SPH PT. Medika Sejahtera Purnama (Rev04272015) - All

PT.
MEDIKA SEJAHTERA PURNAMA

[MEDISENA]
Jl. GRIYA BABATAN MUKTI XIV/4 BLOK O/18
BABATAN WIYUNG SURABAYA 60227 JAWA TIMUR INDONESIA
email : medisena@yahoo.com, phone / fax : +62 31 753 2119, mobile phone : +62 811 32 6945
Ref. No.:154002/WJP/BLN/IV/2015. Surabaya, 16 April 2015.
Kepada Yth:
WJP Consultation Network.
c.q.: MARINA PERMATA HOSPITAL – Batulicin – Kalsel.
Jl. Wisma Permai Barat II / NN-9
Surabaya
Attn. : Widodo J.P., dr., MS., MPH., Dr.PH

cc. : Tito Yustiawan, drg., MARS
Perihal : Penawaran harga peralatan rumah sakit.
Dengan Hormat,
Sehubungan kebutuhan atas beberapa peralatan medis – rumah sakit untuk ”MARINA PERMATA
HOSPITAL”, maka bersama ini kami sampaikan penawaran dengan kondisi sebagai berikut:
No. URAIAN-TYPE-MEREK-DISTRIBUTOR QUANTITY Harga Harga

SATUAN TOTAL
(US$ atau Rp) (US$ atau Rp)
RADIOLOGI:
1. US$396,429.CT-SCAN 16 SLICE, SIEMENS SOMATOM
SCOPE 16 SLICE, DV Medika. 1(satu) unit US$ ……..- US$ …………-
2. X-RAY STATIONER, SIEMENS MULTIX

DR X-RAY UNIT, DV Medika. 1(satu) unit US$ 170,181.- US$ 170,181.-
3. X-RAY CEILING, SIEMENS Multix Fusion X-Ray,

DV Medika. 1(satu) unit US$ 140,000.- US$ 140,000.-
CSSD:
1. STEAM STERILIZER, WHITE ELEPHANT,
HS-360, DV Medika. 1(satu) unit, Rp.962.940.000,- Rp. 962.940.000,-
2. GAS PLASMA STERILIZER, WHITE ELEPHANT

PS-200, DV Medika. 1(satu) unit, Rp.1.818.850.000,- Rp. 1.818.850.000,-
3. ULTRASONIC CLEANER, MENYUSUL.

1(satu) unit Rp. …………,- Rp. ………….,-
4. WASHER DISINFECTOR, WHITE ELEPHANT,

QPQ-320, DV Medika. 1(satu) unit, Rp.642.015.000,- Rp.642.015.000,-
5. PORTABLE STEAM VACUUM STERILIZER,

TINGET XXXX, MEDISENA. 1(satu) unit, Rp. ………,- Rp. …………,-
6. STAINLESS STEEL MEJA, RAK, KABINET,

LOKAL INDONESIA,MEDISENA. 1(satu) paket, Rp. ………,- Rp. …………,-
7. CSSD – ACC. SUPPLIES, INCLUDED

DI ITEM 1. STEAM DAN ITEM 2. GAS PLASMA.
IBS – OT, ICU – ICCU PICU – NICU, KEBIDANAN - VK and RAWAT INAP:
1. SURGICAL LIGHT LED DUAL LIGHT HEAD,
ACOMED, AGENIUS, DV Medika. 1(satu) unit Rp. ……….,- Rp. ………….,-
2. SURGICAL TABLE ELECTRIC, ACOMED, AT-6700N,
”QUALITY and AFTER SALES is OUR PRIORITY”

”committed to care, serve and successfully”
PT. MEDIKA SEJAHTERA PURNAMA
[MEDISENA]
DV Medika. 1(satu) unit Rp. 647.980.000,- Rp.647.980.000,-
3. ANESTHESIA MACHINE, AR-325A

(w. VCV and PCV), MEDISENA. 1(satu) unit US$. 14,410.oo US$. 14,410.oo
4. VENTILATOR MACHINE, AR-203

(air compressor inside), MEDISENA, 1(satu) unit, US$. 12,430.oo US$. 12,430.oo
5. ELECTROSURGICAL UNIT,
ESU-2000AI(LCD), MEDISENA. 1(satu) unit, US$. 9,350.oo US$. 9,350,oo
6. PENDANT IBS, (ELECTRICAL,

SURGICAL, ANESTHESIA), MEDISENA,1(satu) unit,US$.21,000.oo US$. 21,000.oo
7. STRETCHER, P2500NG, DV Medika, 1(satu) unit, Rp. 56.380.000,- Rp. 56.380.000,-
8. SCRUB SINK, PLATINUM, DV Medika, 1(satu) unit,Rp. …………,- Rp. ……………,-
9. PATIENT MONITOR.
Alternative 1, PHILIPS, BERCA, terlampir.
Alternative 2, INFINITY, DV Medika, 1(satu) unit, Rp. ..………,-
10. ECG 12 CHANNEL, XXX, MENYUSUL, 1(satu) unit, Rp. ….…….,- Rp. ……………,-
11. DEFIBRILLATOR:
Alt,:1, Philips, HeartStart XL+, terlampir.
Alt,:2, DEF-7000, MEDISENA, 1(satu) unit, US$. 7,040.oo US$. 7,040.oo
12. MOBILE ELECTRIC SUCTION, XX, MENYUSUL, 1(satu) unit Rp. …………,- Rp. …………….,-
13. INFUS PUMP, XXXX, MENYUSUL. 1(satu) unit Rp. …………..,- Rp. ……………..,-
14. SYRINGE PUMP, XXX, MENYUSUL. 1(satu) unit Rp. …………..,- Rp. ..……………,-
15. USG 4D, XXX, MENYUSUL. 1(satu) unit Rp. …………..,- Rp. ……………..,-
16. FETAL MONITOR, AFM-600P1(FETAL),

MEDISENA. 1(satu) unit US$. 2,310.oo US$. 2,310.oo
17. DELIVERY BED – DV Medika. 1(satu) unit Rp. .…………,- Rp. ……………..,-
18. INFANT WARMER, AW-1, MEDISENA. 1(satu) unit US$. 10,560.oo US$. 10,560.oo
19. INFANT INCUBATOR, AI-3 Standard, MEDISENA.

