Lampiran 7
DAFTAR PERINCIA PERI NCIAN N ALAT KESEHAT KESE HATAN AN DINAS INAS KESEH ESEHA ATAN PROV PROVIN INSI SI NUSA USA TENG TENGGA GAR RA TI No
URAIAN
1
POLIKLINIK SET
VOLUME SATUAN
HARGA SATUAN SATUAN
52,489,182
1
Anuskop
3
Buah
2
Baki Baki loga logam m tempa tempatt alat alat steril steril bertut bertutup up
2
Buah
3
Bingk Bingkai ai uji-c uji-cob oba a untuk untuk pemerik pemeriksa saan an rer rerak aksi si
1
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!
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1
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1 3 $ ,0 0 0
%
orong telinga)&peculum telinga ukuran kecil, besar, se.ang
1
&et
8 ' $ ,8 2 0
'
(mes (mesis is bas basin in )*i )*ier erbe bek ken bes besar ar
1
Buah
7
+arp +a rput utal ala a %12 %12 , , 102 102! ! , , 208! 208!
1
&et
3 0 $ ,0 0 0
8
an.le n.le kaca la larin ring
1
Buah
$%,000
$
an. a n.le le kaca aca naso nasoph phar arin ing g
1
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2 2 0 ,0 0 0
10 /aca /aca laring laring ukur ukuran an 2,!,%, 2,!,%,' '
1
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2 2 0 ,0 0 0
11 /aca /aca nasop nasophar haring ing ukur ukuran an 2,!,%, 2,!,%,' '
1
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12 /aca /aca pembe pembesar sar unt untuk uk .iagno .iagnos sk k
1
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3 3 ' ,7 0 0
13 Lampu Lampu kepala kepala)ea. )ea. Lamp Lamp A.apto A.aptorr A) A)
1
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3 0 $ ,0 0 0
1! Lampu senter untuk periksa)pen light
1
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1 2 3 ,% 0 0
1% Lensa uji-coba untuk pemeriksaan reraksi
1
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1' Lup binokuler 4lensa pembesar5 3-% ioptri
1
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1 7 ' ,2 2 0
17 6etline 4 pengukur lingkar pinggang 5
1
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$ 8 ,0 0 0
18 pthalmoscope
1
Buah
1,8%!,000
1$ toscope
1
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118!%00
20 Palu ree9
1
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1,3!1,377
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n
22
1
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23 &nellen hart 2 jenis 4( hart Alphabet hart5
1
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3
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1
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7,8%%,1$'
2' &ph=gmomanometer untuk .e
1
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2,$$$,000
27 &u.ip li.ah logam)spatula logam)spatula li.ah logam panjang 12 cm
!
Buah
' 0 $ ,$ % 0
28 &u.ip li.ah logam)spatula logam)spatula li.ah logam panjang 1',% cm
!
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' 0 ,$ $ %
2$ #empat .ur periksa .an perlengkapann=a
1
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17,8%!,100
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1
