DINAS KESEHATAN KABUPATEN SERANG

DAFTAR PERHITUNGAN BARANG PAKAI HABIS UPT PUSKESMAS TUNJUNG TEJA

TAHUN 2020

URAIAN PERSEDIAAN PENAMBAHAN PENGGUNAAN SISA

NO
NAMA BARANG PER 31 DESEMBER 2019 PER 31 DESEMBER 2020 PER 31 DESEMBER 2020 PER 31 DESEMBER 2020
1 ATK JKN Rp Rp Rp Rp
2 BHP Rp Rp Rp Rp
3 Cetak Rp Rp Rp Rp
4 Reagent JKN Rp 4,072,638 Rp Rp Rp 4,275,000
5 Alkon Rp 73,289,518 Rp Rp Rp 74,182,144
6 Persediaan Gizi Rp 90,893,788 Rp Rp Rp 15,484,392
7 Persediaan Lain Rp Rp Rp Rp -
8 Vaksin Rp 8,902,818 Rp Rp Rp 16,141,325
9 obat Rp 68,030,075 Rp 67,530,832
Rp 245,188,837 Rp Rp Rp 177,613,693

Mengetahui Serang, 31 Desember 2020

Kepala UPT Puskesmas Tunjung Teja Petugas Barang

Hj.Dedeh Muhtiarah, S.ST.Keb Yasin Muhtar Abdul Hasan

NIP. 196901081988032003 NIP. 198505192009021004
 LAPORAN PERHITUNGAN SISA PERSEDIAAN BARANG PAKAI HABIS
PER DESEMBER 2020

NO URAIAN PERSEDIAAN PER DESEMBER 2019 PENAMBAHAN PENGURANGAN PERSEDIAAN PER DESEMBER 2020
NAMA BARANG SATUAN Banyak Harga satuan (Rp) Jumlah (Rp) Banyaknya Banyaknya Banyaknya Harga Satuan (Rp) Jumlah

