Blanko Stok Opname Gigi 2023

PETUNJUK PENGERJAAN STOK OPN
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PETUNJUK PENGERJAAN STOK OPNAME
Untuk setiap sheet silakan ganti sesuai nama Puskesmas/Pustu/Poskesdes/Polindes.
Isi Nama dan NIP "Kepala Puskesmas" dan "Yang Membuat Laporan".
Isi dengan jumlah satuan terkecil. Khusus reagen dan obat gigi yang dalam bentuk larutan, gel, pasta, dan lain-lain, silakan
(kalau handak habis kada usah dihitung atau kada usah diulah nol koma).
Format jangan diubah-ubah, jangan di "insert" atau "delete" karena akan mengubah formula/rumus.
Kalau ada obat yang tidak termasuk di form "OBAT GENERIK'' sampai "PENUNJANG BUFFER", masukkan di kolom ''OBAT Y
kurang kolomnya, silahkan insert paling bawah.
Format lama sudah tidak digunakan, jangan di-copy-paste, gunakan urutan dan harga form yang ini.
Isi dengan cermat dan teliti, cek selalu kesesuaian hasil TOTAL dan JUMLAH (Siapkan kalkulator untuk jaga-jaga).
"Rekap Pustu" dan "Rekap ALL" itu tinggal pian copy-paste aja sisa stoknya dari sheet yg sudah diisi sebelumnya sagan men
stoknya, jangan sampai selisih 1 rupiah pun.
"Rekap Pustu" dan "Rekap ALL'' cuma untuk di-softcopy, tidak perlu di print.
Print 1x, fotocopy 1x, 1 gasan dikumpul di Dinas Kesehatan, 1 gasan arsip pian.
Softcopy apabila sudah selesai, bisa dikumpul duluan, bisa dikirim melalui link gdrive yang sudah disediakan dengan forma
ARANIO_SO_2023 dalam bentuk EXCEL tanpa menunggu ttd kapus.
Hardcopy dilampiri "Berita Acara Stock Opname " yang ditanda tangani "Kepala Puskesmas"dan "Yang Membuat Laporan"
STOK OPNAME OBAT DAN PERBEKALAN KESEHATAN DI PUSKES
DINAS KESEHATAN KABUPATEN BANJAR
PER 31 DESEMBER 2023
PUSKESMAS/PUSTU:
NO. NAMA OBAT SATUAN
1 2 3
OBAT GENERIK
1 ALBENDAZOLE 400 MG Tablet
2 ALBENDAZOLE SUSPENSI 200 MG/5 ML Kotak
3 ALOPURINOL TABLET 100 MG Tablet
5 AMITRIPTILIN HCL TABLET SALUT 25 MG Tablet
6 AMLODIPIN 10 MG TABLET Tablet
8 AMOKSISILIN KAPLET 500 MG Tablet
9 AMOKSISILIN SERBUK INJEKSI 1000 MG Vial
10 AMOKSISILIN SIRUP KERING 125 MG/5 ML- 6O ML Botol
11 AMOKSISILIN SIRUP KERING 250MG/5ML Botol
12 ANTASIDA DOEN SUSPENSI Botol
13 ANTASIDA DOEN TABLET KUNYAH Tablet
14 ANTI BAKTERI DOEN SALEP KOMBINASI (BASITRACIN) Tube
15 ANTI DIARE ANAK SYRUP Botol
16 ANTI FUNGI DOEN SALEP KOMBINASI Pot
17 ANTI HEMAROID SUPOSITORIA Supp
18 ANTI PARKISON (LEVOPAR) Tablet
19 AQUA PRO INJEKSI Vial
20 ARTESUNATE 50 MG + AMODIAQUINE ANHYDRIDA 200 MG (ACT) Tablet
21 ASAM ASETILSALISILAT 100 MG (ASETOSAL) Tablet
22 ASAM ASKORBAT (VIT C) TABLET 50 MG Tablet
23 ASAM FOLAT 0,4 MG Tablet
24 ASAM FOLAT 1 MG Tablet
25 ASAM MEFENAMAT TABLET 500 MG Tablet
26 ASAM TRANEKSAMAT 500MG Tablet
27 ASAM TRANEKSAMAT INJEKSI 50 MG / ML Ampul
28 ASIKLOVIR 200 MG TABLET Tablet
30 ATTAPULGIT TABLET 600 MG Tablet
31 BETAHISTINE TABLET Tablet
32 BETAMETASON KRIM 0.1 %- 5 MG Tube
33 BISAKODIL TABLET 5 MG Tablet
34 BISOPROLOL 5 MG TABLET Tablet
35 CEFOTAXIME 1000 MG Botol
36 CETRIZINE SIRUP 5 MG/5 ML Botol
37 CETRIZINE TABLET 10 MG Tablet
38 CLOZAPINE 25 MG Tablet
39 DEKSAMETASON INJ 5 MG/ML-1ML Ampul
40 DEKSAMETASON TABLET 0,5 MG Tablet
41 DIAZEPAM 2 MG TABLET Tablet
42 DIAZEPAM INJEKSI 5 MG / ML Ampul
43 DIAZEPAM LARUTAN REKTAL 10 MG/2,5 ML (STESOLID REKTAL) Tube
45 DIFENHIDRAMIN HCL INJEKSI 10 MG/ML - 1 ML Ampul
46 DIGOKSIN TABLET 0,25 MG Tablet
47 DILTIAZEM HCL TABLET 30 MG Tablet
48 DIMENHIDRINAT TABLET 50 MG Tablet
49 DOMPERIDONE 5MG SUSPENSI 60ML Botol
50 DOMPERIDONE TABLET 10 MG Tablet
51 DULCOLAX SUPP INFANT (BISAKODIL SUPP 5MG) Supp
52 EPINEPRIN HCL/BITARTRAT(ADRENALINA)INJ 0,1%-1ML Ampul
53 ERYTHROMICIN SIRUP 200 MG / 5 ML Botol
54 ERYTROMICIN 250 MG Tablet
56 FENITOIN NATRIUM KAPSUL 100 MG Kapsul
57 FENOBARBITAL INJEKSI 50 MG/ML-2ML Ampul
58 FENOBARBITAL TABLET 30 MG Tablet
59 FITOMENADION (VIT.K1) INJEKSI 2 MG/-1ML Ampul
60 FITOMENADION (VIT.K1) TABLET SALUT 10 MG Tablet
61 FLUOXETIN TABLET 20MG Tablet
62 FUROSEMIDE 40 MG TABLET Tablet
63 FUROSEMIDE INJEKSI 10 MG / ML Ampul
64 GARAM ORALIT Sachet
65 GENTAMISIN TETES MATA 0,3% Botol
66 GLIBENKLAMIDA TABLET 5 MG Tablet
