Lampiran Spesifikasi Teknis Alkes 2011

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1 PO PONE NED D KID KID 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Setengah Setengah Kocher Kocher , SS 14 14 cm Alas Kaki untuk untuk Perlindungan Perlindungan Infeksi Infeksi Apron untuk untuk Perlindungan Perlindungan Infeksi Infeksi Bak Instrument Instrument Tertut Tertutup up 508 Bak Instrumen Instrumentt Tertutup Tertutup 509 B Bak Instrument Instrument Tertut Tertutup up 512 Benang Chromic Chromic 2.0 2.0 / 3.0 box isi 12 12 Spuit Disposible Disposible E 10 10 cc Spuit Disposible Disposible E 3 cc cc Endotrachea Endotracheall Tube 2.5 , 3, 4 Fetal Steto Stetoscope scope Pinard Pinard Gunting Gunting Episiotomy Episiotomy 14 14 cm Guntin Gunting g Kuku Kuku Gunting Gunting tali Pusat 16 16 cm Halogen Halogen Examinatio Examination n Lamp Features: Perfect Focusing Light Cool Beam Light Desktop Adjustable Flexible Arm Complete with dimmer Specification : Illuminance Bulb Lower Stand Arm

: : : :

-

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16 Handuk Handuk Keci Kecill 17 Hb Sahl Sahlii Specification : -

Castor Power Consumption Power

44.000 Lux :Halogen 12 Volt / 50 W Stainless steel 70 cm long flexible arm can be stayed in any desired position 5 Castors 2µ mobile stand with tube frame 95 cm high 50 Watt 110~220 V,50Hz/60Hz

Comparator Sahli pipette Sahli tube Rubber suction Stirring rod/Glass stic

18 Infuse Infuse set dewasa, dewasa, box/50 box/50 19 Infuse Infuse set Pediatric, Pediatric, box/50 box/50

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20 Inkubator Inkubator dengan Thermostat Thermostat Sederhana Sederhana Specifications Dimensi Konstuksi -

21 22 23 24 25 26 27

Finishing Heater Accessories

IV Catheter Catheter No. 18 G untuk Dewasa, Dewasa, box/50 box/50 IV Catheter Catheter No. 26 G untuk Bayi, Bayi, box/50 Jam / Timer Timer Jarum Jahit Jahit Tajam Tajam (9 & 11) / pak 12 Kacamata Kacamata / Google untuk Perlindungan Perlindungan Infeksi Infeksi Kain Bersih Bersih Dan Kering Kering Kateter Kateter Penghisap Penghisap Lendir 6, 6, 8, 10

: 65 x 45 x 120 cm : Plat MS, Pipa q, Kaca 5 mms MS Pintu Acrylic 5 mm : Cat Epoxy Powder Coating (MS) : 3 x 40 watt (bulb lamp) : - Thermostat 0-40° : - Thermometer : - Matras lapis vinyl 5 cm : - Roda 2"

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20 Inkubator Inkubator dengan Thermostat Thermostat Sederhana Sederhana Specifications Dimensi Konstuksi -

21 22 23 24 25 26 27 28 29 30 31 32

Finishing Heater Accessories

: 65 x 45 x 120 cm : Plat MS, Pipa q, Kaca 5 mms MS Pintu Acrylic 5 mm : Cat Epoxy Powder Coating (MS) : 3 x 40 watt (bulb lamp) : - Thermostat 0-40° : - Thermometer : - Matras lapis vinyl 5 cm : - Roda 2"

IV Catheter Catheter No. 18 G untuk Dewasa, Dewasa, box/50 box/50 IV Catheter Catheter No. 26 G untuk Bayi, Bayi, box/50 Jam / Timer Timer Jarum Jahit Jahit Tajam Tajam (9 & 11) / pak 12 Kacamata Kacamata / Google untuk Perlindungan Perlindungan Infeksi Infeksi Kain Bersih Bersih Dan Kering Kering Kateter Kateter Penghisap Penghisap Lendir 6, 6, 8, 10 Kateter Kateter Umbilical Umbilical 3 & 5 Klem Kasa Kasa dan tempat tempat Korentang Korentang Klem kelly kelly / Klem Kocher Kocher lurus lurus 14 cm Klem Klem Ovum Ovum Laringoscop Laringoscope e Infant Infant Spesifikasi : High quality laryngoscope stainless steel with standard or halogen lamp. Available with a selection of handles, spatula design and sizes. Consist of : 1 Handle & 3 Blades No. 0, 1, 2

33 Manekin (Pelfic Model + Boneka Bayi + Placenta ) 34 Masker Masker 3 Ply Ear Loop, Loop, box isi 50 35 Meja instrum instrument ent 2 Rak Rak Specification : Dimensi Konstruksi Finishing Accessories

: 70 x 43 x 80cm : Plat S/S, Pipa S/S : Polishing : Roda 2"

36 Meja Tindakan Tindakan Resusitasi Resusitasi Bayi Bayi Specification : Dimensi Konstruksi Finishing Accessories

: (90 - 125) x 50 x 80 cm : Plat MS, Pipa q, As MS : Cat Epoxy Powder Coating : Matras 5cm Lapis Vinyl

37 Meteran Meteran / Met Line 1.5 cm cm

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38 39 40 41

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Nald Holder 14 cm Naso gastric tube 6 & 8 Nelaton Catheter No. 14 Partus Bed Specifications Dimensi Konstruksi Finishing -

Accessories

42 Penghisap Lendir Dr. Lee

: 200 x 70 x 80 cm : Pipa S/S Ø, Pipa MS, As MS : - Cat Epoxy Powder Coating - Polishing : - 2 Penyangga Kaki - Waskom Ø 36 cm - Matras 5 cm lapis Vinyl - Posisi Punggung dapat diatur - Dapat dipisah menjadi 2 bagian - Foot Step

No.

