KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
RUANG KARTU 1 Kursi Busa Chitose 2 2010
2 Kursi Lipat Phoenix 1 2010
3 Meja komputer Big Panel 1 2014
4 Desktop Perangkat Computer ( PC ) H530s Lenovo 1 2014
5 UPS CE1200 ICA 1 2014
6 Instalasi jaringan Aplikasi Data ( SIK ) 1 2014
7 Lemari Steel Ofice Equipmen Unital 4 2015

RUANG IGD 1 Lemari Kaca Dharma Heltcare 1 2009

2 Tabung Oxigen 2 2009
3 Kipas Angin GMC 2 2010
4 Tempat tidur (Brankar) - 2 2010
5 Lampu sorot 2 2010
6 Tiang Infuls 2 2010
7 Tangga Tempat Tidur - 1 2010
8 Troli Oxigens 1 2012
9 Ember Cuci Tangan 1 2012
 10 Nurse set 1 2012
11 Meja 1/2 Biro, Rangka Orbitrend 1 2015
12 Kursi Biasa Unital Premium 2 2015
13 Lemari Arsip Silling Kaca Mustang 1 2015
14 ELECTROCARDIO GRAPH/ EKG 3 CHANNEL WITH ECG DISPL GE Healthcare/MAC 600 1 UNIT 2015
15 PORTABLE PULSE OXIMETRY GE Healthcare/Trusat 1 UNIT 2015

IMUNISASI 1 Lemari Arsip Montana 1 2008

2 Lemari Arsip Mustang 2 2010
3 Kipas Angin GMC 1 2010
4 Solar Cell PolyCryataline Silicon Sankulex/SPV 1610-100 4 PCS 2015
5 Solar Charge Controller (SCC), 10 Amp-12 VDC EP Solar/ EPHC!)-EC 4 PCS 2015
6 Portable Cold Chain Refrigenerator Waeco /CF 50 1 PCS 2015
7 Batt Outdo/MF80D26R (L) 4 Pcs 2015
8 Box Battery ABS Plastik Elka/ ABS100-INT 4 Pcs 2015
9 Hanger/Hub Lokal 1 Set 2015
10 Penyangga Modul Surya HDG Elka/ PM.100-LK 4 Set 2015
11 Kabel Set Super/ NYYHY 4 Set 2015
12 Material Instalasi & Aksesories Elka/ MA.100-LK 4 Set 2015
13 Meja 1/2 Biro, Rangka Orbitrend 2 2015
14 Kursi Biasa Unital Premium 2 2015
POLI UMUM 1 Tempat Tidur Besi/Metal A - 1 2009
2 Kasur - 1 2009
3 Bantal - 1 2009
4 Kipas Angin GMC 1 2010
5 Tensi 1 2010
6 Stetoscope 1 2010
7 Timbangan Bayi 1 2010
8 Timbangan Dewasa 1 2010
9 Kursi Lipat 1 2010
10 Meja 1/2 Biro, Rangka Orbitrend 2 2015
11 Kursi Biasa Unital Premium 2 2015

1 Rak Plastik 2 2008

KIA/ KB 2 Kursi Putar Belgio 1 2008
3 Kasur - 1 2009
4 Tempat Tidur Besi/Metal - 1 2009
5 Bantal - 1 2009
6 Kipas Angin Cosmos 1 2010
7 Timbangan Dewasa 1 2010
8 Tensi Meter 1 2010
9 Meja 1/2 Biro, Rangka Orbitrend 1 2015
10 Kursi Biasa Unital Premium 2 2015
11 Lemari Arsip Silling Kaca Mustang 3 2015

1 Lemari Arsip Silling Kaca Mustang 1 2010 APBK

R. Kepala 2 Filling Kabinet 4 Laci Standar Yunika 2 2010 APBK
 3 Dispenser 80919375 Gea Mercuri 1 2010
4 Kulkas 2312 TOSHIBA 1 2010
5 Kursi Putar Figueras 1 2010
6 Kipas Angin GMC 1 2010
7 Filling Kabinet 4 Laci Standar Unital Premium 1 2015
8 Meja 1/2 Biro, Rangka Orbitrend 1 2015
9 Kursi Biasa Unital Premium 2 2015
10 Lemari Arsip Silling Kaca Mustang 2 2015

1 Mesin Ketik Manual Portable Royal 1 2008 JKN

R. Tata Usaha 2 Filling Kabinet 4 Laci Standar Yunika 1 2009
3 Lemari Arsip Silling Kaca Montana 1 2009
4 Meja Komputer Gkage 1 2010
5 Kipas Angin GMC 1 2010
6 Desktop Perangkat Computer ( PC ) H530s Lenovo 2 2014
7 UPS CE1200 ICA 2 2014
8 Instalasi jaringan Aplikasi Data ( SIK ) 2 2014
9 Printer CANON PIXMA IP 2770 1 2015
10 Printer EPSON EPSON L 120 1 2015
11 Filling Kabinet 4 Laci Standar Unital Premium 2 2015
12 Meja 1/2 Biro, Rangka Orbitrend 3 2015
13 Kursi Biasa Unital Premium 3 2015
Mustang

1 Meja Tulis Big Panel 1 2010

Apotik 2 Kipas Angin GMC 1 2010
3 Meja komputer Big Panel 1 2014
4 Desktop Perangkat Computer ( PC ) H530s Lenovo 1 2014
5 UPS CE1200 ICA 1 2014
6 Instalasi jaringan Aplikasi Data ( SIK ) 1 2014
 7 Kursi Biasa Unital Premium 4 2015

