Alkes Rumah Sakit Pratama

PERALATAN MEDIS DAN NON MEDIS
RUMAH SAKIT PRATAMA

KECAMATAN MAUROLE
KABUPATEN ENDE
NO JENIS PERALATAN
A PELAYANAN GAWAT DARURAT
I TRIAGE
1 Lampu Periksa (mobile)
2 Patient Stretcher
3 Stetoskop
4 Tensimeter
5 Diagnostik Set terdiri dari :
- Penlight
- Senter kepala (head lamp)
- Spatula lidah
- Reflex hammer
- Spekulum hidung
- Otoskop
- Ophtalmoskop
6 Kursi roda
II Resusitasi dan Tindakan

1 Meja Periksa
2 Lampu Tindakan (mobile)
3 Stetoskop dewasa
4 Stetoskop anak
5 Stetoskop Neonatus
6 Tensimeter Analog Standing
7 Tensimeter Analog table
8 Film Viewer
9 Termometer Digital
10 EKG
11 Nebulizer Dewasa
12 Nebulizer Anak
13 Portable Pulse Oximetri
16 Tiang infus
17 Suction Pump
21 Minor Surgery Set
22 Tabung Oksigen + Regulator flowmeter + Troli
23 Tabung Oksigen Kecil + Regulator + Troli
24 Autoclave
25 Baki logam, SS
26 Tromol/Korentang (Dressing Drum)
27 Nierbeken, SS
28 Waskom antiseptik + tutup
29 Waskom Kassa + tutup
B. POLIKLINIK (RUANG RAWAT JALAN)

1 Poliklinik OBSGYN
1 Tempat tidur periksa
2 Tempat tidur Ginekologi
4 Film Viewer
5 Timbangan dewasa + pengukur tinggi badan
7 Stetoskop
8 Stetoskop Laenec
10 Tensimeter Analog Table
11 Examination lamp
12 Set Minor Surgery
13 Doppler
14 Cardiotocography
15 Gynecologycal Examination set
16 Pap Smear Kit
17 IUD kit
18 Implant kit
20 Autoclave
21 Nierbekhen
22 Sonde uterus
23 Tampon Tang
25 Kursi Dorong
II Poliklinik Umum / Poliklinik Penyakit Dalam

4 Examination lamp
Penlight
Senter kepala (head lamp)
Spatula lidah
Reflex hammer
Spekulum hidung
Otoskop
Ophtalmoskop
6 Stetoskop
9 EKG
10 Film Viewer
11 Termometer
15 Suction pump
16 Utility trolley
17 Tromol kasa
18 Tampon Tang
19 Bak instrument
21 Kursi Roda
III Poliklinik Kesehatan Anak

2 Stetoskop Anak
4 Tensimeter dengan manset untuk bayi dan anak
5 Examination lamp
6 Infant dan baby weighting scale
7 Termometer rectal
8 Termometer axial
9 Reflex Hammer
10 Tongue spatel (Stainless steel )
11 EKG
12 Nebulizer
13 Infant dan baby pediatric resusitation
14 Vena section set :
-Gunting lurus
- Gunting bengkok
-Hak 2 bh
-Klem lurus 2 bh
-Klem bengkok 2 bh
-Pinset anatomi 1 bh
-Pinset chirurgi 1 bh
-Pinset bengkok 2 bh
-Bisturi 1 buah
-Gagang bisturi 1 bh
-Needle holder (pemegang jarum jahit) 1 bh
-Kom stainless steel wadah 60 cc 1 bh
-Bak stainless steel wadah dengan tutup 1 bh
15 Baby Suction pump
16 Oxygen set dan flow meter
18 Refrigerator Medical Grade
IV Poliklinik Bedah
2 Stetoskop
3 Examination lamp
4 Reflex hammer
5 Termometer
6 Film Viewer
7 Set Minor Surgery
8 Hecting set
9 Alat pembuka gips (manual )
11 Circumsisi set
12 Suction Pump
13 Autoclave
14 Nierbeken
V Klinik Gigi
A Dental Unit terdiri dari :
1 Kursi Gigi:
-Up Down Movement
-Reclining
-Head Rest
-Lampu Halogen Tanpa Bayangan
2 Cuspidor Unit:
Spitton Bowl + Bowl Flush
Water Cup Filler
Saliva Ejector
Transparent Water Tank (1000 cc)
3 Meja Instrumen
Air Turbin Hand Piece 400.000 rpm
Air Motor 20.000 rpm dengan Straight dan Contra Angle Hand
Triple Syringe
4 Foot Controller untuk Hand Piece
5 Kompresor Oilless 1 PK
B Dental Instrument Set

1 Atraumatic Restorative Treatment (ART)
1.1. Enamel Access Cutter
1.2. Eksavator Berbentuk Sendok Ukuran Kecil (Spoon Excavator Small)
1.3. Eksavator Berbentuk Sendok Ukuran Sedang (Spoon Excavator Medium)
1.4. Eksavator Berbentuk Sendok Ukuran Besar (Spoon Excavator Large)
1.5. Double Ended Applier and Carver
1.6. Spatula Plastik
1.7. Hatchet
1.8. Batu Asah
2 Bein Lurus Besar
3 Bein Lurus Kecil
5 Bor Intan Kontra Angle Hand Piece Conventional (Kecepatan Rendah) (round,
inverted dan fissure)
6 Polishing Bur
7 Ekskavator Berujung Dua (Besar)
8 Ekskavator Berujung Dua (Kecil)
9 Gunting Operasi Gusi (Wagner) (12 cm )
10 Handpiece Contra Angle
11 Handpiece Straight
12 Kaca Mulut Datar No.4 Tanpa Tangkai
13 Tangkai Untuk Kaca Mulut
14 Klem/Pemegang Jarum Jahit (Mathieu Standar)
15 Korentang, Penjepit Sponge (Foerster)
16 Light Curing
17 Mikromotor dengan Straight dan Contra Angle Hand Piece (Low Speed Micro
Motor portable)
18 Pelindung Jari
19 Pemegang Matriks (Matrix Holder)
20 Penahan Lidah
21 Pengungkit Akar Gigi Kanan Mesial (Cryer Distal)
22 Pengungkit Akar Gigi Kanan Mesial (Cryer Mesial)
23 Penumpat Plastis
24 Periodontal Probe
25 Penumpat Semen Berujung Dua
26 Pinset Gigi
27 Skeler Standar , Bentuk Cangkul Kiri (Type Chisel/Mesial)
28 Skeler Standar , Bentuk Cangkul Kanan (Type Chisel/Mesial)
29 Skeler Standar, Bentuk Tombak (Type Hook)
30 Skeler Standar, Black Kiri dan Kanan (Type Chisel/Mesial)
31 Skeler Standar, Black Kiri dan Kiri (Type Chisel/Mesial)
32 Skeler Ultrasonik
33 Sonde Lengkung
34 Sonde Lurus
35 Spatula Pengaduk Semen
36 Spatula Pengaduk Semen Ionomer
37 Set Tang Pencabutan Dewasa :
37.1. Tang gigi anterior rahang atas dewasa
37.2. Tang gigi premolar rahang atas
37.3. Tang gigi molar kanan rahang atas
37.4. Tang gigi molar kiri rahang atas
37.5. Tang molar 3 rahang atas
37.6. Tang sisa akar gigi anterior rahang atas
37.7. Tang sisa akar gigi posterior rahang atas
37.8. Tang gigi anterior dan premolar rahang bawah
37.9. Tang gigi molar rahang bawah kanan/kiri
37.10. Tang gigi molar 3 rahang bawah
37.11. Tang sisa akar rahang bawah
38 Set Tang pencabutan anak
38.1. Tang gigi anterior rahang atas
38.2. Tang molar rahang atas
38.3. Tang molar susu rahang atas
38.4. Tang sisa akar rahang atas
38.5. Tang gigi anterior rahang bawah
38.6. Tang molar rahang bawah
39 Skalpel, Mata Pisau Bedah (Besar)
40 Skalpel, Mata Pisau Bedah (Kecil)
41 Skalpel, Tangkai Pisau Operasi
42 Silinder Korentang Steril
43 Tempat Alkohol (Dappen Glas)
44 Toples Kapas Logam dengan Pegas dan Tutup (50 x 70 mm)
45 Toples Pembuangan Kapas (50 x 75 mm)
46 Baki Logam Tempat Alat Steril
47 Lempeng Kaca Pengaduk Semen
C RUANG TINDAKAN :
I Ruang persiapan (sebelum tindakan)
1 Bed Side Monitor
2 Tensimeter
3 Stethoscope
4 Suction Pump
5 Film Viewer
6 Saturasi Oksigen
II Kamar Bedah
1 Meja Operasi (gynecologi)
2 Meja Operasi
3 Lampu Operasi
4 Mesin Anestesi
5 Film Viewer
6 Monitor Pasien
7 EKG
8 Defibrilator
9 Ventilator
10 Oxygen Set (tabung oksigen+ Flow meter)
11 Electrosurgical unit
12 UV lamp for room sterilization
13 Vacum pump
15 Suction pump
17 ETT, LMA, Nasotracheal, dewasa dan pediatric
18 Laringoscope set (dewasa dan pediatric)
19 Mayo table stand mobile
20 Sectio caesarian set
21 Laparatomy set
22 Histerectomy set
23 Histeroscopy set
24 Embriotomi set
25 Inkubator bayi
26 Micro Surgery set
27 Patient Strecher
28 Utility Troly
30 Ambubag
31 Ring aplikator set
32 Kocher
33 Chirurgical pinset
34 Gunting lurus
35 Jarum lumbal
36 Needle holder
37 Tromol kasa
38 Pean lurus
39 Spekulum cocor bebek
40 Hak langen beck
41 Speculum Shim
42 Aligator
43 Mini Laparotomy Set
44 Folding Endurance Tester
45 Fenster Klem
46 Bak bengkok
47 Standar Infus
48 Autoclave
III Recovery Room

1 Monitor Pasien
2 Patient Strecher
4 Emergency trolley
5 Infusion pump
6 Suction pump
D RAWAT INAP
I Rawat Umum
1 Tempat Tidur dewasa
2 Tempat Tidur Anak
3 Termometer rectal
4 Termometer axial
5 Examination lamp
6 Stetoskop dewasa
7 Stetoskop bayi dan anak
8 Tensimeter anaroid with stand
10 Timbangan Bayi
11 Timbangan Dewasa
12 Doppler
13 Reflex Hammer
14 Film Viewer
17 EKG
18 Suction pump
22 Oxygen Set + Flow meter
23 Recusitation Set
24 Minor surgery instrument set
25 Emergency set
26 Nebulyzer
27 Vena section set
28 Lumbal needle Punction :
-Lumbal needle
-Duk Steril Bolong
30 UV Lamp
31 Branchard
32 Anatomische pinset
34 Glukometer
37 Vena section set
38 Buli-buli panas
39 Gilyserine Spuit
40 Irigator
41 Korentang
42 Nierbekhen
44 Sputum bak
45 Set Perawatan Luka
46 Emergency trolley
47 Oxygen set + Flowmeter
50 Pisfot dewasa
51 Bak instrument
52 Bak Catheter
53 Kursi Roda
II Ruang Bayi (gabung rawat inap)

