RINCIAN HASIL INVENTARISASI PERSEDIA

PER 30 DESEMBER 2018

NAMA SKPD: DINAS KESEHATAN KOTA BA
PUSKESMAS : MUARA RAPAK

SALDO AKHIR ( 30 SEPTEMBER 2018) Mutasi Barang Mas

NO URAIAN BARANG Satuan
Jumlah Harga Satuan Jumlah
Jumlah (Rp)
satuan (Rp) satuan

Lembar Catatan Medis Rim 3

1 0 Rp 80,000 Rp -

Lembaran Sambung Catatan Medis Rim 0

2 3 Rp 80,000 Rp 240,000

Lembaran Sambung Catatan Medis Rim 4

0 Rp - Rp -

Lembar Pemeriksaan Laboratorium Buku 0

3 40 Rp 10,000 Rp 400,000
Lembar Daftar Rawat Jalan BPJS di pelayanan
Buku 0
4 Dasar 0 Rp 10,000 Rp -

Lembar Resep JKN 1/3 Folio Buku 0

5 23 Rp 10,000 Rp 230,000

Lembar Resep JKN 1/4 Folio Buku 0

6 60 Rp 5,000 Rp 300,000

Lembar Resep Buku 0

80 Rp 5,000 Rp 400,000

Leaflet Diet rendah Kolesterol Rim 0

7 1 Rp 700,000 Rp 700,000

Leaflet rendahPurin ( Asam Urat ) Rim 0

8 1 Rp 700,000 Rp 700,000

Leafeat Lambung Rim 0

9 0 Rp 700,000 Rp -

Leaflet Diabetes Melitus Rim 0

10 1 Rp 700,000 Rp 700,000

Laeflet Hipertensi Rim 0

11 1 Rp 700,000 Rp 700,000
Kartu Pengobatan Pasien TB 9 ( TB
Rim 0
12 01 ) 0 Rp 2,000 Rp -
LaporanPelaksanaan Program UK. Folio HVS 70
Rim 0
13 Gr 0 Rp 740,000 Rp -
Pencatatan Imunisasi Rutin Bayi / balita di unit
Buku 0
14 Uk. Folio HVS 70 gr 0 Rp 18,000 Rp -
Surat Persetujuan / Penolakan tindakan Medis
Rim 0
15 HVS 70 Gr Cetak bolak balik 0 Rp 84,000 Rp -
Formulir Pemeriksaan Odontogram Uk. Folio
Rim 0
16 HVS 70 Gram 0 Rp 78,000 Rp -