67 GLIMEPIRIDE 2MG TABLET Tablet
69 GLUKOSA LARUTAN INFUS 5 % STERIL 500 ML Botol
70 GRISEOFULVIN TABLET 125 MG Tablet
72 GUAIFENESIN 100 MG Tablet
73 HALOPERIDOL TABLET 0,5 MG Tablet
75 HALOPERIDOL TABLET 5 MG Tablet
76 HIDROKLOROTIAZID 25 MG (HCT) TABLET Tablet
77 HIDROKORTISON KRIM 2,5% Tube
78 HYOSCINE-N- BUTILBROMIDE 10 mg TABLET Tablet
79 IBUPROFEN SIRUP 100MG/5ML Botol
80 IBUPROFEN TABLET 200 MG Tablet
82 ISOSORBID DINITRAT TABLET SUBLINGUAL 5 MG Tablet
83 KALSIUM LAKTAT (KALK) TABLET 500 MG Tablet
84 KAPTOPRIL TABLET 12,5 MG Tablet
85 KAPTOPRIL TABLET 25 MG Tablet
86 KARBAMAZEPIN TABLET 200 MG Tablet
87 KARBOGLISERIN TETES TELINGA 10% (FENOL TT) Tube
88 KETOKONAZOLE CREAM 2% Tube
89 KETOKONAZOLE TABLET 200 MG Tablet
90 KLINDAMISIN KAPSUL 150 MG Kapsul
92 KLORAMFENIKOL KAPSUL 500 MG Kapsul
93 KLORAMFENIKOL SALEP MATA 1 % Tube
94 KLORAMFENIKOL SUSPENSI 125 MG / 5 ML Botol
95 KLORFENIRAMIN MALEAT (CTM) TABLET 4 MG Tablet
96 KLORPROMAZIN HCL TABLET SALUT 100 MG Tablet
97 KLORPROMAZINE HCL TABLET SALUT 25 MG Tablet
98 KODEIN 10 MG TABLET Tablet
100 KOTRIMOKSAZOL SIRUP 240 MG/5 ML Botol
101 KOTRIMOKSAZOL SUSPENSI 60 ML Botol
102 KOTRIMOKSAZOL TABLET KOMBINASI 480 MG Tablet
103 LANZOPRAZOLE 30 MG Tablet
104 LIDOKAIN INJEKSI 2% Ampul
105 LIDOKAIN INJEKSI 2% (HCL) + EPINEPRIN 2 ML Ampul
106 LOPERAMIDE TABLET 2 MG Tablet
107 LORATADINE TABLET Tablet
108 MAGNESIUM SULFAT INJEKSI 20% (MGSO4 20%) Vial
109 METAMIZOL INJEKSI (ANTALGIN) 500 MG/ML Vial
110 METFORMINE HCL TABLET 500 MG Tablet
112 METILERGOMETRIN MALEAT INJEKSI 0,2 MG / ML Ampul
113 METILERGOMETRIN MALEAT TABLET SALUT 0,125 MG Tablet Salut
114 METILPREDNISOLON 4 MG TABLET Tablet
115 METOCLOPRAMIDE SIRUP 5MG/ML Botol
116 METOKLOPRAMIDE TABLET 10 MG Tablet
117 METRONIDAZOL 125 MG/ 5 ML SYRUP Botol
118 METRONIDAZOL TABLET 500 MG Tablet
119 MICONAZOLE KRIM /SALEP 2 % (NITRAT) Tube
120 N-ASETIL SISTEIN 200 MG TABLET Kapsul
121 NATRIUM DIKLOFENAK TABLET 50 MG Tablet
122 NATRIUM KLORIDA LARUTAN INFUS 0,9 STERIL 500 ML (NACL) Botol
123 NIFEDIPIN TABLET 10 MG Tablet
124 NISTATIN TABLET SALUT 500.000 IU Tablet Salut
125 NISTATIN TABLET VAGINAL 100.000 IU/G Tablet Vaginal
126 OKSITETRASIKLIN SALEP MATA 1% 3,5 ML Tube
127 OKSITOSIN INJEKSI 10 IU/ML Ampul
128 PARASETAMOL DROPS Botol
129 PARASETAMOL SIRUP 120 MG/5 ML Botol
130 PARASETAMOL TABLET 500 MG Tablet
131 PERAK SULFADIAZIN KRIM 1% (BURNAZIN CREAM) Tube
132 PERMETRIN KRIM 5% (SCABIMITE CREAM 10 G) Tube
133 PREDNISONE 5 MG TABLET Tablet
134 PROPANOLOL TABLET 10 MG (HCL) Tablet
135 RANITIDIN INJEKSI 25 MG/ 2 ML Ampul
136 RANITIDINE TABLET Tablet
137 RETINOL (VITAMIN A) 100.000 IU Kapsul
139 RINGER LAKTAT LARUTAN INFUS Botol
140 RISPERIDON TABLET 2 MG Tablet
141 SALBUTAMOL CAIRAN IH 0,1% (NEBULIZER) Botol
142 SALBUTAMOL TABLET 2 MG Tablet
144 SALEP 2 - 4 KOMBINASI Pot
145 SEFADROKSIL KAPSUL 500 MG Kapsul
146 SEFADROKSIL SIRUP 125 MG / 5 ML Botol
147 SEFIKSIM 100 MG Kapsul
148 SEFOTAKSIM SERBUK INJEKSI 500 MG Vial
149 SERUM ANTI BISA ULAR (ABU) INJEKSI (IM/IV) Vial
150 SERUM ANTI TETANUS (ATS) INJEKSI1500 IU/ML Ampul
151 SIANOKOBALAMIN (VIT B12) INJEKSI Ampul
152 SIANOKOBALAMIN (VIT B12) TABLET 50 MCG Tablet
153 SIMVASTATIN 10 MG TABLET Tablet
154 SIPROFLAKSASIN TABLET 500 MG Tablet
155 SPIRONOLACTONE 100 MG TABLET Tablet
156 THIAMFENIKOL 500 MG KAPSUL Kapsul
157 THIAMIN HCL MONONITRAT (VIT.B1) TABLET 50 MG Tablet
158 TRAMADOL 50 MG INJEKSI Ampul
159 TRIFLUOPERAZINE DIHYDROCHLORIDE TABLET 5 MG Tablet
160 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG Tablet
161 VITAMIN B KOMPLEKS TABLET Tablet
162 VITAMIN B6 TABLET Tablet
163 ZINC DISPERSIBLE 20 MG TABLET Tablet
164 ZINC/ZIRCUM SIRUP 20MG/5ML Botol
OBAT PENUNJANG
1 AMBROXOL SIRUP 15 MG/ML Botol
2 AMBROXOL TABLET 30 MG Tablet
3 ASIKLOVIR KRIM 5% Tube
4 GENTAMISIN SALEP KULIT 0,1% Tube
5 GENTIAN VIOLET 1% Botol
6 HYOSCINE-N- BUTILBROMIDE INJEKSI 20 MG/ML Ampul
8 KLORAMFENIKOL TETES MATA 0,5% (RECO) Botol
9 KLORAMFENIKOL TETES TELINGA (ERLAMYCETIN) Botol
10 MELOXICAM 15 MG TABLET Tablet
11 METOKLOPRAMIDE INJEKSI Ampul
12 MULTIVITAMIN NEUROTROPIK (BIONEURON) Tablet
