Berita Acara Koreksi 2014

LAMPIRAN BERITA ACARA KOREKSI
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
NAMA OBAT
Acyclovir 5 % Cream
Alat suntik sekali pakai 2,5 ml
Ambroxol 30 mg
Aminofilin tablet 200 mg
Amoksisilin kapsul 250 mg
Amoksisilin sirup kering 125 mg/5 ml
Antalgin (Metampiron) tablet 500 mg
Antasida DOEN suspensi btl. 60 ml
Antasida DOEN tablet 500 mg
Anti Bakteri DOEN Salep kombinasi
Anti Hemoroid DOEN kombinasi supp
Antifungi DOEN kombinasi (White Field Salep)
Asam Askorbat (Vit. C) tablet 50 mg
Asam Mefenamat 500 mg
Asetosal tablet 500 mg
Besi (II) Sulfat (Tambah darah) tablet
Betametason krim 0,1 %
Buscopan injeksi
Captopril 12,5 mg
Captopril 25 mg
Catgut/Benang Bedah No.2/0-3/0 dengan Jarum
Cefadroxil 500 mg
Cimetidine 200 mg tablet
Dekstrometorfan Sirup 10mg/5ml
Dekstrometorfan Tablet 15 mg
Dexametason Injeksi Amp
Dexametason tablet 0,5 mg
Diapet kapsul
Diazepam tablet 5 mg
Difenhidramin HCL injeksi 10 mg/ml-1ml
Diklofenak Natrium/Sodium 50 mg tablet
Diltiazem tablet
Doxyciclin 100 mg tablet
Dulcolax supp. Anak
Efedrin HCL tablet 25 mg
Erythromicin 500 mg
Fenitoin Natrium Kapsul 30 mg
Fenobarbital tablet 30 mg
Fenol Gliserol tetes telinga 10%
Fitomenadion (Vit. K1) tablet salut gula 10 mg
Furosemida tablet 40 mg
Garam Oralit untuk 200 ml air
Gentian Violet larutan 1%
Glibenklamid Tablet 5 mg
Gliseril Guaiakolat tablet 100 mg
Griseofulvin tablet 125 mg
Haloperidol 0,5 mg tablet
JUMLAH AWAL
385
645
1,250
262
6,795
954
170
20
47
6,511
490
24,028
99
3
1,250
6,084
17
5,000
82
4,673
100
161
186
4
1,000
145
400
6,159
110
625
3,000
14
1,507
9,818
711
-
JUMLAH SETELAH
KOREKSI
38.00
438.00
127.00
745.00
5,260.00
300.00
8,379.00
37.00
1,954.00
232.00
47.00
99.00
7,916.00
150.00
550.00
25,094.00
147.00
9.00
1,965.00
6,808.00
22.00
55.00
250.00
29.00
5,985.00
88.00
9,493.00
300.00
296.00
281.00
115.00
200.00
150.00
9.00
1,905.00
245.00
670.00
8,338.00
23.00
280.00
760.00
3,880.00
33.00
3,954.00
14,464.00
1,315.00
100.00
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100

Hidroklorotiazid (HCT) tablet 25 mg
Hidrokortison krim 2,5%
Ibuprofen tablet 200 mg
Infusion Set dewasa
Jarum Disposible 23 G
Kalsium Laktat (Kalk) tablet 500 mg
Karbamazepin tablet 200 mg
Kloramfenikol salep mata 1%
Kloramfenikol tetes telinga 3 %
Klorfeniramin Maleat (CTM) tablet 4 mg
Klorpromazin HCL tablet salut 100 mg
Kotrimoksazol suspensi 240 mg/5ml
Kotrimoksazol tablet Pedriatik 120 mg
Kotrimoksazol tablet, 480 mg
Lidokain Komp.injeksi, Kombinasi: Lidokain HCL 2
Mebendazol tablet 100 mg
Metformin 500
Metilergometrin Maleat tablet salut 0,125 mg
Metronidazol tablet 500 mg
Miconazole 2% Cream
Natrium Klorida (NaCl) infus 0,9%
Nifedipin 10 mg tablet
Nistatin tablet salut 500.000 iu
Nistatin tablet Vaginal 100.000 iu/g
Obat Batuk Hitam (OBH) sirup
Oksitetrasiklin HCL salep kulit 3%
Oksitetresiklin HCL salep mata 1%
Oseltamivir 75 mg
Papaverin tablet 40 mg
Parasetamol Sirup 120 mg/5 ml
Parasetamol tablet 500 mg
Phenylbutason 200
Piridoksin HCL (Vit. B6) Tablet 10 mg
Plester 5 Yard x 2 Inch
Prednison tablet 5 mg
Pyrantel Pamoat 125 mg tablet
Ranitidin (Radin) 150 mg tablet
Ringer Laktat larutan Infus Steril
Salbutamol tablet 2 mg
Salep 2-4, Kombinasi: Asam Salisilat 2% + Beler
Salisil Bedak 2 %
Serum Anti Tetanus (ATS) injeksi 1.500 iu/amp
Sianokobalamin (Vit. B12) injeksi 500 mcg/ml-1ml
Stesolid Rectal Anak (Diazepam 5 mg/2,5 ml)
Sulfasetamida Natrium tetes mata 15%-5ml
Thiamphenicol 500 mg kapsul
Tiamin HCL/Monotatrat (Vit. B1) Tablet 50 mg
Triheksilfenidil (THP) Hidroklorida tablet 2 mg
Vitamin B Complex tablet
Xylomidon Injeksi vial
Zinc 20 mg
100
670
4,390
1,580
6
260
1,480
440
20
33
5,587
51
1,000
50
300
970
9,715
108
6
460
100
176
146
36
510
141
16,124
6,455
6
1,273
88
14
1,299
100
288
814
2
50
8,558
190
11,730
18
180.00
845.00
108.00
5,380.00
2,120.00
7.00
314.00
2,660.00
580.00
73.00
72.00
8,752.00
1,000.00
105.00
1,050.00
772.00
83.00
309.00
1,045.00
130.00
10,565.00
168.00
8.00
645.00
200.00
55.00
223.00
200.00
62.00
40.00
765.00
249.00
18,639.00
70.00
7,845.00
8.00
2,173.00
175.00
10.00
18.00
2,619.00
134.00
325.00
8.00
928.00
4.00
11.00
135.00
11,586.00
260.00
16,750.00
20.00
355.00
101
102
103
104
105
106
107
108
109
Amitriptilin 25 mg.
