IGD HCU BERLIAN SAFIR

Tensi meter 2 1 PASIEN MONITOR 5 2 SPIGNOMANOMETER 2 1 NEBULIZER 1 1

Termometer 2 1 SPIGNOMANOMETER 1 1 SATURASI O2 2 1 TIMBANGAN BB 1 1
Nebulizer 3 1 SUCTION 2 1 TERMOMETER 2 1 SPIGNOMETER 2 1
6
EKG 1 1 INFUS PUM 3 1 STETOSCOPE 2 1 STETOSCOPE 2 1
10
Timbangan bayi & dewasa 2 2 SHIRING PUM 3 1 TIMBANGAN BB 1 1 SATURASI O2 1 1
Otoscop 1 1 SATURASI O2 MANUAL 1 1 NEBULEZER 1 1 TERMOMETER 2 1
Laringskop 2 1 3 TERMOMETER DIGITAL 1 1 SUCTION 1 1
NST 1 1 NEBULIZER 1 1 10 6 INFUS PUM 1 1
USG 1 1 EKG 1 1
Monitor 1 1 TIMBANGAN BB 2 1 11 8
Accu Check 1 1 INKUBATOR 2 1
Suction 1 1 STETOSKOP 4 1
Infus Pump 1 1 FOTOTHERAPI 1 1
String Pump 1 1
Stetoscop Anak dan Dewasa 3 2
Tensi Anak 1 1
24 18 27 14
POLI MUTIARA KYANIT GARNET
TENSI DEWASA 4 2 INFUS PUM 2 1 7 INCUBATOR 2 1 NEBULIZER 1 1
TENSI ANAK 1 1 SPIGNOMANOMETER 1 1 SATURASI O2 1 1 TIMBANGAN BB 1 1
STETOSCOP DEWASA 5 2 TERMOMETER 3 1 STETOSCOPE 2 1 SPIGNOMETER 3 1
Stetoscop Anak dan Dewasa 1 1 4 TIMBANGAN BB 1 1 SUCTION 1 1 STETOSCOPE 2 1
Nebulizer (2017) 1 1 STETOSCOP 1 1 TERMOMETER 3 1 SATURASI O2 2 1
NEBULEZER (2018) BARU 1 1 NEBULIZER 1 1 BLUE LIGHT 3 2 TERMOMETER 1 1
NEBULEZER (2010) 1 1 SATURASI O2 1 1 TIMBANGAN BB 1 1 OUTUCLAVE 1 1
NST 1 1 10 7 13 8 EKG 1 1
TENSI AIR RAKSA 1 1
11
EKG 1 TOURMALIN
1 RUBI 12 8
TERMOMETER DIGITAL(LAMA) 3 1 5 SPIGNOMANOMETER 2 1 8 NEBULEZER 1 1
TERMOMETER (BARU) 1 1 SATURASI O2 2 1 TIMBANGAN BB 1 1 O.K
Suction 1 1 TERMOMETER 2 1 SPIGNOMANOMETER 2 1 MESIN ANASTESI 2 1
STERILISATOR 1 1 STETOSCOPE 2 1 STETOSCOPE 3 1 MONITOR 1 1
TIMBANGAN BERDIRI 2 1 NST 1 1 SATURASI O2 1 1 MEJA OPRASI 2 1
Timbangan bayi 1 1 PATIEN MONITOR 1 1 TERMOMETER 1 1 SACTION 2 1
TIMBANGAN DEWASA 1 1 INFANWARMER 1 1 MESIN COUTER 2 1
27 19 SUCTION 1 1 OTOCLAP 2 1
POPLER 1 1 TIMBANGAN BAYI 1 1
STERILAN 1 1 MEJA RESUSITASI B 1 1
14 10 9 6
EMERALD
NEBULEZER 1 1 13 8
TIMBANGAN BB 1 1
SPIGNOMANOMETER 1 1
STETOSCOPE 1 1
9
SATURASI O2 1 1
TERMOMETER 1 1
SUCTION 1 1
INFUS PUM 3 2
10 9
10 NST 1 AM-1400 ANALOGI MEDICAL 2015
11 USG 1 DP-10 / MINDRAY 6XL-79014400 2015
12 PATIENT Monitor 1 CONTEX CMS-6000 AV-005 22-02-2016
13 IGD Accu Check 1
14 Suction Pump 1 7E-A General Care/ Phlegem 20150123367 2015
15 Infus Pump 1 JYM/JSB-1200 120900615 2015
16 SHERING PUMP 1 JYM/JZB-1800 12070141Z 2015
17 Stetoscop Dewasa 1
18 Stetoscop Anak 1
19 Tensi Anak 1
20 OKSIMETRI 2 OXY ONE AV-004 20-08-2018
21 DC SOCK 1 LIFEPAK 20 C
22 TIMBANGAN DEWASA 1 CAMRY/120kg J1608101277
23 DOOPLER 1 LOTUS
24 REGULATOR 7
25 DEFIBRILATOR MONITOR 1
26 33
27 MIDRAY 1 BC-3000 PLUS RJ-5A1212 2019 KSO INDOHADETAMA
28 MIDRAY 1 BC-1800 RK-74106889 2019 KSO INDOHADETAMA
29 MIDRAY 1 BS-120 WK-25102591 2019 KSO INDOHADETAMA
30 ELECTROLYTE 1 CBS-400 BE021490 2018 KSO INDOHADETAMA
31 SB BIOSENSOR 1 F200 FA20B02FA1022 2018 KSO PT STANDAR BIOSENSOR INDONESIA
32 UROMETER 1 120 12074215 2015
33 LAB ROLLER MIXER 1 H-RM-700 2015

