No.

: SIH/ODX/231159/08/2023
Tanggal : 03 Agustus 2023
Hal : Informasi Harga Alat Kesehatan Merk ZEISS

Kepada Yth.
Direktur RSUD Ir. Soekarno Kabupaten Sukoharjo
Jalan Dokter Muwardi No.71, Bulusari, Gayam, Kec. Sukoharjo, Kabupaten Sukoharjo, Jawa
Tengah 57514

Dengan hormat,

Bersama ini kami PT. Elo Karsa Utama sebagai distributor resmi ZEISS Indonesia bermaksud untuk
memberikan informasi harga alat kesehatan merk ZEISS sebagai berikut :

Harga
Nama Produk Asuransi
Kategori No. Produk E-Katalog
E-Katalog (Rp)
(Rp)
CARL ZEISS CIRRUS 4812199020-
OCT 1,022,653,000 3,067,959
HD-OCT 500 AK1-001066362

Svarat dan Ketentuan:

1. Harga diatas sudah termasuk PPN 11%
2. Biaya Pengiriman : Rp 8,500,000,-/Unit
3. Tujuan Pengiriman : Delivered Duty Paid (DDP) RSUD Ir. Soekarno Kabupaten Sukoharjo
4. Pembayaran : Sesuai dengan yang tertera pada surat kontrak
5. Bukti transfer pembayaran : Harap dikirimkan ke email: admin.medical@elokarsa.com
6. Pengiriman : 8 hingga 16 minggu terhitung sejak kontrak ditandatangani kedua belah
pihak
7. Konfigurasi : Terlampir

Untuk informasi lebih lanjut dapat menghubungi Haidar Maris (+62 811-9700-6329) atau Hendry Sabella
(+62 815-8490-1775) email: hendry.s@elokarsa.com

Demikian surat ini kami sampaikan, atas perhatian dan kerjasamanya kami ucapkan terima kasih.

Hormat kami,
PT Elo Karsa Utama

Hendry Sabella
Medical General Manager
No. : SIH/ODX/231159/08/2023
Tanggal : 03 Agustus 2023
Lampiran :

*Konfigurasi CARL ZEISS CIRRUS HD-OCT 500

Sales Code Description Qty

266002-1162-
CIRRUS HD OCT 500
266
CIRRUS 500 instrument includes 11.5.2 SW upgrade kit, OCT
scanning, LiveOCT™ Fundus Imaging Technology, reference
databases for macula/RNFL/ONH/GCL&IPL (diversified and
10C5115I Asian populations), Anterior Segment Basic Module, 1
Instrument Review Software, DICOM support, integrated
Windows 10 computer with monitor, accessory kit, keyboard,
mouse
Anterior Segment Premier Module (Imaging & Measurements)
80ASLPRM 1
includes external lens kit
230VINTL OCT Power Table 230V 1
60BRSHLD Breath Shield 1

Printer 1
UPS 1000VA 1
No. : SIH/ODX/231159/08/2023
Tanggal : 03 Agustus 2023
Lampiran :

*Spesifikasi CARL ZEISS CIRRUS HD-OCT 500

Optical Coherence Tomography (OCT)

OCT Imaging
Methodology : Spectral Domain OCT
Optical Source : Superluminescent diode (SLD), 840 nm
Scan Speed : 27,000 - 68,000 A-scans per second
A-scan Depth : 2.0 mm (in tissue), 1024 points
Axial Resolutions : 5 µm (in tissue)
Transverse resolutions : 15 µm (in tissue)

Fundus Imaging
Methodology : Live OCT Fundus
Live Fundus Image : During alignment
Optical Source : Superluminescent diode (SLD), 840 nm
Field of View (W x H) : 36⁰ x 22⁰
Frame Rate : > 1.7 Hz
Transverse resolutions : 45 µm (in tissue)

Iris Imaging
Methodology : CCD Camera
Resolution : 1280 x 1024
Live iris image : During alignment

Internal Computer
Operating System/ Processor : Windows® 10, i7 Intel® processor
Memory : 4 GB
Hard Drive/ Internal Storage : ≥ 750 GB (> 80,000 scans)
Display : Integrated 19 inches color flat panel display
USB Ports : 6 ports

Scan Pattern
Macular Scan Pattern
High Density Raster Scan
Optic Disc Scan Pattern
Anterior Segment Scan
200 horizontal scan lines and each line comprise of 200 A-scans; 128
: horizontal scan lines and comprise of 512 A-scans, HD 21 lines scan, HD
Cross Hair/ Radial Scan, and HD 1 line x 100 scans.
Minimum of 4050 A-scans per horizontal scan line and able to scan until
:
choroid
: 200 horizontal scan lines and each line comprise of 200 A-scans
128 horizontal scan lines and each line comprise of 512 A-scans, raster scan,
:
and line scan with 6 mm, 9 mm, 15.8 mm.

Data Analysis
Macular Thickness and Change Analysis, Macular Thickness Normative Data,
Retina :
En Face Analysis
ONH and RNFL OU Analysis with normative data, Guided Progression
Glaucoma :
Analysis with two RNFL baselines, Ganglion Cell Analysis, PanoMap Report
Angle Cornea Visualization, Central Corneal Thickness, Angle Opening
Distance (AOD500/AOD750), Trabecular Iris Space Area (TISA500/TISA750),
Anterior Segment : Scleral Spur Angle Measurement, Residual Stromal Thickness Measurement,
Anterior Chamber Depth, Lens Vault Distance, Angle to Angle Distance
Measurement, and Pachymetry Map.
Electrical and Physical Data
Weight : 34 Kg
Dimensions of Instrument (L x W x H) : 65 x 46 x 53 (cm)
Dimensions of Table (L x W) : 99 x 56 (cm)
Fixation light : Internal and External
Internal Fixation Focus Adjustment : - 20 D to + 20 D (diopters)
Electrical Rating (230 V) : Single Phase, 220 - 240 V ~ systems: 50/60 Hz, 2.5 A

Additional Component
Printer : Printer color; merk : HP / EPSON / CANON / BROTHER
UPS : 1000 VA; 600 watt; merk : APC
No. : SIH/ODX/231159/08/2023
Tanggal : 03 Agustus 2023
Lampiran :

*Gambar CARL ZEISS CIRRUS HD-OCT 500

No. : SIH/ODX/231159/08/2023
Tanggal : 03 Agustus 2023
Lampiran :

*Sreen Shoot CARL ZEISS CIRRUS HD-OCT 500

No. : SIH/ODX/231159/08/2023
Tanggal : 03 Agustus 2023
Lampiran :

*Data Populasi CARL ZEISS CIRRUS HD-OCT 500

No Customer City / District

1 Ciputra SMG Eye Clinic Pondok Indah Jakarta
2 Ciputra SMG Eye Clinic Pondok Indah Jakarta
3 Ciputra SMG Eye Clinic Surabaya Surabaya
4 Kardia Eye Center Jakarta Jakarta
5 Keluarga Sehat, RS Pati Pati
6 Sosodoro, RSUD Bojonegoro Bojonegoro