DAFTAR INVENTARISASI ALAT MEDIS/NON

RUMAH SAKIT PURI ASIH JATISAR

INTENSIF CARE UNIT ( ICU )

ALAT MEDIS
NO NAMA BARANG MERK/TYPE SATUAN
1 Ventilator ICU + Compresor 175-30L MV2000 SU:M2 Mek-Korea Set
2 Defibrilator Everest Unit
3 Bed Pasien Electrik Tmotion MD7C-230-24-1-4 Unit
BED ELECTRIK WITH WIGH SCALE + CPR
4 SUPRAMAX 73003 Set
- MATRAS FOAM DEWASA T=10 CM
5 Patient Monitor Zoncare PM 7000C Unit
6 Infusion Pump Terumo TE-112 Japan Unit
7 Patient Monitor Adecon Unit
8 Bed Side Monitor Unit
9 Suction Pump Medline MD-6000 PS Unit
10 Infus Pump Terumo TE-112 Unit
11 Syringe Pump Terumo TE-331 Unit
12 Alat EKG 3 Chanel BLT-1203B Unit
13 Thermometer Digital Gold Temp Microlife MT-200 Pcs
14 Tensimeter Raksa Berdiri ABN Unit
15 Regulator High Presure Unit
16 Lampu Tindakan Bipmed Unit
17 Nebulizer ABN COMPAMIST 1 Unit
18 Trolly Emergency Unit
19 Laringoscope Dewasa Renz Set
20 Laringoscope Anak Renz Set
21 Ambu Bag Dewasa Topster Unit
22 Ambu Bag Anak Topster Unit
23 Stetoskope Dewasa Unit
24 Reflek Hammer General Care Unit
25 Tromol Sedang Unit
26 Korentang 25 Cm Unit
27 Trolly Instrument Stainless Unit
28 Bengkok Sedang 23cm Unit
29 Bengkok Kecil Unit
30 Kom Alkohol Unit
31 Nampan Stainless Unit
32 Urinal Laki-laki Unit
33 Pispot One Med Unit
34 Tongue Spatel Plastik Pcs
35 Torniquet Pcs
36 Gunting Kasa Pcs
37 Buli-buli/Warm Water Zack Unit
38 Over Bed Table Unit
39 Termometer Raksa Safety Pcs
40 WT Set :
 41 - Bak Instrument Sedang Unit
42 - Pinset Anatomis Pcs
43 - Pinset Cirrughis Pcs
44 - Gunting Jaringan Pcs
45 - Gunting Up Hecting Pcs
46 - Kom Betadine Kecil Unit
47 - Kom Betadine Kecil Unit
48 Bak Instrument Kecil Unit
49 Tiang Inufs P/C Unit
50 Meja Mayo Trolly S/S Unit
51 Lemari Instrument 4 Lantai Unit
52 Lampu Baca Rontgen Double Unit
53 Foot Step/Tangga Bed Pasien P/C Unit
54 Waskom Stainless Unit
55 Standard Waskom Double Unit
56 Meja Mayo Besar Unit
57 Trolley Instrument Kaleng Unit
58 Standar Infus Unit
59 Stethoscope Anak Littman Pcs
60 Urinal Perempuan Pcs

JUMLAH

ALAT NON MEDIS

NO NAMA BARANG MERK/TYPE SATUAN
1 AC 1 PK Panasonic Unit
2 AC 1/2 PK Sharp Set
3 Kulkas 1 Pintu Sanyo Unit
4 Telephone Panasonic Unit
5 Lampu Emergency Philips Unit
6 Senter Cas Centralite CS-2D Unit
7 Dispenser Hot & Normal Miyako WD-189 H Unit
8 Kursi Lipat Chitose Unit
9 Meja Kantor Crown Unit
10 Lemari Kecil 2 Pintu Unit
11 Kursi Baso Napolly Unit
12 Sofa Warna Coklat Unit
13 Kursi Hijau Sandar Napolly Unit
14 Meja Kantor Big Panel Unit
15 Kursi Stainless Phoenix Unit
16 Laci Besar 2 Susun Lion Star Unit
17 Laci Kecil 4 Susun Unit
18 Tempat Sampah Medis 50 Liter Bio Earth Unit
19 Tempat Sampah Non Medis 50 Liter Bio Earth Unit
20 Tempat Sampah Kecil 11 L Claris Unit
21 Jam Dinding Remax Unit
22 Laci Besar 4 Susun Wendy Bear Unit
23 Washtafel Toho Unit
 24 Rak Sepatu 3 Susun Unit
25 Ember Besar 60 L Kiramas Unit
26 Pisau Kecil Stainless Carrefour Pcs
27 Kalkulator Casio MZ-125 Unit
28 Pembolong Kertas No. 30xl Joyko Unit
29 Selimut Loreng Warna Lembar
30 Baju Pasien Lembar
31 Sprei+Sarung Bantal Hijau Cotton Lembar
32 Sprei+Sarung Bantal Hijau Kotak-kotak Lembar
33 Bantal Dacron Unit
34 Kain Perlak 1X1,5M Lembar
35 Sprei Single Polos 100x200 Turkis SKY Pcs
36 Sarung Bantal Polos Turkis SKY Pcs