1(satu) unit US$. 7,040.oo US$. 7,040.oo
20. BED PATIENT MANUAL 1 CRANK, P108MS,
DV Medika. 1(satu) unit, Rp.15.660.000,- Rp. 78.300.000,-

DV Medika. 1(satu) unit, Rp.16.380.000,- Rp. 327.600.000,-

DV Medika. 1(satu) unit, Rp. 18.018.000,- Rp. 180.180.000,-
23. BED PATIENT MOTOR/ELECTRIC 3 CRANK,

P608MS, DV Medika. 1(satu) unit, Rp. 25.000.000,- Rp. 250.000.000,-
24. BED PATIENT MOTOR 3 CRANK with up down,

[MEDISENA]
P1800NG, DV Medika. 1(satu) unit, Rp. 38.824.000,- Rp.200.000.000,-
25. BED PATIENT MOTOR 3 CRANK with up down

and weightscale, P3800NG, DV Medika, 1(satu) unit, Rp.119.163.000,- Rp.595.815.000,-
26. BED PEDIATRIC, LINET, Eleganza Smart Junior,

DV Medika, 1(satu) unit, Rp.91.520.000,- Rp. 91.520.000,-
GIGI - DENTIST:
1. Dental Unit, xxx, menyusul. 1(satu) unit Rp. …..……,- Rp. ………..,-
2. Foto-Camera …., TINGET. 1(satu) unit Rp. ………..,- Rp. ………,-
3. Panoramic, …. ARI. 1(satu) unit Rp. …………,- Rp. ……….,-
KALKULASI I(KESATU) – PRODUCT DENGAN HARGA US$:

------------------------------------------------------------------------------------------
Sub Total (US$), incl. PPN 10% US$ ………...-
Sub Total e-catalog (US$) US$ …………,-
Sub Total non e-catalog (US$) US$ ………….-

30% Discount non e-catalog (US$) US$ ………...-
-----------------------------------------------
Sub Total non e-catalog stlh disc. (US$) US$ ………...-
Total Harga stlh Discount, incl. PPN 10% US$ ………….,-
Terbilang : ………………………………………………………US Dollar.

Note:
- Exchange rate – Kurs mengikuti Kurs Jual BI pada saat pembayaran.
- Asumsi rate saat ini Rp. 13.000,- per US$.
KALKULASI I (KESATU), US$ ……….. x 13.000 = Rp. …………..,-
KALKULASI II(KEDUA) – PRODUCT DENGAN HARGA Rp.:

--------------------------------------------------------------------------------------------
Sub Total (Rp.), incl. PPN 10% Rp. …………………,-
Sub Total e-catalog (Rp.) Rp. ….……………..,-
Sub Total non-e-catalog(Rp.) Rp. ………………..,-

30% Discount non e-catalog (Rp.) Rp. ……………….,-
----------------------------------------------------------
Sub Total non e-catalog stlh disc.(Rp.) Rp. …………………,-
Total Harga stlh Discount, incl. PPN 10% Rp. …………………,-
Terbilang : ………………………………………………………….. rupiah.
Total Harga seluruh peralatan diatas sebesar Rp. ………………….,-

Terbilang : ………………………………………………………….. rupiah.

[MEDISENA]
Daftar Peralatan Rumah Sakit

MARINA PERMATA HOSPITAL
Batulicin – Kalimantan Selatan
No. Instalasi Merek Quantity e-Catalog Group

======================= Negara Asal Satuan (EC) atau Paket
Nama Alat Type non e- Mata
Model catalog Uang
(NE) US$
Atau
Rp.
RADIOLOGY
1 CT-SCAN 16 SLICE, spec.: SIEMENS 1(satu) NE US$

- Focusing on the essence of CT. This Germany UNIT
cost-efficient scanner delivers CT-Scan 16 Slice X-Ray
outstanding image quality, at the System
right dose. SOMATOM Scope.
- Focus on clinical excellence,
supports daily routine, while strike
the perfect balance between the right
dose and image quality – with noise
reduction of up to 25%.
- 24 row adaptive detector array that
collects 16 Slice of data
simultaneously, with sub millimeter
isotropic accuracy.
- High-performance UFC(ultra fast
ceramics) detector material, it
delivers bright, crisp images.
- SureView reconstruction algorithm,
can produce first-rate images even at
higher scan speeds. The scanner
selects the right pitch value for the
defined coverage and scan time,
while retaining slice thickness and
image integrity. Can be particularly
valuable for performing
submillimeter lung scans without
reducing axial image quality.
- Break-through Iterative
Reconstruction in Image Space (IRIS)
accelerates reconstruction while
reducing image noise by up to 25%.
- Software version Syngo CT VC28
(Somaris/5 VC28) are whole body X-
Ray computed tomography scanners
which operate with SOMARIS/5
software. SOMARIS/5 is a windows
based program used for patient
management, data management, xray
scan control, image reconstruction
and image archive/evaluation. Able
to transfer the acquired CT image
data for image evaluation, using the

[MEDISENA]
DICOM standard.
- Syngo CT VC28 supports the
addition of eCockpit, eStart, eMode,
eSleep, a Table Footswitch, Adaptive
Signal Boost and Gantry tilt Speed
Up.
- Generator Output, 26 KW.
- Tube Name, DURA 202 MV.
- Max Number of slices/rotation, 16.
- # Elements//Channels, 24 x 1472.
- Slice Thickness, (0.6 – 19.2) mm.
- KV-Range//mA-Range, 80, 110, 130
kV/20-180MV, DURA 202 MV.
- Anode Heat Storage, 2MHU//DURA
20.
- Tube Focal Spot/mm, 0.8 x 0.4 / 0.8 x
0.7 // DURA 202 MV.
- Scan Times (partial) // Subsec
(partial), 1,0; 1.5 sec.
- Topogram (Length x Scan Field), 128
– 1530 x 500 mm.
2 X-RAY STATIONER, spec.: SIEMENS 1(satu) EC US$
- Acquisition matrix size, 3072 x 2560 China UNIT
pixels. X-RAY Stationer
- Maximum spatial resolution, 3.6 MULTIX Select DR
lp/mm. (stationer non Ceiling)
- Acquisition bit depth, 14 bits with 8-
fold oversampling.
- Patient Table, max patient weight 200
Kg, Tabletop dimensions 235 x 80
cm. Lateral movement +- 10 cm
transverse. Longitudinal movement
+-46 cm longitudinal, Maximum
height 75 cm.
- X-Ray Production, Generator Power
55 kW, Preffered x-ray tubes
Polydoros/Optitop, Radiographic 40
kV to 133 kV, Radiographic mA range
550 mA at 100 kV.
- Control room monitor size 19”
Monitor.
- Connectivity, DICOM 3.0 and IHE
Profiles.
- Remote Diagnostics.
- Power requirements, 3 phase, 380 V
+/- 10%, 50 Hz.
- Function Floor mounted digital
radiography system.