Gudang Apotik 1 Rak kayu -

2 Kipas Angin GMC 1 2010
3 GENSET LISTRIK 80800251 CLEMAKSH2900DX 1 2010
4 BOK P3K - 2014
5 AC QSNC0566NAO LG 1 2015

1 Troli Baskom 1 2010

R. TB/Kusta 2 Meja 1/2 Biro, Rangka Orbitrend 2 2015
3 Kursi Biasa Unital Premium 2 2015
4 Lemari Arsip Silling Kaca Mustang 2 2015
5

1 Meja 1/2 Biro, Rangka Orbitrend 1 2015

R. Sanitasi 2 Kursi Biasa Unital Premium 2 2015
3 Lemari Arsip Silling Kaca Mustang 1 2015

1 Jam Dinding 1 2010

R. Tunggu 2 Televisi 21 inc Polytron 1 2010
3 Meja 1/2 Biro, Rangka Orbitrend 1 2015
4 Kursi Biasa Unital Premium 1 2015
5 Kursi Tunggu 4 set STEADY BOY 6 2015
6 Runing text NA 10RD-0105S-N09-15-1341 Netra 1 2015
 Gudang 1 Tiang dan Umbul-Umbul 6 2010
2 Sapu 1 2015
3 Kain pel 1 2015
4 Superpell

1 Meja 1/2 Biro, Rangka Orbitrend 2015

R. Inventaris 2 Kursi Biasa Unital Premium 2015
3 Kursi Tunggu 4 set STEADY BOY 2015
4 Lemari Arsip Silling Kaca Mustang 2015
5 Filling Kabinet 4 Laci Standar Unital Premium 2015
6 Locker 6 Compartments UNITAL 2015
7 Tempat Tidur Spring Bed 6 Kaki Full Hause 2015
8 Kursi Tamu Vivo 2015
9 Lemari Pakaian 3 Pintu Dj Tech 2015
10 Meja TV Nacwood 2015
11 Meja Makan Sweet 2015
12 Palu 2015
13 Gergaji 2015
14 Klip Tembak 2015

ALAT-ALAT KESEHATAN
1 UMBILICAL CORD SCISSORS 105 MM ET 152 R 1 2015
2 MAYO-STILLE SCISS BVLD STR 140 MM BC 576 R 1 2015
3 UMBILICAL CORD SCISSORS LAT-CVD 135 MM BC 796 R 2 2015
4 MICHEL SUTURE CLIP 12x2,5 MM BN 512 R 2 2015
5 SURGICAL SCISSORS STR S/S 130 MM BC 343 R 2 2015
6 MAYO-STILLE SCISS BVLD-BLD STR 140 MM BC 576 R 2 2015
7 SURGICAL SCISSORS STR S/S 130 MM BC 343 R 2 2015
8 SPENCER SUTURE SCISSORS 90 MM BC 801 R 1 2015
9 HEGAR-OLSEN NDL/SCISS SERR 140 MM BM 290 R 1 2015
10 MINOR SURGERY SET Aesculap/Various 2 SET 2015
 SCALPEL HANDLE #3 125 MM 1 2015
SURGICAL SCISSORS STR s/b145 MM 1 2015
MAYO SCISSORS CVD 140 MM 1 2015
METZENBAUM SCISSORS CVD 180 MM 1 2015
TISSUE FORCEPS SERR 145 MM 1 2015
STANDARD FORCEPS SERR 145 MM 2 2015
STANDARD FORCEPS SERR 180 MM 2 2015
STANDARD TISSUE FORCEPS 1x2 145 MM 2 2015
STANDARD TISSUE FORCEPS 1x2 180 MM 2 2015
FOERSTER-BALLENGR SPNG FCPSERSTR 180 MM 1 2015
BACKHAUS TOWEL CLAMPA 90 MM 2 2015
HALDTED-MOSQUITO FORCEPS DELSTR125 MM 1 2015
CRILE FORCEPS CVD 140 MM 1 2015
SPENCER-WELLS FORCEPS STR 130 MM 1 2015
KOCHER-OCHSNER FORCEPS STR 1x2 160 MM 1 2015
KOCHER-OCHSNER FORCEPS STR 1x2 185 MM 1 2015
CRILE-WOOD NDLHLDRFINE-SERR150 MM 1 2015
DIRECTOR W/ TONGUE STR 145 MM 1 2015
MYRTLE-LEAF PROBE 2.0 MM 145 MM 1 2015
SENN-MILLERR RECTOR.SH.8x7/18x5.5 MM 1 2015
FARABEUF RTRCTRS 25x10/32x12-22x10/28x12 1 2015
BOSE TRACHEAL LFT-HOOK 165 MM 1 2015
LANGENBECK RETRACTOROPEN 28x10 MM210MM 1 2015
ALLIS FORCEPS 4x5 155MM 1 2015
VOLKMANN BONE CURUTTE#00002.8MM170MM 1 2015
BASKET WIDE PERFORATION 485x253x56 MM 1 2015

11 Heacting Set Aesculap / Various 1 SET 2015

SPENCER SUTURE SCISSORS 90 MM 1 2015
STANDARD FORCEPS SERR 145 MM 1 2015
JACOBSON MOSQUITO FCPSX-DEL STR.130MM 1 2015
HALSTED-MOSQUITO FORCEPS DEL CVD125 MM 1 2015
STANDARD TISSUE FORCEPS 1x2 145 MM 1 2015
 HEGAR-OLSEN NDL HLDR/SCISS SERR 140MM 1 2015

