BARANG MEDIK LANTAI 3 (Harga > Rp. 500.

000)

NO LANTAI DEPARTMENT/AREA NO. RUANG/ KAMAR NAMA RUANG KODE SPECS NAMA BARANG CATEGORY
RUANG (PERUNTUKAN)

1,411 Lt. 3 R. INAP LANTAI 3 R. obat/alkes K. Suite Room (Nurse U-002 Ultrasonic Nebulizer Medik
Station)

1,402 Lt. 3 R. INAP LANTAI 3 301 K. Suite Room B-020 Beds, 4-Motorized, Medik
President/Suite Room; Inc
Accessories

1,403 302 K. Suite Room Beds, 4-Motorized, Medik

President/Suite Room; Inc
Accessories

1,404 K. Suite Room T-036 Trolley, Medicine Medik

1,405 K. Suite Room Trolley, Medicine Medik

1,407 Lt. 3 R. INAP LANTAI 3 R. obat/alkes K. Suite Room S-047 Syringe Pump Medik

1,404 Lt. 3 R. INAP LANTAI 3 R. obat/alkes K. Suite Room I-047 Instrument Set, Stainless Steel Medik
Ware

K. Suite Room Instrument Set, Stainless Steel Medik

Ware

1,410 Lt. 3 R. INAP LANTAI 3 R. obat/alkes K. Suite Room T-038 Trolley, Treatment/Dressing Medik

K. Suite Room Trolley, Treatment/Dressing Medik

1,418 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Kelas 2 (Nurse Station) S-033 Sterilizer, Electric Heated; 32 Medik
Liters

1,414 Lt. 3 R. INAP LANTAI 3 303 Kelas 2 B-018 Beds, Manual, 3 Crank; Inc Medik
Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

304 Kelas 2 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

305 Kelas 2 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories
 Beds, Manual, 3 Crank; Inc Medik
Accessories

306 Kelas 2 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

1,419 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Kelas 2 S-047 Syringe Pump Medik

1,416 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Kelas 2 I-047 Instrument Set, Stainless Steel Medik
Ware

1,422 Lt. 3 R. INAP LANTAI 3 307 Kelas 3 B-018 Beds, Manual, 3 Crank; Inc Medik
Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

308 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

309 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

310 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories
 Beds, Manual, 3 Crank; Inc Medik
Accessories

311 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

312 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

313 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories
Beds, Manual, 3 Crank; Inc Medik
Accessories
Beds, Manual, 3 Crank; Inc Medik
Accessories
314 Kelas 3 Beds, Manual, 3 Crank; Inc Medik
Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

315 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

316 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories
 Beds, Manual, 3 Crank; Inc Medik
Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

318 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories
Beds, Manual, 3 Crank; Inc Medik
Accessories

319 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

320 Kelas 3 Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

Beds, Manual, 3 Crank; Inc Medik

Accessories

1,426 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Kelas 3 S-047 Syringe Pump Medik

1,424 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Kelas 3 I-047 Instrument Set, Stainless Steel Medik
Ware

1,432 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station I-009 Infusion Pumps Medik

Infusion Pumps Medik

Infusion Pumps Medik

1,443 Nurse Station T-036 Trolley, Medicine Medik

Trolley, Medicine Medik

1,444 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station T-036 Trolley, Medicine Medik

Trolley, Medicine Medik

1,433 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station I-023 Instrument Set, Diagnostic Medik

Instrument Set, Diagnostic Medik

1,434 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station L-013 Lights, Examination, Mobile Medik

Lights, Examination, Mobile Medik

1,428 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station C-002 Cabinet, Medicine Medik

Cabinet, Medicine Medik

1,448 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station C-001 Cabinet, Instrument Medik

Cabinet, Instrument Medik

Cabinet, Instrument Medik

Cabinet, Instrument Medik

1,445 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station T-038 Trolley, Treatment/Dressing Medik

T-038 Trolley, Treatment/Dressing Medik

1,436 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station O-012 Oxygen Therapy, Mobile Type Medik

1,442 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station T-032 Trolley, Instrument Medik

Trolley, Instrument Medik

Trolley, Instrument Medik

Trolley, Instrument Medik

1,440 Lt. 3 R. INAP LANTAI 3 Nurse Station Nurse Station S-035 Stethoscopes Medik

