Total Harga
4+,7,+017322 ,1.+222322 ,,2+222322 ,1+582322 8+/4.+222322 02+/22322 5+./7+222322 5+./7+222322 .4+.4.322 8+2/8+222322 57+522322 12+222322 ..+222322 022+222322 12+.22322 12+.22322 ,,2+222322
Keterangan E a"alog
E a"alog E a"alog E a"alog E a"alog
0,0+.22322 .,8+4.2322 .,8+4.2322 0.4+222322 4.0+222322 4.0+222322
..+222322 ./0+112322 45,+.22322 45,+.22322 4+855+482322 E a"alog 4/+122322 4.+022322 00+882322 .4+.4.322 8+2/8+222322 E a"alog ,,+822+222322 E a"alog 11+222322 45+722322 00+222322 40+,22322
Total Harga
Keterangan
,/+722322 ,2/+242322 6 442+222322 442+222322 442+222322 442+222322 4+/21+/82322 E a"alog 8+1.2+222322 E a"alog 8/5+.22322 4+855+482322 E a"alog 11+222322 11+222322 ,4,+222322 7+,22+222322 E a"alog ,54+.22322 ,1.+222322 00+222322
814+222322 6 6 8+1.2+222322 E a"alog .+.22322 85+.22322 4+/21+/82322 E a"alog 858+/52322 ,2,+7.2322 ,1.+222322 ,+0/1+222322
45,+.22322 884+422322 10+757+0..322
04.+222322
Total Harga
Keterangan
4,+222+222322
,,2+222322 ,,2+222322 4.0+222322 .+.22322 ,1.+222322 8+/4.+222322 E a"alog 02+/22322 5+./7+222322 E a"alog 5+./7+222322 E a"alog 85+.22322 57+522322 12+222322 .+.22322 1/7+.22322 ..+222322 ,01+822322 022+222322 6 12+.22322
0,0+.22322 5+8./+5/4322 E a"alog .,8+4.2322 .,8+4.2322 /0+2.2322
..2+222322 //+222322 45,+.22322 4+855+482322 6 ,4+1.8322 ,4+1.8322 ,4+1.8322 4/+122322 ..+222322
E a"alog E a"alog E a"alog E a"alog
Total Harga
47+582322 44+222322 4/+/42322 72+,/2322 1.+,42322 00+882322 0/+212322 48+/12322 4.+512322 4.+512322 8+1.2+222322 ,4+71.322 ,4+255322 8+2/8+222322 47+.22322 6 ,/+722322 ,/+722322 40+,22322 ,+240+222322
Keterangan
E a"alog E a"alog E a"alog E a"alog
..+222322 ,1+.22322 ,1+.22322 442+222322 442+222322 442+222322 442+222322 442+222322 442+222322 4+/22+222322 E a"alog 8/5+.22322 4+855+482322 E a"alog ,+8,5+222322 ,2/+242322 7+,22+222322 E a"alog ,,+822+222322 E a"alog 4+/21+/82322 E a"alog ,54+.22322
Total Harga
442+222322 02+,82322 1.+,42322 4/+122322 88+772322 7/+.82322
4+7.2+222322 ,4+1.8322 ,4+1.8322 ,4+1.8322 ,4+1.8322 6 6 0+142+,22322
Keterangan
E E E E
a"alog a"alog a"alog a"alog
0,7+5.8+222322 E a"alog 078+222322 ..+222322 4+7.2+222322 8/7+022322
5+./7+222322 E a"alog 5+./7+222322 E a"alog .4+.4.322 814+222322 85+.22322 ,2+222322 4+50,+.22322 E a"alog ,1.+222322 .,8+4.2322 /0+2.2322 0.4+222322
No 8 . 1 7 / 5 ,2 ,, ,4 ,0 ,8 ,. ,1 ,7 ,/ ,5 42 4, 44 40 48 4. 41
Nama Barang Dorongan "a(ung oksigen )engan "ali pengaman Duk (olong+ se)ang $am9 "imer ain (alu" segi"iga # mi"ella & asur o"ak penyimpan 'arum (ekas ;emari ala" ;emari o(a" >angkok un"uk laru"an >e'a ins"rumen9ala" Perlak plas"iPispo" Sarung (an"al Seprei Sika" "angan Sika" un"uk mem(ersi!kan perala"an S"op Ca"-! Tempa" sampa! "er"u"up yang )ilengkapi )engan in'akan pem(uka penu"up Toples kapas9asa s"eril Tromol kasa9ain s"eril 4. ,42 mm Caskom (engkok Caskom -ekung Caskom -u-i
Set Pemeriksaan Kesehatan I%u ,3 ,94 lem or-!er 43 Anuskop 03 Bak Ins"rumen )engan "u"up 83 Baki ;ogam Tempa" Ala" S"eril Ber"u"up .3 Doppler 13 Gun"ing Benang 73 Gun"ing Ver(an) /3 or-!er Tang 53 >angkok un"uk ;aru"an ,2 >e'a Ins"rumen 9 Ala" ,, >e'a Periksa Ginekologi )an kursi pemeriksa ,4 Palu Re*leks ,03 Pen ;an-e" ,8 Pinse" Ana"omi Pan'ang ,. Pinse" Ana"omi Pen)ek
Kemasan/Spesiikasi/ Merk Ersa
ari?a Ersa Ersa Ersa
Satuan
Ersa ari?a
Harga
P-s P-s P-s P-s P-s P-s Uni" Uni" P-s Uni" P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
Eli"e-!
Jumlah
P-s P-s P-s P-s P-s P-s P-s P-s P-s Uni" Uni" P-s P-s P-s P-s
5/0+017322 ,1.+222322 ,,2+222322 ,1+582322 0+24.+222322 02+/22322 7+107+222322 7+107+222322 .4+.4.322 0+24/+222322 57+522322 12+222322 ..+222322 022+222322 12+.22322 12+.22322 ,,2+222322
ongkir ,+,//+222322
,+/22+222322 ,+5.2+222322 ,+5.2+222322 ,+2.1+222322
0,0+.22322 #1!$2#0 #1!$2#0 3#2$000 2#3$000 2#3$000
..+222322 ./0+112322 45,+.22322 45,+.22322 4+0,2+222322 4/+122322 4.+022322 00+882322 .4+.4.322 0+24/+222322 5+122+222322 11+222322 45+722322 00+222322 40+,22322
,/5+482322
,+2.1+222322 ,+/22+222322
Total Harga
,,2+222322 .+/22+512322 4+/21+/82322 8+1.2+222322 858+/52322 ,+8,5+222322 7+,22+222322 ,2,+7.2322 ,54+.22322 4+50,+.22322
,,2+222322 442+222322 ,07+.22322 002+222322 8+/4.+222322 02+/22322 5+./7+222322 5+./7+222322 0+78/+222322 57+522322 12+222322 1/7+.22322 ..+222322 ,01+822322 ,01+822322 022+222322 12+.22322 0,0+.22322 .,8+4.2322 .,8+4.2322 /0+2.2322
8/8+222322
Keterangan
E a"alog E a"alog E a"alog
E a"alog
E a"alog
E a"alog E a"alog E a"alog E a"alog
Total Harga
Keterangan
882+222322 882+222322 882+222322 442+222322 ,5/+222322 418+222322 10/+222322 807+/20322 E a"alog 807+/20322 E a"alog
002+222322
002+222322 ,52+848322 ,52+848322 084+/28322 4+122+222322 4+122+222322 8,5+454322 080+,,7322 /.+088+222322
E a"alog E a"alog E a"alog
E a"alog E a"alog E a"alog
/0,+122322 ,/7+222322 ,/7+222322 0+022+222322 44+772+222322 474+4.2322 41,+.51322 442+011322 8.8+/18322 E a"alog 8.8+/18322 E a"alog
Total Harga
Keterangan
170+7.2322 40,+710322 E a"alog 44+525322 ,25+7.7322 ,,5+222322 47.+222322 47.+222322 47.+222322 002+222322 002+222322 ,17+710322 ,17+710322 ,04+222322 42/+527322 E a"alog 42/+527322 E a"alog 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322
E E E E E E E E E E E
a"alog a"alog a"alog a"alog a"alog a"alog a"alog a"alog a"alog a"alog a"alog
154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 ,78+7.7322 ,78+7.7322
E E E E E E E E E
a"alog a"alog a"alog a"alog a"alog a"alog a"alog a"alog a"alog
Total Harga
Keterangan
,78+7.7322 E a"alog 1.+270322 E a"alog
45,+.22322 1.+,42322 77+222322 5+./7+222322 E a"alog 4.+/.2322 7+870+222322 E a"alog ,2/+242322 8+5.0+,82322 E a"alog .4+.4.322 .,8+4.2322 .,8+4.2322 /0+2.2322
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
Total Harga 6 6 6 6 6 6 6 6 6 6 6 6 6 1/7+.22322
4.+/.2322 48+182322 6 ,/+412322 4/+/42322 6 88+222322 ,,/+./2322 6 8/7+782322 4+87.+222322 02+/..+222322 6 6 4.+512322 ,+/72322 0+102322 4+842322 ,/+,.2+222322 05+502+222322 /+872+222322 025+1.2322 457+222322 6
Keterangan
Total Harga
,,5+1/2322 6 1+/72322 82+722322 6 6 6 ,,+222322
6 77+222322 6 6 6 6 6 6 4,8+.22322 ,,2+222322 6 ,1+.22322 ,,2+222322
4.+/.2322 6 6 6 6 7,+4/2322 12+582322 ,4.+/82322 6 6 6 6 6 6 ,,2+222322
Keterangan
Total Harga
Keterangan
45,+.22322 ..2+222322 022+222322 ,2+,22+222322 E a"alog ..+222322 ..+222322 ..+222322 ..+222322 02+,82322 4/+122322 0,+482322 ,4+255322 E a"alog 6 6 6 02+/22322 4.+512322 02+/22322 4.+512322 4.+022322 6 ,44+,22322 6 0/+212322 824+0/2322
1.+,42322 1.+,42322 .+/22+512322 E a"alog 8+1.2+222322 E a"alog 50+.22322 8,1+242322
No
Nama Barang
803 Skalpel+ Tangkai Pisau Operasi 883 Tangkai ka-a mulu"
Kemasan/Spesiikasi/ Merk O""o O""o
Perlengkapan ,3 Baki ;ogam Tempa" Ala" S"eril Ber"u"up 43 oren"ang+ Pen'epi" Sponge #Foers"er& 03 ;ampu Spiri"us Isi ,42 -Ersa 83 ;emari perala"an .3 ;empeng a-a Penga)uk Semen Eli"e-! 13 %ee)le Des"royer 73 Silin)er oren"ang S"eril Eli"e-! /3 S"erilisa"or kering 53 Tempa" Alko!ol #Dappen Glas& ,23 Toples apas ;ogam )engan Pegas )an Tu"up #.2 ? 72 mm& ,, Toples Pem(uangan apas #.2 ? 7. mm& ,4 Caskom Bengkok #%eir(eken&
Set Promosi Kesehatan ,3 Ala" Peraga =ara >enyusui yang Benar #Boneka )an *an"om payu)ara& 43 Ala" Permainan E)uka"i* #APE& 03 Bi(lio"erapi 83 Boneka Bayi .3 Bule"in Boar) 9 Papan In*ormasi 13 =e"akan $am(an 73 =e"akan Sumur Gali #=i-in& /3 ompu"er )an Prin"er 53 Fan"om Gigi Anak ,2 Fan"om Gigi Deasa ,, Fan"om >a"a Ukuran Asli ,4 Fan"om >a"a Ukuran Besar #Fi(erglass& ,0 Fan"om Panggul Cani"a ,83 Flip =!ar" )an S"an) ,. Foo) >o)el ,1 Gam(ar Ana"omi Gigi ,7 Gam(ar Ana"omi >a"a ,/ Gam(ar Ana"omi >a"a 12 ? 52 ,5 Gam(ar Panggul ;aki6;aki
Satuan
Jumlah
Harga
P-s P-s
P-s P-s P-s Uni" P-s P-s P-s P-s P-s
,25+7.7322 88+270322
P-s P-s P-s
45,+.22322 6#$120 77+222322 7+107+222322 4.+/.2322 1+502+222322 108$020 0+8,2+222322 .4+.4.322 #1!$2#0 #1!$2#0 /0+2.2322
ongkir 1.+222322 4,+222322
,+5.2+222322 .80+222322 ,+.80+,82322
Total Harga
822+452322 8+2/8+222322 8+2/8+222322 ,+/,4+222322 40+,22322 00+222322 40+,22322 ,/+722322 47+.22322 ,+240+222322 ,+240+222322 ,4+255322 ,1+.22322 /8+722322 4+/21+/82322 4+/22+222322 4+101+222322 0+8,7+/.2322 8/7+022322 858+/52322 8/5+.22322 4+7.2+222322 88+772322 88+772322 8+257+.22322 ,+8,5+222322 ,+240+222322 ,2,+7.2322 ,54+.22322 47+222+222322 ,,+./.+222322 00+222322 .,8+4.2322 .,8+4.2322 0.4+222322 4.0+222322 4.0+222322 ,4+042322
