DINAS KESEHATAN ANGKATAN LAUT

LADOKGI R.E. MARTADINATA

RENBUT PERMOHONAN PERMINTAAN BEKKES

BULAN : Maret 2018 KLINIK : Prosto Reguler

BEKAL SISA
NO NAMA BARANG SATUAN PEMAKAIAN RENBUT DIMINTA DITERIMA
AWAL AKHIR
1 2 3 4 5 6 7 8 9

1 Albothil Botol 0 1 1 - -
2 Alginate Bks 6 6 - 8 8
3 Alkohol Botol 1 1 - 2 2
4 Aquabidest Botol 0 1 1 - -
5 Articulating Paper Box 1 1 0 1 1
6 Biflouride Box 1 1 1 - -
7 Bonding Botol 1 1 1 - -
8 Broided Ginggiva retraction cord Buah 0 0 - 1 1
9 Bur Diamond Buah 1 1 1
10 Bur TF 14 Pack 0 2 2
11 Bur TR 14,15 Pack 4 4 0 4 4
12 Bur RS 11 Pack 1 1 0 2 2
13 Bur FO 32 Seat - - 0 2 2
14 Bur BR Seat - - 0
15 Bur SI Seat - - 0
16 Bur WR 13, 13C Seat - - 0 2 2
17 Bur TF Seat - - 0
18 Bur TR Seat - - 0
19 Bur Fresser/ Poles Akrilic Buah 1 1 1 1 1
20 Bur kuning GW2, SS white Buah 2 2 1 2 2
21 Bur Round Buah 2 2 1
22 Calcium Hydroxyde,Ultracal Tube 1 1 1 - -
23 Cavit Box 1 1 1 - -
24 CHKM Botol 1 1 1 - -
25 Cocoa butter Tube 1 1 1 - -
26 Coeliner Set 1 1 1 1 1
 2

1 2 3 4 5 6 7 8 9

27 Composit Flow Tube 1 1 - 1 1

28 Composit Z 350 Tube 1 1 1 1 1
29 Composite P 60 Tube - - - - -
30 Composite Z 250 Tube 1 1 1 1 1
31 Cresophen Botol 1 1 1 - -
32 Dental Floss Roll 1 1 1 - -
33 Dycal Box 1 1 1 - -
34 Edta Botol 1 1 1 1 1
35 Elite Cement Set 1 1 1 1 1
36 Enhance Buah 5 5 1 5 5
37 Etching Botol 1 1 1 - -
38 Eugenol Botol 1 1 1 - -
39 Exaflex, Putty + Exaflex injection Set 1 1 - 1 1
40 Fletcher Botol 1 1 1 - -
41 Fuji I, G.C Set 1 1 1 - -
42 Fuji II,G.C Set 1 1 1 - -
43 Fuji IX, G.C Set 1 1 1 - -
44 Fuji Varnis, G.C Botol 1 1 - 1 1
45 Gate gliden drill Pack 1 1 - 1 1
46 Green Steak Pack 0 1 - 1 1
47 H2O2 Botol 1 1 0 1 1
48 Jarum Citoject Pack 1 1 1 - -
49 Jarum lentulo Pack 1 1 - 1 1
50 Liquid Hillon Liter 1 1 1 - -
51 Major Pin Cutter Disc Box - - - 1 1
52 Major Roughing Disc Box - - - - -
53 Malam Box 1 1 - 1 1
54 Masker disposible Box 2 2 - 4 4
55 Metronidazol, Ti-es Tube 0 0 0 1 1
56 Microbrush Pack 4 4 0 4 4
57 Muldano Kg 5 5 - 5 5
58 Muldaroc Kg 5 5 - 5 5
59 NaCl Botol 1 1 1 0 0
 3

1 2 3 4 5 6 7 8 9

60 New plaston Box 2 2 - 2 2

61 Occo Botol 1 1 1 - -
62 Pasak screw readamet
63 Panaspray Botol 1 1 1 - -
64 Pehacain Box - - - - -
65 Peso reamer Pack 1 1 - 2 2
66 Polybib Pack 2 2 - 2 2
67 Poles Acrilic / Porcelin kit Set 0 1 1 1 1
68 Sarung tangan, Sensigloves Box 4 4 1 8 8
69 Scandonest 3%, Septodont Box - - - - -
70 Self Curing liquid Botol 1 1 1 - -
71 Self Curing Powder, Stellon Botol 1 1 1 - -
72 Sikat Hitam Kasar Buah - - -
73 Sikat Putih Wool Buah 1 1 - 1 1
74 Spuit 5 Ml Box 1 1 1 - -
75 Stone Hitam Box 0 0 0 5 5
76 Stone hijau Buah 4 4 2 2 2
77 Suction disposible Pack 1 1 1 1 1
78 Tembon/fregenol Box 0 1 1 1 1
79 Tempron Set 1 1 1 - -
80 Vaselin Kg 1 1 1 - -
81 Viscostat refill, Ultradent Buah 1 1 - 1 1
82 Vita Special Modelling Liquid Botol - - - - -
83 Vita VMK 95 Transculent Botol - - - - -
84 Xylonor spray, Botol 0 1 1 1 1

