STOK OPNAME DES 16 Ok

PEMERINTAH KABUPATEN LUWU TIMUR
DINAS KESEHATAN PUSKESMAS MALILI

Jalan Dr.Ratulangi No. Telp: (0474) 321 456
MALILI
LAPORAN PERSEDIAAN BMHP PUSKESMAS MALILI

BULAN : DESEMBER
TAHUN : 2016
GUDANGDG OBAT/ BAHAN MEDIS HABIS PAKAI (BMHP)
NO TOTAL
SUB UNIT APBD PROGRAM JAMKESMAS APBD PKM ASKES JAMPERSAL LOGISTIK JKN
1 GUDANG OBAT Rp 20,917,847.24 Rp - Rp 800,000 Rp 5,272,055 Rp - Rp 800,000 Rp - Rp 13,598,900.00 Rp 41,388,802.24
2 APOTEK Rp 130,750.00 Rp - Rp 121,000 Rp 456,500 Rp - Rp - Rp - Rp - Rp 708,250.00
3 UGD Rp 663,605.50 Rp - Rp - Rp - Rp - Rp - Rp - Rp 56,000.00 Rp 719,605.50
4 LAB0RATORIUM Rp 316,876.00 Rp 2,567,200.00 Rp 218,000 Rp 6,740,000 Rp - Rp - Rp - Rp 224,400.00 Rp 10,066,476.00
5 KIA Rp 1,445,370.48 Rp - Rp - Rp - Rp - Rp 132,250 Rp - Rp 399,400.00 Rp 1,977,020.48
6 PRWTN 1 Rp 128,345.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp 28,000.00 Rp 156,345.00
7 PUSKEL Rp 78,200.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 78,200.00
8 POLI GIGI Rp 45,614.50 Rp - Rp - Rp - Rp 312,500.00 Rp - Rp - Rp 877,500.00 Rp 1,235,614.50
9 PROG.FILARIASIS Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp -
10 PROG.TB Rp - Rp 1,782,500.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp 1,782,500.00
11 P.MALILI Rp 82,834.17 Rp - Rp - Rp - Rp - Rp 380,333 Rp - Rp 17,100.00 Rp 480,267.17
12 P.P.INDAH Rp 175,952.50 Rp - Rp 21,000 Rp - Rp - Rp 85,000 Rp - Rp 25,000.00 Rp 306,952.50
13 P.BARUGA Rp 77,445.63 Rp - Rp - Rp - Rp - Rp - Rp - Rp 12,500.00 Rp 89,945.63
14 P.BALANTANG Rp 195,106.00 Rp - Rp - Rp - Rp - Rp 200,640 Rp - Rp 25,000.00 Rp 420,746.00
15 P.WRIU Rp 103,978.58 Rp - Rp - Rp - Rp - Rp - Rp - Rp 38,900.00 Rp 142,878.58
16 P.USSU Rp 120,797.78 Rp - Rp - Rp - Rp - Rp - Rp - Rp 82,500.00 Rp 203,297.78
17 PUSTU ATUE Rp 209,704.36 Rp - Rp 26,500 Rp - Rp - Rp 76,020 Rp - Rp 113,000.00 Rp 425,224.36
18 P.MANURUNG Rp 85,237.31 Rp - Rp - Rp - Rp - Rp - Rp - Rp 60,000.00 Rp 145,237.31
19 P.LAKAWALI Rp 33,228.47 Rp - Rp - Rp - Rp - Rp - Rp - Rp 92,500.00 Rp 125,728.47
20 P.LKWL. PANTAI Rp 241,592.31 Rp - Rp - Rp - Rp - Rp - Rp - Rp 27,500.00 Rp 269,092.31
21 P.KORE2A Rp 145,740.16 Rp - Rp - Rp - Rp - Rp 129,500 Rp - Rp 53,000.00 Rp 328,240.16
22 P.TARABBI Rp 418,259.64 Rp - Rp 63,000 Rp - Rp - Rp 125,000 Rp - Rp 5,000.00 Rp 611,259.64
TOTAL Rp 25,616,485.62 Rp 4,349,700.00 Rp 1,249,500 Rp 12,468,555 Rp 312,500.00 Rp 1,928,743.00 Rp - Rp 15,736,200.00 Rp 61,661,683.62
Mengetahui
Kepala Puskesmas Malili Pengelola Obat
dr.Benny Farianti Najamudin,S.Si.Apt

NIP. 19580823 198901 1 001 NIP. 19791225 201001 2 017
MALILI
LAPORAN PERSEDIAAN OBAT PUSKESMAS MALILI

BULAN : DESEMBER
TAHUN : 2016
GUDANGDG OBAT/ OBAT
NO TOTAL
SUB UNIT APBD PROGRAM JAMKESMAS APBD PKM ASKES JAMPERSAL JKN
1 GUDANG OBAT Rp 51,171,481.50 Rp 136,540.00 Rp 30,900 Rp - Rp - Rp - Rp 635,250.00 Rp 51,974,171.50
2 APOTEK Rp 5,686,774.78 Rp 93,523.40 Rp 17,613 Rp - Rp - Rp - Rp 81,675.00 Rp 5,879,586.18
3 UGD Rp 419,025.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp 419,025.00
4 LAB0RATORIUM Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp -
5 KIA Rp 287,033.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp 287,033.00
6 PRWTN 1 Rp 216,080.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp 216,080.00
7 PUSKEL Rp 444,411.10 Rp - Rp - Rp - Rp - Rp - Rp - Rp 444,411.10
8 POLI GIGI Rp 16,976.00 Rp - Rp - Rp - Rp - Rp - Rp 137,500.00 Rp 154,476.00
9 PROG.FILARIASIS Rp - Rp 215,985.00 Rp - Rp - Rp - Rp - Rp - Rp 215,985.00
10 PROG.TB Rp - Rp 2,375,400.00 Rp - Rp - Rp - Rp - Rp - Rp 2,375,400.00
11 P.MALILI Rp 646,538.06 Rp 5,110.00 Rp - Rp - Rp 42,052.20 Rp - Rp 9,075.00 Rp 702,775.26
12 P.P.INDAH Rp 360,730.10 Rp 3,625.00 Rp - Rp - Rp - Rp - Rp - Rp 364,355.10
13 P.BARUGA Rp 128,615.00 Rp - Rp - Rp - Rp - Rp - Rp 9,075.00 Rp 137,690.00
14 P.BALANTANG Rp 974,268.59 Rp - Rp - Rp - Rp - Rp - Rp - Rp 974,268.59
15 P.WRIU Rp 451,443.90 Rp 14,600.00 Rp - Rp - Rp - Rp - Rp 7,260.00 Rp 473,303.90
16 P.USSU Rp 314,734.40 Rp 2,853.00 Rp - Rp - Rp - Rp - Rp 8,349.00 Rp 325,936.40
17 PUSTU ATUE Rp 1,099,915.02 Rp - Rp - Rp - Rp - Rp - Rp - Rp 1,099,915.02
18 P.MANURUNG Rp 367,512.15 Rp 6,340.00 Rp - Rp - Rp - Rp - Rp - Rp 373,852.15
19 P.LAKAWALI Rp 207,994.60 Rp - Rp - Rp - Rp - Rp - Rp - Rp 207,994.60
20 P.LKWL. PANTAI Rp 745,815.10 Rp 9,510.00 Rp - Rp - Rp - Rp - Rp 9,982.50 Rp 765,307.60
21 P.KORE2A Rp 523,745.50 Rp 12,223.00 Rp - Rp - Rp - Rp - Rp 8,167.50 Rp 544,136.00
22 P.TARABBI Rp 868,370.50 Rp - Rp - Rp - Rp - Rp - Rp - Rp 868,370.50
TOTAL Rp 64,931,464.30 Rp 2,875,709.40 Rp 48,513 Rp - Rp 42,052.20 Rp - Rp 906,334.00 Rp 68,804,072.90
Mengetahui

NIP. 19580823 198901 1 001 NIP. 19791225 201001 2 017
MALILI
LAPORAN PERSEDIAAN OBAT DAN BMHP PUSKESMAS MALILI

BULAN : DESEMBER
TAHUN : 2016
GUDANGDG OBAT/ PERSEDIAAN (Rp) SUMBER DANA
NO APBD PROGRAM JAMKESMAS APBD PKM ASKES JAMPERSAL JKN TOTAL
SUB UNIT
BMHP OBAT BMHP OBAT BMHP OBAT BMHP OBAT BMHP OBAT BMHP OBAT BMHP OBAT
1 GUDANG OBAT Rp 20,917,847.24 Rp 51,171,481.50 Rp - Rp 136,540.00 Rp 800,000.00 Rp 30,900.00 Rp 5,272,055 Rp - Rp - Rp - Rp 800,000 Rp - Rp 13,598,900.00 Rp 635,250.00 Rp 93,362,973.74
2 APOTEK Rp 130,750.00 Rp 5,686,774.78 Rp - Rp 93,523.40 Rp 121,000.00 Rp 17,613.00 Rp 456,500 Rp - Rp - Rp - Rp - Rp - Rp - Rp 81,675.00 Rp 6,587,836.18
3 UGD Rp 663,605.50 Rp 419,025.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 56,000.00 Rp - Rp 1,138,630.50
4 LAB0RATORIUM Rp 161,641.75 Rp - Rp 2,567,200.00 Rp - Rp 218,000.00 Rp - Rp 6,895,225 Rp - Rp - Rp - Rp - Rp - Rp 224,400.00 Rp - Rp 10,066,466.75
5 KIA Rp 1,445,370.48 Rp 287,033.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 132,250 Rp - Rp 399,400.00 Rp - Rp 2,264,053.48
6 PRWTN 1 Rp 128,345.00 Rp 216,080.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 28,000.00 Rp - Rp 372,425.00
7 PUSKEL Rp 78,200.00 Rp 444,411.10 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 522,611.10
8 POLI GIGI Rp 45,614.50 Rp 16,976.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp 312,500.00 Rp - Rp - Rp - Rp 877,500.00 Rp 137,500.00 Rp 1,390,090.50
9 PROG.FILARIASIS Rp - Rp - Rp - Rp 215,985.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 215,985.00
10 PROG.TB Rp - Rp - Rp 1,782,500.00 Rp 2,375,400.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 4,157,900.00
11 P.MALILI Rp 82,834.17 Rp 646,538.06 Rp - Rp 5,110.00 Rp - Rp - Rp - Rp - Rp - Rp 42,052.20 Rp 380,333 Rp - Rp 17,100.00 Rp 9,075.00 Rp 1,183,042.43
12 P.P.INDAH Rp 175,952.50 Rp 360,730.10 Rp - Rp 3,625.00 Rp 21,000.00 Rp - Rp - Rp - Rp - Rp - Rp 85,000 Rp - Rp 25,000.00 Rp - Rp 671,307.60
13 P.BARUGA Rp 77,445.63 Rp 128,615.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 12,500.00 Rp 9,075.00 Rp 227,635.63
14 P.BALANTANG Rp 195,106.00 Rp 974,268.59 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 200,640 Rp - Rp 25,000.00 Rp - Rp 1,395,014.59
15 P.WRIU Rp 103,978.58 Rp 451,443.90 Rp - Rp 14,600.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 38,900.00 Rp 7,260.00 Rp 616,182.48
16 P.USSU Rp 120,797.78 Rp 314,734.40 Rp - Rp 2,853.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 82,500.00 Rp 8,349.00 Rp 529,234.18
17 PUSTU ATUE Rp 209,704.36 Rp 1,099,915.02 Rp - Rp - Rp 26,500.00 Rp - Rp - Rp - Rp - Rp - Rp 76,020 Rp - Rp 113,000.00 Rp - Rp 1,525,139.38
18 P.MANURUNG Rp 85,237.31 Rp 367,512.15 Rp - Rp 6,340.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 60,000.00 Rp - Rp 519,089.46
19 P.LAKAWALI Rp 33,228.47 Rp 207,994.60 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 92,500.00 Rp - Rp 333,723.07
20 P.LKWL. PANTAI Rp 241,592.31 Rp 745,815.10 Rp - Rp 9,510.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp - Rp 27,500.00 Rp 9,982.50 Rp 1,034,399.91
21 P.KORE2A Rp 145,740.16 Rp 523,745.50 Rp - Rp 12,223.00 Rp - Rp - Rp - Rp - Rp - Rp - Rp 129,500 Rp - Rp 53,000.00 Rp 8,167.50 Rp 872,376.16
22 P.TARABBI Rp 418,259.64 Rp 868,370.50 Rp - Rp - Rp 63,000.00 Rp - Rp - Rp - Rp - Rp - Rp 125,000 Rp - Rp 5,000.00 Rp - Rp 1,479,630.14
Rp 25,461,251.37 Rp 64,931,464.30 Rp 4,349,700.00 Rp 2,875,709.40 Rp 1,249,500.00 Rp 48,513.00 Rp 12,623,780 Rp - Rp 312,500.00 Rp 42,052.20 Rp 1,928,743 Rp - Rp 15,736,200.00 Rp 906,334.00
TOTAL Rp 130,465,747.27
Rp 90,392,715.67 Rp 7,225,409.40 Rp 1,298,013.00 Rp 12,623,780 Rp 354,552.20 Rp 1,928,743.00 Rp 16,642,534.00
Mengetahui

NIP. 19580823 198901 1 001 NIP. 19791225 201001 2 017
MALILI
LAPORAN PERSEDIAAN OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP) PUSKESMAS MALILI
BULAN : DESEMBER
TAHUN : 2016
PERSEDIAAN (Rp) JUMLAH

