LAPORAN P

PUSKESMAS : GEYER 1
KECAMATAN : GEYER
KAB/ KOTA : GROBOGAN
PROPINSI : JAWA TENGAH

PENERIMAAN

NO NAMA ALAT TULIS KANTOR

HARGA SATUAN JUMLAH

1 2 3 4 5
1 Amplop Putih 104 PPL 11,500 Pak 2
2 Amplop Putih 90 PPL 16,000 Pak 2
3 Spidol Permanen Black Snowman 6,500 Pcs 5
4 Spidol BM Hitam Snow 6,500 Pcs 5
5 Bolp AE7 Standar Hitam 17,000 Lusin 5
6 Bussiness File 29,000 Pak 3
7 Map Plastik Kancing 26,600 Lusin 3
8 Isi Stap GW No. 10 HL 1,400 Pcs 2
9 Isi Stap GW No. 369 HL 24,000 Pak 1
10 Paper Clips 5 Jmb Kenko 4,500 Pcs 4
11 Binder C 200 ZRM 10,500 Pak 2
12 Binder C 155 ZRM 6,500 Pak 4
13 Stapler HD- 50 Kenko 18,000 Pcs 1
14 Max Stap HD-10 Purple 14,000 Pcs 5
15 Binder Clip 260 ZRM 17,000 Pak 2
16 Nota NCR B2 PPL 44,000 Pak 1
17 Buku Tulis 38 Kiky 24,000 Pak 1
18 Buku HC Kwarto 100 GLK 41,500 Pak 2
19 Stamp Pab K Hero 6,500 Pcs 1
20 Cal MJ 120 TW 68,000 Pcs 1
21 Zenith Tinta Ungu 2,300 Pcs 2
22 Binder C III DBZ 5,000 Pak 2
23 Bolp Tizo T6340 3,500 Pcs 5
24 Bolp Balliner Pilot 15,000 Pcs 5

Kepala UPTD Puskesmas

dr. AGUNG PROBO MULJONO, M.Si.
NIP. 19691007 200202 1 001
 LAPORAN PENERIMAAN DAN PENGELUARAN ALAT TULIS KANTOR
(ATK)

PENERIMAAN
JUMLAH
STOK AWAL PENERIMAAN
HARGA SATUAN
(3X4) PEMAKAIAN
6 7 8 9
23,000 pak 0 2
32,000 pak 0 2
32,500 pcs 0 5
32,500 pcs 0 5
85,000 pcs 0 60
87,000 pcs 0 36
79,800 pcs 0 36
2,800 pcs 0 20
24,000 dos kecil 0 10
18,000 dos kecil 0 4
21,000 pcs 0 24
26,000 pcs 0 48
18,000 pcs 0 1
70,000 pcs 0 5
34,000 pcs 0 24
44,000 buah 0 10
24,000 buah 0 10
83,000 buah 0 10
6,500 pcs 0 1
68,000 pcs 0 1
4,600 pcs 0 2
10,000 pcs 0 24
17,500 pcs 0 5
75,000 pcs 0 5
918,200

UPTD Puskesmas
G PROBO MULJONO, M.Si.
91007 200202 1 001
TULIS KANTOR

PELAPORAN BULAN : DESEMBER

TAHUN : 2016

PERSEDIAAN STOK AKHIR

PEMAKAIAN

(8+9) (10-11)
10 11 12
2 0 2
2 2 0
5 3 2
5 1 4
60 35 25
36 16 20
36 12 24
20 5 15
10 3 7
4 2 2
24 0 24
48 12 36
1 1 0
5 1 4
24 6 18
10 2 8
10 1 9
10 3 7
1 1 0
1 1 0
2 2 0
24 12 12
5 2 3
5 2 3

Petugas
 UPTD Puskesmas

MARIEANA CHANDRA KUSUMA, S.Farm.

NIP. 19840903 200903 2 005
KET.

