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DH.FR.014 - OKSİJEN JAKI TEMİZLEME FORMU

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Demo Hastanesi (Prokalite.Com) OKSİJEN JAKI TEMİZLEME FORMU

Doküman Kodu: DH.FR.014

Yayın Tarihi: 28.03.2014

Revizyon Tarihi: 17.08.2022

Revizyon No: 1

Sayfa: Otomatik

TARİH		TEMİZLİK SORUMLU PERSONEL		KONTROL EDEN SORUMLU HEMŞİRE				İMZA
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<table style="border-collapse:collapse; width:882px" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="2" style="border-color:black; border-style:solid; border-width:1px; height:39px; text-align:center; vertical-align:middle; width:127px"><span style="font-size:13px"><strong>TARİH</strong></span></td><td colspan="2" style="border-color:black black black currentcolor; border-style:solid solid solid none; border-width:1px 1px 1px medium; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong>TEMİZLİK SORUMLU PERSONEL</strong></span></td><td colspan="4" style="border-color:black black black currentcolor; border-style:solid solid solid none; border-width:1px 1px 1px medium; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"><strong>KONTROL EDEN SORUMLU HEMŞİRE</strong></span></td><td colspan="2" style="border-color:black black black currentcolor; border-style:solid solid solid none; border-width:1px 1px 1px medium; text-align:center; vertical-align:middle; width:110px"><span style="font-size:13px"><strong>İMZA</strong></span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; 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border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; 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text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; 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border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:middle"><span style="font-size:13px">…../…../20..</span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:167px"><span style="font-size:13px"><strong> </strong></span></td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom; width:204px"><span style="font-size:13px"> </span></td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"><span style="font-size:13px"> </span></td></tr></tbody></table>