,,2+222322
Keterangan
E a"alog E a"alog E a"alog
E a"alog
E E E E
a"alog a"alog a"alog a"alog
E a"alog E a"alog
Total Harga
Keterangan
4+,7,+017322 E a"alog 6 6 6
6 77+222322 ,1.+222322 ,07+.22322 ,,2+222322 002+222322 8+/4.+222322 E a"alog ,+/,.+222322 48+422322 ,2+222322 ,2+222322 12+222322 12+222322 57+522322 ..+222322 ,01+822322 ,01+822322 12+.22322 022+222322 ,07+.22322 0,0+.22322
8+5.0+,82322 E a"alog
1.+,42322
.+.22322 ,1.+222322 4.0+222322 5+107+222322 E a"alog 12+.22322 0,0+.22322
Total Harga
Keterangan
0.4+222322 6 45,+.22322 7,.+222322 7,.+222322 4.0+222322 4.0+222322
6 4/+122322 4.+022322 487+582322 8,5+454322 E a"alog 4.+022322 ,07+.22322 1.+,42322 1.+,42322 1.+,42322 6 .4+.4.322 ,5+4.2322 85+.22322 6 11+222322 6 814+222322 /4.+222322 /4.+222322 170+7.2322 45+722322 40+,22322 48+/12322 41+822322 1/7+.22322 8/+/82322
Total Harga
Keterangan
04+.12322 47.+222322
04+.12322 47.+222322 6 6 ,45+/22322 05+122322 ,1+.22322 022+222322 88+772322 48+422322 88+772322 /8+722322 ..+222322 442+222322 442+222322 442+222322 4+/21+/82322 4+/21+/82322 8+5.0+,82322 8/5+.22322 858+/52322 8/7+022322 6 11+222322 11+222322 ,+8,,+2/2322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322
E a"alog E a"alog E a"alog
E a"alog E a"alog E E E E E E E
a"alog a"alog a"alog a"alog a"alog a"alog a"alog
Total Harga
Keterangan
.8.+582322 10+270322 E a"alog ,2,+7.2322 ,54+.22322 4+50,+.22322 E a"alog ,1.+222322 00+222322 0.4+222322 4.0+222322
6 6 6 6 6 1/7+.22322 4+5.2+174322 E a"alog .4+.4.322 .,8+4.2322 .,8+4.2322 4.0+222322
442+222322 45,+.22322
77+222322 ,1.+222322 0.4+222322 44+222322 4/+122322 4.+022322 11+222322 ,07+.22322 1.+,42322 50+.22322 8+2/8+222322 E a"alog 85+.22322
Total Harga
814+222322 40+,22322 40+,22322 47+.22322 07+822322 47+.22322 ,/+722322 ,+2/2+442322 ,1+.22322 4+/21+/82322 4+/22+222322 8+5.0+,82322 8/5+.22322 11+222322 7+,22+222322 ,54+.22322 ,1.+222322 4+50,+.22322 00+222322 .,8+4.2322
Keterangan
E a"alog E a"alog E a"alog
E a"alog
E a"alog
8+822+222322 0/.+222322 7.+222322 6 82+222+222322
.2+222322 8+/4.+222322 E a"alog 02+/22322 12+222322 12+.22322
Total Harga
Keterangan
12+.22322 ,07+.22322 0,0+.22322 .,8+4.2322
12.+222322
45,+.22322 4/+122322 /4+.22322 4/+122322 4.+022322 11+222322 .4+.4.322 .4+.4.322 .4+.4.322 /0+2.2322 11+222322 052+.22322 00+222322 50+.22322 40+,22322 ,/+722322 4+/21+/82322 E a"alog 858+/52322 8/5+.22322 ,54+.22322 ,1.+222322
,1.+222322 ,1.+222322 85+.22322 57+522322 57+522322 022+222322
04.+222322
Total Harga
Keterangan
,0.+782322 11+222322 /8+412322 85+.22322 6 ..+222322 020+122322 77+222322 8/5+.22322 11+222322
4+/21+/82322 E a"alog 44+222322 55+222322 ,1.+222322 00+222322
8/8+222322 882+222322 882+222322
882+222322 442+222322 ,5/+222322 418+222322 10/+222322 ,52+848322 ,52+848322 /+012+222322 8,5+454322 170+7.2322 ,/2+7.7322
E a"alog E a"alog E a"alog E a"alog
No ,.3 ,13 ,13 ,73 ,/3 ,53 423 4,3 443 403 483 4.3 413 473 4/3 4/3 453 453 023 0,3 043 003 083 083
Nama Barang Pengukur pan'ang (a)an Pin Pinse" se" Ana Ana"om "omis #Un"u Un"uk k Spe-i e-imen& men& Pinse" Ana"omis+ ,8+. -m Pinse" Ana"omis+ ,/ -m Pinse" Bayone" P348. Pinse" Be)a! ,/ -m Pinse" Be)a!+ ,8+. -m Silin)er oren"ang S"eril Skalpel+ Ta Tangkai Pi Pisau Op Operasi Sp!ygmomanome"er )e )easa S"an)ar in*us S"erilisa"or S"e"oskop Su)ip )ip ;i)a ;i)a! !+ ;oga ;ogam+ m+ Pan Pan'a 'ang ng ,4 -m Temp Tempa" a" Ti)u Ti)urr Peri Periks ksa a Dan Dan Perl Perlen engk gkap apan anny nya a Termome"er Tim(angan De Deasa Tim(angan Bayi Tornike" kare" Trom Tromol ol asa asa9 9a ain S"e S"eril #,4. ,4. ? ,42 ,42 mm& mm&
Kemasan/Spesiikasi/ Merk
AD ari?a Eli"e-!
ari?a
Eli"e-!
Satuan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s Uni" P-s P-s P-s P-s P-s
814+222322 40+,22322 40+,22322 47+.22322 07+822322 47+.22322 ,/+722322 ,+2/2+442322 ,1+.22322 4+881+/82322 ,+222+222322 0+8,2+222322 8/5+.22322 11+222322 .+022+222322 ,54+.22322 ,1.+222322 ,+0/1+222322 00+222322 .,8+4.2322
P-s Bo? Bo?
8+822+222322 0/.+222322 7.+222322
Uni"
82+222+222322
P-s P-s P-s P-s P-s
.2+222322 0+24.+222322 02+/22322 12+222322 12+.22322
ongkir
012+222322 ,+/22+222322 ,+.80+,82322
,+/22+222322
,+.8.+.22322
II, Set Pemeriksaan Kesehatan I%uIII, Set Pemeriksaan Kesehatan AnakI., Set Pela&anan KB ., Set Pemeriksaan Pemeriksaan *a%oratorium Se!erhana Se!erhana , Ala" pemeriksaan H( PO=T 4 Tes =elup Glu-opro"ein Urin 0 Tes =elup !=G #"es ke!amilan& 8 Tes Golongan Dara! . ulka lkas #pen #penyi yim mpan pan reag eagen+ en+ @aks @aksiin )an )an o(a o(a"&
Perlengkapan ,3 Han)uk e-il un"uk ;ap Tangan 43 asur 03 o"ak Penyimpan $arum Bekas 83 Pispo" .3 Sika" Tangan
ari?a
,+/22+222322
Total Harga
Keterangan
04+.12322 8/+/82322 04+.12322 47.+222322
04+.12322 404+710322 ,04+222322 ,07+527322 8+,.7+182322 154+582322 154+582322 154+582322 154+582322 154+582322 154+582322 8+5.0+,82322 10+270322
E a"alog
E a"alog E a"alog E a"alog E a"alog E a"alog E a"alog E a"alog E a"alog E a"alog
.4+.4.322 .,8+4.2322 .,8+4.2322 .,8+4.2322 6 6 4,5+.22322 022+222322
..+222322 4+7.2+222322 45,+.22322 45,+.22322 /0+2.2322 0.4+222322 4+855+482322 E a"alog 4/+122322 ..+222322 4.+022322
Total Harga
Keterangan
4/+/42322 8+822+222322 11+222322 00+882322 ..+222322 ,/+,.2322 .4+.4.322 85+.22322 11+222322 11+222322 .,5+7.2322 814+222322 .+.22322 814+222322 85+.22322 40+,22322 40+,22322 ,/+722322 ,/+722322 .+.22322 0/+.22322 4+855+482322 E a"alog 8/7+022322 11+222322 11+222322 6 88+772322 442+222322 442+222322 442+222322 8/5+.22322 ,2/+242322 442+222322 6 ,4,+222322 5,/+.22322 ,54+.22322 ,54+.22322 4+/21+/82322 E a"alog ,1.+222322 4+50,+.22322 E a"alog
Total Harga
Keterangan
.,8+4.2322 00+222322 .,8+4.2322 ,+240+222322 ,+240+222322 0.4+222322 4.0+222322 4+50,+.22322 E a"alog
,1.+222322 02+/22322 50+.22322 ,5+0,8322 E a"alog 12+.22322 ,,2+222322 04.+222322 6 442+222322
6 6 4.+022322 4+50,+.22322 E a"alog 6 ,1.+222322 ,2,+7.2322 022+222322
6 6 6 6
6 6
Total Harga
Keterangan 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
PEMERINTAH KABUPATEN TABANAN DINAS KESEHATAN Jl. Gunung Agung No.82 Telp.0361811!1" TABA
DAFTAR SURVEY HARGA
Program Peker'aan
No , 4 0 8 . 1 7 / 5 ,2 ,, ,4 ,0 ,8 ,. ,1 ,7 ,/ ,5 42 4, 44 40 48 4. 41 47 4/ 45 02 0, 04 00
: Dukungan Biaya Oprasional Pelayanan ese!a"an #$%& : Belan'a Ba!an Pakai Ha(is e)ok"eran # In*us+ $arum Sun"ik
Nama Barang Sarung Tangan S"eril Cing %ee)le %o3 40 Cing %ee)le %o3 4. Cing %ee)le %o 47 apas pem(alu" 4.2 gram Benang a'a! Un)erpa) IV i"! por" %o3 ,1+ ,/+ 42+44+48+41 Silk 492 Su"ra Silk 092 Su"ra Silk 092 Roll =a" gu" 092 -!romi=a" gu" 492 -!romi=a"gu" 492 =!romi- roll =a"gu" 092 =!romi- Roll =a"gu" ,92 =!romi=a"gu" plain 492 =a"gu" 092 Plain Spui" 0 ml Spui" . ml Spui" , ml Spui" ,2 ml $elly Ul"rasoniFolley =a"!e"er %o3 ,/ Han)s-oon on > Han)s-!oen on > Sarung Tangan ; Sarung Tangan > Sarung Tangan S Sarung "angan Gynae-olog Sarung Tangan ;a"e? E"anol 72J ,222 ml E"anol 72J ,22 ml
Kemasan/Spes iikasi/Merk Euro)erm
B(raun
TP TP TP TP Reme)i Super-are Super-are Super-are Super-are Super-are Reme)i
Satuan Pasang P-s P-s P-s Roll P-s P-s p-s P-s P-s Roll P-s P-s Roll Roll Roll Roll Roll P-s P-s P-s P-s Tu(e P-s Bo? Bo? Bo? Bo? Bo? Pasang Pasang Bo"ol Bo"ol
08 0. 01 07 0/ 05 82 8, 84 80 88 8. 81 87 8/ 85 .2 ., .4 .0 .8 .. .1 .7 ./ .5 12 1, 14 10 18 1. 11 17 1/ 15 72 7, 74 70 78 7. 71 77 7/ 75
In*usion se" Anak In*usion Se" Deasa asa Gulung 82 ? /2 asa Hi)ro*il 8 ? ,2 asa pem(alu" !i)ro*il 8m ? ,. -m asa pem(alu" !i)ro*il 8m ? 0 -m asa s"eril # ,/ ? 44 & Ples"er . yar) ? 4 in-! Daryan"ulle Hypa*i? #Ul"ra*i? & ,. ? . Hypa*i? #Ul"ra*i? & ,2 ? . Hypa*i? #Ul"ra*i? & . ? . Hypa*i? #Ul"ra*i? & . ? , lip ke-il lip Tanggung >asker >asker %5. Spalk "ungkai a"as anak spalk "ungkai a"as )easa spalk "ungkai (aa! anak spalk "ungkai (aa! )easa IV =a"! )engan ka"up Sen)ok "akar Po" salep 02== Alko!ol Sa( $arum kuli" $arum $a!i" $arum in' Bis"uri =o""on Apli-a"or #;i)i apas& An"isep"ik Han) Gel An"isep"ik Ruangan Gelang Bayi er"as ;akmus Alko!ol Sa( Um(illi-al =or) a"e"er Peng!isap ;en)ir no / )an ,2 ain Balu" Segi"iga #>i"ella& %asogas"ri- "u(e )easa Bloo) Glukosa Tes" s"rip Uri- A-i) "es" s"rip =!loles"erol "es" s"rip "es -om(ur Hemoglo(in Tes" S"rip T!ree Cay > $elly
TP TP Biokasa Biokasa Biokasa
Bo?
