
82 windriyani v
83 marwati v v
84 devi v
85 amanda v
86 tita v v
15 9
12/8/2017 87 devi v
88 ai m v
89 siti julaeha v
90 marwati v v
91 teni v
92 amanda v
93 tita v
94 dewi v
95 sri seskya v v
96 anggie v
97 risna v v
98 vini v v
99 ai faridah v v
13 5
13/8/2017 100 dusti v v
101 amanda v
102 rany v
103 dewi v
104 gabrielle v v
105 risna v v
106 irma v v
107 ai faridah v
108 sri s v v
9 5
14/08/2017 109 gabrielle v
110 rany v v
111 dewi v v
112 runi v v
113 risna v v
114 irma v v
6 4 1
15/08/2017 115 rista v v
116 suryani v
117 eva v
118 rany v
119 runy v v
120 nurlaela v
121 filda v v
122 dinar v
123 intan v
9 3
16/8/2017 124 rista v v
125 erlin v v
126 elli v v
127 maya v
128 nurlaela v
129 filda v v
130 intan v
131 dinar v
8 4
17/8/2017 132 ros enros v v
133 deasy v
134 astri v
135 nurlela v
136 rinrin v
137 elvia v
6 1
18/8/2017 138 inin v v
139 ros enros v v
140 astri v
141 fitri v v
142 leni v v
143 rinrin v
144 ani v
7 4
19/8/2017 145 rahma v
146 ani v v
147 lindiani v v
148 ros enros v v
149 elsy v v
150 susilawati v
151 fitri v v
152 dewi v v
8 6
20/8/2017 153 nenden v
154 susilawati v
155 ros enros v
3
21/8/2017 156 erma v v
157 nurani v v
158 atik v v
159 putri v
160 dewi v v
161 peti v v
6 5
22/8/2017 162 atik v v
1 1
23/8/2017 163 ai m v v
164 irma v v
165 dinar v
3 2
24/8/2017 166 risna v v
167 indri v
168 irma v v
169 ani v
170 neng rina v
5 2
25/8/2017 171 nina v v
172 nurhamalin v
173 irma v v
174 neng rina v
175 hani v v
5 3
26/08/2017 176 sri sarbini v v
177 nina v v
178 dahlia v v
179 dewi v v
180 rinawati v v
181 yeni v
182 tita v v
183 hani v
184 isye v v
9 7
27/8/2017 185 sri sarbini v
186 dahlia v
187 dewi v
188 sari v v
189 ratu felisha v v
190 ani v
191 isye v v
7 3
28/8/2017 192 selvi v
193 upi v v
194 sari v
195 ani v
196 warliani v v
197 isye v
198 millati v v
7 3
29/8/2017 199 ilah v v
200 heni v
201 warliani v
202 imas v v
203 millati v v
204 evi v v
6 4
30/08/2017 205 imas v v
206 evi v v
207 Defira v
208 pasca v v
209 winni v v
210 tini v
6 4
31/08/2017 211 intan v v
212 natia v
213 mutia v v
214 pasca v
215 siti rodiah v v
216 winni v v
217 atik v v
218 tati v v
8 6
216 122 1 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT SEPTEMBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2017 1 Linda v
2 Remi v v
3 Cucu v v
4 siti rodiah v
5 tini v
6 winni v v
7 tati v
8 natia v
9 mutia v
9 3
02/09/2017 10 remi v
11 cucu v v
12 winni v
13 linda v v
14 rita v v
15 nova v v
16 septi v v
7 5
03/09/2017 17 linda v v
18 nina v v
2 2
04/09/2017 19 dewi v v
20 lilis v v
21 sri v
22 ilis v v
23 annisa v v
24 margareta v v
6 5
5/9/2017 25 annisa v v
26 margareta v v
27 ilis v v
28 lilis v v
29 sri v
30 dewi v v
31 yuniasari v v
32 lilis v v
33 sinta v v
34 melinda v v
10 9
06/09/2017 35 yuniasari v
36 lilis v
37 sinta v
38 neni v
39 iip v v
40 siti aisyah v v
41 nurendah v
42 noni v v
43 yosa v
44 melinda v v
10 4
07/09/2017 45 iip v v
46 siti aisyah v v
47 nurendah v
48 noni v v
49 sukaesih v v
50 cyndi v
51 lusi v
52 midauliana v v
8 5
08/09/2017 55 sukaesih v v
56 nova v v
57 cyndi v
58 rin rin v v
59 lusi v
60 emilia v v
61 dini v v
62 nia v v
8 6

09/09/2017 63 cyndi v
64 lusi v
65 fitri v
66 nova v
67 emilia v
68 riska v
69 popy v
70 dini v v
71 susanti v v
72 nia v
10 2
10/09/2017 73 fitri v
74 nelis v v
75 kristina v v
76 lina v
4 2
11/09/2017 77 fitri/denny v v
78 fitri v
79 cucu v
80 kristina v
81 nelis v
82 sinta v v
83 tiara v v
84 winda v v
8 4
12/09/2017 85 fitri/denny v
86 sinta v
87 tiara v
3 0
13/09/2017 88 herlina v v v
89 wulan v v
2 2 1
14/09/2017 90 herlina v v
91 R witania v v
92 euis v v
93 ani v
94 wulan v
4 3
15/9/2017 95 euis v
96 ani v
97 R Witania v
98 wulan/rian v v
99 astri v v
100 siti kulsum v v
6 3
16/9/2017 101 anggi v v
102 wulan v
103 neng tuti v
104 yani rahayu v v
105 irni v v
106 siti kulsum v
107 khomsiah v v
108 icha v v
8 5
17/09/2017 109 anggi v v
110 irni v v
111 ia v v
112 rena v
113 arty v v
114 khomsiah v
115 icha v
7 4
18/09/2017 116 herlina v v
117 anggi v v
118 ia v
119 rena v
120 irni v v
121 rini v v
122 yuliawati v v
123 arty v
124 tursini v
125 adhinda v v
126 tati v
127 siti jenab v
12 6
19/09/2017 128 rini v v
129 amanda v v
130 fenti v v
131 helmi v v
132 yuliawati v v
133 adhinda v v
134 siti jenab v
135 kurnia v v
136 oom v v
9 8
20/09/2017 137 euis v
138 amanda v
139 helmi v v
140 fenti v
141 marliana v v
142 aisah v v
143 fazrin v v
144 mala v v
145 aryanti v v
146 entang v
147 nurya v v
148 kurnia v v
149 adhinda v v
150 elis v v
151 oom v v
152 dewi v
16 11
21/09/2017 153 ai kulsum v
154 vera v
155 marliana v
156 aisah v
157 fazrin v
158 aryanti v v
159 dewi v
160 elis v
161 oom v v
9 2
22/9/2017 162 santi v
163 rani v
164 oom v v
165 lina v v
166 riska v v
5 3
23/9/2017 167 tia v
168 neneng v v
169 vidia v v
170 desi v v
171 kurnia v
172 lina v v
173 riska v
174 dede v
175 mailitina v v
9 5
24/09/2017 176 vidia v
177 tia v
178 ai sari v v
179 herlina v v
180 kurnia v
181 desi v v
182 mailitina v
7 3
25/09/2017 183 erni v v
184 santi v v
185 ani v
186 ai sari v v
187 rena v
188 herlina v v
189 wiwin v v
190 emi v v
191 desi v v
192 leni v
10 7
26/09/2017 193 yuningsih v v
194 santi v v
195 wiwin v v
196 nita v
197 ai sari v v
198 leni v
199 oeij v
200 wulan v
201 emi v
202 shiva v v
10 5
27/9/2017 203 wiwin v v
204 yosi v v
205 ani v v
206 nita v
207 mira v
208 rosweliyah v v
209 indah v v
210 leni v v
211 wulan v
212 shiva v
10 6
28/9/2017 213 rani v
214 dewi v
215 erna v v
216 wiwin v v
217 yosi v
218 mira v
219 indah v
220 leni v
221 wulan v
222 santi v v
223 rosweliyah v v
11 4
29/9/2017 224 imas v v
225 pipih v
226 erna v v
227 mira v
228 rida v v
229 lala v
230 ratih v
231 santi v v
232 ockta v
233 rosweliyah v v
10 5
30/9/2017 234 ratih v v
235 peny v
236 rida v
237 lala v
238 ani budiasih v
5 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT OKTOBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2017 1 Ella v v
2 Lia v
3 Susi v
4 Afrida v v
5 Diana v v
6 Hadimah v v
7 nia v v
8 sutirah v v
9 nopi v v
10 Lala v
11 yani v v
11 8
02/10/2017 12 Ella v v
13 Lia v v
14 Hadimah v v
15 Yani v
16 Afrida v
17 nopi v
18 masniar v
19 mimin v
8 3
03/10/2017 20 Lia v v
21 Hadimah v v
22 Roshinta v v
23 evi v v
24 reni v
25 yuliati v v
6 5
04/10/2017 26 nurlia v
27 dessy v v
28 Roshinta v
29 erliyana v
30 sri handayani v v
31 iis v
32 vany v
7 2
05/10/2017 33 midaulyna v v
34 asyyida v v
35 handayani v v
36 dessy v v
37 diah v
38 karlina v v
39 yuli v
40 sri handayani v
8 5
06/10/2017 41 neneng andriani v v
42 asysyida v
43 midaulyna v
44 handayani v
45 mia v
46 karlina v
47 yuli v
48 rika v
49 heni v
50 susilawati v v
10 2
07/10/2017 51 oom v
52 fanny v v
53 kokom v
54 neneng v
55 susilawati v
56 hartanti v v
6 2
08/10/2017 57 sari v v
58 pipeu v v
59 rani v v
60 hartanti v
4 3
9/10/2017 61 priskila v v
62 melly v v
63 novi v
64 sari v v
65 ai marlia v v
66 atikah v v
67 rani v
68 pipeu v
69 gita v v
9 6
10/10/2017 70 priskilla v v
71 melly v
72 evit v v
73 ai marlia v
74 atikah v
75 gita v
76 ani s v v
77 leni v v
78 sangadah v
79 RA Hana v
10 4
11/10/2017 80 evit v
81 ani s v
82 leni v
83 lani v v
84 fitri v v
85 cut yuna v
86 rini v v
7 3
12/10/2017 87 yulianti v
88 susi susilawati v
89 yati v v
90 fitri v v
91 dedeh v v
92 cut yuna v
93 rike v v
94 heni v v
95 irmawanti v v
96 rini v v
97 rika v v
98 lani v
99 nenden v v
13 9
13/10/2017 100 sadiyah v
101 yati v v
102 dedeh v v
103 selvy v
104 rike v v
105 cindy v v
106 heni v
107 rika v v
108 nenden v v
9 6
14/10/2017 109 retnowati v
110 cindy v v
111 teti v
3 1
15/10/2017 112 marsinem v
113 iin v v
114 nurdini v v
3 2
16/10/2017 115 marsinem v
116 iin v v
117 kethi v
118 nia v v
119 nurdini v
120 kethi v
121 rinrin v v
122 neneng patmi v
123 neng susilawati v
9 3
17/10/2017 124 siti fatimah v v
125 marsinem v
126 suminah v v
127 nia v v
128 rinrin v v
129 yeni v v
130 kethy v
131 rinrin v v
132 via v v
133 rini/yayat v
10 7
18/10/2017 134 via v v
135 dewi v v
136 femmy v
137 leni v v
138 nenden v
139 siti G V V
140 Delita v
141 fatimah v
142 rini v v
143 rini/yayat v
144 nia v v
11 6
19/10/2017 145 leni v
146 eni v v
147 via v v
148 dewi v v
149 ati v v
150 siti G v v
151 sunarti v
152 rini v
153 desi v v
9 6
20/10/2017 154 eni v v
155 desi v
156 ati v v
157 risty v
158 susi v v
159 yani v v
160 susi R v
161 suminah v
161 nurhaeni v v
162 masriva v v
10 6
21/10/2017 163 susi v
164 yani v
165 ati v
166 santi v v
167 risty v
168 masriva v
169 nurhaeni v v
7 1 1
22/10/2017 170 tina v
171 omah v v
2 1
23/10/2017 172 via v v
173 rika v v
174 masitoh v v
175 omah v
4 3
24/10/2017 176 iip v
177 via v v
178 lisdiana v v
179 milda v v
180 rika v v
181 rina v v
182 yuni v v
183 gina v v
8 7
25/10/2017 184 milda v
185 rika v v
186 rina v v
187 nurazizah v v
188 gina v
189 milia v
190 ibah v
191 juju v
192 santi v
193 niken v v
10 4
26/10/2017 194 ridha v
195 lisa v
196 cucu v v
197 niken v
198 yuni v v
199 annisa v v
200 siti v v
201 nurazizah v
202 gina v
203 rina v v
204 meli v
11 5
27/10/2017 205 cucu v v
206 annisa v
207 siti v
208 rani v v
209 rina/novan v
210 rina/endang v v
211 meliawati v
212 ipah v
8 3
28/10/2017 213 rani v v
214 rina v v
215 nurul v
216 ipah v v
217 windriyani v v
218 meliawati v
219 rina/endang v
7 4
29/10/2017 220 liliawati v v
221 meliawati v
222 rika v v
223 windriyani v v
224 ipah v v
225 wiwin v
6 4
30/10/2017 226 siti pupu v
227 rika v
228 cucu v v
229 wiwin v
230 syifa v
5 1
31/10/2017 231 cucu v v
232 lilis v v
233 yuli v
3 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT NOVEMBER 2017


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2017 1 Sahra v
2 sari v v
3 lina v v
4 fenti v
5 hasni v v
6 eneng sumiati v v
7 fitriani v
8 marcella v v
9 puji v
10 via v v
11 hasni v v
12 nenden v v
12 8
02/11/2017 13 sahra v v
14 sesilia v v
15 sheny v
16 susanti v
17 sari v v
18 fenti v
19 mintarsih v v
20 eneng v
21 marcella v
22 via v v
23 hasni v v
24 nenden v v
12 7
3/11/2017 25 fransisca v
26 sahra v
27 sesilia v v
28 fenti v
29 mintarsih v
30 dini v
31 nuriva v
32 siti nurjanah v v
8 2
04/11/2017 33 santi v
34 siti nurjanah v
35 nuriva v
3 0
05/11/2017 36 Ranti v v
37 nuriva v
38 ani v v
39 euis v
40 hesty v v
5 3
06/11/2017 41 Ranti v
42 ani v
43 ela v v
44 maya v
45 rida v v
5 2
07/11/2017 46 ela v
47 maya v v
48 lilis v
49 dian v v
50 neng nani v
51 tintin v
6 2
08/11/2017 52 nining v v
53 nita v
54 dea v
55 neng nani v
56 sri v v
57 dian v
6 2
09/11/2017 58 sri v v
59 siti saadah v v
60 neng nani v
61 siti j v v
62 maesaroh v v
4 4 1
10/11/2017 63 imas v
64 siti a v v
65 desi v v
66 maesaroh v
67 susi v
68 elis v
69 fitri v
70 cucu v
71 siti H v v
7 4
11/11/2017 72 dita v
73 nursanti v
74 Siti H v v
75 sri marlia v
76 cucu v
77 siti a v v
78 desi v
79 fitri v
80 ida v
81 maesaroh v
10 2
12/11/2017 82 tika v v
83 cucu v
84 siska v v
85 rima v v
4 3
13/11/2017 86 tika v v
87 ratih v
88 liarasanti v
89 mutiara v
90 siska v
91 ratna v v
92 entin v
7 2
14/11/2017 93 vebi v v
94 ratna v v
95 entin v
96 susilawati v v
97 fitri v
98 maya v
99 tating v
100 tuti v v
8 4
15/11/2017 101 maya v
102 susilawati v v
103 solihat v v
104 tini v v
105 tuti v
106 irawati v v
107 yuliana v v
108 entin v
109 vebi v v
110 yeni v v
10 7
16/11/2017 111 yuliana v v
112 tini v v
113 rini v v
114 irawati v
115 santi v v
116 imas v v
117 yeni v v
7 6
17/11/2017 118 rini v
119 imas v v
120 santi v
121 rohaeti v v
4 2
18/11/2017 122 rifa v
123 melis v
124 sifa v v
125 rohaeti v
126 ria v
127 rifa v
128 risa v
7 1
19/11/2017 129 erlin v v
130 rifa v
131 melis v
132 adinda v
133 sifa v
134 liza v v
135 rahayu v v
136 yulianingsih v
137 rina v v
138 risa v
139 nenden v
11 4
20/11/2017 140 erlin v v v
141 rifa v
142 hanny v v
143 ria v v
144 leni v
145 erika v v
146 rina v v
147 rahayu v
148 risa v
149 nur uviyah v
10 5 1
21/11/2017 150 erlin v
151 rifa v
152 ria v v
153 lina v v
154 nenden v
155 erni v
156 wati v
157 nurmayanti v v
158 nur uviyah v
159 lina v v
160 wartini v v
9 5
22/11/2017 161 dini v v
162 suci v
163 fitri v v
164 otih v
165 erni v
166 wati v
167 nurmayanti v v
168 nur uviyah v
169 lina v
170 wartini v
10 3
23/11/2017 171 sri v v v
172 mela v
173 wina v
174 indri v v
175 dini v v
176 meliawaty v
177 isma v v
7 4
24/11/2017 178 meliawaty v
179 neni v
180 maudina v
181 ika v v
182 ria v
5 1
25/11/2017 183 siti jubaedah v
184 tri v v
185 nining v v
186 yati v v
187 dini v
188 endang v v
189 maudina v
7 4
26/11/2017 190 evi v
191 nining v v
192 nurul v v
193 sri v
4 2
27/11/2017 194 ati v v
195 neng sulastri v
196 tintin v v
197 neng rani v v
198 dwi v v
199 nining v v
200 isa v
201 imas v v
202 hesti v
9 6
28/11/2017 203 susan v
204 laely v v
205 peni v v
206 diva v v
207 ika v
208 regina v
209 hesti v v
210 ningrum v
211 cucu v v
9 4 1
29/11/2017 212 putty v
213 laely v v
214 diva v v
215 ika v
216 regina v
217 ellke v v
218 cucu v
219 ningrum v
7 3 1
30/11/2017 220 Putty v
221 siti N v v
222 sri v v
223 mega v
224 herlina v v
225 nurhayati v v
6 4
FORMAT SURVEY HARIAN PEMAKAIAN ALAT DESEMBER 2017
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2017 1 imas v v
2 Desi v v
3 lina v
4 debi v v
5 putty v
6 sri v v
7 siti n v v
7 5
02/12/2017 8 imas v v
9 desi v v
10 debi v v
11 lenekeu v v
12 nurhasanah v
13 rika v v
6 5
03/12/2017 14 imas v v
15 sari v
16 debi v v
17 lenekeu v
18 mery v
19 nurhasanah v
20 rika v
21 siti m v v
8 3
04/12/2017 22 imas v
23 debi v v
24 devi v v
25 siti m v
26 nurhasanah v
27 melani v
28 dini v v
29 imas v v
8 4
05/12/2017 30 annisa v v
31 sari v v
32 fuji v v
33 melani v
34 debi v v
35 rina v
36 ika v v
37 sri w v
38 dini v v
39 imas v v
10 7
06/12/2017 40 lina v v
41 any v v
42 novia v
43 melani v
44 ika v
45 nurhasanah v
46 sari v
47 susi v v
48 annisa v
9 3
07/12/2017 49 santi v v
50 intan v v
51 novia v v
52 kokom v
53 susi v v
5 4
08/12/2017 54 irma v v
55 yuliana v
56 herti v v
57 wulan v v
58 uun v v
59 novia v v
60 yulia v
61 intan v
8 5
09/12/2017 62 ida v v
63 yulia v v
64 hani v
65 wulan v v
66 risna v
5 3
10/12/2017 67 defi v
68 linda v
69 penni v v
70 ruli v
71 ida v
72 yustina v v
73 sri v
74 dini v
8 2
11/12/2017 75 lia v v
76 lilis v
77 penni v v
78 yois v v
79 ike v
80 hani v
81 ruli v
82 reni v v
7 3
12/12/2017 83 teti v v
84 lia v v
85 titin v
86 hani v v
87 yois v v
88 ruli v
89 reni v v
7 5
13/12/2017 90 nurhasanah v
91 neneng erna v
92 cucu v
93 dewi v v
94 nurhayati v
95 sylvia v v
96 sri wulan v v
97 hanna v
98 titin v
99 ira v
10 3
14/12/2017 100 mega v
101 ayu v
102 hestila v v
103 nurhasanah v v
104 regina v v
105 arti v v
106 sella v
107 sylvia v v
108 mala v v
9 6
15/12/2017 109 dewi v v
110 tita v
111 teteh ema v v
112 Sri lestari v v
113 yulia v v
5 4
16/12/2017 114 dewi v
115 sri L v
116 Dedeh v v
117 yulia v v
118 mulyasari v v
119 teteh ema v v
120 susi v
7 4
17/12/2017 121 karmila v v
122 dewi v v
123 teteh ema v v
124 dedeh v
125 yeshy v v
5 4
18/12/2017 126 erna v v
127 dewi v v
128 atik v v
129 sri isna v
130 iis v
131 yeshy v
132 erin v v
133 Rosdiani v
134 maharani v
135 siti muflihah v v
10 5
19/12/2017 136 maharani v
137 siti muflihah v v
138 erin v v
139 juantini v
140 rina v v
141 erna v v
142 lilis v v
143 atik v v
8 6
20/12/2017 144 mulyanah v
145 arni v v
146 risma v v
147 wulan v
148 rina v v
149 atik v v
6 4
21/12/2017 150 arni v
151 mulyanah v
152 susiyanti v v
152 risma v v
153 rina v v
154 maryani v v
155 rina/deden v v
156 veti v
8 5
22/12/2017 157 mulyanah v
158 novianti v v
159 susiyanti v v
160 rina/deden v v
161 maryani v v
162 veti v
6 4
23/12/2017 163 Fitri v v
164 herawati v
165 tessa v
166 sri r v v
167 ayudya v
168 juliana v
169 novianti v
170 eva v v
171 nelis v v
9 4
24/12/2017 172 astri v
173 lina v v
174 tessa v
175 sri r v
176 juliana v
177 erni v v
178 nelis v v
7 3
25/12/2017 179 widawati v v
180 eka v
181 ratna v
182 lina v
183 tessa v
184 erni v v
185 eva v
186 juliana v
187 nelis v v
188 meylis v v
189 nela v v
11 5
26/12/2017 190 tesa v
191 herlina v v
192 ratna v
193 yanyan v v
194 nela v
195 meylis v v
6 3
27/12/2017 196 nyimas v
197 yanyan v v
198 yulianti v v
199 marisa v v
200 widya v v
201 erni v v
202 widaeni v v
203 wulandarini v
8 6
28/12/2017 204 reni v
205 hana v v
206 nyimas v v
207 iis v v
208 rimbun v v
209 siti n v v
210 marisa v v
211 widya v v
212 erni v v
213 widaeni v v
214 wulandarini v v
215 nining v v
216 wiwi v
13 11
29/12/2017 217 yanti v
218 lucy v v
219 nining v v
220 reni v
221 iis v
222 sri v
223 rimbun v v
224 rima v v
225 rian v v
9 5
30/12/2017 226 nilam v
227 rima v
228 rian v
229 lucy v v
230 sri yulianti v v
231 jean v v
6 3
31/12/2017 232 ucu v
233 laili v
234 jean v
235 sri yulianti v
4
134
Ruang VK - RSKIA - Februari 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2015 1 NY RIZA V
2 NY SITI F V
Y 3 NY ERMA V V
4 NY APRIYANTI V
5 NY ANI V
6 NY RAHMAYANI V
JUMLAH 6 1

02/02/2015 1 NY LENI Y V
2 NY IIS SUGIARTI V
3 NY SITI A V V
4 NY SITI N V
5 NY RATNA V
JUMLAH 5 1

03/02/2015 1 NY NOVI A V
2 NY METI V
3 NY SITI NURLAELA V
4 NY NOPIANI V V
JUMLAH 4 1

05/02/2015 1 NY IMAS V
2 NY MILDA V
3 NY ELAH V V
4 NY WINDA V
JUMLAH 4 1

06/02/2015 1 NY WULAN V
2 NY IMAS V
3 NY HERNI V
4 NY YUAN V
JUMLAH 4

07/02/2015 1 NY RINA V
2 NY ULFAH V
3 NY ERLY V
4 NY RURI V
5 NY HERNI V
6 NY KIKI V
7 NY KARTINI V
JUMLAH 7

08/02/2015 1 NY ENOK SITI V


2 NY RURI V
3 NY SELVIRA V
4 NY NANI V
5 NY YULIANTI V V
JUMLAH 5 1

09/02/2015 1 NY INA V
2 NY ROSTINAH V
3 NY WATI V
4 NY YULIANTI V
5 NY ANI R V
JUMLAH 5

11/02/2015 1 NY INDAH V
2 NY DWI V
3 NY ENENG F V
4 NY YENI * V V
5 NY NIA V
6 NY TITA V
7 NY RISMA V
8 NY HENI V V
9 NY SITI JUBAEDAH V
JUMLAH 9 1 1

12/02/2015 1 NY NURYANI V
2 NY LIA V
3 NY SITI V
4 NY SILMI V
5 NY ASTRI V
6 NY YULIA V
JUMLAH 6

13/02/2015 1 NY MERI V
2 NY EMPAT V
3 NY KIKI V
4 NY RIMA V
5 NY SRI V
6 NY DEWI V
7 NY SITA V
JUMLAH 7

14/02/2015 1 NY DIANA V V
2 NY IIS V
3 NY ANA V
4 NY TINI V
JUMLAH 4 1

16/02/2015 1 NY SARI V
2 NY SRI V
3 NY MANIK V
4 NY ANIH V
5 NY ANI H V V
JUMLAH 5 1

17/02/2015 1 NY ANIH V
2 NY SITI N V
3 NY CINTA V
4 NY RISA V
5 NY YATI V
JUMLAH 5

18/02/2015 1 NY RISA V
2 NY YATI V
3 NY DEWI V
4 NY RIZKIYAH V
5 NY FITRI V
6 NY MEGA S V
7 NY VINI V
8 NY LINA V V
9 NY TINA V V
JUMLAH 9 2

19/02/2015 1 NY SITI FATIMAH V


2 NY QONITA V
3 NY NENG RINA V
4 NY NURBAYANTI V V
5 NY FUJIANTI V
6 NY LINA V
JUMLAH 6 1

21/02/2015 1 NY RIA V
2 NY ISTI V
3 NY CUCU V
4 NY RANI V
5 NY TRESNA V
JUMLAH 5

22/02/2015 1 NY LISNAWATI V
2 NY CUCU V
3 NY AJENG V
4 NY YULIANTI V
5 NY YENI V
6 NY TRIKA V
7 NY SITI K V
8 NY MURLENSIS V V
9 NY PERA V
JUMLAH 9 1

24/02/2015 1 NY SEPTI V
2 NY TINI V
3 NY DEDE S V
4 NY SRIYANTI V
5 NY IMAS V V
JUMLAH 5 1

25/02/2015 1 NY MAYA V
2 NY IMAS V V
3 NY ANI V
4 NY NURHAYATI V
5 NY NURATMI V V
JUMLAH 5 2

27/02/2015 1 NY TINI V
2 NY SUNDARI V
3 NY NY IIS M V
4 NY IA YAYAH V
5 NY MIMIN V
JUMLAH 5

TOTAL 120 12 4
TOTAL PASIEN 249

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - Maret 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2015 1 NY KRISTIANI V
2 NY RINA V
3 NY EVA SITI V
4 NY HESTI V
JUMLAH 4

02/03/2015 1 NY NIA AUDINA* V V


2 NY YAYAH V
3 NY DIANTI V
4 NY REMAYANTI V
5 NY NINA* V V
6 NY RETNO V
7 NY YOYOH V
8 NY SUPRIYATI V
JUMLAH 8 2

05/03/2015 1 NY NENGKY V
2 NY HANI V
3 NY NURWATI V
4 NY NOVI V
5 NY KANIA V
JUMLAH 5

06/03/2015 1 NY SANTI V V
2 NY SITI ROHMAH V
3 NY NENDEN V
4 NY ANA V
5 NY SISKA V
JUMLAH 5 1
09/03/2015 1 NY SITI SOPIAH V V
2 NY SRI V V
3 NY ATIKAH V
4 NY DEWI V
5 NY EVI V
JUMLAH 5 2

10/03/2015 1 NY WIWIN V
2 NY SULASTRI V
3 NY DARMAYANTI V
4 NY YULI V
5 NY EMMA V
6 NY NURAINI V V V
7 NY SITI HANIFAH V
8 NY NURHERNAWATI V
9 NY ROTUPA V
JUMLAH 9 1 1

13/03/2015 1 NY NURSANTI V
2 NY CINTA V
3 NY TARINAH V
4 NY SORAYA V V
5 NY ANA V
6 NY IYAM V
JUMLAH 6 1

14/03/2015 1 NY MARTINI V
2 NY FADIAH V V
3 NY TITIN V V
4 NY YANTI V
5 NY ELAH V
JUMLAH 5 1 1

15/03/2015 1 NY KUSTINAH V
2 NY IAM V
3 NY DINNI V
4 NY NENI V V
5 NY MILA V
6 NY SINTA V
JUMLAH 6 1
18/03/2015 1 NY SANTI V
2 NY KERIN V V
3 NY YATI V
4 NY NINGRUM V
5 NY DEVI V
6 NY SITI ROPIAH V
7 NY DIAN V
8 NY NASROH V
9 NY SRI WENDA V
JUMLAH 9 1

19/03/2015 1 NY TITA V
2 NY RAHMAYANI V
3 NY GITA V
4 NY HESTI V
5 NY SRIWENDA V
6 NY NIA V
JUMLAH 6

20/03/2015 1 NY SOFIA V
2 NY NIA SURYANI V
3 NY CHOSIMAH V V
4 NY ELIS V
5 NY ELA V
JUMLAH 5 1

21/03/2015 1 NY NINING V
2 NY CINCIN V V
3 NY DEDE V V
JUMLAH 3 1 1

23/03/2015 1 NY ADE V
2 NY WULAN V
3 NY RINI V V
4 NY SETIATI V
5 NY RINI V
6 NY SUSI V
JUMLAH 6 1

24/03/2015 1 NY RINRIN V
2 NY SANNY V
3 NY YUNI V
4 NY IDA MARLINA V
5 NY IIM V
6 NY SUMIATI V
JUMLAH 6

26/03/2015 1 NY LINDA V
2 NY LILIS V
3 NY EUIS NURUL V
JUMLAH 3

27/03/2015 1 NY YULIA V
2 NY WINDA V
JUMLAH 2

28/03/2015 1 NY ITA F V
2 NY LISNIAWATI V V
3 NY DETI V
4 NY NANI V
5 NY DINI V
6 NY YUNENGSIH V
JUMLAH 6 1

31/03/2015 1 NY EVA V
2 NY YULI V
3 NY WNA V
4 NY ERNI V V
JUMLAH 4 1

JUMLAH TOTAL 103 13 5


TOTAL PASIEN 266

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - APRIL 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2015 1 NY AI RUKMINI V
2 NY ETI V
3 NY TATI V
4 NY ERNI V V
5 NY NENDAH V
JUMLAH 5 1

02/04/2015 1 NY LITA V
2 NY FARAZVESTIA V V
3 NY TIKA V
4 NY PATMAWATI V V
5 NY YENTI V V
JUMLAH 5 2 1

03/04/2015 1 NY SANTI V
2 NY ROHAENI V
3 NY RINI V
JUMLAH 3

05/04/2015 1 NY PITRIA V
2 NY IPAH V
3 NY NURSAADAH V
4 NY WIWIN V
JUMLAH 4

06/04/2015 1 NY TITIN V
2 NY EVI V V
3 NY NANI V V
JUMLAH 3 2

08/04/2015 1 NY VENI V
2 NY KOKOM V
3 NY ERNI V
4 NY YUNITA V
5 NY MULYANI V
6 NY SUMIATI V
JUMLAH 6

11/04/2015 1 NY NITA V /
2 NY MULYANI V V V
3 NY ARNI V
4 NY YENI V
JUMLAH 4 1 1

12/04/2015 1 NY YENI V
2 NY FITRI V V
3 NY SUSANTI V
4 NY DAHLIA V
JUMLAH 4 1

13/04/2015 1 NY DIAH V
2 NY VIKY V V
3 NY KRISTIANA V
4 NY AI ELI V
5 NY SUSAN V
JUMLAH 5 1

16/04/2015 1 NY PURWATI V
2 NY DENNY V
3 NY YENI V
4 NY SYAMSIAH V
5 NY YULIANTI V
JUMLAH 5

17/04/2015 1 NY WIWIN V
2 NY YULIANTI V
3 NY RATNA V
4 NY RATIH V
5 NY NINA V V
6 NY RISSA V
7 NY DESSY V
8 NY RIRI V
JUMLAH 8 1

18/04/2015 1 NY IIM V V
2 NY SURYATI V
3 NY ELIA V
4 NY IMAS V
5 NY ERTI V
6 NY AISYAH V V
JUMLAH 6 2

19/04/2015 1 NY IMAS V
2 NY LENI V
3 NY ROSI V V
4 NY ALFIATUS V
5 NY AISYAH V V
6 NY RUSMIASIH V
7 NY SULASTRI V
8 NY NIA V
9 NY DESTI V
10 NY SITI J V V
11 NY AWANG V
12 NY VENI V
13 NY KANTINI V
JUMLAH 13 2 1

22/04/2015 1 NY NENDAH V
2 NY SITI V
3 NY YULIA V
4 NY TIAN V
5 NY NINING V V
JUMLAH 5 1

23/04/2015 1 NY NURENDAH V
2 NY MULYATI V V
3 NY HARTINI V
4 NY IMAS V
JUMLAH 4 1

24/04/2015 1 NY DEVI V V
2 NY NANI V
3 NY RINI V
4 NY YUNENGSIH V
5 NY RENI V
6 NY ENENG V
JUMLAH 6 1

27/04/2015 1 NY RENI V
2 NY INDRI V
3 NY YANI V
4 NY NORMA V
5 NY SRI SUNARTI V
6 NY WIWIN V
JUMLAH 6

28/04/2015 1 NY WANTI V
2 NY YANI V
3 NY WIWIN V
4 NY DIANA V V
5 NY NUR V V
6 NY KANIA V
7 NY AI LINDA V V
JUMLAH 7 3
29/04/2015 1 NY DIANA V V
2 NY WIWIN V
3 NY RINA V
4 NY ENDAH V V
5 NY DETI V
6 NY TITIN V V
7 NY NINA V
8 NY SITI V
JUMLAH 8 2
30/04/2105 1 NY FITRI V
2 NY RINA V
3 NY WIKEU V V
4 NY HETI V
5 NY NINA V
6 NY NIA V
7 NY DETI V
8 NY TETI V
JUMLAH 8 1

JUMLAH TOTAL 107 22 4


JUMLAH PASIEN 270

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - MEI 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
02/05/2015 1 NY NANI V V
2 NY UMILAH V
3 NY FERAWATI V
4 NY IIS V
5 NY DEDEH V
6 NY WULAN V
JUMLAH 6 1

04/05/2015 1 NY FERAWATI V
2 NY ELIS V
3 NY YENI V
4 NY SITI V
JUMLAH 4

06/05/2015 1 NY EMA V
2 NY ANITA V
3 NY SUMIATI V
4 NY ROHANI V V
5 NY KARTINA V
6 NY RINA V
JUMLAH 6 1

07/05/2015 1 NY NY OOM K V
2 NY MULYATI V
3 NY CANDRA V
JUMLAH 3

08/05/2015 1 NY NELY V
2 NY LISNAWATI V
3 NY ILIS V V
4 NY ISYANA V V
5 NY ERNI V
6 NY RIRIN V
JUMLAH 6 1 1

09/05/2015 1 NY YANI V
2 NY RIRIN V V
3 NY SITI A V
4 NY ENENG V /
5 NY LILIS V
JUMLAH 5 1

10/05/2015 1 NY ROSALINA V
2 NY RENI V V
3 NY YULIS V
4 NY SITI ROKAYAH V V
5 NY YUPI V
6 NY ANI M V V
7 NY SANTI V
JUMLAH 7 2 1
\
13/05/2015 1 NY NY NITA V
2 NY YANI V
3 NY DENIA V
4 NY TINAH V V
5 NY LIA V
6 NY ELSA V
7 NY KRISTIANTI V
8 NY TINAH V V
9 NY AZFIA V
10 NY RISMA V
11 NY MARYANI V
JUMLAH 11 2

14/05/2015 1 NY LESTARI V
2 NY YENI V
3 NY ROSITA V
4 NY ROSI V
5 NY NINA V V
6 NY LENI V
7 NY DIAN V
JUMLAH 11 1

15/05/2015 1 NY SANTI V
2 NY ROSI V
3 NY AYUNI V
4 NY PIPIT V
5 NY FRITIANI V
6 NY HENNY V
JUMLAH 6

16/05/2015 1 NY DINA V
2 NY RINA V
3 NY DATI V
4 NY ROSI V
5 NY TUTI V
6 NY WARTINI V
7 NY NIA V
8 NY SITI SAMSIAH V
JUMLAH 8

17/05/2015 1 NY SUHAYATI V
2 NY TITIN V
3 NY DEDEH V V
4 NY LILIS V V
5 NY NANI V
6 NY SUGIH V
JUMLAH 6 2

18/05/2015 1 NY ROSDIANA V
2 NY SUGIH V
3 NY YENI V V
4 NY RESTU V
5 NY CICI V V
6 NY FANI V
7 NY ENDANG V
JUMLAH 7 2

19/05/2015 1 NY YATI V
2 NY SUSANTI V
3 NY EPON V
4 NY DESI V
5 NY BELLA V
6 NY MARFUAH V V
JUMLAH 6 1

20/05/2015 1 NY SUTARMI V
2 NY NURAENI V
3 NY ANISHA V
4 NY YAYU V
JUMLAH 4

21/05/2015 1 NY NURLAELA V
2 NY SRI PUJI V
3 NY YAYU V
4 NY LENI V V
5 NY SANTI V V
6 NY ROHANI V
JUMLAH 6 2

22/05/2015 1 NY ALI V
2 NY ROHANI V
3 NY SITI PAIDAH V
4 NY MUTIARA V
5 NY SANTI V V
6 NY SUSAN V
7 NY DEWI V
8 NY NENG H V
9 NY LINI V
10 NY DEWI SUSANTI V
JUMLAH 10 1

23/05/2015 1 NY SITI PAIDAH V


2 NY NENG H V
3 NY LINI V
4 NY GUMIATI V
5 NY DEWI SUSANTI V
6 NY SANTI V V
7 NY DEWI SITI v
8 NY SENI V
9 NY DEDE V
10 NY YUSMIATI V V
11 NY SITI AMINAH V V
JUMLAH 11 3

24/05/2015 1 NY PITRI V
2 NY IIS V
3 NY YUSMIATI V V
4 NY SITI AMINAH V V
5 NY PUTRI V V
6 NY ERISTIAN V
7 NY RIKAWATI V V
8 NY ANI V V
JUMLAH 8 5

25/05/2015 1 NY ISYANA V
2 NY MIMIN V
3 NY ANI V V
4 NY RIKAWATI V V
5 NY RENNI V
6 NY YULIANTI V V
7 NY PUTRI V V
8 NY HERNA V
9 NY HAMIDAH V
10 NY R.TEMMY V
11 NY TIKA V
12 NY NENENG V
JUMLAH 12 4

26/05/2015 1 NY HAMIDAH V
2 NY NENENG V
3 NY SITI K V V
4 NY EVIL V V
5 NY DIAN V
6 NY INDRI V V
7 NY NURLAELA V
8 NY DIANA V
JUMLAH 8 3
27/05/2015 1 NY HAMIDAH V
2 NY NURLAELA V V
3 NY DIAN V
4 NY NENENG V V
5 NY SITI A V
6 NY YENIE V
7 NY SITI R V
8 NY NINA V V
9 NY MIRININGSIH V
10 NY EVIL V V
11 NY SITI ROKAYAH V V
JUMLAH 11 5

28/05/2015 1 NY ANE Y V
2 NY RESA V
3 NY SITI V
4 NY INDRIYANI V
5 NY SITI ROKAYAH V V
6 NY LENNA V
7 NY YOMITA V
8 NY DINDA V
9 NY PIPIT V
10 NY RISKI V
11 NY MELAWATI V
12 NY MAYA V
13 NY HENI V
JUMLAH 13 1

29/05/2015 1 NY HENI V
2 NY MAYA V
3 NY YOMITA V
4 NY YANI V
5 NY RISKI V
6 NY DINDA V
7 NY PIPIT V
8 NY MELAWATI V
9 NY SINKA V
10 NY MIMIN V
11 NY EVRINA V
12 NY RITA V
13 NY TANTRI V
14 NY RINI V
15 NY SITI V
16 NY KOKOM V V
JUMLAH 16 1

30/05/2015 1 NY RINI V
2 NY SITI V
3 NY TUTI V V
4 NY LULU V
5 NY KOKOM V
6 NY EVI V
7 NY DIAN V
8 NY SITI V
9 NY HAERANI V
10 NY OMAH V V
JUMLAH 10 2
31/05/2015 1 NY OMAH V V
2 NY NUNUR V
3 NY LULU V
4 NY LINA V
5 NY KARTINI V
6 NY AISYAH V V
7 NY EVI' V
8 NY TITIN V
JUMLAH 8 2

JUMLAH TOTAL 209 43 2


JUMLAH PASIEN 291

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JUNI 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2015 1 NY TITIN V
2 NY LINDA V
3 NY DEDE V
4 NY NELI V
5 NY FITRI V
JUMLAH 5

02/06/2015 1 NY FITRI V
2 NY NELI' V
3 NY RANI V
4 NY NENG HAYATI V V
5 NY LINDAWATI V
6 NY PERONIKA V V
7 NY ANGGI V V V
8 NY SRI NUR V
JUMLAH 8 3 1

03/06/2015 1 NY PERONIKA V V
2 NY SRI NUR V V
3 NY MAESAROH V
4 NY QORIAH V
5 NY ITA ROSITA V V
6 NY SITI A V
7 NY SENI V
JUMLAH 7 3

04/06/2015 1 NY DANILAH V
2 NY MAESAROH V
3 NY SITI A V
4 NY RANI V
5 NY SUSI V
6 NY TINI V
7 NY IRMA V V
8 NY RITA V
JUMLAH 8 1

05/06/2015 1 NY IRMA V V
2 NY NURHAYATI V
3 NY SITI DAMILAH V
4 NY NIA V
5 NY IIS V
6 NY DANILAH V
7 NY SANTI V
8 NY DIAN V V
9 NY GRANTINI V V
10 NY IMA V
11 NY PUTRIA V
JUMLAH 11 3

06/06/2015 1 NY SITI DAMILAH V


2 NY IMA V
3 NY PUTRIA V
4 NY SANTI V
5 NY SITI SARIPAH V
6 NY GIANTINI V
7 NY CICAH V V
8 NY NIA V
9 NY DEPI V
10 NY UCU V
11 NY ENENG SITI V
12 NY DANTIKA V
JUMLAH 12 1

07/06/2015 1 NY DEPI V
2 NY YANI V
3 N UCU SITI V
4 NY TITA V
5 NY NENG SITI V
6 NY SRI MULYANTINA V
7 NY AI SITI V
8 NY DANTIKA V
9 NY NEULIS V
10 NY SITI V
11 NY AI SITI V
12 NY FITRI V
13 NY ERMA V V
14 NY NENDEN V
JUMLAH 14 1

08/06/2015 1 NY AI SITI V
2 NY FITRI V
3 NY NENDEN V
4 NY ERMA V
5 NY TIA V
6 NY SITI FATIMAH V
7 NY SITI AISYAH V
8 NY SUSI V
9 NY RIKA V
JUMLAH 9

09/06/2015 1 NY SITI AISYAH V


2 NY ERMA V
3 NY SITI FATIMAH V
4 NY RIKA V
5 NY TIA V
6 NY SUSI V
7 NY YANI V
8 NY SARIPAH V
9 NY NINA V
10 NY INDRI V
JUMLAH 10

10/06/2015 1 NY INDRI V
2 NY SARIPAH V
3 NY RAGIL V
4 NY ENUR JANAH V
5 NY FITRI V
6 NY ISNAINI V
7 NY ADE V
JUMLAH 7

11/06/2015 1 NY ISNAINI V
2 NY ENUR V
3 NY NENG MARIANA V
4 NY RANI V
5 NY CUCU V
6 NY ENENG ELAH V
7 NYNUNUNG V V
8 NY SUPRAPMI V
9 NY ELMIRA V
10 NY IRAWATI V
11 NY RATINI V
12 NY ROSLINA V V
13 NY ADE DINA V
JUMLAH 13 2

12/06/2015 1 NY ROSLINA V
2 NY ELIS V
3 NY YANTI V
4 NY RANI' V
5 NY ADE V
6 NY WULAN V V
7 NY ERNA V
8 NY RETI V
9 NY MERTINA V
10 NY GINA V
11 NY SINTIA V
12 NY WIDA V
13 NY NISA V
14 NY AI HARTATI V
JUMLAH 14 1

13/06/2015 1 NY MERTINA V
2 NY GINA V
3 NY ENI KARWATI V
4 NY NISSA SELLY V
5 NY RENI V
6 NY AI H V
7 NY WULAN V
8 NY NINING V
9 NY HUNHUN V
10 NY IMAS V
11 NY DEUIS V
12 NY IRA INDRIYANI V
13 NY WIWIN V
JUMLAH 13

14/06/2015 1 NY DEUIS V
2 NY NINING V V
3 NY RENI V
4 NY WIWIN V
5 NY IMAS NENI V
6 NY REKA V
7 NY IKA V V
8 NY IRA V
9 NY DEDE V
10 NY ANI V
11 NY IRMA V
12 NY SITI N V
13 NY NYKI V
JUMLAH 13 2

15/06/2015 1 NY NIKY V
2 NY NENG ELI V
3 NY SITI N V
4 NY IRMA V
5 NY NENENG V V
6 NY DEDE V
7 NY ERNI V
8 NY NENENG V V
9 NY YULI V
10 NY DIANA V
11 NY DEWI V
12 NY ROSI V V
13 NY NURHAYATI V
14 NY ERNI V
JUMLAH 14 3

16/06/2015 1 NY ERNI V
2 NY ROSI V V
3 NY DEWI V
4 NY IIM V
5 NY RITA V
6 NY YULI V
7 NY NURHAYANIH V V
8 NY ERIKA V
9 NY ROSITA V
10 NY WIWIN V
11 NY RATIH V
12 NY SAILA V
13 NY JUARIAH V V
JUMLAH 13 3

17/06/2015 1 NY ERIKA V
2 NY RISKA V
3 NY ADE V
4 NY WIWIN' V
5 NY SAILA V
6 NY DADAH V V
7 NY NOVIA V
8 NY JUARIAH V V V
9 NY LIA V
10 NY GINA V
11 NY KOMALASARI V
JUMLAH 11 2 1

18/06/2015 1 NY NOVIA V
2 NY KOMALASARI V
3 NY LIA V
4 NY GINA V
5 NY FENTI V
6 NY E WIDA V
7 NY NENENG V V
8 NY BELLE HASNA V
JUMLAH 8 1

19/06/2015 1 NY YULIA V
2 NY GINA R V
3 NY BELLA HASNA V
4 NY NENENG V V
5 NY SURYANI V
JUMLAH 5 1

20/06/2015 1 NY NENG V V
2 NY NIA V
3 NY UMU LIAWATI' V
4 NY SITI N V
5 NY NINING V
6 NY HERNA V V
7 NY SITI M V
8 NY FITRIANI V
9 NY IIS H V V
10 NY ANNE V
11 NY FATIMAH V V
JUMLAH 11 4

21/06/2015 1 NY NIA V
2 NY NINING V
3 NY IIS V
4 NY ANNE V
5 NY HERNA V V
6 NY FITRIANI V
7 NY FATIMAH V V
8 NY SINTA BELLA V
9 NY PUTRI V
10 NY SODIYAH V V
11 NY ASMA V
JUMLAH 11 3

22/06/2015 1 NY NY SADIYAH V V
2 NY WINA V
3 NY YURI V
4 NY NY SITI A V
5 NY YANI V
6 NY SITI M V
JUMLAH 6 1

23/06/2015 1 NY SITI MARYATI V


2 NY NURMIKA V
3 NY RINA V
4 NY DARSIH V V
5 NY YANI V
6 NY SITI AISYAH V
7 NY YURI V
8 NY YETI V
9 NY CAHYATI V
10 NY AI SUSI V
11 NY YENI V V
12 NY MIRNA V
13 NY DIAN V
14 NY SITI V
15 NY NOVITA V V
16 NY RENI V
17 NY SANTIKA V V
JUMLAH 17 3 1

24/06/2015 1 NY SITI M V
2 NY YETI V
3 NY SANTIKA V V
4 NY LUSI V
5 NY RENI V
6 NY DIAN V
7 NY NOVITA V
8 NY POPON V
9 NY JUMILA V
10 NY FITRIA V
JUMLAH 10 1

25/06/2015 1 NY RENI V
2 NY ROSITA V
3 NY ANI S V
4 NY LENI V
5 NY SRI M V V
6 NY SENI V
JUMLAH 6 1

26/06/2015 1 NY SRI M V
2 NY ANISAH V
3 NY SENI V
4 NY BELLA V
5 NY RANIKA V
6 NY NIAWATI V
7 NY YULIANA V
JUMLAH 7

27/06/2015 1 NY KOKOM V
2 NY HASANAH V
3 NY NIA V
4 NY NIAWATI V
5 NY SANTI V
6 NY AJENG V
7 NY ONIH V V
8 NY NURMELA V
9 NY LANI V V
10 NY SANDRI V
11 NY ERNA V
12 NY ANIS V
13 NY YULIANTI V
JUMLAH 13 2

28/06/2015 1 NY SANDRI V
2 NY ONIH V V
3 NY YULIANTI V
4 NY ROSITA V
5 NY RINA V
6 NY EMIH V
7 NY YAYAN V
8 NY IIS V
9 NY ANI NURHAYATI V
10 NY ANIS V
11 NY NONENG V
12 NY RANI V
13 NY IMAS V
JUMLAH 13 1
29/06/2015 1 NY ANI V
2 NY RANI V
3 NY ANIS V
4 NY NONENG V
5 NY IMAS V
6 NY ARTIE V
7 NY NURAINI V
JUMLAH 7

30/06/2015 1 NY ELLY V
2 NY TRESNA V
3 NY TRIA V
4 NY ARIE V
5 NY DEWI V
6 NY NIA V
7 NY NURLELAWATI V
8 NY SANTI M V
9 NY HENI R V
10 NY CUCU V
11 NY PERA V
JUMLAH 11

JUMLAH TOTAL 307 42 4


JUMLAH PASIEN 281

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JULI 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2015 1 NY HENI V
2 NY NIA V
3 NY ARI V
4 NY PERA V
5 NY DEWI YULIANA V
6 NY ANI M V V
7 NY DIANITA V
8 NY ETI V
JUMLAH 8 1

02/07/2015 1 NY NY YENI V
2 NY TANTRI V
3 NY NITA V
4 NY FITRI V
5 NY HERNI V
6 NY SANTI V V
7 NY ANISA V
8 NY YULI V
9 NY FITRI V V
10 NY MEIS V V
11 NY MAYA V
12 NY E ASTRIANTY V V
JUMLAH 12 4

03/07/2015 1 NY E ASTRIANTY V
2 NY YULI V
3 NY MEIS V V
4 NY MAYA V
5 NY TITI V
6 NY FITRI V
7 NY ANISA V
8 NY LILIS V
9 NY DIAH V V
10 NY DIANI V
11 NY WAWAT V
12 NY AAT V V
13 NY SRI HAYATI V
14 NY I HARYATI V
JUMLAH 14 3

04/07/2015 1 NY NY FITRI V V
2 NY WAWAT V
3 NY LILIS V
4 NY SRI HAYATI V V
5 NY I HARYATI V
6 NY NURKAMILA V
7 NY TITA V
8 NY RETA V
9 NY EVI L V
10 NY SUSANTI V
JUMLAH 10 1 1

05/07/2015 1 NY SUSANTI V
2 NY AI KARWATI V
3 NY SITI AMINAH V
4 NY TITA ROSITA V
5 NY RIMA V
6 NY AAN V
7 NY ELIS V
8 NY SANTI V
9 NY ANISA V
JUMLAH 9

06/07/2015 1 NY SANTI V
2 NY ANISA V V
3 NY NOVITA V
4 NY RENI V
5 NY ANISA V
6 NY AYI V
7 NY INA V
8 NY DIAN V
9 NY TUTIK V
10 NY IMAS M V
10 NY SITI HASANAH V
JUMLAH 10 1

07/07/2015 1 NY RENI V
2 NY SITI HASANAH V
3 NY DIAN D V
4 NY INA V
5 NY ROKHILAH V
6 NY IMAS V
7 NY AYI V
8 NY MELINA V
9 NY HAFTIANA V
10 NY MELINA V
11 NY MIMIN V
12 NY SANTI FITRIANI V V
13 NY ROSIDA V V
14 NY MIRAWATI V
15 NY ISALORA V
16 NY AI H V
JUMLAH 16 2

08/07/2015 1 NY NY ISALORA V
2 NY IIS V
3 NY AI HAYATI V
4 NY RISMA V
5 NY ROSIDA V V
6 NY MIRAWATI V
7 NY MARLIAH V
8 NY ADE SUMIATI V
9 NY ETI N V
10 NY TIARA V
11 NY SITI NURLELA V
JUMLAH 11 1

09/07/2015 1 NY SITI NURLELA V


2 NY RISMA F V
3 NY TIARA F V
4 NY ETI N V
5 NY CASWATI V V
6 NY SITI MARYAM V
7 NY DINA V
JUMLAH 7 1

10/07/2015 1 NY CASWATI V
2 NY RIYANTI V
3 NY DINA V
4 NY RINA V
5 NY ANIN V
6 NY YUYUN V
7 NY ADE V
8 NY ERLINA V
9 NY RIKEN V
10 NY ENDAH V
11 NY YENI V
12 NY ROSITA V V
13 NY SARINENGSIH V
JUMLAH 13 1

11/07/2015 1 NY SARINENGSIH V
2 NY YENI V
3 NY ROSITA V V
4 NY SOPIANI V
5 NY ANGGI F V V
6 NY AMI V
7 NY YAYU V
JUMLAH 7 1 1

12/07/2015 1 NY ANGGI F V
2 NY SUSI SUSILAWATI V V
3 NY NILAH V
4 NY ANGGI F V
5 NY SUSI SUSILAWATI V V
6 NY EUIS V
7 NY ROSI V
8 NY GITA V
9 NY ELA V V
10 NY MELIANA V
11 NY RISKA V V
JUMLAH 11 4

13/07/2015 1 NY NENI V
2 NY RISKA V V
3 NY MELIANA V
4 NY ANE V V
5 NY LIA V
6 NY RINI V
7 NY SRI V
8 NY ELIS V
9 NY NURYAWANTI V
JUMLAH 9 2

14/07/23015 1 NY IKA V
2 NY NURYAWANTI V V
3 NY WULAN V
4 NY FITRI V
5 NY SALMA V
6 NY SANTI V
7 NY YAYAN V
8 NY HOLIS V
9 NY ARI V
10 NY EKA V
11 NY ELIS V
JUMLAH 11 1

15/07/2015 1 NY EULIS V
2 NY SALMA V
3 NY YAYANG V
4 NY HOLIS V
5 NY ARI V
6 NY SENI V
7 NY ELIS V
8 NY SANTI V
9 NY SITI SALMA V
10 NY EROS V V
11 NY ROSE V
12 NY SENDI V
JUMLAH 12 1

16/07/2015 1 NY SENI V
2 NY REKSA V
3 NY EROS V V
4 NY SENDI V
5 NY ROSE V
6 NY NY NURAENI V
7 NY AI V
8 NY SOPIA V V
9 NY INA V
10 NY SUPRIATIN V
JUMLAH 10 2

17/07/2015 1 NY AI V
2 NY SOPIA V V
3 NY SUPRIATIN V
4 NY INA V
5 NY NY RUPINAH V V
6 NY YANTI V
7 NY WISTY V
8 NY TUTI V V
9 NY YULIANI V
10 NY IKE V
JUMLAH 10 3

18/07/2015 1 NY TUTI V V
2 NY IDA V
3 NY YULIANI V
4 NY IKE V
5 NY WISTY V
6 NY ROSI V
7 NY WINA V
8 NY INA V
9 NY NURAZIZAH V
10 NY SOSILOWATI V
11 NY GILANG V V
JUMLAH 11 2

19/07/2015 1 NY IMA V V
2 NY SRI V
3 NY WINA V
4 NY GILANG V V
5 NY EVA V
6 NY ENTIN V
7 NY HANI V V
JUMLAH 7 2 1

20/07/2005 1 NY SRI V
2 NY ENTIN V
3 NY GILANG V V
4 NY ROMLAH V
5 NY RINI V
6 NY LISKA V
7 NY SANTI V
8 NY NIA V
JUMLAH 8 1

21/07/2015 1 NY LISKA V
2 NY ANNISA V
3 NY RIKA V
4 NY FITRI V
5 NY SARI V
JUMLAH 5

22/07/2015 1 NY FITRI V
2 NY SARI V
3 NY RINA V
4 NY SISKA V
5 NY IRMI V
JUMLAH 5

23/07/2015 1 NY AI V V
2 NY RINA V
3 NY SISKA V
4 NY SITI PATONAH V
5 NY CHANDENI V
6 NY YANI V V
7 NY ASTRI V
8 NY NENDEN V
JUMLAH 8 2

24/07/2015 1 NY RINA V
2 NY NURDIANI V
3 NY ASTRI V
4 NY SITI KHODARIAH V V
5 NY YULI V
6 NY SOTCA V
7 NY ENENG S V
8 NY SISKA V
9 NY SITI N V
JUMLAH 9 1

25/07/2015 1 NY SITI N V
2 NY CHINTIA V
3 NY SITI K V
4 NY DEVI V
5 NY DEANE V
6 NY SITI CHOTIMAH V
7 NY AI SITI V V
8 NY DESI V
9 NY SINTIA V
10 NY LINA V V
11 NY LINA S V
12 NY SRI RAHAYU V V
13 NY LENNI MARLINA V
JUMLAH 13 2 1

26/07/2015 1 NY DESI V
2 NY AI SITI V
3 NY LINA V
4 NY LENNI MARLINA V
5 NY SINTIA V
6 NY SRI R V
7 NY DEANE V
8 NY RAKANITA V
9 NY AI N V
10 NY EUIS V
JUMLAH 10

27/07/2015 1 NY NUNUNG V V
2 NY EUIS V
3 NY DEANE V
4 NY SITI MASITOJ V
5 NY RISNEU V
6 NY LILIS V
7 NY RISA V
JUMLAH 7 1

28/07/2015 1 NY IRMA V
2 NY EUIS V
3 NY FITRI V
4 NY KIKI V
5 NY KINKIN V
6 NY RISNEU V
7 NY MILA V
8 NY NINA H V
9 NY TIARA V
JUMLAH 9

29/07/2015 1 NY TIARA V
2 NY KIKI V
3 NY SITI N V V
4 NY SAFIRA V
5 NY IRMAYANTI V
6 NY EEM V
7 NY YONA V
JUMLAH 7 1

30/07/2015 1 NY NURLAELA V
2 NY NURHAYATI V
3 NY NINA V
4 NY ELIS V
5 NY MERI V
JUMLAH 5

31/07/2015 1 NY ELIS V
2 NY AJENG V
3 NY RUSTIANA V
4 NY EULIS V
JUMLAH 4

JUMLAH TOTAL 287 36 6


JUMLAH PASIEN 295

KESIMPULAN = FLEBITIS = 2%

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - AGUSTUS 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2015 1 NY NY ENI V
2 NY SITI A V
3 NY ERNA V
4 NY IPAH V
5 NY EMA V V
6 NY WITRI V
7 NY MULYANI V
8 NY AI YETI V
9 NY YANI M V V
10 NYTIKA V
JUMLAH 10 2

02/08/2015 1 NY YANI V V
2 NY MULYANI V
3 NY AI YETI V
4 NY TIKA V
5 NY YUNITA V
6 NY FITRI V
7 NY WETI V
8 NY DERIA V
9 NY LIAN V
10 NY TINEU V
11 NY PITRIYANI V
12 NY SUSANA V
JUMLAH 12 1

03/08/2015 1 NY ROBIATUL V
2 NY RENI RIZKI V
3 NY SANTI V
4 NY HETY V
5 NY CASTEN' V
6 NY SITI N V V
7 NY NENI H V
JUMLAH 7 1

04/08/2015 1 NY NENI V
2 NY SITI N V V
3 NY LINDA V
4 NY FITRI V
5 NY SANDRA V
6 NY SUMARNI V
7 NY KARTINI V
JUMLAH 7 1

05/08/2015 1 NY KARTINI V
2 NY EULIS V
3 NY CAHYANTI V
4 NY DIAN V
5 NY SANDRA V
6 NY SUMARNI V
7 NY RANI V
8 NY ROHAENI V
9 NY RENI V
10 NY YUNINGSIH V
11 NY ELIN V
JUMLAH 11

06/08/2015 1 NY IMAS V
2 NY ROHAENI V
3 NY RENI V
4 NY HANI V
5 NY DEDE V
6 NY DINA V
7 NY KIKI RIZKI V V
JUMLAH 7 1

07/08/2015 1 NY NY HANI V
2 NY ROHAENI V
3 NY KIKI RIZKI V V
4 NY RIKA V
5 NY NENNI V
6 NY WULANSARI V
7 NY RATIH V
8 NY HASANAH V
JUMLAH 8 1

08/08/2015 1 NY HASANAH V
2 NY WULANSARI V
3 NY R YULIATI V
4 NY HARDA V
5 NY AYI V
6 NY TUTI V
JUMLAH 6

09/08/2015 1 NY NY DETI V V
2 NY NY R YULIATI V
3 NY MULYATI V
4 NY HARYATI V
5 NY TUTI V
6 NY ANNISA V
7 NY SANI V
8 NY DESI V
9 NY RINA V
10 NY N SURYANI V V
11 NY RANFINAH V
12 NY WIDIYATI V
JUMLAH 12 2

10/08/2015 1 NY IMELDA V
2 NY RANTINAH V
3 NY WIDIYATI V
4 NY VINA V
5 NY TENGKU V
6 NY DESI V
7 NY WINA V
8 NY JENI V
9 NY ANE V
10 NY YULIANTI V
11 NY IDA V
JUMLAH 11

11/08/2015 1 NY DESI V
2 NY IDA V
3 NY ELIS V
4 NY NINA V
5 NY TITA V
6 NY MEGA V
7 NY NY ELIS V
8 NY YURRI V
9 NY MINA V
JUMLAH 9

12/087/2015 1 NY MEGA V
2 NY YURRI V
3 NY ULI V V
4 NY ELIS SITI V
5 NY MINA V
6 NY ENTIN V V
7 NY AE MAESAROH V
8 NY AI SUMARNI V
9 NY KETHI V
JUMLAH 9 2

13/08/2015 1 NY KETHI V
2 AI SUMARNI V
3 NY ASTRI V
4 NY SRI N V
5 NY NURAZIZAH V
JUMLAH 5

14/08/2015 1 NY NURAZIZAH V
2 NY ASTRI K V
3 NY HERLINDA V
4 NY SILMI V
5 NY AYU V
JUMLAH 5

15/08/2015 1 NY NY SRI WAHYUNI V


2 NY KEUIS V
3 NY NURLAENI V V
4 NY RINI V V
5 NY YENI V
JUMLAH 5 1 1

16/08/2015 1 NY RINI V
2 NY NURHALIMAH V
3 NY MULYANI V
4 NY KEULIS V
5 NY FITRI ANDRIANI V
6 NY GITA V
7 NY GINA V
8 NY FANI V
9 NY DESI V
10 NY AI MAESAROH V
JUMLAH 10

17/08/2015 1 NY NIA V
2 NY DEWI V
3 NY LIA V
4 NY DEWI W V
5 NY FANI V
6 NY WIDAYANTI V
7 NY WINA V
8 NY RIKA V
JUMLAH 8

18/08/2015 1 NY.RIKA V
2 NY.WINA V
3 NY.NOVA V
4 NY.DEWI V
5 NY.ICA V
6 NY.PERAWATI V
7 NY.SUMARYATI V
8 NY.INTAN V
JUMLAH 8

19/08/2015 1 NY.ICA V
2 NY.SUMARYATI V
3 NY.ENENG V
4 NY.PERAWATI V
5 NY.HERAWATI V
6 NY.INTAN V
7 NY.DEWI N V
8 NY.MURNIATI V
9 NY.MULYANI V V
10 NY.UMI R V
JUMLAH 10 1

20/08/2015 1 NY.HERAWATI V
2 NY.UMI R V
3 NY.MURNIATI V
4 NY.MULYATI V
5 NY.SUSI V
6 NY.APRILIA V
7 NY.SATINEM V
JUMLAH 7

21/08/2015 1 NY.SATINEM V V
2 NY.EVI V V
3 NY.NUNUNG V
4 NY.AYU V
5 NY.YUSI V
6 NY.EKA V V
7 NY.SITI R V
8 NY.SUWARNI V
9 NY.ROSMANAH V
JUMLAH 9 3

22/08/2015 1 NY.ROSMANAH V
2 NY INE V
3 NY.EKA V V
4 NY.SITI R V
5 NY.GINA V
6 NY.REMA V
7 NY.ENENG V
8 NY.LILAH V V
9 NY.NUR Y V
10 NY.DEWI K V
11 NY.LISNA V
12 NY.RINA V
13 NY.SESILIA V V
14 NY.POPON V V
JUMLAH 14 3 1

23/08/2015 1 NY.SRI R V V
2 NY.SESILIA V
3 NY.GINA V
4 NY.POPON V V
5 NY.LILAH V V
6 NY.ONOH V
7 NY.YAYU V
8 NY.YOYOH V
JUMLAH 8 3

24/08/2015 1 NY WIDAYANTI V V
2 NY HALIMAH V
3 NY TETI ROSITA V
4 NY HERNI HERMALI V V
5 NY RINA RTISNAWATI V
JUMLAH 5 2

25/08/2015 1 NY HERNI HERMALI V V


2 NY RINA V
3 NY WIDAYANTI V V
4 NY WINA V
5 NY SUMIATI V
6 NY NURHAYATI V V
7 NY APRILIANTINI V
8 NY SOINAH V
9 NY AMILAH V
JUMLAH 9 3

26/08/2015 1 NY APRILIANTINI V
2 NY SOINAH V V
3 NY NURHAYATI V V
4 NY AMINAH V
5 NY TETI S V
6 NY YUNENGSIH V
7 NY TATI V
8 NY RANI V V
9 NY DINI P V
10 NY LAILA V
JUMLAH 10 3

27/08/2015 1 NY DINI P V
2 NY LAILA V
3 NY MIA V
4 NY RIKA V
5 NY TITA V
6 NY RIA V V
7 NY YENI V
8 NY NEULIS V V
JUMLAH 8 1 1

28/08/2015 1 NY NINA V V
2 NY NEULIS V V
3 NY ERMA V
4 NY ENENG V
5 NY SOPIA V
6 NY EJAH V
7 NY NIA V V
JUMLAH 7 3

29/08/2015 1 NY NIA V V
2 NY NENI V
JUMLAH 2 1
30/08/2015 1 NY AYU V
2 NY MIRNA V
3 NY ROSMALIA V
4 NY ELI V
5 NY LAILA V
JUMLAH 5
31/08/2015 1 NY IRMA V
2 NY ELIS V
3 NY KARTIKA V
4 NY TANTRI V
5 NY DEWI V
6 NY ELIS V
JUMLAH 6 FLEBITIS
JUMLAH 250 35 3
JUMLAH PSN 266

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - SEPTEMBER 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2015 1 NY ANI V
2 NY DEDE V
3 NY RESTI V
JUMLAH 3

02/09/2015 1 NY FITRI V
2 NY NENG ELIS V
3 NY RIKA V
4 NY ATI V V
5 NY RISNA V V
6 NY DEDEH V
7 NYNURUL V
8 NY IDA V V
9 NY WENI V
10 NY ESIH V V
JUMLAH 10 4

03/09/0215 1 NY NURUL V
2 NY DEDEH V
3 NY YANI V
4 NY WENI V
5 NY SUMIATI V
6 NY YULIANI V V
7 NY RISMA V V
8 NY ESIH V
9 NY SITI S V
10 NY ROSITA V
JUMLAH 10 2

04/09/2015 1 NY ROSITA V
2 NY SITI S V
3 NY DEWI V
4 NY RENI V
5 NY SUKESI V
6 NY MISDIARTI V
7 NY IIS V V
8 NY NURUL V
9 NY SUSI V V
10 NY HENI V
JUMLAH 10 2

05/09/2015 1 NY NURUL V
2 NY RENI' V
3 NY HENI V
4 NY SUSI V V
5 NY IIS V V
6 NY MISDIARTI V
7 NY SISKA V
8 NY ERNI V
9 NY MIRA V
10 NY DENA V
11 NY DINI V V
12 NY ROSE SITI V V
JUMLAH 12 4

06/09/2015 1 NY DENA V
2 NY AMELIA V
3 NY DINI V V
4 NY ATI V V
5 NY MARSINAH V
6 NY ROSMALASARI V
7 NY SANTIKA V
8 NY SUMIATI V
9 NY SUSANTI V
10 NY SITI R V V
11 NY FITRI V
JUMLAH 11 3

07/09/2015 1 NY.SITI R V V
2 NY.SUSANTI V
3 NY.SUMIATI V
4 NY ATI V
5 NY TINI V
6 NY ANAWATI V
7 NY FITRI V
8 NY DINI V V
9 NY HERMIN V
10 NY RISMA V
11 NY SELI V
12 NY EMA V
JUMLAH 12 2

08/09/2015 1 NY DEWI V
2 NY EMA V
3 NY RATNA V
4 NY NANI V V
5 NY RESNA V
6 NY DIAN V
7 NY EUIS V
8 NY MIRA V
9 NY DENINTA V
10 NY SITI H V
11 NY RINA V
12 NY NURUL V
JUMLAH 12 1

09/09/2015 1 NY SITI H V
2 NY DIAN V
3 NY RINA V
4 NY RESNA V
5 NY RINI V
6 NY RUNI V
7 NY DESI V
8 NY SITI R V
9 NY NURUL V
10 NY MAEMUNAH V
11 NY MIRA V
12 NY ELIS V
13 NY AI V
14 NY WATI V
15 NY YETI V
JUMLAH 15

10/09/2015 1 NY ELIS V
2 NY YETI V
3 NY WATI V
4 NY AI SARTIKA V
5 NY LILIS V V
6 NY LINA V
7 NY KURNIASARI V
8 NY HALIMATUS V
9 NY ITA V
10 NY VIVI V V
11 NY DESI V
12 NY LINA V
13 NY RITA V
JUMLAH 13 2

11/09/2015 1 NY RITA V
2 NY LINA V
3 NY DESI V
4 NY ITA R V
5 NY VIVI V V
6 NY MASLIPAH V
7 NY LUSIANA V
8 NY SANTI V V
9 NY IMAS SOLEHA V
10 NY RINI V
11 NY SYARIFAH V
12 NY GITA V
JUMLAH 12 2

12/09/2015 1 NY SANTI V V
2 NY LUSIANA V
3 NY RINI V
4 NY GITA V
5 NY IMAS V
6 NY RIAS V
7 NY ANGGRAENI V V
8 NY SITI ROKAYAH V
9 NY WULANSARI V
JUMLAH 9 2

13/09/2015 1 NY NY ATI V
2 NY RIAS V
3 NY ANGGRAENI V V
4 NY NY WULANSARI V
5 NY HERLINA V
6 NY SITI ROKAYAH V
7 NY SUCI V
8 NY NANDA V
9 NY TRI LESTARI V
10 NY RENI V V
JUMLAH 10 2

14/09/2015 1 NY TRI LESTARI V


2 NY WULANSARI V
3 NY HERLINA V
4 NY RENI V
5 NY ENDANG V
6 NY IIS V
7 NY SUSAN V
8 NY WENI V
9 NY NY HENI S V V
10 NY NANI V
JUMLAH 10 1

15/09/2015 1 NY RANI V
2 NY SUSANTI V V
3 NY SANI V V
4 NY NITA V
5 NY NURHASANAH V
6 NY HENI V V
7 NY LILIS V
8 NY SANTI V
9 NY DEDEH V V
10 NY SUTINI V V
11 NY SITI KULSUM V
JUMLAH 11 5

16/09/2015 1 NY NY SITI KULSUM V


2 NY LILIS V V
3 NY WIDYA D V
4 NY SANI A V V
5 NY DEDEH V V
6 NY LILIS R V
7 NY NURHASANAH V
8 NY ENENG V V
JUMLAH 8 4

17/09/2015 1 NY SANI V
2 NY ANI V
3 NY YANI V
4 NY MIA MARIANA V
5 NY MARYANI V
6 NY MUJI R V
JUMLAH 6

18/09/2015 1 NY MUJI R V
2 NY PUJI A V
3 NY YANI V
4 NY ANING V
5 NY LINA V V
6 NY SITI V
7 NY IIN V
8 NY ROSITA V
9 NY SITI S V
10 NY HERNI V
JUMLAH 10 1

19/09/2015 1 NY PUJI A V
2 NY JUHANAH V
3 NY SITI S V
4 NY ROSITI V
5 NY HERNI V
6 NY IDA V
7 NY RINI V
8 NY ERNASARI V
9 NY TUTI V
10 NY DINAR V
11 NY TETI V
12 NY SAIROH V
13 NY PIPIH V
JUMLAH 13

20/09/2015 1 NYNY EKA V


2 NY ELIS V
3 NY NY ERNI V
4 NY DINAR V
5 NY SAIROH V
6 NY PIPIH V
7 NY WIKE V
8 NY NINA V
JUMLAH 8

21/09/2015 1 NY.YULI V
2 NY.WENNY V
3 NY.SINTA V
4 NY.ERNA V
5 NY.NINA V
6 NY.DEWI V
7 NY.RITA V V
8 NY.NOPI V
9 NY.RANI V
10 NY.RITA H V
11 NY.NENDEN V
12 NY.JUJU V V
13 NY.IMAS V V
JUMLAH 13 3

22/09/2015 1 NY.JUJU V V
2 NY.RITA H V
3 NY.RITA V V
4 NY.NENDEN V
5 NY.IMAS V V
6 NY.INE V
7 NY.YULIANI V
8 NY.MUGI AYU V
9 NY.HADIDAWATI V V
10 NY.ROSI V
11 NY.LINNE V
12 NY.EMA V
JUMLAH 12 4

23/09/2015 1 NY.LINNE V
2 NY.ROSSI V
3 NY.INE V
4 NY.PUTRI V
5 NY.MUGI AYU V
6 NY.MUTMAINAH V
7 NY.JULAEHA V
8 NY.EMA V
9 NY.HADIDAWATI V V
10 NY.GITA V
11 NY.SISKA V
12 NY.IMAS V
13 NY.NELI V
14 NY.ERNI V
15 NY.SITI FATIMAH V
JUMLAH 15 1

24/09/2015 1 NY.NELI V
2 NY.GITA V
3 NY.MAESAROH V
4 NY.IMAS V
5 NY.SITI FATIMAH V
6 NY.ERNI V
7 NY.HADIDAWATI V V
8 NY.ANI V
9 NY.KURNIAWATI V
10 NY.SUNARI V
11 NY.TURIMAH V
JUMLAH 11 1

25/09/2015 1 NY.IMAS V
2 NY.SUNARI V
3 NY.KURNIAWATI V
4 NY.RIKA V
5 NY.ERNI V
6 NY.TURIMAH V
7 NY.RIZKI V
8 NY.AI NURAINI V
9 NY.WULAN V
10 NY.SITI AISYAH V
11 NY.ANI V
JUMLAH 11

26/09/2015 1 NY.NINA V
2 NY.MIRA V
3 NY.METTY V
4 NY.PRATIWI V
5 NY.DEWI V
6 NY.ERNA V
7 NY.SARIAH V
8 NY.FANNY V
9 NY.ANGGIA V
JUMLAH 9
27/09/2015 1 NY.ERNA V
2 NY.MIRA V
3 NY.METTY V
4 NY.FANNY V
5 NY.PRATIWI V
6 NY.ANGGIA V
7 NY.NENG ANI V V
8 NY.AI SITI ROMLAH V
9 NY.SUNINGSIH V
10 NY.DEWI V V
11 NY.EMA V
12 NY.WITA V
13 NY.SANTI V V
14 NY.MEGA V
15 NY.MASPUAH V
JUMLAH 15 3

28/09/2015 1 NY.FANNY V
2 NY.DEWI V V
3 NY.MASPUAH V
4 NY.SANTI V V
5 NY.MEGA V
6 NY.IMAS V
7 NY.INTAN V
8 NY.FERA V V
9 NY.FEBI F V
10 NY.SISKA V
11 NY.MEGA V
12 NY.PUJI V
13 NY.AYU ASSARI V
JUMLAH 13 3

29/09/2015 1 NY.NUNUNG V
2 NY.ANA NOVIANA V
3 NY.SISKA V
4 NY.PUJI V
5 NY.MASPUAH V
6 NY.SANTI V V
7 NY.FERA V
8 NY.SILVY V
9 NY.ARIS V V
10 NY.NINA V
11 NY.SUMARNI V V
JUMLAH 11 3

30/09/2015 1 NY.ARIS V V
2 NY.FERA V V
3 NY.SUMARNI V V
4 NY.SILVY V
5 NY.SINTA V
6 NY.ROSIDAH V
7 NY.ICAH V
8 NY.YULIANI V
9 NY.LILIS V
10 NY.ASIMA V
11 NY.WULANSARI V V
JUMLAH 11 4
JUMLAH 326 59
JUMLAH PSN 263
Formulir Survey Harian Pemakaian Alat
Ruang VK - RSKIA - OKTOBER 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2015 1 NY.WULANSARI V V
2 NY.ASIMA V
3 NY.LIA V
4 NY.YULIANI V
5 NY.ELA V
6 NY.NOORJANAH V
7 NY.ROHANAH V V
8 NY.ENENG YANI V
JUMLAH 7 2

02/10/2015 9 NY.ENENG YANI V


10 NY.ROHANAH V V
11 NY.YULIANI V
12 NY.ELA V
13 NY.SRI WULAN V
14 NY,UUN ELI V V
15 NY.BELA V
16 NY.PUPUH V
17 NY.DESI V
18 NY.NURANI V
19 NY.ADIT V
JUMLAH 11 2

03/10/2015 20 NY.DESI V
21 NY.NURANI V
22 NY.PUPUH V
23 NY.BELLA V
24 NY.ADIT V
25 NY.DONA V
26 NY.NIA V
27 NY.RIMA V V
28 NY.HIKMAH V
JUMLAH 9 1

04/10/2015 29 NY.DONA V
30 NY.RIMA V V
31 NY.NIA V
32 NY.BELLA V
33 NY.HIKMAH V
34 NY.SITI V
35 NY.DEWI V
36 NY.ELI V V
37 NY.TIKTIK V
38 NY.RITA V
39 NY.PIPIT V V
40 NY.DINI V
41 NY.ESTER V
JUMLAH 13 2 1

05/10/2015 42 NY RIMA V
43 NY ESTER V
44 NY DINI V
45 NY PIPIT V
46 NY NURUL V
47 NY DIAN P V
48 NY RITA V
49 NY RESTI V
50 NY SUSI ANITA V
51 NY EUIS V
52 NY LILIS V
53 NY IIS WIDANINGSIIH V V
54 NY NOFIANTY V
55 NY NISA V
JUMLAH 14 1

06/10/2015 56 NY IIS WIDANINGSIH V V


57 NY NOFIANTY V
58 NY NISA V
59 NY IIS M V
60 NY NENG KIKI V
61 NY IPAH V V
62 NY SUMI V
63 JUMLAH 7 2

07/10/2015 64 NY SUMI V
65 NY NENG KIKI V
66 NY ENAT V V
67 MY RISFA V
68 NY DEDE V
JUMLAH 5 1

08/10/2015 69 NY.TITING V
70 NY.RISFA V
71 NY.DEDE V
72 NY.WIDANINGSIH V
73 NY.NINING V
74 NY.NIA SRI V
75 NY.YULIANTI V V
JUMLAH 7 1

09/10/2015 76 NY.NIA SRI V


77 NY.RISFA V
78 NY.WIDANINGSIH V
79 NY.YULIAWATI V V
80 NY.NINING V
81 NY.ANIZA V
82 NY.ELA V
83 NY.RENI V
84 NY.DEWI V
JUMLAH 9 1

10/10/2015 85 NY.RENI V
86 NY.YENI V
87 NY.NURHAYATI V
88 NY.SUSAN V
89 NY.LINA V
90 NY.YOYOH V
91 NY.LILIS TETI V
JUMLAH 7

11/10/2015 92 NY.LINA V
93 NY.RINI V
94 NY.KUSMIANTI V
95 NY.IMAS V
96 NY.NENG V
97 NY.YOYOH V
98 NY.RINA V
99 NY.IRMA V
100 NY.SITI M V
101 NY.INE V
JUMLAH 10

12/10/2015 102 NY.NENG NUR V


103 NY.FEMI V
104 NY.LIA V
105 NY.DIDA V
106 NY.TINI V
107 NY.NINIK V
108 NY.EROS V
109 NY.NURHAYATI V
JUMLAH 8

13/10/2015 110 NY.NINIK V


111 NY.DIDA V
112 NY.EROS V
113 NY.INTAN V
114 NY.NURHAYATI V
115 NY.TINI V
116 NY.TRI V
117 NY.YANYAN V
118 NY.RIRIN V
119 NY.TANTI V
JUMLAH 10

14/10/2015 120 NY.NATALIA V


121 NY.LOMRAH V
122 NY.TINTIN V
123 NY.RIRIN V
124 NY.TANTI V
125 NY.WIWIN V
126 NY.YULIANTI V
127 NY.ROSITA V
128 NY.WINDA V
129 NY.NURCAHYATI V
130 NY.ANI V
JUMLAH 11

15/10/2015 131 NY IMAS V


132 NY ANI V
133 NY ROSITA V
134 NY PURI RETNO V
135 NY ENUR V
136 NY TRISNAWATI V
137 NY YULI V
138 NY TANTI V
JUMLAH 8

16/10/2015 139 NY TRISNAWATI V


140 NY YULI V
141 NY SURYATI V
142 NY NENG RISKA V
143 NY TANTI V
144 NY ERICHA V
JUMLAH 6

17/10/2015 145 NY WETI V V


146 NY TANTI V V
147 NY ERICHA V
148 NY ENUNG V
149 NY NENG SAIDAH V
150 NY RATNA V
151 NY SANTI' V
152 NY YAYU V
153 NY MUJIATI V
154 NY SITI YULIAWATI V
155 NY PUJI V V
JUMLAH 11 3

18/10/2015 156 NY RATNA V


157 NY NENG SAIDAH V
158 NY YULI V
159 NY MUJIATI V
160 NY SITI YULIAWATI V
161 NY SANTI V
162 NY.MIRA V
163 NY.NELLA V
164 NY.NURLELA V
165 NY.SILVI V
166 NY.MARA SARI V
167 NY.NISA V
168 NY.HERLIN V
169 NY.TRI RAHAYU V
170 NY.LINLIN V
JUMLAH 15

19/10/2015 171 NY.HERLIN V


172 NY.NISA V
173 NY.HERLIN V
174 NY.LINLIN V
175 NY.LISE V
176 NY.LEVI V
177 NY.ERNAWATI V
JUMLAH 7

20/10/2015 178 NY.EDAH V


179 NY.NURJANAH V
180 NY.WIDANINGSIH V
181 NY.EDAH V
182 NY.FITRI V
183 NY.UMI V
184 NY.LIA V
185 NY.SRI V
186 NY.SITI JENAB V
JUMLAH 9

21/10/2015 187 NY.ERNI V


188 NY.DINI V V
189 NY.TENI V
190 NY.SITI R V
191 NY.HAYATI V
192 NY.YOHANA V
JUMLAH 6 1

22/10/2015 193 NY.ANDI EKI V


194 NY.MARIAM V V
195 NY.YOHANA V V
196 NY.KOKOM V V
197 NY.DINI V V
198 NY.IRNA V
199 NY.ERNI V
200 NY.LELA V
201 NY.WIWIN V
202 NY.ELIS V
JUMLAH 10 4

23/10/2015 203 NY.DEWI V


204 NY.KOKOM V V
205 NY.MARIAM V V
206 NY.ELIS V
207 NY.DINI V V
208 NY.ENI V V
209 NY.LINDA V
210 NY.RINI RAHAYU V
JUMLAH 8 4

24/10/2015 211 NY.IIN V


212 NY.LINDA V
213 NY.SITI KOMARIAH V
214 NY.SANTI V
215 NY.ELIS V
216 NY.RINI RAHAYU V
217 NY.SENI V V
218 NY.NELI V
219 NY.DEDEH V
JUMLAH 9 1

25/10/2015 220 NY.SARIPAH V


221 NY.RISKA V
222 NY.SITI R V
223 NY.NANI V
224 NY.RINA V
225 NY.FUJI V
JUMLAH 6

26/10/2015 226 NY.UNIYATI V V


227 NY.FUJI V
228 NY.AYUGINA V
229 NY.KOMALASARI V
230 NY.MELLYANA V V
231 NY.MUSTAQIMATUN V
232 NY.SRI V
JUMLAH 7 2

27/10/2015 233 NY.RISTA V


234 NY.KOMALASARI V
235 NY.NANI V
236 NY.MUSTAQIMATUN V
237 NY.HERIS V
238 NY.RIKA V
239 NY.SRI V
240 NY.LISTIYANI V V
241 NY.FIRA V
242 NY.ROSITA V
JUMLAH 10 1

28/10/2015 243 NY.LESTARI V


244 NY.WULAN V
245 NY.KRISTINA V
246 NY.RIKA V
247 NY.LISTIYANI V
248 NY.RIRIN V
249 NY.WULAN V
JUMLAH 7

29/10/2015 250 NY.ELIS V


251 NY.TITA V
252 NY.IIS V
253 NY.NAENI V
254 NY.DIANA V
255 NY.SINTA V
256 NY.DESI V
257 NY.NADIA V
JUMLAH 8

30/10/2015 258 NY.YAYAN V


259 NY.ANI V
260 NY.NADIA V
261 NY.DESI V
262 NY.SINTA V
263 NY.ASNI V
264 NY.TITA V
265 NY.HANI V V
266 NY.LINA V
267 NY.LENI V V
268 NY.CICIH V V
269 NY.ISYE V V
270 NY.RINRIN V
JUMLAH 13 4

31/10/2015 271 NY.ISYE V V


272 NY.RINRIN V
273 NY.CICIH V
274 NY.LENI V V
275 NY.SUPIANTI V
JUMLAH 5 2
JUMLAH 273 35 1
JUMLAH PSN 233

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - NOVEMBER 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2015 1 NY.YULIANTI V V
2 NY.NOVIANTI V
3 NY.SRI MULYANI V
4 NY.SUPIANTI V V
5 NY.NOVIANTI V
6 NY.KURNIASIH V
7 NY.RANI V V
8 NY.UKE V
9 NY.DENIA V
10 NY.YUNIAR V
JUMLAH 10 3

02/11/2015 11 NY.NENI V V
12 NY.YUNIAR V
13 NY.ATING V
14 NY.YULI V
15 NY.IRENE V
16 NY.VINI V
17 NY.IKA V
JUMLAH 7 1
03/11/2015 18 NY.IKA V
19 NY.ATING V
20 NY.DIAN V
21 NY.IRENE V V
22 NY.VINY V
23 NY.IMAS V V
JUMLAH 6 2

04/11/2013 24 NY.NURHAYATI V
25 NY.DIAH V V
26 NY.IMAS V V
27 NY.VINY V
28 NY.PENNY V
29 NY.HANISAH V
30 NY.SITI H V V
JUMLAH 7 3

05/11/2015 31 NY.SITI HAMIDAH V V


32 NY.HANISAH V
33 NY.DIAH V V
34 NY.IMAS V V
35 NY.YANI V
36 NY.VINI V
37 NY.RISMA V
JUMLAH 7 3

06/11/2015 38 NY.HERTATI V
39 NY.RISMA V
40 NY.SITI HAMIDAH V V
41 NY.LENDA V
42 NY.ELI V V
43 NY.SHENI V
JUMLAH 6 2

07/11/2015 44 NY.SHENI V
45 NY.ASRI V
46 NY.NEPTISHELA V
47 NY.LENA V
48 NY.ZAHARA V
JUMLAH 5

08/11/2015 49 NY.IMAS V
50 NY..AGUSTIN V V
51 NY.NURHAYATI V V
52 NY.RATNA V
53 NY ENTIN V
54 NY.NURLELA V V
JUMLAH 6 3

09/11/2015 55 NY.ENTIN V
56 NY.ATIN V V
57 NY.RATNA V
58 NY.HASANAH V
59 NY.WIWIN V V
60 NY.PUTRI V V
61 NY.EMMA V
JUMLAH 7 3

10/11/2015 62 NY.TRI V
63 NY.WIWIN V
64 NY.EMMA V
65 NY.PUTRI V
66 NY.WIBLIK V
67 NY.MIRA V
68 NY.SITI MAESAROH V V
69 NY.MIA V
JUMLAH 8 1

11/11/2015 70 NY.WIBLIK V
71 NY.MIA V
72 NY.MIRA V
73 NY.SITI MAESAROH V
74 NY.NINDI V
75 NY.HERNAWATI V
76 NY.SHENDY V
77 NY.EVA V
JUMLAH 8

12/11/2015 78 NY.NENG PIPIT V


79 NY.NINDY V
80 NY.SHENDY V
81 NY.HERLINAWATI V
82 NY.NENG H V
83 NY.NENIH V
84 NY.NELLY V
85 NY.IDA KOMALA V V
86 NY.RENI V
JUMLAH 9 1
13/11/2015 87 NY.SRI WIDA V
88 NY.NELLY V
89 NY.MAE SITI V
90 NY.RENI V
91 NY.ITAS V
92 NY.MIMIN V
93 NY.ERNAWATI V
94 NY.SITI ANISAH V V
JUMLAH 8 1

14/11/2015 95 NY.SITI ANISAH V V


96 NY.MIMIN V
97 NY.ERIN V
98 NY.MAE SITI V
99 NY.SONIYA V
JUMLAH 5 1

15/11/2015 100 NY NURUL V


101 NY LINDUANA V
JUMLAH 2

16/11/2015 102 NY.LINDUANA V


103 NY.SARI V V
104 NY.DEWI V
105 NY HAMIDAH V V
106 NY DESI V
JUMLAH 5 2

17/11/2015 107 NY DEWI S V


108 NY NY LINA S V
109 NY SETIAWATI V
110 NY HAMIDAH V V
111 NY DESI V V
112 NY DEWI S V V
113 NY CUCU V V
114 NY HANI V
115 NY SITI V
116 NY EUIS V
117 NY SITI SOLIHA V
118 NY ANI V
119 NY AAN R V
JUMLAH 13 4

18/11/2015 120 NY DINI V


121 NY EULIS V
122 NY SETIAWATI V
123 NY SITI V
124 NY MEGA V
125 NY NURAENI V
126 NY MELI V
127 NY ROSYANTI V
128 NY ENUNG V
129 NY HANI V
JUMLAH 10

19/11/2015 130 NY SITI V


131 NY ENUNG V
132 NY NY HANI V
133 NY CUCU V
134 NY EKA V
135 NY GUSTIANI V
136 NY MELLY V
137 NY MIRA V
138 NY ELMADITA V V
139 NY WILA V
140 NY RESMA V
JUMLAH 11 1

20/11/2015 141 NY CUCU V


142 NY GUSTIANI V
143 NY WILA V
144 NY ELMADITA V
145 NY NY MIRA V
146 NY EKA V
147 NY ANEU V
148 NY MILA V
149 NY WINDA V V
150 NY AAT V V
151 NY IRA V V
JUMLAH 11 3

21/11/2015 152 NY NY ANEU V


153 NY MILA V
154 NY AAT V V
155 NY RURI V
156 NY WINDA V V
157 NY IRAYANTI V V
158 NY DHEANITA V
159 NY YUYUN V
160 NY ROSTANTI V
161 NY SUSI V
162 NY LISDA V
JUMLAH 11 3
22/11/2015 163 NY NY KARNIA V
164 NY YUYUN V
165 NY LISDA V
166 NY TITIN V V
167 NY RENIATI V
JUMLAH 5 1

23/11/2015 168 NY KARNIA V


169 NY RENIATI V
170 NY NY RINA M V
171 NY NURJANAH V
172 NY YENI V V
173 NY DEVI V
174 NY IMAS V V
JUMLAH 7 2

24/11/2015 175 NY IMAS V


176 NY TITIN V
177 NY NENG RISKA V
178 NY YANI V
179 NY NINING V V
180 NY ANISA V
JUMLAH 6 1

25/11/2015 181 NY NY YUNI V


182 NY LINDA V
183 NY ASTRI V
184 NY TITIN V
185 NY YANI V
186 NY ROSITA V
187 NY SITI JAENAB V
188 NY MEINA V
189 NY NURYANI V
190 NY RUPIYATI V V
191 NY NURVIA V
JUMLAH 11 1

26/11/2015 192 NY RISA EVA V


193 NY SARAH V
194 NY NYRHASANAH V
195 NY FITRI V
196 NY PUTRI V
JUMLAH 5

27/11/2015 197 NY RISA EVA V


198 NY SARAH V
199 NY PITRIA V
200 NY NURHASANAH V
201 NY PIUTRI V
202 NY FITRI V
203 NY IMAS V
204 NY RUMIATI V V
JUMLAH 8 1
28/11/2015 205 NY.RUMIYATI V
206 NY.DHINI V
207 NY.FITRI V
208 NY.RIAN V
209 NY.SITI M V
210 NY.AAN V
211 NY.NURYANTI V
212 NY YATI V
213 NY.SANTI V
214 NY.RENI V V
215 NY.YENI V
JUMLAH 11 1

29/11/2015 216 NY.NURYAN V


217 NY.HENI V
218 NY.YENI V
219 NY.DAHLIA V
220 NY.ZANUS V V
221 NY.RANI V
222 NY.NENG SUSANTI V
223 NY.RANI V V
JUMLAH 8 2

30/11/2015 224 NY.SANI V


225 NY.ADE RITA V
226 NY.RANI V V
227 NY.ZANUS V V
228 NY.DESSI V V
229 NY.DEPI V
230 NY.RINA V
231 NY.KOKOM V
232 NY.SISKA V
JUMLAH 9 3

JUMLAH 232 49
JUMLAH PSN 232

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - DESEMBER 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2015 1 NY.METTY V
2 NY.ADERITA V
3 NY.DEPI V
4 NY.DESSI V V
5 NY.KOKOM V
6 NY.RINA V
7 NY.SISKA V
8 NY.HARLINA V
9 NY.EKA V
10 NY.ENTIN V
JUMLAH 10 1

02/12/2015 11 NY.ENTIN V
12 NY.HARLINA V
13 NY.RINA V
14 NY.SISKA V
15 NY WIDA V
16 NY MARIYANTI V
17 NY IDA KARWATI V
18 NY DEVI V
JUMLAH 8

03/12/2015 19 NY DEVI V
20 NY IDA V
21 NY RINI V
22 NY IIS V
23 NY FUJI V
24 NY SILVI V
25 NY ANITA V
26 NY DIANA V
27 NY MIMIN V
28 NY HENI V
JUMLAH 10

04/12/2015 29 NY SUMIATI V V
30 NY SUPRI V
31 NY YANI V V
32 NY IMAS V
33 NY DIANA V
34 NY IMAS V
35 NY IRMA V
JUMLAH 7 2

05/12/2015 36 NY RINA V
37 NY VIKA V
38 NY YANTI V V
39 NY WINA V
40 NY DEWI V V
41 NY RIKA V
42 NY DEWI ENDAH V
43 NY LINA V
44 NY PITRIYANI V V
JUMLAH 9 2 1

06/12/2015 45 NY VIKA V
46 NY PITRIYANI V V
47 NY RIKA V
48 NY PERAWATI V
49 NY URIP V
50 NY LILIS V
JUMLAH 6 1

07/12/2015 51 NY RISMAH V
52 NY URIP V
53 NY RISMAH V
54 NY HUJAN V
55 NY TRIYATI V V
56 NY NURHAYATI V
57 NY SRI Y V
58 NY AI RUKMINI V
59 NY RATIH V V
JUMLAH 9 2

08/12/2015 60 NY RATIH V V
61 NY HUJAN V
62 NY AI RUKMINI V
63 NY TRIYATI V V
64 NY NURHAYATI V
65 NY IMAS V V
66 NY NURI V
JUMLAH 7 3

09/12/2015 67 NY NINA V V
68 NY RIA V
69 NY IMAS V V
70 NY LIA V
71 NY ROSI V
72 NY WINDA V V
JUMLAH 6 3
10/12/2015 73 NY YANTI V
74 NY IMAS ATUN V
75 NY ERNA WATI V V
76 NY ROSI V
77 NY WINDA V V
78 NY YESITA V
79 NY LIA V
JUMLAH 7 2

11/12/2015 80 NY ROHATI V V
81 NY LIA MARYANI V
82 NY NURJANAH V
83 NY TITA JUWITA V V
84 NY NOVIA V
JUMLAH 5 2

12/12/2015 85 NY RINRIN V
86 NY KURNIA V
87 NY NOVIA V
88 NY LIA V
89 NY RINRIN V
90 NY NOVI V
91 NY NANI V V
92 NY SOPIAH V
93 NY LESTYOWATI V
JUMLAH 9 1

13/12/2015 94 NY RINRIN V
95 NY NENG SITI V
96 NY YANTI V
97 NY LESTYOWATI V
98 NY NANI V V
99 NY RATNA V
100 NY ADE S V
101 NY ELI N V
102 NY OKTAVIANA V
103 NY TRISNI V
JUMLAH 10 1

14/12/2015 104 NY NANI V V


105 NY YANTI V
106 NY TRISNI] V
107 NY NENG SITI V
108 NY KETI V V
109 NY IIS V
110 NY SITI V
111 NY SITI AISYAH V
112 NY WIWIN V
113 NY WAHIDAH V
JUMLAH 10 1 1

15/12/2015 114 NY WAHIDAH V


115 NY WIWIN V
116 NY SITI R V
117 NY DEWI V
118 NY IIS V
119 NY HERLINA V
120 NY SARMI V
JUMLAH 7
16/12/2015 121 NY INA V
122 NY ANISA V
123 NY SARMI V
124 NY HERLINA V
125 NY SITI R V
126 NY ANI ROHAENI V
127 NY ANISA V
128 NY INA V
129 NY NURYATI V
129 NY YATI V
130 NY SOFIYATUL V
131 NY IIN V
132 NY SRI R V
JUMLAH 13

17/12/2015 133 NY SRI V


134 NY SOFIYATUN V
135 NY ANISA V
136 NY DESI V
137 NY NURYATI V
138 NY RISMA V
139 NY RISNAWATI V
JUMLAH 7

18/12/2015 140 NY NURYATI V


141 NY RISMA V
142 NY RISNAWATI V
143 NY ASRI V
144 NY WIWIK V
145 NY ELI V
146 NY DEWI V
JUMLAH 7

19/12/2015 147 NY ASRI V


148 NY INDRI V
149 NY NY DEWI V
150 NY SANTI V
151 NY ERNA V
152 NY MIRA V
153 NY WIWIT V
154 NY NANI V V
155 NY NOVI V
156 NY ATIN V
157 NY DEWI KARTIKA V
JUMLAH 11 1

20/12/2015 158 NY MIRA V


159 NY DENI V
160 NY NURDIANA V
161 NY NURAIDA V
162 NY TANTI V
JUMLAH 5

21/12/2015 163 NY ROSSI V


164 NY NURAZIZAH V
165 NY ENI RINI V
166 NY JUNITA V
167 NY INE JUNIANTI V
168 NY ATI N V
169 NY GITA DEWI V
JUMLAH 7
22/12/2015 170 NY JUNITA V
171 NY EGA V
172 NY INE JUNIANTI V
173 NY GITA DEWI V
174 NY ROSSI V
175 NY LILIS V V
176 NY WARSIH V
177 NY ATI N V
178 NY RIKA V
179 NY YANTI V
JUMLAH 8 1

23/12/2015 180 NY ATI N V


181 NY YANTI V
182 NY MUTI R V
183 NY ENDAH V
184 NY MUSLIMAH V
185 NY LENA MARLINA V
186 NY ANISA V
187 NY LENI V
188 NY ENUNG V V
189 NY DINAR V
` JUMLAH 9 1

24/12/2015 190 NY LENI V


191 NY ENUNG V V
192 NY LENA MARLINA V
193 NY SILFI EKA V
194 NY DINAR V
195 NY NOPI V
196 NY ANNISA V
197 NY IRMA V
198 NY AI RANI V
199 NY HARYANI V
JUMLAH 10 1

25/12/2015 200 NY AI NURMAYANTI V V


201 NY KASMAYANTI V
202 NY IVA SARIPAH V
203 NY HARYANI V
204 NY RITA V
205 NY ELMA V V
206 NY SRI V
207 NY SITI V
208 NY DESI V
JUMLAH 9 1 1

26/12/2015 209 NY LILAH SARI V V


JUMLAH 1 1

27/12/2015 210 NY UUN V V


211 NY WULANDARI V
212 NY SUMIATI V
213 NY RICHI V
214 NY LILIS V
215 NY ETI V
216 NY NENDEN V
217 NY YESI V
JUMLAH 8 1
28/12/2015 218 NY NURHAYATI V
219 NY SITI HOSITOH V
220 NY IMAS V V
221 NY NENDEN V
222 NY EMPON V
223 NY IMAS V V
224 NY KOMALA DEWI V
225 NY YESI V
JUMLAH 8 2

29/12/2015 226 NY HANI V


227 NY NURHAYATI V
228 NY DEWI V V
229 NY YENI V
230 NY WIWIN V
231 NY KIKI V
232 NY DEWI V V
233 NY ELA V
234 NY ELY V
235 NY SARAH V
236 NY SHANTY V
237 NY VOPPY V
238 NY HASANAH V
237 NY VOPPY V
238 NY HASANAH V
JUMLAH 15 2

30/12/2015 239 NY ENDAH RINA V V


240 NY TENI V
241 NY SHANTY V
242 NY HASANAH V
243 NY TENI V
244 NY DEWI SUCI V V
245 NY DEWI V
246 NY SANTI V V
247 NY RINA V
248 NY ANDRI V
JUMLAH 10 3

31/12/2015 249 NY ANDRI V


250 NY NINING V
251 NY NINING V
252 NY SANTI V V
253 NY RATMAH V
254 NY TUTI V
255 NY TENI V
256 NY LILIS V
JUMLAH 8 1

JUMLAH 226 36 3
JUMLAH PASIEN 221

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JANUARI 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2016 1 NY SITI WAHYU V
2 NY ENDAH V V
3 NY SANTY V
4 NY RISMA V
JUMLAH 4 1

02/01/2016 5 NY RISMA V
6 NY ENDAH V V
7 NY ADILA V
8 NY POPON V
9 NY FINA V
10 NY EUIS V
11 NY ERNI V
12 NY GITA HANI V
13 NY SEGI V
JUMLAH 9 1

03/01/2016 14 NY GITA HANI V


15 NY SEGI V
16 NY ERNI V
17 NY FINA V
18 NY WULAN V
19 NY IMAS V
20 NY POPON V
21 NY EUIS V
22 NY E RODIATUS V
23 NY MARYAMAH V V
24 NY ERNI V
25 NY IAH V
26 NY WATI V
JUMLAH 13 1

04/01/2016 27 NY WULAN V
28 NY FINA V
29 NY MARYAMAH V V
30 NY IAH V
31 NY DEDEH V V
32 NY WATI V
33 NY SISKA V
34 NY EVI Y V
35 NY EVIE S V
36 NY ANISA V
37 NY RESTI V V
38 NY SRI F V
JUMLAH 12 3

05/01/2016 39 NY ANISA V
40 NY RESTI V V
41 NY EVIE Y V
42 NY SRI Y V
43 NY NY SISKA R V
44 NY WINDA V
45 NY TITIN V
46 NY RODIAH V
47 NY MARYAN V
48 NY WINADA V
49 NY YULIANTI V
50 NY NOVEL V V
JUMLAH 12 2

06/01/2016 51 NY TITIN V
52 NY MARYAM V
53 NY NOVEL V V
54 NY MIMIN V V
55 NY WINDA V
56 NY YULIANTI V
57 NY LENI M V
58 NY SUMARNI V
59 NY ENUNG SITI V
JUMLAH 9 2

07/01/2016 60 NY ATIK ATIKAH V


61 NY NY RINDI V
62 NY ENUNG V
63 NY SUSILAWATI V
64 NY YULIANTI V
65 NY HESTINI V
66 NY ISMI V
67 NY DESI V
68 NY INA V
69 NY WIDIA V
JUMLAH 10

08/01/2016 70 NY DESI V
71 NY HESTINI V
72 NY WIDIYA V
73 NY TUNIK V
74 NY ISMI LESTARI V
75 NY INA V
76 NY UPIT V V
77 NY WINDA V
JUMLAH 8 1

09/01/2016 78 NY UPIT V V
79 NY ISMI V
80 NY PIA V
81 NY INA V V
82 NY FITRI V
83 NY ARSYA V
84 NY NANI V
85 NY REZTY V V
86 NY ENENG V
87 NY YANTI V
88 NY IIS V
89 NY MIRNAWATI V
90 NY LASMANAH V
JUMLAH 13 3

10/01/2016 91 NY REZTY V
92 NY ENENG V
93 NY LASMANAH V
94 NY IIS V
95 NY DESI V
96 NY YANTI V
97 NY VANI V
98 NY NOLIS V
99 NY MIRNAWATI V
100 NY RANI A V
101 NY ROHIMAH V V
JUMLAH 11 1

11/01/2016 102 NY DESI V


103 NY ROHIMAH V
104 NY NOLIS V
105 NY MIRNAWATI V
106 NY NOPI V
107 NY RISMA V
108 NY YULI YULIANA V
109 NY SUMIATI V V
JUMLAH 8 1

12/01/2016 110 NY YULI YULIANA V


111 NY NEPI V
112 NY MELY V
113 NY RISMA V
114 NY SUMIATI V V
115 NY MURSIDAH V
116 NY ENUNG SITI V
117 NY DINI ANGGRAENI V
118 NY PITRIAH V
JUMLAH 9 1

13/01/2016 119 NY ENENG TUTI V


120 NY ERLITA V
121 NY HERLINA V
122 NY ENDAH V V
123 NY CUCU SUMIATI V
124 NY LISMAWATI V V
125 NY SANTI SUSANTI V
126 NY WIDANINGSIH V
JUMLAH 8 2

14/01/2016 127 NY HERLINA V


128 NY ENDAH V
129 NY LISMAWATI V V
130 NY EKA V
131 NY CUCU V
132 NY FITRI V
133 NY ESTER V
134 NY YATI V
135 NY NURHASANAH V
136 NY ANNE SUSILAWATI V
137 NY LINDA V
JUMLAH 11 1

15/01/2016 138 NY IIN NURMAYANTI V


139 NY RENI V
140 NY DESI V
141 NY RISTA V
142 NY ICE V
143 NY SINTA V V
144 NY FITRI ANIRA V
JUMLAH 7 1

16/01/2015 145 NY SITI S V


146 NY SHERA V
147 NY WASIAH V
148 NY LENI V
149 NY LAELASARI V
150 NY WAWAT V
151 NY NITA V
JUMLAH 7

17/01/2016 152 NY NITA V


153 NYILA V
154 NY WASIAH V
155 NY WAWAT V V
156 NY NINING V
157 NY SUSILAWATI V
JUMLAH 6 1

18/01/2016 158 NY NENENG V


159 NY RINA V
160 NY SUSILAWATI V
161 NY LINA V
162 NY NINING V
163 NY TATI V V
164 NY NANI V V
165 NY SUSAN V
JUMLAH 8 2

19/01/2016 166 NY ISNAENI V


167 NY NANI V V
168 NY ANI V
169 NY VINA V
170 NY SITI D V
171 NY SUSAN V
172 NY SRI S V
173 NY SITI JULAEHA V
JUMLAH 8 1

20/01/2016 174 NY ELIN V V


175 NY ANI V
176 NY SRI S V
177 NY SUSANTI V
178 NY NENI V
179 NY SANTI V
180 NY TUTI V
181 NY YULI YULIANTI V
JUMLAH 8 1

21/01/2016 182 NY ILAH V


183 NY SUMINAR V
184 NY SRI S V
185 NY TUTI V
186 NY NENI V
187 NY NUNIK V
188 NY LENI V
189 NY EUIS V
JUMLAH 8

22/01/2016 190 NY LISTIYANA V


191 NY HAJAR V
192 NY CICA V
193 NY SUSI V
194 NY RANI V
195 NY RINI V V
196 NY EKA V
JUMLAH 7 1

23/01/2016 197 NY EKA V


198 NY HAJAR V
199 NY RANI V
200 NY RINI V V
201 NY ROSSA V
202 NY LISA V
203 NY HARYANTI V
204 NY EUIS V
205 NY IDA V
206 NY WIWIN V
JUMLAH 10 1

24/01/2016 207 NY MINTARSIH V


208 NY LIA V
209 NY EUIS V
210 NY TINTIN V
211 NY LIA AMALIA V
212 NY TINI V
213 NY TITA V
214 NY SUSI V
JUMLAH 8

25/01/2016 215 NY SITI R V


216 NY IMAS V
217 NY LULU V V
218 NY TUNTUN V
JUMLAH 4 1

26/01/2016 219 NY LIANA V


220 NY SIFAWATI V
221 NY LULU V V
222 NY TUNTUN V
223 NY EVI A V
224 NY DEDEH V V
225 NY TATI V
226 NY CAHYANENGSIH V
227 NY SUCI PUSPA V
JUMLAH 9 2

27/01/2016 228 NY LISNAWATI V


229 NY ATI FITRIA V
230 NY IMAS V
231 NY DIAN V
232 NY CAHYANENGSIH V
233 NY TATI V
234 NY SUCI V
235 NY LISNAWATI V
236 NY IMAS V
237 NY IPAH V
238 NY METI V
239 NY CHICA V V
240 NY SANTI V
241 NY DIANA V
JUMLAH 14 1

28/01/2016 242 NY YOKE V


243 NY SARA V V
244 NY IMAS V
245 NY METI V
246 NY CHICA V V
247 NY SANTI V
248 NY DIANA V
249 NY AI SUMIATI V
250 NY RUSMIATI V V
251 NY ROSI ROSITA V V
JUMLAH 10 4
29/01/2016 252 NY LINA V
253 NY NURAINI V
254 NY NIA V V
255 NY AYU NIA V
256 NY RUSMIATI V V
257 NY DIANA V
258 NY ANNISA V V
259 NY RINRIN V
260 NY MUSRIYAH V
JUMLAH 9 3

30/01/2016 261 NY DINA V


262 NY ATI SUMIATI V V
263 NY TINTIN V
264 NY NELLY V
265 NY IDA ROYANI V V
266 NY NURHAYATI V V
267 NY WIKE V
268 NY PITRI V
269 NY MIRA NUR V
JUMLAH 9 3

31/01/2016 270 NY NOFI V


271 NY SOLIHAH V
272 NY RANI V V
273 NY NURHAYATI V V
274 NY WIKE V
275 NY IDA V V
276 NY FITRI V
276 NY RENI V
277 NY DENOVIANI V
278 NY SUSI S V
JUMLAH 10 3

JUMLAH 279 45
JUMLAH PASIEN 232

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - FEBRUARI 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2016 1 NY DENOVIANI V
2 NY IDA ROYANI V V
3 NY RENI V
4 NY SUSI SUSILAWATI V
5 NY ETI V
6 NY SITI V
7 NY AAM AMELIA V
8 NY WASINI V
JUMLAH 8 1

02/02/2016 9 NY ETI V
10 NY WASINI V
11 NY MIRDA V
12 NY META V
13 NY DHIAN V
14 NY DINI V
15 NY JENI V
16 NY NI WAYAN V
17 NY TIKA V
18 NY NELLY V V
19 NY SETIAWANTI V V
JUMLAH 11 2

03/02/2016 20 NY SITI MARYAM V


21 NY SETIAWATI V V
22 NY JENI V
23 NY NELLY V V
24 NY DINI V
25 NY ANA V
26 NY META V
27 NY ARI V V
28 NY YULIAWATI V
29 NY NANI V
JUMLAH 10 3

04/02/2016 30 NY RIYAN V
31 NY SITI ALIYAH V V
32 NY SELVIA V
33 NY YULIAWATI V
34 NY ARI V
35 NY ANGGI V V
36 NY LILIS V
37 NY DEDE V
JUMLAH 8 2

05/02/2016 38 NY IHAT V
39 NY BIDA V
40 NY FINA V
41 NY ANGGI V V
42 NY ALLNY V
43 NY DEDE V
44 NY SRI V
JUMLAH 7 1

06/02/2016 45 NY RITANTI V
46 NY RENI V
47 NY SUTINEM V
48 NY SITI SURYANI V
49 NY ANNISA V
50 NY SANNY V
51 NY PIPIH V
52 NY SAMIA V V
53 NY DELIA V
54 NY KIKI MARIA V
JUMLAH 10 1

07/02/2016 55 NY LILIS V
56 NY SAMIA V V
57 NY SITI SOLIHAH V
58 NY MEGA V
59 NY MARNI V V
JUMLAH 5 2

08/02/2016 60 NY CITRA V
61 NY MARNI V V
62 NY MELDA V V
63 NY MEGA V
64 NY RIYANTI V
65 NY ELPINAWATI V
66 NY NOVA V
67 NY FITRI V
JUMLAH 8 2

09/02/2016 68 NY FITRI V
69 NY NARNI V
70 NY SITI KOMARIAH V
71 NY ERNI V
72 NY NOVA V
73 NY RIYANTI V
74 NY HERLINA V
75 NY RAHAYU V
76 NY VITA V
77 NY YEYEN V
JUMLAH 10

10/02/2016 78 NY YEYEN V
79 NY VITA V
80 NY SRI BAGJA V
81 NY IMIH V
82 NY SAMIRAH V V
83 NY WIDA V
84 NY USI V
85 NY JUANINGSIH V
86 NY ANI H V
87 NY FITRIA V
88 NY EULIS V
JUMLAH 11 1

11/02/2016 89 NY SAMIRAH V V
90 NY WIDA V
91 NY SHINTIAWATI V
92 NY USI V
93 NY TIKA V
94 NY EULIS V
95 NY LISNA V
96 NY KURSINAH V V
97 NY FITRIANINGSIH V
98 NY YANTI V
JUMLAH 10 1

12/02/2016 99 NY YANTI V
100 NY KURSINAH V V
101 NY NOVI V
102 NY YANTI V
103 NY NINA V
104 NY MASITOH V
105 NY IPAH SUSI V
106 NY FUNI V
JUMLAH 8 1

13/02/2016 107 NY NY NINA V


108 NY IPAH SUCI V
109 NY RISKA J V
110 NY RINI V
111 NY FUNI V
112 NY TINA V
113 NY PIPIT V
114 NY AISAH V
115 NY SARASWATI V
JUMLAH 9

14/02/2016 116 NY TUTI S V


117 NY FUNI V
118 NY RINI V
119 NY TINA T V
120 NY LILIS V
121 NY LIS NURAENI V
122 NY SITI ROSITA V
123 NY MEGA V
JUMLAH 8

15/02/2016 124 NY SITI ROSITA V


125 NY RINI V
126 NY SUSANTI V
127 NY DEWI R V
128 NY SHINTA V V
129 NY YULIANTI V
130 NY AYU S V
131 NY AYU PAULA V
132 NY YANTI V
JUMLAH 9 1

16/02/2016 133 NY ERNI V


134 NY WASTINAH V
135 NY DEWI V
136 NY YULIANTI V
137 NY SHINTA V
138 NY NURAENI V
139 NY YANTI V
140 NY DEWI AENI V
141 NY RINI P V
142 NY TINI V
143 NY TITIN V
JUMLAH 11

17/02/2016 144 NY SUGIYANTI V


145 NY EVI V
146 NY INRI V
147 NY SISKA V
148 NY TINI GUSTINI V
149 NY SARAH V
150 NY PIPIT V
151 NY SITI AMINAH V
JUMLAH 8

18/02/2016 152 NY JUMROTUN V


153 NY ELY V V
154 NY SANTIKA V
155 NY DITA V
156 NY SARAH V
157 NY SITI AMINAH V
158 NY ROSIDA V
159 NY RAHMAWATI V
160 NY NENG KARTINI V
JUMLAH 9 1

19/02/2016 161 NY RITA P V


162 NY ELIS V
163 NY NENAH V
164 NY TINI V V
165 NY ROSSIE V
166 NY WIWIN V
167 NY LIA V
JUMLAH 7 1

20/02/2016 168 NY IDA V


169 NY RIMA V
170 NY VIVI V
171 NY HERAWATI V
172 NY ERNAWATI V
173 NY SOPIYANTI V
JUMLAH 6

21/02/2016 174 NY TIA V


175 NY SOPIYANTI V
176 NY ERNAWATI V
177 NY RIMA V
178 NY GINA V
JUMLAH 5

22/02/2016 179 NY SRI NURJANAH V


180 NY TANTI V V
181 NY GINA V
182 NY IPAH V
JUMLAH 4 1

23/02/2016 183 NY RITA KARTIKA V


184 NY IPAH V
185 NY LILIS V
186 NY ENENG V
JUMLAH 4

24/02/2016 187 NY MIMI V


188 NY ENENG HASANAH V
189 NY ROSITA V
190 NY SUSI V
191 NY MIRA TUTI V
192 NY TINA AGUSTINA V
193 NY RATNA WULAN V
194 NY ASTRI V
JUMLAH 8

25/02/2016 195 NY RAHAYU V


196 NY NINING V V
197 NY YUYU V
198 NY SURYANINGSIH V
199 NY TINA V
200 NY SRI V
JUMLAH 6 1

26/02/2016 201 NY LINDA V


202 NY MELI V
203 NY TUTI V V
204 NY R.MIEKE V
205 NY YUYU V
206 NY SRI V
207 NY ANA V
208 NY IIS V
209 NY FITRIANI V V
JUMLAH 9 2

27/02/2016 210 NY ANI V


211 NY ANA V
212 NY R.MIEKE V
213 NY IIS V
214 NY MIRA V
215 NY AYAS V
216 NY FITRIANI V V
217 NY AGUSTIN V
218 NY INA V
219 NY AGUSTIN R V V
JUMLAH 10 2

28/02/2016 220 NY DWI V


221 NY FITRIANI V V
222 NY WIDA V
223 NY INA V
224 NY DWI V
225 NY YAYUNG V
226 NY INTAN V
227 NY NURSANTI V
228 NY EFNI V
229 NY EMA V
JUMLAH 10 1

29/02/2016 230 NY NOVA V


231 NY ELIN V
232 NY NENI V
233 NY MIMIN V
234 NY NENI V
235 NY YAYANG V
236 NY ERNIWATI V
237 NY ELIS V
JUMLAH 8

JUMLAH 237 27
JUMLAH PASIEN 204

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - MARET 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2016 1 YUYUN YUNENGSIH V
2 SANTI V
3 DEWI V
4 LUKE V
5 TRESSA V
6 DEVI V
7 ANTI V
8 YAYANG V
9 SUSILAWATI V
10 TATI V
JUMLAH 10

02/03/2016 11 YUNIKA V
12 LUKE V
13 DEVI V
14 YAYANG V
15 ANTI V V
16 MELI HARTATI V
17 YUNI RUSIANA V
JUMLAH 7 1

03/03/2016 18 SRI M V
19 MELI HARTATI V
20 YUNI RUSIANA V
21 EMI V
22 DINA V
23 SRI M V
24 NUR HENTI V
25 SRI HARYANTI V V
26 NUR DIANA V
27 NIA KURNIASIH V
28 NENG DESTI V
29 ASTRI PURWANTI V
30 ENOK RASTINAH V
JUMLAH 13 1