Stethoscopes Medik
Stethoscopes Medik
Stethoscopes Medik
1,435 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station M-007 Manual Resuscitator, Adult Medik

1,439 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station S-023 Sphygmomanometer Medik

Sphygmomanometer Medik
Sphygmomanometer Medik

Sphygmomanometer Medik

1,446 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Nurse Station U-003 Ultrasonic Nebulizer, Jet Type Medik

1,458 Lt. 3 R. INAP LANTAI 3 R. obat/alkes R. Isolasi P-017 Physiologic Monitoring System, Medik
tanpa Printer

1,456 Lt. 3 R. INAP LANTAI 3 317 R. Isolasi B-015 Beds, 4-Motorized, Luxury; Inc Medik
Accessories

1,457 Lt. 3 R. INAP LANTAI 3 R. obat/alkes R. Isolasi I-047 Instrument Set, Stainless Steel Medik
Ware

1,469 Lt. 3 R. INAP LANTAI 3 R. Linen R. Linen T-034 Trolley, Linen/Cleaner Medik

Trolley, Linen/Cleaner Medik

1,462 Lt. 3 R. INAP LANTAI 3 R. obat/alkes R. Preparasi/Obat T-036 Trolley, Medicine Medik
1,450 Lt. 3 R. INAP LANTAI 3 R. obat/alkes R. Tindakan I-047 Instrument Set, Stainless Steel Medik
Ware

1,451 Lt. 3 R. INAP LANTAI 3 R. obat/alkes R. Tindakan P-029 Pulse Oximeter, Portable Medik

1,453 Lt. 3 R. INAP LANTAI 3 R. obat/alkes R. Tindakan T-001 Tables, Examination; Manual Medik

1,452 Lt. 3 R. INAP LANTAI 3 R. obat/alkes R. Tindakan S-025 Sphygmomanometer, Mobile Medik

1,475 Lt. 3 R. INAP LANTAI 3 R. obat/alkes Utiliti Bersih T-040 Tromol; Diameter 50 cm Medik

Tromol; Diameter 50 cm Medik

Tromol; Diameter 50 cm Medik

Tromol; Diameter 50 cm Medik
1,472 Lt. 3 R. INAP LANTAI 3 R25.10 Utiliti Kotor D-022 Double Bowls Sink; SS Medik
1,471 Lt. 3 R. INAP LANTAI 3 R25.10 Utiliti Kotor C-021 Chamber Pot Medik

Lt. 3 S-047 Syringe Pump Medik

Lt. 3 Syringe Pump Medik

Syringe Pump Medik

Syringe Pump

Syringe Pump

Lt. 3 C-021 Chamber Pot/ pispot ceper Medik

Lt. 3 Viewer Film Medik
Lt. 3 Viewer Film

Tambahan
1 Lt. 3 R. INAP LANTAI 3 Timbangan duduk pampers Chamry
2 Lt. 3 R. INAP LANTAI 3 Kasur dekubitus
3 Lt. 3 R. INAP LANTAI 3 Kasur dekubitus
4 Lt. 3 R. INAP LANTAI 3 Laringoskop anak
5 Lt. 3 R. INAP LANTAI 3 Laringoskop Dewasa
6 Lt. 3 R. INAP LANTAI 3 Timbangan duduk pampers Chamry
7 Lt. 3 R. INAP LANTAI 3 Trolley emergency
8 Lt. 3 R. INAP LANTAI 3 Trolley emergency
9 Lt. 3 R. INAP LANTAI 3 Papan RJP
10 Lt. 3 R. INAP LANTAI 3 EKG ARI
11 Lt. 3 R. INAP LANTAI 3 Trolly obat

Diperiksa oleh
Bagian aset/ Maintenance

Anton juargo bawono

COUNTRY OF BRAND TYPE NO.SERI / CATALOG JML Unit/ Keterangan Jml Kelebihan/
ORIGIN Set kekurangan

Japan Sharp Comport 2000 KU-400 01 2504 10 0001 1 ditempatkan smt di lemari R.
alat Di NS barat

Indonesia Paramount KA642+KE801+PF110 01 2501 10 0002 2

+PF310+KC56A

01 2501 10 0003

Indonesia Karixa KA 38-00A 2 Diserahkan ke ICU Barang sudah tidak

ada di lt 3

Germany Fresenius Kabi Agilia 01 2504 10 0004 1 ditempatkan smt di lemari R.

