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SKPD : UPTD PUSKESMAS CIBEUREUM

KOTA : TASIKMALAYA
PROVINSI : JAWA BARAT

BUKU PENERIMAAN BARANG

Dokumen Faktur
No. Tanggal Dari Nama Barang Banyaknya
Nomor Tanggal
1 2 3 4 5 6 7
Sisa tahun 2015
1 04/01/2016 DKJKN-ND (silpa) Ambroxol Syr 15 mg 600 Botol
2 04/01/2016 DKJKN-ND (silpa) Ambroxol 30 mg tab 11000 Tablet
3 04/01/2016 DKJKN-ND (silpa) Antifungi 200 Pot
4 04/01/2016 DKJKN-ND (silpa) Asiklovir cream 550 Tube
5 04/01/2016 DKJKN-ND (silpa) Gentamicyn sk 3100 Tube
6 04/01/2016 DKJKN-ND (silpa) Gliceril Guaiacolat 100 mg 180000 Tablet
7 04/01/2016 DKJKN-ND (silpa) Chloramphenicol Tetes mata 529 Fls
8 04/01/2016 DKJKN-ND (silpa) Chloramphenicol Tetes Telinga 488 Fls
9 04/01/2016 DKJKN-ND (silpa) Multivitamin syr 500 Botol
10 04/01/2016 DKJKN-ND (silpa) Obat Flu Kombinasi syr 400 Botol
11 04/01/2016 DKJKN-ND (silpa) Obat Batuk Anak/bayi 700 Botol
12 04/01/2016 DKJKN-ND (silpa) Obat Batuk Flu Tab Kombinasi 8000 Tablet
13 04/01/2016 DKJKN-ND (silpa) Obat Batuk Antitusif 8000 Tablet
14 04/01/2016 DKJKN-ND (silpa) Obat Batuk Hitam 1100 Botol
15 04/01/2016 DKJKN-ND (silpa) Oxytetracycline Sk 1850 Tube
16 04/01/2016 DKJKN-ND (silpa) Prednison Tab 50000 Tablet
17 04/01/2016 DKJKN-ND (silpa) Saccharin Tab 40000 Tablet
18 04/01/2016 DKJKN-ND (silpa) Tiamin hcl 50 mg 100000 Tablet
19 04/01/2016 DKJKN-ND (silpa) Vitamin Neutripik 16000 Kaplet
20 04/01/2016 DKJKN-ND (silpa) Lidocain + Adrenalin 600 Ampul
21 04/01/2016 DKJKN-ND (silpa) Ethyl Chlorida 16 Can
22 04/01/2016 DKJKN-ND (silpa) Fuji IX Besar 7 Set
23 04/01/2016 DKJKN-ND (silpa) Bahan Untuk Pengisian Saluran Akar 3 Pot
24 04/01/2016 DKJKN-ND (silpa) Mummifying Pasta 1 Botol
25 04/01/2016 DKJKN-ND (silpa) Kalsium Hidroksida Pasta 4 Set
26 04/01/2016 DKJKN-ND (silpa) Tambalan Sementara 3 Pot
27 04/01/2016 DKJKN-ND (silpa) Devitalisasi Pasta Non Arsen 1 Botol
28 04/01/2016 DKJKN-ND (silpa) Semen Seng Fospat 2 Botol
29 04/01/2016 DKJKN-ND (silpa) Tropikal Anantesi 2 Pot
30 04/01/2016 DKJKN-ND (silpa) Silver Amalgam 2 Botol
31 04/01/2016 DKJKN-ND (silpa) Composit A1 4 tb
32 04/01/2016 DKJKN-ND (silpa) Composit A2 4 tb
33 04/01/2016 DKJKN-ND (silpa) Composit A3 4 tb
34 04/01/2016 DKJKN-ND (silpa) Composit Paket 2 Set
35 04/01/2016 DKJKN-ND (silpa) Air Raksa 2 Set
36 04/01/2016 DKJKN-ND (silpa) Rockles 3
37 04/01/2016 DKJKN-ND Amoxicillin Tablet 500 mg 83693 Tablet
38 04/01/2016 DKJKN-ND Asam Mefenamat 500 mg 26880 Tablet
39 04/01/2016 DKJKN-ND Betametason salep 233 Tube
40 04/01/2016 DKJKN-ND Glimepiride 3 mg 1000 Tablet
41 04/01/2016 DKJKN-ND Glucosa larutan inf 5% 7790 Botol
42 04/01/2016 DKJKN-ND Kloramphenicol susp 52 Botol
43 04/01/2016 DKJKN-ND Chlorpheniraminimaleat 68000 Tablet
44 04/01/2016 DKJKN-ND Mathilergometrin maleat tab 6096 Tablet
45 04/01/2016 DKJKN-ND Nacl 0.9 % 145 Botol
46 04/01/2016 DKJKN-ND piridoxin hcl tab 146665 Tablet
47 04/01/2016 DKJKN-ND Ringer Laktat larutan infus 267 Botol
48 04/01/2016 DKJKN-ND Ciprofloxacine tab 500 mg 1108 Tablet
49 04/01/2016 DKJKN-ND Paracetamol tab 500 mg 98888 Tablet
50 04/01/2016 DKJKN-ND Kaolin Pektin 7500 Tablet
51 04/01/2016 DKJKN-ND Paracetamol syr 442 Botol
52 04/01/2016 DKJKN-ND Aqua pro inj 25 ml 10 Botol
53 04/01/2016 DKJKN-ND Ambroxol syr 50 Botol
54 04/01/2016 DKJKN-ND Chloramphenicol 250 mg Capsule 120 Capsul
55 04/01/2016 DKJKN-ND Pyridoxin / vit B6 12000 Tablet
56 04/01/2016 DKJKN-ND Salbutamol 4 mg 2000 Tablet
57 04/01/2016 DKJKN-ND Sianocobalamin tab (B12) 6000 Tablet
58 04/01/2016 DKJKN-ND Sulfacetamid Natrium tetes mata 120 Botol
59 04/01/2016 DKJKN-ND Tramadol Capsul 700 Capsul
Obat Flu Kombinasi Syr / Molexflu
60 04/01/2016 DKJKN-ND Botol
syr 120
Ekspektoran kombinasi syr /
61 04/01/2016 DKJKN-ND 60 Botol
Molexdryl syr
Antitusif Kombinasi Syr / Dextral
62 04/01/2016 DKJKN-ND 120 Botol
Syr
63 04/01/2016 DKJKN-ND Neocenta / Bioplecenton 20 Tube
DKJKN-ND
64 04/01/2016 DKJKN-ND Kertas HVS 30 rim
65 04/01/2016 DKJKN-ND Spidol Permanent 30 buah
66 04/01/2016 DKJKN-ND Spidol Whitebord 10 buah
67 04/01/2016 DKJKN-ND Ball point 190 buah
68 04/01/2016 DKJKN-ND Buku Double Folio 5 buah
69 04/01/2016 DKJKN-ND Tinta Printer Hitam 810 20 buah

70 04/01/2016 DKJKN-ND Tinta Printer Warna 811 10 buah

71 04/01/2016 DKJKN-ND Tinta Printer Hitam T6641 100 buah

72 04/01/2016 DKJKN-ND Tinta Printer Hitam T6642 49 buah


73 04/01/2016 DKJKN-ND Catridge Printer Hitam 3 buah

74 04/01/2016 DKJKN-ND Penghapus Tinta Cair 9 buah


75 04/01/2016 DKJKN-ND Tissue 10 buah
76 04/01/2016 DKJKN-ND Pencil 23 buah
77 04/01/2016 DKJKN-ND (silpa) Map Plastik snelihecter buah
50
78 04/01/2016 DKJKN-ND (silpa) Box File 26 buah
79 04/01/2016 DKJKN-ND Jarum Hecting 3/8 lingkaran 10 buah

80 04/01/2016 DKJKN-ND Jarum Hecting setengah lingkaran 10 buah


81 04/01/2016 DKJKN-ND Bak Instrumen 1 buah
82 04/01/2016 DKJKN-ND Gunting benang 1 buah
83 04/01/2016 DKJKN-ND Gunting Lister 1 buah
84 04/01/2016 DKJKN-ND Korentang set 2 set
85 04/01/2016 DKJKN-ND Klem Arteri 1 buah
86 04/01/2016 DKJKN-ND Mata bor 30 buah
87 04/01/2016 DKJKN-ND Masker kain tali 576 buah
88 04/01/2016 DKJKN-ND Sarung tangan uk s 5 dus
89 04/01/2016 DKJKN-ND Sarung tangan uk m 6 dus
90 04/01/2016 DKJKN-ND Spuit 3 cc 3 dus
91 04/01/2016 DKJKN-ND Spuit 5 cc 5 dus
92 04/01/2016 DKJKN-ND Spuit 1 cc 4 dus
93 04/01/2016 DKJKN-ND Abocath 18 30 buah
94 04/01/2016 DKJKN-ND Abocath 20 40 buah
95 04/01/2016 DKJKN-ND Abocath 22 40 buah
96 04/01/2016 DKJKN-ND Infus set makro 25 buah
97 04/01/2016 DKJKN-ND Termometer Digital 6 buah
98 04/01/2016 DKJKN-ND Timbangan Injak 2 buah