04/03/2016 31 DESI KUSUMAWATI V


32 DINA V
33 EMI V
34 ASTRI PURWANTI V
35 NIA KURNIASIH V
36 YUYUN V
37 HENI INDRIANI V
JUMLAH 7

05/03/2016 38 ATIT SUPRIATI V


39 HENI V
40 JUJU V
41 ERNA V V
42 WIWI V
43 MIRANTI V
44 VINA V
45 YULI YANTI V
46 VIVI AMALIA V
47 YAYAH V
JUMLAH 10

06/03/2016 48 YANTI V
49 ICEUS V
50 RENI SETIAWATI V
51 WIWI V
52 YULI YANTI V
53 ROHAENI V
54 EMMA V
JUMLAH 7

07/03/2016 55 YULI YANTI V


56 RATNA SARI V
57 EMMA V
58 MIRA V
59 ANE V
60 SRI HANDAYANI V
61 SITI HALIMAH V
JUMLAH 7

08/03/2016 62 JUAEROH V
63 RINI V
64 ANE NOVANTI V
65 AJENG V
66 OKLI V
67 EMMA V
68 MILA KARTIKA V
69 OON FATONAH V
70 AVON RISMAYA V
71 DEVI NURHAYATI V
72 YANTI APRILIANTI V
73 TITIN V
JUMLAH 12

09/03/2016 74 TITIN V
75 YANTI APRILIANTI V
76 AVON RISMAYA V
77 DEVI NURYANTI V
78 RIPA V
JUMLAH 5

10/03/2016 79 DEWI V
80 RIPA V
81 SARTIKA SARI V
82 ANASIH V
83 RIKA V
84 TITIN V
85 SARI V
86 YELFITRI V
87 NURAENI V
JUMLAH 9

11/03/2016 88 NENI V
89 SARI ASIH V
90 YELFITRI V
91 ANASIH V
92 SARTIKA SARI V
93 DEWI MAYA V
94 RENI V V
95 ASTRI V
96 YANTI V
JUMLAH 9 1

12/03/2016 97 YELFITRI V
98 NENI V
99 LINA MARLINA V
100 YULIANTI V
101 RENI V V
102 NURHAYATI V
103 YENI V
104 IIS V
JUMLAH 8 1

13/03/2016 105 YENI V


106 IIS V
107 TINAH V
108 RENI V
JUMLAH 4

14/03/2016 109 RENI V


110 SARI V
111 AGNES V
112 IMAS SANTI V
113 NINA KARLINA V V
114 SITI MARDIAH V
115 ROHIMAS V V
116 IRMA V
117 NELI V
JUMLAH 9 2

15/03/2016 118 REGINA V


119 RODIAH V
120 FITRI JAMILAH V
121 IMAS SANTI V
122 KOMALA SARI V
123 LATIFAH V
124 SITI M V
JUMLAH 7

16/03/2016 125 REGINA V


126 SITI M V
127 IRMA V
128 RINA V V
129 NOVIANTI V
130 NENDEN V
JUMLAH 6 1

17/03/2016 131 NENDEN V


132 YATI V
133 LINDA V
134 YULI V
135 GINA SONIA V
136 JURNALIS V
JUMLAH 6

18/03/2016 137 JURNALIS V


138 LINDA V
139 YETI V
140 SELVIYANI V
141 GINA V
142 HENA V
143 SUPRIYANI V
144 FITRIYANI V
145 EMA V
146 MARLINDA V V
147 SILVI V
148 NURLELA V
JUMLAH 12 1

19/03/2016 149 FITRIYANI V


150 MARLINDA V V
151 EMA V
152 NURLELA V
153 YANI V V
154 SILVI V
155 SITI V
156 LANI V
157 TITIN V
JUMLAH 9 2

20/03/2016 158 YANI V V


159 LANI V
160 TITIN V
161 SILVI V
162 ANITA V
163 FITRIANI V V V
164 EVA ROSDIAN V
JUMLAH 7 2 1

21/03/2016 165 FITRIANI V V


166 TITIN V
167 YANTI V
168 SITI R V
169 ANITA V
170 ANANDA V
171 HANI V
] 172 DELFA V
173 YENI V
JUMLAH 9 1

22/03/2016 174 YENI V


175 SISKA V
176 DEWI N V
177 SHINTIA V
178 DEWI N V
179 ELFANI V
JUMLAH 6

23/03/2016 180 SHINTIA V


181 DEWI V
182 ELFANI V
183 EVI V
184 FENNY V
185 JUNIARTI V
186 SHANTY V V
187 ERTY V
188 RITA V
JUMLAH 9 1

24/03/2016 189 ERLLI V


190 ELA V
191 SENI V
192 NITA V
193 NIDESWIRA V
194 ERPINI V V
195 AI YANTI V
196 ELIN V
JUMLAH 8 1

25/03/2016 197 SENI V


198 ERNAWATI V
199 SITI N V
200 ELIN V
201 TESSA V
202 DESSY V
203 RATNA SARI V V
JUMLAH 7 1

26/03/2016 204 RATNA SARI V V


205 ANA M V
206 YULIANI V V
207 ANING V
208 DEWI YULIANI V
209 FIRDA V
210 RENI V
JUMLAH 7 2
27/03/2016 211 NINA V
212 KHUZAEMAH V
213 FIRDA V
214 MITA MEIDA V
215 YULIANI V V
216 HERAWATI V
217 NINGSIH V
JUMLAH 7 1

28/03/2016 218 ROSARI V


219 ADLITA V
220 PUJI V V
JUMLAH 3 1

29/03/2016 221 FITRI V V


222 NENI V
223 HAMIDAH V
224 PUJI V V
225 MARINA V
226 FITRI V V
227 PIPIT V
228 FENI SANITA V
229 NURJANAH V
230 SUCI V
231 SRI PUJI V
232 ANDINI V
233 ROHITA V
234 NURSANTI V
JUMLAH 14 3

30/03/2016 235 NOPI YULIANTI V


236 NURHAYATI V
237 RINA V
238 NURSANTI V
239 ADE SURYANAH V
240 NURJANAH V
241 ROHITA V
242 RINA V
243 SITI FATIMAH V
244 YENI RAHMAYANI V
245 YULIANTI V
246 EUIS V
247 DASMINAH V V
248 ENDAH V
JUMLAH 14 1

31/03/2016 249 SINTA V V


250 ENDAH V
251 DASMINAH V V
252 EUIS V
253 NENG ITA V
254 NENDEN V
255 INNA ROSALINA V
256 YANTI ROSITA V
257 LILIS V
258 SUNENGSIH V
259 YULIANTI V
JUMLAH 11 2

JUMLAH 259 26 1
JUMLAH PASIEN 233
Formulir Survey Harian Pemakaian Alat
Ruang VK - RSKIA - APRIL 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 1 SRI ARNIYATI V V
2 RISNA V
3 YANTI V
4 YULIYANTI V
5 LILIS V
6 NENG LIA V
7 PENI V
8 FUJI PERTIWI V
9 ANIS FITRIANI V
10 ISMI V
JUMLAH 10 1

02/04/2016 11 DIAN V
12 ANIS FITRIANI V
13 ISMI V
14 SRI ARNIYATI V V
15 PENI V
16 FUJI PERTIWI V
17 YESI GUSMAN V
18 SETIAWATI V
JUMLAH 8 1

03/04/2016 19 YULI V
20 IDA SUSILAWATI V
21 MIRA ISEUTIAWATI V
22 EUIS YUNINGSIH V
23 SETIAWATI V
24 SRI ARNIYATI V
25 SHINTA V
JUMLAH 7

04/04/2016 26 ALGIE V
27 NIA V
28 NURYANI V
29 ASTI V
30 TINI V V
31 AYUNIAH V V
JUMLAH 6 2

05/04/2016 32 TINA V
33 HANI V
34 AYUNIAH V
35 IYOM V
36 TIKA V
37 ENUNG V
38 KRISNA AULIA V
JUMLAH 7

06/04/2016 39 RESTI V
40 KRISNA AULIA V
41 NENENG V
42 EMPU V
43 IMAS V
44 SUKAESIH V
45 RINI V
46 NOVI SUSILAWATI V
47 MIMI YULIHARNI V
48 SANTI V
JUMLAH 10

07/04/2016 49 SANTI V
50 NOVITASARI V
51 IMAS V
52 EMPU V
53 MIMI YULIHARNI V
54 KARTINI V
55 ROSI ROSTIANI V
56 HARYANI V
57 GINA V
58 DEWI V
JUMLAH 10

08/04/2016 59 FITRI V
60 DEWI Y V
61 INTAN V
62 SHANTI V
63 NENA V
64 MEGA V
65 ERVINA V
66 YUYUN V
67 YANI V
JUMLAH 9

09/04116 68 SHANTI V
69 ERVINA V
70 NENA V
71 YANI KURAESIN V
72 UUS V
73 DINI V
74 LUTFI HAJAM V
75 FITRI V
76 LIA NATALIA V
77 TINI V
78 CAHYATI V
79 EUIS V
80 IMAS ROHAETI V
81 ANI SINA V
JUMLAH 14

10/04/2016 82 DIAN V
83 EUIS V
84 FITRI V
85 DIAN V
86 ANI V
87 TIAH V
88 IIM ROHAETI V
JUMLAH 7

11/04/2016 89 REVA V
90 LUSI V
91 DIAN V
92 IIM ROHAETI V
93 MARLIA V
94 EVA SEPTIYANI V
95 ASTRI HERDIANTI V
96 TIAH V
97 EKA SEKARYANI V V
98 IMAS V
99 KARTIKA INTAN V
100 ANIH V
JUMLAH 11 1 1

12/04/2016 101 AMELIA V


102 ADIS V V
103 NANI V
104 ANIH V
105 TIAH V
106 KARTIKA V
107 ASTRI V
108 NITA V
109 SITI NURLIAH V
110 NYANYIK V V
JUMLAH 10 2

13/04/2016 111 YULIANI V


112 NYANYIK V V
113 FITRI LUTFIANI V
114 KUSMINI V
115 EKA V
116 ANGGI V
117 SRI M V
JUMLAH 7 1

14/04/2016 118 YULI V


119 SRI MULYATI V
120 DEBI MARIA V
121 NENI V
122 ANISAH V
123 WIDA W V
124 ERNI H V
125 SAMSIYAH V
126 WULANDARI V
JUMLAH 9

15/04/2016 127 WIDA W V


128 ERNI H V
129 SAMSIYAH V
130 ANISAH V
131 FRISKA V
132 ELZA V
133 AI ATIKAH V V
134 WIDOERI V V
135 FITRI SAFITRI V
136 SULASTRI V
JUMLAH 10 1 1

16/04/2016 137 NENI H V


138 SULASTRI V
139 FITRI SAFITRI V
140 WIDOERI V V
141 KOKOM V
142 SILVIA H V
143 WIWI V
144 YULI M V
145 LIA SANTIKA V
146 DEWI RANI H V
147 WINI SANIA V
148 NENG SULASTRI V V
JUMLAH 12 2

17/04/2016 149 LIANA ANGELICA V V


150 SRI WAHYUNI V
151 DEWI RANI H V
152 WINI SANIA V
153 LIA SANTIKA V
154 NENG SULASTRI V V
JUMLAH 7 2

18/04/2016 155 METI SETIAWATI V


156 YULIA V V
157 HASANAH V V
158 RENI V
159 HERAWATI V
JUMLAH 5 2

19/04/2016 160 APRILIANI V


161 EFI ASTON V
162 YENI A V
163 LENI V
164 MELI V
165 ANISA V
166 LISNAWATI V
167 SUCI V
168 SANTI V
JUMLAH 9

20/04/2016 169 SUCI V


170 NENGSIH V
171 CAS FITRIA V
172 ANA CHRISTIAN V
173 NENENG V
174 RIKA V
175 AI V
176 LEADYA V V
JUMLAH 8 1

21/04/2016 177 NENENG V


178 RIKA HERLINA V
179 ELA NURJANAH V
180 ELIS V
181 OLA V
JUMLAH 5

22/04/2016 182 ELIS V


183 DEVI HERLINA V
184 ERIJUNI V
185 DIAN V
186 ELIS ROMLAH V
187 ERNA V
JUMLAH 6

23/04/2016 188 SULASTRI V


189 LASMINI V
190 TITA V
191 NURSAIDAH V
192 NURENDAH V
193 SANI V
194 LILIS V
195 ULFAH V V
JUMLAH 8 1

24/04/2016 196 ULFAH V V


197 NOVIANI V
198 IIS V
199 LILIS V
200 MARITA V
201 DEWI PURWANTI V
JUMLAH 6 1

25/04/2016 202 DIAN V V


203 ENDANG V
204 HARNITA V
205 ISMI V
206 RINI SURYANI V
207 SELLY V
JUMLAH 6 1

26/04/2016 208 SELLY V


209 YULLY V
JUMLAH 2

27/04/2016 210 EULIS V


JUMLAH 1

28//04/2016 211 CHINTYA V


212 SITI N V
213 SRI RATNA V
214 RINANINGSIH V
215 LILI V
216 WIWI WIDANINGSIH V V
JUMLAH 6 1

29/04/2016 217 LILI V


218 ALYA V
219 YULI V
220 EVA V
221 WIDIA V
222 NESYA V
JUMLAH 6

30/04/2016 223 DEWI NURDIANTI V


224 SELLY V V
225 AAS SUMIATI V
226 SANTI V
227 IVA Y V
JUMLAH 5 1

JUMLAH 227 21 1 1
JUMLAH PASIEN 198

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - MEI 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2016 1 AI DARIAH V
2 YULI V
3 HANI V
JUMLAH 3

02/05/2016 4 YULI V
5 HANI V
6 RESNAWATI V
7 MEGAWATI V
8 LANI V
9 TINA SUHARTINA V
10 YANTI SUPRIATIN V
11 ELIN MARLINA V
12 MIMIN V
JUMLAH 9

03/05/2016 13 LANI V
14 PUJINIATI V V
15 TINI V
16 DESI JESICA V
17 MURSALINA V
18 DIDAH V
19 NURAINI V
20 MIMIN V
21 MEGAWATI V
22 CHITRA V
23 LINA APRILIA V
24 ANI DWI V V
25 KRISTINA V
JUMLAH 13 2

04/05/2016 26 KRISTINA V
27 ANI DMI V V
28 LINA V
29 CHITRA V
30 WIRANTI V
31 AMINAH V
32 RISKA V
33 SUSILAWATI V
34 SRI MULYATI V
35 ROSI V V
36 LUSI LUSIANA V
37 SITI AMINAH V
JUMLAH 12 2

05/05/2016 38 RISKA V
39 LUSI V
40 SITIAMINAH V
41 MERY V
42 IDA SOPIAH V V
43 NURSANTI V
JUMLAH 6 1

06/05/2016 44 NURSANTI V
45 IDA SOPIAH V V
46 REYNIZA V
47 NINA V
48 DEDE V V
JUMLAH 5 2

07/05/2016 49 REYNIZA V
50 NINA V
51 RENI V
52 ULFA GANDARI V
53 MAYA V
54 UCI V
55 NOVITASARI V
56 SRI ELAWATI V
JUMLAH 8

08/05/2016 57 ROSA V
58 ANI V
59 YESI V
60 DEVI V
61 ENENG CUCU V
62 SUMIARTI V
63 IIS M V
64 RIFQI V
JUMLAH 8

09/05/2016 65 RIFQI V
66 IIS M V
67 PIPIH V
68 INA V
69 WIDA V
70 ATI SUMIATI V
71 SANTI V
72 NENDEN V
JUMLAH 8

10/05/2016 73 NENDAN V
74 ATI SUMIATI V
75 SANTI V
76 INA MARDIANA V
77 ENENG YANI V
78 IIS MARDIANA V
79 MASNENDAH V
80 ERNI V
81 SALMA V
82 DINE V
83 RANI V
JUMLAH 11

11/05/2016 84 RANI V
85 ERNI V
86 SANTI V
87 KRIS V
88 MASNENDAH V
89 IIS MARDIANA V
90 SINDI V
91 NUNUNG V
92 FITRI V V
93 RIZKIANI V
94 SITI A V
JUMLAH 11 1

12/05/2016 95 LIA V
96 NUNUNG V
97 SITIA V
98 RIZKIANI V
99 HAMIDAH V
100 FITRI V
101 YESI V
102 EUIS V
103 YUYUN V V
JUMLAH 9 1

13/05/2016 104 HAMIDAH V


105 RIKA V
106 NURI V
107 EUIS V
108 RENI V
109 JENI V
110 WIDA V
111 YENI V
JUMLAH 8

14/05/2016 112 JENI V


113 WIDA V
114 RINI V
115 SUHARTINI V
116 ELSA V
117 YENI V
118 WINA V
119 MIA V
120 NURAENI V
121 SITI NURJANAH V
JUMLAH 10

15/05/2016 122 MIA HERYANI V


123 NURAENI V
124 SITI NURJANAH V
125 DINI V
126 MIA HERYANI V
127 IMAS V
128 PANJILAH V
129 ISMIATUN V
JUMLAH 8

16/05/2016 130 IMAS V


131 ISMIATUN V
132 ANI V
133 RESKI V
134 NUNUNG V
135 IDA FARIDA V
136 ENDAH V
137 NELIS V V
138 RAFIKA V
139 UPIAH V
JUMLAH 10 1

17/05/2016 140 RAFIKA V


141 IDA FARIDA V
142 NELIS V
143 UPIAH V
144 AJENG V
145 SANTI V
146 DEDEH V
147 ENUR V
JUMLAH 8

18/05/2016 148 HILDA V


149 TUTI V
150 NELIS V
151 ERA V V
152 UPIAH V
153 DEDEH V
154 MARYAM V
155 LISNA V
156 YUNINGSIH V
JUMLAH 9 1

19/05/2016 157 RINA V


158 ERA V V
159 ENON V
160 TUTI HARYATI V
161 ROSITA V
162 YUNINGSIH V
163 WINE V
164 SARI V V
165 ELLY YULIANTI V
166 SRI MULYANI V
JUMLAH 10 2

20/05/2016 167 ROSITA V


168 YUNENGSIH V
169 ERA V
170 WINE V
171 SRI MULYANI V
172 ELLY YULIANTI V
173 SARI V V
174 RINA V
175 RISMA V
JUMLAH 9 1

21/05/2016 176 YUNI V


177 EMAN V
178 NOVA R V
179 HANI V
180 SHINTA V
181 ENTIN V
182 RIKA V
JUMLAH 7

22/05/2016 183 NOVA V


184 TUTI V
185 HANI V
186 SHINTA V
187 RIKA V
188 ENTIN V
JUMLAH 6

23/05/2016 189 SHINTA V


190 ULFA V
191 SUMIATI V
192 ANGGUN V
193 MIRA V
JUMLAH 5

24/05/2016 194 IPAH V


195 SUMIATI V
196 NANI V
197 MUNAROH V
198 EMA V
199 VERA V
200 LISNAWATI V
201 BARIYAH V
JUMLAH 8

25/05/2016 202 BARIAH V


203 ANISA V
204 NURAENI V
205 IPAH V
206 DINI V
207 LISNAWATI V
208 NENG YUNI V
209 AYU V
210 EUIS V
211 SITI NURHUSAENI V
JUMLAH 10

26/05/2016 212 RESDI SITANGGANG V


213 SITI NURHUSAENI V
214 EUIS V
215 AYU V
216 TENI GUSTIANTI V
217 IKA V
218 NENDEN V
219 SISKA DAMAYANTI V
220 TINI HARTINI V
JUMLAH 9

27/05/2016 221 SITI NUR V


222 SISKA V
223 WINDARI V
224 RIA V
225 SEPTI V
226 KIKI V
JUMLAH 6

28/05/2016 227 RIA V


228 SEPTI V
229 SEPTARIKA V
230 TITA JUWITA V
231 LINDA V
232 MITA V
233 KIKI V
234 EVITA V
235 MARTA V
JUMLAH 9

29/05/2016 236 SARAH V


237 EVITA V
238 SEFTARIKA V
239 MIA V
240 MARHA V
241 SARAH V
242 AYU V
243 IMAS V
244 ROHAYATI V
245 TITING SULASTRI V
246 IRDAWATI V
247 NOVIYANTI V
JUMLAH 12

30/05/2016 248 YANTI V


249 LILIS V
250 FIA V
251 IMAS V
252 FIA V
253 YANTI V
256 NOVIANTI V
257 IRDAWATI V
258 SRI MULYATI V
259 HENISYAH V V
260 WIWIN V
261 MARLINA V
JUMLAH 12 1

31/05/2016 262 LINA MARLINA V


263 NOVIANTI V
264 RISNAWATI V
265 CHYNTIA V
266 MARLINA V
267 HENISYAH V V
268 SUMINAR V
269 SITI MULYATI V
270 NOVI SOVIANI V
271 RENDWY IDHAM V
272 HANI NURHAENI V
273 YAYAN V
274 KUSMIASIH V
JUMLAH 13 1

JUMLAH 272 16
JUMLAH PASIEN 235

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JUNI 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2016 1 AI V
2 CHYNTIA V
3 RENDWY V
4 TIKA V V
5 DEWI RODIAH V
JUMLAH 5 1

02/06/2016 6 SUCI V
7 SITI V
8 NINA V
JUMLAH 3

03/06/2016 9 SUCI V
10 PIPIT V
11 SITI AMINAH V
12 LUSINAH V
JUMLAH 4

04/06/2016 13 SITI AMINAH V


14 LUSINAH V
15 NOPI SOPIANTI V
16 SRI DAYANTI V
JUMLAH 4

05/06/2016 17 IKA KARTIKA V


18 IRMA V
19 SELVI V
20 IYAM V
21 RIKA V
JUMLAH 5

06/06/16 22 CICIN V
23 HENI V
24 NIA KURNIATI V
25 ANE V V
26 ALIYA V
27 AI BENTANG V
JUMLAH 6 1

07/06/16 28 HERMA V
29 ALIT ANI V
30 SELPI V
31 RIMA V
32 ALIYA V
33 AI BENTANG V
34 NUR SARIPAH V V
35 WANGSIH V
36 LIAH V V
JUMLAH 9 2

08/06/16 37 LIAH V V
38 RODIAH V
39 SINDI V
40 WULAN SARI V
41 EFI V
JUMLAH 5 1

09/06/16 42 WIDANINGSIH V
43 SHEILA V
44 AI SUSILAWATI V V
45 YENI V
46 EFI V
47 SRI NOVIYANI V
JUMLAH 6 1

10/06/16 48 AI SUSILAWATI V
49 EFI V
50 SRI NOVIYANI V
51 AAN V
52 EKA V
53 KURNIASIH V
54 SRI WAHYUNI V
55 HENI LASMANAH V
56 ANGGRAENI V
JUMLAH 9

11/06/16 57 SRI V
58 RIANE V
59 NENI V
60 ENUNG V
61 HENI LASMANAH V
62 KURNIASIH V
63 ANGGRAENI V
64 AYU ASTUTUTI V
65 EUIS SARININGSIH V
66 NENENG V
67 RODIAH V
68 ANI SUSILAWATI V
69 TRI ARTIVINING V
70 SITI PATIMAH V
JUMLAH 14

12/06/16 71 NENENG V
72 ANGGRAENI V
73 SITI PATIMAH V
74 TRI ARTIVINING V
75 SUSILAWATI V
76 SURYATI V
77 PATIMAH V
78 ITA PUSPA V
JUMLAH 8

13/06/16 79 TRI ARTIVINING V


80 ITA PUSPA V
81 SITI ROSIAH V
82 MULYANI V
83 INDAH V
84 NENI V
85 NUR AFNI V
86 CASWI V
87 DINI V
JUMLAH 9

14/06/16 88 SITI ROSIAH V


89 KRISTIANY V
90 TRIANI V
91 AGUS MARYANTI V
92 DINI V
93 YENI V
94 KARTIKA V
95 VINA V
96 PUTI V
97 REBECA V
98 VITTA V V
JUMLAH 11 1

15/06/16 99 NOVA MELISA V


100 LIA NUR ENDAH V V
101 VITTA
102 VINA V
103 KARTIKA V
104 NUNUNG
105 SITI MARYANI V
106 SITI PAPAT V
JUMLAH 7 1

16/06/16 107 WARLIA V


108/ SARTINI V
109 ROSI V
110 MERLIN V
111 MUNIROH V
JUMLAH 5

17/06/16 113 DEWI V


114 FERA V
115 SUSI SUSILAWATI V
116 YANTI V
117 AMI V
118 NIKMAH V
JUMLAH 6

18/06/16 119 SUMINAR V V


120 AMI V
121 YANTI V
122 SELVI V
123 NIKMAH V
124 VIVI V V
125 JUENDAH V
126 SHERLY V
127 KARTINI V
JUMLAH 9 2

19/06/16 128 VIVI V


129 SERLI V
130 SUMINAR V
131 MEGA R V
132 CUCU V
133 JUENDAH V
134 RIANI V
135 ARI ROSTIKASARI V
JUMLAH 8

20/06/16 136 RIANI V


137 ARI ROSTIKASARI V
138 IKEU PURNAMASARI V V
139 NURHAYATI V
140 DINA V
JUMLAH 5 1

21/06/16 141 NURHAYATI V


142 WINIARTI V
143 DINA V
144 IKE P V V
145 RINI V
146 NENG RANI V
147 WIDANINGSIH V
148 LINAWATI V
149 EKA V
150 SHELY PUJI V
JUMLAH 10 1

22/06/16 151 RINA V


152 TETI V
153 SONENAGSIH V
154 NENG RANI V
155 SHELY V
156 RIANA V
157 IRMA V
158 SITI N V
JUMLAH 8

23/06/16 159 NENG RANI V


160 RINA ROHI V
161 SITI N V
162 RINA V
163 LITA V
164 YETTI V
165 NENI V
166 SRI DEVI V
167 SITI JUBAEDAH V
168 SITI ROHAENI V
169 NURHAYATI V
170 IKA V
JUMLAH 12

24/06/16 171 FARIDA V


172 SELVIRA V
173 NURHAYATI V
174 IKA V
175 SITI R V
176 DESTA PEBIANI V V
177 SITI NURYULIYANI V
178 ARVI V V
JUMLAH 8 2

25/06/16 179 AMI SITI AMINAH V


180 DESTI V V
181 SITI NURYULIYANI V
182 ARVI V V
183 VERA V
184 EDAH V V
185 ENENG N V
JUMLAH 7 2

26/06/16 186 IDA FARIDA V


187 FITRIANI V
188 ENENG N V
189 DESTA V V
190 RISNAWATI V
191 EDAH V V
192 YAYAH V
JUMLAH 7 2

27/06/16 193 YAYAH V


194 EDAH V V
195 TITI V
196 RESTI V
JUMLAH 4 1

28/06/16 197 RESTI V


198 KARMILA V
199 AI DARWATI V
200 EKA SARTIKA V
201 IIS NURJANAH V
202 EVA KRISTIANA V
JUMLAH 6

29/06/16 203 ADE SUMINAR V


204 KARMILA V
205 EVA KRISTIANA V
206 IIS NURJANAH V
207 NURYANTI V
208 DAHLIA V
209 FARIDA V V
210 SUSILAWATI V
211 LUSITHANIA V V
212 NUR JUWITA V
213 WULAN SARI V
JUMLAH 11 2
30/06/16 214 DEWI NURHAYATIN V V
215 IIS NURJANAH V
216 NUR JUWITA V
217 WULAN SARI V
218 LUSITHANIA V V
219 FARIDA V V
220 HALIDA V
221 MILA V
222 ENDAH V
JUMLAH 9 3

JUMLAH TOTAL 244 24


JUMLAH PASIEN 217

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JULI 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/16 1 ANISA V
2 WINA V
3 NUR JUWITA V
4 CINTIA V
5 LUSITANIA V V
6 POPON V
7 RATNA V
8 WULANSARI V
9 DETI V
JUMLAH 9 1

02/07/16 10 WINA V
11 WULANSARI V
12 GEBBY V
13 DEVI OKTA V
14 DETI V
15 ANISA V
16 MAS AIT V
17 LUSI LESTARI V
18 TIN RUSTINI V
19 INDHIRA V
JUMLAH 10

03/07/16 20 TINA V
21 TIN RUSTINI V
22 LUSI LESTARI V
23 LIA DAHLIA V
24 VINA V
25 INDHIRA V
26 ANISA V
27 YANTI V V
JUMLAH 7 1

04/07/16 28 LINDA NOVIA V


29 VINA V
30 YANTI V V
31 SELFIA V
32 NURLAELAWATI V
33 LILIS V
34 PIPIT V
35 DWI SUSILAWATI V
JUMLAH 8 1
05/07/16 36 YANTI V V
37 PIPIT V
38 MARTA V
39 ATIN V
40 RISNAWATI V
41 RIA LISDIANI V
42 MINA V
43 MILA V
44 AJENG V
45 KOKOM V V
46 GUSPIANA V
JUMLAH 11 2

06/07/16 47 KOKOM V V
48 AJENG V
49 PIPIT V
50 MINA V
51 RIA LISDIANI V
52 GUSPIANA V
53 HARYATI V
54 MILA V
55 RESHA V
56 NENG ROHAENI V
JUMLAH 10 1

07/07/16 57 HERLINA V
58 IIN RATNA V
59 ELIS V
JUMLAH 3

08/07/16 60 TIA V
61 RIANSRI V
62 WINDA V
63 ELIS V
64 AI V
JUMLAH 5

09/07/16 65 DESI V
66 YANI
67 SANTI V
68 ANAH V
69 SUHARTINI V V
JUMLAH 5 1

10/07/16 70 ANAH V
71 SUHARTINI V V
72 RINA V
JUMLAH 3 1

11/07/16 73 ROMAULI V V
74 INDRESYAWARI V
75 FITRIYANI V
76 NENG RIPNI V
JUMLAH 4 1

12/07/16 77 NEULIS V
76 NINA V
77 INDRESYAWARI V
78 NENG RIPNI V
79 NINA V
80 RIKA MULYANI V V
81 YUNIARTI V
JUMLAH 7 1

13/07/16 82 WINA HERAWATI V


83 AJENG V
84 RAMADIAN ULFA V
85 RISKA V
86 NENG SUMIATI V
87 AJEUNG V
88 IRMA V
89 INTEN V
90 DEFIRA V
91 ROSMIATI V V
JUMLAH 10 1

14/07/16 92 IDAH V
93 MUSLIAH V
94 SITI NURJANAH V
95 PUTRI V
96 ROSMIATI V V
97 WINA HERAWATI V
98 PIPIT V
99 RESTI V
100 ELSA V V
JUMLAH 9 2

15/07/16 101 LILIS V


102 SRI V
103 WINA V
104 LILIS V
105 RENI V
106 NENG SANTI V
107 NITA R V V
108 RINA V V
JUMLAH 8 2

16/07/16 109 PIPIT V


110 NIA KURNIASIH V
111 SITI JULAEHA V
112 RINA V V
113 ALIKA V
114 SISKA V
115 FITRI V
116 AI ROHAETI V
117 TITA V
JUMLAH 9 1

17/07/16 118 ERNA V


119 GIGIN V
120 RIKA V
121 ANCE V
122 INDAH V
JUMLAH 5

18/07/16 123 ANCE V


124 NOVI W V
125 MUNIKAH V
126 YULI V V
127 YANTI ARYANTI V V
128 RIA V
129 DEWI NOVIA V
130 SRI KESUMA V
JUMLAH 8 2

19/07/16 131 SATRI V


132 JUHAERIAH V
133 YANTI ARYANTI V V
134 YULI V V
135 SRI KESUMA V
136 NOVI V
137 IMAS V
138 LANI V
139 MIRA V
JUMLAH 9 2

20/07/0163 140 MIRA V


141 YULI V
142 LANI V
143 NOVI V
144 SELVI ERPIANA V
145 KOKOM V
146 MARIA V
147 ANE V
JUMLAH 8

21./07/16 148 MELDA V


149 ISMAYANTI V
150 INA DASIMA V V
151 RISKA V
152 SRI ENDAHWATI V
153 RINA V
154 SARININGSIH V V
155 YUYUN V
156 MUSTIKASARI V
157 RIZKY V
JUMLAH 10 2

22/07/2016 158 MUSTIKASARI V


159 RINA V
160 YUYUN V
161 RIZKY V
162 RISKA V
163 DEDEH V
164 INA V V
165 FRISKA V
166 WANTINI V
167 NUR AZIZAH V
168 EMMI V
JUMLAH 11 1

23/07/2016 169 EMMI V


170 NUR AZIZAH V
171 RANI V
172 TIKA KARTIKA V V
JUMLAH 4 1

24/07/16 173 CICIN KURAESIN V


174 TUTI RUSMIATI V
175 ROSITA V
176 SUFAJARWATI V
177 LILIS V
178 YULAN V
179 ITA JUWITA V V
180 MERRY V
181 NYIMAS V V
JUMLAH 9 2

25/07/16 182 SINTA V V


183 SRI V
184 EUIS V
185 SUFAJARWATI V
186 NYIMAS V V
187 LILIS V
188 MERRY V
189 IIS V
190 NENGSIH V V
191 NUNU V
JUMLAH 10 3

26/07/16 192 EUIS V


193 NUNU V
194 ENENG V
195 LILIS V
196 SINTA V V
197 YUNI V
198 WINDARI V
199 NENGSIH V
JUMLAH 8 1

27/07/16 200 RIZKI V


201 WINDARI V
202 SILVIA V
203 RENI V
204 NURAZIZAH V
205 IRMA V
206 SITI YULIANI V
JUMLAH 7

28/07/16 207 NURAZIZAH V


208 DIAH Y V
209 ELIN V
210 YANI V
211 RIMA V
212 KANIA V
JUMLAH 6

29/07/16 213 NETI V


214 SUMAETI V
215 RIMA V
216 YANI V
217 ENUNG V
218 KANIA V
219 NYIMAS V V
220 AINI V
221 RENI V
222 DEWI V
223 RINA V
224 RISMAWATI V
JUMLAH 12 1

30/07/16 225 RINA V


226 RISMAWATI V
227 ARNI V V
228 ELIYA V V
229 REGINA V
230 SRI V
231 TINTIN V
JUMLAH 7 2

31/07/16 232 HENI V


233 ROSITA V
234 EUIS V
235 AAS V
JUMLAH 4

JUMLAH TOTAL 235 32 1


JUMLAH PASIEN 237

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - AGUSTUS 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/16 1 IDA ROYANI V
2 R.ISTI V
3 LELI V
4 SYIFA V
5 LILIS V
JUMLAH 5

02/08/16 6 LENI V
7 RATNASIH V
8 EPI V V
9 SYIFA V
10 DEWI V
11 YENI V V
JUMLAH 6 2

03/08/16 12 EPI V V
13 YENI V V
14 DEWI V
15 NURHANDAYANI V
16 TITA V
17 RIMELDA V
18 EMA V
19 IIN INA V
JUMLAH 8 2

04/08/16 20 YENI V
21 SITI NUR AISYAH V V
22 IIN INA V
23 RIMELDA V
24 FITRI V
25 IRMA V
26 YANTI V
27 SUPRIATI V
JUMLAH 8 1

05/08/16 28 ROSNA V
29 SILVIA V
30 SITI NUR AISYAH V V
31 RIKA V V
32 DETI KURNIATI V
33 NUR ASIYAH V
34 VIVI V
JUMLAH 7 2

06/08/16 35 SITI M V
36 EVA V
37 RIKA V V
38 NOVIANA V
39 TIKA V
40 ERNA V
JUMLAH 6 1

07/08/16 41 RIKA V V
42 SUMARNI V
43 SITI V
44 ASRI ALFIAH V
JUMLAH 4 1

08/08/16 45 MELINA V
46 SANTI SRI V V
47 NENI V
48 ANE V
49 ASRI ALFIAH V
50 DEWI P V
51 MAMAH V V
52 ANI V
53 AI GUSTINI V
54 IMARYATI V
JUMLAH 10 2

09/08/16 55 IMARYATI V
56 AI GUSTINI V
57 DEWI P V
58 SANTI SRI V V
59 ANI V
60 FITRI V
61 DEA V
62 ERNA V
63 ITA V
64 IKA V
65 MIA H V
JUMLAH 11 1

10/08/16 66 NOVI P V
67 SUSI V
68 ERNA V
69 MIA V V
70 ITA V
71 IKA V
72 LELA V
73 SUSI V
74 IIS V V
75 KOMALASARI V
76 YANTI V
77 KARTIKA V
JUMLAH 12 2

11/08/16 78 YANTI V
79 KARTIKA V
80 EUIS V
81 ANISA V
JUMLAH 4

12/08/16 82 VINA V
83 EUIS V
84 ANISA V
85 IYAM V
86 OMAH V
87 NURI V
88 RINA V
JUMLAH 7

13/08/16 89 WULAN SARI V


90 MARICA V
91 DEDE V
92 NONENG V
93 OMAH V
94 NURI V
95 YUNI V V
96 DARI V V
97 LIAH V
JUMLAH 9 2

14/08/16 98 NURI V
99 IRMA V
100 EVI V
101 PANTI V
102 YUNI V V
103 DARI V V
104 DARNISYAH V V
JUMLAH 7 2 1

15/08/16 105 YUNI V V


106 RANI V
107 IRMA V
108 TITIN V
109 DESY V
110 VIVI V
111 YULIDAR V
112 ANE V
JUMLAH 8 1

16/08/16 113 TENI V


114 NENG SAWIYAH V
115 VIVI V
116 ANE V
117 TITIN V
118 SITI ATIKAH V
119 HENI SUSANTI V V
120 DEDE V
121 DINI V
JUMLAH 9 1

17/08/16 122 IRAWATI V


123 LIA V
124 HENI SUSANTI V V
125 DEDE V
126 DINI V
127 TITIN V
128 NOVIASTUTI V
129 ENENG V
JUMLAH 8 1

18/08/16 130 RIKEU V


131 ENENG V
132 EKA SAPUTRI V
133 NITA V
134 FITRIA V V
135 TIA IRAWANA V V
136 VITRIYANI V
137 TITIN V
138 ADE RITA V
139 EKA V
JUMLAH 10 2

19/08/16 140 ADE RITA V V


141 NITA V
142 EKA SAPUTRI V
143 VITRIYANI V
144 TIA IRAWANA V V
145 EKA V
146 DEVY V
147 IDA DAENAH V
148 YOLANDA V
149 DINI V
150 SITI ROHANAH V V
JUMLAH 11 2 1

20/08/16 151 MIMIN V


152 DINI ANGGRAENI V
153 SITI ROHANAH V V
154 DEVY V
155 DINI SETIAWATI V
156 RIA ROSDIANA V V
157 SYIFA V
158 IRMA V
JUMLAH 8 2

21/08/16 159 IRMA V


160 SYIFA V
JUMLAH 2

22/08/16 161 SYIFA V


162 ENDAH SANTIKS V
163 YANI V V
164 DEVI V
165 ENENG V
166 AENI V
167 IMAS YULITA V
JUMLAH 7 1

23/08/16 168 IMAS YULITA V


169 ENENG V
170 YANI V V
171 YUYUN V
172 DEVI V
173 DIMA V
174 SITI NURSIFA V
175 MIRNAWATI V
JUMLAH 8 1

24/08/16 176 SILVI V V


177 INGEU V
178 SEPTI V V
179 YUYUN V
180 SITI NURSIFA V
181 HANA V
182 DESI V
183 IDA V
184 AGNES V
185 SITI HAJAR V
186 DEWI NURAINI V
187 SILVI V
JUMLAH 12 2

25/08/16 187 AGNES V


188 SILVI V
189 HANA V
190 SITI HAJAR V
191 DEWI NURAINI V
192 RIMA V
193 MINA V
194 SYAYIDAH V
195 SANTIKA V
196 RINA V
JUMLAH 10

26/08/16 197 MIA YULIA V


198 ANGGIA V
199 SILVI V
200 YASIROH V
201 LINA V V
202 SITI SOLIHAH V V
203 NOVIE V
204 DEBORA V
205 NENDEN V
JUMLAH 10 2

27/08/16 206 SANTI V


207 NITA SARI V
208 DEBORA V
209 NENDEN V
210 LINA V V
211 HANIFAH V
212 TRIANI V
213 RINA V
214 HENI V
215 FITRIA V V
216 YUSTI V
JUMLAH 11 2

28/08/16 217 LINA V V


218 NITA V
219 ENENG V
220 PURNAMASARI V
JUMLAH 4 2

29/08/16 221 MALANI V


222 YULIA V
223 YANI HARYANI V
224 NITA V
225 ROMLAH V
226 YULIA V
227 NURSAODAH V
228 PURNAMASARI V
229 PANTI V V
230 SARA V
231 MIRNA V
232 DELA V
JUMLAH 12 1

30/08/16 233 MARTINA V


234 SAELINA V
235 KARLINDA V
236 ANABELA V
237 ROMLAH V
238 DELA V
239 CARI AYU V
240 RATNA SARI V
241 DESI SUSANTI V
242 ADE NINA V
JUMLAH 10

31/08/2016 243 SITI HALIMAH V


244 RATNASARI V
245 IDA V
246 FENNI V V
247 ERNA V
248 MURNIYATI V
JUMLAH 6 1
JUMLAH TOTAL 248 39 2
JUMLAH PASIEN 228

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - SEPTEMBER 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/16 1 IDA PARIDA V
2 NIRMALA V
3 MURNIYATI V
4 ERNA V
5 KRISTINE V
6 YANI MULYANI V
7 LIA V
8 ERNITA V
9 DEWI V
10 RINI V
11 IDA V
JUMLAH 11

02/09/2016 12 WINDINING SARI V


13 UTARI V V
14 NENENG V
JUMLAH 3 1

03/09/16 15 SITI YATIMAH V


16 WINDINING SARI V
17 SITI NOVISAH V
18 LENI KUSMIATI V V
19 DESI SRI V
20 NOVI SARTIKA V
JUMLAH 6 1

04/09/16 21 SITI YATIMAH V


22 RINA V
23 NOVI SARTIKA V
24 LIA RATNASARI V
JUMLAH 4

05/09/16 25 ERNAH V
26 MELY V
27 IIS SUMIRAH V
JUMLAH 3

06/09/16 28 ANI MULYANI V


29 SITI ZUAERIAH V
30 WINA V
31 AYU V
32 DEDE V
33 ANI V
34 IIS SUMIRAH V
35 TRI MULYATI V
36 MURNI V
37 HERMIN V
38 ENIS V
JUMLAH 11

07/09/16 39 IIS SUMIRAH V


40 MURNI V
41 ENIS V
42 SANTIE V
JUMLAH 4

08/09/16 43 IMAS V
44 SANTIE V
45 MARIATI V
46 HASUNAH V
47 TIANA V
48 NENOH V
49 KIKI V
50 NURSAIDAH V
JUMLAH 8

09/09/16 51 EUIS JAMILAH V


52 NENOH V
53 KIKI V V
54 NURJAYANTI V
55 IMAS V
56 NURSAIDAH V
57 NURHAYATI V
58 LENA V
59 PIPIH V
60 SRI WENDAH V V
JUMLAH 10 1 1

10/09/16 61 AI WINARI V
62 LISNA V
63 NURHAYATI V
64 NURJAYANTI V V
65 SRI WENDAH V V
66 HANIFAH V
67 RUMANSA V V
68 DARWATI V
69 DEBY YULIA V
70 ING DEA V
71 LENI V V
72 YANTI V
JUMLAH 12 3 1

11/09/16 73 DEBY YULIA V


74 DARWATI V
75 YANTI V
76 SRI WENDAH V V
77 LENI V V
78 RUMANSA V V
79 FOZANI V
80 DIAN V
81 RISNAWATI V
82 DITIA V
JUMLAH 10 3

12/09/16 82 FOZANI V
83 DITIA V
84 RUMANSA V V
85 LENI V V
86 RISNAWATI V
87 ERNA YULIANTI V
88 FIVIH V
89 NUR HALIMAH V
JUMLAH 8 2

13/09/16 90 NURI FIRDANI V


JUMLAH 1

14/09/16 91 IMAS V
92 YULIANTI V
93 NURI FIRDANI V
94 NURUL V
95 MIA AMELIA V
96 DEWI V
97 TRESNAWATI V
98 LILIS V
99 EVA V V
100 ROSITA V
JUMLAH 10 1

15/09/16 101 NURUL V


102 LILIS V
103 MIA AMELIA V
104 EVA V V
105 ROSITA V
106 TRESNAWATI V
107 EUIS V V
108 NURI FIRDANI V
109 RESTIANTI V V
110 ANI R V
111 LUSI V
JUMLAH 11 3

16/09/16 112 AYU DEWI V


113 DIAN V V
114 NETI V
115 YATI HARYATI V
116 KANIA V
117 ANI R V
118 RESTIANTI V V
119 HERIYEN V
120 IPPITA V
121 LUSI V
122 SHANTY V
JUMLAH 11 2

17/09/16 123 SRI H V


124 ENDAH V
125 CUCU V
126 ANI R V
127 HERIYEN V
128 SENI V
129 RINA AGUSTINA V
JUMLAH 7

18/09/16 130 HANI V V


131 JUBAEDAH V
132 ADE NASIHAH V V
133 NURYANI V
JUMLAH 4 1 1

19/09/16 134 NURYANI V


135 ADE NASIHAH V
136 RINA V V
137 IDA ROSIDA V
138 ENENG V V
139 FITRIANTI V
140 KANIA V
JUMLAH 7 2

20/09/16 141 KANIA V


142 FITRIANTI V
143 IDA ROSIDA V
144 RINA V V
145 ANNISA V
146 ENENG V V
147 SILVIA AMELIA V
148 PUTRI DEISI V
149 SITI NURLAELA V V
150 DEWI JULIANTI V
151 EDAH V V
JUMLAH 11 4

21/09/16 152 YANI V


153 JUJU V
154 EDAH V V
155 TRISTANTI V
156 EVI V
157 MAYA V
JUMLAH 6 1

22/09/16 158 KOKOM V V


159 IRA V
160 NURANI V V
161 SANTI V
JUMLAH 4 2

23/09/16 162 SANTI V


163 IDAH V
164 CICH V
165 WITA V
166 ENENG V V
168 ENENG V
JUMLAH 6 1

24/09/16 169 FANI AGUSTIN V


170 SINTA V
171 ELSA V
172 ENENG V
173 RISKA V
JUMLAH 5

25/09/16 174 YULIANI V


175 RENI V
176 RISKA V
177 MUTIARA V
178 ALINDA V
179 ELINA V
180 YULI YANTI V V
JUMLAH 7 1

26/09/16 181 ELINA V


182 YULI YANTI V V
183 ALINDA V
184 DIAN V
185 RENI V
186 NIA V
187 MAYA V
188 CUCU V
JUMLAH 8 1

27/09/16 189 CUCU V


190 ELVITA V
191 RATIH V
192 NANING V
193 MIA V V
194 YOYOH V
195 SITI N V
196 TETI V
197 MARYAMAH V
198 INEU V V
JUMLAH 10 2

28/09/16 199 RIKA V V ~ `11


200 RATIH V
201 SITI N V
202 TETI V
203 MIA V V
204 SUBAEDAH V
205 UCU TITA V
206 RINA AGUSTINA V
207 DESY V V
208 YESI V
JUMLAH 10 3

29/09/16 209 NUR CAHYA V


210 DESY V
211 YESI V
212 TETI V
213 FINI V
214 IDA V
JUMLAH 6

30/09/16 215 SELPI V


216 IDA V
217 SELPI V
218 RINA V
219 ANISA V
220 IIS V
221 HARNINGSIH V
222 NURSIMA V
223 SETIAWATI V
JUMLAH 9

JUMLAH 223 35 1 2
JUMLAH PASIEN 203

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - OKTOBER 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/16 1 NURSIMA V
2 SETIAWATI V
3 SUMIYATI V
4 ELIS V
5 YANTI V
6 MARYANTI V
7 M.SANTI V
JUMLAH 7

02/10/16 8 SUMIYATI V
9 ROS HAMIDAH V V
10 SELLY V
11 ELMANIA V
12 RATIH V
JUMLAH 5 1

03/10/16 13 SELLY V
14 RATIH V
15 ITA ROSITA V
16 TIA V
17 FITRI V
JUMLAH 5

04/10/16 18 ITA ROSITA V


19 BERLIANA V
20 ASTRIANI V
21 EKA V
22 YULITA V
23 YAYU V
JUMLAH 6

05/10/16 24 YAYU V
25 ENDANG V V
26 YULITA V
27 ASTRIYANI V
28 ENOK V
29 EKA AGUSTINA V
30 EKA YULIANA V
31 TITA V
32 RINA V
33 NITA V V
34 HERAWATI V V
35 KOKOM V
36 NIA V
37 RINI V
JUMLAH 14 2

06/10/16 38 ASTRIANI V
39 LIA V
40 HERAWATI V
41 NITA V V
42 KOKOM V
43 RINI V
44 ANI V
45 SRI WAHYUNI V
JUMLAH 8 1

07/10/16 46 MERLIN V
47 IIN V
48 ANI V
49 SRI WAHYUNI V
50 NIA V
51 INEU V V
52 ELMA V
JUMLAH 7 1

08/10/16 53 YULIA V
54 ELMA V
55 WULANDARI V
56 INEU V V
57 HOLIPAH V
58 MARYANI V
59 NURWITA V
60 LINA V
JUMLAH 8 1

09/10/16 61 OKTI V
62 SUSILAWATI V
63 RIZKA V
64 LINA V
65 NURWITA V
JUMLAH 5

11/10/16 66 YANI V
67 LINA V
68 REVA V
69 NITA V
JUMLAH 4

12/10/16 70 YANI V
71 LINA V
72 DEVI V
73 SHILVIA V
74 REVA V
75 TATI V
76 LIA YULIATI V V
JUMLAH 7 1

13/10/16 77 REVA V
78 TATI V
79 MARYATI V V
80 SUNDARI V
81 NURHALIMAH V
82 SITI NURLELA V V
83 DINA V
84 DESMIAR V
JUMLAH 8 2

14/10/16 85 SISKA WARDENI V


86 SITI NURLELA V V
87 DINA V
88 YENI V
89 CHINTIYA V
90 TIORIDA V
JUMLAH 6 1

15/10/16 91 ADHITA V V
92 ANISA V V
93 TIORIDA V
94 WINA V
95 NADIA V
96 EUIS V V
97 RIKA V
98 SANNI V
JUMLAH 8 3

16/10/16 99 ASRI V
100 NADIA V
101 EUIS V V
102 SARI V
103 ANISA V
104 NUNUNG V
105 VERA V
106 SRI WULANSARI V
107 LIA V
JUMLAH 9 1

17/10/16 108 VERA V


109 SRI V
110 NADIA V
111 LIA V
112 SANI INDRIANI V
113 KIAH V
114 NENG YETI V
115 SITI SYAINA V
116 SIFA V
JUMLAH 9

18/10/16 117 SIFA V


118 SITI SYAINA V
119 NENG YETI V
120 KIAH V
121 NINA V
122 TIA ASTRIANI V
JUMLAH 6

19/10/16 123 EVI V


124 KIAH V
125 SYARIFAH V
126 FITRIYANI V
127 EVI V
128 ANI V
129 EWIH V
130 KARWATI V
131 NINDA V
JUMLAH 9

20/10/16 132 CICIN V


133 MAESAROH V
134 FITRIYANI V
135 ANI V
136 KARWATI V
137 NADYAN V
138 FITRI V
JUMLAH 7

21/10/16 139 KARWATI V


140 NURLAELA V
141 DEWI V V
142 DHERIKA V
143 PIPIH ARYANTI V
144 SITI S V
JUMLAH 6 1

22/10/2016 145 NURLAELA V


146 PIPIH ARYANTI V
147 NURLAELA V
148 PIPIH ARYANTI V
149 NINING V
150 SUMARNI V
151 WIDANINGSIH V V
152 HENI V
153 SRI MULYATI V
JUMLAH 9 1

23/10/2016 154 SRI MULYATI V


155 SUMARNI V
156 NURUL V
157 RESI OKTAP V
158 ETI SURYATI V
159 RANI FITRIANI V
JUMLAH 6

24/10/2016 160 IRMA L V


161 SUSANTI V V
162 VICKI V V
163 FITRIYANI V V V
164 NOVA V
165 RENI V
JUMLAH 6 2 2

25/10/2016 166 SUSANTI V


167 RENI V
168 TATI V
169 SCHINTIA V
170 WIDHYASTUTI V
171 NINA V
172 SITI JULAEHA V V
173 RAHMAKILLAH V
JUMLAH 8 1
26/10/16 174 METI V
175 TRIMEGA V
176 RAHMATILLAH V
177 LINA V
178 MULYATI V
179 ARI V
180 FITRI V
7

27/10/16 181 LINA V


182 ARI V
183 FITRI V
184 ELIS V
185 ESIN V V
JUMLAH 5 1

28/10/2016 186 ERTINA V


187 NENENG V
188 ESIN V V
189 YANI V V
190 ARYANI V
191 WAWAT V V
192 KOMAH V
193 ANISA V
194 YAYU V V
JUMLAH 9 4

29/10/2016 195 YANI V V


196 ANISA V
197 YAYU V V
198 WAWAT V V
199 ARYANI V
200 MIRA V
201 ANISA V
202 CITAWATI V
203 ELVANY V
204 ANI V V
205 EEM V
206 LINA V
JUMLAH 12 4

30/10/2016 207 CITAWATI V


208 ANISA V
209 LINA V
210 ELVANY V
211 EEM V
212 ANI V V
213 SARYATI V
214 SILFIANTI V
215 LINDA V
216 ENENG LIA V V
217 YULIANTI V
218 SINTA V
219 SITI NUR KHOLIFAH V
JUMLAH 13 2

31/10/2016 220 SITI NUR KHOLIFAH V


221 LINDA V
222 ENENG LIA V V
223 YULIANTI V
224 AFIFAH V
225 MELI NURHASANAH V V
JUMLAH 6 2

JUMLAH 225 32 2
JUMLAH PASIEN 210

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - NOVEMBER 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/11/2016 1 MELI NURHASANAH V V
2 AFIFAH V
3 ARMILA V
4 DISNA V
5 LENI V
6 SITI R V
7 RIYANA V
8 MEGA V
9 DEDEH V
10 LINA V
JUMLAH 10 1

02/11/16 11 LIA V
12 LINA V
13 DEDEH V
14 LENI V
15 RIYANA V
16 MEGA V
17 SATRIAH V
18 EUIS V V
19 NENI V
20 NADIA V V
21 RITA V
22 SRI V
JUMLAH 12 2

03/11/16 23 SRI V
24 NENI V
25 EUIS V
26 KURNIASIH V
JUMLAH 4

04/11/16 27 ERMA V
28 FITRI V
29 SANTI V
30 KURNIASIH V
31 SYIFA V
32 SITI NURHALIMAH V
33 DEWI V
34 SANI V V
35 DETI V
36 SITI RUKMINI V
JUMLAH 10 1

05/11/16 37 HENI V V
38 SYIFA V
39 DEWI V
40 SANI V V
41 DETI V
42 SITI RUKMINI V
43 SITI NURHALIMAH V
44 ULFAH V
45 SRI NINGSIH V
46 WARNITI V V
JUMLAH 10 3

06/11/16 47 YULIANTI V
48 WARNITI V V
49 NITA V
50 ULFAH V
51 SARI V
52 LYA NOVY V
53 PUTRI V
54 YANI V V
JUMLAH 8 2

07/11/16 55 RIKA V
56 TITA V
57 YANI V V
58 LYA NOVY V
59 ULFAH V
60 HANILAH V
61 TRIS RYANTY V
62 VERA V
63 SITI NURHALIMAH V
64 ERNI V V
65 JULAEHA V
JUMLAH 11 2

08/11/16 66 NENG WINDI V


67 NURI V
68 HANILAH V
69 SITI NURHALIMAH V
70 ERNI V V
71 AI V
72 JULAEHA V
73 TETI V V
74 VERA V
75 CUCUN V
76 AI RATNA V
77 WINDI ASTUTI V
78 RISNA V
79 LIA ROSALIA V
JUMLAH 14 2

09/11/16 80 MIRA V V
81 RIKA V
82 AI RATNA V
83 ERNI V
84 LINA V V
85 SRIYANTI V V
86 AI SUPRIYATIN V V
JUMLAH 7 4

10/11/2016 87 ERNI V
88 LINA V V
89 RANI V
90 SRI V
91 NENG SUSI V
92 MARINI V
93 SUMARNI V
94 DEWI LESTARI V
95 CURYA V
JUMLAH 9 1

11/11/2016 96 NENG SUSI V


97 MARINI V
98 CURYA V
99 SUMARNI V
100 TUTI V
101 CICI V
102 RENI V
103 YUNI V V
104 MIMIN V
105 ELI YULANDARI V V
106 DEDEH V
JUMLAH 11 2

12/11/2016 107 DEDEH V


108 ELI V
109 LENI V
110 YUNI V V
111 TUTI V
112 RENI V
113 LINDA V V
114 IRMA V
115 ROSIDA V V
116 SISKA V
117 ANA RATIH V V
118 BELLA V
119 GRACE V
120 SRI R V
121 LENSI V
JUMLAH 15 4

13/11/16 122 LENSI V


123 IRMA V
124 BELLA V
125 GRACE V
126 SRI R V
127 ROSIDA V V
128 NURHASANAH V
129 RANTI V
130 SRI HERMINAH V
131 SULIMAH V
132 NONENG V
JUMLAH 11 1

14/11/16 133 ERNI V


134 INNI V
135 DINA V
136 SULIMAH V
137 NONENG V
138 FITRIAH V
139 TIKA V
140 ITA V
141 LISNAWATI V
142 EKA V
JUMLAH 10

15/11/16 143 SOFI V


144 PEPY V
145 RINI V
146 DINA V
147 LISNAWATI V
148 EKA V
149 SUSILAWATI V
150 EKA V
151 UPIT V V
JUMLAH 9 1

16/11/16 152 UPIT V V


153 RISTI V
154 YANTI V
155 BASARIA ULINA V
156 TITIN V
157 NENG SITI V
JUMLAH 6 1

17/11/16 158 NENG SITI V


159 SUMIYANTI V
160 TITIN V
161 FITRI V
162 RENNY V
163 TIKE V
JUMLAH 6

18/11/16 164 GINA RANA V


165 LILIS V
166 TIKE V
167 RINA V V
JUMLAH 4 1

19/11/16 168 GRES V


169 IMAS V
170 ROHAYATI V
JUMLAH 3

20/11/16 171 TITIN V


172 SUMIATI V
173 TIKA FITRIA V V
JUMLAH 3 1

21/11/16 174 EVI SETIYANI V


175 NENI V V
176 HANI V
177 TITIN V
178 YUNI V
179 MELIYATI V
180 ETI V
JUMLAH 7 1

22/11/16 181 TITIN V


182 TIKA FITRIA V V
183 ETI V V
184 NENG MULYANI V V
185 POPY V
186 GITA APRILIA V V
187 SUTINI V V
JUMLAH 7 5

23/11/16 188 SUTINI V V


189 GITA APRILIA V V
190 HALIMAH V V
JUMLAH 3 3
24/11/16 191 IPAH HANIFAH V
192 MIRA V
193 NENI V
194 HALIMAH V V
195 SITI ROHIMAH V
196 SITI SOFIAH V
197 CHANDRA V
198 FITRI V
199 TINA V V
200 ERNA V V
201 CUCU V
JUMLAH 11 3

25/11/16 202 CUCU V


203 SITI SOPIAH V
204 SITI ROHIMAH V
205 CHANDRA V
206 FITRI V
207 TINA V V
208 ERNA V V
209 SUCI V V
210 NURHALIMAH V
211 SITI NURLINDA V
212 SOLIAH V
213 ENENG V V
JUMLAH 12 4

26/11/16 214 ENENG V V


215 NURHALIMAH V
216 SOLIAH V
217 NN. PINA V
218 EULIS V
219 KIKI V
220 YANI V
221 SUNIANGSIH V V
222 ERISA V
JUMLAH 9 2

27/11/16 223 YANI KURNIAWATI V


224 TETI V
225 NN. PINA V
226 SUNIANGSIH V V
227 KIKI V
228 ATIK KOMANAH V
229 TATI MARYATI V
230 YENI V
231 RESA RESITA V
JUMLAH 9 1

28/11/16 232 YENI V


233 RESA V
234 ATIK V
235 TATI MARYATI V
236 YENI V
237 RESA V
238 SITI RAHMAWATI V
239 LELY V
JUMLAH 8

29/11/16 240 LELY V


241 SITI RAHMAWATI V
242 NN. DORGANDA V V
243 SUSI V
244 TRI UTAMI V V
245 EGA V
246 YULI V
247 LIAWATI V
JUMLAH 8 2

30/11/16 248 SUSI V


249 YULI V
250 LIAWATI V
251 RAHMAWATI V
252 SARAH V
253 LISNA V
254 RIZKIA V
255 VIA V
256 DESI V
JUMLAH 9 0

JUMLAH KESELURUHAN 256 50


JUMLAH PASIEN MASUK VK 230

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - DESEMBER 2016
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/12/16 1 VIA V
2 RENI AMALIA V
3 DESI DAYANTI V
4 AVTURI V
5 RIZKIA V
6 ANI ROHAENI V
7 NOPIYANA V
JUMLAH 7 0

2/12/16 8 NOPIYANA V
9 LISNA V
10 WATI V
11 RIZKIA V
12 RENI V
13 NURLAELASARI V
14 JULIA DEWI V V
JUMLAH 7 1

3/12/16 15 NUR LAELASARI V


16 JULIA DEWI V
17 RAINY V
18 ISMI V
19 JULIA DEWI V
20 TIA SETIAWATI V
21 ROKAYAH V V
22 IIS SUSILAWATI V
JUMLAH 8 1

4/12/16 23 IIS SUSILAWATI V


24 ENAH V
25 WAHYU V
26 RATNASARI V V
27 PUJI UTAMI V
28 RISMA ULI V V
29 YOSI V
30 SITI V
31 RINA V
JUMLAH 9 2

5/12/16 32 RINA V
33 RISMA ULI V V
34 RATNA V V
35 LIYA V
36 DEWI V
37 EKA V
JUMLAH 6 2

6/12/16 38 LIYA V
39 SUSANTI V
40 HARTI V
41 EKA SURYATI V
42 IRMA V V
43 RANI V
44 KOKOM V
JUMLAH 7 1

7/12/16 45 EKA V
46 IRMA V V
47 KOKOM V
48 OKTARIA V
49 SUSI V
JUMLAH 5 1

08/12/16 50 IRMA V V
51 OKTARIA V
52 SUSI V
53 NURLAELA V
54 MULYATI V
55 YULI V
56 DETI V
57 NURCAHYATI V
58 SITI NURJANAH V
59 NENG DIDAH V
JUMLAH 10 1

09/12/16 60 AJENG V
61 NENG DIDAH V
62 NURCAHYATI V
63 IRMA V V
64 SITI NURJANAH V
65 SARIFAH V
66 NUR FADILAH V
JUMLAH 7 1

10/12/16 67 SARIFAH V
68 DELLA V V
69 SULASTRI V
70 SUSILAWATI V
71 EVA V
JUMLAH 5 1

11/12/16 72 EVA V
73 AMELIA V
74 SANTI V
75 DELLA V V
76 ERINA V V
JUMLAH 5 2

12/12/16 77 LIA N V
78 RANTI V V
JUMLAH 2 1

13/12/16 79 LERI V
80 EULIS V
81 RISKA V V
82 ANNISA V
83 IRA FITRIANI V
JUMLAH 5 1

14/12/16 84 IMAS V
85 ROSINDA V
86 RISKA V V
87 NINING V
88 ANNISA V
89 EUIS V
90 AAM V
JUMLAH 7 1

15/12/16 91 AI FARIDA V
92 EUIS V
93 SANI V
94 NURHASANAH V
95 IMAS V
96 SARINAWATI V
97 MILA V V
98 EVITA V
99 TITIN V
JUMLAH 9 1

16/12/16 100 IMAS V


101 SARINAWATI V
102 NURHASANAH V
103 MULA KURNIA V V
104 EVITA V
105 TITIN V
106 TIORIA V
107 MARYAM V
108 TRI V
109 NOVI V
110 YUYUN V
111 EUIS V
JUMLAH 12 1

17/12/16 112 EUIS V


113 TIORIA V
114 MARYAM V
115 TRI AMBAR V
116 MELI V
117 YUYUN V
118 ENDAH V
119 AI V V
JUMLAH 8 1

18/12/16 120 ADE V


121 CUCU V
122 FITRI V
123 AI V V
JUMLAH 4 1

19/12/16 124 SRI ANDIYANI V


125 SUKIRAH V
126 NONENG V
127 IIS V V
128 IRMAYANTI V
129 LELI V
130 ELIS NOVA V
JUMLAH 7 1

20/12/16 131 SRI MULYANI V


132 SANDRA V
133 IRMAYANTI V
134 ELIS NOVA V
135 LELI V
136 ENENG V
137 EUIS V
138 ERNIYATI V
JUMLAH 8

21/12/16 139 DEWI V


140 LILIS V
141 RESTIARA V
142 PENI V
143 ANI HANDAYANI V V
144 RENI ERNAWATI V
145 SITI N V
JUMLAH 7 1

22/12/16 146 NITA V


147 EULIS V
148 LILIS V
149 ANI HANDAYANI V V
150 WITA JUWITA V
151 NOVI V
152 YUYUN V
JUMLAH 7 1

23/12/16 153 TETI V


154 WINA V
155 LILIS V
156 NENG NENI V
157 SITI FAUZIAH V
168 HAFIRDA V
JUMLAH 6

24/12/16 169 HAFIRDA V


170 ELSA V
171 SITI FAUZIAH V
172 SANTI V
173 ANE YULIANA V
JUMLAH 5

25/12/16 174 SITI SRI V


175 NOVA V
176 ANE YULIANA V
177 LENI HERLINA V
178 MELI V
179 ELIS V
180 ARISKA V
JUMLAH 7

26/12/16 181 IRMA V


182 YULIA V
183 ELSA V V
184 DINI V
185 RITA V
JUMLAH 5 1

27/12/16 186 ELSA V V


187 RITA V
188 NELI V
189 CUCU V
190 SHINTA V
JUMLAH 5 1

28/12/16 191 RITA V


192 ELSA V V
193 SHINTA V
194 MIA V
195 NELI V
196 SRI ANDINI V
197 MELY SANDI V
198 RIKA V
JUMLAH 8 1

29/12/16 KOSONG
30/12/16 199 UTAMI V
200 ANNISA V
JUMLAH 2

31/12/16 201 ANNISA V


202 OPI ARAPIAH V
203 ITA ROSTIANI V
JUMLAH 3

JUMLAH KESELURUHAN : 203 26


JUMLAH PASIEN MASUK: 186

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JANUARI 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2017 1 NOVI V
2 MUTIA V V
3 SITI WULAN V
4 ROHIMAH V
5 NILA V
6 KHOTIJAH V V
JUMLAH 6 2

02/01/17 7 KHOTIJAH V V
8 LIA V V
9 ANA V
10 IMAS V
11 KOKOM V
12 AWANG V
13 LIDIA V
14 RANI V V
15 AI RITA V
JUMLAH 9 3

03/01/17 16 RANI V V
17 AI RITA V
18 LIDIA V
19 AWANG V
20 ENENG AISAH V
21 RINI V
22 HERWI V V
23 ROSMAWATI V
24 ANIAS V
25 MAFTUHAH V
26 JESIKA V
JUMLAH 11 2

04/01/17 22 JESIKA V
23 ANIAS V
24 HUTAMI V
25 LINA V
26 TRI V
27 ASTUTI V
JUMLAH 6

05/01/17 28 RITA YULIANA V


29 LINA V
30 ASTUTI V
31 NOK EMAH V
32 HUTAMI V
33 TRI V
34 FITRIYANTI V
35 IYAN YANTI V
36 TIN TIN V
JUMLAH 9

06/01/17 37 NURUL KOMARIAH V


38 RANI RONA V
39 ITA ROSITA V V
40 FITRIYANTI V
41 TIN TIN V
42 WAISE V
43 SITI HASANAH V
44 RINI APRIANTI V
45 FITRI V
46 RINI V V
JUMLAH 10 2

07/01/17 47 NENG TUTI V


48 WAISE V
49 ITA ROSITA V V
50 RINI APRIANTI V
51 SITI HASANAH V
52 RINI V V
53 ANIS V
54 LENI V
55 IKA KARTIKA V
56 DETI SETIAWATI V
JUMLAH 10 2

08/01/17 57 LIA AMALIA V


58 IKA KARTIKA V
59 RINI V
60 DETI SETIAWATI V
61 JENIH V
62 ASTRI V
JUMLAH 6

09/01/17 63 IDA V V
64 JENIH V
65 ASRI V
66 RINI V
67 RIMA V
68 NURHASANAH V
JUMLAH 6 1

10/01/17 69 SITI HAMIDAH V


70 DITA V
71 RINI V
72 RINI 000212 V
73 FAUZIYAH V
74 NURHASANAH V
75 ASTRI V
76 AFRIZA V
JUMLAH 8

11/01/17 77 INA WIJAYANTI V


78 NENTI V
79 NURAENI V
80 AFRIZA V
81 SITI HAMIDAH V
82 NOVIANTI V
83 MAYA SARI V
84 JULAEHA V
85 LELI V
JUMLAH 9

12/01/17 86 RUSMIYATI V
87 YULIANTI V
88 ANTARYANI V
89 MAS IYAM V
90 SUSILAWATI V
JUMLAH 5

13/01/17 91 AMELIA V
92 SUMIATI V V
93 EVA V
94 SUSILAWATI V
95 MEGA V
96 EUIS TARYANI V
97 NENG YANI V
98 ERICA V
99 EUIS AISAH V V
100 RITA V
JUMLAH 10 2

14/01/17 100 NURI V


101 RITA V
102 RATNA V
103 NENG YANI V
104 EUIS AISAH V V
105 SILFI V
106 NURI V
107 MARTINI V
JUMLAH 8 1

15/01/17 108 IPAH V


109 CAROLIN V
110 SRI V V
111 YULIANTI V
112 NURAETIN V
113 MARTINI V
114 ENI V
115 LINA V
JUMLAH 8 1

16/01/17 116 MAE V


117 YATI V
118 INDRI CAHYANI V
119 YATI V
120 DESIANA V
121 ERNA V
JUMLAH 6
17/01/17 122 TANTI V
123 HIRA V
124 NINING V
125 DESIANA V
126 TANTI V
127 HIRA V
128 AAS V
129 LULU V
130 NOVI V
131 GRACE V
132 DINA V
133 PARWATI V
JUMLAH 12

18/01/17 134 NOVI V


135 AAS V
136 LULU V
137 NURSITA V
138 RINA V
139 YANTI V
140 LILIS EKA V
JUMLAH 7

19/01/17 141 ARISAH V


142 LILIS EKA V
143 ROHAENI V V
144 RINA V
145 RISKA V
146 MELIA V
147 RINA V V
148 DESI V
JUMLAH 8 2

20/01/17 149 JULAEHA V V


150 IRNA V
151 DESI V
152 ROHAENI V V
153 PRISILLA V
154 WANTI V
155 SOLEHATI V
156 EVI V
157 SELLY V
JUMLAH 9 2

21/01/17 158 DEWI ANIH V V


159 SRI NINGSIH V
160 SELLY V
161 SOLEHATI V
162 ISRAMI V V
163 IRMA V
164 WANTI V
165 NURHIDAYAH V
JUMLAH 8 2

22/01/17 166 JUMINAH V


167 IRMA V
168 WANTI V
169 ISRAMI V V
170 MIMIN V
171 SETIAWATI V
JUMLAH 6 1

23/01/17 172 IMAS V


173 ANDARSIH V V
174 SRI V
175 DENA V
JUMLAH 4 1

24/01/17 176 SANTI V


177 ANDARSIH V V
178 DENA V
179 SANTI V
180 SINDI V
181 NOVIA V
182 IMAS V
183 ROHIMAH V V
184 POPI V V
185 RANI V
186 WIDAYANTI V
JUMLAH 11 3

25/01/17 187 RICA V


188 ROHIMAH V V
189 RANI V
190 MIA V
191 TRI V
192 SUSANAH V
193 EUIS V
1

26/01/17 194 SALAMAH V


195 GITA V
196 DEWI V V
197 TRI V
198 EUIS V
199 NITA V
200 KOMALASARI V V
201 SHENI ESA V
JUMLAH 8 2

27/01/17 202 GITA V V V


203 SHENI ESA V
204 SRI V
205 PUTRI V
206 KOMALA V
207 TINI V
208 TUTI V
JUMLAH 7 1 1

28/01/17 209 KOMALA V


210 TINI V
211 LUSI V
212 ERISTA V V
213 WIWIT V
214 NEULIS V
JUMLAH 6 1

29/01/2017 215 NEULIS V


216 ANISA V
217 INTAN V
218 NUNUNG V
219 DESI V V
220 LISNA V
221 SONIA V
JUMLAH 7 1

30/01/2017 222 RINA V


223 SONIA V
224 FITRI V
225 SITI N V V
226 YULI P V
227 TITIN V
228 DESI V
JUMLAH 7 1

31/01/2017 229 SITI N V V


230 DESI V
231 SRI V
232 DEWI V
JUMLAH 4 1

JUMLAH 232 35 1
JUMLAH PASIEN 219

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - FEBRUARI 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/17 1 NOVY V
2 IRRA V
3 IIS RUSTINI V
4 SUSAN V V
5 NOVI V
6 RIVA V
JUMLAH 6 1

02/02/17 7 IIN V
8 NIA V
9 RIVA V
10 FITRI V
11 LENI V
12 NUR SINTA V
JUMLAH 6

03/02/17 13 RIVA V
14 SANTI V
15 NUR ROFIQOH V
16 YUYUN V
17 TITA V
18 OPI V
19 AI SITI K V V
JUMLAH 7 1

04/02/17 20 TITA V
21 RINI ARYANTINI V
22 YUPI SITA DEFI V
23 SANTI V
24 AI SITI V V
25 DEPI V
26 LILIS V
JUMLAH 7 1

05/02/17 27 EMA V
28 MASKIYAH V
29 DIYANI V
JUMLAH 3

06/02/17 30 ERNI V
31 SRI W V
32 SANTI V
33 LINA V V
34 NINA V V
35 UMMU V
JUMLAH 6 2

07/02/17 36 TANTI V
37 UMMU V
38 SANTI V
39 NINA V V
40 IIS V
41 DIAR V
JUMLAH 6 1

08/02/17 42 WIWIT V
43 NENI V
44 YUNI V
45 DIAR V
46 SILI V
47 WATI V
48 MIA MULYATI V
49 EPI V
50 SINTA V
51 ERNI V
JUMLAH 10

09/02/17 52 DEWI V
53 ANI R V
54 WATI V
55 DEWI V
56 SOFIAH V
57 IMAS V
58 SOPIAH V
59 DIAN V
JUMLAH 8

10/02/17 60 DIAN V
61 MIRA V
62 ANISA V
63 ERNI V
64 KARTIKA V
65 RIKA V
66 ELIS V V
JUMLAH 7 1

11/02/17 67 NURHAYATI V
68 KARTIKA V
69 ELIS V V
70 FITHRI V
71 NITA WIJAYA V
JUMLAH 5 1

12/02/17 72 WIWIN V
73 ASRI V
74 FITHRI V
75 ELIN V
76 DEDEH V
77 DESI V
JUMLAH 6

13/01/17 78 FITHRI V
79 TESA V V
80 DEDEH V
81 KURNIA V
82 AGUSTINA V
83 EROS V
84 NURWINA V
85 IRA V
86 FITRIANI V
JUMLAH 9 1

14/02/17 89 NINA V
90 IIS V
91 NURWINA V
92 RIKA V
93 ERNA V V
94 SITI ROSITA V
95 TITA V
96 IIS V
97 ONENG V V
JUMLAH 9 2

15/02/17 98 ERNA V V
99 YANTI V
100 SITI R V
101 ONENG V V
102 WULAN V
103 LISNAWAROH V
104 DESI V
JUMLAH 7 2
16/02/17 105 NANI V
106 DESI V
107 SITI N V
108 MULYANI V
109 MIRA V V
110 SRI YULIANTI V
JUMLAH 6 1

17/02/17 111 SRI YULIANTI V


112 MIRA V V
113 NENI V
114 KUSTINI V
115 RINI V
116 WIWIN V
117 RATNA V
JUMLAH 7 1

18/02/17 118 YUSI V


119 NUR AISAH V
120 AMELIA . V V
121 KUSTINI V
122 WIWIN V
123 NOVI V
124 RIA V
125 SITI MASITOH V
126 RITA YANTY V
127 RITA SUPRIATI V V
128 KIKI V V
JUMLAH 11 3

19/02/17 129 SUSILAWATI V V


130 ENUR V
131 KIKI V V
132 RITA YANTY V
133 RITA SUPRIATI V V
134 EUIS V
JUMLAH 6 3

20/02/17 135 HOSIYAH V


136 CACIH V
137 KIKI V V
138 ITA ROSITA V
139 YUYUN V
JUMLAH 5 1

21/02/17 140 HERAWATI V


141 YUYUN V
142 ITA ROSITA V
143 NENG ELSA V
144 ARIN V
145 LIA YULIANI V
JUMLAH 6

22/02/17 146 ADE CUCU V


147 ITA V
148 MERITTA V
149 DEASY V
JUMLAH 4

23/02/17 150 ANISA V


151 NENI V
152 MIA V
153 TUTI V
154 NOVI V
155 LINDAWATI V
JUMLAH 6

24/02/17 156 NENI V


157 LINDAWATI V
158 WINDA V V
159 ITA JUWITA V
160 RINI ROHAENI V V
161 RERE V V
162 ANEU V
163 MARINI V
164 PIPIH V
JUMLAH 6 3

25/02/17 165 ANEU V


166 RINI ROHAENI V V
167 PIPIH V
168 MARINI V
169 CINDY V
JUMLAH 5 1

26/02/17 170 CINDY V


171 RASY V
172 ANILA V
173 ELMA V
174 NIA V
175 LENA V
176 NIRA V
177 THANIA V
178 NOVA V
JUMLAH 9

27/02/17 179 NIA V


180 NOVA V
181 WENNY V
182 MULYATI V
183 WIWIN V
JUMLAH 5

28/02/17 184 MULYATI V


185 ENUNG V
186 WIWIN V
187 DEWI MUSTIKA V
188 KOMARIAH V
189 RITA V
190 ESIH V
191 RINA V
192 NIA V
193 SITI MAEMUNAH V
JUMLAH 10

JUMLAH 193 26
JUMLAH PASIEN 188

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - MARET 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/17 1 RINA V
2 SITI MAEMUNAH V
3 KOMARIAH V
4 NIA V
5 ESIH V
6 RITA V
7 DEWI MUSTIKA V
8 YENI V
9 NENI V
10 NENA V
JUMLAH 10

02/03/17 11 ANI V
12 MIMIN V
13 CEDINA V
14 YENTI V
JUMLAH 4

03/03/17 15 YENTI V
16 LISA V
17 ERNA V
18 TINI V
JUMLAH 4

04/03/17 19 TINI V
20 ERNA V
21 LISA V
22 NUR ANGGRAINI V
JUMLAH 4

05/03/17 23 PESTI SULASTRI V


24 ELSA V
25 ROTUPA V
26 SURINI V
JUMLAH 4

06/03/17 27 ENENG V
28 WIWIN V
29 RATNA V
30 ASIH V
JUMLAH 4

07/03/17 31 WIWIN V
32 ROSI V
33 NURMALA V
34 SUSI V
35 DIYAN V
JUMLAH 5

08/03/17 36 DIYAN V
37 MIMA V
38 SUSI V
39 SILVANI V
40 WIWIN V
41 DIDAH V
42 IDA V
43 SITI FATIMAH V
44 YUNITA V
45 TITIN HENDAYANI V V
JUMLAH 10 1
09/03/17 46 ASIFA V
47 SRI SUWARSINI V V
48 DEWI V
49 YUNITA V
50 DEWI V
51 TITIN HENDAYANI V V
52 ENENG V
53 IRNA YULIANTI V V
54 SRI YUNIARTI V
55 MALA V
JUMLAH 10 3

10/03/17 56 MALA V
57 IRNA YULIANTI V V
58 DINI ANDRIANI V
59 RIKA V
60 SISKA V
61 WIDIASARI V
62 DINA V
JUMLAH 7 1

11/03/17 63 MALA V
64 DINA V
65 ANGGI V
66 NENGSIH V
67 ASIH V
68 CANTI V
69 IRMA V
JUMLAH 7

12/03/17 70 RANTI V
71 ASIH V
72 NENGSIH V
73 IRTA V
74 AJENG RESTU V
75 RISKA KRISTIANI V
76 CHRISTELLA V
77 JUJU V V
JUMLAH 8 1

13/03/17 78 JUJU V V
79 CHRISTELLA V
80 IRTA V
81 RISKA KRISTIANI V
82 MIRA V
83 EKA V
84 SITI M V
85 TIZZA V V
86 SEPTI V
87 ARIN V
JUMLAH 10 1

14/03/17 88 TIZZA V V
89 ANI V
90 SITI MARYAM V
91 SEPTI V
92 ARIN V
93 JULIANTI V
94 MARYAM V
95 AI S V
96 NANI V
97 FITRIYANI V
JUMLAH 8 1

15/03/17 98 NANI V
99 SEPTI V
100 RANTI V
101 JULIANTI V
102 FITRIYANI V
103 RAMADONA V
104 SONDANG V
105 DESI V
106 ANNISA V
JUMLAH 9

16/03/17 107 NURHAYATI V


108 RATNA V
109 FITRIANI V
110 RAMADONA V
111 NURHAYATI V
112 DESI V
113 IRA V
114 ELIS SOLIHATIN V
JUMLAH 8

17/03/17 115 YENI V


116 INA V
117 DINI MARDIAN V
118 NABILA V
119 DETI V V
120 SUSAN V
JUMLAH 6 1

18/03/17 121 DETI V V


122 SUSAN V
123 PUTRI V
124 ANEU V
125 SINTA V
126 YETI V
JUMLAH 6 1

19/03/17 127 TENI V


128 MIRA V
129 ANI NUR HIKMAH V
JUMLAH 3

20/03/17 130 ANI NUR HIKMAH V


131 ANI NOVIANTI V
132 ELIS V
133 ANI V
134 ARENI V
135 TRIANA V
136 LAELASARI V
JUMLAH 7

21/03/17 137 DESI V


138 SOLIHATUN V
139 NENG RITA V
140 ANI V
141 RUSMAYANTI V
142 SOLEHATUN V
143 TESA V
144 LAELASARI V
145 DWI RAHAYU V
146 ANGGI KARINA V
147 KARTIKA V
148 RIESTANTI V
149 ULFA V
JUMLAH 13

22/03/17 150 SURYANI V


151 ULFA V
152 IMAS V
153 FANI V
154 SUSILAWATI V V
155 ANGGI V V
JUMLAH 6 2

23/03/17 156 SINTA V


157 LILIS V
158 RITA NINGRUM V
159 ERRY FITRIA V
160 EULIS V
161 SUSILAWATI V V
162 ANGGI V V
163 FELICIA V
164 IMAS V
165 YUNI V
JUMLAH 10 2

24/03/17 166 NENG ROSITA V


167 LUMINA V V
168 TINA V V
169 IMAS SITI V
170 SUSILAWATI V V
171 WINARNI V
172 PUJI NUR V
173 YOLANDA V
174 WINA V
175 NURMAYA V
JUMLAH 10 3

25/03/17 176 NURMAYA V


176 SUSILAWATI V V
177 LAELA V
178 DARYANTI V
179 DETI V
180 EKA V
181 ERISNAWATI V
182 TINI V
183 DEDEH V V
JUMLAH 9 2

26/03/17 184 LAELA V


185 RISA V
186 DETI V
187 ERISNAWATI V
188 SITI JUBAEDAH V
189 KRISTIA V V
190 NUR IMAWATI V
191 SRI YUNI V
192 HENI ROHAENI V
193 AI MARIAM V
JUMLAH 10 1

27/03/17 194 RANI V V


195 KRISTIA V V
196 AI MARIAM V
197 RISA V
198 SITI JUBAEDAH V
199 RISNA V
200 IIS V
201 MILAH V
202 HERAWATI V
203 NIA V
204 TATI V
205 INDRIYANI V
206 YULIANI V
JUMLAH 13 2

28/03/17 207 INDRIYANI V


208 DINI V
209 LASTINI V
210 IDA ROHAYATI V
JUMLAH 4

29/03/17 211 DINI V


212 IRMA V
213 DINI V
JUMLAH 3

30/03/17 214 DINI V


215 WIBLIK V
216 NURMALA V
217 NENG YAYANG V
JUMLAH 5

31/03/17 218 NENG YAYANG V


219 NURMALA V
220 AKITA V
221 ULFA V
222 JUNENGSIH V
223 TITIN V
224 TINA AGUSTIN V
225 IIS YANI V V
226 WATI AFIYAH V
JUMLAH 10 1

JUMLAH 227 23
JUMLAH PASIEN 200

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - APRIL 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/17 1 KARMILA V
2 WATI V
3 IIS YANI V V
4 AKITA V
5 ULFA V
6 NURPRATIWI V
7 DESI RESNIATI V V
8 ROSITA V
9 TUTI V
10 NINA HAYATI V V
JUMLAH 10 3

02/04/17 11 SITI N V V
12 NOPI V
13 SITI NURAENI V
14 TUTI MARYATI V V
15 NINA HAYATI V V
16 IIS YANI V V
17 NURPRATIWI V
18 EUIS V
19 NOVI V
20 SITI SARIPAH V
21 EKA DWI V
JUMLAH 11 4

03/04/17 22 EUIS V
23 DEVI V
24 RIA MARYANI V
JUMLAH 3

04/04/17 25 SUMIATI V
26 RIA MARYANI V
27 ELIN V
28 SRI RAHAYU V
29 DINDA MINA V
30 SITI AISYAH V V
31 HANA SUHANA V
JUMLAH 7 1

05/04/17 32 ELA V
33 RESTY V
34 CANTIKA V
35 MARYAM V
36 HANA SUHANA V
37 NITA V
38 CUCU V
39 DINDA V
40 VAMELIA V
41 EUIS CAHYA V V
JUMLAH 10 1

06/04/17 42 CUCU V
43 EUIS CAHYA V V
44 FITRI V
45 AI YANTI V
46 NONENG V
47 DIAN V
48 IIS V
JUMLAH 7 1

07/04/17 49 IIS V
50 DIAN V
51 NONENG V
52 AI YANTI V
53 FITRI V
54 EUIS CAHYA V V
55 ELA V
56 RATNASARI V
59 TEPIH V
60 TRIA V
61 ELVA V
62 WIWIN V
JUMLAH 12 1

08/04/17 63 FURY V
64 SALY V
65 WIWIN V
66 EKA V
67 SUSANTI V
68 TRIA V
69 YULI V
70 YULIA V
JUMLAH 8

09/04/17 71 DEWI V
72 NENENG V
73 NOVIA V
74 YULIA V
75 HERLINA V
76 NURAZIZAH V
77 PRISKA V
JUMLAH 7

10/04/17 78 MARIA V
79 MELATI V
80 NENENG V
81 MUTIARA V
82 FITRI V
83 RITA V
84 MALA V V
JUMLAH 7 1

11/04/17 85 RITA V
85 MALA V V
86 MUTIARA V
87 RUSLIAH V
88 TANTI V
89 INDAH V
90 ERNA V
91 MESAROH V
92 LAELA V
93 SITI M V V
94 NURAJIZAH V
JUMLAH 11 2

12/04/17 95 LINDRI V
96 MALA V V
97 RUSLIAH V
98 ERNA V
99 SUSAN V
100 ANISA V
101 ANNA V
102 NITA V
JUMLAH 8 1

13/04/17 103 RAHMI V


104 ELIS V
105 YANI V
106 ANNA V
107 ANISA V
108 RUSLIAH V
109 DIAN V
110 SANI V
111 ELAH V
112 MIRA V V
113 NENI V V
JUMLAH 11 2

14/04/17 114 MIRA V V


115 NENI V V
116 EEM V
117 GITA V
118 HANIFAH V
119 ANI V V
120 WINA V
JUMLAH 6 3

15/04/17 121 MIRNA V


122 SULFIA V
123 NURHAYATI V
124 MULYATI V
125 MULYANI V
126 WINA V
127 ANNA V
128 GITA V
129 SITI MARYAM V
130 RESTI V
131 SITI N V
JUMLAH 11

16/04/17 132 YANI V V


133 FITRI V V
134 LINA V V
135 RINDA V
136 FITRI V
137 RENI V
138 DESI V
139 RATNA V
140 HALIMAH V
141 NENI V
JUMLAH 10 3

17/04/17 142 NENG SITI V


143 RENI V
144 MIRA V
145 RINI V
146 SINDI V
JUMLAH 5

18/04/17 147 NOVIA V


148 RISSA V V
149 RINA V V
150 RINI V
151 HENI V
152 RIA PURI V
153 SRI NUR V
154 PUTRI V
JUMLAH 8 2

19/04/17 155 EPI SUMIATI V


156 VERAWATI V
157 RIA ATIKAH V
158 RADEN UTAMI V
159 TUTI V
160 LIA V
161 PUTRI INDAH V
162 NENG LIDIA V
JUMLAH 8

20/04/17 163 NENG LIDIA V


164 RIA V
165 RADEN UTARI V
166 LILIS V V
167 IMAS V
168 NENNI V
167 HENI ROHAENI V
168 AGUSTINA V
JUMLAH 8 1

21/04/17 169 CUCU ANDARI V V


170 HENI ASTUTI V
171 HENI ROHAENI V
172 NUR SYAMSIAH V
173 SRI MULYATI V
174 DINI V
175 NENNI V
176 RIA V
177 SITI MAEMUNAH V
JUMLAH 9 1

22/04/17 178 DESI V


179 CUCU MIRA V
180 JUMIATI V
181 DINI V
182 YENI V
183 HAENI V
184 RIKA V
185 SRI V
JUMLAH 8

23/04/17 186 YANI V


187 YUANTI V
188 ELI SOLIHAT V
189 ADE V
190 NIA V
191 RIA V
192 SRI V
193 RIKA V
194 RESNA V
195 YATI V V
196 IKE V
JUMLAH 11 1

24/04/17 197 PURWANTI V


198 RESNA V
199 LILIS V
JUMLAH 3

25/04/17 200 RENI V


201 DEWI AMALIA V
202 SITI ROBIAH V
203 SITI ROHAENI V
204 HANI V V
JUMLAH 5 1
26/04/17 205 SITI ROHAENI V
206 DEWI AMALIA V
207 KHOERANI V
208 AI SULISTIAWATI V
209 LELA V
210 FAUZIAH V
211 YATI V
JUMLAH 7

27/04/17 212 INDAH V


213 ADE RANI V
214 YANTI V
215 AI SULISTIAWATI V
216 RISMA V
217 DARSI V V
218 CUCU V V
JUMLAH 7 2

28/04/17 219 MIMIN V


220 FATHI V
221 WINDA V
222 YAYU V
223 DARSI V V
224 CUCU V V
225 KARMILA V V
226 PIPIH V V
227 ANISA V
JUMLAH 9 4

29/04/17 228 CUCU V V


229 MUMUN V V
230 ANISA V V
231 KARMILA V V
232 ICEU V
233 OYA V
234 DIAN V
235 HANI V
JUMLAH 8 4

30/04/17 236 HANI V


237 RINA RAHMAWATI V
238 NENENG V
239 NIA V
240 YENI V
241 NURUL V
242 IYA V
JUMLAH 7

JUMLAH TOTAL 242


JUMLAH PASIEN 228

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - MEI 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/17 1 NIA V
02/05/17 2 YENI V
3 NENENG V
4 NURUL V
5 IYA V
6 GINA V
7 NERI V
8 WARTINI V
9 VINA V
10 ANDRIYANI V
11 WILIYANTI V
12 NINING V V
JUMLAH 12 1

02/05/17 13 INTAN V
14 SRI MULYATI V
15 VINA V
16 SINTA V
17 INTAN V
18 NURFAUZIAH V
19 MAMAH V
20 TATI SUMIRAT V
21 MIA V
22 IIS V
JUMLAH 10 0

03/05/17 23 MEGA ASTUTI V


24 RINA V
25 MIA V
26 IIS V
27 MAMAH V
28 LISDA V
29 KARTIKA V
30 SITI A V
31 MIRA SRI V
32 IKA V
33 NITA V
34 ITA V V
35 SITI N V
JUMLAH 13 1

04/05/17 36 NITA V
37 SITI N V
38 IKA V
39 SITI A V
40 WIDIA V
41 META V
42 ROSSI V
43 FELLY V V
44 YAYAH V
45 YANTI V
46 NELLA V
47 DEDEH V
JUMLAH 12 1

05/05/17 48 DEDEH V
49 YAYAH V
50 NELLA V
51 YANTI V
52 META V
53 ROSSI V
54 FELLI V V
55 SARI V
56 TOWINGAH V
57 JENI V
58 MAEMUNAH V
JUMLAH 11 1
06/05/17 59 NELLA V
60 WINDA V
61 MAEMUNAH V
62 META V
63 TOWINGAH V
64 YUMIATI V
65 SUSI SUSANTI V
JUMLAH 7

07/05/17 66 RITA V
67 YUNIATI V
68 IIS NENIH V
69 ARTI V
70 WIDI V
71 SUSI V
72 MAYANG V V
JUMLAH 7 1

08/05/17 73 NILAH V
74 MIEKE V
75 RITA V
76 MEIKE V
77 YATI V
78 TIRA V
79 NIA V
80 YUNI V
81 NIA V
82 RINI V
JUMLAH 10

09/05/17 83 GITA V
84 FRISKA V
85 SITI N V
86 IMAS V
87 NENDEN V
88 YUNI V
89 RINI V
90 YANTI V
91 JUWITA V
92 RENI V
93 SUKIYEM V V
94 SUSWATI V
95 SUNARTI V
JUMLAH 13 1

10/05/17 96 DIANA V
97 HANI V
98 MARYANI V
99 SUKIYEM V V
100 GITA V
101 WINDY V
JUMLAH 6 1

11/05/17 102 WINDY V


103 SANTI V
104 TITIN V
105 PUTRI V
JUMLAH 4

12/05/17 106 LISNAWATI V V


107 AMBAR V
108 SANTI V
109 JUANINGSIH V V
110 REKA V
111 IDA V
112 YULIANINGSIH V
JUMLAH 7 2

13/05/17 113 IDA V


114 ATIIKAH V
115 CICIH V
116 NUNUNG V V
JUMLAH 4 1

14/05/17 117 RENI V


118 CICIH V
119 YANTI V
120 NUNUNG V V
121 RENI V
122 WAHDAH V
123 ARNIMA V
124 SADIAH V
JUMLAH 8 1

15/05/17 125 ELIS V


126 ARNIMA V
127 IMAS V
128 LUSTI V
129 TIYANA V
JUMLAH 5

16/05/17 130 ATIK V V


131 HERAWATI V
132 TIYANA V
133 WINDA V V
134 ISTI V
135 JUJU V
136 RATIH V
137 MELISYA V
138 YULI HERNAWATI V
139 IRMA IMEILDA V
140 SANTI V
141 ARNIMA V
JUMLAH 12 2

17/05/17 142 YULI HERNAWATI V


143 WINDA V V
144 MELISYA V
145 SANTI V
146 IRMA IMEILDA V
147 MONIKA V
148 TITI V
149 N. IDA FARIDA V V
150 ICEU V V
151 RIKA V
152 SOVI V
JUMLAH 11 3

18/05/17 153 DHEASY V


154 N. IDA FARIDA V V
155 RIKA V
156 RONIDA V
157 KURNIASIH V
158 SOVI V
159 ICEU V V
160 NENI V
161 RENI V
162 RINA V
JUMLAH 10 2

19/05/17 163 SELLY V


164 RINA V
165 EVIANA V
166 LESTY V
167 TIYANA V V
168 ENUNG V
169 NURYANTI V
170 DEWI UTARI V V
JUMLAH 8 2

20/05/17 171 EVIANA V


172 DEWI UTARI V V
173 TIYANA V V
174 YANI V
175 KHARIMAH V
176 YULIANTI V
177 NENI V
JUMLAH 7 2

21/05/17 178 REGINA V V


179 FRANSESKA V
180 KHARIMAH V
181 NENI V
182 FITRIAWATI V
183 RANNI V
184 SURYATI V
185 TUTI V
186 KARMILA V
JUMLAH 9 1

22/05/17 187 WATI V


188 FITRIAWATI V
189 KARMILA V
190 NENG LILIS V
191 TINA JUSTINA V
192 IIS SITI V
193 CUCU V
194 IIS YULIANTI V V
JUMLAH 8 1

23/05/17 195 LELA V


196 DINDA V
197 SOPIYAH V
198 IIS YULIANTI V V
199 SUSI V
200 IIS SUKARTIKA V
201 YUNITA V
202 NINA V
203 KARMILA V V
204 DEDAH V
JUMLAH 10 2
24/05/17 205 WENNY V
206 EFA V
207 YAYAN V
208 LENI V
209 PUTRI V
210 NINA V
211 LAELA V
212 SOPIYAH V
213 KARMILA V
214 YETI V
215 ARINAL V
JUMLAH 11

25/05/17 216 ANI ANDRIANI V


217 HERNI V
218 ARINAL V
219 YETI V
220 MELIA V
221 IPAH V
222 SRI M V
223 DESI V
JUMLAH 8

26/05/17 224 DINI V


225 IRENA V
226 RINA V
227 DEVI V
228 RUMIATUN V
229 VINA R V
230 RINA V
231 AMBAR V
232 VINNI V
233 SIFA NURUL A V V
JUMLAH 10 1

27/05/17 234 TETI V


235 MULYATIN V V
236 AMBAR V
237 VINNI V
238 TETI V
239 SIFA NURUL A V V
240 RINA V
241 VINA R V
242 SAMIJAH V
243 ALIN V
244 ANE V V
JUMLAH 11 3

28/05/17 245 MILA V


246 VINNI V
247 KUSYANTI V V
248 SAMIJAH V
249 WATI V
250 ALIN V
251 FITRI V
JUMLAH 7 1

29/05/17 252 ELA V


253 ALIN V
254 INDRI V
255 ELVINA V
256 LALA AISAH V V
257 SANNY V
258 SHINTA V
259 DEWI SITI V V
260 YULIANTI V
261 LIA V V
JUMLAH 10 3

30/05/17 262 YULIANTI V


263 ELVINA V
264 LIA V V
265 II V
266 SINTA V
267 INDRIANE V
268 DEWI V
269 AI ROHAENI V
270 RISA V
271 ECHA V
JUMLAH 10 1

31/05/17 272 ETI L V


273 ECHA V
274 DINI YULIA V
275 ANI AGUSTINA V
276 YOSI YULIANI V
277 NOPI V
278 KUSTINI V V
279 SITI MAE V V
280 AJI SULASTRI V
281 WINDI V
JUMLAH 10 2

JUMLAH TOTAL 281 37


JUMLAH PASIEN 244

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JUNI 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/17 1 WINDI V
2 ANI AGUSTINA V
3 ASRI V
4 RINA SUSANTI V
5 TRI PUDYASTUTI V V
6 YUNI V V
JUMLAH 6 2

02/06/17 7 YUNI V
8 PURNITA V
9 RESA V
10 LENA V
11 SUSILAWATI V
JUMLAH 5 0

03/06/17 12 LENA V
13 SUSILAWATI V
14 ERNA V V
15 CUCU V
16 SITI V V
17 LENI V V
JUMLAH 6 3
04/06/17 18 ITA V
19 LENI V V
20 LENA V
21 CUCU V
22 LENI V V
23 NOVI V V
24 NANI V V
25 AI SUMIATI V
26 SRI NURHAYATI V
JUMLAH 9 4

05/06/17 27 NANI V V
28 SRI NURHAYATI V
29 AI SUMIATI V
30 IKA SUPARTIKA V
31 SITI NURHAYATI V
32 CUCUN ADITYA V
33 TIKA WANINGSIH V
34 IRMAWATI V V
35 FITRIYANI\ V
36 DARYANTI V
37 ISKA V V
JUMLAH 11 3

06/06/2017 38 ISKA V
39 IMAS V
40 FITRIYANTI V
41 DARYANTI V V
42 IRMA V
43 WIWIN V V
44 SITI V
45 YESI V
46 ENUR V
45 IN IN V
JUMLAH 10 2

07/06/2017 46 ININ V
47 FITRIYANTI V V
48 YESI V
49 IRMA V
50 ENUR V
51 KARYATI V V
52 SITI V V
53 ENAH V
54 NENG SUSILAWATI V
55 MELANI V
JUMLAH 10 3

08/06/2017 56 NENG SUSILAWATI V


57 MELANI V
58 EUTIK V
59 RINA MARLINA V
60 IIS V
JUMLAH 5

09/06/2017 61 IIS V
62 RINA MARLINA V
63 SHIFA V
64 ASTARI V
65 KARMILAH V
66 ANING V V
67 RANI M V
JUMLAH 7 1

10/06/2017 68 RANI M V
69 ASTARI V
70 NENG YETI V
71 NENI V
72 LILIS V
73 NOVIAWATI V
74 REKHA V
75 RATU V V
76 SITI FATIMAH V
JUMLAH 9 1

11/06/2017 77 NENG YETI V


78 RANI V
79 REKHA V
80 RATU V V
81 NOVIAWATI V
82 SITI FATIMAH V
83 NENI V
84 RANI NURHABIBAH V
85 YANTI NURYANTI V
JUMLAH 9 1

12/06/2017 86 KARINA V
87 ANTI V
88 SITI ROMLAH V
89 IN IN V
JUMLAH 4 0

13/06/2017 90 VANY V
91 PIPIN V
92 ININ V
93 MAYA V
94 NANIH V
95 OON FATONAH V
96 YENI V
97 ANASTESIA V
98 IDA ROSIDA V V
JUMLAH 9 1

14/06/2017 99 IDA ROSIDA V V


100 ANASTESIA V
101 MAYA V
102 AYU A V
103 GINA V
104 YOHANITA V
105 POPI V
JUMLAH 7 1

15/06/2017 106 SITI J V V


107 ELINDA V
108 POPI V V
109 WINA V
110 NURHAYATI V
111 SANTI AMELIA V V
112 IDA SAIDAH V
JUMLAH 7 3

16/06/2017 113 NURHAYATI V


114 IDA V
115 DEBY V
116 SURI YULIAWATI V
117 RENI V
118 YUNIARTI V
119 YULINDA V
120 VERA SETIAWATI V
121 DEDE RODIAH V V
122 MEGA V
JUMLAH 10 1

17/06/2017 123 YUNIARTI V


124 ANI V
125 YULINDA V
126 DEDE RODIAH V V
127 VERA V
128 MEGA V
129 ADE V
130 MIMIN V
131 PARWATI V
132 YUNI V V
JUMLAH 10 2

18/06/2017 133 PARWATI V


134 MIMIN V
135 YUNI V V
136 MEGA V
137 LIA V
138 UMI V
JUMLAH 6 1

19/06/2017 139 MALA V


140 HERLINA V V
141 LIA V
142 MEGA V
143 NURWULAN V
144 REZANIA V
145 KARTIKA V
146 MARTINA V
147 YETI V
148 TATI V
JUMLAH 10 1

20/06/2017 149 NENDAH V


150 TATI V
151 MARTINA V
152 KARTIKA V
153 IIN V
154 SITI MAEMUNAH V
155 YANTI V
156 SITI S V
157 DIANA V
JUMLAH 9 0

21/06/2017 158 MARINA V


159 SITI JUBAEDAH V
160 IIN V
161 YANTI V
162 EVI V
163 YOLANDA V
164 ESTY V
165 NANAY V
166 WIDYA V
167 YUYU V
168 NENI MULYANI V
169 SANTI ALANSARI V
170 POPON SUMIATI V
JUMLAH 13 0

22/06/2017 171 SYIFA NURSANDI V


172 YOLANDA V
173 SANTI V
174 WIDYA V
175 NENI V
176 YUYU V
177 SELFI V
178 YULIA V
179 JUJU V
180 YULIA SARI V
181 LILIS V
182 AYU V
183 NOVI V
JUMLAH 13

23/06/17 184 AYU V


185 JUJU V
186 LILIS V
187 RISWANTI V
188 DESI V
189 RINA AGUSTINA V V
190 NISA V
JUMLAH 7 1

24/06/17 191 ENI V


192 RIZKYA V
193 ASRI V
194 NENG SITI V
195 CHRISTIN V
196 RISWANTI V
197 ERNAWATI V
198 EUIS V
JUMLAH 8

25/06/17 199 SITI V V


200 THANTY V
201 LINA MARLINA V
202 RIMA V
203 MASRIPAH V
204 SRI V
205 ELSA V
JUMLAH 7 1

26/06/17 206 IIS AISYAH V


207 SRI V
208 DEWI V
209 IIS ROHIMAH V
210 SITI SOFIA V
211 MARA V
212 RIMA V V
JUMLAH 7 1

27/06/17 213 NENG YULIAWATI V


214 SITI SOFIA V
215 RIMA V V
216 CUCU V V
217 EMI SRI V
218 NENG FAUZIAH V
JUMLAH 6 2

28/06/17 219 IIN V V


210 FREIDA V
211 EMI SRI V
212 NENG FAUZIAH V
213 RINA V
214 NOER WULAN V
215 ASNAWATI V
216 RENA V
JUMLAH 8 1

29/06/17 217 MIMPRIASIH V V


218 NURSELAWATI V
219 SITI NURTAMA V
220 THIANA V
221 SITI M V
222 PRISKA V
223 SANTI V
224 PUTRI V
JUMLAH 8 1

30/06/17 225 HALIN V


226 SANTI V
227 DESTA V V
228 SUPARTINI V V
229 SETIAWATI V
230 WULAN NURUL V
231 DEWI V
232 YULIANA V
JUMLAH 8 2

JUMLAH TOTAL 244 39


JUMLAH PASIEN 199 199

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - JULI- 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/17 1 WULAN NURUL V
2 DEWI V
3 YULIYANA V
4 AI DAMILAH V
5 PIPIT V V
6 TITIN V V
7 YULIANTI V
8 RANI V
9 ANITA V
10 ENTIN V
JUMLAH 10 2
02/07/17 11 RANI V
12 ENTIN V
13 TITIN V V
14 FILIANI V
15 CUCU V
16 AYU V
17 SITI V
18 RINA V
19 RIA DESI V
JUMLAH 9 1

03/07/17 20 RIA DESI V


21 RINA V
22 YUNIA V
23 NURWINDA V
24 DINA V
JUMLAH 5 0

04/07/17 25 LIA MULYANI V


26 YUNIA V
27 DINA V
28 NOPITA V
29 WIWI V V
30 DEWI PERTIWI V
31 LEAH SOLEAH V
JUMLAH 7 1

05/07/17 32 FELISYA V
33 YUNI V
34 DEWI V
35 LEAH V
36 WIWIN V
37 SITI V
38 KUSNI V
39 CICI DWITA V
JUMLAH 8 0

06/07/17 40 FITRIA V
41 SITI R V
42 RISKANTI V
43 ELIS V
44 CICI V
45 RINA MARIANA V
46 NENIH V
47 RINDA V
48 SITI V
49 MUTIA V
JUMLAH 10 0

07/07/17 50 ASTRI Y V
51 NENG LENI V
52 SITI V
53 MUTIA V
54 RINDA V
55 YUNINGSIH V
56 DINI A V
57 SELFI V
58 DINI DEDE V
59 YUYUN V V
60 IIK V
JUMLAH 11 1

08-07-17 61 DINI A V
62 YUNINGSIH V
63 DINI DEDE V
64 YUYUN V V
65 IIK V
66 EKA CITRA V
JUMLAH 6 1

09-07-17 67 YUYUN V V
68 MEIRINA V
69 IMAS V
70 YETI V
71 NOVITA V
72 IIS SITI V
73 RATIH V
74 INE N V
JUMLAH 8 1

10-07-17 75 ROSITA V
76 DEWI V
77 RATIH V
78 CAHYATI V
79 IIS V
80 HILDA V
81 DIAN V
82 ELAH V
83 INE INDRIANI V
84 LINDA IRMAWATI V
JUMLAH 10

11/07/17 85 RATIH V
86 SITI H V
87 ENGKUM V
88 INE INDRIANI V
89 IRMA V
90 SITI SOLIHAT V V
91 RISKA V
92 AI SUMIATI V
93 RINI M V
JUMLAH 9 1

12/07/17 94 DEWI CAHYANI V


95 RINI M V
96 RENI V
97 AI SUMIATI V
98 SITI SOLIHAT V V
99 RIEKE V
100 NUNUNG V
101 ALFIAH V
102 FITRI V
JUMLAH 9 1

13/07/17 103 ALFIAH V


104 NUNUNG V
105 FITRI V
106 FARIDA V
107 TRIANA V
108 DIAN V
109 SUTINI V
110 BEYTA V
JUMLAH 8

14/07/17 111 TANISAH V


112 NURHASANAH V
113 ANING V
114 IRA V
JUMLAH 4

15/07/17 115 NIA V V


116 SUMI V
117 WIWI WIARSIH V
118 YANTI V
119 NIA KURNIASIH V
120 SARI V
121 AGITA V
122 LILIS V
123 EMPON V
JUMLAH 9 1

16/07/17 124 EMPON V


125 AGITA V
126 IMAS V V
127 SRI M V
128 NIA V
129 NEULIS V
130 PUTRIANI V
JUMLAH 7 1

17/07/17 131 TITIN V


132 SINTA V
133 GERHANA V
134 EGA NUR HABIBAH V
135 DEDEH YUNINGSIH V
JUMLAH 5 0

18/07/17 136 DEDEH YUNINGSIH V


137 AMANDA V V
138 TINA V
139 PITRIA V
140 VERAWATI V
141 WIWIT V
JUMLAH 6 1

19/07/17 142 PITRIA V


143 VERAWATI V
144 WIWIT V
145 SUSAN SULASTRI V
146 SONIA V
147 NURLELA V V
148 SUMIATI V
149 SUCI V
JUMLAH 8 1

20/07/17 150 CITRA V


151 SUMIATI V
152 NURLELA V V
153 CITRA V
154 SUSAN V
155 TANTI V
156 INTAN V
157 MAS AJENG V
158 SITI NURJANAH V V
159 MAYASARI V
160 RINI V V
JUMLAH 11 3

21/07/17 161 MAS AJENG V


162 CITRA V
163 ARPI V
164 POPI ENDAH V
165 ANNISA V
166 RITA V
167 TINI V V
168 FITRIA V
169 DEWI PURWANTI V
JUMLAH 9 1

22/07/17 170 ESIH V


171 IDAH V
172 DEWI P V
173 RITA V
174 IDAH V
175 FITRIA V
176 NIDES V
177 NIA V V
178 SILVIA V
179 SHERLY V
JUMLAH 10 1

23/07/17 180 IIT V V


181 ANNISA V
JUMLAH 2 1

24/07/17 182 ANNISA V


183 AI SITI V
184 NOVIYANTI V
185 AI ELIH V
186 POPY V
187 NINA V V
188 NADYA V
189 LIA BADRIYAH V
190 DEA V
191 TITIN V
JUMLAH 10 1

25/07/17 192 DEWI V


193 MARIATI V V
194 TITIN V
195 NADYA V
196 POPY V
197 LIA BADRIYAH V
198 NINA V V
199 YUNI V
200 NANI HERYANI V
201 SITI K V
202 NINA MARLINA V V
203 NURHAYATI V V
JUMLAH 12 4

26/07/17 204 ANITA V


205 NINA MARLINA V V
206 NANI HERYANI V
207 ANGGI V
208 LISNA V V
209 NIA V V
210 RESTI V
JUMLAH 7 3

27/07/17 212 RESTI V


213 LISNA V V
214 CHRISTINE V
215 WINDY V
216 SITI H V
217 WIDIAWATI V V
218 TETI R V
JUMLAH 7 2

28/07/17 219 YAYAH V


220 MAYUSNIATI V
221 WIDIAWATI V V
222 TETI V
223 SITI H V
224 YAYAH V
225 MAYUSNIATI V
226 KOMALASARI V
227 NUNING V
228 TIMIA V
229 SITI SOLIHAH V
JUMLAH 11 1

29/07/17 230 TIMIA V


231 NUNING V
232 ANDRIANI V
233 NIA V
234 LUPI V
235 WINDA V
JUMLAH 6 0

30/07/17 236 SANTI V


237 WINDA V
238 WULAN V V
239 NIA V
240 NISA V
241 FITRI V
242 RATIYEM V
JUMLAH 7 1

31/07/17 243 LELI V


244 WIWI V
245 WULAN V
246 RESTIAWATI V
247 WULAN V
248 GITA V
249 SHINTA V
7 0
JUMLAH TOTAL 248 31
JUMLAH PASIEN 216 216

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - AGUSTUS- 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/17 1 SHINTA V
2 KOMALAWATI V
3 WULAN V
4 EUTIK V
5 SYIFA V
6 VINA V V
7 ETI V
8 EVI V
9 ULFA V
10 ADE PUPU V V
JUMLAH 10 1 1

02/08/17 11 EVI K V
12 KOMALAWATI V
13 ADE PUPU V V
14 ULFA V
15 VIRNA V V
16 SIBIL V
17 NURAENI V
18 RULIANE V
19 NENI V V
JUMLAH 9 2 1

03/08/17 20 NUR'AENI V
21 NURAENI V
22 RULIANE V
23 YURIKE V
24 SIBIL V
25 MARSHANDA V
26 NENI V V
27 RAHMI V
28 TUTI V
JUMLAH 9 1

04/08/17 29 TUTI V
30 MARSHANDA V
31 ROSMANA V
32 ONENG V
33 WARIYAH V
JUMLAH 5

05/08/17 34 ELI V
35 RISKA V
36 ONENG V
37 EUIS V
38 WARIYAH V
39 LENNY V
40 ROHAENI V
41 SITI V
42 ROSMAYANTI V
43 KARNIA V
44 RENA V
JUMLAH 11

06/08/17 45 KARINA V
46 KANIA V
47 ROHAENI V
48 KARNIA V
49 EUIS V
50 RENA V
51 VINA V
52 YADIANTI V
53 ELSA V
54 LINA V
JUMLAH 10

07/08/17 55 TSANIA V
56 BELLA V
57 RINI V
58 YAYU V
59 FITRIA V
60 NURAINI V
61 YANI SURYANI V V V
JUMLAH 7 1 1

08/08/17 62 IMAS JUBAEDAH V V


63 DINA V
64 ILAH V
65 RINI V
66 FITRIA V
67 LINGGORA V
68 LEHA V
69 EVI V
70 ASTRI V
71 ENTIN V
72 SITI R V
JUMLAH 11 1

09/08/17 73 SINTA V
74 ASTRI V
75 IMAS V V
76 ELAH V
77 ANI NURAENI V
78 SUSANTI V
79 RISNAWATI V
80 NIDA KOMALA V
81 TINI SUPARTINI V
JUMLAH 9 1

10/08/17 82 NUR HAYANI V V V


83 FITRI V V
84 AYU KALIH V V
85 RISNAWATI V
86 KONINGAH V
87 HASNI V V
88 SOFI V V V
89 WINDIARTI V
JUMLAH 8 4 3

11/08/17 90 TITA V
91 NUR HAYANI V
92 MARWATI V
93 WINDIARTI V
94 HASNI V V
95 ATTI V
96 ISTIVIANI V
97 SRI JULAEHA V
98 NURHAYATI V V V
JUMLAH 9 2 1

12/08/17 99 ATTI V
100 ISTIVIANI V
101 ETIN V V
102 TRIANA V
103 DUSTI V V
104 IRMA V V
JUMLAH 6 3

13/08/17 105 KOMALASARI V V


106 ETIN V V
107 IRMA V V
108 TRIANA V
109 TATI V V
JUMLAH 5 2 2

14/08/17 110 RIKA V


111 WIDA V
112 KIKI V
113 EMIL V
114 WULAN V V
115 ETIN V V
116 DEDEH V
117 NENENG V
118 WIDIA V
113 FRIANI V
114 DEDE V V
115 FILDA V
JUMLAH 10 2 3

15/08/17 116 NINING V


117 DEDE V V
118 FRIANI V
119 YUYUN V
120 FILDA V
121 WIDIA V
122 CANDRA V
123 SISKA V
124 YANI V
JUMLAH 9 1

16/08/17 125 ELVIA V


126 SEPTI V
127 ANI V
128 ROS ENROS V
129 SEPTI V
130 SISKA V
131 PITRIANI V
132 YUSI V
133 RIKA V
134 ENDAH V
JUMLAH 10

17/08/17 135 SISKA V V


136 CASMINI V
137 LENI V
138 DEDEH V
JUMLAH 4 1
18/08/17 139 ANI V
140 SINDY V
141 SRI V
142 RINI V
143 RAHMA DEWI V
144 NOVRIANI V
145 MAYA V
146 OMI V
147 RIYAH V V
148 MIMIN V
149 PURWATI V
JUMLAH 11 1

19/08/17 150 RAHMA DEWI V


151 OMI V
152 GINA V
153 PURWATI V
154 NOVRIANI V
155 RINI V
156 RIYAH V V
157 SRI V
158 MIMIN V
159 SUNDARI V
160 RISKI V
161 NURANI V V
162 MOSLIHAH V
163 ROS ENROS V
164 NURIKE V
JUMLAH 15 2

20/08/17 165 RIZKI V


166 ROS ENROS V
167 RIA V
168 RIYAH V V
169 NURANI V V
170 NURIKE V
171 MOSLIHAH V V
172 FINA V
173 MIA V
174 MINTARSIH V
JUMLAH 10 3

21/08/17 175 PANI V


176 MIA V
177 MINTARSIH V
178 MOSLIHAH V V
179 AI MARYATI V V
180 WIDA V
181 ENENG V
JUMLAH 7 2

22/08/17 182 ATI M V


183 DINAR V
184 PATONAH V
185 IIN V
186 AI M V V
187 AKOY V
186 VADILA V
187 MELVIN V
188 CANDRA V V
189 LINA V
JUMLAH 10 2

23/08/17 190 RISNA V V


191 EKA V V
192 AI M V V
193 MELVIN V
194 CHANDRA V
195 CHICA V
196 RENI V
197 LINCE V
198 RODIAH V
199 FEBY V
200 ATIN V
JUMLAH 10 2 2

24/08/17 201 DESSY V V


202 FEBY V
203 CHICA V
204 ATIN V
205 DEWI V
206 NENG LENI V
207 SUSILAWATI V
208 ARTI MELANI V
209 RINI V
JUMLAH 9 1

25/08/17 210 LAELATUL M V


211 SUSILAWATI V
212 RINI V
213 DESI V
214 DAHLIA V V V
215 NITA V V
216 SUKAEDAH V
JUMLAH 7 2 1

26/08/17 217 ETI S V


218 YENI V
219 SUKAEDAH V
220 RINAWATI V V
221 NITA V V
222 EFI V
223 UPI NUR V
224 HASNAH V
225 SARI H V
JUMLAH 9 2

27/08/17 226 ROSY V


227 MILLATI V
228 SISKA V V
229 HASNAH V
230 ROSY V
231 UPI NUR V
232 NITA V
232 NUR MAHMUDAH V
JUMLAH 8 1

28/08/17 233 NUR MAHMUDAH V


234 MILLATI V
235 SISKA V
236 WARLIANI V
237 IMAS V
238 SANI A V
239 NEPTA V
JUMLAH 7

29/08/17 240 SANI A V


241 WARLIANI V
JUMLAH 2

30/08/17 241 DEVIRA V


241 RISMAWATI V
243 DEDE V V
244 ANI V
245 NANI V
246 IMAS V
247 HANI V
248 TINI V
JUMLAH 8 1

31/08/17 249 MUTIA V


250 NUNUNG V
251 IMAS V
252 NANI V
253 TINI V
254 HILDA V V
255 SITI HANI V
256 REMI V V
JUMLAH 8 2
JUMLAH TOTAL 256 42 15 KOMFIRMASI Bd LISMA
JUMLAH PASIEN 217 ISK DIAGNOSA DARI IGD
DAN IRJ

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - SEPTEMBER- 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/17 1 YETI V
2 YENNI V
3 SYAIBATUL V
4 POPPY V
5 NINA V V
JUMLAH 5 1

02/09/17 6 RENI V
7 FITRI V
8 NINA V V
9 POPPY V
10 SARIPAH V V dx ISK dari IRJ
11 RINA V V
12 KURNIA V
JUMLAH 7 2 1

03/09/17 13 DIAN V
14 YENI V
15 NINA V V
16 RINA V V V ISK krn pemasangan kateter di IGD untuk penatalaksanaan px PEB
17 SUMIATI V
18 LANI V
19 MILA V
20 JULIANA V
JUMLAH 8 2 1
04/09/17 21 TINI V
22 DESANTI V
23 ILIS V V
24 DIAN V
25 YUNIDA V
26 DEWI SRI M V
27 YETI V
28 MELINDA V
JUMLAH 8 1