38 39 40 41

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Nald Holder 14 cm Naso gastric tube 6 & 8 Nelaton Catheter No. 14 Partus Bed Specifications Dimensi Konstruksi Finishing -

42 43 44 45 46 47 48 49

Accessories

: 200 x 70 x 80 cm : Pipa S/S Ø, Pipa MS, As MS : - Cat Epoxy Powder Coating - Polishing : - 2 Penyangga Kaki - Waskom Ø 36 cm - Matras 5 cm lapis Vinyl - Posisi Punggung dapat diatur - Dapat dipisah menjadi 2 bagian - Foot Step

Penghisap Lendir Dr. Lee Pengikat Tali pusat, box /50 Pinset Anatomi 14 cm Pinset Chirugis Pita pengukur lengan Plastik untuk Alas Tidur Plester non Woven 5x5 M Pocket Doppler Features: Hi.Bebe is pocket size doppler for Obsterician, Midwives, and Pregnant Women. Compact and Light High-Sensitivity Doppler Probe Ergonomic Design Large-Display & Clean Sound Easy to Use Low Power Consumption Long Time to Continuous Use ( 6 hours) Specification : Display : LCD (Low battery & Signal Quality display) Heart Rate Range : 50 ~ 240 bpm Accuracy : ± 2% Ultrasound Frequency : 2 MHz Ultrasound Intensity : < 10 mW/cm² Speaker Output Power : 1.2 W (Built-in Loudspeaker) Audio output for earphone : Auto Shut-off : 5 Minutes Auto Shut-off on signal : 1 Minutes Power : 1.5 V Battery x2 (Type:AA) Sensitivity : 10 ~ 12 Weeks Onward PC Interface : Sound card Battery Life : 360 Minutes

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50 Resusitator Dewasa Bahan Polysufone Specification : Max. tidal volume of approx 1300 ml Patient connector: 22/15 mm (ISO) Weight with patient valve: 415 g Size: (Length x Diameter) 275 x 135 mm Volume O2 Reservoir: approx. 1500 ml Expiratory connector: 30 mm 51 Resusitator Neonatus Bahan Polysufone Specification : Max. tidal volume of approx 300 ml Patient connector: 22/15 mm (ISO) Weight with patient valve: 190 g Size: (Length x Diameter) 265 x 85 mm Volume oxygen reservoir tube: 100 ml

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50 Resusitator Dewasa Bahan Polysufone Specification : Max. tidal volume of approx 1300 ml Patient connector: 22/15 mm (ISO) Weight with patient valve: 415 g Size: (Length x Diameter) 275 x 135 mm Volume O2 Reservoir: approx. 1500 ml Expiratory connector: 30 mm 51 Resusitator Neonatus Bahan Polysufone Specification : Max. tidal volume of approx 300 ml Patient connector: 22/15 mm (ISO) Weight with patient valve: 190 g Size: (Length x Diameter) 265 x 85 mm Volume oxygen reservoir tube: 100 ml Expiratory connector: 30 mm 52 53 54 55

Sarung tangan DTT/ Steril, Pasang 7, 7.5 Sarung tangan Panjang untuk Manuli Plasenta 6.5, 7 @ 5psg Sarung tangtan Heavy Duty ps Set Ekstraksi Vakum Spesifikasi : Completed with 3 cup various size baby extrator manual pump & Handoperated vacuum device for suction cups. Detail of Instrument : Hanger (Acrylic) for bottle & pump Vacuum-gauge with straight connector Connector angled Ditto, screw cap for elbow pipe Rubber-plug with 3 holes Vacuum bottle of glass Vacuum pump ERN silicone rubber tubing 75cm long, for pump Ditto, 150cm long, for vacuum cup & rubber cup Vacuum cup S.S Ø 40mm Ditto Ø 50mm Ditto Ø 60mm Traction handle with hook Rubber cup Ø 50mm (yellow) Ditto Ø 60mm (blue)

56 Sikat Kuku 57 Speculum SIMS 58 Sphygmomanometer Hg + Manset Anak A Traditional Desk Model Mercurial sphygmomanometer

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This model features precision and easy reading up to 300 mmHg scale. A locking reservoir prevents mercury spillage during transportation. It comes complete with calibrated nylon cuff, plastic connector and standard air release valve. The unit assembled into housing with rugged die cast alloy in oyster white texture baked powder coating for nice presentation. Three years of calibration warranty. 59 Standard Infus Spesifikasi : -

Dimensi Tinggi

: 60 x (105 - 185) cm (Adjustable)

-

Konstruksi

-

Finishing Accessories

: - Pipa MS, Pipa S/S, As MS - Kaki 5 plastik : Cat Epoxy Powder Coating : Roda 2"

1 1 1 1 1 2 1 1 1 1 1 1 1 1 1

Pce Pce Pce Pce Pce Pcs Pce Pce Pce Pce Pce Pce Pce Pce Pce

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This model features precision and easy reading up to 300 mmHg scale. A locking reservoir prevents mercury spillage during transportation. It comes complete with calibrated nylon cuff, plastic connector and standard air release valve. The unit assembled into housing with rugged die cast alloy in oyster white texture baked powder coating for nice presentation. Three years of calibration warranty. 59 Standard Infus Spesifikasi : -

Dimensi Tinggi

: 60 x (105 - 185) cm (Adjustable)

-

Konstruksi

-

Finishing Accessories

: - Pipa MS, Pipa S/S, As MS - Kaki 5 plastik : Cat Epoxy Powder Coating : Roda 2"

60 Tong / Ember dengan Kran 61 Stetoscope Duplex Bayi Stainless Steel Stethescope Featuring the Superior accoustic and rugged durability. He chestpiece is precisely machined to exacting tolerance from surgical Stainless Steel for outstanding performance. The color coordinate non-child ring and diapraghm retaining ring provide excellent patient comfort. The unit comes in a foam lined box with two extra set of soft sealing eartips and one diapraghm 62 Stetoscope Duplex Dewasa Stainless Steel Stethescope Featuring the Superior accoustic and rugged durability. He chestpiece is precisely machined to exacting tolerance from surgical Stainless Steel for outstanding performance. The color coordinate non-child ring and diapraghm retaining ring provide excellent patient comfort. The unit comes in a foam lined box with two extra set of soft sealing eartips and one diapraghm 63 Stilet No. 1 untuk Pemasangan EET 64 Sungkup Resusitator Neonatus Spesifikasi : Neonate Resuscitator, 220 ml Single shutter patient valve Valve with 40 cm H 2O pressure limitation -

Silicone Face Mask, size 00 Oxygen reservoir Direction for use Supllied in pouch & carton

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No.