13
 LAPORAN PEN

PUSKESMAS : GEYER 1
KECAMATAN : GEYER
KAB/ KOTA : GROBOGAN
PROPINSI : JAWA TENGAH

PENERIMAAN

NO NAMA ALAT TULIS KANTOR

HARGA SATUAN JUMLAH

1 2 3 4 5
1 Amplop Putih 104 PPL 11,500 Pak
2 Amplop Putih 90 PPL 16,000 Pak
3 Spidol Permanen Black Snowman 6,500 Pcs
4 Spidol BM Hitam Snow 6,500 Pcs
5 Bolp AE7 Standar Hitam 17,000 Lusin
6 Bussiness File 29,000 Pak
7 Map Plastik Kancing 26,600 Lusin
8 Isi Stap GW No. 10 HL 1,400 Pcs
9 Isi Stap GW No. 369 HL 24,000 Pak
10 Paper Clips 5 Jmb Kenko 4,500 Pcs
11 Binder C 200 ZRM 10,500 Pak
12 Binder C 155 ZRM 6,500 Pak
13 Stapler HD- 50 Kenko 18,000 Pcs
14 Max Stap HD-10 Purple 14,000 Pcs
15 Binder Clip 260 ZRM 17,000 Pak
16 Nota NCR B2 PPL 44,000 Pak
17 Buku Tulis 38 Kiky 24,000 Pak
18 Buku HC Kwarto 100 GLK 41,500 Pak
19 Stamp Pab K Hero 6,500 Pcs
20 Cal MJ 120 TW 68,000 Pcs
21 Zenith Tinta Ungu 2,300 Pcs
22 Binder C III DBZ 5,000 Pak
23 Bolp Tizo T6340 3,500 Pcs
24 Bolp Balliner Pilot 15,000 Pcs
 Kepala UPTD Puskesmas

dr. AGUNG PROBO MULJONO, M.Si.

NIP. 19691007 200202 1 001
 LAPORAN PENERIMAAN DAN PENGELUARAN ALAT TULIS KANTOR
(ATK)

PENERIMAAN
JUMLAH
STOK AWAL PENERIMAAN
HARGA SATUAN
(3X4) PEMAKAIAN
6 7 8 9
pak 2
pak 0
pcs 2
pcs 4
pcs 25
pcs 20
pcs 24
pcs 15
dos kecil 7
dos kecil 2
pcs 24
pcs 36
pcs 0
pcs 4
pcs 18
buah 8
buah 9
buah 7
pcs 0
pcs 0
pcs 0
pcs 12
pcs 3
pcs 3
0
UPTD Puskesmas

G PROBO MULJONO, M.Si.

91007 200202 1 001
TULIS KANTOR

PELAPORAN BULAN : JANUARI

TAHUN : 2017

PERSEDIAAN STOK AKHIR

PEMAKAIAN KET.

(8+9) (10-11)
10 11 12 13
2 0 2
0 0 0
2 2 0
4 1 3
25 18 7
20 10 10
24 24 0
15 0 15
7 0 7
2 0 2
24 0 24
36 12 24
0 0 0
4 0 4
18 0 18
8 0 8
9 4 5
7 5 2
0 0 0
0 0 0
0 0 0
12 0 12
3 0 3
3 0 3
 Petugas
UPTD Puskesmas

MARIEANA CHANDRA KUSUMA, S.Farm.

NIP. 19840903 200903 2 005
 LAPORAN PEN

PUSKESMAS : GEYER 1
KECAMATAN : GEYER
KAB/ KOTA : GROBOGAN
PROPINSI : JAWA TENGAH

PENERIMAAN

NO NAMA ALAT TULIS KANTOR

HARGA SATUAN JUMLAH

1 2 3 4 5
1 Amplop Putih 104 PPL 11,500 Pak
2 Amplop Putih 90 PPL 16,000 Pak
3 Spidol Permanen Black Snowman 6,500 Pcs
4 Spidol BM Hitam Snow 6,500 Pcs
5 Bolp AE7 Standar Hitam 17,000 Lusin
6 Bussiness File 29,000 Pak
7 Map Plastik Kancing 26,600 Lusin
8 Isi Stap GW No. 10 HL 1,400 Pcs
9 Isi Stap GW No. 369 HL 24,000 Pak
10 Paper Clips 5 Jmb Kenko 4,500 Pcs
11 Binder C 200 ZRM 10,500 Pak
12 Binder C 155 ZRM 6,500 Pak
13 Stapler HD- 50 Kenko 18,000 Pcs
14 Max Stap HD-10 Purple 14,000 Pcs
15 Binder Clip 260 ZRM 17,000 Pak
16 Nota NCR B2 PPL 44,000 Pak
17 Buku Tulis 38 Kiky 24,000 Pak
18 Buku HC Kwarto 100 GLK 41,500 Pak
19 Stamp Pab K Hero 6,500 Pcs
20 Cal MJ 120 TW 68,000 Pcs
21 Zenith Tinta Ungu 2,300 Pcs
22 Binder C III DBZ 5,000 Pak
23 Bolp Tizo T6340 3,500 Pcs
24 Bolp Balliner Pilot 15,000 Pcs

