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NO NAMA BARANG MEREK SERIAL NUMBER JUMLAH SATUAN TAHUN
Daftar Barang :
 PEMERINTAH KABUPATEN BUOL
UPT.RUMAH SAKIT UMUM DAERAH MOKOYURLI
Jln. Dr. WahidinSudirohusodo No. 12 Kel. Leok II Kec. Biau Kab. Buol - 94563

BERITA ACARA PENYERAHAN BARANG

Nomor : /PPB/ BAST/ RSUD/2022

Pada hari ini rabu tanggal tiga belas bulan oktober tahun Dua Ribu Dua Puluh Satu, yang bertanda tangan
dibawah ini :

Nama : Nursyamsi
Nip : 19810727 200604 1 013
Jabatan : Pengurus Barang
Selanjutnya disebut Pihak Pertama

Menyerahkan barang/Aset 1 (Satu) Unit alat / Barang dengan Spesifikasi (Terlampir) Kepada:

Nama : SUPARMAN S LAINJONG.SKM

Nip : 19820809 200903 1 001
Jabatan : Bpjs
Selanjutnya disebut Pihak Kedua

1. Bahwa barang diserahkan lengkap dalam kondisi baik dan siap untuk dioperasikan.
2. Bahwa barang adalah barang inventaris Rumah Sakit Umum Mokoyurli Daerah Kabupaten Buol.
3. Bahwa pihak kedua akan menggunakan barang pada point 1 diatas untuk dukungan pelayanan di
Rumah Sakit Umum Daerah Mokoyurli Buol.
4. Bahwa pihak kedua bertanggung jawab atas penggunaan dan pemeliharaan barang inventaris selama
dalam penguasaan.
5. Bahwa pihak kedua Jika Menghilangkan atau dengan sengaja Merusak barang atau aset yang sudah di
terima siap mempertanggung jawabkan.
6. Bahwa pihak kedua tidak dapat memindah tangankan atau memindah tempatkan barang Inventaris
tersebut tanpa persetujuan atau tanpa sepengetahuan dari Pihak Pertama dan Kasubag Keuangan dan
Aset.

Daftar Barang :
NO NAMA BARANG MEREK SERIAL NUMBER JUMLAH SATUAN TAHUN

2 SCAN Fujitsu C92J007010 1 Unit 2021

Demikian berita acara serah terima barang ini di buat untuk dipergunakan sebagaimana mestinya.

Buol, 13 October 2021

Yang Menerima Yang Menyerahkan
Pihak Kedua Pihak Pertama

SUPARMAN S LAINJONG.SKM NURSYAMSI

NIP : 19820809 200903 1 001 NIP. 19810727 200604 1 013

Mengetahui
Kasubag. Keuangan dan Aset
UPT. RSUD Mokoyurli Buol

PRASITORESMI AK. MENTEMAS, SKM

NIP. 19881006 201101 1 007
NO TANGGAL BAP NAMA KARU NIP KARU

1 2 3 4
1 Sunarti R. Nggai 19840904 200801 2 005
2 Nurmawati Haris, A.Md.Fis 19840101 200903 2 003
3 Falen Natalia Samad 19801226 200502 2 004
4 Olyn Lahati, Amd.Keb 19671029 198803 2 006
5 Nismawati M. Turungku, A.Md.Kep 19840728 200312 2 001
6 Umi Fitriani H. Mukalap, A.Md.Kep
7
8
9 Suryani Yunus, A.Md.Rad 19860828 201101 2 011
10 Julaeha AR. Batalipu, A.Md.Kep 19690314 198912 2 002
11 Yusrianti Natalia, A.Md. Kep
12 Ermita Puspita Sari, A.Md. Kep
13 Nahriati, A.Md. Kep
14 Rahman Antu 19740606 199603 1 003
15
16
17 Sucianti, A.Md. Kep
18 Nurlelawati, S.Kep.Ners 19790702 200012 2 001
19 Nahriati, A.Md. Kep

20 Sumardi Yusup, Amd.Kep

21 Nurmawati Haris, A.Md.Fis 19840101 200903 2 003
22 Sri Ariyanti, S.Far. Apt 19820918 200804 2 002
23 Nurlaila H. Hi. Muhtang, S.Tr.Keb 19860428 201001 2 008
24 Rafika Duri, A.Md.Kep 19830108 201001 2 009
25 Muhammad, S.Kep.Ns
26 Rani R. Said, Amd.Kep
27 Yusrianti Natalia, A.Md. Kep
28 Megawati, Amd.Kep
29 Sumardi Yusup, Amd.Kep
30 Yusrianti Natalia, A.Md. Kep
31 Sumardi Yusup, Amd.Kep
32 Ezwarni, S.sos 19670505198803 2 021
33 Falen Natalia Samad, Amd. Kep
34 Nahriati, A.Md. Kep
35 Sarmila Skm.
36 Muhammad, S.Kep.Ns
37 Nurmawati Haris, A.Md.Fis 19840101 200903 2 003
38 Amna amd, Keb.
39 Farida Handayani, SE.
40 Nahriati, A.Md. Kep
41 Muhammad, S.Kep.Ns
42 Rina Hefriani
43 Nurmawati Haris, A.Md.Fis 19840101 200903 2 003
44 Syahril B. Koping Amd. Kep
45 Risno
46 Suyanto Salakea
47 Vicky Wulan Kareba
48 Vicky Wulan Kareba
49 Meilany, Skm.
50 Vicky Wulan Kareba
51 Olyn Lahati, Amd.Keb 19671029 198803 2 006
52 Prasitoresmi AK. Mentemas, SKM. 19881006 201101 1 007
53 Ezwarni, S.sos 19670505198803 2 021
54 Rina Hefriani
55 Vicky Wulan Kareba
56 Muhammad, S.Kep.Ns
57 Muhammad, S.Kep.Ns
58 drg. Siti Yurika
59 Syahril B. Koping Amd. Kep
60 Muhammad, S.Kep.Ns
61 Muhammad, S.Kep.Ns
62 Suyanto A. Salakea, SKM 19830113 200212 1 005
63 Hardiman
64 Nurlelawati, S.Kep.Ners 19790702 200012 2 001
65 Ezwarni, S.sos 19670505198803 2 021
66 Muhammad, S.Kep.Ns
67 Muhammad, S.Kep.Ns
68 Muhammad, S.Kep.Ns
69 Muhammad, S.Kep.Ns
70 Lukman S.Sos, M.Kes 19640620 198701 1001
71 Santi, Skm 19810825 200903 2 001
72 Muhammad, S.Kep.Ns
73 8/11/2020 Megawati, Amd.Kep
74 8/10/2020 dr. Arianto S. Panambang
75 8/11/2020 Darmawati S.kep NS.
76 8/11/2020 Narti S, nggai
77 8/11/2020 Minarni H. Kotae
78 8/11/2020 Farida Handayani, SE.
79 8/25/2020 Prasitoresmi AK. Mentemas, SKM. 19881006 201101 1 007
80 8/26/2020 Nurlelawati, S.Kep.Ners 19790702 200012 2 001
81 8/27/2020 Rosita Jafar
82 8/27/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
83 8/27/2020 Darmawati S.kep NS.

84 11/12/2020 Rahman Antu 19740606 199603 1 003

85 11/5/2020 Sarini Abd Kadir 198008262001122003
86 11/5/2020 Rina Hefriani

87 Rahman Antu 19740606 199603 1 003

88 11/6/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
88 11/6/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
88 11/6/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
89 11/6/2020 RAHMAN ANTU 19740606 199603 1 003
89 11/6/2020 RAHMAN ANTU 19740606 199603 1 003
89 11/6/2020 RAHMAN ANTU 19740606 199603 1 003
89 11/6/2020 RAHMAN ANTU 19740606 199603 1 003
89 11/6/2020 RAHMAN ANTU 19740606 199603 1 003
89 11/6/2020 RAHMAN ANTU 19740606 199603 1 003
89 11/6/2020 RAHMAN ANTU 19740606 199603 1 003
90 11/6/2020 NOFRINCE, S.Kep., NS 19841113 200604 2 004
90 11/6/2020 NOFRINCE, S.Kep., NS 19841113 200604 2 004
90 11/6/2020 NOFRINCE, S.Kep., NS 19841113 200604 2 004
90 11/6/2020 NOFRINCE, S.Kep., NS 19841113 200604 2 004
90 11/6/2020 NOFRINCE, S.Kep., NS 19841113 200604 2 004
91 11/6/2020 MISRIAWATI I. AMBOMOLONG, S.Kep.,198101182002122003
92 11/6/2020 MEGAWATI, A.Md.Kep 19700610 198911 2 002
92 11/6/2020 MEGAWATI, A.Md.Kep 19700610 198911 2 002
92 11/6/2020 MEGAWATI, A.Md.Kep 19700610 198911 2 002
92 11/6/2020 MEGAWATI, A.Md.Kep 19700610 198911 2 002
92 11/6/2020 MEGAWATI, A.Md.Kep 19700610 198911 2 002
93 11/6/2020 IRSANTO IB MASTURA., A.Md.Tem 197904112008041001
93 11/6/2020 IRSANTO IB MASTURA., A.Md.Tem 197904112008041001
94 10/8/2020 Prasitoresmi AK. Mentemas, SKM. 19881006 201101 1 007
95 5/3/2020 Nurhaeda Zainu 19810225200502 2 003
96 1/7/2020 ICHSAN, S.Kep.NS,,MPH 19780103 200604 1 008
97 4/8/2020 AMNA, A.Md. Keb 19661204198912 2 001
98 4/8/2020 RABIHATUN MANGIL, A.Md.Kep 19691023 198903 2 007
99 4/8/2020 FALEN NATALIA SAMAD 19801226 200502 2 004
100 4/8/2020 NURHAEDA ZAINU 19810225200502 2 003
101 12/30/2020 SUSANTI.A.MD.KEP 198410162010012013
102 12/30/2020 MISRIAWATI I. AMBOMOLONG, S.Kep.,198101182002122003
102 12/30/2020 MISRIAWATI I. AMBOMOLONG, S.Kep.,198101182002122003
103 12/17/2020 SANTI, SKM 19810825 200903 2 001
103 12/17/2020 SANTI, SKM 19810825 200903 2 001
104 12/30/2020 NURLELAWATI, S.KEP.NERS 19790702 200012 2 001
105 3/21/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
106 4/8/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
106 4/8/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
107 4/1/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
108 5/1/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
109 4/9/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
109 4/9/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
110 4/11/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
111 4/16/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
112 4/11/2020 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
113 4/16/2020 HERIYANI HASNAWI, SKM 198912102015022001
113 4/16/2020 HERIYANI HASNAWI, SKM 198912102015022001
114 4/13/2020 ERMITA PUSPITA SARI, A.Md.Kep 19830417 201001 2 013
115 4/8/2020 HERIYANI HASNAWI, SKM 198912102015022001
116 1/8/2021 dr. Lisdiana Amin Asri 19640419 198903 2 002
116 1/8/2021 dr. Lisdiana Amin Asri 19640419 198903 2 002
116 1/8/2021 dr. Lisdiana Amin Asri 19640419 198903 2 002
117 1/11/2021 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
117 1/11/2021 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
118 1/12/2021 SARINI ABD KADIR 198008262001122003
119 2/3/2021 HERIYANI HASNAWI, SKM 198912102015022001
120 2/3/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
121 2/4/2021 HERIYANI HASNAWI, SKM 198912102015022001
122 2/15/2021 HARDIMAN, AMAK 197406101994031005
123 2/15/2021 SURYANI YUNUS, A.MD.RAD 19860828 201101 2 011
124 2/15/2021 HARDIMAN, AMAK 197406101994031005
125 2/15/2021 SUMARDI YUSUP, A.Md.Kep 19841204 200604 1 004
126 2/15/2021 SURYANI YUNUS, A.MD.RAD 19860828 201101 2 011
127 2/15/2021 dr. Emi Wardani Sp. N
128 2/15/2021 NOFRINCE, S.Kep., NS 19841113 200604 2 004
129 2/15/2021 SURYANI YUNUS, A.MD.RAD 19860828 201101 2 011
130 2/16/2021 MISRIAWATI I. AMBOMOLONG, S.Kep.,198101182002122003
131 2/16/2021 HARDIMAN, AMAK 197406101994031005
132 8/31/2021 NOFRINCE, S.Kep., NS 19841113 200604 2 004
132 8/31/2021 NOFRINCE, S.Kep., NS 19841113 200604 2 004
133 8/12/2021 SAHRONI S. LANGENRE, S. Farm. MM 19840410 200903 1 002
133 8/12/2021 SAHRONI S. LANGENRE, S. Farm. MM 19840410 200903 1 002
134 9/18/2021 MOH. NEGARAWAN PUTRA S.ip 19840410 201001 1 004
135 9/30/2021 SUPARMAN S LAINJONG.SKM 19820809 200903 1 001
136 10/13/2021 SUPARMAN S LAINJONG.SKM 19820809 200903 1 001
137 8/12/2021 MOHAMMAD AMRIL HENTU.S.SI 19840618 200804 1 001
137 8/12/2021 MOHAMMAD AMRIL HENTU.S.SI 19840618 200804 1 001
138 7/29/2021 MEILANY, SKM 19631215 198503 1 017
139 12/7/2021 RAHMAN ANTU 19740606 199603 1 003
139 12/7/2021 RAHMAN ANTU 19740606 199603 1 003
139 12/7/2021 RAHMAN ANTU 19740606 199603 1 003
139 12/7/2021 RAHMAN ANTU 19740606 199603 1 003
139 12/7/2021 RAHMAN ANTU 19740606 199603 1 003
139 12/7/2021 RAHMAN ANTU 19740606 199603 1 003
139 12/7/2021 RAHMAN ANTU 19740606 199603 1 003
140 12/31/2021 ISRAM P NDIGI 19830503 200502 1 000
140 12/7/2021 ISRAM P NDIGI 19830503 200502 1 000
140 12/7/2021 ISRAM P NDIGI 19830503 200502 1 000
141 12/7/2021 NURSAMSY 19810727 200604 1 013
141 12/7/2021 NURSAMSY 19810727 200604 1 013
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
142 12/12/2021 HERIYANI HASNAWI, SKM 198912102015022001
143 12/7/2021 IRSANTO IB MASTURA., A.Md.Tem 197904112008041001
143 12/7/2021 IRSANTO IB MASTURA., A.Md.Tem 197904112008041001
143 12/7/2021 IRSANTO IB MASTURA., A.Md.Tem 197904112008041001
144 12/6/2021 YULIANI.A.MD.KEP 198512022009032001
145 1/10/2022 SUYANTO A. SALAKEA, SKM 19830113 200212 1 005
146 1/10/2022 SARMINI.S, Kep. Ns 198507072009032001
146 1/10/2022 SARMINI.S, Kep. Ns 198507072009032001
147 1/10/2022 ZULFIAH.A.MD.FAR 19850821 200903 2 000
148 1/10/2021 SRI ARIYANTI, S.FAR. APT 19820918 200804 2 002
149 1/9/2021 RINA HEFRIANI, SKM 19840819 201001 2 013
150 1/21/2021 MOHAMMAD AMRIL HENTU.S.SI 19840618 200804 1 001
150 1/21/2021 MOHAMMAD AMRIL HENTU.S.SI 19840618 200804 1 001
150 1/21/2021 MOHAMMAD AMRIL HENTU.S.SI 19840618 200804 1 001