Penerimaan Tahun 2016


99 16/01/2016 BOK Map Plastik 10 buah
100 16/01/2016 BOK Kertas Karton 31 lmbr
101 16/01/2016 BOK Kertas Manila 31 buah
102 16/01/2016 BOK Box File 12 buah
103 29/02/2016 BOK Kertas HVS 70 gram 36 rim
104 29/02/2016 BOK Ballpoint 155 buah
105 29/02/2016 BOK Tinta printer hitam 24 dus
106 29/02/2016 BOK Blok Note 155 buah
107 29/02/2016 BOK Buku Double folio 200 L 21 buah
108 29/02/2016 BOK Spidol 16 buah
109 24/03/2016 BOK Materai 6000 60 lmbr
110 24/03/2016 BOK Materai 3000 120 lmbr
111 30/04/2016 DKJKN-NKD Plastik Obat 1000 pak
112 30/04/2016 DKJKN-NKD Medicine Packet 1 pak
113 30/04/2016 DKJKN-NKD Tissue 120 pak
114 30/04/2016 DKJKN-NKD Kantong Obat 250 pak
115 30/04/2016 DKJKN-NKD Model Rahang Gigi 1 buah
116 30/04/2016 DKJKN-NKD Pispot 3 buah
117 30/04/2016 DKJKN-NKD Buku Resep Rawat Jalan 150 buah
118 30/04/2016 DKJKN-NKD Kir Sehat 5 buku
119 30/04/2016 DKJKN-NKD Kartu Rekamedis Pasien 1800 buah
120 30/04/2016 DKJKN-NKD Kartu Identitas berobat 3487 buah
121 30/04/2016 DKJKN-NKD Buku Register Rawat Jalan 2 buku
122 30/04/2016 DKJKN-NKD Buku Kas Sejenis 4 buku
123 30/04/2016 DKJKN-NKD Buku Salinan Resep BPJS 12 buku
124 30/04/2016 DKJKN-NKD Buku SSP 10 buku
125 30/04/2016 DKJKN-NKD Amplop Cetak Kop surat 10 pak
126 25/07/2016 DKJKN-NKD Asam Urat 1 kit
127 25/07/2016 DKJKN-NKD Cholesterol 1 kit
128 25/07/2016 DKJKN-NKD Creatinin 1 kit
129 25/07/2016 DKJKN-NKD Glukosa 1 kit
130 25/07/2016 DKJKN-NKD Golongan darah (anti A dan anti B) 1 paket
131 25/07/2016 DKJKN-NKD Golongan darah (anti D dan anti AB) 1 paket
132 25/07/2016 DKJKN-NKD HB Quick-Chek 1 box
133 25/07/2016 DKJKN-NKD Hemoglobin 1 kit
134 25/07/2016 DKJKN-NKD Reagen urine analyzer 1 kit
135 25/07/2016 DKJKN-NKD SGOT 1 kit
136 25/07/2016 DKJKN-NKD SGPT 1 kit
137 25/07/2016 DKJKN-NKD Stik Asam Urat 10 tube
138 25/07/2016 DKJKN-NKD Stik Cholesterol 17 tube
139 25/07/2016 DKJKN-NKD Stik Glukosa 15 tube
140 25/07/2016 DKJKN-NKD Stik Hb 20 box
141 25/07/2016 DKJKN-NKD Stik urine 3 parameter 5 box
142 25/07/2016 DKJKN-NKD Tes kehamilan 300 pcs
143 25/07/2016 DKJKN-NKD Trigliserida 1 kit
144 25/07/2016 DKJKN-NKD Ureum 1 kit
145 25/07/2016 DKJKN-NKD Widal 2 set
146 01/08/2016 DKJKN-NKD Kertas HVS F4 141 rim
147 01/08/2016 DKJKN-NKD Spidol Permanent 33 buah
148 01/08/2016 DKJKN-NKD Ball point 421 buah
149 01/08/2016 DKJKN-NKD Spidol Whitebord 10 buah
150 01/08/2016 DKJKN-NKD Pensil 44 buah
151 01/08/2016 DKJKN-NKD Penghapus Tinta Cair 10 buah
152 01/08/2016 DKJKN-NKD Buku Double Folio 5 buah
153 01/08/2016 DKJKN-NKD Tinta Printer Hitam 15 buah
154 01/08/2016 DKJKN-NKD Tinta Printer Warna 10 buah
155 01/08/2016 DKJKN-NKD Tinta Printer Hitam 50 buah
156 01/08/2016 DKJKN-NKD Tinta Printer Warna 27 buah
157 01/08/2016 DKJKN-NKD Sapu injuk 20 buah
158 01/08/2016 DKJKN-NKD Sapu Lidi 20 buah
159 01/08/2016 DKJKN-NKD Pengki 10 buah
160 01/08/2016 DKJKN-NKD Kemoceng 10 buah
161 01/08/2016 DKJKN-NKD Kesed kecil 50 buah
162 01/08/2016 DKJKN-NKD Kesed besar 5 buah
163 01/08/2016 DKJKN-NKD Tempat sampah tertutup kecil 20 buah
164 01/08/2016 DKJKN-NKD Tempat sampah tertutup sedang 20 buah
165 01/08/2016 DKJKN-NKD Sabun cuci tangan 50 bungkus
166 01/08/2016 DKJKN-NKD Sabun cuci piring 50 bungkus
167 01/08/2016 DKJKN-NKD Detergent 50 buah
168 01/08/2016 DKJKN-NKD Alat pel lantai karet 5 buah
169 01/08/2016 DKJKN-NKD Alat pel lantai karet 20 buah
170 01/08/2016 DKJKN-NKD Lap kaca 5 buah
171 01/08/2016 DKJKN-NKD Lysol 25 botol
172 01/08/2016 DKJKN-NKD Pembersih Lantai 50 botol
173 01/08/2016 DKJKN-NKD Pembersih Kaca 25 bungkus
174 01/08/2016 DKJKN-NKD Pewangi Ruangan 25 buah
175 01/08/2016 DKJKN-NKD Lampu 5 watt 75 buah
176 01/08/2016 DKJKN-NKD Lampu 18 watt 100 buah
177 01/08/2016 DKJKN-NKD Lampu LED 10 watt 25 buah
178 01/08/2016 DKJKN-NKD Lampu Neon panjang 50 buah
179 01/08/2016 DKJKN-NKD Terminal kabel 8 buah
180 23/09/2016 DKJKN-NKD Kain Batik 900 meter
181 15/10/2016 DKJKN-NKD Benang Silk 5 box
182 15/10/2016 DKJKN-NKD Cutget 1.5 m 3 unit
183 15/10/2016 DKJKN-NKD Sarung tangan ukuran S 25 box
184 15/10/2016 DKJKN-NKD Sarung tangan steril ukuran no 7 250 pasang
185 15/10/2016 DKJKN-NKD Sarung tangan steril ukuran no 7.5 250 pasang
186 15/10/2016 DKJKN-NKD Needle 10 box
187 15/10/2016 DKJKN-NKD Jarum Citoject 3 box
188 15/10/2016 DKJKN-NKD Spuit 3 cc 50 box
189 15/10/2016 DKJKN-NKD Spuit 5 cc 15 box
190 15/10/2016 DKJKN-NKD Spuit 10 cc 2 box
191 15/10/2016 DKJKN-NKD Spuit 1 cc 5 box
192 15/10/2016 DKJKN-NKD Abocath no 18 100 pcs
193 15/10/2016 DKJKN-NKD Abocath no 20 400 pcs
194 15/10/2016 DKJKN-NKD Abocath no 22 400 pcs
195 15/10/2016 DKJKN-NKD Abocath no 24 100 pcs
196 15/10/2016 DKJKN-NKD Infuset Makro 200 pcs
197 15/10/2016 DKJKN-NKD Decglass 5 btl
198 15/10/2016 DKJKN-NKD Yellow tape 1 bag
199 15/10/2016 DKJKN-NKD Blue tape 1 bag
200 15/10/2016 DKJKN-NKD White tape 1 bag
201 15/10/2016 DKJKN-NKD Blood Lancet 6 pcs
202 15/10/2016 DKJKN-NKD Kacamata Pelindung 4 buah
203 15/10/2016 DKJKN-NKD Tabung EDTA 6 pack
204 15/10/2016 DKJKN-NKD Tabung Non EDTA 6 pack
205 15/10/2016 DKJKN-NKD Tabung reaksi 3 ml 200 pcs
206 15/10/2016 DKJKN-NKD Gunting jaringan 6 buah
207 15/10/2016 DKJKN-NKD Abocath no 26 50 pcs
208 15/10/2016 DKJKN-NKD NGT 8 20 pcs
209 15/10/2016 DKJKN-NKD Kapas Gulung 500 gr 2 buah
210 15/10/2016 DKJKN-NKD Kapas Gulung Besar 5 buah
211 18/10/2016 DKJKN-NKD Buku Resep Rawat Jalan 150 buku
212 18/10/2016 DKJKN-NKD Kir Sehat 5 buku
213 18/10/2016 DKJKN-NKD Kartu Rekamedis Pasien 1813 buah
214 18/10/2016 DKJKN-NKD Buku Register Rawat Jalan 2 buku
215 18/10/2016 DKJKN-NKD Buku Kas Sejenis 4 buku
216 18/10/2016 DKJKN-NKD Buku Salinan Resep BPJS 12 buku
217 18/10/2016 DKJKN-NKD Amplop Cetak Kop Surat 10 pak
218 18/10/2016 DKJKN-NKD Silpa Buku Ontang Anting Kegiatan 55 buku
219 25/10/2016 DKJKN-NKD Map biasa 240 buah
220 25/10/2016 DKJKN-NKD Map Plastik snelihecter 120 buah
221 25/10/2016 DKJKN-NKD Binder Klip Kecil 50 buah
222 25/10/2016 DKJKN-NKD Binder Klip Sedang 50 buah
223 25/10/2016 DKJKN-NKD Binder Klip Besar 19 buah
224 25/10/2016 DKJKN-NKD Map ordner 20 buah
225 25/10/2016 DKJKN-NKD Steples sedang 100 buah
226 25/10/2016 DKJKN-NKD Flasdish 25 buah
227 25/10/2016 DKJKN-NKD Gunting 10 buah
228 25/10/2016 DKJKN-NKD Amplop 95x152 mm 100 buah
229 25/10/2016 DKJKN-NKD Catridge printer hitam 6 buah
230 25/10/2016 DKJKN-NKD Handuk Kecil 50 buah
231 25/10/2016 DKJKN-NKD Gelas melamin 20 buah
232 25/10/2016 DKJKN-NKD Baki melamin 20 buah
233 25/10/2016 DKJKN-NKD Lap tangan 25 buah
234 25/10/2016 DKJKN-NKD Tempat tissue 20 buah
235 25/10/2016 DKJKN-NKD Taplak meja 30 buah
236 28/11/2016 DKJKN-ND Plastik Obat 1000 pak
237 28/11/2016 DKJKN-ND Medicine Packet 1 pak
238 28/11/2016 DKJKN-ND Tissue 120 pak
239 28/11/2016 DKJKN-ND Kantong Obat 250 pak
240 28/11/2016 DKJKN-ND Model Rahang Gigi 1 buah
241 28/11/2016 DKJKN-ND Pispot 3 buah

242 26/12/2016 DKJKN-ND Amboxol tab 5000 Tab


243 26/12/2016 DKJKN-ND Bioplacenon 50 Tube
244 26/12/2016 DKJKN-ND Bond Solore 3 Pcs
245 26/12/2016 DKJKN-ND Cazetin Drop 30 Botol
246 26/12/2016 DKJKN-ND Chlorethyl 12 Pcs
247 26/12/2016 DKJKN-ND Ciprofloxacine 10000 Tab
248 26/12/2016 DKJKN-ND Citicetin syr 300 Botol
249 26/12/2016 DKJKN-ND Dapyrin syr 1000 Botol
250 26/12/2016 DKJKN-ND Dionicol 500 mg 2000 Caps
251 26/12/2016 DKJKN-ND Erlamycetin T telinga 240 Botol
252 26/12/2016 DKJKN-ND Folising Finising 3 Pcs
253 26/12/2016 DKJKN-ND Fuji IX 4 Pcs
254 26/12/2016 DKJKN-ND Grantusif tab 5000 Kaplet
255 26/12/2016 DKJKN-ND H2O2 6 pcs
256 26/12/2016 DKJKN-ND Histigo 900 Tab
257 26/12/2016 DKJKN-ND Hufagrif F 5000 Kaplet
258 26/12/2016 DKJKN-ND Kaotin 250 Botol
259 26/12/2016 DKJKN-ND Komposit Light Curing ( A1 merk 3M 2 Syringe
260 26/12/2016 DKJKN-ND Komposit Light Curing ( A2 merk 3M 2 Syringe
261 26/12/2016 DKJKN-ND Komposit Light Curing ( A3 merk 3M 2 Syringe
262 26/12/2016 DKJKN-ND Meloxicam 15 Mg 2000 Tab
263 26/12/2016 DKJKN-ND Meloxicam 7.5 Mg 1000 Tab
264 26/12/2016 DKJKN-ND Musin tab 750 Tab
265 26/12/2016 DKJKN-ND Neo - k 200 Ampul
266 26/12/2016 DKJKN-ND Neurosanbe Inj 100 Ampul
267 26/12/2016 DKJKN-ND Omegdiar 20000 Tab
268 26/12/2016 DKJKN-ND Ondansetron Inj 200 Ampul
269 26/12/2016 DKJKN-ND Opistan 500 mg 30000 Kaplet
270 26/12/2016 DKJKN-ND Pehacain Inj 720 Ampul
271 26/12/2016 DKJKN-ND Pinkids syr 440 Botol
272 26/12/2016 DKJKN-ND Piroxicam 20 mg 3000 tab
273 26/12/2016 DKJKN-ND Santocyn Inj 100 Ampul
274 26/12/2016 DKJKN-ND Prednison Tab 20000 Tab
275 26/12/2016 DKJKN-ND Propepsa syr 50 Botol
276 26/12/2016 DKJKN-ND Recco T. Mata 480 Botol
277 26/12/2016 DKJKN-ND Salep 24 3600 Tube
278 26/12/2016 DKJKN-ND Spasminal 1000 Tab
279 26/12/2016 DKJKN-ND Terycortin SK 480 Tube
280 26/12/2016 DKJKN-ND Curcuma Tablet 1430 Tab
281 26/12/2016 DKJKN-ND Lacto B 560 Sachet
282 26/12/2016 DKJKN-ND Tooth Stain Remover 10 Pcs