Regester Kohort bayi / Double Folio Buku 0

17 0 Rp 50,000 Rp -

Stiker Inventaris 0
18 Lembar 100 Rp 500 Rp 50,000

Daftar Barang Operasional 0

19 Rim 1 Rp 80,000 Rp 80,000

Leaflet despepsia 2 Muka 0

20 Rim 1 Rp 700,000 Rp 700,000

Leaflet Gagal GinjalKronis 2 Muka 0

21 Rim 1 Rp 700,000 Rp 700,000
 Formulir Permintaan Pemeriksaaan Lab 1/4
0
22 Folio Lembar 45 Rp 5,000 Rp 225,000

Surat keterangan Sakit isi 50 lembar 1/2 folio 0

23 Buku 3 Rp 5,000 Rp 15,000

Surat keterangan Sakit isi 50 lembar 1/2 folio 10

Buku 0 Rp - Rp -

Surat keterangan berobat isi 50 lembar 1/2 folio 0

24 Buku 13 Rp 5,000 Rp 65,000

Surat keterangan berobat isi 50 lembar 1/2 folio 10

Buku 0 Rp - Rp -

Surat Rujukan isi 50 isi 50 lembar 1/2 folio 0

25 Buku 50 Rp 5,000 Rp 250,000

Blangko rujukan BPJS isi 50 Lembar 0

26 Buku 69 Rp 10,000 Rp 690,000

Leaflet tuberculosis kebal obat Lembar 0

27 100 Rp 6,000 Rp 600,000

Leaflet tosis TB Lembar 0

28 100 Rp 6,000 Rp 600,000

Rekap Medik Merah Lembar 0

29 1256 Rp 5,000 Rp 6,280,000

Rekap Medik Biru Lembar 0

30 2400 Rp 5,000 Rp 12,000,000

Kartu stok obat Lembar 0

0 Rp 1,250 Rp -

Cetak Form Resep Obat Sirup Rim 0

31 0 Rp 135,000 Rp -

Cetak Form Resep Obat Luar ( HVSBiru ) Rim 0

32 0 Rp 135,000 Rp -

Cetak Form Resep Obat Kapsul Rim 0

33 0 Rp 135,000 Rp -

Cetak Form Resep Obat Tablet Rim 0

34 0 Rp 135,000 Rp -

Papan Acrylic Ruang Konseling ( Sedang ) Buah 0

35 0 Rp 125,000 Rp -

Papan Acrylic Ruang Konseling ( Besar ) Buah 0

36 0 Rp 150,000 Rp -

Cetak Pengambilan Nomor Antrian Buah 0

37 0 Rp 45,000 Rp -

Cetak Form Pengenalan Muara Rapak Rim 0

38 0 Rp 110,000 Rp -

Form Info Consent Gigi Rim 0

39 0 Rp 70,000 Rp -

Kartu Golongan Darah Lembar 0

40 0 Rp 250 Rp -

Form Pemeriksaan Odontogram ½ Folio Rim 0

41 0 Rp 750 Rp -

Sticke Inventaris Ruangan Lembar 0

42 0 Rp 25,000 Rp -

Cetak Kartu Control Puskesmas M. Rapak Lembar 0

43 0 Rp 750 Rp -

Cetak PIN Ayo Ikut KB Buah 0

44 0 Rp 25,000 Rp -

Sticker Non Medis Lembar 5000 10

45 0 Rp -
 Sticker Bahan Berbahaya dan Beracun Lembar 5000 5
46 0 Rp -

Sticker Sampah Organik Lembar 5000 7

47 0 Rp -

Sticker Sampah Anorganik Lembar 5000 7

48 0 Rp -

cetak kotak saran Buah 300,000 13

49 0 Rp -

Cetak Stempel Puskesmas Buah 120,000 2

50 0 Rp -

Cetak Spanduk Lembar 4

51 0 Rp -

SKRD Buku 6 9350 0

Rp 56,100

SKRD Lab Buku 9 9350 0

Rp 84,150

Buku KIA Buku 392 8300 0

Rp 3,253,600

Rp 30,018,850
ASIL INVENTARISASI PERSEDIAAN AKHIR
PER 30 DESEMBER 2018
D: DINAS KESEHATAN KOTA BALIKPAPAN
PUSKESMAS : MUARA RAPAK

Mutasi Barang Masuk Mutasi Barang Keluar SALDO AKHIR ( 31 DESEMEBER 2018)

Harga Satuan Jumlah Harga Satuan Harga Satuan

Jumlah (Rp) Jumlah (Rp) Jumlah satuan
(Rp) satuan (Rp) (Rp)

Rp 110,000 Rp 330,000 1 Rp 110,000 Rp 110,000 2

Rp 110,000

Rp 80,000 Rp - 0 Rp 80,000 Rp - 3
Rp 80,000

Rp 110,000 Rp 440,000 0 Rp 110,000 Rp - 4

Rp 110,000

Rp 10,000 Rp - 14 Rp 10,000 Rp 140,000 26

Rp 10,000

Rp 10,000 Rp - 0 Rp 10,000 Rp - 0
Rp 10,000

Rp 10,000 Rp - 4 Rp 10,000 Rp 40,000 19

Rp 10,000

Rp 5,000 Rp - 7 Rp 5,000 Rp 35,000 53

Rp 5,000

Rp 5,000 Rp - 0 Rp 5,000 Rp - 80
Rp 5,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 0
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 2,000 Rp - 0 Rp 2,000 Rp - 0
Rp 2,000

Rp 740,000 Rp - 0 Rp 740,000 Rp - 0
Rp 740,000

Rp 18,000 Rp - 0 Rp 18,000 Rp - 0
Rp 18,000

Rp 84,000 Rp - 0 Rp 84,000 Rp - 0
Rp 84,000

Rp 78,000 Rp - 0 Rp 78,000 Rp - 0
Rp 78,000

Rp 50,000 Rp - 0 Rp 50,000 Rp - 0
Rp 50,000

Rp 500 Rp - 0 Rp 500 Rp - 100

Rp 500

Rp 80,000 Rp - 0 Rp 80,000 Rp - 1
Rp 80,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000
Rp 5,000 Rp - 5 Rp 5,000 Rp 25,000 40
Rp 5,000

Rp 5,000 Rp - 2 Rp 5,000 Rp 10,000 1

Rp 5,000

Rp 17,500 Rp 175,000 0 Rp 17,500 Rp - 10

Rp 17,500

Rp 5,000 Rp - 1 Rp 5,000 Rp 5,000 12

Rp 5,000

Rp 17,500 Rp 175,000 0 Rp 17,500 Rp - 10

Rp 17,500

Rp 5,000 Rp - 0 Rp 5,000 Rp - 50
Rp 5,000

Rp 10,000 Rp - 0 Rp 10,000 Rp - 69
Rp 10,000

Rp 6,000 Rp - 0 Rp 6,000 Rp - 100

Rp 6,000

Rp 6,000 Rp - 0 Rp 6,000 Rp - 100

Rp 6,000

Rp 5,000 Rp - 300 Rp 5,000 Rp 1,500,000 956

Rp 5,000

Rp 5,000 Rp - 250 Rp 5,000 Rp 1,250,000 2150

Rp 5,000

Rp 1,250 Rp - 0 Rp 1,250 Rp - 0
Rp 1,250

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 125,000 Rp - 0 Rp 125,000 Rp - 0
Rp 125,000