05/09/17 29 YULI V
30 RENI V
31 DEWI SRI M V
32 MELINDA V
33 YOSA V
34 NENGSIH V
35 TUTI V
36 DINI V
JUMLAH 8

06/09/17 37 DEBI V
38 YOSA V
39 NURENDAH V
40 WINDI V V
41 INDAH V V
42 NOVA V V
JUMLAH 6 3

07/09/17 43 IIS YUNENGSIH V


44 NILA JULIANA V
45 ELI WIDIAWATI V
46 INDAH V V
47 NOVA V
48 IIS SOPIANTI V
49 ANISA V
50 RISMA TIARA V
51 PRIMA V
JUMLAH 9 1

08/09/17 52 RIA V
53 SITI HAMIDAH V
54 SUSANTI V V
55 RATNA V
56 NILA JULIANA V
57 NOVA V
58 SUSANTI V V
59 PRIMA V
60 EVI V
61 KIN KIN V
62 IIS KOMALASARI V
63 DEVI V
64 PRIYANTI V
65 POPI YULIANTI V
JUMLAH 14 2

09/09/17 65 LUSI V
66 RIA V
67 KIN KIN V
68 PRIYANTI V
69 KARINA V
70 SUMARNI V
71 DEVI V
72 RINDA V
73 LINA SITI V
JUMLAH 9

10/09/17 74 WINDA V
75 KARINA V
76 DEVI V
77 SUMARNI V
78 RINDA V
79 TIA SRI V
80 IMAS V
JUMLAH 7

11/09/17 81 SULASTRI V
82 SINTA V
83 NELI V
84 IMAS V
85 DEDEH V
86 NUR YANI V
87 KHARINA V
88 MAHISA V
JUMLAH 8

12/09/17 89 KURNIAWATI V
90 MAHISA V
91 KHARINA V
92 CHANDRA V
93 DEDEH V
94 SITI K V
95 MILA V
96 AJENG V
97 IRA WATI V
98 ELLIN V
JUMLAH 10

13/09/17 99 NINDA V
100 YENI V
101 ELLIN V
102 EUIS V
103 ELA V
104 NENG TUTI V
JUMLAH 6

14/09/17 105 HENI V


106 ASTRI V
107 ARI V
108 ROSMAYA V
109 NENG TUTI V
110 ELLA N V
JUMLAH 6

15/09/17 111 RAHAYU V


112 ROSMAYA V
113 NENG TUTI V
114 LINDA V
115 LENI V
116 LIAN V
117 ARTI V
118 MIA V
119 YANI V V
120 IIM V
121 ANI V V
JUMLAH 11 2

16/09/17 122 DINI APRIANI V


123 YANI V V
124 ARTI V
125 KHOMSIAH V
126 JUARIAH V
127 NURAISYAH V
128 ELI V
129 MIRNA V
JUMLAH 8 1

17/09/17 130 MIRNA V


131 ARTI V
132 FERA V
133 DEWI K V V dx ISK dari IGD
134 ANE M V V dx ISK dari IGD
135 ERNA V
JUMLAH 6 2

18/09/17 136 ANA V


137 SITI KOMARIAH V
138 INDAH V
139 RD. AMANDA V
140 SRI V
141 WIDYA V
142 AISYAH V
143 FENTI V
144 DESI V
145 RANI V
JUMLAH 10

19/09/17 146 DESI V


147 SRI V
148 AISYAH V
149 MALA V
150 ELIS V
151 NURYA V
152 SRI V
JUMLAH 7

20/09/17 153 MAMAH V


154 SRI V
155 AISYAH V
156 IMAS V
157 NURYA V
158 VERA V
159 RISTINA V
160 RIMMA V
161 DINA V
JUMLAH 9

21/09/17 162 RANI V


163 TISA V
164 RISTINA V
165 VERA V
166 YANI V
167 LENA V
JUMLAH 6

22/09/17 168 LENA V


169 WIWIN WINARSIH V
170 LILI YULIANI V V dx ISK dari IGD
171 LUSI V
172 VERA V
173 EVI V
174 ANI V
175 RINA V
JUMLAH 8 1

23/09/17 176 ANI V


177 RISHKI V
178 TYA V
179 LISA V
180 RATNANINGSIH V
181 LINA V V ISK krn pemasangan kateter di IGD untuk penatalaksanaan px PEB
JUMLAH 6 1

24/09/17 182 HERLINA V V


183 DINA V V V ISK krn pemasangan kateter di IGD untuk penatalaksanaan px PEB
184 ERNI V
185 WIDYA V
186 ANGEL V
187 MERLY V V dx ISK dari IGD
188 DEA RIZKI V
JUMLAH 7 2 2

25/09/17 189 ELIN V V


190 INEU V
191 ANGEL V
192 VINI V
193 MERLY V V dx ISK dari IGD
194 FITRI V
195 SYARIFA V V dx ISK dari IRJ
196 MEGA V
197 OEIJ V dx ISK dari IGD
JUMLAH 8 3

26/09/17 198 SITI NURLAENI V


199 LATIPAH V
200 DHEA V
201 INDAH V
JUMLAH 4

27/09/17 202 DENAH V


203 RINA V
204 INDAH V
205 REVA V
206 ELIN V
JUMLAH 5

28/09/17 207 SELA V


208 SITI M V
209 SRI RAHAYU V
210 REVA V
211 ELIN V
212 GINA V V dx ISK dari IGD
213 HERDIANA V
214 SANTI V
215 NURBAYANI V
216 YENI V V
JUMLAH 10 1 1

29/09/17 217 REVA V


218 NURBAYANI V
219 HETI V
220 GINA V V dx ISK dari IGD
221 WIWI V
222 IMAS V
223 LASMANAH V
224 LINDA V V
225 NENG SUTIJAYATI V
226 ANI V
JUMLAH 10 1 1

30/09/17 227 ANI V


228 LINDA V V
229 AFRIDA V
230 HETI V
231 SUTIRAH V
232 TIK TIK V
233 ELLA V V V ISK krn pemasangan kateter di IGD untuk penatalaksanaan px PEB
234 SITI KULSUM V
235 NENI V
JUMLAH 9 2 1

JUMLAH TOTAL 235 21 14


JUMLAH PASIEN 211
4

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - OKTOBER- 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/17 1 ELLA V V V ISK krn pemasangan kateter di IGD untuk penatalaksanaan px PEB
2 AFRIDA V
3 YULIATI V V
JUMLAH 3 2 1

02/10/17 4 YULIATI V V
5 EVI N V V
JUMLAH 2 2

03/10/17 6 LESTARI V
7 SUSI V
8 VANY V
9 LYMIA V
JUMLAH 4

04/10/17 10 SRI NINGSIH V


11 TITA V
12 NURLIN V
13 LINLIN V V
14 NURHAYATI V
15 SITI FATIMAH V
JUMLAH 6 1

05/10/17 16 DIAH V
17 ASYSYIDA V
18 LINLIN V V
19 EFA SARIPAH V
20 NENENG V
21 KARLINA V
22 RIKA V
23 NURPIA V dx ISK dari IGD
24 ELIS V V
25 NENG LELA V
JUMLAH 9 2 1

06/10/17 26 NENG LELA V


27 NOVI LESTARI V
28 FANNY V
29 FITRI V
30 KOKOM V
31 RISMA V
32 IRANINGSIH V
JUMLAH 7

07/10/17 33 NENENG V V
JUMLAH 1 1

08/10/17 34 PIPEU V
35 NENENG V V
36 PRISKILA V
37 ANGGI V V
JUMLAH 4 2

09/10/17 38 HASANAH V
39 NOVA V
40 PRISKILA V
41 GITA V
JUMLAH 4

10/10/17 42 EVIT V
43 NYANYU V
44 LENI MARLINA V
45 SENI V
46 FITRI V V
47 RIRIN V V
48 NENG ELLA V
JUMLAH 7 2

11/10/17 49 DEWI V
50 FITRI V V
51 NENG ELLA V
52 RIRIN V V
53 ANNISA V
54 LENI TARLIA V
55 NURKHOLIFAH V
56 SUMIATI V
57 YATI SUMIATI V V
58 YULIANTI V
JUMLAH 10 3

12/10/17 59 HALIMAH V
60 SUSI V
61 IHAT V
62 YATI SUMIATI V V
63 YULIANTI V
64 NORA V
65 RIKE V V
66 SITI AISYAH V V
67 SUMI V
68 EEN V
JUMLAH 10 3

13/10/17 69 MAMAH V
70 MINTARSIH V V
71 SELVY V
72 SUMI V
73 MARTHA V
74 AISYAH V V
JUMLAH 6 2

14/10/17 75 TETI V
76 MAMAH V
77 AISYAH V
78 NURDINI V
79 NENG NENI V
80 IKE V
81 ANI V
82 YENI V V
83 YULIAWATI V
JUMLAH 9 1

15/10/17 84 LELI V
85 YULIAWATI V
86 IKE V
87 YENI V V
88 IIN V V
89 NURDINI V
90 NENENG PATNI V
91 NENG NENI V
92 DEDE V
93 HOHO V
94 SHOPIA V
JUMLAH 11 2

16/10/17 95 SHOPIA V
96 SANDRA V
97 PITRIANI V
98 NURIYANTI V
JUMLAH 4 0

17/10/17 99 TUTI V
100 KETHY V
101 MAYA V
102 FENI V
103 SITI P V
104 LUSIANA V
JUMLAH 6 0

18/10/17 105 SURYANI V


106 RINI V V
107 RINI AGUSTINA V
108 RINA A V
109 SUPRIYATI V
110 ELIN V V DX ISK DARI IGD
111 ANIS V
112 LENI V
113 YENI V
JUMLAH 9 1

19/10/17 114 LENI V


115 YENI V
116 ELIN V V DX ISK DARI IGD
117 ANIS V
118 AI ATIKAH V
119 DEVI V
120 SHEYLA V
121 RESI V
122 VINA ROMLAH V
123 ASTUTI V
124 RESSY V
JUMLAH 11 0

20/10/17 125 ASTUTI V


126 ELIN V V DX ISK DARI IGD
127 RESI V
128 EKA SAFITRI V
129 WIWIN V V
130 SITI V
131 RINI V
132 ELYANUR V V DX ISK DARI IGD
133 YANTI V
134 IDA FARIDA V V V DX ISK DARI IGD
135 FITRI V
136 ATI V
JUMLAH 12 2 3

21/10/17 137 FITRI V


138 OMAH V
139 YANTI V
140 ELYANUR V V DX ISK DARI IGD
141 IDA FARIDA V V V DX ISK DARI IGD
142 NIA V
143 NURUL V
JUMLAH 7 1 2

22/10/17 144 NURUL V


145 SUPRIANTI V
146 OMAH V
147 NENDAH V
148 TIKA V
149 SAPITRI V V DX ISK DARI IGD
150 SRI W V
JUMLAH 7 0 1

23/10/17 151 TIKA V


152 SAPITRI V V DX ISK DARI IGD
153 SRI W V
154 LISDIANA V V
155 RINA V V DX ISK DARI IGD
156 NITA V
JUMLAH 6 1 2

24/10/17 157 LISDIANA V V


158 SULASTRI V
159 RINA V V V DX ISK DARI IGD
160 FEBI V
161 NOVA V
162 DINI V
163 ANITA V
JUMLAH 7 2 1

25/10/17 164 SULASTRI V


165 DINI V
166 ANITA V
167 FITRI V
168 LISNA V
169 NIKEN V
170 RINA V
171 DINA V
JUMLAH 8 0 0

26/10/17 172 DINA V


173 NENI V
174 RICKA V
175 FITRI V
176 CUCU V V V DX ISK DARI IGD
177 EMPIT V
178 WATI SITI SARAH V
179 EVI V
180 MELI V
JUMLAH 9 1 1

27/10/17 181 EVI V


182 MELI V
183 EVA V
184 SANIAH V
185 ERSA V
186 LILIS V V
187 WINDRIYANI V V V DX ISK DARI IGD
188 SINTA V
189 SITI F V
190 ELIN V
191 UTAMI V
JUMLAH 11 2 1

28/10/17 192 WINDRIYANI V V V DX ISK DARI IGD


193 LILIS V V
194 UTAMI V
195 ERSA V
196 ELIN V
197 RIKA V V DX ISK DARI IGD
198 WIWIN V
199 NURI V
200 DINDA V
JUMLAH 9 2 2

29/10/17 201 NURI V


202 ELSA V
203 RUKMINI V
JUMLAH 3

30/10/17 204 RISMA V


205 LILIS V V
206 LILIS WIDIANINGSIH V V
207 DEWI ROHANAH V
JUMLAH 4 2 0

31/10/17 208 LILIS V V


209 LILIS WIDIANINGSIH V V
210 DEWI ROHANAH V
211 PUJI V
212 SELA V
213 DATI V V DX ISK DARI IGD
214 YULIANI V V DX ISK DARI POLI
215 SARI M V V
216 LINA V
217 YULI YULIANTI V
218 SANTI V
JUMLAH 11 3 2
JUMLAH 217 40 17
JUMLAH PASIEN 209

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - NOVEMBER- 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/11/17 1 SANTI V
2 ENENG V V DX ISK DARI IGD
3 SARI M V V
4 RINI V V
5 UUN V V
JUMLAH 5 3 1

2/11/17 6 RINI V V
7 UUN V V
8 SUSANTI V
9 SITI NAFISAH V
JUMLAH 4 2

3/11/17 10 FRANSISKA V
11 SITI NAFISAH V
12 UUN V V
13 ERNI V V DX ISK DARI POLI
14 ERIN V
JUMLAH 5 1 1

04/11/17 15 ENI V V V DX ISK DARI IGD


16 WINDA V V DX ISK DARI IGD
17 IQ SOPIA V
18 ERNI V V DX ISK DARI POLI
19 ERIN V
20 UUN V V
21 RENI V
22 FITRI V V
23 SITI HODIJAH V
24 HESTY V V V
25 TITI V
26 MARINI V
JUMLAH 12 4 4

05/11/17 27 RANTI V V
28 ANI V V
29 WINDA V V
30 MARINI V
31 HESTY V V V DX ISK DARI IGD
32 RENI V
33 TITI V
34 DINI V
35 SRI V
36 RIKA V V
JUMLAH 10 4 2

06/11/17 37 MIMI V V
38 SRI V
39 RANI V V
40 DIAN V
41 HOLLIS V
42 RINA V
43 SEKAR V
JUMLAH 7 2 0

07/11/17 44 RIKA V
45 LENI V V
46 NITA V
47 RINA V
48 SEILA V
49 ERNI V
50 NANA V
51 INDRIANI V V DX ISK DARI IGD
52 NURAZIZAH V
53 ANI V
JUMLAH 10 1 1

08/11/17 54 NENENG V V
55 ANI V
56 ERNI V
57 INDRIYANI V V DX ISK DARI IGD
58 SITI SAADAH V V
59 DEDEH V V
60 ANITA V
JUMLAH 7 3 1

09/11/17 61 NINA V V DX ISK DARI IGD


62 YUYUN V
63 FITRI V
64 SITI SAADAH V V DX ISK DARI IGD
65 MELIS FATONAH V
66 SANTI V
67 TINA V
68 JESNITA V
69 PUTRI V
70 ELIS V
JUMLAH 10 2 0

10/11/17 71 ENDANG V
72 SITI V
73 NURYANTI V V V DX ISK DARI IGD
74 ENDANG V
75 ELIS V
76 DITA V V DX ISK DARI IGD
77 SITI H V
78 NIA V
79 INA V
80 JUMLAH 9 1 2

11/11/17 81 DITA V V DX ISK DARI IGD


82 NIA V
83 INA V
84 NOVA OKTAVIA V
85 RIMA V V
86 SISKA V
JUMLAH 6 1 1

12/11/17 87 SISKA V
88 SANTIA V
89 TIKA V V
90 MUTIARA V V DX ISK DARI IGD
91 RATNA V V
JUMLAH 5 2 1

13/11/17 92 RATNA V V
93 SANTI V V V DX ISK DARI IGD
94 NENENG V V DX ISK DARI IGD
95 DESI V V V DX ISK DARI IGD
96 FITRI V DX ISK DARI IGD
97 IDA V
JUMLAH 5 3 4

14/11/17 98 IIN V
99 IDA V
100 DESI V V V
101 LISNAWATI V
102 FATIMAH V V
103 NENG AZMI V
104 WIDI V
105 YULIANA V
JUMLAH 8 2 1

15/11/17 106 TRESNA V V DX ISK DARI IGD


107 RINI V
108 NENI V V
109 SUMINI V V
110 SITI N V
JUMLAH 5 2 1

16/11/17 111 SITI N V


112 DIAN V
113 RINI V
114 SINTA V
115 SUMINI V V
116 NENI V V
117 DEWI NUR V
118 DEWI SULISTIA V
119 NENI V V V DX ISK DARI IGD
120 ANITA V
121 KARTIKA V
JUMLAH 11 3 1

17/11/17 122 KARTIKA V


123 DIAN V
124 TATI NAWATI V
125 RISKA V
126 TATI V
127 NOPEMA V V DX ISK DARI IGD
128 SYIFA V
129 DAYANI V V
130 SRI ANALIA V
JUMLAH 9 1 1

18/11/17 131 DEWI V


132 NOPEMA V V
133 IPON V
134 RENI V
135 SANTI V
136 RINA V
137 NISA V V
138 NENDEN V
JUMLAH 8 1 1

19/11/17 139 HESTI V


140 NISA V V
141 NENDEN V
142 RINA V V
143 WINARNI V V
144 HANA V V
145 SHINTA V
146 RIA V V
147 LANI V
148 TIKA V
149 HANNY V V
JUMLAH 11 6 0

20/11/17 150 HANA V V


151 LANI V
152 RIA V V
153 HANNY V V
154 MERRY WAHYUNI V V
JUMLAH 5 3 1

21/11/17 155 FITRI V V


156 YUNIARTI V
157 RISKI WIDARI V
158 APRIANTI V
159 DINI V V
160 INDRI SUSANTI V V
161 ISMA V V V DX ISK DARI IGD
JUMLAH 7 4 1

22/11/17 162 DINI V V


163 INDRI SUSANTI V V
164 ISMA V V V DX ISK DARI IGD
165 YUNIARTI V
166 KHOIRUNNISA V
167 LILIS V
168 CUCU V
169 DEWI A V
170 KHARISMA V
JUMLAH 9 3 1

23/11/17 171 YUNIARTI V


172 INDRI SUSANTI V V
173 DEWI A V
174 KHARISMA V
175 RIA V
176 WIAR V
177 PITRI SISWATI V
178 TITIN V
179 ADE V
180 IDA V
181 KIKI V V
182 KOMALASARI V
183 YANI V
JUMLAH 13 2 0

24/11/17 184 CUCUN V


185 RINI V
186 NENENG V
187 MITA V
188 KIKI V V
189 IDA V
190 TITIN V
191 ADE V
192 SITI ZUBAEDAH V V
JUMLAH 9 1 1

25/11/17 193 EVI LISWARA V


194 SABINA V V
195 MAUDINA V
196 NURAINI V
197 RINI V
198 SITI ROYANI V
199 TINTIN V V
200 DWI V V
201 NENG RANI V V V DX ISK DARI IGD
JUMLAH 9 3 2

26/11/17 202 YOLA V


203 NENG RANI V V V DX ISK DARI IGD
204 TUTI V V
205 SUCI V
206 TINTIN V V
207 DWI V V
208 KIKI V
209 YANI V
JUMLAH 8 4 1

27/11/17 210 NENG SULASTRI V


211 LIA V
212 LENI V
213 YANI V
214 CUCU V
215 NENG SITI V
216 DEWI V V
217 YANTI V
218 SITI NURJANAH V
219 TITIN V V
220 ROSYANTI V
221 TINI V
JUMLAH 12 2 0

28/11/17 222 TINI V


223 SITI NURJANAH V
224 DEWI V V
225 CUCU V
226 ANIS V V
227 ELLKE V V V RETENSIO URINE (KALA 2 LAMA)
228 SUMYANI V V
229 NOVIA V V DX ISK DARI IGD
230 RENI V V DX ISK DARI IGD
231 TRIAS V V DX ISK DARI IGD
232 OVI FAUZIAH V
233 EMAWATI V V
JUMLAH 12 4 3
29/11/17 234 SUMYANI V V
235 RENI V V DX ISK DARI IGD
236 NOVIA V V DX ISK DARI IGD
237 TRIAS V V DX ISK DARI IGD
238 IKA V
239 EMAWATI V V
240 OVI FAUZIAH V
241 ASARIA V
242 NURHAYATI V V V DX ISK DARI IGD
243 WINA V 2
244 HERLINA V
JUMLAH 11 3 4

30/11/17 245 LILIS MARYAM V


246 WINA V
247 RANTIE V
248 YULIANI V
249 QORY V
250 PIPIH V V
251 DESI V V
JUMLAH 7 2

JUMLAH 251 75 37 diagnosa igd tdk 37


JUMLAH PASIEN 225 retensio 1 ..

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - DESEMBER- 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/17 1 AYU SILVI V
2 DESI V V
3 QORY V
4 PIPIH V
5 NENG SITI V
6 YANTI V
7 NENENG V V V DX ISK DARI IGD
8 SUDARSIH V V V DX ISK DARI IGD
JUMLAH 8 3 2

02/12/17 9 SITI NURHAFSAH V


10 NENENG V V V DX ISK DARI IGD
11 SUDARSIH V V V DX ISK DARI IGD
12 YANI V V DX ISK DARI POLI
12 AI KANIA V
13 RIKA V
14 SITI M V V DX ISK DARI IGD
15 DEWI V
16 YULIYANI V
17 SUCI V
18 SUGIYANI V
JUMLAH 11 2 4

03/12/17 19 OPI V
20 MERY V
21 SUCI V
22 YULIYANI V
23 SUGIYANI V
24 DINI NOVIYANTI V V
25 OOM V
26 NISFI V
27 NINING V
28 SUSYANTI V V
JUMLAH 10 2

04/12/17 29 NISFI V
30 OOM V
31 DINI NOVIYANTI V V
32 SUSYANTI V V
33 SARI V
34 NENDEN V
35 ANIS V V DX ISK DARI IGD
36 IIS V
37 IMAS V V DX ISK DARI IGD
38 YAYANG V
JUMLAH 10 2 2

05/12/17 39 ANISA V
40 INEU V
41 IIS V
42 SRI V
43 IMAS V V
44 RESTY V
45 FITRI V
46 RINI V
JUMLAH 8 1

06/12/17 47 RESTY V
48 SUSI V V DX ISK DARI IGD
49 TITA V
50 DERA V V DX ISK DARI IGD
51 YUYUN V V DX ISK DARI IGD
52 MEGA V
53 DAHLIA V
54 SANTI V V
55 INDAH V
JUMLAH 9 1 3

07/12/17 56 FITRIA V
57 NANI V
58 FARIDA V
59 INDAH V
60 SANTI V V
61 UUN V V
62 IRMA V V DX ISK DARI POLI
63 YULIANA V
64 YULIA V
JUMLAH 9 2 1

08/12/17 65 DIAN TRIANDINI V V


66 NENI V V
67 YULIA V
68 YENI V
69 NENENG V V DX ISK DARI IGD
70 YULIANA V
71 MIRA V V
72 ANI V
73 NURHAENI V
JUMLAH 9 3 1

09/12/17 74 RITA ROSILAWATI V V


75 ANI V
76 NURHAENI V
77 NENENG V V DX ISK DARI IGD
78 SOPIE V
79 WINDA V V DX ISK DARI IGD
80 SITI A V
81 LINDA V
82 SARIFA V
JUMLAH 9 1 2

10/12/17 83 RENI V
84 YULI V V
85 WINDA V V DX ISK DARI IGD
86 LINDA V
87 RITA V V
88 SOPY V
89 IKE SURYANI V
JUMLAH 7 2 1

11/12/17 90 IRA ZULFA V V DX ISK DARI IGD


91 SERLINA V V
92 RENA ROSMI V
93 TINA V
94 YULI V V V DX ISK DARI IGD
JUMLAH 5 2 2

12/12/17 95 RUTI V
96 GHIANI V
97 IRA ZULFA V V DX ISK DARI IGD
98 SERLINA V V
99 RENA ROSMI V
100 DEWI V
101 TINA V
102 YULI V V V DX ISK DARI IGD
103 IMAS V V DX ISK DARI IGD
104 AYU RIZQI V
105 SANTI V V
106 SITI SARIKAH V V
107 TINI V
108 NILA V V
JUMLAH 14 5 3

13/12/17 109 AYU RIZQI V


110 NILA V V
111 SITI NURAENI V
112 SITI SARIKAH V V
113 SANTI V V
114 TINI V
115 SELLA V
116 ARTI V V
117 TITI V V
118 IDA SUPRIATIN V
119 NENDEN V
JUMLAH 11 5 0

14/12/17 120 NENDEN V


121 YANI MULYANI V
122 ZITTA V
123 YENI V
124 NENI ROHAENI V
JUMLAH 5

15/12/17 125 NENGSIH V V


126 RINI V
127 SARAH V
128 NENI ROHAENI V
129 YENI V
130 SANI V
131 WINDI V
132 CINTIA V
133 SRI JUMIATI V V DX ISK DARI IGD
JUMLAH 9 1 1

16/12/17 134 PUSPA V


135 SRI JUMIATI V V
136 NELI SUMINAR V
137 SANTINI V V V DX ISK DARI IGD
138 HARYATI V
JUMLAH 5 1 2

17/12/17 139 SANTINI V V V DX ISK DARI IGD


140 HARYATI V
141 NANI OKTARINA V
142 EVIYANTI V
143 INDRI V
144 ROSMAYANTI V
JUMLAH 6 1 1

18/12/17 145 ROSMAYANTI V


146 HARYATI V
147 MAHARANI V
JUMLAH 3 0 0

19/12/17 148 SITI SAHARAH V


149 MALA V
150 ARNI SULASTRI V V DX ISK DARI IGD
151 ASTRI V V
152 ATIK V V
153 ATI V
154 JUHAERIAH V
155 SELIN V
156 SANTI V
JUMLAH 9 2 1

20/12/17 157 SANTI V


158 HELMI V V DX ISK DARI IGD
159 ATIK V V
160 ARNI SULASTRI V V DX ISK DARI IGD
161 LIA V
162 DIAN V
163 KHOTIMAH V
164 DESI V V
165 NANI ROHANI V
JUMLAH 9 1 3

21/12/17 166 RINA SAHIDILAH V V


167 DESI V V DX ISK DARI IGD
168 KHOTIMAH V
169 NANI ROHANI V
170 NINA V
171 NURSANI V
172 SADIAH V V DX ISK DARI IGD
173 ROSSI V
174 WIWIN V
175 FITRI V
176 RENI V
JUMLAH 11 1 2

22/12/17 177 NURSANI V


178 RENI V
179 FITRI V
180 RATIH V
181 SILVIA V V DX ISK DARI IGD
182 NURI V V DX ISK DARI IGD
183 SOPIAH V V
184 LINAYANTI V
JUMLAH 8 1 2

23/12/17 185 NELIS V V DX ISK DARI IGD


186 SILVIA V V DX ISK DARI IGD
187 DEDE V
188 LINA V
189 RITA V
190 LINA V
191 ERNI V V
192 CINDI V V DX ISK DARI IGD
193 NANI V V
JUMLAH 9 2 3

24/12/17 194 ERNI V V


195 CINDI V V DX ISK DARI IGD
196 NANI V V
197 IIS V
198 WIDIAWATI V
199 LINA V V
200 SANTI V
201 IIS AISYAH V
JUMLAH 8 3 1

25/12/17 202 FITRIYANI V


203 NELA V
204 SITI HODIJAH V
205 IIS AISYAH V
206 MELANI V
207 EKA HAYU V
208 YULIANI V
209 HERLINA V V
JUMLAH 8 1 0

26/12/17 210 TESA V


211 YANTI V V
212 YENI KARTIKA V
JUMLAH 3 1 0

27/12/17 213 IIS ROSITA V


214 SUSILAWATI V V
215 RENI V
216 MASWATI V
217 CHITRA V V DX ISK DARI IGD
218 MAELANI V V
219 SINTA V V DX ISK DARI IGD
220 MAUDY V V DX ISK DARI IGD
JUMLAH 8 2 3

28/12/17 221 NINING V V


222 CHITRA V V DX ISK DARI IGD
223 RENI V
224 MASWATI V
225 MAUDY V V DX ISK DARI IGD
226 SINTA V V DX ISK DARI IGD
227 MAELANI V V
228 NUNI V
229 IIS V
230 YULI V V DX ISK DARI IGD
231 DESI V
JUMLAH 11 2 4

29/12/17 232 NINA V V DX ISK DARI IGD


233 YANTI V
234 YUNITA V
235 MAELANI V V
236 LUCY V V DX ISK DARI IGD
237 DESI V
238 YULI V V DX ISK DARI IGD
239 RIAN BUDI V V DX ISK DARI POLIKLINIK
240 HANIVAH V
241 MELA V
242 PUTRI V V DX ISK DARI POLIKLINIK
243 LILIS V
244 SHAPIRA V
245 KAKAN V V
JUMLAH 14 2 5

30/12/17 246 LENI KARLINA V


247 MELA V
248 KAKAN V V
249 LILIS V
250 SHAPIRA V
251 PUTRI V V DX ISK DARI POLIKLINIK
JUMLAH 6 1 1

31/12/17 252 MELA V


253 SISKA V
254 IMAS V
256 SITI V
257 INDI V
258 YANI V
JUMLAH 6

JUMLAH TOTAL 258 53 50 isk penatalaksanaan di vk o


JUMLAH PASIEN 218
Formulir Survey Harian Pemakaian Alat
Ruang NIPAS 4 - RSKIA - APRIL - 2018
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2018 1 Sarah v v
2 tita v
3 ai nurhayati v v
4 kartini v
5 ayu v
5 2
02/04/2018 6 ade yeti v
7 sarah v
8 ai nurhayati v
9 nurhasanah v v
10 julita v v
11 ela v v
12 alisa v v
13 imas v
14 dhara v
9 4
03/04/2018 15 nurhasanah v v
16 yulita v v
17 ela v
18 mamah v v
19 haifa v v
20 ami v v
21 widya ingsih v
22 windi v v
23 aas v v
24 dewi v v
10 8
4/4/2018 25 sumiati v v
26 levi v
27 lia v v
28 ami v v
29 haifa v
30 widyaingsih v
31 dewi v
32 mamah v
33 aas v
34 windi v
35 dinar v v
11 4
5/4/2018 36 venty v v
37 eprina v v
38 elis v
39 miati v v
40 ai hamidah v
41 widyaingsih v v
42 niken v
43 widianti v v
44 dinar v v
9 5 1
06/04/2018 45 venty v
46 niken v
47 eprina v v
48 tarisa v v
49 tintin v v
50 widianti v
51 Ari v v
52 diani v
53 yulia v v
9 5
7/4/2018 54 sarah v v
55 ani v v
56 cucu v v
57 intan v v
58 ari v
59 diani v
60 niken v
61 yati v v
62 indriliyanti v v
63 yulia v v
64 tintin v
65 yati v v
12 8
8/4/2018 66 tina v
67 intan v
68 riani v v
69 ani v
70 yati v v
71 anisa v
72 siska v v
73 lusi v
74 indriliyanti v
75 yulia v v
10 4
9/4/2018 76 tati v v
77 tina v
78 eva v v
79 riani v
80 ani v
81 sofie v
82 nl regina v v
7 3
10/04/2018 83 titin v v
84 ani v
85 NL Regina v v
86 yati v v
87 ami v v
88 sumartini v v
89 leni v v
7 6
11/4/2018 90 nofitasari v v
91 sella v v
92 siti nuryanti v
93 titin v
94 rina v v
95 ani v v
96 iyam v v
97 sumartini v v
98 leni v v
9 7
12/4/2018 99 rifa v v
100 ifani v v
101 yayah v v
102 gracelia v v
103 iyam v v
5 5
13/4/2018 104 nenden v
105 desy v v
106 widyawati v
107 rifa v v
108 ifani v v
109 annisa v
110 nina v v
111 yayah v
112 gracelia v v
113 sri intan v v
114 rini v v
11 7
14/4/2018 115 desy v
116 indriyani v v
117 nenden v
118 annisa v
119 sri intan v v
120 rini v
6 2
15/4/2018 121 nenden v
122 riska v
123 dea v
124 sri mulyati v
4
16/4/2018 125 yuyun yunengih v
126 nenden v
127 riska v
128 dea v
129 sri mulyati v
130 siti jubaedah v
6
17/04/2018 131 Elly v
132 annisa v v
133 maya v v
134 wulan v
135 ina v v
136 hana v v
137 siti jubaedah v
138 tika v v
8 5
18/04/2018 139 maya v v
140 nuraida v v
141 neng r v v
142 listi v v
143 nurdina v v
144 tika v
145 nia v v
146 nenden v v
147 sri m v v
9 8
19/04/2018 148 listi v
149 nurdina v v
150 sri m v v
151 nuraida v v
152 neng r v
153 nia v v
154 nenden v v
155 enung v v
156 siti m v v
9 7
20/04/2018 157 nurdina v v
158 merisa v
159 komala v v
160 ima v
161 enung v v
162 siti m v v
163 linda v v
7 5
21/04/2018 164 nurdina v v
165 parida v
166 merisa v
167 lisnawati v v
168 siti nurhayati v v
169 linda v
170 komala v v
171 siti aisah v v
172 riri v v
9 6
22/04/2018 173 lisnawati v
174 siti nurhayati v v
175 rosmayanti v v
176 komala v v
177 siti aisah v
5 3
23/04/2018 178 rini v v
179 gania v v
180 neneng v
181 dela v v
182 rosmayanti v
183 komala v v
184 ai suryati v v
185 suci v
8 5
24/04/2018 186 hera v
187 rini v v
188 neneng v
189 dela v v
190 komala v v
191 ratih v v
192 siti zakiah v v
193 tati v
194 ai suryati v
9 5
25/04/2018 195 siti rohimah v v
196 zahara v v
197 ucu v v
198 ratna v
199 tati v
200 komala v v
201 ratih v v
202 siti zakiah v v
203 pipih v v
9 7
26/04/2018 204 susan v v
205 siti rohimah v v
206 zahara v v
207 elis v v
208 ucu v v
209 ratna v v
210 ita v
211 sri v
212 rochimah v
213 hanna v
214 dechi v v
215 gina v v
216 bernitaria v v
13 8 1
27/04/2018 217 susan v
218 mega v v
219 elis v
220 adriana v v
221 nenden v v
222 ita v
223 pipit v v
224 dechi v
225 gina v
226 neni v
227 bernitaria v
11 4
28/04/2018 228 mega v v
229 adriana v v
230 nenden v v
231 ita v
232 pipit v v
233 kokom v
234 siti rohimah v
235 yati v v
236 enung v v
237 eva v v
238 siti sutinah v
239 fitri v v
12 8
29/04/2-18 240 siti rohimah v
241 yati v v
242 enung v
243 dwi v
244 gita v
245 fitri v
246 indah v
247 noviasari v
8 1
30/04/2018 248 indah v
249 tina v
250 stella v
251 dhea v v
252 duryati v v
253 nuri v v
254 sariah v
255 dwi v
256 diana v v
9 4
146 2

Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2018 1 indah v
2 stella v v
3 dhea v v
4 duryati v v
5 nuri v v
6 tuti v v
7 dini v
8 riska v v
9 diana v
9 5 1
02/05/2018 10 indah v
11 euis v
12 dian v
13 rini v v
14 riska v
15 agustina v v
16 mimin v
17 ghina v v
18 suti v
19 dini v
10 3
03/05/2018 20 indah v
21 euis v
22 rini v v
23 maya v v
24 irma v v
25 agustina v v
26 gina v v
27 nelis v v
28 dini v
9 6
04/05/2018 29 yulianti v v
30 rini v v
31 irma v
32 maya v v
33 ayu rohimah v v
34 diah v v
35 widia v
36 nelis v v
37 dede v v
9 7
05/05/2018 38 ela v v
39 yulianti v
40 devi v
41 maya v v
42 ayu v
43 widia v
44 dede v v
45 fatimah v
46 widaningsih v v
9 4
06/05/2018 47 ela v
48 dwi v
49 rona v v
50 devi v
51 santi v v
52 widaningsih v
53 ratna v v
54 dewi v v
7 4 1
07/05/2018 55 ena v v
56 dwi v v
57 rona v
58 devi v
59 agustina v v
60 rini v v
61 dewi v
62 ratna v
7 5
08/05/2018 63 ena v v
64 dwi v v
65 devi v v
66 mulyanah v v
67 meliawaty v v
68 mila v v
69 nurrisa v v
70 fitri v v
8 8
9/5/2018 71 mila v
72 erva v v
73 nurrisa v
74 devi v
75 fitri v
76 rina v
77 opi v v
78 umi v v
79 riska v
80 mia v v
81 supita v v
11 5
10/5/2018 82 fitri megawati v v
83 opi v
84 yuli v
85 suyati v v
86 rona 4 2

11/5/2018 87 suyati v v
88 rona v v
2 2
12/5/2018 89 tini v v
90 karti v
91 linawati v v
92 dwi v v
93 dine v
94 febi v v
95 nany v
7 4
13/5/2018 96 karti v v
97 linawati v v
98 dwi v v
99 tri v v
4 4
14/05/2018 100 ayu v
101 linawati v v
102 litawati v v
103 titin v v
104 fitri v
105 siti nurohmah v v
106 farida v v
107 nenden v v
8 6
15/05/2018 108 litawati v
109 titin v v
110 siti nurohmah v v
111 farida v
112 indah v v
5 3
16/05/2018 113 titin v v v
114 tina v
115 sri H V V
116 ela v v
117 nani v
118 beti v v
119 tanti v v
120 indah v
121 ai r v v
9 6 1
17/05/2018 122 khotimah v
123 siti j v
124 runi v v
125 tina v
126 nia v v
127 tantri v
128 nuri v v
129 nining v v
130 sri h v
131 ai r v
10 4
18/05/2018 132 rini v
133 sri yati v
134 tantri v
135 ida v v
136 nuri v v
137 nining v v
6 3
19/05/2018 138 rona v v
139 putri v
140 nining v v
141 elis v v
142 tantri v
5 3
20/05/2018 143 santi v
144 mega v v
145 nyayu v
3 1
21/05/2018 146 iis v v
147 ermawati v v
148 yati v
149 jayanti v
150 wenny v v
5 3
22/05/2018 151 mita v
152 marliantini v v
153 iis v
154 wenny v v
155 rina v
156 ermawati v v
157 ria v
7 3
23/05/2018 158 hilda v
159 yanti v
160 ria v v
161 irma v
162 samirah v
163 elis v
164 wulan v
165 desrina v
8 1
24/05/2018 166 samirah v
167 neni v v
168 dede v v
169 wulan v
170 dewi v
171 hilda v v
172 elis v
173 emilawati v v
8 4
25/05/2018 174 ika v v
175 eka v
176 samirah v
177 neni v v
178 wihartini v v
179 dewi v
6 3
26/05/2018 180 wihartini v v
181 indah v v
182 dewi v
183 ika v
184 ayu v
5 2
27/05/2018 185 riani v v
186 hadiani v
187 rina v
3 1
28/05/2018 188 riani v
189 neni v
190 yunita v v
191 linawati v
4 1
29/05/2018 192 puji v v
193 ratu v
194 imas v
195 linawati v v
196 rosmawati v v
197 yunita v v
198 rini v
7 4
30/05/2018 199 ina v
200 linawati v
201 puji v
202 neti v v
203 astri v v
204 hajarwati v
205 andini v
206 imas v
8 2
31/05/2018 207 putri v
208 neti v v
209 astri v v
210 hajarwati v v
211 imas v
212 ina v v
213 yuliyanti v
7 4
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2018 1 neneng v
2 mulyanah v v
3 tri v v
4 rossandini v v
3 3 1
02/06/2018 5 dewi anggun v v
6 tantri v
7 neneng v
8 mulyanah v v
9 tri v
10 rossandini v
11 vania v v
12 widiawati v
7 4
03/06/2018 13 mulyanah v v
14 etin v
15 rossandini v
16 siti mulyani v
17 dewi anggun v v
18 nining v v
19 sumarni v
20 sindy v v
7 5
04/06/2018 21 sindy v
22 nurul v
23 santi v
24 etin v v
25 sriyami v v
4 2 1
05/06/2018 26 dian v
27 melda v v
28 yanti v
29 nurul v v
30 kesumastuti v v
31 santi v v
32 etin v
33 herlina v v
34 siti sarah v
35 sriyami v
9 6
06/06/2018 36 destha v v
37 herlina v
38 vita v
39 rhany v
40 rofiah v
41 tina v v
42 risma v
43 santi v
8 2
07/06/2018 44 rhany v v
45 ratna v
46 yuningsih v
47 tina v v
48 pipit v v
49 destha v
50 jeni v v
51 evani v v
52 siti s v v
53 nurul v v
10 7
08/06/2018 54 suprih v v
55 dea v v
56 nina v
57 lusi v
58 jeni v
59 evani v v
60 ratna v
61 yuningsih v v
62 meilani v
63 zatin v
10 4
09/06/2018 64 wahyu v v
65 novianti v
66 nina v v
67 lusi v v
68 sundari v
69 rian v
6 3
10/06/2018 70 siti khodijah v
71 ros rosita v v
72 novianti v v
73 wahyu v v
74 eni v
75 siti aisyah v
76 yeti v v
7 4
11/06/2018 77 euis v
78 annisa v
79 siti aisyah v
80 yeti v
81 sri r v v
82 siti n v
83 lusi v
84 ineu v
8 1
12/06/2018 85 shandra v v
86 dwi v
87 desy v v
88 neng susanti v
89 sumi v
90 cheryank v
91 euis v v
92 sri r v v
8 4
13/06/2018 93 desy v
94 nahdaturahmi v v
95 aprianti v v
96 agustini v v
97 sumi v
98 maria v v
99 cheriyank v
7 4
14/06/2018 100
Formulir Survey Harian Pemakaian Alat
Ruang VK - RSKIA - JANUARI- 2018

TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/18 1 DESI V 15/04/18 124 NURLINDA V
2 NOVI V 125 KIKI V
3 HESTI V 126 WULAN V
4 MUSTIKA V 127 SRI H V
5 VIZA V 128 ANGGI V
6 YENI V JUMLAH 12
JUMLAH 6
16/04/18 129 ANGGI V
02/01/18 7 DEWI V 130 KURNIASIH V
8 NURAENI V 131 JULIA V
9 ENDANG V 132 LIA V
JUMLAH 3 133 INA V
134 AI KOMALA V V
03/01/18 10 NURAENI V 135 SRI V
11 AYU V 136 SANTI V
12 LINA V V 137 TINA V
13 NENG MIA V 138 ANNISA V V
14 EMMA V JUMLAH 10 2
15 DENA V
16 FITRIANI V 17/04 139 INA V
17 NURUL F V 140 SRI V
18 NURUL V 141 SANTI V
19 SANTI V V 142 CICI V
JUMLAH 10 2 143 ROSMAYANTI V V
144 NETI V
04/01/18 20 EKA V 145 SANIAWATI V
21 LINA V V 146 SRI MULYATI V
22 SANTI V V JUMLAH 8 1
23 R. RISMA V
24 YUNI SETIAWATI V V 18/04/18 147 SANIAWATI V
25 EMMA V 148 SURYATI V
26 NURUL V 149 SITI NURAINDAH V
27 RINI V JUMLAH 3 0
28 HENI V
29 RATNA V 19/04/18 150 RESTIANI V
30 HANNA V 151 NENDEN V
JUMLAH 11 3 152 YENI V
153 ATING V
05/01/18 31 BUNGA V 154 DEWI V
32 HANNA V 155 GINA V
33 HENI V JUMLAH 6 0
34 RATNA V
35 TANTRI V V 20/04/18 156 RIRI V
36 TRIANTI V 157 GINA V
37 DIAN V 158 DEWI V
38 SITI N V V 159 AMBARSARI V
39 MILDA V 160 DEWI V
40 NOVA V 161 ANITAIRMA V
JUMLAH 10 2 162 PANDA V
163 LENI V
06/01/18 41 HENI V JUMLAH 8
42 BUNGA V
43 TANTRI V V 21/04/18 164 ERIKA V
44 DIAN V 165 YUNIA V V
45 SITI N V V 166 DESI V
46 NOVA V 167 FATIMA V
47 RATNA V 168 ROSMAYANTI V
48 TRIANTI V JUMLAH 5 1
49 IKA SARTIKA V
50 YULIANTI V 22/04/18 169 DESI V
JUMLAH 10 2 170 FATIMA V
171 NOPI V
07/01/18 51 LADY V 172 ROSMAYANTI V
52 SRI V 173 GANIA V V
53 YULIANTI V 174 DELA V
54 FITRI V 175 NENI H V
55 NENENG V V JUMLAH 7 1
56 YENI V
JUMLAH 6 1 23/04/18 176 DELA V
177 TINA V
08/01/18 57 LADY V 178 NURLAELA V
58 YAYAT V 179 NANING V
59 NENENG V V 180 YUNI V V
60 FITRI V 181 SITI NURBAYA V
61 YENI V 182 SITI ZAFIAH V
JUMLAH 5 1 183 ATIKAH V V
JUMLAH 8 2
09/01/18 62 MARLINA V
63 HORY V 24/04/18 184 RATIH V V
64 DEWI PUJI V 185 ATIKAH V V
65 IIN CASINAH V V 186 YAYUK V V
66 KARTIKA V 187 SITI ZAKIAH V
67 KARTIKA V 189 NUNUNG V
JUMLAH 6 1 190 IIS V
191 SANTI V
10/01/18 68 RESTI V 192 SITI ROHIMAH V
69 SITI AYU V JUMLAH 9 4
70 ESIN V
71 DEWI PUJI V 25/04/18 193 RATIH V V
72 IRMA V 26/04/18 194 DEWI V
73 IDA V 195 RANI V
JUMLAH 6 196 SITI ROHMAH V
197 RANI V
11/01/18 74 YAYU V 198 IIS V
75 IDA V 199 SANTI V
76 SITI NURYANI V 200 ZAKIAH V
77 ERMA V 201 NURHIKMAH V
78 DIAN V JUMLAH 9 1
79 SRI MULYATI V
80 MIMIN V 26/04/18 202 NURAISAH V
81 ERITA V V 203 RIA V
82 TINA HERLINA V 204 FANIA V
83 RATNA V 205 YASINTA V
JUMLAH 10 1 206 SITI AISYAH V
207 TANTI K V
12/01/18 84 INDAH V 208 EVA MELYA V V
85 ERITA V V 209 ADRIANA V
86 ERNI V 210 MEGA V V
87 MIMIN V 211 RINRIN V
88 RATNA V 212 TANTI M V
89 TINA HERLINA V JUMLAH 11 2
90 NURYANTI V V
91 ROSI V 27/04/18 213 MEGA V
JUMLAH 8 2 214 ANDRIANA V
215 EVA MELYA V V
13/01/18 92 SITI MARIAM V 216 TANTI K V
93 NURYANTI V V 217 TANTI M V
94 ERITA V V 218 SITI H V
95 YAYU V 219 DELISKA V V
96 NU ELLAH V 220 NENG NURAENI V V
97 IIS AISYAH V 221 NENG DERI V
98 TINI V V JUMLAH 9 3
99 TRI YAYUK V
100 OTEH V V 28/04/18 222 SAWITRI V
JUMLAH 9 4 223 NENG DERI V
224 RESA V
14/01/18 101 LENI V 225 NOVIASARI V
102 OTEH V V 226 SAFARINA V
103 TRI YAYUK V 227 SITI SUTINAH V
104 SITI MARIAM V 228 FITRI V
105 YANI V 229 TINI HARTINI V
106 SEPTIANY V V 230 INDRI V V
JUMLAH 6 2 231 TIAH V V
232 FETI V
15/01/18 107 SHARLY V 233 SARIAH V V
JUMLAH 13 3
108 RINA V
109 YANI V 29/04/18 234 DINA V
110 YUNI V 235 TINA V
111 NENENG V 236 ELITA V
112 AAS V 237 INDRI V V
JUMLAH 6 238 SARIAH V V
239 NUROHMAH V
16/01/18 113 SRI NURHAYATI V 240 LUSIANA V
114 NAWANG V V 241 ANISA V
115 AAS V 242 DEWI V
116 ROSIYANTI V 243 RIKA V
117 IMAS V JUMLAH 10 2
118 LILIS V
119 RUROH V V 30/04/18 244 IKA V V
JUMLAH 7 2 245 RIKA V
246 INDRI V V
17/01/18 120 TINTIN V 247 ANISA V
121 LILIS V 248 LUSIANA V
122 RUROH V V 249 TAMALA V
123 ETI V 250 SITI JUBAEDAH V
124 UCU V 251 YUYUN V
125 IDA SETIAWATI V JUMLAH 8 2
126 DINI V
127 MARINA V JUMLAH TOTAL 251 56
JUMLAH 8 1 JUMLAH PASIEN 236

18/01/18 128 EUIS V Formulir Survey Harian Pemakaian Alat


129 MARINA V Ruang VK - RSKIA - MEI- 2018
130 YULIA V V
131 RITA V TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
132 ERNAWATI V 01/05/2018 1 SEILA V
133 NURHAYATIN V 2 MIMIN V V
134 YANTI V 3 YUYUN V
135 LILIS V V 4 RIKA V
135 DESI V 5 SITI MARISA V
JUMLAH 9 1 6 MARYAM V
7 AGUSTINA V V
19/01/18 136 DIANA V 8 SITI KADIYAH V
137 ERNAWATI V 9 NURHALIMAH V
138 DIANA V JUMLAH 9 2
139 YULIA V V
140 RITA V 02/05/2018 10 SUTINI V
141 DESI V 11 DEVI V
142 ELA V 12 MIMIN V V
143 SINTA V 13 WAHDANIAH V
144 ANI V 14 DEBORAH V
145 YANI V V 15 KOKOM V
146 LINDA V 16 DELA V
147 IIM V JUMLAH 7 1
JUMLAH 12 2
03/05/18 17 TITIN V
20/01/18 148 LINDA V 18 NOVI S V
149 IIM V 19 IRMA M V
150 YANI V V JUMLAH 3
151 NENI V V
152 FETI V 04/05/18 20 DESY V
JUMLAH 5 2 21 INDAH V
22 ANGGITA V
21/01/18 153 FETI V 23 AI ROSMAYANTI V
154 WIDANINGSIH V 24 DIAH V
155 ULFA V 25 WENI V
156 WIWI V 26 ENUNG V
157 NENG YULIA V V 27 DEDE V V
158 ARISKA V 28 WULAN V
159 NISA V 29 SELLY V
160 FENTI V JUMLAH 10 1
161 TITA V
JUMLAH 9 1 05/05/18 30 RIMA V
31 SANTI V
22/01/18 162 RIMA V 32 SANTI V V
163 RATIAH V JUMLAH 3 1
164 TITA V
165 NENG YULIA V V 06/05/18 33 WATI V
166 FENTI V 34 ETI ROHAETI V
167 NISA V 35 IIN V
168 LENA V V 36 RATNA V
169 RUSTIATI V 37 INTANIDA V
170 SUSIANI V 38 SOPIAH V
171 ELA V 39 DEWI V
172 ROSY SURYAWATI V V 40 RINI V V
173 FENTY V JUMLAH 8 1
174 ASIH V V
175 TUTI RISNAWATI V 07/05/18 41 SRI SUNARI V
176 IDA V V 42 YOLANDA V
JUMLAH 15 5 43 RINI V V
44 KESTIA V
23/01/18 177 NOVA V 45 ADE V
178 IDA V V 46 RINI APRILIA V
179 JAMILAH V 47 YULI YANA V
180 EUIS V 48 ADE V
JUMLAH 4 1 49 TETI V
JUMLAH 9 1
24/01/18 181 HENI HERNIATI V
182 EUIS V 08/05/18 50 SITI KARMILAH V
183 SONIA S V 51 YULIANI V
184 JAMILAH V 52 ILOH V
185 SELVI V 53 YULIANTI V
186 NENG SITI V 54 RIMA V
JUMLAH 6 55 SANDRA V V
56 TIWI V
25/01/18 187 LILIS V 57 FITRI V
188 NENG SITI V 58 LASTIKA V V
189 SELVI V 59 RISKA V
190 DINI V JUMLAH 10 2
191 SANTI V
192 TESSA V 09/05/18 60 RINI AGUSTINA V V
193 CUCU V V 61 TIWI V
194 KOKOM V V 62 RISKA V
JUMLAH 8 2 63 RINA AGUSTINA V V
64 RISKA V
26/01/18 195 YENI A V 65 SRI LESTARI V
196 MELDA V 66 MIA V
197 ERWITA V V 67 NINA V
198 JUMIDAH V V 68 SHINTA V
199 SUSILA V JUMLAH 9 2
200 NINA V
201 LAILI V 10/05/18 69 ROSTIKA V
202 KOKOM V V 70 IRMA SETIAWATI V
203 RATU V 71 FITRI V V
204 DEWI V 72 DEWI V
JUMLAH 10 3 73 ETIN V
74 DWI V
27/01/18 205 ISTIQOMAH V 75 YULI V
206 DWI V JUMLAH 7 1
207 IMAS V
208 RATU V 11/05/18 76 YULI V
209 SANTI V 77 DWI V
210 NANI V 78 IIS S V
211 NONENG V 79 IIS N V
JUMLAH 7 80 NURHAYATI V V
81 KARTI KARTIKA V
28/01/18 212 NONENG V 82 ENDANG V V
213 SANTI V 83 FEBI V V
214 MIRA V JUMLAH 8 3
215 SITI V
216 DITA V 12/05/18 84 YUYUN V
217 SITI N V 85 IIS V
218 DITA 2 V 86 NURHAYATI V
JUMLAH 7 87 NURHAYATI V V
88 ENDANG V
29/01/18 219 GITA V 89 KARTIKA V V
220 DITA V 90 DWI V
221 RATNASARI V 91 TRI KARUNIA V V
222 ANEU V JUMLAH 8 3
223 SUPRIYANTI V
224 ITA V V 13/05/18 92 EUIS V
225 YUNI RAHMAWATI V V 93 RENI V
JUMLAH 7 2 94 IIS V
95 TRI KARUNIA V V
30/01/18 226 SHERLY V 96 LISNAWATI V
227 ANEU V 97 SITI HALIMAH V
228 RATNASARI V 98 RAI ANJARSARI V
229 ITA V V 99 RINA V
230 RISNAWATI V JUMLAH 8 1
231 JULIANI V
232 ARNIA V V 14/05/18 100 RINA V
JUMLAH 7 2 101 KARYATI V V
102 SANTI V
31/01/18 233 YASINTA V 103 SECILIA V
234 RISNAWATI V 104 ERMA V
235 HUSNA V 105 TITIN V V
236 JULIANI V 106 SUSI V
237 ARNIA V V 107 EKA V
238 LINA V 108 MIRA V
239 YAYAH V JUMLAH 9 2
240 AI YULIANTI V V
241 NURAISAH V 15/05/18 109 MIRA V
242 ROHIMAH V 110 SECILIA V
JUMLAH 10 2 111 KARYATI V V
112 SNATI KUSUMIATI V
TOTAL 243 47 113 ASTRI NURENDAH V V
JUMLAH TOTAL PASIEN : 203 114 SILVIA F V
115 ASIMA V
116 NURHAYATI V
117 SRI INDRA V V
JUMLAH 9 3

16/05/18 118 DESI V


Formulir Survey Harian Pemakaian Alat 119 KIKI V
Ruang VK - RSKIA - FEBRUARI- 2018 120 SRI INDRA V V
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN 121 NURHAYATI V
01/02/18 1 ANISA V 122 SILVIA F V
2 DEUIS V 123 DESI V
3 NURAISYAH V 124 ASTRI NURENDAH V V
4 AISYAH V 125 NENDEN V
5 TANTRI V V 126 AI ROHIMAH V
6 SANTI V 127 NURI KURNIAWATI V V
7 DINA V 128 NIA V
8 SINTA V V JUMLAH 11 3
9 ROSDIANA V
JUMLAH 9 2 17/05/18 129 MERISA V
130 DIAN V V
02/02/18 10 MIA SITI V V 131 NURI KURNIAWATI V V
11 SINTA V V 132 ONENG V
12 SINTA V V 133 NENG SARAH V
13 IMELDA V 134 HANISAH V V
14 TETI V 135 RONA KUSTINA V V
15 RIA V V 136 KIKI L V
16 SUSANTI V 137 ROHIMAH V
17 YESSI V 138 ADINDA V
JUMLAH 8 4 JUMLAH 10 4

18/05/18 139 ROHIMAH V


03/02/18 18 SUSANTI V 140 DEWI V
19 RIA V V 141 HENISYAH V V
JUMLAH 2 1 142 RONA KUSTINA V V
143 RIZQIA V
04/02/18 20 IIN DARWATI V V 144 RINI V
21 SURYANI V 145 SUPRIYANI V
22 LIA HERMINA V V 146 ELIS V
23 SITI V JUMLAH 8 2
JUMLAH 4 2
19/05/18 147 SUPRIYANI V
05/02/18 24 YETI V 148 ELIS V
25 FINI R V 149 NIDA V
26 LIA HERMINA V V 150 SITI HARYATI V
27 ANISA V 151 LOUISE V
28 DEVI V JUMLAH 5
29 FERA V
30 WINI V 20/05/18 152 MEGA V V
31 AMANDA V 153 LIA V
32 LIANTI V 154 MAYA V
33 NURHAYATI V JUMLAH 3 1
34 LINA V
35 SULBIAH V 21/05/18 155 SANTI V
36 ERNA V 156 LIA V
37 AAM V 157 MAYA V
JUMLAH 14 1 158 SISKA V
159 NENG ROSI V V
06/02/18 38 YANI SURYANI V 160 HAMIDAH V
39 AAM V 161 IIS V
40 AMANDA V 162 RIANITA V
41 SULBIAH V JUMLAH 8 1
42 IKA SARTIKA V V
43 NURAISAH V 22/05/18 163 NENG ROSI V V
44 AYU SRI V 164 RIANITA V
45 SARININGSIH V 165 SANI V
46 RIAN V V 166 IIS V
JUMLAH 9 2 167 MELINA V
168 ANITA V
07/02/18 47 MINANTI V V 169 IRMA V
48 NENENG V 170 PITRI V
49 TITIN V JUMLAH 8 1
50 MELANI V
51 RIAN V V 23/05/18 171 REZA V
52 REKA KURNIA V 172 ANITA V
53 NELLY V 173 MELINA V
54 LIA V V 174 IIS V
JUMLAH 8 3 175 EMIRAWATI V V
176 FITRI V
08/02/18 55 SUKAESIH V V 177 INTAN V V
56 NELLY V 178 NOVIANTI V
57 LIA V V 179 KINANTI V
58 RESTI V JUMLAH 9 2
59 WARTINI V
60 LIANA V 24/05/18 180 NOVI V
JUMLAH 6 2 181 ELIN V
182 NENI V
09/02/18 61 SITI SOLIHAH V 183 KINANTI V
62 DEVI V 184 SITI YULINAH V
63 TUTI IDAYATI V 185 KHOSIAHWATI V V
64 DEWI TRIASTUTI V 186 FATIMAH V
65 RATNANINGSIH V 187 SUCI WULANDARI V
66 NURELA V JUMLAH 8 1

25/05/18 188 YULIANA V


10/02/18 67 NURELA V 189 SUCI WULANDARI V
68 RATNANINGSIH V 190 NOVI V
69 DETI V V 191 INDAH V
70 KIKI V 192 KHOSIAHWATI V V
71 INDRA V 193 YANI V
72 DIAN V V 194 YULI SARAH V
73 IRNE V 195 KHOLIFAH V
74 ANGGI V 196 DINIARTI V
75 SITI ROHMAH V 197 NITA V
76 GITA V JUMLAH 10 1
JUMLAH 10 2
26/05/18 198 SARAH V
11/02/18 77 LINA V 199 KHOLIFAH V
78 SITI ROHMAH V 200 DINIARTI V
79 IRNE V 201 NITA V
80 RATNA V 202 RITA V
81 ANGGI V 203 KURNIA V
82 SARAH V 204 INA V
83 SITI N V V 205 NURHAYATI V
84 DEFFY V V 206 HADIANA V
85 ARISKA V 207 KANAH V
JUMLAH 9 2 208 SUSILAWATI V V
209 ROSITA V
12/02/18 86 ARISKA V 210 YUNI V
87 SARAH V 211 NURWITA V
88 IRA V JUMLAH 14 1
89 EVA V
90 YUNI V 27/05/18 212 NURWITA V
91 JHOSIE V V 213 YUNI V
92 IIS V 214 INA V
93 ZAKIAH V 215 RIANI V
94 FITRI V V 216 RISKA V
JUMLAH 9 2 217 NENI V
218 WAINAH V V
13/02/18 95 IIS V JUMLAH 7 1
96 FITRI V V
JUMLAH 2 1 28/05/18 219 WAINAH V V
220 DEWI V
14/02/18 97 SITI ANGGRAENI V 221 RATU V
98 RESTONIDA V V 222 SITI ROFIQAH V
99 RISTA AULIA V 223 PUJI ASTUTI V
100 DINI V 224 MUTASRINI V
225 TINTIN V
101 ISNAH V 226 SHERLY V
102 TIA V 227 ROSMAWATI V V
JUMLAH 6 1 JUMLAH 9 2

15/02/18 103 RESTONIDA V V 29/05/18 228 SITI ROFIQAH V


104 DINI V 229 ROSMAWATI V V
105 TIA V 230 TINTIN V
106 ISNAH V 231 HENI V V
107 INA V 232 NETI V
108 INSAN V 233 SINTA V
109 CITA V V 234 YUNI V
110 PUTRI DEWI V 235 PUTRI V
111 NIA V JUMLAH 8 2
112 DINA SETIANA V
JUMLAH 10 2 30/05/18 236 ELI TIA V
237 PUTRI V
16/02/18 113 NIA V 238 YULIANTI V
114 PUTRI DEWI V 239 TRI K V
115 NOVI V 240 SUSANTI V
116 DINA SETIANA V 241 SITI FATIMAH V
117 AI KARTIKA V 242 EPI LIANAH V V
118 TUTI V 243 ROSITA V
JUMLAH 6 JUMLAH 8 1

17/02/18 119 SENA V 31/05/18 244 SUSANTI V


120 REZA V 245 SITI FATIMAH V
121 FITRIA V 246 ROSITA V
122 AI V 247 EPI LIANAH V V
123 TUTI V 248 NOVIANTINI V
124 AJENG V 249 DEDE V
125 RENI V 250 NINING V V
126 IIS V 251 AJENG V
JUMLAH 8 JUMLAH 8 2

18/02/18 127 REZA V JUMLAH TOTAL 251 49


128 RENI V JUMLAH PASIEN 233
129 AJENG V
130 PUTTY V Formulir Survey Harian Pemakaian Alat
131 MERI V Ruang VK - RSKIA - JUNI- 2018
132 DESI V
133 ADE V TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
JUMLAH 7 01/06/18 1 ROSITA V
2 NOVIANTINI V
19/02/18 134 DESI V 3 NINING V V
135 PUTTY V 4 LILIS V
136 DITA V 5 RANI V V
137 ADE V JUMLAH 5 2
138 ANI SOFIA V
139 TIARA V 02/06/18 6 REGINA V
140 TINI V 7 LILIS V
141 NENI V V 8 RANI V V
142 NENDEN V 9 NINING V V
JUMLAH 9 1 10 SRI H V
11 SINDI V
20/02/18 143 HARTINI V JUMLAH 6 2
144 SELI V
145 ERNI V 03/06/18 12 SINDI V
146 SANI V 13 MELDA V
147 TIARA V 14 RIANTI V
148 REGINA V 15 DIAN V
149 FANNI V 16 NOVIA V
150 WATRI V 17 SYIFA V
JUMLAH 8 18 FINA V
19 LINA V
JUMLAH 8

21/02/18 151 SELA V 04/06/18 20 ROROS V


152 FANNI V 21 LINA V
153 REGINA V 22 MELDA V
154 LINA V 23 DIAN V
155 FIRDA V 24 ENTANG V
156 RISTI V 25 SRI R V V
157 SAFITRI V 26 WINDA V
158 DEWI MISNA V 27 IMAS V V
159 EUIS NURUL V 28 HERLINA V
160 SANTI V 29 IKE M V
JUMLAH 10 JUMLAH 10 2

22/02/18 161 SITI W V 05/06/18 30 SRI SARININGSIH V


162 ANIS V 31 SRI R V V
163 SYAFITRI V 32 WINDA V
164 NUNIK MARYANI V 33 YAYU V
165 EUIS V 34 HERMALIA V
166 NUNIK V 35 YESI V
167 TITA V V JUMLAH 6 1
168 YUYUN V
169 DINA V 06/06/18 36 ERLINA V
170 NOVI PITRIANI V 37 YESI V
171 NOVI N V 38 YULIANDINI V
JUMLAH 11 1 39 SRI SETIA V
40 NURUL V
23/02/18 172 FANNY V 41 SUSILAWATI V
173 NOVI P V 42 CICIN V
174 RIKA V JUMLAH 7
175 YUYUN V
176 DINA V 07/06/18 43 ENOK V
177 NOVI N V 44 DEA V V
178 DIAN V 45 EKA SULASTRI V
179 WATI V V 46 SUSILAWATI V
180 DITA V 47 IMAS RINI V
181 NUNI V 48 WINDI V
JUMLAH 10 1 JUMLAH 6 1

24/02/18 182 RUBIYANTI V V 08/06/18 49 SYIFA V


183 DIAN V 50 WIWIN V
184 KRISTIN V 51 WINDI V
185 DITA V 52 DEWI V
186 SITI P V 53 DEWI RATNASARI V
187 NUNI V V 54 YULIAWATI V
188 WATI V V 55 SUNDARI V
189 IROS ROSITA V 56 NURHAYATI V
190 ISYE V V 57 YULI V
JUMLAH 9 4 JUMLAH 9

25/02/18 191 IROS ROSITA V 09/06/18 58 WAHYU V


192 ISYE V V 59 NURHAYATI V
193 ROSITA V 60 SRI V
194 RISKA V 61 YULI V
195 ARTILLA V 62 YULIAWATI V
196 LOLA V 63 ROS ROSITA V
197 WINDA V 64 EKA V
198 ICEU V 65 ANISA V
JUMLAH 8 1 66 TASYA V
67 WINDI V
26/02/18 199 ANISA V 68 CITRA V
200 WINDA V JUMLAH 12
201 ICEU V
202 RIMA V V 10/06/18 69 PARNI V
203 NENENG V 70 AYU V
204 MARIA ULFA V 71 TASYA V
205 NIA KURNIASIH V 72 WINDI V
206 SUSI SUSANTI V 73 CITRA V
207 HARTATI V V RETENSIO URINE A/I KALA 2 LAMA 74 ANISA V
208 NINING V 75 SITI N V
209 NUNUNG V 76 YULIAWATI V
JUMLAH 11 1 77 SOPIAH V
JUMLAH 9
27/02/18 210 SUSILA V
211 HARTATI V 11/06/18 78 FITRINA V
212 NINING V 79 SANDRA V
213 MIRA V 80 SITI SOPIAH V V
214 NOVI V 81 SRI V
215 SUSI V 82 SAVI V
216 REZA V 83 YULI V
217 RINI V 84 MELIA V
218 YENI JUMILAH V 85 YATI V
219 SURATI V 86 LIA V
JUMLAH 10 87 FITRI V
88 DESY NUR V
28/02/18 220 REZA V JUMLAH 11 1
221 YENI JUMILAH V
222 SURATI V 12/06/18 89 MIMIN V V
223 YENI V 90 AGUSTINA V
224 REKNO V 91 GINA V
225 SUPRIHATIN V 92 MONIKA V V
JUMLAH 6 93 ARISTA V
94 ROSTIYANTI V
TOTAL 219 36 95 MARYAM V
JUMLAH TOTAL PASIEN : 192 JUMLAH 7 2

Formulir Survey Harian Pemakaian Alat 13/06/18 96 MIMIN V V


Ruang VK - RSKIA - MARET- 2018 97 MARYAM V
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN 98 RENI V
01/03/18 1 SUPRIHATIN V 99 ARISTYA V
2 NOVIA V 100 AYU SITI V
3 ANI S V 101 NIDA V V
4 DILLA V JUMLAH 6 2
5 ANI S V
6 LELA V 14/06/18 102 NIDA V V
7 ASTRI V 103 ENOK V
8 CAROLYN V 104 LUPI V
JUMLAH 8 105 IYAM V V
106 HENI V V
02/03/18 9 DILLA V 107 SUNARI V
10 DEWINDA V 108 SITI N V
11 WIWI V V 109 DEWI SHINTA V
12 TATI V V 110 DESI V
13 NISA V JUMLAH 9 3
14 RISKA V V
15 ROMLA V 15/06/18 111 ELIS V
JUMLAH 7 3 112 SUNARI V
113 NURWASIAH V
03/03/18 16 WIWI V V 114 EUIS V
17 TATI V V 115 ITAA V
18 NISA V 116 MARCELA V
19 RISKA V V 117 YULIAWATI V V
20 ELSA V 118 FINA V
21 MAYA V 119 FITRIYANI V
22 QONI V 120 PUTRY V V
23 ELSA V V JUMLAH 10 2
JUMLAH 8 4
16/06/18 121 SANTI V
04/03/18 24 WIWI V 122 TINA V V
25 MIFTAKHUL V 123 FITRIYANI V
26 ELSA V V 124 PUTRY V V
27 MAYA V 125 SITI M V
28 TATI V 126 NIA V
29 SITI S V 127 RIKA V
JUMLAH 6 1 128 YANTI V
129 CITRA V
05/03/18 30 SURTINI V 130 ADE EHA V
31 RISMA V 131 BETTY V V
32 RITA V V 132 TRI HANI V
33 MIMI V 133 SITI ROBAYAH V V
34 IMA V JUMLAH 14 4
35 ENTI C V
36 SUCI V 17/06/18 134 BETTY V V
37 SITI ZUBAIDAH V 135 MIRA V
38 SUSANTI V 136 WIWI V
JUMLAH 9 1 137 LIA V
138 DEWI V V
06/03/18 39 IMA V 139 RIZKI V
40 MIMI V 140 ANIE V
41 SUSANTI V 141 EUIS V
42 SUCI V JUMLAH 8 2
43 SITI J V
44 AYU V 18/06/18 142 YULI V
45 ROFI V 143 EUIS V
46 RIKA V 144 WIWI V
47 DINI V 145 ANIE V
48 TUTI V V 146 ANANDA V
JUMLAH 10 1 147 DEWI YULIANTI V
148 IMAS V
07/03/18 49 TUTI V V 149 KARMILAH V
50 DINI V 150 AAH SITI V
51 YANI V 151 IKEU V
52 VINA V 152 SITI R V
53 SHERLY V 153 N.KURNIASIH V V
54 RENI V V 154 SITI MULYANI V V
55 RATNA V JUMLAH 13 2
JUMLAH 7 2
19/06/18 155 NUR ASRIYANA V
08/03/18 56 WINTARSIH V 156 SITI R V
57 RATNA V 157 IKEU V
58 RENI V V 158 SITI MULYANI V V
59 JIHAN V 159 IMAS V
60 IRMA V 160 KARMILAH V
61 JIHAN RAHAYU V 161 N.KURNIASIH V V
JUMLAH 6 1 162 FEMI V
163 GARNIS V
09/03/18 62 JIHAN RAHAYU V 164 ENDAH V
63 CUCU V 165 DEWI V
64 LIA V 166 PIPIH V
JUMLAH 3 0 JUMLAH 12 2

10/03/18 65 NENDEN V 20/06/18 167 NURMALASARI V V


66 TENTI V
67 PUTRI V
68 NUNING V
69 CUCU V
70 ELI V V
71 YULI V V
72 IIS V V
JUMLAH 8 3

11/03/18 73 IIS V V
74 YULI V V
75 ELI V V
76 IKA V
77 KIKI V
78 DEVI V V
79 NENI V
JUMLAH 7 4

12/03/18 80 ELI V
81 DEVI V V
82 KIKI V
83 IKA V
84 NENI V Terjadi reaksi transfusi PRC di labu 1
85 YULI V V
86 AI KARTIKA V
87 IIS V
88 ELIN V
89 DEDE V
90 YOLANDA V
JUMLAH 11 2

13/03/18 91 YOLANDA V
92 NETIK V
93 RENI V
94 YANTI V
95 AYU V
96 RANI V
97 NURMIKA V
JUMLAH 7

14/03/18 98 RANI V
99 NURMIKA V
100 NURSADIAH V V
101 PIPIT V
102 TANTI V
JUMLAH 5 1

15/03/18 103 EUIS V


104 TANTI V
105 RIKA V
106 NOVITA V
107 WIDYAWATI V
108 NURHAYATI V
109 NENI V
110 ERNAWATI V
111 LASMINI V
112 RINI V V
JUMLAH 10 1

16/03/18 113 NENI V


114 RINI V V
115 NENI V V
116 WARSINAH V
117 YULI ISMAYANTI V
118 NENI SRI V V
119 DINA V V
JUMLAH 7 4

17/03/18 120 WARSINAH V


121 SELLI V
122 DINA V V
123 MIMIN V V
124 KURAESIN V
JUMLAH 5 2

18/03/18 125 YULIYAWATI V


126 SITI LESTARI V
127 LINA SILVER V
128 WINA V
129 SARI DARWATI V
130 JUARIAH V V
JUMLAH 6 1

19/03/18 131 UCU V


132 AI ROKAYAH V
133 SARI DARWATI V
134 NISA M V
135 YULIA V
JUMLAH 5 0

20/03/18 136 RIRIN V


137 ASRI V
138 WASTINI V
139 FITRIA V V
140 DEWI KANIA V
141 LINA V
JUMLAH 6 1

21/03/18 142 RINNE V


143 DEWI V
144 LINA V
145 RINA V
146 IDAH MAHIDAH V V
147 SHANTI NURHAYATI V
148 YUYUN Y V V
149 MELLY V
150 SITI SOLIHAH V
151 SOLEHA V
152 IRMA V

22/03/18 153 SOLEHA V


154 SANTI V
155 ALIYA V
156 YUYUN V V
157 IRMA V
158 AI SUMARNI V
159 WULANTIKA V
160 LIA MARLIA V V
161 LENI V V
162 ANISA V
JUMLAH 10 3

23/03/18 163 LIA MARLIA V V


164 ANISA V
165 YULIANTI V
166 AI SUMARNI V
167 TINA V
168 RIKA V
169 RUKAINI V
170 FINA V
171 SITI V
JUMLAH 9 1

24/03/18 172 SITI NURJANAH V


173 FINA V
174 MIRA V
175 SITI CHUNAENI V
176 ROKAINI V
177 AI V V
178 MARINI V
179 JUJU V
180 TETI V
181 HALIMAH V
JUMLAH 10 1

25/03/18 182 CITRA V


183 VATMA V
184 FANI V
185 DEWI V
186 SHANTI V
187 RINA V V
JUMLAH 6 1

26/03/18 188 RINA V V


189 SRI V
190 HESTI V
191 NOVITA V
192 SYAH PUTRI V
JUMLAH 5 1

27/03/18 193 ENGKOM V V


194 ERNI V
195 SYAH PUTRI V
196 RODIAH V
197 IDAH V
198 HINDUN V
199 MEI V
200 RISKA V
201 YENI V
JUMLAH 9 1

28/03/18 202 IDAH V


203 EULIS V
204 HINDUN V
205 NITA V
206 NURASIH V
207 VINA V
208 EUIS V
JUMLAH 7

29/03/18 209 VINA V


210 ERLANI V
211 DEWI V
212 SISKA V
213 ROSIFAH V
214 LIA V
215 IRA V
216 CAHYANI V
217 NURJANAH V V
JUMLAH 9 1

30/03/18 218 LIA V


219 LILIS V V
220 NURJANAH V V
221 DEWI V
222 IRA V
223 CAHYANI V
224 ROSIFAH V
225 SITI M V
226 AYU V
JUMLAH 9 2

31/03/18 227 AYU V


228 LIRA V
229 HANI V
230 ENUR V
231 PUPUT V
232 HOJANAH V
233 AI N V
234 YANI V
JUMLAH 8

JUMLAH 234 43
JUMLAH PASIEN 206

Formulir Survey Harian Pemakaian Alat


Ruang VK - RSKIA - APRIL- 2018
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/18 1 WASKEM V
2 SARAH V
3 PUPUT V
4 HOJANAH V
5 YANI V V
6 AI V
7 USWATUN V
8 DINA V
9 HANI V
JUMLAH 10 1

02/04/18 11 NENG DEWI V


12 ELA V V
13 WINDI V
14 HANI V
15 NURI V
16 IMAS V V
17 ALISA V V
18 HUSNUL V
19 AAS V
20 MAMAH V
21 ANISA V
JUMLAH 11 3

03/04/18 22 IMAS V V
23 WINDI V
24 HUSNUL V
25 AAS V
26 POPONG V
27 LEVI V
28 EVI V
29 MUJI V
JUMLAH 8 1

04/04/18 30 ASTRI V V
31 DINI V
32 ANE V
33 STELLA V
34 PUTRI V
35 MIATI V V
JUMLAH 6 2

05/04/18 36 AGUSTINA V
37 MELIANA V
38 ANEU V
39 MIATI V
40 DIANI V
41 DWI INDRAYATI V
42 CICIH V
43 TINA V
44 NOVI V V
JUMLAH 9 1

06/04/18 45 INTAN V
46 TINA V
47 DIANI V
48 NOVI V V
49 ARI SITI V
50 RINI V
JUMLAH 6 1

07/04/18 51 SHINTA V
52 SULASTRI V
53 RINI V
54 YATI V
55 ROSTI V
56 INDRI V
57 ANESSA V
58 JUHAERIAH V
59 SISKA V V
60 MARLIANA V
61 TITIN V V
62 FITRIA V
63 ERNA V
64 RISKA V V
JUMLAH 14 3

08/04/18 65 NURUL LATIFAH V


66 ROSSY V
67 TITIN V V
68 MARLIANA V
69 FINA V
70 TINA V
71 SURYATI V
72 DETI V V
JUMLAH 8 2

09/04/18 73 SURYATI V
74 DETI V V
75 IMAY V
76 LUTHFI V
77 SUTRI V
78 LINA YULIANTINAH V
JUMLAH 6 1

10/04/18 79 LUTHFI V
80 LINA V
81 DAMAYANTI V
82 NENI V
83 DEDE V
84 ANINA V V
JUMLAH 6 1

11/04/18 85 ROHIMAH V
86 DAMAYANTI V
87 ANINA V V
88 RIA V
89 TRESNA V
90 IFANI V V
91 YAYAT V V
JUMLAH 7 3

12/04/18 92 ANINA V V
93 IFANI V V
94 SITI MARYANI V
95 DELSY V
96 UMAEROHINI V
97 SENDI OLIVIA V
98 MERRY V
99 SRI INTAN V
JUMLAH 8 2

13/04/18 100 NINA V V


101 SRI INTAN V
102 TITIN V
103 INDRIYANI V V
104 KURNIAWATI V V
105 NUR AZIZAH V
JUMLAH 6 8

14/04/18 106 AI MARLINA V


107 CANDRA DEWI V V
108 KURNIAWATI V V
109 TINA V
110 INDRIYANI V V
111 NUR AZIZAH V
112 LINDA V
113 YUYUN V
114 KURNIASIH V
115 RISKA V
116 RANI V
JUMLAH 11 3

15/04/18 117 NURLINDA V


118 YUYUN V
119 LINDA V
120 YUYUN YUNENGSIH V
121 TINA V
122 KURNIASIH V
123 RANI V
RUANG IRNA 3 BULAN JANUARI 2016
TANGGAL NO NAMA ETT IVL UC ISK FLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/01/2016 1 ny rini v v
2 ny sugandini v v
3 ny wulandari v v
4 ny teni v
5 ny komalsari v
6 ny kaniati v
7 ny ratmah v
8 ny yulianti v
9 ny neng sukma v
9 3
02/01/2016 10 ny kaniati v
11 ny pitri v v
12 ny dasri v v
13 ny santi v
4 2

03/01/2016 14 ny kaniati v
15 ny pitri v
16 ny dasri v v
17 ny segi v
4 1
04/01/2016 18 ny wati v v
19 ny purwanti v v
20 ny yani v v
21 ny kaniati v
22 ny cristin v v
23 ny pitri v v
24 ny dasri v v
25 ny popon v v
26 ny fina v v
27 ny wulansari v v
10 9
05/01/2016 28 ny popon v
29 ny yani v v
30 ny dedeh v v
31 ny rini v v
32 ny fina v v
33 ny wulansari v v
34 ny purwati v
35 cristin v
36 ny ate v
37 ny fitri v
38 ny evi v
39 ny wati v
12 5
06/01/2016 40 ny.Ida v
41 ny. Siska v
42 ny.Reni v v
43 ny. Rani v
44 ny.Kartika v
45 ny.Evi v
6 1
07/01/2016 46 ny leni v
47 ny nia v
48 ny mimin v v
49 ny reni v v
50 ny sumarni v v
51 ny uun v
52 ny kartika v v
7 4
08/01/2016 53 ny ipah v v
54 ny nia v v
55 ny enung v v
56 ny titing v
57 ny tesa v
58 ny faurani v
59 ny rindi v
7 3

09/01/2016 60 ny ai siti v
61 ny upik v v
62 ny winda v
63 ny epon v
64 ny ipah v v
65 ny eneng v
66 ny ina v v
67 ny enung v v
68 ny titing v v
69 ny rindi v
10 5
10/01/2016 70 ny. Nia v
71 ny.Septia v
72 ny.Rezty v v
73 ny. Olis v v
74 ny. Eneng v
75 ny.Hani v
76 ny.Ismi v
77 ny.Ina v v
78 ny. Yulianur v
9 3
11/01/2016 79 ny.Septia v
80 ny. Olis v v
81 ny. Maesaroh v
82 ny. Yulianur v
4 1
12/01/2016 83 ny.Septia v
84 ny.Mirnawati v
85 ny.Nolis v v
86 ny. Evi v
87 ny.Ria v
88 ny.Hera v
89 ny.Risma v
90 ny.Nepi v
91 ny. Yuli v
9 - 1
13/01/2016 92 ny wiwin v v
93 ny hani v v
94 ny imas v v
95 ny ria v
96 ny dode v
97 ny risma v
98 ny rindi v
99 ny pitriah v v
7 4 1
14/01/2016 100 ny wiwin v
101 ny warsinah v v
102 ny yayang v
103 ny herlina v
104 ny lisnawati v v
105 ny endah v v
106 ny erlita v
107 ny eneng v
108 ny elis v
109 ny melani v v
110 ny maya v
111 ny rindi v
112 ny pitriah v
113 ny rina v v
13 6
15/01/2016 114 ny. Warsinah v
115 ny.Yayang v
116 ny. Warsinah v
117 ny. Endah v v
118 ny.Putri v v
119 ny.Melani v v
120 ny. yati v v
121 ny.Maya v
122 ny. Rindy v
123 ny. Rina v
10 4
16/01/2016 124 ny. Tiawati v
125 ny.Neng Windan v
126 ny. Rindy v
3
17/01/2016 127 ny.Tiawati v
128 ny.neng Windan v
129 ny. Evi v
130 ny.Fitri v
131 ny. Rindy v
5 -
18/01/2016 132 ny.Wawat v
133 ny.Winni v
134 ny.Evi v
3
19/01/2016 135 ny cucu v v
136 ny fitri v
137 ny wini v v
138 ny susilawati v
139 ny aam v v
140 ny nining v v
141 ny rahayu v v
142 ny aas v v
143 ny fauziah v v
144 ny rindi v
145 ny neneng v v
146 ny yuliani v v
12 9

20/01/2016 147 ny rindi v


148 ny santi v
149 ny dede v
150 ny ratna v v
151 ny nina v v
152 ny ismi v
153 ny fitri v
154 ny ima v v
8 3

21/01/2016 155 ny ratna v v


156 ny ismi v
157 ny susanti v v
158 ny fitri v
159 ny ima v v
160 ny dede v
161 ny rindi v
7 3
22/01/2016 162 ny ismi v
163 ny tuti v v
164 ny neni v
165 ny yeni v
166 ny sutiah v v
5
23/01/2016 167 ny cucu v v
168 ny lilis v v
169 ny ismi v v
170 ny nely v v
171 ny neni v v
172 ny pipit v
173 ny rini v v
174 ny sutiah v v
175 ny yulia v v
176 ny leni v v
177 ny eka v
178 ny rindi v
179 ny lena v v
13 10

24/01/2016 180 ny cucu v


181 ny yulia v
182 ny ismi v
183 ny yufi v
184 ny lena v
185 ny siti r v
186 ny tika v
187 ny iis v v
8 1
25/01/2016 188 ny imas v
189 ny hesti v
190 ny ismi v
191 ny yufi v
192 ny iis v v
5 1
26/01/2016 193 ny ismi v
194 ny aan v
195 ny novi v v
196 ny.Lulu v v
4 2
27/01/2016 197 ny.IIm v v
198 ny.Cacih v v
1 1
28/01/2016 199 ny. Ati Fitria v
200 ny. Siti Rokayah v
201 ny.Sutiah v
202 ny. Idah v
203 ny. Siti Fatimah v v
204 ny.Iim v
205 ny.Sri v
206 ny. Neng Susanti v
207 ny.Sugiyanti v
208 ny.Neneng v
209 ny. Siska v v
11 2

29/01/2016 210 ny siti r v


211 ny sutiah v v
212 ny diana v
213 ny santi v
214 ny nelly v v
215 ny linda v v
216 ny sugianti v
217 ny rusmiati v v
218 ny annisa v
219 ny nia v v
220 ny rini v v
11 6

30/01/2016 221 ny siti r v


222 ny sutiah v
223 ny linda v
224 ny iatnawati v v
225 ny nelli v
226 ny annisa v
227 ny nia v v
228 ny rini v v
8 3
31/01/2016 229 ny susi v v
230 ny siti r v v
231 ny husnul v
232 ny tika v
233 ny solihah v v
234 ny novi v
235 ny nurhayati v v
236 ny rani v v
237 ny iatnawati v
238 ny rini v
10 5

235 97 1 1

RUANG IRNA 3 BULAN Februari 2016


TANGGAL NO NAMA ETT IVL UC ISK FLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/02/2016 1 ny.Husnul v
2 ny. Tika v
3 ny.Solihah v
4 ny.Susi v
5 ny. Denoviani v
6 ny.Fitri v
7 ny.Novi v v v
7 1 1
02/02/2016 8 ny.Siti Maryam v
9 ny.Husnul v
10 ny.Tika v
11 susi v v
12 ny.Denoviani v
13 ny.Fitri v
14 ny.Novi v
15 ny.Liska v
16 ny.Yanti v
9 1
03/02/2016 17 ny santi v
18 ny siti v
19 ny irmawati v
20 ny vera v
21 ny novi v
22 ny liska v v
23 ny eti v
24 ny ari v
8 1
04/02/2016 25 ny. Sherly v
26 ny. Irmawati v
27 ny. Nurjannah v
28 ny. Setiawanti v
29 ny.Ina v v
5 1
05/02/2016 30 ny. Lilis v
31 ny. Sherly v
32 ny. Ina v v
33 ny. Siti F v v
34 ny. Eli v
35 ny. Novi v
36 ny.Feny v
37 ny.Nurjannah v v
38 ny. Setiawanti v
39 ny.Ari v
06/02/2016 10 3
40 ny.Elly v v
41 ny.Ervina v
42 ny.Marni v v
43 ny. Dede v
44 ny. Asih v
45 ny. Novi v
46 ny. Cucu v v
47 ny.Penny v v
48 ny.Evi v
9 4
07/02/2016 49 ny. Ervina v v
50 ny. Marni v v
51 ny. Risnawati v
52 ny.Asih v v
53 ny.Sany v
54 ny.Novi v
55 ny.siti Rohmah v v
56 ny.Samia v
57 ny.Atri v
9 4
08/02/2016 58 ny.Marni v v
59 ny. Nurasidah v
60 ny. Novi v
61 ny.Lilis v
62 ny.Mimin v
63 ny. Atri v
6 1
09/02/2016 64 ny.Marni v
65 ny. Nurasidah v
66 ny. Novi v
67 ny.Mimin v
68 ny.Atri v

10/02/2016 69 ny setiawati v
70 ny erni v
71 ny novi v
72 ny mimin v v
73 ny lilis v
74 ny.Siti Komariah v
75 ny.Nurosyidah v
7 1
11/02/2016 76 ny.Hani v
77 ny.Imi v
78 ny.Yenyen v
79 ny.Imas v
80 ny.Mimin v
81 ny.Ai v
82 ny.Samirah v v
7 1
12/02/2016 83 ny.Eulis v
84 ny.Samirah v v
85 ny. Usi v
86 ny. Wati v v
87 ny. Nita v
88 ny. Yeyen v v
89 ny. Rr Amalia v
90 ny.Atikah v
91 ny.Sugiarti v v
92 ny.Shitiawati v v
93 ny.Liya v
11 5
13/02/2016 94 ny.Susanti v
95 ny. Fani v
96 ny.Kursinah v v
97 ny. Lena v
98 ny.Atikah v
99 ny.Shintiawati v v
100 ny.eneng Yati v
101 ny.Liya v
8 2
14/02/2016 102 ny. Susanti v
103 ny. Fani v
104 ny.Ina v v
105 ny. Novi v v
106 ny. Lena v
107 ny.Debi v v
108 ny.Riska v
7 3
15/02/2016 109 ny.Tusilawati v
110 ny.Tuti v v
2 1
16/02/2016 111 ny. Tusilawati v
112 ny.Wastinah v
113 ny. Tati v
114 ny.Yanti v
115 ny. Anis v
116 ny. Cucu v
117 ny.Pupun v
7
17/02/2016 118 ny. Reni v
119 ny. Rini v
120 ny. Sriningsih v
121 ny.Wastinah v
122 ny. Tati v v
123 ny. Shinta v v
124 ny. Yeti v
7 2
18/02/2016 125 ny. Mala v
126 ny. Rini v v
127 ny. Siti Rodiah v
128 ny.Shinta v v
129 ny. yeti v v
130 ny.Nur Rohaeti v
131 ny.Sulastri v
132 ny. Sri Wahyuni v
133 ny. Hastuti v
9 3
19/02/2016 134 ny.Rahmawati v
135 ny. Mala v v
136 ny. Karyati v
137 ny. Siti Umu Kulsum v
138 ny. Yeni v
139 ny. Desi v
140 ny.Mirawati v
141 ny. Yeti v
142 ny. Sri Wahyuni v
9 1
20/02/2016 143 Ny. Mala v v
144 Ny. Ida v
145 Ny. Stefani v
146 Ny. Tini v v
4 2

21/02/2016 147 ny mala v v


148 ny neni v
149 rina v v
150 ny susi v
151 ny heni v v
152 ny ida v
153 ny yanti v v
154 ny rosmawati v
155 ny mila v
156 ny lindawati v
157 ny rima v v
11 5

22/02/2016 158 ny mila v


159 ny lindawati v
160 ny iis f v v
161 ny rima v
162 ny yanti v
163 ny mala v v
164 ny heni v
165 ny iis f v v
8 3
23/02/2016 166 ny. Siti Rokayah v
167 ny. Mala v v
168 ny. Heni v
169 ny. Iis v
170 ny. Vina v v
171 ny. Iya v v
172 ny. Iis v
8 3
24/02/2016 173 ny. Siti Maryam v
174 ny. Sri Mulyani v
175 ny. Lina v
176 ny. Sumarti v
177 ny. Mimin v
5
25/02/2016 178 ny. Siti Rohaeni v
179 ny.Yuyun v
180 ny.Siti Maryam v v
181 ny.Sri Mulyani v
182 ny.Lina v
183 ny. Sumarti v v
184 ny. Mala v
185 ny. Mimin v
8 2
26/02/2016 186 ny.Lina v v
187 ny. Mala v
188 ny. Suryaningsih v v
189 ny. Dian v v
190 ny. Rahma v
5 3
27/02/2016 191 ny. Meli v v
192 ny. Depi v v
193 ny. Cacih v v v
194 ny. Tuti v v
195 ny. Mala v
196 ny. Suryaningsih v
197 ny. Ade Mimin v v
198 ny. Rahma v
199 ny.Wina v
9 4 2
28/02/2016 200 ny. Cacih v
201 ny. Sonata v v
202 ny.Agustin v v
203 ny. Fitriani v
204 ny.Dewi v
205 ny.Rahma v
206 ny.Ani v
7 2
29/02/2016 207 ny. Dinda v
208 ny.Rina v
209 ny. Agustin v
210 ny. Rahma v
4
206 56 `1 3

RUANG IRNA 3 BULAN MARET 2016


TANGGAL NO NAMA ETT IVL UC ISK FLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/03/2016 1 NY. Leni v
2 NY. Yayang v
2
02/03/2016 3 ny suryani v v
4 ny ita v
5 ny yulli v v
6 ny ratnawati v
7 ny rosita v
8 ny susilawati v v
9 ny leni v
7 3
03/03/2016 10 ny yulli v
11 ny mimin v
12 ny egi v
13 ny fitri v
14 ny yenni v
15 ny lastri v v
16 ny mia v v
17 ny titin v v
18 ny rosita v
19 ny susilawati v v
20 ny suryani v
11 4
04/03/2016 21 ny rini v v
22 ny wawat v v
23 ny suryani v v
24 ny danisme v v
25 ny rina v
26 ny heni v v
27 ny titin v v
28 ny vera v v
29 ny yulli v
30 ny mimin v
31 ny yeni v v
11 8

05/03/2016 32 ny mimin v
33 ny emi v
34 ny wiwi v
35 ny yeni v v
36 ny nuraisyah v
37 ny vera v
38 ny suryani v v
39 ny danisme v v
8 3

06/03/2016 40 mimin v
41 juju v
42 ratna v v
43 vina v v
44 erna v v
45 wiwi v
6 3

07/03/2016 46 yayah v v
47 neni v
48 rohaeni v v
49 melli v v
50 vera v
51 novianti v v
52 mimin v
7 4

08/03/2016 53 mila v v
54 erna v
55 meli v v
56 novianti v
4 2

09/03/2016 57 melli v
58 ane v v
59 lindawati v
60 mila v
61 erna v
5 1
10/03/2016 62 Melli v
63 Mirna v
64 Rohimas v
65 Lindawati v
66 Avon v
5

11/03/2016 67 melli v
68 adelva v
69 ina v
70 tina v
71 rika v
72 fitri v
73 rohimas v v
74 dini v
8 1
12/03/2016 75 Melly v
76 Adelva v
77 Neni v v
78 Tina v
79 Sartikasri v
80 Rohimas v
81 Lia v
82 Yayah v
83 Kania v
84 Nuraisyah v v
85 Reni G v
11 2
13/03/2016 86 Melly v v
87 Reni v v
88 Rohimas v
89 Kokom v
90 Nina v
91 Yayah v
5 2 1
14/03/2016 92 Melly v
93 Kokom v
94 Rohimah v
95 Kania v
96 Yulianti v
5
15/03/2016 97 melli v
98 rina v
99 rohimas v v
100 nina v v
101 ika v
102 shinta v v
6 3
16/03/2016 103 ny melli v
104 yani v v
105 hani v
106 ani v
107 rika v
5 1
17/03/2016 108 endang v v
109 mariam v
110 yani v
111 ningrum v v
112 fitriyani v
113 ria v
114 melli v
115 irma v
116 yuli v
117 sri ningsih v
118 ani v
11 2

18/03/2016 119 yoyoh v v


120 yuli v
121 sriningsih v
122 aat v
123 herawati v
124 meli v
125 suprianti v
126 siti merlina v
127 siti mulyani v
128 endang v v
129 yani v
130 ningrum v v
131 yeni v
132 ria v
14 3 1

19/03/2016 133 melli v


134 suprianti v
135 siti merlina v
136 siti mulyani v
137 endang v
138 ningrum v v
139 yeni v
140 yuli v
141 aat v
142 herawati v
10 1
20/03/2016 143 nurhayati v v
144 yuli v
145 atriani v v
146 mira v v
147 siti nurmala v
148 herawati v
149 ema v
150 yani v
151 ningrum v v
152 yeni v
153 meli v
154 imas v
12 4

21/03/2016 155 melli v


156 rika v
157 yani v
158 yeni v
159 atri v v
160 nurhayati v v
161 yuli v
162 fitriani v v
163 siti nurmala v
164 herawati v
10 3

22/03/2016 165 melli v


166 rika v
167 yani v
168 yani v
169 atri v
170 yuli v
171 fitri v
172 siti nurmala v
8
23/03/2016 173 Meli v
174 Rika v
175 Ai KAryati v
176 Yeni v
177 Astri v
178 Siti Nurmala v
6
24/03/2016 179 Melly v
180 Sri Andriani v
181 Rika v v
182 Astri v
183 Nabilah v
184 Eneng Yani v
185 Shintia v
7 1
25/03/2016 186 Melly v
187 Sri Andriani v
188 Nabilah v
189 Ani v
190 Junairah v
5
26/03/2016 191 Sri Andriani v
192 Susi V V
193 Ratna Sari v v
194 Ani v
195 Junairah v
5 2
27/03/2016 196 herawati v v
197 hamidah v
2 1

28/03/2016 198 elis v


199 yeni v
200 herawati v
201 irma v
202 iis saripah v v
203 hamidah v
204 rini v v
7 2
29/03/2016 205 susi v
206 puji v v
207 elis v
208 yeni v v
209 hani v v
5 3

30/03/2016 210 tati v v


211 atri v v
212 ade v v
213 puji v
214 susi v
215 fitri a v v
216 rosanah v v
217 elis m v
218 fitria v v
9 6

31/03/2016 219 fitria v


220 suwartini v
221 erlina v
222 nurjanah v v
223 yati v v
224 nenden v v
225 tati v
226 rina v v
227 atri v v
228 ade v
10 5
228 70 1 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 1 Rina v v
2 Diana v
3 Atri v v
4 Yosi v
5 Erlina v
6 Yani v
7 Nenden v
8 Sunengsih v
8 2
02/04/2016 9 Atri v
10 Diana v
11 Yosi v
12 Yani v
13 Susanti v v
14 Iis v
6 1
03/04/2016 15 Febi v
16 Aisah v
17 Puji v
18 Vina v v
19 Susanti v v
20 Ai Nani v
21 Iis v
7 2
04/04/2016 22 Aisah v
1
05/04/2016 23 Rini v v
24 Ayu v
25 Aisyah v
26 Iis v
27 Siti v
28 Enung v
6
06/04/2016 29 ayuniah v v
30 rini v v
31 siti masitoh v
32 iin v
33 ratna sari v
34 neni v
35 evi v v
36 novi v
37 stefani v
9 3
07/04/2016 38 rini v v
39 tini v
40 dede v v
41 stefani v
42 suliyati v v
43 elitasari v
6 3

08/04/2016 44 empu v
45 tini v
46 siti k v
47 reni v
48 ucu v v
49 rosi v v
50 gilang v v
51 santi v
52 elitasari v
9 3
09/04/2016 53 Karnati v
54 Tini v
55 Ati v
56 Siti Nurjamilah v
57 Reni v
58 Ucu v
59 Gina v
60 Rosi v
8
10/04/2016 61 Any v
62 Tini v
63 Rika v
64 Yuyun v
4
11/04/2016 65 Ani v
66 Enis v
67 Nena v
68 Pipih v
69 Ita v v
70 Lia v
71 Anisina v
7 1
12/04/2016 72 Eva v
73 Ani v
74 Sri v v
75 Nena v
76 Yeni v
77 Pipih v v
78 Eka v
79 Imas v
80 Susi v
81 Ulfah v
9 3
13/04/2016 82 Srimulyani v
83 Sri Ningsih v
84 Elis v
85 Yeni v
86 Eka v
87 Astri v v
88 Fitri v
89 Ulfah v
90 Nani v
8 2
14/04/2016 91 Sri endang v v
92 Sri M v
93 Neng Lisda v
94 Sri Ningsih v v
95 Elis v v
96 Sri W v
97 Hera v
98 Fitri v v
99 Eli v
100 Yuli
101 Eka v v
102 Lia v v
103 Astri v v
11 7 1
15/04/2016 104 Herawati v
105 Fitri v
106 Sri Endang v v
107 Sri M v
108 Neng Lisda v
109 Sri Ningsih v
110 Syamsiah v
111 Sri W v
112 Hasanah v v
113 Yuli v
114 Eka v
115 Lia v v
116 Astri v v
11 6
16/04/2016 117 Hasanah v
118 yuli v
119 Lia v
120 Sri M v
121 Neng Lisda v
122 Sri W v
123 Ai Atikah v
124 Dewi v
125 Desi v v
7 3
17/04/2016 126 Liana v v
127 Ajeng v
128 Silma v v
129 Ulfah v v
130 Neng Lisda v
131 Sri M v
132 Wini v
133 Sri W v v
134 Hasanah v
135 Lia v v
10 5
18/04/2016 136 Yulia v v
137 Sri M v
138 Neng Lisda v v
139 Liana v
140 Wini v v v
141 Yulianti v v
142 Reni v v
143 Tini v
8 5 1
19/04/2016 144 Efi v v
145 Reni v
146 Aprilia v
147 Sri M v
148 Neng Lisda v
149 Wini v v v
6 2 1
20/04/2016 150 Evie v
151 Leni v v
152 Wini v v
153 Efi v v
4 3
21/04/2016 154 efi v v
155 neneng v v
156 rika v v
157 mardeliati v
158 evie v v
159 yanti v v
6 5
22/04/2016 160 neneng v
161 suryati v v
162 cicih v
163 rika v v
164 herni v v
165 evie v v
166 nunung v
167 yanti v v
168 aida v
169 siti n v v
10 6
23/04/2016 170 yanti v v
171 aida v v
172 siti n v
173 nia v
174 rika v v
175 elis v v
6 4
24/04/2016 176 Sulastri v
177 Wawat v
178 Aida v v
179 Erna v v
4 2
25/04/2016 180 Yeti v
181 Rani v
182 Lilis/Tn.Asep v
183 Lilis/Tn.Teten v
184 Iis v
185 Rini v v
6 1
26/04/2016 186 Fitria v
187 Yeti v v
188 Gina v
189 Rani v
4 1
27/04/2016 190 Tita v
1
28/04/2016 191 Yuyun v
192 Tita v
193 Yuli v
194 Ovi v
4
29/04/2016 195 Ira v v
196 Ai Rohaeti v
197 Yuyun v v
198 Yuli v
199 Ema v
200 Dewi v
6 2
30/04/2016 201 Eva v
202 Santi v
203 Komariah v
204 Deti v
205 Ema v v
206 Dewi v
5 1
197 73 2 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MEI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2016 1 Eva v
2 Selly v
3 Juhariyah v
4 Nurhasanah v v
3 2
02/05/2016 5 Susilawati v
6 Eva v
7 Nelly v v
8 Mursalinah v
9 Lela v
10 Imas v
5 2
03/05/2016 11 Susilawati v
12 Imas/Tn.Ateng v
13 Mursalinah v
14 Sri Mulyati v
15 Imas/Tn.taufik v
16 Devi v
17 Chinta v v
18 Pujiniati v v
8 2
04/05/2016 19 Imas v
20 Devi v
21 Sri Mulyati v
22 Sri Mulyani v
23 Chinta v v
24 Pujiniati v v
25 Nelly v v
7 3
05/05/2016 26 Susilawati v
27 Rosa v
28 Ina R v v
3 1
06/05/2016 29 Rosa v
30 Yani v
31 Widia v
32 Siti A v
4
07/05/2016 33 tina v
34 Rosa v
35 Rismawati v
36 Pipit v
37 Widia v
38 Dede v v
6 1
08/05/2016 39 Elis v
40 Ela v v
41 Didah v
42 Devi v
43 Rismawati v
44 dede v v
6 2
09/05/2016 45 Elis v
46 Didah v v
47 Wiwin v
48 Fenty v
4 1
10/05/2016 49 Elis/Tn.Dadan v
50 Elis/Tn.Iman v
51 Cucu v
52 wiwin v
53 Fenty v v
5 1
11/05/2016 54 Rosita v
55 Gina v
56 Elis v v
57 Fani v
58 Ati v
59 Satma v v
6 2
12/05/2016 60 Rosita v
61 Fani v
62 Gina v
63 Satma v v
64 Linda v
65 Teti v v
66 Tati v
7 2
13/05/2016 67 Rosita v
68 Nunung v v
69 Yeni v
70 Rizqiani v
71 Siti Rohmah v
72 Fitri v v
73 Linda v
74 Nina v
75 Yessi v
76 Teti v
77 Tati v
11 2
14/05/2016 78 Rosita v
79 Rika v
80 Ani v
81 Aneu v
82 Nury v
83 Dani v
84 Nur Saripah v v
7 1
15/05/2016 85 Ane v v
86 Dani v
87 NurSaripah v v
88 Ari v
4 2
16/05/2016 89 Neng Cahyani v
90 Septi v
91 Ari v
92 Aas v
4
17/05/2016 93 Kartika v
94 Neni v
95 Homsah v
96 Imas v
97 Iis v
5
18/05/2016 98 Dini v v
99 Kartika v
100 Imas v
101 Rafika v v
102 Homsah v
103 Ai Rohayati v
104 Imas v v
105 Suryatiningsih v
8 3
19/05/2016 106 Susan v
107 Melli v v
108 Enur v
109 Imas v
110 Hotlin v
111 Ani v v
112 Timur v
113 Dede v
114 Nelis v v
115 Yanti v
10 3
20/05/2016 116 Desri v
117 Ani v v
118 Tia v
119 Timur v
120 Evi v
121 Enon v v
122 Tuti v
123 Asih v
124 Yeni v
9 2
21/05/2016 125 Neni v
126 Neng Titin v
127 Latika v
3
22/05/2016 128 Rike v
129 Neni v
130 Sari v v
131 Romiah v v
132 Diah v
133 Lia v
134 Yuliani v
7 2
23/05/2016 135 Rina v v
136 Kiki v v
137 Elis v
138 Rika v
4
24/05/2016 139 Rina v
140 Risma v
141 Irma v v
142 Dini v
4 1
25/05/2016 143 Iyan Yanti v
144 Diny v v
145 Bariyah v
3 1
26/05/2016 146 Iyan Ynati v
147 Neng Yeni v
148 Nunung v
149 Tika v v
150 Susri v
5 1
27/05/2016 151 Iyan Yanti v
152 Emil v v
153 Dewi v
154 Nina v
155 Tini v
156 Erna v
6 6
28/05/2016 157 Siti N v
158 Erna v v
159 Nurohmah v v
160 Tati v v
161 Dewi v
162 Nina v
163 Tini v
164 Cucun v v
8 4
29/05/2016 165 Narti v v
166 Imas v
167 Ike v v
168 Wawang v v
169 Cucun v v
170 Dewi v
6 4
30/05/2016 171 Dewi v
172 Imas v
173 Ani v
174 Tini v
175 Cucun v
5
31/05/2016 176 AI Yulianti v
177 Henisah v
178 Suminar v v
179 Lilis v v
180 Ani v
181 Irdawati v v
182 JUbaedah v
7 3
182 49

FORMAT SURVEY HARIAN PEMAKAIAN ALAT juni 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2016 1 sunarti v v
2 novi v
3 leni v
4 yuli v
5 sulastri v
6 ayi v v
7 sariah v
8 ai yuli v
8 2
02/06/2016 9 nuni v
10 anggi v
11 tika v
12 nunung v v
13 sunarti v v
14 novi v
15 elis v
16 rendwi v
8 2
03/06/2016 17 lasmanah v
18 anggi v
19 tika v
20 nunung v
21 elis v
5 0
04/06/2016 22 Arni v
23 Lessa v
24 Eneng Susanti v v
25 Fitri v
26 Cucun v
5 1
05/06/2016 27 Nopi v
28 Lesa v v
29 Eneng Susanti v v
30 Cucun v
31 Santi v v
5 3
06/06/2016 32 Nopi v
33 Nina v v
34 Nur Astri v
35 Cucun v
36 Selvi v v
37 Farida v
38 Sumarni v
7 2
07/06/2016 39 Sumiati v v
40 Heni v v
41 Cucun v
3 2
08/06/2016 42 Susi v
43 Ryanti v
44 Yani v
45 Heni v v
46 Cucun v
47 Ipah v
6 1
09/06/2016 48 Susi v v
49 Nia K v
50 Triya v
51 Kokom v
52 Eli v v
53 Liah v v
54 Ipah v
7 2
10/06/2016 55 Ipah v v v
56 Dahliah v
57 Riyanti v
58 Tria v
59 Kokom v v
60 Nunung v v
61 Sri v v
62 Efi v v
63 Sindi v
9 5 1
11/06/2016 64 Isty v
65 Siti N v
66 Sirly v
67 Riyanti v
68 Pia v v
69 Ipah v v
70 Dahliah v
71 Nunung v v
72 Sri v
73 Efi v
10 3
12/06/2016 74 Isti v
75 Siti N v
76 Rianti v
77 Euis v
78 Pia v v
79 Ipah v
80 Dahlia v
81 Sumiati v v
82 Dea v v
9 3
13/06/2016 83 Hanny v
84 Suryati v
85 Nunung v v
86 Cucu v
87 Nia v
88 Dea v
6 1
14/06/2016 89 Marliani v
90 Neng Linda v
91 Sari v
92 Dini v
93 Tuti v
94 Cucu v
6
15/06/2016 95 yuningsih v v
96 Agusmariyanti v
97 Muniroh v
98 Lia v v
99 Hena v
100 Yuningsih v
6 2
16/06/2016 101 Yuningsih v v
102 Sapitri v
103 Mira v
104 Muniroh v
105 PIa v
106 Evi v v
6 1
17/06/2016 107 IIm v
108 Ane v
109 Sapitri v
110 Mira v
111 Titi v
112 Dian v
113 Iim v
7
18/06/2016 114 Cucu v
115 Dede v
116 Titi v
117 Iim v
4
19/06/2016 118 Novitasari v v
119 Hamidah v
120 Sadianti v
121 Dede v
122 Dina v
123 Ami v
124 Selvi v v
7 1
20/06/2016 125 Novitasari v
126 Hamidah v
127 KOmariah v
128 Juendah v v
129 Dina v
130 Vivi v
21/06/2016 6 1
131 Novitasari v
132 Hamidah v v
133 Komariah v v
134 Heni v v
135 Nita v
136 Juendah v
137 Sari v v
7 4
22/06/2016 138 Rina v
139 Rini K v
140 Elvia v
141 Fitri v
4
23/06/2016 142 herna v v
143 rina v
144 neng rani v v
145 elvia v v
146 nani v v
5 4

24/06/2016 147 neng rani v v


148 nani v v
149 elin v v
150 lalas v
151 ika v v
152 nurhayati v v
6 5
25/06/2016 153 Nisa v
154 Dede v
155 nani v v
156 Santi v
157 Elin v v
158 Nurhayati v v
6 3
26/06/2016 159 Nisa v
160 Ida v
161 Dede v
162 Vera v v
163 Ita v v
164 Atik v
6 2
27/06/2016 165 Didah v
166 Ratmi v
167 Ida v
168 Dede v
169 Ria v v
170 yayah v
6 1
28/06/2016 171 Didah v v
172 Edah v v
173 Ida v
3 2
29/06/2016 174 Rahayu v
1
30/06/2016 175 Rahayu v
176 Dahlia v v
177 LIna v
178 Erin v
179 Karmila v
180 Eva v
6 1
180 53 2
total jml pasen total ?

