PGN Laporan Evaluasi Reagensia 2018

LABORATORIUM
BLUD PUSKESMAS KECAMATAN MENTENG

Jl. Pegangsaan Barat No.14
JAKARTA PUSAT, Telp : 31935836-3103439 Fax : 31904965
LAPORAN EVALUASI REAGEN LABORATORIUM TAHUN 2018

PERIODE : Januari
JUMLAH JUMLAH STOK STOK YANG AKAN

STOK JUMLAH STOK KADALUWARS SISA STOK AKHIR KEBUTUHAN KADALUWARSA DALAM KURUN JUMLAH
NAMA MERK UNIT SATUAN AWAL STOK TERPAKAI A/ RUSAK / BULAN INI UNTUK 3 BULAN WAKTU 1-3 BULAN KE DEPAN PERMINTAAN Expired Date
NO JENIS BARANG BULAN DITERIMA HILANG UNTUK 3 BULAN
DAGANG TERKECIL BULAN INI
BULAN INI
JUMLAH LOT ED
A B C D E = (A+B)-(C+D) F = (3X C) G H = (CX3)-E I
1 Cholesterol Thermo, Scientific Kit , 6 x 6 ml 3 0 1 0 2 3 1 2018/10 : 2
2 Trigliserid Thermo, Scientific Kit , 12 x 20 ml 3 0 1 0 2 3 1 2019/02 : 3
3 Asam Urat Thermo, Scientific Kit , 8 x 16 ml + 8 x 4 ml 3 0 1 0 2 3 1 2018/10
4 Urea Thermo, Scientific Kit , 12 x 20 ml 5 0 1 0 4 3 -1 2018/06
5 Creatinin Thermo, Scientific Kit ,4 x 20 ml + 4 x 10 ml 3 0 0 0 3 0 2 N596 2018/04 -3 2018/04
6 HDL Cholesterol Thermo, Scientific Kit , 6 x 18 ml + 6 x 6 ml 4 0 2 0 2 6 4 2018/10
7 LDL Cholesterol Thermo, Scientific Kit , 6 x 18 ml + 6 x 6 ml 2 0 1 0 1 3 2 2018/10
8 AST / GOT Thermo, Scientific Kit, 8 x 16 ml + 8 x 4 ml 1 0 0 0 1 0 -1 2018/06
9 ALT / GPT Thermo, Scientific Kit, 8 x 16 ml + 8 x 4 ml 2 0 1 0 1 3 2 2018/06
Kit, 4 x 20 ml + 20 x 4 ml
10 Bilirubin Direct Thermo, Scientific
+ 1 x 5 ml
0 0 0 0 0 0 0
11 E-CAL Indiko Thermo Thermo, Scientific Kit, 5x3 ml 0 0 0 0 0 0 -1 2018/10
12 HDL/LDL Calibrator Thermo, Scientific Kit, 5 x 1 ml 1 0 0 0 1 0 1 N589C 2018/04 -1 2018/04
13 Nortrol Thermo, Scientific Kit, 10 x 5 ml 1 0 0 0 1 0 -1 2020/02
14 Wash fluid Thermo, Scientific Kit, 8 x 20 ml 0 0 0 0 0 0 0
Electrolytes Quality
15 Control
Merk Cornley Box, 10 x 1 ml 0 0 0 0 0 0 0
Box, 5 x 50 mg + 5 x 0.6
16 Deproteinizer Merk Cornley
ml
0 0 0 0 0 0 0
17 Conditioning Solution Merk Cornley Box, 5 x 0.8 ml 1 0 1 0 0 3 3

18 Reagen Golongan Darah Merk Fortrest Set, 4 x 5 ml 0 0 0 0 0 0 0
7 1 6 H : 2019
19 Reagen Widal Merk Fokus Set, 8 x 5 ml 0 0 12 -3

12 3 9 O : 2018/2019
20 Rheumatoid Factor
21 Refill Solution Elektrolit Merk Cornley Kit , 5 x 0.8 ml 0 0 0 0 0 0 0

Eight Check,
22 Quality Kontrol Darah
Sysmex
Set, 3 x 1,5 ml 6 0 1 0 5 3 -2 2018/02
Merk Thermo,
23 Lipotrol Indiko Thermo
Scientific
Kit, 5 x 3 ml 3 0 2 0 1 6 5 2019/02
24 Tes Kehamilan Merk Answer Kit, 50 test 0 0 0 0 0 0 0
25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 0 0 8 0 -8 2018/10
26 Reagen HIV Advance/Intec Box, 100 tes 0 0 0 0 0 0 0
27 Reagen HIV FOKUS Box, 50 tes 0 0 0 0 0 0 0
28 Reagen HIV SD Box, 30 tes 0 0 0 0 0 0 0
29 Reagen HIV ONCOPROBE Box, 50 tes 0 0 0 0 0 0 0
30 Syphillis Rapid Test MONOTES Box, @ 25 tes 7 0 1 0 6 3 -3 2018/07
31 Strip Glukosa Merk Diabcheck Box, 2x 25 strip 0 0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 12 0 3 0 9 9 9 01AMA0244 2018/03 0 2018/03
33 Reagen HBsAg Merk Oncoprobe Box, 50 tes 0 0 0 0 0 0 0
34 Reagen HBsAg Merk FOKUS Box, 50 tes 0 0 0 0 0 0 0
35 Strip Urin Lengkap Merk URS 10 BOX, @ 100 strip 0 0 0 0 0 0 0
36 Strip Urin Lengkap Merk Siemens Box, @ 100 strip 9 0 4 0 5 12 7 2019/01
37 Amphetamine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0 0 0
38 Benzodiazephine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0 0 0
39 THC Merk Oncoprobe Box, @25 cassette 0 0 0 0 0 0 0
40 Wash benzine Merk PT.Brataco Botol, @1000 ml 2 0 0 0 2 0 -2 N/A
41 Oil Imersi Merk MERCK Botol, 500 l 0 0 0 0 0 0 0
42 Spiritus BE Reagen Botol, 1000 ml 8 0 0 0 8 0 -8 N/A
43 Alkohol 70 % Merk One Med Botol, 1000 ml 7 0 2 0 5 6 1 2020/02
44 Giemsa Merk MERCK Botol, 500 ml 0 0 0 0 0 0 0

45 KOH 10 % Indoreagen Botol, 500 ml 5 0 0 0 5 0 -5
46 Stromatolyzer Merk Sysmex Botol, 500 ml 8 0 0 0 8 0 -8 8/4/2018
47 Cell Clean Merk Sysmex Botol, 50 ml 1 0 1 0 0 3 3
48 Lugol Indoreagen Botol, @ 100 ml 0 0 0 0 0 0 0
2018/03
49 Pewarnaan Gram Indoreagen Botol, 500 ml 3 0 0 0 3 0 -3
2019/01
50 Eosin Indoreagen Botol, 100 ml 1 0 0 0 1 0 -1 2018/12
51 Asam alkohol Indoreagen Botol, 500 ml 0 0 0 0 0 0 0
52 Methyleen Blue Indoreagen Botol, 100 ml 6 0 6 0 0 18 18 2018/11
53 Carbol Fuchsin Indoreagen Botol, 100 ml 5 0 5 0 0 15 15 2018/11
54 IgG/IgM Dengue Monotes Box, 50 tes 0 0 0 0 0 0 0
55 NS1 Dengue Cortez Box, 25 tes 0 0 0 0 0 0 0 2018/05
56 Cell Pack Merk Sysmex Box, 30 L 8 0 3 0 5 9 4 2019/02
57 Aquabidest Botol, 1000 ml 7 0 3 0 4 9 5
58 Na. Hipoklorit Lokal Botol, 1000 ml 1 0 0 0 1 0 -1 N/A
59 Lisol Onemed Botol, 1000 ml 6 0 1 0 5 3 -2 2019/03
Tes Narkoba 3 in 1 (Amp,

60 Morp, THC)
Sensor Box, 25 panel 0 0 0 0 0 0 0
2018/09
61 Strip Glucosa Accu Check Box, 100 tes 146 0 14 0 132 42 -90
2018/11
62 Tes Kehamilan Ultra One Test Box, 50 tes 0 0 0 0 0 0 0
63 Reagen HIV Onestep HIV, Intec Box, 100 tes 0 0 0 0 0 0 0
2018/05 : 8
64 Reagen HIV SD HIV Box, 100 tes 72 0 6 0 66 18 -48 2018/08 : 12
2019/09 : 46
65 Scal Thermo, Scientific Kit, 10 x 3 ml 1 0 0 0 1 0 -1 2019/06
66 Washing Solution 4,5% Thermo, Scientific Kit, 4x20 ml 1 0 1 0 0 3 3
67 Abtrol Thermo, Scientific Kit, 10 x 5 ml 4 0 0 0 4 0 -4 2018/02
1 2018/02
68 RPR Fokus Kit, 100 tes 0 7 0 0 21 21
6 2019/09
1
69 HCV Strip FOKUS Box, 25 tes 0 0 0 11 0 -11 2019/07 : 11
10
70 Strip Hb Meter Mission Box, 50 strip 39 0 0 0 39 0 -39
71 Asam Sulfosalisilat 20% Indoreagen Botol 100 ml 0 0 0 0 0 0 0 2018/01
72 Reagen Pak Elektrolit Klite Pak 2 0 2 0 0 6 6 2018/06
73 Strip Urin Lengkap FOKUS Box, 100 tes 0 0 0 0 0 0 0
74 Ziehl Neelsen Indoreagen Kit, 4 x 100 ml 3 0 0 0 3 0 -3
75 Anti A Golongan Darah Lorne Botol 10 ml 8 0 1 0 7 3 -4 8/9/2018
76 Anti B Golongan Darah Lorne Botol 10 ml 8 0 1 0 7 3 -4 8/9/2018
77 Anti AB Golongan Darah Lorne Botol 10 ml 8 0 1 0 7 3 -4 8/10/2018
78 Anti D Golongan Darah Lorne Botol 10 ml 8 0 1 0 7 3 -4 8/11/2018
Liquicheck Urine
79 Chemistry level 1
Biorad Kit, 12x10 ml 0 0 0 0 0 0 0 2018/06
Liquicheck Urine
Biorad Kit, 12x10 ml 0 0 0 0 0 0 0 2018/09
Check stik combo pack

81 kontrol
Siemens 50 pcs/set 1 0 1 0 0 3 3
82 Tes Narkoba 5 in 1 Sensor Box, 25 panel 0 0 0 0 0 0 0
83 RDT Leptospirosis Biomedika Box, 10 alat uji 2 0 0 0 2 0 2 AUC14DO9 2018/04 -2 2018/04
84 Ziehl Neelsen One Med Botol, 100 ml (3 botol) 15 0 0 0 15 0 -15 2020/02
85 Reagen Wright Puppy Botol, 100 ml 0 0 0 0 0 0 0
86 Reagen Giemsa Puppy Botol, 100 ml 1 0 0 0 1 0 -1
87 Metanol absolut Puppy Botol, 100 ml 1 0 0 0 1 0 -1
88 Larutan Turk Puppy Botol, 100 ml 0 0 0 0 0 0 0
Larutan Ammonium
89 Oxalat
Puppy Botol, 100 ml 0 0 0 0 0 0 0
90 Malaria rapid tes Fokus Kit, 25 tes 0 0 0 0 0 0 0 2018/08
91 Syphillis Rapid Test Human Kit, 20 tes 27 0 0 0 27 0 -27 2019/05
92 Eter Alkohol St Reagen Botol, 1000 ml 18 0 0 0 18 0 -18 2019/01
93 HCG strip GEA BOX, 25 TES 17 0 3 0 14 9 -5 2018/08
Multi Drugs Answer 5

94 panel
Human BOX, 25 TES 0 0 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 2 0 0 0 2 0 -2 2019/07
96 Reagen HIV VIKIA BOX , 25 Tes 1 0 0 0 1 0 -1 2019/3

