KARTU IN

PROVINSI : DKI JAKARTA

KOTA ADMINISTRASI : JAKARTA SELATAN
SATUAN KERJA : DINAS KESEHATAN PROV. DKI JAKARTA
UNIT : RSUD JATI PADANG
RUANG/LANTAI : PERINATOLOGI / 3

No.Seri
NO. Jenis Barang / Nama Barang Merk/ Model Ukuran
Pabrik

1 2 3 4 5
ADC-USA Stetoscope Adult
1 Stetoscope Neonatus ADSCPE(Stainless steel
ADC-USA scope)
Stetoscope Adult
2 Stetoscope Neonatus ADSCPE(Stainless steel
scope)
Infant Flow CPAP
3 FISHER
Comperehensive
Infant Flow CPAP
4 FANEM
Comperehensive
5 Trolly Tindakan (dressing Trolly) AGS Dressing Trolley

6 Baby Scale TANITA

7 Pulse Oxymeter Neonatus Mindray Pulse Oximeter

8 Infus Pump + Cassan BBRAUN INFUSOMAT

BBRAUN INFUSOMAT Space
9 Shyringe Pump + Cassan
p
10 Blue Light LULLABY

11 Blue Light NURITEK INDONESIA

Allied Healthcare Timeter
12 Flow Meter Konektor Dinding Oxygen Flowmeter 15 LPM
Brass
Allied set-Disposable
Healthcare Timeter
Flow Meter + Humidifier +
13 Oxygen Flowmeter 15 LPM
Konektor Dinding
Brass set-Disposable
Schwert - Germany Bandage
14 Gunting Verband
scissors LISTER 14cm5 1/2"
Microlife Digital Ear
15 Thermometer Digital
Thermometer FR1DL1
16 Baby Examination table TESENA
Meja Resusitasi Bayi Manual
17 Meja Rresusitasi Bayi
Powder Coating HBL-02
18 Incubator Ruangan ATOM

19 Incubator Transport Draegerwerk AG & CO.KGAA

20 Infant Warmer FANEM

Sle Medical Air Compressor
21 Sle Medical Air Compressor 500
500
Material breast pump
22 Breast Pump
polypropylene,BA free bottle
23 Accu Cek GDS ACCU CEK

24 Steam Botol Susu baby safe

25 Neopuff FANEM
FYROM INTERNATIONAL
INFANT BLENDING
26 Infant Blending Resuscitator
RESUSCITATOR MIX SAFE
FORTE
27 Kursi Diklat STRAMM

28 Lemari Arsip DATASCRIP

29 Tempat Tidur Bayi MAK HOSPITAL EQUIPMENT

30 Meja Kerja MEJA 1/2 BIRO

31 Kulkas Gea/ kulkas mini 1 pintu

HP ProDesk 400 G4 MT
32 Komputer PC
(1NU52PA)
hp ProDesk 400 G4 MT
33 CPU komputer hp
businness pc
34 Dispenser Miyako