alat Di NS barat

Germany Medicon 01 2504 10 0005 2 ditempatkan smt di lemari R.

alat Di NS barat

01 2504 10 0006

Indonesia Karixa KA 18-02A 01 2504 10 0007 2 ditempatkan smt di lemari R.

alat Di NS barat

01 2504 10 0008

Germany Memmert UNB 200 01 2504 10 0009 1 ditempatkan smt di lemari R.

alat Di NS barat

Indonesia Paramount PA986+PE210+PF110+ 01 2502 10 0010 12

PF310+KC56A

01 2502 10 0011

01 2502 10 0012

01 2502 10 0013

01 2502 10 0014

01 2502 10 0015

01 2502 10 0016

01 2502 10 0017
 01 2502 10 0018

01 2502 10 0019

01 2502 10 0020

01 2502 10 0021

Germany Fresenius Kabi Agilia 01 2504 10 0022 1 ditempatkan smt di lemari R.

alat Di NS barat
Germany Medicon 01 2504 10 0023 1 ditempatkan smt di lemari R.
alat Di NS barat

Indonesia Paramount PA986+PE210+PF110+ 01 2503 10 0024 52 bed kurang 1 di kamar

PF310+KC56A 309

01 2503 10 0025

01 2503 10 0026

01 2503 10 0027

01 2503 10 0028

01 2503 10 0029

01 2503 10 0030

01 2503 10 0031

01 2503 10 0032

01 2503 10 0033

01 2503 10 0034

01 2503 10 0035

01 2503 10 0036

01 2503 10 0037

01 2503 10 0038
01 2503 10 0039

01 2503 10 0040

01 2503 10 0041

01 2503 10 0042

01 2503 10 0043

01 2503 10 0044

01 2503 10 0045

01 2503 10 0046

01 2503 10 0047

01 2503 10 0048

01 2503 10 0049

01 2503 10 0050

01 2503 10 0051

01 2503 10 0052

01 2503 10 0053

01 2503 10 0054

01 2503 10 0055

01 2503 10 0056

01 2503 10 0057

01 2503 10 0058

01 2503 10 0059

01 2503 10 0060
 01 2503 10 0061

01 2503 10 0062

01 2503 10 0063

01 2503 10 0064

01 2503 10 0065

01 2503 10 0066

01 2503 10 0067

01 2503 10 0068

01 2503 10 0069

01 2503 10 0070

01 2503 10 0071

01 2503 10 0072 Dipindahkan ke Hemodialisa Barang sudah tidak

ada di lt 3

01 2503 10 0073

01 2503 10 0074

01 2503 10 0075

Germany Fresenius Kabi Agilia 01 2504 10 0076 1 ditempatkan smt di lemari R.

alat Di NS barat
Germany Medicon 01 2504 10 0077 1 ditempatkan smt di lemari R.
alat Di NS barat

Germany Fresenius Kabi Optima Vs 01 2504 10 0078 3 ditempatkan smt di lemari R.

alat Di NS barat

01 2504 10 0079

01 2504 10 0080

Indonesia Karixa KA 38-00A 2 Diserahkan ke IGD Barang sudah tidak

ada di lt 3
01 2507 10 0081
Indonesia Karixa KA 38-00A 01 2507 10 0082 2 ditempatkan smt di lemari R.
alat Di NS barat

01 2507 10 0083 Di pinjam HD tgl

26/08/14
Germany Medicon 01 2504 10 0084 2 ditempatkan smt di lemari R.
alat Di NS barat

01 2504 10 0085
Germany Heine J-005.27.108 01 2505 10 0086 2 ditempatkan smt di lemari R.
alat Di NS barat

01 2504 10 0087

Indonesia Karixa KA 25-02B 01 2504 10 0088 2 ditempatkan smt di lemari R.

alat Di NS barat

01 2504 10 0089

Indonesia Karixa KA 25-02A 01 2504 10 0090 4 ditempatkan smt di lemari R. Kurang 2 karena
alat Di NS barat diserahkan ke OK dan
poliklinik
01 2504 10 0091

diserahkan ke Poliklinik (1) Barang sudah tidak

ada di lt 3

diserahkan ke OK (1)
Indonesia Karixa KA 18-02A 01 2504 10 0092 2 ditempatkan smt di lemari R.
alat Di NS barat

