Contoh Form Persediaan Dari Inspektorat

……………………………..
KOTA MADIUN
DAFTAR PERSEDIAAN BARANG PER 31 JANUARI 2021
REKAPITULASI MUTASI BARANG PAKAI HABIS

KEADAAN
MUTASI/PERUBAHAN SELAMA 1 JANUARI 2021 S/D 31 JANUARI 2021
KEADAAN PER 1 JANUARI 2021 PER 31 JANUARI 2021
NO NAMA BARANG BERTAMBAH BERKURANG KET
JUMLAH HARGA JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA JUMLAH JUMLAH JUMLAH
BARANG SATUAN HARGA BARANG SATUAN HARGA BARANG SATUAN HARGA BARANG HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Barang Cetak
1 Alur antibiotik awal 0 bk Rp 30,800 Rp - 18 bk Rp 30,800 Rp 554,400 0 bk Rp 30,800 Rp - 18 bk Rp 554,400
2 Alur antibiotik lanjutan 0 bk Rp 30,800 Rp - 18 bk Rp 30,800 Rp 554,400 0 bk Rp 30,800 Rp - 18 bk Rp 554,400
3 Amplop dinas besar 165 lbr Rp 2,000 Rp 330,000 0 lbr Rp 2,000 Rp - 8 lbr Rp 2,000 Rp 16,000 157 lbr Rp 314,000
4 Amplop dinas kecil 239 lbr Rp 1,000 Rp 239,000 300 lbr Rp 1,000 Rp 300,000 90 lbr Rp 1,000 Rp 90,000 449 lbr Rp 449,000
5 Amplop dinas putih 100 bh Rp 1,000 Rp 100,000 0 bh Rp 1,000 Rp - 0 bh Rp 1,000 Rp - 100 bh Rp 100,000
6 Amplop ECG 47 lbr Rp 2,700 Rp 126,900 0 lbr Rp 2,700 Rp - 24 lbr Rp 2,700 Rp 64,800 23 lbr Rp 62,100
7 Amplop patologi anatomi 100 lbr Rp 1,000 Rp 100,000 0 lbr Rp 1,000 Rp - 0 lbr Rp 1,000 Rp - 100 lbr Rp 100,000
8 Amplop patologi klinik 0 bh Rp 1,000 Rp - 0 bh Rp 1,000 Rp - 0 bh Rp 1,000 Rp - 0 bh Rp -
9 Amplop radiologi besar 575 lbr Rp 8,500 Rp 4,887,500 0 lbr Rp 8,500 Rp - 0 lbr Rp 8,500 Rp - 575 lbr Rp 4,887,500
10 Amplop radiologi kecil 22x27 1129 lbr Rp 2,500 Rp 2,822,500 0 lbr Rp 2,500 Rp - 500 lbr Rp 2,500 Rp 1,250,000 629 lbr Rp 1,572,500
Rp 8,605,900 Rp 1,408,800 Rp 1,420,800 Rp 8,593,900
Alat Tulis Kantor
1 Amplop besar (persegi panjang) 5 pak Rp 18,200 Rp 91,000 5 pak Rp 21,500 Rp 107,500 2 pak Rp 21,500 Rp 43,000 8 pak Rp 172,000
2 Amplop sedang (persegi) 5 pak Rp 17,500 Rp 87,500 5 pak Rp 17,500 Rp 87,500 5 pak Rp 17,500 Rp 87,500 5 pak Rp 87,500
3 Bak stempel kecil 3 bh Rp 10,500 Rp 31,500 6 bh Rp 9,000 Rp 54,000 1 bh Rp 9,000 Rp 9,000 8 bh Rp 72,000
4 Binder clip 105 50 pak Rp 4,500 Rp 225,000 0 pak Rp 4,500 Rp - 4 pak Rp 4,500 Rp 18,000 46 pak Rp 207,000
6 Binder clip 111 6 pak Rp 14,600 Rp 87,600 24 pak Rp 7,000 Rp 168,000 6 pak Rp 7,000 Rp 42,000 24 pak Rp 168,000
7 Binder clip 200 0 pak Rp 14,500 Rp - 25 pak Rp 14,500 Rp 362,500 15 pak Rp 14,500 Rp 217,500 10 pak Rp 145,000
8 Binder clip 155 12 pak Rp 12,100 Rp 145,200 13 pak Rp 12,100 Rp 157,300 0 pak Rp 12,100 Rp - 25 pak Rp 302,500
9 Binder clip 260 12 bh Rp 19,400 Rp 232,800 24 bh Rp 29,000 Rp 696,000 20 bh Rp 29,000 Rp 580,000 16 bh Rp 464,000
10 Bolpoin AE7 hitam 48 bh Rp 2,300 Rp 110,400 432 bh Rp 2,000 Rp 864,000 372 bh Rp 2,000 Rp 744,000 108 bh Rp 216,000
Rp 1,141,000 Rp 2,496,800 Rp 1,801,000 Rp 1,904,000
Alat Kebersihan
1 Alat glade matic 0 bh Rp 76,500 Rp - 1 bh Rp 76,500 Rp 76,500 0 bh Rp 76,500 Rp - 1 bh Rp 76,500
2 Bayclin 1 ltr 50 btl Rp 14,000 Rp 700,000 0 btl Rp 14,000 Rp - 15 btl Rp 14,000 Rp 210,000 35 btl Rp 490,000