35 Botol Susu Kaca

36 Botol Susu Plastik Pigeon

37 Box Susu Plastik

38 Torniquete vaccuette

39 Bengkok

40 Kom Kecil

41 AC DAIKIN
42 Laringoskop Set Neonatus HEINE

43 Chamber CPAP FISHER

44 Resusitasi Set Neonatus Laedral

45 Gunting Jaringan

46 Bubble Generator CPAP FANEM

47 Klem Arteri

48 Suction Pump MEDELA

50 Inkubator bluelight novos

51 Hecting set safa

52 Printer Epson

53 Penghangat botol susu philips

54 Penlight spirit

55 Telepon ruangan panasonic

56 Tangga 3 steps krisbow

57 Neopuff fisher

58 Suhu Ruangan krisbow

59 Trolley emergency buma

60 Tiang infus kaki 5

61 Oksigen blender gentec

62 tempat sampah claris

63 tempat sampah cal

64 exhaust fan KDK

Mengetahui, Menyetu
Direktur Kepala Sub. Bagia
 RSUD Jati Padang RSUD Jati P

dr. Siti Ainun Dwiyanti, MPH Fendrik Jeksi Afrizo

NIP: 196710272007012022 NIP: 197302021
 KARTU INVENTARIS RUANGAN

ARTA

Tahun Jumlah Harga

Bahan Pembuatan/ No. Kode Barang Barang Beli /
Pembelian (Satuan) Perolehan

6 7 8 9 10
Warna Pink 2018 1

Warna Hitam 2018 1

Stainless 2020 02080110062000002 1

Campuran 2017 02080101680001 1

Stainless 2018 02080101999000252 2

Digital 2018 02080101010000003 1

Digital 2018 02080101999000044 1

Plastik, Stainless 2018 02080120010000001 1

Plastik, Stainless 2018 02080101999000057 1

Lampu 2019 02080109999000025 1

Lampu 2017 02090701020000001 1

Kaca, Plastik 2018 2

Kaca, Plastik 2017 2

Stainless 2018 1

Digital Ear 2018 1

Kayu, Kain 2018 02080109069000001 1

Stainless 2018 02060201025000003 1

 Plastik, Kaca 2020 02080109063000001 1

Plastik, Kaca 2018 02080101999000059 1

Campuran 2017 02080112015000003 1

Plastik, Campuran 2018 02020303002000001 1

Plastik 2018 1

2019 1

Plastik, listrik 2018 1

Campuran 2018 02080110062000002 1

2018 1

Campuran 2017 2

Lemari Besi/Metal 2017 020602060390011 1

Tempat Tidur
2017 02060201080002 2
Besi/Metal (Lengkap)
Kayu 2017 1

1 Pintu 2018 1
P.C. Unit
2018 1
(PersonalComputer)
P.C. Unit
2018 2060302001000012
(PersonalComputer)
Plastik 2017 020602060390011 1

kaca 2019 4

Plastik 2019 10

Plastik 2019 1

Plastik 2020 2

Stainless 2020 2

Stainless 2020 1

Campuran 2
 Stainless 2018 1

Plastik 2018 1

Plastik 2018 1

Stainless 2018 1

Plastik 2018 2

Stainless 2018 1

Plastik, Kaca 2018 1

besi 2022 1

stainless 2022 1

plastik 2022 1

plastik 2022 1

stainless 2022 1

plastik 1

besi 2022 1

plastik 2022 1

plastik 1

besi 1

besi+plastik 1

2022 1

plastik 2

plastik 3

2022 3

Menyetujui, Jakarta, 24 Oktober 20

Kepala Sub. Bagian Tata Usaha Pengurus Barang
 RSUD Jati Padang

Fendrik Jeksi Afrizon, S.Kep,M.AP Sukarno Mohamad N

NIP: 197302021992011001 NIP: 197412031996031
 CM-109/JPD/2017

NO.KODE LOKASI :

Keadaan Barang
Kurang Rusak
Baik Keterangan
Baik Berat
(B) ( KB ) ( RB )
11 12 13 14
B

B
B

B
lokasi ada di
KB
atem
B

B Lokasi di ATEM

B
di ruang jaga
B
perawat
B
di ruang jaga
B
perawat
B

B
 B

B Lokasi di OK

B punya ranap 4

Jakarta, 24 Oktober 2021

Pengurus Barang
 Sukarno Mohamad Nur
NIP: 197412031996031001
 KARTU INVENTARIS
PROVINSI : DKI JAKARTA
KOTA ADMINISTRASI : JAKARTA SELATAN
SATUAN KERJA : DINAS KESEHATAN PROV. DKI JAKARTA
UNIT : RSUD JATI PADANG
RUANG/LANTAI : PERINATOLOGI / 5

No.Seri
NO. Jenis Barang / Nama Barang Merk/ Model Ukuran
Pabrik

1 2 3 4 5

1 kursi diklat STRAMM

2 Lemari Arsip DATASCRIP

3 Bedside Cabinet / Nahkas MAK HOSPITAL EQUIPMENT

6 Tempat Tidur Bayi MAK HOSPITAL EQUIPMENT

7 Meja Makan Pasien

10 Meja Kerja MEJA 1/2 BIRO

HP ProDesk 400 G4 MT
11 Komputer PC (1NU52PA)