KA 18-02A 01 2504 10 0093

Indonesia Karixa KA 24-01A 01 2504 10 0094 1

Indonesia Karixa KA 16-00BSS 01 2504 10 0095 4 ditempatkan smt di lemari R. Kurang 2

alat Di NS barat
01 2505 10 0096
Barang tidak ada

Italy Gima Adult 01 2504 10 0097 4 Nurse Station

Adult 01 2504 10 0098

Adult 01 2504 10 0099
Adult 01 2504 10 00100
USA Hudson Adult 01 2504 10 0101 1 ditempatkan dlm Troly
Emergency

Germany Riester Nova Presameter 01 2504 10 0102 4 ditempatkan smt di lemari R.

alat Di NS barat
01 2504 10 0103
01 2504 10 0104

01 2504 10 0105

Japan Omron Omron C 28 01 2504 10 0106 1 ditempatkan di Lemari R. alat

utk NS 2
China Mindray MEC 2000 01 2506 10 0107 1 butuh trolly khusus + sejak terima tdk ada
keranjangnya trolly dan
keranjangnya

Indonesia Paramount P642C+PE210+PF110+ 01 2506 10 0108 1

PF310+KC56A

Germany Medicon 01 2506 10 0109 1 √

Indonesia Karixa KA 26-00BSS 01 2509 10 0110 2 Utk NS1 Di Pinjam HD tgl

26/08/14
01 2509 10 0111 Utk NS2

Indonesia Karixa KA 38-00A 01 2507 10 0112 1

Germany Medicon 01 2505 10 0113 1 ditempatkan smt di lemari R. √
alat Di NS barat

China Mindray PM 60 01 2505 10 0114 1 ditempatkan smt di lemari R.

alat Di NS barat
Indonesia Paramount PK-122 01 2505 10 0115 1

Germany Riester Empire N 01 2505 10 0116 1 ditempatkan smt di lemari R. Di pminta HD tgl
alat Di NS barat 26/08/14

Germany Medicon 01 2511 10 0117 4 ditempatkan smt di lemari R. Kelebihan 2

alat Di NS barat

01 2511 10 0118

01 2511 10 0149
01 2511 10 0150
Indonesia Karixa KA 17-02BSS 01 2510 10 0119 1 Penempatan smt di R. Linen
Lokal 01 2510 10 0120 1 Penempatan smt di lemari R.
Linen
Germany Fresenius Kabi Agilia 01 2510 10 0121 3 Ditempatkan smt di Lemari R.
Linen utk NS 2
01 2510 10 0122 Ditempatkan smt di Lemari R.
Linen utk NS 2
01 2510 10 0123 Ditempatkan smt di Lemari R.
Linen utk NS 2
01 2505 10 0093 2 di R. Tindakan di Lt 4
01 2506 10 0093 di R. Isolasi

Lokal 01 2603 10 0011 1 dipindah ke VIP Lt 4

012008100072
012503280034

Tambahan
012510100151 1 Beli tgl 30 sept'14
012510100152 2
012510100153 Untuk di NS Barat
012510100154 1 Tgl 09/10/14
012510100155 1
012510100156 1 beli tgl 31okt'14
012510100157 1 NS Timur
012510100158 1 NS Barat
012510100159 1 NS Timur
2 Tgl 04/12/14

Jakarta,25 Juli 2017

Pembuat Laporan
KOORDINATOR RAWAT INAP

Br.Bambang Febrian S,AMK

√

√
ANG

MED
IK LANTAI
NO
RUANG
DEPARTMENT/ AREA NO. RUANG/ KAMAR NAMA RUANG KODE SPECS NAMA BARANG CATEGORY COUNTRY OF
ORIGIN
LAN1,401 Lt. 3 R. INAP LANTAI 3 301 K. Suite Room B-012 Bed Pans with Handle Medik Lokal
TAI 302 Bed Pans with Handle
31,408 Lt. 3 R. INAP LANTAI 3 R. Alkes/obat K. Suite Room T-019 Tongue Spatula Medik Germany
(Har
ga < Tongue Spatula

