LAPORAN

MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM

No. : 01/LM-IPM/GPS/IX/2017
TGL : 17 - 23 SEPTEMBER 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tgl Pelaksanaan IPM
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN KETERANGAN

1 IPM Baby Incubator/Infant Incubator Atom Incu 1 23X 0739 11411114000161 Perinatologi 20/09/2017 Harus dilakukan pergantian
baterai dan filter

2 IPM Baby Incubator/Infant Incubator Atom Incu 1 23X 0046 11411114000171 Perinatologi 20/09/2017 Harus dilakukan pergantian
baterai
3 IPM Baby Incubator/Infant Incubator Atom Incu 1 23X 0049 11411114000174 Perinatologi 20/09/2017 Harus dilakukan pergantian
baterai
4 IPM Baby Incubator/Infant Incubator Ohmeda Ohio CP2000 HDEN 5091 11411114000148 Perinatologi 20/09/2017 Harus dilakukan pergantian
baterai
5 IPM Patient Monitor GE B650 SK415431124HA 11411114000162 Perinatologi 20/09/2017 Kertas print habis
6 IPM Patient Monitor GE B650 SK415421047HA 11411114000159 Perinatologi 20/09/2017 Kertas print habis, harus
dilakukan pengadaan kabel
dan sensor SPO2
7 IPM Patient Monitor GE B650 SK415421062HA 11411114000167 Perinatologi 20/09/2017 Kabel dan Probe SPO2
bermasalah
8 IPM Blood Warmer Animec AM-2S 123309920 11411114001602 Zaitun I 18/09/2017
9 IPM Blood Warmer Animec Am-2S 12330498 11411114001669 HCU 22/09/2017
10 IPM Electrocardiography Philips TC50 U501508519 11411114000221 Zaitun II Medical 23/09/2017
11 IPM Electrocardiography Philips TC50 U501508553 11411114000230 Zaitun II Bedah 23/09/2017
12 IPM Electrocardiography Philips TC50 US01508516 11411114000342 Stoke Unit 22/09/2017
13 IPM Electrocardiography Philips TC50 U801508520 11411114000604 Zaitun I 18/09/2017
14 IPM Electrocardiography BTL BTL-08LC 0730 B 00192 11411114000515 HCU 22/09/2017 Harus dilakukan perbaikan
Stilus Print
15 IPM Electrocardiography Esaote P80 15455 11411114000605 Zaitun I 18/09/2017 Harus dilakukan pergantian
baterai
16 IPM Electrocauter DRE ASG-120 DR0111006 11411114000882 Poli Kulit 19/09/2017 Harus dilakukan pergantian
kabel netral plate

17 IPM ENT Treatment Uzumcu KN-7h 01129018006 11411114000866 Poli THT 19/09/2017
18 IPM Defibrillator Nihon Kohden TEC-5521K 05281 11411114000514 HCU 22/09/2017 Perlu ada penggantian Baterai
dan kertas print habis

19 IPM Fetal Doppler Huntleigh Sonicaid One 601.1 11411114001670 HCU 22/09/2017
20 IPM Infant Warmer DRE Neolite 23130502003 11411114000646 Perinatologi 22/09/2017 Tombol kontrol tidak
berfungsi untuk merubah
mode dan setting temperatur

21 IPM Nebulizer SAN-AP Ultarasound Nebulizer 021694 11411114001627 Zaitun II Medical 23/09/2017
22 IPM Nebulizer Devilbiss Pulmo Aide 316000224 11411114000111 Zaitun II Medical 20/09/2017
 23 IPM Refrigator Medik Panasonic MPR-5163-PE 15010051 11411114000139 Perinatologi 20/09/2017
24 IPM Suction Pump Blue Cross CNS 1054511017 11411114000628 Perinatologi 22/09/2017
25 IPM Suction Pump Madela Vario 18 AC/DC 1391594 11411114000651 Perinatologi 20/09/2017
26 IPM Suction Pump DRE SPM 5313-2236-88 11411114000232 Zaitun II Bedah 23/09/2017
27 IPM Syringe Pump B'Braun Perfusor Compact S 102491 11411114000640 Perinatologi 22/09/2017 Harus dilakukan pergantian
baterai

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 02/LM-IPM/GPS/IX/2017
TGL : 24 - 30 SEPTEMBER 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tgl Pelaksanaan IPM
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN KETERANGAN

IPM Baby Blanket/Phototherapy Unit Novos Bilicot BCL-12-01-147 11411114000177 Perinatologi 25/09/2017 Harus dilakukan pergantian
1 skin probe failure

