Persediaan 2020 Contoh

OPD : PUSKESMAS KWADUNGAN
KABUPATEN : NGAWI
PROPINSI : JAWA TIMUR
TAHUN ANGGARAN : 2020
JENIS BELANJA : Persediaan Alat Tulis Kantor
DAFTAR PENGADAAN BARANG
TAHUN ANGGARAN 2019
SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

Jenis Barang Yang Dipergunakan
No Ket
Dibeli Banyaknya Pada Unit
Tanggal Nomor Tanggal Nomor Merk Satuan Harga Satuan Jumlah Harga
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 modem 1/6/2020 8 prolink unit 1 Rp 595,000 Rp 595,000.00 tu
2 spidol BM 1/30/2020 9 - biji 1 Rp 8,000 Rp 8,000.00 ugd
3 lakban 1/30/2020 9 - biji 1 Rp 15,000 Rp 15,000.00 ugd
4 buku tulis isi 38 1/30/2020 10 sidu pak 3 Rp 25,000 Rp 75,000.00 tu
6 buku folio isi 100 1/30/2020 10 paperline biji 6 Rp 15,000 Rp 90,000.00 tu
8 kwitansi tanggung 1/30/2020 10 sidu biji 5 Rp 4,000 Rp 20,000.00 tu
9 kwitansi besar 1/30/2020 10 sidu biji 3 Rp 5,000 Rp 15,000.00 tu
10 snell helter 1/30/2020 10 bisnis pak 1 Rp 33,000 Rp 33,000.00 tu
11 hvs 70 gr 1/30/2020 10 maxi rim 7 Rp 42,000 Rp 294,000.00 tu
12 snell helter 2/27/2020 29 bisnis pak 1 Rp 35,000 Rp 35,000.00 ugd
13 snell helter 2/27/2020 29 bisnis biji 2 Rp 4,000 Rp 8,000.00 ugd
14 snell helter 2/27/2020 29 bisnis biji 5 Rp 4,000 Rp 20,000.00 tu
15 hvs 70 gr 2/27/2020 29 sidu rim 1 Rp 50,000 Rp 50,000.00 ugd
16 kalkulator 2/27/2020 29 - unit 1 Rp 54,000 Rp 54,000.00 ugd
18 tinta print 2/27/2020 30 blue print tube 3 Rp 38,000 Rp 114,000.00 tu
19 odwner 2/27/2020 30 - biji 3 Rp 17,000 Rp 51,000.00 tu
20 box file 2/27/2020 30 - biji 1 Rp 13,000 Rp 13,000.00 tu
21 binder clip 107 2/27/2020 30 - box 2 Rp 5,000 Rp 10,000.00 tu
22 bolpoint 2/27/2020 30 x data pak 1 Rp 10,000 Rp 10,000.00 tu
23 stabilo 2/27/2020 30 - biji 1 Rp 4,000 Rp 4,000.00 tu
24 solasi kecil 2/27/2020 30 - biji 10 Rp 1,000 Rp 10,000.00 tu
25 kertas karbon 2/27/2020 30 - lembar 4 Rp 1,000 Rp 4,000.00 ugd
27 spidol permanen 2/27/2020 30 - biji 3 Rp 4,000 Rp 12,000.00 tu
28 bufalo+mika 2/27/2020 30 - pak 1 Rp 35,000 Rp 35,000.00 tu
29 lakban hitam 2/27/2020 30 - biji 1 Rp 12,000 Rp 12,000.00 tu
31 map kertas 2/27/2020 30 - biji 25 Rp 500 Rp 12,500.00 tu
32 map snell kertas 2/27/2020 30 pak 1 Rp 11,000 Rp 11,000.00 tu
33 amplop besar 2/27/2020 30 paperline pak 1 Rp 18,000 Rp 18,000.00 tu
34 amplop tanggung 2/27/2020 30 paperline pak 1 Rp 13,500 Rp 13,500.00 tu
35 buku folio isi 200 2/27/2020 30 sidu biji 2 Rp 26,000 Rp 52,000.00 tu
36 buku folio isi 100 2/27/2020 30 sidu biji 2 Rp 15,000 Rp 30,000.00 tu
37 binder clip 200 2/27/2020 30 - pak 1 Rp 15,000 Rp 15,000.00 tu
38 paper clip 2/27/2020 30 - pak 2 Rp 5,000 Rp 10,000.00 tu
39 stempel 2/27/2020 30 - biji 2 Rp 90,000 Rp 180,000.00 laborat
40 steples kecil 3/30/2020 62 - biji 1 Rp 18,000 Rp 18,000.00 ugd
41 isi steples 3/30/2020 62 - biji 1 Rp 3,000 Rp 3,000.00 ugd
42 stipo kertas 3/30/2020 62 - biji 1 Rp 7,000 Rp 7,000.00 ugd
43 map 3/30/2020 62 - biji 1 Rp 10,000 Rp 10,000.00 ugd
44 stabilo 3/30/2020 62 - biji 2 Rp 10,000 Rp 20,000.00 obat
45 carter 3/30/2020 62 - biji 1 Rp 15,000 Rp 15,000.00 obat
46 lakban besar 3/30/2020 62 - biji 1 Rp 17,000 Rp 17,000.00 obat
47 stipo kertas 3/30/2020 62 - biji 7 Rp 6,000 Rp 42,000.00 ugd
50 lem castol 3/30/2020 63 - tube 1 Rp 6,000 Rp 6,000.00 tu
52 odwner 3/30/2020 63 - biji 3 Rp 17,000 Rp 51,000.00 tu
54 isi steples 3/30/2020 63 gw pak 1 Rp 19,000 Rp 19,000.00 tu
55 stop map benik 3/30/2020 63 - biji 9 Rp 3,000 Rp 27,000.00 tu
62 doubel foam hansa 3/22/2020 64 hansa biji 1 Rp 14,000 Rp 14,000.00 obat
63 doubel tape 3/22/2020 64 huli biji 1 Rp 4,000 Rp 4,000.00 obat
64 doebel foam huli 3/22/2020 64 huli biji 1 Rp 4,000 Rp 4,000.00 obat
65 print 3/30/2020 65 epson unit 1 Rp 2,469,150 Rp 2,469,150.00 tu
66 buku folio isi 100 4/14/2020 98 paperline biji 2 Rp 12,000 Rp 24,000.00 mutu
67 isi steples 4/14/2020 99 - pak 1 Rp 50,000 Rp 50,000.00 ugd
68 mika 4/28/2020 100 - biji 5 Rp 4,500 Rp 22,500.00 ugd
69 stop map benik 4/28/2020 100 - biji 1 Rp 5,000 Rp 5,000.00 ugd
70 doubel tape 4/28/2020 100 - biji 4 Rp 7,500 Rp 30,000.00 ugd
71 tinta 4/28/2020 100 - tube 2 Rp 49,500 Rp 99,000.00 ugd
72 nota 4/28/2020 100 sidu biji 2 Rp 3,000 Rp 6,000.00 ugd
73 stop map benik 4/28/2020 100 - biji 1 Rp 4,000 Rp 4,000.00 poned
74 buku folio isi 200 4/28/2020 100 paperline biji 1 Rp 18,000 Rp 18,000.00 poned
75 bolpoint 4/28/2020 100 - biji 2 Rp 1,000 Rp 2,000.00 poned
78 kwitansi tanggung 4/28/2020 101 sidu biji 2 Rp 4,000 Rp 8,000.00 tu
82 solasi kecil 4/28/2020 101 - pak 2 Rp 11,000 Rp 22,000.00 tu
83 stipo kertas 4/28/2020 101 - biji 2 Rp 5,000 Rp 10,000.00 tu
84 steples besar 4/28/2020 101 - biji 1 Rp 20,000 Rp 20,000.00 tu
85 gunting tanggung 4/28/2020 101 - biji 1 Rp 7,000 Rp 7,000.00 tu
86 stop map 4/28/2020 101 - pak 6 Rp 23,500 Rp 141,000.00 ugd
87 snell kertas 4/28/2020 101 - pak 1 Rp 12,000 Rp 12,000.00 tu
88 steples kecil 4/28/2020 101 - biji 3 Rp 10,000 Rp 30,000.00 tu
89 isi steples 4/28/2020 101 - pak 1 Rp 18,000 Rp 18,000.00 tu
91 kwitansi 5/7/2020 135 bisnis biji 3 Rp 10,500 Rp 31,500.00 tu
92 kwitansi 5/28/2020 136 kiki biji 10 Rp 6,400 Rp 64,000.00 tu
95 steples kecil 5/28/2020 137 - biji 1 Rp 10,000 Rp 10,000.00 tu
96 trigonal clip 5/28/2020 137 - pak 3 Rp 3,000 Rp 9,000.00 tu
97 doubel tape 5/28/2020 137 - biji 1 Rp 2,500 Rp 2,500.00 tu
99 mouse 6/6/2020 165 - unit 1 Rp 65,000 Rp 65,000.00 tu
100 date stampel 6/10/2020 166 - biji 1 Rp 13,500 Rp 13,500.00 tu
101 tinta yamura 6/10/2020 166 - tube 1 Rp 5,000 Rp 5,000.00 tu
102 stampad 6/10/2020 166 - biji 1 Rp 6,500 Rp 6,500.00 tu
103 stampad 6/26/2020 167 - biji 1 Rp 8,000 Rp 8,000.00 ugd
104 spidol permanen 6/26/2020 167 - biji 1 Rp 8,000 Rp 8,000.00 laborat
105 bolpoint 6/26/2020 167 - pak 1 Rp 10,000 Rp 10,000.00 laborat
106 label harga 6/26/2020 167 - pak 1 Rp 4,000 Rp 4,000.00 laborat
107 bofalo 6/26/2020 167 - rim 1 Rp 35,000 Rp 35,000.00 laborat
108 bufalo 6/26/2020 167 - rim 1 Rp 35,000 Rp 35,000.00 laborat
109 label harga 6/26/2020 167 - pak 1 Rp 4,000 Rp 4,000.00 laborat
110 bufalo 6/26/2020 167 - rim 1 Rp 35,000 Rp 35,000.00 laborat
111 staples 6/26/2020 167 - biji 1 Rp 18,000 Rp 18,000.00 gizi
112 isi steples 6/26/2020 167 - biji 1 Rp 3,000 Rp 3,000.00 gizi
113 bolpoint 6/26/2020 167 standart biji 2 Rp 2,000 Rp 4,000.00 ugd
115 gunting tanggung 6/26/2020 168 - biji 1 Rp 7,000 Rp 7,000.00 tu
116 penghapus 6/26/2020 168 - biji 1 Rp 1,500 Rp 1,500.00 tu
119 stop map benik 6/26/2020 168 - pak 1 Rp 33,000 Rp 33,000.00 tu
122 isi steples 6/26/2020 168 - pak 1 Rp 18,000 Rp 18,000.00 tu
123 trigonal clip 6/26/2020 168 - pak 1 Rp 3,000 Rp 3,000.00 tu
125 lakban 6/26/2020 168 - biji 1 Rp 12,500 Rp 12,500.00 tu
126 doubel tape 6/26/2020 168 - biji 1 Rp 2,500 Rp 2,500.00 tu
127
128
TOTAL Rp 8,516,150.00
Pengguna Barang Pengurus Barang

UPT Puskesmas Kwadungan UPT Puskesmas Kwadungan
drg. RIKA WANDANSARI SUYANTI YAHNA

NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : MAKAN MINUM KANTOR

No Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 snack 1/8/2020 1 - porsi 12 Rp 7,500.00 Rp 90,000.00 mfk
2 nasi 1/8/2020 1 - porsi 12 Rp 27,500.00 Rp 330,000.00 mfk
3 snack 1/9/2020 2 - porsi 17 Rp 7,500.00 Rp 127,500.00 kp
4 nasi 1/9/2020 2 - porsi 17 Rp 27,500.00 Rp 467,500.00 kp
5 snack 1/10/2020 3 - porsi 13 Rp 7,500.00 Rp 97,500.00 ppi
6 nasi 1/10/2020 3 - porsi 13 Rp 27,500.00 Rp 357,500.00 ppi
7 nasi ayam 1/21/2020 2 - porsi 12 Rp 15,000.00 Rp 180,000.00 pertemuan anc
8 snack 1/21/2020 2 - porsi 12 Rp 5,000.00 Rp 60,000.00 pertemuan anc
air minum
9 air mineral 1/30/2020 15 aqua galon 12 Rp 20,000.00 Rp 240,000.00
pertemuan
10 snack 2/5/2020 7 - porsi 30 Rp 7,500.00 Rp 225,000.00 smd
11 nasi 2/5/2020 7 - porsi 30 Rp 27,500.00 Rp 825,000.00 smd
12 snack 2/12/2020 8 - porsi 50 Rp 7,500.00 Rp 375,000.00 pkp
13 nasi 2/12/2020 8 - porsi 50 Rp 27,500.00 Rp 1,375,000.00 pkp
16 snack 2/24/2020 10 - porsi 17 Rp 7,500.00 Rp 127,500.00 kp
17 nasi 2/24/2020 10 - porsi 17 Rp 27,500.00 Rp 467,500.00 kp
18 snack 2/25/2020 11 - porsi 35 Rp 7,500.00 Rp 262,500.00 pembina desa
19 nasi 2/25/2020 11 - porsi 35 Rp 27,500.00 Rp 962,500.00 pembina desa
air minum
pertemuan
27 snack 3/12/2020 17 - porsi 17 Rp 7,500.00 Rp 127,500.00 tim kp
28 nasi 3/12/2020 17 - porsi 17 Rp 27,500.00 Rp 467,500.00 tim kp
29 snack 3/13/2020 18 - porsi 13 Rp 7,500.00 Rp 97,500.00 ppi
30 nasi 3/13/2020 18 - porsi 13 Rp 27,500.00 Rp 357,500.00 ppi
31 snack 3/14/2020 19 - porsi 30 Rp 7,500.00 Rp 225,000.00 manajemen
32 nasi 3/14/2020 19 - porsi 30 Rp 27,500.00 Rp 825,000.00 manajemen
air minum
pertemuan
air minum
pertemuan
air minum
pertemuan
air minum
pertemuan
37 snack 6/29/2020 32 - porsi 25 Rp 7,500.00 Rp 187,500.00 zi
38 nasi 6/29/2020 32 - porsi 25 Rp 27,500.00 Rp 687,500.00 zi
39
JUMLAH Rp 12,180,000.00
Rp -

KABUPATEN : NGAWI
JENIS BELANJA : Persediaan Perangko, materai dan benda pos lainnya

No Ket
Barang
1 2 3 4 04 Januari 1900 6 7 8 9 10 11 = 9 * 10 12 13
1 materai 3000 1/23/2020 7 - lembar 12 Rp 3,000 Rp 36,000.00 spj
JUMLAH Rp 1,446,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : belanja cetak
No Banyaknya Ket
Dibeli Tanggal Nomor Tanggal Nomor Merk Satuan Harga Satuan Jumlah Harga Pada Unit
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 blanko hematologi 2/28/2020 24 - rim 2 Rp 110,000 Rp 220,000.00 laborat
2 blanko resiko jatuh 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 loket
catatan
3 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 ugd
perkembangan
4 askep 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 ugd
lembar pemberian
5 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 ugd
obat
6 analisa 2/28/2020 24 - rim 3 Rp 105,000 Rp 315,000.00 ugd
7 askep 2/28/2020 24 - rim 1 Rp 125,000 Rp 125,000.00 ugd
8 blanko pkm kwd 2/28/2020 24 - rim 2 Rp 105,000 Rp 210,000.00 tu
9 surat umum 2/28/2020 24 - rim 2 Rp 105,000 Rp 210,000.00 tu
10 aturan minum 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 obat
11 resep 2/28/2020 24 - rim 1 Rp 125,000 Rp 125,000.00 obat
12 surat perintah RI 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 ugd
surat perintah
13 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 ugd
rujukan
14 form permintaan lab 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 laborat

15 bon obat 2/28/2020 24 - rim 5 Rp 40,000 Rp 200,000.00 obat
16 resep 2 mk 2/28/2020 24 - rim 1 Rp 125,000 Rp 125,000.00 bp
17 bon obat 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 obat
18 nota retribusi 2/28/2020 24 - rim 2 Rp 150,000 Rp 300,000.00 tu
19 amplop casing 3/31/2020 57 - pak 5 Rp 37,450 Rp 187,250.00 tu
20 persetujuan hiv 3/31/2020 57 - rim 5 Rp 105,000 Rp 525,000.00 lab
21 catatan px 3/31/2020 57 - rim 7 Rp 135,000 Rp 945,000.00 ugd
22 form permintaan lab 3/31/2020 57 - rim 3 Rp 105,000 Rp 315,000.00 lab
23 catatan px 3/31/2020 57 - rim 1 Rp 125,000 Rp 125,000.00 ugd
24 lembar discange 3/31/2020 57 - rim 2 Rp 110,000 Rp 220,000.00 ugd
25 resume medis 3/31/2020 57 - rim 2 Rp 110,000 Rp 220,000.00 ugd
26 infus 3/31/2020 57 - rim 1 Rp 105,000 Rp 105,000.00 ugd
27 catatan perawat 3/31/2020 57 - rim 1 Rp 105,000 Rp 105,000.00 ugd
28 formulir bunde 3/31/2020 57 - rim 1 Rp 105,000 Rp 105,000.00 ugd
29 general konsent 3/31/2020 57 - rim 1 Rp 125,000 Rp 125,000.00 ugd
30 pemantauan bayi 3/31/2020 57 - rim 1 Rp 105,000 Rp 105,000.00 poned
31 kartu stok 3/31/2020 57 - lembar 600 Rp 400 Rp 240,000.00 obat
32 kartu steling 3/31/2020 57 - lembar 600 Rp 200 Rp 120,000.00 obat
blanko tata laksana
33 3/31/2020 57 - rim 7 Rp 125,000 Rp 875,000.00 kia
balik
34 form bayi muda 3/31/2020 57 - rim 3 Rp 125,000 Rp 375,000.00 kia
35 resep 3/31/2020 57 - rim 5 Rp 105,000 Rp 525,000.00 bp
36 lembar observasi 3/31/2020 57 - rim 2 Rp 105,000 Rp 210,000.00 ugd
37 resep 3/31/2020 57 - rim 5 Rp 105,000 Rp 525,000.00 bp
38 pemantauan resiko 3/31/2020 57 - rim 3 Rp 105,000 Rp 315,000.00 ugd
39 tata laksana bp 3/31/2020 57 - rim 7 Rp 125,000 Rp 875,000.00 ugd
40 stiker 3/31/2020 57 - lembar 750 Rp 477 Rp 357,750.00 obat
41 resep 2 mk 4/29/2020 93 - rim 1 Rp 125,000 Rp 125,000.00 obat
42 nota retribusi 4/29/2020 93 - rim 6 Rp 130,000 Rp 780,000.00 tu
catatan
43 5/28/2020 130 - rim 1 Rp 105,000 Rp 105,000.00 ugd
perkembangan
44 aturan minum 5/28/2020 130 - rim 1 Rp 105,000 Rp 105,000.00 obat
45 kartu px 5/28/2020 130 - rim 1 Rp 150,000 Rp 150,000.00 loket
46 blanko hiv 6/26/2020 160 - rim 2 Rp 105,000 Rp 210,000.00 lab
47 kartu steling obat 26 Juni 2020 160 - rim 1 Rp 375,000.00 Rp 375,000.00 obat
48 hematologi 26 Juni 2020 160 - rim 2 Rp 105,000.00 Rp 210,000.00 lab
49 form bundle 26 Juni 2020 160 - rim 2 Rp 100,000.00 Rp 200,000.00 ugd
JUMLAH Rp 12,535,000.00

NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : penggandaan

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 foto copy 1/30/2020 11 - lembar 1,504 Rp 250 Rp 376,000.00 ranap
2 foto copy 1/30/2020 12 - lembar 2,484 Rp 250 Rp 621,000.00 askep
3 foto copy 2/27/2020 32 - lembar 648 Rp 250 Rp 162,000.00 askep
4 foto copy 2/27/2020 33 - lembar 2,920 Rp 250 Rp 730,000.00 askep
5 foto copy 3/30/2020 66 - lembar 440 Rp 250 Rp 110,000.00 klaim ranap
klaim
6 foto copy 3/30/2020 67 - lembar 1,944 Rp 250 Rp 486,000.00
persalinan
7 scan 4/10/2020 102 - lembar 75 Rp 1,000 Rp 75,000.00 blud
8 foto copy 4/28/2020 103 - lembar 932 Rp 250 Rp 233,000.00 klaim bpjs
form
9 foto copy 4/28/2020 104 - lembar 750 Rp 250 Rp 187,500.00
survelance
10 foto copy 5/27/2020 138 - lembar 874 Rp 250 Rp 218,500.00 ranap
11 foto copy 5/27/2020 139 - lembar 460 Rp 250 Rp 115,000.00 klaim bpjs
12 foto copy 6/26/2020 169 - lembar 840 Rp 250 Rp 210,000.00 obat
13 foto copy 6/26/2020 170 - lembar 172 Rp 250 Rp 43,000.00 rujukan ugd
14 foto copy 6/26/2020 171 - lembar 2,012 Rp 250 Rp 503,000.00 doc. Zi
15 print copy 6/26/2020 172 - lembar 156 Rp 500 Rp 78,000.00 doc. zi
16 jilid 6/26/2020 172 - jilid 5 Rp 2,500 Rp 12,500.00 doc. zi
JUMLAH Rp 4,160,500.00

NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017
KABUPATEN : NGAWI
JENIS BELANJA : makan pasien

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 makan pasien 1/21/2020 1 - porsi 60 Rp 10,000 Rp 600,000.00 pasien ranap
2 makan pasien 1/30/2020 15 - porsi 642 Rp 10,000 Rp 6,420,000.00 pasien ranap
JUMLAH Rp 22,680,000.00
NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : makmin lembur

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 nasi bungkus 1/30/2020 14 - porsi 248 Rp 5,000 Rp 1,240,000.00 petugas ranap
JUMLAH Rp 8,480,000.00

NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : BBM

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 pertalit 2/28/2020 - liter 300 Rp 7,650 Rp 2,295,000.00 ambulan

2 pertalit 4/28/2020 - liter 300 Rp 7,650 Rp 2,295,000.00 ambulan
JUMLAH Rp 4,590,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : perlengkapan ruang pasien

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 roda karet bed 2/7/2020 29 - biji 1 Rp 32,500 Rp 32,500.00 ugd
JUMLAH Rp 32,500.00

NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : pakaian dinas

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 seragam skort biru 3/30/2020 86 - potong 71 Rp 115,000.00 Rp 8,165,000.00 unit pelayanan
2 seragam skort kuning 4/28/2020 127 - potong 71 Rp 115,000.00 Rp 8,165,000.00 unit pelayanan
3 seragam skort merah 5/28/2020 154 - potong 30 Rp 120,000.00 Rp 3,600,000.00 unit pelayanan
JUMLAH Rp 19,930,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : BHP NON MEDIS