151 5/10/2021 NOFRINCE, S.Kep., NS 19841113 200604 2 004

151 5/10/2021 NOFRINCE, S.Kep., NS 19841113 200604 2 004

151 5/10/2021 NOFRINCE, S.Kep., NS 19841113 200604 2 004

152 5/28/2021 MINARNI H. KOTAE, SKM 198412242008042002
152 5/28/2021 MINARNI H. KOTAE, SKM 198412242008042002
152 5/28/2021 MINARNI H. KOTAE, SKM 198412242008042002
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
153 5/10/2021 SUDIRMAN.A.MD.KEP 19881120 201101 1 003
154 5/28/2021 NOFRINCE, S.Kep., NS 19841113 200604 2 004
155 6/18/2021 SUYANTO A. SALAKEA, SKM 19830113 200212 1 005
155 6/18/2021 SUYANTO A. SALAKEA, SKM 19830113 200212 1 005
156 6/18/2021 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
156 6/18/2021 MUHAMMAD, S.Kep., NS 1985031 201903 2 004
157 6/18/2021 OLYN LAHATI, AMD.KEB 19671029 198803 2 006
158 7/15/2021 RINA HEFRIANI, SKM 19840819 201001 2 013
159 8/2/2021 Ummi Fitriani H. Mukalap, A.md. Kep 19810922 200212 2 002
159 8/2/2021 Ummi Fitriani H. Mukalap, A.md. Kep 19810922 200212 2 002
160 8/24/2021 HERIYANI HASNAWI, SKM 198912102015022001
161 8/24/2021 NURLAILA H. HI. MUHTANG, S.TR.Keb 19860428 201001 2 008
162 8/24/2021 RAHMAN ANTU 19740606 199603 1 003
163 8/24/2021 PRASITORESMI AK. MENTEMAS, SKM. 19881006 201101 1 007
164 8/24/2021 WAHYUNI.SKM 19860522 201001 2 008
165 8/24/2021 MEILANY, SKM 198105072006042017
166 8/25/2021 dr. H. ARIANTO S. PANAMBANG 19760806 201001 1 012
167 8/30/2021
168 8/30/2021
169 11/1/2021 ZULFIAH.A.MD.FAR 19850821 200903 2 000
170 12/7/2021 ATMAN.A.MD.KEP 198409262010011006
171 12/27/2021 NISMA B D HASYIM, SKM 196803181990032004
172 12/31/2021 Nursyamsi 19810727 200604 1 013
173 12/31/2021 Andi Muh Reski Pausi
174 12/31/2021 Nursyamsi 19810727 200604 1 013
175 12/31/2021 ISRAM P NDIGI 19830503 200502 1 000
174 12/31/2021 Nursyamsi 19810727 200604 1 013
176 11/1/2021 ZULFIAH.A.MD.FAR 19850821 200903 2 000
177 1/21/2021 MOHAMMAD AMRIL HENTU.S.SI 19840618 200804 1 001
178 3/22/2021 HARDIMAN, AMAK 197406101994031005
179 3/22/2021 HERIYANI HASNAWI, SKM 198912102015022001
180 3/16/2021 SUPARMAN S LAINJONG.SKM 198208092009031001
180 3/16/2021 SUPARMAN S LAINJONG.SKM 198208092009031001
180 3/16/2021 SUPARMAN S LAINJONG.SKM 198208092009031001
180 3/16/2021 SUPARMAN S LAINJONG.SKM 198208092009031001
181 4/16/2021 HARDIMAN, AMAK 197406101994031005
182 12/14/2021 OLYN LAHATI, AMD.KEB 196710291988032006
183 12/29/2021 SANTI, SKM 19810825 200903 2 001
183 12/29/2021 SANTI, SKM 19810825 200903 2 001
183 12/29/2021 SANTI, SKM 19810825 200903 2 001
183 12/29/2021 SANTI, SKM 19810825 200903 2 001
183 12/29/2021 SANTI, SKM 19810825 200903 2 001
183 12/29/2021 SANTI, SKM 19810825 200903 2 001
183 12/29/2021 SANTI, SKM 19810825 200903 2 001
184 7/30/2021 SYAMSURIZAL UDIN, SKM 197508302006041019
185 8/6/2021 ICHSAN.S.KEP.,M P H 197801032006041008
 1

TAHUN
NAMA RUANGAN DANA NAMA BARANG
PENGADAAN

5 6 7 8
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2019 BLUD Meje 1/2 Biro Hitam
2019 BLUD Kursi Chitosse
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2020 BLUD Flash Disk 8 Gb
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Lampu Operasi
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2020 DAK Mobile
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 2020 BLUD Timbangan Dewasa

