DAFTAR LIST BARANG 2018

NO NAMA OBAT SATUAN HNA + PPN 10% HNA

1 Acyclovir Zalp Tube 4,999 4,545
2 ACYCLOVIR 400MG TABLET 914 831
3 ACYCLOVIR 200MG TABLET 563 512
4 ADONA INJ AMPUL 33,350 30,318
5 ADONA TAB TABLET 4,704 4,276
6 ALBOTHYL CONCENTRAT 10 ML btl 49,800 45,273
7 ALBOTHYL CONCENTRATE 5 ML btl 35,900 32,636
8 ALLOPURINOL 100MG TABLET 299 272
9 ALLOPURINOL 300MG TABLET 495 450
10 Ambroxol 30 mg Tablet 226 205
11 Ambroxol Sirup Botol 6,000 5,455
12 AMLODIPINE 5MG TABLET 714 649
13 AMLODIPINE 10MG TABLET 1,356 1,233
14 Amoxicillin 500 Mg 10X10 TABLET 554 504
15 Amoxicillin Ds 125 Mg/5Ml Botol 8,250 7,500
16 Ampicillin 500 mg Tablet TABLET 772 702
17 ANTALGIN 500 MG TABLET TABLET 300 273
18 ANTASIDA DOEN TABLET 379 345
19 Antasida DOEN Suspensi Botol 8,653 7,866
20 Antrain Injeksi Ampul 15,800 14,364
21 ASAM MEPENAMAT TABLET 315 286
22 Asam Traneksamat 500 mg Tablet 1,950 1,773
23 Asam Traneksamat Injeksi Ampul 8,300 7,545
24 ASERING INFUS BTL 39,800 36,182
25 ATORVASTATIN 10MG TABLET 4,125 3,750
26 ATORVASTATIN 20MG TABLET 6,600 6,000
27 Baby Cough Botol 5,832
28 BETADINE KUMUR 100 ML btl 15,153 13,775
29 BETADINE KUMUR 190 ML btl 25,980 23,618
30 Betahistin Tablet 1,340 1,218
31 Bioplacenton Tube 23,128 21,025
32 Bisturi pcs 2,000 1,818
33 BROMHEXIN TAB TABLET 195 177
34 BUSCOPAN TAB TABLET 6,103 5,548
35 BUSCOPAN INJ VIAL 48,850 44,409
36 CAVIPLEX KAP TABLET 632 575
37 CAZETIN DROPS BTL 29,890 27,173
38 CAPTOPRIL 25MG TABLET 298 271
39 CAPTOPRIL 50MG TABLET 379 345
40 Cefadroxil 500 mg Kapsul 1,099 999
41 Cefadroxil Syr Botol 13,960 12,691
42 CEFOTAXIME INJ AMPUL 15,428 14,025
43 CEFIXIME 100 MG Tablet 3,825 3,477
44 CEFIXIME 200 MG Tablet 6,656 6,051
45 CEFIXIME SYR Botol 30,980 28,164
46 CEFTRIAXONE INJ AMPUL 17,800 16,182
47 CENDOXITROL 5ML Botol 43,786 39,805
48 Cetirizin 10 mg Tablet 495 450
49 CIPROFLOXACIN TABLET 686 624
50 Chloramphenicol ear drops Botol 8,469 7,699
51 ERMAMYCETIN EAR DROPS Botol 8,762 7,965
52 CIMETIDIN Tablet 290 264
53 CLINDAMYCIN 150mg TABLET 1,053 957
54 CLINDAMYCIN 300mg TABLET 1,945 1,768
55 CLOPIDOGREL TAB TABLET 15,980 14,527
56 Combivent Pcs 22,452 20,411
57 Curcuma PLUS Sirup Botol 19,850 18,045
58 Curcuma Tab Tablet 1,399 1,272
59 Daryantulle Pcs 25,988 23,625
60 Dettol Antiseptik 50 ML Botol 8,250 7,500
61 DEXAMETHASONE 0.5 MG Tablet 288 262
62 DISPOSABLE DETAL NEEDLE PCS 2,640 2,400