13 MULTIVITAMIN SIRUP ANAK Botol
14 MULTIVITAMIN TABLET (VITSAP) Tablet
15 OBAT FLU (NOZA TABLET) Tablet
16 OBAT TAMBAH DARAH (SF) Tablet
17 OBAT TAMBAH DARAH KOMBINASI Tablet
18 OBAT FLU ANAK SIRUP KOMBINASI Botol
19 OBH SIRUP Botol
20 OKSITETRASIKLIN SALEP KULIT Tube
21 PAPAVERIN TABLET Tablet
22 PROPILTIOURASIL TABLET 100 MG (PTU) Tablet
23 SALISIL BEDAK 2 %- 50 G Pcs
24 VITAMIN NEUROTROPIK INJEKSI Ampul
BMHP
1 ALAT SUNTIK 10 ML Pcs
2 ALAT SUNTIK SEKALI PAKAI 1 ML Pcs
3 ALAT SUNTIK SEKALI PAKAI 2,5 ML + 3 ML Pcs
5 ALKOHOL 70% Botol
6 ASEPTIC GEL + DISPENSER Botol
7 CATGUT BEDAH NO. 3/0 + JARUM 1/2 GT 35 MM 24 Pcs
8 HANDSCOON (PF SEFAGLOVE NO. 7,5/7/6) STERIL Pcs
9 HANDSCOON (SEFAGLOVE) NON STERIL UK S, M, dan L Pcs
10 INFUSET ANAK Set
11 INFUSET DEWASA Set
12 IV CATHETER NO. 18 G Pcs
16 KAPAS PEMBALUT / ABSORBEN 250 GR Pcs
17 KASA HYDROPIL STERIL 16 x 16 CM Kotak
18 KASA HYDROPIL STERIL 36 x 80 CM Roll
20 KASA PEMBALUT HIDROFIL 4 M x 10 CM Roll
22 MASKER Pcs
23 MASKER HIJAB (U/LAB) Pcs
24 NEEDLE TERUMO 22 G Pcs
27 PHARMAFIX 20CM X 5M Roll
28 PHARMAFIX 5 X 500 CM Roll
29 POLICLEAN 500ML (HANDRUB) Botol
30 POLLY CATETER 2 WAY NO.16 / NO. 18 Pcs
31 POVIDON IODIDA LARUTAN 10 % 30 ML Botol
33 RIVANOL Botol
34 SAFETY BOX Pcs
35 SILK (Benang Bedah Sutera No. 2/0 + Jarum) Pcs
36 SPECULUM/PAPSMEAR KIT Pcs
37 UMBILICAL CORD KLEM STERIL NYLON Pcs
38 UNDERPAD STERIL 60 X 90 CM Pcs
39 URINE BAG Pcs
OBAT GIGI
1 AQUADEST Botol
2 ARTICULATING PAPER Kotak
3 BENANG+NEEDLE UTK MUKOSA MULUT Pcs
4 BONDING LIQUID (MASTERBOND) Botol
5 CELULOID PASTA Strip
6 COMPOSIT A 2 (SOLARE X2) 2 ml Pcs
8 COMPOSIT A 3 (SOLARE X3) 4 ml Tube
9 CRESOPHENE (CRESOTIN) LIQUID Botol
10 DEVITALISASI PASTA (NON ARSEN) / PULP-X Cup
11 DEVITEX/ARSEN Cup
12 ETCHING (ETCHING GEL) / SCHOTCHBOND Tube
13 ETIL KLORIDA SPRAY 100 ML Vial
14 EUGENOL CAIRAN 10 ML Botol
15 FLETCHER SERBUK Kotak
16 GLASS IONOMER CEMENT (FUJI GC IX) Botol
17 HEMOSPON/SPONGOSTAN Pcs
18 IODOFORM PASTA Kotak
19 KALSIUM HIDROKSIDA PASTA (CALPLUS) Kotak
20 KALSIUM HIDROKSIDA PASTA (HYDCAL) Kotak
21 MONOKLORKAMFER MENTOL CAIRAN 10 ML / CHKM (CHAMFENOL) Botol
22 NaOCl Botol
23 SEMEN SENG FOSFAT SERBUK DAN CAIRAN- 30 G Botol
24 TAMBALAN SEMENTARA, premix (CAVITON) Cup
25 TAMBALAN SEMENTARA, premix (CAVIT-W) Cup
26 TKF Kotak
27 ZINC PHOSPHAT Pot
REAGEN LABORATORIUM
1 ALKOHOL 95% Botol
2 ALKOHOL SWAB Pcs
3 BLOOD LANCETS Pcs
4 DENGUE IgG / IgM Pcs
5 DENGUE NS1 Pcs
6 HB SAHLI Pcs
7 HBSAG STRIP FOKUS Stik
8 HCG STRIP FOKUS Stik
9 HIV TEST Stik
10 KERTAS SARING Lembar
11 LARUTAN ALKOHOL ASAM Botol
12 LARUTAN ASAM ASETAT 6% Botol
13 LARUTAN ASAM KLORIDA 0,1 N 100 ML/HCL Botol
14 LARUTAN ASAM SULFO 20% Botol
15 LARUTAN BENEDICT 100ML Botol
16 LARUTAN EDTA Botol
17 LARUTAN EOSIN 2% Botol
18 LARUTAN FUCHSIN / SAFRANIN 1% Botol
19 LARUTAN GIEMSA 100 ML STAIN Botol
20 LARUTAN GIEMSA 250 ML Botol
21 LARUTAN H2O2 Botol
22 LARUTAN HAYEM Botol
23 LARUTAN KARBOL FUCHSIN 250 ML Botol
24 LARUTAN KOH 10% Botol
25 LARUTAN LUGOL Botol
26 LARUTAN METANOL 250ML Botol
27 LARUTAN METILEN BLUE Botol
28 LARUTAN OIL EMERSI Botol
29 LARUTAN POCH-PACK D (II) Botol
30 LARUTAN POCH-PACK L (II) Botol
31 LARUTAN RAESSECHER 100 ML Botol
32 LARUTAN TURK 100 ML Botol
33 LARUTAN XYLOL Botol
34 LIDI SWABB/ COTTON SWABB Pcs
35 LYSOL Botol
36 ONE CLEAN 1 LITER Botol
37 ONE SCRUB 500CC Botol
38 RAPID HCG @1 Strip
39 RAPID SYPHILIS Stik
40 RAPID TEST HIV 1/2 (SD BIOLINE) Pcs
41 REAGEN CHOLESTEROL (RANDOX) Botol
42 REAGEN DIRUI CLEANSER Botol
43 REAGEN DIRUI DILLUENT Botol
44 REAGEN DIRUI LYSE Botol
45 REAGEN FOTOMETER (5010) SGOT Botol
46 REAGEN FOTOMETER (5010) SGPT Kit
47 REAGEN FOTOMETER ASAM URAT Kit
48 REAGEN FOTOMETER GULA Kit
49 REAGEN FOTOMETER HB CYANMENT Kit
50 REAGEN FOTOMETER KOLESTEROL Kit
51 REAGEN FOTOMETER KREATININ Botol
52 REAGEN FOTOMETER TRIGLISERIDE Kit
53 REAGEN FOTOMETER UREUM Kit
54 REAGEN GOLONGAN DARAH ANTI A Set
55 REAGEN GOLONGAN DARAH ANTI B Set
56 REAGEN NORMA CLEANSER Botol
57 REAGEN NORMA DILUENT Botol
58 REAGEN NORMA LYSE Botol
59 REAGEN PACK TEST BIOSYSTEM Pack
60 REAGEN SYSMEX CELL CLEAN Botol