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31 #imbangan .e
1
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1
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Page 1
7 7 8 ,1 0 0
2,821,$$$
1'1,$00 1'1,$00
UR 2015 JUMLAH
SUMBER HARGA
64,921,427 1,%%',200
internet
13$,000
8'$,820 2,821,$$$
P#> itra 6e.ika
30$,000
P#> 6egah Alkesin.o P#> itra 6e.ika
$%,000 P#> #ri /arsa "n.o "nstrumen
220,000 P#> #ri /arsa "n.o "nstrumen
220,000 P#> #ri /arsa "n.o "nstrumen 33',700 30$,000
P#> itra 6e.ika
123,%00 internet 17',220 $8,000
P#> itra 6e.ika
1,8%!,000
P#> itra 6e.ika
1,18!,%00
P#> itra 6e.ika
1,3!1,377
P#> 6egah Alkesin.o
1'1,$00 internet $3,170
P#> itra 6e.ika
1!,!'1,$'%
P#> 6egah Alkesin.o
7,8%%,1$'
P#> 6egah Alkesin.o
2,$$$,000
P#> 6egah Alkesin.o
2,!3$,800 internet 2!3,$80 internet
17,8%!,100 internet 2,178,%00 internet
%18,700 internet !,!'0,800 internet Page 2
UR 2015 JUMLAH
SUMBER HARGA
64,921,427 1,%%',200
internet
13$,000
8'$,820 2,821,$$$
P#> itra 6e.ika
30$,000
P#> 6egah Alkesin.o P#> itra 6e.ika
$%,000 P#> #ri /arsa "n.o "nstrumen
220,000 P#> #ri /arsa "n.o "nstrumen
220,000 P#> #ri /arsa "n.o "nstrumen 33',700 30$,000
P#> itra 6e.ika
123,%00 internet 17',220 $8,000
P#> itra 6e.ika
1,8%!,000
P#> itra 6e.ika
1,18!,%00
P#> itra 6e.ika
1,3!1,377
P#> 6egah Alkesin.o
1'1,$00 internet $3,170
P#> itra 6e.ika
1!,!'1,$'%
P#> 6egah Alkesin.o
7,8%%,1$'
P#> 6egah Alkesin.o
2,$$$,000
P#> 6egah Alkesin.o
2,!3$,800 internet 2!3,$80 internet
17,8%!,100 internet 2,178,%00 internet
%18,700 internet !,!'0,800 internet Page 2
PERSYARATAN PERALATAN PUS SESU SESUAI AI PERM PERME ENKES NKES NO 75 TAH
No
JENIS PERALATAN
A. Ruangan Pemer!"aan Umum I. SET PERIKSAAN UMUM
1 Anuskop Anuskop 2 Bk! "o#$ %&$p% %&$p% "% s%&'!" (&'%u%up (&'%u%up ) B!n#k! u*!+,o( un%uk p&$&'!ksn p&$&'!ksn '&-'ks! . Buku Is/!/' T&s T&s 5 Co'on# %&"!n#Sp&,u"u$ %&"!n# uku'n k&,!" (&s' (&s' s&n# 3 E$&s!s (s!n N!&'(&k&n N!&'(&k&n (&s' (&s' 4 G'pu%" 512 H H 102. H 206. H 6 Hn"& k, k, "'!n# 7 Hn"& k, k, nsop/'!n# nsop/'!n# 10 K, "'!n# uku'n uku'n 2.53 11 K, nsop/'!n# uku'n 2.53 2.53 12 K, p&$(&s' p&$(&s' un%uk !#nos%!k !#nos%!k 1) L$pu k&p"H& k&p"H& L$p 8 Ap%o' ACDC 1. L$pu s&n%&' un%uk p&'!ksp&n p&'!ksp&n "!#/% 15 L&ns u*!+,o( un%uk p&$&'!ksn p&$&'!ksn '&-'ks! 13 Lup (!noku"&' 9"&ns 9"&ns p&$(&s': )+5 D!op%'!
Page 3
JENIS PERALATAN
No
14 M&%"!n& 9 p&n#uku' p&n#uku' "!n#k' p!n##n# p!n##n# : 16 Op%/"$os,op& Op%/"$os,op& 17 O%os,op O%os,op& & 20 P"u '&-"&; '&-"&; 21 P&"!"!% kpsCo%%on kpsCo%%on pp"!,%o' pp"!,%o' 22 Sk!n-o" ,""!p&' 2) Sn&""&n C/'% 2 *&n!s *&n!s 9E C/'% 8 A"p/(&% C/'%: 2. Sp&ku"u$ <#!n <#!n 9,o,o' (&(&k: s&n# s&n# 25 Sp&ku"u$ /!un# /!un# &=s &=s 23 Sp/>#$o$no$&%&' Sp/>#$o$no$&%&' un%uk &=s 24 Su!p "!/ "o#$sp%u" "o#$sp%u" "!/ "o#$ pn*n# 12 ,$ 26 Su!p "!/ "o#$sp%u" "o#$sp%u" "!/ "o#$ pn*n# 135 135 ,$ 27 T&$p% %!u' p&'!ks n p&'"&n#kpnn> p&'"&n#kpnn> )0 T&'$o$&%&' un%uk &=s 1 (u/ )1 T!$(n#n T!$(n#n &=s &=s )2 Tono$&%&' S,/!o% II. #a$an Ha%" Pa!a
1 A"ko/o" A"ko/o" 2 Po
Page !