500
1,413 Lt. 3 R. INAP LANTAI 3 R. Spoelhook 303 B-012 Bed Pans with Handle Medik Lokal
ribu)
304 Bed Pans with Handle
305 Bed Pans with Handle
306 Bed Pans with Handle
307 Bed Pans with Handle
308 Bed Pans with Handle
309 Bed Pans with Handle
310 Bed Pans with Handle
311 Bed Pans with Handle
312 Bed Pans with Handle
313 Bed Pans with Handle
314 Bed Pans with Handle
315 Bed Pans with Handle
316 Bed Pans with Handle
317 Bed Pans with Handle
319 Bed Pans with Handle
320 Bed Pans with Handle
1,420 Lt. 3 R. INAP LANTAI 3 R. Alkes/obat Kelas 2 T-019 Tongue Spatula Medik Germany

Tongue Spatula

Tongue Spatula

Tongue Spatula
1,421 Lt. 3 R. INAP LANTAI 3 R. Spoelhook Kelas 3 B-012 Bed Pans with Handle Medik Lokal

Bed Pans with Handle

Bed Pans with Handle
Bed Pans with Handle
Bed Pans with Handle
Bed Pans with Handle
1,430 Lt. 3 R. INAP LANTAI 3 R. Alkes/obat Nurse Station C-035 Cotton Bowl Medik Germany

Cotton Bowl
1,447 Lt. 3 R. INAP LANTAI 3 Nurse Station Nurse Station W-018 Weight and Height Scale Medik China

Weight and Height Scale

1,441 Lt. 3 R. INAP LANTAI 3 Nurse Station Nurse Station T-015 Thermometer Digital Medik Italy

Thermometer Digital

1,437 Lt. 3 R. INAP LANTAI 3 Nurse Station Nurse Station R-002 Reflex Hammer Medik Germany

Reflex Hammer
Reflex Hammer

Reflex Hammer
1,455 Lt. 3 R. INAP LANTAI 3 R. Isolasi R. Isolasi B-012 Bed Pans with Handle Medik Lokal

1,449 Lt. 3 R. INAP LANTAI 3 R. Alkes/obat R. Tindakan F-008 Foot Step, 2 Steps Medik Indonesia
 1,454 Lt. 3 R. INAP LANTAI 3 NS R. Tindakan T-015 Thermometer Digital Medik Italy

1,474 Lt. 3 R. INAP LANTAI 3 R. Alkes/obat Utiliti Bersih I-052 Instrument Tray Medik Germany

Instrument Tray

Tambahan
1 Lt. 3 R. INAP LANTAI 3 Gelas Ukur 2 L Lokal
2 Lt. 3 R. INAP LANTAI 3 Gelas Ukur 2 L
3 Lt. 3 R. INAP LANTAI 3 Gelas Ukur 2 L
4 Lt. 3 R. INAP LANTAI 3 Gelas Ukur 2 L
5 Lt. 3 R. INAP LANTAI 3 Penlight Vin med Lokal
6 Lt. 3 R. INAP LANTAI 3 Penlight Vin med Lokal

Diperiksa oleh Diperiksa oleh

Bagian aset/ MaBagian aset/ Ma

Anton juargo bawono

BRAND TYPE No. Seri Barang/ JML Unit/ Keterangan Jumlah Kelebihan/
CATALOG Set Kekurangan
01 2601100002 2

01 2604100036
Medicon 01 2504 10 0124 2 Di NS 1

01 2504 10 0125

01 2604100037 18 kurang 3

01 2604100038
01 2604100039
01 2604100040
01 2604100041
01 2604100042
01 2604100043
01 2604100044
01 2604100045
01 2604100046
01 2604100047
01 2604100048
01 2604100049
01 2604100050
01 2604100051
01 2604100052
01 2604100053
Medicon 01 2504 10 0126 4 Di NS

01 2504 10 0127

01 2504 10 0128

01 2504 10 0129
01 2503 10 0130 6 Kekurangan 2

01 2503 10 0131
01 2503 10 0132
01 2503 10 0133
01 2503 10 0134
01 2503 10 0135
Medicon 01 2504 10 0134 2 Di NS