Jumlah Penerimaan 2016


TOTAL SISA 2015 + PENERIMAAN 2016

Mengetahui
Kepala UPTD Puskesmas Cibeureum

drg. Titin Hajari


NIP : 19771122 200312 2 003
ARANG PAKAI HABIS 2016
Bukti Penerimaan
Harga Satuan Jumlah Harga B.A Penerimaan Ket.
Nomor Tanggal
8 9 10 11 12

3100 1,860,000.00 447/442/PKM-CBR/2015 05/12/2015


168 1,848,000.00 447/442/PKM-CBR/2015 05/12/2015
2750 550,000.00 447/442/PKM-CBR/2015 05/12/2015
3144 1,729,200.00 447/442/PKM-CBR/2015 05/12/2015
3000 9,300,000.00 447/442/PKM-CBR/2015 05/12/2015
32 5,760,000.00 447/442/PKM-CBR/2015 05/12/2015
7000 3,703,000.00 447/442/PKM-CBR/2015 05/12/2015
3000 1,464,000.00 447/442/PKM-CBR/2015 05/12/2015
8790 4,395,000.00 447/442/PKM-CBR/2015 05/12/2015
11000 4,400,000.00 447/442/PKM-CBR/2015 05/12/2015
7500 5,250,000.00 447/442/PKM-CBR/2015 05/12/2015
558 4,464,000.00 447/442/PKM-CBR/2015 05/12/2015
531 4,248,000.00 447/442/PKM-CBR/2015 05/12/2015
3300 3,630,000.00 447/442/PKM-CBR/2015 05/12/2015
2000 3,700,000.00 447/442/PKM-CBR/2015 05/12/2015
110 5,500,000.00 447/442/PKM-CBR/2015 05/12/2015
44 1,760,000.00 447/442/PKM-CBR/2015 05/12/2015
48 4,800,000.00 447/442/PKM-CBR/2015 05/12/2015
660 10,560,000.00 447/442/PKM-CBR/2015 05/12/2015
3113 1,867,800.00 447/442/PKM-CBR/2015 05/12/2015
115000 1,840,000.00 447/442/PKM-CBR/2015 05/12/2015
770000 5,390,000.00 447/442/PKM-CBR/2015 05/12/2015
687500 2,062,500.00 447/442/PKM-CBR/2015 05/12/2015
268000 268,000.00 447/442/PKM-CBR/2015 05/12/2015
290000 1,160,000.00 447/442/PKM-CBR/2015 05/12/2015
200000 600,000.00 447/442/PKM-CBR/2015 05/12/2015
462000 462,000.00 447/442/PKM-CBR/2015 05/12/2015
175000 350,000.00 447/442/PKM-CBR/2015 05/12/2015
175000 350,000.00 447/442/PKM-CBR/2015 05/12/2015
400000 800,000.00 447/442/PKM-CBR/2015 05/12/2015
510000 2,040,000.00 447/442/PKM-CBR/2015 05/12/2015
510000 2,040,000.00 447/442/PKM-CBR/2015 05/12/2015
510000 2,040,000.00 447/442/PKM-CBR/2015 05/12/2015
1650000 3,300,000.00 447/442/PKM-CBR/2015 05/12/2015
500000 1,000,000.00 447/442/PKM-CBR/2015 05/12/2015
735000 2,205,000.00 447/442/PKM-CBR/2015 05/12/2015
485 40,591,105.00 447/426/PKM-CBR/2015 11/12/2015
223 5,994,240.00 447/426/PKM-CBR/2015 11/12/2015
3749 873,517.00 447/426/PKM-CBR/2015 11/12/2015
318 318,000.00 447/426/PKM-CBR/2015 11/12/2015
67 521,930.00 447/426/PKM-CBR/2015 11/12/2015
7077 368,004.00 447/426/PKM-CBR/2015 11/12/2015
75 5,100,000.00 447/426/PKM-CBR/2015 11/12/2015
243 1,481,328.00 447/426/PKM-CBR/2015 11/12/2015
7790 1,129,550.00 447/426/PKM-CBR/2015 11/12/2015
36 5,279,940.00 447/426/PKM-CBR/2015 11/12/2015
7790 2,079,930.00 447/426/PKM-CBR/2015 11/12/2015
693 767,844.00 447/426/PKM-CBR/2015 11/12/2015
135 13,349,880.00 447/426/PKM-CBR/2015 11/12/2015
200 1,500,000.00 447/426/PKM-CBR/2015 11/12/2015
3904 1,725,568.00 447/426/PKM-CBR/2015 11/12/2015
6050 60,500.00 447/426/PKM-CBR/2015 11/12/2015
3,300.00 165,000.00 447/426/PKM-CBR/2015 11/12/2015
310.20 37,224.00 447/426/PKM-CBR/2015 11/12/2015
23.10 277,200.00 447/426/PKM-CBR/2015 11/12/2015
96.80 193,600.00 447/426/PKM-CBR/2015 11/12/2015
18.70 112,200.00 447/426/PKM-CBR/2015 11/12/2015
3,950.10 474,012.00 447/426/PKM-CBR/2015 11/12/2015
354.20 247,940.00 447/426/PKM-CBR/2015 11/12/2015
10,670.00 1,280,400.00 447/426/PKM-CBR/2015
11/12/2015
9,680.00 580,800.00 447/426/PKM-CBR/2015 11/12/2015
10,000.10 1,200,012.00 447/426/PKM-CBR/2015 11/12/2015 -
17,900.30 358,006.00 447/426/PKM-CBR/2015 11/12/2015
Jumlah 192,764,230.00
57,500.00 1,725,000.00 954/47/CBR/VII/2015 31/07/2015
8,000.00 240,000.00 954/47/CBR/VII/2015 31/07/2015
10,000.00 100,000.00 954/47/CBR/VII/2015 31/07/2015
4,000.00 760,000.00 954/47/CBR/VII/2015 31/07/2015
50,000.00 250,000.00 954/47/CBR/VII/2015 31/07/2015
52,000.00 1,040,000.00 954/47/CBR/VII/2015
31/07/2015
58,000.00 580,000.00 954/47/CBR/VII/2015
31/07/2015
120,000.00 12,000,000.00 954/47/CBR/VII/2015
31/07/2015
120,000.00 5,880,000.00 954/47/CBR/VII/2015
31/07/2015
250,000.00 750,000.00 954/47/CBR/VII/2015
31/07/2015
10,000.00 90,000.00 954/47/CBR/VII/2015
31/07/2015
20,000.00 200,000.00 954/47/CBR/VII/2015 31/07/2015
5,000.00 115,000.00 954/358/CBR/VII/2015 04/11/2015
500,000.00 954/358/CBR/VII/2015
10,000.00 04/11/2015
40,000.00 1,040,000.00 954/358/CBR/VII/2015 04/11/2015
41,000.00 410,000.00 954/451/XII/2015
15/12/2015
41,000.00 410,000.00 954/451/XII/2015
15/12/2015
221,000.00 221,000.00 954/451/XII/2015 15/12/2015
46,000.00 46,000.00 954/451/XII/2015 15/12/2015
45,000.00 45,000.00 954/451/XII/2015 15/12/2015
200,000.00 400,000.00 954/451/XII/2015 15/12/2015
45,000.00 45,000.00 954/451/XII/2015 15/12/2015
30,000.00 900,000.00 954/451/XII/2015 15/12/2015
5,000.00 2,880,000.00 954/451/XII/2015 15/12/2015
45,000.00 225,000.00 954/451/XII/2015 15/12/2015
45,000.00 270,000.00 954/451/XII/2015 15/12/2015
80,000.00 240,000.00 954/451/XII/2015 15/12/2015
130,000.00 650,000.00 954/451/XII/2015 15/12/2015
434,000.00 1,736,000.00 954/451/XII/2015 15/12/2015
14,000.00 420,000.00 954/451/XII/2015 15/12/2015
14,000.00 560,000.00 954/451/XII/2015 15/12/2015
14,000.00 560,000.00 954/451/XII/2015 15/12/2015
6,435.00 160,875.00 954/451/XII/2015 15/12/2015
70,000.00 420,000.00 954/451/XII/2015 15/12/2015
120,000.00 240,000.00 954/451/XII/2015 15/12/2015
Jumlah 36,108,875.00
total 228,873,105.00