34 CENTRIFUGE 1 H-C-8 2015

35 CENTRIFUGE 1 MDM0412 LD16BAC0000382 2019

36 MICROSCOP 1 YAZUMI 2015
37 ROTATOR 1 H-RM-700 POLLER MIXER
38 MICRO PIPET 5 EPPENDROF
39 16
40 TENSI BERDIRI 1 AZON SPYGMOMANOMETER RUSAK
41 TENSI BERDIRI 1 AZON SPYGMOMANOMETER RUSAK
42 TENSI BERDIRI 1 AZON SPYGMOMANOMETER RUSAK
43 TENSI BERDIRI 1
44 TENSI COMPAS 1 ABN 2019
45 TENSI DUDUK 1 ABN 2017
46 TENSI ANAK 1 2016
47 TERMOMETER 1 PRM
48 TERMOMETER 1 RUSAK
49 TIMBANGAN BB 1 2T-120 /SERENITI 2018 POLI ANAK
50 TIMBANGAN BB 1 2T-120 /SERENITI 2018 POLI OBG
51 TIMBANGAN BB 1 2T-120 /SERENITI 2017 POLI IPD
52 BABY SCALE 1 YB-77 YAMAMOTO AV-016 2017 POLI ANAK
Suction Pump 1 ABN 5V16101018 2018 POLI GIGI
53 POLI LIGHT CHURE 1 D-LUX DLB-B1 0401 2019
54 ULTRASONIC SCALER 1 D2 LED/DTE 51870057D2L 2019
55 SUCTION 1 7E-A/ABN 20141028582 2016 POLI THT
56 COMPRESOR
57 EKG 1 33U3B/MEDICARDIU 330381507915 2014 RUSAK
58 EKO 1 330U3B/MEDICARDIU 330381507915 2014 SEMI RUSAK
59 ECHO 1 PHILIPS 2019
60 NEBULIZER 1 OMRON/ME-C28 20170603623 UF 2016