12 Partus Set Aesculap / Various 1 SET 2015

SURGICAL SCISSORS STR STR S/ B 145 MM 1 2015
LISTER BANDAGE SCISSORS HVY 180 MM 1 2015
STANDARD FORCEPS SERR 145 MM 2 2015
STANDARDTISSUE FORCEPS 1x2 145 MM 2 2015
FOERSTER SPONGE FCPS SERR STR 245 MM 1 2015
COLLER ARTERYFORCEPS STR 160 MM 2 2015
MAYO-HEGAR NEEDLE HOLDER 160 MM 1 2015
BEACHAM AMNIOTOME 250 MM 1 2015
BRAUN-STADLER EPISIOTOMY SCISSORS 145 MM 1 2015
UMBILICAL CORD SCISSORS 105 MM 1 2015
CRILLE FORCEPS STR 160 MM 1 2015
SIMS VAG. SPECULUM 70x26MM/75x30 MM 125 MM 1 2015
SIMS VAG. SPECULUM 75x30MM/80x35 MM 150 MM 1 2015
BOZEMANN-DOUGLAS FCPSS-CVDSERR 260 MM 1 2015
1/2 SIZE PERF BASKET 243x253x56 MM 1 2015

13 Set Obstetri & Ginekologi 1 SET 2015

DOYEN DIRECTOR W/TONGUE CVD 145 MM 1 2015
MAYO-STILLE SCISS BVLD-BLD STR 140 MM 1 2015
BRAUN-STADLER EPISIOTOMY SCISSORS 145 MM 1 2015
SURGICAL SCISSORS STR STR S/S 130 MM 2 2015
SURGICAL SCISSORS STR STR S/ B 145 MM 2 2015
UMBILICAL CORD SCISSORS LAT-CVD 135MM 2 2015
BONNEY POLYP FORCEPS 240 MM 1 2015
FOERSTER-BALLENGR SPNG FCPSERSTR 180 MM 1 2015
KELLY FORCEPS DELSTR 140 MM 2 2015
BACKHAUS TOWEL CLAMP 110 MM 2 2015
HALSTED-MOSQUITO FORCEPS DEL CVD 125 MM 2 2015
HALSTED-MOSQUITO FORCEPS DELSTR 125 MM 2 2015
REVERSE ACTION FCPSF/MICHELCLIP120 MM+CLIP 1 2015
 MICHEL SUTURE CLIP1x2.5 MM 2 2015
MARTHIEU NDL HLDRGRIP/RCHT SERR140MM 1 2015
MARTIN PELVIMETER GRAD-IN/CM 1 2015
STANDARD TISSUE FORCEPS 1x2 145 MM 2 2015
SEMKEN DEL.TISSUE FORCEPS 1x2 125 MM 2 2015
STANDARD FORCEPS SERR130 MM 2 2015
BEACHAM AMNIOTOME 250 MM 1 2015
SCALPEL HANDLE #3 125 MM 1 2015
SCALPEL HANDLE #4 135 MM 1 2015
SIMS VAG.SPECULUM 70x26MM/90x40MM 175 MM 1 2015
SIMS VAG.SPECULUM 75x30MM/80x35MM 150 MM 1 2015
GRAVE VAGINAL SPECULUM 105x33 MM 1 2015
GRAVE VAGINAL SPECULUM 75x20 MM 1 2015
GRAVE VAGINAL SPECULUM 95x30 MM 1 2015
BASKET WIDE PERFORATION 485x253x56 MM 1 2015

14 Set Ganti Verban 1 SET 2015

SCALPEL HANDLE #3 125 MM 1 2015
TISSUE FORCEPS SERR 145 MM 1 2015
TISSUE FORCEPS SERR 1x2 145 MM MM 1 2015
TC MAYO-LEXER SCISSORS CVD 165 MM 1 2015
FOERSTER SPONGE FCPS SERR STR 145 MM 1 2015

15 Circumsisi Set 1 SET 2015

FOERSTER SPONGE FCPS SERR STR 245 MM 2 2015
SCALPEL HANDLE #3 125 MM 1 2015
TC MAYO-LEXER SCISSORS CVD 140 MM 1 2015
TC METZENBAUM SCISSORS CVD180 MM 1 2015
SURGICAL SCISSORS STR S/B145 MM 1 2015
STANDARD FORCEPS SERR 145 MM 1 2015
STANDARD TISSUE FORCEPS 1x2 145 MM 1 2015
ADSON FORCEPS SERR120 MM 1 2015
ADSON TISSUE FCPS FINE W/1x2T 120 MM 1 2015
 ALLIS FORCEPS 5x6 155 MM 2 2015
HALSTED-MOSQUITO FORCEPS DELSTR 125 MM 2 2015
HALSTED-MOSQUITO FORCEPS DEL CVD 125 MM 2 2015
DIRECTOR W/TONGUE STR 145 MM 1 2015
PROBE W/EYE 2.5 MM 145 MM 1 2015
TC CRILE-WOOD NDL HLDRSTR SERR 145 MM 1 2015
CIRCUMCISION FORCEPS 16MM DIA 1 2015
1/2 SIZE PERF BASKET 243x253x56 MM 1 2015