1 2 3 4 5 6 7 8 9 (4+7-8) 10 11 (9*10)
ALAT TULIS KANTOR (5.2.2.01.05)
1 Map Plastik Kancing lsn 0 Rp - Rp 165,000 6 6 0 27,500 Rp -
2 Map Bufalo Snell dus 0 Rp - Rp 201,000 3 3 0 67,000 Rp -
3 Tellstruk Thermal 80 x 80 rol 0 Rp - Rp 115,000 5 5 0 23,000 Rp -
4 Pejn Jokyo 4 w bh 0 Rp - Rp 144,000 24 24 0 6,000 Rp -
5 Map Business File lsn 0 Rp - Rp 165,000 6 6 0 27,500 Rp -
6 Pen Standar AE7 pak 0 Rp - Rp 483,000 23 23 0 21,000 Rp -
7 Palstik Laminating Toho Folio rim 0 Rp - Rp 105,000 1 1 0 105,000 Rp -
8 Kertas HVS Sinar Dunia A4 70 gr rim 0 Rp - Rp 1,419,000 33 33 0 43,000 Rp -
9 Kertas HVS Sinar Dunia F4 70 gr rol 0 Rp - Rp 5,145,000 105 105 0 49,000 Rp -
10 Lakban Daimaru Bening rol 0 Rp - Rp 468,000 39 39 0 12,000 Rp -
11 Isolasi Daimaru 1'' bh 0 Rp - Rp 70,000 10 10 0 7,000 Rp -
12 Ordner Bantex F4 Tebal bh 0 Rp - Rp 1,225,000 35 35 0 35,000 Rp -
13 Tinta Epson 664 Black bh 0 Rp - Rp 1,000,000 10 10 0 100,000 Rp -
14 Tinta Epson 664 Color bh 0 Rp - Rp 1,100,000 11 11 0 100,000 Rp -
15 Tinta Epson 003 Black/ Color bh 0 Rp - Rp 1,995,000 19 19 0 105,000 Rp -
16 Map Saegull Spring File bh 0 Rp - Rp 396,000 36 36 0 11,000 Rp -
17 Lem Stick Kecil bh 0 Rp - Rp 108,000 18 18 0 6,000 Rp -
18 Doubel Tip Bening lsn 0 Rp - Rp 40,000 10 10 0 4,000 Rp -
19 Tipe - X bh 0 Rp - Rp 336,000 42 42 0 8,000 Rp -
20 Buku Quarto 100 lbr lsn 0 Rp - Rp 85,000 10 10 0 8,500 Rp -
21 Buku Quarto 200 lbr pak 0 Rp - Rp 96,000 6 6 0 16,000 Rp -
 22 Buku Folio 100 lbr rim 0 Rp - Rp 459,000 27 27 0 17,000 Rp -
23 Buku Folio 200 lbr rim 0 Rp - Rp 372,000 12 12 0 31,000 Rp -
24 Buku Folio 500 lbr rol 0 Rp - Rp 214,500 3 3 0 71,500 Rp -
25 Pensil Stadeler Ae7 bh 0 Rp - Rp 117,000 26 26 0 4,500 Rp -
26 Penggaris Butterfly 30 CM bh 0 Rp - Rp 75,000 25 25 0 3,000 Rp -
27 Hekter Max HD 10 bh 0 Rp - Rp 216,000 12 12 0 18,000 Rp -
28 Isi Hekter Max No.10 bh 0 Rp - Rp 110,000 2 2 0 55,000 Rp -
29 Pembolong Kenko/Jokyo 30 xl bh 0 Rp - Rp 240,000 12 12 0 20,000 Rp -
30 Spidol Snowman Permanen bh 0 Rp - Rp 480,000 60 60 0 8,000 Rp -
31 Spidol Bos bh 0 Rp - Rp 108,000 12 12 0 9,000 Rp -
32 Lem Fox 150 gr bh 0 Rp - Rp 55,000 5 5 0 11,000 Rp -
33 Lakban Daimaru Warna rol 0 Rp - Rp 166,500 9 9 0 18,500 Rp -
34 Stopmap Kertas Pack 0 Rp - Rp 48,000 2 2 0 24,000 Rp -
35 Amplop Paperline Besar Dus 0 Rp - Rp 110,000 5 5 0 22,000 Rp -
36 Amplop Paperline Kecil Dus 0 Rp - Rp 80,000 5 5 0 16,000 Rp -
37 Gunting Kenco Tanggung Buah 0 Rp - Rp 54,000 6 6 0 9,000 Rp -
38 Cutter Coco Besar Buah 0 Rp - Rp 96,000 6 6 0 16,000 Rp -
39 Isi Hekter Max no 10 BUah 0 Rp - Rp 210,000 60 60 0 3,500 Rp -
40 Kertas Blue Print Photo 210gr Pack 0 Rp - Rp 57,000 2 2 0 28,500 Rp -
41 Lem Stick Kecil Buah 0 Rp - Rp 90,000 15 15 0 6,000 Rp -
42 Tellstruk Thermal 57 x 47 rol 0 Rp - Rp 30,000 5 5 0 6,000 Rp -
43 Buku Kuarto Lebar Buah 0 Rp - Rp 180,000 20 20 0 9,000 Rp -
44 Trigonal Clip No. 03 Pack 0 Rp - Rp 36,000 2 2 0 18,000 Rp -
45 Binder Klip 155 Lusin 0 Rp - Rp 40,000 5 5 0 8,000 Rp -
46 Binder Klip 111 lusin 0 Rp - Rp 30,000 5 5 0 6,000 Rp -
47 Binder Klip 107 Lusin 0 Rp - Rp 60,000 12 12 0 5,000 Rp -
48 Doble Tip 1 Rol 0 Rp - Rp 20,000 5 5 0 4,000 Rp -
49 Glue Gun Refill Buah 0 Rp - Rp 5,000 4 4 0 1,250 Rp -
50 Pensil Staedler 2 B Buah 0 Rp - Rp 96,000 24 24 0 4,000 Rp -
51 Spidol Snowman Permanen Buah 0 Rp - Rp 288,000 36 36 0 8,000 Rp -
JUMLAH Rp -
REKAPAN BELANJA PERLENGKAPAN PASIEN KORING 5.2.2.01.25
1 KERTAS USG PACK 0 Rp - Rp - 4 4 0 Rp 245,000 Rp -
2 KERTAS PUYER PRES PACK 0 Rp - Rp - 6 6 0 Rp 105,000 Rp -
3 Stick HB (Mek Easy Touch) 0 Rp - Rp - 5 5 0 Rp 175,000 Rp -
4 Stick Gula Darah (Mek Easy Touch) 0 Rp - Rp - 5 5 0 Rp 112,000 Rp -
5 Stick Asam Urat (Mek Easy Touch) 0 Rp - Rp - 5 5 0 Rp 112,000 Rp -
 6 Stick Kolesterol (Mek Easy Touch) 0 Rp - Rp - 3 3 0 Rp 195,000 Rp -
7 Protein Urine 3P Verify 0 Rp - Rp - 2 2 0 Rp 100,000 Rp -
8 Saim Sacher Lotus 0 Rp - Rp - 55 55 0 Rp 15,000 Rp -
9 Apron Whith Apron 0 Rp - Rp - 10 10 0 Rp 285,500 Rp -
10 Kertas USG Sony 0 Rp - Rp - 3 3 0 Rp 280,000 Rp -
11 Kertas Puyer Press Sony 0 Rp - Rp - 2 2 0 Rp 100,000 Rp -
12 Underpads PACK 0 Rp - Rp - 35 35 0 Rp 38,000 Rp -
13 Tabung EDTA PACK 0 Rp - Rp - 5 5 0 Rp 135,000 Rp -
14 Slam Sacher PCS 0 Rp - Rp - 50 50 0 Rp 15,000 Rp -
15 Appron BOX 0 Rp - Rp - 2 2 0 Rp 285,000 Rp -
16 ONEMED APRON ONE PLASTIK PACK 0 Rp - Rp - 60 60 0 Rp 39,050 Rp -
17 Umbilical Cleamp PACK 0 Rp - Rp - 10 10 0 Rp 82,500 Rp -
18 JAS HUJAN PLASTIK Unit 0 Rp - Rp - 150 150 0 Rp 25,000 Rp -
19 HAND SANITALYSER 500 ML MERK Unit 0 Rp - Rp - 8 8 0 Rp 200,000 Rp -
20 VECOM
KACAMATA(500GOOGLE
ML) BS004 BE SAVE Unit 0 Rp - Rp - 4 4 0 Rp 95,000 Rp -
21 SEPATU BOTS SAFETY (PETROPA UK-41 Unit 0 Rp - Rp - 2 2 0 Rp 200,000 Rp -
22 DAN 42) TANGAN LEOPARD
SARUNG Unit 0 Rp - Rp - 3 3 0 Rp 25,000 Rp -
23 HELM SAFETY NSA KUNING DAN KACA Unit 0 Rp - Rp - 2 2 0 Rp 200,000 Rp -
VISOR BLUE EAGLE
JUMLAH Rp -
BELANJA CETAK (5.2.2.06.01)
1 Form Pendataan eppgb rim 0 Rp - Rp - 24 24 0 Rp 95,000 Rp -
2 Buku formar pemantauan EPBGGM buku 0 Rp - Rp - 61 61 0 Rp 40,000 Rp -
3 buku resep Rim 0 Rp - Rp - 10 10 0 Rp 135,000 Rp -
4 Alur Pelayanan Rawat jalan buah 0 Rp - Rp - 1 1 0 Rp 225,000 Rp -
5 Xbanner unit 0 Rp - Rp - 1 1 0 Rp 150,000 Rp -
6 Xbanner unit 0 Rp - Rp - 1 1 0 Rp 150,000 Rp -
7 novel Coronavirus unit 0 Rp - Rp - 1 1 0 Rp 300,000 Rp -
8 cuci tangan pakai sabun unit 0 Rp - Rp - 1 1 0 Rp 300,000 Rp -
9 knapa cuci tangan harus pakai SABUN unit 0 Rp - Rp - 1 1 0 Rp 300,000 Rp -
10 BUKU REGISTER KHORT IBU 5 desa buku 0 Rp - Rp - 2 2 0 Rp 185,000 Rp -
11 BUKU REGISTER KHORT IBU 10 desa buku 0 Rp - Rp - 1 1 0 Rp 185,000 Rp -
12 Lembar Rawat jalan Pink lebar 0 Rp - Rp - 500 500 0 Rp 1,200 Rp -
13 Alur Covid-19 unit 0 Rp - Rp - 1 1 0 Rp 250,000 Rp -
14 acrylic pendaftaran unit 0 Rp - Rp - 1 1 0 Rp 650,000 Rp -
15 buku Surat sehat dokter rim 0 Rp - Rp - 1 1 0 Rp 130,000 Rp -
16 bingkai ASI PCS 0 Rp - Rp - 6 6 0 Rp 250,000 Rp -
17 Bingkai PCS 0 Rp - Rp - 4 4 0 Rp 175,000 Rp -
 18 Acrylic Meja unit 0 Rp - Rp - 6 6 0 Rp 450,000 Rp -
19 Acrylic Meja unit 0 Rp - Rp - 3 3 0 Rp 350,000 Rp -
20 buku profil Buku 0 Rp - Rp - 4 4 0 Rp 90,000 Rp -
21 buku profil Buku 0 Rp - Rp - 1 1 0 Rp 35,000 Rp -
22 cetak oneway Meter 0 Rp - Rp - 10.08 10.08 0 Rp 80,000 Rp -
23 Jasa Setting ulang oneway Jasa 0 Rp - Rp - 6 6 0 Rp 10,000 Rp -
24 Jasa pasang Oneway Jasa 0 Rp - Rp - 6 6 0 Rp 50,000 Rp -
25 Lemabar Rawat Jalan Lembar 0 Rp - Rp - 7000 7000 0 Rp 1,100 Rp -
Belanja Bahan Laboratorium/ Reagent (5.2.2.02.25)
1 Reagent zein neilshen box 3 Rp 195,046 Rp 585,138 0 3 0 Rp - Rp -
2 Diatro Dil 5 p 20 l box 1 Rp 1,700,000 Rp 1,700,000 3 3 1 Rp 1,700,000 Rp 1,700,000
3 Diatro Lyse Diff +key 1 l botol 1 1,485,000 Rp 1,485,000 3 3 1 Rp 1,600,000 Rp 1,600,000
4 Diatro cleaner botol 1 302,500 Rp 302,500 4 2 3 Rp 325,000 Rp 975,000
JUMLAH Rp 4,072,638 Rp 4,275,000
1 Suntik Vial 6,141 Rp 6,090 Rp 37,398,690 2200 4,685 3,656 Rp 6,090 Rp 22,265,040
2 pil strip 6,289 Rp 1,920 Rp 12,074,880 2500 1,953 6,836 Rp 1,518 Rp 10,377,048
3 AKDR buah 83 Rp 13,156 Rp 1,091,948 158 7 151 Rp 13,156 Rp 1,986,556
4 implan buah 8 Rp 212,500 Rp 1,700,000 360 293 75 Rp 212,500 Rp 15,937,500
5 kondom buah 219 Rp 96,000 Rp 21,024,000 327 87 240 Rp 98,400 Rp 23,616,000
6 PP TEST Pics 0 0 Rp - 3 3 - Rp 1,500 Rp -
JUMLAH Rp 73,289,518 Rp 74,182,144
PERSEDIAAN GIZI
PMT ibu hamil Kek Kilogram 808.08 68,035.00 Rp 54,977,723 648 1,209.12 246.96 62,700 Rp 15,484,392
PMT - Balita Kilogram 648.48 55,385.00 Rp 35,916,065 124.32 772.80 0 71,169 Rp -
JUMLAH Rp 90,893,788 Rp 15,484,392
PERSEDIAAN LAINNYA
1 Kalender BUAH - Rp - Rp - 245 245 - Rp 12,400 -
2 Baju Coverald bUAH - Rp - Rp - 40 40 - Rp 192,000 -
3 Alkohol Swab Buah - Rp - Rp - 5 5 - Rp 49,000 -
4 Alkohol 70 Galon - Rp - Rp - 12 12 - Rp 270,000 -
5 Sarung Tangan Obgin Pcs - Rp - Rp - 80 80 - Rp 49,000 -
6 RDT Covid BUah - Rp - Rp - 245 245 - Rp 280,000 -
JUMLAH Rp - Rp -