61 REAGEN SYSMEX CELL PACK Botol
62 REAGEN SYSMEX STROMATOLYSER Botol
63 REAGEN TRIGLISERID (RANDOX) Botol
64 REAGEN TRIGLYSERIDES BIOSYSTEM Kotak
65 REAGEN URIC ACID BIOSYSTEM Kotak
66 REAGEN WIDAL TEST type AH Kit
67 REAGEN WIDAL TEST type AO Kit
68 REAGEN WIDAL TEST type BH Kit
69 REAGEN WIDAL TEST type BO Kit
70 REAGEN WIDAL TEST type H Kit
71 REAGEN WIDAL TEST type O Kit
72 SPIRITUS Botol
73 STIK AMPHETAMINE TEST Stik
74 STIK BENZODIAZEPINE TEST Stik
75 STIK GLUKO DR Pcs
76 STIK GULA DARAH Pcs
77 STIK MARIJUANA(THC) TEST Stik
78 STIK NARKOBA Pcs
79 STIK PEMERIKSAAN ASAM URAT Stik
80 STIK PEMERIKSAAN HB Pcs
81 STIK PEMERIKSAAN KOLESTEROL Stik
82 STIK PEMERIKSAAN TRIGLISERIDA (TG) Stik
83 STIK URINE TEST Pcs
84 TABUNG HEMATOKRID @100 Botol
85 TABUNG VACUTAINER MERAH Tabung
86 TABUNG VACUTAINER UNGU Tube
87 TISUE LENSA MIKROSKOP Pack
88 VACUTAINER NEEDLE /JARUM VACUTAINER Pcs
89 ZIELH NELSEN Botol
OBAT YANG TIDAK ADA DI DALAM FORM

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Mengetahui,
(Kepala Puskesmas)
NIP. …...................................
KALAN KESEHATAN DI PUSKESMAS
KABUPATEN BANJAR
EMBER 2023
SISA STOK
HARGA SATUAN KETERANGAN
JUMLAH TOTAL HARGA
4 5 6 7
323 -
4,600 -
206 -
200 -
210 -
110 -
99 -
518 -
8,135 -
3,480 -
5,200 -
1,756 -
99 -
4,800 -
3,905 -
3,637 -
3,738 -
904 -
2,650 -
3,600 -
256 -
70 -
68 -
61 -
276 -
1,838 -
2,870 -
519 -
759 -
159 -
620 -
2,100 -
216 -
143 -
7,404 -
2,215 -
90 -
946 -
1,210 -
60 -
170 -
1,545 -
19,693 -
14,459 -
1,347 -
124 -
140 -
150 -
14,710 -
160 -
5,085 -
1,740 -
12,836 -
647 -
900 -
188 -
1,700 -
185 -
3,219 -
781 -
387 -
221 -
969 -
280 -
8,547 -
179 -
317 -
2,000 -
6,627 -
306 -
1,040 -
242 -
160 -
212 -
255 -
148 -
2,940 -
743 -
2,339 -
155 -
199 -
99 -
105 -
155 -
75 -
706 -
3,999 -
4,800 -
431 -
900 -
3,480 -
1,174 -
2,054 -
5,352 -
54 -
525 -
208 -
611 -
1,385 -
2,052 -
3,765 -
240 -
499 -
1,341 -
1,532 -
77 -
129 -
4,973 -
3,590 -
290 -
435 -
1,069 -
214 -
193 -
2,750 -
115 -
3,765 -
233 -
1,900 -
752 -
150 -
7,673 -
220 -
869 -
550 -
3,500 -
1,248 -
13,119 -
4,957 -
160 -
21,934 -
6,641 -
109 -
63 -
1,058 -
235 -
356 -
637 -
8,498 -
130 -
5,280 -
130 -
150 -
1,475 -
775 -
5,991 -
398 -
5,650 -
517,132 -
152,625 -
1,066 -
49 -
125 -
468 -
552 -
1,013 -
80 -
1,764 -
330 -
126 -
70 -
72 -
195 -
3,285 -
TOTAL -
4,160 -
210 -
4,100 -
4,400 -
4,200 -
6,188 -
1,200 -
7,600 -
8,100 -
520 -
1,983 -
970 -
15,400 -
3,067 -
990 -
409 -
185 -
8,217 -
3,091 -
2,255 -
330 -
440 -
5,868 -
5,225 -
TOTAL -
1,294 -
938 -
878 -
974 -
44,870 -
23,100 -
2,524 -
8,800 -
1,110 -
9,546 -
7,881 -
3,800 -
9,990 -
9,990 -
9,990 -
14,520 -
7,215 -
145,800 -
110,250 -
2,188 -
1,024 -
682 -
462 -
880 -
330 -
330 -
84,200 -
23,000 -
80,104 -
10,164 -
3,079 -
61,858 -
5,500 -
17,649 -
3,606 -
17,538 -
89,910 -
8,500 -
5,508 -
TOTAL -
36,300 -
242,000 -
18,150 -
314,133 -
150,000 -
266,400 -
266,400 -
303,050 -
870,000 -
260,300 -
319,000 -
696,046 -
218,000 -
162,000 -
41,250 -
399,600 -
834 -
440,000 -
111,164 -
220,000 -
72,314 -
165,000 -
199,800 -
183,150 -
193,600 -
80,150 -
242,000 -
TOTAL -
26,250 -
134 -
101 -
29,855 -
37,143 -
151,250 -
15,500 -
7,181 -
15,297 -
33,300 -
77,440 -
23,419 -
23,000 -
277,000 -
23,900 -
65,810 -
171,000 -
110,000 -
502,000 -
243,184 -
225,000 -
54,600 -
131,296 -
30,000 -
41,745 -
45,360 -
61,790 -
200,000 -
555,583 -
1,140,752 -
64,000 -
33,240 -
121,000 -
1,066 -
86,000 -
27,000 -
75,000 -
2,886 -
- -
28,700 -
805,093 -
1,221,000 -
1,387,500 -
1,496,000 -
1,331,000 -
1,331,000 -
1,452,000 -
355,600 -
110,000 -
1,421,200 -
2,242,600 -
2,176,000 -
1,354,600 -
119,884 -
119,884 -
2,970,000 -
2,761,000 -
3,520,000 -
7,722,000 -
1,570,000 -
1,910,700 -
1,570,000 -
794,753 -
5,577,000 -
3,366,000 -
119,406 -
107,933 -
120,618 -
107,933 -
107,933 -
107,933 -
75,000 -
8,441 -
9,550 -
3,052 -
3,330 -
9,550 -
56,310 -
6,000 -
8,122 -
25,000 -
47,200 -
6,700 -
111,000 -
1,998 -
1,860 -
33,000 -
3,980 -
228,278 -
TOTAL -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
JUMLAH TOTAL -
Yang Membuat Laporan
…..............................