JUMLAH
Data Baru/Penambahan

Jumlah Alat Medis : 67 ,Nomin

Jumlah Alat Non Medis : 74 ,Nomin
Total : 141

Karawang,20

Dilaporkan Oleh, Mengetahui,

..
AT MEDIS/NON MEDIS
ASIH JATISARI

PEMBELIAN
QTY HARGA SUBTOTAL KONDISI
BLN THN
1 09 2014 318,500,000 318,500,000 90%
1 03 2012 43,500,000 43,500,000 90%
2 03 2012 23,000,000 46,000,000 90%

1 10 2014 40,000,000 40,000,000 90%

1 12 2014 17,600,000 17,600,000 90%

1 01 2015 12,000,000 12,000,000 90%
1 03 2012 17,000,000 17,000,000 90%
2 03 2012 12,000,000 24,000,000 90%
1 02 2012 3,500,000 3,500,000 90%
1 03 2012 16,300,000 16,300,000 90%
1 03 2012 12,500,000 12,500,000 80%
1 10 2010 5,500,000 5,500,000 80%
1 04 2016 175,000 175,000 100%
1 03 2012 2,191,000 2,191,000 90%
1 03 2012 3,000,000 3,000,000 90%
1 02 2012 800,000 800,000 80%
1 03 2012 400,000 400,000 85%
1 11 2012 3,500,000 3,500,000 80%
1 03 2012 700,000 700,000 80%
1 03 2012 750,000 750,000 90%
1 03 2012 200,000 200,000 90%
1 03 2012 200,000 200,000 90%
1 03 2012 584,000 584,000 90%
1 03 2012 20,000 20,000 80%
1 03 2012 275,000 275,000 90%
1 03 2012 75,000 75,000 90%
2 03 2012 800,000 1,600,000 90%
1 03 2012 35,000 35,000 90%
1 03 2012 35,000 35,000 80%
1 03 2012 40,000 40,000 80%
1 03 2012 229,000 229,000 90%
1 03 2012 8,000 8,000 85%
1 03 2012 38,000 38,000 80%
2 03 2012 38,000 76,000 80%
1 03 2012 10,000 10,000 80%
1 03 2012 14,000 14,000 80%
1 03 2012 18,000 18,000 80%
2 03 2012 1,300,000 2,600,000 80%
1 03 2012 7,800 7,800 80%
80%
 1 03 2012 15,000 15,000 90%
1 03 2012 9,000 9,000 90%
1 03 2012 9,000 9,000 90%
1 03 2012 15,000 15,000 90%
1 03 2012 15,000 15,000 90%
1 03 2012 8,000 8,000 90%
1 03 2012 8,000 8,000 90%
1 03 2012 8,000 8,000 90%
2 03 2012 120,000 240,000 90%
2 03 2012 800,000 1,600,000 85%
1 03 2012 1,300,000 1,300,000 85%
1 03 2012 550,000 550,000 85%
1 03 2012 110,000 110,000 85%
2 10 2013 50,000 100,000 85%
1 10 2013 350,000 350,000 85%
1 04 2012 1,200,000 1,200,000 85%
1 02 2012 450,000 450,000 80%
1 02 2012 110,000 110,000 80%
1 10 2010 1,000,000 1,000,000 95%
1 01 2015 14,000 14,000 100%

67 581,091,800

PEMBELIAN
QTY HARGA SUBTOTAL KONDISI
BLN THN
2 03 2012 2,800,000 5,600,000 80%
1 11 2015 3,850,000 3,850,000 80%
1 02 2012 1,300,000 1,300,000 80%
1 02 2012 125,000 125,000 80%
1 04 2012 250,000 250,000 80%
1 01 2014 22,000 22,000 80%
1 03 2014 205,000 205,000 80%
3 02 2012 205,000 615,000 90%
1 11 2012 250,000 250,000 90%
1 11 2012 150,000 150,000 85%
2 11 2012 25,000 50,000 90%
1 10 2010 600,000 600,000 80%
1 11 2012 43,000 43,000 75%
1 04 2014 300,000 300,000 80%
2 04 2014 250,000 500,000 80%
1 06 2014 85,000 85,000 95%
1 12 2013 35,000 35,000 85%
1 03 2012 300,000 300,000 80%
1 03 2012 300,000 300,000 80%
1 12 2013 73,000 73,000 90%
1 12 2013 35,000 35,000 90%
1 08 2011 50,000 50,000 80%
1 02 2012 250,000 250,000 80%
 1 09 2013 35,000 35,000 85%
1 09 2013 90,000 90,000 90%
1 03 2014 20,500 20,500 95%
1 09 2013 45,000 45,000 90%
1 02 2012 8,000 8,000 85%
4 02 2012 35,000 140,000 80%
5 02 2012 60,000 300,000 80%
4 02 2012 75,000 300,000 80%
2 02 2012 75,000 150,000 90%
2 02 2012 35,000 70,000 90%
4 02 2012 16,000 64,000 80%
10 09 2016 65,000 650,000 100%
10 09 2016 23,000 230,000 100%

74 17,090,500

,Nominal : 581,091,800
,Nominal : 17,090,500
598,182,300

tahui, Menyetujui,

 DATA NOMER INVENTARIS
RUMAH SAKIT PURI A

INTENSIF CARE UNIT ( ICU )

