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Type spesitasi | pase & No Unt satuanfanng “ene wai freee ee ~BeatbesihGhgy | “le yng = NepnsAssl Bang Jurlah nis | ahan ‘Kemasin 7° 35 [oe 1010 Tapa Faia 15.8000 Pese CE) | |ATRAMAT PLAIN GUT SURGICAL SUTURE USP_| Noor Peniaflran Ast 0.0000 Kg nrR| 1-0 EP2, 75 CM NEEDLE CE-9 REVERSE Kesehatn/Depes (10) 0 Package PK) (CUTTING 19 4m 378 CL 7 -CE1924-75 - BAIK DAN BARU IBARANG BARU Mexico (MX) 34 30061090 Tapa Fass BM: 35.000 Pie CE) sar 'ATRAMAT SILK SURGICAL SUTURE BLACK USP |-Nowor Pedra Att BM ~ .0¢00 Ke wn EP4.75CM NEFDLEG40 HEAVY TAPER | KeschatanDephes(®) BMAD = 0 Package (PX) PoNT4e Nat 12 Cr : MP | Gio3e - BamK DAN BARU bre. BBARANG BARU Mexico (Mx) PaBM:- Ph: 2.5% 55 |3006.1090 Tapa Facts BM: - 20.0900 Peze(PCE) 159.03) |ATRAMAT SILK SURGICAL SUTURE BLACK USP |RamnorPendaflaan Alat BMI: 00030 Ks NTR EP 4,75 CM NEEDLE G40 HEAVY TAPER | KehetnDepka(@) BMAD = 0 Package Pk) POINT 40 wat 12.C1 7 Me -GH038 - BAIK DAN BARU MTP {BARANG BARU ki Mexico (>) PN: 10% NBM: Fem 2.5% 56 30061090 Tinpa astas IBM. 530000 Pies PCED rat ‘ATRAMAT NYLON SURGICALSUTURE BLACK Nomor Peniafiaran Alt BM 2.0000 NTR, [USP 2.0 EP 3,75 CM NEEDLE CE24 REVERSE | Keschatan/Dephes (9), ‘ADs Package PK) (CUTTING 264M 378 Br: CE2482.75N ~ BAIK DAN BARU pxTP- BARANG BARU ki | Mexico 4X) i PN 1% | | PabM:- i pr 2.5% | | | | L Jake, 26-11202LEMBAR LANJUTAN PEMBERITAHUAN IMPOR BARANG (PIB) Tor Pabaan RPA Soka Hana Taio Haleaan- 1a Gat omer Pengsiaa 0000-005795-20211126-011676 Timgpal Puen: ~ Nomor Pantaran 1 Ten Pesan Si. ]32-Pos Ta TS naan DF Taare Fasiias 93 Dai eas— BO> Pabeae No, |" “Union dens Baring. Meck. Type spesiiasi parents No Unt ‘stun Bang | Je “ai tree Beste ig) | ~Nityene -Neprs Aas Barong, inaaamninie ~Jumlah tenis | _Gambhlan Kern no 37006 1050 "Tp Faas Bie T5000 PesePCE Tas IATRAMAT NYLON SURGICAL SUTURE BLACK |- Nomar Pendafran Ait BM: 0.0000 kg NTR) LUSP 3.0 EP 2,75 CM NEEDLE CE-24 REVERSE | Kesehatan Depkes() 0 Package PK |currinc 2e nt ae 7 | ce2443-18 ~ BAIK DAN BARU [BARANG BARU [Mexico 0) 2M 25% 58 006.1090 -Tanpa Fass BM: 100.0000 Pees 12604 IATRAMAT PGA SUROICAL SUTURE VIOLET USP.|-Nomor Pendafiarn Abt BML 2 ce) TR "2, 1QDCM NEEDLE G48 HEAVY TAPER | Xechan/Dephas 0.000 xg POINT 48 Maa 12C : 0 Package PK) 699.100 - Balk DAN BARU [BARANG BARU ‘Mexiso (0X) BM: Ph 2 5% 89. 