BULAN DESEMBER
TAHUN ANGGARAN 2020 ( JKN/BLUD )
JUMLAH -
CETAKAN
1 Famili Folder 0 Lbr 3,850 - Lbr 3,850 - Lbr
2 Resep Merah BPJS Bk 5,500 - Bk 5,500 - Bk
3 KTPK pak 330,000 - pak 330,000 - pak
4 KTPK Pustu lbr 200 - lbr 200 - lbr
5 Resep Luar 0 rim 120,000 - rim 120,000 - rim
6 Blangko Hasil Laborat Bk 25,000 - Bk 25,000 - Bk
7 Permintaan Laborat Bk 15,000 - Bk 15,000 - Bk
8 Resp Putih rim 100,000 - rim 100,000 - rim
9 MTBS rim 120,000 - rim 120,000 - rim
10 MTBM rim 120,000 - rim 120,000 - rim
11 Lembar Disposisi 1 rim 120,000 120,000 rim 120,000 - rim
12 Form TB 0 rim 110,000 - rim 110,000 - rim
13 Register Laborat 0 rim 50,000 - rim 50,000 - rim
14 Penolakan Tindakan Medis 0 rim 110,000 - rim 110,000 - rim
15 Persetujuan Tindakan Medis 0 rim 95,000 - rim 95,000 - rim
16 Blanko Hasil Lab bk 25,000 - bk 25,000 - bk
17 Surat Keterangan Sakit rim 100,000 - rim 100,000 - rim
18 Surat Keterangan Sehat rim 100,000 - rim 100,000 rim
19 MMT lbr 138,309 - lbr 138,309 - bk
20 Kartu Capeng 0 lbr 1,383,096 - lbr 1,383,096 - lbr
21 CM Gigi Rim 110,000 - Rim 110,000 - Rim
22 Etiket Obat rim 137,500 - rim 137,500 - rim
23 Kuesinoner Kepuasan Pelanggan 0 set 950,000 - set 950,000 - set
24 Kuesioner Pre Screening DDtk 0 rim 95,000 - rim 95,000 - rim
25 Form Kunjungan BPJS rim 95,000 - rim 95,000 - rim
26 Amplop Puskesmas pak 35,000 - pak 35,000 - pak
27 Blangko Home Visit 0 Rim 137,500 - Rim 137,500 - Rim
28 Form Prolanis 0 rim 137,500 - rim 137,500 - rim
29 Denah Puskesmas 0 540,000 - -
30 MMT UKP,UKM 0 150,000 - -
31 Poster Hak & Kewajiban 0 150,000 - -
32 Inform Concert rim 110,000 - rim 110,000 - rim
33 Kuesioner Deteksi Hepar rim 65,000 - rim 65,000 - rim
34 Form Tes & Konseling HIV rim 110,000 - rim 110,000 - rim
35 Surat Pernyataan 0 rim 121,000 - rim 121,000 - rim
36 Form Laborat Permintaan bk 5,500 - bk 5,500 - bk
37 Rekam Medik Umum rim 90,000 - rim 90,000 - rim
38 poli KIA dan inform rim 120,000 rim 120,000 - rim
39 Kartu KB pak 121,000 - pak 121,000 - pak
40 Rekam Medik Anak 140,000 - rim 140,000 - lbr
41 MMT Selamat Datang 0 75,000 - -
42 Maklumat 0 200,000 - -
43 Bumil 0 pak 121,000 - pak 121,000 pak
44 Pustu & Pigura 0 250,000 - -
45 Kartu 3 M 0 rim 110,000 - rim 110,000 - rim
form tes HIV rim 110,000 rim 110,000 rim
46 MAP RM - 3,000 -
47 Kartu Anak,BB rim 110,000 rim 110,000 - rim
48 Form Kuisener HIV,BB rim 110,000 rim 110,000 rim
49 Kartu Stok Obat lbr 1,100 lbr 1,100 - lbr
50 Kartu Berobat Personal rim 1,045,000 rim 1,045,000 - rim
51 Kartu GOLDA lbr 350 lbr 350 - lbr
52 Checklist Rekam Medis rim 110,000 rim 110,000 - rim
53 Informed Consent HIV rim 110,000 rim 110,000 - rim
54 Buku Register Loket rim 110,000 rim 110,000 - rim
55 Form Pendaftaran Prolanis rim 110,000 rim 110,000 - rim
56 Form CM Prolanis Lbr 1,100 Lbr 1,100 - Lbr
57 Resep Prolanis rim 110,000 rim 110,000 - rim
58 Form Pemeriksaan Hepatitis rim 110,000 rim 110,000 - rim
59 Surat Keterangan Berobat rim 125,000 rim 125,000 rim
Jumlah 120,000 -
ALAT KEBERSIHAN
1 Wipol 2 Bh 19,250 38,500 10 btl 19,250 192,500 7 Bh
