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 OKTOBER 2022
RSUD AL IHSAN PROVINSI JAWA BARAT TAHUN 2022

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

1 IPM Injecttor Liebel - Flarsheim Mallinckrodt CI 0409B013 11411114001189 Radiologi 03/10/2022

2 IPM Mobile X - Ray Philips Practix 160 P3-1024 11411114000837 Radiologi 03/10/2022
3 IPM Mobile X - Ray Allengers 100MA 2K111110228 - X 11411114000839 Radiologi 04/10/2022
4 IPM Patient Monitor DRE Waveline Pro WLPRO 1011-51495 11411114001081 IBS 04/10/2022
5 IPM Patient Monitor GE F-FM-01 6747158 11411114001146 IBS 05/10/2022
6 IPM Patient Monitor GE B650 SK416261014HA 11411114002088 IBS 05/10/2022
7 IPM Patient Monitor GE B650 SK416241105HA 11411114002014 IBS 06/10/2022
8 IPM Suction Pump Medela Dominant Flex 1605008 11411114002013 IBS 06/10/2022
9 IPM Suction Pump Medela Dominant 50 1346618 11411114001092 07/10/2022
10 IPM Ultrasonography GE Logic C2 126000WX9 11411114000838 Radiologi 07/10/2022
11 IPM Ultrasonography GE Logic P5 304526SU7 11411114001187 Radiologi 08/10/2022
12 IPM Electrocardiography Philips TC50 U501508553 11411114000230 Zaitun II Bedah 10/10/2022
13 IPM Electrocardiography Philips TC50 US01508516 11411114000342 Stoke Unit 10/10/2022
14 IPM Electrocardiography Philips TC50 U801508520 11411114000604 Zaitun I 11/10/2022
15 IPM Electrocardiography BTL BTL-08LC 0730 B 00192 11411114000515 HCU 11/10/2022 Harus dilakukan perbaikan Stilus Print
16 IPM Electrocardiography Esaote P80 15455 11411114000605 Zaitun I 12/10/2022 Harus dilakukan pergantian baterai
17 IPM Electrocauter DRE ASG-120 DR0111006 11411114000882 Poli Kulit 12/10/2022 Harus dilakukan pergantian kabel netral plate
18 IPM ENT Treatment Uzumcu KN-7h 01129018006 11411114000866 Poli THT 13/10/2022
19 IPM Defibrillator Nihon Kohden TEC-5521K 05281 11411114000514 HCU 13/10/2022 Perlu ada penggantian Baterai dan kertas print habis
20 IPM Fetal Doppler Huntleigh Sonicaid One 601.1 11411114001670 HCU 14/10/2022
IPM Infant Warmer DRE Neolite 23130502003 11411114000646 Perinatologi 17/10/2022 Tombol kontrol tidak berfungsi untuk merubah mode
21 dan setting temperatur
22 IPM Nebulizer SAN-AP Ultarasound Nebulizer 021694 11411114001627 Zaitun II Medical 17/10/2022
23 IPM Nebulizer Devilbiss Pulmo Aide 316000224 11411114000111 Zaitun II Medical 18/10/2022
24 IPM Refrigator Medik Panasonic MPR-5163-PE 15010051 11411114000139 Perinatologi 18/10/2022
25 IPM Suction Pump Blue Cross CNS 1054511017 11411114000628 Perinatologi 19/10/2022
26 IPM Suction Pump Madela Vario 18 AC/DC 1391594 11411114000651 Perinatologi 19/10/2022
27 IPM Infusion Pump B'Braun Infusomat Space P 227233 11411114000152 Perinatologi 20/10/2022
28 IPM Infusion Pump B'Braun Infusomat Space P 227230 11411114000164 Perinatologi 20/10/2022
29 IPM Patient Monitor GE B650 SK415431122HA 11411114000291 Lukmanul Hakim 21/10/2022
30 IPM Patient Monitor GE B650 SK415441004HA 11411114000292 Lukmanul Hakim 24/10/2022
31 IPM Patient Monitor GE B650 SK415441001HA 11411114000289 Lukmanul Hakim 25/10/2022
32 IPM Patient Monitor GE B650 SK416431108HA 11411114001784 Zaitun II Medical 26/10/2022
33 IPM Podoscope GIMA Podoscopio Podoscope 5995 11411114001718 IRM 26/10/2022
34 IPM Pulse Oximeter Mindray PM-60 CR-67173402 11411114001785 IGD 27/10/2022
35 IPM Suction Pump Blue Cross CNS 1054511017 11411114000628 Perinatologi 28/10/2022
36 IPM Suction Pump Madela Vario 18 AC/DC 1391594 11411114000651 Perinatologi 28/10/2022
37 IPM Baby Incubator DRE Infantia 06130802034 11411114000149 Perinatologi 30/10/2022
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
17 IPM Patient Monitor DRE Waveline Pro WLPRO 1011-51495 11411114001081 IBS 13/10/2017
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 Patient Monitor GE B650 SK416431096HA 11411114002086 ICCU 21/11/2017