JENIS PERALATAN
No
5 Ks non s%&'!" s%&'!" 3 Ks s%&'! s%&'!"" 4 Msk&' Msk&' =*/ 6 S(un %n#n %n#n %u n%!s&p%!, n%!s&p%!, 7 S'un# %n#n %n#n s%&'!" s%&'!" 10 S'un# %n#n %n#n non s%&'!" s%&'!" III. Per&eng!a'an
1 Bn% Bn%"" 2 Bsko$ ,u,! %n#n %n#n ) Ksu' Ksu' . L$pu L$pu sp!'!%us 5 L&$'! L&$'! "% "% 3 M&* !ns%'u$&n 4 M&%&'n %!n##! %!n##! (n (n 6 P&'"k P&'"k 7 P!spo% P!spo% 10 S'un# (n%" 11 S&p'&! 12 S!k% un%uk $&$(&'s!/kn $&$(&'s!/kn p&'"%n p&'"%n 1) S%op @%,/ @%,/ 1. T&$p% s$p/ %&'%u%up >n# !"&n#kp!
Page %
JENIS PERALATAN
No
&n#n !n*kn p&$(uk p&nu%up I(.Meu%e&ar
1 Ku's! Ku's! K&'* 2 L&$'! L&$'! 's!p ) M&* %u"!s (!'o (. Pen)a*a*an +an Pe&a'oran
1 Buku '&#!s%&' '&#!s%&' p&">nn p&">nn Fo'$u"!' n su'% k&%&'n#n "!n s&su! 2 k&(u%u/n k&(u%u/n p&">nn >n# !(&'!kn !(&'!kn ) Fo'$u"!' In-o'$& In-o'$& Cons&n% Cons&n% . Fo'$u"!' 'u*ukn 5 K&'%s K&'%s '&s&p 3 Su'% K&%&'n#n K&%&'n#n Sk!% Sk!% 4 Su'% K&%&'n#n K&%&'n#n S&/% S&/%
#. Ruangan Tn+a!an Tn+a!an +an Ruangan ,a-a* arura* I.Se* Tn+a!an Me+"/,a-a* arura*
1 Bk! "o#$ %&$p% %&$p% "% s%&'!" %&'%u%up %&'%u%up 2 Co""' B',&N&,k B',&N&,k Co""' nk nk ) Co""' B',&N&,k B',&N&,k Co""' &=s &=s . Co'on# %&"!n#Sp&ku"u$ %&"!n# uku'n k&,!" (&s' (&s' s&n#
Page '
No
JENIS PERALATAN
5 Dopp"&' Dopp"&' 3 D'&ss!n# Fo',&ps 4 EKG EKG 6 E$&s!s Bs!n Bs!n N!&'(&k&n (&s' (&s' 7 Fo',&ps A"!#%o' 10 Fo',&ps B>on&% 11 Gu&&" A!'=> 9O'op/'!n#&" A!'=>: A!'=>: 12 Gun%!n# (&/ s%n' s%n' "&n#kun# 1) Gun%!n# (&/ s%n' s%n' "&n#kun# u*un# %*$%*$ 1. Gun%!n# (&/ s%n' s%n' "&n#kun# u*un# %*$%u$pu" 15 Gun%!n# (&/ s%n' s%n' "&n#kun# u*un# %u$pu"%u$pu" 13 Gun%!n# (&/ s%n' s%n' "u'us u*un# %u$pu"%u$pu" %u$pu"%u$pu" 14 Gun%!n# (&/ s%n' s%n' "u'us u*un# %*$%*$ 16 Gun%!n# (&/ s%n' s%n' "u'us u*un# %*$%u$pu" 17 Gun%!n# p&$("u% 20 Gun%!n# p&$(uk p&$(uk */!%n */!%n 21 Hn"& k, k, "'!n# "'!n# 22 Hn"& k, k, nsop/'!n# nsop/'!n# 2) Hook& p'o(&s 2. K, "'!n# uku'n uku'n 2.53 25 K, nsop/'!n# nsop/'!n# uku'n 2.53 2.53