Mengetahui, Mengetahui, Jakarta, 20 Pebruari 2018

Mengetahui,
Kadep Matkesgilut, Ka RSGM Ladokgi TNI AL Kabag Prostho
REM,

drg. Rukmi Wicitrowati drg. Dwina Ariadno, Sp.Pros

Letkol Laut (K/W) NRP 10538/P drg. Dwi Afrosiansi, Sp.Perio Letkol Laut (K/W) NRP 13164/P
Kolonel Laut (K) NRP 9513/P
r

HARGA
SATUAN (Rp.) JUMLAH (Rp.)
10 11
10 11

no.1,2,3,4
10 11

no. 1,2,3,4
 Jakarta, 20 Pebruari 2018
Mengetahui,
Kabag Prostho

drg. Dwina Ariadno, Sp.Pros

Letkol Laut (K/W) NRP 13164/P
DINAS KESEHATAN ANGKATAN LAUT
LADOKGI R.E. MARTADINATA

RENBUT PERMOHONAN PERMINTAAN BEKKES

BULAN : Juni 2018 KLINIK : Prosto Reguler

BEKAL SISA
NO NAMA BARANG SATUAN PEMAKAIAN RENBUT DIMINTA DITERIMA
AWAL AKHIR
1 2 3 4 5 6 7 8 9

1 Albothil Botol 0 1 1 - -
2 Alginate Bks 4 4 - - -
3 Alkohol Botol 2 2 - - -
4 Aquabidest Botol 0 1 1 - -
5 Articulating Paper Box 1 1 0 1 -
6 Biflouride Box 1 1 1 - -
7 Bonding Botol 1 1 1 1 1
8 Broided Ginggiva retraction cord Buah 0 0 - 1 1
9 Bur Diamond Buah 1 1 1 1 1
10 Bur TF 14 TC Pack 1 1 0 1 1
11 Bur TR 14,15 TF 1 Pack 1 1 0 1 1
12 Bur RS 11 Pack 1 1 0 1 1
13 Bur FO 32 EX 21 Seat 1 1 0 1 1
14 Bur BR Seat - - 0 1 1
15 Bur SI Seat - - 0 1 1
16 Bur WR 13, 13C Seat - - 0 1 1
17 Bur TF 12 Seat - - 0 1 1
18 Bur TR Seat - - 0 1 1
19 Bur Fresser/ Poles Akrilic Buah 1 1 1 1 1
20 Bur kuning GW2, SS white Buah 2 2 1 1 1
21 Bur Round Buah 2 2 1 - -
22 Calcium Hydroxyde,Ultracal Tube 1 1 1 - -
23 Cavit Box 1 1 1 - -
24 CHKM Botol 1 1 1 - -
25 Cocoa butter Tube 1 1 1 - -
26 Coeliner Set 1 1 1 1 1
 2

1 2 3 4 5 6 7 8 9

27 Composit Flow Tube 1 1 - 1 1

28 Composit Z 350 Tube 1 1 1 1 1
29 Composite P 60 Tube - - - - -
30 Composite P 61 Tube - - - - -
31 Composite P 62 Tube - - - - -
32 Composite P 63 Tube - - - - -
33 Composite P 64 Tube - - - - -
34 Composite P 65 Tube - - - - -
35 Composite P 66 Tube - - - - -
36 Composite P 67 Tube - - - - -
37 Composite P 68 Tube - - - - -
38 Composite P 69 Tube - - - - -
39 Composite P 70 Tube - - - - -
40 Composite P 71 Tube - - - - -
41 Composite P 72 Tube - - - - -
42 Composite P 73 Tube - - - - -
43 Composite P 74 Tube - - - - -
44 Composite P 75 Tube - - - - -
45 Composite P 76 Tube - - - - -
46 Composite P 77 Tube - - - - -
47 H2O2 Botol 1 1 0 1 1
48 Jarum Citoject Pack 1 1 1 - -
49 Jarum lentulo Pack 1 1 - 1 1
50 Liquid Hillon Liter 1 1 1 - -
51 Major Pin Cutter Disc Box - - - 1 1
52 Major Roughing Disc Box - - - - -
53 Malam Box 1 1 - 1 1
54 Masker disposible Box 3 3 - 4 4
55 Metronidazol, Ti-es Tube 0 0 0 1 1
56 Microbrush Pack 4 4 0 4 4
57 Muldano Kg 3 3 - 5 5
58 Muldaroc Kg 3 3 - 5 5
59 NaCl Botol 1 1 1 0 0
 3

