NO
I. Pelayanan
A. Pelayanan Medik Umum
1
2
B. Pelayanan Gawat Darurat
1
C. Pelayanan Medik Spesialis Dasar
1
2
3
4
D. Pelayanan Spesialis Penunjang Medik
1
2
3
E. Pelayanan Kefarmasian
1
2
. Pelayanan Keperawatan dan Kebidanan
1
2
H. Pelayanan Penunjang Klinik
1
2
3
4
5
I. Pelayanan Penunjang Non Klinik
1
2
3
4
5
6
7
8
9
10
11
J. Pelayanan Rawat Inap
1
2
3
II. Sumber Daya Manusia
A. Pelayanan Medik Dasar
1
B. Pelayanan Medik Spesialis Dasar
1
2
3
4
C. Pelayanan Medik Penunjang
1
2
3
D. Pelayanan Kefarmasian
1
2
3
4
. Tenaga Kesehatan dan Petugas Lainnya
1
2
3
4
5
6
7
8
9
III. Peralatan
A. Pelayanan Gawat Darurat
Ruang Triase
1
2
3
4
5
6
7
8
9
Resusitasi
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Tindakan
1
2
3
4
5
6
Isolasi
observasi
kamar tindakan
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Rawat Inap
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
C. Pelayanan Bedah
Klinik (Rawat Jalan)
1
2
3
4
5
6
7
8
9
C. Pelayanan Bedah
1
2
3
4
5
6
7
8
9
10
11
12
13
kamar tindakan
1
2
3
4
5
6
7
8
9
10
11
12
13
Ruang persiapan (sebelum operasi)
kamar bedah
Recovery Room
Perawatan Anak
perinatologi
Ruang Bayi
Breathing
Circulation
1
2
3
1
2
3
4
5
6
7
8
9
10
11
12
13
NO
14
15
16
17
18
19
20
21
22
23
24
1
2
3
4
1
2
3
4
J.PELAYANAN RADIOLOGI
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
NO
14
15
16
17
18
19
20
21
22
23
24
25
26
1
1
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
NO
7
8
9
10
11
1
2
3
4
5
6
7
8
9
10
11
12
13
14
1
2
3
4
5
1
2
3
4
5
6
1
2
3
4
NO
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
10
11
12
13
14
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
INSTRUMEN SELF ASSESMENT IZIN OPERASIONAL RUMAH SAKIT KELAS C
PERSYARATAN KELAS C
I. Pelayanan
A. Pelayanan Medik Umum
pelayanan Medik Dasar
Pelayanan KIA/KB
B. Pelayanan Gawat Darurat
24 Jam & 7 Hari seminggu
C. Pelayanan Medik Spesialis Dasar
Penyakit Dalam
Kesehatan Anak
Bedah
Obstetri & Ginekologi
D. Pelayanan Spesialis Penunjang Medik
Anestesiologi
Radiologi
Patologi Klinik
E. Pelayanan Kefarmasian
Pengelolaan sediaan farmasi, alat kesehatan dan bahan habis pakai
Farmasi Klinik
erawatan dan Kebidanan
Asuhan keperawatan generalis dan spesialis
Asuhan kebidanan
an Penunjang Klinik
Pelayanan bank darah
Perawatan intensif
Gizi
Sterilisasi instrumen
Rekam medik
Penunjang Non Klinik
Laundry/Linen
Jasa boga / dapur
Teknik dan Pemeliharaan fasilitas
Pengelolaan limbah
Gudang
Ambulans
Sistem informasi dan komunikasi
pemulasaran jenazah
Sistem penanggulangan Kebakaran
Pengelolaan Gas Medik
Pengelolaan Air Bersih
nan Rawat Inap
Jumlah TT Perawatan kelas III (RS Pemerintah)
Jumlah TT Perawatan kelas III (RS Swasta)
Jumlah TT Perawatan intensif (RS Pemerintah & swasta)
er Daya Manusia
nan Medik Dasar
Dokter Umum
Medik Spesialis Dasar
Penyakit Dalam
Kesehatan Anak
bedah
Obstetri & Ginekologi
n Medik Penunjang
Anestesiologi
Radiologi
Patologi Klinik
nan Kefarmasian
Kepala Instansi farmasi RS
Apoteker bertugas di rawat jalan
Apoteker bertugas di rawat inap
Apoteker sebagai koordinator penerimaan dan distribusi farmasi
tan dan Petugas Lainnya
Keperawatan (Perawat dan Bidan)
Gizi
keterapian Fisik