Rp 150,000 Rp - 0 Rp 150,000 Rp - 0
Rp 150,000

Rp 45,000 Rp - 0 Rp 45,000 Rp - 0
Rp 45,000

Rp 110,000 Rp - 0 Rp 110,000 Rp - 0
Rp 110,000

Rp 70,000 Rp - 0 Rp 70,000 Rp - 0
Rp 70,000

Rp 250 Rp - 0 Rp 250 Rp - 0
Rp 250

Rp 750 Rp - 0 Rp 750 Rp - 0
Rp 750

Rp 25,000 Rp - 0 Rp 25,000 Rp - 0
Rp 25,000

Rp 750 Rp - 0 Rp 750 Rp - 0
Rp 750

Rp 25,000 Rp - 0 Rp 25,000 Rp - 0
Rp 25,000

Rp 5,000 Rp 50,000 10 Rp 5,000 Rp 50,000 0

Rp 5,000
Rp 5,000 Rp 25,000 5 Rp 5,000 Rp 25,000 0
Rp 5,000

Rp 5,000 Rp 35,000 7 Rp 5,000 Rp 35,000 0

Rp 5,000

Rp 5,000 Rp 35,000 7 Rp 5,000 Rp 35,000 0

Rp 5,000

Rp 300,000 Rp 3,900,000 0 Rp 300,000 Rp - 13

Rp 300,000

Rp 120,000 Rp 240,000 2 Rp 120,000 Rp 240,000 0

Rp 120,000

Rp 15,000 Rp 60,000 4 Rp 15,000 Rp 60,000 0

Rp 15,000

Rp 9,350 Rp - 2 Rp 9,350 Rp 18,700 4 Rp 9,350

Rp 9,350 Rp - 3 Rp 9,350 Rp 28,050 6 Rp 9,350

Rp 8,300 Rp - 94 Rp 8,300 Rp 780,200 298 Rp 8,300

Rp 5,465,000 Rp 4,386,950

Balikpapan, 31 Desember 2018

Kepala Puskesmas Muara Rapak

Ns.Fahmy Rosady,S.Kep

NIP.196701211988011003
R ( 31 DESEMEBER 2018)

Jumlah (Rp)

Rp 220,000 Rp 220,000 Rp -

Rp 240,000 Rp 240,000 Rp -

Rp 440,000 Rp 440,000 Rp -

Rp 260,000 Rp 260,000 Rp -

Rp - Rp - Rp -

Rp 190,000 Rp 190,000 Rp -

Rp 265,000 Rp 265,000 Rp -

Rp 400,000 Rp 400,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp - Rp - Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp 50,000 Rp 50,000 Rp -

Rp 80,000 Rp 80,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -
Rp 200,000 Rp 200,000 Rp -

Rp 5,000 Rp 5,000 Rp -

Rp 175,000 Rp 175,000 Rp -

Rp 60,000 Rp 60,000 Rp -

Rp 175,000 Rp 175,000 Rp -

Rp 250,000 Rp 250,000 Rp -

Rp 690,000 Rp 690,000 Rp -

Rp 600,000 Rp 600,000 Rp -

Rp 600,000 Rp 600,000 Rp -

Rp 4,780,000 Rp 4,780,000 Rp -

Rp 10,750,000 Rp 10,750,000 Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -
Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp 3,900,000 Rp 3,900,000 Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp 37,400
Rp 37,400 0

Rp 56,100
Rp 56,100 0

Rp 2,473,400
Rp 2,473,400 0

Rp 31,096,900
Rp 31,096,900 0
 RINCIAN HASIL INVENTARISASI PERSED
PER 30 DESEMBER 2018
NAMA SKPD: DINAS KESEHATAN KOTA B
PUSKESMAS : MUARA RAPAK

SALDO AKHIR ( 31 DESEMEBER 2018) Mutasi Barang M

NO URAIAN BARANG Satuan
Jumlah Harga Satuan Jumlah
Jumlah (Rp)
satuan (Rp) satuan

Lembar Catatan Medis Rim

1 0 Rp 80,000 Rp -

Lembaran Sambung Catatan Medis Rim

2 3 Rp 80,000 Rp 240,000

Lembaran Sambung Catatan Medis Rim

0 Rp - Rp -

Lembar Pemeriksaan Laboratorium Buku

3 40 Rp 10,000 Rp 400,000
Lembar Daftar Rawat Jalan BPJS di pelayanan
Buku
4 Dasar 0 Rp 10,000 Rp -