1 HB O Vial 18 Rp 20,900 Rp 376,200 640 599 59 21,991 Rp 1,297,469

2 BCG Vial Rp 59,950 Rp - 320 314 6 60,140 Rp 360,840
3 POLIO Vial 21 Rp 137,610 Rp 2,889,810 530 515 36 137,610 Rp 4,953,960
 4 DPT - HB Vial Rp - Rp - 830 830 - - Rp -
5 DPT - HB-Hib Vial 7 Rp 76,285 Rp 533,995 - 1 6 78,991 Rp 473,946
6 CAMPAK /MR Vial 0 Rp 40,017 Rp - 360 326 34 151,150 Rp 5,139,100
7 CAMPAK/BIAS Vial 0 Rp - Rp - - - - - Rp -
8 TT Vial 0 Rp - Rp - - - - - Rp -
9 TD (RUTIN) Vial 4 Rp 16,500 Rp 66,000 300 304 - 16,995 Rp -
10 TD (BIAS) Vial 20 Rp 16,500 Rp 330,000 - 20 - 16,995 Rp -
11 DT Vial 26 Rp 16,412 Rp 426,712 - 26 - 16,412 Rp -
12 ADS 0.05 ml Vial 195 Rp 1,995 Rp 389,025 925 1,020 100 1,995 Rp 199,500
13 ADS 0,5 ml Vial 650 Rp 1,395 Rp 906,750 5,700 6,050 300 1,395 Rp 418,500
14 ADS 5 ml Vial 316 Rp 2,041 Rp 644,956 500 616 200 2,041 Rp 408,200
15 IPV Vial 17 Rp 137,610 Rp 2,339,370 40 36 21 Rp 137,610 Rp 2,889,810
16 SAFETY BOX BOX - Rp - Rp - 50 50 - Rp 22,443 Rp -
JUMLAH Rp 8,902,818 Rp 16,141,325
PERSEDIAAN OBAT
1 Aceptic Gel Botol - 22,000 - - - - - -
2 Alat Suntik 1 ml Set 69 990 68,310 900 849 120 990 118,800
3 Alat suntik 3 ml Set 225 924 207,900 2,400 2,345 280 924 258,720
4 Alat Suntik 5 ml Set 70 839 58,730 400 407 63 963 60,669
5 Alat suntik 10 ml Set 100 1,257 125,700 300 328 72 1,257 90,504
6 Alat suntik 20 ml Set 106 1,954 207,124 300 275 131 1,954 255,974
7 Albendazole Tablet 3,510 404 1,418,040 11,580 5,820 9,270 431 3,995,370
8 Albendazole Suspensi Botol - - - - - - - -
9 Alkohol swab kotak 2 29,000 58,000 30 25 7 29,000 203,000
10 Allopurinol 100 mg Tablet 4,100 99 405,900 5,800 9,200 700 2,000 1,400,000
11 Ambroxol Sirup 15 mg/ml Botol - - - - - - - -
12 Ambroxol 30 mg Tablet - - - - - - - -
13 Aminophilin Inj Ampul 68 3,345 227,460 - 68 - - -
14 Aminophilin 200 mg Tablet 100 91 9,100 - 100 - - -
15 Amitripilin 25 mg Tablet 100 167 16,700 800 400 500 167 83,500
16 Amlodipin 5 mg Tablet - - - - - - - -
17 Amlodipin 10 mg Tablet 2,100 93 195,300 14,100 16,200 - 93 -
18 Amoxisilin Inj 1 mg vial - - - - - - - -
19 Amoxisilin 125 mg. syr Botol - - - - - - - -
20 Amoxisilin Syr Forte 250 mg Botol 180 3,400 612,000 540 500 220 3,628 798,160
21 Amoxisilin 250 mg Tablet 18,600 184 3,422,400 10,000 25,800 2,800 196 548,800
22 Amoxisilin 500 mg Tablet 1,100 233 256,300 27,500 25,600 3,000 249 747,000
23 Ampisilin inj vial 30 10,300 309,000 160 170 20 10,300 206,000
24 Antalgin 500 mg Tablet - - - - - - - -
25 Antasida Doen Tablet 1,700 54 91,800 32,300 31,200 2,800 58 162,400
26 Antasida Doen Sirup Botol 100 1,995 199,500 850 800 150 2,129 319,350
27 Anti Bakteri Doen salep Tube - - - - - - - -
28 Anti Fungi Doen Komb. Tube - - - 168 168 - 4,158 -
29 Anti Vertigo (Betahistin Maleat) Tablet - - - - - - - -
30 Antihaemoroid Doen Komb. Supp supp 50 3,167 158,350 200 220 30 3,167 95,010
31 Aqua Pro inj Steril 20 ml. Botol 14 2,860 40,040 285 244 55 2,860 157,300
32 Asam Askorbat 250 mg. Tablet - - - - - - - -
33 Asam Askorbat 50 mg. Tablet 2,700 105 283,500 9,700 12,400 - 105 -
34 Asam Mafenamat 500 mg. Tablet 2,600 103 267,800 14,500 15,900 1,200 103 123,600
35 Asetosal 500 mg. Tablet - - - - - - - -
36 Asiclovir 200 mg. Tablet - - - - - - - -
37 Asiclovir 400 mg. Tablet 1,500 380 570,000 - 450 1,050 - -
38 Asiclovir. Cream Tube - - - - - - - -
39 Atropin Sulfat inj. 0,25 mg/ml Ampul - - - - - - - -
40 Attapulgit 650 mg Tablet 200 206 41,200 3,200 3,200 200 206 41,200
41 Betamethason krim Tube 70 1,340 93,800 450 470 50 1,430 71,500
42 Bisacodyl Tablet - - - - - - - -
43 Bisturi pcs - 3,000 - 6 4 2 300,000 600,000
44 Canul oksigen anak pcs 4 5,900 23,600 210 209 5 10,000 50,000
45 Canul oksigen dewasa pcs 26 5,900 153,400 160 186 - 6,900 -
46 Calsium Hidroksida pasta Set - - - - - - - -
47 Captopril 12,5 mg Tablet - 66 - 5,500 1,900 3,600 66 237,600
48 Captopril 25 mg Tablet 5,600 68 380,800 2,000 7,600 - 66 -
49 Cat-Gut/Benang Bedah Set 4 46,769 187,076 26 30 - 682,800 -
50 Cefadroxyl sirup kering 125mg/ml Botol 100 8,100 810,000 - 100 - - -
51 Cefadroxyl 250 mg Tablet - - - - - - - -
52 Cefadroxyl 500 mg. Tablet - - - - - - - -
53 Cefixim Sirup Botol - - - - - - - -
54 Cefotaxim inj. vial - - - - - - - -
55 Ceftriaxone inj. vial - - - - - - - -
56 Cendo Lyteers Botol - - - - - - - -
57 Cetrizine Kapsul - - - - - - - -
58 Cetrizine 5 Mg Syrup Botol 100 2,915 291,500 1,200 505 795 2,915 2,317,425
59 Cimetidine 200 mg Tablet - - - - - - - -
60 Clobazam 10 mg Tablet - 739 - - - - - -
61 Deksametason 0,5 mg Tablet 5,000 32 160,000 22,000 23,500 3,500 32 112,000
62 Deksametason inj. 5 mg Ampul - 1,500 - 500 460 40 1,097 43,880
63 Devitalisasi pasta (non arsen) Botol - - - - - - - -
64 Dextrose 40% inj. vial - - - - - - - -
65 Diazepam 2 mg Tablet - - - - - - - -
66 Diazepam 5 mg Tablet - - - - - - - -
67 Diazepam inj 5 mg/ml Ampul 100 1,735 173,500 - 100 - - -
68 Diazepam Rectal 5 mg/ml Tube 3 12,573 37,719 15 10 8 12,573 100,584
69 Dietylcarbamazin Sitrat 100 mg Tablet - - - - - - - -
70 Difenhidramin HCL inj 10 mg/ml Ampul 135 1,176 158,760 - 135 - - -
71 Digoksin 0,25 mg. Tablet - 104 - - - - - -
72 Diltiazem HCl 30 mg Tablet 500 127 63,500 - 500 - - -
73 Doksisiklin 100 mg Kapsul - 269 - 2,700 300 2,400 269 645,600
74 Domperidone Syrup Botol 100 2,700 270,000 50 150 - 2,700 -
75 Domperidone tab. Tablet 2,100 118 247,800 - 2,100 - - -
76 Dycal (Doridentcaliumhidr) Tablet - - - - - - - -
77 Epinefrin HCL inj. 0,1% 1 ml. Ampul 43 1,397 60,071 - 6 37 - -
78 Eritromisin 250 mg. Kapsul - - - - - - - -
79 Eritromisin 500 mg. Kapsul 100 750 75,000 1,300 1,400 - 750 -
80 Eritromisin Syr Botol 23 6,700 154,100 - 23 - - -
81 Etakridin (Rivanol) 0,1% Botol 15 3,000 44,996 - 8 7 - -
82 Etanol 70%-100 ml Botol - 4,000 - - - - - -
83 Etanol 70%-1000 ml Botol 1 25,000 25,000 25 25 1 25,000 25,000
84 Etilklorida Semprot-100 ml. Botol - - - - - - - -
85 Eugenol cairan Botol 1 18,824 18,824 1 2 - 18,100 -
86 Extract placenta 10 % 0,1 ml + neomycin suTube - - - - - - - -
87 Extrak Belladon 10 mg Tablet - - - - - - - -
88 FDC KAT I Tablet 4 415,467 1,661,868 28 29 3 415,467 1,246,401
89 FDC. KAT II Tablet - 1,384,983 - 1 1 - 1,384,977 -
90 Fenobarbital 30 mg Tablet - - - - - - - -
91 Fenol Glicerol TT Botol 48 2,590 124,320 96 120 24 2,590 62,160
92 Fitomenadion 10 mg Tablet 400 758 303,200 300 700 - - -
93 Fitomenadion inj. 10 mg/ml Ampul - - - - - - - -
94 Fletcher Set - - - - - - - -
95 Foley Catheter No 16 pcs 18 11,800 212,400 140 133 25 11,800 295,000
96 Foley Catheter No 18 pcs 20 11,800 236,000 130 120 30 11,800 354,000
97 Fuji IX Set - - - - - - - -
98 Furosemida 40 mg Tablet 300 100 30,000 - 300 - - -
99 Furosemida inj 10 mg/ml Ampul - 1,333 - - - - - -
100 Gameksan Emulsi 1%-100 ml. Botol - - - - - - - -
101 Garam Oralit 200 ml sachet 200 260 52,000 1,400 1,400 200 260 52,000
102 Gentamicin Tetes Mata Botol - 4,232 - 96 72 24 4,232 101,568
