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Dİ.FR.003 - DİYALİZ MAKİNASI DEZENFEKSİYON KONTROL ÇİZELGESİ

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Demo Hastanesi (Prokalite.Com) DİYALİZ MAKİNASI DEZENFEKSİYON KONTROL ÇİZELGESİ

Doküman Kodu: Dİ.FR.003

Yayın Tarihi: 14.05.2025

Revizyon Tarihi: -

Revizyon No: -

Sayfa: Otomatik

Tarih :

1.seans

Uygulayan Personelin Adı Soy Adı

İşlem Saati

Dezenfeksiyon süresi

Dezenfektan Adı

Personel İmza

Tarih :

2.seans

Uygulayan Personelin Adı Soy Adı

İşlem Saati

Dezenfeksiyon süresi

Dezenfektan Adı

Personel İmza

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

1.Makina

7.Makina (HBSAG)

7.Makina (HBSAG)

<meta charset="utf-8"/>
<table cellspacing="0" style="border-collapse:collapse; width:1292px">
 <tbody>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:46px; width:64px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Tarih :</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">1.seans</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:115px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Uygulayan Personelin Adı Soy Adı</span></strong></span></p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:53px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">İşlem Saati</span></strong></span></p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:82px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Dezenfeksiyon süresi</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:73px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Dezenfektan Adı</span></strong></span></p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:116px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Personel İmza</span></strong></span></p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:8px">
   <p style="text-align:center"> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:304px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Tarih :</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:bottom; width:5px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">2.seans</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:115px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Uygulayan Personelin Adı Soy Adı</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:24px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">İşlem Saati</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:61px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Dezenfeksiyon süresi</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:73px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Dezenfektan Adı</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; width:35px">
   <p style="text-align:center"><span style="font-size:16px"><strong><span style="color:#000000">Personel İmza</span></strong></span></p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:29px; width:64px">
   <p style="text-align:justify"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:53px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:82px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:8px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:304px">
   <p style="text-align:left"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:24px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:35px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:29px; width:64px">
   <p style="text-align:justify"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:53px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:82px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:8px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:304px">
   <p style="text-align:left"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:24px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:35px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:29px; width:64px">
   <p style="text-align:justify"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:53px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:82px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:8px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:304px">
   <p style="text-align:left"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:24px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:35px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:29px; width:64px">
   <p style="text-align:justify"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:53px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:82px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:8px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:304px">
   <p style="text-align:left"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:24px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:35px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:29px; width:64px">
   <p style="text-align:justify"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:53px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:82px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:8px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:304px">
   <p style="text-align:left"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:24px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:35px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:41px; width:64px">
   <p style="text-align:justify"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:53px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:82px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; vertical-align:top; width:8px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor currentcolor #000000; border-style:solid none none solid; border-width:1px medium medium 1px; width:304px">
   <p style="text-align:left"><span style="font-size:16px"><strong><span style="color:#000000">1.Makina</span></strong></span></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:24px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:35px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:28px; width:64px">
   <p style="text-align:justify"><span style="font-size:16px"><strong><span style="color:#000000">7.Makina (HBSAG)</span></strong></span></p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor #000000 #000000; border-style:solid none solid solid; border-width:1px medium 1px 1px; vertical-align:top; width:53px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor #000000 #000000; border-style:solid none solid solid; border-width:1px medium 1px 1px; vertical-align:top; width:82px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor #000000 #000000; border-style:solid none solid solid; border-width:1px medium 1px 1px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor #000000 #000000; border-style:solid none solid solid; border-width:1px medium 1px 1px; vertical-align:top; width:8px">
   <p> </p>
   </td>
   <td style="border-color:#000000 currentcolor #000000 #000000; border-style:solid none solid solid; border-width:1px medium 1px 1px; width:304px">
   <p style="text-align:left"><span style="font-size:16px"><strong><span style="color:#000000">7.Makina (HBSAG)</span></strong></span></p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:5px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:115px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:24px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:73px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:35px">
   <p> </p>
   </td>
  </tr>
 </tbody>
</table>