AIRWAY MANAGEMENT SUPPORT

1 1 SET GUEDEL AIRWAY (7 SIZE) RUSCH

2 1 SET ENDOTRACHEAL TUBE (7 SIZE) RUSCH
3 LARYNGOSKOP 3 BLADE
4 INTUBATION STYLET
5 ADULT MAGILL FORCEP
6 VIGEL 30 GR
VENTILATION SUPPORT
1 CPR MASK BESMED
TOUNGE SPATEL SS POLOS
RESUSITATOR SILC ADULT BESMED
MANUAL SUCTION HAND
HEACTING SET
1 1 SET HEACTING SPALL
ALKES:
1 1 PCS TENSI CLOCK RIESTER
2 1 PCS STETOSKOP RIESTER
3 1 PCS THERMOMETER
4 5 PCS INFUS SET
5 5 PCS IV CATH 24
6 5 PCS IV CATH 22
7 5 PCS IV CATH 20
8 2 PCS MITELA
9 2 BOX KASA 16 X 16
10 1 ROL KAPAS 50 GR
11 2 PCS PEMBALUT CEPAT SIZE 1
12 1 PCS PEMBALUT CEPAT SIZE 2
13 1 PCS PEMBALUT CEPAT SIZE 3
14 3 ROL ELASTIS BANDAGE 7,5;10;15CM
15 1 PAK BETADINE PLESTER
16 1 ROL PLESTER GULUNG
17 1 PAK PERBAN 5 CM
18 1 PAK PERBAN 10 CM
19 1 PAK COTTON BUDS
20 1 BOX ALCOHO SWAB
21 1 BTL BETADINE CAIR 60 ML
22 1 PCS PINSET ANATOMI 14 CM
23 1 PCS SENTER
24 10 PSG SARUNG TANGAN
25 1 PAK MASKER
26 2 COOL COMPRESS
27 1 PCS TORNIQUETTE

DAFTAR OBAT & ALKES

1 STESOLID 1 AMP
2 MORFIN 1 AMP
3 EPINEPRIN 10 AMP
4 SULFAS ATROPIN 10 AMP
5 CEDOCARD 2 AMP
6 CORDARON 2 AMP
7 AMINOPHYLIN 1 AMP
8 DOPAC 1 AMP
9 DOBUTAMIN 1 AMP
10 VASCON 1 AMP
11 FARGOXIN 1 AMP
12 LASIX 1 AMP
13 ONDANSENTRON 2 AMP
14 ANTRAIN 2 AMP
15 OTSU D40 25 ML 1 FLASH
16 MEYLON 8,4 %/ BICNAT 25 ML
17 WATER FOR INJ 25 ML 1 FLASH
18 CEDOCAR 5 MG 2 TAB
19 CAPTOPRIL 12,5 MG 2 TAB
20 IV CATH NO. 24 5 PCS
21 IV CATH NO. 22 5 PCS
22 IV CATH NO. 30 5 PCS
23 TORNIQUETTE 1 EA
24 PASTIK PAD 10 EA

28 1 PCS REFLEX HAMMER

DAFTAR OBAT & ALKES

TESOLID 1 AMP
MORFIN 1 AMP
PINEPRIN 10 AMP
ULFAS ATROPIN 10 AMP
EDOCARD 2 AMP
ORDARON 2 AMP
MINOPHYLIN 1 AMP
OPAC 1 AMP
OBUTAMIN 1 AMP
ASCON 1 AMP
ARGOXIN 1 AMP
ASIX 1 AMP
ONDANSENTRON 2 AMP
NTRAIN 2 AMP
OTSU D40 25 ML 1 FLASH
MEYLON 8,4 %/ BICNAT 25 ML 1 FLASH
WATER FOR INJ 25 ML 1 FLASH
EDOCAR 5 MG 2 TAB
APTOPRIL 12,5 MG 2 TAB
V CATH NO. 24 5 PCS
V CATH NO. 22 5 PCS
V CATH NO. 30 5 PCS
ORNIQUETTE 1 EA
ASTIK PAD 10 EA