97 panel
ANSWER BOX, 25 Tes 0 0 0 0 0 0 0 2019/05
98 Strip Glukosa Benecheck Box, 50 Tes 30 0 2 0 28 6 -22 2018/07

99 Strip Cholesterol Benecheck Box, 10 Tes 74 0 0 0 74 0 -74 2019/01
100 Strip Uric Acid Benecheck Box, 25 Tes 20 0 2 0 18 6 -12 2018/04
Jakarta , 31 Januari 2018

Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : Januari
STOK YANG AKAN
KADALUWARSA DALAM
KURUN WAKTU 1-3 BULAN
JUMLAH JUMLAH STOK JUMLAH STOK KEBUTUHAN KE DEPAN
UNIT STOK AWAL KADALUWARSA/ SISA STOK AKHIR
NAMA MERK STOK TERPAKAI UNTUK 3 JUM
NO JENIS BARANG SATUAN BULAN DITERIMA BULAN INI RUSAK / HILANG BULAN INI BULAN LOT ED
DAGANG BULAN INI LAH
TERKECIL
A B C D E = (A+B)-(C+D) F = (3X C) G
Thermo,
1 Cholesterol
Scientific
Kit , 6 x 6 ml 3 0 1 0 2 3
Thermo, Kit , 12 x 20
2 Trigliserid
Scientific ml
3 0 1 0 2 3
Thermo, Kit , 8 x 16 ml
3 Asam Urat
Scientific + 8 x 4 ml
3 0 1 0 2 3
4 Urea
Scientific ml
4 0 1 0 3 3
Thermo, Kit ,4 x 20 ml
5 Creatinin
3 0 0 0 3 0 2 N596 2018/04
6 HDL Cholesterol
2 0 2 0 0 6
7 LDL Cholesterol
3 0 1 0 2 3
Thermo, Kit, 8 x 16 ml
8 AST / GOT
1 0 0 0 1 0
9 ALT / GPT
2 0 1 0 1 3
Kit, 4 x 20 ml
Thermo,
10 Bilirubin Direct
Scientific
+ 20 x 4 ml + 0 0 0 0 0 0
1 x 5 ml
Thermo,
11 E-CAL Indiko Thermo
Scientific
Kit, 5x3 ml 0 0 0 0 0 0
Thermo,
12 HDL/LDL Calibrator
Scientific
Kit, 5 x 1 ml 1 0 0 0 1 0 1 N589C 2018/04
Thermo,
13 Nortrol
Scientific
Kit, 10 x 5 ml 1 0 0 0 1 0
Thermo,
14 Wash fluid
Scientific
Kit, 8 x 20 ml 0 0 0 0 0 0
Electrolytes Quality
15 Control
Merk Cornley Box, 10 x 1 ml 0 0 0 0 0 0
Box, 5 x 50
16 Deproteinizer Merk Cornley mg + 5 x 0.6 0 0 0 0 0 0
ml
Box, 5 x 0.8
17 Conditioning Solution Merk Cornley
ml
0 0 0 0 0 0
Reagen Golongan
18 Darah
Merk Fortrest Set, 4 x 5 ml 0 0 0 0 0 0
19 Reagen Widal Merk Fokus Set, 8 x 5 ml 7 0 4 0 3 0
20 Rheumatoid Factor 0 0 0
21 Refill Solution Elektrolit Merk Cornley Kit , 5 x 0.8 ml 0 0 0 0 0 0
Eight Check, Set, 3 x 1,5

Sysmex ml
5 0 1 0 4 3
Merk Thermo,
Scientific
Kit, 5 x 3 ml 3 0 2 0 1 6
24 Tes Kehamilan Merk Answer Kit, 50 test 0 0 0 0 0 0
25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 0 0 8 0
26 Reagen HIV Advance/Intec Box, 100 tes 0 0 0 0 0 0
27 Reagen HIV FOKUS Box, 50 tes 0 0 0 0 0 0
28 Reagen HIV SD Box, 30 tes 0 0 0 0 0 0
29 Reagen HIV ONCOPROBE Box, 50 tes 0 0 0 0 0 0
30 Syphillis Rapid Test MONOTES Box, @ 25 tes 7 0 0 0 7 0
Box, 2x 25
31 Strip Glukosa Merk Diabcheck
strip
0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 12 0 3 0 9 9 9 01AMA0244 2018/03
Merk
33 Reagen HBsAg
Oncoprobe
Box, 50 tes 0 0 0 0 0 0
34 Reagen HBsAg Merk FOKUS Box, 50 tes 0 0 0 0 0 0

BOX, @ 100
35 Strip Urin Lengkap Merk URS 10
strip
0 0 0 0 0 0
Box, @ 100
36 Strip Urin Lengkap Merk Siemens
strip
9 0 4 0 5 12
Merk Box, @ 25
37 Amphetamine
Oncoprobe cassette
0 0 0 0 0 0
Merk Box, @ 25
38 Benzodiazephine
Oncoprobe cassette
0 0 0 0 0 0
Merk Box, @25

39 THC
Oncoprobe cassette
0 0 0 0 0 0
Merk Botol, @1000

40 Wash benzine
PT.Brataco ml
2 0 0 0 2 0
41 Oil Imersi Merk MERCK Botol, 500 l 0 0 0 0 0 0
Botol, 1000
42 Spiritus BE Reagen
ml
8 0 0 0 8 0
Botol, 1000
43 Alkohol 70 % Merk One Med
ml
5 0 2 0 3 6
44 Giemsa Merk MERCK Botol, 500 ml 0 0 0 0 0 0
45 KOH 10 % Indoreagen Botol, 500 ml 5 0 0 0 5 0
46 Stromatolyzer Merk Sysmex Botol, 500 ml 8 0 0 0 8 0
47 Cell Clean Merk Sysmex Botol, 50 ml 1 0 1 0 0 3
Botol, @ 100
48 Lugol Indoreagen
ml
0 0 0 0 0 0
49 Pewarnaan Gram Indoreagen Botol, 500 ml 1 0 0 0 1 0
50 Eosin Indoreagen Botol, 100 ml 0 0 0 0 0 0
51 Asam alkohol Indoreagen Botol, 500 ml 0 0 0 0 0 0
52 Methyleen Blue Indoreagen Botol, 100 ml 0 0 0 0 0 0
53 Carbol Fuchsin Indoreagen Botol, 100 ml 0 0 0 0 0 0
54 IgG/IgM Dengue Monotes Box, 50 tes 0 0 0 0 0 0
55 NS1 Dengue Cortez Box, 25 tes 0 0 0 0 0 0

56 Cell Pack Merk Sysmex Box, 30 L 8 0 3 0 5 9
Botol, 1000
57 Aquabidest
ml
5 0 3 0 2 9
Botol, 1000
58 Na. Hipoklorit Lokal
ml
1 0 0 0 1 0
Botol, 1000
59 Lisol Onemed
ml
0 0 0 0 0 0
Tes Narkoba 3 in 1
60 (Amp, Morp, THC)
Sensor Box, 25 panel 0 0 0 0 0 0
61 Strip Glucosa Accu Check Box, 100 tes 146 0 14 0 132 42
62 Tes Kehamilan Ultra One Test Box, 50 tes 0 0 0 0 0 0
Onestep HIV,
63 Reagen HIV
Intec
Box, 100 tes 0 0 0 0 0 0
64 Reagen HIV SD HIV Box, 100 tes 72 0 1 0 71 3
Thermo,
65 Scal
Scientific
Kit, 10 x 3 ml 1 0 0 0 1 0
Thermo,
66 Washing Solution 4,5%
Scientific
Kit, 4x20 ml 1 0 1 0 0 3
Thermo,
67 Abtrol
Scientific
Kit, 10 x 5 ml 4 0 0 0 4 0
68 RPR Fokus Kit, 100 tes 7 0 7 0 0 21
69 HCV Strip FOKUS Box, 25 tes 11 0 0 0 11 0
70 Strip Hb Meter Mission Box, 50 strip 39 0 0 0 39 0
71 Asam Sulfosalisilat 20% Indoreagen Botol 100 ml 0 0 0 0 0 0
72 Reagen Pak Elektrolit Klite Pak 2 0 2 0 0 6
73 Strip Urin Lengkap FOKUS Box, 100 tes 0 0 0 0 0 0
74 Ziehl Neelsen Indoreagen Kit, 4 x 100 ml 1 0 0 0 1 0
75 Anti A Golongan Darah Lorne Botol 10 ml 8 0 1 0 7 3
76 Anti B Golongan Darah Lorne Botol 10 ml 8 0 1 0 7 3

Anti AB Golongan
77 Darah
Lorne Botol 10 ml 8 0 1 0 7 3
78 Anti D Golongan Darah Lorne Botol 10 ml 8 0 1 0 7 3
Liquicheck Urine
Biorad Kit, 12x10 ml 0 0 0 0 0 0
Liquicheck Urine
Biorad Kit, 12x10 ml 0 0 0 0 0 0

81 kontrol
Siemens 50 pcs/set 0 0 0 0 0 0
82 Tes Narkoba 5 in 1 Sensor Box, 25 panel 0 0 0 0 0 0
Box, 10 alat
83 RDT Leptospirosis Biomedika
uji
2 0 0 0 2 0 2 AUC14DO9 2018/04
Botol, 100 ml
84 Ziehl Neelsen One Med
(3 botol)
15 0 0 0 15 0
85 Reagen Wright Puppy Botol, 100 ml 0 0 0 0 0 0
86 Reagen Giemsa Puppy Botol, 100 ml 0 0 0 0 0 0
87 Metanol absolut Puppy Botol, 100 ml 0 0 0 0 0 0
88 Larutan Turk Puppy Botol, 100 ml 0 0 0 0 0 0
Larutan Ammonium
89 Oxalat
Puppy Botol, 100 ml 0 0 0 0 0 0
90 Malaria rapid tes Fokus Kit, 25 tes 0 0 0 0 0 0
91 Syphillis Rapid Test Human Kit, 20 tes 27 0 0 0 27 0
Botol, 1000
92 Eter Alkohol St Reagen
ml
10 0 0 0 10 0
93 HCG strip GEA BOX, 25 TES 17 0 3 0 14 9

94 panel
Human BOX, 25 TES 0 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 0 0 0 2 0

2
96 Reagen HIV VIKIA BOX , 25 Tes 0 0 0 1 0

1
97 panel
ANSWER BOX, 25 Tes 0 0 0 0 0
0
98 Strip Glukosa Benecheck Box, 50 Tes 0 2 0 28 6
30
99 Strip Cholesterol Benecheck Box, 10 Tes 0 0 0 74 0