Asam Folat
Domperidon Syr 60 ml
Loperamid 2 mg
Paracetamol (Dumin) 125 mg/2,5 ml Rect
Piracetam 1200 mg
Piracetam Inj.
Simvastatin 10 mg
Valsartan 80 mg
Total
100
1,900
80
10
5
28
160,172
120.00
2,350.00
3.00
160.00
11.00
140.00
25.00
5.00
36.00
217,223
SELISIH
38.00
53.00
127.00
100.00
4,010.00
38.00
1,584.00
37.00
1,000.00
62.00
27.00
52.00
1,405.00
150.00
60.00
1,066.00
48.00
6.00
715.00
724.00
5.00
55.00
250.00
29.00
985.00
6.00
4,820.00
200.00
135.00
95.00
115.00
200.00
150.00
5.00
905.00
100.00
270.00
2,179.00
23.00
170.00
135.00
880.00
19.00
2,447.00
4,646.00
604.00
100.00
80.00
175.00
108.00
990.00
540.00
1.00
54.00
1,180.00
140.00
53.00
39.00
3,165.00
1,000.00
54.00
50.00
772.00
33.00
9.00
75.00
130.00
850.00
60.00
2.00
185.00
100.00
55.00
47.00
54.00
26.00
40.00
255.00
108.00
2,515.00
70.00
1,390.00
2.00
900.00
87.00
10.00
4.00
1,320.00
34.00
37.00
8.00
114.00
2.00
11.00
85.00
3,028.00
70.00
5,020.00
2.00
355.00
20
450
3
80
1
140
20
5
8
57,051
LAPORAN MUTASI BARANG PERSEDIAAN

BARANG QUASI ,ATK, CETAK,ALAT RUMAH TANGGA DAN OBAT
REKAP
TAHUN ANGGARAN 2013
Puskesmas : Buleleng II
NO
KOD
UR
E
UT
1
2
#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
URAIAN (NAMANBARANG)
3
Puskesmas Buleleng II
Abbocat set Anak
Abbocat set Dewasa
Acyclovir 200 mg tab.
Acyclovir 5 % Cream
Air Raksa dental use
Alat suntik sekali pakai 3 ml
Albendazol tablet 400 mg
Alopurinol tablet 100 mg
Ambroxol 30 mg
Aminofilin injeksi 24 mg/ml-10ml
Ampisilin kapsul 250 mg
Ampisilin sirup kering 125mg/5 ml
Antalgin (Metampiron) injeksi 250 mg/ml-2ml
Aqua pro injeksi steril bebas pirogen
Artemeter Inj.
Artesdiaquine
Artesunate Inj
Asam mefenamat 250 mg
Atrofin Sulfat Injeksi 0,25 mg/ml-1 ml
Azithromycin/Zistic 500
Benzatin Benzil Penicillin Injeksi 1,2 juta iu/vial
Bioplacenton Jelly
Bromhexin 8 mg
Buscopan injeksi
SATUA
N
(BUAH,
LUSIN,
SET,
UNIT)
4
KEADAAN PER 31 DESEMBER 2012
MUTASI / PERUBAHAN 1 Januari S/D 31 Desember 2013
KEADAAN PER 31 Desember 2013

KET
Harga Satuan
JML BARANG
SALDO AWAL
JUMLAH HARGA
(RP)
JUMLAH HARGA
(RP)
JML BARANG
Selisih Br
Selisih Uang
5
18,304
18,304
534
3,000
141,700
560
594
800
407
132
125
3,000
114
289
370
3,700
269
381
3,700
1,334
149
3,850
162
2,517
2,000
1,719
5,500
15,265
800
825
32
124
176
96
156
1,265
12,569
8,200
11,400
67
1,866
11,000
39
22,600
1
180
12
220
500
200
660
110
1,875
2,600
11,660
655
148
31
35
1,510
595
300
490
30,605
18,304.00
96,120.00
36,000.00
176,000.00
203,500.00
26,400.00
82,500.00
12,540.00
541,875.00
962,000.00
15,554,440.00
106,110.00
372,516.00
62,000.00
60,165.00
48,320.00
104,720.00
28,800.00
76,440.00
2,050,535.00
-
1
180
12
220
500
200
660
110
1,875
2,600
11,660
655
148
31
35
1,510
595
300
490
30,605
Harga
Satuan
18,304
96,120
36,000
176,000
203,500
26,400
82,500
12,540
541,875
962,000
15,554,440
106,110
372,516
62,000
60,165
48,320
104,720
28,800
76,440
2,050,535
-
18,304
18,304
534
3,000
141,700
560
594
800
407
132
125
3,000
114
289
370
3,700
269
381
3,700
1,334
149
3,850
162
2,517
2,000
1,719
5,500
15,265
800
825
32
124
176
96
156
1,265
12,569
8,200
11,400
67
1,866
11,000
39
22,600
BERTAMBAH
JML BARANG
7
BERKURANG
JML HARGA (RP)

8
JML BARANG
9
JML HARGA (RP)

10
JML BARANG
JML HARGA (RP)
11
12
3
232
385
60
3,050
257
645
1,250
262
6,795
954
170
20
47
6,511
300
490
24,028
99
254
3
54,912
123,888
215,600
48,000
1,241,350
33,924
73,530
361,250
969,400
1,012,455
154,548
427,890
40,000
80,793
208,352
28,800
76,440
1,609,876
184,734
9,906
67,800
13
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Captopril 12,5 mg
Captopril 25 mg
Catgut/Benang Bedah No.2/0-3/0 dengan Jarum Bedah
Cefadroxil 500 mg
Ciprofloxacin 500 mg kaptab
Clobazam (Frisium) 10 mg tablet
Devitalisasi Pasta (Non Arsen)
Diapet kapsul
Diazepam injeksi 5 mg/ml-2ml
Digoksin tablet 0,25 mg
Diklofenak Kalium/Potasium 25 mg tablet
Diltiazem tablet
Dulcolax supp. Anak
Dulcolax supp. Dewasa
Duradryl injeksi
Ekstrak Belladona tablet 10 mg
Epinefrina HCL/Bitatrat (Epinefrin/Adrenalin) injeksi
Ergotamin Tartat komp.
