KEBUTUHAN BMHP PUSKESM

SUMBER KAPITASI / JKN

NO NAMA BARANG SATUAN

1 2 3
1 AMBUBAG (ANAK) SET

2 AMBUBAG (BAYI) SET

3 AMBUBAG (DEWASA) SET

4 AQUADEST LITER

5 ASAM URAT STRIP BOTOL

6 BLOOD LANCET BOX

7 CATGUT CROMIC (PLAIN) NO. 3 PCS

8 CATGUT CROMIC (SILK) NO. 3 PCS

9 CHOLESTEROL STRIP BOTOL

10 COVER GLASS 18 X 18 BOX

11 COVER GLASS 22 X 22 BOX

12 DISPOSABLE SYRING WITH NEEDLE 20 CC PCS

13 DISPOSABLE SYRING WITH NEEDLE 50 CC PCS

14 FOLLEY CATHETER NO 16 PCS

15 FOLLEY CATHETER NO 18 PCS

16 FOLLEY CATHETER NO 20 PCS

17 GLUKOSA STRIP BOTOL

18 Hb STRIP BOTOL

19 HCL 0,1 N LITER

20 I.V. CATHETER (POLYWIN) NO. 18 PCS

21 I.V. CATHETER (POLYWIN) NO. 20 PCS

22 I.V. CATHETER (POLYWIN) NO. 24 PCS

23 INFUS SET DEWASA PCS

24 JARUM BEDAH UKURAN 1/2 LINGKARAN LUSIN

NO NAMA BARANG SATUAN

1 2 3
25 JELLY DOPLER BOTOL

26 KAPAS PEMBALUT 250 GRAM

27 KASA GULUNG (BESAR) 40 X 80 CM ROLL

28 KASA STERIL 16 X 16 BOX

29 KATETER PENGHISAP LENDIR PCS

30 KERTAS GOLONGAN DARAH PAK

31 KERTAS PUYER PAK

32 KJEEL BOTOL

33 MASKER 3 PLY (JILBAB) BOX

34 MUCUS EXRAKTOR PCS

35 NASAL OXYGEN CANULA (ANAK) PCS

36 NASAL OXYGEN CANULA (BAYI) PCS

37 NGT PCS

38 OBJECT GLASS BOX

39 PEWARNA GRAM SET

40 PLESTER 5 YARDS ROLL

41 PLESTER HYPAFIX ROLL

42 POT DAHAK PCS

43 POT FESES PCS

44 POT URIN PCS

45 PROTEIN URINE TES BOTOL

46 REAGEN GOL. DARAH, A,B,AB,O SET

47 SARUNG TANGAN NON STERIL BOX

48 SARUNG TANGAN STERIL PSG

49 SELANG SUCTION CATHETER PCS

50 SENDOK OBAT PCS

51 SKALPEL / MATA PISAU BEDAH PCS

NO NAMA BARANG SATUAN

1 2 3
52 STYLET PCS

53 TORNIKUET PCS

54 UMBILICAL KLEMP BOX

55 UNDERPAD PCS

56 URINE BAG PCS

57 URINE RUTIN (10 PEMERIKSAAN) BOTOL

58 URINE RUTIN (2 PEMERIKSAAN : PROTEIN + GLUKOSA) BOTOL

59 WING NEEDLE (UKURAN BAYI) PCS

JUMLAH NILAI PEROLEHAN

Mengetahui / Menyetujui
Kepala UPTD Yankes Cikancung

H. Dadan Wardana, S.K.M.

NIP : 19600702 198203 1 007
HP PUSKESMAS CIKANCUNG
TASI / JKN TAHUN 2016

VOLUME HARGA SATUAN TOTAL HARGA KET.

4 5 6 6
4

20

250

250

100

12

60

60

60

1,000

1,000

500

1,500

15
VOLUME HARGA SATUAN TOTAL HARGA KET.

4 5 6 6
10

20

30

1,000

20

20

30

20

50

100

200

100

200

150

500

100

500

20

100

200

100

1,000

500
VOLUME HARGA SATUAN TOTAL HARGA KET.

4 5 6 6
5

10

10

500

200

100

Rp -

Cikancung, Juli 2016

Apoteker

Husni Ahmad Khusaeri, S.Si., Apt.

NRP : 873.04.01.020