Prokalite | M.S.Ü. SET KONTROL FORMU

Örnek Doküman

Temizlik, Dezenfeksiyon ve Sterilizasyon Hizmetleri - Form

DS.FR.008 - M.S.Ü. SET KONTROL FORMU

PDF Dokümanı Gör

Paylaş

DİKKAT! Buradaki bilgiler sağlık profesyonelleri için hazırlanmıştır.
Arama motorları vs. ile bu sayfadaki bilgilere ulaştıysanız, sağlık profesyonellerine danışmadan, sadece buradaki bilgiler ile hareket etmeyiniz.

(Logonuz Burada)

Demo Hastanesi (Prokalite.Com) M.S.Ü. SET KONTROL FORMU

Doküman Kodu: DS.FR.008

Yayın Tarihi: 10.07.2014

Revizyon Tarihi: 18.10.2022

Revizyon No: 4

Sayfa: Otomatik

İLGİLİ BİRİM / SERVİS GÖREVLİSİ TARAFINDAN DOLDURULACAK
HASTA ADI SOYADI :	TESLİM TARİHİ :
SET ADI ve SAYISI:	SETİN KULLANILDIĞI SALON / SERVİS:
SETİ TESLİM EDEN :	SET DIŞINDAN AÇILAN ALET VE SAYILARI :
M.S.Ü DOLDURULACAK BÖLÜM
TESLİM ALAN M.S.Ü GÖREVLİSİ :	Tarih:
TESLİM ALINAN ALET SAYISI :	EKSİK TESLİM ALINAN ALETLER VE SAYISI :
STERİLİZASYON SONRASI:	Tarih:
TESLİM EDEN M.S.Ü GÖREVLİSİ	TESLİM ALAN SERVİS GÖREVLİSİ

✄.......................................................

İLGİLİ BİRİM / SERVİS GÖREVLİSİ TARAFINDAN DOLDURULACAK
HASTA ADI SOYADI :	TESLİM TARİHİ :
SET ADI ve SAYISI:	SETİN KULLANILDIĞI SALON / SERVİS:
SETİ TESLİM EDEN :	SET DIŞINDAN AÇILAN ALET VE SAYILARI :
M.S.Ü DOLDURULACAK BÖLÜM
TESLİM ALAN M.S.Ü GÖREVLİSİ :	Tarih:
TESLİM ALINAN ALET SAYISI :	EKSİK TESLİM ALINAN ALETLER VE SAYISI :
STERİLİZASYON SONRASI:	Tarih:
TESLİM EDEN M.S.Ü GÖREVLİSİ	TESLİM ALAN SERVİS GÖREVLİSİ

✄......................................................

İLGİLİ BİRİM / SERVİS GÖREVLİSİ TARAFINDAN DOLDURULACAK
HASTA ADI SOYADI :	TESLİM TARİHİ :
SET ADI ve SAYISI:	SETİN KULLANILDIĞI SALON / SERVİS:
SETİ TESLİM EDEN :	SET DIŞINDAN AÇILAN ALET VE SAYILARI :
M.S.Ü DOLDURULACAK BÖLÜM
TESLİM ALAN M.S.Ü GÖREVLİSİ :	Tarih:
TESLİM ALINAN ALET SAYISI :	EKSİK TESLİM ALINAN ALETLER VE SAYISI :
STERİLİZASYON SONRASI:	Tarih:
TESLİM EDEN M.S.Ü GÖREVLİSİ	TESLİM ALAN SERVİS GÖREVLİSİ