61 NEBULIZER 1 OMRON/ME-C28 20180301493 UF 2016

62 NEBULIZER 1 3U20/SANUP 17810 2012 RUSAK
63 USG (OBG) 1 P8 BT 16 /VULOSON P8 VP8004196 2019
TENSI 1 ABN 2018
64 TENSI AIR RAKSA 1 ABN 2018 POLI MATA
65 NEBULIZER 1 SANUP/3020 17810 2012 RUSAK
66 17
ALAT RONGSENT 1 MEDONICA/E7239 X 17F1043 2018
67 RADIOLOGI USG 1 VINNO-6 U141811001 2018
68 USG 1 MINDRAY/ DP-10 QL-28001490
69 DOOPLER 1 BT- 250 FETAL DOPPLER
70 INFANT WARMER 1 GEA MEDICAL HKN-90 21170202015
71 VK SUCTION 1 GEA MEDICAL YB-SXT-1A
 VK
72 TIMBANGAN BAYI 1 ONE MED/OD231B AV-010
73 CTJ 1
74 6
75 FOTOTHERAPHI 1 GEA MEDICAL/ XHZ-90 4213030505
76 FOTOTHERAPHI 1 GEA MEDICAL/ XHZ-90 42140307033
77 FOTOTHERAPHI 1 GEA MEDICAL/ XHZ-90 42090904024
78 PERI INCUBATOR 1 GEA/D2006 10030312
79 INCUBATOR 1 D2006 10030287
80 TIMBANGAN BAYI 1 ONE MED/0D231B AV-011
81 SUCTION 1 ABN MEDICAL/ ASPIRA SU16101224
82 7
83 INFUS PUMP 1 JBS-1200 120900575
84 INFUS PUMP 1 CF-IPX2 60190200631
85 INFUS PUMP 1 CF-IPX2 60190200625
86 INFUS PUMP 1 CF-IPX2 60190200633
87 INFUS PUMP 1 CF-IPX2 60190200628
88 INFUS PUMP 1 CF-IPX2 60190200627
89 INFUS PUMP 1 IP-7700 NE ISL0023
90 INFUS PUMP 1 amp-all AV 007
91 INFUS PUMP 1 11040363
92 INFUS PUMP 1 DI TEKNISI
93 MUTIARA Tensi meter Aneroid 2
94 TERMOMETER DIGITAL 2
 PT. AVISENA MANDIRI SEJAHTERA

RUMAH SAKIT UMUM AVISEN

Jl. Melong No. 170 Cimahi
Telp. 022 600830

REKAPITULASI
DAFTAR KALIBRASI ALAT MEDIS
BULAN……………………………….TAHUN……………………….

Nama RS:
Alamat :

KEPEMILIKAN TANGGAL TANGGAL

NO NAMA ALAT
RS DOKTER PIHAK III KALIBRASI KADALUWARSA
1 CENTRIFUGE √ 04 November 2018 04 November 2019
2 SPHYGNOMANOMETER √ 04 November 2018 04 November 2019
3 SPHYGNOMANOMETER √ 04 November 2018 04 November 2019
4 SPHYGNOMANOMETER √ 04 November 2018 04 November 2019
5 SUCTION PUMP √ 04 November 2018 04 November 2019
6 SUCTION PUMP √ 04 November 2018 04 November 2019
7 SUCTION PUMP √ 04 November 2018 04 November 2019
8 SUCTION PUMP √ 04 November 2018 04 November 2019
9 SUCTION PUMP √ 04 November 2018 04 November 2019
10 EKG √ 04 November 2018 04 November 2019
11 EKG √ 04 November 2018 04 November 2019
12 INFUSION PUMP √ 04 November 2018 04 November 2019
13 INFUSION PUMP √ 04 November 2018 04 November 2019
14 INFUSION PUMP √ 04 November 2018 04 November 2019
15 INFUSION PUMP √ 04 November 2018 04 November 2019
16 INFUSION PUMP √ 04 November 2018 04 November 2019
17 INFANT WARMER √ 04 November 2018 04 November 2019
18 INFANT INCUBATOR √ 04 November 2018 04 November 2019
19 INCUBATOR BAYI √ 04 November 2018 04 November 2019
20 DEFIBRILLATOR √ 04 November 2018 04 November 2019
21 SPO2/OXIMETER √ 04 November 2018 04 November 2019
22 SPO2/OXIMETER √ 04 November 2018 04 November 2019
23 PATIENT MONITOR √ 04 November 2018 04 November 2019
24 PATIENT MONITOR √ 04 November 2018 04 November 2019
25 TIMBANGAN BAYI √ 04 November 2018 04 November 2019
26 TIMBANGAN BAYI √ 04 November 2018 04 November 2019
27 TIMBANGAN BAYI √ 04 November 2018 04 November 2019
28 TIMBANGAN BAYI √ 04 November 2018 04 November 2019
29 TIMBANGAN BAYI √ 04 November 2018 04 November 2019
30 TIMBANGAN DEWASA √ 04 November 2018 04 November 2019
31 SYRINGE PUMP √ 04 November 2018 04 November 2019
32 SYRINGE PUMP √ 04 November 2018 04 November 2019
33 SYRINGE PUMP √ 04 November 2018 04 November 2019
34 USG √ 04 November 2018 04 November 2019
35 NEBULIZER √ 04 November 2018 04 November 2019
36 COMPRESSOR NEBULIZER √ 04 November 2018 04 November 2019
37 SUCTION PUMP √ 05 November 2018 05 November 2019
38 INFUSION PUMP √ 05 November 2018 05 November 2019
39 INCUBATOR BAYI √ 05 November 2018 05 November 2019
40 INCUBATOR BAYI √ 05 November 2018 05 November 2019
UM AVISENA