16 Set Puskesmas Perawatan 1 SET 2015

KIDNEY TRAY 275 MM 750 ML 1 2015
SURGICAL SCISSORS STR S/S 130 MM 2 2015
MAYO-STILLE SCISS BVLD-BLD STR 140 MM 2 2015
LISTER BANDAGE SCISSORS 140 MM 1 2015
KELLY FORCEPS DEL STR 140 MM 2 2015
MAYO-HEGAR NEEDLE HOLDER 190 MM 1 2015
FOERSTER-BALLENGR SPNG FCPSER STR 180 MM 2 2015
STANDARD FORCEPS SERR 145 MM 2 2015
STANDARD FORCEPS SERR 180 MM 2 2015
GRUERNWALD FORCEPS BAYO SERR 200 MM 2 2015
MICRO-SCISSORS RND-HLD STR S/S 145 MM 1 2015
MICRO SPRING SCISSORS STR. SP/SP 180 MM 1 2015
SCALPEL HANDLE #3 125 MM 2 2015
TONGUE DEPRESSORS 16 MM 145 MM 1 2015
1/2 SIZE PERF BASKET 243x253x56 MM 1 2015
TONGUE DEPRESSORS 16 MM 145 MM 1
1/2 SIZE PERF BASKET 243x253x56 MM 1

Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 KARTU INVENTARIS BARANG ( KIB ) B
PERALATAN DAN MESIN

KARTU INVENTARIS BARANG

NO NAMA MODEL / JUMLAH TAHUN SUMBER
NAMA/JENIS No. Rangka No. Mesin KETERNGAN
URUT BARANG TIPE BARANG PEMBELIAN DANA

Ambulance 1 TOYOTA/ KIJANG HILUX 2.0 L MT MROAW12G190017861 1TR6796963 Roda 4 1 2011 APBN KB

Sepeda Motor 1 Honda/Astrea Star Roda 2 1 2009 RB

2 Suzuki/ Tander Roda 2 1 2009 RB

3 Honda / Blade MH1JBB1189K205546 JBB1E1201414 Roda 2 1 2010 B

4 Honda / Blade MH1JBB1169K210664 JBB1E1206151 Roda 2 1 2010 B

5 YAMAHA/VEGA R MH34D72038J157216 4D71151250 Roda 2 1 2010 B

MENGETAHUI BUKIT GADENG 02 JANUARI 2016

KEPALA UPTD PUSKESMAS PETUGAS INVENTARIS
BUKIT GADENG

ZULFRI
ABDURRAHMAN NIP. 19850705 200604 1 006
NIP. 19681231 198812 1 005
 KARTU INVENTARIS BARANG ( KIB ) C
GEDUNG DAN BANGUNAN

KARTU INVENTARIS BARANG

Jenis Barang/ Letak/ Lokasi Luas Lantai Luas Tanah
NO Status Tanah Keterangan
Nama Barang Alamat ( M2 ) ( M2 )
1 Bangunan Gedung Kantor Jln. T.R Angkasah 375 2,538 Tanah Milik Pemda KB

Semi Permanen No. 2 Bukit Gadeng

Kecamatan Kota Bahagia

Bangunan Gedung Kantor Jln. T.R Angkasah 525 525 Tanah Milik Pemda B

Semi Permanen No. 2 Bukit Gadeng

Kecamatan Kota Bahagia

2 Rumah Dinas Jln. T.R Angkasah 150 2,538 Tanah Milik Pemda B

Permanen No. 2 Bukit Gadeng

Kecamatan Kota Bahagia

3 Rumah Dinas Jln. T.R Angkasah 180 2,538 Tanah Milik Pemda B

Permanen No. 2 Bukit Gadeng

Kecamatan Kota Bahagia

Rumah Dinas Jln. T.R Angkasah 120 120 Tanah Milik Pemda B
 Permanen No. 2 Bukit Gadeng
Kecamatan Kota Bahagia

4 Bangunan Gedung Kantor Seunebok Keuranji 48 200 Tanah Milik Pemda B

Poskesdes Kecamatan Kota Bahagia

5 Bangunan Gedung Kantor Seunebok Alur Buloh 60 250 Tanah Milik Pemda B

Poskesdes Kecamatan Kota Bahagia

6 Bangunan Gedung Kantor Jambo Keupok 60 300 Tanah Milik Pemda B

Posyandu Plus Kecamatan Kota Bahagia

7 Bangunan Gedung Kantor Jambo Keupok 60 300 Tanah Milik Pemda B

Pustu Kecamatan Kota Bahagia

8 Bangunan Gedung Kantor Ujong Tanoh 60 300 Tanah Milik Pemda KB

Pustu Kecamatan Kota Bahagia

9 Bangunan Gedung Kantor Ujong Gunong Cut 60 250 Tanah Milik Pemda B

Pustu Kecamatan Kota Bahagia

BUKIT GADENG 02 JANUARI 2016

 MENGETAHUI PETUGAS INVENTARIS
KEPALA UPTD PUSKESMAS
BUKIT GADENG

ZULFRI
NIP. 19850705 200604 1 006
ABDURRAHMAN
NIP. 19681231 198812 1 005
 KARTU INVENTARIS BARANG ( KIB ) E
POSTER DAN BUKU

KARTU INVENTARIS BARANG

NO NAMA JUDUL MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KET
URUT BARANG BUKU/POSTER TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
RUANG KAPUS 1 Poster Foto Presiden 1 2014
2 Foto Waikil Presiden 1 2014
3 Buku Majalah Interaksi 1 2011 Dinkes