DAFTAR ISI KIT EMERGENCY RANSEL

AIRWAY MANAGEMENT SUPPORT
1 1 SET GUEDEL AIRWAY (7 SIZE) RUSCH
2 1 SET ENDOTRACHEAL TUBE (7 SIZE) RUSCH
3 LARYNGOSKOP 3 BLADE
4 INTUBATION STYLET
5 ADULT MAGILL FORCEP
6 VIGEL 30 GR
VENTILATION SUPPORT
1 CPR MASK BESMED
TOUNGE SPATEL SS POLOS
RESUSITATOR SILC ADULT BESMED
MANUAL SUCTION HAND
HEACTING SET
1 1 SET HEACTING SPALL
ALKES:
1 1 PCS TENSI CLOCK RIESTER
2 1 PCS STETOSKOP RIESTER
3 1 PCS THERMOMETER
4 5 PCS INFUS SET
5 5 PCS IV CATH 24
6 5 PCS IV CATH 22
7 5 PCS IV CATH 20
8 2 PCS MITELA
9 2 BOX KASA 16 X 16
10 1 ROL KAPAS 50 GR
11 2 PCS PEMBALUT CEPAT SIZE 1
12 1 PCS PEMBALUT CEPAT SIZE 2
13 1 PCS PEMBALUT CEPAT SIZE 3
14 3 ROL ELASTIS BANDAGE 7,5;10;15CM
15 1 PAK BETADINE PLESTER
16 1 ROL PLESTER GULUNG
17 1 PAK PERBAN 5 CM
18 1 PAK PERBAN 10 CM
19 1 PAK COTTON BUDS
20 1 BOX ALCOHO SWAB
21 1 BTL BETADINE CAIR 60 ML
22 1 PCS PINSET ANATOMI 14 CM
23 1 PCS SENTER
24 10 PSG SARUNG TANGAN
25 1 PAK MASKER
26 2 COOL COMPRESS
27 1 PCS TORNIQUETTE

DAFTAR OBAT & ALKES

1 STESOLID 1 AMP
2 MORFIN 1 AMP
3 EPINEPRIN 10 AMP
4 SULFAS ATROPIN 10 AMP
5 CEDOCARD 2 AMP
6 CORDARON 2 AMP
7 AMINOPHYLIN 1 AMP
8 DOPAC 1 AMP
9 DOBUTAMIN 1 AMP
10 VASCON 1 AMP
11 FARGOXIN 1 AMP
12 LASIX 1 AMP
13 ONDANSENTRON 2 AMP
14 ANTRAIN 2 AMP
15 OTSU D40 25 ML 1 FLASH
16 MEYLON 8,4 %/ BICNAT 25 ML
17 WATER FOR INJ 25 ML 1 FLASH
18 CEDOCAR 5 MG 2 TAB
19 CAPTOPRIL 12,5 MG 2 TAB
20 IV CATH NO. 24 5 PCS
21 IV CATH NO. 22 5 PCS
22 IV CATH NO. 30 5 PCS
23 TORNIQUETTE 1 EA
24 PASTIK PAD 10 EA

28 1 PCS REFLEX HAMMER

29 OXYMETRY SPO2

CY RANSEL

DAFTAR OBAT & ALKES

TESOLID 1 AMP
MORFIN 1 AMP
PINEPRIN 10 AMP
ULFAS ATROPIN 10 AMP
EDOCARD 2 AMP
ORDARON 2 AMP
MINOPHYLIN 1 AMP
OPAC 1 AMP
OBUTAMIN 1 AMP
ASCON 1 AMP
ARGOXIN 1 AMP
ASIX 1 AMP
ONDANSENTRON 2 AMP
NTRAIN 2 AMP
OTSU D40 25 ML 1 FLASH
MEYLON 8,4 %/ BICNAT 25 ML 1 FLASH
WATER FOR INJ 25 ML 1 FLASH
EDOCAR 5 MG 2 TAB
APTOPRIL 12,5 MG 2 TAB
V CATH NO. 24 5 PCS
V CATH NO. 22 5 PCS
V CATH NO. 30 5 PCS
ORNIQUETTE 1 EA
ASTIK PAD 10 EA