[MEDISENA]
3 X-RAY CEILING(ceiling & stationer) SIEMENS 1(satu) EC US$

- Function Ceiling mounted general China UNIT
radiology system. X-RAY Stationer & Ceiling
- Digital ceiling-mounted x-ray system MULTIX FUSION
for general radiography complete (DIGITAL)
with patient table and bucky wall
stand.
- Stand configuration with overtable
and remote operation.
- Imaging tower ceiling mounted,
longitudinal movement 346 cm,
lateral movement 220 cm, vertical
movement 180 cm, maximum SID 220
cm transverse, minimum SID 83 cm,
controls with color touchscreen user
interface on tube and control
console. High performance PC with
flat panel display and user interface.
- Table/Tower movement, kick
switches at table base for table
height adjustment and control of 8-
way tabletop float movements.
Manual movement of x-ray tube.
- Detector wireless flat panel detector,
Cesium Iodine (Csl) scintillator with
amorphous silicon (a-Si) technology.
Detector size 35 x 43 cm. Field sizes
35.3 x 42.4 cm active area.
- Radiography, spot filming,
acquisition matrix size 3.072 x 2.560
pixels, max spatial resolution 3.6
lp/mm, acquisition bit depth 16 bits.
- Radiography conventional, digital
detector wireless flat panel detector,
in table, on tower, vertical chest,
cross table.
- Patient Table, max patient weight 300
Kg. Table top dimensions 240 x 80
cm, lateral movement +- 14 cm,
longitudinal movement +-48 cm,
vertical movement 51,5 cm to 95,5
cm, max height 51,5 cm.
- X-Ray production, generator power
55 kW, x-ray tube polydoros/optitop,
radiographic 40 kV to 150 kV, 550 mA
at 100 kV.
- Image Display 19” monitor,
connectivity Dicom 3.0, IHE profiles.
- Bucky wall stand.
- Remote Diagnostic.
- Power 3 phase, 380 V +-10% 50Hz.

[MEDISENA]
CSSD
1 STEAM STERILIZER, spec.: Merek WHITE ELEPHANT 1(satu) NE Rp.

- Single Door. Negara asal China UNIT
- Pulse Vacuum Steam Sterilizer. Type Steam Sterilizer
- Chamber Dimension 1.000 mm length Model i-steam HS360
x 600 mm height x 600 mm depth.
- Chamber Volume Capacity 360 liter.
- Load net Volume Capacity 260 liter.
- Android Control System, 10” LCD
Display dynamically shows
temperature, pressure and time, as
well as other parameters.
- Main Body of the machine and the
pipeline system are isolated with
aluminum silicate fiber as the heat
preservation measures to minimize
the energy consumption. Low
Carbon and Environment – friendly.
- Water consumption 275 liter.
- Max power 30 kW 380 V ac 3 phase
50 Hz for Integral Steam generator
and electronic Control.
2 GAS PLASMA LOW TEMP Merek WHITE ELEPHANT 1(satu) NE Rp.

STERILIZER, spec.: Negara asal China UNIT
- Single Door, i-Plasma, Low Type Plasma Sterilizer
Temperature Plasma Sterilizer. Model PS120
- Overall Dimension 1.725 mm height x
820 mm width x 890 mm depth.
- Chamber capacity 120 Liter.
- Chamber Size Ø500 mm x 770 mm
depth.
- Sterilization Temperature 50 ~ 60 °C
- Sterilization Mode:
- Quick.
- Standard.
- Enhanced cycle.
- 7” LCD (Liquid Crystal Display) and
Android Operating System.
- Android System, Intelligent
management.
- Cassette, 12 Capsule for each
cassette, which can be used for 6
cycles.
- Finger Print ID Module.
- Leybold vacuum pump from
Germany

[MEDISENA]
3 SONIC CLEANER, spec.: Merek MEDISAFE 1(satu) NE US$

- Cleaning and disinfect 20+ lumen Negara asal UK/Inggris UNIT
instrument in a single uninterrupted Type High Pressure
cycle. Sonic Irrigation Washer
- Parametrically controls the flow Disinfector
through the lumen devices Model SI PCF System
optimizing both mechanical and
chemical cleaning action inside the
cannula while simultaneously
controlling the propagation of
unwanted wash foam build up.
- Internal and External cleaning of fine
surgical instruments and other
lumen instruments.
- Sonic Irrigation.
- Lumen Flush.
- Power Flush.
- Thermal Disinfection.
- Deluge Wash.
- Fast Cycle Time
- Touch Screen Interface.
- Thermal Disinfection System, to raise
the temperature of the water in the
rinse phase following both
internationally recognized time
temperature relationships and the A0
calculation.
- The PCF system ensures all surface
internal and external are exposed
and are disinfected almost
regardless of their length or bore.
- CPE(Cannulated Pulse
Enhancement) and Power Flush,
system have been scientifically
tested to remove 92% of soluble
residues in the first 20 seconds of
the pre-wash phase and the
remainder of insoluble residues in
the main wash phase.
- WRAS Compliant.
- External Dimension:
- Height 1.005 mm
- Width 850 mm
- Depth 650 mm
- Chamber Volume 160 liter.
- Unit weight 137 Kg.
- Electrical, 15 kW, 3 phase, 380 V AC,
50 Hz.
- Water supply, softened cold and hot
water.
- Construction, High grade corrosion
resistant stainless steel with brushed
finish.

[MEDISENA]
4 WASHER DISINFECTOR, spec.: WHITE ELEPHANT 1(satu) NE Rp.