Page 7
No
JENIS PERALATAN
23 K!% n ku'&% s&'u$&n 24 Knu" /!un# nk 26 Knu" /!un# &=s 27 K"&$ '%&'! 1. ,$ 9Ko,/&': )0 K"&$ '%&'! 12 ,$ "&n#kun# &n#n #!#! 1;2 9H"s%&+Mosu!%o: )1 K"&$ '%&'! 12 ,$ "&n#kun# %np #!#! 9H"s%&+Mosu!%o: )2 K"&$ '%&'! 12 ,$ "u'us &n#n #!#! 1;2 9H"s%&+Mosu!%o: )) K"&$ '%&'! 12 ,$ "u'us %np #!#! 9H"s%&+Mosu!%o: ). K"&$ '%&'! 12 ,$ "u'us 9k&"">: )5 K"&$p&$&#n# *'u$ */!% 16 ,$ 9M>oH&#': )3 Ko'&n%n# "&n#kun# p&n*&p!% "% s%&'!" 92) ,$: )4 Ko'&n%n# p&n*&p!% spon#& )6 Ku's! 'o )7 L$pu k&p" .0 L'!n#oskop nk .1 L'!n#oskop &=s .2 L'!n#oskop n&on%us (!"/ "u'us .) M#!"" Fo',&ps .. N&(u"!&' .5 O%oskop .3 P"u '&-"&;
Page 8
JENIS PERALATAN
No
.4 P!ns&% "% (&n#kok 9R&$k>: .6 P!ns&% n%o$!s 1.5 ,$ .7 P!ns&% n%o$!s 16 ,$ 50
P!ns&% (&/ 1.5 ,$
51 P!ns&% (&/ 16 ,$ 52 P!ns&% &p!"s! 5) P!ns&% %&"!n# 5. P!ns&% !ns!s! Ho'&o"u$ C/"!on 1 (u/ 1 (u/ 55 R&sus!%%o' nk+nk sun#kup 53 R&sus!%%o' &=s sun#kup 54 R&sus!%%o' n&on%us sun#kup 56 R&%'k%o' p&$(uk k&"opk $% 57 S&$p'!% #"!s&'!n 30 S!"!n&' ko'&n%n# s%&'!" 31 Sk"p&" %n#k! p!su op&'s! 32 Sp"k 3) Sp&ku"u$ /!un# 3. Sp&ku"u$ $% 35 Sp/>#$o$no$&%&' un%uk nk 33 Sp/>#$o$no$&%&' un%uk &=s 34 S%n "$p un%uk %!nkn
Page $
JENIS PERALATAN
No
36 S%n' !n-us 37 S%&%&skop nk 40 S%&%&skop &=s 41 S%&%&skop *n!nL&n, 42 Su,%!on pu$p 9"% p&n#/!sp: 4) Su!p "!/ "o#$Sp%u" "!/ "o#$ pn*n# 12 ,$ 4. Su!p "!/ "o#$Sp%u" "!/ "o#$ pn*n# 135 ,$ 45 T(un# oks!#&n n '&#u"%o' 43 T&$p% %!u' p&'!ks n p&'"&n#kpnn> 44 T&'$o$&%&' nk 46 T&'$o$&%&' &=s 47 T!$(n#n nk 60 T!$(n#n &=s 61 T!ssu& Fo',&ps 62 To'n!k&% k'&% 6) Usun#n 9('nk' : II. #a$an Ha%" Pa!a
1 A(o,%/=!n# n&&"& No 20 2 A(o,%/=!n# n&&"& No 2) ) A(o,%/=!n# n&&"& No 23 . A(o,%/=!n# n&&"& No16
Page 10
No
JENIS PERALATAN
