PEMERINTAH KABUPATEN SUMBAWA

RUMAH SAKIT UMUM DAERAH

JALAN GARUDA NO.5 TELP: 0371-21929 FAX: 0371-23974 SUMBAWA BESAR
Sumbawa Besar, 10 September 2018
Kepada : Yth. PT. SUMBER CAHAYAKU PUTRI G.
Jl. R.A. Kartini No. 69 Monjok - Mataram
0370-640395

SURAT PESANAN

Mohon dikirim Reagen / BHP untuk keperluan Laboratorium kami sebagai berikut :
PT. SUMBER CAHAYAKU PUTRI GRISELDA
NO NAMA REAGEN JUMLAH SATUAN VOLUME MEREK KET

1 Cleaning Acidick Solution (AC) 1 Botol 500ml/Botol ERBA

2 Cleaning Basic Solution (AL) 1 Botol 500ml/Botol ERBA
3 Spuit Heparin 3cc 15 Box 100's/ Box BD
4 Tabung EDTA 3 ml 25 Box 100's/Box Vaculab
5 Tabung EDTA Bayi 0,5ml 10 Box 100's/Box Vaculab
6 CC ACID WASH 1 Set 2 x 500 ml/Set Architect / Abbott
7 CC Alkaline WASH 1 Set 2 x 500 ml/Set Architect / Abbott
8 DIRECT BILIRUBIN 1 Kit Kit/R1: 1 x 39 ml, R2: 1 x 13 ml Architect / Abbott
9 TOTAL BILIRUBIN 1 Kit Kit/R1: 1 x 53 ml, R2: 1 x 17 ml Architect / Abbott
10 Creatinine 2 Kit 2x100ml/Kit QCA
11 CC DETERGENT B 1 Kit 2 x 400 ml / Kit Architect / Abbott
12 D-LDL-C 2 Kit 80ml/Kit Human
13 LDH Liquid UV 1 Kit 10x10ml / Kit Human
14 SGOT 1 Kit 8x50ml / Kit Human
15 SGPT 1 Kit 8x50ml / Kit Human
16 Lyse CD Emerald 1 Botol 960ml / Botol Abbott
17 HBsAg Device Test S/P 25 Box 40's/Box V-Care
18 HCG / Test Kehamilan Device Urine 2 Box 40's/Box V-Care
19 IgG/IgM Dengue 15 BoX 10's / Box V-Care
20 Typhoid IgG dan IgM 2 Box 10's / Box V-Care
21 TSH 1 Kit 96's / Kit ACON
22 fT3 1 Kit 96's / Kit ACON
23 fT4 1 Kit 96's / Kit ACON
24 Golda Antisera-A 6 Vial 10ml / Vial Tulip
25 Golda Antisera-B 6 Vial 10ml / Vial Tulip
26 Golda Antisera-AB 6 Vial 10ml / Vial Tulip
27 Test Narcoba AMP Card 2 Box 25's / Box Promeds
28 Coag Control N+P 8 Vial 1ml / Vial Stago
29 Stik Urine Insight Expert 10M 5 Vial 100's / Vial ACON

Kepala Instalasi Farmasi Kepala Ruangan Laboratorium

Sandra Afriani, S.Farm HJ. Salwa, S. ST

NIP : 19880427 201502 2 004 NIP : 19681029198803 2 004

Mengetahui
Penanggung Jawab Laboratorium

( dr. Hj. Musayadah, Sp. PK. M. Kes )

NIP : 19690307 200312 2 002
 PEMERINTAH KABUPATEN SUMBAWA
RUMAH SAKIT UMUM DAERAH
JALAN GARUDA NO.5 TELP: 0371-21929 FAX: 0371-23974 SUMBAWA BESAR
Sumbawa Besar, 05 Agustus 2019
Kepada : Yth. PT. SUMBER CAHAYAKU PUTRI G.
Jl. R.A. Kartini No. 69 Monjok - Mataram
0370-640395

SURAT PESANAN

Mohon dikirim Reagen / BHP untuk keperluan Laboratorium kami sebagai berikut :
PT. SUMBER CAHAYAKU PUTRI GRISELDA

