Anda di halaman 1dari 519

INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : Januari 2022
1 2
NO NAMA ALAT JUMLAH
P S M P
1 MESIN VENTILATOR 1 1 1 1 1
2 MONITOR TTV 6 6 6 6 6
3 SYRINGE PUMP 5 4 4 4 4
4 INFUSION PUMP 3 3 3 3 3
5 MESIN EKG 1 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1 1
7 BLOOD WARMER 1 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1 1
13 DC SHOCK 1 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1 1

NAMA PEMERIKSA VI GR RS GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : Januari 2022
1 2
NO NAMA ALAT JUMLAH
P S M P
1 BED PASIEN 6 6 6 6 6
2 TROLY MONITOR  4  4  4  4  4
3 NAKAS MONITOR 2 2 2 2 2
4 NAKAS EKG 1 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5 5
9 KERANJANG OBAT  7  7  7  7  7
10 TROLY OBAT 1 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1 1
12 LEMARI LINEN 1 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5 5
15 SHARP CONTAINER 2 2 2 2 2
16 TOURNIQUET 2 2 2 2 2
17 SENTEL 1 1 1 1 1
18 MANISET DEWAS 6 6 6 6 6
19 MANISET ANAK 2 2 2 2 2

PARAF VI GR RS GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : Januari 2022
1 2
NO NAMA ALAT JUMLAH
P S M P
1 KOMPUTER 1 1 1 1 1
2 CPU merk hp 1 1 1 1 1
3 KURSI 3 3 3 3 3
4 URINE POT 1 1 1 1 1
5 GELAS UKUR 2 2 2 2 2
6 PISPOT 1 1 1 1 1
7 EMBER BESAR 1 1 1 1 1
8 KULKAS 1 1 1 1 1
9 DISPENSER 1 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6 6
12 JAM DINDING 1 1 1 1 1
13 AC & REMOTE 2 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2 2
17 STAPLES 1 1 1 1 1
18 CUK ROLL 2 2 2 2 2
19 PERFURATOR 1 1 1 1 1
20 KERANJANG LINEN 2 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4 4
22 WASKOM BESAR 5 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1 1
27 APAR 6 Kg 1 1 1 1 1

PARAF VI GR RS GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : Januari 2022
1 2
NO NAMA ALAT JUMLAH
P S M P
1 BAK INSTRUMENT 4 4 4 4 4
2 KUPET 3 3 3 3 3
3 KOM BESAR 5 5 5 5 5
4 KOM SEDANG 2 2 2 2 2
5 KOM KECIL 4 4 4 4 4
6 PINSET ANATOMIS 2 2 2 2 2
7 PINSET CHIRURGIS 3 3 3 3 3
8 GUNTING JARINGAN 2 2 2 2 2
9 GUNTING BENANG 5 5 5 5 5
10 GUNTING PERBAN 1 1 1 1 1
11 KLEM ARTERI 2 2 2 2 2
12 NALDPOEDER 2 2 2 2 2
13 BENGKOK BESAR 2 2 2 2 2
14 BENGKOK KECIL 1 1 1 1 1
15 TONGUE SPATEL 2 2 2 2 2
16 KLEM KHOCHER 2 2 2 2 2
17 MARGIL FORCEP 2 2 2 2 2
PARAF VI GR RS GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
U

2 3 4 5
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG VI GR DW AG IN DW GR RS DW

2 3 4 5
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG VI GR DW AG IN DW GR RS DW

2 3 4 5
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG VI GR DW AG IN DW GR RS DW

ANAN

2 3 4 5
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
AG VI GR DW AG IN DW GR RS DW
5 6 7 8
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN RS VI DW AG VI RS GR AG VI

(Ns.Go

5 6 7 8
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN RS VI DW AG VI RS GR AG VI

(Ns.Go

5 6 7 8
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN RS VI DW AG VI RS GR AG VI

(Ns.Go

5 6 7 8
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN RS VI DW AG VI RS GR AG VI

(Ns.Go
9 10 11 12
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 3 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN GR AG IN RS GR RS VI IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

9 10 11 12
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN GR AG IN RS GR RS VI IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

9 10 11 12
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN GR AG IN RS GR RS VI IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

9 10 11 12
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN GR AG IN RS GR RS VI IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
12 13 14 15
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 3 3 3 4 4
3 1 0 0 0 0 0 0 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW GR VI RS GR AG VI IN GR

12 13 14 15
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS DW GR VI RS GR AG VI IN GR

12 13 14 15
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS DW GR VI RS GR AG VI IN GR

12 13 14 15
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS DW GR VI RS GR AG VI IN GR
15 16 17 18
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 3
3 3 3 1 1 1 3 3 3 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG DW IN AG RS DW IN VI RS DW

15 16 17 18
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG DW IN AG RS DW IN VI RS DW

15 16 17 18
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG DW IN AG RS DW IN VI RS DW

15 16 17 18
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
AG DW IN AG RS DW IN VI RS DW
19 20 21 22
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 4 5 5
2 2 2 2 2 2 2 2 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG VI RS DW AG VI DW GR AG DW

19 20 21 22
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG VI RS DW AG VI DW GR AG DW

19 20 21 22
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG VI RS DW AG VI DW GR AG DW

19 20 21 22
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
AG VI RS DW AG VI DW GR AG DW
22 23 24 25
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 5 5 5 4 5 5 5 5 5
3 3 3 3 3 3 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN GR RS DW IN AG RS DW AG VI

22 23 24 25
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN GR RS DW IN AG RS DW AG VI

22 23 24 25
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN GR RS DW IN AG RS DW AG VI

22 23 24 25
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN GR RS DW IN AG RS DW AG VI
25 26 27 28
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
1 1 1 1 3 3 3 3 3 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW AG VI IN GR AG DW IN GR

25 26 27 28
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS DW AG VI IN GR AG DW IN GR

25 26 27 28
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS DW AG VI IN GR AG DW IN GR

25 26 27 28
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS DW AG VI IN GR AG DW IN GR
29 30 31
P S M P S M P S M
1 1 1 1 1 1 1
6 6 6 6 6 6 6
5 5 5 5 5 5 5
2 2 2 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
5 5 5 5 5 5 5
2 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1

RS DW IN VI RS DW VI

29 30 31
P S M P S M P S M
6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2

RS DW IN VI RS DW VI AG RS

29 30 31
P S M P S M P S M
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1

RS DW IN VI RS DW VI AG RS

29 30 31
P S M P S M P S M
4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2
RS DW IN VI RS DW VI AG RS
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : FEBRUARI 2022
1 2
NO NAMA ALAT JUMLAH
P S M P S
1 MESIN VENTILATOR 1 1 1 1 1 1
2 MONITOR TTV 6 6 6 6 6 4
3 SYRINGE PUMP 5 5 5 5 5 5
4 INFUSION PUMP 3 1 1 1 1 2
5 MESIN EKG 1 1 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1 1 1
7 BLOOD WARMER 1 1 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1 1 1
13 DC SHOCK 1 1 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1 1 1

NAMA PEMERIKSA IN AG VI IN GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : FEBRUARI 2022
1 2
NO NAMA ALAT JUMLAH
P S M P S
1 BED PASIEN 6 6 6 6 6 6
2 TROLY MONITOR  4  4  4  4  4  4
3 NAKAS MONITOR 2 2 2 2 2 2
4 NAKAS EKG 1 1 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5 5 5
9 KERANJANG OBAT  7  7  7  7  7  7
10 TROLY OBAT 1 1 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1 1 1
12 LEMARI LINEN 1 1 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5 5 5
15 SHARP CONTAINER 2 2 2 2 2 2
16 TOURNIQUET 2 2 2 2 2 2
17 SENTEL 1 1 1 1 1 1
18 MANISET DEWAS 6 6 6 6 6 6
19 MANISET ANAK 2 2 2 2 2 2

PARAF IN AG VI IN GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : FEBRUARI 2022
1 2
NO NAMA ALAT JUMLAH
P S M P S
1 KOMPUTER 1 1 1 1 1 1
2 CPU merk hp 1 1 1 1 1 1
3 KURSI 3 3 3 3 3 3
4 URINE POT 1 1 1 1 1 1
5 GELAS UKUR 2 2 2 2 2 2
6 PISPOT 1 1 1 1 1 1
7 EMBER BESAR 1 1 1 1 1 1
8 KULKAS 1 1 1 1 1 1
9 DISPENSER 1 1 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6 6 6
12 JAM DINDING 1 1 1 1 1 1
13 AC & REMOTE 2 2 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2 2 2
17 STAPLES 1 1 1 1 1 1
18 CUK ROLL 2 2 2 2 2 2
19 PERFURATOR 1 1 1 1 1 1
20 KERANJANG LINEN 2 2 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4 4 4
22 WASKOM BESAR 5 5 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1 1 1
27 APAR 6 Kg 1 1 1 1 1 1

PARAF IN AG VI IN GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : FEBRUARI 2022
1 2
NO NAMA ALAT JUMLAH
P S M P S
1 BAK INSTRUMENT 4 4 4 4 4 4
2 KUPET 3 3 3 3 3 3
3 KOM BESAR 5 5 5 5 5 5
4 KOM SEDANG 2 2 2 2 2 2
5 KOM KECIL 4 4 4 4 4 4
6 PINSET ANATOMIS 2 2 2 2 2 2
7 PINSET CHIRURGIS 3 3 3 3 3 3
8 GUNTING JARINGAN 2 2 2 2 2 2
9 GUNTING BENANG 5 5 5 5 5 5
10 GUNTING PERBAN 1 1 1 1 1 1
11 KLEM ARTERI 2 2 2 2 2 2
12 NALDPOEDER 2 2 2 2 2 2
13 BENGKOK BESAR 2 2 2 2 2 2
14 BENGKOK KECIL 1 1 1 1 1 1
15 TONGUE SPATEL 2 2 2 2 2 2
16 KLEM KHOCHER 2 2 2 2 2 2
17 MARGIL FORCEP 2 2 2 2 2 2
PARAF IN AG VI IN GR

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
U

2 3 4 5 6 7
M P S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 4
1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG GR DW IN RS DW GR VI RS DW AG VI AG IN AG RS

2 3 4 5 6 7
M P S M P S M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

AG GR DW IN RS DW GR VI RS DW AG VI AG IN AG RS

2 3 4 5 6 7
M P S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG GR DW IN RS DW GR VI RS DW AG VI AG IN AG RS

ANAN

2 3 4 5 6 7
M P S M P S M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
AG GR DW IN RS DW GR VI RS DW AG VI AG IN AG RS
8 9 10 11 12 13
P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4 5 5 4 4 4 4
2 2 2 2 2 3 3 3 3 3 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG GR IN DW IN GR RS DW IN RS VI DW VI AG RS GR

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11 12 13
P S M P S M P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

AG GR IN DW IN GR RS DW IN RS VI DW VI AG RS GR

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11 12 13
P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG GR IN DW IN GR RS DW IN RS VI DW VI AG RS GR

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11 12 13
P S M P S M P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
AG GR IN DW IN GR RS DW IN RS VI DW VI AG RS GR

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
13 14 15 16 17 18
S M P S M P S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 5 5 5 5 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 5 5 5 5 3 3 4 4 3 3
2 2 2 3 3 3 3 3 3 3 3 3 2 2 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG VI IN GR AG DW IN GR RS DW IN AG VI DW SN AG

13 14 15 16 17 18
S M P S M P S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4  4  4  4  4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7 7 7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

AG VI IN GR AG DW IN GR RS DW IN AG VI DW SN AG

13 14 15 16 17 18
S M P S M P S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG VI IN GR AG DW IN GR RS DW IN AG VI DW SN AG

13 14 15 16 17 18
S M P S M P S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
AG VI IN GR AG DW IN GR RS DW IN AG VI DW SN AG
18 19 20 21 22 23
M P S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 5 5 4 4 4 4 4
2 3 3 2 2 2 3 2 2 3 3 2 3 3 3 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

VI IN AG VI DW SN GR VI SN IN AG VI DW SN AG VI

18 19 20 21 22 23
M P S M P S M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4 4 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7 7 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