1 Tempat tidur bayi
2 Stetoskop Bayi
3 Tensimeter dengan manset untuk bayi
4 Termometer rectal
5 Infant Incubator
6 Infant Warmer
7 Incubator Transpor
8 Vena section set
9 Baby Resusitasion Set
E RADIOLOGI
1 Mobile X-Ray Unit 100mA
2 Vertical Bucky Stand
3 Peralatan protektif radiasi terdiri dari :
-Lead apron , tebal 0.25 ·0,5 mm Pb,
-Sarung tangan, 0.25 -0.5 mm Pb
-Kaca mata Pb, 1 mm Pb
-Pelindung tiroid Pb, 1 mm Pb
-Pelindung gonad Pb, 0.25 -0.5 mm Pb
-Tabir mobile minimal 200 Mm (t}x100 cm
4 Perlengkapan proteksi radiasi terdiri dari :
,-Survei meter
-Digital Pocket Dosimeter
-Film badge/TLD
5 Film viewer (doule film)
6 Cassette X-ray (Stand)
7 Film X-ray semua ukuran :
-18 x 24 cm
-24 x 30 cm
-30 x 40 cm
-35 x 35 cm
8 X-Ray Automatic Processing Film
9 Film marker
10 Film dryer
11 X - Ray Protection Screen with Lead Glass (untuk operator)
F RUANG LABORATORIUM
1 Mikroskop Binokuler
2 Waterbath
3 Sentrifus hematocrit
4 Mikrosentrifus
5 Fotometer / Spektrofotometer
6 Peralatan Laju Endap Darah (LED)
7 Hematologi Analyzer (Three Parts differential)
8 Urine analyzer
9 Reagensia
10 Rapid Test : Gula Darah, Kolesterol
11 Set pemeriksaan faeces
12 Mikropipet
13 Perlengkapan dan pengambilan Sample set
14 Peralatan Gelas
15 Medical Refrigerator
16 Rak Tabung Reaksi
17 Rak untuk pewarnaan
G INSTALASI FARMASI
1 Cawan + Mortir Obat
2 Timbangan gram dan miligram
4 Meja peracikan obat (Work Table for Medicine)
H RUANG GIZI/PANTRY
1 Kitchen Set
2 Kulkas
3 Kompor Gas
4 Tabung Gas
5 Timbangan
6 Perlengkapan Masak Set
7 Perlengkapan Makan Set
8 Pantry Trolley
I RUANG STERILISASI dan LOUNDRY

1 Autoclave
2 Washing Machine
3 Instrument Cabinet
4 Laundry Trolley, SS
5 Meja setrika + Setrika
J RUANG REKAM MEDIK

1 Filling Cabinet
2 Writing Desk
3 Chair
4 Komputer + Printer + UPS + Table
5 Lemari Arsip
K RUANG ADM/KANTOR
1 Filling Cabinet
2 Writing Desk
3 Chair
4 Komputer Desk Set
5 Lemari Arsip
TOTAL ANGGARAN
HOSPITAL FURNITURE
NO JENIS PERALATAN
1 Lemari Instrumen
2 Lemari obat kaca
3 Lemari Steril
4 Penyekat ruangan
5 Meja obat
6 Meja Suntik Beroda
7 Food Troly
8 Instrument trolley
9 Meja laboratorium
10 Tempat Sampah (Tutup)
11 Lemari penyimpanan narkotika
12 Lemari penyimpanan psikotropika
13 Meja Tulis
14 Kursi
15 Waskom mandi
S DAN NON MEDIS
T PRATAMA
N MAUROLE
EN ENDE
HARGA
VOLUME SATUAN JUMLAH
SATUAN
2,502,426,500
342,161,500
2 Unit 20,500,000 41,000,000
3 Unit 35,500,000 106,500,000
3 Unit 3,225,750 9,677,250
3 Unit 2,994,750 8,984,250
1 Paket 49,500,000 49,500,000
###
###
###
2 Unit 63,250,000 126,500,000
2,160,265,000
6 Unit 16,500,000 99,000,000
4 Unit 20,500,000 82,000,000
4 Unit 3,225,750 12,903,000
4 Unit 3,225,750 12,903,000
4 Unit 3,225,750 12,903,000
4 Unit 3,225,750 12,903,000
4 Unit 3,225,750 12,903,000
2 Unit 45,000,000 90,000,000
2 Unit 75,000,000 150,000,000
1 Unit 115,000,000 115,000,000
1 Unit 75,000,000 75,000,000
1 Unit 75,000,000 75,000,000
1 Unit 95,000,000 95,000,000
100 Unit 4,500,000 450,000,000
3 Unit 125,000,000 375,000,000
3 Unit 75,000,000 225,000,000
10 Unit 6,750,000 67,500,000
5 Unit 5,750,000 28,750,000
1 Unit 75,000,000 75,000,000
10 Unit 3,750,000 37,500,000
10 Unit 3,750,000 37,500,000
10 Unit 750,000 7,500,000
10 Unit 550,000 5,500,000
10 Unit 550,000 5,500,000
4,749,568,000
1,261,406,000
2 Unit 15,000,000 30,000,000
1 Unit 125,000,000 125,000,000
1 Unit 45,000,000 45,000,000
1 Unit 35,000,000 35,000,000
2 Unit 75,000,000 150,000,000
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 20,500,000 41,000,000
2 Unit 175,000,000 350,000,000
2 Unit 17,500,000 35,000,000
1 Unit 110,500,000 110,500,000
1 Unit 75,500,000 75,500,000
1 Unit 45,500,000 45,500,000
1 Unit 45,500,000 45,500,000
1 Unit 45,500,000 45,500,000
1 Unit 75,000,000 75,000,000
10 Unit 750,000 7,500,000
2 Unit 550,000 1,100,000
2 Unit 750,000 1,500,000
2 Unit 2,750,000 5,500,000
2 Unit 5,750,000 11,500,000
1,373,604,500
2 Unit 15,000,000 30,000,000
1 Unit 35,000,000 35,000,000
2 Unit 75,000,000 150,000,000
3 Unit 7,500,000 22,500,000
1 Paket 49,500,000 49,500,000
2 Unit 3,225,750 6,451,500

2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
1 Unit 115,000,000 115,000,000
2 Unit 45,000,000 90,000,000
5 Unit 750,000 3,750,000
3 Unit 75,000,000 225,000,000
3 Unit 125,000,000 375,000,000
3 Unit 75,000,000 225,000,000
2 Unit 2,750,000 5,500,000
2 Unit 2,750,000 5,500,000
2 Unit 2,750,000 5,500,000
2 Unit 2,750,000 5,500,000
2 Unit 5,750,000 11,500,000
722,806,000
2 Unit 15,000,000 30,000,000
3 Unit 3,225,750 9,677,250
3 Unit 3,225,750 9,677,250
2 Unit 3,225,750 6,451,500
3 Unit 7,500,000 22,500,000
3 Unit 7,500,000 22,500,000
3 Unit 7,500,000 22,500,000
3 Unit 7,500,000 22,500,000
3 Unit 7,500,000 22,500,000
1 paket 7,500,000 7,500,000
1 Unit 115,000,000 115,000,000
1 Unit 75,000,000 75,000,000
1 Unit 95,000,000 95,000,000
1 Paket 95,000,000 95,000,000
1 Unit 75,000,000 75,000,000
1 Unit 75,000,000 75,000,000
2 Unit 2,750,000 5,500,000
2 Unit 5,750,000 11,500,000
863,451,500
3 Unit 16,500,000 49,500,000
2 Unit 3,225,750 6,451,500
2 Unit 7,500,000 15,000,000
2 Unit 7,500,000 15,000,000
2 Unit 7,500,000 15,000,000
1 Unit 45,000,000 45,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 7,500,000 15,000,000
2 Unit 35,000,000 70,000,000
2 Unit 125,000,000 250,000,000
1 Unit 75,000,000 75,000,000
10 Unit 750,000 7,500,000
528,300,000
185,000,000
1 Unit 75,000,000 75,000,000 ###
###
1 Unit 30,000,000 30,000,000
1 Unit 35,000,000 35,000,000
1 Unit 25,000,000 25,000,000

1 Unit 20,000,000 20,000,000
343,300,000
1 Unit 50,000,000 50,000,000

1 Unit 45,000,000 45,000,000
1 Unit 45,000,000 45,000,000
1 Unit 65,000,000 65,000,000
1 Unit 45,000,000 45,000,000
1 Unit 25,000,000 25,000,000
1 Unit 15,000,000 15,000,000
3 Unit 100,000 300,000
2 Unit 200,000 400,000
2 Unit 190,000 380,000
2 Unit 850,000 1,700,000
2 Unit 190,000 380,000
2 Unit 75,000 150,000
2 Unit 65,000 130,000
2 Unit 190,000 380,000
2 Unit 310,000 620,000
2 Unit 310,000 620,000
2 Unit 310,000 620,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 2,750,000 5,500,000
2 Unit 50,000 100,000
2 Unit 2,750,000 5,500,000
2 Unit 190,000 380,000

2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000
2 Unit 190,000 380,000
2 Unit 390,000 780,000

2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000

2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 850,000 1,700,000
2 Unit 850,000 1,700,000
2 Unit 850,000 1,700,000
2 Unit 850,000 1,700,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 390,000 780,000
2 Unit 290,000 580,000
4,734,153,000
554,903,000
2 Unit 115,000,000 230,000,000
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 125,000,000 250,000,000
1 Unit 45,000,000 45,000,000
1 Unit 17,000,000 17,000,000
3,754,250,000
2 Unit 115,000,000 230,000,000
2 Unit 115,000,000 230,000,000
1 Unit 115,000,000 115,000,000
1 Unit 115,000,000 115,000,000
1 Unit 45,000,000 45,000,000
1 Unit 115,000,000 115,000,000
1 Unit 115,000,000 115,000,000
1 Unit 115,000,000 115,000,000
1 Unit 115,000,000 115,000,000
1 Unit 115,000,000 115,000,000
1 Unit 115,000,000 115,000,000
1 Unit 65,000,000 65,000,000
1 Unit 65,000,000 65,000,000
2 Unit 125,000,000 250,000,000
2 Unit 125,000,000 250,000,000
2 Unit 15,000,000 30,000,000
2 Unit 15,000,000 30,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 15,000,000 30,000,000
2 Unit 7,500,000 15,000,000
2 Unit 7,500,000 15,000,000
2 Unit 4,500,000 9,000,000
2 Unit 1,750,000 3,500,000
2 Unit 1,750,000 3,500,000
2 Unit 1,750,000 3,500,000
2 Unit 2,750,000 5,500,000
2 Unit 375,000 750,000
2 Unit 1,750,000 3,500,000
2 Unit 1,750,000 3,500,000
2 Unit 1,750,000 3,500,000
2 Unit 5,750,000 11,500,000
2 Unit 1,750,000 3,500,000
2 Unit 75,000,000 150,000,000
2 Unit 1,750,000 3,500,000
2 Unit 1,750,000 3,500,000
2 Unit 1,750,000 3,500,000
10 Unit 1,750,000 17,500,000
2 Unit 75,000,000 150,000,000
425,000,000
1 Unit 75,000,000 75,000,000
1 Unit 75,000,000 75,000,000
1 Unit 75,000,000 75,000,000
1 Unit 75,000,000 75,000,000
1 Unit 125,000,000 125,000,000
2,299,469,000
10 Unit 16,000,000 160,000,000
10 Unit 10,500,000 105,000,000
10 Unit 150,000 1,500,000
10 Unit 150,000 1,500,000
3 Unit 7,500,000 22,500,000
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 16,000,000 32,000,000
2 Unit 1,160,000 2,320,000
1 Unit 45,000,000 45,000,000
1 Unit 115,000,000 115,000,000
2 Unit 125,000,000 250,000,000
10 Unit 6,750,000 67,500,000
4 Unit 6,750,000 27,000,000
2 Unit 55,000,000 110,000,000
2 Unit 75,000,000 150,000,000
2 Unit 75,000,000 150,000,000
2 Unit 95,000,000 190,000,000
2 Unit 55,000,000 110,000,000
2 Unit 27,000,000 54,000,000