Lembar Resep JKN 1/3 Folio Buku

5 23 Rp 10,000 Rp 230,000

Lembar Resep JKN 1/4 Folio Buku

6 60 Rp 5,000 Rp 300,000

Lembar Resep Buku

80 Rp 5,000 Rp 400,000

Leaflet Diet rendah Kolesterol Rim

7 1 Rp 700,000 Rp 700,000

Leaflet rendahPurin ( Asam Urat ) Rim

8 1 Rp 700,000 Rp 700,000

Leafeat Lambung Rim

9 0 Rp 700,000 Rp -

Leaflet Diabetes Melitus Rim

10 1 Rp 700,000 Rp 700,000

Laeflet Hipertensi Rim

11 1 Rp 700,000 Rp 700,000
Kartu Pengobatan Pasien TB 9 ( TB
Rim
12 01 ) 0 Rp 2,000 Rp -
LaporanPelaksanaan Program UK. Folio HVS 70
Rim
13 Gr 0 Rp 740,000 Rp -
Pencatatan Imunisasi Rutin Bayi / balita di unit
Buku
14 Uk. Folio HVS 70 gr 0 Rp 18,000 Rp -
Surat Persetujuan / Penolakan tindakan Medis
Rim
15 HVS 70 Gr Cetak bolak balik 0 Rp 84,000 Rp -
Formulir Pemeriksaan Odontogram Uk. Folio
Rim
16 HVS 70 Gram 0 Rp 78,000 Rp -

Regester Kohort bayi / Double Folio Buku

17 0 Rp 50,000 Rp -

Stiker Inventaris
18 Lembar 100 Rp 500 Rp 50,000

Daftar Barang Operasional

19 Rim 1 Rp 80,000 Rp 80,000

Leaflet despepsia 2 Muka

20 Rim 1 Rp 700,000 Rp 700,000

Leaflet Gagal GinjalKronis 2 Muka

21 Rim 1 Rp 700,000 Rp 700,000
 Formulir Permintaan Pemeriksaaan Lab 1/4
22 Folio Lembar 45 Rp 5,000 Rp 225,000

Surat keterangan Sakit isi 50 lembar 1/2 folio

23 Buku 3 Rp 5,000 Rp 15,000

Surat keterangan Sakit isi 50 lembar 1/2 folio

Buku 0 Rp - Rp -

Surat keterangan berobat isi 50 lembar 1/2 folio

24 Buku 13 Rp 5,000 Rp 65,000

Surat keterangan berobat isi 50 lembar 1/2 folio

Buku 0 Rp - Rp -

Surat Rujukan isi 50 isi 50 lembar 1/2 folio

25 Buku 50 Rp 5,000 Rp 250,000

Blangko rujukan BPJS isi 50 Lembar

26 Buku 69 Rp 10,000 Rp 690,000

Leaflet tuberculosis kebal obat Lembar

27 100 Rp 6,000 Rp 600,000

Leaflet tosis TB Lembar

28 100 Rp 6,000 Rp 600,000

Rekap Medik Merah Lembar

29 1256 Rp 5,000 Rp 6,280,000

Rekap Medik Biru Lembar

30 2400 Rp 5,000 Rp 12,000,000

Kartu stok obat Lembar

0 Rp 1,250 Rp -

Cetak Form Resep Obat Sirup Rim

31 0 Rp 135,000 Rp -

Cetak Form Resep Obat Luar ( HVSBiru ) Rim

32 0 Rp 135,000 Rp -

Cetak Form Resep Obat Kapsul Rim

33 0 Rp 135,000 Rp -

Cetak Form Resep Obat Tablet Rim

34 0 Rp 135,000 Rp -

Papan Acrylic Ruang Konseling ( Sedang ) Buah

35 0 Rp 125,000 Rp -

Papan Acrylic Ruang Konseling ( Besar ) Buah

36 0 Rp 150,000 Rp -

Cetak Pengambilan Nomor Antrian Buah

37 0 Rp 45,000 Rp -

Cetak Form Pengenalan Muara Rapak Rim

38 0 Rp 110,000 Rp -

Form Info Consent Gigi Rim

39 0 Rp 70,000 Rp -

Kartu Golongan Darah Lembar

40 0 Rp 250 Rp -

Form Pemeriksaan Odontogram ½ Folio Rim

41 0 Rp 750 Rp -

Sticke Inventaris Ruangan Lembar

42 0 Rp 25,000 Rp -

Cetak Kartu Control Puskesmas M. Rapak Lembar

43 0 Rp 750 Rp -

Cetak PIN Ayo Ikut KB Buah

44 0 Rp 25,000 Rp -

Sticker Non Medis Lembar 5000

45 0 Rp -
 Sticker Bahan Berbahaya dan Beracun Lembar 5000
46 0 Rp -

Sticker Sampah Organik Lembar 5000

47 0 Rp -

Sticker Sampah Anorganik Lembar 5000

48 0 Rp -

cetak kotak saran Buah 300,000

49 0 Rp -

Cetak Stempel Puskesmas Buah 120,000

50 0 Rp -

Cetak Spanduk Lembar

51 0 Rp -

SKRD Buku 6 9350

Rp 56,100

SKRD Lab Buku 9 9350

Rp 84,150

Buku KIA Buku 392 8300

Rp 3,253,600

Rp 30,018,850
ASIL INVENTARISASI PERSEDIAAN AKHIR
PER 30 DESEMBER 2018
D: DINAS KESEHATAN KOTA BALIKPAPAN
PUSKESMAS : MUARA RAPAK

Mutasi Barang Masuk Mutasi Barang Keluar SALDO AKHIR ( 30 Juni 2019 )

Harga Satuan Jumlah Harga Satuan Harga Satuan

Jumlah (Rp) Jumlah (Rp) Jumlah satuan
(Rp) satuan (Rp) (Rp)