VI IN AG VI DW SN GR VI SN IN AG VI DW SN AG VI

18 19 20 21 22 23
M P S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

VI IN AG VI DW SN GR VI SN IN AG VI DW SN AG VI

18 19 20 21 22 23
M P S M P S M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
VI IN AG VI DW SN GR VI SN IN AG VI DW SN AG VI
24 25 26 27 28 29
P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 3 3 3 3 3 3 3 3
2 3 3 3 3 3 2 2 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

GR SN SN GR IN AG VI IN GR VI DW IN AG VI DW GR

24 25 26 27 28 29
P S M P S M P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

GR SN AG GR IN AG AG IN GR VI DW IN AG VI DW GR

24 25 26 27 28 29
P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

GR SN AG GR IN AG AG IN GR VI DW IN AG VI DW GR

24 25 26 27 28 29
P S M P S M P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
GR SN AG GR IN AG AG IN GR VI DW IN AG VI DW GR
29 30 31
S M P S M P S M
1
6
3
3
1
1
1
1
5
2
1
1
1
2
1
1
1
1
2
1
2
1

VI

29 30 31
S M P S M P S M
6
 4
2
1
1
1
4
5
 7
1
1
1
1
5
2
2
1
6
2

VI

29 30 31
S M P S M P S M
1
1
3
1
2
1
1
1
1
5
6
1
2
1
7
2
1
2
1
2
4
5
2
1
1
1
1

VI

29 30 31
S M P S M P S M
4
3
5
2
4
2
3
2
5
1
2
2
2
1
2
2
2
VI
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : MARET 2022
1
NO NAMA ALAT JUMLAH
P S
1 MESIN VENTILATOR 1 1 1
2 MONITOR TTV 6 6 6
3 SYRINGE PUMP 5 3 3
4 INFUSION PUMP 3 3 3
5 MESIN EKG 1 1 1
6 MESIN NEBULIZER 1 1 1
7 BLOOD WARMER 1 1 1
8 OKSIGEN MOBILE 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5
10 LARINGOSKOP DEWASA 2 2 2
11 LARINGOSKOP ANAK 1 1 1
12 LARINGOSKOP BAYI 1 1 1
13 DC SHOCK 1 1 1
14 SUCTION TEMPEL 2 2 2
15 AMBUBAGE DEWASA 1 1 1
16 AMBUBAGE ANAK 1 1 1
17 MESIN CEK GULA DARAH 1 1 1
18 TENSI METER NON RAKSA 1 1 1
19 STETOSKOP DEWASA 2 2 2
20 STETOSKOP ANAK 1 1 1
21 THERMOMETER RAKSA 2 2 2
22 LAMPU BACA X-RAY 1 1 1

NAMA PEMERIKSA SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : MARET 2022
1
NO NAMA ALAT JUMLAH
P S
1 BED PASIEN 6 6 6
2 TROLY MONITOR  4  4  4
3 NAKAS MONITOR 2 2 2
4 NAKAS EKG 1 1 1
5 TROLY RAWAT LUKA 1 1 1
6 TROLY PASANG INFUS 1 1 1
7 MEJA MAKAN PASIEN 4 4 4
8 MEJA KAYU PASIEN 5 5 5
9 KERANJANG OBAT  7  7  7
10 TROLY OBAT 1 1 1
11 TROLY EMERGENCY 1 1 1
12 LEMARI LINEN 1 1 1
13 LEMARI ALAT-ALAT 1 1 1
14 TEMPAT SPUIT 5 5 5
15 SHARP CONTAINER 2 2 2
16 TOURNIQUET 2 2 2
17 SENTEL 1 1 1
18 MANISET DEWAS 6 6 6
19 MANISET ANAK 2 2 2

PARAF SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : MARET 2022
1
NO NAMA ALAT JUMLAH
P S
1 KOMPUTER 1 1 1
2 CPU merk hp 1 1 1
3 KURSI 3 3 3
4 URINE POT 1 1 1
5 GELAS UKUR 2 2 2
6 PISPOT 1 1 1
7 EMBER BESAR 1 1 1
8 KULKAS 1 1 1
9 DISPENSER 1 1 1
10 STANDAR INFUS RODA 5 5 5
11 STANDAR INFUS BED 6 6 6
12 JAM DINDING 1 1 1
13 AC & REMOTE 2 2 2
14 PENGGARIS 30 CM 1 1 1
15 KERANJANG HIJAU 7 7 7
16 TEMPAT PENSIL 2 2 2
17 STAPLES 1 1 1
18 CUK ROLL 2 2 2
19 PERFURATOR 1 1 1
20 KERANJANG LINEN 2 2 2
21 TEMPAT SAMPAH 4 4 4
22 WASKOM BESAR 5 5 5
23 TEMPAT TISSUE 2 2 2
24 TELEPON RUANGAN 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1
26 THERMOMETER RUANGAN 1 1 1
27 APAR 6 Kg 1 1 1

PARAF SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : MARET 2022
1
NO NAMA ALAT JUMLAH
P S
1 BAK INSTRUMENT 4 4 4
2 KUPET 3 3 3
3 KOM BESAR 5 5 5
4 KOM SEDANG 2 2 2
5 KOM KECIL 4 4 4
6 PINSET ANATOMIS 2 2 2
7 PINSET CHIRURGIS 3 3 3
8 GUNTING JARINGAN 2 2 2
9 GUNTING BENANG 5 5 5
10 GUNTING PERBAN 1 1 1
11 KLEM ARTERI 2 2 2
12 NALDPOEDER 2 2 2
13 BENGKOK BESAR 2 2 2
14 BENGKOK KECIL 1 1 1
15 TONGUE SPATEL 2 2 2
16 KLEM KHOCHER 2 2 2
17 MARGIL FORCEP 2 2 2
PARAF SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
U

1 2 3 4
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI GR IN SN GR AG GR SN DW VI

Kep)

1 2 3 4
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI GR IN SN GR AG GR SN DW VI

Kep)

1 2 3 4
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI GR GR SN GR AG GR SN DW VI

Kep)

BANAN

1 2 3 4
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI GR IN SN GR AG GR SN DW VI

Kep)
5 6 7 8
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 5 5 3 3 3 5 5 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW SN IN AG VI SN GR VI AG IN

5 6 7 8
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW SN IN AG VI SN GR VI AG IN

5 6 7 8
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW SN IN AG VI SN GR VI AG IN

5 6 7 8
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW SN IN AG VI SN GR VI AG IN
8 9 10 11
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 5 3 3 3 2 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 0 0 0 0 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 0 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

GR VI GR AG DW SN VI GR VI IN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

GR VI GR AG DW SN VI GR VI IN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

GR VI GR AG DW SN VI GR VI IN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
GR VI GR AG DW SN VI GR VI IN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
11 12 13 14
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG IN IN SN IN VI AG AG GR IN

11 12 13 14
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG IN IN SN IN VI AG AG GR IN

11 12 13 14
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG IN IN SN IN VI AG AG GR IN

11 12 13 14
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
AG IN IN SN IN VI AG AG GR IN
15 16 17 18
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 5 5 5 5 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG SN IN SN DW AG VI DW SN IN

15 16 17 18
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG SN IN SN DW AG VI DW SN IN

15 16 17 18
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG SN IN SN DW AG VI DW SN IN

15 16 17 18
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
AG SN IN SN DW AG VI DW SN IN
18 19 20 21
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN DW GR IN VI AG gr IN AG SN

18 19 20 21
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN DW GR IN VI AG GR IN AG SN

18 19 20 21
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN DW GR IN VI AG gr IN AG SN

18 19 20 21
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN DW GR IN VI AG gr IN AG SN
21 22 23 24
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

GR SN DW AG VI DW SN VI VI DW

21 22 23 24
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

GR SN DW AG VI DW SN VI VI DW

21 22 23 24
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

GR SN DW AG VI DW SN VI VI DW

21 22 23 24
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
GR SN DW AG VI DW SN VI VI DW
25 26 27 28
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 4 4
3 3 3 3 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

GR IN VI AG GR IN SN AG GR DW

25 26 27 28
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

GR IN VI AG GR IN SN AG GR DW

25 26 27 28
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

GR IN VI AG GR IN SN AG GR DW

25 26 27 28
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
GR IN VI AG GR IN SN AG GR DW
28 29 30 31
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN AG VI DW SN IN VI DW GR IN

28 29 30 31
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
 4  4  4  4  4  4  4  4  4  4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

SN AG VI DW SN IN VI DW GR IN

28 29 30 31
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

SN AG VI DW SN IN VI DW DW IN

28 29 30 31
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
SN AG VI DW SN IN VI DW DW IN
31
M
1
6
5
3
1
1
1
1
5
2
1
1
1
2
1
1
1
1
2
1
2
1

VI

31
M
6
 4
2
1
1
1
4
5
 7
1
1
1
1
5
2
2
1
6
2

VI

31
M
1
1
3
1
2
1
1
1
1
5
6
1
2
1
7
2
1
2
1
2
4
5
2
1
1
1
1

VI

31
M
4
3
5
2
4
2
3
2
5
1
2
2
2
1
2
2
2
VI
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : APRIL 2022
1
NO NAMA ALAT JUMLAH
P S M
1 MESIN VENTILATOR 1 1 1 1
2 MONITOR TTV 6 5 5 5
3 SYRINGE PUMP 5 5 5 5
4 INFUSION PUMP 3 3 3 3
5 MESIN EKG 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1
7 BLOOD WARMER 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1
13 DC SHOCK 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1

NAMA PEMERIKSA AG GR IN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : APRIL 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BED PASIEN 6 5 5 5
2 TROLY MONITOR  4 3 3 3
3 NAKAS MONITOR 2 2 2 2
4 NAKAS EKG 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5
9 KERANJANG OBAT  7  7  7  7
10 TROLY OBAT 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1
12 LEMARI LINEN 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5
15 SHARP CONTAINER 2 2 2 2
16 TOURNIQUET 2 2 2 2
17 SENTEL 1 1 1 1
18 MANISET DEWAS 6 6 6 6
19 MANISET ANAK 2 2 2 2

PARAF AG GR IN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : APRIL 2022
1
NO NAMA ALAT JUMLAH
P S M
1 KOMPUTER 1 1 1 1
2 CPU merk hp 1 1 1 1
3 KURSI 3 3 3 3
4 URINE POT 1 1 1 1
5 GELAS UKUR 2 2 2 2
6 PISPOT 1 1 1 1
7 EMBER BESAR 1 1 1 1
8 KULKAS 1 1 1 1
9 DISPENSER 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6
12 JAM DINDING 1 1 1 1
13 AC & REMOTE 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2
17 STAPLES 1 1 1 1
18 CUK ROLL 2 2 2 2
19 PERFURATOR 1 1 1 1
20 KERANJANG LINEN 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4
22 WASKOM BESAR 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1
27 APAR 6 Kg 1 1 1 1

PARAF AG GR IN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : APRIL 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BAK INSTRUMENT 4 4 4 4
2 KUPET 3 3 3 3
3 KOM BESAR 5 5 5 5
4 KOM SEDANG 2 2 2 2
5 KOM KECIL 4 4 4 4
6 PINSET ANATOMIS 2 2 2 2
7 PINSET CHIRURGIS 3 3 3 3
8 GUNTING JARINGAN 2 2 2 2
9 GUNTING BENANG 5 5 5 5
10 GUNTING PERBAN 1 1 1 1
11 KLEM ARTERI 2 2 2 2
12 NALDPOEDER 2 2 2 2
13 BENGKOK BESAR 2 2 2 2
14 BENGKOK KECIL 1 1 1 1
15 TONGUE SPATEL 2 2 2 2
16 KLEM KHOCHER 2 2 2 2
17 MARGIL FORCEP 2 2 2 2
PARAF AG GR IN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
2 3 4 5 6 7 8
P S M P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
5 5 5 5 4 4 4 4 4 4 4 4 4 4 5 5 5 5 4
3 3 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

SN AG GR DW SN AG SN DW VI IN VI SN GR IN VI AG AG IN SN

2 3 4 5 6 7 8
P S M P S M P S M P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