13 Kursi Hadap (Hijau) STRAMM

ADC-USA Stetoscope Adult

14 stetoscope neonatus ADSCPE(Stainless steel scope)
Infant flow CPAP
15 comperehensive FANEM

16 Trolly Tindakan (dressing Trolly) AGS Dressing Trolley

17 Baby Scale TANITA

18 Pulse oxymeter neonatus Mindray Pulse Oximeter

19 Infus pump BBRAUN INFUSOMAT

20 Shyringe pump BBRAUN INFUSOMAT Space p

21 Blue Light NURITEK INDONESIA
Allied Healthcare Timeter
FLOW METER KONEKTOR Oxygen Flowmeter 15 LPM
22 DINDING
Brass set-Disposable
Allied Healthcare Timeter
FLOW METER + HUMIDIFIER &
23 Oxygen Flowmeter 15 LPM
KONEKTOR DINDING
Brass set-Disposable
Schwert - Germany Bandage
24 Gunting Verband
scissors LISTER 14cm5 1/2"

Thermometer Digital Microlife Digital Ear

25 Thermometer FR1DL1
A Class Stand
26 Stand Waskom Double trolley Waskom(basin)/Double Bowl
SS
27 Baby Examination table TESENA

Meja Resusitasi Bayi Manual

28 meja resusitasi bayi Powder Coating HBL-02

29 Incubator Transport Draegerwerk AG & CO.KGAA

30 sle medical air compressor 500 sle medical air compressor 500

31 Kulkas Gea/ kulkas mini 1 pintu

Material breast pump

32 Breast Pump
polypropylene,BA free bottle
FYROM INTERNATIONAL
Infant Blending Resuscitator INFANT BLENDING
33 RESUSCITATOR MIX SAFE
FORTE
34 dispenser miyako

35 Suction pump MEDELA

36 steam botol susu baby safe

37

38

39

40

41

Mengetahui
Kepala Sub. Bagian Tata Usaha
 RSUD Jati Padang

Fendrik Jeksi Afrizon, S.Kep

NIP: 197302021992011001
 CM-109/JPD/2017

KARTU INVENTARIS RUANGAN

RTA

NO.KODE LOKASI :

Keadaan barang
Tahun Jumlah Kurang
Harga Beli /
Bahan Pembuatan/ No. Kode Barang Barang Baik
Perolehan Baik
Pembelian (Satuan)
(B) ( KB )
6 7 8 9 10 11 12

Campuran 2017 1 B

LEMARI BESI/METAL 2017 020602060390011 1 B

LEMARI BESI/METAL 2017 02060104010043 3 B

TEMPAT TIDUR BESI/METAL

2017 02060201080002 1 B
(LENGKAP)

Meja Makan Pasien 2017 02060201120021 3 B

KAYU 2017 1 B

P.C. UNIT (PERSONAL

COMPUTER) 2018 1 B

WARNA HIJAU 2017 2 B

WARNA HITAM 2018 1 B

2017 02080101680001 1 B

STAINLESS 2018 1 B

DIGITAL 2018 1 B

DIGITAL 2018 1 B

2018 1 B

2018 1 B
 LAMPU 2017 02090701020000001 1 B

2018 2 B

2017 2 B

STAINLESS 2018 1 B

DIGITAL EAR 2018 1 B

STAINLESS STEEL 2018 02080101008000003 1 B

2018 02080109069000001 1 B

STAINLESS 2018 02060201025000003 1 B

2018 1 B

2018 1 B

1 PINTU 2018 1 B

ELECTRIC 2018 1 B

2018 1 B

plastik 2017 020602060390011 1 B

PORTABLE 1 TABUNG 2018 1 B

plastik, listrik 2018 1 B

Jakarta,….....................................
Pengurus Barang
 Sukarno Mohamad Nur
NIP: 197412031996031001
 CM-109/JPD/2017

E LOKASI :

eadaan barang
Rusak
Keterangan
Berat
( RB )
13 14
,….........................................2019
Pengurus Barang
 Sukarno Mohamad Nur
NIP: 197412031996031001