Rp 110,000 Rp - Rp 110,000 Rp - 0
Rp 110,000

Rp 80,000 Rp - Rp 80,000 Rp - 3
Rp 80,000

Rp 110,000 Rp - Rp 110,000 Rp - 0
Rp 110,000

Rp 10,000 Rp - Rp 10,000 Rp - 40
Rp 10,000

Rp 10,000 Rp - Rp 10,000 Rp - 0
Rp 10,000

Rp 10,000 Rp - Rp 10,000 Rp - 23
Rp 10,000

Rp 5,000 Rp - Rp 5,000 Rp - 60
Rp 5,000

Rp 5,000 Rp - Rp 5,000 Rp - 80
Rp 5,000

Rp 700,000 Rp - Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - Rp 700,000 Rp - 0
Rp 700,000

Rp 700,000 Rp - Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - Rp 700,000 Rp - 1
Rp 700,000

Rp 2,000 Rp - Rp 2,000 Rp - 0
Rp 2,000

Rp 740,000 Rp - Rp 740,000 Rp - 0
Rp 740,000

Rp 18,000 Rp - Rp 18,000 Rp - 0
Rp 18,000

Rp 84,000 Rp - Rp 84,000 Rp - 0
Rp 84,000

Rp 78,000 Rp - Rp 78,000 Rp - 0
Rp 78,000

Rp 50,000 Rp - Rp 50,000 Rp - 0
Rp 50,000

Rp 500 Rp - Rp 500 Rp - 100

Rp 500

Rp 80,000 Rp - Rp 80,000 Rp - 1
Rp 80,000

Rp 700,000 Rp - Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - Rp 700,000 Rp - 1
Rp 700,000
Rp 5,000 Rp - Rp 5,000 Rp - 45
Rp 5,000

Rp 5,000 Rp - Rp 5,000 Rp - 3
Rp 5,000

Rp 17,500 Rp - Rp 17,500 Rp - 0
Rp 17,500

Rp 5,000 Rp - Rp 5,000 Rp - 13
Rp 5,000

Rp 17,500 Rp - Rp 17,500 Rp - 0
Rp 17,500

Rp 5,000 Rp - Rp 5,000 Rp - 50
Rp 5,000

Rp 10,000 Rp - Rp 10,000 Rp - 69
Rp 10,000

Rp 6,000 Rp - Rp 6,000 Rp - 100

Rp 6,000

Rp 6,000 Rp - Rp 6,000 Rp - 100

Rp 6,000

Rp 5,000 Rp - Rp 5,000 Rp - 1256

Rp 5,000

Rp 5,000 Rp - Rp 5,000 Rp - 2400

Rp 5,000

Rp 1,250 Rp - Rp 1,250 Rp - 0
Rp 1,250

Rp 135,000 Rp - Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - Rp 135,000 Rp - 0
Rp 135,000

Rp 125,000 Rp - Rp 125,000 Rp - 0
Rp 125,000

Rp 150,000 Rp - Rp 150,000 Rp - 0
Rp 150,000

Rp 45,000 Rp - Rp 45,000 Rp - 0
Rp 45,000

Rp 110,000 Rp - Rp 110,000 Rp - 0
Rp 110,000

Rp 70,000 Rp - Rp 70,000 Rp - 0
Rp 70,000

Rp 250 Rp - Rp 250 Rp - 0
Rp 250

Rp 750 Rp - Rp 750 Rp - 0
Rp 750

Rp 25,000 Rp - Rp 25,000 Rp - 0
Rp 25,000

Rp 750 Rp - Rp 750 Rp - 0
Rp 750

Rp 25,000 Rp - Rp 25,000 Rp - 0
Rp 25,000

Rp 5,000 Rp - Rp 5,000 Rp - 0
Rp 5,000
Rp 5,000 Rp - Rp 5,000 Rp - 0
Rp 5,000

Rp 5,000 Rp - Rp 5,000 Rp - 0
Rp 5,000

Rp 5,000 Rp - Rp 5,000 Rp - 0
Rp 5,000

Rp 300,000 Rp - Rp 300,000 Rp - 0
Rp 300,000

Rp 120,000 Rp - Rp 120,000 Rp - 0
Rp 120,000

Rp 15,000 Rp - Rp 15,000 Rp - 0
Rp 15,000

Rp 9,350 Rp - Rp 9,350 Rp - 6 Rp 9,350

Rp 9,350 Rp - Rp 9,350 Rp - 9 Rp 9,350

Rp 8,300 Rp - Rp 8,300 Rp - 392 Rp 8,300

Rp 7,954,500 Rp - Rp 7,954,500 Rp - Rp 4,756 Rp 7,954,500

Balikpapan, 31 Desember 2018

Kepala Puskesmas Muara Rapak

Ns.Fahmy Rosady,S.Kep

NIP.196701211988011003
AKHIR ( 30 Juni 2019 )

Jumlah (Rp)