Radiografer
Keteknisan Medis
Rekam Medik
Petugas IPSRS
Petugas Pengelola Limbah
petugas Kamar jenazah
an Gawat Darurat
Defribilator
Emergency Trolley/Resucitation Crash Cart
Film Viewer
Lampu Periksa/Examination Lamp/Hanging Lamp
Laryngoscope
Nebulizer
Pulse oximetry/Portable Pulse Oxymetri
Stethoscope /stetoskop
Suction Pump portable/Aspirator/Vacuum
Infusion Pump
Syringe Pump
Bed Patient Electric/Tempat Tidur Paien Elektrik
Bed Patient Manual/Tempat Tidur Pasien Manual
Sphygmomanometer Digital/Tensimeter Digital
Sphygmomanometer Aneroid /Tensimeter Anaeroid
termometer Digital
Stretcher/Brankar
Bed Side monitor/patient monitor/ pasien monitor 4 parameter
Defribilator
ECG/EKG/Elektrocardiograph 6 Channels
Emergency Trolley/Resucitation Crash Cart
Infusion Pump
Pneumatic Splint Set
Resusitator Kit/Recusitation Bay
Stethoscope /stetoskop
Suction Pump portable/Aspirator/Vacuum
Syringe Pump
Sphygmomanometer Digital/Tensimeter Digital
Sphygmomanometer Aneroid /Tensimeter Anaeroid
an Penyakit Dalam
klinik (Rawat Jalan)
Film Viewer
Examination Table/meja periksa/tempat tidur periksa
medical flash Light/Pen Light
Stethoscope /stetoskop
Sphygmomanometer Aneroid /Tensimeter Anaeroid
Sphygmomanometer Digital/Tensimeter Digital
termometer Digital
ar tindakan
Meja periksa/Tempat Tidur periksa/examination table
tensimeter digital/Sphygmomanometer digital
tensimeter anaeroid/Sphygmomanometer Aneroid
Film Viewer
medical flash Light/Pen Light
Stethoscope /stetoskop
termometer Digital
Emergency Trolley/Resucitation Crash Cart
Defribilator
Minor Surgery Set
lever biopsi set (jarum biopsi khusus)
ECG/EKG/Elektrocardiograph 6 Channels
Syringe Pump
Trokar
Oximeter/Pulse oximetry/Oksigen Saturasi
operting table
mayo table
operating lamp ceiling type
Lampu Periksa/Examination Lamp/Hanging Lamp
ETT, LMA, Nasotracheal, (Dewasa dan Pediatric)
laringoscope Set (Dewasa dan Pediatric)
Fiber Optic
Mesin Anesthesi
Defribilator
Ventilator Anesthesi
Autoklaf
Mastektomi Set
Infusion Pump
suction pump
Patient Monitor
Patient Stracher
Syringe Pump
overy Room
bed Side Monitor
Patient Stracher
Defribilator
Emergency Trolley/Resucitation Crash Cart
Infusion Pump
Suction Pump
Bedah Umum
Hospital Bed
Stethoscope /stetoskop
Brandchard
Infusion Pump
Examination Table/meja periksa/tempat tidur periksa
Sphygmomanometer
Film Viewer
Minor Surgery Instrument Set
Set Perawatan Luka
Emergency Set
an Kesehatan Anak
(Rawat Jalan)
ECG
Infant dan Baby pediatric resusitation
Infant dan Baby pediatric Stetoscope
Examination Lamp
Sphygmomanometer dengan manset untuk bayi dan anak
Infant dan baby Weighting scale
termometer Rectal
Termometer Axial
Reflex Hammer
Cold chain :
Kulkas vaksin Termos portable
Vena Suction set
Baby Suction Pump
Oxygen set dan flow meter
Nebulizer
watan Anak
Diagnostic Set
ECG/EKG/Elektrocardiograph 6 Channels
Emergency Trolley/Resucitation Crash Cart
Film Viewer
Lampu Periksa/Examination Lamp/Hanging Lamp
Nebulizer
oxygen concentrator portable
stethoscope pediatric /stetoskop anak
pediatric hospital bed/tempat tidur anak
Suction Pump portable/Aspirator/Vacuum
Syringe Pump
Infusion Pump
Sthetoskop Infant / Baby/Stetoskop Bayi