01 2504 10 0135
GEA ZT 120 01 2504 10 0136 2 Di NS

01 2504 10 0137

Gima 01 2504 10 0138 2 Di NS Rusak

01 2504 10 0139

Medicon 01 2504 10 0140 4 Di NS kurang 1

01 2504 10 0141
01 2504 10 0142

01 2504 10 0143
01 2506 10 0144 1

Karixa KA 07-001 01 2505 10 0145 1 Tidak ada

 Gima 01 2505 10 0146 1

Medicon 01 2511 10 0147 2 ditempatkan smt di

lemari R.Obat/ alkes

01 2511 10 0148

012511100148 4 Tgl 09/10/14

012511100149
012511100150
012511100150
Tgl 04/06/17
Tgl 04/06/17

Jakarta,25 Juli 2017

eriksa oleh Pembuat Laporan
ian aset/ Maintenance KOORDINATOR RAWAT INAP

Br.Bambang Febrian,AMK
 DAFTAR INVENTARIS BARANG NON MEDIK LANTAI 3

NO LANTAI DEPARTMENT/AREA NO. RUANG/ NAMA RUANG KODE SPECS NAMA BARANG CATEGORY
RUANG KAMAR

1,406 Lt. 3 R. INAP LANTAI 3 301 K. Suite Room S-017 Sofa Bed, Director; Non Medik
4 persons, incl.
Table

Sofa kecil
Sofa kecil
Meja
302 Sofa Bed, Director; Non Medik
4 persons, incl.
Table

Sofa kecil
Sofa kecil
Meja
1,412 Lt. 3 R. INAP LANTAI 3 R25.01 K. Suite Room W-013 Waste Disposal; Non Medik
Steel, 80L

Waste Disposal; Non Medik

Steel, 80L

1,405 Lt. 3 R. INAP LANTAI 3 301 K. Suite Room S-008 Shelf, Towel; Non Medik
Alumunium

302 Shelf, Towel; Non Medik

Alumunium

1,403 Lt. 3 R. INAP LANTAI 3 301 K. Suite Room C-020 Chair, Visitors Non Medik

302 Chair, Visitors Non Medik

1,417 Lt. 3 R. INAP LANTAI 3 303 Kelas 2 S-008 Shelf, Towel; Non Medik
Alumunium

304 Shelf, Towel; Non Medik

Alumunium

305 Shelf, Towel; Non Medik

Alumunium
306 Shelf, Towel; Non Medik
Alumunium

1,415 Lt. 3 R. INAP LANTAI 3 307 Kelas 3 C-020 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

308 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

309 Chair, Visitors Non Medik

 309

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

310 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

311 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

312 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

313 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

314 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

1,425 Lt. 3 R. INAP LANTAI 3 307 Kelas 3 S-008 Shelf, Towel; Non Medik
Alumunium

308 Shelf, Towel; Non Medik

Alumunium
309 Shelf, Towel; Non Medik
Alumunium

310 Shelf, Towel; Non Medik

Alumunium

311 Shelf, Towel; Non Medik

Alumunium

312 Shelf, Towel; Non Medik

Alumunium
 313 Shelf, Towel; Non Medik
Alumunium

314 Shelf, Towel; Non Medik

Alumunium

315 Shelf, Towel; Non Medik

Alumunium

316 Shelf, Towel; Non Medik

Alumunium

318 Shelf, Towel; Non Medik

Alumunium

319 Shelf, Towel; Non Medik

Alumunium
320 Shelf, Towel; Non Medik
Alumunium

1,423 Lt. 3 R. INAP LANTAI 3 303 Kelas 2 C-020 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

304 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

305 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

306 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

319 Chair, Visitors Non Medik

Chair, Visitors Non Medik

Chair, Visitors Non Medik

ISOLASI Chair, Visitors Non Medik

1,438 Lt. 3 R. INAP LANTAI 3 R25.04 Nurse Station R-004 Refrigerator, Drug Non Medik

1,431 Lt. 3 R. INAP LANTAI 3 R25.04 Nurse Station D-006 Desk, Nurses Non Medik
Station

Desk, Nurses Non Medik

Station

1,429 Lt. 3 R. INAP LANTAI 3 R25.04 Nurse Station C-019 Chair, Staff Non Medik

Chair, Staff Non Medik

Chair, Staff Non Medik

Chair, Staff Non Medik

1,468 Lt. 3 R. INAP LANTAI 3 R25.09 R. Linen S-005 Shelf, Stainless Non Medik
Steel; 4 Shelves

