LAPORAN MUTASI OBAT DAN BMHP

PUSKESMAS KANDANG
BULAN : AGUSTUS
TAHUN :2021
SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75
A OBAT-OBATAN
1 Albendazole Tablet 400 mg Tablet - - - - - 3,000 3,000 - 2,500 - - 2,500 500 500
2 Allopurinol tab 100 mg Tablet 500 - - - 500 1,000 1,000 600 - - - 600 900 900
3 Aminofillin tab 200 mg Tablet - - - - - - - - - - - -
4 Ambroxol tablet 30 mg Tablet - - 2,300 - 2,300 1,000 1,000 - - 1,800 - 1,800 1,500 1,500
5 Ambroxol Syrup 15 mg/5ml Botol - - - - - 100 100 - - 40 - 40 60 60
6 Amitriptyline Tablet - 337 - - 337 - - 95 - - 95 242 242
7 Amlodipine 5 mg Tablet 600 - - - 600 900 900 1,200 - - - 1,200 300 300
8 Amlodipine 10 mg Tablet 400 - - - 400 - 400 - - - 400 -
9 Amoksisilin kaplet 500 mg Kaplet 14,800 - - - 14,800 2,900 2,900 4,400 - - - 4,400 13,300 13,300
10 Amoksisilin kapsul 250 mg Kapsul 800 - - - 800 - 300 - - - 300 500 500
11 Amoksisilin sirup kering 125 mg/ml - 60 ml Botol 70 - 31 - 101 100 100 55 - - - 55 115 31 146
12 Antasida Doen Tab Tablet 1,600 - - - 1,600 1,000 1,000 1,600 - - - 1,600 1,000 1,000
13 Antasida Doen Syrup Botol 185 - - - 185 100 100 125 - - - 125 160 160

14 Anti Bakteri DOEN salap kombinasi(Bacitracin Tube

Polymyksin) - - - - - - - - - - - -
15 Anti fungi doen Pot 64 - - - 64 - 4 - - - 4 60 60
16 Anti Hemoroid Suppositoria Supp - 8 - - 8 - - 6 - - 6 2 2
17 Asam askorbat (vit c) tab 50 mg Tablet 3,000 - - - 3,000 - 1,500 - - - 1,500 1,500 1,500
18 Asam Folat 1 mg Tablet - - 2,700 - 2,700 - - - - - - 2,700 2,700
19 Asam mefenamat tab 500 mg Kaplet - - 1,300 - 1,300 2,000 2,000 - - 1,200 - 1,200 2,100 2,100
20 Asiklovir krim 5% - 5gr Tube - - 25 - 25 - - - 5 - 5 20 20
21 Asiklovir tab 400 mg Tablet 1,000 - - - 1,000 - 400 - - - 400 600 600
22 Azitromycin tab 500 mg Tablet - 189 - - 189 - - 138 - - 138 51 51
23 Baby Cough Syrup (Pacdin Syrup) Botol - - - - - 50 50 - - 13 - 13 37 37
24 Berotec 0,1 mg MDI HFA AS Botol 23 - - - 23 - 16 - - - 16 7 7