7,900.00 79,000.00 027/4/CBR/2016 16/01/2016


4,000.00 124,000.00 027/4/CBR/2016 16/01/2016
13,900.00 430,900.00 027/4/CBR/2016 16/01/2016
14,000.00 168,000.00 027/4/CBR/2016 16/01/2016
57,500.00 2,070,000.00 027/48/CBR/2016 29/02/2016
1,600.00 248,000.00 027/48/CBR/2016 29/02/2016
52,000.00 1,248,000.00 027/48/CBR/2016 29/02/2016
4,500.00 697,500.00 027/48/CBR/2016 29/02/2016
53,000.00 1,113,000.00 027/48/CBR/2016 29/02/2016
8,000.00 128,000.00 027/48/CBR/2016 29/02/2016
8,500.00 510,000.00 027/55/CBR/2016 24/03/2016
4,000.00 480,000.00 027/55/CBR/2016 24/03/2016
10,500.00 10,500,000.00 900/16/CBR/IV/2016 30/04/2016
4,000,000.00 4,000,000.00 900/16/CBR/IV/2016 30/04/2016
20,000.00 2,400,000.00 900/16/CBR/IV/2016 30/04/2016
8,000.00 2,000,000.00 900/16/CBR/IV/2016 30/04/2016
234,000.00 234,000.00 900/16/CBR/IV/2016 30/04/2016
70,000.00 210,000.00 900/16/CBR/IV/2016 30/04/2016
15,300.00 2,295,000.00 900/12/CBR/IV/206 30/04/2016
21,500.00 107,500.00 900/12/CBR/IV/206 30/04/2016
1,000.00 1,800,000.00 900/12/CBR/IV/206 30/04/2016
220.00 767,140.00 900/12/CBR/IV/206 30/04/2016
124,000.00 248,000.00 900/12/CBR/IV/206 30/04/2016
48,000.00 192,000.00 900/12/CBR/IV/206 30/04/2016
15,000.00 180,000.00 900/12/CBR/IV/206 30/04/2016
35,300.00 353,000.00 900/12/CBR/IV/206 30/04/2016
70,000.00 700,000.00 900/12/CBR/IV/206 30/04/2016
352,000.00 352,000.00 900/42/CBR/VII/2016 25/07/2016
390,000.00 390,000.00 900/42/CBR/VII/2016 25/07/2016
540,000.00 540,000.00 900/42/CBR/VII/2016 25/07/2016
310,000.00 310,000.00 900/42/CBR/VII/2016 25/07/2016
590,000.00 590,000.00 900/42/CBR/VII/2016 25/07/2016
590,000.00 590,000.00 900/42/CBR/VII/2016 25/07/2016
698,000.00 698,000.00 900/42/CBR/VII/2016 25/07/2016
525,000.00 525,000.00 900/42/CBR/VII/2016 25/07/2016
805,000.00 805,000.00 900/42/CBR/VII/2016 25/07/2016
360,000.00 360,000.00 900/42/CBR/VII/2016 25/07/2016
360,000.00 360,000.00 900/42/CBR/VII/2016 25/07/2016
130,000.00 1,300,000.00 900/42/CBR/VII/2016 25/07/2016
200,000.00 3,400,000.00 900/42/CBR/VII/2016 25/07/2016
130,000.00 1,950,000.00 900/42/CBR/VII/2016 25/07/2016
234,000.00 4,680,000.00 900/42/CBR/VII/2016 25/07/2016
78,000.00 390,000.00 900/42/CBR/VII/2016 25/07/2016
10,000.00 3,000,000.00 900/42/CBR/VII/2016 25/07/2016
2,110,000.00 2,110,000.00 900/42/CBR/VII/2016 25/07/2016
470,000.00 470,000.00 900/42/CBR/VII/2016 25/07/2016
1,630,000.00 3,260,000.00 900/42/CBR/VII/2016 25/07/2016
55,000.00 7,755,000.00 900/64/CBR/VIII/2016 01/08/2016
8,000.00 264,000.00 900/64/CBR/VIII/2016 01/08/2016
4,000.00 1,684,000.00 900/64/CBR/VIII/2016 01/08/2016
10,000.00 100,000.00 900/64/CBR/VIII/2016 01/08/2016
5,000.00 220,000.00 900/64/CBR/VIII/2016 01/08/2016
10,000.00 100,000.00 900/64/CBR/VIII/2016 01/08/2016
50,000.00 250,000.00 900/64/CBR/VIII/2016 01/08/2016
52,000.00 780,000.00 900/64/CBR/VIII/2016 01/08/2016
58,000.00 580,000.00 900/64/CBR/VIII/2016 01/08/2016
120,000.00 6,000,000.00 900/64/CBR/VIII/2016 01/08/2016
120,000.00 3,240,000.00 900/64/CBR/VIII/2016 01/08/2016
26,000.00 520,000.00 900/68/CBR/VIII/2016 01/08/2016
10,000.00 200,000.00 900/68/CBR/VIII/2016 01/08/2016
20,000.00 200,000.00 900/68/CBR/VIII/2016 01/08/2016
16,000.00 160,000.00 900/68/CBR/VIII/2016 01/08/2016
20,000.00 1,000,000.00 900/68/CBR/VIII/2016 01/08/2016
250,000.00 1,250,000.00 900/68/CBR/VIII/2016 01/08/2016
46,000.00 920,000.00 900/68/CBR/VIII/2016 01/08/2016
145,000.00 2,900,000.00 900/68/CBR/VIII/2016 01/08/2016
18,000.00 900,000.00 900/68/CBR/VIII/2016 01/08/2016
14,000.00 700,000.00 900/68/CBR/VIII/2016 01/08/2016
7,000.00 350,000.00 900/68/CBR/VIII/2016 01/08/2016
80,000.00 400,000.00 900/68/CBR/VIII/2016 01/08/2016
54,000.00 1,080,000.00 900/68/CBR/VIII/2016 01/08/2016
47,000.00 235,000.00 900/68/CBR/VIII/2016 01/08/2016
21,000.00 525,000.00 900/68/CBR/VIII/2016 01/08/2016
19,000.00 950,000.00 900/68/CBR/VIII/2016 01/08/2016
13,000.00 325,000.00 900/68/CBR/VIII/2016 01/08/2016
40,000.00 1,000,000.00 900/68/CBR/VIII/2016 01/08/2016
30,000.00 2,250,000.00 900/72/CBR/VIII/2016 01/08/2016
45,000.00 4,500,000.00 900/72/CBR/VIII/2016 01/08/2016
80,000.00 2,000,000.00 900/72/CBR/VIII/2016 01/08/2016
50,000.00 2,500,000.00 900/72/CBR/VIII/2016 01/08/2016
100,000.00 800,000.00 900/72/CBR/VIII/2016 01/08/2016
37,000.00 33,300,000.00 900/212/CBR/IX/2016 23/09/2016
251,000.00 1,255,000.00 900/258/CBR/X/2016 15/10/2016
30,000.00 90,000.00 900/258/CBR/X/2016 15/10/2016
65,000.00 1,625,000.00 900/258/CBR/X/2016 15/10/2016
10,000.00 2,500,000.00 900/258/CBR/X/2016 15/10/2016
10,000.00 2,500,000.00 900/258/CBR/X/2016 15/10/2016
65,000.00 650,000.00 900/258/CBR/X/2016 15/10/2016
130,000.00 390,000.00 900/258/CBR/X/2016 15/10/2016
130,000.00 6,500,000.00 900/258/CBR/X/2016 15/10/2016
218,750.00 3,281,250.00 900/258/CBR/X/2016 15/10/2016
175,000.00 350,000.00 900/258/CBR/X/2016 15/10/2016
260,000.00 1,300,000.00 900/258/CBR/X/2016 15/10/2016
17,550.00 1,755,000.00 900/258/CBR/X/2016 15/10/2016
17,550.00 7,020,000.00 900/258/CBR/X/2016 15/10/2016
17,550.00 7,020,000.00 900/258/CBR/X/2016 15/10/2016
17,550.00 1,755,000.00 900/258/CBR/X/2016 15/10/2016
10,000.00 2,000,000.00 900/258/CBR/X/2016 15/10/2016
113,200.00 566,000.00 900/258/CBR/X/2016 15/10/2016
145,769.00 145,769.00 900/258/CBR/X/2016 15/10/2016
290,400.00 290,400.00 900/258/CBR/X/2016 15/10/2016
309,760.00 309,760.00 900/258/CBR/X/2016 15/10/2016
65,000.00 390,000.00 900/258/CBR/X/2016 15/10/2016
200,000.00 800,000.00 900/258/CBR/X/2016 15/10/2016
200,000.00 1,200,000.00 900/258/CBR/X/2016 15/10/2016
200,000.00 1,200,000.00 900/258/CBR/X/2016 15/10/2016
4,000.00 800,000.00 900/258/CBR/X/2016 15/10/2016
50,000.00 300,000.00 900/258/CBR/X/2016 15/10/2016
17,550.00 877,500.00 900/258/CBR/X/2016 15/10/2016
260,000.00 5,200,000.00 900/258/CBR/X/2016 15/10/2016
50,000.00 100,000.00 900/262/CBR/X/2016 15/10/2016
140,000.00 700,000.00 900/262/CBR/X/2016 15/10/2016
15,300.00 2,295,000.00 900/268/CBR/X/2016 18/10/2016
21,500.00 107,500.00 900/268/CBR/X/2016 18/10/2016
1,000.00 1,813,000.00 900/268/CBR/X/2016 18/10/2016
124,000.00 248,000.00 900/268/CBR/X/2016 18/10/2016
48,000.00 192,000.00 900/268/CBR/X/2016 18/10/2016
15,000.00 180,000.00 900/268/CBR/X/2016 18/10/2016
70,000.00 700,000.00 900/268/CBR/X/2016 18/10/2016
20,000.00 1,100,000.00 900/271/CBR/X/2016 18/10/2016
2,000.00 480,000.00 900/284/CBR/X/2016 25/10/2016
10,000.00 1,200,000.00 900/284/CBR/X/2016 25/10/2016
2,200.00 110,000.00 900/284/CBR/X/2016 25/10/2016
3,500.00 175,000.00 900/284/CBR/X/2016 25/10/2016
5,000.00 95,000.00 900/284/CBR/X/2016 25/10/2016
28,900.00 578,000.00 900/284/CBR/X/2016 25/10/2016
19,000.00 1,900,000.00 900/284/CBR/X/2016 25/10/2016
150,000.00 3,750,000.00 900/284/CBR/X/2016 25/10/2016
10,000.00 100,000.00 900/284/CBR/X/2016 25/10/2016
15,000.00 1,500,000.00 900/284/CBR/X/2016 25/10/2016
250,000.00 1,500,000.00 900/284/CBR/X/2016 25/10/2016
25,000.00 1,250,000.00 900/279/CBR/X/2016 25/10/2016
20,000.00 400,000.00 900/279/CBR/X/2016 25/10/2016
30,000.00 600,000.00 900/279/CBR/X/2016 25/10/2016
27,000.00 675,000.00 900/279/CBR/X/2016 25/10/2016
30,000.00 600,000.00 900/279/CBR/X/2016 25/10/2016
40,000.00 1,200,000.00 900/279/CBR/X/2016 25/10/2016
10,500.00 10,500,000.00 900/332/CBR/XI/2016 28/11/2016
4,000,000.00 4,000,000.00 900/332/CBR/XI/2016 28/11/2016
20,000.00 2,400,000.00 900/332/CBR/XI/2016 28/11/2016
8,000.00 2,000,000.00 900/332/CBR/XI/2016 28/11/2016
234,000.00 234,000.00 900/332/CBR/XI/2016 28/11/2016
70,000.00 210,000.00 900/332/CBR/XI/2016 28/11/2016
Jumlah 234,264,219.00
209.00 1,045,000.00 900/386/CBR/XII/2016 26/12/2016
17,600.00 880,000.00 900/386/CBR/XII/2016 26/12/2016
1,170,696.00 3,512,088.00 900/386/CBR/XII/2016 26/12/2016
24,421.00 732,630.00 900/386/CBR/XII/2016 26/12/2016
150,000.00 1,800,000.00 900/386/CBR/XII/2016 26/12/2016
421.00 4,210,000.00 900/386/CBR/XII/2016 26/12/2016
6,375.00 1,912,500.00 900/386/CBR/XII/2016 26/12/2016
6,366.00 6,366,000.00 900/386/CBR/XII/2016 26/12/2016
950.00 1,900,000.00 900/386/CBR/XII/2016 26/12/2016
6,609.00 1,586,160.00 900/386/CBR/XII/2016 26/12/2016
185,000.00 555,000.00 900/386/CBR/XII/2016 26/12/2016
1,350,000.00 5,400,000.00 900/386/CBR/XII/2016 26/12/2016
425.00 2,125,000.00 900/386/CBR/XII/2016 26/12/2016
50,000.00 300,000.00 900/386/CBR/XII/2016 26/12/2016
694.00 624,600.00 900/386/CBR/XII/2016 26/12/2016
320.00 1,600,000.00 900/386/CBR/XII/2016 26/12/2016
5,025.00 1,256,250.00 900/386/CBR/XII/2016 26/12/2016
800,001.00 1,600,002.00 900/386/CBR/XII/2016 26/12/2016
800,000.00 1,600,000.00 900/386/CBR/XII/2016 26/12/2016
800,000.00 1,600,000.00 900/386/CBR/XII/2016 26/12/2016
679.00 1,358,000.00 900/386/CBR/XII/2016 26/12/2016
523.00 523,000.00 900/386/CBR/XII/2016 26/12/2016
2,250.00 1,687,500.00 900/386/CBR/XII/2016 26/12/2016
8,420.00 1,684,000.00 900/386/CBR/XII/2016 26/12/2016
6,275.00 627,500.00 900/386/CBR/XII/2016 26/12/2016
141.10 2,822,000.00 900/386/CBR/XII/2016 26/12/2016
5,600.00 1,120,000.00 900/386/CBR/XII/2016 26/12/2016
295.00 8,850,000.00 900/386/CBR/XII/2016 26/12/2016
4,204.00 3,026,880.00 900/386/CBR/XII/2016 26/12/2016
5,749.00 2,529,560.00 900/386/CBR/XII/2016 26/12/2016
258.00 774,000.00 900/386/CBR/XII/2016 26/12/2016
9,300.00 930,000.00 900/386/CBR/XII/2016 26/12/2016
147.00 2,940,000.00 900/386/CBR/XII/2016 26/12/2016
51,454.00 2,572,700.00 900/386/CBR/XII/2016 26/12/2016
8,983.00 4,311,840.00 900/386/CBR/XII/2016 26/12/2016
4,493.00 16,174,800.00 900/386/CBR/XII/2016 26/12/2016
640.00 640,000.00 900/386/CBR/XII/2016 26/12/2016
6,688.00 3,210,240.00 900/386/CBR/XII/2016 26/12/2016
1,200.00 1,716,000.00 900/386/CBR/XII/2016 26/12/2016
5,000.00 2,800,000.00 900/386/CBR/XII/2016 26/12/2016
209,675.00 2,096,750.00 900/386/CBR/XII/2016 26/12/2016
Jumlah 103,000,000.00
337,264,219.00
566,137,324.00