3 Baygon/hit 600ml 2 btl Rp 45,000 Rp 90,000 6 btl Rp 45,000 Rp 270,000 6 btl Rp 45,000 Rp 270,000 2 btl Rp 90,000
4 Botol semprot jet spray besar 1 btl Rp 11,500 Rp 11,500 3 btl Rp 11,500 Rp 34,500 2 btl Rp 11,500 Rp 23,000 2 btl Rp 23,000
5 Botol semprot jet spray kecil 0 btl Rp 9,000 Rp - 5 btl Rp 9,000 Rp 45,000 0 btl Rp 9,000 Rp - 5 btl Rp 45,000
6 Container box (CB 45) 0 bh Rp 94,000 Rp - 6 bh Rp 94,000 Rp 564,000 2 bh Rp 94,000 Rp 188,000 4 bh Rp 376,000
7 Container box (CB 35) 0 bh Rp 80,000 Rp - 5 bh Rp 80,000 Rp 400,000 5 bh Rp 80,000 Rp 400,000 0 bh Rp -
9 Ember 30 ltr 0 bh Rp 60,000 Rp - 1 bh Rp 60,000 Rp 60,000 1 bh Rp 60,000 Rp 60,000 0 bh Rp -
10 Garuk kaca 3 bh Rp 13,400 Rp 40,200 0 bh Rp 13,400 Rp - 1 bh Rp 13,400 Rp 13,400 2 bh Rp 26,800
Rp 841,700 Rp 1,662,500 Rp 1,376,900 Rp 1,127,300
Pemeliharaan Komputer
1 Adaptor/Power Supply 450W 0 bh Rp 105,000 Rp - 2 bh Rp 105,000 Rp 210,000 2 bh Rp 105,000 Rp 210,000 0 bh Rp -
2 HD internal 1 TB 0 bh Rp 635,000 Rp - 0 bh Rp 635,000 Rp - 0 bh Rp 635,000 Rp - 0 bh Rp -
3 Keyboard 0 bh Rp 50,000 Rp - 5 bh Rp 50,000 Rp 250,000 5 bh Rp 50,000 Rp 250,000 0 bh Rp -
4 Kipas CPU 12 volt 0 bh Rp 39,000 Rp - 0 bh Rp 39,000 Rp - 0 bh Rp 39,000 Rp - 0 bh Rp -
5 Motherboard 0 bh Rp 980,000 Rp - 0 bh Rp 980,000 Rp - 0 bh Rp 980,000 Rp - 0 bh Rp -
6 Mouse wirelles 0 bh Rp 110,000 Rp - 0 bh Rp 110,000 Rp - 0 bh Rp 110,000 Rp - 0 bh Rp -
7 Mouse pad 0 bh Rp 10,000 Rp - 0 bh Rp 10,000 Rp - 0 bh Rp 10,000 Rp - 0 bh Rp -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
8 Pita epson LX-310 cartridge 0 bh Rp 55,000 Rp - 0 bh Rp 55,000 Rp - 0 bh Rp 55,000 Rp - 0 bh Rp -
9 Pita epson LQ-2190 cartridge 0 bh Rp 70,000 Rp - 4 bh Rp 70,000 Rp 280,000 4 bh Rp 70,000 Rp 280,000 0 bh Rp -
10 Pita epson LQ300 0 bh Rp 45,000 Rp - 0 bh Rp 45,000 Rp - 0 bh Rp 45,000 Rp - 0 bh Rp -
Rp - Rp 740,000 Rp 740,000 Rp -
Bahan Bangunan
1 Tiner A Spesial 0 klg Rp 39,400 Rp - 5 klg Rp 39,400 Rp 197,000 5 klg Rp 39,400 Rp 197,000 0 klg Rp -
2 Kuas 2 1/2 0 psg Rp 11,250 Rp - 5 psg Rp 11,250 Rp 56,250 5 psg Rp 11,250 Rp 56,250 0 psg Rp -
3 Paving segienam 0 btg Rp 67,500 Rp - 23 btg Rp 67,500 Rp 1,552,500 23 btg Rp 67,500 Rp 1,552,500 0 btg Rp -
4 Cat Biru Emco 0 glg Rp 90,000 Rp - 2 glg Rp 90,000 Rp 180,000 2 glg Rp 90,000 Rp 180,000 0 glg Rp -
5 Semen 0 sak Rp 78,750 Rp - 10 sak Rp 78,750 Rp 787,500 10 sak Rp 78,750 Rp 787,500 0 sak Rp -
6 Silent hitam 0 btl Rp 33,750 Rp - 2 btl Rp 33,750 Rp 67,500 2 btl Rp 33,750 Rp 67,500 0 btl Rp -
7 Abu Bata 0 dam Rp 1,012,500 Rp - 1 dam Rp 1,012,500 Rp 1,012,500 1 dam Rp 1,012,500 Rp 1,012,500 0 dam Rp -
8 Cat Merah Emco 0 glg Rp 90,000 Rp - 2 glg Rp 90,000 Rp 180,000 2 glg Rp 90,000 Rp 180,000 0 glg Rp -
9 Cat Hijau Muda Avian 0 glg Rp 67,500 Rp - 2 glg Rp 67,500 Rp 135,000 2 glg Rp 67,500 Rp 135,000 0 glg Rp -
10 Kornis 0 bh Rp 78,750 Rp - 1 bh Rp 78,750 Rp 78,750 1 bh Rp 78,750 Rp 78,750 0 bh Rp -
Rp - Rp 4,247,000 Rp 4,247,000 Rp -
Jumlah Persediaan Rp 10,588,600 Rp 10,555,100 Rp 9,585,700 Rp 11,625,200
Madiun, 28 Desemberi 2021