NO NAMA REAGEN JUMLAH SATUAN VOLUME MEREK KET

1 Albumin BCG 6 kit Kit / 1x84ml Architect / Abbott

2 Albumin Erba XL 3 kit Kit /1 x 44 ml Erba Mannaheim
3 CC Alkaline WASH 1 set 2 x 500 ml/Set Architect / Abbott
4 Bilirubin Direct 2 kit Kit / R1: 1 x 39 ml, R2: 1 x 13 ml Architect / Abbott
5 Bilirubin 2 kit Kit/1x245ml QCA
6 Bilirubin Total 2 kit Kit / R1: 1 x 53 ml, R2: 1 x 17 ml Architect / Abbott
7 Bilirubin Total 2 kit Kit / R1: 2 x 44 ml, R2: 1 x 22 ml Erba Mannaheim
8 Bilirubin Direct 2 kit Kit/R1:2x44ml,R2:1x22ml Erba Mannaheim
9 Cholesterol 2 kit Kit / R1 : 1 x 44 ml Erba Mannaheim
10 Cholesterol 9 kit Kit/ 1x84 ml Architect / Abbott
11 Creatinine 4 kit Kit / R1: 1 x 44 ml, R2: 1 x 11 ml Erba Mannaheim
12 Creatinine 2 kit Kit / 2x100ml QCA
13 Erba Norm 1 kit Kit / 4x5ml Erba Mannaheim
14 XL Wash 1 kit Kit / 4x100ml Erba Mannaheim
15 Glukosa 8 kit Kit / 1x20ml Architect / Abbott
16 Glucose 6 kit Kit / R1 : 1 x 44 ml Erba Mannaheim
17 CC H20 WATER BATH ADD 1 kit Kit / 2 x 500 ml Architect / Abbott
18 HbA1C 15 box Box /20's Taidoc
19 MCC (MULTICONTITUENT) Calibrator 1 kit Kit / Cal 1:3x5ml,Cal 2:3x5ml Architect / Abbott
20 SGOT 2 kit Kit/2x44ml,1x22ml Erba Mannaheim
21 SGOT 2 kit Kit/ R1 1x70 ml R2 1x21 ml Architect / Abbott
22 SGPT 2 kit Kit/ R1 1x70 ml R2 1x21 ml Architect / Abbott
23 SGPT 2 kit Kit/2x44ml,1x22ml Erba Mannaheim
24 Lyphocheck Assayed Chemistry Control, Level 1 kit Kit / 12 x 5 ml Architect / Abbott
25 Triglycerides 4 kit Kit / 1x84ml Architect / Abbott
26 Triglycerides 2 kit Kit / R1 : 1 x 44 ml Erba Mannaheim
27 Urea 1 kit Kit / 2x100ml Human
28 UREA 6 kit Kit/ 1x44ml,1x11ml Erba Mannaheim
29 Ureum 6 kit Kit/ R1: 1x10 ml, R2: 1x12 ml Architect / Abbott
30 Uric Acid 2 kit Kit / R1 : 1 x 44 ml Erba Mannaheim
31 Uric Acid 1 kit Kit / 4x100ml Human
32 XL Multical 1 kit Kit / 4x3ml Erba Mannaheim
33 Opti Casette 6 box Box/25's OPTI

Kepala Instalasi Farmasi Kepala Ruangan Laboratorium

Sandra Afriani, S.Farm HJ. Salwa, S. ST

NIP : 19880427 201502 2 004 NIP : 19681029198803 2 004

Mengetahui
Penanggung Jawab Laboratorium

( dr. Hj. Musayadah, Sp. PK. M. Kes )

NIP : 19690307 200312 2 002
 PEMERINTAH KABUPATEN SUMBAWA
RUMAH SAKIT UMUM DAERAH
JALAN GARUDA NO.5 TELP: 0371-21929 FAX: 0371-23974 SUMBAWA BESAR
Sumbawa Besar, 05 Agustus 2019
Kepada : Yth. PT. SUMBER CAHAYAKU PUTRI G.
Jl. R.A. Kartini No. 69 Monjok - Mataram
0370-640395

SURAT PESANAN

Mohon dikirim Reagen / BHP untuk keperluan Laboratorium kami sebagai berikut :
PT. SUMBER CAHAYAKU PUTRI GRISELDA

NO NAMA REAGEN JUMLAH SATUAN VOLUME MEREK KET

1 Gas calibrator 1 Buah Buah/1's OPTI

2 Reagen Pack Elektrolite 6 Pack Pack/Cal A 650 ml, Cal B 200 ml QC Past Cornley
3 Cleaner CD Emerald 6 Botol Botol/960ml Abbott
4 Lyse CD Emerald 2 Botol Botol / 960ml Abbott
5 Balls Vial 1 Tube Tube / 1850 balls Stago
6 Neoplastin Cl 2+ 4 Kit Kit/6x2ml Stago
7 STA CaCl² 2 Botol Botol/ 15 ml Stago
8 CK Press 4 Kit Kit/ 6x2 ml Stago
9 fT4 1 Kit 96's / Kit ACON
10 ASTO 1 Kit Kit / 50's Fortress
11 HCG/Test Kehamilan 10 box Box / 50's OneMed
12 PSA 1 Kit V Care V-Care
13 RF 1 Kit Kit / 50's Fortress
14 Troponin I 2 box Box / 40's V-Care
15 Benedict 1 Botol Botol / 1000ml E-Merck
16 Pot Urine 1000 Pcs Pcs / 1's Lokal
17 Kertas Lensa 1 Exp Exp / 50's Lokal
18 Giemsa 2 Botol Botol / 500ml E-Merck
19 Enzimatic Cleaner 1 Kit Kit / 2x50ml Abbott
20 Tabung EDTA 3ml 30 box Box / 100's Lokal
21 Tabung Citrat 1,8ml 30 box Box / 100's Interma
22 Slides 30 box Box / 72's SailBrand
23 VDRL 2 Vial Vial / 10ml Reiged/Fortress
24 HBsAg Device 50 box Box / 40's V-Care
25 Lidi Tusuk Sate 30 Bungkus Bungkus / 100's Lokal
Kepala Instalasi Farmasi Kepala Ruangan Laboratorium

Sandra Afriani, S.Farm HJ. Salwa, S. ST

NIP : 19880427 201502 2 004 NIP : 19681029198803 2 004

Mengetahui
Penanggung Jawab Laboratorium

( dr. Hj. Musayadah, Sp. PK. M. Kes )

NIP : 19690307 200312 2 002