Anda di halaman 1dari 50

DAFTAR HASIL PENGADAAN BARANG

UPT : UPT PUSKESMAS SENDANG


Kabupaten : CIREBON
Gol Barang : BELANJA MODAL
Bulan : DESEMBER 2016
SPK / Perjanjian / Kontrak DPA / SPM / SP2D / Kwitansi
No Jenis Barang Dibeli Banyaknya
Tanggal Nomor Tanggal Nomor
Barang
1 2 3 4 5 6 7
Belanja Modal Pengadaan komputer/PC
Merk ASUS ( seri K31 CD-1001 iD, Procc G 4400, Ram DDR3 4 GB,LED 18.5" ) 12/16/2016 380/XII/2016 2
2 Belanja Modal Pengadaan Komputer Notebook
Notebook Merk Dell.Inspiron 14-3458 Ram 4 GB Hdd 500 GB Black 12/16/2016 380/XII/2016 2
3 Belanja Modal Pengadaan Printer
Printer EPSON L310 12/16/2016 383/XII/2016 1
Printer EPSON L365 12/16/2016 383/XII/2016 1
Belanja Modal Pengadaan UPS/Stabilizer
Belanja Modal Perangkat Lunak Sistem Operasi
Belanja modal Pengadaan Sound System
Speaker system ( Rocky ) 12/14/2016 365/XII/2016 1
Belanja modal Pengadaan Televisi
Samsung 43 Inci 12/13/2016 355/XII/2016 1
Belanja modal Pengadaan Penyedot Debu
Vacum Tipe Home Use aeru 21-01 pc 12/13/2016 358/XII/2016 1
Belanja modal Pengadaan AC Split
LG 1 PK 12/13/2016 361/XII/2016 7
Belanja modal Pengadaan Kipas Angin
Kipas Angin Air Monster 12/14/2016 364/XII/2016 1
Belanja modal PengadaanVCD/DVD Player
Pengadaan VCD/DVD player Samsung 12/14/2016 373/XII/2016 1
Belanja modal Pengadaan Camera
Camera Canon 12/15/2016 370/XII/2016 1
Belanja modal Pengadaan Meubelar
Lemari Locker sdie+door (L ) lokcker 12 DRS WHT-YLW P(1/2 ) 12/19/2016 396/XII/2016 1
Kursi Lipat 12/19/2016 397/XII/2016 30
Dispenser Cosmos 12/19/2016 398/XII/2016 1
Filing Kabinet Playwood L. 50. P. 150 Cm 12/20/2016 402/XII/2016 1
Papan Whiteboard Kabinet ( 244 X 122 Cm ) 12/20/2016 406/XII/2016 1
Lemari Playwood L50 X P 290 Cm 12/21/2016 412/XII/2016 4
Papan Plang puskesmas (360 X 150 Cm ) 12/21/2016 412/XII/2016 1
Meja kerj1 1/2 biro 12/21/2016 415/XII/2016 3
Rak Buku Playwood 12/21/2016 418/XII/2016 1
Running teks (200 X21 Cm ) 12/23/2016 424/XII/2016 1
Pembelian Papan Informasi ( 50 X 60 Cm ) 12/23/2016 427/XII/2016 1
Belanja Modal Pengadaan Konstruksi
Rehab/Perbaikan sedang ruang/Bangunan Puskesmas 12/28/2016 465/XII/2016 1
Pembuatan kanopi Parkir motor dan Mobil 12/28/2016 468/XII/2016 1
1. Pipa Galvanis dia 2" ( 24,18 m' ))
2. Rangka Atap Pipa Galvanis Dia 1" ( 50,46 M' )
3. Pemasangan UNP 200 x 75x8,5 mm' ( 308,04 kg )
4. Pasangan Atap Zincalum, 36,46 M2
5. Pengecatan Besi ( ( 16 M2 )
Belanja Modal Pengadaan Pengecatan
Pengadaan pengecatan 12/27/2016 431/XII/2016 1
Cat Dulux Catylac Putih 2 Peal
Cat Dulux Exterior Blue 4 Galon
Koas Eterna, roll Ace, Baki cat
Compound
Wallpaper
Belanja modal Pengadaan alat-alat kedokteran Gigi
Belanja modal Pengadaan alat-alat kedokteran Umum
Belanja modal Pengadaan alat-alat kedokteran kebidanan dan penyakit kandungan
Doppler Niifish 12/15/2016 373/XII/2016 1
Belanja modal Pengadaan alat-alat laboratorium biologi
Belanja modal Pengadaan instalasi listrik
Tambah Daya Listrik 12/20/2016 400/XII/2016 1
TOTAL