SN AG GR DW SN AG SN DW VI IN VI SN GR IN VI AG AG IN SN

2 3 4 5 6 7 8
P S M P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

SN AG GR DW SN AG SN DW VI IN VI SN GR IN VI AG IN IN SN

ANAN

2 3 4 5 6 7 8
P S M P S M P S M P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
SN AG GR DW SN AG SN DW VI IN VI SN GR IN VI AG IN IN SN
8 9 10 11 12 13 14
S M P S M P S M P S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
4 4 3 3 3 5 5 5 5 5 5 4 4 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG GR SN DW AG VI IN SN IN VI DW RS IN VI RS AG IN RS SN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11 12 13 14
S M P S M P S M P S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

AG GR SN DW AG VI IN SN IN VI DW RS IN VI RS AG IN RS SN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11 12 13 14
S M P S M P S M P S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG GR SN DW AG VI IN SN IN VI DW RS IN VI RS AG IN RS SN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11 12 13 14
S M P S M P S M P S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
AG GR SN DW AG VI IN SN IN VI DW RS IN VI RS AG IN RS SN

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
14 15 16 17 18 19 20
M P S M P S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 5 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5 5 5 3 3 3 5 3 3 3
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG DW SN GR VI DW SN IN VI DW AG VI IN IN AG VI SN AG RS

14 15 16 17 18 19 20
M P S M P S M P S M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

AG DW SN GR VI DW SN IN VI DW AG VI IN IN AG VI SN AG RS

14 15 16 17 18 19 20
M P S M P S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

AG DW SN GR VI DW SN IN VI DW AG VI IN IN AG VI SN AG RS

14 15 16 17 18 19 20
M P S M P S M P S M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
AG RS SN GR VI DW SN IN VI DW AG VI IN IN AG VI SN AG RS
21 22 23 24 25 26 27
P S M P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
3 3 3 3 4 4 4 5 5 5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3 2 2 2 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

SN DW AG IN DW SN RS VI DW RS VI IN AG RS VI AG SN VI DW

21 22 23 24 25 26 27
P S M P S M P S M P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

SN DW AG IN DW SN RS VI DW RS VI IN AG RS VI AG SN VI DW

21 22 23 24 25 26 27
P S M P S M P S M P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

SN DW AG IN DW SN RS VI DW RS VI IN AG RS VI AG SN VI DW

21 22 23 24 25 26 27
P S M P S M P S M P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
SN DW AG IN DW SN RS VI DW RS VI IN AG RS VI AG SN VI DW
27 28 29 30 31
S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1

SN AG IN DW SN VI IN DW RS VI IN

27 28 29 30 31
S M P S M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2 2

SN AG IN DW SN VI IN DW RS VI IN

27 28 29 30 31
S M P S M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1

SN AG IN DW SN VI IN DW RS VI IN

27 28 29 30 31
S M P S M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2
SN AG IN DW SN VI IN DW RS VI IN
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : MEI 2022
1
NO NAMA ALAT JUMLAH
P S M
1 MESIN VENTILATOR 1 1 1 1
2 MONITOR TTV 6 6 6 6
3 SYRINGE PUMP 5 5 5 5
4 INFUSION PUMP 3 3 3 3
5 MESIN EKG 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1
7 BLOOD WARMER 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1
13 DC SHOCK 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1

NAMA PEMERIKSA VI RS AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : MEI 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BED PASIEN 6 5 5 5
2 TROLY MONITOR  4 3 3 3
3 NAKAS MONITOR 2 2 2 2
4 NAKAS EKG 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5
9 KERANJANG OBAT  7  7  7  7
10 TROLY OBAT 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1
12 LEMARI LINEN 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5
15 SHARP CONTAINER 2 2 2 2
16 TOURNIQUET 2 2 2 2
17 SENTEL 1 1 1 1
18 MANISET DEWAS 6 6 6 6
19 MANISET ANAK 2 2 2 2

PARAF VI RS AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : MEI 2022
1
NO NAMA ALAT JUMLAH
P S M
1 KOMPUTER 1 1 1 1
2 CPU merk hp 1 1 1 1
3 KURSI 3 3 3 3
4 URINE POT 1 1 1 1
5 GELAS UKUR 2 2 2 2
6 PISPOT 1 1 1 1
7 EMBER BESAR 1 1 1 1
8 KULKAS 1 1 1 1
9 DISPENSER 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6
12 JAM DINDING 1 1 1 1
13 AC & REMOTE 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2
17 STAPLES 1 1 1 1
18 CUK ROLL 2 2 2 2
19 PERFURATOR 1 1 1 1
20 KERANJANG LINEN 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4
22 WASKOM BESAR 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1
27 APAR 6 Kg 1 1 1 1

PARAF VI RS AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : MEI 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BAK INSTRUMENT 4 4 4 4
2 KUPET 3 3 3 3
3 KOM BESAR 5 5 5 5
4 KOM SEDANG 2 2 2 2
5 KOM KECIL 4 4 4 4
6 PINSET ANATOMIS 2 2 2 2
7 PINSET CHIRURGIS 3 3 3 3
8 GUNTING JARINGAN 2 2 2 2
9 GUNTING BENANG 5 5 5 5
10 GUNTING PERBAN 1 1 1 1
11 KLEM ARTERI 2 2 2 2
12 NALDPOEDER 2 2 2 2
13 BENGKOK BESAR 2 2 2 2
14 BENGKOK KECIL 1 1 1 1
15 TONGUE SPATEL 2 2 2 2
16 KLEM KHOCHER 2 2 2 2
17 MARGIL FORCEP 2 2 2 2
PARAF VI RS AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
ICU

2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 3
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN DW RS SN DW VI IN DW SN GR

p)

2 3 4 5
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 2
3 3 3 3 3 3 3 3 3 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

SN DW RS SN DW VI IN DW SN GR

p)

2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

SN DW RS SN DW VI IN DW SN GR

p)

TABANAN

2 3 4 5
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
SN DW RS SN DW VI IN DW SN GR

p)
5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
3 3 5 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN DW GR VI DW GR RS VI SN AG

5 6 7 8
S M P S M P S M P S
2 2 5 5 5 5 5 5 5 5
1 1 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN DW GR VI DW GR RS VI SN AG

5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN DW GR VI DW GR RS VI SN AG

5 6 7 8
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN DW GR VI DW GR RS VI SN AG
8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 4 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW SN AG IN DW SN VI IN DW

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS DW SN AG IN DW SN VI IN DW

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS DW SN AG IN DW SN VI IN DW

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS DW SN AG IN DW SN VI IN DW

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS VI IN AG RS VI RS AG SN RS

12 13 14 15
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS VI IN AG RS VI RS AG SN RS

12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS VI INI AG RS VI RS AG SN RS

12 13 14 15
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS VI IN AG RS VI RS AG SN RS
15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW AG IN DW RS VI IN DW SN VI

15 16 17 18
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW AG IN DW RS VI IN DW SN VI

15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW AG IN DW RS VI IN DW SN VI

15 16 17 18
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW AG IN DW RS VI IN DW SN VI
18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 3 3 3 3 4 4
2 2 2 3 3 3 3 3 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN AG SN VI VI AG SN RS DW AG

18 19 20 21
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN AG SN VI VI AG SN RS DW AG

18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN AG SN VI VI AG SN RS DW AG

18 19 20 21
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN AG SN VI VI AG SN RS DW AG
22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 3 3 3 3 3 4 4
2 2 2 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN DW RS VI IN DW VI SN IN AG

22 23 24 25
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN DW RS VI IN DW VI SN IN AG

22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN DW RS VI IN DW VI SN IN AG

22 23 24 25
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN DW RS VI IN DW VI SN IN AG
25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 3 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN VI RS AG SN RS DW AG IN DW

25 26 27 28
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

SN VI RS AG SN RS DW AG IN DW

25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

SN VI RS AG SN RS DW AG IN DW

25 26 27 28
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
SN VI RS AG SN RS DW AG IN DW
28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG IN VI RS SN VI IN AG SN IN

28 29 30 31
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG IN VI RS SN VI IN AG SN IN

28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG IN VI RS SN VI IN AG SN IN

28 29 30 31
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
AG IN VI RS SN VI IN AG SN IN
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : Juni 2022
1
NO NAMA ALAT JUMLAH
P S
1 MESIN VENTILATOR 1 1 1
2 MONITOR TTV 6 6 6
3 SYRINGE PUMP 5 5 5
4 INFUSION PUMP 3 2 2
5 MESIN EKG 1 1 1
6 MESIN NEBULIZER 1 1 1
7 BLOOD WARMER 1 1 1
8 OKSIGEN MOBILE 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5
10 LARINGOSKOP DEWASA 2 2 2
11 LARINGOSKOP ANAK 1 1 1
12 LARINGOSKOP BAYI 1 1 1
13 DC SHOCK 1 1 1
14 SUCTION TEMPEL 2 2 2
15 AMBUBAGE DEWASA 1 1 1
16 AMBUBAGE ANAK 1 1 1
17 MESIN CEK GULA DARAH 1 1 1
18 TENSI METER NON RAKSA 1 1 1
19 STETOSKOP DEWASA 2 2 2
20 STETOSKOP ANAK 1 1 1
21 THERMOMETER RAKSA 2 2 2
22 LAMPU BACA X-RAY 1 1 1

NAMA PEMERIKSA AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : Juni 2022
1
NO NAMA ALAT JUMLAH
P S
1 BED PASIEN 6 5 5
2 TROLY MONITOR  4 3 3
3 NAKAS MONITOR 2 2 2
4 NAKAS EKG 1 1 1
5 TROLY RAWAT LUKA 1 1 1
6 TROLY PASANG INFUS 1 1 1
7 MEJA MAKAN PASIEN 4 4 4
8 MEJA KAYU PASIEN 5 5 5
9 KERANJANG OBAT  7  7  7
10 TROLY OBAT 1 1 1
11 TROLY EMERGENCY 1 1 1
12 LEMARI LINEN 1 1 1
13 LEMARI ALAT-ALAT 1 1 1
14 TEMPAT SPUIT 5 5 5
15 SHARP CONTAINER 2 2 2
16 TOURNIQUET 2 2 2
17 SENTEL 1 1 1
18 MANISET DEWAS 6 6 6
19 MANISET ANAK 2 2 2

PARAF AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : Juni 2022
1
NO NAMA ALAT JUMLAH
P S
1 KOMPUTER 1 1 1
2 CPU merk hp 1 1 1
3 KURSI 3 3 3
4 URINE POT 1 1 1
5 GELAS UKUR 2 2 2
6 PISPOT 1 1 1
7 EMBER BESAR 1 1 1
8 KULKAS 1 1 1
9 DISPENSER 1 1 1
10 STANDAR INFUS RODA 5 5 5
11 STANDAR INFUS BED 6 6 6
12 JAM DINDING 1 1 1
13 AC & REMOTE 2 2 2
14 PENGGARIS 30 CM 1 1 1
15 KERANJANG HIJAU 7 7 7
16 TEMPAT PENSIL 2 2 2
17 STAPLES 1 1 1
18 CUK ROLL 2 2 2
19 PERFURATOR 1 1 1
20 KERANJANG LINEN 2 2 2
21 TEMPAT SAMPAH 4 4 4
22 WASKOM BESAR 5 5 5
23 TEMPAT TISSUE 2 2 2
24 TELEPON RUANGAN 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1
26 THERMOMETER RUANGAN 1 1 1
27 APAR 6 Kg 1 1 1

PARAF AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : Juni 2022
1
NO NAMA ALAT JUMLAH
P S
1 BAK INSTRUMENT 4 4 4
2 KUPET 3 3 3
3 KOM BESAR 5 5 5
4 KOM SEDANG 2 2 2
5 KOM KECIL 4 4 4
6 PINSET ANATOMIS 2 2 2
7 PINSET CHIRURGIS 3 3 3
8 GUNTING JARINGAN 2 2 2
9 GUNTING BENANG 5 5 5
10 GUNTING PERBAN 1 1 1
11 KLEM ARTERI 2 2 2
12 NALDPOEDER 2 2 2
13 BENGKOK BESAR 2 2 2
14 BENGKOK KECIL 1 1 1
15 TONGUE SPATEL 2 2 2
16 KLEM KHOCHER 2 2 2
17 MARGIL FORCEP 2 2 2
PARAF AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
CU

1 2 3 4
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW SN RS IN DW AG VI IN SN

Kep)

1 2 3 4
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS DW SN RS IN DW AG VI IN SN

Kep)

1 2 3 4
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS DW SN RS IN DW AG VI IN SN