Tasikmalaya, 31 Desember 2016

Penyimpan Barang

Entis Sutisna
NIP : 1969228 199103 1 805
SKPD : UPTD PUSKESMAS CIBEUREUM
KOTA : TASIKMALAYA
PROVINSI : JAWA BARAT

BUKU PENGELUARAN BARANG PAKA


Nomor
No Tanggal Nama Barang Banyaknya Harga Satuan
urut
1 2 3 4 5 6
1 04/01/2016 Ambroxol Syr 15 mg 600 Botol 3100
2 04/01/2016 Ambroxol 30 mg tab 11000 Tablet 168
3 04/01/2016 Antifungi 200 Pot 2750
4 04/01/2016 Asiklovir cream 504 Tube 3144
5 04/01/2016 Gentamicyn sk 2753 Tube 3000
6 04/01/2016 Gliceril Guaiacolat 100 mg 136000 Tablet 32
7 04/01/2016 Chloramphenicol Tetes mata 529 Fls 7000
8 04/01/2016 Chloramphenicol Tetes Telinga 488 Fls 3000
9 04/01/2016 Multivitamin syr 500 Botol 8790
10 04/01/2016 Obat Flu Kombinasi syr 400 Botol 11000
11 04/01/2016 Obat Batuk Anak/bayi 700 Botol 7500
12 04/01/2016 Obat Batuk Flu Tab Kombinasi 8000 Tablet 558
13 04/01/2016 Obat Batuk Antitusif 8000 Tablet 531
14 04/01/2016 Obat Batuk Hitam 1028 Botol 3300
15 04/01/2016 Oxytetracycline Sk 1850 Tube 2000
16 04/01/2016 Prednison Tab 50000 Tablet 110
17 04/01/2016 Saccharin Tab 40000 Tablet 44
18 04/01/2016 Tiamin hcl 50 mg 69000 Tablet 48
19 04/01/2016 Vitamin Neutripik 16000 Kaplet 660
20 04/01/2016 Lidocain + Adrenalin 420 Ampul 3113
21 04/01/2016 Ethyl Chlorida 16 Can 115000
22 04/01/2016 Fuji IX Besar 7 Set 770000
23 04/01/2016 Bahan Untuk Pengisian Saluran Akar 3 Pot 687500
24 04/01/2016 Mummifying Pasta 1 Botol 268000
25 04/01/2016 Kalsium Hidroksida Pasta 4 Set 290000
26 04/01/2016 Tambalan Sementara 3 Pot 200000
27 04/01/2016 Devitalisasi Pasta Non Arsen 1 Botol 462000
28 04/01/2016 Semen Seng Fospat 2 Botol 175000
29 04/01/2016 Tropikal Anantesi 2 Pot 175000
30 04/01/2016 Silver Amalgam 2 Botol 400000
31 04/01/2016 Composit A1 4 tb 510000
32 04/01/2016 Composit A2 4 tb 510000
33 04/01/2016 Composit A3 4 tb 510000
34 04/01/2016 Composit Paket 2 Set 1650000
35 04/01/2016 Air Raksa 2 Set 500000
36 04/01/2016 Rockles 3 735000
37 04/01/2016 Amoxicillin Tablet 500 mg 68693 Tablet 485
38 04/01/2016 Asam Mefenamat 500 mg 24880 Tablet 223
39 04/01/2016 Betametason salep 233 Tube 3749
40 04/01/2016 Glimepiride 3 mg 1000 Tablet 318
41 04/01/2016 Glucosa larutan inf 5% 7790 Botol 67
42 04/01/2016 Kloramphenicol susp 52 Botol 7077
43 04/01/2016 Chlorpheniraminimaleat 68000 Tablet 75
44 04/01/2016 Mathilergometrin maleat tab 6096 Tablet 243
45 04/01/2016 Nacl 0.9 % 145 Botol 7790
46 04/01/2016 piridoxin hcl tab 79665 Tablet 36
47 04/01/2016 Ringer Laktat larutan infus 267 Botol 7790
48 04/01/2016 Ciprofloxacine tab 500 mg 1108 Tablet 693
49 04/01/2016 Paracetamol tab 500 mg 59288 Tablet 135
50 04/01/2016 Kaolin Pektin 7500 Tablet 200
51 04/01/2016 Paracetamol syr 442 Botol 3904
52 04/01/2016 Aqua pro inj 25 ml 10 Botol 6050
53 04/01/2016 Ambroxol syr 50 Botol 3,300.00
54 04/01/2016 Chloramphenicol 250 mg Capsule 120 Capsul 310.20
55 04/01/2016 Pyridoxin / vit B6 12000 Tablet 23.10
56 04/01/2016 Salbutamol 4 mg 1200 Tablet 96.80
57 04/01/2016 Sianocobalamin tab (B12) 1000 Tablet 18.70
58 04/01/2016 Sulfacetamid Natrium tetes mata 120 Botol 3,950.10
59 04/01/2016 Tramadol Capsul 700 Capsul 354.20
Obat Flu Kombinasi Syr / Molexflu
60 04/01/2016 120 Botol 10,670.00
syr
Ekspektoran kombinasi syr /
61 04/01/2016 60 Botol 9,680.00
Molexdryl syr
Antitusif Kombinasi Syr / Dextral
62 04/01/2016 120 Botol 10,000.10
Syr
63 04/01/2016 Neocenta / Bioplecenton 20 Tube 17,900.30
Jumlah