306.1090 Tanga Fastin av. 150.0000 Pisce 2am |ATRAMAT FGA SURGICAL SUTURE VIOLET USP | Nomar Penafuran Als hth ‘ece) Nr [25'S IS0CMNEEDLE-G.48 HEAVY TAPER |icschaun/Dephes (0) BMAD: - 9.0000 Kg PONT 48MM U2 7 MP 0 Package (PA) -69899-150 ~BAIK DAN BARU MTP JSARANG BARU aka Mexico (3) PN 10% ah ~ rn2s% © |3006.10.10 Temp sits 50000 Pice (°C) ‘ATRAMAT POC2S SURGICAL SUTURE VIOLET Nomer Peataran Alt BM .oc00 Ke USP 1 EP4,100CM NEFDLESG48 PREMIUM /KeshetDephes() BMAD:~ 0 Package (PK) [HEAVY TAPER FONT 7 MP. "scaaos.t00H - Tr BARANG BARU ha ‘Mexio (4X) PN 10% i | PBMC: bona i I 112028PEMBERITAHUAN IMPOR BARANG (PIB) LEMBAR LANJUTAN Be20 Kantor Paes PU Soekame Hare 0100] Hobsnan 7, alt 2 omer Pengosan ‘040000.005758-20211126.011676 “TrnasalPeegajuan : = NomiorPendafern ‘ ‘Tangeal Pendairan =~ SI. [52 Pos Tan [3 Kecanman De TRAT festins 5. Tama CTR P= Pen No, |” “Ursin JenisBorang, Merek, Type. spesifikasi pant & No. Unt ‘tan a Lets wai 7 ie uel - Barat bes Nia ang = Negara Asi! Barang sities sumtah nis | _Saban Kemasin ‘t_o06 10.10 Tampa Fl BM 6.0000 Fess sa [ATRAMAT CHROMIC GUTSURGICAL SUTURE |= Nemor Pendaftran Alat B= (ree) NTR) \USP2 BP 6,90. CM NEEDLE G-48 HEAVY TAPER | Kesthatsy/Depies (6) BMAD: 1.000 xg POINT 48 MM 172 : MP: D Packager) |.G4819.50 - BATK DAN BARU MTP [BARANG BARU ka IMexico (MX) 10% Ph 2.5% @ 3006.10.90 + TanpaFastias 150000 Pie (PCE) 1135 |ATRAMAT PGA SURCICAL SUTURE VIOLET USP | Nomnor Pendataran AL 0.0000 Ke. NTR 5-0 EP 1,75 CM NEEDLE F-17 FINE TAPER POINT | Keschalan/Depkes ) 0 Fackage(PK) TMM inc . |. F1795.785 - Baik DAN BARU [BARANG BARU Mexico (sx), he 2.5% 63 [3006.10.90 ~Tanpa Fsiias BM: - 20,0000 Piece (®CE) 199.0 |ATRAMAT PGA SURGICAL SUTURE VIOLET UsP |: Nomar Pendftran Alot BME = 6.0000 Ke rR 1-0 EP2. 75 CM NEEDLE R-20 REGULAR TAPER | Kesthatn/Dephes (4) SMD: = o package Pk) Poms 20 MM 17 : MP |- 2053-75 - Balk DAN BARU MTP. 'BARANG BARU kai [Mexico (AX) PN 10% "POBM: = Pr 2.59% 64 3006.10.90 Tappa Fesiiae law 45.0000 Piece (PCE) 483.46 |ATRAMAT PGA SURGICAL SUTURE VIOLET USP |“Nomor Pendafiren Alt BMI. 0.0000 Ke, NIR 1EP4,90CMNEEDLEG37 HEAVY TAPER | Keecatan/Dephes (4) BMAD: 0 Package (PK) POINT 37MM 12 C1 Fi P:- 1-03798.90 - BAIK DAN BARU | BNP: 'BARANG BARU we ‘Mexico (Mx) PN 10% | ota: ons 2.s96 Joka, 26LEMBAR LANJUTAN PEMBERITAHUAN IMPOR BARANG (PIB) Taare WRU Sodan tor] Taste 1a