BUKTI ARUS BARANG UNIT LAUNDRY RSUD KEBAYORAN LAMA TAHUN 2019

JUMLAH JUMLAH
TANGGAL NAMA BARANG UNIT DIBERIKAN DITERIMA
1/1/2019 selimut rawat inap 5
1/2/2019 selimut rawat inap 4
BAYORAN LAMA TAHUN 2019
PETUGAS PETUGAS MENERIMA
MENYERAHKAN
 NILAI PERSEDIAAN ALKES BMH
April 20

SKPD : Dinas Kesehatan

KAB/KOTA : Jakarta Selatan
PROVINSI : DKI Jakarta

APOTEK : Rumah Sakit Umum Daerah Kebayoran Lama

LOT.
No Nama Barang Satuan Spesifikasi
Batch
1 Alkohol Swab 200 pcs/box Cosmo 20180210
2 Blood Set 50 pcs/box Stera 01081588
3 CUTICELL 7,5cm X 20cm pcs BSN 621174
4 Discofix Threeway 50 pcs/box B-Braun 1005316A
5 ECG Adult 30 pcs/pouch Zoll 3017
6 ECG Infant 30 pcs/pouch EF Medika 60704-8007
Endotracheal Tube No. 3
7 pcs Idealcare 275H16
(Uncuff)
Endotracheal Tube No. 3,5
8 pcs Idealcare 275H16
(Uncuff)
Endotracheal Tube No. 4
9 pcs Idealcare 275H16
(Uncuff)
Endotracheal Tube No. 4,5
10 pcs Idealcare 275H19
(Uncuff)
Endotracheal Tube No. 5
11 pcs Idealcare 365H16
(Cuffed)
Endotracheal Tube No. 6
12 pcs Aximed 246H16
(Cuffed)
Endotracheal Tube No. 6,5
13 pcs Idealcare 69H16
(Cuffed)
Endotracheal Tube No. 6,5
14 pcs Idealcare 69H16
(Cuffed) (2)
Endotracheal Tube No. 6,5
15 pcs Aximed 69H16
(Cuffed) (3)
16 Folley Catheter No. 6 pcs Idealcare 1704020493
17 Folley Catheter No. 10 pcs Idealcare 57H15
18 Folley Catheter No. 12 pcs Idealcare 348H16
19 Folley Catheter No. 18 pcs Cosmomed 20170930
20 Folley Catheter No. 18 (2) 10 pcs/box Onemed 15-G-01M
21 Folley Catheter No. 20 pcs Idealcare 21H15
22 Guedel 000 pcs - OP1/11395
23 Guedel 0 pcs - OP1/11043
24 Guedel 02 pcs - OP3/606
25 Guedel 03 pcs - OP1/11038
26 Guedel 04 pcs - OP3/308
27 Handscoon XS 100 pcs/box Sensi -
28 Handscoon M 100 pcs/box Skifa 1802131
29 Handscoon L 100 pcs/box Skifa 170213
30 Handscoon Steril No. 6,5 50 pairs/box Ansell 1702101105
31 Handscoon Steril No. 7,5 100 pairs/box Ansell 1612604404
32 Infus Set Cyto-set Mix pcs B-Braun 17E18F00H2
Infus Set Intrafix Premilene
33 100 pcs/box B-Braun 14L16K8421
Microdropper
Infus Set Intrafix Premilene Type
34 100 pcs/box B-Braun 15L24K8429
I.S
35 IV. Catheter 18G 50 pcs/box Fresco 150125
36 IV. Catheter 18G (2) 50 pcs/box B-Braun 15K12G8271
37 IV. Catheter 20G 50 pcs/box B-Braun 15N30G8252
38 IV. Catheter 22G 50 pcs/box Polymed 3070616C
39 IV. Catheter 24G 50 pcs/box B-Braun 160410
40 IV. Catheter 24G (2) 50 pcs/box Fresco 15N30G8252
41 Kassa Roll 40y x 40cm pcs SN Medika 88501
42 Kassa Roll 40y x 20cm pcs SN Medika 88501
43 Micropore 1/2 in x 10 yard 24 pcs/box 3M 2022-11G3G
44 Micropore 1 in x 10 yard 12 PCS/box 3M 2023-07AAG
45 N-95 Mask 20 pcs/box 3M R17250
46 Nasal O2 Cannula Neonate pcs Remedi 1712022360
47 Nasal O2 Cannula Paed pcs Mas 20171125
48 Nasal O2 Cannula Adult pcs Mas 20171125
49 Nebulizer Mask Adult pcs Stardec FY1705059
50 O2 Mask Adult pcs Serenity 20160220
51 Plesterin Roll 5 cm x 5 m pcs Onemed 01121688
52 Plasterin Roll 10 cm x 5 m pcs Onemed 23061688
53 Plasterin Roll 15 cm x 5 m pcs Onemed 23061688
54 Plasterin Roll 20 cm x 5 m pcs Onemed 09021788
55 Plasterin Roll 20 cm x 5 m (2) pcs Onemed -
56 Silk 2/0 HR-26 12 pcs/box SMI 141102