………………. Kota Madiun Penyimpan Barang
…………………………………… ………………………………
NIP. 19630408 198903 1 014 NIP. 1971280171 200501 1 011
……………………………..KOTA MADIUN
DAFTAR PERSEDIAAN BARANG PER 28 FEBRUARI 2021

KEADAAN
MUTASI/PERUBAHAN SELAMA 1 JANUARI 2021 S/D 31 JANUARI 2021
KEADAAN PER 1 JANUARI 2021 PER 31 JANUARI 2021
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Barang Cetak
1 Alur antibiotik awal 0 bk Rp 30,800 Rp - 18 bk Rp 30,800 Rp 554,400 0 bk Rp 30,800 Rp - 18 bk Rp 554,400
2 Alur antibiotik lanjutan 0 bk Rp 30,800 Rp - 18 bk Rp 30,800 Rp 554,400 0 bk Rp 30,800 Rp - 18 bk Rp 554,400
3 Amplop dinas besar 165 lbr Rp 2,000 Rp 330,000 0 lbr Rp 2,000 Rp - 8 lbr Rp 2,000 Rp 16,000 157 lbr Rp 314,000
4 Amplop dinas kecil 239 lbr Rp 1,000 Rp 239,000 300 lbr Rp 1,000 Rp 300,000 90 lbr Rp 1,000 Rp 90,000 449 lbr Rp 449,000
5 Amplop dinas putih 100 bh Rp 1,000 Rp 100,000 0 bh Rp 1,000 Rp - 0 bh Rp 1,000 Rp - 100 bh Rp 100,000
6 Amplop ECG 47 lbr Rp 2,700 Rp 126,900 0 lbr Rp 2,700 Rp - 24 lbr Rp 2,700 Rp 64,800 23 lbr Rp 62,100
7 Amplop patologi anatomi 100 lbr Rp 1,000 Rp 100,000 0 lbr Rp 1,000 Rp - 0 lbr Rp 1,000 Rp - 100 lbr Rp 100,000
8 Amplop patologi klinik 0 bh Rp 1,000 Rp - 0 bh Rp 1,000 Rp - 0 bh Rp 1,000 Rp - 0 bh Rp -
9 Amplop radiologi besar 575 lbr Rp 8,500 Rp 4,887,500 0 lbr Rp 8,500 Rp - 0 lbr Rp 8,500 Rp - 575 lbr Rp 4,887,500
10 Amplop radiologi kecil 22x27 1129 lbr Rp 2,500 Rp 2,822,500 0 lbr Rp 2,500 Rp - 500 lbr Rp 2,500 Rp 1,250,000 629 lbr Rp 1,572,500
Rp 8,605,900 Rp 1,408,800 Rp 1,420,800 Rp 8,593,900
Alat Tulis Kantor
1 Amplop besar (persegi panjang) 5 pak Rp 18,200 Rp 91,000 5 pak Rp 21,500 Rp 107,500 2 pak Rp 21,500 Rp 43,000 8 pak Rp 172,000
2 Amplop sedang (persegi) 5 pak Rp 17,500 Rp 87,500 5 pak Rp 17,500 Rp 87,500 5 pak Rp 17,500 Rp 87,500 5 pak Rp 87,500
3 Bak stempel kecil 3 bh Rp 10,500 Rp 31,500 6 bh Rp 9,000 Rp 54,000 1 bh Rp 9,000 Rp 9,000 8 bh Rp 72,000
6 Binder clip 111 6 pak Rp 14,600 Rp 87,600 24 pak Rp 7,000 Rp 168,000 6 pak Rp 7,000 Rp 42,000 24 pak Rp 168,000
7 Binder clip 200 0 pak Rp 14,500 Rp - 25 pak Rp 14,500 Rp 362,500 15 pak Rp 14,500 Rp 217,500 10 pak Rp 145,000
8 Binder clip 155 12 pak Rp 12,100 Rp 145,200 13 pak Rp 12,100 Rp 157,300 0 pak Rp 12,100 Rp - 25 pak Rp 302,500
9 Binder clip 260 12 bh Rp 19,400 Rp 232,800 24 bh Rp 29,000 Rp 696,000 20 bh Rp 29,000 Rp 580,000 16 bh Rp 464,000
10 Bolpoin AE7 hitam 48 bh Rp 2,300 Rp 110,400 432 bh Rp 2,000 Rp 864,000 372 bh Rp 2,000 Rp 744,000 108 bh Rp 216,000
Rp 1,141,000 Rp 2,496,800 Rp 1,801,000 Rp 1,904,000
Alat Kebersihan
1 Alat glade matic 0 bh Rp 76,500 Rp - 1 bh Rp 76,500 Rp 76,500 0 bh Rp 76,500 Rp - 1 bh Rp 76,500
2 Bayclin 1 ltr 50 btl Rp 14,000 Rp 700,000 0 btl Rp 14,000 Rp - 15 btl Rp 14,000 Rp 210,000 35 btl Rp 490,000
3 Baygon/hit 600ml 2 btl Rp 45,000 Rp 90,000 6 btl Rp 45,000 Rp 270,000 6 btl Rp 45,000 Rp 270,000 2 btl Rp 90,000
