LAPORAN PENERIMAAN VAKSIN COVID-19 DAN KEADAAN STOK JAN-DES 2021

PUSKESMAS AMPANA BARAT

No. Jenis Vaksin Satuan Tgl. Penerimaan Jumlah Penerimaan Suhu Pengiriman Suhu Penerimaan No. Batch Expire Date Stok Saat ini Harga Satuan Jumlah Harga Keterangan
1 2 3 4 5 6 7 8 9 10 11 12 13
1. Coronavac @1 Dosis Vial 2/8/2021 200 6,0o Celcius 7,3o Celsius 202011042 Nov-23 0 Rp - Rp -
2. Coronavac @10 Dosis Vial 3/4/2021 8 6,0o Celcius 3,0o Celcius 24000521 Jul-21 0 Rp 1,473,385 Rp -
3. Covid-19 Vaccine Biofarma @10Dosis Vial 4/1/2021 20 7,3o Celcius 2,0o Celcius 240001121 Aug-21 0 Rp 1,473,385 Rp -
4. Covid-19 Vaccine Biofarma @10Dosis Vial 5/19/2021 30 6,7o Celcius 2,5o Celcius 240002021 Aug-21 0 Rp 1,473,385 Rp -
5. Covid-19 Vaccine Biofarma @10Dosis Vial 6/26/2021 20 5,7o Celcius 4,2o Celcius 24200721 Nov-21 0 Rp 1,473,385 Rp -
6. Covid-19 Vaccine Biofarma @10Dosis Vial 6/30/2021 10 7,6o Celcius 5,1o Celcius 240002021 Aug-21 0 Rp 1,473,385 Rp -
7. Covid-19 Vaccine Biofarma @10Dosis Vial 7/10/2021 20 4,7o Celcius 4,0o Celcius 24200121 Okt-21 0 Rp 1,473,385 Rp -
8. Covid-19 Vaccine Biofarma @10Dosis Vial 7/23/2021 10 5,7o Celcius 4,1o Celcius 24201521 Des-21 0 Rp 1,473,385 Rp -
9. Covid-19 Vaccine Biofarma @10Dosis Vial 8/4/2021 30 6,7o Celcius 2,9o Celcius 24004621 Des-21 0 Rp 1,473,385 Rp -
10. Vaksin Covid-19 Moderna@14Dosis Vial 8/16/2021 2 2,1o Celcius 2,7o Celcius 01201A Nov-21 0 Rp - Rp - 1 Vial ED. Penyimpanan
11. Covid-19 Vaccine Biofarma @2Dosis Vial 9/7/2021 100 4,4o Celcius 4,8o Celcius 0 Rp 218,933 Rp -
12. Covid-19 Vaccine Biofarma @2Dosis Vial 9/10/2021 400 4,7o Celcius 4,9o Celcius 0 Rp 218,933 Rp -
13. Vaksin Sinovak @2Dosis Vial 10/19/2021 280 4,6o Celcius 4,8o Celcius 202108174F 27-Feb-22 0 Rp 218,933 Rp -
14. Vaksin Sinovak @2Dosis Vial 10/25/2021 200 4,3o Celcius 4,1o Celcius 202108165I 19-Feb-22 0 Rp 218,933 Rp -
15. Vaksin Sinovak @2Dosis Vial 10/28/2021 200 4,3o Celcius 5,3o Celcius 202108165I 19-Feb-22 0 Rp 218,933 Rp -
16. Vaksin Sinovak @2Dosis Vial 11/1/2021 300 4,3o Celcius 4,5o Celcius 202108165I 19-Feb-22 0 Rp 218,933 Rp -