63 DORNER TAB TABLET 14,629 13,299
64 DOMPERIDONE TAB TABLET 606 551
65 DOMPERIDONE SYR Botol 18,343 16,675
66 DULCOLACTOL 10 MG/15 ML SYR 60 ML BTL 86,716 78,833
67 DULCOLAX SUPPO SUPPO 32,550 29,591
68 ETHAMBUTOL 250 MG. TABLET 665 605
69 ETHAMBUTOL 500 MG. TABLET 897 815
70 ELKANA SYR 60 ml btl 33,737 30,670
71 ERDOSTAIN TAB KAPSUL 14,900 13,545
72 FARBION INJ AMPUL 8,059 7,326
73 FARBION tab TABLET 1,733 1,575
74 FOLAMIL GENIO BTL30 CAPS CAPSUL 6,353 5,775
75 FUZON SALP TUBE 66,000 60,000
76 FUROSEMIDE 40 MG. TABLET 267 243
77 Gentamicin Salep Tube 3,028 2,753
78 GENTAMYCIN INJ VIAL 6,090 5,536
79 Gentian Violet Botol 3,880 3,527
80 GLIMEPIRIDE 1 Tablet 998 907
81 GLIMEPIRIDE 2 Tablet 1,980 1,800
82 GLIMEPIRIDE 3 Tablet 2,980 2,709
83 GLIMEPIRIDE 4 Tablet 3,970 3,609
84 GLYCERIL GUAIKOLAT TABLET 269 245
85 GLUCOSAMINE 500 MG/100'S TABLET 2,890 2,627
86 Handscoen Steril No. 7 Pairs 8,250 7,500
87 Handscoen Steril No. 7 1/2 Pairs 8,250 7,500
88 HISTAPAN/INTERHISTIN TABLET 1,050 955
89 Insto eye drops 7,5ml Botol 14,998
90 IMBOS FORCE TAB TABLET 9,979 9,072
KALBION
91 Ketoconazole Tablet 879 799
92 KETOCONAZOLE KRIM TUBE 6,766 6,151
93 KETOROLAC 10 MG/ML INJ VIAL 11,975 10,886
94 KETOROLAC 30 MG/ML INJ VIAL 20,651 18,774
95 Lacto Bio Sachet 7,054
96 LAXADINE SYRUP 110 ML btl 70,920 64,473
97 LAXADINE SYRUP 60 ML btl 53,900 49,000
98 LANZOPRASOLE TABLET 919 835
99 Loperamid HCl 2 mg Tablet 158 144
100 LORATADIN TABLET 500 455
101 masker hijab BOX 32,000 29,091
102 Mediamer B6 Tablet 4,244 3,858
103 MELOXICAM 15 MG TABLET 2,172 1,975
104 MELOXICAM 7,5 MG TABLET 1,212 1,102
105 METFORMIN 500MG Tablet 263 239
106 Methyl Ergometrin mg Tablet 447 406
107 Methylprednisolone 16Mg Tablet 509 463
108 METHYL PREDNISOLONE 4 MG 100 KAP Tablet 640 582
109 METOCLOPRAMID 10MG TAB TABLET 236 215
110 METOCLOPRAMID INJ AMPUL 7,095 6,450
111 Metronidazol Infuse Botol 30,000 27,273
112 METRONIDAZOLE SYR Botol 31,900 29,000
113 MICROLAX SUPPO 28,975 26,341
114 NEFROLITE Tablet 997 906
115 KALBION TABLET 704 1,568
116 Nifedipin 10 mg Tablet 318 289
117 NISTATIN TAB Tablet 18,330 16,664
118 NOVADIAR SYR Botol 5,961 5,419
119 OBH Sirup Botol 5,600 5,091
120 OMEPRAZOLE 20MG TABLET 614 558
121 ONDANSETRON 4MG INJ AMPUL 10,550 9,591
122 ONDANSETRON 4MG TAB Tablet 2,541 2,310
123 Oxytetrasiklin 1% salep mata Tube 4,620 4,200