RUANG TATA USAHA 1 Kawasan Dilarang Merokok 1 2013

POLI UMUM 1 Daftar 144 Diagnosa penyakit 1 2014

2 Kawasan Dilarang Merokok 1 2013

RUANG KARTU 1 Kawasan Dilarang Merokok 1 2013

GUDANG -
RUANG BERSALIN 1 Poster Posisi Dalam Persalinan 1 2010
2 Pemrosesan Alat Bekas Pakai 1 2010
3 5 Langkah APN 1 2010
4 Penatalaksanaan Atonia Uteri 1 2010
5 Manajemen BBL dengan Asfiksia 1 2010
6 KBI-KBE 1 2010
7 Hand Manuver 1 2010
8 Rumus membuat Larutan Klorin 1 2010

RUANG TUNGGU 1 Poster MARI....!!! Lakukan Hidup Bersih dan Sehat 1 2013 Bkkbn
2 UKS 1 2010
3 Bebas Malaria 1 2010
4 Metode Kontrasepsi 1 2010 BkkbN
 5 Awas Bahaya Malaria 1 2010
6 Pakailah Kelambu 1 2010
7 Ayo..! Keklinik KB 1 2010 BkkbN
8 AYO Kita Berolah Raga 1 2010
9 Gotong Royong Budaya Bangsa 1 2010
10 Penyakit Kusta 1 2010
11 Kawasan Dilarang Merokok 1 2013

RUANG KIA/KB 1 Poster Tanda Bahaya pada kehamilan 1 2010 BkkbN

2 Hindari 4 terlalu 1 2010 BkkbN
3 Alat Reproduksi Pada Manusia 1 2010 BkkbN

RUANG GIZI 1 Poster Desa Siaga Aktif 1 2010

2 Miliki Buku KIA 1 2010
3 Resiko Tertular HIV/AIDS 1 2010
4 Ingin Sehat 1 2010

RUANG IGD 1 Poster Cuci Tangan Yang Efektif 1 2012

2 Penanggulangan Anapilaktic 1 2010
3 Kawasan Dilarang Merokok 1 2013

RUANG TB
RUANG APOTIK
GUDANG APOTIK

BUKIT GADENG 02 JANUARI 2016

MENGETAHUI PETUGAS INVENTARIS
KEPALA UPTD PUSKESMAS
BUKIT GADENG

ZULFRI
NIP. 19850705 200604 1 006
 ABDURRAHMAN
NIP. 19681231 198812 1 005
 KARTU INVENTARIS RUANGAN 2017 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
RUANG KARTU 1 Kursi Busa Unital 3 2015
2 Meja 1/2 Biro, Rangka Orbitrend 1 2015
3
4 Lemari Steel Ofice Equipmen Unital 1 2015

Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
RUANG IGD 1 Lemari Kaca Dharma Heltcare 1 2009
2 Tabung Oxigen 2 2009
3 Kipas Angin GMC 2 2010
4 Tempat tidur (Brankar) - 2 2010
5 Lampu sorot 2 2010
6 Tiang Infuls 2 2010
7 Tangga Tempat Tidur - 1 2010
8 Troli Oxigens 1 2012
9 Ember Cuci Tangan 1 2012
10 Nurse set 1 2012
11 Meja 1/2 Biro, Rangka Orbitrend 1 2015
12 Kursi Biasa Unital Premium 2 2015
13 Lemari Arsip Silling Kaca Mustang 1 2015
14 ELECTROCARDIO GRAPH/ EKG 3 CHANNEL WITH ECG DISPLAY GE Healthcare/MAC 600 1 UNIT 2015
15 PORTABLE PULSE OXIMETRY GE Healthcare/Trusat 1 UNIT 2015

Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MERK / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
IMUNISASI 1 Lemari Arsip Montana 1 2008
2 Lemari Arsip Mustang 2 2010
3 Kipas Angin GMC 1 2010
4 Solar Cell PolyCryataline Silicon Sankulex/SPV 1610-100 4 PCS 2015
5 Solar Charge Controller (SCC), 10 Amp-12 VDC EP Solar/ EPHC!)-EC 4 PCS 2015
6 Portable Cold Chain Refrigenerator Waeco /CF 50 1 PCS 2015
7 Batt Outdo/MF80D26R (L) 4 Pcs 2015
8 Box Battery ABS Plastik Elka/ ABS100-INT 4 Pcs 2015
9 Hanger/Hub Lokal 1 Set 2015
10 Penyangga Modul Surya HDG Elka/ PM.100-LK 4 Set 2015
11 Kabel Set Super/ NYYHY 4 Set 2015
12 Material Instalasi & Aksesories Elka/ MA.100-LK 4 Set 2015
13 Meja 1/2 Biro, Rangka Orbitrend 2 2015
14 Kursi Biasa Unital Premium 2 2015

Penanggung Jawab Ruangan

 =. . . . . . . . . . . . . . . . =

KARTU INVENTARIS RUANGAN 2017 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
RUANG LABORATORIUM 1 Kursi Busa Unital Premium 3 2015
2 Meja 1/2 Biro, Rangka Orbitrend 1 2015
3 Lemari Arsip Silling Kaca Mustang 1 2015
4 Lemari Steel Ofice Equipmen Unital 1 2015
5
6
7
8
9
10
11
12
13
14
15

Penanggung Jawab Ruangan

 =. . . . . . . . . . . . . . . . =

KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
POLI UMUM 1 Tempat Tidur Besi/Metal A - 1 2009
2 Kasur - 1 2009
3 Bantal - 1 2009
4 Kipas Angin GMC 1 2010
5 Tensi 1 2010
6 Stetoscope 1 2010
7 Timbangan Bayi 1 2010
8 Timbangan Dewasa 1 2010
9 Kursi Lipat 1 2010
10 Meja 1/2 Biro, Rangka Orbitrend 2 2015
11 Kursi Biasa Unital Premium 2 2015
 Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =

KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Rak Plastik 2 2008
KIA/ KB 2 Kursi Putar Belgio 1 2008
3 Kasur - 1 2009
4 Tempat Tidur Besi/Metal - 1 2009
5 Bantal - 1 2009
6 Kipas Angin Cosmos 1 2010
7 Timbangan Dewasa 1 2010
8 Tensi Meter 1 2010
9 Meja 1/2 Biro, Rangka Orbitrend 1 2015
10 Kursi Biasa Unital Premium 2 2015
11 Lemari Arsip Silling Kaca Mustang 3 2015
 Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =

KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Lemari Arsip Silling Kaca Mustang 1 2010 APBK
R. Kepala 2 Filling Kabinet 4 Laci Standar Yunika 2 2010 APBK
3 Dispenser 80919375 Gea Mercuri 1 2010
4 Kulkas 2312 TOSHIBA 1 2010
5 Kursi Putar Figueras 1 2010
6 Kipas Angin GMC 1 2010
7 Filling Kabinet 4 Laci Standar Unital Premium 1 2015
8 Meja 1/2 Biro, Rangka Orbitrend 1 2015
9 Kursi Biasa Unital Premium 2 2015
10 Lemari Arsip Silling Kaca Mustang 2 2015
 Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =

KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Mesin Ketik Manual Portable Royal 1 2008 JKN
R. Tata Usaha 2 Filling Kabinet 4 Laci Standar Yunika 1 2009
3 Lemari Arsip Silling Kaca Montana 1 2009
4 Meja Komputer Gkage 1 2010
5 Kipas Angin GMC 1 2010
6 Desktop Perangkat Computer ( PC ) H530s Lenovo 2 2014
7 UPS CE1200 ICA 2 2014
8 Instalasi jaringan Aplikasi Data ( SIK ) 2 2014
9 Printer CANON PIXMA IP 2770 1 2015
10 Printer EPSON EPSON L 120 1 2015
11 Filling Kabinet 4 Laci Standar Unital Premium 2 2015
12 Meja 1/2 Biro, Rangka Orbitrend 3 2015
13 Kursi Biasa Unital Premium 3 2015
Mustang
Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Meja Tulis Big Panel 1 2010
Apotik 2 Kipas Angin GMC 1 2010
3 Meja komputer Big Panel 1 2014
4 Desktop Perangkat Computer ( PC ) H530s Lenovo 1 2014
5 UPS CE1200 ICA 1 2014
6 Instalasi jaringan Aplikasi Data ( SIK ) 1 2014
7 Kursi Biasa Unital Premium 4 2015

Gudang Apotik 1 Rak kayu -

2 Kipas Angin GMC 1 2010
3 GENSET LISTRIK 80800251 CLEMAKSH2900DX 1 2010
4 BOK P3K - 2014
5 AC QSNC0566NAO LG 1 2015

Penanggung Jawab Ruangan

 =. . . . . . . . . . . . . . . . =
KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Troli Baskom 1 2010
R. TB/Kusta 2 Meja 1/2 Biro, Rangka Orbitrend 2 2015
3 Kursi Biasa Unital Premium 2 2015
4 Lemari Arsip Silling Kaca Mustang 2 2015
5

Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Meja 1/2 Biro, Rangka Orbitrend 1 2015
R. Sanitasi 2 Kursi Biasa Unital Premium 2 2015
3 Lemari Arsip Silling Kaca Mustang 1 2015

Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MERK / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Jam Dinding 1 2010
R. Tunggu 2 Televisi 21 inc Polytron 1 2010
3 Meja 1/2 Biro, Rangka Orbitrend 1 2015
4 Kursi Biasa Unital Premium 1 2015
5 Kursi Tunggu 4 set STEADY BOY 6 2015
6 Runing text NA 10RD-0105S-N09-15-1341 Netra 1 2015

Gudang 1 Tiang dan Umbul-Umbul 6 2010

2 Sapu 1 2015
3 Kain pel 1 2015
4 Superpell

Penanggung Jawab Ruangan

 =. . . . . . . . . . . . . . . . =

KARTU INVENTARIS RUANGAN 2016 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MERK / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
1 Meja 1/2 Biro, Rangka Orbitrend 2015
R. Inventaris 2 Kursi Biasa Unital Premium 2015
3 Kursi Tunggu 4 set STEADY BOY 2015
4 Lemari Arsip Silling Kaca Mustang 2015
5 Filling Kabinet 4 Laci Standar Unital Premium 2015
6 Locker 6 Compartments UNITAL 2015
7 Tempat Tidur Spring Bed 6 Kaki Full Hause 2015
8 Kursi Tamu Vivo 2015
9 Lemari Pakaian 3 Pintu Dj Tech 2015
10 Meja TV Nacwood 2015
11 Meja Makan Sweet 2015
12 Palu 2015
13 Gergaji 2015
14 Klip Tembak 2015