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JULI 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2016 1 Yulimah v
2 Dewi v v
3 Dahlia v
4 Risnawati v
5 Endah v
5 1
02/07/2016 6 Jumiyah v
7 Neni v v
8 Endah v v
9 Yanti v v
10 Cintia v v
11 Neng Imas v v
12 Risnawati v v
7 6
03/07/2016 13 Gebby v
14 Rika v
15 Jumiyah v v
16 Titin v
17 Yanti v v
18 Syafitriyanti v
04/07/2016 6 2
19 Lusy v
05/07/2016 1
20 Ai K v
21 Guspina v
22 Linda v
23 Lilis v
4
06/07/2016 24 Dedeh v
25 Sri v v
26 Nia v
27 yanti v
4 1
07/07/2016 28 Kokom v v
29 Mila v
30 Iyen v
31 Shindi v
32 Dedeh v
33 Nia v
6 1
08/07/2016 34 Dedeh v
1
09/07/2016 35 Dedeh v
36 Sugiyanti v
2
10/07/2016 37 Rika v
38 Sri M v
39 Juju v
3
11/07/2016 40 Sera v
41 Kalimah v
42 Eva v v
43 Rika v
44 Nunung v v
45 Sri v
46 Efi v
7 2
12/07/2016 47 Fitri v
48 Elis v
49 Yuni v
50 Rika v
51 Ajeng v
52 Sumiati v
53 Dea v v
7 1
13/07/2016 54 Ruhlianti v
55 Ati v
56 neng Ripni v v
57 Nurul v
58 Maryati v v
59 Nina v
60 Neli v
61 Sariningsih v
9 2
14/07/2016 62 Wulan v
63 Ati v v
64 Ajeng v
65 Ruhlianti v
66 Elsa v
67 Irma v v
68 Nurul v v
69 Tastianty v v
70 Tami v v
71 Sariningsih V V
10 4
15/07/2016 72 Rina v v
73 Elsa v v
74 Musliah v
75 Tastianty v
76 Rosmiati v
77 Yanti v
78 Resty v
7 2
16/07/2016 79 Nita v v
80 Yanti v v
81 Rina v
82 Elsa v v
4 3
17/07/2016 83 Rina v v
84 Fitri v
1 2
18/07/2016 85 Fitri v
1
19/07/2016 86 Fatimah v
87 Yuli v
88 Eris v
89 Maya v
90 Fitri v
91 Ani v
92 Yanti v v
93 Sariningsih v v
7 3
20/07/2016 94 Rizki v
95 Lilis v
96 Emi v v
97 Ariesca v
4 1
21/07/2016 98 Rizky v
99 Empong v v
100 Yuli v
101 Lilis v
102 Dedeh v
103 Kokom v
104 Sariningsih v v
105 Rini v
106 Nurcahyani v
9 2
22/07/2016 107 Lilis v
108 Neni v
109 Dedeh v
110 Irma v
111 Nena v
112 Sariningsih v v
113 Rini v
114 Nurcahyani v
8 1
23/07/2016 115 Yuyun v
116 Ina v
117 Nuti v
118 Mila v
119 Mia v
120 Mutmainah v v
121 Dina v
122 Siti Khodijah v
123 Nurcahyani v v
9 2
24/07/2016 124 Tika v v
125 Nuti v
126 Siti Hajar v
127 Mutmainah v v
4 2
25/07/2016 128 Tika v v
129 Nurlaela v
130 Nurul v
131 Cucu v
132 Iis v
133 Siti Kanari v
6 1
26/07/2016 134 Sri v
135 Suharni v v
136 Nunu v
137 Fatimah v
4 1
27/07/2016 138 didah v v
139 supartini v
140 heni v v
141 fatimah v
142 eneng v
143 heni v
144 neng linda v
145 darti v
8 2
28/07/2016 146 fivih v
147 heni v v
148 rahayu v
149 edah v v
4 2
29/07/2016 150 rahayu v
151 nurhayati v
152 ernawati v v
3 1
30/07/2016 153 nuti v v
154 nyimas v v
155 dahlia v
156 lina v
4 2
31/07/2016 157 ai v v
158 lilis v
159 iis rohaeti v
3 1
Total 157 49

FORMAT SURVEY HARIAN PEMAKAIAN ALAT AGUSTUS 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2016 1 titin v v
2 tastianty v v
3 dasri v v
4 lilis v
5 iis rohaeti v v
5 4
02/08/2016 6 rachmawati v v
7 titin v v
8 tastianty v v
9 dasri v v
10 cucu v
11 tati v
12 iyam v
13 dahliah v v
14 iis rohaeti v v
9 6
03/08/2016 15 rachmawati v v
16 epi v v
17 wenti v v
18 tastianty v v
19 dasri v v
20 iyam v v
6 6
04/08/2016 21 iin v v
22 nerry v
23 mela v
24 dasri v v
4 2
05/08/2016 25 rohayati v
26 iin v v
27 sarmini v v
28 rita v v
29 dasri v v
30 rina v v
31 irma v v
32 megawati v v
8 7
06/08/2016 33 rohayati v v
34 cucu v
35 lia v v
36 esih v
4 2
07/08/2016 37 asti v
38 erna v
39 yuni v
40 deti v
41 rani v
42 hanijah v v
43 lia v v
7 2
08/08/2016 44 rani v v
45 elirita v
46 tika v v
47 yuni v
48 deti v
49 evi v
50 yuni v
6 2 1
09/08/2016 51 mamah v v
52 rani v v
53 nenden v v
54 een v 3
10/08/2016 55 fitri v v
56 n sawiah v v
57 wuryani v
58 mila v
59 mia v v
60 romansa v v
61 ani v
7 4
11/08/2016 62 ana v v
63 dedeh v v
64 dede v v
65 erna v
66 wuryani v
67 susi v
68 mila v
7 3
12/08/2016 69 ai erna v v
70 anisa v
71 fatimah v
72 asni v v
4 2
13/08/2016 73 tati v v
74 rina v v
75 asni v v
76 wulan v
77 nia v v
78 noneng v
6 3 1
14/08/2016 79 noneng v
80 fatimah v
81 ria v
82 panti v v
83 nia v
84 neng sawiah v v
6 2
15/08/2016 85 nia v
86 neng sawiah v v
87 irma v v
88 susilawati v
89 melli v 2
16/08/2016 90 ane v v
91 dini v v
2 2
17/08/2016 92 dede v v
93 leni v v
94 irawati v
95 heni v
96 ane v
97 suci v v
98 heni v
7 3
18/08/2016 99 iis v v
100 yuyun v v
2 2
19/08/2016 101 lina v v
1 1
20/08/2016 102 umayah v
103 lina v
104 siti hajar v
105 linda v
106 siti r v v
107 rina v
6 1
21/08/2016 108 sri rahayu v v
109 santika v
110 linda v
111 rani v
112 erna v v
113 endah v
114 juwita v v
115 mutiara v v
8 4

22/08/2016 116 santika v v


117 sendi v v
118 risma v v
119 rosalya v v
120 rika v v
121 depi v v
6
23/8/16 122 siti solihat v
123 juwita v
124 sendi v v
125 risma v v
126 rosalya v v
127 rika v v
128 devi v v
129 widawati v
8 5

24/08/2016 130 manisem v v


131 widawati v
132 erna v
133 nurleli v
134 yulianti v
5 1

25/08/2016 135 nurleli v


136 septi v v
137 nurkomariah v
138 yulianti v
139 siti N v v
140 ny. rd tiara v v
141 fenty v
3
26/08/2016 142 rd tiara v v
143 cucu v
144 herni v
145 fenty v
146 safita v v
147 syayidah v
148 hastini v v
149 lilis v
150 mia v
9 3

27/08/2016 151 herniza v v


152 siti solihah v v
153 cucu v v
154 heni v v
155 eneng v
5 4

28/08/2016 156 heni v v


157 ayu v
158 neng dina v
159 siti azizah v v
4 2

29/08/2016 160 ai kuraesin v v


161 sri m v
162 sri r v
163 juminah v v
164 fitria v v
165 naneu v
6 3

30/08/2016 166 siti ruqiatul v


167 cholisoh v
168 sri r v
169 panti v v
170 ai kuraesin v v
171 sri mulyani v v
172 nita v v
173 elda v v
8 5

31/8/2016 174 rosita v


175 ai kuraesin v
176 elda v
177 dewi v
178 sri r v
179 neng ria v
180 cholisoh v
181 yani v v
8 1

181 91 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT SEPTEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2016 1 NENG RIA V
2 syifa v
3 eneng nurhayati v v
4 yani v
5 dewi v v
6 ayu v v
7 elda v v
8 euis v
8 4
02/09/2016 9 lili v v
10 windi v
11 cari ayu v v
12 alberta v v
13 lindawati v v
14 neng nurhayati v v
15 irawati v v
16 reni v v
8 7
03/09/2016 17 rani v
18 khapriatin v v
19 neng nurhayati v v
20 dali v v
21 irawati v
22 utari v v
23 lili v
24 alberta v v
25 lindawati v v
9 6
04/09/2016 26 neng nurhayati v v
27 ina v v
2 2

05/09/2016 28 nendah v
29 dedeh v v
30 lia v v
31 dedeh/itang v v
32 dewi v v
5 4
06/09/2016 33 ani v v
34 wina v
35 wiwin v v
36 dewi v
37 dedeh v
38 hanijah v v
39 erna v v
7 4
07/09/2016 40 riani v v
41 lina v v
42 dede v
43 hanijah v
44 erna v
5 2
08/09/2016 45 lina v
46 iis v v
47 riani v
3 1
09/09/2016 49 yuyun v v
50 mevi v v
51 siti a v v
52 nenoh v v
53 yeni v v
54 kiki v v
55 syanti v v
56 romaeni v v
57 ai siti v
58 rani v
9 8 1

10/09/2016 59 kiki v
60 winni v v
61 teti v
62 syanti v v
3 3
11/09/2016 63 hanifah v v
64 syanti v v
65 teti v
66 kiki v
3 3

12/9/16 67 titing v v
68 syanti v
69 siti aisyah v v
70 kiki v
3 3

13/09/2016 71 ina v
72 rumansa v v
73 yesi v
74 desi v
75 yulianti v
76 ita v
6 1

14/09/2016 77 seli v v
78 rita v v
79 widaningsih v v
80 ina v v
81 dewi v v
82 yesi v
6 5

15/09/2016 83 eva v v
84 ratna v
85 lindawati v
86 rita v v
4 2

16/09/2016 87 euis v v
88 elly v v
89 lindawati v
90 fitria v
91 titin v
92 eva v v
93 neni v
94 ratna v
8 3

17/09/2016 95 eva v v
96 dewi v
97 yani v v
98 herrien v
99 euis v v
5 3

18/09/2016 100 Ani R v


101 Ani H v
102 sumarni v
103 yani v v
104 intan v
5 1

19/09/2016 105 intan v


106 siti v
107 nenden v
108 sumarni v
109 ani H v
110 ida v
111 herlina v
7 0
20/09/2016 112 sari v v
113 awang v
114 wida v v
115 ade v
116 neni v
117 nuning v v
118 susanti v v
7 4

21/09/16 113 haeroni v v


114 eneng hartati v v
115 wida v v
116 susanti v v
117 anisa v
118 susanti v v
119 neng nurlela v v
120 sanis v
8 6

22/09/2016 121 haeroni v v


122 eneng hartati v v
123 alis v v
124 siti N v v
125 silvia v v
126 histanti v
127 anis v
128 entin v
129 santi v v
130 anisa v
10 6

23/09/2016 131 nurmalinda v


132 idah v
133 siti R v v
134 yani v
135 anis v
136 niknik v
137 santi v v
138 nurani v v
7 4

24/09/2016 139 imas v


140 idah v
141 suryani v v
142 lilis v v
143 siska v

6 2

25/09/2016 144 elsa v v


145 riska v
146 chintya v
147 siti nur v v
148 neng dina v
5 2

26/09/2016 149 intan v


150 ineu v v
2 1

27/09/2016 151 wuryani v


152 nanan v v
153 novi v
154 cucu v
155 ineu v v
156 m santi v
157 nia v
158 wida v v
8 3

28/09/2016 159 dewi v


160 nia v
161 dedeh v
162 reni v
163 wuryani v
5

29/09/16 164 dedeh v v


165 eni v
166 wuryani v
167 irma v
168 cucu v
169 yati v v
170 m santi v
171 ucu v
8 2

30/09/2016 172 yati v


173 yuli v
174 ucu v
175 finy v
4

175 92 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT OKTOBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2016 1 nanan v v
2 siti v
3 rina v v
4 suryani v v
5 sheni v
6 nursima v v
7 ayi v v
8 yeni v
9 yuliyanti v v
10 yuli v
11 dede v
12 kustina v v
13 marni v v
14 syanti v v
15 sumarni v
16 maryanti v
16 9

2/10/2016 17 syanti v v
18 nanan v
19 nursima v
20 ayi v
21 tia v
22 marni v v
23 yuningsih v v
24 yeni v
25 kustina v v
26 suryani v v
27 ita v
28 ros v v
12 6
03/10/2016 29 ros v v
30 suryani v v
31 yeni v
32 ita v
33 kustina v
34 tia v
35 yuningsih v
36 widayanti/suriadi v v
37 eulis/ojob v v
9 4
04/10/2016 38 ai soraya/tn yedi v
39 widayanti/suriadi v v
40 annisa/galih v
41 eulis/ojob v v
42 suryani v v
43 seni v
44 winda v
7 3
5/10/2016 45 eulis v
46 suci v v
47 erni v
48 nia v
49 lia v
50 ai v
51 suryani v v
7 2

6/10/2016 52 ati v v
53 enok v v
54 elva v
55 suci v v
56 dewi v v
57 nadia v
58 maesa v
59 lia v
60 desrina v
9 4
7/10/2016 61 Rita v
62 Dewi v v
63 Ati v
64 Nadia v v
65 Nia v
66 Yulia v
67 Destina v
7 2
8/10/2016 68 Yayah v
69 Rita v
70 Yulia v v
71 Mimin v
72 Dike v
5 1
9/10/2016 73 maryani v v
74 wulandari v v
75 siti v
76 susilawati v
77 susanti v
78 siti saropah v
79 okti v
7 2

10/10/2016 80 siti nurwendah v v


81 MARYANI V
82 desmawati v
83 elin v
84 syarifah v
85 rini v
6 1
11/10/2016 86 desmawati v
87 elin v
88 syarifah v
89 rini v
90 lia v
5 1
12/10/2016 91` Elin v
92 Rini v
93 Aneu v v
94 Nurhasanah v
95 Ine siti v
96 Endang v
97 Yeti v
98 Maryani v
99 Sumi v
9 1
13/10/2016 100 elin v v
101 aneu v v
103 nurhasanah v
104 sumi v
105 fitri v
106 lilis v
107 siti sumirat v
108 suci v v
109 endang v
110 lia y v v
10 4

14/10/2016 111 agustin v


112 maryati v v
113 wiwin v
114 Iin v
115 Tati v v
116 elin v v
117 aisyah v
118 sumi v
119 fitri v
9 3
15/10/2016 120 aisyah v
121 sumi v
122 ikeu v v
123 kiah v
124 suryani v v
125 deti v
126 agustin v v
127 nadia v
128 wiwin v
9 3
16/10/2016 129 Widya v v
130 Nadia v v
131 Adhita v v
132 Anisa v
133 Kiah v
134 Deti v v
6 3 1
17/10/2016 135 sri nurwahyuni v v
136 nurmala v
137 imas v v
138 nadia v
139 nunung v
5 2
18/10/16 140 eva v v
141 sri nurwahyuni v v
142 imas v v
143 nunung v
4 3
19/10/16 144 ima v
145 gesti v
2 0
20/10/16 146 Gesti v v
147 Siti v
148 Ima v v
149 Tanti v
150 Siti J v v
151 Maryati v
152 Eli v
153 Erna v
8 2 1
21/10/16 154 Heni v v
155 yuli v
156 siti j v v
157 maryati v v
158 zulaikah v
159 rolma v
160 fitri v
161 siti maryani v v
8 3

22/10/16 162 dewi v v


163 rolina v v
164 yuly v v
165 dewanti v
166 karwati v
167 siti solihat v v
168 santi v v
7 5
23/10/16 169 nining v
170 nunung v v
171 wiwin v v
172 elly v
173 santi v
174 sekartini v v
6 3

24/10/16 175 Widaningsih v v


176 Nunung v v
177 Wiwin v v
178 Devi v
179 Sumarni v
180 Elly v v
181 Santi v
182 Sukartini v
183 Rani v v
184 Anisa v v
9 6

25/10/16 185 neni v


186 siti julaeha v v
187 nunung v
188 wiwin v v
189 devi v v
190 irma v
191 annisa v
192 vicky v v
193 astuti v v
194 nova v
9 6

26/10/16 195 putri v


196 astuti v v
197 tuti v v
198 susanti v v
199 mulianis v v
200 neni v v
201 siti julaeha v v
7 6
27/10/2016 202 wiwin v
203 salma v
204 sekartini v
205 sarah v v
206 rani v
207 putri v
208 astuti v
209 tuti v v
210 rahmatilla v v
9 3

28/10/16 211 salma v


212 sekartini v
213 rani v
214 putri v
4 0
29/10/16 215 rina v
216 tati v
217 sri v
218 eni v v
4 1
30/10/16 219 tati v v
1 1
31/10/2016 220 ana v
221 eem v
222 citawati v
223 tati v v
224 ana v
225 armila v
226 ani v v

7 2 1 1

jumlah 226 88 1 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT NOVEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
FORMAT SURVEY HARIAN PEMAKAIAN AL 2016 1 erna v v
01/11/2016 2 sumiyati v
3 armila v
4 siti rodiah v
5 mely v v
6 ana v
7 anisah v v
7 2 1

02/11/2016 8 tuti v v
9 linda v v
10 sumiyati v
11 anisah v v
4 3

03/11/2016 12 aminah v
13 nadia v v
14 euis v
15 linda v
16 lina v
17 nelly v
18 rita v
7 1

04/11/2016 19 neni v
20 nuraeni v
21 aminah v v
22 sri v
23 euis v v
24 dewi v
25 nina v v
26 rina v
27 santi v
28 nadia v v
10 3 1
05/11/2016 29 neni v v
30 nuraeni v v
31 saripah v v
32 lisa v
33 aminah v
34 nina v v
35 anisa v
36 nadia v v
37 imas v
9 5
06/11/2016 38 Titin v
39 Sani v v
40 LIsa v v
3 2
07/11/2016 41 Nia v
42 Sani v
43 Widya v
44 Sumarni v
4
08/11/2016 45 sumarni v
46 Siti R v
47 Susi v
48 Sumarni v
4
09/11/2016 49 Yulianti v
50 Ai Ratna v
51 Siti R v
52 Susi v
53 LIna v
54 Sriyanti v v
55 Tina v v
7 2
10/11/2016 56 erni v v
57 siti r v v
58 susi v
59 ai s v v
60 lina v
61 sriyanti v v
6 4

11/11/16 62 tina v
63 isye v
64 sriyamti v
65 susilawati v
66 leni v
5
12/11/16 67 TUTI V
68 SRI RAHAYU V
69 ELI Y V V
70 DEDEH V
71 SITI MARYATI V V
72 GITA V
6 2

13/11/16 73 sri r v
74 nina v v
75 siti maryati v v
3 2

14/11/16 76 SITI MARYAM V


77 YANI V
78 KOKOM V V
79 HARTIWI V
4 1

15/11/2016 80 sofi v
81 yani v
82 kokom v v
83 mila v v
4 2
16/11/2016 84 osy v v
85 ati v
86 neni v v
87 upit v v
88 ita v
89 mila v v
6 4

17/11/2016 90 erni v
91 upit v v
92 Neng Siti Maryam v
3 1
18/11/2016 93 Renny v
94 Yeni v v
95 Dea v v
96 Kokom v
4 2
19/11/2016 97 mimin v
98 reni v
99 meliyah v
100 yeni v
101 dea v
102 yayu v v
6 1

20/11/16 103 aat v v


104 yani v
105 reni v
106 meliyah v v
107 mimin v
108 imas v
6 1 1

21/11/2016 109 melyah v


110 ridayani v v
111 ita v
112 ai v v
113 aat v v
114 yani v
115 caryati v
7 3
22/11/2016 116 nenti v
117 suhartini v v
118 neni v v
119 ridayani v v
120 cindi v v
121 novita v v
6 5
23/11/2016 122 neni v v
123 febri v
124 sutini v v
125 jejeh v v
126 fitri v
127 waway v
128 sofiani v
129 yeti v v
130 suhartini v v
131 tika v v
132 titin v v
11 7
24/11/2016 133 fitri v v
134 fatma v
135 linda v
136 tati v
137 sri mulyani v
138 nurhasanah v v
139 nova v v
7 3
25/11/2016 140 Siti Soliha v
141 Aat v v
142 Susilawati v
143 Fitri v
144 Neni v
145 Nova v v
146 Nurhasanah v
7 2
26/11/2016 147 Siti Soliha v
148 Aat v v
149 Masenen v
150 Erna v v
151 Lilis v v
152 ema v v
153 Iis v v
154 Kokom v
155 Sri K v
9 5
27/11/2016 156 Aat v
157 Mas enen v
158 Kokom v
159 LIlis v
160 Yani v
161 Ineu v
6
28/11/2016 162 fitri v
163 suniangsih v
164 aat v
165 eva v
166 suci v
167 ina v
168 pina v
7
29/11/16 169 RATIH v
170 atik v
171 erna v
172 yeni v v
173 rostini v
174 tita rosita v
175 erni v
176 suryati v
177 eva v v
178 ineu v v
10 3
30/11/16 179 Fitria v
180 Tri Utami v
181 Eka v
182 Mega v v
183 Rostini v v
184 Tita v
185 Erni v
7 2

jumlah 187 68 3

FORMAT SURVEY HARIAN PEMAKAIAN ALAT DESEMBER 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/112/2016 1 SITI HABIBAH V V
2 VINA V
3 SUNARSIH V V
4 NENG ADAH V
5 ADE V
5 2
02/12/2016 6 desi v v
7 dede v v
8 nia v
9 desi v
10 biana v
11 yanti v
6 2
03/12/2016 12 rohaeni v v
13 ria v
14 siti rodiah v v
15 khoerunisa v
16 dede v
5 2

4/12/2016 17 Ong suk sien v


18 Siti Rodiah v v
19 khoerunisa v v
20 Anisa v
21 noneng v
22 risna v
23 iis v
24 julia v v
8 3

5/12/2016 25 iis v
26 rita v
27 siti hamilah v
28 rokhayati v
29 siti uswatun v
5

06/12/16 31 asti v
32 rokhayati v
33 risma v v
34 diana v
35 siti uswatun v
36 rita v
6 1

7/12/2016 37 asti v v
38 safitri v v
39 imas v
40 harti v
41 iceu v
42 rani v
43 trisnawati v
7 2
8/12/2016 44 iceu v
45 yulia v
46 imas v
47 kokom v
4

9/12/2016 48 irma v v
49 iceu v
50 nia v
3 1

10/12/2016 51 siti nurlasmi v v


52 lilis rohaeti v
53 mas iyam v
54 nia v
55 neng didah v v
56 siti auliyah v v
57 dewi v
58 elin v
8 3
11/12/2016 59 Siti Auliyah v
60 Elin v
61 Siti Nurlasmi v
3
12/12/2016 62 0
13/12/2016 63 dati v v
64 nurhayati v v
2 2
14/12/16 65 endah v
66 dati v v
67 dwilingga v v
3 2
15/12/16 68 endah v v
69 idah v v
2 2
16/12/2016 70 silvi v
71 Ai farida v v
2 1
17/12/2016 72 imas v v
73 sandra v
74 lina v
75 rodianingsih v
76 winda v
5 1
18/12/2016 77 Sandra v
78 Winda v
79 Yuni v v
80 Euis v
81 Maryam v v
82 Melly v v
6 3
19/12/2016 83 Sandra v
84 Winda v
85 Yuni v
87 Ade v
4
20/12/16 88 yuyun y v v
89 riska v
90 anah v v
91 Eli v v
4 3
21/12/2016 92 anti v v
93 Euis v v
94 Eli v
95 Anah v v
96 IIs v
97 komala v v
98 yeni v
7 4
22/12/16 99 anti v
100 euis v
101 rini v
102 reni v
103 n.ririn v v
104 anah v v
105 dewi v v
106 komala v v
107 eni v v
9 5
23/12/16 108 reni v
109 anti v
110 eni v
3
24/12/16 111 wina v
112 lilis s v v
113 lia v
3 1
25/12/16 114 santi v v
115 yusi v v
2 2
26/12/16 116 Yanti v
1
27/12/16 117 Yuli Yulianti v
118 Juju v v
119 Irma R v
120 Tri K v
121 Santi v
122 Yosi v
6 1
28/12/16 123 Maesaroh v
124 Yuli Yulianti v
125 ULfa v
126 Juju v v
4 1
29/12/16 127 Yuli Yulianti v
128 Winda v
129 Elsa v v
3 1
30/12/2016 130 winda v
131 heni v
132 sri v
133 wiwik v
134 rokhayati v v
5 1
31/12/2016 135 heni v
136 sri v
137 Yani v v
138 Nengsih v
139 Rohayati v
5 1

jumlah 139 45
FORMAT SURVEY HARIAN PEMAKAIAN ALAT JANUARI 2018
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2018 1 Mela v v
2 N neni v
3 Kakan v v
4 Sumiati v v
4 3
02/01/2018 5 Ani v
6 Reti v
7 Imas v
8 Yani v v
4 1
03/01/2018 9 Apon v
10 Ani v v
11 Peni v
12 Imas yani v
13 Yani v v
14 Yeni v
15 Ai hasanah v v
16 Atik v v
8 4
04/01/2018 17 Yuyun v v
18 Ratna v v
19 Siti pani v
20 Atik v v
21 Mimi v v
22 Dian v
23 Apon v v
24 Dena v v
25 Fitriyani v v
26 Ririn v
10 7
05/01/2018 27 Dian v v
28 Santi v v
29 Mimi v v
30 Ati v
31 Siti pani v
5 3
6/1/2018 32 ati v v
33 milda v
34 nisa v
35 susanti v
36 yanti v
5 1
07/01/2018 37 Dian v
38 Nisa v
39 Rina v v
40 Heni v v
4 2
08/01/2018 41 tantri v v
42 yuliana v v
43 susanti v
44 ai tita v v
45 indriyani v v
5 4
09/01/2018 46 Melyanti v
47 Nengsih v v
48 Lady v
49 Neneng v v
50 Yeni v v
5 3
10/01/2018 51 Rina v v
52 Rani v
53 Melyyanti v
54 Auvi v v
55 Erna v v
56 Jihan v
57 Lilis v
58 Siska v
59 Anisyah v
60 Dini v
9 4
11/01/2018 61 Rina v v
62 Rani v
63 Tesa v v
64 Elis v
65 Desi v v
66 Irma v v
67 Jihan v
68 Lilis/Asep v v
69 Lilis/Rahmat v v
70 Siska v v
71 Sofia v
72 Lufita v
11 8
12/01/2018 73 Lilis s v v
74 Tesa v
75 Elis v
76 Siti nuryani v v
78 Ida v
79 Tati v
80 Lufita v v
81 Sofia v v
82 Tati v
9 4
13/01/2018 83 Tati v v
84 Yanti v v
85 Novi v
86 Ida v v
87 Rina v v
88 Nurita v
89 Arni v
90 Mimin v v
8 5
14/01/2018 91 Tati v v
92 Erita v v
93 Novi v v
94 Sulastri v
95 Ida v v
96 Tesa v
6 4

15/01/2018 98 Rabecca v
99 Sulastri v
100 Tesa v
101 Ida v v
102 Oteh v v
103 Nurul v
104 Tika v
6 3
16/01/2018 105 Sharly v
106 Milda v v
107 Tesa v
108 Ida v v
109 Rebecca v
110 Marliah v v
111 Nurul v
112 Tika v v
113 Neneng v v
8 6
17/1/2018 114 Tesa v
115 Nurul v
116 Nawang wulan v v
117 Nining v
118 Apriyanti v v
119 Ayu v v
120 Rebecca v v
6 5
18/01/2018 121 Ucu v v
122 Enur v v
123 Kurniati v v
124 Ida v v
125 Wita v
126 Sulastri v
127 Dwi v v
128 Herlina v
129 Lilis v v
9 6
19/01/2018 130 Vivi v
131 Hanhan v
132 Kiki v v
133 Siti a v
134 Herlina v v
135 Ai siti f v v
136 Nurhayatin v v
137 Yuli v
138 Shani v
9 4
20/01/2018 139 Siti a v
140 Anggi v
141 Teteh ema v v
142 Ela v v
143 Yeni v v
144 Yeti v v
145 Mayasari v
146 Neng yulia v v
8 5
21/1/2018 147 Teteh ema v v
148 Anggi v v
149 Jie bun ing v v
150 Neng yulia v v
4 4
22/01/2018 151 Siti pani v v
152 Teteh ema v v
153 Siti julaeha v v
154 Rina v
155 Ulfah v v
156 Ai siti v v
6 5
23/01/2018 157 Siti pani v v
158 Teteh ema v v
159 Ai siti v
160 Jie bun ing v
161 Siti julaeha v v
162 Rena v v
163 Elis v v
164 Lepi v
165 Tesa v v
166 Susiani v v
167 Tuti v v
11 8
24/1/2018 168 Widayanti v v
169 Tuti v v
170 Elis v
171 Lepi v
172 Susiani v v
173 Dedeh v
174 Fitri siti v v
7 4
25/01/2018 175 Widayanti v v
176 Ingeu v
177 Dedeh v v
178 Fitri v v
179 Heni v v
180 Sonia v v
181 Desiyani v v
182 Ayu v
183 Sella v
9 6
26/01/2018 184 Ingeu v v
185 Sella v
186 Elis v
187 Devi v
188 Cucu v v
5 2
27/01/2018 189 Elis v v
190 Sella v v
191 Cucu v v
192 Devi v
193 Rohimah v v
194 Cicah v v
195 Vina v v
7 6
28/01/2018 196 Erlin v
197 Aneu v
198 Noneng v v
3 1
29/01/2018 199 erlin v
200 aneu v
201 yani v
3 0
30/01/2018 202 Yani v
203 Wulan v
204 Sulbiyah v
205 Reni v
4 0
31/01/2018 206 wulan v
207 sulbiyah v
208 febrianti v
3 0

FORMAT SURVEY HARIAN PEMAKAIAN ALAT FEBRUARI 2018


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2018 1 Enti v
2 Lina v v
3 Ana v v
4 Erika v
5 Lina v v
6 Siti m v v
7 Febrianti v v
7
02/02/2018 8 Erika v
9 Ana v v
10 Enti v v
11 Sri nurul v
12 Gina v v
13 Destriana v
6
3/2/2018 14 mia v v
15 i gusti v v
16 iis v
17 susi v
4
04/02/2018 18 Yessi v
19 Mia amelia v v
20 Iis aryani v v
21 Mia siti v v
4
05/02/2018 22 Yessi v v
23 Yeti v v
24 Neni v
25 Dari siti k v v
26 Sulbiyah v
5
06/02/2018 27 Neni v v
28 Yani v
29 Kartika v v
30 Yuli v v
31 Iceu v v
5
07/02/2018 32 Rohayati v v
33 Aam v
34 Iceu v v
35 Rida v
36 Sri v
37 Yani v
38 Ika v
7
08/02/2018 39 Minanti v v
40 Rida v v
41 Sri A v v
42 Yani v
43 Yani m v v
44 Hana v
45 Restu v
46 Dea v v
47 Lelawati v
9
09/02/2018 48 Yeni v
49 Nelly v
50 Reka v v
51 Lia v v
52 Hana v
53 Dea v v
54 Yani v
55 Ina v
8

10/2/18 56 yeni v v
57 imas v v
58 dedeh v v
59 siti n v
60 ina v
61 wati v
62 restu v
63 yani v
64 iis v v
9
11/02/2018 65 srimulya v v
66 imas v v
67 dedeh v v
68 siti n v v
69 restu v
70 yani v
71 iis v v
72 tarsinah v
8
12/02/2018 73 Gitawati v v
74 Inta v
75 Ai suminar v v
76 Yani v
77 Deffy v v
78 Tarsinah v
79 Sri mulya v v
80 Restu v v
81 Yani kartini v
82 Ratnasari v
10
13/2/2018 83 Rika v v
84 Annida v v
85 Ani n v
86 Yuni v
87 Sri m v v
88 Ai suminar v
89 sarah v v
7
14/2/2018 90 neneng v v
91 ai rosita v v
92 erly v
93 endit v v
94 fitri v
5
15/2/2018 95 dita v
96 ai rosita v v
97 detin v
98 dini v
99 tia v
5
16/2/2018 100 dita v
101 ai rosita v
102 tina v
103 dea v v
104 titin v
105 cita v v
106 prima v v
107 nia v
7
17/2/2018 108 tina v
109 sari v
120 dea v v
121 titin v
122 yati v v
123 desi v
5
18/2/18 124 sari v
125 dea v v
126 tina v
127 nurlatifah v
128 desi v
129 restu v
130 yati v
131 cicin v
7
19/2/18 132 anisa v
133 sari v
134 ira v
135 sherliyanti v
136 cicin v
137 restu v
138 nur rosita v
7 0
20/2/18 139 anisa v
140 amalia v
141 tini v
142 restu v
143 nur rosita v
5 0
21/2/2018 144 Ernawati v v
145 Neni v v
146 Nenden v v
147 Selly v v
148 Santi v
149 Ari v
150 Mila v
7
22/2/2018 151 Sela v v
152 Siti sarifah v v
153 Mila v v
154 Enon v v
155 Murniati v v
156 Yuanita v
157 Lani v
158 Liawati v
8
23/02/2018 159 Yuanita v v
160 Lani v v
161 Liawati v v
162 Murniati v v
163 Enon v v
164 Reni v
165 Nunik v v
166 Indri v v
167 Enur hayati v
168 Elis v
10
24/2/2018 169 Yuyun v v
170 Reni v v
171 Dina v v
172 Sarifah v v
173 Euis v v
174 Saidah v v
175 Salsa v v
7 7
25/2/2018 176 christine v
177 saidah v v
178 siti fatonah v
179 iis v v
4 2
26/02/2018 180 Iis v v
181 Artila v v
182 Masripah v
183 Leni v v
4 3
27/02/2018 184 Rima v v
185 aan v
186 maria v v
187 nia v
2 4

28/2/18 188 sri v v


189 sopiah v v
190 puput v
191 eti v v
192 diana v
193 hartati v
5 4
FORMAT SURVEY HARIAN PEMAKAIAN ALAT MARET 2018
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2018 1 Krisna v
2 Lina v
3 Rina rose v v
4 Sri v v
5 Eti v v
6 Sofiah v v
7 Surati v
8 Puput v
9 Firyal v v
10 Resalia v
11 Tati v v
12 Wati v v
12 7
02/03/2018 13 Hartati v
14 Kusmiati v v
15 Siti nurzanah v v
16 Sulastri v
17 Novia v v
18 Tati v v
19 Reselia v
20 Firyal v v
21 Iceu v v
8 6
03/03/2018 22 Ai karwati v
23 Santi v
24 Saidah v v
25 Dilla v v
26 Rahayu v v
28 iceu v v
29 Tati v v
30 Ai heni v v
8 6
04/03/2018 31 Goldy v v
32 Ai karwati v
33 Yulianti v
34 Yayah v
4 1
05/03/2018 35 Ai suhartini v
36 Anita v
37 Yulianti v v
3 1
06/03/2018 38 anita v
39 ai suharni v v
40 triani v v
41 nurhayati v
42 enur v
43 lusi v
6 2
07/03/2018 44 Ikah v v
45 Siti jubaidah v v
46 Eva v
47 Iceu v v
48 Linda v
49 Sti aliah v
50 Triyany v v
51 Rinjani v v
52 Lusi v v
53 Rika v v
10 7
08/03/2018 54 iis v
55 tuti v v
56 linda v
57 devi v
58 vina v
59 lilik v
60 rinjani v
61 dea v
8 1
09/03/2018 62 Wintarsih v
63 Devi v v
64 Reni v
65 Dea v v
66 Jihan v
5 2
10/03/2018 67 Teti v v
68 Yayah v v
69 Iis v
3 2
11/03/2018 70 Iis v v
71 Nunik v v
72 Sari v v
73 Putri v v
74 Anisa v v
75 Ita v v
76 Nurul v
77 Siti m v
8 6
12/03/2018 78 Nengsih v
79 Ikah v v
80 Novianti v
81 Nurul v
82 Lia v
83 Isye v
84 Hana v
7 1
13/3/2018 85 Nengsih v v
86 Ikah v
87 nopiyanti v v
88 Hana v v
89 Nurul v
90 Lia v v
91 Lilis v
7 4
14/3/2018 92 Nurul v
93 Lia v v
94 Lia M v v
95 Lilis v v
96 Lina v
97 Ida v
6 3

15/3/18 98 nursadiah v v
99 kerisma v v
100 nurul v
101 dede v v
102 lia marlia v v
103 lia mardia v
104 nurmika v
105 santi v
106 lia yulia v
9 4
16/3/18 107 rita v v
108 dede v v
109 tanti v
110 khoiriyah v
4 2

17/3/18 111 neni v v


112 siti a v
113 maulani v v
114 rini v v
115 emil v
116 dede v v
117 mia v
118 eka v
119 atik v
9 4

18/3/2018 120 siti a v


121 Dina v v
122 Mimin v v
123 Eka v
4 2
19/03/2018 124 Yuliyawati v v
125 Nurul v
126 Anita v
3 1
20/03/2018 127 Nurul v v
128 Anita v v
129 Noviyanti v v
130 Solekahtun v
131 Diah v
132 Lena v v
6 4
21/3/2018 133 novi v
134 solekhatun v
135 atin v v
136 nengsih v v
137 sri v
138 siti f v
139 ai s v
140 eli v
8 2
22/3/18 141 novi v
142 idah v v
143 nursaadah v v
144 sri v
145 santi v
146 ai s v
147 tika v v
148 rine v
8 3
23/3/2018 149 alia v v
150 yati v
151 nezalia v
152 astri v v
153 leni v v
154 tika v v
155 rine v
7 4
24/3/2018 156 astri v v
157 neni v
158 adnin v
159 sabila v
160 riska v
161 masait v v
162 nurhasanah v v
163 lia v v
164 corina v v
165 ai sumarni v v
10 6
25/3/2018 166 nurhayati v
167 neni v v
168 astri v
169 riska v
3 2
26/3/2018 170 Nurhayati v v
172 Novi v
173 Erni v
174 Anis v
175 Vatma v v
5 2
27/03/2018 176 Alia v
177 Erni v v
178 Lina v v
179 Vatma v v
180 Nurhayati v v
181 Nezalia v v
6 5
28/03/2018 182 Marianty v
183 Wida v v
184 Engkom v v
185 Yuwangsih v v
186 Ranika v
187 Kiki v
6 3
29/03/2018 188 idah v v
189 eulis v
190 eka v v
191 siti a v
4 2
30/3/18 192 avturi v
193 cahyani v
194 ani v
3
31/3/18 195 avturi v
196 cahyani v
170 ani v
jumlah 194 97 2

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2018


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2018 1 yeni v
2 didah v
3 hani v
4 ani v
5 ani v
6 pipih v
6 0
2/4/18 7 rena v
8 yani v v
9 stevie v
10 puput v
11 novi v
5 1
3/4/18 12 rena v v
13 stevie v
14 chica v v
15 hani v
16 nopi v
17 yani v v
18 eliza v v
7 4
04/04/2018 19 eti v
20 dedeh v
21 siti saodah v
22 cicih v v
23 astri v v
24 elisah v v
25 nabila v
26 fitri v v
8 4
05/04/2018 27 eti v
28 dedeh v v
29 siti saodah v v
30 cicih v v
31 aneu v v
32 elisah v v
33 nabila v
34 rina v v
35 ana v
36 putri v v
10 7
06/04/2018 37 eti v v
38 aneu v v
39 Resa v
40 Elisah v v
41 Dedeh v v
42 Siti saodah v v
43 Rina v v
44 Nabila v
45 Putri v v
9 7
7/4/18 46 rina v v
47 nina v
48 lina v
49 novi v v
50 saida v
51 nabila v
52 neng rika v
53 wiwit v v
8 3
08/04/2018 54 riska v v
56 ika v
7 tia v
58 nina v v
59 lina v v
60 santi v
61 fitria v
62 novy v v
63 saidah v
64 iis v
65 siska v
11 4
9/4/2018 66 yuli v v
67 susi v v
68 tia v
3 2
10/04/2018 69 yuli v v
70 deti v v
71 kurniasih v
72 suryani v v
73 mega v
74 iis w v v
6 4
11/4/2018 75 Mega v v
76 Yuniarti v
77 Santi v v
78 Heli v
79 Iis lina v
80 Iis wida v v
81 Popi v v
82 Wina v v
8 5
12/04/2018 83 Iis w v v
84 Damayanti v v
85 Fitriani v v
86 Husana v
87 Nela v
88 Ai k v
89 Siti m v
90 Yuniarti v v
91 Yesi v v
92 Iis w v
93 Yayat v v
11 6
13/4/2018 94 Yesi v v
95 Delsy v v
96 Anina v v
97 Ai k v
98 Siti m v
99 Detina v
6 3
14/04/2018 100 Juhaeriyah v
101 Yati v v
102 Winda v
103 Nita v
104 Yuli v
5 1
15/4/2018 105 Juhaeriyah v
106 Candra v
107 Nurazizah v v
108 Winda v
109 Kurniawati v v
5 2
16/4/2018 110 Kurniawati v v
111 Linda v v
112 Shela v
113 Yani v v
4 3
17/4/18 114 Shella v v
115 Nita v v
116 Oning v v
117 Widia v
118 Lia v v
119 Yani v v
6 5
18/042018 120 Oning v v
121 Suhartiningsih v
122 Lia v
123 Yani v v
124 Anggie v
125 Eri v
126 Cici v
127 Seli v v
128 Susi v
129 Sri mulyati v
10 3
19/4/2018 130 Sri m v v
131 Nyai v
132 Dewi v
133 Marni v v
134 Anggie v v
135 Destiana v v
136 Mia v
137 Suhartiningsih v v
138 Lia v v
139 Yani v v
10 7
20/04/2018 140 N kurniasih v v
141 Nina v v
2 2
21/4/2018 142 leni v v
143 yayuk v
144 hanita v
145 santika v v
146 n. kurniasih v v
147 elisa v v
6 4
22/4/2018 148 lastri v
149 elisa v v
2 1
23/4/2018 150 Nopi v
155 Fatimah v v
156 Siti m v
3 1
24/04/2018 157 Siti m v v
158 Riska v
159 Nia r v
160 Nopi v
161 Sulastri v v
162 Nuni v v
163 Siti rokayah v v
164 Ane s v v
8 5
25/4/2018 165 Atikah v v
166 Sariah v
167 Nabila v
168 Nurcahya v
169 Nunung v v
170 Sarah v
6 2
26/04/2018 171 Hasanah v v
172 Fani v
173 Nabila v v
174 Nurlaela v
175 Nurcahya v v
176 Sri v
6 3
27/4/2018 177 Hasanah v v
178 Ende v v
179 Indri v v
180 Sariah v v
181 Nurlaela v v
182 Eneng v
183 Sri v v
184 Dessy v
185 Fani v
10 7

28/04/2018 186 eneng v v


187 dessy v v
188 indri v v
189 sariah v
190 tanti mulya v v
191 n.nuraeni v v
192 rina v
193 susilowati v
8 5

29/04/2018 194 tiah v v


195 eti v
2 1

30/4/18 196 yuliyanti v


197 endah v
198 sariah v
199 linda v
4 0

JUMLAH 195 102

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MEI 2018


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2018 1 Nurhayati v
2 Indri v v
3 Linda v
4 Annisa v v
4 2
02/05/2018 5 Nurhayati v
6 Mini v
7 Seila v v
8 Rumanah v
9 Leny v v
10 Siti v v
11 Nopi v
7 3
3/5/18 12 Rumanah v v
13 Devi v
14 Leny v
15 Siti k v v
16 Nia v v
17 Mini v v
18 Nining v v
19 Kokom v
8 5
4/5/18 20 yeni v
21 tini v v
22 wina v v
23 kokom v v
24 nopi v
25 siti m v v
6 4
5/5/18 26 ratiria v v
27 siti a v
28 ai r v v
29 yulianti v
30 weny v
31 indah v
32 susi v
33 novi v
34 siti m v v
35 leny v
10 3
6/5/18 36 ai r v v
37 elisa v v
38 susi v
39 siti m v v
40 eci v v
41 rina v v
6 5
07/05/2018 42 Ai v
43 neng nuriyanti v
44 erni v
45 siti v
46 sintha v
47 siti N v v
48 rina v
6 2
08/05/2018 49 Erni v v
50 Shinta v v
51 Devi v v
52 Siti wulan v v
4 4
09/05/2018 53 Siti k v
54 Yulianti v v
55 Desi v
56 Lia v
57 Nurwita v
58 Helmiana v
59 Dini v v
60 Herlina v
8 2
10/5/2018 61 Lia v v
62 Irma v v
63 Nina v v
64 Herlina v v
65 Dini v v
66 Sri v v
67 Tiwi v v
68 Nurwita v
69 Rina v v
70 Siti k v
71 Sri v v
11 9
11/05/2018 72 Dian m v
1
12/5/2018 73 Lucy v v
74 Euis v v
75 Siti l v
3 2
13/05/2018 76 Siti l v v
77 Endang v v
78 Nurfitria v v
79 Endah v v
80 Lucy v v
81 Teti v v
6 6
14/05/2018 82 Desi v
83 Endang v v
84 Rani v v
85 Rika v
86 Rumisa v v
87 Endah v
88 Lusi v
6 3
15/05/2018 89 Lusi v v
90 Rina v v
91 Rani v v
92 Rika v
93 Eli v v
94 Ai lestari v v
95 Endah v v
96 Siti m v
8 6
16/5/2018 97 Heni v v
98 Karyati v v
99 Devy v v
100 Rosma v
101 Tina v v
102 Nai v v
103 Suci v v
104 Asima v v
8 7
17/05/2018 105 Heni v v
106 Rury v
107 Rosma v v
108 Tina v v
109 Imas v v
110 Irma v
111 Ernawati v
112 Eva v
113 Nurhayati v v
9 5
18/5/2018 114 Rury v v
115 Mimin v
116 Helmiana v
117 Kuraesin v
118 Eva v v
119 Adinda v
120 Siti h v
7 2
19/05/2018 121 Helmiana v
122 Mimin v
123 Nella v
124 Siti h v
125 Henisah v v
5 1
20/05/2018 126 Supriyani v v
127 Mimin v v
128 Nella v v
129 Helmiana v
130 Lasmawati v v
5 4
21/05/2018 131 Louise v v
132 Euis v
133 Lina v
134 Lasmawati v v
4 2
22/5/2018 135 euis v v
136 dewi v v
137 nurul v v
138 elis v
139 lina v v
140 rinelda v
141 hamidah v v
142 lasmawati v v
143 tia v v
9 7
23/05/2018 144 Sani v
145 Laelasari v
146 neng Rosi v v
147 Yulianti v
148 Nopi v
149 Lasmawati v
150 Novi Yuliani v
151 Siti D v
8 1
24/05/2018 152 Novi v v
153 Lilis v v
154 Yulianti v v
155 Lelasari v v
156 Nyasiati v v
157 Atit v v
158 Wiwin v
7 6
25/5/2018 159 Siti y v
160 Sti efi v v
161 Wiwin v v
162 Lilis v v
163 Atit v v
164 Rostati v
6 4
26/5/2018 165 siti atikah v v
166 yuli sarah v
167 kinanti v
168 khosiahwati v v
169 cucun v
170 rostati v
171 novi v v
7 3
27/5/2018 172 Siti atikah v v
173 Ika v v
174 Nuryati v v
175 Nurcholis v v
176 Lilis v
5 4
28/5/2018 177 Ina v
178 Nopi v
179 Tia v
180 Ika v
4 0
29/5/2018 181 tia v v
182 ratna v v
183 Imas v
3 2
30/5/2018 184 Heni v v
185 Dini v v
186 Sherly v v
187 Ratna v
188 Desi v
189 Leli v
190 Dinda v v
7 4
31/5/2018 191 Mini v v
192 Ratna v v
193 Mamay v v
194 Tri v
195 Roroh v
196 Desi v v
197 Nurjanah v v
198 Leli v v
8 6
JUMLAH 196 114
Ruang NIPAS 4 - RSKIA - JANUARI - 2018
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2018 1 Ucu Anggraeni v
2 laili v
3 novi v v
4 weli v v
4 2
02/01/2018 5 yuli v v
6 ucu anggraeni v
7 laili v
8 sansan v
9 elis v
10 rizqi v
11 indah v v
12 mustika v
13 novi v
14 irma Y v
10 2
03/01/2018 15 dewi v v
16 yuli v v
17 irma v
18 sansan v
19 elis v v
20 sri ningsih v
21 leni v v
22 Khotimah v v
23 hany v
24 evi v v
10 6
04/01/2018 25 Khotimah v v
26 hany v v
27 yunita v
28 Lia v v
29 leni v v
30 evi v v
31 Dewi v
32 Reni v
33 lina v v v
34 neng riska v v
35 ayu v v
36 elis v v
37 R Risma v
38 eka v v
14 9 2
05/01/2018 39 Ria v v
40 Hany v
41 Yunita v v
42 Lia v v
43 reni v
44 lina v v
45 ayu v v
46 R risma v
47 eka v
48 tini v
10 5
06/01/2018 49 ria v v
50 hany v
51 winny v v
52 yuni v
53 reni v
54 tini v v
55 ayu v
56 Khotimah v v
57 bunga v v
9 5
07/01/2018 58 winny v
59 sri v v v
60 yuni v
61 tini v
62 khotimah v v
63 siti N v
64 iis v
65 bunga v
66 yulianti v v
67 wina v v
10 4 1
08/01/2018 68 sri v
69 yani v v
70 yulianti v
71 wina v
72 siti n v v
73 iis v
74 fitri v v
75 rully v
76 wina v
77 ina v
9 4
09/01/2018 78 marlina v v
79 sri v
80 fitri v v
81 rully v v
82 anti v
83 inna v v
84 ike v v
85 dewi v
86 maya v v
87 ina v
10 6
10/01/2018 88 helis v v
89 marlina v
90 inna v v
91 rully v
92 anti v
93 nova v
94 ike v v
95 dewi v
96 maya v v
97 suci v
98 iin v v
99 erna v
100 ina v
13 5
11/01/2018 101 Helis v
102 Qistina v v
103 inna v v
104 maya v v
105 iin v v
106 yuyun v v
6 5
12/01/2018 107 yuyun v
108 ade irma v v
109 maya v v
110 erni v v
111 iin v v
112 dede v
113 iin v v
114 yuyn v
115 ade irma v v
116 peni v v
10 7
13/01/2018 117 isty v v
118 ade irma v
119 erni v v
120 nurhotimah v
121 endah v v
122 neng pipi v
123 rina v
124 rina herliani v v
125 etin v v
126 dita v v
127 lisnawati v v
11 7
14/01/2018 128 isty v
129 rina herliani v v
130 Rina v
131 etin v
132 tini v v
133 dita v
134 lisnawati v v
7 3
15/01/2018 135 Rizka v v
136 heni v v
137 rina herliani v v
138 ningrum v
139 hanipah v v
140 septiana v v
141 lisnawati v v
7 6
16/01/2018 142 rizka v v
143 heni v v
144 rina herliani v v
145 yuliantika v
146 lisnawati v v
147 nahary v
148 yuni v
149 ani v v
150 nursaidah v v
151 rohati v v
10 7
17/01/2018 152 yuni v
153 imas v
154 tintin v v
155 deandha v v
156 ruroh v v
157 nursaidah v
158 yeni v v
159 siti v v
8 5
18/01/2018 160 yuni v
161 imas v
162 karlina v v
163 tintin v v
164 loli v v
165 sri w v v
166 ruroh v v
167 yeni v
168 wiwin v v
169 yani v v
10 7
19/01/2018 170 melis v v
171 yani v
172 sri w v v
173 karlina v v
174 loli v v
175 suci v v
176 yulia v v
177 wiwin v v
178 fitri v
179 ernawati v v
10 8
20/01/2018 180 melis v
181 suci v
182 nurul v v v
183 tiara v
184 yulia v v
185 linda v
186 ernawati v v
7 3 1
21/01/2018 187 melis v
188 feti v
189 widaningsih v v
190 nurul v v
191 fenty v
5 2
22/01/2018 192 devi v
193 widaningsih v
194 endang v v
195 lena v v
196 fenty v
197 nisa v v
198 lia v
7 3
23/01/2018 199 isnawati v v
200 belinda v v
201 endang v
202 nisa v
203 ela v v
204 asih v v
205 lena v v
206 fenty v
207 fitriani v v
9 6
24/01/2018 208 ai mintarsih v v
209 belinda v v
210 fitriani v v
211 sumiati v
212 nova v
213 wida aryani v v
214 rizka v v
7 5
25/01/2018 215 tessa v
216 dini v
217 wida v v
218 tina v v
219 yeni v v
220 rizka v v
221 tuti v
7 4
26/01/2018 222 nunik v v
223 putty v
224 tularsih v v
225 kokom v v
226 mimin v
227 yeni v
6 3
27/01/2018 228 nunik v v
229 putty v
230 erwin v v
231 laeli v v
232 ratu v v
233 tularsih v v
234 tati v v
7 6
28/01/2018 235 ratu v v
236 santi v
237 tati v v
238 yanti v
4 2
29/01/2018 239 santi v v
240 siti N v
241 Maria v
242 yanti v
4 1
30/01/2018 243 verawati v
244 santi v v v
245 yuni v v

31/01/2018 246 iis v v


247 yasinta v
248 husna v
249 andini v v v
250 juliani v v
251 lenny v
252 santi v v
253 ruri v v
254 putri v
5

254 143 3 3
Formulir Survey Harian Pemakaian Alat
Ruang NIPAS 4 - RSKIA - FEBRUARI - 2018
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2018 1 rani v v
2 nenden v
3 desi v
4 alya v
5 tati v
6 arnia v v
7 iis v
8 juliani v v
9 santi v
10 ruri v v
11 nia v v
12 nuraisyah v v
12 6
02/02/2018 13 nia v v
14 nuraisyah v v
15 alya v
16 suryati v v
17 tati v v
18 eti v
19 novianti v
7 4
03/02/2018 20 eva v v
21 titin v
22 suryati v v
23 eti v
24 novianti v
25 lia v
26 cucun v
27 imelda v v
8 3
04/02/2018 28 feny v v
29 titin v
30 astri v
31 annisa v
32 herni v v
33 eva v v
34 lia v v
7 4
05/02/2018 35 dewi v
36 fera v v
37 kristina v v
38 Lia v
39 feny v
40 nurhalimah v v
6 3
06/02/2018 41 eka v
42 siti A v v
43 Titin v v
44 nurhalimah v
45 dewi v v
46 fera v
47 ati v v
48 erna v v
49 kristina v v
9 5 1
07/02/2018 50 eka v
51 ima v v
52 Hany v
53 titin v
54 melani v v
55 neni v v
56 lia v v
57 ati v
8 4
08/02/2018 58 eka v
59 ima v v
60 hany v
61 astia v v
62 melani v v
63 neni v
64 lia v v
65 reni v v
66 euis v v
67 taniroh v v
10 7
09/02/2018 68 Dewi sulis v v
69 eli v
70 sri s v
71 ela v
72 reni v
73 ima v
74 tanirah v
75 reni v
76 euis v
9 1
10/02/2018 77 ely v v
78 dewi v v
79 rosmiati v
80 eli v
81 noviyanti v
82 nurul v
83 deti v v
7 3
11/02/2018 84 indra v v
85 nurul v
86 ratna v v
87 noviyanti v
88 vita v v
5 3
12/02/2018 89 yanti v
90 nurul v
91 neng sinta v v
92 heni v v
93 ratna v
94 noviyanti v
95 anggi v v
96 nida v
97 ariska v v
98 siti s v v
10 5
13/02/2018 99 nena v v
100 zakiah v v
101 jhosie v v
102 syafitriyanti v
103 nurhasanah v v
104 neng sinta v v
105 heni v v
106 femy v v
107 siti s v v
108 nida v
10 8
14/02/2018 109 nena v v
110 intan v
111 tina v v
112 novi v
113 nida v v
114 sri ayu v
115 zakiah v
116 femy v
117 nurul v v
9 4
15/02/2018 118 fitriyah v
119 dian v
120 novi v
121 restonida v v
122 nurul v v
123 tina v v
124 karminih v v
125 ismawati v v
126 imas v
127 isnah v
10 5
16/02/2018 128 teti v
129 novi v
130 suryati v
131 restonida v v
132 lina v v
133 imas v v
134 sri solehat v v
135 nenden v v
8 4 1
17/02/2018 136 novi v
137 nenden v v
138 suryati v
139 restonida v
140 winny v v
141 tuti v v
142 vivie v v
143 imas v
144 sri solehat v v
145 nenden v v
10 6
18/02/2018 146 nenden v v v
147 suryati v
148 restonida v
149 reza v v
150 elvia v v
151 ajeng v v
152 nisa v
7 4 1
19/02/2018 153 elvia v
154 suryati v
155 restonida v
156 siti v v
157 ajeng v
158 nisa v
159 putty v v
160 dewi v
8 2
20/02/2018 161 restonida v
162 hartini v v
163 siti v v
164 nita v
165 dewi v
5 2
21/02/2018 166 tiara v v
167 nita v
168 dewi v
169 iis v
170 ana v
171 watri v v
172 regina v v
173 desri v v
174 dian v
175 penni v v
10 5
22/02/2018 176 dewi v
177 mimin v v
178 asiri v
179 yessi v v
180 fanny v
5 2
23/02/2018 181 tita v v
182 mimin v v
183 eva v v
184 neng nani v
4 3
24/02/2018 185 eva v v
186 ida v
187 rika v
188 sopi v
189 fanny v v
190 gladys v
191 fryda v v
192 resa v
8 3
25/02/2018 193 wati v v
194 esih v
195 nuni v v
196 eva v
197 sopi v v
198 fanny v v
6 4
26/02/2018 199 iceu v v
200 rosita v v
201 imas v
202 rusmini v v
203 sopi v
204 roswati v v
6 4
27/02/2018 205 lina v
206 yuyun v v
207 dewi v
208 iceu v
209 rusmini v v
5 2
28/02/2018 210 lina v
211 lina herlina v
212 yuyun v v
213 inten v
214 rini v
215 nuraeni v
6 1

215 107 3

Formulir Survey Harian Pemakaian Alat


Ruang NIPAS 4 - RSKIA - MARET - 2018
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2018 1 Dedeh v v
2 tini v v
3 rohmah v
4 nurkoyum v
5 suharti v
6 cica v v
7 rusmini v
8 siti lutfiah v v
9 lina herlina v
10 asri v v
10 5
02/03/2018 11 carolyn v v
12 nita v
13 asri v
14 lela v
15 yati v v
16 sri v v
17 dewinda v v
18 siti julaeha v
19 siti v
9 4
03/03/2018 20 carolyn v
21 nuraeni v
22 yati v v
23 nita v
24 sri v v
25 maesaroh v
26 riska v v
27 dewinda v
28 dewi v
29 denisa v
10 3
04/03/2018 30 siti susanti v v
31 siti aisyah v
32 nita v
33 riska v v
34 wiwi v v
35 elsa v v
36 dewi v
37 denisa v
7 4 1
05/03/2018 38 halida v v
39 siti susanti v
40 wiwi v v
41 rita v v
42 ai sumiati v
4 4
06/03/2018 43 halida v v
44 siti susanti v
45 ai masitoh v v
46 patmawati v v
47 iis v v
48 mulyatin v v
5 6
07/03/2018 49 jubaedah v v
50 eli v v
51 siti v
52 erla v
53 ayu v
54 patmawati v
55 iis v v
56 resa v
57 siti v v
58 rohimah v v
9 6
08/03/2018 59 iis v v
60 resa v
61 rohimah v
62 grecetien v v
63 jubaedah v v
64 mirna v
6 3
09/03/2018 65 gracetin v v
66 dini v v
67 desi v v
68 mirna v
69 irma v
70 iis v v
71 mia v
72 tini v v
8 5
10/03/2018 73 iis v v
74 mia v
75 tini v v
76 desi v v
4 3
11/03/2018 77 yanti v
78 nunung v
79 iis v
80 mia v
81 nopi v
5
12/03/2018 82 gina v
83 dewi v
84 dian v v
85 r arni v
86 siti h v v
87 iis v
88 asri v
89 mia v
90 ola v
91 nopi v v
10 2 1
13/03/2018 92 dian v v
93 devi v v
94 yolanda v
95 siti h v
96 iis v v
97 asri v v
98 neni v v
99 yuli v v
8 6
14/03/2018 100 asri v v
101 netik v
102 neni v v
103 wiwin v
104 herti v v
105 riska v
106 neng liyah v v
7 4
15/03/2018 107 nunik v v
108 sri santi v v
109 rosita v
110 elis v v
111 Nely v
5 3
16/03/2018 112 nely v
113 elis v
114 nurhayati v
115 nunik v v
116 widyawati v
117 sri santi v
118 pipih v v
119 siti m v v
8 3
17/03/2018 120 tanty v
121 pipih v
122 neni v v
123 siti m v
124 tika v
125 reka v
126 warsinah v v
7 2
18/03/2018 127 kuraesin v v
128 lina v
129 warsinah v
130 ai v
131 siti v v
5 2
19/03/2018 132 nurisyani v
133 riani v
134 siti v
135 nunik v
136 irma v
137 mima v
138 sari v v
7 1
20/03/2018 139 nunik v v
140 irma v
141 yuni v v
3 2
21/03/2018 142 tini v v
143 muna v v
144 fitria v
145 rulli v v
146 imas v
147 demi v
148 resty v v
149 diah v v
150 andriani v
151 welly v v
152 yuni v v
11 7
22/03/2018 153 tini v
154 muna v v
155 diah v
156 fitria v
157 resty v
158 andriani v
159 welly v
160 ani v
161 yuyun v v
9 2
23/03/2018 162 wulantika v v
163 lina silver v v
164 yuyun v v
165 eva saulina v v
166 iis v v
167 tessa v v
168 warsinah v
7 6
24/03/2018 169 wulantika v
170 eva saulina v v
171 lina M v v
172 tessa v
173 warsinah v
5 2
25/03/2018 174 devi v v
175 siti v v
176 lina M v
177 Citra v v
178 winda v
179 warsinah v
6 3
26/03/2018 180 widiastuti v v
181 siti nuryani v v
182 nani v
183 juliah v
184 citra v
185 winda v
186 warsinah v
187 sri v v
188 urwatil v
189 imas v v
10 4
27/03/2018 190 Sri v
191 siti n v
192 mimin v v
193 nani v v
194 wiwin v v
195 warsinah v
196 putri v v
197 imas v v
198 widiastuti v v
199 urwatil v
10 6
28/03/2018 200 ira haryani v v
201 mimin v
202 nuraisyah v
203 neng hartini v v
204 nani v v
205 warsinah v v
206 ai v v
207 putri v v
208 hindun v v
9 7
29/03/2018 209 ai v
210 mimin v
211 nuraisyah v
212 neng hartini v v
213 warsinah v
214 ria v v
215 vina v v
7 3
30/03/2018 216 nurjanah v v
217 neng hartini v v
218 rosifah v v
219 ira irawati v v
220 oom v v
5 5
31/03/2018 221 neng hartini v v
222 rosifah v
223 ira irawati v
224 oom v v
225 Ayu v v
226 kartini v v
6 4

Formulir Survey Harian Pemakaian Alat


Ruang NIPAS 4 - RSKIA - APRIL - 2018
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2018 1 Sarah v v
2 tita v
3 ai nurhayati v v
4 kartini v
5 ayu v
5 2
02/04/2018 6 ade yeti v
7 sarah v
8 ai nurhayati v
9 nurhasanah v v
10 julita v v
11 ela v v
12 alisa v v
13 imas v
14 dhara v
9 4
03/04/2018 15 nurhasanah v v
16 yulita v v
17 ela v
18 mamah v v
19 haifa v v
20 ami v v
21 widya ingsih v
22 windi v v
23 aas v v
24 dewi v v

4/4/2018 25 sumiati v v
26 levi v
27 lia v v
28 ami v v
29 haifa v
30 widyaingsih v
31 dewi v
32 mamah v
33 aas v
34 windi v
35 dinar v v

5/4/2018 36 venty v v
37 eprina v v
38 elis v
39 miati v v
40 ai hamidah v
41 widyaingsih v v
42 niken v
43 widianti v v
44 dinar v v

06/04/2018 45 venty v
46 niken v
47 eprina v v
48 tarisa v v
49 tintin v v
50 widianti v
Ari v v
diani v
yulia v v

7/4/2018 sarah v v
ani v v
cucu v v
intan v v
ari v
diani v
niken v
yati v v
indriliyanti v v
yulia v v
tintin v
yati v v
8/4/2018 tina v
intan v
riani v v
ani v
yati v v
anisa v
siska v v
lusi v
indriliyanti v
yulia v v

9/4/2018 tati v v
tina v
eva v v
riani v
ani v
sofie v
nl regina v v

10/04/2018 titin v v
ani v
NL Regina v v
yati v v
ami v v
sumartini v v
leni v v

11/4/2018 nofitasari v v
sella v v
siti nuryanti v
titin v
rina v v
ani v v
iyam v v
sumartini v v
leni v v

12/4/2018 rifa v v
ifani v v
yayah v v
gracelia v v
iyam v v

13/4/2018 nenden v
desy v v
widyawati v
rifa v v
ifani v v
annisa v
nina v v
yayah v
gracelia v v
sri intan v v
rini v v

14/4/2018 desy v
indriyani v v
nenden v
annisa v
sri intan v v
rini v

15/4/2018 nenden v
riska v
dea v
sri mulyati v

16/4/2018 yuyun yunengih v


nenden v
riska v
dea v
sri mulyati v
ina v

17/4/2018 hana v
ina v
siti jubaedah v
Formulir Survey Harian Pemakaian Alat
Ruang IGD - RSKIA BULAN JANUARI 2018
01/01/2018 1 DESI INFUS
2 ISEU INFUS
3 LENI INFUS
4 INDAH TRI NOOR INFUS DC
02/01/2018 5 IMAS WIDIANTI INFUS
6 DEWI INFUS
7 NURJANAH INFUS
8 ELIS VERONIKA INFUS
9 AI HASANAH INFUS DC
10 IPAH SARIPAH INFUS
11 BRIANSYAH INFUS
12 SANSAN FEBRIYANTI INFUS
13 ATIK KUSMIATI INFUS
14 DEWI SARTIKA INFUS
03/01/2018 15 AYU ANTIKA INFUS
16 EMMA LESTARI INFUS
17 SANTI SUSANTI INFUS
18 DENA IRIANI INFUS
19 RATNA INFUS
20 KHOTIMAH INFUS
21 NENG MIA NUR INFUS
22 YUYUN YUNENGSIH INFUS
23 FITRIYANI INFUS
24 EVI NURFARIDA INFUS DC
25 DINI YULIANI INFUS
04/01/2018 26 RIRIN INFUS
27 AIRA INFUS
28 EKA AGUSTINA INFUS
29 R RISMA INFUS
30 YUNI SETIAWATI INFUS DC
31 RATNA INFUS
32 RENI INFUS
33 RINI INFUS
34 ATI SUPRIATIN INFUS
05/01/2018 35 TANTRI INFUS DC
36 NURSETIAWATI INFUS DC
37 RESTI WULAN INFUS
38 DEWI KOMALASARI INFUS
39 YULI SETIAWATI INFUS DC
40 RINA RODIAH INFUS DC
41 WINNY WINENGSIH INFUS
42 CLOVIS INFUS
06/01/2018 43 AI SULASTRI INFUS
44 M SHALWAN INFUS
45 IKHSANU RACHMAT INFUS
46 SABRINA WIDIANINGSIH INFUS
47 KHOTIMAH INFUS DC
07/01/2018 48 NENI SRI MAERYANI INFUS
49 WINA INFUS
50 ALIFA KANZIA INFUS
51 AI TITA INFUS
52 ATIKAH INFUS
53 INDRIYANI INFUS DC
08/01/2018 54 YANI MULYANI INFUS DC
55 NENENG SARIPAH INFUS
56 YENI ANGGRAENI INFUS
57 INA GUSTIANA INFUS
58 LILIS ELFIRA LUSIANTI INFUS
59 SRI ROSIANA INFUS
60 RUSMALIA INFUS
61 NENGSIH INFUS DC
62 MARLINA INFUS DC
63 IKE NURJAYANTI INFUS
64 WARSIH INFUS
65 SAKILA ALMIRA INFUS
09/01/2018 66 SAILA INFUS
67 ASSYFA INFUS
68 JIHAN NAFLAH INFUS
69 MAYA MAYANGSARI INFUS DC
70 IIN CASINAH INFUS DC
71 RINA INFUS DC
72 ERNA HERLINA INFUS
73 AUFI INFUS
74 AI INFUS
75 EFI SILFIA INFUS
10/01/2018 76 IRMA NUR SPIANTI INFUS
77 LAELASARI INFUS
78 TESSA INFUS
79 SITI INFUS
80 DESI INFUS
81 NAZRIL INFUS
82 LIZZAN INFUS
11/01/2018 83 YAYU INFUS
84 FITRIANI INFUS
85 DEDE II KARTINI INFUS
86 ERITA MIA HERLINA INFUS DC
87 ARKAN SAID RAMADAN INFUS
88 MUHAMAD RIZKI RAMADHAN INFUS
89 DIFA ALPI PADILAH INFUS
12/01/2018 90 REZA ALFIANDRI INFUS
91 AZMI INFUS
92 DARA INFUS
93 TATI HARTATI INFUS
94 INDAH INFUS
95 YANTI INFUS
96 PENI SOPIANI INFUS
97 ROSI ROSITA INFUS
98 ERNI INFUS DC
99 NENG PIPI INFUS DC
100 NUR HOTIMAH INFUS
101 RINA HASANAH INFUS
102 IDA INFUS DC
103 LILIS NOVIANTI INFUS
104 ETIN INFUS
13/01/2018 105 YANI SANTI INFUS
106 SITI MARIAM INFUS
107 ENDAH INFUS DC
108 MEIRANI KADIR INFUS
109 TRI YAYUK SUGIARTI INFUS
110 ISTY SAPTIANTY INFUS
111 SULASTRI INFUS
112 TINI WARTINI INFUS DC
113 OTEH KARMILA INFUS DC
14/01/2018 114 ANI INFUS
115 MEGA KARTIKA INFUS
116 SANDI INFUS
117 ALIF MUHAMAD AZKA INFUS
14/01/2018 118 YANI YUNENGSIH INFUS
119 HANIPAH INFUS DC
15/01/2018 120 SHARLY YANA SAFITRI INFUS
121 ANDRA ARTHA INFUS
122 M LUTFI INFUS
123 SITI SUTIYANI INFUS
124 ATIN INFUS DC
125 EVA JUMATALASARI INFUS DC
126 NENENG HERYANTI INFUS
127 AAS INFUS
128 YULIANTIKA INFUS
16/01/2018 129 YUNI INFUS
130 ARSHAKA INFUS
131 DYAZ INFUS
132 ROHATI INFUS DC
133 NAWANG INFUS DC
134 AYU LESTARI INFUS
135 NINING NURWAHYUNINGSIH INFUS
136 ETI INFUS
17/01/2018 137 DEANDHA INFUS
138 YULIS INFUS
139 DINI SUSANTI INFUS
140 DWI RAHAYU INFUS DC
141 KURNIATI INFUS DC
142 ENUR SRI RAHAYU INFU7S DC
143 YULIA FITRIYANI INFUS DC
144 RITA HERMAWATI INFUS
145 IDA SUPARTIKA INFUS
18/01/2018 146 FEBY AULIA INFUS
147 MUHAMAD AKBAR INFUS
148 FITRI LUSIAWATI INFUS
149 KIKI RIZKY INFUS
150 ERNAWATI INFUS
151 AI SITI FATIMAH INFUS
152 SITI AMINAH INFUS
153 LILIS WARSIAH INFUS DC
154 YANTI SITI INFUS
19/01/2018 155 YENI SURYANI INFUS
156 ARRAFI INFUS
157 FATHIMA AFRA INFUS
158 RUZAIN MALIK I INFUS
159 TETEH EMA INFUS DC
160 ERNA SANTIKA INFUS
161 YETI ANGGI INFUS
162 NENENG NURHASANANA INFUS
163 TIARA MEGAWATI INFUS
164 YANI INFUS
165 ANI SUMARNI INFUS
166 LINDA ANGGRAENI INFUS
167 IIM SITI ROHIMAH INFUS
168 NENG YULIA INFUS DC
20/01/2018 169 SRI HANDAYANI INFUS DC
170 HARMONI INFUS
171 RAFI INFUS
172 FAUZIA KHAERUNNISA INFUS
173 ERNA INFUS DC
174 NENI ROHAENI INFUS
175 JIE BUN ING INFUS
176 SITI LATIFAH INFUS DC
177 MARDIANA UNTARI infus
21/01/2018 178 FETI SETIAWAN infus
179 SITI JULAEHA INFUS
180 WILDA RISMAYANTI INFUS
181 AI SITI AISYAH INFUS
182 FENTY PRISILLA HERNAWAN INFUS
183 LIA MARLIATIN INFUS
184 TITA PUSPA INFUS
22/01/2018 185 LENA KUSMIRAN INFUS DC
186 ARSYA ALMALIK INFUS
187 M FAZLI ARDIANI SUNTANI INFUS
188 KARTIKA SARI INFUS
189 YULIANI SARIDEWI INFUS
190 KOKOM KOMALASARI INFUS
191 RENA SUPRIANINGSIH INFUS
192 TUTI RISNAWATI INFUS
193 SITI HALIMAH INFUS
194 LEPI LESTARI INFUS
195 IDA INFUS DC
23/01/2018 196 AI MINTARSIH INFUS
197 WISNU PRATAMA INFUS
198 FITRIANI INFUS DC
199 FITRI SITI ROBIAH INFUS
200 NENG NURHAYATI INFUS
201 TETI MULYATI INFUS
24/01/2018 202 WIDA ARYANI INFUS
203 FAHMI ABDUL GANI INFUS
204 HENI HENIARTI INFUS
205 DESIYANI INFUS
206 TIKA SITI SOLEHA INFUS DC
207 AYU WULANSARI INFUS
208 SELLA NURUL NURAENI INFUS
209 LILIS NURHAYATI INFUS
25/01/2018 210 NURLITA INFUS
211 M RAYYAN INFUS
212 SANTI NURHAYATI INFUS
213 YENY LEWI INFUS DC
214 TESSA ERI EPRIYANTI INFUS
215 CUCU INFUS DC
216 KOKOM INFUS DC
217 MIMIN MINTARSIH INFUS DC
26/01/2018 218 CICAH HIDAYAT INFUS
219 JUMIDAH INFUS DC
220 ROHIMAH INFUS
221 WANDA APRILIANI INFUS
222 PUTTY IZZA UMRATAMI INFUS
223 DENISA NUR AZIZAH INFUS
224 HAIFA AGNIA INFUS
225 MUHAMMAD MALKHA INFUS
226 VINA INFUS
227 IMAS SITI INFUS DC
27/01/2018 228 TATI KUSMIATI INFUS
229 KAYLLA NUR AZIZAH INFUS
230 SITI PATMAWATI INFUS
231 NONENG INFUS
232 ANEU INFUS
28/01/2018 233 YANTI INFUS
234 AQMAR INFUS
235 MALIKA INFUS
236 YANI INFUS
237 SITI NURROHMAH INFUS
238 MARIA INFUS
239 DIOTA INFUS
29/01/2018 240 GITA NUR SAHARA INFUS
241 SULBIYAH INFUS
242 YUNI RAHMAWATI INFUS
243 RAISYA INFUS
244 RAFIF ARKAN HIDAYAT INFUS
30/01/2018 245 M ZEIN INFUS
246 RISNAWATI INFUS
247 JULIANI SOENGKONO INFUS
248 ARNIA INFUS DC
249 ANDINI INFUS
250 YASINTA INFUS
251 LENI SUMARNI INFUS
252 LINA MARLINA INFUS
31/01/2018 253 AI YULIANTI INFUS DC
254 SITI MARPUAH INFUS
255 PUTRI INFUS
256 ROHIMAH INFUS
257 ANA RATIH INFUS
258 ENTI SURYATI INFUS
259 M ALFIN WIJAYA INFUS
260 NABILA AZRINA SHALIHA INFUS
261 DARELL ALBY INFUS
TOTAL 261 50
JUMLAH PASIEN IGD 759

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN FEBRUARI 2018
01/02/2018 1 GINA INFUS
2 SANTI INFUS
3 DEIS RISMA INFUS
4 TATI INFUS DC
5 ALYA INFUS
6 NENDEN INFUS
7 ANISA INFUS
8 ERIKA INFUS
9 DESI INFUS
10 CUCU INFUS
11 DESIYARNI INFUS
12 M FACHRI INFUS
13 ROSDIARA INFUS
14 NOVIYANTI INFUS
02/02/2018 15 IMELDA INFUS
16 TETI INFUS
17 SUSANTI INFUS
18 SURYATI INFUS DC
19 NINING INFUS
20 SRI INFUS
21 I GUSTI INFUS
22 INDRAWATI INFUS DC
23 EVA ROSMADEWI INFUS
03/02/2018 24 AGI H INFUS
25 TITIN INFUS
26 LIA INFUS DC
27 MIA INFUS
28 ELI S INFUS
29 CUCUN INFUS
30 ERIKA INFUS
31 PRATAJA INFUS
32 AULIA INFUS
33 YETI INFUS
34 VENI INFUS
35 ARFAN INFUS
04/02/2018 36 SOPIATUL INFUS
37 DEVI INFUS
38 ASTRI INFUS
39 HANA INFUS
40 DARI S INFUS
41 SULBIAH INFUS
05/02/2018 42 KARTIKA INFUS DC
43 LIANTI EKA INFUS
44 KRISTINA INFUS
45 EGA INFUS
46 LIKA L INFUS
47 ERNA INFUS
48 NURHALIMAH INFUS
49 YANI INFUS
50 YULI INFUS
51 FAUZIL INFUS
52 AAM INFUS
53 EKA INFUS
54 RAFIKA INFUS
06/02/2018 55 ICEU INFUS
56 YANI INFUS
57 ROHAYATI INFUS
58 KIKI INFUS
59 HANI INFUS
60 ATI INFUS
61 TITIN INFUS
62 MINARTI INFUS DC
63 RIAN INFUS
07/02/2018 64 TITIN INFUS
65 SAQUILA INFUS
66 FIKRI INFUS
67 NOVITA INFUS
68 LIA INFUS
69 AISYAH INFUS
70 HANA INFUS
71 RESTU INFUS
72 LIA INFUS DC
73 DEA INFUS
08/02/2018 74 SUKAESIH INFUS DC
75 YANI INFUS
76 ENI INFUS DC
77 ELA INFUS
78 FAUZI INFUS
79 INDAH INFUS
80 RIDWAN INFUS
81 LIANA INFUS
82 TUTI INFUS
09/02/2018 83 SITI SOLIHAH INFUS
84 SITI HANIFAH INFUS
85 IIS RUKANDA INFUS DC
86 DEWI SULISTYA INFUS
87 DEDEH INFUS DC
88 SRI INFUS
89 RATNA INFUS
90 ELI INFUS
91 IMAS INFUS
92 NURELA INFUS
93 DESI INFUS DC
94 KIKI INFUS
95 DIAN INFUS DC
96 IRNE INFUS
97 AZFAR INFUS
98 NURUL INFUS
99 DEVIRA INFUS
10/02/2018 100 SRI MULYA INFUS
101 VITA INFUS
11/02/2018 102 SITI INFUS DC
103 AI SUMINAR INFUS DC
104 DEFFY INFUS DC
12/02/2018 105 RATNASARI INFUS
106 NADIN INFUS
107 RIKA ROSTINA INFUS
108 ANNIDA INFUS
109 ALFAJRI INFUS
110 BY.NY.RENI INFUS
111 EVA INFUS
112 ARTI INFUS
113 YULIA INFUS
114 JHOSIE INFUS
115 IIS INFUS
116 RHAISA INFUS
117 SITI INFUS DC
118 NEULIS INFUS
119 HARUN INFUS
120 FITRI INFUS DC
13/02/2018 121 RATIH INFUS
122 M ABDUL INFUS
123 M RAKA INFUS
124 ENDIK INFUS DC
125 DZAKIRA INFUS
126 NURUL INFUS
127 TINA INFUS DC
128 NENENG INFUS DC
129 INTAN INFUS
14/02/2018 130 ERLIA INFUS
131 M RAFA INFUS
132 ELIS INFUS
133 DITA INFUS
134 DESI INFUS DC
15/02/2018 135 TIA INFUS
136 KARMINIH INFUS DC
137 ISMAWATI INFUS
138 GITA INFUS DC
139 DEA INFUS DC
140 PRIMA INFUS DC
141 M NAUFAL INFUS
142 M RAIHAN INFUS
143 SRI INFUS
144 LINA INFUS
16/02/2018 145 SURYATI INFUS DC
146 AI HASANAH INFUS
147 YATI INFUS DC
148 NENDEN INFUS
149 WINNY INFUS
150 VIVIE INFUS
151 SARI INFUS DC
152 DESI INDRIANI INFUS
17/02/2018 153 NURLATIFA INFUS
154 CICIN INFUS
155 IIS DATI INFUS
156 ABIZAR INFUS
157 ENONG INFUS
158 SUDARIAH INFUS DC
18/02/2018 159 SITI YULIA INFUS
160 M DAFA INFUS
161 MERRY INFUS
162 ELVIA INFUS
163 NISA INFUS
164 IRA SUTIRAH INFUS
165 ADE INFUS
19/02/2018 166 DEDEH INFUS
167 AZKA FARIS INFUS
168 TIARA INFUS
169 TINI INFUS
170 NITA INFUS
171 SELI INFUS
20/02/2018 172 BY.NY.ANGEI I INFUS OGT
173 BY.NY.ANGEL II INFUS
174 RISMA INFUS
175 DIAN INFUS
176 FANY INFUS
177 SILFI INFUS
178 WATRI INFUS
179 ABYAKSA INFUS
180 ERNAWATI INFUS
181 NAYSHAY INFUS
182 TATI INFUS
183 SELA INFUS DC
21/02/2018 184 ROSI INFUS
185 FIRDANISA INFUS
186 SITI SARIPAH INFUS
187 SITI TARSIAH INFUS
188 SANTI INFUS
189 ASIRI INFUS
190 SURYATI INFUS
191 ENON INFUS
192 FITRAH INFUS
193 NABIL INFUS
194 MURNI INFUS
195 NUNIK INFUS
22/02/2018 196 WIWIN INFUS DC
197 TITA INFUS
198 SITI INFUS
199 INDRI INFUS
200 EVA INFUS
201 ENUR INFUS DC
202 DINA INFUS
203 ELIS INFUS
204 NENG NANI INFUS
23/02/2018 205 RIKA INFUS
206 FANNY INFUS
207 SAIDAH INFUS DC
208 GLADIS INFUS
209 SALSA INFUS DC
210 IDA INFUS
211 EUIS INFUS
212 NUNI INFUS DC
213 NADISA INFUS
214 FANI INFUS
215 RIA INFUS
216 SOFI INFUS
217 DEVI INFUS
218 PURGIYANTI INFUS DC
24/02/2018 219 SITI PATONANH INFUS
220 KRISTIN ANGGRAENI INFUS
221 M ABIZARD INFUS
222 KULSUM INFUS
223 ESIH INFUS
224 MIKA INFUS
225 ZULIA INFUS
226 ISEU INFUS DC
227 MIN SUMIATI INFUS
228 RENI INFUS DC
25/02/2018 229 HANDAYANI INFUS
230 RUSMINI INFUS DC
231 IMAS INFUS
232 LENI INFUS
233 RIMA INFUS DC
234 ANISA INFUS
26/02/2018 235 MARIA ULFA INFUS
236 NENENG INFUS
237 NENI INFUS DC
238 KHAIRAN INFUS
239 AL FATIH INFUS
240 AAN INFUS
241 YUYUN INFUS DC
242 SUSILA INFUS
27/02/2018 243 SURATI INFUS
244 ALIF INFUS
245 PUPUT INFUS
28/02/2018 246 INTEN INFUS
247 RINA INFUS
248 ROHMAH INFUS
249 SITI LUTFIAH INFUS
250 WATI INFUS DC
251 SUPRIHATIN INFUS
252 TATI INFUS DC
TOTAL 252 45 1
JUMLAH PASIEN IGD 751

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN MARET 2018
01/03/2018 1 NOVIA INFUS
2 ANI INFUS
3 TINI INFUS DC
4 KUSMIAH INFUS
5 NITA INFUS
6 DESI INFUS
7 ICEU INFUS DC
8 IBRAHIM INFUS
02/03/2018 9 SURATI INFUS
10 NOVIANTI INFUS
11 SAIDAH INFUS DC
12 AI HENI INFUS
13 ARKAN INFUS
14 SRI INFUS
15 RAHAYU INFUS
16 AI KARWATI INFUS
17 RISKA INFUS DC
18 SANTI INFUS
19 NONOK TUTI INFUS
20 ROMLAH INFUS
21 DEWI INFUS
03/03/2018 22 NURAENI INFUS
23 DEWI RAHAYU INFUS
24 MAYXIRA INFUS
25 DENIRAN INFUS
26 SITI F INFUS
27 GOLDY INFUS
28 HABIB INFUS
29 TIA MARWATI INFUS
30 ELSA INFUS DC
31 YULIANTI INFUS
32 YAYAH INFUS
04/03/2018 33 SURTINI INFUS
34 AI INFUS
35 GIBRAN INFUS
05/03/2018 36 RITA INFUS DC
37 TITIN INFUS
38 KANESYA INFUS
39 SANTI INFUS
40 NURHAYATI INFUS
41 GALANG INFUS
42 ARFAN INFUS
06/03/2018 43 ICEU INFUS
44 AYU INFUS
45 ROFI INFUS
46 RINJANI INFUS
47 LINDA INFUS
48 UMI INFUS
49 PATMAWATI INFUS DC
50 MULYATIN INFUS
51 DINI INFUS
52 TUTI INFUS DC
53 NAIRA INFUS
54 AZRIEL INFUS
07/03/2018 55 IIS INFUS DC
56 ROHIMAN INFUS
57 DINA INFUS
58 SITI INFUS
59 KHAERY INFUS
60 RENI INFUS
61 DEVI INFUS
62 SHERLY INFUS
63 GRACETON INFUS DC
64 RAFKA INFUS
65 SANTI INFUS
08/03/2018 66 JUJU INFUS
67 IRMA INFUS
68 DZAKIRA INFUS
69 MIRNA INFUS
70 DESI INFUS
71 DINI INFUS
72 ADITYA INFUS
09/03/2018 73 IRMA INFUS
74 TINI INFUS
75 IIS INFUS
76 YAYAH INFUS
77 TETI INFUS
78 MIA INFUS
79 FEBIAN INFUS
80 DESI INFUS
81 NUNIK INFUS DC
82 LIA INFUS
83 DEDE INFUS
84 NENDEN INFUS
85 NUNUNG INFUS
10/03/2018 86 SARI INFUS
87 ADIFA INFUS
88 NOVI INFUS
89 YULI INFUS DC
90 ANISA INFUS
91 YANTI INFUS DC
92 ITA ROSITA INFUS
93 NURUL HUSNA INFUS
11/03/2018 94 IKA INFUS
95 ISYEU INFUS
96 ASRI INFUS
97 IRMA INFUS
98 GINA INFUS
99 KIKI INFUS
100 DEWI INFUS
101 NENGSIH INFUS
102 DEVI INFUS DC
103 HANA INFUS
12/03/2018 104 IMAS INFUS
105 AI KARTIKA INFUS
106 DEDE INFUS
107 KHANZA INFUS
108 SITI JULAEHA INFUS
13/03/2018 109 BY.NY.SANTI INFUS
110 SRI W INFUS
111 LIA INFUS DC
112 LIA INFUS
14/03/2018 113 KERISNA INFUS
114 TIANI INFUS
115 ADARA INFUS
116 YENI INFUS
117 SANTI INFUS
118 AYUMI INFUS
119 EUIS CUCUM INFUS
15/03/2018 120 WIDIYAWATI INFUS
121 RITA INFUS
122 SINTA INFUS
123 TINI SAHRINI INFUS
124 NURSYAHWAL INFUS
125 LASMINI INFUS
16/03/2018 126 NAJWAN INFUS
127 ADRIAN INFUS
128 MIA INFUS
129 PIPIH INFUS
130 ASTRI INFUS
131 SITI MARIAM INFUS
132 ATIK INFUS
133 MAULANI INFUS
134 DINA INFUS DC
135 TANTY INFUS
136 NENGSIH INFUS
17/03/2018 137 MIMIN INFUS DC
138 KURAESIN INFUS
139 SARI INDRIANI INFUS
140 SITI INFUS
141 YULI INFUS
142 KEJI INFUS
143 ZASKIA INFUS DC OGT
18/03/2018 144 IRPAN INFUS
145 HASNA INFUS
146 MIFTAKHUR INFUS
147 JUARIAH INFUS DC
148 MEIANI INFUS
149 NURISYAH INFUS
150 RIANI INFUS
151 BAGAS INFUS
152 NOVIANTI INFUS
19/03/2018 153 LENA INFUS
154 MIMA INFUS
155 NUNIK INFUS
156 ALISA INFUS
157 IRMA INFUS
158 YUNI INFUS DC
159 MARIPAH INFUS
160 WINA INFUS
161 ATIN INFUS
162 M LUTFI INFUS
20/03/2018 163 FITRIA INFUS
164 RAKA INFUS
165 DEWI INFUS
166 ANDRIANI INFUS
167 SITI FARIDA INFUS
168 RULLI INFUS DC
169 ALZAIDAN INFUS
170 PUTRA INFUS
171 MUNA INFUS
172 TINI INFUS
173 DIAH INFUS
174 NURSAADAH INFUS
21/03/2018 175 ANI INFUS
176 PONY INFUS
177 ALIA INFUS
178 NEZALIA INFUS
179 YANI INFUS
22/03/2018 180 ASTRI INFUS
181 WULANTIKA INFUS
182 LENI MARLINA INFUS DC
183 IIS C INFUS DC
184 MASAIT INFUS
185 TINAH INFUS
186 EVA INFUS DC
23/03/2018 187 SABILA INFUS DC
188 ENTIN INFUS
189 NURUL INFUS
190 TESSA INFUS
191 CORINA INFUS
192 NURHASANAH INFUS DC
193 NURINA INFUS
194 ADNIN AZMIATUL INFUS
195 RISKA INFUS
196 JULIAH INFUS
24/03/2018 197 AI YULIANTI INFUS DC
198 DEASY INFUS
199 NUR SUSILAWATI INFUS DC
200 YESI N INFUS DC
201 MARINI INFUS
202 NENI INFUS DC
203 NURHAYATI INFUS
204 TATI INFUS
205 HALIMAH INFUS
206 DEVIRA FIKA INFUS DC
25/03/2018 207 RANI INFUS DC
208 CITRA INFUS
209 SISKA INFUS
210 WINDA INFUS
211 FANNY INFUS
212 DEWI TRI INFUS DC
213 SANTI INFUS
214 AFIZA INFUS
215 NOPI INFUS
216 RINA INFUS
217 NANI INFUS
218 ANIS INFUS
219 SRI IRAWATI INFUS
26/03/2018 220 AYU SITI INFUS
221 SITI INFUS DC
222 NEZALIN INFUS DC
223 EULIS INFUS DC
224 IMAS INFUS DC
225 HESTI INFUS
226 SITI INFUS DC
227 LINA INFUS DC
228 APRILIA A INFUS
229 ERNI INFUS DC
230 NANI INFUS
231 NOVITA INFUS DC
232 SYAHPUTRI INFUS
233 ENGKOM INFUS DC
234 VANIA INFUS
27/03/2018 235 YUWANGSIH INFUS DC
236 FAJAR INFUS
237 MIA INFUS
238 VINI INFUS
239 IDAH INFUS
240 MIMIN INFUS DC
241 RANIKA INFUS DC
242 PUTRI INFUS DC
243 WIDA INFUS DC
244 RISKA INFUS
245 MARIANTY INFUS
246 LILIS INFUS
247 NUR FITRI INFUS
248 YENI INFUS
28/03/2018 249 FITRI INFUS
250 NITA INFUS DC
251 EKA INFUS DC
252 IRA INFUS DC
253 NENG HARTINI INFUS
254 AI HERMAWATI INFUS DC
255 EUIS INFUS
256 ASSYIFA INFUS
29/03/2018 257 TINA INFUS
258 FITRILIA INFUS
259 HANA INFUS
260 FRIDA INFUS
261 IRA INFUS
262 DZAKI INFUS
263 AVTURI INFUS
264 LILIS INFUS DC
265 OOM INFUS DC
30/03/2018 266 RIVA INFUS
267 DEWI SRI INFUS
268 AYU INFUS
269 SAIROH INFUS
270 RAISYA INFUS
271 ANI INFUS
272 SHELDA INFUS
273 ALHASAN INFUS
274 HANI INFUS
275 M AZAM INFUS
30/03/2018 276 LIRA INFUS DC
277 LARA INFUS
278 ANI INFUS DC
279 PUPUT INFUS
280 SITI SOPIAH INFUS
281 KARTINI INFUS
282 ZAKI INFUS
283 PIPIH INFUS
31/03/2018 284 AI NURHAYATI INFUS
TOTAL 284 55 1
JUMLAH PASIEN IGD 802

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN APRIL 2018
01/04/2018 1 USWATUN HASANAH INFUS
2 SAIPUL INFUS
3 DINA INFUS
4 NURHASANAH INFUS
5 STEFIE INFUS
6 NONI INFUS
7 NENG DEWI INFUS
8 ELA INFUS
02/04/2018 9 WINDI INFUS
10 NURY INFUS
11 BURHANUDIN INFUS
12 DHARA INFUS
13 IMAS INFUS
14 ELISAH INFUS DC
15 YANI INFUS DC
16 MAMAH INFUS
17 CHICHA INFUS
18 SISKA INFUS
03/04/2018 19 DEWI INFUS
20 SAHLAN INFUS
21 LEVI INFUS
22 AMY INFUS DC
23 TINI INFUS
24 RINA INFUS
25 YUSNITA INFUS DC
26 WIDIA INFUS
27 NABILA INFUS
28 ASRI INFUS DC
29 TETI INFUS
30 ROHAENI INFUS
04/04/2018 31 LIA INFUS DC
32 SUMIATI INFUS
33 CICIH INFUS
34 PUTRI INFUS
35 M BAJA INFUS
36 FITRI INFUS
37 AGUSTINA INFUS
05/04/2018 38 NURYANTI INFUS
39 ROSALINA INFUS
40 WIDIANTI INFUS
41 RINA INFUS
42 NOVI INFUS DC
43 NIKEN INFUS
44 ANA SUSANA INFUS
45 INTAN INFUS
06/04/2018 46 REZA INFUS
47 YULIA INFUS DC
48 INDAH INFUS
49 ANNESA INFUS
50 ANI INFUS DC
51 RAFIFAH INFUS
52 CUCU INFUS DC
07/04/2018 53 WIWIT INFUS DC
54 SARAH INFUS DC
55 ROSSY INFUS
56 JUHAERIAH INFUS
57 IKA INFUS DC
58 ELGIO INFUS
59 TITIN INFUS DC
60 SANTI INFUS DC
61 RISKA INFUS DC
62 IRMA INFUS DC
63 TIA INFUS
64 AFIFA INFUS
65 NURUL INFUS
08/04/2018 66 M FALAH INFUS
67 ANISA INFUS
68 TATI INFUS
69 SANTI INFUS
70 DETI INFUS DC
09/04/2018 71 IMAY INFUS
72 KURNIASIH INFUS
73 AINI INFUS
74 REGINA INFUS
75 FENTI INFUS DC
76 SUMARNI INFUS
77 SUTRI INFUS
78 M FIKRAN INFUS
79 HELI INFUS
80 IIS LIAN INFUS
81 IIS WIDIANTI INFUS
10/04/2018 82 NINIS INFUS
83 ENDAH INFUS
84 LENI INFUS
85 POPY INFUS
86 AYU INFUS
87 SUMARTINI INFUS
88 YATI INFUS
89 SANTI INFUS
90 DEDE NURHAYATI INFUS
91 ROHIMAH INFUS
11/04/2018 92 ETI INFUS DC
93 RIA INFUS
94 TRESNA INFUS
95 IYAM INFUS DC
96 FITRIANI INFUS
97 AI INFUS
98 SITI N INFUS
99 HAFID INFUS
100 YAYAH INFUS
101 YAYAT INFUS DC
102 YESI INFUS
12/04/2018 103 HUMAEROH INFUS
104 FITRIANI INFUS
105 MERRY INFUS
106 SRI INTAN INFUS
107 WIDIAWATI INFUS
108 NINA INFUS DC
13/04/2018 109 GIANDRA INFUS
110 JUHAERIAH INFUS
111 YATI INFUS
112 KURNIAWATI INFUS
113 ANISA INFUS
114 NITA INFUS
115 NITA INFUS
116 NENDEN INFUS
117 WINDA INFUS
118 YULI INFUS
119 KINAN INFUS
14/04/2018 120 CANDRA DEWI INFUS DC
121 DEWI INFUS
122 KURNIASIH INFUS
123 RANI INFUS
124 SRI MULYANI INFUS
125 RAISYA INFUS
126 BY NY DEWI INFUS OGT
127 SAIDAH INFUS
128 NURLINDA INFUS
15/04/2018 129 FESY INFUS DC
130 KIKI INFUS
131 YANI INFUS
132 DEA INFUS
133 RATNA SARI INFUS
134 SITI HANDAYANI INFUS DC
135 YANI INFUS DC
136 AQILA INFUS
137 SHELA INFUS DC
138 NITA INFUS DC
16/04/2018 139 YULIA INFUS
140 ELLY INFUS
141 SURYANI INFUS
142 LIA INFUS
143 AMI INFUS DC
144 AI KOMALA INFUS DC
145 ONING INFUS DC
146 LIA INFUS DC
147 GENDARVID INFUS OGT
148 ANNISA INFUS DC
149 HANA INFUS DC
150 SITI JUBAEDAH INFUS
151 ASYIFA INFUS
17/04/2018 152 SITI ROHIMAH INFUS
153 ERI INFUS
154 ROSMAYANTI INFUS DC
155 ROSITA INFUS DC
156 TIKA INFUS DC
157 SELI INFUS
158 KINARA INFUS
159 ADIVA INFUS OGT
160 NETI INFUS
161 MIRNA INFUS
18/04/2018 162 NAYA INFUS
163 SURYATI INFUS
164 SITI NURAINDAH INFUS
165 MARNI INFUS DC
166 NENDEN INFUS DC
167 YENI INFUS DC
168 LISTI INFUS DC
169 DESTIANA INFUS DC
170 ARSYILLA INFUS
171 WINA INFUS
172 NURDINA INFUS
173 GINA INFUS
174 SUSI INFUS
19/04/2018 175 MIA INFUS
176 RESTIANI INFUS
177 ATING INFUS DC
178 ENUNG INFUS DC
179 RINA INFUS
180 NINA INFUS DC
181 DEWI INFUS
182 LINA INFUS
20/04/2018 183 GINA INFUS
184 MERISA INFUS
185 ANITA INFUS
186 HANITA INFUS DC
187 ELISA INFUS DC
188 IRMA INFUS
189 KOMALA INFUS DC
190 PARIDA INFUS
191 SALSABILA INFUS
192 SANTIKA INFUS DC
21/04/2018 193 SITI NUR INFUS DC
194 SITI AISYAH INFUS DC
195 LASTRI INFUS DC
196 LISNAWATI INFUS DC
197 DESY INFUS
198 NAYLA INFUS
199 FATIMAH INFUS
200 TANIA INFUS
201 ISNAENI INFUS
22/04/2018 202 DELLA INFUS
203 NOPI NOPIAH INFUS
204 NOPI RATNI INFUS
205 BAIHAKI INFUS
206 AINAYYA INFUS
207 ATTA INFUS
208 PUTRI INFUS
23/04/2018 209 SUCI INFUS
210 NURLAELA INFUS
211 SULASTRI INFUS DC
212 WIDURI INFUS
213 ATU GISVA INFUS DC
214 NAPOLEON INFUS
215 NUNI INFUS DC
216 SITI INFUS
217 ANE INFUS DC
218 YUNI INFUS DC
219 SITI NURBAYA INFUS
220 TITA INFUS DC
221 TITIN SUPRIATIN INFUS
222 NENENG INFUS
24/04/2018 223 RATIH INFUS
224 GUSTI INFUS
225 YAYULE INFUS
226 AHMAD INFUS
227 SANTI INFUS
228 DEWI INFUS
25/04/2017 229 PIPIN INFUS DC
230 NUR HIKMAH INFUS
231 ZAKIYAH INFUS
232 RADYTIA INFUS
233 RUVI INFUS
234 FANIA INFUS
235 ADISTY INFUS
236 HANA INFUS
237 YASINTA INFUS
238 RATNA INFUS
239 SITI AISAH INFUS
26/04/2018 240 ENDE ANGGRAENI INFUS
241 ITA HARTIATI INFUS
242 SARIPAH INFUS DC
243 DECHI INFUS DC
244 RINRIN INFUS
245 RAKA INFUS
246 INDRI INFUS
247 AQMAR INFUS
248 NENI INFUS
27/04/2018 249 RINA INFUS
250 SITI INFUS
251 NENDEN INFUS DC
252 DINA INFUS
253 NAZRIL INFUS OGT
254 NENG NURAENI INFUS DC
255 RESA INFUS
256 SAWITRI INFUS
257 YATI INFUS DC
258 ETI PRIHATIN INFUS
28/04/2018 259 SAFARINA INFUS
260 SUTINAH INFUS DC
261 ENUNG NURJANAH INFUS
262 TINI INFUS
263 ASRI P INFUS
264 TIAL INFUS DC
265 GHASANI INFUS
266 SARIAH INFUS DC
267 DEWI INFUS
268 GITA INFUS
269 TINA INFUS
29/04/2018 270 INDAH INFUS
271 NUROHMAH INFUS
272 KAYLA INFUS OGT
273 YULI INFUS
274 STELA INFUS
275 RIKA AGUS INFUS
276 ANISA INFUS
277 ENDAH INFUS
278 TUTI H INFUS
279 LINDA INFUS
280 IKA INFUS DC
30/04/2018 281 MIA INFUS
282 ASYFA INFUS
283 TAMALA INFUS
284 DIANA INFUS
285 SITI JUBAEDAH INFUS
286 LUCKY INFUS
287 DHEA INFUS
288 SALSABILA INFUS
289 VICKY INFUS
290 MIMIN INFUS DC
291 SEILA INFUS
TOTAL 291 73 5
JUMLAH PASIEN IGD 813

Formulir Survey Harian Pemakaian Alat


Ruang IGD - RSKIA BULAN MEI 2018

01/05/2018 1 ANENG INFUS


2 RIKA INFUS
3 MINI INFUS DC
4 DINI INFUS
5 AGUSTINA INFUS DC
6 MARIAM INFUS
7 LENI INFUS DC
8 NURHALIMAH INFUS
9 RINI INFUS
10 DIAN INFUS
02/05/2018 11 EUIS INFUS DC
12 RIKA INFUS
13 NINING INFUS
14 FIQIH INFUS
15 NIA INFUS
16 SARI INFUS
17 KOKOM INFUS
03/05/2018 18 LILIM INFUS DC
19 TITIN INFUS
20 ELSA INFUS
21 TINI INFUS DC
22 ZAFRAN INFUS
23 MELIS INFUS
24 WINA INFUS
25 WILDAN INFUS
26 PUTRI INFUS
27 NOPI INFUS
28 ADI INFUS
29 INDAH INFUS
30 DIAH INFUS
04/05/2018 31 DEDE INFUS DC
32 AYU ROHIMAH INFUS
33 WIDYA INFUS
34 LENI INFUS DC
35 SUSI INFUS
36 SELI INFUS
37 YUSI INFUS
38 RONA INFUS
05/05/2018 39 IRMA INFUS
40 YANI INFUS
41 SANTI INFUS
42 M JALAL INFUS
43 DEVY INFUS
44 ELISA INFUS DC
45 ALBARTAMA INFUS
46 WINA NINGSIH INFUS
47 IIN INFUS
48 RINA INFUS DC
49 SRI MULYANI INFUS
50 SITI ROHAITI INFUS
06/05/2018 51 SOPIAH INFUS
52 DEWI INFUS
53 SRI INFUS
54 YANE INFUS
55 KUSTIA INFUS
07/05/2018 56 YULIANA INFUS
57 TETI INFUS
58 LINAWATI INFUS
59 SHERLY INFUS
60 IDAH INFUS
61 DEVI INFUS
62 ILOH INFUS
63 MULYANAH INFUS DC
08/05/2018 64 RIMA INFUS
65 NURWITA INFUS
66 MILA INFUS
67 NOLIS INFUS DC
68 DEWI INFUS
69 LASTIKA INFUS
70 TIWI INFUS
71 FITRI INFUS
72 HESTIANA INFUS
73 NURITA INFUS
74 RIZQI INFUS
75 RINA INFUS DC
76 SRI INFUS
09/05/2018 77 ERVA INFUS
78 DWI INFUS
79 IRMA INFUS
80 FITRI INFUS DC
81 FARIZ INFUS
82 SITI INFUS DC
83 MARYATI INFUS
84 YULI INFUS
10/05/2018 85 SUYATI INFUS DC
86 HETY INFUS
11/05/2018 87 NURHAYATI INFUS DC
88 RIANA INFUS
89 EUIS INFUS
90 MARI INFUS
91 FEBI INFUS DC
92 SAPITRI INFUS DC
93 NURHAYATI INFUS
94 ENDANG INFUS
12/05/2018 95 NURFITRIA INFUS DC
96 TETI INFUS DC
97 ZULFA INFUS
98 SITI INFUS
99 EUIS INFUS
100 RENI INFUS
101 DESI INFUS DC
13/05/2018 102 LISNAWATI INFUS
103 SITI HALIMAH INFUS
104 ANJUNGAN INFUS
105 RUMISA INFUS DC
106 NENAH INFUS
107 RIKA INFUS
108 FITRI INFUS
14/05/2018 109 RANI INFUS
110 KARYATI INFUS DC
111 SANTI INFUS
112 SITI NUROHIMAH INFUS DC
113 AI LESTARI INFUS
114 ELI INFUS
115 AHMAD INFUS
116 GIO INFUS
117 GIAN INFUS
118 TITIN INFUS DC
119 LITAWATI INFUS
120 MIRA INFUS
121 SUSI INFUS
15/05/2018 122 RINDI INFUS
123 FATIR INFUS
124 NAI INFUS
125 SUCI INFUS
126 INDAH INFUS
127 PIPIT INFUS
128 NANI INFUS
129 ROSITA INFUS
130 NOPI INFUS
131 DEVI INFUS
132 SRI INFUS DC
16/05/2018 133 DESY INFUS
134 CLAIRINE INFUS
135 TINA INFUS
136 IMAS INFUS DC
137 BY NY ELIA INFUS
138 NIA INFUS
139 NURWINDA INFUS
140 IRMA INFUS
141 ANISA INFUS
17/05/2018 142 MARISA INFUS
143 DIAN INFUS DC
144 NENG SARAH INFUS
145 SAKINA INFUS
146 GIBRAN INFUS
147 ALMIRA INFUS
148 NINING INFUS DC
149 TANTRI INFUS
150 ROHIMAH INFUS
151 HELMIANA INFUS
Formulir Survey Harian Pemakaian Alat
Ruang IGD - RSKIA BULAN MEI 2018

01/05/2018 1 ANENG INFUS


2 RIKA INFUS
3 MINI INFUS DC
4 DINI INFUS
5 AGUSTINA INFUS DC
6 MARIAM INFUS
7 LENI INFUS DC
8 NURHALIMAH INFUS
9 RINI INFUS
10 DIAN INFUS
02/05/2018 11 EUIS INFUS DC
12 RIKA INFUS
13 NINING INFUS
14 FIQIH INFUS
15 NIA INFUS
16 SARI INFUS
17 KOKOM INFUS
03/05/2018 18 LILIM INFUS DC
19 TITIN INFUS
20 ELSA INFUS
21 TINI INFUS DC
22 ZAFRAN INFUS
23 MELIS INFUS
24 WINA INFUS
25 WILDAN INFUS
26 PUTRI INFUS
27 NOPI INFUS
28 ADI INFUS
29 INDAH INFUS
30 DIAH INFUS
04/05/2018 31 DEDE INFUS DC
32 AYU ROHIMAH INFUS
33 WIDYA INFUS
34 LENI INFUS DC
35 SUSI INFUS
36 SELI INFUS
37 YUSI INFUS
38 RONA INFUS
05/05/2018 39 IRMA INFUS
40 YANI INFUS
41 SANTI INFUS
42 M JALAL INFUS
43 DEVY INFUS
44 ELISA INFUS DC
45 ALBARTAMA INFUS
46 WINA NINGSIH INFUS
47 IIN INFUS
48 RINA INFUS DC
49 SRI MULYANI INFUS
50 SITI ROHAITI INFUS
06/05/2018 51 SOPIAH INFUS
52 DEWI INFUS
53 SRI INFUS
54 YANE INFUS
55 KUSTIA INFUS
07/05/2018 56 YULIANA INFUS
57 TETI INFUS
58 LINAWATI INFUS
59 SHERLY INFUS
60 IDAH INFUS
61 DEVI INFUS
62 ILOH INFUS
63 MULYANAH INFUS DC
08/05/2018 64 RIMA INFUS
65 NURWITA INFUS
66 MILA INFUS
67 NOLIS INFUS DC
68 DEWI INFUS
69 LASTIKA INFUS
70 TIWI INFUS
71 FITRI INFUS
72 HESTIANA INFUS
73 NURITA INFUS
74 RIZQI INFUS
75 RINA INFUS DC
76 SRI INFUS
09/05/2018 77 ERVA INFUS
78 DWI INFUS
79 IRMA INFUS
80 FITRI INFUS DC
81 FARIZ INFUS
82 SITI INFUS DC
83 MARYATI INFUS
84 YULI INFUS
10/05/2018 85 SUYATI INFUS DC
86 HETY INFUS
11/05/2018 87 NURHAYATI INFUS DC
88 RIANA INFUS
89 EUIS INFUS
90 MARI INFUS
91 FEBI INFUS DC
92 SAPITRI INFUS DC
93 NURHAYATI INFUS
94 ENDANG INFUS
12/05/2018 95 NURFITRIA INFUS DC
96 TETI INFUS DC
97 ZULFA INFUS
98 SITI INFUS
99 EUIS INFUS
100 RENI INFUS
101 DESI INFUS DC
13/05/2018 102 LISNAWATI INFUS
103 SITI HALIMAH INFUS
104 ANJUNGAN INFUS
105 RUMISA INFUS DC
106 NENAH INFUS
107 RIKA INFUS
108 FITRI INFUS
14/05/2018 109 RANI INFUS
110 KARYATI INFUS DC
111 SANTI INFUS
112 SITI NUROHIMAH INFUS DC
113 AI LESTARI INFUS
114 ELI INFUS
115 AHMAD INFUS
116 GIO INFUS
117 GIAN INFUS
118 TITIN INFUS DC
119 LITAWATI INFUS
120 MIRA INFUS
121 SUSI INFUS
15/05/2018 122 RINDI INFUS
123 FATIR INFUS
124 NAI INFUS
125 SUCI INFUS
126 INDAH INFUS
127 PIPIT INFUS
128 NANI INFUS
129 ROSITA INFUS
130 NOPI INFUS
131 DEVI INFUS
132 SRI INFUS DC
16/05/2018 133 DESY INFUS
134 CLAIRINE INFUS
135 TINA INFUS
136 IMAS INFUS DC
137 BY NY ELIA INFUS
138 NIA INFUS
139 NURWINDA INFUS
140 IRMA INFUS
141 ANISA INFUS
17/05/2018 142 MARISA INFUS
143 DIAN INFUS DC
144 NENG SARAH INFUS
145 SAKINA INFUS
146 GIBRAN INFUS
147 ALMIRA INFUS
148 NINING INFUS DC
149 TANTRI INFUS
150 ROHIMAH INFUS
151 HELMIANA INFUS
Ruang Nifas 4 Bulan Februari 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2015 1 NY IIM V V
2 NY YUANITA V
3 NY NUR V
4 NY TRI V
5 NY RIRIN V
6 NY SRI V V
7 NY MEGA V
7 2
02/02/2015 1 NY RAHMAYANI V V
2 NY EMBANG V V
2 2
03/02/2015 1 NY NURJANAH V
2 NY RATNA V
3 NY ELAH V
4 NY NURLINA V
5 NY SUPARNI V
6 NY RIA V
7 NY NINA V V
8 NY RAHMAYANI V
9 NY MEILIA V V
10 NY DEWI V
11 NY YENI V V
12 NY IPAH V V
12 4
04/02/2015 1 NY NOPIANI V V
2 NY SITHIA V
3 NY NENENG V
4 NY SARIDA V
5 NY SITI PUPU V
6 NY ELAH V
7 NY GEUIS V V
8 NY WANDA V
9 NY NINA V V
10 NY MEILIA V V
11 NY EMA V
12 NY YENI V
13 NY ANDRIYANI V
14 NY SITI N V
15 NY ELIS V
15 3 1
05/02/2015 1 NY SITI H V
2 NY YUNENGSIH V V
3 NY LILIS V V
4 NY TRI V
5 NY GEUIS V V
6 NY YENI V V
7 NY MISNAENI V
8 NY ANDRIYANI V
9 NY ELIS V
9 4
06/02/2015 1 NY TINTIN V
2 NY YUNENGSIH V V
3 NY ELAH V
4 NY LILIS V V
5 NY INTAN V V
6 NY TRI V
7 NY GEUIS V
8 NY GUSPRIHATINI V V
9 NY YENI V V
9 5
07/02/2015 1 NY RIA V
2 NY ELAH V
3 NY SITI R V V
4 NY INTAN V V
5 NY RINA V V
6 NY ULFA V
7 NY GUSPRIHATINI V
8 NY SITI N V V
9 NY ANITA V V
9 5
08/02/2015 1 NY YULIANTI V
2 NY SELVIRA V
3 NY LINDA V V
4 NY INTAN V V
5 NY THIA V V
6 NY RINA V
7 NY WATI V
8 NY SITI N V
9 NY HERNI V V
10 NY ANITA V
11 NY RIMA V V
11 5
09/02/2015 1 NY LINDA V V
2 NY THIA V V
3 NY YUPI V V
3 3
10/02/2015 1 NY INNE V V
2 NY RONASIH V
3 NY MEGA V
4 NY THIA V V
5 NY YUPI V V
6 NY ENUNG V
7 NY WINE V
7 3
11/02/2015 1 NY MEGA V
2 NY NELIS V
3 NY THIA V V
4 NY LENI V V
5 NY HEPPY V V
6 NY ITA V
7 NY ENENG V V
8 NY SARMA V V
8 5
12/02/2015 1 NY ASRI V
2 NY MEGA V
3 NY HEPPY V
4 NY LENI V
5 NY SANDRA BUDI V V
6 NY YENI V
7 NY SANDRA DENI V
8 NY ENENG V
9 NY SARMA V V
10 NY INNE V V
10 3
13/02/2015 1 NY SITI GINA V
2 NY MEGA V
3 NY MUKHYATI V
4 NY SRI SUSIANI V
5 NY TITA V
6 NY SINTIA V
7 NY RISA V
8 NY DIAH V V
9 NY SHANDRA V V
10 NY SRI V
11 NY SITI MAYASARI V V
12 NY SARMA V
12 3
14/02/2015 1 LISNA V
2 DETI V
3 MEGA V
4 WINDA V
5 NY RISA V
6 NY TITA V
7 NY SRI V
8 NY DESI V
9 NYEEM V
10 NY SITI M V
11 NY WAWANG V V
11 1
15/02/2015 1 NY MEGA V
2 NY ESA V
3 NY WINDA V
4 NY ELIS V
5 NY PIPIET V
6 NY RISA V
7 NY DIANA V
8 NY DESI V
9 NY NONOK V V
9 1
16/02/2015 1 NY MEGA V
2 NY WINDA V
3 NY NIA V
4 NY SITI N V
5 NY SURYATI V
6 NY DIAN V V
7 NY RIA V V
7 3
17/02/2015 1 NY MEGA V
2 NY OMAH V
3 NY NIA V
4 NY YENI V V
5 NY SURYATI V
6 NY YULI YULIANA V V
7 NY LINA V V
8 NY LELA V V
9 NY SRI S V
10 NY ENENG EEM V
11 NY IKA V
11 5
18/02/2015 1 NY YENI V V
2 NY DWI V
3 NY NITA V
4 NY SURYATI V
5 NY YULI YULIANA V
6 NY SALNI V V
7 NY RIZKIAH V
8 NY LINA V V
9 NY AMALIA V
10 NY LELA V
11 NY ANIH V
11 4
19/02/2015 1 NY SALNI V V
2 NY KENSHA V V
3 NY AMALIA V
4 NY WIWIN V V
4 3
20/02/2015 1 NY QONITA V
2 NY KHENSA V
3 NY NURHAYATI V
4 NY MUTIA V V
5 NY TITA V V
6 NY YULIANTI V V
6 3
21/02/2015 1 NY HENDAYANA V
2 NY WATI V
3 NY MUTIA V
4 NY TITA V
5 NY YULIANTI V
6 NY NURYATI V
6 0
22/02/2015 1 NY YENI V
2 NY YULIANTI V
3 NY NENDAH V
4 NY HANI V V
5 LISNA V
6 IRMA V
7 NY LIA V V
8 NY SUSI V V
9 NY ISTI K V V
10 NY NURYATI V
10 4
23/02/2015 1 NY BANIAH V
2 NY NADIA V
3 NY NENDAH V
4 NY HANI V V
5 NY DINI V
6 NY HILDA V V
7 NY LISNA V
8 NY LIA V
9 NY SUSI V
9 2
24/02/2015 1 NY HANI V
2 SITI V
3 ITA V
4 SRI V V
5 NY PERA V
6 NY LISNA V
7 NY TINI V V
8 NY EMA V
8 2
25/02/2015 1 NY ITA V
2 NY NINA V
3 NY SRI V V
4 NY ISMA V
5 NY LISNA V
6 NY NOVI V
7 NY TINI V V
8 NY HANI V V
9 NY EMA V V
9 4
26/02/2015 1 NY ANI V
2 NY EVI V
3 NY RIFKA V
4 NY NOVI V
5 NY TINI V V
6 NY NURATMI V V v
7 NY LINA V V
8 NY HANI V
8 3 1
27/02/2015 1 NY ROHMENDE V V
2 NY ALIS V
3 NY LASTINA V
4 NY ADE V
5 NY WAHYUNI V V
6 NY RITA V
6 2
28/02/2015 1 NY ROHMENDE V V
2 NY SANTI V
3 NY ALIS V
4 NY ADE V
5 NY FITRI V V
6 NY EVI V
7 NY WAHYUNI V V
8 NY SUNDARI V V
9 9 V V
10 NY RENI V V
11 NY POPON V V
11 7 4

Ruang Nifas 4 Bulan MARET 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2015 1 NY.MARIAH/TN.ANDRI V
2 NY.DEDEH/TN.TEDI V
3 NY.ALIS/TN.KUSMAN V
4 NY.DYNA/TN.DERI V
5 NY.ADE/TN.KOMARA V
6 NY.MINAH/TN.DEDE V V
7 NY.LEAH/TN.ASEP V V
8 NY.MIMIN/TN.KUSNANDAR V
9 NY.TINI/TN.TONO V V
10 NY.WAODE/TN.MAULAU V
11 NY.POPON/TN.NANA V V
11 4
02/03/2015 1 NY.OYANG/TN.BASUKI V
2 NY.LISNAWATI/TN.ODIN V
3 NY.ALIS/TN.KUSMAN V
4 NY.DYNA/TN.DERI V
5 NY.ADE/TN.KOMARA V
6 NY.MINAH/TN.DEDE V V
7 NY.LEAH/TN.ASEP V V
8 NY.ITA/TN.RONI V
9 NY.FITRI/TN.ARI V
10 NY.HESTI/TN.SOLEH V
11 NY.SINTA/TN.YUDI V
12 NY.NINA/TN.AGUS V
13 NY.RHINA/ANWAR V
13 2
03/03/2015 1 NY.OYANG/TN.BASUKI V
2 NY.LISNAWATI/TN.ODIN V
3 NY.DESSY/TN.ANDI V
4 NY.YAYAH/TN.SANDI V
5 NY.NINA/TN.USMAN V V
6 NY.DIANTY/TN.JAJANG V
7 NY.DYNA/TN.DERI V
8 NY.ADE/TN.KOMARA V
9 NY.MINAH/TN.ADE V V
10 NY.LEAH/TN.ASEP V V
11 NY.SENI/TN.AIP V V
12 NY.ATHINA/TN.YONO V
13 NY.HESTI/TN.SOLEH V
14 NY.JUJU/TN.HENHEN V V
15 NY.LUMBAN/TN.ROLLI V V
16 NY.JANEUARDI/TN.RUYADI V
17 NY.TENI/TN.SUTIYONO V
17 6
04/03/2015 1 NY.SITI R/TN.KIKI V
2 NY.SASI/TN.ISMAIL V
3 NY.NINA/TN.USMAN V V
4 NY.DIANTY/TN.JAJANG V V
5 NY.MINAH/TN.DEDE V V
6 NY.DEDEH/TN.RUKMANA V V
7 NY.OKE/TN.RENOLD V V
8 NY.SENI/TN.AIP V
9 NY.RETNO/TN.SUHERMAN V
10 NY.LUMBAN/TN.ROLIS V
11 NY.SUPRIYATI/TN.ZAENAL V V
12 NY.NIA/TN.RAHMAT V V
13 NY.EUIS/TN.AGAN V
13 6 1
05/03/2015 1 NY.DIANTI/TN.JAJANG V V
2 NY.MINAH/TN.ADE V V
3 NY.TOTI/TN.TEDI V
4 NY.OKE/TN.RENOLD V V
5 NY.ATHINA/TN.TONO V
6 NY.TARSINAH/TN.YUDI V V
7 NY.DEDEH/TN.RUDI V
8 NY.NENG TIKA/TN.DEDE V
9 NY.INEU/TN.ENO V V
9 5
06/03/2015 1 NY.FITRI/TN.YADI V
2 NY.DIANTI/TN.JAJANG V V
3 NY.ATHINA/TN.TONO V
4 NY.AAN/TN.OPIK V V
5 NY.TARSINAH/TN.YUDI V
6 NY.DEDEH/TN.RUDI V
7 NY.TIKA/TN.DEDE V
8 NY.INEU/TN.ENO V
9 NY.MIRA/TN.HUSENUDIN V V
9 3
07/03/2015 1 NY.YUYUN/TN.INDRA V
2 NY.AI KARYAWATI/TN.SUTRIMO V
3 NY.EVA/TN.ASEP V
4 NY.CUCU/TN.ASEP V
5 NY.NENI/TN.NOOR WAHYU V
6 NY.AAN/TN.OPIK V
7 NY.ANA/TN.HERMAN V V
8 NY.LINA/TN.ROHDI V V
9 NY.SITI R/TN. DAUD V
9 2
08/03/2015 1 NY.DIAN/TN.DEDE V
2 NY.RIA/TN.ARDI V
3 NY.HANA/TN.RENDI V
4 NY.ISYE/TN.ANDRI V V
5 NY.NENI/TN.NOORWAHYU V
6 NY.ANITA/TN.AHMAD V
7 NY.AAS/TN.TOHA V
8 NY.ANA/TN.HERMAN V
9 NY.LINA/TN.ROHDI V
10 NY.YUPI/TN.DONI V V
11 NY.SITI R/TN.DAUD V
11 2
09/03/2015 1 NY.RIA/TN.ARDI V
2 NY.MIMIN/TN.IKIN V
3 NY.YAYUK/TN.AMRON V
4 NY.IMAS/TN.MISBAH V V
4 1
10/03/2014 1 NY.EVI/TN.HERI V
2 NY.NEPI/TN.SULAEMAN V
3 NY.R.KARTINI/TN.ASEP V V
4 NY.DEWI/TN.WIDI V
4 1
11/03/2015 1 NY.NEPI/TN.SULAEMAN V
2 NY.ICA/TN.MIFTAH V
3 NY.NUREVA/TN.RIKI V
4 NY.VINI/TN.ERI V
5 NY.R.KARTINI/TN.ASEP V
6 NY.SITI.H/TN.NEFRI V V
7 NY.YULI/TN.YUDITA V
8 NY.NIA/TN.DENI V V
9 NY.WIDA/TN.UUS V V
10 NY.LIA/TN.ERIK V V
11 NY.LIA/TN.ALE V V
11 5
12/03/2015 1 NY.NUR ASHRIAN/TN.M.DEFFI V
2 NY.DINNY/TN.INDRA V
3 NY.VINI/TN.ERI V
4 NN.WENI V
5 NY.SITI.H/TN.NEFRI V V
6 NY.NIA/TN.DENI V V
7 NY.WIDA/TN.UUS V V
8 NN.NURI V V
9 NY.LIA/TN.ALE V
10 NY.NUREVA/TN.RIKI V
10 4
13/03/2015 1 NY.ENDAH/TN.M.SAFI'I V
2 NY.ADE/TN.ASEP V
3 NY.NURI/TN.ENGKOS V
4 NY.JAZIARTI/TN.ADIT V V
5 NY.AYU MEGA/ V
6 NY.CINTA/TN.ASEP V
6 1
14/03/2015 1 NY.LILIS/TN.DEDE V V
2 NY.SITI N/TN.APIPUDIN V V
3 NY.LILIS/TN.IMAN V V
4 NY.LINDA/TN.ASEP V V
5 NY.ENDAH/TN.SAFI'I V V
6 NY.DORA/TN.REDI V
7 NY.CITA/TN.ASRIKO V
8 NY.RISKA/TN.CAHYA V V
8 6
15/03/2015 1 NY.RISKA/TN.CAHYA V
2 NY.ENDAH/TN.M.SAFI'I V
3 NY.ITA.F/TN.SAEFULLAH V
4 NY.LILIS/TN.DODO V
5 NY.YANTI/TN.ADE V V
6 NY.RENI/TN.TOTONG V V
7 NY.FADIAH/TN.FIRDAUS V V
8 NY.NOVI P/TN.BURHANUDIN V
9 NY.ATIK/TN.ARIYO V
10 NY.KARSIANTI/TN.PARMAN V
11 NY.CITA/TN.ARTIKO V
12 NY.ROSMAULINA/TN.TIODORIS V
13 NY.SINTA/TN.BUDI V
14 NY.NOVITA/TN.DEDE V V
14 4
16/03/2015 1 NY.NOVITA/TN.DEDE V V
2 NY.ITA/TN.SAEFULLAH V
3 NY.RUSDY/TN.EPI V
4 NY.YANTI/TN.ADE V V
4 2
17/03/2015 1 NY.ROSDY/TN.EPI V
2 NY.SRI/TN.ADING V
3 NY.ATIK/TN.ARIYO V V
4 NY.ELI/TN.MUHTAR V
5 NY.SUMANAH/TN.JAJANG V V
6 NY.ERNA/TN.TONI V
7 NY.ASTRI/TN.ANTO V
8 NY.MILA/TN.ADITYA V
9 NY.IMAS/TN.NANA V V
10 NY.TATI/TN.YUSNADI V
11 NY.RINI/TN.FERI V
12 NY.DIAN/TN.DIDO V
13 NY.VERAWATY/TN.RUDI V
14 NY.DEWI/TN. V
15 NY.RANITA.TN.SETIA V
16 NY.ENIH/TN.AHMAD V V
17 NY.DIAN/TN.DIDO V
17 4
18/03/2015 1 NY.ENIH/TN.AHMAD V
2 NY.ETI/TN.USMAN V
3 NY.TUTI/TN.AHMAD V V
4 NY.ALIDA/TN.NIRMAN V
5 NY.SARI/TN.YUYU V V
6 NY.SUMANAH/TN.JAJANG V V
7 NY.ATIK/TN.ARIYO V
8 NY.KERIN/TN.ALAM V V
9 NY.SANTI/TN.DIAN V
10 NY.DERI/TN.FARID V
11 NY.IMAS/TN.TIARA V
12 NY.FARAH/TN.DONI V V
13 NY.NINGRUM/TN.DEDE V V
14 NY.SITI/TN. V
15 NY.ELISABETH/TN.TUBAGUS V
15 6
19/03/2015 1 NY.ATIK/TN.ARYO V
2 NY.KERIN/TN.ALAM V
3 NY.IMAS/TN.TIARA V V
4 NY.FARAH/TN.DONI V
5 NY.THIA/TN.ASEP V
6 NY.TUTI/TN.AHMAD V V
7 NY.ALIDA/TN.NIRMAN V V
7 2
20/03/2015 1 NY.ALIDA/TN.NIRMAN V
2 NY.ENTIN/TN.YOPIANA V V
3 NY.PAUDJIAH/TN.ARI V
4 NY.CAHYATI/TN.DEDI V V
5 NY.ATIK/TN.ARYO V V
6 NY.ELIS/TN.ASEP V
7 NY.SITI A/TN.IWAN V
8 NY.NOVITASARI/TN.M.RIDWAN V
9 NY.TINI/TN.DESTI V
10 NY.ROSMAYANI/TN,HARI V
11 NY.THIA/TN.ASEP V
11 3
21/03/2015 1 NY.SOFIA/TN.SAEFUL V
2 NY.ENTIN/TN.YOPIANA V
3 NY.PAUJIAH/TN.ARI V
4 NY.NUNUNG/TN.ZULKIFLI V
5 NY.CAHYATI/TN.DEDI V
6 NY.IKEU/TN.IYAN V V
7 NY.CHOSIMAH/TN.MUTINI V
8 NY.ATIK/TN/ARYO V V
9 NY.ELA/TN.AGUS V
10 NY.SHINTAMI/TN.YAYAT V
11 NY.NOVITASRI/TN.RIDWAN V
12 NY.CAHYATI/TN.DEDI V
13 NY.ANISA/TN.ANDRI V
14 NY.FAUZIAH/TN.ARI V
14 2
22/03/2015 1 NY.ENI/TN.ACE V
2 NY.SANTI/TN.DODO V
3 NY.TESYA/TN.FIRMANSYAH V
4 NY.RAHAYU/TN.ENDANG V
5 NY.IDA/TN.ROHMAT V
6 NY.CAHYATI/TN.DEDI V
7 NY.ANISA/TN.ANDRI V
8 NY.KURAESIN/TN.ODANG V
9 NY.FIRA/TN.BUDI V
9
23/03/2015 1 NY.ADE/TN.ARIP V
2 NY.WULAN/TN.RISTANTO V
3 NY.NUNUNG/TN.ARIF V
4 NY.SUSI/TN.DIYAN V
5 NY.ENI/TN.ACE V
6 NY.CAHYATI/TN.DEDI V
7 NY.ANISA/TN.ANDRI V
7
24/03/2015 1 NY.ELAH/TN.KARNA V V
2 NY.SUPRIYATI/TN.DADA V V
3 NY.SITI/TN.ASEP V
4 NY.EUIS/TN.ATOR V V
5 NY.ICAH/TN.ADI V V
6 NY.SITI/TN.ASEP V
6 4
25/03/2015 1 NY.CAHYATI/TN.DEDI V
2 NY.ETIN/TN.BAGUS V
3 NY.SRI/TN.ARDAN V
4 NY.IIM/TN.IWAN V
5 NY.SITI MARIAM/TN.DADAN V V
6 NY.RINI/TN.YOSEP V
7 NY.ELAH/TN.KARNA V
8 NY.SUPRIYATI/TN.DADA V
9 NY.EUIS/TN.ATOR V
10 NY.ICAN/TN.ADI V V
11 NY.RUMANDANG/TN.RUDOL V V
12 NY.RIRIN/TN.TAOFIK V V
12 4
26/03/2015 1 NY.YUNI/TN.SUROHMAT V
2 NY.SANNY/TN.ANGGARA V
3 NY.RUMANDANG/TN.RUDOL V
4 NY.RIRIN/TN.TAUFIK V
5 NY.SRI R/TN.JAMALAH V V
5 1
27/03/2015 1 NY.IRESTU/TN.DADANG V
2 NY.SRI/TN.JAMALAH V V
3 NY.SUNDARYATI/TN.SUGINO V
4 NY.LINDA/TN.ASEP V V
5 NY.EUIS/TN.SHIDIQ V
6 NY.SARI/TN.BAMBANG V
7 NY.LILIS/TN.ZENI V
7 2
28/03/2015 1 NY.TATIK/N.SAHUDI V V
2 NY.YUNI/TN.SUDARYANTO V V
3 NY.SARI/TN.BAMBANG V
4 NY.IYAR/TN.ROHANAH V
5 NY.IRESTU/TN.DADANG V
6 NY.EKA/TN.YUSUP V V
6 3
29/03/2015 1 NY.EKA/TN.YUSUP V
2 NY.TATIK/TN.SAHUDI V
3 NY.YUNI/TN.SUDARYANTO V
4 NY.NANI/TN.EKI V
5 NY.INA/TN.SARAN V
6 NY.IHAT/TN.YAYAT V V
7 NY.KHASANAH/TN.ABDULLAH V V
8 NY.DINI/TN.ANDRIYANA V
9 NY.FISCHA/TN.M.RAMDHAN V
9 2
30/03/2015 1 NY.INA/TN.SARAN V
2 NY.IHAT/TN.YAYAT V
3 NY.KHASANAH/TN.ABDULILLAH V
4 NY.EPI/TN.WAHYUDIN V
5 NY.SAGITA/TN.HADI V
6 NY.WULAN/TN.UMAR V
7 NY.WIWIN/TN.RIANA V
8 NY.PUJA/TN.M.IRFAN V
9 NY.ANISA/TN.ANDRI V
10 NY.DEVI/TN.ADI V
10
31/03/2015 1 NY.YUNI/TN.YAYANG V
2 NY.RESTI/TN.YADI V
3 NY.INA/TN.SARAN V
4 NY.NENENG/TN.KUSMWAN V V
5 NY.RISKA/TN.ARI V
6 NY.TITA/TN.UMAR V
7 NY.ELI/TN.ALI V V
8 NY.DEWI/TN.SUDIRMAN V V
9 NY.AZIMAH/TN.KRISTIYANTO V
10 NY.WULAN/TN.UMAR V V V
11 NY.PUJA/TN.M IRFAN V
12 NY.DEVI/TN.ADI V
12 3 2

