Prokalite | DİYALİZ MAKİNALARI YÜZEY TEMİZLİĞİ TAKİP FORMU

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Dİ.FR.012 - DİYALİZ MAKİNALARI YÜZEY TEMİZLİĞİ TAKİP FORMU

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Demo Hastanesi (Prokalite.Com) DİYALİZ MAKİNALARI YÜZEY TEMİZLİĞİ TAKİP FORMU

Doküman Kodu: Dİ.FR.012

Yayın Tarihi: 14.05.2025

Revizyon Tarihi: -

Revizyon No: -

Sayfa: Otomatik

	Uygulayan Personelin Adı Soy Adı	İşlem Saati	Dezenfektan Adı	Personel İmza			Uygulayan Personelin Adı Soy Adı	İşlem Saati	Dezenfektan Adı	Personel İmza
l.Makina						l.Makina
2.Makina						2.Makina
3.Makina						3.Makina
4.Makina						4.Makina
5.Makina						5.Makina
6.Makina						6.Makina
7.Makina hbs (+)						7.Makina hbs (+)

<meta charset="utf-8"/>
<table cellspacing="0" style="border-collapse:collapse; width:881px">
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   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:98px; width:108px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:104px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">Uygulayan Personelin Adı Soy Adı</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:45px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">İşlem Saati</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">Dezenfektan Adı</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:44px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">Personel İmza</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:3px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:100px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">Uygulayan Personelin Adı Soy Adı</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:47px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">İşlem Saati</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:80px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">Dezenfektan Adı</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; width:46px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">Personel İmza</span></span></strong></p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:43px; width:108px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">l.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:104px">
   <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:45px">
   <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:90px">
   <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:44px">
   <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:3px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">l.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:100px">
   <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:47px">
   <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:80px">
   <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:46px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:43px; width:108px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">2.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:104px">
   <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:45px">
   <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:90px">
   <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:44px">
   <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:3px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">2.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:100px">
   <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:47px">
   <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:80px">
   <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:46px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:42px; width:108px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">3.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:104px">
   <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:45px">
   <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:90px">
   <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:44px">
   <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:3px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">3.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:100px">
   <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:47px">
   <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:80px">
   <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:46px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:43px; width:108px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">4.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:104px">
   <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:45px">
   <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:90px">
   <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:44px">
   <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:3px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">4.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:100px">
   <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:47px">
   <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:80px">
   <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:46px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:43px; width:108px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">5.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:104px">
   <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:45px">
   <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:90px">
   <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:44px">
   <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:3px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">5.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:100px">
   <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:47px">
   <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:80px">
   <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:46px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:42px; width:108px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">6.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:104px">
   <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:45px">
   <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:90px">
   <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:44px">
   <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:3px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">6.Makina</span></span></strong></p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:100px">
   <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:47px">
   <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:80px">
   <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:46px">
   <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:43px; width:108px">
   <p style="text-align:center"><strong><span style="color:#000000"><span style="font-size:12pt">7.Makina hbs (+)</span></span></strong></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:104px">
   <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:45px">
   <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:90px">
   <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:44px">
   <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:3px">
   <p> </p>
   </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:90px">
   <p style="text-align:left"><strong><span style="color:#000000"><span style="font-size:12pt">7.Makina hbs (+)</span></span></strong></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:100px">
   <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:47px">
   <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:80px">
   <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:46px">
   <p> </p>
   </td>
  </tr>
 </tbody>
</table>