74
100 Strip Uric Acid Benecheck Box, 25 Tes 20 0 2 0 18 6
Jakarta , 3
Pembu
NIP. 19811
LABORATORIUM
KESMAS KECAMATAN MENTENG
. Pegangsaan Barat No.14
T, Telp : 31935836-3103439 Fax : 31904965
REAGEN LABORATORIUM TAHUN 2018
JUMLAH
PERMINTAAN Expired Date
UNTUK 3 BULAN
H = (CX3)-E I
1 2018/10 : 2
1 2019/02 : 3
1 2018/10
0 2018/06
-3 2018/04
6 2018/10
1 2018/10
-1 2018/06
2 2018/06
-1 2018/10
-1 2018/04
-1 2020/02
0
0 O : 2018/2019
-1 2018/02
5 2019/02
-8 2018/10
-7 2018/07
0 2018/03
0
0
7 2019/01
-2 N/A
-8 N/A
3 2020/02
-5
-8 8/4/2018
-1 2018/12
0 2018/11
0 2018/11
0 2018/05
4 2019/02
-1 N/A
0 2019/03
-90 2018/09
-68 2018/05 : 8
-1 2019/06
3 2018/03
-4 2018/02
21 2018/02
-11 2019/07 : 11
-39
0 2018/01
6 2018/06
-1
-4 8/9/2018
-4 8/9/2018
-4 8/10/2018
-4 8/11/2018
0 2018/06
0 2018/09
-2 2018/04
-15 2020/02
0 2018/08
-27 2019/05
-10 2019/01
-5 2018/08
-2 2019/07
-1 2019/3
0 2019/05
-22 2018/07
-74 2019/01
-12 2018/04
Jakarta , 31 Januari 2018
Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : Februari
STOK YANG AKAN
KADALUWARSA DALAM
KURUN WAKTU 1-3 BULAN KE
STOK JUMLAH JUMLAH JUMLAH STOK KEBUTUHAN DEPAN
UNIT STOK KADALUWARSA/ SISA STOK AKHIR
NAMA MERK AWAL STOK TERPAKAI RUSAK / HILANG BULAN INI UNTUK 3 JUMLA
NO JENIS BARANG DAGANG SATUAN BULAN DITERIMA BULAN INI BULAN H LOT ED
TERKECIL BULAN INI
A B C D E = (A+B)-(C+D) F = (3X C) G
Thermo,
1 Cholesterol Scientific
Kit , 6 x 6 ml 2 1 0 0 3 0
2 Trigliserid Scientific ml
2 1 0 0 3 0
3 Asam Urat Scientific + 8 x 4 ml
2 0 0 0 2 0
4 Urea Scientific ml
3 1 0 0 4 0
5 Creatinin Scientific + 4 x 10 ml
3 0 1 0 2 3
6 HDL Cholesterol Scientific + 6 x 6 ml
0 1 0 0 1 0
7 LDL Cholesterol Scientific + 6 x 6 ml
2 1 2 0 1 6
8 AST / GOT Scientific + 8 x 4 ml
1 0 1 0 0 3
9 ALT / GPT Scientific + 8 x 4 ml
1 0 0 0 1 0
Kit, 4 x 20 ml
Thermo,
10 Bilirubin Direct Scientific
+ 20 x 4 ml + 0 0 0 0 0 0
1 x 5 ml
Thermo,
11 E-CAL Indiko Thermo Scientific
Kit, 5x3 ml 0 0 0 0 0 0
Thermo,
12 HDL/LDL Calibrator Scientific
Kit, 5 x 1 ml 1 0 0 0 1 0
Thermo,
13 Nortrol Scientific
Kit, 10 x 5 ml 1 0 0 0 1 0
Thermo,
14 Wash fluid Scientific
Kit, 8 x 20 ml 0 1 1 0 0 3
15 Electrolytes Quality Control Merk Cornley Box, 10 x 1 ml 0 0 0 0 0 0
Box, 5 x 50
16 Deproteinizer Merk Cornley mg + 5 x 0.6 0 0 0 0 0 0
ml
Box, 5 x 0.8
ml
0 0 0 0 0 0
18 Reagen Golongan Darah Merk Fortrest Set, 4 x 5 ml 0 0 0 0 0 0
20 Rheumatoid Factor 0 0 0 0
Eight Check,
22 Quality Kontrol Darah Sysmex
Set, 3 x 1,5 ml 4 0 0 4 0 0 4 2018/02
Merk Thermo,
23 Lipotrol Indiko Thermo Scientific
Kit, 5 x 3 ml 1 0 0 0 1 0
Box, 2x 25
31 Strip Glukosa Merk Diabcheck
strip
0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 9 5 1 8 5 3 8 2018/03
Merk
33 Reagen HBsAg Oncoprobe
Box, 50 tes 0 0 0 0 0 0
BOX, @ 100
strip
0 0 0 0 0 0
Box, @ 100
strip
5 0 4 0 1 12
Merk Box, @ 25
37 Amphetamine Oncoprobe cassette
0 0 0 0 0 0
Merk Box, @ 25
38 Benzodiazephine Oncoprobe cassette
0 0 0 0 0 0
Merk Box, @25

39 THC Oncoprobe cassette
0 0 0 0 0 0
Merk Botol, @1000

40 Wash benzine PT.Brataco ml
2 0 0 0 2 0
42 Spiritus BE Reagen Botol, 1000 ml 8 0 0 0 8 0
43 Alkohol 70 % Merk One Med Botol, 1000 ml 3 0 1 0 2 3
Botol, @ 100
48 Lugol Indoreagen
ml
0 0 0 0 0 0

57 Aquabidest Botol, 1000 ml 2 20 22 0 0 66
58 Na. Hipoklorit Lokal Botol, 1000 ml 1 0 0 0 1 0
59 Lisol Onemed Botol, 1000 ml 0 5 0 0 5 0
60 Tes
THC)
Narkoba 3 in 1 (Amp, Morp,
Onestep HIV,
63 Reagen HIV Intec
Box, 100 tes 0 0 0 0 0 0
Thermo,
65 Scal Scientific
Kit, 10 x 3 ml 1 0 0 0 1 0
Thermo,
66 Washing Solution 4,5% Scientific
Kit, 4x20 ml 0 0 0 0 0 0 1 2018/03
Thermo,
67 Abtrol Scientific
Kit, 10 x 5 ml 4 0 0 0 4 0 1 2/3/2018
68 RPR Fokus Kit, 100 tes 0 0 0 0 0 0
77 Anti AB Golongan Darah Lorne Botol 10 ml 7 0 1 0 6 3

79 Liquicheck
level 1
Urine Chemistry
Biorad Kit, 12x10 ml 0 0 0 0 0 0
80 Liquicheck
level 2
Urine Chemistry
Biorad Kit, 12x10 ml 0 0 0 0 0 0
81 Check stik combo pack kontrol Siemens 50 pcs/set 0 0 0 0 0 0
83 RDT Leptospirosis Biomedika Box, 10 alat uji 2 0 0 0 2 0
Botol, 100 ml
(3 botol)
15 0 0 0 15 0
89 Larutan Ammonium Oxalat Puppy Botol, 100 ml 0 0 0 0 0 0
92 Eter Alkohol St Reagen Botol, 1000 ml 10 0 0 0 10 0
94 Multi Drugs Answer 5 panel Human BOX, 25 TES 0 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 2 0 1 0 1 3
96 Reagen HIV VIKIA BOX , 25 Tes 1 0 0 0 1 0
97 Multi Drugs Answer 5 panel ANSWER BOX, 25 Tes 0 0 0 0 0 0
98 Strip Glukosa Benecheck Box, 50 Tes 28 0 0 0 28 0

99 Strip Cholesterol Benecheck Box, 10 Tes 74 0 0 0 74 0
Jakarta ,
Pem
NIP. 1981
LABORATORIUM
ESMAS KECAMATAN MENTENG
Pegangsaan Barat No.14
Telp : 31935836-3103439 Fax : 31904965
REAGEN LABORATORIUM TAHUN 2018
JUMLAH
UNTUK 3
BULAN
H = (CX3)-E I
-3 2018/10 II 2019/02
-3 2019/02 II 2019/.04
-2 2018/10
-4 2018/06
1 2018/04
-1 2018/10 & 12
5 2018/10
3 2018/08
-1 2018/06
0 2018/10
-1 2018/04
-1 2020/02
3 2019/03
0
0 2019
0 2018/02
-1 2018/02 II 2019/02
-8 2018/10
21 2018/07
-2 2018/03 II 2018/11 II 2019/11
0
11 2019/01
-2
-8
-5
-4 2018/04 II 2018/09
-1
7
66
-1
-5 2019/03
-88 2018/09 & 11
-51 2018/05 & 08 II 2019/09
-1 2019/06
0 2018/03
-4 2/3/2018
-3 2019/07
-35 2019/02
-3
-3
-3
-3
-2
-15 2020/02
0 2018/08
-19 2019/05
-10
-2 2018/08
2 2019/07
-1 2019/03
-28 2019/08
-74 2019/01
-18 2019/03
Jakarta , 28 Februari 2018
Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : Maret
STOK YANG AKAN KADALUWARSA
DALAM KURUN WAKTU 1-3 BULAN
JUMLAH KE DEPAN
STOK JUMLAH JUMLAH STOK KEBUTUHAN JUMLAH
NAMA UNIT STOK KADALUWAR SISA STOK AKHIR PERMINTAAN
AWAL STOK UNTUK 3
NO JENIS BARANG MERK SATUAN BULAN DITERIMA TERPAKAI SA/ RUSAK / BULAN INI BULAN JUMLAH LOT ED UNTUK 3
DAGANG TERKECIL BULAN INI HILANG BULAN
BULAN INI
A B C D E = (A+B)-(C+D) F = (3X C) G H = (CX3)-E

Thermo,
1 Cholesterol
Scientific
Kit , 6 x 6 ml 3 0 0 0 3 0 -3
2 Trigliserid
Scientific ml
3 0 0 0 3 0 -3
3 Asam Urat
2 0 0 0 2 0 -2
4 Urea
Scientific ml
4 1 0 0 5 0 3 2018/06 -5
5 Creatinin
2 0 0 0 2 0 -2
6 HDL Cholesterol
1 1 0 0 2 0 -2
7 LDL Cholesterol
1 1 1 0 1 3 2
8 AST / GOT
0 1 0 0 1 0 -1
9 ALT / GPT
1 0 0 0 1 0 -1
Kit, 4 x 20 ml
Thermo,
10 Bilirubin Direct
Scientific
+ 20 x 4 ml + 0 0 0 0 0 0 0
1 x 5 ml
Thermo,
Scientific
Kit, 5x3 ml 0 0 0 0 0 0 0
Thermo,
Scientific
Kit, 5 x 1 ml 1 0 0 0 1 0 -1
Thermo,
13 Nortrol
Scientific
Kit, 10 x 5 ml 1 0 1 0 0 3 3
Thermo,
14 Wash fluid
Scientific
Kit, 8 x 20 ml 0 0 0 0 0 0 0
Box, 10 x 1
15 Electrolytes Quality Control Merk Cornley
ml
0 0 0 0 0 0 0
Box, 5 x 50
16 Deproteinizer Merk Cornley mg + 5 x 0.6 0 0 0 0 0 0 0
ml
Box, 5 x 0.8
ml
0 0 0 0 0 0 0
19 Reagen Widal Merk Fokus Set, 8 x 5 ml 2 0 2 0 0 6 6
20 Rheumatoid Factor 0 0 0 0 0 0 0
Kit , 5 x 0.8
21 Refill Solution Elektrolit Merk Cornley
ml
0 0 0 0 0 0 0
Eight Check, Set, 3 x 1,5

Sysmex ml
0 1 1 0 0 3 0 3
Merk Thermo,
Scientific
Kit, 5 x 3 ml 1 0 0 0 1 0 -1
25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 0 0 8 0 -8
ONCOPROB
29 Reagen HIV
E
Box, 50 tes 0 0 0 0 0 0 0
Box, @ 25
30 Syphillis Rapid Test MONOTES
tes
0 0 0 0 0 0 0
Merk Box, 2x 25
31 Strip Glukosa
Diabcheck strip
0 0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 5 0 1 0 4 3 -1
Merk
33 Reagen HBsAg
Oncoprobe
Box, 50 tes 0 0 0 0 0 0 0
BOX, @ 100
strip
0 0 0 0 0 0 0
Merk Box, @ 100

36 Strip Urin Lengkap
Siemens strip
1 2 3 0 0 9 9
Merk Box, @ 25
37 Amphetamine
Oncoprobe cassette
0 0 0 0 0 0 0
Merk Box, @ 25
38 Benzodiazephine
Oncoprobe cassette
0 0 0 0 0 0 0
Merk Box, @25

39 THC
Oncoprobe cassette
0 0 0 0 0 0 0
Merk Botol, @1000
40 Wash benzine
PT.Brataco ml
2 0 0 0 2 0 -2
Botol, 1000
42 Spiritus BE Reagen
ml
8 0 0 0 8 0 -8
Merk One Botol, 1000