<table style="border-collapse:collapse; width:882px" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="2" style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; text-align:center; vertical-align:top; width:850px"><span style="font-size:12px"><span style="color:black">İLGİLİ BİRİM / SERVİS GÖREVLİSİ TARAFINDAN DOLDURULACAK</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:17px; vertical-align:top"><span style="font-size:12px"><span style="color:black">HASTA ADI SOYADI :</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:425px"><span style="font-size:12px"><span style="color:black">TESLİM TARİHİ :</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SET ADI ve SAYISI:  </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:425px"><span style="font-size:12px"><span style="color:black">SETİN KULLANILDIĞI SALON /  SERVİS: </span></span></td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:52px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SETİ TESLİM EDEN :</span></span></td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; height:52px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SET DIŞINDAN AÇILAN ALET VE SAYILARI :</span></span></td></tr><tr><td colspan="2" style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; text-align:center; vertical-align:top"><span style="font-size:12px"><span style="color:black">M.S.Ü DOLDURULACAK BÖLÜM</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALAN M.S.Ü GÖREVLİSİ :</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:12px"><span style="color:black">Tarih:</span></span></td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:44px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALINAN ALET SAYISI :</span></span></td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; height:44px; vertical-align:top"><span style="font-size:12px"><span style="color:black">EKSİK TESLİM   ALINAN  ALETLER VE SAYISI : </span></span></td></tr><tr><td style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">STERİLİZASYON SONRASI:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:12px"><span style="color:black">Tarih:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:39px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM EDEN M.S.Ü GÖREVLİSİ</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALAN SERVİS GÖREVLİSİ</span></span></td></tr></tbody></table><p>✄.......................................................</p><table style="border-collapse:collapse; width:882px" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="2" style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; text-align:center; vertical-align:top; width:850px"><span style="font-size:12px"><span style="color:black">İLGİLİ BİRİM / SERVİS GÖREVLİSİ TARAFINDAN DOLDURULACAK</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:17px; vertical-align:top"><span style="font-size:12px"><span style="color:black">HASTA ADI SOYADI :</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:425px"><span style="font-size:12px"><span style="color:black">TESLİM TARİHİ :</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SET ADI ve SAYISI:  </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:425px"><span style="font-size:12px"><span style="color:black">SETİN KULLANILDIĞI SALON /  SERVİS: </span></span></td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:52px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SETİ TESLİM EDEN :</span></span></td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; height:52px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SET DIŞINDAN AÇILAN ALET VE SAYILARI :</span></span></td></tr><tr><td colspan="2" style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; text-align:center; vertical-align:top"><span style="font-size:12px"><span style="color:black">M.S.Ü DOLDURULACAK BÖLÜM</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALAN M.S.Ü GÖREVLİSİ :</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:12px"><span style="color:black">Tarih:</span></span></td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:44px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALINAN ALET SAYISI :</span></span></td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; height:44px; vertical-align:top"><span style="font-size:12px"><span style="color:black">EKSİK TESLİM   ALINAN  ALETLER VE SAYISI : </span></span></td></tr><tr><td style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">STERİLİZASYON SONRASI:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:12px"><span style="color:black">Tarih:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:39px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM EDEN M.S.Ü GÖREVLİSİ</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALAN SERVİS GÖREVLİSİ</span></span></td></tr></tbody></table><p> ✄......................................................</p><table style="border-collapse:collapse; width:882px" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="2" style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; text-align:center; vertical-align:top; width:850px"><span style="font-size:12px"><span style="color:black">İLGİLİ BİRİM / SERVİS GÖREVLİSİ TARAFINDAN DOLDURULACAK</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:17px; vertical-align:top"><span style="font-size:12px"><span style="color:black">HASTA ADI SOYADI :</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:425px"><span style="font-size:12px"><span style="color:black">TESLİM TARİHİ :</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SET ADI ve SAYISI:  </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:425px"><span style="font-size:12px"><span style="color:black">SETİN KULLANILDIĞI SALON /  SERVİS: </span></span></td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:52px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SETİ TESLİM EDEN :</span></span></td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; height:52px; vertical-align:top"><span style="font-size:12px"><span style="color:black">SET DIŞINDAN AÇILAN ALET VE SAYILARI :</span></span></td></tr><tr><td colspan="2" style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; text-align:center; vertical-align:top"><span style="font-size:12px"><span style="color:black">M.S.Ü DOLDURULACAK BÖLÜM</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALAN M.S.Ü GÖREVLİSİ :</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:12px"><span style="color:black">Tarih:</span></span></td></tr><tr><td style="border-color:currentcolor black black; border-style:none solid solid; border-width:medium 1px 1px; height:44px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALINAN ALET SAYISI :</span></span></td><td style="border-color:currentcolor black black currentcolor; border-style:none solid solid none; border-width:medium 1px 1px medium; height:44px; vertical-align:top"><span style="font-size:12px"><span style="color:black">EKSİK TESLİM   ALINAN  ALETLER VE SAYISI : </span></span></td></tr><tr><td style="background-color:#daeef3; border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; vertical-align:top"><span style="font-size:12px"><span style="color:black">STERİLİZASYON SONRASI:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:12px"><span style="color:black">Tarih:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:39px; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM EDEN M.S.Ü GÖREVLİSİ</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:12px"><span style="color:black">TESLİM ALAN SERVİS GÖREVLİSİ</span></span></td></tr></tbody></table>