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Tanggal : 13 Mei 2015

1 Baki Logam Tempat Alat Steril Bertutup 1 Unit √ √ √

Specification : - Made of stainless steel

2 Bingkai Kaca Mata 1 Unit √ √

-Specification : - Frame made of metal - PD distance : 48-76 mm - Frame adjustable length : 35 mm - Nose pad adjustable length : 22 mm - Maximum available lens : 6 pcs - Axis of lens : 0-180°

- Bahan terbuat dari kaca

- Pegangan & Bingkai terbuat dari Plastik

5 Lampu Periksa 1 Unit √ √ √

Specification :

- Shadowless high-performance LED light for examination with adjustable arm - The absence of UV or infrared in the light beam is suitable to light heat - sensitive parts - Foldable stainless steel base with 5 x Ø50 mm. Castors

- Light Intensity : 30.000lux @ 50cm - Color temperature : 6000ºK - Voltage : 12V

- Angle : 30°

QTY NAMA ALAT DAN SPESIFIKASI TEKNIS

"REVISI DAFTAR SPESIFIKASI DAN ADMINISTRASI TEKNIS ALAT YANG DISYARATKAN" PENGADAAN ALAT KESEHATAN/PENUNJANG UNTUK PUSKESMAS MAMPU PONED

(2)

Tunggal/Distri

- Construction : Steel Plat

- Dimension : Approx. 900X400X1700mm

- Door : 2 ( Two )

- Finishing : Epoxy Powder Coating

7 Meja Instrumen 1 Unit √ √ √

Specification :

- Construction : Stainless Steel Non Magnetic

- Dimension : Approx. 600 x 400 x 800mm

- Drawer : Stainless Steel Non Magnetic, Equipped with handle

- Shelves : 2 (Two) stainless steel sheet H.I. Non magnetic

- Handle : Stainless Steel pipe Non Magnetic

- Guard List : Stainless Steel Non Magnetic

- Castor : 2"

- Finishing : Polishing

8 Meteran 3 Unit - √

-Specification :

- Made substance from vynil - Measuring range : 150 cm - Graduation : 1 mm

9 Palu Pengukur Refleks 1 Unit √ √ √

Specification : - Made of stainless steel

(3)

Tunggal/Distri

13 Sudip Lidah,Logam Panjang 17 cm 2 Unit √ √ √

Specification : - Made of stainless steel

14 Tempat Tidur Periksa dan Perlengkapannya 1 Unit √ √ √

Specification :

- Construction : Stainless Steel Pipe Non Magnetic

- Dimension : Approx. 2000x650x800mm

- Mattress : FOAM, Imitation Leather

- Finishing : Polishing

Foot Step Specification :

- Construction : Stainless Steel Pipe Non Magnetic

- Consist : Two step with rubber sheet cover

- Dimension : Approx. 400 x 400 x 330 mm

- Finishing : Polishing

15 Tensimeter Anak 1 Unit √ √ √

Specification :

- Range 0-300 mm/Hg, high precision mercury apparatus in dye cast aluminium case - Glass tube of excellent precision.

- Easy to read anodized graduation plate.

- All metal parts chrome-plated, with mercury locking device complete with adult velcro cuff and metal ring.

- Cuff with single tube 45x10 cm

16 Tensimeter Dewasa 1 Unit √ √ √

Specification :

- Range 0-300 mm/Hg, high precision mercury apparatus in dye cast aluminium case - Glass tube of excellent precision.

- Easy to read anodized graduation plate.

- All metal parts chrome-plated, with mercury locking device complete with adult velcro cuff and metal ring.

17 Termometer Dahi dan Telinga 1 Unit √ √ √

Specification :

- Display range : 32-42°

- Accuracy : +/- 0.1°

- Min.scale : 0.1

(4)

Tunggal/Distri

- Celcius scales, range : Approx 35ºC to 42ºC

19 Timbangan Anak + Pengukur Tinggi Badan 1 Unit √ √ √

Specification :

- Body weighing max. weight : Approx 120 kg Sub-divisions of the weighing dial : 0,5 kg - Height Measuring

Height measuring range : Approx 70-190 cm

Sub-divisions of graduation : Approx 0.5 cm

- Size of platform (L x W) : Approx 385 x 280 mm - Made of stainless steel

22 Viewer X-Ray Double 1 Unit √ √ √

Specification :

- Power Supply : AC220V

- Frequency : 50 Hz

- Power Consumption : < 80W

- Screen Size : Approx. 720 x 435 mm

- Dimension : Approx. 800 x 540 x 120 mm

23 Sterilisator kering 1 Unit √ √ √

Specification :

- Ozone cleaning for upper cabinet

(5)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.)