4 Botol semprot jet spray besar 1 btl Rp 11,500 Rp 11,500 3 btl Rp 11,500 Rp 34,500 2 btl Rp 11,500 Rp 23,000 2 btl Rp 23,000
5 Botol semprot jet spray kecil 0 btl Rp 9,000 Rp - 5 btl Rp 9,000 Rp 45,000 0 btl Rp 9,000 Rp - 5 btl Rp 45,000
6 Container box (CB 45) 0 bh Rp 94,000 Rp - 6 bh Rp 94,000 Rp 564,000 2 bh Rp 94,000 Rp 188,000 4 bh Rp 376,000
9 Ember 30 ltr 0 bh Rp 60,000 Rp - 1 bh Rp 60,000 Rp 60,000 1 bh Rp 60,000 Rp 60,000 0 bh Rp -
10 Garuk kaca 3 bh Rp 13,400 Rp 40,200 0 bh Rp 13,400 Rp - 1 bh Rp 13,400 Rp 13,400 2 bh Rp 26,800
Rp 841,700 Rp 1,662,500 Rp 1,376,900 Rp 1,127,300
Pemeliharaan Komputer
1 Adaptor/Power Supply 450W 0 bh Rp 105,000 Rp - 2 bh Rp 105,000 Rp 210,000 2 bh Rp 105,000 Rp 210,000 0 bh Rp -
2 HD internal 1 TB 0 bh Rp 635,000 Rp - 0 bh Rp 635,000 Rp - 0 bh Rp 635,000 Rp - 0 bh Rp -
3 Keyboard 0 bh Rp 50,000 Rp - 5 bh Rp 50,000 Rp 250,000 5 bh Rp 50,000 Rp 250,000 0 bh Rp -
4 Kipas CPU 12 volt 0 bh Rp 39,000 Rp - 0 bh Rp 39,000 Rp - 0 bh Rp 39,000 Rp - 0 bh Rp -
5 Motherboard 0 bh Rp 980,000 Rp - 0 bh Rp 980,000 Rp - 0 bh Rp 980,000 Rp - 0 bh Rp -
6 Mouse wirelles 0 bh Rp 110,000 Rp - 0 bh Rp 110,000 Rp - 0 bh Rp 110,000 Rp - 0 bh Rp -
7 Mouse pad 0 bh Rp 10,000 Rp - 0 bh Rp 10,000 Rp - 0 bh Rp 10,000 Rp - 0 bh Rp -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
8 Pita epson LX-310 cartridge 0 bh Rp 55,000 Rp - 0 bh Rp 55,000 Rp - 0 bh Rp 55,000 Rp - 0 bh Rp -
9 Pita epson LQ-2190 cartridge 0 bh Rp 70,000 Rp - 4 bh Rp 70,000 Rp 280,000 4 bh Rp 70,000 Rp 280,000 0 bh Rp -
10 Pita epson LQ300 0 bh Rp 45,000 Rp - 0 bh Rp 45,000 Rp - 0 bh Rp 45,000 Rp - 0 bh Rp -
Rp - Rp 740,000 Rp 740,000 Rp -
Bahan Bangunan
1 Tiner A Spesial 0 klg Rp 39,400 Rp - 5 klg Rp 39,400 Rp 197,000 5 klg Rp 39,400 Rp 197,000 0 klg Rp -
2 Kuas 2 1/2 0 psg Rp 11,250 Rp - 5 psg Rp 11,250 Rp 56,250 5 psg Rp 11,250 Rp 56,250 0 psg Rp -
3 Paving segienam 0 btg Rp 67,500 Rp - 23 btg Rp 67,500 Rp 1,552,500 23 btg Rp 67,500 Rp 1,552,500 0 btg Rp -
4 Cat Biru Emco 0 glg Rp 90,000 Rp - 2 glg Rp 90,000 Rp 180,000 2 glg Rp 90,000 Rp 180,000 0 glg Rp -
5 Semen 0 sak Rp 78,750 Rp - 10 sak Rp 78,750 Rp 787,500 10 sak Rp 78,750 Rp 787,500 0 sak Rp -
6 Silent hitam 0 btl Rp 33,750 Rp - 2 btl Rp 33,750 Rp 67,500 2 btl Rp 33,750 Rp 67,500 0 btl Rp -
7 Abu Bata 0 dam Rp 1,012,500 Rp - 1 dam Rp 1,012,500 Rp 1,012,500 1 dam Rp 1,012,500 Rp 1,012,500 0 dam Rp -
8 Cat Merah Emco 0 glg Rp 90,000 Rp - 2 glg Rp 90,000 Rp 180,000 2 glg Rp 90,000 Rp 180,000 0 glg Rp -
9 Cat Hijau Muda Avian 0 glg Rp 67,500 Rp - 2 glg Rp 67,500 Rp 135,000 2 glg Rp 67,500 Rp 135,000 0 glg Rp -
10 Kornis 0 bh Rp 78,750 Rp - 1 bh Rp 78,750 Rp 78,750 1 bh Rp 78,750 Rp 78,750 0 bh Rp -
Rp - Rp 4,247,000 Rp 4,247,000 Rp -
Jumlah Persediaan Rp 10,588,600 Rp 10,555,100 Rp 9,585,700 Rp 11,625,200
Madiun, 28 Desemberi 2021