300 90 2 3
RUANG IRNA 3 BULAN JANUARI 2016
TANGGAL NO NAMA ETT IVL UC ISK FLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/01/2016 1 ny rini v v
2 ny sugandini v v
3 ny wulandari v v
4 ny teni v
5 ny komalsari v
6 ny kaniati v
7 ny ratmah v
8 ny yulianti v
9 ny neng sukma v
9 3
02/01/2016 10 ny kaniati v
11 ny pitri v v
12 ny dasri v v
13 ny santi v
4 2

03/01/2016 14 ny kaniati v
15 ny pitri v
16 ny dasri v v
17 ny segi v
4 1
04/01/2016 18 ny wati v v
19 ny purwanti v v
20 ny yani v v
21 ny kaniati v
22 ny cristin v v
23 ny pitri v v
24 ny dasri v v
25 ny popon v v
26 ny fina v v
27 ny wulansari v v
05/01/2016 28 ny popon v
29 ny yani v v
30 ny dedeh v v
31 ny rini v v
32 ny fina v v
33 ny wulansari v v
34 ny purwati v
35 cristin v
36 ny ate v
37 ny fitri v
38 ny evi v
39 ny wati v
12 5
06/01/2016 40 ny.Ida v
41 ny. Siska v
42 ny.Reni v v
43 ny. Rani v
44 ny.Kartika v
45 ny.Evi v
6 1
07/01/2016 46 ny leni v
47 ny nia v
48 ny mimin v v
49 ny reni v v
50 ny sumarni v v
51 ny uun v
52 ny kartika v v
7 4
08/01/2016 53 ny ipah v v
54 ny nia v v
55 ny enung v v
56 ny titing v
57 ny tesa v
58 ny faurani v
59 ny rindi v
7 3

09/01/2016 60 ny ai siti v
61 ny upik v v
62 ny winda v
63 ny epon v
64 ny ipah v v
65 ny eneng v
66 ny ina v v
67 ny enung v v
68 ny titing v v
69 ny rindi v
10 5
10/01/2016 70 ny. Nia v
71 ny.Septia v
72 ny.Rezty v v
73 ny. Olis v v
74 ny. Eneng v
75 ny.Hani v
76 ny.Ismi v
77 ny.Ina v v
78 ny. Yulianur v
9 3
11/01/2016 79 ny.Septia v
80 ny. Olis v v
81 ny. Maesaroh v
82 ny. Yulianur v
4 1
12/01/2016 83 ny.Septia v
84 ny.Mirnawati v
85 ny.Nolis v v
86 ny. Evi v
87 ny.Ria v
88 ny.Hera v
89 ny.Risma v
90 ny.Nepi v
91 ny. Yuli v
9 - 1
13/01/2016 92 ny wiwin v v
93 ny hani v v
94 ny imas v v
95 ny ria v
96 ny dode v
97 ny risma v
98 ny rindi v
99 ny pitriah v v
7 4 1
14/01/2016 100 ny wiwin v
101 ny warsinah v v
102 ny yayang v
103 ny herlina v
104 ny lisnawati v v
105 ny endah v v
106 ny erlita v
107 ny eneng v
108 ny elis v
109 ny melani v v
110 ny maya v
111 ny rindi v
112 ny pitriah v
113 ny rina v v
13 6
15/01/2016 114 ny. Warsinah v
115 ny.Yayang v
116 ny. Warsinah v
117 ny. Endah v v
118 ny.Putri v v
119 ny.Melani v v
120 ny. yati v v
121 ny.Maya v
122 ny. Rindy v
123 ny. Rina v
10 4
16/01/2016 124 ny. Tiawati v
125 ny.Neng Windan v
126 ny. Rindy v
3
17/01/2016 127 ny.Tiawati v
128 ny.neng Windan v
129 ny. Evi v
130 ny.Fitri v
131 ny. Rindy v
5 -
18/01/2016 132 ny.Wawat v
133 ny.Winni v
134 ny.Evi v
3
19/01/2016 135 ny cucu v v
136 ny fitri v
137 ny wini v v
138 ny susilawati v
139 ny aam v v
140 ny nining v v
141 ny rahayu v v
142 ny aas v v
143 ny fauziah v v
144 ny rindi v
145 ny neneng v v
146 ny yuliani v v
12 9

20/01/2016 147 ny rindi v


148 ny santi v
149 ny dede v
150 ny ratna v v
151 ny nina v v
152 ny ismi v
153 ny fitri v
154 ny ima v v
8 3

21/01/2016 155 ny ratna v v


156 ny ismi v
157 ny susanti v v
158 ny fitri v
159 ny ima v v
160 ny dede v
161 ny rindi v
7 3
22/01/2016 162 ny ismi v
163 ny tuti v v
164 ny neni v
165 ny yeni v
166 ny sutiah v v

23/01/2016 167 ny cucu v v


168 ny lilis v v
169 ny ismi v v
170 ny nely v v
171 ny neni v v
172 ny pipit v
173 ny rini v v
174 ny sutiah v v
175 ny yulia v v
176 ny leni v v
177 ny eka v
178 ny rindi v
179 ny lena v v
13 10

24/01/2016 180 ny cucu v


181 ny yulia v
182 ny ismi v
183 ny yufi v
184 ny lena v
185 ny siti r v
186 ny tika v
187 ny iis v v
8 1
25/01/2016 188 ny imas v
189 ny hesti v
190 ny ismi v
191 ny yufi v
192 ny iis v v
5 1
26/01/2016 193 ny ismi v
194 ny aan v
195 ny novi v v
196 ny.Lulu v v
4 2
27/01/2016 197 ny.IIm v v
198 ny.Cacih v v
1 1
28/01/2016 199 ny. Ati Fitria v
200 ny. Siti Rokayah v
201 ny.Sutiah v
202 ny. Idah v
203 ny. Siti Fatimah v v
204 ny.Iim v
205 ny.Sri v
206 ny. Neng Susanti v
207 ny.Sugiyanti v
208 ny.Neneng v
209 ny. Siska v v
11 2

29/01/2016 210 ny siti r v


211 ny sutiah v v
212 ny diana v
213 ny santi v
214 ny nelly v v
215 ny linda v v
216 ny sugianti v
217 ny rusmiati v v
218 ny annisa v
219 ny nia v v
220 ny rini v v
11 6

30/01/2016 221 ny siti r v


222 ny sutiah v
223 ny linda v
224 ny iatnawati v v
225 ny nelli v
226 ny annisa v
227 ny nia v v
228 ny rini v v
8 3
31/01/2016 229 ny susi v v
230 ny siti r v v
231 ny husnul v
232 ny tika v
233 ny solihah v v
234 ny novi v
235 ny nurhayati v v
236 ny rani v v
237 ny iatnawati v
238 ny rini v
10 5 1 1

RUANG IRNA 3 BULAN Februari 2016


TANGGAL NO NAMA ETT IVL UC ISK FLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/02/2016 1 ny.Husnul v
2 ny. Tika v
3 ny.Solihah v
4 ny.Susi v
5 ny. Denoviani v
6 ny.Fitri v
7 ny.Novi v v v
7 1 1
02/02/2016 8 ny.Siti Maryam v
9 ny.Husnul v
10 ny.Tika v
11 susi v v
12 ny.Denoviani v
13 ny.Fitri v
14 ny.Novi v
15 ny.Liska v
16 ny.Yanti v
9 1
03/02/2016 17 ny santi v
18 ny siti v
19 ny irmawati v
20 ny vera v
21 ny novi v
22 ny liska v v
23 ny eti v
24 ny ari v
8 1
04/02/2016 25 ny. Sherly v
26 ny. Irmawati v
27 ny. Nurjannah v
28 ny. Setiawanti v
29 ny.Ina v v
5 1
05/02/2016 30 ny. Lilis v
31 ny. Sherly v
32 ny. Ina v v
33 ny. Siti F v v
34 ny. Eli v
35 ny. Novi v
36 ny.Feny v
37 ny.Nurjannah v v
38 ny. Setiawanti v
39 ny.Ari v
06/02/2016 10 3
40 ny.Elly v v
41 ny.Ervina v
42 ny.Marni v v
43 ny. Dede v
44 ny. Asih v
45 ny. Novi v
46 ny. Cucu v v
47 ny.Penny v v
48 ny.Evi v
9 4
07/02/2016 49 ny. Ervina v v
50 ny. Marni v v
51 ny. Risnawati v
52 ny.Asih v v
53 ny.Sany v
54 ny.Novi v
55 ny.siti Rohmah v v
56 ny.Samia v
57 ny.Atri v
9 4
08/02/2016 58 ny.Marni v v
59 ny. Nurasidah v
60 ny. Novi v
61 ny.Lilis v
62 ny.Mimin v
63 ny. Atri v
6 1
09/02/2016 64 ny.Marni v
65 ny. Nurasidah v
66 ny. Novi v
67 ny.Mimin v
68 ny.Atri v

10/02/2016 69 ny setiawati v
70 ny erni v
71 ny novi v
72 ny mimin v v
73 ny lilis v
74 ny.Siti Komariah v
75 ny.Nurosyidah v
7 1
11/02/2016 76 ny.Hani v
77 ny.Imi v
78 ny.Yenyen v
79 ny.Imas v
80 ny.Mimin v
81 ny.Ai v
82 ny.Samirah v v
7 1
12/02/2016 83 ny.Eulis v
84 ny.Samirah v v
85 ny. Usi v
86 ny. Wati v v
87 ny. Nita v
88 ny. Yeyen v v
89 ny. Rr Amalia v
90 ny.Atikah v
91 ny.Sugiarti v v
92 ny.Shitiawati v v
93 ny.Liya v
11 5
13/02/2016 94 ny.Susanti v
95 ny. Fani v
96 ny.Kursinah v v
97 ny. Lena v
98 ny.Atikah v
99 ny.Shintiawati v v
100 ny.eneng Yati v
101 ny.Liya v
8 2
14/02/2016 102 ny. Susanti v
103 ny. Fani v
104 ny.Ina v v
105 ny. Novi v v
106 ny. Lena v
107 ny.Debi v v
108 ny.Riska v
7 3
15/02/2016 109 ny.Tusilawati v
110 ny.Tuti v v
2 1
16/02/2016 111 ny. Tusilawati v
112 ny.Wastinah v
113 ny. Tati v
114 ny.Yanti v
115 ny. Anis v
116 ny. Cucu v
117 ny.Pupun v
7
17/02/2016 118 ny. Reni v
119 ny. Rini v
120 ny. Sriningsih v
121 ny.Wastinah v
122 ny. Tati v v
123 ny. Shinta v v
124 ny. Yeti v
7 2
18/02/2016 125 ny. Mala v
126 ny. Rini v v
127 ny. Siti Rodiah v
128 ny.Shinta v v
129 ny. yeti v v
130 ny.Nur Rohaeti v
131 ny.Sulastri v
132 ny. Sri Wahyuni v
133 ny. Hastuti v
9 3
19/02/2016 134 ny.Rahmawati v
135 ny. Mala v v
136 ny. Karyati v
137 ny. Siti Umu Kulsum v
138 ny. Yeni v
139 ny. Desi v
140 ny.Mirawati v
141 ny. Yeti v
142 ny. Sri Wahyuni v
9 1
20/02/2016 143 Ny. Mala v v
144 Ny. Ida v
145 Ny. Stefani v
146 Ny. Tini v v
4 2

21/02/2016 147 ny mala v v


148 ny neni v
149 rina v v
150 ny susi v
151 ny heni v v
152 ny ida v
153 ny yanti v v
154 ny rosmawati v
155 ny mila v
156 ny lindawati v
157 ny rima v v
11 5

22/02/2016 158 ny mila v


159 ny lindawati v
160 ny iis f v v
161 ny rima v
162 ny yanti v
163 ny mala v v
164 ny heni v
165 ny iis f v v
8 3
23/02/2016 166 ny. Siti Rokayah v
167 ny. Mala v v
168 ny. Heni v
169 ny. Iis v
170 ny. Vina v v
171 ny. Iya v v
172 ny. Iis v
8 3
24/02/2016 173 ny. Siti Maryam v
174 ny. Sri Mulyani v
175 ny. Lina v
176 ny. Sumarti v
177 ny. Mimin v
5
25/02/2016 178 ny. Siti Rohaeni v
179 ny.Yuyun v
180 ny.Siti Maryam v v
181 ny.Sri Mulyani v
182 ny.Lina v
183 ny. Sumarti v v
184 ny. Mala v
185 ny. Mimin v
8 2
26/02/2016 186 ny.Lina v v
187 ny. Mala v
188 ny. Suryaningsih v v
189 ny. Dian v v
190 ny. Rahma v
5 3
27/02/2016 191 ny. Meli v v
192 ny. Depi v v
193 ny. Cacih v v v
194 ny. Tuti v v
195 ny. Mala v
196 ny. Suryaningsih v
197 ny. Ade Mimin v v
198 ny. Rahma v
199 ny.Wina v
9 4 2
28/02/2016 200 ny. Cacih v
201 ny. Sonata v v
202 ny.Agustin v v
203 ny. Fitriani v
204 ny.Dewi v
205 ny.Rahma v
206 ny.Ani v
7 2
29/02/2016 207 ny. Dinda v
208 ny.Rina v
209 ny. Agustin v
210 ny. Rahma v
4
206 56 `1 3

RUANG IRNA 3 BULAN MARET 2016


TANGGAL NO NAMA ETT IVL UC ISK FLEBITIS VAP HASIL KULTUR KETERANGAN KETERANGAN KETERANGAN
01/03/2016 1 NY. Leni v
2 NY. Yayang v
2
02/03/2016 3 ny suryani v v
4 ny ita v
5 ny yulli v v
6 ny ratnawati v
7 ny rosita v
8 ny susilawati v v
9 ny leni v
7 3
03/03/2016 10 ny yulli v
11 ny mimin v
12 ny egi v
13 ny fitri v
14 ny yenni v
15 ny lastri v v
16 ny mia v v
17 ny titin v v
18 ny rosita v
19 ny susilawati v v
20 ny suryani v
11 4
04/03/2016 21 ny rini v v
22 ny wawat v v
23 ny suryani v v
24 ny danisme v v
25 ny rina v
26 ny heni v v
27 ny titin v v
28 ny vera v v
29 ny yulli v
30 ny mimin v
31 ny yeni v v
11 8

05/03/2016 32 ny mimin v
33 ny emi v
34 ny wiwi v
35 ny yeni v v
36 ny nuraisyah v
37 ny vera v
38 ny suryani v v
39 ny danisme v v
8 3

06/03/2016 40 mimin v
41 juju v
42 ratna v v
43 vina v v
44 erna v v
45 wiwi v
6 3

07/03/2016 46 yayah v v
47 neni v
48 rohaeni v v
49 melli v v
50 vera v
51 novianti v v
52 mimin v
7 4

08/03/2016 53 mila v v
54 erna v
55 meli v v
56 novianti v
4 2

09/03/2016 57 melli v
58 ane v v
59 lindawati v
60 mila v
61 erna v
5 1
10/03/2016 62 Melli v
63 Mirna v
64 Rohimas v
65 Lindawati v
66 Avon v
5

11/03/2016 67 melli v
68 adelva v
69 ina v
70 tina v
71 rika v
72 fitri v
73 rohimas v v
74 dini v
8 1
12/03/2016 75 Melly v
76 Adelva v
77 Neni v v
78 Tina v
79 Sartikasri v
80 Rohimas v
81 Lia v
82 Yayah v
83 Kania v
84 Nuraisyah v v
85 Reni G v
11 2
13/03/2016 86 Melly v v
87 Reni v v
88 Rohimas v
89 Kokom v
90 Nina v
91 Yayah v
5 2 1
14/03/2016 92 Melly v
93 Kokom v
94 Rohimah v
95 Kania v
96 Yulianti v
5
15/03/2016 97 melli v
98 rina v
99 rohimas v v
100 nina v v
101 ika v
102 shinta v v
6 3
16/03/2016 103 ny melli v
104 yani v v
105 hani v
106 ani v
107 rika v
5 1
17/03/2016 108 endang v v
109 mariam v
110 yani v
111 ningrum v v
112 fitriyani v
113 ria v
114 melli v
115 irma v
116 yuli v
117 sri ningsih v
118 ani v
11 2

18/03/2016 119 yoyoh v v


120 yuli v
121 sriningsih v
122 aat v
123 herawati v
124 meli v
125 suprianti v
126 siti merlina v
127 siti mulyani v
128 endang v v
129 yani v
130 ningrum v v
131 yeni v
132 ria v
14 3 1

19/03/2016 133 melli v


134 suprianti v
135 siti merlina v
136 siti mulyani v
137 endang v
138 ningrum v v
139 yeni v
140 yuli v
141 aat v
142 herawati v
10 1
20/03/2016 143 nurhayati v v
144 yuli v
145 atriani v v
146 mira v v
147 siti nurmala v
148 herawati v
149 ema v
150 yani v
151 ningrum v v
152 yeni v
153 meli v
154 imas v
12 4

21/03/2016 155 melli v


156 rika v
157 yani v
158 yeni v
159 atri v v
160 nurhayati v v
161 yuli v
162 fitriani v v
163 siti nurmala v
164 herawati v
10 3

22/03/2016 165 melli v


166 rika v
167 yani v
168 yani v
169 atri v
170 yuli v
171 fitri v
172 siti nurmala v
8
23/03/2016 173 Meli v
174 Rika v
175 Ai KAryati v
176 Yeni v
177 Astri v
178 Siti Nurmala v
6
24/03/2016 179 Melly v
180 Sri Andriani v
181 Rika v v
182 Astri v
183 Nabilah v
184 Eneng Yani v
185 Shintia v
7 1
25/03/2016 186 Melly v
187 Sri Andriani v
188 Nabilah v
189 Ani v
190 Junairah v
5
26/03/2016 191 Sri Andriani v
192 Susi V V
193 Ratna Sari v v
194 Ani v
195 Junairah v
5 2
27/03/2016 196 herawati v v
197 hamidah v
2 1

28/03/2016 198 elis v


199 yeni v
200 herawati v
201 irma v
202 iis saripah v v
203 hamidah v
204 rini v v
7 2
29/03/2016 205 susi v
206 puji v v
207 elis v
208 yeni v v
209 hani v v
5 3

30/03/2016 210 tati v v


211 atri v v
212 ade v v
213 puji v
214 susi v
215 fitri a v v
216 rosanah v v
217 elis m v
218 fitria v v
9 6

31/03/2016 219 fitria v


220 suwartini v
221 erlina v
222 nurjanah v v
223 yati v v
224 nenden v v
225 tati v
226 rina v v
227 atri v v
228 ade v
10 5
228 70 1 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2016


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 1 Rina v v
2 Diana v
3 Atri v v
4 Yosi v
5 Erlina v
6 Yani v
7 Nenden v
8 Sunengsih v
8 2
02/04/2016 9 Atri v
10 Diana v
11 Yosi v
12 Yani v
13 Susanti v v
14 Iis v
6 1
03/04/2016 15 Febi v
16 Aisah v
17 Puji v
18 Vina v v
19 Susanti v v
20 Ai Nani v
21 Iis v
7 2
04/04/2016 22 Aisah v
1
05/04/2016 23 Rini v v
24 Ayu v
25 Aisyah v
26 Iis v
27 Siti v
28 Enung v
6
06/04/2016 29 ayuniah v v
30 rini v v
31 siti masitoh v
32 iin v
33 ratna sari v
34 neni v
35 evi v v
36 novi v
37 stefani v
9 3
07/04/2016 38 rini v v
39 tini v
40 dede v v
41 stefani v
42 suliyati v v
43 elitasari v
6 3

08/04/2016 44 empu v
45 tini v
46 siti k v
47 reni v
48 ucu v v
49 rosi v v
50 gilang v v
51 santi v
52 elitasari v
9 3
09/04/2016 53 Karnati v
54 Tini v
55 Ati v
56 Siti Nurjamilah v
57 Reni v
58 Ucu v
59 Gina v
60 Rosi v
8
10/04/2016 61 Any v
62 Tini v
63 Rika v
64 Yuyun v
4
11/04/2016 65 Ani v
66 Enis v
67 Nena v
68 Pipih v
69 Ita v v
70 Lia v
71 Anisina v
7 1
12/04/2016 72 Eva v
73 Ani v
74 Sri v v
75 Nena v
76 Yeni v
77 Pipih v v
78 Eka v
79 Imas v
80 Susi v
81 Ulfah v
9 3
13/04/2016 82 Srimulyani v
83 Sri Ningsih v
84 Elis v
85 Yeni v
86 Eka v
87 Astri v v
88 Fitri v
89 Ulfah v
90 Nani v
8 2
14/04/2016 91 Sri endang v v
92 Sri M v
93 Neng Lisda v
94 Sri Ningsih v v
95 Elis v v
96 Sri W v
97 Hera v
98 Fitri v v
99 Eli v
100 Yuli
101 Eka v v
102 Lia v v
103 Astri v v
11 7 1
15/04/2016 104 Herawati v
105 Fitri v
106 Sri Endang v v
107 Sri M v
108 Neng Lisda v
109 Sri Ningsih v
110 Syamsiah v
111 Sri W v
112 Hasanah v v
113 Yuli v
114 Eka v v
115 Lia v v
116 Astri v v
11 6 1
16/04/2016 117 Hasanah v
118 yuli v
119 Lia v
120 Sri M v
121 Neng Lisda v
122 Sri W v
123 Ai Atikah v
124 Dewi v
125 Desi v v
7 3
17/04/2016 126 Liana v v
127 Ajeng v
128 Silma v v
129 Ulfah v v
130 Neng Lisda v
131 Sri M v
132 Wini v
133 Sri W v v
134 Hasanah v
135 Lia v v
10 5
18/04/2016 136 Yulia v v
137 Sri M v
138 Neng Lisda v v
139 Liana v
140 Wini v v v
141 Yulianti v v
142 Reni v v
143 Tini v
8 5 1
19/04/2016 144 Efi v v
145 Reni v
146 Aprilia v
147 Sri M v
148 Neng Lisda v
149 Wini v v v
6 2 1
20/04/2016 150 Evie v
151 Leni v v
152 Wini v v
153 Efi v v
4 3
21/04/2016 154 efi v v
155 neneng v v
156 rika v v
157 mardeliati v
158 evie v v
159 yanti v v

22/04/2016 160 neneng v


161 suryati v v
162 cicih v
163 rika v v
164 herni v v
165 evie v v
166 nunung v
167 yanti v v
168 aida v
169 siti n v v

23/04/2016 170 yanti v v


171 aida v v
172 siti n v
173 nia v
174 rika v v
175 elis v v
NB : t Lastri maaf kembali ke NIFAS 3 2016 ya ini buat copy z ;)
Ruang Nifas 3 JANUARI 2018
Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 4 3
2 4 1
3 8 4
4 10 7
5 5 3
6 5 1
7 4 2
8 5 4
9 5 3
10 9 4
11 11 8
12 9 4
13 8 5
14 6 4
15 6 3
16 8 6
17 6 5
18 9 6
19 9 4
20 8 5
21 4 4
22 6 5
23 11 8
24 7 4
25 9 6
26 5 2
27 7 6
28 3 1
29 3 0
30 4 0
31 3 0
JUMLAH 201 118

Jumlah Pasien Ibu dalam kota 193 orang


Jumlah Pasien Ibu luar kota 37 orang
Jumlah Pasien bayi dalam kota 103 orang
Jumlah Pasien bayi luar kota 21 orang

Ruang Nifas 3 FEBRUARI 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 7 5
2 6 3
3 4 2
4 4 3
5 5 3
6 5 4
7 7 2
8 9 5
9 8 3
10 9 4
11 8 5
12 10 5
13 7 4
14 5 4
15 5 1
16 7 4
17 5 3
18 7 2
19 7 0
20 5 0
21 7 4
22 8 5
23 10 7
24 7 7
25 4 2
26 4 3
27 2 4
28 5 4
29
30
31
JUMLAH 177 98

Jumlah Pasien Ibu dalam kota 164 orang


Jumlah Pasien Ibu luar kota 42 orang
Jumlah Pasien bayi dalam kota 79 orang
Jumlah Pasien bayi luar kota 22 orang

Ruang Nifas 3 MARET 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 12 7
2 8 6
3 8 6
4 4 1
5 3 1
6 6 2
7 10 7
8 8 1
9 5 2
10 3 2
11 8 6
12 7 1 1
13 7 4 1
14 6 3
15 9 4
16 4 2
17 9 4
18 4 2
19 3 1
20 6 4
21 8 2
22 8 3
23 7 4
24 10 6
25 3 2
26 5 2
27 6 5
28 6 3
29 4 2
30 4 2
31 3
JUMLAH 194 97 2

Jumlah Pasien Ibu dalam kota 196 orang


Jumlah Pasien Ibu luar kota 36 orang
Jumlah Pasien bayi dalam kota 107 orang
Jumlah Pasien bayi luar kota 24 orang

Ruang Nifas 3 APRIL 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 6 0
2 5 1
3 7 4
4 8 4
5 10 7
6 9 7
7 8 3
8 11 4
9 3 2
10 6 4
11 8 5
12 11 6
13 6 3
14 5 1
15 5 2
16 4 3
17 6 5
18 10 3
19 10 7
20 2 2
21 6 4
22 2 1
23 3 1
24 8 5
25 6 2
26 6 3
27 10 7
28 8 5
29 2 1
30 4 0
31
JUMLAH 195 102

Jumlah Pasien Ibu dalam kota 218 orang


Jumlah Pasien Ibu luar kota 41 orang
Jumlah Pasien bayi dalam kota 109 orang
Jumlah Pasien bayi luar kota 23 orang

Ruang Nifas 3 MEI 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 4 2
2 7 3
3 8 5
4 6 4
5 10 3
6 6 5
7 6 2
8 4 4
9 8 2
10 11 9
11 1
12 3 2
13 6 6
14 6 3
15 8 6
16 8 7
17 9 5
18 7 2
19 5 1
20 5 4
21 4 2
22 9 7
23 8 1
24 7 6
25 6 4
26 7 3
27 5 4
28 4 0
29 3 2
30 7 4
31 8 6
JUMLAH 196 114

Jumlah Pasien Ibu dalam kota 248 orang


Jumlah Pasien Ibu luar kota 50 orang
Jumlah Pasien bayi dalam kota 142 orang
Jumlah Pasien bayi luar kota 25 orang

Ruang Nifas 3 JUNI 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 6 6
2 8 6
3 7 2
4 4 4
5 5 4
6 5 2
7 8 5
8 7 4
9 6 3
10 7 3
11 7 3
12
13 8 7
14 3 1
15 3 3
16 4 1
17 4 2
18 5 1
19 3 1
20 4 1
21 2 2
22 4 4
23 8 4
24 6 3
25 11 8
26 5 2
27 5 1
28 5
29 7 2
30 5 1
31
JUMLAH 162 86

Jumlah Pasien Ibu dalam kota 219 orang


Jumlah Pasien Ibu luar kota 35 orang
Jumlah Pasien bayi dalam kota 120 orang
Jumlah Pasien bayi luar kota 22 orang

Ruang Nifas 3, juli 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 6 2
2 6 1
3 6 3
4 7 4
5 7 4
6 9 2
7 5 3
8 3 2
9 4 1
10 6 6
11 4 3
12 5 4
13 10 8
14 8 1
15 7 1
16 7 0
17 5 2
18 7 3
19 9 6
20 6 2
21 9 3
22 3 2
23 7 2
24 9 3
25 9 3
26 8 5
27 7 2
28 4 3
29 3 3
30 5 2
31 4 2

jumlah 195 88
Jumlah Pasien Ibu dalam kota 240
Jumlah Pasien Ibu luar kota 47
Jumlah Pasien bayi dalam kota 112
Jumlah Pasien bayi luar kota 18

Agustus 2018
Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1 10 2
2 10 3
3 10 3
4 7 4
5 5 1
6 9 3
7 5 3
8 11 4
9 7 3
10 4 1
11 3 2
12 2 1
13 4 2
14 6 4
15 5 2
16 7 2
17 3 3
18 3 0
19 4 2
20 5 0
21 5 2
22 5 1
23 4 1
24 6 6
25 5 2
26 4 1
27 4 2
28 4 3
29 2 0
30 3 1
31 4 1
jumlah 166 65
Jumlah Pasien Ibu dalam kota 219
Jumlah Pasien Ibu luar kota 42
Jumlah Pasien bayi dalam kota 99
Jumlah Pasien bayi luar kota 14

Ruang Nifas 3 september 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2018 4 0
02/09/2018 2 2
03/09/2018 5 4
04/09/2018 3 2
05/09/2018 4 1
06/09/2018 7 2
07/09/2018 3 1
08/09/2018 3 3
09/09/2018 2 2
10/09/2018 2 2
11/09/2018 4 3
12/09/2018 8 3
13/09/2018 11 2
14/09/2018 3 1
15/09/2018 5 1
16/09/2018 8 0
17/09/2018 5 1
18/09/2018 6 5
19/09/2018 7 5
20/09/2018 10 3
21/09/2018 2 0
22/09/2018 6 3
23/09/2018 2 2
24/09/2018 5 0
25/09/2018 9 7
26/09/2018 6 3
27/09/2018 5 4
28/09/2018 2 0
29/09/2018 4 3
30/09/2018 4 3
JUMLAH 147 68

Jumlah Pasien Ibu dalam kota 215


Jumlah Pasien Ibu luar kota 45
Jumlah Pasien bayi dalam kota 98
Jumlah Pasien bayi luar kota 14

Ruang Nifas 3 OKTOBER 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2018 6 1
02/10/2018 8 4
03/10/2018 4 3
04/10/2018 5 4
05/10/2018 2 2
06/10/2018 4 3
07/10/2018 4 4
08/10/2018 4 1
09/10/2018 4 3
10/10/2018 6 4
11/10/2018 6 3
12/10/2018 4 3
13/10/2018 4 2
14/10/2018 4 3
15/10/2018 4 3
16/10/2018 1 1
17/10/2018 3 1
18/10/2018 4 2
19/10/2018 5 0
20/10/2018 2 1
21/10/2018 8 6
22/10/2018 5 2
23/10/2018 5 3
24/10/2018 4 2
25/10/2018 6 4
26/10/2018 3 0
27/10/2018 9 3
28/10/2018 6 6
29/10/2018 3 2
30/10/2018 3 2
31/10/2018 6 3
JUMLAH 142 81
Jumlah Pasien Ibu dalam kota 176
Jumlah Pasien Ibu luar kota 63
Jumlah Pasien bayi dalam kota 63
Jumlah Pasien bayi luar kota 20

Ruang Nifas 3 NOVEMBER 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2018 4 4
02/11/2018 4 0
03/11/2018 4 3
04/11/2018 1 2
05/11/2018 3 2
06/11/2018 2 2
07/11/2018 8 3
08/11/2018 7 3
09/11/2018 2 1
10/11/2018 3 2
11/11/2018 2 1
12/11/2018 5 3
13/11/2018 5 5
14/11/2018 0 0
15/11/2018 3 2
16/11/2018 5 4
17/11/2018 3 2
18/11/2018 5 4
19/11/2018 6 5
20/11/2018 5 3
21/11/2018 6 5
22/11/2018 2 3
23/11/2018 7 6
24/11/2018 2 2
25/11/2018 4
26/11/2018 6 5
27/11/2018 5 5
28/11/2018 6 4
29/11/2018 5 4
30/11/2018 7 6
JUMLAH 127 91

Jumlah Pasien Ibu dalam kota 169


Jumlah Pasien Ibu luar kota 51
Jumlah Pasien bayi dalam kota 83
Jumlah Pasien bayi luar kota 23

Ruang Nifas 3 DESEMBER 2018


Tanggal jml psn ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2018 6 3
02/12/2018 8 4
03/12/2018 4 1
04/12/2018 3 1
05/12/2018 4 3
06/12/2018 6 4
07/12/2018 5 4
08/12/2018 5 4
09/12/2018 5 4
10/12/2018 3 3
11/12/2018 3 1
12/12/2018 6 3
13/12/2018 7 3
14/12/2018 3 0
15/12/2018 4 4
16/12/2018 2 0
17/12/2018 5 4
18/12/2018 2 2
19/12/2018 5 3
20/12/2018 8 5
21/12/2018 3 2
22/12/2018 3 2
23/12/2018 4 1
24/12/2018 2 0
25/12/2018 3 1
26/12/2018 3 3
27/12/2018 7 3
28/12/2018 4 0
29/12/2018 3 2
30/12/2018 5 3
31/12/2018 6 6
JUMLAH 131 79
Jumlah Pasien Ibu dalam kota 188
Jumlah Pasien Ibu luar kota 50
Jumlah Pasien bayi dalam kota 83
Jumlah Pasien bayi luar kota 25
Ruang Nifas 4 Bulan MEI 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2015 10 7 2
02/05/2015 7 7 0
03/05/2015 9 6 0
04/05/2015 8 3 0
05/05/2015 9 8 0
06/05/2015 12 6 3
07/05/2015 20 14 5 1
08/05/2015 16 9 2
09/05/2015 15 10 1
10/05/2015 16 11 9
11/05/2015 10 8 1 1
12/05/2015 9 2 1
13/05/2015 14 14 7
14/05/2015 20 18 3
15/05/2015 14 9 7
16/05/2015 13 13 2 1
17/05/2015 16 16 3
18/05/2015 14 14 1
19/05/2015 14 13 5
20/05/2015 19 15 2 1
21/05/2015 14 8 4 2
22/05/2015 16 8 6
23/05/2015 18 18 2
24/05/2015 15 12 4 1
25/05/2015 16 16 7 1
26/05/2015 14 14 6
27/05/2015 13 13 5 1
28/05/2015 17 17 2 1
29/05/2015 19 14 2
30/05/2015 20 20 2
31/05/2015 14 8 4
441 351 98 10

Ruang Nifas 4 Bulan JUNI 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2015 13 6 1
02/06/2015 7 5
03/06/2015 12 3
04/06/2015 4 1 1
05/06/2015 13 5
06/06/2015 9 2
07/06/2015 7 3
08/06/2015 13 2
09/06/2015 16 6 1
10/06/2015 15 4
11/06/2015 14 5
12/06/2015 13 5
13/06/2015 13 2 2
14/06/2015 6 1
15/06/2015 8 0
16/06/2015 8 6
17/06/2015 11 7
18/06/2015 17 9 1
19/06/2015 8 4
20/06/2015 9 5
21/06/2015 10 5
22/06/2015 10 4 1
23/06/2015 7 3
24/06/2015 10 5
25/06/2015 6 2
26/06/2015 8 4
27/06/2015 8 4
28/06/2015 13 5
29/06/2015 7 5
30/06/2015 15 6

310 124 7
jumlah pasien ibu dalam kota 222 orang
jumlah pasien ibu luar kota 68 orang
jumlah pasien bayi dalam kota 149 orang
jumlah pasien bayi luar kota 45 orang

Ruang Nifas 4 Bulan JULI 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2015 17 4
02/07/2015 10 4
03/07/2015 9 5
04/07/2015 19 6
05/07/2015 9 3 1
06/07/2015 8 3
07/07/2015 11 5
08/07/2015 10 4
09/07/2015 7 2
10/07/2015 14 5
11/07/2015 11 3
12/07/2015 6 2 1
13/07/2015 15 6
14/07/2015 18 7
15/07/2015 15 4
16/07/2015 10 1
17/07/2015 5 2
18/07/2015 8 2
19/07/2015 6 3
20/07/2015 6 1
21/07/2015 7 4
22/07/2015 4 2 1
23/07/2015 6 3
24/07/2015 9 2
25/07/2015 9 1
26/07/2015 4 1
27/07/2015 10 3
28/07/2015 12 1
29/07/2015 6 3
30/07/2015 10 3
31/07/2015 10 2 1

301 97 2 2
jumlah pasien ibu dalam kota 232 orang
jumlah pasien ibu luar kota 61 orang
jumlah pasien bayi dalam kota 138 orang
jumlah pasien bayi luar kota 54 orang
Ruang Nifas 4 Bulan AGUSTUS 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2015 10 3
02/08/2015 10 2 1
03/08/2015 8 4
04/08/2015 10 5 1
05/08/2015 5 1
06/08/2015 5 1
07/08/2015 4 2
08/08/2015 7 2
09/08/2015 5 1
10/08/2015 11 4
11/08/2015 8 3
12/08/2015 5 3
13/08/2015 7 3
14/08/2015 7 6
15/08/2015 9 2
16/08/2015 8 4
17/08/2015 14 5
18/08/2015 12 3
19/08/2015 9 1
20/08/2015 5 2
21/08/2015 9 2 1
22/08/2015 12 4
23/08/2015 9 3
24/08/2015 9 4 1
25/08/2015 10 2
26/08/2015 9 2
27/08/2015 17 4
28/08/2015 12 7
29/08/2015 9 4
30/08/2015 5 1
31/08/2015 7 2 1

267 92 1 4
jumlah pasien ibu dalam kota 185 orang
jumlah pasien ibu luar kota 62 orang
jumlah pasien bayi dalam kota 126 orang
jumlah pasien bayi luar kota 50 orang

Ruang Nifas 4 Bulan SEPTEMBER 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2015 6 3 1
02/09/2015 9 5
03/09/2015 11 6
04/09/2015 12 5
05/09/2015 5 3
06/09/2015 6 4
07/09/2015 9 3
08/09/2015 9 4
09/09/2015 7 1
10/09/2015 5 1
11/09/2015 12 2 1
12/09/2015 9 6
13/09/2015 3 2
14/09/2015 4 2
15/09/2015 9 1
16/09/2015 11 6 1
17/09/2015 12 8
18/09/2015 16 9 2
19/09/2015 12 9
20/09/2015 8 1
21/09/2015 3 1
22/09/2015 5 5
23/09/2015 11 5
24/09/2015 11 1 1
25/09/2015 7 1 1
26/09/2015 8 2
27/09/2015 8 1
28/09/2015 2
29/09/2015 7 5
30/09/2015 10 2

247 103 1 7

jumlah pasien ibu dalam kota 199 orang


jumlah pasien ibu luar kota 74 orang
jumlah pasien bayi dalam kota 132 orang
jumlah pasien bayi luar kota 49 orang

Ruang Nifas 4 Bulan OKTOBER 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2015 10 8
02/10/2015 8 5
03/10/2015 9 6
04/10/2015 8 4 1
05/10/2015 7 2 1
06/10/2015 13 3
07/10/2015 7 1
08/10/2015 13 3
09/10/2015 8 2
10/10/2015 7 3
11/10/2015 5 1
12/10/2015 11 4
13/10/2015 4 0
14/10/2015 8 0
15/10/2015 5 2
16/10/2015 11 5
17/10/2015 12 3 1
18/10/2015 5 3
19/10/2015 3 1
20/10/2015 3 1
21/10/2015 5 2
22/10/2015 4 2
23/10/2015 9 5
24/10/2015 7 3
25/10/2015 5 3
26/10/2015 9 4
27/10/2015 7 3
28/10/2015 4 1
29/10/2015 7 2
30/10/2015 5 0
31/10/2015 13 4

232 86 1 2
jumlah pasien ibu dalam kota 194 orang
jumlah pasien ibu luar kota 59 orang
jumlah pasien bayi dalam kota 125 orang
jumlah pasien bayi luar kota 31 orang

Ruang Nifas 4 Bulan NOVEMBER 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2015 6 3
02/11/2015 4 3 1
03/11/2015 6 4
04/11/2015 15 7
05/11/2015 7 3
06/11/2015 5 4
07/11/2015 12 3
08/11/2015 4 1
09/11/2015 8 5
10/11/2015 6 3
11/11/2015 9 2
12/11/2015 10 2
13/11/2015 12 4
14/11/2015 7 3
15/11/2015 2 0
16/11/2015 3 3
17/11/2015 4 3
18/11/2015 11 5
19/11/2015 9 5 1
20/11/2015 11 3
21/11/2015 6 3
22/11/2015 12 5
23/11/2015 3 2 1
24/11/2015 4 4
25/11/2015 9 7
26/11/2015 8 5
27/11/2015 9 4
28/11/2015 6 2
29/11/2015 7 4
30/11/2015 6 3
221 105 2 1
jumlah pasien ibu dalam kota 179 orang
jumlah pasien ibu luar kota 133 orang
jumlah pasien bayi dalam kota 94 orang
jumlah pasien bayi luar kota 39 orang

Ruang Nifas 4 Bulan DESEMBER 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2015 10 5
02/12/2015 9 4
03/12/2015 8 1
04/12/2015 6 3
05/12/2015 9 2
06/12/2015 7 1
07/12/2015 7 3 2
08/12/2015 3 2
09/12/2015 5 1
10/12/2015 3 1
11/12/2015 4 2
12/12/2015 4 0
13/12/2015 4 0
14/12/2015 9 5
15/12/2015 8 3 1
16/12/2015 5 1
17/12/2015 7 2
18/12/2015 5 1
19/12/2015 7 1
20/12/2015 3 2 1
21/12/2015 5 3
22/12/2015 3 0
23/12/2015 4 1
24/12/2015 4
25/12/2015 8 5 1
26/12/2015 7 4 1
27/12/2015 6 1
28/12/2015 7 5
29/12/2015 6 1
30/12/2015 10 5
31/12/2015 11 4

194 69 2 4
jumlah pasien ibu dalam kota 187 orang
jumlah pasien ibu luar kota 58 orang
jumlah pasien bayi dalam kota 120 orang
jumlah pasien bayi luar kota 38 orang

Ruang Nifas 4 Bulan JANUARI 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2016 8 1 1
02/01/2016 4 1
03/01/2016 5 2
04/01/2016 5 1
05/01/2016 8 4
06/01/2016 9 4
07/01/2016 10 3
08/01/2016 3 0
09/01/2016 5 2
10/01/2016 4 0
11/01/2016 3 3
12/01/2016 6 1
13/01/2016 11 3
14/01/2016 8 2
15/01/2016 12 3 1
16/01/2016 5 2 1
17/01/2016 2
18/01/2016 3
19/01/2016 3
20/01/2016 6 2
21/01/2016 12 5
22/01/2016 10 2
23/01/2016 8 1
24/01/2016 3 1
25/01/2016 2 1
26/01/2016 5 1
27/01/2016 8 3
28/01/2016 8 1
29/01/2016 6 2
30/01/2016 10 4 1
31/01/2016 5 1

197 56 1 3
jumlah pasien ibu dalam kota 152 orang
jumlah pasien ibu luar kota 69 orang
jumlah pasien bayi dalam kota 91 orang
jumlah pasien bayi luar kota 46 orang

Ruang Nifas 4 Bulan Februari 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2016 7 3
02/02/2016 9 2
03/02/2016 6 1
04/02/2016 5 3
05/02/2016 8 3
06/02/2016 6 3
07/02/2016 6 1
08/02/2016 1 1
09/02/2016 6 5 1
10/02/2016 10 3
11/02/2016 7 5
12/02/2016 7 3
13/02/2016 7 2
14/02/2016 3 2
15/02/2016 9 4
16/02/2016 7 4 1
17/02/2016 8 4
18/02/2016 5 3
19/02/2016 5 1
20/02/2016 4 2
21/02/2016 4 1
22/02/2016 7 4
23/02/2016 6 1
24/02/2016 6 4
25/02/2016 5 1
26/02/2016 6 3
27/02/2016 9 4
28/02/2016 8 0
29/02/2016 2 1 1

179 74 2 1

jumlah pasien ibu dalam kota 164 orang


jumlah pasien ibu luar kota 63 orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang

Ruang Nifas 4 Bulan Maret 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2016 5 5
02/03/2016 7 3
03/03/2016 11 3
04/03/2016 9 5
05/03/2016 8 3
06/03/2016 6 1
07/03/2016 7 2
08/03/2016 5 1
09/03/2016 6 2
10/03/2016 5 3
11/03/2016 4 3
12/03/2016 8 5
13/03/2016 13 3
14/03/2016 9
15/03/2016 5
16/03/2016 7 2 1
17/03/2016 2 1
18/03/2016 2 1
19/03/2016 5 2
20/03/2016 4 1
21/03/2016 5
22/03/2016 5
23/03/2016 3 3
24/03/2016 8 4
25/03/2016 8 2
26/03/2016 3 1
27/03/2016 3 2
28/03/2016 4 2
29/03/2016 9 5
30/03/2016 6 5
31/03/2016 8 4

190 74 1
jumlah pasien ibu dalam kota orang
jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang
Ruang Nifas 4 Bulan April 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 7 2
02/04/2016 6 3
03/04/2016 7 2
04/04/2016 5 3
05/04/2016 5 2 1
06/04/2016 4 1
07/04/2016 4 2
08/04/2016 10 9
09/04/2016 8 4
10/04/2016 6
11/04/2016 4
12/04/2016 9 6
13/04/2016 5 1
14/04/2016 7 4
15/04/2016 14 8
16/04/2016 9 3
17/04/2016 7 1 1
18/04/2016 4 1
19/04/2016 12 8
20/04/2016 5 2
21/04/2016 6 2 1
22/04/2016 8 3
23/04/2016 8 1
24/04/2016 5 2
25/04/2016 8
26/04/2016 9 4
27/04/2016 5 2
28/04/2016 7 5
29/04/2016 6 3
30/04/2016 2 1

202 85 1 2

jumlah pasien ibu dalam kota 170 orang


jumlah pasien ibu luar kota 72 orang
jumlah pasien bayi dalam kota 99 orang
jumlah pasien bayi luar kota 35 orang
Ruang Nifas 4 Bulan Mei 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2016 1
02/05/2016 5 1
03/05/2016 3 2
04/05/2016 5 1
05/05/2016 6 2 1
06/05/2016 6 1
07/05/2016 6 3
08/05/2016 5 2 1
09/05/2016 2
10/05/2016 7 2
11/05/2016 6 1
12/05/2016 8 3
13/05/2016 5 2
14/05/2016 6 1
15/05/2016 4 3
16/05/2016 7 4
17/05/2016 7 3
18/05/2016 6 1
19/05/2016 4 5 1
20/05/2016 5 4
21/05/2016 7 5
22/05/2016 6 1
23/05/2016 6 1
24/05/2016 8 1
25/05/2016 9 2
26/05/2016 5 3
27/05/2016 3
28/05/2016 5 2 1
29/05/2016 6
30/05/2016 6 2
31/05/2016 8 5

173 61 1 5
jumlah pasien ibu dalam kota 154 orang
jumlah pasien ibu luar kota 64 orang
jumlah pasien bayi dalam kota 78 orang
jumlah pasien bayi luar kota 31 orang
Ruang Nifas 4 Bulan Juni 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2016 5
02/06/2016 5 2 1
03/06/2016 4 1
04/06/2016 2
05/06/2016 2
06/06/2016 1
07/06/2016 6 3
08/06/2016 7 1
09/06/2016 3 1
10/06/2016 1 1
11/06/2016 3 1
12/06/2016 7 1
13/06/2016 10 2 1
14/06/2016 7 2
15/06/2016 1 2
16/06/2016 9 7
17/06/2016 4 2
18/06/2016 2
19/06/2016 3
20/06/2016 2 1
21/06/2016 1
22/06/2016 7 3
23/06/2016 7 3
24/06/2016 5 3
25/06/2016 3 1
26/06/2016 5
27/06/2016 8 2
28/06/2016 5 1
29/06/2016 8 4
30/06/2016 8 2

141 46 2 0

jumlah pasien ibu dalam kota 134 orang


jumlah pasien ibu luar kota 59 orang
jumlah pasien bayi dalam kota 48 orang
jumlah pasien bayi luar kota 18 orang
Ruang Nifas 4 Bulan Juli 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2016 3 1
02/07/2016 7 2
03/07/2016 4 1
04/07/2016 2
05/07/2016 2 1
06/07/2016 5 2
07/07/2016 3 1
08/07/2016 3 2
09/07/2016 3
10/07/2016 2
11/07/2016 1
12/07/2016 5
13/07/2016 7 2
14/07/2016 5 2
15/07/2016 9
16/07/2016 4
17/07/2016 5 3 1
18/07/2016 6 3
19/07/2016 3 1
20/07/2016 5 2
21/07/2016 6 2
22/07/2016 8 1
23/07/2016 4 3 1
24/07/2016 4 2 1
25/07/2016 5
26/07/2016 7 2
27/07/2016 6 1
28/07/2016 5 3
29/07/2016 4 4 1
30/07/2016 3
31/07/2016 6 2

142 43 1 3
jumlah pasien ibu dalam kota 127 orang
jumlah pasien ibu luar kota 82 orang
jumlah pasien bayi dalam kota 53 orang
jumlah pasien bayi luar kota 30 orang
Ruang Nifas 4 Bulan Agustus 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2016 9 3
02/08/2016 6 2
03/08/2016 6 3
04/08/2016 9 3
05/08/2016 6 2
06/08/2016 6 2
07/08/2016 2
08/08/2016 9 3
09/08/2016 6
10/08/2016 5 1
11/08/2016 7 3
12/08/2016 2 1
13/08/2016 6 2
14/08/2016 4 1 1
15/08/2016 6 3
16/08/2016 1 1 1
17/08/2016 2
18/08/2016 3
19/08/2016 3 3
20/08/2016 3 2
21/08/2016 2
22/08/2016 5 1
23/08/2016 6 4
24/08/2016 9 3
25/08/2016 4 2
26/08/2016 12 5
27/08/2016 10 5
28/08/2016 5 2
29/08/2016 8 7
30/08/2016 11 6
31/08/2016 5 2

178 72 1 1
jumlah pasien ibu dalam kota 143 orang
jumlah pasien ibu luar kota 73 orang
jumlah pasien bayi dalam kota 74 orang
jumlah pasien bayi luar kota 28 orang
Ruang Nifas 4 Bulan September 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2016 2 2
02/09/2016 7 2
03/09/2016 2 1
04/09/2016 5 2
05/09/2016 2 2
06/09/2016 5 1
07/09/2016 7 2
08/09/2016 5 1
09/09/2016 5 3
10/09/2016 2
11/09/2016 3 2
12/09/2016 3 2
13/09/2016 3
14/09/2016 5 2 1
15/09/2016 9 2
16/09/2016 9 5
17/09/2016 7 3
18/09/2016 4
19/09/2016 4 1
20/09/2016 4
21/09/2016 11 3 1
22/09/2016 5 3
23/09/2016 2 1
24/09/2016 6 3 1 1
25/09/2016 7 1
26/09/2016 4 1
27/09/2016 5 2
28/09/2016 8 3 1
29/09/2016 5 2 1
30/09/2016 9 2

155 54 2 4

jumlah pasien ibu dalam kota orang


jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang
Ruang Nifas 4 Bulan Oktober 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2016 6 4
02/10/2016 8 1
03/10/2016 6 4
04/10/2016 9 2
05/10/2016 5 2
06/10/2016 8 3
07/10/2016 9 4
08/10/2016 1 1
09/10/2016 2 1
10/10/2016 5 1
11/10/2016 5 3
12/10/2016 5 1
13/10/2016 5 2
14/10/2016 6 4 1
15/10/2016 8 4
16/10/2016 3 2
17/10/2016 6 1
18/10/2016 5 1
19/10/2016 7 2
20/10/2016 4 1
21/10/2016 3 1 1
22/10/2016 11 3
23/10/2016 6 3
24/10/2016 4 1
25/10/2016 4 1
26/10/2016 6 1
27/10/2016 5 2
28/10/2016 7 1 1
29/10/2016 1 2
30/10/2016 5 2
31/10/2016 4 2

169 62 2 2
jumlah pasien ibu dalam kota orang
jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang
Ruang Nifas 4 Bulan november 2016

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2016 3 2
02/11/2016 7 2
03/11/2016 5 2
04/11/2016 9 2
05/11/2016 9 4
06/11/2016 4 1
07/11/2016 7 1
08/11/2016 4 1
09/11/2016 7 3
10/11/2016 5
11/11/2016 6 3
12/11/2016 2 2
13/11/2016 6 3
14/11/2016 7 2
15/11/2016 4 2 1
16/11/2016 4 2
17/11/2016 5 4
18/11/2016 5 3
19/11/2016 4 1
20/11/2016 2 1
21/11/2016 3
22/11/2016 10 2
23/11/2016 8 3
24/11/2016 4 4
25/11/2016 5 1
26/11/2016 5 2
27/11/2016 6 2
28/11/2016 7 4
29/11/2016 5 3
30/11/2016 10 4

168 65 1 1
jumlah pasien ibu dalam kota orang
jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang
Ruang Nifas 4 Bulan desember 2016
Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2016 10 5
02/12/2016 7 2 1
03/12/2016 4 1
04/12/2016 5 1
05/12/2016 4
06/12/2016 3 1
07/12/2016 6 4 1
08/12/2016 6
09/12/2016 4 1
10/12/2016 11 4 1
11/12/2016 2
12/12/2016 7 3
13/12/2016 6 3
14/12/2016 9 1
15/12/2016 8 2
16/12/2016 9 1
17/12/2016 11 2
18/12/2016 8 5
19/12/2016 14 7
20/12/2016 11 10
21/12/2016 14 9
22/12/2016 11 7 1
23/12/2016 8 2
24/12/2016 3 2
25/12/2016 1 1
26/12/2016 2 1
27/12/2016 3 1 2
28/12/2016 8 3
29/12/2016 7 3
30/12/2016 3 0
31/12/2016 4 2

209 84 1 5
jumlah pasien ibu dalam kota 158 orang
jumlah pasien ibu luar kota 47 orang
jumlah pasien bayi dalam kota 76 orang
jumlah pasien bayi luar kota 32 orang
Ruang Nifas 4 Bulan JANUARI 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2017 9 1
02/01/2017 5 2
03/01/2017 11 3 1
04/01/2017 12 6
05/01/2017 9 7
06/01/2017 12 5 1
07/01/2017 5 2
08/01/2017 3 3
09/01/2017 8 3
10/01/2017 10 5
11/01/2017 8 3
12/01/2017 9
13/01/2017 6 2
14/01/2017 2 1
15/01/2017 4 1
16/01/2017 5 3
17/01/2017 14 6
18/01/2017 18 6
19/01/2017 11 3
20/01/2017 9 4
21/01/2017 11 5
22/01/2017 12 5
23/01/2017 11 6
24/01/2017 8 2 2
25/01/2017 6 4
26/01/2017 5 2
27/01/2017 2 1 1
28/01/2017 5 1
29/01/2017 5 1
30/01/2017 10 1
31/01/2017 7 4
252 98 2 3
jumlah pasien ibu dalam kota 154 orang
jumlah pasien ibu luar kota 62 orang
jumlah pasien bayi dalam kota 92 orang
jumlah pasien bayi luar kota 29 orang

Ruang Nifas 4 Bulan FEBRUARI 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2017 7 5
02/02/2017 10 2
03/02/2017 4
04/02/2017 10 3
05/02/2017 4 1
06/02/2017 11 7
07/02/2017 10 4
08/02/2017 11 5
09/02/2017 9 6
10/02/2017 14 3
11/02/2017 7 3
12/02/2017 7 4
13/02/2017 10 5
14/02/2017 12 5
15/02/2017 8 4
16/02/2017 9 4
17/02/2017 10 3
18/02/2017 5 1
19/02/2017 6 1
20/02/2017 4
21/02/2017 5 2
22/02/2017 8 3
23/02/2017 13 5
24/02/2017 12 4
25/02/2017 11 6
26/02/2017 14 5
27/02/2017 11 4 1
28/02/2017 8 3

250 98 1

jumlah pasien ibu dalam kota 141 orang


jumlah pasien ibu luar kota 56 orang
jumlah pasien bayi dalam kota 72 orang
jumlah pasien bayi luar kota 21 orang

Ruang Nifas 4 Bulan MARET 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2017 11 4 1
02/03/2017 8 1 1
03/03/2017 10 3 1
04/03/2017 10 6
05/03/2017 3 1
06/03/2017 4 2
07/03/2017 7 3
08/03/2017 7 5
09/03/2017 12 6
10/03/2017 8 3
11/03/2017 8 3
12/03/2017 7 3
13/03/2017 9 1
14/03/2017 11 5
15/03/2017 9 3
16/03/2017 8 4
17/03/2017 7 6
18/03/2017 6 3
19/03/2017 4 2
20/03/2017 7 1
21/03/2017 10 5
22/03/2017 8 7 1
23/03/2017 12 9 1
24/03/2017 10 7
25/03/2017 5 3
26/03/2017 7 4
27/03/2017 5 2 1
28/03/2017 2 2
29/03/2017 7 7
30/03/2017 7 3
31/03/2017 5 5
234 119 1 5
jumlah pasien ibu dalam kota 141 orang
jumlah pasien ibu luar kota 68 orang
jumlah pasien bayi dalam kota 87 orang
jumlah pasien bayi luar kota 28 orang

Ruang Nifas 4 Bulan APRIL 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2017 6 2
02/04/2017 3 1
03/04/2017 6 2
04/04/2017 8 4
05/04/2017 4 3
06/04/2017 8 4
07/04/2017 7 4
08/04/2017 6 1
09/04/2017 2
10/04/2017 6
11/04/2017 11 7
12/04/2017 13 7
13/04/2017 8 2
14/04/2017 5 4
15/04/2017 9 1
16/04/2017 6 2
17/04/2017 8 4
18/04/2017 7 5
19/04/2017 8 2
20/04/2017 7 2
21/04/2017 10 6
22/04/2017 10 5
23/04/2017 5 3
24/04/2017 7 4
25/04/2017 4 4
26/04/2017 9 5
27/04/2017 10 5 1
28/04/2017 7 3
29/04/2017 6 2
30/04/2017 7 3 1
213 97 1 1

jumlah pasien ibu dalam kota 158 orang


jumlah pasien ibu luar kota 63 orang
jumlah pasien bayi dalam kota 77 orang
jumlah pasien bayi luar kota 24 orang

Ruang Nifas 4 Bulan MEI 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2017 8 1
02/05/2017 7 1
03/05/2017 13 7
04/05/2017 12 7
05/05/2017 12 8
06/05/2017 11 6
07/05/2017 9 5 1
08/05/2017 6 5 1
09/05/2017 11 6 1
10/05/2017 10 5
11/05/2017 8 3
12/05/2017 8 5
13/05/2017 10 4
14/05/2017 6 2
15/05/2017 6 5
16/05/2017 9 5
17/05/2017 13 10
18/05/2017 14 10
19/05/2017 6 4
20/05/2017 6 1
21/05/2017 4 1
22/05/2017 9 5
23/05/2017 10 5
24/05/2017 11 6
25/05/2017 10 3
26/05/2017 7 3
27/05/2017 10 6
28/05/2017 6 2
29/05/2017 6 3
30/05/2017 8 5
31/05/2017 9 5 1
275 144 2 2
jumlah pasien ibu dalam kota orang
jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang

Ruang Nifas 4 Bulan JUNI 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2017 9 6 1
02/06/2017 10 6
03/06/2017 9 3
04/06/2017 7 6 1
05/06/2017 13 7
06/06/2017 7 5
07/06/2017 6 2
08/06/2017 7 4
09/06/2017 8 2 1
10/06/2017 7 3
11/06/2017 5 2
12/06/2017 2 1
13/06/2017 11 4
14/06/2017 11 6
15/06/2017 12 8
16/06/2017 9 6
17/06/2017 7 6
18/06/2017 9 5
19/06/2017 7 2
20/06/2017 9 2
21/06/2017 7 4
22/06/2017 8 7 1
23/06/2017 6 3
24/06/2017 2 3
25/06/2017 1 1
26/06/2017 3 3 1
27/06/2017 3 1
28/06/2017 5 4
29/06/2017 3
30/06/2017 2 1

205 113 3 2
jumlah pasien ibu dalam kota orang
jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang

Ruang Nifas 4 Bulan JULI 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2017 8 3
02/07/2017 8 3
03/07/2017 8 5
04/07/2017 5 2
05/07/2017 3 1
06/07/2017 7 1
07/07/2017 5 4
08/07/2017 7 2
09/07/2017 9 7
10/07/2017 7 3
11/07/2017 9 3
12/07/2017 7 2
13/07/2017 8 4
14/07/2017 5 3
15/07/2017 5 3
16/07/2017 2
17/07/2017 7 4 1
18/07/2017 6 5 1
19/07/2017 6 3
20/07/2017 7 6 1
21/07/2017 7 2 1
22/07/2017 6 2
23/07/2017 5 1
24/07/2017 3 2
25/07/2017 7 3
26/07/2017 6 3
27/07/2017 6 3
28/07/2017 7 2
29/07/2017 8 4
30/07/2017 4 3
31/07/2017 1
189 89 4
jumlah pasien ibu dalam kota orang
jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang

Ruang Nifas 4 Bulan AGUSTUS 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2017 9 4
02/08/2017 12 7
03/08/2017 12 7 1
04/08/2017 6 4
05/08/2017 5 3
06/08/2017 3 2
07/08/2017 3 2
08/08/2017 5 1
09/08/2017 6 5
10/08/2017 8 6
11/08/2017 15 9
12/08/2017 13 5
13/08/2017 9 5
14/08/2017 6 4 1
15/08/2017 9 3
16/08/2017 8 4
17/08/2017 6 1
18/08/2017 7 4
19/08/2017 8 6
20/08/2017 3
21/08/2017 6 5
22/08/2017 1 1
23/08/2017 3 2
24/08/2017 5 2
25/08/2017 5 3
26/08/2017 9 7
27/08/2017 7 3
28/08/2017 7 3
29/08/2017 6 4
30/08/2017 6 4
31/08/2017 8 6
216 122 1 1
jumlah pasien ibu dalam kota orang
jumlah pasien ibu luar kota orang
jumlah pasien bayi dalam kota orang
jumlah pasien bayi luar kota orang

Ruang Nifas 4 Bulan SEPTEMBER 2017

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2017 9 3
02/09/2017 7 5
03/09/2017 2 2
04/09/2017 6 5
05/09/2017 10 4
06/09/2017 10 4
07/09/2017 8 5
08/09/2017 8 6
09/09/2017 10 2
10/09/2017 4 2
11/09/2017 8 4
12/09/2017 3 0
13/09/2017 2 2 1
14/09/2017 4 3
15/09/2017 6 3
16/09/2017 8 5
17/09/2017 7 4
18/09/2017 12 6
19/09/2017 9 8
20/09/2017 16 11
21/09/2017 9 2
22/09/2017 5 3
23/09/2017 9 5
24/09/2017 7 3
25/09/2017 10 7
26/09/2017 10 5
27/09/2017 10 6
28/09/2017 11 4
29/09/2017 10 5
30/09/2017 5 1

235 125 1
jumlah pasien ibu dalam kota 155 orang
jumlah pasien ibu luar kota 74 orang
jumlah pasien bayi dalam kota 96 orang
jumlah pasien bayi luar kota 35 orang
Ruang PERINATOLOGI - RSKIA - Februari 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2015 1 by ny tuti V
2 by.ny arlina V
jumlah 2

02/02/2015 1 By.ny kustiyah V


2 by ny Arlina V
jumlah 2

03/02/2015 1 By ny kustiyah V
2 by ny arlina V
jumlah 2
04/02/2015 1 by ny kustiyah V
2 by ny arlina V
3 by ny ria V
jumlah 3

05/02/2015 1 by ny kustiyah V
2 by ny arlina V
3 by ny ria V
jumlah 3
06/02/2015 1 by ny kustiyah V
2 by ny ria V
3 by ny arlina V
3
07/02/2015 1 by ny rina V
2 by ny geuis V
3 by ny arlina V
4 by ny leni V
5 by ny ria V
5
08/02/2015 1 by ny rina V
2 by ny geuis V
3 by ny arlina V
4 by ny leni V
5 by ny ria V
5
09/02/2015 1 by ny rina V
2 by ny geuis V
3 by ny arlina V
4 by ny leni V
5 by ny ria V
6 by ny nani II V
7 by ny ani I V
8 by ny ani II V
9 by ny Enung V
9
10/02/2015 1 by ny rina V
2 by ny geuis V
3 by ny arlina V
4 by ny leni V
5 by ny ria V
6 by ny nani II V
7 by ny ani I V
8 by ny nurhayati V
9 by ny Enung V
9
11/02/2015 1 by ny nani II V
2 by ny indah V V
3 by ny geuis V
4 by ny ema I V
5 by ny arlina V
6 by ny enung V
7 by ny nurhayati V
8 by ny ani I V
9 by ny ria V
10 by ny reni I V
11 by ny reni II V
1 11
12/02/2015 1 by ny nani II V
2 by ny indah V V
3 by ny geuis V
4 by ny reni I V
5 by ny reni II V
6 by ny yeni V
7 by ny ani I V
1 7
13/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny geuis V
4 by ny yeni V
5 by ny nani II V
6 by ny ani I V
7 by ny sintia V
7
14/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny ani I V
4 by ny yeni V
5 by ny sintia V
6 by ny sumiati V V
1 6
15/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny yeni V
4 by ny sintia V
5 by ny sumiati V V
1 5
16/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny yeni V
4 by ny sintia V
5 by ny sumiati V V
6 by ny sri V
1 6
17/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny yeni V
4 by ny sintia V
5 by ny sumiati V V
6 by ny sri V
7 by ny nurul V
8 by ny risa V
1 8
18/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny yeni V
4 by ny sintia V
5 by ny sumiati V V
6 by ny nia V
7 by ny nurul V
8 by ny risa V
1 8
19/02/2015 1 by ny siti f V
2 by ny reni II V
3 by ny sintia V
4 by ny sumiati V V
5 by ny nia V
6 by ny nurul V
7 by ny risa V
1 7
20/02/2015 1 by ny reni II V
2 by ny nia V
3 by ny nurul V
4 by ny sintia V
5 by ny reni I V
6 by ny eka V
6
21/02/2015 1 by ny reni II V
2 by ny nia V
3 by ny nurul V V
4 by ny sintia V
5 by ny reni I V
6 by ny eka V
1 6
22/02/2015 1 by ny reni II V
2 by ny nia V
3 by ny nurul V V
4 by ny sintia V
5 by ny reni I V
6 by ny eka V
1 6
23/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny sintia V
4 by ny eka V
4
24/02/2015 1 by ny reni I V
2 by ny reni II V
3 by ny sintia V
4 by ny eka V
4
25/02/2015 1 by ny reni II V
2 by ny sintia V
2
26/02/2015 1 by ny reni II V
2 by ny sintia V
3 by. lina v
4 by. winarti v
4
27/02/2015 1 by ny sintia V
2 by. lina v
3 by. winarti v
4 by. heti v
4
28/02/2015 1 by ny sintia V
2 by. lina v
3 by. winarti v
4 by. heti v
4

10 148
Jumlah Bayi lahir hidup 354

Formulir Survey Harian Pemakaian Alat


Ruang PERINATOLOGI - MARET 2015
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. lina V
4
02/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. lina V
5 by. ny. siti M V
6 by.ny. erni V
6
03/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. lina V
5 by. ny. siti M V
6 by.ny. erni V
6
04/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. lina V
5 by. ny. siti M V
6 by.ny. erni V
6
05/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. lina V
5 by. ny. siti M V
6 by.ny. erni V
7 by.ny. ineu V
8 by.ny. febi V
8
06/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. lina V
5 by. ny. siti M V
6 by.ny. febi V
7 by.ny. ineu V

7
07/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. lina V
5 by. ny. siti M V
6 by.ny. febi V
7 by.ny. ineu V
8 by.ny. ismia V
9 by.ny. yupi V
9
08/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. ismia V
5 by. ny. siti M V
6 by.ny. febi V
7 by. ny. yupi V
7
09/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by. ny. siti R V
5 by. ny. siti M V
6 by.ny. febi V
6
10/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by. ny. siti R V
5 by. ny. siti M V
6 by.ny. febi V
6
11/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. febi V
5 by. ny. siti M V
6 by.ny. nureva V

6
12/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. febi V
5 by. ny. siti M V
6 by.ny. nureva V
7 by.ny. leni V
8 by.ny. fitriani V
9 by.ny. iyam V

9
13/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. febi V
5 by. ny. siti M V
6 by.ny. nureva V
7 by.ny. Cinta V
8 by.ny. fitriani V
9 by.ny. iyam V
10 by. ny. tarinah V
11 by.ny. rina V
12 by. ny. leni V
13 by.ny. elia V
13
14/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. febi V
5 by. ny. siti M V
6 by.ny. nureva V
7 by.ny. Cinta V
8 by.ny. fitriani V
9 by.ny. iyam V
10 by. ny. atik II V
11 by.ny. rina V V
12 by. ny. leni V
13 by.ny. elia V
1 13
15/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. leni V
5 by. ny. siti M V
6 by.ny. nureva V
7 by.ny. elia V
8 by.ny. fitriani V
9 by.ny. atik II V
9
16/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. leni V
5 by. ny. siti M V
6 by.ny. nureva V
7 by.ny. elia V
8 by.ny. fitriani V
9 by.ny. atik II V
10 by.ny. sinta V
10
17/03/2015 1 by ny Winarti V
2 by.ny Heti V
V
3 by.ny. sintia
4 by.ny. leni V
5 by. ny. siti M V
6 by.ny. nureva V
7 by.ny. elia V
8 by.ny. fitriani V
9 by.ny. atik II V
10 by.ny. sinta V
10
18/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. sinta V
7 by.ny. fitriani V
8 by.ny. atik II V
8
19/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. fitriani V
6
20/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. fitriani V
6
21/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. fitriani V
6
22/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. fitriani V
6
23/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. fitriani V
6
24/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. fitriani V
7 by.ny. rini V
8 by. ny. rahmawati V
8
25/03/2015 1 by ny farah V
2 by.ny Heti V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. siti M V
6 by.ny. frahmawati V
7 by.ny. rini V
7
26/03/2015 1 by ny farah V
2 by.ny. rini V
V
3 by.ny. ningrum II
4 by.ny. sumanah V
5 by. ny. rahmawati V
5
27/03/2015 1 by ny farah V
2 by.ny. rini V
V
3 by.ny. ningrum II
4 by ny yanti V
5 by. ny. rahmawati V
5
28/03/2015 1 by ny farah V
2 by ny yanti V
V
3 by ny rahmawati
3
29/03/2015 1 by ny farah V
2 by ny yanti V
V
3 by ny rahmawati
4 by ny khasanah V
4
30/03/2015 1 by ny yanti V
2 by ny rahmawati V
V
3 by ny khasanah V
1 3
31/03/2015 1 by ny yanti V
2 by ny rahmawati V
V
3 by ny khasanah V
1 3

3 288 Jumlah Bayi lahir hidup 403

Formulir Survey Harian Pemakaian Alat


Ruang PERINATOLOGI - APRIL 2015

01/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V

02/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V

03/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V

04/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V

05/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V

06/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V
3 by ny vitria V

07/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V
3 by ny vitria V
4 by ny rita V

08/04/2015 1 By NY Rahmawati V
By ny khasanah
2 V V
3 by ny vitria V
4 by ny rita V

09/04/2015 1 by. rita v


2 by. khasanah v v
3 by. vitria v
4 by. rahmawati v

10/04/2015 1 by. rita v


2 by. khasanah v v
3 by. Yeni v
4 by. rahmawati v
5 by. Elia v
6 by. ririn v

11/04/2015 1 by. rita v


2 by. khasanah v v
3 by. yeni v
4 by. rahmawati v
5 by. Elia v
6 by. ririn v
7 by. siti M 2 v
8 by. iin v

12/04/2015 1 by. rita v


2 by. khasanah v v
3 by. yeni v
4 by. rahmawati v
5 by. Elia v
6 by. iin v
7 by. siti M 2 v

13/04/2015 1 by. rita v


2 by. khasanah v v
3 by noviasari v
4 by. rahmawati v
5 by. Elia v
6 by. iin v
7 by. siti M 2 v

14/04/2015 1 by. rita v


2 by. khasanah v v
3 by noviasari v
4 by. rahmawati v
5 by. Elia v

6 by. siti M 2 v

15/04/2015 1 by ny siti m 2 v
2 by ny yuli v
3 by noviasari v
4 by. rahmawati v
5 by. Elia v

16/04/2015 1 by ny siti m 2 v
2 by ny yuli V
3 by noviasari v
4 by. rahmawati v
5 by. Elia v

17/04/2015 1 by ny siti m 2 v
2 by ny yuli V
3 by noviasari v
4 by. rahmawati v
5 by. Elia v
6 by ny sofiah v
7 by ny tiktik v

18/04/2015 1 by ny siti m 2 v
2 by ny yuli V
3 by noviasari v
4 by. rahmawati v
5 by. Elia v
6 by ny sofiah v
7 by ny tiktik v
8 by ny ratih v

19/04/2015 1 by ny siti m 2 v
2 by ny yuli V
3 by noviasari v
4 by. rahmawati v
5 by. Elia v
6 by ny sofiah v
7 by ny tiktik v
8 by ny ratih v

20/04/2015 1 by ny siti m 2 v
2 by ny ratih V
3 by noviasari v
4 by. rahmawati v
5 by. Elia v
6 by ny sofiah v
7 by ny tiktik v

21/04/2015 1 by ny siti m 2 v
2 by ny ratih V
3 by noviasari v
4 by. rahmawati v
5 by. Elia v
6 by ny sofiah v
7 by ny tiktik v

22/04/2015 1 by ny siti m 2 v
2 by ny ratih V
3 by noviasari v
4 by ny tiktik v
5 by. Elia v
6 by ny sofiah v

23/04/2015 1 by ny siti m 2 v
2 by ny sofiah V
3 by noviasari v
4 by ny elia v

24/04/2015 1 by ny siti m 2 v
2 by ny sofiah V
3 by noviasari v
4 by ny elia v

25/04/2015 1 by ny siti m 2 v
2 by ny sofiah V
3 by noviasari v
4 by. linda v

26/04/2015 1 by ny linda v
2 by ny sofiah V
3 by noviasari v

27/04/2015 1 by ny linda v
2 by ny sofiah V
3 by noviasari v
4 by. enah v

28/04/2015 1 by ny linda v
2 by ny sofiah V
3 by noviasari v

29/04/2015 1 by ny linda v
2 by ny sofiah V
3 by noviasari v

30/04/2015 1 by ny linda v
2 by ny sofiah V
3 by noviasari v

14 130 Jumlah bayi 390

Formulir Survey Harian Pemakaian Alat


Ruang PERINATOLOGI - MEI 2015

01/05/2015 1 BY ny linda V
2 by ny sopiah V
3 by ny noviasari v

02/05/2015 4 BY ny linda V
5 by ny sopiah V
6 by ny noviasari v

03/05/2015 7 BY ny linda V
8 by ny sopiah V
9 by ny noviasari V
10 by ny wulan V
11 by ny sinta V

04/05/2015 12 BY ny linda V
13 by ny sopiah V
14 by ny noviasari V
15 by ny wulan V
16 by ny sinta v V

05/05/2015 17 BY ny linda V
18 by ny sopiah V
19 by ny noviasari V
20 by ny wulan V
21 by ny sinta v V

06/05/2015 22 BY ny linda V
23 by ny sopiah V
24 by ny noviasari V
25 by ny wulan V
26 by ny sinta v V
27 by ny tita V
28 by ny dewi V
07/05/2015 29 BY ny linda V
30 by ny sopiah V
31 by ny noviasari V
32 by ny wulan V
33 by ny sinta v V
34 by ny tita V
35 by ny dewi V

08/05/2015 36 BY ny linda V
37 by ny sopiah V
38 by ny noviasari V
39 by ny wulan V
40 by ny sinta v V
41 by ny tita V
42 by ny dewi V

09/05/2015 43 BY ny linda V
44 by ny sopiah V
45 by ny noviasari V
46 by ny wulan V
47 by ny sinta v V
48 by ny tita V
49 by ny dewi V

10/05/2015 50 BY ny linda V
51 by ny sopiah V
52 by ny noviasari V
53 by ny wulan V
54 by ny sinta v V
55 by ny tita V
56 by ny dewi V

11/05/2015 57 BY ny linda V
58 by ny sopiah V
59 by ny noviasari V
60 by ny wulan V
61 by ny sinta v V
62 by ny tita V
63 by ny dewi V

12/05/2015 64 BY ny linda V
65 by ny sopiah V
66 by ny noviasari V
67 by ny wulan V
68 by ny sinta v V
69 by ny tita V
70 by ny dewi V
by ny ika
71 V

13/05/2015 72 by ny sopiah V
73 BY NY TITA V
74 by ny noviasari V
75 by ny wulan V
76 by ny sinta v V
77 by ny dewi V

14/05/2015 78 by ny sopiah V
79 by ny dewi V
80 by ny noviasari V
81 by ny wulan V
82 by ny sinta v V

15/05/2015 83 by ny sopiah V
84 by ny dewi V
85 by ny noviasari V
86 by ny wulan V
87 by ny sinta v V

16/05/2015 88 by ny sopiah V
89 by ny dewi V
90 by ny noviasari V
91 by ny wulan V
92 by ny sinta v V
by ny pipit
93 V

17/05/2015 94 by ny sopiah V
95 by ny dewi V
96 by ny noviasari V
97 by ny wulan V
98 by ny sinta v V
99 By ny sarah V

18/05/2015 0 by ny sopiah V
101 by ny dewi V
102 by ny noviasari V
103 by ny wulan V
104 by ny sinta v V

19/05/2015 105 by ny sopiah V


106 by ny dewi V
107 by ny noviasari V
108 by ny wulan V
109 by ny sinta v V
20/05/2015 110 by ny sopiah V
111 by ny dewi V
112 by ny noviasari V
113 by ny wulan V
114 by ny sinta V
115 by ny yati V

21/05/2015 116 by ny sopiah V


117 by ny dewi V
118 by ny noviasari V
119 by ny wulan V
120 by ny sinta V
121 by ny yati V
121 by ny nursiah V

22/05/2015 122 by ny sopiah V


123 by ny dewi V
124 by ny noviasari V
125 by ny wulan V
126 by ny sinta V
127 by ny yati V
128 by ny nursiah V
129 by ny poppy V

23/05/2015 130 by ny sopiah V


131 by ny dewi V
132 by ny noviasari V
133 by ny wulan V
134 by ny sinta V
135 by ny yati V
136 by ny nursiah V
137 by ny poppy V
138 by ny rida V

24/05/2015 139 by ny sopiah V


140 by ny dewi V
141 by ny noviasari V
142 by ny wulan V
143 by ny sinta V
144 by ny yati V
145 by ny nursiah V
146 by ny poppy V

25/05/2015 147 by ny sopiah V


148 by ny dewi V
149 by ny santi V
149 by ny wulan V
150 by ny sinta V
151 by ny yati V
152 by ny nursiah V
153 by ny poppy V
154 by ny dianty V

26/05/2015 155 by ny sopiah V


156 by ny dewi V
157 by ny santi V
158 by ny wulan V
159 by ny poppy V
160 by ny yati V
161 by ny nursiah V
162 by ny dianty V

27/05/2015 163 by ny sopiah V


164 by ny dewi V
165 by ny santi V
166 by ny wulan V
167 by ny poppy V
168 by ny yati V
169 by ny nursiah V
170 by ny dianty V
170 by ny mimin II V
171 by ny siti khodijah V

28/05/2015 172 by ny wulan V


173 by ny poppy V
174 by ny yati V
175 by ny nursiah V
176 by ny dianty V
177 by ny mimin II V
178 by ny siti khodijah V

29/05/2015 179 by ny wulan V


180 by ny poppy V
181 by ny yati V
182 by ny nursiah V
183 by ny dianty V
184 by ny mimin II V
185 by ny siti khodijah V

30/05/2015 186 by ny wulan V


187 by ny siti khodijah V
188 by ny yati V
189 by ny nursiah V
190 by ny dianty V
191 by ny mimin II V
31/05/2015 192 by ny wulan V
193 by ny siti khodijah V
194 by ny yati V
195 by ny nursiah V
196 by ny dianty V
197 by ny mimin II V
16 197

Jumlah Byi 407

Ruang PERINATOLOGI - JUNI 2015


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2015 1 by ny yati 1
2 by ny nursiah 1
3 by mimin II 1
4 by ny dainty 1
5 by ny siti khodijah 1
6 by ny pipin 1

02/06/2015 1 by ny yati 1
2 by ny nursiah 1
3 by mimin II 1
4 by ny dainty 1
5 by ny siti khodijah 1
6 by ny pipin 1

03/06/2015 1 by ny yati 1
2 by ny nursiah 1
3 by mimin II 1
4 by ny Ayu 1 1
5 by ny pipin 1
1
04/06/2015 1 by ny yati 1
2 by ny nursiah 1
3 by mimin II 1
4 by ny pipin 1

05/06/2015 1 by ny yati 1
2 by ny nursiah 1
3 by mimin II 1
4 by ny pipin 1

06/06/2015 1 by ny yati 1
2 by ny nursiah 1
3 by mimin II 1

07/06/2015 1 by ny yati 1
2 by ny nursiah 1
3 by mimin II 1

08/06/2015 1 by ny mimin II 1

09/06/2015 1 by ny mimin II 1

10/06/2015 1 by ny mimin II 1

11/06/2015 1 by. hani II 1

12/06/2015 1 by ny hani II 1
2 by ny sylmi 1

13/06/2015 1 by ny hani II 1
2 by ny sylmi 1

14/06/2015 1 by ny hani II 1
2 by ny sylmi 1

15/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3 by ny erni 1 1

16/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3 by ny erni 1

17/06/2015 1 by ny hani II 1
2 by ny sylmi 1

18/06/2015 1 by ny hani II 1
2 by ny sylmi 1

19/06/2015 1 by ny hani II 1
2 by ny sylmi 1

20/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3 by ny sumiyati 1 1
4 by ny ani 1
5 by ny martini 1
21/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3 by ny sumiyati 1 1
4 by ny ani 1
5 by ny martini 1
6 by ny iis 1

22/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3 by ny sumiyati 1 1
4 by ny ani 1
5 by ny martini 1
6 by ny iis 1
7 by ny nining 1
8 by ny lia 1
9 by ny nursiah 1

23/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3 by ny sumiyati 1 1
4 by ny ani 1
5 by ny martini 1
6 by ny iis 1
7 by ny nining 1
8 by ny lia 1
9 by ny nursiah 1
10 by ny yuri 1

24/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3 by ny sumiyati 1 1
4 by ny ani 1
5 by ny martini 1
6 by ny iis 1
7 by ny nining 1
8 by ny lia 1
9 by ny nursiah 1
10 by ny yuri 1

25/06/2015 1 by ny hani II 1
2 by ny sylmi 1
3. by. nuralin 1
4 by ny ani 1
5 by ny martini 1
6. by. nani 1
7. by. yuri 1
8. by. nursiah 1
9. by. lia 1

26/06/2015 1 by lia 1
2 by ny sylmi 1
3. by. nuralin 1
4 by ny ani 1
5 by ny martini 1
6. by. nani 1
7. by. yuri 1
8. by. nursiah 1

27/06/2015 1 by lia 1
2 by ny sylmi 1
3. by. nuralin 1
4 by ny ani 1
5 by ny martini 1
6. by. nani 1
7. by. yuri 1
8. by. nursiah 1

28/06/2015 1 by nia 1
2 by ny sylmi 1
3. by. nuralin 1
4 by ny ani 1
5 by ny martini 1
6. by. nani 1
7. by. yuri 1
8. by. nursiah 1

29/06/2015 1 by nia 1
2 by ny sylmi 1
3. by. nuralin 1
4 by ny ani 1 1
5 by ny martini 1
6. by. nani 1
7. by. yuri 1
8. by. nursiah 1
9 by ny eni 1

30/06/2015 1 By. Ny. Nursiah 1


2. By. Ny. Martini 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1

9 141 Jumlah bayi baru rawat peri 202


Jumlah lahir 374
Formulir Survey Harian Pemakaian Alat
Ruang PERINATOLOGI - JULI 2015
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2015 1 By. Ny. Nursiah 1
2. By. Ny. Martini 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1

02/07/2015 1 By. Ny. Nursiah 1


2. By. Ny. Martini 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1
7. by ny Tri 1

03/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1
7. By.Ny. Maya 1

04/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1
7. By.Ny. Maya 1
8. By Adzan 1

05/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1
7. By.Ny. Maya 1
8. By Adzan 1
By ny tita
9. 1

06/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1
7. By.Ny. Maya 1
8. By Adzan 1
By.ny neni
9 1

07/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1
7. By.Ny. Maya 1
8. By Adzan 1
9. by. siti aminah 1

08/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. By. Ny. Teni 1
6. By. Ny. Sarni 1
7. By.Ny. Maya 1
8. By Adzan 1
9. by. siti aminah 1
10. by. iis 1

09/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. by ny erni 1
6. by ny siti A 1
7. By.Ny. Maya 1

10/07/2015 1. By. Ny. Tri 1


2. By. Ny. Nursiah 1
3. By. Ny. Nuralin 1
4. By. Ny. Eni 1
5. by ny erni 1
6. by ny siti A 1
7. By.Ny. Maya 1
8. by ny riyanti 1
11/07/2015 1. By. Ny. Tri 1
2. by ny rika 1
3. by ny siti A 1
4. by ny maya 1
5. by ny erni 1

12/07/2015 1. By. Ny. Tri 1


2. by ny rika 1
3. by ny siti A 1
4. by ny maya 1
5. by ny erni 1

13/07/2015 1. By. Ny. Tri 1


2. by ny rika 1
3. by ny siti A 1
4. by ny maya 1
5. by ny erni 1

14/07/2015 1. By. Ny. Tri 1


2. by ny erni 1
3. by ny siti A 1
4. by ny maya 1

15/07/2015 1. By. Ny. Tri 1


2. by ny erni 1
3. by ny siti A 1
4. by ny maya 1
5. by ny nuryawanti 1
6 by ny oktavianti 1 1

16/07/2015 1. By. Ny. Tri 1


2. by ny erni 1
3. by ny siti A 1
4. by ny maya 1
5. by ny nuryawanti 1

17/07/2015 1 by ny siti A 1
2 by ny maya 1
3 by ny nuryawanti 1

18/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1

19/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1

20/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1

21/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1
4 by ny rita/ananda 1
5 by ny anisa 1

22/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1
4 by ny rita/ananda 1
5 by ny anisa 1

23/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1
4 by ny rita/ananda 1

24/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1
4 by ny rita/ananda 1
5 by ny imas 1
6 by ny mahyati 1

25/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1
4 by ny rita/ananda 1
5 by ny imas 1
6 by ny mahyati 1

26/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1
4 by ny rita/ananda 1
5 by ny imas 1
6 by ny mahyati 1

27/07/2015 1 by ny siti a 1
2 by ny nuryawanti 1
3 by ny rani 1
4 by ny rita/ananda 1
5 by ny imas 1

28/07/2015 1 By.Ny. Evi 1 1


2 By. Ny. Imas 1
3 By.Ny. Siti Aminah 1
4 By.Ny. Nuryawanti 1
5 By.Ny. Rani 1

29/07/2015 1 By.Ny. Evi 1 1


2 By. Ny. Imas 1
3 By.Ny. Siti Aminah 1
4 By.Ny. Rani 1
5 By.Ny. Nuryawanti

30/07/2015 1 By.Ny. Evi 1 1


2 By. Ny. Imas 1
3 By.Ny. Siti Aminah 1
4 By.Ny. Rani 1

31/07/2015 1 By.Ny. Evi 1 1 1


2 By. Ny. Imas 1
3 By.Ny. Rani 1

TOTAL
5 173 1 Jumlah bayi baru rawat peri 247
Jumlah lahir hidup 411 bayi
Ruang PERINATOLOGI - Agustus 2015
Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2015 1 By.Ny. Evi 1 1
2 By. Ny. Imas 1

02/08/2015 1 By.Ny. Evi 1 1


2 By.NY. Linda 1

03/08/2015 1 By.Ny. Evi 1 1


2 By.NY. Linda 1

04/08/2015 1 By.Ny. Evi 1


2 By.NY. Linda 1
3 By.Ny. Hetty 1

05/08/2015 1 By.Ny. Evi 1


2 By.NY. Linda 1
3 By.Ny. Hetty 1
4 By.NY. Rita 1
5 By.Ny. Sri Rejeki 1

06/08/2015 1 By.Ny. Evi 1


2 By.Ny. Hetty 1
3 By.NY. Rita 1
4 By.Ny. Sri Rejeki 1

07/08/2015 1 By.Ny. Evi 1


2 By.Ny. Hetty 1
3 By.NY. Rita 1
4 By.Ny. Sri Rejeki 1

08/08/2015 1 By.Ny. Evi 1


2 By.Ny.Hetty 1
3 By.Ny.Rita 1
4 By.Ny. Suyatun 1
1

09/08/2015 1 By.Ny. Evi 1


2 By.Ny.Hetty 1
3 By.Ny.Rita 1
4 By.Ny. Suyatun 1
5 By.Ny. Harda 1
6 By.NY. Neng Anih 1
7 By.NY. Nikeu 1

10/08/2015 1 By.Ny. Suyatun 1


2 By.Ny. Harda 1
3 By.NY. Neng Anih 1
4 By.NY. Nikeu 1

11/08/2015 1 By.Ny. Suyatun 1


2 By.Ny. Harda 1
3 By.NY. Neng Anih 1
4 By.NY. Nikeu 1 V
5 by. ny. Rita 1
6 by. ny. Jeni 1

12/08/2015 1 By.Ny. Suyatun 1


2 By.Ny. Neng Anih 1
3 By.NY. Nikeu 1

13/08/2015 1 By.Ny. Risna 1


2 By.Ny. Neng Anih 1
3 By.NY. Nikeu 1

14/08/2015 1 By.Ny. Risna 1


2 By.Ny. Neng Anih 1
3 By.NY. Nikeu 1

15/08/2015 1 By.Ny. Risna 1


2 By.Ny. Neng Anih 1
3 By.NY. Nikeu 1

16/08/2015 1 By.Ny. Risna 1


2 By.Ny. Neng Anih 1
3 By.NY. Nikeu 1

By.Ny.Neng Anih
17/08/2015 1 1
By.Ny.Risna
2 1
By.Ny.Nikeu
3 1

18/08/2015 1 By.Ny.Neng Anih 1


2 By.Ny.Risna 1
3 By.Ny.Nikeu 1
4 By.Ny.Yanti 1

19/08/2015 1 By.Ny.Neng Anih 1


2 By.Ny.Nikeu 1
3 By.Ny.Yanti 1

20/087/2015 1 By.Ny.Neng Anih 1


2 By.Ny.Nikeu 1
3 By.Ny.Yanti 1

21/08/2015 1 By.Ny.Neng Anih 1


2 By.Ny.Nikeu 1
3 By.Ny.Yanti 1

22/08/2015 1 By. Ny.Nikeu 1


2 By.Ny.Yanti 1

23/08/2015 1. By.Ny.Yanti 1
2 By.NY. Nurmayanti 1
3 By.Ny.Nikeu 1

24/08/2015 1 By.Ny. Yati 1


2 By.Ny.Nurmayanti 1

25/08/2015 1 By.Ny.Yati 1

26/08/2015 1 By.Ny.Yanti 1

27/08/2015 1 by ny tati 1
2 by ny efi 1 1
3 by ny yanti 1

28/08/2015 1 by ny tati 1
2 by ny yanti 1 1

29/08/2015 1 by ny tati 1
2 by ny yanti 1
3 by ny neulis 1

30/08/2015 1 by ny tati 1
2 by ny neulis 1

31/08/2015 1 By.Ny.Tati 1
2 By.Ny. Neulis 1
3 By.Ny. Meida 1

Jumlah Bayi Lahir : 377 bayi


TOTAL 5 97 1 Jumlah bayi baru rawat peri : 202

Ruang PERINATOLOGI - September 2015


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2015 1 By.Ny. Neulis 1
2 By. Ny.Tati 1
3 By. Ny. Meida 1

02/09/2015 4 By.Ny. Neulis 1


5 By.Ny. Tati 1
6 By. Ny. Meida 1
7 by ny rd ajeng 1
8 by ny nurhayati 1

03/09/2015 9 By.Ny. Neulis 1


10 By.Ny. Tati 1
11 By. Ny. Meida 1
12 by ny rd ajeng 1
13 by ny lilis 1

04/09/2015 14 by ny rd ajeng 1
15 by meida 1
16 by ny lilis 1
17 by ny imas 1
18 by ny tati 1 1

05/09/2015 18 by ny rd ajeng 1
20 by meida 1
21 by ny lilis 1
22 by ny imas 1
23 by ny susi 1
06/09/2015 24 by ny rd ajeng 1
25 by meida 1
26 by ny lilis 1
27 by ny imas 1

07/09/2015 28 by ny rd ajeng 1
29 by meida 1
30 by ny lilis 1
31 by ny imas 1
32 by ny euis 1 1

08/09/2015 33 by ny rd ajeng 1
34 by meida 1
35 by ny lilis 1
36 by ny imas 1
37 by ny euis 1 1

09/09/2015 38 by ny rd ajeng 1
39 by meida 1
40 by ny lilis 1
41 by ny imas 1
42 by ny euis 1 1
43 by ny tri 1
44 by ny deninta 1
45 by ny runi 1

10/09/2015 46 by ny deninta 1
47 by ny rd ajeng 1
48 by meida 1
49 by ny lilis 1
50 by ny imas 1
51 by ny euis 1
52 by ny runi 1

11/09/2015 53 by ny siti h 1
54 by ny rd ajeng 1
55 by meida 1
56 by ny lilis 1
57 by ny imas 1
58 by ny runi 1
59 by ny elis 1

12/09/2015 60 by ny siti h 1
61 by ny rd ajeng 1
62 by meida 1
63 by ny lilis 1
64 by ny imas 1
65 by ny runi 1
66 by ny elis 1

13/09/2015 67 by ny siti h 1
68 by ny rd ajeng 1
69 by meida 1
70 by ny lilis 1
71 by ny imas 1
72 by ny runi 1
73 by ny elis 1
74 by ny rise 1

14/09/2015 75 by ny siti h 1
76 by ny rd ajeng 1
77 by meida 1
78 by ny lilis 1
79 by ny rise 1
80 by ny runi 1
81 by ny elis 1

15/09/2015 82 by ny siti h 1
83 by ny rd ajeng 1
84 by meida 1
85 by ny lilis 1
86 by ny rise 1

16/09/2015
87 by ny rd ajeng 1
88 by meida 1
89 by ny lilis 1
90 by ny rise 1
91 by ny heni 1

17/09/2015
92 by ny rd ajeng 1
93 by meida 1
94 by ai sutinah 1
95 by ny rise 1

18/09/2015
96 by ny rd ajeng 1
97 by meida 1
98 by ai sutinah 1
99 by ny rise 1
100 by. heni 1

19/09/2015
101 by ny rd ajeng 1
102 by meida 1
103 by ai sutinah 1

20/09/2015
104 by ny rd ajeng 1
105 by meida 1
106 by ai sutinah 1
107 by. heni 1

21/09/2015
108 by ny rd ajeng 1
109 by meida 1
110 by ai sutinah 1
111 by. heni 1
4
22/09/2015
112 by ny rd ajeng 1
113 by meida 1
114 by. heni 1
3
23/09/2015
115 by ny rd ajeng 1
116 by meida 1
117 by. heni 1
3
24/09/2015 118 by ny rd ajeng 1
119 by meida 1
2
25/09/2015 120 by ny rd ajeng 1
121 by meida 1
2
26/09/2015 122 by ny rd ajeng 1
123 by meida 1
2
27/09/2015 124 by ny rd ajeng 1
1
28/09/2015 125 by ny rd ajeng 1
126 by. ny. santi 1
2
29/09/2015 127 by ny rd ajeng 1
128 by. ny. santi 1
2
30/09/2015 129 by ny rd ajeng 1
1
4 129

Ruang PERINATOLOGI - Oktober 2015


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2015 -

02/10/2015 1 by ny ratih V
1
03/10/2015 2 by ny ratih V
3 by ny niar V
2
04/10/2015 4 by ny ratih V
5 by ny niar V V
2 1
05/10/2015 6 by ny ratih V
7 by ny niar V V
2 1
06/10/2015 8 by ny ratih V
9 by ny niar V V
10 by ny ipah V 1
3
07/10/2015 11 by ny niar V V
12 by ny ipah V 1
13 by ny iis siti V
3
08/10/2015 14 by ny tini V
15 by ny ipah V V
1 2
09/10/2015 16 by ny tini V
1
10/10/2015 17 by ny tini V
1
11/10/2015 18 by ny tini V
1
12/10/2015 19 by ny tini V
1
13/10/2015 20 by ny tini V
21 by. lian v
2
14/10/2015 22 by ny tini V
23 by. lian v
2
15/10/2015 24 by ny tini V
25 by. lian v V
2 1
16/10/2015 26 by ny tini V
27 by. lian v
2
17/10/2015 28 by ny tini V
29 by. lian v
2
18/10/2015 30 by ny tini V
31 by. lian v
2
19/10/2015 32 by ny tini V
1
20/10/2015 33 by.Ny. Mira v
34 By.Ny. Wulani V V
2

21/10/2015 35 by.Ny. Mira v


36 By.Ny. Wulani V v
2

22/10/2015 37 By.Ny. Mira V


38 By.Ny. Wulani V V
39 By.Ny. Sri Ida V
3

23/10/2015 40 By.Ny. Mira V


41 By.Ny. Wulani V V
42 By.Ny. Sri Ida V
43 By.Ny. Dini V
4

24/10/2015 44 By.Ny. Mira V


45 By.Ny. Wulani V V
46 By.Ny. Sri Ida V
47 By.Ny.Destri V
4

25/10/2015 48 By.Ny. Mira V


49 By.Ny. Wulani V V
50 By.Ny. Destri V
3

26/10/2015 51 By.Ny. Mira V


52 By.Ny. Wulani V
53 By.Ny. Destri V
3

27/10/2015 54 By.Ny. Mira V


55 By.Ny. Wulani V
56 By.Ny. Fani V
3

28/10/2015 57 By.Ny. Mira V


58 By.Ny. Wulani V
59 By.Ny. Fani V
60 By. Ny. Yanti V/V
4

29/10/2015 61 By.Ny. Mira V


62 By.Ny. Fani V
63 By. Ny. Yanti V/V
3
30/10/2015 64 by. rina v v
65 by. fani v
66 by. yanti v/v
67 by. mira v
1 4

31/10/2015 68 by. yanti v/v


1
9 77 5 jumlah bayi baru rawat peri:203 bayi

Ruang PERINATOLOGI - November 2015


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2015 1 by ny yanti v/v
1
02/11/2015 2 by ny yanti v/v
1
03/11/2015 3 by ny yanti v/v
1
04/11/2015 4 by.ny.yanti v/v
1
05/11/2015 5 by ny yanti v/v
6 by ny ating v
7 by ny viny v
8 by ny eulis v
4
06/11/2015 9 by ny yanti v/v
10 by ny ating v
11 by ny viny v
12 by ny eulis v
4
07/11/2015 13 by ny yanti V/V
1
08/11/2015 14 by ny yanti V/V
1
09/11/2015 15 by ny yanti V/V
16 by ny dini V
2
10/11/2015 17 by ny yanti V/V
18 by ny dini V
19 by ny aas V
20 by ny titin V
4
11/11/2015 21 by ny yanti V/V
22 by ny dini V
23 by ny aas V
24 by ny titin V
4
12/11/2015 25 by ny yanti V/V
26 by ny dini V
27 by ny aas V
28 by ny titin V
4
13/11/2015 29 by ny yanti V/V
30 by ny dini V
31 by ny aas V
32 by ny titin V
4
14/11/2015 33 by ny yanti V/V
34 by ny dini V
35 by ny aas V
36 by ny titin V
4
15/11/2015 37 by ny yanti V/V
38 by ny dini V
39 by ny aas V
3
16/11/2015 40 by ny yanti V/V
41 by ny dini v
42 by vera v
3
17/11/2015 43 by ny yanti V/V
44 by ny hamidah v
45 by ny vera v
3
18/11/2015 46 by ny yanti V/V
47 by ny hamidah v
48 by ny vera v
3
19/11/2015 49 by ny yanti V/V
50 by ny hamidah v
51 by ny vera v
3
20/11/2015 52 by ny yanti V/V
53 by ny hamidah v
54 by ny vera v
55 by ny enung V
56 by ny siti r I V
57 by ny siti r II V
6
21/11/2015 58 by ny yanti V/V
59 by ny hamidah v
60 by ny vera v
61 by ny enung V
62 by ny siti r I V
63 by ny siti r II V
64 by ny safitri V
7
22/11/2015 65 by ny yanti V/V
66 by ny hamidah v
67 by ny safitri v
68 by ny enung V
69 by ny siti r I V
70 by ny siti r II V
6
23/11/2015 71 by ny yanti V/V
72 by ny hamidah v
73 by ny safitri v
74 by ny enung V
75 by ny siti r I V
76 by ny siti r II V
6
24/11/2015 77 by ny yanti V/V
78 by ny hamidah v
79 by ny safitri v
80 by ny siti r I V
81 by ny siti r II V
5
25/11/2015 82 by ny yanti v/v
83 by ny safitri v
2
26/11/2015 84 by ny yanti v/v
85 by ny yani v
86 by ny tina v
87 by ny evi v
88 by ny nuraeni v
5

27/11/2015 89 by ny yanti v/v


90 by ny yani v
91 by ny tina v
92 by ny evi v
93 by ny nurhasanah v
94 by nu nuraeni v
6

28/11/2015 95 by ny yanti v/v


96 by ny yani v
97 by ny tina v
98 by ny evi v
99 by ny nurhasanah v
100 by ny nuraeni v
6

29/11/2015 101 by ny yanti v/v


102 by ny yani v
103 by ny tina v
104 by nurhasanah v
4
30/11/2015 105 by ny yanti v/v
1

105/ 29

Ruang PERINATOLOGI - DESEMBER 2015


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2015 1 BY ny yanti v/v
1
02/12/2015 2 by ny yanti v/v
3 by ny kokom v
2
03/12/2015 4 by ny yanti v/v
5 by ny kokom v
6 by ny rina v
3
04/12/2015 7 by ny yanti v/v
8 by. rina v
9 by. meyzha v
3
05/12/2015 10 by. yanti v/v
11 by. meyzha v
2
06/12/2015 12 by. yanti v/v
13 by. rika v
2
07/12/2015 14 by. yanti v/v
15 by. rika v v
2
08/12/2015 16 by. yanti v/v
17 by. hani v
2
09/12/2015 18 by. yanti v/v
19 by. hani v
2
10/12/2015 20 by. yanti v/v
21 by. hani v
2
11/12/2015 22 by. yanti v/v
23 by. yesita v
2
12/12/2015 24 by. yanti v/v
25 by. yesita v
2
13/12/2015 26 by. yanti v/v
27 by. euis v
28 by. oktaviyani v
29 by. ratna v
4
14/12/2015 30 by. yanti v/v
31 by. euis v
32 by. oktaviyani v
33 by. ratna v
34 by. trisni II v
35 by. sopiah v
6
15/12/2015 36 by. yanti v/v
37 by. euis v
38 by. oktaviyani v
39 by. trisni II v
4
16/12/2015 40 by. yanti v/v
41 by. euis v
42 by. oktaviyani v
43 by. trisni II v
4
17/12/2015 44 by. laela v
45 by. imas v
46 by. euis v
47 by. oktaviyani v
48 by. trisni II v
5
18/12/2015 49 by. laela v
50 by. imas v
51 by. euis v
52 by. oktaviyani v
53 by. trisni II v
54 by. yuyun v
6
19/12/2015 55 by. laela v
56 by. imas v
57 by. euis v
58 by. yuyun v
59 by. trisni II v
5
20/12/2015 60 by. laela v
61 by. imas v
62 by. euis v
63 by. yuyun v
64 by. trisni II v
5
21/12/2015 65 by. euis v
66 by. imas v
67 by. trisni II v
3
22/12/2015 68 by. euis v
1
23/12/2015 69 by. euis v
1
24/12/2015 70 by. euis v
1
25/12/2015 71 by. euis v
1
26/12/2015 72 by. elis v
73 by. titin v
2
27/12/2015 74 by. elis v
1
28/12/2015 75 by. elis v v
76 by. rina v
2
29/12/2015 77 by. elis v v
78 by. rina v
79 by. warsih v
3
30/12/2015 80 by. elis v v
81 by. rina v
82 by. dewi v
83 by. warsih v
4
31/12/2015 84 by. elis v v
85 by. rina v
86 by. dewi v
85 by. warsih v
4
87/20

Ruang PERINATOLOGI - JANUARI 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2016 1 by. elis v v
2 by. rina v
3 by. warsih v
3
02/01/2016 4 by. rina v
5 by. dewi v
6 by. erni 1 v
7 by. erni 2 v
4
03/01/2016 8 by. rina v
9 by. nurul v
10 by. by. erni 1 v
3
04/01/2015 11 by. rina v
12 by. nurul v
13 by. by. erni 1 v
3
05/01/2015 14 by. rina v
15 by. nurul v
16 by. by. erni 1 v
3

06/01/2015 17 by. rina v


18 by. nurul v
19 by. by. erni 1 v
20 By.Ny. Wati v
4

07/01/2016 21 by. rina v


22 by. nurul v
23 by. by. erni 1 v
24 By.Ny. Wati v
4
08/01/2016 25 by. rina v
26 by. nurul v
27 by. by. erni 1 v
28 By.Ny. Wati v
29 By. Euis N v
5
09/01/2016 30 by. rina v
31 by. nurul v
32 by. by. erni 1 v
33 By.Ny. Wati v
34 By. Euis N v
35 By. Desi v
6

10/01/2016 36 by. rina v


37 by. nurul v
38 by. by. erni 1 v
39 By.Ny. Wati v
40 By. Euis N v
41 By. Desi v
6

11/01/2016 42 by. rina v


43 by. nurul v
44 by. by. erni 1 v
45 By.Ny. Wati v
46 By. Euis N v
5
12/01/2016 47 by. rina v
48 by. nurul v
49 by. by. erni 1 v
50 by. euis. n v
4
13/01/2016 51 by. nurul v
52 by. by. erni 1 v
53 by. euis. n v
3

14/01/2016 54 by. nurul v


55 by. by. erni 1 v
56 by. euis. n v

57 By.Ny. Rina Indrayani v


4

15/01/2016 58 By.Ny. Rina I v


59 by. nurul v
60 by. by. erni 1 v
61 by. euis. n v
4

16/01/2016 62 by. nurul v


63 by. by. erni 1 v
64 by. euis. n v
3

17/01/2016 65 By.Ny. Nurul v

18/01/2016 66 By.Ny. Nurul v


67 By. Ny. Wasiah v
2
19/01/2016 68 By.Ny. Nurul v
69 By. Ny. Wasiah v
70 By. ny. Ratih v
3
20/01/2016 71 By.Ny. Nurul v
72 By. Ny. Ratih v
3
21/01/2016 73 By.Ny. Nurul v
74 By. Ny. Ratih v
75 By. ny. Pujiati v
3
22/01/2016 76 By.Ny. Nurul v
77 By. Ny. Ratih v
78 By. ny. Pujiati v
79 By. ny. tita v
4
23/01/2016 80 By.Ny. Nurul v
81 By. Ny. Ratih v
82 By. ny. Pujiati v
83 By. ny. tita v
4
24/01/2016 84 By.Ny. Nurul v
85 By. Ny. Ratih v
86 By. ny. Pujiati v
87 By. ny. tita v
4
25/01/2016 88 By.Ny. Nurul v
89 By. Ny. Ratih v
90 By. ny. Pujiati v
91 By. ny. tita v
4
26/01/2016 92 By.Ny. Nurul v
93 By. Ny. Ratih v
94 By. ny. Pujiati v
95 By. ny. tita v
4
27/01/2016 96 By.Ny. Nurul v
97 By. Ny. Ratih v
98 By. ny. Pujiati v
99 By. ny. tita v
4

28/01/2016 100 by. imas v


101 by. nurul v
102 by. tita v
103 by, ratih v
4

29/01/2016 104 by. imas v


105 by. nurul v
106 by. tita v
107 by. nia v
108 by. lisnawati v
109 by. sutiah v
6
30/01/2016 110 by. imas v
111 by. nurul v
112 by. tita v
113 by. nia v
114 by. lisnawati v
115 by. enti v
6

31/01/2016 116 by. imas v


117 by. tita v
118 by. nia v
119 by. lisnawati v
4

jumlah pasien 119/19

Ruang PERINATOLOGI - FEBRUARI 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2016 1 By. lisnawati v
2 By. iim v
3 by. susi v v
4 by. imas v
5 by. nia v
6 by. tita v
1 6

02/02/2016 7 by. imas v


8 by. nia v
9 by. tita v
10 by. dhian v
11 by. lsnawati v
5

03/02/2016 12 by. imas v


13 by. nia v
14 by. tita v
15 by. dhian v
16 by. lsnawati v
17 by. dhini v/v
6/1

04/02/2016 18 by. nia v


19 by. tita v
20 by. dhian v
21 by. lsnawati v
22 by. dhini v/v
23 by. siti f v/v
24 by. dhian v
7/2

05/02/2016 25 by. tita v/v


26 by. dini v/v
27 by. siti f v/v
28 by. dhian v
4/3

06/02/2016 29 by. tita v/v


30 by. dini v/v
31 by. siti f v/v
32 by. dhian v
4/3

07/02/2016 33 by. tita v/v


34 by. dini v/v
35 by. siti f v/v
3 /3
08/02/2016 36 by. tita v/v
37 by. dini v/v
38 by. siti f v
39 by. warsih v
4/2

09/02/2016 40 by. tita v/v


41 by. dini v/v
42 by. siti f v
43 by. warsih v
44 by. narni v
5/2
10/02/2016 45 by. tita v/v
46 by. dini v
47 by. siti f v
48 by. warsih v
49 by. narni v v
1 5/1
11/02/2016 50 by. tita v/v
51 by. dini v
52 by. siti f v
53 by. warsih v
54 by. narni v
55 By.Ny. Eulis v
6/1
12/02/2016 56 by. tita v/v
57 by. dini v
58 by. siti f v
59 by. warsih v
60 by. narni v v
61 By.Ny. Eulis v
1 6/1
13/02/2016 62 by. tita v/v
63 by. dini v
64 by. siti f v
65 by. warsih v
66 by. narni v v
67 By.Ny. Eulis v
1 6/1
14/06/2016 68 by. tita v/v
69 by. dini v
70 by. siti f v
71 by. warsih v
72 by. narni v v
73 By.Ny. Eulis v
1 6/1
15/02/2016 74 By. NY. Siti R v v
75 by. dini v
76 by. siti f v
77 by. warsih v
78 by. narni v v
79 By.Ny. Eulis v
2 6
16/02/2016 80 by. dini v
81 by. siti f v
82 by. warsih v
83 by. narni v v
84 By.Ny. Eulis v
1 5
17/02/2016 85 by. dini v
86 by. siti f v
87 by. warsih v
88 by. narni v v
1 4

18/02/2015 89 by. dini v


90 by. siti f v
91 by. warsih v
92 by. narni V v
93 by. yeni v
1 5

19/02/2016 94 by. siti f v


95 by. warsih v
96 by. yeni v
3

20/02/2016 97 by. siti f v


98 by. warsih v
99 by. yeni v
3

21/02/2016 100 by. ny. yeni v


101 by. ny. warsih v
102 by. ny. rosmawati v
103 by. ny. siti f v
104 by. ny. ida v
5

22/02/2016 105 by. ny. yeni v


106 by. ny. warsih v
107 by. ny. rosmawati v
108 by. ny. siti f v
109 by. ny. ida v
5

23/02/2016 110 by. ny. warsih v


111 by. ny. rosmawati v v
112 by. ny. siti f v
113 by. ny. ida v
1 4
24/02/2016 114 by. ny.ida v
115 by. ny. mala v
116 by. ny. yani v v
1 3
25/06/2016 117 by. ny.ida v
118 by. ny. mala v
119 by. ny. yani v v
1 3
26/02/2016 120 by. ny.ida v
121 by. ny. mala v
122 By.Ny. Anggia v
3

27/02/2016 123 by. ny. ida v


124 by. ny. mala v
125 by. mimin v
126 by. anna v
4

28/02/2016 127 by. ny. ida v


128 by. ny. mala v
129 by. mimin v
130 by. anna v
4

29/02/2016 131 by. ny. ida v


132 by. ny. mala v
133 by. mimin v
134 by. anna v
4

13 134/ 21 jumlah bayi rawat peri = 179


jumlah seluruh bayi = 333

Ruang PERINATOLOGI - MARET 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2018 1 BY. Mala v
2 by. ida v
3 by. mimin v
4 by. susilawati v
5 by. anna v
5
02/03/2016 6 by. mala v
7 by. ida v
8 by. susilawati v
9 by. anna v
4

03/03/2016 10 by. mala v


11 by. susilawati v
12 by. yayang 1 v
13 by. yayang 2 v
14 by. siti munirah v
15 by. elly v
6

04/03/2016 16 by. mala v v


17 by. susilawati v
18 by. siti munirah v
19 by. elly v
20 by. astri v
1 5

05/03/2016 21 by. susilawati v


23 by. elly v
24 by. astri v
25 by. nuraisah II v
26 by. nuraisah I v
5

06/03/2016 27 by. nuraisah I v


28 by. nuraisah II v
29 by. susilawati v
30 by. elly v
4

08/03/2016 31 by. nuraisah I v


32 by. nuraisah I v
33 by. susilawati v
3

09/03/2016 34 by. nuraisah I v


35 by. nuraisah I v
36 by. susilawati v
37 by. bintang v v
1 4
10/03/2016 38 by. nuraisah I v
39 by. nuraisah II v
40 by. susilawati v
41 by. bintang v v
1 4

11/03/2016 42 by. nuraisah I v


43 by. nuraisah II v
44 by. susilawati v
45 by. bintang v
46 by. silfi v v
1 5

12/03/2016 47 by. nuraisah I v


48 by. nuraisah II v
49 by. susilawati v
50 by. bintang v
51 by. silfi v v
52 by. kokom v
1 6
13/03/2016 53 by. nuraisah I v
54 by. nuraisah II v
55 by. susilawati v
56 by. bintang v
57 by. silfi v v
58 by. kokom v
1 6

14/03/2016 59 by. nuraisah I v


60 by. susilawati v
61 by. bintang v
62 by. kokom v
63 by. erni v
64 by. yusnita v
65 by. fitri 1 v
7
15/03/2016 66 by. nuraisah I v
67 by. susilawati v
68 by. bintang v
69 by. erni v
70 by. yusnita v
71 by. fitri 1 v
72 by. neli v
7

16/03/2016 73 by. nuraisah I v


74 by. susilawati v
75 by. yusnita v
76 by. neli v
77 By.Ny. Fitri v
78 By.Ny.Erni v
6
17/03/2016 79 By.Ny. Erni v
80 By.Ny. Nuraisah v
81 By.Ny. Susilawati v
82 By.nY. Yusnita v
83 By.Ny. Neli v
84 By.NY. Tuti v
85 By.Ny. Ida v
7