NO SUMBER DANA GUDANG SUB UNIT TOTAL
BMHP OBAT
BMHP OBAT JUMLAH BMHP OBAT JUMLAH
1 APBD DINKES Rp 20,917,847.24 Rp 51,171,481.50 Rp 72,089,328.74 Rp 4,543,404.13 Rp 13,759,982.80 Rp 18,303,386.93 Rp 25,461,251.37 Rp 64,931,464.30 Rp 90,392,715.67
3 PROGRAM Rp - Rp 136,540.00 Rp 136,540.00 Rp 4,349,700.00 Rp 2,739,169.40 Rp 7,088,869.40 Rp 4,349,700.00 Rp 2,875,709.40 Rp 7,225,409.40
4 JAMKESMAS Rp 800,000.00 Rp 30,900.00 Rp 830,900.00 Rp 449,500.00 Rp 17,613.00 Rp 467,113.00 Rp 1,249,500.00 Rp 48,513.00 Rp 1,298,013.00
5 APBD PUSKESMAS Rp 5,272,055.00 Rp - Rp 5,272,055.00 Rp 7,351,725.00 Rp - Rp 7,351,725.00 Rp 12,623,780.00 Rp - Rp 12,623,780.00
6 ASKES Rp - Rp - Rp - Rp 312,500.00 Rp 42,052.20 Rp 354,552.20 Rp 312,500.00 Rp 42,052.20 Rp 354,552.20
7 JAMPERSAL Rp 800,000.00 Rp - Rp 800,000.00 Rp 1,128,743.00 Rp - Rp 1,128,743.00 Rp 1,928,743.00 Rp - Rp 1,928,743.00

9 JKN Rp 13,598,900.00 Rp 635,250.00 Rp 14,234,150.00 Rp 2,137,300.00 Rp 271,084.00 Rp 2,408,384.00 Rp 15,736,200.00 Rp 906,334.00 Rp 16,642,534.00
TOTAL Rp 41,388,802.24 Rp 51,974,171.50 Rp 93,362,973.74 Rp 20,272,872.13 Rp 16,829,901.40 Rp 37,102,773.53 Rp 61,661,674.37 Rp 68,804,072.90 Rp 130,465,747.27
Mengetahui

NIP. 19580823 198901 1 001 NIP. 19791225 201001 2 017
LAMPIRAN BERITA ACARA STOCK OPNAME
SUMBER OBAT : APBD DINAS KESEHATAN
SUB UNIT : GUDANG OBAT PUSKESMAS MALILI
PER TANGGAL 31 DESEMBER 2016
SATU STOK
AN
NO NAMA BARANG KEMA JUMLA STOK STOK TOTAL HARGA
HARGA TOTAL HARGA HARGA TOTAL HARGA STOK HARGA TOTAL HARGA
SAN H LAMA BARU BARU
A. BMHP
1 Alat Suntik Sekali Pakai 1 ml Set 174 174 Rp 796.25 Rp 138,547.50 Rp - Rp - Rp 138,547.50
2 Alat Suntik Sekali Pakai 2,5 ml Set 125 125 Rp 796.25 Rp 99,531.25 Rp - Rp - Rp 99,531.25
3 Alat Suntik Sekali Pakai 5 ml Set 187 187 Rp 862.50 Rp 161,287.50 Rp - Rp - Rp 161,287.50
4 Catgut / Benang Bedah No. 3/0 dan Set 70 70 Rp 6,839.58 Rp 478,770.81 Rp - Rp - Rp 478,770.81
5 Folley catheter No.14 Pcs 15 15 Rp 11,000.00 Rp 165,000.00 Rp - Rp - Rp 165,000.00
6 Folley catheter No.16 Pcs 3 3 Rp 9,200.00 Rp 27,600.00 Rp - Rp - Rp 27,600.00
7 Folley catheter No.18 Pcs 2 2 Rp 9,200.00 Rp 18,400.00 Rp - Rp 11,000.00 Rp - Rp 18,400.00
8 Hanscoen Pasang 195 195 Rp 4,598.00 Rp 896,610.00 Rp - Rp - Rp 896,610.00
9 Hanscoen Non Steril Pasang 1856 1227 Rp 747.50 Rp 917,182.50 Rp - 629 Rp 796.25 Rp 500,841.25 Rp 1,418,023.75
10 Infusion Set Anak Set 284 234 Rp 4,290.00 Rp 1,003,860.00 Rp - 50 Rp 6,600.00 Rp 330,000.00 Rp 1,333,860.00
11 Infusion Set Dewasa Set 298 298 Rp 7,920.00 Rp 2,360,160.00 Rp - Rp - Rp 2,360,160.00
12 IV Catheter No. 18 Buah 61 61 Rp 8,309.40 Rp 506,873.40 Rp - Rp - Rp 506,873.40
13 IV Catheter No. 20 Buah 44 44 Rp 7,700.00 Rp 338,800.00 Rp - Rp - Rp 338,800.00
14 IV Catheter No. 22 Buah 157 157 Rp 7,700.00 Rp 1,208,900.00 Rp - Rp - Rp 1,208,900.00
15 IV Catheter No. 24 Buah 155 155 Rp 7,700.00 Rp 1,193,500.00 Rp - Rp - Rp 1,193,500.00
16 Jarum jahit ( bedah ) no. 10 Set 15 15 Rp 2,567.00 Rp 38,505.00 Rp - Rp - Rp 38,505.00
19 Kapas pembalut/absorben 250 mg Gulung 16 16 Rp 15,312.50 Rp 245,000.00 Rp - Rp - Rp 245,000.00
20 Kasa Pembalut Hidrofil 38 Yds x 80 Rol 14 14 Rp 128,625.00 Rp 1,800,750.00 Rp - Rp - Rp 1,800,750.00
21 Masker Buah 590 590 Rp 404.25 Rp 238,507.50 Rp - Rp - Rp 238,507.50
22 Plester 5 yard x 2 inch Rol 15 15 Rp 12,076.00 Rp 181,140.00 Rp - Rp - Rp 181,140.00
23 Silk ( Benang Bedah Sutera ) No 3/0 Set 24 24 Rp 3,513.89 Rp 84,333.31 Rp - Rp - Rp 84,333.31
24 Etakridin (rivanol) larutan 0,1 % Botol 12 12 Rp 3,123.75 Rp 37,484.99 Rp - Rp - Rp 37,484.99
25 Etanol 70% Botol 19 19 Rp 26,337.50 Rp 500,412.50 Rp - Rp - Rp 500,412.50
26 Glass lonomer cement (gc ix ) Botol 1 1 Rp 495,000.00 Rp 495,000.00 Rp - Rp - Rp 495,000.00
27 Lisol Botol 3 1 Rp 50,225.00 Rp 50,225.00 Rp - 2 Rp 33,000.00 Rp 66,000.00 Rp 116,225.00
28 Yodium povidon larutan 10% 300 ml 14 14 Rp 15,386.00 Rp 215,404.00 Rp - Rp - Rp 215,404.00
29 Disable Syringes 0,05 ml Botol 100 100 Rp 1,655.50 Rp 165,550.00 Rp - Rp - Rp 165,550.00
30 Kasa Pembalut Hidrofil 4 x 10 cm Ktk 325 325 Rp 1,980.00 Rp 643,500.00 Rp - Rp - Rp 643,500.00
31 IV Catheter No. 26 Paket 209 209 Rp 17,600.00 Rp 3,678,400.00 Rp - Rp - Rp 3,678,400.00
32 Maag slang 14 Set 5 5 Rp 19,800.00 Rp 99,000.00 Rp - Rp - Rp 99,000.00
35 Nasal canula bayi Set 14 14 Rp 17,600.00 Rp 246,400.00 Rp - Rp - Rp 246,400.00
36 Nasal canula anak Set 12 12 Rp 17,600.00 Rp 211,200.00 Rp - Rp - Rp 211,200.00
37 Nasal Canula dewasa Set 12 12 Rp 17,600.00 Rp 211,200.00 Rp - Rp - Rp 211,200.00
38 Bisturi N0.11 Pcs 467 467 Rp 1,540.00 Rp 719,180.00 Rp - Rp - Rp 719,180.00
39 Larutan Pemutih Gigi/ remover staint Botol 1 1 Rp 132,000.00 Rp 132,000.00 Rp - Rp - Rp 132,000.00
40 GC Tooth Mouse Tube 1 1 Rp 220,000.00 Rp 220,000.00 Rp - Rp - Rp 220,000.00
TOTAL BMHP Rp 20,917,847.24
B. OBAT
1 Alopurinol tablet 100 mg Tablet 1120 1120 Rp 90.00 Rp 100,800.00 Rp - Rp - Rp 100,800.00
2 Aminofilin Injeksi 24 mg/ml - 10 ml Ampul 9 9 Rp 4,200.00 Rp 37,800.00 Rp - Rp - Rp 37,800.00
3 Aminofilin tablet 200 mg Tablet 400 400 Rp 86.00 Rp 34,400.00 Rp - Rp - Rp 34,400.00
4 Amitriptilin tab Tablet 200 200 Rp 123.00 Rp 24,600.00 Rp - Rp - Rp 24,600.00
5 Amoksisilin 500 mg Tablet 11900 11900 Rp 292.00 Rp 3,474,800.00 Rp - Rp - Rp 3,474,800.00
6 Amoksisilin Kapsul 250 mg Kapsul 3480 2400 Rp 207.00 Rp 496,800.00 Rp - 1080 Rp 220.00 Rp 237,600.00 Rp 734,400.00
7 Amoksisilin sirup kering 125 mg/5 mlBotol 595 595 Rp 2,560.00 Rp 1,523,200.00 Rp - Rp - Rp 1,523,200.00
8 Ampisilin injeksi I,m/i.v 500 mg/vial Vial 30 30 Rp 5,610.00 Rp 168,300.00 Rp - Rp - Rp 168,300.00
9 Antalgin injeksi 250 mg/ml - 2 ml Ampul 90 90 Rp 1,466.67 Rp 132,000.30 Rp - Rp - Rp 132,000.30
10 Antasida doen tablet kombinasi Tablet 9900 9900 Rp 78.00 Rp 772,200.00 Rp - Rp - Rp 772,200.00
11 Antihemoroid supp Supp 50 50 Rp 3,350.00 Rp 167,500.00 Rp - Rp - Rp 167,500.00
12 Antimigrain doen kombinasi Tablet 300 300 Rp 149.00 Rp 44,700.00 Rp - Rp - Rp 44,700.00
13 Aqua proinjeksi steril, bebas pirogen Botol 25 25 Rp 2,750.00 Rp 68,750.00 Rp - Rp - Rp 68,750.00
14 Asam askorbat (vit c) tablet 50 mg Tablet 2000 2000 Rp 45.00 Rp 90,000.00 Rp - Rp - Rp 90,000.00
15 Asam mefenamat 500 mg Tablet 10200 10200 Rp 125.00 Rp 1,275,000.00 Rp - Rp - Rp 1,275,000.00
16 Asiklovir tab 400 mg Tablet 1520 200 Rp 381.00 Rp 76,200.00 120 Rp 340.00 Rp 40,800.00 1200 Rp 362.00 Rp 434,400.00 Rp 551,400.00
17 Betametason krim 0,1 % Tube 258 258 Rp 1,596.00 Rp 411,768.00 Rp - Rp - Rp 411,768.00
18 Captopril 25 mg Tablet 6400 6400 Rp 100.00 Rp 640,000.00 Rp - Rp - Rp 640,000.00
19 Cimetidin Tablet 4400 4400 Rp 126.39 Rp 556,116.00 Rp - Rp - Rp 556,116.00
20 Ciprofloxasin 500 mg Tablet 700 700 Rp 473.00 Rp 331,100.00 Rp - Rp - Rp 331,100.00
21 Deksametason inj Ampul 260 68 Rp 1,740.00 Rp 118,320.00 Rp - 192 Rp 1,738.00 Rp 333,696.00 Rp 452,016.00
22 Deksametason tablet 0,5 mg Tablet 22900 22900 Rp 74.00 Rp 1,694,600.00 Rp - Rp - Rp 1,694,600.00
23 Difenhidramin hcl inj 10 mg/ml - 1 mAmpul 72 72 Rp 1,156.00 Rp 83,232.00 Rp - Rp - Rp 83,232.00
24 Diltiazem 30 mg tab 100 100 Rp 141.00 Rp 14,100.00 Rp - Rp - Rp 14,100.00
25 Doksisiklin 100 mg Tablet 200 200 Rp 298.00 Rp 59,600.00 Rp - Rp - Rp 59,600.00
26 Epinefrin(adrenalin) inj 0,1 %-1 ml Tablet 50 50 Rp 8,910.00 Rp 445,500.00 Rp - Rp - Rp 445,500.00
27 Eugenol cairan Botol 8 8 Rp 18,333.00 Rp 146,664.00 Rp - Rp - Rp 146,664.00
28 Eritromisin Sirup Kapsul 150 150 Rp 8,090.00 Rp 1,213,500.00 Rp - Rp - Rp 1,213,500.00
29 Fitomenadion tablet salut 10 mg Ampul 450 300 Rp 796.00 Rp 238,800.00 Rp - 150 Rp 690.00 Rp 103,500.00 Rp 342,300.00
30 Furosemid inj 10 mg/ml Tablet 20 20 Rp 2,012.00 Rp 40,240.00 Rp - Rp - Rp 40,240.00
31 Furosemid tablet 40 mg Ampul 650 650 Rp 84.00 Rp 54,600.00 Rp - Rp - Rp 54,600.00
32 Garam oralit untuk 200 ml air Tablet 1590 1590 Rp 317.00 Rp 504,030.00 Rp - Rp - Rp 504,030.00
33 Glibenklamid tablet 5 mg Set 2950 2950 Rp 61.00 Rp 179,950.00 Rp - Rp - Rp 179,950.00
34 Glukosa larutan infus 5 % steril Botol 88 88 Rp 5,720.00 Rp 503,360.00 Rp - Rp - Rp 503,360.00
35 Griseofulvin tablet 125 mg, microniz Botol 150 150 Rp 241.00 Rp 36,150.00 Rp - Rp - Rp 36,150.00
36 Haloperidol 5 mg Botol 100 100 Rp 105.00 Rp 10,500.00 Rp - Rp - Rp 10,500.00
37 Haloperidol tablet 1,5 mg Tablet 400 400 Rp 76.00 Rp 30,400.00 Rp - Rp - Rp 30,400.00
38 Hidrokortison krim 2,5 % 139 139 Rp 2,938.00 Rp 408,382.00 Rp - Rp - Rp 408,382.00
39 Ibuprofen tablet 400 mg Tablet 3500 3500 Rp 133.00 Rp 465,500.00 Rp - Rp - Rp 465,500.00
40 Isosorbid dinitrat tablet subling 5 mgTablet 300 300 Rp 98.00 Rp 29,400.00 Rp - Rp - Rp 29,400.00
41 Karbamazepin tab 200 mg Tablet 1200 1200 Rp 269.00 Rp 322,800.00 Rp - Rp - Rp 322,800.00
42 Ketokenazol krim 2% Tube 22 22 Rp 2,697.00 Rp 59,334.00 Rp - Rp - Rp 59,334.00
43 Ketokenazol tab 200 mg Tablet 800 800 Rp 320.00 Rp 256,000.00 Rp - Rp - Rp 256,000.00
44 Kloramfenikol kapsul 250 mg Tablet 1440 1440 Rp 293.33 Rp 422,395.20 Rp - Rp - Rp 422,395.20
45 Kloramfenikol suspensi 125 mg/ 5 mlKapsul 50 Rp 4,016.00 Rp - Rp - 50 Rp 4,000.00 Rp 200,000.00 Rp 200,000.00
46 Klorfeniramin maleat (ctm) tablet 4 mg 30570 30570 Rp 54.00 Rp 1,650,780.00 Rp - Rp - Rp 1,650,780.00
47 Klorpromazin hcl tablet salut 100 mg Botol 300 300 Rp 165.00 Rp 49,500.00 Rp - Rp - Rp 49,500.00
48 Klorpromazin hcl tablet salut 25 mg 400 400 Rp 50.00 Rp 20,000.00 Rp - Rp - Rp 20,000.00
49 Kodein hcl tablet 10 mg Tablet 700 700 Rp 550.00 Rp 385,000.00 Rp - Rp - Rp 385,000.00
50 Kotrimoksazol Adult Tablet 6800 6800 Rp 152.00 Rp 1,033,600.00 Rp - Rp - Rp 1,033,600.00
51 Kotrimoksazol Suspensi Ampul 395 395 Rp 2,298.00 Rp 907,710.00 Rp - Rp - Rp 907,710.00
52 Lidokain injeksi 2 % Botol 70 70 Rp 875.00 Rp 61,250.00 Rp - Rp - Rp 61,250.00
53 Lidokain kompositum injeksi Botol 20 20 Rp 2,122.00 Rp 42,440.00 Rp - Rp - Rp 42,440.00
54 Loperamid tab 2 mg Botol 200 200 Rp 97.00 Rp 19,400.00 Rp - Rp - Rp 19,400.00
55 Magnesium Sulfat Injeksi 20 %-25 mBotol 6 6 Rp 3,200.00 Rp 19,200.00 Rp - Rp - Rp 19,200.00
56 Metilergometrin maleat injeksi 0,20 Botol 45 45 Rp 1,639.00 Rp 73,755.00 Rp - Rp - Rp 73,755.00
57 Metilergometrin maleat tablet salut Tablet 100 100 Rp 128.70 Rp 12,870.00 Rp - Rp - Rp 12,870.00
58 Metoklopramid sirup 5 mg/ml Ampul 105 105 Rp 2,900.00 Rp 304,500.00 Rp - Rp - Rp 304,500.00
59 Metoklopramid tab 10 mg Tablet 3250 500 Rp 100.00 Rp 50,000.00 Rp - 2750 Rp 113.00 Rp 310,750.00 Rp 360,750.00
60 Metronidazol tablet 500 mg Ampul 1650 1650 Rp 169.00 Rp 278,850.00 Rp - Rp - Rp 278,850.00
61 Mikonazol krim 2 % Tablet 70 70 Rp 3,150.00 Rp 220,500.00 Rp - Rp - Rp 220,500.00
62 Natrium diklofenat 50 mg Ampul 200 200 Rp 161.00 Rp 32,200.00 Rp - Rp - Rp 32,200.00
63 Natrium klorida larutan infus 0,9 % stBotol 79 79 Rp 6,410.00 Rp 506,390.00 Rp - Rp - Rp 506,390.00
64 Nistatin tab 500.000UI/g Tablet 100 Rp 704.00 Rp - Rp - 100 Rp 857.00 Rp 85,700.00 Rp 85,700.00
65 Oksitosin injeksi 10 iu/ml - 1 ml Paket 242 242 Rp 2,420.00 Rp 585,640.00 Rp - Rp - Rp 585,640.00
66 Papaverin tab 40 mg Paket 6000 6000 Rp 109.45 Rp 656,700.00 Rp - Rp - Rp 656,700.00
67 Parasetamol sirup 120 mg/5 ml Botol 460 Rp 1,119.00 Rp - Rp - 460 Rp 1,535.00 Rp 706,100.00 Rp 706,100.00
68 Parasetamol tablet 500 mg Vial 22700 22700 Rp 88.00 Rp 1,997,600.00 Rp - Rp - Rp 1,997,600.00
69 Pirantel pamoat tablet 125 mg Ampul 1500 1500 Rp 318.00 Rp 477,000.00 Rp - Rp - Rp 477,000.00
70 Piridoksin Tablet 7250 400 Rp 121.00 Rp 48,400.00 Rp - 6850 Rp 19.14 Rp 131,109.00 Rp 179,509.00
71 Polikresulen Tablet 6 6 Rp 18,635.00 Rp 111,810.00 Rp - Rp - Rp 111,810.00
72 Prednison tablet 5 mg Blister 7600 7600 Rp 152.00 Rp 1,155,200.00 Rp - Rp - Rp 1,155,200.00
73 Propitiourasil tablet 100 mg Tablet 100 100 Rp 330.00 Rp 33,000.00 Rp - Rp - Rp 33,000.00
74 Propranolol hcl tablet 40 mg Tablet 200 200 Rp 80.00 Rp 16,000.00 Rp - Rp - Rp 16,000.00
75 Retinol (Vitamin A) 100.000 IU kapsuTablet 50 50 Rp 327.00 Rp 16,350.00 Rp - Rp - Rp 16,350.00
76 Retinol (Vitamin A) 200.000 IU kapsuTablet 100 100 Rp 505.00 Rp 50,500.00 Rp - Rp - Rp 50,500.00
77 Ringer laktat larutan infus steril Vial 1238 1238 Rp 7,150.00 Rp 8,851,700.00 Rp - Rp - Rp 8,851,700.00
78 Salbutamol tablet 4 mg Tablet 670 670 Rp 99.00 Rp 66,330.00 Rp - Rp - Rp 66,330.00
79 Salep 2-4 Tablet 67 67 Rp 2,200.00 Rp 147,400.00 Rp - Rp - Rp 147,400.00
80 Salisil bedak 2% Ampul 27 Rp 1,350.00 Rp - Rp - 27 Rp 1,066.00 Rp 28,782.00 Rp 28,782.00
81 Sianokobalamin (vit b 12) inj. 500 m Tablet 15 15 Rp 1,226.00 Rp 18,390.00 Rp - Rp 1,050.00 Rp - Rp 18,390.00
82 Sianokobalamin tab Pot 5900 5900 Rp 63.00 Rp 371,700.00 Rp - Rp - Rp 371,700.00
83 Tetrasiklinhcl kapsul 500 mg Ampul 1400 1400 Rp 282.70 Rp 395,780.00 Rp - Rp - Rp 395,780.00
84 Tiamin hcl mononitrat 50 mg Tablet 8650 4650 Rp 41.58 Rp 193,347.00 Rp - 4000 Rp 91.00 Rp 364,000.00 Rp 557,347.00
85 Tiampenikol tab 500 mg Tablet 300 300 Rp 677.61 Rp 203,283.00 Rp - Rp - Rp 203,283.00
86 Vitamin B-Compleks Kapsul 7300 7300 Rp 112.00 Rp 817,600.00 Rp - Rp - Rp 817,600.00
87 Zinc dispersibel tab Ampul 350 350 Rp 592.00 Rp 207,200.00 Rp - Rp - Rp 207,200.00
88 Simvastatin 10 mg Set 900 900 Rp 135.00 Rp 121,500.00 Rp - Rp - Rp 121,500.00
89 Amlodipin 10 mg strip 300 300 Rp 163.00 Rp 48,900.00 Rp - Rp - Rp 48,900.00
90 Ibuprofen Suspensi 200 mg/5ml buah 40 40 Rp 2,560.00 Rp 102,400.00 Rp - Rp - Rp 102,400.00
91 Parasetamol Drops Tablet 56 Rp 5,980.00 Rp - Rp - 56 Rp 5,720.00 Rp 320,320.00 Rp 320,320.00
92 Nifedipin 10 mg Roll 100 100 Rp 123.00 Rp 12,300.00 Rp - Rp - Rp 12,300.00
93 Kloramfenikol salep mata 1 % Botol 141 141 Rp 1,680.00 Rp 236,880.00 Rp - Rp - Rp 236,880.00
94 Vitamin K injeksi 2 mg/ml Tablet 252 252 Rp 3,754.00 Rp 946,008.00 Rp - Rp 8,250.00 Rp - Rp 946,008.00
95 Pyrantel suspensi Botol 25 25 Rp 9,100.00 Rp 227,500.00 Rp - Rp - Rp 227,500.00
96 Domperidon tablet Tablet 500 500 Rp 133.00 Rp 66,500.00 Rp - Rp - Rp 66,500.00
97 Domperidon suspensi 5mg/ml Botol 50 50 Rp 3,180.00 Rp 159,000.00 Rp - Rp - Rp 159,000.00
98 Omeprazole kaps Kapsul 450 450 Rp 221.00 Rp 99,450.00 Rp - Rp - Rp 99,450.00
99 Ranitidin tablet Tablet 5900 5900 Rp 132.00 Rp 778,800.00 Rp - Rp - Rp 778,800.00
100 Larutan mengandung karbohidrat Botol 93 93 Rp 10,000.00 Rp 930,000.00 Rp - Rp - Rp 930,000.00
101 larutan mengandung elektrolit Botol 34 34 Rp 9,000.00 Rp 306,000.00 Rp - Rp - Rp 306,000.00
102 Metformin 500 mg tablet Tablet 3200 2200 Rp 118.50 Rp 260,700.00 Rp - 1000 Rp 115.00 Rp 115,000.00 Rp 375,700.00
103 Sefadroksil syrup 250 mg/5 ml Botol 150 150 Rp 6,285.00 Rp 942,750.00 Rp - Rp - Rp 942,750.00
104 Permetrin krim Tube 18 18 Rp 11,475.00 Rp 206,550.00 Rp - Rp - Rp 206,550.00
105 Hyocine N Bromide inj Ampul 25 25 Rp 4,950.00 Rp 123,750.00 Rp - Rp - Rp 123,750.00
106 Salbutamol cairan Botol 180 180 Rp 7,260.00 Rp 1,306,800.00 Rp - Rp - Rp 1,306,800.00
107 Streptomisin serbuk inj 1000mg/ml Vial 2 2 Rp 5,750.00 Rp 11,500.00 Rp - Rp - Rp 11,500.00
108 Metilprednisolon 4 mg Tablet 700 700 Rp 200.00 Rp 140,000.00 Rp - Rp - Rp 140,000.00
109 Omeprazole inj 40 mg/ml Ampul 10 10 Rp 18,537.00 Rp 185,370.00 Rp - Rp - Rp 185,370.00
110 Attapulgite 600 mg Tablet 300 300 Rp 173.00 Rp 51,900.00 Rp - Rp - Rp 51,900.00
111 Asam folat tab 0.4 mg Tablet 300 300 Rp 68.00 Rp 20,400.00 Rp - Rp - Rp 20,400.00
112 Glimepirid 2 mg Tablet 500 500 Rp 297.00 Rp 148,500.00 Rp - Rp - Rp 148,500.00
113 N-Asetil sistein kapsul 200 mg Kapsul 1000 1000 Rp 474.00 Rp 474,000.00 Rp - Rp - Rp 474,000.00
TOTAL OBAT Rp 51,171,481.50
TOTAL Rp 72,089,328.74
Mengetahui
dr.Benny Farianti Najamuddin,S.Si.Apt