1 2 3 4 5 6 7 8 9

60 New plaston Box 1 1 - 2 2

61 Occo Botol 1 1 1 - -
62 Pasak screw readamet Set - - - 1 1
63 Panaspray Botol 1 1 1 - -
64 Pehacain Box - - - - -
65 Peso reamer Pack 1 1 - 2 2
66 Polybib Pack 2 2 - 2 2
67 Poles Acrilic / Porcelin kit Set 0 1 1 1 1
68 Sarung tangan, Sensigloves Box 4 4 1 8 8
69 Scandonest 3%, Septodont Box - - - - -
70 Self Curing liquid Botol 1 1 1 - -
71 Self Curing Powder, Stellon Botol 1 1 1 - -
72 Sikat Hitam Kasar Buah - - - - -
73 Sikat Putih Wool Buah 1 1 - 1 1
74 Spuit 10 Ml Box 10 10 3 7 7
75 Stone Hitam Box 0 0 0 5 5
76 Stone hijau Buah 4 4 2 2 2
77 Suction disposible Pack 1 1 1 1 1
78 Tembon/fregenol Box 0 1 1 1 1
79 Tempron Set 1 1 1 - -
80 Vaselin Kg 1 1 1 - -
81 Viscostat refill, Ultradent Buah 1 1 - 1 1
82 Vita Special Modelling Liquid Botol - - - - -
83 Vita VMK 95 Transculent Botol - - - - -
84 Xylonor spray, Botol 0 1 1 1 1

Jakarta, 21 Mei 2018

Mengetahui, Mengetahui, Mengetahui,
Kadep Matkesgilut, Ka RSGM Ladokgi TNI AL REM, Kabag Prostho

drg. Rukmi Wicitrowati drg. Agus Gamal Putra, Sp.Perio drg. Dwina Ariadno, Sp.Pros
Letkol Laut (K/W) NRP 10538/P Kolonel Laut (K) NRP 11714/P Letkol Laut (K/W) NRP 13164/P
 HARGA
SATUAN (Rp.) JUMLAH (Rp.)
10 11
10 11
10 11

no. 1,2,3,4
 Jakarta, 21 Mei 2018
Mengetahui,
Kabag Prostho

drg. Dwina Ariadno, Sp.Pros

Letkol Laut (K/W) NRP 13164/P
 LADOKGI TNI AL R.E MARTADINATA
RUMAH SAKIT GIGI DAN MULUT

RENBUT BEKKES
BULAN : Nopember 2019
NAMA KLINIK : PROSTHO REGULER

BEKAL SISA
NO NAMA BARANG PEMAKAIAN RENBUT DIMINTA DITERIMA
AWAL AKHIR
1 2 3 4 5 6 7 8 9

1 Albothil Botol 1 1 0 0 0
2 Alginate Bks 7 7 0 7 7
3 Alkohol Botol 2 2 0 2 2
4 Aquabidest Botol 1 1 0 0 0
5 Articulating Paper Box 1 1 0 1 1
6 Biflouride Box 0 0 0 0 0
7 Bonding Botol 1 1 1 0 0
8 Broided Ginggiva retraction cord Buah 1 1 1 0 0
9 Bur TF 11, 12,13 14 Strip 1 1 0 1 1
10 Bur TR 11,12,13,14, 15 Strip 1 1 0 1 1
11 Bur TC 11, SO 21, RS 11 Strip 1 1 0 1 1
12 Bur FO 25, 27, 32 Strip 1 1 0 1 1
13 Bur SF 11, 12, 13 Strip 1 1 0 1 1
14 Bur EX 11, 20, 21, Strip 1 1 0 1 1
15 Bur BR 41, 31, 31C Strip 1 1 0 1 1
16 Bur SI 47, WR 13, WR 13C Strip 1 1 0 1 1
17 Bur TF 12EF, 21EF Strip 1 1 0 1 1
18 Bur TR 13EF, TR 25EF Strip 1 1 0 1 1
19 Bur Fresser Pcs 1 1 0 1 1
20 Bur CE-15 EF Strip 1 1 0 1 1
21 Bur EX 21EF Strip 1 1 0 1 1
22 Calcium Hydroxyde,Ultracal Tube 1 1 0 0 0
23 Cavit Botol 1 1 0 0 0
24 CHKM Botol 1 1 0 0 0
25 Cotton Rool Pack 1 1 0 1 1
26 Cooliner Set 1 1 0 1 1
 2