124 Oxytetrasiklin 3% salep kulit Tube 3,350 3,045
125 OXYTETRASIKLIN HCL INJ 50MG/ML VIAL 11,950 10,864
126 Papaverin mg Tablet 304 276
127 PARACETAMOL TAB TABLET 388 353
128 Paracetamol Drops Botol 20,969 19,063
129 Paracetamol Infus Kolf 69,300 63,000
130 Paracetamol Rectal Tube 25,862 23,511
131 PEDITOX btl 8,085 7,350
132 PEHACAIN INJ AMPUL 4,969 4,517
133 Perlak Disposible Pcs 49,000
134 Perlak Bisa dicuci Pcs 119,000
135 Piracetam 400 MG Tablet 795 723
136 Piracetam 800 MG Tablet 1,205 1,095
137 Piroxicam 10 mg Tablet 216 196
138 Piroxicam 20 mg Tablet 228 207
139 Premaston Tablet 10,900 9,909
140 Planotest Pcs 1,550
141 Propylthiouracil (PTU) 50 mg Tablet 743 675
142 Ranitidin inj Ampul 3,980 3,618
143 RENALITE BTL 23,850 21,682
144 Reagen Goda set 430,000 390,909
145 SALBUTAMOL 2 MG. TABLET 295 268
146 SALBUTAMOL 4 MG. TABLET 287 261
147 SANMOL DROPS btl 23,843 21,675
148 Scabimite Cr. 10 mg Tube 59,813 54,375
149 Scopma KAPLET Tablet 1,688 1,535
150 sendok obat Pcs 550 500
151 Sotatik Inj 5 mg/ml x 2 ml Ampul 6,996 6,360
152 SIMVASTATIN 20 MG @30 TABLET TABLET 1,488 1,353
153 SIMVASTATIN 10MG TABLET 743 675
154 Spasminal Tablet 936 851
155 Strip Asam Urat pcs 7,590 6,900
156 Strip Glukosa Pcs 7,590 6,900
157 Strip Hb easy touch pcs 12,120 11,018
158 Strip Hb easy family PCS 18,502 16,820
159 Strip Kolesterol Nesco pcs 29,000 27,682
160 Supra Tulle Schet 35,932 32,665
161 Suction Cateter Bayi Pcs 11,250
162 Suction Cateter Anak Pcs 11,250
163 Suction Cateter Dewasa Pcs 11,250
T Teosal tab Tablet 290
164 TERRAMYCIN OPTH 1% TUBE 17,433 15,848
165 TRIAMCINOLON ACETONID TUBE 80,795 73,450
166 VAGISTIN OVULA SUPPO 21,931 19,937
167 Ventolin INHALER Botol 153,717 139,743
168 VILCALSIN SYR BTL 8,925 8,114
169 VIT C (IPI) Tablet 104 95
170 VIT C 100 MG Tablet 150 136
171 VIT C 50MG Tablet 250 227
172 VIT K INJ Ampul 3,039 2,763
173 Vit. B1 Injeksi Ampul 6,035 5,486
174 Vit. B12 Injeksi VIAL 15,551 14,137
175 ZAK OBAT PAK 13,500 12,273
176 Zinc Syr 60 ml botol 51,040 46,400
177 KERTAS PERKAMEN BOX 20,000 18,182
178 BIOLYSIN SYR 60ML BTL 16,500 15,000
179 BIOLYSIN SYR 100ML BTL 23,100 21,000
180 sucralfat 200ml BTL 88,000 80,000
Pot obat tablet pot 3,520
Pot obat salep pot 2,450
Cefadroxil 250mg KAPSUL
 PT. SALOKEJA MEDIKA FARMA (SMF)
JL. KERUKUNAN 01 BTP BLOK AD NO.1301
IZIN PBF : FP.01.04/IV/0323/2017
TELEPON : 081526039040