43 Alkohol 70 %
Med ml
2 5 1 0 6 3 -3
46 Stromatolyzer Merk Sysmex Botol, 500 ml 7 0 2 0 5 6 1
Botol, @ 100
48 Lugol Indoreagen
ml
0 0 0 0 0 0 0
50 Eosin Indoreagen Botol, 100 ml 0 0 0 0 0 0 0
52 Methyleen Blue Indoreagen Botol, 100 ml 0 0 0 0 0 0 0
53 Carbol Fuchsin Indoreagen Botol, 100 ml 0 0 0 0 0 0 0
55 NS1 Dengue Cortez Box, 25 tes 0 0 0 0 0 0 0
56 Cell Pack Merk Sysmex Box, 30 L 2 0 1 0 1 3 2
Botol, 1000
57 Aquabidest
ml
0 20 20 0 0 60 60
Botol, 1000
58 Na. Hipoklorit Lokal
ml
1 0 0 0 1 0 -1
Botol, 1000
59 Lisol Onemed
ml
5 0 0 0 5 0 -5

60 Morp, THC)
Ultra One
62 Tes Kehamilan
Test
Box, 50 tes 0 0 0 0 0 0 0
Onestep HIV,
63 Reagen HIV
Intec
Box, 100 tes 0 0 0 0 0 0 0
64 Reagen HIV SD HIV Box, 100 tes 66 0 3 0 63 9 -54
Thermo,
65 Scal
Scientific
Kit, 10 x 3 ml 1 0 0 0 1 0 -1
Thermo,
Scientific
Kit, 4x20 ml 0 0 0 0 0 0 1 2018/03 0
Thermo,
67 Abtrol
Scientific
Kit, 10 x 5 ml 0 0 0 0 0 0 0
68 RPR Fokus Kit, 100 tes 0 0 0 0 0 0 0
69 HCV Strip FOKUS Box, 25 tes 9 9 0 0 18 0 -18
71 Asam Sulfosalisilat 20% Indoreagen Botol 100 ml 0 0 0 0 0 0 0
72 Reagen Pak Elektrolit Klite Pak 0 0 0 0 0 0 0
Kit, 4 x 100
74 Ziehl Neelsen Indoreagen
ml
0 0 0 0 0 0 0
75 Anti A Golongan Darah Lorne Botol 10 ml 6 0 0 0 6 0 -6
76 Anti B Golongan Darah Lorne Botol 10 ml 6 0 0 0 6 0 -6
77 Anti AB Golongan Darah Lorne Botol 10 ml 6 0 0 0 6 0 -6
78 Anti D Golongan Darah Lorne Botol 10 ml 6 0 0 0 6 0 -6
Liquicheck Urine
Biorad Kit, 12x10 ml 0 0 0 0 0 0 0
Liquicheck Urine
Biorad Kit, 12x10 ml 0 0 0 0 0 0 0

81 kontrol
Siemens 50 pcs/set 0 0 0 0 0 0 0
82 Tes Narkoba 5 in 1 Sensor Box, 25 panel 0 10 0 0 10 0 -10
Box, 10 alat
83 RDT Leptospirosis Biomedika
uji
2 0 0 0 2 0 -2
Botol, 100 ml
(3 botol)
15 0 0 0 15 0 -15
86 Reagen Giemsa Puppy Botol, 100 ml 0 0 0 0 0 0 0
87 Metanol absolut Puppy Botol, 100 ml 0 0 0 0 0 0 0

89 Larutan Ammonium Oxalat Puppy Botol, 100 ml 0 0 0 0 0 0 0
90 Malaria rapid tes Fokus Kit, 25 tes 0 0 0 0 0 0 0
91 Syphillis Rapid Test Human Kit, 20 tes 25 0 15 0 10 45 35
Botol, 1000
92 Eter Alkohol St Reagen
ml
10 0 0 0 10 0 -10
93 HCG strip GEA BOX, 25 TES 11 0 3 0 8 9 1

94 panel
Human BOX, 25 TES 0 0 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 1 0 0 0 1 0 -1
96 Reagen HIV VIKIA BOX , 25 Tes 1 0 0 0 1 0 -1

97 panel
ANSWER BOX, 25 Tes 0 0 0 0 0 0 0
98 Strip Glukosa Benecheck Box, 50 Tes 28 0 0 0 28 0 -28
99 Strip Cholesterol Benecheck Box, 10 Tes 74 0 0 0 74 0 -74
100 Strip Uric Acid Benecheck Box, 25 Tes 18 0 0 0 18 0 -18
Jakarta , 31 Maret 2018

Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
Expired Date
2018/10 II 2019/02
2019/02 II 2019/.04
2018/10
2018/06
2018/04
2018/10 & 12
2018/10
2018/08
2018/06
2018/10
2018/04
2020/02
2019/03
2018/05
2019/02
2018/10
2018/07
2018/11 II 2019/11
2019/01
0
2018/04 II 2018/09
2019/03
2018/09 & 11
2018/05 & 08 II 2019/09
2019/06
2018/03
2019/07
2019/02
2020/02
2018/08
2019/05
2018/08
2019/07
2019/03
2019/08
2019/01
2019/03
Jakarta , 31 Maret 2018

Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : April
JUMLAH
STOK STOK YANG AKAN
KADALU
STOK JUMLAH JUMLAH STOK WARSA/ SISA STOK AKHIR KEBUTUHAN KADALUWARSA DALAM
NAMA MERK UNIT SATUAN AWAL STOK TERPAKAI UNTUK 3 KURUN WAKTU 1-3 BULAN
NO JENIS BARANG RUSAK / BULAN INI KE DEPAN
DAGANG TERKECIL BULAN DITERIMA BULAN INI HILANG BULAN
BULAN JUMLAH LOT ED
A B C D
INI E = (A+B)-(C+D) F = (3X C) G
1 Cholesterol Thermo, Scientific Kit , 6 x 6 ml 3 0 1 0 2 3
2 Trigliserid Thermo, Scientific Kit , 12 x 20 ml 3 0 0 0 3 0
Kit , 8 x 16 ml +
3 Asam Urat Thermo, Scientific
8 x 4 ml
2 1 1 0 2 3
4 Urea Thermo, Scientific Kit , 12 x 20 ml 5 0 1 0 4 3
Kit ,4 x 20 ml +
5 Creatinin Thermo, Scientific
4 x 10 ml
2 0 1 0 1 3
Kit , 6 x 18 ml +
6 HDL Cholesterol Thermo, Scientific
6 x 6 ml
2 0 0 0 2 0
Kit , 6 x 18 ml +
7 LDL Cholesterol Thermo, Scientific
6 x 6 ml
1 0 0 0 1 0
Kit, 8 x 16 ml +
8 AST / GOT Thermo, Scientific
8 x 4 ml
1 0 0 0 1 0
Kit, 8 x 16 ml +
9 ALT / GPT Thermo, Scientific
8 x 4 ml
1 0 1 0 0 3
Kit, 4 x 20 ml +
10 Bilirubin Direct Thermo, Scientific 20 x 4 ml + 1 x 0 0 0 0 0 0
5 ml
11 E-CAL Indiko Thermo Thermo, Scientific Kit, 5x3 ml 0 0 0 0 0 0

12 HDL/LDL Calibrator Thermo, Scientific Kit, 5 x 1 ml 1 0 0 0 1 0
13 Nortrol Thermo, Scientific Kit, 10 x 5 ml 0 0 0 0 0 0
14 Wash fluid Thermo, Scientific Kit, 8 x 20 ml 0 1 0 0 1 0
Box, 5 x 50 mg
+ 5 x 0.6 ml
0 0 0 0 0 0
17 Conditioning Solution Merk Cornley Box, 5 x 0.8 ml 0 0 0 0 0 0
20 Rheumatoid Factor 0 0 0 0 0 0
22 Quality Kontrol Darah Eight Check, Sysmex Set, 3 x 1,5 ml 0 0 0 0 0 0
Merk Thermo,
Scientific
Kit, 5 x 3 ml 1 0 1 0 0 3

31 Strip Glukosa Merk Diabcheck Box, 2x 25 strip 0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 4 10 4 0 10 12
33 Reagen HBsAg Merk Oncoprobe Box, 50 tes 0 0 0 0 0 0
BOX, @ 100
strip
0 0 0 0 0 0
Box, @ 100
strip
0 4 0 2 2 0
Box, @ 25
37 Amphetamine Merk Oncoprobe
cassette
0 0 0 0 0 0
Box, @ 25
38 Benzodiazephine Merk Oncoprobe
cassette
0 0 0 0 0 0
Box, @25
39 THC Merk Oncoprobe
cassette
0 0 0 0 0 0
Botol, @1000
40 Wash benzine Merk PT.Brataco
ml
2 0 0 0 2 0
43 Alkohol 70 % Merk One Med Botol, 1000 ml 6 0 1 0 5 3

48 Lugol Indoreagen Botol, @ 100 ml 0 0 0 0 0 0
Tes Narkoba 3 in 1 (Amp, Morp,

60 THC)
63 Reagen HIV Onestep HIV, Intec Box, 100 tes 0 0 0 0 0 0
65 Scal Thermo, Scientific Kit, 10 x 3 ml 1 0 0 0 1 0

66 Washing Solution 4,5% Thermo, Scientific Kit, 4x20 ml 0 0 0 0 0 0
67 Abtrol Thermo, Scientific Kit, 10 x 5 ml 0 0 0 0 0 0
68 RPR Fokus Kit, 100 tes 0 2 2 0 0 6
Liquicheck Urine Chemistry

79 level 1
Biorad Kit, 12x10 ml 0 0 0 0 0 0
Liquicheck Urine Chemistry

80 level 2
Biorad Kit, 12x10 ml 0 0 0 0 0 0
81 Check stik combo pack kontrol Siemens 50 pcs/set 0 0 0 0 0 0

Botol, 100 ml (3
botol)
15 0 1 0 14 3
94 Multi Drugs Answer 5 panel Human BOX, 25 TES 0 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 1 0 1 0 0 3
96 Reagen HIV VIKIA BOX , 25 Tes 1 0 1 0 0 3
97 Multi Drugs Answer 5 panel ANSWER BOX, 25 Tes 0 0 0 0 0 0
98 Strip Glukosa Benecheck Box, 50 Tes 28 0 0 0 28 0
99 Strip Cholesterol Benecheck Box, 10 Tes 74 0 0 0 74 0
101 TPHA FOKUS Kit, 100 Tes 0 1 0 0 1 0

102 Dengue IgG/IgM Pakar Biomedika Kit, 10 test 0 5 0 0 5 0
Jakarta ,
Pembu
W
NIP. 19811
RIUM
AMATAN MENTENG
arat No.14
36-3103439 Fax : 31904965
ABORATORIUM TAHUN 2018
JUMLAH
PERMINTAAN
Expired Date
UNTUK 3
BULAN
H = (CX3)-E I
1 2019/02
-3 2019/02 // 2019/04
1 2018/12
-1 2018/10 // 2018/12
2 2018/04
-2 2018/10 // 2018/12
-1 2018/08
-1 2018/08
0
-1 2018/04
-1 2019/03
-2 2020
-8
0
0
-2 2019/06
-2
-8
-2
-5
0
0
-1
0 2019/09
60
-1
-5
-39 2018/11 // 2018/09
-39 2018/05 // 2018/08 //

2019/09
-1
0
-14 2019/07
-34
-2
-2
-2
-2
-2
6
-11
-8
-10
-4 2018/08
-28
-74
-18
-1
-5
Jakarta , 30 April 2018

Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : Mei
STOK YANG AKAN
STOK JUMLAH STOK JUMLAH STOK KADALUWARSA DALAM KURUN JUMLAH
AWAL JUMLAH STOK TERPAKAI KADALUWARSA/ SISA STOK AKHIR KEBUTUHAN UNTUK 3 WAKTU 1-3 BULAN KE DEPAN PERMINTAAN
NAMA MERK DITERIMA RUSAK / HILANG BULAN INI BULAN
NO JENIS BARANG DAGANG UNIT SATUAN TERKECIL BULAN BULAN INI JUMLAH LOT ED UNTUK 3 BULAN
BULAN INI
Thermo,
1 Cholesterol
Scientific
Kit , 6 x 6 ml 2 0 0 0 2 0 -2
Thermo,
2 Trigliserid
Scientific
Kit , 12 x 20 ml 3 0 0 0 3 0 -3
Thermo,
3 Asam Urat
Scientific
Kit , 8 x 16 ml + 8 x 4 ml 2 0 0 0 2 0 -2
Thermo,
4 Urea
Scientific
Kit , 12 x 20 ml 4 0 1 0 3 3 0
Thermo,
5 Creatinin
Scientific
Kit ,4 x 20 ml + 4 x 10 ml 1 0 1 0 0 3 3
Thermo,
6 HDL Cholesterol
Scientific
Kit , 6 x 18 ml + 6 x 6 ml 2 0 1 0 1 3 2
Thermo,
7 LDL Cholesterol
Scientific
Kit , 6 x 18 ml + 6 x 6 ml 1 0 1 0 0 3 3
Thermo,
8 AST / GOT
Scientific
Kit, 8 x 16 ml + 8 x 4 ml 1 0 0 0 1 0 1 2018/08 -1
Thermo,
9 ALT / GPT
Scientific
Kit, 8 x 16 ml + 8 x 4 ml 0 0 0 0 0 0 0
Thermo, Kit, 4 x 20 ml + 20 x 4 ml +
10 Bilirubin Direct Scientific 1 x 5 ml
0 0 0 0 0 0 0
Thermo,
11 E-CAL Indiko Thermo Scientific
Kit, 5x3 ml 0 0 0 0 0 0 0
Thermo,
12 HDL/LDL Calibrator Scientific
Kit, 5 x 1 ml 1 0 1 0 0 3 3
Thermo,
13 Nortrol Scientific
Kit, 10 x 5 ml 0 0 0 0 0 0 0
Thermo,
14 Wash fluid Scientific
Kit, 8 x 20 ml 1 0 0 0 1 0 -1
15 Electrolytes Quality Control Merk Cornley Box, 10 x 1 ml 0 0 0 0 0 0 0
16 Deproteinizer Merk Cornley Box, 5 x 50 mg + 5 x 0.6 ml 0 0 0 0 0 0 0

19 Reagen Widal Merk Fokus Set, 8 x 5 ml 8 0 1 0 7 3 -4
Eight Check,
22 Quality Kontrol Darah Sysmex
Set, 3 x 1,5 ml 0 3 2 0 1 6 5
Merk Thermo,
23 Lipotrol Indiko Thermo Scientific
Kit, 5 x 3 ml 0 0 0 0 0 0 0
25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 0 0 8 0 -8
30 Syphillis Rapid Test MONOTES Box, @ 25 tes 0 0 0 0 0 0 0
31 Strip Glukosa Merk Diabcheck Box, 2x 25 strip 0 0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 10 0 3 0 7 9 2
33 Reagen HBsAg Merk Oncoprobe Box, 50 tes 0 0 0 0 0 0 0
36 Strip Urin Lengkap Merk Siemens Box, @ 100 strip 2 0 2 0 0 6 6
37 Amphetamine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0 0 0
38 Benzodiazephine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0 0 0
39 THC Merk Oncoprobe Box, @25 cassette 0 0 0 0 0 0 0
40 Wash benzine Merk PT.Brataco Botol, @1000 ml 2 0 0 0 2 0 -2

42 Spiritus BE Reagen Botol, 1000 ml 8 0 0 0 8 0 -8
43 Alkohol 70 % Merk One Med Botol, 1000 ml 5 0 0 0 5 0 -5
46 Stromatolyzer Merk Sysmex Botol, 500 ml 2 10 2 0 10 6 -4
47 Cell Clean Merk Sysmex Botol, 50 ml 0 1 0 0 1 0 -1
53 Carbol Fuchsin Indoreagen Botol, 100 ml 0 0 0 0 6 0 -6
58 Na. Hipoklorit Lokal Botol, 1000 ml 1 0 0 0 1 0 -1
59 Lisol Onemed Botol, 1000 ml 5 0 0 0 5 0 -5
60 Tes Narkoba 3 in 1 (Amp, Morp, THC) Sensor Box, 25 panel 0 0 0 0 0 0 0
Onestep HIV,
63 Reagen HIV Intec
Box, 100 tes 0 0 0 0 0 0 0
64 Reagen HIV SD HIV Box, 100 tes 57 0 4 0 53 12 12 2018/08 -41
Thermo,
65 Scal Scientific
Kit, 10 x 3 ml 1 0 0 0 1 0 -1
Thermo,
66 Washing Solution 4,5% Scientific
Kit, 4x20 ml 0 0 0 0 0 0 0
Thermo,
67 Abtrol Scientific
Kit, 10 x 5 ml 0 0 0 0 0 0 0
68 RPR Fokus Kit, 100 tes 0 8 3 0 5 9 4
74 Ziehl Neelsen Indoreagen Kit, 4 x 100 ml 0 0 0 0 0 0 0
75 Anti A Golongan Darah Lorne Botol 10 ml 5 0 1 0 4 3 -1
76 Anti B Golongan Darah Lorne Botol 10 ml 5 0 1 0 4 3 -1
77 Anti AB Golongan Darah Lorne Botol 10 ml 5 0 1 0 4 3 -1
78 Anti D Golongan Darah Lorne Botol 10 ml 5 0 1 0 4 3 -1
79 Liquicheck Urine Chemistry level 1 Biorad Kit, 12x10 ml 0 0 0 0 0 0 0
80 Liquicheck Urine Chemistry level 2 Biorad Kit, 12x10 ml 0 0 0 0 0 0 0
81 Check stik combo pack kontrol Siemens 50 pcs/set 0 0 0 0 0 0 0
83 RDT Leptospirosis Biomedika Box, 10 alat uji 0 0 0 0 0 0 0
84 Ziehl Neelsen One Med Botol, 100 ml (3 botol) 14 0 0 0 14 0 -14

92 Eter Alkohol St Reagen Botol, 1000 ml 10 0 0 0 10 0 -10
93 HCG strip GEA BOX, 25 TES 7 0 2 0 5 6 5 2018/08 1
94 Multi Drugs Answer 5 panel Human BOX, 25 TES 0 0 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 0 0 0 0 0 0 0
96 Reagen HIV VIKIA BOX , 25 Tes 0 0 0 0 0 0 0
97 Multi Drugs Answer 5 panel ANSWER BOX, 25 Tes 0 0 0 0 0 0 0
101 TPHA FOKUS Kit, 100 Tes 1 0 0 0 1 0 -1
102 Dengue IgG/IgM Pakar Biomedika Kit, 10 test 5 0 0 0 5 0 -5
103 CLE-P Cleanser Gracia Botol, 50 ml 0 3 0 0 3 0 -3
104 DIL-A Diluent Gracia Kit, 20 L 0 4 0 0 4 0 -4
105 LYA-1 Lyse Gracia Kit,500 ml 0 5 0 0 5 4 -5
106 LYA-2 Lyse Gracia Kit,500 ml 0 5 0 0 5 0 -5
107 LYA-3 Lyse Gracia Kit,1 L 0 5 0 0 5 0 -5
108 Blood Control 5 Diff Trilevel Gracia Vial 0 0 0 0 0 0 0
109 Liquicheck Sedimentation Rate Ctrl LGracia Vial 0 1 0 0 1 0 -1
110 Liquicheck Sedimentation Rate Ctrl LGracia Vial 0 1 0 0 1 0 -1
111 Liquicheck Urinalysis Control Lv 1 Gracia Vial 0 3 0 0 3 0 -3
112 Liquicheck Urinalysis Control Lv 2 Gracia Vial 0 3 0 0 3 0 -3
113 Urine Strip 11 A Gracia Botol 0 20 0 0 20 0 -20

114 Stri 3 Parameter Verify Gracia Botol ,100 tes 0 5 0 0 5 0 -5
115 DI Smart Diagnostik Gracia Pack 0 8 0 0 0 0
Jakarta , 31 Mei 2018
Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
Expired Date
2019/02
2019/02 //
2019/04
2018/12
2018/10 //
2018/12
2018/04
2018/10 //
2018/12
2018/08
2018/08
2018/04
2019/03
2020
2019/06
2019/09
2018/11 //
2018/09
2018/08
2019/09
2019/07
2018/08
26/10/2018
4/5/2019
4/5/2019
06/03/2020
8/2/2020
04/05/2019
27/02/2020
29/07/2018
28/05/2019
28/05/2019
31/07/2019
31/07/2020
14/01/2019
20/07/2019
1/3/2020
Jakarta , 31 Mei 2018
Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : Juni
JUMLAH STOK STOK YANG AKAN

NAMA MERK UNIT SATUAN STOK AWAL JUMLAH STOK JUMLAH STOK KADALUWARSA KEBUTUHAN KADALUWARSA
NO JENIS BARANG DAGANG TERKECIL BULAN DITERIMA TERPAKAI / RUSAK / SISA STOK AKHIR BULAN INI UNTUK 3 BULAN DALAM KURUN
BULAN INI HILANG BULAN WAKTU 1-3 BULAN
INI KE DEPAN
1 Cholesterol Thermo, Scientific Kit , 6 x 6 ml 2 0 0 0 2
2 Trigliserid Thermo, Scientific Kit , 12 x 20 ml 3 0 0 0 3
Kit , 8 x 16 ml + 8 x
3 Asam Urat Thermo, Scientific
4 ml
2 0 1 0 1
4 Urea Thermo, Scientific Kit , 12 x 20 ml 3 0 0 0 3
Kit ,4 x 20 ml + 4 x
5 Creatinin Thermo, Scientific
10 ml
0 1 1 0 0
Kit , 6 x 18 ml + 6 x
6 HDL Cholesterol Thermo, Scientific
6 ml
1 0 0 0 1
Kit , 6 x 18 ml + 6 x
7 LDL Cholesterol Thermo, Scientific
6 ml
0 0 0 0 0
Kit, 8 x 16 ml + 8 x
8 AST / GOT Thermo, Scientific
4 ml
1 0 0 0 1
Kit, 8 x 16 ml + 8 x
9 ALT / GPT Thermo, Scientific
4 ml
0 0 0 0 0
Kit, 4 x 20 ml + 20 x
10 Bilirubin Direct Thermo, Scientific
4 ml + 1 x 5 ml
0 0 0 0 0
11 E-CAL Indiko Thermo Thermo, Scientific Kit, 5x3 ml 0 0 0 0 0
12 HDL/LDL Calibrator Thermo, Scientific Kit, 5 x 1 ml 0 0 0 0 0
13 Nortrol Thermo, Scientific Kit, 10 x 5 ml 0 0 0 0 0
14 Wash fluid Thermo, Scientific Kit, 8 x 20 ml 1 0 0 0 1
15 Electrolytes Quality Control Merk Cornley Box, 10 x 1 ml 0 0 0 0 0
Box, 5 x 50 mg + 5
x 0.6 ml
0 0 0 0 0
17 Conditioning Solution Merk Cornley Box, 5 x 0.8 ml 0 0 0 0 0
18 Reagen Golongan Darah Merk Fortrest Set, 4 x 5 ml 0 0 0 0 0