2 Bayclin Btl 19,500 - Btl 19,500 - Btl
Hand soap kecil btl 26,400 - 10 btl 26,400 264,000 5 btl
3 Hand Soap besar 1 Btl 33,000 33,000 Btl 33,000 - 1 Btl
4 Kapur Barus pcs 25,300 - 10 pcs 25,300 253,000 5 pcs
5 Ember Bh 110,000 - Bh 110,000 - Bh
6 Tissue gulung pcs 4,400 - 20 pcs 4,400 88,000 10 pcs
Tissue kotak kecil 5 pcs 6,000 30,000 25 pcs 6,000 150,000 10 pcs
7 Tissue Besar pcs 27,500 - 10 pcs 27,500 275,000 5 pcs
8 Baygon 1 btl 46,700 46,700 btl 46,700 - btl
9 Sapu pcs 46,200 - 2 pcs 46,200 92,400 2 pcs
10 Sodol pel pcs 33,000 - pcs 33,000 - pcs
11 Sunlight 1 btl 19,600 19,600 5 btl 19,600 98,000 3 btl
12 Pewangi mobil bh 38,500 bh 38,500 - bh
13 Kantong plastik kuning pcs 8,000 - pcs 8,000 - pcs
14 Plastik KKG Dof kecil bh 5,500 - bh 5,500 - bh
15 Ember 0 bh 86,000 - bh 86,000 - bh
Keset handuk bh 27,500 bh 27,500 - bh
16 Keset sepet 0 bh 195,800 - bh 195,800 - bh
17 Gayung 0 bh 11,000 - bh 11,000 - bh
18 Engkrak 0 bh 55,000 bh 55,000 - bh
19 Kanebo pcs 22,000 - pcs 22,000 - pcs
20 plastik hitam besar pak 30,250 - pak 30,250 - pak
21 Plastik hitam tanggung pak 24,200 - pak 24,200 - pak
22 Plastik kuning pak 27,500 - pak 27,500 - pak
23 Tissue gulung glg 4,400 - glg 4,400 - glg
24 Tempat sampah bh 119,537 bh 119,538 bh
25 Sikat wc bh 8,250 bh 8,250 bh
26 Pewangi Ruangan btl 27,500 - btl 27,500 - btl
27 Pembersih kaca 1 bh 12,100 12,100 bh 12,100 - 1 bh
28 Sapu Lowo2 bh 22,000 bh 22,000 - bh
29 Sapu Lidi bh 38,500 bh 38,500 - bh
30 Sikat kamar mandi bh 19,250 - bh 19,250 - bh
Colour Ball pak 14,300 - pak 14,300 - pak
Detergen pak 2,200 - pak 2,200 - pak
31 Pembersih kamar mandi btl 33,000 - btl 33,000 - btl
sapu bh 38,500 bh 38,500 - bh
Pembersih kamar mandi botol 17,600 - btl 17,600 - btl
Molto 2 pcs 7,700 15,400 pcs 7,700 - 1 pcs
Rinso 80 pcs 1,650 132,000 pcs 1,650 - 30 pcs
Bayfres 2 btl 26,400 52,800 btl 26,400 - btl
Kain pel pcs 22,000 - pcs 22,000 - pcs
Sulak bh 33,000 bh 33,000 - bh
JUMLAH 380,100 1,412,900
ALAT LISTRIK
1 Kabel Internet roll 1,925,000 roll 1,925,000 - roll
2 Router Acces point unit 385,000 unit 385,000 - unit
3 Konektor internet pkt 275,000 pkt 16,500 - pkt
4 Baterai AAA 10 bh 7,500 75,000 bh 7,500 - 5 bh
5 Baterai AA 20 bh 8,500 170,000 bh 8,500 - 15 bh
6 Baterai Kotak 5 bh 17,160 85,800 bh 17,160 - 2 bh
7 Kabel mtr 5,500 - mtr 5,500 - mtr
Lampu LED 18 watt bh 24,000 - bh 24,000 - bh
8 Lampu LED 16 watt bh 48,000 bh 48,000 - bh
9 Lampu LED 14,5 watt bh 85,000 bh 85,000 - bh
10 Lampu LED 19 watt bh 115,000 bh 115,000 - bh
11 Bolam kuning 15 watt bh 18,500 bh 18,500 - bh
12 Stater TL bh 12,500 bh 12,500 - bh
13 Bolam LED 20 watt bh 13,500 bh 13,500 - bh
14 Jam dinding pcs 50,000 pcs 50,000 pcs
Rol Kabel bh 55,000 bh 55,000 - bh
JUMLAH 330,800 -
Mengetahui
Kepala Puskesmas Manyaran
18,150 - - Bh 18,150 -
27,500 - - Bk 27,500 -
3,300 - - Bk 3,300 -
10,000 - - Bh 10,000 -
7,500 - - Bh 7,500 -
82,500 - - Bh 82,500 -
110,000 - - Bh 110,000 -
90,000 - 1 Bh 90,000 90,000
27,500 - - rim 27,500 -
9,500 - - Buah 9,500 -
40,000 - - Rim 40,000 -