2 Unit 35,500,000 71,000,000
2 Unit 375,000 750,000
2 Unit 15,000,000 30,000,000
2 Unit 395,000 790,000
2 Unit 95,000,000 190,000,000
2 Unit 500,000 1,000,000
2 Unit 750,000 1,500,000
2 Unit 950,000 1,900,000
2 Unit 1,750,000 3,500,000
10 Unit 750,000 7,500,000
10 Unit 750,000 7,500,000
2 Unit 15,000,000 30,000,000
2 Unit 15,000,000 30,000,000
4 Unit 6,750,000 27,000,000
40 Unit 1,750,000 70,000,000
25 Unit 2,750,000 68,750,000
25 Unit 2,750,000 68,750,000
10 Unit 5,750,000 57,500,000
1,013,203,000
10 Unit 16,000,000 160,000,000
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 150,000 300,000
2 Unit 110,000,000 220,000,000
1 Unit 45,000,000 45,000,000
2 Unit 175,000,000 350,000,000
1 Unit 95,000,000 95,000,000
1 Unit 65,000,000 65,000,000
1 Unit 65,000,000 65,000,000
950,600,000
1 Unit 265,000,000 265,000,000
1 Unit 15,000,000 15,000,000
1 Paket 175,000,000 175,000,000
1 Paket 75,000,000 75,000,000
1 Unit 45,000,000 45,000,000

1 Unit 115,000,000 115,000,000
10 Unit 15,000 150,000

10 Unit 15,000 150,000
10 Unit 15,000 150,000
10 Unit 15,000 150,000
1 Paket 75,000,000 75,000,000
1 Paket 55,000,000 55,000,000
1 Paket 55,000,000 55,000,000
1 Paket 75,000,000 75,000,000
774,450,000
2 Unit 15,000,000 30,000,000
1 Unit 56,000,000 56,000,000
1 Unit 8,000,000 8,000,000
1 Unit 14,000,000 14,000,000
1 Unit 14,000,000 14,000,000
10 Unit 1,000,000 10,000,000
1 unit 293,000,000 293,000,000
1 unit 110,000,000 110,000,000
1 paket 100,000,000 100,000,000
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
1 paket 125,000,000 125,000,000
2 paket 175,000 350,000
2 paket 175,000 350,000
50,500,000
2 paket 2,750,000 5,500,000
1 paket 7,750,000 7,750,000
1 paket 15,750,000 15,750,000
2 paket 10,750,000 21,500,000
529,500,000
2 paket 50,750,000 101,500,000
2 paket 25,750,000 51,500,000
2 paket 20,750,000 41,500,000
2 paket 5,000,000 10,000,000
2 paket 5,000,000 10,000,000
1 paket 150,000,000 150,000,000
1 paket 150,000,000 150,000,000
3 paket 5,000,000 15,000,000
115,000,000
1 paket 45,000,000 45,000,000
1 paket 45,000,000 45,000,000
1 paket 7,500,000 7,500,000
2 paket 5,000,000 10,000,000
1 paket 7,500,000 7,500,000
247,000,000
2 Unit 35,000,000 70,000,000
2 Unit 7,500,000 15,000,000
12 Unit 7,500,000 90,000,000
4 Unit 10,500,000 42,000,000
4 Unit 7,500,000 30,000,000
247,000,000
2 Unit 35,000,000 70,000,000
2 Unit 7,500,000 15,000,000
12 Unit 7,500,000 90,000,000
4 Unit 10,500,000 42,000,000
4 Unit 7,500,000 30,000,000
17,022,666,500
RUMAH SAKIT PRATAMA
KECAMATAN MAUROLE
KABUPATEN ENDE
NO JENIS PERALATAN
I TRIAGE
2 Patient Stretcher
3 Stetoskop
4 Tensimeter
- Penlight
- Spatula lidah
- Reflex hammer
- Spekulum hidung
- Otoskop
- Ophtalmoskop

1 Meja Periksa
2 Lampu Tindakan (mobile)
3 Stetoskop dewasa
4 Stetoskop anak
7 Tensimeter Analog table
8 Film Viewer
9 Termometer Digital
10 EKG
11 Nebulizer Dewasa
12 Suction Pump
13 Minor Surgery Set
14 Tabung Oksigen + Regulator flowmeter + Troli
15 Autoclave
16 Baki logam, SS
18 Nierbeken, SS
19 Waskom antiseptik + tutup
20 Waskom Kassa + tutup

I Poliklinik OBSGYN
2 Tempat tidur Ginekologi
5 Stetoskop
6 Stetoskop Laenec
8 Examination lamp
9 Set Minor Surgery
10 Doppler
11 Gynecologycal Examination set
12 IUD kit
13 Implant kit
14 Nierbekhen
15 Sonde uterus
16 Tampon Tang

4 Examination lamp
Penlight
Spatula lidah
Reflex hammer
Spekulum hidung
Otoskop
Ophtalmoskop
6 Stetoskop
11 Termometer
15 Suction pump
17 Tromol kasa
18 Tampon Tang
19 Bak instrument
21 Kursi Roda

2 Stetoskop Anak
5 Examination lamp
7 Termometer rectal
8 Termometer axial
9 Reflex Hammer
10 Tongue spatel (Stainless steel )
14 Vena section set :
-Gunting lurus
- Gunting bengkok
-Hak 2 bh
-Klem lurus 2 bh
-Klem bengkok 2 bh
-Bisturi 1 buah
IV Poliklinik Bedah
2 Tensimeter dengan manset
3 Stetoskop
4 Examination lamp
5 Reflex hammer
6 Termometer
7 Set Minor Surgery
8 Hecting set
9 Alat pembuka gips (manual )
10 Circumsisi set
11 Suction Pump
12 Autoclave
13 Nierbeken
V Klinik Gigi
1 Kursi Gigi:
-Up Down Movement
-Reclining
-Head Rest
2 Cuspidor Unit:
Water Cup Filler
Saliva Ejector
3 Meja Instrumen
Triple Syringe
4 Foot Controller untuk Hand Piece
5 Kompresor Oilless 1 PK

1.1. Enamel Access Cutter
1.2. Eksavator Berbentuk Sendok Ukuran Kecil (Spoon Excavator Small)
1.4. Eksavator Berbentuk Sendok Ukuran Besar (Spoon Excavator Large)
1.5. Double Ended Applier and Carver
1.6. Spatula Plastik
1.7. Hatchet
1.8. Batu Asah
2 Bein Lurus Besar
3 Bein Lurus Kecil
6 inverted dan
Polishing Burfissure)
7 Ekskavator Berujung Dua (Besar)
8 Ekskavator Berujung Dua (Kecil)
9 Gunting Operasi Gusi (Wagner) (12 cm )
10 Handpiece Contra Angle
11 Handpiece Straight
12 Kaca Mulut Datar No.4 Tanpa Tangkai
13 Tangkai Untuk Kaca Mulut
14 Klem/Pemegang Jarum Jahit (Mathieu Standar)
15 Korentang, Penjepit Sponge (Foerster)
16 Light Curing
18 Motor portable)
Pelindung Jari
19 Pemegang Matriks (Matrix Holder)
20 Penahan Lidah
21 Pengungkit Akar Gigi Kanan Mesial (Cryer Distal)
22 Pengungkit Akar Gigi Kanan Mesial (Cryer Mesial)
23 Penumpat Plastis
24 Periodontal Probe
25 Penumpat Semen Berujung Dua
26 Pinset Gigi
27 Skeler Standar , Bentuk Cangkul Kiri (Type Chisel/Mesial)
28 Skeler Standar , Bentuk Cangkul Kanan (Type Chisel/Mesial)
29 Skeler Standar, Bentuk Tombak (Type Hook)
30 Skeler Standar, Black Kiri dan Kanan (Type Chisel/Mesial)
31 Skeler Standar, Black Kiri dan Kiri (Type Chisel/Mesial)
32 Skeler Ultrasonik
33 Sonde Lengkung
34 Sonde Lurus
35 Spatula Pengaduk Semen
36 Spatula Pengaduk Semen Ionomer
37.1. Tang gigi anterior rahang atas dewasa
37.2. Tang gigi premolar rahang atas
37.3. Tang gigi molar kanan rahang atas
37.4. Tang gigi molar kiri rahang atas
37.5. Tang molar 3 rahang atas
37.6. Tang sisa akar gigi anterior rahang atas
37.7. Tang sisa akar gigi posterior rahang atas
37.8. Tang gigi anterior dan premolar rahang bawah
37.9. Tang gigi molar rahang bawah kanan/kiri
37.10. Tang gigi molar 3 rahang bawah
38.1. Tang gigi anterior rahang atas
38.2. Tang molar rahang atas
38.3. Tang molar susu rahang atas
38.4. Tang sisa akar rahang atas
38.5. Tang gigi anterior rahang bawah
38.6. Tang molar rahang bawah
39 Skalpel, Mata Pisau Bedah (Besar)
40 Skalpel, Mata Pisau Bedah (Kecil)
41 Skalpel, Tangkai Pisau Operasi
42 Silinder Korentang Steril
43 Tempat Alkohol (Dappen Glas)
44 Toples Kapas Logam dengan Pegas dan Tutup (50 x 70 mm)
45 Toples Pembuangan Kapas (50 x 75 mm)
46 Baki Logam Tempat Alat Steril
47 Lempeng Kaca Pengaduk Semen
C RUANG TINDAKAN :
2 Tensimeter
3 Stethoscope
4 Suction Pump
5 Film Viewer
II Kamar Bedah
1 Meja Operasi
2 Lampu Operasi
3 Oxygen Set (tabung oksigen+ Flow meter)
4 UV lamp for room sterilization
5 Suction pump
6 Laringoscope set (dewasa dan pediatric)
7 Mayo table stand mobile
8 Sectio caesarian set
9 Laparatomy set
10 Histeroscopy set
11 Micro Surgery set
12 Patient Strecher
13 Utility Troly
14 Ambubag
15 Kocher
17 Gunting lurus
18 Needle holder
19 Tromol kasa
20 Pean lurus
21 Spekulum cocor bebek
22 Hak langen beck
23 Speculum Shim
24 Aligator
25 Mini Laparotomy Set
26 Fenster Klem
27 Bak bengkok
28 Standar Infus
29 Autoclave
III Recovery Room

1 Patient Strecher
2 Emergency trolley
3 Suction pump
D RAWAT INAP
I Rawat Umum
1 Tempat Tidur dewasa
3 Termometer rectal
4 Termometer axial
5 Examination lamp
6 Stetoskop dewasa
7 Stetoskop bayi dan anak
8 Tensimeter anaroid with stand
10 Timbangan Bayi
11 Timbangan Dewasa
12 Doppler
13 Reflex Hammer
18 Suction pump
22 Oxygen Set + Flow meter
23 Recusitation Set
24 Minor surgery instrument set
25 Branchard
26 Anatomische pinset
28 Buli-buli panas
29 Gilyserine Spuit
30 Irigator
31 Korentang
32 Nierbekhen
33 Sputum bak
34 Pisfot dewasa
35 Bak instrument
36 Bak Catheter
37 Kursi Roda

1 Tempat tidur bayi
2 Stetoskop Bayi
3 Tensimeter dengan manset untuk bayi
4 Termometer rectal
5 Infant Incubator
9 Baby Resusitasion Set
E RADIOLOGI
1 Mobile X-Ray Unit 100mA
2 Vertical Bucky Stand
3 Peralatan protektif radiasi terdiri dari :
4 Perlengkapan proteksi radiasi terdiri dari :
,-Survei meter
-Film badge/TLD
5 Film viewer (doule film)
6 Cassette X-ray (Stand)
-18 x 24 cm
-24 x 30 cm
-30 x 40 cm
-35 x 35 cm
8 X-Ray Automatic Processing Film
9 Film marker
10 Film dryer
11 X - Ray Protection Screen with Lead Glass (untuk operator)
1 Mikroskop Binokuler
2 Sentrifus Hematocrit
3 Peralatan Laju Endap Darah (LED)
4 Hematologi Analyzer (Three Parts differential)
5 Set pemeriksaan faeces
6 Mikropipet
7 Perlengkapan dan pengambilan Sample set
8 Peralatan Gelas
9 Rak Tabung Reaksi
10 Rak untuk pewarnaan
G INSTALASI FARMASI
1 Cawan + Mortir Obat
2 Timbangan gram dan miligram
4 Meja peracikan obat (Work Table for Medicine)
H RUANG GIZI/PANTRY
1 Kitchen Set
2 Kulkas
3 Kompor Gas
4 Tabung Gas
5 Timbangan
6 Perlengkapan Masak Set
7 Perlengkapan Makan Set
8 Pantry Trolley

