BERITA ACARA SERAH TERIMA OBAT dan BHP DARI RUANG KAMAR BEDAH

No Nama Obat Jumlah Satuan Keterangan

1 ASERING 500 ML 8
2 Dext 5% 500cc 1
3 INFUSAN D5 500 ML SP 5
4 INFUSAN D5+1/4 NS DP 500 ML 1
5 KAEN 1 B 3
6 KAEN MG3 3
7 OTSU MANITOL 20% 500 ML 2
8 OTSU NS 1000 ML 2
9 OTSU NS 25 ML 5
10 INFUSAN-NS SP 500 ML 8
11 INFUSAN RL 500 ML 6
12 OTSU WFI 25 ML 7
13 AMINOFILIN INJ 24 MG/ 5 ML 1
14 ASAM TRANEKSAMAT 500 MG/5ML INJEKSI 2
15 ATROPIN 0,25 MG/ ML INJ 5
16 BUPIVAKAIN HCL HEAVY INJ 3
17 CEFTRIAXONE 1 GRAM INJEKSI BERNOFARM 1
18 DEXAMETHASONE 5 MG/ML INJ 5
19 EFEDRIN INJ 50 MG/ML 4
20 DUROGESIC PATCH 12,5 MCG 2
21 FUROSEMID INJ 10 MG/ML 2
22 GENTAMISIN INJ 40 MG/ML 1
23 KCL 7.46 (25ml) 3
24 Ketamine 50mg inj/ KTM 4
25 KETOROLAK 30 MG/ML INJ 5
26 MARCAIN SPINAL 0,5% HEAVY 2
27 METVELL 0,2 INJEKSI 3
28 METRONIDAZOLE 500 MG/100 ML INF 1
29 OTSU MGSO4 20% 2
30 OTSU MGSO4 40% 2
31 PANTOPRAZOLE 40MG INJEKSI 1
32 PETHIDINE INJ 50 MG/ML 3
33 Propofol 20 ml/Nupovel Inj 3
34 NEOSTIGMINE 0,5 MG/ML INJ 2
35 Sodalime 1
36 TRADOSIK 50MG/ML INJEKSI 2 ML 8
37 NEO-K 2 MG/ML INJEKSI 5
38 THREE WAY STOPCOCK ONEMED 2
39 IV CATHETER 14 G SURFLO TERUMO 1
40 IV CATHETER 16 G SURFLO TERUMO 1
41 IV CATHETER WING 18 G SURFLO PLUS 4
42 IV CATHETER WING 20 G SURFLO PLUS 8
43 IV CATHETER WING 22 G SURFLO PLUS 8
44 Alkohol swab onemed 42
45 BLOOD SET TERUMO 5
46 DISP ANESTH BREATH CORRUGATED 1,5M INNOQ 2
47 SPUIT 50 CC CATHETER TIP ONEMED 5
48 CERTOFIX PROTECT TRIO V720 BBRAUN 2
49 ELEKTRODA ONE DOT PAED ONEMED 15
50 ELEKTRODA ONE DOT ADULT ONEMED 32
51 ETT CLEAR NO. 6,5 RUSCH 1
52 ETT CLEAR NO. 7 RUSCH + PORTEX CUFF 2
53 ETT CLEAR NO. 7,5 RUSCH 2
54 ETT PORTEX CUFF + RUSCH 8.0 2
55 ETT No 3.5 Tanpa CUFF 1
56 EXTENSION TUBE 150 CM ONEMED 5
57 ANAESTHESIA MASK NEONATE KOO CRYSTAL 1
58 ANAESTHESIA MASK INFANT KOO CRYSTAL 1
59 ANAESTHESIA MASK CHILD KOO CRYSTAL 1
60 ANAESTHESIA MASK SIZE SMALL KOO CRYSTAL 1
61 ANAESTHESIA MASK SIZE MEDIUM KOO CRYSTAL 1
62 Feeding Tube No. 4 1
63 SAFEED FEEDING TUBE FR 5 (40CM) TERUMO 1
64 FEEDING TUBE NO.6 JMS 1
65 SAFEED FEEDING TUBE FR 8 (100CM) TERUMO 1
66 FILTER HUMIDIFIER HMEF WITH GSP 3
67 GUEDEL AIRWAY SIZE 3 FLEXICARE 1
68 GUEDEL AIRWAY SIZE 4 FLEXICARE 1