1 2 3 4 5 6 7 8 9

27 Composit Flow Tube 1 1 0 0 0

28 Composit Z 350 Tube 2 2 0 2 2
29 Composite P 60 Tube 1 1 0 1 1
30 Crown Ready Made Box 1 1 0 1 1
31 Cemen Relik /relyx V200 Seat 1 1 0 0 0
32 Dental Floss Roll 1 1 0 0 0
33 Dycal Box 1 1 0 0 0
34 Ceramax Botol 1 1 0 0 0
35 Elite Cement Set 1 1 0 0 0
36 Enhance Buah 6 6 0 6 6
37 Etching Botol 1 1 1 0 0
38 Eugenol Botol 1 1 0 0 0
39 Exaflex, Putty Set 1 1 0 1 1
40 Fletcher Botol 1 1 0 0 0
41 Fuji I, G.C Set 1 1 0 0 0
42 Fuji IX,G.C Set 1 1 0 1 1
43 Fiber post Set 1 1 0 0 0
44 Fuji Varnis, G.C Botol 1 1 0 0 0
45 Gate gliden drill Pack 1 1 0 1 1
46 Green Stiek compound Pack 1 1 1 0 0
47 H2O2 Botol 1 1 0 0 0
48 Jarum Citoject Pack 1 1 0 0 0
49 Jarum lentulo Pack 1 1 0 1 1
50 Kontainer Cotton Roll Pcs 2 2 0 2 2
51 Major Pin Cutter Disc Box 1 1 0 1 1
52 Major Roughing Disc Box 1 1 0 1 1
53 Malam / wax merah Box 1 1 0 1 1
54 Masker disposible Box 4 4 0 4 4
55 Metronidazol, Ti-es Tube 1 1 0 0 0
56 Microbrush Pack 1 1 0 0 0
57 Muldano / gips Bks 6 6 0 6 6
58 Muldaroc/ gips Bks 6 6 0 6 6
59 Minozep kumur Botol 2 2 0 2 2
 3

1 2 3 4 5 6 7 8 9

60 New plaston /Gips Kuning Bks 2 2 0 2 2

61 Occo Botol 1 1 0 0 0
62 Pasak screw readamet Set 1 1 0 0 0
63 Panaspray Botol 1 1 0 1 1
64 Peso reamer Pack 2 2 0 2 2
65 Polybib Pack 2 1 1 1 1
66 Porcelin kit Set 1 1 0 1 1
67 Sarung tangan, Sensigloves Box 6 6 0 6 6
68 Self Curing liquid Botol 1 1 0 1 1
69 Self Curing Powder, Stellon Botol 1 1 0 1 1
70 Stone (bur) Coklat Buah 1 1 0 1 1
71 Stone (bur) Merah Muda Buah 0 0 0 1 1
72 Spuit 5 Ml Pcs 10 10 0 0 0
73 Stone (bur) Hitam / Rubber Hita Box 2 2 0 2 2
74 Stone Hijau Buah 4 4 0 4 4
75 Suction disposible Pack 1 1 0 0 0
76 Tembon/fregenol Box 1 1 0 0 0
77 Tempron Set 1 1 1 0 0
78 Vaselin Ons 1 1 0 0 0
79 Viscostat refill, Ultradent Buah 1 1 0 1 1
80 Relyx Luting 2 Set 1 1 1 0 0
81 Acrylik Self Curing Set 1 1 0 1 1
82 Xylonor spray, Botol 1 1 0 1 1

Jakarta, 18 Oktober 2019

 Mengetahui, Mengetahui, Mengetahui,
Kasi Matkes RSGM Ka RSGM Ladokgi REM, Kabag Prostho

Susi Suyanawati drg. Agus Gamal Putra, Sp.Perio drg. Dwina Ariadno, Sp.Pros
Mayor Laut (K/W) NRP 11122/P Kolonel Laut (K) NRP 11714/P Letkol Laut (K/W) NRP 13164/P
 HARGA
SATUAN (Rp.) JUMLAH (Rp.)
10 11

cito
10 11

A 3.5 & A.3

A 3.5
gigi anterior

no.1,2,3,4

Hijab 3 biasa 1
 10 11

no. 1,2,3,4

S, XS

Jakarta, 18 Oktober 2019

 Mengetahui,
Kabag Prostho

drg. Dwina Ariadno, Sp.Pros

Letkol Laut (K/W) NRP 13164/P