57 Silk 2/0 HR-26 (2) 12 pcs/box SMI 150702
58 Spuit 1 ml 100 pcs/box Terumo 1709140
59 Spuit 1 ml (2) 100 pcs/box Rajawali 1701201
60 Spuit 3 ml 100 pcs/box Rajawali 1703201
61 Spuit 5 ml 100 pcs/box Terumo 140428R
62 Spuit 5 ml (2) 100 pcs/box Rajawali 1704201
63 Spuit 5 ml (3) 100 pcs/box Rajawali 1705201
64 Spuit 20 ml 50 pcs/box Terumo 181010B
65 Spuit 50 ml 20 pcs/box Terumo 171022E
Stomach Tube/Feeding
66 pcs Onemed 1041788
Tube/NGT No. 8
Stomach Tube/Feeding
67 pcs Aximed 180614B
Tube/NGT No. 12
Stomach Tube/Feeding
68 pcs Aximed 180926B
Tube/NGT No. 14
Stomach Tube/Feeding
69 50 pcs/box Terumo 160827B
Tube/NGT No. 16
70 Suction Catheter No. 8 pcs Mas 20151009
71 Suction Catheter No. 10 pcs Onemed 1111588
72 Suction Catheter No. 12 pcs Mas 20150610
73 Suction Catheter No. 14 pcs Remedi 1622819
74 Surgical Blade/Bisturi No. 11 100 pcs/box GEA 4508792676
75 Surgical Blade/Bisturi No. 12 pcs B-Braun A6311002
76 Surgical Blade/Bisturi No. 19 pcs B-Braun F6076071
77 Surgical Blade/Bisturi No. 19 (2) pcs Vygon 190417FQ
78 Umbilical Cord Klem 50 pcs/box Onemed 1031688 /-
79 Underpads 10 pcs/pack Cosmomed 20171010
80 Vicryl 1 VCP519H 36 pcs/box Ethicon JP7032
81 Vicryl 3/0 VCP452H 36 pcs/box Ethicon JK7134
82 Wing Needle 21G 3/4" 100 pcs/box Onemed 05081588
83 Wing Needle 21G 3/4" (2) 100 pcs/box Onemed 05051588
84 Wing Needle 25G x 3/4" 50 pcs/box Terumo 161006B
85 Wing Needle 25G x 3/4" (2) 50 pcs/box Terumo 170112B2019
86 Chromic Catgut 3/0 Pcs 1603061
87 Cervical Collar pcs -
88 Copper T Pcs DAQ2125
89 Disposible Syringe 3CC BKKBN pcs 16319
90 Folley Catheter No. 8 pcs 57H15
91 Folley Catheter No. 16 pcs 04/SDP/17
92 Handscoon Steril Panjang 7 pcs 18113101
93 Handscoon Steril Panjang 7,5 pcs 2932175
94 Feeding Tube 5 Fr 40 cm pcs 180611B
95 Feeding Tube 5 Fr 100 cm pcs 180702B
96 Kassa Steril DRC 16X16 cm Box -
97 Masker Hijab Box -
98 Micropore 2 Inch Pcs 2023-06A5G
99 Nebulizer Mask Anak pcs 05/SDP17
100 Non Rebreathing Mask Adult pcs 05/SDP/17
101 Non Rebreathing Mask Child pcs 1704020492
102 Oxygen Mask Anak Pcs FYI702059
103 Rectal Tube No 16 Pcs 20170515
104 Rectal Tube No 18 Pcs 20170515
105 Rectal Tube No 20 pcs 20150330
106 Rectal Tube No 22 Pcs 20150330
107 Rectal Tube No 26 Pcs 20150330
108 Rectal Tube No 28 Pcs 20170515
Stomach Tube/Feeding
109 Pcs 20160112
Tube/NGT
Susuk KB IINo.
3 Tahunan
10
110 (Levonorgestrel + Inserter Auto Pcs 6J030330
Disable)
111 Tegaderm 1624 Pcs 2020-10P0
112 Tegaderm 1626 Pcs 2021-03T5
113 Tegaderm 1627 Pcs 2021-01RD
114 Wing Needle No 23 Pcs 161001B2019
115 Spuit 10 mL Pcs 181122N
116 Spalk 6 x 20 Pcs -
117 Handscoon Steril no 7 Pcs 1702101005
118 Folley Catheter no 8 Pcs 57H15
119 Urine Bag Pcs 20151211
120 Umbilical Catheter 5FR Pcs 190417FQ
121 ETT no 7,0 Pcs 246H16
122 ETT no 7,5 Pcs 69H16
123 ETT no 8,0 Pcs 69H16
124 Safety Box Pcs -
125 Kapas 500 g Pcs -
126 IV Catheter 26 G Pcs 2280665
127 Handscoon S Box 17080201
128 Silk Braided 3/0 HR-26 Pcs 151004
129 Silk USP 2/0 Pcs 150702
130 Sputum Botol -
131 Kassa Roll 40y x 80cm pcs 190319
132 N-95 Mask pcs
133 Masker Bedah buah
TOTAL PERSEDIAAN