- Fully Automatic Washer Disinfector, China UNIT
i-Washer. Washer Disinfector
- Chamber capacity 360 liter. QPQ-360
- Water Consumption 15 liter per
cycle.
- Finger Print Access Control,
- Temperature, 20 up to 98°C.
- Power 380 V, 50 Hz, 17 kW.
- Overall Dimension 1.865 height x 700
width x 700 depth mm
5 AUTOCLAVE, spec.: Merek TINGET 1(satu) NE US$

- Application: Super-long instrument, Negara asal CHINA UNIT
Laparoscope. Type Product Sterilizer
- Class B autoclave, has Vacuum Model STE-23L-T Class B
System.
- Post vacuum drying provides
completed drying of porous loads
and hollow instruments at the end of
the sterilization process.
- Program-parameter:
- Solid.
- Liquid.
- Wrapped.
- Textile.
- Prion.
- Drying.
- Plastic.
- B&D Test.
- Helix Test.
- Vacuum Test.
- Two Japanese brand ”ULVAC”
vacuum pumps, which have lowest
noise, but stable and long life.
- Chamber Ø230mm x 580 mm length.
- Volume 25 Liter.
- Power 2.200 W, 110-240 V, 50/60 Hz.
- Weight 62 Kg.
6 STAINLESS STEEL MEJA – RAK – LOCAL 1(satu) NE US$
CABINET, terdiri dari : Indonesia UNIT
- Meja pemilah Linen, Instrument, SS304/316
laundry dan sampah.
- Meja Linen Inspection.
- Meja Packing.
- Meja Instrument.
- Rak/Meja Penyerahan
- MEJA, 1.500 X 800 mm, 1(satu) unit.

- MEJA, 800 X 1.800 mm, 4(empat) unit

[MEDISENA]
- MEJA, 800 x 1.000 mm, 2(dua) unit

- RAK, 1.000 x 600 mm, 2(dua) unit
- RAK, 800 X 1.800 mm, 2(dua) unit
- Lemari - cabinet Accessories CSSD
7 CSSD – ACC. SUPPLIES 1(satu) NE
UNIT
IBS – OT, ICU – ICCU PICU – NICU,
KEBIDANAN - VK and RAWAT INAP:
1 SURGICAL LIGHT LED DUAL LIGHT ACOMA 1(satu) NE Rp.
HEAD, spec.: China UNIT
- Glareless lighting protects doctors Agenius LED Medical
and patient eyes. Grade
- Color temperature 4,300°K to ensure K6+K3 U Dual Light Head
clarity of operating field.
- Delivers 160,000 Lux at max. 36 W for
K6 and 70,000 Lux at 18 W for K3.
- Adjustable Laparoscope lighting
mode in K6 series.
- Heat Sink Structure keep LED cooler,
increasing LED life and efficiency.
- Light Head Diameter, K6 ~ 62 cm and
K3 ~ 30 cm.
- Focusable from 60 cm to 180 cm.
- Light field diameter, 15 ~ 27 cm for
K6, and 12 ~ 20 cm for K3.
- K6 with 36 LED and K3 with 7 LED.
- LED Life time 50,000 Hours.
- Sterile light handle is reusable and
autoclavable.
2 SURGICAL TABLE ELECTRIC, spec.: ACOMA 1(satu) NE Rp.

- Table Top 50 x 193 cm. China UNIT
- High Low Rate 54 ~ 102 cm, electric. Electric Sliding
- Back Section - 40° + 90°, electric. AT-6700N
- Lateral Tilt + 22° / - 22°, electric.
- Trendelenburg./Reverse
Trendelenburg + 22° / - 22°, electric.
- Table Top Rotation 180°, manual.
- Head Section + 30° / - 90°, manual.
- Leg Section + 15° / - 90°, manual.
Included:
- Screen/Anesthesia Screen, 1 pcs.
- Armboard, 1 pair
- Goepel/Universal Leg Holder, 1 pair.
- Lateral brace assembly, 1 pair.
- Body Strap, 1 ea.

[MEDISENA]
3 ANESTHESIA MACHINE, spec.: ARI 1(satu) NE US$

- Ergonomic design, integrates a CHINA UNIT
concise and smooth structure and ANAESTHESIA MACHINE
high mobility. AR-325A(w. VCV-PCV)
- Microcomputer-controlled Ventilator
adopts exported sensors and other
components.
- Mechanical ventilation is made
secure and visible by the folded
respiratory bellows and the security
of air supply is guaranteed by
pneumatic transmission and
measurement system
- With multiple modern technologies
applied, the anesthesia machine is
both outstanding in performance and
versatile in functions.
- The ventilator adopts microcomputer
control with high-definition 8.4”TFT
color LCD display. Integrating the
functions of respiratory control and
displaying the monitoring
parameters.
- It is versatile in function and
excellent in performance.
- The high-precision Vaporizer is
design with a stable concentration
output, automatic compensation for
pressure, temperature and flow rate
and it is available to choose two
kinds of gas from Halothane,
Enflurane, Isoflurane and
Sevoflurane, ensuring a successful
anesthesia operation.
- High-definition FIVE-TUBE flowmeter
(oxygen, nitrous oxide and air),
designed with stopper for oxygen
and nitrous oxide to control the
output oxygen concentration.
- Reliable pneumatic transmission
system.
- Modularized design and upgrading,
upgrading is available as required by
the customer.