18/03/2016 86 By.Ny. Erni v


87 By.Ny. Nuraisah v
88 By.Ny. Susilawati v
89 By.Ny. Ida v
90 By. Ria v
91 By.Ny. Tuti v
6

19/03/2016 92 By.Ny. Erni v


93 By.Ny. Nuraisah v
94 By.Ny. Susilawati v
95 By. Ria v
96 By.Ny. Tuti v
5

20/03/2016 97 By.Ny. Erni v


98 By.Ny. Nuraisah v
99 By.Ny. Susilawati v
100 By. Ria v
101 By.Ny. Tuti v
102 By.Ny. Sri Dewi K v
103 By. Ny. Imas v
7
21/03/2016 104 By.Ny. Erni v
105 By.Ny. Nuraisah v
106 By.Ny. Susilawati v
107 By. Ria v
108 By.Ny. Tuti v
109 By.Ny. Sri Dewi K v
110 By.Ny. Imas v
7
22/03/2016 111 By.Ny. Erni v
112 By.Ny. Nuraisah v
113 By.Ny. Susilawati v
114 By. Ria v
115 By.Ny. Sri Dewi K v
116 By.Ny. Imas v
117 by. Ny. Wulansari 2 v
7
23/03/2016 118 By.Ny. Erni v
119 By.Ny. Nuraisah v
120 By.Ny. Susilawati v
121 By. Ria v
122 By.Ny. Sri Dewi K v
123 by. Ny. Wulansari 2 v
6

24/03/2016 124 By.Ny. Erni v


125 By.Ny. Nuraisah v
126 By.Ny. Susilawati v
127 By. Ria v
128 By.Ny. Sri Dewi K v
129 by. Ny. Wulansari 2 v
6
25/03/2016 130 By.Ny. Erni v
131 By.Ny. Nuraisah v
132 by. ria v
133 by. anita v
134 By.Ny. Sri Dewi K v
135 by. Ny. Wulansari 2 v
6
26/03/2016 136 By.Ny. Erni v
137 By.Ny. Nuraisah v
138 by. ria v
139 by. anita v
140 By.Ny. Sri Dewi K v
141 by. Ny. Wulansari 2 v
6
27/03/2016 142 By.Ny. Erni v
143 By.Ny. Nuraisah v
144 by. ria v
145 By.Ny. Sri Dewi K v
146 by. Ny. Wulansari 2 v
5

28/03/2016 147 By.Ny. Erni v


148 by. ria v
149 By.Ny. Sri Dewi K v
150 by. Ny. Wulansari 2 v
151 by.ny. nining v
5
29/03/2016 152 By.Ny. Erni v
153 by. ria v
154 By.Ny. Sri Dewi K v
155 by. Ny. Wulansari 2 v
156 by.ny. nining v
157 by. ny. rosari v
6
30/03/2016 158 By.Ny. Erni v
159 by. ria v
160 By.Ny. Sri Dewi K v
161 by. Ny. Wulansari 2 v
162 by.ny. nining v
163 by. ny. rosari v
164 by. lindawati v v/v
1 7/1

31/03/2016 185 By.Ny. Erni v


166 by. ria v
167 By.Ny. Sri Dewi K v
168 by. Ny. Wulansari 2 v
169 by.ny. nining v
170 by. ny. rosari v
171 by. lindawati v v/v
172 by.ny.euis v
1 8/1
jumlah 8 172 / 2

191/172

Ruang PERINATOLOGI - APRIL 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 1 by. ny. wulansari II v
2 by. ny. euis v
3 by. ny. neng lisda v
4 by. ny. lindawati v -/v
5 by. ny. erni v
6 by. ny. ria v
7 by. ny. nining v
1 6/1

02/04/2016 8 by. ny. wulansari II v


9 by. ny. neng lisda v
10 by. ny. lindawati v -/v
11 by. ny. erni v
12 by. ny. ria v
13 by. ny. nining v
1 5/1

03/04/2016 14 by. ny. wulansari II v


15 by. ny. neng lisda v
16 by. ny. lindawati v -/v
17 by. ny. erni v
18 by. ny. ria v
19 by. ny. hanimah I v
20 by. ny. hanimah II v
1 6/1

04/04/2016 21` by. ny. wulansari II v


22 by. ny. lindawati v -/v
23 by. ny. hanimah I v v
24 by. ny. hanimah II v
25 by. siti lestari v
26 by. epi v
2 5/1

05/04/2016 27 by. wulansari II v


28 by. epi v
29 by. iin v
30 by. lindawati v -/v
31 by. hanimah I v v
32 by. hanimah II v
2 5/1
06/04/2016 33 by. wulansari II v
34 by. epi v
35 by. iin v
36 by. evi v
37 by. lindawati v -/v
38 by. hamimah I v v
39 by. hamimah II v
2 6/1

07/04/2016 40 by. lindawati v -/v


41 by. hamimah I v v
42 by. hamimah II v
43 by. wulansari II v
44 by. krisna v
45 by. evi v
46 by. surtini v
2 6/1
08/04/2016 47 by. surtini v
48 by. santi v
49 by. epi v
50 by. hamimah I v -/v
51 by. hamimah II v
52 by. lindawati v -/v
2 4/2

09/04/2016 53 by. zafran v


54 by. hamimah I v -/v
55 by. hamimah II v
56 by. surtini v
57 by. santi v
58 by. ervina v
59 by. luthfi v
1 6/1

10/04/2016 60 by. zafran v


61 by. hamimah I v -/v
62 by. hamimah II v
63 by. surtini v
64 by. santi v
65 by. ervina v
by. luthfi v
1 6/1

11/04/2016 66 by. enis v


67 by. surtini v
68 by. hamimah I v -/v
69 by. hamimah II v
70 by. zafran v
1 4/1

12/04/2016 71 by. hamimah I v -/v


72 by. hamimah II v
73 by. zafran v
74 by. erni v
75 by. surtini v
76 by. enis v
77 by. ny. rina v
1 6/1

13/04/2016 78 by. surtini v


79 by. rina v
80 by. hamimah I v v/-
81 by. hamimah II v
82 by. zafran v
83 by. erni v
84 by. fitri v
1 6/1

14/04/2016 85 by. hamimah I v v/-


86 by. hamimah II v
87 by. erni v/-
88 by. fitri v
89 by. surtini v
90 by. anggi v
1 5/2

15/04/2016 91 by. hamimah I v v/-


92 by. hamimah II v
93 by. erni v/-
94 by. surtini v
95 by. ervina v
96 by. anggi v
97 by. lina v
98 by. neni v
1 7/2

16/04/2016 99 by. surtini v


100 by. hamimah I v v/ -
101 by. erni v/-
102 by. widuri v v
103 by elza v
104 by neni v
105 by. ervina v
106 by. anggi v
107 by. lia v
108 by. erni 1 v
1 8/2
17/04/2016 109 by. lia v
110 by. ervina v
111 by. elza v
112 by. r. lia v
113 by. sri. w v
114 by. hamimah I v v/-
115 by. surtini v
116 by. erni v/-
1 6/2
18/04/2016 117 by. hamimah I v v/-
118 by. surtini v
119 by. erni v/-
120 by. hasanah I v
121 by. hasanah 2 v
122 by. lia v
1 4/2
19/04/2016 123 by. hasanah I v
124 by. hasanah 2 v
125 by. efi v
126 by. yeni v
127 by. hamimah I v v/-
128 by. surtini v
129 by. erni v/-
130 by. lia v
1 6/2
20/04/2016 130 by. hamimah I v/-
131 by. surtini v
132 by. erni v/-
133 by. lia v
134 by. hasanah 2 v
135 by. yeni v
136 by. lisnawati v
137 by. santi v
138 by. gina v
139 by. suci v
8/2

21/04/2016 140 by. hasanah 2 v


141 by. yeni v
142 by. lisnawati v
143 by. santi v
144 by. gina v
145 by. suci v
146 by. rika v
147 by. elih v
148 by. cas fitrianingsih v
149 by. neneng v
150 by. hamimah I v/-
151 by. surtini v
152 by. erni v/-
153 by. lia v
12 / 2

22/04/2016 154 by. rika v


155 by. elih v
156 by. cas fitrianingsih v
157 by. neneng v
158 by. eulis v
159 by. lisnawati v
160 by. minarti v
161 by. hamimah I v/-
162 by. erni v/-
163 by. lia v
8/2

23/04/2016 164 by. rika v


165 by. elih v
166 by. cas fitrianingsih v
167 by. neneng v
168 by. eulis v
169 by. lisnawati v
170 by. minarti v
171 by. amalia 1 v
172 by. amalia 2 v
173 by. hamimah I v/-
174 by. erni v/-
175 by. lia v
10 / 2

24/04/2016 176 by. nursaidah v


177 by. lilis v
178 by. amalia 1 v
179 by. amalia 2 v
180 by. lisnawati v
181 by. hamimah I v/-
182 by. erni v/-
183 by. lia v
6 /2

25/04/2016 184 by. hamimah I v/-


185 by. erni v/-
186 by. lia v
187 by. nursaidah v
188 by. lilis v
189 by. lisnawati v
4/2

26/04/2016 190 by. lilis v


191 by. lisnawati v
192 by. erni v/-
193 by. lia v
3/1
27/04/2016 194 by. lilis v
195 by. lisnawati v
196 by. erni v/-
197 by. Yuliawati v
3/1
28/04/2016 198 by. yuliawati v
199 by. lisnawati v
200 by. devvy v
201 by. lilis v
202 by. lia v
203 by. erni v/-
5/1

29/04/2016 204 by. lilis v


205 by. lia v
206 by. erni v/-
207 by. yuliawati v
208 by. lisnawati v
209 by. devvy v
5/1
30/04/2016 210 by. iva v
211 by. siti z v
212 by. juhariyah v v
213 by. lia v
214 by. erni v/-
215 by. lisnawati v
1 5/1
29 177 / 43
jumlah pasien peri 152 pasien

Ruang PERINATOLOGI - MEI 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2016 1 by. juhariyah v v
2 by. lia v
3 by. lisnawati v
4 by. erni v/-
5 by. iva v
6 by. siti. z v
1 6/-
02/05/2016 6 by. juhariyah v v
7 by. erni v/-
8 by. iva v
9 by. siti. z v
10 by. yuliyanti v
1 5/-
03/05/2016 11 by. juhariyah v
12 by. erni v/-
13 by. desi v
14 by. nelly I v v
15 by. yuliyanti v
16 by. nelly II v
1 6/-
04/05/2016 17 by. nelly II v
18 by. erni v/-
19 by. juhariyah v
20 by. nelly I v v
21 by. desi v
1 5/-
05/05/2016 22 by. nelly II v
23 by. erni v/-
24 by. juhariyah v
25 by. nelly I v
26 by. desi v
27 by. riska v
1 6/-
06/05/2016 28 by. erni v/-
29 by. juhariyah v
30 by. nelly I v
31 by. desi v
32 by. nelly II v
33 by. riska v
6/-
07/05/2016 34 by. nelli II v
35 by. erni v/-
36 by. desi v
37 by. nelli I v

08/05/2016 38 by. nelli II v


39 by. erni v/-
40 by. desi v
41 by sumiarti v
42 by. nelli I v

09/05/2016 43 by. nelli II v


44 by. erni v/-
45 by. desi v
46 by sumiarti v
47 by. nelli I v
5/-
10/05/2015 48 by. nelli II v
49 by. erni v/-
50 by. desi v
51 by sumiarti v
52 by. nelli I v
53 by sinta v
6/-
11/05/2016 54 by mega v
55 by. erni v/-
56 by. desi v
57 by sumiarti v
58 by. nelli I v
59 by sinta v
60 by satma v
7/-
12/05/2016 61 by mega v
62 by. erni v/-
63 by sumiarti v
64 by. nelli I v
65 by rosa v
66 by Ai setiawati v
67 by Lia v
68 by satma v
8/-
13/05/2016 69 by mega v
70 by. erni v/-
71 by sumiarti v
72 by. nelli I v
73 by yeni v v
74 by rosa v
75 by Ai setiawati v
76 by Lia v
77 by satma v
78 by debora v
79 by neng nurhayati v
1 11
14/05/2016 80 by nuri v
81 by widaningsih v
82 by debora v
83 by filani v
84 by hamidah v
85 by didah v
86 by satma v
87 by mega v
88 by. erni v/-
89 by sumiarti v
90 by. nelli I v
11/-
15/05/2016 91 by. erni v/-
92 by sumiarti v
93 by tita v
94 by debora v
5 by filani v
6 by hamidah v
7 by widaningsih v
8 by ari anggraeni v
by didah 8/-

16/05/2016 1 by. erni v/-


2 by sumiarti v/-
3 by tita v
4 by dena v
5 by debora v
6 by didah v
6/-
17/05/2016 1 by sumiarti v/-
2 by tita v
3 by dini I v
4 by dini II v
5 by dini III v

18/05/2016 1 by sumiarti v/-


2 by tita v
3 by dini I v
4 by dini II v
5 by dini III v
6 by. hotlin v

6/-
19/05/2016 1 by sumiarti v/-
2 by tita v
3 by dini I v
4 by dini II v
5 by dini III v
6 by. hotlin v
6/-
20/05/2016 1 by. rina v
2 by. wine v
3 by sumiarti v/-
4 by tita v
5 by dini I v
6 by dini II v
7 by dini III v
8 by. hotlin v
8/-
21/05/2016 1 by. rina v
2 by. wine v
3 by sumiarti v/-
4 by tita v
5 by dini I v
6 by dini II v
7 by dini III v
8 by. rike v

22/05/2016 1 by. rina v


2 by. wine v
3 by sumiarti v/-
4 by tita v
5 by dini I v
6 by dini II v
7 by dini III v
8 by. rike v
8/-
23/05/2016 1 by. rina v
2 by. kiki v
3 by sumiarti v/-
4 by tita v
5 by dini I v
6 by dini II v
7 by dini III v
8 by. rike v
8/-
24/05/2016 1 by. rina v
2 by. kiki v
3 by sumiarti v/-
4 by tita v
5 by dini I v
6 by dini II v
7 by dini III v
8 by. rike v
9 by. rismi v

25/05/2016 1 by sumiarti v/-


2 by tita v
3 by dini I v
4 by dini II v/-
5 by dini III v
6 by. rike v
7 by. rismi v
8 by. rina v
9 by. kiki v
10 by. dini. f v
10/-

26/05/2016 1 by. rismi v


2 by. rina v
3 by. kiki v
4 by. dini. f v
5 by. tika v
6 by sumiarti v/-
7 by tita v
8 by dini II v/-
9 by dini III v
10 by. rike v
10/-

27/05/2016 1 by. teni v


2 by. rismi v
3 by. kiki v
4 by sumiarti v/-
5 by tita v
6 by dini II v/-
7 by dini III v
8 by. rike v/-
8/-

28/05/2016 by. teni v


by. kiki v
by. astri v
by sumiarti v/-
by tita v
by dini II v/-
by dini III v
by. rike v/-
by. imas v

29/05/2016 1 by. teni v


2 by. kiki v
3 by. astri v
4 by sumiarti v/-
5 by tita v
6 by dini II v/-
7 by dini III v
8 by. rike v/-
9 by. imas v v
10 by. elita v

30/05/2016 1 by sumiarti v v
2 by tita v
3 by dini II v/-
4 by dini III v
5 by. rike v/-
6 by. elita v
7 by. teni v
8 by. lilis v

31/05/2016 by sumiarti v v
by tita v
by dini II v/-
by dini III v
by. rike v/-
by. elita v
by. teni v
by. lilis v
by. fia v
216 7

Ruang PERINATOLOGI - JUNI 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2016 1 By.NY. Sumiarti v
2 By.Ny. Dini 3 v
3 By.Ny. Elita v
4 By. Ny. Dini 2 v
5 By. Ny. Rike v/-
6 By.Ny. Fia v
7 By.NY. Teni v
8 By.Ny. Sulastri v

02/06/2016 9 By.NY. Sumiarti V v


10 By.Ny. Dini 3 v
11 By.Ny. Elita v
12 By. Ny. Dini 2 v
13 By. Ny. Rike v/-
14 By.Ny. Fia v
15 By.NY. Teni v
16 By.Ny. Sulastri v

03/06/2016 17 By.NY. Sumiarti V v


18 By.Ny. Dini 3 v
19 By.NY. Dewi Ayu v
20 By. Ny. Dini 2 v
21 By. Ny. Rike v/-
22 By.Ny. Tika v
23 By.NY. Teni v
24 By.Ny. Sulastri v

04/06/2016 25 By.NY. Sumiarti V v


26 By.Ny. Dini 3 v
27 By.NY. Dewi Ayu v
28 By. Ny. Dini 2 V v
29 By. Ny. Rike v/-
30 By.Ny. Sulastri v

05/06/2016 31 By.NY. Sumiarti V v


32 By.Ny. Dini 3 v
33 By.NY. Dewi Ayu v
34 By. Ny. Dini 2 V v
35 By. Ny. Rike v/-
36 By.Ny. Sulastri v
37 By. Ny. Iyam Maryam v

06/06/2016 38 By.NY. Sumiarti V v


39 By.Ny. Dini 3 v
40 By.NY. Dewi Ayu v
41 By. Ny. Dini 2 v
42 By. Ny. Rike v/-
43 By.Ny. Sulastri v
44 By. Ny. Iyam Maryam v
45 By.Ny. Tina v

07/06/2016 46 By.NY. Sumiarti V v


47 By.Ny. Dini 3 v
48 By.NY. Dewi Ayu v
49 By. Ny. Dini 2 v
50 By. Ny. Rike v/-
51 By.Ny. Sulastri v
52 By. Ny. Iyam Maryam v
53 By.Ny. Tina v
54 by. cucun v
08/06/2016 55 By.NY. Sumiarti V v
56 By.Ny. Dini 3 v
57 By.NY. Dewi Ayu v
58 By. Ny. Dini 2 v
59 By. Ny. Rike v/-
60 By.Ny. Sulastri v
61 By. Ny. Iyam Maryam v
62 By.Ny. Tina v
63 by. cucun v
64 by. rima v

09/06/2016 64 by. sumiarti v


65 by. dini 2 v
66 by. dini 3 v
67 by. rike -/v
68 by. rima v
69 by. sulastri v
70 by. cucun v
71 by. iyam v
72 by. dewi v
73 by. tina v
74 by. yeni v

10/06/2016 75 by. sumiarti v


76 by. dini 2 v
77 by. dini 3 v
78 by. rike -/v
79 by. cucun v
80 by. dewi v
81 by. yeni v

11/6/2016 82 by. sumiarti v


83 by. dini 2 v
84 by. dini 3 v
85 by. rike -/v
86 by. cucun v
87 by. dewi v
88 by. yeni v
89 by. nunung v

12/6/2016 90 by. sumiarti v


91 by. rike -/v
92 by. cucun v
93 by. nunung v

13/06/2016 94 by. sumiarti v


95 by. rike -/v
96 by. cucun v
97 by. nunung v
98 by. selvia v v

14/06/2016 99 by. sumiarti v


100 by. rike -/v
101 by. cucun v
102 by. nunung v
103 by. selvia v v
104 by. reni v
105 by. fitria v

15/06/2016 106 by. sumiarti v


107 by. rike -/v
108 by. cucun v
109 by. nunung v
110 by. selvia v v
111 by. reni v
112 by. fitria v
113 by. puti v

16/06/2016 114 by. sumiarti v


115 by. rike -/v
116 by. cucun v v
117 by. puti v

17/06/2016 118 by. rike -/v


119 by. cucun v v

18/06/2016 120 by. rike -/v

19/06/2016 121 by. rike -/v


122 by. nizar v v
123 by. reni v
124 by. sherly v

20/06/2016 125 by. rike -/v


126 by. nizar v v
127 by. reni v
128 by. sewrli v

21/06/2016 129 by. rike -/v


130 by. nizar v v
131 by. reni v
132 by. sewrli v

22/06/2016 133 by. rike -/v


134 by. nizar v v
135 by. reni v
136 by. sewrli v

23/06/2016 137 by. nizar v v


138 by. tresnawati v
139 by. wiwin I v
140 by. wiwin II v
141 by. widawangasih v
142 by. riana v

24/06/2016 143 by. nizar v v


144 by. tresnawati v
145 by. riana v
146 by. ika v
147 by. cristine v

25/06/2016 148 by. tresnawati v


149 by. riana v
150 by. ika v
151 by. cristine v v
152 by. selvira v
153 by. sumiarti v v
154 by. nizar v v

26/06/2016 155 by. selvira v


156 by. sugiarni v
157 by. riana v
158 by. cristine v v

27/06/2016 159 by. selvira v


160 by. sugiarni v
161 by. riana v

28/06/2016 162 by. riana v

29/6/2016 163 by. farida v


164 by. riana v
165 by. eka v
166 by. iis v

30/6/2016 166 by. farida v


167 by. riana v
168 by. eka v
169 by. iis v
24 169/14

Ruang PERINATOLOGI - JUNI 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/7/2016 1 by. farida -/v
2 by. dini 3 v v
3 by. ai. s v v
4 by. rahayu v
5 by. riana v
6 by. neng imas v
7 by. neni v
6/1
2/7/2016 8 by. riana v
9 by. neng imas v
10 by. neni v
11 by. mas ait v
12 by. farida -/v
13 by. dini 3 v v
14 by. ai. s v v
15 by. rahayu v
7/1
3/7/2016 16 by. mas ait v
17 by. farida -/v
18 by. dini 3 v v
19 by. ai. s v v
20 by. rahayu v
21 by. riana v
22 by. neng imas v
23 by. neni v

7/1

4/7/2016 24 by. neng imas v


25 by. anisa v
26 by. mas ait v
27 by. farida -/v
28 by. dini 3 v v
29 by. ai. s v v
by. rahayu v
6/1
5/7/2016 30 by. mas ait v
31 by. farida -/v
32 by. dini 3 v v
33 by. ai. s v v
34 by. rahayu v
35 by. neng imas v
36 by. dwi v
37 by. lia v
7/1
6/7/2016 38 by. dwi v
39 by. lia v
40 by. neng imas v
41 by. guspina v
42 by. sri v
43 by. mas ait v
44 by. farida -/v
45 by. dini 3 v v
46 by. ai. s v
47 by. rahayu v
9/1

7/7/2016 48 by. mas ait v v


49 by. farida -/v
50 by. dini 3 v v
51 by. ai. s v
52 by. rahayu v
53 by. guspina v
54 by. sri v
6/1
8/7/2016 55 by. farida -/v
56 by. dini 3 v v
57 by. ai. s v
58 by. rahayu v
59 by. guspina v
4/1
9/7/2016 60 by. farida -/v
61 by. dini 3 v v
62 by. rahayu v
63 by. guspina v
64 by. nurul v
4/1
10/7/2016 65 by. farida -/v
66 by. dini 3 v v
67 by. rahayu v
68 by. guspina v
69 by. nurul v
4/1
11/7/2016 70 by. farida -/v
71 by. rahayu v
72 by. guspina v
2/1
12/7/2016 73 by. farida -/v
74 by. rahayu v
75 by. guspina v
2/1

13/7/2016 76 By.Ny. Guspina v


77 By.Ny. Farida -/v
78 By.Ny Rahayu v
79 By.Ny. Maryati v

3/1

14/07/2016 80 By.Ny. Guspina


81 By.Ny. Farida -/v
82 By.Ny Rahayu v
83 By.Ny. Maryati v
84 By. Ny. Ajeng v
85 By.Ny. Nurul v
4/1
15/07/2016 86 By.Ny. Guspina v
87 By.Ny. Farida -/v
88 By.Ny Rahayu v
89 By. Ny. Ajeng v
90 By.Ny. Nurul v
3/1
16/07/2016 91 By.Ny. Guspina v
92 By.Ny. Farida -/v
93 By.Ny Rahayu v
94 By.Ny. Nurul v
3/1
17/07/2016 95 By.Ny. Nurul v
96 By.Ny. Erna v
97 By.Ny. Guspina v
98 By.Ny. Farida -/v
99 By.Ny Rahayu v
4/1
18/07/2016 100 By.Ny. Guspina v
101 By.Ny. Farida -/v
102 By.Ny Rahayu v
103 By.Ny. Yani v
104 By.Ny. Erna v
3/1
19/07/2016 105 By.Ny. Guspina v
106 By.Ny. Farida -/v
107 By.Ny Rahayu v
108 By.Ny. Yani v
109 By.Ny. Erna v
4/1
20/07/2016 110 By.Ny. Guspina v
111 By.Ny. Farida -/v
112 By.Ny Rahayu v
113 By.Ny. Yani v
114 By.Ny. Erna v
3/1
21/07/2016 115 By.Ny. Guspina v
116 By.Ny. Farida -/v
117 By.Ny Rahayu v
118 By.Ny. Yani v
3/1
22/07/2016 119 By. Ny. farida -/v
120 By.Ny. Guspina v
121 by. sariningsih 2 v
122 by. sri v
123 by. neneng v
4/1
23/07/3016 124 By. Ny. farida -/v
125 By.Ny. Guspina v
126 by. sariningsih 2 v
127 by. sri v
128 by. neneng v
4/1

24/07/2016 129 By. Ny. farida -/v


130 By.Ny. nurlela v
131 by. sariningsih 2 v
132 by. sri v
133 by. neneng v
4/1

25/7/2016 134 by. farida -/v


135 by. aan v
136 By.Ny. nurlela v
137 by. sariningsih 2 v
138 by. sri v
139 by. neneng v
140 by. cicin I v
141 by. cicin II v
7/1

26/07/2016 141 By.Ny. nurlela v


142 by. sariningsih 2 v
143 by. sri v
144 by. neneng v
145 by. cicin I v
146 by. cicin II v
147 by. farida -/v
148 by. aan v
7 /1

27/7/2016 149 By.Ny. nurlela v


150 by. sariningsih 2 v
151 by. sri v
152 by. neneng v
153 by. cicin I v
154 by. cicin II v
155 by. farida -/v
156 by. rahayu v
7/1

28/7/2016 156 by. cicin I v


157 by. cicin II v
158 by. fivih v
159 by. farida /v
160 by. rahayu v
4/1

29/7/2016 161 by. cicin I v


162 by. cicin II v
163 by. fivih v
164 by. farida /v
165 by. rahayu v
4/1

30/7/2016 162 by. farida /v


163 by. rahayu v
164 by. sintia v v
165 by. cicin I v
166 by. cicin II v
167 By.Ny. Lilis v
5/1
31/07/2016 168 By.Ny. Ai Siti v
169 by. cicin I v
170 by. cicin II v
171 by. rahayu v
4
16 171/30 Bayi rawat peri 238

Ruang PERINATOLOGI - AGUSTUS 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2016 1 By.Ny. Ai Siti v
2 by. cicin I v
3 by. cicin II v
4 by. rahayu v
5 by. nuti 3 v
6 by. dewi v
6

02/08/2016 7 By.Ny. Ai Siti v


8 by. cicin I v
9 by. cicin II v
10 by. rahayu v
11 by. dewi v
5

3/8/2016 12 By.Ny. Ai Siti v


13 by. cicin I v
14 by. cicin II v
15 by. rahayu v
16 by. dewi v
17 by. tastiyanti v
6

4/8/2016 18 by. devi v


19 by. cicin I v
20 by. cicin II v
21 by. rahayu v
22 by. dewi v
23 by. tastiyanti v
6

5/8/2016 24 by. cicin I v


25 by. cicin II v
26 by. rahayu v
27 by. dewi v
28 by. tastiyanti v
5

6/8/2016 29 by. cicin I v


30 by. cicin II v
31 by. rahayu v
32 by. dewi v
33 by. tastiyanti v
34 by. erna v
35 by. ema v
7

7/8/2016 36 by. cicin I v


37 by. cicin II v
38 by. rahayu v
39 by. rika v
40 by. tastiyanti v
41 by. erna v
42 by. ema v
7

8/8/2016 43 by. cicin I v


44 by. cicin II v
45 by. rahayu v
46 by. rika v
47 by. tastiyanti v
48 by. erna v
49 by. ema v
7

9/8/2016 50 by. cicin I v


51 by. cicin II v
52 by. rahayu v
53 by. rika v
54 by. tastiyanti v
55 by. erna v
56 by. ema v
7

10/8/2016 57 by. rika v


58 by. ema v
59 by. tastianty v
3

11/8/2016 60 by. rika v


61 by. ema v
62 by. wulansari v
3

12/8/2016 63 by. ema v


64 by. wulansari v
65 by. rika v
3

13/8/2016 66 by. ema v


67 by. wulansari v
68 by. rika v
3

14/8/2016 69 by. ema v


70 by. wulansari v
71 by. rika v
72 by. dini 3 v v
1 4
15/8/2016
73 by. ema v
74 by. wulansari v
75 by. rika v
76 by. dini 3 v v
1 4

16/8/2016 77 by. ema v


78 by. wulansari v
79 by. rika v
3

17/8/2016 80 by. ema v


81 by. wulansari v
82 by. rika v
3

18/8/2016 83 by. ema v


84 by. wulansari v
85 by. rika v
86 by. tia 1 v
87 by. tia 2 v
5

19/8/2016 88 by. ema v


89 by. wulansari v
90 by. rika v
91 by. tia 1 v
92 by. tia 2 v
93 5

20/08/2016 94 by. ema v


95 by. wulansari v
96 by. rika v
97 by. tia 1 v
98 by. tia 2 v
5
21/08/2016 99 by. wulansari v
100 by. rika v
101 By.Ny. Mutiara v
102 by. tia 1 v
103 by. tia 2 v
5
22/08/2016 104 by. rika v
105 By.Ny. Mutiara v
106 by. tia 1 v
107 by. tia 2 v
4
23/08/2016 108 By.Ny. Mutiara v
109 by. tia 1 v
110 by. tia 2 v
3
24/08/2016 111 By.Ny. Mutiara v
112 by. tia 1 v
113 by. tia 2 v
114 By.Ny. Santi v
4
25/08/2016 115 By.Ny. Mutiara v
116 by. tia 1 v
117 by. tia 2 v
118 By.Ny. Santi v
119 By.Ny. Santika v
5

26/08/2016 120 By.Ny. Santi v v


121 By.Ny. Santika v
122 By.Ny. Mutiara v
123 By. Ny. Silvi 1 v
124 By.Ny. Silvi2 v
5
27/08/2016 125 By.Ny. Santi v
126 By.Ny. Santika v
127 By.Ny. Mutiara v
128 By. Ny. Silvi 1 v
129 By.Ny. Silvi2 v
5
28/08/2016 130 By.Ny. Santi v
131 By.Ny. Santika v
132 By.Ny. Mutiara v
133 By. Ny. Silvi 1 v
134 By.Ny. Silvi2 v
5
29/08/2016 135 By.Ny. Santi v
136 By.Ny. Santika v
137 By.Ny. Mutiara v
138 By. Ny. Silvi 1 v
139 By.Ny. Silvi2 v
140 By.Ny. Yuni v
6
30/08/2016 141 By.Ny. Santi v
142 By.Ny. Santika v
143 By.Ny. Mutiara v
144 By. Ny. Yuni v
145 By.Ny. Neng Ria v
5
31/08/2016 146 By.Ny. Santika v
147 By.Ny. Mutiara v
148 By. Ny. Yuni v
149 By.Ny. Neng Ria v

3 149
jml pasen total 340 Bayi rawat peri 234

Ruang PERINATOLOGI - SEPTEMBER 2016


Formulir Survey Harian Pemakaian Alat
Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2016 1 By.Ny. Santika v
2 By.Ny. Mutiara v
3 By. Ny. Yuni v
4 By.Ny. Neng Ria v
5 By.Ny. Nirmala v
5
02/09/2016 6 By.Ny. Santika v
7 By.Ny. Neng Ria v
8 By.Ny. Nirmala v
9 by. rani v
4

3/9/2016 10 By.Ny. Santika v


11 By.Ny. Neng Ria v
12 by. rani v
3

4/9/2016 13 By.Ny. Santika v


14 By.Ny. Neng Ria v
15 by. rani v
3

5/9/2016 16 By.Ny. Santika v


17 By.Ny. Neng Ria v
18 by. rani v
19 by. ai v v
1 4
6/9/2016 20 By.Ny. Santika v
21 By.Ny. Neng Ria 0/v
22 by. rani v
23 by. ai v v
24 By. Ny. Hanijah v
25 By.Ny. Cucu v
26 By.Ny. Dede v
27 By.Ny. Ernah v
1 7/1
7/9/2016 28 By.Ny. Santika v
29 By.Ny. Neng Ria 0/v
30 By.Ny. Hermin v
31 by. ai v v
32 By. Ny. Hanijah v
33 By.Ny. Cucu v
34 By.Ny. Dede v
1 6/1
8/9/2016 35 By.Ny. Santika v
36 By.Ny. Neng Ria 0/v
37 By.Ny. Hermin v
38 by. ai v v
39 By. Ny. Hanijah v
40 By.Ny. Cucu v
41 By.Ny. Dede v
42 By.Ny. Santie v
1 7/1
9/9/2016 43 By.Ny. Cucu v
44 By.Ny. Santika v
45 by. ai v
46 By.Ny. Santie v v
47 By.Ny. Neng Ria 0/v
48 By. Ny. Hanijah v
49 By.Ny. Dede v
50 by hermin v
51 by hasunah v
52 by fatazah v
53 by Aas aisah v
1 10/1
10/09/2016 54 By.Ny. Dede v
55 by hermin v
56 by hasunah v
57 by fatazah v
58 by Aas aisah v
59 By.Ny. Cucu v
60 By.Ny. Santika v
61 by. ai v
62 By.Ny. Neng Ria 0/v
63 By. Ny. Hanijah v
9/1
11/09/2016 64 By.Ny. Cucu v
65 by. ai v
66 By.Ny. Neng Ria 0/v
67 By. Ny. Hanijah v
68 By.Ny. Dede v
69 by hermin v
70 by fatazah v
71 by hasunah v
7/1
12/09/2016 72 By.Ny. Dede v
73 by hermin v
74 by Aas aisah v
75 by fatazah v
76 by hasunah v
77 by cucu v
78 by. ai v
79 By.Ny. Neng Ria 0/v
80 By. Ny. Hanijah v
81 by rahma v
9/1
13/09/2016 83 by rahma v
84 By.Ny. Neng Ria 0/v
85 by hermin v
85 By.Ny. Dede v
86 by Aas aisah v
5
14/09/2016 87 by Aas aisah v
88 by hermin v
89 By.Ny. Dede v
90 by rahma v
91 By.Ny. Neng Ria 0/v
4/1
15/09/2016 92 By.Ny. Dede v
93 by hermin v
94 by rahma v
95 By.Ny. Neng Ria 0/v
3/1
16/9/2016 96 by rahma v
97 By.Ny. Neng Ria 0/v
98 by awang v
99 by ny shanty v
100 By.Ny. Dede v
101 by hermin v
5/1
17/9/2016 102 by rahma v
103 By.Ny. Neng Ria 0/v
104 by awang v
105 by ny shanty 0/v
106 By.Ny. Dede v
107 by hermin v
5/1

18/9/2016 108 by ny seni v


109 by ny neng ria 0/v
110 by ny awang v
111 by sri v
112 by ny santy 0/v
4/1

19/9/2016 113 by ny seni v


114 by ny neng ria v
115 by ny awang v
116 by sri v
117 by ny santy 0/v
118 By.Ny. Minarti v
5/1

20/09/2016 119 by ny seni v


120 by ny neng ria v
121 by ny awang v/v
122 by sri v
123 by ny santy 0/v
124 By.Ny. Minarti v
4/2

21/09/2016 125 by ny seni v


126 by ny neng ria v/v
127 by ny awang v/v
128 by sri v
129 by ny santy 0/v
130 By.NY. Fitriyanti v
4/2
22/09/2016 131 by ny seni v
132 by ny neng ria 0/v
133 by ny awang 0/v
134 by sri v
135 by ny santy 0/v
136 By.NY. Fitriyanti v
3/3
23/04/2016 135 by ny seni v
136 by ny neng ria 0/v
137 by ny awang 0/v
138 by sri v
139 by ny santy 0/v
2/3

24/09/2016 140 by ny neng ria 0/v


141 by ny seni v
142 by ny awang 0/v
143 by sri v
144 by ny santy v 0/v
145 by cicih v v
146 by ny imas 1 v
147 by imas 2 v
2 5/3

25/09/2016 148 by ny awang 0/v


149 by ny imas 1 v
150 by imas 2 v
151 by ny santy v 0/v
152 by ny seni v
1 3/2
26/09/2016 153 by ny awang v 0/v
154 by ny imas 1 v
155 by imas 2 v
156 by ny santy v 0/v
157 by ny seni v
2 3/2

27/09/2016 158 by ny awang v 0/v


159 by ny imas 1 v
160 by imas 2 v
161 by ny santy v 0/v
162 by ny seni v
163 by. erni 0/v
2 3/3

28/09/2016 164 by ny awang v 0/v


165 by ny imas 1 v
166 by ny santy v 0/v
167 by ny seni v
168 by. erni 0/v
2 2/ 3

29/09/2016 169 by ny awang v 0/v


170 by ny imas 1 v
171 by ny santy v 0/v
172 by ny seni v
173 by. erni 0/v
2 2/ 3

30/09/2016 174 by ny santy v 0/v


175 by imas 1 v
176 by ny awang v 0/v
177 by. erni 0/v
178 bY.nY. lINDAWATI 2 v
2/3

18 137/46
jumlah pasien:319
Bayi rwat peri 246

RUANG PERINATOLOGI - OKTOBER 2016


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
TANGGAL NO NAMA ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/10/2016 1 By ny nanan v
2 by ny mitha v
3 by ny lindawati v
4 by ny awang v 0/v
5 by ny shanty v 0/v
6 by erni 0/v
2 3/3

2/10/2016 7 by ny nanan v
8 by ny mitha v
9 by ny lindawati v
10 by ny awang v 0/v
11 by ny santy v 0/v
12 by ny erni 0/v
2 3/3

3/10/2016 13 by ny nanan v
14 by ny mitha v
15 by ny lindawati v
16 by ny awang v 0/v
17 by ny santy v 0/v
18 by ny erni 0/v
2 3/3

4/10/2016 19 by santy v 0/v


20 by ny awang v 0/v
21 by ny erni 0/v
22 by ny lindawati 0/v
23 by tia v
24 by nanan v
25 by mitha v
26 by berliana v
2 4/4

5/10/2016 27 by berliana v
28 by santy v 0/v
29 by ny awang v 0/v
30 by ny erni 0/v
31 by ny lindawati 0/v
2 1/4
6/10/2016 32 by santy v 0/v
33 by ny awang v 0/v
34 by ny erni 0/v
35 by ny lindawati 0/v
2 4

7/10/2016 36 by santy v 0/v


37 by ny awang v 0/v
38 by ny erni 0/v
39 by ny lindawati 0/v
2 4

8/10/2016 40 by santy v 0/v


41 by ny awang v 0/v
42 by ny erni 0/v
43 by ny lindawati 0/v
2 4

9/10/2016 44 by santy v 0/v


45 by ny awang v 0/v
46 by ny erni 0/v
47 by ny lindawati 0/v
2 4

10/10/2016 48 by santy v 0/v


49 by ny awang v 0/v
50 by ny erni 0/v
51 by ny lindawati 0/v
52 by nia v
2 1/4

11/10/2016 53 by santy v 0/v


54 by ny awang v 0/v
55 by ny erni 0/v
56 by ny lindawati 0/v
57 by nia v
2 1/4

12/10/2016 58 by santy v 0/v


59 by ny awang v 0/v
60 by ny lindawati v
61 by nia v
2 2/2
13/10/2016 62 by santy v 0/v
63 by ny awang v 0/v
64 by ny lindawati v
65 by nia v
2 2//2

14/10/2016 66 by santy v 0/v


67 by ny awang v 0/v
68 by ny lindawati v
2 1/2

15/10/2016 69 by santy v 0/v


70 by ny awang v 0/v
71 by ny lindawati v
2 1/2

16/10/2016 72 by santy v 0/v


73 by ny awang v 0/v
74 by ny lindawati v
75 by nadia v
76 by widya v
2 3/2

17/10/2016 77 by widya v
78 by santy v 0/v
79 by ny lindawati v
80 by nadia v
81 by ny awang v v
2 4/1

18/10/2016 82 by santy v 0/v


83 by ny awang v v
84 by ny lindawati v
85 by nadia v
86 by widya v
87 by santika v
2 5/1

19/10/2016 88 by santy v 0/v


89 by ny awang v v
90 by ny lindawati v
91 by nadia v
92 by widya v
93 by santika v
2 5/1

20/10/2016 94 by santy v 0/v


95 by ny awang v 0/v
96 by ny lindawati v
97 by nadia v
98 by widya v
99 by santika v
100 by. ani v
101 by. komalasari v
2 7/2

21/10/2016 101 by santy v 0/v


102 by ny awang v 0/v
103 by ny lindawati v
104 by. ani v
105 by. komalasari v
106 by. siti m v
107 by. raulina v
108 by widya v
109 by santika v
2 7/2

22/10/2016 110 by santy v 0/v


111 by ny awang v 0/v
112 by ny lindawati v
113 by. ani v
114 by. komalasari v
115 by. siti m v
116 by. raulina v
117 by widya v
118 by santika v
2 7/2
23/10/2016 119 by santy v 0/v
120 by ny awang v 0/v
121 by ny lindawati v
122 by. ani v
123 by. komalasari v
124 by. siti m v
125 by. raulina v
126 by debora v
127 by santika v
2 7/2
24/10/0201 128 by santy v 0/v
129 by ny awang v 0/v
130 by ny lindawati v
131 by. komalasari v
132 by. siti m v
133 by. raulina v
134 by debora v
135 by santika v
2 6/2

25/10/2016 136 by santy v 0/v


137 by ny lindawati v
138 by. komalasari v
139 by. siti m v
140 by. raulina v
141 by debora v
142 by ny awang 0/v
143 by santika v
1 6/2

26/10/2016 144 by santy v 0/v


145 by ny lindawati v
146 by ny awang 0/v
147 by debora v
148 by santika v
149 by. raulina v
150 by sumiati v
151 by elly v
1 6/2

27/10/2016 152 by santy v 0/v


153 by ny lindawati v
134 by ny awang 0/v
155 by debora v
156 by santika v
157 by. raulina v
158 by sumiati v
159 by elly v
1 6/2

28/10/2016 160 By.Ny.Elly v


161 By.Ny. Rolina v
162 By.Ny. Sumiati v
163 By.Ny. Debora v
164 By.Ny. Lindawati v
165 By.Ny. Awang 0/v
166 By.ny. Santika v
167 By.Ny. Shanty v 0/v
1 6/2

29/10/2016 168 By.Ny.Elly v


169 By.Ny. Komah v
170 By.Ny. Sumiati v
171 By.Ny. Debora v
172 By.Ny. Lindawati v
173 By.Ny. Awang 0/v
174 By.ny. Santika v
175 By.Ny. Shanty v 0/v
176 By.Ny. wawat v
1 7/2
30/10/2016 177 By.Ny. Komah v
178 By.Ny. Sumiati v
179 By.Ny. Debora v
180 By.Ny. Lindawati v
181 By.Ny. Awang 0/v
182 By.ny. Santika v
183 By.Ny. Shanty v 0/v
184 By.Ny. wawat v
1 6/2
31/10/2016 185 By.Ny. Komah v
186 By.Ny. Sumiati v
187 By.Ny. Debora v
188 By.Ny. Lindawati v
189 By.Ny. Awang 0/v
190 By.ny. Santika v
191 By.Ny. Shanty v 0/v
192 By.Ny. wawat v
193 By.Ny. Tati v
1 7/2

53 170/78 Jumlah pasien 326

RUANG PERINATOLOGI - November 2016


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
TANGGAL NO NAMA ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/11/2016 1 by. sumiati v
2 by. debora v
3 by. lindawati v
4 by. tati v
5 by. awang -/v
6 by. santika v
5/1

2/11/2016 7 by. sumiati v


8 by. debora v
9 by. lindawati v
10 by. tati v
11 by. awang -/v
12 by. santika v
5/1

3/11/2016 13 by. sumiati v


14 by. debora v
15 by. santika v
16 by. lindawati v
17 by. tati v
18 by. awang -/v
5/1

4/11/2016 19 by. sumiati v


20 by. debora v
21 by. tati v
22 by. awang -/v
23 by mega v
24 by imas v v
25 by debora v
26 by santika v
1 7/1

5/11/2016 27 by. awang -/v


28 by debora -/v
29 by titin -/v
30 by imas v v
1 1/3

6/11/2016 31 by debora -/v


32 by warniti v
33 by sani v
34 by nadia v v
35 by titin -/v
36 by. awang -/v
37 by. sumiati v
1 4/3

7/11/2016 38 by titin -/v


39 by. awang -/v
40 by warniti v
41 by debora v
42 by sani v
3/2
8/11/2016 43 By.Ny. Titin -/v
44 By.ny. Awang -/v
45 By.Ny. Debora -/v Stapilokokus Capitis
46 By.Ny. Warniti v
47 by. eneng v
48 by. sani v
4/2

9/11/2016 49 By.Ny. Titin - /v


50 By.ny. Awang -/v
51 by. sriyanti v
52 By.Ny. Warniti v
53 by. eneng v
54 by. sani v
55 by. teti v
56 by. neng winengsih v
6/2

10/11/2016 57 By.Ny. Titin v - /v


58 By.ny. Awang -/v
59 by. sriyanti v
60 By.Ny. Warniti v
61 by. eneng v
62 by. sani v
63 by. teti v
64 by. neng winengsih v
1 6/2

11/11/2016 65 By.Ny. Titin v - /v


66 By.ny. Awang -/v
67 by. sriyanti v
68 By.Ny. Warniti v
69 by. teti v
70 by. neng winengsih v
1 4/2

12/11/2016 71 by nita v
72 by teti v
73 by neng winengsih v
74 By.ny. Awang -/v
75 by. sriyanti v
76 By.Ny. Warniti v
5/1

13/11/2016 77 by nita v
78 by teti v
79 by neng winengsih v
80 by. sriyanti v
81 By.Ny. Warniti v
82 by awang -/v
5/1

14/11/2016 83 by nita v
84 by teti v
85 by neng winengsih v
86 by. sriyanti - /v
87 By.Ny. Warniti v
88 by awang -/v
4/2

15/11/2016 89 by teti v
90 by neng winengsih v
91 by. sriyanti - /v
92 By.Ny. Warniti v
93 by awang -/v
3/2

16/11/2016 94 By.Ny. Awang -/v


95 By.Ny. Warniti v
96 By.NY. Sriyanti -/v
97 By. Ny. Osy v
98 By.Ny. Tika v
99 By. Neng Winengsih v
4/2

17/11/2016 100 By.Ny. Awang -/v


101 By.Ny. Warniti v
102 By.NY. Sriyanti -/v
103 By. Ny. Osy v
104 By.Ny. Tika v
105 By. Neng Winengsih v
4/2
18/11/2016 106 By.Ny. Dea v/-
107 By.Ny. Awang -/v Stafilokocus
108 By.Ny. Warniti v/- enterobacter cloaceae
109 By.NY. Sriyanti -/v Tidak ditemukan kuman
2/2
19/11/2016 110 By.Ny. Dea v
111 By.Ny. Awang -/v
112 By.Ny. Warniti v
113 By.NY. Sriyanti -/v
2/2

20/11/2016 114 By.Ny. Warniti v


115 By.NY. Sriyanti -/v
1/1

21/11/2016 116 By.Ny. Warniti v


117 By.NY. Sriyanti -/v
118 By.Ny. Eti 1 v Tidak ditemukan kuman
1 2/1
22/11/2016 119 By.Ny. Warniti v
120 By.NY. Sriyanti -/v
121 by. tuti v Tidak ditemukan kuman
122 al khalifi v
3/1

23/11/2016 123 By.Ny. Warniti v


124 By.NY. Sriyanti -/v
125 by. tuti v
126 al khalifi v Tidak ditemukan kuman
127 by hafsah v
4/1

24/11/2016 128 By.NY. Sriyanti -/v


129 by. tuti v
130 al khalifi v
131 by hafsah v
3/1

25/11/2016 132 By.NY. Sriyanti -/v


133 by. tuti v
134 al khalifi v
135 by hafsah v
136 By.Ny. Sumiyati v
4/1

26/11/2016 137 By.NY. Sriyanti -/v


138 by. tuti v
139 al khalifi v
140 by hafsah v
141 By.Ny. Sumiyati v
142 by kokom v
5/1

27/11/2016 143 By.NY. Sriyanti -/v


144 by. tuti v
145 by kokom v tidak ditemukan pertumbuhan kuman
2/1

28/11/2016 146 By.NY. Sriyanti -/v


147 by. tuti -/v
148 by kokom v -/v
1 0/3

29/11/2016 149 By.NY. Sriyanti -/v


150 by. tuti -/v
151 by kokom v -/v
152 By.Ny. Lely v tidak ditemukan pertumbuhan kuman
153 By.Ny. DEwi v
1 2/3

30/11/2016 154 By.NY. Sriyanti -/v


155 by. tuti -/v
156 by kokom v -/v
157 By.Ny. Lely v -/v
158 By.Ny. DEwi v
159 By.Ny. Eka v tidak ditemukan pertumbuhan kuman
2 2/4 Jumlah pasien 213
10 107/52

RUANG PERINATOLOGI DESEMBER 2016


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
TANGGAL NO NAMA ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/12/2016 1 By.NY. Sriyanti -/v
2 by. tuti -/v
3 by kokom v v/-
4 By.Ny. Lely v -/v
5 By.Ny. DEwi v/-
6 By.Ny. Eka v/-
2 3/3
2/12/2016 7 By.NY. Sriyanti -/v
8 by. tuti -/v
9 by kokom v -/v
10 By.Ny. Lely v -/v
11 by. eka v/-
12 by. yanti I v/-
13 by. yanti II v/-
2 3/4

3/12/2016 14 By.NY. Sriyanti -/v


15 by. tuti -/v
16 by kokom v v
17 By.Ny. Lely v -/v
18 by. eka v/-
19 by. yanti I -/v
20 by. yanti II -/v
2 2/5

4/12/2016 21 By.NY. Sriyanti -/v


22 by. tuti -/v
23 by kokom -/v
24 By.Ny. Lely v -/v
25 by. eka v/-
Enterobacter cloacea
26 by. yanti I -/v
27 by. yanti II -/v
28 By.Ny. Eneng Rohaeti -/v
1 1/7

5/12/2016 29 By.NY. Sriyanti -/v


30 by. tuti v -/v tidak ada pertumbuhan
31 by kokom -/v tidak ada pertumbuhan
32 By.Ny. Lely v -/v tidak ada pertumbuhan
33 by. eka v/-
34 by. yanti I -/v
35 by. yanti II -/v
36 By.Ny. Eneng Rohaeti -/v
2 1/7

6/12/2016 37 By.NY. Sriyanti -/v


38 by. eka v/-
39 by. yanti I -/v
40 by. yanti II -/v
41 By.Ny. Eneng Rohaeti -/v
1/4
7/12/2016 42 By.NY. Sriyanti -/v
43 by. yanti II -/v
44 by. yanti I V -/v
45 by. eka v/- tidak ada pertumbuhan
46 By.Ny. Eneng Rohaeti -/v
47 by asti v/-
2/4

8/12/2016 48 By.NY. Sriyanti -/v


Enterobacter cloacea
49 BY.NY. Yanti2 v -/v
50 By.Ny. Eneng Rohaeti -/v
51 by asti v/- tidak ada pertumbuhan
52 by wulansari v/-
1 2/3

9/12/2016 53 By.NY. Sriyanti -/v


54 By.Ny. Eneng Rohaeti -/v
55 by asti v/-
56 by wulansari v/-
2/2

10/12/16 57 By.NY. Sriyanti -/v


58 By.Ny. Eneng Rohaeti -/v
59 by asti v/-
60 by wulansari v/-
61 BY. SUSILAWATI v/-
62 BY. SYARIFAH v/-
4/2

11/12/16 63 By.NY. Sriyanti -/v


64 By.Ny. Eneng Rohaeti -/v
65 by asti v/-
66 by wulansari v/-
67 BY. SUSILAWATI v/-
68 BY. SYARIFAH v/-
4/2

12/12/2016 69 By.NY. Sriyanti -/v


70 By.Ny. Eneng Rohaeti -/v
71 by asti v/-
72 by wulansari v/-
73 BY. SUSILAWATI v/-
74 BY. SYARIFAH v/-
4/2

13/12/2016 75 By.Ny. Sriyanti v/-


76 By.Ny. Eneng Rohaeti -/v
77 By.Ny. Asti v/-
78 By.Ny. Wulansari v/-
79 By.Ny. Saripah v/-
80 By.Ny. Susilawati v/-
81 By.Ny. Ranti v/- tidak ada pertumbuhan
6/2

14/12/2016 82 By.Ny. Sriyanti v/-


83 By.Ny. Eneng Rohaeti -/v
84 By.Ny. Wulansari v/-
85 By.Ny. Saripah v/-
86 By.Ny. Susilawati v/-
87 By.Ny. Ranti v/-
5/1
15/12/2016 88 By.Ny. Sriyanti v/-
89 By.Ny. Eneng Rohaeti -/v
90 By.Ny. Wulansari v/-
2/1

16/12/2016 91 By.Ny. Sriyanti v/-


92 By.Ny. Eneng Rohaeti -/v
93 By.Ny. Wulansari v/- tidak ada pertumbuhan
94 By. Ny. Yeni v/-
95 By.Ny.Nurhasanah v/-
4/2

17/12/2016 96 By.Ny. Sriyanti v/-


97 By.Ny. Eneng Rohaeti -/v
98 By.Ny. Wulansari v/-
99 By. Ny. Yeni v/-
100 By.Ny.Nurhasanah v/-
4/1

18/12/2016 101 by meli v/-


102 By.Ny. Sriyanti v/-
103 By.Ny. Eneng Rohaeti -/v
104 by yulianti v/-
105 by rodia v/-
4/1
19/12/2016 106 by meli v/-
107 By.Ny. Sriyanti v/-
108 By.Ny. Eneng Rohaeti -/v
109 by yulianti v/-
110 by rodia v/-
111 By.Arsya v/-
5/1

20/12/2016 112 by meli v/-


113 By.Ny. Eneng Rohaeti -/v
114 by yulianti v/-
115 By.Arsya v/-
116 By.Ny. Sandra1 v/-

117 By.Ny. Sandra2 v/-


5/1

21/12/2016 118 by meli v/-


119 By.Ny. Eneng Rohaeti -/v
120 by yulianti v/-
121 By.Arsya v/-
122 By.Ny. Sandra1 v/-
123 By.Ny. Sandra2 v/-
124 by yulianti/Tn.Ari v/-
6/1

22/12/2016 125 by meli v/-


126 By.Ny. Eneng Rohaeti -/v
127 by yulianti v/-
128 By.Arsya v/-
129 By.Ny. Sandra1 v/-
130 By.Ny. Sandra2 v/-
131 by yulianti/Tn.Ari v/-
6/1

23/12/2016 132 by meli v/-


133 By.Ny. Eneng Rohaeti -/v
134 By.Arsya v/-
135 By.Ny. Sandra1 v/-
136 By.Ny. Sandra2 v/-
137 by teti v/-
138 by yulianti/Tn.Ari v/-
139 By.Ny. Eni v/-
7/1

24/12/2016 140 by meli v/-


141 By.Ny. Eneng Rohaeti -/v
142 By.Arsya v/-
143 By.Ny. Sandra1 v/-
144 By.Ny. Sandra2 v/-
145 By.Ny. Eni v/-
146 By.Ny. Lia v/-
147 By.Ny. Wina v/-

7/1

25/12/2016 148 by meli v/-


149 By.Ny. Eneng Rohaeti -/v
150 By.Arsya v/-
151 By.Ny. Sandra1 v/-
152 By.Ny. Sandra2 v/-
153 by wina v/-
154 by elis v/-
6/1

26/12/2016 155 by elis v/-


156 by meli v/-
157 By.Ny. Sandra1 v/- tidak ada pertumbuhan
158 By.Ny. Sandra2 v/- stapylococcus saprophylieus
159 By.Ny. Eneng Rohaeti -/v
160 by yulia v/-
161 By.Arsya v/-
6/1

27/12/2016 162 By.Arsya v/-


163 by elis v/-
164 by meli v/- tidak ada pertumbuhan
165 By.Ny. Sandra1 v/-
166 by yulia v/-
167 By.Ny. Eneng Rohaeti -/v
5/1

28/12/2016 168 By.Arsya v/-


169 By.Ny. Sandra1 v/-
170 By.Ny. Eneng Rohaeti -/v
171 By.Ny. santi v/-
3/1
29/12/2016 172 By.Arsya v/-
173 By.Ny. Sandra1 v/-
174 By.Ny. Eneng Rohaeti -/v
175 by yayah v/-
176 by siti v/-
177 By.Ny. Santi v/-
5/1
30/12/2016 178 By.Arsya v/-
179 By.Ny. Sandra1 v/-
180 By.Ny. Eneng Rohaeti v/-
181 by yayah v/- micrococcus sp
182 by siti Solihat v/-
5/0

31/12/2016 183 By.Arsya v/-


184 By.Ny. Sandra1 v/-
185 By.Ny. Eneng Rohaeti v/- tidak ada pertumbuhan
186 by siti Solihat v/- tidak ada pertumbuhan
187 by ny amanda v/-
5/0

11 125/64

TOTAL JUMLAH BAYI RAWAT PERI 182


lAHIR HIDUP 273
RUANG PERINATOLOGI DESEMBER 2017
FORMULIR SURVEY HARIAN PEMAKAIAN ALAT FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/1/2017 1 BY. SANDRA I 1 1/12/2017 1 By.Ny. Riani 1
2 BY. HANA 1 2 By.Ny. Teni 1
3 BY. ENENG 1 3 By. Ny. Putri 1
4 BY. EVA 1 4 By. Ny. Cucun 1
5 BY. ARSYA 1 5 By.Ny. sri M 1
2/1/2017 6 BY. SANDRA I 1 6 By.Ny. Cucu 1
7 BY. HANA 1 7 By.Ny. Asaria 1
8 BY. ENENG 1 8 By.Ny. Novia 1
9 BY. EVA 1
10 BY. ARSYA 1 2/12/2017 9 By.Ny. Riani 1
10 By.Ny. Teni 1
03/01/2017 11 BY. SANDRA I 1 11 By. Ny. Putri 1
12 BY. HANA 1 12 By. Ny. Cucun 1
13 BY. ENENG 1 13 By.Ny. sri M 1
14 BY. EVA 1 14 By.Ny. Cucu 1
15 BY. ARSYA 1 15 By.Ny. Asaria 1
16 By.Ny. Rini 1
17 By.Ny. Eneng aisah 1 3/12/2017 16 By.Ny. Riani 1
18 by siti rodiah 1 1 17 By.Ny. Teni 1
18 By. Ny. Putri 1
4/1/2017 19 BY. SANDRA I 1 19 By. Ny. Cucun 1
20 BY. HANA 1 20 By.Ny. sri M 1
21 BY. ENENG 1 21 By.Ny. Cucu 1
22 BY. EVA 1 22 By.Ny. Asaria 1
23 by rokhayati 1 23 By.Ny. SIti Nurhafsah 1
24 by siti rodiah 1 1
4/12/2017 24 by.Ny. Yulinar 1
5/1/2017 25 BY. SANDRA I 1 25 By.Ny. Cucu 1
26 BY. HANA 1 26 By.Ny. Asaria 1
27 BY. ENENG 1 27 By.Ny. Riani 1
28 BY. EVA 1 28 By. Ny. Putri 1
29 by rokhayati 1 29 By. Ny. Cucun 1
30 by farida 1 30 By.Ny. sri M 1
31 By.Ny. siti Nurhafsah 1
31 by tri puji 1 32 By.Ny. Leni 1

5/12/2017 33 by.Ny. Yulinar 1 1


6/1/2017 32 BY. ENENG 1 34 By.Ny. Cucu 1
33 by rokhayati 1 35 By.Ny. Asaria 1
34 by farida 1 36 By. Ny. Putri 1
35 by tintin 1 37 By. Ny. Cucun 1
36 by nurul 1 38 By.Ny. sri M 1
37 by wati 1 39 By.Ny. devi 1
38 by tri puji 1 40 By.Ny. Fuji 1
41 By.Ny. Leni 1
7/1/2017 39 by rokhayati 1 42 By.Ny. Siti Nurhafsah 1
43 By.Ny. sari 1
40 by neneng tini 1
41 by farida 1 6/12/2017 44 By.Ny. leni 1
42 by tintin 1 45 By.Ny. dera Santika 1
43 by nurul 1 46 By.Ny. devi 1
44 by wati 1 47 By.Ny. Fuji 1
45 by tri puji 1 48 By.Ny. Yulinar 1 1
49 By.Ny. sri M 1
8/1/2017 46 by rokhayati 1 50 By.Ny. Cucun 1
47 by neneng tini 1 51 By.Ny. Cucu 1
48 By.Ny. Lia 1 52 By.Ny. Sari 1
49 By.Ny. Kokom 1 53 By.Ny. Susi 1
50 By.Ny. Deti Setiawati 1

9/1/2017 51 by rokhayati 1 7/12/2017 54 By.Ny. Dera 1


52 by neneng tini 1 55 By.Ny. Susi 1
53 By.Ny. Lia 1 56 By. Ny. Sari 1
54 By.Ny. Kokom 1 57 By.Ny. Yulinar 1 1
55 By.Ny. Deti Setiawati 1 58 By.Ny. Sri M 1
56 By.Ny. Imas 1 59 By. Ny. Cucun 1
60 By.Ny. devi 1
10/1/2017 57 by rokhayati 1 61 By.Ny. Fuji 1
58 BY ELISABETH 1
59 by karsih 1 8/12/2017 62 By.Ny. Susi 1
63 By.Ny. Yulinar 1 1
11/1/2017 60 by rokhayati 1 64 By.Ny. Sri M 1
61 by karsih 1 65 By.Ny. Cucun 1
62 by julaeha 1 66 By.Ny. fuji 1
63 by novianti 1 67 By.Ny. Devi 1
68 By.Ny. Iftitah 1
12/1/2017 64 by novianti 1 69 By.Ny. Yuliana 1
65 by rokhayati 1
66 by karsih 1
67 by julaeha 1 9/12/2017 70 By.Ny. Yulinar 1 1
68 by rani 1 71 By.Ny. Sri M 1
72 By.Ny. Cucun 1
13/1/2017 69 by novianti 1 73 By.Ny. fuji 1
70 by rokhayati 1 74 By.Ny. Devi 1
71 by karsih 1 75 By.Ny. Iftitah 1
72 by julaeha 1 76 By.Ny. Yuliana 1
73 by rani 1 77 By.Ny. Linda 2 1 1
74 By.Ny. Tanti 1 78 By.Ny. Yulia N 1
75 By.Ny. susilawati 1 10/12/2017 79 By.Ny. Sri M 1
76 By.Ny. Sumiati 1 80 By.Ny. Cucun 1
81 By.Ny. fuji 1
14/01/2017 77 by novianti 1 stapilo 82 By.Ny. Devi 1
78 by rokhayati 1 83 By.Ny. Iftitah 1
79 by karsih 1 84 By.Ny. Yuliana 1
80 By.Ny.Euis 1 85 By.Ny. Rita 1 1
81 by rani 1 86 By.Ny. Linda 2 1 1
82 By.Ny. Tanti 1 87 By.Ny. Yulia N 1
83 By.Ny. susilawati 1 11/12/2017 88 By.Ny. Linda 2 1 1
84 By.Ny. Sumiati 1 89 By.Ny. Cucun 1
85 By.Ny.Euis 1 90 By.Ny. Sri M 1
91 By.Ny. Yuliana 1
15/01/2017 86 by novianti 1 92 By.Ny. Iftitah 1
87 by rokhayati 1 93 By.Ny. Devi 1
88 by karsih 1 94 By.Ny. Yulia N 1
89 By.Ny.Euis 1
90 By.Ny.Euis 1 12/12/2017 95 By. Ny. Devi 1
96 By. Ny. Iftitah 1
16/01/2017 91 by novianti 1 97 By.Ny. Yuliana 1
92 by rokhayati 1 98 By.Ny. Linda 2 1 1
93 by karsih 1 99 By.Ny. Cucun 1
94 By.Ny.Euis 1 100 By.Ny. Sri M 1
95 By.Ny. Eni 1 101 By.Ny. Tini 1
96 By.Ny. Martini 1 102 By.Ny. Fujiawati 1

17/01/2017 97 by rokhayati 1 13/12/2017 103 By.Ny. Cucun 1


98 by karsih 1 104 By.Ny. Sri M 1
99 By.Ny.Euis 1 105 By.Ny. Tini 1
100 By.Ny. Eni 1 106 By.Ny. devi 1
101 By.Ny. Martini 1 107 By.Ny. Fujiawati 1
108 By.Ny. Yuliana 1
18/1/2017 102 by rokhayati 1 109 By.Ny. Titi 1
103 by karsih 1 110 By.Ny. ayu Rizki 1
104 By.Ny.Euis 1
105 By.Ny. Eni 1 14/12/2017 111 By.Ny.ayu Rizki 1
112 By.Ny. devi 1
19/01/2017 106 by. rokhayati 1 113 By.Ny. Fujiawati 1
107 by. euis 1 114 By.Ny. Cucun 1
by. lulu
108 1 115 By.Ny. Sri M 1
116 By.Ny. Tini 1
20/01/2017 109 By.Ny. Rokhayati 1 117 By.Ny. Titi 1
110 By. Ny. Euis 1
111 By. Ny. Lulu 1 15/12/2017 118 By.Ny. Cucun 1
119 By.Ny. Sri M 1
21/01/2017 112 By.Ny. Rokhayati 1 120 By.Ny. Tini 1
113 By. Ny. Euis 1 121 By.Ny. Titi 1
122 By. Ny. Arti 1
123 By.Ny. devi 1
22/01/2017 114 By.Ny. Rokhayati 1 124 By.Ny. Ayu Rizki 1
115 By. Ny. Euis 1 125 By.Ny. Dewi 1

116 By.Ny. Hepi 1 16/12/2017 126 By.Ny. Cucun 1


127 By.Ny. Sri M 1
23/01/2017 117 By.Ny. Rokhayati 1 128 By.Ny. Tini 1
118 By. Ny. Euis 1 129 By.Ny. Titi 1
119 By.Ny. Hepi 1 130 By. Ny. Arti 1
131 By.Ny. devi 1
24/01/2017 120 By.Ny. Rokhayati 1
121 By. Ny. Euis 1 17/12/2017 132 By.Ny. Cucun 1
122 By.Ny. Hepi 1 133 By.Ny. Sri M 1

134 By.Ny. Tini 1


25/01/2017 123 By.Ny. Rokhayati 1 135 By.Ny. Titi 1
124 By. Ny. Euis 1 136 By. Ny. Arti 1
125 By.Ny. Hepi 1 137 By.Ny. Siti Aisyah 1 1
126 By.Ny. Rica 1 1 138 BY.Ny. dewi 1
139 By.Ny. Aisyah 1
26/01/2017 127 By.Ny. Rokhayati 1
128 By. Ny. Euis 1 18/12/2017 140 By.Ny. Sri M 1
129 By.Ny. Rica 1 1 141 By.Ny. Titi Sumarni 1
142 By.Ny. Cucun 1
27/01/2017 130 By. Ny. Euis 1 143 By.Ny. Tini 1
131 By.Ny. Rica 1 1 144 By.Ny. Siti Aisah 1 1
145 By.Ny. Aisah 1 1
28/01/2017 132 By.Ny. Lis Setiawati 1 146 By.Ny. Dewi 1
133 By.Ny. Sheni 1
19/12/2017 147 By.Ny. Cucun 1
29/01/2017 134 By.Ny. Lis Setiawati 1 148 By.Ny. Tini 1
135 By.Ny. Sheni 1 149 By.Ny. Siti Aisah 1 1
150 By.Ny. Aisah 1 1
30/01/2016 136 By.Ny. Lis Setiawati 1 151 By.Ny. Dewi 1
137 By.Ny. Sheni 1 152 By.Ny. Sri M 1
153 By.Ny. Dinar 1
31/01/2017 138 By.Ny. Yuni Agustina 1
20-12-2017 154 By.Ny. Cucun 1
2 138 Jumlah bayi rawat peri 194 155 By.Ny. Tini 1
Bayi lahir hidup 307 156 By.Ny. Siti Aisah 1 1
157 By.Ny. Dewi 1
RUANG PERINATOLOGI FEBRUARI 2017 158 By.Ny. Sri M 1
FORMULIR SURVEY HARIAN PEMAKAIAN ALAT 159 By.Ny. Dinar 1
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN 160 By.Ny. nani 2 1
1/2/2017 1 By ny amelia 1
21-12-2017 161 By.Ny. Cucun 1
2/2/2017 2 by ny amelia 1 1 162 By.Ny. Tini 1
3 by ernawati 1 163 By.Ny. Siti Aisah 1 1
164 By.Ny. Dewi 1
3/2/2017 4 by amelia 1 1 165 By.Ny. Sri M 1
5 by dedeh 1 166 By.Ny. Dinar 1
6 by intan 1 167 By.Ny. nani 2 1
7 by ernawati 1
22-12-2017 168 By.Ny. Cucun 1
4/2/2017 8 by santi 1 169 By.Ny. Tini 1
9 by dedeh 1 170 By.Ny. Siti Aisah 1 1
10 by intan 1 171 By.Ny. Dewi 1
11 by ernawati 1 172 By.Ny. Sri M 1
173 By.Ny. Dinar 1
5/2/2017 12 by santi 1 174 By.Ny. nani 2 1
13 by dedeh 1 175 By Sandi 1
14 by intan 1 176 By.Ny. Nursani 1
15 by ernawati 1
16 by. albi 1 1 23-12-2017 177 By.Ny. Cucun 1
17 by neni 1 178 By.Ny. Tini 1
179 By.Ny. Siti Aisah 1 1
6/2/2017 18 by ny neni 1 180 By.Ny. Dewi 1
19 by dedeh 1 181 By.Ny. Sri M 1
20 by santi 1 182 By.Ny. Dinar 1
21 by intan 1 183 By.Ny. nani 2 1
22 by lastari 1 184 By Sandi 1
23 by ernawati 1 185 By.Ny. Nursani 1
24 by iis 1 186 By.Ny. laswati 1
25 by dedeh 1
24-12-2017 187 By.Ny. Cucun 1
7/2/2017 26 by ny neni 1 188 By.Ny. Tini 1
27 by dedeh 1 189 By.Ny. Siti Aisah 1 1
28 by santi 1 190 By.Ny. Dewi 1
29 by intan 1 191 By.Ny. Sri M 1
30 by lastari 1 192 By.Ny. Dinar 1
31 by ernawati 1 193 By.Ny. nani 2 1
32 by iis 1 194 By.Ny. Nursani 1
33 by dedeh 1 195 By.Ny. laswati 1
34 By.Ny. Hersa 1
35 By.Ny. Lina 1 25-12-2017 196 By.Ny. Cucun 1
36 By. Dewi 1 197 By.Ny. Tini 1
198 By.Ny. Siti Aisah 1 1
8/2/2017 37 by ny neni 1 199 By.Ny. Dewi 1
Arsyad
38 1 200 By.Ny. Sri M 1
39 by santi 1 201 By.Ny. Dinar 1
40 by ernawati 1 202 By.Ny. nani 2 1
41 By.Ny. Nina 1 203 By.Ny. Nursani 1
42 By.Ny. Lina 1 204 By.Ny. laswati 1
43 By.Dewi 1 205 By.Ny. Rita 1
44 By.Ny. Hersa 1
45 By.Ny. Lastari 1 26-12-2017 206 By.Ny. Cucun 1
207 By.Ny. Tini 1
09/02/2017 46 by ny neni 1 208 By.Ny. Siti Aisah 1 1
Arsyad
47 1 209 By.Ny. Dewi 1
48 by santi 1 210 By.Ny. Sri M 1
49 by ernawati 1 211 By.Ny. Dinar 1
50 By.Ny. Lina 1 212 By.Ny. nani 2 1
51 By.Dewi 1 213 By.Ny. Nursani 1
52 By.Ny. Hersa 1 214 By.Ny. laswati 1
53 By.Ny. Lastari 1 215 By.Ny. Rita 1
216 By.Ny. Herlina 1
10/02/2017 54 By.Ny. Hersa 1
55 By.Dewi 1 27-12-2017 217 By.Ny. Cucun 1
56 By.Ny. Santi 1 218 By.Ny. Tini 1
57 By. Ny. Neni 1 219 By.Ny. Siti Aisah 1 1
58 By.Ny. Lina 1 220 By.Ny. Dewi 1
59 By.Ny. Ernawati 1 221 By.Ny. Sri M 1
60 By.Ny. Lastari 1 222 By.Ny. Dinar 1
61 Arsyad 1 223 By.Ny. nani 2 1
224 By.Ny. Nursani 1
11/2/2017 62 By.Ny. Hersa 1 225 By.Ny. laswati 1
63 By.Dewi 1 226 By.Ny. Rita 1
64 By.Ny. Santi 1 227 By.Ny. Herlina 1
65 By. Ny. Neni 1 228 By.Ny. Nela 1
66 By.Ny. Lina 1
67 By.Ny. Ernawati 1 28-12-2017 229 By.Ny. Cucun 1
68 By.Ny. Lastari 1 230 By.Ny. Tini 1
69 by ny anisa 1 231 By.Ny. Siti Aisah 1 1
232 By.Ny. Dewi 1
12/2/2017 70 By.Ny. Hersa 1 233 By.Ny. Sri M 1
71 By.Ny. Santi 1 234 By.Ny. Dinar 1
72 By. Ny. Neni 1 235 By.Ny. nani 2 1
73 By.Ny. Lina 1 236 By.Ny. Nursani 1
74 By.Ny. Lastari 1 237 By.Ny. Marissa 1
75 by anisa 1 238 By.Ny. IIs 1
76 by ela 1 239 By.Ny. Rimbun 1
77 by anisa 1 240 By.Ny. herlina 1
29-12-2017 241 By.Ny. Cucun 1
13/2/2017 78 By.Ny. Hersa 1 242 By.Ny. Tini 1
79 By. Ny. Neni 1 243 By.Ny. Siti Aisah 1 1
80 By.Ny. Lina 1 244 By.Ny. Dewi 1
81 By.Ny. Lastari 1 245 By.Ny. Sri M 1
82 by ela 1 1 246 By.Ny. Dinar 1
83 by anisa 1 247 By.Ny. nani 2 1
84 by shinta 1 248 By.Ny. Nursani 1
249 By.Ny. Marissa 1
14/2/2017 85 by ela 1 1 250 By.Ny. IIs 1
86 by shinta 1 251 By.Ny. Rimbun 1
87 By. Ny. Neni 1 252 By.Ny. Yati 1
88 By.Ny. Lina 1 253 By.Ny. Nela 1

15/2/2017 89 by ela 1 1 30-12-2017 254 By.Ny. Cucun 1


90 by shinta 1 255 By.Ny. Tini 1
91 By. Ny. Neni 1 256 By.Ny. Siti Aisah 1 1
92 By.Ny. Lina 1 257 By.Ny. Dewi 1
258 By.Ny. Sri M 1
16/02/2017 93 by ela 1 1 259 By.Ny. Dinar 1
94 by shinta 1 260 By.Ny. Nursani 1
95 By. Ny. Neni 1 261 By.Ny. Marissa 1
96 By.Ny. Lina 1 262 By.Ny. IIs 1
263 By.Ny. Rimbun 1
17/2/2017 97 by ela 1 1 264 By.Ny. Yati 1
98 by shinta 1
99 By. Ny. Neni 1
100 By.Ny. Lina 1
31-12-2017 265 By.Ny. Cucun 1
18/02/2017 101 by ela 1 1 266 By.Ny. Tini 1
102 by shinta 1 267 By.Ny. Siti Aisah 1 1
103 BY.Ny. Selvi 1 268 By.Ny. Dewi 1
104 By.Ny. Lina 1 269 By.Ny. Sri M 1
105 By.Ny. Sumiati 1 270 By.Ny. Dinar 1
106 By.Ny. Gini 1 271 By.Ny. Nursani 1
107 By.Ny. Ratna 1 272 By.Ny. Rimbun 1

19/02/2017 108 by ela 1 1


109 by shinta 1 27 160 0 112
110 BY.Ny. Selvi 1
111 By.Ny. Lina 1
112 By.Ny. Gini 1
113 By.Ny. Ratna 1
114 By.Ny. Yani 1

20/02/2017 115 by ela 1 1


116 by shinta 1
117 BY.Ny. Selvi 1
118 By.Ny. Lina 1
119 By.Ny. Gini 1
120 By.Ny. Ratna 1
121 By.Ny. Yani 1

21/02/2017 122 by ela 1 1


123 by shinta 1 1
124 By.Ny. Lina 1
125 By.Ny. Yani 1
126 By.Ny. Dewilda 1

22/02/2017 127 by ela 1 1


128 by shinta 1 1
129 By.Ny. Lina 1
130 By.Ny. Yani 1
131 By.Ny. Dewilda 1

23/2/2017 132 by ela 1 1


133 by shinta 1
134 By.Ny. Lina 1
135 By.Ny. Yani 1
136 By.Ny. Dewilda 1
137 By.Ny. Anisa 1

24/02/2017 138 by ela 1


139 by shinta 1
140 By.Ny. Lina 1
141 By.Ny. Yani 1
142 By.Ny. Anisa 1
143 by ny didah 1

25/02/2017 144 By.Ny. Yani 1 1


145 By.Ny. Lina 1
146 by ny didah 1
147 by ela 1 staphylokokus hemoliticus
148 by shinta 1
149 by iis 1
150 by rika 1

26/02/2017 151 By.Ny. Yani 1 1


152 By.Ny. Lina 1 Enterobacter cloaceae
153 by ny didah 1
154 by ela 1
155 by shinta 1 tdk ada pertumbuhan kuman
156 by iis 1
157 By.Ny. Desi 1

27/02/2017 158 By.Ny. Yani 1 1


159 By.Ny. Lina 1
160 by ny didah 1
161 by ela 1
162 by shinta 1
163 by iis 1
164 By.NY. Nia 1

28/02/2017 165 By.Ny. Yani 1 1


166 By.Ny. Lina 1
167 by ny didah 1
168 by ela 1
169 by shinta 1
170 by iis 1
171 By.NY. Nia 1
172 By.Ny. Mulyanti 1 1
173 By.Ny. Wiwin 1

22 139 14 498734 jumlah pasen : 186

RUANG PERINATOLOGI MARET 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2017 1 By.Ny. Yani 1 1
2 By.Ny. Lina 1
3 by ela 1
4 by shinta 1
5 By.NY. Nia 1
6 By.Ny. Mulyanti 1 1
7 By.Ny. Wiwin 1

2/3/2017 8 By.Ny. Yani 1


9 By.Ny. Lina 1
10 by ela 1
11 by shinta 1
12 By.NY. Nia 1
13 By.Ny. Mulyanti 1 1
14 By.Ny. Wiwin 1

3/3/2017 15 By.Ny. Yani 1


16 By.Ny. Lina 1
17 by ela 1
18 by shinta 1
19 By.NY. Nia 1
20 By.Ny. Mulyanti 1 1
21 By.Ny. yani 1
22 by. ny. erni 1

4/3/2017 23 By.Ny. Yani 1


24 By.Ny. Lina 1
25 by ela 1
26 by shinta 1
27 By.NY. Nia 1
28 By.Ny. Mulyanti 1 1
29 By.Ny. yani 1
30 by. ny. erni 1
31 by erna 1

5/3/2017 32 By.Ny. Yani 1


33 By.Ny. Lina 1
34 by ela 1
35 by shinta 1
36 By.NY. Nia 1
37 By.Ny. Mulyanti 1 1
38 By.Ny. yani 1
39 by. ny. erni 1
40 by erna 1

6/3/2017 41 By.Ny. Yani 1


42 By.Ny. Lina 1
43 by ela 1
44 by shinta 1
45 By.NY. Nia 1
46 By.Ny. Mulyanti 1 1
47 by. ny. erni 1
48 BY NY evi 1 1
49 by erna 1 1

7/3/2017 50 By.Ny. Lina 1


51 by ela 1
52 by shinta 1
53 By.NY. Nia 1
54 By.Ny. Mulyanti 1 1
55 by. ny. erni 1 Enterobacter cloaceae
56 by asih 1 Tdk ada pertumbuhan kuman
57 by wiwin 1
58 by siti aliyah 1
59 by erna 1

8/3/2017 60 By.Ny. Lina 1


61 by ela 1
62 by shinta 1
63 By.NY. Nia 1
64 By.Ny. Mulyanti 1 1
65 by. ny. erni 1
66 by asih 1
67 by wiwin 1
68 by siti aliyah 1
69 by fitri 1 1 tdk ada pertumbuhn

9/3/2017 70 By.Ny. Mulyanti 1


71 By.Ny. Fitri 1 1
72 By.Ny. Shinta 1
73 By.Ny. Ela 1
74 By. Ny. Asih 1
75 By. Ny. Nia 1
76 By.Ny. Lina 1
77 By.Ny. Siti Aliyah 1
78 By.Ny. Wiwin 1

10/3/2017 79 By.Ny. Mulyanti 1


80 By.Ny. Shinta 1
81 By.Ny. Ela 1
82 By. Ny. Asih 1
83 By. Ny. Nia 1
84 By.Ny. Lina 1
85 by ny siti aliyah 1

11/3/2017 86 By.Ny. Shinta 1


87 By.Ny. Ela 1
88 By. Ny. Asih 1
89 By. Ny. Nia 1
90 By.Ny. Lina 1

12/3/2017 91 By.Ny. Shinta 1


92 By.Ny. Ela 1
93 By. Ny. Asih 1
94 By. Ny. Nia 1
95 By.Ny. Lina 1
96 by. aas 1
97 by. widiasari 1
98 By.NY. Mia 1
13/3/2017 99 By.Ny. Shinta 1
100 By.Ny. Ela 1
101 By. Ny. Asih 1
102 By. Ny. Nia 1
103 By.Ny. Lina 1
104 by. aas 1
105 by. widiasari 1
106 By.NY. Mia 1 Enterbacter cloaceaeRujukan kebonjati
107 By.Ny. Ajeung 1
108 By.NY. Mimin 1
109 By.NY. Cahya 1

14/3/2017 110 BY.NY. sinta 1


111 BY.nY. Ela 1
112 By. Ny. Asih 1
113 By. Ny. Nia 1
114 By.NY. Mia 1
115 By.Ny. Ajeung 1
116 by razqa 1
117 by. aas 1
118 by. widiasari 1
119 By.NY. Mimin 1
120 By.NY. Cahya 1
121 By.Ny. Mira sari 1
122 By.Ny. Rias 1

15/3/2017 123 By. Ny. Asih 1


124 By. Ny. Nia 1
125 By.NY. Mia 1
126 By.Ny. Ajeung 1
127 BY. CRISTELA 1

16/3/2017 128 by. mia 1


129 by. mita 1
130 by. asih 1
131 cristella 1
132 by. ajeng 1

17/3/2017 133 by. mia 1


134 by. mita 1
135 by. asih 1
136 cristella 1
137 by. ajeng 1
138 by lisma 2 1
139 by santi 1

18/3/2017 140 by lisma 2 1


141 by santi 1
142 by. mia 1
143 by. mita 1
144 by. asih 1

19/3/2017 145 by lisma 2 1


146 by santi 1
147 by. mia 1
148 by. mita 1
149 by. asih 1
150 by fitrahtullah 1

20/3/2017 151 by lisma 2 1


152 by santi 1
153 by. mia 1
154 by. asih 1
155 by fitrahtullah 1
156 by yannita 1

21/3/2017 157 by santi 1


158 by. mia 1
159 by. asih 1
160 by fitrahtullah 1
161 by yannita 1
162 By.Ny. Triana 1

22/03/2017 163 by santi 1


164 by. mia 1
165 by. asih 1
166 by fitrahtullah 1
167 by yannita 1
168 By.Ny. Triana 1
169 By.Ny. Ika 1

23/03/2017 170 by santi 1


171 by. asih 1
172 By.Ny. Lilis 1
173 By.Ny. Triana 1
174 By.Ny. Ika 1
175 By.Ny. Tintin 1
176 By.Ny. Febriyani 1
177 By.NY. Fani 1
178 By.NY. MIa 1

24/03/2017 179 by santi 1


180 by. asih 1
181 By.Ny. Lilis 1
182 By.Ny. Triana 1
183 By.Ny. Ika 1 1
184 By.Ny. Tintin 1
185 By.Ny. Febriyani 1
186 By.NY. Fani 1
187 By.NY. Mia 1

25/03/2017 188 by santi 1


189 by. asih 1
190 By.Ny. Yeni 1
191 By.Ny. Triana 1
192 By.Ny. Ika 1 1
193 By.Ny. Tintin 1
194 By.Ny. Febriyani 1
195 By.NY. Fani 1

26/03/2017 196 by santi 1


197 by. asih 1
198 By.Ny. Yeni 1
199 By.Ny. Triana 1 1
200 By.NY. Nurmaya 1
201 By.Ny. Tintin 1
202 By.Ny. Febriyani 1
203 By.NY. Fani 1

27/03/2017 204 by santi 1


205 by. asih 1
206 By.Ny. Yeni 1
207 By.NY. Nurmaya 1
208 By.Ny. Tintin 1
209 By.Ny. Febriyani 1
210 By.NY. Fani 1

28/03/2017 211 by santi 1


212 by. asih 1
213 By.Ny. Yeni 1
214 By.NY. Nurmaya 1
215 By.Ny. Tintin 1
216 By.Ny. Febriyani 1
217 By.NY. Fani 1
218 By.Ny. Siti Latifah 1

29/03/2017 219 by. asih 1


220 By.Ny. Yeni 1
221 By.Ny. Tintin 1
222 By.Ny. Febriyani 1
223 By.NY. Fani 1

30/03/2017 224 by. asih 1


225 By.Ny. Yeni 1
226 By.Ny. Tintin 1
227 By.Ny. Febriyani 1
228 By.NY. Fani 1
229 By.Ny. Devi 1
230 By.Ny. Nuraliyah 1

31/03/2017 231 by. asih 1


232 By.Ny. Yeni 1
233 By.Ny. Tintin 1
234 By.Ny. Febriyani 1
235 By.NY. Fani 1
236 By.Ny. Devi 1
237 By.Ny. Nuraliyah 1
238 By.Ny. Tina 1
Pasien lahir hidup 309
JUMLAH 16 151 28 59

RUANG PERINATOLOGI APRIL 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/4/2017 1 by. asih 1
2 By.Ny. Yeni 1
3 By.Ny. Tintin 1
4 By.Ny. Febriyani 1
5 By.NY. Fani 1
6 By.Ny. Devi 1
7 By.Ny. Nuraliyah 1
8 By.Ny. Tina 1

2/4/2017 9 by. asih 1


10 By.Ny. Yeni 1
11 By.Ny. Tintin 1
12 By.Ny. Febriyani 1
13 By.NY. Fani 1
14 By.Ny. Devi 1
15 By.Ny. Nuraliyah 1
16 By.Ny. Tina 1

3/4/2017 17 by. asih 1


18 By.Ny. Yeni 1
19 By.Ny. Tintin 1
20 By.Ny. Febriyani 1
21 By.NY. Fani 1
22 By.Ny. Devi 1
23 By.Ny. Nuraliyah 1
24 By.Ny. Tina 1

4/4/2017 25 by. asih 1


26 by. devi 1
27 by. tintin 1
28 by. febriyani 1
29 by. nuraliyah 1
30 by. tina 1

5/4/2017 31 by. asih 1


32 by. devi 1
33 by. tintin 1
34 by. febriyani 1
35 by. nuraliyah 1
36 by. tina 1

6/4/2017 37 by. asih 1


38 by. devi 1
39 by. tintin 1
40 by. febriyani 1
41 by. nuraliyah 1
42 by. tina 1
43 by noni 1
44 by yeni 1

7/4/2017 45 by. asih 1


46 by. devi 1
47 by. tintin 1
48 by. febriyani 1
49 by. nuraliyah 1
50 by. tina 1
51 by noni 1
52 by yeni 1
53 by elva 1

8/4/2017 54 by. asih 1


55 by. devi 1
56 by. tintin 1
57 by. febriyani 1
58 by. nuraliyah 1
59 by noni 1
60 by yeni 1
61 by elva 1

9/4/2017 62 by. asih 1


63 by. devi 1
64 by. tintin 1
65 by. febriyani 1
66 by. nuraliyah 1
67 by noni 1
68 by elva 1
69 by irnia 1

10/4/2017 70 by. asih 1


71 by. devi 1
72 by. tintin 1
73 by. febriyani 1
74 by. nuraliyah 1
75 by noni 1
76 by elva 1
77 by irnia 1

11/4/2017 78 by. asih 1


79 by. devi 1
80 by. tintin 1
81 by. febriyani 1
82 by. nuraliyah 1
83 by. yeni 1
84 by noni 1
85 by elva 1
86 by irnia 1
87 by. siska 1
88 by. tanti 1
89 by. siti maryam 1

12/4/2017 90 by. asih 1


91 by. devi 1
92 by. tintin 1
93 by. febriyani 1
94 by. nuraliyah 1
95 by. yeni 1
96 by. maya 1
97 by elva 1
98 by irnia 1
99 by. siska 1
100 by. tanti 1
101 by. siti maryam 1
102 by. santi 1

13/4/2017 103 by. asih 1


104 by. devi 1
105 by. tintin 1
106 by. febriyani 1
107 by. nuraliyah 1
108 by. yeni 1
109 by. maya 1
110 by elva 1
111 by irnia 1
112 by. siska 1
113 by. tanti 1
114 by. siti maryam 1
115 by. santi 1

14/4/2017 116 by. asih 1


117 by. devi 1
118 by. tintin 1
119 by. febriyani 1
120 by. nuraliyah 1
121 by. sri 1
122 by. maya 1
123 by elva 1
124 by irnia 1
125 by. siska 1
126 by. tanti 1
127 by. siti maryam 1

15/4/2017 128 by. asih 1


129 by. devi 1
130 by. tintin 1
131 by. febriyani 1
132 by. nuraliyah 1
133 by. sri 1
134 by. maya 1
135 by elva 1
136 by irnia 1
137 by. siska 1
138 by. tanti 1
139 by. siti maryam 1

16/4/2017 140 by. asih 1


141 by. devi 1
142 by. tintin 1
143 by. febriyani 1
144 by. nuraliyah 1
145 by. sri 1
146 by. maya 1
147 by elva 1
148 by irnia 1
149 byny tanti 1
150 by siti maryam 1

17/04/2016 151 by. asih 1


152 by. devi 1
153 by. tintin 1
154 by. febriyani 1
155 by. nuraliyah 1
156 by. tanti 1
157 by. sri 1
158 by. siti maryam 1
159 by. elva 1
160 by. maya 1
161 by. eneng 1
162 by. siti I 1
163 by. siti n 1
164 by. yani 1
165 by. mia 1

18/04/2017 166 by. asih 1


167 by. devi 1
168 by. tintin 1
169 by. febriyani 1
170 by. nuraliyah 1
171 by. tanti 1
172 by. sri 1
173 by. siti maryam 1
174 by. elva 1
175 by. maya 1
176 by. eneng 1
177 by. siti I 1
178 by. siti n 1
179 by. yani 1
180 by. mia 1

19/4/2017 181 by. asih 1


182 by. ratna 1
183 by. tintin 1
184 by. febriyani 1
185 by. nuraliyah 1
186 by. tanti 1
187 by. sri 1
188 by. siti maryam 1
189 by. elva 1
190 by. maya 1
191 by. eneng 1
192 by. siti I 1
193 by. siti n 1
194 by. yani 1
195 by. mia 1

20/04/2014 196 by. asih 1


197 by. ratna 1
198 by. syaila 1
199 by. febriyani 1
200 by. nuraliyah 1
201 by. tanti 1
202 by. sri 1
203 by. siti maryam 1
204 by. elva 1
205 by. maya 1
206 by. eneng 1
207 by. siti I 1
208 by. siti n 1
209 by. yani 1
210 by. mia 1

21/04/2017 211 by. siti. m 1


212 by. sri. y 1
213 by. asih 1
214 by. febriyani 1
215 by. nuraliyah 1
216 by. yani 1
217 by. ratna 1
218 by. syaila 1
219 by. siti. n 1
220 by. kiki 1

22/04/2017 221 by. siti m 1


222 by. nuraliyah 1
223 by. febriyani 1
224 by. sri y 1
225 by. ria 1
226 by. erni 1
227 by. yani 1
228 by. ratna 1
229 by. syaila 1
230 by. siti. n 1
231 by. kiki 1

23/04/2017 232 by. siti m 1


233 by. nuraliyah 1
234 by. febriyani 1
235 by. sri y 1
236 by. ria 1
237 by. erni 1
238 by. yani 1
239 by. ratna 1
240 by. syaila 1
241 by. siti. n 1
242 by. kiki 1

24/04/2017 243 by. ria 1


244 by. nuraliyah 1
245 by. siti m 1
246 by. sri. y 1
247 by. febriyani 1
248 by, erni 1
249 by. kiki 1

25/04/2017 250 by. ria 1


251 by. nuraliyah 1
252 by. siti m 1
253 by. sri. y 1
254 by. febriyani 1
255 by, erni 1
256 by. sri pahani 1

26/04/2017 257 by. kokom 1


258 by. nuraliyah 1
259 by. siti m 1
260 by. sri. y 1
261 by. febriyani 1
262 by, erni 1
263 by. sri pahani 1 1
264 by. winda 1
265 by. hani 1

27/04/2017 266 by. hani 1


267 by. siti m 1
268 by. sri. y 1
269 by. febriyani 1
270 by. winda 1
271 by. nuraliyah 1
272 by. kokom 1
273 by. rani 1
274 By.Ny. Erni 1

28/4/2017 275 by. hani 1


276 by. siti m 1
277 by. sri. y 1
278 by. febriyani 1
279 by. winda 1
280 by. nuraliyah 1
281 by. kokom 1
282 by. rani 1
283 By.Ny. Erni 1

29/4/2017 284 by. siti m 1


285 by. sri. y 1
286 by. febriyani 1
287 by. winda 1
288 By.Ny. hani 1
289 By.Ny. Erni 1

30/4/2017 290 by. siti m 1


291 by. sri. y 1
292 by. febriyani 1
293 by. winda 1
294 By.Ny. Hani 1
295 By.NY. Erni 1

1 140 0 155 0 0

JUmlah pasien 277

RUANG PERINATOLOGI MEI 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/5/2017 1 By.Ny. Siti mAryam 1
2 By.Ny. HAni 1
3 By. Ny. Febriyani 1
4 By.Ny. Erni 1
5 BY.NY. Sri Yulianti 1
6 By.NY. Winda 1

2/5/2017 7 By.Ny. Siti mAryam 1


8 By.Ny. HAni 1
9 By. Ny. Febriyani 1
10 By.Ny. Erni 1
11 BY.NY. Sri Yulianti 1
12 by mira 1
13 by lilis 1

3/5/2017 14 By.Ny. Siti mAryam 1


15 by mamah 1
16 By. Ny. Febriyani 1
17 By.Ny. Erni 1
18 BY.NY. Sri Yulianti 1
19 by nani 1
20 by yeni 1
21 by kartika 1

4/5/2017 22 By.Ny. Siti mAryam 1


23 by mamah 1
24 By. Ny. Febriyani 1
25 By.Ny. Erni 1
26 BY.NY. Sri Yulianti 1
27 by nani 1
28 by yeni 1
29 by kartika 1
30 by ika 1
31 by siti nuriyah 1

5/5/2017 32 By.Ny. Siti mAryam 1


33 by mamah 1
34 By. Ny. Febriyani 1
35 By.Ny. Erni 1
36 BY.NY. Sri Yulianti 1
37 by nani 1
38 by yeni 1
39 by kartika 1
40 by ika 1
41 by siti nuriyah 1

6/5/2017 42 by mamah 1
43 By. Ny. Febriyani 1
44 By.Ny. Erni 1
45 by nani 1
46 by yeni 1
47 by kartika 1
48 by ika 1
49 by siti nuriyah 1

7/5/2017 50 By. Ny. Febriyani 1


51 By.Ny. Erni 1
52 by laura 1
53 by yuniati 1
54 by tati 1
55 by. ika 1

8/5/2017 56 By. Ny. Febriyani 1


57 By.Ny. Erni 1
58 by. ika 1

9/5/2017 59 By. Ny. Febriyani 1


60 By.Ny. Erni 1
61 by. ika 1
62 by. imas 1

10/5/2017 63 By. Ny. Febriyani 1


64 by, winda 1
65 by. imas 1

11/5/2017 66 By. Ny. Febriyani 1


67 by, winda 1
68 by. imas 1
69 BY ANISA 1
70 by ipah 1
71 by titin 1

12/5/2017 72 By. Ny. Febriyani 1


73 by, winda 1 Stafilococus Epidermidis
74 by. imas 1
75 BY ANISA 1
76 by santi 1
77 by reka 1
78 by ipah 1
79 by titin 1

13/5/2017 80 By. Ny. Febriyani 1


81 by, winda 1
82 by. imas 1
83 BY ANISA 1
84 by santi 1
85 by reka 1
86 by ipah 1
87 by titin 1

14/5/2017 88 By. Ny. Febriyani 1


89 by, winda 1
90 by. imas 1
91 BY ANISA 1
92 By.Ny. Aisyah 1
93 By.Ny. Novy 1

15/05/2017 94 By. Ny. Febriyani 1


95 by, winda 1
96 by. imas 1
97 BY ANISA 1
98 By.Ny. Aisyah 1
99 By.Ny. Novy 1

16/05/2017 100 By. Ny. Febriyani 1


101 by, winda 1
102 by. imas 1
103 BY ANISA 1
104 By.Ny. Aisyah 1
105 By.Ny. Novy 1
106 By.Ny. Ratna 1

17/5/2017 107 by. imas 1


108 by. winda 1
109 by. arnimah 1
110 by. annisa 1
111 by. novy 1
112 by. ratna 1

18/5/2017 113 by. imas 1


114 by. winda 1
115 by. arnimah 1
116 by. annisa 1
117 by. ratna 1
118 by kurniasih 1
119 by dheasy 1

19/5/2017 120 by. imas 1


121 by. winda 1
122 by. arnimah 1
123 by. annisa 1
124 by kurniasih 1
125 by dheasy 1

20/05/2017 126 By.Ny. Isma 2 1


127 By.Ny. Rina 1
128 by. imas 1
129 by. winda 1
130 by. arnimah 1
131 by. annisa 1
132 By.Ny. irma 1
133 By.Ny. Yuliati 1

21/05/2017 134 By.Ny. Isma 2 1


135 By.Ny. Rina 1
136 by. imas 1
137 by. winda 1
138 By.Ny. Nurfatimah 1
139 by. annisa 1
140 By.Ny. irma 1
141 By.Ny. Yuliati 1

22/05/2017 142 By.Ny. Imas 1


143 by. winda 1
144 By.Ny. Nurfatimah 1
145 by. annisa 1
146 By.Ny. Yuliati 1
147 by dian 1

23/05/2017 148 By.Ny. Imas 1


149 by. winda 1
150 By.Ny. Nurfatimah 1
151 by. annisa 1
152 By.Ny. Dian 1
153 By.Ny. Nurazizah 1

24/5/2017 154 By.Ny. Imas 1


155 by. winda 1
156 By.Ny. Dian 1
157 By.NY. Nurazizah 1

25/05/2017 158 By.Ny. Karmila 1 1


159 By.Ny. Imas 1
160 by. winda 1
161 By.Ny. Karmila 2 1
162 BY.NY. Nurazizah 1
163 BY.NY. Sopiyah 1
164 By.Ny. Ratna sari 1
165 By.NY. Mayang 1
166 By.NY. Dian 1

26/05/2017 167 By.NY. Leni 1


168 By.Ny. Karmila 1 1
169 By.Ny. Imas 1
170 by. winda 1
171 By.Ny. Karmila 2 1
172 BY.NY. Nurazizah 1
173 BY.NY. Sopiyah 1
174 By.Ny. Ratna sari 1
175 By.NY. Mayang 1
176 By.NY. Dian 1
177 BY.NY. IIS 1

27/05/2017 178 By.NY. Leni 1


179 By.Ny. Karmila 1 1
180 by. winda 1
181 By.Ny. Karmila 2 1
182 By.NY. Mayang 1
183 By.NY. Dian 1
184 By.Ny. IIS 1
185 BY.NY. Sifa 1
186 By.NY. Rina Risnawati 1

28/05/2017 187 By.NY. Leni 1


188 By.Ny. Karmila 1 1
189 by. winda 1
190 By.Ny. Karmila 2 1
191 By.NY. Mayang 1
192 By.NY. Dian 1
193 BY.Ny. Sifa 1

29/05/2017 194 By.NY. Leni 1


195 By.Ny. Karmila 1 1
196 by. winda 1
197 By.Ny. Karmila 2 1
198 By.NY. Mayang 1
199 By.NY. Dian 1
200 BY.Ny. Sifa 1
201 By.Ny. Lala 1
202 By.Ny. Neti 1

30/05/2017 203 By.NY. Leni 1


204 by. winda 1
205 By.Ny. Karmila 2 1
206 By.NY. Mayang 1
207 By.NY. Dian 1
208 By.Ny. Lala 1
209 By.Ny. Neti 1
210 By.Ny. Elvina 1
211 By.Ny. Lia 1

31/05/2017 212 by. winda 1


213 By.Ny. Karmila 2 1
214 By.NY. Mayang 1
215 By.NY. Dian 1
216 By.Ny. Lala 1
217 By.Ny. Neti 1
218 By.Ny. Elvina 1
219 By.Ny. Lia 1

Jumlah Pasien 277 139 5 75

RUANG PERINATOLOGI JUNI 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2017 1 By. Ny. Neti 1
2 By.Ny. Mayang 1
3 By.Ny. Dian 1
4 By.Ny. Lala 1
5 By.Ny. Karmila 2 1
6 By.Ny. Lia 1

02/06/2017 7 By. Ny. Neti 1


8 By.Ny. Mayang 1
9 By.Ny. Dian 1
10 By.Ny. Lala 1
11 By.Ny. Karmila 2 1
12 By.Ny. Lia 1
13 By.Ny. Resa 1
14 By.Ny. elsa 1

03/06/2017 15 By. Ny. Neti 1


16 By.Ny. Mayang 1
17 By.Ny. Dian 1
18 By.Ny. Lala 1
19 By.Ny. Karmila 2 1
20 By.Ny. Lia 1
21 By.Ny. Resa 1
22 By.Ny. elsa 1

04/06/2017 23 By. Ny. Neti 1


24 By.Ny. Mayang 1
25 By.Ny. Dian 1
26 By.Ny. Lala 1
27 By.Ny. Karmila 2 1
28 By.Ny. Lia 1
29 By.Ny. Resa 1
30 By.Ny. elsa 1

05/06/2017 31 By. Ny. Neti 1


32 By.Ny. Mayang 1
33 By.Ny. Dian 1
34 By.Ny. Lala 1
35 By.Ny. Karmila 2 1
36 By.Ny. Lia 1
37 by. anita 1
38 By.Ny. Resa 1

6//6/1017 39 By. Ny. Neti 1


40 By.Ny. Mayang 1
41 By.Ny. Dian 1
42 By.Ny. Lala 1
43 By.Ny. Karmila 2 1
44 By.Ny. Lia 1
45 by. anita 1

7/6/2017 46 By. Ny. Neti 1


47 By.Ny. Mayang 1
48 By.Ny. Dian 1
49 By.Ny. Lala 1
50 By.Ny. Karmila 2 1
51 By.Ny. Lia 1
52 by. anita 1

8/6/2017 53 By. Ny. Neti 1


54 By.Ny. Mayang 1
55 By.Ny. Dian 1
56 By.Ny. Lala 1
57 By.Ny. Karmila 2 1
58 By.Ny. Lia 1
59 by. anita 1
60 By.Ny. Elis 1
61 By.Ny. Eneng 1
62 By.Ny. Eutik 1
63 By. Ny. Widya 1

9/6/2017 64 By.Ny. Elis 1


65 By.Ny. Anita 1
66 By.Ny. Widya 1
67 By.Ny. Neti 1
68 By.Ny. mayang 1
69 By.Ny. Dian 1
70 By.Ny. Karmila 2 1
71 By.Ny. Eutik 1

10/06/2017 72 By.Ny. Anita 1


73 By.Ny. Widya 1
74 By.Ny. Neti 1
75 By.Ny. mayang 1
76 By.Ny. Dian 1
77 By.Ny. Karmila 2 1
78 By. Ny. IIS 1
79 By.Devano 1

11/06/2017 80 By.Ny. Anita 1


81 By.Ny. Fitri 1
82 By.Ny. Neti 1
83 By.Ny. mayang 1
84 By.Ny. Dian 1
85 By.Ny. Karmila 2 1
86 By. Ny. IIS 1
87 By.Devano 1

12/06/2017 88 By.Ny. Anita 1


89 By.Ny. Fitri 1
90 By.Ny. Neti 1
91 By.Ny. mayang 1
92 By.Ny. Dian 1
93 By.Ny. Karmila 2 1
94 By. Ny. IIS 1
95 By.Devano 1
96 By.Ny. Elis 1
97 By.Ny. Neni haryanti 1

13/6/2017 98 By.Ny. Anita 1


99 By.Ny. Fitri 1
100 By.Ny. Neti 1
101 By.Ny. mayang 1
102 By. Ny. IIS 1
103 By.Devano 1
104 By.Ny. Elis 1
105 By.Ny. Neni haryanti 1

14/06/2017 106 by. neti 1


107 by. mayang 1
108 by. iis 1
109 by. devano 1
110 by. elis 1
111 by. neni 1
112 by. anti 1
113 By.Ny. Siti Masitoh 1

15/06/2017 114 by. mayang 1


115 by fatma 1
116 by yohania 1
117 by. elis 1
118 by. anti 1
119 BY.Ny. Siti Masitoh 1

16/06/2017 120 by. mayang 1


121 by fatma 1
122 by yohanita 1
123 by. elis 1
124 by. anti 1
125 by lilis 1
126 by lia 1
127 by santi saripah 1
128 by siti julaeha 1
129 By.Ny.Nurhayati 1

17/06/2017 130 by yohanita 1


131 by. elis 1
132 by. anti 1 1
133 by lilis 1
134 by lia 1
135 by santi saripah 1
136 by siti julaeha 1
137 By. Ny. Hirmawati 1
138 by ela 1
139 By. Ny.Asmanah 1
140 By.Ny. Vera 1

18/06/2017 141 by. anti 1 1


142 by. elis 1
143 By.Ny. Yohanita 1
144 By.Ny. Vera 1
145 By.Ny. Asmanah 1
146 By.Ny. Hirmawati 1
147 By.Ny. Ela 1
148 By.Ny. Umi 1

19/06/2017 149 by. anti 1 1


150 By.Ny. Elis 1
151 By.Ny. Yohanita 1
152 By.Ny. Vera 1
153 By.Ny. Asmanah 1
154 By.Ny. Hirmawati 1
155 By.Ny. Ela 1
156 By.Ny. Cartinah 1
157 By.Ny. Yanti 1
158 By.Ny. Umi 1 1

20/06/2017 159 By.Ny. Yanti 1


160 By.Ny. Vera 1
161 By.Ny. Sabrina 1 1
162 By.Ny. Asmanah 1
163 By.Ny. Cartinah 1
164 By.Ny. Erna 1
165 By.Ny. Yeti 1
166 By.Ny. Lia 1
167 By.Ny. Anti 1 1
168 By.Ny. Elis 1
169 By.Ny. Yohanita 1
170 By.Ny. Umi 1 1

21/06/2017 171 By.Ny. Yanti 1


172 By.Ny. Vera 1
173 By.Ny. Sabrina 1
174 By.Ny. Asmanah 1
175 By.Ny. Cartinah 1
176 By.Ny. Erna 1
177 By.Ny. Yeti 1
178 By.Ny. Lia 1
179 By.Ny.Yuyu 1
180 By.Ny. Anti 1 1
181 By.Ny. Elis 1
182 By.Ny.Yohanita 1
183 By.Ny. Umi 1 1

22/06/2017 184 By.Ny. Asmanah 1


185 By.Ny. Vera 1
186 By.Ny. Cartinah 1
187 By.Ny. Umi 1
188 By.Ny. Yanti 1
189 By.Ny. Lia 1
190 By.Ny. Widya 1
191 By.NY. Yuyu 1
192 By.Ny. Yanti yusanti 1
193 By.Ny. Nanay 1
194 By.Ny.Erna 1
195 By.Santi 1
196 By.Ny. Elis 1
197 By.Ny. Anti 1 1

23/06/2017 198 By.Ny. Asmanah 1


199 By.Ny. Vera 1
200 By.Ny. Cartinah 1
201 By.Ny. Umi 1
202 By.Ny. Yanti 1
203 By.Ny. Widya 1
204 By.NY. Yuyu 1
205 By.Ny. Yanti yusanti 1
206 By.Ny. Nanay 1
207 By.Santi 1
208 By.Ny. Elis 1
209 By.Ny. Anti 1 1
210 by ny neni 1
211 by ny yulia dewi 1
212 By.Ny. Yolanda 1
213 By.Ny. Novi 1
214 by ny esty 1

24/6/2017 215 By.Ny. Vera 1


216 By.Ny. Umi 1
217 By.Ny. Anti 1 1
218 by esty 1
219 by neni 1
220 by yanti 1

25/6/2017 221 By.Ny. Anti 1


222 by esty 1
223 BY Yanti 1

26/6/2017 224 By.Ny. Anti 1 1


225 by esty 1
226 by asri 1
27/6/2017 227 By.Ny. Anti 1 1
228 by esty 1
229 by asri 1

28/6/2017 230 By.Ny. Anti 1 1


231 by esty 1
232 BY nunung 1

29/06/2017 233 by. esty 1


234 by. nunung 1
235 by. lelly 1
236 BY. SITI M 1
237 BY. NUNUNG 1
238 by. rena 1
239 bby. wiwin 1

30/06/2017 240 by. esty 1


241 by. nunung 1
242 by. lelly 1
243 BY. SITI M 1
244 BY. NUNUNG 1
245 by. rena 1
246 bby. wiwin 1

15 162 1 83 0 0
Jumlah Pasien 238

RUANG PERINATOLOGI JULI 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/7/2017 1 BY.Ny. Siti Maesaroh 1
2 By.Ny. Esty 1
3 By.Ny. Neng Fauziah 1
4 By.Ny. Nunung 1
5 By.Ny. Setiawati 1

2/7/2017 6 BY.Ny. Siti Maesaroh 1


7 By.Ny. Esty 1
8 By.Ny. Neng Fauziah 1
9 By.Ny. Nunung 1
10 By.Ny. Setiawati 1

3/7/2017 11 BY.Ny. Siti Maesaroh 1


12 By.Ny. Esty 1
13 By.Ny. Neng Fauziah 1
14 By.Ny. Nunung 1
15 By.Ny. Setiawati 1

4/7/2017 16 by maryamah 1 1
17 By.Ny. Esty 1
18 by nurwinda 1

5/7/2017 19 by maryamah 1 1
20 By.Ny. Esty 1
21 by nurwinda 1
22 by romadhona 1

6/7/2017 23 By.Ny. Esty 1


24 by nurwinda 1
25 by romadhona 1
26 By.Ny. Sri Sulastri 1
27 By.Ny. Dewi 1
28 By.Ny. Naomi 1
29 By.Ny. Riskanti 1
30 By.Ny. Asum 1

7/7/2017 31 by nurwinda 1
32 by romadhona 1
33 By.Ny. Sri Sulastri 1
34 By.Ny. Dewi 1
35 By.Ny. Naomi 1
36 By.Ny. Riskanti 1
37 By.Ny. Asum 1

8/7/2017 38 By.Ny. Romadhona 1


39 By.Ny. Riskantiya 1
40 By.Ny. Naomi 1

9/7/2017 41 By.Ny. Romadhona 1


42 By.Ny. Riskantiya 1
43 By.Ny. Naomi 1
44 By.Ny. Rini 1

10/7/2017 45 By.Ny. Romadhona 1


46 By.Ny. Riskantiya 1
47 By.Ny. Naomi 1
48 By.Ny. Rini 1
49 By.NY. Eli 1
50 BY.NY. Ineu 1
51 by iis 1
52 by chyntia 1

11/7/2017 53 By.Ny. Romadhona 1


54 By.Ny. Riskantiya 1
55 By.Ny. Naomi 1
56 By.Ny. Rini 1
57 By.NY. Eli 1
58 BY.NY. Ineu 1
59 by susanti 1
60 by rosita 1
61 by iis 1
62 by fitria 2 1
63 chyntia 1

12/7/2017 64 By.Ny. Naomi 1


65 By.NY. Eli 1
66 by susanti 1
67 by rosita 1
68 by iis 1

13/7/2017 69 By.Ny. Naomi 1


70 by ny alfiah 1
71 by iis 1
72 by rosita 1

14/7/2017 73 By.Ny. Naomi 1


74 by ny alfiah 1
75 by iis 1

15/7/2017 76 By.Ny. Naomi 1


77 by ny alfiah 1
78 by iis 1
79 by wiwi 1
80 by zeim 1
81 by zein 1

16/7/2017 82 by wiwi 1
83 by zeim 1
84 by zein 1
85 by eli 1
86 by empon 1
87 by naomi 1

17/7/2017 88 by novi 1
89 by naomi 1
90 by wiwi 1
91 by zeim 1
92 by zein 1
93 by eli 1
94 by empon 1
95 by sri 1

18/7/2017 96 by novi 1
97 by naomi 1 1
98 by wiwi 1
99 by zeim 1
100 by zein 1
101 by eli 1
102 by empon 1
103 by sri 1
104 bY.nY. sANTI 1

19/7/2017 105 by naomi 1 1


106 by zeim 1
107 by zein 1
108 by sri 1
109 by titin 1
110 by putriani 1
111 by tina 1

20/7/2017 112 by naomi 1 1


113 by zeim 1
114 by zein 1
115 By.Ny. Hani 1
116 By.Ny. Wiwit 1
117 by putriani 1
118 by tina 1
119 by sona 1
120 By.Ny. Hani 1

21/07/2017 121 by naomi 1 1


122 by zeim 1
123 by zein 1
124 By.Ny. Hani 1
125 By.Ny. Wiwit 1
126 By.Ny. Intan 1
127 by tina 1
128 by sona 1
129 By.Ny. Hani 1
130 By.Ny. IIS 1

22/7/2017 131 by naomi 1 1


132 by zeim 1
133 by zein 1
134 By.Ny. Hani 1
135 By.Ny. Wiwit 1
136 By.Ny. Intan 1
137 By.Ny. Nenti 1
138 by sona 1
139 By.Ny. Hani 1
140 By.Ny. IIS 1

23/7/2017 141 ny nenti 1


142 by iis 1
143 by intan 1
144 by naomi 1 1
145 by sona 1
146 by zeim 1
147 by zein 1

24/7/2017 148 by dating 1


149 by ai elih 1
150 by naomi 1 1
151 by sona 1
152 by zeim 1
153 by zein 1
154 by annisa 1
155 by iis 1
156 by nenti 1
157 by amanda 1
158 by anggi 1
159 by noviyanti 1

25/7/2017 160 by noviyanti 1


161 by anggi 1
162 by iis 1
163 by novi 1
164 by annisa 1
165 by naomi 1 1
166 by zeim 1
167 by zein 1
168 by dating 1
169 by sona 1
170 by ai elih 1

26/7/2017 171 By.Ny. Novi Puspita 1


172 by noviyanti 1
173 by siska 1
174 by nia 1
175 by annisa 1
176 by zeim 1
177 by zein 1
178 by dating 1
179 by sona 1
180 by naomi 1 1
181 by iis 1
182 by nenti 1
183 by amanda 1
184 by anggi 1
185 By.Ny. Nurhayati 1
186 BY.Ny. Detty 1

27/7/2017 187 by annisa 1


188 by naomi 1 1
189 by zeim 1
190 by dating 1
191 by sona 1
192 by nurhayati 1
193 by detty 1
194 by siska 1
195 by nia 1
196 By.Ny. Zein 1
197 By.Ny. Novi P 1
198 By.Ny. Anggi 1
199 By.Ny. IIs Nani 1
200 By.Ny. Noviyanti 1

28/7/2017 201 by annisa 1


202 by naomi 1 1
203 by zeim 1
204 by dating 1
205 by sona 1
206 by nurhayati 1
207 by detty 1
208 by siska 1
209 by nia 1
210 By.Ny. Zein 1
211 By.Ny. Novi P 1
212 By.Ny. Siti Solihah 1
213 By.Ny. IIs Nani 1
214 By.Ny. Noviyanti 1

29/7/2017 215 by nurul eka 1


216 by vinny 1
217 by nuning 1
218 by dede yati 1
219 by annisa 1
220 by naomi 1 1
221 by zeim 1
222 by dating 1
223 by sona 1
224 by zein 1
225 by iis 1
226 by noviyanti 1
227 by nia 1
228 by novi p 1
229 by siti soliha 1
230 by setiawati I 1 1
231 by setiawati II 1 1

30/7/2017 232 by annisa 1


233 by sona 1
234 by siti soliha 1
235 by naomi 1 1
236 by dede yati 1
237 by dating 1
238 by setiawati I 1 1
239 by setiawati II 1 1
240 by nurul eka 1
241 by nuning 1
242 by lupi 1
243 by nia 1
244 by novi p 1
245 by zein 1
246 by zeim 1
247 by noviyanti 1
248 by vinny 1

31/7/2017 249 by siti soliha 1


250 by novi p 1
251 by nia 1
252 by lupi 1
253 by vinny 1
254 by setiawati II 1 1
255 by naomi 1 1
256 by annisa 1
257 by sona 1
258 by dede yati 1
259 by dating 1

21 183 0 76

jumlah pasien = 226

RUANG PERINATOLOGI AGUSTUS 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/8/2017 1 By.Ny. Anisa 1
2 By.Ny. Sona 1
3 By.Ny. Dating 1
4 By.Ny.Setawati 2 1
5 By.Ny. Dede Yati 1
6 By.Ny. Nia 1
7 By.Ny. Novi P 1
8 By.Ny. Siti Solihat 1

2/8/2017 9 by endang 1
10 by lilis 1
11 by komalawati 1
12 by dede 1
13 By.Ny.Setawati 2 1
14 By.Ny. Dating 1
15 By.Ny. Anisa 1
16 By.Ny. Sona 1
17 By.Ny. Novi P 1
18 By.Ny. Nia 1
19 By.Ny. Siti Solihat 1

3/8/2017 20 by lilis 1
21 by komalawati 1
22 By.Ny. Novi P 1
23 By.Ny. Siti Solihat 1
24 By.Ny. Nia 1
25 by dede 1 1
26 By.Ny.Setawati 2 1
27 By.Ny. Dating 1
28 By.Ny. Anisa 1
29 By.Ny. Sona 1
30 by susi 1
31 by endang 1

4/8/2017 32 by susi 1
33 By.Ny.Setawati 2 1
34 By.Ny. Dating 1
35 By.Ny. Anisa 1
36 By.Ny. Sona 1
37 By.Ny. Siti Solihat 1
38 By.Ny. Nia 1
39 by lilis 1
40 by komalawati 1
41 By.Ny. Novi P 1
42 by endang 1

5/8/2017 43 By.Ny.Setawati 2 1
44 By.Ny. Dating 1
45 By.Ny. Anisa 1
46 By.Ny. Sona 1
47 BY.NY. Siti solihat 1
48 By.Ny. Novi P 1
49 By.Ny. Lilis 1
50 By.NY. Nia 1

6/8/2017 51 By.Ny.Setawati 2 1
52 By.Ny. Dating 1
53 By.Ny. Anisa 1
54 By.Ny. Sona 1
55 BY.NY. Siti solihat 1
56 By.Ny. Novi P 1
57 By.Ny. Lilis 1
58 By.NY. Nia 1

7/8/2017 59 By.Ny.Setawati 2 1
60 By.Ny. Dating 1
61 By.Ny. Anisa 1
62 By.Ny. Sona 1
63 BY.NY. Siti solihat 1
64 By.Ny. Novi P 1
65 By.Ny. Vina 1 1
66 By.Ny. Ristina 1