Mengetahui :
KEPALA UPT PUSKESMAS SENDANG
KABUPATEN CIREBON

ETI ENTIN EFWANITA,SKM, M. Kes


NIP. 19730117 199303 2 004
G

Jumlah
Diperguna
kan Pada Ket
Harga Satuan Jumlah Harga
Unit
8 9 10 11

7,300,000 14,600,000

7,400,000 14,800,000

3,000,000 3,000,000
3,000,000 3,000,000

3,925,000 3,925,000

7,350,000 7,350,000

3,400,000 3,400,000

4,950,000 34,650,000

975,000 975,000

1,850,000 1,850,000

4,750,000 4,750,000

3,499,000 3,499,000
289,000 8,670,000
285,000 285,000
4,300,000 4,300,000
2,300,000 2,300,000
3,400,000 13,600,000
4,900,000 4,900,000
2,400,000 7,200,000
2,400,000 2,400,000
3,900,000 3,900,000
3,850,000 3,850,000

80,500,000 80,500,000
149,184,000 149,184,000

7,000,000 7,000,000 348,488,000

1,850,000 1,850,000

5,000,000 5,000,000
Rp 322,957,000 Rp 390,738,000
Sendang, 09 Januari 2017

Pengurus Barang

WAHYUDI
NIP.19820310 201409 1 002
DAFTAR HASIL PENGADAAN BARANG
UPT : UPT PUSKESMAS SENDANG
Kabupaten : CIREBON
Gol Barang : HABIS PAKAI
Bulan : DESEMBER 2016
SPK / Perjanjian / Kontrak DPA / SPM / SP2D / Kwitansi Jumlah
No Jenis Barang Dibeli
Tanggal Nomor Tanggal Nomor Banyaknya Barang Harga Satuan
1 2 3 4 5 6 7 8
1 Belanja Alat Tulis Kantor (ATK)
Odner 12/16/2016 341/XII/2016 56 18,000
Kertas HVS 12/16/2016 341/XII/2016 10 32,000
Buku Kwarto 100 lbr 12/16/2016 341/XII/2016 30 6,500
Kertas A4 12/16/2016 341/XII/2016 2 27,000
Nota 12/16/2016 341/XII/2016 5 2,000
Kwitansi 12/16/2016 341/XII/2016 2 2,500
Stempel Tanggal 12/16/2016 341/XII/2016 1 12,000
Gunting 12/16/2016 341/XII/2016 2 7,000
Kertas Karbon 12/16/2016 341/XII/2016 1 40,000
Klip 12/16/2016 341/XII/2016 2 2,000
Memo Stik 12/16/2016 341/XII/2016 1 18,000
Spidol marker 12/16/2016 341/XII/2016 2 5,500
Tinta marker 12/16/2016 341/XII/2016 1 10,000
Binder klip 12/16/2016 341/XII/2016 1 7,000
Bok File 12/16/2016 341/XII/2016 12 16,000
ppn 10% 12/16/2016 342/XII/2016 1 172,727
Map plastik 12/13/2016 352/XII/2016 5 20,000
Zipper bag 12/13/2016 352/XII/2016 12 6,500
Map kertas 12/13/2016 352/XII/2016 50 320
Buku tulis isi 38 lbr 12/13/2016 352/XII/2016 40 1,650
Buku tulis bigboss 12/13/2016 352/XII/2016 10 2,500
Buku folio isi 100 lbr 12/13/2016 352/XII/2016 12 11,000
Buku folio isi 200 lbr 12/13/2016 352/XII/2016 7 22,000
Stabilo 12/13/2016 352/XII/2016 2 3,500
Bak stempel 12/13/2016 352/XII/2016 2 5,000
Isi bak stempel 12/13/2016 352/XII/2016 2 8,000
Bulpen 12/13/2016 352/XII/2016 2 11,500
Penghapus 12/13/2016 352/XII/2016 10 2,000
Tipe x 12/13/2016 352/XII/2016 1 47,000
Staples 12/13/2016 352/XII/2016 8 11,500
Isi staples 12/13/2016 352/XII/2016 30 975
Double tip 12/13/2016 352/XII/2016 2 3,000
Pensil 12/13/2016 352/XII/2016 1 30,000
Tinta epson warna 12/13/2016 352/XII/2016 5 75,000
Tinta epson hitam 12/13/2016 352/XII/2016 2 80,000
Kertas foto 12/13/2016 352/XII/2016 1 22,000
Kertas puyer 12/13/2016 352/XII/2016 6 16,500
Plastik obat 12/13/2016 352/XII/2016 4 25,000
Penggaris 12/13/2016 352/XII/2016 7 1,500
Kertas stiker 12/13/2016 352/XII/2016 1 3,500
Spidol warna 12/13/2016 352/XII/2016 1 12,000
Gunting 12/13/2016 352/XII/2016 1 9,000
Pembolong kertas 12/13/2016 352/XII/2016 1 14,000
JUMLAH 823,172
2 Belanja Perangko, Materai dan Benda Pos Lainnya
Materai 3000 12/5/2016 347/XII/2016 10 3,000
Materai 6000 12/5/2016 347/XII/2016 10 6,000
JUMLAH 20 9,000
3 Belanja Kelengkapan (Aksesoris) Komputer