1 Autoclave
2 Washing Machine
3 Instrument Cabinet
4 Laundry Trolley, SS
5 Meja setrika + Setrika
TOTAL ANGGARAN
HOSPITAL FURNITURE
NO JENIS PERALATAN
1 Lemari Instrumen
2 Lemari obat kaca
3 Lemari Steril
4 Penyekat ruangan
5 Meja obat
7 Food Troly
9 Meja laboratorium
13 Meja Tulis
14 Kursi
15 Waskom mandi
S DAN NON MEDIS
T PRATAMA
N MAUROLE
EN ENDE
HARGA
VOLUME SATUAN JUMLAH
SATUAN
308,399,250
49,720,500
1 Unit 7,500,000 7,500,000
3 Unit 9,500,000 28,500,000
1 Unit 3,225,750 3,225,750
1 Unit 2,994,750 2,994,750
1 Paket 7,500,000 7,500,000
258,678,750
4 Unit 9,500,000 38,000,000
1 Unit 7,500,000 7,500,000
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 7,500,000 7,500,000
1 Unit 750,000 750,000
1 Unit 46,750,000 46,750,000
1 Unit 11,500,000 11,500,000
1 Unit 23,500,000 23,500,000 e-catalogue
1 Unit 15,000,000 15,000,000
2 Unit 6,750,000 13,500,000
1 Unit 50,500,000 50,500,000
3 Unit 3,750,000 11,250,000
3 Unit 3,750,000 11,250,000
3 Unit 750,000 2,250,000
3 Unit 550,000 1,650,000
3 Unit 550,000 1,650,000
681,780,200
196,597,700
1 Unit 10,500,000 10,500,000
1 Unit 95,820,450 95,820,450
1 Unit 4,500,000 4,500,000
1 Unit 4,500,000 4,500,000
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 12,500,000 12,500,000
1 Unit 7,500,000 7,500,000
1 Unit 13,500,000 13,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
10 Unit 750,000 7,500,000
2 Unit 550,000 1,100,000
2 Unit 750,000 1,500,000
2 Unit 2,750,000 5,500,000
111,354,500
1 Unit 10,000,000 10,000,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Paket 7,500,000 7,500,000
2 Unit 3,225,750 6,451,500

2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
1 Unit 750,000 750,000
1 Unit 7,500,000 7,500,000 e-catalogue
1 Unit 23,500,000 23,500,000
2 Unit 2,750,000 5,500,000
2 Unit 2,750,000 5,500,000
2 Unit 2,750,000 5,500,000
2 Unit 2,750,000 5,500,000
1 Unit 5,750,000 5,750,000
82,677,250
1 Unit 10,500,000 10,500,000
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 paket 7,500,000 7,500,000
1 Paket 7,500,000 7,500,000
1 Unit 12,000,000 12,000,000

2 Unit 2,750,000 5,500,000
144,475,750
1 Unit 10,500,000 10,500,000
1 Unit 3,225,750 3,225,750

1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 24,500,000 24,500,000 e-catalogue
1 Unit 50,000,000 50,000,000
5 Unit 750,000 3,750,000
146,675,000
95,000,000
1 Unit 55,000,000 55,000,000 175,000,000
(80,000,000)
1 Unit 10,000,000 10,000,000

1 Unit 10,000,000 10,000,000
1 Unit 10,000,000 10,000,000

1 Unit 10,000,000 10,000,000
51,675,000
28,100,000
1 Unit 4,000,000 4,000,000
1 Unit 4,000,000 4,000,000
1 Unit 4,000,000 4,000,000
1 Unit 4,000,000 4,000,000
1 Unit 4,000,000 4,000,000
1 Unit 4,000,000 4,000,000
1 Unit 4,000,000 4,000,000
1 Unit 100,000 100,000
1 Unit 200,000 200,000
1 Unit 190,000 190,000
1 Unit 850,000 850,000
1 Unit 190,000 190,000
1 Unit 75,000 75,000
1 Unit 65,000 65,000
1 Unit 190,000 190,000
1 Unit 310,000 310,000
1 Unit 310,000 310,000
1 Unit 310,000 310,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 1,750,000 1,750,000
1 Unit 50,000 50,000
1 Unit 1,750,000 1,750,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
1 Unit 390,000 390,000
1 Unit 190,000 190,000
4,290,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
2,730,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 850,000 850,000
1 Unit 850,000 850,000
1 Unit 850,000 850,000
1 Unit 850,000 850,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 390,000 390,000
1 Unit 290,000 290,000
461,446,800
25,451,500
1 Unit 3,225,750 3,225,750
1 Unit 3,225,750 3,225,750
1 Unit 14,500,000 14,500,000 e-catalogue
1 Unit 4,500,000 4,500,000
406,495,300
1 Unit 95,000,000 95,000,000
1 Unit 109,620,300 109,620,300 21,640,750
1 Unit 6,750,000 6,750,000
1 Unit 25,000,000 25,000,000
1 Unit 14,500,000 14,500,000 e-catalogue
1 Unit 6,000,000 6,000,000
1 Unit 7,000,000 7,000,000 10,820,375
1 Unit 7,500,000 7,500,000 120,440,675
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 4,500,000 4,500,000
1 Unit 1,750,000 1,750,000
1 Unit 1,750,000 1,750,000
1 Unit 2,750,000 2,750,000
1 Unit 375,000 375,000
1 Unit 1,750,000 1,750,000
1 Unit 1,750,000 1,750,000
1 Unit 1,750,000 1,750,000
1 Unit 5,750,000 5,750,000
1 Unit 1,750,000 1,750,000
1 Unit 7,500,000 7,500,000
1 Unit 1,750,000 1,750,000
1 Unit 1,750,000 1,750,000
3 Unit 1,750,000 5,250,000
1 Unit 50,000,000 50,000,000
29,500,000
1 Unit 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000
1 Unit 14,500,000 14,500,000 e-catalogue
1,155,723,750
1,046,520,750
50 Unit 13,000,000 650,000,000
50 Unit 150,000 7,500,000
50 Unit 150,000 7,500,000
2 Unit 12,500,000 25,000,000 e-catalogue
6 Unit 3,225,750 19,354,500
2 Unit 3,225,750 6,451,500
6 Unit 3,225,750 19,354,500
2 Unit 3,225,750 6,451,500
1 Unit 3,225,750 3,225,750
4 Unit 3,225,750 12,903,000
1 Unit 24,000,000 24,000,000
4 Unit 1,160,000 4,640,000
4 Unit 24,500,000 98,000,000 e-catalogue
4 Unit 5,750,000 23,000,000
3 Unit 6,750,000 20,250,000
1 Unit 15,000,000 15,000,000
2 Unit 7,500,000 15,000,000
2 Unit 375,000 750,000
2 Unit 395,000 790,000
3 Unit 500,000 1,500,000
3 Unit 750,000 2,250,000
3 Unit 950,000 2,850,000
4 Unit 1,750,000 7,000,000
15 Unit 750,000 11,250,000
15 Unit 550,000 8,250,000
10 Unit 1,750,000 17,500,000
8 Unit 2,750,000 22,000,000
4 Unit 2,750,000 11,000,000
1 Unit 3,750,000 3,750,000
109,203,000
4 Unit 13,000,000 52,000,000
2 Unit 3,225,750 6,451,500
2 Unit 3,225,750 6,451,500
2 Unit 150,000 300,000
1 Unit 25,000,000 25,000,000
1 Unit 7,000,000 7,000,000
1 Unit 12,000,000 12,000,000
188,100,000
1 Unit 115,000,000 115,000,000
1 Unit 10,000,000 10,000,000
1 Paket 10,000,000 10,000,000
1 Paket 7,500,000 7,500,000
1 Unit 7,500,000 7,500,000

1 Unit 7,500,000 7,500,000
10 Unit 15,000 150,000

10 Unit 15,000 150,000
10 Unit 15,000 150,000
10 Unit 15,000 150,000
1 Paket 7,500,000 7,500,000
1 Paket 7,500,000 7,500,000
1 Paket 7,500,000 7,500,000
1 Paket 7,500,000 7,500,000
115,800,000
2 Unit 12,000,000 24,000,000 e-catalogue
1 Unit 7,800,000 7,800,000 e-catalogue
10 Unit 1,000,000 10,000,000
1 unit 62,300,000 62,300,000 e-catalogue
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
2 paket 175,000 350,000
2 paket 175,000 350,000
21,750,000
1 paket 2,750,000 2,750,000
1 paket 2,750,000 2,750,000
1 paket 6,750,000 6,750,000
2 paket 4,750,000 9,500,000
39,500,000
1 paket 8,500,000 8,500,000
1 paket 8,500,000 8,500,000
1 paket 3,750,000 3,750,000
1 paket 3,750,000 3,750,000
1 paket 3,750,000 3,750,000
1 paket 3,750,000 3,750,000
1 paket 3,750,000 3,750,000
1 paket 3,750,000 3,750,000
27,500,000
1 paket 7,500,000 7,500,000
1 paket 7,500,000 7,500,000
1 paket 5,500,000 5,500,000
1 paket 3,500,000 3,500,000
1 paket 3,500,000 3,500,000
3,000,000,000 3,000,000,000
-
Lampiran : 1
Surat Peralatan Kesehatan dan
Non Kesehatan Rumah Sakit Pratama
Nomor : /TU.01/VII/2015
PERALATAN KESEHATAN DAN NON KESEHATAN
RUMAH SAKIT PRATAMA KABUPATEN ENDE
TAHUN ANGGARAN 2016
No Jenis Pelayanan Per Kebutuhan Peralatan Vol
1 2 3
I TRIAGE
1 Lampu Periksa (mobile) 1
2 Patient Stretcher 3
3 Stetoskop 1
4 Tensimeter 1
5 Diagnostik Set terdiri dari : 1
- Penlight
- Spatula lidah
- Reflex hammer
- Spekulum hidung
- Otoskop
- Ophtalmoskop
1 Meja Periksa 4
2 Lampu Tindakan (mobile) 1
3 Stetoskop dewasa 1
4 Stetoskop anak 1
5 Stetoskop Neonatus 1
6 Tensimeter Analog Standing 1
7 Tensimeter Analog table 1
8 Film Viewer 1
9 Termometer Digital 1
10 EKG 1
11 Nebulizer Dewasa 1
12 Suction Pump 1
13 Minor Surgery Set 1
14 Tabung Oksigen + Regulator flowmeter + Troli 2
15 Autoclave 1
16 Baki logam, SS 3
17 Tromol/Korentang (Dressing Drum) 3
18 Nierbeken, SS 3
19 Waskom antiseptik + tutup 3
20 Waskom Kassa + tutup 3
I Poliklinik OBSGYN
1 Tempat tidur periksa 1
2 Tempat tidur Ginekologi 1
3 Timbangan dewasa + pengukur tinggi badan 1
4 Lampu Periksa (mobile) 1
5 Stetoskop 1
6 Stetoskop Laenec 1
8 Examination lamp 1
9 Set Minor Surgery 1
10 Doppler 1
11 Gynecologycal Examination set 1
12 IUD kit 1
13 Implant kit 1
14 Nierbekhen 10
15 Sonde uterus 2
16 Tampon Tang 2
2 Timbangan dewasa + pengukur tinggi badan 1
5 Diagnostik Set terdiri dari : 1
Penlight
Spatula lidah
Reflex hammer
Spekulum hidung
Otoskop
Ophtalmoskop
6 Stetoskop 2