2 IPM Baby Blanket/Phototherapy Unit Novos Bilicot BCL-11-04-114 11411114001707 Perinatologi 25/09/2017 Harus dilakukan pergantian
adaptor
3 IPM Baby Incubator Olidef SCTI Line 4 12 J 200 11411114000145 Perinatologi 25/09/2017
4 IPM Baby Incubator DRE Infantia 06130802028 11411114000150 Perinatologi 25/09/2017
5 IPM Baby Incubator DRE Infantia 06130802034 11411114000149 Perinatologi 25/09/2017
6 IPM Baby Incubator Olidef SCTI Line 4 12 J 199 11411114000156 Perinatologi 25/09/2017
7 IPM Baby Incubator Ohmeda Ohio CP200 HDEN 50185 11411114000163 Perinatologi 28/09/2017 Harus dilakukan perbaikan
skin temperatur
8 IPM Blood Warmer DRE Automed 61305047 11411114000549 ICCU 29/09/2017
9 IPM Blood Warmer Animec AM-2S 13330741 11411114001635 VIP 26/09/2017
10 IPM Blood Warmer Animec AM-2S 13330744 11411114001641 Utama 26/09/2017
11 IPM Blood Warmer Animec AM-2S 13330746 11411114000127 Zaitun III 28/09/2017
12 IPM Blood Warmer Animec AM-2S 13330742 11411114000414 Zumar 28/09/2017
13 IPM CTG GE Crometric 170 Series SA511597773 11411114000670 Zaitun III 28/09/2017
14 IPM Defibrillator Medtronik Lifepak 20e 41794043 11411114000548 ICCU 30/09/2017
15 IPM Defibrillator Nihon Kohden Chardiolife/TEC-7731K 00958 11411114000991 Hemodialisa 28/09/2017
16 IPM Electrocardiography Philips TC50 US01508506 11411114000252 VIP 29/09/2017
17 IPM Electrocardiography Philips TC50 US01508499 11411114000929 Utama 26/09/2017
18 IPM Electrocardiography Philips TC50 US01508518 11411114000547 ICCU 29/09/2017
19 IPM Electrocardiography Philips TC50 US91508437 11411114000492 A'sal 28/09/2017
20 IPM Electrocardiography Philips TC50 US01508517 11411114000305 Zumar 28/09/2017
21 IPM Feeding Pump Carewell Feeding Pump System 13101234Y 11411114000545 ICCU 30/09/2017
22 IPM Feeding Pump Carewell Feeding Pump System 13101235Y 11411114000546 ICCU 30/09/2017
23 IPM Infusion Pump B'Braun Infusomat space P 227242 11411114000189 Perinatologi 25/09/2017
24 IPM Infusion Pump B'Braun Infusomat space P 227201 11411114000196 Perinatologi 25/09/2017
25 IPM Infusion Pump B'Braun Infusomat space P 227245 11411114000144 Perinatologi 25/09/2017
26 IPM Infusion Pump B'Braun Infusomat space P 227303 11411114000176 Perinatologi 25/09/2017
27 IPM Infusion Pump B'Braun Infusomat space P 227211 11411114001742 Perinatologi 25/09/2017
28 IPM Infusion Pump B'Braun Infusomat P 109666 11411114000143 Perinatologi 25/09/2017
29 IPM Infusion Pump B'Braun Infusomat P 109671 11411114000194 Perinatologi 25/09/2017
30 IPM Infusion Pump B'Braun Infusomat space P 227194 11411114000197 Perinatologi 25/09/2017
31 IPM Infusion Pump B'Braun Infusomat space P 227259 11411114000198 Perinatologi 25/09/2017
32 IPM Infusion Pump B'Braun Infusomat P 108707 11411114001795 Lukmanul Hakim 27/09/2017
33 IPM Infusion Pump B'Braun Infusomat P 109668 11411114000459 Lukmanul Hakim 27/09/2017
34 IPM Infusion Pump B'Braun Infusomat P 109452 1141111400073 Lukmanul Hakim 27/09/2017
35 IPM Infusion Pump B'Braun Infusomat space P 230351 11411114000355 ICCU 29/09/2017
36 IPM Infusion Pump B'Braun Infusomat space P 230107 11411114000543 ICCU 29/09/2017
37 IPM Infusion Pump B'Braun Infusomat space P 230350 11411114000363 ICCU 29/09/2017
38 IPM Infusion Pump B'Braun Infusomat space P 227213 11411114000542 ICCU 29/09/2017
39 IPM Infusion Pump B'Braun Infusomat space P 109673 11411114000998 Hemodialisa 29/09/2017
40 IPM Infusion Pump B'Braun Infusomat space P 109679 11411114001177 Hemodialisa 29/09/2017
41 IPM Infusion Pump B'Braun Infusomat P 109672 11411114000395 A'sal 28/09/2017
42 IPM Infusion Pump B'Braun Infusomat space P 230361 11411114000354 ICCU 30/09/2017
44 IPM Nebulizer Omron NE-C900 20150500035UF 11411114001648 Lukmanul Hakim 27/09/2017
45 IPM Nebulizer Omron NE-C900 20150500083UF 11411114001649 Lukmanul Hakim 27/09/2017
46 IPM Nebulizer Omron NE-U17 20151100010AF 11411114001793 Lukmanul Hakim 27/09/2017
47 IPM Nebulizer Omron NE-U17 20150700005AF 11411114001650 Lukmanul Hakim 27/09/2017
48 IPM Nebulizer Elmaslar Compressor nebulizer IPXO 11411114001601 Perinatologi 22-092017
49 IPM Nebulizer Omron NE-C25 22151 11411114001713 IRM 30/09/2017
50 IPM Nebulizer Omron NE-U17 20150700080AF 11411114000245 VIP 26/09/2017
51 IPM Nebulizer Omron NE-U17 20150500002AF 11411114000427 Zumar 28/09/2017
52 IPM Nebulizer Omron NE-U17 20150700079AF 11411114000055 Utama 26/09/2017
53 IPM Nebulizer Omron NE-U17 20151100017AF 11411114001642 Utama 26/09/2017
54 IPM Patient Monitor GE B650 SK415441004HA 11411114000492 Lukmanul Hakim 27/09/2017
55 IPM Patient Monitor GE B650 SK415431122HA 11411114000291 Lukmanul Hakim 27/09/2017
56 IPM Patient Monitor GE B650 SK415441001HA 11411114000289 Lukmanul Hakim 27/09/2017
57 IPM Patient Monitor Surgimed M7000 A0705129 11411114000387 Lukmanul Hakim 27/09/2017
58 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500088 11411114001800 Lukmanul Hakim 27/09/2017
59 IPM Pulse Oximeter Bionet Oxy 9 Wave JMW110KA0503N02 11411114001657 Lukmanul Hakim 27/09/2017
60 IPM Pulse Oximeter Masimo RAD-5 N71197 11411114000192 Perinatologi 25/09/2017
61 IPM Suction Pump Dixion Vacus 7209 07-04-1309-0369 11411114001794 Lukmanul Hakim 27/09/2017 Harus dilakukan pergantian
baterai
62 IPM Suction Pump DRE Operating Suction unit 5313-2236-89 11411114001796 Lukmanul Hakim 27/09/2017
63 IPM Suction Pump DRE Portable Suction Unit 5313-2236-80 11411114001799 ICCU 29/09/2017
64 IPM Suction Pump Thomas 1632 GL 061100009880 11411114000490 A'sal 28/09/2017
65 IPM SWD BTL 6000 Shortwave 4000 013-B-00766 11411114000502 IRM 30/09/2017
66 IPM Syringe Pump B'Braun Purfusor Compact S 102487 11411114000641 Perinatologi 25/09/2017
67 IPM Syringe Pump B'Braun Purfusor Compact S 102448 11411114000644 Perinatologi 25/09/2017
68 IPM Syringe Pump B'Braun Purfusor Compact S 102490 11411114000643 Perinatologi 25/09/2017
69 IPM Syringe Pump B'Braun Purfusor Compact S 102492 11411114000642 Perinatologi 25/09/2017
70 IPM Syringe Pump B'Braun Perfusor Compact S 102499 11411114001797 Hemodialisa 29/09/2017
71 IPM Syringe Pump B'Braun Purfusor Compact S 102485 11411114000391 Lukmanul Hakim 27/09/2017
72 IPM Syringe Pump B'Braun Purfusor Compact S 102489 11411114000458 Lukmanul Hakim 29/09/2017
IPM Ultrasound Therapy Physiomed Physioson Expert PSE-1311509GB 11411114000505 IRM 30/09/2017
73 electromedizin
 74 IPM Ultrasound Therapy Chattanooga Z776 T11727 11411114000418 IRM 30/09/2017
IPM Ultrasound Therapy Physiomed Physioson Expert PSE-1313910GB 11411114000499 IRM 30/09/2017
75 electromedizin
76 IPM Ultrasonography Toshiba Capasee D5512380 11411114000993 Hemodialisa 28/09/2017
77 IPM Vein Viewer Christie Flax +$+FlexA521980 11411114000800 Lukmanul Hakim 27/09/2017
Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN
LAPORAN JUNI 2022
RSUD AL IHSAN PROVINSI JAWA BARAT TAHUN 2022

No. Tanggal
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Pelaksanaan IPM KETERANGAN