17. Vaksin Sinovak @2Dosis Vial 11/6/2021 200 4,5o Celcius 4,2o Celcius 202108165I 19-Feb-22 0 Rp 218,933 Rp -
18. Vaksin Sinovak @2Dosis Vial 11/6/2021 140 4,2o Celcius 3,2o Celcius 202109185F 6-Mar-22 0 Rp 218,933 Rp -
19. Vaksin AstraZeneka (THAI) @10Dosis Vial 11/6/2021 30 4,2o Celcius 3,2o Celcius A1116 2-Mar-22 0 Rp - Rp -
20. Vaksin AstraZeneka (SGP) @10Dosis Vial 11/24/2021 70 3,9o Celcius 6,1o Celcius 210300 31-Des-21 7 Rp - Rp - 7 Vial ED
21. Vaksin Sinovak @2Dosis Vial 11/25/2021 40 4,3o Celcius 4,8o Celcius 202109185F 6-Mar-22 0 Rp 218,933 Rp -
22. Vaksin Sinovak @10Dosis Vial 11/26/2021 10 4,3o Celcius 4,9o Celcius 24007121 2-Mar-22 0 Rp 783,306 Rp -
23. Vaksin Sinovak @2Dosis Vial 11/26/2021 27 4,3o Celcius 4,6o Celcius 202109150O 13-Mar-22 0 Rp 218,933 Rp -
24. Vaksin Sinovak @2Dosis Vial 12/1/2021 410 3,9o Celcius 4,9o Celcius 202109197G 21-Mar-22 0 Rp 218,933 Rp -
25. Vaksin Sinovak @2Dosis Vial 12/15/2021 300 4,3o Celcius 4,4o Celcius 202109204E 22-Mar-22 0 Rp 218,933 Rp -
26. Vaksin Sinovak @2Dosis Vial 12/23/2021 100 5,3o Celcius 3,4o Celcius 202109154P 18-Mar-22 0 Rp 218,933 Rp -
27. Pfizer @6Dosis Vial 12/23/2021 5 30o Celcius 4,3o Celcius FL4789 30-Jun-22 0 Rp 567,000 Rp -
28. Vaksin Sinovak @2Dosis Vial 12/24/2021 300 4,5o Celcius 4,3o Celcius 202109154P 18-Mar-22 0 Rp 218,933 Rp -
29. Pfizer @6Dosis Vial 12/24/2021 150 33o Celcius 4,6o Celcius FL4789 30-Jun-22 70 Rp 567,000 Rp 39,690,000
30. Vaksin Sinovak @2Dosis Vial 12/25/2021 60 3,6o Celcius 4,8o Celcius 202109146O 13-Mar-22 0 Rp 218,933 Rp -
31. Vaksin Sinovak @2Dosis Vial 12/25/2021 40 3,6o Celcius 4,8o Celcius 202109152P 15-Mar-22 0 Rp 218,933 Rp -
32. Vaksin Sinovak @2Dosis Vial 12/28/2021 200 4,3o Celcius 5,7o Celcius 202110209G 11-Apr-22 Rp 218,933 Rp -
33. Vaksin Sinovak @10Dosis Vial 12/29/2021 20 4,4o Celcius 5,2o Celcius 24202021 4-Jan-22 0 Rp 783,306 Rp -
34. Vaksin Sinovak @2Dosis Vial 12/31/2021 90 3,8o Celcius 4,6o Celcius 202109152P 15-Mar-22 90 Rp 218,933 Rp 19,703,981
35. Vaksin Sinovak @2Dosis Vial 12/31/2021 10 3,8o Celcius 4,6o Celcius 202110209G 4-Nov-22 10 Rp 218,933 Rp 2,189,331