NIP.19680608 200112 1 003 NIP.19791225 201001 2 017
SUMBER OBAT : PROGRAM
NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL

KEMASAN
A. OBAT
1 Fenobarbital injeksi 50 mg/ml - 2 Ampul 30 Rp 1,888.00 Rp 56,640.00
2 Fenobarbital injeksi 50 mg/ml - 2 Ampul 30 Rp 1,980.00 Rp 59,400.00
3 Primakuin tab 15 mg Tablet 100 Rp 205.00 Rp 20,500.00
TOTAL OBAT Rp 136,540.00
Mengetahui,
Kepala Puskesmas Pengelola Obat,
dr. Benny Farianti Najamuddin,S.Si.Apt

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
SUMBER OBAT : JAMKESMAS
NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

A. BMHP
1 Folley Chateter No 12 Buah 40 Rp 20,000.00 Rp 800,000.00
TOTAL BMHP Rp 800,000.00
B.OBAT
1 Propanolol Tablet 300 Rp 103.00 Rp 30,900.00
TOTAL Rp 830,900.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
SUMBER OBAT : APBD PKM
NO NAMA BARANG SATUAN JUMLAH HARGA SATUAN TOTAL

A.BMHP
1 Spritus Botol 5 Rp 14,611.00 Rp 73,055.00
2 Kertas Puyer Bks 47 Rp 6,000.00 Rp 282,000.00
3 Klip Plastik 5 x 8 cm Bks 255 Rp 3,500.00 Rp 892,500.00
4 Kertas Puyer BKS 96 Rp 15,000.00 Rp 1,440,000.00
6 Kertas Puyer Press Bks 15 Rp 125,000.00 Rp 1,875,000.00
7 Plastik obat Bks 37 Rp 10,000.00 Rp 370,000.00
8 Lumpang diameter 15 cm Buah 1 Rp 70,000.00 Rp 70,000.00
Mengetahui,
Kepala Puskesmas Penanggung Jawab