RUANGAN
KET

LAB
IGD
IGD
MUTIARA
IGD
OK
OK
HCU
PERINATOLOGI
IGD
HCU
IGD
HCU
HCU
HCU
HCU
PERINATOLOGI
OK
PERINATOLOGI
HCU
MUTIARA
IGD
OK
HCU
IGD
HCU
MUTIARA
VK
IGD
PERINATOLOGI
HCU
HCU
HCU
VK
IGD
IGD
EMERALD
SAFIR
PERINATOLOGI
HCU
 PT. AVISENA MANDIRI SEJAHTERA

RUMAH SAKIT UMUM AVISEN

Jl. Melong No. 170 Cimahi
Telp. 022 600830

REKAPITULASI
DAFTAR KALIBRASI ALAT MEDIS
BULAN OKTOBER TAHUN 2019

NO NAMA ALKES UNI

IGD POLI RAD LAB MUTIARA VK
1 SPHYGNOMANOMETER 2 1
2 SUCTION PUMP 1 1
3 EKG 1 1
4 INFUSION PUMP 1 10
5 SPO2/OXIMETER 1 1
6 TIMBANGAN BAYI 2 2
7 NEBULIZER 2 3 3
8 CENTRIFUGE 1
9 INFANT INCUBATOR
10 PATIENT MONITOR 1
11 DEFIBRILLATOR 1
12 SYRINGE PUMP
13 INCUBATOR BAYI
14 INFANT WARMER
15 TIMBANGAN DEWASA 1 3 1
16 Tensi meter Aneroid 2
17 Termometer 1
18 Otoscop ANAK 1
19 NST 1
20 USG 1 1
21 ACCU CHECK 1
22 STETOSCOP DEWASA 1
23 STETOSCOP ANAK 1
24 TENSI ANAK 1
25 DC SOCK 1
26 DOOPLER 1
27 MIDRAY 3
28 ELECTROLYTE 1
29 SB BIOSENSOR 1
30 UROMETER 1
31 ROLLER MIXER 1
32 CENTRIFUGE 1
33 CENTRIFUGE 1
34 MICROSCOP 1
35 ROTATOR
36 TENSI BERDIRI 4
37 TENSI COMPAS 1
38 TENSI DUDUK 1
39 TENSI ANAK 1
40 TERMOMETER 2 2
41 BABY SCALE 1
42 LIGHT CHURE 1
43 ULTRASONIC SCALER 1
44 COMPRESOR 1
45 EKO 1
46 ECHO 1
47 TENSI 1
48 TENSI AIR RAKSA 1
49 ALAT RONGSENT 1
50 USG 1
51 USG 1
52 DOOPLER 1
53 INFANT WARMER 1
54 SUCTION 1
55 TIMBANGAN BAYI 1
56 CTJ 1
57 FOTOTHERAPHI
58 Tensi meter Aneroid 1
59 TENSI SPIGNOMETER
60 TEMP DIGITAL
61 MONITOR
62 MEJA OPRASI
63
64
65
66
67
68
UM AVISENA

UNIT
PERI FISIO OK HCU RUBY EMERALD SAFIR BERLIAN GARNET

1 2 2 1
1 1
2 4 1
1 2 1
1 1 1
2 1 1 1 1

1
1 3
1
4
2 1
1
1 1 1
 1

1
1 1 1

2
JUMLAH

3
8
4
18
6
7
14
1
1
5
2
4
3
1
8
2
1
1
1
2
1
1
1
1
1
1
3
1
1
1
1
 1
1
1
0
4
1
1
1
4
1
1
1
1
1
1
1
1
1
1
1
1
2
1
2
1
3
1
1
3
0
2
0
0
0
0
0
0
0
0

147