65 Tabung Oxygen 1m3 + Regulator + Troley + Nasal Specification : Complete with Oxygen cylinder Material Finishing Trolley : Features Construction Finishing Castor 66 Thermometer Klinis Hg 67 Tempat tidur Periksa Spesifikasi : Dimensi Konstruksi

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: : : :

Nasal canula, Regulator oxygen 1 m3 Steel pipes Powder coating

: : : :

For 1 m Steel pipe Powder coating 4" castors

3

: 185 x 65 x 80 cm : Pipa S/S, Pipa MS, As MS

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65 Tabung Oxygen 1m3 + Regulator + Troley + Nasal Specification : Complete with Oxygen cylinder Material Finishing Trolley : Features Construction Finishing Castor 66 Thermometer Klinis Hg 67 Tempat tidur Periksa Spesifikasi : Dimensi Konstruksi Finishing -

Accessories

: : : :

Nasal canula, Regulator oxygen 1 m3 Steel pipes Powder coating

: : : :

For 1 m Steel pipe Powder coating 4" castors

3

: 185 x 65 x 80 cm : Pipa S/S, Pipa MS, As MS : - Cat Epoxy Powder Coating - Polishing : - Matras busa 5 cm lapis vinyl - Bagian Kepala dapat diatur s/d 70° - Foot Step

68 Three Way Stop Cook 69 Timbangan bayi 20 Kg + Baki Features: Can be used for both baby and infant (about 6 years old) You can use on a flat surface It has a wide view with fine graduation Specification: Capacities Gross weight Net weight Graduation Measurement Color Certificate Registration

: : : : : : : :

70 Timbangan Injak Dewasa Specifications: Capacity Graduation Dimension (L x W x H)

: 120 kg / 260 lb : 1000 g (1 kg / 2 lbs) : 25.7 x 26.3 x 5 cm

20 kg 4 kg 3 kg 50 gram or 2 oz Approx 57.5 cm x 33.5 cm x 19 cm Pink, blue, yellow (on request) ISO 9001, CE 123, TUV Departemen Kesehatan

71 Vakum Aspirasi manual untuk Paska Keguguran Specifications:

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Complete vacuum delevery system 1 pc omni cup,60 cm 2 pcs Ceiling, 40 cm 6 pcs silicone rubber, 17 cm Ø 0.5 cm 2 pcs o ring for trap cup 2 pcs handlewith indikator 1 pc Brushes, 16 cm 1 pc kawat pengait 1 pc DVD 1 pc Case, 21x13x6.5 cm

72 Waskom Stainless Steel 40 cm 73 IUD Kit terdiri dari : Iodine Cup Forceps, Schroeder Tenaculum Forceps, IUD Removal Alligator Jow

1 Bh 1 Bh 1 Bh

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Complete vacuum delevery system 1 pc omni cup,60 cm 2 pcs Ceiling, 40 cm 6 pcs silicone rubber, 17 cm Ø 0.5 cm 2 pcs o ring for trap cup 2 pcs handlewith indikator 1 pc Brushes, 16 cm 1 pc kawat pengait 1 pc DVD 1 pc Case, 21x13x6.5 cm

72 Waskom Stainless Steel 40 cm 73 IUD Kit terdiri dari : Iodine Cup Forceps, Schroeder Tenaculum Forceps, IUD Removal Alligator Jow Forceps, Sponge Foster Straight Scissor Operating Mayo CVD IUD String Retrivver Uterine Sonde Sims Speculum Vagina, Graves Large Speculum Vagina, Graves Medium Handschoen No. 6.5 Handschoen No. 7 Utility Tray with Cover, SS Sphygmomanometer A Traditional Desk Model Mercurial sphygmomanometer This model features precision and easy reading up to 300 mmHg scale. A locking reservoir prevents mercury spillage during transportation. It comes complete with calibrated nylon cuff, plastic connector and standard air release valve. The unit assembled into housing with rugged die cast alloy in oyster white texture baked powder coating for nice presentation. Three years of calibration warranty.

Bh Bh Bh Bh Bh Bh Bh Bh Bh Bh Bh Bh Bh

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Stetoscope Duplex Dual Head Stethocope Featuring fine accoustic reponse and superlight design makes extraordinary comfortable. The adult chestpiece precisely machined to exacting tolerance from lightweight aluminium. Double leaf internal spring binaurals are fixed at a 15° angle for greater comfort. The unit comes with an extra set soft sealing eartips and spare diapraghm.

1 Bh

-

Fixing Clamp Tas Bidan

1 Bh 1 Bh

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74 Ari timer Standard Unicef

75 76 77 78 79 80 81 82 83 84 85

1 1 1 1 1 1 1 1 1 5 5 1 1

SET UMBILICAL (UNTUK NEONATAL) Kocher Artery Klem str, 10 cm Kocher Artery Klem cvd, 10 cm Pinset Chirugis 10 cm Gunting Operasi Scaper Handle no. 3 Small Needle Holder Kom Kecil 8 cm Curved Mosquito hemostat Iris Forceps Curved Non Iris Forceps Pinset bengkok kecil SET VENA SECTIO

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74 Ari timer Standard Unicef

75 76 77 78 79 80 81 82 83 84 85

SET UMBILICAL (UNTUK NEONATAL) Kocher Artery Klem str, 10 cm Kocher Artery Klem cvd, 10 cm Pinset Chirugis 10 cm Gunting Operasi Scaper Handle no. 3 Small Needle Holder Kom Kecil 8 cm Curved Mosquito hemostat Iris Forceps Curved Non Iris Forceps Pinset bengkok kecil

86 87 88 89 90 91 92 93 94 95 96 97

SET VENA SECTIO Mayo hegar Needle Holder 14 cm Baby Mosquito str 10 cm Baby Mosquito cvd 10 cm Langenback Hak Pinset Chirugis 10 cm Forceps Splinter 11.5 cm Pinset Anatomi 10 cm Gunting Operasi tajam, 9 cm str Gunting Operasi tajam, 9 cm cvd Knife Handle No. 3 Pisau Bisturi No. 15 Kom Kecil 8 cm

2 POSKESDES KID 1

Bidan Kit Terdiri dari : -

Appron Plastic Tebal Alat penghisap lendir Ari sound timer Autoclic device Baby scale 7 kg + celana Bak Instrument 509 Blood lanccete 28G Bowl Metal 12 cm Catgut 2/0 1,5 m Kateter disposible no 12 Duk kain katun 60 x 60 Funduscope Kayu Gunting Episotomi 14 cm

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Gunting operasi lurus 14 cm ta/tu Gunting tali pusat 16 cm HB Talquist Book Hecting nald GR 12 Hecting nald Gt 12 Infusion set Dewasa Infusion set Pediatric IV. Catheter No. 18 G IV. Catheter No. 26 G Jarum Diposible no 23 G box50's Kocher Lurus 16 cm, Ss Meteran / Metline 150 cm Mucous penghisap lendir Nasogatric tube no.14 Needle holder mayo 14 cm Nelaton Chateter No.12 Neerbiken 20 cm, SS