Non Kapitasi
25 Kertas HVS 70 Gr Sidu 41,000 rim
26 Odner merk R&R 20,500 buah
27 Stopmap merk Sriti 880 buah
28 Tinta Printer Reffile merk DataPrint 27,500 botol
29 Kuitansi Besar merk Gelatik 9,900 buah
30 Spidol Permanent merk Snowman 6,300 buah
31 Stepler merk Mark HD 10 18,800 buah
32 Amplop Putih besar merk Royal 18800 Pak

Kepala UPTD Puskesmas

dr. AGUNG PROBO MULJONO, M.Si.

NIP. 19691007 200202 1 001
 LAPORAN PENERIMAAN DAN PENGELUARAN ALAT TULIS KANTOR
(ATK)

PENERIMAAN
JUMLAH
STOK AWAL PENERIMAAN
HARGA SATUAN
(3X4) PEMAKAIAN
6 7 8 9
pak 2
pak 0
pcs 0
pcs 3
pcs 7
pcs 10
pcs 0
pcs 15
dos kecil 7
dos kecil 2
pcs 24
pcs 24
pcs 0
pcs 4
pcs 18
buah 8
buah 5
buah 2
pcs 0
pcs 0
pcs 0
pcs 12
pcs 3
pcs 3

rim 0 10
 buah 0 12
buah 0 75
botol 0 26
buah 0 2
buah 0 24
buah 0 20
Pak 0 16

UPTD Puskesmas

G PROBO MULJONO, M.Si.

91007 200202 1 001
TULIS KANTOR

PELAPORAN BULAN : FEBRUARI

TAHUN : 2017

PERSEDIAAN STOK AKHIR

PEMAKAIAN KET.

(8+9) (10-11)
10 11 12 13
2 1 1
0 0 0
0 0 0
3 2 1
7 1 6
10 2 8
0 0 0
15 4 11
7 0 7
2 1 1
24 0 24
24 12 12
0 0 0
4 1 3
18 0 18
8 3 5
5 5 0
2 1 1
0 0 0
0 0 0
0 0 0
12 0 12
3 2 1
3 0 3

10 0 10
12 0 12
75 0 75
26 1 25
2 1 1
24 3 21
20 0 20
16 0 16

Petugas
UPTD Puskesmas

MARIEANA CHANDRA KUSUMA, S.Farm.

NIP. 19840903 200903 2 005
 LAPORAN PEN

PUSKESMAS : GEYER 1
KECAMATAN : GEYER
KAB/ KOTA : GROBOGAN
PROPINSI : JAWA TENGAH

PENERIMAAN

NO NAMA ALAT TULIS KANTOR

HARGA SATUAN JUMLAH

1 2 3 4 5
1 Amplop Putih 104 PPL 11,500 Pak
2 Amplop Putih 90 PPL 16,000 Pak
3 Spidol Permanen Black Snowman 6,500 Pcs
4 Spidol BM Hitam Snow 6,500 Pcs
5 Bolp AE7 Standar Hitam 17,000 Lusin
6 Bussiness File 29,000 Pak
7 Map Plastik Kancing 26,600 Lusin
8 Isi Stap GW No. 10 HL 1,400 Pcs
9 Isi Stap GW No. 369 HL 24,000 Pak
10 Paper Clips 5 Jmb Kenko 4,500 Pcs
11 Binder C 200 ZRM 10,500 Pak
12 Binder C 155 ZRM 6,500 Pak
13 Stapler HD- 50 Kenko 18,000 Pcs
14 Max Stap HD-10 Purple 14,000 Pcs
15 Binder Clip 260 ZRM 17,000 Pak
16 Nota NCR B2 PPL 44,000 Pak
17 Buku Tulis 38 Kiky 24,000 Pak
18 Buku HC Kwarto 100 GLK 41,500 Pak
19 Stamp Pab K Hero 6,500 Pcs
20 Cal MJ 120 TW 68,000 Pcs
21 Zenith Tinta Ungu 2,300 Pcs
22 Binder C III DBZ 5,000 Pak
23 Bolp Tizo T6340 3,500 Pcs
24 Bolp Balliner Pilot 15,000 Pcs