ALAT MEDIS
NO NAMA BARANG MERK/TYPE SATUAN
Bed Electrik With Wigh Scale+CPR
1 Supramax 73003 Set
* Matras Foam Dewasa T=10 Cm
2 Ventilator ICU + Compresor 175-3L MV2000 SU:M2 Set
3 ECG 3 Channel Biolight BLT-1203B Unit
4 Defibrilator Unit
5 Bed Pasien Electrik Tmotion MD7C-230 Unit
6 Bed Pasien Electrik Tmotion MD7C-231 Unit
7 Patient Monitor Zoncare PM 7000C Unit
8 Infusion Pump Terumo TE-112 Japan Unit
9 Patient Monitor Adecon Unit
10 Bed Side Monitor Unit
11 Bed Side Monitor Unit
12 Suction Pump Medline MD-6000 PS Unit
13 Infus Pump Terumo TE-112 Unit
14 Syringe Pump Terumo TE-331 Unit
15 Lampu Tindakan Bipmed Unit
16 Thermometer Digital Gold Temp Microlife MT-200 Pcs
17 Tensimeter Raksa Berdiri ABN Unit
18 Regulator High Presure Unit
19 Trolly Emergency Unit
20 Laringoscope Dewasa Renz Set
21 Laringoscope Anak Renz Set
22 Ambu Bag Dewasa Topster Unit
23 Ambu Bag Anak Topster Unit
24 Stetoskope Dewasa Unit
25 Reflek Hammer General Care Unit
26 Tromol Sedang Unit
27 Korentang 25 Cm Unit
28 Trolly Instrument Stainless Unit
29 Trolly Instrument Stainless Unit
30 Bengkok Sedang 23cm Unit
31 Bengkok Kecil Unit
32 Kom Alkohol Unit
33 Nampan Stenlis Unit
34 Urinal Laki-laki Unit
35 Pispot One Med Unit
36 Tongue Spatel Plastik @ 38.000 Pcs
 37 Torniquet Pcs
38 Nebulizer ABN COMPAMIST 1 Unit
39 Gunting Kasa Pcs
40 Buli-buli/Warm Water Zack Unit
41 Over Bed Table Unit
42 Over Bed Table Unit
43 Termometer Raksa Safety Pcs
44 WT Set :
- Bak Instrument Sedang Unit
- Pinset Anatomis Pcs
- Pinset Cirrughis Pcs
- Gunting Jaringan Pcs
- Gunting Up Hecting Pcs
- Kom Betadine Kecil Unit
- Kom Betadine Kecil Unit
45 Bak Instrument Kecil Unit
46 Tiang Inufs P/C Unit
47 Tiang Inufs P/C Unit
48 Meja Mayo Trolly S/S Unit
49 Meja Mayo Trolly S/S Unit
50 Lemari Instrument 4 Lantai Unit
51 Lampu Baca Rontgen Double Unit
52 Foot Step/Tangga Bed Pasien P/C Unit
53 Waskom Stainless Unit
54 Waskom Stainless Unit
55 Standard Waskom Double Unit
56 Meja Mayo Besar Unit
57 Trolley Instrument Kaleng Unit
58 Standar Infus Unit
59 Stethoscope Anak Littman Pcs

JUMLAH

ALAT NON MEDIS

NO NAMA BARANG MERK/TYPE SATUAN
1 AC 1 PK Panasonic Unit
2 AC 1 PK Panasonic Unit
3 AC 1/2 PK Sharp Set
4 Telephone Panasonic Unit
5 Lampu Emergency Philips Unit
6 Senter Cas Centralite CS-2D Unit
7 Dispenser Hot & Normal Miyako WD-189 H Unit
8 Kulkas 1 Pintu Sanyo Unit
 9 Kursi Lipat Chitose Unit
10 Kursi Lipat Chitose Unit
11 Kursi Lipat Chitose Unit
12 Meja Kantor Crown Unit
13 Lemari Kecil 2 Pintu Unit
14 Kursi Baso Napolly Unit
15 Kursi Baso Napolly Unit
16 Sofa Warna Coklat Unit
17 Kursi Hijau Sandar Napolly Unit
18 Meja Kantor Big Panel Unit
19 Kursi Stainless Phoenix Unit
20 Kursi Stainless Phoenix Unit
21 Penggaris Plastik 30 Cm Butterfly Pcs
22 Penggaris Plastik 30 Cm Butterfly Pcs
23 Stapler No.10 Kenko HD-10 Unit
24 Pembolong Kertas No. 30xl Joyko Unit
25 Papan Alas Unit
26 Kalkulator Casio MZ-125 Unit
27 Sandal Baim@35.000 New Era Pasang
28 Ember Besar 60 L Kiramas Unit
29 Tempat Sampah Kecil 11 L Claris Unit
30 Laci Kecil 4 Susun Unit
31 Tempat Sampah Medis 50 Liter Bio Earth Unit
32 Tempat Sampah Non Medis 50 Liter Bio Earth Unit
33 Sapu Lantai Carrefour Unit
34 Pengki/Serokan Sampah Lion Star Unit
35 Rak Sepatu 3 Susun Unit
36 Kapstok Kayu Unit
37 Jam Dinding Remax Unit
38 Laci Besar 4 Susun Wendy Bear Unit
39 Washtafel Toho Unit
40 Alat Pel Mulya Jaya Unit
41 Pisau Kecil Stainless Carrefour Pcs
42 Laci Besar 2 Susun Lion Star Unit

JUMLAH
Data Baru/Penambahan

Jumlah Alat Medis : 66 ,Nominal :

Jumlah Alat Non Medis : 44 ,Nominal :
Total : 110

Karawang ,28 Februari 2014

Diperiksa Oleh ,
 Agung Kurnia, Amd.Kep
Ka.Unit Ruangan
Ket :
Direvisi Tanggal 17-September-2014
A NOMER INVENTARIS MEDIS/NON MEDIS
RUMAH SAKIT PURI ASIH JATISARI