Reme)i
P-s P-s Roll Roll Roll Roll Pa-k Roll Bo? Roll Roll Roll Roll Pa-k Pa-k P-s P-s P-s P-s P-s P-s P-s P-s Pa-k P-s P-s Bo? Bo?
Fres-o
P-s
Reme)i
Bo? P-s Pa-k
Reme)i
P-s P-s P-s Bo? Bo? Bo? (o? Bo? P-s Tu(e
/2 /, /4 /0 /8 /. /1 /7 // /5 52 5, 54 50 58
Reagen =on"rol Serum imia linik Dilluen" Rinse ;yse E =leanser Pro(e =leanser Perkamen an"ong Puyer %asal =annula Ri@anol (ay-lean Dermalon Bloo) lan-e" Po" urine Ci)al
P-s P-s Reme)i
lorne
(o"ol , l" P-s BO P=S @ial
AN
+ Per(an )ll&
HAR"A
,,+004382 ,4+042322 ,4+042322 ,4+042322 ,4+.22322 ,22+4,2322 8+284322 /+7.2322 .+122322 .+122322 051+222322 ,0+122322 ,0+122322 ,+.27+222322 ,+8.7+.22322 ,+07.+222322 ,+.27+222322 ,+802+222322 1/.3,8 /,.3,. 175345 57/377 45+282322 ,2+4,4322 /5+,,7344 /5+,,7344 /5+,,7344 /5+,,7344 /5+,,7344 ,5+0,8322 ./+/.2322 41+022322 0+522322
Keterangan E a"alog
E a"alog
E E E E
a"alog a"alog a"alog a"alog
E E E E E E E
a"alog a"alog a"alog a"alog a"alog a"alog a"alog
,4+101322 1+81.322 ,,4+4573.2 ,+.7034. 4+475322 772322 .+522322 8,+2,.322 ,7/+422322 ,.8+4.5322 ,,,+12,322 ./+.77322 ,4+2,,322 ,4+722322 ,0+022322 0.+784322
E E E E E
a"alog a"alog a"alog a"alog a"alog
E a"alog
.8+8.2322 .8+8.2322 .8+8.2322 .8+8.2322 /+7.2322 ,+,22322 4+422322 E a"alog
,0.+512322 ,0.+512322 55+222322 022+222322 ,21+722322 E a"alog
,1.+222322 ,,0+,22322 ,0+1.0322 E a"alog E a"alog 0+..4322 E a"alog 48+422322 81+122322 8,/+222322 ,.1+222322 581+442322 852+2.2322 51.+222322 4/+822322 0.+,22322
PEMERINTAH KABUPA KA BUPATEN TEN TABANAN DINAS KESEHATAN Jl. Gunung Agung No.82 Telp.0361811!1" TABANAN
DAFTAR SURVEI HARGA Program Peker'aan No
: Dukungan Biaya Oprasional Pelayanan ese!a"an #$%& : Belan'a Ba!an Pakai Ha(is e)ok"eran # In*us+ $arum Sun"ik+ Per(an )ll& Nama Barang
Kemasan/Spesiikasi/ Merk
Satuan
Jumlah
Harga
ongkir
SET PEMERIKSAAN UMUM , 4 0 8 . 1 7 / 5 ,2 ,, ,4 ,0 ,8 ,. ,1 ,7 ,/ ,5 42 4, 44 40 48 4. 41 47 4/
Anuskop Baki logam "empa" ala" s"eril (er"u"up Bingkai u'i6-o(a un"uk pemeriksaan re*raksi Buku Is!i!ara Tes =orong "elinga9Spe-ulum "elinga ukuran ke-il+ (esar+ se)ang Emesis (asin 9%ier(eken (esar Garpu"ala .,4 H+ ,248 H+ 42/8 H Han)le ka-a laring Han)le ka-a nasop!aring a-a laring ukuran 4+8+.+1 a-a nasop!aring ukuran 4+8+.+1 a-a pem(esar un"uk )iagnos"ik ;ampu kepala9 Hea) ;amp < A)ap"or A=9D= ;ampu sen"er un"uk periksa9 pen lig!" ;ensa u'i6-o(a un"uk pemeriksaan re*raksi ;up (inokuler #lensa pem(esar& 06. Diop"ri >e"line # pengukur lingkar pinggang & Op"!almos-ope O"os-ope Palu re*le? Pelili" kapas9 =o""on appli-a"or Skin*ol) -alliper Snellen =!ar" 4 'enis #E =!ar" < Alp!a(e" =!ar"& Spekulum @agina #-o-or (e(ek& se)ang Spekulum !i)ung )easa Sp!ygmomanome"er Sp!ygmomanome"er un"uk )easa S"e"oskop un"uk )easa Su)ip li)a! logam9spa"ula li)a! logam pan'ang ,4 -m
AD
P-s P-s P-s P-s
./0+112322 45,+.22322 752+.72322 55+222322
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
77+222322 0.4+222322 ,0.+782322
..+222322 442+222322 020+122322 4+881+/82322 4+881+/82322 8/5+.22322
P-s
11+222322
0,+482322 081+.22322 50+.22322 8+11/+,/2322 ,,+222322 4+818+222322 ,+1/2+222322 11+222322 00+222322
012+222322 012+222322
No 45
Nama Barang Su)ip li)a! logam9spa"ula li)a! logam pan'ang ,1+. -m
02 Tempa" "i)ur periksa )an perlengkapannya 0, Termome"er un"uk )easa 04 Tim(angan )easa 00 Tonome"er S-!io" Perlengkapan , Ban"al 4 Baskom -u-i "angan 0 asur 8 ;ampu spiri"us . ;emari ala" 1 >e'a ins"rumen 7 >e"eran "inggi (a)an / Perlak 5 Pispo" ,2 Sarung (an"al ,, Seprei ,4 Sika" un"uk mem(ersi!kan perala"an ,0 S"op Ca"-! Tempa" sampa! "er"u"up yang )ilengkapi )engan ,8 in'akan pem(uka penu"up Set Tin!akan Me!is/"a#at $arurat , Baki logam "empa" ala" s"eril "er"u"up 4 =ollar Bra-e9%e-k =ollar anak 0 =ollar Bra-e9%e-k =ollar )easa =orong "elinga9Spekulum "elinga9Spekulum "elinga ukuran ke-il+ (esar+ 8 se)ang . Doppler 1 Dressing For-eps 7 EG / Emesis Basin9 %ier(eken (esar 5 For-eps Aliga"or ,2 For-eps Bayone" ,, Gue)el Airay #Orop!aringeal Airay& ,4 Gun"ing (e)a! s"an)ar+ lengkung Gun"ing (e)a! s"an)ar+ lengkung+ u'ung "a'am9"a'am ,0 ,8
Kemasan/Spesiikasi/ Merk
Gun"ing (e)a! s"an)ar+ lengkung+ u'ung "a'am9"umpul
ari?a
ari?a Ersa Ersa
Eli"e-! Eli"e-!
Satuan
Jumlah
Harga
P-s Uni" P-s P-s P-s
11+222322 .+022+222322 ,54+.22322 ,1.+222322 ,+0.8+712322
P-s P-s P-s P-s Uni" Uni" P-s P-s P-s P-s P-s P-s P-s
,,2+222322 442+222322 0+24.+222322 77+222322 7+107+222322 0+24/+222322 85+.22322 57+522322 12+222322 ..+222322 022+222322 12+.22322 ,,2+222322
P-s
0,0+.22322
P-s P-s P-s
45,+.22322 77+882322 77+882322
P-s P-s P-s P-s P-s P-s P-s P-s P-s
77+222322 4+0,2+222322 40+,22322 08+1.2+222322 0.4+222322 442+222322 07+822322 ,.1+842322 44+222322
P-s
44+222322
P-s
44+222322
ongkir
,+/22+222322
,+/22+222322 ,+5.2+222322 ,+2.1+222322
,/5+482322 ,+00/+122322
No ,. ,1 ,7 ,/ ,5 42 4, 44 40 48 4. 41 47 4/ 45
Nama Barang
Kemasan/Spesiikasi/ Merk
Gun"ing (e)a! s"an)ar+ lengkung+ u'ung "umpul9"umpul
00
Gun"ing (e)a! s"an)ar+ lurus u'ung "umpul9"umpul Gun"ing (e)a! s"an)ar+ lurus+ u'ung "a'am9"a'am Gun"ing (e)a! s"an)ar+ lurus+ u'ung "a'am9"umpul Gun"ing pem(alu" Gun"ing pem(uka 'a!i"an lurus Han)le ka-a laring Han)le ka-a nasop!aring Hooke) pro(es a-a laring ukuran 4+8+.+1 a-a nasop!aring ukuran 4+8+.+1 ai" )an kure" serumen Reme)i anula !i)ung anak Reme)i anula !i)ung )easa lem ar"eri ,8 -m #o-!er& lem ar"eri+ ,4 -m lengkung+ )engan gigi ,?4 #Hals"ea)6>osui"o& lem ar"eri+ ,4 -m lengkung+ "anpa gigi #Hals"ea)6 #Hals"ea)6 >osui"o& lem ar"eri+ ,4 -m lurus+ )engan gigi ,?4 #Hals"ea)6 >osui"o& lem ar"eri+ ,4 -m lurus+"anpa gigi #Hals"ea)6>osui"o& #Hals"ea)6>osui"o&
08 0. 01 07 0/ 05 82 8, 84 80 88 8. 81 87 8/ 85 .2
lem ar"eri+ lurus #elly& lem9pemegang 'arum 'a!i"+ ,/ -m #>ayo6 Hegar& oren"ang+ oren"ang+ lengkung+ pen'epi" ala" s"eril #40 -m& oren"ang+ pen'epi" sponge ursi ro)a ;ampu kepala ;aringoskop anak ;aringoskop )easa ;aringoskop neona"us (ila! lurus >agill For-eps %e(ulier O"oskop Palu re*le? Pinse" ala"+ (engkok #Remky& Pinse" ana"omis+ ,8+. -m Pinse" ana"omis+ ,/ -m Pinse" (e)a!+ ,8+. -m
02 0, 04
Eli"e-!