Kep)

BANAN

1 2 3 4
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS DW SN RS IN DW AG RS IN SN

Kep)
5 6 7 8
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 4 4 4 4 5 4 4 4
2 2 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI VI IN AG RS IN AG SN RS SN

5 6 7 8
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI VI IN AG RS IN AG SN RS SN

5 6 7 8
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI VI IN AG RS IN AG SN RS SN

5 6 7 8
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI VI IN AG RS IN AG SN RS SN
8 9 10 11
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 5 5 4 4 4
3 3 3 3 3 2 2 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW AG IN DW SN VI IN DW AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW AG IN DW SN VI IN DW AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW AG IN DW SN VI IN DW AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW AG IN DW SN VI IN DW AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
11 12 13 14
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 5 5
3 3 3 3 3 3 3 3 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN AG RS VI SN AG RS DW SN AG

11 12 13 14
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN AG RS VI SN AG RS DW SN AG

11 12 13 14
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN AG RS VI AG RS DW SN AG
SN

11 12 13 14
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN AG RS VI SN AG RS DW SN AG
15 16 17 18
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 4 4 4 5 5 5 5
2 2 2 3 3 3 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN DW SN VI IN DW RS VI IN AG

15 16 17 18
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN DW SN VI IN DW RS VI IN AG

15 16 17 18
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN DW SN VI IN DW RS VI IN AG

15 16 17 18
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN DW SN VI IN DW RS VI IN AG
18 19 20 21
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS VI SN AG RS DW SN AG IN DW

18 19 20 21
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS VI SN AG RS DW SN AG IN DW

18 19 20 21
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS VI SN AG RS DW SN AG IN DW

18 19 20 21
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS VI SN AG RS DW SN AG IN DW
21 22 23 24
M P S M P S M P S M
1 1 1
6 6 6
4 5 5
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1
5 5 5
2 2 2
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1
2 2 2
1 1 1

SN VI IN

21 22 23 24
M P S M P S M P S M
5 5 5
3 3 3
2 2 2
1 1 1
1 1 1
1 1 1
4 4 4
5 5 5
 7  7  7
1 1 1
1 1 1
1 1 1
1 1 1
5 5 5
2 2 2
2 2 2
1 1 1
6 6 6
2 2 2

SN VI IN

21 22 23 24
M P S M P S M P S M
1 1 1
1 1 1
3 3 3
1 1 1
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1
5 5 5
6 6 6
1 1 1
2 2 2
1 1 1
7 7 7
2 2 2
1 1 1
2 2 2
1 1 1
2 2 2
4 4 4
5 5 5
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1

SN VI IN

21 22 23 24
M P S M P S M P S M
4 4 4
3 3 3
5 5 5
2 2 2
4 4 4
2 2 2
3 3 3
2 2 2
5 5 5
1 1 1
2 2 2
2 2 2
2 2 2
1 1 1
2 2 2
2 2 2
2 2 2
SN VI IN
25 26 27 28
P S M P S M P S M P

25 26 27 28
P S M P S M P S M P
25 26 27 28
P S M P S M P S M P
25 26 27 28
P S M P S M P S M P
28 29 30 31
S M P S M P S M P S

28 29 30 31
S M P S M P S M P S
28 29 30 31
S M P S M P S M P S
28 29 30 31
S M P S M P S M P S
31
M

31
M
31
M
31
M
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : Juli 2022
1
NO NAMA ALAT JUMLAH
P S
1 MESIN VENTILATOR 1 1 1
2 MONITOR TTV 6 6 6
3 SYRINGE PUMP 5 2 2
4 INFUSION PUMP 3 2 2
5 MESIN EKG 1 1 1
6 MESIN NEBULIZER 1 1 1
7 BLOOD WARMER 1 1 1
8 OKSIGEN MOBILE 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5
10 LARINGOSKOP DEWASA 2 2 2
11 LARINGOSKOP ANAK 1 1 1
12 LARINGOSKOP BAYI 1 1 1
13 DC SHOCK 1 1 1
14 SUCTION TEMPEL 2 2 2
15 AMBUBAGE DEWASA 1 1 1
16 AMBUBAGE ANAK 1 1 1
17 MESIN CEK GULA DARAH 1 1 1
18 TENSI METER NON RAKSA 1 1 1
19 STETOSKOP DEWASA 2 2 2
20 STETOSKOP ANAK 1 1 1
21 THERMOMETER RAKSA 2 2 2
22 LAMPU BACA X-RAY 1 1 1

NAMA PEMERIKSA SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : Juli 2022
1
NO NAMA ALAT JUMLAH
P S
1 BED PASIEN 6 5 5
2 TROLY MONITOR  4 3 3
3 NAKAS MONITOR 2 2 2
4 NAKAS EKG 1 1 1
5 TROLY RAWAT LUKA 1 1 1
6 TROLY PASANG INFUS 1 1 1
7 MEJA MAKAN PASIEN 4 4 4
8 MEJA KAYU PASIEN 5 5 5
9 KERANJANG OBAT  7  7  7
10 TROLY OBAT 1 1 1
11 TROLY EMERGENCY 1 1 1
12 LEMARI LINEN 1 1 1
13 LEMARI ALAT-ALAT 1 1 1
14 TEMPAT SPUIT 5 5 5
15 SHARP CONTAINER 2 2 2
16 TOURNIQUET 2 2 2
17 SENTEL 1 1 1
18 MANISET DEWAS 6 6 6
19 MANISET ANAK 2 2 2

PARAF SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : Juli 2022
1
NO NAMA ALAT JUMLAH
P S
1 KOMPUTER 1 1 1
2 CPU merk hp 1 1 1
3 KURSI 3 3 3
4 URINE POT 1 1 1
5 GELAS UKUR 2 2 2
6 PISPOT 1 1 1
7 EMBER BESAR 1 1 1
8 KULKAS 1 1 1
9 DISPENSER 1 1 1
10 STANDAR INFUS RODA 5 5 5
11 STANDAR INFUS BED 6 6 6
12 JAM DINDING 1 1 1
13 AC & REMOTE 2 2 2
14 PENGGARIS 30 CM 1 1 1
15 KERANJANG HIJAU 7 7 7
16 TEMPAT PENSIL 2 2 2
17 STAPLES 1 1 1
18 CUK ROLL 2 2 2
19 PERFURATOR 1 1 1
20 KERANJANG LINEN 2 2 2
21 TEMPAT SAMPAH 4 4 4
22 WASKOM BESAR 5 5 5
23 TEMPAT TISSUE 2 2 2
24 TELEPON RUANGAN 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1
26 THERMOMETER RUANGAN 1 1 1
27 APAR 6 Kg 1 1 1

PARAF SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : Juli 2022
1
NO NAMA ALAT JUMLAH
P S
1 BAK INSTRUMENT 4 4 4
2 KUPET 3 3 3
3 KOM BESAR 5 5 5
4 KOM SEDANG 2 2 2
5 KOM KECIL 4 4 4
6 PINSET ANATOMIS 2 2 2
7 PINSET CHIRURGIS 3 3 3
8 GUNTING JARINGAN 2 2 2
9 GUNTING BENANG 5 5 5
10 GUNTING PERBAN 1 1 1
11 KLEM ARTERI 2 2 2
12 NALDPOEDER 2 2 2
13 BENGKOK BESAR 2 2 2
14 BENGKOK KECIL 1 1 1
15 TONGUE SPATEL 2 2 2
16 KLEM KHOCHER 2 2 2
17 MARGIL FORCEP 2 2 2
PARAF SN AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
U

1 2 3 4
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 4 4 4 4 4 4 5 5
2 2 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS SN DW AG IN DW SN VI RS SN

Kep)

1 2 3 4
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS SN DW AG IN DW SN VI RS SN

Kep)

1 2 3 4
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS SN DW AG IN DW SN VI RS SN

Kep)

BANAN

1 2 3 4
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS SN DW AG IN DW SN VI RS SN

Kep)
5 6 7 8
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 5 5 5 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS VI IN VI RS AG SN VI AG DW

5 6 7 8
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS VI IN VI RS AG SN VI AG DW

5 6 7 8
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS VI IN VI RS AG SN VI AG DW

5 6 7 8
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS VI IN VI RS AG SN VI AG DW
8 9 10 11
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI VI IN DW GR AG IN DW RS AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI VI IN DW GR AG IN DW RS AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI VI IN DW GR AG IN DW RS AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI VI IN DW GR AG AG DW RS AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
11 12 13 14
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 5 4 4 4 4 4 4
3 3 2 3 3 3 3 2 2 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN VI RS IN SN VI RS DW SN VI

11 12 13 14
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN VI RS IN SN VI RS DW SN VI

11 12 13 14
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN VI RS IN SN VI RS DW SN VI

11 12 13 14
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN VI RS IN SN VI RS DW SN VI
15 16 17 18
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 4 4 4 4
2 2 2 2 2 2 2 2 2 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

gr DW SN GR AG DW RS AG GR VI

15 16 17 18
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

GR DW SN GR AG DW RS AG GR VI

15 16 17 18
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

GR DW SN GR AG DW RS AG GR VI

15 16 17 18
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
GR DW SN GR AG DW RS AG GR VI
18 19 20 21
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 4 4 4 4 4 4 4
2 2 2 2 2 2 2 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS AG SN VI RS AG DW VI AG DW

18 19 20 21
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS AG SN VI RS AG DW VI AG DW

18 19 20 21
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS AG SN VI RS AG DW VI AG DW

18 19 20 21
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS AG SN VI RS AG DW VI AG DW
21 22 23 24
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 5 5 5 5 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI SN AG DW GR AG DW VI VI AG

21 22 23 24
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI SN AG DW GR AG DW VI VI AG

21 22 23 24
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI SN AG DW GR AG DW VI VI AG

21 22 23 24
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI SN AG DW GR AG DW VI VI AG
25 26 27 28
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 5 5 5 5 5 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI DW AG GR SN DW VI VI AG VI

25 26 27 28
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI DW AG GR SN DW VI VI AG VI

25 26 27 28
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI DW AG GR SN DW VI VI AG VI

25 26 27 28
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI DW AG GR SN DW VI VI AG VI
28 29 30 31
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 4 4 4 4 4 4 4 4 4
3 2 2 2 2 2 2 2 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW AG SN AG IN GR RS AG SN VI

28 29 30 31
S M P S M P S M P S
5 5 5 5 6 6 6 6 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW AG SN AG IN GR RS AG SN VI

28 29 30 31
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW AG SN AG IN GR RS AG SN VI

28 29 30 31
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW AG SN AG IN GR RS AG SN VI
31
M
1
6
4
3
1
1
1
1
5
2
1
1
1
2
1
1
1
1
2
1
2
1

RS

31
M
5
3
2
1
1
1
4
5
 7
1
1
1
1
5
2
2
1
6
2

RS

31
M
1
1
3
1
2
1
1
1
1
5
6
1
2
1
7
2
1
2
1
2
4
5
2
1
1
1
1

RS

31
M
4
3
5
2
4
2
3
2
5
1
2
2
2
1
2
2
2
RS
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : AGUSTUS 2022
1
NO NAMA ALAT JUMLAH
P S M
1 MESIN VENTILATOR 1 1 1 1
2 MONITOR TTV 6 6 6 6
3 SYRINGE PUMP 5 4 4 4
4 INFUSION PUMP 3 3 3 3
5 MESIN EKG 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1
7 BLOOD WARMER 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1
13 DC SHOCK 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1

NAMA PEMERIKSA SN DW VI

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : AGUSTUS 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BED PASIEN 6 5 5 5
2 TROLY MONITOR  4 3 3 3
3 NAKAS MONITOR 2 2 2 2
4 NAKAS EKG 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5
9 KERANJANG OBAT  7  7  7  7
10 TROLY OBAT 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1
12 LEMARI LINEN 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5
15 SHARP CONTAINER 2 2 2 2
16 TOURNIQUET 2 2 2 2
17 SENTEL 1 1 1 1
18 MANISET DEWAS 6 6 6 6
19 MANISET ANAK 2 2 2 2