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
SUMBER OBAT : JAMPERSAL

A.BMHP
1 IV.Chateter No 24 Buah 40 Rp 20,000.00 Rp 800,000.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
amuddin,S.Si.Apt
225 201001 2 017
SUMBER OBAT : JKN

A.BMHP
1 Lancet Strip 1000 Rp 345.00 Rp 345,000.00
2 Plester Roll 3 Rp 28,000.00 Rp 84,000.00
3 Tambalan sementara Buah 2 Rp 170,000.00 Rp 340,000.00
4 Monotes HIV Buah 75 Rp 120,000.00 Rp 9,000,000.00
5 Jelly Botol 15 Rp 60,000.00 Rp 900,000.00
6 Penjepit Tali Pusat Buah 100 Rp 2,500.00 Rp 250,000.00
7 Hansaplast Buah 500 Rp 1,999.00 Rp 999,500.00
8 One swabs (kapas Alkohol) Buah 400 Rp 1,999.00 Rp 799,600.00
9 IV.Chateter 24 Buah 20 Rp 7,000.00 Rp 140,000.00
10 Kertas Lakmus Strip 400 Rp 867.50 Rp 347,000.00
11 Tes kehamilan Strip 130 Rp 1,760.00 Rp 228,800.00
12 Urinalisis 3 parameter Buah 100 Rp 1,650.00 Rp 165,000.00
B.OBAT
1 Ambroxol Tablet 3500 Rp 181.50 Rp 635,250.00
TOTAL Rp 14,234,150.00
Mengetahui,
Kepala Puskesmas Penaggung Jawab

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
SUB UNIT : APOTEK PUSKESMAS MALILI
SATU STOK
NO NAMA BARANG AN STOK TOTAL HARGA
KEMA JUMLA STOK HARGA TOTAL HARGA BAR HARGA TOTAL HARGA
SAN H LAMA
U
A. BMHP
1 Folley catheter No.14 Pcs 1 1 Rp 11,000.00 Rp 11,000.00 Rp - Rp 11,000.00
3 Folley catheter No.18 Pcs 5 2 Rp 9,200.00 Rp 18,400.00 3 Rp 11,000.00 Rp 33,000.00 Rp 51,400.00
4 Urine bag Pcs 3 3 Rp 3,450.00 Rp 10,350.00 Rp - Rp 10,350.00
5 Maag slang 14 Set 2 2 Rp 19,800.00 Rp 39,600.00 Rp - Rp 39,600.00
B. OBAT
1 Alopurinol tablet 100 mg Tablet 158 158 Rp 90.00 Rp 14,220.00 Rp - Rp 14,220.00
2 Aminofilin Injeksi 24 mg/ml - 10 ml Ampul 4 4 Rp 4,200.00 Rp 16,800.00 Rp - Rp 16,800.00
3 Aminofilin tablet 200 mg Tablet 41 41 Rp 86.00 Rp 3,526.00 Rp - Rp 3,526.00
4 Amitriptilin tab Tablet 176 176 Rp 123.00 Rp 21,648.00 Rp - Rp 21,648.00
5 Amoksisilin 500 mg Tablet 428 428 Rp 292.00 Rp 124,976.00 Rp - Rp 124,976.00
6 Amoksisilin Kapsul 250 mg Kapsul 400 Rp 207.00 Rp - 400 Rp 220.00 Rp 88,000.00 Rp 88,000.00
7 Amoksisilin sirup kering 125 mg/5 mlBotol 28 28 Rp 2,560.00 Rp 71,680.00 Rp - Rp 71,680.00
8 Antalgin (metampiron) tablet 500 m Tablet 340 340 Rp 163.90 Rp 55,726.00 Rp - Rp 55,726.00
9 Antalgin injeksi 250 mg/ml - 2 ml Ampul 23 23 Rp 1,466.67 Rp 33,733.41 Rp - Rp 33,733.41
10 Antasida doen tablet kombinasi Tablet 211 211 Rp 78.00 Rp 16,458.00 Rp - Rp 16,458.00
11 Antihemoroid supp Supp 9 9 Rp 3,350.00 Rp 30,150.00 Rp - Rp 30,150.00
12 Antimigrain doen kombinasi Tablet 88 88 Rp 149.00 Rp 13,112.00 Rp - Rp 13,112.00
13 Aqua proinjeksi steril, bebas pirogen Botol 9 9 Rp 2,750.00 Rp 24,750.00 Rp - Rp 24,750.00
14 Asam askorbat (vit c) tablet 50 mg Tablet 198 198 Rp 45.00 Rp 8,910.00 Rp - Rp 8,910.00
15 Asam mefenamat 500 mg Tablet 450 450 Rp 125.00 Rp 56,250.00 Rp - Rp 56,250.00
16 Asiklovir krim 5 % Tube 4 4 Rp 3,465.00 Rp 13,860.00 Rp - Rp 13,860.00
17 Asiklovir tab 400 mg Tablet 103 103 Rp 340.00 Rp 35,020.00 Rp 362.00 Rp - Rp 35,020.00
18 Betametason krim 0,1 % Tube 21 21 Rp 1,596.00 Rp 33,516.00 Rp - Rp 33,516.00
19 Captopril 25 mg Tablet 808 808 Rp 100.00 Rp 80,800.00 Rp - Rp 80,800.00
20 Cimetidin Tablet 441 441 Rp 126.39 Rp 55,737.99 Rp - Rp 55,737.99
21 Ciprofloxasin 500 mg Tablet 552 552 Rp 473.00 Rp 261,096.00 Rp - Rp 261,096.00
22 Deksametason inj Ampul 8 8 Rp 1,740.00 Rp 13,920.00 Rp 1,738.00 Rp - Rp 13,920.00
23 Deksametason tablet 0,5 mg Tablet 273 273 Rp 74.00 Rp 20,202.00 Rp - Rp 20,202.00
24 Difenhidramin hcl inj 10 mg/ml - 1 mAmpul 11 11 Rp 1,156.00 Rp 12,716.00 Rp - Rp 12,716.00
25 Digoksin tablet 0,25 mg Tablet 300 300 Rp 103.00 Rp 30,900.00 Rp - Rp 30,900.00
26 Doksisiklin 100 mg Tablet 20 20 Rp 298.00 Rp 5,960.00 Rp - Rp 5,960.00
27 Epinefrin(adrenalin) inj 0,1 %-1 ml Tablet 19 19 Rp 8,910.00 Rp 169,290.00 Rp - Rp 169,290.00
28 Eritromisin Sirup Kapsul 5 5 Rp 8,090.00 Rp 40,450.00 Rp - Rp 40,450.00
29 Fitomenadion tablet salut 10 mg Ampul 17 17 Rp 690.00 Rp 11,730.00 Rp 690.00 Rp - Rp 11,730.00
30 Furosemid inj 10 mg/ml Tablet 4 4 Rp 2,012.00 Rp 8,048.00 Rp - Rp 8,048.00
31 Furosemid tablet 40 mg Ampul 36 36 Rp 84.00 Rp 3,024.00 Rp - Rp 3,024.00
32 Garam oralit untuk 200 ml air Tablet 46 46 Rp 317.00 Rp 14,582.00 Rp - Rp 14,582.00
33 Glibenklamid tablet 5 mg Set 250 250 Rp 61.00 Rp 15,250.00 Rp - Rp 15,250.00
34 Griseofulvin tablet 125 mg, microniz Botol 50 50 Rp 241.00 Rp 12,050.00 Rp - Rp 12,050.00
35 Haloperidol 5 mg Botol 35 35 Rp 105.00 Rp 3,675.00 Rp - Rp 3,675.00
36 Haloperidol tablet 0,5 mg Tablet 78 78 Rp 62.00 Rp 4,836.00 Rp - Rp 4,836.00
37 Hidrokortison krim 2,5 % 4 4 Rp 2,938.00 Rp 11,752.00 Rp - Rp 11,752.00
38 Ibuprofen tablet 400 mg Tablet 599 599 Rp 133.00 Rp 79,667.00 Rp - Rp 79,667.00
39 Isosorbid dinitrat tablet subling 5 mgTablet 40 40 Rp 98.00 Rp 3,920.00 Rp - Rp 3,920.00
40 Karbamazepin tab 200 mg Tablet 40 40 Rp 269.00 Rp 10,760.00 Rp - Rp 10,760.00
41 Ketokenazol krim 2% Tube 7 7 Rp 2,697.00 Rp 18,879.00 Rp - Rp 18,879.00
42 Ketokenazol tab 200 mg Tablet 44 44 Rp 320.00 Rp 14,080.00 Rp - Rp 14,080.00
43 Kloramfenikol kapsul 250 mg Tablet 178 178 Rp 293.33 Rp 52,212.74 Rp - Rp 52,212.74
44 Kloramfenikol suspensi 125 mg/ 5 mlKapsul 37 37 Rp 4,016.00 Rp 148,592.00 Rp 4,000.00 Rp - Rp 148,592.00
45 Klorfeniramin maleat (ctm) tablet 4 mg 399 399 Rp 54.00 Rp 21,546.00 Rp - Rp 21,546.00
46 Klorpromazin hcl tablet salut 100 mg Botol 20 20 Rp 165.00 Rp 3,300.00 Rp - Rp 3,300.00
47 Klorpromazin hcl tablet salut 25 mg 91 91 Rp 50.00 Rp 4,550.00 Rp - Rp 4,550.00
48 Kodein hcl tablet 10 mg Tablet 9 9 Rp 550.00 Rp 4,950.00 Rp - Rp 4,950.00
49 Kotrimoksazol Adult Tablet 280 280 Rp 152.00 Rp 42,560.00 Rp - Rp 42,560.00
50 Kotrimoksazol Suspensi Ampul 40 40 Rp 2,298.00 Rp 91,920.00 Rp - Rp 91,920.00
51 Loperamid tab 2 mg Botol 182 182 Rp 97.00 Rp 17,654.00 Rp - Rp 17,654.00
52 Metilergometrin maleat tablet salut Tablet 104 104 Rp 128.70 Rp 13,384.80 Rp - Rp 13,384.80
53 Metoklopramid sirup 5 mg/ml Ampul 39 39 Rp 2,900.00 Rp 113,100.00 Rp - Rp 113,100.00
54 Metoklopramid tab 10 mg Tablet 320 320 Rp 113.00 Rp 36,160.00 Rp 113.00 Rp - Rp 36,160.00
55 Metronidazol tablet 500 mg Ampul 335 335 Rp 169.00 Rp 56,615.00 Rp - Rp 56,615.00
56 Mikonazol krim 2 % Tablet 12 12 Rp 3,150.00 Rp 37,800.00 Rp - Rp 37,800.00
57 Natrium diklofenat 50 mg Ampul 564 564 Rp 161.00 Rp 90,804.00 Rp - Rp 90,804.00
58 Nistatin tab 500.000UI/g Tablet 60 60 Rp 704.00 Rp 42,240.00 Rp 857.00 Rp - Rp 42,240.00
59 Nistatin tablet vaginal 100.000UI/g 122 122 Rp 528.00 Rp 64,416.00 Rp - Rp 64,416.00
60 Oksitosin injeksi 10 iu/ml - 1 ml Paket 3 3 Rp 2,420.00 Rp 7,260.00 Rp - Rp 7,260.00
61 Papaverin tab 40 mg Paket 941 941 Rp 109.45 Rp 102,992.45 Rp - Rp 102,992.45
62 Parasetamol sirup 120 mg/5 ml Botol 25 25 Rp 1,535.00 Rp 38,375.00 Rp 1,535.00 Rp - Rp 38,375.00
63 Parasetamol tablet 500 mg Vial 635 635 Rp 88.00 Rp 55,880.00 Rp - Rp 55,880.00
64 Piridoksin Tablet 343 313 Rp 121.00 Rp 37,873.00 30 Rp 19.14 Rp 574.20 Rp 38,447.20
65 Prednison tablet 5 mg Blister 413 413 Rp 152.00 Rp 62,776.00 Rp - Rp 62,776.00
66 Propitiourasil tablet 100 mg Tablet 65 65 Rp 330.00 Rp 21,450.00 Rp - Rp 21,450.00
67 Salbutamol tablet 4 mg Tablet 557 557 Rp 99.00 Rp 55,143.00 Rp - Rp 55,143.00
68 Salep 2-4 Tablet 5 5 Rp 2,200.00 Rp 11,000.00 Rp - Rp 11,000.00
69 Sianokobalamin (vit b 12) inj. 500 m Tablet 14 8 Rp 1,226.00 Rp 9,808.00 6 Rp 1,050.00 Rp 6,300.00 Rp 16,108.00
70 Sianokobalamin tab Pot 459 459 Rp 63.00 Rp 28,917.00 Rp - Rp 28,917.00
71 Tetrasiklinhcl kapsul 500 mg Ampul 150 150 Rp 282.70 Rp 42,405.00 Rp - Rp 42,405.00
72 Tiamin hcl mononitrat 50 mg Tablet 414 414 Rp 41.58 Rp 17,214.12 Rp 91.00 Rp - Rp 17,214.12
73 Tiampenikol tab 500 mg Tablet 37 37 Rp 677.61 Rp 25,071.57 Rp - Rp 25,071.57
74 Vitamin B-Compleks Kapsul 501 501 Rp 112.00 Rp 56,112.00 Rp - Rp 56,112.00
75 Zinc dispersibel tab Ampul 111 111 Rp 592.00 Rp 65,712.00 Rp - Rp 65,712.00
76 Simvastatin 10 mg Set 119 119 Rp 135.00 Rp 16,065.00 Rp - Rp 16,065.00
77 Amlodipin 10 mg strip 233 233 Rp 163.00 Rp 37,979.00 Rp - Rp 37,979.00
78 Ibuprofen Suspensi 200 mg/5ml buah 5 5 Rp 2,560.00 Rp 12,800.00 Rp - Rp 12,800.00
79 Parasetamol Drops Tablet 39 14 Rp 5,980.00 Rp 83,720.00 25 Rp 5,720.00 Rp 143,000.00 Rp 226,720.00
80 Nifedipin 10 mg Roll 185 185 Rp 123.00 Rp 22,755.00 Rp - Rp 22,755.00
81 Isoniazid tab 100 mg Botol 94 94 Rp 49.00 Rp 4,606.00 Rp - Rp 4,606.00
82 Kloramfenikol salep mata 1 % Botol 25 25 Rp 1,680.00 Rp 42,000.00 Rp - Rp 42,000.00
83 Vitamin K injeksi 2 mg/ml Tablet 24 24 Rp 3,754.00 Rp 90,096.00 Rp 8,250.00 Rp - Rp 90,096.00
84 Pyrantel suspensi Botol 24 24 Rp 9,100.00 Rp 218,400.00 Rp - Rp 218,400.00
85 Bisakodil supp 10 mg Supp 102 102 Rp 6,045.00 Rp 616,590.00 Rp - Rp 616,590.00
86 Domperidon tablet Tablet 271 271 Rp 133.00 Rp 36,043.00 Rp - Rp 36,043.00
87 Domperidon suspensi 5mg/ml Botol 32 32 Rp 3,180.00 Rp 101,760.00 Rp - Rp 101,760.00
88 Omeprazole kaps Kapsul 79 79 Rp 221.00 Rp 17,459.00 Rp - Rp 17,459.00
89 Ranitidin tablet Tablet 65 65 Rp 132.00 Rp 8,580.00 Rp - Rp 8,580.00
90 Diazepam Retal 5 mg/2,5 ml Tube 11 1 Rp 12,751.00 Rp 12,751.00 10 Rp 18,458.00 Rp 184,580.00 Rp 197,331.00
91 Diazepam Retal 10 mg/2,5 ml Tube 13 13 Rp 18,461.00 Rp 239,993.00 Rp - Rp 239,993.00
92 Metformin 500 mg tablet Tablet 537 537 Rp 118.50 Rp 63,634.50 Rp 115.00 Rp - Rp 63,634.50
93 Sefadroksil syrup 250 mg/5 ml Botol 2 2 Rp 6,285.00 Rp 12,570.00 Rp - Rp 12,570.00
94 Zinc Sirup 20 mg/5 ml Botol 41 41 Rp 6,500.00 Rp 266,500.00 Rp - Rp 266,500.00
95 Permetrin krim Tube 11 11 Rp 11,475.00 Rp 126,225.00 Rp - Rp 126,225.00
96 Salbutamol cairan Botol 14 14 Rp 7,260.00 Rp 101,640.00 Rp - Rp 101,640.00
97 Setirisin sirup 5mg/ml Botol 15 15 Rp 7,756.00 Rp 116,340.00 Rp - Rp 116,340.00
98 Metilprednisolon 4 mg Tablet 234 234 Rp 200.00 Rp 46,800.00 Rp - Rp 46,800.00
99 Asam folat tab 0.4 mg Tablet 170 170 Rp 68.00 Rp 11,560.00 Rp - Rp 11,560.00
TOTAL Rp 5,817,524.78
Mengetahui
dr.Benny Farianti Najamuddin,S.Si.Apt