25 Besi (II) sulfat 200 mg + Asam Folat 0,25 mg

(tablet tambah darah kombinasi) Tablet 20,220 - - - 20,220 - 1,200 - - - 1,200 19,020 19,020
26 Betahistin Mesilat Tablet - - 350 - 350 - - - - - - 350 350
27 Betametason krim 0,1% - 5 gr Tube 110 - - - 110 - 35 - - - 35 75 75
28 Boraks gliserin Botol - - 15 - 15 - - - 1 - 1 14 14
29 Bricasma Nebuhaler Aerosol 0.25 mg/ Dosis Botol - - - - - - - - - - - -
30 Burnazin cream Tube - - 3 - 3 - - - 1 - 1 2 2
31 Cefadroksil kapsul 500 mg Kapsul - - - - - - - - - - - -
 SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75
32 Cefadroksil Syrup 125 mg/ml Botol 58 - - - 58 - 6 - - - 6 52 52
33 Cetirizine Tablet 10 mg Tablet - - - - - 3,000 3,000 - - 1,300 - 1,300 1,700 1,700
34 Cetirizine syrup 5 mg/5 ml Botol - - 68 - 68 - - - - - - 68 68
35 Clindamycin Kapsul 150 mg Kapsul - - - - - - - - - - - -
36 Clindamycin Kapsul 300 mg Kapsul - - 400 - 400 - - - 100 - 100 300 300
37 Ciprofloxacin 500 mg Tablet - - - - - 3,000 3,000 - - 800 - 800 2,200 2,200
38 Counterpain cream Tube - - - - - - - - - - - -
39 Deksametason Tablet 0,5 mg Tablet - - 3,600 - 3,600 - - - 2,000 - 2,000 1,600 1,600
40 Deksametason Injeksi Ampul 80 - 40 - 120 - 10 - - - 10 70 40 110
41 Diazepam injeksi 5 mg/ml-2ml Ampul - - 2 - 2 - - - - - - 2 2
42 Diazepam tablet 2 mg Tablet - 265 - - 265 - - 12 - - 12 253 253
43 Diazepam tablet 5 mg Tablet - - - - - - - - - - - -
44 Diazepam Rectal Tube 5 mg/2,5 ml (Stesolid) Tube - - - - - 10 10 - - - - - 10 10
45 Difenhidramin HCl Injeksi 10 mg Ampul - - 120 - 120 - - - - - - 120 120
46 Domperidon 10 mg Tablet 900 - - - 900 2,000 2,000 1,100 - - - 1,100 1,800 1,800
47 Domperidone suspensi 60 ml Botol - - 76 - 76 - - - 8 - 8 68 68
48 Doxycycline 100 mg Kapsul - - - - - - - - - - - -
49 Epinefrin Injeksi Tube - - 13 - 13 - - - - - - 13 13
50 Erytromycin kaplet 500 mg Kaplet - 400 - - 400 - - - - - - 400 400
51 Fenobarbital injeksi 50 mg/ml Tablet - - - - - - - - - - - -
52 Fitomenadion (Vit K1) 10 mg Tablet Tablet 500 - - - 500 - 300 - - - 300 200 200
53 Fitomenadion Injeksi 10 mg / ml Ampul 40 - - - 40 - - - - - - 40 40
54 Fluconazole 150 mg Kotak - - - - - - - - - - - -
55 Furosemide 40 mg Tablet - - - - - 400 400 - - - - - 400 400
56 Garam Oralit Serbuk Sacchet - 400 - - 400 - - 70 - - 70 330 330
57 Gentamisin tetes mata Botol 96 - - - 96 - 24 - - - 24 72 72
58 Gentamisin Salap Kulit Tube - - 100 - 100 - - - 60 - 60 40 40
59 Gentamisin salap mata 0,3 % Tube - - - - - - - - - - - -
60 Gentian Violet Botol - - 21 - 21 - - - - - - 21 21
61 Glimepiride Tablet 1 mg Tablet 400 - - - 400 - 100 - - - 100 300 300
62 Glimepiride Tablet 2 mg Tablet 1,000 - - - 1,000 - 300 - - - 300 700 700
63 Glibenklamid tab 5 mg Tablet 400 - - - 400 400 400 300 - - - 300 500 500
64 Glutavit Tablet 400 - - - 400 - - - - - - 400 400
65 Guaifenesin (GG) Tablet - - - - - 3,000 3,000 - - 1,500 - 1,500 1,500 1,500
66 Griseofulvin tab 125 mg micronized Tablet 300 - - - 300 - 300 - - - 300 -
67 Guanistrep Syrup Botol - - - - - - - - - - - -
68 Haloperidol tab 1,5 mg Tablet - 576 - - 576 - - 176 - - 176 400 400
69 Hidroklhorthiazid (HCT) tab 25 mg Tablet 68 - - - 68 - - - - - - 68 68
70 Hidrokortison krim 2,5% - 5 gr Tube 72 - - - 72 - 24 - - - 24 48 48
 SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75
71 Ibuprofen tab 400 mg Tablet - - 1,000 - 1,000 2,000 2,000 - - 1,700 - 1,700 1,300 1,300
72 Ibuprofen Suspensi 200 mg/ 5 ml Botol 132 - - - 132 - - - - - - 132 132
73 Ichtyol Pot - - - - - - - - - - - -
74 Isosorbide Dinitrate Table 5 mg Tablet - - - - - - - - - - - -
75 Kalsium Laktat tab 500 mg Tablet 1,300 - - - 1,300 - 700 - - - 700 600 600
76 Kaptopril 12,5 mg Tablet 400 - - - 400 - 300 - - - 300 100 100
77 Kaptopril 25 mg Tablet - - - - - - - - - - - -
78 Ketoconazole tablet Tablet - - - - - - - - - - - -
79 Ketorolac Inj Ampul - - 12 - 12 24 24 - - - - - 36 36
80 Klorampenikol 250 mg Kapsul - - - - - - - - - - - -
81 Kloramfenikol Syrup Botol - - 79 - 79 - - - - - - 79 79
82 Klorampenikol salap mata 1 % - 5 gr Tube - - - - - - - - - - - -
83 Klorampenikol salap kulit 10 gr Tube - - - - - - - - - - - -
84 Klorampenikol TM Botol - - 85 - 85 - - - 10 - 10 75 75
85 Kloramfenikol Tetes Telinga Botol - - 37 - 37 - - - 12 - 12 25 25
86 Klorfeniramin maleat (ctm) tab 4 mg Tablet 1,100 - - - 1,100 - 1,100 - - - 1,100 -
87 Kombipak Azithromycin- Cefixime Kombinasi Paket - - - - - - - - - - - -
88 Klorpromazin 100 mg tablet Salut Selaput Tablet - 92 - - 92 - - 80 - - 80 12 12
89 Kotrimoksazole DOEN I (Dewasa) Tablet 300 - - - 300 1,000 1,000 400 - - - 400 900 900
90 Kotrimoksazole Forte 800 mg + 160 mg Tablet - - - - - - - - - - - -
91 Kotrimoksazole Suspensi Botol 55 - - - 55 - 20 - - - 20 35 35
92 Lactulosa Syrup Botol - - - - - - - - - - - -
93 Lidocaine HCl Injeksi 2 % Ampul 65 - - - 65 - - - - - - 65 65
94 MDT MB Dewasa Tablet - - - - - - - - - - - -
95 Meloksikam 7,5 mg Tablet - - - - - - - - - - - -
96 Metformin 500 mg Tablet 300 - 1,000 - 1,300 - - - - - - 300 1,000 1,300
97 Methylergometrine Tablet Salut Selaput 0,125 Tablet - 100 - - 100 - - - - - - 100 100
98 Methylergometrine Maleat Injection 0.200 mg Ampul - - - - - - - - - - - -
99 Metilprednisolon tablet 4 mg Tablet 2,000 - - - 2,000 1,000 1,000 1,800 - - - 1,800 1,200 1,200
100 Metoklopramide Injeksi (Sotatic) Ampul - - - - - - - - - - - -
101 Metronidazole tablet 500 mg Tablet - - - - - - - - - - - -
102 Metronidazole tablet 500 mg (Flagsol) Tablet - - 1,100 - 1,100 - - - 200 - 200 900 900
103 Mikonazole krim 2 % - 10 gram Tube 120 - - - 120 - 72 - - - 72 48 48
104 Muliavit Syrup Botol - - 86 - 86 - - - 14 - 14 72 72
105 Multivitamin HB Vit Tablet 600 - - - 600 - 300 - - - 300 300 300
106 Natrium Bicarbonat 500 mg Tablet - - 1,000 - 1,000 2,000 2,000 - - 700 - 700 2,300 2,300
107 Natrium Diklofenac tab 50 mg Tablet - - - - - - - - - - - -
108 Natrium klorida lar infus 0,9% steril Botol 20 - - - 20 - - - - - - 20 20
109 New Antides tab 500 mg Tablet 500 - - - 500 500 500 400 - - - 400 600 600
110 Nifedipine 10 mg Tablet - 200 - - 200 - - - - - - 200 200
 SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75
111 OAT FDC Kategori I Paket - - - - - - - - - - - -
112 OAT Kategori II Paket - - - - - - - - - - - -
113 Obat Batuk Hitam (OBH) 100 ml Botol - - 62 - 62 - - - 54 - 54 8 8
114 Obat Batuk Putih (OBP) 100 ml Botol - - - - - 100 100 - - 22 - 22 78 78
115 Oksitetrasiklin Salap Mata 1 % Tube - - - - - - - - - - - -
116 Omeprazole 20 mg Kapsul - - 2,100 - 2,100 - - - 1,100 - 1,100 1,000 1,000
117 Omeprazole 20 mg (Zeprazol) Kapsul - - - - - - - - - - - -
118 Omegdiar Syrup Botol - - 24 - 24 - - - 7 - 7 17 17
119 Oxytocin Injeksi 10 IU/ml Ampul 6 - - - 6 10 10 16 - - - 16 -
120 Oseltamivir 75 mg Kapsul - 248 - - 248 - - 174 - - 174 74 74
121 Parasetamol Drop Botol - - - - - - - - - - - -
122 Parasetamol sirup 120 mg/5ml-60 ml Botol 210 - 64 - 274 100 100 110 - - - 110 200 64 264
123 Parasetamol tablet 500 mg Tablet 1,000 - 4,800 - 5,800 5,000 5,000 4,700 - 200 - 4,900 1,300 4,600 5,900
124 Pehacain injeksi 20 ml Ampul - - 60 - 60 - - - - - - 60 60
125 Pyrantel Pamoat Tablet 125 mg Tablet 38 - - - 38 - 10 - - - 10 28 28
126 Piridoksin (Vit B6) tab 10 mg Tablet 800 - - - 800 1,000 1,000 500 - - - 500 1,300 1,300
127 Piroksikam 10 mg Tablet - - - - - 2,000 2,000 - - 600 - 600 1,400 1,400
128 PK Kristal Pot - - - - - - - - - - - -
129 Prednison tab 5 mg Tablet 600 - - - 600 10,000 10,000 1,000 - - - 1,000 9,600 9,600
130 Propiltiourasil tab 100 mg Tablet - - - - - - - - - - - -
131 Ranitidine HCl Injeksi 25 mg/ml Ampul - - 30 - 30 50 50 - - - - - 80 80
132 Ranitidine 150 mg Tablet - - 300 - 300 2,900 2,900 - - 1,400 - 1,400 1,800 1,800
133 Retinol 100.000 IU Kapsul 4,000 - - - 4,000 - 500 - - - 500 3,500 3,500
134 Retinol 200.000 IU Kapsul 4,000 - - - 4,000 - 1,000 - - - 1,000 3,000 3,000
135 Ringer laktat lar infus steril Botol 35 - - - 35 40 40 20 - - - 20 55 55
136 Risperidone tab 2 mg Tablet - 380 - - 380 - - 70 - - 70 310 310
137 Salap 2 - 4 Pot 30 - - - 30 96 96 18 - - - 18 108 108
138 Salbutamol tab 2 mg Tablet - - 4,800 - 4,800 - - - 400 - 400 4,400 4,400
139 Salap Luka Bakar (Levertran) Zalf 15 gr Pot - - - - - - - - - - - -
140 Salisil Bedak 2 % - 50 gr Sacchet - - 6 - 6 50 50 - - 10 - 10 46 46
141 Scabimite cream 10 gr Tube 134 - - - 134 - 34 - - - 34 100 100
142 Serum Anti Bisa Ular (ABU) Vial - - - - - - - - - - - -
143 Serum Anti Tetanus (ATS) Ampul 10 - - - 10 - - - - - - 10 10
144 Sianokobalamin injeksi (Vit B12) Ampul 90 - - - 90 - - - - - - 90 90
145 Sianokobalamin injeksi (Vit B12) 8 ml Vial - - 20 - 20 - - - - - - 20 20
146 Simvastatin tab 10 mg Tablet 840 - - - 840 600 600 660 - - - 660 780 780
147 Simvastatin tab 20 mg Tablet - - - - - - - - - - - -
148 Thiamin HCl/Monohidrat (Vit B1) tablet 50 mg Tablet 600 - - - 600 1,000 1,000 600 - - - 600 1,000 1,000
149 Thiamin HCL(Vit B1) Injeksi 100 mg/ml Vial - - - - - - - - - - - -
150 Trihexifenidil 2 mg Tablet 315 - - - 315 - 110 - - - 110 205 205
 SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75
151 Ventoliin Nebules - Salbutamol cairan ih 0,1 % Ampul - - - - - 100 100 - - 15 - 15 85 85
152 Vitamin B kompleks tablet Tablet 1,000 - - - 1,000 - 1,000 - - - 1,000 -
153 Xylestesin-A Ampul - - - - - - - - - - - -
154 Zink syrup Botol 28 - - - 28 - 8 - - - 8 20 20
155 Zink tab 20 mg Tablet 800 - - - 800 - 300 - - - 300 500 500
- - - - - - - - - - - -
B BARANG MEDIS HABIS PAKAI - - - - - - - - - - - -