Erythromicin 250 mg
Erythromicin 500 mg
Erythromicin sirup
Etakridin (Rivanol) larutan 0,1%
Etanol 70 %
Ethambutol HCL tablet 250 mg
Etil Klorida semprot
Eugenol cairan
Fenitoin Natrium kapsul 100 mg
Fenobarbital injeksi 50 mg/ml-2ml
Fenoksimetil Penisilin tablet 250 mg
Fitomenadion (Vit. K1) inj. 10 mg/ml-1ml
Fluor tablet 0,5 mg
Gameksan emulsi 1%
Gentamisin Sulfat 0,3% Tetes Mata
Glass Ionomer Cement (GC IX)
90
138
8,897
420
115
260
950
2,865
110
388,994
2,002
87
388
2,369
31
48
960
143
391
708
168
218
152
253
8,859
8,948
46
52
32
1,240
124
504
930
8,100
1,800
18,698
348
105,000
45,833
80
73
1,560
146
56
262
465
1,009
1,740
681
33
101
2,200
380
3,300
450
380,000
2,600
5,880
19
92
53
5,000
1
189
6,750
1,000
191
50
100
200
48
1,963
500
73
5
22
2
17
100
32
90
260
15
1,090
10
22
1
234,000.00
811,440.00
169,043.00
23,920.00
151,845.00
550,000.00
388,994.00
378,378.00
587,250.00
31,000.00
9,168.00
48,000.00
14,300.00
33,600.00
12,144.00
102,076.00
16,000.00
90,520.00
9,000.00
411,356.00
210,000.00
26,520.00
100,900.00
55,680.00
61,290.00
26,260.00
33,000.00
414,200.00
33,000.00
9,900.00
380,000.00
2,600
5,880
19
92
53
5,000
1
189
6,750
1,000
191
50
100
200
48
1,963
500
73
5
22
2
17
100
32
90
260
15
1,090
10
22
1
234,000
811,440
169,043
23,920
151,845
550,000
388,994
378,378
587,250
31,000
9,168
48,000
14,300
33,600
12,144
102,076
16,000
90,520
9,000
411,356
210,000
26,520
100,900
55,680
61,290
26,260
33,000
414,200
33,000
9,900
380,000
90
138
8,897
420
115
260
950
2,865
110
388,994
2,002
87
388
2,369
31
48
960
143
391
708
168
218
152
253
8,859
8,948
46
52
32
1,240
124
504
930
8,100
1,800
18,698
348
105,000
45,833
80
73
1,560
146
56
262
465
1,009
1,740
681
33
101
2,200
380
3,300
450
380,000
1,250
6,084
17
5,000
82
4,673
100
161
186
110
1,000
260
70
30
145
7
40
400
17
6,159
32
110
625
3,000
14
1
112,500
839,592
151,249
550,000
164,164
406,551
38,750
7,728
178,560
15,730
35,436
52,000
8,320
86,800
3,720
134,850
12,600
747,920
29,200
26,520
344,904
55,680
74,910
63,125
1,140,000
6,300
380,000
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
Glukosa larutan infus 5% steril 500 ml
H2O2/Hidrogen Peroksida (Perhidrol) 3%
Haloperidol 5 mg tablet
Infusion Set anak
Infusion Set dewasa
Iodiol kapsul lunak
Isoniazid tablet (INH) 100 mg
Isosorbid Dinitrat (ISDN) tablet sublingual 5 mg
Jarum Jahit (bedah) No. 9 s/d 14
Kaca Sediaan
Kalsium Hidroksida Pasta/Cement
Kapas Pembalut/Absorben 250 g
Kasa Kompres 40/40 steril
Kasa Pembalut 2 m x 80 cm
Kasa Pembalut Hidrofil 4 x 15 cm
Ketokonazol 2 % Krim.
Ketokonazol 200 mg tab.
Kloramfenikol kapsul 250 mg
Kloramfenikol tetes mata
Klorokuin tablet 250 mg
Klorpromazin HCL injeksi 25 mg/ml-1ml
Kuinina (Kina) tablet 222 mg
Kuinina Dihidroklorida Injeksi 25%-2ml
Larutan Asam Alkohol
Larutan Asam Klorida 0,1 N
Larutan Asam Sulfosalisilat 20% reagen
Larutan Benedict
Larutan Eosin 2%
Larutan Eter Alkohol
Larutan Gabbet
Larutan Giemsa Stain
Larutan Karbol Puksin
Larutan Metanol
72
28
5,060
240
13,000
61
83
123
37
2,980
116
205
4,000
4,000
930
41
97
98
380
4,500
400
102,363
52
2,000
247
393
8,799
3,373
733
7,000
410
231
1,563
2,500
1,600
24
105
817
724
122
38
3,960
76
165
400
4,227
32,347
16,500
2,744
34,683
1,954
4,400
60,046
22,020
910
3,190
3
315
100
140
100
531
60
715
1,220
2
180
2,000
5
340
120
1
50
59
720
272
96
3,528
960
182
500
4,112
65,520.00
89,320.00
15,180.00
75,600.00
6,100.00
11,620.00
12,300.00
19,647.00
178,800.00
82,940.00
250,100.00
8,000.00
17,640.00
104,000.00
10,000.00
83,980.00
47,160.00
8,799.00
168,650.00
43,247.00
166,320.00
680,000.00
153,600.00
84,672.00
36,480.00
720,720.00
38,000.00
678,480.00
-
910
3,190
3
315
100
140
100
531
60
715
1,220
2
180
2,000
5
340
120
1
50
59
720
272
96
3,528
960
182
500
4,112
65,520
89,320
15,180
75,600