Mengetahui,
Kepala Seksi Keperawatan dan Penunjang Medis

Indri Mulyani Bunyamin, Apt.

NIP. 198109192011012008
AI PERSEDIAAN ALKES BMHP RSUD KEBAYORAN LAMA
April 2019

oran Lama

Expired Saldo Saldo 30

Awal AprilPenerimaan
PersediaanPemakaian Exp. Date April
Date 2019 2019
Feb-23 3791 0 3791 2159 1632
Jul-20 7 15 22 14 8
April-19 0 0 0 0 0
Dec-20 37 100 137 74 63
Jul-19 23 0 23 6 17
Jul-19 64 0 64 0 64
Jul-21 2 0 2 0 2
Jul-21 2 0 2 0 2
Jul-21 2 0 2 0 2
Jul-21 2 0 2 0 2
Oct-21 2 0 2 0 2
Jul-21 2 0 2 0 2
Feb-21 2 0 2 0 2
Feb-21 0 0 0 0 0
Feb-21 0 0 0 0 0
Mar-22 1 5 6 2 4
Feb-20 4 0 4 0 4
Sep-21 5 5 10 3 7
Sep-22 6 0 6 2 4
Nov-20 0 0 0 0 0
Feb-20 3 0 3 1 2
Jun-19 4 0 4 0 4
Jun-19 3 5 8 4 4
Mar-22 4 5 9 4 5
Jun-19 2 0 2 0 2
Mar-19 0 0 0 0 0
- 7 7 14 9 5
Dec-22 14 0 14 14 0
Feb-22 7 5 12 8 4
Jan-22 41 0 41 6 35
Nov-19 18 0 18 6 12
May-19 8 0 8 8 8 0
Oct-19 43 0 43 3 40
Oct-20 17 200 217 145 72
Jan-20 47 0 47 7 40
Sep-20 50 0 50 0 50
Dec-20 96 0 96 44 52
Feb-21 70 150 220 126 94
Apr-21 81 0 81 57 24
Dec-20 0 50 50 0 50
Nov-23 0 0 0 0 0
Nov-23 5 0 5 2 3
Nov-22 101 0 101 0 101
Jul-23 60 0 60 28 32
Jul-22 19 0 19 19 0
Nov-22 5 0 5 0 5
Nov-22 9 0 9 0 9
Nov-22 16 50 66 46 20
Sep-21 25 5 30 28 2
Feb-21 20 10 30 8 22
Nov-21 1 0 1 0 1
May-21 0 0 0 0 0
May-21 3 0 3 1 2
Jan-22 5 0 5 0 5
- 0 0 0 0 0
Nov-19 0 24 24 5 19
Jul-20 0 0 0 0 0
Aug-22 0 0 0 0 0
Feb-22 64 300 364 241 123
Feb-22 696 300 996 845 151
Mar-19 0 0 0 0 0
Feb-22 396 100 496 27 469
Apr-22 0 0 0 0 0
Sep-23 94 0 94 50 44
Sep-22 10 0 10 9 1
Mar-22 0 0 0 0 0
May-23 8 0 8 0 8
Aug-23 5 0 5 1 4
Jul-21 25 0 25 2 23
Oct-20 2 5 7 4 3
Oct-20 20 0 20 0 20
Jun-20 5 0 5 0 5
Apr-21 7 5 12 3 9
Jun-22 107 0 107 4 103
Sep-19 9 0 9 1 8
Jun-19 38 0 38 0 38
Apr-22 0 0 0 0 0
Feb-21 55 0 55 0 55
Oct-22 20 20 40 18 22
Nov-20 10 0 10 0 10
Aug-20 15 0 15 0 15
Jul-20 8 0 8 0 8
Apr-20 0 0 0 0 0
Sep-19 0 0 0 0 0
Dec-19 33 25 58 21 37
Apr-21 1 0 1 1 0
- 3 0 3 0 3
Jan-25 18 0 18 0 18
Oct-21 79 0 79 0 79
Feb-20 0 0 0 0 0
Aug-22 4 13 17 7 10
Mar-23 22 0 22 0 22
Oct-21 11 0 11 0 11