- - - - - - - - -
1 Abbocath 18 Pcs 45 - - - 45 - - - - - - 45 45
2 Abbocath 20 Pcs 30 - - - 30 - 20 - - - 20 10 10
3 Abbocath 22 Pcs 20 - - - 20 - 10 - - - 10 10 10
4 Abbocath 24 Pcs 35 - - - 35 - 6 - - - 6 29 29
5 Alat suntik sekali pakai 1 ml Pcs 190 - - - 190 - - - - - - 190 190
6 Alat suntik sekali pakai 2,5 ml Pcs - 150 - - 150 - - - - - - 150 150
7 Alat suntik sekali pakai 3 ml Pcs 85 - - - 85 200 200 30 - - - 30 255 255
8 Alat suntik sekali pakai 5 ml Pcs 120 - - - 120 - - - - - - 120 120
9 Alkacide Larutan - 1 L Botol 1 - - - 1 - - - - - - 1 1
10 Alkazyme Powder - (25 Sachet x 25 gr) Serbuk 1 - - - 1 - - - - - - 1 1
11 Alkohol Swabs 100 pcs Kotak 8 - - - 8 - 5 - - - 5 3 3
12 Alveogyl - Dental Kotak - - - - - - - - - - - -
13 Apron Tebal Warna Pcs - - - - - - - - - - - -
14 Anaestesi Gel Tube - - - - - - - - - - - -
15 Alat Cek Gula - Contour Plus Pcs - - - - - 2 2 - - 2 - 2 -
16 Alat Cek Asam Urat - EasyTouch Pcs - - - - - 1 1 - - 1 - 1 -
17 APD (Set 4 Item) Set - - - 50 50 - - - - - - 50 50
18 Aquacel Ag 4 x 4 Pcs - - - - - - - - - - - -
19 Aquacel Dressing 10 x 10 Pcs - - - - - - - - - - - -
20 Aquadest 1000 ml Botol - - 3 - 3 - - - - - - 3 3
21 Betadine Solution 60 Botol 4 - - - 4 - - - - - - 4 4
22 Betadine Solution - 30 ml Botol - 2 - - 2 - - - - - - 2 2
23 Betadine Solution 300 ml Botol - 2 - - 2 - - 1 - - 1 1 1
24 Bisturi No. 10 Kotak - - - - - - - - - - - -
25 Bisturi No. 11 Kotak - - - - - - - - - - - -
26 Bisturi No. 12 Kotak - - - - - - - - - - - -
27 Bisturi No. 20 Bbraun
Blades/Carbon Steel Scalpel Blades Pcs - - 15 - 15 - - - - - - 15 15
28 (Aesculap)#20
Blades/Carbon Steel Scalpel Blades Kotak - - - - - - - - - - - -
29 (Aesculap)#24 Kotak - - - - - - - - - - - -
30 Blood Lancet Onemed Box - - - - - 5 5 - - - - - 5 5
 SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75
31 Carpule Box - - - - - - - - - - - -
32 Caviton Box - - - - - - - - - - - -
33 Catgut/Benang bedah plain No. 3/0 75 cm Kotak 2 - - - 2 - - - - - - 2 2
34 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Kotak - - - - - - - - - - - -
35 Catgut Optime 3-0 Pcs 10 - - - 10 36 36 10 - - - 10 36 36
36 Catgut Peters Plain 3/0 Pcs - - - - - - - - - - - -
37 Cerument Set Set - - - - - 1 1 - - 1 - 1 -
38 CHKM Box - - - - - - - - - - - -
39 Cocoa Butter Box - - - - - - - - - - - -
40 Combiscreen 11 Sys Kotak - - - - - - - - - - - -
41 Cutticell Classic Pcs - - 10 - 10 - - - - - - 10 10
42 Dengue Early Rapid Test Box - - - - - - - - - - - -
43 Duoderm CGF Tube - - - - - - - - - - - -
44 Duoderm Extra Thin 2 x 8 Pcs - - - - - - - - - - - -
45 Etanol 70% - 100 ml Botol - - - - - - - - - - - -
46 Etanol 70% - 1000 ml Botol 9 - - - 9 - 1 - - - 1 8 8
47 Etanol 96 % - 1000 ml Botol - - - - - - - - - - - -
48 Eugenol Box - - - - - - - - - - - -
49 Etil Klorida Spray - 200 ml Botol - - - - - - - - - - - -
50 Etil Klorida Spray - 100 ml Botol - - 3 - 3 - - - 1 - 1 2 2
51 Fuji 2 Universal Restorative Pcs - - - - - - - - - - - -
52 Fuji IX A3 Box - - - - - - - - - - - -
53 Fletcher Set Dental Box - - - - - - - - - - - -
54 Fescoplast 5cm x 4,5 cm Kotak 10 - - - 10 - 2 - - - 2 8 8
55 Golongan Darah Set - - - - - - - - - - - -
56 Gunting Iris Bengkok 14 cm Pcs - - - - - - - - - - - -
57 Gunting Iris Lurus 14 cm Pcs - - - - - - - - - - - -
58 Hand Rub Antiseptic Liquid - 500 ml Botol 120 - - - 120 - - - - - - 120 120
59 Hand Sanitizer 500 ml Botol - - - - - - - - - - - -
60 Hand Sanitizer 2 L Botol - - - - - - - - - - - -
61 Hand Sanitizer 5 L Botol - - - - - - - - - - - -
62 Handscun Non Steril M Kotak 7 - - - 7 10 10 5 - - - 5 12 12
63 Handscun Non Steril S Kotak - - - - - 10 10 - - - - - 10 10
64 Handscun Non Steril L Kotak 1 - - - 1 5 5 2 - - - 2 4 4
65 Handscun Steril No. 7.5 Pasang - - - - - - - - - - - -
66 H2O2 3% 800cc - 0m Botol - - - - - 2 2 - - - - - 2 2
67 Infusset Anak Pcs 40 - - - 40 - 6 - - - 6 34 34
68 Infusset Dewasa Pcs 25 - - - 25 - 1 - - - 1 24 24
69 Isi Ulang Oksigen Tabung kecil Buah - - - - - - - - - - - -
70 Isi Ulang Oksigen Tabung Besar Buah - - - - - - - - - - - -
 SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75
71 Kapas gulung 500 gr Pcs - - - - - - - - - - - -
72 Kasa Gulung 80 yard x 80 cm Gulung - - - - - - - - - - - -
73 Kasa Gulung 40 yard x 80 cm Gulung 3 - - - 3 2 2 - - - - - 5 5
74 Kasa Hidrofil 4 yard x 5 cm Pcs - - - - - 100 100 20 - - - 20 80 80
75 Kasa Steril16 x 16 Pcs 18 - - - 18 - 10 - - - 10 8 8
76 Kapas Pembalut/absorben 250 gr Gulung 12 - - - 12 - 2 - - - 2 10 10
77 Kasa Pembalut Hidrofil 3,6 x 15 cm Pack - - - - - - - - - - - -
78 Kertas Perkamen Pack - - 26 - 26 - - - 1 - 1 25 25
79 Masker Pcs - - 20 200 220 - - - - 20 20 20 180 200
80 Masker N95 Pcs - - - - - 200 200 - 20 - - 20 180 180
81 Masker Oksigen Non Rebreathing Anak Pcs - - - - - 10 10 - - - - - 10 10
82 Masker Oksigen Non Rebreathing Dewasa Pcs - - - - - 10 10 - - - - - 10 10
83 Needle No. 22 Pcs - - - - - - - - - - - -
84 Needle No. 23 G DM Pcs - - - - - - - - - - - -
85 Needle No. 25 G FXL Trm Pcs - - - - - - - - - - - -
86 Nald Heating GT.10/GR.10 Merk Remedi Pcs - - - - - - - - - - - -
87 Paper Roll (Thermal Paper 5 cm) Roll - - - - - - - - - - - -
88 Paper Tape 2,5 cm Roll 24 - - - 24 - - - - - - 24 24
89 Peter Silk S 25290 Pcs 40 - - - 40 - 4 - - - 4 36 36
90 Pharmafix Plester Roll 2 - - - 2 - 2 - - - 2 -
91 Planotest pcs - - - - - - - - - - - -
92 Plastik Obat Klip ukuran 10 x 7 cm Pack - - 1,500 - 1,500 - - - 1,000 - 1,000 500 500
93 Plastik Sampah Kuning Pack - - 1 - 1 - - - - - - 1 1
94 Plastik Kantong Obat Putih Pack - 19 - 19 30 30 - - 9 - 9 40 40
95 Plastik Sampah Hitam Pack - 11 - 11 - - - 2 - 2 9 9
96 Pot Salap 20 gr Pcs - - - - - 50 50 - - - - - 50 50
97 Pot Dahak (Sputum Pot) Pot - - - - - - - - - - - -
98 Pot Tetes Telinga Pot - - - - - 44 44 - - - - - 44 44
99 Poli Soft Botol - - 22 - 22 - - - - - - 22 22
100 Rapid Test Psc - - - - - - - - - - - -
101 Rapid Test (Antibody) Pcs - - - - - - - - - - - -
102 Reagent Glukosa Kit - - - - - - - - - - - -
103 Reagent kolesterol Botol - - - - - - - - - - - -
104 Reagent LDL Kolesterol Kit - - - - - - - - - - - -
105 Rivanol Botol - - 2 - 2 - - - - - - 2 2
106 Selang Oksigen Dewasa (L) Pcs - - - - - 5 5 1 - - - 1 4 4
107 Selang Oksigen Anak (M) Pcs - - - - - 5 5 - - - - - 5 5
108 Selang Oksigen Bayi (S) Pcs 1 - - - 1 5 5 - - - - - 6 6
109 Selang Oksigen Bayi (XS) Pcs 1 - - - 1 - - - - - - 1 1
110 Septalkan Alcohol Free Cleaner Desinfectant Botol 5 - - - 5 - - - - - - 5 5
 SALDO AWAL 01/08/2021 MUTASI BULAN AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021