Lampu Operasi
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2020 DAK Mobile
Kepala Ruang COVID-19 2020 DAK Suction Pump
Kepala Ruang COVID-19 2020 DAK Syringe Pump
Kepala Ruang COVID-19 2020 DAK Infusion Pump
Kepala Ruang Ok 2020 DAK Intubasi Set
Kepala Ruang Ok 2020 DAK Lampu Operasi Bergerak/Opera
Kepala Ruang Ok 2020 DAK Major Surgery Instrument Set u
Kepala Ruang Ok 2020 DAK Major Surgery Instrument Set ut
Kepala Ruang Ok 2020 DAK Major Surgery Instrument Set u
Kepala Ruang Ok 2020 DAK Mesin Anestesi ventilator
Kepala Ruang Ok 2020 DAK Defibrilator
Kepala Ruang ICU 2020 DAK Bed-side Monitor/Bed-patient
Kepala Ruang ICU 2020 DAK Defibrilator
Kepala Ruang ICU 2020 DAK Central Monitor
Kepala Ruang ICU 2020 DAK ECG/EKG/Electrocardiograph 6
Kepala Ruang ICU 2020 DAK Bed-sideMonitor/Bed-patient m
Kepala Instalasi Gawat Darurat 2020 DAK ECG/EKG/Electrocardiograph 6
Kepala Ruang NICU 2020 DAK Tarnsfort Incubator
Kepala Ruang NICU 2020 DAK Infant Warmer With Scale (Di I
Bersalin)
Kepala Ruang NICU 2020 DAK
Kepala Ruang NICU 2020 DAK CPAP
Kepala Ruang NICU 2020 DAK Phototerapy With Trolly
Kepala IPS-RS 2020 DAK Suction Unit For Neonate
Kepala IPS-RS 2020 DAK Oxygen Concentrator
Kepala Kasubag. Keuangan & Aset 2020 BLUD Kursi Chitose
Polik Gigi 2020 BLUD Dental Care Unit
Kepa Ruangan SIM RS 2020 BLUD Power Supply
Kepala Ruangan POLIK KIA 2020 BLUD Baju APD Kain Coklat
Kepala Ruangan Polik Anak 2020 BLUD Baju APD Kain Coklat
Kepala Ruangan Polik Covid 19 2020 BLUD Baju APD Kain Coklat
Kepala Ruangan Polik GIGi 2020 BLUD Baju APD Kain Coklat
Kepala Ruangan Pavilliun 2020 BLUD Stetoskop
Kepala Ruangan IGD Umum 2020 BLUD Stetoskop
Kepala Ruangan IGD Umum 2020 BLUD Tensi Meter
Kepala Ruangan Kepegawaian 2020 BLUD Scan
Kepala Ruangan Kepegawaian 2020 BLUD Hardisk External
Kepala Ruangan Bedah 2020 BLUD Stetoskop
Kepala Ruangan Covid 19 2020 BLUD Termometer
Kepala Ruangan Covid 19 2020 BLUD Bantal Kepala
Kepala Ruangan Covid 19 2020 BLUD Bantal Guling
Kepala Ruangan Covid 19 2020 BLUD Kasur Busa
Kepala Ruangan Covid 19 2020 BLUD Kasur Busa
Kepala Ruangan Covid 19 2020 BLUD Sprei Motif
Kepala Ruangan Covid 19 2020 BLUD Sprei
Kepala Ruangan Covid 19 2020 BLUD Cermin
Kepala Ruangan Covid 19 2020 BLUD Cermin
Kepala Ruangan Covid 19 2020 BLUD Mesin Cuci
Kepala Ruangan Sanitasi 2020 BLUD Tong Sampah Medis
Kepala Ruangan Sanitasi 2020 BLUD Tong Sampah Medis
Kepala Ruangan ICU 2020 BLUD Kasur Decubitus
Kepala Ruangan Sanitasi 2020 BLUD Westafel
Rumah Dinas Direktur 2021 BLUD Rice Cooker
Rumah Dinas Direktur 2021 BLUD Besi Horden + Keset
Rumah Dinas Direktur 2021 BLUD Gelas Plastik
Kepala Ruangan Covid 19 2021 BLUD Senter Kepala
Kepala Ruangan Covid 19 2021 BLUD Lakban Merah + Bening
Kepala Ruang THT 2021 BLUD Kapas Wajah/kecantikan
Ruang Sanitasi 2021 BLUD Kantongan Kuning
Ruang Sanitasi 2021 BLUD Gabus 6,2
Ruang Sanitasi 2021 BLUD Sifon Westafel
Ruang Sanitasi 2021 BLUD Krant Westafel
Ruang Sanitasi 2021 BLUD Krant Bcp
Ruang Sanitasi 2021 BLUD Selang Flexible
Ruang Sanitasi 2021 BLUD Socket 1/2
Ruang Sanitasi 2021 BLUD Lem PVC Kaleng
Ruang Sanitasi 2021 BLUD Te 2
Ruang Sanitasi 2021 BLUD Elbow 2
Ruang Sanitasi 2021 BLUD Socket 2
Ruang Sanitasi 2021 BLUD TE 1/2
Ruang Sanitasi 2021 BLUD Elbow 1/2
Ruang Sanitasi 2021 BLUD Supralon Aw 2
Ruang Sanitasi 2021 BLUD Exelon Aw 2
Ruang Sanitasi 2021 BLUD Exelon aw 1/2
Laboratorium 2021 BLUD Meja 1/2 Biro MT 120
Radiologi 2021 BLUD Meja 1/2 Biro MT 120
Laboratorium 2021 BLUD Kursi Statis/Citos Busa Biru
Polik Bedah 2021 BLUD Kursi Statis/Citos Busa Biru
Radiologi 2021 BLUD Kursi Statis/Citos Busa Biru
Rumdis Ahli Syaraf 2021 BLUD Tv LED
Ruang ICU 2021 BLUD Springbed Set
Radiologi 2021 BLUD Loker
Ruang IGD Umum 2020 BLUD AC split
Laboratorium 2020 BLUD AC split
Ruang ICU 2021 BLUD termometer Gun
Ruang ICU 2021 BLUD Termometer Ruangan
Kabag Umum 2021 BLUD Laptop
Kabag Umum 2021 BLUD Printer
Staff Aset Dan Keuangan 2021 BLUD Laptop
Bpjs 2021 BLUD Printer
Bpjs 2021 BLUD SCAN
Perencanaan 2021 BLUD Mouse
Perencanaan 2021 BLUD flash disk
Penunjang Medik Dan Non Medik 2021 BLUD Printer
Kepala Ruangan IBS 2021 BLUD AC UNIT
Kepala Ruangan IBS 2021 BLUD Perlak
Kepala Ruangan IBS 2021 BLUD Kain Drill
Kepala Ruangan IBS 2021 BLUD GELAS
Kepala Ruangan IBS 2021 BLUD RAK PIRING
Kepala Ruangan IBS 2021 BLUD Sendok
Kepala Ruangan IBS 2021 BLUD Tong Sampah
Ruangan CSSD 2021 BLUD AC Unit
Ruangan CSSD 2021 BLUD AC Unit
Ruangan CSSD 2021 BLUD AC Unit
Gudang ASET 2021 BLUD AC Unit
Gudang ASET 2021 BLUD Meja 1/2 Biro
Kepala Ruangan Sanitasi 2021 BLUD Pompa Celup
Kepala Ruangan Sanitasi 2021 BLUD Pompa Celup
Kepala Ruangan Sanitasi 2021 BLUD Pompa Celup
Kepala Ruangan Sanitasi 2021 BLUD RESIN
Kepala Ruangan Sanitasi 2021 BLUD KATALIS
Kepala Ruangan Sanitasi 2021 BLUD MAT/SERAT
Kepala Ruangan Sanitasi 2021 BLUD TALK
Kepala Ruangan Sanitasi 2021 BLUD Lampu
Kepala Ruangan IPS RS 2021 DAK Syiringe Pump
Kepala Ruangan IPS RS 2021 DAK Patient Monitor
Kepala Ruangan IPS RS 2021 DAK Infusion Pump
AN. Kepala Ruangan ICU 2021 DAK Patient Monitor
Keuangan 2022 DAU Laptop
Kepala Ruangan Bayi 2022 Blud Stetoskop
Kepala Ruangan Bayi 2022 Blud Thermometer
Kepala Apotik Depo 2021 DAU Laptop
Gudang Apotik 2021 DAU Komputer pC
Ruang Gizi 2021 BLUD CCTV
Perencanaan 2021 BLUD Ram Elite
Perencanaan 2021 BLUD UPS
Perencanaan 2021 BLUD Hardisk External
Coaxial Breathing Circuit With
Flow
Ruang ICU 2021 BLUD Sensor,Preassembled,peds to
adult ( only for C1,T1 and MR1
) ( Isi 20 Pcs/box )

Temperature/flow probes for

Ruang ICU 2021 BLUD circuit 1,5M Length
Ruang ICU 2021 BLUD Oxygen Cell
Rekam Medik Penyimpanan 2021 BLUD Lemari Arsip Rm
Rekam Medik Penyimpanan 2021 BLUD Lemari Arsip Rm
Rekam Medik Penyimpanan 2021 BLUD Lemari Arsip Rm
Transit COVID 19 2021 BLUD Breathing Circuit Dual Limb Disposable ( Include 2 Bact
Transit COVID 19 2021 BLUD Breathing Circuit Single Limb Disposable ( Include 2 Bac
Transit COVID 19 2021 BLUD Breathing Circuit Pediatric Disposable ( Include 2 Bacte
Transit COVID 19 2021 BLUD Humidifier F&P set ( include probe temperature,probe
Transit COVID 19 2021 BLUD Face Mask Adult disposable
Transit COVID 19 2021 BLUD face mask pediatric disposable x 30
Transit COVID 19 2021 BLUD HME Filter
Transit COVID 19 2021 BLUD Chamber Adult
Ruang ICU 2021 BLUD Exhause Fan
Bendahara Penerimaan 2021 BLUD Charger Laptop Asus
Bendahara Penerimaan 2021 BLUD HDD WD 1 TB ( Hardisk )
Ruang Kohorting 2021 BLUD Tensi One 1a
Ruang Kohorting 2021 BLUD Stetoscope
Pelayanan Medik 2021 BLUD Printer
Ruang Gizi 2021 BLUD Blender
Seroja C 2021 BLUD Tensi Digital
Seroja C 2021 BLUD Kipas Angin Berdiri
Sanitasi 2021 BLUD Selang TANGKI
IGD PONEK 2021 BLUD Fetal Doppler
RUANG OK 2021 BLUD Fetal Doppler
Ruang Keuangan 2021 BLUD Dispenser + Galon
Ruang O2 2021 BLUD Dispenser + Galon
Pos Satpam 2021 BLUD Dispenser + Galon
Ruang Direktur 2021 BLUD Prasmanan + sendok
2021 BLUD termogun
2021 BLUD termometer
Apotik DEPO 2021 BLUD AC split floor standing
Ruang Instalasi Bedah Sentral 2021 BLUD Rice Cooker
Ruang Kabid. Keperawatan 2021 BLUD AC Split
Pengurus Barang 2021 BLUD Hardisk External
Staff Aset 2021 BLUD SSD Internal
Pengurus Barang 2021 BLUD SCAN
CSSD 2021 BLUD Printer
Pengurus Barang 2021 BLUD Hub TL
Apotik DEPO 2021 Blud AC Split
PPK APBD 2021 BLUD SSD Internal
Laboratorium 2021 BLUD Lemari Arsip
Sanitasi 2021 BLUD Trolly
GEDUNG BPJS 2021 BLUD Scan
GEDUNG BPJS 2021 BLUD Ribon
GEDUNG BPJS 2021 BLUD Keyboard
GEDUNG BPJS 2021 BLUD Hub 4 Port DG
Laboratorium 2021 BLUD Cool Box
Kasi Pelayanan Medik 2021 BLUD Charger ( Adaptor )
Kepegawaian 2021 BLUD Mixer PVC
Kepegawaian 2021 BLUD Loudspeaker
Kepegawaian 2021 BLUD AMPLIFIER
Kepegawaian 2021 BLUD Microphone Table Stand
Kepegawaian 2021 BLUD Bracket Gantung
Kepegawaian 2021 BLUD Microphone/Wireless Mic
Kepegawaian 2021 BLUD Kabel
Perencanaan 2021 BLUD Printer
Sim Rs 2021 BLUD Printer
 TAHUN
MERK/TYPE NO SERI QTY SATUAN NAMA BARANG
PENGADAAN

9 10 11 12 13 14
- - 1- 2019 -
- - 2 Buah 2019 Kipas Angin
- - 2 Buah 2019 Kursi Chitosse
- - 1 Buah 2019 Kursi Chitosse
2 Buah 2019 Kursi Chitosse
2 Buah 2019 Kursi Chitosse
- 1 Buah 2019 -
- 1 Buah 2019 -
Panasonik/2 pk 3792945019 1 Unit 2019 -
Polytron/1 PK 87HO1136 1 Unit 2019 Air Conditioner
- - - - - -
Panasonik/2PK 3792944692 1 Unit 2019 -
Regency/Z.TW 1910924 1 Unit 2019 kipas Angin Tempel
Panasonik/NR. A19 11906578 1 Unit 2019 Lemari linen
Sharp/32 INCI LC32LE260ITT 9643616D009 1 Unit 2019 -
- - - - 2019 -
Erka 194102637 1 Unit 2019
Nuritek 19215 0110101 001 1 Unit 2019 Hospital Bed
Nuritek 19215 0110101 002 1 Unit 2019 Hospital Bed

19215
Nuritek
0100125 006 19215 01001124 001 19215 010011253 Unit
085 2019 Lemari
Nuritek 19215 01001125 003 1 Unit 2019 Lemari
Narcotik Cabinet 19215 0102610 001 1 Unit 2019
Nuritek 19215 01015111 001 1 Unit 2019
Nuritek 19215 01001125 002 1 Unit 2019 Lemari
Nuritek 1 Unit 2019
1 Unit 2019
Nuritek 19215 01001125 004 1 Unit 2019 Lemari
1 Unit 2019
MEND HK-4001 02020683 1 Unit 2019
MEND HK-4001 02019689 1 Unit 2019
Platinum InspirationP-011 1 Unit 2016 TV LED 24 Inci
Polytron 3792955347 1 Unit 2019
Miyako 0810027906 1 Unit 2020 Jam Dinding
Maspion 79257064 1 Unit 2019 kipas Angin Tempel
Toshiba 1 Unit 2020
3 Unit 2020 Bantal Guling
Miyako 0810026830 1 Unit 2020
Miyako 0810027903 1 Unit 2020 Bak Cok 4 Mata
Miyako 0810026814 1 Unit 2020 Galon
1 Unit 2020
ENDO 360250-M19b02840009 1 Unit 2020
Bundar 7 set 2020 Rantang makanan
Aqua 1 Unit 2020
Sharp swd-72EAL-wh 1 Unit 2020 Galon
Olympic 1 Unit 2020
Olympic 1 Unit 2020
20 Unit 2020 Bayclin
Kaneda Sprayer 2 Unit 2020
Rostar Chain Lock 5 Unit 2020 Gembok Biasa
2 Unit 2020
sandisk 1 Buah 2020
Dell DJWH3P2 1 Unit 2020
LG 908VWL22C392 1 Unit 2020 Kantongan Hitam Jumbo
2 Unit 2020 Sarung Tangan cuci Piring
red fox 1 Unit 2020 Alat Semprot 8 ltr
1 Unit 2020 Sendok Besi
LG 1 Unit 2020 Kasur Busa
Omron 20190846920VG 1 Unit 2020
1 Unit 2020 Bantal Guling
4 mata 1 Unit 2020 TV LED 32 INC
10 Unit 2020
Sekai 1440087-06072019 1 Unit 2020
Lion Star 12 Unit 2020
Apex Medical 9P-047000 1 Unit 2020
LG 809WSCF1Z611 1 Unit 2020
VEV/V10 2015U0651 1 Unit 2020 HANDY TALK
2 Unit 2020
1 Unit 2020
1 Unit 2020
Polytron 578280B00713 1 Unit 2020
Polytron 578280B00737 1 Unit 2020
Maspion 1 Unit 2020 kipas Angin Tempel
Miyako 0907015626 1 Unit 2020
Polytron 931589K00120 1 Unit 2020
New Star 5 Unit 2020 Kursi Chitosse
New Star 2 Unit 2020
New Star 3 Unit 2020
New Star 2 Unit 2020
Polytron 578280C01396 1 Unit 2020 AC Unit
Polytron 616329k00384 1 Unit 2020 Kursi Bundar
555 1 Unit 2020
Quennera 1 Unit 2020
Maspion 1 Unit 2020 kipas Angin Tempel

