FORMULIR

ANGGARAN PEMBELIAN

TAHUN : 2017
DEPARTEMEN : Rumah Sakit / A POLI GIGI
KOORDINATOR ANGGARAN :

Quantity
Nomor Harga/Tarif
No Nama Barang Uraian Satuan
Akun Rumah (Rp)
Klinik
Sakit
1 62130001 anastetikum 5 box
2 62130001 needle 5 box
3 62130001 Chlor ethyl 5 botol
4 62130001 betadine gargle 10 botol
5 62130001 kassa 3 gulung
6 62130001 tampon 3 gulung
7 62130001 spongostan 2 box
8 62130001 jarum hecting 10 piece
9 62130001 benang hecting 5 roll
10 62130001 alvogyl 2 botol
11 62130001 metronidazole paste 2 syringe
12 62130001 kapas gulung 3 gulung
13 62130001 larutan H2O2 5 botol
14 62130001 larutan alkohol 5 botol
15 62130001 bahan medikamen 2 botol
16 62130001 paper point 15/40 5 box
17 62130001 paper point 45/80 5 box
18 62130001 gutta percha 15/40 5 box
19 62130001 gutta percha 45/80 5 box
20 62130001 sealer 2 box
21 62130001 base it 3 syringe
22 62130001 etching 2 syringe
23 62130001 bonding 2 botol
24 62130001 pulp capping 2 pair
20 62130001 resin komposit 6 syringe
21 62130001 glass ionomer class 2 box
22 62130001 cavit 2 box
23 62130001 eugenol 2 botol
24 62130001 chkm 2 botol
20 62130001 calcium hydroxide 2 syringe
21 62130001 articulating paper 2 box
22 62130001 diamond bur 20 piece
23 62130001 bur tulang 10 piece
24 62130001 bur polish 10 piece
20 62130001 ekstirpasi 5 box
21 62130001 K-file 15/40 5 box
22 62130001 K-file 45/80 5 box
23 62130001 kuas bonding 2 box
24 62130001 matrix 2 box
20 62130001 wooden wedge 2 box
21 62130001 occo 1 botol
22 62130001 blade scalpel 1 box
23 62130001 masker 5 box
24 62130001 handskun 5 box
20 62130001 spuit 2 box
21 62130001 extracem 1 box
22 62130001 saliva ejector 3 box
23 62130001 devitec 1 botol
24 62130001 aquades 5 botol
20 62130001 gates glidden 3 box
21 62130001 pasta carrier 3 box
22 62130001
23 62130001
24 62130001
JUMLAH
 NOMOR : IM - 4006 - 3230
Tanggal 01 Nopember 2013
Revisi 00
Halaman 1/1

Total Nilai Waktu

(Rp) Pembelian

- jan-mar
- jan-mar
- jan-juni
- jan-mar
- jan-juni
- jan-juni
- jan-juni
- jan-juni
- jan-juni
- jan-juni
- jan-juni
- jan-juni
- jan-juni
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-mar
- jan-juni
- jan-mar
- jan-mar
- jan-juni
- jan-des
- jan-mar
- jan-mar
- jan-mar
- jan-juni
- jan-mar
- jan-des
- jan-mar
- jan-juni
- jan-juni
-
-
-
-
 FORMULIR
ANGGARAN PEMBELIAN

TAHUN : 2017
DEPARTEMEN : Rumah Sakit / POLI GIGI
KOORDINATOR ANGGARAN :

Quantity
No Nomor Akun Nama Barang Uraian Satuan
Rumah
Klinik
Sakit
1 62130001 kaca mulut 10 piece
2 62130001 excavator 10 piece
3 62130001 pinset 10 piece
4 62130001 sonde 10 piece
5 62130001 plastis instrumen 10 piece
6 62130001 bein 5 piece
7 62130001 cryer 5 piece
8 62130001 burnisher 5 piece
9 62130001 spatel logam 5 piece
10 62130001 tang dewasa 1 piece
11 62130001 tang desidui 1 piece
12 62130001 blok file 2 piece
13 62130001 tong sampah kecil 2 piece
14 62130001 knable tang 1 piece
15 62130001 bone file 2 piece
16 62130001 carpul 1 piece
17 62130001 neirbeken 4 piece
18 62130001 matrix holder 1 piece
19 62130001 hakken 2 piece
20 62130001 tounge holder 1 piece
21 62130001 cheek retractor 2 piece
22 62130001 rubber bowl 2 piece
23 62130001 spatel 2 piece
24 62130001
25 62130001
26 62130001
27 62130001
28 62130001
29 62130001
30
31
JUMLAH

Aceh Utara, 16 Juni 2016

Disiapkan Oleh,
..........................................
 NOMOR : IM - 4006 - 3230
Tanggal 01 Nopember 2013
Revisi 00
Halaman 1/1

Harga/Tarif Total Nilai Waktu

(Rp) (Rp) Pembelian

- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
- jan-des
-
-
-
-
-
-
-
-

Disetujui Oleh,
.................................