PEMBELIAN
QTY NO.INVENTARIS HARGA
BLN THN
1 M.01.1.09/2014.04.04D.007.N 09 2014 40,000,000

1 M.01.1.09/2014.04.04D.008.N 09 2014 318,500,000

1 M.01.1.10/2010.04.04D.009.N 10 2010 5,500,000
1 M.01.1.03/2012.04.04D.010.N 03 2012 43,500,000
1 M.01.1.03/2012.04.04D.011.N 03 2012 23,000,000
1 M.01.1.03/2012.04.04D.012.N 03 2012 23,000,000
1 M.01.1.12/2014.04.04D.013.N 12 2014 17,600,000
1 M.01.1.01/2015.04.04D.014.N 01 2015 12,000,000
1 M.01.1.03/2012.04.04D.001.N 03 2012 17,000,000
1 M.01.1.03/2012.04.04D.002.N 03 2012 12,000,000
1 M.01.1.03/2012.04.04D.003.N 03 2012 12,000,000
1 M.01.1.03/2012.04.04D.004.N 02 2012 3,500,000
1 M.01.1.03/2012.04.04D.005.N 03 2012 16,300,000
1 M.01.1.03/2012.04.04D.006.N 03 2012 12,500,000
1 M.01.2.03/2012.04.04D.001.N 03 2012 800,000
1 05 2016 175,000
1 M.02.1.03/2012.04.04D.001.N 03 2012 2,191,000
1 M.02.1.03/2012.04.04D.002.N 03 2012 3,000,000
1 M.02.1.11/2012.04.04D.003.N 11 2012 3,500,000
1 M.02.2.03/2012.04.04D.001.N 03 2012 700,000
1 M.02.2.03/2012.04.04D.002.N 03 2012 750,000
1 M.02.2.03/2012.04.04D.003.N 03 2012 200,000
1 M.02.2.03/2012.04.04D.004.N 03 2012 200,000
1 M.02.2.03/2012.04.04D.005.N 03 2012 584,000
1 M.02.2.03/2012.04.04D.006.N 03 2012 20,000
1 03 2012 275,000
1 M.02.2.03/2012.04.04D.007.N 03 2012 75,000
1 M.02.2.03/2012.04.04D.008.N 03 2012 800,000
1 M.02.2.03/2012.04.04D.009.N 03 2012 800,000
1 M.02.2.03/2012.04.04D.010.N 03 2012 35,000
1 M.02.2.03/2012.04.04D.011.N 03 2012 35,000
1 M.02.2.03/2012.04.04D.012.N 03 2012 40,000
1 M.02.2.03/2012.04.04D.013.N 03 2012 229,000
1 M.02.2.03/2012.04.04D.014.N 03 2012 8,000
1 M.02.2.03/2012.04.04D.015.N 03 2012 38,000
2 Tanpa Nomor 03 2012 76,000
 1 Tanpa Nomor 03 2012 10,000
1 M.02.2.03/2012.04.04D.016.N 03 2012 400,000
1 Tanpa Nomor 03 2012 14,000
1 M.02.2.03/2012.04.04D.017.N 03 2012 18,000
1 M.02.2.03/2012.04.04D.018.N 03 2012 1,300,000
1 M.02.2.03/2012.04.04D.019.N 03 2012 1,300,000
1 Tanpa Nomor 03 2012 7,800

1 M.02.2.03/2012.04.04D.020.N 03 2012 15,000

1 Tanpa Nomor 03 2012 9,000
1 Tanpa Nomor 03 2012 9,000
1 Tanpa Nomor 03 2012 15,000
1 Tanpa Nomor 03 2012 15,000
1 Tanpa Nomor 03 2012 8,000
1 Tanpa Nomor 03 2012 8,000
1 M.02.2.03/2012.04.04D.021.N 03 2012 8,000
1 M.02.2.03/2012.04.04D.022.N 03 2012 120,000
1 M.02.2.03/2012.04.04D.032.N 03 2012 120,000
1 M.02.2.03/2012.04.04D.024.N 03 2012 800,000
1 M.02.2.03/2012.04.04D.025.N 03 2012 800,000
1 M.02.2.03/2012.04.04D.023.N 03 2012 1,300,000
1 M.02.2.03/2012.04.04D.026.N 03 2012 550,000
1 M.02.2.03/2012.04.04D.027.N 03 2012 110,000
1 M.02.2.03/2012.04.04D.028.N 10 2013 50,000
1 M.02.2.03/2012.04.04D.029.N 10 2013 50,000
1 M.02.2.03/2012.04.04D.030.N 10 2013 350,000
1 M.02.2.04/2012.04.04D.031.N 04 2012 1,200,000
1 M.02.2.03/2012.04.04D.033.N 03 2012 450,000
1 03 2012 110,000
1 M.02.2.10/2010.04.04D.035.N 10 2010 1,000,000

