LAPORAN PENERIMAAN BARANG

BAHAN PEMBERSIH
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER 2018

BUKTI PENERIMAAN
DOKUMEN FAKTUR
NO TANGGAL DARI NAMA BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA B.A. PENERIMAAN KETERANGAN
NOMOR TANGGAL NOMOR TANGGAL
Siti Rahmah, SKM
1 08/01/2018 Toko Dhafitha Sapu Ijuk 10 40,000 400,000
2 Slaber Sumbu 10 50,000 500,000
3 Sekop Sampah 10 20,000 200,000
4 Pendorong Air 5 25,000 125,000
5 Tempat Sampah 10 150,000 1,500,000

2,725,000

6 09/02/2018 Toko Dhafitha Tissue Multi 1000 gram 13 37,500 487,500

7 Handsanitizer 13 37,000 481,000
8 Pengharum Lantai 10 17,500 175,000
9 Pengharum Ruangan 20 15,000 300,000
10 Sabun Cuci Pakaian 8 18,000 144,000
11 Sabun Cuci Tangan 10 18,000 180,000
12 Sabun Cuci Piring 8 18,000 144,000

1,911,500

13 09/03/2018 Toko Dhafitha Lap Kaki 19 35,000 665,000

14 Tempat Sampah 10 130,000 1,300,000

1,965,000

15 06/04/2018 Toko Dhafitha Tissue Multi 1000 gram 4 37,500 150,000

16 Handsanitizer 5 37,000 185,000
17 Pengharum Lantai 6 17,500 105,000
18 Pengharum Ruangan 6 15,000 90,000
19 Sabun Cuci Pakaian 8 18,000 144,000
20 Sabun Cuci Tangan 7 18,000 126,000
21 Sabun Cuci Piring 8 18,000 144,000

944,000

22 07/05/2018 Toko Dhafitha Bayclin 17 15,000 255,000

23 Pembersih Lantai Kamar Mandi 12 20,000 240,000
24 Sikat WC Pendek 11 12,500 137,500
25 Pembersih Kaca 14 23,000 322,000
954,500
26 07/06/2018 Toko Dhafitha Sapu Ijuk 8 40,000 320,000
27 Sapu Lidi 8 20,000 160,000
28 Ember 7 40,000 280,000
29 Baskom 5 30,000 150,000
910,000
30 11/07/2018 Toko Dhafitha Tissue Multi 1000 gram 6 37,500 225,000
31 Handsanitizer 4 37,000 148,000
32 Pengharum Lantai 4 17,500 70,000
33 Pengharum Ruangan 8 15,000 120,000
34 Sabun Cuci Pakaian 6 18,000 108,000
35 Sabun Cuci Tangan 10 18,000 180,000
36 Sabun Cuci Piring 5 18,000 90,000
941,000
37 08/08/2018 Toko Dhafitha Tissue Multi 1000 gram 5 37,500 187,500
38 Handsanitizer 4 37,000 148,000
39 Pengharum Lantai 6 17,500 105,000
40 Pengharum Ruangan 8 15,000 120,000
41 Sabun Cuci Pakaian 4 18,000 72,000
42 Sabun Cuci Tangan 8 18,000 144,000
43 Sabun Cuci Piring 5 18,000 90,000
866,500
44 06/09/2018 Toko Dhafitha Tissue Multi 1000 gram 4 37,500 150,000
45 Handsanitizer 3 37,000 111,000
46 Pengharum Lantai 5 17,500 87,500
47 Pengharum Ruangan 7 15,000 105,000
48 Sabun Cuci Pakaian 3 18,000 54,000
49 Sabun Cuci Tangan 7 18,000 126,000
50 Sabun Cuci Piring 3 18,000 54,000
687,500
51 11/10/2018 Toko Dhafitha Pembersih Kamar Mandi 11 17,000 187,000
52 Pengharum Lantai 8 17,500 140,000
53 Handsanitizer 8 37,000 296,000
623,000
54 07/11/2018 Toko Dhafitha Keset kaki 10 35,000 350,000
55 Selaber 6 40,000 240,000
56 Pembersih Kaca 10 13,000 130,000
57 Sendok Sampah 6 20,000 120,000
840,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang

Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns

NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002
 BUKU PENGELUARAN BARANG
ALAT TULIS KANTOR
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER 2018

TANGGAL
NO TANGGAL NAMA BARANG KODE BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA UNTUK
PENYERAHAN
1 08/01/2018 Kertas HVS Folio 70 Gram 10 58,000 580,000 Bendahara BOK 10/01/2018
2 Kertas HVS Folio 70 Gram 5 58,000 290,000 Bendahara JKN
3 Kertas HVS Folio 70 Gram 5 58,000 290,000 Tata Usaha
4 Kertas HVS Folio 70 Gram 1 58,000 58,000 Poli KIA
5 Kertas HVS Folio 70 Gram 2 58,000 116,000 Gizi
6 Kertas HVS Folio 70 Gram 2 58,000 116,000 Promkes
7 Kertas HVS Folio 70 Gram 2 58,000 116,000 Kartu
8 Kertas HVS Folio 70 Gram 1 58,000 58,000 Pustu Bori Appaka
9 Kertas HVS Folio 70 Gram 1 58,000 58,000 Poskesdes Bori Appaka
10 Kertas HVS Folio 70 Gram 1 58,000 58,000 Poskesdes Padang-Padangeng
11 Tinta Print Warna Hitam 1 110,000 110,000 Bendahara JKN
12 Tinta Print Warna Hitam 1 110,000 110,000 Tata Usaha
13 Tinta Print Warna Hitam 1 110,000 110,000 Bendahara BOK
14 Tinta Print Warna 1 110,000 110,000 Poskesdes Padang-Padangeng
15 Tinta Print Warna 1 110,000 110,000 Pustu Bori Appaka
16 Tinta Print Warna 1 110,000 110,000 Pustu Bulu Cindea
17 Businnes File 40 10,000 400,000 Bendahara JKN
18 Businnes File 40 10,000 400,000 Bendahara BOK
19 Businnes File 20 10,000 200,000 Tata Usaha
20 Buku Isi 100 Lembar 5 25,000 125,000 Imunisasi
21 Buku Isi 100 Lembar 1 25,000 25,000 Promkes
22 Buku Isi 100 Lembar 2 25,000 50,000 Gizi
23 Buku Isi 100 Lembar 1 25,000 25,000 Kartu
24 Buku Isi 100 Lembar 2 25,000 50,000 KIA
25 Buku Isi 100 Lembar 1 25,000 25,000 Pustu Bori Appaka
26 Buku Isi 100 Lembar 1 25,000 25,000 Poskesdes Bori Appaka
27 Buku Isi 100 Lembar 1 25,000 25,000 Poskesdes Padang-Padangeng
28 Buku Isi 100 Lembar 1 25,000 25,000 Poli Gigi
 3,775,000