Non Kapitasi
25 Kertas HVS 70 Gr Sidu 41,000 rim
26 Odner merk R&R 20,500 buah
27 Stopmap merk Sriti 880 buah
28 Tinta Printer Reffile merk DataPrint 27,500 botol
29 Kuitansi Besar merk Gelatik 9,900 buah
30 Spidol Permanent merk Snowman 6,300 buah
31 Stepler merk Mark HD 10 18,800 buah
32 Amplop Putih besar merk Royal 18800 Pak

33 Ballpoint standar 24,000 dos 10

34 Ballpoint balliner biru 20,000 pcs 5
35 Ballpoint balliner merah 20,000 pcs 5
36 Map plastik snelheter transparan 42,000 pak 5
37 Map plastik kancing 42,000 pak 5
38 Map kertas 25,000 pak 2
39 Buku folio 20,000 pcs 10
40 Buku kuarto 12,500 pcs 15
41 Buku tulis sidu 4,000 pcs 10
42 Spidol permanen 78,000 dos 1
43 Spidol boardmarker 90,000 dos 1
44 Amplop putih besar 20,000 dos 5
45 Amplop putih tanggung 15,000 dos 2
46 Otner folio 22,500 pcs 10
47 Binder klip No.260 24,000 dos 3
48 Binder klip No.111 7,000 dos 3
49 Paper klip No.3 30,000 pak 2
50 Paper klip No.5 60,000 pak 2
51 Tip ex Kenko 6,000 pcs 12
52 Pensil 2B Steadler 72,000 dos 1
53 Penggaris 30 cm 2,000 pcs 20
54 Isi stappler besar 30,000 pak 1
55 Isi stappler kecil 20,000 pak 1
56 Map snelheter kertas 50,000 pak 1
57 Papan triplek 15,000 pcs 10
58 Tinta spidol permanen 15,000 botol 5
59 Tinta spidol board marker 17,500 botol 5
60 Tinta stempel ungu 3,000 botol 2
61 Ballpoint standar biru 24,000 dos 2
62 Ballpoint standar merah 24,000 dos 1
63 Penghapus steadler 30,000 dos 1
 Kepala UPTD Puskesmas

dr. AGUNG PROBO MULJONO, M.Si.

NIP. 19691007 200202 1 001
 LAPORAN PENERIMAAN DAN PENGELUARAN ALAT TULIS KANTOR
(ATK)

PENERIMAAN
JUMLAH
STOK AWAL PENERIMAAN
HARGA SATUAN
(3X4) PEMAKAIAN
6 7 8 9
lembar 1
lembar 0
pcs 0
pcs 1
pcs 6
pcs 8
pcs 0
pcs 11
dos kecil 7
dos kecil 1
pcs 24
pcs 12
pcs 0
pcs 3
pcs 18
buah 5
buah 0
buah 1
pcs 0
pcs 0
pcs 0
pcs 12
pcs 1
pcs 3

rim 10
 buah 12
buah 75
botol 25
buah 1
buah 21
buah 20
Pak 16

240,000 pcs 0 120

100,000 pcs 0 5
100,000 pcs 0 5
210,000 buah 0 60
210,000 buah 0 60
50,000 buah 0 100
200,000 buah 0 10
127,000 buah 0 15
40,000 buah 0 10
78,000 pcs 0 12
90,000 pcs 0 12
100,000 dos 0 5
30,000 dos 0 2
225,000 buah 0 10
72,000 pcs 0 36
21,000 pcs 0 36
60,000 dos 0 20
120,000 dos 0 20
72,000 pcs 0 12
72,000 pcs 0 12
40,000 pcs 0 20
30,000 dos 0 10
20,000 dos 0 10
50,000 buah 0 50
150,000 pcs 0 10
75,000 botol 0 5
87,500 botol 0 5
6,000 botol 0 2
48,000 pcs 0 24
24,000 pcs 0 12
30,000 pcs 0 40
2,777,500
UPTD Puskesmas

G PROBO MULJONO, M.Si.