NIP.19680608 200112 1 003 NIP.19791225 201001 2 017

KEMASAN
A. OBAT
1 Primakuin tab 15 mg Tablet 86 Rp 205.00 Rp 17,630.00

2 Darplex Tablet 18 Rp 4,216.30 Rp 75,893.40
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
SUB UNIT :APOTEK PUSKESMAS MALILI

A. BMHP
1 Folley Chateter 12 Buah 5 Rp 20,000.00 Rp 100,000.00
2 Maag Slang Buah 1 Rp 21,000.00 Rp 21,000.00
B. OBAT
1 Propanolol Tablet 171 Rp 103.00 Rp 17,613.00
TOTAL Rp 138,613.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017

A. BMHP
2 Kertas Puyer Bks 14 Rp 6,000.00 Rp 84,000.00
3 Klip Plastik 8x 12cm BKS 6 Rp 5,500.00 Rp 33,000.00
4 Kertas Puyer Press Bks 2 Rp 125,000.00 Rp 250,000.00
5 Plastik obat Bks 3 Rp 10,000.00 Rp 30,000.00
TOTAL Rp 456,500.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
SUMBER OBAT : JKN

A OBAT
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19791225 201001 2 017
SUB UNIT : UNIT GAWAT DARURAT PUSKESMAS MALILI
NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL HARGA

KEMASAN
A. BMHP
1 Alat Suntik Sekali Pakai 1 ml Set 6 Rp 796.25 Rp 4,777.50

2 Alat Suntik Sekali Pakai 2,5 ml Set 5 Rp 796.25 Rp 3,981.25
4 Catgut / Benang Bedah No. 3/0 dan 2/0 Set 3 Rp 6,839.58 Rp 20,518.75
5 Hanscoen Non Steril Pasang 6 Rp 747.50 Rp 4,485.00
6 Infusion Set Dewasa Set 19 Rp 7,920.00 Rp 150,480.00
7 IV Catheter No. 18 Buah 20 Rp 8,309.40 Rp 166,188.00
15 Kasa Pembalut Hidrofil 4 x 10 cm Ktk 10 Rp 1,980.00 Rp 19,800.00
16 IV Catheter No. 26 Paket 5 Rp 17,600.00 Rp 88,000.00
19 Bisturi N0.11 Pcs 5 Rp 1,540.00 Rp 7,700.00
B OBAT
1 Larutan mengandung karbohidrat Botol 9 Rp 10,000.00 Rp 90,000.00
2 larutan mengandung elektrolit Botol 20 Rp 9,000.00 Rp 180,000.00
3 Glukosa larutan infus 5 % steril Botol 13 Rp 5,720.00 Rp 74,360.00
4 Lidokain injeksi 2 % Botol 7 Rp 875.00 Rp 6,125.00
5 Natrium klorida larutan infus 0,9 % steril Botol 4 Rp 6,410.00 Rp 25,640.00
6 Ringer laktat larutan infus steril Vial 6 Rp 7,150.00 Rp 42,900.00
Total Rp 1,082,630.50
Mengetahui
Kepala Puskesmas Malili Penanggung Jawab
dr.Benny Nurmila, Amk

NIP.19680608 200112 1 003 NIP.19830124 200604 2 009
SUMBER OBAT : JKN
SUB UNIT : UNIT GAWAT DARURAT PUSKESMAS MALILI

A. BMHP
1 Plester Roll 2 28,000.00 56,000.00
TOTAL Rp 56,000.00
Mengetahui,
dr. Benny Nurmila,AMK

Nip. 19680608 200112 1 003 Nip. 19830124 200604 2 009
SUB UNIT : LABORATORIUM PUSKESMAS MALILI

KEMASAN
A BMHP
3 Masker Buah 40 Rp 404.25 Rp 16,170.00
4 Aqua proinjeksi steril, bebas pirogen Botol 1 Rp 2,750.00 Rp 2,750.00
5 Larutan Benedict Tablet 4 Rp 28,957.00 Rp 115,828.00
Mengetahui
dr.Benny Salmawati.R
NIP.19680608 200112 1 003 NIP.19710118 199402 2 001

KEMASAN
A BMHP
1 Slide Dos 8 Rp 44,400.00 Rp 355,200.00

2 Reagen Pemeriksaan TB Paru Botol 8 Rp 276,500.00 Rp 2,212,000.00
Mengetahui,
dr. Benny Salmawati.R

Nip. 19680608 200112 1 003 Nip. 19710118 199402 2 001

A BMHP
1 Coper Glas/Deck Glas Buah 1 Rp 62,000.00 Rp 62,000.00
2 Rak LED Buah 1 Rp 62,000.00 Rp 62,000.00
3 Natrium Sitrat btl 2 Rp 47,000.00 Rp 94,000.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19710118 199402 2 001

A. BMHP
1 Haemometer Set 1 Rp 100,000.00 Rp 100,000.00
2 Rak LED Set 3 Rp 150,000.00 Rp 450,000.00
3 DEG glass Dos 1 Rp 50,000.00 Rp 50,000.00
4 Larutan turk 100cc Botol 1 Rp 275,000.00 Rp 275,000.00
5 Strip GDS tipe 1 Buah 250 Rp 6,600.00 Rp 1,650,000.00
6 Strip asam urat tipe 1 Buah 230 Rp 6,600.00 Rp 1,518,000.00
7 Golongan darah set 2 Rp 357,500.00 Rp 715,000.00
8 Strip kolesterol tipe 1 Buah 90 Rp 19,800.00 Rp 1,782,000.00
9 Hayem 100 cc Botol 1 Rp 200,000.00 Rp 200,000.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19710118 199402 2 001
SUMBER OBAT : APBD DINKES
A. BMHP
1 Timer Led Buah 1 Rp 71,225.00 Rp 71,225.00
2 Yellow Tip Buah 640 Rp 131.25 Rp 84,000.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19710118 199402 2 001
SUMBER OBAT :JKN

A. BMHP
1 Lancet Buah 220 Rp 345.00 Rp 75,900.00
2 Urinalisis 3 Parameter Buah 90 Rp 1,650.00 Rp 148,500.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19710118 199402 2 001
SUB UNIT : KIA PUSKESMAS MALILI
A. BMHP
5 Hanscoen Pasang 55 Rp 4,598.00 Rp 252,890.00
7 Infusion Set Anak Set 5 Rp 4,290.00 Rp 21,450.00
12 Kapas pembalut/absorben 250 mg Gulung 1 Rp 15,312.50 Rp 15,312.50
13 Kasa Pembalut Hidrofil 38 Yds x 80 cm Rol 1 Rp 128,625.00 Rp 128,625.00
14 Masker Buah 34 Rp 404.25 Rp 13,744.50
15 Plester 5 yard x 2 inch Rol 2 Rp 12,076.00 Rp 24,152.00
18 Etakridin (rivanol) larutan 0,1 % Botol 1 Rp 3,123.75 Rp 3,123.75
19 Etanol 70% Botol 1 Rp 26,337.50 Rp 26,337.50
20 Yodium povidon larutan 10% 300 ml 1 Rp 15,386.00 Rp 15,386.00
21 Nasal canula bayi Set 1 Rp 17,600.00 Rp 17,600.00
22 Nasal canula anak Set 1 Rp 17,600.00 Rp 17,600.00
23 Nasal Canula dewasa Set 2 Rp 17,600.00 Rp 35,200.00
B. OBAT
2 Deksametason inj Ampul 5 Rp 1,740.00 Rp 8,700.00
3 Lidokain injeksi 2 % Botol 5 Rp 875.00 Rp 4,375.00
4 Lidokain kompositum injeksi Botol 7 Rp 2,122.00 Rp 14,854.00
5 Metilergometrin maleat injeksi 0,200 mg- Botol 4 Rp 1,639.00 Rp 6,556.00
7 Oksitosin injeksi 10 iu/ml - 1 ml Paket 6 Rp 2,420.00 Rp 14,520.00
8 Retinol (Vitamin A) 200.000 IU kapsul lun Tablet 30 Rp 505.00 Rp 15,150.00
10 Kloramfenikol salep mata 1 % Botol 1 Rp 1,680.00 Rp 1,680.00
11 Vitamin K injeksi 2 mg/ml Tablet 12 Rp 3,754.00 Rp 45,048.00
Total Rp 1,732,403.48
Mengetahui
dr.Benny Masrah,Amd.Keb
NIP.19680608 200112 1 003 NIP.19680711 199001 2 002

A. BMHP
1 Hanscoen Panjang Pasang 3 Rp 20,000.00 Rp 60,000.00
2 Kertas Lakmus Buah 85 Rp 850.00 Rp 72,250.00
Mengetahui,
dr. Benny Masrah,Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19680711 199001 2 002
SUMBER OBAT :JKN

A BMHP
2 Urinalisis 3 Parameter Buah 4 Rp 1,150.00 Rp 4,600.00
3 Tes Kehamilan Buah 90 Rp 1,760.00 Rp 158,400.00
4 Penjepit tali pusat Buah 16 Rp 2,500.00 Rp 40,000.00
5 Kapas lidi buah 39 Rp 3,600.00 Rp 140,400.00
Mengetahui,
dr. Benny Masrah,Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19680711 199001 2 002
SUB UNIT : PERAWATAN PUSKESMAS MALILI

KEMASAN
A. BMHP
8 IV Catheter No. 26 Paket 2 Rp 17,600.00 Rp 35,200.00
B. OBAT
1 Glukosa larutan infus 5 % steril Botol 2 Rp 5,720.00 Rp 11,440.00
4 larutan mengandung elektrolit Botol 4 Rp 9,000.00 Rp 36,000.00
Total Rp 344,425.00
Mengetahui
dr.Benny Astriani Raoda,AMK