ALAT-ALAT KESEHATAN
1 UMBILICAL CORD SCISSORS 105 MM ET 152 R 1 2015
2 MAYO-STILLE SCISS BVLD STR 140 MM BC 576 R 1 2015
3 UMBILICAL CORD SCISSORS LAT-CVD 135 MM BC 796 R 2 2015
4 MICHEL SUTURE CLIP 12x2,5 MM BN 512 R 2 2015
5 SURGICAL SCISSORS STR S/S 130 MM BC 343 R 2 2015
6 MAYO-STILLE SCISS BVLD-BLD STR 140 MM BC 576 R 2 2015
 7 SURGICAL SCISSORS STR S/S 130 MM BC 343 R 2 2015
8 SPENCER SUTURE SCISSORS 90 MM BC 801 R 1 2015
9 HEGAR-OLSEN NDL/SCISS SERR 140 MM BM 290 R 1 2015
10 MINOR SURGERY SET Aesculap/Various 2 SET 2015
SCALPEL HANDLE #3 125 MM 1 2015
SURGICAL SCISSORS STR s/b145 MM 1 2015
MAYO SCISSORS CVD 140 MM 1 2015
METZENBAUM SCISSORS CVD 180 MM 1 2015
TISSUE FORCEPS SERR 145 MM 1 2015
STANDARD FORCEPS SERR 145 MM 2 2015
STANDARD FORCEPS SERR 180 MM 2 2015
STANDARD TISSUE FORCEPS 1x2 145 MM 2 2015
STANDARD TISSUE FORCEPS 1x2 180 MM 2 2015
FOERSTER-BALLENGR SPNG FCPSERSTR 180 MM 1 2015
BACKHAUS TOWEL CLAMPA 90 MM 2 2015
HALDTED-MOSQUITO FORCEPS DELSTR125 MM 1 2015
CRILE FORCEPS CVD 140 MM 1 2015
SPENCER-WELLS FORCEPS STR 130 MM 1 2015
KOCHER-OCHSNER FORCEPS STR 1x2 160 MM 1 2015
KOCHER-OCHSNER FORCEPS STR 1x2 185 MM 1 2015
CRILE-WOOD NDLHLDRFINE-SERR150 MM 1 2015
DIRECTOR W/ TONGUE STR 145 MM 1 2015
MYRTLE-LEAF PROBE 2.0 MM 145 MM 1 2015
SENN-MILLERR RECTOR.SH.8x7/18x5.5 MM 1 2015
FARABEUF RTRCTRS 25x10/32x12-22x10/28x12 1 2015
BOSE TRACHEAL LFT-HOOK 165 MM 1 2015
LANGENBECK RETRACTOROPEN 28x10 MM210MM 1 2015
ALLIS FORCEPS 4x5 155MM 1 2015
VOLKMANN BONE CURUTTE#00002.8MM170MM 1 2015
BASKET WIDE PERFORATION 485x253x56 MM 1 2015

11 Heacting Set Aesculap / Various 1 SET 2015

SPENCER SUTURE SCISSORS 90 MM 1 2015
STANDARD FORCEPS SERR 145 MM 1 2015
JACOBSON MOSQUITO FCPSX-DEL STR.130MM 1 2015
HALSTED-MOSQUITO FORCEPS DEL CVD125 MM 1 2015
 STANDARD TISSUE FORCEPS 1x2 145 MM 1 2015
HEGAR-OLSEN NDL HLDR/SCISS SERR 140MM 1 2015

12 Partus Set Aesculap / Various 1 SET 2015

SURGICAL SCISSORS STR STR S/ B 145 MM 1 2015
LISTER BANDAGE SCISSORS HVY 180 MM 1 2015
STANDARD FORCEPS SERR 145 MM 2 2015
STANDARDTISSUE FORCEPS 1x2 145 MM 2 2015
FOERSTER SPONGE FCPS SERR STR 245 MM 1 2015
COLLER ARTERYFORCEPS STR 160 MM 2 2015
MAYO-HEGAR NEEDLE HOLDER 160 MM 1 2015
BEACHAM AMNIOTOME 250 MM 1 2015
BRAUN-STADLER EPISIOTOMY SCISSORS 145 MM 1 2015
UMBILICAL CORD SCISSORS 105 MM 1 2015
CRILLE FORCEPS STR 160 MM 1 2015
SIMS VAG. SPECULUM 70x26MM/75x30 MM 125 MM 1 2015
SIMS VAG. SPECULUM 75x30MM/80x35 MM 150 MM 1 2015
BOZEMANN-DOUGLAS FCPSS-CVDSERR 260 MM 1 2015
1/2 SIZE PERF BASKET 243x253x56 MM 1 2015

13 Set Obstetri & Ginekologi 1 SET 2015

DOYEN DIRECTOR W/TONGUE CVD 145 MM 1 2015
MAYO-STILLE SCISS BVLD-BLD STR 140 MM 1 2015
BRAUN-STADLER EPISIOTOMY SCISSORS 145 MM 1 2015
SURGICAL SCISSORS STR STR S/S 130 MM 2 2015
SURGICAL SCISSORS STR STR S/ B 145 MM 2 2015
UMBILICAL CORD SCISSORS LAT-CVD 135MM 2 2015
BONNEY POLYP FORCEPS 240 MM 1 2015
FOERSTER-BALLENGR SPNG FCPSERSTR 180 MM 1 2015
KELLY FORCEPS DELSTR 140 MM 2 2015
BACKHAUS TOWEL CLAMP 110 MM 2 2015
HALSTED-MOSQUITO FORCEPS DEL CVD 125 MM 2 2015
HALSTED-MOSQUITO FORCEPS DELSTR 125 MM 2 2015
REVERSE ACTION FCPSF/MICHELCLIP120 MM+CLIP 1 2015
MICHEL SUTURE CLIP1x2.5 MM 2 2015
MARTHIEU NDL HLDRGRIP/RCHT SERR140MM 1 2015
 MARTIN PELVIMETER GRAD-IN/CM 1 2015
STANDARD TISSUE FORCEPS 1x2 145 MM 2 2015
SEMKEN DEL.TISSUE FORCEPS 1x2 125 MM 2 2015
STANDARD FORCEPS SERR130 MM 2 2015
BEACHAM AMNIOTOME 250 MM 1 2015
SCALPEL HANDLE #3 125 MM 1 2015
SCALPEL HANDLE #4 135 MM 1 2015
SIMS VAG.SPECULUM 70x26MM/90x40MM 175 MM 1 2015
SIMS VAG.SPECULUM 75x30MM/80x35MM 150 MM 1 2015
GRAVE VAGINAL SPECULUM 105x33 MM 1 2015
GRAVE VAGINAL SPECULUM 75x20 MM 1 2015
GRAVE VAGINAL SPECULUM 95x30 MM 1 2015
BASKET WIDE PERFORATION 485x253x56 MM 1 2015