NIP. …..........................
PUSKESMAS/PUSTU:
1 2 3
OBAT GENERIK
OBAT PENUNJANG
19 OBH SIRUP Botol
BMHP
5 ALKOHOL 70% Botol
10 INFUSET ANAK Set
22 MASKER Pcs
33 RIVANOL Botol
34 SAFETY BOX Pcs
39 URINE BAG Pcs
OBAT GIGI
1 AQUADEST Botol
22 NaOCl Botol
26 TKF Kotak
REAGEN LABORATORIUM
1 ALKOHOL 95% Botol
2 ALKOHOL SWAB Pcs
3 BLOOD LANCETS Pcs
5 DENGUE NS1 Pcs
6 HB SAHLI Pcs
9 HIV TEST Stik
35 LYSOL Botol
72 SPIRITUS Botol
78 STIK NARKOBA Pcs

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Mengetahui,
(Kepala Puskesmas)
NIP. …...................................
KABUPATEN BANJAR
EMBER 2023
SISA STOK
JUMLAH TOTAL HARGA
4 5 6 7
323 -
4,600 -
206 -
200 -
210 -
110 -
99 -
518 -
8,135 -
3,480 -
5,200 -
1,756 -
99 -
4,800 -
3,905 -
3,637 -
3,738 -
904 -
2,650 -
3,600 -
256 -
70 -
68 -
61 -
276 -
1,838 -
2,870 -
519 -
759 -
159 -
620 -
2,100 -
216 -
143 -
7,404 -
2,215 -
90 -
946 -
1,210 -
60 -
170 -
1,545 -
19,693 -
14,459 -
1,347 -
124 -
140 -
150 -
14,710 -
160 -
5,085 -
1,740 -
12,836 -
647 -
900 -
188 -
1,700 -
185 -
3,219 -
781 -
387 -
221 -
969 -
280 -
8,547 -
179 -
317 -
2,000 -
6,627 -
306 -
1,040 -
242 -
160 -
212 -
255 -
148 -
2,940 -
743 -
2,339 -
155 -
199 -
99 -
105 -
155 -
75 -
706 -
3,999 -
4,800 -
431 -
900 -
3,480 -
1,174 -
2,054 -
5,352 -
54 -
525 -
208 -
611 -
1,385 -
2,052 -
3,765 -
240 -
499 -
1,341 -
1,532 -
77 -
129 -
4,973 -
3,590 -
290 -
435 -
1,069 -
214 -
193 -
2,750 -
115 -
3,765 -
233 -
1,900 -
752 -
150 -
7,673 -
220 -
869 -
550 -
3,500 -
1,248 -
13,119 -
4,957 -
160 -
21,934 -
6,641 -
109 -
63 -
1,058 -
235 -
356 -
637 -
8,498 -
130 -
5,280 -
130 -
150 -
1,475 -
775 -
5,991 -
398 -
5,650 -
517,132 -
152,625 -
1,066 -
49 -
125 -
468 -
552 -
1,013 -
80 -
1,764 -
330 -
126 -
70 -
72 -
195 -
3,285 -
TOTAL -
4,160 -
210 -
4,100 -
4,400 -
4,200 -
6,188 -
1,200 -
7,600 -
8,100 -
520 -
1,983 -
970 -
15,400 -
3,067 -
990 -
409 -
185 -
8,217 -
3,091 -
2,255 -
330 -
440 -
5,868 -
5,225 -
TOTAL -
1,294 -
938 -
878 -
974 -
44,870 -
23,100 -
2,524 -
8,800 -
1,110 -
9,546 -
7,881 -
3,800 -
9,990 -
9,990 -
9,990 -
14,520 -
7,215 -
145,800 -
110,250 -
2,188 -
1,024 -
682 -
462 -
880 -
330 -
330 -
84,200 -
23,000 -
80,104 -
10,164 -
3,079 -
61,858 -
5,500 -
17,649 -
3,606 -
17,538 -
89,910 -
8,500 -
5,508 -
TOTAL -
36,300 -
242,000 -
18,150 -
314,133 -
150,000 -
266,400 -
266,400 -
303,050 -
870,000 -
260,300 1 260,300
319,000 -
696,046 -
218,000 1 218,000
162,000 1 162,000
41,250 -
399,600 -
834 -
440,000 1 440,000
111,164 1 111,164
220,000 -
72,314 1 72,314
165,000 -
199,800 -
183,150 -
193,600 -
80,150 1 80,150
242,000 -
TOTAL 1,343,928
26,250 -
134 -
101 -
29,855 -
37,143 -
151,250 -
15,500 -
7,181 -
15,297 -
33,300 -
77,440 -
23,419 -
23,000 -
277,000 -
23,900 -
65,810 -
171,000 -
110,000 -
502,000 -
243,184 -
225,000 -
54,600 -
131,296 -
30,000 -
41,745 -
45,360 -
61,790 -
200,000 -
555,583 -
1,140,752 -
64,000 -
33,240 -
121,000 -
1,066 -
86,000 -
27,000 -
75,000 -
2,886 -
- -
28,700 -
805,093 -
1,221,000 -
1,387,500 -
1,496,000 -
1,331,000 -
1,331,000 -
1,452,000 -
355,600 -
110,000 -
1,421,200 -
2,242,600 -
2,176,000 -
1,354,600 -
119,884 -
119,884 -
2,970,000 -
2,761,000 -
3,520,000 -
7,722,000 -
1,570,000 -
1,910,700 -
1,570,000 -
794,753 -
5,577,000 -
3,366,000 -
119,406 -
107,933 -
120,618 -
107,933 -
107,933 -
107,933 -
75,000 -
8,441 -
9,550 -
3,052 -
3,330 -
9,550 -
56,310 -
6,000 -
8,122 -
25,000 -
47,200 -
6,700 -
111,000 -
1,998 -
1,860 -
33,000 -
3,980 -
228,278 -
TOTAL -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
JUMLAH TOTAL 1,343,928
…..............................
NIP. …..........................