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Gunting operasi lurus 14 cm ta/tu Gunting tali pusat 16 cm HB Talquist Book Hecting nald GR 12 Hecting nald Gt 12 Infusion set Dewasa Infusion set Pediatric IV. Catheter No. 18 G IV. Catheter No. 26 G Jarum Diposible no 23 G box50's Kocher Lurus 16 cm, Ss Meteran / Metline 150 cm Mucous penghisap lendir Nasogatric tube no.14 Needle holder mayo 14 cm Nelaton Chateter No.12 Neerbiken 20 cm, SS Pincet anatomy 14 cm SS Pincet Chirugis 14 cm Pincet chirugis 18 cm Ambu Bag Infant Specification : - Max. tidal volume of approx 300 ml - Patient connector: 22/15 mm (ISO) - Weight with patient valve: 190 g - Size: (Length x Diameter) 265 x 85 mm - Volume oxygen reservoir tube: 100 ml - Expiratory connector: 30 mm

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Sarung Tangan Bedah No. 6,5 ; 7 ; 7,5 Selimut Bayi Senter Besar Setengah Kocher SS 14 cm Sheet Plastic tebal Sikat tangan Dengan Nylon Tensimeter Aneroid The Professional Sphygmomanometer with Variety Color selection Designed in eight fashion colors cuff that match to your office, department or uniform. 300mmHg no pin stop manometer with black enamel finish and 3 years calibration warranty ±3mmHg. Specially packed in oversized matching nylon carrying case provides room to cary additional item.

-

Spiritus Sumbu Spuit Disposible 1cc Spuit Disposible 3 cc Stetoscope Duplex dewasa Dual Head Stethocope

Pa e 9 of 13

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Featuring fine accoustic reponse and superlight design makes extraordinary comfortable. The adult chestpiece precisely machined to exacting tolerance from lightweight aluminium. Double leaf internal spring binaurals are fixed at a 15° angle for greater comfort. The unit comes with an extra set soft sealing eartips and spare diapraghm. -

Thermometer Bayi Rektal Thermometer Digital Features compact size and easy to read display. Measures in 60 seconds and includes the beeper function to indicate peak temperature. Memory recalls for last reading and auto shut down function. One year limited warranty

-

Timbangan Bayi 20 kg Features: - Can be used for both baby and infant (about 6 years old)

No.

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Featuring fine accoustic reponse and superlight design makes extraordinary comfortable. The adult chestpiece precisely machined to exacting tolerance from lightweight aluminium. Double leaf internal spring binaurals are fixed at a 15° angle for greater comfort. The unit comes with an extra set soft sealing eartips and spare diapraghm. -

Thermometer Bayi Rektal Thermometer Digital Features compact size and easy to read display. Measures in 60 seconds and includes the beeper function to indicate peak temperature. Memory recalls for last reading and auto shut down function. One year limited warranty

-

Timbangan Bayi 20 kg Features: - Can be used for both baby and infant (about 6 years old) - You can use on a flat surface - It has a wide view with fine graduation

Specification: -

2 3 4 5 6

Capacities Gross weight Net weight Graduation Measurement Color Certificate Registration

: : : : : : : :

Timbangan Dewasa Specifications: - Capacity - Graduation - Dimension (L x W x H)

: 120 kg / 260 lb : 1000 g (1 kg / 2 lbs) : 25.7 x 26.3 x 5 cm

Ukuran lengan ibu hamil Umbilical Cord klaem Tas Bidan Dari Kulit Tas Partus kit Wing Needle 23 & 25 G

Palu pengukur reflek Pelvimeter Obstetric untuk pengukur panggul Speculum vagina, cocor bebek, besar Speculum vagina, cocor bebek, kecil Speculum vagina, cocor bebek, sedang

Pa e 10 of 13

No.

7

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Stethoscope Dual Head Stethocope Featuring fine accoustic reponse and superlight design makes extraordinary comfortable. The adult chestpiece precisely machined to exacting tolerance from lightweight aluminium. Double leaf internal spring binaurals are fixed at a 15° angle for greater comfort. The unit comes with an extra set soft sealing eartips and spare diapraghm.

8 Stethoscope janin Allumanium 9 Sudip lidah logam, 16 cm ss 10 Tensimeter air raksa A Traditional Desk Model Mercurial sphygmomanometer This model features precision and easy reading up to 300 mmHg scale. A locking reservoir prevents mercury spillage during transportation. It comes complete with calibrated nylon cuff, plastic connector and standard air release valve. The unit assembled into housing with rugged die cast alloy in oyster

20 kg 4 kg 3 kg 50 gram or 2 oz Approx 57.5 cm x 33.5 cm x 19 cm Pink, blue, yellow (on request) ISO 9001, CE 123, TUV Departemen Kesehatan

No.

7

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Stethoscope Dual Head Stethocope Featuring fine accoustic reponse and superlight design makes extraordinary comfortable. The adult chestpiece precisely machined to exacting tolerance from lightweight aluminium. Double leaf internal spring binaurals are fixed at a 15° angle for greater comfort. The unit comes with an extra set soft sealing eartips and spare diapraghm.

8 Stethoscope janin Allumanium 9 Sudip lidah logam, 16 cm ss 10 Tensimeter air raksa A Traditional Desk Model Mercurial sphygmomanometer This model features precision and easy reading up to 300 mmHg scale. A locking reservoir prevents mercury spillage during transportation. It comes complete with calibrated nylon cuff, plastic connector and standard air release valve. The unit assembled into housing with rugged die cast alloy in oyster white texture baked powder coating for nice presentation. Three years of calibration warranty. 11 Termometr Bayi Features compact size and easy to read display. Measures in 60 seconds and includes the beeper function to indicate peak temperature. Memory recalls for last reading and auto shut down function. One year limited warranty 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Alat Pemasang IUD alat Pengait IUD Gunting bedah standard, lurus ujung tajam/tajam Gunting bedah standard, lurus ujung tajam/tumpul Gunting bedah standard, lurus ujung tumpul/tumpul Kateter karet, nelaton, no. 10 (steril) Kateter karet, nelaton, no. 14 (steril) Kateter logam untuk wanita, no. 12 Klem tampon uterus (Bozemen), 25 cm Klem / Penjepit porsio (Schroder), 25 cm Korentang lengkung, penjepit alat steril (Cheatle), 23 cm Korentang penjepit spong (Foerster) Pincet anatomis 14.5 cm Pincet anatomis 18 cm Semprit gliserin ss, 30cc Sonde uterus, penduga Sarung tanga 6,5 ; 7 & 7.5 Bak logam tempat alat steril SS Mangkok untuk larutan Silinder korentang steril 17 cm