5 A"ko/o" 3 An&s%&s! %op!k" %&%&s $% 4 B&nn# ,/'o$!, ,%#u% 6 B&nn# s!"k 7 C!'n &s!n-&k%nPo'!n#& 1 ,, 11 D!spos("& s>'!n#& 10 ,, 12 D!spos("& s>'!n#& 25 + ) ,, 1) D!spos("& s>'!n#& 5 ,, 1. D!spos("& s>'!n#& 50 ,, 15 Eno%',/&" %u(& 9 ETT : 25 13 Eno%',/&" %u(& 9 ETT : ) 14 Eno%',/&" %u(& 9 ETT : . 16 Go##"& 17 In-us s&% !n%' <&n s&% &=s 20 In-us s&%!n%' <&n s&% nk 21 'u$ */!% un%uk op&'s! $% "!n#k'n 22 'u$ */!% "&n#kun# "!n#k'n p&n$pn# s&#!%!# 2) 'u$ */!% "&n#kun# "!n#k'n p&n$pn# (u"% 2. 'u$ */!% "&n#kun# )6 "!n#k'n p&n$pn# s&#!%!# 25 'u$ */!% "&n#kun# )6 "!n#k'n p&n$pn# (u"%
Page 11
No
JENIS PERALATAN
23 Kps 24 Ks non s%&'!" 26 Ks s%&'!" 27 K%&%&' Fo"&> uku'n 5+6 F'&n,/ )0 K%&%&' k'&% No 10 9N&"%on: )1 K%&%&' k'&% No 12 9N&"%on: )2 K%&%&' k'&% No 1. 9N&"%on: )) Lu('!,n% #&" ). Msk&' =*/ )5 M!,'opo'& su'#!," %p& )3 Mu,ous su,%!on s!"!kon No$o' 6 n 10 )4 Nso#s%'!, Tu(&s&"n# "$(un# 9 )56 : )6 P&"!"!% kpsCo%%on pp"!,%o' )7 S(un %n#n %u n%!s&p%!, .0 S'un# %n#n non s%&'!" .1 S'un# %n#n s%&'!" .2 S&"n# k'&% un%uk nus .) Skp&" $% p!su (&/ (&s' .. Skp&"$% p!su (&/ k&,!" .5 V&'(n &"s%!, .3 @%&' (s& #&" un%uk EKG n Dopp"&'
Page 12
JENIS PERALATAN
No III. Per&eng!a'an
1 Bk !ns%'u$&n% %&'%u%up 2 Bn%" ) C&"&$&k p"s%!, . Do'on#n %(un# oks!#&n &n#n %"! p&n#$n 5 Duk (o"on# s&n# 3 $%!$&' 4 K!n ("u% s&#!%!# 9 $!%&"" : 6 Ksu' 7 Ko%k p&n>!$pn *'u$ (&ks 10 L&$'! "% 11 L&$'! o(% 12 Mn#kok un%uk "'u%n 1) M&* !ns%'u$&n"% 1. P&'"k p"s%!, 15 S'un# (n%" 13 S&p'&! 14 S!k% %n#n 16 S!k% un%uk $&$(&'s!/kn p&'"%n 17 S%op @%,/ 20 T&$p% s$p/ %&'%u%up >n# !"&n#kp! &n#n !n*kn p&$(uk p&nu%up
Page 13
JENIS PERALATAN
No
21 Top"&s kpsKs s%&'!" 22 T'o$o" ksK!n s%&'!" 25 120 $$ 2) @sko$ (&n#kok 2. @sko$ ,&kun# 25 @sko$ ,u,! I(. Meu%e&ar
1 Ku's! k&'* 2 L&$'! 's!p ) M&* %u"!s (!'o (. Pen)a*a*an Pe&a'oran
1 Buku '&#!s%&' p&">nn 2 Fo'$u"!' n Su'% K&%&'n#n "!n s&su! k&(u%u/n p&">nn >n# !(&'!kn ) Fo'$u"!' In-o'$& Cons&n% . Fo'$u"!' 'u*ukn 5 K&'%s '&s&p 3 Su'% K&%&'n#n Sk!%
. Ruangan Ke"e$a*an I%u Ana! 3KIA K# +an Imun"a" I. Se* Pemer!"aan Ke"e$a*an I%u
1 12 K"&$ Ko',/&' 2 Anuskop
Page 1!