103 Gentamycine inj. Ampul 97 1,010 97,970 - 97 - - -
104 Gentamycine salep Tube - - - - - - - -
105 Gentian Violet Lar. 1%-10 ml. Botol - - - - - - - -
106 Glass Ionomer semen Set - - - - - - - -
107 Glibenklamid 5 mg Tablet 200 119 23,800 2,200 1,600 800 119 95,200
108 Gliseril Guaiacolat 100 mg Tablet - - - - - - - -
109 Gliserin Botol - - - - - - - -
110 Glucosa 10% Botol - - - - - - - -
111 Glucosa 5% Botol 10 6,900 69,000 - 10 - - -
112 Griseovulfin 125 mg Tablet 200 210 42,000 500 700 - 210 -
113 H2O2 Botol - - - - - - - -
114 Haloperidol 5mg Tablet - 59 - - - - - -
115 Haloperidol Decanoat Inj Ampul - - - 10 5 5 101,300 506,500
116 Hand schoon non steril S kotak 12 49,900 598,800 124 136 - 49,900 -
117 Hand schoon non steril M kotak 14 49,900 698,600 225 237 2 55,100 110,200
118 Hibiscrub Cairan Obat Luar Botol - - - 8 6 2 78,200 156,400
119 Hidrocortison cream 2,5 % Tube 44 2,650 116,600 336 356 24 2,475 59,400
120 Hidrogen Peroksida (H2O2) Botol - - - - - - - -
121 Hidroklortiazida (HCT) 25 mg Tablet 200 36 7,260 - 200 - - -
122 Hyoscine-N-Butilbromide 10 mg Tablet - - - 500 200 300 350 105,000
123 I.V catheter no : 16 pcs - - - - - - - -
124 I.V Catheter no :18 pcs 150 8,700 1,305,000 780 730 200 8,700 1,740,000
125 I.V Catheter no : 20 pcs 73 8,355 609,915 450 433 90 8,700 783,000
126 I.V Catheter no 22 pcs 75 8,700 652,500 200 215 60 8,700 522,000
127 I.V Catheter no 24 pcs 92 8,700 800,400 350 317 125 8,700 1,087,500
128 I.V Catheter no 26 pcs 87 4,700 408,900 250 187 150 4,700 705,000
129 Ibuprofen 200 mg Tablet - - - - - - - -
130 Ibuprofen 400 mg Tablet 1,800 270 486,000 - 1,800 - - -
131 Infus Set Pediatric (Anak) Set 59 4,400 259,600 400 359 100 4,400 440,000
132 Infus Set Dewasa Set 75 7,920 594,000 850 811 114 4,800 547,200
133 Isosorbit Dinitrat 5 mg Tablet 5,400 88 475,200 - 5,400 - - -
134 Kalium Diklofenak Tablet - - - - - - - -
135 Kalium Permanganat Serbuk pot - - - - - - - -
136 Kalsium Hidroksida Pasta Set - - - - - - - -
137 Kalsium Laktas 500 mg Tablet 7,500 59 442,500 24,000 29,600 1,900 59 112,100
138 Kanamycin inj Vial - - - - - - - -
139 Kapas Pembalut Adsorben roll 13 12,500 162,500 14 27 - 12,500 -
140 Kasa Elastis 4 Inch roll 5 20,858 104,290 11 9 7 20,858 146,006
141 Kasa Hidrofil 4 m x 15 cm roll 85 2,100 178,500 130 190 25 2,100 52,500
142 Kasa 36m X 80cm roll 2 105,000 210,000 19 20 1 105,000 105,000
143 Kasa Kompres 40/40 steril pcs 11 1,600 17,600 90 101 - 18,034 -
144 Kasa Steril 16x16 cm kotak - - - 340 325 15 8,000 120,000
145 Kodein Tablet 86 550 47,300 - 86 - - -
146 Ketokonazol Cream Tube 65 2,596 168,740 475 440 100 2,596 259,600
147 Ketokonazol 200 Mg Tablet 500 270 135,000 1,400 1,900 - 270 -
148 Ketoprofen inj 100 mg Ampul - - - - - - - -
149 Ketorolac Inj Ampul - - - - - - - -
150 Klindamisin kap 150 mg Kapsul - - - - - - - -
151 Klindamisin kap 300 mg Kapsul 550 583 320,650 2,000 2,550 - 583 -
152 Kloramfenikol 250 mg Kapsul - 400 - - - - - -
153 Kloramfenikol SM 1% Tube 96 1,881 180,576 192 264 24 2,007 48,168
154 Kloramfenikol Syr Botol 90 4,700 423,000 150 240 - 4,700 -
155 Kloramfenikol SK Tube - 3,242 - 576 456 120 3,242 389,040
156 Kloramfenikol TM Botol - - - - - - - -
157 Kloramfenikol TT Botol - 4,000 - 144 116 28 4,000 112,000
158 Klorfeniramin Maleat (CTM) 4mg Tablet 8,000 22 176,000 28,500 26,500 10,000 23 230,000
159 Klorpromazin 100 mg Tablet 500 147 73,500 3,700 3,800 400 157 62,800
160 KOMBIPAK kotak - 31,708 - 1 - 1 317,018 317,018
161 Kotrimoksazol 120 mg Tablet - - - - - - - -
162 Kotrimoksazol 480 mg Tablet 4,900 151 739,900 7,000 6,200 5,700 151 860,700
163 Kotrimoksazol Syp Botol 200 2,140 428,000 200 320 80 2,190 175,200
164 Levertraan pot - - - - - - - -
165 Levofloxacin tab 500 mg Kapsul - - - - - - - -
166 Lidocain inj. Kombinasi Ampul 30 1,845 55,350 180 180 30 1,229 36,870
167 Lidokain Inj Ampul 210 1,111 233,310 100 310 - - -
168 Lisol 1000 ml. Botol - - - 35 30 5 41,000 205,000
169 Loperamide 2 mg Tab. Tablet - - - - - - - -
170 Loratadine 10 mg. tab. Tablet 1,500 131 196,500 10,000 9,850 1,650 131 216,150
171 Lytacur Syrup Botol 192 13,200 2,534,400 - 192 - - -
172 Magnesium sulfat inj. 20% Vial 20 3,328 66,560 160 152 28 3,328 93,184
173 Magnesium sulfat inj. 40% Vial 39 3,796 148,044 199 205 33 3,796 125,268
174 Masker sachet 1,400 500 700,000 13,950 15,350 - 500 -
175 MDT MB Anak blister - 20,554 - 6 6 - 27,062 -
176 MDT MB Dewasa blister 6 31,570 189,420 39 45 - 39,880 -
177 MDT PB Anak blister - 13,300 - - - - - -
178 MDT PB Dewasa blister - 9,770 - - - - - -
179 Megatic Gel 20 gr Tube - - - - - - - -
180 Meloxicam 15 Tablet - - - - - - - -
181 Meloxicam 7,5 Tablet - - - - - - - -
182 Metformin 500 mg Tablet 1,100 96 105,600 17,000 18,100 - 102 -
183 Metildopa tab 250 mg. Tablet - - - - - - - -
184 Metilegometrin Maleat 0,125 mg. Tablet 270 210 56,700 - 270 - - -
185 Metilegometrin Maleat inj. Tablet 465 2,550 1,185,750 - 465 - - -
186 Metilprednisolon 4 mg Tablet 3,700 143 529,100 12,200 11,700 4,200 143 600,600
187 Metoclorpropamid 10 mg Tablet 500 - - - 500 - - -
188 Metoclorpropamid injeksi Ampul - - - - - - - -
189 Metoklopramide Syrup Botol - - - - - - - -
190 Metronidazol 250 mg Tablet - - - - - - - -
191 Metronidazol 500 mg Tablet - 400 - 10,600 9,500 1,100 400 440,000
192 Micropore 3M roll - - - - - - - -
193 Miconazole Cream Tube 312 3,250 1,014,000 120 360 72 3,414 245,808
194 Minyak Kayu Putih Botol - - - - - - - -
195 N Asetyl Systein Kapsul 9,480 382 3,621,360 31,800 33,360 7,920 382 3,025,440
196 Natrium Bicarbonat 500 mg Tablet - - - - - - - -
197 Natrium dikloffenak tab 25 mg Tablet - - - - - - - -
198 Natrium Dikloffenak tab 50 mg Tablet 1,000 123 123,000 11,400 9,150 3,250 123 399,750
199 Natrium Klorida 0,9% Botol 10 6,840 68,400 100 76 34 6,840 232,560
200 Natrium Thiosulfat inj 25 % Vial - - - - - - - -
201 Neo K Ampul 450 3,682 1,656,900 60 510 - - -
202 Neo Kaulana Syrup Botol - - - - - - - -
203 Nifedipin 10 Mg Tablet - 108 - - - - - -
204 Nistatin Vaginal tab 100.000 IU Tablet 500 598 299,000 300 200 600 523 313,800
205 Nistatin Vaginal tab 500.000 IU Tablet 800 843 674,400 - 800 - - -
206 O.B.H. Sirup Botol - - - - - - - -
207 OAT Kat Anak box 3 248,120 744,360 - 3 - - -
208 Ofloxacin Tablet - - - - - - - -
209 Oksitetrasiklin HCL inj. Ampul - - - - - - - -
210 Oksitetrasiklin HCL SK 3% Tube - - - - - - - -
211 Oksitetrasiklin HCL SM 1% Tube 314 12,700 3,987,800 - 241 73 - -
212 Oksitosin inj. 10 IU/ml Ampul - - - 600 500 100 1,199 119,900
213 Omeprazol Inj Vial - - - 20 11 9 10,393 93,537
214 Omeprazol kap 20 mg Kapsul - 140 - - - - - -
215 Papaverin 40 mg Tablet - - - - - - - -
216 Parasetamol 100 mg Tablet - - - - - - - -
217 Parasetamol 160 mg supp supp - - - - - - - -
218 Parasetamol 240 mg supp supp - - - - - - - -
219 Parasetamol 500 mg Tablet 9,900 53 524,700 38,000 40,000 7,900 143 1,132,307
220 Parasetamol 80 mg supp supp - - - - - - - -