Modem 12/27/2016 440/XII/2016 1 200,000

Flashdish 12/27/2016 440/XII/2016 4 80,000

Presenter PP 12/27/2016 440/XII/2016 1 90,000

TP Link 12/27/2016 440/XII/2016 1 130,000

Mouse 12/27/2016 440/XII/2016 3 60,000

Keyboard Mouse 12/27/2016 440/XII/2016 2 150,000

Speaker Besar 12/27/2016 440/XII/2016 1 300,000

Speaker 12/27/2016 440/XII/2016 1 180,000

DVD External 12/27/2016 440/XII/2016 2 400,000


PPN 10% 12/27/2016 441/XII/2016 1 227,273

PPH 3% 12/27/2016 442/XII/2016 1 68,182

JUMLAH 1,885,455

4 Belanja Bahan Obat-obatan


JUMLAH N I
5 Belanja Cetak
Kartu antrian pasien 12/16/2016 343/XII/2016 3 90,000
Blanko rujukan bpjs 12/16/2016 343/XII/2016 15 25,000
Kartu ibu 12/16/2016 343/XII/2016 1 75,000
Blanko PHN 12/16/2016 343/XII/2016 2 90,000
Kartu pasien 12/16/2016 393/XII/2016 4 100,000
Rekam medik pasien 12/16/2016 393/XII/2016 3 700,000
Ppn 10% 12/16/2016 394/XII/2016 1 227,273
Pph 4% 12/16/2016 395/XII/2016 1 109,109
JUMLAH 1,416,382
6 Belanja Penggandaan
Penggandaan 12/27/2016 443/XII/2016 4000 200
JUMLAH 200
7 Belanja Penjilidan
TOTAL
Mengetahui : Sendang, 09
KEPALA UPT PUSKESMAS SENDANG
KABUPATEN CIREBON Penguru

ETI ENTIN EFWANITA,SKM, M. Kes WAH


NIP. 19730117 199303 2 004 NIP.19820310

Belanja Alat Tulis Kantor (ATK)


Belanja Perangko, Materai dan Benda Pos Lainnya
Belanja Kelengkapan (Aksesoris) Komputer
Belanja Bahan Obat-obatan
Belanja Cetak
Belanja Penggandaan
Belanja Penjilidan
Jumlah
Ket
Jumlah Harga
Dipergunakan Pada Unit
9 10 11