No
JENIS PERALATAN
) Bk Ins%'u$&n &n#n %u%up . Bk! Lo#$ T&$p% A"% S%&'!" B&'%u%up 5 Dopp"&' 3 Gun%!n# B&nn# 4 Gun%!n# V&'(n 6 Ko',/&' Tn# 7 Mn#kok un%uk L'u%n 10 M&* Ins%'u$&n A"% 11 M&* P&'!ks G!n&ko"o#! n ku's! p&$&'!ks 12 P"u R&-"&ks 1) P&n Ln,&% 1. P!ns&% An%o$! Pn*n# 15 P!ns&% An%o$! P&n&k 13 P!ns&% B&/ 14 S!"!n&' Ko'&n%n# S%&'!" 16 Son& $u"u% 17 Sp&ku"u$ V#!n 9Co,o' B&(&k: B&s' 20 Sp&ku"u$ V#!n 9Co,o' B&(&k: K&,!" 21 Sp&ku"u$ V#!n 9Co,o' B&(&k: S&n# 22 Sp&ku"u$ V#!n 9S!$s: 2) Sp/>#$o$no$&%&' D&=s
Page 1%
JENIS PERALATAN
No
2. S%n L$p un%uk %!nkn 25 S%&%oskop D&=s 23 S%&%oskop n!n F&%os,op& 24 Su!p "!/ "o#$ Sp%u" L!/ Lo#$ pn*n# 12 ,$ 26 Su!p "!/ "o#$ Sp%u" L!/ Lo#$ pn*n# 135 ,$ 27 T$pon Tn# )0 T&$p% T!u' P&'!ks )1 T&'$o$&%&' D&=s )2 T!$(n#n D&=s )) To'n!k&% K'&% II. Se* Pemer!"aan Ke"e$a*an Ana!
1 A"% P&n#uku' Pn*n# B>! 1 (u/ 1 (u/ 2 F"o=$&%&' nk 9/!#/ -"o=: 1 (u/ 1 (u/ ) F"o=$&%&' n&on%us 9"o= -"o=: 1 (u/ 1 (u/ . L$pu p&'!ks
1 (u/ 1 (u/
5 P&n#uku' "!n#k' k&p" 1 (u/ 1 (u/ 3 P&n#uku' %!n##! (n nk 1 (u/ 1 (u/ 4 Sp/>#$o$no$&%&' n $ns&% nk 1 (u/ 1 (u/ 6 S%&%oskop p&!%'!, 1 (u/ 1 (u/ 7 T&'$o$&%&' Ank 1 (u/ 1 (u/ 10 T!$(n#n Ank 1 (u/ 1 (u/
Page 1'
JENIS PERALATAN
No
11 T!$(n#n (>! 1 (u/ 1 (u/ III. Se* Pe&aanan K#
1 Bk! Lo#$ T&$p% A"% S%&'!" B&'%u%up 1 (u/ 1 (u/ 2 I$p"n% K!% 1 (u/ 1 (u/ ) IUD K!% 1 (u/ 1 (u/ I(. Se* Imun"a"
1 V,,!n& ,''!&' 2 V,,!n& R&-'!#&'%o' (. #a$an Ha%" Pa!a
1 A"ko/o" 2 B&nn# C/'o$!, C%#u% ) C!'n D&s!n-&k%n . D!spos("& S>'!n#& 1 ,, 5 D!spos("& S>'!n#& 25 ) ,, 3 D!spos("& S>'!n#& 5 ,, 4 K!n S%&'!" 6 Kps 7 Ks Non S%&'!" 10 Ks S%&'!" 11 L!! kps S%&'!" 12 Lu('!kn #&" 1 %u(& 1 %u(&