PARAF SN DW VI

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : AGUSTUS 2022
1
NO NAMA ALAT JUMLAH
P S M
1 KOMPUTER 1 1 1 1
2 CPU merk hp 1 1 1 1
3 KURSI 3 3 3 3
4 URINE POT 1 1 1 1
5 GELAS UKUR 2 2 2 2
6 PISPOT 1 1 1 1
7 EMBER BESAR 1 1 1 1
8 KULKAS 1 1 1 1
9 DISPENSER 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6
12 JAM DINDING 1 1 1 1
13 AC & REMOTE 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2
17 STAPLES 1 1 1 1
18 CUK ROLL 2 2 2 2
19 PERFURATOR 1 1 1 1
20 KERANJANG LINEN 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4
22 WASKOM BESAR 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1
27 APAR 6 Kg 1 1 1 1

PARAF SN DW VI

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : AGUSTUS 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BAK INSTRUMENT 4 4 4 4
2 KUPET 3 3 3 3
3 KOM BESAR 5 5 5 5
4 KOM SEDANG 2 2 2 2
5 KOM KECIL 4 4 4 4
6 PINSET ANATOMIS 2 2 2 2
7 PINSET CHIRURGIS 3 3 3 3
8 GUNTING JARINGAN 2 2 2 2
9 GUNTING BENANG 5 5 5 5
10 GUNTING PERBAN 1 1 1 1
11 KLEM ARTERI 2 2 2 2
12 NALDPOEDER 2 2 2 2
13 BENGKOK BESAR 2 2 2 2
14 BENGKOK KECIL 1 1 1 1
15 TONGUE SPATEL 2 2 2 2
16 KLEM KHOCHER 2 2 2 2
17 MARGIL FORCEP 2 2 2 2
PARAF SN DW VI

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
CU

2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW IN VI IN AG DW RS AG IN VI

p)

2 3 4 5
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW IN VI IN AG DW RS AG IN VI

p)

2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW IN VI IN AG DW RS AG IN VI

p)

ABANAN

2 3 4 5
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW IN VI IN AG DW RS AG IN VI

p)
5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI AG SN VI RS DW SN VI IN IN

5 6 7 8
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI AG SN VI RS DW SN VI IN IN

5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI AG SN VI RS DW SN VI IN IN

5 6 7 8
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI AG SN VI RS DW SN VI IN IN
8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN IN IN IN IN IN IN RS VI AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN IN IN IN IN IN IN RS VI AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN IN IN IN IN IN IN RS VI AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN IN IN IN IN IN IN RS VI AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 4 5 5 5 5 4
2 2 2 3 3 2 2 2 2 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN VI RS DW SN VI IN SN SN IN

12 13 14 15
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

SN VI RS DW SN VI IN SN SN IN

12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

SN VI RS DW SN VI IN SN SN IN

12 13 14 15
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
SN VI RS DW SN VI IN SN SN IN
15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG DW AG RS IN VI RS AG SN VI

15 16 17 18
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG DW AG RS IN VI RS AG SN VI

15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG DW AG RS IN VI RS AG SN VI

15 16 17 18
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
AG DW AG RS IN VI RS AG SN VI
18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW SN VI IN DW SN IN AG DW

18 19 20 21
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS DW SN VI IN DW SN IN AG DW

18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS DW SN VI IN DW SN IN AG DW

18 19 20 21
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS DW SN VI IN DW SN IN AG DW
22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 3 3 3 3 5 5 5
2 2 2 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW AG IN VI RS AG SN VI AG SN

22 23 24 25
P S M P S M P S M P
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW AG IN VI RS AG SN VI AG SN

22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW AG IN VI RS AG SN VI AG SN

22 23 24 25
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW AG IN VI RS AG SN VI AG SN
25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 4 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW VI IN DW SN AG IN DW RS AG

25 26 27 28
S M P S M P S M P S
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW VI IN DW SN AG IN DW RS AG

25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW VI IN DW SN AG IN DW RS AG

25 26 27 28
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW VI IN DW SN AG IN DW RS AG
28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 5 5 5 5 5 5
3 3 3 3 2 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW RS VI AG SN VI RS DW SN VI

28 29 30 31
M P S M P S M P S M
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW RS VI AG SN VI RS DW SN VI

28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW RS VI AG SN VI RS DW SN VI

28 29 30 31
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW RS VI AG SN VI RS DW SN VI
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : SEPTEMBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 MESIN VENTILATOR 1 1 1 1
2 MONITOR TTV 6 6 6 6
3 SYRINGE PUMP 5 5 5 3
4 INFUSION PUMP 3 3 3 2
5 MESIN EKG 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1
7 BLOOD WARMER 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1
13 DC SHOCK 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1

NAMA PEMERIKSA IN DW SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : SEPTEMBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BED PASIEN 6 6 6 6
2 TROLY MONITOR  4 3 3 3
3 NAKAS MONITOR 2 2 2 2
4 NAKAS EKG 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5
9 KERANJANG OBAT  7  7  7  7
10 TROLY OBAT 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1
12 LEMARI LINEN 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5
15 SHARP CONTAINER 2 2 2 2
16 TOURNIQUET 2 2 2 2
17 SENTEL 1 1 1 1
18 MANISET DEWAS 6 6 6 6
19 MANISET ANAK 2 2 2 2

PARAF IN DW SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : SEPTEMBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 KOMPUTER 1 1 1 1
2 CPU merk hp 1 1 1 1
3 KURSI 3 3 3 3
4 URINE POT 1 1 1 1
5 GELAS UKUR 2 2 2 2
6 PISPOT 1 1 1 1
7 EMBER BESAR 1 1 1 1
8 KULKAS 1 1 1 1
9 DISPENSER 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6
12 JAM DINDING 1 1 1 1
13 AC & REMOTE 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2
17 STAPLES 1 1 1 1
18 CUK ROLL 2 2 2 2
19 PERFURATOR 1 1 1 1
20 KERANJANG LINEN 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4
22 WASKOM BESAR 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1
27 APAR 6 Kg 1 1 1 1

PARAF IN DW SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : SEPTEMBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BAK INSTRUMENT 4 4 4 4
2 KUPET 3 3 3 3
3 KOM BESAR 5 5 5 5
4 KOM SEDANG 2 2 2 2
5 KOM KECIL 4 4 4 4
6 PINSET ANATOMIS 2 2 2 2
7 PINSET CHIRURGIS 3 3 3 3
8 GUNTING JARINGAN 2 2 2 2
9 GUNTING BENANG 5 5 5 5
10 GUNTING PERBAN 1 1 1 1
11 KLEM ARTERI 2 2 2 2
12 NALDPOEDER 2 2 2 2
13 BENGKOK BESAR 2 2 2 2
14 BENGKOK KECIL 1 1 1 1
15 TONGUE SPATEL 2 2 2 2
16 KLEM KHOCHER 2 2 2 2
17 MARGIL FORCEP 2 2 2 2
PARAF IN DW SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 4
1 1 2 2 2 2 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN AG DW RS AG IN VI RS AG VI

2 3 4 5
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN AG DW RS AG IN VI RS AG VI

2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN AG DW RS AG IN VI RS AG VI

ANAN

2 3 4 5
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
IN AG DW RS AG IN VI RS AG VI
5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS AG VI SN DW IN IN DW IN IN

5 6 7 8
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS AG VI SN DW IN IN DW IN IN

5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS AG VI SN DW IN IN DW IN IN

5 6 7 8
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
RS AG VI SN DW IN IN DW IN IN
8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 3 3 3 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI AG AG IN DW RS AG SN DW RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI AG AG IN DW RS AG SN DW RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI AG AG IN DW RS AG SN DW RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI AG AG IN DW RS AG SN DW RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 1 2 2 2 2 3 3 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW SN VI IN DW SN IN DW AG RS

12 13 14 15
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW SN VI IN DW SN IN DW AG RS

12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW SN VI IN DW SN IN DW AG RS

12 13 14 15
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW SN VI IN DW SN IN DW AG RS
15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 2 2 2 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW IN VI RS DW SN VI RS DW SN

15 16 17 18
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW IN VI RS DW SN VI RS DW SN

15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW IN VI RS DW SN VI RS DW SN

15 16 17 18
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW IN VI RS DW SN VI RS DW SN
18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 2 2 2 2 2 2 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI IN DW SN IN IN DW IN VI RS

18 19 20 21
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI IN DW SN IN IN DW IN VI RS

18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI IN DW SN IN IN DW IN VI RS

18 19 20 21
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI IN DW SN IN IN DW IN VI RS
22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 2 4 4 2 2 4 4
3 3 3 3 3 3 2 2 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI IN AG SN VI IN DW SN VI RS

22 23 24 25
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI IN AG SN VI IN DW SN VI RS

22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI IN AG SN VI IN DW SN VI RS

22 23 24 25
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
VI IN AG SN VI IN DW SN VI RS
25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 2
3 3 3 3 3 3 3 3 3 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW SN AG RS DW RS RS IN VI RS

25 26 27 28
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW SN AG RS DW RS RS IN VI RS

25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW SN AG RS DW RS AG IN VI RS

25 26 27 28
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
DW SN AG RS DW RS AG IN VI RS
28 29 30 31
M P S M P S M P S M
1 1 1 1 1
6 6 6 6 6
2 2 2 2 2
2 2 3 3 3
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
5 5 5 5 5
2 2 2 2 2
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
2 2 2 2 2
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
2 2 2 2 2
1 1 1 1 1
2 2 2 2 2
1 1 1 1 1

AG SN VI RS DW

28 29 30 31
M P S M P S M P S M
6 6 6 6 6
3 3 3 3 3
2 2 2 2 2
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
4 4 4 4 4
5 5 5 5 5
 7  7  7  7  7
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
5 5 5 5 5
2 2 2 2 2
2 2 2 2 2
1 1 1 1 1
6 6 6 6 6
2 2 2 2 2

AG SN VI RS DW

28 29 30 31
M P S M P S M P S M
1 1 1 1 1
1 1 1 1 1
3 3 3 3 3
1 1 1 1 1
2 2 2 2 2
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
5 5 5 5 5
6 6 6 6 6
1 1 1 1 1
2 2 2 2 2
1 1 1 1 1
7 7 7 7 7
2 2 2 2 2
1 1 1 1 1
2 2 2 2 2
1 1 1 1 1
2 2 2 2 2
4 4 4 4 4
5 5 5 5 5
2 2 2 2 2
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1

AG SN VI RS DW

28 29 30 31
M P S M P S M P S M
4 4 4 4 4
3 3 3 3 3
5 5 5 5 5
2 2 2 2 2
4 4 4 4 4
2 2 2 2 2
3 3 3 3 3
2 2 2 2 2
5 5 5 5 5
1 1 1 1 1
2 2 2 2 2
2 2 2 2 2
2 2 2 2 2
1 1 1 1 1
2 2 2 2 2
2 2 2 2 2
2 2 2 2 2
AG SN VI RS DW
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : OKTOBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 MESIN VENTILATOR 1 1 1 1
2 MONITOR TTV 6 6 6 6
3 SYRINGE PUMP 5 2 2 2
4 INFUSION PUMP 3 3 3 3
5 MESIN EKG 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1
7 BLOOD WARMER 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1
13 DC SHOCK 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1

NAMA PEMERIKSA AG AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : OKTOBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BED PASIEN 6 6 6 6
2 TROLY MONITOR  4 3 3 3
3 NAKAS MONITOR 2 2 2 2
4 NAKAS EKG 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5
9 KERANJANG OBAT  7  7  7  7
10 TROLY OBAT 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1
12 LEMARI LINEN 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5
15 SHARP CONTAINER 2 2 2 2
16 TOURNIQUET 2 2 2 2
17 SENTEL 1 1 1 1
18 MANISET DEWASA 6 6 6 6
19 MANISET ANAK 2 2 2 2

PARAF AG AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : OKTOBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 KOMPUTER 1 1 1 1
2 CPU merk hp 1 1 1 1
3 KURSI 3 3 3 3
4 URINE POT 1 1 1 1
5 GELAS UKUR 2 2 2 2
6 PISPOT 1 1 1 1
7 EMBER BESAR 1 1 1 1
8 KULKAS 1 1 1 1
9 DISPENSER 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6
12 JAM DINDING 1 1 1 1
13 AC & REMOTE 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2
17 STAPLES 1 1 1 1
18 CUK ROLL 2 2 2 2
19 PERFURATOR 1 1 1 1
20 KERANJANG LINEN 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4
22 WASKOM BESAR 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1
27 APAR 6 Kg 1 1 1 1