64 04/01/2016 Kertas HVS 30 rim 57,500.00


65 04/01/2016 Spidol Permanent 30 buah 8,000.00
66 04/01/2016 Spidol Whitebord 10 buah 10,000.00
67 04/01/2016 Ball point 190 buah 4,000.00
68 04/01/2016 Buku Double Folio 5 buah 50,000.00
69 04/01/2016 Tinta Printer Hitam 810 20 buah 52,000.00
70 04/01/2016 Tinta Printer Warna 811 10 buah 58,000.00
71 04/01/2016 Tinta Printer Hitam T6641 100 buah 120,000.00
72 04/01/2016 Tinta Printer Hitam T6642 49 buah 120,000.00
73 04/01/2016 Catridge Printer Hitam 3 buah 250,000.00
74 04/01/2016 Penghapus Tinta Cair 9 buah 10,000.00
75 04/01/2016 Pencil 23 buah 5,000.00
76 04/01/2016 Map Plastik snelihecter 50 buah 10,000.00
77 04/01/2016 Box File 26 buah 40,000.00
78 04/01/2016 Tissue 10 buah 20,000.00
79 04/01/2016 Jarum Hecting 3/8 lingkaran 10 buah 41,000.00
80 04/01/2016 Jarum Hecting setengah lingkaran 10 buah 41,000.00
81 04/01/2016 Bak Instrumen 1 buah 221,000.00
82 04/01/2016 Gunting benang 1 buah 46,000.00
83 04/01/2016 Gunting Lister 1 buah 45,000.00
84 04/01/2016 Korentang set 2 set 200,000.00
85 04/01/2016 Klem Arteri 1 buah 45,000.00
86 04/01/2016 Mata bor 30 buah 30,000.00
87 04/01/2016 Masker kain tali 576 buah 5,000.00
88 04/01/2016 Sarung tangan uk s 5 dus 45,000.00
89 04/01/2016 Sarung tangan uk m 6 dus 45,000.00
90 04/01/2016 Spuit 3 cc 3 dus 80,000.00
91 04/01/2016 Spuit 5 cc 5 dus 130,000.00
92 04/01/2016 Spuit 1 cc 4 dus 434,000.00
93 04/01/2016 Abocath 18 30 buah 14,000.00
94 04/01/2016 Abocath 20 40 buah 14,000.00
95 04/01/2016 Abocath 22 40 buah 14,000.00
96 04/01/2016 Infus set makro 25 buah 6,435.00
97 04/01/2016 Termometer Digital 6 buah 70,000.00
98 04/01/2016 Timbangan Injak 2 buah 120,000.00
99 18/01/2016 Map Plastik 10 buah 7,900.00
100 18/01/2016 Kertas Karton 31 lmbr 4,000.00
101 18/01/2016 Kertas Manila 31 buah 13,900.00
102 18/01/2016 Box File 12 buah 14,000.00
103 01/03/2016 Kertas HVS 70 gram 36 rim 57,500.00
104 01/03/2016 Ballpoint 155 buah 1,600.00
105 01/03/2016 Tinta printer hitam 24 dus 52,000.00
106 01/03/2016 Blok Note 155 buah 4,500.00
107 01/03/2016 Buku Double folio 200 L 21 buah 53,000.00
108 01/03/2016 Spidol 16 buah 8,000.00
109 28/03/2016 Materai 6000 60 lmbr 8,500.00
110 28/03/2016 Materai 3000 120 lmbr 4,000.00
111 02/05/2016 Plastik Obat 1000 pak 10,500.00
112 02/05/2016 Medicine Packet 1 pak 4,000,000.00
113 02/05/2016 Tissue 100 pak 20,000.00
114 02/05/2016 Kantong Obat 250 pak 8,000.00
115 02/05/2016 Model Rahang Gigi 1 buah 234,000.00
116 02/05/2016 Pispot 1 buah 70,000.00
117 02/05/2016 Pispot 1 buah 70,000.00
118 02/05/2016 Pispot 1 buah 70,000.00
119 10/052016 Buku Resep Rawat Jalan 150 buah 15,300.00
120 10/052016 Kir Sehat 5 buku 21,500.00
121 10/052016 Kartu Rekamedis Pasien 1800 buah 1,000.00
122 10/052016 Kartu Identitas berobat 3487 buah 220.00
123 10/052016 Buku Register Rawat Jalan 2 buku 124,000.00
124 10/052016 Buku Kas Sejenis 4 buku 48,000.00
125 10/052016 Buku Salinan Resep BPJS 12 buku 15,000.00
126 10/052016 Buku SSP 10 buku 35,300.00
127 10/052016 Amplop Cetak Kop surat 10 pak 70,000.00
128 27/07/2016 Asam Urat 1 kit 352,000.00
129 27/07/2016 Cholesterol 1 kit 390,000.00
130 27/07/2016 Creatinin 1 kit 540,000.00
131 27/07/2016 Glukosa 1 kit 310,000.00
132 27/07/2016 Golongan darah (anti A dan anti B) 1 paket 590,000.00
133 27/07/2016 Golongan darah (anti D dan anti AB) 1 paket 590,000.00
134 27/07/2016 HB Quick-Chek 1 box 698,000.00
135 27/07/2016 Hemoglobin 1 kit 525,000.00
136 27/07/2016 Reagen urine analyzer 1 kit 805,000.00
137 27/07/2016 SGOT 1 kit 360,000.00
138 27/07/2016 SGPT 1 kit 360,000.00
139 27/07/2016 Stik Asam Urat 10 tube 130,000.00
140 27/07/2016 Stik Cholesterol 17 tube 200,000.00
141 27/07/2016 Stik Glukosa 15 tube 130,000.00
142 27/07/2016 Stik Hb 20 box 234,000.00
143 27/07/2016 Stik urine 3 parameter 5 box 78,000.00
144 27/07/2016 Tes kehamilan 300 pcs 10,000.00
145 27/07/2016 Trigliserida 1 kit 2,110,000.00
146 27/07/2016 Ureum 1 kit 470,000.00
147 27/07/2016 Widal 2 set 1,630,000.00
148 01/08/2016 Kertas hvs F 4 136 rim 55,000.00
149 01/08/2016 Spidol Permanent 26 buah 8,000.00
150 01/08/2016 Ball point 385 buah 4,000.00
151 01/08/2016 Spidol Whitebord 10 buah 10,000.00
152 01/08/2016 Pensil 32 buah 5,000.00
153 01/08/2016 Penghapus Tinta Cair 10 buah 10,000.00
154 01/08/2016 Buku Double Folio 5 buah 50,000.00
155 01/08/2016 Tinta Printer Hitam Canon 5 buah 52,000.00
156 01/08/2016 Tinta Printer Warna Canon 5 buah 58,000.00
157 01/08/2016 Tinta Printer Hitam Epson 45 buah 120,000.00
158 01/08/2016 Tinta Printer Warna Epson 21 buah 120,000.00
159 08/08/2016 Sapu injuk 20 buah 26,000.00
160 08/08/2016 Sapu Lidi 20 buah 10,000.00
161 08/08/2016 Pengki 10 buah 20,000.00
162 08/08/2016 Kemoceng 10 buah 16,000.00
163 08/08/2016 Kesed kecil 50 buah 20,000.00
164 08/08/2016 Kesed besar 5 buah 250,000.00
165 08/08/2016 Tempat sampah tertutup kecil 20 buah 46,000.00
166 08/08/2016 Tempat sampah tertutup sedang 20 buah 145,000.00
167 08/08/2016 Sabun cuci tangan 50 bungkus 18,000.00
168 08/08/2016 Sabun cuci piring 30 bungkus 14,000.00
169 08/08/2016 Detergent 30 buah 7,000.00
170 08/08/2016 Alat pel lantai karet 5 buah 80,000.00
171 08/08/2016 Alat pel lantai karet 20 buah 54,000.00
172 08/08/2016 Lap kaca 5 buah 47,000.00
173 08/08/2016 Lysol 20 botol 21,000.00
174 08/08/2016 Pembersih Lantai 45 botol 19,000.00
175 08/08/2016 Pembersih Kaca 20 bungkus 13,000.00
176 08/08/2016 Pewangi Ruangan 20 buah 40,000.00
177 08/08/2016 Lampu 5 watt 75 buah 30,000.00
178 08/08/2016 Lampu 18 watt 95 buah 45,000.00
179 08/08/2016 Lampu LED 10 watt 25 buah 80,000.00
180 08/08/2016 Lampu Neon panjang 50 buah 50,000.00
181 08/08/2016 Terminal kabel 8 buah 100,000.00
182 19/10/2016 Kain Batik 900 meter 37,000.00
183 01/12/2016 Benang Silk 2 box 251,000.00
184 01/12/2016 Benang Silk 3 box 251,000.00
185 01/12/2016 Cutget 1.5 m 1 unit 30,000.00
186 01/12/2016 Cutget 1.5 m 2 unit 30,000.00
187 01/12/2016 Sarung tangan ukuran S 5 box 65,000.00
188 01/12/2016 Sarung tangan ukuran S 5 box 65,000.00
189 01/12/2016 Sarung tangan ukuran S 5 box 65,000.00
190 01/12/2016 Sarung tangan ukuran S 5 box 65,000.00
191 01/12/2016 Sarung tangan ukuran S 5 box 65,000.00
192 01/12/2016 Sarung tangan steril ukuran no 7 200 pasang 10,000.00
193 01/12/2016 Sarung tangan steril ukuran no 7.5 200 pasang 10,000.00
194 01/12/2016 Needle 10 box 65,000.00
195 01/12/2016 Jarum Citoject 3 box 130,000.00
196 01/12/2016 Spuit 3 cc 20 box 130,000.00
197 01/12/2016 Spuit 3 cc 5 box 130,000.00
198 01/12/2016 Spuit 3 cc 5 box 130,000.00
199 01/12/2016 Spuit 3 cc 10 box 130,000.00
200 01/12/2016 Spuit 5 cc 5 box 218,750.00
201 01/12/2016 Spuit 5 cc 5 box 218,750.00
202 01/12/2016 Spuit 5 cc 3 box 218,750.00
203 01/12/2016 Spuit 5 cc 2 box 218,750.00
204 01/12/2016 Spuit 10 cc 1 box 175,000.00
205 01/12/2016 Spuit 10 cc 1 box 175,000.00
206 01/12/2016 Spuit 1 cc 1 box 260,000.00
207 01/12/2016 Spuit 1 cc 1 box 260,000.00
208 01/12/2016 Spuit 1 cc 1 box 260,000.00
209 01/12/2016 Abocath no 18 50 pcs 17,550.00
210 01/12/2016 Abocath no 18 50 pcs 17,550.00
211 01/12/2016 Abocath no 20 150 pcs 17,550.00
212 01/12/2016 Abocath no 20 150 pcs 17,550.00
213 01/12/2016 Abocath no 22 150 pcs 17,550.00
214 01/12/2016 Abocath no 22 150 pcs 17,550.00
215 01/12/2016 Abocath no 24 50 pcs 17,550.00
216 01/12/2016 Abocath no 24 50 pcs 17,550.00
217 01/12/2016 Infuset Makro 100 pcs 10,000.00
218 01/12/2016 Infuset Makro 100 pcs 10,000.00
219 01/12/2016 Decglass 5 btl 113,200.00
220 01/12/2016 Yellow tape 1 bag 145,769.00
221 01/12/2016 Blue tape 1 bag 290,400.00
222 01/12/2016 White tape 1 bag 309,760.00
223 01/12/2016 Blood Lancet 6 pcs 65,000.00
224 01/12/2016 Kacamata Pelindung 1 buah 200,000.00
225 01/12/2016 Kacamata Pelindung 1 buah 200,000.00
226 01/12/2016 Kacamata Pelindung 1 buah 200,000.00
227 01/12/2016 Tabung EDTA 6 pack 200,000.00
228 01/12/2016 Tabung Non EDTA 6 pack 200,000.00
229 01/12/2016 Tabung reaksi 3 ml 200 pcs 4,000.00
230 01/12/2016 Gunting jaringan 3 buah 50,000.00
231 01/12/2016 Abocath no 26 25 pcs 17,550.00
232 01/12/2016 Abocath no 26 25 pcs 17,550.00
233 01/12/2016 NGT 8 20 pcs 260,000.00
234 01/12/2016 Kapas Gulung 500 gr 1 buah 50,000.00
235 01/12/2016 Kapas Gulung 500 gr 1 buah 50,000.00
236 01/12/2016 Kapas Gulung Besar 1 buah 140,000.00
237 01/12/2016 Kapas Gulung Besar 1 buah 140,000.00
238 01/12/2016 Kapas Gulung Besar 1 buah 140,000.00
239 01/12/2016 Kapas Gulung Besar 1 buah 140,000.00
240 01/12/2016 Kapas Gulung Besar 1 buah 140,000.00
241 05/12/2016 Buku Resep Rawat Jalan 150 buku 15,300.00
242 05/12/2016 Kir Sehat 5 buku 21,500.00
243 05/12/2016 Kartu Rekamedis Pasien 1813 buah 1,000.00
244 05/12/2016 Buku Register Rawat Jalan 2 buku 124,000.00
245 05/12/2016 Buku Kas Sejenis 4 buku 48,000.00
246 05/12/2016 Buku Salinan Resep BPJS 12 buku 15,000.00
247 05/12/2016 Amplop Cetak Kop Surat 10 pak 70,000.00
248 05/12/2016 Buku Ontang Anting Kegiatan 55 buku 20,000.00
249 05/12/2016 Map biasa 220 buah 2,000.00
250 05/12/2016 Map Plastik snelihecter 110 buah 10,000.00
251 05/12/2016 Binder Klip Kecil 50 buah 2,200.00
252 05/12/2016 Binder Klip Sedang 50 buah 3,500.00
253 05/12/2016 Binder Klip Besar 19 buah 5,000.00
254 05/12/2016 Map ordner 20 buah 28,900.00
255 05/12/2016 Steples sedang 95 buah 19,000.00
256 05/12/2016 Flasdish 25 buah 150,000.00
257 05/12/2016 Gunting 10 buah 10,000.00
258 05/12/2016 Amplop 95x152 mm 10 buah 15,000.00
259 05/12/2016 Catridge printer hitam 5 buah 250,000.00
260 05/12/2016 Handuk Kecil 50 buah 25,000.00
261 05/12/2016 Gelas melamin 20 buah 20,000.00
262 05/12/2016 Baki melamin 20 buah 30,000.00
263 05/12/2016 Lap tangan 25 buah 27,000.00
264 05/12/2016 Tempat tissue 20 buah 30,000.00
265 05/12/2016 Taplak meja 30 buah 40,000.00
266 05/12/2016 Plastik Obat 1000 pak 10,500.00
267 05/12/2016 Medicine Packet 1 pak 4,000,000.00
268 05/12/2016 Tissue 40 pak 20,000.00
269 05/12/2016 Kantong Obat 250 pak 8,000.00
270 05/12/2016 Model Rahang Gigi 1 buah 234,000.00
271 05/12/2016 Pispot 2 buah 70,000.00
272 05/12/2016 Pispot 1 buah 70,000.00
Jumlah
JUMLAH