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 Pembersih 1/30/2020 tisu paseo biji 20 Rp 9,500.00 Rp 190,000.00 poli-poli
3 Pembersih 1/30/2020 kanebo biji 2 Rp 15,000.00 Rp 30,000.00 r.arsip
4 Kantong plastik 1/30/2020 klip pak 3 Rp 5,500.00 Rp 16,500.00 apotik
6 Pembersih 1/30/2020 penebah biji 1 Rp 13,500.00 Rp 13,500.00 ugd
7 Pembersih 1/30/2020 pel biji 1 Rp 35,000.00 Rp 35,000.00 ugd
8 Pembersih 1/30/2020 sapu lidi biji 1 Rp 10,000.00 Rp 10,000.00 ugd
9 Pembersih 1/30/2020 berlian biji 2 Rp 25,000.00 Rp 50,000.00 poned
10 Sandal 1/30/2020 swallow pasang 1 Rp 10,000.00 Rp 10,000.00 kia
11 Kantong plastik 1/30/2020 pop es pak 10 Rp 5,000.00 Rp 50,000.00 apotik
12 Tempat minum 1/30/2020 gelas es biji 4 Rp 11,000.00 Rp 44,000.00 gigi
13 Alat makan 1/30/2020 sendok pak 2 Rp 15,000.00 Rp 30,000.00 ugd
14 Pembersih 1/30/2020 serbet biji 1 Rp 10,000.00 Rp 10,000.00 ugd
15 Alas tidur 1/30/2020 perlak meter 2 Rp 33,750.00 Rp 67,500.00 poned
19 Pembersih 1/30/2020 garukan air biji 1 Rp 45,000.00 Rp 45,000.00 ugd
20 Tempat minum 1/30/2020 gelas es pak 2 Rp 11,000.00 Rp 22,000.00 gigi
22 Sikat gigi 1/30/2020 kodomo lusin 2 Rp 37,500.00 Rp 75,000.00 gigi
23 Desinfektan 1/30/2020 bayclin botol 6 Rp 12,500.00 Rp 75,000.00 lab,kia,pnd
24 Pengharum 1/30/2020 stella biji 8 Rp 12,500.00 Rp 100,000.00 poli-poli
25 Pembersih 1/30/2020 handshoap tube 6 Rp 20,000.00 Rp 120,000.00 poli-poli
26 Pembersih 1/30/2020 super pel biji 6 Rp 12,500.00 Rp 75,000.00 ugd,poned
27 Pembersih 1/30/2020 cling biji 3 Rp 7,500.00 Rp 22,500.00 poli-poli
28 Pembersih 1/30/2020 so klin biji 2 Rp 18,500.00 Rp 37,000.00 ugd
29 Obat nyamuk 1/30/2020 hit semprot tube 2 Rp 30,000.00 Rp 60,000.00 ugd,poned
30 Pembersih 1/30/2020 vixal tube 2 Rp 24,500.00 Rp 49,000.00 udd
31 Obat nyamuk 1/30/2020 hit ulang pak 2 Rp 7,500.00 Rp 15,000.00 ugd
32 Pembersih 1/30/2020 sunlik biji 1 Rp 12,500.00 Rp 12,500.00 ugd
33 Pembersih 2/27/2020 sapu lidi biji 2 Rp 15,000.00 Rp 30,000.00 ugd
34 Pembersih 2/27/2020 ikrak biji 1 Rp 9,500.00 Rp 9,500.00 ugd
35 Gelas 2/27/2020 pop es biji 2 Rp 10,000.00 Rp 20,000.00 gigi
36 Pembersih 2/27/2020 pel biji 1 Rp 35,000.00 Rp 35,000.00 apotik
37 Pembersih 2/27/2020 kelud biji 1 Rp 25,000.00 Rp 25,000.00 arsip
38 Penerang 2/27/2020 senter biji 1 Rp 30,000.00 Rp 30,000.00 bp
45 Pembersih 2/27/2020 sulak biji 1 Rp 25,000.00 Rp 25,000.00 arsip
47 Kantong plastik 2/27/2020 kresek h pak 1 Rp 20,000.00 Rp 20,000.00 laborat
48 Kantong plastik 2/27/2020 kesek k pak 1 Rp 20,000.00 Rp 20,000.00 ugd
49 Pembersih 2/27/2020 handshoap biji 10 Rp 15,000.00 Rp 150,000.00 poli-poli
50 Pembersih 2/27/2020 rinso biji 4 Rp 19,500.00 Rp 78,000.00 ugd
51 Pembersih 2/27/2020 vixal biji 2 Rp 24,500.00 Rp 49,000.00 gigi
52 Desinfektan 2/27/2020 bayclin tube 7 Rp 12,500.00 Rp 87,500.00 lab,kia,pnd
53 Pengharum 2/27/2020 stella biji 14 Rp 12,500.00 Rp 175,000.00 poli-poli
54 Pengharum 2/27/2020 kapur brs biji 2 Rp 24,000.00 Rp 48,000.00 rajal
55 Baterai 2/27/2020 ABC biji 4 Rp 8,350.00 Rp 33,400.00 ugd
56 Baterai 2/27/2020 ABC biji 4 Rp 7,600.00 Rp 30,400.00 ugd
57 jas hujan 3/19/2020 biji 4 Rp 7,500.00 Rp 30,000.00 tim covid
58 kran air 3/20/2020 biji 5 Rp 13,000.00 Rp 65,000.00 ugd
59 lepak makan 3/30/2020 biji 10 Rp 19,000.00 Rp 190,000.00 ugd
60 sendok makan 3/30/2020 biji 200 Rp 150.00 Rp 30,000.00 ugd
61 gelas es 3/30/2020 biji 4 Rp 10,000.00 Rp 40,000.00 ugd
62 sendok makan 3/30/2020 pk 2 Rp 15,000.00 Rp 30,000.00 ugd
63 plastik keletan 3/30/2020 pk 1 Rp 28,000.00 Rp 28,000.00 ugd
64 serbet 3/30/2020 biji 1 Rp 10,000.00 Rp 10,000.00 ugd
65 tisu besar 3/30/2020 pk 5 Rp 9,500.00 Rp 47,500.00 rajal
66 plastik c tik 5x8 3/30/2020 pk 10 Rp 2,000.00 Rp 20,000.00 gizi
67 Kantong plastik 3/30/2020 kresek h pk 3 Rp 20,000.00 Rp 60,000.00 ugd
68 gelas es 3/30/2020 pk 4 Rp 10,000.00 Rp 40,000.00 ugd
69 sendok makan 3/30/2020 pk 2 Rp 15,000.00 Rp 30,000.00 ugd
70 plastik keletan 3/30/2020 pk 1 Rp 28,000.00 Rp 28,000.00 ugd
71 sapu 3/30/2020 berlian biji 2 Rp 25,000.00 Rp 50,000.00 poned
72 senter 3/30/2020 biji 1 Rp 20,000.00 Rp 20,000.00 bp
73 tisu besar 3/30/2020 paseo biji 10 Rp 9,500.00 Rp 95,000.00 rajal
74 kap agar 3/30/2020 biji 5 Rp 6,500.00 Rp 32,500.00 lab
75 tisu besar 3/30/2020 paseo biji 15 Rp 9,500.00 Rp 142,500.00 rajal
76 tisu kecil 3/30/2020 paseo biji 10 Rp 3,500.00 Rp 35,000.00 rajal
77 kantong plastik 3/30/2020 kresek k pk 3 Rp 20,000.00 Rp 60,000.00 poned
78 katembat 3/30/2020 pk 2 Rp 3,500.00 Rp 7,000.00 bp
79 shower cup 3/30/2020 biji 17 Rp 8,000.00 Rp 136,000.00 poli-poli
80 sepatu 3/30/2020 boots buah 4 Rp 60,000.00 Rp 240,000.00 covid
81 sepatu 3/30/2020 parfix boots buah 4 Rp 60,000.00 Rp 240,000.00 covid
82 Desinfektan 3/30/2020 bayclin biji 4 Rp 10,000.00 Rp 40,000.00 poned
83 desinfektan 3/30/2020 vixal biji 2 Rp 24,500.00 Rp 49,000.00 ugd
84 Pembersih 3/30/2020 cling biji 2 Rp 7,500.00 Rp 15,000.00 kia
85 sabun 3/30/2020 yuris biji 10 Rp 18,000.00 Rp 180,000.00 poli-poli
86 pewangi 3/30/2020 kapur brs biji 1 Rp 25,000.00 Rp 25,000.00 ugd
87 toples 3/30/2020 leotin biji 1 Rp 39,000.00 Rp 39,000.00 ugd
88 tempat gula 3/30/2020 biji 1 Rp 70,000.00 Rp 70,000.00 ugd
89 tisu 3/30/2020 paseo biji 30 Rp 9,500.00 Rp 285,000.00 poli-poli
90 tisu 3/30/2020 paseo biji 8 Rp 6,500.00 Rp 52,000.00 poli-poli
91 Pembersih 3/30/2020 rinso biji 3 Rp 19,500.00 Rp 58,500.00 ugd
92 pewangi 3/30/2020 stella biji 3 Rp 25,000.00 Rp 75,000.00 ug
93 Obat nyamuk 3/30/2020 hit biji 2 Rp 17,500.00 Rp 35,000.00 ugd
94 alat nyamuk 3/30/2020 hit biji 1 Rp 170,000.00 Rp 170,000.00 ugd
95 Pembersih 3/30/2020 so klin biji 1 Rp 12,000.00 Rp 12,000.00 apotik
96 pewangi 3/30/2020 stella biji 12 Rp 12,500.00 Rp 150,000.00 poli-poli
97 Obat nyamuk 3/30/2020 hit biji 2 Rp 17,500.00 Rp 35,000.00 ugd
98 kaca mata las 3/30/2020 biji 29 Rp 15,000.00 Rp 435,000.00 covid
99 jas hujan 3/30/2020 plevia buah 6 Rp 75,000.00 Rp 450,000.00 covid
100 pembersih 3/30/2020 sower biji 13 Rp 8,000.00 Rp 104,000.00 poli-poli
101 busa 4/15/2020 buah 2 Rp 15,000.00 Rp 30,000.00 covid
102 busa 4/15/2020 buah 1 Rp 39,000.00 Rp 39,000.00 covid
103 batrai 4/15/2020 ABC biji 1 Rp 200.00 Rp 200.00 covid
104 batrai 4/15/2020 ABC biji 3 Rp 15,900.00 Rp 47,700.00 covid
105 masker 4/17/2020 dos 1 Rp 200,000.00 Rp 200,000.00 covid
106 kantong plastik 4/28/2020 kresek pak 2 Rp 58,000.00 Rp 116,000.00 covid
107 pewangi 4/28/2020 stella tube 1 Rp 16,500.00 Rp 16,500.00 ugd
108 plastik 4/28/2020 cup pak 3 Rp 30,000.00 Rp 90,000.00 laborat
109 rak 4/28/2020 keranjang biji 1 Rp 8,500.00 Rp 8,500.00 tu
110 sapu 4/28/2020 berlian biji 2 Rp 25,000.00 Rp 50,000.00 ugd
111 gelas 4/28/2020 biji 4 Rp 10,000.00 Rp 40,000.00 gigi
112 sendok makan 4/28/2020 pak 3 Rp 15,000.00 Rp 45,000.00 ugd
113 plastik roll 4/28/2020 roll 1 Rp 28,000.00 Rp 28,000.00 ugd
114 kantong plastik 4/28/2020 elip pak 20 Rp 2,000.00 Rp 40,000.00 apotek
115 kantong plastik 4/28/2020 1kg pak 12 Rp 8,500.00 Rp 102,000.00 apotek
116 pembersih 4/28/2020 kanebo biji 2 Rp 17,500.00 Rp 35,000.00 poned
117 sapu 4/28/2020 berlian biji 2 Rp 25,000.00 Rp 50,000.00 ugd
118 pembersih 4/28/2020 kemoceng biji 1 Rp 25,000.00 Rp 25,000.00 ugd
119 kantong plastik 4/28/2020 kresek pak 2 Rp 20,000.00 Rp 40,000.00 ugd
120 kantong plastik 4/28/2020 kresek pak 2 Rp 20,000.00 Rp 40,000.00 poned
121 kantong plastik 4/28/2020 kresek pak 1 Rp 8,500.00 Rp 8,500.00 gizi
122 pembersih 4/28/2020 sapu berlian biji 2 Rp 25,000.00 Rp 50,000.00 pustu
123 pembersih 4/28/2020 sapu lidi biji 1 Rp 15,000.00 Rp 15,000.00 ugd
124 alat kebersihan 4/28/2020 sulak biji 1 Rp 25,000.00 Rp 25,000.00 ugd
127 pembersih 4/28/2020 stella biji 50 Rp 9,500.00 Rp 475,000.00 poli-poli
128 pembersih 4/28/2020 rinso biji 20 Rp 17,500.00 Rp 350,000.00 ugd poned
129 obat nyamuk 4/28/2020 hit biji 5 Rp 17,500.00 Rp 87,500.00 ugd poned
130 kapur barus 4/28/2020 swallow biji 4 Rp 20,000.00 Rp 80,000.00 ugd poned
131 pembersih 4/28/2020 tisu paseo biji 100 Rp 9,500.00 Rp 950,000.00 poli-poli
133 helm apd 4/28/2020 apd biji 3 Rp 130,000.00 Rp 390,000.00 covid
134 pembersih 4/28/2020 super pel biji 15 Rp 12,500.00 Rp 187,500.00 poli-poli
135 pembersih 4/28/2020 sabun dettol biji 10 Rp 33,000.00 Rp 330,000.00 poli-poli
137 obat nyamuk 4/28/2020 hit biji 3 Rp 17,500.00 Rp 52,500.00 ugd poned
138 kapur barus 4/28/2020 swallow biji 1 Rp 20,000.00 Rp 20,000.00 ugd
139 sabun pembersih 4/28/2020 dettol biji 10 Rp 32,500.00 Rp 325,000.00 poli-poli
140 desinfektan 4/28/2020 vixal biji 15 Rp 15,000.00 Rp 225,000.00 ugd
141 desinfektan 4/28/2020 venis biji 10 Rp 23,000.00 Rp 230,000.00 laborat
142 pewangi 4/28/2020 stella tube 10 Rp 17,500.00 Rp 175,000.00 poli-poli
144 sabun pembersih 4/28/2020 lifeboy biji 5 Rp 17,000.00 Rp 85,000.00 ugd
145 desinfektan 4/28/2020 bayclin tube 1 Rp 17,500.00 Rp 17,500.00 poned
146 desinfektan 4/28/2020 bayclin tube 10 Rp 23,000.00 Rp 230,000.00 poned
147 desinfektan 4/28/2020 venis tube 1 Rp 9,500.00 Rp 9,500.00 laborat
148 pewangi 4/28/2020 stella biji 45 Rp 12,500.00 Rp 562,500.00 poli-poli
149 alat makan 5/28/2020 biji 12 Rp 70,000.00 Rp 840,000.00 ugd
150 gelas 5/28/2020 biji 200 Rp 270.00 Rp 54,000.00 ugd
151 sendok 5/28/2020 biji 200 Rp 150.00 Rp 30,000.00 ugd
152 rol plastik 5/28/2020 roll 1 Rp 28,000.00 Rp 28,000.00 ugd
153 sepatu 5/28/2020 buah 4 Rp 60,000.00 Rp 240,000.00 covid
154 jas hujan 5/28/2020 lusin 2 Rp 350,000.00 Rp 700,000.00 covid
155 kantong plastik 5/28/2020 1kg pak 8 Rp 8,500.00 Rp 68,000.00 apotek
156 kantong plastik 5/28/2020 pop es pak 20 Rp 5,000.00 Rp 100,000.00 apotek
157 kantong plastik 5/28/2020 kresek pak 5 Rp 20,000.00 Rp 100,000.00 laborat
159 perlak 5/28/2020 1m 1 Rp 87,000.00 Rp 87,000.00 ugd
160 pemb 5/28/2020 sikat biji 1 Rp 20,000.00 Rp 20,000.00 poned
161 plastik 5/28/2020 klip pak 10 Rp 2,000.00 Rp 20,000.00 apotek
162 pembersih pel 5/28/2020 2 macan biji 1 Rp 35,000.00 Rp 35,000.00 poned
163 kantong plastik 5/28/2020 klip pak 10 Rp 5,000.00 Rp 50,000.00 apotek
164 semprotan 5/28/2020 nagata biji 10 Rp 16,500.00 Rp 165,000.00 apotek
165 kantong plastik 5/28/2020 pres pak 1 Rp 146,000.00 Rp 146,000.00 ugd
166 plester 5/28/2020 pres pak 3 Rp 10,000.00 Rp 30,000.00 ugd
167 pengharum 5/28/2020 stella biji 6 Rp 12,500.00 Rp 75,000.00 poli-poli
168 pembersih 5/28/2020 dettol pak 20 Rp 5,500.00 Rp 110,000.00 poli-poli
169 desinfektan 5/28/2020 bayclin tube 3 Rp 38,000.00 Rp 114,000.00 laborat
170 pewangi 5/28/2020 swallow biji 6 Rp 20,000.00 Rp 120,000.00 poli-poli
171 pembersih 5/28/2020 lifeboy biji 10 Rp 3,500.00 Rp 35,000.00 poli-poli
172 pembersih 5/28/2020 lifeboy cair biji 8 Rp 20,000.00 Rp 160,000.00 poli-poli
173 minyak 5/28/2020 tube 1 Rp 37,900.00 Rp 37,900.00 ugd
174 jas hujan 5/28/2020 biji 10 Rp 40,000.00 Rp 400,000.00 covid
175 kantong plastik 5/28/2020 biji 7 Rp 6,000.00 Rp 42,000.00 apotek
176 lem 5/28/2020 biji 1 Rp 10,000.00 Rp 10,000.00 apotek
177 kawat 5/28/2020 meter 1 Rp 6,000.00 Rp 6,000.00 ugd
178 triliun 5/28/2020 biji 5 Rp 23,000.00 Rp 115,000.00 ugd
179 plastik 5/28/2020 pak 4 Rp 2,000.00 Rp 8,000.00 apotek
180 plastik 5/28/2020 pak 14 Rp 2,500.00 Rp 35,000.00 apotek
181 pembersih 6/20/2020 lifeboy cair tube 3 Rp 22,500.00 Rp 67,500.00 poli-poli
182 desinfektan 6/20/2020 bayclin tube 3 Rp 12,500.00 Rp 37,500.00 laborat
sabun cuci
183 pembersih 6/20/2020 biji 2 Rp 12,000.00 Rp 24,000.00 ugd
piring
185 pembersih 6/20/2020 keset biji 1 Rp 23,000.00 Rp 23,000.00 ugd
186 sendok atum 6/20/2020 pak 2 Rp 15,000.00 Rp 30,000.00 ugd
187 gelas tutup 6/20/2020 buah 4 Rp 13,500.00 Rp 54,000.00 ugd
188 semprotan 6/20/2020 biji 5 Rp 14,000.00 Rp 70,000.00 apotek
189 kantong plastik 6/20/2020 kresek biji 5 Rp 20,000.00 Rp 100,000.00 ugd poned
190 kantong plastik 6/20/2020 kresek h pak 5 Rp 20,000.00 Rp 100,000.00 ugd poned
191 gelas 6/20/2020 agar-agar pak 5 Rp 6,500.00 Rp 32,500.00 ugd
192 seprei 6/20/2020 biji 1 Rp 85,000.00 Rp 85,000.00 poned
JUMLAH Rp 18,054,600.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : ALAT LISTRIK

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 kabel nym 2/28/2020 48 meter 22 Rp 12,000.00 Rp 264,000.00 rajal
2 kabel nya 2/28/2020 48 rol 2 Rp 150,000.00 Rp 300,000.00 rajal
3 mcb 2 ap 2/28/2020 48 pcs 1 Rp 40,000.00 Rp 40,000.00 rajal
4 paralon 2/28/2020 48 biji 5 Rp 5,000.00 Rp 25,000.00 rajal
5 saklar 2/28/2020 48 biji 2 Rp 12,500.00 Rp 25,000.00 rajal
6 lamou 19 waat 2/28/2020 48 philip biji 2 Rp 95,000.00 Rp 190,000.00 rajal
7 clem visicom 2/28/2020 48 biji 1 Rp 35,000.00 Rp 35,000.00 rajal
8 stop kontak 2/28/2020 48 biji 2 Rp 12,500.00 Rp 25,000.00 rajal
9 sanyo 2/28/2020 49 panasonic unit 1 Rp 470,000.00 Rp 470,000.00 rajal
10 kabel 2/28/2020 49 meter 10 Rp 5,000.00 Rp 50,000.00 rajal
11 keni 2/28/2020 49 biji 10 Rp 3,000.00 Rp 30,000.00 rajal
12 solatip 2/28/2020 49 biji 2 Rp 2,500.00 Rp 5,000.00 rajal
13 solasi 2/28/2020 49 biji 1 Rp 7,000.00 Rp 7,000.00 rajal
14 paralon 2/28/2020 49 biji 1 Rp 23,000.00 Rp 23,000.00 rajal
15 saklar 2/28/2020 49 biji 1 Rp 12,000.00 Rp 12,000.00 rajal
16 lem 2/28/2020 49 biji 1 Rp 10,000.00 Rp 10,000.00 rajal
17 lampu 6 waat 3/14/2020 85 philip biji 3 Rp 40,000.00 Rp 120,000.00 rajal
19 lampu 3/20/2020 86 philip biji 2 Rp 162,000.00 Rp 324,000.00 rajal
20 stavolt 3/30/2020 87 unit 1 Rp 625,000.00 Rp 625,000.00 rajal
24 stavolt 500va 4/6/2020 125 kasugawa unit 1 Rp 195,000.00 Rp 195,000.00 rajal
25 bell otomatis 4/14/2020 126 unit 1 Rp 70,000.00 Rp 70,000.00 rajal
26 kabel tis 5/6/2020 152 gulung 1 Rp 20,000.00 Rp 20,000.00 rajal
27 baterai remot 5/5/2020 153 biji 1 Rp 5,000.00 Rp 5,000.00 rajal
28 baterai jam 5/5/2020 153 biji 4 Rp 2,500.00 Rp 10,000.00 rajal
29 kabel telepon 6/6/2020 182 meter 10 Rp 2,300.00 Rp 23,000.00 rajal
30 kabel tis 6/6/2020 182 gulung 1 Rp 13,000.00 Rp 13,000.00 rajal
31 pitingan 6/6/2020 182 biji 1 Rp 5,000.00 Rp 5,000.00 rajal
JUMLAH Rp 3,191,000.00

NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : Bahan Kimia Laborat

No Banyaknya Ket
Barang
1 2 3 4 5 6 7 8 9 10 11 = 9 * 10 12 13
1 Strip Gula 2020 - 1/23/2020 On Call Plus Box 12 Rp 150,700.00 Rp 1,808,400.00 LAB
2 Strip As Urat 2020 - 1/23/2020 Easy Touch Box 1 Rp 126,500.00 Rp 126,500.00 LAB
3 Strip Kolersterol 2020 - 1/23/2020 Mission Box 2 Rp 522,500.00 Rp 1,045,000.00 LAB
4 Strip HB 2020 - 1/23/2020 Quicek Box 1 Rp 577,500.00 Rp 577,500.00 LAB
5 Alkohol Swab 2020 - 1/23/2020 One Med Box 10 Rp 24,200.00 Rp 242,000.00 LAB
6 Widal 2020 - 1/23/2020 Biotek Set 1 Rp 696,000.00 Rp 696,000.00 LAB
7 Kartu golongan darah 2020 - 1/23/2020 pack 2 Rp 71,500.00 Rp 143,000.00 LAB
8 Strip Gula 2020 - 1/23/2020 On call redi Box 2 Rp 121,000.00 Rp 242,000.00 LAB
9 Stromalizer 2020 - 2/22/2020 sysmex unit 1 Rp 1,611,500.00 Rp 1,611,500.00 LAB
10 Control Set 2020 - 2/21/2020 sysmex unit 1 Rp 1,210,000.00 Rp 1,210,000.00 LAB
11 Cell pack 2020 2/21/2020 sysmex unit 1 Rp 2,420,000.00 Rp 2,420,000.00 LAB
12 Tabung K3EDTA 2020 - 2/24/2020 Voculab Box 3 Rp 198,000.00 Rp 594,000.00 LAB
13 Blood Lancet 2020 - 2/24/2020 One Med Box 5 Rp 41,800.00 Rp 209,000.00 LAB
14 Thermal paper 2020 - 2/24/2020 Roll 8 Rp 38,500.00 Rp 308,000.00 LAB
15 Kartu golongan darah 2020 - 2/24/2020 pack 5 Rp 71,500.00 Rp 357,500.00 LAB
17 Strip Hb 2020 - 2/24/2020 Quicek Box 1 Rp 577,500.00 Rp 577,500.00 LAB
18 Strip UA 2020 - 2/24/2020 Easy Touch Box 2 Rp 126,500.00 Rp 253,000.00 LAB
19 Strip Kolersterol 2020 - 2/24/2020 Mission Box 1 Rp 522,500.00 Rp 522,500.00 LAB
20 Pleserin 2020 - 2/24/2020 One Med Box 4 Rp 49,300.00 Rp 197,200.00 LAB
21 Tisue lensa 2020 - 2/24/2020 Roll 5 Rp 33,000.00 Rp 165,000.00 LAB
22 R// Widal 2020 - 2/24/2020 Biotek Set 1 Rp 695,200.00 Rp 695,200.00 LAB
23 R// Gol darah D 2020 - 2/24/2020 Tube 1 Rp 176,000.00 Rp 176,000.00 LAB
24 Yellow TIP 2020 - 2/24/2020 Box1 1 Rp 140,250.00 Rp 140,250.00 LAB
25 Cell pack 2020 - 2/24/2020 sysmex unit 1 Rp 2,420,000.00 Rp 2,420,000.00 LAB
26 Cell Clean 2020 - 2/24/2020 sysmex Box 1 Rp 1,479,500.00 Rp 1,479,500.00 LAB
27 Strip Hb 2020 - 4/13/2020 Quicek Box 2 Rp 577,500.00 Rp 1,155,000.00 LAB
28 Strip As Urat 2020 - 4/13/2020 Easy Touch Box 2 Rp 126,500.00 Rp 253,000.00 LAB
29 Strip Kolersterol 2020 - 4/13/2020 Mission Box 2 Rp 522,500.00 Rp 1,045,000.00 LAB
31 Tes Kehamilan 2020 - 4/13/2020 One Med Box 1 Rp 141,900.00
Rp 141,900.00 LAB
32 Alkohol Swab 2020 - 4/13/2020 One Med Box 5 Rp 24,200.00
Rp 121,000.00 LAB
33 Golongan Darah A 2020 - 4/13/2020 Tube 1 Rp 126,500.00
Rp 126,500.00 LAB
34 Golongan Darah B 2020 - 4/13/2020 Tube 1 Rp 126,500.00
Rp 126,500.00 LAB
35 Golongan Darah AB 2020 - 4/13/2020 Tube 1 Rp 126,500.00
Rp 126,500.00 LAB
36 Cell Pack 2020 - 4/1/2020 sysmex Unit 1 Rp 2,420,000.00
Rp 2,420,000.00 LAB
37 Cell Clean 2020 - 4/1/2020 sysmex Unit 1 Rp 1,611,500.00
Rp 1,611,500.00 LAB
38 Blood Lancet 2020 - 5/15/2020 One Med Box 5 Rp 41,800.00
Rp 209,000.00 LAB
39 Alkohol Swab 2020 - 5/15/2020 One Med Box 5 Rp 24,200.00
Rp 121,000.00 LAB
40 Strip Hb 2020 - 5/15/2020 Quicek Box 1 Rp 577,500.00
Rp 577,500.00 LAB
41 Urin Strip verify 2020 - 5/15/2020 Verify Box 1 Rp 170,500.00 Rp 170,500.00 LAB
42 Strip Gula 2020 - 5/15/2020 On Call Plus Roll 5 Rp 150,700.00 Rp 753,500.00 LAB
43 Strip Kolesterol 2020 - 5/15/2020 Mission Box 2 Rp 522,500.00 Rp 1,045,000.00 LAB
44 Strip Asam Urat 2020 - 5/15/2020 Easy Touch Box 1 Rp 126,500.00 Rp 126,500.00 LAB
45 Tabung K3EDTA 2020 - 5/15/2020 Vaculab Box 4 Rp 198,000.00 Rp 792,000.00 LAB
46 Lancet 2020 - 6/8/2020 One Med Box 20 Rp 41,800.00 Rp 836,000.00 LAB
47 Alkohol Swab 2020 - 6/8/2020 One Med Box 20 Rp 27,500.00 Rp 550,000.00 LAB
48 Strip Gula 2020 - 6/8/2020 On call plus Box 4 Rp 150,700.00 Rp 602,800.00 LAB
49 Strip Gula 2020 - 6/8/2020 On Call redi Box 2 Rp 121,000.00 Rp 242,000.00 LAB
50 Kolesterol 2020 - 6/8/2020 Mission Box 2 Rp 522,500.00 Rp 1,045,000.00 LAB
51 Asam Urat 2020 - 6/8/2020 Easy Touch Box 2 Rp 126,500.00 Rp 253,000.00 LAB
52 Strip Hb 2020 6/8/2020 Quicek Box 2 Rp 577,500.00 Rp 1,155,000.00 LAB
53
54
JUMLAH Rp 7,571,300.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017
12000
1500
5000
4000
78000
48000
3000
5000
156500
100500
60000
14000
67500
20000
13000
7000
30000
12000
9000
333000
125000
2517500
2971500
680000
3651500
7400
NIP.
PENGGUNA BARANG
OPD
NAMA
NIP.
KABUPATEN : NGAWI
TAHUN ANGGARAN2020
JENIS BELANJA : Persediaan Alat Tulis Kantor
BUKU BARANG PAKAI HABIS
TAHUN ANGGARAN 2019
PENERIMAAN PENGELUARAN
Tgl/No. Kontrak/SP/SPK : Tgl/No.Surat Penyerahan :

Merk/ Tahun Berita Acara
No. Tanggal Diterima Nama/Jenis Barang Dari Jumlah Satuan/ Barang Tanggal Ket.
Ukuran Pembuatan Pemeriksaan Diserahkan Jumlah
- - Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
JML Satuan Harga Satuan Jumlah Harga Tanggal Nomor Harga Satuan Jumlah Harga
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
1 1/6/2020 modem prolink 2020 gudang atk 1 unit Rp 595,000.00 Rp 595,000.00 1/6/2020 tu 1 Rp 595,000.00 Rp 595,000.00
2 1/30/2020 spidol BM - 2020 gudang atk 1 biji Rp 8,000.00 Rp 8,000.00 1/30/2020 ugd 1 Rp 8,000.00 Rp 8,000.00
3 1/30/2020 lakban - 2020 gudang atk 1 biji Rp 15,000.00 Rp 15,000.00 1/30/2020 ugd 1 Rp 15,000.00 Rp 15,000.00
4 1/30/2020 buku tulis isi 38 sidu 2020 gudang atk 3 pak Rp 25,000.00 Rp 75,000.00 1/30/2020 tu 3 Rp 25,000.00 Rp 75,000.00
6 1/30/2020 buku folio isi 100 paperline 2020 gudang atk 6 biji Rp 15,000.00 Rp 90,000.00 1/30/2020 tu 6 Rp 15,000.00 Rp 90,000.00
8 1/30/2020 kwitansi tanggung sidu 2020 gudang atk 5 biji Rp 4,000.00 Rp 20,000.00 1/30/2020 tu 5 Rp 4,000.00 Rp 20,000.00
9 1/30/2020 kwitansi besar sidu 2020 gudang atk 3 biji Rp 5,000.00 Rp 15,000.00 1/30/2020 tu 3 Rp 5,000.00 Rp 15,000.00
10 1/30/2020 snell helter bisnis 2020 gudang atk 1 pak Rp 33,000.00 Rp 33,000.00 1/30/2020 tu 1 Rp 33,000.00 Rp 33,000.00
11 1/30/2020 hvs 70 gr maxi 2020 gudang atk 7 rim Rp 42,000.00 Rp 294,000.00 1/30/2020 tu 7 Rp 42,000.00 Rp 294,000.00
12 2/27/2020 snell helter bisnis 2020 gudang atk 1 pak Rp 35,000.00 Rp 35,000.00 2/27/2020 ugd 1 Rp 35,000.00 Rp 35,000.00
13 2/27/2020 snell helter bisnis 2020 gudang atk 2 biji Rp 4,000.00 Rp 8,000.00 2/27/2020 ugd 2 Rp 4,000.00 Rp 8,000.00
14 2/27/2020 snell helter bisnis 2020 gudang atk 5 biji Rp 4,000.00 Rp 20,000.00 2/27/2020 tu 5 Rp 4,000.00 Rp 20,000.00
15 2/27/2020 hvs 70 gr sidu 2020 gudang atk 1 rim Rp 50,000.00 Rp 50,000.00 2/27/2020 ugd 1 Rp 50,000.00 Rp 50,000.00
16 2/27/2020 kalkulator - 2020 gudang atk 1 unit Rp 54,000.00 Rp 54,000.00 2/27/2020 ugd 1 Rp 54,000.00 Rp 54,000.00
18 2/27/2020 tinta print blue print 2020 gudang atk 3 tube Rp 38,000.00 Rp 114,000.00 2/27/2020 tu 3 Rp 38,000.00 Rp 114,000.00
19 2/27/2020 odwner - 2020 gudang atk 3 biji Rp 17,000.00 Rp 51,000.00 2/27/2020 tu 3 Rp 17,000.00 Rp 51,000.00
20 2/27/2020 box file - 2020 gudang atk 1 biji Rp 13,000.00 Rp 13,000.00 2/27/2020 tu 1 Rp 13,000.00 Rp 13,000.00
21 2/27/2020 binder clip 107 - 2020 gudang atk 2 box Rp 5,000.00 Rp 10,000.00 2/27/2020 tu 2 Rp 5,000.00 Rp 10,000.00
22 2/27/2020 bolpoint x data 2020 gudang atk 1 pak Rp 10,000.00 Rp 10,000.00 2/27/2020 tu 1 Rp 10,000.00 Rp 10,000.00
23 2/27/2020 stabilo - 2020 gudang atk 1 biji Rp 4,000.00 Rp 4,000.00 2/27/2020 tu 1 Rp 4,000.00 Rp 4,000.00
24 2/27/2020 solasi kecil - 2020 gudang atk 10 biji Rp 1,000.00 Rp 10,000.00 2/27/2020 tu 10 Rp 1,000.00 Rp 10,000.00
25 2/27/2020 kertas karbon - 2020 gudang atk 4 lembar Rp 1,000.00 Rp 4,000.00 2/27/2020 ugd 4 Rp 1,000.00 Rp 4,000.00
27 2/27/2020 spidol permanen - 2020 gudang atk 3 biji Rp 4,000.00 Rp 12,000.00 2/27/2020 tu 3 Rp 4,000.00 Rp 12,000.00
28 2/27/2020 bufalo+mika - 2020 gudang atk 1 pak Rp 35,000.00 Rp 35,000.00 2/27/2020 tu 1 Rp 35,000.00 Rp 35,000.00
29 2/27/2020 lakban hitam - 2020 gudang atk 1 biji Rp 12,000.00 Rp 12,000.00 2/27/2020 tu 1 Rp 12,000.00 Rp 12,000.00
31 2/27/2020 map kertas - 2020 gudang atk 25 biji Rp 500.00 Rp 12,500.00 2/27/2020 tu 25 Rp 500.00 Rp 12,500.00
32 2/27/2020 map snell kertas 0 2020 gudang atk 1 pak Rp 11,000.00 Rp 11,000.00 2/27/2020 tu 1 Rp 11,000.00 Rp 11,000.00
33 2/27/2020 amplop besar paperline 2020 gudang atk 1 pak Rp 18,000.00 Rp 18,000.00 2/27/2020 tu 1 Rp 18,000.00 Rp 18,000.00
34 2/27/2020 amplop tanggung paperline 2020 gudang atk 1 pak Rp 13,500.00 Rp 13,500.00 2/27/2020 tu 1 Rp 13,500.00 Rp 13,500.00
35 2/27/2020 buku folio isi 200 sidu 2020 gudang atk 2 biji Rp 26,000.00 Rp 52,000.00 2/27/2020 tu 2 Rp 26,000.00 Rp 52,000.00
36 2/27/2020 buku folio isi 100 sidu 2020 gudang atk 2 biji Rp 15,000.00 Rp 30,000.00 2/27/2020 tu 2 Rp 15,000.00 Rp 30,000.00
37 2/27/2020 binder clip 200 - 2020 gudang atk 1 pak Rp 15,000.00 Rp 15,000.00 2/27/2020 tu 1 Rp 15,000.00 Rp 15,000.00
38 2/27/2020 paper clip - 2020 gudang atk 2 pak Rp 5,000.00 Rp 10,000.00 2/27/2020 tu 2 Rp 5,000.00 Rp 10,000.00
39 2/27/2020 stempel - 2020 gudang atk 2 biji Rp 90,000.00 Rp 180,000.00 2/27/2020 laborat 2 Rp 90,000.00 Rp 180,000.00
40 3/30/2020 steples kecil - 2020 gudang atk 1 biji Rp 18,000.00 Rp 18,000.00 3/30/2020 ugd 1 Rp 18,000.00 Rp 18,000.00
41 3/30/2020 isi steples - 2020 gudang atk 1 biji Rp 3,000.00 Rp 3,000.00 3/30/2020 ugd 1 Rp 3,000.00 Rp 3,000.00
42 3/30/2020 stipo kertas - 2020 gudang atk 1 biji Rp 7,000.00 Rp 7,000.00 3/30/2020 ugd 1 Rp 7,000.00 Rp 7,000.00
43 3/30/2020 map - 2020 gudang atk 1 biji Rp 10,000.00 Rp 10,000.00 3/30/2020 ugd 1 Rp 10,000.00 Rp 10,000.00
44 3/30/2020 stabilo - 2020 gudang atk 2 biji Rp 10,000.00 Rp 20,000.00 3/30/2020 obat 2 Rp 10,000.00 Rp 20,000.00
45 3/30/2020 carter - 2020 gudang atk 1 biji Rp 15,000.00 Rp 15,000.00 3/30/2020 obat 1 Rp 15,000.00 Rp 15,000.00
46 3/30/2020 lakban besar - 2020 gudang atk 1 biji Rp 17,000.00 Rp 17,000.00 3/30/2020 obat 1 Rp 17,000.00 Rp 17,000.00
47 3/30/2020 stipo kertas - 2020 gudang atk 7 biji Rp 6,000.00 Rp 42,000.00 3/30/2020 ugd 7 Rp 6,000.00 Rp 42,000.00
50 3/30/2020 lem castol - 2020 gudang atk 1 tube Rp 6,000.00 Rp 6,000.00 3/30/2020 tu 1 Rp 6,000.00 Rp 6,000.00
52 3/30/2020 odwner - 2020 gudang atk 3 biji Rp 17,000.00 Rp 51,000.00 3/30/2020 tu 3 Rp 17,000.00 Rp 51,000.00
54 3/30/2020 isi steples gw 2020 gudang atk 1 pak Rp 19,000.00 Rp 19,000.00 3/30/2020 tu 1 Rp 19,000.00 Rp 19,000.00
55 3/30/2020 stop map benik - 2020 gudang atk 9 biji Rp 3,000.00 Rp 27,000.00 3/30/2020 tu 9 Rp 3,000.00 Rp 27,000.00
62 3/22/2020 doubel foam hansa hansa 2020 gudang atk 1 biji Rp 14,000.00 Rp 14,000.00 3/22/2020 obat 1 Rp 14,000.00 Rp 14,000.00
63 3/22/2020 doubel tape huli 2020 gudang atk 1 biji Rp 4,000.00 Rp 4,000.00 3/22/2020 obat 1 Rp 4,000.00 Rp 4,000.00
64 3/22/2020 doebel foam huli huli 2020 gudang atk 1 biji Rp 4,000.00 Rp 4,000.00 3/22/2020 obat 1 Rp 4,000.00 Rp 4,000.00
65 3/30/2020 print epson 2020 gudang atk 1 unit Rp 2,469,150.00 Rp 2,469,150.00 3/30/2020 tu 1 Rp 2,469,150.00 Rp 2,469,150.00
66 4/14/2020 buku folio isi 100 paperline 2020 gudang atk 2 biji Rp 12,000.00 Rp 24,000.00 4/14/2020 mutu 2 Rp 12,000.00 Rp 24,000.00
67 4/14/2020 isi steples - 2020 gudang atk 1 pak Rp 50,000.00 Rp 50,000.00 4/14/2020 ugd 1 Rp 50,000.00 Rp 50,000.00
68 4/28/2020 mika - 2020 gudang atk 5 biji Rp 4,500.00 Rp 22,500.00 4/28/2020 ugd 5 Rp 4,500.00 Rp 22,500.00
69 4/28/2020 stop map benik - 2020 gudang atk 1 biji Rp 5,000.00 Rp 5,000.00 4/28/2020 ugd 1 Rp 5,000.00 Rp 5,000.00
70 4/28/2020 doubel tape - 2020 gudang atk 4 biji Rp 7,500.00 Rp 30,000.00 4/28/2020 ugd 4 Rp 7,500.00 Rp 30,000.00
71 4/28/2020 tinta - 2020 gudang atk 2 tube Rp 49,500.00 Rp 99,000.00 4/28/2020 ugd 2 Rp 49,500.00 Rp 99,000.00
72 4/28/2020 nota sidu 2020 gudang atk 2 biji Rp 3,000.00 Rp 6,000.00 4/28/2020 ugd 2 Rp 3,000.00 Rp 6,000.00
73 4/28/2020 stop map benik - 2020 gudang atk 1 biji Rp 4,000.00 Rp 4,000.00 4/28/2020 poned 1 Rp 4,000.00 Rp 4,000.00
74 4/28/2020 buku folio isi 200 paperline 2020 gudang atk 1 biji Rp 18,000.00 Rp 18,000.00 4/28/2020 poned 1 Rp 18,000.00 Rp 18,000.00
75 4/28/2020 bolpoint - 2020 gudang atk 2 biji Rp 1,000.00 Rp 2,000.00 4/28/2020 poned 2 Rp 1,000.00 Rp 2,000.00
76 4/28/2020 hvs 70 gr maxi 2020 gudang atk 8 rim Rp 42,000.00 Rp 336,000.00 4/28/2020 poned 8 Rp 42,000.00 Rp 336,000.00
78 4/28/2020 kwitansi tanggung sidu 2020 gudang atk 2 biji Rp 4,000.00 Rp 8,000.00 4/28/2020 tu 2 Rp 4,000.00 Rp 8,000.00
82 4/28/2020 solasi kecil - 2020 gudang atk 2 pak Rp 11,000.00 Rp 22,000.00 4/28/2020 tu 2 Rp 11,000.00 Rp 22,000.00
83 4/28/2020 stipo kertas - 2020 gudang atk 2 biji Rp 5,000.00 Rp 10,000.00 4/28/2020 tu 2 Rp 5,000.00 Rp 10,000.00
84 4/28/2020 steples besar - 2020 gudang atk 1 biji Rp 20,000.00 Rp 20,000.00 4/28/2020 tu 1 Rp 20,000.00 Rp 20,000.00
85 4/28/2020 gunting tanggung - 2020 gudang atk 1 biji Rp 7,000.00 Rp 7,000.00 4/28/2020 tu 1 Rp 7,000.00 Rp 7,000.00
86 4/28/2020 stop map - 2020 gudang atk 6 pak Rp 23,500.00 Rp 141,000.00 4/28/2020 tu 6 Rp 23,500.00 Rp 141,000.00
87 4/28/2020 snell kertas - 2020 gudang atk 1 pak Rp 12,000.00 Rp 12,000.00 4/28/2020 ugd 1 Rp 12,000.00 Rp 12,000.00
88 4/28/2020 steples kecil - 2020 gudang atk 3 biji Rp 10,000.00 Rp 30,000.00 4/28/2020 tu 3 Rp 10,000.00 Rp 30,000.00
89 4/28/2020 isi steples - 2020 gudang atk 1 pak Rp 18,000.00 Rp 18,000.00 4/28/2020 tu 1 Rp 18,000.00 Rp 18,000.00
91 5/7/2020 kwitansi bisnis 2020 gudang atk 3 biji Rp 10,500.00 Rp 31,500.00 5/7/2020 tu 3 Rp 10,500.00 Rp 31,500.00
92 5/28/2020 kwitansi kiki 2020 gudang atk 10 biji Rp 6,400.00 Rp 64,000.00 5/28/2020 tu 10 Rp 6,400.00 Rp 64,000.00
95 5/28/2020 steples kecil - 2020 gudang atk 1 biji Rp 10,000.00 Rp 10,000.00 5/28/2020 tu 1 Rp 10,000.00 Rp 10,000.00
96 5/28/2020 trigonal clip - 2020 gudang atk 3 pak Rp 3,000.00 Rp 9,000.00 5/28/2020 tu 3 Rp 3,000.00 Rp 9,000.00
97 5/28/2020 doubel tape - 2020 gudang atk 1 biji Rp 2,500.00 Rp 2,500.00 5/28/2020 tu 1 Rp 2,500.00 Rp 2,500.00
99 6/6/2020 mouse - 2020 gudang atk 1 unit Rp 65,000.00 Rp 65,000.00 6/6/2020 tu 1 Rp 65,000.00 Rp 65,000.00
100 6/10/2020 date stampel - 2020 gudang atk 1 biji Rp 13,500.00 Rp 13,500.00 6/10/2020 tu 1 Rp 13,500.00 Rp 13,500.00
101 6/10/2020 tinta yamura - 2020 gudang atk 1 tube Rp 5,000.00 Rp 5,000.00 6/10/2020 tu 1 Rp 5,000.00 Rp 5,000.00
102 6/10/2020 stampad - 2020 gudang atk 1 biji Rp 6,500.00 Rp 6,500.00 6/10/2020 tu 1 Rp 6,500.00 Rp 6,500.00
103 6/26/2020 stampad - 2020 gudang atk 1 biji Rp 8,000.00 Rp 8,000.00 6/26/2020 tu 1 Rp 8,000.00 Rp 8,000.00
104 6/26/2020 spidol permanen - 2020 gudang atk 1 biji Rp 8,000.00 Rp 8,000.00 6/26/2020 ugd 1 Rp 8,000.00 Rp 8,000.00
105 6/26/2020 bolpoint - 2020 gudang atk 1 pak Rp 10,000.00 Rp 10,000.00 6/26/2020 laborat 1 Rp 10,000.00 Rp 10,000.00
106 6/26/2020 label harga - 2020 gudang atk 1 pak Rp 4,000.00 Rp 4,000.00 6/26/2020 laborat 1 Rp 4,000.00 Rp 4,000.00
107 6/26/2020 bofalo - 2020 gudang atk 1 rim Rp 35,000.00 Rp 35,000.00 6/26/2020 laborat 1 Rp 35,000.00 Rp 35,000.00
108 6/26/2020 bufalo - 2020 gudang atk 1 rim Rp 35,000.00 Rp 35,000.00 6/26/2020 laborat 1 Rp 35,000.00 Rp 35,000.00
109 6/26/2020 label harga - 2020 gudang atk 1 pak Rp 4,000.00 Rp 4,000.00 6/26/2020 laborat 1 Rp 4,000.00 Rp 4,000.00
110 6/26/2020 bufalo - 2020 gudang atk 1 rim Rp 35,000.00 Rp 35,000.00 6/26/2020 laborat 1 Rp 35,000.00 Rp 35,000.00
111 6/26/2020 staples - 2020 gudang atk 1 biji Rp 18,000.00 Rp 18,000.00 6/26/2020 laborat 1 Rp 18,000.00 Rp 18,000.00
112 6/26/2020 isi steples - 2020 gudang atk 1 biji Rp 3,000.00 Rp 3,000.00 6/26/2020 gizi 1 Rp 3,000.00 Rp 3,000.00
113 6/26/2020 bolpoint standart 2020 gudang atk 2 biji Rp 2,000.00 Rp 4,000.00 6/26/2020 gizi 2 Rp 2,000.00 Rp 4,000.00
114 6/26/2020 hvs 70 gr maxi 2020 gudang atk 7 rim Rp 42,000.00 Rp 294,000.00 6/26/2020 ugd 7 Rp 42,000.00 Rp 294,000.00
115 6/26/2020 gunting tanggung - 2020 gudang atk 1 biji Rp 7,000.00 Rp 7,000.00 6/26/2020 tu 1 Rp 7,000.00 Rp 7,000.00
116 6/26/2020 penghapus - 2020 gudang atk 1 biji Rp 1,500.00 Rp 1,500.00 6/26/2020 tu 1 Rp 1,500.00 Rp 1,500.00
119 6/26/2020 stop map benik - 2020 gudang atk 1 pak Rp 33,000.00 Rp 33,000.00 6/26/2020 tu 1 Rp 33,000.00 Rp 33,000.00
122 6/26/2020 isi steples - 2020 gudang atk 1 pak Rp 18,000.00 Rp 18,000.00 6/26/2020 tu 1 Rp 18,000.00 Rp 18,000.00
123 6/26/2020 trigonal clip - 2020 gudang atk 1 pak Rp 3,000.00 Rp 3,000.00 6/26/2020 tu 1 Rp 3,000.00 Rp 3,000.00
125 6/26/2020 lakban - 2020 gudang atk 1 biji Rp 12,500.00 Rp 12,500.00 6/26/2020 tu 1 Rp 12,500.00 Rp 12,500.00
126 6/26/2020 doubel tape - 2020 gudang atk 1 biji Rp 2,500.00 Rp 2,500.00 6/26/2020 tu 1 Rp 2,500.00 Rp 2,500.00
127 12/30/1899 0 - Rp - Rp - 12/30/1899 - Rp - Rp -
128 12/30/1899 - Rp - Rp - 12/30/1899 - Rp - Rp -
129 12/30/1899 - 12/30/1899 -
-
JUMLAH Rp 8,516,150.00 Rp 8,516,150.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : MAKAN MINUM KANTOR

