BERITA ACARA RETUR OBAT DAN ALKES BERITA ACARA RETUR OBAT D

DARI RUANG IGD KE DEPO FARMASI IGD DARI RUANG IGD KE DEPO FARMA

NO NAMA BARANG JML NO

1 AMINOFUSIN HEPAR 1 31
2 AMINOPHYLLINE INJ* 1 32
3 ASERING 500CC OTSUKA* 3 33
4 AXIMED FEEDING TUBE NO 6 100CM #EP21 1 34
5 BLOOD TRANFUSI SET TYPE OB-1 #EP21 2 35
6 CALCIUM GLUCONATE INJ 10% 10 ML#P21 1 36
7 CEFTRIAXONE 1 GR#P21 9 37
8 CHROMA 2 WAY FR 16#EP21 9 38
9 CITICOLINE 250 MG/2ML 3 39
10 DEXAMETHASONE INJ 5MG/ML* 1 40
11 DISP 1 CC TUBERCULIN#EP21 8 41
12 DISP 20 CC 5 42
13 DISP 5 CC** 48 43
14 DISP 50 CC LUER LOCK WITHOUT NEEDLE#EP21 5 44
15 DISP 50CC CATH.TIP "STERA" (E-CAT) 2 45
16 DOPAMINE INJ 200MG/5ML#EP21 2 46
17 ENDOTRACHEAL TUBE UNCUFFED NO. 2,5 (E-CAT) 1 47
18 ENDOTRACHEAL TUBE WITH CUFFED NO. 6,5 (E-CAT) 1 48
19 ENDOTRACHEAL TUBE WITH CUFFED NO. 7,5* 3 49
20 EXTENSION TUBE 150 CM* 3 50
21 EYE PROTECTOR* 2 51
22 FOLLEY CATHETER 2 WAY 10 FR#EP21 1 52
23 FUROSEMID 10 MG/ML INJ (E-CAT) 9 53
24 GUEDEL 60 MM 1 54
25 GUEDEL AIRWAY 100MM*BTT 1 55
26 GUEDEL AIRWAY 90 MM 2 56
27 HUMALOG KWIKPEN 3 ML 100* 2 57
28 INTRAFIX CHILD 2 58
29 ISOSORBID DINITRATE INJ 1 MG 2 59
30 KA-EN 1B SOL/K OTSUKA* 3 60

Serang, 17 DES 2021

YANG MENYERAHKAN YANG MENERIMA
BERITA ACARA RETUR OBAT DAN ALKES
DARI RUANG IGD KE DEPO FARMASI IGD

NAMA BARANG JML

KETOROLAC 30 MG/ML#EP21 3
LEVOFLOXACIN INFUS 500 MG/100 ML #EP21 3
LIDOCAINE INJ 2%/2 ML#EP21 4
LOVENOX 0,6 1
MEROPENEM 1 GR INJ 1
METRONIDAZOLE 500 MG/ 100 ML INFUS#EP21 4
NACL 0.9% 100ML PIGGY #EP21 3
NASAL CANUL NEONATUS (MAS HOSPITALS) 1
NASAL O2 CANUL ANAK#EP21 1
NASAL O2 CANUL DEWASA#EP21 9
NICARDIPINE HCL 10MG INJ#P21 6
NOREPINEPHRINE BITARTRATE MONOHYDRATE#EP21 1
OMEPRAZOLE SODIUM 40 MG INJ#EP21 3
ONDANSETRON INJ 4 MG/2ML#P21 8
OTSU-MANITOL 20% 250 ML 2
OTSU-SALIN 3% 500ML 3
OXYGEN MASK REBREATHING DEWASA* 1
PARACETAMOL INFUS 100 ML (OGB DV) 2
SPUIT 10 CC NIPRO 6
SPUIT 3 CC NIPRO 6
STOMACH TUBE FR.14#P21 2
STOMACH TUBE NO 12 1
STOMACH TUBE NO 16 ONEMED 5
SUCTION CATHETER F 8 MAS -MAS HOSPITALS (E-CAT) 1
SURPLUG 3B 30CM LOCK#EP21 3
TEGADERM 4
THREE WAY STOPCOCK #EP21 1
TRANEXAMIC ACID INJ 5% 250 MG/5ML #EP 6
URINE BAG#EP21 8
WIDA GLUKOSA 5% D5-1/2NS (E-CAT) 1