66 581,077,800

PEMBELIAN
QTY NO.INVENTARIS HARGA
BLN THN
1 N.03.1.03/2012.04.04D.001.N 03 2012 2,800,000
1 N.03.1.03/2012.04.04D.002.N 03 2012 2,800,000
1 11 2015 3,850,000
1 N.03.2.02/2012.04.04D.001.N 02 2012 125,000
1 N.03.2.04/2012.04.04D.002.N 04 2012 250,000
1 N.03.2.01/2014.04.04D.003.N 01 2014 22,000
1 N.03.2.03/2014.04.04D.004.N 03 2014 205,000
1 N.03.2.10/2010.04.04D.005.N 10 2010 1,300,000
 1 N.01.2.02/2012.04.04D.001.N 02 2012 205,000
1 N.01.2.02/2012.04.04D.002.N 02 2012 205,000
1 N.01.2.02/2012.04.04D.003.N 02 2012 205,000
1 N.01.2.11/2012.04.04D.004.N 11 2012 250,000
1 N.01.2.11/2012.04.04D.005.N 11 2012 150,000
1 N.01.2.11/2012.04.04D.006.N 11 2012 25,000
1 N.01.2.11/2012.04.04D.007.N 11 2012 25,000
1 N.01.2.10/2010.04.04D.008.N 10 2010 600,000
1 N.01.2.11/2012.04.04D.009.N 11 2012 43,000
1 N.01.2.04/2014.04.04D.010.N 04 2014 300,000
1 N.01.2.04/2014.04.04D.011.N 04 2014 250,000
1 N.01.2.04/2014.04.04D.012.N 04 2014 250,000
1 N.02.2.02/2012.04.04D.001.N 02 2012 2,500
1 N.02.2.02/2012.04.04D.002.N 02 2012 2,500
1 N.02.2.02/2012.04.04D.003.N 02 2012 8,000
1 N.02.2.02/2012.04.04D.004.N 02 2012 8,000
1 N.02.2.11/2013.04.04D.005.N 11 2013 10,000
1 N.02.2.09/2013.04.04D.006.N 09 2013 45,000
3 Tanpa Nomor 08 2013 105,000
1 N.04.2.09/2013.04.04D.001.N 09 2013 90,000
1 N.04.2.12/2013.04.04D.002.N 12 2013 73,000
1 N.04.2.12/2013.04.04D.003.N 12 2013 35,000
1 N.04.2.03/2012.04.04D.004.N 03 2012 300,000
1 N.04.2.03/2012.04.04D.005.N 03 2012 300,000
1 N.04.2.10/2013.04.04D.006.N 10 2013 32,500
1 N.04.2.09/2013.04.04D.007.N 09 2013 27,000
1 N.04.2.09/2013.04.04D.008.N 09 2013 35,000
1 N.04.2.04/2013.04.04D.009.N 04 2013 5,000
1 N.04.2.12/2013.04.04D.010.N 12 2013 35,000
1 N.04.2.08/2011.04.04D.011.N 08 2011 50,000
1 N.04.2.02/2012.04.04D.012.N 02 2012 250,000
1 N.04.2.01/2014.04.04D.013.N 01 2014 12,000
1 N.04.2.03/2014.04.04D.014.N 03 2014 20,500
1 06 2014 85,000

44 15,391,000

,Nominal : 581,077,800
,Nominal : 15,391,000
: 596,468,800
KEL.BARANG KETERANGAN

Electro Medis Investasi

Electro Medis Investasi

Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Investasi
Electro Medis Non Investasi
Electro Medis Non Investasi
Alat Medis Investasi
Alat Medis Investasi
Alat Medis Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
 Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi

Alat Medis Non Investasi

Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi
Alat Medis Non Investasi

KEL.BARANG KETERANGAN
Electrical Investasi
Electrical Investasi
Electrical Investasi
Electrical Non Investasi
Electrical Non Investasi
Electrical Non Investasi Rusak 17/12/2015
Electrical Non Investasi
Electrical Non Investasi
 Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Furniture Non Investasi
Alat Kantor Non Investasi
Alat Kantor Non Investasi
Alat Kantor Non Investasi
Alat Kantor Non Investasi
Alat Kantor Non Investasi
Alat Kantor Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi
ART Non Investasi

Diserahkan ,
 Jemarun
Unit Rumah Tangga
 INVENTARISASI DAN EVALUASI BARANG INVENTARIS TAHUN 2016
RUMAH SAKIT PURI ASIH JATISARI

ICU ( INTENSIF CARE UNIT )