1/21/2020 2 Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 7*9 11 12 13 14 15 16 17 = 15*16 18
1 1/8/2020 snack - 2020 koordinator 12 porsi Rp 7,500.00 Rp 90,000.00 xxx xxx 1/8/2020 mfk 12 Rp 7,500.00 Rp 90,000.00
1/8/2020 nasi - 2020 koordinator 12 porsi Rp 27,500.00 Rp 330,000.00 1/8/2020 mfk 12 Rp 27,500.00 Rp 330,000.00
1/9/2020 snack - 2020 koordinator 17 porsi Rp 7,500.00 Rp 127,500.00 1/9/2020 kp 17 Rp 7,500.00 Rp 127,500.00
1/9/2020 nasi - 2020 koordinator 17 porsi Rp 27,500.00 Rp 467,500.00 1/9/2020 kp 17 Rp 27,500.00 Rp 467,500.00
1/10/2020 snack - 2020 koordinator 13 porsi Rp 7,500.00 Rp 97,500.00 1/10/2020 ppi 13 Rp 7,500.00 Rp 97,500.00
1/10/2020 nasi - 2020 koordinator 13 porsi Rp 27,500.00 Rp 357,500.00 1/10/2020 ppi 13 Rp 27,500.00 Rp 357,500.00
pertemuan
1/21/2020 nasi ayam - 2020 koordinator 12 porsi Rp 15,000.00 Rp 180,000.00 1/21/2020 12 Rp 15,000.00 Rp 180,000.00
anc
pertemuan
1/21/2020 snack - 2020 koordinator 12 porsi Rp 5,000.00 Rp 60,000.00 1/21/2020 12 Rp 5,000.00 Rp 60,000.00
anc
air minum
1/30/2020 air mineral aqua 2020 koordinator 12 galon Rp 20,000.00 Rp 240,000.00 1/30/2020 12 Rp 20,000.00 Rp 240,000.00
pertemuan
2/5/2020 snack - 2020 koordinator 30 porsi Rp 7,500.00 Rp 225,000.00 2/5/2020 smd 30 Rp 7,500.00 Rp 225,000.00
2/5/2020 nasi - 2020 koordinator 30 porsi Rp 27,500.00 Rp 825,000.00 2/5/2020 smd 30 Rp 27,500.00 Rp 825,000.00
2/12/2020 snack - 2020 koordinator 50 porsi Rp 7,500.00 Rp 375,000.00 2/12/2020 pkp 50 Rp 7,500.00 Rp 375,000.00
2/12/2020 nasi - 2020 koordinator 50 porsi Rp 27,500.00 Rp 1,375,000.00 2/12/2020 pkp 50 Rp 27,500.00 Rp 1,375,000.00
2/20/2020 snack - 2020 koordinator 12 porsi Rp 7,500.00 Rp 90,000.00 2/20/2020 mfk 12 Rp 7,500.00 Rp 90,000.00
2/24/2020 snack - 2020 koordinator 17 porsi Rp 7,500.00 Rp 127,500.00 2/24/2020 kp 17 Rp 7,500.00 Rp 127,500.00
2/24/2020 nasi - 2020 koordinator 17 porsi Rp 27,500.00 Rp 467,500.00 2/24/2020 kp 17 Rp 27,500.00 Rp 467,500.00
pembina
desa
pembina
2/25/2020 nasi - 2020 koordinator 35 porsi Rp 27,500.00 Rp 962,500.00 2/25/2020 35 Rp 27,500.00 Rp 962,500.00
desa
air minum
pertemuan
pertemuan
anc
pertemuan
anc
pertemuan
anc
pertemuan
anc
3/10/2020 snack - 2020 koordinator 13 porsi Rp 7,500.00 Rp 97,500.00 3/10/2020 mfk 13 Rp 7,500.00 Rp 97,500.00
3/12/2020 snack - 2020 koordinator 17 porsi Rp 7,500.00 Rp 127,500.00 3/12/2020 tim kp 17 Rp 7,500.00 Rp 127,500.00
3/12/2020 nasi - 2020 koordinator 17 porsi Rp 27,500.00 Rp 467,500.00 3/12/2020 tim kp 17 Rp 27,500.00 Rp 467,500.00
3/13/2020 snack - 2020 koordinator 13 porsi Rp 7,500.00 Rp 97,500.00 3/13/2020 ppi 13 Rp 7,500.00 Rp 97,500.00
3/13/2020 nasi - 2020 koordinator 13 porsi Rp 27,500.00 Rp 357,500.00 3/13/2020 ppi 13 Rp 27,500.00 Rp 357,500.00
3/14/2020 snack - 2020 koordinator 30 porsi Rp 7,500.00 Rp 225,000.00 3/14/2020 manajemen 30 Rp 7,500.00 Rp 225,000.00
3/14/2020 nasi - 2020 koordinator 30 porsi Rp 27,500.00 Rp 825,000.00 3/14/2020 manajemen 30 Rp 27,500.00 Rp 825,000.00
air minum
pertemuan
air minum
pertemuan
air minum
pertemuan
air minum
pertemuan
6/29/2020 snack - 2020 koordinator 25 porsi Rp 7,500.00 Rp 187,500.00 6/29/2020 zi 25 Rp 7,500.00 Rp 187,500.00
6/29/2020 nasi - 2020 koordinator 25 porsi Rp 27,500.00 Rp 687,500.00 6/29/2020 zi 25 Rp 27,500.00 Rp 687,500.00
JUMLAH Rp 12,180,000.00 Rp 12,180,000.00

KABUPATEN : NGAWI
JENIS BELANJA : Persediaan Perangko, materai dan benda pos lainnya

Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
1 1/23/2020 materai 3000 2020 koordinator 12 lembar Rp 3,000.00 Rp 36,000.00 28/02/2019 7 1/23/2020 spj 12 Rp 3,000.00 Rp 36,000.00
JUMLAH Rp 1,446,000.00 Rp 1,446,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : belanja cetak
0

Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 7*9 11 12 13 14 15 16 17 = 15*16 18
1 2/28/2020 blanko hematologi - 2020 TU 2 rim Rp 110,000.00 Rp 220,000.00 2/28/2020 laborat 2 Rp 110,000.00 Rp 220,000.00
2 2/28/2020 blanko resiko jatuh 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 loket 1 Rp 105,000.00 Rp 105,000.00
catatan
3 2/28/2020 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
perkembangan
4 2/28/2020 askep 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
lembar pemberian
5 2/28/2020 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
obat
6 2/28/2020 analisa 2020 TU 3 rim Rp 105,000.00 Rp 315,000.00 2/28/2020 ugd 3 Rp 105,000.00 Rp 315,000.00
7 2/28/2020 askep 2020 TU 1 rim Rp 125,000.00 Rp 125,000.00 2/28/2020 ugd 1 Rp 125,000.00 Rp 125,000.00
8 2/28/2020 blanko pkm kwd 2020 TU 2 rim Rp 105,000.00 Rp 210,000.00 2/28/2020 tu 2 Rp 105,000.00 Rp 210,000.00
9 2/28/2020 surat umum 2020 TU 2 rim Rp 105,000.00 Rp 210,000.00 2/28/2020 tu 2 Rp 105,000.00 Rp 210,000.00
10 2/28/2020 aturan minum 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 obat 1 Rp 105,000.00 Rp 105,000.00
11 2/28/2020 resep 2020 TU 1 rim Rp 125,000.00 Rp 125,000.00 2/28/2020 obat 1 Rp 125,000.00 Rp 125,000.00
12 2/28/2020 surat perintah RI 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
13 2/28/2020 surat perintah rujukan 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
14 2/28/2020 form permintaan lab 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 laborat 1 Rp 105,000.00 Rp 105,000.00
15 2/28/2020 bon obat 2020 TU 5 rim Rp 40,000.00 Rp 200,000.00 2/28/2020 obat 5 Rp 40,000.00 Rp 200,000.00
16 2/28/2020 resep 2 mk 2020 TU 1 rim Rp 125,000.00 Rp 125,000.00 2/28/2020 bp 1 Rp 125,000.00 Rp 125,000.00
17 2/28/2020 bon obat 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 2/28/2020 obat 1 Rp 105,000.00 Rp 105,000.00
18 2/28/2020 nota retribusi 2020 TU 2 rim Rp 150,000.00 Rp 300,000.00 2/28/2020 tu 2 Rp 150,000.00 Rp 300,000.00
19 3/31/2020 amplop casing 2020 TU 5 pak Rp 37,450.00 Rp 187,250.00 3/31/2020 tu 5 Rp 37,450.00 Rp 187,250.00
20 3/31/2020 persetujuan hiv 2020 TU 5 rim Rp 105,000.00 Rp 525,000.00 3/31/2020 lab 5 Rp 105,000.00 Rp 525,000.00
21 3/31/2020 catatan px 2020 TU 7 rim Rp 135,000.00 Rp 945,000.00 3/31/2020 ugd 7 Rp 135,000.00 Rp 945,000.00
22 3/31/2020 form permintaan lab 2020 TU 3 rim Rp 105,000.00 Rp 315,000.00 3/31/2020 lab 3 Rp 105,000.00 Rp 315,000.00
23 3/31/2020 catatan px 2020 TU 1 rim Rp 125,000.00 Rp 125,000.00 3/31/2020 ugd 1 Rp 125,000.00 Rp 125,000.00
24 3/31/2020 lembar discange 2020 TU 2 rim Rp 110,000.00 Rp 220,000.00 3/31/2020 ugd 2 Rp 110,000.00 Rp 220,000.00
25 3/31/2020 resume medis 2020 TU 2 rim Rp 110,000.00 Rp 220,000.00 3/31/2020 ugd 2 Rp 110,000.00 Rp 220,000.00
26 3/31/2020 infus 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 3/31/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
27 3/31/2020 catatan perawat 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 3/31/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
28 3/31/2020 formulir bunde 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 3/31/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
29 3/31/2020 general konsent 2020 TU 1 rim Rp 125,000.00 Rp 125,000.00 3/31/2020 ugd 1 Rp 125,000.00 Rp 125,000.00
30 3/31/2020 pemantauan bayi 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 3/31/2020 poned 1 Rp 105,000.00 Rp 105,000.00
31 3/31/2020 kartu stok 2020 TU 600 lembar Rp 400.00 Rp 240,000.00 3/31/2020 obat 600 Rp 400.00 Rp 240,000.00
32 3/31/2020 kartu steling 2020 TU 600 lembar Rp 200.00 Rp 120,000.00 3/31/2020 obat 600 Rp 200.00 Rp 120,000.00
blanko tata laksana
33 3/31/2020 2020 TU 7 rim Rp 125,000.00 Rp 875,000.00 3/31/2020 kia 7 Rp 125,000.00 Rp 875,000.00
balik
34 3/31/2020 form bayi muda 2020 TU 3 rim Rp 125,000.00 Rp 375,000.00 3/31/2020 kia 3 Rp 125,000.00 Rp 375,000.00
35 3/31/2020 resep 2020 TU 5 rim Rp 105,000.00 Rp 525,000.00 3/31/2020 bp 5 Rp 105,000.00 Rp 525,000.00
36 3/31/2020 lembar observasi 2020 TU 2 rim Rp 105,000.00 Rp 210,000.00 3/31/2020 ugd 2 Rp 105,000.00 Rp 210,000.00
37 3/31/2020 resep 2020 TU 5 rim Rp 105,000.00 Rp 525,000.00 3/31/2020 bp 5 Rp 105,000.00 Rp 525,000.00
3/31/2020 pemantauan resiko 2020 TU 3 rim Rp 105,000.00 Rp 315,000.00 3/31/2020 ugd 3 Rp 105,000.00 Rp 315,000.00
3/31/2020 tata laksana bp 2020 TU 7 rim Rp 125,000.00 Rp 875,000.00 3/31/2020 ugd 7 Rp 125,000.00 Rp 875,000.00
3/31/2020 stiker 2020 TU 750 lembar Rp 477.00 Rp 357,750.00 3/31/2020 obat 750 Rp 477.00 Rp 357,750.00
4/29/2020 resep 2 mk 2020 TU 1 rim Rp 125,000.00 Rp 125,000.00 4/29/2020 obat 1 Rp 125,000.00 Rp 125,000.00
4/29/2020 nota retribusi 2020 TU 6 rim Rp 130,000.00 Rp 780,000.00 4/29/2020 tu 6 Rp 130,000.00 Rp 780,000.00
catatan
5/28/2020 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 5/28/2020 ugd 1 Rp 105,000.00 Rp 105,000.00
perkembangan
5/28/2020 aturan minum 2020 TU 1 rim Rp 105,000.00 Rp 105,000.00 5/28/2020 obat 1 Rp 105,000.00 Rp 105,000.00
5/28/2020 kartu px 2020 TU 1 rim Rp 150,000.00 Rp 150,000.00 5/28/2020 loket 1 Rp 150,000.00 Rp 150,000.00
6/26/2020 blanko hiv 2020 TU 2 rim Rp 105,000.00 Rp 210,000.00 6/26/2020 lab 2 Rp 105,000.00 Rp 210,000.00
6/26/2020 kartu steling obat 2020 TU 1 rim Rp 375,000.00 Rp 375,000.00 6/26/2020 obat 1 Rp 375,000.00 Rp 375,000.00
6/26/2020 hematologi 2020 TU 2 rim Rp 105,000.00 Rp 210,000.00 6/26/2020 lab 2 Rp 105,000.00 Rp 210,000.00
6/26/2020 form bundle 2020 TU 2 rim Rp 100,000.00 Rp 200,000.00 6/26/2020 ugd 2 Rp 100,000.00 Rp 200,000.00
JUMLAH Rp 12,535,000.00 2,057 Rp 12,535,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : penggandaan

Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
1 1/30/2020 foto copy 1/30/2020 KOORDINATOR 1,504 lembar Rp 250.00 Rp 376,000.00 1/31/2019 4 1/30/2020 ranap 1,504 Rp 250.00 Rp 376,000.00
2 1/30/2020 foto copy 1/30/2020 KOORDINATOR 2,484 lembar Rp 250.00 Rp 621,000.00 1/31/2019 4 1/30/2020 askep 2,484 Rp 250.00 Rp 621,000.00
3 2/27/2020 foto copy 2/27/2020 KOORDINATOR 648 lembar Rp 250.00 Rp 162,000.00 2/28/2019 7 2/27/2020 askep 648 Rp 250.00 Rp 162,000.00
4 2/27/2020 foto copy 2/27/2020 KOORDINATOR 2,920 lembar Rp 250.00 Rp 730,000.00 3/31/2019 11 2/27/2020 askep 2,920 Rp 250.00 Rp 730,000.00
5 3/30/2020 foto copy 3/30/2020 KOORDINATOR 440 lembar Rp 250.00 Rp 110,000.00 4/30/2019 12 3/30/2020 klaim ranap 440 Rp 250.00 Rp 110,000.00
klaim
6 3/30/2020 foto copy 3/30/2020 KOORDINATOR 1,944 lembar Rp 250.00 Rp 486,000.00 5/31/2019 15 3/30/2020 1,944 Rp 250.00 Rp 486,000.00
persalinan
7 4/10/2020 scan 4/10/2020 KOORDINATOR 75 lembar Rp 1,000.00 Rp 75,000.00 6/30/2019 18 4/10/2020 blud 75 Rp 1,000.00 Rp 75,000.00
8 4/28/2020 foto copy 4/28/2020 KOORDINATOR 932 lembar Rp 250.00 Rp 233,000.00 7/31/2019 21 4/28/2020 klaim bpjs 932 Rp 250.00 Rp 233,000.00
form
9 4/28/2020 foto copy 4/28/2020 KOORDINATOR 750 lembar Rp 250.00 Rp 187,500.00 8/31/2019 25 4/28/2020 750 Rp 250.00 Rp 187,500.00
survelance
10 5/27/2020 foto copy 5/27/2020 KOORDINATOR 874 lembar Rp 250.00 Rp 218,500.00 8/31/2019 25 5/27/2020 ranap 874 Rp 250.00 Rp 218,500.00
11 5/27/2020 foto copy 5/27/2020 KOORDINATOR 460 lembar Rp 250.00 Rp 115,000.00 8/31/2019 25 5/27/2020 klaim bpjs 460 Rp 250.00 Rp 115,000.00
12 6/26/2020 foto copy 6/26/2020 KOORDINATOR 840 lembar Rp 250.00 Rp 210,000.00 8/31/2019 25 6/26/2020 obat 840 Rp 250.00 Rp 210,000.00
13 6/26/2020 foto copy 6/26/2020 KOORDINATOR 172 lembar Rp 250.00 Rp 43,000.00 9/30/2019 27 6/26/2020 rujukan ugd 172 Rp 250.00 Rp 43,000.00
14 6/26/2020 foto copy 6/26/2020 KOORDINATOR 2,012 lembar Rp 250.00 Rp 503,000.00 10/31/2019 30 6/26/2020 doc. Zi 2,012 Rp 250.00 Rp 503,000.00
15 6/26/2020 print copy 6/26/2020 KOORDINATOR 156 lembar Rp 500.00 Rp 78,000.00 11/30/2019 33 6/26/2020 doc. zi 156 Rp 500.00 Rp 78,000.00
16 6/26/2020 jilid 6/26/2020 KOORDINATOR 5 jilid Rp 2,500.00 Rp 12,500.00 12/31/2019 35 6/26/2020 doc. zi 5 Rp 2,500.00 Rp 12,500.00
JUMLAH Rp 4,160,500.00 Rp 4,160,500.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : makan pasien
Merk/ Tahun Tgl/No. Kontrak/SP/SPK : Tgl/No.Surat Penyerahan :