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32 Torniquete karet 33 Waskom bengkok SS (Nierbeken 12 cm) 34 Doppler Features: Hi.Bebe is pocket size doppler for Obsterician, Midwives, and Pregnant Women. Compact and Light High-Sensitivity Doppler Probe Ergonomic Design Large-Display & Clean Sound Easy to Use Low Power Consumption Long Time to Continuous Use ( 6 hours) Specification : Display : LCD (Low battery & Signal Quality display) Heart Rate Range : 50 ~ 240 bpm Accuracy : ± 2% Ultrasound Frequency : 2 MHz

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32 Torniquete karet 33 Waskom bengkok SS (Nierbeken 12 cm) 34 Doppler Features: Hi.Bebe is pocket size doppler for Obsterician, Midwives, and Pregnant Women. Compact and Light High-Sensitivity Doppler Probe Ergonomic Design Large-Display & Clean Sound Easy to Use Low Power Consumption Long Time to Continuous Use ( 6 hours) Specification : Display : LCD (Low battery & Signal Quality display) Heart Rate Range : 50 ~ 240 bpm Accuracy : ± 2% Ultrasound Frequency : 2 MHz Ultrasound Intensity : < 10 mW/cm² Speaker Output Power : 1.2 W (Built-in Loudspeaker) Audio output for earphone : Auto Shut-off : 5 Minutes Auto Shut-off on signal : 1 Minutes Power : 1.5 V Battery x2 (Type:AA) Sensitivity : 10 ~ 12 Weeks Onward PC Interface : Sound card Battery Life : 360 Minutes 35 Timbangan Injak Specifications: -

Dewasa Capacity Graduation Dimension (L x W x H)

: 120 kg / 260 lb : 1000 g (1 kg / 2 lbs) : 25.7 x 26.3 x 5 cm

36 Timbangan Bayi Features: - Can be used for both baby and infant (about 6 years old) - You can use on a flat surface - It has a wide view with fine graduation Specification: -

Capacities Gross weight Net weight Graduation Measurement Color Certificate Registration

: : : : : : : :

20 kg 4 kg 3 kg 50 gram or 2 oz Approx 57.5 cm x 33.5 cm x 19 cm Pink, blue, yellow (on request) ISO 9001, CE 123, TUV Departemen Kesehatan

Pa e 12 of 13 No.

Nama Barang

Mengetahui : Kepala Dinas Kesehatan Kabupaten Kupang

dr. M . B . Ataupah Pembina Tk. I NIP : 196402040996031001

Pejabat Pembuat Komitmen

Theresia Ili, S.Sos Penata NIP : 196604041987032«

No.

Nama Barang

Mengetahui : Kepala Dinas Kesehatan Kabupaten Kupang

Pejabat Pembuat Komitmen

dr. M . B . Ataupah Pembina Tk. I NIP : 196402040996031001

Theresia Ili, S.Sos Penata NIP : 196604041987032«

Pa e 13 of 13

I

POLIKLINIK SET 1 Diagnostik set lengkap Specifications : Ophthalmoscope. Xenon :  Precision ground lenses provide 24 dioptre setting, from +ve: 0,1 to 6 then 8,10, 12, 15, 20 and 40 to -ve: 0,1 to 6 then 8, 10, 15, 20, and 25. The May wheel containing the lenses can be rotated in either clockwise or anti clockwise direction.  Otoscopes. Xenon : The otoscope head has universal fifting, which allow a myriad of attachments to be used for Aural and Nasal examinations.  Laryngeal Stems Various attachments such as mirrors and tongue depressors can be attached to the laryngeal stem Handles  Orion handles contain real working Rheostats. To turn the power on / off, defress the red button and rotate the Rheostat. The handles are made to universal fiftings and accept all components in the Orion Diagnostic range. The Orion handles accept 2 x "C" batteries. We recommend "Alkaline" batteries for all our Diagnostic system for Optimum performance.

I

POLIKLINIK SET 1 Diagnostik set lengkap Specifications : Ophthalmoscope. Xenon :  Precision ground lenses provide 24 dioptre setting, from +ve: 0,1 to 6 then 8,10, 12, 15, 20 and 40 to -ve: 0,1 to 6 then 8, 10, 15, 20, and 25. The May wheel containing the lenses can be rotated in either clockwise or anti clockwise direction.  Otoscopes. Xenon : The otoscope head has universal fifting, which allow a myriad of attachments to be used for Aural and Nasal examinations.  Laryngeal Stems Various attachments such as mirrors and tongue depressors can be attached to the laryngeal stem Handles  Orion handles contain real working Rheostats. To turn the power on / off, defress the red button and rotate the Rheostat. The handles are made to universal fiftings and accept all components in the Orion Diagnostic range. The Orion handles accept 2 x "C" batteries. We recommend "Alkaline" batteries for all our Diagnostic system for Optimum performance. 2 Doppler Features: Specification : -

Hi.Bebe is pocket size doppler for Obsterician, Midwives, and Pregnant Women. Compact and Light High-Sensitivity Doppler Probe Ergonomic Design Large-Display & Clean Sound Easy to Use Low Power Consumption Long Time to Continuous Use ( 6 hours) Display Heart Rate Range Accuracy Ultrasound Frequency Ultrasound Intensity Speaker Output Power Audio output for earphone Auto Shut-off Auto Shut-off on signal Power Sensitivity PC Interface Battery Life

3 EKG 3 chanel Specifications Lead Input circuit Input Impedance lnput circuit current Calibration voltage Polarizing voltage Sensitivity Filter

Time constant Noise level Frequency response CMRR Sampling rate A,/D converter Recording paper Operation mode l Recorder Baseline control Rhythm lead Signal input ECG output Power requiremen Packaging Net/Gross weight

: : : : : : : : : : : : :

LCD (Low battery & Signal Quality display) 50 ~ 240 bpm ± 2% 2 MHz < 10 mW/cm² 1.2 W (Built-in Loudspeaker) 5 Minutes 1 Minutes 1.5 V Battery x2 (Type:AA) 10 ~ 12 Weeks Onward Sound card 360 Minutes

: : : :

Standard 12 leads simultaneous acquisition lsolated input circuit with protection against pacemaker and defibrillator  50 M  0.1 µA

: : : : : : : : : : : : : : : : : : : : : : : : : :

1mV ± 3% ± 500mV 2.5, 5, 10, .20mm/mv±3% AC : 50Hz ('- 20dB) EMG :3 5-45H2( -3dB) D FT :  0.45Hz >3.2s < 15 µ Vp-p 0.05 - 150 Hz > 60dB, > 100dB (AC filter in use) 1ms 12bit Roll:6 3mmx20m (30m) Zip-fold : 63mmx75mm( 20m) Manual/Auto High resolution thermal array recorder Automatice limination of baseline drift Automatic adjustment of baseline position Selectable among standard 12 leads 10mm/v ±5%; single ended input  100k 1V/mV ±5%; single ended input  100k AC: 100-240V, 50/60Hz 40VA DC: Built-in rechargeable Li-ion batterv 360Lx315Wx200H (mm) for 1 set 643Lx370WX410H (mm) for 4 sets 2kg/4.8kg