PENAMBAHAN PENGELUARAN
SUMBER
NO JENIS BARANG SATUAN DAK APBA JKN TOTAL SUMBER
LAIN DAK APBA JKN JUMLAH KELUAR SUMBE JUMLAH
LAIN TOTAL TOTAL DAK APBA JKN
R LAIN TOTAL
SUMBER
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah DAK APBA JKN
LAIN
1 2 3 5 7 9 11 13 14 16 18 20 22 51 52 53 60 61 71 72 73 74 75

111 Septalkan Lingettes/wipes Alcohol Free Pack

Cleaner Desinfectan - - - - - - - - - - - -
112 Slide kaca (Object Glass) Kotak - - - - - - - - - - - -
113 Strip Asam Urat Kotak - - - - - 2 2 - - 2 - 2 -
114 Strips Hemoglobin (Hb) Test Kotak - - - - - - - - - - - -
115 Strips Cholesterol Test Kotak - - - - - 5 5 - - 5 - 5 -
116 Strips glucosa Test Kotak - - - - - 15 15 15 - - - 15 -
117 Steam Indicator Tape Roll 1 - - - 1 - - - - - - 1 1
118 Soffratulle Lembar - - - - - - - - - - - -
119 Surgical Gown Premium (L) Pcs - - - - - - - - - - - -
120 Surgical Gown Premium (XL) Pcs - - - - - - - - - - - -
121 Terumo Dental Needle (16) Kotak 4 - - - 4 - - - - - - 4 4
122 USG Gel 250 ml Botol - - - - - 5 5 - - 1 - 1 4 4
123 Underpad Onemed Pack - - - - - - - - - - - -
124 VTM Kit/pcs - - - - - - - - - - - -
125 Wrapping Paper 100 x 100 cm Reliance Pack 1 - - - 1 - - - - - - 1 1
126 3 M Comply Steam Indicator Tape Roll - - - - - - - - - - - -
SUB TOTAL 69,989 3,349 29,461 250 29,574 3,200 21,516 - 30,129 3,342 16,297 20 70,457 2,184 34,680 230
103,049 54,290 49,788 107,551
TOTAL 110,770,473 45,848,606 49,788 107,551
 LAPORAN OPNAME PERSEDIAAN
PUSKESMAS KANDANG

SALDO AWAL AGUSTUS 2021

NO JENIS BARANG SATUAN Harga PENAMBAHAN

Jumlah Nilai Jumlah

1 2 3 6 7 7 =( 4 x 5) 8
A OBAT-OBATAN
1 Albendazole Tablet 400 mg Tablet 463.00 - - 3,000
2 Allopurinol tab 100 mg Tablet 105.00 500 52,500 1,000
3 Aminofillin tab 200 mg Tablet 231.00 - - -
4 Ambroxol tablet 30 mg Tablet 156.10 2,300 359,030 1,000
5 Ambroxol Syrup 15 mg/5ml Botol 6,523.00 - - 100
6 Amitriptyline Tablet 167.00 337 56,279 -
7 Amlodipine 5 mg Tablet 79.00 600 47,400 900
8 Amlodipine 10 mg Tablet 94.00 400 37,600 -
9 Amoksisilin kaplet 500 mg Kaplet 265.00 14,800 3,922,000 2,900
10 Amoksisilin kapsul 250 mg Kapsul 209.00 800 167,200 -
11 Amoksisilin sirup kering 125 mg/ml - 60 ml Botol 2,050.00 101 207,050 100
12 Antasida Doen Tab Tablet 60.00 1,600 96,000 1,000
13 Antasida Doen Syrup Botol 2,239.00 185 414,215 100

14 Anti Bakteri DOEN salap kombinasi(Bacitracin Tube

Polymyksin) 6,166.00 - - -
15 Anti fungi doen Pot 99.00 64 6,336 -
16 Anti Hemoroid Suppositoria Supp 3,642.00 8 29,136 -
17 Asam askorbat (vit c) tab 50 mg Tablet 120.00 3,000 360,000 -
18 Asam Folat 1 mg Tablet 77.00 2,700 207,900 -
19 Asam mefenamat tab 500 mg Kaplet 396.23 1,300 515,099 2,000
20 Asiklovir krim 5% - 5gr Tube 5,693.00 25 142,325 -
21 Asiklovir tab 400 mg Tablet 454.00 1,000 454,000 -
22 Azitromycin tab 500 mg Tablet 1,888.00 189 356,832 -
23 Baby Cough Syrup (Pacdin Syrup) Botol 7,655.59 - - 50
24 Berotec 0,1 mg MDI HFA AS Botol 83,190.00 23 1,913,370 -