29 06/02/2018 Pulpen 2 42,000 84,000 Bendahara BOK 08/02/2018

30 Pulpen 2 42,000 84,000 Bendahara JKN
31 Pulpen 2 42,000 84,000 Tata Usaha
32 Pulpen 1 42,000 42,000 KIA
33 Pulpen 1 42,000 42,000 Laboratorium
34 Pulpen 1 42,000 42,000 Poli Gigi
35 Pulpen 1 42,000 42,000 Apotik
36 Pulpen 1 42,000 42,000 Kartu
37 Pulpen 2 42,000 84,000 Poli Umum
38 Pulpen 1 42,000 42,000 Gizi
39 Pulpen 1 42,000 42,000 Promkes
40 Pulpen 1 42,000 42,000 Pustu Bori Appaka
41 Pulpen 1 42,000 42,000 Poskesdes Bori Appaka
42 Pulpen 1 42,000 42,000 Poskesdes Padang-Padangeng
43 Pulpen 1 42,000 42,000 UGD
44 Pulpen 1 42,000 42,000 Rawat Inap
45 Kartu NCR 2 80,000 160,000 Bendahara JKN
46 Kartu NCR 2 80,000 160,000 Bendahara BOK
47 Kertas HVS 2 60,000 120,000 Bendahara BOK
48 Kertas HVS 2 60,000 120,000 Tata Usaha
49 Kertas HVS 1 60,000 60,000 Bendahara JKN
50 Pulpen Tanda Tangan 2 215,000 430,000 Ruangan kapus
51 Hecter Kecil 2 20,000 40,000 Apotik
52 Hecter Kecil 2 20,000 40,000 Kartu
53 Hecter Kecil 2 20,000 40,000 Pustu Bori Appaka
54 Hecter Kecil 1 20,000 20,000 Promkes
55 Hecter Kecil 1 20,000 20,000 Tata Usaha
56 Hecter Kecil 2 20,000 40,000 Bendahara JKN
57 Hecter Kecil 2 20,000 40,000 Bendahara BOK
58 Hecter Kecil 2 20,000 40,000 Poli Umum
59 Hecter Kecil 1 20,000 20,000 UGD
60 Hecter Kecil 2 20,000 40,000 Poskesdes Bori Appaka
61 Hecter Kecil 1 20,000 20,000 Poskesdes padang-Padangeng
62 Hecter Kecil 1 20,000 20,000 KIA
63 Hecter Kecil 1 20,000 20,000 Poli Gigi
 2,290,000
64 09/03/2018 Spidol Permanen 2 120,000 240,000 Apotik 12/03/2018
65 Spidol Permanen 2 120,000 240,000 Kartu
66 Spidol Permanen 1 120,000 120,000 Pustu Bori Appaka
67 Spidol Permanen 1 120,000 120,000 Poskesdes padang-Padangeng
68 Spidol Permanen 1 120,000 120,000 UGD
69 Spidol Permanen 1 120,000 120,000 Poli Umum
70 Spidol Permanen 1 120,000 120,000 Poskesdes Bori Appaka
71 Spidol Permanen 1 120,000 120,000 Rawat Inap
72 Map plastik Lobang 50 10,000 500,000 Tata Usaha
73 Map plastik Lobang 10 10,000 100,000 Ruangan kapus
74 Map plastik Lobang 50 10,000 500,000 Bendahara JKN
75 Map plastik Lobang 40 10,000 400,000 Bendahara BOK
76 Pensil 1 35,000 35,000 Bendahara BOK
77 Pensil 2 35,000 70,000 Bendahara JKN
78 Pensil 2 35,000 70,000 Tata Usaha

2,875,000

79 05/04/2018 Kertas HVS Folio 70 Gram 7 58,000 406,000 Bendahara BOK 09/04/2018
80 Kertas HVS Folio 70 Gram 5 58,000 290,000 Bendahara JKN
81 Kertas HVS Folio 70 Gram 3 58,000 174,000 Tata Usaha
82 Kertas HVS Folio 70 Gram 1 58,000 58,000 Poli KIA
83 Kertas HVS Folio 70 Gram 2 58,000 116,000 Gizi
84 Kertas HVS Folio 70 Gram 2 58,000 116,000 Promkes
85 Kertas HVS Folio 70 Gram 2 58,000 116,000 Kartu
86 Kertas HVS Folio 70 Gram 2 58,000 116,000 Pustu Bori Appaka
87 Kertas HVS Folio 70 Gram 3 58,000 174,000 Ruangan kapus
88 Kertas HVS Folio 70 Gram 1 58,000 58,000 Poskesdes Padang-Padangeng
89 Kertas HVS Folio 70 Gram 2 58,000 116,000 Poli Umum
90 Buku Tulis Biasa 10 4,500 45,000 Tata Usaha
91 Buku Tulis Biasa 10 4,500 45,000 Bendahara JKN
92 Buku Tulis Biasa 10 4,500 45,000 Bendahara BOK
93 Buku Tulis Biasa 5 4,500 22,500 Rawat Inap
94 Buku Tulis Biasa 5 4,500 22,500 UGD
95 Buku Tulis Biasa 5 4,500 22,500 Poli Umum
96 Buku Tulis Biasa 5 4,500 22,500 KIA
 1,965,000

97 07/05/2018 Pulpen 2 42,000 84,000 Bendahara JKN 09/05/2018

98 Pulpen 2 42,000 84,000 Bendahara BOK
99 Pulpen 1 42,000 42,000 Tata Usaha
100 Pulpen 1 42,000 42,000 KIA
101 Pulpen 1 42,000 42,000 Laboratorium
102 Pulpen 1 42,000 42,000 Poli Gigi
103 Pulpen 1 42,000 42,000 Poli Umum
104 Pulpen 1 42,000 42,000 Kartu
105 Pelubang Kertas 2 20,000 40,000 Bendahara BOK
106 Pelubang Kertas 1 20,000 20,000 Kartu
107 Pelubang Kertas 2 20,000 40,000 Tata Usaha
108 Pelubang Kertas 2 20,000 40,000 Bendahara JKN
109 Pelubang Kertas 1 20,000 20,000 UGD
110 Pelubang Kertas 1 20,000 20,000 Rawat Inap
111 Pelubang Kertas 1 20,000 20,000 Poli Umum
112 Gunting 2 25,000 50,000 Tata Usaha
113 Gunting 1 25,000 25,000 Poli Umum
114 Gunting 2 25,000 50,000 Bendahara BOK
115 Cutter 1 25,000 25,000 Bendahara JKN
116 Cutter 2 25,000 50,000 Tata Usaha
117 Cutter 1 25,000 25,000 Ruangan kapus
118 Cutter 1 25,000 25,000 Bendahara BOK
119 Hecter Kecil 2 20,000 40,000 Tata Usaha
120 Hecter Kecil 1 20,000 20,000 Promkes
121 Hecter Kecil 1 20,000 20,000 Gizi
122 Hecter Kecil 2 20,000 40,000 Kartu
123 Hecter Kecil 1 20,000 20,000 KIA
124 Hecter Kecil 1 20,000 20,000 Pustu Bori Appaka
125 Hecter Kecil 1 20,000 20,000 Poskesdes Padang-Padangeng
126 Hecter Kecil 1 20,000 20,000 Poskesdes Bori Appaka
127 Hecter Kecil 1 20,000 20,000 Poli Gigi
128 Hecter Kecil 2 20,000 40,000 Poli Umum
129 Hecter Kecil 1 20,000 20,000 UGD
130 Hecter Kecil 1 20,000 20,000 Rawat Inap
 1,170,000