Satuan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
/8+412322 ,2+522322 ,2+522322 00+882322
P-s
02+/22322
P-s
4.+512322
P-s
02+/22322
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
4.+512322 4.+022322 81+842322 1.+,42322 1.+,42322 ,+/,.+222322 081+.22322 0+142+,22322 0+142+,22322 0+142+,22322 ,10+082322 ,+4/7+222322 ,+1/2+222322 11+222322
ongkir
44+222322 44+222322 44+222322 44+222322 4/+122322 4/+122322
40+,22322 00+222322 ,/+722322
,+,55322 ,+,55322
.4.+222322
No ., .4 .0 .8 .. .1 .7 ./ .5 12 1, 14 10 18 1. 11 17 1/ 15 72 7, 74
Nama Barang
70
Pinse" (e)a!+ ,/ -m Pinse" epilasi Pinse" "elinga Pinse" insisi Hor)eolum9 =!alaion Resusi"a"or anak6anak sungkup Resusi"a"or )easa sungkup Resusi"a"or neona"us sungkup Re"rak"or+ pem(uka kelopak ma"a Sempri" gliserin Silin)er koren"ang s"eril Skalpel+ "angkai pisau operasi Spalk Spekulum !i)ung Spekulum ma"a Sp!ygmomanome"er un"uk anak Sp!ygmomanome"er un"uk )easa S"an) lamp un"uk "in)akan S"an)ar in*us S"e"eskop anak S"e"eskop )easa S"e"eskop 'anin9;aenaSu-"ion pump # ala" peng!isap& Su)ip li)a! logam9Spa"ula li)a! logam pan'ang ,4 -m
78
Su)ip li)a! logam9Spa"ula li)a! logam pan'ang ,1+. -m
7. 71 77 7/ 75 /2 /, /4 /0
Ta(ung oksigen )an regula"or Tempa" "i)ur periksa )an perlengkapannya Termome"er anak Termome"er )easa Tim(angan anak Tim(angan )easa Tissue For-eps Tornike" kare" Usungan #(rankar &
Perlengkapan , Bak ins"rumen" "er"u"up 4 Ban"al 0 =elemek plas"i-
Kemasan/Spesiikasi/ Merk
AD AD ari?a ari?a
Eli"e-!
ari?a
ari?a
Satuan
Jumlah
Harga
P-s P-s P-s P-s Se" Se" Se" P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
47+.22322 4/+122322 4,+7/2322 882+222322 ,+240+222322 ,+240+222322 ,+240+222322 ,4,+112322 ,85+,12322 ,2/+242322 ,1+.22322 /8+722322 020+122322 442+222322 4+881+/82322 4+881+/82322 4+/.2+222322 ,+222+222322 858+/52322 851+5/2322 4+0,2+222322 4+7.2+222322
P-s
11+222322
P-s P-s Uni" P-s P-s P-s P-s P-s P-s P-s
11+222322 ,+8,5+222322 .+022+222322 ,1.+222322 ,54+.22322 ,1.+222322 ,1.+222322 ,/+722322 00+222322 /+022+222322
P-s P-s P-s
45,+.22322 ,,2+222322 .+.22322
ongkir
012+222322 012+222322 ,+/22+222322 ,+/22+222322
,/5+482322
,+/22+222322
,+/22+222322
No ,1 ,7 ,/ ,5 42 4, 44 403 48 4. 41 473 4/3 45 02 0, 04 00
Nama Barang Pinse" Be)a! Silin)er oren"ang S"eril Son)e mulu" Spekulum Vagina #=o-or Be(ek& Besar Spekulum Vagina #=o-or Be(ek& e-il Spekulum Vagina #=o-or Be(ek& Se)ang Spekulum Vagina #Sims& Sp!ygmomanome"er Deasa S"an) ;amp un"uk "in)akan S"e"oskop Deasa S"e"oskop $anin 9 Fe"os-ope Su)ip li)a! logam 9 Spa"ula ;i)a! ;ogam pan'ang ,4 -m Su)ip li)a! logam 9 Spa"ula ;i)a! ;ogam pan'ang ,1+. -m Tampon Tang Tempa" Ti)ur Periksa Termome"er Deasa Tim(angan Deasa Tornike" are"
Set Pemeriksaan Kesehatan Anak ,3 Ala" Pengukur Pan'ang Bayi 43 Flome"er anak #!ig! *lo& 03 Flome"er neona"us #lo *lo& 83 ;ampu periksa .3 Pengukur lingkar kepala 13 Pengukur "inggi (a)an anak 73 Sp!ygmomanome"er )an manse" anak /3 S"e"oskop pe)ia"ri53 Termome"er Anak ,2 Tim(angan Anak ,, Tim(angan (ayi
Kemasan/Spesiikasi/ Merk
AD ari?a Eli"e-!
Satuan
,/+722322 ,2/+242322
P-s P-s P-s P-s
442+222322 442+222322 442+222322 442+222322 4+881+/82322 4+/.2+222322 8/5+.22322 4+0,2+222322
P-s P-s P-s P-s P-s
P-s Uni" P-s P-s P-s
P-s
ari?a
AD
Harga
P-s P-s
P-s
ari?a
Jumlah
Uni" P-s P-s P-s P-s P-s P-s P-s
11+222322
11+222322 ,4,+222322 .+022+222322 ,54+.22322 ,1.+222322 00+222322
814+222322
4+/.2+222322 .+.22322 85+.22322 4+881+/82322 858+/52322 ,2,+7.2322 ,1.+222322 ,+0/1+222322
Set Pela&anan KB ,3 Baki ;ogam Tempa" Ala" S"eril Ber"u"up 43 Implan" i" 03 IUD i"
P-s P-s P-s
45,+.22322 884+422322 10+757+0..322
Set Imunisasi ,3 Va--ine -arrier
P-s
04.+222322
ongkir
012+222322 ,+/22+222322 ,/5+482322
,+/22+222322
,+/22+222322
012+222322
No 43
Nama Barang
Kemasan/Spesiikasi/ Merk
Va--ine Re*rigera"or
Perlengkapan ,3 Ari "imer 43 Ban"al 03 Baskom =u-i Tangan 83 =elemek Plas"ik .3 Duk Bolong+ Se)ang 13 asur 73 o"ak Penyimpan $arum Bekas /3 ;emari Ala" 53 ;emari O(a" ,2 >e"eran #un"uk mengukur "inggi Fun)us& ,, Perlak ,4 Pispo" ,0 Pi"a Pengukur ;ila ,8 Pompa Payu)ara un"uk ASI ,. Sarung Ban"al ,1 Selimu" ,7 Seprei ,/ Se" Tum(u! em(ang Anak ,5 Sika" un"uk >em(ersi!kan Perala"an 423 Tempa" Sampa! Ter"u"up yang )ilengkapi )engan in'akan pem(uka penu"up 4, Tirai 44 Toples apas 9 asa S"eril 40 Tromol asa 9 ain S"eril 48 Caskom Bengkok e-il
Set '%stetri ( "inekologi ,3 Bak ins"rumen "er" u"up (esar #O(gin& 43 Bak ins"rumen "er"u"up ke-il 03 Bak ins"rumen "er"u"up >e)ium 83 Doppler .3 Doyeri Pro(e ;engkung 13 En)o"ra-!eal Tu(e Deasa 4+. 73 En)o"ra-!eal Tu(e Deasa 0 /3 En)o"ra-!eal Tu(e Deasa 8 53 Gun"ing Benang ,2 Gun"ing Episio"omi
ari?a Ersa Ersa
Satuan
Eli"e-! Reme)i Reme)i Reme)i
Harga
ongkir
P-s
4,+222+222322
P-s P-s P-s P-s P-s P-s
P-s P-s P-s
P-s P-s P-s
110$000 ,,2+222322 4.0+222322 .+.22322 ,1.+222322 0+24.+222322 02+/22322 7+107+222322 7+107+222322 85+.22322 57+522322 12+222322 .+.22322 1/7+.22322 ..+222322 ,01+822322 022+222322
P-s P-s
12+.22322
0,0+.22322
P-s P-s P-s P-s
4,894,982.00
#1!$2#0 #1!$2#0 /0+2.2322
##0$000 88$000 2"1$#00 4+0,2+222322
P-s P-s P-s P-s
Ersa
Jumlah
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
11,400
11,400
11,400
4/+122322 ..+222322
,+/22+222322 ,+5.2+222322 ,+5.2+222322
4,564,000.00
,/5+482322 ,+4.8322 ,+4.8322 ,+4.8322
No ,, ,4 ,0 ,8 ,. ,1 ,7 ,/ ,5 42 4, 44 40 48 4. 41 47 4/ 45 02 0, 04 00 08 0. 01 07 0/ 05 82 8, 84 80 88 8. 81 87 8/ 85
Nama Barang Gun"ing Iris ;engkung Gun"ing Operasi ;urus Gun"ing Tali Pusa" lem Fens"er9lem O@um lem asa #oren"ang& lem elly9lem o-!er ;urus lem ;inen Ba-k!auss lem >osui"o Hals"e) ;engkung lem >osui"o Hals"e) ;urus lem P emasang lip Hegen(ar"! ;ampu Periksa Halogen >asker Oksigen anula %asal Deasa >e'a Ins"rumen %ee)le Hol)er >a"!eiu Pel@ime"er O(s"e"rik Pinse" $aringan #Sirurgis& Pinse" $aringan Semken Pinse" asa #Ana"omis& Resusi"a"or Deasa Re"rak"or Finsen Ta'am Se"enga! o-!er Skalpel %o3 0 Skalpel %o3 8 Spekulum #Sims& Besar Spekulum #Sims& e-il Spekulum #Sims& >e)ium Spekulum =o-or Be(ek Gra@e Besar Spekulum =o-or Be(ek Gra@e e-il Spekulum =o-or Be(ek Gra@e >e)ium S"an)ar in*us S"e"oskop Deasa S"e"oskop $anin9 Fe"os-ope S"ile" un"uk P emasangan ETT Ta(ung Oksigen )an Regula"or Tempa" lem asa #oren"ang& Tempa" Ti)ur Periksa #e?amina"ion (e) & Tempa" Ti)ur un"uk Persalinan Tensime"er )easa Termome"er Deasa
Kemasan/Spesiikasi/ Merk
ari?a Reme)i Reme)i Ersa
ari?a Eli"e-!
ari?a ari?a AD
Satuan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
47+582322 44+222322 4/+/42322 72+,/2322 1.+,42322 00+882322 0/+212322 48+/12322 4.+512322 4.+512322 4+/.2+222322 ,,+.22322 ,2+522322 0+24/+222322 47+.22322
P-s P-s P-s Se"
,/+722322 ,/+722322 40+,22322 ,+240+222322
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
..+222322 ,1+.22322 ,1+.22322 442+222322 442+222322 442+222322 442+222322 442+222322 442+222322 ,+222+222322 8/5+.22322 4+0,2+222322
P-s P-s P-s P-s P-s P-s
,+8,5+222322 ,2/+242322 .+022+222322 5+122+222322 4+881+/82322 ,54+.22322
ongkir
,+/22+222322 ,+41.322 ,+,55322 ,+2.1+222322
,+/22+222322 ,/5+482322
,+/22+222322 ,+/22+222322 012+222322
No
Nama Barang
Kemasan/Spesiikasi/ Merk
Set Insersi !an Ekstraksi AK$R ,3 Aliga"or Eks"rak"or ADR 43 Gun"ing >ayo =VD 03 lem asa ;urus #Sponge Fos"er S"raig!"& 83 lem Penarik Benang ADR .3 Son)e U"erus Sims 13 Tenakulum S-!roe)er
Set Resusitasi Ba&i ,3 Ba(y Su-"ion Pump por"a(le 43 En)o"ra-!eal Tu(e 4+. 03 En)o"ra-!eal Tu(e 0 83 En)o"ra-!eal Tu(e 0+. .3 En)o"ra-!eal Tu(e 8 13 In* an" T pie-e resus-i"a"or )engan PE EP 73 In*an" T pie-e Sys"em /3 ;aringoskop %eona"us Bila! ;urus #0 ukuran& 53 >e'a Resusi"asi )engan Pemanas #In*an" Ra)ian" Carmer& ,23 O?ygen =on-en"ra"or Peng!isap ;en)ir De;ee #neona"us& ,, ,4 ,0
Set Pera#atan Pas)a Persalinan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s
Reme)i Reme)i Reme)i Reme)i
P-s P-s P-s P-s P-s
ongkir
442+222322 02+,82322 1.+,42322 4/+122322 88+772322 7/+.82322
4+7.2+222322
11,400
11,400
11,400
11,400
,+4.8322 ,+4.8322 ,+4.8322 ,+4.8322
P-s
0+142+,22322
Eli"e-!