8 Tensimeter Analog Table 2
11 Termometer 1
15 Suction pump 1
17 Tromol kasa 2
18 Tampon Tang 2
19 Bak instrument 2
21 Kursi Roda 1
2 Stetoskop Anak 1
3 Stetoskop Neonatus 1
4 Tensimeter dengan manset untuk bayi dan anak 1
7 Termometer rectal 1
8 Termometer axial 1
9 Reflex Hammer 1
10 Tongue spatel (Stainless steel ) 1
14 Vena section set : 1
-Gunting lurus
- Gunting bengkok
-Hak 2 bh
-Klem lurus 2 bh
-Klem bengkok 2 bh
-Bisturi 1 buah
15 Baby Suction pump 1
IV Poliklinik Bedah
2 Tensimeter dengan manset
3 Stetoskop 1
5 Reflex hammer 1
6 Termometer 1
8 Hecting set 1
9 Alat pembuka gips (manual ) 1
10 Circumsisi set 1
11 Suction Pump 1
12 Autoclave 1
13 Nierbeken 5
V Klinik Gigi
1 Kursi Gigi: 1
-Up Down Movement
-Reclining
-Head Rest
2 Cuspidor Unit: 1
Water Cup Filler
Saliva Ejector
3 Meja Instrumen 1
Triple Syringe
4 Foot Controller untuk Hand Piece 1
5 Kompresor Oilless 1 PK 1
1.1. Enamel Access Cutter 1
1.2. Eksavator Berbentuk Sendok Ukuran Kecil (Spoon Excavator Small) 1
1.3. Eksavator Berbentuk Sendok Ukuran Sedang (Spoon Excavator Medium) 1
1.4. Eksavator Berbentuk Sendok Ukuran Besar (Spoon Excavator Large) 1

1.5. Double Ended Applier and Carver 1
1.6. Spatula Plastik 1
1.7. Hatchet 1
1.8. Batu Asah 1
2 Bein Lurus Besar 1
3 Bein Lurus Kecil 1
inverted dan fissure) 1
6 Polishing Bur 1
7 Ekskavator Berujung Dua (Besar) 1
8 Ekskavator Berujung Dua (Kecil) 1
9 Gunting Operasi Gusi (Wagner) (12 cm ) 1
10 Handpiece Contra Angle 1
11 Handpiece Straight 1
12 Kaca Mulut Datar No.4 Tanpa Tangkai 1
13 Tangkai Untuk Kaca Mulut 1
14 Klem/Pemegang Jarum Jahit (Mathieu Standar) 1
15 Korentang, Penjepit Sponge (Foerster) 1
16 Light Curing 1
Motor portable) 1
18 Pelindung Jari 1
19 Pemegang Matriks (Matrix Holder) 1
20 Penahan Lidah 1
21 Pengungkit Akar Gigi Kanan Mesial (Cryer Distal) 1
22 Pengungkit Akar Gigi Kanan Mesial (Cryer Mesial) 1
23 Penumpat Plastis 1
24 Periodontal Probe 1
25 Penumpat Semen Berujung Dua 1
26 Pinset Gigi 1
27 Skeler Standar , Bentuk Cangkul Kiri (Type Chisel/Mesial) 1
28 Skeler Standar , Bentuk Cangkul Kanan (Type Chisel/Mesial) 1
29 Skeler Standar, Bentuk Tombak (Type Hook) 1
30 Skeler Standar, Black Kiri dan Kanan (Type Chisel/Mesial) 1
31 Skeler Standar, Black Kiri dan Kiri (Type Chisel/Mesial) 1
32 Skeler Ultrasonik 1
33 Sonde Lengkung 1
34 Sonde Lurus 1
35 Spatula Pengaduk Semen 1
36 Spatula Pengaduk Semen Ionomer 1
37.1. Tang gigi anterior rahang atas dewasa 1
37.2. Tang gigi premolar rahang atas 1
37.3. Tang gigi molar kanan rahang atas 1
37.4. Tang gigi molar kiri rahang atas 1
37.5. Tang molar 3 rahang atas 1
37.6. Tang sisa akar gigi anterior rahang atas 1
37.7. Tang sisa akar gigi posterior rahang atas 1
37.8. Tang gigi anterior dan premolar rahang bawah 1
37.9. Tang gigi molar rahang bawah kanan/kiri 1
37.10. Tang gigi molar 3 rahang bawah 1
37.11. Tang sisa akar rahang bawah 1
38.1. Tang gigi anterior rahang atas 1
38.2. Tang molar rahang atas 1
38.3. Tang molar susu rahang atas 1
38.4. Tang sisa akar rahang atas 1
38.5. Tang gigi anterior rahang bawah 1
38.6. Tang molar rahang bawah 1
38.7. Tang sisa akar rahang bawah 1
39 Skalpel, Mata Pisau Bedah (Besar) 1
40 Skalpel, Mata Pisau Bedah (Kecil) 1
41 Skalpel, Tangkai Pisau Operasi 1
42 Silinder Korentang Steril 1
43 Tempat Alkohol (Dappen Glas) 1
44 Toples Kapas Logam dengan Pegas dan Tutup (50 x 70 mm) 1
45 Toples Pembuangan Kapas (50 x 75 mm) 1
46 Baki Logam Tempat Alat Steril 1
47 Lempeng Kaca Pengaduk Semen 1
C RUANG TINDAKAN :
1 Tensimeter 1
2 Stethoscope 1
3 Suction Pump 1
4 Film Viewer 1
II Kamar Bedah
1 Meja Operasi 1
2 Lampu Operasi 1
3 Oxygen Set (tabung oksigen+ Flow meter) 1
4 UV lamp for room sterilization 1
5 Suction pump 1
6 Laringoscope set (dewasa dan pediatric) 1
7 Mayo table stand mobile 1
8 Sectio caesarian set 1
9 Laparatomy set 1
10 Histeroscopy set 1
11 Micro Surgery set 1
12 Patient Strecher 1
13 Utility Troly 1
14 Ambubag 1
15 Kocher 1
16 Chirurgical pinset 1
17 Gunting lurus 1
18 Needle holder 1
19 Tromol kasa 1
20 Pean lurus 1
21 Spekulum cocor bebek 1
22 Hak langen beck 1
23 Speculum Shim 1
24 Aligator 1
25 Mini Laparotomy Set 1
26 Fenster Klem 1
27 Bak bengkok 1
28 Standar Infus 3
29 Autoclave 1
III Recovery Room
1 Patient Strecher 1
2 Emergency trolley 1
3 Suction pump 1
D RAWAT INAP
I Rawat Umum
1 Tempat Tidur dewasa 50
3 Termometer axial 50
5 Stetoskop dewasa 6
6 Stetoskop bayi dan anak 2
7 Tensimeter anaroid with stand 6
8 Tensimeter dengan manset untuk bayi dan anak 2
9 Timbangan Bayi 1
10 Timbangan Dewasa 4
11 Doppler 1
12 Reflex Hammer 4
13 Suction pump 4
14 Oxygen Set + Flow meter 4
15 Recusitation Set 3
16 Minor surgery instrument set 1
17 Branchard 2
18 Anatomische pinset 2
19 Chirurgical pinset 2
20 Buli-buli panas 3
21 Gilyserine Spuit 3
22 Irigator 3
23 Korentang 4
24 Nierbekhen 15
25 Sputum bak 15
26 Pisfot dewasa 10
27 Bak instrument 8
28 Bak Catheter 4
29 Kursi Roda 1
1 Tempat tidur bayi 4
2 Stetoskop Bayi 2
3 Tensimeter dengan manset untuk bayi 2
5 Infant Incubator 1
6 Baby Resusitasion Set 1
7 Baby Suction pump 1
E RADIOLOGI
1 Mobile X-Ray Unit 100mA 1
2 Vertical Bucky Stand 1
3 Peralatan protektif radiasi terdiri dari : 1

4 Perlengkapan proteksi radiasi terdiri dari : 1
,-Survei meter
-Film badge/TLD
5 Film viewer (doule film) 1
6 Cassette X-ray (Stand) 1
-18 x 24 cm 10
-24 x 30 cm 10
-30 x 40 cm 10
-35 x 35 cm 10
8 X-Ray Automatic Processing Film 1
9 Film marker 1
10 Film dryer 1
11 X - Ray Protection Screen with Lead Glass (untuk operator) 1
1 Mikroskop Binokuler 2
2 Sentrifus Hematocrit 1
3 Peralatan Laju Endap Darah (LED) 10
4 Hematologi Analyzer (Three Parts differential) 1
5 Set pemeriksaan faeces 1
6 Mikropipet 1
7 Perlengkapan dan pengambilan Sample set 1
8 Peralatan Gelas 1
9 Rak Tabung Reaksi 2
10 Rak untuk pewarnaan 2
G INSTALASI FARMASI
1 Cawan + Mortir Obat 1
2 Timbangan gram dan miligram 1
3 Refrigerator Medical Grade 1
4 Meja peracikan obat (Work Table for Medicine) 2
H RUANG GIZI/PANTRY
1 Kitchen Set 1
2 Kulkas 1
3 Kompor Gas 1
4 Tabung Gas 1
5 Timbangan 1
6 Perlengkapan Masak Set 1
7 Perlengkapan Makan Set 1
8 Pantry Trolley 1
1 Autoclave 1
2 Washing Machine 1
3 Instrument Cabinet 1
4 Laundry Trolley, SS 1
5 Meja setrika + Setrika 1
TOTAL ANGGARAN
HOSPITAL FURNITURE
NO JENIS PERALATAN
1 Lemari Instrumen
2 Lemari obat kaca
3 Lemari Steril
4 Penyekat ruangan
5 Meja obat
7 Food Troly
9 Meja laboratorium
13 Meja Tulis
14 Kursi
15 Waskom mandi
N KESEHATAN DAN NON KESEHATAN
SAKIT PRATAMA KABUPATEN ENDE
TAHUN ANGGARAN 2016
Sat Harga Satuan Jumlah
4 5 6
308,399,250
49,720,500
Unit 7,500,000 7,500,000
Unit 9,500,000 28,500,000
Unit 3,225,750 3,225,750
Unit 2,994,750 2,994,750
Paket 7,500,000 7,500,000
258,678,750
Unit 9,500,000 38,000,000
Unit 7,500,000 7,500,000
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 7,500,000 7,500,000
Unit 750,000 750,000
Unit 46,750,000 46,750,000
Unit 11,500,000 11,500,000
Unit 23,500,000 23,500,000
Unit 15,000,000 15,000,000
Unit 6,750,000 13,500,000
Unit 50,500,000 50,500,000
Unit 3,750,000 11,250,000
Unit 3,750,000 11,250,000
Unit 750,000 2,250,000
Unit 550,000 1,650,000
Unit 550,000 1,650,000
681,780,200
196,597,700
Unit 10,500,000 10,500,000
Unit 95,820,450 95,820,450
Unit 4,500,000 4,500,000
Unit 4,500,000 4,500,000
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 12,500,000 12,500,000
Unit 7,500,000 7,500,000
Unit 13,500,000 13,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 750,000 7,500,000
Unit 550,000 1,100,000
Unit 750,000 1,500,000
Unit 2,750,000 5,500,000
111,354,500
Unit 10,000,000 10,000,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Paket 7,500,000 7,500,000
Unit 3,225,750 6,451,500
Unit 3,225,750 6,451,500

Unit 3,225,750 6,451,500
Unit 750,000 750,000
Unit 7,500,000 7,500,000
Unit 23,500,000 23,500,000
Unit 2,750,000 5,500,000
Unit 2,750,000 5,500,000
Unit 2,750,000 5,500,000
Unit 2,750,000 5,500,000
Unit 5,750,000 5,750,000
82,677,250
Unit 10,500,000 10,500,000
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
paket 7,500,000 7,500,000
Paket 7,500,000 7,500,000
Unit 12,000,000 12,000,000

Unit 2,750,000 5,500,000
144,475,750
Unit 10,500,000 10,500,000
Unit 3,225,750 3,225,750

Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 24,500,000 24,500,000
Unit 50,000,000 50,000,000
Unit 750,000 3,750,000
146,675,000
95,000,000
Unit 55,000,000 55,000,000
Unit 10,000,000 10,000,000
Unit 10,000,000 10,000,000
Unit 10,000,000 10,000,000

Unit 10,000,000 10,000,000
51,675,000
28,100,000
Unit 4,000,000 4,000,000
Unit 4,000,000 4,000,000
Unit 4,000,000 4,000,000
Unit 4,000,000 4,000,000