Calibration voltage Polarizing voltage Sensitivity Filter

: : : : : : : : : : : : : : : : : : : : : : : : : : :

Time constant Noise level Frequency response CMRR Sampling rate A,/D converter Recording paper Operation mode l Recorder Baseline control Rhythm lead Signal input ECG output Power requiremen Packaging Net/Gross weight Safety level

1mV ± 3% ± 500mV 2.5, 5, 10, .20mm/mv±3% AC : 50Hz ('- 20dB) EMG :3 5-45H2( -3dB) D FT :  0.45Hz >3.2s < 15 µ Vp-p 0.05 - 150 Hz > 60dB, > 100dB (AC filter in use) 1ms 12bit Roll:6 3mmx20m (30m) Zip-fold : 63mmx75mm( 20m) Manual/Auto High resolution thermal array recorder Automatice limination of baseline drift Automatic adjustment of baseline position Selectable among standard 12 leads 10mm/v ±5%; single ended input  100k 1V/mV ±5%; single ended input  100k AC: 100-240V, 50/60Hz 40VA DC: Built-in rechargeable Li-ion batterv 360Lx315Wx200H (mm) for 1 set 643Lx370WX410H (mm) for 4 sets 2kg/4.8kg Class l, Type CF

4 Tensi Meter Manset Anak The Professional Sphygmomanometer with Variety Color selection Designed in eight fashion colors cuff that match to your office, department or uniform. 300mmHg no pin stop manometer with black enamel finish and 3 years calibration warranty ±3mmHg. Specially packed in oversized matching nylon carrying case provides room to cary additional item. 5 microtoise 6 stetoskop Dual Head Stethocope Featuring fine accoustic reponse and superlight design makes extraordinary comfortable. The adult chestpiece precisely machined to exacting tolerance from lightweight aluminium. Double leaf internal spring binaurals are fixed at a 15° angle for greater comfort. The unit comes with an extra set soft sealing eartips and spare diapraghm. 7 Tempat tidur periksa Spesifikasi : Dimensi Konstruksi Finishing -

Accessories

: 185 x 65 x 80 cm : Pipa S/S, Pipa MS, As MS : - Cat Epoxy Powder Coating - Polishing : - Matras busa 5 cm lapis vinyl - Bagian Kepala dapat diatur s/d 70° - Foot Step

8 Tensi meter air raksa A Traditional Desk Model Mercurial sphygmomanometer This model features precision and easy reading up to 300 mmHg scale. A locking reservoir prevents mercury spillage during transportation. It comes complete with calibrated nylon cuff, plastic connector and standard air release valve. The unit assembled into housing with rugged die cast alloy in oyster white texture baked powder coating for nice presentation. Three years of calibration warranty. 9 Termometer klinik/ digital Features compact size and easy to read display. Measures in 60 seconds and includes the beeper function to indicate peak temperature. Memory recalls for last reading and auto shut down function. One year limited warranty 10 tes buta warna Ishihara 11 Timbangan dewasa Specifications: Capacity

: 120 kg / 260 lb

- Bagian Kepala dapat diatur s/d 70° - Foot Step

8 Tensi meter air raksa A Traditional Desk Model Mercurial sphygmomanometer This model features precision and easy reading up to 300 mmHg scale. A locking reservoir prevents mercury spillage during transportation. It comes complete with calibrated nylon cuff, plastic connector and standard air release valve. The unit assembled into housing with rugged die cast alloy in oyster white texture baked powder coating for nice presentation. Three years of calibration warranty. 9 Termometer klinik/ digital Features compact size and easy to read display. Measures in 60 seconds and includes the beeper function to indicate peak temperature. Memory recalls for last reading and auto shut down function. One year limited warranty 10 tes buta warna Ishihara 11 Timbangan dewasa Specifications: Capacity Graduation Dimension (L x W x H) 12 Sikat tangan 13 Lampu senter 14 Lemari peralatan Spesifikasi Dimensi Konstruksi Finishing Accessories 15 Meja instrumen Spesifikasi Dimensi Konstruksi Finishing -

Accessories

16 17 18 19 20

silinder korentang steril torniket karet tromol kasa 25 x 120 cm waskom bengkok waskom cuci

2

Gynbed -

Dimensi Konstruksi Finishing

-

Accessories

-

Optional

: 120 kg / 260 lb : 1000 g (1 kg / 2 lbs) : 25.7 x 26.3 x 5 cm

: 70 x 40 x 170 cm : Plat MS, Kaca 5 mm : Cat Epoxy Powder Coating : 3 shelf (Adjustable High)

: 60 x 40 x 80 cm : Pipa q : - Cat Epoxy Powder Coating - Polishing : - Roda 2" - Kaca 5 mm

: 125 x 65 x 75 cm : Plat MS, Pipa Ø S/S, As MS : - Cat Epoxy Powder Coating - Polishing : - 2 Penyangga Kaki - Waskom Ø 36 cm - Matras busa 5 cm lapis Vinyl - Posisi Punggung/kepala dapat diatur : Foot Step

3 Inkubator Specifications -

Dimensi Konstuksi

-

Finishing Heater Accessories

4 Sterilisator

: 65 x 45 x 120 cm : Plat MS, Pipa q, Kaca 5 mms MS Pintu Acrylic 5 mm : Cat Epoxy Powder Coating (MS) : 3 x 40 watt (bulb lamp) : - Thermometer : - Matras lapis vinyl 5 cm : - Roda 2"

2

Gynbed -

Dimensi Konstruksi Finishing

-

Accessories

-

Optional

: 125 x 65 x 75 cm : Plat MS, Pipa Ø S/S, As MS : - Cat Epoxy Powder Coating - Polishing : - 2 Penyangga Kaki - Waskom Ø 36 cm - Matras busa 5 cm lapis Vinyl - Posisi Punggung/kepala dapat diatur : Foot Step

3 Inkubator Specifications -

Dimensi Konstuksi

-

Finishing Heater Accessories

: 65 x 45 x 120 cm : Plat MS, Pipa q, Kaca 5 mms MS Pintu Acrylic 5 mm : Cat Epoxy Powder Coating (MS) : 3 x 40 watt (bulb lamp) : - Thermometer : - Matras lapis vinyl 5 cm : - Roda 2"