- Body dimension (LxWxH) : 435 x 333 x 795 mm

- Reted Capacity : 80 L

- Rated Voltage : 220 V

- Rated Frequency : 50 Hz

- Rated Power of heating tube : 550 W

- Rack in upper cabinet : 1

- Rack in lower cabinet : 2

- Temperature in lower cabinet : 120 – 170°C

- Ozone chroma : 10 – 15 mg/ m3

- Ozone time : 15 min

B. Indera Pendengaran

1 Alat Penghisap/Suction pump 1 Unit √ √ √

Specification :

- Power supply : 230V/50-60Hz 185VA

- Power consumption : 110V/60Hz 195VA

- Suction power : 26 l/min

- Max vacuum : 0,75 bar - 563 mmHg / -75 kPa

- Dimensions : Approx. 300 x 190 x 160 (H) mm

- Weight : Approx. 2,5 kg

- JAR : 1 x 1 L jar

2 Aligator Forceps 1 Unit √ √ √

Specification : - Made of stainless steel

3 Corong Telinga/Spekulum Telinga Ukuran Kecil,Sedang Besar 1 Unit √ √ √

Specification : - Made of stainless steel

4 Ear Syrings 1 Unit √ √ √

Specification : - Made of stainless steel

5 Garpu Tala 512 Hz 1 Unit √ √ √

Specification : - Made of stainless steel

6 Handle Kaca Larings 1 Unit √ √ √

Specification : - Made of stainless steel

7 Kaca Larings ukuran 2,4,5,6 1 Unit √ √ √

(6)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.) - Made of stainless steel

8 Kaca Nasopharing Ukuran 2,4,5,6 1 Unit √ √ √

Specification : - Made of stainless steel

9 Lampu Kepala/Head Lamp + Adaptor AC/DC 1 Unit √ √

-Spesification : - Yellow Light LED Lamp - ABS Casing - Adjustable Light Intencity - Light and Comfort to put on - Rechargeable Lithium battery - 10.000/H Life time

10 Lampu Spiritus 2 Unit √ √

-Specification : - Made of stainless steel

11 Nierbeken Besar 2 Unit √ √

-Specification : - Made of stainless steel

12 Otoscope 1 Unit √ √ √

Spesification :

- 2,5 V. standard illumination

- Chrome plated handle, 4 x magnifying glass - 3 reusable specula included

- Connection for pneumatic otoscopy - Battery handle for 2 C batteries - Rheostat for adjustment of illumination

13 Pelilit Kapas/Cotton Aplicator 1 Unit √ √ √

Specification : - Made of stainless steel

14 Pengait Serumen dan Sendok Serumen 1 Unit √ √ √

Specification : - Made of stainless steel

15 Pinset Bayonet 2 Unit √ √ √

Specification : - Made of stainless steel

(7)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.) Specification :

- Made of stainless steel

17 Sudip Lidah,Logam Panjang 17 cm 2 Unit √ √ √

Specification : - Made of stainless steel

C. Indera Mata

- Standard illumination 2,5 V.

- Corrective lenses ranging from 0 to +20 and from 0 to -20 diopters, aperture large circle - Battery handle for 2 C batteries

4 Optivisor 1 Unit √ √ √

Specification :

- Two magnifying systems (2.2X and 3.3X).

- The system is mounted on an adjustable webbing head band and provided with two separate lenses

- The first lens provides a 2.2 X magnification, moving down the second lens, we reach a total 3.3 X magnification

- The superior quality of this lens permits high precision examinations

- The HEAD LOUPE magnifying system can be used in combination with any kind of glasses - Working distance : Approx. 30 cm

5 Reading Card Edisi Bahasa Indonesia 2 Unit - √

-6 Tonometer Schiotz 2 Unit √ √ √

Specification :

- Instrument according to prof. schiotz for measuring eye pressure - Jewel operated. Complete with three weight

(8)
(9)

Tunggal/Distri

- Timing accuracy : Within 0.1 second

- Timing source : Crystal oscillator of 32768Hz

2 Alas kaki untuk perlindungan infeksi 2 Unit - √

-3 Alat Pasang IUD 2 Unit √ √ √

Specification : - Made of stainless steel

4 Bak instrumen tertutup 2 Unit √ √

-Specification : - Made of stainless steel

5 Benang chromic 2 Unit √ √ √ - Made of stainless steel

8 Gunting Tali Pusat 2 Unit √ √ √

Specification : - Made of stainless steel

9 Examination Lamp 1 Unit √ √ √

Specification :

- Shadowless high-performance LED light for examination with adjustable arm - The absence of UV or infrared in the light beam is suitable to light heat - sensitive parts - Foldable stainless steel base with 5 x Ø50 mm. Castors

(10)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.)

