CHECKLIST INVENTARIS RUANGAN

ALAT MEDIS
LANTAI III
NURSE STATION RANAP RATNA

Sub – Sub Kelompok Kondisi

Jumlah Barang
NO Nama Barang RATNA
Kd Brg Type/Merk Thn didpt Barang Baik Rusak
Berat
1 BENGKOK/NIERBEKEN 23CM ONEMED 2015 2 √ -
2 CEK BS FREESTYLE OPTIUM NEO H 2017 1 √ -
3 COM TUTUP 12CM ONEMED 2015, 2017 2 √ -
4 CUCING KECIL 8CM ONEMED 2015 4 √ -
5 YAMAMOTO HAK MILIK RATNA, NAMUN DIPAKAI
DOPLER 102N 2015 1 √ -
GIKEN SANDAT JEPUN
6 DRESSING TROLY SDM 180 DTDS SDM 2015 1 √ - ,
7 FOTOTHERAPI - GEA 2017 1 √ -
8 GUNTING JARINGAN 14CM ONEMED 2016 2 √ -
9 INFUSION STAND - SOLMED 2015 2 √ -
10 INFUSION STAND MORIKO 2015 3
11 INSTRUMEN TROLLY - LOKAL 2015 1 √ -
12 KLEM PEAN BENGKOK 14CM ONEMED 2015 2 √ -
13 KLEM PEAN LURUS 14CM ONEMED 2015 2 √ -
14 KUPET BESAR / BAK INSTRUMEN SH 509 ONEMED 2015 2 √ -
15 KUPET INJEKSI / BAK INSTRUMEN SH 508 ONEMED 2015 2 √ -
16 LEMARI INSTRUMEN (ABU) 185312 PLATINUM 2015 1 √ - ,
17 MEDICINE CABINET (PUTIH) 281060 PLATINUM 2015 1 √ - Medicine Cabinet Platinum 281060 ,
18 MES HOLDER / SCAPEL HANDLE NO. 3 ONEMED 2015 2 √ -
19 NALD VOEDAR MAYO 14CM ONEMED 2015 1 √ -
20 NEBULIZER COMPRESSOR C28 OMRON 2018 1 √ -
21 PINSET ANATOMIS 14CM ONEMED 2015 2 √ -
22 PINSET CHIRUGIS 14CM ONEMED 2015 2 √ -
23 PISPOT - ONEMED 2015 5 √ -
24 STETOSCOPE ANAK 4041 RIESTER 2015 1 √ - ,
25 STETOSCOPE DEWASA 4001 RIESTER 2015 2 √ - ,
26 SUCTION PORTABLE ASPIRATION 1
27 SYRINGE PUMP SP-SMART NIPRO 2015 1 √ -
28 TABUNG O2 MOBILE - 2015 1 √ - ,
29 TENSIMETER MOBILE ANAK - RIESTER 2015 1 √ - ,
30 TENSIMETER MOBILE DEWASA - RIESTER 2015 2 √ - ,
31 TERMOMETER DIGITAL - THERMO ONE 2018 2 √ -
32 TERMOMETER RUANGAN / - LOKAL 2018 - √ -
HYGROMETER

33 TIMBANGAN DEWASA - - 2015 1 √ -

34 TOUNGUE SPATEL DEWASA - ONEMED 2015 1 √ -
35 TOURNIQUET - ONEMED 2015 1 √ -
36 URINAL - ONEMED 2015 5 √ - ,
37 X-RAY FILM VIEWER LED - ONEMED 2015 1 √ - ,
38 PENLIGHT DELUXE - 2018 1 √ - ,

Sub –Sub Kelompok Kondisi

Jumlah Barang
NO Nama Barang Rusak KAMAR RATNA
Kd Brg Type/Merk Thn didpt Barang Baru
Berat
1 BEDSIDE CABINET P-1800DX PLATINUM NG 2015 19 √ - ,
2 MANUAL HOSPITAL BED 3 CRANK PI-308MS INSPIRATION 2015 19 √ - ,
3 MATRASS P202-MA PLATINUM NG 2015 19 √ - ,
4 MOVABLE DINING TABLE P-011 PLATINUM NG 2015 19 √ - ,
5 HUMIDIFIER - - 2015 19 √ - ,

Pengelola, 20 JuLI 2018 Mengetahui,

Kepala Unit Ratna Ka. Unit Logistik

Dewa Ayu Sri Cahyaningsih, SS

KARTU INVENTARIS RUANGAN
ALAT NON MEDIS
LANTAI III
RATNA (19 KAMAR, NS, SPOLHOK)

Sub –Sub Kelompok Kondisi Barang

Jumlah
NO Nama Barang Thn Rusak
Kd Brg Type/Merk didpt Barang Baik Berat
1 BANTAL SOFA LOCAL 2015 36 √
2 BANTAL TEMPAT TIDUR 2015 19 √
3 BASKOM NAGATA 816 2017 10 √
4 BASKOM NAGATA 818 2015 1 √
5 BASKOM STAINLES 2015 1 √
6 BOX CONTAINER CB 8 2015 2 √
7 BOX FILE KERANJANG PLASTIK 2015 12 √
8 DISPENSER MIYAKO MIYAKO 1 √
9 EMBER LINEN 70 LTR 2015 2 √
10 FRAME 10 R 20 √
11 FRAME A3 1 √
12 GANTUNGAN BAJU BESI (ISI 8) 2015 1 √
GANTUNGAN BAJU KAYU (ISI 6) 20
13 2015 √