1,008,000 TU Nop
320,000 TU Nop
195,000 TU Nop
54,000 TU Nop
10,000 TU Nop
5,000 TU Nop
12,000 TU Nop
14,000 TU Nop
40,000 TU Nop
4,000 TU Nop
18,000 TU Nop
11,000 TU Nop
10,000 TU Nop
7,000 TU Nop
192,000 TU Nop
172,727 TU Nop
100,000 TU Des
78,000 TU Des
16,000 TU Des
66,000 TU Des
25,000 TU Des
132,000 TU Des
154,000 TU Des
7,000 TU Des
10,000 TU Des
16,000 TU Des
23,000 TU Des
20,000 TU Des
47,000 TU Des
92,000 TU Des
29,250 TU Des
6,000 TU Des
30,000 TU Des
375,000 TU Des
160,000 TU Des
22,000 TU Des
109,000 TU Des
100,000 TU Des
10,500 TU Des
3,500 TU Des
12,000 TU Des
9,000 TU Des
14,000 TU Des
3,738,977 3738977

30,000
60,000
90,000 90,000

200,000
320,000
90,000
130,000
180,000
300,000
300,000
180,000
800,000
227,273
68,182
2,795,455
2,795,455

H I L

270,000 NOP
375,000 NOP
75,000 NOP
180,000 NOP 900,000
400,000 DES 2,836,382
2,100,000 DES
227,273 DES
109,109
3,736,382 3,736,382

800,000
800,000 800,000

11,160,814 14897196
Sendang, 09 Januari 2017

Pengurus Barang

171864
WAHYUDI
NIP.19820310 201409 1 002
172000 168 1023.81

58000
420000
172000
650000
DAFTAR HASIL PENGADAAN BARANG
UPT : UPT PUSKESMAS SENDANG
Kabupaten : CIREBON
Gol Barang : PEMELIHARAAN
Bulan : DESEMBER 2016

SPK / Perjanjian / Kontrak DPA / SPM / SP2D / Kwitansi Jumlah


No Jenis Barang Dibeli Banyaknya Harga
Tanggal Nomor Tanggal Nomor Jumlah Harga
Barang Satuan
1 2 3 4 5 6 7 8 9
1 Pemeliharaan Wastafel
12/27/2016 434/XII/2016 1 3400000 Rp 3,400,000

TOTAL Rp 3,400,000 Rp 3,400,000

Sendang, 09 Januari 2017


Mengetahui :
KEPALA UPT PUSKESMAS SENDANG Pengurus Barang
KABUPATEN CIREBON

ETI ENTIN EFWANITA,SKM, M. Kes WAHYUDI


NIP. 19730117 199303 2 004 NIP.19820310 201409 1 002
Dipergunakan Ket
Pada Unit
10 11

09 Januari 2017

urus Barang

AHYUDI
10 201409 1 002
LAPORAN PERSEDIAAN BARANG (STOCK OPNAME)

TAHUN 2016

UPT : UPT PUSKESMAS SENDANG


Kabupaten : CIREBON
Gol Barang : STOK OPNAME
Bulan : DESEMBER 2016

NO./ TANGGAL SURAT DASAR PENERIMAAN/ BARANG JUMLAH HARGA BARANG YANG DITERIMA / YANG DIKELUARKAN/ SISA
TANGGAL URAIAN SISA HARGA SATUAN (Rp)
PENGELUARAN
MASUK KELUAR MASUK KELUAR
BARANG PAKAI HABIS
5.2.2.02.04 Belanja Bahan Obat-obatan
Rp - Rp -
Rp - Rp -

N I H I L
Rp - Rp -
Rp - Rp -
Rp - Rp -
Rp - Rp -
Rp - Rp -
Rp - Rp -

JUMLAH #REF! #REF!