No. Tanggal Diterima Nama/Jenis Barang Dari Berita Acara Tanggal Ket.
Ukuran Pembuatan Jumlah Satuan/ Barang Diserahkan Jumlah
Pemeriksaan Dikeluarkan/
Kepada Barang 0 0
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
1 1/21/2020 makan pasien 2019 KOORDINATOR 60 porsi Rp 10,000.00 Rp 600,000 1/31/2019 3 1/21/2020 pasien ranap 60 Rp 10,000 Rp 600,000
2 1/30/2020 makan pasien 2019 KOORDINATOR 642 porsi Rp 10,000.00 Rp 6,420,000 1/31/2019 3 1/30/2020 pasien ranap 642 Rp 10,000 Rp 6,420,000
JUMLAH Rp 22,680,000.00 Rp 22,680,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : makmin lembur
Merk/ Tahun Tgl/No. Kontrak/SP/SPK : Tgl/No.Surat Penyerahan :

No. Tanggal Diterima Nama/Jenis Barang Dari Berita Acara Tanggal Ket.
Ukuran Pembuatan Jumlah Satuan/ Barang Diserahkan Jumlah
Pemeriksaan Dikeluarkan/
Kepada Barang 0 0
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
petugas
1 1/30/2020 nasi bungkus 2019 KKORDINATOR 248 porsi Rp 5,000.00 Rp 1,240,000 1/31/2019 3 1/30/2020 248 Rp 5,000 Rp 1,240,000
ranap
petugas
ranap
petugas
ranap
petugas
ranap
petugas
ranap
petugas
ranap
JUMLAH Rp 8,480,000.00 Rp 8,480,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : BBM

Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
1 2/28/2020 pertalit 2019 KOORDINATOR 300 liter Rp 7,650.00 Rp 2,295,000 1/31/2019 4 2/28/2020 ambulan 300 Rp 7,650 Rp 2,295,000
2 4/28/2020 pertalit 2019 KOORDINATOR 300 liter Rp 7,650.00 Rp 2,295,000 2/28/2019 7 4/28/2020 ambulan 300 Rp 7,650 Rp 2,295,000
JUMLAH Rp 4,590,000.00 Rp 4,590,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : perlengkapan ruang pasien
Merk/ Tahun
No. Tanggal Diterima Nama/Jenis Barang Dari Ket.
Ukuran Pembuatan
Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
1 2/7/2020 roda karet bed 2020 KOORDINATOR 1 biji Rp 32,500.00 Rp 32,500 2/7/2020 ugd 1 Rp 32,500 Rp 32,500
JUMLAH Rp 32,500.00 Rp 32,500.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : pakaian dinas

Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
unit
1 3/30/2020 seragam skort biru 2020 KOORDINATOR 71 potong Rp 115,000.00 Rp 8,165,000 3/30/2020 71 Rp 115,000 Rp 8,165,000
pelayanan
unit
2 4/28/2020 seragam skort kuning 2020 KOORDINATOR 71 potong Rp 115,000.00 Rp 8,165,000 4/28/2020 71 Rp 115,000 Rp 8,165,000
pelayanan
unit
3 5/28/2020 seragam skort merah 2020 KOORDINATOR 30 potong Rp 120,000.00 Rp 3,600,000 5/28/2020 30 Rp 120,000 Rp 3,600,000
pelayanan
JUMLAH Rp 19,930,000.00 Rp 19,930,000.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : BHP NON MEDIS
Tgl/No. Kontrak/SP/SPK : Berita Acara Tgl/No.Surat Penyerahan :
Merk/ Tahun Jumlah Satuan/ Barang Tanggal
No. Tanggal Diterima Nama/Jenis Barang Dari Pemeriksaan Diserahkan Jumlah 0 0 Ket.
Ukuran Pembuatan Dikeluarkan/
Kepada Barang
JML Satuan Harga Satuan Jumlah Harga Tanggal Nomor Penyerahan Harga Satuan Jumlah Harga
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
tisu
1 1/30/2020 Pembersih 2020 koordinator 20 biji Rp 9,500.00 Rp 190,000.00 1/30/2020 poli-poli 20 Rp 9,500.00 Rp 190,000.00
paseo
tisu
paseo
3 1/30/2020 Pembersih kanebo 2020 koordinator 2 biji Rp 15,000.00 Rp 30,000.00 1/30/2020 r.arsip 2 Rp 15,000.00 Rp 30,000.00
4 1/30/2020 Kantong plastik klip 2020 koordinator 3 pak Rp 5,500.00 Rp 16,500.00 1/30/2020 apotik 3 Rp 5,500.00 Rp 16,500.00
6 1/30/2020 Pembersih penebah 2020 koordinator 1 biji Rp 13,500.00 Rp 13,500.00 1/30/2020 ugd 1 Rp 13,500.00 Rp 13,500.00
7 1/30/2020 Pembersih pel 2020 koordinator 1 biji Rp 35,000.00 Rp 35,000.00 1/30/2020 ugd 1 Rp 35,000.00 Rp 35,000.00
8 1/30/2020 Pembersih sapu lidi 2020 koordinator 1 biji Rp 10,000.00 Rp 10,000.00 1/30/2020 ugd 1 Rp 10,000.00 Rp 10,000.00
9 1/30/2020 Pembersih berlian 2020 koordinator 2 biji Rp 25,000.00 Rp 50,000.00 1/30/2020 poned 2 Rp 25,000.00 Rp 50,000.00
10 1/30/2020 Sandal swallow 2020 koordinator 1 pasang Rp 10,000.00 Rp 10,000.00 1/30/2020 kia 1 Rp 10,000.00 Rp 10,000.00
11 1/30/2020 Kantong plastik pop es 2020 koordinator 10 pak Rp 5,000.00 Rp 50,000.00 1/30/2020 apotik 10 Rp 5,000.00 Rp 50,000.00
12 1/30/2020 Tempat minum gelas es 2020 koordinator 4 biji Rp 11,000.00 Rp 44,000.00 1/30/2020 gigi 4 Rp 11,000.00 Rp 44,000.00
13 1/30/2020 Alat makan sendok 2020 koordinator 2 pak Rp 15,000.00 Rp 30,000.00 1/30/2020 ugd 2 Rp 15,000.00 Rp 30,000.00
14 1/30/2020 Pembersih serbet 2020 koordinator 1 biji Rp 10,000.00 Rp 10,000.00 1/30/2020 ugd 1 Rp 10,000.00 Rp 10,000.00
15 1/30/2020 Alas tidur perlak 2020 koordinator 2 meter Rp 33,750.00 Rp 67,500.00 1/30/2020 poned 2 Rp 33,750.00 Rp 67,500.00
tisu
paseo
tisu
paseo
garukan
19 1/30/2020 Pembersih 2020 koordinator 1 biji Rp 45,000.00 Rp 45,000.00 1/30/2020 ugd 1 Rp 45,000.00 Rp 45,000.00
air
20 1/30/2020 Tempat minum gelas es 2020 koordinator 2 pak Rp 11,000.00 Rp 22,000.00 1/30/2020 gigi 2 Rp 11,000.00 Rp 22,000.00
22 1/30/2020 Sikat gigi kodomo 2020 koordinator 2 lusin Rp 37,500.00 Rp 75,000.00 1/30/2020 gigi 2 Rp 37,500.00 Rp 75,000.00
23 1/30/2020 Desinfektan bayclin 2020 koordinator 6 botol Rp 12,500.00 Rp 75,000.00 1/30/2020 lab,kia,pnd 6 Rp 12,500.00 Rp 75,000.00
24 1/30/2020 Pengharum stella 2020 koordinator 8 biji Rp 12,500.00 Rp 100,000.00 1/30/2020 poli-poli 8 Rp 12,500.00 Rp 100,000.00
handsho
25 1/30/2020 Pembersih 2020 koordinator 6 tube Rp 20,000.00 Rp 120,000.00 1/30/2020 poli-poli 6 Rp 20,000.00 Rp 120,000.00
ap
26 1/30/2020 Pembersih super pel 2020 koordinator 6 biji Rp 12,500.00 Rp 75,000.00 1/30/2020 ugd,poned 6 Rp 12,500.00 Rp 75,000.00
27 1/30/2020 Pembersih cling 2020 koordinator 3 biji Rp 7,500.00 Rp 22,500.00 1/30/2020 poli-poli 3 Rp 7,500.00 Rp 22,500.00
28 1/30/2020 Pembersih so klin 2020 koordinator 2 biji Rp 18,500.00 Rp 37,000.00 1/30/2020 ugd 2 Rp 18,500.00 Rp 37,000.00
hit
29 1/30/2020 Obat nyamuk 2020 koordinator 2 tube Rp 30,000.00 Rp 60,000.00 1/30/2020 ugd,poned 2 Rp 30,000.00 Rp 60,000.00
semprot
30 1/30/2020 Pembersih vixal 2020 koordinator 2 tube Rp 24,500.00 Rp 49,000.00 1/30/2020 udd 2 Rp 24,500.00 Rp 49,000.00
31 1/30/2020 Obat nyamuk hit ulang 2020 koordinator 2 pak Rp 7,500.00 Rp 15,000.00 1/30/2020 ugd 2 Rp 7,500.00 Rp 15,000.00
32 1/30/2020 Pembersih sunlik 2020 koordinator 1 biji Rp 12,500.00 Rp 12,500.00 1/30/2020 ugd 1 Rp 12,500.00 Rp 12,500.00
33 2/27/2020 Pembersih sapu lidi 2020 koordinator 2 biji Rp 15,000.00 Rp 30,000.00 2/27/2020 ugd 2 Rp 15,000.00 Rp 30,000.00
34 2/27/2020 Pembersih ikrak 2020 koordinator 1 biji Rp 9,500.00 Rp 9,500.00 2/27/2020 ugd 1 Rp 9,500.00 Rp 9,500.00
35 2/27/2020 Gelas pop es 2020 koordinator 2 biji Rp 10,000.00 Rp 20,000.00 2/27/2020 gigi 2 Rp 10,000.00 Rp 20,000.00
36 2/27/2020 Pembersih pel 2020 koordinator 1 biji Rp 35,000.00 Rp 35,000.00 2/27/2020 apotik 1 Rp 35,000.00 Rp 35,000.00
37 2/27/2020 Pembersih kelud 2020 koordinator 1 biji Rp 25,000.00 Rp 25,000.00 2/27/2020 arsip 1 Rp 25,000.00 Rp 25,000.00
38 2/27/2020 Penerang senter 2020 koordinator 1 biji Rp 30,000.00 Rp 30,000.00 2/27/2020 bp 1 Rp 30,000.00 Rp 30,000.00
tisu
paseo
tisu
paseo
tisu
paseo
tisu
paseo
45 2/27/2020 Pembersih sulak 2020 koordinator 1 biji Rp 25,000.00 Rp 25,000.00 2/27/2020 arsip 1 Rp 25,000.00 Rp 25,000.00
47 2/27/2020 Kantong plastik kresek h 2020 koordinator 1 pak Rp 20,000.00 Rp 20,000.00 2/27/2020 laborat 1 Rp 20,000.00 Rp 20,000.00
48 2/27/2020 Kantong plastik kesek k 2020 koordinator 1 pak Rp 20,000.00 Rp 20,000.00 2/27/2020 ugd 1 Rp 20,000.00 Rp 20,000.00
handsho
ap
50 2/27/2020 Pembersih rinso 2020 koordinator 4 biji Rp 19,500.00 Rp 78,000.00 2/27/2020 ugd 4 Rp 19,500.00 Rp 78,000.00
51 2/27/2020 Pembersih vixal 2020 koordinator 2 biji Rp 24,500.00 Rp 49,000.00 2/27/2020 gigi 2 Rp 24,500.00 Rp 49,000.00
52 2/27/2020 Desinfektan bayclin 2020 koordinator 7 tube Rp 12,500.00 Rp 87,500.00 2/27/2020 lab,kia,pnd 7 Rp 12,500.00 Rp 87,500.00
53 2/27/2020 Pengharum stella 2020 koordinator 14 biji Rp 12,500.00 Rp 175,000.00 2/27/2020 poli-poli 14 Rp 12,500.00 Rp 175,000.00
kapur
54 2/27/2020 Pengharum 2020 koordinator 2 biji Rp 24,000.00 Rp 48,000.00 2/27/2020 rajal 2 Rp 24,000.00 Rp 48,000.00
brs
55 2/27/2020 Baterai ABC 2020 koordinator 4 biji Rp 8,350.00 Rp 33,400.00 2/27/2020 ugd 4 Rp 8,350.00 Rp 33,400.00
56 2/27/2020 Baterai ABC 2020 koordinator 4 biji Rp 7,600.00 Rp 30,400.00 2/27/2020 ugd 4 Rp 7,600.00 Rp 30,400.00
57 3/19/2020 jas hujan 0 2020 koordinator 4 biji Rp 7,500.00 Rp 30,000.00 3/19/2020 tim covid 4 Rp 7,500.00 Rp 30,000.00
58 3/20/2020 kran air 0 2020 koordinator 5 biji Rp 13,000.00 Rp 65,000.00 3/20/2020 ugd 5 Rp 13,000.00 Rp 65,000.00
59 3/30/2020 lepak makan 0 2020 koordinator 10 biji Rp 19,000.00 Rp 190,000.00 3/30/2020 ugd 10 Rp 19,000.00 Rp 190,000.00
60 3/30/2020 sendok makan 0 2020 koordinator 200 biji Rp 150.00 Rp 30,000.00 3/30/2020 ugd 200 Rp 150.00 Rp 30,000.00
61 3/30/2020 gelas es 0 2020 koordinator 4 biji Rp 10,000.00 Rp 40,000.00 3/30/2020 ugd 4 Rp 10,000.00 Rp 40,000.00
62 3/30/2020 sendok makan 0 2020 koordinator 2 pk Rp 15,000.00 Rp 30,000.00 3/30/2020 ugd 2 Rp 15,000.00 Rp 30,000.00
63 3/30/2020 plastik keletan 0 2020 koordinator 1 pk Rp 28,000.00 Rp 28,000.00 3/30/2020 ugd 1 Rp 28,000.00 Rp 28,000.00
64 3/30/2020 serbet 0 2020 koordinator 1 biji Rp 10,000.00 Rp 10,000.00 3/30/2020 ugd 1 Rp 10,000.00 Rp 10,000.00
65 3/30/2020 tisu besar 0 2020 koordinator 5 pk Rp 9,500.00 Rp 47,500.00 3/30/2020 rajal 5 Rp 9,500.00 Rp 47,500.00
66 3/30/2020 plastik c tik 5x8 0 2020 koordinator 10 pk Rp 2,000.00 Rp 20,000.00 3/30/2020 gizi 10 Rp 2,000.00 Rp 20,000.00
67 3/30/2020 Kantong plastik kresek h 2020 koordinator 3 pk Rp 20,000.00 Rp 60,000.00 3/30/2020 ugd 3 Rp 20,000.00 Rp 60,000.00
68 3/30/2020 gelas es 0 2020 koordinator 4 pk Rp 10,000.00 Rp 40,000.00 3/30/2020 ugd 4 Rp 10,000.00 Rp 40,000.00
69 3/30/2020 sendok makan 0 2020 koordinator 2 pk Rp 15,000.00 Rp 30,000.00 3/30/2020 ugd 2 Rp 15,000.00 Rp 30,000.00
70 3/30/2020 plastik keletan 0 2020 koordinator 1 pk Rp 28,000.00 Rp 28,000.00 3/30/2020 ugd 1 Rp 28,000.00 Rp 28,000.00
71 3/30/2020 sapu berlian 2020 koordinator 2 biji Rp 25,000.00 Rp 50,000.00 3/30/2020 poned 2 Rp 25,000.00 Rp 50,000.00
72 3/30/2020 senter 0 2020 koordinator 1 biji Rp 20,000.00 Rp 20,000.00 3/30/2020 bp 1 Rp 20,000.00 Rp 20,000.00
73 3/30/2020 tisu besar paseo 2020 koordinator 10 biji Rp 9,500.00 Rp 95,000.00 3/30/2020 rajal 10 Rp 9,500.00 Rp 95,000.00
74 3/30/2020 kap agar 0 2020 koordinator 5 biji Rp 6,500.00 Rp 32,500.00 3/30/2020 lab 5 Rp 6,500.00 Rp 32,500.00
75 3/30/2020 tisu besar paseo 2020 koordinator 15 biji Rp 9,500.00 Rp 142,500.00 3/30/2020 rajal 15 Rp 9,500.00 Rp 142,500.00
76 3/30/2020 tisu kecil paseo 2020 koordinator 10 biji Rp 3,500.00 Rp 35,000.00 3/30/2020 rajal 10 Rp 3,500.00 Rp 35,000.00
77 3/30/2020 kantong plastik kresek k 2020 koordinator 3 pk Rp 20,000.00 Rp 60,000.00 3/30/2020 poned 3 Rp 20,000.00 Rp 60,000.00
78 3/30/2020 katembat 0 2020 koordinator 2 pk Rp 3,500.00 Rp 7,000.00 3/30/2020 bp 2 Rp 3,500.00 Rp 7,000.00
79 3/30/2020 shower cup 0 2020 koordinator 17 biji Rp 8,000.00 Rp 136,000.00 3/30/2020 poli-poli 17 Rp 8,000.00 Rp 136,000.00
80 3/30/2020 sepatu boots 2020 koordinator 4 buah Rp 60,000.00 Rp 240,000.00 3/30/2020 covid 4 Rp 60,000.00 Rp 240,000.00
parfix
81 3/30/2020 sepatu 2020 koordinator 4 buah Rp 60,000.00 Rp 240,000.00 3/30/2020 covid 4 Rp 60,000.00 Rp 240,000.00
boots
82 3/30/2020 Desinfektan bayclin 2020 koordinator 4 biji Rp 10,000.00 Rp 40,000.00 3/30/2020 poned 4 Rp 10,000.00 Rp 40,000.00
83 3/30/2020 desinfektan vixal 2020 koordinator 2 biji Rp 24,500.00 Rp 49,000.00 3/30/2020 ugd 2 Rp 24,500.00 Rp 49,000.00
84 3/30/2020 Pembersih cling 2020 koordinator 2 biji Rp 7,500.00 Rp 15,000.00 3/30/2020 kia 2 Rp 7,500.00 Rp 15,000.00
85 3/30/2020 sabun yuris 2020 koordinator 10 biji Rp 18,000.00 Rp 180,000.00 3/30/2020 poli-poli 10 Rp 18,000.00 Rp 180,000.00
kapur
86 3/30/2020 pewangi 2020 koordinator 1 biji Rp 25,000.00 Rp 25,000.00 3/30/2020 ugd 1 Rp 25,000.00 Rp 25,000.00
brs
87 3/30/2020 toples leotin 2020 koordinator 1 biji Rp 39,000.00 Rp 39,000.00 3/30/2020 ugd 1 Rp 39,000.00 Rp 39,000.00
88 3/30/2020 tempat gula 0 2020 koordinator 1 biji Rp 70,000.00 Rp 70,000.00 3/30/2020 ugd 1 Rp 70,000.00 Rp 70,000.00
89 3/30/2020 tisu paseo 2020 koordinator 30 biji Rp 9,500.00 Rp 285,000.00 3/30/2020 poli-poli 30 Rp 9,500.00 Rp 285,000.00
90 3/30/2020 tisu paseo 2020 koordinator 8 biji Rp 6,500.00 Rp 52,000.00 3/30/2020 poli-poli 8 Rp 6,500.00 Rp 52,000.00
91 3/30/2020 Pembersih rinso 2020 koordinator 3 biji Rp 19,500.00 Rp 58,500.00 3/30/2020 ugd 3 Rp 19,500.00 Rp 58,500.00
92 3/30/2020 pewangi stella 2020 koordinator 3 biji Rp 25,000.00 Rp 75,000.00 3/30/2020 ug 3 Rp 25,000.00 Rp 75,000.00
93 3/30/2020 Obat nyamuk hit 2020 koordinator 2 biji Rp 17,500.00 Rp 35,000.00 3/30/2020 ugd 2 Rp 17,500.00 Rp 35,000.00
94 3/30/2020 alat nyamuk hit 2020 koordinator 1 biji Rp 170,000.00 Rp 170,000.00 3/30/2020 ugd 1 Rp 170,000.00 Rp 170,000.00
95 3/30/2020 Pembersih so klin 2020 koordinator 1 biji Rp 12,000.00 Rp 12,000.00 3/30/2020 apotik 1 Rp 12,000.00 Rp 12,000.00
96 3/30/2020 pewangi stella 2020 koordinator 12 biji Rp 12,500.00 Rp 150,000.00 3/30/2020 poli-poli 12 Rp 12,500.00 Rp 150,000.00
97 3/30/2020 Obat nyamuk hit 2020 koordinator 2 biji Rp 17,500.00 Rp 35,000.00 3/30/2020 ugd 2 Rp 17,500.00 Rp 35,000.00
98 3/30/2020 kaca mata las 0 2020 koordinator 29 biji Rp 15,000.00 Rp 435,000.00 3/30/2020 covid 29 Rp 15,000.00 Rp 435,000.00
99 3/30/2020 jas hujan plevia 2020 koordinator 6 buah Rp 75,000.00 Rp 450,000.00 3/30/2020 covid 6 Rp 75,000.00 Rp 450,000.00
100 3/30/2020 pembersih sower 2020 koordinator 13 biji Rp 8,000.00 Rp 104,000.00 3/30/2020 poli-poli 13 Rp 8,000.00 Rp 104,000.00
101 4/15/2020 busa 0 2020 koordinator 2 buah Rp 15,000.00 Rp 30,000.00 4/15/2020 covid 2 Rp 15,000.00 Rp 30,000.00
102 4/15/2020 busa 0 2020 koordinator 1 buah Rp 39,000.00 Rp 39,000.00 4/15/2020 covid 1 Rp 39,000.00 Rp 39,000.00
103 4/15/2020 batrai ABC 2020 koordinator 1 biji Rp 200.00 Rp 200.00 4/15/2020 covid 1 Rp 200.00 Rp 200.00
104 4/15/2020 batrai ABC 2020 koordinator 3 biji Rp 15,900.00 Rp 47,700.00 4/15/2020 covid 3 Rp 15,900.00 Rp 47,700.00
105 4/17/2020 masker 0 2020 koordinator 1 dos Rp 200,000.00 Rp 200,000.00 4/17/2020 covid 1 Rp 200,000.00 Rp 200,000.00
106 4/28/2020 kantong plastik kresek 2020 koordinator 2 pak Rp 58,000.00 Rp 116,000.00 4/28/2020 covid 2 Rp 58,000.00 Rp 116,000.00
107 4/28/2020 pewangi stella 2020 koordinator 1 tube Rp 16,500.00 Rp 16,500.00 4/28/2020 ugd 1 Rp 16,500.00 Rp 16,500.00
108 4/28/2020 plastik cup 2020 koordinator 3 pak Rp 30,000.00 Rp 90,000.00 4/28/2020 laborat 3 Rp 30,000.00 Rp 90,000.00
keranjan
109 4/28/2020 rak 2020 koordinator 1 biji Rp 8,500.00 Rp 8,500.00 4/28/2020 tu 1 Rp 8,500.00 Rp 8,500.00
g
110 4/28/2020 sapu berlian 2020 koordinator 2 biji Rp 25,000.00 Rp 50,000.00 4/28/2020 ugd 2 Rp 25,000.00 Rp 50,000.00
111 4/28/2020 gelas 0 2020 koordinator 4 biji Rp 10,000.00 Rp 40,000.00 4/28/2020 gigi 4 Rp 10,000.00 Rp 40,000.00
112 4/28/2020 sendok makan 0 2020 koordinator 3 pak Rp 15,000.00 Rp 45,000.00 4/28/2020 ugd 3 Rp 15,000.00 Rp 45,000.00
113 4/28/2020 plastik roll 0 2020 koordinator 1 roll Rp 28,000.00 Rp 28,000.00 4/28/2020 ugd 1 Rp 28,000.00 Rp 28,000.00
114 4/28/2020 kantong plastik elip 2020 koordinator 20 pak Rp 2,000.00 Rp 40,000.00 4/28/2020 apotek 20 Rp 2,000.00 Rp 40,000.00
115 4/28/2020 kantong plastik 1kg 2020 koordinator 12 pak Rp 8,500.00 Rp 102,000.00 4/28/2020 apotek 12 Rp 8,500.00 Rp 102,000.00
116 4/28/2020 pembersih kanebo 2020 koordinator 2 biji Rp 17,500.00 Rp 35,000.00 4/28/2020 poned 2 Rp 17,500.00 Rp 35,000.00
117 4/28/2020 sapu berlian 2020 koordinator 2 biji Rp 25,000.00 Rp 50,000.00 4/28/2020 ugd 2 Rp 25,000.00 Rp 50,000.00
kemocen
118 4/28/2020 pembersih 2020 koordinator 1 biji Rp 25,000.00 Rp 25,000.00 4/28/2020 ugd 1 Rp 25,000.00 Rp 25,000.00
g
119 4/28/2020 kantong plastik kresek 2020 koordinator 2 pak Rp 20,000.00 Rp 40,000.00 4/28/2020 ugd 2 Rp 20,000.00 Rp 40,000.00
120 4/28/2020 kantong plastik kresek 2020 koordinator 2 pak Rp 20,000.00 Rp 40,000.00 4/28/2020 poned 2 Rp 20,000.00 Rp 40,000.00
121 4/28/2020 kantong plastik kresek 2020 koordinator 1 pak Rp 8,500.00 Rp 8,500.00 4/28/2020 gizi 1 Rp 8,500.00 Rp 8,500.00
sapu
122 4/28/2020 pembersih 2020 koordinator 2 biji Rp 25,000.00 Rp 50,000.00 4/28/2020 pustu 2 Rp 25,000.00 Rp 50,000.00
berlian
123 4/28/2020 pembersih sapu lidi 2020 koordinator 1 biji Rp 15,000.00 Rp 15,000.00 4/28/2020 ugd 1 Rp 15,000.00 Rp 15,000.00
124 4/28/2020 alat kebersihan sulak 2020 koordinator 1 biji Rp 25,000.00 Rp 25,000.00 4/28/2020 ugd 1 Rp 25,000.00 Rp 25,000.00
127 4/28/2020 pembersih stella 2020 koordinator 50 biji Rp 9,500.00 Rp 475,000.00 4/28/2020 poli-poli 50 Rp 9,500.00 Rp 475,000.00
128 4/28/2020 pembersih rinso 2020 koordinator 20 biji Rp 17,500.00 Rp 350,000.00 4/28/2020 ugd poned 20 Rp 17,500.00 Rp 350,000.00
129 4/28/2020 obat nyamuk hit 2020 koordinator 5 biji Rp 17,500.00 Rp 87,500.00 4/28/2020 ugd poned 5 Rp 17,500.00 Rp 87,500.00
130 4/28/2020 kapur barus swallow 2020 koordinator 4 biji Rp 20,000.00 Rp 80,000.00 4/28/2020 ugd poned 4 Rp 20,000.00 Rp 80,000.00
tisu
131 4/28/2020 pembersih 2020 koordinator 100 biji Rp 9,500.00 Rp 950,000.00 4/28/2020 poli-poli 100 Rp 9,500.00 Rp 950,000.00
paseo
133 4/28/2020 helm apd apd 2020 koordinator 3 biji Rp 130,000.00 Rp 390,000.00 4/28/2020 covid 3 Rp 130,000.00 Rp 390,000.00
134 4/28/2020 pembersih super pel 2020 koordinator 15 biji Rp 12,500.00 Rp 187,500.00 4/28/2020 poli-poli 15 Rp 12,500.00 Rp 187,500.00
sabun
dettol
tisu
paseo
137 4/28/2020 obat nyamuk hit 2020 koordinator 3 biji Rp 17,500.00 Rp 52,500.00 4/28/2020 ugd poned 3 Rp 17,500.00 Rp 52,500.00
138 4/28/2020 kapur barus swallow 2020 koordinator 1 biji Rp 20,000.00 Rp 20,000.00 4/28/2020 ugd 1 Rp 20,000.00 Rp 20,000.00
139 4/28/2020 sabun pembersih dettol 2020 koordinator 10 biji Rp 32,500.00 Rp 325,000.00 4/28/2020 poli-poli 10 Rp 32,500.00 Rp 325,000.00
140 4/28/2020 desinfektan vixal 2020 koordinator 15 biji Rp 15,000.00 Rp 225,000.00 4/28/2020 ugd 15 Rp 15,000.00 Rp 225,000.00
141 4/28/2020 desinfektan venis 2020 koordinator 10 biji Rp 23,000.00 Rp 230,000.00 4/28/2020 laborat 10 Rp 23,000.00 Rp 230,000.00
142 4/28/2020 pewangi stella 2020 koordinator 10 tube Rp 17,500.00 Rp 175,000.00 4/28/2020 poli-poli 10 Rp 17,500.00 Rp 175,000.00
tisu
paseo
144 4/28/2020 sabun pembersih lifeboy 2020 koordinator 5 biji Rp 17,000.00 Rp 85,000.00 4/28/2020 ugd 5 Rp 17,000.00 Rp 85,000.00
145 4/28/2020 desinfektan bayclin 2020 koordinator 1 tube Rp 17,500.00 Rp 17,500.00 4/28/2020 poned 1 Rp 17,500.00 Rp 17,500.00
146 4/28/2020 desinfektan bayclin 2020 koordinator 10 tube Rp 23,000.00 Rp 230,000.00 4/28/2020 poned 10 Rp 23,000.00 Rp 230,000.00
147 4/28/2020 desinfektan venis 2020 koordinator 1 tube Rp 9,500.00 Rp 9,500.00 4/28/2020 laborat 1 Rp 9,500.00 Rp 9,500.00
148 4/28/2020 pewangi stella 2020 koordinator 45 biji Rp 12,500.00 Rp 562,500.00 4/28/2020 poli-poli 45 Rp 12,500.00 Rp 562,500.00
149 5/28/2020 alat makan 0 2020 koordinator 12 biji Rp 70,000.00 Rp 840,000.00 5/28/2020 ugd 12 Rp 70,000.00 Rp 840,000.00
150 5/28/2020 gelas 0 2020 koordinator 200 biji Rp 270.00 Rp 54,000.00 5/28/2020 ugd 200 Rp 270.00 Rp 54,000.00
151 5/28/2020 sendok 0 2020 koordinator 200 biji Rp 150.00 Rp 30,000.00 5/28/2020 ugd 200 Rp 150.00 Rp 30,000.00
152 5/28/2020 rol plastik 0 2020 koordinator 1 roll Rp 28,000.00 Rp 28,000.00 5/28/2020 ugd 1 Rp 28,000.00 Rp 28,000.00
153 5/28/2020 sepatu 0 2020 koordinator 4 buah Rp 60,000.00 Rp 240,000.00 5/28/2020 covid 4 Rp 60,000.00 Rp 240,000.00
154 5/28/2020 jas hujan 0 2020 koordinator 2 lusin Rp 350,000.00 Rp 700,000.00 5/28/2020 covid 2 Rp 350,000.00 Rp 700,000.00
155 5/28/2020 kantong plastik 1kg 2020 koordinator 8 pak Rp 8,500.00 Rp 68,000.00 5/28/2020 apotek 8 Rp 8,500.00 Rp 68,000.00
156 5/28/2020 kantong plastik pop es 2020 koordinator 20 pak Rp 5,000.00 Rp 100,000.00 5/28/2020 apotek 20 Rp 5,000.00 Rp 100,000.00
157 5/28/2020 kantong plastik kresek 2020 koordinator 5 pak Rp 20,000.00 Rp 100,000.00 5/28/2020 laborat 5 Rp 20,000.00 Rp 100,000.00
159 5/28/2020 perlak 0 2020 koordinator 1 1m Rp 87,000.00 Rp 87,000.00 5/28/2020 ugd 1 Rp 87,000.00 Rp 87,000.00
160 5/28/2020 pemb sikat 2020 koordinator 1 biji Rp 20,000.00 Rp 20,000.00 5/28/2020 poned 1 Rp 20,000.00 Rp 20,000.00
161 5/28/2020 plastik klip 2020 koordinator 10 pak Rp 2,000.00 Rp 20,000.00 5/28/2020 apotek 10 Rp 2,000.00 Rp 20,000.00
162 5/28/2020 pembersih pel 2 macan 2020 koordinator 1 biji Rp 35,000.00 Rp 35,000.00 5/28/2020 poned 1 Rp 35,000.00 Rp 35,000.00
163 5/28/2020 kantong plastik klip 2020 koordinator 10 pak Rp 5,000.00 Rp 50,000.00 5/28/2020 apotek 10 Rp 5,000.00 Rp 50,000.00
164 5/28/2020 semprotan nagata 2020 koordinator 10 biji Rp 16,500.00 Rp 165,000.00 5/28/2020 apotek 10 Rp 16,500.00 Rp 165,000.00
165 5/28/2020 kantong plastik pres 2020 koordinator 1 pak Rp 146,000.00 Rp 146,000.00 5/28/2020 ugd 1 Rp 146,000.00 Rp 146,000.00
166 5/28/2020 plester pres 2020 koordinator 3 pak Rp 10,000.00 Rp 30,000.00 5/28/2020 ugd 3 Rp 10,000.00 Rp 30,000.00
167 5/28/2020 pengharum stella 2020 koordinator 6 biji Rp 12,500.00 Rp 75,000.00 5/28/2020 poli-poli 6 Rp 12,500.00 Rp 75,000.00
168 5/28/2020 pembersih dettol 2020 koordinator 20 pak Rp 5,500.00 Rp 110,000.00 5/28/2020 poli-poli 20 Rp 5,500.00 Rp 110,000.00
169 5/28/2020 desinfektan bayclin 2020 koordinator 3 tube Rp 38,000.00 Rp 114,000.00 5/28/2020 laborat 3 Rp 38,000.00 Rp 114,000.00
170 5/28/2020 pewangi swallow 2020 koordinator 6 biji Rp 20,000.00 Rp 120,000.00 5/28/2020 poli-poli 6 Rp 20,000.00 Rp 120,000.00
171 5/28/2020 pembersih lifeboy 2020 koordinator 10 biji Rp 3,500.00 Rp 35,000.00 5/28/2020 poli-poli 10 Rp 3,500.00 Rp 35,000.00
lifeboy
cair
173 5/28/2020 minyak 0 2020 koordinator 1 tube Rp 37,900.00 Rp 37,900.00 5/28/2020 ugd 1 Rp 37,900.00 Rp 37,900.00
174 5/28/2020 jas hujan 0 2020 koordinator 10 biji Rp 40,000.00 Rp 400,000.00 5/28/2020 covid 10 Rp 40,000.00 Rp 400,000.00
175 5/28/2020 kantong plastik 0 2020 koordinator 7 biji Rp 6,000.00 Rp 42,000.00 5/28/2020 apotek 7 Rp 6,000.00 Rp 42,000.00
176 5/28/2020 lem 0 2020 koordinator 1 biji Rp 10,000.00 Rp 10,000.00 5/28/2020 apotek 1 Rp 10,000.00 Rp 10,000.00
177 5/28/2020 kawat 0 2020 koordinator 1 meter Rp 6,000.00 Rp 6,000.00 5/28/2020 ugd 1 Rp 6,000.00 Rp 6,000.00
178 5/28/2020 triliun 0 2020 koordinator 5 biji Rp 23,000.00 Rp 115,000.00 5/28/2020 ugd 5 Rp 23,000.00 Rp 115,000.00
179 5/28/2020 plastik 0 2020 koordinator 4 pak Rp 2,000.00 Rp 8,000.00 5/28/2020 apotek 4 Rp 2,000.00 Rp 8,000.00
180 5/28/2020 plastik 0 2020 koordinator 14 pak Rp 2,500.00 Rp 35,000.00 5/28/2020 apotek 14 Rp 2,500.00 Rp 35,000.00
lifeboy
181 6/20/2020 pembersih 2020 koordinator 3 tube Rp 22,500.00 Rp 67,500.00 6/20/2020 poli-poli 3 Rp 22,500.00 Rp 67,500.00
cair
182 6/20/2020 desinfektan bayclin 2020 koordinator 3 tube Rp 12,500.00 Rp 37,500.00 6/20/2020 laborat 3 Rp 12,500.00 Rp 37,500.00
sabun
183 6/20/2020 pembersih cuci 2020 koordinator 2 biji Rp 12,000.00 Rp 24,000.00 6/20/2020 ugd 2 Rp 12,000.00 Rp 24,000.00
piring
tisu
paseo
185 6/20/2020 pembersih keset 2020 koordinator 1 biji Rp 23,000.00 Rp 23,000.00 6/20/2020 ugd 1 Rp 23,000.00 Rp 23,000.00
186 6/20/2020 sendok atum 0 2020 koordinator 2 pak Rp 15,000.00 Rp 30,000.00 6/20/2020 ugd 2 Rp 15,000.00 Rp 30,000.00
187 6/20/2020 gelas tutup 0 2020 koordinator 4 buah Rp 13,500.00 Rp 54,000.00 6/20/2020 ugd 4 Rp 13,500.00 Rp 54,000.00
188 6/20/2020 semprotan 0 2020 koordinator 5 biji Rp 14,000.00 Rp 70,000.00 6/20/2020 apotek 5 Rp 14,000.00 Rp 70,000.00
189 6/20/2020 kantong plastik kresek 2020 koordinator 5 biji Rp 20,000.00 Rp 100,000.00 6/20/2020 ugd poned 5 Rp 20,000.00 Rp 100,000.00
190 6/20/2020 kantong plastik kresek h 2020 koordinator 5 pak Rp 20,000.00 Rp 100,000.00 6/20/2020 ugd poned 5 Rp 20,000.00 Rp 100,000.00
agar-
191 6/20/2020 gelas 2020 koordinator 5 pak Rp 6,500.00 Rp 32,500.00 6/20/2020 ugd 5 Rp 6,500.00 Rp 32,500.00
agar
192 6/20/2020 seprei 0 2020 koordinator 1 biji Rp 85,000.00 Rp 85,000.00 6/20/2020 poned 1 Rp 85,000.00 Rp 85,000.00
JUMLAH 1812 Rp 18,054,600.00 1812 Rp 18,054,600.00