131 06/06/2018 Spidol Permanen 1 120,000 120,000 Tata Usaha 08/06/2018

132 Spidol Permanen 1 120,000 120,000 KIA
133 Spidol Permanen 2 120,000 240,000 Apotik
134 Spidol Permanen 1 120,000 120,000 UGD
135 Spidol Permanen 1 120,000 120,000 Rawat Inap
136 Spidol Permanen 1 120,000 120,000 Kartu
137 Tinta Print Warna Hitam 1 110,000 110,000 Bendahara JKN
138 Tinta Print Warna Hitam 1 110,000 110,000 Tata Usaha
139 Tinta Print Warna Hitam 1 110,000 110,000 Ruangan kapus
140 Tinta Print Warna Hitam 1 110,000 110,000 Bendahara BOK
141 Tinta Print Warna 1 115,000 115,000 Bendahara JKN
142 Tinta Print Warna 2 115,000 230,000 Tata Usaha
143 Tinta Print Warna 1 115,000 115,000 Ruangan kapus
144 Tinta Print Warna 2 115,000 230,000 Bendahara BOK
1,970,000
145 05/07/2018 Kertas HVS Folio 70 Gram 5 58,000 290,000 Bendahara BOK 09/07/2018
146 Kertas HVS Folio 70 Gram 5 58,000 290,000 Tata Usaha
147 Kertas HVS Folio 70 Gram 2 58,000 116,000 KIA
148 Kertas HVS Folio 70 Gram 2 58,000 116,000 Gizi
149 Kertas HVS Folio 70 Gram 2 58,000 116,000 Promkes
150 Kertas HVS Folio 70 Gram 1 58,000 58,000 Kartu
151 Kertas HVS Folio 70 Gram 3 58,000 174,000 Bendahara JKN
152 Mistar 2 3,000 6,000 Bendahara BOK
153 Mistar 2 3,000 6,000 Bendahara JKN
154 Mistar 2 3,000 6,000 Tata Usaha
155 Mistar 1 3,000 3,000 KIA
156 Mistar 1 3,000 3,000 Laboratorium
157 Mistar 1 3,000 3,000 Poli Gigi
158 Mistar 1 3,000 3,000 Apotik
159 Mistar 2 3,000 6,000 Kartu
160 Mistar 3 3,000 9,000 Poli Umum
161 Mistar 1 3,000 3,000 Gizi
162 Mistar 1 3,000 3,000 Promkes
163 Mistar 1 3,000 3,000 Pustu Bori Appaka
164 Mistar 1 3,000 3,000 Poskesdes Bori Appaka
165 Mistar 1 3,000 3,000 Poskesdes Padang-Padangeng
166 Trigonal Clip 10 5,000 50,000 Bendahara BOK
167 Tip X 5 5,000 25,000 Bendahara JKN
168 Tip X 2 5,000 10,000 Kartu
169 Tip X 1 5,000 5,000 Promkes
170 Tip X 3 5,000 15,000 Tata Usaha
171 Tip X 5 5,000 25,000 Bendahara BOK
172 Tip X 2 5,000 10,000 Poli Umum
173 Tip X 2 5,000 10,000 KIA
174 Tip X 1 5,000 5,000 Rawat Inap
175 Tip X 2 5,000 10,000 Poli Gigi
176 Tip X 2 5,000 10,000 Laboratorium
177 Binder Clip 260 2 38,000 76,000 Tata Usaha
178 Binder Clip 260 13 38,000 494,000 Bendahara BOK
1,965,000
179 08/08/2018 Buku Agenda 2 45,000 90,000 UGD 10/08/2018
180 Buku Agenda 2 45,000 90,000 Poli Gigi
181 Buku Agenda 1 45,000 45,000 KIA
182 Buku Agenda 2 45,000 90,000 Tata Usaha
183 Buku Agenda 2 45,000 90,000 Poli Umum
184 Buku Agenda 1 45,000 45,000 Bendahara BOK
185 Buku Isi 400 Lembar 4 48,000 192,000 Apotik
186 Buku Isi 400 Lembar 2 48,000 96,000 Poli Gigi
187 Buku Isi 400 Lembar 2 48,000 96,000 KIA
188 Buku Isi 100 Lembar 10 25,000 250,000 Bendahara BOK
189 Buku Isi 100 Lembar 5 25,000 125,000 Tata Usaha
190 Buku Isi 100 Lembar 5 25,000 125,000 KIA
191 Buku Isi 100 Lembar 5 25,000 125,000 Gizi
192 Buku Isi 100 Lembar 2 25,000 50,000 Promkes
193 Buku Isi 100 Lembar 5 25,000 125,000 Poli Umum
194 Buku Isi 100 Lembar 10 25,000 250,000 Bendahara JKN
195 Buku Isi 100 Lembar 3 25,000 75,000 Apotik
196 Buku Isi 100 Lembar 5 25,000 125,000 Imunisasi
197 Buku Isi 100 Lembar 2 25,000 50,000 Laboratorium
198 Buku Isi 100 Lembar 3 25,000 75,000 Pustu Bori Appaka
199 Buku Isi 100 Lembar 3 25,000 75,000 Poskesdes Bori Appaka
200 Buku Isi 100 Lembar 2 25,000 50,000 Poskesdes Padang-Padangeng
 2,334,000
201 07/09/2018 Pulpen 2 48,000 96,000 Bendahara BOK 10/09/2018
202 Pulpen 2 48,000 96,000 Tata Usaha
203 Pulpen 1 48,000 48,000 KIA
204 Pulpen 1 48,000 48,000 Gizi
205 Pulpen 1 48,000 48,000 Promkes
206 Pulpen 2 48,000 96,000 Bendahara JKN
207 Pulpen 2 48,000 96,000 Kartu
208 Pulpen 2 48,000 96,000 Poli Umum
209 Pulpen 1 48,000 48,000 UGD
210 Pulpen 1 48,000 48,000 Apotik
211 Pulpen 1 48,000 48,000 Rawat Inap
212 Pulpen 1 48,000 48,000 Laboratorium
213 Pulpen 1 48,000 48,000 Poli Gigi
214 Pulpen 1 48,000 48,000 Poskesdes Padang-Padangeng
215 Pulpen 1 48,000 48,000 Pustu Bori Appaka
216 NCR 2 80,000 160,000 Bendahara JKN
217 NCR 2 80,000 160,000 Bendahara BOK
218 Pulpen Tanda Tangan 3 215,000 645,000 Ruangan kapus
219 Buku Folio isi 200 Lembar 1 38,000 38,000 Apotik
220 Buku Folio isi 200 Lembar 1 38,000 38,000 Imunisasi
221 Buku Folio isi 200 Lembar 1 38,000 38,000 Promkes
222 Buku Folio isi 200 Lembar 2 38,000 76,000 Tata Usaha
223 Buku Folio isi 200 Lembar 1 38,000 38,000 Pustu Bori Appaka
224 Buku Folio isi 200 Lembar 2 38,000 76,000 Ruang Bendahara
2,229,000
225 08/10/2018 Kertas HVS Folio 70 Gram 6 58,000 348,000 Bendahara BOK 10/10/2018
226 Kertas HVS Folio 70 Gram 10 58,000 580,000 Bendahara JKN
227 Kertas HVS Folio 70 Gram 2 58,000 116,000 Tata Usaha
228 Kertas HVS Folio 70 Gram 2 58,000 116,000 Ruangan kapus
229 Box File 3 20,000 60,000 Poli Umum
230 Box File 50 20,000 1,000,000 Tata Usaha
231 Box File 5 20,000 100,000 Ruangan kapus
232 Box File 4 20,000 80,000 UGD
233 Box File 3 20,000 60,000 Rawat Inap
234 Box File 5 20,000 100,000 Kartu
 2,560,000
235 09/11/2018 Spidol Permanen 3 48,000 144,000 Apotik 12/11/2018
236 Spidol Permanen 2 48,000 96,000 Kartu
237 Spidol Permanen 2 48,000 96,000 Tata Usaha
238 Spidol Permanen 1 48,000 48,000 Pustu Bori Appaka
239 Spidol Permanen 1 48,000 48,000 UGD
240 Spidol Permanen 1 48,000 48,000 Rawat Inap
241 Tinta Print Warna Hitam 1 110,000 110,000 Ruangan kapus
242 Tinta Print Warna Hitam 3 110,000 330,000 Tata Usaha
243 Businnes File 10 5,000 50,000 Poli Umum
244 Businnes File 120 5,000 600,000 Tata Usaha
245 Businnes File 5 5,000 25,000 KIA
246 Businnes File 5 5,000 25,000 Gizi
247 Businnes File 5 5,000 25,000 Promkes
248 Businnes File 5 5,000 25,000 UGD
1,670,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang

Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns

NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002
 LAPORAN PENERIMAAN BARANG
ALAT TULIS KANTOR
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER TAHUN 2018

BUKTI PENERIMAAN
DOKUMEN FAKTUR
NO TANGGAL DARI NAMA BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA B.A. PENERIMAAN KETERANGAN
NOMOR TANGGAL NOMOR TANGGAL
Siti Rahmah, SKM
1 08/01/2018 CV.Global Sistima Citra Kertas HVS Folio 70 Gram 30 58,000 1,740,000
2 Tinta Print Hitam Epson 3 110,000 330,000
3 Tinta Print Warna Epson 3 110,000 330,000
4 Businnes File 100 10,000 1,000,000
5 Buku Isi 100 Lembar 15 25,000 375,000
3,775,000
Siti Rahmah, SKM
6 06/02/2018 CV.Global Sistima Citra Pulpen 20 42,000 840,000
7 Kertas NCR 4 80,000 320,000
8 Kertas HVS 5 60,000 300,000
9 Pulpen Tanda Tangan 2 215,000 430,000
10 Hecter Kecil 20 20,000 400,000
2,290,000
Siti Rahmah, SKM
11 09/03/2018 CV.Global Sistima Citra Spidol Permanen 10 120,000 1,200,000
12 Map Plastik Lobang 150 10,000 1,500,000
13 Pensil 5 35,000 175,000
2,875,000
Siti Rahmah, SKM

14 05/04/2018 CV.Global Sistima Citra Kertas HVS Folio 70 gram 30 58,000 1,740,000
15 Buku Tulis Biasa 50 4,500 225,000
1,965,000
Siti Rahmah, SKM
16 07/05/2018 CV.Global Sistima Citra Pulpen 10 42,000 420,000
17 Pelubang Kertas 10 20,000 200,000
18 Gunting 5 25,000 125,000
19 Cutter 5 25,000 125,000
20 Hecter Kecil 15 20,000 300,000
1,170,000
Siti Rahmah, SKM
21 06/06/2018 CV.Global Sistima Citra Tinta Printer Epson Hitam 4 110,000 440,000
22 Tinta Printer Epson Warna 6 115,000 690,000
23 Spidol Permanen 7 120,000 840,000
1,970,000
Siti Rahmah, SKM
24 05/07/2018 CV.Global Sistima Citra Kertas HVS Folio 70 gram 20 58,000 1,160,000
25 Tip X 25 5,000 125,000
26 Mistar 20 3,000 60,000
27 Trigonal Clip 10 5,000 50,000
28 Binder Clip 260 15 38,000 570,000
1,965,000

Siti Rahmah, SKM

29 08/08/2018 CV.Global Sistima Citra Buku Isi 100 60 25,000 1,500,000
30 Buku Isi 400 8 48,000 384,000
31 Buku Agenda 10 45,000 450,000
2,334,000
Siti Rahmah, SKM
32 07/09/2018 CV.Global Sistima Citra Pulpen 20 48,000 960,000
33 Pulpen Tanda Tangan 3 215,000 645,000
34 Buku Folio Isi 200 Lembar 8 38,000 304,000
35 Kertas NCR 4 80,000 320,000
 2,229,000
Siti Rahmah, SKM
36 08/10/2018 CV.Global Sistima Citra Kertas HVS Folio 70 gram 20 58,000 1,160,000
37 Box File 70 20,000 1,400,000
2,560,000

38 09/11/2018 CV.Global Sistima Citra Spidol Permanen 10 48,000 480,000

39 Businnes File 150 5,000 750,000
Tinta Printer Warna Hitam 4 110,000 440,000
1,670,000
24,803,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang

Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns

NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002
 BUKU PENGELUARAN BARANG
BAHAN PEMBERSIH
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER 2018