19 Reagen Widal Merk Fokus Set, 8 x 5 ml 7 0 1 0 6
20 Rheumatoid Factor 0 0 0 0 0
21 Refill Solution Elektrolit Merk Cornley Kit , 5 x 0.8 ml 0 0 0 0 0
22 Quality Kontrol Darah Eight Check, Sysmex Set, 3 x 1,5 ml 1 1 1 0 1
23 Lipotrol Indiko Thermo Merk Thermo, Scientific Kit, 5 x 3 ml 0 1 0 0 1
24 Tes Kehamilan Merk Answer Kit, 50 test 0 0 0 0 0
25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 0 0 8
26 Reagen HIV Advance/Intec Box, 100 tes 0 0 0 0 0
27 Reagen HIV FOKUS Box, 50 tes 0 0 0 0 0
28 Reagen HIV SD Box, 30 tes 0 0 0 0 0
29 Reagen HIV ONCOPROBE Box, 50 tes 0 0 0 0 0
30 Syphillis Rapid Test MONOTES Box, @ 25 tes 0 0 0 0 0
31 Strip Glukosa Merk Diabcheck Box, 2x 25 strip 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 7 0 1 0 6
33 Reagen HBsAg Merk Oncoprobe Box, 50 tes 0 0 0 0 0
34 Reagen HBsAg Merk FOKUS Box, 50 tes 0 0 0 0 0
35 Strip Urin Lengkap Merk URS 10 BOX, @ 100 strip 0 0 0 0 0
36 Strip Urin Lengkap Merk Siemens Box, @ 100 strip 0 8 1 0 7
37 Amphetamine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0
38 Benzodiazephine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0
39 THC Merk Oncoprobe Box, @25 cassette 0 0 0 0 0
40 Wash benzine Merk PT.Brataco Botol, @1000 ml 2 0 1 0 1
41 Oil Imersi Merk MERCK Botol, 500 l 0 0 0 0 0
42 Spiritus BE Reagen Botol, 1000 ml 8 0 1 0 7
43 Alkohol 70 % Merk One Med Botol, 1000 ml 5 0 2 0 3
44 Giemsa Merk MERCK Botol, 500 ml 0 2 0 0 2
45 KOH 10 % Indoreagen Botol, 500 ml 5 0 0 0 5

46 Stromatolyzer Merk Sysmex Botol, 500 ml 10 10 1 0 19
47 Cell Clean Merk Sysmex Botol, 50 ml 1 0 1 0 0
48 Lugol Indoreagen Botol, @ 100 ml 0 0 0 0 0
49 Pewarnaan Gram Indoreagen Botol, 500 ml 1 0 0 0 1
50 Eosin Indoreagen Botol, 100 ml 0 0 0 0 0
51 Asam alkohol Indoreagen Botol, 500 ml 0 0 0 0 0
52 Methyleen Blue Indoreagen Botol, 100 ml 0 0 0 0 0
53 Carbol Fuchsin Indoreagen Botol, 100 ml 0 0 0 0 0
54 IgG/IgM Dengue Monotes Box, 50 tes 0 0 0 0 0
55 NS1 Dengue Cortez Box, 25 tes 0 0 0 0 0
56 Cell Pack Merk Sysmex Box, 30 L 6 0 1 0 5
57 Aquabidest Botol, 1000 ml 0 30 8 0 22
58 Na. Hipoklorit Lokal Botol, 1000 ml 1 0 0 0 1
59 Lisol Onemed Botol, 1000 ml 5 0 1 0 4
60 Tes Narkoba 3 in 1 (Amp, Morp, THC) Sensor Box, 25 panel 0 0 0 0 0
61 Strip Glucosa Accu Check Box, 100 tes 93 20 6 0 107
62 Tes Kehamilan Ultra One Test Box, 50 tes 0 0 0 0 0
63 Reagen HIV Onestep HIV, Intec Box, 100 tes 0 0 0 0 0
64 Reagen HIV SD HIV Box, 100 tes 53 0 2 0 51
65 Scal Thermo, Scientific Kit, 10 x 3 ml 1 0 0 0 1
66 Washing Solution 4,5% Thermo, Scientific Kit, 4x20 ml 0 0 0 0 0
67 Abtrol Thermo, Scientific Kit, 10 x 5 ml 0 0 0 0 0
68 RPR Fokus Kit, 100 tes 5 0 4 0 1
69 HCV Strip FOKUS Box, 25 tes 16 0 1 0 15
70 Strip Hb Meter Mission Box, 50 strip 37 0 10 0 27
71 Asam Sulfosalisilat 20% Indoreagen Botol 100 ml 0 0 0 0 0
72 Reagen Pak Elektrolit Klite Pak 0 0 0 0 0

73 Strip Urin Lengkap FOKUS Box, 100 tes 0 0 0 0 0
74 Ziehl Neelsen Indoreagen Kit, 4 x 100 ml 0 0 0 0 0
75 Anti A Golongan Darah Lorne Botol 10 ml 4 0 0 0 4
76 Anti B Golongan Darah Lorne Botol 10 ml 4 0 0 0 4
77 Anti AB Golongan Darah Lorne Botol 10 ml 4 0 0 0 4
78 Anti D Golongan Darah Lorne Botol 10 ml 4 0 0 0 4
79 Liquicheck Urine Chemistry level 1 Biorad Kit, 12x10 ml 0 0 0 0 0
80 Liquicheck Urine Chemistry level 2 Biorad Kit, 12x10 ml 0 0 0 0 0
81 Check stik combo pack kontrol Siemens 50 pcs/set 0 0 0 0 0
82 Tes Narkoba 5 in 1 Sensor Box, 25 panel 5 0 5 0 0
83 RDT Leptospirosis Biomedika Box, 10 alat uji 0 0 0 0 0
Botol, 100 ml (3
botol)
14 0 0 0 14
85 Reagen Wright Puppy Botol, 100 ml 0 0 0 0 0
86 Reagen Giemsa Puppy Botol, 100 ml 2 0 0 0 2
87 Metanol absolut Puppy Botol, 100 ml 0 0 0 0 0
88 Larutan Turk Puppy Botol, 100 ml 0 0 0 0 0
89 Larutan Ammonium Oxalat Puppy Botol, 100 ml 0 0 0 0 0
90 Malaria rapid tes Fokus Kit, 25 tes 0 0 0 0 0
91 Syphillis Rapid Test Human Kit, 20 tes 0 0 0 0 0
92 Eter Alkohol St Reagen Botol, 1000 ml 10 0 0 0 10
93 HCG strip GEA BOX, 25 TES 5 0 0 0 5
94 Multi Drugs Answer 5 panel Human BOX, 25 TES 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 0 0 0 0 0
96 Reagen HIV VIKIA BOX , 25 Tes 0 0 0 0 0
97 Multi Drugs Answer 5 panel ANSWER BOX, 25 Tes 0 0 0 0 0
98 Strip Glukosa Benecheck Box, 50 Tes 28 0 1 0 27
99 Strip Cholesterol Benecheck Box, 10 Tes 74 0 3 0 71

100 Strip Uric Acid Benecheck Box, 25 Tes 18 0 2 0 16
101 TPHA FOKUS Kit, 100 Tes 1 0 0 0 1
102 Dengue IgG/IgM Pakar Biomedika Kit, 10 test 5 0 0 0 5
103 CLE-P Cleanser Gracia Botol, 50 ml 3 0 0 0 3
104 DIL-A Diluent Gracia Kit, 20 L 4 1 0 0 5
105 LYA-1 Lyse Gracia Kit,500 ml 5 0 0 0 5
106 LYA-2 Lyse Gracia Kit,500 ml 5 0 0 0 5
107 LYA-3 Lyse Gracia Kit,1 L 5 0 0 0 5
108 Blood Control 5 Diff Trilevel Gracia Vial 0 2 0 0 2
109 Liquicheck Sedimentation Rate Ctrl Lv 1 Gracia Vial 1 0 0 0 1
110 Liquicheck Sedimentation Rate Ctrl Lv 2 Gracia Vial 1 0 0 0 1
111 Liquicheck Urinalysis Control Lv 1 Gracia Vial 3 0 0 0 3
112 Liquicheck Urinalysis Control Lv 2 Gracia Vial 3 0 0 0 3
113 Urine Strip 11 A Gracia Botol 20 0 0 0 20
114 Stri 3 Parameter Verify Gracia Botol ,100 tes 5 0 0 0 5
115 DI Smart Diagnostik Gracia Pack 8 0 0 0 8
Jaka
Pem
NIP. 198
ORIUM
AMATAN MENTENG
Barat No.14
36-3103439 Fax : 31904965
ABORATORIUM TAHUN 2018
JUMLAH
UNTUK 3 BULAN
Jakarta , 30 Juni 2018
Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : Juli STOK YANG AKAN

KADALUWARSA DALAM
KURUN WAKTU 1-3 BULAN
KE DEPAN
JUMLAH JUMLAH STOK JUMLAH
STOK JUMLAH KADALUWARS
NAMA STOK SISA STOK AKHIR KEBUTUHAN PERMINTAAN Expired
UNIT SATUAN AWAL STOK TERPAKAI A/ RUSAK / BULAN INI UNTUK 3 BULAN JUMLA UNTUK 3 Date
NO JENIS BARANG MERK BULAN DITERIMA HILANG LOT ED
TERKECIL BULAN INI H BULAN
DAGANG BULAN INI
Thermo, 2019/02
1 Cholesterol
Scientific
Kit , 6 x 6 ml 2 4 0 0 6 0 2019/05
Thermo, 2019/02
2 Trigliserid
Scientific
Kit , 12 x 20 ml 3 4 1 0 6 3 2019/04
3 Asam Urat
1 4 0 0 5 0 2018/12
4 Urea
Scientific ml
3 0 1 0 2 3 2018/12
Thermo, Kit ,4 x 20 ml +
5 Creatinin
Scientific 4 x 10 ml
0 3 0 0 3 0 2018/12
Thermo, Kit , 6 x 18 ml 2018/12

6 HDL Cholesterol
1 4 0 0 5 0 2019/06
Thermo, Kit , 6 x 18 ml 2018/10

7 LDL Cholesterol
0 3 1 0 2 3 2018/10 2019/01
Thermo, Kit, 8 x 16 ml +
8 AST / GOT
Scientific 8 x 4 ml
1 0 1 0 0 3
Thermo, Kit, 8 x 16 ml +
9 ALT / GPT
Scientific 8 x 4 ml
0 1 1 0 0 3
Kit, 4 x 20 ml +
Thermo,
10 Bilirubin Direct
Scientific
20 x 4 ml + 1 x 0 0 0 0 0 0
5 ml
Thermo,
Scientific
Kit, 5x3 ml 0 1 0 0 1 0 1 2018/10 2018/10
Thermo,
Scientific
Kit, 5 x 1 ml 0 1 1 0 0 3
Thermo,
13 Nortrol
Scientific
Kit, 10 x 5 ml 0 2 0 0 2 0 2020/02
Thermo,
14 Wash fluid
Scientific
Kit, 8 x 20 ml 1 0 0 0 1 0 2019/03

Box, 5 x 50 mg
+ 5 x 0.6 ml
0 0 0 0 0 0
17 Conditioning Solution Merk Cornley Box, 5 x 0.8 ml 0 0 0 0 0 0
20 Rheumatoid Factor 0 0 0 0 0 0
Eight Check,
Sysmex
Set, 3 x 1,5 ml 1 0 1 0 0 3
Merk Thermo,
Scientific
Kit, 5 x 3 ml 1 2 1 0 2 3 2019/02
25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 0 0 8 0 2018/10
ONCOPROB
29 Reagen HIV
E
Box, 50 tes 0 0 0 0 0 0
Merk Box, 2x 25
31 Strip Glukosa
Diabcheck strip
0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 6 0 3 0 3 9 2020/01
Merk
33 Reagen HBsAg
Oncoprobe
Box, 50 tes 0 0 0 0 0 0
BOX, @ 100
strip
0 0 0 0 0 0
Box, @ 100
strip
7 0 2 0 5 6
Merk Box, @ 25
37 Amphetamine
Oncoprobe cassette
0 0 0 0 0 0 2019/01
Merk Box, @ 25
38 Benzodiazephine
Oncoprobe cassette
0 0 0 0 0 0
Merk Box, @25

