Prokalite | HEMODİYALİZ ÜNİTESİ ULTRAVİYOLE AMPUL DEĞİŞİM FORMU

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Diyaliz Ünitesi - Form

Dİ.FR.024 - HEMODİYALİZ ÜNİTESİ ULTRAVİYOLE AMPUL DEĞİŞİM FORMU

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Demo Hastanesi (Prokalite.Com) HEMODİYALİZ ÜNİTESİ ULTRAVİYOLE AMPUL DEĞİŞİM FORMU

Doküman Kodu: Dİ.FR.024

Yayın Tarihi: 14.05.2025

Revizyon Tarihi: -

Revizyon No: -

Sayfa: Otomatik

CİHAZIN BULUNDUĞU KURUM

ARIZA BAŞLANGIÇ SAATİ

ARIZA BİTİŞ SAATİ

TARİH

/ /20....

MARKA

SERİ NO

KÜNYE NO

ÇALIŞMA SAATİ

GARANTİLİ

GARANTİ DIŞI

C77)

MUHTEMEL ARIZALAR

YAPILAN İŞLER, TAVSİYELER

Değişen Parçalar Ünite Yetkililerine Teslim Edildi Ç ")

KULLANILAN PARÇALAR

PARÇA NO

PARÇA ADI

MİKTARI

BİRİMİ

TUTARI

DEPODAKİ YEDEK PARÇALARDAN KULLANILDI İSE

o

o

o

o

o

o

TOPLAM

<meta charset="utf-8"/>
<table cellspacing="0" style="border-collapse:collapse; width:1292px">
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:5px; vertical-align:bottom; width:190px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">CİHAZIN BULUNDUĞU KURUM</span></strong></span></p>
   </td>
   <td colspan="11" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:855px">
   <p> </p>
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 <tbody>
  <tr>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:22px; vertical-align:bottom; width:116px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">ARIZA BAŞLANGIÇ SAATİ</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:150px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:bottom; width:94px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">ARIZA BİTİŞ SAATİ</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:156px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:99px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">TARİH</span></strong></span></p>
   </td>
   <td colspan="5" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; width:373px">
   <p style="text-align:center"><span style="font-size:11pt"><span style="color:#000000">/ /20....</span></span></p>
   </td>
  </tr>
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   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:5px; vertical-align:bottom; width:116px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">MARKA</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:150px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:bottom; width:94px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">SERİ NO</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:156px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:bottom; width:99px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">KÜNYE NO</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:136px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:bottom; width:101px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">ÇALIŞMA SAATİ</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; vertical-align:top; width:109px">
   <p> </p>
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  </tr>
 </tbody>
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   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:5px; width:116px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">GARANTİLİ</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:150px">
   <p> </p>
   </td>
   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:94px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">GARANTİ DIŞI</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:156px">
   <p style="text-align:center"><span style="font-size:11pt"><span style="color:#000000"><span style="font-size:15pt">C77)</span></span></span></p>
   </td>
   <td colspan="7" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; width:486px">
   <p> </p>
   </td>
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   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:83px; width:116px">
   <p style="text-align:center"><span style="font-size:11pt"><strong><span style="color:#000000">MUHTEMEL ARIZALAR</span></strong></span></p>
   </td>
   <td colspan="12" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; width:929px">
   <p> </p>
   </td>
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 </tbody>
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   <td rowspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:64px; width:116px">
   <p style="text-align:center"><span style="font-size:11pt"><strong><span style="color:#000000">YAPILAN İŞLER, TAVSİYELER</span></strong></span></p>
   </td>
   <td colspan="12" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; width:929px">
   <p> </p>
   </td>
  </tr>
  <tr>
   <td colspan="12" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom; width:929px">
   <p style="text-align:left"><span style="font-size:11pt"><span style="color:#000000">Değişen Parçalar Ünite Yetkililerine Teslim Edildi Ç ")</span></span></p>
   </td>
  </tr>
 </tbody>
 <tbody>
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   <td colspan="13" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:5px; vertical-align:bottom; width:1059px">
   <p style="text-align:center"><span style="font-size:11pt"><strong><span style="color:#000000">KULLANILAN PARÇALAR</span></strong></span></p>
   </td>
  </tr>
 </tbody>
 <tbody>
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   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:41px; width:116px">
   <p style="text-align:center"><span style="font-size:11pt"><strong><span style="color:#000000">PARÇA NO</span></strong></span></p>
   </td>
   <td colspan="4" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:400px">
   <p style="text-align:center"><span style="font-size:11pt"><strong><span style="color:#000000">PARÇA ADI</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:61px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">MİKTARI</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:80px">
   <p style="text-align:left"><span style="font-size:11pt"><strong><span style="color:#000000">BİRİMİ</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; width:166px">
   <p style="text-align:center"><span style="font-size:11pt"><strong><span style="color:#000000">TUTARI</span></strong></span></p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:165px">
   <p style="text-align:center"><span style="font-size:11pt"><strong><span style="color:#000000">DEPODAKİ YEDEK PARÇALARDAN KULLANILDI İSE</span></strong></span></p>
   </td>
  </tr>
 </tbody>
 <tbody>
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   <td style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; height:15px; vertical-align:top; width:116px">
   <p> </p>
   </td>
   <td colspan="4" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:400px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
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   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:166px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom; width:165px">
   <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#000000"><span style="font-size:22pt">o</span></span></span></p>
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   <p> </p>
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   <p> </p>
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   <td colspan="2" 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 colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:80px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:166px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom; width:165px">
   <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#000000"><span style="font-size:22pt">o</span></span></span></p>
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   <p> </p>
   </td>
   <td colspan="4" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:400px">
   <p> </p>
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   <td colspan="2" 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 colspan="2" 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 colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:166px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom; width:165px">
   <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#000000"><span style="font-size:22pt">o</span></span></span></p>
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   <p> </p>
   </td>
   <td colspan="4" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:400px">
   <p> </p>
   </td>
   <td colspan="2" 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 colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:80px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:166px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom; width:165px">
   <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#000000"><span style="font-size:22pt">o</span></span></span></p>
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   <p> </p>
   </td>
   <td colspan="4" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:400px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:80px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:166px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom; width:165px">
   <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#000000"><span style="font-size:22pt">o</span></span></span></p>
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   <p> </p>
   </td>
   <td colspan="4" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:400px">
   <p> </p>
   </td>
   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:61px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:80px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:none; border-top:1px solid #000000; vertical-align:top; width:166px">
   <p> </p>
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   <td colspan="2" style="border-bottom:none; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom; width:165px">
   <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#000000"><span style="font-size:22pt">o</span></span></span></p>
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   <p style="text-align:right"><span style="font-size:11pt"><span style="color:#000000">TOPLAM</span></span></p>
   </td>
   <td colspan="4" 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:345px">
   <p> </p>
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</table>