Sphygmomanometer Aneroid /Tensimeter Anaeroid
Sphygmomanometer Digital/Tensimeter Digital
termometer Digital
Diagnostic Set
Incubator
Infant Warmer
Baby Suction Pump
Infant dan baby Weighting scale
infant stetoscope
Spyhgmomanometer dengan manset untuk bayi dan anak
termometer Rectal
Termometer Axial
Tongue Spatel
Photo Therapy
Baby Resusitasion Set
Infusion Pump
Syringe Pump
Baby Examination table
Examination lamp
Bed Side Monitor
Reflex Hammer
Phono Cardiograph
Intubation set
Incubator
Infant Warmer
Tempat Tidur
Termometer
Lampu Periksa
Stetoskop
Suction Pump
Infusion set
Infusion Pump
Oxygen set dan flow meter
resusitation set
USG 2 Dimensi
Stelisisator Uap
Minor Surgery Instrument Set
Antidecubitus Matras
Gynecologycal Examination set
Emergency Set
Film Viewer
Nebulizer
Vena Suction set
Cardiotocography
Food Troly
lemari obat kaca
Tensimeter
lemari steril
Bak Catheter
Meja Suntik Beroda
Operating Lamp
Manometer
Perkakas
Pinset
Timbangan Bayi
Instrument Trolley
Meja Periksa
Patient Monitor
EKG Elektro Photo
Timbangan Dewasa
Sterilisator
Waskom Mandi
Anatomische pinset
Chirurgical pinset
Air Viva
Bak Instrument
Buli-buli panas
Flow Meter O2
Gilyserine Spuit
Irigator
Korentang
lemari obat kaca
Nierbekken
Kursi Dorong
Standar Infus
Vena Sectie Set
Slim Zuiger
Meja Obat
Gelas Takar
Tabung O2
Baby Incubator
Timbangan Dewasa
Arteri Klem
Bed Skreen/Sherm 3
Kom Kompres
Sputum bak
Standar Waskom
Pisfot dewasa
laser Theraphy
UV Lamp
Brandchard
Oksigen meter dinding
Suction pump dinding
Traffic Light
Droppler
microscope labophot
automatic emergency
Box baby
Emergency Trolley
tempat tidur
termometer
lampu periksa
stetoskop
kan persalinan (VK)
Delivery Instrument set
Curretage instrument set
Minor Surgery set
Doppler
Tensimeter
Suction Pump
Examination lamp
Timbangan Bayi
Oxygen set dan flow meter
Sterilisator
Forceps
Vacum Ekstaktor
Cardiotocography
Stethoscope
Recusitation set
Suction Curetage
Sectio Caesarian set
Anesthesi machine
Infusion Pump
Infusion Warmer
Auto Tranfusion set
Embriotomi set
Timbangan Bayi
operating Lamp
Utility trolley
heating Set
Alat Partus Set
Cardiotocography Unit
Gynecologycal Examination set
Manometer
Alat Pemanas
Stetoscope
Gunting bengkok
Pengait IUD
Spekulum
Tenakulum
Pinset
Korentang
Tromol Kasa
pean Bengkok
Gagang Pisau no.3
Meja Ginekologi
Chirurgical pinset
Meja Obat
Busi
Himinoplasti
Forceps
Bak Instrument
Bak Korentang
Nierbekken
Sonde Uterus
Sim Utarine Currete Blunt
partus instrument set
Pemecah ketuban
Sendok kuret
Tampon Tang
Metal Catheter
Tabung O2
Generator Set
Pump Suction
perasi Kebidanan
Operating Table (gynecologi)
operating lamp
Anesthesi machine
Ventilator dgn probe pengukur
Oxygen set dan flow meter
Electrosurgical unit
UV Lamp for room sterilization
Vacum Pump
Autoclave
Sectio Caesarian set
laparatomy set
Histerectomy set
Laparoscopy set
Histeroscopy set
Electro Cauter bipolaar
Electro couter monopolar
Embriotomi set
Incubator Bayi
Micro Surgery set
Operating lamp
Standar Infus
Standar Waskom
Utility Troly
operating tableb bedah
Electric suction pump
Mayo table stand mobile
Caesarean secction set
Ventilator internal
