Lampiran Surat Perintah Kerja (SPK)

Pekerjaan : Belanja Modal Pengadaan Alat-alat Kedokteran Umum di Ruang Rawat Inap berupa Oximeter Portable
dan di Ruang Nicu/ Picu berupa Oximeter untuk bayi
Kegiatan : Pengadaan Alat-alat Rumah Sakit
Program : Pengadaan Peningkatan Sarana dan Prasarana Rumah Sakit/ Rumah sakit Jiwa/
Rumah sakit Paru-paru/ Rumah Sakit Mata pada UPT.RSUD Bali Mandara Dinas Kesehatan Provinsi Bali
Nomor : 027/7639/UPT.RSBM.Diskes/2017
Tanggal : 25 Oktober 2017

Harga Satuan Ongkos Kirim Jumlah Harga Keterangan

No. No. Rekening Nama Barang Spesifikasi barang Volume Satuan
(Rp). (Rp). (Rp).
1 5.2.3.19.001 Oximeter Portable (MEDICAL SUPPLY CO Features : Economically designed to fit your hand comfortably 6 Unit 9,649,881.00 1,500,000.00 59,399,286.00 E-Catalog
Handheld Pulse Oximeter For Adult) : Compact size and easily mounted on a pole
: TFT 3.5” Color LCD display
: Plethymograph, numeric display
: Graphic and tabular trend
: Built-in rechargeable battery
: USB I/O port for software upgrade & PC interface
: Audible and visible alarm

Weight : Approx. 300g

Power Supply : Input : AC 100 - 240V. 50/60Hz. 2,5A
: Output : DC 12V. 1A (Medical Grade Adapter)

Battery : 7.4V, 1800mAh, Li-lon

: Operating time : 6 hours
: Charging time : 2 hours
Safety Standard : EN60601-1
Protection Class : BF, Class 1
Environmental Condit : Operating Temperatur : 10°C - 40°C
: Storage Temperatur : - 10°C - 50°C
: Operating Humidity : 15% - 95%
: Operation Altitude : -300m - 3,658m
Output Interface : USB
SpO2
Range of Display : 0 - 100%
Resolution : 1%
Accuracy : Without Motion Adult : 70 - 100% ± 2 digits
: Without Motion Neonate : 70 - 100% ± 3 digits
: With Motion Adult : 70 - 100% ± 3 digits
: With Motion Neonate : 70 - 100% ± 4 digits
Average Time : 10 sec
Perfusion Index : 0,1 - 20%

Pulse Rate
Measurement Range : 25 - 250 bpm
Resolution : 1 bpm
Accuracy : Without Motion : 25 - 250 bpm ± 2%
With Motion : 25 - 250 bpm ± 5%
Average Time : 10 sec

Display / Alarm
Display Type : TFT 3.5" Color LCD
Display Size : 320 x 240 pixel
Display Information : % SpO2 & limits, Pulse rate & limits, Plethymograph
PA, Alarm status, Trends, Battery status, Time & Date
Alarm Type : Physiological and technical with audible and visible way
Alarm Limit : Low SpO2 : 85 - 100%
High SpO2 : 85 - 100%, off
Low PR : off, 25 - 250 bpm
High PR : 25 - 250bpm, off
Alarm Suppression : 10, 20, 30, 60, 120, 180 sec

Delivered Aceessories : Reusable or Disposible Infant SPO2 Sensor Probe.

: Pole Clamp
: Power Adapter
2 5.2.3.19.001 Oximeter untuk bayi (MEDICAL SUPPLY CO
Handheld Pulse Oximeter For Adult)
Features : Economically designed to fit your hand comfortably 2 Unit 13,080,060.00 500,000.00 26,660,120.00 E-Catalog
: Compact size and easily mounted on a pole
: TFT 3.5” Color LCD display
: Plethymograph, numeric display
: Graphic and tabular trend
: Built-in rechargeable battery
: USB I/O port for software upgrade & PC interface
: Audible and visible alarm

Weight : Approx. 300g

Power Supply : Input : AC 100 - 240V. 50/60Hz. 2,5A
: Output : DC 12V. 1A (Medical Grade Adapter)

Battery : 7.4V, 1800mAh, Li-lon

: Operating time : 6 hours
: Charging time : 2 hours
Safety Standard : EN60601-1
Protection Class : BF, Class 1
Environmental Condit : Operating Temperatur : 10°C - 40°C
: Storage Temperatur : - 10°C - 50°C
: Operating Humidity : 15% - 95%
: Operation Altitude : -300m - 3,658m
Output Interface : USB

SpO2
Range of Display : 0 - 100%
Resolution : 1%
Accuracy : Without Motion Adult : 70 - 100% ± 2 digits
: Without Motion Neonate : 70 - 100% ± 3 digits
: With Motion Adult : 70 - 100% ± 3 digits
: With Motion Neonate : 70 - 100% ± 4 digits
Average Time : 10 sec
Perfusion Index : 0,1 - 20%
 Pulse Rate
Measurement Range : 25 - 250 bpm
Resolution : 1 bpm
Accuracy : Without Motion : 25 - 250 bpm ± 2%
With Motion : 25 - 250 bpm ± 5%
Average Time : 10 sec

Display / Alarm
Display Type : TFT 3.5" Color LCD
Display Size : 320 x 240 pixel
Display Information : % SpO2 & limits, Pulse rate & limits, Plethymograph
PA, Alarm status, Trends, Battery status, Time & Date
Alarm Type : Physiological and technical with audible and visible way
Alarm Limit : Low SpO2 : 85 - 100%
High SpO2 : 85 - 100%, off
Low PR : off, 25 - 250 bpm
High PR : 25 - 250bpm, off
Alarm Suppression : 10, 20, 30, 60, 120, 180 sec

Delivered Aceessories : Reusable or Disposible Infant SPO2 Sensor Probe.

: Pole Clamp
: Power Adapter
TOTAL 8 Unit 86,059,406.00
Terbilang : Delapan Puluh Enam Juta Lima Puluh Sembilan Ribu Empat Ratus Enam Rupiah

Pihak Kedua Pihak Pertama

PT. Bintang Sarana Medika Kuasa Pengguna Anggaran/
Kuasa Pengguna Barang pada
UPT.RSUD Bali Mandara
Dinas Kesehatan Provinsi Bali

Kreuz Septian Mahendra dr. Gede Bagus Darmayasa, M.Repro

Direktur Utama Pembina Tk.I
NIP : 19610726 198803 1 004