TANGGAL
NO TANGGAL NAMA BARANG KODE BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA UNTUK
PENYERAHAN
1 08/01/2018 Sapu Ijuk 6 40,000 240,000 Puskesmas 10/01/2018
2 Sapu Ijuk 2 40,000 80,000 Pustu Bori Appaka
3 Sapu Ijuk 1 40,000 40,000 Poskesdes Bori Appaka
4 Sapu Ijuk 1 40,000 40,000 Poskesdes Padang-Padangeng
5 Slaber Sumbu 7 50,000 350,000 Puskesmas
6 Slaber Sumbu 1 50,000 50,000 Pustu Bori Appaka
7 Slaber Sumbu 1 50,000 50,000 Poskesdes Padang-Padangeng
8 Slaber Sumbu 1 50,000 50,000 Poskesdes Bori Appaka
9 Tempat Sampah Besar 7 150,000 1,050,000 Puskesmas
10 Tempat Sampah Besar 1 150,000 150,000 Pustu Bori Appaka
11 Tempat Sampah Besar 1 150,000 150,000 Poskesdes Bori Appaka
12 Tempat Sampah Besar 1 150,000 150,000 Poskesdes Padang-Padangeng
13 Pendorong Air 3 25,000 75,000 Puskesmas
14 Pendorong Air 1 25,000 25,000 Poskesdes Bori Appaka
15 Pendorong Air 1 25,000 25,000 Pustu Bori Appaka
16 Skop Sampah 8 20,000 160,000 Puskesmas
17 Skop Sampah 1 20,000 20,000 Pustu Bori Appaka
18 Skop Sampah 1 20,000 20,000 Poskesdes Padang-Padangeng
2,725,000