Serang, 17 DES 2021

YANG MENYERAHKAN YANG MENERIMA
 BERITA ACARA RETUR OBAT DAN ALKES
DARI RUANG IGD KE DEPO FARMASI IGD

NO NAMA BARANG JML NO NAMA BARANG JML

1 AMINOFUSIN HEPAR 1 31 KETOROLAC 30 MG/ML#EP21 3
2 AMINOPHYLLINE INJ* 1 32 LEVOFLOXACIN INFUS 500 MG/100 ML #EP21 3
3 ASERING 500CC OTSUKA* 3 33 LIDOCAINE INJ 2%/2 ML#EP21 4
4 AXIMED FEEDING TUBE NO 6 100CM #EP21 1 34 LOVENOX 0,6 1
5 BLOOD TRANFUSI SET TYPE OB-1 #EP21 2 35 MEROPENEM 1 GR INJ 1
6 CALCIUM GLUCONATE INJ 10% 10 ML#P21 1 36 METRONIDAZOLE 500 MG/ 100 ML INFUS#EP21 4
7 CEFTRIAXONE 1 GR#P21 9 37 NACL 0.9% 100ML PIGGY #EP21 3
8 CHROMA 2 WAY FR 16#EP21 9 38 NASAL CANUL NEONATUS (MAS HOSPITALS) 1
9 CITICOLINE 250 MG/2ML 3 39 NASAL O2 CANUL ANAK#EP21 1
10 DEXAMETHASONE INJ 5MG/ML* 1 40 NASAL O2 CANUL DEWASA#EP21 9
11 DISP 1 CC TUBERCULIN#EP21 8 41 NICARDIPINE HCL 10MG INJ#P21 6
12 DISP 20 CC 5 42 NOREPINEPHRINE BITARTRATE MONOHYDRATE#EP21 1
13 DISP 5 CC** 48 43 OMEPRAZOLE SODIUM 40 MG INJ#EP21 3
14 DISP 50 CC LUER LOCK WITHOUT NEEDLE#EP21 5 44 ONDANSETRON INJ 4 MG/2ML#P21 8
15 DISP 50CC CATH.TIP "STERA" (E-CAT) 2 45 OTSU-MANITOL 20% 250 ML 2
16 DOPAMINE INJ 200MG/5ML#EP21 2 46 OTSU-SALIN 3% 500ML 3
17 ENDOTRACHEAL TUBE UNCUFFED NO. 2,5 (E-CAT) 1 47 OXYGEN MASK REBREATHING DEWASA* 1
18 ENDOTRACHEAL TUBE WITH CUFFED NO. 6,5 (E-CAT) 1 48 PARACETAMOL INFUS 100 ML (OGB DV) 2
19 ENDOTRACHEAL TUBE WITH CUFFED NO. 7,5* 3 49 SPUIT 10 CC NIPRO 6
20 EXTENSION TUBE 150 CM* 3 50 SPUIT 3 CC NIPRO 6
21 EYE PROTECTOR* 2 51 STOMACH TUBE FR.14#P21 2
22 FOLLEY CATHETER 2 WAY 10 FR#EP21 1 52 STOMACH TUBE NO 12 1
23 FUROSEMID 10 MG/ML INJ (E-CAT) 9 53 STOMACH TUBE NO 16 ONEMED 5
24 GUEDEL 60 MM 1 54 SUCTION CATHETER F 8 MAS -MAS HOSPITALS (E-CAT) 1
25 GUEDEL AIRWAY 100MM*BTT 1 55 SURPLUG 3B 30CM LOCK#EP21 3
26 GUEDEL AIRWAY 90 MM 2 56 TEGADERM 4
27 HUMALOG KWIKPEN 3 ML 100* 2 57 THREE WAY STOPCOCK #EP21 1
28 INTRAFIX CHILD 2 58 TRANEXAMIC ACID INJ 5% 250 MG/5ML #EP 6
29 ISOSORBID DINITRATE INJ 1 MG 2 59 URINE BAG#EP21 8
30 KA-EN 1B SOL/K OTSUKA* 3 60 WIDA GLUKOSA 5% D5-1/2NS (E-CAT) 1

Serang, ...................................... 2021

YANG MENYERAHKAN YANG MENERIMA