[MEDISENA]
4 VENTILATOR MACHINE, spec.: ARI 1(satu) NE US$

- Display High-definition 10.4” TFT CHINA UNIT
color LCD Screen. VENTILATOR
- Ventilation Mode: AR-203
- IPPV, SIPPV, SIMV. (Air Compressor Inside)
- PEEP, MANUAL, SIGH.
- IMV, VCV, PCV, PSV, CPAP.
- Tidal Volume, 20 ~ 2,000 ml.
- Rate, 1 ~ 120 bpm.
- SIMV rate, 1 ~ 20 bpm.
- I:E, 2:1 ~ 1:8.
- Pressure Trigger Sensitivity, -1.0 –
2.0 kPa.
- Flow Trigger Sensitivity, 1 – 20 L/min.
- PEEP 0 ~ 2.0 kPa.
- Pressure Range 1 ~ 60 cmH2O.
- Pressure Support 3 ~ 60 cmH2O.
- SIGH, 1.5 times the inspiratory time
(60 – 120 adjustable).
- Inspiratory Platform 0 ~ 50 %.
- Oxygen Concentration 21 ~ 100%.
- Security Alarm System.
- Storage Battery and Air Compressor.
5 ELECTROSURGICAL UNIT, spec.: ARI 1(satu) NE US$
- Max 400W Electrosurgical Generator, CHINA UNIT
w. mono-polar and bipolar function. ELECTROSURGICAL
- Nine working modes: ESU-2000AI(LCD)
- pure cut.
- blend1.
- blend2.
- blend3.
- contact coag.
- Forced coag.
- soft coag.
- bipolar coag.
- bipolar cut.
- Wide Clinical Applications:
- General Surgery.
- Thoracic Surgery.
- Orthopedic Surgery.
- Cardiology.
- Gynecology.
- Urology (under water TUR).
- Oncology.
- Neurosurgery, etc.
- Microprocessor controlled, LCD
touch screen display, audible and
visual indicators and error codes
during the process of outputting.
- Return Electrode Monitoring System
and Power Peak System, minimizing
the risk of tissue damage.
- Both hand and foot controlled.
- Separate power display and outlet
socket for mono-polar cut,
mono_polar coag, bipolar cut and
bipolar coag, each output can be

[MEDISENA]
individually configured.
6 PENDANT IBS, Spec.: ARI 1(tiga) NE US$
- Horizontal rotation. CHINA UNIT
- Pneumatic brake and damper PENDANT IBS
device. (electrical, surgical,
- Gas Outlet, one of: anesthesia)
- Air, O2, VAC, N2O. AGSS.
- Four Power outlets for each arm.
- One Network outlet for each arm.
- High Carrying Capacity.
- Imported outlet from Germany.
- One-shot forming by aluminum
alloy.
7 Multi Function Emergency Stretcher, PLATINUM 1(satu) NE Rp.

Spec.: Indonesia UNIT
- Backrest adjustment assisted by Stretcher
hydraulic. P2500NG
- Foldable side guards, easy and safe
handling, solid and hygienic
construction, no danger of accidental
crushing.
- 15 cm castors with central locking.
- High/low, Trendelenburg /reverse
trendelenburg positions.
- X-Ray translucent sleep surface.
- Patient belt for fastening.
- Height adjustable stainless steel IV
pole.
- Washable at 95°, fire retardant,
mattress cover.
- Plastic crash bumpers.
- Electrostatic painted metal frame.
- Cleaning with NANO technology.
- Height range 62 up to 91 cm.
- Trendelenburg 13°
- Reverse Trendelenburg 13°
- Backrest Angel 75°
- Castor diameter 15 cm.
- Safe Working Load, 175 Kg.
8 SCRUB SINK MEDISENA. PLATINUM 1(satu) NE Rp.
UNIT
9a PATIENT MONITOR Philips 1(satu) NE Rp.
UNIT
9b PATIENT MONITOR Infinity 1(satu) NE Rp.
UNIT

[MEDISENA]
10 ECG 12 CHANNEL ARI 1(satu) NE Rp.

CHINA UNIT
12 Channel ECG Machine
ECG-W12
11 DEFIBRILLATOR, spec.: ARI 1(satu) NE US$

- DISPLAY SCREEN 7” ( 17.7 cm) CHINA UNIT
DIAGONALLY. DEF-7000
- Biphasic, AED, MANUAL, (BI-PHASIC)
RECORDER.
- AED MODE, AUTO ANALYZE AND
CHARGE X3 WITH PROGRAMMABLE
AUTO ENERGY LEVEL SELECTION,
SCREEN PROMPTS AND VOICE
PROMPTS.
- MANUAL MODE, ENERGY
SELECTABLE AT 2, 5, 7, 10, 20, 30,
50, 70, 100, 150, 200, 300, 360
JOULES.
- SYNCHRONIZED MODE,
DEFIBRILLATOR PULSE TO
PATIENT’S R-WAVE. “SYNC”
MESSAGE DISPLAYED ON
MONITOR.
- BATTERY OPERATING TIME, FULLY
CHARGED BATTERY UP TO 60
DEFIBRILLATOR DISCHARGES AT
MAXIMUM ENERGY.
12 MOBILE ELECTRIC SUCTION UNIT ARI 1(satu) NE Rp.
CHINA UNIT
SUCTION MOBILE
23C.I

[MEDISENA]
13 INFUSION PUMP ARI 1(satu) NE Rp.

CHINA UNIT
INFUSION PUMP
AIP-1200
14 SYRINGE PUMP ARI 1(satu) NE Rp.

CHINA UNIT
Syringe Pump
ASP-1800G
Blood Infusion Warmer ARI

CHINA
Blood Infusion Warmer
AIW-500
15 USG 4D Color Doppler Ultrasound ARI 1(satu) NE US$

Diagnostic System, spec.: CHINA UNIT
- Full-digital color Doppler ultrasonic 4D COLOR DOPPLER
diagnostic system. ULTRASOUND
- 2D(B mode), TM(M mode), PW, CW, DIAGNOSTIC SYSTEM
CFM scanning mode.
- Ultrasound host operating system, AR-480
Windows operating system.
- Monitor, >= 17-inch high-definition
professional medical LCD display,
with a 7-inch widescreen touch-
navigation system.
- Probe connector (all effectively
activate) >= 3.
- Two-dimensional gray-scale imaging
unit.
- The PW pulse wave Doppler.
- Doppler energy and directional
energy diagram.
- Color Doppler ultrasound diagnostic