PUSKESMAS/PUSTU:
1 2 3
OBAT GENERIK
OBAT PENUNJANG
19 OBH SIRUP Botol
BMHP
5 ALKOHOL 70% Botol
10 INFUSET ANAK Set
22 MASKER Pcs
33 RIVANOL Botol
34 SAFETY BOX Pcs
39 URINE BAG Pcs
OBAT GIGI
1 AQUADEST Botol
22 NaOCl Botol
26 TKF Kotak
REAGEN LABORATORIUM
1 ALKOHOL 95% Botol
2 ALKOHOL SWAB Pcs
3 BLOOD LANCETS Pcs
5 DENGUE NS1 Pcs
6 HB SAHLI Pcs
9 HIV TEST Stik
35 LYSOL Botol
72 SPIRITUS Botol
78 STIK NARKOBA Pcs

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Mengetahui,
(Kepala Puskesmas)
NIP. …...................................
KABUPATEN BANJAR
EMBER 2023
SISA STOK
JUMLAH TOTAL HARGA
4 5 6 7
323 -
4,600 -
206 -
200 -
210 -
110 -
99 -
518 -
8,135 -
3,480 -
5,200 -
1,756 -
99 -
4,800 -
3,905 -
3,637 -
3,738 -
904 -
2,650 -
3,600 -
256 -
70 -
68 -
61 -
276 -
1,838 -
2,870 -
519 -
759 -
159 -
620 -
2,100 -
216 -
143 -
7,404 -
2,215 -
90 -
946 -
1,210 -
60 -
170 -
1,545 -
19,693 -
14,459 -
1,347 -
124 -
140 -
150 -
14,710 -
160 -
5,085 -
1,740 -
12,836 -
647 -
900 -
188 -
1,700 -
185 -
3,219 -
781 -
387 -
221 -
969 -
280 -
8,547 -
179 -
317 -
2,000 -
6,627 -
306 -
1,040 -
242 -
160 -
212 -
255 -
148 -
2,940 -
743 -
2,339 -
155 -
199 -
99 -
105 -
155 -
75 -
706 -
3,999 -
4,800 -
431 -
900 -
3,480 -
1,174 -
2,054 -
5,352 -
54 -
525 -
208 -
611 -
1,385 -
2,052 -
3,765 -
240 -
499 -
1,341 -
1,532 -
77 -
129 -
4,973 -
3,590 -
290 -
435 -
1,069 -
214 -
193 -
2,750 -
115 -
3,765 -
233 -
1,900 -
752 -
150 -
7,673 -
220 -
869 -
550 -
3,500 -
1,248 -
13,119 -
4,957 -
160 -
21,934 -
6,641 -
109 -
63 -
1,058 -
235 -
356 -
637 -
8,498 -
130 -
5,280 -
130 -
150 -
1,475 -
775 -
5,991 -
398 -
5,650 -
517,132 -
152,625 -
1,066 -
49 -
125 -
468 -
552 -
1,013 -
80 -
1,764 -
330 -
126 -
70 -
72 -
195 -
3,285 -
TOTAL -
4,160 -
210 -
4,100 -
4,400 -
4,200 -
6,188 -
1,200 -
7,600 -
8,100 -
520 -
1,983 -
970 -
15,400 -
3,067 -
990 -
409 -
185 -
8,217 -
3,091 -
2,255 -
330 -
440 -
5,868 -
5,225 -
TOTAL -
1,294 -
938 -
878 -
974 -
44,870 -
23,100 -
2,524 -
8,800 -
1,110 -
9,546 -
7,881 -
3,800 -
9,990 -
9,990 -
9,990 -
14,520 -
7,215 -
145,800 -
110,250 -
2,188 -
1,024 -
682 -
462 -
880 -
330 -
330 -
84,200 -
23,000 -
80,104 -
10,164 -
3,079 -
61,858 -
5,500 -
17,649 -
3,606 -
17,538 -
89,910 -
8,500 -
5,508 -
TOTAL -
36,300 -
242,000 -
18,150 -
314,133 -
150,000 -
266,400 -
266,400 -
303,050 -
870,000 -
260,300 -
319,000 -
696,046 -
218,000 -
162,000 -
41,250 -
399,600 -
834 -
440,000 -
111,164 -
220,000 -
72,314 -
165,000 -
199,800 -
183,150 -
193,600 -
80,150 -
242,000 -
TOTAL -
26,250 -
134 -
101 -
29,855 -
37,143 -
151,250 -
15,500 -
7,181 -
15,297 -
33,300 -
77,440 -
23,419 -
23,000 -
277,000 -
23,900 -
65,810 -
171,000 -
110,000 -
502,000 -
243,184 -
225,000 -
54,600 -
131,296 -
30,000 -
41,745 -
45,360 -
61,790 -
200,000 -
555,583 -
1,140,752 -
64,000 -
33,240 -
121,000 -
1,066 -
86,000 -
27,000 -
75,000 -
2,886 -
- -
28,700 -
805,093 -
1,221,000 -
1,387,500 -
1,496,000 -
1,331,000 -
1,331,000 -
1,452,000 -
355,600 -
110,000 -
1,421,200 -
2,242,600 -
2,176,000 -
1,354,600 -
119,884 -
119,884 -
2,970,000 -
2,761,000 -
3,520,000 -
7,722,000 -
1,570,000 -
1,910,700 -
1,570,000 -
794,753 -
5,577,000 -
3,366,000 -
119,406 -
107,933 -
120,618 -
107,933 -
107,933 -
107,933 -
75,000 -
8,441 -
9,550 -
3,052 -
3,330 -
9,550 -
56,310 -
6,000 -
8,122 -
25,000 -
47,200 -
6,700 -
111,000 -
1,998 -
1,860 -
33,000 -
3,980 -
228,278 -
TOTAL -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
JUMLAH TOTAL -
…..............................
NIP. …..........................
PUSKESMAS/PUSTU:
1 2 3
OBAT GENERIK
OBAT PENUNJANG
19 OBH SIRUP Botol
BMHP
5 ALKOHOL 70% Botol
10 INFUSET ANAK Set
22 MASKER Pcs
33 RIVANOL Botol
34 SAFETY BOX Pcs
39 URINE BAG Pcs
OBAT GIGI
1 AQUADEST Botol
22 NaOCl Botol
26 TKF Kotak
REAGEN LABORATORIUM
1 ALKOHOL 95% Botol
2 ALKOHOL SWAB Pcs
3 BLOOD LANCETS Pcs
5 DENGUE NS1 Pcs
6 HB SAHLI Pcs
9 HIV TEST Stik
35 LYSOL Botol
72 SPIRITUS Botol
78 STIK NARKOBA Pcs

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Mengetahui,
(Kepala Puskesmas)
NIP. …...................................