ALAT MEDIS
PEMBELIAN KONDISI
NO NAMA BARANG MERK/TYPE SATUAN QTY
BLN THN BAIK RUSAK
1 Ventilator ICU + Compresor 175-30L MV2000 SU:M2 Mek-Korea Set 1 09 2014
2 Defibrilator Everest Unit 1 03 2012
3 Bed Pasien Electrik Tmotion MD7C-230-24-1-4 Unit 1 03 2012
4 Bed Pasien Electrik Tmotion MD7C-230-24-1-4 Unit 1 03 2012
BED ELECTRIK WITH WIGH SCALE + CPR
5 SUPRAMAX 73003 Set 1 10 2014
- MATRAS FOAM DEWASA T=10 CM
6 Patient Monitor Zoncare PM 7000C Unit 1 12 2014
7 Infusion Pump Terumo TE-112 Japan Unit 1 01 2015
8 Patient Monitor Adecon Unit 1 03 2012
9 Bed Side Monitor Unit 1 03 2012
10 Bed Side Monitor Unit 1 03 2012
11 Suction Pump Medline MD-6000 PS Unit 1 02 2012
12 Infus Pump Terumo TE-112 Unit 1 03 2012
13 Syringe Pump Terumo TE-331 Unit 1 03 2012
14 Alat EKG 3 Chanel BLT-1203B Unit 1 10 2010
15 Lampu Tindakan Bipmed Unit 1 02 2012
16 Thermometer Digital Gold Temp Microlife MT-200 Pcs 1 05 2016
17 Nebulizer ABN COMPAMIST 1 Unit 1 03 2012
18 Tensimeter Raksa Berdiri ABN Unit 1 03 2012
19 Regulator High Presure Unit 1 03 2012
20 Trolly Emergency Unit 1 11 2012
21 Laringoscope Dewasa Renz Set 1 03 2012
22 Laringoscope Anak Renz Set 1 03 2012
23 Ambu Bag Dewasa Topster Unit 1 03 2012
24 Ambu Bag Anak Topster Unit 1 03 2012
25 Stetoskope Dewasa Unit 1 03 2012
26 Reflek Hammer General Care Unit 1 03 2012
27 Tromol Sedang Unit 1 03 2012
28 Korentang 25 Cm Unit 1 03 2012
29 Trolly Instrument Stainless Unit 1 03 2012
30 Trolly Instrument Stainless Unit 1 03 2012
31 Bengkok Sedang 23cm Unit 1 03 2012
32 Bengkok Kecil Unit 1 03 2012
33 Kom Alkohol Unit 1 03 2012
34 Nampan Stainless Unit 1 03 2012
35 Urinal Laki-laki Unit 1 03 2012
36 Pispot One Med Unit 1 03 2012
37 Tongue Spatel Plastik Pcs 2 03 2012
38 Torniquet Pcs 1 03 2012
39 Gunting Kasa Pcs 1 03 2012
40 Buli-buli/Warm Water Zack Unit 1 03 2012
41 Over Bed Table Unit 1 03 2012
42 Over Bed Table Unit 1 03 2012
43 Termometer Raksa Safety Pcs 1 03 2012
44 WT Set :
- Bak Instrument Sedang Unit 1 03 2012
- Pinset Anatomis Pcs 1 03 2012
- Pinset Cirrughis Pcs 1 03 2012
- Gunting Jaringan Pcs 1 03 2012
- Gunting Up Hecting Pcs 1 03 2012
- Kom Betadine Kecil Unit 1 03 2012
- Kom Betadine Kecil Unit 1 03 2012
45 Bak Instrument Kecil Unit 1 03 2012
46 Tiang Inufs P/C Unit 1 03 2012
47 Tiang Inufs P/C Unit 1 03 2012
48 Meja Mayo Trolly S/S Unit 1 03 2012
 49 Meja Mayo Trolly S/S Unit 1 03 2012
50 Lemari Instrument 4 Lantai Unit 1 03 2012
51 Lampu Baca Rontgen Double Unit 1 03 2012
52 Foot Step/Tangga Bed Pasien P/C Unit 1 03 2012
53 Waskom Stainless Unit 1 10 2013
54 Waskom Stainless Unit 1 10 2013
55 Standard Waskom Double Unit 1 10 2013
56 Meja Mayo Besar Unit 1 04 2012
57 Trolley Instrument Kaleng Unit 1 02 2012
58 Standar Infus Unit 1 02 2012
59 Stethoscope Anak Littman Pcs 1 10 2010

Jumlah 66

ALAT NON MEDIS

PEMBELIAN KONDISI
NO NAMA BARANG MERK/TYPE SATUAN QTY
BLN THN BAIK RUSAK
1 AC 1 PK Panasonic Unit 1 03 2012
2 AC 1 PK Panasonic Unit 1 03 2012
3 AC 1/2 PK Sharp Set 1 11 2015
4 Kulkas 1 Pintu Sanyo Unit 1 02 2012
5 Telephone Panasonic Unit 1 02 2012
6 Lampu Emergency Philips Unit 1 04 2012
7 Senter Cas Centralite CS-2D Unit 1 01 2014
8 Dispenser Hot & Normal Miyako WD-189 H Unit 1 03 2014
9 Kursi Lipat Chitose Unit 1 02 2012
10 Kursi Lipat Chitose Unit 1 02 2012
11 Kursi Lipat Chitose Unit 1 02 2012
12 Meja Kantor Crown Unit 1 11 2012
13 Lemari Kecil 2 Pintu Unit 1 11 2012
14 Kursi Baso Napolly Unit 1 11 2012
15 Kursi Baso Napolly Unit 1 11 2012
16 Sofa Warna Coklat Unit 1 10 2010
17 Kursi Hijau Sandar Napolly Unit 1 11 2012
18 Meja Kantor Big Panel Unit 1 04 2014
19 Kursi Stainless Phoenix Unit 1 04 2014
20 Kursi Stainless Phoenix Unit 1 04 2014
21 Laci Besar 2 Susun Lion Star Unit 1 06 2014
22 Laci Kecil 4 Susun Unit 1 12 2013
23 Tempat Sampah Medis 50 Liter Bio Earth Unit 1 03 2012
24 Tempat Sampah Non Medis 50 Liter Bio Earth Unit 1 03 2012
25 Tempat Sampah Kecil 11 L Claris Unit 1 12 2013
26 Jam Dinding Remax Unit 1 12 2013
27 Laci Besar 4 Susun Wendy Bear Unit 1 08 2011
28 Washtafel Toho Unit 1 02 2012
29 Rak Sepatu 3 Susun Unit 1 09 2013
30 Ember Besar 60 L Kiramas Unit 1 09 2013
31 Pisau Kecil Stainless Carrefour Pcs 1 03 2014
32 Kalkulator Casio MZ-125 Unit 1 09 2013
33 Pembolong Kertas No. 30xl Joyko Unit 1 02 2012
34 Selimut Loreng Warna Lembar 4 02 2012
35 Baju Pasien Lembar 5 02 2012
36 Sprei+Sarung Bantal Hijau Cotton Lembar 4 02 2012
37 Sprei+Sarung Bantal Hijau Kotak-kotak Lembar 2 02 2012
38 Bantal Dacron Unit 2 02 2012
39 Kain Perlak 1X1,5M Lembar 4 02 2012