Major Surgery
Instrument Set utk
Emaled 3 Unit 2020 urologi Dewasa
Miyako 0910025553 1 Unit 2020 Kursi Busa
Gea 10901715480 1 Unit 2020

Major Surgery
Instrument Set utk
Emaled 3 Unit 2020 urologi Dewasa
Fyrom InterNasional 2 Unit
Fyrom InterNasional 3 Unit
Fyrom InterNasional 2 Unit
3 Unit
Emaled 3 Unit
Tontarra 1 Unit
Tontarra 1 Unit
Medicon 1 Unit
Phillips 1 Unit
CMOS DRAKE 1 Unit
DIST/Ds 7000 2 Unit
CMOS DRAKE 1 Unit
HP 1 Unit
3 ray 1 Unit
DIST/Ds 7000 2 Unit
3 ray 1 Unit
Fanem 1 Unit
Fanem 1 Unit
Fanem 1 Unit
Fanem/Mod. 1150 S 1 Unit
Fanem 2 Unit
Simex 1 Unit
SYSMED/OC-S100 6 Unit
Chitose 6 Unit
1 Unit
Xtreme 4 Unit
2 Buah 2020
2 Buah 2020
4 Buah 2020
2 Buah 2020
ABN Majestik 1 Unit 2020
ABN Majestik 1 Unit 2020
Riester 1 Unit 2020
Fujitsu 1 Unit 2020
Transcend 1 Unit 2020
ABN Majestik 1 Unit 2020
Dekko 1 Unit 2020
9 Unit 2020
9 Unit 2020
5 Unit 2020
2 Unit 2020
6 Unit 2020
10 Unit 2020
 1 Unit 2020
2 Unit 2020
LG PG 05 1 Unit 2020
10 Unit 2020
2 Unit 2020
Apex Medical 1 Unit 2020
3 Unit 2020
Maspion 1 Unit 2021
1 set 2021
1 Lusin 2021
Light Led 4 Unit 2021
4 Roll 2021
20 Pak 2021
10 pak 2021
10 Buah 2021
1 Buah 2021
1 Buah 2021
1 Buah 2021
1 Buah 2021
20 Buah 2021
1 Buah 2021
5 Buah 2021
15 Buah 2021
15 Buah 2021
5 Buah 2021
10 Buah 2021
3 Buah 2021
12 Buah 2021
10 Buah 2021
1 Unit 2021
2 Unit 2021
1 Unit 2021
2 Unit 2021
6 Unit 2021
Sharp 1 Unit 2021
1 Unit 2021
1 Unit 2021
Polytron 665789J00321 1 Unit 2020
Polytron 665789H00298 1 Unit 2020
DT 8826 2 Unit 2021
Safety SK-109 2 Unit 2021
Asus Zenbook 7384 1 Unit 2021
Epson L3110 X6NX256850 1 Unit 2021
MSI KATANA 1D84C6C9-EFD0-4E69-A8C8- 1 Unit 2021
Canon Pixma G3010 1 Unit 2021
Fujitsu C92J007010 1 Unit 2021
Logitech 2 Unit 2021
32 gb 1 Unit 2021
 Epson L3110 1 Unit 2021
SHARP 2 PK 63229984285 1 Unit 2021
Cokelat 10 Meter 2021
Biru tua 10 Meter 2021
Asvita 12 Buah 2021
Nagata 1 Buah 2021
Golden 1 Lusin 2021
Jaring Orange 4 Buah 2021
Sharp 1 Pk 63229984281 1 Unit 2021
Sharp 1 Pk 63229984281 1 Unit 2021
Sharp 1 Pk 1 Unit 2021
Daikin 1 pk 1 Unit 2021
Active Furniture 1 Unit 2021
ALDO SEWAGE PUM000059 1 unit 2021
YAMAHA PRO HSZ 400A 1 unit 2021
YAMAHA PRO HSZ 400A 1 unit 2021
Cairan/reagen 20 kg 20 kg 2021
Cairan/reagen 2 kg 2 kg 2021
SERAT Busa 10 pcs 2021
bubuk 6 bungkus 2021
Evaco Panjang 4 unit 2021
Mindray 14 Unit 2021
Mindray 14 Unit 2021
Mindray 13 Unit 2021
Mindray 9 Unit 2021
Acer TravelMate P214 Series 1 Unit 2021
Littman Quality K17K10065 1 Unit 2022
YUWELL B2107001709 1 Unit 2022
Acer UNVLESD006146000B10601 1 Unit 2021
Lenovo MP1TV3SX 1 Unit 2021
Smart 1 Unit 2021
8 GB DDR4 2 Unit 2021
APC 1400 1 Unit 2021
WD 2 TB ( PCHA500 ) 1 Unit 2021

1 Box 2021

1 pcs 2021

1 pcs 2021
1 Unit 2021
1 Unit 2021
1 Unit 2021
ual Limb Disposable ( Include 2 Bacterial Filter ) 4 pcs 2021
ngle Limb Disposable ( Include 2 Bacterial Filter ) 4 pcs 2021
ediatric Disposable ( Include 2 Bacterial Filter ) 2 pcs 2021
( include probe temperature,probe heater wire dan bracket ) 2 pcs 2021
4 pcs 2021
disposable x 30 1 Box 2021
40 pcs 2021
2 pcs 2021
2 Unit 2021
1 Unit 2021
1 Unit 2021
1 Unit 2021
1 Unit 2021
Epson L3110 1 Unit 2021
1 Unit 2021
one IIA 1 Unit 2021
Miyako 2 Unit 2021
2 Buah 2021
1 Unit 2021
1 Unit 2021
Miyako 1 Unit 2021
Miyako 1 Unit 2021
Miyako 1 Unit 2021
Onyx 1 set 2021
1 unit 2021
1 unit 2021
Polytron 1 unit 2021
Miyako 1 unit 2021
Daikin 1 pk 1 unit 2021
Kingston 500 gb 1 unit 2021
1 unit 2021
Fujitsu 1 Unit 2021
Epson L3210 1 Unit 2021
TP LINK 1 Unit 2021
Polytron Standing 1 Unit 2021
Panther 240 GB 1 Unit 2021
Informa Besi full 6 Unit 2021
Ace Hrdware 1 Unit 2021
Fujitsu 1 Unit 2021
Epson 3 Unit 2021
2 Unit 2021
2 Unit 2021
1 Unit 2021
Lenovo 1 Unit 2021
Yamaha MG10xu 1 Unit 2021
BMB CS-550V 2 Unit 2021
BMB DA-3000 1 Unit 2021
KREZT 3 Unit 2021
2 Unit 2021
Shure 1 Unit 2021
100 Meter 2021
Epson L3110 1 Unit 2021
Epson L3110 1 Unit 2021
 2

TAHUN
MERK/TYPE NO SERI QTY SATUAN NAMA BARANG MERK/TYPE
PENGADAAN

15 16 17 18 19 20 21
- - - - - - -
Regency/Z.TW 201845267 1 Unit 2019 Kipas Angin Regency/Z.TW
- - 3 Buah 2019 Meje 1/2 Biro Hit -
- - 2 Buah 2019 Lemari Linen -
- 3 Buah 2019 Lemari Loker Krisbow/5 Laci
- 2 Buah 2019 Lemari Linen Quennera/-
- - - - - - -
- - - - - - -
- - - - - - -
Polytron/1 PK 87101020 1 Unit 2019 - -
- - - - - - -
- - - - - - -
Regency/Z.TW 1910991 1 Unit 2019 kipas Angin BerdiriRegency/Z.TST
Quennera/- - 1 Buah 2019 - -
- - - - - - -
- - - - - - -

Nuritek 19215 01001125 001 1 Unit 2019 Lemari Karixa

Nuritek 19215 01001125 007 1 Unit 2019 Lemari Karixa

19263160431009
Karixa 19263160431010 19263160431005
3 Unit 2019 Overbed Table
Karixa 1926316043008 1 Unit 2019

Karixa 19263160431001 1 Unit 2019

Karixa 19101160431023 1 Unit 2019

PLD 24D1850/L 857329G00561 1 Unit 2020

Dekko Quartz 1 Unit 2020 Galon Aqua Aqua

Maspion 79257260 1 Unit 2019 kipas Angin TempeMaspion

3 Unit 2020 SPREI

kuriyama 1 Unit 2020

AQUA 1 Unit 2020
 kotak 10 Buah 2020

AQUA 1 Buah 2020 Gelas Plastik Asvita

26 Botol 2020 Tisu Kotak Paseo

Padlock 1 Unit 2020

an Hitam Jumbo 9 Pack 2020 Kantongan Kuning

Tangan cuci Piring 3 Pasang 2020
Dexan 1 Unit 2020
1 Unit 2020 Kompor Gas 2 MATA
8 Unit 2020

1 Unit 2020 Sprei Bonita

Sharp 9643719co1363 1 Unit 2020 Sepatu boot AP Boot

VEV/V10 2015U01660 1 Unit 2020 Bel Electrik Bell

Maspion 1 Unit kipas Angin TempeMaspion

New Star 3 unit Kipas Angin BerdiriMiyako

Polytron/1 PK 578280CO1387 1 Unit 2020

SINDA/BESI 11 Unit 2020 Kursi Tunggu 555

Maspion 1 Unit 2020 kipas Angin TempeMaspion

Major Surgery
Instrument Set
utk urologi
Tontarra 1 Unit 2020 Pediatric tontarra
Chitose 2 Unit 2020 Kursi Tunggu Pasien
 Major Surgery
Instrument Set
utk urologi
Tontarra 1 unit 2020 Pediatric Tontarra
AU - A9UCY
AU - A9UCY
AU - A9UCY

PC833
 3 4

TAHUN
NO SERI QTY SATUAN NAMA BARANG
PENGADAAN

22 23 24 25 26
- - - - -
201910949 1 Unit 2019 -
- 1 Buah 2019 -
- 1 Buah 2019 Kursi Dokter
- 1 Buah 2019 Lemari Linen
- 1 Buah 2019 Meje 1/2 Biro Hitam
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
201805468 1 Unit 2019 -
- - - - -
- - - - -
- - - - -