Faktur Penjualan
No: SMF/ 2018/

Jatuh Tempo : Februari 2018

NO NAMA OBAT SATUAN HARGA JUMLAH

1 Curcuma Tab Tablet Rp 1,399.00 200

2 METOCLOPRAMID 10MG TAB TABLET Rp 236 500
3 masker hijab BOX Rp 32,000 13
4 Bisturi pcs Rp 2,000.00 200
5 Premaston Tablet Rp 10,900.00 30
6 Ranitidin inj Ampul Rp 3,980.00 50
7 Strip Kolesterol Nesco pcs Rp 29,000.00 30
8 Strip Asam Urat pcs Rp 7,590.00 50
9 Strip Glukosa Pcs Rp 7,590.00 50
11 Strip Hb easy touch pcs Rp 12,120.00 50
12 Curcuma Syr botol Rp 19,850.00 24
13 Gentian Violet Botol Rp 3,880.00 31
TOTAL HARGA
PPN
PPH
TOTAL BAYAR

Penerima Apoteker Pengelola PBF

____________________ Abdul Majid, S.Si.,Apt

SIPA :446/374.1.14/SIPA/DKK/II/2017

.
Makassar, Februari 2018
Kepada Yth,
Puskesmas Lara
(Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

TOTAL HARGA

Rp 279,800
Rp 118,000
Rp 416,000
Rp 400,000
Rp 327,000
Rp 199,000
Rp 870,000
Rp 379,500
Rp 379,500
Rp 606,000
Rp 476,400
Rp 120,280
Rp 4,571,480
Rp -
Rp -
Rp 4,571,480

Gudang

_____________
 DAFTAR BELANJA OBAT
JKN (JAMINAN KESEHATAN NASIONAL)
PUSKESMAS POLOCAMBA
DINAS KESEHATAN KABUPATEN MAMUJU TENGAH

NO NAMA OBAT SATUAN HARGA JUMLAH TOTAL HARGA

1 Planotest Pcs Rp 1,550.00 50 Rp 77,500

2 Cefadroxil 500mg Kapsul Rp 1,099.00 300 Rp 329,700
3 Piroxicam 20 mg Tablet Rp 228.00 300 Rp 68,400
4 masker hijab BOX Rp 32,000.00 3 Rp 96,000
5 Bioplacenton Tube Rp 23,128.00 2 Rp 46,256
6 Ambroxol Sirup Botol Rp 6,000.00 13 Rp 78,000
TOTAL HARGA Rp 695,856
PPN Rp -
PPH Rp -
TOTAL BAYAR Rp 695,856
 PT. SALOKEJA MEDIKA FARMA (SMF) Makassar, Februari 2018
JL. KERUKUNAN 01 BTP BLOK AD NO.1301 Kepada Yth,
IZIN PBF : FP.01.04/IV/0323/2017 Puskesmas Saloadak
TELEPON : 081526039040 (Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

Faktur Penjualan
No: SMF/ 2018/

Jatuh Tempo : 20 Februari 2018

NO NAMA OBAT SATUAN JUMLAH HARGA TOTAL HARGA

1 Bioplacenton Tube Rp 23,128 10 Rp 231,280

2 Zak Obat Kecil PAK Rp 13,500 10 Rp 135,000
3 Curcuma Tab Tablet Rp 1,399 100 Rp 139,900
4 masker hijab BOX Rp 32,000 10 Rp 320,000
5 Curcuma PLUS Sirup Botol Rp 19,850 8 Rp 158,800
6 Planotest Pcs Rp 1,550 200 Rp 310,000
TOTAL HARGA Rp 1,294,980
PPN Rp -
PPH Rp -
TOTAL BAYAR Rp 1,294,980