NIP.19680608 200112 1 003 NIP.19830813 201001 2 021
SUMBER OBAT : JKN
SUB UNIT : PERAWATAN PUSKESMAS MALILI

A. BMHP
1 Plester Roll 1 28,000.00 28,000.00
TOTAL BMHP 28,000.00
Mengetahui,
dr. Benny Wulan Purnamasari,S.kep,Ns

Nip. 19680608 200112 1 003 Nip.19880925 201404 2 001
SUB UNIT : PUSKEL PUSKESMAS MALILI

KEMASAN
A. BMHP
B. OBAT
1 Amoksisilin 500 mg Tablet 240 Rp 292.00 Rp 70,080.00
2 Amoksisilin sirup kering 125 mg/5 ml Botol 21 Rp 2,560.00 Rp 53,760.00
3 Antalgin (metampiron) tablet 500 mg Tablet 80 Rp 163.90 Rp 13,112.00
4 Antasida doen tablet kombinasi Tablet 270 Rp 78.00 Rp 21,060.00
5 Asam mefenamat 500 mg Tablet 10 Rp 125.00 Rp 1,250.00
6 Difenhidramin hcl inj 10 mg/ml - 1 ml Ampul 5 Rp 1,156.00 Rp 5,780.00
7 Fitomenadion tablet salut 10 mg Ampul 30 Rp 690.00 Rp 20,700.00
8 Furosemid tablet 40 mg Ampul 40 Rp 84.00 Rp 3,360.00
9 Garam oralit untuk 200 ml air Tablet 26 Rp 317.00 Rp 8,242.00
10 Glibenklamid tablet 5 mg Set 20 Rp 61.00 Rp 1,220.00
11 Griseofulvin tablet 125 mg, micronized Botol 90 Rp 241.00 Rp 21,690.00
12 Klorfeniramin maleat (ctm) tablet 4 mg 50 Rp 54.00 Rp 2,700.00
13 Kotrimoksazol Adult Tablet 228 Rp 152.00 Rp 34,656.00
14 Kotrimoksazol Suspensi Ampul 12 Rp 2,298.00 Rp 27,576.00
15 Loperamid tab 2 mg Botol 96 Rp 97.00 Rp 9,312.00
16 Metoklopramid sirup 5 mg/ml Ampul 12 Rp 2,900.00 Rp 34,800.00
17 Metoklopramid tab 10 mg Tablet 140 Rp 113.00 Rp 15,820.00
18 Parasetamol sirup 120 mg/5 ml Botol 10 Rp 1,535.00 Rp 15,350.00
19 Parasetamol tablet 500 mg Vial 280 Rp 88.00 Rp 24,640.00
20 Piroksikam 20 mg Botol 50 Rp 92.41 Rp 4,620.50
21 Prednison tablet 5 mg Blister 10 Rp 152.00 Rp 1,520.00
22 Sianokobalamin (vit b 12) inj. 500 mcg/m Tablet 4 Rp 1,226.00 Rp 4,904.00
23 Tiampenikol tab 500 mg Tablet 60 Rp 677.61 Rp 40,656.60
24 Vitamin B-Compleks Kapsul 56 Rp 112.00 Rp 6,272.00
25 Domperidon tablet Tablet 10 Rp 133.00 Rp 1,330.00
Total Rp 522,611.10
Mengetahui
dr.Benny Srikandi Yustianti S, S.Kep.Ns

NIP.19680608 200112 1 003 NIP.19840320 200604 2 015
SUB UNIT : POLI GIGI PUSKESMAS MALILI
NO NAMA BARANG SATUAN STOK HARGA TOTAL HARGA TOTAL HARGA

KEMASAN LAMA
A. BMHP
1 Alat Suntik Sekali Pakai 1 ml Set 37 Rp 796.25 Rp 29,461.25 Rp 29,461.25
2 Alat Suntik Sekali Pakai 2,5 ml Set 5 Rp 796.25 Rp 3,981.25 Rp 3,981.25
3 Hanscoen Non Steril Pasang 10 Rp 747.50 Rp 7,475.00 Rp 7,475.00
4 Masker Buah 4 Rp 404.25 Rp 1,617.00 Rp 1,617.00
5 Bisturi N0.11 Pcs 2 Rp 1,540.00 Rp 3,080.00 Rp 3,080.00
B. OBAT
1 Lidokain kompositum injeksi Botol 8 Rp 2,122.00 Rp 16,976.00 Rp 16,976.00
TOTAL Rp 62,590.50
Mengetahui
dr.Benny drg.Lenni Tangkeallo

NIP.19680608 200112 1 003 NIP. 19790520 201001 2 026
SUMBER OBAT : ASKES

A. BMHP
1 Cotton Roll Buah 50 Rp 6,250.00 Rp 312,500.00
Mengetahui,
dr. Benny drg.Lenni Tangkeallo

Nip. 19680608 200112 1 003 Nip. 19790520 201001 2 026
SUMBER OBAT : JKN
NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN

A. BMHP
1 Needle carpule Buah 390 Rp 2,250.00
TOTAL BMHP
B. OBAT
1 Ethyl klorida Botol 1 Rp 137,500.00
TOTAL OBAT
TOTAL
Mengetahui,
dr. Benny drg.Lenni Tangkeallo

Nip. 19680608 200112 1 003 Nip. 19790520 201001 2 026
TOTAL
Rp 877,500.00
Rp 877,500.00
Rp 137,500.00
Rp 137,500.00
Rp 1,015,000.00
Penanggung Jawab
drg.Lenni Tangkeallo
Nip. 19790520 201001 2 026
SUB UNIT : PROG.FILARIASIS PUSKESMAS MALILI
SATUAN
NO NAMA BARANG KEMASAN JUMLAH HARGA TOTAL
A. OBAT
1 Albendazole Tablet 595 Rp 363.00 Rp 215,985.00
Mengetahui
dr.Benny Muliati,AMK
NIP.19680608 200112 1 003 NIP.19881024 201101 2 009
SUB UNIT : PROGRAM TB
SATUAN
NO NAMA BARANG KEMASAN JUMLAH HARGA TOTAL
A. BMHP
1 Pot Dahak Buah 713 Rp 2,500.00 Rp 1,782,500.00
B. OBAT
1 Obat anti tuberculosis kategori I Paket 6 Rp 395,900.00 Rp 2,375,400.00
TOTAL Rp 4,157,900.00
Mengetahui
dr.Benny Wulan Purnamasari,S.Kep.Ns

NIP.19680608 200112 1 003 NIP.19880925 201404 2 001
SUB UNIT : PUSTU MALILI PUSKESMAS MALILI

KEMASAN
A. BMHP
1 Set
Alat Suntik Sekali Pakai 2,5 ml 17 Rp 796.25 Rp 13,536.25
5 Masker Buah 10 Rp 404.25 Rp 4,042.50
B. OBAT
5 Captopril 25 mg Tablet 165 Rp 100.00 Rp 16,500.00
6 Deksametason tablet 0,5 mg Tablet 260 Rp 74.00 Rp 19,240.00
7 Glibenklamid tablet 5 mg Set 50 Rp 61.00 Rp 3,050.00
8 Ibuprofen tablet 400 mg Tablet 60 Rp 133.00 Rp 7,980.00
9 Kalsium Laktat (Kalk) tab 500 mg Kapsul 510 Rp 76.00 Rp 38,760.00
13 Loperamid tab 2 mg Botol 100 Rp 97.00 Rp 9,700.00
14 Metilergometrin maleat tablet salut 0,12 Tablet 170 Rp 128.70 Rp 21,879.00
15 Metoklopramid sirup 5 mg/ml Ampul 4 Rp 2,900.00 Rp 11,600.00
16 Metronidazol tablet 500 mg Ampul 80 Rp 169.00 Rp 13,520.00
18 Papaverin tab 40 mg Paket 200 Rp 109.45 Rp 21,890.00
21 Piridoksin Tablet 370 Rp 121.00 Rp 44,770.00
22 Prednison tablet 5 mg Blister 270 Rp 152.00 Rp 41,040.00
23 Tablet tambah darah Kapsul 80 Rp 45.00 Rp 3,600.00
24 Tiamin hcl mononitrat 50 mg Tablet 207 Rp 41.58 Rp 8,607.06
TOTAL Rp 729,372.23
Mengetahui
dr.Benny Wifasari,Amd.Keb
NIP.19680608 200112 1 003 NIP.19860226 201001 2 031
SUB UNIT : P.MALILI PUSKESMAS MALILI
SATUAN
NO. NAMA BARANG JUMLAH HARGA TOTAL
KEMASAN
A.OBAT
1 Tablet tambah darah Tablet 70 Rp 73.00 Rp 5,110.00

Mengetahui
dr.Benny Wifasari,Amd.Keb
NIP.19680608 200112 1 003 NIP.19860226 201001 2 031
SUMBER OBAT : ASKES

A.OBAT
1 Ibuprofen 400mg tablet 150 Rp 280.348 Rp 42,052.20
Mengetahui,
dr. Benny Wifa Sari,A.Md.Keb

Nip. 19680608 200112 1 003 Nip. 19860226 201001 2 031
LAMPIRAN BERITA ACARA STOC K OPNAME
SUB UNIT :PUSTU MALILI PUSKESMAS MALILI

A. OBAT
1 Underpad Buah 16 Rp 7,500.00 Rp 120,000.00
2 Pembalut Wanita Bks 6 Rp 28,500.00 Rp 171,000.00
3 IV.Chateter No 20 Buah 3 Rp 20,000.00 Rp 60,000.00
4 Catgut Buah 1 Rp 29,333.00 Rp 29,333.00
Mengetahui,
dr. Benny Wifa Sari,A.Md.Keb

Nip. 19680608 200112 1 003 Nip. 19860226 201001 2 031
SUMBER OBAT : JKN

A. BMHP
B .OBAT
TOTAL Rp 26,175.00
Mengetahui,
dr. Benny Wifa Sari,Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19860226 201001 2 031
SUB UNIT : PUSTU P. INDAH PUSKESMAS MALILI
SATU STOK
AN STO
NO NAMA BARANG TOTAL HARGA
KEMA JUMLA STOK HARGA TOTAL HARGA
K
HARGA TOTAL HARGA
SAN H LAMA BAR
U
A. BMHP
1 Alat Suntik Sekali Pakai 2,5 ml Set 9 9 Rp 796.25 Rp 7,166.25 Rp - Rp 7,166.25
2 Catgut / Benang Bedah No. 3/0 dan Set 3 3 Rp 6,839.58 Rp 20,518.75 Rp - Rp 20,518.75
3 Hanscoen Pasang 5 5 Rp 4,598.00 Rp 22,990.00 Rp - Rp 22,990.00
4 Hanscoen Non Steril Pasang 6 6 Rp 747.50 Rp 4,485.00 Rp - Rp 4,485.00
5 Infusion Set Dewasa Set 4 4 Rp 7,920.00 Rp 31,680.00 Rp - Rp 31,680.00
6 IV Catheter No. 20 Buah 5 5 Rp 7,700.00 Rp 38,500.00 Rp - Rp 38,500.00
8 Masker Buah 10 10 Rp 404.25 Rp 4,042.50 Rp - Rp 4,042.50
9 Urine bag Pcs 1 1 Rp 3,450.00 Rp 3,450.00 Rp - Rp 3,450.00
10 Kasa Pembalut Hidrofil 4 x 10 cm Ktk 14 14 Rp 1,980.00 Rp 27,720.00 Rp - Rp 27,720.00
B. OBAT
3 Amoksisilin sirup kering 125 mg/5 mBotol 4 4 Rp 2,560.00 Rp 10,240.00 Rp - Rp 10,240.00
4 Antasida doen suspensi Botol 2 2 Rp 2,300.00 Rp 4,600.00 Rp - Rp 4,600.00
12 Griseofulvin tablet 125 mg, microni Botol 60 60 Rp 241.00 Rp 14,460.00 Rp - Rp 14,460.00
15 Lidokain injeksi 2 % Botol 3 3 Rp 875.00 Rp 2,625.00 Rp - Rp 2,625.00
17 Metilergometrin maleat tablet salut Tablet 20 20 Rp 128.70 Rp 2,574.00 Rp - Rp 2,574.00
19 Metoklopramid tab 10 mg Tablet 80 80 Rp 113.00 Rp 9,040.00 Rp - Rp 9,040.00
20 Natrium klorida larutan infus 0,9 % sBotol 1 1 Rp 6,410.00 Rp 6,410.00 Rp - Rp 6,410.00
23 Parasetamol sirup 120 mg/5 ml Botol 10 10 Rp 1,535.00 Rp 15,350.00 Rp - Rp 15,350.00
25 Piroksikam 20 mg Botol 10 10 Rp 92.41 Rp 924.10 Rp - Rp 924.10
27 Ringer laktat larutan infus steril Vial 2 2 Rp 7,150.00 Rp 14,300.00 Rp - Rp 14,300.00
28 Salisil bedak 2% Ampul 5 5 Rp 1,350.00 Rp 6,750.00 Rp - Rp 6,750.00
30 Tiamin hcl mononitrat 50 mg Tablet 50 50 Rp 41.58 Rp 2,079.00 Rp - Rp 2,079.00
34 Vitamin K injeksi 2 mg/ml Tablet 3 3 Rp 3,754.00 Rp 11,262.00 Rp - Rp 11,262.00
TOTAL Rp 536,682.60
Mengetahui
dr.Benny Ana Indriana, S.Kep.Ns

NIP.19680608 200112 1 003 NIP.19880421 201404 2 001
SUB UNIT : PUSTU P.INDAH PUSKESMAS MALILI

KEMASAN
A. OBAT
1 Fitomenadion injeksi 10 mg/ml - 1 ml Ampul 1 Rp 1,723 Rp 1,723.00
2 Garam oralit untuk 200 ml air Sachet 6 Rp 317 Rp 1,902.00
Mengetahui
dr.Benny Ana Indriana, S.Kep.Ns

NIP.19680608 200112 1 003 NIP.19880421 201404 2 001

A. BMHP
1 Termometer Buah 1 Rp 21,000.00 Rp 21,000.00
Mengetahui,
dr. Benny Ana Indriana,S.Kep.NS

Nip. 19680608 200112 1 003 Nip. 19880421 201404 2 001

A. BMHP
1 Hanscoen panjang Steril Pasang 2 Rp 20,000.00 Rp 40,000.00
Mengetahui,
dr. Benny Ana Indriana,S.Kep.NS

Nip. 19680608 200112 1 003 Nip. 19880421 201404 2 001
SUMBER OBAT : JKN

A.BMHP
TOTAL Rp 25,000.00
Mengetahui,
dr. Benny Kiki Angryani

Nip. 19680608 200112 1 003 Nip. 19900427 201001 2 006
SUB UNIT : PUSTU BARUGA PUSKESMAS MALILI
SATUAN
NO NAMA BARANG JUMLAH HARGA TOTAL HARGA
KEMASAN
A. BMHP
B.OBAT
6 Griseofulvin tablet 125 mg, micronized Botol 10 Rp 241.00 Rp 2,410.00
8 Lidokain injeksi 2 % Botol 1 Rp 875.00 Rp 875.00
12 Salisil bedak 2% Ampul 1 Rp 1,350.00 Rp 1,350.00
13 Zinc dispersibel tab Ampul 20 Rp 592.00 Rp 11,840.00
Total Rp 206,060.63
Mengetahui
Kepala Puskesmas Malili Penanggung Jwab
dr.Benny Ahmawati A.Amd.Keb