Shelf, Stainless Non Medik

Steel; 4 Shelves

1,467 Lt. 3 R. INAP LANTAI 3 R25.09 R. Linen D-009 Desk, Staff Non Medik

1,466 Lt. 3 R. INAP LANTAI 3 R25.09 R. Linen C-019 Chair, Staff Non Medik

1,464 Lt. 3 R. INAP LANTAI 3 R25.08 R. Perawat D-009 Desk, Staff Non Medik

1,463 Lt. 3 R. INAP LANTAI 3 R25.08 R. Perawat C-019 Chair, Staff Non Medik

Chair, Staff Non Medik

1,465 Lt. 3 R. INAP LANTAI 3 R25.08 R. Perawat W-020 White Board; Non Medik
90x120 cm

1,461 Lt. 3 R. INAP LANTAI 3 R25.07 R. Preparasi/ Obat R-004 Refrigerator, Drug Non Medik

1,460 Lt. 3 R. INAP LANTAI 3 R25.07 R. Preparasi/ Obat D-009 Desk, Staff Non Medik

1,459 Lt. 3 R. INAP LANTAI 3 R25.07 R. Preparasi/ Obat C-019 Chair, Staff Non Medik

1,473 Lt. 3 R. INAP LANTAI 3 R25.10 Utiliti Kotor W-012 Waste Disposal; Non Medik
Stainless Steel,
40 Liters, 2 Buah

R25.06 R. Isolasi C-020 Chair, Visitors Non Medik

R25.05 R. Tindakan F-008 Chair, Staff Non Medik

R25.06 R. Isolasi B-012 Shelf, Towel; Non Medik
Alumunium

1,431 Lt. 3 R. INAP LANTAI 3 R25.04 Nurse Station D-006 Desk, Nurses Non Medik
Station

R25.04 Nurse Station D-006 Desk, Nurses Non Medik

Station

Tambahan
1 Lt. 3 R. INAP LANTAI 3 R25.04 Nurse Station D-006 Printer Non Medik
2 Lt. 3 R. INAP LANTAI 3 R25.04 Nurse Station D-006
3 Lt. 3 R. INAP LANTAI 3 Bantal Pasien Non Medik
4 Lt. 3 R. INAP LANTAI 3 TV Non Medik
5 Lt. 3 R. INAP LANTAI 3 Akrilik papan nama Non Medik
pasien
6 Try Dokument fille Non Medik

7 White Board; Non Medik

90x120 cm
RANG NON MEDIK LANTAI 3 (Harga > 500)

COUNTRY OF BRAND TYPE NO.SERI / CATALOG JML Unit/ Keterangan kelebihan/ kurang
ORIGIN Set