Penerima Apoteker Pengelola PBF Gudang

_____________________ Abdul Majid, S.Si.,Apt _____________

SIPA :446/374.1.14/SIPA/DKK/II/2017
PT. SALOKEJA MEDIKA FARMA (SMF) Makassar, Februari 2018
JL. KERUKUNAN 01 BTP BLOK AD NO.1301 Kepada Yth,
IZIN PBF : FP.01.04/IV/0323/2017 Puskesmas Durikumba
TELEPON : 081526039040 (Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

Faktur Penjualan
No: SMF/ 2018/

Jatuh Tempo : Februari 2018

NO NAMA OBAT SATUAN HARGA JUMLAH TOTAL HARGA

1 Cefadroxil 500 mg Kapsul Rp 1,099.00 300 Rp 329,700

2 Ambroxol 30 mg Tablet Rp 226.00 500 Rp 113,000
3 Ambroxol Sirup Botol Rp 6,000.00 20 Rp 120,000
4 Gentian Violet Botol Rp 3,880.00 20 Rp 77,600
5 Curcuma PLUS Sirup Botol Rp 19,850.00 10 Rp 198,500
6 Combivent Pcs Rp 22,452.00 10 Rp 224,520
7 Bioplacenton Tube Rp 23,128.00 10 Rp 231,280
8 masker hijab BOX Rp 32,000.00 10 Rp 320,000
9 Ranitidin inj Ampul Rp 3,980.00 100 Rp 398,000
TOTAL HARGA Rp 2,012,600
PPN Rp -
PPH Rp -
TOTAL BAYAR Rp 2,012,600
PT. SALOKEJA MEDIKA FARMA (SMF) Makassar, Februari 2018
JL. KERUKUNAN 01 BTP BLOK AD NO.1301 Kepada Yth,
IZIN PBF : FP.01.04/IV/0323/2017 Puskesmas Tobadak
TELEPON : 081526039040 (Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

Faktur Penjualan
No: SMF/ 2018/

Jatuh Tempo : 20 FEBRUARI 2018

NO NAMA OBAT SATUAN HARGA JUMLAH TOTAL HARGA

1 Ambroxol 30 mg Tablet Rp 226.00 3000 Rp 678,000

3 Antrain Injeksi Ampul Rp 15,800.00 50 Rp 790,000
4 Cefadroxil Syr Botol Rp 13,960.00 90 Rp 1,256,400
5 CEFTRIAXONE INJ AMPUL Rp 17,800.00 50 Rp 890,000
6 CEFOTAXIME INJ AMPUL Rp 15,428.00 50 Rp 771,400
7 KETOROLAC 10 MG/ML INJ VIAL Rp 11,975.00 50 Rp 598,750
8 METOCLOPRAMID INJ AMPUL Rp 7,095.00 20 Rp 141,900
9 Oxytetrasiklin 3% salep kulit Tube Rp 3,350.00 100 Rp 335,000
Vit. B12 Injeksi VIAL Rp 15,551.00 20 Rp 311,020
10 Suction Cateter Bayi Pcs Rp 11,250.00 5 Rp 56,250
11 Suction Cateter Anak Pcs Rp 11,250.00 5 Rp 56,250
12 Suction Cateter Dewasa Pcs Rp 11,250.00 5 Rp 56,250
13 Piroxicam 20 mg Tablet Rp 228.00 2000 Rp 456,000
TOTAL HARGA Rp 6,397,220
PPN Rp -
PPH Rp -
TOTAL BAYAR Rp 6,397,220
 PT. SALOKEJA MEDIKA FARMA (SMF) Makassar, 20 Februari 2018
JL. KERUKUNAN 01 BTP BLOK AD NO.1301 Kepada Yth,
IZIN PBF : FP.01.04/IV/0323/2017 Puskesmas Salupangkang
TELEPON : 081526039040 (Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