DAFTAR CHECKLIST ISI TAS EMERGENCY

BULAN:
CHECKLIST DAFTAR ISI TAS EMERGENCY KIT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43

GUEDEL AIRWAY (7 SIZE) RUSCH

ENDOTRACHEAL TUBE (7 SIZE) RUSCH
LARYNGOSKOP BLADE
INTUBATION STYLET
ADULT MAGILL FORCEP
VIGEL 30 GR
CPR MASK BESMED
TOUNGE SPATEL SS POLOS
RESUSITATOR SILC ADULT BESMED
MANUAL SUCTION HAND
SET HEACTING SPALL
PCS TENSI CLOCK RIESTER
PCS STETOSKOP RIESTER
PCS THERMOMETER
PCS INFUS SET
IV CATH 24
IV CATH 22
IV CATH 20
PCS MITELA
BOX KASA 16 X 16
ROL KAPAS 50 GR
PCS PEMBALUT CEPAT SIZE 1
PCS PEMBALUT CEPAT SIZE 2
PCS PEMBALUT CEPAT SIZE 3
ROL ELASTIS BANDAGE 7,5;10;15CM
BETADINE PLESTER
ROL PLESTER GULUNG
PERBAN 5 CM
PERBAN 10 CM
COTTON BUDS
ALCOHO SWAB
BETADINE CAIR 60 ML
PINSET ANATOMI 14 CM
SENTER
SARUNG TANGAN
MASKER
COOL COMPRESS
TORNIQUETTE
REFLEX HAMMER
OXYMETRY SPO2
STESOLID INJ
MORFIN INJ
EPINEPRIN INJ

JUMLAH

SATUAN

1
1
3
1
1
1
1
1
1
1
1
1
1
1
5
5
5
5
2
2
1
2
1
1
3
1
1
1
1
1
1
1
1
1
10
1
2
1
1
1
1
1
10

SET
SET
PCS
PCS
PCS
EA
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
PCS
AMP
AMP
AMP

44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60

SULFAS ATROPIN INJ

CEDOCARD INJ
CORDARON INJ
AMINOPHYLIN INJ
DOPAC INJ
DOBUTAMIN INJ
VASCON INJ
FARGOXIN INJ
LASIX INJ
ONDANSENTRON INJ
ANTRAIN INJ
OTSU D40 25 ML
MEYLON 8,4 %/ BICNAT 25 ML
WATER FOR INJ 25 ML
CEDOCAR 5 MG
CAPTOPRIL 12,5 MG
TORNIQUETTE