Page 17
JENIS PERALATAN
No
1) Msk&' 1. Poo-!"!n T!n,%u' 25? 15 S(un Tn#n %u An%!s&p%!k 13 S'un# %n#n (I. Per&eng!a'an
1 A'! %!$&' 2 Bn%" ) Bsko$ Cu,! Tn#n . C&"&$&k P"s%!k 5 Duk Bo"on# S&n# 3 Ksu' 4 Ko%k P&n>!$pn 'u$ B&ks 6 L&$'! A"% 7 L&$'! O(% 10 M&%&'n 9un%uk $&n#uku' %!n##! Funus: 11 P&'"k 12 P!spo% 1) P!% P&n#uku' L!" 1. Po$p P>u' un%uk ASI 15 S'un# Bn%" 13 S&"!$u%
Page 18
JENIS PERALATAN
No
14 S&p'&! 2 (u/ 2 (u/ 16 S&% Tu$(u/ K&$(n# Ank 1 (u/ 1 (u/ 17 S!k% un%uk M&$(&'s!/kn P&'"%n 1 (u/ 1 (u/ 20 T&$p% S$p/ T&'%u%up >n# !"&n#kp! &n#n !n*kn p&$(uk p&nu%up 21 T!'! 1 (u/ 1 (u/ 22 Top"&s Kps Ks S%&'!" 1 (u/ 1 (u/ 2) T'o$o" Ks K!n S%&'!" 1 (u/ 1 (u/ 2. @sko$ B&n#kok K&,!" 1 (u/ 1 (u/ (II. Meu%e&ar
1 Ku's! K&'* 2 L&$'! A's!p ) M&* Tu"!s (!'o (III. Pen)a*a*an Pe&a'oran A. KESEHATAN I#U K#
1 Buku KIA 2 Buku Ko/o'% I(u ) Buku R&#!s%&' I(u . Fo'$u"!' n su'% k&%&'n#n "!n s&su! k&(u%u/n p&">nn >n# !(&'!kn 5 Fo'$u"!' In-o'$& Cons&n% 3 Fo'$u"!' Lpo'n 4 Fo'$u"!' Ru*ukn
Page 1$
2 (u/ 2 (u/
JENIS PERALATAN
No #. KESEHATAN ANAK
1 B#n D!n!n# MTBS 2 B#n MTBS ) Buku '&#!s%&' B>! . Fo'$u"!' D&%&ks! D!n! Tu$(u/ K&$(n# Ank 5 Fo'$u"!' Ku&s!on&' P' Sk'!n!n# P&'k&$(n#n 9KPSP: 3 Fo'$u"!' Lpo'n K&s&/%n Ank B"!% n P's&ko"/ 4 Fo'$u"!' Lpo'n K&s&/%n B>! 6 Fo'$u"!' P&n,%%n B"!% Sk!% u$u' 2 (u"n s$p! 5 %/un 7 Fo'$u"!' P&n,%%n B>! Mu u$u' ku'n# '! 2 (u"n 10 Fo'$u"!' R&kp!%u"s! Lpo'n K&s&/%n Ank B"!% n P's&ko"/ 11 Fo'$u"!' R&kp!%u"s! Lpo'n K&s&/%n B>! 12 R&#!s%&' Ko/o'% Ank B"!% 1) R&#!s%&' Ko/o'% B>! . IMUNISASI