PARAF AG AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : OKTOBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BAK INSTRUMENT 4 4 4 4
2 KUPET 4 4 4 4
3 KOM BESAR 4 5 5 5
4 KOM KECIL ( Cucing) 8 4 4 4
5 PINSET ANATOMIS 4 4 4 4
6 PINSET CHIRURGIS 6 6 6 6
7 GUNTING JARINGAN 2 2 2 2
8 GUNTING BENANG 4 5 5 5
9 GUNTING PERBAN 1 1 1 1
10 KLEM ARTERI 4 4 4 4
11 NALDPOEDER 2 2 2 2
12 BENGKOK BESAR 2 2 2 2
13 BENGKOK KECIL 1 1 1 1
14 TONGUE SPATEL 2 2 2 2
15 GUNTING UP HECTING 2 2 2 2
15 MARGIL FORCEP 2 2 2 2

PARAF 52 AG AG SN
PARAF 52 AG AG SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

Catatan :
Tgal 5 Oktober dilakukan retur alat Alasan
2 gunting up hecting Tumpul
2 Gunting Jaringan Tumpul
1 gunting Benang Rusak
1 Gunting Perban rusak
1 Kom Besar Berkarat
2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG IN SN RS AG IN RS VI RS RS

2 3 4 5
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG IN SN RS AG IN RS VI RS RS

2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG IN SN RS AG IN RS VI RS RS

NAN

2 3 4 5
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 4
4 4 4 4 4 4 4 4 4 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

AG IN SN RS AG IN RS VI RS RS
AG IN SN RS AG IN RS VI RS RS
5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 5 5 5
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI SN DW RS VI IN DW RS AG IN

5 6 7 8
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI SN DW RS VI IN DW RS AG IN

5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI SN DW RS VI IN DW RS AG IN

5 6 7 8
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

VI SN DW RS VI IN DW RS AG IN
VI SN DW RS VI IN DW RS AG IN
8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
5 5 5 5 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS SN AG GR VI SN AG SN VI RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS SN AG GR VI SN AG SN VI RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS SN AG GR VI SN AG SN VI RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

RS SN AG GR VI SN AG SN VI RS
RS SN AG GR VI SN AG SN VI RS

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 3 3 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

GR AG VI IN AG SN IN RS AG GR

12 13 14 15
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

GR AG VI IN AG SN IN RS AG GR

12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

GR AG VI IN AG SN IN RD AG GR

12 13 14 15
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

GR AG VI IN AG SN IN RS AG GR
GR AG VI IN AG SN IN RS AG GR
15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN RS VI IN GR VI SN IN AG SN

15 16 17 18
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN RS VI IN GR VI SN IN AG SN

15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN RS VI IN GR VI SN IN AG SN

15 16 17 18
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

IN RS VI IN GR VI SN IN AG SN
IN RS VI IN GR VI SN IN AG SN
18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 0 0 0
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

VI rs AG VI IN RS AG gr in AG

18 19 20 21
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

VI RS AG VI IN RS AG gr in AG

18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

VI RS AG VI IN RS AG gr in AG

18 19 20 21
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

VI RS AG VI IN RS AG in gr AG
VI RS AG VI IN RS AG in gr AG
22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 2 2 4 4
3 3 3 3 3 3 1 1 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN VI RS SN VI AG GR SN VI RS

22 23 24 25
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN VI RS SN VI AG GR SN VI RS

22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN VI RS SN VI AG GR SN VI RS

22 23 24 25
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

IN VI RS SN VI AG GR SN VI RS
IN VI RS SN VI AG GR SN VI RS
25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG SN IN RS AG RS VI AG SN VI

25 26 27 28
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG SN IN RS AG RS VI AG SN VI

25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG SN IN RS AG RS VI AG SN VI

25 26 27 28
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

AG SN IN RS AG RS VI AG SN VI
AG SN IN RS AG RS VI AG SN VI
28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 1 1 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

AG VI IN GR AG SN IN DW GR IN

28 29 30 31
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG VI IN GR AG SN IN GR DW IN

28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG VI IN GR AG SN IN GR DW IN

28 29 30 31
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
8 8 8 8 8 8 8 8 8 8
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

AG VI IN GR AG SN IN GR DW IN
AG VI IN GR AG SN IN GR DW IN
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : NOVEMBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 MESIN VENTILATOR 1 1 1 1
2 MONITOR TTV 6 6 6 6
3 SYRINGE PUMP 5 4 4 4
4 INFUSION PUMP 3 3 3 3
5 MESIN EKG 1 1 1 1
6 MESIN NEBULIZER 1 1 1 1
7 BLOOD WARMER 1 1 1 1
8 OKSIGEN MOBILE 1 1 1 1
9 HUMIDIFIRE OKSIGEN 5 5 5 5
10 LARINGOSKOP DEWASA 2 2 2 2
11 LARINGOSKOP ANAK 1 1 1 1
12 LARINGOSKOP BAYI 1 1 1 1
13 DC SHOCK 1 1 1 1
14 SUCTION TEMPEL 2 2 2 2
15 AMBUBAGE DEWASA 1 1 1 1
16 AMBUBAGE ANAK 1 1 1 1
17 MESIN CEK GULA DARAH 1 1 1 1
18 TENSI METER NON RAKSA 1 1 1 1
19 STETOSKOP DEWASA 2 2 2 2
20 STETOSKOP ANAK 1 1 1 1
21 THERMOMETER RAKSA 2 2 2 2
22 LAMPU BACA X-RAY 1 1 1 1

NAMA PEMERIKSA GR DW AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : OKTOBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BED PASIEN 6 6 6 6
2 TROLY MONITOR  4 3 3 3
3 NAKAS MONITOR 2 2 2 2
4 NAKAS EKG 1 1 1 1
5 TROLY RAWAT LUKA 1 1 1 1
6 TROLY PASANG INFUS 1 1 1 1
7 MEJA MAKAN PASIEN 4 4 4 4
8 MEJA KAYU PASIEN 5 5 5 5
9 KERANJANG OBAT  7  7  7  7
10 TROLY OBAT 1 1 1 1
11 TROLY EMERGENCY 1 1 1 1
12 LEMARI LINEN 1 1 1 1
13 LEMARI ALAT-ALAT 1 1 1 1
14 TEMPAT SPUIT 5 5 5 5
15 SHARP CONTAINER 2 2 2 2
16 TOURNIQUET 2 2 2 2
17 SENTEL 1 1 1 1
18 MANISET DEWASA 6 6 6 6
19 MANISET ANAK 2 2 2 2

PARAF GR DW AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : OKTOBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 KOMPUTER 1 1 1 1
2 CPU merk hp 1 1 1 1
3 KURSI 3 3 3 3
4 URINE POT 1 1 1 1
5 GELAS UKUR 2 2 2 2
6 PISPOT 1 1 1 1
7 EMBER BESAR 1 1 1 1
8 KULKAS 1 1 1 1
9 DISPENSER 1 1 1 1
10 STANDAR INFUS RODA 5 5 5 5
11 STANDAR INFUS BED 6 6 6 6
12 JAM DINDING 1 1 1 1
13 AC & REMOTE 2 2 2 2
14 PENGGARIS 30 CM 1 1 1 1
15 KERANJANG HIJAU 7 7 7 7
16 TEMPAT PENSIL 2 2 2 2
17 STAPLES 1 1 1 1
18 CUK ROLL 2 2 2 2
19 PERFURATOR 1 1 1 1
20 KERANJANG LINEN 2 2 2 2
21 TEMPAT SAMPAH 4 4 4 4
22 WASKOM BESAR 5 5 5 5
23 TEMPAT TISSUE 2 2 2 2
24 TELEPON RUANGAN 1 1 1 1
25 HP ICU merk SAMSUNG J3 1 1 1 1
26 THERMOMETER RUANGAN 1 1 1 1
27 APAR 6 Kg 1 1 1 1

PARAF GR DW AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : OKTOBER 2022
1
NO NAMA ALAT JUMLAH
P S M
1 BAK INSTRUMENT 4 4 4 4
2 KUPET 4 4 4 4
3 KOM BESAR 4 5 5 5
4 KOM KECIL ( Cucing) 8 4 4 4
5 PINSET ANATOMIS 4 4 4 4
6 PINSET CHIRURGIS 6 6 6 6
7 GUNTING JARINGAN 2 2 2 2
8 GUNTING BENANG 4 5 5 5
9 GUNTING PERBAN 1 1 1 1
10 KLEM ARTERI 4 4 4 4
11 NALDPOEDER 2 2 2 2
12 BENGKOK BESAR 2 2 2 2
13 BENGKOK KECIL 1 1 1 1
14 TONGUE SPATEL 2 2 2 2
15 GUNTING UP HECTING 2 2 2 2
15 MARGIL FORCEP 2 2 2 2

PARAF 52 GR DW AG
PARAF 52 GR DW AG

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

Catatan :
Tgal 5 Oktober dilakukan retur alat Alasan
2 gunting up hecting Tumpul
2 Gunting Jaringan Tumpul
1 gunting Benang Rusak
1 Gunting Perban rusak
1 Kom Besar Berkarat
2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 5 5
4 4 4 4 4 4 4 4 4 4
3 3 3 3 0 0 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW RS AG VI VI DW SN VI RS AG

2 3 4 5
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

DW RS AG VI VI DW SN VI RS AG

2 3 4 5
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

DW RS AG VI VI DW SN VI RS AG

NAN

2 3 4 5
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

DW RS AG VI VI DW SN VI RS AG
DW RS AG VI VI DW SN VI RS AG
5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 1
4 4 4 4 4 4 4 4 4 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 1
2 2 2 2 2 2 2 2 2 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 1
1 1 1 1 1 1 1 1 1 1

IN RS SN AG IN DW SN AG RS DW

5 6 7 8
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN RS SN AG IN DW SN AG RS DW

5 6 7 8
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN RS SN AG IN DW SN AG RS DW

5 6 7 8
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

IN RS SN AG IN DW SN AG RS DW
IN RS SN AG IN DW SN AG RS DW
8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 5 5 1 1 6 5 5
1 1 2 4 4 1 1 4 4 4
1 1 1 1 1 1 1 2 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 5 5 1 1 5 5 5
1 1 1 2 2 1 1 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 2 2 1 1 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 2 2 1 1 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 2 2 1 1 2 2 2
1 1 1 1 1 1 1 1 1 1

AG VI RS IN IN VI RS AG IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

AG VI RS IN IN VI RS AG IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

AG VI RS IN IN VI RS AG IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

AG VI RS IN IN VI RS AG IN VI
AG VI RS IN IN VI RS AG IN VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
4 4 4 3 3 3 3 3 3 4
1 2 1 3 3 3 3 3 3 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN AG IN DW SN AG RS DW SN VI

12 13 14 15
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

SN AG IN DW SN AG RS DW SN VI

12 13 14 15
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

SN AG IN DW SN AG RS DW SN VI

12 13 14 15
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

SN AG IN DW SN AG RS DW SN VI
SN AG IN DW SN AG RS DW SN VI
15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
5 5 4 4 4 4 4 4 5 5
1 1 1 1 1 1 1 1 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW IN VI RS AG IN VI SN AG

15 16 17 18
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

RS DW IN VI RS AG IN VI SN AG

15 16 17 18
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

RS DW IN VI RS AG IN VI SN AG

15 16 17 18
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

RS DW IN VI RS AG IN VI SN AG
RS DW IN VI RS AG IN VI SN AG
18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
5 5 5 5 5 5 5 5 3 3
3 2 2 2 2 2 2 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN SN DW AG RS DW AG VI RS DW

18 19 20 21
M P S M P S M P S M
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN SN DW AG RS DW AG VI RS DW

18 19 20 21
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN SN DW AG RS DW AG VI RS DW

18 19 20 21
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

IN SN DW AG RS DW AG VI RS DW
IN SN DW AG RS DW AG VI RS DW
22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
4 5 5 3 5 4 4 4 3 3
1 1 1 1 1 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

IN VI RS AG IN VI SN AG IN DW

22 23 24 25
P S M P S M P S M P
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