10
2
2
1
1
1
1
1
1
2
2
1
1
1
2
2
1

AMP
AMP
AMP
AMP
AMP
AMP
AMP
AMP
AMP
AMP
AMP
FLASH
FLASH
FLASH
TAB
TAB
EA

TAS EMERGENCY KIT

MINGGU
2
3

PARAF

CHECKLIST OKSIGEN
TANGGAL PARAF PEMERIKSA KETERANGAN

TANGGAL

CHECKLIST OKSIGEN
TANGGAL PARAF PEMERIKSA KETERANGAN

TANGGAL

CHECKLIST OKSIGEN
PARAF PEMERIKSA KETERANGAN

CHECKLIST OKSIGEN
PARAF PEMERIKSA KETERANGAN

DATA PEMAKAIAN TAS KIT EME

NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21

TGL

NAMA PETUGAS

22
23
24
25
26
27
28
29
30

AN TAS KIT EMERGENCY

KETERANGAN

PARAF

DAFTAR OBAT INJEKSI UNIT GAWAT

NO

ID OBAT

M00000593

M00050960

M00000361

M00048775

M00038916

M00041565

M00055845

M00049103

M00050724

10

M00001455

11

M00056755

12

M00001142

13

M00050746

14

M00006764

15

M00055226

16

M00044564

17

M00043433

18

M00000221

19

M00048694

20

M00056700

21

M00056906

22

M00055694

23

M00043525

24

M00017485

DAFTAR OBAT INHALASI UNIT GAWA

NO

ID OBAT

1
2
3
4
5

M00001956
M00002004
M00050153
M00051015
M00048230

DAFTAR OBAT INJEKSI UNIT GAWAT DARURAT

NAMA OBAT
AMINOPHYLLIN 2.4% 10ML INJ, 24'S/BOX (ETCA)
ANTRAIN 500MG/ML INJ, 5'S/BOX (INTR)
BUSCOPAN 20MG/ML 1ML INJ, 10'S/PACK (BHRI)
CITICOLINE 125MG/ML INJ, 10'S/BOX (OGB)
CORTIDEX 5MG/ML INJ, 10'S/BOX (SANB)
DYNASTAT 40MG INJ (PFZR)
ETASON 5MG/ML INJ, 5'S/BOX (OTTO)
IKADRYL 10MG/ML INJ, 30'S/BOX (IKAP)
FARMADOL INFUS 10MG/ML INF (FAHR)
KALNEX 250MG/5ML INJ, 10'S/BOX (KLBF)
KETOROLAC 30MG/ML INJ, 6'S/BOX (OGB)
LASIX 20MG/2ML INJ, 5'S/BOX (AVEN)
METHYL PREDNISOLON 125MG/2ML INJ (OGB)
NEUROBION 5000MCG/3ML INJ, 20'S/BOX (MRCK)
ONDANSETRON 4MG/2ML INJ, 10'S/BOX (OGB)
ONDANSETRON 8MG/4ML INJ, 5'S/BOX (OGB)
PIRACETAM 3G INJ, 4'S/BOX (OGB)
PRIMPERAN 10MG INJ, 6'S/BOX (SOHO)
PIRALEN 10MG/2ML INJ, 5'S/BOX (OTTO)
PROSOGAN 30MG INJ (TKDA)
ROCER 40MG INJ (OTTO)

RANITIDINE 25MG/ML INJ, 10'S/BOX (OGB)

TRAMADOL 100MG/2ML INJ, 5'S/BOX (OGB)
TRAMAL 100MG/2ML INJ

AFTAR OBAT INHALASI UNIT GAWAT DARURAT

NAMA OBAT
BEROTEC 50ML SOL (BHRI)
BISOLVON 50ML SOL (BHRI)
COMBIVENT 0.5MG/2.5MG UDV DOSE, 20'S/BOX (BHRI)
FLEXOTIDE NEBULES 2ML SOL, 10'S/BOX (GLAX)
VENTOLIN NEBULES 2.5MG SOL, 20'S/BOX (GLAX)