19263160431013 1 Unit 2019

19263160431011 1 Unit 2019

19286160503001 2 Unit 2019 Push Tep

1 Unit 2020 Foot Step

89015484 1 Unit 2019

2 Unit 2020
 12 Buah 2020

20 Buah 2020 Kain Pel

15 Pack 2020 Kantongan Hitam

1 Unit 2020 Tabung Gas

1 Unit 2020
9 Pasang 2020 Setrika + alat strik

7502/17a7328 1 Unit 2020

1 Unit 2020 Kipas Angin Tempe

1 Unit 2020 Kipas Angin Berdiri

10 Unit 2020

1 Unit 2020 kipas Angin Tempe

Major Surgery
Instrument Set
1 Unit 2020 utk vaskuler
2 Unit 2020 Tensi Digital
 Major Surgery
Instrument Set
1 Unit 2020 utk vaskuler
 4 5+AG2:AL6

TAHUN
MERK/TYPE NO SERI QTY SATUAN NAMA BARANG MERK/TYPE
PENGADAAN

27 28 29 30 31 32 33
- - - - - - -
- - - - - - -
- - - - - - -
Quennera - 1 Buah 2019 - -
Quennera/- - 1 Buah 2019 - -
/2 Biro Hitam - 1 Buah 2019 - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -

Mak Hospital Equpment 1607341520001020 1607341520001019 1607341520001002

Mark Hospital 1 Unit 2016

 30 Lembar 2020 Tangki Semprot Vanda

20 Pack 2020

1 Unit 2020

6c122/37/6c 04.6292.2.3 1 Set 2020 Loyang+ rak piring

Maspion 1 Unit 2020

Miyako 1 Unit

Maspion 1 Unit 2020 kipas Angin TempeMaspion

Mesin Anestesi
Medicon 1 Unit 2020 ventilator Phillips
Omron 202003001287V 1 Unit 2020
 Mesin Anestesi
Medicon 1 unit 2020 ventilator Phillips
5+AG2:AL6

TAHUN
NO SERI QTY SATUAN
PENGADAAN

34 35 36 37
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
1 Unit 2020

4 Buah 2020

1 Unit 2020

1 Unit 2020
1 unit 2020
 NAMA RUANGAN/INSTALASI NAMA PENANGGUNGJAWAB
Kepala Kepala AKepala Admission SUYANTO SALAKEA
Kepala Kepala B Kepala Bendahara Penerimaan (Kasir) SUYANTO A. SALAKEA, SKM
Kepala Kepala DiKepala Direktur dr. H. ARIANTO S. PANAMBANG
Kepala Kepala GKepala Gudang Obat ROSITA JAFAR, S.Farm
Kepala Kepala Kepala Gudang Rekam Medik MINARNI H. KOTAE, SKM
Kepala Kepala InKepala Instalasi Gawat Darurat MISRIAWATI I. AMBOMOLONG, S.Kep., NS
Kepala Kepala Ins
Kepala Inst. Rawat Jln/Poli Geriatri SUCIANTI, A.Md.Kep
Kepala Kepala InKepala Instalasi Farmasi SRI ARIYANTI, S.FAR. APT
Kepala Kepala InKepala Instalasi Laboratorium HARDIMAN, AMAK
Kepala Kepala InKepala Instalasi Loundry EZWARNI, S.SOS
Kepala Kepala InKepala Instalasi Radiologi SURYANI YUNUS, A.MD.RAD
Kepala Kepala InKepala Instalasi Unit Transfusi Darah SYAHRIL B. KOPING A.Md.Kep
Kepala Kepala IPKepala IPS-RS IRSANTO IB MASTURA., A.Md.Tem
Kepala Kepala K Kepala Kabid Pelayanan Medik LUKMAN S.SOS, M.Kes
Kepala Kepala KaKepala Kasie. Pelayanan Rawat Jalan (Polik HIV) OLYN LAHATI, AMD.KEB
Kepala Kepala K Kepala Kasie. Penunjang Non Medik MEILANY, SKM
Kepala Kepala K Kepala Kasubag. Kepegawaian SANTI, SKM
Kepala Kepala K Kepala Kasubag. Keuangan & Aset PRASITORESMI AK. MENTEMAS, SKM.
Kepala Kepala PoKepala Polik Geriatri FALEN NATALIA SAMAD
Kepala Kepala PoKepala Polik Gigi NURHAEDA ZAINU
Kepala Kepala PoKepala Polik KIA AMNA, A.Md. Keb
Kepala Kepala PoKepala Polik Syaraf NISMAWATI M. TURUNGKU, A.Md.Kep
Kepala Kepala PoKepala Polik THT SARINI ABD KADIR
Kepala Kepala Kepala Rekam Medik JULAEHA AR. BATALIPU, A.Md.Kep
Kepala Kepala R Kepala Ruang Admition FARIDA HANDAYANI, SE
Kepala Kepala R Kepala Ruang Anak YUSRIANTI NATALIA, A.Md.Kep
Kepala Kepala R Kepala Ruang Bedah NURLELAWATI, S.KEP.NERS
Kepala Kepala R Kepala Ruang COVID-19 MUHAMMAD, S.Kep., NS
Kepala Kepala R Kepala Ruang CSSD RANI R. SAID, A.Md.Kep
Kepala Kepala RuKepala Ruang Fisioterapy NURMAWATI HARIS, A.MD.FIS
Kepala Kepala R Kepala Ruang GIZI RINA HEFRIANI, SKM
Kepala Kepala R Kepala Ruang ICU NOFRINCE, S.Kep., NS
Kepala Kepala R Kepala Ruang ICU ERMITA PUSPITA SARI, A.Md.Kep
Kepala Kepala R Kepala Ruang IGD MUHAMMAD, S.Kep., NS
Kepala Kepala RuKepala Ruang Isolasi NAHRIATI, A.Md.Kep
Kepala Kepala R Kepala Ruang Loket SUNARTI R. NGGAI
Kepala Kepala R Kepala Ruang Melati DARMAWATI S.Kep., NS
Kepala Kepala R Kepala Ruang NICU MEGAWATI, A.Md.Kep
Kepala Kepala R Kepala Ruang Nifas RAFIKA DURI, A.Md.Kep
Kepala Kepala R Kepala Ruang Ok RAHMAN ANTU
Kepala Kepala RuKepala Ruang Paviliun SUMARDI YUSUP, A.Md.Kep
Kepala Kepala R Kepala Ruang Ponek Bersalin NURLAILA H. HI. MUHTANG, S.TR.Keb
Kepala Kepala Kepala Ruang Rekam Medik SARMILA SKM.
Kepala Kepala Kepala Ruang Workshop RISNO
Kepala Kepala R Kepala Ruangan SIM RS ICHSAN, S.Kep.NS,,MPH
Kepala Kepala R Kepala Ruangan Polik Anak RABIHATUN MANGIL, A.Md.Kep
Kepala Kepala R Kepala Ruangan Polik Covid 19 SRI SULISTIAWATI Z AKIL.A.MD.KEP
Kepala AN. KepalAN. Kepala Ruangan Pavilliun SUSANTI.A.MD.KEP
Kepala Kepala R Kepala Ruangan Sanitasi HERIYANI HASNAWI, SKM
Kepala RuMah DiRuMah Dinas Direktur dr. Lisdiana Amin Asri
Rumah Dinas AhlRumah Dinas Ahli Syaraf dr. Emi Wardani Sp. N
Kepala Kepala R Ruangan CSSD ISRAM P NDIGI
Kepala Kepala R Gudang ASET NURSAMSY
Kepala Kepala R Kepala Ruangan ICU YULIANI.A.MD.KEP
Kepala Kepala R Ruangan Bayi SARMINI.S, Kep. Ns
Kepala Kepala P PJB APOTIK DEPO IGD ZULFIAH.A.MD.FAR
Kepala Perenca Perencanaan MOHAMMAD AMRIL HENTU.S.SI
Kepala Transit Transit COVID 19 SUDIRMAN.A.MD.KEP
Kepala Ruang IsoRuang Isolasi NORMA S LAOPO.A.MD.KEP
Kepala Kasi Pen Kasi Penunjang Medik WAHYUNI.SKM
Kepala Ruang InsRuang Instalasi Bedah Sentral ATMAN.A.MD.KEP
Kepala Ruang KaRuang Kabid. Keperawatan NISMA B D HASYIM, SKM
Kepala PengurusPengurus Barang Nursyamsi
Kepala Staff AseStaff Aset Andi Muh Reski Pausi
Kepala Ruang IsoRuang Isolasi Ummi Fitriani H. Mukalap, A.md. Kep
Kepala GEDUNGGEDUNG BPJS SUPARMAN S LAINJONG.SKM
Kepala Perenca Perencanaan SYAMSURIZAL UDIN, SKM
NIP
Ruang Direktur
19830113 200212 1 005 Ruang Kabag. Umum
19760806 201001 1 012 Ruang Kabid. Pelayanan Medik
Ruang Kabid. Penunjang Medik
198412242008042002 Ruang Kabid. Keperawatan
198101182002122003 Ruang Keuangan
19820410 200501 2 013 Ruang Kepegawaian
19820918 200804 2 002 Ruang Perencanaan
197406101994031005 Instalasi Gawat Darurat
19670505198803 2 021 Instalasi Laboratorium
19860828 201101 2 011 Instalasi UTD
19711125 199703 007 Instalasi Radiologi
197904112008041001 Instalasi Farmasi
19640620 198701 1001 Ruang CT-Scan
19671029 198803 2 006 Ruang Admition
198105072006042017 Ruang IPS-RS
19810825 200903 2 001 Ruang Komite Medik
19881006 201101 1 007 Ruang Komite Keperawatan
19801226 200502 2 004 Ruang Kasir
19810225200502 2 003 Ruang IGD Ponek
19661204198912 2 001 Ruang Rekam Medik
19840728 200312 2 001 Poli Bedah
198008262001122003 Poli Dalam
19690314 198912 2 002 Poli Mata
19800405 201101 2 008 Poli KIA
19811218 200502 2 004 Poli Gigi
19790702 200012 2 001 Poli Anak
1985031 201903 2 004 Poli Syaraf
19850420200903 2 008 Ruang Bayi
19840101 200903 2 003 Ruang Ponek
19840819 201001 2 013 Ruang Nifas
19841113 200604 2 004 Ruang Anggrek
19830417 201001 2 013 Ruang Bedah
19781011 200502 1 004 Ruang ICU
19871162 201001 2 006 Ruang Anak
19840904 200801 2 005 Ruang Isolasi
Ruang Melati
19700610 198911 2 002 Ruang VIP
19830108 201001 2 009 Ruang VVIP
19740606 199603 1 003 Ruang Tulip
19841204 200604 1 004 Ruang Operasi
19860428 201001 2 008 Instalasi Laundry
Instalasi CSSD
 Fisioterapi
19780103 200604 1 008 Instalasi Gizi
19691023 198903 2 007 Ruang Mesin Genset
19820321 200604 2 026 Ruang Pokja PPI
198410162010012013 Ruang SPI
198912102015022001 Ruang SIM-RS
19640419 198903 2 002 Ruang AULA
Ruang Oxygen
19830503 200502 1 000 Kantin
19810727 200604 1 013 Cleaning Service
198512022009032001 Kasir
198507072009032001 PPI
19850821 200903 2 000 MPP
19840618 200804 1 001 Loket
19881120 201101 1 003 Security/Pol PP
19880913 201101 2 011 Sisrute
19860522 201001 2 008 RM. Penyimpanan
198409262010011006 Transit COVID 19
196803181990032004 Ruang Sanitasi
19810727 200604 1 013 HUMAS
0 Management
19810922 200212 2 002 Bupati
198208092009031001 Sekda
197508302006041019 PEMDA
dr. Emi
dr. Indah
Dirjen Kementrian Kelautan
Laboratorium COVID19
Pinjaman DINKES
IRJA/IRNA
RUJAB
dr. Hartono
dr. Andika
dr. Aras
dr. Dian
Ruang IPAL
Kebidanan COVID19
Wakil Bupati
Expire Date
Rusak
dr. H. ARIANTO S. PANAMBANG 19760806 201001 1 0
NURAINI PUSADAN, S.Sos 19630628198503200
LUKMAN.S.SOS.M.KES 19640620198701100
SADIK LATJINDUNG
NISMA B D HASYIM, SKM 19680318199003200
PRASITORESMI AK. MENTEMAS, SKM. 19881006 201101 1 0
SANTI, SKM 19810825 200903 2 0
SYAMSURIZAL UDIN, SKM 19750830200604101
MISRIAWATI I. AMBOMOLONG, S.Kep., NS 19810118200212200
HARDIMAN, AMAK 19740610199403100
SYAHRIL B. KOPING A.Md.Kep 19711125 199703 00
SURYANI YUNUS, A.MD.RAD 19860828 201101 2 0
SRI ARIYANTI, S.Far., Apt 19820918200804200
SURYANI YUNUS, A.MD.RAD 19860828 201101 2 0
FARIDA HANDAYANI, SE 19800405 201101 2 0
IRSANTO IB MASTURA., A.Md.Tem 19790411200804100

