SURAT BUKTI BARANG KELUAR(S

INSTALASI FARMASI DINAS KESEHATAN KABU

Nomor Dokumen 2021-02-17

Unit Penerima UPT. PUSKESMAS KEMUSU

No Nama Satuan
1 Alkohol Swab BOX
2 Handschoen ( Sarung Tangan ) L BOX
3 Handscrub 0,5 % Medicare 5 Liter Botol
4 Infus Set Dewasa Set
5 Kassa Hidrofil Steril 16 x 16 Roll
6 Plester 4,5 m x 7,5 cm Roll
7 Plesterin Bulat T box/100
8 Soft Pad Underpad 60 x 90 pack
9 Ambroxol 30 mg Tablet
10 Amlodipin tablet 5 mg Tablet
11 Antacida Doen Tablet Kombinasi Tablet
12 Asam Folat 1 mg ( Anelat ) Tablet
13 Bromhexin 8 mg ( Novahexin ) Tablet
14 Kloramphenicol Tetes Telinga 3 % Botol
15 Ibuprofen 400 mg TABLET
16 Ketorolac Injeksi ( Tromethamine 30 mg / ml ) Ampul
17 Methyl Prednisolon 4 mg Tablet
18 Multivitamin + Mineral tablet
19 Natrium Diclovenak 50 mg Tablet
20 Omeprazole 20 mg Kapsul
21 Paracetamol 500 mg Tablet
22 Prednison 5 mg Tablet
23 Ringer Lactat Larutan Infus ( RL ) Botol
24 Sianocobalamin ( Vit B12 ) Tablet 50 mcg tablet
25 Thiamin HCl ( Vit B1 ) 50 mg tablet

Total

Yang Menerima

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TI BARANG KELUAR(SBBK)
NAS KESEHATAN KABUPATEN BOYOLALI

Jumlah Tanggal Kadaluarsa Harga (Rp) Total Harga(Rp) Sumber pengadaan

100 2022-10-01 11604 1160400 DAK 2020
1 2025-04-01 99000 99000 DAK 2020
1 2024-10-01 204600 204600 DAK 2020
100 2025-01-01 8400 840000 DAK 2020
5 2023-02-01 5950 29750 DAK 2020
3 2022-07-01 37371 112113 DAK 2020
2 2025-02-01 38934 77868 DAK 2020
10 2024-08-01 4162.4 41624 DAK 2020
500 2022-07-01 99 49500 DAK 2020
300 2021-08-01 75 22500 DAK 2020
1200 2022-10-01 58 69600 DAK 2020
100 2022-06-01 154 15400 DAK 2020
600 2021-08-01 250 150000 DAK 2020
20 2021-10-01 7568 151360 DAK 2020
300 2023-07-01 242 72600 DAK 2020
15 2021-11-01 1089 16335 DAK 2020
1200 2022-01-01 143 171600 DAK 2020
200 2021-06-01 1696 339200 DAK 2020
500 2022-03-01 253 126500 DAK 2020
300 2022-05-01 352 105600 DAK 2020
4000 2022-11-01 77 308000 DAK 2020
500 2022-02-01 73 36500 DAK 2020
300 2023-04-01 7630 2289000 DAK 2020
500 2023-08-01 46 23000 DAK 2020
500 2022-03-01 91 45500 DAK 2020

6557550

Boyolali,
Yang Menyerahkan/Memeriksa

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