IN VI RS AG IN VI SN AG IN DW

22 23 24 25
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

IN VI RS AG IN VI SN AG IN DW

22 23 24 25
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

IN VI RS AG IN VI SN AG IN DW
IN VI RS AG IN VI SN AG IN DW
25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 1 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN AG DW RS SN VI RS DW GR VI

25 26 27 28
S M P S M P S M P S
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
 7  7  7  7  7  7  7  7  7  7
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2

SN AG DW RS SN VI RS DW GR VI

25 26 27 28
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
7 7 7 7 7 7 7 7 7 7
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1

SN AG DW RS SN VI RS DW GR VI

25 26 27 28
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

SN AG DW RS SN VI RS DW GR VI
SN AG DW RS SN VI RS DW GR VI
28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1
5 5 5 5 5 5 5
2 2 2 3 3 3 3
1 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
5 5 5 5 5 5 5
2 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1

RS GR AG VI SN AG VI

28 29 30 31
M P S M P S M P S M
6 6 6 6 6 6 6
3 3 3 3 3 3 3
2 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
4 4 4 4 4 4 4
5 5 5 5 5 5 5
 7  7  7  7  7  7  7
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
5 5 5 5 5 5 5
2 2 2 2 2 2 2
2 2 2 2 2 2 2
1 1 1 1 1 1 1
6 6 6 6 6 6 6
2 2 2 2 2 2 2

RS GR AG VI SN AG VI

28 29 30 31
M P S M P S M P S M
1 1 1 1 1 1 1
1 1 1 1 1 1 1
3 3 3 3 3 3 3
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
5 5 5 5 5 5 5
6 6 6 6 6 6 6
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1
7 7 7 7 7 7 7
2 2 2 2 2 2 2
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1
2 2 2 2 2 2 2
4 4 4 4 4 4 4
5 5 5 5 5 5 5
2 2 2 2 2 2 2
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1

RS GR AG VI SN AG VI

28 29 30 31
M P S M P S M P S M
4 4 4 4 4 4 4
4 4 4 4 4 4 4
5 5 5 5 5 5 5
4 4 4 4 4 4 4
4 4 4 4 4 4 4
6 6 6 6 6 6 6
2 2 2 2 2 2 2
5 5 5 5 5 5 5
1 1 1 1 1 1 1
4 4 4 4 4 4 4
2 2 2 2 2 2 2
2 2 2 2 2 2 2
1 1 1 1 1 1 1
2 2 2 2 2 2 2
2 2 2 2 2 2 2
2 2 2 2 2 2 2

RS GR AG VI SN AG VI
RS GR AG VI SN AG VI
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : DESEMBER 2022
1
NO NAMA ALAT JUMLAH
P
1 MESIN VENTILATOR 1 1
2 MONITOR TTV 6 5
3 SYRINGE PUMP 5 3
4 INFUSION PUMP 3 2
5 MESIN EKG 1 1
6 MESIN NEBULIZER 1 1
7 BLOOD WARMER 1 1
8 OKSIGEN MOBILE 1 1
9 HUMIDIFIRE OKSIGEN 5 5
10 LARINGOSKOP DEWASA 2 2
11 LARINGOSKOP ANAK 1 1
12 LARINGOSKOP BAYI 1 1
13 DC SHOCK 1 1
14 SUCTION TEMPEL 2 2
15 AMBUBAGE DEWASA 1 1
16 AMBUBAGE ANAK 1 1
17 MESIN CEK GULA DARAH 1 1
18 TENSI METER NON RAKSA 1 1
19 STETOSKOP DEWASA 2 2
20 STETOSKOP ANAK 1 1
21 THERMOMETER DIGITAL 2 2
22 LAMPU BACA X-RAY 1 1
23 TOURNIQUET 2 2
24 MAINSET DEWASA 6 6
25 MAINSET ANAK 2 2
26 PISPOT 1 1
27 STANDAR INFUS RODA 5 5
28 STANDAR INFUS BED 6 6
29 TEST LUNG 1 1
30 URINAL 1 1
31 THERMOMETER KULKAS 1 1
32 BED PASIEN 6 6

NAMA PEMERIKSA SN

72
Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : DESEMBER 2022
1
NO NAMA ALAT JUMLAH
P
1 TROLY MONITOR  4 3
2 NAKAS MONITOR 2 2
3 NAKAS EKG 1 1
4 TROLY RAWAT LUKA 1 1
5 TROLY PASANG INFUS 1 1
6 MEJA MAKAN PASIEN 4 4
7 MEJA KAYU PASIEN 5 5
8 KERANJANG OBAT 6 6
9 TROLY ALKES 1 1
10 TROLY EMERGENCY 1 1
11 LEMARI LINEN 1 1
12 LEMARI ALAT / KACA 1 1
13 TEMPAT SPUIT/ kuvet Alat 5 5
14 SAFETY BOX 1 1
15 SENTER 1 1
16 GELAS UKUR 2000 ML 2 2
17 GELAS UKUR 1000 ML 1 1
18 EMBER BESAR 1 1
19 KONTAINER SPILLKIT 1 1
20 KONTAINER STERIL ALAT 2 2
21 BOX RENDAM ALAT 2 2
22 WASKOM BESAR 6 6
23 BOX KONTAINER BESAR 1 1

PARAF SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT PENUNJANG ICU RS KASIH IBU TABANAN


Bulan : DESEMBER 2022
1
NO NAMA ALAT JUMLAH
P
1 LCD MONITOR 1 1
2 Thin Client HP 1 1
3 Mouse + Keyboard Logitec 1 1
4 KURSI PERAWAT 2 2
5 KURSI PASIEN 1 1
6 KULKAS 1 1
7 DISPENSER 1 1
8 JAM DINDING 1 1
9 AC Split 1 PK + Remote 2 2
10 AC Split 5 PK + Remote 1 1
11 PENGGARIS BESI 1 1
12 KERANJANG HIJAU 6 6
13 TEMPAT PENSIL 2 2
14 STAPLES 1 1
15 CUK ROLL 2 2
16 PERFURATOR 1 1
17 KERANJANG LINEN 2 2
18 TEMPAT SAMPAH MEDIS 2 2
19 TEMPAT SAMPAH NON MEDIS 3 3
20 TEMPAT TISSUE DINDING 2 2
21 PESAWAT TELEPON 1 1
22 HANDPHONE 1 1
23 THERMOMETER RUANGAN 1 1
24 Cermin Wastafel 1 1
25 DULANG TEMPAT SEMBAHYANG 1 1
26 GANTUNGAN BAJU DINDING 1 1
27 Meja Counter Lapis HPL 1 1
28 Meja Panjang 1 1
29 Nakas Kayu 1 1
30 Wastafel 1 1
31 Gunting 2 2
32 Jet Shower 1 1
33 Roll Blind 6 6
34 Stempel 2 2
35 Tempat Tissue Scott 1 1
36 WASTAFEL 1 1
37 Water Closet 1 1
38 KABINET WASTAFEL 1 1
39 Tempat Sabun Cuci Tangan 2 2
40 APAR 6 Kg 1 1

PARAF SN
PARAF SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : DESEMBER 2022
1
NO NAMA ALAT JUMLAH
P
1 BAK INSTRUMENT 4 4
2 KUPET 4 4
3 KOM BESAR 4 5
4 KOM KECIL ( Cucing) 8 4
5 PINSET ANATOMIS 4 4
6 PINSET CHIRURGIS 6 6
7 GUNTING JARINGAN 2 2
8 GUNTING BENANG 4 5
9 GUNTING PERBAN 1 1
10 KLEM ARTERI 4 4
11 NALDPOEDER 2 2
12 BENGKOK BESAR 2 2
13 BENGKOK KECIL 1 1
14 TONGUE SPATEL 2 2
15 GUNTING UP HECTING 2 2
15 MARGIL FORCEP 2 2

PARAF 52 SN

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

Catatan :
Tgal 5 Oktober dilakukan retur alat Alasan
2 gunting up hecting Tumpul
2 Gunting Jaringan Tumpul
1 gunting Benang Rusak
1 Gunting Perban rusak
1 Kom Besar Berkarat
NG ICU

1 2 3 4
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 6 6
3 3 4 4 3 3 3 3 4 4
2 2 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

DW AG RS DW SN VI RS DW GR VI
ab

ajaya,S.Kep)

1 2 3 4
S M P S M P S M P S
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

DW AG RS DW SN VI RS DW GR VI

ab

ajaya,S.Kep)
1 2 3 4
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW AG RS DW SN VI RS DW GR VI
DW AG RS DW SN VI RS DW GR VI

ab

ajaya,S.Kep)

BU TABANAN

1 2 3 4
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

DW AG RS DW SN VI RS DW GR VI

ab

ajaya,S.Kep)
4 5 6 7
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 3 3 3 3 3 3 3 3
3 3 3 3 3 3 3 3 3 3
1 1 0 0 0 0 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 5 5 5 5

RS AG GR VI SN AG GR DW SN AG
4 5 6 7
M P S M P S M P S M
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

RS AG GR VI SN AG GR DW SN AG
4 5 6 7
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS AG GR VI SN AG GR DW SN AG
RS AG GR VI SN AG GR DW SN AG

4 5 6 7
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

RS AG GR VI SN AG GR DW SN AG
8 9 10 11
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 3 3 3 3 3 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5

DW RS SN VI RS DW GR VI RS AG
Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
P S M P S M P S M P
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

DW RS SN VI RS DW GR VI RS AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
8 9 10 11
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW RS SN VI RS DW GR VI RS AG
DW RS SN VI RS DW GR VI RS AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

8 9 10 11
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

DW RS SN VI RS DW GR VI RS AG

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
11 12 13 14
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 2 2 3 3 3 3 3 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5

GR VI AG SN GR DW SN AG RS DW
11 12 13 14
S M P S M P S M P S
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

GR VI AG SN GR DW SN AG RS DW
11 12 13 14
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

GR VI AG SN GR DW SN AG RS DW
GR VI AG SN GR DW SN AG RS DW

11 12 13 14
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

GR VI AG SN GR DW SN AG RS DW
14 15 16 17
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 2 2 2 0 0 0 0 1 1
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5

SN VI RS SN GR VI RS AG GR VI
14 15 16 17
M P S M P S M P S M
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

SN VI RS SN GR VI RS AG GR VI
14 15 16 17
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN VI RS SN GR VI RS AG GR VI
SN VI RS SN GR VI RS AG GR VI

14 15 16 17
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

SN VI RS SN GR VI RS AG GR VI
18 19 20 21
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5

DW AG GR DW RS AG RS DW SN VI
18 19 20 21
P S M P S M P S M P
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

DW AG GR DW RS AG RS DW SN VI
18 19 20 21
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

DW AG GR DW RS AG RS DW SN VI
DW AG GR DW RS AG RS DW SN VI

18 19 20 21
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

DW AG GR DW RS AG RS DW SN VI
21 22 23 24
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 5 5 5 6 6 6 6
2 2 2 2 2 2 3 3 3 4
3 3 2 2 2 2 3 3 3 3
1 1 0 0 0 0 0 0 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 3 3 3 3 5 5 5 5

RS DW GR VI RS AG GR VI SN AG
21 22 23 24
S M P S M P S M P S
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

RS DW GR VI RS AG GR VI SN AG
21 22 23 24
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW GR VI RS AG GR VI SN AG
RS DW GR VI RS AG GR VI SN AG

21 22 23 24
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

RS DW GR VI RS AG GR VI SN AG
24 25 26 27
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5

GR DW SN AG RS DW SN RS EK DW
24 25 26 27
M P S M P S M P S M
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

GR DW SN AG RS DW SN RS EK DW
24 25 26 27
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

GR DW SN AG RS DW SN RS EK DW
GR DW SN AG RS DW SN RS EK DW

24 25 26 27
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

GR DW SN AG RS DW SN RS EK DW
28 29 30 31
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
4 4 4 4 4 4 3 3 3 3
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 6 6 6

EK EK RS AG SN VI SN AG VI GR
28 29 30 31
P S M P S M P S M P
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

EK EK RS AG SN VI SN AG VI GR
28 29 30 31
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