JUMLAH Rp 61,583,312

Mengetahui Ampana, 31 Desember 2021

Kepala Puskesmas Ampana Barat Pengelola Obat Puskesmas

NURHADIST,SKM Apt. Djafar A Kalube,S.Farm

NIP. 19730616 199203 2 002
 LAPORAN PENERIMAAN LOGISTIK VAKSIN COVID-19 DAN KEADAAN STOK JAN-DES 2021

PUSKESMAS AMPANA BARAT

No. Jenis Logistik Satuan Tgl. Penerimaan Jumlah Penerimaan No. Batch Expire Date Stok Saat ini Harga Satuan Jumlah Harga
1 2 3 4 5 6 7 8 9 10
1. APD Lengkap Paket 2/8/2021 12 0 Rp - Rp -
2. Ads 0,5 ml Pcs 2/8/2021 200 1908401 Jun-24 0 Rp 1,050 Rp -
3. Alkohol Swab Pcs 2/8/2021 200 5102088 Sep-23 0 Rp 48 Rp -
4. Safety Box Box 2/8/2021 2 0 Rp 14,000 Rp -

1. APD Lengkap Paket 3/4/2021 4 0 Rp -

2. Ads 0,5 ml Pcs 3/4/2021 80 1908405 Jun-25 0 Rp 1,050 Rp -
3. Alkohol Swab Pcs 3/4/2021 80 5102088 Sep-23 0 Rp 48 Rp -
4. Safety Box Pcs 3/4/2021 1 0 Rp 14,000 Rp -
5. Hazmat Pcs 3/4/2021 4 0 Rp - Rp -

1. Ads 0,5 ml Pcs 4/1/2021 200 2008301 Mei-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 4/1/2021 200 5102088 Sep-23 0 Rp 48 Rp -
3. Safety Box Pcs 4/1/2021 2 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 5/19/2021 300 20114 Aug-25 0 Rp - Rp -

2. Alkohol Swab Pcs 5/19/2021 300 5102088 Sep-23 0 Rp 48 Rp -
3. Safety Box Pcs 5/19/2021 1 0 Rp 14,000 Rp -

1. APD Lengkap Paket 6/26/2021 50 5

2. Ads 0,5 ml Pcs 6/26/2021 200 20104 Feb-25 0 Rp 1,050 Rp -
3. Alkohol Swab Pcs 6/26/2021 200 2020515 Mei-2025 0 Rp 48 Rp -
4. Safety Box Pcs 6/26/2021 1 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 6/30/2021 100 20125 Sep-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 6/30/2021 100 5102088 Sep-23 0 Rp 48 Rp -
3. Safety Box Pcs 6/30/2021 1 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 7/10/2021 200 21136 Sep-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 7/10/2021 200 20200515 Sep-23 0 Rp 48 Rp -
3. Safety Box Pcs 7/10/2021 2 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 7/23/2021 100 20138 Sep-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 7/23/2021 100 0 Rp 48 Rp -
3. Safety Box Pcs 7/23/2021 1 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 8/4/2021 300 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 8/4/2021 300 0 Rp 48 Rp -
3. Safety Box Pcs 8/4/2021 3 0 Rp 14,000 Rp -
4. Hazmat Pcs 8/4/2021 2 0 Rp - Rp -

1. Ads 0,5 ml Pcs 8/16/2021 28 0 Rp 1,050 Rp -

2. alkohol Swab Pcs 8/16/2021 28 0 Rp 48 Rp -

1. Ads 0,5 ml Pcs 9/7/2021 200 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 9/7/2021 200 0 Rp 48 Rp -
3. Safety Box Pcs 9/7/2021 2 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 9/10/2021 800 0 Rp 1,050 Rp -

2. Safety Box Pcs 9/10/2021 8 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 10/19/2021 560 20104 Feb-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 10/19/2021 560 2136181 Jul-25 0 Rp 48 Rp -
3. Safety Box Pcs 10/19/2021 6 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 10/25/2021 400 2136181 Jul-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 10/25/2021 400 20157 Nov-25 0 Rp 48 Rp -
3. Safety Box Pcs 10/25/2021 4 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 10/28/2021 400 20157 Nov-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 10/28/2021 400 2136207 Aug-25 0 Rp 48 Rp -
3. Safety Box Pcs 10/28/2021 2 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 11/1/2021 600 20157 Nov-25 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 11/1/2021 600 2136207 Aug-25 0 Rp 48 Rp -
3. Safety Box Pcs 11/1/2021 6 0 Rp 14,000 Rp -
1. Ads 0,5 ml Pcs 11/6/2021 400 20080303 Sep-25 0 Rp 1,050 Rp -
2. Alkohol Swab Pcs 11/6/2021 400 2136207 Aug-25 0 Rp 48 Rp -
3. Safety Box Pcs 11/6/2021 4 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 11/6/2021 580 21118 Feb-26 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 11/6/2021 580 18082188 Jul-24 0 Rp 48 Rp -
3. Safety Box Pcs 11/6/2021 6 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 11/24/2021 700 202102 Jan-26 570 Rp 1,050 Rp -