6,100
11,620
12,300
19,647
178,800
82,940
250,100
8,000
17,640
104,000
10,000
83,980
47,160
8,799
168,650
43,247
166,320
680,000
153,600
84,672
36,480
720,720
38,000
678,480
-
72
28
5,060
240
13,000
61
83
123
37
2,980
116
205
4,000
4,000
930
41
97
98
380
4,500
400
102,363
52
2,000
247
393
8,799
3,373
733
7,000
410
231
1,563
2,500
1,600
24
105
817
724
122
38
3,960
76
165
400
4,227
32,347
16,500
2,744
34,683
1,954
4,400
60,046
22,020
1,507
9,818
3
711
18
100
100
670
4,390
1,580
6
260
216
1,480
440
120
204
99
916
20
33
5,587
51
1,000
108,504
274,904
15,180
170,640
234,000
8,300
12,300
24,790
509,240
323,900
24,000
98,800
86,400
76,960
108,680
47,160
1,794,996
72,567
211,596
31,260
52,800
134,088
201,960
76,000
-
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
16,195
Larutan Methylen Blue
13,819
Larutan Turk
1,225
Levertran Zalf 15 g
1,137
Lidokain Komp.injeksi, Kombinasi: Lidokain HCL 2% + Epine
150
Livron B plex tablet
49,862
Lizol mengandung Kresol tersabun 50 %
217
182
Metformin 500
1,490
Metilergometrin Maleat inj. 0,200 mg 1ml
121
143
220
3,000
Miconazole 2% Cream
48,762
Monoklorkamfer Mentol cairan (CHKM)
137,853
Mummifying Pasta/Iodoform Pasta
15
Natrium Bikarbonat tablet 500 mg
4,900
3,000
Natrium Tiosulfat injeksi 25%-10ml
4,900
Neurotropin/Neuroboran Injeksi
129
600
370
360,000
Obat Antituberkulosis FDC Katagori 1 & 3 Paket
1,200,000
Obat Antituberkulosis FDC Katagori 2 Paket
215,000
Obat Antituberkulosis Kategori Anak Paket
160,000
Obat Antituberkulosis Kategori Sisipan Paket
1,430
Obat Kusta Paket MB & PB Treatment/MDT Anak Paket
Obat Kusta Paket MB & PB Treatment/MDT Dewasa Paket
Ofloxacin 400 mg
Oksigen gas dalam tabung (Oxycan)
Oksitetrasiklin HCL injeksi i.m 50 mg/ml 10 ml
Oksitosin injeksi 10iu/ml-1ml
Oseltamivir 75 mg
Papaverin Injeksi
Paraformaldehida tablet 1 gam
Phenylbutason 200
Piroxicam 10 mg
Piroxicam 20 mg
Polikresulen (Albothyl) 10 ml
Pot Dahak
Prazikuantel tablet 600 mg
Primaquin tablet 15 mg
Procain Benzil Penisilin injeksi 3 juta iu/vial
Propanolol 10 mg tablet
Propil Tiourasil (PTU) 100 mg tablet
873
39,225
3,100
1,675
1,920
1,785
1,300
530
100
60
2,300
42
105
81
18
84
105
7,186
23,000
170
63
109
6,017
77
121
300
90
840
90
100
870
460
4
100
200
100
329
107
68
150
890
162
200
5,400
1,800
2,500
7,300
3
1
2,000
900
100
300
102,330.00
152,880.00
134,100.00
12,100.00
124,410.00
101,200.00
19,600.00
490,000.00
25,800.00
60,000.00
470,470.00
179,225.00
130,560.00
267,750.00
89,000.00
372,600.00
8,400.00
567,000.00
145,800.00
45,000.00
613,200.00
21,558.00
23,000.00
126,000.00
98,100.00
12,100.00
90,000.00
90
840
90
100
870
460
4
100
200
100
329
107
68
150
890
162
200
5,400
1,800
2,500
7,300
3
1
2,000
900
100
300
102,330
152,880
134,100
12,100
124,410
101,200
19,600
490,000
25,800
60,000
470,470
179,225
130,560
267,750
89,000
372,600
8,400
567,000
145,800
45,000
613,200
21,558
23,000
126,000
98,100
12,100
90,000
16,195
13,819
1,225
1,137
150
49,862
217
182
1,490
121
143
220
3,000
48,762
137,853
15
4,900
3,000
4,900
129
600
370
360,000
1,200,000
215,000
160,000
1,430
873
39,225
3,100
1,675
1,920
1,785
1,300
530
100
60
2,300
42
105
81
18
84
105
7,186
23,000
170
63
109
6,017
77
121
300
50
300
970
870
9,715
108
6
10
460
100
8
176
6
100
146
36
510
10
141
2,000
16,124
6,455
6
500
1,273
880
100
300
56,850
65,100
176,540
124,410
2,137,300
324,000
29,400
49,000
59,340
60,000
2,880,000
251,680
87,300
244,550
69,120
51,000
600
324,300
84,000
1,693,020
116,190
43,116
80,199
95,920
12,100
90,000
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256

Reserpin Tablet 0,10 mg
Retinol (Vit.A ) kapsul 100.000 iu
Rifampisin Kapsul 300 mg
Salep 2-4, Kombinasi: Asam Salisilat 2% + Belerang Endap
Salisil Bedak 2 %
Salisil Spiritus 10 %
Sarung Tangan Karet (Hand Scund)