91007 200202 1 001
TULIS KANTOR

PELAPORAN BULAN : MARET

TAHUN : 2017

PERSEDIAAN STOK AKHIR

PEMAKAIAN KET.

(8+9) (10-11)
10 11 12 13
1 0 1
0 0 0
0 0 0
1 0 1
6 0 6
8 0 8
0 0 0
11 1 10
7 0 7
1 0 1
24 0 24
12 0 12
0 0 0
3 2 1
18 12 6
5 0 5
0 0 0
1 0 1
0 0 0
0 0 0
0 0 0
12 0 12
1 1 0
3 3 0

10 0 10
12 0 12
75 3 72
25 0 25
1 0 1
21 1 20
20 0 20
16 0 16

120 49 71
5 1 4
5 0 5
60 9 51
60 34 26
100 0 100
10 1 9
15 3 12
10 0 10
12 0 12
12 0 12
5 0 5
2 0 2
10 0 10
36 0 36
36 0 36
20 0 20
20 1 19
12 3 9
12 0 12
20 0 20
10 0 10
10 0 10
50 0 50
10 1 9
5 1 4
5 0 5
2 1 1
24 0 24
12 2 10
40 0 40
 Petugas
UPTD Puskesmas

MARIEANA CHANDRA KUSUMA, S.Farm.

NIP. 19840903 200903 2 005
 LAPORAN PEN

PUSKESMAS : GEYER 1
KECAMATAN : GEYER
KAB/ KOTA : GROBOGAN
PROPINSI : JAWA TENGAH

PENERIMAAN

NO NAMA ALAT TULIS KANTOR

HARGA SATUAN JUMLAH

1 2 3 4 5
1 Amplop Putih 104 PPL 11,500 Pak
2 Amplop Putih 90 PPL 16,000 Pak
3 Spidol Permanen Black Snowman 6,500 Pcs
4 Spidol BM Hitam Snow 6,500 Pcs
5 Bolp AE7 Standar Hitam 17,000 Lusin
6 Bussiness File 29,000 Pak
7 Map Plastik Kancing 26,600 Lusin
8 Isi Stap GW No. 10 HL 1,400 Pcs
9 Isi Stap GW No. 369 HL 24,000 Pak
10 Paper Clips 5 Jmb Kenko 4,500 Pcs
11 Binder C 200 ZRM 10,500 Pak
12 Binder C 155 ZRM 6,500 Pak
13 Stapler HD- 50 Kenko 18,000 Pcs
14 Max Stap HD-10 Purple 14,000 Pcs
15 Binder Clip 260 ZRM 17,000 Pak
16 Nota NCR B2 PPL 44,000 Pak
17 Buku Tulis 38 Kiky 24,000 Pak
18 Buku HC Kwarto 100 GLK 41,500 Pak
19 Stamp Pab K Hero 6,500 Pcs
20 Cal MJ 120 TW 68,000 Pcs
21 Zenith Tinta Ungu 2,300 Pcs
22 Binder C III DBZ 5,000 Pak
23 Bolp Tizo T6340 3,500 Pcs
24 Bolp Balliner Pilot 15,000 Pcs

Non Kapitasi
25 Kertas HVS 70 Gr Sidu 41,000 rim
26 Odner merk R&R 20,500 buah
27 Stopmap merk Sriti 880 buah
28 Tinta Printer Reffile merk DataPrint 27,500 botol
29 Kuitansi Besar merk Gelatik 9,900 buah
30 Spidol Permanent merk Snowman 6,300 buah
31 Stepler merk Mark HD 10 18,800 buah
32 Amplop Putih besar merk Royal 18800 Pak