2. Alkohol Swab Pcs 11/24/2021 700 2136207 Aug-25 570 Rp 48 Rp -
3. Safety Box Pcs 11/24/2021 7 4 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 11/25/2021 100 202102 Jan-26 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 11/25/2021 100 2136207 Aug-25 0 Rp 48 Rp -
3. Safety Box Pcs 11/25/2021 1 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 11/26/2021 100 202102 Jan-26 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 11/26/2021 100 2136207 Aug-25 0 Rp 48 Rp -
3. Safety Box Pcs 11/26/2021 1 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 11/26/2021 54 202102 Jan-26 0 Rp 1,050 Rp -

2. Alkohol Swab Pcs 11/26/2021 54 2136207 Aug-25 0 Rp 48 Rp -
3. Safety Box Pcs 11/26/2021 1 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 12/1/2021 820 202102 Jan-26 0 Rp 1,185 Rp -

2. Alkohol Swab Pcs 12/1/2021 820 2136207 Aug-25 0 Rp 48 Rp -
3. Safety Box Pcs 12/1/2021 8 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 12/15/2021 600 20104 Feb-26 0 Rp 1,185 Rp -

2. Alkohol Swab Pcs 12/15/2021 600 GM2109153 Sep-26 0 Rp 79 Rp -
3. Safety Box Pcs 12/15/2021 6 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 12/23/2021 200 20104 Feb-26 0 Rp 1,185 Rp -

2. Ads 0,3 ml Pcs 12/23/2021 30 210B30 Sep-26 0 Rp 1,255 Rp -
3. Ads 3 ml Pcs 12/23/2021 5 21303 Aug-26 0 Rp 569 Rp -
4. Alkohol Swab Pcs 12/23/2021 130 GM2109153 Sep-26 0 Rp 79 Rp -
5. Pelarut Pfizer Botol 12/23/2021 5 B80I51A 11-Sep-23 0 Rp 3,280 Rp -
6. Safety Box Pcs 12/23/2021 2 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 12/24/2021 600 20104 Feb-26 0 Rp 1,185 Rp -

2. Ads 0,3 ml Pcs 12/24/2021 900 210B30 Sep-26 420 Rp 1,255 Rp 527,100
3. Ads 3 ml Pcs 12/24/2021 150 21303 Aug-26 70 Rp 569 Rp 39,830
4. Alkohol Swab Pcs 12/24/2021 900 GM2109153 Sep-26 0 Rp 79 Rp -
5. Pelarut Pfizer Botol 12/24/2021 150 B80I51A 11-Sep-23 70 Rp 3,280 Rp 229,600
6. Safety Box Pcs 12/24/2021 9 4 Rp 14,000 Rp 56,000

1. Ads 0,5 ml Pcs 12/25/2021 200 20104 Feb-26 0 Rp 1,185 Rp -

2. Alkohol Swab Pcs 12/25/2021 200 GM2109153 Sep-26 0 Rp 79 Rp -
3. Safety Box Pcs 12/25/2021 2 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 12/28/2021 200 20104 Feb-26 0 Rp 1,185 Rp -

2. Alkohol swab Pcs 12/28/2021 200 GM2109153 Sep-26 0 Rp 79 Rp -
3. Safety Box Pcs 12/28/2021 2 0 Rp 14,000 Rp -

1. Alkohol Swab Pcs 12/29/2021 200 GM2109153 Sep-26 0 Rp 79 Rp -

1. Ads 0,5 ml Pcs 12/29/2021 200 20104 Feb-26 0 Rp 1,185 Rp -

2. Alkohol Swab Pcs 12/29/2021 200 GM2109153 Sep-26 0 Rp 79 Rp -
3. SafetyBox Pcs 12/29/2021 2 0 Rp 14,000 Rp -

1. Ads 0,5 ml Pcs 12/31/2021 200 20104 Feb-26 200 Rp 1,185 Rp 237,000
2. Alkohol Swab Pcs 12/31/2021 200 GM2109153 Sep-26 200 Rp 79 Rp 15,800
3. Safety Box Pcs 12/31/2021 2 2 Rp 14,000 Rp 28,000

JUMLAH Rp 1,133,330

Mengetahui Ampana, 31 Desember 2021

Kepala Puskesmas Ampana Barat Pengelola Obat Puskesmas
 NURHADIST,SKM Apt. Djafar A Kalube,S.Farm
NIP. 19730616 199203 2 002
Ket
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