Semen Zeng Fosfat serbuk dan cairan
Serum Anti bisa Ular Polivalen Injeksi 5 ml
Silk (Benang Bedah Sutera )
Silver Amalgam Serbuk
Stesolid Rectal Dewasa (Diazepam 10 mg/2,5 ml)
Streptomisin Sulfat serbuk injeksi 1.000 mg/vial
Tablet Tambah Darah Kombinasi
Temporary Stopping (Fletcher) Serbuk dan Cairan
Tetrasiklin HCL kapsul 250 mg
Tetrasiklin HCL Kapsul 500 mg
Trikresol Formalin (TKF) Cairan
Valium/Diazepam inj. 10mg/ml
Ventolin Inhaler
Ventolin Nebolizer
Yodium Povidon larutan 10% 30 ml
Zinc 20 mg
Jumlah
320
220
76
88
286
462
480
660
879
5,200
84
98
1,230
1,430
3,500
80,659
240,449
52,500
1,037
3,750
227,311
20,807
22,500
2,625
1,900
3,446
500
6,862
167
257
319
616
38
42
65,000
327
200,000
9,000
23
6,750
2,000
14,500
475
98
5
1,415
50
1
940
33
2
5
66
2,000
100
8,022
240
1
112,090
15
8
4
17,000
266,332.00
Kepala Puskesmas
Buleleng II
dr.Ni Luh Sustemi
31,360.00
26,000.00
138,670.00
61,500.00
240,449.00
974,780.00
123,750.00
41,614.00
112,500.00
227,436.00
334,000.00
61,600.00
304,836.00
10,080.00
65,000.00
2,578,070.00
101,250.00
16,000.00
58,000.00
8,075,000.00
47,963,022.00
98
5
1,415
50
1
940
33
2
5
66
2,000
100
8,022
240
1
112,090
15
8
4
17,000
266,332
31,360
26,000
138,670
61,500
240,449
974,780
123,750
41,614
112,500
227,436
334,000
61,600
304,836
10,080
65,000
2,578,070
101,250
16,000
58,000
8,075,000
47,963,022
320
220
76
88
286
462
480
660
879
5,200
84
98
1,230
1,430
450
80,659
240,449
52,500
1,037
3,750
227,311
20,807
22,500
2,625
1,900
3,446
500
6,862
167
257
319
616
38
42
65,000
327
200,000
9,000
23
6,750
2,000
14,500
475
Singaraja, 31 Desember 2013

Petugas Pembantu Pengurus Barang
Made Satramika
88
14
1,299
100
288
1,800
1
814
53
2
5
50
8,558
20
11,730
18
2
3
170,926
28,160
72,800
109,116
123,000
411,840
810,000
80,659
844,118
198,750
41,614
112,500
30,800
325,204
180,000
269,790
121,500
4,000
43,500
-
30,401,968
Nip: 19720504 200701 2 023
Nip.19750622 200701 1 017
1
180
12
220
500
200
660
110
1,875
2,600
11,660
655
148
31
35
1,510
595
300
490
30,605
-
54,912
123,888
215,600
48,000
1,241,350
33,924
73,530
361,250
969,400
1,012,455
154,548
427,890
40,000
80,793
208,352
28,800
76,440
1,609,876
184,734
9,906
67,800
2,600
5,880
19
92
53
5,000
1
189
6,750
1,000
191
50
100
200
48
1,963
500
73
5
22
2
17
100
32
90
260
15
1,090
10
22
1
112,500
839,592
151,249
550,000
164,164
406,551
38,750
7,728
178,560
15,730
35,436
52,000
8,320
86,800
3,720
134,850
12,600
747,920
29,200
26,520
344,904
55,680
74,910
63,125
1,140,000
6,300
380,000
910
3,190
3
315
100
140
100
531
60
715
1,220
2
180
2,000
5
340
120
1
50
59
720
272
96
3,528
960
182
500
4,112
-
108,504
274,904
15,180
170,640
234,000
8,300
12,300
24,790
509,240
323,900
24,000
98,800
86,400
76,960
108,680
47,160
1,794,996
72,567
211,596
31,260
52,800
134,088
201,960
76,000
-
90
840
90
100
870
460
4
100
200
100
329
107
68
150
890
162
200
5,400
1,800
2,500
7,300
3
1
2,000
900
100
300
56,850
65,100
176,540
124,410
2,137,300
324,000
29,400
49,000
59,340
60,000
2,880,000
251,680
87,300
244,550
69,120
51,000
600
324,300
84,000
1,693,020
116,190
43,116
80,199
95,920
12,100
90,000
98
5
1,415
50
1
940
33
2
5
66
2,000
100
8,022
240
1
112,090
15
8
4
17,000
266,332
28,160
72,800
109,116
123,000
411,840
810,000
80,659
844,118
198,750
41,614
112,500
30,800
325,204
180,000
269,790
121,500
4,000
43,500
#VALUE!
No.
Nama Obat
Satuan
Abbocat set Anak
Buah
Abbocat set Dewasa
Buah
Tab
Acyclovir 5 % Cream
Tube
Btl
Bj
Bj
Bj
Tab
10
Alopurinol tablet 100 mg
Tab
11
Ambroxol 30 mg
Tab
12
Aminofilin injeksi 24 mg/ml-10ml
Amp
13
Tab
14
Kap
15
Kap
16
Btl
17
Kap
18
Kap
19
Ampisilin sirup kering 125mg/5 ml
Btl
20
Antalgin (Metampiron) injeksi 250 mg/ml-2ml
Amp
21
Tab
22
Btl
23
Tab
24
Pot
25
Supp
26
Pot
27
Aqua pro injeksi steril bebas pirogen
Vial
28
Artemeter Inj.