Jumlah 54
Data Baru/Penambahan
HUN 2016

ONDISI
NOMOR INVENTARIS KETERANGAN
HILANG
M.01.1.09/2014.04.04D.008.N
M.01.1.03/2012.04.04D.010.N
M.01.1.03/2012.04.04D.011.N
M.01.1.03/2012.04.04D.012.N

M.01.1.09/2014.04.04D.007.N

M.01.1.12/2014.04.04D.013.N
M.01.1.01/2015.04.04D.014.N
M.01.1.03/2012.04.04D.001.N
M.01.1.03/2012.04.04D.002.N
M.01.1.03/2012.04.04D.003.N
M.01.1.03/2012.04.04D.004.N
M.01.1.03/2012.04.04D.005.N
M.01.1.03/2012.04.04D.006.N
M.01.1.10/2010.04.04D.009.N
M.01.2.03/2012.04.04D.001.N

M.02.2.03/2012.04.04D.016.N
M.02.1.03/2012.04.04D.001.N
M.02.1.03/2012.04.04D.002.N
M.02.1.11/2012.04.04D.003.N
M.02.2.03/2012.04.04D.001.N
M.02.2.03/2012.04.04D.002.N
M.02.2.03/2012.04.04D.003.N
M.02.2.03/2012.04.04D.004.N
M.02.2.03/2012.04.04D.005.N
M.02.2.03/2012.04.04D.006.N
Sedang Di Steril
M.02.2.03/2012.04.04D.007.N
M.02.2.03/2012.04.04D.008.N
M.02.2.03/2012.04.04D.009.N
M.02.2.03/2012.04.04D.010.N
M.02.2.03/2012.04.04D.011.N
M.02.2.03/2012.04.04D.012.N
M.02.2.03/2012.04.04D.013.N
M.02.2.03/2012.04.04D.014.N
M.02.2.03/2012.04.04D.015.N
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
M.02.2.03/2012.04.04D.017.N
M.02.2.03/2012.04.04D.018.N
M.02.2.03/2012.04.04D.019.N
Tanpa Nomor

M.02.2.03/2012.04.04D.020.N
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
M.02.2.03/2012.04.04D.021.N
M.02.2.03/2012.04.04D.022.N
M.02.2.03/2012.04.04D.032.N
M.02.2.03/2012.04.04D.024.N
 M.02.2.03/2012.04.04D.025.N
M.02.2.03/2012.04.04D.023.N
M.02.2.03/2012.04.04D.026.N
M.02.2.03/2012.04.04D.027.N
M.02.2.03/2012.04.04D.028.N
M.02.2.03/2012.04.04D.029.N
M.02.2.03/2012.04.04D.030.N
M.02.2.04/2012.04.04D.031.N
M.02.2.03/2012.04.04D.033.N

M.02.2.10/2010.04.04D.035.N

ONDISI
NOMOR INVENTARIS KETERANGAN
HILANG
N.03.1.03/2012.04.04D.001.N
N.03.1.03/2012.04.04D.002.N

N.03.2.10/2010.04.04D.005.N
N.03.2.02/2012.04.04D.001.N
N.03.2.04/2012.04.04D.002.N
N.03.2.01/2014.04.04D.003.N Rusak
N.03.2.03/2014.04.04D.004.N
N.01.2.02/2012.04.04D.001.N
N.01.2.02/2012.04.04D.002.N
N.01.2.02/2012.04.04D.003.N
N.01.2.11/2012.04.04D.004.N
N.01.2.11/2012.04.04D.005.N
N.01.2.11/2012.04.04D.006.N
N.01.2.11/2012.04.04D.007.N
N.01.2.10/2010.04.04D.008.N
N.01.2.11/2012.04.04D.009.N
N.01.2.04/2014.04.04D.010.N
N.01.2.04/2014.04.04D.011.N
N.01.2.04/2014.04.04D.012.N

N.04.2.12/2013.04.04D.003.N
N.04.2.03/2012.04.04D.004.N
N.04.2.03/2012.04.04D.005.N
N.04.2.12/2013.04.04D.002.N
N.04.2.12/2013.04.04D.010.N
N.04.2.08/2011.04.04D.011.N
N.04.2.02/2012.04.04D.012.N
N.04.2.09/2013.04.04D.008.N
N.04.2.09/2013.04.04D.001.N
N.04.2.01/2014.04.04D.013.N
N.02.2.09/2013.04.04D.006.N
N.02.2.02/2012.04.04D.004.N
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
Tanpa Nomor
 DATA PENAMBAHAN BARANG INVENTARIS

INTENSIF CARE UNIT ( ICU )

NO NAMA BARANG MERK/TYPE SATUAN QTY
1 Meja Kerja Panel Unit 1
2 Kursi Stainless Phoenix Unit 1
3 Kursi Stainless Phoenix Unit 1