Unit 4,000,000 4,000,000
Unit 4,000,000 4,000,000
Unit 4,000,000 4,000,000
Unit 100,000 100,000
Unit 200,000 200,000
Unit 190,000 190,000
Unit 850,000 850,000
Unit 190,000 190,000

Unit 75,000 75,000
Unit 65,000 65,000
Unit 190,000 190,000
Unit 310,000 310,000
Unit 310,000 310,000
Unit 310,000 310,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 1,750,000 1,750,000
Unit 50,000 50,000
Unit 1,750,000
1,750,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
Unit 390,000 390,000
Unit 190,000 190,000
4,290,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
2,730,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 850,000 850,000
Unit 850,000 850,000
Unit 850,000 850,000
Unit 850,000 850,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 390,000 390,000
Unit 290,000 290,000
461,446,800
25,451,500
Unit 3,225,750 3,225,750
Unit 3,225,750 3,225,750
Unit 14,500,000 14,500,000
Unit 4,500,000 4,500,000
406,495,300
Unit 95,000,000 95,000,000
Unit 109,620,300 109,620,300
Unit 6,750,000 6,750,000
Unit 25,000,000 25,000,000
Unit 14,500,000 14,500,000
Unit 6,000,000 6,000,000
Unit 7,000,000 7,000,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 4,500,000 4,500,000
Unit 1,750,000 1,750,000
Unit 1,750,000 1,750,000
Unit 2,750,000 2,750,000
Unit 375,000 375,000
Unit 1,750,000 1,750,000
Unit 1,750,000 1,750,000
Unit 1,750,000 1,750,000
Unit 5,750,000 5,750,000
Unit 1,750,000 1,750,000
Unit 7,500,000 7,500,000
Unit 1,750,000 1,750,000
Unit 1,750,000 1,750,000
Unit 1,750,000 5,250,000
Unit 50,000,000 50,000,000
29,500,000
Unit 7,500,000 7,500,000
Unit 7,500,000 7,500,000
Unit 14,500,000 14,500,000
1,155,723,750
1,046,520,750
Unit 13,000,000 650,000,000
Unit 150,000 7,500,000
Unit 150,000 7,500,000
Unit 12,500,000 25,000,000
Unit 3,225,750 19,354,500
Unit 3,225,750 6,451,500
Unit 3,225,750 19,354,500
Unit 3,225,750 6,451,500
Unit 3,225,750 3,225,750
Unit 3,225,750 12,903,000
Unit 24,000,000 24,000,000
Unit 1,160,000 4,640,000
Unit 24,500,000 98,000,000
Unit 5,750,000 23,000,000
Unit 6,750,000 20,250,000
Unit 15,000,000 15,000,000
Unit 7,500,000 15,000,000
Unit 375,000 750,000
Unit 395,000 790,000
Unit 500,000 1,500,000
Unit 750,000 2,250,000
Unit 950,000 2,850,000
Unit 1,750,000 7,000,000
Unit 750,000 11,250,000
Unit 550,000 8,250,000
Unit 1,750,000 17,500,000
Unit 2,750,000 22,000,000
Unit 2,750,000 11,000,000
Unit 3,750,000 3,750,000
109,203,000
Unit 13,000,000 52,000,000
Unit 3,225,750 6,451,500
Unit 3,225,750 6,451,500
Unit 150,000 300,000
Unit 25,000,000 25,000,000
Unit 7,000,000 7,000,000
Unit 12,000,000 12,000,000
188,100,000
Unit 115,000,000 115,000,000
Unit 10,000,000 10,000,000
Paket 10,000,000 10,000,000
Paket 7,500,000 7,500,000
Unit 7,500,000 7,500,000

Unit 7,500,000 7,500,000
Unit 15,000 150,000

Unit 15,000 150,000
Unit 15,000 150,000
Unit 15,000 150,000
Paket 7,500,000 7,500,000
Paket 7,500,000 7,500,000
Paket 7,500,000 7,500,000
Paket 7,500,000 7,500,000
115,800,000
Unit 12,000,000 24,000,000
Unit 7,800,000 7,800,000
Unit 1,000,000 10,000,000
unit 62,300,000 62,300,000
paket 2,750,000 2,750,000
paket 2,750,000 2,750,000
paket 2,750,000 2,750,000
paket 2,750,000 2,750,000
paket 175,000 350,000
paket 175,000 350,000
21,750,000
paket 2,750,000 2,750,000
paket 2,750,000 2,750,000
paket 6,750,000 6,750,000
paket 4,750,000 9,500,000
39,500,000
paket 8,500,000 8,500,000
paket 8,500,000 8,500,000
paket 3,750,000 3,750,000
paket 3,750,000 3,750,000
paket 3,750,000 3,750,000
paket 3,750,000 3,750,000
paket 3,750,000 3,750,000
paket 3,750,000 3,750,000
27,500,000
paket 7,500,000 7,500,000
paket 7,500,000 7,500,000
paket 5,500,000 5,500,000
paket 3,500,000 3,500,000
paket 3,500,000 3,500,000
3,000,000,000
Ende, 14 Juli 2014
An. Kepala Dinas Kesehatan

Kabupaten Ende
Sekretaris
drg. Muna Fatma, M.Kes

Nip : 197109041999032010
KELNGKAPAN DOKUMEN USULAN
PEMBANGUNAN RUMAH SAKIT PRATAMA KABUPATEN ENDE
TAHUN ANGGARAN 2016
NO URAIAN KRITERIA PEMBANGUNAN RS PRATAMA

1 Wilayah
a. Terpencil/Sangat Terpencil
2 Lokasi
- Kesiapan Lahan
- Kondisi Lahan
3 Lahan
- Luas Lahan
4 Administrasi
a. Usulan Terdata di e-planning
b. Surat Pernyataan Bermaterai dari Bupati
c. Setifikat / Bukti Proses Kepemilikian Lahan
d. Fotocopy Lokasi Pembangunan RS Pratama dan Batas-Batas
e. Surat Rekomdasi dari Dinas PU tetang Lokasi Lahan
f. Surat Analisis Bangunan dengan Luas Lahan 50 TT dari PU
g. Surat Harga Peralatan Kesehatan dan Non Kesehatan utk RS
Pratama sesuai dengan Permenkes 24 Tahun 2014
h. Surat Pernyataan dari RSUD sebagai Pengampuh RS Pratama
N USULAN
AMA KABUPATEN ENDE
N 2016
DALAM
KETERANGAN ADA
PROSES
SK Bupati
Sertifikat/Surat
Bukti Penyerahan
RUMAH SAKIT PRATAMA
KECAMATAN MAUROLE
KABUPATEN ENDE
NO JENIS PERALATAN VOLUME SATUAN

I TRIAGE
1 Lampu Periksa (mobile) 2 Unit
2 Patient Stretcher 3 Unit
3 Stetoskop 3 Unit
4 Tensimeter 3 Unit
5 Diagnostik Set terdiri dari : 2 Paket
- Penlight
- Spatula lidah
- Reflex hammer
- Spekulum hidung
- Otoskop
- Ophtalmoskop
6 Kursi roda 2 Unit

1 Meja Periksa 6 Unit
2 Lampu Tindakan (mobile) 4 Unit
3 Stetoskop dewasa 4 Unit
4 Stetoskop anak 4 Unit
5 Stetoskop Neonatus 4 Unit
6 Tensimeter Analog Standing 4 Unit
7 Tensimeter Analog table 4 Unit
8 Film Viewer 2 Unit
9 Termometer Digital 2 Unit
10 EKG 1 Unit
11 Nebulizer Dewasa 3 Unit
12 Nebulizer Anak 3 Unit
13 Portable Pulse Oximetri 3 Unit
16 Tiang infus 100 Unit
17 Suction Pump 3 Unit
21 Minor Surgery Set 3 Unit
22 Tabung Oksigen + Regulator flowmeter + Troli 10 Unit
23 Tabung Oksigen Kecil + Regulator + Troli 6 Unit
24 Autoclave 2 Unit
25 Baki logam, SS 10 Unit
26 Tromol/Korentang (Dressing Drum) 10 Unit
27 Nierbeken, SS 10 Unit
28 Waskom antiseptik + tutup 10 Unit
29 Waskom Kassa + tutup 10 Unit

1 Poliklinik OBSGYN
1 Tempat tidur periksa 2 Unit
2 Tempat tidur Ginekologi 2 Unit
5 Timbangan dewasa + pengukur tinggi badan 2 Unit
7 Stetoskop 2 Unit
8 Stetoskop Laenec 2 Unit
10 Tensimeter Analog Table 2 Unit
11 Examination lamp 2 Unit
12 Set Minor Surgery 2 Unit
13 Doppler 2 Unit
14 Cardiotocography 2 Unit
15 Gynecologycal Examination set 2 Unit
16 Pap Smear Kit 2 Unit

17 IUD kit 2 Unit
18 Implant kit 2 Unit
20 Autoclave 2 Unit
21 Nierbekhen 10 Unit
22 Sonde uterus 2 Unit
23 Tampon Tang 2 Unit
25 Kursi Dorong 2 Unit

2 Timbangan dewasa + pengukur tinggi badan 2 Unit
5 Diagnostik Set terdiri dari : 2 Paket
Penlight
Spatula lidah
Reflex hammer
Spekulum hidung
Otoskop
Ophtalmoskop
6 Stetoskop 2 Unit
8 Tensimeter Analog Table 2 Unit
9 EKG 1 Unit
11 Termometer 5 Unit
15 Suction pump 3 Unit
16 Utility trolley 3 Unit
17 Tromol kasa 2 Unit
18 Tampon Tang 2 Unit
19 Bak instrument 2 Unit
21 Kursi Roda 2 Unit

2 Stetoskop Anak 3 Unit
3 Stetoskop Neonatus 3 Unit
4 Tensimeter dengan manset untuk bayi dan anak 2 Unit
6 Infant dan baby weighting scale 3 Unit
7 Termometer rectal 3 Unit
8 Termometer axial 3 Unit
9 Reflex Hammer 3 Unit
10 Tongue spatel (Stainless steel ) 2 paket
11 EKG 1 Unit
12 Nebulizer 2 Unit
13 Infant dan baby pediatric resusitation 2 Unit
14 Vena section set : 2 Paket
-Gunting lurus
- Gunting bengkok
-Hak 2 bh
-Klem lurus 2 bh
-Klem bengkok 2 bh
-Bisturi 1 buah

15 Baby Suction pump 2 Unit
16 Oxygen set dan flow meter 2 Unit
18 Refrigerator Medical Grade 2 Unit
IV Poliklinik Bedah
2 Stetoskop 2 Unit
4 Reflex hammer 2 Unit
5 Termometer 2 Unit
8 Hecting set 2 Unit
9 Alat pembuka gips (manual ) 2 Unit
11 Circumsisi set 2 Unit
13 Autoclave 2 Unit
14 Nierbeken 10 Unit
V Klinik Gigi
1 Kursi Gigi: 2 Unit
-Up Down Movement
-Reclining
-Head Rest
2 Cuspidor Unit: 1 Unit
Water Cup Filler
Saliva Ejector
3 Meja Instrumen 2 Unit
Triple Syringe
4 Foot Controller untuk Hand Piece 1 Unit
5 Kompresor Oilless 1 PK 1 Unit

1.1. Enamel Access Cutter 1 Unit
1.2. Eksavator Berbentuk Sendok Ukuran Kecil (Spoon Excavator Small) 1 Unit
1 Unit
1.4. Eksavator Berbentuk Sendok Ukuran Besar (Spoon Excavator Large) 1 Unit
1.5. Double Ended Applier and Carver 1 Unit
1.6. Spatula Plastik 1 Unit
1.7. Hatchet 1 Unit
1.8. Batu Asah 3 Unit
2 Bein Lurus Besar 2 Unit
3 Bein Lurus Kecil 2 Unit
inverted dan fissure) 2 Unit
6 Polishing Bur 2 Unit