Amp
29
Artesdiaquine
Tab
30
Artesunate Inj
Vial
31
Tab
32
Asam mefenamat 250 mg
Tab
33
Tab
34
Tab
35
Tab
36
Atrofin Sulfat Injeksi 0,25 mg/ml-1 ml
Amp
37
Azithromycin/Zistic 500
Kap
38
Vial
39
Vial
40
Tab
41
Tube
42
Bioplacenton Jelly
Tube
43
Bromhexin 8 mg
Tab
44
Buscopan injeksi
Amp
45
Captopril 12,5 mg
Tab
46
Captopril 25 mg
Tab
47
Catgut/Benang Bedah No.2/0-3/0 dengan Jarum Bedah
Bj
48
Cefadroxil 500 mg
Kap
49
Tab
50
Ciprofloxacin 500 mg kaptab
Tab
51
Clobazam (Frisium) 10 mg tablet
Tab
52
Btl
53
Tab
54
Devitalisasi Pasta (Non Arsen)
Pot
55
Amp
56
Tab
57
Diapet kapsul
Kap
58
Diazepam injeksi 5 mg/ml-2ml
Amp
59
Tab
60
Tab
61
Amp
62
Digoksin tablet 0,25 mg
Tab
63
Tab
64
Tab
65
Tab
66
Tab
67
Diltiazem tablet
Tab
68
Tab
69
Dulcolax supp. Anak
Supp
70
Dulcolax supp. Dewasa
Supp
71
Duradryl injeksi
Vial
72
Tab
73
Ekstrak Belladona tablet 10 mg
Tab
74
Epinefrina HCL/Bitatrat (Epinefrin/Adrenalin) injeksi
Amp
75
Ergotamin Tartat komb./Antimigren DOEN Tablet kombinasi
Tab
76
Erythromicin 250 mg
Kap
77
Erythromicin 500 mg
Kap
78
Erythromicin sirup
Btl
79
Etakridin (Rivanol) larutan 0,1%
Btl
80
Etanol 70 %
Btl
81
Ethambutol HCL tablet 250 mg
Tab
82
Etil Klorida semprot
Btl
83
Eugenol cairan
Btl
84
Fenitoin Natrium kapsul 100 mg
Kap
85
Kap
86
Fenobarbital injeksi 50 mg/ml-2ml
Amp
87
Tab
88
Tab
89
Tab
90
Tab
91
Btl
92
Fitomenadion (Vit. K1) inj. 10 mg/ml-1ml
Amp
93
Tab
94
Fluor tablet 0,5 mg
Tab
95
Tab
96
Gameksan emulsi 1%
Btl
97
Sak
98
Gentamisin Sulfat 0,3% Tetes Mata
Btl
99
Btl
100
Glass Ionomer Cement (GC IX)
Set
101
Tab
102
Tab
103
Glukosa larutan infus 5% steril 500 ml
Btl
104
Tab
105
H2O2/Hidrogen Peroksida (Perhidrol) 3%
Btl
106
Tab
107
Tab
108
Haloperidol 5 mg tablet
Tab
109
Tab
110
Tube
111
Tab
112
Tab
113
Infusion Set anak
Set
114
Infusion Set dewasa
Set
115
Iodiol kapsul lunak
Kap
116
Tab
117
Tab
118
Isosorbid Dinitrat (ISDN) tablet sublingual 5 mg
Tab
119
Bj
120
Jarum Jahit (bedah) No. 9 s/d 14
Pack
121
Kaca Sediaan
Bj
122
Kalsium Hidroksida Pasta/Cement
Btl
123
Tab
124
Kapas Pembalut/Absorben 250 g
Bks
125
Tab
126
Kasa Kompres 40/40 steril
Bks
127
Kasa Pembalut 2 m x 80 cm
Roll
128
Roll
129
Roll
130
Ketokonazol 2 % Krim.
Tube
131
Ketokonazol 200 mg tab.
Tab
132
Kloramfenikol kapsul 250 mg
Kap
133
Tube
134
Kloramfenikol tetes mata
Btl
135
Btl
136
Tab
137
Klorokuin tablet 250 mg
Tab
138
Amp
139
Amp
140
Tab
141
Tab
142
Btl
143
Tab
144
Tab
145
Kuinina (Kina) tablet 222 mg
Tab
146
Kuinina Dihidroklorida Injeksi 25%-2ml
Amp
147
Larutan Asam Alkohol
Btl
148
Larutan Asam Klorida 0,1 N
Btl
149
Larutan Asam Sulfosalisilat 20% reagen
Btl
150
Larutan Benedict
Btl
151
Larutan Eosin 2%
Btl
152
Larutan Eter Alkohol
Btl
153
Larutan Gabbet
Btl
154
Larutan Giemsa Stain
Btl
155
Larutan Karbol Puksin
Btl
156
Larutan Metanol
Btl
157
Larutan Methylen Blue
Btl
158
Larutan Turk
Btl
159
Levertran Zalf 15 g
Pot
160
Lidokain Komp.injeksi, Komb.: Lidokain HCL 2% + Epinefrin
Amp
161
Livron B plex tablet
Tab
162
Lizol mengandung Kresol tersabun 50 %
Btl
163
Tab
164
Metformin 500
Tab
165
Metilergometrin Maleat inj. 0,200 mg 1ml
Amp
166
Tab
167
Tab
168
Tab
169
Miconazole 2% Cream
Tube
170
Monoklorkamfer Mentol cairan (CHKM)
Btl
171
Mummifying Pasta/Iodoform Pasta
Btl
172
Natrium Bikarbonat tablet 500 mg
Tab
173
Btl
174
Natrium Tiosulfat injeksi 25%-10ml
Vial
175
Neurotropin/Neuroboran Injeksi
Vial
176
Tab
177
Tab
178
Tab
179
Obat Antituberkulosis FDC Katagori 1 & 3 Paket
Paket
180
Obat Antituberkulosis FDC Katagori 2 Paket
Paket
181
Obat Antituberkulosis Kategori Anak Paket
Paket
182
Obat Antituberkulosis Kategori Sisipan Paket
Paket
183
Btl
184
Obat Kusta Paket MB & PB Treatment/MDT Anak
Paket
185
Obat Kusta Paket MB & PB Treatment/MDT Dewasa
Paket
186
Ofloxacin 400 mg
Tab
187
Oksigen gas dalam tabung (Oxycan)
Tabung
188
Oksitetrasiklin HCL injeksi i.m 50 mg/ml 10 ml
Vial
189
Tube
190
Tube
191
Oksitosin injeksi 10iu/ml-1ml
Amp
192
Oseltamivir 75 mg
Tab
193
Papaverin Injeksi
Amp
194
Tab
195
Paraformaldehida tablet 1 gam
Tab
196
Btl
197
Tab
198
Tab
199
Phenylbutason 200
tab
200
Tab
201
Piroxicam 10 mg
Kap
202
Piroxicam 20 mg
Kap
203
Roll
204
Polikresulen (Albothyl) 10 ml
Btl
205
Pot Dahak
Pot
206
Prazikuantel tablet 600 mg
Tab
207
Tab
208
Primaquin tablet 15 mg
Tab
209
Procain Benzil Penisilin injeksi 3 juta iu/vial
Vial
210
Tab
211
Tab
212
Propil Tiourasil (PTU) 100 mg tablet
Tab
213
Tab
214
Tab
215
Tab
216
Tab
217
Kap
218
Kap
219
Kap
220
Kap
221
Kap
222
Btl
223
Tab
224
Tab
225
Salep 2-4, Komb.: As. Salisilat 2% + Belerang Endap 4%
Pot
226
Salisil Bedak 2 %
Pot
227
Salisil Spiritus 10 %
Btl
228
Sarung Tangan Karet (Hand Scund)
Pcs
229
Semen Zeng Fosfat serbuk dan cairan
Btl
230
Serum Anti bisa Ular Polivalen Injeksi 5 ml
Vial
231
Amp
232
Amp
233
Silk (Benang Bedah Sutera )
Sak
234
Silver Amalgam Serbuk
Btl
235
Tube
236
Stesolid Rectal Dewasa (Diazepam 10 mg/2,5 ml)
Tube
237
Vial
238
Vial
239
Btl
240
Tablet Tambah Darah Kombinasi
Tab
241
Temporary Stopping (Fletcher) Serbuk dan Cairan
Set
242
Tetrasiklin HCL kapsul 250 mg
Kap
243
Tetrasiklin HCL Kapsul 500 mg
Kap
244
Kap
245
Kap
246
Tab
247
Tab
248
Trikresol Formalin (TKF) Cairan
Btl
249
Valium/Diazepam inj. 10mg/ml
Amp
250
Ventolin Inhaler
Btl
251
Ventolin Nebolizer
Btl
252
Tab
253
Vial
254
Btl
255
Btl
256
Zinc 20 mg
Tab
JUMLAH
Obat diluar LPLPO

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
Amitriptilin 25 mg.