Sendang, 09 Januari 2017
Mengetahui :
KEPALA UPT PUSKESMAS SENDANG Pengurus Barang
KABUPATEN CIREBON

ETI ENTIN EFWANITA,SKM, M. Kes WAHYUDI


NIP. 19730117 199303 2 004 NIP.19820310 201409 1 002
ITERIMA / YANG DIKELUARKAN/ SISA
KET.
SISA
-

Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -

#REF!
Sendang, 09 Januari 2017

Pengurus Barang

WAHYUDI
NIP.19820310 201409 1 002
DAFTAR HASIL PENGADAAN
UPT : UPT PUSKESMAS SENDANG
Kabupaten : CIREBON
Gol Barang : TOTAL BELANJA BULANAN
Bulan : DESEMBER 2016
SPK / Perjanjian / DPA / SPM / SP2D /
Jumlah
Kontrak Kwitansi
No Jenis Barang Dibeli Banyaknya
Tanggal Nomor Tanggal Nomor Harga Satuan
Barang
1 2 3 4 5 6 7 8
1 Honorarium Panitia Pelaksana Kegiatan
Nara Sumber Edukasi 12/16/2016 391/XII/2016 1 332,500
PPh psl 21 (5%) 12/16/2016 392/XII/2016 1 17,500
Instruktur Senam 12/9/2016 350/XII/2016 1 380,000
PPh psl 21 (5%) 12/9/2016 351/XII/2016 1 20,000
JUMLAH 750,000
2 Honorarium Tim Pengadaan Barang dan Jasa NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
3 Belanja Alat Tulis Kantor (ATK) NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
Odner 12/16/2016 341/XII/2016 56 18,000
Kertas HVS 12/16/2016 341/XII/2016 10 32,000
Buku Kwarto 100 lbr 12/16/2016 341/XII/2016 30 6,500
Kertas A4 12/16/2016 341/XII/2016 2 27,000
Nota 12/16/2016 341/XII/2016 5 2,000
Kwitansi 12/16/2016 341/XII/2016 2 2,500
Stempel Tanggal 12/16/2016 341/XII/2016 1 12,000
Gunting 12/16/2016 341/XII/2016 2 7,000
Kertas Karbon 12/16/2016 341/XII/2016 1 40,000
Klip 12/16/2016 341/XII/2016 2 2,000
Memo Stik 12/16/2016 341/XII/2016 1 18,000
Spidol marker 12/16/2016 341/XII/2016 2 5,500
Tinta marker 12/16/2016 341/XII/2016 1 10,000
Binder klip 12/16/2016 341/XII/2016 1 7,000
Bok File 12/16/2016 341/XII/2016 12 16,000
ppn 10% 12/16/2016 342/XII/2016 1 172,727
Map plastik 12/13/2016 352/XII/2016 5 20,000
Zipper bag 12/13/2016 352/XII/2016 12 6,500
Map kertas 12/13/2016 352/XII/2016 50 320
Buku tulis isi 38 lbr 12/13/2016 352/XII/2016 40 1,650
Buku tulis bigboss 12/13/2016 352/XII/2016 10 2,500
Buku folio isi 100 lbr 12/13/2016 352/XII/2016 12 11,000
Buku folio isi 200 lbr 12/13/2016 352/XII/2016 7 22,000
Stabilo 12/13/2016 352/XII/2016 2 3,500
Bak stempel 12/13/2016 352/XII/2016 2 5,000
Isi bak stempel 12/13/2016 352/XII/2016 2 8,000
Bulpen 12/13/2016 352/XII/2016 2 11,500
Penghapus 12/13/2016 352/XII/2016 10 2,000
Tipe x 12/13/2016 352/XII/2016 1 47,000
Staples 12/13/2016 352/XII/2016 8 11,500
Isi staples 12/13/2016 352/XII/2016 30 975
Double tip 12/13/2016 352/XII/2016 2 3,000
Pensil 12/13/2016 352/XII/2016 1 30,000
Tinta epson warna 12/13/2016 352/XII/2016 5 75,000
Tinta epson hitam 12/13/2016 352/XII/2016 2 80,000
Kertas foto 12/13/2016 352/XII/2016 1 22,000
Kertas puyer 12/13/2016 352/XII/2016 6 16,500
Plastik obat 12/13/2016 352/XII/2016 4 25,000
Penggaris 12/13/2016 352/XII/2016 7 1,500
Kertas stiker 12/13/2016 352/XII/2016 1 3,500
Spidol warna 12/13/2016 352/XII/2016 1 12,000
Gunting 12/13/2016 352/XII/2016 1 9,000
Pembolong kertas 12/13/2016 352/XII/2016 1 14,000
JUMLAH 823,172
4 Belanja Perangko, Materai dan Benda Pos Lainnya
Materai 3000 12/5/2016 347/XII/2016 10 3,000
Materai 6000 12/5/2016 347/XII/2016 10 6,000
JUMLAH 9,000
5 Belanja Kelengkapan (Aksesoris) Komputer
Modem 12/27/2016 440/XII/2016 1 200,000
Flashdish 12/27/2016 440/XII/2016 4 80,000
Presenter PP 12/27/2016 440/XII/2016 1 90,000
TP Link 12/27/2016 440/XII/2016 1 130,000
Mouse 12/27/2016 440/XII/2016 3 60,000
Keyboard Mouse 12/27/2016 440/XII/2016 2 150,000
Speaker Besar 12/27/2016 440/XII/2016 1 300,000
Speaker 12/27/2016 440/XII/2016 1 180,000
DVD External 12/27/2016 440/XII/2016 2 400,000
PPN 10% 12/27/2016 441/XII/2016 1 227,273
PPH 3% 12/27/2016 442/XII/2016 1 68,182
JUMLAH 1,885,455
6 Belanja Bahan Obat-obatan
JUMLAH
7 Belanja Kawat/Faksimili/Internet
Pulsa internet untuk modem 12/19/2016 399/XII/2016 1 100,000