Rp - Rp - Rp -

Rp 240,000 Rp 240,000 Rp -

Rp - Rp - Rp -

Rp 400,000 Rp 400,000 Rp -

Rp - Rp - Rp -

Rp 230,000 Rp 230,000 Rp -

Rp 300,000 Rp 300,000 Rp -

Rp 400,000 Rp 400,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp - Rp - Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp 50,000 Rp 50,000 Rp -

Rp 80,000 Rp 80,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -
Rp 225,000 Rp 225,000 Rp -

Rp 15,000 Rp 15,000 Rp -

Rp - Rp - Rp -

Rp 65,000 Rp 65,000 Rp -

Rp - Rp - Rp -

Rp 250,000 Rp 250,000 Rp -

Rp 690,000 Rp 690,000 Rp -

Rp 600,000 Rp 600,000 Rp -

Rp 600,000 Rp 600,000 Rp -

Rp 6,280,000 Rp 6,280,000 Rp -

Rp 12,000,000 Rp 12,000,000 Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -
Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp 56,100 Rp 56,100 Rp -

Rp 84,150 Rp 84,150 Rp -

Rp 3,253,600 Rp 3,253,600 Rp -

Rp 30,018,850
Rp 31,096,900 Rp (1,078,050)
 RINCIAN HASIL INVENTARISASI PERSED
PER 30 DESEMBER 2018
NAMA SKPD: DINAS KESEHATAN KOTA B
PUSKESMAS : MUARA RAPAK

SALDO AKHIR ( 31 Desember 2019 ) Mutasi Barang M

NO URAIAN BARANG Satuan
Jumlah Harga Satuan Jumlah
Jumlah (Rp)
satuan (Rp) satuan

Lembar Catatan Medis Rim

1 2 Rp 110,000 Rp 220,000

Lembaran Sambung Catatan Medis Rim

2 3 Rp 80,000 Rp 240,000

Lembaran Sambung Catatan Medis Rim

4 Rp 110,000 Rp 440,000

Lembar Pemeriksaan Laboratorium Buku

3 26 Rp 10,000 Rp 260,000
Lembar Daftar Rawat Jalan BPJS di pelayanan
Buku
4 Dasar 0 Rp 10,000 Rp -

Lembar Resep JKN 1/3 Folio Buku

5 19 Rp 10,000 Rp 190,000

Lembar Resep JKN 1/4 Folio Buku

6 53 Rp 5,000 Rp 265,000

Lembar Resep Buku

80 Rp 5,000 Rp 400,000

Leaflet Diet rendah Kolesterol Rim

7 1 Rp 700,000 Rp 700,000

Leaflet rendahPurin ( Asam Urat ) Rim

8 1 Rp 700,000 Rp 700,000

Leafeat Lambung Rim

9 0 Rp 700,000 Rp -

Leaflet Diabetes Melitus Rim

10 1 Rp 700,000 Rp 700,000

Laeflet Hipertensi Rim

11 1 Rp 700,000 Rp 700,000
Kartu Pengobatan Pasien TB 9 ( TB
Rim
12 01 ) 0 Rp 2,000 Rp -
LaporanPelaksanaan Program UK. Folio HVS 70
Rim
13 Gr 0 Rp 740,000 Rp -
Pencatatan Imunisasi Rutin Bayi / balita di unit
Buku
14 Uk. Folio HVS 70 gr 0 Rp 18,000 Rp -
Surat Persetujuan / Penolakan tindakan Medis
Rim
15 HVS 70 Gr Cetak bolak balik 0 Rp 84,000 Rp -
Formulir Pemeriksaan Odontogram Uk. Folio
Rim
16 HVS 70 Gram 0 Rp 78,000 Rp -