SUYANTO A. SALAKEA, SKM 19830113 200212 1 0

NURLELAWATI, S.KEP.NERS 19790702 200012 2 0
JULAEHA AR. BATALIPU, A.Md.Kep 19690314 198912 2 0
SUMARDI BUHANG
RABAIYAH, A.Md.Kes
NURAINI PUSADAN, S.Sos
LUKMAN.S.SOS.M.KES
JAWIYAH
ASURA
MARYAM TUDAAN
AMNA.A.MD KEB
HERLINA A TILOLI
EZWARNI
FLUMA DONATHA HATIMURA
OLYN LAHATI.A.MD.KEB
NISMA B D HASYIM, SKM
SRIMULIANI TARAKUKU
ROSMIATY A LAMAKA.A.MD.KEB
JULAEHA AR BATALIPU.A.MD.KEP
RABIHATUN MANGIL, A.Md.Kep
LILISURYANI.A.MD.KEP
AMIRUDIN H DAUD
MEGAWATI.A.MD.KEP
SYAHRIL BAKAR KOPING, A.Md.Kep
RAHMAN ANTU
drg. SITI YURIKA
HARDIMAN
GAFAR M HI NOORS
MOH ARIF Y UMAR
SYAMSURIZAL UDIN, SKM
DR.ARIANTO
WITRI IRFANI.SKM
NURAINI M RUDIN
ICHSAN.S.KEP.,M P H
MASMIATI T HI UKUM A MD KEP
JAFAR G SAINING, SKM.,M.Kes
MUHAMMAD, S.Kep, Ners
NURHAYA RASYID, S.Kep
IRSANTO IB MASTURA.A.MD.TEM
NURLELAWATI, S.Kep.Ners
RAHMAWATY S RAUKANG.A.MD.KEP
SUARNO
ASMIWARTI ABDULLAH, S ST
SARASWATI H MUKALAP SKM
NUR HASNA, S. Farm.Apt, M.Farm
ARWIN ALI
196212081987111001
196301191986032007
196306281985032006
196406201987011001
196501031989032011
196509132014092001
196512251987032021
196612041989122001
196704102006042009
196705051988032021
196710081989022006
196710291988032006
196803181990032004
196805181987032003
196812051988032006
196903141989122002
196910231989032007
196911031989122002
196912252006041008
197006101989112002
197111251997031007
197406061996031003
197406062005022005
197406101994031005
197505051997031003
197505152007011025
197508302006041019
197608062010011012
197611222008042001
197705302003122006
197801032006041008
197804082002122007
197809281998031004
197810112005021004
197901032002122004
197904112008041001
197907022000122001
197907032003122006
197911302003121007
198001162003122010
198002012001122002
198002032006042026
198002242008011004
FARIDA HANDAYANI.SE 198004052011012008
RAFIGA.SKM 198006122006042010
RUSTAM I LABOKO 198006212002121002
SARINI ABDUL KADIR.A.MD.KEP 198008262001122003
FALEN NATALIA SAMAD 198012262005022004
MISRAWATI I AMBOMOLONG.A.MD.KEP 198101182002122003
NURAINI, ST 198102092005022003
NURHAEDA ZAINU, AMD, Kg 198102252005022003
MEILANY.SKM 198105072006042017
KARSILA SY K. HADU 198106112014072002
FITRI.A.MD.KEP 198106302003122006
SRI ZUMRIYAH.S.Kep.Ners 198107192006042022
NURSAMSY 198107272006041013
SANTI.SKM 198108252009032001
YUSRIANTI NATALIA.A.MD.KEP 198112182005022004
ROSIDHA M MARHUM, S.Kep 198202102005022003
WATINI.SKM 198202122010012012
MARNI 198203072000122003
SRI SULISTIAWATI Z AKIL.A.MD.KEP 198203212006042026
SUCIANTI, S.Kep 198204102005102013
ABDUL SALAM A KANOLI 198206112003121003
IRWANDI.A.MD.KEP 198207272003121002
SUPARMAN S LAINJONG.SKM 198208092009031001
ROSITA JAFAR.S.FARM 198208182010012012
NURHIDAYAH.AMAK 198208192001122001
SRI ARIYANTI.S.FAR..APT 198209182008042002
NORMA I KASAD.S.FARM 198211062010012013
SUHARTINA LABAS 198212262002122001
RAFIKA DURI.A.MD.KEP 198301082010012009
SUYANTO A SALAKEA,SKM 198301132002121005
HIDAYAT TAUFIQURAHMAN.S.KEP 198302082009031002
SRIWANA.A.MD.KEP 198302212010012008
HERLINA.A.MD.KEP 198303262005022001
NURRISKA 198303292014072003
dr ARAS ARTHUR THANA PAMANGIN 198304022011011014
DEDY ARMAN L KOROMPOT.A.MD.KEP 198304142005021003
ERMITA PUSPITASARI TOBIGO.A.MD.KEP 198304172010012013
ISRAM P NDIGI 198305032005021000
NI PUTU DARMAWATI.A.MD.KEP 198305082010012011
RONAWATI. S.Kep 198305112006041016
TITI KURNIAWATI, S Sit 198307032006042008
NURAFNI N LABUKA.S.SI.APT 198307032009032003
SULAWATI 198310042005022001
KARMILA M LABAKURU.A.MD.KEP 198310052006042009
HUSNI.A.MD.KEP 198310052009031002
KARMILA S LAOPO.A.MD.KEP
RUSLAN, SKM
NURMAWATI HARIS.A.MD.FIS
SAPRI HASAN.A.MD.KEP
INDRAWATY DULANIMO, S.Tr.Keb
SAHRUDIN SY ABD RAHMAN.A.MD.KEP
MOHAMMAD AMRIL HENTU.S.SI
NISMAWATI M TURUNGKU
SUDARMONO A Md Kep
AHRIANI.A.MD.KEP
RINA HEFRIANI.SKM
SUNARTI R NGGAI
ATMAN.A.MD.KEP
SUSANTI.A.MD.KEP
NOFRINCE.A.MD.KEP
SUMARDI S YUSUP.A.MD.KEP
MINARNI H KOTAE.SKM
ARIE WIBOWO, A.Md.Ak.
ANDI MOH TAMIR.A.MD.KEP
SARIPAH.A.MD.KEP
VICKY WULAN KAREBA, A.Md.Kes
RANI R SAID.A.MD.KEP
SARMINI.S, Kep. Ns
WIWIN WINARTY DATUEHA.A.MD.KEB
ZULFIAH.A.MD.FAR
ELEN INDRIANI.A.MD.KEP
SISKA ANUGERAH.A.MD.KEP
HERNAWATI.A.MD.KEP
ASRIANI.A.MD.KEP
YULIANI.A.MD.KEP
SARINI A LAHAMADE.A.MD.KEP
DIAN NOVITA HANGGI.A.MD.KEP
ROSITA.AMD.KEP
DARMAWATI.A.MD.KEP
dr. IRMA SULING
NURLAILA H HI MUHTANG. S.Tr. Keb
WAHYUNI.SKM
NI LUH CANDRAWATI.A.MD.KEP
SYAMSIAR DM.AMAK
SITI FATIMAH.AMKL
SURYANI YUNUS.A.MD.RAD
MASLINA.A.MD.KEP
RIFAL EKAPUTRA.A.MD.KEP
MAHANAIM KA'U.A.MD.FAR
SUNARSI S ST
198310272006042013
198311022005021002
198401012009032003
198403092010011008
198403142009032005
198405202010011010
198406182008041001
198407282003122002
198408042005021002
198408122010012013
198408192010012013
198409042008012005
198409262010011006
198410162010012013
198411132006042004
198412042006041004
198412242008042002
198501142009031001
198501202009031001
198503112010012005
198503312019032004
198504202009032008
198507072009032001
198508202009032001
198508212009032002
198508312009032002
198509282010012014
198510172010012008
198511092010012012
198512022009032001
198601212010012011
198601242010012007
198602072010012011
198602142010012008
198604182015022001
198604282010012008
198605222010012008
198605242010012007
198607292010012007
198608082011012012
198608282011012011
198609062010012010
198611082010011003
198611172011012014
198611192009032002
ARDIASYAH.A.MD.KEP
ROSNA.A.MD.KEP
CANDRA INTAN.A.MD.KEP
IRIANTI AIN.A.MD.KEP
ROLAND YULIANDRA.A.MD.KEP
LASRI A MD KEP
NAHRIATI.A.MD.KEP
TRISUSETYO PUTRA UTAMA.SKM
ERLINA M SALEH.A.MD.KEB
WILASTRI M ALITONANG.A.MD.KEP
NURFAIDAH ALAM, S.Kep.,Ns
MUKARAM, A.Md.Kep
dr. YULIANTI RAUF
NURASIA.A.MD.KEP
GLADIES LANGITAN.A.MD.KEP
NORMA S LAOPO.A.MD.KEP
PRASITORESMI A K MENTEMAS.SKM
ARIFANDI.SKM MPH
SUDIRMAN.A.MD.KEP
HUDAYANA RAIF.A.MD.KEP
I MADE TONI ADYANA, AMAK
FITRYANI.AMD.FAR
HERIYANI HASNAWI, SKM
MUTMAINNA, S.Tr.Keb
SUSILAWATY LESTARI,S.Kep.,Ns
DEWIRINA DJ. MADAS, A.Md.Farm
NOFRIANTI, S.Gz
dr. DIAN WAHYUNI
RESKI RAMADHANI, A.Md
SUCHIYATI H TAKULOE, S.Tr.Keb
RISNA PUSPITA, S.Tr.Ft
ROSKYA SARI A TIMUMUN, S.Tr.Keb
IMAM HUSAIN, A.Md.Rad
dr. Lisdiana Amin Asri
dr. Emi Wardani Sp. N
SAHRONI S. LANGENRE, S. Farm. MM
MOH. NEGARAWAN PUTRA S.ip
Nursyamsi
198612072010011006
198612252009032001
198701272010012011
198706082010012005
198707092009031001
198709242017052003
198711162010012006
198712192011011010
198802122011012011
198802182010012007
198806142019032009
198806242019031011
198807192019032007
198808012011012012
198808272010012003
198809132011012011
198810062011011007
198811042011011002
198811202011011003
198902272011012011
198904012019031015
198905122011012008
198912102015022001
199004162011012002
199102142015022001
199106272019032024
199211072019032008
199212312019032013
199303072015022001
199407142019032019
199408302019032012
199509062019032014
199607192019031001
19640419 198903 2 002
19840410 200903 1 002
19840410 201001 1 004
19810727 200604 1 013
 DISTRIBUS
TAHUN 2
KODE TANGGAL NAMA BARANG MERK/TYPE
1/16/2020 Dispenser Miyako
2/27/2020 Flash Disk 16 GB Toshiba
2/24/2020 Bantal Kepala
2/24/2020 Dispenser Miyako
2/26/2020 Dispenser Miyako
2/26/2020 Dispenser Miyako
2/26/2020 Dudukan Galon
2/27/2020 EKG ENDO
3/17/2020 Rantang makanan Bundar
Galon AIR Aqua
3/18/2020 Dispenser Sharp
3/18/2020 Kasur Busa Olympic
3/18/2020 Kasur Busa Olympic
3/19/2020 Botol Spray
3/19/2020 Tangki Semprot Kaneda Sprayer
3/20/2020 Gembok + Rantai Rostar Chain Lock
3/20/2020 Ember Tutup Besar
Flash Disk sandisk
3/20/2020 Laptop Dell
3/21/2020 Mesin Cuci LG
3/30/2020 Celemek cuci Piring
3/30/2020 Semprot 5 liter Red Fox
Belanga Kecil
Mesin Cuci LG
4/1/2020 Mesin Cuci Polytron
Bantal Kepala
Bak Cok 4 mata
Tempat Jemuran Aluminium
4/8/2020 Kasur Busa olympic
4/8/2020 Kipas Angin Tempel Regency Z.TW 20
5/4/2020 Kasur Apex Oasis 2000 Apex Medical
5/22/2020 Mesin Cuci 12,5 kg LG
5/22/2020 Handy Talk VEV/V10
5/22/2020 MUG pemanas Air Steinlees
5/12/2020 Brangkar Pasien Covid
5/12/2020 Brangkar Pasien Covid
6/2/2020 AC 1 pk Polytron
6/2/2020 AC 1 pk Polytron
6/2/2020 kipas Angin Tempel Maspion
Jam Dinding Dekko Quartz