Tab
Amlodipin
Tab
Asam Asetil Salisilat (Aspilet) 80 mg.
Tab
Asam Folat
Tab
Asam Traneksamat Tab.
Tab
Asam Traneksamat Inj.
Amp
Betahistine Mesilat
Tab
Bisoprolol 5 mg.
Tab
Borax Gliserin
Btl
Desoksimetason + Neomicin Cream
Tube
Btl
Ketoprofen 100 mg
Tab
Ketoprofen 100 mg (Profenid) Suppo.
Supo
Ketorolac 10 mg/ml Inj.
Amp
Lanzoprazol
Tab
Lisinopril 10 mg
Tab
Loperamid 2 mg
Tab
Loratadin 10 mg
Tab
MgSO4 20% Inj.
Vial
MgSO4 40% Inj.
Vial
Meloxicam 15 mg
Tab
Metil Prednisolon 4 mg
Tab
Metoclopramid 10 mg
Tab
Metoclopramid Inj.
Amp
Nistatin Drop
Btl
Omeprazol 20 mg.
Tab
Ondansetron 4 mg/ml Inj
Amp
Paracetamol (Dumin) 125 mg/2,5 ml RectaTube
Paracetamol (Dumin) 250 mg/4 ml Rectal Tube
Permetrin 5% Salep
Tube
Piracetam 1200 mg
Tab
Piracetam Inj.
Amp
Placenta + Neomycin Cream
Tube
Ranitidin Inj.
Amp
Simvastatin 10 mg
Tab
Spironolacton 100 mg.
Tab
Tramadol 50 mg
Tab
Valsartan 80 mg
Tab
Vit. K Infant Inj.
Amp
JUMLAH
Bahan Habis Pakai

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Catgut Chromic Rol 100 m

Catgut Plain Rol 100 m
Folly Kateter
Kapas Lidi Steril
Kassa Gulung 40 Y x 80 cm
Kassa Hidropil 16 x 16
Kertas Puyer
Klorin 5,25 %
KY Jely USG
Masker
Masker N 95
Muchus Suction (Penghisap Lendir)
Pisau Bedah
Plastik Klip
Pot Salep 20 Gr
Sabun Anti Bakteri
Sarung Tangan Obgyn
Sarung Tangan Steril No. 7
Silk (Benang Sutra) Rol 100 m
Tissue
Umbilical Cord Clamp
Underpad
Urobag
Wing Nedle 19 G
Wing Nedle 23 G
Wing Nedle 25 G
Rol
Rol
Pcs
Bks
Rol
Pcs
Bks
Btl
Btl
Pcs
Pcs
Pcs
Pcs
Bks
Pcs
Btl
Pasang
Pasang
Rol
Box
Pcs
Pcs
Pcs
Buah
Buah
Buah
JUMLAH
Bahan Laboratorium
1
2
3
4
5
6
7
8
9
10
11
Aseptik gel
Cuka dixi
Gliserin
Larutan KOH 1%
Cito brush (pembersih tabung)
Metilin blue
PH paper 3,8 - 5,4
Cover glass
Torniquet
Reagensia ABX 60 atphalyse
Reagensia ABX 60 cleaner
botol
botol
botol
botol
buah
botol
roll
set
buah
liter
liter
12
13
14
15
16
17
18
19
Reagensia ABX 60 minilidi

Jarum vanoject/Vacuntainer
Safety box
Tabung criyo 15 ml
Tabung vacuntainer EDTA
Tabung vancuntainer 5 cc
Holder
Yelow tip isi 1000 pcs
JUMLAH
liter
pcs
buah
tube
pcs
pcs
buah
pcs
C
BARANG QUASI ,ATK, CETAK,ALAT RUMAH TANGGA DAN OBAT
REKAP
TAHUN ANGGARAN 2014
20 PUSKESMAS
NO URUT
KOD
E
2
4
6
11
13
14
16
21
22
23
24
25
26
31
33
35
40
41
44
45
46
47
48
49
52
53
55
56
57
60
61
66
67
68
69
72
77
85
88
91
93
95
97
URAIAN (NAMANBARANG)
3
Acyclovir 5 % Cream
Ambroxol 30 mg
Buscopan injeksi
Captopril 12,5 mg
Captopril 25 mg
Catgut/Benang Bedah No.2/0-3/0 dengan Jarum
Cefadroxil 500 mg
Diapet kapsul
Diltiazem tablet
Dulcolax supp. Anak
Erythromicin 500 mg
SATUA
N
(BUAH,
LUSIN,
SET,
Harga Satuan
UNIT)
JML BARANG
SALDO AWAL
JUMLAH HARGA
(RP)
Koreksi
Saldo Awal
385
645
1,250
262
6,795
954
170
20
47
6,511
490
24,028
99
3
1,250
6,084
17
5,000
82
4,673
100
161
186
4
1,000
145
400
6,159
110
625
3,000
215,600.00
73,530.00
361,250.00
969,400.00
1,012,455.00
154,548.00
427,890.00
40,000.00
80,793.00
208,352.00
76,440.00
1,609,876.00
184,734.00
67,800.00
112,500.00
839,592.00
151,249.00
550,000.00
164,164.00
406,551.00
38,750.00
7,728.00
178,560.00
35,436.00
52,000.00
134,850.00
29,200.00
344,904.00
74,910.00
63,125.00
1,140,000.00
38.00
53.00
127.00
100.00
4,010.00
38.00
1,584.00
37.00
1,000.00
62.00
27.00
52.00
1,405.00
150.00
60.00
1,066.00
48.00
6.00
715.00
724.00
5.00
55.00
250.00
29.00
985.00
6.00
4,820.00
200.00
135.00
95.00
115.00
200.00
150.00
5.00
905.00
100.00
270.00
2,179.00
23.00
170.00
135.00
880.00
Nilai Koreksi
Harga
Satuan
4
Tube
Bj
Tab
Tab
Kap
Btl
Tab
Btl
Tab
Pot
Supp
Pot
Tab
Tab
Tab
Tab
Tube
Amp
Tab
Tab
Bj
Kap
Tab
Btl
Tab
Amp