Regester Kohort bayi / Double Folio Buku

17 0 Rp 50,000 Rp -

Stiker Inventaris
18 Lembar 100 Rp 500 Rp 50,000

Daftar Barang Operasional

19 Rim 1 Rp 80,000 Rp 80,000

Leaflet despepsia 2 Muka

20 Rim 1 Rp 700,000 Rp 700,000

Leaflet Gagal GinjalKronis 2 Muka

21 Rim 1 Rp 700,000 Rp 700,000
 Formulir Permintaan Pemeriksaaan Lab 1/4
22 Folio Lembar 40 Rp 5,000 Rp 200,000

Surat keterangan Sakit isi 50 lembar 1/2 folio

23 Buku 1 Rp 5,000 Rp 5,000

Surat keterangan Sakit isi 50 lembar 1/2 folio

Buku 10 Rp 17,500 Rp 175,000

Surat keterangan berobat isi 50 lembar 1/2 folio

24 Buku 12 Rp 5,000 Rp 60,000

Surat keterangan berobat isi 50 lembar 1/2 folio

Buku 10 Rp 17,500 Rp 175,000

Surat Rujukan isi 50 isi 50 lembar 1/2 folio

25 Buku 50 Rp 5,000 Rp 250,000

Blangko rujukan BPJS isi 50 Lembar

26 Buku 69 Rp 10,000 Rp 690,000

Leaflet tuberculosis kebal obat Lembar

27 100 Rp 6,000 Rp 600,000

Leaflet tosis TB Lembar

28 100 Rp 6,000 Rp 600,000

Rekap Medik Merah Lembar

29 956 Rp 5,000 Rp 4,780,000

Rekap Medik Biru Lembar

30 2150 Rp 5,000 Rp 10,750,000

Kartu stok obat Lembar

0 Rp 1,250 Rp -

Cetak Form Resep Obat Sirup Rim

31 0 Rp 135,000 Rp -

Cetak Form Resep Obat Luar ( HVSBiru ) Rim

32 0 Rp 135,000 Rp -

Cetak Form Resep Obat Kapsul Rim

33 0 Rp 135,000 Rp -

Cetak Form Resep Obat Tablet Rim

34 0 Rp 135,000 Rp -

Papan Acrylic Ruang Konseling ( Sedang ) Buah

35 0 Rp 125,000 Rp -

Papan Acrylic Ruang Konseling ( Besar ) Buah

36 0 Rp 150,000 Rp -

Cetak Pengambilan Nomor Antrian Buah

37 0 Rp 45,000 Rp -

Cetak Form Pengenalan Muara Rapak Rim

38 0 Rp 110,000 Rp -

Form Info Consent Gigi Rim

39 0 Rp 70,000 Rp -

Kartu Golongan Darah Lembar

40 0 Rp 250 Rp -

Form Pemeriksaan Odontogram ½ Folio Rim

41 0 Rp 750 Rp -

Sticke Inventaris Ruangan Lembar

42 0 Rp 25,000 Rp -

Cetak Kartu Control Puskesmas M. Rapak Lembar

43 0 Rp 750 Rp -

Cetak PIN Ayo Ikut KB Buah

44 0 Rp 25,000 Rp -

Sticker Non Medis Lembar

45 0 Rp 5,000 Rp -
 Sticker Bahan Berbahaya dan Beracun Lembar
46 0 Rp 5,000 Rp -

Sticker Sampah Organik Lembar

47 0 Rp 5,000 Rp -

Sticker Sampah Anorganik Lembar

48 0 Rp 5,000 Rp -

cetak kotak saran Buah

49 13 Rp 300,000 Rp 3,900,000

Cetak Stempel Puskesmas Buah

50 0 Rp 120,000 Rp -

Cetak Spanduk Lembar

51 0 Rp 15,000 Rp -

SKRD Buku
4 Rp 9,350 Rp 37,400

SKRD Lab Buku

6 Rp 9,350 Rp 56,100

Buku KIA Buku

298 Rp 8,300 Rp 2,473,400

Rp 31,096,900 Rp -
ASIL INVENTARISASI PERSEDIAAN AKHIR
PER 30 DESEMBER 2018
D: DINAS KESEHATAN KOTA BALIKPAPAN
PUSKESMAS : MUARA RAPAK

Mutasi Barang Masuk Mutasi Barang Keluar SALDO AKHIR ( 31 Maret 2019)

Harga Satuan Jumlah Harga Satuan Harga Satuan

Jumlah (Rp) Jumlah (Rp) Jumlah satuan
(Rp) satuan (Rp) (Rp)

Rp 110,000 Rp - 1 Rp 110,000 Rp 110,000 1

Rp 110,000

Rp 80,000 Rp - 0 Rp 80,000 Rp - 3
Rp 80,000

Rp 110,000 Rp - 0 Rp 110,000 Rp - 4
Rp 110,000

Rp 10,000 Rp - 14 Rp 10,000 Rp 140,000 12

Rp 10,000

Rp 10,000 Rp - 0 Rp 10,000 Rp - 0
Rp 10,000

Rp 10,000 Rp - 4 Rp 10,000 Rp 40,000 15

Rp 10,000

Rp 5,000 Rp - 7 Rp 5,000 Rp 35,000 46

Rp 5,000

Rp 5,000 Rp - 0 Rp 5,000 Rp - 80
Rp 5,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 0
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 2,000 Rp - 0 Rp 2,000 Rp - 0
Rp 2,000

Rp 740,000 Rp - 0 Rp 740,000 Rp - 0
Rp 740,000

Rp 18,000 Rp - 0 Rp 18,000 Rp - 0
Rp 18,000

Rp 84,000 Rp - 0 Rp 84,000 Rp - 0
Rp 84,000

Rp 78,000 Rp - 0 Rp 78,000 Rp - 0
Rp 78,000

Rp 50,000 Rp - 0 Rp 50,000 Rp - 0
Rp 50,000

Rp 500 Rp - 0 Rp 500 Rp - 100

Rp 500

Rp 80,000 Rp - 0 Rp 80,000 Rp - 1
Rp 80,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000

Rp 700,000 Rp - 0 Rp 700,000 Rp - 1
Rp 700,000
Rp 5,000 Rp - 5 Rp 5,000 Rp 25,000 35
Rp 5,000