13,750 - - Dos 13,750 -
6,600 - 3 Bh 6,600 19,800
65,000 - 1 dos 37,300 37,300
45,000 135,000 - Bh 45,000 -
12,000 - - roll 12,000 -
3,500 - - Bh 3,500 -
25,000 150,000 2 pak 25,000 50,000
16,500 16,500 1 Bh 16,500 16,500
33,000 - 1 pak 33,000 33,000
22,000 - - pak 22,000 -
22,000 - - roll 22,000 -
18,000 126,000 3 roll 18,000 54,000
55,000 - - Dos 55,000 -
300,000 - - Bh 300,000 -
350,000 - - Bh 350,000 -
100,000 - - Bh 100,000 -
3,850 - 5 Dos 3,850 19,250
3,300 6,600 3 dos 3,300 9,900
2,500 - - bh 2,500 -
180,000 - - bh 180,000 -
35,000 - - bh 35,000 -
3,500 - 5 dos 3,500 17,500
8,800 61,600 1 lsn 79,500 79,500
6,600 - - bh 6,600 -
8,800 8,800 2 lsn 105,000 210,000
8,250 - - bh 8,250 -
11,000 - - bh 11,000 -
8,250 - - Bk 8,250 -
19,800 - - Bk 19,800 -
50,000 - - pak 50,000 -
5,500 11,000 6 pak 5,500 33,000
30,250 - - bh 30,250 -
8,800 - pak 8,800 -
16,500 - - bh 16,500 -
8,800 - - Dos 8,800 -
23,500 70,500 Dos 23,500 -
3,000 - - buku 3,000 -
27,500 - - Bh 27,500 -
10,000 - - Bh 10,000 -
55,000 165,000 25 rim 39,500 987,500
55,000 - - rim 55,000 -
99,000 - - pak 99,000 -
- - -
- - -
- - -
180,000 - - pcs 180,000 -
- - -
19,500 - - roll 19,500 -
2,500 - - bh 2,500 -
6,000 - - lbr 6,000 -
3,000 - - lbr 3,000 -
143,000 - - bh 143,000 -
143,000 - bh 143,000 -
132,500 - 2 bh 132,500 265,000
110,000 - - btl 110,000 -
115,000 - 1 btl 115,000 115,000
110,000 - - unit 110,000 -
143,000 - btl 143,000
750,000 - - bh 750,000 -
35,200 - - bh 35,200 -
35,000 - - bh 35,000 -
120 - - lbr 120 -
175,000 - - kali 175,000 -
70 - - lbr 70 -
-
- - -
751,000 2,037,250
-
3,850 - - Lbr 3,850 -
5,500 - Bk 5,500 -
330,000 - pak 330,000 -
200 - lbr 200 -
120,000 - - rim 120,000 -
25,000 - - Bk 25,000 -
15,000 - - Bk 15,000 -
100,000 - rim 100,000 -
120,000 - - rim 120,000 -
120,000 - - rim 120,000 -
120,000 - 1 rim 120,000 120,000
110,000 - - rim 110,000 -
50,000 - - rim 50,000 -
110,000 - - rim 110,000 -
95,000 - - rim 95,000 -
25,000 - bk 25,000 -
100,000 - rim 100,000 -
100,000 - rim 100,000 -
138,309 - bk 138,309 -
1,383,096 - - lbr 1,383,096 -
110,000 - Rim 110,000 -
137,500 - rim 137,500 -
950,000 - - set 950,000 -
95,000 - - rim 95,000 -
95,000 - - rim 95,000 -
35,000 - pak 35,000 -
137,500 - - Rim 137,500 -
137,500 - - 95,000 -
540,000 - - 540,000 -
150,000 - - 150,000 -
150,000 - - 150,000 -
110,000 - rim 110,000 -
65,000 - - rim 65,000 -
110,000 - rim 110,000 -
121,000 - - rim 121,000 -
5,500 - bk 5,500 -
90,000 - rim 90,000 -
120,000 - rim 120,000
121,000 - - pak 121,000 -
140,000 - rim 140,000 -
75,000 - - 75,000 -
200,000 - - 200,000 -
121,000 - pak 121,000 -
250,000 - - 250,000 -
110,000 - - rim 110,000 -
110,000 rim 110,000
3,000 - - 3,000 -
110,000 - 110,000
110,000 - 110,000
1,100 - lbr 1,100
1,045,000 - rim 1,045,000
350 - lbr 350
110,000 - rim 110,000
110,000 - rim 110,000
11,000 rim 110,000
110,000 - rim 110,000
1,100 - Lbr 1,100
110,000 - rim 110,000
110,000 - rim 125,000
125,000 -
- 120,000
Semarang,Januari 2021
Bendahara Pengurus Barang
Ferry Septiawan,AMK
NIP.19840229 201001 1 001