Faktur Penjualan
No: SMF/ 2018/

Jatuh Tempo : 20 Februari 2018

NO NAMA OBAT SATUAN HARGA JUMLAH TOTAL HARGA

1 Teosal Tablet Rp 290.00 500 Rp 145,000.00

2 KALBION TABLET Rp 704.00 500 Rp 352,000.00
3 CAVIPLEX KAP TABLET Rp 632.00 200 Rp 126,400.00
4 Ranitidin inj Ampul Rp 3,980.00 20 Rp 79,600.00
5 Strip Kolesterol Nesco pcs Rp 29,000.00 30 Rp 870,000.00
6 Strip Hb easy touch pcs Rp 12,120.00 50 Rp 606,000.00
7 Ambroxol 30 mg Tablet Rp 226.00 1000 Rp 226,000.00
8 Lacto Bio Sachet Rp 7,054.00 52 Rp 366,808.00
9 masker hijab BOX Rp 32,000.00 7 Rp 224,000.00
TOTAL HARGA Rp 2,995,808.00

Penerima Apoteker Pengelola PBF Gudang

_____________________ Abdul Majid, S.Si.,Apt _____________

SIPA :446/374.1.14/SIPA/DKK/II/2017
 PT. SALOKEJA MEDIKA FARMA (SMF) Makassar, Februari 2018
JL. KERUKUNAN 01 BTP BLOK AD NO.1301 Kepada Yth,
IZIN PBF : FP.01.04/IV/0323/2017 Puskesmas Topoyo
TELEPON : 081526039040 (Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

Faktur Penjualan
No: SMF/ 2018/

Jatuh Tempo : 20 Februari 2018

NO NAMA OBAT SATUAN HARGA JUMLAH TOTAL HARGA

1 Ambroxol 30 mg Tab Rp 226.00 1000 Rp 226,000

2 CIMETIDIN Tablet Rp 290.00 500 Rp 145,000
3 Piroxicam 10 mg Tab Rp 216.00 500 Rp 108,000
4 Ambroxol Syr botol Rp 6,000.00 30 Rp 180,000
5 Gentamicin Salep Tube Rp 3,028.00 20 Rp 60,560
6 Curcuma Syr botol Rp 19,850.00 50 Rp 992,500
7 Strib HB Easy Touch pcs Rp 12,120.00 50 Rp 606,000
8 Strip Kolesterol pcs Rp 29,000.00 50 Rp 1,450,000
9 Kertas Perkamen sak Rp 20,000.00 10 Rp 200,000
10 Bisturi pcs Rp 2,000.00 200 Rp 400,000
11 Paracetamol Drops Botol Rp 20,969.00 20 Rp 419,380
13 Pot obat pcs Rp 2,450.00 10 Rp 24,500
Reagent Tes Golda b-Jes Diagnostic ser 430,000 1 Rp 430,000
14 masker hijab BOX Rp 32,000.00 4 Rp 128,000
TOTAL HARGA Rp 5,369,940
PPN Rp -
PPH Rp -
TOTAL BAYAR Rp 5,369,940

Penerima Apoteker Pengelola PBF Gudang

_________________ Abdul Majid, S.Si.,Apt _____________

SIPA :446/374.1.14/SIPA/DKK/II/2017
.
 PT. SALOKEJA MEDIKA FARMA (SMF) Makassar, 20 Desember 2017
JL. KERUKUNAN 01 BTP BLOK AD NO.1301 Kepada Yth,
IZIN PBF : FP.01.04/IV/0323/2017 Puskesmas Salugatta
TELEPON : 081526039040 (Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

Faktur Penjualan
No: SMF/ 2017/

Jatuh Tempo : Februari 2018

NO NAMA OBAT SATUAN HARGA JUMLAH TOTAL HARGA

1 ZAK OBAT PAK Rp 13,500.00 12 Rp 162,000

2 Ranitidin inj Ampul Rp 3,980.00 60 Rp 238,800
3 Zinc Syr 60 ml botol Rp 51,040.00 20 Rp 1,020,800
4 masker hijab BOX Rp 32,000.00 18 Rp 576,000
TOTAL HARGA Rp 1,997,600
PPN Rp -
PPH Rp -
TOTAL BAYAR Rp 1,997,600