Mengetahui
Kepala UPTD Puskesmas Cibeureum
drg. Titin Hajari
NIP : 19771122 200312 2 003
ANG PAKAI HABIS 2016
Tempat
Jumlah Harga Untuk Ket.
Penyerahan
7 8 9 10
1,860,000.00 Gudang Obat Pkm Cibeureum
1,848,000.00 Gudang Obat Pkm Cibeureum
550,000.00 Gudang Obat Pkm Cibeureum
1,584,576.00 Gudang Obat Pkm Cibeureum
8,259,000.00 Gudang Obat Pkm Cibeureum
4,352,000.00 Gudang Obat Pkm Cibeureum
3,703,000.00 Gudang Obat Pkm Cibeureum
1,464,000.00 Gudang Obat Pkm Cibeureum
4,395,000.00 Gudang Obat Pkm Cibeureum
4,400,000.00 Gudang Obat Pkm Cibeureum
5,250,000.00 Gudang Obat Pkm Cibeureum
4,464,000.00 Gudang Obat Pkm Cibeureum
4,248,000.00 Gudang Obat Pkm Cibeureum
3,392,400.00 Gudang Obat Pkm Cibeureum
3,700,000.00 Gudang Obat Pkm Cibeureum
5,500,000.00 Gudang Obat Pkm Cibeureum
1,760,000.00 Gudang Obat Pkm Cibeureum
3,312,000.00 Gudang Obat Pkm Cibeureum
10,560,000.00 Gudang Obat Pkm Cibeureum
1,307,460.00 Gudang Obat Pkm Cibeureum
1,840,000.00 Gudang Obat Pkm Cibeureum
5,390,000.00 Gudang Obat Pkm Cibeureum
2,062,500.00 Gudang Obat Pkm Cibeureum
268,000.00 Gudang Obat Pkm Cibeureum
1,160,000.00 Gudang Obat Pkm Cibeureum
600,000.00 Gudang Obat Pkm Cibeureum
462,000.00 Gudang Obat Pkm Cibeureum
350,000.00 Gudang Obat Pkm Cibeureum
350,000.00 Gudang Obat Pkm Cibeureum
800,000.00 Gudang Obat Pkm Cibeureum
2,040,000.00 Gudang Obat Pkm Cibeureum
2,040,000.00 Gudang Obat Pkm Cibeureum
2,040,000.00 Gudang Obat Pkm Cibeureum
3,300,000.00 Gudang Obat Pkm Cibeureum
1,000,000.00 Gudang Obat Pkm Cibeureum
2,205,000.00 Gudang Obat Pkm Cibeureum
33,316,105.00 Gudang Obat Pkm Cibeureum
5,548,240.00 Gudang Obat Pkm Cibeureum
873,517.00 Gudang Obat Pkm Cibeureum
318,000.00 Gudang Obat Pkm Cibeureum
521,930.00 Gudang Obat Pkm Cibeureum
368,004.00 Gudang Obat Pkm Cibeureum
5,100,000.00 Gudang Obat Pkm Cibeureum
1,481,328.00 Gudang Obat Pkm Cibeureum
1,129,550.00 Gudang Obat Pkm Cibeureum
2,867,940.00 Gudang Obat Pkm Cibeureum
2,079,930.00 Gudang Obat Pkm Cibeureum
767,844.00 Gudang Obat Pkm Cibeureum
8,003,880.00 Gudang Obat Pkm Cibeureum
1,500,000.00 Gudang Obat Pkm Cibeureum
1,725,568.00 Gudang Obat Pkm Cibeureum
60,500.00 Gudang Obat Pkm Cibeureum
165,000.00 Gudang Obat Pkm Cibeureum
37,224.00 Gudang Obat Pkm Cibeureum
277,200.00 Gudang Obat Pkm Cibeureum
116,160.00 Gudang Obat Pkm Cibeureum
18,700.00 Gudang Obat Pkm Cibeureum
474,012.00 Gudang Obat Pkm Cibeureum
247,940.00 Gudang Obat Pkm Cibeureum
1,280,400.00 Gudang Obat Pkm Cibeureum

580,800.00 Gudang Obat Pkm Cibeureum

1,200,012.00 Gudang Obat Pkm Cibeureum


358,006.00 Gudang Obat Pkm Cibeureum 172,234,726.00
172,234,726.00

1,725,000.00 Pengelola Program Pkm Pkm Cibeureum


240,000.00 Pengelola Program Pkm Pkm Cibeureum
100,000.00 Pengelola Program Pkm Pkm Cibeureum
760,000.00 Pengelola Program Pkm Pkm Cibeureum
250,000.00 Pengelola Program Pkm Pkm Cibeureum
1,040,000.00 Pengelola Program Pkm Pkm Cibeureum
580,000.00 Pengelola Program Pkm Pkm Cibeureum
12,000,000.00 Pengelola Program Pkm Pkm Cibeureum
5,880,000.00 Pengelola Program Pkm Pkm Cibeureum
750,000.00 Pengelola Program Pkm Pkm Cibeureum
90,000.00 Pengelola Program Pkm Pkm Cibeureum
115,000.00 Pengelola Program Pkm PKM Cibeureum
500,000.00 Pengelola Program Pkm PKM Cibeureum
1,040,000.00 Pengelola Program Pkm PKM Cibeureum
200,000.00 Pengelola Program Pkm PKM Cibeureum
410,000.00 Pengelola Program Pkm PKM Cibeureum
410,000.00 Pengelola Program Pkm PKM Cibeureum
221,000.00 Pengelola Program Pkm PKM Cibeureum
46,000.00 Pengelola Program Pkm PKM Cibeureum
45,000.00 Pengelola Program Pkm PKM Cibeureum
400,000.00 Pengelola Program Pkm PKM Cibeureum
45,000.00 Pengelola Program Pkm PKM Cibeureum
900,000.00 Pengelola Program Pkm PKM Cibeureum
2,880,000.00 Pengelola Program Pkm PKM Cibeureum
225,000.00 Pengelola Program Pkm PKM Cibeureum
270,000.00 Pengelola Program Pkm PKM Cibeureum
240,000.00 Pengelola Program Pkm PKM Cibeureum
650,000.00 Pengelola Program Pkm PKM Cibeureum
1,736,000.00 Pengelola Program Pkm PKM Cibeureum
420,000.00 Pengelola Program Pkm PKM Cibeureum
560,000.00 Pengelola Program Pkm PKM Cibeureum
560,000.00 Pengelola Program Pkm PKM Cibeureum
160,875.00 Pengelola Program Pkm PKM Cibeureum
420,000.00 Pengelola Program Pkm PKM Cibeureum
240,000.00 Pengelola Program Pkm PKM Cibeureum 36,108,875.00
79,000.00 Program BOK PKM Cibeureum
124,000.00 Program BOK PKM Cibeureum
430,900.00 Program BOK PKM Cibeureum
168,000.00 Program BOK PKM Cibeureum
2,070,000.00 Program BOK PKM Cibeureum
248,000.00 Program BOK PKM Cibeureum
1,248,000.00 Program BOK PKM Cibeureum
697,500.00 Program BOK PKM Cibeureum
1,113,000.00 Program BOK PKM Cibeureum
128,000.00 Program BOK PKM Cibeureum
510,000.00 Program BOK PKM Cibeureum
480,000.00 Program BOK PKM Cibeureum
10,500,000.00 Gudang Obat PKM Cibeureum
4,000,000.00 Gudang Obat PKM Cibeureum
2,000,000.00 Pkm Cibeureum PKM Cibeureum
2,000,000.00 Gudang Obat PKM Cibeureum
234,000.00 Poli Gigi PKM Cibeureum
70,000.00 IGD PKM Cibeureum
70,000.00 Perawatan PKM Cibeureum
70,000.00 Poned PKM Cibeureum
2,295,000.00 TU PKM Cibeureum
107,500.00 TU PKM Cibeureum
1,800,000.00 TU PKM Cibeureum
767,140.00 TU PKM Cibeureum
248,000.00 TU PKM Cibeureum
192,000.00 TU PKM Cibeureum
180,000.00 TU PKM Cibeureum
353,000.00 TU PKM Cibeureum
700,000.00 TU PKM Cibeureum
352,000.00 Laboratorium PKM Cibeureum
390,000.00 Laboratorium PKM Cibeureum
540,000.00 Laboratorium PKM Cibeureum
310,000.00 Laboratorium PKM Cibeureum
590,000.00 Laboratorium PKM Cibeureum
590,000.00 Laboratorium PKM Cibeureum
698,000.00 Laboratorium PKM Cibeureum
525,000.00 Laboratorium PKM Cibeureum
805,000.00 Laboratorium PKM Cibeureum
360,000.00 Laboratorium PKM Cibeureum
360,000.00 Laboratorium PKM Cibeureum
1,300,000.00 Laboratorium PKM Cibeureum
3,400,000.00 Laboratorium PKM Cibeureum
1,950,000.00 Laboratorium PKM Cibeureum
4,680,000.00 Laboratorium PKM Cibeureum
390,000.00 Laboratorium PKM Cibeureum
3,000,000.00 Laboratorium PKM Cibeureum
2,110,000.00 Laboratorium PKM Cibeureum
470,000.00 Laboratorium PKM Cibeureum
3,260,000.00 Laboratorium PKM Cibeureum
7,480,000.00 Pkm Cibeureum PKM Cibeureum
208,000.00 Pkm Cibeureum PKM Cibeureum
1,540,000.00 Pkm Cibeureum PKM Cibeureum
100,000.00 Pkm Cibeureum PKM Cibeureum
160,000.00 Pkm Cibeureum PKM Cibeureum
100,000.00 Pkm Cibeureum PKM Cibeureum
250,000.00 Pkm Cibeureum PKM Cibeureum
260,000.00 Pkm Cibeureum PKM Cibeureum
290,000.00 Pkm Cibeureum PKM Cibeureum
5,400,000.00 Pkm Cibeureum PKM Cibeureum
2,520,000.00 Pkm Cibeureum PKM Cibeureum
520,000.00 Pkm Cibeureum PKM Cibeureum
200,000.00 Pkm Cibeureum PKM Cibeureum
200,000.00 Pkm Cibeureum PKM Cibeureum
160,000.00 Pkm Cibeureum PKM Cibeureum
1,000,000.00 Pkm Cibeureum PKM Cibeureum
1,250,000.00 Pkm Cibeureum PKM Cibeureum
920,000.00 Pkm Cibeureum PKM Cibeureum
2,900,000.00 Pkm Cibeureum PKM Cibeureum
900,000.00 Pkm Cibeureum PKM Cibeureum
420,000.00 Pkm Cibeureum PKM Cibeureum
210,000.00 Pkm Cibeureum PKM Cibeureum
400,000.00 Pkm Cibeureum PKM Cibeureum
1,080,000.00 Pkm Cibeureum PKM Cibeureum
235,000.00 Pkm Cibeureum PKM Cibeureum
420,000.00 Pkm Cibeureum PKM Cibeureum
855,000.00 Pkm Cibeureum PKM Cibeureum
260,000.00 Pkm Cibeureum PKM Cibeureum
800,000.00 Pkm Cibeureum PKM Cibeureum
2,250,000.00 Pkm Cibeureum PKM Cibeureum
4,275,000.00 Pkm Cibeureum PKM Cibeureum
2,000,000.00 Pkm Cibeureum PKM Cibeureum
2,500,000.00 Pkm Cibeureum PKM Cibeureum
800,000.00 Pkm Cibeureum PKM Cibeureum
33,300,000.00 Karyawan PKM Cibeureum PKM Cibeureum
502,000.00 Poned PKM Cibeureum
753,000.00 Perawatan PKM Cibeureum
30,000.00 Poned PKM Cibeureum
60,000.00 Perawatan PKM Cibeureum
325,000.00 Laboratorium PKM Cibeureum
325,000.00 Poli Gigi PKM Cibeureum
325,000.00 Perawatan PKM Cibeureum
325,000.00 Poned PKM Cibeureum
325,000.00 IGD PKM Cibeureum
2,000,000.00 Poned PKM Cibeureum
2,000,000.00 Poned PKM Cibeureum
650,000.00 Laboratorium PKM Cibeureum
390,000.00 Poli Gigi PKM Cibeureum
2,600,000.00 Laboratorium PKM Cibeureum
650,000.00 IGD PKM Cibeureum
650,000.00 Poned PKM Cibeureum
1,300,000.00 Perawatan PKM Cibeureum
1,093,750.00 Perawatan PKM Cibeureum
1,093,750.00 Poned PKM Cibeureum
656,250.00 IGD PKM Cibeureum
437,500.00 Laboratorium PKM Cibeureum
175,000.00 Perawatan PKM Cibeureum
175,000.00 Poned PKM Cibeureum
260,000.00 Perawatan PKM Cibeureum
260,000.00 Poned PKM Cibeureum
260,000.00 Igd PKM Cibeureum
877,500.00 Perawatan PKM Cibeureum
877,500.00 Poned PKM Cibeureum
2,632,500.00 Perawatan PKM Cibeureum
2,632,500.00 Poned PKM Cibeureum
2,632,500.00 Perawatan PKM Cibeureum
2,632,500.00 Poned PKM Cibeureum
877,500.00 Perawatan PKM Cibeureum
877,500.00 Poned PKM Cibeureum
1,000,000.00 Perawatan PKM Cibeureum
1,000,000.00 Poned PKM Cibeureum
566,000.00 Laboratorium PKM Cibeureum
145,769.00 Laboratorium PKM Cibeureum
290,400.00 Laboratorium PKM Cibeureum
309,760.00 Laboratorium PKM Cibeureum
390,000.00 Laboratorium PKM Cibeureum
200,000.00 IGD PKM Cibeureum
200,000.00 Perawatan PKM Cibeureum
200,000.00 Poned PKM Cibeureum
1,200,000.00 Laboratorium PKM Cibeureum
1,200,000.00 Laboratorium PKM Cibeureum
800,000.00 Laboratorium PKM Cibeureum
150,000.00 IGD PKM Cibeureum
438,750.00 Perawatan PKM Cibeureum
438,750.00 Poned PKM Cibeureum
5,200,000.00 Poned PKM Cibeureum
50,000.00 Perawatan PKM Cibeureum
50,000.00 Poned PKM Cibeureum
140,000.00 Perawatan PKM Cibeureum
140,000.00 Poned PKM Cibeureum
140,000.00 Poli Gigi PKM Cibeureum
140,000.00 Laboratorium PKM Cibeureum
140,000.00 Gudang Obat PKM Cibeureum
2,295,000.00 Tu PKM Cibeureum
107,500.00 Tu PKM Cibeureum
1,813,000.00 Tu PKM Cibeureum
248,000.00 Tu PKM Cibeureum
192,000.00 Tu PKM Cibeureum
180,000.00 Tu PKM Cibeureum
700,000.00 Tu PKM Cibeureum
1,100,000.00 Karyawan PKM Cibeureum PKM Cibeureum
440,000.00 Pkm Cibeureum PKM Cibeureum
1,100,000.00 Pkm Cibeureum PKM Cibeureum
110,000.00 Pkm Cibeureum PKM Cibeureum
175,000.00 Pkm Cibeureum PKM Cibeureum
95,000.00 Pkm Cibeureum PKM Cibeureum
578,000.00 Pkm Cibeureum PKM Cibeureum
1,805,000.00 Pkm Cibeureum PKM Cibeureum
3,750,000.00 Pkm Cibeureum PKM Cibeureum
100,000.00 Pkm Cibeureum PKM Cibeureum
150,000.00 Pkm Cibeureum PKM Cibeureum
1,250,000.00 Pkm Cibeureum PKM Cibeureum
1,250,000.00 Poli Gigi PKM Cibeureum
400,000.00 Poli Gigi PKM Cibeureum
600,000.00 Poli Gigi PKM Cibeureum
675,000.00 Poli Gigi PKM Cibeureum
600,000.00 Poli Gigi PKM Cibeureum
1,200,000.00 Puskesmas Cibeureum PKM Cibeureum
10,500,000.00 Gudang Obat PKM Cibeureum
4,000,000.00 Gudang Obat PKM Cibeureum
800,000.00 PKM Cibeureum
2,000,000.00 Gudang Obat PKM Cibeureum
234,000.00 Poli Gigi PKM Cibeureum
140,000.00 Perawatan PKM Cibeureum
70,000.00 Poned PKM Cibeureum 219,974,219.00
256,083,094.00