14 Set Ganti Verban 1 SET 2015

SCALPEL HANDLE #3 125 MM 1 2015
TISSUE FORCEPS SERR 145 MM 1 2015
TISSUE FORCEPS SERR 1x2 145 MM MM 1 2015
TC MAYO-LEXER SCISSORS CVD 165 MM 1 2015
FOERSTER SPONGE FCPS SERR STR 145 MM 1 2015

15 Circumsisi Set 1 SET 2015

FOERSTER SPONGE FCPS SERR STR 245 MM 2 2015
SCALPEL HANDLE #3 125 MM 1 2015
TC MAYO-LEXER SCISSORS CVD 140 MM 1 2015
TC METZENBAUM SCISSORS CVD180 MM 1 2015
SURGICAL SCISSORS STR S/B145 MM 1 2015
STANDARD FORCEPS SERR 145 MM 1 2015
STANDARD TISSUE FORCEPS 1x2 145 MM 1 2015
ADSON FORCEPS SERR120 MM 1 2015
ADSON TISSUE FCPS FINE W/1x2T 120 MM 1 2015
ALLIS FORCEPS 5x6 155 MM 2 2015
HALSTED-MOSQUITO FORCEPS DELSTR 125 MM 2 2015
HALSTED-MOSQUITO FORCEPS DEL CVD 125 MM 2 2015
DIRECTOR W/TONGUE STR 145 MM 1 2015
PROBE W/EYE 2.5 MM 145 MM 1 2015
 TC CRILE-WOOD NDL HLDRSTR SERR 145 MM 1 2015
CIRCUMCISION FORCEPS 16MM DIA 1 2015
1/2 SIZE PERF BASKET 243x253x56 MM 1 2015

16 Set Puskesmas Perawatan 1 SET 2015

KIDNEY TRAY 275 MM 750 ML 1 2015
SURGICAL SCISSORS STR S/S 130 MM 2 2015
MAYO-STILLE SCISS BVLD-BLD STR 140 MM 2 2015
LISTER BANDAGE SCISSORS 140 MM 1 2015
KELLY FORCEPS DEL STR 140 MM 2 2015
MAYO-HEGAR NEEDLE HOLDER 190 MM 1 2015
FOERSTER-BALLENGR SPNG FCPSER STR 180 MM 2 2015
STANDARD FORCEPS SERR 145 MM 2 2015
STANDARD FORCEPS SERR 180 MM 2 2015
GRUERNWALD FORCEPS BAYO SERR 200 MM 2 2015
MICRO-SCISSORS RND-HLD STR S/S 145 MM 1 2015
MICRO SPRING SCISSORS STR. SP/SP 180 MM 1 2015
SCALPEL HANDLE #3 125 MM 2 2015
TONGUE DEPRESSORS 16 MM 145 MM 1 2015
1/2 SIZE PERF BASKET 243x253x56 MM 1 2015

Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 KARTU INVENTARIS RUANGAN 2017 ( KIR )

KARTU INVENTARIS BARANG

NO NAMA NO. SERI MODEL / JUMLAH TAHUN SUMBER
NAMA RUANGAN KETERNGAN
URUT BARANG BARANG TIPE BARANG PEMBELIAN DANA
1 2 3 4 5 6 7 8 9
RUANG LABORATORIUM 1 Kursi Busa Chitose 2 2010
2 Meja 1/2 Biro, Rangka Orbitrend 2015
3
4
5
6
7
8
9
10
11
12
13
14
15

Penanggung Jawab Ruangan

=. . . . . . . . . . . . . . . . =
 082361858877 AGENDA INVENTARIS BARANG & ATK
NO Nama Harga @ Jlh. Barang Harga Total Tgl. Masuk Jlh. Barang Tgl. Keluar Sisa Harga Sisa
Ket
URUT Barang Barang Masuk Rp Barang Keluar Barang Barang Rp

1 2 3 4 5 = 3X4 6 7 8 9=4-7 10 = 9X3 11

1 Meja 1/2 Biro, Rangka Orbitrend

2 Kursi Biasa Unital Premium
3 Kursi Tunggu 4 set STEADY BOY
4 Lemari Arsip Silling Kaca Mustang
5 Filling Kabinet 4 Laci Standar Unital Premium
6 Locker 6 Compartments UNITAL
7 Tempat Tidur Spring Bed 6 Kaki Full Hause
8 Kursi Tamu Vivo
9 Lemari Pakaian 3 Pintu Dj Tech
10 Meja TV Nacwood
11 Meja Makan Sweet
1 2 3 4 5 = 3X4 6 7 8 9=4-7 10 = 9X3 11
1 2 3 4 5 = 3X4 6 7 8 9=4-7 10 = 9X3 11

PETUGAS INVENTARIS
 = ZULFRI =
NIP. 19850705 200604 1 006