69 GUEDEL AIRWAY NO.5 RUSCH 1
70 PLESTERIN WP ONEMED 33
71 INFUS SET WITH 100 ML BURET JMS 4
72 Infuset biuret dewasa 0
73 INFUS SET ADULT TERUMO 6
74 INFUS SET PAED TERUMO 2
75 INTRAFIX SAFESET B`BRAUN 5
76 SPINOCAN NEEDLE 25G 8
77 SPINOCAN NEEDLE 26G 7
78 SPINOCAN NEEDLE 27G 3
79 Micropore 2 inci 1
80 NEEDLE 18G TERUMO 5
81 NEEDLE 20 G TERUMO 5
82 NEEDLE 21G ONEMED 5
83 NEEDLE 23G ONEMED 5
84 STOMACH TUBE FR. 16 TERUMO 2
85 STOMACH TUBE FR. 18 TERUMO 2
86 STOMACH TUBE FR.20 JMS 1
87 MASKER NRM ANAK SALTER LABS 1
88 MASKER NRM DEWASA WITH TUBING B MED A0301 2
89 NASAL CANUL O2 PAED REMIDI 3
90 NASAL CANUL O2 ADULT REMIDI 2
91 One way Kanul/ OXYGEN CONNECTION TUBE 4
92 Tegaderm 1623W 7
93 SPUIT 10 CC BD 7
 94 SPUIT 1 CC TB ONEMED 6
95 SPUIT 20 CC ONEMED 6
96 SPUIT 3 CC ONEMED 3
97 SPUIT 50 CC CATHETER TIP ONEMED 5
98 SPUIT 50 CC ONEMED 3
99 SPUIT 5 CC ONEMED 13
100 SUCTION CATHETER FR.8 ONEMED 1
101 SUCTION CATHETER FR.10 ONEMED 2
102 SUCTION CATHETER FR.12 ONEMED 2
103 SUCTION CATHETER FR.14 ONEMED 2
104 WING NEEDLE 25 G TERUMO 5
105 WING NEEDLE 23 G ONEMED 5
106 Alkohol 100ml onemed 9
107 Armsling L onemed 1
108 Armsling M onemed 1
109 Armsling S onemed 1
110 Benang Brilon No. 2/0 ▼ ( B27CD300 ) 9
111 Benang Brilon No. 3/0 ▼ ( B37CD240 ) 8
112 Benang Brilon No. 4/0 ▼ ( B47CD240 ) 9
113 Benang Brilon No. 5/0 ▼ ( B57CD160 ) 9
114 Benang Catgut Crom No 0 ● ( C09RH370 ) 9
115 BENANG CATGUT CROM N0. 2/0 ( C29RH370 ) 9
116 BENANG CATGUT PLAIN N0. 3/0 ( P37RH260 ) 9
117 BENANG CATGUT PLAIN TAPER 2/0 (P27RH370) 9
118 BENANG ECOSORB NO. 0 ( E09RH370 ) 10
119 BENANG ECOSORB N0. 1/0 ( E19RH480 ) 6
120 BENANG ECOSORB NO. 2/0 ( E29RH370 ) 9
121 BENANG ECOSORB NO. 3/0 ( E39RH260 ) 9
122 BENANG ECOLENE N0. 3/0 DUA JARUM ( R39RH262 ) 9
123 BENANG ECOLENE NO. 2/0 DUA JARUM ( R29RH262 ) 9
124 BENANG SILK NO. 2/0 TANPA JARUM ( S26P150 ) 9
125 BENANG SILK NO. 3/0 TANPA JARUM ( S36P150 ) 9
126 BENANG SILK NO. 0 TRIANGLE ( S07CD370 ) 8
127 BENANG SILK NO. 0 TAPPER POINT S07RH300 9
128 BENANG SILK NO. 0 TAPPER POINT S07RH370 9
129 BENANG SILK NO. 0 TANPA JARUM ( S06P150 ) 9
130 Benang Silk No. 2/0 ▼ 3
131 Benang Silk No. 2/0 ● 2
132 BENANG SILK NO. 3/0 ( S37RH260 ) 9
133 POVIDON IODINE 10% 1L ONEMED 1