Internet Aplikasi e-Puskesmas 12/24/2016 430/XII/2016 1 1,000,000


JUMLAH 1,100,000
8 Belanja Jasa Transaksi Keuangan NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
Administrasi Bank 12/22/2016 421/XII/2016 1 5,000
Biaya Bunga 12/22/2016 423/XII/2016 1 152,407
Kliring bank 12/16/2016 387/XII/2016 1 10,000
JUMLAH 157,407
9 Belanja Jasa Kesehatan NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
10 Belanja Jasa Service NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
11 Belanja Penggantian Suku Cadang NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
12 Belanja Bahan Bakar Minyak/Gas dan Pelumas
Pembelian olie mesin mobil pusling 12/20/2016 401/XII/2016 2 125,000
Pembelian olie mesin motor opersional 12/20/2016 402/XII/2016 4 35,000
Pembelian bahan bakar minyak mobil pusling 12/27/2016 445/XII/2016 1 850,000
Pembelian bahan bakar minyak motor opersional 12/27/2016 446/XII/2016 2 150,000
JUMLAH 1,160,000
13 Belanja Cetak NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
Kartu antrian pasien 12/16/2016 343/XII/2016 3 90,000
Blanko rujukan bpjs 12/16/2016 343/XII/2016 15 25,000
Kartu ibu 12/16/2016 343/XII/2016 1 75,000
Blanko PHN 12/16/2016 343/XII/2016 2 90,000
Kartu pasien 12/16/2016 393/XII/2016 4 100,000
Rekam medik pasien 12/16/2016 393/XII/2016 3 700,000
Ppn 10% 12/16/2016 394/XII/2016 1 227,273
Pph 4% 12/16/2016 395/XII/2016 1 109,109
JUMLAH 1,416,382
14 Belanja Penggandaan
Penggandaan 12/27/2016 443/XII/2016 4000 200
JUMLAH 200
15 Belanja Penjilidan
16 Belanja Makanan dan Minuman Rapat
a Kegiatan Senam Prolanis 12/9/2016 348/XII/2016
Makan 60 22,000
Snack 60 8,000
PPn 10% 12/9/2016 1 180,000
b Kegiatan Penyuluhan Prolanis 12/16/2016 389/XII/2016
Snack 30 8,000
ppH 4% 12/16/2016 390/XII/2016 1 9,600
JUMLAH
17 Belanja Perjalanan Dinas Dalam Daerah
Belanja Kursus Singkat 12/15/2016 375/XII/2016
Pelatihan Bendahara 1 5,000,000
Uang Saku Pelatihan 1 600,000
Perjalanan Dinas dari Puskesmas ke Desa
Transport Kunjungan rumah /Pembinaan KK Rawan 12/27/2016 444/XII/2016 12 30,000
JUMLAH 5,630,000
18 Belanja Pemeliharaan Perlengkapan dan Peralatan Kantor NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
19 Belanja Pemeliharaan Komputer dan Jaringan
20 Belanja Jasa Tenaga Ahli / Instruktur / Narasumber PNS NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
21 Belanja Modal Pengadaan komputer/PC NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
Merk ASUS ( seri K31 CD-1001 iD, Procc G 4400, Ram DDR3 4 GB,LED 18.5" ) 12/16/2016 380/XII/2016 2 7,300,000