25 Besi (II) sulfat 200 mg + Asam Folat 0,25 mg (tablet

tambah darah kombinasi) Tablet 409.00 20,220 8,269,980 -
26 Betahistin Mesilat Tablet 519.00 350 181,651 -
27 Betametason krim 0,1% - 5 gr Tube 1,465.00 110 161,150 -
28 Boraks gliserin Botol 5,575.00 15 83,625 -
29 Bricasma Nebuhaler Aerosol 0.25 mg/ Dosis Botol 7,602.00 - - -
30 Burnazin cream Tube 107,600.00 3 322,800 -
31 Cefadroksil kapsul 500 mg Kapsul 677.80 - - -
32 Cefadroksil Syrup 125 mg/ml Botol 4,360.00 58 252,880 -
33 Cetirizine Tablet 10 mg Tablet 276.00 - - 3,000
34 Cetirizine syrup 5 mg/5 ml Botol 5,776.00 68 392,768 -
35 Clindamycin Kapsul 150 mg Kapsul 754.00 - - -
36 Clindamycin Kapsul 300 mg Kapsul 2,463.45 400 985,380 -
37 Ciprofloxacin 500 mg Tablet 1,359.00 - - 3,000
38 Counterpain cream Tube 44,117.50 - - -
39 Deksametason Tablet 0,5 mg Tablet 979.00 3,600 3,524,400 -
40 Deksametason Injeksi Ampul 1,210.00 120 145,200 -
41 Diazepam injeksi 5 mg/ml-2ml Ampul 3,015.00 2 6,030 -
42 Diazepam tablet 2 mg Tablet 86.00 265 22,790 -
43 Diazepam tablet 5 mg Tablet 105.00 - - -
44 Diazepam Rectal Tube 5 mg/2,5 ml (Stesolid) Tube 14,459.00 - - 10
45 Difenhidramin HCl Injeksi 10 mg Ampul 27,028.42 120 3,243,410 -
46 Domperidon 10 mg Tablet 86.00 900 77,400 2,000
47 Domperidone suspensi 60 ml Botol 6,100.00 76 463,600 -
48 Doxycycline 100 mg Kapsul 435.00 - - -
49 Epinefrin Injeksi Tube 1,518.00 13 19,734 -
50 Erytromycin kaplet 500 mg Kaplet 781.00 400 312,400 -
51 Fenobarbital injeksi 50 mg/ml Tablet 2,265.00 - - -
52 Fitomenadion (Vit K1) 10 mg Tablet Tablet 873.00 500 436,500 -
53 Fitomenadion Injeksi 10 mg / ml Ampul 4,236.00 40 169,440 -
54 Fluconazole 150 mg Kotak 187,200.00 - - -
55 Furosemide 40 mg Tablet 84.00 - - 400
56 Garam Oralit Serbuk Sacchet 263.00 400 105,200 -
57 Gentamisin tetes mata Botol 4,885.00 96 468,960 -
58 Gentamisin Salap Kulit Tube 4,950.00 100 495,000 -
59 Gentamisin salap mata 0,3 % Tube 3,075.00 - - -
60 Gentian Violet Botol 3,476.00 21 72,996 -
61 Glimepiride Tablet 1 mg Tablet 158.18 400 63,272 -
62 Glimepiride Tablet 2 mg Tablet 207.00 1,000 207,000 -
63 Glibenklamid tab 5 mg Tablet 137.00 400 54,800 400
64 Glutavit Tablet 7,600.00 400 3,040,000 -
65 Guaifenesin (GG) Tablet 210.18 - - 3,000
66 Griseofulvin tab 125 mg micronized Tablet 238.00 300 71,400 -
67 Guanistrep Syrup Botol 6,580.00 - - -
68 Haloperidol tab 1,5 mg Tablet 59.00 576 33,984 -
69 Hidroklhorthiazid (HCT) tab 25 mg Tablet 171.00 68 11,628 -
70 Hidrokortison krim 2,5% - 5 gr Tube 2,533.00 72 182,376 -
71 Ibuprofen tab 400 mg Tablet 416.10 1,000 416,100 2,000
72 Ibuprofen Suspensi 200 mg/ 5 ml Botol 5,414.00 132 714,648 -
73 Ichtyol Pot 6,413.96 - - -
74 Isosorbide Dinitrate Table 5 mg Tablet 154.00 - - -
75 Kalsium Laktat tab 500 mg Tablet 63.00 1,300 81,900 -
76 Kaptopril 12,5 mg Tablet 69.00 400 27,600 -
77 Kaptopril 25 mg Tablet 86.00 - - -
78 Ketoconazole tablet Tablet 490.00 - - -
79 Ketorolac Inj Ampul 1,823.95 12 21,887 24
80 Klorampenikol 250 mg Kapsul 693.00 - - -
81 Kloramfenikol Syrup Botol 9,132.00 79 721,428 -
82 Klorampenikol salap mata 1 % Tube 2,054.00 - - -
83 Klorampenikol salap kulit 10 gr Tube 3,585.00 - - -
84 Klorampenikol TM Tube 14,740.00 85 1,252,900 -
85 Kloramfenikol Tetes Telinga Botol 14,740.00 37 545,380 -
86 Klorfeniramin maleat (ctm) tab 4 mg Tablet 26.00 1,100 28,600 -
87 Kombipak Azithromycin- Cefixime Kombinasi Paket 31,231.00 - - -
88 Klorpromazin 100 mg tablet Salut Selaput Tablet 147.00 92 13,524 -
89 Kotrimoksazole DOEN I (Dewasa) Tablet 133.00 300 39,900 1,000
90 Kotrimoksazole Forte 800 mg + 160 mg Tablet 325.00 - - -
91 Kotrimoksazole Suspensi Botol 2,190.00 55 120,450 -
92 Lactulosa Syrup Botol 47,000.00 - - -
93 Lidocaine HCl Injeksi 2 % Ampul 1,405.00 65 91,325 -
94 MDT MB Dewasa Tablet 41,784.00 - - -
95 Meloksikam 7,5 mg Tablet 375.00 - - -
96 Metformin 500 mg Tablet 109.00 1,300 141,700 -
97 Methylergometrine Tablet Salut Selaput 0,125 mg Tablet 244.00 100 24,400 -
98 Methylergometrine Maleat Injection 0.200 mg Ampul 3,399.00 - - -
99 Metilprednisolon tablet 4 mg Tablet 148.00 2,000 296,000 1,000
100 Metoklopramide Injeksi (Sotatic) Ampul 4,287.35 - - -
101 Metronidazole tablet 500 mg Tablet 321.53 - - -
102 Metronidazole tablet 500 mg (Flagsol) Tablet 487.99 1,100 536,789 -
103 Mikonazole krim 2 % - 10 gram Tube 3,926.00 120 471,120 -
104 Muliavit Syrup Botol 6,600.00 86 567,600 -
105 Multivitamin HB Vit Tablet 3,410.00 600 2,046,000 -
106 Natrium Bicarbonat 500 mg Tablet 72.00 1,000 72,000 2,000
107 Natrium Diklofenac tab 50 mg Tablet 145.00 - - -
108 Natrium klorida lar infus 0,9% steril Botol 35.00 20 700 -
109 New Antides tab 500 mg Tablet 159.00 500 79,500 500
110 Nifedipine 10 mg Tablet 215.60 200 43,120 -
111 OAT FDC Kategori I Paket 415,469.00 - - -
112 OAT Kategori II Paket 259.50 - - -
113 Obat Batuk Hitam (OBH) 100 ml Botol 4,840.00 62 300,080 -
114 Obat Batuk Putih (OBP) 100 ml Botol 6,802.00 - - 100
115 Oksitetrasiklin Salap Mata 1 % Tube 2,774.00 - - -
116 Omeprazole 20 mg Kapsul 1,008.00 2,100 2,116,792 -
117 Omeprazole 20 mg (Zeprazol) Kapsul 866.35 - - -
118 Omegdiar Syrup Botol 10,871.26 24 260,910 -
119 Oxytocin Injeksi 10 IU/ml Ampul 1,232.00 6 7,392 10
120 Oseltamivir 75 mg Kapsul 7,000.00 248 1,736,000 -
121 Parasetamol Drop Botol 9,248.00 - - -
122 Parasetamol sirup 120 mg/5ml-60 ml Botol 3,750.00 274 1,027,500 100
123 Parasetamol tablet 500 mg Tablet 170.00 5,800 986,000 5,000
124 Pehacain injeksi 20 ml Ampul 4,512.35 60 270,741 -
125 Pyrantel Pamoat Tablet 125 mg Tablet 353.00 38 13,414 -
126 Piridoksin (Vit B6) tab 10 mg Tablet 150.00 800 120,000 1,000
127 Piroksikam 10 mg Tablet 154.54 - - 2,000
128 PK Kristal Pot 6,450.00 - - -
129 Prednison tab 5 mg Tablet 79.00 600 47,400 10,000
130 Propiltiourasil tab 100 mg Tablet 351.00 - - -
131 Ranitidine HCl Injeksi 25 mg/ml Vial 2,511.30 30 75,339 50
132 Ranitidine 150 mg Tablet 229.12 300 68,736 2,900
133 Retinol 100.000 IU Kapsul 353.00 4,000 1,412,000 -
134 Retinol 200.000 IU Kapsul 636.00 4,000 2,544,000 -
135 Ringer laktat lar infus steril Botol 35.00 35 1,225 40
136 Risperidone tab 2 mg Tablet 287.00 380 109,060 -
137 Salap 2 - 4 Pot 3,215.00 30 96,450 96
138 Salbutamol tab 2 mg Tablet 121.80 4,800 584,640 -
139 Salap Luka Bakar (Levertran) Zalf 15 gr Pot 5,150.00 - - -
140 Salisil Bedak 2 % - 50 gr Sacchet 5,341.97 6 32,052 50