1 IPM Infusion Pump B'Braun Infusomat Space P 227242 11411114000189 Perinatologi 01/06/2022
2 IPM Infusion Pump B'Braun Infusomat Space P 227245 11411114000144 Perinatologi 02/06/2022
3 IPM Computed Radiograph Fuji film PCR Eleva S Plus 6424692 11411114001188 Radiologi 02/06/2022
4 IPM Computed Radiograph Fuji film PCR Eleva S Plus 17130066 11411114001000 Radiologi 02/06/2022
5 IPM Defibrillator Nihon Kohden Cardiolife 06922 11411114001141 03/06/2022
6 IPM Defibrillator Nihon Kohden Cardiolife 06922 11411114001141 03/06/2022
7 IPM Infusion Pump B'Braun Infusomat Space P 227211 11411114001742 Perinatologi 06/06/2022
8 IPM Infusion Pump B'Braun Infusomat Space P 227303 11411114000176 Perinatologi 07/06/2022
9 IPM Infusion Pump B'Braun Infusomat Space P 227259 11411114000198 Perinatologi 08/06/2022
10 IPM Infusion Pump B'Braun Infusomat Space P 230174 11411114000540 ICCU 08/06/2022
11 IPM Mixer Oxygen Mix-Safe Forte 02100104160020 11411114002034 Perinatologi 08/06/2022
12 IPM Mixer Oxygen Mix-Safe Forte 02100104160005 11411114002081 Perinatologi 09/06/2022
13 IPM Infusion Pump B'Braun Infusomat Space P 109666 11411114000143 Perinatologi 09/06/2022
14 IPM Infusion Pump B'Braun Infusomat P 109672 11411114000295 A'sal 10/06/2022
15 IPM Lampu Operasi Trumpf Trumpf Medical 102685686 IBS 13/06/2022
16 IPM Infusion Pump B'Braun Infusomat Space P 230254 11411114000033 ICU 13/06/2022
17 IPM Infusion Pump B'Braun Infusomat P 72368 11411114000470 Lukmanul Hakim 13/06/2022
18 IPM Light Curing Seker L-40 8051110700024 11411114001242 Poli Gigi 14/06/2022
19 IPM Laparoscopy Allgaier Aline MT1213528 11411114001706 IBS 14/06/2022
20 IPM Nebulizer Omron NE-U17 20151100010AF 11411114001793 Lukmanul Hakim 14/06/2022
21 IPM Nebulizer Omron NE-U17 20150700005AF 11411114001650 Lukmanul Hakim 14/06/2022
22 IPM Nebulizer Elmaslar Compressor nebulizer IPXO 11411114001601 Perinatologi 14/06/2022
23 IPM Nebulizer Omron NE-C25 22151 11411114001713 IRM 15/06/2022
24 IPM Nebulizer Omron NE-U17 20150700080AF 11411114000245 VIP 15/06/2022
25 IPM Nebulizer Omron NE-U17 20150500002AF 11411114000427 Zumar 15/06/2022
26 IPM Nebulizer Omron NE-U17 20150700079AF 11411114000055 Utama 15/06/2022
27 IPM Operating Microscope Bedah Mata Zeiss Medilive Video Control Unit 6627192674 IBS 15/06/2022
28 IPM Operating Microscope Bedah Syaraf Carl Zeiss Lumera 700 6634144213 11411114001071 IBS 16/06/2022
29 IPM Resusitator Bayi Fisher & Paykel Neopuff 150915003258 11411114002083 Perinatologi 16/06/2022
30 IPM Syringe Pump B'Braun Perfusor Space 336734 11411114001739 Perinatologi 16/06/2022
31 IPM Syringe Pump B'Braun Perfusor Space 336755 11411114001744 Perinatologi 17/06/2022
32 IPM Operating Microscope for Opthalmology Zeiss Pentero 900 6637102793 11411114001101 IBS 17/06/2022
33 IPM Operating Table DRE 1846 20120627 11411114001730 IBS 20/06/2022
34 IPM Operating Table REQ JVS-2000 11411114001705 IBS 21/06/2022
35 IPM Patient Monitor GE B650 SK415421047HA 11411114000159 Perinatologi 22/06/2022
36 IPM Patient Monitor GE B650 SK416431094HA 11411114001741 A'sal 22/06/2022
37 IPM Patient Monitor GE B650 SK416241105HA 11411114002014 IBS 23/06/2022
38 IPM Patient Monitor GE B650 SK416261014HA 11411114002088 IBS 23/06/2022
39 IPM Conventive Warmer / Blanket Warmer Equator Convective Warming S102B01157 11411114000368 IGD 23/06/2022
40 IPM Defibrillator Nihon Kohden TEC-5521K 07986 11411114000267 ICU 27/06/2022
41 IPM Dental Unit Aidec 200 CI89575 11411114001219 Poli Eksekutif Gigi 27/06/2022
42 IPM Ultrasonography GE Logic C2 126000WX9 11411114000838 Radiologi
43 IPM Ultrasonography GE Logic P5 304526SU7 11411114001187 Radiologi
44 IPM Suction Pump Medela Dominant Flex 1605008 11411114002013 IBS
45 IPM Suction Pump Medela Dominant 50 1346618 11411114001092 IBS
46 IPM Patient Monitor GE B650 SK416261015HA IBS 28/06/2022
47 IPM Patient Monitor GE Datex Ohmeda F-CM1-04 6408424 11411114001134 IBS 30/06/2022

Catatan : Mengetahui
Kepala IPSRS pelaksana elektromedis

Dede Setia Rosana, S.sos.,MM. Tedi Rukmawan, AMTE

NIPT : 020119701228199511100 NIP: 199401042019031006
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 04/LM-IPM/GPS/IX/2017
TGL : 8 - 14 OKTOBER 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No.
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN

1 IPM Anasthesia Unit GE Avance CS2 APKT03051 11411114001135 IBS 13/10/2017

2 IPM Anasthesia Unit GE Aespire 7900 ANCV00280 11411114002032 IBS 13/10/2017
3 IPM Anasthesia Unit GE Aespire 7900 ANCT02507 11411114001051 IBS 13/10/2017
4 IPM Anasthesia Unit GE Aespire 7900 ANCV00277 11411114002031 IBS 13/10/2017
5 IPM Anasthesia Unit GE Integra SP II Anasthesia SP041355 11411114001295 IBS 13/10/2017
System
6 IPM Computed Radiograph Fuji film PCR Eleva S Plus 6424692 11411114001188 Radiologi 12/10/2017
7 IPM Computed Radiograph Fuji film PCR Eleva S Plus 17130066 11411114001000 Radiologi 12/10/2017
8 IPM Defibrillator Nihon Kohden Cardiolife 06922 11411114001141 13/10/2017
9 IPM Electrocardiographs Philips TC50 US01508522 11411114002030 Hemodialisa 14/10/2017
10 IPM ESU Valeylab Force FX F7J56929A 11411114001294 IBS 13/10/2017
11 IPM ESU DRE ASG - 300 DR4012002 11411114001093 IBS 13/10/2017
12 IPM ESU DRE ASG - 300 DR3212001R 11411114001099 IBS 13/10/2017
13 IPM Infant Warmer DRE Neolite DRE Neolite 24130104015 11411114001129 Ruang OK 13/10/2017
14 IPM Injecttor Liebel - Flarsheim Mallinckrodt CI 0409B013 11411114001189 Radiologi 12/10/2017