8/8/2017 67 By.Ny. Satiawati 2 1


68 By.Ny. Dating 1
69 By.Ny. Anisa 1
70 By.Ny. Sona 1
71 By.Ny. Novi P 1
72 By.Ny.Vina 1 1
73 By.Ny. Ristina 1

9/8/2017 74 By.Ny. Satiawati 2 1


75 By.Ny. Dating 1
76 By.Ny. Anisa 1
77 By.Ny. Sona 1
78 By.Ny. Vina 1 1

10/8/2017 79 By.Ny. Vina 1 1


80 By.Ny. Satiawati 2 1 1
81 By.Ny. Dating 1
82 By.Ny. Anisa 1

11/8/2017 83 By.Ny. Satiawati 2 1 1


84 By.Ny. Dating 1
85 By.Ny. Anisa 1

12/08/2017 86 By.Ny. Satiawati 2 1 1


87 By.Ny. Dating 1
88 By.Ny. Anisa 1 1
89 By.Ny. Sumiati 1

13/08/2017 90 By.Ny. Satiawati 2 1 1


91 By.Ny. Dating 1
92 By.Ny. Anisa 1 1
93 By.Ny. Sumiati 1

14/08/2017 94 By.Ny. Satiawati 2 1 1


95 By.Ny. Dating 1
96 By.Ny. Anisa 1 1
97 By.Ny. Sumiati 1 1

15/08/2017 98 By.Ny. Satiawati 2 1 1


99 By.Ny. Sumiati 1 1
100 By. Ny. Yani 1 1

16/08/2017 101 By.Ny. Satiawati 2 1


102 By.Ny. Sumiati 1 1
103 By.Ny. Dedeh 1
104 By.Ny. Rani 1

17/9/2017 105 By.Ny. Satiawati 2 1


106 By.Ny. Sumiati 1 1
107 By.Ny. Siska 1
108 By.Ny. Dedeh 1
109 By. Ny. Septi 1
110 By.Ny. Wini 1

18/8/2017 111 By.Ny. Satiawati 2 1


112 By.Ny. Sumiati 1 1
113 By.Ny. Siska 1
114 By.Ny. Dedeh 1
115 By. Ny. Septi 1
116 By.Ny. Wini 1
117 By. Ny. Ani Mulyani 1
118 By.NY. Elsa 1

19/8/2017 119 By.Ny. Satiawati 2 1


120 By.Ny. Sumiati 1 1
121 By.Ny. Siska 1
122 By.Ny. Dedeh 1
123 By. Ny. Septi 1
124 By.Ny. Wini 1
125 By. Ny. Ani Mulyani 1
126 By.NY. Elsa 1
127 By.Ny. Maya 1
128 By.Ny. Gina 1
129 By.Ny. Dewi 1
130 By. NY. Solihah 1

20/8/2017 131 By.NY. Satiawati 1


132 By.Ny. Sumiati 1 1
133 By.Ny. Gina 1
134 By.Ny. Solihah 1
135 By.Ny. Ani mulyani 1
136 By.Ny. Dewi 1
137 By.Ny. Siska 1
138 By.Ny. Dedeh 1
139 By.Ny. Septi 1
140 By.Ny. Elsa 1

21/8/2017 141 By.NY. Satiawati 1


142 By.Ny. Sumiati 1 1
143 By.Ny. Gina 1
144 By.Ny. Solihah 1
145 By.Ny. Ani mulyani 1
146 By.Ny. Dewi 1
147 By.Ny. Siska 1
148 By.Ny. Dedeh 1
149 By.Ny. Shopiah 1

22/8/2017 150 By.NY. Satiawati 1


151 By.Ny. Sumiati 1 1
152 By.Ny. Gina 1
153 By.Ny. Solihah 1
154 By.Ny. Ani mulyani 1
155 By.Ny. Dewi 1
156 By.Ny. Siska 1
157 By.Ny. Dedeh 1
158 By.Ny. Shopiah 1
159 By.Ny. Novriani 2 1

23/8/2017 160 By.Ny. Sumiati 1 1


161 By.NY. Gina 1
162 By.NY. Solihah 1 1
163 By.Ny. Ani 1
164 By.Ny. Dewi 1
165 By.Ny. Dedeh 1
166 By.Ny. Siska 1
167 By.Ny. Sopiah 1
168 By.Ny. Maya 1
169 By.Ny. Novriani 2 1

24/8/2017 170 By.Ny. Sumiati 1 1


171 By.NY. Gina 1
172 By.NY. Solihah 1 1
173 By.Ny. Ani 1
174 By.Ny. Dewi 1
175 By.Ny. Dedeh 1
176 By.Ny. Siska 1
177 By.Ny. Sopiah 1
178 By.Ny. Maya 1
179 By.Ny. Novriani 2 1

25/08/2017 180 By.NY. Sopiah 1


181 By.Ny. Arti 1
182 By.Ny. Siska 1
183 By.Ny. Maya 1
184 By.Ny. novriani 2 1
185 By.Ny. Atik 1
186 By.Ny. Sumiati 1 1
187 By. Gina 1
188 By.Ny. Ani Mulyani 1
189 By.Ny. Dewi Mariam 1

26/8/2017 190 By.Ny. Sumiati 1 1


191 By.Ny. Gina 1
192 BY.Ny. Arti 1
193 By.Ny. Ani 1
194 By.Ny. Dewi Mariam 1
195 By.Ny. Sopiah 1
196 By.Ny. Atik 1
197 By.Ny. Maya 1
198 By.Ny. Siska 1
199 By.Ny. Novriyani 2 1

27/8/2017 200 By.Ny. Sumiati 1 1


201 By.Ny. Gina 1
202 BY.Ny. Arti 1
203 By.Ny. Ani 1
204 By.Ny. Dewi Mariam 1
205 By.Ny. Sopiah 1
206 By.Ny. Atik 1
207 By.Ny. Maya 1
208 By.Ny. Siska 1
209 By.Ny. Novriyani 2 1

28/8/2017 210 By.Ny. Sumiati 1 1


211 By.Ny. Gina 1
212 BY.Ny. Arti 1
213 By.Ny. Ani 1
214 By.Ny. Dewi Mariam 1
215 By.Ny. Sopiah 1
216 By.Ny. Atik 1
217 By.Ny. Maya 1
218 By.Ny. Siska 1
219 By.Ny. Eti 1

29/8/2017 220 By.Ny. Sani 1


221 By.Ny. Sumiati 1
222 By.Ny. Gina 1
223 BY.Ny. Arti 1
224 By.Ny. Ani 1
225 By.Ny. Dewi Mariam 1
226 By.Ny. Sopiah 1
227 By.Ny. Atik 1
228 By.Ny. Eti 1

30/8/2017 229 By.Ny. Sumiati 1


230 By.Ny. Gina 1
231 BY.Ny. Arti 1
232 By.Ny. Ani 1
233 By.Ny. Dewi Mariam 1
234 By.Ny. Sopiah 1
235 By.Ny. Atik 1
236 By.Ny. Eti 1

31/8/2017 237 By.Ny. Sumiati 1


238 By.Ny. Gina 1
239 BY.Ny. Arti 1
240 By.Ny. Ani 1
241 By.Ny. Dewi Mariam 1
242 By.Ny. Sopiah 1
243 By.Ny. Atik 1
244 By.Ny. Eti 1

28 152 0 92

Jumlah Bayi rawat peri: 206

RUANG PERINATOLOGI SEPTEMBER 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/9/2017 1 By.Ny. Sopiah 1
2 By.Ny. Dewi 1
3 By.Ny. Sumiati 1
4 By.Ny. Gina 1
5 By.Ny. Arti 1
6 By.Ny. ANi 1
7 By. Ny. Remi 1

2/9/2017 8 By.Ny. Sumiati 1


9 By.Ny. Gina 1
10 By.Ny. Arti 1
11 By.Ny. ANi 1
12 By. Ny. Remi 1
13 By.Ny. satiawati 1
14 By.Ny. Sopiah 1

3/9/2017 15 By.Ny. Arti 1


16 By.Ny. ANi 1
17 By. Ny. Remi 1
18 By.NY. Sumiati 1
19 By.Ny. Sopiah 1

4/9/2017 20 By.Ny. Arti 1


21 By.Ny. ANi 1
22 By. Ny. Remi 1
23 By.NY. Sumiati 1
24 By.Ny. Sopiah 1
25 By.Ny. Annisa 1
26 By.Ny. Tini 1

5/9/2017 27 By.Ny. Arti 1


28 By.Ny. ANi 1
29 By. Ny. Remi 1
30 By.NY. Sumiati 1
31 By.Ny. Sopiah 1
32 By.Ny. Annisa 1
33 By.Ny. Tini 1

6/9/2017 34 By.Ny. Arti 1


35 By. Ny. Remi 1
36 By.NY. Sumiati 1
37 By.Ny. Sopiah 1
38 By.Ny. Annisa 1
39 By.Ny. Tini 1
40 By.Ny. IIP 1

7/9/2017 41 By.Ny. Arti 1


42 By. Ny. Remi 1
43 By.NY. Sumiati 1
44 By.Ny. Sopiah 1
45 By.Ny. Annisa 1
46 By.Ny. Tini 1
47 By.Ny. IIP 1

8/9/2017 48 By.Ny. Arti 1


49 By. Ny. Remi 1
50 By.NY. Sumiati 1
51 By.Ny. Sopiah 1
52 By.Ny. Annisa 1
53 By.Ny. Tini 1
54 By.Ny. IIP 1

9/9/2017 55 By.Ny. Arti 1


56 By. Ny. Remi 1
57 By.NY. Sumiati 1
58 By.Ny. Sopiah 1
59 By.Ny. Annisa 1
60 By.Ny. Tini 1
61 By.Ny. IIP 1
62 BY. IIS 1
63 by. emilia 1
64 by. lusi 1

10/9/2017 65 By.Ny. Arti 1


66 By. Ny. Remi 1
67 By.NY. Sumiati 1
68 By.Ny. Sopiah 1
69 By.Ny. Annisa 1
70 By.Ny. Tini 1
71 By.Ny. IIP 1
72 BY. IIS 1
73 by. emilia 1
74 by. lusi 1

11/0/2017 75 By.Ny. Arti 1


76 By. Ny. Remi 1
77 By.NY. Sumiati 1
78 By.Ny. Sopiah 1
79 By.Ny. Annisa 1
80 By.Ny. Tini 1
81 by. iis 1
82 by. lusi 1

12/9/2017 83 By.Ny. Arti 1


84 By. Ny. Remi 1
85 By.NY. Sumiati 1
86 By.Ny. Sopiah 1
87 By.Ny. Annisa 1
88 By.Ny. Tini 1
89 by. iis 1
90 by. lusi 1
91 by. karina 1

13/9/2017 92 By.Ny. Arti 1


93 By.Ny. Sopiah 1
94 By.Ny. Tini 1
95 by. iis 1
96 by. lusi 1
97 by. karina 1

14/9/2017 98 By.Ny. Arti 1


99 by. karina 1 1
100 By.Ny. Tini 1
101 By.Ny. Sopiah 1
102 by. iis 1
103 by. lusi 1
104 by nining 1 1
105 By.Ny. Herlina 1 1
106 By.Ny. Ela 1

15/9/2017 107 By.Ny. Arti 1


108 by. karina 1 1
109 By.Ny. Tini 1
110 By.Ny. Sopiah 1
111 by. lusi 1
112 By.Ny. Herlina 1 1
113 By. Ny. Euis 1
114 By.Ny. Heni anggraeni 1
115 By.Ny. Ela 1

16/9/2017 116 By.Ny. Arti 1


117 by. karina 1 1
118 By.Ny. Tini 1
119 By.Ny. Sopiah 1
120 by. lusi 1
121 By.Ny. Herlina 1 1
122 By. Ny. Euis 1
123 By.Ny. Heni anggraeni 1

17/9/2017 124 by. lusi 1


125 By.Ny. Herlina 1 1
126 By. Ny. Euis 1
127 By.Ny. Heni anggraeni 1
128 By.Ny. Arti 1
129 by. karina 1 1
130 By.Ny. Tini 1
131 By.Ny. Irni 1

18/9/2017 132 By. Ny. Euis 1


133 By.Ny. Heni anggraeni 1
134 By.Ny. Arti 1
135 by. karina 1 1
136 By.Ny. Tini 1
137 By.Ny. Irni 1 1

19/9/2017 138 By.Ny. Heni Anggraeni 1


139 By.Ny. fenti 1 1
140 By.Ny. Irni 1 1
141 By.Ny. Tini 1
142 By.Ny. Arti 1
143 By.Ny. Rani 1

20/9/2017 144 By.Ny. Rani 1


145 By.Ny. karlina 1
146 By.Ny. Irni 1 1
147 By.Ny. Fenti 1 1
148 By.Ny. Tini 1
149 By.Ny. Arti 1

21/9/2017 150 By.Ny. Rani 1


151 By.Ny. Aisah 1
152 By.Ny. Dina 1
153 By.Ny. Nurya 1
154 By.Ny. Imas 1
155 By.Ny. Irni 1 1
156 By.Ny. Fenti 1 1
157 By.Ny. Tini 1
158 By.Ny. Arti 1
159 By.Ny. Karlina 1
160 By.Ny. Elim 1

22/9/2017 161 By.Ny. Aisah 1


162 By.Ny. Dina 1
163 By.Ny. Nurya 1
164 By.Ny. Imas 1
165 By.Ny. Irni 1 1
166 By.Ny. Fenti 1 1
167 By.Ny. Tini 1
168 By.Ny. Arti 1 1
169 By.Ny. Karlina 1
170 By.Ny. Elim 1

23/9/2017 171 By.Ny. Dina 1


172 By. Ny. Aisah 1
173 By.Ny. Elim 1
174 By.Ny. Karlina 1
175 By.Ny. Imas 1
176 By.Ny. Irni 1 1
177 By.Ny. Fenti 1 1
178 By.Ny. Tini 1
179 By.Ny. Arti 1 1

24/9/2017 180 By.Ny. Aisah 1


181 By.Ny. Karlina 1
182 By.Ny. Irni 1 1
183 By.Ny. Fenty 1 1
184 By.Ny. Tini 1
185 By.Ny. Arti 1 1
186 By.Ny. Dewi 1
187 By. Ny. Ani 1
25/9/2017 188 By.Ny. Aisah 1
189 By.Ny. Karlina 1
190 By.Ny. Irni 1 1
191 By.Ny. Fenty 1 1
192 By.Ny. Tini 1
193 By.Ny. Arti 1 1
194 By. Ny. Ani 1

26/9/2017 195 By. Ny. Leni 1


196 By. Ny. Karlina 1
197 By. Ny. Ani 1
198 By. Ny. Ineu 1
199 By. Ny. Irni 1 1
200 By. Ny. Ai Sari 1 1
201 BY. NY. Fenti 1
202 By. Ny. Wiwin 1
27/9/2017 203 By. Ny. Leni 1
204 By. Ny. Karlina 1
205 By. Ny. Ani 1
206 By. Ny. Rosweliyah 1
207 By. Ny. Irni 1 1
208 By. Ny. Ai Sari 1 1
209 By. Ny. Fenti 1 1
210 By.Ny. Wiwin 1

28/9/2017 211 By. Ny. Leni 1


212 By. Ny. Karlina 1
213 By. Ny. Ani 1
214 By. Ny. Rosweliyah 1
215 By. Ny. Irni 1 1
216 By. Ny. Ai Sari 1 1
217 By. Ny. Fenti 1 1
218 By.Ny. Wiwin 1
219 By.Ny. Ani 1
220 by.Ny. Emilia 1

29/9/2017 221 By. Ny. Ani 1


222 By. Ny. Rosweliyah 1
223 By. Ny. Irni 1 1
224 By. Ny. Ai Sari 1 1
225 By. Ny. Fenti 1 1
226 By.Ny. Wiwin 1
227 By.Ny. Rida 1
228 By.Ny. Emilia 1
229 By.Ny. Ratih 1

30/9/2017 230 By.Ny. Rida 1


231 By.Ny. Emilia 1
232 By.Ny. Ratih 1
233 By. Ny. Rosweliyah 1
234 By.Ny. Ani 1
235 By Manaf 1
236 By. Ny. Irni 1 1
237 By. Ny. Fenti 1
238 By.Ny. Wiwin 1
239 By.ny. selli 1
41 129 110

Jumlah bayi peri 230

RUANG PERINATOLOGI OKTOBER 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/10/2017 1 By.Ny. Rida 1
2 By.Ny. Emilia 1
3 By.Ny. Ratih 1
4 By Manaf 1
5 By. Ny. Irni 1 1
6 By. Ny. Fenti 1
7 By.Ny. Wiwin 1
8 By.ny. selli 1
9 By.Ny. Ela 1
10 By.Ny. Susi 1

2/10/2017 11 By Manaf 1
12 By. Ny. Irni 1 1
13 By. Ny. Fenti 1
14 By.Ny. Wiwin 1
15 By.ny. selli 1
16 By.Ny. Ela 1
17 By.Ny. Susi 1
18 By.Ny. Mira 1
19 By.Ny. Rida 1

3/10/2017 20 By Manaf 1
21 By. Ny. Irni 1 1
22 By. Ny. Fenti 1
23 By.Ny. Wiwin 1 1
24 By.ny. selli 1
25 By.Ny. Ela 1
26 By.Ny. Susi 1
27 By.Ny. Mira 1
28 By.Ny. Lilis 1
29 By.Ny. Rida 1

4/10/2017 30 By Manaf 1
31 By. Ny. Irni 1 1
32 By. Ny. Fenti 1
33 By.Ny. Wiwin 1 1
34 By.ny. selli 1
35 By.Ny. Ela 1
36 By.Ny. Susi 1
37 By.Ny. Mira 1
38 By.Ny. Lilis 1
39 By.Ny. Rida 1

5/10/2017 40 By Manaf 1
41 By. Ny. Irni 1 1
42 By. Ny. Fenti 1
43 By.Ny. Wiwin 1 1
44 By.ny. selli 1
45 By.Ny. Mira 1
46 By.Ny. Lilis 1
47 By.Ny. Rida 1
48 By.Ny. Ela 1
49 By.Ny. Asysyda 1

6/10/2017 50 By Manaf 1
51 By. Ny. Irni 1 1
52 By.Ny. Wiwin 1 1
53 By.ny. selli 1
54 By.Ny. Mira 1
55 By.Ny. Lilis 1
56 By.Ny. Rida 1
57 By.Ny. Ela 1
58 By.Ny. Asysyda 1

7/10/2017 59 By Manaf 1
60 By. Ny. Irni 1 1
61 By.Ny. Wiwin 1 1
62 By.ny. selli 1
63 By.Ny. Mira 1
64 By.Ny. Rida 1
65 By.Ny. Ela 1

8/10/2017 66 By Manaf 1
67 By. Ny. Irni 1
68 By.Ny. Wiwin 1 1
69 By.ny. selli 1
70 By.Ny. Mira 1
71 By.Ny. Rida 1
72 By.Ny. Ela 1

9/10/17 73 By. Ny. Irni 1


74 By.Ny. Wiwin 1 1
75 By.ny. selli 1
76 By.Ny. Rida 1
77 By.Ny. Ela 1
78 By.Ny. Ira 1
79 By.Ny. Atikah 1
80 By.Ny. Nova 1

10/10/2017 81 By. Ny. Irni 1


82 By.Ny. Wiwin 1 1
83 By.ny. selli 1
84 By.Ny. Ira 1 1
85 By.Ny. Atikah 1
86 By.Ny. Ela 1
87 By.Ny. Nova 1

11/10/2017 88 By. Ny. Irni 1


89 By.Ny. Wiwin 1 1
90 By.ny. selli 1
91 By.Ny. Atikah 1
92 By.Ny. Ela 1
93 By.Ny. Nova 1

12/10/2017 94 By. Ny. Irni 1


95 By.Ny. Wiwin 1 1
96 By.ny. selli 1
97 By.Ny. Ela 1
98 By.Ny. Nova 1

13/10/2017 99 By.Ny. Irni 1


100 By.Ny. Wiwin 1 1
101 By.ny. selli 1
102 By.Ny. Ela 1
103 By.Ny. Henny 1 1
104 By.Ny. Fany 1
105 By.Ny. Yayan 1

14/10/2017 106 By.Ny. Irni 1


107 By.Ny. Wiwin 1 1
108 By.ny. selli 1
109 By.Ny. Ela 1
110 By.Ny. Henny 1 1
111 By.Ny. Fany 1
112 By.Ny. Yayan 1
113 By.Ny. Dedeh 1 1
114 By.Ny. Aisyah 1

15/10/2017 115 By.Ny. Irni 1


116 By.Ny. Wiwin 1 1
117 By.ny. selli 1
118 By.Ny. Ela 1
119 By.Ny. Henny 1 1
120 By.Ny. Fany 1
121 By.Ny. Yayan 1
122 By.Ny. Dedeh 1 1
123 By.Ny. Aisyah 1
124 By.Ny. Yuliawati 1

16/10/2017 125 By.Ny. Irni 1


126 By.Ny. Wiwin 1 1
127 By.ny. selli 1
128 By.Ny. Ela 1
129 By.Ny. Henny 1 1
130 By.Ny. Fany 1
131 By.Ny. Yayan 1
132 By.Ny. Dedeh 1 1
133 By.Ny. Aisyah 1
134 By.Ny. Yuliawati 1
135 By.Ny. Dede Fita 1

17/10/2017 136 By.Ny. Irni 1


137 By.Ny. Wiwin 1 1
138 By.ny. selli 1
139 By.Ny. Ela 1
140 By.Ny. Henny 1 1
141 By.Ny. Fany 1
142 By.Ny. Yayan 1
143 By.Ny. Aisyah 1
144 By.Ny. Yuliawati 1
145 By.Ny. Dede Fita 1
146 By.Ny. Sandra 1
147 By.Ny. Lilis 1
148 By.Ny. Suminah 1

18/10/2017 149 By.Ny. Irni 1


150 By.Ny. Wiwin 1 1
151 By.ny. selli 1
152 By.Ny. Ela 1
153 By.Ny. Henny 1 1
154 By.Ny. Fany 1
155 By.Ny. Yayan 1
156 By.Ny. Aisyah 1
157 By.Ny. Yuliawati 1
158 By.Ny. Dede Fita 1
159 By.Ny. Sandra 1
160 By.Ny. Lilis 1
161 By.Ny. Suminah 1
162 By.Ny. Eni 1

19/10/2017 163 By.Ny. Irni 1


164 By.Ny. Wiwin 1 1
165 By.ny. selli 1
166 By.Ny. Ela 1
167 By.Ny. Henny 1 1
168 By.Ny. Fany 1
169 By.Ny. Yayan 1
170 By.Ny. Aisyah 1
171 By.Ny. Yuliawati 1
172 By.Ny. Sandra 1
173 By.Ny. Lilis 1
174 By.Ny. Suminah 1
175 By.Ny. Eni 1
176 By.Ny. Emi 1

20/10/2017 177 By.Ny. Irni 1


178 By.Ny. Wiwin 1 1
179 By.ny. selli 1
180 By.Ny. Henny 1 1
181 By.Ny. Fany 1
182 By.Ny. Lilis 1
183 By.Ny. Suminah 1
184 By.Ny. Eni 1
185 By.Ny. Aisyah 1
186 By.Ny. Yuliawati 1
187 By.Ny. Emi 1
188 By.Ny. Vina 1
189 By.Ny. Risty 1
190 By.NY. Devi 1
191 By. Ny. Yani 1
192 By.Ny. Masriva 1

21/10/2017 193 By.Ny. Irni 1 1


194 By.Ny. Wiwin 1 1
195 By.ny. selli 1
196 By.Ny. Henny 1 1
197 By.Ny. Fany 1
198 By.Ny. Lilis 1
199 By.Ny. Suminah 1
200 By.Ny. Eni 1
201 By.Ny. Aisyah 1
202 By.Ny. Yuliawati 1
203 By.Ny. Emi 1
204 By.Ny. Vina 1
205 By.Ny. Risty 1
206 By.NY. Devi 1
207 By. Ny. Yani 1
208 By.Ny. Masriva 1 1

22/10/2017 209 By.Ny. Irni 1 1


210 By.Ny. Wiwin 1 1
211 By.ny. selli 1
212 By.Ny. Henny 1 1
213 By.Ny. Fany 1
214 By.Ny. Lilis 1
215 By.Ny. Suminah 1
216 By.Ny. Eni 1
217 By.Ny. Aisyah 1
218 By.Ny. Yuliawati 1
219 By.Ny. Emi 1
220 By.Ny. Vina 1
221 By.Ny. Risty 1
222 By.NY. Devi 1
223 By. Ny. Yani 1
224 By.Ny. Masriva 1 1
225 By.Ny. Yanti Damayanti 1
226 By.Ny. Omah 1

23/10/2017 227 By.Ny. Irni 1 1


228 By.Ny. Wiwin 1 1
229 By.ny. selli 1
230 By.Ny. Fany 1
231 By.Ny. Suminah 1
232 By.Ny. Eni 1
233 By.Ny. Yuliawati 1
234 By.Ny. Vina 1 1
235 By.Ny. Risty 1
236 By.NY. Devi 1
237 By. Ny. Yani 1
238 By.Ny. Masriva 1 1
239 By.Ny. Yanti Damayanti 1
240 By.Ny. Omah 1
241 By.Ny. Tika 1
242 By.Ny. Emi 1

24/10/2017 243 By.Ny. Irni 1 1


244 By.Ny. Wiwin 1 1
245 By.Ny. Fany 1
246 By.Ny. Yuliawati 1
247 By.Ny. Vina 1 1
248 By.Ny. Risty 1
249 By.NY. Devi 1
250 By.Ny. Emi 1
251 By.Ny. Masriva 1 1
252 By.Ny. Yanti Damayanti 1
253 By.Ny. Omah 1
254 By.Ny. Tika 1
255 By.Ny. Enur 1

25/10/2017 256 By.Ny. Irni 1 1


257 By.Ny. Wiwin 1 1
258 By.Ny. Fany 1
259 By.Ny. Yuliawati 1
260 By.Ny. Vina 1 1
261 By.Ny. Risty 1
262 By.Ny. Masriva 1 1
263 By.Ny. Omah 1
264 By.Ny. Tika 1
265 By.Ny. Enur 1

26/10/2017 266 By.Ny. Irni 1 1


267 By.Ny. Wiwin 1 1
268 By.Ny. Fany 1
269 By.Ny. Yuliawati 1
270 By.Ny. Vina 1 1
271 By.Ny. Risty 1
272 By.Ny. Masriva 1 1
273 By.Ny. Tika 1
274 By.Ny. Enur 1
275 By.Ny. Nawati 1
276 By.Ny. Ridha 1

27/10/2017 277 By.Ny. Irni 1 1


278 By.Ny. Wiwin 1 1
279 By.Ny. Fany 1
280 By.Ny. Yuliawati 1
281 By.Ny. Vina 1 1
282 By.Ny. Risty 1
283 By.Ny. Masriva 1 1
284 By.Ny. Meli 1
285 By.Ny. Enur 1
286 By.Ny. Nawati 1
287 By.Ny. Ridha 1

28/10/2017 288 By.Ny. Irni 1 1


289 By.Ny. Wiwin 1 1
290 By.Ny. Fany 1
291 By.Ny. Yuliawati 1
292 By.Ny. Vina 1 1
293 By.Ny. Risty 1
294 By.Ny. Masriva 1 1
295 By.Ny. Meli 1
296 By.Ny. Nawati 1
297 By.Ny. Ridha 1

29/10/2017 298 By.Ny. Wiwin 1 1


299 By.Ny. Fany 1
300 By.Ny. Yuliawati 1
301 By.Ny. Risty 1
302 By.Ny. Masriva 1 1
303 By.Ny. Meli 1
304 By.Ny. Nawati 1
305 By.keisya 1 1

30/10/2017 306 By.Ny. Fany 1


307 By.Ny. Yuliawati 1
308 By.Ny. Risty 1
309 By.Ny. Masriva 1 1
310 By.Ny. Nawati 1
311 By.keisya 1 1

31/10/2017 312 By.Ny. Fany 1


313 By.Ny. Yuliawati 1
314 By.Ny. Risty 1
315 By.Ny. Masriva 1 1
316 By.Ny. Nawati 1
317 By.keisya 1 1
318 By.Ny. Lilis 1

73 220 0 98 Jumlah Pasen 307

RUANG PERINATOLOGI NOVEMBER 2017


FORMULIR SURVEY HARIAN PEMAKAIAN ALAT
UVC CVL
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/11/2017 1 By.Ny. Fany 1
2 By.Ny. Yuliawati 1
3 By.Ny. Risty 1
4 By.Ny. Masriva 1
5 By.Ny. Via 1
6 By.Ny. Sari 1
7 By.Ny. Lilis W 1

2-11-2017 8 By.Ny. Fany 1


9 By.Ny. Yuliawati 1
10 By.Ny. Risty 1
11 By.Ny. Masriva 1
12 By.Ny. Sari 1
13 By.Ny. Via 1
14 By.Ny. Lilis 1
15 By.Ny. Susanti 1

3-11-2017 16 By.Ny. Fany 1


17 By.Ny. Yuliawati 1
18 By.Ny. Risty 1
19 By.Ny. Masriva 1
20 By.Ny. Sari 1
21 By.Ny. Via 1
22 By.Ny. Susanti 1

4-11-2017 23 By.Ny. Fany 1


24 By.Ny. Yuliawati 1
25 By.Ny. Risty 1
26 By.Ny. Masriva 1
27 By.Ny. Sari 1
28 By.Ny. Via 1
29 By.Ny. Susanti 1
30 By.Ny. Yani 1 1 1

5-11-2017 31 By.Ny. Yuliawati 1


32 By.Ny. Risty 1
33 By.Ny. Sari 1
34 By.Ny. Via 1 1
35 By.Ny. Yani 1 1 1

6/11/2017 36 By.Ny. Yuliawati 1


37 By.Ny. Sari 1
38 By.Ny. Via 1 1
39 By.Ny. Yani 1 1 1
40 By.Ny. Lilis 1 1
41 By.Ny. Rida 1
42 By.Ny. Maya 1

7/11/2017 43 By.Ny. Yuliawati 1


44 By.Ny. Nizma 1
45 By.Ny. Rida 1
46 By.Ny. Via 1 1
47 By.Ny. Maya 1
48 By.Ny. Lilis 1 1

8/11/2017 49 By.Ny. Yuliawati 1


50 By.Ny. Nizma 1
51 By.Ny. Rida 1
52 By.Ny. Via 1 1
53 By.Ny. Maya 1
54 By.Ny. Lilis 1 1
55 By.Ny. Fanny 1
56 By.Ny. Asri 1

9/11/2017 57 By.Ny. Yuliawati 1


58 By.Ny. Nizma 1
59 By.Ny. Rida 1
60 By.Ny. Via 1 1
61 By.Ny. Maya 1
62 By.Ny. Lilis 1 1
63 By.Ny. Mumun 1
64 By.Ny. Asri 1

10-11-2017 65 By.Ny. Yuliawati 1


66 By.Ny. Nizma 1
67 By.Ny. Anita 1
68 By.Ny. Via 1 1
69 By.Ny. Maya 1
70 By.Ny. Lilis 1 1
71 By.Ny. Mumun 1
72 By.Ny. Asri 1
73 By.Ny. Putri 1 1

11-11-2017 74 By.Ny. Riani 1


75 By.Ny. Anita 1
76 By.Ny. Via 1 1
77 By.Ny. Lilis 1 1
78 By.Ny. Mumun 1
79 By.Ny. Asri 1
80 By.Ny. Putri 1 1

12-11-2017 81 By.Ny. Mumun 1


82 by erika 1
83 By.Ny. Putri 1 1
84 By.Ny. Lilis 1 1
85 By.Ny. Via 1 1

13-11-2017 86 by erika 1
87 By.Ny. Putri 1 1
88 By.Ny. Lilis 1 1
89 By.Ny. Via 1 1
90 by riani 1 1
91 by fitri 1
92 by tika 1
93 by selvi 1

14-11-2017 94 by erika 1
95 By.Ny. Putri 1 1
96 By.Ny. Lilis 1 1
97 By.Ny. Via 1 1
98 by riani 1 1
99 by fitri 1
100 by tika 1
101 by selvi 1

15-11-2017 102 by erika 1


103 By.Ny. Putri 1 1
104 By.Ny. Lilis 1 1
105 By.Ny. Via 1 1
106 by riani 1 1
107 by fitri 1
108 By.Ny. Kartini 1
109 By.Ny. Susi 1

16-11-2017 110 By.Ny. Ratih 1


111 By.Ny. Putri 1 1
112 By.Ny. Lilis 1 1
113 By.Ny. Via 1 1
114 by riani 1 1
115 by fitri 1
116 By.Ny. Kartini 1
117 By.Ny.Ida 1
17-11-2017 118 By.Ny. Ratih 1
119 By.Ny. Putri 1 1
120 By.Ny. Lilis 1
121 By.Ny. Via 1
122 by riani 1 1
123 By.Ny. Kartini 1
124 By.Ny.Ida 1
125 By.Ny. Sukeri 1
126 By.Ny. Sinta 1
127 By.Ny. popon 1
18-11-2017 128 By.Ny. Ratih 1
129 By.Ny. Putri 1 1
130 By.Ny. Lilis 1
131 By.Ny. Via 1
132 by riani 1 1
133 By.Ny. Kartini 1
134 By.Ny.Ida 1
135 By.Ny. Sukeri 1
136 By.Ny. Sinta 1
137 By.Ny. popon 1
19-11-2017 138 By.Ny. Putri 1 1
139 By.Ny. Lilis 1
140 By.Ny. Via 1
141 by riani 1 1
142 By.Ny. Kartini 1
143 By.Ny. Sukeri 1
144 By.Ny. Sinta 1
145 By.Ny. popon 1
146 By.Ny. Reni 1 1
20-11-2017 147 By.Ny. Putri 1 1
148 By.Ny. Lilis 1
149 By.Ny. Via 1
150 by riani 1 1
151 By.Ny. Kartini 1
152 By.Ny. Sukeri 1
153 By.Ny. Sinta 1
154 By.Ny. popon 1
155 By.Ny. reni 1 1
156 By.Ny. Rohayati 1
21-11-2017 157 By. Ny. Putri 1 1
158 By. Ny. Via 1
159 By. Ny. Rohayati 1
160 By. Ny. Riani 1
161 bY.nY. Lilis
162 By.Ny. Reni 1
163 By.Ny. Hana 1
164 By.Ny. Popon 1
22-11-2017 165 By. Ny. Putri 1 1
166 By. Ny. Via 1
167 By. Ny. Rohayati 1
168 By. Ny. Riani 1
169 bY.nY. Lilis
170 By.Ny. Reni 1
171 By.Ny. Hana 1
172 By.Ny. Popon 1
173 By.Ny. Riski
23-11-2017 174 By. Ny. Putri 1
175 By. Ny. Via 1
176 By. Ny. Rohayati 1
177 By. Ny. Riani 1
178 By.Ny. Reni 1
179 By.Ny. Hana 1
180 By.Ny. Popon 1
181 By.Ny. Riski 1
182 By.Ny. Evi 1
24/11/2017 183 By. Ny. Putri 1
184 By. Ny. Via 1
185 By. Ny. Rohayati 1
186 By. Ny. Riani 1
187 By.Ny. Cucun 1
188 By.Ny. Hana 1
189 By.Ny. Popon 1
190 By.Ny. Riski 1
191 By.Ny. Evi 1
25/11/2017 192 By.Ny. Putri 1
193 By.Ny. Riani 1
194 By.Ny. Cucun 1
195 By.Ny. Riski 1
26/11/2017 196 By.Ny. Putri 1
197 By.Ny. Riani 1
198 By.Ny. Cucun 1
199 By.Ny. Evi 1
27/11/2017 200 By.Ny. Putri 1
201 By.Ny. Riani 1
202 By.Ny. Cucun 1
203 By.Ny. Evi 1
204 By.Ny. Neng Sulastri 1
205 By.Ny. Suci 1
206 By.Ny. Kiki 1
28/11/2017 207 By.Ny. Putri 1
208 By.Ny. Riani 1
209 By.Ny. Cucun 1
210 By.Ny. Evi 1
211 By.Ny. Kiki 1
212 By.Ny. Suci 1
213 By.Ny. Yani 1
214 By.Ny. Cucu 1
29/11/2017 215 By.Ny. Putri 1
216 By.Ny. Riani 1
217 By.Ny. Cucun 1
218 By.Ny. Cucu 1
219 By.Ny. suci 1
220 By.Ny. Yani 1
221 By.ny. Kiki 1
222 By.ny. Novia 1
30/11/2017 223 By.Ny. Yani 1
224 By.Ny. Putri 1
225 By.Ny. Riani 1
226 By.Ny. Cucun 1
227 BY. ASARYA 1
228 BY, CUCU 1
229 By.Ny. Novia 1
230 By.Ny. Teni 1
49 154 73
Jumlah Bayi rawat 245
Formulir Survey Harian Pemakaian Alat
Ruang R Perinatologi Januari 2018- RSKIA
Tanggal No. Nama ETT IVL UMC PICC decubi PLEBITIS VAP IADP Hasil kultur
01/01/2018 1 By.Ny. Cucun 1
2 By.Ny. Tini 1
3 By.Ny. Siti Aisah 1 1
4 By.Ny. Dewi 1
5 By.Ny. Sri M 1
6 By.Ny. Dinar 1
7 By.Ny. Nursani 1
8 By.Ny. Rimbun 1
9 By.Ny. Novi 1
2-1-2018 10 By.Ny. Cucun 1
11 By.Ny. Tini 1
12 By.Ny. Siti Aisah 1 1
13 By.Ny. Dewi 1
14 By.Ny. Sri M 1
15 By.Ny. Dinar 1
16 By.Ny. Nursani 1
17 By.Ny. Rimbun 1
18 By.Ny. Novi 1
19 By.NY. Yani 1
3-1-2018 20 By.Ny. Cucun 1
21 By.Ny. Tini 1
22 By.Ny. Siti Aisah 1
23 By.Ny. Dewi 1
24 By.Ny. Sri M 1
25 By.Ny. Dinar 1
26 By.Ny. Nursani 1
27 By.Ny. Rimbun 1
28 By.Ny. Novi 1
29 By.NY. Yani 1
30 Ai H 1
31 By.Ny. Elis 1 1
4-1-2018 32 By.Ny. Cucun 1
33 By.Ny. Tini 1
34 By.Ny. Siti Aisah 1
35 By.Ny. Dewi 1
36 By.Ny. Sri M 1
37 By.Ny. Dinar 1
38 By.Ny. Nursani 1
39 By.Ny. Novi 1
40 By.NY. Yani 1
41 Ai H 1
42 By.Ny. Elis 1 1
43 BY.Ny. Dena 1
05/01/2018 44 By.Ny. Cucun 1
45 By.Ny. Tini 1
46 By.Ny. Siti Aisah 1
47 By.Ny. Dewi 1
48 By.Ny. Sri M 1
49 By.Ny. Dinar 1
50 By.Ny. Nursani 1
51 Ai H 1
52 By.Ny. Elis 1 1
53 By.Ny. Yuli 1
54 By.Ilham 1
55 By.Ny. Emma 1
56 By.Ny. dena 1
6/1/2018 57 By.Ny. Siti Aisah 1
58 By.Ny. Dewi 1
59 By.Ny. Sri M 1
60 By.Ny. Dinar 1
61 By.Ny. Elis 1 1
62 By.Ilham 1 1
63 By.Ny. Ai H 1
64 By.Ny. Yuli 1
65 By.Ny. Emma 1
66 By.Ny. dena 1
7/1/2018 67 By.Ny. Siti Aisah 1
68 By.Ny. Dewi 1
69 By.Ny. Sri M 1
70 By.Ny. Dinar 1
71 By.Ny. Elis 1 1
72 By.Ilham 1 1
73 By.Ny. Ai H 1
74 By.Ny. Yuli 1
75 By.Ny. Emma 1
76 By.Ny. dena 1
77 By.Ny. Ika 1
78 By.Ny. siti 1
08/01/2018 79 By.Ny. Siti Aisah 1
80 By.Ny. Dewi 1
81 By.Ny. Sri M 1
82 By.Ny. Dinar 1
83 By.Ny. Elis 1
84 By.Ilham 1 1
85 By.Ny. Ai H 1
86 By.Ny. Emma 1
87 By.Ny. Ika
88 By.Ny. siti 1
89 By.Ny. Yani 1
90 By.Ny. Rina 1
9-1-2018 91 By.Ny. Siti Aisah 1
92 By.Ny. Dewi 1
93 By.Ny. Sri M 1
94 By.Ny. Dinar 1
95 By.Ny. Elis 1
96 By.Ilham 1 1
97 By.Ny. Ai H 1
98 By.Ny. Ika 1
99 By.Ny. siti 1
100 By.Ny. Yani 1
101 By.Ny. Rina 1
10/1/2018 102 By.Ny. Siti Aisah 1
103 By.Ny. Dewi 1
104 By.Ny. Sri M 1
105 By.Ny. Dinar 1
106 By.Ny. Elis 1
107 By.Ilham 1 1
108 By.Ny. Ika 1 1
109 By.Ny. Yani 1
110 By.Ny. Rina 1
111 By.Ny. Siti Ayu 1
11/1/2018 112 By.Ny. Siti Aisah 1
113 By.Ny. Dewi 1
114 By.Ny. Sri M 1
115 By.Ny. Dinar 1
116 By.Ny. Elis 1
117 By.Ilham 1 1
118 By.Ny. Yani 1
119 By.Ny. Rina 1
120 By.Ny. Siti Ayu 1
121 By.Ny. maya 1
12-1-2018 122 By.Ny. Siti Aisah 1
123 By.Ny. Dewi 1
124 By.Ny. Sri M 1
125 By.Ny. Dinar 1
126 By.Ny. Elis 1
127 By.Ilham 1 1
128 By.Ny. Yani 1
129 By.Ny. irma 1
130 By.Ny. Siti Ayu 1
131 By.Ny. maya 1
13/1/2018 130 By.Ny. Siti Aisah 1
133 By.Ny. Dewi 1
134 By.Ny. Sri M 1
135 By.Ny. Dinar 1
136 By.Ny. Elis 1
137 By.Ilham 1 1
138 By.Ny. Yani 1
139 By.Ny. irma 1
140 By.Ny. maya 1 1
14/1/2018 141 By.Ny. Siti Aisah 1
142 By.Ny. Dewi 1
143 By.Ny. Sri M 1
144 By.Ny. Dinar 1
145 By.Ny. Elis 1
146 By.Ilham 1 1
147 By.Ny. Yani 1
148 By.Ny. irma 1
149 By.Ny. maya 1 1
15/1/2018 150 By.Ny. Siti Aisah 1
151 By.Ny. Sri M 1
152 By.Ny. Dinar 1
153 By.Ilham 1 1
154 By.Ny. irma 1
155 By.Ny. maya 1
156 By.Ny. Septiana 1
157 By.Ny. Ida Widari 1
16/1/2018 158 By.Ny. Siti Aisah 1
159 By.Ny. Sri M 1
160 By.Ny. Dinar 1
161 By.Ilham 1 1
162 By.Ny. irma 1
163 By.Ny. maya 1
164 By.Ny. Septiana 1
165 By.Ny. Ida Widari 1
166 By.Ny. Yuliantika 1
17/1/2018 167 By.Ny. Siti Aisah 1
168 By.Ny. Sri M 1
169 By.Ny. Dinar 1
170 By.Ilham 1 1
171 By.Ny. irma 1
172 By.Ny. maya 1
173 By.Ny. Septiana 1
174 By.Ny. Ida Widari 1
175 By.Ny. Yuliantika 1
18/1/2018 176 By.Ny. Yuliantika 1
177 by ny kurniati 1
178 By.Ny. Ida Widari 1
179 By.Ny. irma 1
180 By.Ny. Septiana 1
181 by ny karlina 1
182 By.Ny. Sri M 1
183 By.Ilham 1 1
184 By.Ny. Dinar 1
185 By.Ny. maya 1
186 By.Ny. Siti Aisah 1
19/1/2018 187 By.Ny. Sri M 1
188 By.Ilham 1 1
189 By.Ny. Dinar 1
190 By.Ny. Siti Aisah 1
191 by ny karlina 1
192 by ny kurniati 1
193 By.Ny. irma 1
194 By.Ny. Septiana 1
195 By.Ny. Ida Widari 1
20/1/2018 196 By.Ny. Ida Widari 1
197 by ny karlina 1
198 by ny yulia 1
199 By.Ny. Sri M 1
200 By.Ilham 1
201 By.Ny. Dinar 1
202 by ny larasanti 1 1
203 By.Ny. Siti Aisah 1
21/1/2018 204 By.Ny. Sri M 1
205 By.Ilham 1
206 by ny larasanti 1 1
207 by ny ida 1 1
208 by ny yulia 1
209 by ny karlina 1
210 by ny sri mulyati 1
22/1/2018 211 by ny siti julaeha 1
212 by ny yulia 1
213 by ny tessa 1
214 By.Ilham 1
215 by ny ida 1 1
216 by ny larasanti 1 1
217 by yuniarti 1 1
218 by ny karlina 1
23/1/2018 219 by ny tessa 1
220 by ny siti julaeha 1
221 By.Ny. Sri M 1
222 by ny karlina 1
223 by ny ida 1
224 By.Ilham 1
225 by ny larasanti 1
24/1/2018 226 by ny ida 1
227 By.Ilham 1
228 by ny widayanti 1 1
229 by ny tessa 1
230 by ny siti julaeha 1
231 By.Ny. Sri M 1
232 by ny larasanti 1
25/1/2018 233 by ny tessa 1
234 by ny siti julaeha 1
235 by ny ida 1
236 By.Ilham 1
237 by ny widayanti 1 1
26/1/2018 238 by ny tessa 1
239 by ny ida 1
240 By.Ilham 1
241 by ny widayanti 1 1
27/1/2018 242 by ny ida 1
243 By.Ilham 1
244 by ny widayanti 1 1
28/1/2018 245 by ny ida 1
246 By.Ilham 1
247 by ny widayanti 1 1
248 By.Ny. Yani 1
249 By. Ny. Siti Fatmawati 1
29/1/2018 250 by ny ida 1
251 By.Ilham 1
252 By.Ny. Yani 1 1
253 By. Ny. Siti Fatmawati 1
254 By.Ny. Mira Lena 1
30/1/2018 255 by ny ida 1
256 By.Ilham 1
257 By.Ny. Yani 1 1 Enterobactercloacea
258 By. Ny. Siti Fatmawati 1
259 By.Ny. Mira Lena 1
260 By.Ny. Ita 1
261 By.Ny. Yuni Rachmawati 1
262 By.Ny. Dita 1
31/1/2018 263 by ny ida 1
264 By.Ilham 1
265 By.Ny. Yani 1 1
266 By. Ny. Siti Fatmawati 1
267 By.Ny. Mira Lena 1
268 By.Ny. Ita 1
269 By.Ny. Yuni Rachmawati 1
270 By.Ny. Dita 1
271 By.Ny. Yayah 1
272 By.Ny. Anna 1
49 173 0 86 1
Jumlah Pasen 307
Formulir Survey Harian Pemakaian Alat
Ruang R Perinatologi Pebruari 2018- RSKIA
Tanggal No. Nama ETT IVL UC PICC/UmC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/2/2018 1 BY NY HUSNA 1
2 BY ANA 1
3 BY SANTI 1 1
4 BY GINA 1
5 BY ILHAM 1
6 BY IDA 1
7 BY YANI 1 1
2/2/2018 8 BY NY HUSNA 1 2
9 BY GINA 1 1
10 BY SANTI 1 1
11 BY IDA 1
12 BY ILHAM 1
13 BY YANI 1 1
3/2/2018 14 BY SANTI 1 1
15 by mia amelia 1
16 by erika 2 1
17 by teti 1
18 BY GINA 1 1
19 BY ILHAM 1 1
20 BY YANI 1 1
4/2/2018 21 by teti 1
22 BY GINA 1 1
23 BY ILHAM 1 1
24 BY YANI 1 1
25 by mia amelia 1
26 BY SANTI 1 1
27 by erika 2 1
28 By.Ny. Dari 1 1
5-2-2017 29 BY GINA 1 1
30 BY ILHAM 1 1
31 BY YANI 1 1
32 by mia amelia 1
33 BY SANTI 1 1
34 by erika 2 1
35 By.Ny. Dari 1 1
36 by rafika 1
6/2/2018 37 BY SANTI 1 1
38 BY GINA 1 1 1
39 BY ILHAM 1 1
40 BY YANI 1 1 1
41 by rafika 1 1
42 BY.Ny. erika 2 1
43 By.Ny. Mia Amelia1 1
44 BY.Ny. Titin 1
7/2/2018 45 BY SANTI 1 1
46 BY GINA 1 1 1
47 BY ILHAM 1 1
48 BY YANI 1 1 1
49 by rafika 1 1
50 Shaquella 1
8/2/2018 51 BY SANTI 1 1
52 BY GINA 1 1 1
53 BY ILHAM 1
54 BY YANI 1 1 1
55 by rafika 1 1 1
56 Shaquella 1
57 By.Ny. Astia 1
9/2/2018 58 BY SANTI 1 1
59 BY GINA 1 1 1
60 BY ILHAM 1
61 BY YANI 1 1 1
62 By.Ny. Astia 1
10/2/2018 63 by ny noviyanti 1
64 by minanti 1
65 by astia 1
66 by ny santi 1 1
67 by ny gina 1
68 by ilham 1
69 by yani 1 1
11-2-2018 70 by ny noviyanti 1
71 by minanti 1
72 by ny santi 1 1
73 by ny gina /1
74 by ilham 1
75 by yani 1 1
76 By.Ny. Vita 1
77 Devira 1
78 naufal 1
79 By.Ny. ai suminar 1
12/2-2018 80 by ny noviyanti 1
81 by minanti 1
82 by ny santi 1 1
83 by ny gina /1
84 by ilham 1
85 by yani 1 1
86 By.Ny. Vita 1
87 Devira 1
88 naufal 1
89 By.Ny. ai suminar 1
90 By.nY. Reni 1 1
91 By.Ny. Eva Hnadayani 1
13/2/2018 92 By.Ny. ai suminar 1
93 By.Ny. Noviyanti 1
94 Nadin 1
95 By.Ny. Minanti 1
96 By.Ny. Vita 1
97 By. Ny. Nida 1 1
98 By.Ny. eva 1
99 By.Ny. Yani 1 1
14/2/2018 100 By.Ny. Vita 1
101 By.Ny. Nida 1
102 By.Ny. Eva 1 1
103 By.Ny. yani 1
104 By.Ny. ai suminar 1
105 Nadin 1
106 By.Ny. Minanti 1
107 By.Ny. Nurul 1
15/2/2018 108 By.Ny. Yani 1 1
109 By.Ny. Minanti 1
110 By.Ny. ai Suminar 1
111 By.Ny. Vita 1
112 By.Ny. Nida 1 1 1
113 By.Ny. Eva 1 1 1
114 By.Ny. Nurul 1
115 M. Raihan 1
16/2/2018 116 By.Ny. Yani 1 1
117 M. Raihan 1
118 By.Ny. Ai Suminar 1
119 By.Ny. Titin 1
120 By.Ny. Vita
121 By.Ny. Nida 1
122 By.Ny. Nurul 1
123 By.Ny. Lina marlina 1
17/2/2018 124 By.Ny. Nurul 1
125 By.Ny. Novi 1
126 By.Ny. Lina Marlina 1
127 By.Ny. Vita 1
128 By. Ny. Nida 1
129 By.Ny. Ai Suminar 1
130 By.Ny. Titin 1
131 M. Raihan 1
18/2/2018 132 By.Ny. Ai Suminar 1
133 M. Raihan 1
134 By.Ny. Vita 1
135 By.Ny. Nida 1
136 By.Ny. Novi 1
137 By.Ny. Pipit 1
19/2/2018 138 By.Ny. Ai Suminar 1
139 By.Ny. Ani Sopia 1
140 By.Ny. Vita 1
141 By.Ny. Nida 1
142 By.Ny. Novi 1
143 By.Ny. Pipit 1
144 By.Ny. Putti Izza 1
20/2/2018 145 By.Ny. Vita 1
146 By.Ny. Nida 1 1
147 By.Ny. Angel 1 1 1
148 By.Ny. Angel 2 1 1 1
149 By.Ny. Putti izza 1
150 By. Ny. Ani Sopia 1
151 By. Ny. Tini 1
21/2/2018 152 By.Ny. Vita 1
153 By.Ny. Nida 1 1
154 By.Ny. Angel 1 1 1
155 By.Ny. Angel 2 1 1 1
156 By.Ny. Putti izza 1 1
157 By. Ny. Ani Sopia 1
158 By.Ny. Tati 1 1 1
159 By.Ny. Mila 1
22/2/2018 160 By.Ny. Mila 1
161 By.Ny. Nida 1
162 By.Ny. ani sofia 1
163 By.Ny. Vita 1
164 By. Ny. Tati 1 1
165 By.Ny. putty 1 1
166 By.Ny. Angel 2 1 1 1
167 By.Ny. Angel 1 1 1 1
168 By.Ny. Yuanita 1
169 By.Ny. santi 1
23-2-2018 170 By.Ny. Mila 1
171 By.Ny. Yuanita 1
172 By.Ny. Nida 1
173 By.Ny. Nunik M 1
174 By.Ny. Vita 1
175 By. Ny. Tati 1
176 By.Ny. putty 1 1
177 By.Ny. Angel 2 1 1 1
178 By.Ny. Angel 1 1 1 1
179 By.Ny. Santi 1
24-2-2018 180 By.Ny. Nida 1
181 By.Ny. Mila 1
182 By. Ny. Yuanita 1
183 By.Ny. Nunik 1
184 By.Ny. Enur 1
185 By.Ny. Vita 1
186 By. Ny. Tati 1 1
187 By.Ny. putty 1 1
188 By.Ny. Angel 2 1 1 1
189 By.Ny. Angel 1 1 1 1
25-2-2018 190 By.Ny. Nida 1
191 By.Ny. Mila 1
192 By. Ny. Yuanita 1
193 By.Ny. Nunik 1
194 By.Ny. Enur 1
195 By.Ny. Vita 1
196 By. Ny. Tati 1 1
197 By.Ny. putty 1
198 By.Ny. Angel 2 1 1 1
199 By.Ny. Angel 1 1 1 1
200 By.NY. Iseu 1
26-2-2018 201 By.Ny. putty 1 1
202 By.Ny. Angel 2 1 1
203 By.Ny. Angel 1 1 1
204 By.Ny. Vita 1
205 By.Ny. Nunik 1
206 By. Ny. Yuanita 1
207 By.Ny. Enur 1
208 By.NY. Iseu 1 1
209 By.Ny. Raswati 1
210 By.Ny. Leni 1
27-2-2018 211 By.Ny. putty 1 1
212 By.Ny. Angel 2 1 1
213 By.Ny. Angel 1 1 1
214 By.Ny. Vita 1
215 By.Ny. Nunik 1
216 By. Ny. Yuanita 1
217 By.Ny. Enur 1
218 By.Ny. Leni 1
219 By.Ny. Anisa 1
220 By.Ny. Raswati 1
28-2-2018 221 By.Ny. putty 1 1
222 By.Ny. Raswati 1
223 By.Ny. Angel 2 1 1
224 By.Ny. Angel 1 1 1 1
225 By.Ny. Vita 1 1
226 By.Ny. Nunik 1
227 By.Ny. Yuanita 1
228 By.Ny. Leni 1
229 By.Ny. Anisa 1
52 141 86/2 1
Jumlah pasen peri 308
Formulir Survey Harian Pemakaian Alat
Ruang R Perinatologi Maret 2018- RSKIA
Tanggal No. Nama ETT IVL UC PICC/UmC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/3/2018 1 By.Ny. Nunik 1
2 By.Ny. Vita 1
3 By.Ny. Angel 1 1 1
4 By.Ny. Angel 2 1
5 By.Ny. Raswati 1
6 By.Ny. Anisa 1
7 By.Ny. Eti Mulyati 1
8 By.Ny. Putty 1
2/3/2018 9 By.Ny. Nunik 1
10 By.Ny. Vita 1
11 By.Ny. Angel 1 1 1
12 By.Ny. Angel 2 1
13 By.Ny. Raswati 1
14 By.Ny. Saidah 1 /1
15 By.Ny. Eti Mulyati 1
3/3/2018 16 By.Ny. Saidah 1 /1
17 By.Ny. Nunik 1
18 By.Ny. Vita 1
19 By.Ny. Angel 1 1 1
20 By.Ny. raswati 1
21 BY.Ny. Rahayu 1
22 By.Ny. Riska 1
4/3/2018 23 By.Ny. Riska 1
24 By.Ny. rahayu 1
25 By.Ny. Saidah 1 /1
26 By.Ny. Nunik 1
27 By.Ny. Vita 1
5/3/2018 28 By.Ny. Saidah 1 /1
29 By.Ny. Nunik 1
30 By.Ny. Vita 1
31 By.Ny. Riska 1
32 Galang 1
33 By.Ny. Wiwi 1
34 By.Ny. rahayu 1
6/3/2018 35 By.Ny. Saidah 1 /1
36 By.Ny. Nunik 1
37 By.Ny. Vita 1
38 By.Ny. Rofi 1
39 By.Ny. Risma 1
40 By.Ny. Wiwi 1
41 By.Ny. Iceu 1
42 By.Ny. Galang 1
43 By.Ny. Riska 1 1
7/3/2018 44 By.Ny. Saidah 1 /1
45 By.Ny. Nunik 1
46 By.Ny. Vita 1
47 By.Ny. Rofi 1
48 By.Ny. Risma 1
49 By.Ny. Iis R 1
50 By.Ny. Iceu 1
51 By.Ny. Galang 1
52 By.Ny. Riska 1
8/3/2018 53 By.Ny. Saidah 1 /1
54 By.Ny. Vita 1
55 By.Ny. Rofi 1
56 By.Ny. IIs R 1
57 By.Ny. Iceu 1
58 By.Ny. Nunik 1
59 Galang 1
60 By. Ny. Risma 1
9/3/2018 61 By.Ny. Saidah 1 /1
62 By.Ny. Vita 1
63 By.Ny. Rofi 1
64 By.Ny. IIs R 1
65 By.Ny. Iceu 1
10/3/2018 66 By.Ny. Saidah 1 /1
67 By.Ny. Vita 1
68 By.Ny. Rofi 1
69 By.Ny. IIs R 1
70 By.Ny. Iceu 1
11/3/2018 71 By.Ny. IIs R 1
72 By.Ny. Iceu 1
73 By.Ny. Vita 1
74 By.Ny. Saidah 1
75 By.Ny. Rofi 1
12/3/2018 76 By.Ny. IIs R 1
77 By.Ny. Iceu 1
78 By.Ny. Vita 1
79 By.Ny. Saidah 1
80 By.Ny. Rofi 1
81 By.Ny. IIS 1 1
82 By.Ny. IIS 2 1
13/3/2018 83 By.Ny. Dedah 1
84 By.Ny. Noviyanti 1
85 By.Ny. Iceu 1
86 By. Ny. IIS 1 1
87 By.Ny. Rofi 1
88 By.Ny. Saidah 1
89 By.Ny. Santi 1 1 /1
90 By.Ny. IIS 2 1
91 By.Ny. Sri Wahyuni 1
14/3/2018 92 By.Ny. Dedah 1
93 By.Ny. Noviyanti 1
94 By.Ny. Iceu 1
95 By.Ny. IIS 1 1
96 By.Ny. Sri Wahyuni 1
97 By.Ny. Santi 1 1
98 By.Ny. Rofi 1
99 By.Ny. Saidah 1
100 By.Ny. IIS 2 1 1
101 Tiara Fauziah 1
102 By.Ny. Lia Yulia 1
15/3/2018 103 By.Ny. Dedah 1
104 By.Ny. Noviyanti 1
105 By.Ny. Iceu 1
106 By.Ny. IIS 1 1
107 By.Ny. Sri Wahyuni 1
108 By.Ny. Santi 1 1 1
109 By.Ny. Rofi 1
110 By.Ny. Saidah 1
111 By.Ny. IIS 2 1 1
112 Tiara Fauziah 1
113 By.Ny. Lia Yulia 1
114 By.Ny. Euis 1
115 By.Ny. Pipit 1
116 By.Ny. Vinna 1
16/3/2018 117 By.Ny. Iceu 1
118 By.Ny. IIS 1 1
119 By.Ny. Santi 1 1 1
120 By.Ny. Rofi 1
121 By.Ny. Saidah 1
122 By.Ny. IIS 2 1 1
123 Tiara Fauziah 1
124 By.Ny. Euis 1
125 By.Ny. Pipit 1
126 By.Ny. Vinna 1
17/3/2018 127 by mimin 1
128 By.Ny. IIS 2 1 1
129 By.Ny. Rofi 1
130 By.Ny. Santi 1 1 1
131 By.Ny. Saidah 1
18/3/2018 132 By.Ny. Warsinah 1
133 By.Ny. IIS 2 1 1
134 By.Ny. Rofi 1
135 By.Ny. Santi 1 1 1
136 By.Ny. Saidah 1
137 by mimin 1
19/3/2018 138 by ny warsinah 1
139 by mimin 1
140 By.Ny. IIS 2 1 1
141 By.Ny. Rofi 1
142 By.Ny. Santi 1 1 1
143 by tiara 1
144 by ny lena 1
20/3/2018 145 by ny lena 1
146 by ny yulia 1
147 by ny nurul 1
148 by mimin 1
149 By.Ny. IIS 2 1 1
150 By.Ny. Rofi 1
151 By.Ny. Santi 1 1 1
152 by saidah 1
21/3/2018 153 by ny lena 1
154 by ny yulia 1
155 by ny nurul 1
156 by mimin 1
157 By.Ny. IIS 2 1 1
158 By.Ny. Rofi 1
159 By.Ny. Santi 1 1
22/3/2018 160 by ny nurul 1
161 by lena 1
162 by idah 1
163 by mimin 1
164 by rofi 1
165 By.Ny. IIS 2 1 1
166 by muna 1
167 By.Ny. Santi 1 1
168 by tiara 1
169 by saidah 1
23/3/2018 170 By.Ny. IIS 2 1 1
171 by muna 1 1
172 By.Ny. Santi 1 1
173 by saidah 1
174 by lia 1 1
175 by sabila 1 1
176 by mimin 1
177 by rofi 1
178 by idah 1
179 by ervi 1
180 By.Ny. Tinah 1
24/3/2018 181 By.Ny. Santi 1 1
182 by rofi 1
183 by tinah 1
184 By.Ny. IIS 2 1 1
185 by muna 1 1
186 by saidah 1
187 by lia 1 1
188 by sabila 1 1
189 by ervi 1
190 by yulianti 1
191 By. Ny. Tiara 1
25/3/2018 192 By.Ny. Yulianti 1
193 By.ny. Ervi 1
194 By.Ny. Vatma 1
195 By.Ny. santi 1
196 By.Ny. Rofi 1
197 By. Ny. Tinah 1
198 By. Ny. Entin 1
199 By.Ny. Iis 2 1
200 By.Ny. Sabila 1 1
201 By. Ny. Muna 1 1
202 By.Ny. Lia marlia 1 1
203 By. Ny. Saidah 1
204 By. Tiara 1
26/3/2018 205 By.Ny. santi 1
206 By.Ny. Rofi 1
20 By. Ny. Entin 1
208 By.Ny. Iis 2 1
209 By.Ny. Sabila 1 1
210 By. Ny. Muna 1 1
211 By. Ny. Saidah 1
212 By. Tiara 1
213 By.Ny. Siti N 1
214 By.Ny. Yulianti 1
215 By. ny. Fatma 1
27-3-2018 216 By.Ny. santi 1
217 By.Ny. Mia 1
218 By.Ny. Iis 2 1
219 By.Ny. Sabila 1 1
220 By. Ny. Muna 1
221 By. Ny. Saidah 1
222 By. Tiara 1
223 By.Ny. Siti N 1
224 By.Ny. Novita 1
225 By. ny. Fatma 1
28/3/2018 226 By.Ny. santi 1
227 By.Ny. Mia 1
228 By.Ny. Iis 2 1
229 By.Ny. Sabila 1
230 By. Ny. Muna 1
231 By. Ny. Saidah 1
232 By. Tiara 1
233 By.Ny. Novita 1
29/3/2018 234 By.Ny. santi 1
235 By.Ny. Mia 1
236 By.Ny. Iis 2 1
237 By.Ny. Sabila 1
238 By. Ny. Muna 1
239 By. Ny. Saidah 1
240 By. Tiara 1
241 By.Ny. Novita 1
30/3/2018 242 By.Ny. santi 1
243 By.Ny. Mia 1
244 By.Ny. Iis 2 1
245 By.Ny. Sabila 1
246 By. Ny. Muna 1
247 By. Ny. Saidah 1
248 By. Tiara 1
249 By.Ny. Novita 1
250 By. Ny. OOM 1
251 By.Ny. Yuwangsih 1
31/3/2018 252 By.Ny. santi 1
253 By.Ny. Iis 2 1
254 By.Ny. Sabila 1
255 By. Ny. Muna 1
256 By. Tiara 1
257 By.Ny. Novita 1
258 By. Ny. OOM 1
259 By.Ny. Yuwangsih 1

87 352 78/7 0 3 0 0
Jumlah pasien : 339
Formulir Survey Harian Pemakaian Alat
Ruang R Perinatologi APril 2018- RSKIA
Tanggal No. Nama ETT IVL UC PICC/UmC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/4/2018 1 By.Ny. santi 1
2 By.Ny. Iis 2 1
3 By.Ny. Sabila 1
4 By. Ny. Muna 1
5 By. Tiara 1
6 By.Ny. Novita 1
7 By. Ny. OOM 1
8 By.Ny. Yuwangsih 1
9 By.Ny. Neti 1
2/4/2018 10 By.Ny. santi 1
11 By.Ny. Iis 2 1
12 By.Ny. Sabila 1
13 By. Ny. Muna 1
14 By. Tiara 1
15 By.Ny. Novita 1
16 By.Ny. Yuwangsih 1
17 By.Ny. Neti 1
3/4/2018 18 By.Ny. santi 1
19 By.Ny. Iis 2 1
20 By.Ny. Sabila 1
21 By. Tiara 1
22 By.Ny. Novita 1
23 By.Ny. Yuwangsih 1
24 By.Ny. Mamah 1
25 By.Ny. Neti 1
4/4/2018 26 By.Ny. santi 1
27 By.Ny. Iis 2 1
28 By.Ny. Sabila 1
29 By. Tiara 1
30 By.Ny. Novita 1
31 By.Ny. Yuwangsih 1
32 By.Ny. Mamah 1 1
33 By.Ny. Neti 1
34 By.Ny. Chica 1
5/4/2018 35 By.Ny. Mamah 1
36 By.Ny. Sabila 1
37 By.Ny. Tiara 1
38 By.Ny. Yuwangsih 1
39 By.Ny. Novita 1
40 By.Ny. Chica 1
6/4/2018 41 By.Ny. Mamah 1
42 By.Ny. Sabila 1
43 By.Ny. Tiara 1
44 By.Ny. Yuwangsih 1
45 By.Ny. Novita 1
46 By.Ny. Chica 1
47 By.Ny. IIS 1
48 By.Ny. Tintin 1
7/4/2018 49 By.Ny. Sabila 1
50 By.Ny. Mamah 1 1
51 By.Ny. Tiara 1
52 By.Ny. Yuwangsih 1
53 BY.Ny. Tintin 1
54 By.Ny. Novita 1
8/4/2018 55 By.Ny. Tintin 1
56 By.Ny. Novita 1
57 By.Ny. Sabila 1
58 By.Ny. Mamah 1
59 By.Ny. Tiara 1
60 By.Ny. Yuwangsih 1
61 By.Ny. Titin 1
9/4/2018 62 By.Ny. Tintin 1
63 By.Ny. Sabila 1
64 By.Ny. Mamah 1
65 By.Ny. Yuwangsih 1
66 By.Ny. Titin 1
10/4/2018 67 By.Ny. Tintin 1
68 By.Ny. Sabila 1
69 By.Ny. Mamah 1
70 By.Ny. Yuwangsih 1
71 By.Ny. Titin 1
72 by luthfi 1
11/4/2018 73 By.Ny. Tintin 1
74 By.Ny. Sabila 1
75 By.Ny. Mamah 1
76 By.Ny. Yuwangsih 1
77 by luthfi 1
78 by neni 1
79 by lina 1
80 By.Ny. Titin 1
81 by fitriani 1
12-4-2018 82 By.Ny. Sabila 1
83 by yesi 1
84 by fitriani 1
85 By.Ny. Mamah 1
86 By.Ny. Yuwangsih 1
87 By.Ny. Tintin 1
88 By.Ny. Titin 1
89 by yuniarti 1
90 by luthfi 1
91 by neni 1
92 by lina 1
13/4/2018 93 By.Ny. Sabila 1
94 by yesi 1
95 by fitriani 1
96 By.Ny. Mamah 1
97 By.Ny. Yuwangsih 1
98 by yuniarti 1
99 By.Ny. Tintin 1
100 by luthfi 1
101 by rini 1
102 by sendi 1
103 by neysa 1
104 by utih 1
14/4/2018 105 By.Ny. Tintin 1
106 by yuniarti 1
107 by yesi 1
108 by luthfi 1
109 by kurniawati 1
110 By.Ny. Sabila 1
111 by fitriani 1
112 By.Ny. Yuwangsih 1
113 by devi 1
114 by rini 1
115 by sendi 1
116 by neysa 1
117 by utih 1
118 by nur azizah 1
15/4/2018 119 By.Ny. Kurniawati 1
120 by luthfi 1
121 by yuniarti 1
122 By.Ny. Tintin 1
123 by devi 1
124 by fitriani 1
125 by mamah 1
126 by utih 1
127 by neysa 1
128 by rini 1
129 by nur azizah 1
130 by sendi 1
131 by linda 1
16/4/2018 132 By.Ny. Kurniawati 1
133 By.Ny. Yuniarti 1
134 By.Ny. Tintin 1
135 By.Ny. Yesi 1
136 By.Ny. Fitriani 1
137 By.Ny. Dewi Ratnasari 1
138 By.NY. Linda 1
17/4/2018 139 By.Ny. Kurniawati 1
140 By.Ny. Yuniarti 1
141 By.Ny. Tintin 1
142 By.Ny. Yesi 1
143 By.Ny. Fitriani 1
144 By.Ny. Dewi Ratnasari 1
145 By.NY. Linda 1
146 by ny ina 1
147 by hana 1
148 by tika 1
18/4/2018 149 By.Ny. Kurniawati 1
150 by ny ina 1
151 by hana 1
152 By.Ny. Tintin 1
153 by tika 1
154 By.NY. Linda 1
19/4/2018 155 by ny lia 1
156 by ny nuraida 1
157 by ina 1
158 by yani
159 by hana 1
160 by tika 1
161 by kurniawati 1

20-4-2018 162 By.Ny. Tika 1 1


163 By.Ny. Ina 1
164 Tiara 1
165 By.Ny. Hana 1
166 By.Ny. Yani 1
167 By.Ny. Nuraida 1
168 By.Ny. Lia 1
169 By.Ny. Wiwi 1
21-4-2018 170 By.Ny. Tika 1 1
71 By.Ny. Ina 1
172 Tiara 1
173 By.Ny. Hana 1
174 By.Ny. Yani 1
175 By.Ny. Anita 1
176 By.Ny. Dewi 1
177 By.Ny. Wiwi 1
22-4-2018 178 By.Ny. Tika 1 1
179 By.Ny. Ina 1
180 Tiara 1
181 By.Ny. Hana 1
182 By.Ny. Yani 1
183 By.Ny. Anita 1
184 By.Ny. Dewi 1
185 By.Ny. Wiwi 1
186 By.Ny. Fatimah 1
187 By.Ny. Siti aisyah 1
23-4-2018 188 By.Ny. Tika 1 1
189 Tiara 1
190 By.Ny. Hana 1
191 By.Ny. Yani 1
192 By.Ny. Anita 1
193 By.Ny. Dewi 1
194 By.Ny. Wiwi 1
195 By.Ny. Fatimah 1
196 By.Ny. Siti aisyah 1
24/4/2018 197 by sulastri 1
198 By.Ny. Siti aisyah 1
199 By.Ny. Hana 1
200 By.Ny. Tika 1 1
201 by komala /1
202 By.Ny. Fatimah 1
25/4/2018 203 By.Ny. Tika 1 1
204 by komala /1
205 by sulastri 1
206 By.Ny. Siti aisyah 1
207 By.Ny. Hana 1
208 By.Ny. Siti Rochimah 1
26/4/2018 209 By.Ny. Tika 1 1
210 by komala /1
211 by sulastri 1
212 By.Ny. Siti aisyah 1
213 By.Ny. Hana 1
214 By.Ny. Siti Rochimah 1
27/4/2018 215 By.Ny. Tika 1 1
216 by komala 1 /1
217 by ny listia 2 1
218 By.Ny. Siti Rochimah 1
219 by iis 1
220 by ria 1
221 by listia 1 1
222 by sabila 1
28/4/2018 223 by ria 1
224 By.Ny. Siti Rochimah 1
225 by iis 1
226 by listia 1 1
227 by sabila 1
228 By.Ny. Tika 1
229 by komala 1 1
230 by ny listia 2 1
231 By.Ny. Deliska 1
29/4/2018 232 By.Ny. Deliska 1
233 By.Ny. Siti Rochimah 1
234 By.Ny. Enung 1
235 By.Ny. Tika 1
236 By.Ny. Listia 2 1
237 By.Ny. Komala 1 1
238 By.Ny. Yuliyanti 1 1
239 By.Ny. Yuliayanti 2 1 1 1
240 By.Ny. Listia 1 1
241 By.Ny. Sabila 1
242 By.Ny. Lusiana 1
30-4-2018 243 By.Ny. Tamala 1
244 By.Ny. Komala 1 1
245 By.Ny. Listia 2 1
246 By.Ny. Yuliyanti 1 1 1 1
247 By.Ny. Yuliayanti 2 1 1 1
248 By.Ny. Tika 1
249 By.Ny. Listia 1 1
250 By.Ny. Rika 1
251 By.Ny. Enung 1
252 By. Assyfa 1
17 215 0 35/4
jumlah pasien 390
Formulir Survey Harian Pemakaian Alat
Ruang R Perinatologi MEI 2018- RSKIA
Tanggal No. Nama ETT IVL UC PICC/UmC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/5/2018 1 By.Ny. Sheila idola 1 1
2 By.Ny. Tamala 1
3 By.Ny. Komala 1
4 By.Ny. Listia 2 1
5 By.Ny. Yuliyanti 1 1 1 1
6 By.Ny. Yuliayanti 2 1 1 1
7 By.Ny. Tika 1
8 By.Ny. Listia 1 1
9 By.Ny. Rika 1
10 By.Ny. Sheila idola 2 1
11 Assyfa 1
2/5/2018 12 By.Ny. Agustina 2 1
13 By.Ny. Komala 1
14 By.Ny. Sheila 1 1
15 By.Ny. Sheila 2 1
16 By.Ny. Yuliyanti 2 1
17 By.Ny. Listia 1 1
18 By.Ny. Listia 2 1
19 by tamala 1
3/5/2018 20 by rika 1
21 by tamala 1
22 By.Ny. Listia 2 1
23 By.Ny. Listia 1 1
24 By.Ny. Agustina 2 1
25 By.Ny. Komala 1
26 By.Ny. Sheila 2 1
27 By.Ny. Yuliyanti 2 1
28 by agustina 1 1
4/5/2018 29 By.Ny. Agustina 2 1 1
30 By.Ny. Komala 1
31 By.Ny. Sheila 2 1
32 By.Ny. Yuliyanti 2 1
33 By.Ny. Listia 2 1
34 By.Ny. Listia 1 1
35 by rika 1
36 by tamala 1
5/5/2018 37 By.Ny. Listia 2 1
38 By.Ny. Listia 1 1
39 by nelis 1
40 by irma 1
41 by rina 1
42 By.Ny. Komala 1
43 By.Ny. Sheila 2 1
44 by yani 1 1
45 By.Ny. Yuliyanti 2 1
6/5/2018 46 By.Ny. Listia 2 1
47 By.Ny. Listia 1 1
48 by nelis 1
49 by rina 1
50 By.Ny. Komala 1
51 by yani 1 1
52 By.Ny. Sheila 2 1
53 By.Ny. Yuliyanti 2 1
7/5/2018 54 By.Ny. Listia 2 1
55 By.Ny. Listia 1 1
56 by nelis 1
57 by rina 1
58 By.Ny. Komala 1
59 by yani 1 1
60 By.Ny. Sheila 2 1
61 By.Ny. Yuliyanti 2 1
8/5/2015 62 By.Ny. Listia 2 1
63 By.Ny. Listia 1 1
64 by nelis 1
65 by rina 1
66 By.Ny. Komala 1
67 by yani 1 1
68 By.Ny. Sheila 2 1
69 By.Ny. Yuliyanti 2 1
70 BY.Ny. Yulianti 1

9/5/2018 71 By.Ny. Listia 2 1


72 by nelis 1
73 by rina 1
74 By.Ny. Komala 1
75 by yani 1 1
76 By.Ny. Sheila 2 1
77 By.Ny. Yuliyanti 2 1

10-5-2018 78 By.Ny. Listia 2 1


79 by nelis 1
80 by rina 1
81 By.Ny. Komala 1
82 by yani 1 1
83 By.Ny. Sheila 2 1
84 By.Ny. Yuliyanti 2 1
85 By.Ny. Ecin 1
11-5-2018 86 By.Ny. Listia 2 1
87 by nelis 1
88 By.Ny. Komala 1
89 by yani 1 1
90 By.Ny. Sheila 2 1
91 By.Ny. Yuliyanti 2 1
92 By.Ny. Ecin 1

12-5-2018 93 By.Ny. Listia 2 1


94 by nelis 1
95 By.Ny. Komala 1
96 by yani 1 1
97 By.Ny. Sheila 2 1
98 By.Ny. Yuliyanti 2 1
99 By.Ny. Ecin 1

13-5-2018 100 by nelis 1


101 By.Ny. Komala 1
102 by yani 1 1
103 By.Ny. Sheila 2 1
104 By.Ny. Yuliyanti 2 1
106 By.Ny. Ecin 1
14-5-2018 108 By.Ny. Listia 2 1
109 by nelis 1
110 By.Ny. Komala 1
111 by yani 1 1
112 By.Ny. Sheila 2 1
113 By.Ny. Yuliyanti 2 1
114 By.Ny. Ecin 1
15/5/2018 115 by nelis 1
116 By.Ny. Komala 1
117 by yani 1 1
118 By.Ny. Yuliyanti 2 1
119 By.Ny. Sheila 2 1
16-5-2018 120 By.Ny. Komala 1
121 by yani 1 1
122 By.Ny. Yuliyanti 2 1
123 By.Ny. Sheila 2 1
124 By.Ny. Lita 1
17-5-2018 125 by litawati 1
126 by listia 2 1
127 By.Ny. Komala 1
128 by yani 1 1
129 By.Ny. Yuliyanti 2 1
130 By.Ny. Sheila 2 1
18/5/2018 131 by yani 1 1
132 By.Ny. Yuliyanti 2 1
133 by listia 2 1
134 by litawati 1
19/5/2018 135 by listia 2 1
136 by nella 1
137 by yani 1 1
138 By.Ny. Yuliyanti 2 1
139 by siti 1
Ruang R ICU bln februari 2015- RSKIA

Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
03 Feb '15 1 ny.liawati v v
2 ny.elis sumarni v v

04 feb '15 1 ny.liawati v v


v
2 ny.febri v v

05 feb '15 1 ny.febri v v v

06 feb '15 1 ny.febri v v v

07 feb '15 1 ny.febri v v v

08 feb '15 1 ny.febri v v v

09 feb '15 1 ny.febri v v v

10 feb '15 1 ny.inne v v


2 ny.nurhayati v v

11 feb '15 1 ny.inne v v


2 ny.nurhayati v v

12 feb '15 1 ny.inne v v


2 ny.nurhayati v v

13 feb '15 1 ny.nurhayati v v v

14 feb '15 1 ny.uruh v v

15 feb '15 1 ny.uruh v v

25 feb '15 1 ny.nuratmi v v

26 feb '15 1 ny.nuratmi v v

28 feb '15 1 ny.cica v v

total 6 21 21 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT 2015

BULAN MARET RUANG ICU - RSKIA

11/03/2015 1 Ny. Jaziarti v v

12/03/2015 1 Ny. Jaziarti v v

13/03/2015 1 Ny. Jaziarti v v


2 Ny. Rina v v

16/03/2015 1. Ny.Atin v v v
17/03/2015 1 Ny. Atin v v v
2 Ny. Wati v v

18/03/2015 1 Ny.Atin v v
2 Ny. Wati v v/v v

19/03/2015 1 Ny.Wati v v/v v

20/03/2015 1 Ny.Wati v v/v v

21/03/2015 1 Ny.Wati v v/v v

22/03/2015 1 Ny.Wati v v/v v

23/03/2015 1 Ny.Wati v v/v v

24/03/2015 1 Ny.Wati v v/v v

25/03/2015 1 Ny.Wati v v/v v

v
26/03/2015 1 Ny.wati v v/v v

27/03/2015 1 Ny.Wati v v/v v

28/03/2015 1 Ny.Wati v v/v v

30/03/2015 1 Ny.Dewi v v
2. Ny.Siti v v

31/03/2015 1 Ny.Dewi v v
2 Ny.Siti v v

Total 13 23 / 11 23 1

FORMAT SURVEY HARIAN PEMAKAIAN ALAT APRIL 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
Ny.Caca Hardianti
05/04/2015 1 v v v
Ny.Caca Hardianti
06/04/2015 v v v
Ny.Caca Hardianti
07/04/2015 v v v
Ny.Caca Hardianti
08/04/2015 v v v v
Ny.Caca Hardianti
09/04/2015 v v v
Ny.Caca Hardianti
10/04/2015 v v
Ny. Ipah
11/04/2015 v v
Ny. Nurhayati
18/04/2015 v v
Ny. Nurhayati
19/04/2015 v v v
20/04/2015 Ny.Nurhayati v v v
Ny.Siti Jubaedah v v v
21/04/2015 Ny.Siti Jubaedah v v
22/04/2015 Ny.Siti Jubaedah v v
23/04/2015 Ny.Minah v v v
24/04/2015 Ny.Minah v v v v
25/04/2015 Ny.Minah v v
6 16 16 1 5

FORMAT SURVEY HARIAN PEMAKAIAN ALAT MEI 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
Ny. Siti Rostita
12/05/2015 1 v v
Ny. Siti Rostita v v
13/05/2015 2

15/05/2015 3 Ny.Wulan v v

15/05/2015 4 Ny. Tita v v

16/05/2015 5 Ny.Wulan v v

5 5

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JUNI 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
05/06/2015 1 NY.NOVI v v
06/06/2015 v v
11/06/2015 2 NY CUCU v v
12/06/2015 NY CUCU v v v

13/06/2015 NY CUCU v v
13/06/2015 3 NY.WIDA v v
14/06/2015 NY.WIDA v v
15/06/2015 NY.WIDA v v
16/06/2015 NY.WIDA v v v
17/06/2015 NY.WIDA v v
18/06/2015 NY.WIDA v v
19/06/2015 4 NY.LIA v v
19/06/2015 5 NY.ELSA v v
20/06/2015 NY.LIA v v v
20/06/2015 NY.ELSA v v v
NY.LIA
21/06/2015 v v
21/06/2015 NY.ELSA v v
NY.ELSA
22/06/2015 v v

18 18 4

FORMAT SURVEY HARIAN PEMAKAIAN ALAT JULI 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
05/07/2015 1 NY.TITIN V V
06/07/2015 2 NY.LILIS V V
05/07/2015 3 NY.TITIN V V

07/07/2015 4 NY.LILIS V V

07/07/2015 5 NY.IMAS V V
08/07/2015 6 NY.IMAS V V
08/07/2015 7 NY.Iis V V
09/07/2015 8 NY.Iis V V v
10/07/2015 9 NY.Iis V V
11/07/2015 10 ny.Rosita V V
12/07/2015 11 ny.Rosita V V
12/07/2015 12 ny.Rossi V V
13/07/2015 13 ny.Rossi V V
Ny.Novi sintia
26/07/2015 14 V V
30/07/2015 15 Ny.rina v v v
31/07/2015 16 Ny.jejeh v v

16 16 2
Jumlah 8

FORMAT SURVEY HARIAN PEMAKAIAN ALAT AGUSTUS 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
02/08/2015 1 Ny.warsiti V V
05/08/2015 2 Ny.Iin V V
06/08/2015 3 Ny.Iin v v

07/08/2015 4 Ny.Iin v v

08/08/2015 5 Ny.IIn
12/08/2015 6 Ny.Dini V V
Ny.Sunarti
20/08/2015 7 V V
Ny.Sunarti
21/08/2015 8 V V
24/08/2015 9 Ny.Anggraeni V v
25/08/2015 10 Ny.Anggraeni V V
27/08/2015 11 Ny.Iis Purwaningsih V V
Ny.Iis Purwaningsih
28/08/2015 12 V V
31/08/2015 13 Ny.Nisha v v
13 13

jumlah pasien 7

FORMAT SURVEY HARIAN PEMAKAIAN ALAT SEPTEMBER 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2015 1 Ny.saidah v v
2 ny.nisha v v
02/09/2015 3 an.riki v v

03/09/2015 4 an.riki v v

04/09/2015 5 ny.imas v v
05/09/2015 6 ny.imas v v
7 ny.mita v v
06/09/2015 8 ny.mita v v
07/09/2015 9 ny.mita v v
08/09/2015 10 ny.saidah v v
17/09/2015 11 an.risma v v
18/09/2015 12 an.risma v v
20/09/2015 13 ny.martaulina v v v
21/09/2015 14 ny.martaulina v v

1 14 14
jumlah pasien 8

FORMAT SURVEY HARIAN PEMAKAIAN ALAT OKTOBER 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2015 1 ny.nunik v v
02/10/2015 2 ny.nunik v v
03/10/2015 3 ny.nunik v v

12/10/2015 4 ny.ani rosmayani v v

13/10/2015 5 ny.ani rosmayani v v


6 ny.euis fatimah v v
14/10/2015 7 ny.euis fatimah v v
21/10/2015 8 ny.rika v v
22/10/2015 9 ny.rika v v
23/10/2015 10 ny.rika v v
24/10/2015 11 ny.rika v v

jumlah pasien 3 11 11

FORMAT SURVEY HARIAN PEMAKAIAN ALAT NOVEMBER 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
04/11/2015 1 NY.NENG RINI v v - -
05/11/2015 2 NY.NENG RINI v v - -
06/11/2015 3 ny.diah v v - -
07/11/2015 4 ny.diah v v - -

22/11/2015 5 NY.TITIN v v - -
23/11/2015 6 NY.TITIN v v - -
24/11/2015 7 NY.TITIN v v - -
24/11/2015 8 ny.iyus v v - -
25/11/2015 9 ny.iyus v v - -

9 9 JML PASIEN=4

FORMAT SURVEY HARIAN PEMAKAIAN ALAT DESEMBER 2015


Tanggal No. Nama ETT IVL/CVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
07/12/2015 1 NY.SUPRIHANI v v v - - -
09/12/2015 2 An.IZZATUL ANDINI v v - - -
10/12/2015 3 An.IZZATUL ANDINI v v - - -
17/12/2015 4 NY.YUYUN v v - - -

18/12/2015 5 NY.YUYUN v v - - -
19/12/2015 6 NY.YUYUN v v - - -
26/12/2015 7 ny.elis v v v - - -
27/12/2015 8 ny.elis v v - v -
28/12/2015 9 ny.elis v v - - -
29/12/2015 10 ny.elis v v - v -
30/12/2015 11 ny.elis v v - - -
31/12/2015 12 ny.ika
01/01/2016 13 ny.ika
2 11 11 2 JML PASIEN=5
Ruang R anak 2018- RSKIA

LAPORAN BULAN JANUARI 2018


Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2018 1 Ania v
2 Aqilla v
3 Alhanan v
4 Fajar v
5 M. Raid v
6 Zhalika v
7 M. Reza v
8 Kayisa v

2/1/2018 9 Ania v
10 Alhana v
11 FAjar v
12 Zhalika v
13 M. Reza v
14 KAyisa v

03/01/2018 15 Ania v
16 Briansyah v
17 Fajar v
18 Vanesa v
19 Fauzan v
20 M.Reza v
21 Kayyisa v

4/1/2018 22 Ania v
23 Briansyah v
24 Fajar v
25 Vanesa v
26 Fauzan v
27 M.Reza v
28 Kayyisa v

05/01/2018 29 Briansyah v
30 Fajar v
31 Fauzan v
32 M.Reza v
33 Rafa v
34 Aira v
35 Clovis v

06/01/2018 36 Briansyah v
37 Fajar v
38 Fauzan v
39 M.Reza v
40 Rafa v
41 Aira v
42 Clovis v

07/01/2018 43 Clovis v
44 Rafa v
45 M.Reza v
46 Zia v
47 Alifa v
48 Sabrina v
49 Ikhsan v
50 Shalwan v

08/01/2018 51 Clovis v
52 Rafa v
53 M.Reza v
54 Zia v
55 Alifa v
56 Sabrina v
57 Ikhsanu v
58 Shalwan v

09/01/2018 59 Sabrina v
60 Ikhsanu v
61 Shalwan v
62 Ainiyyatus v
63 Rafa v
64 Zia v

10/01/2018 65 ikhsanu v
66 saila v
67 ainiyyatus v
68 syakila v
69 zia v
70 shalwan v

11/01/2018 71 saila v
72 ainiyyatus v
73 nazril v
74 lizan v
75 syakila v

12/01/2018 76 nazril v
77 lizan v
78 Difa v
79 Arkan v

13/01/2018 80 M. Lizzam v
81 Arkan v
82 Reza v
83 Azmia v
84 Difa v
85 Nazril v

14/1/2018 86 deand v
87 arkan v
88 reza v
89 azmi v
90 difa v
91 cyntia v

15/1/2018 92 deand v
93 arkan v
94 cyntia v
95 sandi v
96 alif v

16/1/2018 97 deand v
98 arkan v
99 andra v
100 sandi v
101 alif v
102 m.lutfi v

17/1/2018 103 andra v


104 alif v
105 m.lutfi v
106 arsaka v
107 dyaz v

18/1/2018 108 m.lutfi v


109 dyaz v
110 adreena v
111 azmya v
112 arshaka v
113 m.khalis v

19/1/2018 114 Adreena v


115 M.Khalis v
116 M.Luthfi v
117 Azamya v
118 M.Akbar v
119 Dyaz v

20/01/2018 120 M.Khalis v


121 M.Luthfi v
122 M.Akbar v
123 Dyaz v
124 Arrafi v
125 Ruzain v
126 Fatima v

21/01/2018 127 M. Khalis v


128 Lutfi v
129 Ruzain v
130 Fathima v
131 Arrafi v
132 Harmoni v
133 Rafi v

22/01/2017 134 M. Azka v


135 M. Khalis v
136 Lutfi v
137 Ruzain v
138 Fathima v
139 Arrafi v
140 Rafi v
141 Harmoni v

23/1/2018 142 m.azka v


143 zulaikha v
144 m.khalis v
145 lutfi v
146 fathima v
147 arrafi v
148 arsya v
149 aira v

24/1/2018 150 aira v


151 fathima v
152 arsya v
153 wisnu v

25/01/2018 154 m.rayan v


155 aira v
156 fathima v
157 fathika v
158 wisnu v
159 fahmi v

26/01/2018 160 Rayyan v


161 Denisa v
162 Hanifa v
163 Aira v
164 Fathima v
165 Fatikha v
166 Wisnu v
167 Fahmi v

27/1/2018 168 Rayyan v


169 haifa v
170 fathima v
171 wisnu v
172 fahmi v
173 anindya v

28/1/2018 174 rayyan v


175 anindya v
176 haifa v
177 m.malkha v
178 kayla v

29/1/2018 179 rayyan v


180 m.malkha v
181 kayla v
182 lela v
183 malika v
184 aqmar v

30/1/2018 185 malika v


186 kayla v
187 lela v
188 aqmar v
189 raisa v
190 rafif v

31/1/2018 191 malika v


192 kayla v
193 lela v
194 aqmar v
195 rafif v

jumlah bandung 85
luar 8

LAPORAN BULAN FEBRUARI 2018


Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/2/2018 1 lela v
2 zein v
3 alfin v
4 nabila v
5 darrel v
6 malika v
7 aqmar v

2/2/2018 8 lela v
9 zein v
10 alfin v
11 nabila v
12 darrel v
13 aqmar v
14 fahri v

3/2/2018 15 darrel v
16 fahri v
17 agi v

4/2/2018 18 prataya v
19 darrel v
20 agi v
21 aulia v
22 hulya v
23 arfan v

5/2/2018 24 prataya v
25 darrel v
26 agi v
27 aulia v
28 hulya v
29 arfan v
30 hana v

6/2/2018 31 prataya v
32 darrel v
33 hana v
34 hulya v
35 fauzil v

7/2/2018 36 prataya v
37 darrel v
38 hana v
39 hani v
40 hulya v
41 fauzil v
42 alvin v

8/2 43 Hani v
44 Alvin v
45 Aisyah v
46 Fitri v
47 Darrel v
48 Fauzil v
49 Prataya v
50 Hulya v
51 Hana v

09/02/2018 52 Alvin v
53 Hani v
54 Prataya v
55 Fitri v
56 Darrel v
57 Ridwan v
58 Fauzi v

10/02/2018 59 Alvin v
60 Hani v
61 Afifah v
62 Ridwan v
63 Fauzi v
64 Fikri v

11/02/2018 65 Afifah v
66 Ridwan v
67 Fauzi v
68 Alvin v
69 Shofa v
70 Azfar v
71 Semi v
72 Hani v

12/02/2018 73 Shofa v
74 Azfar v
75 Semi v
76 Hani v
77 Ridwan v
78 Fauzi v

13/2/2018 79 raisha v
80 ridwan v
81 al fajri v v
82 harun v v

14/2/2018 83 raisha v
84 dzakira v
85 m/raka v
86 ridwan v
87 alfajri v
88 harun v v
89 m.abdul v

15/2/2018 90 raisha v
91 dzakira v
92 m.raka v
93 m.ridwan v
94 alfajri v
95 harun v v
96 m.abdul v
97 m.rafa v

16/2/2018 98 dzakira v
99 m.raka v
100 m.ridwan v
101 m.fajri v
102 harun v v
103 m.abdul v
104 m.rafa v

17/2/0108 105 dzakira v


106 m.raka v
107 m.ridwan v
108 m.fajri v
109 harun v
110 m.abdul v
111 m.rafa v

18/2/2018 112 dzakira v


113 m.raka v
114 m.ridwan v
115 m.fajri v
116 harun v
117 m.abdul v
118 m.rafa v

19/2/2018 119 harun v


120 kayra v
121 siti v

20/2/2018 122 harun v


123 kayra v
124 azka v
125 siti v

21/02/2018 126 Raka v


127 Siti v
128 Harun v
129 Khairan v
130 Azka v
131 Abiyaksa v
132 Naysha v
133 Selvi v

22/02/2018 134 Nabil v


135 Siti v
136 Harun v
137 Siti.F v
138 Azka v
139 Abiyaksa v
140 Naysha v
141 Selvi v
142 Nadya v

23/02/2018 143 Silfi v


144 Nadya v
145 Nabil v
146 Siti. F v
147 Naysha v
148 Abiyaksa v
149 Azka v

24/02/2018 150 Siti Fatimah v


151 Abiyaksa v
152 Azka v
153 Silfi v
154 Nadisa v

25/02/2018 155 siti fatimah v


156 abidzar v
157 abiyaksa v
158 azka v
159 silfi v
160 milea v
161 nadisa v
162 zulia v

26/02/2018 163 abidzar v


164 silfi v
165 milea v
166 nadisa v
167 zulia v
168 hamdan v

27/02/2018 169 abidzar v


170 milea v
171 hamdani v
172 khairan v
173 zulfa v
174 alfatih v
175 nadia v

28/2/2018 176 abidzar v


178 milea v
179 hamdani v
180 khairan v
181 zulfa v
182 alfatih v
183 nadia v
184 alif v
jumlah pasien bandung 65 , luar bandung 12
LAPORAN BULAN MARET 2018
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/3/2018 1 Raffi v
2 Khairan v
3 Nadisa v
4 Alif v
5 Al fatih v
6 Hamdani v
2/3/2018 7 raffi v
8 khairan v
9 nadisa v
10 alfatih v
11 fauzan v
12 hamdani v

3/3/2018 13 novianti v
14 arkan v
15 nadisa v
16 nayyira v
17 fauzan v
18 alfatih v
19 habib v
20 rafi v

4/3/2018 21 novianti v
22 arkan v
23 nadisa v
24 nayyira v
25 fauzan v
26 alfatih v
27 habib v
28 rafi v

5/3/2018 29 novianti v
30 gibran v
31 nadisa v
32 nayyira v
33 habbib v

6/3/2018 34 gibran v
35 nadisa v
36 nayyira v
37 keinesya v
38 habib v
39 arfan v

7/3/2018 40 Nayyira v
41 Arfan v
42 Nadisa v
43 Nayra v
44 Azril v
45 Kanesya v

08/03/2018 46 Rafka v
47 Khairey v
48 Nadisa v
49 Nayyira v
50 Kanesya v
51 Azril v
52 Arfan v
53 Nayra v

09/03/2018 54 Kanesya v
55 Arfan v
56 Nayra v
57 Dzakira v
58 Nadisa v
59 Aditya v
60 khayrey v
61 nayra v

10/03/2018 62 Rafka v
63 Dzakira v
64 Khayrei v
65 Nadisa v
66 Febryan v
67 Kanesya v
68 Aditya v
69 Nayra v

11/03/2018 70 Dzakira v
71 Khayrei v
72 Nadisa v
73 Febryan v
74 Kanesya v
75 Aditya v
76 Nayra v
77 Adifa

12/03/2018 78 Dzakira v
79 Khayrei v
80 Nadisa v
81 Febryan v
82 Kanesya v
83 Aditya v
84 Adifa v

13/03/2018 85 khansa v
86 dzakira v
87 febrian v
88 khedira v
89 adifa v
90 marwah v

14/3/2018 91 khansa v
92 dzakira v
93 febrian v
94 khedira v
95 ansel v
96 marwah v

15/3/2018 97 adira v
98 dzakira v
99 febrian v
100 khedira v
101 ansel v
102 ayumi v

16/03/2018 103 Dzakira v


104 Ansel v
105 Adara v
106 M. Syawal v
107 Khedira v
108 Ayumi v

17/03/2018 109 Najwan v


110 Ansel v
111 Adara v
112 M.Syawal v
113 Khedira v
114 Ardian v

18/03/2018 115 Ansel v


116 Najwan v
117 adara v
118 M.Syawal v
119 Khedira v
120 Ardian v

19/03/2018 121 Hasna v


122 Ansel v
123 Zaskiya v
124 Miftaqwa v
125 Bagas v
126 Najwan v
127 Adara v
128 Ardian v
v
20/3/2018 129 ansel v
130 nazwan v
131 zaskia v
132 miftakwa v
133 ardian v
134 alisa v
135 bagas v

21/3/2018 136 zaidan v


137 putra v
138 miftakwa v
139 ansel v
140 zaskia v
141 raka v
142 alisa v
143 bagas v

22/3/2018 144 zaidan v


145 putra v
146 miftakwa v
147 ansel v
148 zaskia v
149 raka v
v
23/03/2018 150 Raka v
151 Zaskya v
152 Zaidan v
153 M.Arif v
154 Putra v
155 Shahir v
156 M.Rasyid v
157 Ansel v
158 Miftakwa v

24/03/2018 159 Raka v


160 Zaskya v
161 Zaidan v
162 M.Arif v
163 Putra v
164 Shahir v
165 M.Rasyid v
166 Miftakwa v

25/03/2018 167 Raka v


168 Zaskya v
169 Zaidan v
170 M.Arif v
171 Putra v
172 Shahir v
173 M.Rasyid v
174 Miftakwa v
175 Afiza v

26/03/2018 176 M.Arif v


177 Afiza v
178 Shahir v
179 M.Rasyid v
180 Raka v

27/03/2018 181 Raka v


182 Rasyid v
183 Azmi v
184 Vania v
185 Aprilia v
186 Fajar v

28/03/2018 187 Fajar v


188 Assyifa v
189 Vania v
190 Raka v
191 M. Rasyid v
192 M. Azmi v
193 Aprilia v

29/03/2018 194 Fajar v


195 Assyifa v
196 Ardiana v
197 Raka v
198 M. Rasyid v
199 M. Azmi v
200 Aprilia v

30/3/2018 201 m.rasyid v


202 aprilia v
203 raka v

31/3/2018 204 M. Rasyid v


205 Aprilia v
206 Raka v
207 Rafasya v
208 Al hasan v
209 Raisya v
210 Dewi v
211 M. Azam v

jumlah pasien 68 pasien


LAPORAN BULAN APRIL 2018
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2018 1 Aprilia v
2 Dzaki v
3 Raisya v
4 M. Azam v
5 Al hasan v
6 Raka v
7 Dewi v

02/04/2018 8 raisya v
9 al hasan v
10 dewi v
11 raka v
12 saeful v
13 dzaki v
3/4/2018 14 raisya v
15 al hasan v
16 dewi v
17 raka v
18 saeful v
19 dzaki v

4/4/2018 20 raisya v
21 alhasan v
22 raka v
23 sahlan v
24 burhanudin v

5/4/2018 25 raisya v
26 raka v
27 sahlan v
28 burhanudin v
29 bagja v

6/4/2018 30 raka v
31 sahlan v
32 baja v

33 sahlan v
34 baja v
35 afifah v
36 indah v
37 reza v

7/4/2018 38 Baja v
39 Indah v
40 Rafifah v
41 sahlan v
42 reza v

8/4/2018 43 Indah v
44 Rafifah v
45 reza v
46 ahmad v
47 ellgio v
48 afifa v

9/4/2018 49 indah v
50 reza v
51 ahmad v
52 ellgio v
53 afifa v
54 falah v

10/4/2018 55 reza v
56 afifa v
57 aini v
58 deandra v
59 ellgio v
60 ahmad v
61 falah v

11/04/2018 62 reza v
63 afifa v
64 aini v
65 deandra v
66 ellgio v
67 ahmad v
68 falah v

12/04/2018 69 Aini v
70 Deandra v
71 Ellgio v
72 Ahmad v
73 Hafizh v
74 M. Firkhan v

13/04/2018 75 Aini v
76 Ellgio v
77 Ahmad v
78 Hafizh v

14/04/2018 79 Aini v
80 elgio v
81 kinan v
82 giandra v
83 nabila v

15/04/2018 84 aini v
85 raisya v
86 giandra v
87 kinan v
88 nabila v

16/4/2018 89 aini v
90 raisya v
91 giandra v
92 kinan v
93 nabila v

17/04/2018 94 Asyifa v
95 Aini v
96 Ibrahim v
97 Nabila v
98 Gendarvid v
99 Giandra v
18/04/2018 100 Kinara v
101 Asyifa v
102 Adiva v
103 Ibrahim v
104 Nabila v
105 Gendarvid v
106 Giandra v
107 Nayla v

19/04/2018 108 Kinara v


109 Asyifa v
110 Adiva v
111 Ibrahim v
112 Nabila v
113 Gendarvid v
114 Nayla v

20/04/2018 115 Kinara v


116 Asyifa v
117 Adiva v
118 Ibrahim v
119 Nabila v
120 Gendarvid v
121 Nayla v

21/04/2014 122 kinara v


123 asyifa v
124 salsabila v
125 nayla v

22/04/2018 126 kinara v


127 asyifa v
128 salsabila v
129 nayla v
130 nayla zahra v

23/4/2018 131 atta v


132 asyifa v
133 salsabila v
134 putri v
135 nayla v

24/04/2018 136 putri v


137 asyifa v
138 salsabila v
139 zaenal v
140 nayla v
141 m. Atha v
142 Atu v
143 napoleon v
25/04/2018 144 putri v
145 m. atha v
146 salsabila v
147 zaenal v
148 nayla v
149 ahmad v
150 atu v
151 napoleon v

26/4/2018 152 ahmad v


153 m.atha v
154 zainal v
155 nayla v
156 raditya v
157 adisty v
158 atu v
159 napoleon v

27/4/2018 160 ahmad v


161 m.atha v
162 aqmar v
163 zainal v
164 nayla v
165 raditya v
166 atu v
167 napoleon v

28/04/2018 168 raditya v


169 nazril v
170 atu v
171 napoleon v
172 ahmad v
173 m. atha v
174 aqmar v
175 zaenal v
176 nayla v

29/04/2018 177 ghassani v


178 nazril v
179 atu v
180 naura v
181 aqmar v
182 nayla v

30/04/2018 183 ghassani v


184 nazril v
185 naura v
186 aqmar v
187 nayla v
Jumlah Pasien : 64 pasien

LAPORAN BULAN MEI 2018


Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2018 1 Naura v
2 Salsabila v
3 Aqmar v
4 Nayla v
5 Ghassani v
6 Nazril v

02/05/2018 7 Ghassani v
8 Nazril v
9 Naura v
10 Salsabila v
11 Nayla v

3/5/2018 12 ghassani v
13 zafran v
14 salsabila v
15 fiqih v

4/5/2018 16 ghasani v
17 adi v
18 zafran v
19 salsabila v
20 fiqih v
21 wildan v

5/5/2018 22 zafran v
23 yoshi v
24 shafana v
25 fiqih v
26 wildan v
27 fayra v

6/5/2018 28 albartama v
29 m.jalal v
30 zafran v
31 yoshi v
32 shafana v
33 wildan v
34 fayra v

7/5/2018 35 albartama v
36 m,jalal v
37 zafran v
38 shafana v
39 fayra v
8/5/2018 40 albartama v
41 m.jalal v
42 shafana v
43 syamil v
44 wildan v
45 fayra v

9/5/2018 46 albartama v
47 m.jalal v
48 nina v
49 syamil v
50 shafana v
51 m.rizqi v
52 wildan v
53 fayra v

10/05/2018 54 Albartama v
55 M. Jalal v
56 By. Ny. Nina v
57 Syamil v
58 Shafana v
59 M. Rizqy v
60 Fariz v

11/05/2018 61 Syamil v
62 Jalal v
63 Nina v
64 Shafana v
65 M. Rizky v
66 Fariz v
67 Dendi v

12/05/2018 68 Riana v
69 Shafana v
70 M.Rizky v
71 Dendi v

13/05/2018 72 Zulfa v
73 Riana v
74 Dendi v

14/5/2018 75 zulfa v
76 riana v
77 dendi v

15/5/2018 78 zulfa v
79 dendi v
80 gio v
81 gian v
82 ahmad v
16/5/2018 83 ahmad v
84 radisa v

17/5/2018 85 ahmad v
86 radisa v
87 sakina v
88 m.fathir v

18/05/2018 89 Radisa v
90 Sakina v
91 Almira v
92 Fathir v
93 Angga v

19/05/2018 94 Angga v
95 Sakina v
96 Almira v
97 Akmal v

20/5/2018 98 nadifa v
99 angga v
100 sakina v
101 almira v
102 m.akmal v

21/5/2018 103 nadifa v


104 arfan v

22/5/2018 105 nadifa v


106 arfan v

23/05/2018 107 Velani v


108 Fathar v
109 Shaqueena v
110 Arkan v
111 Devika v

24/05/2018 112 Fathar v


113 Shaqueena v
114 Velani v
115 Devika v

25/05/2018 Shaqueena v
Velani v
Devika v
Hana v
Hanif v

26/05/2018 Shaqueena v
Bintang v
Hanif v
Hana v
Chiyo v
Noval v

27/05/2018 Bintang v
Hanif v
Chiyo v
Nova v
Hana v

28/05/2018 Bintang v
Hanif v
Chiyo v
Nova v
Hana v
Mirna v

29/05/2018 Bintang v
Mirna v
Hanif v
Ria v
Alika v
Hana v

30/05/2018 Bintang v
Hanif v
Ria v
Aufa v
Rainaka v
M,Fathir v

31/05/2018 Bintang v
Ria v
Rainaka v
M.Fathir v

Jumlah Pasien : 69 pasien


LAPORAN BULAN JUNI 2018
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2018 1 M. Fathir v
2 Gibran v
3 Ria v
4 Rainasa v
5 Cep salman v

02/06/2018 6 Nadia v
7 Andini v
8 Cep Salman v

03/06/2018 9 Robi v
10 Nadia v
11 Andini v
12 Nazira v

04/06/2018 13 Nurwulandari v
14 Robi v
15 Andini v
16 Nazira v
17 M. Selfa v
18 Sirilla v

05/06/2018 19 Nurwulandari v
20 Robi v
21 Najma v
22 M. Selga v
23 Sirilla v

06/06/2018 24 Nurwulandari v
25 Najma v
26 Risa v

07/06/2018 27 Shafira v
28 Risa v
29 Najma v

08/06/2018 30 Safira v
31 Risa v
32 Dista v
33 Najma v

09/06/2018 34 Maharaja v
35 Safira v
36 Risa v
37 Dista v
38 Najma v
39 Haura v
40 Alif v
41 Nadia v

10/06/2018 42 Maharaja v
43 Safira v
44 Risa v
45 Dista v
46 Haura v
47 Alif v
48 Nadia v

11/06/2018 49 Maharaja v
50 Safira v
51 Risa v
52 Dista v
53 Alif v
54 Haura v

12/06/2018
Ruang R anak bln februari 2015- RSKIA

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2015 1 By.Latief v
2 By.Alan v
3 By.Stevi v
4 An.Rayhan v
4

02/02/2015 5 By.M.rafa v
6 By.Alan v
3 By.Azana v
4 By.Latief v
5 An.M.Sabiq v
6 By.Stevi v
7 An.Rayhan v
8 By.Aulia v
8

03/02/2015 1 An.Reska v
2 An.Rayhan v
3 By.Aulia v
4 By.M.Alan v
5 By.Azana v
6 By.latief v
7 An.M.Sabiq v
8 An.Deza v
8

04/02/2015 1 By.Latief v
2 An.M.Sabiq v
3 An.Rezka v
4 By.M.Riza v
5 By.Aulia v
5

05/02/2015 1 By.M.Riza v
2 An.M.Rizki v
3 By.Nanih v
4 By.Cika v
5 By.Gilman v
5

06/02/2015 1 By.M.Riza v
2 By.Nanih v
3 By.Cika v
4 By.Gilman v
5 By.M.Ricky v
5

07/02/2015 1 By.M.Riza v
2 By.Nanih v
3 By.Gilman v
4 By.M.Ricky v
5 An. Rafka v
6 By. Rahmawati v
6 By. Demian v
7

08/02/2015 1 By.M.Riza v
2 An.Naila v
3 By.Nanih v
4 By.M.Ricky v
5 By.Hady v
6 By.Rachmawati v
7 An.Rafka v
7

09/02/2015 1 An.Naila v
2 By.Nanih v
3 By.Hady v
4 By.Rachmawati v
5 By.Rafa v
6 By.Raisa v
6

10/02/2015 1 By.nanih v
2 By.Rafa v
3 By.Hady v
4 An.Raisa v
5 An.Aziz v
5

11/02/2015 1 By.Nanih v
2 By.Rafa v
3 By.Hadi v
4 An.Raisa v
5 An.Aziz v
6 An.Cantika v
7 By.Haidar v
7

12/02/2015 1 By.Nanih v
2 By.Sazkia v
3 An.Aziz v
4 By.Ikhsan v
5 By.Haidar v
6 By.Sri v
8

13/02/2015 1 An.Aziz v
2 An.Deta v
3 By.Ikhsan v
4 By.Haidar v
5 By.Zaki v
6 By.Raisan v
7 By.Alif v
7

14/02/2015 1 By.Alif v
2 By.M.Zaki v
3 By.Risan v
4 By.Haidar v
5 By.Bintang v
6 By.febri v
7 An.Deta v
8 By.M.Ikhsan v
8

15/02/2015 1 An.Deta v
2 By.Faiza v
3 By.Febri v
4 By.Alif v
5 By.M.Zaki v
6 By.Bintang v
6

16/02/2015 1 An.Deta v
2 By.Faiza v
3 By.Anisa v
4 An.Tira v
5 By.Bintang v
5

17/02/2015 1 An.Deta v
2 By.Faiza v
3 By.Anisa v
4 An.Tira v
5 An.Noumira v
6 By.Bintang v
7 An.Sania v
8 An.Denis v
9 An.Dara v
9

18/02/2015 1 An.dara v
2 An.Sania v
3 An.Danis v
4 An.Kristiano v
5 An.Noumira v
6 By.Bintang v
7 By.Faiza v
8 By.Annisa v
8
19/02/2015 1 By.Rayi v
2 By.Annisa v
3 An.Dara v
4 An.Sania v
5 An.Denis v
6 An.Kristiano v
7 By.Bintang v
7

20/02/2015 1 An.Sania v
2 An.Denis v
3 An.Kristiano v
4 By.Rhadit v
5 By.Tantan v
6 By.Rayi v
7 By.Zenira v
8 By.Annisa v
8

21/02/2015 1 By.Rayi v
2 By.Zenira v
3 An.Dwi v
4 An.Denis v
5 An.Kristiano v
6 By.Rhadit v
7 By.Tantan v
8 An.Isa v
8

22/02/2015 1 An.Dwi v
2 An.Isa v
3 By.Rhadit v
4 By.Tantan v
5 By.Rayi v
6 By.Zenira v
7 By.Wildan v
7

23/02/2015 1 By.Wildan v
2 By.Alfatih v
3 An.Dwi v
4 An.Isa v
5 By.Annisa v
6 By.Billi v
7 By.Rhadit v
8 An.Irsya v
8

24/02/2015 1 An.Dwi v
2 By.Annisa v
3 By.Billi v
4 An.Irsya v
5 By.Reynald v
6 By.Alfatih v
7 By.Wildan v
7

25/02/2015 1 By.Reynald v
2 By.Alfatih v
3 By.Wildan v
4 By.Ika v
5 By.Annisa v
6 By.Billi v
7 By.Zaidan v
8 By.Irsya v
8

26/02/2015 1 By.Hafidz v
2 By.Nurrizki v
3 By.Billi v
4 By.Zaidan v
5 By.Komariah v
6 By.Reynald v
7 By.Alfatih v
8 By.Ika v
8

27/02/2015 1 By.Hafidz v
2 By.Nurrizki v
3 By.Billi v
4 By.Zaidan v
5 By.Komariah v
6 By.Reynald v
7 By.Alfatih v
8 By.Ika v
8

28/02/2015 1 By.Hafidz v
2 By.Nurrizki v
3 By.Komariah v
4 By.Firman v
5 An.Aziz v
6 An.Nizam v
6

TOTAL 193

FORMULIR SURVEY HARIAN PEMAKAIAN ALAT


RUANG ANAK BULAN MARET 2015
01/03/2015 1 by.aziz v
2 an.nizam v
3 by.firman v
3

02/03/2015 1 an.nizam v
2 by.ny.imas v
3 by.raihan v
4 by.rasya v
5 by.aziz v
6 by.yoga v
6

03/03/2015 1 by.yoga v
2 by.rasya v
3 by.wildan v
4 an.nizam v
5 by.raihan v
6 an.khairlansyah v
6

04/03/2015 1 an.nizam v
2 by.raihan v
3 by.yoga v
4 by.rayi v
5 by.rasya v
6 an.michel v
7 an.nesya v
8 an.khairlansyah v
8
05/03/2015 1 by.rayi v
2 by.rasya v
3 an.nazwa v
4 an.michel v
5 an.nesya v
6 an.rini v
7 an.nizam v
8 by.raihan v
9 by.aulia v
10 an.khairlansyah v
10
06/03/2015 1 an.nizam v
2 by.raihan v
3 an.rini v
4 by,rasya v
5 an.nazwa v
6 an.mischel v
7 an.khairlansyah v
7
07/03/2015 1 an.rini v
2 by.virzha v
3 by.rani v
4 an.khairlansyah v
4
08/03/2015 1 by.rani v
2 by.virzha v
3 an.khairlansyah v
3

09/03/2015 1 by.adli v
2 by.rani v
3 an.faiq v
4 by.ristiani v
5 an.khairlansyah v
6 by.revita v
6

10/03/2015 1 by.revita v
2 an.faiq v
3 by.ristiani v
4 an.nava v
5 an.rizka v
6 by.adli v
7 by.rani v
8 by.akmal v
6

11/03/2015 1 an.rizka v
2 by.adli v
3 by.akmal v
4 an.nisvi v
5 by.revita v
6 by.zihan v
7 by.ristiani v
8 an.nava v
8

12/03/2015 1 an.rizka v
2 by.adli v
3 by.akmal v
4 an.nisvi v
5 by.revita v
6 by.zihan v
7 by.ristiani v
8 an.nava v
9 an.welsen v
10 an.qatrunnada v
10

13/03/2015 1 an.rizka v
2 by.adli v
3 an.welsen v
4 an.qatrunada v
5 by.ibrahim v
6 an.nava v
7 by.zihan v
8 by.naufal v
8

14/03/2015 1 an.rizka v
2 by.adli v
3 an.qatrunnada v
4 by.ibrahim v
5 an.nava v
6 by.zihan v
7 by.naufal v
7

15/03/2015 1 by.m.adli v
2 an.m.ansori v
3 by.zihan v
4 by.ibrahim v
5 an.nava v
5

16/03/2015 1 an.m.ansori v
2 by.nizam v
3 by.novita v
4 an.dimas v
5 by.seni v
5

17/03/2015 1 by.arrasyid v
2 by.novita v
3 by.akhdan v
4 by.seni v
5 an.dimas v
6 an.revani v
7 by.naufal v
8 by.nizam v
8

18/03/2015 1 by.naufal v
2 an.revani v
3 by.nizam v
4 by.sintia v
5 by.novita v
6 by.banu v
by.arrasyid
7 v
8 by.seni v
9 by.haidar v
9

19/03/2015 1 by.novita v
2 by.banu v
3 by.arrasyid v
4 by.haidar v
5 an.irfan v
6 by.sintia v
7 by.nizam v
7

20/03/2015 1 by.alfan v
2 an.arsaka v
3 by.sintia v
4 by.novita v
5 by.banu v
6 by,haidar v
7 by.bagus v
8 an.irfan v
9 by.asyifa v
9

21/03/2015 1 by.asyifa v
2 by.haidar v
3 by.bagus v
4 an.irfan v
5 by.alfan v
6 an.arsaka v
7 by.sintia v
7

22/03/2015 1 by.adyasa v
2 by.bagus v
3 by.alfan v
4 an.arsaka v
5 by.sintia v
5

23/04/2015 1 by.alfan v
2 by.sintia v
3 an.naffi v
4 by.adyasa v
5 an.bilal v
6 by.hadfina v
7 by.kenzi v
7

24/03/2015 1 by.alfan v
2 an.naffi v
3 by.hadfina v
4 an.selfa v
5 by.kenzi v
5

25/03/2015 1 by.sinta v
2 by.hadfina v
3 an.selfa v
4 by.kenzi v
5 by.galang v
6 by.arizki v
7 an.naffi v
7

26/03/2015 1 by.sinta v
2 by.galang v
3 by.hadfina v
4 by.ahmad v
5 by.fahmi v
6 an.selfa v
7 by.arizki v
7

27/03/2015 1 an.rafardan v
2 by.fahmi v
3 by.galang v flebitis:merah
4 by.hadfina v
5 by.arizki v
6 by.febrian v
7 an.amanda v
7

28/03/2015 1 an.amanda v
2 an.wafa v
3 by.arizki v
4 by.jaka v
5 by.fahmi v
6 by.hadfina v
7 by.febrian v
8 by.ny.teti II v
8

29/03/2015 1 by.ny.teti II v
2 by.febrian v
3 by.jaka v
4 an.amanda v
5 an.wafa v
5

30/03/2015 1 by.ny.teti v
2 by.jaka v
3 by.aisha v
4 by.dafa v
an.khanza
5 v

by.fauzan
31/03/2015 1 v
by.dafa
2 v
3 an.khanza v
4 by.jaka v
5 by.aisha v
6 by.raindra v
7 an.dika v
7
jumlah 295

FORMULIR SURVEY HARIAN PEMAKAIAN ALAT


RUANG ANAK BULAN APRIL 2015

01/04/2015 1 by.fauzan v
2 by.dafa v
3 an.khanza v
4 an.dika v
4

02/04/2015 -

03/04/2015 -

04/04/2015 -

05/04/2015 1 by.zahra v
2 by.rafa v
3 by.abid v
3

06/04/2015 1 by.zahra v
2 by.rafa v
3 by.abid v
4 by.shanum v
4

07/04/2015 1 by.zahra v
2 by.rafa v
3 byabid v
4 by,najwa v
5 by.raihan v
6 by.shanum v
7 by.m.rega v
8 an.shifa v
8