KABUPATEN BANJAR
EMBER 2023
SISA STOK
JUMLAH TOTAL HARGA
4 5 6 7
323 -
4,600 -
206 -
200 -
210 -
110 -
99 -
518 -
8,135 -
3,480 -
5,200 -
1,756 -
99 -
4,800 -
3,905 -
3,637 -
3,738 -
904 -
2,650 -
3,600 -
256 -
70 -
68 -
61 -
276 -
1,838 -
2,870 -
519 -
759 -
159 -
620 -
2,100 -
216 -
143 -
7,404 -
2,215 -
90 -
946 -
1,210 -
60 -
170 -
1,545 -
19,693 -
14,459 -
1,347 -
124 -
140 -
150 -
14,710 -
160 -
5,085 -
1,740 -
12,836 -
647 -
900 -
188 -
1,700 -
185 -
3,219 -
781 -
387 -
221 -
969 -
280 -
8,547 -
179 -
317 -
2,000 -
6,627 -
306 -
1,040 -
242 -
160 -
212 -
255 -
148 -
2,940 -
743 -
2,339 -
155 -
199 -
99 -
105 -
155 -
75 -
706 -
3,999 -
4,800 -
431 -
900 -
3,480 -
1,174 -
2,054 -
5,352 -
54 -
525 -
208 -
611 -
1,385 -
2,052 -
3,765 -
240 -
499 -
1,341 -
1,532 -
77 -
129 -
4,973 -
3,590 -
290 -
435 -
1,069 -
214 -
193 -
2,750 -
115 -
3,765 -
233 -
1,900 -
752 -
150 -
7,673 -
220 -
869 -
550 -
3,500 -
1,248 -
13,119 -
4,957 -
160 -
21,934 -
6,641 -
109 -
63 -
1,058 -
235 -
356 -
637 -
8,498 -
130 -
5,280 -
130 -
150 -
1,475 -
775 -
5,991 -
398 -
5,650 -
517,132 -
152,625 -
1,066 -
49 -
125 -
468 -
552 -
1,013 -
80 -
1,764 -
330 -
126 -
70 -
72 -
195 -
3,285 -
TOTAL -
4,160 -
210 -
4,100 -
4,400 -
4,200 -
6,188 -
1,200 -
7,600 -
8,100 -
520 -
1,983 -
970 -
15,400 -
3,067 -
990 -
409 -
185 -
8,217 -
3,091 -
2,255 -
330 -
440 -
5,868 -
5,225 -
TOTAL -
1,294 -
938 -
878 -
974 -
44,870 -
23,100 -
2,524 -
8,800 -
1,110 -
9,546 -
7,881 -
3,800 -
9,990 -
9,990 -
9,990 -
14,520 -
7,215 -
145,800 -
110,250 -
2,188 -
1,024 -
682 -
462 -
880 -
330 -
330 -
84,200 -
23,000 -
80,104 -
10,164 -
3,079 -
61,858 -
5,500 -
17,649 -
3,606 -
17,538 -
89,910 -
8,500 -
5,508 -
TOTAL -
36,300 -
242,000 -
18,150 -
314,133 -
150,000 -
266,400 -
266,400 -
303,050 -
870,000 -
260,300 -
319,000 -
696,046 -
218,000 -
162,000 -
41,250 -
399,600 -
834 -
440,000 -
111,164 -
220,000 -
72,314 -
165,000 -
199,800 -
183,150 -
193,600 -
80,150 -
242,000 -
TOTAL -
26,250 -
134 -
101 -
29,855 -
37,143 -
151,250 -
15,500 -
7,181 -
15,297 -
33,300 -
77,440 -
23,419 -
23,000 -
277,000 -
23,900 -
65,810 -
171,000 -
110,000 -
502,000 -
243,184 -
225,000 -
54,600 -
131,296 -
30,000 -
41,745 -
45,360 -
61,790 -
200,000 -
555,583 -
1,140,752 -
64,000 -
33,240 -
121,000 -
1,066 -
86,000 -
27,000 -
75,000 -
2,886 -
- -
28,700 -
805,093 -
1,221,000 -
1,387,500 -
1,496,000 -
1,331,000 -
1,331,000 -
1,452,000 -
355,600 -
110,000 -
1,421,200 -
2,242,600 -
2,176,000 -
1,354,600 -
119,884 -
119,884 -
2,970,000 -
2,761,000 -
3,520,000 -
7,722,000 -
1,570,000 -
1,910,700 -
1,570,000 -
794,753 -
5,577,000 -
3,366,000 -
119,406 -
107,933 -
120,618 -
107,933 -
107,933 -
107,933 -
75,000 -
8,441 -
9,550 -
3,052 -
3,330 -
9,550 -
56,310 -
6,000 -
8,122 -
25,000 -
47,200 -
6,700 -
111,000 -
1,998 -
1,860 -
33,000 -
3,980 -
228,278 -
TOTAL -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
JUMLAH TOTAL -
…..............................
NIP. …..........................
STOK OPN
PUSKESMAS/PUSTU:
1 2 3
OBAT GENERIK
OBAT PENUNJANG
19 OBH SIRUP Botol
BMHP
5 ALKOHOL 70% Botol
10 INFUSET ANAK Set
22 MASKER Pcs
33 RIVANOL Botol
34 SAFETY BOX Pcs
39 URINE BAG Pcs
OBAT GIGI
1 AQUADEST Botol
22 NaOCl Botol
26 TKF Kotak
REAGEN LABORATORIUM
1 ALKOHOL 95% Botol
2 ALKOHOL SWAB Pcs
3 BLOOD LANCETS Pcs
5 DENGUE NS1 Pcs
6 HB SAHLI Pcs
9 HIV TEST Stik
35 LYSOL Botol
72 SPIRITUS Botol
78 STIK NARKOBA Pcs

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Mengetahui,
(Kepala Puskesmas)
NIP. …...................................
STOK OPNAME OBAT DAN PERBEKALAN KESEHATAN DI PUSKESMAS
SISA STOK
HARGA SATUAN
PUSTU 1 PUSTU 2 PUSTU 3 POSKESDES 1
4 5 6 7 8
323
4,600
206
200
210
110
99
518
8,135
3,480
5,200
1,756
99
4,800
3,905
3,637
3,738
904
2,650
3,600
256
70
68
61
276
1,838
2,870
519
759
159
620
2,100
216
143
7,404
2,215
90
946
1,210
60
170
1,545
19,693
14,459
1,347
124
140
150
14,710
160
5,085
1,740
12,836
647
900
188
1,700
185
3,219
781
387
221
969
280
8,547
179
317
2,000
6,627
306
1,040
242
160
212
255
148
2,940
743
2,339
155
199
99
105
155
75
706
3,999
4,800
431
900
3,480
1,174
2,054
5,352
54
525
208
611
1,385
2,052
3,765
240
499
1,341
1,532
77
129
4,973
3,590
290
435
1,069
214
193
2,750
115
3,765
233
1,900
752
150
7,673
220
869
550
3,500
1,248
13,119
4,957
160
21,934
6,641
109
63
1,058
235
356
637
8,498
130
5,280
130
150
1,475
775
5,991
398
5,650
517,132
152,625
1,066
49
125
468
552
1,013
80
1,764
330
126
70
72
195
3,285
4,160
210
4,100
4,400
4,200
6,188
1,200
7,600
8,100
520
1,983
970
15,400
3,067
990
409
185
8,217
3,091
2,255
330
440
5,868
5,225
1,294
938
878
974
44,870
23,100
2,524
8,800
1,110
9,546
7,881
3,800
9,990
9,990
9,990
14,520
7,215
145,800
110,250
2,188
1,024
682
462
880
330
330
84,200
23,000
80,104
10,164
3,079
61,858
5,500
17,649
3,606
17,538
89,910
8,500
5,508
36,300
242,000
18,150
314,133
150,000
266,400
266,400
303,050
870,000
260,300
319,000
696,046
218,000
162,000
41,250
399,600
834
440,000
111,164
220,000
72,314
165,000
199,800
183,150
193,600
80,150
242,000
26,250
134
101
29,855
37,143
151,250
15,500
7,181
15,297
33,300
77,440
23,419
23,000
277,000
23,900
65,810
171,000
110,000
502,000
243,184
225,000
54,600
131,296
30,000
41,745
45,360
61,790
200,000
555,583
1,140,752
64,000
33,240
121,000
1,066
86,000
27,000
75,000
2,886
-
28,700
805,093
1,221,000
1,387,500
1,496,000
1,331,000
1,331,000
1,452,000
355,600
110,000
1,421,200
2,242,600
2,176,000
1,354,600
119,884
119,884
2,970,000
2,761,000
3,520,000
7,722,000
1,570,000
1,910,700
1,570,000
794,753
5,577,000
3,366,000
119,406
107,933
120,618
107,933
107,933
107,933
75,000
8,441
9,550
3,052
3,330
9,550
56,310
6,000
8,122
25,000
47,200
6,700
111,000
1,998
1,860
33,000
3,980
228,278
PUSKESMAS
SISA STOK
POSKESDES 2 POLINDES 1 POLINDES 2 JUMLAH TOTAL HARGA
9 10 11 12 13
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
JUMLAH TOTAL -
…..............................