KABUPATEN : NGAWI
JENIS BELANJA : ALAT LISTRIK

Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
1 2/28/2020 kabel nym 0 2020 KOORDINATOR 22 meter Rp 12,000.00 Rp 264,000 2/28/2020 rajal 22 Rp 12,000 Rp 264,000
2 2/28/2020 kabel nya 0 2020 KOORDINATOR 2 rol Rp 150,000.00 Rp 300,000 2/28/2020 rajal 2 Rp 150,000 Rp 300,000
3 2/28/2020 mcb 2 ap 0 2020 KOORDINATOR 1 pcs Rp 40,000.00 Rp 40,000 2/28/2020 rajal 1 Rp 40,000 Rp 40,000
4 2/28/2020 paralon 0 2020 KOORDINATOR 5 biji Rp 5,000.00 Rp 25,000 2/28/2020 rajal 5 Rp 5,000 Rp 25,000
5 2/28/2020 saklar 0 2020 KOORDINATOR 2 biji Rp 12,500.00 Rp 25,000 2/28/2020 rajal 2 Rp 12,500 Rp 25,000
6 2/28/2020 lamou 19 waat philip 2020 KOORDINATOR 2 biji Rp 95,000.00 Rp 190,000 2/28/2020 rajal 2 Rp 95,000 Rp 190,000
7 2/28/2020 clem visicom 0 2020 KOORDINATOR 1 biji Rp 35,000.00 Rp 35,000 2/28/2020 rajal 1 Rp 35,000 Rp 35,000
8 2/28/2020 stop kontak 0 2020 KOORDINATOR 2 biji Rp 12,500.00 Rp 25,000 2/28/2020 rajal 2 Rp 12,500 Rp 25,000
panasoni
9 2/28/2020 sanyo 2020 KOORDINATOR 1 unit Rp 470,000.00 Rp 470,000 2/28/2020 rajal 1 Rp 470,000 Rp 470,000
c
10 2/28/2020 kabel 0 2020 KOORDINATOR 10 meter Rp 5,000.00 Rp 50,000 2/28/2020 rajal 10 Rp 5,000 Rp 50,000
11 2/28/2020 keni 0 2020 KOORDINATOR 10 biji Rp 3,000.00 Rp 30,000 2/28/2020 rajal 10 Rp 3,000 Rp 30,000
12 2/28/2020 solatip 0 2020 KOORDINATOR 2 biji Rp 2,500.00 Rp 5,000 2/28/2020 rajal 2 Rp 2,500 Rp 5,000
13 2/28/2020 solasi 0 2020 KOORDINATOR 1 biji Rp 7,000.00 Rp 7,000 2/28/2020 rajal 1 Rp 7,000 Rp 7,000
14 2/28/2020 paralon 0 2020 KOORDINATOR 1 biji Rp 23,000.00 Rp 23,000 2/28/2020 rajal 1 Rp 23,000 Rp 23,000
15 2/28/2020 saklar 0 2020 KOORDINATOR 1 biji Rp 12,000.00 Rp 12,000 2/28/2020 rajal 1 Rp 12,000 Rp 12,000
16 2/28/2020 lem 0 2020 KOORDINATOR 1 biji Rp 10,000.00 Rp 10,000 2/28/2020 rajal 1 Rp 10,000 Rp 10,000
17 3/14/2020 lampu 6 waat philip 2020 KOORDINATOR 3 biji Rp 40,000.00 Rp 120,000 3/14/2020 rajal 3 Rp 40,000 Rp 120,000
19 3/20/2020 lampu philip 2020 KOORDINATOR 2 biji Rp 162,000.00 Rp 324,000 3/20/2020 rajal 2 Rp 162,000 Rp 324,000
20 3/30/2020 stavolt 0 2020 KOORDINATOR 1 unit Rp 625,000.00 Rp 625,000 3/30/2020 rajal 1 Rp 625,000 Rp 625,000
kasugaw
24 4/6/2020 stavolt 500va 2020 KOORDINATOR 1 unit Rp 195,000.00 Rp 195,000 4/6/2020 rajal 1 Rp 195,000 Rp 195,000
a
25 4/14/2020 bell otomatis 0 2020 KOORDINATOR 1 unit Rp 70,000.00 Rp 70,000 4/14/2020 rajal 1 Rp 70,000 Rp 70,000
26 5/6/2020 kabel tis 0 2020 KOORDINATOR 1 gulung Rp 20,000.00 Rp 20,000 5/6/2020 rajal 1 Rp 20,000 Rp 20,000
27 5/5/2020 baterai remot 0 2020 KOORDINATOR 1 biji Rp 5,000.00 Rp 5,000 5/5/2020 rajal 1 Rp 5,000 Rp 5,000
28 5/5/2020 baterai jam 0 2020 KOORDINATOR 4 biji Rp 2,500.00 Rp 10,000 5/5/2020 rajal 4 Rp 2,500 Rp 10,000
29 6/6/2020 kabel telepon 0 2020 KOORDINATOR 10 meter Rp 2,300.00 Rp 23,000 6/6/2020 rajal 10 Rp 2,300 Rp 23,000
30 6/6/2020 kabel tis 0 2020 KOORDINATOR 1 gulung Rp 13,000.00 Rp 13,000 6/6/2020 rajal 1 Rp 13,000 Rp 13,000
31 6/6/2020 pitingan 0 2020 KOORDINATOR 1 biji Rp 5,000.00 Rp 5,000 6/6/2020 rajal 1 Rp 5,000 Rp 5,000
JUMLAH Rp 3,191,000.00 Rp 3,191,000.00

NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017

KABUPATEN : NGAWI
JENIS BELANJA : Bahan Kimia Laborat

Dikeluarkan/ 0 0
Kepada Barang
Penyerahan
1 2 3 4 5 6 7 8 9 10 = 8-9 11 12 13 14 15 16 17 = 15*16 18
On Call
1 1/23/2020 Strip Gula 2020 koordinator 12 Box Rp 150,700.00 Rp 1,808,400.00 1/23/2020 LAB 12 Rp 150,700.00 Rp 1,808,400.00
Plus
Easy
2 1/23/2020 Strip As Urat 2020 koordinator 1 Box Rp 126,500.00 Rp 126,500.00 1/23/2020 LAB 1 Rp 126,500.00 Rp 126,500.00
Touch
3 1/23/2020 Strip Kolersterol Mission 2020 koordinator 2 Box Rp 522,500.00 Rp 1,045,000.00 1/23/2020 LAB 2 Rp 522,500.00 Rp 1,045,000.00
4 1/23/2020 Strip HB Quicek 2020 koordinator 1 Box Rp 577,500.00 Rp 577,500.00 1/23/2020 LAB 1 Rp 577,500.00 Rp 577,500.00
5 1/23/2020 Alkohol Swab One Med 2020 koordinator 10 Box Rp 24,200.00 Rp 242,000.00 1/23/2020 LAB 10 Rp 24,200.00 Rp 242,000.00
6 1/23/2020 Widal Biotek 2020 koordinator 1 Set Rp 696,000.00 Rp 696,000.00 1/23/2020 LAB 1 Rp 696,000.00 Rp 696,000.00
7 1/23/2020 Kartu golongan darah 0 2020 koordinator 2 pack Rp 71,500.00 Rp 143,000.00 1/23/2020 LAB 2 Rp 71,500.00 Rp 143,000.00
On call
8 1/23/2020 Strip Gula 2020 koordinator 2 Box Rp 121,000.00 Rp 242,000.00 1/23/2020 LAB 2 Rp 121,000.00 Rp 242,000.00
redi
9 2/22/2020 Stromalizer sysmex 2020 koordinator 1 unit Rp 1,611,500.00 Rp 1,611,500.00 2/22/2020 LAB 1 Rp 1,611,500.00 Rp 1,611,500.00
10 2/21/2020 Control Set sysmex 2020 koordinator 1 unit Rp 1,210,000.00 Rp 1,210,000.00 2/21/2020 LAB 1 Rp 1,210,000.00 Rp 1,210,000.00
11 2/21/2020 Cell pack sysmex 2020 koordinator 1 unit Rp 2,420,000.00 Rp 2,420,000.00 2/21/2020 LAB 1 Rp 2,420,000.00 Rp 2,420,000.00
12 2/24/2020 Tabung K3EDTA Voculab 2020 koordinator 3 Box Rp 198,000.00 Rp 594,000.00 2/24/2020 LAB 3 Rp 198,000.00 Rp 594,000.00
13 2/24/2020 Blood Lancet One Med 2020 koordinator 5 Box Rp 41,800.00 Rp 209,000.00 2/24/2020 LAB 5 Rp 41,800.00 Rp 209,000.00
14 2/24/2020 Thermal paper 0 2020 koordinator 8 Roll Rp 38,500.00 Rp 308,000.00 2/24/2020 LAB 8 Rp 38,500.00 Rp 308,000.00
15 2/24/2020 Kartu golongan darah 0 2020 koordinator 5 pack Rp 71,500.00 Rp 357,500.00 2/24/2020 LAB 5 Rp 71,500.00 Rp 357,500.00
On Call
Plus
17 2/24/2020 Strip Hb Quicek 2020 koordinator 1 Box Rp 577,500.00 Rp 577,500.00 2/24/2020 LAB 1 Rp 577,500.00 Rp 577,500.00
Easy
18 2/24/2020 Strip UA 2020 koordinator 2 Box Rp 126,500.00 Rp 253,000.00 2/24/2020 LAB 2 Rp 126,500.00 Rp 253,000.00
Touch
19 2/24/2020 Strip Kolersterol Mission 2020 koordinator 1 Box Rp 522,500.00 Rp 522,500.00 2/24/2020 LAB 1 Rp 522,500.00 Rp 522,500.00
20 2/24/2020 Pleserin One Med 2020 koordinator 4 Box Rp 49,300.00 Rp 197,200.00 2/24/2020 LAB 4 Rp 49,300.00 Rp 197,200.00
21 2/24/2020 Tisue lensa 0 2020 koordinator 5 Roll Rp 33,000.00 Rp 165,000.00 2/24/2020 LAB 5 Rp 33,000.00 Rp 165,000.00
22 2/24/2020 R// Widal Biotek 2020 koordinator 1 Set Rp 695,200.00 Rp 695,200.00 2/24/2020 LAB 1 Rp 695,200.00 Rp 695,200.00
23 2/24/2020 R// Gol darah D 0 2020 koordinator 1 Tube Rp 176,000.00 Rp 176,000.00 2/24/2020 LAB 1 Rp 176,000.00 Rp 176,000.00
24 2/24/2020 Yellow TIP 0 2020 koordinator 1 Box1 Rp 140,250.00 Rp 140,250.00 2/24/2020 LAB 1 Rp 140,250.00 Rp 140,250.00
25 2/24/2020 Cell pack sysmex 2020 koordinator 1 unit Rp 2,420,000.00 Rp 2,420,000.00 2/24/2020 LAB 1 Rp 2,420,000.00 Rp 2,420,000.00
26 2/24/2020 Cell Clean sysmex 2020 koordinator 1 Box Rp 1,479,500.00 Rp 1,479,500.00 2/24/2020 LAB 1 Rp 1,479,500.00 Rp 1,479,500.00
27 4/13/2020 Strip Hb Quicek 2020 koordinator 2 Box Rp 577,500.00 Rp 1,155,000.00 4/13/2020 LAB 2 Rp 577,500.00 Rp 1,155,000.00
Easy
28 4/13/2020 Strip As Urat 2020 koordinator 2 Box Rp 126,500.00 Rp 253,000.00 4/13/2020 LAB 2 Rp 126,500.00 Rp 253,000.00
Touch
29 4/13/2020 Strip Kolersterol Mission 2020 koordinator 2 Box Rp 522,500.00 Rp 1,045,000.00 4/13/2020 LAB 2 Rp 522,500.00 Rp 1,045,000.00
On Call
Plus
31 4/13/2020 Tes Kehamilan One Med 2020 koordinator 1 Box Rp 141,900.00 Rp 141,900.00 4/13/2020 LAB 1 Rp 141,900.00 Rp 141,900.00
33 4/13/2020 Golongan Darah A 0 2020 koordinator 1 Tube Rp 126,500.00 Rp 126,500.00 4/13/2020 LAB 1 Rp 126,500.00 Rp 126,500.00
34 4/13/2020 Golongan Darah B 0 2020 koordinator 1 Tube Rp 126,500.00 Rp 126,500.00 4/13/2020 LAB 1 Rp 126,500.00 Rp 126,500.00
35 4/13/2020 Golongan Darah AB 0 2020 koordinator 1 Tube Rp 126,500.00 Rp 126,500.00 4/13/2020 LAB 1 Rp 126,500.00 Rp 126,500.00
36 4/1/2020 Cell Pack sysmex 2020 koordinator 1 Unit Rp 2,420,000.00 Rp 2,420,000.00 4/1/2020 LAB 1 Rp 2,420,000.00 Rp 2,420,000.00
37 4/1/2020 Cell Clean sysmex 2020 koordinator 1 Unit Rp 1,611,500.00 Rp 1,611,500.00 4/1/2020 LAB 1 Rp 1,611,500.00 Rp 1,611,500.00
38 5/15/2020 Blood Lancet One Med 2020 koordinator 5 Box Rp 41,800.00 Rp 209,000.00 5/15/2020 LAB 5 Rp 41,800.00 Rp 209,000.00
40 5/15/2020 Strip Hb Quicek 2020 koordinator 1 Box Rp 577,500.00 Rp 577,500.00 5/15/2020 LAB 1 Rp 577,500.00 Rp 577,500.00
41 5/15/2020 Urin Strip verify Verify 2020 koordinator 1 Box Rp 170,500.00 Rp 170,500.00 5/15/2020 LAB 1 Rp 170,500.00 Rp 170,500.00
On Call
42 5/15/2020 Strip Gula 2020 koordinator 5 Roll Rp 150,700.00 Rp 753,500.00 5/15/2020 LAB 5 Rp 150,700.00 Rp 753,500.00
Plus
43 5/15/2020 Strip Kolesterol Mission 2020 koordinator 2 Box Rp 522,500.00 Rp 1,045,000.00 5/15/2020 LAB 2 Rp 522,500.00 Rp 1,045,000.00
Easy
44 5/15/2020 Strip Asam Urat 2020 koordinator 1 Box Rp 126,500.00 Rp 126,500.00 5/15/2020 LAB 1 Rp 126,500.00 Rp 126,500.00
Touch
45 5/15/2020 Tabung K3EDTA Vaculab 2020 koordinator 4 Box Rp 198,000.00 Rp 792,000.00 5/15/2020 LAB 4 Rp 198,000.00 Rp 792,000.00
46 6/8/2020 Lancet One Med 2020 koordinator 20 Box Rp 41,800.00 Rp 836,000.00 6/8/2020 LAB 20 Rp 41,800.00 Rp 836,000.00
On call
plus
On Call
redi
50 6/8/2020 Kolesterol Mission 2020 koordinator 2 Box Rp 522,500.00 Rp 1,045,000.00 6/8/2020 LAB 2 Rp 522,500.00 Rp 1,045,000.00
Easy
51 6/8/2020 Asam Urat 2020 koordinator 2 Box Rp 126,500.00 Rp 253,000.00 6/8/2020 LAB 2 Rp 126,500.00 Rp 253,000.00
Touch
52 6/8/2020 Strip Hb Quicek 2020 koordinator 2 Box Rp 577,500.00 Rp 1,155,000.00 6/8/2020 LAB 2 Rp 577,500.00 Rp 1,155,000.00
JUMLAH Rp 36,233,450.00 Rp 36,233,450.00


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017
PENGGUNA BARANG
OPD
PENGURUS BARANG
OPD
NAMA
NIP. NAMA
NIP.
KARTU PERSEDIAAN BARANG

KABUPATEN : NGAWI
Nama Barang : pakaian dinas
Satuan : potong
Kartu No
Spesifikasi
No/Tanggal Surat Dasar Barang-barang Jumlah Harga Barang Yang Diterima/Yang Dikeluarkan/Sisa
Ketera
No. Uraian Masuk/ Keluar/ Harga Satuan
Penerimaan Pengeluaran Satuan Sisa Berjumlah Berkurang Sisa ngan
Terima Penyerahan
1 2 3 4 5 6 7 8 = 6-7 9 10 11 12 =10-11 13
1 3/30/2020 3/30/2020 seragam skort biru potong 71 71 - Rp 115,000.00 Rp 8,165,000.00 Rp 8,165,000.00 Rp -
seragam skort
4/28/2020 4/28/2020 potong 71 71 - Rp 115,000.00 Rp 8,165,000.00 Rp 8,165,000.00 Rp -
kuning
5/28/2020 5/28/2020 seragam skort merah potong 30 30 - Rp 120,000.00 Rp 3,600,000.00 Rp 3,600,000.00 Rp -
Rp -
JUMLAH 172 172 0 Rp 19,930,000.00 Rp 19,930,000.00 Rp -


NIP. 19700308 200312 2 003 NIP. 19850630 201101 2 017
KABUPATEN : NGAWI
REKAPITULASI KARTU PERSEDIAAN BARANG

PERIODE 01-01-2019 s/d 31-12-2019
SALDO MUTASI SALDO

Per Tanggal : 31-12-2018 Periode : 01-01-2019 s/d 31-12-2019 Per Tanggal : 31-12-2019
No. Kode Barang Uraian Barang Bertambah Berkurang Keterangan
Jumlah Barang Jumlah Harga Jumlah Barang Jumlah Harga
Jumlah Barang Jumlah Harga Jumlah Barang Jumlah Harga
1 2 3 4 5 6 7 8 9 10=6-8+4 11=7-9+5 12
9.1.2.01. Beban Bahan Pakai Habis
1 9.1.2.01.001. Beban Persediaan Alat Tulis Kantor 320 8,516,150.00 320 8,516,150.00 0 -
Beban Persediaan Dokumen/
2 9.1.2.01.002. 0 -
Administrasi Tender
Beban Persediaan Alat listrik dan
3 9.1.2.01.003. 96 3,191,000.00 96 3,191,000.00 0
Elektronik
Beban Persediaan Perangko, Meterai
4 9.1.2.01.004. 332 1,446,000.00 332 1,446,000.00 0 -
dan Benda Pos lainnya
Beban Persediaan Bahan Bakar, Minyak
5 9.1.2.01.005. 600 4,590,000.00 600 4,590,000.00 0 -
dan Gas
Beban Persediaan Pengisian Tabung
6 9.1.2.01.006. 0 -
Pemadam Kebakaran
Beban Persediaan Pengisian Tabung
7 9.1.2.01.007. 0 -
Gas
Beban Persediaan Peralatan Kebersihan
8 9.1.2.01.008. 1,812 18,054,600.00 1,812 18,054,600.00
& Bahan Pembersih
Beban Persediaan Perlengkapan
9 9.1.2.01.009. Sosialisasi, Penyuluhan, Pelatihan, 0 -
Workshop
Beban Persediaan Peralatan dan
10 9.1.2.01.010. 0 -
Perlengkapan Kantor
Beban Persediaan Kebutuhan Rumah
11 9.1.2.01.011. 0 -
Tangga Pejabat Negara
12 9.1.2.01.012. Beban Persediaan Sarana Lomba 0 -
Beban Persediaan Bahan Perlengkapan
13 9.1.2.01.013. 0 -
Medis
Beban Persediaan Peralatan Kerja
14 9.1.2.01.014. 0 -
Kebinamargaan
15 9.1.2.01.015. 0 -
Promosi Pariwisata
Beban Persediaan Peralatan dan
16 9.1.2.01.016. 0 -
Perlengkapan Panti
Beban Persediaan perlengkapan
17 9.1.2.01.017. 0 -
keamanan Lalu lintas
Beban Persediaan Peralatan
18 9.1.2.01.018 0 -
Pembelajaran
9.1.2.02. Beban Bahan/Material
Beban Persediaan Bahan Baku
1 9.1.2.02.001. 0 -
Bangunan
2 9.1.2.02.002. Beban Persediaan Bahan/Bibit Tanaman 0 -
3 9.1.2.02.003. Beban Persediaan Bibit Ternak 0 -
4 9.1.2.02.004. Beban Persediaan Bahan Obat-obatan 0 -
5 9.1.2.02.005. Beban Persediaan Bahan Kimia laborat 182 36,233,450.00 182 36,233,450.00 0 -
Beban Persediaan Bahan
6 9.1.2.02.006. 0 -
Praktek/Peraga Percontohan
Beban Persediaan Bahan Makanan
7 9.1.2.02.007. 0 -
Pokok
Beban Persediaan Sarana dan
8 9.1.2.02.008. 0 -
Prasarana Lomba
Beban Persediaan Sarana & Prasarana
9 9.1.2.02.009. 0 -
Produksi
Beban Persediaan Bahan Seni dan
10 9.1.2.02.010. 0 -
Budaya
11 9.1.2.02.011. 0 -
Olahraga
Beban Persediaan Bahan Bacaan dan
12 9.1.2.02.012. 0 -
Peraturan Perundang-undangan
Beban Persediaan Barang Bercorak
13 9.1.2.02.013. 0 -
Kesenian
Beban Persediaan Sarana dan
14 9.1.2.02.014. 0 -
Prasarana Pameran/Festival
15 9.1.2.02.015. Beban Persediaan Papan Informasi 0 -
Beban Persediaan Perlengkapan Korban
16 9.1.2.02.016. 0 -
Bencana
17 9.1.2.02.017. Beban Persediaan Barang Penghargaan 0 -
18 9.1.2.02.018. 1 32,500.00 1 32,500.00 0 -
Ruangan Pasien
19 9.1.2.02.019. 0 -
Tera/Tera Ulang
Beban Persediaan Bahan Pemeliharaan
20 9.1.2.02.020. 0 -
Tanaman
Beban Persediaan Patok Pembatas
21 9.1.2.02.021 0 -
Tanah
Beban Persediaan Alat Bantu Bagi
22 9.1.2.02.022. 0 -
Penyandang Disabilitas
Beban Persediaan Bahan Perlengkapan
23 9.1.2.02.023. 0 -
Uji Kendaraan
Beban Persediaan Bahan Bermain dan
24 9.1.2.02.024 0 -
Bahan Belajar
25 9.1.2.02.025. Beban Persediaan Relokasi Pasar 0 -
26 9.1.2.02.026. Beban Persediaan Kotak Sampah 0 -

Beban Persediaan Perlengkapan Ruang
27 9.1.2.02.027. 0 -
Kelas
Beban Persediaan Perlengkapan Ruang
28 9.1.2.02.028. 0 -
Perpustakaan
29 9.1.2.02.029. 0 -
Laboratorium
9.1.2.03. Beban Cetak dan Penggandaan
1 9.1.2.03.001. Beban Persediaan Cetak 2,057 12,535,000.00 2,057 12,535,000.00 0 -
2 9.1.2.03.002. Beban Persediaan Penggandaan 16,216 4,160,500.00 16,216 4,160,500.00 0 -
9.1.2.04. Beban Makanan dan Minuman

Beban Persediaan Makanan dan
1 9.1.2.04.001. 0 -
Minuman harian pegawai
2 9.1.2.04.002. 716 12,180,000.00 716 12,180,000.00 0 -
Minuman Rapat
3 9.1.2.04.003. 0 -
Minuman Tamu
4 9.1.2.04.004. 1,696 8,480,000.00 1,696 8,480,000.00 0 -
Minuman Lembur
5 9.1.2.04.005. 2,268 22,680,000.00 2,268 22,680,000.00 0 -
Minuman Pasien
9.1.2.05. Beban Pakaian Dinas dan Atributnya
Beban Persediaan Pakaian Dinas KDH
1 9.1.2.05.001. 0 -
dan WKDH
Beban Persediaan Pakaian Sipil Harian
2 9.1.2.05.002. 0 -
(PSH)
Beban Persediaan Pakaian Sipil
3 9.1.2.05.003. 0 -
Lengkap
4 9.1.2.05.004. Beban Persediaan Pakaian Dinas Harian 0 -
Beban Persediaan Pakaian Dinas
5 9.1.2.05.005. 0 -
Upacara (PDU)
6 9.1.2.05.006. Beban Persediaan Pakaian Sipil Resmi 0 -
7 9.1.2.05.007. Beban Persediaan Atribut Kedinasan 0 -
9.1.2.06. Beban Pakaian Kerja

Beban Persediaan Pakaian Kerja
1 9.1.2.06.001. 172 19,930,000.00 172 19,930,000.00 0 -
Lapangan
Beban Pakaian Khusus dan Hari-hari
9.1.2.07.
Tertentu
1 9.1.2.07.001. Beban Persediaan Pakaian KORPRI 0 -
2 9.1.2.07.002. Beban Persediaan Pakaian Adat Daerah 0 -
3 9.1.2.07.003. Beban Persediaan Pakaian Batik 0 -
4 9.1.2.07.004. Beban Persediaan Pakaian Olahraga 0 -
9.1.2.08. Beban Barang dan Jasa Dana BOS

Beban Persediaan Barang dan Jasa
1 9.1.2.08.001. 0 -
Dana BOS SD
2 9.1.2.08.002. 0 -
Dana BOS SMP
9.1.2.09. Beban Barang dan Jasa BLUD
1 9.1.2.09.001. 0 -
BLUD Rumah Sakit
2 9.1.2.09.002. 0 -
BLUD Puskesmas
Jumlah 0 - 26,468 152,029,200.00 26,468 152,029,200.00 0 -
Catatan :
Nb : Bertambah :
Jumlah barang adl akumulasi dari total jumlah barang masuk pada Lap Persediaan
Jumlah harga adl akumulasi dari total jumlah harga masuk pada Lap Persediaan
Berkurang :
Jumlah barang adl akumulasi dari total jumlah barang keluar pada Lap Persediaan
Jumlah harga adl akumulasi dari total jumlah harga keluar pada Lap Persediaan
PENGGUNA BARANG PENGURUS BARANG

OPD OPD
NAMA
NAMA NIP.
NIP.
KABUPATEN : NGAWI
Dokumen /Faktur Dasar Penerimaan
No Terima Tgl. Dari

No Tgl Jenis Surat No
1 2 3 4 5 6 7
1 1/6/2020 gudang atk
10 1/30/2020 gudang atk
11 1/30/2020 gudang atk
12 2/27/2020 gudang atk
13 2/27/2020 gudang atk
14 2/27/2020 gudang atk
15 2/27/2020 gudang atk
16 2/27/2020 gudang atk
17 2/27/2020 gudang atk
18 2/27/2020 gudang atk
19 2/27/2020 gudang atk
20 2/27/2020 gudang atk
21 2/27/2020 gudang atk
22 2/27/2020 gudang atk
23 2/27/2020 gudang atk
24 2/27/2020 gudang atk
25 2/27/2020 gudang atk
26 2/27/2020 gudang atk
27 2/27/2020 gudang atk
28 2/27/2020 gudang atk
29 2/27/2020 gudang atk
30 2/27/2020 gudang atk
31 2/27/2020 gudang atk
32 2/27/2020 gudang atk
33 2/27/2020 gudang atk
34 2/27/2020 gudang atk
35 2/27/2020 gudang atk
36 2/27/2020 gudang atk
37 2/27/2020 gudang atk
38 2/27/2020 gudang atk
39 2/27/2020 gudang atk
40 3/30/2020 gudang atk
41 3/30/2020 gudang atk
42 3/30/2020 gudang atk
43 3/30/2020 gudang atk
44 3/30/2020 gudang atk
45 3/30/2020 gudang atk
46 3/30/2020 gudang atk
47 3/30/2020 gudang atk
48 3/30/2020 gudang atk
49 3/30/2020 gudang atk
50 3/30/2020 gudang atk
51 3/30/2020 gudang atk
52 3/30/2020 gudang atk
53 3/30/2020 gudang atk
54 3/30/2020 gudang atk
55 3/30/2020 gudang atk
56 3/30/2020 gudang atk
57 3/30/2020 gudang atk
58 3/30/2020 gudang atk
59 3/30/2020 gudang atk
60 3/30/2020 gudang atk
61 3/30/2020 gudang atk
62 3/22/2020 gudang atk
63 3/22/2020 gudang atk
64 3/22/2020 gudang atk
65 3/30/2020 gudang atk
66 4/14/2020 gudang atk
67 4/14/2020 gudang atk
68 4/28/2020 gudang atk
69 4/28/2020 gudang atk
70 4/28/2020 gudang atk
71 4/28/2020 gudang atk
72 4/28/2020 gudang atk
73 4/28/2020 gudang atk
74 4/28/2020 gudang atk
75 4/28/2020 gudang atk
76 4/28/2020 gudang atk
77 4/28/2020 gudang atk
78 4/28/2020 gudang atk
79 4/28/2020 gudang atk
80 4/28/2020 gudang atk
81 4/28/2020 gudang atk
82 4/28/2020 gudang atk
83 4/28/2020 gudang atk
84 4/28/2020 gudang atk
85 4/28/2020 gudang atk
86 4/28/2020 gudang atk
87 4/28/2020 gudang atk
88 4/28/2020 gudang atk
89 4/28/2020 gudang atk
90 4/28/2020 gudang atk
92 5/28/2020 gudang atk
93 5/28/2020 gudang atk
94 5/28/2020 gudang atk
95 5/28/2020 gudang atk
96 5/28/2020 gudang atk
97 5/28/2020 gudang atk
98 5/28/2020 gudang atk
100 6/10/2020 gudang atk
101 6/10/2020 gudang atk
102 6/10/2020 gudang atk
103 6/26/2020 gudang atk
104 6/26/2020 gudang atk
105 6/26/2020 gudang atk
106 6/26/2020 gudang atk
107 6/26/2020 gudang atk
108 6/26/2020 gudang atk
109 6/26/2020 gudang atk
110 6/26/2020 gudang atk
111 6/26/2020 gudang atk
112 6/26/2020 gudang atk
113 6/26/2020 gudang atk
114 6/26/2020 gudang atk
115 6/26/2020 gudang atk
116 6/26/2020 gudang atk
117 6/26/2020 gudang atk
118 6/26/2020 gudang atk
119 6/26/2020 gudang atk
120 6/26/2020 gudang atk
121 6/26/2020 gudang atk
122 6/26/2020 gudang atk
123 6/26/2020 gudang atk
124 6/26/2020 gudang atk
125 6/26/2020 gudang atk
126 6/26/2020 gudang atk
127 12/30/1899
128
129
0
0
0
0
0
0
0
0
JUMLAH
OPD : JAWA TIMUR