Patient monitor
meja obat
Perkakas
Ultrasonic cleaner
DC/AC standar
EKG Monitor
Fluid management system
Suction head silicone
Mesin Anesthesi
Ligasure USAm
Folley Lab
Hemodinamic monitoring
Gagang Pisau no.3
Monitor Sony
Mini Viewer
Set Jahit
Ring Aplikasi set
Kocher
Chirurgical pinset
Gunting lurus
Air Viva
Jarum Lumbal
Bed Side monitor
lemari obat kaca
Meja Suntik Beroda
Nidle holder
Tromol Kasa
Spatel lidah
Pean Lurus
Spekulum cocor bebek
Hak Langen beck
Speculum Shim
Aligator
Mini Laparotomy Set
Laringoscope
Folding Endurance Tester
Fenster Klem
Kromatografi Gas
Oksigen meter
Tubing Slip
Bak Bengkok
Stetoscope
Timbangan Dewasa
Tabung O2
Bak Catheter
Lampu Sorot
Pisfot dewasa
Kursi Dorong
Standar Infus
Electric suction pump
Emergency trolley
meja periksa
Manometer
USG 2 Dimensi
Utility trolley
Gynecologycal Examination set
Timbangan Bayi
Syringe Pump
X-ray connect teraphy
Baby Bath tube
Meja Rontgen
lemari obat kaca
Sterilisator
Branchard
api Intensif Alat untuk pelayanan Anestesi
Tindakan Anestesi
em Mesin Anestesi
Mesin Anestesi Sederhana
Mesin Anestesi Standar
Ventilator Standar
Ventilator Canggih
Resusitasi dan Emergency Airway
Laryngoscope Set : Dewasa, Anak/Bayi
Laryngoscope Mc Coy
Nasopharyngeal tube
Oropharyngeal tube
Endotracheal Tube (ETT): Dewasa, Anak/Bayi
Stylet
Magyl Forcep : Dewasa, Anak/Bayi
Mouth spreader
Suction Apparatus
Neck collar
Ventilator Standar
Ventilator Canggih
Ventilator Bayi
Pelayanan terapi intensif airway
Laryngoscope Set : Dewasa, Anak/Bayi
Laryngoscope Mc Coy
Nasopharyngeal tube
Oropharyngeal tube
Endotracheal Tube (ETT): Dewasa, Anak/Bayi
Stylet
Magyl Forcep : Dewasa, Anak/Bayi
Mouth spreader
Suction Apparatus
Defribilator
Syringe Pump
Infusion Pump
Infusion Pressure Bag
Infuse warmer
Standart infuse
Timbangan Darah
elayanan Terap Intensif
Monitor Standart
monitor canggih
monitor sangat canggih
Pulse Oxymeter
Capnometer
Tensimeter
Stetoscope
elayanan Terapi Intensif
Hb-meter
Gluco-Stick
Blood Gas Analyzer
Spirometer manuil
hecting-set
Doek sterile set
TOF Guard
Infant Warmer
Mesin Bulleau Drain
layanan Terapi Intensif
Alat pemeriksa Hemoglobin
Alat Pemeriksa Gula Darah
Alat Pemeriksa Electrolit
Alat pemeriksa lactate Darah
nan Mikrobiologi
Biosafety Cabinet Level 2A
Mikroskop (Binokuler, pembesaran 1000x)
Sink dan Rak untuk pewarnaan
Bunsen
Incubator, suhu sd 45 C (Suhu 20-45⁰C)
Incubator , suhu sampai 80-90 C
Refrigerator suhu 4⁰C (Kapasitas yang besar (600 liter))
Freezer -20⁰C (Kapasitas 200 Liter)
Sentrifus (Volume tabung sd 15 ml; kecepatan sampai dengan 10.000 rpm)
Timbangan Anak Analitik (Kapasitas menimbang di bawah 1 gram)
Timbangan / Balance untuk media (Kapasitas sd 1 Kilogram)
Water Purifier
Autoklaf (Volume 60 liter)
Alat-alat Gelas (Tabung Reaksi, Petri Dish, Erlenmever, Pinet)
n Patologi Anotomi
Jaringan dan Pemeriksaan makroskopik)
Work Station / Grossing Station
Autopsi Set
pisau Potong (1 set)
pisau Potong (1 set)
Gunting (lurus, bengkok, kecil)
Gergaji Listrik
Pinset, Scalpel
Alat Pengukur berat badan (Timbangan)<1 kg
Alat Pengukur berat badan (Timbangan)>1 kg
Loop/Kaca Pembesar
Talenan (Alas Pemotong Jaringan)
san Jaringan (Histologi)