19 09/02/2018 Handwash 2 18,000 36,000 Laboratorium 12/02/2018

20 Handwash 1 18,000 18,000 Poli Umum
21 Handwash 3 18,000 54,000 Poli Gigi
22 Handwash 3 18,000 54,000 UGD
23 Handwash 1 18,000 18,000 Poli KIA
24 Tissue Multi 1000 Gram 2 37,500 75,000 Poli KIA
25 Tissue Multi 1000 Gram 3 37,500 112,500 Laboratorium
26 Tissue Multi 1000 Gram 3 37,500 112,500 UGD
27 Tissue Multi 1000 Gram 2 37,500 75,000 Poli Umum
28 Tissue Multi 1000 Gram 3 37,500 112,500 Poli Gigi
29 Hand Sanitizer 2 37,000 74,000 Klinik
30 Hand Sanitizer 2 37,000 74,000 Ruangan Kapus
31 Hand Sanitizer 2 37,000 74,000 Poli Gigi
32 Hand Sanitizer 2 37,000 74,000 Poli Umum
33 Hand Sanitizer 2 37,000 74,000 Poli KIA
34 Hand Sanitizer 3 37,000 111,000 laboratorium
35 Pengharum Ruangan 3 15,000 45,000 Poli KIA
36 Pengharum Ruangan 3 15,000 45,000 Laboratorium
37 Pengharum Ruangan 3 15,000 45,000 Klinik
38 Pengharum Ruangan 3 15,000 45,000 Ruangan Kapus
39 Pengharum Ruangan 3 15,000 45,000 Ruangan Bendahara
40 Pengharum Ruangan 3 15,000 45,000 Aula
41 Pengharum Ruangan 1 15,000 15,000 UGD
42 Pengharum Ruangan 1 15,000 15,000 Kartu
43 Pengharum Lantai 3 17,500 52,500 Puskesmas
44 Pengharum Lantai 3 17,500 52,500 Poskesdes Padang-Padangeng
45 Pengharum Lantai 3 17,500 52,500 Pustu Bori Appaka
46 Pengharum Lantai 1 17,500 17,500 Poskesdes Bori Appaka
47 Sabun Cuci Pakaian 8 18,000 144,000 Puskesmas
48 Sabun Cuci Piring 8 18,000 144,000 Puskesmas
1,911,500
49 09/03/2018 Tempat Sampah 4 130,000 520,000 Puskesmas 12/03/2018
50 Tempat Sampah 2 130,000 260,000 Poskesdes Bori Appaka
51 Tempat Sampah 2 130,000 260,000 Poskesdes Padang-Padangeng
52 Tempat Sampah 2 130,000 260,000 Pustu Bori Appaka
53 Keset Kaki 13 35,000 455,000 Puskesmas
54 Keset Kaki 2 35,000 70,000 Pustu Bori Appaka
55 Keset Kaki 2 35,000 70,000 Poskesdes Bori Appaka
56 Keset Kaki 2 35,000 70,000 Poskesdes Padang-Padangeng
1,965,000
57 06/04/2018 Tissue Multi 1000 Gram 1 37,500 37,500 Poli KIA 09/04/2018
58 Tissue Multi 1000 Gram 1 37,500 37,500 Laboratorium
59 Tissue Multi 1000 Gram 1 37,500 37,500 Poli Gigi
60 Tissue Multi 1000 Gram 1 37,500 37,500 Poli Umum
61 Handsanitizer 1 37,000 37,000 Klinik
62 Handsanitizer 1 37,000 37,000 Ruangan Kapus
63 Handsanitizer 1 37,000 37,000 Poli Gigi
64 Handsanitizer 1 37,000 37,000 Laboratorium
65 Handsanitizer 1 37,000 37,000 Poli KIA
66 Pengharum Lantai 3 17,500 52,500 Puskesmas
67 Pengharum Lantai 1 17,500 17,500 Poskesdes Padang-Padangeng
68 Pengharum Lantai 1 17,500 17,500 Pustu Bori Appaka
69 Pengharum Lantai 1 17,500 17,500 Poskesdes Bori Appaka
70 Pengharum Ruangan 1 15,000 15,000 Poli KIA
71 Pengharum Ruangan 1 15,000 15,000 Laboratorium
72 Pengharum Ruangan 1 15,000 15,000 Klinik
73 Pengharum Ruangan 1 15,000 15,000 Ruangan Bendahara
74 Pengharum Ruangan 1 15,000 15,000 Ruangan Kapus
75 Pengharum Ruangan 1 15,000 15,000 Aula
76 Sabun Cuci Pakaian 8 18,000 144,000 Puskesmas
77 Sabun Cuci Piring 8 18,000 144,000 Puskesmas
78 Sabun Cuci Tangan 1 18,000 18,000 laboratorium
79 Sabun Cuci Tangan 1 18,000 18,000 Poli Umum
80 Sabun Cuci Tangan 2 18,000 36,000 Poli Gigi
81 Sabun Cuci Tangan 2 18,000 36,000 UGD
82 Sabun Cuci Tangan 1 18,000 18,000 Poli KIA
944,000
83 07/05/2018 Pembersih Lantai Kamar mandi 9 20,000 180,000 Puskesmas 08/05/2018
84 Pembersih Lantai Kamar mandi 1 20,000 20,000 Pustu Bori Appaka
85 Pembersih Lantai Kamar mandi 1 20,000 20,000 Poskesdes Bori Appaka
86 Pembersih Lantai Kamar mandi 1 20,000 20,000 Poskesdes Padang-Padangeng
87 Pembersih kaca 12 23,000 276,000 Puskesmas
88 Pembersih kaca 1 23,000 23,000 Pustu Bori Appaka
89 Pembersih kaca 1 23,000 23,000 Poskesdes Bori Appaka
90 Bayclin 11 15,000 165,000 Puskesmas
91 Bayclin 2 15,000 30,000 Poskesdes padang-Padangeng
92 Bayclin 2 15,000 30,000 Poskesdes Bori Appaka
93 Bayclin 2 15,000 30,000 Pustu Bori Appaka
94 Sikat WC 7 12,500 87,500 Puskesmas
95 Sikat WC 2 12,500 25,000 Pustu Bori Appaka
96 Sikat WC 2 12,500 25,000 Poskesdes Bori Appaka
954,500
97 08/06/2018 Sapu Ijuk 5 40,000 200,000 Puskesmas 09/06/2018
 98 Sapu Ijuk 1 40,000 40,000 Pustu Bori Appaka
99 Sapu Ijuk 1 40,000 40,000 Poskesdes padang-Padangeng
100 Sapu Ijuk 1 40,000 40,000 Poskesdes Bori Appaka
101 Sapu Lidi 5 20,000 100,000 Puskesmas
102 Sapu Lidi 1 20,000 20,000 Poskesdes padang-Padangeng
103 Sapu Lidi 1 20,000 20,000 Pustu Bori Appaka
104 Sapu Lidi 1 20,000 20,000 Poskesdes Bori Appaka
105 Ember 5 40,000 200,000 Puskesmas
106 Ember 1 40,000 40,000 Poskesdes Padang-Padangeng
107 Ember 1 40,000 40,000 Poskesdes Bori Appaka
108 Baskom 3 30,000 90,000 Puskesmas
109 Baskom 1 30,000 30,000 Poskesdes Padang-Padangeng
110 Baskom 1 30,000 30,000 Poskesdes Bori Appaka
910,000
111 11/07/2018 Tissue Multi 1000 Gram 1 37,500 37,500 Poli KIA 13/07/2018
112 Tissue Multi 1000 Gram 2 37,500 75,000 laboratorium
113 Tissue Multi 1000 Gram 2 37,500 75,000 Poli Gigi
114 Tissue Multi 1000 Gram 1 37,500 37,500 Poli Umum
115 Handsanitizer 1 37,000 37,000 Klinik
116 Handsanitizer 1 37,000 37,000 Poli KIA
117 Handsanitizer 1 37,000 37,000 Poli Gigi
118 Handsanitizer 1 37,000 37,000 laboratorium
119 Pengharum Lantai 3 17,500 52,500 Puskesmas
120 Pengharum Lantai 1 17,500 17,500 Pustu Bori Appaka
121 Pengharum Ruangan 2 15,000 30,000 Poli KIA
122 Pengharum Ruangan 1 15,000 15,000 laboratorium
123 Pengharum Ruangan 1 15,000 15,000 Klinik
124 Pengharum Ruangan 1 15,000 15,000 Ruangan Kapus
125 Pengharum Ruangan 1 15,000 15,000 Ruangan Bendahara
126 Pengharum Ruangan 2 15,000 30,000 Aula
127 Sabun Cuci Pakaian 6 18,000 108,000 Puskesmas
128 Sabun Cuci Piring 5 18,000 90,000 Puskesmas
129 Sabun Cuci Tangan 2 18,000 36,000 Laboratorium
130 Sabun Cuci Tangan 2 18,000 36,000 Poli Umum
131 Sabun Cuci Tangan 2 18,000 36,000 Poli Gigi
132 Sabun Cuci Tangan 2 18,000 36,000 UGD
133 Sabun Cuci Tangan 2 18,000 36,000 Poli KIA
 941,000
134 08/08/2018 Tissue Multi 1000 Gram 1 37,500 37,500 Poli KIA 10/08/2018
135 Tissue Multi 1000 Gram 1 37,500 37,500 Laboratorium
136 Tissue Multi 1000 Gram 2 37,500 75,000 Poli Gigi
137 Tissue Multi 1000 Gram 1 37,500 37,500 Poli Umum
138 Hand Sanitizer 1 37,000 37,000 Klinik
139 Hand Sanitizer 1 37,000 37,000 Poli KIA
140 Hand Sanitizer 1 37,000 37,000 Poli Gigi
141 Hand Sanitizer 1 37,000 37,000 Laboratorium
142 Pengharum Lantai 4 17,500 70,000 Puskesmas
143 Pengharum Lantai 1 17,500 17,500 Pustu Bori Appaka
144 Pengharum Lantai 1 17,500 17,500 Poskesdes Bori Appaka
145 Pengharum Ruangan 2 15,000 30,000 Poli KIA
146 Pengharum Ruangan 1 15,000 15,000 Laboratorium
147 Pengharum Ruangan 1 15,000 15,000 Klinik
148 Pengharum Ruangan 1 15,000 15,000 Ruangan Kapus
149 Pengharum Ruangan 1 15,000 15,000 Ruangan Bendahara
150 Pengharum Ruangan 2 15,000 30,000 Aula
151 Sabun Cuci Pakaian 4 18,000 72,000 Puskesmas
152 Sabun Cuci Piring 5 18,000 90,000 Puskesmas
153 Sabun Cuci Tangan 2 18,000 36,000 Laboratorium
154 Sabun Cuci Tangan 1 18,000 18,000 Poli Umum
155 Sabun Cuci Tangan 2 18,000 36,000 Poli Gigi
156 Sabun Cuci Tangan 2 18,000 36,000 UGD
157 Sabun Cuci Tangan 1 18,000 18,000 Poli KIA
866,500
158 06/09/2018 Tissue Multi 1000 Gram 1 37,500 37,500 Poli KIA 10/09/2018
159 Tissue Multi 1000 Gram 1 37,500 37,500 Poli Gigi
160 Tissue Multi 1000 Gram 1 37,500 37,500 laboratorium
161 Tissue Multi 1000 Gram 1 37,500 37,500 Poli Umum
162 Hand Sanitizer 1 37,000 37,000 Klinik
163 Hand Sanitizer 1 37,000 37,000 Poli KIA
164 Hand Sanitizer 1 37,000 37,000 UGD
165 Pengharum Lantai 3 17,500 52,500 Puskesmas
166 Pengharum Lantai 1 17,500 17,500 Pustu Bori Appaka
167 Pengharum Lantai 1 17,500 17,500 Poskesdes Padang-Padangeng
168 Pengharum Ruangan 1 15,000 15,000 Poli KIA
169 Pengharum Ruangan 1 15,000 15,000 laboratorium
170 Pengharum Ruangan 1 15,000 15,000 Klinik
171 Pengharum Ruangan 1 15,000 15,000 Ruangan Kapus
172 Pengharum Ruangan 1 15,000 15,000 Ruangan Bendahara
173 Pengharum Ruangan 2 15,000 30,000 Aula
174 Sabun Cuci Pakaian 3 18,000 54,000 Puskesmas
175 Sabun Cuci Piring 3 18,000 54,000 Puskesmas
176 Sabun Cuci Tangan 1 18,000 18,000 laboratorium
177 Sabun Cuci Tangan 1 18,000 18,000 Poli Umum
178 Sabun Cuci Tangan 2 18,000 36,000 Poli Gigi
179 Sabun Cuci Tangan 2 18,000 36,000 UGD
180 Sabun Cuci Tangan 1 18,000 18,000 Poli KIA
687,500
181 11/10/2018 Pembersih Kamar Mandi 8 17,000 136,000 Puskesmas 15/10/2018
182 Pembersih Kamar Mandi 1 17,000 17,000 Poskesdes padang-Padangeng
183 Pembersih Kamar Mandi 1 17,000 17,000 Pustu Bori Appaka
184 Pembersih Kamar Mandi 1 17,000 17,000 Poskesdes Bori Appaka
185 Pengharum Lantai 5 17,500 87,500 Puskesmas
186 Pengharum Lantai 1 17,500 17,500 Pustu Bori Appaka
187 Pengharum Lantai 1 17,500 17,500 Poskesdes Bori Appaka
188 Pengharum Lantai 1 17,500 17,500 Poskesdes padang-Padangeng
189 Handsanitizer 2 37,000 74,000 Klinik
190 Handsanitizer 1 37,000 37,000 Pustu Bori Appaka
191 Handsanitizer 1 37,000 37,000 Poli Gigi
192 Handsanitizer 1 37,000 37,000 UGD
193 Handsanitizer 1 37,000 37,000 Poli KIA
194 Handsanitizer 1 37,000 37,000 laboratorium
195 Handsanitizer 1 37,000 37,000 Poskesdes Bori Appaka
623,000
196 07/11/2018 Keset Kaki 1 35,000 35,000 Ruangan Kapus 09/11/2018
197 Keset Kaki 1 35,000 35,000 Ruangan Bendahara
198 Keset Kaki 2 35,000 70,000 Ruangan Poli
199 Keset Kaki 1 35,000 35,000 UGD
200 Keset Kaki 3 35,000 105,000 Rawat Inap
201 Keset Kaki 1 35,000 35,000 Poli KIA
202 Keset Kaki 1 35,000 35,000 Pustu Bori Appaka
203 Selaber 4 40,000 160,000 Puskesmas
204 Selaber 1 40,000 40,000 Pustu Bori Appaka
205 Selaber 1 40,000 40,000 Poskesdes Bori Appaka
206 Pembersih Kaca 8 13,000 104,000 Puskesmas
207 Pembersih Kaca 1 13,000 13,000 Pustu Bori Appaka
208 Pembersih Kaca 1 13,000 13,000 Poskesdes Bori Appaka
209 Sendok Sampah 4 20,000 80,000 Puskesmas
210 Sendok Sampah 1 20,000 20,000 Pustu Bori Appaka
211 Sendok Sampah 1 20,000 20,000 Poskesdes Bori Appaka
840,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang

Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns

NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002
 LAPORAN PENERIMAAN BARANG
MATERAI
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER TAHUN 2018

BUKTI PENERIMAAN
DOKUMEN FAKTUR
NO TANGGAL DARI NAMA BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA B.A. PENERIMAAN KETERANGAN
NOMOR TANGGAL NOMOR TANGGAL
Siti Rahmah, SKM
1 14/05/2018 Kantor Pos Bungoro Materai 6,000 70 6,000 420,000
2 Materai 3,000 30 3,000 90,000
510,000

Siti Rahmah, SKM

3 21/08/2018 Kantor Pos Bungoro Materai 6,000 150 6,000 900,000
4 Materai 3,000 30 3,000 90,000
990,000

Siti Rahmah, SKM

5 06/11/2018 Kantor Pos Bungoro Materai 6,000 120 6,000 720,000
6 Materai 3,000 40 3,000 120,000
840,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang
Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns
NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002
 BUKU PENGELUARAN BARANG
BAHAN HABIS PAKAI
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER 2018

TANGGAL
NO TANGGAL NAMA BARANG KODE BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA UNTUK
PENYERAHAN
1 05/03/2018 Oksigen O2 6M3 5 175,000 875,000 UGD 06/03/2018
2 Oksigen O2 1M3 1 80,000 80,000 Poli KIA
3 Oksigen O2 1M3 2 80,000 160,000 UGD
4 Oksigen O2 1M3 2 80,000 160,000 Ambulance
1,275,000