………………. Kota Madiun Penyimpan Barang
…………………………………… ………………………………
NIP. 19630408 198903 1 014 NIP. 1971280171 200501 1 011
OPD KOTA MADIUN
DAFTAR PERSEDIAAN BARANG PER 31 DESEMBER 2021

KEADAAN
MUTASI/PERUBAHAN SELAMA 1 JANUARI 2021 S/D 31 DESEMBER 2021
KEADAAN PER 1 JANUARI 2021 PER 31 DESEMBER 2021
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1
2
3
4
jumlah Rp - Rp - - Rp -
Madiun, 28 Desember 2021

Kepala OPD Kota Madiun Penyimpan Barang
…………………………………. ………………………………..
NIP. 19630408 198903 1 014 NIP. 19760520 201001 1 003

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REKAPITULASI MUTASI BARANG PAKAI HABIS

Jumlah Persediaan Rp 10,588,600 Rp 10,555,100 Rp 9,585,700 Rp 11,625,200

Madiun, 28 Desemberi 2021

REKAPITULASI MUTASI BARANG PAKAI HABIS

Jumlah Persediaan Rp 10,588,600 Rp 10,555,100 Rp 9,585,700 Rp 11,625,200

Madiun, 28 Desemberi 2021

REKAPITULASI MUTASI BARANG PAKAI HABIS

Madiun, 28 Desember 2021

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