221 Parasetamol Drop 100 Mg/ml Botol 50 6,649 332,450 180 110 120 6,649 797,880
222 Parasetamol sirup Botol 500 1,107 553,500 1,900 2,000 400 1,181 472,400
223 Perak Sulfadiazin 10 Mg (Burnazin) Tube 2 20,700 41,400 5 7 - 20,700 -
224 Permethrin Cream Tube 65 11,825 768,625 65 130 - 11,825 -
225 Pine Oil 7,0%+benzyl clorophenol 0 Botol - - - - - - - -
226 Pirantel Pamoat 125 mg Tablet - - - - - - - -
227 Piridoksin HCl 10 mg Tablet 3,400 123 418,200 11,000 13,000 1,400 131 183,400
228 Piridoksin HCL 25 mg Tablet - - - - - - - -
229 Piroksikam 10 mg Tablet - - - - - - - -
230 Piroksikam 20 mg Tablet - - - - - - - -
231 Plester 5 yard x 2 inch roll 20 8,259 165,180 48 63 5 43,850 219,250
232 Povidon Yodida 30 ml Botol - - - - - - - -
233 Povidon Yodida 60 ml Botol 13 3,699 48,091 113 126 - 3,700 -
234 Povidon yodida 300 ml Botol 1 18,000 18,000 26 27 - 18,000 -
235 PPDRT kotak - - - - - - - -
236 Prednison 5 mg Tablet 3,400 68 231,200 11,000 14,400 - 68 -
237 Propanolol HCL 40 mg Tablet - 76 - - - - - -
238 Proteksinal Syrup 60 ml Botol - - - - - - - -
239 Quantidex Syrup Botol - - - - - - - -
240 Ranitidine Tablet - 209 - - - - - -
241 Ranitidine inj. Ampul - - - - - - - -
242 Retinol 100.000 IU Kapsul 100 306 30,600 1,300 1,400 - 306 -
243 Retinol 200.000 IU Kapsul 950 552 524,400 8,050 8,500 500 552 276,000
244 Ringer Laktat Botol - - - 1,220 1,100 120 7,630 915,600
245 Risperidon 20 mg Tablet - 287 - - - - - -
246 Salbutamol 2 mg Tablet - 63 - 6,500 5,400 1,100 67 73,700
247 Salbutamol 4 mg Tablet - 70 - - - - - -
248 Salep 2-4 Komb. Tube 24 2,429 58,296 48 48 24 2,429 58,296
249 Salisil Bedak 2%-50 mg kotak 74 4,796 354,904 300 293 81 7,500 607,500
250 Sanadril Syrup Botol - - - - - - - -
251 Schizonoat Inj (Fluphenazin Decanoat) Ampul - 59,800 - 30 30 - 63,813 -
252 Serum ABU IU Vial 3 479,996 1,439,988 8 11 - 479,996 -
253 Serum ATS Tetagam 1 ml (250 IU) Ampul - - - - - - - -
254 Serum ATS 1.500 IU Ampul 7 130,999 916,993 70 68 9 130,999 1,178,991
255 Serum ATS 20.000 IU Kapsul - - - - - - - -
256 Sianokobalamin inj. Ampul 90 1,104 99,360 - 50 40 - -
257 Sianokobalamin tab Tablet 200 49 9,800 - 200 - - -
258 Silk Benang Bedah Sutra set 6 110,000 660,000 - 6 - - -
259 Silver Amalgam Serbuk Botol - - - - - - - -
260 Simvastatin 10 mg Tablet - - - - - - - -
261 Simvastatin 20 mg Tablet - 217 - 2,500 2,000 500 217 108,500
262 Siprofloxacin 500 mg Tablet - 400 - 2,900 2,100 800 400 320,000
263 Spons Gelatin Cubicle 1x1x1 cm pcs - - - - - - - -
264 Sulfasetamida Natrium TM 15% Botol - - - - - - - -
265 Syintetic Filling Material set - - - - - - - -
266 Tablet tambah darah Tablet 23,520 354 8,326,080 252,300 208,120 67,700 354 23,965,800
267 Temporary Stopping Fletcher set - - - - - - - -
268 Tetrasiklin 250 mg Kapsul - - - - - - - -
269 Tetrasiklin 500 mg Kapsul - - - - - - - -
270 Theophyllin 130 mg Tablet - - - - - - - -
271 Thiamin HCL 50 mg Tablet - 91 - 8,500 4,400 4,100 91 373,100
272 Thiamin HCL inj. Ampul - - - - - - - -
273 Tiamfenikol kap 500 mg Kapsul - - - - - - - -
274 Tramadol 50 mg Tablet - - - - - - - -
275 Tramadol inj. Ampul - - - - - - - -
276 Tranfusi Set set - - - - - - - -
277 triamcinolone A.C Tube - - - - - - - -
278 Trihexypenidyl 2 mg Tablet - 80 - 2,100 2,100 - 91 -
279 Under pad pcs 30 7,900 237,000 750 740 40 7,900 316,000
280 Urine bag set 40 5,500 220,000 100 120 20 4,700 94,000
281 Vaksin rabies verro Vial - - - - - - - -
282 Ventolin Nebules 2,5 mg Ampul - - - - - - - -
283 Vitamin B. komplek Tablet 1,000 118 118,000 21,000 18,400 3,600 118 424,800
284 Zinc Dispersible tab Tablet 600 524 314,400 300 900 - 524 -
285 Zinc Drop Botol - - - - - - - -
286 Zinc Syr (zircumkid syr) Botol 30 6,290 188,700 432 354 108 3,171 342,468
287 Plester Cuticell classic 10 cm x 10 cm unit 68 5,198 353,464 - 68 - - -
288 Sarung Tangan Steril Obgyn pasang 24 19,360 464,640 250 274 - 19,360 -
289 Lidocain jelly 2% Tube - - - - - - - -
290 Ca glukonas Ampul 34 4,800 163,200 - 34 - - -
291 Ibuprofen 200 mg/5 ml Suspensi Botol 36 4,665 167,940 288 252 72 4,665 335,880
292 Laxadin Emulsi 60 ml Botol - 12,450 - - - - - -
293 Miniaspi (Asam Asetil Salisilat) 80 mg Tablet - 114 - 200 200 - 105 -
294 Combivent 2,5 ml Vial 30 4,550 136,500 110 130 10 4,550 45,500
295 Leukomed kotak 1 123,056 123,056 3 4 - 123,056 -
296 Sterizyme Botol - 712,800 - - - - - -
297 USG gel 250 ml (ONEMED) Botol 22 12,584 276,848 8 30 - 12,584 -
298 Umbilical Cord Klem Steril (onemed) kotak - 65,000 - - - - - -
299 Glucose Test Strip (Stik gula darah) Kotak 5 149,600 748,000 100 105 - 149,600 -
300 Total colesterol test strip (kolesterol) Kotak - 231,000 - 20 20 - 231,000 -
301 Ulric Test Strip (stik asam urat) Kotak - 126,500 - 10 10 - 150,000 -
302 Mineral mix sachet 803 2,550 2,047,650 91 894 - 2,550 -
303 Tumpatan Sementara Pot - - - - - - - -
304 Etching + Bonding Botol - 905,520 - - - - - -
305 Desinfeksi Saluran Akar Botol - - - - - - - -
306 Pasta Desinfeksi Saluran Akar Pot - - - - - - - -
307 Pasta Desinfeksi Saluran Akar non Arsen Pot - 128,398 - - - - - -
308 Poliren (Cairan Pembersih Gigi) Pot - 254,562 - - - - - -
309 Glimepirid 2 mg Tablet - 289 - - - - - -
310 Softanol 500 mg Botol 4 55,000 220,000 - 4 - - -
311 Metronidazol 500 mg/ml infus Vial 24 7,372 176,928 - 24 - - -
312 7 Elektronika Labtrips U11 Plus Urine Test SKotak 6 334,840 2,009,040 - 6 - - -
313 Haloperidol 2 mg (iodomer 2 mg) Tablet - 84 - - - - - -
314 CHKM Botol - 128,398 - - - - - -
315 Cresotin Pasta 25 Gr tube - 371,000 - - - - - -
316 Dental Mylar Strip tube - 130,900 - - - - - -
317 GC Elite Cement Powder + Liquid Packge pcs - 264,922 - - - - - -
318 Pulp-x Pulp Devitalizer Pasta 6 Gr tube - 61,600 - - - - - -
319 Masker (tali) box - - - 19 19 - 16,500 -
320 Onemed Blood Lancets box - - - 40 14 26 14,566 378,716
321 Onemed Safety box Units - - - 12 2 10 15,715 157,150
322 Safeglove exam S Box - - - 25 25 - 35,620 -
323 Yellow Tip makrolit Bag - - - 41 1 40 34,398 1,375,920
324 SD BIOLINE Dengue IgG/IgM Pcs - - - 3 3 - 1,050,000 -
325 SD BIOLINE HBsAg WB (Multi) Test Pcs - - - 2 2 - 987,800 -
326 SD BIOLINE Leptospire IgG/IgM Pcs - - - 1 1 - 1,300,000 -
327 SD HIV-1V2 3.0 (multi) KIT Pcs - - - 1 1 - 1,140,000 -
328 SD Syphilis Elisa 3.0 Pcs - - - 2 2 - 725,000 -
329 TES HIV 1/2/0 TRI- LINE TEST Pcs - - - 3 3 - 330,875 -
330 VACUTAINER K3 EDTA 3 ML ungu Pcs - - - 18 18 - 100,500 -
331 Onemed Disposable Syringe 3 ml units - - - 2,300 500 1,800 779 1,402,200
332 Cosmomed Gloves Non Steril Size L Box - - - 30 30 - 49,900 -
333 Handscoon Steril size 7 Pcs - - - 100 100 - 7,600 -
334 Handscoon Steril size 7,5 Pcs - - - 50 50 - - -
335 Indec, Hepalisa HBsAg (Virocheck) Pcs - - - 250 250 - - -
336 DIALAB Anti AB Monoclonal botol - - - 1 1 - 92,510 -
337 Masker KN95 Pcs - - - - - - - -
338 Geriavita captabs salut selaput Tablet - - - 1,350 1,350 - 2,174 -
JUMLAH Rp 68,030,075 Rp 67,530,832