33 Ballpoint standar 24,000 dos 10

34 Ballpoint balliner biru 20,000 pcs 5
35 Ballpoint balliner hitam 20,000 pcs 5
36 Map plastik snelheter transparan 42,000 pak 5
37 Map plastik kancing 42,000 pak 5
38 Map kertas 25,000 pak 2
39 Buku folio 20,000 pcs 10
40 Buku kuarto 12,500 pcs 15
41 Buku tulis sidu 4,000 pcs 10
42 Spidol permanen 78,000 dos 1
43 Spidol boardmarker 90,000 dos 1
44 Amplop putih besar 20,000 dos 5
45 Amplop putih tanggung 15,000 dos 2
46 Otner folio 22,500 pcs 10
47 Binder klip No.260 24,000 dos 3
48 Binder klip No.111 7,000 dos 3
49 Paper klip No.3 30,000 pak 2
50 Paper klip No.5 60,000 pak 2
51 Tip ex Kenko 6,000 pcs 12
52 Pensil 2B Steadler 72,000 dos 1
53 Penggaris 30 cm 2,000 pcs 20
54 Isi stappler besar 30,000 pak 1
55 Isi stappler kecil 20,000 pak 1
56 Map snelheter kertas 50,000 pak 1
57 Papan triplek 15,000 pcs 10
58 Tinta spidol permanen 15,000 botol 5
59 Tinta spidol board marker 17,500 botol 5
60 Tinta stempel ungu 3,000 botol 2
61 Ballpoint standar biru 24,000 dos 2
62 Ballpoint standar merah 24,000 dos 1
63 Penghapus steadler 30,000 dos 1
64 Otner Forte Folio 12,000 pcs 6
65 Hero Stamp Pad Besar 8,500 pcs 3
66 Hero Stamp Pad Kecil 7,500 pcs 2
67 Pilot Ball Liner Hitam 15,000 pcs 5
68 Pilot Ball Liner Biru 15,000 pcs 3
69 Citizen Calkulator SDC 868 L 65,000 pcs 3
70 Gunindo Gunting FM 6,500 pcs 5
71 Pilot BPT-P Hitam 20,600 lusin 4
72 Map Plastik Kancing 26,600 lusin 5
73 Kampak Kwitansi Besar 44,000 pak 1
74 Astro Lem ALG75 3,500 pcs 2
75 Gluvinal Lem Cair TGG 3,500 pcs 3
76 Gunindo Cutter K SC9A 2,500 pcs 5

Kepala UPTD Puskesmas

dr. AGUNG PROBO MULJONO, M.Si.

NIP. 19691007 200202 1 001
 LAPORAN PENERIMAAN DAN PENGELUARAN ALAT TULIS KANTOR
(ATK)

PENERIMAAN
JUMLAH
STOK AWAL PENERIMAAN
HARGA SATUAN
(3X4) PEMAKAIAN
6 7 8 9
lembar 1
lembar 0
pcs 0
pcs 1
pcs 6
pcs 8
pcs 0
pcs 10
dos kecil 7
dos kecil 1
pcs 24
pcs 12
pcs 0
pcs 1
pcs 6
buah 5
buah 0
buah 1
pcs 0
pcs 0
pcs 0
pcs 12
pcs 0
pcs 0

rim 10
 buah 12
buah 72
botol 25
buah 1
buah 20
buah 20
Pak 16

240,000 71
100,000 4
100,000 5
210,000 51
210,000 26
50,000 100
200,000 9
127,000 12
40,000 10
78,000 12
90,000 12
100,000 5
30,000 2
225,000 10
72,000 36
21,000 36
60,000 20
120,000 19
72,000 9
72,000 12
40,000 20
30,000 10
20,000 10
50,000 50
150,000 9
75,000 4
87,500 5
6,000 1
48,000 24
24,000 10
30,000 40
2,777,500
 72,000 6
25,500 3
15,000 3
75,000 5
45,000 3
195,000 3
32,500 5
82,400 48
133,000 60
44,000 10
7,000 2
10,500 3
12,500 5
749,400

UPTD Puskesmas

G PROBO MULJONO, M.Si.

91007 200202 1 001
TULIS KANTOR

PELAPORAN BULAN : APRIL

TAHUN : 2017

PERSEDIAAN STOK AKHIR

PEMAKAIAN KET.