15 IPM Mobile X - Ray Philips Practix 160 P3-1024 11411114000837 Radiologi 12/10/2017
16 IPM Mobile X - Ray Allengers 100MA 2K111110228 - X 11411114000839 Radiologi 12/10/2017
IPM Patient Monitor DRE Waveline Pro WLPRO 1011-51495 11411114001081 IBS 13/10/2017
17

18 IPM Patient Monitor GE F-FM-01 6747158 11411114001146 IBS 13/10/2017

19 IPM Patient Monitor GE B650 SK416261014HA 11411114002088 IBS 13/10/2017
20 IPM Patient Monitor GE B650 SK416241105HA 11411114002014 IBS 13/10/2017
21 IPM Suction Pump Medela Dominant Flex 1605008 11411114002013 IBS 13/10/2017
22 IPM Suction Pump Medela Dominant 50 1346618 11411114001092 13/10/2017
23 IPM Ultrasonography GE Logic C2 126000WX9 11411114000838 Radiologi 12/10/2017
24 IPM Ultrasonography GE Logic P5 304526SU7 11411114001187 Radiologi 12/10/2017

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 05/LM-IPM/GPS/IX/2017
TGL : 15 - 21 OKTOBER 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No.
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN

1 IPM Baby Incubator Tende VAV VAV-161716 11411114001824 Perinatologi 19/10/2017

2 IPM CTG Bistos BT-350 Fetal Monitor ADBC60177 11411114001033 Poli Eksekutif 18/10/2017
3 IPM Defibrillator Philips DFM100 CN32607060 11411114002087 Tindakan
ICCU 20/10/2017
4 IPM Defibrillator Philips DFM100 CN32607061 11411114002015 ICCU 20/10/2017
5 IPM Echocardiograph Esaote My Lab 40 40-10552 11411114000870 Poli Eksekutif 18/10/2017
Jantung
6 IPM Echocardiograph Hitachi HI VISION AVIUS KE 10923304 11411114000257 ICCU 20/10/2017
7 IPM ENT Treatment Kazama MG-150A 16MG150A1102 11411114002033 Poli Eksekutif THT 18/10/2017
8 IPM Feeding Pump Applix Applix Smart 20524898 11411114000535 Stroke 20/10/2017
9 IPM Feeding Pump Applix Applix Smart 20524900 11411114000536 Stroke 20/10/2017
10 IPM Infusion Pump B'Braun Infusomat Space P 159527 11411114000146 Perinatologi 19/10/2017
11 IPM Infusion Pump B'Braun Infusomat Space P 227233 11411114000152 Perinatologi 19/10/2017
12 IPM Infusion Pump B'Braun Infusomat Space P 109680 11411114000187 Perinatologi 19/10/2017
13 IPM Infusion Pump B'Braun Infusomat Space P 227230 11411114000164 Perinatologi 19/10/2017
14 IPM Infusion Pump B'Braun Infusomat Space P 230395 11411114000544 ICCU 20/10/2017
15 IPM Infusion Pump B'Braun Infusomat Space P 230337 11411114000541 ICCU 20/10/2017
16 IPM Infusion Pump B'Braun Infusomat Space P 230334 11411114000362 ICCU 20/10/2017
17 IPM Infusion Pump B'Braun Infusomat Space P 230174 11411114000540 ICCU 20/10/2017
18 IPM Mixer Oxygen Mix-Safe Forte 02100104160020 11411114002034 Perinatologi 19/10/2017
19 IPM Mixer Oxygen Mix-Safe Forte 02100104160005 11411114002081 Perinatologi 19/10/2017
IPM Nebulizer Omron NE-U17 20150700078AF 11411114001023 Poli Eksekutif 18/10/2017
20 Tindakan
21 IPM Patient Monitor GE B650 SK416241160HA 11411114002040 Perinatologi 19/10/2017
22 IPM Patient Monitor GE B650 SK416261011HA 11411114002036 Perinatologi 19/10/2017
23 IPM Patient Monitor GE B650 SK416431096HA 11411114002086 ICCU 20/10/2017
24 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500094 11411114002005 Perinatologi 19/10/2017
25 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500096 11411114002006 Perinatologi 19/10/2017
26 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500098 11411114002007 Perinatologi 19/10/2017
27 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500091 11411114002080 Perinatologi 19/10/2017
28 IPM Resusitator Bayi Fisher & Paykel Neopuff 150915003257 11411114002082 Perinatologi 19/10/2017

29 IPM Resusitator Bayi Fisher & Paykel Neopuff 150915003258 11411114002083 Perinatologi 19/10/2017

30 IPM Syringe Pump B'Braun Perfusor Space 336734 11411114001739 Perinatologi 19/10/2017
31 IPM Syringe Pump B'Braun Perfusor Space 336755 11411114001744 Perinatologi 19/10/2017
32 IPM Syringe Pump B'Braun Perfusor Space 336749 11411114001720 Perinatologi 19/10/2017
33 IPM Syringe Pump B'Braun Perfusor Space 221428 11411114002010 Perinatologi 19/10/2017
34 IPM Syringe Pump Terumo TE-331 1208000435 11411114002035 Perinatologi 19/10/2017
 35 IPM Syringe Pump B'Braun Perfusor Compact S 102494 11411114002057 HCU 20/10/2017
36 IPM Syringe Pump B'Braun Perfusor Compact S 50335 11411114001304 Stroke 20/10/2017
37 IPM Suction Pump Thomas Medi-Pump 051100009427 11411114000175 Perinatologi 19/10/2017
38 IPM Transcranial Magnetic Stimulation (TMS) Magstim Rapid 2 C0828 11411114000860 Poli Eksekutif Syaraf 18/10/2017
39 IPM Vein Viewer Christie Vein Viewer Flex +$+FlexA52048I 11411114002084 Perinatologi 19/10/2017

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 06/LM-IPM/GPS/IX/2017
TGL : 22 - 31 OKTOBER 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No.
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN

IPM Analisa Gas Darah Abbot i-Stat 1 362354 11411114000274 ICU 8/1/2019 Perlu ada pergantian
1 simulator
2 IPM Autolens Meter Shin-Nippon LM-15 243598 11411114001238 Poli Mata 8/2/2019
3 IPM Breast Pump Medela Mini Electric Plus 700063 11411114002048 Perinatologi 8/5/2019
IPM Conventive Warmer / Blanket Warmer Equator Convective Warming S102B01157 11411114000368 IGD 8/6/2019
4