Mengetahui Serang, 31 Desember 2020

Kepala UPT Puskesmas Tunjung Teja Petugas Barang

Hj.Dedeh Muhtiarah, S.ST.Keb Yasin Muhtar Abdul Hasan

NIP. 196901081988032003 NIP. 198505192009021004
BELANJA ALAT KEBERSIHAN DAN BAHAN PEMBERSIH (5.2.2.01.05)
1 Plastik Klip Ukuran 10 x 7 Unit 0 Rp - Rp - 70 70 0 Rp 6,500 Rp -
2 Plastik Klip Ukuran 13 x 8,7 Unit 0 Rp - Rp - 70 70 0 Rp 8,500 Rp -
3 Kantong Plastik Kecil 400gram Unit 0 Rp - Rp - 20 20 0 Rp 18,000 Rp -
4 Kantong Plastik Kuning 60x100 Unit 0 Rp - Rp - 5 5 0 Rp 50,000 Rp -
5 Kantong Plastik Hitam Ukuran 60 x 100 Unit 0 Rp - Rp - 5 5 0 Rp 24,000 Rp -
6 Kantong Plastik Hitam Ukuran 10 x 100 Unit 0 Rp - Rp - 10 10 0 Rp 18,000 Rp -
7 Kantong Plastik Merah Ukuran 10 x 100 Unit 0 Rp - Rp - 2 2 0 Rp 20,000 Rp -
BELANJA BAHAN OBAT-OBATAN 5.2.2.02.04
1 PHYTOMENADION Box 0 Rp - Rp - 2 2 0 110,460 Rp -
2MG/ML/INJ/30AMP@1MLGKL091990
2 VITAMIN B1 TABLET 5MG MARIN Box 0 Rp - Rp - 40 40 0 8,855 Rp -
3 8943B1
PARACETAMOL 500 MG@BOX/10 Box 0 Rp - Rp - 89 89 0 27,000 Rp -
STRIP NOVAPHARIN
4 PARACETAMOL 500 MG@BOX/10 Box 0 Rp - Rp - 200 200 0 23,100 Rp -
5 STRIP NOVAPHARIN
DEXAMETASON INJ Box 0 Rp - Rp - 1 1 0 197,685 Rp -
SKPD : Kecamatan Tunjung Teja
KABUPATEN : Serang
PROVINSI : Banten