KABUPATEN : 2020
Dokumen /Faktur Dasar Penerimaan
No Terima Tgl. Dari

No Tgl Jenis Surat No
1 2 3 4 5 6 7
1 1/8/2020 koordinator
2 12/30/1899 0
3 12/30/1899 0
4 12/30/1899 0
5 12/30/1899 0
JUMLAH
PENGGUNA BARANG
OPD
NAMA
NIP.
LAPORAN SEMESTER TENTANG PENERIMAAN DAN PENGE
SEMESTER……………… TAHUN……
Buku Penerimaan
Banyaknya Nama Barang Harga Satuan Jml Harga

BA/ Srt. Penerimaan
No.
8 9 10 11 12
1 modem Rp 595,000.00 Rp 595,000.00 12/30/1899
1 spidol BM Rp 8,000.00 Rp 8,000.00
1 lakban Rp 15,000.00 Rp 15,000.00
3 buku tulis isi 38 Rp 25,000.00 Rp 75,000.00
6 buku folio isi 100 Rp 15,000.00 Rp 90,000.00
5 kwitansi tanggung Rp 4,000.00 Rp 20,000.00
3 kwitansi besar Rp 5,000.00 Rp 15,000.00
1 snell helter Rp 33,000.00 Rp 33,000.00
7 hvs 70 gr Rp 42,000.00 Rp 294,000.00
1 hvs 70 gr Rp 50,000.00 Rp 50,000.00
1 kalkulator Rp 54,000.00 Rp 54,000.00
7 hvs 70 gr Rp 42,000.00 Rp 294,000.00
3 tinta print Rp 38,000.00 Rp 114,000.00
3 odwner Rp 17,000.00 Rp 51,000.00
1 box file Rp 13,000.00 Rp 13,000.00
2 binder clip 107 Rp 5,000.00 Rp 10,000.00
1 bolpoint Rp 10,000.00 Rp 10,000.00
1 stabilo Rp 4,000.00 Rp 4,000.00
10 solasi kecil Rp 1,000.00 Rp 10,000.00
4 kertas karbon Rp 1,000.00 Rp 4,000.00
3 spidol permanen Rp 4,000.00 Rp 12,000.00
1 bufalo+mika Rp 35,000.00 Rp 35,000.00
1 lakban hitam Rp 12,000.00 Rp 12,000.00
25 map kertas Rp 500.00 Rp 12,500.00
1 map snell kertas Rp 11,000.00 Rp 11,000.00
1 amplop besar Rp 18,000.00 Rp 18,000.00
1 amplop tanggung Rp 13,500.00 Rp 13,500.00
1 binder clip 200 Rp 15,000.00 Rp 15,000.00
2 paper clip Rp 5,000.00 Rp 10,000.00
2 stempel Rp 90,000.00 Rp 180,000.00
1 steples kecil Rp 18,000.00 Rp 18,000.00
1 isi steples Rp 3,000.00 Rp 3,000.00
1 stipo kertas Rp 7,000.00 Rp 7,000.00
1 map Rp 10,000.00 Rp 10,000.00
2 stabilo Rp 10,000.00 Rp 20,000.00
1 carter Rp 15,000.00 Rp 15,000.00
1 lakban besar Rp 17,000.00 Rp 17,000.00
9 hvs 70 gr Rp 42,000.00 Rp 378,000.00
1 lem castol Rp 6,000.00 Rp 6,000.00
2 tinta print Rp 38,000.00 Rp 76,000.00
3 odwner Rp 17,000.00 Rp 51,000.00
1 bolpoint Rp 10,000.00 Rp 10,000.00
1 isi steples Rp 19,000.00 Rp 19,000.00
9 stop map benik Rp 3,000.00 Rp 27,000.00
1 binder clip 155 Rp 10,000.00 Rp 10,000.00
2 binder clip 107 Rp 5,000.00 Rp 10,000.00
doubel foam
1 Rp 14,000.00 Rp 14,000.00
hansa
1 doubel tape Rp 4,000.00 Rp 4,000.00
1 doebel foam huli Rp 4,000.00 Rp 4,000.00
1 print Rp 2,469,150.00 Rp 2,469,150.00
1 isi steples Rp 50,000.00 Rp 50,000.00
5 mika Rp 4,500.00 Rp 22,500.00
4 doubel tape Rp 7,500.00 Rp 30,000.00
2 tinta Rp 49,500.00 Rp 99,000.00
2 nota Rp 3,000.00 Rp 6,000.00
2 bolpoint Rp 1,000.00 Rp 2,000.00
8 hvs 70 gr Rp 42,000.00 Rp 336,000.00
2 kwitansi tanggung Rp 4,000.00 Rp 8,000.00
1 bolpoint Rp 10,000.00 Rp 10,000.00
2 solasi kecil Rp 11,000.00 Rp 22,000.00
1 steples besar Rp 20,000.00 Rp 20,000.00
1 gunting tanggung Rp 7,000.00 Rp 7,000.00
6 stop map Rp 23,500.00 Rp 141,000.00
1 snell kertas Rp 12,000.00 Rp 12,000.00
1 isi steples Rp 18,000.00 Rp 18,000.00
3 kwitansi Rp 10,500.00 Rp 31,500.00
10 kwitansi Rp 6,400.00 Rp 64,000.00
3 trigonal clip Rp 3,000.00 Rp 9,000.00
1 doubel tape Rp 2,500.00 Rp 2,500.00
15 hvs 70 gr Rp 42,000.00 Rp 630,000.00
1 mouse Rp 65,000.00 Rp 65,000.00
1 date stampel Rp 13,500.00 Rp 13,500.00
1 tinta yamura Rp 5,000.00 Rp 5,000.00
1 stampad Rp 6,500.00 Rp 6,500.00
1 stampad Rp 8,000.00 Rp 8,000.00
1 bolpoint Rp 10,000.00 Rp 10,000.00
1 label harga Rp 4,000.00 Rp 4,000.00
1 bofalo Rp 35,000.00 Rp 35,000.00
1 bufalo Rp 35,000.00 Rp 35,000.00
1 label harga Rp 4,000.00 Rp 4,000.00
1 bufalo Rp 35,000.00 Rp 35,000.00
1 staples Rp 18,000.00 Rp 18,000.00
1 isi steples Rp 3,000.00 Rp 3,000.00
2 bolpoint Rp 2,000.00 Rp 4,000.00
7 hvs 70 gr Rp 42,000.00 Rp 294,000.00
1 gunting tanggung Rp 7,000.00 Rp 7,000.00
1 penghapus Rp 1,500.00 Rp 1,500.00
2 tinta print Rp 38,000.00 Rp 76,000.00
1 isi steples Rp 18,000.00 Rp 18,000.00
1 trigonal clip Rp 3,000.00 Rp 3,000.00
1 lakban Rp 12,500.00 Rp 12,500.00
1 doubel tape Rp 2,500.00 Rp 2,500.00
- 0 Rp -
Rp 8,516,150.00
LAPORAN SEMESTER TENTANG PENERIMAAN DAN PENGE

SEMESTER……………… TAHUN……
Buku Penerimaan
Banyaknya Nama Barang Harga Satuan Jml Harga

BA/ Srt. Penerimaan
No.
8 9 10 11 12
12 snack Rp 7,500.00 Rp 90,000.00 xxx
0 0 Rp - Rp - 12/30/1899
0 0 Rp - Rp - 12/30/1899
0 0 Rp - Rp - 12/30/1899
0 0 Rp - Rp - 12/30/1899
Rp 90,000.00
G PENERIMAAN DAN PENGELUARAN BARANG PAKAI HABIS
TER……………… TAHUN………………
Buku Penerimaan Surat Bon
Ket. No. Urt Terima tgl. Untuk Banyaknya

BA/ Srt. Penerimaan
No. Tgl
Tgl.
13 14 15 16 17 18 19 20
12/30/1899 tu 1
ugd 1
ugd 1
tu 3
tu 1
tu 6
tu 6
tu 5
tu 3
tu 1
tu 7
ugd 1
ugd 2
tu 5
ugd 1
ugd 1
tu 7
tu 3
tu 3
tu 1
tu 2
tu 1
tu 1
tu 10
ugd 4
tu 1
tu 3
tu 1
tu 1
tu 2
tu 25
tu 1
tu 1
tu 1
tu 2
tu 2
tu 1
tu 2
laborat 2
ugd 1
ugd 1
ugd 1
ugd 1
obat 2
obat 1
obat 1
ugd 7
tu 9
tu 7
tu 1
tu 2
tu 3
tu 1
tu 1
tu 9
tu 2
tu 2
tu 1
tu 1
tu 1
tu 2
obat 1
obat 1
obat 1
tu 1
mutu 2
ugd 1
ugd 5
ugd 1
ugd 4
ugd 2
ugd 2
poned 1
poned 1
poned 2
poned 8
tu 2
tu 2
tu 1
tu 1
tu 5
tu 2
tu 2
tu 1
tu 1
tu 6
ugd 1
tu 3
tu 1
tu 2
tu 3
tu 10
tu 2
tu 3
tu 1
tu 3
tu 1
tu 15
tu 1
tu 1
tu 1
tu 1
tu 1
ugd 1
laborat 1
laborat 1
laborat 1
laborat 1
laborat 1
laborat 1
laborat 1
gizi 1
gizi 2
ugd 7
tu 1
tu 1
tu 2
tu 2
tu 1
tu 4
tu 1
tu 1
tu 1
tu 1
tu 1
tu 1
0 -
0
G PENERIMAAN DAN PENGELUARAN BARANG PAKAI HABIS
TER……………… TAHUN………………
Buku Penerimaan Surat Bon
Ket. No. Urt Terima tgl. Untuk Banyaknya

BA/ Srt. Penerimaan
No. Tgl
Tgl.
13 14 15 16 17 18 19 20
xxx mfk 12
12/30/1899 0 0
12/30/1899 0 0
12/30/1899 0 0
12/30/1899 0 0
Tgl.
Nama Brg Harga Satuan Jml Harga Ket.
Penyerahan
21 22 23 24 25
modem Rp 595,000.00 Rp 595,000.00 1/6/2020
spidol BM Rp 8,000.00 Rp 8,000.00 1/30/2020
lakban Rp 15,000.00 Rp 15,000.00 1/30/2020
buku tulis isi 38 Rp 25,000.00 Rp 75,000.00 1/30/2020
buku folio isi 100 Rp 15,000.00 Rp 90,000.00 1/30/2020
kwitansi tanggung Rp 4,000.00 Rp 20,000.00 1/30/2020
kwitansi besar Rp 5,000.00 Rp 15,000.00 1/30/2020
snell helter Rp 33,000.00 Rp 33,000.00 1/30/2020
hvs 70 gr Rp 42,000.00 Rp 294,000.00 1/30/2020
hvs 70 gr Rp 50,000.00 Rp 50,000.00 2/27/2020
kalkulator Rp 54,000.00 Rp 54,000.00 2/27/2020
hvs 70 gr Rp 42,000.00 Rp 294,000.00 2/27/2020
tinta print Rp 38,000.00 Rp 114,000.00 2/27/2020
odwner Rp 17,000.00 Rp 51,000.00 2/27/2020
box file Rp 13,000.00 Rp 13,000.00 2/27/2020
binder clip 107 Rp 5,000.00 Rp 10,000.00 2/27/2020
bolpoint Rp 10,000.00 Rp 10,000.00 2/27/2020
stabilo Rp 4,000.00 Rp 4,000.00 2/27/2020
solasi kecil Rp 1,000.00 Rp 10,000.00 2/27/2020
kertas karbon Rp 1,000.00 Rp 4,000.00 2/27/2020
spidol permanen Rp 4,000.00 Rp 12,000.00 2/27/2020
bufalo+mika Rp 35,000.00 Rp 35,000.00 2/27/2020
lakban hitam Rp 12,000.00 Rp 12,000.00 2/27/2020
map kertas Rp 500.00 Rp 12,500.00 2/27/2020
map snell kertas Rp 11,000.00 Rp 11,000.00 2/27/2020
amplop besar Rp 18,000.00 Rp 18,000.00 2/27/2020
amplop tanggung Rp 13,500.00 Rp 13,500.00 2/27/2020
binder clip 200 Rp 15,000.00 Rp 15,000.00 2/27/2020
paper clip Rp 5,000.00 Rp 10,000.00 2/27/2020
stempel Rp 90,000.00 Rp 180,000.00 2/27/2020
steples kecil Rp 18,000.00 Rp 18,000.00 3/30/2020
isi steples Rp 3,000.00 Rp 3,000.00 3/30/2020
stipo kertas Rp 7,000.00 Rp 7,000.00 3/30/2020
map Rp 10,000.00 Rp 10,000.00 3/30/2020
stabilo Rp 10,000.00 Rp 20,000.00 3/30/2020
carter Rp 15,000.00 Rp 15,000.00 3/30/2020
lakban besar Rp 17,000.00 Rp 17,000.00 3/30/2020
hvs 70 gr Rp 42,000.00 Rp 378,000.00 3/30/2020
lem castol Rp 6,000.00 Rp 6,000.00 3/30/2020
tinta print Rp 38,000.00 Rp 76,000.00 3/30/2020
odwner Rp 17,000.00 Rp 51,000.00 3/30/2020
bolpoint Rp 10,000.00 Rp 10,000.00 3/30/2020
isi steples Rp 19,000.00 Rp 19,000.00 3/30/2020
stop map benik Rp 3,000.00 Rp 27,000.00 3/30/2020
binder clip 155 Rp 10,000.00 Rp 10,000.00 3/30/2020
binder clip 107 Rp 5,000.00 Rp 10,000.00 3/30/2020
doubel foam
Rp 14,000.00 Rp 14,000.00 3/22/2020
hansa
doubel tape Rp 4,000.00 Rp 4,000.00 3/22/2020
doebel foam huli Rp 4,000.00 Rp 4,000.00 3/22/2020
print Rp 2,469,150.00 Rp 2,469,150.00 3/30/2020
isi steples Rp 50,000.00 Rp 50,000.00 4/14/2020
mika Rp 4,500.00 Rp 22,500.00 4/28/2020
doubel tape Rp 7,500.00 Rp 30,000.00 4/28/2020
tinta Rp 49,500.00 Rp 99,000.00 4/28/2020
nota Rp 3,000.00 Rp 6,000.00 4/28/2020
bolpoint Rp 1,000.00 Rp 2,000.00 4/28/2020
hvs 70 gr Rp 42,000.00 Rp 336,000.00 4/28/2020
kwitansi tanggung Rp 4,000.00 Rp 8,000.00 4/28/2020
bolpoint Rp 10,000.00 Rp 10,000.00 4/28/2020
solasi kecil Rp 11,000.00 Rp 22,000.00 4/28/2020
steples besar Rp 20,000.00 Rp 20,000.00 4/28/2020
gunting tanggung Rp 7,000.00 Rp 7,000.00 4/28/2020
stop map Rp 23,500.00 Rp 141,000.00 4/28/2020
snell kertas Rp 12,000.00 Rp 12,000.00 4/28/2020
isi steples Rp 18,000.00 Rp 18,000.00 4/28/2020
kwitansi Rp 10,500.00 Rp 31,500.00 5/7/2020
kwitansi Rp 6,400.00 Rp 64,000.00 5/28/2020
trigonal clip Rp 3,000.00 Rp 9,000.00 5/28/2020
doubel tape Rp 2,500.00 Rp 2,500.00 5/28/2020
hvs 70 gr Rp 42,000.00 Rp 630,000.00 5/28/2020
mouse Rp 65,000.00 Rp 65,000.00 6/6/2020
date stampel Rp 13,500.00 Rp 13,500.00 6/10/2020
tinta yamura Rp 5,000.00 Rp 5,000.00 6/10/2020
stampad Rp 6,500.00 Rp 6,500.00 6/10/2020
stampad Rp 8,000.00 Rp 8,000.00 6/26/2020
bolpoint Rp 10,000.00 Rp 10,000.00 6/26/2020
label harga Rp 4,000.00 Rp 4,000.00 6/26/2020
bofalo Rp 35,000.00 Rp 35,000.00 6/26/2020
bufalo Rp 35,000.00 Rp 35,000.00 6/26/2020
label harga Rp 4,000.00 Rp 4,000.00 6/26/2020
bufalo Rp 35,000.00 Rp 35,000.00 6/26/2020
staples Rp 18,000.00 Rp 18,000.00 6/26/2020
isi steples Rp 3,000.00 Rp 3,000.00 6/26/2020
bolpoint Rp 2,000.00 Rp 4,000.00 6/26/2020
hvs 70 gr Rp 42,000.00 Rp 294,000.00 6/26/2020
gunting tanggung Rp 7,000.00 Rp 7,000.00 6/26/2020
penghapus Rp 1,500.00 Rp 1,500.00 6/26/2020
tinta print Rp 38,000.00 Rp 76,000.00 6/26/2020
isi steples Rp 18,000.00 Rp 18,000.00 6/26/2020
trigonal clip Rp 3,000.00 Rp 3,000.00 6/26/2020
lakban Rp 12,500.00 Rp 12,500.00 6/26/2020
doubel tape Rp 2,500.00 Rp 2,500.00 6/26/2020
0 Rp - 12/30/1899
Rp 8,516,150.00
Tgl.
Nama Brg Harga Satuan Jml Harga Ket.
Penyerahan
21 22 23 24 25
snack Rp 7,500.00 Rp 90,000.00 1/8/2020
0 Rp - Rp - 12/30/1899
0 Rp - Rp - 12/30/1899
0 Rp - Rp - 12/30/1899
0 Rp - Rp - 12/30/1899
Rp 90,000.00
PENGURUS BARANG
OPD
NAMA
NIP.
LAMPIRAN BERITA ACARA PERH
JUMLAH P
NO NAMA BARANG MENURUT ADMINISTRASI

BARANG
JUMLAH SATUAN
1 2 3 4
I. Persediaan Alat Tulis Kantor
1 modem 0 unit
2 Err:509 Err:509 Err:509
3 Err:509 Err:509 Err:509
4 Err:509 Err:509 Err:509
5 0 0 0
Beban Persediaan Dokumen/

Administrasi Tender
II. 1 0
2 0
3 0
4 0
5 0
MAKAN MINUM KANTOR

III. 1 snack 12 porsi
0 12/30/1899 0 0
0 12/30/1899 0 0
0 12/30/1899 0 0
0 12/30/1899 0 0
Material/bahan
IV. 1. Aspal
2. ...........
Benda Pos
V. 1. Perangko
2. Materai
Bahan Makanan Pokok :

VI. 1. Beras
2. ............
JUMLAH
PENGGUNA BARANG
OPD
NAMA
NIP.
AN BERITA ACARA PERHITUNGAN FISIK PERSEDIAAN
JUMLAH PERSEDIAAN PERTANGGAL PERHITUNGAN
MENURUT ADMINISTRASI MENURUT OPNAME

HARGA BARANG HARGA
SATUAN JUMLAH SATUAN
JUMLAH SATUAN
(Rp) (Rp) (Rp)
5 6 7 8 9
Rp 595,000.00 Rp - 0 unit Rp 595,000.00

Err:509 Err:509 Err:509 Err:509 Err:509
Rp - Rp - 0 0 Rp -
Rp 7,500.00 Rp 90,000.00 12 porsi Rp 7,500.00

Rp - Rp - 0 0 Rp -
Rp - Rp - 0 0 Rp -
Rp - Rp - 0 0 Rp -
Rp - Rp - 0 0 Rp -
PENGURUS BARANG
OPD
NAMA
NIP.
PNAME KETERANGAN
HARGA
JUMLAH
(Rp)
10 11
Rp - Cocok/ Selisih
Err:509 Cocok/ Selisih
Rp - Cocok/ Selisih
Cocok/ Selisih
Cocok/ Selisih
Cocok/ Selisih
Cocok/ Selisih
Cocok/ Selisih
Rp 90,000.00 Cocok/ Selisih

Rp - Cocok/ Selisih
Rp - Cocok/ Selisih
Rp - Cocok/ Selisih
Rp - Cocok/ Selisih
PENGURUS BARANG
OPD
NAMA
NIP.
KABUPATEN : NGAWI
KARTU BARANG
Nama Barang : modem

Satuan: unit
No. Tanggal Masuk Keluar

1 2 3 4
1 6/26/2020 1
6/26/2020 9
12/30/1899 -
12/30/1899 11
JUMLAH 1 0

KABUPATEN : NGAWI
KARTU BARANG
Nama Barang : 0
Satuan: 0

1 2 3 4
1 1/23/2020 0 0
JUMLAH 0 0

KABUPATEN : NGAWI
KARTU BARANG
Nama Barang : 0
Satuan: 0

1 2 3 4
1 12/30/1899 0 0
JUMLAH 0 0
KARTU BARANG
Nama Barang : snack

Satuan: porsi

1 2 3 4
1 1/8/2020 12 12
2 8/8/2017 4 4
JUMLAH 12 12
ATASAN LANGSUNG
OPD
NAMA
NIP.
DUPLIKASI MENYESUAIKAN JENIS BARANG YANG DIBELANJAKAN

RANG
Spesifikasi ……………..
Sisa Keterangan
5 = 3-4 6
1
- 8
- 8
- 19
1
RANG
Sisa Keterangan
5 = 3-4 6
RANG
Sisa Keterangan
5 = 3-4 6
RANG
Sisa Keterangan
5 = 3-4 6
0
0
PENGURUS BARANG
OPD
NAMA
NIP.

Persediaan 2020 Contoh

Diunggah oleh

Informasi Dokumen

Deskripsi Asli:

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

Persediaan 2020 Contoh

Diunggah oleh

Hak Cipta:

Format Tersedia

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

DAFTAR PENGADAAN BARANG

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

OPD : PUSKESMAS KWADUNGAN

DAFTAR PENGADAAN BARANG

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

14 form permintaan lab 2/28/2020 24 - rim 1 Rp 105,000 Rp 105,000.00 laborat

Pengguna Barang Pengurus Barang

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

drg. RIKA WANDANSARI SUYANTI YAHNA

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

1 pertalit 2/28/2020 - liter 300 Rp 7,650 Rp 2,295,000.00 ambulan

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

SPK/Perjanjian/Kontrak DPA/SPM/Kwitansi Jumlah

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

Tgl/No. Kontrak/SP/SPK : Tgl/No.Surat Penyerahan :

JUMLAH Rp 8,516,150.00 Rp 8,516,150.00

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

Tgl/No. Kontrak/SP/SPK : Tgl/No.Surat Penyerahan :

JUMLAH Rp 12,180,000.00 Rp 12,180,000.00

OPD : PUSKESMAS KWADUNGAN

Tgl/No. Kontrak/SP/SPK : Tgl/No.Surat Penyerahan :

JUMLAH Rp 1,446,000.00 Rp 1,446,000.00

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN

Tgl/No. Kontrak/SP/SPK : Tgl/No.Surat Penyerahan :

Pengguna Barang Pengurus Barang

drg. RIKA WANDANSARI SUYANTI YAHNA

OPD : PUSKESMAS KWADUNGAN