- Pipet sahli : 1 pc

- Karet penghisap : 1 pc

- Pengaduk kaca : 1 pc

12 Infuset Dewasa 3 Unit √ √ √

Specification : - Syringe latex free - Canula polypropylene - Needle stainless steel - Sterile single use

13 Infuset Pediatric 3 Unit √ √ √

Specification : - Syringe latex free - Canula polypropylene - Needle stainless steel - Sterile single use

14 IV Cateter untuk bayi 6 Unit √ √ √

15 IV Cateter untuk dewasa 6 Unit √ √ √

16 Klem kasa dan tempat korentang 2 Unit √ √ √

Specification : - Made of stainless steel

17 Klem Kocker Lurus 2 Unit √ √ √

Specification : - Made of stainless steel

18 Klem Ovum 2 Unit √ √ √

Specification : - Made of stainless steel

19 Laryngoscope infant 1 Unit √ √ √

Specification :

- Halogen illumination 2,5 V

- Manufactured in AISI 304 stainless steel matt type

- The bulb is inside the handle in order to simplify the sterilization of the blades - Set w/3 s.s. blades size 0-1-2, with case

20 Masker 5 Box √ √ √

Specification :

- 3 Layer Tissue and Elastic ear Loops - Size : 90 x 180 mm

(11)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.) Specification :

- Construction : Stainless Steel Non Magnetic

- Dimension : Approx. 600 x 400 x 800mm

- Drawer : Stainless Steel Non Magnetic, Equipped with handle

- Shelves : 2 (Two) stainless steel sheet H.I. Non magnetic

- Handle : Stainless Steel pipe Non Magnetic

- Guard List : Stainless Steel Non Magnetic

- Castor : 2"

- Finishing : Polishing

22 Meja Tindakan Resusitasi Bayi 1 Unit √ √ √

Specification :

- Construction : Steel Sheet

- Dimension : 900 x 600 x 900 mm

- Mattress : FOAM, Imitation Leather

- Side Table : 600 x 400 mm

- Drawer 2 (Two)

- Finishing : Epoxy Powder Coating

23 Meteran 1 Unit √

-Specification :

- Made substance from vynil - Measuring range : 150 cm - Graduation : 1 mm

24 Naldholder 1 Unit √ √ √

Specification : - Made of stainless steel

25 Nelaton Cateter 3 Unit √ √ √

26 Partus bed 1 Unit √ √ √

Specification :

- Construction : Steel Pipe

- Dimension : 2000 x 650 x 650-800mm

- Head Raise : Adjustable

- Back Raise : Adjustable

- Pelvic Raise : Adjustable

- Hi-Low : Adjustable By Crank

- Knee Support : Adjustable

- Castor : 4" (Two With Brake)

- Mattress : Foam with Imitation Leather

- Basin : Stainless Steel Non Magnetic

- Finishing : Epoxy Powder Coating

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Tunggal/Distri

- Sterility guaranteed unless package has been opened or damaged - Discard after single use

- Size : 10 fr - Vol : 25 cc

28 Pengikat Tali Pusat 1 Unit √ √ √

29 Pinset Chirurgis 2 Unit √ √ √

Specification : - Made of stainless steel

30 Pita Pengukur Lengan 1 Unit - √

-Specification : - Material from vinyl - Ukuran : 0-36 cm

31 Pocket Dopler 1 Unit √ √ √

For clinic as followings : - Early diagnose of pregnancy - Early affirmation of fetus survival - Diagnose of placentas position

- Orientation of pregnant womens blood vessel - Distinction of mid-pregnancy and cell-like abnormal fetus - Guardianship of fetuss hear when pregnancy and parturition Primary Technical Indexes :

- Frequency of supersonic : 2.5 MHz ±0.25MHz

- Fetal heart rate : 50 – 210 BPM

- Intencity of supersonic : < 10M w / CM2

- Power supply : AC 220V / DC 3.6 – 4.5V

(1.2V x 3R6 Nickel-Cadmium Rechargeable Battery Installed)

- Power dissipation : <120ma when staticmaximum

Output > 300ma

- Dimensions (mm) : 140 (L) x 65 (W) x 34 (H)

- Working temperature : + 10-40°C

32 Resusitator Dewasa 1 Unit √ √ √

Consist of :

(13)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.)