08/04/2015 1 by.raihan v
2 by.shanum v
3 an.shifa v
4 by.m.rega v
5 by.abid v
6 by.najwa v
7 an.indri v
7

09/04/2015 1 by.m.rega v
2 an.indri v
3 by.alif v
4 by.najwa v
5 by.neha v
6 by.raihan v
7 by.shanum v
8 an.shifa v
8

10/04/2015 1 by.raihan v
2 by.m.rega v
3 an.indri v
4 by.alif v
5 by.m.rifal v
6 by.najwa v
7 by.neha v
8 by.reno v
by.ny.sinta
9 v
9

11/04/2015 1 by.sinta v
2 by.m.rega v
3 by.reno v
4 by.raihan v
5 an.sharat v
5

12/04/2015 1 by.sinta v
2 by.m.rega v
3 by.alif v
4 by.m.rifal v
5 by.neha v
6 by.reno v
7 by.raihan v
8 an.sharat v
9 by.farhan v
9

13/04/2015 1 by.farhan v
2 by.sinta v
3 by.m.rega v
4 by.neha v
5 by.m.rifal v
6 an.nurlaela v
6
14/04/2015 1 an.nurlaela v
2 by.m.rizki v
3 an.ridwan v
4 an.naufal v
5 by.farhan v
6 an.theodore v
6

15/04/2015 1 by.rania v
2 by.farhan v
3 an.nurlaela v
4 by.m.rizki v
5 an.naufal v
5

16/04/2015 1 an.nurlaela v
2 by.m.rizki v
3 an.naufal v
4 by.rania v
4

17/04/2015 1 by.rania v
2 by.m.rizki v
3 an.resty v
4 an.nurlaela v
5 an.naufal v
5

18/04/2015 1 an.naufal v
2 by.rania v
3 by.aidel v
4 an.resty v
4

19/04/2015 1 by.rania v
2 by.aidel v
3 an.naufal v
4 an.reisa v
4

20/04/2015 1 by.raina v
2 by.rania v
3 by.aidel v
4 by.reisa v
5 an.naufal v
5

21/04/2015 1 by.rania v
2 by.fauzan v
3 an.farida v
3

22/04/2015 1 by.rania v
2 by.fauzan v
3 an.farida v
4 an.fakhri v
4

23/04/2015 1 an.neng v
2 an.serli v
3 by.rido v
4 ab.fakhri v
5 by.fauzan v
6 by.rania v
7 by.rizka v
7

24/04/2015 1 by.rania v
2 an.rizka v
3 an.nur amira v
4 by.serli v
5 by.rido v
6 an.fakhri v
7 by.fauzan v
7

25/04/2015 1 by.nurahma v
2 by.rido v
3 by.fauzan v
4 an.nur amira v
4

26/04/2015 1 an.nur amira v


2 by.alvin v
3 by.nurahma v
4 by.ridho v
5 by.fauzan v
5

27/04/2015 1 by.sarah v
2 an.salsabila v
3 by.ridho v
4 by.fauzan v
5 by.ahmad v
6 an.alvin v
6

28/04/2015 1 by.ahmad v
2 an.alvin v
3 by.sarah v
4 an.salsabila v
5 by.rido v
5

29/04/2015 1 by.sarah v
2 by.alvin v
3 an.salsabila v
3

30/04/2015 1 by.sarah v
2 by.danis v
3 by.hafiz v
3

jumlah 137

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln MEI 2015- RSKIA

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2015 1 By.Sarah v
2 an.denis v
3 by.hafiz v
3

02/05/2015 1 by.hafiz v
2 an.siti v
3 an.denis v
4 by.sarah v
4

03/05/2015 1 an.siti v
2 an.galang v
3 an.denis v
4 an.anisa v
5 an.bilal v
6 an.ajrian v
6

04/05/2015 1 an.siti v
2 an.galang v
3 an.denis v
4 an.anisa v
5 an.bilal v
6 an.ajrian v
6

05/05/2015 1 an.galang v
2 by.gian v
3 an.bilal v
3

06/05/2015 1 an.gian v
2 an.excel v
2

07/05/2015 1 an.bilal v
2 by.gian v
2

08/05/2015 1 an.m.alkhalifi v
2 by.gian v
3 by.m.dendy v
4 by.neha v
5 an.bilal v
5

09/05/2015 1 an.indah v
2 by.neha v
3 by.nadia v
4 an.m.alkhalifi v
5 by.m.dendy v
5

10/05/2015 1 an.m.alkhalifi v
2 an.rafa v
3 by.m.dendy v
4 an.indah v
5 by.nadia v
6 by.davina v
7 an.sintiara v
7

11/05/2015 1 an.indah v
2 by.nadia v
3 an.m.alkhalifi v
4 an.rafa v
5 an.dendy v
6 by.davina v
7 an.sintiara v
7

12/05/2015 1 an.m.alkhalifi v
2 an.wildan v
2

13/05/2015 1 an.alisya v
2 an.wildan v
2

14/05/2015 1 an.alisya v
2 an.wildan v
2

15/05/2015 1 an.alisya v
2 by.hauzan v
2

16/05/2015 1 by.rini v
2 an.rayhan v
3 by.hauzan v
4 by.rifal v
4

17/05/2015 1 by.rifal v
2 by.rini v
3 an.reyhan v
4 an.saeful v v
4 1
18/05/2015 1 an.saeful v v
1 1

19/05/2015 1 an.saeful v
2 an.nadiya v
2

20/05/2015 1 an.nadiya v
2 an.lutfi v
3 by.nazwa v
3

21/05/2015 1 by.nadiya v
2 by.nazwa v
3 by.rafi v
4 an.lutfi v
4

22/05/2015 1 an.lutfi v
2 an.naila v
3 by.nazwa v
3

23/05/2015 1 an.lutfi v
2 an.naila v
3 by.desi v
4 by.arcello v
5 by.naura v
6 by.arya v
6

24/05/2015 1 by.desi v
2 by.arya v
3 by.arcello v
4 by.naura v
5 an.kharisma v
5
25/05/2015 1 by.naura v
2 an.kharisma v
3 by.aulia v
4 by.desi v
5 by.arya v
5
26/05/2015 1 by.aulia v
2 an.kharisma v
3 by.desi v
4 by.arya v
5 by.taslim v
5
27/05/2015 1 by.aulia v
2 by.desi v
3 by.arya v
4 by.taslim v
4

28/05/2015 1 by.aulia v
2 by.ilham v
3 an.ridwan v
4 an.alisha v
5 an.ufaira v
5

29/05/2015 1 by.aulia v
2 an.ridwan v
3 an.alisha v
4 an.ufaira v
5 by.fadil v
5

30/05/2015 1 by.aulia v
2 by.desi v
3 by.fadil v
4 an.ridwan v
4
31/05/2015 1 By. Aulia v
2 By. Desi v
3 By. Fadil v
4 An. Ridwan v
5 An. Natasha v
5
jumlah 121
jumlah pasien 85
Formulir Survey Harian Pemakaian Alat
Ruang R anak bln Juni 2015- RSKIA
TANGGAL NO NAMA ETT IVL UC ISK PLEBITIS

by.aulia
01/06/2015 1 v
2 by.fadil v
3 an.ridwan v
4 an.natasha v
5 an.evan v
5

02/06/2015 1 by.aulia v
2 by.fadil v
3 by.sahad v
4 an.ridwan v
5 an.natasha v
6 an.evan v
6

03/06/2015 1 by.sahad v
2 by.fadil v
3 by.faiz v
3

04/06/2015 1 by.sahad v
2 by.fadil v
3 by.faiz v
3

05/06/2015 1 by.sahad v
1

06/06/2015 1 by.sahad v
1

07/06/2015 1 by.sahad v
2 by.renno v
2

08/06/2015 1 an.nazwa v
2 an.sahad v
3 by.renno v
4 by.nabila v
4

09/06/2015 1 an.zidan v
2 by.diva v
3 by.renno v
4 by.nabila v
4

10/06/2015 1 an.zidan v
2 by.diva v
3 an.tubagus v
4 by.rendy v
5 an.daffa v
5

11/06/2015 1 an.zidan v
2 by.diva v
3 an.tubagus v
4 by.rendy v
5 by.fathir v
5

12/06/2015 1 An. M. Zidan v


2 By. Diva v
3 An. Tubagus v
4 An. Zenira v
5 By. Rendi v
6 By. Fathir v
6

13/06/2015 1 By. DIva v


2 An. Zenira v
3 An. Rendi v
4 By. Fathir v
5 By. Denis v
5

14/06/2015 1 An. M Fadil v


2 By. Revan v
3 By. Denis v
3

15/06/2015 1 an.m.fadli v
2 an.fadilah v
3 by.denis v
4 by.revan v
5 by.tiara v
5

16/06/2015 1 an.m.fadli v
2 an.fadilah v
3 an.alisha v
4 An. Virghi v
5 By. M. Nurzaqi v
6 An. M. Nurizqi v
7 An. Kiki v
8 An. belantara v
8

17/06/2015 1 An. M. Rizki v


2 An. Alisha v
3 An. Kiki v
4 An. Nurizki v
5 By. M. Nurzaqi v
6 An. Belantara v
6

18/06/2015 1 an.kiki v
2 an.arizqi v
3 an.m.nurzaki v
4 an.belantara v
5 an.albi v
6 an.rizqi v
7 by.alif v
8 an.asti v
8

19/06/2015 1 an.kiki v
2 an.arizqi v
3 an.m.nurzaki v
4 an.belantara v
5 an.albi v
6 an.rizqi v
7 by.alif v
8 an.asti v
8

20/06/2015 1 an.kiki v
2 an.arizqi v
3 an.m.nurzaki v
4 an.belantara v
5 an.albi v
6 an.rizqi v
7 by.alif v
8 an.asti v
8

21/06/2015 1 an.m.nurzaki v
2 an.albi v
3 an.rizki v
4 an.asti v
5 By. Enzha v
5

22/06/2015 1 an.m.nurzaki v
2 an.albi v
3 an.rizki v
4 an.asti v
5 By. Enzha v
5
23/06/2015 1 By. Ridwan v
2 An. Febrian v
An. M. Nurzaki
3 v
4 By. Lutfi v
5 By. Enzha v
5
24/06/2015 1 By. Ridwan v
2 An. Febrian v
3 An. anugrah v 8
4 An. Nurzaki v
5 An. Lutfi v
6 By. Enzha v
6

25/06/2015 1 By. Khanza v


2 An. Defita v
3 By. Ridwan v
4 an. Febrian v
5 By. Lutfi v
6 An. Mujib v
6

26/06/2015 1 By. Ridwan v


2 An. Febrian v
3 An. Khanza v
4 An. Defita v
5 An. Faiza v
6 An. Mujib v
7 By. Lutfi v
7

27/06/2015 1 An. Khanza v


2 An. Defita v
3 An. Faiza v
4 By. Lutfi v
4

28/06/2015 1 An. Khanza v


2 An. Defita v
3 An. Faiza v
4 By. Alif v
5 BY. Candra v
6 By Dian v

29/06/2015 1 BY Ny Dian v
2 By. Ny Vina v
3 By Khanza v
4 BY. Faiza v
5 By Annisa v
6 An Abyan v
7 By Alif v
8 An Nurul v
8

30/06/2015 1 BY Ny Dian v
2 By. Ny Vina v
3 By Khanza v
4 BY. Faiza v
5 By Annisa v
6 An Abyan v
7 By Alif v
8 An Nurul v
8
Jumlah 156
Jumlah pasien 72
Pasien Bandung 63
Luar Bandung 9

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln Juli 2015- RSKIA

Tanggal No. Nama IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN

01/07/2015 1 By. Ny Dian v


2 By. Ny Vina v
3 An. Annisa v
4 An. Abyan v
5 An. Nurul v
6 An. Salia v
6

02/07/2015 7 By. Ny Dian v


8 By. Ny Vina v
9 An. Annisa v
10 An. Abyan v
11 An. Nurul v
12 An. Salia v
6

03/07/2015 13 By Rasya v
14 An annisa v
15 By. Arizki v
16 By. Raffi v
17 By Shamil v
18 By Saila v
19 BY. Arkan v
7

04/07/2015 20 by.kenji v
21 by.arka v
22 by.arizki v
23 by.m.taslim v
4

05/07/2015 24 by.kenji v
25 bym.taslim v
26 by.arka v
3

06/07/2015 27 by.kenji v
28 bym.taslim v
29 by.arka v
30 by.m.alzaki v
31 by.putri v
5

07/07/2015 32 M. Alzaki v
33 By. Fadilah v
34 By. Putri v
35 By. Arkan v
36 An. Yulian v
37 BY. Taslim v
38 An. NUrul v

08/07/2014 39 By. M alzaki v


40 By Fadilah v
41 An. Yulian v
42 BY. Zulfan v
43 By. Arkan v
44 An. Nurul v
45 AN. aLFATIH v
46 By. Bembi v
47 By. Taslim v

09/07/2015 48 aN. yULIAn v


49 An. Hilman v
50 An Dianda v
51 By Zulfan v
52 By Rafa v
53 By Arkan v
54 AN. Nurul v
55 An. Alif v
56 An. Bembi v
57 By Taslim v

10/07/2015 58 aN. yULIAn v


59 An. Hilman v
60 An Dianda v
61 By Rafa v
62 By Arkan v
63 AN. Nurul v
64 An. Bembi v
65 By Taslim v

11/07/2015 66 An. Kartika v


67 By. Rafa v
68 BY Arkan v

12/07/2015 69 An. Kartika v


70 By. Rafa v
71 By. Arkan v
13/07/2015 72 By Friska v
73 By. rafa v
74 By Arkan v
75 By Yaqhdan v
76 An Kartika v
77 An. Zakir v

14/07/2015 78 An. Aqilla v


79 By Yaqdhan v
80 By Arkan v
81 An kartika v
82 an. zakir v
83 an dalisa v

15/07/2015 84 An. Aqilla v


85 By Yaqdhan v
86 By Arkan v
87 an. zakir v
88 an dalisa v
89 By dafa v

16/07/2015 90 By Aqilla v
91 By Dafa v
92 By Yaqdhan v
93 By Arkan v
94 An Revin v
95 An. Zakir v

17/08/2015 96 By Dafa v
97 By Arkan v
98 An Revan v

18/07/2015 99 By Arkan v
100 An. M. Latief v

19/07/2015 101 By Arkan v


102 An. M. Latief v
103 An. Rizky v

20/07/2015 104 By Arkan v


105 An. M. Latief v
106 An. Rizky v

21/07/2015 107 An. M. Latief v


108 An. Rizky v

22/07/2015 109 an.rizky v


110 by.bilqis v

23/07/2015 111 an.rizky v


112 by.bilqis v

24/07/2015 113 by.bilqis v


114 an.arya v
115 by.cinta v

25/07/2015 116 By Bilqis v


117 By. Cinta v
118 An. Ariya v

26/07/2015 119 By Bilqis v


120 By Cinta v
121 By. Sapna v
122 An Ariya v
123 By Syla v

27/07/2015 124 By Bilqis v


125 An. Ariya v
126 By Syela v

28/07/2015 127 By Bilqis v

29/07/2015 128 By. Bilqis v


129 An. Saila v
130 By. Kinanti v
131 By Fatima v

30/07/3015 132 By. Bilqis v


133 An. Saila v
134 By. Kinanti v
135 By Fatima v
136 An. Rava v

31/07/2015 137 By. Bilqis v


138 An. Saila v
139 By. Kinanti v
140 By Fatima v
141 An. Rava v
142 By Adam v
143 BY Alkhalif v
144 An Rizky v

JUMLAH TOTAL 141 0 0 0 0


JUMLAH PASIEN 67

KESIMPULAN 0%

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln Agustus 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2015 1 By. Bilqis v
2 By Adam v
3 By Fatima v
4 By Alkhalif v
5 By Rizky v
6 An Saila v
7 An. Rava v
8 By Kinanti v

02/08/2015 9 An. Febrian v


10 By Rizky v
11 An. Naura v
13 An. Rava v

03/08/2015 14 By Naura v
15 An Fabian v
16 By Rizky v

04/08/2015 17 An. Fahrizal v


18 By Sheryl v
19 By Audrey v
20 By Idrus V

05/08/2016 21 An. Fahrizal v


22 By Sheryl v
23 By Audrey v
24 By Idris v
25 an.salsa v
26 by.rifa v
27 an.fahmi v

06/08/2015 28 An. Fahrizal v


29 By Sheryl v
30 By Audrey v
31 By Idris v
32 an.salsa v
33 by.rifa v
34 an.fahmi v
35 an.delisha v

07/08/2015 36 By Sheryl v
37 By Audrey v
38 By Idris v
39 by.rifa v
40 an.fahmi v
41 an.delisha v

08/08/2015 41 an.raniah v
42 an.hafidz v
43 by.idris v
44 by.siti v
45 an.fitri v
46 an.ayyasi v
47 an.ricco v

09/08/2015 48 an.raniah v
49 an.fitri v
50 an.ayyasi v
51 by.idris v

10/08/2015 52 an.lithfi v
53 by.ibrahim v
54 an.raniah v
55 an.karim v
56 an.subagja v
57 by.jacob v
58 an.ayyasi v
59 by.idris v

11/08/2015 60 an.hanan v
61 by.idris v
62 an.raniah v
63 an.diwani v
64 an.azzam v

12/08/2015 65 an.hanan v
66 an.diwani v
67 an.azzam v

13/08/2015 68 by.qawulan v
69 an.nizar v
70 an.fazly v

14/08/2015 71 by.ibrahim v
72 by.qawulan v
73 an.nizar v
74 an.fazly v

15/08/2015 75 an.raffi v
76 an.raditya v
77 by.fauzan v
78 by.rangga v
79 an.fazly v

16/08/2015 80 by.rangga v

17/08/2015 81 By Rangga v
82 By Al-Fatih v

18/08/2015 83 By. Alfatih v


84 By. Syami v
85 By Nabila v
86 By. Balqis v
87 An. Aldi v

19/08/2015 88 By Alfatih v
89 By Nabila v
90 An. Syami v
91 By Balqis v
92 BY Darendra v
93 An. Aldi v

20/08/2015 94 by.faiz v
95 by.ranza v
96 an.ananda v
97 an.aldi v
98 an.zaskia v

21/08/2015 99 An. M Aldi v


100 An. Zaskia v
101 By Faiz v
102 By Ranza v
103 An. Ananda v

22/08/2015 104 An. M Aldi v


105 An. Zaskia v
106 By Faiz v
107 By Ranza v
108 An. Ananda v
109 By Rangga v
110 By Gibran v
111 By Rizky v
112 An. M. Fadli v

23/08/2015 113 By Rangga v


114 By Gibran v
115 By Rizky v
116 An zaskia v
117 An. Fadli v

24/08/2015 118 By Rangga v


119 By Gibran v
120 By Rizky v
121 An zaskia v
122 An. Fadli v
123 By. Dewangga v
124 An. Marshanda v

25/08/2015 125 By. Rangga v


126 By. Alba v
127 An. Ragil v
128 An. Rayhan v
129 By. Dewangga v
130 An. Marshanda v
131 By. Rifal v

26/08/2015 132 by.alfariel v


133 an.m.rega v
134 an.mikayla v
135 an.latifa v
136 an.rifal v

27/08/2015 137 by.alfariel v


138 an.m.rega v
139 an.mikayla v
140 an.latifa v
141 by.deandra v
142 an.salvia v
143 an.riki v

28/08/2015 144 an.latifa v


145 by.deandra v
146 an.salvia v
147 an.riki v
148 by.alfariel v
149 an.m.rega v

29/08/2015 150 By Fahmi v


151 By Sophia v
152 By Gilang v
153 An. Latifa v
154 An. M. Rega v
155 By Deandra v
156 An. Salvia v
157 By. Alfarezky v
158 By Alfariel v
159 An. Riki v

30/08/2015 160 By Fahmi v


161 By Sophia v
162 By Galang v
163 An. HAfidz v
164 By Rega v
165 By Deandra v
166 An Salvia v
167 By Alfarezky v
168 An. Riki v

31/08/2015 169 By Fahmi v


170 By Sophia v
171 By HAfidz v
172 By Rega v
173 An. NAila v
174 An. Bilal v
175 An. Salvia v
176 By Alfarezky v
177 An Riki v

jumah pasein 91

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln September 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2015 1 by.fahmi v
2 by.renza v
3 by.latif v
4 an.naila v
5 an.bilal v
6 an.riki v

02/09/2015 7 by.fahmi v
8 by.renza v
9 by.latif v
10 an.jahran v
11 an.naila v
12 an.bilal v
13 by.kanatan v
14 an.fadlian v
15 an.aziz v

03/09/2015 16 by.fahmi v
17 by.renza v
18 by.latif v
19 an.jahran v
20 an.naila v
21 an.bilal v
22 by.kanatan v
23 an.fadlian v
24 an.aziz v

04/09/2015 25 an.riki v
26 by.novia v
27 by.rubi v
28 an.jahran v
29 an.fadli v
30 an.naila v
32 an.zahiya v
33 an.khaiza v

05/09/2015 34 by.novia v
35 by.rubi v
36 an.jahran v
37 an.naila v
38 an.zahiya v
39 an.khaiza v
40 by.rubi v
41 by..novia v

06/09/2015 42 an.jahran v
43 an.m.ali v
44 by.m.alif v

07/09/2015 45 an.arli v
46 by.putri v
47 an.aldo v
48 an.raditya v
49 an.m.alif v
50 an.nadila v

08/09/2015 51 an.arli v
52 by.putri v
53 by.aldo v
54 by.ali v
55 an.raditya v
56 an.nadila v
57 by.m.alif v

09/09/2015 58 by.putri v
59 an.aldo v
60 by.ali v
61 an.nazhifa v
62 an.raditya v

10/09/2015 63 by.putri v
64 an.nazhifa v
65 an.aldo v
66 by.ali v
67 an.raditya v
68 an.naufal v
69 by.dzikri v

11/09/2015 70 by.putri v
71 an.nazhifa v
72 an.aldo v
73 by.senja v
74 by.alifia v
75 by.m.dzikri v

12/09/2015 76 by.putri v
77 an.nazhifa v
78 by.senja v
79 by.alifia v
80 by.m.dzikri v
81 an.aldy v
82 an.raihan v

13/09/2015 83 By. Senja v


84 By. Putri v
85 An. Aldy v
86 By. Hafidz v
87 By. Renaldi v
88 By. Alifia v
89 An. Raihan v
90 By. Revan v

14/09/2015 91 by.dina v
92 an.aldy v
93 by.hafidz v
94 by.renaldi v
95 an.raihan v

15/09/2015 96 by.dina v
97 an.aldy v
98 by.hafidz v
99 by.renaldi v
100 an.raihan v
101 by.arsyila v
102 by.alviano v

16/09/2015 103 by.dina v


104 an.aldy v
105 by.hafidz v
106 by.renaldi v
107 an.raihan v
108 by.arsyila v
109 by.alviano v

17/09/2015 110 by.dina v


111 an.aldy v
112 by.hafidz v
113 by.renaldi v
114 an.raihan v
115 by.arsyila v
116 by.alviano v

18/09/2015 117 by.naufal v


118 an.kinara v
119 by.syakira v

19/09/2015 120 by.naufal v


121 an.syakira v
123 an.risma v
124 an.kinara v
125 by.rizky v

20/09/2015 126 by.naufal v


127 an.rizki v
128 by.kinara v
129 an.risma v

21/09/2015 130 an.risma v


131 by.rafael v
132 an.bunga v
133 by.nugi v
134 an.alifia v

22/09/2015 135 an.bunga v


136 an.risma v
137 by.rafael v

23/09/2015 138 an.bunga v


139 an.risma v
140 by.aqlan v
141 by.mikaela v

24/09/2015 142 an.bunga v


143 an.risma v
144 by.aqlan v
145 by.mikaela v

25/09/2015 146 by.benzema v


147 an.risma v
148 an.naura v
149 by.aqlan v
150 by.m.fitra v
151 an.arif v

26/09/2015 152 by.benzema v


153 an.risma v
154 an.naura v
155 by.aqlan v
156 by.m.fitra v
157 an.arif v

27/09/2015 158 by.benzema v


159 an.m.rafi v
160 by.arkan v

28/09/2015 161 by.benzema v


162 by.anindia v
163 an.rafi v
164 by.raihan v
165 by.arkan v

29/09/2015 166 An. Hilyatul v


167 By. Anindia v
168 An. Rafi v
169 An. Kyran v
170 By. Raihan v
171 By. Rido v
172 An. M. Awaludin v

30/09/2015 173 An. Fatimah v


174 An. Hilyatul v
175 By. Kyran v
176 By. Pasha v
176

jumlah pasien 84

Formulir Survey Harian Pemakaian Alat


Ruang Ruang Anak Bulan Oktober 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2015 1 By. Kyran v
2 An. Hilyatul v
3 By. Pasha v
4 By. Fika v
5 An. Chelsea v
6 By. Kayla v
7 By. Ridho v
8 By. Awaludin v

02/10/2015 9 By. Pasha v


10 By. Fitra v
11 By. Kayla v
12 By. M. Rido v
13 An. Sakir v

03/10/2015 14 An. Sakir v

04/10/2015 15 By. Al Fatih v


16 By. Nabila v
17 An. M. Ryu v

05/10/2015 18 by.alfatih v
19 by.nabila v
20 an.m.ryu v
21 by.vero v

06/10/2015 22 by.alfatih v
23 aby.nabila v
24 an.m.ryu v
25 by.helmi v
26 by.karina v
27 by.kahfi v

07/10/2015 28 by.alfatih v
29 aby.nabila v
30 an.m.ryu v
31 by.helmi v
32 by.karina v
33 by.kahfi v
34 by.banyu v
35 by.zahara v

08/10/2015 36 by.alfatih v
37 by.helmi v
38 by.syakira v
39 by.zahra v
40 by.sifa v
41 an.banyu v

09/10/2015 42 by.alfatih v
43 by.abizar v
44 by.zahra v
45 by.syakira v
46 by.sifa v
47 an.banyu v

10/10/2015 48 by.alfatih v
49 an.nabil v
50 by,syakira v
51 by.abizar v

11/10/2015 52 By. Al-fatih v


53 An. M. Nabil v
54 By. M. Alvin v
55 By. Reza v
56 An. Syakira v
57 By. Safitri

12/10/2015 58 By. Al-fatih v


59 An. Nabil v
60 By. M. Alvin v
61 By. Reza v
62 By. Safitri v
63 An. Al kindi v

13/10/2015 64 By. Al fatih v


65 An. Nabil v
66 An. M. Alvin v
67 By. Nur Azmi v
68 By. Safitri v
69 An. Al kindi v

14/10/2015 70 By. Qaireen v


71 By. Nur azmi v

15/10/2015 72 By. Alfi v

16/10/2015 73 By. Alfi v


74 An. Adelia v
75 An. Billy v
76 An. Boni v
77 By. Revera v
78 By. Hakim v

17/10/2015 79 by.alfi v
80 an.adelia v
81 an.billy v
82 an.boni v
83 by.reveera v
84 by.hakim v

18/10/2015 85 an.adelia v
86 by.alfi v
87 an.billy v
3

19/10/2015 88 an.adelia v
89 by.alfi v
90 an.billy v
3

20/10/2015 91 an.adelia v
92 by.azka v
2

21/10/2015 93 an.adelia v
94 by.azka v
95 by.m.azka v
96 an.wildan v
97 an.ilham v
98 by.syakila v
6

22/10/2015 99 an.adelia v
100 by.azka v
101 by.m.azka v
102 an.wildan v
103 an.ilham v
104 by.syakila v
105 by.ny.sri v
7

23/10/2015 106 an.Adelia v


107 by.syakila v
108 by.gian v
109 an.elsen v
200 by.faziah v
5
24/10/2015 201 an.adelia v
202 by.elsen v
203 an.faziah v
204 an.regina v
4

25/10/2015 205 An. Adelia v


206 An. Elsen v
207 An. Faziyah v
208 An. Regina v

26/10/2015 209 an.fajar v


210 an.anisa v
211 by.elsen v
212 an.regina v

27/10/2015 213 an.anisa v


214 an.fitri v
215 by.elsen v
216 an.regina v
4

28/10/2015 217 an.aliando v


218 an.anisa v
219 by.winni v
3

29/10/2015 220 by.winni v


221 an.risfa v
222 by.nazril v
3
30/10/2015 223 by.nazril v
224 by.raisa v
225 by.marcel v
226 by.azalea v
227 by.aima v
5
31/10/2015 228 by.M.nazril v
229 By.marcel v
300 by.azalea v
301 by.aima v
302 by.raisa v
5

jumlah pasien 73

Formulir Survey Harian Pemakaian Alat


Ruang Ruang Anak Bulan November 2015

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2015 1 by.raisa v
2 by.nazril v
3 by.aima v
4 by.azalea v
4
0211/2015 5 by.azalea v
1

03/11/2015 6 an.hadi v
7 an.damar v
8 by.azalea v
3

04/11/2015 9 an.hadi v
10 an.zivana v
11 by.m.zaki v
12 by.azalea v
13 an.damar v
14 an.dhea v
6

05/11/2015 15 an.zivana v
16 an.hadi v
17 by.m.zaki v
18 an.eka v
19 by.azalea v
20 an.dhea v
6

06/11/2015 21 an.zivana v
22 an.hadi v
23 by.m.zaki v
24 an.eka v
25 by.azalea v
26 an.dhea v
6

07/11/2015 27 an.zivana v
28 an.hadi v
29 by.m.zaki v
30 by.azalea v
31 by.almydina v
5

08/11/2015 32 an.qaira v
33 an.yasfiani v
34 an.mita v
35 by.almydina v
4
09/11/2015 36 an.qaira v
37 an.yasfiani v
38 by.almydina v
39 an.mita v
4

10/11/2015 40 an.qaira v
41 an.yastiani v
42 by.alif v
43 an.mita v
44 an.nizar v
5

11/11/2015 45 an.raisa v
46 an.wildan v
47 an.nizar v
3

12/11/2015 48 an.raisa v
49 an.wildan v
50 an.nizar v
3

13/11/2015 51 an.gian v
52 an.raisa v
53 an.nizar v
3

14/11/2015 54 by.arsyil v
55 an.fadli v
56 by.gian v
57 an.kailani v
58 an.nizar v
5

15/11/2015 59 by.arsyil v
60 by.dinda v
61 an.fadli v
62 an.m.arfa v
63 an.kailani v
5

16/11/2015 64 by.dinda v
65 an.fadli v
2

17/11/2015 66 by.dinda v
67 an.fadli v
2
18/11/2015 68 an.Dimas v
69 An.zakia v
2
19/11/2015 -

20/11/2015 70 by.ardana v
71 an.sesil v
2
21/11/2015 72 by.ardana v
73 an.sesil v
2
22/11/2015 -

23/11/2015 74 By. Ufaira v


75 By. Gendis v
76 An. Arsaka v
77 By. Mikayla v
4

24/11/2015 78 By. Ufaira v


79 By. Gendis v
80 By. Mikayla v
3
25/11/2015 81 By. Ufaira v
82 By. Gendis v
83 By. Mikayla v
3

26/11/2015 84 by.gendis v
85 by.ufaira v
86 an.rizal v
87 an.m.adyana v
88 by.m.fachri v
5

27/11/2015 89 by.gendis v
90 by.rayi v
91 an.dzakira v
92 by.m.fachri v
93 an.rizal v
94 an.m.adyana v
95 by.ufaira v
7

28/11/2015 96 by.gendis v
97 by.rayi v
98 an.dzakira v
99 by.m.fachri v
100 an.rizal v
101 an.m.adyana v
102 by.ufaira v
7

29/11/2015 103 an.dzakira v


104 an.m.adyana v
2

30/11/2015 105 An Anjasari v


106 An. Rizal v
2

106
jumlah pasien 50

Formulir Survey Harian Pemakaian Alat


Ruang anak bln Desember 2015- RSKIA

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2015 1 by.melia v
2 by.anjasi v
02/12/2015 3 an.melia v
4 an.ibrahim v
5 by.rio v
6 an.anjasi v
7 an.miftah v

03/12/2015 8 an.melia v
9 an.ibrahim v
10 by.rio v
11 by.miftah v
12 by.khalifa v

04/12/2015 13 by.rio v
14 by.khalifa v
15 by.miftah v
16 an.melia v
17 an.ibrahim v

05/12/2015 18 by.sabrina v
19 an.kinara v
20 by.marwah v

06/12/2015 21 by.sabria v
22 by.m.wais v
23 an.aisyah v

07/12/2015 24 by.m.wais v
25 an.aisyah v

08/12/2015 26 by.m.wais v
27 an.aisyah v
09/12/2015 28 by.m.wais v

10/12/2015 29 by.syakila v
30 an.izzatul v
31 an.m.parel v

11/12/2015 32 by.syakila v
33 an.izzatul v
34 an.m.parel v

12/12/2015 35 an.m.parel v
36 an.m.jamaludin v
37 by.m.reza v
38 an.aufar v

13/12/2015 39 by.m.jamaludin v
40 an.m.parel v

14/12/2015 41 by.m.jamaludin v
42 an.m.parel v

15/12/2015 43 An. Sayid v

16/12/2015 44 An. Sayid v


By. Rerenzia v

17/12/2015 45 By. Sayid v


46 By. Rerenzia v
47 By. Azka v

18/12/2015 48 An. Rerenzia v


49 An. Haikal v
50 An. Shinta v
51 An. Azka v
52 An. M. Jainal v

19/12/2015 53 An. Shinta v


54 An. Haikal v
55 By. Asyifa v
56 By. Salma v
57 By. Azka v
58 By. Jainal v

20/12/2015 58 An. Shinta v


59 An. Andini v
60 An. Haikal v
61 By. Asyifa v
62 By. Salma v
63 By. Azka v
64 By. Jainal v

21/12/2015 65 An. Shinta v


66 An. Andini v
67 An. Haikal v
68 By. Asyifa v
69 By. Salma v
70 By. Randani v
71 An. Jainal v

22/12/2015 72 an.shinta v
73 an.andini v
74 by.assyifa v
75 by.ramadani v
76 an.jainal v

23/12/2015 77 an.andini v
78 by.assyifa v
79 by.ramadani v
80 By. Japran v

24/12/2015 81 By. Japran v


82 By. Asyifa v
83 By. Ramadhani v

25/12/2015 84 By. M. Rian v

26/12/2015 85 By.M.Rian v
86 By.Wafa v

27/12/2015 87 by.rayhan v
88 by.wafa v

28/12/2015 89 by.reyhan v
90 by.wafa v
91 an.aditya v
92 an.rifqi v

29/12/2015 93 by.rayhan v
94 by.hilman v
95 an.arkhyti v
96 by.afnun v
97 an.aditya v
98 an.rifqi v

30/12/2015 99 an.hilman v
100 an.arkhyti v
101 by.afnun v
102 an.nabila v

31/12/2015 103 by.hilman v


104 an.arkhyti v
105 by.afnun v
106 an.nabila v
107 an.navia v

JUMLAH PASIEN 58

Formulir Survey Harian Pemakaian Alat


Ruang anak bln Januari 2016- RSKIA

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/01/2016 1 by. verrel v
2 by. M. Rizki v
3 An. Nabila v
4 by. Navia v

02/01/2016 5 by. verrel v


6 by. M. Rizki v
7 An. Nabila v
8 by. Navia v
9 by. Mahardika v

03/01/2016 10 by. Mahardika v


11 by. Verrel v

04/01/2016 12 by. Mahardika v

05/01/2016 -
06/01/2016 13 An. Ramadhan v
14 An. Raditian v

07/01/2016 15 An. Ramadhan v


16 An. Radytian v
17 By. Imam v

08/01/2016 18 by.imam v
19 by.m.alvi v

09/01/2015 20 by.m.alvi v
21 an.rindi v
22 an.adara v

10/01/2016 23 by.alvi v
24 an.rindi v
25 an.adara v

11/01/2016 26 by.alvin v
27 an.sendi v

12/01/2016 28 by.rizki v
29 by.alvi v
30 an.hera v
31 an.sendi v

13/01/2016 32 by.rizki v
33 by.alvi v
34 an.hera v
35 an.sendi v
36 an.alsab v

14/01/2016 37 by.alvi v
38 an.sendi v
39 an.alsab v
40 by.syam v

15/01/2016 41 by.alvi v
42 an.syam v
43 by.adifa v
44 an.rifki v

16/01/2016 45 by.alvi v
46 an.syam v
47 an.rifki v
48 an.nadira v
49 by.khalifa v

17/01/2016 50 An.Rifki v
51 An.nadira v

18/01/2016 52 An.Rifki v
53 An.Nadira v
54 By.Ibrahim v

19/01/2016 55 an.rifki v
56 an.nadira v
57 by.ibrahim v
58 by.mila v

20/01/2016 59 by.rayhan v
60 by.ibrahim v
61 by.mila v
62 by.salma v

21/01/2016 63 by.rayhan v
64 by.ibrahim v
65 by.mila v
66 by.salma v
67 by.quensha v

22/01/2016 68 by.quensha v
69 by.mila v
70 by.aufa v

23/01/2016 71 an.m.zaki v
72 by.m. aufa v

24/01/2016 73 An. M.Aufa v


74 An. Febiliana v
75 An. Mey v
76 By. Azam v
77 By. Dinda v
78 An. M. Zaki v

25/01/2016 79 by.m.aufa v
80 an.febiliana v
81 an. mey v
82 an.dinada v
83 an.pixie v
84 an.sinta v

26/01/2016 85 an.renatha v
86 by.m.aufa v
87 an.mey v
88 an.dinada v
89 an.pixie v
90 an.sinta v

27/01/2016 91 by.m.aufa v
92 an.dava v
93 an.mikayla v
94 by.ihsan v

28/01/2016 95 by.sabila v
96 an.rohman v
97 an.mikayla v
98 an.diva v
99 by.ihsan v

29/01/2016 100 by.sabila v


101 by.ihsan v
102 by.eza v
103 by.rohman v
104 by.mikayla v

30/01/2016 105 by.sabila v


106 by.ihsan v
107 by.eza v
108 by.rohman v
109 by.mikayla v
110 by.rafa v

31/01/2016 111 by.sabila v


112 by.eza v
113 by.milky v
114 an.indar v

jumlah pasien 73

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln februari 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/02/2016 1 by.eza v
2 by.milky v
3 an.indar v

02/02/2016 4 an.hasna v
5 by.siti v
6 by.umar v
7 by.reja v
8 by.nurainun v

03/02/2016 9 an.hasna v
10 by.siti v
11 by.umar v
12 by.nizam v
13 by.farhan v
14 by.devano v
15 by.reja v

04/02/2016 16 an.hasna v
17 by.siti v
18 by.umar v
19 by.nizam v
20 by.farhan v
21 by.devano v
22 by.reja v
23 by.farhan v

05/02/2016 24 by.siti v
25 by.umar v
26 by.nizam v
27 by.farhan v
28 by.devano v
29 by.reja v
30 by.farhan v

06/02/2016 31 By. Deviana v


32 By. Farhan v
33 An. Sayad v
34 By. Sandi v
35 By. Devano v
36 By. Reja v

07/02/2016 37 By. Aurelia v


38 By. Sayad v
39 By. Sandi v
40 An. Arkan v
41 An. Dedi v
42 By. Deviana v
43 By. Farhan v
44 By. Reja v

08/02/2016 45 By. Aurelia v


46 By. Sayad v
47 By. Sandi v
48 An. Arka v
49 By. Deviana v
50 By. Farhan v
51 By. Dedi v
52 By. Kailan v

09/02/2016 53 by.aurelia v
54 by.azka v
55 by.sandi v
56 an.arkan v
57 by.farhan v
58 an.wiki v
59 an.kailan v

10/02/2016 60 gibran v
61 albian v
62 sabrina v
63 azalea v
64 adrian v
65 wiki v
66 kailan v

11/02/2016 67 gibran v
68 albian v
69 sabrina v
70 azalea v
71 adrian v
72 naya v
73 wiki v
74 kailan v

12/01/2016 75 gibran v
76 albian v
77 sabrina v
78 azalea v
79 wiki v

13/02/2016 80 gibran v
81 albian v
82 sabrina v
83 azalea v
84 keisya v
85 wiki v
86 salsabila v

14/02/2016 87 Raditya v
88 Sabrina v
89 Gesta v
90 Fatma v
91 Wikki v
92 Salsabila v

15/02/2016 93 Raditya v
94 Rizkiya v
95 Gesta v
96 Fatma v
97 Wikki v
98 Salsabila v

16/02/2016 99 Raditya v
100 Kahfi v
101 Rizqia v
102 Gesta v
103 Fatma v
104 Tubagus v
105 Kiki v

17/02/2016 106 Kahfi v


107 Rizkia v
108 Fatma v
109 Tubagus v
110 Kiki v
111 Zahra v

18/02/2016 112 Kahfi v


113 Bintang v
114 Yudi v
115 Zahra v
116 Tubagus v
117 Fatma v
118 Qonita v

19/02/2016 119 lena v


120 yudi v
121 bintang v
122 zahra v
123 tubagus v
124 zavier v

20/02/2016 125 lena v


126 yudi v
127 siti v
128 zahra v
129 risma v
130 tubagus v
131 javier v
132 renaldi v

21/02/2016 133 siti v


134 risma v
135 tubagus v
136 abigel v
137 zavier v
138 renaldi v

22/02/2016 139 amika v


140 kanaysah v
141 siti v
142 abigel v
143 risma v
144 tubagus v
145 renaldi v

23/02/2016 146 amika v


147 kanaysah v
148 siti v
149 abigel v
150 jundi v

24/02/2016 151 amika v


152 siti v
153 novan v
154 raisa v
155 jundi v
156 ola v

25/02/2016 157 amika v


158 melati v
159 siti v
160 novan v
161 raisa v
162 rezky v
163 ola v

26/02/2016 164 amika v


165 melati v
166 ihsan v
167 sigit v
168 novan v
169 rezky v
170 ola v

27/02/2016 171 insan v


172 sigit v
173 nizam v
174 aluna v
175 rania v
176 rezky v
177 olla v
178 arsyila v

28/02/2016 179 aditya v


180 insan v
181 rania v
182 nizam v
183 aluna v
184 rangga v
185 rezky v
186 syafiq v

29/01/2016 187 aditya V


188 insan V
189 rania V
190 rangga V
191 nizam V
192 aluna V
193 syafiq V
194 nayla V

JUMLAH PASIEN 93

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln Maret 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2016 1 By. Aditya v
2 By. Insan v
3 An. Rangga v
4 An. Nizam v
5 An. Syafiq v
6 By. Nayla v

02/03/2016 7 By. Aditya v


8 By. Insan v
9 An. Rangga v
10 An. Syafiq v
11 An. Nizam v
12 An. Arni v
13 By. Annisa v

03/03/2016 14 By. Aditya v


15 By. Insan v
16 An. Rangga v
17 An. Syafiq v
19 An. Arni v
19 By. Annisa v
20 An. Razka v
21 By. Rezky v

04/03/2016 22 By. Insan v


23 An. Fadhil v
24 An. Arni v
25 An. RAngga v
26 An. Razka v
27 An. Danian v
28 An. Syafiq v
29 By. Rezky v

05/03/2016 30 By. Insan v


31 An. FAdhil v
32 An. Kara v
33 An. Alya v
34 An. Razka v
35 By. Rezky v

06/03/2016 36 An. Fadhil v


37 By. Insan v
38 An. Kara v
39 An. Alya v
40 An. Razka v
41 By. Galang v
42 By. Gendis v
43 By. Rezky v

07/03/2016 44 An. Insan v


45 An. Kara v
46 An. Alya v
47 An. Razka v
48 An. Galang v
49 by.gendis v
50 by.azka v

08/03/2016 51 an.insan v
52 by.anisa v
53 by.maulidana v
54 an.razka v
55 an.galang v
56 by.gendis v
57 by.azka v

09/03/2016 58 an.insan v
59 by.anisa v
60 by.maulidana v
61 by.alif v
62 by.galang v
63 by.alfiansyah v
64 by.gendis v
65 by.reihan v

10/03/2016 66 an.insan v
67 by.anisa v
68 by.maulidana v
69 by.alif v
70 by.galang v
71 by.alfiansyah v
72 by.gendis v
73 by.reihan v

11/03/2016 74 reihan v
75 dimas v
76 m.fassal v

12/03/2016 77 reihan v
78 m.fassal v
79 dimas v
80 khalisa v

13/03/2016 81 dimas v
82 nazwa v
83 khalisa v
84 haikal v
85 ragil v

14/03/2016 86 nazwa v
87 dimas v
88 khalisa v
89 haikal v
90 raqil v

15/03/2016 91 nazwa v
92 m.fadlan v
93 khalisa v
94 haikal v
95 raqil v

16/03/2016 96 m.fadlan v
97 jibran v
98 raqil v

17/03/2016 99 nadyla v
100 m.fadlan v
101 rania v
102 neng azka v
103 jibran v
104 alisa v
105 raqil v
106 dalil v

18/03/2016 107 nadyla v


108 m.fadlan v
109 rania v
110 neng azka v
111 dalil v
112 jibran v
113 raqil v

19/03/2016 114 nadyla v


115 neng azka v
116 dalil v
117 jibran v
118 alika v

20/03/2016 119 nadyla v


120 fikri v
121 dalil v
122 alika v
123 adelia v

21/03/2016 124 ezha v


125 nadine v
126 rayhan v
127 faqih v
128 fikri v
129 adiva v
130 adelia v

22/03/2016 131 ezha v


132 afrizan v
133 nadine v
134 rayhan v
135 fikri v
136 adwa v
137 adelia v

23/03/2016 138 afrizan v


139 rayhan v
140 naura v
141 adwa v
142 nazwa v

24/03/2016 143 afrizan v


144 naura v
145 anindita v
146 adwa v
147 nazwa v

25/03/2016 148 afizam v


149 irsyad v
150 luthfi v
151 naura v
152 anindita v
153 adwa v
154 nazwa v
155 raply v

26/03/2016 156 raply v


157 irsyad v
158 zian v
159 naura v
160 ramdhan v
161 lutfi v

27/03/2016 162 raply v


163 irsyad v
164 lutfi v
165 hamlan v
166 shafa v

28/03/2016 167 raply v


168 irsyad v
169 hamlan v
170 shafa v

29/03/2016 171 raply v


172 irsyad v
173 abdul v
174 azka v
175 hamla v
176 shafa v
177 farah v
178 putra v

30/03/2016 179 raply v


180 irsyad v
181 abdul v
182 azka v
183 hamla v
184 shafa v
185 farah v
186 putra v

31/03/2016 187 irsyad v


188 abdul v
189 azka v
190 putra v

jumlah pasien
kota bandung 70
luar kota 7

Formulir Survey Harian Pemakaian Alat


Ruang anak bln APRIL 2016- RSKIA

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2016 1 irsyad v
2 abdul v
3 azka v
4 putra v
5 rizki v
6 shifa v

02/04/2016 7 shifa v
8 putra v
9 irsyad v
10 azka v
11 dwi v

03/04/2016 12 shifa v
13 dwifani v
14 putra v
15 arkan v
16 maulidana v
17 ayub v

04/04/2016 18 shifa v
19 dwifani v
20 iqbal v
21 ayub v
22 arkan v
23 maulidana v

05/04/2016 24 Syifa v
25 Iqbal v
26 Abyan v
27 Ayub v
28 Akmal v
29 Arkan v
30 Maulida v
06/04/2016 31 abyan v
32 iqbal v
33 alfiansyah v
34 ayub v
35 akmal v
36 maulidana v

07/04/2016 37 alfiansyah v
38 abyan v
39 hasbi v
40 ayub v
41 akmal v
42 rizky v

08/04/2016 43 satria v
44 zulham v
45 hasbi v
46 ayub v
47 akmal v
48 rizky v
49 kevin v

09/04/2016 50 satria v
51 zulham v
52 kevin v

10/04/2016 53 satria v
54 zulham v

11/04/2016 55 daniel v
56 raya v
57 argiya v
58 arseno v

12/04/2016 59 arseno v
60 dea v
61 mirza v

13/04/2016 62 arseno v
63 dea v
64 galuh v
65 mirza v
66 afandi v

14/04/2016 67 afandi v
68 dea v
69 razka v
70 mirza v
71 arseno v
72 naya v
73 galuh v

15/04/2016 74 afandi v
75 razka v
76 mirza v
77 abizar v
78 abyan v
79 naya v
80 galuh v

16/04/2016 81 naya v
82 galuh v
83 afandi v
84 azka v
85 razka v
86 mirza v
87 inara v
88 abizar v
89 abyan v

17/04/2016 90 abyan v
91 abizar v
92 hasbi v
93 rama v
94 nurkeysa v
95 inara v
96 galuh v

18/04/2016 97 rama v
98 hasbi v
99 abyan v
100 abizar v
101 nurkeysa v
102 inara v
103 galuh v
104 azka v

19/04/2016 105 rama v


106 desti v
107 daren v
108 nurkeysa v
109 kaula v

20/04/2016 110 rama v


111 desti v
112 giansah v
113 nurkeysa v
114 kaula v

21/04/2016 115 rama v


116 desti v
117 giansyah v
118 arsyad v
119 nurkeysa v
120 kaula v
121 sifa v

22/04/2016 122 rama v


123 desti v
124 giansyah v
125 arsad v
126 kaula v
127 alvaro v

23/04/2016 128 giansyah v


129 alvaro v
130 kaisar v
131 arfan v
132 nadila v
133 zahra v

24/04/2016 134 nadia v


135 rifaldi v
136 giansyah v
137 arfan v
138 alvaro v
139 zahra v

25/04/2016 140 nadia v


141 rifaldi v
142 giansyah v
143 arfan v
144 zahra v
145 kaisar v

26/04/2016 146 nadia v


147 rivaldi v
148 giansyah v
149 arfan v
150 zahra v
151 azana v
152 adinda v
153 m.fikri v

27/04/2016 154 nadia v


155 rivaldi v
156 giansyah v
157 arfan v
158 m.fikri v
159 adinda v
160 zahra v

28/04/2016 161 nadira v


162 rifaldi v
163 giansyah v
164 arfan v
165 fikri v
166 adinda v
167 alif v

29/04/2016 168 fikri v


169 adinda v
170 m.agis v
171 sintya v

30/04/2016 172 m.agis v


173 destia v
174 sintya v
175 ira v
176 fikri v
177 adinda v
178 idwan v

jumlah pasien 85

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln MEI 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2016 1 m.agis v
2 destia v
3 sintia v
4 ira v
5 m.fikri v
6 adinda v
7 idwan v
8 anisa v

02/05/2016 9 m.agis v
10 destia v
11 ira v
12 yahya v
13 fikri v
14 adinda v
15 sinta v
16 anisa v

03/05/2016 17 adinda v
18 anisa v
19 yahya v

04/05/2016 20 adinda v
21 rhea v
22 anisa v
23 arsyad v
24 m.miftah v
25 yahya v
26 zhia v

05/05/2016 27 anisa v
28 arsyad v
29 yahya v

06/05/2016 30 anisa v
31 arsyad v
32 yahya v

07/05/2016 33 nisa v
34 putri v
35 arsyad v
36 melinda v

08/05/2016 37 ibnu v
38 putri v
39 anisa v
40 alkholifi v
41 melinda v
42 alvaro v
43 hari v

09/05/2016 44 alkholifi v
45 putri v
46 anisa v
47 zahra v
48 hari v

10/05/2016 49 alkhalifi v
50 putri v
51 anisa v
52 zahra v
53 hari v

11/05/2016 54 alkhalifi v
55 rival v
56 anisa v
57 aurelia v
58 akbar v

12/05/2016 59 rival v
60 anisa v
61 aurelia v
62 akbar v
63 rania hari v

13/05/2016 64 rival v
65 anisa v
66 aurelia v
67 akbar v
68 alfarizki v

14/05/2016 69 rival v
70 anisa v
71 aurelia v
72 akbar v
73 alfarizqi v

15/05/2016 74 anisa v
75 rival v
76 aurelia v
77 akbar v

16/05/2016 78 anisa v
79 rival v
80 aurelia v

17/05/2016 81 rival v
82 sadam v

18/05/2016 83 sadam v
84 azahra v

19/05/2016 85 sadam v
86 azahra v
87 desta v
88 inara v

20/05/2016 89 azahra v
90 rihanatul v
91 rian v
92 anugrah v
93 desta v
94 inara v

21/05/2016 95 Salsabila v
96 rihanatul v
97 rian v
98 anugrah v
99 inara v

22/05/2016 100 Afiqah v


101 Innara v
102 Renaldi v
103 Rian v
104 Anugrah v
105 Vina v

23/05/2016 106 rian v


107 afiqah v
108 vira v
109 rayhan v
110 renaldi v

24/05/2016 111 renaldi v


112 asti v
113 citra v
114 farhan v
115 vina v

25/05/2016 116 nayla v


117 renaldi v
118 asti v
119 rasya v
120 citra v
121 farhan v
122 vina v

26/05/2016 123 nada v


124 asti v
125 raffasa v
126 citra v

27/05/2016 127 nada v


128 asti v
129 raffasa v
130 citra v
131 daffa v
132 alika v

28/05/2016 133 nada v


134 fatan v
135 shaqila v
136 raffasa v
137 citra v
138 daffa v
139 alika v

29/03/2016 140 Nada v


141 M. Fatan v
142 Shabila v
143 Najma v
144 Citra v
145 Dafa v
146 Qisya v
147 Reyhan v

30/05/2016 148 Nada v


149 M. Fatan v
150 Shaqila v
151 Najma v
152 Daffa v
153 Qisya v
154 Reyhan v

31/05/2016 155 najma v


156 adli v

jumlah pasien
bandung 65
luar bandung 6

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln Juni 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2016 1 rafka v
2 najma v
3 adli v
4 arfan v

02/06/2016 5 rafka v
6 najma v
7 adli v
8 arfan v

03/06/2016 9 najma v
10 adli v

04/06/2016 11 aldi v
12 naufalia v
13 taufiqur v
14 nahl v
15 siti v

05/06/2016 16 taufiqur v
17 nahl v
18 siti v
19 irraiza v

06/06/2016 20 adhelia v
21 nahl v
22 irraiza v
23 siti

07/06/2016 24 nahl v
25 irraiza v
26 adhelia v
27 siti v
28 arsenio v
29 septian v

08/06/2016 30 adhelia v
31 siti v
32 arsenio v
33 septian v
34 m.abian v
35 ardiansyah v

09/06/2016 36 Salwa v
37 Arsenio v
38 Abyan v
39 Siti v

10/06/2016 40 haikal v
41 abyan v
42 siti v
43 rini v
44 salwa v
45 arka v
46 asyifa v

11/06/2016 47 haikal v
48 m.abyan v
49 siti v
50 rini v
51 salwa v
52 asyifa v
53 arka v

12/06/2016 54 Delisa v
55 Salwa v
56 Neyla v
57 Asyifa v
58 Haikal v
59 Abyan v
60 Siti v

13/06/2016 61 Delisa v
62 Nayla v
63 M.Sugih v
64 M.Adrian v
65 Haikal v
66 Abyan v
67 Siti v

14/06/2016 68 Sugih v
69 Adrian v
70 Haikal v
71 Putri v
72 Neyla v
73 Siti v

15/06/2016 74 putri v
75 siti v
76 sugih v
77 mey v

16/06/2016 78 putri v
79 siti v
80 abimanyu v
81 mey v
82 sugih v
83 elsa v

17/06/2016 84 abimanyu v
85 siti v
86 elsa v
87 mey v
88 fadlan v

18/06/2016 89 abimanyu v
90 nizar v
91 siti v
92 elsa v
93 mey v
94 fadlan v

19/06/2016 95 nizar v
96 elsa v
97 fairy v

20/06/2016 98 fairy v
99 elsa v

21/06/2016 100 Dinda v


101 Elsa v

22/06/2016 102 dinda v


103 elsa v
104 aqila v

23/06/2016 105 dinda v


106 elsa v
107 aqila v
108 Sapta v

24/06/2016 109 dylan v


110 rifqi v
111 sintia v

25/06/2016 112 dylan v


113 sintia v
114 Mutiara v
115 Katumbiri v
116 M. Radja v

26/06/2016 117 Dylan v


118 M.Radja v
119 Mutiara v
120 Khatumbiri v
121 Sintia v

27/06/2016 122 dylan v


123 m.radja v
124 khatumbiri v
125 alvin v
126 putri v

28/06/2016 127 dylan v


128 m.radja v
129 khatumbiri v
130 alvin v
131 putri v
132 Prabu v
133 Gilby v

29/06/2019 134 alvin v


135 putri v
136 Prabu v
137 Gilby v

30/06/2016 138 nazwa v


139 ali rajan v
139
jumlah pasien B 63
LB 6

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln JULI 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2016 1 ali v
2 nazwa v

02/07/2016 3 ali v
4 nazwa v
5 bintang v
6 arsa

03/07/2-16 7 bintang v
8 ali razzam v
9 arsa v
10 aditya v
11 m.abiel v
12 husna v

04/07/2016 13 bintang v
14 ali razzam v
15 aditya v
16 m.abiel v
17 husna v

05/07/2016 18 bintang v
19 aditya v
20 ali razzam v
21 m. abiel v
22 husna v

06/07/2016 23 M. Salman v

07/07/2016 24 M.salman v

08/07/2016 25 M. Salman v
09/07/2016 26 M.salman v
27 M.Zulkarnain v
28 M.Rasyid v

10/07/2016 29 M.Salman v
30 M.zulkarnain v
31 M.Rasyid v
32 Devita v

11/07/2016 33 devita v
34 m.rasyid v
35 m.zulkarnain v

12/07/2016 36 humaira v
37 aliya v

13/07/2016 38 aliya v
39 putri v
40 ghaida v

14/07/2016 41 putri v
42 ghaida v

15/07/2016 43 putri v
44 keyla v
45 nabilah v

16/07/2016 46 keyla v
47 nabilah v
48 putri v
49 tria v

17/07/2016 50 keyla v
51 nabila v
52 tria v

18/07/2016 53 nabila v
54 tria v
55 adiba v
56 abidzar v
57 azkha v

19/07/2016 58 adiba v
59 abidzar v
60 azkha v

20/07/2016 61 adiba v
62 abidzar v
63 azkha v
64 m.riza v

21/07/2016 65 abidzar v
66 hamzari v

22/07/2016 67 nadira v
68 hamzari v
69 falih v
70 nazar v
71 nayara v
72 berdikari v
73 abidzar v
74 azka v

23/07/2016 75 nadira v
76 hamzari v
77 falih v
78 nazar v
79 nayara v
80 azka v
81 berdikari v

24/07/2016 82 nadira v
83 falih v
84 anindita v

25/07/2016 85 anindita v
86 syafiq v

26/07/2016 87 SYAFIQ v
88 qweni v
89 alif v
90 anindita v
91 natan v

27/06/2016 92 alif v
93 natan v

28/07/2016 94 fatimah v
95 raffi v
96 natan v
97 mikayla v

29/07/2016 98 fatimah v
99 raffi v
100 randi v
101 adinda v
102 abraham v
103 ramadhani v

30/07/2016 104 Fatimah v


105 Rafi v
106 Randi v
107 Adinda v
108 Abraham v
109 Ramadani v
110 Mondy v

31/07/2016 111 Randi v


112 Riskiya v
113 Ramadani v
114 Aqilla v
115 Mondy v

jumlah pasien
bandung 60
luar bandung 5

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln Agustus 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2016 1 rima v
2 mondy v
3 riskya v

02/08/2016 4 rima v
5 senja v
6 mondy v
7 elsa v

03/08/2016 8 rima v
9 senja v
10 mondy v

04/08/2016 11 rima v
12 siti v
13 m.rezky v
14 bunga v

05/08/2016 15 rima v
16 azka v
17 bunga v
18 m.rezky v
19 siti v
20 zahra v

06/08/2016 21 rima v
22 m.rezky v
23 nabila v
24 azka v
25 siti v
26 zahra v
27 bunga v

07/08/2016 28 devi v
29 zahra v
30 rima v
31 rezky v
32 nabila v
33 azka v

08/08/2016 34 devi v
35 rima v
36 azka v

09/08/2016 37 devi v
38 hafiz v
39 reyhan v
40 jefry v
41 azka v

10/08/2016 42 hafiz v
43 fakhirah v
44 reyhan v
45 jefry v
46 azka v

11/08/2016 47 hafiz v
48 fakhirah v
49 fathan v
50 devi v
51 azka v
52 akka v
53 sahril v

12/08/2016 54 fathan v
55 devi v
56 fakhirah v
57 cahya v
58 akka v
59 sahril v

13/08/2016 60 fathan v
61 devi v
62 nindi v
63 fakhirah v
64 akka v
65 sahril v

14/08/2016 66 fakhirah v
67 khanza v
68 syifa v

15/08/2016 6970 fakhirah v


71 khanza v
72 syifa v

16/08/2016 73 fakhirah v
74 khanza v
75 syifa v

17/08/2016 76 khanza v
77 syifa v

18/08/2016 78 aryo v
79 dafa v
80 abdul v

19/08/2016 81 aryo v
82 daffa v
83 intan v
84 gaza v

20/08/2016 85 daffa v
86 intan v
87 khiar v

21/08/2016 88 intan v
89 alifiandra v

22/08/2016 90 intan v
91 putra v
92 alifiandra v

23/08/2016 93 alifiandra v
94 m.rival v
95 raditya v

24/08/2016 96 m.rival v
97 raditya v
98 m.fikri v

25/08/2016 99 zavanya v
100 m.rifki v
101 m.sheeva v
102 m.rifal v
103 raditya v
104 harsa v

26/08/2016 105 gendis v


106 m.rifki v
107 farwa v
108 m.sheeva v
109 m.rifal v
110 raditya v
111 harsa v

27/08/2016 112 gendis v


113 m.rifki v
114 farwa v
115 m.sheeva v
116 harsa v

28/08/2016 117 gendis v


118 m.rifki v
119 ranfi v
120 nabila v
121 aditya v
122 raditya v

29/08/2016 123 gendis v


124 nabila v
125 m.rifki v
126 ranti v
127 aditya v
128 raditya v

30/08/2016 129 aditya v


130 m.rifki v
131 m.adila v
132 mita v

31/08/2016 133 mita v


134 m.rifki v
135 m.adila v
136 m.aditya v

jumlah pasien 75
bandung 64
luar bandung 11

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln September 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2016 1 m.aditya v
2 mita v
3 m.rifki v
4 rezki v

02/09/2016 5 rezki v
6 m.lutfan v
7 yasa v
8 rayhan v

03/09/2016 9 rezki v
10 m.lutfan v
11 yasa v
12 rayhan v
13 bre v

04/09/2016 14 rezki v
15 m.lutfan v
16 rasya v
17 rayhan v
18 kania v
19 m.fahri v

05/09/2016 20 rezki v
21 m.lutfan v
22 rasya v
23 kania v
24 m.fahri v

06/09/2016 25 rezki v
26 m.lutfan v
27 rasya v
28 alesha v

07/09/2016 29 rezki v
30 kamila v
31 indar v
32 rani v
33 anira v

08/09/2016 34 rezki v
35 kamila v
36 indar v
37 rani v
38 anira v
39 nabil v
40 najwan v

09/09/2016 41 najwan v
42 hasan v
43 m.meinas v

10/09/2016 44 najwan v
45 hasan v
46 m.almeinas v
47 m.aldebaran v

11/09/2016 48 Najwan v
49 Al-Meinas v
50 Ahsan v
51 Al debaran v
52 Adnan v
53 Nazwa v
54 Fauzan v

12/09/2016 55 Najwan v
56 Fauziah v
57 Al debaran v
58 Adnan v
59 Nazwa v

13/09/0206 60 Najwan v
61 Al debaran v
62 Adnan v
63 Nazwa v

14/09/2016 64 Najwan v
65 Adnan v
66 M. Zaki v
67 Alif v

15/09/2016 68 haifa v
69 m.zaki v
70 alif v
71 pratama v

16/09/2016 72 Zidan v
73 Haifa v
74 Fadhil v
75 M. Zaki v
76 Pratama v
77 Syahila v
78 Alif v

17/09/2016 79 Zidan v
80 FAdhil v
81 Pratama v
82 Syahila v
83 Indira v

18/09/2016 84 Fadhil v
85 Alika v
86 Indira v
87 Adnan v

19/09/2016 88 Fadhil v
89 Alika v
90 Indira v
91 Adnan v

20/09/2016 92 indira v

21/09/2016 93 aas v
94 indira v
95 arya v

22/09/2016 96 aas v
97 indira v
98 arya v
99 alesha v
100 haikal v
101 cep ahmad v

23/09/2016 102 aas v


103 alesha v
104 arya v
105 cep ahmad v
106 M. fahmi v
107 haikal v
108 indira v

24/09/2016 109 aas v


110 cep ahmad v
111 arya v
112 alesha v
113 M. fahmi v
114 haikal v
115 indira v

25/09/2016 116 aas v


117 cep ahmad v
118 alesha v
119 M. fahmi v
120 haikal v
121 indira v

26/09/2016 122 cep ahmad v


123 alesha v
124 m. fahmi v
125 haikal v
126 rafa v

27/09/2016 127 elvina v


128 rafa v
129 reza v

28/09/2016 130 elvina v


131 reza v

29/09/2016 132 algi v


133 elvina v
134 habibi v
30/9/2016 135 algi V
136 luthfi V
137 elvina V
138 habibi V
139 raffi V
140 insan V
141 radhika V

Jumlah pasien dalam 66


luar 11

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln OKTOBER 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2016 1 algi v
2 lutfhi v
3 rahma v
4 putra v
5 arya v
6 insan v
7 radhika v

02/10/2016 8 algi v
9 lutfhi v
10 rahma v
11 putra v
12 arya v
13 insan v
14 radhika v

03/10/2016 15 lutfhi v
16 rahma v
17 syafira v
18 radhika v
19 insan v
20 arya v

04/10/2016 21 rahma v
22 syafira v
23 radhika v
24 insan v
25 arya v
26 azis v

05/10/2016 27 Arya v
28 M. Aziz v
29 Maisyara v
30 Rahma v

06/10/2016 31 Arya v
32 M. Aziz v
33 Maisyara v
34 Rahma v

07/10/2016 35 Qirani v
36 Miftah v
37 Reza v

08/10/2016 38 qirani v
39 miftah v
40 m.dirga v
41 m.azis v
42 raditya v

09/10/2016 43 miftah v
44 m.dirga v
45 rifa v
46 m.azis v
47 raditya v

10/10/2016 48 miftah v
49 m.dirga v
50 rifa v
51 m.azis v
52 raditya v

11/10/2016 53 devita v
54 nur aini v
55 raditya v
56 rifa v
57 m.azis v

12/10/2016 58 nur aini v


59 m.azis v

13/10/2016 60 nur aini v

14/10/2016 61 Karim v
62 Nur Aini v
63 Fina v

15/10/2016 64 Karim v
65 Nur Aini v
66 Fina v

16/10/2016 67 Faiza v
68 M. Adrian v

17/10/2016 69 ghozi v
70 m.adrian v
71 faiza v
72 syifa v

18/10/2016 73 faiza v
74 syifa v
75 ghozi v

19/10/2016 76 faiza v
77 kanya v
78 bening v
79 khairunisa v

20/10/2016 80 faiza v
81 khairunisa v
82 bening v
83 kanya v
84 m.faqih v
85 benzema v

21/10/2016 86 faiza v
87 kanya v
88 benzema v

22/10/2016 89 Benzema v
90 Gideon v
91 Faiqa v
92 Faiza v
93 Akram v

23/10/2016 94 Benzema v
95 Gideon v
96 Faiqa v
97 Windri v
98 Akram v

24/10/2016 99 Benzema v
100 Gideon v
101 Faiqa v
102 Windri v
103 Akram v

25/10/2016 104 Windri v

26/10/2016 105 Windri v

27/10/2016 106 Nazma v


107 Putra v
108 M.Adam v

28/10/2016 109 M.Adam v


110 Alif v
111 M.Sabilul v
29/10/2016 112 Al Matik v
113 Adam v
114 Alif v
115 Sabilul v
116 Zafira v
117 M.Faizal v

30/10/2016 118 Alif v


119 Zafira v
120 Faisal v
121 Al Matik v

31/10/2016 122 Alif v


123 Zafira v
124 Faisal v
125 Al Matik v

JUMLAH PASIEN
BANDUNG 57
LUAR BANDUNG 11
68

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln NOVEMBER 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/11/2016 1 TAUFIQ V
2 M.FAISAL V
3 YESICA V
4 JASMIN V
5 TAUFIQUR V
6 M.ALMATIC V

02/11/2016 7 m.al matic v


8 m.faisal v
9 taufik v

03/11/2016 10 taufik v
11 hifdzil v
12 chika v
13 shintya v
14 rania v

04/11/2016 15 Taufik v
16 Hifdil v
17 Adfa v
18 Naisa v
19 Raisha v
20 Shintia v
21 Rania v
22 Naufal v

05/11/2016 23 Taufik v
24 Hifdil v
25 Adfa v
26 Mishael v
27 Naisa v
28 Raisa v
29 Naufal

06/11/2016 30 Taufik v
31 Naufal v
32 Adfa v
33 Mishael v
34 Naisa v
35 Raisa v

07/11/2016 36 taufik v
37 adfa v
38 mishael v
39 naisa v
40 raisa v

08/11/2016 41 taufik v
42 adfa v
43 raisa v
44 dias v
45 cheryl v

09/11/2016 46 taufik v
47 adfa v
48 raisa v
49 dias v
50 cheryl v
51 alisha v
52 yusbar v
53 gio v

10/11/2016 54 taufik v
55 adfa v
56 raisa v
57 dias v
58 cheryl v
59 alisha v
60 yusbar v
61 gio v

11/11/2016 62 taufik v
63 yusbar v
64 marwa v

12/11/2016 65 taufik v
66 yusbar v

13/11/2016 67 taufik v
68 yusbar v
69 alifia v
70 fabrizia v
71 yuyun v
72 putra v

14/11/2016 73 fabrizia v
74 taufik v
75 alifia v
76 yuyun v
77 putra v

15/11/2016 78 alifia v
79 yuyun v
80 yoga v
81 adrian v
82 sifa v

16/11/2016 83 yoga v
84 adrian v
85 sifa v
86 aisyah v
87 rizky v

17/11/2016 88 rizky v
89 sifa v
90 asyraf v
91 alif v

18/11/2016 92 rizky v
93 asyraf v
94 arfan v
95 sifa v
96 alif v

19/11/2016 97 arfan v
98 asyraf v
99 sifa v
100 m.fadil v
101 innara v

20/11/2016 102 asyraf v


103 fadil v
104 shifa v
105 innara v

21/11/2016 106 asyraf v


107 m.fadil v
108 sabrina v
109 alika v
110 innara v

22/11/2016 111 asyraf v


112 sabrina v
113 alika v
114 innara v

23/11/2016 115 m.salimul v


116 asyraf v
117 m.hafiz v
118 innara v
119 abizar v

24/11/2016 120 m.salimul v


121 putri v
122 asyraf v
123 abizar v
124 m. hafiz v
125 innara v

25/11/2016 126 M.Salimul v


127 Putri v
128 Asyraf v
129 Abizar v
130 Rizki v
131 Innara v

26/11/2016 132 innara v


133 abidzar v
134 dzaki v

27/11/2016 135 dzaki v


136 abizar v

28/11/2016 137 Dzaki v


138 M.Zikra v
139 Keyla v

29/11/2016 140 M. Zikra v


141 Keyla v

30/11/2016 142 m.zikra v

jumlah pasien
bandung 59
luar bandung 7

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln Desember 2016

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/12/2016 1 Rivki v
2 Fathurasya v
3 M.Dzikra v
4 M. Iqbal v

02/12/2016 5 M. Dzikra v
6 Fathurrsya v
7 Nabila v
8 Khalifa v
9 Bela v
10 M. Ikbal v
11 Rivky v

03/12/2016 12 Nabila v
13 Shifa v
14 Khalifa v
15 Bela v
`16 M. Ikbal v
17 Rivki v

04/12/2016 TIDAK DIISI

05/12/2016 18 mustiramdani v
19 innara v
20 m.ikbal v
21 adila v
22 dyvia v
23 Layla v
24 nabila v
25 syifa v

06/12/2016 26 Dyvia v
27 Layla v
28 Nabila v
29 Innara v
30 Mustiramdhani v
31 M. Ikbal v

07/12/2016 32 dyvia v
33 layla v
34 nabila v
35 innara v
36 mustiramdani v
37 adila v
38 rafif v
39 m.azka v

08/12/2016 40 dyvia v
41 layla v
42 m.azka v
43 rafif v
44 najwa v
45 mustiramdani v

09/12/2016 46 dyvia v
47 layla v
48 m. azka v
49 najwa v
50 mustiramdani v
51 rafif v

10/12/2016 52 innara v
53 m. azka v
54 najwa v
55 rafif v
56 mustiramdani v

11/12/2016 57 M.Ferdiansyah v
58 Azka v
59 By.Ny.Ajeng v

12/12/2016 60 M.Ferdiansyah v
61 Azka v
62 By.Ny.Ajeng v

13/12/2016 63 M.Ferdiansyah v
64 Azka v
65 By.Ny.Ajeng v

14/12/2016 66 By. Ny. Ajeng v


67 M. Azka v
68 Silvia v
69 Shifa v
70 Daffa v

15/12/2016 71 by.ny.ajeng v
72 silvia v
73 shifa v
74 daffa v
75 azmi v
76 najwa v

16/12/2016 77 by.ny.ajeng v
78 m.reza v
79 fauzia v
80 najwa v
81 azmi v
82 daffa v

17/12/2016 83 by.ny.ajeng v
84 safira v
85 azmi v
86 najwa v
87 daffa v
88 m.reza v
89 fauzia v

18/12/2016 90 by.ny.ajeng v
91 safira v
92 najwa v
93 daffa v
94 Nachita v

19/12/2016 95 by.ny.ajeng v
96 safira v
97 m.rifki v
98 daffa v
99 nachita v

20/12/2016 100 m.rifki V


101 daffa V
102 nachita V

21/12/2016 103 m.rifki v


104 nachita v

22/12/2016 105 m.rifki v


106 nacita v

23/12/2016 107 m. riki v


108 rizky v
109 nachita v
110 rayyan v
111 tirta v
112 fitri v
113 fiqri v

24/12/2016 114 m. riki v


115 rizky v
116 nachita v
117 rayyan v
118 tirta v
119 fitri v
120 fiqri v
121 putra v

25/12/2016 122 M Riki v


123 Rizky v
124 Putra v
125 By Hari v

26/12/2016 126 m.riki v


127 hari v
128 tirta v
129 egi v

27/12/2016 130 m.riki v


131 hari v
132 tirta v
133 egi v

28/12/2016 134 m.riki v


135 egi v
136 silma v
137 naisha v
138 alysha v

29/12/2016 139 naisha v


140 alysha v
141 fabian v

30/12/2016 142 alysha v


143 aditia v
144 fabian v
145 naisa v

31/12/2016 146 aditia v


147 alwi v
148 m surya v
149 risky v
150 m hanif v

Jumlah pasien
Bandung 62
Luar Bandung 5
Ruang R anak bln Januari 2017

Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN Tanggal Nomer Nama ETT IVL UC ISK Plebitis VAP Hasil Kultur Keterangan
01/01/2017 1 aditia v 8/12/17 39 elkin v
2 alwi v 40 ahmad v
3 m surya v 41 reynal v
4 risky v 42 syahira v
5 m hanif v
6 m rasya v

02/01/2017 7 aditya v
8 alwi v
9 m. surya v 9/12/2017 43 elkin v
10 m. hanif v 44 nazril v
11 m. rasya v 45 ahmad v
12 siti v 46 reynal v
13 m. miljan v 47 dihya v
48 syahira v
03/01/2017 14 m.hanif v
15 m.miljan v 10/12/2017 49 elkin v
16 aditya v 50 nazril v
17 m.rasya v 51 ahmad v
52 reynal v
18 siti v 53 dihya v
54 syahira v
55 ariq v
04/01/2017 19 m.miljan v
20 m.rasya v 11/12/2017 56 elkin v
21 novi v 57 nazril v
22 fatih v 58 ahmad v
59 dihya v
05/01/2017 23 m. miljan v 60 syakira v
24 m. rasya v
25 agil v 12/12/2017 61 elkin v
25 azka v 62 nazril v
26 novi v 63 ahmad v
27 fatih v 64 dihya v
65 syakira v
06/01/2017 28 m. miljan v 66 m.rizqi v
29 agil v 67 davin v
30 m. fadlan v
31 azka v 13/12/2017 68 gideon v
32 novi v 69 rifqi v
33 al-farizi v 70 m.rizqi v
34 fatih v 71 nayla v
72 gevin v
07/01/2017 35 m. fadlan v
36 arsya v 14/12/2017 73 gideon v
37 azka v 74 rifqi v
36 novi v 75 m.rizqi v
39 al-farizi v 76 nayla v
40 shila v 77 gevin v
78 jaka v
08/01/2017 41 m. fadlan v
42 arsya v 15/12/2017 79 Jaka v
43 azka v 80 M. Rifki v
44 al-farizi v 81 Gidion v
45 shila v 82 Khanaya v
83 M. Rizki v
09/01/2017 46 m. fadlan v 84 Dihya v
47 arsya v 85 Nayla v
48 shilla v
49 Kanaya Unzurna v 16/12/2017 86 Jaka v
87 M. Rifki v
10/1/2017 50 Kanaya Unzurna v 88 Gidion v
51 naura v 89 Khanaya v
90 M. Rizki v
11/01/2017 52 Kanaya Unzurna v 91 Dihya v
53 Kanaya Alifa v 92 Nayla v
54 khoirotun v 93 Esya v
55 rinjani v
17/12/2017 94 Jaka v
12/01/2017 56 Kanaya Alifa v 95 M.Rifki v
57 Kanaya Unzurna v 96 Dihya v
58 khoirotun v 97 Esha v
59 zamzam v 98 M. Azzka v
60 anisah v
61 naura v 18/12/2017 99 Jaka v
100 M.Rifki v
13/01/2017 62 Kanaya Unzurna v 101 Dihya v
63 M Alif v 102 Esha v
103 M. Azzka v
14/01/2017 64 Nepi v 104 Azzam v
65 Habil v
66 Rangga v 19/12/2017 105 adelia v
67 Kanaya v 106 jaka v
68 M. Alif v 107 rifki v
108 azzam v
15/01/2017 69 Nepi v 109 esha v
70 Habil v 110 azzka v
71 Zalfa v 111 dihya v
72 Rangga v 112 zam zam v
73 Kanaya v
74 Diva v 20/12/17 113 nabila v
75 M.Alif v 114 adelia v
115 jaka v
16/01/2017 76 kanaya v 116 rifki v
77 m.alif v 117 esha v
118 azzam v
17/01/2017 78 kanaya v 119 azzka v
79 m.alif v
80 alby v
21/12/2017 120 nabila v
18/01/2017 81 kanaya v 121 adelia v
82 alby v 122 jaka v
83 abizar v 123 rifki v
124 esha v
19/01/2017 84 kanaya v 125 azzam v
85 abizar v 126 azzka v
86 raditya v
87 mikaila v 22/12/2017 127 Adelia
128 Jaka
20/01/2017 88 kanaya v 129 Dihya
89 M. Rasyid v 130 Azzka
90 Kania v 131 Nabila
91 mikaila v 132 Faisal
92 Letisha v
23/12/2017 134 Arkajuna
21/01/2017 93 kanaya v 135 Hideo
94 M. Rasyid v 136 Zahsy
95 Kania v 137 Hasna
96 mikaila v 138 Faisal

22/01/2017 97 kanaya v 24/12/2017 139 Arkajuna


98 m. rasyid v 140 Hideo
99 kania v 141 Alhanan
100 m. rangga v 142 Sandi
143 Zahsy
23/01/2017 101 kania v 144 Hasna
145 Miftah
24/01/2017 102 ratasya v 146 Alvan

ratasya
25/01/2017 103 v 25/12/2017 147 HAsna v
104 siti v 148 Miftah v
105 zuhair v 149 Alfan v
106 kayla v 150 Nazril v
107 fila v 151 Hideo v
108 novi v 152 Alhanan v
153 Sandi v
26/01/2017 109 novi v 154 Karina v
110 siti v
111 zuhair v 26/12/2017 155 Hideo v
112 kayla v 156 Karina v
113 abdullah v 157 Alhanan v
114 fila v 158 Nazril v
115 ratasya v 159 Hasna v
160 Miftah v
27/01/2017 116 novi v 161 Alfan v
117 siti v
118 zuhair v 27/12/2017 162 Karina v
119 kayla v 163 Hideo v
120 abdullah v 164 Alhanan v
121 fila v 165 Nazriel v
122 ratasya v 166 Hasna v
123 Sabila v 167 Miftah v
124 Ramadhani v 168 Alfan v

28/01/2017 125 novi v


126 abdullah v 28/12/17 169 zhalika v
127 ramadhani v 170 alhana v
128 sabila v 171 Miftah v
karina v
29/01/2017 129 novi v
130 abdullah v 29/12/2017 172 Karina v
131 ramadhani v 173 Alhanan v
174 Zalika v
30/01/2017 132 novi v 175 M.Raid v
133 abdullah v 176 Miftah v
134 ramadhani v
30/12/2017 177 alhanan v
31/01/2017 135 azka v 178 aqilla v
136 rivani v 179 zhalika v
137 meysa v 180 M.Raid v
138 zidan v 181 Miftah v
182 M.Reza v
JUMLAH PASIEN MASUK
BANDUNG 70 31/12/2017 183 Ania v
184 Fajar v
185 Kayyisa v
186 Aqilla v
187 Alhanan v
Formulir Survey Harian Pemakaian Alat 188 Raid v
Ruang R anak bln februari 2017 189 Zhalika v
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN 190 M.Reza v
01/02/2017 1 azka v
2 rivani v Jumlah Bandung : 69 Luar Bandung : 7 Total : 76
3 mesya v
4 zidan v

02/02/2017 5 azka v
6 nazhira v
7 dewi v
8 nufaisah v
9 mesya v

03/02/2017 10 azka v
11 nazhira v
12 dewi v
13 wulan v
14 alika v
04/02/2017 15 Farisha v
16 Nazhira v
17 Randika v
18 Dewi v
19 Alika v
20 Azmi v
21 Ayunda v

05/02/0107 22 dewi v
/ 23 azmi v
24 ayunda v
25 farisha v
26 nazhira v
27 radika v
28 rasyid v

06/02/2017 29 dewi v
30 m.iqmal v
31 farisha v
32 randika v
33 rasyid v

07/02/2017 34 dewi v
35 m.iqmal v
36 farisha v
37 rasyid v

08/02/2017 38 M. Iqmal v
39 Farisha v
40 Alisha v
41 Rasyid v

09/02/2017 42 m.iqmal v
43 farisha v
44 oryza v

10/2/2017 45 farisha v
46 oryza v
47 aryal v
48 keysha v
49 anisa v

11/02/2017 50 aryal v
51 keysha v
52 anisa v

12/02/2017 53 afiqah v
54 anisa v

13/2/2017 55 rehan v
54 afiqah v
55 anisa v
56 siti selfie v

14/02/2017 57 rehan v
58 siti selfie v
59 akbar v

15/02/2017 60 panca v
61 m.akbar v
62 afdan v
63 akbar v
64 yura v
65 rehan v

16/02/2017 66 panca v
67 m.akbar v
68 akbar v
69 afdan v
70 rehan v

17/02/2017 71 panca v
72 m.akbar v
73 akbar v
74 rehan v
75 arva v

18/02/2017 76 m.akbar v
77 m.azka v

19/02/2017 78 bilal v
79 m.alfatih v
80 aisha v
81 yani v
82 mikayla v
83 m.azka v

20/02/2017 84 bilal v
85 el fatih v
86 aisha v
87 mikaila v
88 mikayla v
89 m.azka v

21/02/2017 90 bilal v
91 el fatih v
92 aisha v
93 mikaila v
94 mikayla v
95 syakila v
96 arka v

22/02/2017 97 aisha v
98 arka v
99 syakila v
100 elvina v

23/02/2017 101 aisha v


102 arka v
103 elvina v

24/02/2017 102 arka v


103 azka v
104 farista v
105 alif v

25/02/2017 106 arka v


107 azka v
108 alif v

26/02/2017 109 Alif v


110 M. Fahmi v
111 Resya v
112 Rajendra v
113 Azka v

27/02/2017 114 Keyra v


115 Resya v
116 Rajendra v
117 Azka v
118 Alif v

28/02/2017 119 resya v


120 sandi v

jumlah pasien 71
bandung 63
luar bandung 8
Formulir Survey Harian Pemakaian Alat
Ruang R anak bln Maret 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/03/2017 1 reysa v
2 arva v
3 kevin v
4 sandi v

02/03/2017 5 kevin v
6 widi v
7 peni v
8 arva v

3/3/2017 9 widi v
10 peni v
11 rassel v
12 kevin v
13 saba v
14 barley v
15 sarah v

4/3/2017 16 Adara v
17 rassel v
18 barley v
19 sarah v
20 Khairil v

5/3/2017 21 Adara v
22 Rajiq v
23 M RAssel v
24 Kahiril v

6/3/2017 25 Adara v
26 Rajiq v
27 M RAssel v
28 Kahiril v
29 Kayla v

7/3/2017 30 Rajiq v
31 M RAssel v

8/3/2017 32 Rajiq v
33 Nizar v
34 M. Nizam v

9/3/2017 35 rajiq v
36 nizar v
37 m.nizam v
38 danisha v

10/3/2017 39 rajiq v
40 m.nijam v
41 nizar v
42 danisha v
43 dafa v

11/03/2017 44 Nizar v
45 Rafika v
46 Ryan v
47 Daanisha v
48 Dafa v
49 M. RAjiq v
50 Jibran v
51 M. Nizam v

12/03/2017 52 Daanisa v
53 Dafa v
54 Jibran v
55 Ryan v
56 Rafika v
57 Rafardhan v
58 Puput v

13/03/2017 59 Daanisha v
60 Dafa v
61 Rafardhan v
62 Jibran v
63 Ryan v
64 Puput v
65 Arkan v

14/03/2017 66 alvaro v
67 ryan v
68 puput v
69 arkan v
70 adam v
71 rafardhan v

15/03/3017 72 alvaro v
73 adam v
74 rizky
75 dena v

16/03/2017 76 alvaro v
77 m.fauzi v
78 m.kabit v
79 adam v
80 dena v
81 m.rizky v

17/03/2017 82 Alvaro v
83 M. Fauzi v
84 Adam v
85 M. Khabit v
86 Dena v
87 M. Rizky v
88 Daffa v

18/03/2017 89 Adam v
90 M. Khabit v
91 M. Rizky v
92 Daffa v
93 Melisa v
94 Fatih v

19/3/3017 95 adam v
96 m.khabit v
97 melisa v
98 fatih v
99 daffa v

20/3/3017 100 m.khabit v


101 melisa v
102 fatih v
103 arkan v
104 najwan v
105 salwa v

21/3/2017 106 raffi v


107 fatih v
108 arkan v
109 m. akmal v

22/3/2017 110 Ratu v


111 Hanin v
112 Fatih v
113 Fatan v
114 m.lutfi v
115 M.akmal v

23/3/2017 116 Ratu v


117 Hanin v
118 M.akmal v

24/3/2017 119 Reina v


120 Kayla v
121 Ryuken v
122 Akmal v

25/3/2017 123 Bayu v


124 Reina v
125 keyla v
126 ryuken v
127 Keegan v
128 Kleysha v

26/3/2017 129 Keegan v


130 Khaliqa v
131 Kleysha v
132 Bayu v
133 Keyla v
134 Raka v
135 Citra v

27/3/2017 136 Keegan v


137 Khaliqa v
138 Bayu v
139 Keyla v
140 Raka v
141 Citra v

28/3/2017 142 Raka v


143 Citra v
144 Reggie v
145 Agus v

29/3/2017 146 Ahmad v


147 Reggie v
148 Agus v
149 Raka v
150 Citra v

30/3/2017 151 R.Agan v


152 Rafif v
153 alzam v

31/3/2017 154 R.Agam v


155 Elfreda v
156 M.ALzam v
157 Rafif v
158 Ayla v

Jumlah Pasien 90
Bandung 82
Luar Bandung 8

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln APRIL 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/04/2017 1 R.Agam v
2 M.ALzam v
3 Rafif v
4 Ayla v
5 Okta v
6 Fayaska v
7 M Fathir v

02/04/2017 8 R.Agam v
9 M.ALzam v
10 Fayaska v
11 Putri v
12 Okta v
13 M. Fathir v

3/4/2017 14 putri v
15 kevin v

4/4/2017 16 putri v
17 rafi v

5/4/2017 18 putri v
19 rafi v
20 priscila v

6/4/2017 21 priscilla v
22 nursifa v
23 putri v
24 raffi v
25 althafunisa v
26 ahmad v
27 assyam v

7/4/2017 28 Nursifa v
29 keyla v
30 assyam v
31 althafunisa v
32 ahmad v
33 putri v

8/4/2017 34 Nursifa v
35 keyla v
36 assyam v
37 althafunisa v
38 putri v
39 wildan v

9/4/2017 40 assyam v
41 putri v
42 wildan v
43 hani v

10/4/2017 44 bintang v
45 putri v
46 innara v
47 hani v
11/4/2017 48 nisya v
49 al hajul v
50 kirana v

12/4/2017 51 alhazzul v
52 hani v
53 nafisha v
54 kirana v

13/4/2017 55 kirana v
56 alhazzul v
57 nafisha v
58 aisyah v
59 hani v

14/4/2017 60 al hazzul v
61 fatma v
62 aisyah v
63 hani v
64 arfa v
65 nafisa v

15/4/2017 66 alifiandra v
67 arfa v
68 rega v
69 m.arifin v
70 fatma v
71 genta v
72 mey v

16/4/2017 73 m.arifin v
74 fatma v
75 genta v
76 mey v
77 arfa v
78 alifiandra v
79 rega v

17/4/2017 80 m.arifin v
81 mey v
82 rega v

18/4/2017 83 mey v
84 m.arifin v
85 rega v
86 daffin v

19/4/2017 86 Nadira v
87 Mey v
88 M. Rega v
89 Raisha v
90 Kirana v
91 Daffin v

20/4/2017 92 Raisha v
93 Kirana v
94 Nadira v
95 Mey v
96 M Rega v
97 Rizki v
98 Daffin v
99 Keyla v
100 Vero v

21/4/2017 101 keyla v


102 kirana v
103 vero v
104 m.rega v
105 rizki v

22/4/2017 106 m.rega v


107 kirana v
108 keyla v
109 vero v

23/4/2017 110 m.rega v


111 kirana v
112 adara v
113 riska v
114 raditya v
115 syabila v
116 m.haby v

24/4/2017 117 adara v


118 riska v
119 amelia v
120 raditya v
121 syabila v
122 m.huby v

25/4/2017 123 raditya v


124 m.huby v

26/4/2017 125 farisa v


126 stefan v
127 raditya v

27/4/2017 128 farisa v


129 stefan v
130 azzahra v
131 harissa v

28/04/2017 132 farisa v


133 stefan v
134 azzahra v
135 harsa v

29/04/2017 136 azzahra v


137 harsa v

30/04/2017 138 Monica v


139 M. Latieful v

jml ps = 65 org
Formulir Survey Harian Pemakaian Alat
Ruang R anak bln MEI 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/05/2017 1 Monica v

02/05/2017 2 Monica v

03/05/2017 3 Monica v
4 Arya v
5 Ufairah v
6 M.Iqmal v
7 Hoirunnisa v
8 Misha v

4/5/2017 9 monica v
10 m.iqmal v
11 hoirunisa v
12 misha v
13 alifah v
14 fadlullah v
15 ufairah v
16 arya v
17 adiva v

5/5/2017 18 monica v
19 m.iqmal v
20 hoirunisa v
21 misha v
22 alifah v
23 fadlullah v
24 ufairah v
25 arya v
26 adiva v

6/5/2017 27 alifah v
28 fadlullah v
29 ufairah v
30 arya v
31 adiva v
32 Zayan v

7/5/2017 33 Fadlullah v
34 Hani v
35 Alifah v
36 Zayyan v

8/5/2017 37 Hani v
38 Alifah v
39 Sri v
40 Zayyan v

9/5/2017 41 Sri v
42 Nadia v
43 Hani v
44 Zahra v
45 Andi v

10/05/2017 41 Sri v
42 Nadia v
43 Hani v
44 Zahra v
45 Andi v
46 Adzriel v

11/5/2017 47 sri v
48 nadia v
49 zahra v
50 adzriel v

12/5/2017 51 sri v
52 nadia v
53 zahra v
54 adzriel v
55 fatuh v
56 nachita v

13/5/2017 57 nadia v
58 adzriel v
59 fatuh v

14/5/2017 60 adzriel v
61 nadia v
62 aqifa v
63 fatuh v

15/05/2017 64 aqifa v
65 adzriel v
66 raka v
16/05/2017 67 Fadhil v
68 aqifa v
69 raka v

17/05/2017 70 fadhil v
71 Rizki v
72 Zulpian v
73 Arfa v

18/05/2017 74 Fadhil v
75 Hadad v
76 Akbar v
77 Naufal v
78 Raisa v
79 Putra v
80 Raka v
81 Aqifa v

19/06/2017 82 Fadhil v
83 Hadad v
84 Akbar v
85 Naufal v
86 Raisa v
87 Putra v
88 Raka v
89 Aqifa v
90 Raida v

20/05/2017 91 Fadhil v
92 Hadad v
93 Alhazzul v
94 Aqifa v
95 Raida v
96 Ehsan v

21/05/2017 97 Raido v
98 Alhazzul v
99 Eshan v
100 Hani v
101 Harmoni v

22/05/2017 102 Rafka v


103 Najwa v
104 Alhazzul v
105 Harmoni v
106 Eshan v
107 Hani v

23/05/2017 108 Najwa v


109 Rafka v
110 Najwan v
111 Hani v
112 Azriel v
113 Harmoni v

24/05/2017 114 Najwa v


115 Rizki v
116 Najwan v

25/05/2017 117 Najwa v


118 Rizki v
119 Hani v

26/05/2017 120 Najwa v


121 Rizki v
122 Arfa v
123 Zulfian v
124 Anandia v
v

27/05/17 125 audi v


126 assyam v
127 anandia v

28/05/17 128 galih v

29/05/17 129 zafarnadrin v

30/5/2017 130 zafarnadirin v


131 ainun v
132 hawa v
133 assyam v
134 anandia v
135 arfa v

31/5/2017 136 zafaranadirin v


137 ainun v
138 zibran v
139 assyam v
140 anandia v
141 arfa v

jumlah pasien
bandung 69
luar bandung 6

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln JUNI 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2017 1 Ainun v
2 Zibran v
3 Assyam v
4 Alea v
5 Arfa v

02/06/2017 6 Ainun v
7 Zibran v
8 Assyam v
9 Alea v
10 Arfa v

03/06/2017 11 Zibran v
12 Assyam v

4/6/2017 13 zibran v

5/6/2017 14 zibran v
15 zafarunnadirin v
16 aulia v

6/6/2017 17 zafarunnadirin v
18 aulia v
19 rizki v
20 arka v
21 juan v

7/6/2017 22 zafarunnadirin v
23 aulia v
24 rizki v
25 arka v
26 juan v

8/6/2017 27 Rizky v
28 Juan v
29 Aulia v

9/6/2017 30 zahra
31 rizky
32 russel

10/6/17 33 adzaky v
34 aisha v
35 alfathan v

11/6/17 36 nadira v

12/6/2017 37 aisha v
38 nadira v
39 zahra v

13/6/2017 40 aisha v
41 nadira v
42 nadira v
43 rakha v

14/06/2017 44 Rakha v
45 M. Al farizi v
46 Nadira v
47 Nadira v
48 Zian v

15/06/2017 49 Rakha v
59 Al farizi v
69 Nadira v
79 Azandi v
89 Zian v
99 Arsyila v
109 M. Fayza v

16/06/2017 110 Rakha v


111 Al farizi v
112 Azzandi v
113 Zian v
114 Arsyila v
115 M.Fayza v

17/06/2017 116 Arsyila v


117 M. Faeyza v
118 Dhaffa v
119 M. Arkan v
/
18/06/2017 120 Arsyila v
121 M. Faeyza v
123 M. Arkan v
124 Kayla v
125 By. Ny. Ai v

19/6/2017 126 arsyila v


127 m.faeyza v
128 m.arkan v
129 kayla v
130 by.ny.ai v

20/6/2017 131 arsyila v


132 m.faeyza v
133 kayla v
21/6/2017 134 azkiya v
135 rantiara v
136 layla v

22/6/2017 137 rantiara v


138 layla v
139 neng v

23/6/2017 140 layla v


141 arsyla v
142 hasan v
143 juan v
144 arfan v
145 neng Shalu v

24/06/2017 142 arsyla v


143 hasan v
144 juan v
145 amanda v
146 neng shalu v

25/06/2017 147 hasan v


148 juan v
149 amanda v
150 neng shalu v
151 rasyid v

26/06/2017 152 Kledis v


153 Juan v
154 Risyad v
155 Amanda v
156 Neng Shalu v

27/06/2017 157 Kledis v


158 M.Ropi v
159 Amanda v
160 Risyad v

28/6/2017 161 risyad v


162 amanda v
163 m. ropi v

29/06/2017 164 risyad v


165 m. ropi v
166 gita v
167 arvino v

30/6/2017 168 Arvino v


169 Gita v
170 M.Ropi v
171 Risyad v

jumlah pasien
bandung 65
luar bandung 1

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln JULI 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2017 1 M.Fahmi v
2 Firdan v
3 Arvino v
4 Raysa v
5 Gita v
6 M.Ropi v

2/7/2017 7 fhirdan v
8 m.fahri v
9 arvino v
10 raysa v
11 gita v
12 m.ropi v

3/7/2017 13 fhirdan v
14 m.ropi v
15 azkya v

4/7/2017 16 adrian v
17 yuni v staphylococcus epidermidis
18 saqila v
19 rizkya v

5/7/2017 20 adrian v tidak ada pertumbuhan mikroorganisme


21 anasya v
22 yani v
23 mutiara v
24 rizkya v
25 irene v
26 saqila v

6/7/2017 27 adrian v
28 anasya v
29 yani v
31 rizkya v
32 irene v
33 saqila v
34 M. Adriansyah v

7/7/2017 35 adrian v
36 anasya v
37 yani v
38 rizkya v
39 irene v
40 saqila v
41 M. Adriansyah v
42 Arkana v

8/7/2017 43 arkana v
44 saqila v
45 m.ardiansyah v

9/7/2017 46 Arkana v
47 Saqila v
48 M. Ardiansyah v
49 Owen v

10/7/2017 50 arkana v
51 owen v
52 m.bisma v

11/07/2017 53 Razka v
54 Arkana v
55 Aira v
55 Owen

12/07/2017 56 rAZKA v
57 Devika v
58 Aira v
59 Arsen v
60 Meisya v
61 Dimas v
62 Jahdi v

13/7/2017 63 jahdi v
64 dimas v
65 meisya v
66 arsen v
67 aira v
68 devika v

14/7/2017 69 Albartama v
70 Devika v
71 Aira v
72 Arsen v
73 Meisya v
74 Dimas v
75 Jahdi v

15/07/2017 76 Albartama v
77 Devika v
78 Arsen v
79 Meisya v

16/07/2017 80 Albartama v
81 Meisya v
82 By. Ny. Imas

17/07/2017 83 Albartama v
84 Meisya v
85 By. Ny. Imas v

18/07/2017 86 by. ny. imas v


87 by. ny. Eva v
88 Silvia v
89 Arkanha v
90 Damar v

19/07/2017 91 by. ny. Eva v


92 Silvia v
93 Arkanha v
94 Damar v
95 rasya v
96 alkhalifi v tidak ada pertumbuhan mikroorganisme

20/7/2017 97 silvia v
98 arkanha v staphylococcus epidermidis
99 alkhalifi v
100 syafiq v
101 rasya v tidak ada pertumbuhan mikroorganisme
102 hisyam v tidak ada pertumbuhan mikroorganisme
103 yudha v

21/07/2017 104 hisyam v


105 yudha v
106 linda v
107 silvia v
108 syafiq v
109 arkanha v
110 alkhalifi v
111 rasya v

22/07/17 112 ethan v


113 by.ny.nia v
114 kenan v

23/7/2017 115 ethan v


116 azmi v
117 rasyid v
118 nazma v
119 arkanha v

24/7/2017 120 sabrina v


121 azmi v
122 nazma v
123 arkanha v

25/7/2017 124 sabrina v


125 azmi v
126 nazma v
127 gibran v
128 rasyid v
129 Arkanha v

26/7/2017 130 sabrina v


131 azmi v
132 nazma v
133 gibran v
134 rasyid v
135 calista v

27/07/2017 136 azmi v


137 rafa v
138 elvina v
139 calista v
140 gibran v

28/07/2017 141 stevan v


142 rafa v
143 rizki v
144 calysta v
145 elvina v
146 gibran v

29/07/2017 147 tazkya v


148 rafa v
149 rizki v
150 jidan v
151 elvina v
152 gibran

30/7/2017 153 tazkya v


154 rizki v
155 jidan v
156 kaka v
157 najwan v

31/7/2017 158 kaka v

pasien bandung 68
pasien luar bandung 13

Formulir Survey Harian Pemakaian Alat


Ruang R anak bln AGUSTUS 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/8/2017 1 galang v
2 syahla v
3 fatih v

2/8/2017 4 galang v
5 syahla v
6 fatih v
7 saqueena v
8 nadia v
9 kayla v

3/8/2017 10 saqueena v
11 kayla v
12 galang v
13 fatih v
14 nadia v
15 baihaqi v
16 syahla v

4/8/2017 17 kayla v
18 galang v
19 fauzan v
20 fatih v
21 nadia v
22 nendi v
23 baihaqi v
24 m farel v

5/8/2017 25 kayla v
26 galang v
27 fauzan v
28 fatih v
29 nadia v
30 nendi v
31 baihaqi v
32 m farel v
33 Aura v

6/8/2017 34 keyla v
35 aura v
36 nadia v

7/8/2017 37 ariezky v

8/8/2017 38 ariezky v
39 arsyila v

9/8/2017 40 ariezky v

10/08/2017 41 Mark v
42 Mehri v
43 Raffa v
44 ArZieky v
45 M.Keyshar v
46 Nakia v

11/08/2017 47 Mark v
48 Mehri v
49 Raffa v
50 Nakia v
51 M. Keyshar v

12/08/2017 52 Mehri v
53 Raffa v
54 M. Keyshar v

13/08/2017 52 Mehri v
53 Raffa v
54 M. Keyshar v

14/8/2017 55 m.keyshar v

15/8/2017 56 Siti Salwa v


57 Khanza v
58 Radika v
59 M. Al- azzam v

16/8/2017 60 siti salwa v


61 khanza v
62 radika v
63 m. al-azzam v

17/08/2017 64 M Al Azzam v
65 Ethan v

18/08/2017 66 M Al Azzam v
67 Ethan v

19/08/2017 68 Innara v
69 DIandra v
70 Qila v
71 Shaqil v

20/08/2017 72 Innara v
73 DIandra v
74 Qila v
75 Shaqil v
76 Nakia v
77 Alesya v

21/8/2017 78 diandra v
79 noval v
80 alesya v
81 nurkhofifah v

22/08/2017 82 diandra v
83 noval v
84 alesya v
85 nurkhofifah v
86 Anjani v
87 M. Galang v

23/8/2017 88 diandra v
89 noval v
90 nurkhofifah v
91 m.galang v

24/8/2017 92 diandra v
93 nurkhofifah v
94 ratna v
95 rido v

25/8/2017 96 diandra v
97 nurkofifah v
98 galang v
99 rido v

26/08/2017 100 diandra v


101 gilang v
102 fauzan v
103 nurkofifah v

27/8/2017 104 fauzan v


105 yafi v
106 nurkofifah v

28/8/2017 107 fauzan v


108 yafi v

29/8/2017 109 m.radiks v


110 fauzan v
111 arsaka v
112 abhizar v
113 giorgio v
114 natanael v
115 aisyah v

30/8/2017 116 fauzan v


117 rosa v
118 abizar v
119 natanael v
120 aisyah v

31/08/2017 121 Nathanael v


122 Abizar v
123 Aisyah v
124 Fauzan v
125 Layana v
126 Abraruz v
127 Rossa v

Pasien Bandung 63
Pasien Luar Bandung 9

Formulir Survey Harian Pemakaian Alat Formulir Survey Harian Pemakaian Alat
Ruang Anak Bulan September 2017 Ruang R anak bln APRIL 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2017 1 Abizar v
2 Layana v
3 Abraruz v
4 Rossa v
5 M.LUthfan v
6 Azka v
7 Arta v

2/9/2017 8 Abizar v
9 Abraruz v
10 Rossa v
11 Arta v
12 Azka v
13 AL azzam v
14 Innara v

03/09/2017 15 Abizar v
16 Abraruz v
17 Rossa v
18 Arta v
19 Azka v
20 Innara v

04/09/2017 21 Azka v
22 Inara v

05/09/2017 23 M. Hisyam v
24 Azka v
25 Arifa v
26 Inara v
27 Mikail v

6/9/2017 28 abizar v
29 ridwan v
30 arsifa v
31 mikail v
32 sarah v

07/09/2017 33 M.Adshan v
34 Abhizar v
35 Ridwan v
36 Mikail v
37 Sarah v
38 Quinsha v

08/09/2017 39 M.Adshan v
40 Abhizar v
41 Ridwan v
42 Quinsha v

09/09/2017 43 M.Adshan v
44 Abhizar v
45 Quinsha v

10/9/2017 46 Adshan v
47 abhizar v
48 alfito v
49 quinsha v
50 ali zulfi v

11/9/2017 51 adshan v
52 abhizar v
53 axelle v
54 alfito v
55 quinsha v
56 ali zulfi v
57 raka v

12/9/2017 58 axelle v
59 quinsha v
60 raka v

13/9/2017 61 quinsha v

14/9/2017 62 letisha v
63 misha v
64 balqis v
65 m.farel v

15/09/2017 66 Misha v
67 Letisha v
68 Kia v
69 Ahmad v
70 Bilqis v
71 M.Farel v

16/9/2017 72 divia v
73 ibnu v
74 misha v
75 letisha v
76 kia v
77 farel v
78 ahmad v
79 bilqis

17/9/2017 80 divia v
81 ibnu v
82 letisha v
83 raihan v

18/09/2017 84 ibnu v
85 letisha v
86 raihan v

19/9/2017 87 raihan v
88 iqbal v
89 taqiyya v
90 alradya v

20/09/2017 91 raihan v
92 iqbal v
93 taqiyya v
94 alradya v
95 syakilla v
96 M. Faqri v

21/09/2017 97 raihan v
98 alradya v
99 syakila v
100 m. kian v
101 azzam v
102 fakhri v

22/09/2017 103 alradya v


104 syakila v
105 m. kian v
106 azzam v
107 fakhri v
108 abdillah v
109 zyad v

23/09/2017 110 Zyad v


111 Azzam v
112 Arpan v
113 Fauzan v

24/9/2017 114 azzam v


115 jingga v
116 aqila v
117 athalla v
118 syabella v
119 arkan v
120 kinanti v

25/9/2017 121 jingga v


122 aqila v
123 athala v
124 syabella v
125 kinanti v
126 zulfi v

26/9/2017 127 aqila v


128 zulfi v
129 athala v
130 alma v
131 daffa v

27/9/2017 132 zulfi v


133 jibran v
134 athala v
135 alma v
136 daffa v

28/9/2017 137 jibran v


138 zulfi v
139 ahmad v
140 fadhil v
141 ahlan v
142 khanza v

29/9/2017 143 zulfi v


144 ahmad v
145 fadhil v
146 alma v
147 khanza v
148 andika v
149 keysa v

30/9/2017 150 andika v


151 keysa v
152 ahmad v
153 yoana v
154 alma v
155 rizkian v

Pasien Bandun 75
Pasien Luar Bandung 9
Formulir Survey Harian Pemakaian Alat Formulir Survey Harian Pemakaian Alat
Ruang Anak Bulan Oktober 2017 Ruang Anak Bulan September 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/10/2017 1 M.Andika v
2 Keysa v
3 Gerry v
4 Yoana v
5 Alma v
6 Rizkian v

02/10/2017 7 M.Andika v
8 Keysa v
9 Gerry v
10 Rizkian v
11 Alma v
12 Rahmat v

3/10/2017 13 m.andika v
14 malihatul v
15 keysa v
16 gerry v
17 rahmat v
18 m.sultan v

4/10/2017 19 m.sultan v
20 malihatul v
21 keysa v
22 tika v
23 rabani v
24 firkan v

5/10/2017 25 malihatul v
26 tika v
27 fikran v
28 gibran v

6/10/2017 29 malihatul v
30 tika v
31 fikran v
32 gibran v
33 adelia v
34 by. ny. Ani v
35 elsa v
36 M. nadzidan v

7/10/2017 37 adelia v
38 malihatul v
39 by ani v
40 elsa v
41 gibran v
42 revan v
43 bunga v

8/10/2017 44 adelia v
45 malihatul v
46 by ani v
47 elsa v
48 bunga v
49 alika v
50 nadira v

9/10/2017 51 by.ani v
52 bunga v
53 alika v
54 nadira v
55 avelino v
56 sabir v
57 adelia v

10/10/2017 58 rubi v
59 nazhira v
60 nadira v
61 ani v
62 adelia v
63 alika v
64 sabir v
65 avelino v

11/10/2017 66 rubi v
67 ani v
68 adelia v
69 avelino v

12/10/2017 70 rubi v
71 ani v
72 adelia v
73 alvelino v
74 neng v

13/10/2017 75 neng v
76 adelia v
77 alvellino v
78 rubi v
79 ani v
80 zhalika v

14/10/2017 81 neng v
82 kautsar v
83 adelia v
84 zhalika v
85 hanif v
86 ani v

15/10/2017 87 neng v
88 celine v
89 zhalika v
90 hanif v
91 ani v

16/10/2017 92 neng v
93 zhalika v
94 ainun v

17/10/2017 95 neng v
96 alif v
97 jibril v
98 kayla v
99 rizal v
100 petra v

18/10/2017 101 neng v


102 alif v
103 syakil v
104 kayla v
105 kayla v

19/10/2017 106 kayla v


107 rizal v
108 neng v
109 alif v
110 jibril v
111 kayla v
112 syaqil v

20/10/2017 113 kayla v


114 neng v
115 alif v
116 khalif v
117 kayla v
118 syaqil v

21/10/2017 119 kayla v


120 neng v
121 alif v
122 khalif v
123 kayla v
125 rizqi v
126 fauzan v

22/10/2017 127 alif v


128 mikayla v
129 kayla v
130 fauzan v
131 kayla v
132 rizqi v

23/10/2017 133 arsila v


134 alif v
135 mikayla v
136 kayla v
137 fauzan v
138 kayla v
139 rizqi v

24/10/2017 140 asila v


141 alif v
142 mikayla v
143 kayla v
144 afza v
145 m.arafa v
146 rizkialifa v
147 fadilah v

25/10/2017 148 asila v


149 alif v
150 afza v
151 alifa v
152 fadilah v

26/10/2017 153 asila v


154 m.arfan v
155 putri v
156 alifa v

27/10/2017 157 putri v


158 yehenzkiel v
159 alisa v
160 alif v
161 m. afnan v
162 m. arfan v
163 afza v

28/10/2017 164 putri v


165 yehenzkiel v
166 m. arfan v
167 rangga v
168 abdan v

29/10/2017 169 putri v


170 abdan v
171 rangga v
172 m. arfan v
173 fahmi v

30/10/2017 174 putri v


175 abdan v
176 m. rizki v
177 dava v
178 fahmi v

31/10/2017 179 abdan v


180 dava v
181 fahmi v

jumlah pasien bandung 78


luar bandung 12

Formulir Survey Harian Pemakaian Alat


Ruang Anak Bulan November 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/11/2017 1 adrena v
2 m.hafidz v
3 hasbi v
4 m.leviana v
5 m.arifin v
6 dava v
7 raffa v

2/11/2017 8 adrena v
9 m.leviana v
10 m.arifin v

3/11/2017 11 naysila v
12 akmal v

4/11/2017 13 naysila v
14 akmal v
15 rafa v
16 azka v

5/11/2017 17 naysila v
18 alfi v
19 zahra v
20 azka v
21 bintang v
22 haris v
23 m. raffa v

6/11/2017 24 naysila v
25 alfi v
26 zahra v
27 azka v
28 bintang v
29 haris v
30 m. raffa v

7/11/2017 31 zahra v
32 haris v
33 azka v
34 bintang v
35 nabihan v
36 rio v

8/11/2017 37 bintang v
38 nabihan v
39 rio v
40 hamdi v
41 arka v

9/11/2017 41 bintang v
42 nabihan v
43 rio v
44 hamdi v
45 arka v
46 Haris v
47 Satria v
48 M Kailan v

10/11/2017 49 Satria v
50 M Kailan v
51 rio v
52 hamdi v
53 Arsyad v

11/11/2017 54 Satria v
55 M Kailan v
56 rio v
57 hamdi v
58 Arsyad v

12/11/2017 59 Arjuna v
60 rio v
61 Fadly v
62 Alka v

13/11/2017 63 Arjuna v
64 Azka v
65 Rio v
66 Fadly v
67 Deril v

14/11/2017 68 giandra v
69 m.zain v
70 jardino v
71 m.zaka v

15/11/2017 72 giandra v
73 zain v
74 azka v
75 jardino v
76 azmiya v
77 jaka v
78 nadira v

16/11/2017 79 zain v
80 nadhira v
81 azka v
82 akmal v
83 azmia v
84 zaka v
85 ervan v
86 reinata

17/11/2017 87 Zain v
88 Zaka v
89 Azmia v

18/11/2017 80 M.Zain v
81 Azmia v
82 Azzam v
83 M.Zaka v YA bengkak,nyeri
84 Azizah v

19/11/2017 85 M.Zain v
86 M. Zaka v
87 Azmia v
88 Azzam v
89 Jaka v
90 Azizah v
91 Ahmad v

20/11/2017 92 Azizah v

21/11/2017 93 albhi v
94 kalisha v
95 vito v
96 azizah v

22/11/2017 97 vito v
98 kalisha v
99 azizah v
100 fathan v
101 fatir v
102 chandra v

23/11/2017 103 Lovely v


104 Fitri v
105 kalisha v
106 azizah v
107 fathan v
108 fatir v
109 chandra v

24/11/2017 110 Lovely v


111 Fitri v
112 kalisha v
113 azizah v
114 fathan v
115 fatir v
116 chandra v
117 askan v

25/11/2017 118 Lovely v


119 Fitri v
120 raihan v
121 azizah v
122 haifa v
123 fatir v
124 chandra v
125 askan v
126 starla v

26/11/2017 127 haifa v


128 afiza v
129 azizah v
130 asyfa v
131 khaliqa v
132 fitri v

27/11/2017 133 afiza v


134 azizah v
135 novi v
136 asyfa v
137 starla v
138 khalifa v
139 fitri v

28/11/2017 140 Azizah v


141 Starla v
142 Afiza v
143 Asyifa v
144 Khaliqa v
145 Fitri v
146 Novi v
147 Syakira v

29/11/2017 148 Afiza v


149 Khaliqa v
150 Fitri v
151 Novi v
152 Syakira v
153 Starla v

30/11/2017 154 afiza v


155 novi v
156 fitri v
157 starla v

jumlah pasien
bandung 81
luar bandung 10
phlebitis 1

Formulir Survey Harian Pemakaian Alat


Ruang Anak Bulan Desember 2017
Tanggal No. Nama ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
1/12/2017 1 Afiza v
2 Novi v
3 Fitri v
4 Amelia v
5 Satria v
6 Starla v

2/12/2017 7 Satria v
8 Luthfi v
9 Amelia v
10 Fitri v
11 Rifdah v
12 Humaida v

3/12/2017 13 Amelia v
14 Satria v
15 Luthfi v
16 Humaida v
17 Aljena v
18 Reinal v

4/12/2017 19 humaida v
20 satria v
21 aljena v
22 gangan v
23 reinal v
24 chalista v

5/12/2017 25 reinal v
26 chalista v
27 ahmad v
28 arsen v

6/12/2017 29 m.raka v
30 ahmad v
31 arsen v
32 reynal v
33 m.reyhan v
34 elkin v

7/12/2017 35 m.raka v
36 ahmad v
37 reynal v
38 elkin v lanjutannya tanggal 8 di tabel paling atas bagian samping
LAPORAN INOS VK BULAN JUNI 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/06/2015 13 5
02/06/2015 14 8 3 1
03/06/2015 10 7 3
04/06/2015 12 8 1
05/06/2015 11 11 3
06/06/2015 16 12 1
07/06/2015 18 14 1
08/06/2015 14 9
09/06/2015 16 10
10/06/2015 11 7
11/06/2015 16 13 2
12/06/2015 20 14
13/06/2015 19 13
14/06/2015 15 13 2
15/06/2015 16 14 3
16/06/2015 16 13 3
17/06/2015 17 11 2 1
18/06/0205 15 8 1
19/06/2015 14 5 1
20/06/2015 13 11 4
21/06/2015 18 11 3
22/06/2015 12 6 1
23/06/2015 20 17 3 1
24/06/2015 16 10 1
25/06/2015 15 6 1
26/06/2015 15 7
27/06/2015 16 13 2
28/06/2015 13 13 1
29/06/2015 9 7
30/05/2015 12 11
JUMLAH 281 42 3

LAPORAN INOS VK BULAN JULI 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/07/2015 13 8 1
02/07/2015 15 12 4
03/07/2015 18 14 3
04/07/2015 17 10 1 1
05/07/2015 12 9
06/07/2015 15 10 1
07/07/2015 22 16 2
08/07/2015 17 11 1
09/07/2015 14 7 1
10/07/2015 19 13 1
11/07/2015 18 7 1 1
12/07/2015 13 11 4
13/07/2015 12 9 2
14/07/2015 17 11 1
15/07/2015 16 12 1
16/07/2015 17 10 2
17/07/2015 20 10 3
18/07/2015 21 11 2
19/07/2015 13 7 2
20/07/2015 12 8 1
21/07/2015 10 5
22/07/2015 8 8 2
23/07/2015 11 9
24/07/2015 15 13 2 1
25/07/2015 18 10
26/07/2015 18 10
27/07/2015 13 7 1
28/07/2015 18 9
29/07/2015 17 7 1
30/07/2015 12 5
31/07/2015 13 4
JUMLAH

LAPORAN INOS VK BULAN AGUSTUS 2015


Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/08/2015 10 10 2
02/08/2015 15 12 1
03/08/2015 14 7 1
04/08/2015 16 7 1
05/08/2015 16 11
06/08/2015 11 7 1
07/08/2015 13 16 2
08/08/2015 16 11 1
09/08/2015 18 7
10/08/2015 18 13 1
11/08/2015 10 7 1 1
12/08/2015 10 11 4
13/08/2015 10 9 2
14/08/2015 10 11 1
15/08/2015 13 12 1
16/08/2015 15 10 2
17/08/2015 10 10 3
18/08/2015 12 11 2
19/08/2015 13 7 2 1
20/08/2015 8 1
21/08/2015 5
22/08/2015 8 2
23/08/2015 9 1
24/08/2015 13 2 1
25/08/2015 10
26/08/2015 10
27/08/2015 7 1
28/08/2015 9
29/08/2015 7 1
30/08/2015 5
31/08/2015 4
JUMLAH

LAPORAN INOS VK BULAN SEPTEMBER 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN
01/09/2015 3
02/09/2015 10 4
03/09/2015 10 2
04/09/2015 10 2
05/09/2015 12 4
06/09/2015 11 3
07/09/2015 16 12 2
08/09/2015 17 12 1
09/09/2015 15 15
10/09/2015 14 13 2
11/09/2015 15 12 2
12/09/2015 15 9 2
13/09/2015 14 10 2
14/09/2015 15 10 1
15/09/2015 14 11 5
16/09/2015 12 8 4
17/09/2015 12 6
18/09/2015 15 10 1
19/09/2015 19 13
20/09/2015 9 8
21/09/2015
22/09/2015
23/09/2015
24/09/2015
25/09/2015
26/09/2015
27/09/2015
28/09/2015
29/09/2015
30/09/2015

LAPORAN INOS VK BULAN OKTOBER 2015

Tanggal jumlah pasien ETT IVL UC ISK PLEBITIS VAP HASIL KULTUR KETERANGAN

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