JUMLAH 3

Karawang ,28 April 2014

Diperiksa Oleh ,

Agung Kurnia, Amd.Kep

Ka.Unit Ruangan
HAN BARANG INVENTARIS ALAT MEDIS/NON MEDIS

PEMBELIAN
NO.INVENTARIS HARGA KEL.BARANG
BLN THN
N.01.2.04/2014.04.04D.010.N 04 2014 300,000 Furniture
N.01.2.04/2014.04.04D.011.N 04 2014 250,000 Furniture
N.01.2.04/2014.04.04D.012.N 04 2014 250,000 Furniture

800,000

Diketahui ,

Jemarun
Unit Rumah Tangga
 KETERANGAN
Non Investasi
Non Investasi
Non Investasi

Diketahui ,

Jemarun
nit Rumah Tangga
 DATA ASSET INVENTARIS INVESTASI/NONO INVESTASI
RUMAH SAKIT PURI ASIH JATISARI

HIGH CARE UNIT ( H.C.U )

ALAT MEDIS ( INVESTASI )
PEMBELIAN
NO NAMA BARANG MERK/TYPE SATUAN JUMLAH
BLN
1 Pasien Monitor ADECON Unit 1 03
2 Bedside Monitor Unit 2 03
3 Defibrilator Unit 1 03
4 Suction Pump Medline MD-6000PS Unit 1 02
5 Infus Pump Terumo TE-112 Unit 1 03
6 Syringe Pump Terumo TE-331 Unit 1 03
7 Tensimeter Raksa Berdiri ABN Unit 1 03
8 Regulator High Presure Unit 1 03

JUMLAH 9

NON INVESTASI
PEMBELIAN
NO NAMA BARANG MERK/TYPE SATUAN JUMLAH
BLN
1 Laringoscope Dewasa Renz Unit 1 02
2 Laringoscope Anak Renz Unit 1 02
3 Ambu Bag Dewasa Topster Unit 1 02
4 Ambu Bag Anak Topster Unit 1 02
5 Stetoskop Unit 1 02
6 Reflek Hammer Unit 1 02
7 Tromol Sedang Unit 1 02
8 Korentang 25 Cm Unit 1 02
9 Trolly Instrument / Meja Instrument Unit 1 02
10 Kom Sedang Tanpa Tutup Unit 2 02
11 Bengkok/Paratus Etui Unit 2 02
12 Kom Alkohol Unit 1 02
13 Nampan Stenlis Unit 1 02
14 Urinal Unit 1 02
15 Pispot Unit 1 02
16 Tongue Spatel Plastik Pcs 2 02
17 Torniquet Pcs 1 02
18 Nebulizer ABN COMPAMIST 1 Unit 1 02
19 Gunting Kasa Pcs 1 02
20 Buli-buli/Warm Water Zack Unit 1 02
21 Over Bed Table Unit 2 03
22 Termometer Raksa Pcs 1 02
23 WT Set :
- Bak Instrument Sedang Unit 1 03
- Pinset Anatomis Pcs 1 03
- Pinset Cirrughis Pcs 1 03
 - Gunting Jaringan Pcs 1 03
- Kom Betadine Kecil Unit 2 03
- Gunting Up Hecting Pcs 1 03
24 Tiang Inufs P/C Unit 2 03
25 Lemari Instrument Unit 1 03
26 Meja Mayo Trolly S/S Unit 2 03
27 Lemari Instrument 4 Lantai Unit 1 03
28 Lampu Baca Rontgen Double Unit 1 03
29 Foot Step/Tangga Bed Pasien P/C Unit 1 03
30 Baskom Stainless Unit 1 10
31 Standar Waskom Double Unit 1 10

JUMLAH 43
 INVESTASI ALAT MEDIS
ATISARI

PEMBELIAN
HARGA SUBTOTAL KONDISI UMUR ALAT
THN
2012 17,000,000 17,000,000 90% 5 Th
2012 12,000,000 24,000,000 90% 5 Th
2012 90% 5 Th
2012 3,500,000 3,500,000 90% 10 Th
2012 16,300,000 16,300,000 90% 10 Th
2012 12,500,000 12,500,000 90% 10 Th
2012 2,191,000 2,191,000 90% 3 Th
2012 3,000,000 3,000,000 90% 5 Th

78,491,000

PEMBELIAN
HARGA SUBTOTAL KONDISI UMUR ALAT
THN
2012 700,000 700,000 80%
2012 750,000 750,000 80%
2012 200,000 200,000 90%
2012 200,000 200,000 90%
2012 584,000 58,400 80%
2012 20,000 20,000 80%
2012 275,000 275,000 90%
2012 75,000 75,000 90%
2012 800,000 800,000 90%
2012 35,000 70,000 90%
2012 35,000 70,000 80%
2012 40,000 40,000 90%
2012 229,000 22,900 90%
2012 8,000 8,000 90%
2012 38,000 38,000 90%
2012 38,000 78,000 80%
2012 10,000 10,000 80%
2012 400,000 400,000 90%
2012 14,000 14,000 85%
2012 18,000 18,000 80%
2012 1,300,000 1,300,000 80%
2012 7,800 7,800 80%

2012 15,000 15,000 80%

2012 9,000 9,000 80%
2012 9,000 9,000 80%
2012 15,000 15,000 80%
2012 8,000 16,000 80%
2012 15,000 15,000 80%
2012 100,000 200,000 90%
2012 1,300,000 1,300,000 90%
2012 800,000 1,600,000 90%
2012 1,300,000 1,300,000 90%
2012 550,000 550,000 90%
2012 110,000 110,000 90%
2013 50,000 50,000 90%
2013 350,000 350,000 90%

10,694,100