33 Resusitator Neonatus 1 Unit √ √ √

Consist of :

- Reanimation bag 240 ml - Reservoir bag 600 ml - Autoclavable

- Complete with 2 face mask size 0 and 1 - 3 Guedel Airway size 00/1/3 - Oxygen tubing

- Case transparent : Approx. 32x12.5x11 (H) cm

34 Sarung Tangan Steril 6 Unit √ √ √

Specification : - Latex sterile single use

35 Set Ekstraksi Vakum 1 Unit √ √ √

Specification :

- Hand-operated vacuum device for all suction cups

36 Set Umbilical Untuk Neonatal 1 Set

- Kocher Artery Klem str 14 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Kocher Artery Klem cvd 14 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Pinset Chirurgi 14 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Gunting Operasi,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Schalpel Blade No.3,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Needle Holder,SS 1 Unit √ √ √

Specification : - Made of stainless steel

(14)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.) Specification :

- Made of stainless steel

- Curved Mosquito Hemostat,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Iris Forceps,SS 1 Unit √ √ √

Specification : - Made of stainless steel

37 Set Vena Sectie 1 Set

- Mayo Hegar Needle Holder 14 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Mosquito str 12 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Mosquito cud 12 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Langenback Hak,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Pinset Chirurgi 14 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Forceps Splinter 11 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Pinset Anatomis 14 cm,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Gunting Operasi Tajam 13 cm str,SS 1 Unit √ √ √

Specification : - Made of stainless steel

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Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.) Specification :

- Made of stainless steel

- Knife Handle No.3,SS 1 Unit √ √ √

Specification : - Made of stainless steel

- Mangkok Untuk larutan 1 Unit √ √

-Specification : - Made of stainless steel

38 Setengah Kocker 1 Unit √ √ √

Specification : - Made of stainless steel

39 Speculum Simms Set 1 Unit √ √ √

Specification : - Made of stainless steel

40 Standart Infus 1 Unit √ √ √

Specification :

- Construction : Stainless Steel Pipe Non Magnetic & Steel Pipe

- Dimension : Approx. 1500/1850 mm heigth

- Upper stand : Stainless steel non magnetic

- Lower stand : Stainless steel non magnetic

- Base : Stainless Steel Square Pipe

- Hook : 2 Stainless steel non magnetic

- Castor : 2" (5 pcs)

- Finishing : Polishing

41 Stetoskop Bayi 2 Unit √ √ √

Specification : - Dual head - Light weight - Switchable

42 Stetoskop Dewasa 2 Unit √ √ √

Specification : - Dual head - Light weight - Switchable

43 Stilet Untuk Pemasangan ETT 1 Unit √ √ √

44 Tabung Oksigen + Regulator,trolly,Nasal 1 Unit √ √ √

(16)

Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.) - Oxygen Cylinder 1m³

- Oxygen Regulator Made From Transfarent Plastic - Humidifier

- Flowmeter

- Vinyl Mask with Tubing (Adult and Child) - Carrying Stand made from Steel Tube Pipe

45 Tempat Tidur Periksa 1 Unit √ √ √

Specification :

- Construction : Stainless Steel Pipe Non Magnetic

- Dimension : Approx. 2000x650x800mm

- Mattress : FOAM, Imitation Leather

- Finishing : Polishing

Foot Step Specification :

- Construction : Stainless Steel Pipe Non Magnetic

- Consist : Two step with rubber sheet cover

- Dimension : Approx. 400 x 400 x 330 mm

- Finishing : Polishing

46 Termometer Klinik Hg 2 Lsn √ √ √

Specification :

- Celcius scales, range : Approx 35ºC to 42ºC

47 Timbangan Bayi + Baki 2 Unit √ √ √

Specification :

- Capacity : Approx. 20 kg

- Graduated : Approx. 0 - 10kg Precision 50gr

Approx. 11 - 20kg Precision 100gr

48 Timbangan Injak Dewasa 3 Unit √ √ √

Specification : - Capacity : 120 Kg - Graduation : 0.5 Kg - Meas : 27 x 26 x 5 cm

49 Vakum Aspirasi Manual Untuk Paska Keguguran 1 Unit √ √ √

Specification :

- Hand-operated vacuum device for all suction cups

50 Waskom Stainless 2 Unit √ √

-Specification : - Made of stainless steel

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Tunggal/Distri

2,5 V standard illumination for use with 2 batteries type C. Including :

- Otoscope head : Pin contact fitting.