EK EK RS AG SN VI SN AG VI GR
EK EK RS AG SN VI SN AG VI GR

28 29 30 31
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

EK EK RS AG SN VI SN AG VI GR
31
S M
1 1
6 6
3 3
3 3
1 1
1 1
1 1
1 1
5 5
2 2
1 1
1 1
1 1
2 2
1 1
1 1
1 1
1 1
2 2
1 1
2 2
1 1
2 2
6 6
2 2
1 1
5 5
6 6
1 1
1 1
1 1
6 6

SN AG
31
S M
3 3
2 2
1 1
1 1
1 1
4 4
5 5
6 6
1 1
1 1
1 1
1 1
5 5
1 1
1 1
2 2
1 1
1 1
1 1
2 2
2 2
6 6
1 1

SN AG
31
S M
1 1
1 1
1 1
2 2
1 1
1 1
1 1
1 1
2 2
1 1
1 1
6 6
2 2
1 1
2 2
1 1
2 2
2 2
3 3
2 2
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
2 2
1 1
6 6
2 2
1 1
1 1
1 1
1 1
2 2
1 1

SN AG
SN AG

31
S M
4 4
4 4
5 5
4 4
4 4
6 6
2 2
5 5
1 1
4 4
2 2
2 2
1 1
2 2
2 2
2 2

SN AG
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : JANUARI 2023
NO
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
NAMA PEMERIKSA
NAMA PEMERIKSA

Penanggung Jaw

(Ns.Angga Wasis

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : JANUARI 2023
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
PARAF

Penanggung Jaw

(Ns.Angga Wasis
ALAT PENUNJANG ICU RS KASIH IBU TABANAN
Bulan : JANUARI 2023
NO
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
PARAF

Penanggung Jaw

(Ns.Angga Wasis

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANA


Bulan : JANUARI 2023
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15
PARAF

Penanggung Jaw

(Ns.Angga Wasis
INVENTARIS ALAT MEDIS DAN NON MEDIS RUANG ICU

ALAT MEDIS RUANG ICU RS KASIH IBU TABANAN


Bulan : JANUARI 2023
NAMA ALAT JUMLAH

MESIN VENTILATOR 1
MONITOR TTV 6
SYRINGE PUMP 5
INFUSION PUMP 3
MESIN EKG 1
MESIN NEBULIZER 1
BLOOD WARMER 1
OKSIGEN MOBILE 1
HUMIDIFIRE OKSIGEN 5
LARINGOSKOP DEWASA 2
LARINGOSKOP ANAK 1
LARINGOSKOP BAYI 1
DC SHOCK 1
SUCTION TEMPEL 2
AMBUBAGE DEWASA 1
AMBUBAGE ANAK 1
MESIN CEK GULA DARAH 1
TENSI METER NON RAKSA 1
STETOSKOP DEWASA 2
STETOSKOP ANAK 1
THERMOMETER DIGITAL 2
LAMPU BACA X-RAY 1
TOURNIQUET 2
MAINSET DEWASA 6
MAINSET ANAK 2
PISPOT 1
STANDAR INFUS RODA 5
STANDAR INFUS BED 6
TEST LUNG 1
URINAL 1
THERMOMETER KULKAS 1
BED PASIEN 6

NAMA PEMERIKSA
NAMA PEMERIKSA

72
Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

ALAT-ALAT NON MEDIS ICU RS KASIH IBU TABANAN


Bulan : JANUARI 2023
NAMA ALAT JUMLAH

TROLY MONITOR  4
NAKAS MONITOR 2
NAKAS EKG 1
TROLY RAWAT LUKA 1
TROLY PASANG INFUS 1
MEJA MAKAN PASIEN 4
MEJA KAYU PASIEN 5
KERANJANG OBAT 6
TROLY ALKES 1
TROLY EMERGENCY 1
LEMARI LINEN 1
LEMARI ALAT / KACA 1
TEMPAT SPUIT/ kuvet Alat 5
SAFETY BOX 1
SENTER 1
GELAS UKUR 2000 ML 2
GELAS UKUR 1000 ML 1
EMBER BESAR 1
KONTAINER SPILLKIT 1
KONTAINER STERIL ALAT 2
BOX RENDAM ALAT 2
WASKOM BESAR 6
BOX KONTAINER BESAR 1

PARAF

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)
ALAT PENUNJANG ICU RS KASIH IBU TABANAN
Bulan : JANUARI 2023
NAMA ALAT JUMLAH

LCD MONITOR 1
Thin Client HP 1
Mouse + Keyboard Logitec 1
KURSI PERAWAT 2
KURSI PASIEN 1
KULKAS 1
DISPENSER 1
JAM DINDING 1
AC Split 1 PK + Remote 2
AC Split 5 PK + Remote 1
PENGGARIS BESI 1
KERANJANG HIJAU 6
TEMPAT PENSIL 2
STAPLES 1
CUK ROLL 2
PERFURATOR 1
KERANJANG LINEN 2
TEMPAT SAMPAH MEDIS 2
TEMPAT SAMPAH NON MEDIS 3
TEMPAT TISSUE DINDING 2
PESAWAT TELEPON 1
HANDPHONE 1
THERMOMETER RUANGAN 1
Cermin Wastafel 1
DULANG TEMPAT SEMBAHYANG 1
GANTUNGAN BAJU DINDING 1
Meja Counter Lapis HPL 1
Meja Panjang 1
Nakas Kayu 1
Wastafel 1
Gunting 2
Jet Shower 1
Roll Blind 6
Stempel 2
Tempat Tissue Scott 1
WASTAFEL 1
Water Closet 1
KABINET WASTAFEL 1
Tempat Sabun Cuci Tangan 2
APAR 6 Kg 1

PARAF

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

SET PERAWATAN (LUKA & HEACTING ) ICU RS KASIH IBU TABANAN


Bulan : JANUARI 2023
NAMA ALAT JUMLAH

BAK INSTRUMENT 4
KUPET 4
KOM BESAR 4
KOM KECIL ( Cucing) 8
PINSET ANATOMIS 4
PINSET CHIRURGIS 6
GUNTING JARINGAN 2
GUNTING BENANG 4
GUNTING PERBAN 1
KLEM ARTERI 4
NALDPOEDER 2
BENGKOK BESAR 2
BENGKOK KECIL 1
TONGUE SPATEL 2
GUNTING UP HECTING 2
MARGIL FORCEP 2
PARAF 52

Penanggung Jawab

(Ns.Angga Wasistajaya,S.Kep)

Catatan :
Tgal 5 Oktober dilakukan retur alat Alasan
2 gunting up hecting Tumpul
2 Gunting Jaringan Tumpul
1 gunting Benang Rusak
1 Gunting Perban rusak
1 Kom Besar Berkarat
1 2 3 4
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 2 2 2 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

RS DW SN VI RS DW AG EK RS AG
RS DW SN VI RS DW AG EK RS AG

S.Kep)

1 2 3 4
P S M P S M P S M P
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

RS DW SN VI RS DW AG EK RS AG

S.Kep)
1 2 3 4
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW SN VI RS DW AG EK RS AG

S.Kep)

1 2 3 4
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

RS DW SN VI RS DW AG EK RS AG

S.Kep)
4 5 6 7
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
3 3 3 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 0 0 0 1 1
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

EK VI SN VI EK DW SN AG RS DW
EK VI SN VI EK DW SN AG RS DW

4 5 6 7
S M P S M P S M P S
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

EK VI SN VI EK DW SN AG RS DW
4 5 6 7
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

EK VI SN VI EK DW SN AG RS DW

4 5 6 7
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

EK VI SN VI EK DW SN AG RS DW
7 8 9 10
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 5 5 5
4 4 4 4 3 3 3 2 2 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 0 0 0
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 4 4 4
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

SN VI RS DW EK VI RS EK AG VI
SN VI RS DW EK VI RS EK AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

7 8 9 10
M P S M P S M P S M
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

SN VI RS DW EK VI RS EK AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
7 8 9 10
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN VI RS DW EK VI RS EK AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)

7 8 9 10
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

SN VI RS DW EK VI RS EK AG VI

Karu ICU

(Ns.Gora Kharismayana,S.Kep)
11 12 13 14
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
0 0 0 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

SN AG EK SN DW AG RS DW AG VI
SN AG EK SN DW AG RS DW AG VI

11 12 13 14
P S M P S M P S M P
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

SN AG EK SN DW AG RS DW AG VI
11 12 13 14
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN AG EK SN DW AG RS DW AG VI

11 12 13 14
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

SN AG EK SN DW AG RS DW AG VI
14 15 16 17
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

RS DW EK VI RS AG EK VI SN AG
RS DW EK VI RS AG EK VI SN AG

14 15 16 17
S M P S M P S M P S
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

RS DW EK VI RS AG EK VI SN AG
14 15 16 17
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS DW EK VI RS AG EK VI SN AG

14 15 16 17
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

RS DW VI EK RS AG EK VI SN AG
17 18 19 20
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

EK DW SN AG RS DW SN VI RS DW
EK DW SN AG RS DW SN VI RS DW

17 18 19 20
M P S M P S M P S M
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

EK DW SN AG RS DW SN VI RS DW
17 18 19 20
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

EK DW SN AG RS DW SN VI RS DW

17 18 19 20
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

EK DW SN AG RS DW SN VI RS DW
21 22 23 24
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
3 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

EK VI RS AG EK VI AG SN EK RS
EK VI RS AG EK VI AG SN EK RS

21 22 23 24
P S M P S M P S M P
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

EK VI RS AG EK VI AG SN EK RS
21 22 23 24
P S M P S M P S M P
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

EK VI RS AG EK VI AG SN EK RS

21 22 23 24
P S M P S M P S M P
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

EK VI RS AG EK VI AG SN EK RS
24 25 26 27
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 4 4
4 4 3 3 3 3 3 3 2 2
2 2 2 2 2 2 2 2 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

SN AG RS DW SN VI RS DW EK VI
SN AG RS DW SN VI RS DW EK VI

24 25 26 27
S M P S M P S M P S
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

SN AG RS DW SN VI RS DW EK VI
24 25 26 27
S M P S M P S M P S
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

SN AG RS DW SN VI RS DW EK VI

24 25 26 27
S M P S M P S M P S
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

SN AG RS DW SN VI RS DW EK VI
27 28 29 30
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 4 4 4 4 4 4 4 4 4
3 3 3 3 3 3 3 3 3 3
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6

RS AG EK VI SN AG EK DW SN AG
RS AG EK VI SN AG EK DW SN AG

27 28 29 30
M P S M P S M P S M
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
6 6 6 6 6 6 6 6 6 6
1 1 1 1 1 1 1 1 1 1

RS AG VI SN AG DW SN AG
EK EK
27 28 29 30
M P S M P S M P S M
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1

RS AG EK VI SN AG EK DW SN AG

27 28 29 30
M P S M P S M P S M
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5
4 4 4 4 4 4 4 4 4 4
4 4 4 4 4 4 4 4 4 4
6 6 6 6 6 6 6 6 6 6
2 2 2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5 5 5
1 1 1 1 1 1 1 1 1 1
4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2

RS AG EK VI SN AG EK DW SN AG
31
P S M
1 1 1
4 4 4
4 4 4
3 3 3
1 1 1
1 1 1
0 0 0
1 1 1
4 4 4
2 2 2
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1
2 2 2
1 1 1
2 2 2
5 5 5
2 2 2
1 1 1
5 5 5
6 6 6
1 1 1
1 1 1
1 1 1
6 6 6

RS DW AG
RS DW AG

31
P S M
3 3 3
2 2 2
1 1 1
1 1 1
1 1 1
4 4 4
5 5 5
6 6 6
1 1 1
1 1 1
1 1 1
1 1 1
5 5 5
1 1 1
1 1 1
2 2 2
1 1 1
1 1 1
1 1 1
2 2 2
2 2 2
6 6 6
1 1 1

RS DW AG
31
P S M
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1
1 1 1
6 6 6
2 2 2
1 1 1
2 2 2
1 1 1
2 2 2
2 2 2
3 3 3
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1
6 6 6
2 2 2
1 1 1
1 1 1
1 1 1
1 1 1
2 2 2
1 1 1

RS DW AG

31
P S M
4 4 4
4 4 4
5 5 5
4 4 4
4 4 4
6 6 6
2 2 2
5 5 5
1 1 1
4 4 4
2 2 2
2 2 2
1 1 1
2 2 2
2 2 2
2 2 2

RS DW AG

Anda mungkin juga menyukai