DAFTAR OBAT ORAL UNIT GAWAT

NO

ID OBAT

M00000781

M00055635

M00042954

M00055532

M00047681

M00056873

M00055985

M00009494

M00046756

10

M00035626

11

M00005051

12

M00030914

13

M00042980

14

M00005294

15

M00001514

16

M00000346

17

M00002715

18

M00043024

19

M00000814

20

M00046826

21

M00049604

22

M00042696

23

M00046863

24

M00028464

25

M00004292

26

M00039163

27

M00002531

28

M00000022

29

M00055974

30

M00047040

31

M00034090

32

M00047051

33

M00045581

34

M00043201

35

M00055705

36

M00045636

37

M00047880

38

M00050072

39

M00052301

40

M00056243

41

M00027915

42

M00047084

43

M00008400

44

M00048440

45

M00033036

46

M00003566

47

M00056684

48

M00056685

49

M00048742

50

M00000545

51

M00055193

52

M00005725

53

M00034915

54

M00038301

55

M00031021

56

M00003651

57

M00046196

58

M00055182

59

M00055543

60

M00050713

61

M00047364

62

M00047180

63

M00047191

64

M00048241

65

M00017010

66

M00018432

67

M00002472

68

M00012342

69

M00055613

70

M00055926

71

M00055016

72

M00030822

73

M00027963

74

M00038500

75

M00055860

76

M00047530

77

M00047541

78

M00045603

79

M00048204

80

M00055893

81

M00037726

82

M00002251

83

M00002236

84

M00027694

85

M00002645

86

M00002634

87

M00033714

88

M00005364

89

M00047316

90

M00034790

91

M00034801

92

M00030870

93

M00046675

94

M00031006

95

M00054600

96

M00049151

97

M00044693

98

M00038706

99

M00038135

100

M00046255

101

M00055204

102

M00048790

DAFTAR OBAT ORAL UNIT GAWAT DARURAT

NAMA OBAT
ADALAT OROS 30MG TAB, 30'S/BOX (BAYR)
ALCO 7,5 MG/5ML DROPS
AMBROXOL 30MG TAB, 100'S/BOX (OGB)
AMBROXOL 15MG/5ML(OGB)
AMLODIPINE 5MG TAB, 30'S/BOX (OGB)
AMLODIPINE 5MG TAB, 30'S/BOX (OGB)
AMOXICILLIN 125MG/5ML SYR (OGB)
AMOXICILLIN 500MG TAB, 100'S/BOX (OGB)
AMOXSAN 125MG/5ML 60ML SYR (SANB)
AMOXSAN 250MG/5ML 60ML SYR (SANB)
AMOXSAN 500MG CAPS, 100'S/BOX (SANB)
ANGIOTEN 50MG TAB, 30'S/BOX (KLBF)
ASAM MEFENAMAT 500MG CAPL, 100'S/BOX (OGB)
BACTOPRIME FORTE 800MG/160MG CAPL, 100'S/BOX (CMBR)
BORRAGYNOL-N SUPP, 10'S/BOX (TKDA)
BUSCOPAN 10MG TAB, 100'S/BOX (BHRI)
CARDIO ASPIRIN TAB
CAPTOPRIL 12.5MG TAB, 100'S/BOX (OGB)
CEDOCARD 5MG TAB, 60'S/BOX (DARV)
CEFAT 250 MG/SYR
CERINI 10 MG TAB, 20'S/BOX(SANB)
CETIRIZINE 10MG CAPS, 50'S/BOX (OGB)
CLANEKSI 250 MG/62,5MG SYR (SANB)
COMTUSI 60ML SYR (CMBR)
CONCOR 5MG TAB, 100'S/BOX (MRCK)

COUGH- EN EXPECT SYR

DUMIN 500MG TAB, 1000'S/BOX (ACTA)
DEXANTA TAB, 100'S/BOX (DEXA)
DEXAMETASON TAB
DEXTAFEN 2MG CAPS, 100'S/BOX (OTTO)
DEXTAMIN 0,5 MG SYR (PHAP)
DEXTROSIN TAB, 100'S/BOX (OTTO)
DEXYMOX 500MG CAPL, 100'S/BOX (DEXA)
DOMPERIDON 10MG TAB, 100'S/BOX (OGB)
DOMPERIDON 10MG TAB, 50'S/BOX (OGB)
EFLAGEN 25MG TAB, 50'S/BOX (SANB)
EPERISONE 50MG TAB, 100'S/BOX (OGB)
EPRINOC 50 MG TAB
ERICAF 1MG TAB, 30'S/BOX (TSPC)
FLU TAB
FORASMA 60ML SYR (GUAR)
FUZIDE 250MG/5ML SYR (OTTO)
HYDROCORTISON 2.5% 5G CREAM (OGB)
INDORALYTE 4.108G POWD, 25'S/BOX (INDF)
INSAAR 50MG TAB, 30'S/BOX (INTR)
INTERHISTIN 60ML SYR (INTR)
LAPIFED TAB (LAPI)
LAPIFED 60 ML SYR (LAPI)
LACTO-B 10-7CFU/G POWD, 40'S/BOX (NOVL)
LAXADINE 60ML SYR (GALE)
LEXADIUM 2MG TAB,60'S/BOX (MOLEX)
LODIA 2MG TAB, 60'S/BOX (SANB)
MAINTATE 5MG TAB, 30'S/BOX (TNBE)

MEFINAL 250MG CAPL, 100'S/BOX (SANB)

MEFINAL 500MG CAPL, 100'S/BOX (SANB)
MERISLON 6 MG TAB
MERTIGO 6MG TAB, 100'S/BOX (DEXA)
MOLAGIT TAB, 100'S/BOX (MOLEX)
MOLAPECT 30MG/5ML SYR (MOLX)
MUCERA 15MG/ML 15ML DROPS (OTTO)
MUCERA 30MG TAB, 100'S/BOX (OTTO)
MUCERA PAED 15MG/5ML 60ML SYR (OTTO)
MUSIN 500MG/5ML 120ML SYR (OTTO)
NEOKAOLANA 120ML SYR (SANB)
NORVASK 5MG TAB, 30'S/BOX (PFZR)
NOVALGIN 60ML SYR (AVEN)
NONFLAMIN 50 MG CAPS
OBH 100ML SYR (CMBR)
OBH MOLEX SYR (MOLX)
PARACETAMOL 500MG TAB, 100'S/BOX (OGB)
PLANTACID SUSPENSI SYR
PLAVIX 75MG TAB, 28'S/BOX (AVEN)
PROGESIC 250MG/ML SYR (MTSF)
RANITIDINE 150MG TAB, 100'S/BOX (OGB)
RIHEST SYR 5 MG/5ML
RHINOS NEO 7.5MG/5ML DROPS (DEXA)
RHINOS-SR 5MG CAPS, 50'S/BOX (DEXA)
RYVELL 10ML ORAL DROPS (NOVL)
RYVELL 5MG/5ML SYR (NOVL)
SALBUTAMOL 2 MG/5ML SYR
SALBUTAMOL 2 MG/TAB