141 Scabimite cream 10 gr Tube 11,825.00 134 1,584,550 -
142 Serum Anti Bisa Ular (ABU) Vial 512,204.00 - - -
143 Serum Anti Tetanus (ATS) Ampul 130,999.00 10 1,309,990 -
144 Sianokobalamin injeksi (Vit B12) 500 mcg-ml Ampul 1,160.00 90 104,400 -
145 Sianokobalamin injeksi (Vit B12) 8 ml Vial 8,640.00 20 172,800 -
146 Simvastatin tab 10 mg Tablet 117.00 840 98,280 600
147 Simvastatin tab 20 mg Tablet 237.00 - - -
148 Thiamin HCl/Monohidrat (Vit B1) tablet 50 mg Tablet 94.00 600 56,400 1,000
149 Thiamin HCL(Vit B1) Injeksi 100 mg/ml Vial 9,240.00 - - -
150 Trihexifenidil 2 mg Tablet 101.00 315 31,815 -
151 Ventoliin Nebules - Salbutamol cairan ih 0,1 % Ampul 18,118.75 - - 100
152 Vitamin B kompleks tablet Tablet 95.00 1,000 95,000 -
153 Xylestesin-A Ampul 28,750.00 - - -
154 Zink Sulfat syrup Botol 3,285.00 28 91,980 -
155 Zink tab 20 mg Tablet 604.00 800 483,200 -
JUMLAH 100,138 57,414,743.16 53,530
B BARANG MEDIS HABIS PAKAI
1 Abbocath 18 Pcs 7,661.00 45 344,745 -
2 Abbocath 20 Pcs 6,767.00 30 203,010 -
3 Abbocath 22 Pcs 6,767.00 20 135,340 -
4 Abbocath 24 Pcs 6,767.00 35 236,845 -
5 Alat suntik sekali pakai 1 ml Pcs 850.00 190 161,500 -
6 Alat suntik sekali pakai 2,5 ml Pcs 932.00 150 139,800 -
7 Alat suntik sekali pakai 3 ml Pcs 1,430.00 85 121,550 200
8 Alat suntik sekali pakai 5 ml Pcs 1,298.48 120 155,818 -
9 Alkacide Larutan - 1 liter Botol 3,217,500.00 1 3,217,500 -
10 Alkazyme Powder - (25 Sachet x 25 gr) Pack 946,000.00 1 946,000 -
11 Alkohol Swabs 100 pcs Kotak 9,500.00 8 76,000 -
12 Alveogyl - Dental Kotak 1,753,616.00 - - -
13 Apron Tebal Warna Pcs 73,500.00 - - -
14 Anaestesi Gel Tube 1,189,147.00 - - -
15 Alat Cek Gula - Contour Plus Pcs 549,416.00 - - 2
16 Alat Cek Asam Urat - EasyTouch Pcs 571,995.00 - - 1
17 APD (Set 4 Item) Set 98,350.00 50 4,917,500 -
18 Aquacel Ag 4 x 4 Pcs 107,648.42 - - -
19 Aquacel Dressing 10 x 10 Pcs 54,353.40 - - -
20 Aquadest 1000 ml Botol 63,221.00 3 189,663 -
21 Betadine Solution 60 Botol 23,890.00 4 95,560 -
22 Betadine Solution - 30 ml Botol 4,060.00 2 8,120 -
23 Betadine Solution 300 ml Botol 25,200.00 2 50,400 -
24 Bisturi No. 10 Kotak 93,660.00 - - -
25 Bisturi No. 11 Kotak 93,660.00 - - -
26 Bisturi No. 12 Kotak 113,587.00 - - -
27 Bisturi No. 20 Bbraun Pcs 6,773.62 15 101,604 -
28 Blades/Carbon Steel Scalpel Blades (Aesculap)#20 Kotak 300,000.00 - - -
29 Blades/Carbon Steel Scalpel Blades (Aesculap)#24 Kotak 300,000.00 - - -
30 Blood Lancet Onemed Box 20,000.00 - - 5
31 Carpule Box 925,729.00 - - -
32 Caviton Pcs 7,740.50 - - -
33 Catgut/Benang bedah plain No. 3/0 Kotak 78,000.00 2 156,000 -
34 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Kotak 55,000.00 - - -
35 Catgut Optime 3-0 Pcs 55,000.00 10 550,000 36
36 Catgut Peters Plain 3/0 Pcs 40,700.00 - - -
37 Cerument Set Set 90,315.00 - - 1
38 CHKM Box 413,944.00 - - -
39 Cocoa Butter Box 513,290.00 - - -
40 Combiscreen 11 Sys Kotak 279,933.33 - - -
41 Cutticell Classic Pcs 22,579.00 10 225,790 -
42 Dengue Early Rapid Test Box 1,400,000.00 - - -
43 Duoderm CGF Tube 64,193.58 - - -
44 Duoderm Extra Thin 2 x 8 Pcs 40,076.85 - - -
45 Etanol 70% - 100 ml Botol 7,370.03 - - -
46 Etanol 70% - 1000 ml Botol 21,037.50 9 189,338 -
47 Etanol 96 % - 1000 ml Botol 27,360.00 - - -
48 Etanol 96 % - 5 L Jeregen 418,460.00 - - -
49 Etil Klorida Spray - 200 ml Botol 456,000.00 - - -
50 Etil Klorida Spray - 100 ml Botol 361,260.00 3 1,083,780 -
51 Fuji 2 Universal Restorative Pcs 1,505,250.00 - - -
52 Fuji IX A3 Box 3,010,500.00 - - -
53 Fletcher Set Dental Box 606,616.00 - - -
54 Fescoplast 5cm x 4,5 cm Kotak 10,187.50 10 101,875 -
55 Golongan Darah Set 323,750.00 - - -
56 Gunting Iris Bengkok 14 cm Pcs 37,631.00 - - -
57 Gunting Iris Lurus 14 cm Pcs 37,631.00 - - -
58 Hand Rub Antiseptic Liquid - 500 ml Botol 71,090.91 120 8,530,909 -
59 Hand Sanitizer 500 ml Botol 59,400.00 - - -
60 Hand Sanitizer 2 L Botol - - - -
61 Hand Sanitizer 5 L Botol - - - -
62 Handscun Non Steril M Kotak 134,750.00 7 943,250 10
63 Handscun Non Steril S Kotak 134,750.00 - - 10
64 Handscun Non Steril L Kotak 134,750.00 1 134,750 5
65 Handscun Steril No. 7.5 Pasang 7,584.25 - - -
66 H2O2 3% 800cc - 0m Botol 30,625.00 - - 2
67 Infusset Anak Pcs 8,062.00 40 322,480 -
68 Infusset Dewasa Pcs 7,569.00 25 189,225 -
69 Isi Ulang Oksigen Tabung kecil Buah 70,000.00 - - -
70 Isi Ulang Oksigen Tabung Besar Buah 100,000.00 - - -
71 Kapas gulung 500 gr Pcs 38,000.00 - - -
72 Kasa Gulung 80 yard x 80 cm Gulung 320,000.00 - - -
73 Kasa Gulung 40 yard x 80 cm Gulung 142,065.00 3 426,195 2
74 Kasa Hidrofil 4 yard x 5 cm Pcs 2,520.00 - - 100
75 Kasa Kompres Steril 16 x 16 Kotak 6,693.75 18 120,488 -
76 Kapas Pembalut/absorben 250 gr Gulung 15,075.00 12 180,900 -
77 Kasa Pembalut Hidrofil 3.6 m x 15 cm Gulung 91,650.00 - - -
78 Kertas Perkamen Potong Pack 75,263.00 26 1,956,838 -
79 Masker Kotak 88,000.00 220 19,360,000 -
80 Masker N95 Pcs 116,875.00 - - 200
81 Masker Oksigen Non Rebreathing Anak Pcs 16,008.30 - - 10
82 Masker Oksigen Non Rebreathing Dewasa Pcs 16,008.30 - - 10
83 Needle No. 22 Pcs 330.00 - - -
84 Needle No. 23 G Terumo Pcs 752.63 - - -
85 Needle No. 25 G Terumo Pcs 1,354.73 - - -
86 Nald Heating GT.10/GR.10 Merk Remedi Pcs 13,500.00 - - -
87 Paper Roll (Thermal Paper 5 cm) Roll - - - -
88 Paper Tape 2,5 cm Roll 10,187.50 24 244,500 -
89 Peter Silk S 25290 Pcs 40,700.00 40 1,628,000 -
90 Pharmafix Adhesive Tape 5 cm x 5 cm Roll 30,510.00 2 61,020 -
91 Planotest Kotak 2,153.00 - - -
92 Plastik Obat Klip ukuran 10 x 7 cm Pack 225.79 1,500 338,685 -
93 Plastik Sampah Kuning Pack 180,630.00 1 180,630 -
94 Plastik Kantong Obat Putih Pack 13,380.00 19 254,220 30
95 Plastik Sampah Hitam Pack 43,485.00 11 478,335 -
96 Pot Salap 20 gr Pcs 837.56 - - 50
97 Pot Dahak (Sputum Pot) Pot 2,982.00 - - -
98 Pot Tetes Telinga Pot 7,526.00 - - 44
99 Poli Soft Botol 59,400.00 22 1,306,800 -
100 Rapid Test Pcs 69,000.00 - - -
101 Rapid Test (Antibody) Pcs 89,500.00 - - -
102 Reagent Glukosa Kit 401,400.00 - - -
103 Reagent kolesterol Botol 2,574,000.00 - - -
104 Reagent LDL Kolesterol Kit 3,934,700.00 - - -
105 Rivanol Botol 13,770.00 2 27,540 -
106 Selang Oksigen Dewasa (L) Pcs 8,250.00 - - 5
107 Selang Oksigen Anak (M) Pcs 8,250.00 - - 5
108 Selang Oksigen Bayi (S) Pcs 8,250.00 1 8,250 5
109 Selang Oksigen Bayi (XS) Pcs 8,250.00 1 8,250 -
110 Septalkan Alcohol Free Cleaner Desinfectant Botol 166,016.00 5 830,080 -

