RUMAH SAKIT

MEDIKA STANNIA
SUNGAILIAT

BULAN : JANUARI 2013 MUTASI BARANG - BARANG DI POLI GIGI NO. PERKIRAAN ;
BAGIAN : POLI GIGI KELOMPOK BARANG : FARMASI TGL. PERMINTAAN 26-Jan-13

HARGA STOCK AWAL PENERIMAAN PEMAKAIAN SISA AKHIR

NO. NAMA BARANG STN
SATUAN KWANTUM NILAI KWANTUM NILAI KWANTUM NILAI KWANTUM NILAI
1 2 3 4 5 6 (4x5) 7 8 (4x7) 9 10 (4x9) 11 (5+7)-9 12 (4x11)
1 Lidocain Amp 1,100.00 6 6,600.00 - - - - 6 6,600.00
2 Iodine Povidone 1000 ml Btl 44,100.10 - - - - - -
3 Ciprofloxacin 500 Mg Pc 527.54 - - - - - -
4 Pehacain Inj. Amp 2,964.83 - - - - - -
5 Epinephrin Inj. Amp 345.70 - - - - - -
6 Sod. Natr. Chlort. 500 Ml Btl 7,682.40 - - - - - -
7 Disposible 3 cc Pc 1,366.20 8 10,929.60 100 136,620 28 38,254 80 109,296.00
8 Disposible 3 cc Pc 1,188.00 - - - - - - - -
9 Face Mask 2 Ply Pc 1,650.00 16 26,400.00 - - - 16 26,400.00
10 Gluma Comfort Bond 4 ML Pc 141,538.46 - - - - - -
11 Kapas putih @ 1 kg Kg 46,200.00 - - - - - -
12 Kassa Hydrophyl Rol 82,225.00 - - - - - -
13 Multifil Gix, Shade A3 Pc 175,000.00 - - - - - -
14 Scalpel Blade BB-511 Pc 2,530.00 - - - - - - -
15 Surgical Glove Uk. S Pr 495.00 - - - - - - - -
16 Softaman 500 ml btl 91,300.00 1 91,300.00 - - - 1 91,300.00
17 Talcum Powder Pr 8,250.00 - - - - - -
18 Alkohol Ltr 41,800.00 - - - - - - - -
19 Charisma SY @ 4 GR A1 Ltr 141,538.46 - - - - - -
20 Charisma SY @ 4 GR A2 Ltr 141,538.46 - - - - - -
21 Charisma SY @ 4 GR A3 Ltr 141,538.46 - - - - - -
22 Charisma SY @ 4 GR A3.5 Ltr 141,538.46 - - - - - -
23 Charisma SY @ 4 GR B1 Ltr 141,538.46 - - - - - -
24 Charisma SY @ 4 GR B2 Ltr 141,538.46 - - - - - -
25 Charisma SY @ 4 GR B2 Ltr 385,000.01 - - - - - -

JUMLAH 31 135,229.60 100 136,620.00 28 38,253.60 103 233,596.00

103 233,596.00
Diminta Oleh Diketahui Oleh Diterima Oleh
Ptgs.Poli Gigi Ka. Unit Rawat Jalan Ka. Poliklinik Ptgs.Poli Gigi

LISNAWATI drg. Ing. ADITYA IWAN DANI LISNAWATI

BULAN : Agustus 2013 MUTASI BARANG - BARANG DI RADIOLOGI NO. PERKIRAAN :
BAGIAN : RADIOLOGI KELOMPOK BARANG : PENGADAAN PENUNJANG MEDIK TGL. PERMINTAAN 26-Jul-13

HARGA STOCK AWAL penerimaan PEMAKAIAN SISA AKHIR

NO. NAMA BARANG STN
SATUAN KWANTUM NILAI KWANTUM NILAI KWANTUM NILAI KWANTUM NILAI
2 3 4 5 6 (4x5) 7 8 (4x7) 9 10 (4x9) 11 (5+7)-9 12 (4x11)