4 Sterilisator Specifications -

Model No Body dimension (LxWxH) Packing Dimensions ( LxWxH) Reted Capacity Rated Voltage Rated Frequency Rated Power of heating tube Rack in upper cabinet Rack in lower cabinet Temperature in lower cabinet Ozone chroma Ozone time G. Weight

: ZTP 80-15 Coated : 435 x 333 x 795 (mm) : 520 x 415 x 865 (mm) : 80 L : 220 V : 50 Hz : 550 W :1 :2 : 120 - 170 (ºC) : 10 - 15 mg/m3 : 15 Min : 15.5 Kg

5 Alat Resusitasi Specifications -

Neonate Resuscitator, 220 ml Single shutter patient valve Valve with 40 cm H 2O pressure limitation

-

Silicone Face Mask, size 00 Oxygen reservoir Direction for use Supllied in pouch & carton

6 Tabung Oksigen dewasa Specification :

-

7

Complete with Oxygen cylinder Material Finishing Trolley : Features Construction Finishing Castor

: : : :

Nasal canula, Regulator oxygen 6 m3 Steel pipes Powder coating

: : : :

For 6 m Steel pipe & MS Plate Powder coating 5" castors

: : : :

Nasal canula, Regulator oxygen 3 1m Steel pipes Powder coating

: : : :

For 1 m3 Steel pipe Powder coating 4" castors

3

Tabung Oksigen Anak Specification : -

Complete with Oxygen cylinder Material Finishing Trolley : Features Construction Finishing Castor

-

7

Complete with Oxygen cylinder Material Finishing Trolley : Features Construction Finishing Castor

: : : :

Nasal canula, Regulator oxygen 6 m3 Steel pipes Powder coating

: : : :

For 6 m Steel pipe & MS Plate Powder coating 5" castors

: : : :

Nasal canula, Regulator oxygen 3 1m Steel pipes Powder coating

: : : :

For 1 m3 Steel pipe Powder coating 4" castors

3

Tabung Oksigen Anak Specification : -

Complete with Oxygen cylinder Material Finishing Trolley : Features Construction Finishing Castor

Mengetahui : Kepala Dinas Kesehatan Kabupaten Kupang

Pejabat Pembuat Komitmen

dr. M . B . Ataupah Pembina Tk. I NIP : 196402040996031001

Theresia Ili, S.Sos Penata NIP : 196604041987032«

LAMPIRAN KEBUTUHAN TEKNIS No.

Nama Barang

Qty

1 PONED KID 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Setengah Kocher , SS 14 cm Alas Kaki untuk Perlindungan Infeksi Apron untuk Perlindungan Infeksi Bak Instrument Tertutup 508 Bak Instrument Tertutup 509 B Bak Instrument Tertutup 512 Benang Chromic 2.0 / 3.0 box isi 12 Spuit Disposible E 10 cc Spuit Disposible E 3 cc Endotracheal Tube 2.5 , 3, 4 Fetal Stetoscope Pinard Gunting Episiotomy 14 cm Gunting Kuku Gunting tali Pusat 16 cm Halogen Examination Lamp Handuk Kecil Hb Sahli Infuse set dewasa, box/50 Infuse set Pediatric, box/50

TOTAL

Jumlah Harga

KEBUTUHAN

Rp.

5 SET 1 2 2 1 1 1 1 10 1 3 1 1 1 1 1 3 1 1 1

bh bh bh bh bh bh bh bh box bh bh bh bh bh Unit bh set box box

5 10 10 5 5 5 5 50 5 15 5 5 5 5 5 15 5 5 5

LAMPIRAN KEBUTUHAN TEKNIS No.

Nama Barang

Qty

1 PONED KID 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

Setengah Kocher , SS 14 cm Alas Kaki untuk Perlindungan Infeksi Apron untuk Perlindungan Infeksi Bak Instrument Tertutup 508 Bak Instrument Tertutup 509 B Bak Instrument Tertutup 512 Benang Chromic 2.0 / 3.0 box isi 12 Spuit Disposible E 10 cc Spuit Disposible E 3 cc Endotracheal Tube 2.5 , 3, 4 Fetal Stetoscope Pinard Gunting Episiotomy 14 cm Gunting Kuku Gunting tali Pusat 16 cm Halogen Examination Lamp Handuk Kecil Hb Sahli Infuse set dewasa, box/50 Infuse set Pediatric, box/50 Inkubator dengan Thermostat Sederhana IV Catheter No. 18 G untuk Dewasa, box/50 IV Catheter No. 26 G untuk Bayi, box/50 Jam / Timer Jarum Jahit Tajam (9 & 11) / pak 12 Kacamata / Google untuk Perlindungan Infeksi Kain Bersih Dan Kering Kateter Penghisap Lendir 6, 8, 10 Kateter Umbilical 3 & 5 Klem Kasa dan tempat Korentang Klem kelly / Klem Kocher lurus 14 cm Klem Ovum Laringoscope Infant Manekin (Pelfic Model + Boneka Bayi + Placenta ) Masker 3 Ply Ear Loop, box isi 50 Meja instrument 2 Rak Meja Tindakan Resusitasi Bayi Meteran / Met Line 1.5 cm Nald Holder 14 cm Naso gastric tube 6 & 8 Nelaton Catheter No. 14

TOTAL

Jumlah Harga

KEBUTUHAN

Rp.

5 SET 1 2 2 1 1 1 1 10 1 3 1 1 1 1 1 3 1 1 1 1 1 1 1 1 2 5 3 2 1 4 3 1 1 1 1 1 1 1 1 1

bh bh bh bh bh bh bh bh box bh bh bh bh bh Unit bh set box box Unit box box bh box bh bh bh bh bh bh bh bh bh box Unit Unit bh bh bh bh

5 10 10 5 5 5 5 50 5 15 5 5 5 5 5 15 5 5 5 5 5 5 5 5 10 25 15 10 5 20 15 5 5 5 5 5 5 5 5 5

68 69 70 71 72 73

Three Way Stop Cook Timbangan bayi 20 Kg + Baki Timbangan Injak Dewasa Vakum Aspirasi manual untuk Paska Keguguran Waskom Stainless Steel 40 cm IUD Kit terdiri dari : - Iodine Cup 1 Bh - Forceps, Schroeder Tenaculum 1 Bh - Forceps, IUD Removal Alligator Jow 1 Bh - Forceps, Sponge Foster Straight 1 Bh - Scissor Operating Mayo CVD 1 Bh - IUD String Retrivver 1 Bh - Uterine Sonde Sims 1 Bh - Speculum Vagina, Graves Large 1 Bh - Speculum Vagina, Graves Medium 1 Bh - Handschoen No. 6.5 5 Bh - Handschoen No. 7 5 Bh - Utility Tray with Cover, SS 1 Bh - Sphygmomanometer 1 Bh - Stetoscope Duplex 1 Bh - Fixing Clamp 1 Bh - Tas Bidan 1 Bh