SANADRYL PLUS DMP 120ML SYR (SANB)

SANAFLU PLUS 60ML SYR (SANB)
SANMAG 120ML SYR (SANB)
SANMOL 120MG/5ML 60ML SYR (SANB)
SANMOL 500MG TAB, 100'S/BOX
SANMOL 60MG/0.6ML 15ML DROPS (SANB)
SANPRIMA 60ML SYR (SANB)
SCOPAMIN PLUS 10MG/500MG CAPS, 100'S/BOX (OTTO)
TREMENZA 60MG/2.5MG TAB, 100'S/BOX (SANB)
TREMENZA 60ML SYR (SANB)
THROMBO ASPILETS 80MG TAB, 150'S/BOX (DARV)
THERAVASK 5 MG
TUZALOS CAPS, 100'S/BOX (SANB)
ULSAFAT 500MG/5ML 100ML SYR (CMBR)
ULTRACET 37.5MG/325MG CAPL, 30'S/BOX (JANS)
VACLO 75MG TAB, 30'S/BOX (DEXA)
VOMETA 5MG/ML 10ML ORAL DROPS (DEXA)
VOMETA 5MG/ML 60ML SYR (DEXA)
VOMETA FT 10MG FLASH TAB, 50'S/BOX (DEXA)
ZIDIAR 20 MG TAB
ZINK DISPERSIBLE 20MG TAB, 100'S/BOX (OGB)

DAFTAR OBAT TETES & SALEP UNIT GAWA

NO

ID OBAT
OBAT TETES DAN SALEP MATA

M00023155

M00023984

M00048263

M00007770

M00007910

OBAT SARIAWAN
1

M00008481

M00048580

OBAT TETES TELINGA

1

M00007943

M00033692

M00007965

M00058026

OBAT SALEP KULIT

1

M00022536

M00022540

M00043271

OBAT SALEP ANALGETIK

1

M00022304

M00050315

M00054224

DAFTAR OBAT TETES & SALEP UNIT GAWAT DARURAT

NAMA OBAT
OBAT TETES DAN SALEP MATA
CENDO-XITROL 5ML EYE DROPS (CEND)
CENDO-XITROL 5ML EYE OINT (CEND)
SAGESTAM 10G EYE DROPS (SANB)
GENTAMYCIN 3.5G EYE OINT (CEND)
PANTOCAIN 0,5% 5ML EYE DROP

OBAT SARIAWAN
ALBOTHYL CONC 10 ML LIQ
KETRICIN 6G OINT (FERR)

OBAT TETES TELINGA

SOFRADEX 8ML EYE/EAR DROPS (AVEN)
TARIVID OTIC 5ML EAR DROPS (KLBF)
OTOZAMBON 8ML EAR DROPS (ZAMB)
FORUMEN TETES TELINGA 5MG/ML (SANB)

OBAT SALEP KULIT

CINOLON 10G CREAM (SANB)
CINOLON-N 10G CREAM (SANB)
GENTAMYCIN 0.1% 5G OINT, 25'S/BOX (OGB)

OBAT SALEP ANALGETIK

VOLTAREN 20 MG EMULGEL
VOLTADEX GEL

DOLONES 2,5 % 5G CREAM (SANB)

CHECKLIST CONTROL PERLENGKAPAN APD

INSTALASI GAWAT DARURAT
BULAN :
NO

PERLENGKAPAN

JUMLAH

HELM

KACAMATA

EAR PLUG

ROMPI EMERGENCY

WEAR PACK

MINGGU
1

CHECKLIST CONTROL PERLENGKAPAN APD

INSTALASI GAWAT DARURAT
BULAN :
NO

PERLENGKAPAN

JUMLAH

HELM

KACAMATA

EAR PLUG

ROMPI EMERGENCY

WEAR PACK

MINGGU
1

ENGKAPAN APD

ARURAT
MINGGU
3

PARAF

ENGKAPAN APD

ARURAT
MINGGU
3

PARAF