Rp 5,000 Rp - 2 Rp 5,000 Rp 10,000 -1

Rp 5,000

Rp 17,500 Rp - 0 Rp 17,500 Rp - 10
Rp 17,500

Rp 5,000 Rp - 1 Rp 5,000 Rp 5,000 11

Rp 5,000

Rp 17,500 Rp - 0 Rp 17,500 Rp - 10
Rp 17,500

Rp 5,000 Rp - 0 Rp 5,000 Rp - 50
Rp 5,000

Rp 10,000 Rp - 0 Rp 10,000 Rp - 69
Rp 10,000

Rp 6,000 Rp - 0 Rp 6,000 Rp - 100

Rp 6,000

Rp 6,000 Rp - 0 Rp 6,000 Rp - 100

Rp 6,000

Rp 5,000 Rp - 300 Rp 5,000 Rp 1,500,000 656

Rp 5,000

Rp 5,000 Rp - 250 Rp 5,000 Rp 1,250,000 1900

Rp 5,000

Rp 1,250 Rp - 0 Rp 1,250 Rp - 0
Rp 1,250

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 135,000 Rp - 0 Rp 135,000 Rp - 0
Rp 135,000

Rp 125,000 Rp - 0 Rp 125,000 Rp - 0
Rp 125,000

Rp 150,000 Rp - 0 Rp 150,000 Rp - 0
Rp 150,000

Rp 45,000 Rp - 0 Rp 45,000 Rp - 0
Rp 45,000

Rp 110,000 Rp - 0 Rp 110,000 Rp - 0
Rp 110,000

Rp 70,000 Rp - 0 Rp 70,000 Rp - 0
Rp 70,000

Rp 250 Rp - 0 Rp 250 Rp - 0
Rp 250

Rp 750 Rp - 0 Rp 750 Rp - 0
Rp 750

Rp 25,000 Rp - 0 Rp 25,000 Rp - 0
Rp 25,000

Rp 750 Rp - 0 Rp 750 Rp - 0
Rp 750

Rp 25,000 Rp - 0 Rp 25,000 Rp - 0
Rp 25,000

Rp 5,000 Rp - 10 Rp 5,000 Rp 50,000 -10

Rp 5,000
Rp 5,000 Rp - 5 Rp 5,000 Rp 25,000 -5
Rp 5,000

Rp 5,000 Rp - 7 Rp 5,000 Rp 35,000 -7

Rp 5,000

Rp 5,000 Rp - 7 Rp 5,000 Rp 35,000 -7

Rp 5,000

Rp 300,000 Rp - 0 Rp 300,000 Rp - 13
Rp 300,000

Rp 120,000 Rp - 2 Rp 120,000 Rp 240,000 -2

Rp 120,000

Rp 15,000 Rp - 4 Rp 15,000 Rp 60,000 -4

Rp 15,000

Rp 9,350 Rp - 2 Rp 9,350 Rp 18,700 2 Rp 9,350

Rp 9,350 Rp - 3 Rp 9,350 Rp 28,050 3 Rp 9,350

Rp 8,300 Rp - 94 Rp 8,300 Rp 780,200 204 Rp 8,300

Rp 7,954,500 Rp - Rp 718 Rp 7,954,500 Rp 4,386,950 Rp 3,395 Rp 7,954,500

Balikpapan, 31 Desember 2018

Kepala Puskesmas Muara Rapak

Ns.Fahmy Rosady,S.Kep

NIP.196701211988011003
KHIR ( 31 Maret 2019)

Jumlah (Rp)

Rp 110,000 Rp 220,000 Rp -

Rp 240,000 Rp 240,000 Rp -

Rp 440,000 Rp 440,000 Rp -

Rp 120,000 Rp 260,000 Rp -

Rp - Rp - Rp -

Rp 150,000 Rp 190,000 Rp -

Rp 230,000 Rp 265,000 Rp -

Rp 400,000 Rp 400,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp - Rp - Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp 50,000 Rp 50,000 Rp -

Rp 80,000 Rp 80,000 Rp -

Rp 700,000 Rp 700,000 Rp -

Rp 700,000 Rp 700,000 Rp -
Rp 175,000 Rp 200,000 Rp -

Rp (5,000) Rp 5,000 Rp -

Rp 175,000 Rp 175,000 Rp -

Rp 55,000 Rp 60,000 Rp -

Rp 175,000 Rp 175,000 Rp -

Rp 250,000 Rp 250,000 Rp -

Rp 690,000 Rp 690,000 Rp -

Rp 600,000 Rp 600,000 Rp -

Rp 600,000 Rp 600,000 Rp -

Rp 3,280,000 Rp 4,780,000 Rp -

Rp 9,500,000 Rp 10,750,000 Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp - Rp - Rp -

Rp (50,000) Rp - Rp -
Rp (25,000) Rp - Rp -

Rp (35,000) Rp - Rp -

Rp (35,000) Rp - Rp -

Rp 3,900,000 Rp 3,900,000 Rp -

Rp (240,000) Rp - Rp -

Rp (60,000) Rp - Rp -

Rp 18,700 Rp 37,400 0

Rp 28,050 Rp 56,100 0

Rp 1,693,200 Rp 2,473,400 0

Rp 26,709,950
Rp 31,096,900 0