LAPORAN PERHITUNGAN STOCK OPNAME

PER 31 DESEMBER 2019

STOCK OPNAME PER 13 JANUARI 2020

PERSEDIAAN BARANG
NO NAMA BARANG SATUAN Qty Harga (Rp) Jumlah (Rp)
Sisa Penambahan Didistribusikan Rusak/usang Per 31 Desember 2019

1 2 3 4 5 6 7 8 (4-5+6+7) 9 10 (8x9)

ALAT TULIS KANTOR

1 Map Plastik Kancing lsn - - - - 0 Rp 27,500 -
2 Map Bufalo Snell buah - - - - 0 Rp 67,000 -
3 Tellstruk Thermal 80 x 80 buah - - - - 0 Rp 23,000 -
4 Pejn Jokyo 4 w rim - - - - 0 Rp 6,000 -
5 Map Business File buah - - - - 0 Rp 27,500 -
6 Pen Standar AE7 buah - - - - 0 Rp 21,000 -
7 Palstik Laminating Toho Folio buah - - - - 0 Rp 105,000 -
8 Kertas HVS Sinar Dunia A4 70 gr buah - - - - 0 Rp 43,000 -
9 Kertas HVS Sinar Dunia F4 70 gr pcs - - - - 0 Rp 49,000 -
10 Lakban Daimaru Bening buah - - - - 0 Rp 12,000 -
11 Isolasi Daimaru 1'' pcs - - - - 0 Rp 7,000 -
12 Ordner Bantex F4 Tebal buah - - - 0 Rp 35,000 -
13 Tinta Epson 664 Black box - - - - 0 Rp 100,000 -
14 Tinta Epson 664 Color box - - - - 0 Rp 100,000 -
15 Tinta Epson 003 Black/ Color rim - - - - 0 Rp 105,000 -
16 Map Saegull Spring File rim - - - 0 Rp 11,000 -
17 Lem Stick Kecil buah - - - 0 Rp 6,000 -
18 Doubel Tip Bening buah - - - - 0 Rp 4,000 -
 19 Tipe - X buah - - - - 0 Rp 8,000 -
20 Buku Quarto 100 lbr buah - - - - 0 Rp 8,500 -
21 Buku Quarto 200 lbr buah - - - - 0 Rp 16,000 -
22 Buku Folio 100 lbr buah - - - - 0 Rp 17,000 -
23 Buku Folio 200 lbr buah - - - - 0 Rp 31,000 -
24 Buku Folio 500 lbr buah - - - - 0 Rp 71,500 -
25 Pensil Stadeler Ae7 buah - - - - 0 Rp 4,500 -
26 Penggaris Butterfly 30 CM buah - - - - 0 Rp 3,000 -
27 Hekter Max HD 10 buah - - - - 0 Rp 18,000 -
28 Isi Hekter Max No.10 buah - - - - 0 Rp 55,000 -
29 Pembolong Kenko/Jokyo 30 xl buah - - - - 0 Rp 20,000 -
30 Spidol Snowman Permanen buah - - - - 0 Rp 8,000 -
31 Spidol Bos buah - - - - 0 Rp 9,000 -
32 Lem Fox 150 gr buah - - - - 0 Rp 11,000 -
33 Lakban Daimaru Warna buah - - - - 0 Rp 18,500 -
34 Stopmap Kertas buah - - - - 0 Rp 24,000 -
35 Amplop Paperline Besar buah - - - - 0 Rp 22,000 -
36 Amplop Paperline Kecil buah - - - - 0 Rp 16,000 -
37 Gunting Kenco Tanggung buah - - - - 0 Rp 9,000 -
38 Cutter Coco Besar buah - - - - 0 Rp 16,000 -
39 Isi Hekter Max no 10 buah - - - - 0 Rp 3,500 -
40 Kertas Blue Print Photo 210gr buah - - - - 0 Rp 28,500 -
41 Lem Stick Kecil buah - - - - 0 Rp 6,000 -
42 Tellstruk Thermal 57 x 47 buah - - - - 0 Rp 6,000 -
43 Buku Kuarto Lebar buah - - - - 0 Rp 9,000 -
44 Trigonal Clip No. 03 buah - - - - 0 Rp 18,000 -
45 Binder Klip 155 buah - - - - 0 Rp 8,000 -
46 Binder Klip 111 buah - - - - 0 Rp 6,000 -
47 Binder Klip 107 buah - - - - 0 Rp 5,000 -
48 Doble Tip 1 buah - - - - 0 Rp 4,000 -
49 Glue Gun Refill buah - - - - 0 Rp 1,250 -
50 Pensil Staedler 2 B buah - - - - 0 Rp 4,000 -
51 Spidol Snowman Permanen buah - - - - 0 Rp 8,000 -
JUMLAH -
REKAPAN BELANJA PERLENGKAPAN PASIEN KORING 5.2.2.01.25
1 KERTAS USG PACK - - - - 0 Rp 245,000 -
2 KERTAS PUYER PRES PACK - - - - 0 Rp 105,000 -
3 Stick HB (Mek Easy Touch) - - - - 0 Rp 175,000 -
4 Stick Gula Darah (Mek Easy Touch) - - - - 0 Rp 112,000 -
 5 Stick Asam Urat (Mek Easy Touch) - - - - 0 Rp 112,000 -
6 Stick Kolesterol (Mek Easy Touch) - - - - 0 Rp 195,000 -
7 Protein Urine 3P Verify - - - - 0 Rp 100,000 -
8 Saim Sacher Lotus - - - - 0 Rp 15,000 -
9 Apron Whith Apron - - - - 0 Rp 285,500 -
10 Kertas USG Sony - - - - 0 Rp 280,000 -
11 Kertas Puyer Press Sony - - - - 0 Rp 100,000 -
12 Underpads PACK - - - - 0 Rp 38,000 -
13 Tabung EDTA PACK - - - - 0 Rp 135,000 -
14 Slam Sacher PCS - - - - 0 Rp 15,000 -
15 Appron BOX - - - - 0 Rp 285,000 -
16 ONEMED APRON ONE PLASTIK PACK - - - - 0 Rp 39,050 -
17 Umbilical Cleamp PACK - - - - 0 Rp 82,500 -
18 JAS HUJAN PLASTIK Unit - - - - 0 Rp 25,000 -
19 HAND SANITALYSER 500 ML MERK Unit 0 Rp 200,000
VECOM (500 ML) - - - - -