Uni" P-s P-s P-s P-s
,.2+57.+222322 078+222322 ..+222322 4+7.2+222322 8/7+022322
,11+575+222322
Ersa Ersa
Uni" Uni" P-s P-s P-s P-s P-s P-s P-s P-s P-s
7+107+222322 7+107+222322 .4+.4.322 814+222322 85+.22322 ,2+222322 ,+0/1+222322 ,1.+222322 #1!$2#0 /0+2.2322 0.4+222322
,+5.2+222322 ,+5.2+222322
Pompa P eng!isap ; en)ir Elek" rik S"e"oskop Duple? %eona"us
Perlengkapan ,3 ;emari Ala" 43 ;emari O(a" 03 >angkok Io)in 83 Pengukur pan'ang (ayi .3 Pengukur Tinggi Ba)an #mi-ro" oise& 13 Pisau Pen-ukur 73 Tim(angan (ayi /3 Tim(angan Deasa 53 Tromol asa ,2 Caskom Bengkok Ukuran 02 -m ,, Caskom Bengkok Ukuran 40 -m
Satuan
Eli"e-!
,+.8.+.22322
No ,3 43 03 83 .3 13 73 /3 53 ,2
Nama Barang ARI Timer Boks Bayi Sp!ygmomanome"er Deasa S"an)ar in*us S"e"oskop Anak Ta(ung Oksigen )an Regula"or Tempa" Ti)ur Deasa Termome"er Anak Termome"er Deasa Tim(angan Bayi
Perlengkapan ,3 Ban"al 43 Baskom e-il 03 Han)uk Pem(ungkus %eona"us 83 an"ong >e"o)e anguru sesuai ukuran neona"us .3 asur 13 o"ak Penyimpan $arum Bekas 73 ;emari O(a" /3 ;emari Ala" 53 ;emari e-il Pasien Perlak ,2 ,, Pispo" Pompa Payu)ara un"uk ASI ,4 ,0 Sarung Ban"al Selimu" Bayi ,8 ,. ,1 ,7 ,/ ,53 42 4, 44
Selimu" Deasa Seprei Se" Tum(u! em(ang Anak Sika" un"uk >em(ersi!kan Perala"an Tempa" Sampa! Ter"u"up yang )ilengkapi )engan in'akan pem(uka penu"up Toples apas 9 asa S"eril Tromol asa 9 ain S"eril Caskom Bengkok e-il
Set Kesehatan "igi ( Mulut ,3 A"rauma"i- Res"ora"i@e Trea"men" #ART& Enamel A--ess =u""er
Kemasan/Spesiikasi/ Merk Ersa AD ari?a
ari?a
Eli"e-!
ari?a Ersa Ersa Ersa
Satuan P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
Jumlah
Harga
110$000 !$#02$"60 4+881+/82322 4+/.2+222322 858+/52322 ,+8,5+222322 .+022+222322 ,2,+7.2322 ,54+.22322 ,+0/1+222322
P-s P-s P-s P-s P-s P-s Uni" Uni" Uni" P-s P-s P-s P-s P-s P-s P-s
,,2+222322 442+222322 ,07+.22322 002+222322 0+24.+222322 02+/22322 7+107+222322 7+107+222322 4+5.1+222322 57+522322 12+222322 1/7+.22322 ..+222322 ,01+822322 ,01+822322 022+222322
P-s
12+.22322
P-s P-s P-s P-s
P-s
0,0+.22322 #1!$2#0 #1!$2#0 /0+2.2322
8/8+222322
ongkir
1$2"8$000 012+222322 ,+/22+222322
,+/22+222322
,+.8.+.22322
,+/22+222322 ,+5.2+222322 ,+5.2+222322 754+222322
No
43 03 83
.3 13 73 /3 53 ,2 ,, ,43 ,0
,8 ,. ,1 ,7 ,/ ,5 42 4, 443 403
Nama Barang Eksa@a"or Ber(en"uk Sen)ok Ukuran e-il #Spoon E?-a@a"or Small& Eksa@a"or Ber(en"uk Sen)ok Ukuran Se)ang #Spoon E?-a@a"or >e)ium& Eksa@a"or Ber(en"uk Sen)ok Ukuran Besar #Spoon E?-a@a"or ;arge& Dou(le En)e) Applier an) =ar@er Spa"ula Plas"ik Ha"-!e" Ba"u Asa! Bein ;urus Besar Bein ;urus e-il Bor In"an #Diamon) Bur Assor"e)& un"uk Air $e" Han) Pie-e #e-epa"an Tinggi& #roun)+ in@er"e) )an *issure& Bor In"an on"ra Angle Han) Pie-e =on@en"ional #e-epa"an Ren)a!& #roun)+ in@er"e) )an *issure& Ekska@a"or Beru'ung Dua #Besar& Ekska@a"or Beru'ung Dua #e-il& Gun"ing Operasi Gusi #Cagner& #,4 -m & Han)pie-e =on"ra Angle Han)pie-e S"raig!" a-a >ulu" Da"ar %o38 Tanpa T angkai lem9Pemegang $arum $a!i" #>a"!ieu S"an)ar& Se" ursi Gigi Elek"rik yang "er)iri )ari: ursi Gigi =uspi)or Uni" >e'a Ins"rumen Foo" =on"roller un"uk Han) Pie-e ompresor Oilless , P $arum e?"erpasi $arum 6File #,.682& $arum 6File #8.6/2& ;ig!" =uring >ikromo"or )engan S"raig!" )an =on"ra Angle Han) Pie-e #;o Spee) >i-ro >o"or por"a(le& Pelin)ung $ari Pemegang >a"riks #>a"ri? Hol)er& Pena!an ;i)a! Pengungki" Akar Gigi anan >esial #=ryer Dis"al& Pengungki" Akar Gigi anan >esial #=ryer >esial&
Kemasan/Spesiikasi/ Merk
O""o O""o
O""o O""o O""o
O""o O""o o@is"ra
O""o O""o
Satuan
Jumlah
Harga
P-s
882+222322
P-s
882+222322
P-s P-s P-s P-s P-s P-s P-s
882+222322 442+222322 ,5/+222322 418+222322 10/+222322 011+/20322 011+/20322
P-s
002+222322
P-s P-s P-s P-s P-s P-s P-s P-s Uni"
002+222322 ,,5+848322 ,,5+848322 477+/28322 4+122+222322 4+122+222322 0.8+454322 474+,,7322 70+/0.+222322
P-s P-s P-s P-s
/0,+122322 ,/7+222322 ,/7+222322 0+022+222322
P-s P-s P-s P-s P-s P-s
44+772+222322 474+4.2322 41,+.51322 442+011322 0/0+/18322 0/0+/18322
ongkir
7,+222322 7,+222322
7,+222322 7,+222322 1.+222322
1.+222322 7,+222322 ,,+.25+222322
7,+222322 7,+222322
No 48 4. 41 47 4/ 453 023 0, 043 003 08 0. 01 07 0/ 05
Nama Barang Penumpa" Plas"is Perio)on"al Pro(e Penumpa" Semen Beru'ung Dua Pinse" Gigi Polis!ing Bur Skeler S"an)ar + Ben"uk =angkul iri #Type =!isel9>esial& Skeler S"an)ar + Ben"uk =angkul anan #Type =!isel9>esial& Skeler S"an)ar+ Ben"uk Tom(ak #Type Hook& Skeler S"an)ar+ Bla-k iri )an anan #Type =!isel9>esial& Skeler S"an)ar+ Bla-k iri )an iri #Type =!isel9>esial&
Skeler Ul"rasonik Son)e ;engkung Son)e ;urus Spa"ula Penga)uk Semen Spa"ula Penga)uk Semen I onomer Se" Tang Pen-a(u"an Deasa #se"& Tang gigi an"erior ra!ang a"as )easa Tang gigi premolar ra!ang a"as Tang gigi molar kanan ra!ang a"as Tang gigi molar kiri ra!ang a"as Tang molar 0 ra!ang a"as Tang sisa akar gigi an"erior ra!ang a"as Tang sisa akar gigi pos"erior ra!ang a"as Tang gigi an"erior )an premolar ra!ang (aa! Tang gigi molar ra!ang (aa! kanan9kiri Tang gigi molar 0 ra!ang (aa! Tang sisa akar ra!ang (aa! 82 Se" Tang pen-a(u"an gigi anak Tang gigi an"erior ra!ang a"as Tang molar ra!ang a"as Tang molar susu ra!ang a"as Tang sisa akar ra!ang a"as Tang gigi an"erior ra!ang (aa! Tang molar ra!ang (aa! Tang sisa akar ra!ang (aa! 8,3 Skalpel+ >a"a Pisau Be)a! #Besar& 843 Skalpel+ >a"a Pisau Be)a! #e-il&
Kemasan/Spesiikasi/ Merk
Satuan
Jumlah
Harga
ongkir
P-s P-s P-s P-s P-s
170+7.2322 ,17+710322 44+525322 ,25+7.7322 ,,5+222322
P-s
47.+222322
P-s P-s
47.+222322 47.+222322
P-s
002+222322
O""o O""o
P-s P-s P-s P-s P-s P-s
002+222322 ,17+710322 ,17+710322 ,04+222322 ,07+527322 ,07+527322
7,+222322 7,+222322
O""o O""o O""o O""o O""o O""o O""o O""o O""o O""o O""o
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
.8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322
,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322
O""o O""o O""o O""o O""o O""o O""o O""o O""o
P-s P-s P-s P-s P-s P-s P-s P-s P-s
.8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 ,25+7.7322 ,25+7.7322
,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 1.+222322 1.+222322
O""o
18+222322
No 42 4, 44 40 48 4. 41 47 4/ 45 02 0,3 Set ASI ,3
Nama Barang
Kemasan/Spesiikasi/ Merk
Satuan
Jumlah
Harga
amera Fo"o 9 Han)y =amp ;ap"op ;ayar ukuran , ? ,+. > 9 S-reen ;ea*le"6;ea*le" >egap!one 9 P u(li- A))ress Sys"em Papan Tulis Pu"i! Pos"er6Pos"er Proyek"or 9 ;=D Proyek"or Ra)io ase"9 Tape Re-or)er Tele@isi )an An"ena V=D9 DVD Player Cireless Sys"em 9 Ampli*ier Cireless >i-rop!one Breas" pump
Set *a%oratorium ,3 Ba"ang Penga)uk 43 Beker+ Gelas 03 Bo"ol Pen-u-i 83 =orong a-a #. -m& .3 Erlenmeyer+ Gelas 13 Fo"ome"er 73 Gelas Pengukur #,22 --& /3 Gelas Pengukur #,1 O 9 .22 ml& 53 Hema"ology Analier #HA& ,23 Hemosi"ome"er Se" 9Ala" Hi"ung >anual ,,3 ;emari Es ,43 >ikroskop Binokuler ,03 Pipe" >ikro .6.2+ ,226422+ .226,222 ul ,83 Pipe" Berskala #Vol , --& ,.3 Pipe" Berskala #Vol ,2 --& ,13 Pipe" Te"es #Pipe" P as"eur& ,73 Po" Spesimen Da!ak >ulu" ;e(ar ,/3 Po" Spesimen Urine #>ulu" ;e(ar& ,53 Ro"a"or Pla"e 423 Sen"ri*use ;is"rik 4,3 Sen"ri*use >ikro!ema"okri" 443 Tip Pipe" #uning & Tip Pipe" # Biru& 403 Ta(ung apiler >ikro!ema"okri"
P-s
1/7+.22322
P-s P-s
4.+/.2322 48+182322
P-s P-s
,/+412322 4/+/42322
P-s P-s
88+222322 ,,/+./2322
P-s P-s Uni"
8/7+782322 4+87.+222322 02+/..+222322
P-s P-s P-s P-s P-s P-s P-s Bo? Bo?