5 IPM Defibrillator Nihon Kohden TEC-5521K 07986 11411114000267 ICU 8/7/2019

IPM Dental Unit Aidec 200 CI89575 11411114001219 Poli Eksekutif Gigi 8/8/2019
6

7 IPM Echocardiography GE Vivid S6N 057320VS6N 11411114002042 Poli Jantung 8/9/2019

IPM Electrocardiograph (ECG) GE MAC 2000 SMT 16310204PA 11411114001171 Poli Eksekutif 8/12/2019
8 Tindakan
9 IPM Electrocardiograph (ECG) Philips TC50 US01508502 11411114000270 ICU 8/13/2019
10 IPM Indirect Opthalmoscope Keeler All Pupil 118779 11411114002041 Poli Mata 8/14/2019
11 IPM Indirect Opthalmoscope Keeler All Pupil 53453 11411114001042 Poli Mata 8/15/2019
IPM Infant Warmer Gea Medical HKN-93B 24091101007 11411114000201 Perinatologi 8/16/2019 Perlu ada penggantian Roda
12 dan Skin sensor
13 IPM Infusion Pump B'Braun Infusomat Space P 227221 11411114000908 ICU 8/19/2019
14 IPM Infusion Pump B'Braun Infusomat Space P 230254 11411114000033 ICU 8/20/2019
IPM Infusion Pump B'Braun Infusomat P 72368 11411114000470 Lukmanul Hakim 8/21/2019 Perlu ada penggatian batterai
15 dan kabel konektor

16 IPM Light Curing Seker L-40 8051110700024 11411114001242 Poli Gigi 8/22/2019
17 IPM Nebulizer Omron NE-U17 20151100001AF 11411114002044 Lukmanul Hakim 8/23/2019
18 IPM Nebulizer Elmaslar UN600A UN1310010092 11411114000027 ICU 8/26/2019
19 IPM Pulse Oximeter Mindray PM-60 CR-67173403 11411114002043 VIP 8/27/2019
20 IPM Pulse Oximeter Mindray PM-60 CR-67173398 11411114002052 Zumar 8/28/2019
21 IPM Syringe Pump B'Braun Perfusor Compact S 102486 11411114000460 Lukmanul Hakim 8/29/2019
22 IPM Syringe Pump B'Braun Perfusor Compact S 50043 11411114001256 Utama 8/30/2019

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 07/LM-IPM/GPS/IX/2017
TGL : 1 - 12 November 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No.
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN

39 IPM Patient Monitor GE B650 SK416431096HA 11411114002086 ICCU 21/11/2017

40 IPM Patient Monitor GE B650 SK416261013HA 11411114001787 Zaitun III 25/11/2017
41 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500091 11411114002080 Kebidanan
Perinatologi 20/11/2017
42 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500096 11411114002006 Perinatologi 20/11/2017
43 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500094 11411114002005 Perinatologi 20/11/2017
44 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500098 11411114002007 Perinatologi 20/11/2017
45 IPM Pulse Oximeter Mindray PM-60 CR-67173403 11411114002043 VIP 22/11/2017
46 IPM Suction Pump Thomas Medi-Pump 51100009427 11411114000175 Perinatologi 20/11/2017

47 IPM Suction Pump Medela Vario 18 AC/DC 1391600 11411114001131 29/05/2016 Perinatologi 20/11/2017
48 IPM Syringe Pump B'Braun Perfusor Space 221428 11411114002010 Perinatologi 20/11/2017
49 IPM Syringe Pump Terumo TE-331 1208000435 11411114002035 11/05/2016 Perinatologi 20/11/2017
50 IPM Syringe Pump B'Braun Perfusor Space 336755 11411114001744 Perinatologi 20/11/2017
51 IPM Syringe Pump B'Braun Perfusor Compact S 102494 11411114002057 HCU 21/11/2017
52 IPM Syringe Pump B'Braun Perfusor Compact S 50335 11411114001304 Stroke Unit 21/11/2017
IPM Syringe Pump B'Braun Perfusor Compact S 102486 11411114000460 Lukmanul 21/11/2017
53 Hakim
54 IPM Syringe Pump B'Braun Perfusor Space 336734 11411114001739 Perinatologi 22/11/2017
55 IPM Syringe Pump B'Braun Perfusor Space 336746 11411114001727 Perinatologi 22/11/2017
56 IPM Syringe Pump B'Braun Perfusor Space 221535 11411114000035 24/09/2016 ICU 24/11/2017
57 IPM Ultrasonography GE Logic P5 304526SU7 11411114001187 Radiologi 24/11/2017
58 IPM Ultrasonography GE Logic P5 126000WX9 11411114000838 Radiologi 24/11/2017
59 IPM Ultrasonography Optikon Hi Scan Touch 307BO 11411114000867 Poli Mata 24/11/2017
IPM Ultrasonography Esaote Aquila Pro 8239102 11411114001246 Poli Kebidanan 25/11/2017
60
IPM Ultrasonography Philips HD 6 C17030321 11411114000878 Poli Kebidanan 25/11/2017
61
IPM Ultrasonography Philips HD 11XE USD 1470059 11411114001838 12/08/2017 Poli Kebidanan 25/11/2017
62

63 IPM Ventilator Weinman Medumat Transport 2575 11411114002046 IGD 24/11/2017

1 IPM Anesthesia Unit GE Avance CS2 ADKT03051 11411114001135 IBS 10/11/2017
2 IPM Anesthesia Unit DRE Integra SP II Anesthesia SP041355 11411114001295 IBS 10/11/2017
System
3 IPM Anesthesia Unit GE Aespire 7900 Basic ANC100277 IBS 10/11/2017
4 IPM Anesthesia Unit GE Aespire 7900 Basic ANC100280 IBS 10/11/2017
5 IPM Anesthesia Unit GE Aespire 7900 Basic ANC102507 11411114001051 IBS 10/11/2017
IPM Arthoscopy Smith & Nephew Dyonics Power 2 AAX17659 11411114001057 IBS 12/11/2017
6