20 KACAMATA GOOGLE BS004 BE SAVE Unit 0 Rp 95,000

- - - - -

21 SEPATU BOTS SAFETY (PETROPA UK- Unit 0 Rp 200,000

41 DAN 42) - - - - -

22 SARUNG TANGAN LEOPARD Unit - - - - 0 Rp 25,000 -

23 HELM SAFETY NSA KUNING DAN Unit 0 Rp 200,000
KACA VISOR BLUE EAGLE - - - - -

JUMLAH
BELANJA CETAK (5.2.2.06.01)
1 Form Pendataan eppgb rim - - - - 0 Rp 95,000 -
2 Buku formar pemantauan EPBGGM buku - - - - 0 Rp 40,000 -
3 buku resep Rim - - - - 0 Rp 135,000 -
4 Alur Pelayanan Rawat jalan buah - - - - 0 Rp 225,000 -
5 Xbanner unit - - - - 0 Rp 150,000 -
6 Xbanner unit - - - - 0 Rp 150,000 -
7 novel Coronavirus unit - - - - 0 Rp 300,000 -
8 cuci tangan pakai sabun unit - - - - 0 Rp 300,000 -
9 knapa cuci tangan harus pakai SABUN unit - - - - 0 Rp 300,000 -
10 BUKU REGISTER KHORT IBU 5 desa buku - - - - 0 Rp 185,000 -
11 BUKU REGISTER KHORT IBU 10 desa buku - - - - 0 Rp 185,000 -
12 Lembar Rawat jalan Pink lebar - - - - 0 Rp 1,200 -
13 Alur Covid-19 unit - - - - 0 Rp 250,000 -
14 acrylic pendaftaran unit - - - - 0 Rp 650,000 -
 15 buku Surat sehat dokter rim - - - - 0 Rp 130,000 -
16 bingkai ASI PCS - - - - 0 Rp 250,000 -
17 Bingkai PCS - - - - 0 Rp 175,000 -
18 Acrylic Meja unit - - - - 0 Rp 450,000 -
19 Acrylic Meja unit - - - - 0 Rp 350,000 -
20 buku profil Buku - - - - 0 Rp 90,000 -
21 buku profil Buku - - - - 0 Rp 35,000 -
22 cetak oneway Meter - - - - 0 Rp 80,000 -
23 Jasa Setting ulang oneway Jasa - - - - 0 Rp 10,000 -
24 Jasa pasang Oneway Jasa - - - - 0 Rp 50,000 -
25 Lemabar Rawat Jalan Lembar - - - - 0 Rp 1,100 -
Belanja Bahan Laboratorium/ Reagent (5.2.2.02.25)
1 Reagent zein neilshen box - - - - 0 Rp - -
2 Diatro Dil 5 p 20 l box - - - - 0 Rp 1,700,000 -
3 Diatro Lyse Diff +key 1 l botol - - - - 0 Rp 1,600,000 -
4 Diatro cleaner botol - - - - 0 Rp 325,000 -
 Mengetahui Tim Pemeriksa :
Kepala UPT Puskesmas Tunjung Teja Petugas Barang
1. Hj. Sari Mulyati, S.Kp, M.Kes
NIP. 19640331 198708 2 001

Hj.Dedeh Muhtiarah, S.ST.Keb Yasin Muhtar Abdul Hasan 2. H. Yayat Sudrayat, SH, M.Si
NIP. 196901081988032003 NIP. 198505192009021004 NIP. 19641231 199601 1 002

3. Nawa Ratri Rahayu. SE

NIP.

4. Iyos Rosandi, S.Pd

3. Mutiah Syahlany, SE
NIP.
BELANJA CETAK (5.2.2.06.01)
1 Form Pendataan eppgb PACK - - - - 0 Rp 95,000
2 Buku formar pemantauan EPBGGM PACK - - - - 0 Rp 40,000
3 buku resep (Mek Easy Touch) - - - - 0 Rp 135,000
4 Alur Pelayanan Rawat jalan (Mek Easy Touch) - - - - 0 Rp 225,000
5 Xbanner (Mek Easy Touch) - - - - 0 Rp 150,000
6 Xbanner (Mek Easy Touch) - - - - 0 Rp 150,000
7 novel Coronavirus Verify - - - - 0 Rp 300,000
8 cuci tangan pakai sabun Lotus - - - - 0 Rp 300,000
9 knapa cuci tangan harus pakai SABUN Whith Apron - - - - 0 Rp 300,000
10 BUKU REGISTER KHORT IBU 5 desa Sony - - - - 0 Rp 185,000
11 BUKU REGISTER KHORT IBU 10 desa Sony - - - - 0 Rp 185,000
12 Lembar Rawat jalan Pink PACK - - - - 0 Rp 1,200
13 Alur Covid-19 PACK - - - - 0 Rp 250,000
14 acrylic pendaftaran PCS - - - - 0 Rp 650,000
15 buku Surat sehat dokter BOX - - - - 0 Rp 130,000
16 bingkai ASI PACK - - - - 0 Rp 250,000
17 Bingkai PACK - - - - 0 Rp 175,000
18 Acrylic Meja Unit - - - - 0 Rp 450,000
19 Acrylic Meja Unit - - - - 0 Rp 350,000
20 buku profil Unit - - - - 0 Rp 90,000
21 buku profil Unit - - - - 0 Rp 35,000
22 cetak oneway Unit - - - - 0 Rp 80,000
23 Jasa Setting ulang oneway Unit - - - - 0 Rp 10,000
24 Jasa pasang Oneway JASA - - - - 0 Rp 50,000
25 Lemabar Rawat Jalan Unit - - - - 0 Rp 1,100
REKAPAN BELANJA PERLENGKAPAN PASIEN KORING 5.2.2.01.25
1 KERTAS USG PACK - - - - 0 Rp 95,000
2 KERTAS PUYER PRES PACK - - - - 0 Rp 40,000
3 Stick HB (Mek Easy Touch) - - - - 0 Rp 135,000
4 Stick Gula Darah (Mek Easy Touch) - - - - 0 Rp 225,000
5 Stick Asam Urat (Mek Easy Touch) - - - - 0 Rp 150,000
6 Stick Kolesterol (Mek Easy Touch) - - - - 0 Rp 150,000
7 Protein Urine 3P Verify - - - - 0 Rp 300,000
8 Saim Sacher Lotus - - - - 0 Rp 300,000
 9 Apron Whith Apron - - - - 0 Rp 300,000
10 Kertas USG Sony - - - - 0 Rp 185,000
11 Kertas Puyer Press Sony - - - - 0 Rp 185,000
12 Underpads PACK - - - - 0 Rp 1,200
13 Tabung EDTA PACK - - - - 0 Rp 250,000
14 Slam Sacher PCS - - - - 0 Rp 650,000
15 Appron BOX - - - - 0 Rp 130,000
16 ONEMED APRON ONE PLASTIK PACK - - - - 0 Rp 250,000
17 Umbilical Cleamp PACK - - - - 0 Rp 175,000
18 JAS HUJAN PLASTIK Unit - - - - 0 Rp 450,000
19 HAND SANITALYSER 500 ML MERK VECUnit - - - - 0 Rp 350,000
20 KACAMATA GOOGLE BS004 BE SAVE Unit - - - - 0 Rp 90,000
21 SEPATU BOTS SAFETY (PETROPA UK-41Unit - - - - 0 Rp 35,000
22 SARUNG TANGAN LEOPARD Unit - - - - 0 Rp 80,000
23 HELM SAFETY NSA KUNING DAN KACA Unit - - - - 0 Rp 10,000
BELANJA ALAT KEBERSIHAN DAN BAHAN PEMBERSIH (5.2.2.01.05)
1 Plastik Klip Ukuran 10 x 7 Unit - - - - 0 Rp 6,500
2 Plastik Klip Ukuran 13 x 8,7 Unit - - - - 0 Rp 8,500
3 Kantong Plastik Kecil 400gram Unit - - - - 0 Rp 18,000
4 Kantong Plastik Kuning 60x100 Unit - - - - 0 Rp 50,000
5 Kantong Plastik Hitam Ukuran 60 x 100Unit - - - - 0 Rp 24,000
6 Kantong Plastik Hitam Ukuran 10 x 100Unit - - - - 0 Rp 18,000
7 Kantong Plastik Merah Ukuran 10 x 10 Unit - - - - 0 Rp 20,000
BELANJA BAHAN OBAT-OBATAN 5.2.2.02.04
PHYTOMENADION 2MG/ML/INJ/30AMBox - - - - 0 Rp 110,460
VITAMIN B1 TABLET 5MG MARIN Box - - - - 0 Rp 8,855
PARACETAMOL 500 MG@BOX/10 STRIBox - - - - 0 Rp 27,000
PARACETAMOL 500 MG@BOX/10 STRIBox - - - - 0 Rp 23,100
DEXAMETASON INJ Box - - - - 0 Rp 197,685
JUMLAH 0 0
Mengetahui, Pengurus Barang Tim Pemeriksa :
Kepala Puskesmas Tunjung Teja
1. Hj. Sari Mulyati, S.Kp, M.Kes
NIP. 19640331 198708 2 001

2. H. Yayat Sudrayat, SH, M.Si

NIP. 19641231 199601 1 002
HJ. DEDEH MUTHIARAH, S.ST. KEB AHMAD JAHRI
NIP. 196901081988032003 NIP. 197601142010011004 3. Agus Manduri
NIP. 19760921 201001 1 002

4. Sri Indah Gameswari, ST. MT

NIP. 19790921 201001 2 006