[MEDISENA]
unit.
- The THI tissue harmonic imaging.
- Full (wide) scene imaging.
- Extend the (extended) pulse imaging
(EPI).
- Real-time 3D/4D synchronization
imaging.
- Trapezoidal extended imaging.
- Anatomical M-mode imaging.
- Elasticity imaging (ELASTOGRAPH).
- Real-time synchronization unit, 2D,
Color Doppler, Spectral Doppler /
Continuous CWD at the same time
the same screen real-time display.
- Gain, B / PW / CD can be separately
adjusted.
- Cine Loop >= 1,000 frame.
- Probe Configuration, convex array
probe, the high-frequency linear
array probe, transvaginal probe, 4D
volumetric probe.
- .
16 FETAL MONITOR, spec.: ARI 1(satu) NE US$
- 12.1” TFT Color Screen Folding up to CHINA UNIT
90°. FETAL MONITOR
- 3 in 1 transducer, no cable AFM-600P1(FETAL)
intertwisting
- Build-in 152 mm long life thermal
printer.
- DSP technology, real time identify
and measurement for FHR, accurate
and reliable result.
- 12 hours data storage which can be
playback and printed.
- Auto FM testing.
- FHR, Ultrasound Probe Multi-crystal,
high sensitive.
- TOCO, range 0 – 100.
- Fetal Movement, button hand count (
automatic cumulative number of
movement)
- Interface of parameters of FHR,
TOCO and Fetal Movement with
display.
17 DELIVERY BED PLATINUM 1(satu) NE Rp.
UNIT

[MEDISENA]
18 INFANT WARMER, spec.: ARI 1(satu) NE US$

- Microprocessor based servo CHINA UNIT
controlled temperature system. INFANT WARMER
- The microprocessor-controlled unit AW-1
allows for three settings :
- Pre-warm.
- Manual.
- Automatic.
- Alarm functions for safety includes:
- Power failure.
- Temperature deviation.
- Temperature sensor failure.
- Over temperature.
- APGAR timer to record therapy time.
- Convenient X-Ray cassette under
infant bed.
- Heater head can be adjusted +90°
horizontally.
- Tilt angle of infant bed is adjustable.
- Halogen Observe light angel is
adjustable.
- Transparent protector folded.
- Adopts anti-explosion micro crystal
quartz infrared radiation tube for its
radiation sources, the heating is
quick and life-span is long.
- Alarms are audible and visual.
- A second thermal cut-out function
for more safety.
- Skin temperature sensor failure
protect function avoid over
temperature.
- Temperature deviation can be
amended in front panel directly.
- Low Pressure Aspirator, Oxygen
supply system and LED
phototherapy unit.
- Electric height adjusted suit for
operation.
19 INFANT INCUBATOR, spec.: ARI 1(satu) NE US$
- Double Wall Hood. CHINA UNIT
- Cabinet with three drawers. INFANT INCUBATOR
- Protect Fence. A1-3
- Silence Wheels.
- Six operating Windows, two side
operating windows can be swiveled.
- Microprocessor based servo
controlled temperature system.
- Air temperature, Skin temperature
and humidity can be set, controlled,
indicated separately.
- The Infant bed inclination angle is
adjustable.
- Humidity is adjustable.
- Five alarm functions.
- Power Failure.
- Over Temperature.

[MEDISENA]
- Temperature Deviation.
- Temperature Sensor Failure.
- Fan Failure.
- > 37°C temperature setting.
- A keypad lock helps prevent
inadvertent changes the setting.
- Temperature deviation and over
temperature could be amended in
front panel directly.
- Heater is electrically cut-out if air
temperature inside incubator
exceeds 40 °C.
- Integral timer to record therapy time.
- Skin temperature sensor failure
protect function avoid over
temperature.
- A second thermal cut-out function
for more safety.
- Through for pulling and pushing,
which is convenient to add the water
and wash.
- Fan with low noise and long life-
span.
21 BED PATIENT MANUAL 1 PLATINUM 1(satu) EC Rp.
CRANK, incl.: INDONESIA UNIT
- Mango Mattress 194 x 82 x 10 cm, by MANUAL BED
Dunlopillo, 32 Density Splined, PI-108 MS
Material Cover Waterproof Synthetic
Leather(Oscar). IDO 9002.
Spec.:
- Frame made of 1 mm thick cold-
rolled steel plate finishing with
powder coating, antibacterial, and
antitrust.
- 2 Section sleeping surface board are
made of cold-rolled steel plate
finishing with powder coating,
antibacterial and antitrust.
- High quality alloy aluminum folding
side rail.
- 6 hole for IV stand (3 hole each side)
- 4 hooks IV pole Stainless Steel, max
length 2.200 mm.
- ABS and wood adjustable dinning
board.
- 4 pcs medical silent 125 mm casters
dust-proof adopted individual
brakes.
- Back-rest fold upward >=75°.
- Safety side rail 1 pair.

[MEDISENA]
22 BED PATIENT MANUAL 2 CRANK, incl.: PLATINUM 1(satu) EC Rp.

- Mango Mattress 194 x 82 x 10 cm, by INDONESIA UNIT
Dunlopillo, 32 Density Splined, MANUAL BED
Material Cover Waterproof Synthetic PI-208MS
Spec.:
side rail.
- Smooth surface mattrass Base to
ensure strength and durability.
- Detachable blow molding board.
- Sleeping Surface Fixed Height 500
mm.
powder coating, antibacterial and
antitrust.
- 4 section sleeping surface board are
- Removable Head Board / Food Board
are made of High Quality ABS
plastic.
side rail.
- 6 hole for IV stand (3 hole each side).
- Loading bearing capacity 260 Kg.
- Knee-rest fold upward >=45°.
- 4 hooks IV pole stainless steel, max
length 2.200 mm.
brakes.
- ISO 9001-2008 Certified.

[MEDISENA]
23 BED PATIENT MANUAL 3 CRANK, incl.: PLATINUM 1(satu) EC Rp.

Dunlopillo, 32 Density Splined, MANUAL BED
Material Cover Waterproof Synthetic PI-308MS
Spec.:
- High Quality alloy aluminum folding
side rail.
- Smooth Surface Mattrass Base to
ensure strength and durability.
- Detachable blow molding board.
- Sleeping Surface Adjustable Height,
500 – 700 mm, sleeping surface
height adjustable 200 mm.
antitrust.
- Removable Head Board / Foot Board
are made of High Quality ABS
plastic.
- High Quality alloy aluminum folding
side rail.
- 6 hole for IV stand (3 hole each side).
- Knee-rest fold upward >=45°.
- 4 hooks IV pole stainless steel,
maximum length 2.200 mm.
brakes.
- ISO 9001-2008 Certified.

[MEDISENA]
24 BED PATIENT MOTOR 3 CRANK, incl.: PLATINUM 1(satu) EC Rp.