7 IPM Baby Incubator/Infant Incubator Olidef SCTI Line 4 12 J 199 11411114000156 Perinatologi 09/11/2017
8 IPM Baby Incubator/Infant Incubator Olidef SCTI Line 4 12 J 200 11411114000145 Perinatologi 09/11/2017
9 IPM Baby Incubator/Infant Incubator Ohmeda Ohid CP 2000 HDEN 50191 11411114000148 Perinatologi 09/11/2017
10 IPM Baby Incubator/Infant Incubator Atom Incu I 23x0049 11411114000174 Perinatologi 09/11/2017
11 IPM Baby Incubator/Infant Incubator Atom Incu I 23x0739 11411114000161 Perinatologi 09/11/2017
12 IPM Baby Incubator/Infant Incubator Atom Incu I 23x0046 11411114000171 Perinatologi 09/11/2017
13 IPM Blanket Warmer Cocoon CWS 4000 CWS4-2320-14 11411114001083 IBS (PACU) 11/11/2017
14 IPM Blanket Warmer Kanmed Operatherm OP3-022 00418-10 11411114001053 IBS 12/11/2017
15 IPM Bronchoscopy Pentax EPK-1 EF012808 11411114001089 IBS 12/11/2017
16 IPM Ceiling Pedant Trilux 1699 IBS 10/11/2017
17 IPM Ceiling Pedant Trilux 1698 IBS 10/11/2017
18 IPM Defibrillator Nihon Kohden TEC-5531K 6922 11411114001141 IBS 10/11/2017
19 IPM Electrosurgical Unit DRE ASG-300 DR1813001R IBS 10/11/2017
20 IPM Electrosurgical Unit Erbe VIO 300 D 11399922 11411114001058 IBS 12/11/2017
21 IPM Endoscopy Olympus Exera II CLV-180 12201P500007 11411114001112 IBS 10/11/2017
22 IPM Harmonic Ethicon Gen II 1111526156 11411114001096 IBS 12/11/2017
23 IPM Infusion Pump B'Braun Infusomat Space P 227201 11411114000196 Perinatologi 09/11/2017
24 IPM Infusion Pump B'Braun Infusomat Space P 227242 11411114000189 Perinatologi 09/11/2017
25 IPM Infusion Pump B'Braun Infusomat Space P 227245 11411114000144 Perinatologi 09/11/2017
26 IPM Infusion Pump B'Braun Infusomat Space P 227211 11411114001742 Perinatologi 09/11/2017
27 IPM Infusion Pump B'Braun Infusomat Space P 227303 11411114000176 Perinatologi 09/11/2017
28 IPM Infusion Pump B'Braun Infusomat Space P 109671 11411114000194 Perinatologi 09/11/2017
29 IPM Infusion Pump B'Braun Infusomat Space P 227194 11411114000197 Perinatologi 09/11/2017
30 IPM Infusion Pump B'Braun Infusomat Space P 227259 11411114000198 Perinatologi 09/11/2017
31 IPM Infusion Pump B'Braun Infusomat Space P 109666 11411114000143 Perinatologi 09/11/2017
32 IPM Infusion Pump B'Braun Infusomat P 109672 11411114000295 A'sal 09/11/2017
33 IPM Lampu Operasi Trumpf Trumpf Medical 102685686 IBS 10/11/2017
34 IPM Laparoscopy Allgaier Aline MT1213528 11411114001706 IBS 12/11/2017
35 IPM Laser Therapy EME Medical Italy MI06480411 11411114000319 IRM 11/11/2017
36 IPM My Feedback Enraf Nonius Myomed 632 UX 15.537 11411114002049 IRM 11/11/2017
37 IPM Operating Microscope Bedah Mata Zeiss Medilive Video Control Unit 6627192674 IBS 10/11/2017
38 IPM Operating Microscope Bedah Syaraf Carl Zeiss Lumera 700 6634144213 11411114001071 IBS 10/11/2017
39 IPM Operating Microscope for Opthalmology Zeiss Pentero 900 6637102793 11411114001101 IBS 12/11/2017
40 IPM Operating Table DRE 1846 20120627 11411114001730 IBS 10/11/2017
41 IPM Operating Table REQ JVS-2000 11411114001705 IBS 12/11/2017
42 IPM Patient Monitor GE B650 SK415431124HA 11411114000162 Perinatologi 09/11/2017
43 IPM Patient Monitor GE B650 SK415421062HA 11411114000167 Perinatologi 09/11/2017
44 IPM Patient Monitor GE B650 SK415421047HA 11411114000159 Perinatologi 09/11/2017
45 IPM Patient Monitor GE B650 SK416431094HA 11411114001741 A'sal 09/11/2017
 46 IPM Patient Monitor GE B650 SK416241105HA 11411114002014 IBS 10/11/2017
47 IPM Patient Monitor GE B650 SK416261014HA 11411114002088 IBS 10/11/2017
48 IPM Patient Monitor GE B650 SK416261015HA IBS 10/11/2017
49 IPM Patient Monitor GE Datex Ohmeda F-FM-01 6747158 11411114001146 IBS 10/11/2017

50 IPM Patient Monitor DRE Waveline Pro 1007-51255 11411114002051 IBS (PACU) 11/11/2017
51 IPM Patient Monitor DRE Waveline Pro 1011-51495 11411114001081 IBS 11/11/2017
52 IPM Patient Monitor GE Datex Ohmeda F-CM1-04 6408424 11411114001134 IBS 11/11/2017
53 IPM Percutanius Neprectomy Litotripsy Karl Storz Endoat LC RU 3078 IBS 10/11/2017
54 IPM (PCNL)
Pulse Oximeter Solaris NT1A NT1A15110078 11411114001698 Zumar 09/11/2017
55 IPM Pulse Oximeter Bionet Oxy 9 Wave 02m0800034 11411114001108 IBS 11/11/2017
56 IPM Suction Pump Medela Dominant Flex 1604974 11411114002089 IBS 11/11/2017
57 IPM Syringe Pump B'Braun Perfusor Compact S 102487 11411114000641 Perinatologi 09/11/2017
58 IPM Syringe Pump B'Braun Perfusor Compact S 336749 11411114001720 Perinatologi 09/11/2017
59 IPM Syringe Pump B'Braun Perfusor Compact S 102448 11411114000644 Perinatologi 09/11/2017
60 IPM Syringe Pump B'Braun Perfusor Compact S 102492 11411114000642 Perinatologi 09/11/2017
61 IPM Syringe Pump B'Braun Perfusor Compact S 102490 11411114000643 Perinatologi 09/11/2017
62 IPM Traksi (DTS) Chattanoga Triton DTS T1688 IRM 11/11/2017
63 IPM Ultrasound Dissector Soring Sonoca 300 94088101 11411114001094 IBS 12/11/2017

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 08/LM-IPM/GPS/IX/2017
TGL : 13 - 19 November 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No.
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN

1 IPM Baby Incubator/Infant Incubator DRE Infantia NB1 6130802028 11411114000150 Perinatologi 14/11/2017
2 IPM Baby Incubator/Infant Incubator Ohmeda Ohio Care Plus HDEN 50185 11411114000163 Perinatologi 14/11/2017
3 IPM Baby Incubator/Infant Incubator DRE Infantia NB1 6130802034 11411114000149 Perinatologi 14/11/2017
4 IPM Baby Incubator/Infant Incubator Tende VAV-TR VAV-TR-164306 11411114001786 IGD 18/11/2017
5 IPM Baby Incubator/Infant Incubator DRE Infantia NB1 6130106001 11411114000965 IGD 18/11/2017
6 IPM Baby Incubator/Infant Incubator Tende VAV VAV-163411 11411114001822 IGD Kebidanan 18/11/2017
7 IPM CTG Philips Avalon FM 30 DES6026645 11411114001788 Zaitun III Kebidanan 14/11/2017
8 IPM Defibrillator Medtronik Lifepak 20e 41794043 11411114002085 ICCU 15/11/2017