2/24/2020 Bantal Guling
Bak Cok 4 Mata kuriyama
Galon AQUA
3/17/2020 Rantang makanan kotak
Galon AQUA
Bayclin
3/20/2020 Gembok Biasa Padlock
Kantongan Hitam Jumbo
3/30/2020 Sarung Tangan cuci Piring
3/30/2020 Alat Semprot 8 ltr Dexan
Sendok Besi
4/8/2020 Kipas Angin Tempel Regency Z.TW 18
Bantal Guling
4/8/2020 Kipas Angin Tempel Regency Z.TW 18
5/22/2020 HANDY TALK VEV/V10
6/2/2020 kipas Angin Tempel Maspion
Galon Aqua Aqua
SPREI
Gelas Plastik Asvita
Tisu Kotak Paseo
Kantongan Kuning
Kompor Gas 2 MATA
Sprei Bonita
Sepatu boot AP Boot
Bel Electrik Bell
6/2/2020 kipas Angin Tempel Maspion
Foot Step Mark Hospital
Kain Pel
Kantongan Hitam
Tabung Gas
4/8/2020 Kipas Angin Tempel Regency Z.TW 14
6/2/2020 Kipas Angin Tempel Maspion
3/19/2020 Tangki Semprot Vanda
4/8/2020 kipas Angin Tempel Regency Z.TW 20
3/23/2020 Tempat Sampah Pedal Injak Maspion
3/23/2020 Tempat Sampah Pedal Injak Lion Star
3/20/2020 Partus Set SCHWERT
1/15/2020 Blender Phillips
1/18/2020 Televisi Polytron
1/28/2020 Meteran Roll 100m Majesty
2/24/2020 Printer Epson L3110
1/31/2020 Kursi Kerja Pejabat Frontline
2/13/2020 Selang Air Magic Hose
2/18/2020 Hard disk Seagate Expansion
2/26/2020 Laptop Asus
2/18/2020 Hard disk Seagate Expansion
2/19/2020 Jet Cleaner Multipro
2/28/2020 Microphone Ealsem
Ember Tutup Sedang
4/8/2020 kipas Angin Tempel Regency Z.TW 16
3/26/2020 Iphone Krisbow
3/26/2020 Westafel Metalco
4/8/2020 kipas Angin Tempel Regency Z.TW 14
3/31/2020 Dispenser Miyako
4/8/2020 Kipas Angin Tempel Regency Z.TW 20
4/8/2020 Kipas Angin Tempel Regency Z.TW 20
4/8/2020 Kipas Angin Tempel Regency Z.TW 16
4/9/2020 Kipas Angin Tempel Regency Z.TW 14
Kasur Busa Olympic 200x120x14
4/9/2020 kipas Angin Tempel Regency Z.TW 16
4/9/2020 Kipas Angin Tempel Regency Z.TW 16
4/13/2020 Tensi Digital Omron
4/13/2020 Cool Box + Gabus
4/15/2020 TV LED 32 INC Sharp
5/14/2020 Kasur Busa 120x200 Napolly
7/7/2020 Komputer Lenovo
Handphone Oppo A31
7/7/2020 Suction Pump Fyrom International
7/7/2020 Syringe Pump Fyrom International
7/7/2020 Handphone Oppo A31
3/23/2020 Pompa Semprot Mini Red Fox
Galon Aqua
4/15/2020 Setrika + alat strika 6c122/37/6c
4/15/2020 Loyang+ rak piring
4/15/2020 Setrika Phillips
Kasur Busa Olympic 90x200
4/16/2020 Tensi Digital Resources
4/16/2020 Freezer LG
4/16/2020 Cool Box + Gabus Lion Star
7/7/2020 Komputer Lenovo
7/7/2020 Suction Pump Fyrom International
7/7/2020 Syringe Pump Fyrom International
4/20/2020 Kipas Angin Duduk Sekai
4/20/2020 Thermometer Infrared Sincere Person
4/20/2020 Nebulizer Omron
4/20/2020 Thermometer Infrared Sincere Person
4/20/2020 Tensi Digital Resources
4/28/2020 Televisi LED Sharp 24 INCI
4/28/2020 Mesin Cuci Sharp
2/26/2020 Laptop Acer
3/26/2020 Setrika Phillips
4/28/2020 kipas Angin Tempel Regency/Z.TW 14
4/28/2020 Rice Cooker Miyako
4/28/2020 Westafel
4/29/2020 Box Cooler + stereoform Lion Star
4/29/2020 Regulator 02
 DISTRIBUSI ASET
TAHUN 2020
SERIAL JUMLAH SATUAN TAHUN RUANGAN
0810027906 1 Unit 2020 Polik Geriatri
1 Unit 2020 Rekam Medik
3 Unit 2020 Ruang IGD
0810026830 1 Unit 2020 Polik Fisioterapy
0810027903 1 Unit 2020 Polik Kia
0810026814 1 Unit 2020 Admission
1 Unit 2020 Ruang Isolasi
360250-M19b02840009 1 Unit 2020 Ruang IGD
7 set 2020 Ruang GIZI
1 Unit 2020 Polik Fisioterapy
swd-72EAL-wh 1 Unit 2020 UTD RS
1 Unit 2020 Workshop
1 Unit 2020 Admission
20 Unit 2020 Sanitasi
2 Unit 2020 Sanitasi
5 Unit 2020 Kasi.Penunjang Non Medik
2 Unit 2020 Sanitasi
8 Gb 1 Buah 2020 Pelayanan Medik
DJWH3P2 1 Unit 2020 Keuangan Dan Aset
908VWL22C392 1 Unit 2020 Instalasi Loundry
2 Unit 2020 Instalasi Gizi
1 Unit 2020 Sanitasi
1 Unit 2020 Covid 19
1 Unit 2020 Covid 19
337789K00169 1 Unit 2020 Instalasi Loundry
1 Unit 2020 UTD RS
1 Unit 2020 Asrama Covid 19
10 Unit 2020 Asrama Covid 19
8 Unit 2020 Asrama Covid 19
1932013 1 Unit 2020 Ruang Nifas
9P-047000 1 Unit 2020 Ruang Bedah
809WSCF1Z611 1 Unit 2020 Instalasi Loundry
2015U0651 1 Unit 2020 Ruang Transit Covid 19
2 Unit 2020 Ruang Transit Covid 19
1 Unit 2020 Ruang Transit Covid 19
1 Unit 2020 IGD Umum
578280B00713 1 Unit 2020 Kabid Pelyanan Medik
578280B00737 1 Unit 2020 Kasubag Kepegawaian
79257080 1 Unit 2019 IGD Umum
1 Unit 2020 Polik Geriatri
 3 Unit 2020 IGD Umum
1 Unit 2020 Polik Kia
1 Unit 2020 Admission
10 Buah 2020 Instalasi Gizi
1 Buah 2020 UTD RS
26 Botol 2020 Sanitasi
1 Unit 2020 Kasi.Penunjang Non Medik
9 Pack 2020 Instalasi Loundry
3 Pasang 2020 Instalasi Gizi
1 Unit 2020 Sanitasi
1 Unit 2020 Asrama Covid 19
1937056 1 Unit 2020 Admision
1 Unit 2020 UTD RS
1859108 1 Unit 2020 Asrama Covid
2015U01660 1 Unit 2020 Ruang Transit Covid 19
79257214 1 Unit 2019 IGD Umum
1 Unit 2020 Polik Geriatri
2 Unit 2020 IGD Umum
12 Buah 2020 UTD RS
20 Buah 2020 Sanitasi
15 Pack 2020 Instalasi Loundry
1 Unit 2020 Asrama Covid 19
1 Unit 2020 UTD RS
9 Pasang 2020 Asrama Covid 19
7502/17a7328 1 Unit 2020 Ruang Transit Covid 19
79257147 1 Unit 2019 IGD Umum
1 Unit 2016 Polik Geriatri
30 Lembar 2020 Sanitasi
20 Pack 2020 Loundry
1 Unit 2020 Asrama Covid 19
1702071 1 Unit 2020 Asrama Covid
79257066 1 Unit 2019 IGD Umum
1 Unit 2020 Sanitasi
1932158 1 Unit 2020 Ruang Nifas
10 Liter 7 Unit 2020 Sanitasi
14 Liter 7 Unit 2020 Sanitasi
1 Set 2019 Ruang Transit Covid 19
HR2157 1 Unit 2020 Instalasi Gizi
857329G00561 1 Unit 2020 Ruang Paviliun
1 Unit 2020 Ruang IPS RS
X6NX231891 1 Unit 2020 Gudang Logistik
1 Unit 2020 Kepala Bidang Pelayanan
2 Unit 2020 Petugas Sampah
NAAL05LR 1 Unit 2020 Gudang Logistik
K9NOLP01503439C 1 Unit 2020 Bendahara Blud
 NAAL05M3 1 Unit 2020 Keuangan dan Aset
1 Unit 2020 IPS RS
2014070320072 1 Unit 2020 Pramu Bakti
1 Unit 2020 Sanitasi
1 Unit 2020 Asrama Covid
50008/SDPPI/2017 1 Unit 2020 Ruang Covid 19
2 Set 2020 CSSD
1844078 1 Unit 2020 Asrama Covid
709017405 1 Unit 2020 Ruang Covid 19
1932156 1 Unit 2020 Ruang Nifas
1931923 1 Unit 2020 Ruang Nifas
1905414 1 Unit 2020 Asrama Covid
1702097 1 Unit 2020 Asrama Covid
6 Unit 2020 Asrama Covid
1905959 1 Unit 2020 Asrama Covid
1844107 1 Unit 2020 Asrama Covid
20190846920VG 1 Unit 2020 Polik Gigi
13 Unit 2020 Laboratorium
9643719co1363 1 Unit 2020 Asrama Covid 19
3 Unit 2020 Ruang IGD
MP1N4D41 1 Unit 2020 Instalasi Farmasi
IMEI 868488040128991 1 Unit 2020 Laboratorium
2240905200008 1 Unit 2020 Ruang Covid 19
2062804200150 1 Unit 2020 Ruang Covid 19
IMEI 868488040129015 1 Unit 2020 SIM RS
Uk. 5 Ltr 3 Unit 2020 Sanitasi
1 Buah 2020 Ruang Covid 19
04.6292.2.3 1 Set 2020 Asrama Covid 19
4 Buah 2020 Asrama Covid 19
HR2122 1 Unit 2020 Instalasi Loundry
1703594 2 Buah 2020 Asrama Covid
18013100251 1 Unit 2020 Ruang Covid 19
001INHZ11905 1 Unit 2020 Laboratorium
2 Unit 2020 Laboratorium
MP1N4NX8 1 Unit 2020 Instalasi Farmasi
02240905200007 1 Unit 2020 Ruang Covid 19
02062804200189 1 Unit 2020 Ruang Covid 19
1440087-06072019 1 Unit 2020 Kasir
Model JXD-001 1 Unit 2020 Isolasi
20190712953UF 1 Unit 2020 Ruang Melati
Model JXD-001 1 Unit 2020 Ruang Melati
18013100243 1 Unit 2020 Ruang Melati
9612420A006778 1 Unit 2020 Asrama Covid ( Bidan Covid )
9402420A000133 1 Unit 2020 Asrama Covid
MX6J3SN-008746181A07600 1 Unit 2020 Keuangan dan Aset
 HD1172 1 Unit 2020 Loundry
141702055 1 Unit 2020 Asrama Covid ( Bidan Covid )
37050304598 1 Unit 2020 Asrama Covid ( Bidan Covid )
1 Unit 2020 Asrama Covid ( Bidan Covid )
12 Unit 2020 Laboratorium
9 Unit 2020 Petugas O2
 PENERIMA BARANG KET
Falen Natalia Samad, Amd. Kep
Sarmila Skm.
Muhammad, S.Kep.Ns
Nurmawati Haris, A.Md.Fis
Amna amd, Keb.
Farida Handayani, SE.
Nahriati, A.Md. Kep
Muhammad, S.Kep.Ns
Rina Hefriani
Nurmawati Haris, A.Md.Fis
Syahril B. Koping Amd. Kep
Risno
Suyanto Salakea
Vicky Wulan Kareba
Vicky Wulan Kareba
Meilany, Skm.
Vicky Wulan Kareba
Olyn Lahati, Amd.Keb
Prasitoresmi AK. Mentemas, SKM.
Ezwarni, S.sos
Rina Hefriani
Vicky Wulan Kareba
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Ezwarni, S.Sos
Syahril B. Koping Amd. Kep
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Rafika Duri, A.Md.Keb
Nurlelawati, S.Kep.Ners
Ezwarni, S.sos
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Lukman S.Sos, M.Kes
Santi, Skm
Muhammad, S.Kep.Ns
Falen Natalia Samad, Amd. Kep
Muhammad, S.Kep.Ns