May-21 5 0 5 0 5
Jun-21 5 0 5 0 5
- 0 45 45 20 25
- 8 30 38 38 0
Jun-23 7 12 19 7 12
Dec-22 24 0 24 9 15
Dec-22 13 0 13 7 6
Mar-22 28 0 28 1 27
Feb-22 1 0 1 0 1
May-22 20 0 20 0 20
May-22 20 0 20 0 20
Mar-20 20 0 20 0 20
Mar-20 20 0 20 0 20
Mar-20 20 0 20 0 20
May-22 20 0 20 0 20
Jan-21 5 0 5 0 5
Feb-21 13 0 13 0 13
Oct-20 54 0 54 2 52
Mar-21 15 0 15 1 14
Jan-21 8 0 8 3 5
Sep-19 25 0 25 0 25
Oct-23 342 0 342 282 60
- 5 0 5 1 4
Jan-22 9 5 14 12 2
Feb-20 7 0 7 0 7
Dec-22 10 10 20 12 8
Apr-22 10 0 10 0 10
Jul-21 2 0 2 0 2
Feb-21 2 0 2 0 2
Feb-21 2 0 2 0 2
- 4 0 4 2 2
- 1 0 1 1 0
Jun-23 75 0 75 9 66
Jul-22 7 5 12 7 5
Oct-20 26 0 26 9 17
Jul-20 3 0 3 3 0
- 0 20 20 0 20
Mar-22 0 2 2 0 2
0 100 100 0 100
0 250 250 0 250
 Harga Satuan Nilai Akhir
Ket
+Ppn Rp Persediaan
Rp 353 Rp 576,096 APBD
Rp 3,273 Rp 26,184 Hibah
Rp 10,867 Rp - Hibah
Rp 12,750 Rp 803,250 Hibah
Rp 1,998 Rp 33,966 Hibah
Rp 1,998 Rp 127,872 Hibah
Rp 17,754 Rp 35,508 APBD
Rp 17,754 Rp 35,508 APBD
Rp 17,754 Rp 35,508 APBD
Rp 17,754 Rp 35,508 APBD
Rp 17,754 Rp 35,508 APBD
Rp 22,380 Rp 44,760 Hibah
Rp 24,618 Rp 49,236 APBD
Rp 22,380 Rp - APBD
Rp 22,380 Rp - Hibah
Rp 21,318 Rp 85,272 APBD
Rp 21,318 Rp 85,272 APBD
Rp 20,295 Rp 142,065 APBD
Rp 11,800 Rp 47,200 Hibah
Rp 22,380 Rp - APBD
Rp 20,295 Rp 40,590 APBD
Rp 14,909 Rp 59,636 Hibah
Rp 14,909 Rp 59,636 Hibah
Rp 14,909 Rp 74,545 Hibah
Rp 14,909 Rp 29,818 Hibah
Rp 14,909 Rp - Hibah
Rp 740 Rp 3,700 Hibah
Rp 572 Rp - APBD
Rp 572 Rp 2,288 APBD
Rp 11,000 Rp 385,000 Hibah
Rp 11,000 Rp 132,000 Hibah
Rp 9,070 Rp - Hibah
Rp 16,064 Rp 642,560 Hibah
Rp 16,064 Rp 1,156,608 Hibah
Rp 14,960 Rp 598,400 Hibah
Rp 14,960 Rp 748,000 Hibah
Rp 13,640 Rp 709,280 Hibah
Rp 13,640 Rp 1,282,160 Hibah
Rp 13,640 Rp 327,360 Hibah
Rp 13,640 Rp 682,000 Hibah
Rp 78,600 Rp - Hibah
Rp 45,900 Rp 137,700 Hibah
Rp 11,590 Rp 1,170,590 APBD
Rp 25,896 Rp 828,672 APBD
Rp 6,512 Rp - Hibah
Rp 5,082 Rp 25,410 Hibah
Rp 5,083 Rp 45,747 Hibah
Rp 5,085 Rp 101,700 Hibah
Rp 22,000 Rp 44,000 Hibah
Rp 9,500 Rp 209,000 Hibah
Rp 23,760 Rp 23,760 Hibah