9 IPM Defibrillator Nihon Kohden TEC-773IK 00958 11411114000991 Hemodialisa 15/11/2017

10 IPM Electrocardiograph (ECG) Saadat Dena 640 9209189 11411114001287 Poli Jantung 14/11/2017
11 IPM Electrocardiograph (ECG) Philips TC50 US01508522 11411114002030 Hemodialisa 15/11/2017
12 IPM Infusion Pump B'Braun Infusomat P 109452 11411114000473 Lukmanul Hakim 14/11/2017
13 IPM Infusion Pump B'Braun Infusomat Space P 230350 11411114000363 ICCU 15/11/2017
14 IPM Infusion Pump B'Braun Infusomat Space P 230107 11411114000543 ICCU 15/11/2017
15 IPM Infusion Pump B'Braun Infusomat Space P 227213 11411114000542 ICCU 15/11/2017
16 IPM Infusion Pump B'Braun Infusomat P 109673 11411114000998 Hemodialisa 15/11/2017
17 IPM Infusion Pump B'Braun Infusomat P 109679 11411114001177 Hemodialisa 15/11/2017
18 IPM Patient Monitor GE B650 SK415431122HA 11411114000291 Lukmanul Hakim 14/11/2017
19 IPM Patient Monitor GE B650 SK415441004HA 11411114000292 Lukmanul Hakim 14/11/2017
20 IPM Patient Monitor GE B650 SK415441001HA 11411114000289 Lukmanul Hakim 14/11/2017
21 IPM Patient Monitor Surgimed M7000 A0705129 11411114000387 Lukmanul Hakim 14/11/2017
22 IPM Patient Monitor GE B650 SK416431108HA 11411114001784 Zaitun II Medical 14/11/2017
23 IPM Podoscope GIMA Podoscopio Podoscope 5995 11411114001718 IRM 14/11/2017
24 IPM Pulse Oximeter Mindray PM-60 CR-67173402 11411114001785 IGD 18/11/2017
25 IPM Suction Pump Thomas 1632GL 51100009423 11411114000597 IGD 18/11/2017
26 IPM Syringe Pump B'Braun Perfusor Compact S 102489 11411114000458 Lukmanul Hakim 14/11/2017
27 IPM Syringe Pump B'Braun Perfusor Compact S 102485 11411114000391 Lukmanul Hakim 14/11/2017
28 IPM Syringe Pump B'Braun Perfusor Compact S 102491 11411114000640 Perinatologi 14/11/2017
29 IPM Syringe Pump B'Braun Perfusor Compact S 102499 11411114001797 Hemodialisa 15/11/2017
30 IPM Ultrasonography Toshiba Capase D5512380 11411114000993 Hemodialisa 15/11/2017
 31 IPM Ultrasonography Esaote My Lab 40 2011261524 11411114001837 IGD Kebidanan 18/11/2017
32 IPM Ventilator Weinmann Medumat Standar a 8574 11411114000380 IGD 14/11/2017

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 09/LM-IPM/GPS/IX/2017
TGL : 20- 26 November 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tanggal Kalibrasi
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN
Trakhir
1 IPM Baby Incubator/Infant Incubator Tende VAV VAV-161716 11411114001824 Perinatologi 22/11/2017
2 IPM Baby Incubator/Infant Incubator Tende VAV-TR TR-1644303 11411114002038 Perinatologi 22/11/2017
IPM Central Medical Vacum Amcov Air Medical Compressor & VS-24 DB 11411114002079 IGD 23/11/2017 Perlu ada tindakan lanjut
Vacum pump 2. Hour Meter pump 1
3 526 Hours,Hour meter pump
2 426 hours

4 IPM Defibrillator Philips Efficia DFM 100 CN 32607060 11411114002087 ICCU 21/11/2017
5 IPM Defibrillator Philips Efficia DFM 100 CN 32607061 11411114002015 ICCU(Code Blue) 21/11/2017
6 IPM Defibrillator Nihon Kohden TEC-5521K 07986 11411114000297 17/09/2016 ICU 24/11/2017
7 IPM Dental Unit Adec 200 11J91792 11411114000874 Poli Gigi 22/11/2017 Daya sedot suction kurang
maximal
8 IPM Dental Unit Iso Plus 11411114000913 17/11/2016 Poli Gigi 22/11/2017
9 IPM Dental Unit Olsen Logic 158.476 11411114000914 17/11/2016 Poli Gigi 22/11/2017
10 IPM Dental Unit Aidec 200 CI89575 11411114001219 Poli Eksekutif Gigi 24/11/2017
11 IPM Electrocardiographs GE MAC2000 SMT16310205PA 11411114002047 Inap Kebidanan 22/11/2017
12 IPM Electrocardiographs GE MAC 2000 SMT16310204PA 11411114001771 Poli Eksekutif R. 24/11/2017
Tindakan
13 IPM Electrocardiographs GE MAC 2000 SMT16310208PA 11411114002045 IGD 24/11/2017
14 IPM Electrostimulator Chatanoga Intelect Mobile Stim T2618 11411114000038 08/08/2017 IRM 24/11/2017
15 IPM Infusion Pump B'Braun Infusomat Space P 159527 11411114000146 12/05/2016 Perinatologi 20/11/2017
16 IPM Infusion Pump B'Braun Infusomat Space P 227233 11411114000152 11/05/2016 Perinatologi 20/11/2017
17 IPM Infusion Pump B'Braun Infusomat Space P 227230 11411114000164 12/05/2016 Perinatologi 20/11/2017
18 IPM Infusion Pump B'Braun Infusomat Space P 230337 11411114000541 30/05/2016 ICCU 21/11/2017
19 IPM Infusion Pump B'Braun Infusomat Space P 230361 11411114000354 30/05/2016 ICCU 21/11/2017
20 IPM Infusion Pump B'Braun Infusomat Space P 230395 11411114000544 24/09/2016 ICCU 21/11/2017
21 IPM Infusion Pump B'Braun Infusomat Space P 230174 11411114000540 30/05/2016 ICCU 21/11/2017
22 IPM Infusion Pump B'Braun Infusomat Space P 230351 11411114000355 30/05/2016 ICCU 21/11/2017
23 IPM Infusion Pump B'Braun Infusomat Space P 230334 11411114000362 24/09/2016 ICCU 21/11/2017
24 IPM Infusion Pump B'Braun Infusomat P 72368 11411114000470 Lukmanul Hakim 21/11/2017
25 IPM Infusion Pump B'Braun Infusomat P 108707 11411114001795 08/05/2016 Lukmanul Hakim 21/11/2017
26 IPM Infusion Pump B'Braun Infusomat P M18609 11411114000403 21/05/2016 Lukmanul Hakim 21/11/2017
27 IPM Infusion Pump B'Braun Infusomat P 109451 11411114000456 Lukmanul Hakim 21/11/2017
28 IPM Infusion Pump B'Braun Infusomat P 109680 11411114000187 Perinatologi 22/11/2017
29 IPM Infusion Pump B'Braun Infusomat Space P 227221 11411114000908 ICU 24/11/2017
30 IPM Infusion Pump B'Braun Infusomat Space P 230254 11411114000033 ICU 24/11/2017
31 IPM Micro Wave Diathermy (MWD) Micro Thermy ME-8250 BG 14212 11411114002061 17/11/2016 IRM 24/11/2017
32 IPM Micro Wave Diathermy (MWD) Micro Thermy ME-8250 BG 14211 11411114002063 17/11/2016 IRM 24/11/2017
33 IPM Micro Wave Diathermy (MWD) Micro Thermy ME-8250 BG 14214 11411114002062 15/11/2016 IRM 24/11/2017
34 IPM Micro Wave Diathermy (MWD) Micro Thermy ME-8250 BG 14213 11411114001798 17/11/2016 IRM 24/11/2017
35 IPM Motomed Enraff Nonius Viva 2 X44VN2-1102 11411114000040 IRM 24/11/2017
 IPM Nebulizer Devilbiss Pulmo Aide 3i6000223 11411114000215 12/05/2016 Zaitun III Kebidanan 22/11/2017
36