1 Dentus Agfa Pc 8,800.00 69 607,200.00 - - 5 44,000.00 64 563,200.00

2 Developer 5 Ltr Btl
3 Developer 5 Ltr Btl
4 Developer 5 Ltr Btl
5 Film X Ray 24x30 Cm Pc
6 Film X Ray 24x30 Cm Pc
7 Film X Ray 24x30 Cm Pc
8 Film X Ray 30x40 Cm Pc
9 Film X Ray 30x40 Cm Pc
10 Film X Ray 30 x 40 Cm Pc
11 Film X Ray 35x35 Cm Pc
12 Film X Ray 35x35 Cm Pc
13 Film X Ray 35x35 Cm Pc
14 Fixer Cair 5 Ltr Btl
15 Fixer Cair 5 Ltr Btl
16 Fixer Cair 5 Ltr Btl
854,701.00 - 0.00 - - - - - -
810,700.00 - 0.00 - - - - - -
770,000.00 - 0.00 - - - - - -
8,905.60 - 0.00 - - - - - -
8,349.00 - 0.00 - - - - - -
9,350.00 - 0.00 - - - - - -
13,282.50 - 0.00 - - - - - -
15,950.00 - 0.00 - - - - - -
19,341.85 - 0.00 - - - - - -
14,421.00 - 0.00 - - - - - -
16,500.00 - 0.00 - - - - - -
21,011.65 - 0.00 - - - - - -
495,000.00 - 0.00 - - - - - -
528,001.00 - 0.00 - - - - - -
667,920.00 - 0.00 - - - - - -

JUMLAH 69 607,200.00 - - 5 44,000.00 64 563,200.00

64 563,200.00

Diminta Oleh Diketahui Oleh Koord. Radiologi Diterima Oleh

Pgs. KABID. Penunjang Medik
DENNY IQBAL SUSANTO SYORGAYATI DENNY IQBAL SUSANTO DENNY IQBAL SUSANTO
BULAN : Agustus 2013 MUTASI BARANG - BARANG DI RADIOLOGI NO. PERKIRAAN :
BAGIAN : RADIOLOGI KELOMPOK BARANG :BARANG MINTA DI GUDANG FARMASI TGL. PERMINTAAN : 26 Juli 2013

HARGA STOCK AWAL PENERIMAAN PEMAKAIAN SISA AKHIR

NO. NAMA BARANG STN
SATUAN KWANTUM NILAI KWANTUM NILAI KWANTUM NILAI KWANTUM NILAI
2 3 4 5 6 (4x5) 7 8 (4x7) 9 10 (4x9) 11 (5+7)-9 12 (4x11)
1 Leukoplast 4.5 X5 (1624H) Pc 22,972.40 1 22,972.40 - - - - 1 22,972.40
2 Surgical Glove M Pc 528.00 - 0.00 - - - - - -
3 Surgical Glove M Pc 495.00 100 49,500.00 - - 100 49,500.00 - -
4 Softaman 500 ml Pc 82,500.00 - 0.00 - - - - - -
5 Softaman 100 ml Pc 33,000.00 - 0.00 - - - - - -
6 Softaman 500 ml Pc 91,300.00 1 91,300.00 - - 1 91,300.00 - -
6 Softaman 1000 ml Pc 165,000.00 - 0.00 - - - - - -
7 Face Mask 2 ply Pc 1,144.00 - 0.00 - - - - - -
8 Gel ECG /USG Btl 88,000.00 4 352,000.00 - - 2 176,000.00 2 176,000.00
9 Gel ECG /USG Btl 55,000.00 - 0.00 - - - - -
10 Paper USG 110 HG T V Pc 158,950.00 1 158,950.00 1 158,950.00 2 317,900.00 - -
11 Film X Ray 24X30 cm Pc 20,207.00 - 0.00 - - - - -
12 Film X Ray 24X30 cm Pc 9,350.00 - 0.00 100 935,000.00 100 935,000.00 - -
13 Film X Ray 24X30 cm Pc 15,028.20 100 1,502,820.00 100 1,502,820.00 7 105,197.40 193 2,900,442.60
13 Film X Ray 30X40 cm Pc 23,908.50 - 0.00 100 2,390,850.00 - 100 2,390,850.00
14 Film X Ray 30X40 cm Pc 15,950.00 99 1,579,050.00 - - 91 1,451,450.00 8 127,600.00
15 Film x Ray 35x35 cm Pc 16,500.00 - 0.00 100 1,650,000.00 - 100 1,650,000.00
16 Film x Ray 35x35 cm Pc 19,228.00 136 2,615,008.00 - 125 2,403,500.00 11 211,508.00
17 Developer Btl 770,000.00 1 770,000.00 1 770,000.00 1 770,000.00 1 770,000.00
18 Developer Btl 854,700.00 - 0.00 - - - - -
19 Fixer Btl 495,000.00 1 495,000.00 - - - 1 495,000.00
20 Paper printer ck-900s Pc 1,430,000.00 1 1,430,000.00 - - - 1 1,430,000.00
-
JUMLAH 445 9,066,600.40 402 7,407,620.00 429 6,299,847.40 418 10,174,373.00
418 10,174,373.00

Diminta Oleh Diketahui Oleh Koord. Radiologi Diterima Oleh

Pgs. KABID. Penunjang Medik

DENNY IQBAL SUSANTO SYORGAYATI DENNY IQBAL SUSANTO DENNY IQBAL SUSANTO