Gat AL ome: Pngjsan 000-0578 2021112611676 Teele Nomos Fenian i ‘anal Prd 3 Po aS 5 Keane a No. [°C tons Bure, Mack. Type spesitian | URRRSOAR ‘sna deang | cen a ee Le Seatbesiida) | “ASeae + Negara Ast Bang “Jomeh tens | gkaain | mash e050 apa Fnias aN i000 Fixe PCE) 22 JATRAMAT PGA SURGICAL SUTURE VIOLET Us? | Nomer endian Alt 10000 ke in| 12P 4.90 CMNEEDIEGSTHEAVY TAPER. [xohaueboneta BMAD: Oaskage x) ronmsyo act : Bur [398.90 = BAIK DAN BARU parr - AaRANG BARU a Mexico NX) Noe aM: fone 66 051090 Tang aiias pM. 170000 Pace sia [ATRAMAT PCA SURGICALSUTURE VIOLET USP |NorerPenstasn At fo ce) Nin LEP, 90CM NEEDLEGAD HEAVY TAPER /KecimaniDoketo Ba 8000 Ke rowan 13 cr ; OFekage PR) eae-s0 BAIR DAN BARU ieaRaN BARU mexico eM 0% roo Ph 25% «67 to06.1090 Tanga Fastin eM. 2,000 piece re) asa [ATRAMAT PGA SURGICAL SUTURE VIOLET USP | Nomar Penisfann Alat BN 3.0000 Ke NR J-OEPIs. cM NEEDLECEA REVERSE |cehuunDenne Gy BARD. sO astags vmrive 2s : jar SCeRS45 AIK DAN BARU MT BARANG BARU a= IMovico NX) ni rN Prnzsn 6s 005.1090 Tana Faas 10.000 Fase) unl AATRAMAT PGA SURGICAL SUTURE VIOLET USP |” Nower Pondtiran Aa 1000 Ke xR [20 EP3.9%0 cM NEEDLE C= REVERSE CUTTING Ketan Donce oPeekge rR) | ‘done t2c1 “4052-50 - BAIK DAN BARU BARANG BARU. Mexico (xy MTP: PN: 1086 ABM: Ph: 2.5% Jakoma, 26-11-2028LEMBAR LANJUTAN PEMBERITAHUAN IMPOR BARANG (PIB) p20 Ranier Pats PU Socom 250100 alain 19. da 2 Nomor Pengjuan 00000-00579.20211126-011676 ‘TaggelPompjean: - [NomorPendataan 1 angel Penatran > = Si. [32-Pos Tans Recah PR TaRPe Tasos Shek Tape =RaT Pas No. = Ursin Jeni Barng, Merk, Type.speistasi | pete No, Una ‘atuan Borne ene valid Speake ua Berta fg) | = Ni yang Negara Asa Goring “Juni Joos | flaptalan @ wns. 1050 Tapa Fin Tr.0n00 Fiese(PCEY Tai |ATRAMAT PGA SURGICAL SUTURE VIOLET USP | Nomor endataran Alt 0.0000 Ke. NTR \¢-0 EP 04, 30 CM DOUBLE NEEDLE EE KeschaiDepkes 4) (BMAD: 0 Pakage (PK) [PREMIUM SPATULA 6M : MP: | BE658072-30 - BAIK DAN BARU MTF [BARANG BARU kai Mexico (0X) PS: 10% brown. Ph: 23% 70 006.1019 Tampa Fesiias 10.0000 Pee rc) rors 'ATRAMAT CHROMIC GUT SURGICAL SUTURE | Non Pendaftaran Alt 0.0000 Ke wi USP 4.0 FP 2,75CM NEEDLE R26 REGULAR | Keshatn/Dephes (6) 0 Package (PK) ‘TAPER FOINT 26 NN : |. R2614-75 -BAIK DAN BARD BARANG BARU IMerico (MX) 71 fs006.10.10 Tana asia lpae- 30.6000 Piss (PCE) 4a. JATRAMAT PLAIN GUT