: Chrome plated.

: Proective movable lens 4X on plastic frame - 3 Reusable specula are included.

- May-Ophthalmoscope head : Pin contact fitting.

: Lens selection wheel permits choice of

corrective lenses from 0 to +20 and 0 to -20 diopters. - Single large circle aperture.

- Bent-arm illuminator : Pin contact fitting.

Chrome plated.

- Tongue blade holder : Chrome plated.

- Nasal speculum : Chrome plated.

- Two laryngeal mirrors : n. 3 and 4.

- Battery Handle : 28mm.

: Ø for 2 cell C-batteries. Chrome plated

: Rheostat for adjusment of illumination.

- Replacement bulb : 2,5V

2 Set Pemberian Oksigen 3 Unit √ √ √

Specification : - Oxygen Cylinder 1m³

- Oxygen Regulator Made From Transfarent Plastic - Humidifier

- Flowmeter

- Vinyl Mask with Tubing (Adult and Child) - Carrying Stand made from Steel Tube Pipe

3 Oksigen (tabung besar) + Canule 2 Unit √ √ √

- Display : Digital Display for present speed value and remaining time

- Platform Dimensions : 280 x 280 ( mm )

(18)

Tunggal/Distri

- Absorption compartment : Cooling unit heating element aladin 32 burner kerosene tank - Control panel : Situated at the top of the unit ; 1 electro thermostat - Cooling system : Absorption cooling unit filled with NH3 for 120W

- Energy consumption : 2,46 kWh/24h at 32°C amb. Temp.

- Kerosene consomption : 0,76lts/24h at 32°C amb.temp.

- Insulation : 100mm Polyurethane foam, foaming agent : Cyclopentane

- Ice pack freezing : Ice pack freezing with vaccine; 2,4kg/24h at 32°C amb.temp

- Outer body : Rotomouled with polyethylene lockablelid with 2 catches

Silicon gasket ensures, tight sealing, 1 dial thermometer to control the temperature burner lighting instruction on the lid safety distance spacer bar.

- Measurement Principle : Dual Wavelength reflactance methode - Measuring wave length : 3 LED wavelength ( 565, 632, 755 nm )

- Sample suplly : Manual Dipping

- Throughtput : 50 test per hour

- Reaction Time : 60 seconds per test

- Display : Custom liquid crystal display

- Data Memory : 100 test

- External Output : RS 232 C

- Operating environmental : Temperature : 10º - 30 º C , Humidity 30 - 60 % RH

- Dimensions : 124 x 81 x 36 mm ( WxDxH )

- Weight : 180 grams

- Power supply : Alakline Battery x 2 or AC Adapter

- Reagent : Test strip 10 measurement

4 Blood Lancet Set 2 Set √ √ √

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Tunggal/Distri butor

RI/Sertifikasi Mutu (ISO,TUV,CE,dll.) - Adjustable tip, allows precise customization of lancet penetration

- Include 10 lancet

5 Hemocytometer set 2 Set √ √ √

Consist of :

- Erythrocyte pipette : 1 pc

- Leucocyte pipette : 1 pc

- Mouthpieces with rubber tubing : 1 pc

- Counting chamber : 1 pc

- Optically plane cover glasses : 2 pcs

6 Westergreen Set 2 Unit - √

-7 Sentrifuge Mikrohematokrit 1 Unit √ √ √

Specification :

- Speed : Fixed 12000 rpm

- Capacity : 24 tubes

- Reader : Percentage Reader

- Timer : 0~15 minutes

- Power Supply : 110/220V, 0/60Hz. 1.8/0.9A

- Overall Dimension : W220 x H240 x H200 mm

- Net Weight : 10 Kg

- Gross Weight : 10, 5 Kg

8 Kotak Penyimpanan (Box Slide) 6 Unit √ √ √

9 Bunsesn 3 Unit √ √ √

10 Pipet Tetes 6 Unit - √

-11 Rak Pengering Slide 2 Unit - √

-Catatan:

= Disyaratkan

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