NIP. …..........................
KETERANGAN
14
PUSKESMAS/PUSTU:
1 2 3
OBAT GENERIK
OBAT PENUNJANG
19 OBH SIRUP Botol
BMHP
5 ALKOHOL 70% Botol
10 INFUSET ANAK Set
22 MASKER Pcs
33 RIVANOL Botol
34 SAFETY BOX Pcs
39 URINE BAG Pcs
OBAT GIGI
1 AQUADEST Botol
22 NaOCl Botol
26 TKF Kotak
REAGEN LABORATORIUM
1 ALKOHOL 95% Botol
2 ALKOHOL SWAB Pcs
3 BLOOD LANCETS Pcs
5 DENGUE NS1 Pcs
6 HB SAHLI Pcs
9 HIV TEST Stik
35 LYSOL Botol
72 SPIRITUS Botol
78 STIK NARKOBA Pcs

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Mengetahui,
(Kepala Puskesmas)
NIP. …...................................
STOK OPNAME OBAT DAN PERBEKALAN KESEHATAN DI PUSKESMAS
SISA
HARGA SATUAN
GUDANG APOTEK PUSTU 1 PUSTU 2
4 5 6 7 8
323
4,600
206
200
210
110
99
518
8,135
3,480
5,200
1,756
99
4,800
3,905
3,637
3,738
904
2,650
3,600
256
70
68
61
276
1,838
2,870
519
759
159
620
2,100
216
143
7,404
2,215
90
946
1,210
60
170
1,545
19,693
14,459
1,347
124
140
150
14,710
160
5,085
1,740
12,836
647
900
188
1,700
185
3,219
781
387
221
969
280
8,547
179
317
2,000
6,627
306
1,040
242
160
212
255
148
2,940
743
2,339
155
199
99
105
155
75
706
3,999
4,800
431
900
3,480
1,174
2,054
5,352
54
525
208
611
1,385
2,052
3,765
240
499
1,341
1,532
77
129
4,973
3,590
290
435
1,069
214
193
2,750
115
3,765
233
1,900
752
150
7,673
220
869
550
3,500
1,248
13,119
4,957
160
21,934
6,641
109
63
1,058
235
356
637
8,498
130
5,280
130
150
1,475
775
5,991
398
5,650
517,132
152,625
1,066
49
125
468
552
1,013
80
1,764
330
126
70
72
195
3,285
4,160
210
4,100
4,400
4,200
6,188
1,200
7,600
8,100
520
1,983
970
15,400
3,067
990
409
185
8,217
3,091
2,255
330
440
5,868
5,225
1,294
938
878
974
44,870
23,100
2,524
8,800
1,110
9,546
7,881
3,800
9,990
9,990
9,990
14,520
7,215
145,800
110,250
2,188
1,024
682
462
880
330
330
84,200
23,000
80,104
10,164
3,079
61,858
5,500
17,649
3,606
17,538
89,910
8,500
5,508
36,300
242,000
18,150
314,133
150,000
266,400
266,400
303,050
870,000
260,300
319,000
696,046
218,000
162,000
41,250
399,600
834
440,000
111,164
220,000
72,314
165,000
199,800
183,150
193,600
80,150
242,000
26,250
134
101
29,855
37,143
151,250
15,500
7,181
15,297
33,300
77,440
23,419
23,000
277,000
23,900
65,810
171,000
110,000
502,000
243,184
225,000
54,600
131,296
30,000
41,745
45,360
61,790
200,000
555,583
1,140,752
64,000
33,240
121,000
1,066
86,000
27,000
75,000
2,886
-
28,700
805,093
1,221,000
1,387,500
1,496,000
1,331,000
1,331,000
1,452,000
355,600
110,000
1,421,200
2,242,600
2,176,000
1,354,600
119,884
119,884
2,970,000
2,761,000
3,520,000
7,722,000
1,570,000
1,910,700
1,570,000
794,753
5,577,000
3,366,000
119,406
107,933
120,618
107,933
107,933
107,933
75,000
8,441
9,550
3,052
3,330
9,550
56,310
6,000
8,122
25,000
47,200
6,700
111,000
1,998
1,860
33,000
3,980
228,278
KESEHATAN DI PUSKESMAS
ATEN BANJAR
2023
SISA STOK
PUSTU 3 POSKESDES 1 POSKESDES 2 POLINDES 1 POLINDES 2
9 10 11 12 13
…..............................
NIP. …..........................
KETERANGAN
JUMLAH TOTAL HARGA
14 15 16
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL -
JUMLAH TOTAL -
…..............................
NIP. …..........................
NILAI PERSEDIAAN PUSTU, POLINDES, POSKESDES
PUSKESMAS:
NO. NAMA PUSTU NILAI PERSEDIAAN
1 PUSTU 1
2 PUSTU 2
3 PUSTU 3
4 POSKESDES 1
5 POSKESDES 2
6 POLINDES 1
7 POLINDES 2
8
9
10
11
12
13
14
15
TOTAL -
NILAI PERSEDIAAN PUSKESMAS
PUSKESMAS:
NO. NAMA UNIT NILAI PERSEDIAAN
1 GUDANG
2 APOTEK PELAYANAN
3 PUSTU 1
4 PUSTU 2
5 PUSTU 3
6 POSKESDES 1
7 POSKESDES 2
8 POLINDES 1
9 POLINDES 2
10
11
12
13
14
15
TOTAL -

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