39 THC
Oncoprobe cassette
0 0 0 0 0 0
Merk Botol, @1000

40 Wash benzine
PT.Brataco ml
1 0 1 0 0 3
Merk One
43 Alkohol 70 %
Med
Botol, 1000 ml 3 0 2 0 1 6
2019/01
46 Stromatolyzer Merk Sysmex Botol, 500 ml 19 0 3 0 16 9 2019/04
Botol, @ 100
48 Lugol Indoreagen
ml
0 0 0 0 0 0
56 Cell Pack Merk Sysmex Box, 30 L 5 0 2 0 3 6 2019/07

60 Morp, THC)
2018/09
61 107 10 9 0 108 27 2018/11
Strip Glucosa Accu Check Box, 100 tes
2019/02
2019/06
Onestep HIV,
63 Reagen HIV
Intec
Box, 100 tes 0 0 0 0 0 0
64 51 0 4 0 47 12 2018/08
Reagen HIV SD HIV Box, 100 tes
2019/09
Thermo,
65 Scal
Scientific
Kit, 10 x 3 ml 1 2 0 0 3 0 2019/06
Thermo,
Scientific
Kit, 4x20 ml 0 0 0 0 0 0
Thermo,
67 Abtrol
Scientific
Kit, 10 x 5 ml 0 0 0 0 0 0
68 RPR Fokus Kit, 100 tes 1 0 1 0 0 3
69 HCV Strip FOKUS Box, 25 tes 15 0 1 0 14 3 2019/07
70 Strip Hb Meter Mission Box, 50 strip 27 0 0 0 27 0 2019/02
Liquicheck Urine
Biorad Kit, 12x10 ml 0 0 0 0 0 0
Liquicheck Urine
Biorad Kit, 12x10 ml 0 0 0 0 0 0
81 kontrol
Siemens 50 pcs/set 0 0 0 0 0 0
Botol, 100 ml
(3 botol)
14 0 0 0 14 0 2020/02
93 HCG strip GEA BOX, 25 TES 5 0 2 0 3 6 2018/08

94 panel
Human BOX, 25 TES 0 0 0 0 0 0
95 Reagen HIV FOKUS BOX , 25 Tes 0 0 0 0 0 0 2019/07
96 Reagen HIV VIKIA BOX , 25 Tes 0 0 0 0 0 0 2019/03

97 panel
ANSWER BOX, 25 Tes 0 0 0 0 0 0
98 Strip Glukosa Benecheck Box, 50 Tes 27 0 2 0 25 6 2019/08
99 Strip Cholesterol Benecheck Box, 10 Tes 71 0 5 0 66 15 2019/01
100 Strip Uric Acid Benecheck Box, 25 Tes 16 0 1 0 15 3 2019/03
101 TPHA FOKUS Kit, 100 Tes 1 0 0 0 1 0
102 Dengue IgG/IgM Pakar Biomedi Kit, 10 test 5 0 0 0 5 0 2019/09

103 CLE-P Cleanser Gracia Botol, 50 ml 3 0 0 0 3 0
104 DIL-A Diluent Gracia Kit, 20 L 5 0 1 0 4 3
105 LYA-1 Lyse Gracia Botol,500 ml 5 0 0 0 5 0
106 LYA-2 Lyse Gracia Botol,500 ml 5 0 0 0 5 0
107 LYA-3 Lyse Gracia Botol,1 L 5 0 0 0 5 0
Blood Control 5 Diff

108 Gracia Vial 2 0 0 0 2 0
Trilevel
Liquicheck
109 Sedimentation Rate Ctrl Gracia Vial 1 0 0 0 1 0
Lv 1
Liquicheck
110 Sedimentation Rate Ctrl Gracia Vial 1 0 0 0 1 0
Lv 2
111 Liquicheck
Urinalysis
Gracia Vial 3 0 0 0 3 0
Control Lv 1
112 Liquicheck
Urinalysis
Gracia Vial 3 0 0 0 3 0
Control Lv 2
113 Urine Strip 11 A Gracia Botol 20 0 0 0 20 0
114 Stri 3 Parameter Verify Botol ,100 tes 5 0 2 0 3 6 2019/09
115 DI Smart Diagnostik Star Kit 25 Tes 8 0 2 0 6 6 2020/03
116 Glucose Scientific + 8 x 4 ml
0 4 1 0 3 3 2019/07
Jakarta , 31 Juli 2018

Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
PERIODE : Agustus
STOK YANG AKAN
KADALUWARSA
DALAM KURUN
JUMLAH JUMLAH JUMLAH STOK WAKTU 1-3 BULAN JUMLAH
STOK STOK STOK KADALUWARSA SISA STOK AKHIR KEBUTUHAN KE DEPAN PERMINTAA
NAMA MERK UNIT SATUAN AWAL DITERIM TERPAKA / RUSAK / BULAN INI UNTUK 3 N UNTUK 3
NO JENIS BARANG BULAN I BULAN HILANG BULAN BULAN
DAGANG TERKECIL A JUML LOT BULAN
INI INI ED
AH
Thermo,
1 Cholesterol
Scientific
Kit , 6 x 6 ml 6 0 0 0 6 0 -6
Thermo,
2 Trigliserid
Scientific
Kit , 12 x 20 ml 6 0 0 0 6 0 -6
Thermo, Kit , 8 x 16 ml + 8
3 Asam Urat
Scientific x 4 ml
5 0 0 0 5 0 -5
Thermo,
4 Urea
Scientific
Kit , 12 x 20 ml 2 0 0 0 2 0 -2
Thermo, Kit ,4 x 20 ml + 4 x
5 Creatinin
Scientific 10 ml
3 0 0 0 3 0 -3
6 HDL Cholesterol
Scientific x 6 ml
5 0 1 0 4 3 -1
7 LDL Cholesterol
Scientific x 6 ml
2 0 1 0 1 3 2
Thermo, Kit, 8 x 16 ml + 8 x
8 AST / GOT
Scientific 4 ml
0 0 0 0 0 0 0
Thermo, Kit, 8 x 16 ml + 8 x
9 ALT / GPT
Scientific 4 ml
0 0 0 0 0 0 0
Thermo, Kit, 4 x 20 ml + 20
10 Bilirubin Direct
Scientific x 4 ml + 1 x 5 ml
0 0 0 0 0 0 0
Thermo,
Scientific
Kit, 5x3 ml 1 0 0 0 1 0 1 -1
Thermo,
Scientific
Kit, 5 x 1 ml 0 0 0 0 0 0 0
Thermo,
13 Nortrol
Scientific
Kit, 10 x 5 ml 2 0 0 0 2 0 -2
Thermo,
14 Wash fluid
Scientific
Kit, 8 x 20 ml 1 0 0 0 1 0 -1
15 Electrolytes Quality Control Merk Cornley Box, 10 x 1 ml 0 0 0 0 0 0 0
Box, 5 x 50 mg +
5 x 0.6 ml
0 0 0 0 0 0 0
19 Reagen Widal Merk Fokus Set, 8 x 5 ml 4 0 3 0 1 9 8
Eight Check,
Sysmex
Set, 3 x 1,5 ml 0 3 1 0 2 3 1
Merk Thermo,
Scientific
Kit, 5 x 3 ml 2 0 0 0 2 0 -2
25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 2 0 6 6 0

30 Syphillis Rapid Test MONOTES Box, @ 25 tes 0 0 0 0 0 0 0
Merk
31 Strip Glukosa
Diabcheck
Box, 2x 25 strip 0 0 0 0 0 0 0
32 Reagen HBsAg Merk SD Box, 100 tes 3 0 3 0 0 9 9
Merk
33 Reagen HBsAg
Oncoprobe
Box, 50 tes 0 0 0 0 0 0 0
36 Strip Urin Lengkap Merk Siemens Box, @ 100 strip 5 0 3 0 2 9 7
Merk Box, @ 25
37 Amphetamine
Oncoprobe cassette
0 0 0 0 0 0 0
Merk Box, @ 25
38 Benzodiazephine
Oncoprobe cassette
0 0 0 0 0 0 0
Merk Box, @25

39 THC
Oncoprobe cassette
0 0 0 0 0 0 0
Merk
40 Wash benzine
PT.Brataco
Botol, @1000 ml 0 0 0 0 0 0 0
42 Spiritus BE Reagen Botol, 1000 ml 7 0 1 0 6 3 -3
Merk One
43 Alkohol 70 %
Med
Botol, 1000 ml 1 10 3 0 8 9 1
44 Giemsa Merk MERCK Botol, 500 ml 2 0 0 0 2 0 -2
46 Stromatolyzer Merk Sysmex Botol, 500 ml 16 0 4 0 12 12 0
49 Pewarnaan Gram Indoreagen Botol, 500 ml 1 0 1 0 0 3 3
53 Carbol Fuchsin Indoreagen Botol, 100 ml 0 0 0 0 0 0 0
56 Cell Pack Merk Sysmex Box, 30 L 3 0 0 0 3 0 -3
58 Na. Hipoklorit Lokal Botol, 1000 ml 1 0 0 0 1 0 -1
59 Lisol Onemed Botol, 1000 ml 3 5 1 0 7 3 -4
Tes Narkoba 3 in 1 (Amp, Morp,

60 THC)
Onestep HIV,
63 Reagen HIV
Intec
Box, 100 tes 0 0 0 0 0 0 0
64 Reagen HIV SD HIV Box, 100 tes 47 0 11 0 36 33 -3
Thermo,
65 Scal
Scientific
Kit, 10 x 3 ml 3 0 0 0 3 0 -3
Thermo,
Scientific
Kit, 4x20 ml 0 0 0 0 0 0 0
Thermo,
67 Abtrol
Scientific
Kit, 10 x 5 ml 0 0 0 0 0 0 0
68 RPR Fokus Kit, 100 tes 0 0 0 0 0 0 0
70 Strip Hb Meter Mission Box, 50 strip 27 0 8 0 19 24 5
74 Ziehl Neelsen Indoreagen Kit, 4 x 100 ml 0 0 0 0 0 0 0
75 Anti A Golongan Darah Lorne Botol 10 ml 2 5 2 0 5 6 1
76 Anti B Golongan Darah Lorne Botol 10 ml 2 5 2 0 5 6 1
77 Anti AB Golongan Darah Lorne Botol 10 ml 2 5 2 0 5 6 1

78 Anti D Golongan Darah Lorne Botol 10 ml 2 5 2 0 5 6 1
Liquicheck Urine Chemistry level

79 1
Biorad Kit, 12x10 ml 0 0 0 0 0 0 0
Liquicheck Urine Chemistry level

80 2
Biorad Kit, 12x10 ml 0 0 0 0 0 0 0
81 Check stik combo pack kontrol Siemens 50 pcs/set 0 0 0 0 0 0 0
83 RDT Leptospirosis Biomedika Box, 10 alat uji 0 0 0 0 0 0 0
Botol, 100 ml (3
botol)
14 0 2 0 12 6 -6
92 Eter Alkohol St Reagen Botol, 1000 ml 10 0 0 0 10 0 -10
93 HCG strip GEA BOX, 25 TES 3 0 3 0 0 9 9
94 Multi Drugs Answer 5 panel Human BOX, 25 TES 0 0 0 0 0 0 0