Dunlopillo, 32 Density Splined, ELECTRIC
Material Cover Waterproof Synthetic PI-608HG
Spec.:
- 4 pcs Dropdown Safety Side Rail
Made of High Quality ABS Plastic.
- Sleeping Surface Size Height, 500 –
720 mm, adjustable 220 mm.
antirust.
antibacterial and antirust.
- Removable Head Board / Foot Board
are made of high quality ABS Plastic.
- 4 hole for IV Stand (2 hole each side).
- Back-rest fold upward >= 65°
- Knee-rest fold upward >= 45°
- Original LINAK 24V linear-motor from
Denmark.
- Central Locking System with stop
and release function.
- 4 hooks IV pole stainless steel, max
length 2200 mm.
dust-proof adopted central control
system, control pad in the foot
section, hard wearing.
25 BED PATIENT MOTOR 3 CRANK with PLATINUM 5(lima) EC Rp.
up down, incl.: INDONESIA UNIT
- Mango Mattress 194 x 82 x 10 cm, by ELECTRIC
Dunlopillo, 32 Density Splined, P1800NG
Spec.:
- 3 Motor Electrical Hospital Bed.
- Electrical operated backrest, height
and legrest adjustment.
- Integrated side-rail control for 2
sides.
- Hygienic design (PP), lockable and
tuck away side rails.
- 12.5 cm cross lockable castors
(Tente Rollen GmbH Germany)
- Cleaning with NANO technology.
- 1 pcs stainless steel and height
adjustable IV pole, with 4 hooks.
- Plastic crash bumpers.
- Nurse control unit.
- Central and directional lockable
castors.

[MEDISENA]
26 BED PATIENT MOTOR 3 CRANK with PLATINUM 1(satu) EC Rp.

up down and weight scale, incl.: INDONESIA UNIT
- Mango Mattress 194 x 82 x 10 cm, by ELECTRIC
Dunlopillo, 32 Density Splined, P3800NG
Leather (Oscar). IDO 9002.
Spec.:
- 4 motor Electric ICU-ICCU Bed.
- Height Range, 44 – 84 cm.
- Trendelenburg, 0° – 16°
- Reverse Trendelenburg, 0° – 16°
- Backrest Angle (Max) 70°
- Legrest Angle (Max) 34°
- Castor Diameter 15 cm Central and
directional lockable castor (Tante
Rollen GmbH Germany).
- Under Bed Clearance, 15 cm.
- Safe Working Load w. Accessories
230 Kg.
- Auto regression backrest and
legrest, reduce the pressure between
the mattress and tissue, reducing the
risks of decubitus.
- Cleaning with NANO technology,
- NANO technology by Henkel
Germany, which extends the
products paint life cycle up to 3
times more.
- Cardiac Chair Position with one
button.
- Shock position with one button.
- Semi-Fowler position with one
button.
- Bed exit position with one button.
- Examination position with one
button.
- Power In, 1.5 A max.
- Battery, 2 x 12 V Series Connected,
sealed, rechargeable, Lead/Acid gel,
1.2 amp hrs.
- Weight Scale Indicator.
- Nurse Control Panel.
27 BED PEDIATRIC, incl. and Spec.: LINET 1(satu) EC Rp.
- Developed for pediatric patients aged CHEKO-Czech Republic unit
4 – 15, the bed dimensions are Electric
adapted to the ergonomics of a Eleganza Smart Junior-
child’s body. Pediatric Hospital Bed-
- The Bed is fully electrically Children’s Bed
adjustable. The actuators can adjust
the position of the 4-section mattress
platform made of metal segments
and of the bed height.
- Auto-regression of the backrest
enables the enlargement of the pelvic
area by 11 cm.
- The backup battery with an
intelligent charger ensure the bed’s

[MEDISENA]
safe operation.
- The Supervisor panel is equipped
with pre-programmed functions.
- The hand control is designed for the
patient and nurse.
- The backrest is equipped with a CPR
unblocking function.
- 150 mm Tante Standard Concept
castors with a central braking
system.
- 60 mm protective corner bumpers.
- 2 holder for IV pole or lifting pole
- Mattress platform height adjustment,
38,5 – 76,5 cm.
- Backrest Tilt, 70°.
- Thighrest Tilt, 45°.
- Backrest auto-regression, 11 cm.
- Trendelenburg/Rev. Trend. 16° / 16°.
- Safe working load, 180 Kg.
- Clearance Height 14,5 cm.
- 4 horizontal protective bumpers.
- 4 electric motors.
- Electro equipment according to the
EN60601-1
GIGI - DENTIST:
1 DENTAL UNIT, spec.: Merek ARI. 1(satu) NE US$
- High-speed handpiece tubing with Negara CHINA. unit
connector 2 set. Type product DENTAL
- Low-speed handpiece tubing with UNIT.
connector 1 set. Model DU-8900 Luxury.
- 3-way syringe 2 pieces.
- Top-mounted instrument tray 1 set.
- Water suction and saliva ejector 1 set
each.
- Operation sensor lamp 1 set.
- X-film viewer (24V) 1 set.
- Assistant control system 1 set.
- Water purified system 1 set.
- Water heating system 1 set.
- Auto water supply and flush
cuspidor system 1 set each.
- Tunable ceramic cuspidor 1 set.
- Multi-function foot pedal 1 set.
- Dentist stool 1 piece.
- Lower chair frame.

[MEDISENA]
2 FOTO – CAMERA, spec.: Merek TINGET 1(satu) NE US$

- Power, DC 5V+- 0.5 v (1.5A). Negara CHINA unit
- Optic, Sony ¼ CCD. Type product INTRA-
- Interface, USB. ORAL CAMERA
- Lighting, 6 LEDs. Model OV-IIIA
- Focus Range, 3 mm – 40 mm.
- Length of the handle, 205 mm.
- Adjustment, auto-focus.
- Wireless Control.
3 DENTAL X-RAY UNIT, spec.: Merek ARI 1(satu)