4.+512322 ,+/72322 0+102322 4+842322 ,/+,.2+222322 05+502+222322 /+872+222322 025+1.2322 457+222322
ongkir
No 483 4.3 413 473 4/3 453 023 0,3
Nama Barang Ta(ung Reaksi #,4 mm& Ta(ung Reaksi )engan "u"up kare" ga(us Ta(ung Sen"ri* us Tanpa Skala Telly =oun"er Termome"er 26. = Urinome"er #Ala" Pengukur Bera" $enis Urine& Ca)a! Aua)es Ces"ergren Se" #Ta(ung ;a'u En)ap Dara!&
Perlengkapan ,3 aki Tiga 43 ;ampu Spiri"us 03 Pem(en)ung 83 Pen'epi" Ta(ung )ari ayu .3 Pensil a-a 13 Pemanas9Penangas )engan Air 73 Rak Pengering /3 Rak Pearna a-a Prepara" 53 Rak Ta(ung Reaksi ,2 S"opa"-! ,, Sengkeli" 9 Ose ,4 Sika" Ta(ung Reaksi ,0 Timer Set +armasi ,3 Anali"i-al Balan-e #Tim(angan >ikro& 43 Ba"ang Penga)uk 03 =orong 83 =aan Penguap Porselen #)3.6,.-m& .3 Gelas P engukur ,2m;+ ,22m; )an 4.2m; 13 Gelas Piala ,22m;+ .22m; )an ,; 73 Higrome"er /3 >or"ir #)3 .6,2-m & < s"amper ,26,.-m& < s"amper 53 Pipe" Berskala ,2 Spa"el logam ,, S!aker ,4 Termome"er skala ,22 Set Ra#at Inap ,3 Ari Soun) Timer
Kemasan/Spesiikasi/ Merk
Satuan
Jumlah
Harga
P-s
,,5+1/2322
P-s P-s
1+/72322 82+722322
P-s
,,+222322
P-s
77+222322
P-s P-s
4,8+.22322 ,,2+222322
P-s P-s
,1+.22322 ,,2+222322
P-s
2#$8#0
P-s P-s P-s
7,+4/2322 12+582322 ,4.+/82322
P-s
,,2+222322
ongkir
No
Nama Barang
Kemasan/Spesiikasi/ Merk
43 03 83 .3 13
Baki Ins"rumen Ber"u"up Bak Ins"rumen Ber"u"up 02 02 =m Bis"uri %o ,2 ari?a Brankar Gun"ing ;engkung+ U'ung Ta'am #>e"en(aum& #,/ =m&
73 /3
Gun"ing ;engkung+ U'ung Tumpul #>e"en(aum& #,/ =m& #>e"en(aum& #,/ =m& Gun"ing ;urus+ U'ung Ta'am #>e"en(aum& #,/ =m&
53
Gun"ing ;urus+ U'ung Tumpul #>e"en(aum& #,/ =m&
,23 ,,3 ,43 ,03 ,83 ,.3 ,13 ,73
Gun"ing >ayo ;urus9;engkung Gun"ing Pem(uka $a!i"an+ ;urus a-a Pem(esar Reme)i anula Hi)ung a"e"er+ Selang Peng!isap ;en)ir Bayi au"er lem Agra@e+ ,8 >m #Isi ,22& lem Ar"eri+ ,4 =m+ ;engkung Dengan Gigi , 4 # Hals"ea)6>osui"o & lem Ar"eri+ ,4 =m+ ;engkung Tanpa Gigi # Hals"ea)6 >osui"o & lem Ar"eri+ ,4 =m+ ;urus Dengan Gigi , 4 # Hals"ea)6 >osui"o & lem Ar"eri+ ,4 =m+ ;urus Tanpa Gigi , 4 # Hals"ea)6 >osui"o & lem Ar"eri+ ;urus #elly& lem9Pemegang $arum $a!i" Dengan un-i #Barauer&
,/3 ,53 423 4,3 443 403 483 4.3 413 473 4/3 453 023 0,3 043
lem9Pemegang $arum $a!i" #>a"!ieu S"an)ar& lem9Pemegang Sile" #Barrauer& lem9Pen'epi" ain #o-!er6Ba-k!aus&9Duk lem lep Penga"ur Oksigen Dengan Humi)i*er oren"ang+ ;engkung+ Pen'epi" Ala" S"eril+ 40 =m #=!ea""le& oren"ang+ Pen'epi" Sponge #Foers"er& Inku(a"or Bayi ;ampu Periksa ;ampu Sen"er >anse" Anak Dengan Vele-ro
Ersa ari?a
Satuan P-s P-s Pa-k P-s
Jumlah
Harga 45,+.22322 ..2+222322 022+222322 /+022+222322
P-s
..+222322
P-s
..+222322
P-s
..+222322
P-s P-s P-s P-s P-s
..+222322 02+,82322 4/+122322 0,+482322 ,2+522322
P-s
02+/22322
P-s
4.+512322
P-s
02+/22322
P-s P-s
4.+512322 4.+022322
P-s
,44+,22322
P-s P-s
0/+212322 824+0/2322
P-s P-s Uni" Uni" P-s P-s
1.+,42322 1.+,42322 8+.24+512322 4+/.2+222322 50+.22322 8,1+242322
ongkir
,+/22+222322
,+,55322
,+45/+222322 ,+/22+222322
No 003 083 0.3 013 073 0/3 053 823 8,3 843 803 883 8.3 813 873 8/3 853 .23 .,3 .43 .03 .83 ..3 .13 .73 ./3 .53 123 1,3 143 103 183 1.3 113 173 1/3 153 723
Nama Barang >anse" Deasa >e'a Ins"rumen+ >ayo Bers"an)ar >e'a Ins"rumen9Ala" %e(ulier Pinse" Ana"omis+ ,8+. =m Pinse" Ana"omis+ ,/ =m Pinse" Ana"omis #Un"uk Spe-imen& Pinse" Be)a!+ ,8+. =m Pinse" Be)a!+ ,/ =m Resusi"a"or Un"uk Deasa Resusi"a"or For In*an" Selang Oksigen Skalpel+ Tangkai Pisau Operasi Spalk Sp!ygmomanome"er S"an)ar In*us S"an)ar Caskom+ Tunggal S"an)ar Caskom+ Gan)a S"e"oskop In*an" S"e"oskop Anak S"e"oskop Deasa Su-"ion Pump Son)e Dengan >a"a+ ,8+. =m Son)e Pengukur Dalam ;uka Ta(ung Oksigen 1 >e"erku(ik Dan Regula"o Ta(ung Oksigen , >e"erku(ik Dan Regula"or Ta(ung9Sungkup Un"uk Resusi"asi Termome"er In*an" Termome"er Deasa Tempa" Ti)ur Raa" Inap Tempa" Ti)ur Raa" Inap Un"uk Anak Tornike" are" Tromol asa9ain S"eril #,4. ,42 >m& Tromol asa9ain S"eril #,.2 ,.2 >m& Caskom Bengkok Caskom =ekung Caskom =u-i Cing %ee)le
Perlengkapan ,3 Ban"al
Kemasan/Spesiikasi/ Merk Ersa Ersa Eli"e-!
Reme)i
AD ari?a Ersa Ersa
ari?a Ersa
Satuan
Jumlah
Harga
P-s Uni" Uni" P-s P-s P-s P-s P-s P-s Se" Se" P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s Se" P-s P-s Uni" Uni" P-s P-s P-s P-s P-s P-s P-s
822+452322 0+24/+222322 0+24/+222322 ,+4/7+222322 40+,22322 00+222322 40+,22322 ,/+722322 47+.22322 ,+240+222322 ,+240+222322 ,2+522322 ,1+.22322 /8+722322 4+881+/82322 ,+222+222322 ,+./2+222322 4+257+/.2322 8/7+022322 858+/52322 8/5+.22322 4+7.2+222322 88+772322 88+772322 8+257+.22322 ,+8,5+222322 ,+240+222322 ,2,+7.2322 ,54+.22322 4.+422+222322 5+/02+222322 00+222322 .,8+4.2322 .,8+4.2322 0.4+222322 4.0+222322 4.0+222322 ,4+042322
P-s
,,2+222322
ongkir
,+2.1+222322 ,+2.1+222322 .4.+222322
,+,55322
012+222322 ,+/22+222322 ,+2.1+222322 ,+042+222322
,+/22+222322 ,+7..+222322
No 43 03 83 .3 13 73 /3 53 ,23 ,,3 ,43 ,03 ,83 ,.3 ,13 ,73 ,/3 ,53 423 4,3 443 403 483 4.3
Nama Barang Dorongan Un"uk Ta(ung Oksigen Duk Biasa+ Besar #478 ,/0 =m& Duk Biasa+ e-il #5, ,,8 =m& Duk Biasa+ Se)ang #5, 5/ =m& Duk Bolong+ Besar #478 ,/0 =m& ;e"ak ;u(ang Di Tenga! #40 ,2& Duk Bolong+ e-il Duk Bolong+ Se)ang Han)uk Bayi Han)uk e-il #12 82 =m& ain Penu"up >e'a >ayo asur ursi Ro)a ;ap Un"uk >an)i Pasien Pispo" Anak Pispo" Deasa P ispo" Frak"ur9Immo(ilisasi Pispo" Pria9Urinal P erlak+ Te(al ;unak #422 52 =m& Sarung Ban"al Selimu" Selimu" Bayi Sika" Tangan Sprei Sprei e-il9S"eek ;aken Tempa" Sampa! Ter"u"up Dengan In'akan
Set Sterilisasi ,3 Au"o-la@e 43 oren"ang+ ;engkung+ Pen'epi" Ala" S"eril+ 40 =m #=!ea""le& Perlengkapan ,3 Apron9=elemek are" 43 Duk Pem(ungkus Ala" 03 Em(er Plas"ik Un"uk >eren)am Ala" 83 ;emari Ala" Un"uk Ala" ang Su)a! S" eril .3 Sika" Pem(ersi! Ala" 13 T empa" Sampa! Ter"u"up Dengan In'akan
Kemasan/Spesiikasi/ Merk Ersa
ari?a
Eli"e-!