JUMLAH 7,300,000
22 Belanja Modal Pengadaan Komputer Notebook NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
Notebook Merk Dell.Inspiron 14-3458 Ram 4 GB Hdd 500 GB Black 12/16/2016 380/XII/2016 2 7,400,000
JUMLAH 7,400,000
23 Belanja Modal Pengadaan Printer NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
Printer EPSON L310 12/16/2016 383/XII/2016 1 3,000,000
Printer EPSON L365 12/16/2016 383/XII/2016 1 3,000,000
JUMLAH 6,000,000
24 Belanja Modal Pengadaan UPS/Stabilizer NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
25 Belanja Modal Perangkat Lunak Sistem Operasi NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
26 Belanja modal Pengadaan Sound System NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
Speaker system ( Rocky ) 12/14/2016 365/XII/2016 1 3,925,000
Belanja modal Pengadaan Televisi
Samsung 43 Inci 12/13/2016 355/XII/2016 1 7,350,000
Belanja modal Pengadaan Penyedot Debu
Vacum Tipe Home Use aeru 21-01 pc 12/13/2016 358/XII/2016 1 3,400,000
Belanja modal Pengadaan AC Split
LG 1 PK 12/13/2016 361/XII/2016 7 4,950,000
Belanja modal Pengadaan Kipas Angin
Kipas Angin Air Monster 12/14/2016 364/XII/2016 1 975,000
Belanja modal PengadaanVCD/DVD Player
Pengadaan VCD/DVD player Samsung 12/14/2016 373/XII/2016 1 1,850,000
Belanja modal Pengadaan Camera
Camera Canon 12/15/2016 370/XII/2016 1 4,750,000
Belanja modal Pengadaan Meubelar
Lemari Locker sdie+door (L ) lokcker 12 DRS WHT-YLW P(1/2 ) 12/19/2016 396/XII/2016 1 3,499,000
Kursi Lipat 12/19/2016 397/XII/2016 30 289,000
Dispenser Cosmos 12/19/2016 398/XII/2016 1 285,000
Filing Kabinet Playwood L. 50. P. 150 Cm 12/20/2016 402/XII/2016 1 4,300,000
Papan Whiteboard Kabinet ( 244 X 122 Cm ) 12/20/2016 406/XII/2016 1 2,300,000
Lemari Playwood L50 X P 290 Cm 12/21/2016 412/XII/2016 4 3,400,000
Papan Plang puskesmas (360 X 150 Cm ) 12/21/2016 412/XII/2016 1 4,900,000
Meja kerj1 1/2 biro 12/21/2016 415/XII/2016 3 2,400,000
Rak Buku Playwood 12/21/2016 418/XII/2016 1 2,400,000
Running teks (200 X21 Cm ) 12/23/2016 424/XII/2016 1 3,900,000
Pembelian Papan Informasi ( 50 X 60 Cm ) 12/23/2016 427/XII/2016 1 3,850,000
Belanja Modal Pengadaan Konstruksi
Rehab/Perbaikan sedang ruang/Bangunan Puskesmas 12/28/2016 465/XII/2016 1 80,500,000
Pembuatan kanopi Parkir motor dan Mobil 12/28/2016 468/XII/2016 1 149,184,000
1. Pipa Galvanis dia 2" ( 24,18 m' ))
2. Rangka Atap Pipa Galvanis Dia 1" ( 50,46 M' )
3. Pemasangan UNP 200 x 75x8,5 mm' ( 308,04 kg )
4. Pasangan Atap Zincalum, 36,46 M2
5. Pengecatan Besi ( ( 16 M2 )
Belanja Modal Pengadaan Pengecatan
Pengadaan pengecatan 12/27/2016 431/XII/2016 1 7,000,000
Cat Dulux Catylac Putih 2 Peal
Cat Dulux Exterior Blue 4 Galon
Koas Eterna, roll Ace, Baki cat
Compound
Wallpaper 30 m2
JUMLAH 295,407,000
27 Belanja modal Pengadaan alat-alat kedokteran gigi NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
28 Belanja modal Pengadaan alat-alat kedokteran Umum NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
JUMLAH
29 Belanja modal Pengadaan alat-alat kedokteran kebidanan dan penyakit kandungan
Doppler Niifish 12/15/2016 373/XII/2016 1 1,850,000
JUMLAH 1,850,000
30 Belanja modal Pengadaan alat-alat laboratorium biologi NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL NIHIHL
31 Belanja modal Pengadaan instalasi listrik
12/20/2016 400/XII/2016 1 5,000,000
JUMLAH 5,000,000
Sendang, 09 Januari
Mengetahui :
KEPALA UPT PUSKESMAS SENDANG Pengurus Baran
KABUPATEN CIREBON