(8+9) (10-11)
10 11 12 13
1 1 0
0 0 0
0 0 0
1 0 1
6 0 6
8 0 8
0 0 0
10 5 5
7 0 7
1 1 0
24 12 12
12 12 0
0 0 0
1 1 0
6 2 4
5 3 2
0 0 0
1 1 0
0 0 0
0 0 0
0 0 0
12 12 0
0 0 0
0 0 0

10 0 10
12 0 12
72 0 72
25 5 20
1 1 0
20 5 15
20 0 20
16 0 16

71 52 19
4 2 2
5 2 3
51 0 51
26 26 0
100 50 50
9 0 9
12 0 12
10 0 10
12 0 12
12 0 12
5 0 5
2 1 1
10 0 10
36 0 36
36 24 12
20 5 15
19 0 19
9 2 7
12 0 12
20 1 19
10 0 10
10 0 10
50 3 47
9 5 4
4 0 4
5 0 5
1 0 1
24 0 24
10 0 10
40 0 40
6 0 6
3 0 3
3 0 3
5 0 5
3 0 3
3 1 2
5 0 5
48 0 48
60 29 31
10 0 10
2 0 2
3 0 3
5 0 5

Petugas
UPTD Puskesmas

MARIEANA CHANDRA KUSUMA, S.Farm.

NIP. 19840903 200903 2 005
 LAPORAN PEN

PUSKESMAS : GEYER 1
KECAMATAN : GEYER
KAB/ KOTA : GROBOGAN
PROPINSI : JAWA TENGAH

PENERIMAAN

NO NAMA ALAT TULIS KANTOR

HARGA SATUAN JUMLAH

1 2 3 4 5
1 Amplop Putih 104 PPL 11,500 Pak
2 Amplop Putih 90 PPL 16,000 Pak
3 Spidol Permanen Black Snowman 6,500 Pcs
4 Spidol BM Hitam Snow 6,500 Pcs
5 Bolp AE7 Standar Hitam 17,000 Lusin
6 Bussiness File 29,000 Pak
7 Map Plastik Kancing 26,600 Lusin
8 Isi Stap GW No. 10 HL 1,400 Pcs
9 Isi Stap GW No. 369 HL 24,000 Pak
10 Paper Clips 5 Jmb Kenko 4,500 Pcs
11 Binder C 200 ZRM 10,500 Pak
12 Binder C 155 ZRM 6,500 Pak
13 Stapler HD- 50 Kenko 18,000 Pcs
14 Max Stap HD-10 Purple 14,000 Pcs
15 Binder Clip 260 ZRM 17,000 Pak
16 Nota NCR B2 PPL 44,000 Pak
17 Buku Tulis 38 Kiky 24,000 Pak
18 Buku HC Kwarto 100 GLK 41,500 Pak
19 Stamp Pab K Hero 6,500 Pcs
20 Cal MJ 120 TW 68,000 Pcs
21 Zenith Tinta Ungu 2,300 Pcs
22 Binder C III DBZ 5,000 Pak
23 Bolp Tizo T6340 3,500 Pcs
24 Bolp Balliner Pilot 15,000 Pcs

Non Kapitasi
25 Kertas HVS 70 Gr Sidu 41,000 rim
26 Odner merk R&R 20,500 buah
27 Stopmap merk Sriti 880 buah
28 Tinta Printer Reffile merk DataPrint 27,500 botol
29 Kuitansi Besar merk Gelatik 9,900 buah
30 Spidol Permanent merk Snowman 6,300 buah
31 Stepler merk Mark HD 10 18,800 buah
32 Amplop Putih besar merk Royal 18800 Pak

