TABEL KERUSAKAN DAN KERUGIAN

Data Kerusakan
Lokasi Luas (m²)/ Jumlah
Sektor / Sub Sektor Sarana dan Prasarana
(Minimal Nama Kecamatan) Berat Sedang Ringan Satuan Rata2/ Volume

3. SOSIAL
3.1. KESEHATAN
1 Rumah Sakit Umum
Kabupaten XYZ, Provinsi
a. RSUD A ABC
BANGUNAN :
ruang rawat inap A 1 1 m2 100
ruang rawat inap A 2 1 m2 100
rauang rawat inap A3 1 m2 100
ruang rawat inap A 4 1 m2 100
Poli rawat jalan 1 1 m2 100
poli rawat jalan 2 1 m2 100
IGD 1 m2 100
Radiologi 1 m2 100
Gudang Farmasi 1 m2 100
Laboratorium 1 m2 100
Instalasi HD (75%) 1 m2 100

ALKES :
MRI 1 1 unit
USG 1 1 unit
Hematology Analyzer 1 1 unit
USG 1 1 unit
Gene Expert 1 1 unit
Lampu OK 4 4 unit
Central Oksigen 5 5 unit
CT Scan 1 1 unit
Rontgent 1 1 unit
Cold Chain 1 1 unit
TABEL KERUSAKAN DAN KERUGIAN

Nilai Kerusakan (Rp)

Perkiraan Kerusakan Perkiraan Kerugian Total Perkiraan Kerusakan
Harga Satuan
Berat Sedang Ringan (Rp) (Rp) dan Kerugian (Rp)

500,000.00 50,000,000.00 50,000,000.00 25,000,000.00 75,000,000.00

1,000,000.00 100,000,000.00 100,000,000.00 50,000,000.00 150,000,000.00
2,000,000.00 200,000,000.00 200,000,000.00 60,000,000.00 260,000,000.00
1,000,000.00 100,000,000.00 100,000,000.00 50,000,000.00 150,000,000.00
800,000.00 80,000,000.00 80,000,000.00 15,000,000.00 95,000,000.00
800,000.00 80,000,000.00 80,000,000.00 20,000,000.00 100,000,000.00
1,500,000.00 150,000,000.00 150,000,000.00 90,000,000.00 240,000,000.00
2,000,000.00 200,000,000.00 200,000,000.00 56,000,000.00 256,000,000.00
1,100,000.00 110,000,000.00 110,000,000.00 15,000,000.00 125,000,000.00
2,000,000.00 200,000,000.00 200,000,000.00 75,000,000.00 275,000,000.00
2,500,000.00 250,000,000.00 250,000,000.00 110,000,000.00 360,000,000.00

1,000,000,000.00 1,000,000,000.00 1,000,000,000.00 8,000,000.00 1,008,000,000.00

500,000,000.00 500,000,000.00 500,000,000.00 5,000,000.00 505,000,000.00
100,000,000.00 100,000,000.00 100,000,000.00 2,500,000.00 102,500,000.00
50,000,000.00 50,000,000.00 50,000,000.00 2,000,000.00 52,000,000.00
25,000,000.00 25,000,000.00 25,000,000.00 2,000,000.00 27,000,000.00
2,000,000.00 8,000,000.00 8,000,000.00 0.00 8,000,000.00
15,000,000.00 75,000,000.00 75,000,000.00 500,000.00 75,500,000.00
30,000,000.00 30,000,000.00 30,000,000.00 500,000.00 30,500,000.00
17,000,000.00 17,000,000.00 17,000,000.00 500,000.00 17,500,000.00
0.00 0.00 0.00 0.00
TOTAL 3,912,000,000.00
 Keterangan

1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan

1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
1 bulan
 RENCANA REHABILITASI DAN REKON

Sektor / Sub- KEGIATAN Lokasi VOLUME Satuan

Sektor (Minimal Nama Kecamatan)
3. SOSIAL
3.1. KESEHATAN
3 Rumah Sakit
a. RSUD A Kabupaten XYZ, Provinsi ABC

Bangunan:
· ruang rawat inap A 1 1 M2
· ruang rawat inap A 2 1 M2
· ruang rawat inap A3 1 M2
· ruang rawat inap A 4 1 M2
· Poli rawat jalan 1 1 M2
· Poli rawat jalan 2 1 M2
· IGD 1 M2
· Radiologi 1 M2
· Gudang Farmasi 1 M2
· Laboratorium 1 M2
· Instalasi HD 1 M2
ALKES
MRI 1 1 unit
USG 2 unit
Hematology Analyzer 1 unit
Gene Expert 1 unit
Central Oksigen 5 1 unit
CT Scan 1 unit
Rontgent 1 1 unit
Cold Chain 1 unit
Lampu OK 4 1 unit
ABILITASI DAN REKONSTRUKSI PASCABENCANA BIDANG KESEHATAN

Harga Satuan Kebutuhan Kewenangan

(Rp) (Rp) Kabupaten/Kota Provinsi

Rp 20,000,000 Rp 20,000,000 Rp 20,000,000

Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000
Rp 20,000,000 Rp 20,000,000 Rp 20,000,000

Rp 16,000,000,000 Rp 16,000,000,000 Rp 16,000,000,000

Rp 80,000,000 Rp 80,000,000 Rp 80,000,000
Rp 32,000,000 Rp 32,000,000 Rp 32,000,000
Rp 459,200,000 Rp 459,200,000 Rp 459,200,000
Rp 8,000,000 Rp 8,000,000 Rp 8,000,000
Rp 10,000,000,000 Rp 10,000,000,000 Rp 10,000,000,000
Rp 1,000,000,000 Rp 1,000,000,000 Rp 1,000,000,000
Rp 6,000,000 Rp 6,000,000 Rp 6,000,000
Rp 75,000,000 Rp 75,000,000 Rp 75,000,000
Kewenangan Keterangan
K/L Masyarakat Dunia Usaha