Automatic Tissue processing
manual tissue processing
Automatic Staining Machine
Manual Staining
Embedding Center
Fully Motorize Rotary Microtome+Waterbath
Manual Microtome+Waterbath
Cryostat
Hotplate
peralatan gelas untuk processing manual
Timer
microscope Binocular
Virtual Microscope
Lemari Asam
Ph Meter
Alkohol Meter
Klinik Sitologi
Tempat Tidur Pasien
Lampu Sorot
Tempat Tidur Gynekologi
Lampu Rontgen
Lemari Penyimpanan Bahan-bahan FNAB
Meja Trolly untuk Alat
Meja Kerja
Kursi
Spekulum (Cocor Bebek)
Autoclave/Sterillisator Listrik
Piston Gun
microscope Binocular
ng Pemrosesan Cairan (Sitologi)
Manual Staining Jar
Cyto Centrifuge 1500 rpm
Cyto Spin
Timer
Pipet Set (dari kecil sd besar) masing-masing
microscope Binocular
Liquid Base Cytology Manual
liquid Base Cytology Automatic/Machine
Vortex
Lemari Pendingin/Kulkas
Alkohol Meter
Hair Dryer
Rak Slide
ng Immunohistokimia
Mesin Standar Automatic Pulasan Immunohistokimia
Fully Motorize Rotary Microtome+Waterbath
Hotplate
Lemari pendingin 4⁰C
Freezer -20⁰C (Kapasitas 200 Liter)
Timer
microscope Binocular
Microscope Double Head
ng Imunofluoresensi
Mikroskop Imunofluoresensi Lengkap Dengan Kamera Dan Komputer + PC
ng Diagnosa
microscope Binocular
Microscope Double Head
Meja Untuk Mikroskoppiagnosis
Lemari Buku (build In)
LAYANAN PATOLOGI KLINIK
Peralatan Umum
Biosafety Cabinet Level 2A
Mikroskop
Sink Laboraturium
Rak Untuk Pewarnaan
Waterbath
Refrigerator 2-8⁰C
Freezer -20⁰C
Sentrifus
Mikrosentrifus
Mikropipet
Vortex mixer
Timbangan Analitik
Ph Meter
PERSYARATAN KELAS C
Inkubator
Autoklaf
Oven
EIA sistem
Rotator
Bunsen
Fume hood
Water purifier
Sitosentrifus
Spektrofotometer
Peralatan Gelas
Pelayanan
Hematologi
Hematology Analyzer: Three parts differential (B)
Coagulometer
Peralatan Laju Endap Darah (LED)
Spektrofotometer
Kimia Klinik
Chemestry analyzer
Fotometer / spektrofotometer
Analisa gas darah
Urine Analyzer
J.PELAYANAN RADIOLOGI
Diagnostik
Film Viewer
Cassette & Film X-Ray Semua ukuran
Film Maker
Film Dryer
CT Multislice
USG 4D
Mobile X-Ray
Dental X-Ray
Picture Archiving Communication System (PACS)
Peralatan Protektif Radiasi
Emergency Kit
Viewing Box
Generator set
PERSYARATAN KELAS C
Platfrom Walker
Reciprocal Walker
Reverse Walker
Rolling Triceps Walker
Rolling / Gliding Walker
Shortwave Diathermy
Stair-Climbing Walker
Standar walker
Suspetion & Pulley Equipment
Tilt Table
Traction Unit
Treadmill
Kursi Roda/wheel chair
Senam (Gymnasium)
Perangkat Olahraga senam
GIP
Peralatan Ruang GIP
L. PEMULASAN JENAZAH
body Bags
Dissection Table
Autopsi Instrument
Head Lamp
exhamination Lamp
Body Trolley
Preparation Table
Refrigerated Mortuary Cabinet
body Bags
Dissection Table
M. INSTALASI GIZI
Asuhan Gizi Rawat Inap
Kegiatan asuhan Gizi
Alat Ukur Tinggi Badan dan Berat Badan
Alat ukur Lingkar Lengan Atas
Knee Hight (alat ukur tinggi lutut)
food model
timbangan bayi
PERSYARATAN KELAS C
Alat Ukur Panjang badan bayi
Bed Scale
Bioelectrycal analisys Impedance
Chair Scale
Pita Ukur Lingkar Pinggang Dan Pinggul
PERSYARATAN KELAS C
Tempat Sampah
Chiller 4 Pintu
Tangga Lipat
Hand Lift
Trolley Barang
Timbangan Lantai
Container Bertutup
AC Split