Penerima Apoteker Pengelola PBF Gudang

___________________ Abdul Majid, S.Si.,Apt _____________

SIPA :446/374.1.14/SIPA/DKK/II/2017

.
 ember 2017

muju Tengah)
badak,
PT. SALOKEJA MEDIKA FARMA (SMF) Makassar, 20 Desember 2017
JL. KERUKUNAN 01 BTP BLOK AD NO.1301 Kepada Yth,
IZIN PBF : FP.01.04/IV/0323/2017 Puskesmas Babana
TELEPON : 081526039040 (Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

Faktur Penjualan
No: SMF/ 2017/

Jatuh Tempo : Februari 2018

NO NAMA OBAT SATUAN HARGA JUMLAH TOTAL HARGA

1 Ranitidin inj Ampul Rp 3,980 100 Rp 397,950

2 KETOROLAC 10 MG/ML INJ VIAL Rp 11,975 80 Rp 957,969
3 Bioplacenton Tube Rp 23,128.01 20 Rp 462,560
4 Antrain Injeksi Ampul Rp 15,800.00 60 Rp 948,000
Zinc Syr 60 ml botol Rp 51,040.00 38 Rp 1,939,520
5 masker hijab BOX Rp 32,000.00 40 Rp 1,280,000
TOTAL HARGA Rp 5,986,000
PPN Rp 544,182
PPH Rp 81,627
TOTAL BAYAR Rp 5,360,190
20 Desember 2017

b. Mamuju Tengah)
KTM Tobadak,

289.1

4
 PT. SALOKEJA MEDIKA FARMA (SMF)
JL. KERUKUNAN 01 BTP BLOK AD NO.1301
IZIN PBF : FP.01.04/IV/0323/2017
TELEPON : 081526039040

Faktur Penjualan
No: SMF/ 2017/

Jatuh Tempo : 20 FEBRUARI 2018

NO NAMA OBAT SATUAN HARGA JUMLAH

1 Cefadroxil 500 mg Kapsul Rp 1,099.00 2000

2 Cetirizin 10mg Tab Rp 495.00 2000
CIMETIDIN Tablet Rp 290.00 2000
3 Strip Kolesterol pcs Rp 29,000.00 100
4 Ambroxol 30 mg Tablet Rp 226.00 1000
5 Masker Hijab box@50pcs Rp 32,000 10
TOTAL HARGA
PPN
PPH
TOTAL BAYAR

Penerima Apoteker Pengelola PBF

_____________________ Abdul Majid, S.Si.,Apt

SIPA :446/374.1.14/SIPA/DKK/II/2017

.
Makassar, 20 Desember 2017
Kepada Yth,
Puskesmas Pangale
(Dinkes Kab. Mamuju Tengah)
Kompleks KTM Tobadak,
Kec. Tobadak

TOTAL HARGA

Rp 2,198,000
Rp 990,000
Rp 580,000
Rp 2,900,000
Rp 226,000
Rp 320,000
Rp 7,214,000
Rp -
Rp -
Rp 7,214,000

Gudang

_____________
 DAFTAR KEBUTUHAN OBAT TB MATENG 2019

NO NAMA OBAT PEMAKAIAN 2017 STOK AWAL 2018 KEBUTUHAN 2019

1 OAT Kat. I 177 117 220
2 OAT Kat. II 16 4 50
3 OAT Kat. Anak 25 4 30
4 Combipak Kat. I 0 0 0
5 Combipak Kat. Anak 0 0 0
6 Reagent ZN 43 42 50
7 Pot Dahak 4428 572 10000
8 Microskop slide 2088 4392 1500