Ersa
Satuan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
5/0+017322
Uni"
77+222322 ,1.+222322 ,07+.22322 ,,2+222322 002+222322 0+24.+222322 1$81#$000 48+422322 ,2+222322 ,2+222322 12+222322 12+222322 57+522322 ..+222322 ,01+822322 ,01+822322 12+.22322 022+222322 ,07+.22322 0,0+.22322
3,410,000
P-s
1.+,42322
P-s P-s P-s P-s P-s P-s
.+.22322 ,1.+222322 4.0+222322
7,637,000.00
12+.22322 0,0+.22322
ongkir ,+,//+222322
,+/22+222322
1,543,140
2,000,000.00
No
Nama Barang
Kemasan/Spesiikasi/ Merk
Set Puskesmas Keliling ,3 Ala" Pemasang IUD 43 Ala" Pemasang+ %orplan" 03 Baki ;ogam Tempa" Ala" S"eril Ber"u"up 83 Bein ;urus Besar .3 Bein ;urus e-il 13 Ekska@a"or Beru'ung Dua #Besar& 73 Ekska@a"or Beru'ung Dua #e-il& /3 Genera"or Se" mini )engan )aya Ou"pu" >aks3 23/. VA9/.2 Ca""+ Vol"ase A= 442 V9, P!ase9D= ,4V9/30A+ apasi"as Tangki Ba!an Bakar 8+. ; 53 Gun"ing Be)a! S"an)ar+ ;engkung ,23 Gun"ing P em(alu" #;is"er& ,,3 Iriga"or Dengan onek"or %ilon+ ;urus O""o ,43 a-a >ulu" Da"ar %o38 ,03 lem Ar"eri+ ;urus #elly& ,83 lem9Pemegang $arum $a!i"+ ,/ -m #>ayo6Hegar& ,.3 lem9Pen'epi" Porsio+ 4. -m #S-!ro)er& ,13 oren"ang+ ;engkung+ Pen'epi" Ala" S"eril+ 40 -m #=!ea""le& ,73 oren"ang+ Pen'epi" Sponge #Foers"er& ,/3 ;=D Pro'e-"or )engan Pen-a!ayaan >inimal 4222 ;umen ,53 >angkok un"uk ; aru"an 423 >angkuk un"uk laru"an #Dappen glas& 4,3 >e"eran 443 >i-rop!one Tanpa a(el 403 Palu Pengukur Re*lek 483 Pemu"ar V=D9DVD )an araoke yang ompa"i(el )engan Ber(agai >e)ia 4.3 Pengukur Pan'ang Bayi )an Tinggi Ba)an Anak 413 Pengungki" Akar Gigi #=ryer Dis"al& 473 Pengungki" Akar Gigi #=ryer >esial& 4/3 Penumpa" Plas"is 453 Pen ;an-e" 023 Pinse" Ana"omis+ ,8+. -m 0,3 Pinse" Ana"omis+ ,/ 043 Pinse" Gigi 003 Pompa P ayu)ara 9 Breas" Pump 083 S-aller + Bla-k iri )an anan #Type Hoe&
Satuan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s P-s
0.4+222322
P-s P-s P-s P-s P-s P-s P-s
4/+122322 4.+022322 487+582322 0.8+454322 4.+022322 ,07+.22322 1.+,42322
P-s P-s
1.+,42322 1.+,42322
P-s P-s P-s
.4+.4.322 ,5+4.2322 85+.22322
P-s
11+222322
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
814+222322 /4.+222322 /4.+222322 170+7.2322 45+722322 40+,22322 48+/12322 41+822322 1/7+.22322 8/+/82322
ongkir
45,+.22322 7,.+222322 7,.+222322 4.0+222322 4.0+222322
1.+222322
No 0.3 013
Nama Barang
0/3 053 823 8,3 843 803 883 8.3 813 873 8/3 853 .23 .,3 .43 .03 .83 ..3 .13 .73 ./3 .53 123 1,3 143 103 183 1.3
S-aller + S"an)ar+ Ben"uk Bulan Sa(i" #Type Si-kle& S-aller + S"an)ar+ Ben"uk =angkul anan #Type =!isel9>esial& S-aller + S"an)ar+ Ben"uk =angkul iri #Type =!isel9Dis"al& S-aller S"an)ar+ Ben"uk Tom(ak #Type Hoe& Sempri" Un"uk Telinga )an ; uka Sempri"+ Air Sempri"+ Gliserin Silin)er oren"ang e-il Skalpel Tangkai Pisau Operasi Skalpel+ >a"a Pisau Be)a! #%o3,2& Son)e Bengkok Son)e lurus Son)e U"erus9 Pen)uga Spalk Spa"ula P enga)uk Semen Gigi Spekulum Vagina #=o-or Be(ek& Besar Spekulum Vagina #=o-or Be(ek& e-il Spekulum Vagina #=o-or Be(ek& Se)ang Sp!ygmomanome"er )easa Sp!ygmomanome"er anak S"erilisa"or Por"a(le S"e"oskop Deasa S"e"oskop Anak S"e"oskop $anin S"ereo Soun) Sys"em Su)ip ;i)a! ;ogam+ Pan'ang ,4 -m Su)ip ;i)a! ;ogam+ Pan'ang ,1+. -m Tan)u ;ipa" Tang Pen-a(u" Akar Gigi A"as Ben"uk Bayone" Tang Pen-a(u" Akar Gigi Depan A"as Tang Pen-a(u" Akar Gigi Seri )an Sisa Akar Baa!
113 173 1/3 153 723 7,3
Tang Pen-a(u" Akar Gigi Terak!ir A"as Tang Pen-a(u" Akar Gigi Terak!ir Baa! Tang Pen-a(u" Gigi Gera!am A"as anan Tang Pen-a(u" Gigi Gera!am A"as iri Tang Pen-a(u" Gigi Gera!am Besar Baa! Tang Pen-a(u" Gigi Gera!am e-il A"as
073
Kemasan/Spesiikasi/ Merk
AD AD Eli"e-!
Satuan
Jumlah
Harga
P-s
04+.12322
P-s
47.+222322
P-s P-s
04+.12322 47.+222322
P-s P-s P-s Pa-k P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
,45+/22322 05+122322 ,1+.22322 022+222322 88+772322 48+422322 88+772322 /8+722322 ..+222322 442+222322 442+222322 442+222322 2,446,840
ongkir
360,000
2,446,840
360,000
3,410,000
1,543,140
8/5+.22322 858+/52322 8/7+022322
O""o O""o
P-s P-s P-s P-s P-s
11+222322 11+222322 ,+8,,+2/2322 .8.+582322 .8.+582322
,87+222322 ,87+222322
O""o O""o O""o O""o O""o O""o O""o
P-s P-s P-s P-s P-s P-s P-s
.8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322
,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322
No 743 703 783 7.3 713 773 7/3 753 /23
Nama Barang Tang Pen-a(u" Gigi Gera!am e-il e-il )an Taring Baa! Tangkai un"uk a-a >ulu" Termome"er Anak Termome"er Deasa Tim(angan Bayi 9 Tim(angan Da-in Tim(angan Deasa Tornike" are" Caskom Bengkok Caskom =ekung
Perlengkapan ,3 Bo"ol >ulu" ;e(ar 43 Bo"ol >ulu" Sempi" )engan T u"up Ulir 03 =elemek Plas"ik ;ampu sen"er Penggerus O(a" 83 Gelas Pengukur #,1 O9.22 ml& .3 Pen'epi" Ta(ung )ari ayu 13 Pompa Payu)ara un"uk A si 73 S"an)ar Caskom+ Tunggal /3 Tempa" Alko!ol #Dappen Glas& 53 Toples apas ;ogam ,23 Toples apas9asa S"eril ,,3 Caskom =u-i Set Pemeriksaan Umum !i Puskesmas Pem%antu ,3 Aliga"or Fors-eps P3487 43 Baki ;ogam Tempa" Ala" S" eril Ber"u"up 03 =orong Telinga9Spekulum Telinga P348,+ Ukuran e-il+ Besar+ Se)ang 83 Duk Bolong+ Se)ang .3 Emesis (asin9%ier(eken (esar 13 Gun"ing Be)a! S"an)ar+ ;urus 73 Gun"ing Benang /3 Gun"ing Pem(alu"+ ;is"er 53 lem Ar"eri+ ;urus #elly& ,23 lem9Pemegang $arum $a!i"+ ,/ -m #>ayo6Hegar& ,,3 oren"ang+ Pen'epi" Sponge #Foers"er& ,43 ;ampu sen"er un"uk periksa9 pen lig!" ,03 >e'a Ins"rumen9Ala" ,83 Pengukur "inggi (a)an
Kemasan/Spesiikasi/ Merk
O""o
Eli"e-!
Ersa
Ersa
Satuan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s P-s P-s P-s
P-s P-s P-s P-s P-s P-s
.8.+582322 88+270322 ,2,+7.2322 ,54+.22322 ,+0/1+222322 ,1.+222322 00+222322 0.4+222322 4.0+222322
ongkir
,5+222322
,+.8.+.22322
1/7+.22322
1,354,672.00
.4+.4.322 #1!$2#0 #1!$2#0 4.0+222322
P-s P-s
442+222322 45,+.22322
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s Uni" P-s
77+222322 ,1.+222322 0.4+222322 44+222322 4/+122322 4.+022322 11+222322 ,07+.22322 1.+,42322 50+.22322 0+24/+222322 85+.22322
1,596,000.00
,+2.1+222322
No 13 73 /3 53
Nama Barang
Kemasan/Spesiikasi/ Merk
Jumlah
Harga
P-s P-s P-s P-s
Sika" un un"uk >e >em(ersi!kan Pe Perala"an S"eek ;aken #Sprei e-il& Tempa" Sampa! Ter"u"up Toples apas9asa S"eril
Set Kepera#atan Kesehatan Mas&arakat ,3 Ala" Tes" Dara! Por"a(le Por"a(le 9 rapi) rapi) )iagnos"i- "es" # H(+ Gula )ara!+ Asam Ura"+ oles"erol& 43 Bak Ins"rumen )ilengkapi Tu"up 03 Gun"ing Angka" $a!i"an 83 Gun"ing Iris ;urus .3 Gun"ing $aringan 13 Gun"ing Ver(an) 73 lem Ar"eri /3 om Io)ine 53 om apas S"eril ,23 om )ilengkapi "u"up ,,3 %ier(eken ,43 Palu Re*le? ,03 Peak Flo >e"er ,83 Pen lan-e" ,.3 Pe P enlig!" ,13 Pinse" Ana"omis ,73 Pinse" =irurgis ,/3 Sp!ygmomanome"er Deasa )an anak ,53 S"e"oskop Anak 423 S"e"oskop Deasa 4,3 Termome"er 443 Tim(angan Ba)an Deasa
Satuan
12+.22322 ,07+.22322 0,0+.22322 .,8+4.2322
P-s
12.+222322
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
45,+.22322 4/+122322 /4+.22322 4/+122322 4.+022322 11+222322 .4+.4.322 .4+.4.322 .4+.4.322 /0+2.2322 11+222322 052+.22322 00+222322 50+.22322 40+,22322 ,/+722322 4+881+/82322 858+/52322 8/5+.22322 ,54+.22322 ,1.+222322
Perlengkapan ,3 Duk Biasa 43 Duk Bolong 03 >e"eran Gulung 83 Perlak Besar .3 Perlak e-il 13 Tas an@as "empa" ki"
P-s P-s P-s P-s P-s P-s
,1.+222322 ,1.+222322 85+.22322 57+522322 57+522322 022+222322
Kit Imunisasi ,3 Vaksin =arrier
P-s
04.+222322
A D
ongkir
012+222322
No
Nama Barang
Kemasan/Spesiikasi/ Merk
Satuan
Jumlah
Harga
Kit UKS ,3 43 03 83 .3 13 73 /3
Garpu Tala .,4 H9 ,248 H 9 42/8 H Palu pengukur re*leks Pengai" serumen Pengukur "inggi (a)an Pin!ole Snellen+ ala" un"uk pemeriksaan @isus Spe-ulum !i)ung #;emper"& Spe-ulum "elinga )engan ukuran ke-il+ se)ang+ (esar
P-s P-s P-s P-s
,0.+782322 11+222322 /8+412322 85+.22322
P-s P-s P-s
..+222322 020+122322
53 ,23 ,,3
S"e"oskop Su)ip li)a!+ logam pan'ang ,4 -m Sp!ygmomanome"er )engan manse" anak )an )easa
P-s P-s P-s
77+222322 8/5+.22322 11+222322
,43 ,03 ,83 ,.3
T!ermome"er klinis Tes (u"a arna #ISHIHARA& Tim(angan )easa Tornike" are"
4+881+/82322 44+222322 55+222322 ,1.+222322 00+222322
8/8+222322
882+222322
882+222322