74 Ari timer Standard Unicef

75 76 77 78 79 80 81 82 83 84 85

86 87 88 89 90 91 92 93 94

SET UMBILICAL (UNTUK NEONATAL) Kocher Artery Klem str, 10 cm Kocher Artery Klem cvd, 10 cm Pinset Chirugis 10 cm Gunting Operasi Scaper Handle no. 3 Small Needle Holder Kom Kecil 8 cm Curved Mosquito hemostat Iris Forceps Curved Non Iris Forceps Pinset bengkok kecil SET VENA SECTIO Mayo hegar Needle Holder 14 cm Baby Mosquito str 10 cm Baby Mosquito cvd 10 cm Langenback Hak Pinset Chirugis 10 cm Forceps Splinter 11.5 cm Pinset Anatomi 10 cm Gunting Operasi tajam, 9 cm str Gunting Operasi tajam, 9 cm cvd

2 1 1 1 2 2

bh bh bh bh bh Set

1 bh

2 2 2 2 1 1 1 1 1 1 1

bh bh bh bh bh bh bh bh bh bh bh

10 5 5 5 10 10

5

10 10 10 10 5 5 5 5 5 5 5 -

1 1 1 1 1 1 1 1 1

bh bh bh bh bh bh lbr lbr psg

5 5 5 5 5 5 5 5 5

2 3 4 5 6 7 8 9 10 11 12 13 14 15

IV. Catheter No. 18 G IV. Catheter No. 26 G Jarum Diposible no 23 G box50's Kocher Lurus 16 cm, Ss Meteran / Metline 150 cm Mucous penghisap lendir Nasogatric tube no.14 Needle holder mayo 14 cm Nelaton Chateter No.12 Neerbiken 20 cm, SS Pincet anatomy 14 cm SS Pincet Chirugis 14 cm Pincet chirugis 18 cm Ambu Bag Infant Sarung Tangan Bedah No. 6,5 ; 7 ; 7,5 Selimut Bayi Senter Besar Setengah Kocher SS 14 cm Sheet Plastic tebal Sikat tangan Dengan Nylon Tensimeter Aneroid Spiritus Sumbu Spuit Disposible 1cc Spuit Disposible 3 cc Stetoscope Duplex dewasa Thermometer Bayi Rektal Thermometer Digital Timbangan Bayi 20 kg Timbangan Dewasa Ukuran lengan ibu hamil Umbilical Cord klaem Tas Bidan Dari Kulit Tas Partus kit Wing Needle 23 & 25 G

Palu pengukur reflek Pelvimeter Obstetric untuk pengukur panggul Speculum vagina, cocor bebek, besar Speculum vagina, cocor bebek, kecil Speculum vagina, cocor bebek, sedang Stethoscope Stethoscope janin Allumanium Sudip lidah logam, 16 cm ss Tensimeter air raksa Termometr Bayi Alat Pemasang IUD alat Pengait IUD Gunting bedah standard, lurus ujung tajam/tajam Gunting bedah standard, lurus ujung tajam/tumpul

5 5 1 2 1 1 2 2 5 2 1 1 1 1 30 2 1 1 2 1 1 1 1 1 1 1 1 1 1 1 10 1 1 10

bh bh box bh bh Box bh bh bh bh bh bh bh bh bh bh bh bh bh bh bh bh box box bh bh bh bh bh bh bh bh bh Bh

40 40 8 16 8 8 16 16 40 16 8 8 8 8 240 16 8 8 16 8 8 8 8 8 8 8 8 8 8 8 80 8 8 80

1 bh 1 set 1 set 1 set 1 set 1 set 1 bh 1 bh 1 set 1 bh 1 set 1 set 1 bh 1 bh

8 8 8 8 8 8 8 8 8 8 8 8 8 8

dr. M . B . Ataupah Pembina Tk. I IP : 196402040996031001

Theresia Ili, S.Sos Penata NIP : 196604041987032« DAFTAR  LAMPIRAN KEBUTUHAN TEKNIS

No.

Nama Barang

1 POLIKLINIK SET 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Diagnostik set lengkap Doppler EKG 3 chanel Tensi Meter Manset Anak microtoise stetoskop Tempat tidur periksa Tensi meter air raksa Termometer klinik/ digital tes buta warna Ishihara Timbangan dewasa Sikat tangan Lampu senter Lemari peralatan Meja instrumen silinder korentang steril torniket karet tromol kasa 25 x 120 cm waskom bengkok waskom cuci

Qty

TOTAL KEBUTUHAN

Jumlah Harga Rp.

1 SET 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 -

2 Gynbed

13 Unit

13

3 Inkubator

13 Unit

13

4 Sterilisator

13 Unit

13

5 Alat Resusitasi

13 Unit

13

6 Tabung Oksigen dewasa

13 Unit

13

7 Tabung Oksigen Anak

13 Unit

13

Mengetahui : Kepala Dinas Kesehatan Kabupaten Kupang

Pejabat Pembuat Komitmen

DAFTAR  LAMPIRAN KEBUTUHAN TEKNIS No.

Nama Barang

1 POLIKLINIK SET 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Diagnostik set lengkap Doppler EKG 3 chanel Tensi Meter Manset Anak microtoise stetoskop Tempat tidur periksa Tensi meter air raksa Termometer klinik/ digital tes buta warna Ishihara Timbangan dewasa Sikat tangan Lampu senter Lemari peralatan Meja instrumen silinder korentang steril torniket karet tromol kasa 25 x 120 cm waskom bengkok waskom cuci

Qty

TOTAL KEBUTUHAN

Jumlah Harga Rp.

1 SET 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 -

2 Gynbed

13 Unit

13

3 Inkubator

13 Unit

13

4 Sterilisator

13 Unit

13

5 Alat Resusitasi

13 Unit

13

6 Tabung Oksigen dewasa

13 Unit

13

7 Tabung Oksigen Anak

13 Unit

13

Mengetahui : Kepala Dinas Kesehatan Kabupaten Kupang

dr. M . B . Ataupah Pembina Tk. I NIP : 196402040996031001

Pejabat Pembuat Komitmen

Theresia Ili, S.Sos Penata NIP : 196604041987032