Rina Hefriani

Meilany, Skm.

Vicky Wulan Kareba

Farida Handayani, SE

Muhammad, S.Kep.Ns

Muhammad, S.Kep.Ns

Muhammad, S.Kep.Ns
DAK

Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Vicky Wulan Kareba
Rafika Duri, A.Md.Keb
Heriyani Hasnawi
Heriyani Hasnawi
Muhammad, S.Kep.Ns
Rina Hefriani.SKM
Sumardi Yusup, Amd.Kep
Irsanto Ib. Mastura
Delfi sy Kasim
Lukman, S.Sos.M.Kes
Mochamad Faisal
Delfi sy Kasim
SARASWATI H. MUKALAP
Prasitoresmi Ak. Mentemas, SKM
Irsanto Ib. Mastura, S.Tr.Kes
Amirudin H. Daud
Heriyani Hasnawi, SKM
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Ruliyana, S.Farm.Apt
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Rafika Duri, A.Md.Keb
Rafika Duri, A.Md.Keb
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
drg. Siti Yurika
Hardiman, AMAK
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Sri Ariyanti, S.Far. Apt
Hardiman, AMAK
Muhammad, S.Kep.Ns DAK
Muhammad, S.Kep.Ns DAK
Ichsan, S.Kep.Ns..MPH
Heriyani Hasnawi, SKM
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns

Ezwarni, S.Sos
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Hardiman, AMAK
Hardiman, AMAK
Sri Ariyanti, S.Far. Apt
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Suyanto A. Salakea, SKM
Nahriati, A.Md.Kep
Darmawati, S.Kep.Ns
Darmawati, S.Kep.Ns
Darmawati, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
SARASWATI H. MUKALAP
Ezwarni, S.Sos
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Hardiman
Syafrudin
 DISTRIBUSI A
TAHUN 202
KODE TANGGAL NAMA BARANG MERK/TYPE
1/15/2020 Blender Phillips
1/18/2020 Televisi Polytron
1/28/2020 Meteran Roll 100m Majesty
Printer Epson L3110
1/31/2020 Kursi Kerja Pejabat Frontline
2/13/2020 Selang Air Magic Hose
2/18/2020 Hard disk Seagate Expansion
2/26/2020 Laptop Asus
2/18/2020 Hard disk Seagate Expansion
2/19/2020 Jet Cleaner Multipro
2/28/2020 Microphone Ealsem
Ember Tutup Sedang
Setrika Phillips
3/26/2020 Iphone Krisbow
3/26/2020 Westafel Metalco
Mesin Cuci Polytron
Dispenser Miyako
4/8/2020 Kipas Angin Tempel Regency Z.TW 20
4/8/2020 Kipas Angin Tempel Regency Z.TW 18
4/8/2020 Kipas Angin Tempel Regency Z.TW 18
4/8/2020 Kipas Angin Tempel Regency Z.TW 14
Kasur Busa Olympic 200x120x14
Cool Box + Gabus Lion Star
Tensi Digital Resources
Freezer LG
Thermometer Infrared Sincere Person
Nebulizer Omron
Televisi LED Sharp 24 INCI
Kasur Busa 120x200 Napolly
7/7/2020 Komputer Lenovo
Handphone Oppo A31
7/7/2020 Suction Pump Fyrom International
7/7/2020 Syringe Pump Fyrom International
7/7/2020 Handphone Oppo A31
3/23/2020 Pompa Semprot Mini Red Fox
Galon Aqua
4/8/2020 kipas Angin Tempel Regency Z.TW 20
4/8/2020 kipas Angin Tempel Regency Z.TW 16
4/8/2020 kipas Angin Tempel Regency Z.TW 14
Kasur Busa Olympic 90x200
 Cool Box + Gabus Lion Star
Thermometer Infrared Sincere Person
Mesin Cuci Sharp
7/7/2020 Komputer Lenovo
7/7/2020 Suction Pump Fyrom International
7/7/2020 Syringe Pump Fyrom International
4/8/2020 Kipas Angin Tempel Regency Z.TW 20
4/9/2020 Kipas Angin Tempel Regency Z.TW 14
4/9/2020 kipas Angin Tempel Regency Z.TW 16
4/8/2020 Kipas Angin Tempel Regency Z.TW 20
4/9/2020 Kipas Angin Tempel Regency Z.TW 16
4/8/2020 Kipas Angin Tempel Regency Z.TW 16
Tensi Digital Resources
2/26/2020 Laptop Acer
3/26/2020 Setrika Phillips
 DISTRIBUSI ASET
TAHUN 2020
SERIAL JUMLAH SATUAN TAHUN RUANGAN
HR2157 1 Unit 2020 Instalasi Gizi
857329G00561 1 Unit 2020 Ruang Paviliun
1 Unit 2020 Ruang IPS RS
X6NX231891 1 Unit 2020 Gudang Logistik
1 Unit 2020 Kepala Bidang Pelayanan
2 Unit 2020 Petugas Sampah
NAAL05LR 1 Unit 2020 Gudang Logistik
K9NOLP01503439C 1 Unit 2020 Bendahara Blud
NAAL05M3 1 Unit 2020 Keuangan dan Aset
1 Unit 2020 IPS RS
2014070320072 1 Unit 2020 Pramu Bakti
1 Unit 2020 Sanitasi
HR2122 1 Unit 2020 Instalasi Loundry
50008/SDPPI/2017 1 Unit 2020 Ruang Covid 19
2 Set 2020 CSSD
337789K00169 1 Unit 2020 Instalasi Loundry
709017405 1 Unit 2020 Ruang Covid 19
1932013 1 Unit 2020 Ruang Nifas
1937056 1 Unit 2020 Admision
1859108 1 Unit 2020 Asrama Covid
1702071 1 Unit 2020 Asrama Covid
6 Unit 2020 Asrama Covid
13 Buah 2020 Laboratorium
18013100251 1 Unit 2020 Ruang Covid 19
001INHZ11905 1 Unit 2020 Laboratorium
Model JXD-001 1 Unit 2020 Isolasi
20190712953UF 1 Unit 2020 Ruang Melati
9612420A006778 1 Unit 2020 Asrama Covid ( Bidan Covid )
3 Unit 2020 Ruang IGD
MP1N4D41 1 Unit 2020 Instalasi Farmasi
IMEI 868488040128991 1 Unit 2020 Laboratorium
2240905200008 1 Unit 2020 Ruang Covid 19
2062804200150 1 Unit 2020 Ruang Covid 19
IMEI 868488040129015 1 Unit 2020 SIM RS
Uk. 5 Ltr 3 Unit 2020 Sanitasi
1 Buah 2020 Ruang Covid 19
1932158 1 Unit 2020 Ruang Nifas
1 Unit 2020 Asrama Covid
1844078 1 Unit 2020 Asrama Covid
1703594 2 Buah 2020 Asrama Covid
 2 Unit 2020 Laboratorium
Model JXD-001 1 Unit 2020 Ruang Melati
9402420A000133 1 Unit 2020 Asrama Covid
MP1N4NX8 1 Unit 2020 Instalasi Farmasi
02240905200007 1 Unit 2020 Ruang Covid 19
02062804200189 1 Unit 2020 Ruang Covid 19
1932156 1 Unit 2020 Ruang Nifas
1702097 1 Unit 2020 Asrama Covid
1905959 1 Unit 2020 Asrama Covid
1931923 1 Unit 2020 Ruang Nifas
1844107 1 Unit 2020 Asrama Covid
1905414 1 Unit 2020 Asrama Covid
18013100243 1 Unit 2020 Ruang Melati
MX6J3SN-008746181A07600 1 Unit 2020 Keuangan dan Aset
HD1172 1 Unit 2020 Loundry
 PENERIMA BARANG KET
Rina Hefriani.SKM
Sumardi Yusup, Amd.Kep
Irsanto Ib. Mastura
Delfi sy Kasim
Lukman, S.Sos.M.Kes
Mochamad Faisal
Delfi sy Kasim
SARASWATI H. MUKALAP
Prasitoresmi Ak. Mentemas, SKM
Irsanto Ib. Mastura, S.Tr.Kes
Amirudin H. Daud
Heriyani Hasnawi, SKM
Ezwarni, S.Sos
Muhammad, S.Kep.Ns
Ruliyana, S.Farm.Apt
Ezwarni, S.Sos
Muhammad, S.Kep.Ns
Rafika Duri, A.Md.Keb
Farida Handayani, SE
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Hardiman, AMAK
Muhammad, S.Kep.Ns
Hardiman, AMAK
Nahriati, A.Md.Kep
Darmawati, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Sri Ariyanti, S.Far. Apt
Hardiman, AMAK
Muhammad, S.Kep.Ns DAK
Muhammad, S.Kep.Ns DAK
Ichsan, S.Kep.Ns..MPH
Heriyani Hasnawi, SKM
Muhammad, S.Kep.Ns
Rafika Duri, A.Md.Keb
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Hardiman, AMAK
Darmawati, S.Kep.Ns
Muhammad, S.Kep.Ns
Sri Ariyanti, S.Far. Apt
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Rafika Duri, A.Md.Keb
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Rafika Duri, A.Md.Keb
Muhammad, S.Kep.Ns
Muhammad, S.Kep.Ns
Darmawati, S.Kep.Ns
SARASWATI H. MUKALAP
Ezwarni, S.Sos

DAK
4000000
5000000 1,150,000
4,000,000
46,063,600
119,189,400
715,000
1,100,000
5,000,000
585,000
1,150,000
325,000
585,000
123,000
3,000,000