1 Fo'$u"!' "!n s&su! k&(u%u/n p&">nn >n# !(&'!kn 2 Fo'$u"!' "po'n
. Ruangan Per"a&nan
1 Bk !ns%'u$&n %&'%u%up (&s' 9O(#!n: 2 Bk !ns%'u$&n %&'%u%up k&,!"
Page 20
No
JENIS PERALATAN
) Bk !ns%'u$&n %&'%u%up M&!u$ . Dopp"&' 5 Do>&'! P'o(& L&n#kun# 3 Eno%',/&" Tu(& D&=s 25 4 Eno%',/&" Tu(& D&=s ) 6 Eno%',/&" Tu(& D&=s . 7 Gun%!n# B&nn# 10 Gun%!n# Ep!s!o%o$! 11 Gun%!n# I'!s L&n#kun# 12 Gun%!n# Op&'s! Lu'us 1) Gun%!n# T"! Pus% 1. K"&$ F&ns%&'K"&$ OK"&$ Ko,/&' Lu'us 14 K"&$ L!n&n B,k/uss 16 K"&$ Mosu!%o H"s%& L&n#kun# 17 K"&$ Mosu!%o H"s%& Lu'us 20 K"&$ P&$sn# K"!p H&#&n('%/ 21 L$pu P&'!ks H"o#&n 22 Msk&' Oks!#&n 8 Knu" Ns" D&=s 2) M&* Ins%'u$&n
Page 21
No
JENIS PERALATAN
2. N&&"& Ho"&' M%/&!u 25 P&"
Page 22
JENIS PERALATAN
No
.5 T&$p% K"&$ Ks 9Ko'&n%n#: .3 T&$p% T!u' P&'!ks 9&;$!n%!on (&: .4 T&$p% T!u' un%uk P&'s"!nn .6 T&ns!$&%&' &=s .7 T&'$o$&%&' D&=s II. Se* In"er" +an E!"*ra!" AKR
1 A"!#%o' Eks%'k%o' AKDR 2 Gun%!n# M>o CVD ) K"&$ Ks Lu'us 9Spon#& Fos%&' S%'!#/%: . K"&$ P&n'!k B&nn# AKDR 5 Son& U%&'us S!$s 3 T&nku"u$ S,/'o&&' III. Se* Re"u"*a" #a
1 B(> Su,%!on Pu$p po'%("& 2 Eno%',/&" Tu(& 25 ) Eno%',/&" Tu(& ) . Eno%',/&" Tu(& )5 5 Eno%',/&" Tu(& . 3 In-n% T p!&,& '&sus,!%%o' &n#n PEEP 4 In-n% T p!&,& S>s%&$ 6 L'!n#oskop N&on%us B!"/ Lu'us 9) uku'n:
Page 23
JENIS PERALATAN
No
7 M&* R&sus!%s! &n#n P&$ns 9In-n% R!n% @'$&': 10 O;>#&n Con,&n%'%o' 1 (u/ 1 (u/ 11 P&n#/!sp L&n!' D&L&& 9n&on%us: 1 (u/ 1 (u/ 12 Po$p P&n#/!sp L&n!' E"&k%'!k 1 (u/ 1 (u/ 1) S%&%oskop Dup"&; N&on%us 1 (u/ 1 (u/ I(. #a$an Ha%" Pa!a
1 1 A"ko/o" 2 2 B&nn# C/'o$!, C%#u% ) ) D&s!n-&k%n . . G&"n# B>! 5 In-us S&% D&=s 2 s&% 2 s&% 3 In-us S&% &n#n @!n# N&&"& un%uk Ank n B>! no$o' 2) n 25 4 'u$ /!% T*$ 6 'u$ /!% Tu$pu" 7 Kn%on# U'!n 10 Kps 11 K%&%&' Fo""&> &=s 12 K%&%&' N&"%on 1) K%&%&' !n%'<&n 13 G 1. K%&%&' !n%'<&n 16 G 15 K%&%&' In%'<&n 20 G
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JENIS PERALATAN
No
13 K%&%&' P&n#/!sp L&n!' D&=s 10 2 (u/ 2 (u/ 14 K%&%&' P&n#/!sp L&n!' D&=s 6 2 (u/ 2 (u/ 16 Nso#s%'!, Tu(& D&=s ) (u/ ) (u/ 17 Nso#s%'!, Tu(& D&=s 5 ) (u/ ) (u/ 20 P&$("u% 21 P&n#!k% %"! pus% 22 P"&s%&' Non @o<&n 2) S(un C!' un%uk Cu,! Tn#n 2. S'un# Tn#n 25 S'un# Tn#n Pn*n# 9Mnu" P"s&n%: 23 S'un# Tn#n S%&'!" 24 Spu!% !spos("& 9s%&'!": 20 $" 26 Spu!%D!spos("& S>'!n#& 9s%&'!": 1 $" 27 Spu!%D!spos("& S>'!n#& 9s%&'!": 10 $" )0 Spu!%D!spos("& S>'!n#& 9s%&'!": ) $" )1 Spu!%D!spos("& S>'!n#& 9s%&'!": 5 $" )2 T/'&&+=> S%op,o,k 9s%&'!": (. Per&eng!a'an
1 L&$'! A"% 2 L&$'! O(% ) Mn#kok Io!n
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