LOGO RS CHEK LIST PEMELIHARAAN GAS MEDIS

Bulan :

Rack GaS Tank Gas Air

Tank O2 Sentral RSAI LAMA Tank O2 Sentral RSAI BARU
Tgl N20 Medis Compressor Keterangan
LL PT OUT1 OUT2 LL PT OUT1 OUT2 LL PL PR PS 1 PS 2 Comp. 1 Comp. 2

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19 Surabaya, ................................................
20 Koordinator Unit Pemeliharaan dan Teknik
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26 ( ................... )
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