7 Ekskavator Berujung Dua (Besar) 2 Unit
8 Ekskavator Berujung Dua (Kecil) 2 Unit
9 Gunting Operasi Gusi (Wagner) (12 cm ) 2 Unit
10 Handpiece Contra Angle 2 Unit
11 Handpiece Straight 2 Unit

12 Kaca Mulut Datar No.4 Tanpa Tangkai 2 Unit
13 Tangkai Untuk Kaca Mulut 2 Unit
14 Klem/Pemegang Jarum Jahit (Mathieu Standar) 2 Unit
15 Korentang, Penjepit Sponge (Foerster) 2 Unit
16 Light Curing 2 Unit
Motor portable) 2 Unit
18 Pelindung Jari 2 Unit

19 Pemegang Matriks (Matrix Holder) 2 Unit
20 Penahan Lidah 2 Unit
21 Pengungkit Akar Gigi Kanan Mesial (Cryer Distal) 2 Unit
22 Pengungkit Akar Gigi Kanan Mesial (Cryer Mesial) 2 Unit
23 Penumpat Plastis 2 Unit
24 Periodontal Probe 2 Unit
25 Penumpat Semen Berujung Dua 2 Unit
26 Pinset Gigi 2 Unit
27 Skeler Standar , Bentuk Cangkul Kiri (Type Chisel/Mesial) 2 Unit
28Skeler Standar , Bentuk Cangkul Kanan (Type Chisel/Mesial) 2 Unit
29Skeler Standar, Bentuk Tombak (Type Hook) 2 Unit
30Skeler Standar, Black Kiri dan Kanan (Type Chisel/Mesial) 2 Unit
31Skeler Standar, Black Kiri dan Kiri (Type Chisel/Mesial) 2 Unit
32Skeler Ultrasonik 2 Unit
33 Sonde Lengkung 2 Unit
34 Sonde Lurus 2 Unit
35 Spatula Pengaduk Semen 2 Unit
36 Spatula Pengaduk Semen Ionomer 2 Unit
37.1. Tang gigi anterior rahang atas dewasa 2 Unit
37.2. Tang gigi premolar rahang atas 2 Unit
37.3. Tang gigi molar kanan rahang atas 2 Unit
37.4. Tang gigi molar kiri rahang atas 2 Unit
37.5. Tang molar 3 rahang atas 2 Unit
37.6. Tang sisa akar gigi anterior rahang atas 2 Unit
37.7. Tang sisa akar gigi posterior rahang atas 2 Unit
37.8. Tang gigi anterior dan premolar rahang bawah 2 Unit
37.9. Tang gigi molar rahang bawah kanan/kiri 2 Unit
37.10. Tang gigi molar 3 rahang bawah 2 Unit
37.11. Tang sisa akar rahang bawah 2 Unit
38.1. Tang gigi anterior rahang atas 2 Unit
38.2. Tang molar rahang atas 2 Unit
38.3. Tang molar susu rahang atas 2 Unit
38.4. Tang sisa akar rahang atas 2 Unit
38.5. Tang gigi anterior rahang bawah 2 Unit
38.6. Tang molar rahang bawah 2 Unit
38.7. Tang sisa akar rahang bawah 2 Unit
39 Skalpel, Mata Pisau Bedah (Besar) 2 Unit
40 Skalpel, Mata Pisau Bedah (Kecil) 2 Unit
41 Skalpel, Tangkai Pisau Operasi 2 Unit
42 Silinder Korentang Steril 2 Unit
43 Tempat Alkohol (Dappen Glas) 2 Unit
44 Toples Kapas Logam dengan Pegas dan Tutup (50 x 70 mm) 2 Unit
45 Toples Pembuangan Kapas (50 x 75 mm) 2 Unit
46 Baki Logam Tempat Alat Steril 2 Unit
47 Lempeng Kaca Pengaduk Semen 2 Unit
C RUANG TINDAKAN :
1 Bed Side Monitor 2 Unit
2 Tensimeter 2 Unit
3 Stethoscope 2 Unit
6 Saturasi Oksigen 1 Unit
II Kamar Bedah
1 Meja Operasi (gynecologi) 2 Unit

2 Meja Operasi 2 Unit
3 Lampu Operasi 1 Unit
4 Mesin Anestesi 1 Unit
6 Monitor Pasien 1 Unit
7 EKG 1 Unit
8 Defibrilator 1 Unit
9 Ventilator 1 Unit
10 Oxygen Set (tabung oksigen+ Flow meter) 1 Unit
11 Electrosurgical unit 1 Unit
12 UV lamp for room sterilization 1 Unit
13 Vacum pump 1 Unit
17 ETT, LMA, Nasotracheal, dewasa dan pediatric 2 Unit
18 Laringoscope set (dewasa dan pediatric) 2 Unit
19 Mayo table stand mobile 2 Unit
20 Sectio caesarian set 2 Unit
21 Laparatomy set 2 Unit
22 Histerectomy set 2 Unit
23 Histeroscopy set 2 Unit
24 Embriotomi set 2 Unit
25 Inkubator bayi 2 Unit
26 Micro Surgery set 2 Unit
27 Patient Strecher 2 Unit
28 Utility Troly 2 Unit
30 Ambubag 2 Unit
31 Ring aplikator set 2 Unit
32 Kocher 2 Unit
33 Chirurgical pinset 2 Unit
34 Gunting lurus 2 Unit
35 Jarum lumbal 2 Unit
36 Needle holder 2 Unit
37 Tromol kasa 2 Unit
38 Pean lurus 2 Unit
39 Spekulum cocor bebek 2 Unit
40 Hak langen beck 2 Unit
41 Speculum Shim 2 Unit
42 Aligator 2 Unit
43 Mini Laparotomy Set 2 Unit
44 Folding Endurance Tester 2 Unit
45 Fenster Klem 2 Unit
46 Bak bengkok 2 Unit
47 Standar Infus 10 Unit
48 Autoclave 2 Unit
III Recovery Room
1 Monitor Pasien 1 Unit
2 Patient Strecher 1 Unit
4 Emergency trolley 1 Unit
5 Infusion pump 1 Unit
D RAWAT INAP
I Rawat Umum
1 Tempat Tidur dewasa 10 Unit
2 Tempat Tidur Anak 10 Unit
4 Termometer axial 10 Unit
6 Stetoskop dewasa 2 Unit
7 Stetoskop bayi dan anak 2 Unit
8 Tensimeter anaroid with stand 2 Unit
9 Tensimeter dengan manset untuk bayi dan anak 2 Unit
10 Timbangan Bayi 2 Unit
11 Timbangan Dewasa 2 Unit

12 Doppler 2 Unit
13 Reflex Hammer 2 Unit
17 EKG 1 Unit
22 Oxygen Set + Flow meter 15 Unit
23 Recusitation Set 4 Unit
24 Minor surgery instrument set 2 Unit
25 Emergency set 2 Unit
26 Nebulyzer 2 Unit
27 Vena section set 2 Unit
28 Lumbal needle Punction : 2 Unit
-Lumbal needle
-Duk Steril Bolong
30 UV Lamp 2 Unit
31 Branchard 2 Unit
32 Anatomische pinset 5 Unit
34 Glukometer 2 Unit
35 Chirurgical pinset 2 Unit
38 Buli-buli panas 3 Unit
39 Gilyserine Spuit 3 Unit
40 Irigator 2 Unit
41 Korentang 2 Unit
42 Nierbekhen 10 Unit
44 Sputum bak 10 Unit
45 Set Perawatan Luka 2 Unit
46 Emergency trolley 2 Unit
47 Oxygen set + Flowmeter 4 Unit
50 Pisfot dewasa 40 Unit
51 Bak instrument 25 Unit
52 Bak Catheter 25 Unit
53 Kursi Roda 10 Unit

1 Tempat tidur bayi 10 Unit
2 Stetoskop Bayi 3 Unit
3 Tensimeter dengan manset untuk bayi 3 Unit
5 Infant Incubator 2 Unit
6 Infant Warmer 1 Unit
7 Incubator Transpor 4 Unit
9 Baby Resusitasion Set 1 Unit
10 Baby Suction pump 1 Unit
E RADIOLOGI
1 Mobile X-Ray Unit 100mA 1 Unit
2 Vertical Bucky Stand 1 Unit
3 Peralatan protektif radiasi terdiri dari : 1 Paket
4 Perlengkapan proteksi radiasi terdiri dari : 1 Paket
,-Survei meter
-Film badge/TLD
5 Film viewer (doule film) 1 Unit

6 Cassette X-ray (Stand) 1 Unit
-18 x 24 cm 10 Unit
-24 x 30 cm 10 Unit
-30 x 40 cm 10 Unit
-35 x 35 cm 10 Unit
8 X-Ray Automatic Processing Film 1 Paket
9 Film marker 1 Paket
10 Film dryer 1 Paket
11 X - Ray Protection Screen with Lead Glass (untuk operator) 1 Paket
1 Mikroskop Binokuler 3 Unit
2 Waterbath 1 Unit
3 Sentrifus hematocrit 2 Unit
4 Mikrosentrifus 2 Unit
5 Fotometer / Spektrofotometer 2 Unit
6 Peralatan Laju Endap Darah (LED) 10 Unit
7 Hematologi Analyzer (Three Parts differential) 1 unit
8 Urine analyzer 2 unit
9 Reagensia 2 paket
10 Rapid Test : Gula Darah, Kolesterol 2 paket
11 Set pemeriksaan faeces 1 paket
12 Mikropipet 1 paket
13 Perlengkapan dan pengambilan Sample set 2 paket
14 Peralatan Gelas 1 paket
15 Medical Refrigerator 1 paket
16 Rak Tabung Reaksi 2 paket
17 Rak untuk pewarnaan 2 paket
G INSTALASI FARMASI
1 Cawan + Mortir Obat 2 paket
2 Timbangan gram dan miligram 1 paket
3 Refrigerator Medical Grade 1 paket
4 Meja peracikan obat (Work Table for Medicine) 2 paket
H RUANG GIZI/PANTRY
1 Kitchen Set 2 paket
2 Kulkas 2 paket
3 Kompor Gas 2 paket
4 Tabung Gas 2 paket
5 Timbangan 2 paket
6 Perlengkapan Masak Set 1 paket
7 Perlengkapan Makan Set 1 paket
8 Pantry Trolley 3 paket

1 Autoclave 1 paket
2 Washing Machine 1 paket
3 Instrument Cabinet 1 paket
4 Laundry Trolley, SS 2 paket
5 Meja setrika + Setrika 1 paket
J RUANG REKAM MEDIK

1 Filling Cabinet 2 Unit
2 Writing Desk 2 Unit
3 Chair 12 Unit
4 Komputer + Printer + UPS + Table 4 Unit
5 Lemari Arsip 4 Unit
K RUANG ADM/KANTOR
1 Filling Cabinet 2 Unit
2 Writing Desk 2 Unit
3 Chair 12 Unit
4 Komputer Desk Set 4 Unit
5 Lemari Arsip 4 Unit
TOTAL ANGGARAN
Ende, 14 Juli 2014
An. Kepala Dinas Keseha