NIP.19680608 200112 1 003 NIP.19821030 200604 2 018
SUMBER OBAT : JKN
SUB UNIT : PUSTU BARUGA PUSKESMAS MALILI

A.BMHP
B.OBAT
TOTAL Rp 21,575.00
Mengetahui,
dr. Benny Ahmawati A.Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19821030 200604 2 018
SUB UNIT : PUSTU BALANTANG PUSKESMAS MALILI
STOK
SATUAN
NO NAMA BARANG KEMASA JUML STOK STOK TOTAL HARGA
N HARGA TOTAL HARGA HARGA TOTAL HARGA
AH LAMA BARU
A. BMHP
1 Alat Suntik Sekali Pakai 1 ml Set 20 20 Rp 796.25 Rp 15,925.00 Rp - Rp 15,925.00
3 Catgut / Benang Bedah No. 3/0 da Set 3 3 Rp 6,839.58 Rp 20,518.75 Rp - Rp 20,518.75
5 Plester 5 yard x 2 inch Rol 1 1 Rp 12,076.00 Rp 12,076.00 Rp - Rp 12,076.00
6 Etakridin (rivanol) larutan 0,1 % Botol 1 1 Rp 3,123.75 Rp 3,123.75 Rp - Rp 3,123.75
7 Etanol 70% Botol 1 1 Rp 26,337.50 Rp 26,337.50 Rp - Rp 26,337.50
9 Bisturi N0.11 Pcs 4 4 Rp 1,540.00 Rp 6,160.00 Rp - Rp 6,160.00
B.OBAT
2 Amoksisilin sirup kering 125 mg/5 Botol 5 5 Rp 2,560.00 Rp 12,800.00 Rp - Rp 12,800.00
3 Antasida doen suspensi Botol 8 8 Rp 2,300.00 Rp 18,400.00 Rp - Rp 18,400.00
9 Difenhidramin hcl inj 10 mg/ml - 1 Ampul 3 3 Rp 1,156.00 Rp 3,468.00 Rp - Rp 3,468.00
12 Gliseril guayakolat tablet 100 mg Tablet 51 51 Rp 30.69 Rp 1,565.19 Rp - Rp 1,565.19
14 Kalsium Laktat (Kalk) tab 500 mg Kapsul 30 30 Rp 76.00 Rp 2,280.00 Rp - Rp 2,280.00
22 Natrium klorida larutan infus 0,9 % Botol 1 1 Rp 6,410.00 Rp 6,410.00 Rp - Rp 6,410.00
27 Piridoksin Tablet 613 613 Rp 121.00 Rp 74,173.00 Rp - Rp 74,173.00
36 Vitamin K injeksi 2 mg/ml Tablet 8 0 Rp 3,754.00 Rp - 8 Rp 8,250.00 Rp 66,000.00 Rp 66,000.00
TOTAL Rp 1,169,374.59
Mengetahui
dr.Benny Nila Kusumawati,Amd.Keb

NIP.19680608 200112 1 003 NIP.19840630 200604 2 012

A. BMHP
2 Umbilical cord Buah 16 Rp 2,040.00 Rp 32,640.00
Mengetahui,
Kepala Puskesmas Penganggung Jawab
dr. Benny Nila Kusumawati,Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19840630 200604 2 012
SUMBER OBAT : JKN

A. BMHP
Mengetahui,
dr. Benny Nila Kusumawati Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19840630 200604 2 012
SUB UNIT : PUSTU WEWANGRIU PUSKESMAS MALILI
SATUAN
NO NAMA BARANG JUMLAH HARGA TOTAL HARGA
KEMASAN
A. BMHP
B .OBAT
3 Antalgin (metampiron) tablet 500 mg Tablet 180 Rp 163.90 Rp 29,502.00
8 Cimetidin Tablet 100 Rp 126.39 Rp 12,639.00
10 Hidrokortison krim 2,5 % 4 Rp 2,938.00 Rp 11,752.00
14 Oksitosin injeksi 10 iu/ml - 1 ml Paket 8 Rp 2,420.00 Rp 19,360.00
21 Sianokobalamin tab Pot 50 Rp 63.00 Rp 3,150.00
TOTAL Rp 555,422.48
Mengetahui
dr.Benny Sandi Bena,Amd.Keb

NIP.19680608 200112 1 003 Nip. 19760615 200604 2 012
SATUAN
NO NAMA BARANG JUMLAH HARGA TOTAL
KEMASAN
A. OBAT
Mengetahui
dr.Benny Sandi Bena,Amd.Keb

NIP.19680608 200112 1 003 Nip. 19760615 200604 2 012
SUMBER OBAT :JKN

A. BMHP
2 Tes kehamilan Strip 6 Rp 1,900.00 Rp 11,400.00
B. OBAT
1 Ambroxo Tablet 40 Rp 181.50 Rp 7,260.00
TOTAL Rp 46,160.00
Mengetahui,
dr. Benny Sandy Bena Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19760615 200604 2 006
SUB UNIT : PUSTU USSU PUSKESMAS MALILI
SATU STOK
NO NAMA BARANG AN TOTAL HARGA
STOK
HARGA TOTAL HARGA
SAN H LAMA BARU
A. BMHP
3 Catgut / Benang Bedah No. 3/0 dan 2 Set 3 3 Rp 6,839.58 Rp 20,518.75 Rp - Rp 20,518.75
8 Masker Buah 7 7 Rp 404.25 Rp 2,829.75 Rp - Rp 2,829.75
9 Silk ( Benang Bedah Sutera ) No 3/0 Set 2 2 Rp 3,513.89 Rp 7,027.78 Rp - Rp 7,027.78
B. OBAT
2 Amoksisilin sirup kering 125 mg/5 ml Botol 3 3 Rp 2,560.00 Rp 7,680.00 Rp - Rp 7,680.00
4 Asam askorbat (vit c) tablet 50 mg Tablet 92 92 Rp 45.00 Rp 4,140.00 Rp - Rp 4,140.00
10 Griseofulvin tablet 125 mg, micronize Botol 20 20 Rp 241.00 Rp 4,820.00 Rp - Rp 4,820.00
17 Metilergometrin maleat tablet salut 0 Tablet 40 40 Rp 128.70 Rp 5,148.00 Rp - Rp 5,148.00
18 Natrium klorida larutan infus 0,9 % steBotol 1 1 Rp 6,410.00 Rp 6,410.00 Rp - Rp 6,410.00
28 Tablet tambah darah Kapsul 560 560 Rp 45.00 Rp 25,200.00 Rp - Rp 25,200.00
TOTAL Rp 435,532.18
Mengetahui
dr.Benny Tri Natalia yanti, S.Kep.Ns
NIP.19680608 200112 1 003 NIP.19891213 201404 2001
SATUAN
KEMASAN
A. OBAT
1 Garam Oralit untuk 200 ml air Sachet 9 Rp 317.00 Rp 2,853.00
Mengetahui
dr.Benny Tri Natalia yanti, S.Kep.Ns

NIP.19680608 200112 1 003 NIP.19891213 201404 2001
SUMBER OBAT : JKN

A. BMHP
1 Jelly Botol 1 Rp 60,000.00 Rp 60,000.00
B. OBAT
TOTAL Rp 90,849.00
Mengetahui,
dr. Benny Tri Natalia Yanti,s.Kep.Ns

Nip. 19680608 200112 1 003 Nip. 19891213 201404 2001
SUB UNIT : PUSTU ATUE PUSKESMAS MALILI
SATU STOK
AN
HARGA TOTAL HARGA HARGA TOTAL HARGA
SAN H LAMA BARU
A. BMHP
1 Catgut / Benang Bedah No. 3/0 dan 2/0 Set 2 2 Rp 6,839.58 Rp 13,679.17 Rp - Rp 13,679.17
5 Infusion Set Anak Set 3 3 Rp 4,290.00 Rp 12,870.00 Rp - Rp 12,870.00
8 Masker Buah 2 2 Rp 404.25 Rp 808.50 Rp - Rp 808.50
9 Silk ( Benang Bedah Sutera ) No 3/0 dgn Set 5 5 Rp 3,513.89 Rp 17,569.44 Rp - Rp 17,569.44
11 Yodium povidon larutan 10% 300 ml 1 1 Rp 15,386.00 Rp 15,386.00 Rp - Rp 15,386.00
B.OBAT
10 Fitomenadion tablet salut 10 mg Ampul 40 40 Rp 690.00 Rp 27,600.00 Rp - Rp 27,600.00
12 Griseofulvin tablet 125 mg, micronized Botol 30 30 Rp 241.00 Rp 7,230.00 Rp - Rp 7,230.00
13 Hidrokortison krim 2,5 % Tube 5 5 Rp 2,938.00 Rp 14,690.00 Rp - Rp 14,690.00
16 Klorfeniramin maleat (ctm) tablet 4 mg Tablet 773 773 Rp 54.00 Rp 41,742.00 Rp - Rp 41,742.00
21 Metilergometrin maleat injeksi 0,200 mg- Botol 2 2 Rp 1,639.00 Rp 3,278.00 Rp - Rp 3,278.00
22 Metilergometrin maleat tablet salut 0,12 Tablet 90 90 Rp 128.70 Rp 11,583.00 Rp - Rp 11,583.00
24 Metoklopramid tab 10 mg Tablet 160 127 Rp 110.00 Rp 13,970.00 33 Rp 113.00 Rp 3,729.00 Rp 17,699.00
26 Natrium klorida larutan infus 0,9 % steril Botol 5 5 Rp 6,410.00 Rp 32,050.00 Rp - Rp 32,050.00
33 Tablet tambah darah Kapsul 70 70 Rp 45.00 Rp 3,150.00 Rp - Rp 3,150.00
38 Vitamin K injeksi 2 mg/ml Tablet 15 Rp 3,754.00 Rp - 15 Rp 8,250.00 Rp 123,750.00 Rp 123,750.00
TOTAL Rp 1,309,619.38
Mengetahui
dr.Benny Evika Mutmainnah,Amd.Keb

NIP.19680608 200112 1 003 NIP.19750810 200502 2 003

A. BMHP
1 Celemek Buah 1 Rp 26,500.00 Rp 26,500.00
Mengetahui,
dr. Benny Evika Mutmainnah.Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19850219 200604 2 005

A. BMHP
1 Hanscoen panjang Steril Pasang 3 Rp 20,000.00 Rp 60,000.00
3 Umbilical cord Buah 1 Rp 1,020.00 Rp 1,020.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19850219 200604 2 005
SUMBER OBAT : JKN

A. BMHP
2 Jelly Botol 1 Rp 60,000.00 Rp 60,000.00
Mengetahui,

Nip. 19680608 200112 1 003 Nip. 19850219 200604 2 005
SUB UNIT : MANURUNG PUSKESMAS MALILI

KEMASAN
A. BMHP
6 Masker Buah 5 Rp 404.25 Rp 2,021.25
7 Silk ( Benang Bedah Sutera ) No 3/0 dgn jar Set 3 Rp 3,513.89 Rp 10,541.66
B. OBAT
4 Asam askorbat (vit c) tablet 50 mg Tablet 100 Rp 45.00 Rp 4,500.00
5 Betametason krim 0,1 % Tube 3 Rp 1,596.00 Rp 4,788.00
11 Metilergometrin maleat tablet salut 0,125 m Tablet 20 Rp 128.70 Rp 2,574.00
12 Metoklopramid tab 10 mg Tablet 202 Rp 110.00 Rp 22,220.00
13 Mikonazol krim 2 % Tablet 3 Rp 3,150.00 Rp 9,450.00
21 Tiamin hcl mononitrat 50 mg Tablet 180 Rp 41.58 Rp 7,484.40
23 Zinc dispersibel tab Ampul 50 Rp 592.00 Rp 29,600.00
TOTAL Rp 452,749.46
Mengetahui
dr.Benny Anugrah,Amd.Keb
NIP.19680608 200112 1 003 Nip. 19830314 200604 2 024
SUB UNIT : PUSTU MANURUNG PUSKESMAS MALILI

KEMASAN
A. OBAT
1 Garam oralit untuk 200 ml air Sachet 20 Rp 317.00 Rp 6,340.00
Mengetahui
dr.Benny Anugrah,Amd.Keb
NIP.19680608 200112 1 003 Nip. 19830314 200604 2 024
SUMBER OBAT : JKN
SUB UNIT : PUSTU MANURUNG PUSKESMAS MALILI

A. BMHP
1 Jelly Botol 1 Rp 60,000.00 60,000.00
TOTAL 60,000.00
Mengetahui,
dr. Benny Anugrah,Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19830314 200604 2 024
SUB UNIT : PUSTU LAKAWALI PUSKESMAS MALILI
SATU STOK
AN
H LAMA HARGA TOTAL HARGA BARU HARGA TOTAL HARGA
SAN
A. BMHP
1 Catgut / Benang Bedah No. 3/0 Set 1 1 Rp 6,839.58 Rp 6,839.58 Rp - Rp 6,839.58
5 Silk ( Benang Bedah Sutera ) Set 1 1 Rp 3,513.89 Rp 3,513.89 Rp - Rp 3,513.89
B. OBAT
3 Amoksisilin sirup kering 125 mgBotol 5 5 Rp 2,560.00 Rp 12,800.00 Rp - Rp 12,800.00
4 Asam askorbat (vit c) tablet 50 Tablet 50 50 Rp 45.00 Rp 2,250.00 Rp - Rp 2,250.00
11 Ketokenazol krim 2% Tube 1 1 Rp 2,697.00 Rp 2,697.00 Rp - Rp 2,697.00
15 Metilergometrin maleat injeksi Botol 1 1 Rp 1,639.00 Rp 1,639.00 Rp - Rp 1,639.00
19 Oksitosin injeksi 10 iu/ml - 1 mlPaket 5 5 Rp 2,420.00 Rp 12,100.00 Rp - Rp 12,100.00
TOTAL Rp 241,223.07
Mengetahui
dr.Benny Yovita K.Amd.Keb