95 Reagen HIV FOKUS BOX , 25 Tes 0 0 0 0 0 0 0
96 Reagen HIV VIKIA BOX , 25 Tes 0 0 0 0 0 0 0
97 Multi Drugs Answer 5 panel ANSWER BOX, 25 Tes 0 0 0 0 0 0 0
101 TPHA FOKUS Kit, 100 Tes 1 0 0 0 1 0 -1
102 Dengue IgG/IgM Pakar Biomedik Kit, 10 test 5 0 1 0 4 3 -1
103 CLE-P Cleanser Gracia Botol, 50 ml 3 0 1 0 2 3 1
104 DIL-A Diluent Gracia Kit, 20 L 4 0 1 0 3 3 0
105 LYA-1 Lyse Gracia Botol,500 ml 5 0 2 0 3 6 3
106 LYA-2 Lyse Gracia Botol,500 ml 5 0 2 0 3 6 3
107 LYA-3 Lyse Gracia Botol,1 L 5 0 2 0 3 6 3
108 Blood Control 5 Diff Trilevel Gracia Vial 2 0 2 0 0 6 6
109 Liquicheck Sedimentation Gracia Vial 1 0 1 0 0 3 3

Rate Ctrl Lv 1
110 Liquicheck Sedimentation Gracia Vial 1 0 1 0 0 3 3

Rate Ctrl Lv 2
111 Liquicheck Urinalysis Control Gracia Vial 3 0 1 0 2 3 1

Lv 1
112 Liquicheck Urinalysis Control Gracia Vial 3 0 1 0 2 3 1
Lv 2
113 Urine Strip 11 A Gracia Botol 20 0 3 0 17 9 -8
114 Stri 3 Parameter Verify Botol ,100 tes 3 0 0 0 3 0 -3
115 DI Smart Diagnostik Star Kit 25 Tes 6 0 6 0 0 18 18
116 Glucose Scientific x 4 ml
3 0 0 0 3 0 -3
Jakarta , 31 Agustus 201

Pembuat Laporan
Widjiatmi
NIP. 1981100720000320
Expired
Date
I
2018/08
Jakarta , 31 Agustus 2018
Pembuat Laporan
Widjiatmi
NIP. 198110072000032001
LABORATORIUM
Periode : September
STOK YANG AKAN
KADALUWARSA
JUMLAH JUMLAH STOK DALAM KURUN
STOK JUMLAH KEBUTUHA JUMLAH
AWAL STOK STOK KADALUWARSA/ SISA STOK AKHIR WAKTU 1-3 BULAN
N UNTUK 3 JUMLA PERMINTAAN Expired Date
NAMA MERK UNIT SATUAN TERPAKAI RUSAK / HILANG BULAN INI KE DEPAN
NO JENIS BARANG BULAN DITERIMA BULAN LOT ED UNTUK 3 BULAN
DAGANG TERKECIL BULAN INI BULAN INI H
1 Reagen Widal Merk Fokus Set, 8 x 5 ml 1 0 1 0 0 3 3 2020
Eight Check,
Sysmex
Set, 3 x 1,5 ml 1 0 1 0 0 3 3 2018/10
3 Tes kehamilan Merk FOKUS Kit, 25 tes 1 0 1 0 0 3 3 2018/4
5 Reagen HBsAg Merk SD Box, 100 tes 1 0 1 0 0 3 3 2020/01
6 Strip Urin Lengkap Merk Siemens Box, @ 100 strip 1 0 1 0 0 3 3 2019/02
8 Spiritus BE Reagen Botol, 1000 ml 1 0 1 0 0 3 3
9 Alkohol 70 % Merk One Med Botol, 1000 ml 1 0 1 0 0 3 3
2019/01
10 Stromatolyzer Merk Sysmex Botol, 500 ml 3 0 1 0 2 3 1 2019/04
13 Lisol Onemed Botol, 1000 ml 1 0 1 0 0 3 3
2018/11
14 Strip Glucosa Accu Check Box, 100 tes 1 0 1 0 0 3 3 2019/06
2019/09
15 Reagen HIV SD HIV Box, 100 tes 1 0 1 0 0 3 3 2019/09
17 HCV Strip FOKUS Box, 25 tes 1 0 0 0 1 0 -1 2019/07
18 Strip Hb Meter Mission Box, 50 strip 5 0 1 0 4 3 -1 2019/02
20 Anti A Golongan Darah Lorne Botol 10 ml 1 0 1 0 0 3 3 2021/06
21 Anti B Golongan Darah Lorne Botol 10 ml 1 0 1 0 0 3 3 2021/04
22 Anti AB Golongan Darah Lorne Botol 10 ml 1 0 1 0 0 3 3 2020/09
23 Anti D Golongan Darah Lorne Botol 10 ml 1 0 1 0 0 3 3 2019/02
Botol, 100 ml (3
botol)
2 0 1 0 1 3 2 2020/08
26 Eter Alkohol St Reagen Botol, 1000 ml 1 0 1 0 0 3 3
28 Strip urin 3 Parameter Verify Botol ,100 tes 1 0 1 0 0 3 3 2019/09
Jakarta , 30 September 2018

Pembuat Laporan
Harto Waldi Tamara

NIK. 2232016

PGN Laporan Evaluasi Reagensia 2018

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PGN Laporan Evaluasi Reagensia 2018

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LABORATORIUM

BLUD PUSKESMAS KECAMATAN MENTENG

LAPORAN EVALUASI REAGEN LABORATORIUM TAHUN 2018

JUMLAH JUMLAH STOK STOK YANG AKAN

1 Cholesterol Thermo, Scientific Kit , 6 x 6 ml 3 0 1 0 2 3 1 2018/10 : 2

2 Trigliserid Thermo, Scientific Kit , 12 x 20 ml 3 0 1 0 2 3 1 2019/02 : 3

3 Asam Urat Thermo, Scientific Kit , 8 x 16 ml + 8 x 4 ml 3 0 1 0 2 3 1 2018/10

4 Urea Thermo, Scientific Kit , 12 x 20 ml 5 0 1 0 4 3 -1 2018/06

5 Creatinin Thermo, Scientific Kit ,4 x 20 ml + 4 x 10 ml 3 0 0 0 3 0 2 N596 2018/04 -3 2018/04

6 HDL Cholesterol Thermo, Scientific Kit , 6 x 18 ml + 6 x 6 ml 4 0 2 0 2 6 4 2018/10

7 LDL Cholesterol Thermo, Scientific Kit , 6 x 18 ml + 6 x 6 ml 2 0 1 0 1 3 2 2018/10

8 AST / GOT Thermo, Scientific Kit, 8 x 16 ml + 8 x 4 ml 1 0 0 0 1 0 -1 2018/06

9 ALT / GPT Thermo, Scientific Kit, 8 x 16 ml + 8 x 4 ml 2 0 1 0 1 3 2 2018/06

11 E-CAL Indiko Thermo Thermo, Scientific Kit, 5x3 ml 0 0 0 0 0 0 -1 2018/10

12 HDL/LDL Calibrator Thermo, Scientific Kit, 5 x 1 ml 1 0 0 0 1 0 1 N589C 2018/04 -1 2018/04

13 Nortrol Thermo, Scientific Kit, 10 x 5 ml 1 0 0 0 1 0 -1 2020/02

14 Wash fluid Thermo, Scientific Kit, 8 x 20 ml 0 0 0 0 0 0 0

17 Conditioning Solution Merk Cornley Box, 5 x 0.8 ml 1 0 1 0 0 3 3

19 Reagen Widal Merk Fokus Set, 8 x 5 ml 0 0 12 -3

21 Refill Solution Elektrolit Merk Cornley Kit , 5 x 0.8 ml 0 0 0 0 0 0 0

24 Tes Kehamilan Merk Answer Kit, 50 test 0 0 0 0 0 0 0

25 Tes kehamilan Merk FOKUS Kit, 25 tes 8 0 0 0 8 0 -8 2018/10

26 Reagen HIV Advance/Intec Box, 100 tes 0 0 0 0 0 0 0

27 Reagen HIV FOKUS Box, 50 tes 0 0 0 0 0 0 0

28 Reagen HIV SD Box, 30 tes 0 0 0 0 0 0 0

29 Reagen HIV ONCOPROBE Box, 50 tes 0 0 0 0 0 0 0

30 Syphillis Rapid Test MONOTES Box, @ 25 tes 7 0 1 0 6 3 -3 2018/07

31 Strip Glukosa Merk Diabcheck Box, 2x 25 strip 0 0 0 0 0 0 0

32 Reagen HBsAg Merk SD Box, 100 tes 12 0 3 0 9 9 9 01AMA0244 2018/03 0 2018/03

33 Reagen HBsAg Merk Oncoprobe Box, 50 tes 0 0 0 0 0 0 0

34 Reagen HBsAg Merk FOKUS Box, 50 tes 0 0 0 0 0 0 0

35 Strip Urin Lengkap Merk URS 10 BOX, @ 100 strip 0 0 0 0 0 0 0

36 Strip Urin Lengkap Merk Siemens Box, @ 100 strip 9 0 4 0 5 12 7 2019/01

37 Amphetamine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0 0 0

38 Benzodiazephine Merk Oncoprobe Box, @ 25 cassette 0 0 0 0 0 0 0

39 THC Merk Oncoprobe Box, @25 cassette 0 0 0 0 0 0 0

40 Wash benzine Merk PT.Brataco Botol, @1000 ml 2 0 0 0 2 0 -2 N/A

41 Oil Imersi Merk MERCK Botol, 500 l 0 0 0 0 0 0 0

42 Spiritus BE Reagen Botol, 1000 ml 8 0 0 0 8 0 -8 N/A

43 Alkohol 70 % Merk One Med Botol, 1000 ml 7 0 2 0 5 6 1 2020/02

44 Giemsa Merk MERCK Botol, 500 ml 0 0 0 0 0 0 0

46 Stromatolyzer Merk Sysmex Botol, 500 ml 8 0 0 0 8 0 -8 8/4/2018

47 Cell Clean Merk Sysmex Botol, 50 ml 1 0 1 0 0 3 3

48 Lugol Indoreagen Botol, @ 100 ml 0 0 0 0 0 0 0

50 Eosin Indoreagen Botol, 100 ml 1 0 0 0 1 0 -1 2018/12

51 Asam alkohol Indoreagen Botol, 500 ml 0 0 0 0 0 0 0

52 Methyleen Blue Indoreagen Botol, 100 ml 6 0 6 0 0 18 18 2018/11

53 Carbol Fuchsin Indoreagen Botol, 100 ml 5 0 5 0 0 15 15 2018/11

54 IgG/IgM Dengue Monotes Box, 50 tes 0 0 0 0 0 0 0

55 NS1 Dengue Cortez Box, 25 tes 0 0 0 0 0 0 0 2018/05

56 Cell Pack Merk Sysmex Box, 30 L 8 0 3 0 5 9 4 2019/02

57 Aquabidest Botol, 1000 ml 7 0 3 0 4 9 5

58 Na. Hipoklorit Lokal Botol, 1000 ml 1 0 0 0 1 0 -1 N/A

59 Lisol Onemed Botol, 1000 ml 6 0 1 0 5 3 -2 2019/03

Tes Narkoba 3 in 1 (Amp,

62 Tes Kehamilan Ultra One Test Box, 50 tes 0 0 0 0 0 0 0

63 Reagen HIV Onestep HIV, Intec Box, 100 tes 0 0 0 0 0 0 0

64 Reagen HIV SD HIV Box, 100 tes 72 0 6 0 66 18 -48 2018/08 : 12

66 Washing Solution 4,5% Thermo, Scientific Kit, 4x20 ml 1 0 1 0 0 3 3

67 Abtrol Thermo, Scientific Kit, 10 x 5 ml 4 0 0 0 4 0 -4 2018/02

71 Asam Sulfosalisilat 20% Indoreagen Botol 100 ml 0 0 0 0 0 0 0 2018/01

72 Reagen Pak Elektrolit Klite Pak 2 0 2 0 0 6 6 2018/06

73 Strip Urin Lengkap FOKUS Box, 100 tes 0 0 0 0 0 0 0