Scribd Logo
Upload

Welcome to Scribd!

  • Form Permintaan Barang Unit (27-7-2022)

    Uploaded by

    annisa mirdhatillah
    7 views1 page
    This document is a request form for medical supplies from the Outpatient Department unit. It lists 30 items needed including ultrasound gel, ultrasound paper, pens, notebooks, tissues, ink, forms, and a flashlight. The form provides the item name, brand or type, quantity requested, and is dated July 27th 2022 and signed by the head of the Outpatient Department unit.

    Original Description:

    form rajal01

    Original Title

    FORM PERMINTAAN BARANG UNIT (27-7-2022)

    Copyright

    © © All Rights Reserved

    Available Formats

    XLSX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a request form for medical supplies from the Outpatient Department unit. It lists 30 items needed including ultrasound gel, ultrasound paper, pens, notebooks, tissues, ink, forms, and a flashlight. The form provides the item name, brand or type, quantity requested, and is dated July 27th 2022 and signed by the head of the Outpatient Department unit.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    7 views1 page

    Form Permintaan Barang Unit (27-7-2022)

    Uploaded by

    annisa mirdhatillah
    This document is a request form for medical supplies from the Outpatient Department unit. It lists 30 items needed including ultrasound gel, ultrasound paper, pens, notebooks, tissues, ink, forms, and a flashlight. The form provides the item name, brand or type, quantity requested, and is dated July 27th 2022 and signed by the head of the Outpatient Department unit.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    RSIA SITI HAWA

    FORM PERMINTAAN BARANG

    NAMA INSTALASI / UNIT RAWAT JALAN

    JUMLAH
    NO. NAMA BARANG MERK/TYPE/UKURAN KET
    PERMINTAAN
    1 Gel USG Jelly 2
    2 Kertas USG Kertas Foto 40
    3 Pena Hitam 5
    4 Pena Biru 5
    5 Buku isi 200 1
    6 Buku isi 100 1
    7 Plester Bening 2
    8 Tisu Tipis 6
    9 Tisu Tebal 6
    10 Kertas Koran 2 gulung
    11 Tinta Hitam L003 2
    12 Tinta Biru L003 2
    13 Tinta Merah L003 2
    14 Tinta Kuning L003 2
    15 Isi klep kecil 2
    16 Blangko Kiriman Masuk 2
    17 Blangko Labor 2
    18 Blangko keterangan 2
    19 Blangko Resep 2
    20 Blangko skreening covid 1 rim
    21 Blangko laporan katim 1 rim
    22 Blangko resiko jatuh rajal 1 rim
    23 Blangko hand over rajal 1 rim
    24 kartu imunisai poli anak 1 rim
    25 Senter 1
    26
    27
    28
    29
    30

    Padang , 27/7/2022
    Ka/Kasi/Unit Rawat Jalan

    Diambil Tgl : (Annisa Mirdhatillah,Amd.Keb)

    You might also like