SURGICAL SUTUREUSP_ | NomorPendafaan Ala’ BNI: 0000 Ke. rel 0 EP 3.75 CM NEEDLE R26 REGULAR TAPER | KeseintaDepkss (10) BMAD-~ 0 Package (PK) PONNT26MN 1 MP. -R2622-73 - BAIK DAN BARU MTP: = IBARANG BARU kai: Mexico (MX) PN 10% PoM:- Ph 25% 72 {3006.10.10 = Tampa Fasiies BM. 175.9000 Piece Lono.s| |ATRAMAT PLAIN GUT SURGICAL SUTURE USP. |NomorPendatann Alot BM: ce) NrR| 2-0 EP 3.5.75CM NEEDLEG37 HEAVY TAPER | Kesehatn/Dephss (10) BMAD?~ 0.0090 Ke Por 37 MM 172 : MP: 0 Package (Pk) -63722-15 - Balk DAN BARU MTP: = [BARANG BARU ka: Mexio (4X) PN: 10% BM: 259% Sara, 26-11-2021LEMBAR LANJUTAN PEMBERITAHUAN IMPOR BARANG (PIB) 320 anor Pabear RPO Seekamo-Hiana Ca akan 20 dad "Nomer Pengahun (900000-005798-20211(26.011676 ‘Tange Penijuan Nomor Pendstaren 1 ‘Tengen Peadairan SI. S2-Poe Tans BS Keieanaan [A-TRRT Fass 5 Fl a6, aba No |" Unaan Jens Baran. Merek. Type spits |” pase No, Unt “ata Sens Bont boat TN yan void = Peryartan No, Ut Bentbersh tke) | -Nepars Asal Baring “amin ais] _fartatlan i 0e0.50 Tapa Fates Bra THo000 Piese PCE 7a) |ATRAMAT SILK SURGICAL SUTURE BLACK USP | -Nomor Pendafiaran Alat p 6.0000 ks NTR) 13-0 EP2. 75 CM NEEDLE CE-19 REVERSE KesehatavDepkes (8) 0 Package (PK) (CUTTING 19 4M 58 C '=CE1933 ~ BAIK DAN BARU 'EARANG BARU IMeriee (9x), = PN: 10% Pa rhc 25% kana, 26112021LEMBAR LAMPIRAN DOKUMEN PEMBERITAHUAN IMPOR BARANG (PIB) pe20 aor Paar PU Scekarpo Hata 250100 Wananii. dae 2 "Nome Pengajun (900000-005798.20211126.011676 ‘Tenge Pgajuan: = [Noms Pendsfars , Tanga Pendateran: No. |Kede Dokumen Nama Deke ‘Noor dan Tanggal Dokemen pike 1/380 Invoice 32805 18-11-2021 Yai Tidak 2 [ro AWS MEX-08000506 25.11-202 Ye Tidak 3 | Master AW 137-60725501 2512021 Ya/ Tidak a fen Nomor Pendafaran Ala Kesehatan Depkes AKL 21603516136 2610-2018 Ya Tidak 3 [sn Noto PendafiranAlstKeschatan/Depkes AKL 21603816676 28.10.2018 Ya/ Tidak 6 [en [Nomnor PendafaranAlstKesehatan/Daphes AKL 21603516134 os.t1-2019 Yo /Tidek 7 len "Nomor Pendairan Als Kesehatan Depes AKL 20003516135 05112019 Ya/Tiak 8 fan |Nomor Pendaftaan Ast Kesthatn/Depkes AKL 21603816677 26.10.2019 Ya/ Tidak 9 | [NomorPendataren lat Keschatan/Dephes [AKL 21603516141 1209 Ya/ Tidak 10 Jen Noor Pendifaren lat Keschatan/Depkes AKL 21605516133 05.11.2019, Ya/Tidak a en | Nomor Pendafans Alt Kesehatan Depkes AKL 21603816665 21-10-2019, Yas Tisak aka, 26-11-2021 PPuK,