ETI ENTIN EFWANITA,SKM, M. Kes WAHYUDI


NIP. 19730117 199303 2 004 NIP.19820310 201409
Jumlah
Dipergunakan
Ket
Jumlah Harga Pada Unit

9 10 11

332,500 350,000
17,500
380,000
20,000
750,000 750,000
NIHIHL NIHIHL
NIHIHL NIHIHL
1,008,000
320,000
195,000
54,000
10,000
5,000
12,000
14,000
40,000
4,000
18,000
11,000
10,000
7,000
192,000
172,727
100,000
78,000
16,000
66,000
25,000
132,000
154,000
7,000
10,000
16,000
23,000
20,000
47,000
92,000
29,250
6,000
30,000
375,000
160,000
22,000
109,000
100,000
10,500
3,500
12,000
9,000
14,000
3,738,977

30,000
60,000
90,000
200,000
320,000
90,000
130,000
180,000
300,000
300,000
180,000
800,000
227,273
68,182
2,795,455

100,000 TU
1,000,000 TU
1,100,000
NIHIHL NIHIHL
5,000
152,407
10,000
157,407
NIHIHL NIHIHL
NIHIHL NIHIHL
NIHIHL NIHIHL

250,000
140,000
850,000
300,000
1,540,000
NIHIHL NIHIHL
270,000
375,000
75,000
180,000
400,000
2,100,000
227,273
109,109
3,736,382

800,000
800,000

1,320,000
480,000
180,000
-
240,000
9,600
2,229,600

-
5,000,000
600,000

360,000
5,960,000
NIHIHL NIHIHL 32/xi/2065

NIHIHL NIHIHL
NIHIHL NIHIHL
14,600,000
14,600,000
NIHIHL NIHIHL
14,800,000
14,800,000
NIHIHL NIHIHL
3,000,000
3,000,000
6,000,000
NIHIHL NIHIHL
NIHIHL NIHIHL
NIHIHL NIHIHL
3,925,000

7,350,000

3,400,000

34,650,000

975,000

1,850,000

4,750,000

3,499,000
8,670,000
285,000
4,300,000
2,300,000
13,600,000
4,900,000
7,200,000
2,400,000
3,900,000
3,850,000

80,500,000
149,184,000

7,000,000

348,488,000
NIHIHL NIHIHL
NIHIHL NIHIHL

1,850,000
1,850,000
NIHIHL NIHIHL

5,000,000
5,000,000
Sendang, 09 Januari 2017
Pengurus Barang

WAHYUDI
NIP.19820310 201409 1 002