37 IPM Patient Monitor GE B650 SK416241160HA 11411114002040 Perinatologi 20/11/2017

38 IPM Patient Monitor GE B650 SK416261011HA 11411114002036 Perinatologi 20/11/2017
39 IPM Patient Monitor GE B650 SK416431096HA 11411114002086 ICCU 21/11/2017
40 IPM Patient Monitor GE B650 SK416261013HA 11411114001787 Zaitun III Kebidanan 25/11/2017
41 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500091 11411114002080 Perinatologi 20/11/2017
42 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500096 11411114002006 Perinatologi 20/11/2017
43 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500094 11411114002005 Perinatologi 20/11/2017
44 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500098 11411114002007 Perinatologi 20/11/2017
45 IPM Pulse Oximeter Mindray PM-60 CR-67173403 11411114002043 VIP 22/11/2017
46 IPM Suction Pump Thomas Medi-Pump 51100009427 11411114000175 Perinatologi 20/11/2017 Daya sedot tidak maksimal,
Perlu perbaikan lebih lanjut

47 IPM Suction Pump Medela Vario 18 AC/DC 1391600 11411114001131 29/05/2016 Perinatologi 20/11/2017
48 IPM Syringe Pump B'Braun Perfusor Space 221428 11411114002010 Perinatologi 20/11/2017
49 IPM Syringe Pump Terumo TE-331 1208000435 11411114002035 11/05/2016 Perinatologi 20/11/2017
50 IPM Syringe Pump B'Braun Perfusor Space 336755 11411114001744 Perinatologi 20/11/2017
51 IPM Syringe Pump B'Braun Perfusor Compact S 102494 11411114002057 HCU 21/11/2017
52 IPM Syringe Pump B'Braun Perfusor Compact S 50335 11411114001304 Stroke Unit 21/11/2017
53 IPM Syringe Pump B'Braun Perfusor Compact S 102486 11411114000460 Lukmanul Hakim 21/11/2017
54 IPM Syringe Pump B'Braun Perfusor Space 336734 11411114001739 Perinatologi 22/11/2017
55 IPM Syringe Pump B'Braun Perfusor Space 336746 11411114001727 Perinatologi 22/11/2017
56 IPM Syringe Pump B'Braun Perfusor Space 221535 11411114000035 24/09/2016 ICU 24/11/2017
57 IPM Ultrasonography GE Logic P5 304526SU7 11411114001187 Radiologi 24/11/2017
58 IPM Ultrasonography GE Logic P5 126000WX9 11411114000838 Radiologi 24/11/2017
59 IPM Ultrasonography Optikon Hi Scan Touch 307BO 11411114000867 Poli Mata 24/11/2017
60 IPM Ultrasonography Esaote Aquila Pro 8239102 11411114001246 Poli Kebidanan 25/11/2017
61 IPM Ultrasonography Philips HD 6 C17030321 11411114000878 Poli Kebidanan 25/11/2017
62 IPM Ultrasonography Philips HD 11XE USD 1470059 11411114001838 12/08/2017 Poli Kebidanan 25/11/2017
63 IPM Ventilator Weinman Medumat Transport 2575 11411114002046 IGD 24/11/2017

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 10/LM-IPM/GPS/IX/2017
TGL : 27 - 30 November 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tanggal Kalibrasi
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN
Trakhir
1 IPM Syringe Pump B'Braun Perfusor Compact S 50043 11411114001256 19/05/2016 ICU 27/11/2017
2 IPM Syringe Pump B'Braun Perfusor Compact S 50187 11411114000773 24/09/2016 ICU 27/11/2017
3 IPM Spirometer Care Fusion Micro Lab 085-71886 11411114000930 13/11/2016 Poliklinik Paru 29/11/2017
4 IPM Pulse Oximeter Mindray PM60 CR-67173398 11411114002052 Zumar 27/11/2017
5 IPM Othoscope Sometech Dr. Camscope Plus DCSP-12H-007 11411114000879 Cancer 28/11/2017
6 IPM Echocardiography GE Vivid S6N 057320VS6N 11411114002042 Poli Jantung 27/11/2017

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 11/LM-IPM/GPS/IX/2017
TGL : 1 - 9 Desember 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tanggal Kalibrasi
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN
Trakhir
1 IPM Patient Monitor GE Datex Ohmeda 6408424 11411114001134 19/05/2017 IBS 01/12/2017
2 IPM Electrocardiographs Saadat Dena 640 9209189 11411114001287 Poli Jantung 04/12/2017
3 IPM Harmonic Skaple Ethicon Endo Surhery 1111526156 11411114001096 IBS 01/12/2017
4 IPM Infusion Pump B'Braun Infusomat P 109668 11411114000459 Lukmanul Hakim 05/12/2017
5 IPM Patient Monitor DRE Waveline Pro 1007-51255 11411114002051 29/05/2016 IBS 01/12/2017
6 IPM Patient Monitor GE B650 SK416261015HA 11411114002099 IBS 01/12/2017
7 IPM Percutanius Neprectomy Litotripsy Storz Endomat LC RU 3074 11411114002058 IBS 01/12/2017
8 IPM Ultrasound Dissector Soring Sonoca 300 94088101 11411114001094 IBS 01/12/2017
9 IPM Ventilator Weinmann Medumat Standar a 8574 11411114000380 IGD 04/12/2017
10 IPM Ventilator Weinmann Ventilogic LS 02500 11411114000942 ICU 08/12/2017

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 12/LM-IPM/GPS/IX/2017
TGL : 10 - 16Desember 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tanggal Kalibrasi
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN
Trakhir
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 13/LM-IPM/GPS/IX/2017
TGL : 17 - 23 Desember 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tanggal Kalibrasi
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN
Trakhir
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )
 LAPORAN
MINGGUAN PEKERJAAN PEMELIHARAAN ALAT-ALAT KEDOKTERAN UMUM
No. : 14/LM-IPM/GPS/IX/2017
TGL : 24 - 31 Desember 2017 RSUD AL IHSAN KABUPATEN BANDUNG TAHUN 2017
PEKERJAAN YANG DILAKSANAKAN PADA MINGGU INI
No. Tanggal Kalibrasi
SPESIFIKASI URAIAN MERK MODEL S/N BARCODE RUANGAN Tgl Pelaksanaan IPM KETERANGAN
Trakhir
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38

Catatan : Mengetahui : Dibuat oleh : Menyetujui :

Muhammad Kautsar Windu Akbar Cep Purnama, S.ST. Asep Soleh Suhana Ofik Hidayat, Amd. TEM Suhanda, ST.
( Site Manager Project ) ( Adm. Project) ( Ketua PPHP ) (Sek. PPHP) (Ang. PPHP) ( IPSRS )