NIP.19680608 200112 1 003 NIP.19810926 201101 2 010
SUMBER OBAT : JKN
SUB UNIT : PUSTU LAKAWALI PUSKESMAS MALILI

A. BMHP
1 Jelly Botol 1 Rp 60,000.00 Rp 60,000.00
Mengetahui,
dr. Benny Yovita K.Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19780718 200604 2 007
SUB UNIT : PUSTU LAKAWALI PANTAI PUSKESMAS MALILI
SATU STOK
AN
SAN
A. BMHP
2 Catgut / Benang Bedah No. 3/ Set 5 5 Rp 6,839.58 Rp 34,197.92 Rp - Rp 34,197.92
8 Silk ( Benang Bedah Sutera ) Set 9 9 Rp 3,513.89 Rp 31,624.99 Rp - Rp 31,624.99
9 Kasa Pembalut Hidrofil 4 x 10 Ktk 30 30 Rp 1,980.00 Rp 59,400.00 Rp - Rp 59,400.00
B. OBAT
3 Amoksisilin sirup kering 125 m Botol 19 19 Rp 2,560.00 Rp 48,640.00 Rp - Rp 48,640.00
4 Antasida doen tablet kombinasTablet 240 240 Rp 78.00 Rp 18,720.00 Rp - Rp 18,720.00
5 Asam askorbat (vit c) tablet 5 Tablet 90 90 Rp 45.00 Rp 4,050.00 Rp - Rp 4,050.00
8 Captopril 25 mg Tablet170 170 Rp 100.00 Rp 17,000.00 Rp - Rp 17,000.00
10 Deksametason inj Ampul 4 4 Rp 1,740.00 Rp 6,960.00 Rp - Rp 6,960.00
12 Difenhidramin hcl inj 10 mg/mlAmpul 3 3 Rp 1,156.00 Rp 3,468.00 Rp - Rp 3,468.00
17 Klorfeniramin maleat (ctm) tablet 4 230 230 Rp 54.00 Rp 12,420.00 Rp - Rp 12,420.00
23 Natrium klorida larutan infus 0, Botol 3 3 Rp 6,410.00 Rp 19,230.00 Rp - Rp 19,230.00
24 Oksitosin injeksi 10 iu/ml - 1 m Paket 4 4 Rp 2,420.00 Rp 9,680.00 Rp - Rp 9,680.00
26 Parasetamol sirup 120 mg/5 mlBotol 14 14 Rp 1,119.00 Rp 15,666.00 Rp - Rp 15,666.00
35 Ibuprofen Suspensi 200 mg/5mbuah 3 3 Rp 2,560.00 Rp 7,680.00 Rp - Rp 7,680.00
TOTAL Rp 987,407.41
Mengetahui
dr.Benny Nuriana,Amd.Keb
NIP.19680608 200112 1 003 NIP.19871220 201404 2 001
SUB UNIT : PUSTU. LKWLI PANTAI PUSKESMAS MALILI
SATUAN
KEMASAN
A. OBAT
Mengetahui
dr.Benny Nuriana,Amd.Keb
NIP.19680608 200112 1 003 NIP.19871220 201404 2 001
2212088
PR111
1010036
41306
42339
42339
SUMBER OBAT : JKN
SUB UNIT : PUSTU LAKAWALI PANTAI PUSKESMAS MALILI

A. BMHP
B. OBAT
TOTAL Rp 37,482.50
Mengetahui,
dr. Benny Nuriana,Amd.Keb

Nip. 19680608 200112 1 003 Nip. 19871220 201404 2 001
SUB UNIT : PUSTU KORE-KOREA PUSKESMAS MALILI
SATU STOK
AN
SAN
A. BMHP
2 Catgut / Benang Bedah No. 3/0 dan 2/0 Set 3 3 Rp 6,839.58 Rp 20,518.75 Rp - Rp 20,518.75
7 Silk ( Benang Bedah Sutera ) No 3/0 dgn Set 3 3 Rp 3,513.89 Rp 10,541.66 Rp - Rp 10,541.66
9 Etanol 70% Botol 1 1 Rp 26,337.50 Rp 26,337.50 Rp - Rp 26,337.50
B. OBAT
3 Antalgin (metampiron) tablet 500 mg Tablet 110 110 Rp 163.90 Rp 18,029.00 Rp - Rp 18,029.00
12 Hidrokortison krim 2,5 % 4 4 Rp 2,938.00 Rp 11,752.00 Rp - Rp 11,752.00
19 Metilergometrin maleat injeksi 0,200 mg- Botol 3 3 Rp 1,639.00 Rp 4,917.00 Rp - Rp 4,917.00
20 Metilergometrin maleat tablet salut 0,12 Tablet 30 30 Rp 128.70 Rp 3,861.00 Rp - Rp 3,861.00
23 Natrium klorida larutan infus 0,9 % steril Botol 1 1 Rp 6,410.00 Rp 6,410.00 Rp - Rp 6,410.00
32 Salisil bedak 2% Ampul 3 Rp 1,350.00 Rp - 3 Rp 1,066.00 Rp 3,198.00 Rp 3,198.00
40 Domperidon tablet Tablet 15 15 Rp 133.00 Rp 1,995.00 Rp - Rp 1,995.00
TOTAL Rp 669,485.66
Mengetahui
dr.Benny Rahmawati,Amd.Keb
NIP.19680608 200112 1 003 NrPTT.204 048 1465
SUB UNIT : PUSTU KORE2A PUSKESMAS MALILI
PER TANGGAL 31 DESEMBEER 2016
SATUAN
KEMASAN
A. OBAT
1 Fitomenadion injeksi 10 mg/ml - 1 ml Ampul 4 Rp 1,723.00 Rp 6,892.00
2 Garam oralit untuk 200 ml air Sachet 3 Rp 317.00 Rp 951.00
Mengetahui
dr.Benny Rahmawati,Amd.Keb
NIP.19680608 200112 1 003 NrPTT.204 048 1465

A. BMHP
1 Pembalut Wanita Bungkus 3 Rp 28,500.00 Rp 85,500.00
2 Larutan Klorin Botol 1 Rp 24,000.00 Rp 24,000.00
3 Hanscoen Panjang steril Pasang 1 Rp 20,000.00 Rp 20,000.00
Mengetahui,
dr. Benny Rahmawati,Amd.Keb

Nip. 19680608 200112 1 003 NRPTT:204 048 1465
SUMBER OBAT : JKN

A. BMHP
B. OBAT
TOTAL Rp 61,167.50
Mengetahui,
dr. Benny Rahmawati,Amd.Keb

Nip. 19680608 200112 1 003 NRPTT:204 048 1465
SUB UNIT : PUSTU TARABBI PUSKESMAS MALILI
SATU STOK
NO NAMA BARANG AN TOTAL HARGA
STOK
HARGA TOTAL HARGA
SAN H LAMA BARU
A. BMHP
3 Catgut / Benang Bedah No. 3/0 dan Set 10 10 Rp 6,839.58 Rp 68,395.83 Rp - Rp 68,395.83
5 Hanscoen Non Steril Pasang 64 64 Rp 747.50 Rp 47,840.00 Rp 796.25 Rp - Rp 47,840.00
8 Plester 5 yard x 2 inch Rol 1 1 Rp 12,076.00 Rp 12,076.00 Rp - Rp 12,076.00
9 Silk ( Benang Bedah Sutera ) No 3 Set 3 3 Rp 3,513.89 Rp 10,541.66 Rp - Rp 10,541.66
B. OBAT
2 Amoksisilin sirup kering 125 mg/5 mBotol 20 20 Rp 2,560.00 Rp 51,200.00 Rp - Rp 51,200.00
3 Antalgin (metampiron) tablet 500 Tablet 10 10 Rp 163.90 Rp 1,639.00 Rp - Rp 1,639.00
8 Deksametason inj Ampul 3 3 Rp 1,740.00 Rp 5,220.00 Rp 1,738.00 Rp - Rp 5,220.00
9 Difenhidramin hcl inj 10 mg/ml - 1 Ampul 5 5 Rp 1,156.00 Rp 5,780.00 Rp - Rp 5,780.00
10 Fitomenadion tablet salut 10 mg Ampul 50 50 Rp 690.00 Rp 34,500.00 Rp 690.00 Rp - Rp 34,500.00
19 Natrium klorida larutan infus 0,9 % Botol 2 2 Rp 6,410.00 Rp 12,820.00 Rp - Rp 12,820.00
22 Parasetamol sirup 120 mg/5 ml Botol 18 18 Rp 1,119.00 Rp 20,142.00 Rp 1,535.00 Rp - Rp 20,142.00
24 Piridoksin Tablet 120 120 Rp 121.00 Rp 14,520.00 Rp 19.14 Rp - Rp 14,520.00
27 Salep 2-4 Tablet 2 2 Rp 2,200.00 Rp 4,400.00 Rp - Rp 4,400.00
28 Salisil bedak 2% Ampul 2 2 Rp 1,350.00 Rp 2,700.00 Rp 1,066.00 Rp - Rp 2,700.00
29 Sianokobalamin (vit b 12) inj. 500 Tablet 3 3 Rp 1,226.00 Rp 3,678.00 Rp 1,050.00 Rp - Rp 3,678.00
32 Tiamin hcl mononitrat 50 mg Tablet 220 220 Rp 41.58 Rp 9,147.60 Rp 91.00 Rp - Rp 9,147.60
TOTAL Rp 1,286,630.14
Mengetahui
dr.Benny Anita Pabebang,

NIP.19680608 200112 1 003 NRPTT:20.4.048.14648

A. BMHP
1 Termometer Buah 3 Rp 21,000.00 Rp 63,000.00
Mengetahui,
dr. Benny Anita Pabebang

Nip. 19680608 200112 1 003 NRPTT:20.4.048.14648

A. BMHP
1 Jelly Botol 1 Rp 35,000.00 Rp 35,000.00
Mengetahui,

Nip. 19680608 200112 1 003 NRPTT:20.4.048.14648
SUMBER OBAT : JKN

A. BMHP
Mengetahui,

Nip. 19680608 200112 1 003 NRPTT:20.4.048.14648

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PEMERINTAH KABUPATEN LUWU TIMUR

DINAS KESEHATAN PUSKESMAS MALILI

LAPORAN PERSEDIAAN BMHP PUSKESMAS MALILI

22 P.TARABBI Rp 418,259.64 Rp - Rp 63,000 Rp - Rp - Rp 125,000 Rp - Rp 5,000.00 Rp 611,259.64

TOTAL Rp 25,616,485.62 Rp 4,349,700.00 Rp 1,249,500 Rp 12,468,555 Rp 312,500.00 Rp 1,928,743.00 Rp - Rp 15,736,200.00 Rp 61,661,683.62

dr.Benny Farianti Najamudin,S.Si.Apt

LAPORAN PERSEDIAAN OBAT PUSKESMAS MALILI

22 P.TARABBI Rp 868,370.50 Rp - Rp - Rp - Rp - Rp - Rp - Rp 868,370.50

TOTAL Rp 64,931,464.30 Rp 2,875,709.40 Rp 48,513 Rp - Rp 42,052.20 Rp - Rp 906,334.00 Rp 68,804,072.90

dr.Benny Farianti Najamudin,S.Si.Apt

LAPORAN PERSEDIAAN OBAT DAN BMHP PUSKESMAS MALILI

22 P.TARABBI Rp 418,259.64 Rp 868,370.50 Rp - Rp - Rp 63,000.00 Rp - Rp - Rp - Rp - Rp - Rp 125,000 Rp - Rp 5,000.00 Rp - Rp 1,479,630.14

dr.Benny Farianti Najamudin,S.Si.Apt

PERSEDIAAN (Rp) JUMLAH

3 PROGRAM Rp - Rp 136,540.00 Rp 136,540.00 Rp 4,349,700.00 Rp 2,739,169.40 Rp 7,088,869.40 Rp 4,349,700.00 Rp 2,875,709.40 Rp 7,225,409.40

5 APBD PUSKESMAS Rp 5,272,055.00 Rp - Rp 5,272,055.00 Rp 7,351,725.00 Rp - Rp 7,351,725.00 Rp 12,623,780.00 Rp - Rp 12,623,780.00

6 ASKES Rp - Rp - Rp - Rp 312,500.00 Rp 42,052.20 Rp 354,552.20 Rp 312,500.00 Rp 42,052.20 Rp 354,552.20

7 JAMPERSAL Rp 800,000.00 Rp - Rp 800,000.00 Rp 1,128,743.00 Rp - Rp 1,128,743.00 Rp 1,928,743.00 Rp - Rp 1,928,743.00

dr.Benny Farianti Najamudin,S.Si.Apt

dr.Benny Farianti Najamuddin,S.Si.Apt

NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA BARANG SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

dr.Benny Farianti Najamuddin,S.Si.Apt

NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL

1 Primakuin tab 15 mg Tablet 86 Rp 205.00 Rp 17,630.00

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA BARANG SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Farianti Najamuddin,S.Si.Apt

NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL HARGA

1 Alat Suntik Sekali Pakai 1 ml Set 6 Rp 796.25 Rp 4,777.50

dr.Benny Nurmila, Amk

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Nurmila,AMK

NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL HARGA

NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL

1 Slide Dos 8 Rp 44,400.00 Rp 355,200.00

dr. Benny Salmawati.R

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Salmawati.R

NO NAMA BARANG SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Salmawati.R

NO NAMA BARANG SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Salmawati.R

NO NAMA BARANG SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Salmawati.R

NO NAMA BARANG SATUAN JUMLAH HARGA TOTAL

NO NAMA OBAT SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Masrah,Amd.Keb

NO NAMA BARANG SATUAN JUMLAH HARGA SATUAN TOTAL

dr. Benny Masrah,Amd.Keb