111 Septalkan Lingettes/wipes Alcohol Free Cleaner Pack

Desinfectan 142,000.00 - - -
112 Slide kaca (Object Glass) Kotak 19,700.00 - - -
113 Strip Asam Urat Kotak 180,630.00 - - 2
114 Strips Hemoglobin (Hb) Test Kotak 346,208.00 - - -
115 Strips Cholesterol Test Kotak 285,998.00 - - 5
116 Strips glucosa Test Kotak 225,200.00 - - 15
117 Steam Indicator Tape Roll 64,648.00 1 64,648 -
118 Soffratulle Lembar 25,328.00 - - -
119 Surgical Gown Premium (L) Pcs 122,650.00 - - -
120 Surgical Gown Premium (XL) Pcs 122,650.00 - - -
121 Terumo Dental Needle (16) Kotak 388,000.00 4 1,552,000 -
122 USG Gel 250 ml Botol 37,631.00 - - 5
123 Underpad Onemed Pack 34,036.50 - - -
124 VTM Kit/pcs 51,500.00 - - -
125 Wrapping Paper 100 x 100 cm Reliance Pack 800,000.00 1 800,000 -
126 3 M Comply Steam Indicator Tape Roll 64,648.00 - - -
JUMLAH 2,911 53,355,730.10 760
TOTAL JUMLAH A+B 103,049 110,770,473.26 54,290
 SISA 31 AGUSTUS 2021 HASIL STOCK OPNAME 31 AGUSTUS 2021
Harga Satuan
PENAMBAHAN PENGELUARAN
Jumlah Nilai Jumlah Terakhir
Nilai Jumlah Nilai (Rp)
9 = (4 x 7) 10 11 = (4 x 9) 11= ( 5 + 7 - 9) 13 = (4 x 11 ) 15 16

1,389,000.00 2,500 1,157,500.00 500 231,500.00 500 380

105,000.00 600 63,000.00 900 94,500.00 900 105
- - - - - - 231
156,100.00 1,800 280,980.00 1,500 234,150.00 1,500 176
652,300.00 40 260,920.00 60 391,380.00 60 6,200
- 95 15,865.00 242 40,414.00 242 167
71,100.00 1,200 94,800.00 300 23,700.00 300 79
- 400 37,600.00 - - - 94
768,500.00 4,400 1,166,000.00 13,300 3,524,500.00 13,300 265
- 300 62,700.00 500 104,500.00 500 209
205,000.00 55 112,750.00 146 299,300.00 146 2,050
60,000.00 1,600 96,000.00 1,000 60,000.00 1,000 60
223,900.00 125 279,875.00 160 358,240.00 160 2,239

- - - - - - 6,166
- 4 396.00 60 5,940.00 60 99
- 6 21,852.00 2 7,284.00 2 3,642
- 1,500 180,000.00 1,500 180,000.00 1,500 120
- - - 2,700 207,900.00 2,700 77
792,460.00 1,200 475,476.00 2,100 832,083.00 2,100 408
- 5 28,465.00 20 113,860.00 20 5,693
- 400 181,600.00 600 272,400.00 600 454
- 138 260,544.00 51 96,288.00 51 1,888
382,779.50 13 99,522.67 37 283,256.83 37 7,000
- 16 1,331,040.00 7 582,330.00 7 83,190

- 1,200 490,800.00 19,020 7,779,180.00 19,020 409

- - - 350 181,650.70 350 519
- 35 51,275.00 75 109,875.00 75 1,465
- 1 5,575.00 14 78,050.00 14 5,575
- - - - - - 7,602
- 1 107,600.00 2 215,200.00 2 107,600
- - - - - - 678
- 6 26,160.00 52 226,720.00 52 4,360
828,000.00 1,300 358,800.00 1,700 469,200.00 1,700 276
- - - 68 392,768.00 68 5,776
- - - - - - 754
- 100 246,345.00 300 739,035.00 300 2,463
4,077,000.00 800 1,087,200.00 2,200 2,989,800.00 2,200 647
 - - - - - - 44,118
- 2,000 1,958,000.00 1,600 1,566,400.00 1,600 979
- 10 12,100.00 110 133,100.00 110 1,210
- - - 2 6,030.00 2 3,015
- 12 1,032.00 253 21,758.00 253 86
- - - - - - 105
144,590.00 - - 10 144,590.00 10 14,459
- - - 120 3,243,410.40 120 27,028
172,000.00 1,100 94,600.00 1,800 154,800.00 1,800 86
- 8 48,800.00 68 414,800.00 68 6,100
- - - - - - 435
- - - 13 19,734.00 13 1,518
- - - 400 312,400.00 400 781
- - - - - - 2,265
- 300 261,900.00 200 174,600.00 200 873
- - - 40 169,440.00 40 4,236
- - - - - - 187,200
33,600.00 - - 400 33,600.00 400 84
- 70 18,410.00 330 86,790.00 330 263
- 24 117,240.00 72 351,720.00 72 4,885
- 60 297,000.00 40 198,000.00 40 4,950
- - - - - - 3,075
- - - 21 72,996.00 21 3,476
- 100 15,818.00 300 47,454.00 300 158
- 300 62,100.00 700 144,900.00 700 207
54,800.00 300 41,100.00 500 68,500.00 500 137
- - - 400 3,040,000.00 400 7,600
630,540.00 1,500 315,270.00 1,500 315,270.00 1,500 175
- 300 71,400.00 - - - 238
- - - - - - 6,580
- 176 10,384.00 400 23,600.00 400 59
- - - 68 11,628.00 68 171
- 24 60,792.00 48 121,584.00 48 2,533
832,200.00 1,700 707,370.00 1,300 540,930.00 1,300 488
- - - 132 714,648.00 132 5,414
- - - - - - 6,414
- - - - - - 154
- 700 44,100.00 600 37,800.00 600 63
- 300 20,700.00 100 6,900.00 100 69
- - - - - - 86
- - - - - - 490
43,774.80 - - 36 65,662.20 36 2,208
- - - - - - 693
- - - 79 721,428.00 79 9,132
- - - - - - 2,054
- - - - - - 3,585
- 10 147,400.00 75 1,105,500.00 75 14,740
- 12 176,880.00 25 368,500.00 25 14,740
- 1,100 28,600.00 - - - 26
- - - - - - 31,231
 - 80 11,760.00 12 1,764.00 12 147
133,000.00 400 53,200.00 900 119,700.00 900 133
- - - - - - 325
- 20 43,800.00 35 76,650.00 35 2,190
- - - - - - 47,000
- - - 65 91,325.00 65 1,405
- - - - - - 41,784
- - - - - - 375
- - - 1,300 141,700.00 1,300 109
- - - 100 24,400.00 100 244
- - - - - - 3,399
148,000.00 1,800 266,400.00 1,200 177,600.00 1,200 148
- - - - - - 4,287
- - - - - - 322
- 200 97,598.00 900 439,191.00 900 488
- 72 282,672.00 48 188,448.00 48 3,926
- 14 92,400.00 72 475,200.00 72 6,600
- 300 1,023,000.00 300 1,023,000.00 300 3,410
144,000.00 700 50,400.00 2,300 165,600.00 2,300 109
- - - - - - 145
- - - 20 700.00 20 35
79,500.00 400 63,600.00 600 95,400.00 600 159
- - - 200 43,120.00 200 216
- - - - - - 415,469
- - - - - - 260
- 54 261,360.00 8 38,720.00 8 4,840
680,200.00 22 149,644.00 78 530,556.00 78 7,000
- - - - - - 2,774
- 1,100 1,108,795.60 1,000 1,007,996.00 1,000 1,008
- - - - - - 866
- 7 76,098.82 17 184,811.42 17 10,871
12,320.00 16 19,712.00 - - - 1,232
- 174 1,218,000.00 74 518,000.00 74 7,000
- - - - - - 9,248
375,000.00 110 412,500.00 264 990,000.00 264 3,750
850,000.00 4,900 833,000.00 5,900 1,003,000.00 5,900 170
- - - 60 270,741.00 60 4,512
- 10 3,530.00 28 9,884.00 28 353
150,000.00 500 75,000.00 1,300 195,000.00 1,300 150
309,080.00 600 92,724.00 1,400 216,356.00 1,400 145
- - - - - - 6,450
790,000.00 1,000 79,000.00 9,600 758,400.00 9,600 79
- - - - - - 351
125,565.00 - - 80 200,904.00 80 2,360
664,448.00 1,400 320,768.00 1,800 412,416.00 1,800 229
- 500 176,500.00 3,500 1,235,500.00 3,500 353
- 1,000 636,000.00 3,000 1,908,000.00 3,000 636
1,400.00 20 700.00 55 1,925.00 55 7,630
- 70 20,090.00 310 88,970.00 310 287
308,640.00 18 57,870.00 108 347,220.00 108 3,215
 - 400 48,720.00 4,400 535,920.00 4,400 122
- - - - - - 5,150
267,098.50 10 53,419.70 46 245,730.62 46 4,636
- 34 402,050.00 100 1,182,500.00 100 11,825
- - - - - - 512,204
- - - 10 1,309,990.00 10 130,999
- - - 90 104,400.00 90 1,160
- - - 20 172,800.00 20 8,640
70,200.00 660 77,220.00 780 91,260.00 780 117
- - - - - - 237
94,000.00 600 56,400.00 1,000 94,000.00 1,000 94
- - - - - - 9,240
- 110 11,110.00 205 20,705.00 205 101
1,811,875.00 15 271,781.25 85 1,540,093.75 85 19,075
- 1,000 95,000.00 - - - 95
- - - - - - 28,750
- 8 26,280.00 20 65,700.00 20 3,285
- 300 181,200.00 500 302,000.00 500 604
18,636,970.80 48,570 21,840,940.04 105,098 54,210,773.92 105,098