134 Bethadine/Povidone Iodine 50ml 17
135 BISTURI AESCULAP NO. 10 18
136 BISTURI AESCULAP NO. 11 18
137 BISTURI AESCULAP NO. 15 13
138 BISTURI AESCULAP NO.23 17
139 CLEANING PAD FOR ELECTRODES W/ FILM 50X50 6
MM
140 C-SECTION SET WITH 3 SURGICAL GOWNS ( 2
051001001
141 Elastis Verband 3 inci 2
142 Elastis Verband 4 inci 2
143 Elastis Verband 6 inci 2
144 ELECTRO SURGICAL PENCIL/ Lina Pen 5
145 FOLEY CATHETER 2 WAY FR 14 WRP 1
146 FOLEY CATHETER 2 WAY FR 16 WRP 1
147 FOLEY CATHETER 2 WAY FR 18 WRP 2
148 FOLEY CATHETER 2 WAY FR 20 WRP 1
149 FOLEY CATHETER 2 WAY FR 22 WRP 1
150 Gypsona 4 inchi 1
151 Gypsona 6 inchi 2
152 Handscound Steril No. 6.5 13
153 Handscound Steril No. 7.0 11
154 Handscound Steril No. 7.5 13
155 Handscound Steril No. 8 7
156 Hipavix 15 cm x 5 m 1
157 Kassa steril isi 10 14
158 Kassa steril isi 20 8
159 Kassa steril isi 5 6
160 Mayo Stand cover 60x140cm 2
161 Penrose drain Fr. 8 mm 10
162 Penrose drain Fr. 16 mm 10
163 Plester coklat besar 7.5 x 4.5cm 2
164 Plester coklat kecil 1.25 x 4.5cm 2
165 Pot Feces 0
166 Pot PA 0
167 Soap T-Scrub 9
168 Sofband 3 inchi/ TENSOCREPE 3" 2
169 Sofband 4 inchi/ TENSOCREPE 4" 2
170 Sofband 6 inchi/ TENSOCREPE 6" 2
171 Sofratulle/ DARYANT TULLE 1% 8
172 STERI DRAPE 6650 (60 CM X 45 CM) 3M 5
173 Suction Conecting/ SUCTION TUBE 1,8 L 11
174 Surgical Clipper Blade 16
175 Tampon SC 2
176 Tempat Plasenta 0
177 TRANSOFIX BBRAUN 47
178 Umbilikal Cord clamps 50
179 UNDERPAD DR.J 60 X 90 ONEMED 4
180 Universal Set With Mayo and 3 Surgical gown 1
181 URINE BAG STERIL 2L ONEMED 5
182 Verband gulung 10 cm 6
183 Verband gulung 5 cm 4
184 SULENE MESH 6 X 11 CM SUTCON 2
185 WOUND DRESS PAD 10X15 CM DO`CARE 1
186 WOUND DRESS PAD 10X25 CM DO`CARE 1
Akan dibuat paket-paket untuk tindakan operasi yang akan disiapkan oleh bagian farmasi
Floor stock di Kamar Bedah hanya untuk yang bersifat live saving

Jakarta, Desember 2021

Yang Menyerahkan Yang Menerima

Ns. Dewi Allo, S.Kep Fetri Charya Munarsih

Ka. Ins Bedah Sentralisasi Sentral Ka. Instalasi Farmasi

Mengetahui
Disetujui oleh:

dr. Samantha
dr. Evan Luke Aditya
Ka. Pelayanan Medik
Ka. Penunjang Medik

Disaksikan oleh:
Bagian keuangan

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