882+222322 442+222322 ,5/+222322 418+222322 10/+222322 ,,5+848322 ,,5+848322 ,,5+848322 ,,5+848322 /+012+222322 0.8+454322 0.8+454322 170+7.2322 ,25+7.7322 ,25+7.7322
N'
A D
P-s P-s P-s P-s
ongkir
012+222322
JENIS PERA*ATAN
I, Kit UK"S , A"rauma"i- Res"ora"i@e Res"ora"i@e Trea"men #ART& Enamel A--ess A--ess =u""er 4 Eksa@a"or Ber(en"uk Ber(en"uk Sen)ok Ukuran Ukuran e-il # Spoon E?-a@a"or Small& 0 Eksa@a"or Ber(en"uk Sen)ok Ukuran Se)ang # Spoon E?-a@a"or >e)ium & 8 Eksa@a"or Ber(en"uk Ber(en"uk Sen)ok Ukuran Ukuran Besar # Spoon E?-a@a"or ;arge& . Dou(le En)e) Applier an) =ar@er 1 Spa"ula Plas"ik 7 Ha Ha"-!e" / Ba"u Asa! 5 Ekska@a"or Beru'ung Dua #Besar& ,2 Ekska@a"or Beru'ung Dua #e-il& ,, ursi Gigi ;apangan ,4 a-a mulu" nomor 8 "anpa "angkai ,0 Penumpa" Plas"is ,8 Pinse" Gigi
P-s P-s P-s P-s
O""o O""o O""o O""o
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
7,+222322 7,+222322 1.+222322 7,+222322
No ,. ,1 ,7 ,/
Nama Barang
,5
Skeler S"an)ar+ Ben"uk Tom(ak #Type Hoe& Skeler+ Bla-k iri )an anan #Type Hoe& Skeler+ S"an)ar+ Ben"uk Bulan Sa(i" #Type Si-kle& Skeler+ S"an)ar+ Ben"uk =angkul anan #Type =!isel9>esial& Skeler+ S"an)ar+ Ben"uk =angkul iri #Type =!isel9Dis"al&
42 4, 44 40 48 4. 41 47 4/ 45 02 0,
Son)e ;engkung Son)e ;urus Spa"ula Penga)uk Semen Tang Pen-a(u"an Anak #, Se"& Tang Gigi An"erior Ra!ang A"as Tang >olar Ra!ang A"as Tang >olar Susu Ra!ang A"as Tang Gigi An"erior Ra!ang Baa! Tang >olar Ra!ang Baa! Tang Sisa Akar Ra!ang Baa! S"erilisa"or #Pressure =ooker& Tangkai un"uk a-a >ulu"
Kemasan/Spesiikasi/ Merk
Satuan P-s P-s P-s P-s P-s
O""o
O""o O""o O""o O""o O""o O""o O""o Eli"e-! O""o
Perlengkapan ,3 Tempa" Alko!ol #Dappen Glas& 43 Toples apas ;ogam )engan Pegas )an Tu"up #.2 ? 7. mm& 03 Toples apas9asa S"eril 83 Toples Pem(uangan apas #.2 ? 7. mm& .3 Pan"om >o)el Gigi 13 Gam(ar Ana"omi Gigi 73 Baki ;ogam Tempa" Ala" S"eril Ber"u"up /3 Tas an@as "empa" ki" Kit Bi!an ,3 Ala" Peng!isap ;en)ir De;ee 9 Bul( 43 Ala" Peng!isap ;en)ir Elek"rik 03 Bak Ins"rumen )engan "u"up 83 Baki ;ogam Tempa" Ala" S"eril Ber"u"up .3 Bengkok e-il 13 Bengkok Besar 73 Doppler Eli"e-! /3 Gun"ing Benang 53 Gun"ing Episio"omi ,23 Gun"ing Ver(an)
P-s P-s P-s Se" P-s P-s P-s P-s P-s P-s P-s P-s
Jumlah
Harga
04+.12322 8/+/82322 04+.12322
47.+222322
04+.12322 ,17+710322 ,04+222322 ,07+527322 0+47.+182322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 .8.+582322 0+8,2+222322 88+270322
.4+.4.322
P-s P-s
.,8+4.2322 .,8+4.2322 .,8+4.2322
P-s P-s
4,5+.22322 022+222322
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
##$000 4+7.2+222322 45,+.22322 45,+.22322 /0+2.2322 0.4+222322 4+0,2+222322 4/+122322 ..+222322 4.+022322
P-s P-s
ongkir
1.+222322
//4+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,87+222322 ,+.80+,82322 ,5+222322
,/5+482322
No ,,3 ,43 ,03 ,83 ,.3 ,13 ,73 ,/3 ,53 423 4,3 443 403 483 4.3 413 473 4/3 453 023 0,3 043 003 083 0.3 013 073 0/3 053 823 8,3 843 803 883 8.3 813 873 8/3 853 .23 .,3
Nama Barang Gun"ing Tali Pusa" Pemeriksaan H( lem Pean9 lem Tali Pusa" or-!er Tang ,94 lem or-!er9 Peme-a! e"u(an ;an-e" >angkok un"uk ;aru"an >e"eran Palu Re*leks Pen'epi" U"erus Pel@ime"er O(s"e"rik Pengukur Pan'ang Ba)an Bayi Pengukur ;ingkar epala Pengukur Pan'ang Ba)an Bayi Pengukur Tinggi Ba)an #>i-ro"oise& Pinse" Ana"omi Pen)ek Pinse" Ana"omi Pan'ang Pinse" Be)a! Pisau Pen-ukur Pi"a Pengukur ;ila Penu"up >a"a #Oklu)er& S"e"oskop $anin S"e"oskop %eona"us Su)ip li)a! logam pan'ang ,4 -m Su)ip li)a! logam pan'ang ,1+. -m Son)e mulu" Son)e U"erus9Pen)uga Spekulum Vagina #=o-or Be(ek& Besar Spekulum Vagina #=o-or Be(ek& e-il Spekulum Vagina #=o-or Be(ek& Se)ang S"e"oskop Silin)er oren"ang S"eril Spekulum Vagina #Sims& Ta(ung un"uk (ilas @agina Tampon Tang Termome"er Da!i )an Telinga T!ermome"er )igi"al Termome"er Deasa Tensime"er Deasa Tim(angan Deasa Tim(angan Bayi
Kemasan/Spesiikasi/ Merk
Eli"e-!
AD Eli"e-!
Satuan
Jumlah
Harga
P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s P-s
4/+/42322 8+822+222322 11+222322 00+882322 ..+222322 ,/+,.2322 .4+.4.322 85+.22322 11+222322 11+222322 .,5+7.2322 814+222322 .+.22322 814+222322 85+.22322 40+,22322 40+,22322 ,/+722322 ,/+722322 .+.22322 0/+.22322 4+0,2+222322 8/7+022322 11+222322 11+222322
P-s P-s P-s P-s P-s P-s P-s
88+772322 442+222322 442+222322 442+222322 8/5+.22322 ,2/+242322 442+222322
P-s P-s P-s P-s P-s P-s P-s
,4,+222322 5,/+.22322 ,54+.22322 ,54+.22322 4+881+/82322 ,1.+222322 ,+0/1+222322
ongkir
,/5+482322
012+222322 ,+.8.+.22322
No .43 .03 .83 ..3 .13 .73 ./3 .53
Nama Barang Toples apas 9 asa S"eril Tornike" are" Tromol asa 9 ain S"eril Resusi"asi Deasa (eser"a masker Resusi"asi Bayi (eser"a masker Caskom Bengkok Caskom =ekung Ceig!" (a(y s-ale < "ray *or 42 kg
Perlengkapan ,3 Duk s"eril kar"un 43 o"ak Penyimpan $arum a"au Pisau Bekas 03 Sen"er < (a"erai (esar 83 Sarung Tangan are" un"uk >en-u-i Ala" .3 Sika" un"uk >em(ersi!kan Perala"an 13 S"op Ca"-! 73 Tas "a!an air "empa" ki" /3 Tempa" ain o"or 53 Tempa" Plasen"a Kit Pos&an!u , Ala" Permainan E)uka"i* 4 Foo) >o)el 0 Gun"ing per(an 8 Tim(angan Bayi . Tim(angan Da-in )an perlengkapannya 1 Tim(angan Deasa 7 Termome"er Anak Perlengkapan ,3 Tas kan@as "empa" ki" Set Kesehatan *ingkungan ,3 .222 p!o"o me"er 43 Bo"ol sampel air (ermulu" le(ar 03 Bo"ol sampel air (erpem(era" 83 =akram #kekeru!an kolam renang& .3 =ompara"or un"uk mengukur #iron+ magnese+ni"ra"+ ni"ri"+ "o"al !ar)ness+ "o"al )issol@e)+soli)& 13
Digi"al -!lorin "es" ki"
Kemasan/Spesiikasi/ Merk
Eli"e-!
Reme)i
Eli"e-!
Satuan
Jumlah
Harga
P-s P-s P-s Se" Se" P-s P-s P-s
.,8+4.2322 00+222322 .,8+4.2322 ,+240+222322 ,+240+222322 0.4+222322 4.0+222322 ,+0/1+222322
P-s P-s P-s Pasang P-s P-s P-s
,1.+222322 02+/22322 50+.22322 ,7+822322 12+.22322 ,,2+222322 04.+222322
P-s
442+222322
P-s P-s
4.+022322 ,+0/1+222322
P-s P-s
,1.+222322 ,2,+7.2322
P-s
022+222322
ongkir
,+.8.+.22322
1,914
,+.8.+.22322
No 73 /3 53 ,23 ,,3 ,43 ,03 ,83 ,.3 ,13 ,73 ,/3 ,53 423 4,3
Nama Barang Digi"al P! me"er T!ermome"er Tur(i)i"y me"er Ta(ung pengukur kekeru!an ompara"or un"uk mengukur -!lor -!lor Pengukur me"er Pengukur kelem(a(an #!ygrome"er& Ala" un"uk pengukur 'umla! -a-ing )alam "ana! #Soil "es" ki"& Ala" pengukur ke(u"u!an nu"risi ruma! "angga Ala" pengukur kon"aminasi makanan )an minuman # *oo) sani"a"ion ki"& Fly seep ne" *ly griil Pipe" "e"es Pisau pemo"ong yang s"eril Penangkap nyamuk )an lar@a # sur@eillan-e & @e-"or ki" Ala" pem(eran"asan sarang nyamuk
Kemasan/Spesiikasi/ Merk
Satuan
Jumlah
Harga
ongkir
Total Harga
Keterangan
./0+112322 45,+.22322 752+.72322 55+222322 77+222322 0.4+222322 ,0.+782322 6 6 6 6 0,+482322 081+.22322 50+.22322 8+11/+,/2322 6 ,,+222322 4+818+222322 ,+1/2+222322 11+222322 00+222322 6 ..+222322 442+222322 020+122322 4+/21+/82322 E a"alog 8/5+.22322 11+222322
Total Harga
Keterangan
11+222322 7+,22+222322 E a"alog ,54+.22322 ,1.+222322 ,+0.8+712322 ,,2+222322 442+222322 8+/4.+222322 E ka"alog 77+222322 5+./7+222322 E ka"alog 8+2/8+222322 E ka"alog 85+.22322 57+522322 12+222322 ..+222322 022+222322 12+.22322 ,,2+222322 0,0+.22322 45,+.22322 77+882322 77+882322
77+222322 4+855+482322 E a"alog 40+,22322 0.+5//+122322 E a"alog 0.4+222322 442+222322 07+822322 ,.1+842322 44+222322 44+222322 44+222322
Total Harga
Keterangan
44+222322 44+222322 44+222322 44+222322 4/+122322 4/+122322 6 6 6 6 6 /8+412322 ,4+255322 E a"alog ,4+255322 E a"alog 00+882322 02+/22322 4.+512322 02+/22322
4.+512322 4.+022322 81+842322 1.+,42322 1.+,42322 ,+/,.+222322 081+.22322 0+142+,22322 0+142+,22322 0+142+,22322 ,10+082322 ,+/,4+222322 E a"alog ,+1/2+222322 11+222322 6 40+,22322 00+222322 ,/+722322
Total Harga
47+.22322 4/+122322 4,+7/2322 882+222322 ,+240+222322 ,+240+222322 ,+240+222322 ,4,+112322 ,85+,12322 ,2/+242322 ,1+.22322 /8+722322 020+122322 442+222322 4+/21+/82322 4+/21+/82322 8+1.2+222322 4+/22+222322 858+/52322 851+5/2322 4+855+482322 4+7.2+222322
Keterangan
E E E E
a"alog a"alog a"alog a"alog
E a"alog
11+222322
11+222322 ,+8,5+222322 7+,22+222322 E a"alog ,1.+222322 ,54+.22322 ,1.+222322 ,1.+222322 ,/+722322 00+222322 ,2+,22+222322 E a"alog
45,+.22322 ,,2+222322 .+.22322