2 IPM Patient Monitor GE B650 SK416261013HA 11411114001787 Zaitun III 25/11/2017
3 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500091 11411114002080 Kebidanan
Perinatologi 20/11/2017
4 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500096 11411114002006 Perinatologi 20/11/2017
5 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500094 11411114002005 Perinatologi 20/11/2017
6 IPM Pulse Oximeter Bionet Oxy 9 Wave 02Q0500098 11411114002007 Perinatologi 20/11/2017
7 IPM Pulse Oximeter Mindray PM-60 CR-67173403 11411114002043 VIP 22/11/2017
8 IPM Suction Pump Thomas Medi-Pump 51100009427 11411114000175 Perinatologi 20/11/2017

9 IPM Suction Pump Medela Vario 18 AC/DC 1391600 11411114001131 29/05/2016 Perinatologi 20/11/2017
10 IPM Syringe Pump B'Braun Perfusor Space 221428 11411114002010 Perinatologi 20/11/2017
11 IPM Syringe Pump Terumo TE-331 1208000435 11411114002035 11/05/2016 Perinatologi 20/11/2017
12 IPM Syringe Pump B'Braun Perfusor Space 336755 11411114001744 Perinatologi 20/11/2017
13 IPM Syringe Pump B'Braun Perfusor Compact S 102494 11411114002057 HCU 21/11/2017
14 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
15 Hakim
16 IPM Syringe Pump B'Braun Perfusor Space 336734 11411114001739 Perinatologi 22/11/2017
17 IPM Syringe Pump B'Braun Perfusor Space 336746 11411114001727 Perinatologi 22/11/2017
18 IPM Syringe Pump B'Braun Perfusor Space 221535 11411114000035 24/09/2016 ICU 24/11/2017
19 IPM Ultrasonography GE Logic P5 304526SU7 11411114001187 Radiologi 24/11/2017
20 IPM Ultrasonography GE Logic P5 126000WX9 11411114000838 Radiologi 24/11/2017
21 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
22
IPM Ultrasonography Philips HD 6 C17030321 11411114000878 Poli Kebidanan 25/11/2017
23
IPM Ultrasonography Philips HD 11XE USD 1470059 11411114001838 12/08/2017 Poli Kebidanan 25/11/2017
24
25 IPM Ventilator Weinman Medumat Transport 2575 11411114002046 IGD 24/11/2017
26 IPM Anesthesia Unit GE Avance CS2 ADKT03051 11411114001135 IBS 10/11/2017
27 IPM Anesthesia Unit DRE Integra SP II Anesthesia SP041355 11411114001295 IBS 10/11/2017
28 IPM Anesthesia Unit GE System
Aespire 7900 Basic ANC100277 IBS 10/11/2017
29 IPM Anesthesia Unit GE Aespire 7900 Basic ANC100280 IBS 10/11/2017
30 IPM Anesthesia Unit GE Aespire 7900 Basic ANC102507 11411114001051 IBS 10/11/2017
31 IPM Arthoscopy Smith & Nephew Dyonics Power 2 AAX17659 11411114001057 IBS 12/11/2017
32 IPM Baby Incubator/Infant Incubator Olidef SCTI Line 4 12 J 199 11411114000156 Perinatologi 09/11/2017
33 IPM Baby Incubator/Infant Incubator Olidef SCTI Line 4 12 J 200 11411114000145 Perinatologi 09/11/2017
34 IPM Baby Incubator/Infant Incubator Ohmeda Ohid CP 2000 HDEN 50191 11411114000148 Perinatologi 09/11/2017
 35 IPM Baby Incubator/Infant Incubator Atom Incu I 23x0049 11411114000174 Perinatologi 09/11/2017
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
4 IPM Conventive Warmer / Blanket Warmer Equator Convective Warming S102B01157 11411114000368 IGD 8/6/2019
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
3 IPM Anesthesia Unit GE System
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
6 IPM Arthoscopy Smith & Nephew Dyonics Power 2 AAX17659 11411114001057 IBS 12/11/2017
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
36 IPM Nebulizer Devilbiss Pulmo Aide 3i6000223 11411114000215 12/05/2016 Zaitun III Kebidanan 22/11/2017
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 )