33 Ballpoint standar 24,000 dos 10

34 Ballpoint balliner biru 20,000 pcs 5
35 Ballpoint balliner hitam 20,000 pcs 5
36 Map plastik snelheter transparan 42,000 pak 5
37 Map plastik kancing 42,000 pak 5
38 Map kertas 25,000 pak 2
39 Buku folio 20,000 pcs 10
40 Buku kuarto 12,500 pcs 15
41 Buku tulis sidu 4,000 pcs 10
42 Spidol permanen 78,000 dos 1
43 Spidol boardmarker 90,000 dos 1
44 Amplop putih besar 20,000 dos 5
45 Amplop putih tanggung 15,000 dos 2
46 Otner folio 22,500 pcs 10
47 Binder klip No.260 24,000 dos 3
48 Binder klip No.111 7,000 dos 3
49 Paper klip No.3 30,000 pak 2
50 Paper klip No.5 60,000 pak 2
51 Tip ex Kenko 6,000 pcs 12
52 Pensil 2B Steadler 72,000 dos 1
53 Penggaris 30 cm 2,000 pcs 20
54 Isi stappler besar 30,000 pak 1
55 Isi stappler kecil 20,000 pak 1
56 Map snelheter kertas 50,000 pak 1
57 Papan triplek 15,000 pcs 10
58 Tinta spidol permanen 15,000 botol 5
59 Tinta spidol board marker 17,500 botol 5
60 Tinta stempel ungu 3,000 botol 2
61 Ballpoint standar biru 24,000 dos 2
62 Ballpoint standar merah 24,000 dos 1
63 Penghapus steadler 30,000 dos 1
64 Otner Forte Folio 12,000 pcs 6
65 Hero Stamp Pad Besar 8,500 pcs 3
66 Hero Stamp Pad Kecil 7,500 pcs 2
67 Pilot Ball Liner Hitam 15,000 pcs 5
68 Pilot Ball Liner Biru 15,000 pcs 3
69 Citizen Calkulator SDC 868 L 65,000 pcs 3
70 Gunindo Gunting FM 6,500 pcs 5
71 Pilot BPT-P Hitam 20,600 lusin 4
72 Map Plastik Kancing 26,600 lusin 5
73 Kampak Kwitansi Besar 44,000 pak 1
74 Astro Lem ALG75 3,500 pcs 2
75 Gluvinal Lem Cair TGG 3,500 pcs 3
76 Gunindo Cutter K SC9A 2,500 pcs 5

Kepala UPTD Puskesmas

dr. AGUNG PROBO MULJONO, M.Si.

NIP. 19691007 200202 1 001
 LAPORAN PENERIMAAN DAN PENGELUARAN ALAT TULIS KANTOR
(ATK)

PENERIMAAN
JUMLAH
STOK AWAL PENERIMAAN
HARGA SATUAN
(3X4) PEMAKAIAN
6 7 8 9
lembar 0
lembar 0
pcs 0
pcs 1
pcs 6
pcs 8
pcs 0
pcs 5
dos kecil 7
dos kecil 0
pcs 12
pcs 0
pcs 0
pcs 0
pcs 4
buah 2
buah 0
buah 0
pcs 0
pcs 0
pcs 0
pcs 0
pcs 0
pcs 0

rim 10
 buah 12
buah 72
botol 20
buah 0
buah 15
buah 20
Pak 16

240,000 19
100,000 2
100,000 3
210,000 43
210,000 0
50,000 50
200,000 9
127,000 11
40,000 10
78,000 12
90,000 12
100,000 5
30,000 1
225,000 10
72,000 36
21,000 12
60,000 15
120,000 19
72,000 7
72,000 12
40,000 19
30,000 10
20,000 10
50,000 47
150,000 9
75,000 4
87,500 5
6,000 1
48,000 24
24,000 10
30,000 40
2,777,500
 72,000 6
25,500 3
15,000 3
75,000 5
45,000 3
195,000 2
32,500 5
82,400 48
133,000 31
44,000 10
7,000 2
10,500 3
12,500 5
749,400

UPTD Puskesmas

G PROBO MULJONO, M.Si.

91007 200202 1 001
TULIS KANTOR

PELAPORAN BULAN : MEI

TAHUN : 2017

PERSEDIAAN STOK AKHIR

PEMAKAIAN KET.

(8+9) (10-11)
10 11 12 13
0 0
0 0
0 0
1 1
6 6
8 8
0 0
5 5
7 7
0 0
12 12
0 0
0 0
0 0
4 4
2 2
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

10 10
12 12
72 72
20 20
0 0
15 15
20 20
16 16

19 19
2 2
3 3
43 43
0 0
50 50
9 9
11 11
10 10
12 12
12 12
5 5
1 1
10 10
36 36
12 12
15 15
19 19
7 7
12 12
19 19
10 10
10 10
47 47
9 9
4 4
5 5
1 1
24 24
10 10
40 40
6 6
3 3
3 3
5 5
3 3
2 2
5 5
48 48
31 31
10 10
2 2
3 3
5 5

Petugas
UPTD Puskesmas

MARIEANA CHANDRA KUSUMA, S.Farm.

NIP. 19840903 200903 2 005