- - - 45 344,745.00 45 7,661
- 20 135,340.00 10 67,670.00 10 6,767
- 10 67,670.00 10 67,670.00 10 6,767
- 6 40,602.00 29 196,243.00 29 6,767
- - - 190 161,500.00 190 850
- - - 150 139,800.00 150 932
286,000.00 30 42,900.00 255 364,650.00 255 1,430
- - - 120 155,817.60 120 1,298
- - - 1 3,217,500.00 1 3,217,500
- - - 1 946,000.00 1 946,000
- 5 47,500.00 3 28,500.00 3 9,500
- - - - - - 1,753,616
- - - - - - 73,500
- - - - - - 1,189,147
1,098,832.00 2 1,098,832.00 - - - 549,416
571,995.00 1 571,995.00 - - - 571,995
- - - 50 4,917,500.00 50 98,350
- - - - - - 107,648
- - - - - - 54,353
- - - 3 189,663.00 3 63,221
- - - 4 95,560.00 4 23,890
- - - 2 8,120.00 2 4,060
- 1 25,200.00 1 25,200.00 1 25,200
- - - - - - 93,660
- - - - - - 93,660
- - - - - - 113,587
- - - 15 101,604.30 15 6,774
- - - - - - 300,000
- - - - - - 300,000
100,000.00 - - 5 100,000.00 5 20,000
 - - - - - - 925,729
- - - - - - 7,741
- - - 2 156,000.00 2 78,000
- - - - - - 55,000
1,980,000.00 10 550,000.00 36 1,980,000.00 36 55,000
- - - - - - 40,700
90,315.00 1 90,315.00 - - - 90,315
- - - - - - 413,944
- - - - - - 513,290
- - - - - - 279,933
- - - 10 225,790.00 10 22,579
- - - - - - 1,400,000
- - - - - - 64,194
- - - - - - 40,077
- - - - - - 7,370
- 1 21,037.50 8 168,300.00 8 21,038
- - - - - - 27,360
- - - - - - 418,460
- - - - - - 456,000
- 1 361,260.00 2 722,520.00 2 361,260
- - - - - - 1,505,250
- - - - - - 3,010,500
- - - - - - 606,616
- 2 20,375.00 8 81,500.00 8 10,188
- - - - - - 323,750
- - - - - - 37,631
- - - - - - 37,631
- - - 120 8,530,909.20 120 71,091
- - - - - - 59,400
- - - - - - -
- - - - - - -
1,347,500.00 5 673,750.00 12 1,617,000.00 12 134,750
1,347,500.00 - - 10 1,347,500.00 10 134,750
673,750.00 2 269,500.00 4 539,000.00 4 134,750
- - - - - - 7,584
61,250.00 - - 2 61,250.00 2 56,727
- 6 48,372.00 34 274,108.00 34 8,062
- 1 7,569.00 24 181,656.00 24 7,569
- - - - - - 70,000
- - - - - - 100,000
- - - - - - 38,000
- - - - - - 320,000
284,130.00 - - 5 710,325.00 5 142,065
252,000.00 20 50,400.00 80 201,600.00 80 2,520
- 10 66,937.50 8 53,550.00 8 6,694
- 2 30,150.00 10 150,750.00 10 15,075
- - - - - - 91,650
- 1 75,263.00 25 1,881,575.00 25 75,263
- 20 1,760,000.00 200 17,600,000.00 200 88,000
23,375,000.00 20 2,337,500.00 180 21,037,500.00 180 71,500
 160,083.00 - - 10 160,083.00 10 16,008
160,083.00 - - 10 160,083.00 10 16,008
- - - - - - 330
- - - - - - 753
- - - - - - 1,355
- - - - - - 13,500
- - - - - - -
- - - 24 244,500.00 24 10,188
- 4 162,800.00 36 1,465,200.00 36 40,700
- 2 61,020.00 - - - 30,510
- - - - - - 2,153
- 1,000 225,790.00 500 112,895.00 500 226
- - - 1 180,630.00 1 180,630
401,400.00 9 120,420.00 40 535,200.00 40 15,053
- 2 86,970.00 9 391,365.00 11 43,485
41,878.17 - - 50 41,878.17 50 3,011
- - - - - - 2,982
331,144.00 - - 44 331,144.00 44 7,526
- - - 22 1,306,800.00 22 59,400
- - - - - - 69,000
- - - - - - 89,500
- - - - - - 401,400
- - - - - - 2,574,000
- - - - - - 3,934,700
- - - 2 27,540.00 2 13,770
41,250.00 1 8,250.00 4 33,000.00 4 5,530
41,250.00 - - 5 41,250.00 5 5,530
41,250.00 - - 6 49,500.00 6 5,530
- - - 1 8,250.00 1 8,250
- - - 5 830,080.00 5 166,016

- - - - - - 142,000
- - - - - - 19,700
361,260.00 2 361,260.00 - - - 180,630
- - - - - - 346,208
1,429,990.00 5 1,429,990.00 - - - 285,998
3,378,000.00 15 3,378,000.00 - - - 225,200
- - - 1 64,648.00 1 64,648
- - - - - - 25,328
- - - - - - 122,650
- - - - - - 122,650
- - - 4 1,552,000.00 4 388,000
188,155.00 1 37,631.00 4 150,524.00 4 37,631
- - - - - - 34,037
- - - - - - 51,500
- - - 1 800,000.00 1 800,000
- - - - - - 64,648
38,044,015 1,218 14,264,599.00 2,453 77,135,146.27 2,455
56,680,986 49,788 36,105,539.04 107,551 131,345,920.19 107,553
 Mengetahui,
Kepala Puskesmas Mon Geudong

(Suharni, SKM)
NIP. 19691231 199302 2 002
 BULAN : AGUSTUS
TAHUN : 2021

CK OPNAME 31 AGUSTUS 2021 SELISIH

PENJELASAN
Nilai Hasil Stok
Nilai SELISIH/
Opname Jumlah KETERANGAN
(Rp) (Rp)
16 = (13 x 14) 16= (13-11) 18 = (16 X 14) 19

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69241607.60 2 86,970.00
122,451,709.00 2 86,970.00
Pengelola Obat Puskesmas Mon Geudong

(Julia Nora, S.Si)

Nip. 19820327 200504 2 004