14 HAND RAIL TOILET (pegangan) 19 √

15 JAM DINDING BERLOGO 2015 20 √
16 KAKI DISPENSER 1 √
17 KALKULATOR D-R 1 √
18 KERANJANG BESAR 1 √
19 KERANJANG NOTA 2 √
20 KERANJANG SEDANG 1 √
21 KULKAS KECIL SANKEN 1 √
22 KURSI BAKSO MERAH 1 √
23 KURSI KOTAK ABU MONTANA 2015 4 √
24 KURSI KOTAK ABU MONTANA 2017 10 √
LAMPU 90
25 √

26 LEMARI OBAT SS 5 4 √
27 MINI KONTAINER SS 4 2015 5 √
28 NURSE CALL 2015 1 √
29 PAPAN WHITEBOARD 120X80 1 √
30 SOFA LOCAL 2015 18 √
31 TEKO LISTRIK ARASHI 1 √
32 TELEPHONE INTERNAL PANASONIC 2015 21 √
33 TEMPAT BOSUR 2 √
34 TEMPAT PENSIL 1 √
35 TEMPAT SAMPAH 15 LTR 1 √
36 TEMPAT SAMPAH 25 LTR 3 √
37 TEMPAT SAMPAH 5 LTR 39 √
HANDPHONE SAMSUNG + SAMSUNG 1
38 CHARGET √

1 CPU KOMPUTER - HP 2015 1 √ -

2 KEYBOARD KOMPUTER - HP 2015 1 √ -
3 MONITOR KOMPUTER - LG 2015 1 √ -
4 MOUSE KOMPUTER - HP 2015 1 √ -
5 UPS 600VA - - 2018 1 √ -
6 HUB DATA / LAN 1 √

1 AC + REMOTE LG 2014 22 √
2 ALARM OXYGEN 2015 1 √
3 APAR 2015 1 √
4 CCTV 2015 3 √
5 CERMIN 2015 20 √
6 CLOSET 2015 20 √
7 COLOKAN DATA TV 2015 19 √
8 EXHAUST FAN 2015 20 √
9 FLOOR DRAIN 2015 20 √
10 HUB TELEPHONE 2015 21 √
11 HYDRAN 2015 1 √
12 JET SPRAY 2015 20 √
13 KRAN 2015 21 √
14 PANEL (7 MCB) PRESTO 2015 19 √
15 PANEL (8 MCB) PRESTO 2015 1 √
16 SAKLAR GANDA 2015 23 √
17 SAKLAR TUNGGAL 2015 22 √
18 SHOWER 2015 20 √
19 SMOKE DETEKTOR 2015 27 √
20 STOP KONTAK 2015 83 √
21 STOP KONTAK AC 2015 22 √
22 TOA 2015 23 √
23 TV LED + BREKET + REMOTE 32" SHARP 2015 19 √
24 WASTAPEL 2015 21 √

Pengelola,
Kepala Unit Ratna
 Unit
KET. LOKASI USER
Pemelihara

2 BH MASIH PENCARIAN RATNA RATNA

RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
18 KAMAR, 2 NS RATNA RATNA
DISTRIBUSI O/ MARKETING RATNA RATNA
NS RATNA RATNA
19 KAMAR, 1 NS
RATNA
RATNA
RATNA RATNA
19 KAMAR, 1 NS RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
1 BUAH BANTALAN HITAM KRNA SERVICE RATNA RATNA
RATNA RATNA
57 KAMAR, 4 SPOLHOK, 15 KORIDOR, 4 NS,
10 SELASAR RATNA
RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
RATNA RATNA
19 KAMAR, 2 NS RATNA RATNA
DISTRIBUSI O/ PPI RATNA RATNA
RATNA RATNA
NS RATNA RATNA
RATNA RATNA
38 KAMAR, 1 NS RATNA RATNA

RATNA
RATNA

SIMRS RATNA
 SIMRS RATNA
SIMRS RATNA
SIMRS RATNA
SIMRS RATNA
SIMRS RATNA

19 KAMAR ,1 NS, 2 KORIDOR. IPSRS RATNA

IPSRS RATNA
IPSRS RATNA
KORIDOR IPSRS RATNA
19 KAMAR, 1 NS IPSRS RATNA
19 KAMAR, 1 NS IPSRS RATNA
IPSRS RATNA
IPSRS RATNA
IPSRS RATNA
19 KAMAR, 2 NS IPSRS RATNA
IPSRS RATNA
IPSRS RATNA
19 KAMAR, 1 NS, 1 SPOLHOK IPSRS RATNA
IPSRS RATNA
NS IPSRS RATNA
19 KAMAR, 1 SPOLHOK, 1 NS, 2 KORIDOR IPSRS RATNA
19 KAMAR, 1 SPOLHOK, 1 NS, 1 KORIDOR IPSRS RATNA
19 KAMAR, 1 NS IPSRS RATNA
19 KAMAR, 7 KORIDOR, 1 NS IPSRS RATNA
76 KAMAR, 2 SPOLHOK, 5 NS IPSRS RATNA
19 KAMAR ,1 NS, 2 KORIDOR. IPSRS RATNA
19 KAMAR, 1 NS, 3 KORIDOR IPSRS RATNA
2 BH MASIH PENCARIAN IPSRS RATNA
19 KAMAR, 1 NS, 1 SPOLHOK IPSRS RATNA

Mengetahui,
Ka. Unit Logistik

Dewa Ayu Sri Cahyaningsih, SS