Kabupaten Ende
Sekretaris
drg. Muna Fatma, M.K

Nip : 197109041999032
HOSPITAL FURNITURE
NO JENIS PERALATAN
1 Lemari Instrumen
2 Lemari obat kaca
3 Lemari Steril
4 Penyekat ruangan
5 Meja obat
7 Food Troly
9 Meja laboratorium
13 Meja Tulis
14 Kursi
15 Waskom mandi
HARGA SATUAN JUMLAH
3,122,667,500
391,661,500
20,500,000 41,000,000
35,500,000 106,500,000
3,225,750 9,677,250
2,994,750 8,984,250
49,500,000 99,000,000
817,500
54,500,000
55,317,500
63,250,000 126,500,000
2,731,006,000
16,500,000 99,000,000
20,500,000 82,000,000
3,225,750 12,903,000
3,225,750 12,903,000
3,225,000 12,900,000
3,225,000 12,900,000
3,225,000 12,900,000
45,000,000 90,000,000
75,000,000 150,000,000
115,000,000 115,000,000
75,000,000 225,000,000
75,000,000 225,000,000
95,000,000 285,000,000
4,500,000 450,000,000
125,000,000 375,000,000
75,000,000 225,000,000
6,750,000 67,500,000
5,750,000 34,500,000
75,000,000 150,000,000
3,750,000 37,500,000
3,750,000 37,500,000
750,000 7,500,000
550,000 5,500,000
550,000 5,500,000
6,089,050,000
1,863,900,000
15,000,000 30,000,000
125,000,000 250,000,000
45,000,000 90,000,000
35,000,000 70,000,000
75,000,000 150,000,000
3,225,000 6,450,000
3,225,000 6,450,000
3,225,000 6,450,000
3,225,000 6,450,000
20,500,000 41,000,000
175,000,000 350,000,000
17,500,000 35,000,000
110,500,000 221,000,000
75,500,000 151,000,000
45,500,000 91,000,000
45,500,000 91,000,000
45,500,000 91,000,000
75,000,000 150,000,000
750,000 7,500,000
550,000 1,100,000
750,000 1,500,000
2,750,000 5,500,000
5,750,000 11,500,000
1,458,100,000
15,000,000 30,000,000
35,000,000 70,000,000
75,000,000 150,000,000
7,500,000 22,500,000
49,500,000 99,000,000
3,225,000 6,450,000
3,225,000 6,450,000
3,225,000 6,450,000
115,000,000 115,000,000
45,000,000 90,000,000
750,000 3,750,000
75,000,000 225,000,000
125,000,000 375,000,000
75,000,000 225,000,000
2,750,000 5,500,000
2,750,000 5,500,000
2,750,000 5,500,000
2,750,000 5,500,000
5,750,000 11,500,000
1,145,300,000
15,000,000 30,000,000
3,225,000 9,675,000
3,225,000 9,675,000
3,225,000 6,450,000
7,500,000 22,500,000
7,500,000 22,500,000
7,500,000 22,500,000
7,500,000 22,500,000
7,500,000 22,500,000
7,500,000 15,000,000
115,000,000 115,000,000
75,000,000 150,000,000
95,000,000 190,000,000
95,000,000 190,000,000
14,115,000,000
75,000,000 150,000,000
75,000,000 150,000,000
2,750,000 5,500,000
5,750,000 11,500,000
983,450,000
16,500,000 49,500,000
3,225,000 6,450,000
7,500,000 15,000,000
7,500,000 15,000,000
7,500,000 15,000,000
45,000,000 90,000,000
75,000,000 150,000,000
75,000,000 150,000,000
7,500,000 15,000,000
35,000,000 70,000,000
125,000,000 250,000,000
75,000,000 150,000,000
750,000 7,500,000
638,300,000
295,000,000
75,000,000 150,000,000 175,000,000
120,000,000
30,000,000 30,000,000
35,000,000 70,000,000
25,000,000 25,000,000
20,000,000 20,000,000
343,300,000
50,000,000 50,000,000
45,000,000 45,000,000
45,000,000 45,000,000
65,000,000 65,000,000
45,000,000 45,000,000
25,000,000 25,000,000
15,000,000 15,000,000
100,000 300,000
200,000 400,000
190,000 380,000
-
850,000 1,700,000
190,000 380,000 5,450,000.00

75,000 150,000 -
65,000 130,000
190,000 380,000 2,000
310,000 620,000
310,000 620,000 10,900,000,000

310,000 620,000
190,000 380,000 3,815,000,000
390,000 780,000 14,715,000,000
2,750,000 5,500,000
50,000 100,000
2,750,000 5,500,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
190,000 380,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
850,000 1,700,000
850,000 1,700,000
850,000 1,700,000
850,000 1,700,000
390,000 780,000
390,000 780,000
390,000 780,000
390,000 780,000
290,000 580,000
4,734,150,000
554,900,000
115,000,000 230,000,000
3,225,000 6,450,000
3,225,000 6,450,000
125,000,000 250,000,000
45,000,000 45,000,000
17,000,000 17,000,000
3,754,250,000
115,000,000 230,000,000
115,000,000 230,000,000
115,000,000 115,000,000
115,000,000 115,000,000
45,000,000 45,000,000
115,000,000 115,000,000
115,000,000 115,000,000
115,000,000 115,000,000
115,000,000 115,000,000
115,000,000 115,000,000
115,000,000 115,000,000
65,000,000 65,000,000
65,000,000 65,000,000
125,000,000 250,000,000
125,000,000 250,000,000
15,000,000 30,000,000
15,000,000 30,000,000
75,000,000 150,000,000
75,000,000 150,000,000
75,000,000 150,000,000
75,000,000 150,000,000
75,000,000 150,000,000
75,000,000 150,000,000
75,000,000 150,000,000
75,000,000 150,000,000
15,000,000 30,000,000
7,500,000 15,000,000
7,500,000 15,000,000
4,500,000 9,000,000
1,750,000 3,500,000
1,750,000 3,500,000
1,750,000 3,500,000
2,750,000 5,500,000
375,000 750,000
1,750,000 3,500,000
1,750,000 3,500,000
1,750,000 3,500,000
5,750,000 11,500,000
1,750,000 3,500,000
75,000,000 150,000,000
1,750,000 3,500,000
1,750,000 3,500,000
1,750,000 3,500,000
1,750,000 17,500,000
75,000,000 150,000,000
425,000,000
75,000,000 75,000,000
75,000,000 75,000,000
75,000,000 75,000,000
75,000,000 75,000,000
125,000,000 125,000,000
2,335,585,000
16,000,000 160,000,000
10,500,000 105,000,000
150,000 1,500,000
150,000 1,500,000
7,500,000 22,500,000
3,225,000 6,450,000
3,225,000 6,450,000
3,225,000 6,450,000
3,225,000 6,450,000
3,225,000 6,450,000
3,225,000 6,450,000
16,000,000 32,000,000
1,160,000 2,320,000
45,000,000 45,000,000
115,000,000 115,000,000
125,000,000 250,000,000
6,750,000 101,250,000
6,750,000 27,000,000
55,000,000 110,000,000
75,000,000 150,000,000
75,000,000 150,000,000
95,000,000 190,000,000
55,000,000 110,000,000
27,000,000 54,000,000
35,500,000 71,000,000
375,000 1,875,000
15,000,000 30,000,000
395,000 790,000
95,000,000 190,000,000
500,000 1,500,000
750,000 2,250,000
950,000 1,900,000
1,750,000 3,500,000
750,000 7,500,000
750,000 7,500,000
15,000,000 30,000,000
15,000,000 30,000,000
6,750,000 27,000,000
1,750,000 70,000,000
2,750,000 68,750,000
2,750,000 68,750,000
5,750,000 57,500,000
1,369,806,000
16,000,000 160,000,000
3,226,000 9,678,000
3,226,000 9,678,000
150,000 450,000
110,000,000 220,000,000
45,000,000 45,000,000
175,000,000 700,000,000
95,000,000 95,000,000
65,000,000 65,000,000
65,000,000 65,000,000
950,600,000
265,000,000 265,000,000
15,000,000 15,000,000
175,000,000 175,000,000
75,000,000 75,000,000
45,000,000 45,000,000
115,000,000 115,000,000
15,000 150,000
15,000 150,000
15,000 150,000
15,000 150,000
75,000,000 75,000,000
55,000,000 55,000,000
55,000,000 55,000,000
75,000,000 75,000,000
1,040,950,000
15,000,000 45,000,000
56,000,000 56,000,000
8,000,000 16,000,000
14,000,000 28,000,000
14,000,000 28,000,000
1,000,000 10,000,000
293,000,000 293,000,000
110,000,000 220,000,000
100,000,000 200,000,000
2,750,000 5,500,000
2,750,000 2,750,000
2,750,000 2,750,000
2,750,000 5,500,000
2,750,000 2,750,000
125,000,000 125,000,000
175,000 350,000
175,000 350,000
50,497,500
2,750,000 5,500,000
7,747,500 7,747,500 7,745,000
15,750,000 15,750,000
10,750,000 21,500,000
529,500,000
50,750,000 101,500,000
25,750,000 51,500,000
20,750,000 41,500,000
5,000,000 10,000,000
5,000,000 10,000,000
150,000,000 150,000,000
150,000,000 150,000,000
5,000,000 15,000,000
115,000,000
45,000,000 45,000,000
45,000,000 45,000,000
7,500,000 7,500,000
5,000,000 10,000,000
7,500,000 7,500,000
247,000,000
35,000,000 70,000,000
7,500,000 15,000,000
7,500,000 90,000,000
10,500,000 42,000,000
7,500,000 30,000,000
247,000,000
35,000,000 70,000,000
7,500,000 15,000,000
7,500,000 90,000,000
10,500,000 42,000,000
7,500,000 30,000,000 -
###
Ende, 14 Juli 2014
An. Kepala Dinas Kesehatan

Kabupaten Ende
Sekretaris
drg. Muna Fatma, M.Kes

Nip : 197109041999032010

Alkes Rumah Sakit Pratama

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PERALATAN MEDIS DAN NON MEDIS

RUMAH SAKIT PRATAMA

II Resusitasi dan Tindakan

B. POLIKLINIK (RUANG RAWAT JALAN)

II Poliklinik Umum / Poliklinik Penyakit Dalam

III Poliklinik Kesehatan Anak

B Dental Instrument Set

III Recovery Room

II Ruang Bayi (gabung rawat inap)

I RUANG STERILISASI dan LOUNDRY

J RUANG REKAM MEDIK

2 Unit 63,250,000 126,500,000

2 Unit 3,225,750 6,451,500

1 Unit 30,000,000 30,000,000

1 Unit 35,000,000 35,000,000

1 Unit 25,000,000 25,000,000

1 Unit 50,000,000 50,000,000

2 Unit 2,750,000 5,500,000

2 Unit 190,000 380,000

2 Unit 390,000 780,000

2 Unit 390,000 780,000

2 Unit 27,000,000 54,000,000

1 Paket 75,000,000 75,000,000

1 Unit 45,000,000 45,000,000

10 Unit 15,000 150,000

II Resusitasi dan Tindakan

B. POLIKLINIK (RUANG RAWAT JALAN)

II Poliklinik Umum / Poliklinik Penyakit Dalam

III Poliklinik Kesehatan Anak

B Dental Instrument Set

III Recovery Room

II Ruang Bayi (gabung rawat inap)

I RUANG STERILISASI dan LOUNDRY

2 Unit 3,225,750 6,451,500

1 Unit 12,000,000 12,000,000

1 Unit 3,225,750 3,225,750

1 Unit 10,000,000 10,000,000

1 Unit 10,000,000 10,000,000

1 Paket 7,500,000 7,500,000

1 Unit 7,500,000 7,500,000

10 Unit 15,000 150,000

No Jenis Pelayanan Per Kebutuhan Peralatan Vol

7 Tensimeter Analog Standing 2

1.4. Eksavator Berbentuk Sendok Ukuran Besar (Spoon Excavator Large) 1

-Lead apron , tebal 0.25 ·0,5 mm Pb,

Sat Harga Satuan Jumlah

Unit 3,225,750 6,451,500

Unit 3,225,750 6,451,500

Unit 12,000,000 12,000,000

Unit 3,225,750 3,225,750

Unit 10,000,000 10,000,000

Unit 10,000,000 10,000,000

Unit 10,000,000 10,000,000

Unit 4,000,000 4,000,000

Unit 850,000 850,000

Unit 190,000 190,000

Paket 7,500,000 7,500,000

Unit 7,500,000 7,500,000

Unit 15,000 150,000

Ende, 14 Juli 2014

An. Kepala Dinas Kesehatan

drg. Muna Fatma, M.Kes

NO URAIAN KRITERIA PEMBANGUNAN RS PRATAMA

NO JENIS PERALATAN VOLUME SATUAN