428,317,820.00

Tasikmalaya, 31 Desember 2016

Penyimpan Barang
Entis Sutisna
NIP : 1969228 199103 1 805
###
KOP SURAT

BERITA ACARA STOCK OPNAME BARANG


NO : 800 / 285 / CBR / XII /2016

Pada hari ini Sabtu tanggal Tiga Puluh Satu bulan Desember tahun Dua Ribu Emam Belas, bertempat
di UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya, kami yang bertanda tangan dibawah ini :

Nama : drg Titin Hajari


NIP : 19771122 200312 2 003
Jabatan : Kepala UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya

Selaku Kuasa Pengguna Anggaran/Kuasa Pengguna Barang UPTD Puskesmas Cibeureum Dinas Kesehatan Kota
Tasikmalaya, telah melakukan pemeriksaan fisik persediaan terhadap :

Nama : Entis Sutisna


NIP : 19690228 199103 1 005
Jabatan : Penyimpan Barang UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya

Dengan hasil pemeriksaan sebagai berikut :

Saldo Awal Tahun : Rp. 36,108,875.00


Jumlah Penerimaan Barang Tahun 2016 : Rp. 234,264,219.00
Koreksi Kesalahan Tahun 2015 : Rp. -
(sebagaimana terlampir)
Jumlah Pengeluaran Barang Tahun 2016 : Rp. 256,083,094.00
Jumlah Persediaan s/d 31 Desember 2016 : Rp. 14,290,000.00
(sebagaimana terlampir)

Demikian Berita Acara Pemeriksaan fisik persediaan ini dibuat dengan sesungguhnya
untuk dijadikan bahan seperlunya.

Tasikmalaya, 31 Desember 2016


Kepala UPTD Puskesmas Cibeureum Penyimpan Barang
drg. Titin Hajari Entis Sutisna
NIP : 19771122 200312 2 003 NIP : 1969228 199103 1 805
674998150
copy 2012 ###
selisih ###
rekap #REF!
selisih #REF!
KOP SURAT

BERITA ACARA STOCK OPNAME OBAT


NO : 800 / 286 / CBR / XII / 2016

Pada hari ini Sabtu tanggal Tiga Puluh Satu bulan Desember tahun Dua Ribu Emam Belas, bertempat
di UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya, kami yang bertanda tangan dibawah ini :

Nama : drg Titin Hajari


NIP : 19771122 200312 2 003
Jabatan : Kepala UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya

Selaku Kuasa Pengguna Anggaran/Kuasa Pengguna Barang UPTD Puskesmas Cibeureum Dinas Kesehatan Kota
Tasikmalaya telah melakukan pemeriksaan fisik persediaan terhadap :

Nama : Entis Sutisna


NIP : 19690228 199103 1 005
Jabatan : Penyimpan Barang UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya

Dengan hasil pemeriksaan sebagai berikut :

Saldo Awal Tahun : Rp. -


Jumlah Penerimaan Barang Tahun 2016 : Rp. 103,000,000.00
Koreksi Kesalahan Tahun 2015 : Rp. 192,764,230.00
(sebagaimana terlampir)
Jumlah Pengeluaran Barang Tahun 2016 : Rp. 172,234,726.00
Jumlah Persediaan s/d 31 Desember 2016 : Rp. 123,529,504.00
(sebagaimana terlampir)

Demikian Berita Acara Pemeriksaan fisik persediaan ini dibuat dengan sesungguhnya
untuk dijadikan bahan seperlunya.

Tasikmalaya 31 Desember 2016


Kepala UPTD Puskesmas Cibeureum Penyimpan Barang
drg. Titin Hajari Entis Sutisna
NIP : 19771122 200312 2 003 NIP : 1969228 199103 1 805
beureum Dinas Kesehatan Kota

674998150
- copy 2012 ###
selisih ###
14,290,000.00 rekap #REF!
123,529,504.00 selisih #REF!

$ 137,819,504.00
#VALUE!
14,290,000.00
137,819,504.00
123529504
14,290,000.00 137,819,504.00
KOP SURAT

BERITA ACARA STOCK OPNAME


NO : 800 / 287 / CBR / XII /2016

Pada hari ini Sabtu tanggal Tiga Puluh Satu bulan Desember tahun Dua Ribu Emam Belas, bertempat
di UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya, kami yang bertanda tangan dibawah ini :

Nama : drg Titin Hajari


NIP : 19771122 200312 2 003
Jabatan : Kepala UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya

Selaku Kuasa Pengguna Anggaran/Kuasa Pengguna Barang UPTD Puskesmas Cibeureum Dinas Kesehatan Kota
Tasikmalaya telah melakukan pemeriksaan fisik persediaan terhadap :

Nama : Entis Sutisna


NIP : 19690228 199103 1 005
Jabatan : Penyimpan Barang UPTD Puskesmas Cibeureum Dinas Kesehatan Kota Tasikmalaya

Dengan hasil pemeriksaan sebagai berikut :

Saldo Awal Tahun : Rp. 36,108,875.00


Jumlah Penerimaan Barang Tahun 2016 : Rp. 337,264,219.00
Koreksi Kesalahan Tahun 2015 : Rp. 192,764,230.00
(sebagaimana terlampir)
Jumlah Pengeluaran Barang Tahun 2016 : Rp. 428,317,820.00
Jumlah Persediaan s/d 31 Desember 2016 : Rp. 137,819,504.00
(sebagaimana terlampir)

Demikian Berita Acara Pemeriksaan fisik persediaan ini dibuat dengan sesungguhnya
untuk dijadikan bahan seperlunya.

Tasikmalaya, 31 Desember 2016


Kepala UPTD Puskesmas Cibeureum Penyimpan Barang
drg. Titin Hajari Entis Sutisna
NIP : 19771122 200312 2 003 NIP : 1969228 199103 1 805
ureum Dinas Kesehatan Kota

674998150
copy 2012 ###
selisih ###
rekap #REF!
selisih #REF!

#VALUE!
14,290,000.00
137,819,504.00
123529504
14,290,000.00 137,819,504.00