- Tube voltage, 60 KVp. Negara CHINA unit
- Tube Current, 8 mA. Type product DENTAL X-
- Focus size, 1.5 mm. RAY UNIT.
- Total filtration, 2.5 mm AL. Model ADM-10D
- Exposure time, 0.2 to 4 sec.
- Leak radiation, outside one
meter<=0.002 mGy/h.
Note :
1. Harga sudah termasuk PPN.
2. Harga e-catalog sudah termasuk Discount dan PPN.
3. Harga non e-catalog sebelum total, mengandung 30% Discount per product.
4. Harga Franco MARINA PERMATA HOSPITAL – Batulicin, Kalimantan Selatan.
5. Harga total masih belum kami sesuaikan dengan jumlah/quantity kebutuhan total di Marina Permata Hospital,
mohon kesediaan dr. Widodo dan drg. Tito untuk mengkoreksi quantity, item, maupun spesifikasi yang kami
tawarkan untuk diseuaikan dengan kebutuhan MARINA PERMATA HOSPITAL.
6. Harga Total Paket Item dan System Pembayaran bisa dinegosiasikan.
7. Harga diatas termasuk instalasi, material dan pengerjaan infrastruktur penunjang di area bagian dalam ruang-
lokasi penempatan dari masing-masing peralatan tersebut.
Cara pembayaran : 30% Uang Muka saat Surat Pesanan diterima.
65% Saat Barang Dikirim.
5% setelah Serah Terima.
Pengiriman Barang : Indent, 12 minggu setelah Uang Muka diterima.
Masa berlaku Penawaran : 1 (satu) bulan sejak tanggal penawaran ini.
Demikian penawaran harga yang kami ajukan sambil menunggu kabar, kami ucapkan terima kasih atas perhatian
dan kerja samanya.
Hormat Kami,
ttd
Ir. Purnomo Tirtamulia

Direktur


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MEDIKA SEJAHTERA PURNAMA

Ref. No.:154002/WJP/BLN/IV/2015. Surabaya, 16 April 2015.

Attn. : Widodo J.P., dr., MS., MPH., Dr.PH

Perihal : Penawaran harga peralatan rumah sakit.

No. URAIAN-TYPE-MEREK-DISTRIBUTOR QUANTITY Harga Harga

2. X-RAY STATIONER, SIEMENS MULTIX

3. X-RAY CEILING, SIEMENS Multix Fusion X-Ray,

2. GAS PLASMA STERILIZER, WHITE ELEPHANT

3. ULTRASONIC CLEANER, MENYUSUL.

4. WASHER DISINFECTOR, WHITE ELEPHANT,

5. PORTABLE STEAM VACUUM STERILIZER,

6. STAINLESS STEEL MEJA, RAK, KABINET,

7. CSSD – ACC. SUPPLIES, INCLUDED

2. SURGICAL TABLE ELECTRIC, ACOMED, AT-6700N,

”QUALITY and AFTER SALES is OUR PRIORITY”

DV Medika. 1(satu) unit Rp. 647.980.000,- Rp.647.980.000,-

3. ANESTHESIA MACHINE, AR-325A

4. VENTILATOR MACHINE, AR-203

6. PENDANT IBS, (ELECTRICAL,

7. STRETCHER, P2500NG, DV Medika, 1(satu) unit, Rp. 56.380.000,- Rp. 56.380.000,-

8. SCRUB SINK, PLATINUM, DV Medika, 1(satu) unit,Rp. …………,- Rp. ……………,-

16. FETAL MONITOR, AFM-600P1(FETAL),

19. INFANT INCUBATOR, AI-3 Standard, MEDISENA.

21. BED PATIENT MANUAL 2 CRANK, P208MS,

22. BED PATIENT MANUAL 3 CRANK, P308MS,

23. BED PATIENT MOTOR/ELECTRIC 3 CRANK,

24. BED PATIENT MOTOR 3 CRANK with up down,

”QUALITY and AFTER SALES is OUR PRIORITY”

P1800NG, DV Medika. 1(satu) unit, Rp. 38.824.000,- Rp.200.000.000,-

25. BED PATIENT MOTOR 3 CRANK with up down

26. BED PEDIATRIC, LINET, Eleganza Smart Junior,

2. Foto-Camera …., TINGET. 1(satu) unit Rp. ………..,- Rp. ………,-

3. Panoramic, …. ARI. 1(satu) unit Rp. …………,- Rp. ……….,-

KALKULASI I(KESATU) – PRODUCT DENGAN HARGA US$:

Sub Total e-catalog (US$) US$ …………,-

Sub Total non e-catalog (US$) US$ ………….-

Total Harga stlh Discount, incl. PPN 10% US$ ………….,-

Terbilang : ………………………………………………………US Dollar.

KALKULASI I (KESATU), US$ ……….. x 13.000 = Rp. …………..,-

KALKULASI II(KEDUA) – PRODUCT DENGAN HARGA Rp.:

Sub Total e-catalog (Rp.) Rp. ….……………..,-

Sub Total non-e-catalog(Rp.) Rp. ………………..,-

Total Harga stlh Discount, incl. PPN 10% Rp. …………………,-

Terbilang : ………………………………………………………….. rupiah.

Total Harga seluruh peralatan diatas sebesar Rp. ………………….,-

”QUALITY and AFTER SALES is OUR PRIORITY”

Daftar Peralatan Rumah Sakit

No. Instalasi Merek Quantity e-Catalog Group

1 CT-SCAN 16 SLICE, spec.: SIEMENS 1(satu) NE US$

”QUALITY and AFTER SALES is OUR PRIORITY”

”QUALITY and AFTER SALES is OUR PRIORITY”

3 X-RAY CEILING(ceiling & stationer) SIEMENS 1(satu) EC US$

”QUALITY and AFTER SALES is OUR PRIORITY”

1 STEAM STERILIZER, spec.: Merek WHITE ELEPHANT 1(satu) NE Rp.

2 GAS PLASMA LOW TEMP Merek WHITE ELEPHANT 1(satu) NE Rp.

”QUALITY and AFTER SALES is OUR PRIORITY”

3 SONIC CLEANER, spec.: Merek MEDISAFE 1(satu) NE US$

”QUALITY and AFTER SALES is OUR PRIORITY”

4 WASHER DISINFECTOR, spec.: WHITE ELEPHANT 1(satu) NE Rp.

5 AUTOCLAVE, spec.: Merek TINGET 1(satu) NE US$

- MEJA, 1.500 X 800 mm, 1(satu) unit.

”QUALITY and AFTER SALES is OUR PRIORITY”

- MEJA, 800 x 1.000 mm, 2(dua) unit