Veroty 01 2501 28 0001 2

01 2501 28 0091 blm dilabel

01 2501 28 0092
01 2501 28 0093
01 2501 28 0002

01 2501 28 0094 blm dilabel

01 2501 28 0095
01 2501 28 0096
WD 80A 01 2504 29 0003 2 Koridor dkt lift

01 2504 29 0004 Koridor dkt pintu

masuk

Ace Hardware 2 kurang 2

Lokal Chairman 01 2501 28 0005 2

01 2501 28 0006

Ace Hardware 4 kurang 4

Lokal Chairman 01 2502 28 0007 33 Kls 3 ( kurang 15 Kurang utk kamar

bh) 315,316,318,320

01 2502 28 0008

01 2502 28 0009

01 2502 28 0010

01 2502 28 0011

01 2502 28 0012

01 2502 28 0013

01 2502 28 0014

01 2502 28 0015
 01 2502 28 0016

01 2502 28 0017

01 2502 28 0018

01 2503 28 0019

01 2503 28 0020

01 2503 28 0021

01 2503 28 0022

01 2503 28 0023

01 2503 28 0024

01 2503 28 0025

01 2503 28 0026

01 2503 28 0027

01 2503 28 0028

01 2503 28 0029

01 2503 28 0030

01 2503 28 0031

01 2503 28 0032

01 2503 28 0033

01 2503 28 0034

01 2503 28 0035

01 2503 28 0036

01 2503 28 0037

01 2503 28 0038

01 2503 28 0039

Ace Hardware 01 2503 28 0040 13

01 2503 28 0041

01 2503 28 0042

01 2503 28 0043

01 2503 28 0044

01 2503 28 0045
 01 2503 28 0046

01 2503 28 0047

01 2503 28 0048

01 2503 28 0049

01 2503 28 0050

01 2503 28 0051

01 2503 28 0052

Lokal Chairman 01 2503 28 0053 16

01 2503 28 0054

01 2503 28 0055

01 2503 28 0056

01 2503 28 0057

01 2503 28 0058

01 2503 28 0059

01 2503 28 0060

01 2503 28 0061

01 2503 28 0062

01 2503 28 0063

01 2503 28 0064

01 2503 28 0065

01 2503 28 0066

01 2503 28 0067

01 2503 28 0068

Evermed 01 2508 26 0069 1 di NS 1

Lokal Modera 01 2504 28 0070 2 di NS 1

01 2504 28 0071 di NS 2

Lokal Chairman 01 2504 28 0072 4

01 2504 28 0073
01 2504 28 0074

01 2504 28 0075
 Indonesia Karixa KA LR 01 A 01 2509 29 0076 2 di NS 1

01 2509 29 0077 di NS 2

Lokal Modera 01 2509 29 0078 1

Lokal Chairman 01 2509 29 0079 1

Lokal Modera 01 2508 28 0080 1

Lokal Chairman 01 2508 28 0081 2

01 2508 28 0082
Lokal Daiko WB 120x240SF G 01 2504 27 0083 1

Evermed 01 2504 26 0084 1 di NS 2 kulkas harusnya 2

Lokal Modera 01 2507 28 0085 1 Tidak ada

Lokal Chairman 01 2507 28 0086 1 Tidak ada

WD 40A 01 2510 29 0087 2

01 2506 28 0088 1

Lokal Chairman 01 2505 28 0089 1

01 2506 28 0090 1

Lokal Modera 01 2504 28 0097 2 NS 1

Lokal Modera 01 2504 28 0098 3 NS 2

Tambahan
Epson '012504280099 / 100 2
012504280101
Untuk di NS Barat

2 NS Timur
NS Barat
2
 Jakarta,25 Juli
2017
Diperiksa oleh Pembuat Laporan
Bagian aset/ Koordinator Rawat
Maintenance Inap

Anton Juargo Br.Bambang

Bawono Febrian,AMK
 daftar serah terima 2017
DAFTAR SERAH TERIMA INVENTARIS RANAP LT.3 TH 2014

NO NAMA BARANG NO ASET

1 Bed periksa mobile
2 Bed manual + Meja + lemari 01.2503.10.00007.2
01.2503.10.00007.3
01.2503.10.00007.4
01.2503.10.00007.5
01 2501 28 0005

3 Kursi tunggu pasien

01 2502 28 0007
01 2503 28 0022
01 2503 28 0024
01 2503 28 0026
01 2503 28 0029
01 2503 28 0032
01 2503 28 0033
01 2503 28 0034
01 2503 28 0035
01 2503 28 0036
01 2503 28 0037
01 2503 28 0038
01 2503 28 0039
01 2503 28 0053
01 2503 28 0054
01 2503 28 0055
01 2503 28 0057
01 2503 28 0058
01 2503 28 0063
01 2503 28 0064

4 Bed electric
5 TV
6 Tensi meter mobille 01.2505.100.116
7 Trolley tindakan 01.2509.100.110
8 Trolley Obat 01.2507.100.083
9 Cabinet instrument
10 Trolley obat 01.2507.100.081
11 Lemari obat

Page 28
 daftar serah terima 2017
AR SERAH TERIMA INVENTARIS RANAP LT.3 TH 2014

DIVISI YANG MENERIMA TGL PENYERAHAN PETUGAS YANG MENERIMA

Radiologi 03/10/14 Rina
Hemodialisa 03/10/14 Yunita

Awal perencanaan back

Back Office office Bpk. Anton IPSRS

Lt.4 24/09/14 Nike

Poli Kebidanan 29/08/14 Ema
Hemodialisa 26/08/14 Ekhda
Hemodialisa 25/08/14 Yunita
Hemodialisa 25/08/14 Yunita
OK Awal perencanaan OK Bambang
IGD Awal perencanaan IGD Samsudin
OK

Page 29
 daftar serah terima 2017

KETERANGAN

Pinjam 21 unit, Surat menyusul

1 unit
Pinjam 1 unit

Pinjam 1 unit
Pinjam 1 unit
Surat menyusul
Surat menyusul, 2 unit
Widodo

Page 30