Rp 41,360 Rp - Hibah
Rp 69,520 Rp 139,040 Hibah
Rp 79,200 Rp 396,000 Hibah
Rp 15,715 Rp - Hibah
Rp 1,691 Rp 32,129 Hibah
Rp 1,691 Rp - Hibah
Rp 1,430 Rp - Hibah
Rp 838 Rp 103,074 APBD
Rp 882 Rp 133,182 APBD
Rp 1,600 Rp - Hibah
Rp 993 Rp 465,717 APBD
Rp 1,103 Rp - Hibah
Rp 1,980 Rp 87,120 APBD
Rp 6,930 Rp 6,930 Hibah
Rp 3,718 Rp - Hibah
Rp 12,430 Rp 99,440 APBD
Rp 12,430 Rp 49,720 APBD
Rp 3,718 Rp 85,514 Hibah
Rp 3,950 Rp 11,850 Hibah
Rp 3,951 Rp 79,020 Hibah
Rp 3,953 Rp 19,765 Hibah
Rp 3,954 Rp 35,586 Hibah
Rp 2,310 Rp 237,930 Hibah
Rp 2,311 Rp 18,488 Hibah
Rp 2,312 Rp 87,856 Hibah
Rp 23,360 Rp - Hibah
Rp 2,750 Rp 151,250 Hibah
Rp 8,580 Rp 188,760 APBD
Rp 111,614 Rp 1,116,140 Hibah
Rp 86,738 Rp 1,301,070 Hibah
Rp 5,643 Rp 45,144 Hibah
Rp 5,645 Rp - Hibah
Rp 5,646 Rp - Hibah
Rp 5,647 Rp 208,939 Hibah
Rp 2,883 Rp - Hibah
- Rp - program
- Rp - program
- Rp - program
Rp 11,800 Rp - Hibah
Rp 22,380 Rp 223,800 Hibah
Rp 11,000 Rp 242,000 Hibah
Rp 11,000 Rp 121,000 Hibah
Rp 12,800 Rp 64,000 Hibah
Rp 12,800 Rp 64,000 Hibah
Rp 7,900 Rp 197,500 Hibah
Rp 60,900 Rp - Hibah
Rp 51,653 Rp 619,836 APBD
Rp 10,120 Rp 151,800 APBD
Rp 10,120 Rp 60,720 APBD
Rp 10,120 Rp 273,240 APBD
Rp 726 Rp 726 Hibah
Rp 6,600 Rp 132,000 Hibah
Rp 6,600 Rp 132,000 Hibah
Rp 6,600 Rp 132,000 Hibah
Rp 6,600 Rp 132,000 Hibah
Rp 6,600 Rp 132,000 Hibah
Rp 6,600 Rp 132,000 Hibah
Rp 3,718 Rp 18,590 Hibah
- Rp - program
Rp 3,268 Rp 169,936 APBD
Rp 8,663 Rp 121,282 APBD
Rp 44,468 Rp 222,340 APBD
Rp 5,644 Rp 141,100 Hibah
Rp 2,057 Rp 123,420 APBD
Rp 22,814 Rp 91,256 APBD
Rp 11,000 Rp 22,000 Hibah
Rp 8,200 Rp 57,400 APBD
Rp 6,846 Rp 54,768 APBD
Rp 23,360 Rp 233,600 Hibah
Rp 22,380 Rp 44,760 APBD
Rp 24,618 Rp 49,236 APBD
Rp 24,618 Rp 49,236 APBD
Rp 17,287 Rp 34,574 APBD
Rp 28,462 Rp - Hibah
Rp 15,400 Rp 1,016,400 APBD
Rp 422 Rp 2,110 APBD
Rp 2,883 Rp 49,011 Hibah
Rp 1,691 Rp - Hibah
Rp 2,848 Rp 56,960 Hibah
Rp 108,500 Rp 217,000 APBD
Rp 23,510 Rp 2,351,000 program
Rp 440 Rp 110,000 program
Rp 24,865,138

Kepala Instalasi Farmasi

Alfianita, Apt.