5 06/07/2018 Oksigen O2 6M3 5 175,000 875,000 UGD 09/07/2018

6 Oksigen O2 1M3 1 80,000 80,000 Poli KIA
7 Oksigen O2 1M3 2 80,000 160,000 UGD
8 Oksigen O2 1M3 2 80,000 160,000 Ambulance
1,275,000
9 02/08/2018 Strip Cholesterol 6 250,000 1,500,000 Laboratorium 03/08/2018
10 Strip Gula 6 135,000 810,000 Laboratorium
11 Strip Asam Urat 5 150,000 750,000 Laboratorium
12 Spoit 3 ml OM 1 160,000 160,000 UGD
13 Masker Jilbab 2 50,000 100,000 Poli Umum
14 Masker Jilbab 3 50,000 150,000 ugD
3,470,000
15 17/09/2018 Oil Immersion 100 ml 1 550,000 550,000 Laboratorium 18/09/2018
16 Handscoen Steril 7,5 25 15,950 398,750 Poli KIA
17 Handscoen Steril 7,5 10 15,950 159,500 Poli Umum
18 Handscoen Steril 7,5 10 15,950 159,500 Rawat Inap
19 Handscoen Steril 7,5 50 15,950 797,500 UGD
20 Handscoen Steril 7,5 5 15,950 79,750 Ruang TBC
21 Zat Obat 10 x 15 10 10,500 105,000 Apotik
22 Articaine 30 35,000 1,050,000 Poli Gigi
23 Widal Test 1 1,200,000 1,200,000 Laboratorium
24 Kartu Golongan Darah 2 67,000 134,000 Laboratorium
25 Lysol 1 25,000 25,000 Laboratorium
26 White Tip 1 85,000 85,000 Poli Gigi
27 Anastetic Topikal Gel 1 450,000 450,000 Poli Gigi
5,194,000
28 18/10/2018 Oksigen O2 6M3 5 175,000 875,000 UGD 19/10/2018
29 Oksigen O2 1M3 1 80,000 80,000 Poli KIA
30 Oksigen O2 1M3 2 80,000 160,000 UGD
31 Oksigen O2 1M3 2 80,000 160,000 Ambulance
1,275,000
32 19/11/2018 Sarung Tangan Tri Gloves 3 55,000 165,000 Apotik 21/11/2018
33 Ultrasonic Gel 250 ml 2 85,000 170,000 UGD
34 Ultrasonic Gel 250 ml 7 85,000 595,000 Poli KIA
35 Ultrasonic Gel 250 ml 7 85,000 595,000 Poli Umum
36 Aseptik Gel 5 liter 2 396,000 792,000 Apotik
37 Selang O2 Dewasa ( Nasal O2 ) 15 45,000 675,000 Apotik
38 Selang O2 Dewasa ( Nasal O2 ) 5 45,000 225,000 UGD
39 Kertas Puyer Set 4 110,000 440,000 Apotik
40 Safety Vest 0 30,000 0 Gudang
41 ID Band Anak 1 150,000 150,000 Rawat Inap
42 ID Band Dewasa 1 150,000 150,000 Rawat Inap
43 Vaculab 3 ml 200 5,000 1,000,000 Laboratorium
44 Umbilical Cord Klem 80 3,000 240,000 Poli KIA
45 Nasal Canula Anak 10 45,000 450,000 UGD
46 Nasal Canula Bayi 3 45,000 135,000 UGD
47 Nasal Canula Bayi 2 45,000 90,000 Poli KIA
48 Handscoen Non Steril 6 90,000 540,000 UGD
49 Handscoen Non Steril 1 90,000 90,000 Rawat Inap
50 Handscoen Non Steril 1 90,000 90,000 Poli Umum
51 Handscoen Non Steril 2 90,000 180,000 Poli KIA

6,772,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang

Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns

NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002
 LAPORAN PENERIMAAN BARANG
BAHAN HABIS PAKAI
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER 2018

BUKTI PENERIMAAN
DOKUMEN FAKTUR
NO TANGGAL DARI NAMA BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA B.A. PENERIMAAN KETERANGAN
NOMOR TANGGAL NOMOR TANGGAL
Siti Rahmah, SKM
1 05/03/2018 CV.Saputra Jaya Oksigen O2 6M3 5 175,000 875,000
2 Oksigen O2 1M3 5 80,000 400,000
1,275,000
3 06/07/2018 CV.Saputra Jaya Oksigen O2 6M3 5 175,000 875,000
4 Oksigen O2 1M3 5 80,000 400,000
1,275,000
5 02/08/2018 CV.Saputra Jaya Strip Cholesterol 6 250,000 1,500,000
6 Strip Gula 6 135,000 810,000
7 Strip Asam Urat 5 150,000 750,000
8 Spoit 3 ml OM 1 160,000 160,000
9 Masker 5 50,000 250,000
3,470,000
10 17/09/2018 CV.Saputra Jaya Oil Emersion 100 ml 1 550,000 550,000
11 Handscoen Steril 7,5 100 15,950 1,595,000
12 Zak Obat 10 x 15 10 10,500 105,000
13 Articaine 30 35,000 1,050,000
14 Widal Test 1 1,200,000 1,200,000
15 Kartu Golongan Darah 2 67,000 134,000
16 Lysol 1 25,000 25,000
17 White Tip 1 85,000 85,000
18 Anestetic Topical Gel 1 450,000 450,000
5,194,000
19 18/10/2018 CV.Saputra Jaya Oksigen O2 6M3 5 175,000 875,000
20 Oksigen O2 1M3 5 80,000 400,000
 1,275,000
21 19/11/2018 CV.Saputra Jaya Sarung Tangan Tri Gloves 3 55,000 165,000
22 Ultrasonic Gel 250 ml 16 85,000 1,360,000
23 Aseptik Gel 5 ltr 2 396,000 792,000
24 Selang O2 Dewasa ( Nassal O2 ) 20 45,000 900,000
25 Kertas Puyer Set 4 110,000 440,000
26 Safety Vest 1 30,000 30,000
27 ID Band Anak 1 150,000 150,000
28 ID Band Dewasa 1 150,000 150,000
29 Vaculab 3 ML 200 5,000 1,000,000
30 Umbilical Cord Klem 80 3,000 240,000
31 Nasal Canula Anak 10 45,000 450,000
32 Nasal Canula Bayi 5 45,000 225,000
33 Handscoen Non Steril 10 90,000 900,000
6,802,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang

Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns

NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002
 BUKU PENGELUARAN BARANG
MATERAI
PUSKESMAS BOWONG CINDEA
JANUARI - DESEMBER 2018

TANGGAL
NO TANGGAL NAMA BARANG KODE BARANG BANYAKNYA HARGA SATUAN JUMLAH HARGA UNTUK
PENYERAHAN
1 14/05/2018 Materai 6,000 20 6,000 120,000 Bendahara BOK 15/05/2018
2 Materai 6,000 25 6,000 150,000 Bendahara Penerimaan
3 Materai 6,000 25 6,000 150,000 Bendahara JKN
4 14/05/2018 Materai 3,000 10 3,000 30,000 Bendahara BOK 15/05/2018
5 Materai 3,000 10 3,000 30,000 Bendahara JKN
6 Materai 3,000 10 3,000 30,000 Bendahara Penerimaan
510,000

7 21/08/2018 Materai 6,000 50 6,000 300,000 Bendahara BOK 22/08/2018

8 Materai 6,000 50 6,000 300,000 Bendahara Penerimaan
9 Materai 6,000 50 6,000 300,000 Bendahara JKN
10 21/08/2018 Materai 3,000 15 3,000 45,000 Bendahara JKN 22/08/2018
11 Materai 3,000 15 3,000 45,000 Bendahara BOK
990,000

12 06/11/2018 Materai 6,000 30 6,000 180,000 Bendahara BOK 08/11/2018

13 Materai 6,000 50 6,000 300,000 Bendahara Penerimaan
14 Materai 6,000 40 6,000 240,000 Bendahara JKN
15 06/11/2018 Materai 3,000 20 3,000 60,000 Bendahara JKN 08/11/2018
16 Materai 3,000 20 3,000 60,000 Bendahara BOK

840,000

Mengetahui Bowong Cindea

Kepala Puskesmas Bowong Cindea Pengelola Barang
Drg.Nur Syamsi Sartika Sanoni, S.Kep Ns
NIP : 19791015 201406 2 001 NIP : 19850611 200502 2 002