Tab
Kap
Tab
Amp
Tab
Tab
Tab
Supp
Tab
Kap
Kap
Tab
Btl
Tab
Tab
Sak
BERTAMBAH
JML BARANG
harga satuan
masuk unit
7
3,000
560
125
114
289
3,700
149
3,850
162
2,517
2,000
1,719
32
176
156
67
1,866
22,600
90
138
8,897
420
115
2,865
110
2,002
87
388
48
960
218
152
253
8,859
52
930
73
56
1,009
681
101
380
114,000.00
29,680.00
15,875.00
11,400.00
1,158,890.00
140,600.00
236,016.00
142,450.00
162,000.00
156,054.00
54,000.00
89,388.00
44,960.00
26,400.00
9,360.00
71,422.00
89,568.00
135,600.00
64,350.00
99,912.00
44,485.00
23,100.00
28,750.00
83,085.00
108,350.00
12,012.00
419,340.00
77,500.00
6,480.00
91,200.00
25,070.00
30,400.00
37,950.00
44,295.00
47,060.00
93,000.00
19,710.00
122,024.00
23,207.00
115,770.00
13,635.00
334,400.00
3,000
560
125
114
289
3,700
149
3,850
162
2,517
2,000
1,719
32
176
156
67
1,866
22,600
90
138
8,897
420
115
2,865
110
2,002
87
388
48
960
218
152
253
8,859
52
930
73
56
1,009
681
101
380
BERKURANG
JML BARANG
JML HARGA (RP)
8
200
3,300
7,000
1,000
49,440
950
7,600
600
13,200
650
180
150
13,000
9,900
200
400
20
4,000
20,000
24
2,600
2,500
436
200
15,000
1,200
500
1,200
1,000
500
1,300
30
800
2,000
15,000
100
400
1,300
5,600
3,000
560
125.00
114.00
289
3,700
149
3,850
72.00
2,517
2,000
1,719
32.00
176
156
67
1,866
22,600
90
138
8,897
420
115
2,865
110.00
2,002.00
87
388
48
960
218
152
253
8,859
52
930
73
56
1,009
681
101
380
KEADAAN PER 31 Desember
600,000
1,848,000
875,000
114,000
14,288,160
3,515,000
1,132,400
2,310,000
950,400
1,636,050
360,000
257,850
416,000
1,742,400
31,200
746,400
452,000
360,000
2,760,000
213,528
1,092,000
287,500
1,249,140
400,400
1,305,000
465,000
24,000
1,152,000
218,000
76,000
328,900
265,770
744,000
146,000
840,000
100,900
272,400
131,300
2,128,000
JML BARANG
9
103
2,893
7,107
1,745
41,795
980
10,449
579
11,704
765
197
124
13,966
9,550
750
11,281
511
19
4,600
20,358
27
2,655
2,650
465
5,985
288
21,498
1,430
796
943
1,115
200
1,137
36
1,905
765
1,840
18,694
48
306
1,591
7,540
JML HARGA (RP)

10
309,000
1,620,080
888,375
198,930
12,078,755
3,626,000
1,556,901
2,229,150
1,018,548
1,925,505
394,000
213,156
446,912
1,680,800
117,000
755,827
953,526
429,400
414,000
2,809,404
240,219
1,115,100
304,750
1,332,225
658,350
576,576
1,870,326
554,125
38,208
905,280
243,070
30,400
287,661
318,924
99,060
711,450
134,320
1,046,864
48,432
208,386
160,691
2,865,200
11
135
845
20
12,905
270
5,530
58
3,450
117
30
125
6,950
500
13,813
36
10
1,365
6,450
19
100
2,995
70
538
500
313
3
280
830
4,644
75
374
469
1,940
99
101
102
104
106
107
109
110
111
112
114
119
123
125
133
135
136
140
142
143
144
160
163
164
166
168
169
173
176
177
178
183
189
190
192
194
196
198
199
200
203
207
213
214
222
223
225
226
231
232
235
239
245
246

Btl
Tab
Tab
Tab
Tab
Tab
Tab
Tube
Tab
Tab
Set
Infusion Set dewasa
Bj
Tab
Tab
Tube
Btl
Tab
Tab
Btl
Tab
Tab
Lidokain Komp.injeksi, Kombinasi: Lidokain HCL 2 Amp
Tab
Tab
Metformin 500
Tab
Tab
Tube
Miconazole 2% Cream
Btl
Tab
Tab
Tab
Btl
Tube
Tube
Tab
Oseltamivir 75 mg
Tab
Btl
Tab
Phenylbutason 200
tab
Tab
Roll
Tab
Tab
Tab
Btl
Tab
Salep 2-4, Kombinasi: Asam Salisilat 2% + Beler Pot
Pot
Salisil Bedak 2 %
Amp
Sianokobalamin (Vit. B12) injeksi 500 mcg/ml-1ml Amp
Tube
Btl
Kap
Tab
450
72
28
240
61
83
37
2,980
116
205
4,000
380
52
247
1,563
1,600
24
122
3,960
76
165
1,137
217
182
121
220
3,000
4,900
129
600
370
1,430
1,675
1,920
1,300
100
2,300
105
81
18
7,186
63
320
220
5,200
84
1,230
1,430
52,500
1,037
20,807
3,446
616
38
14
1,507
9,818
711
100
670
4,390
1,580
6
260
1,480
440
20
33
5,587
51
1,000
50
300
970
9,715
108
6
460
100
176
146
36
510
141
16,124
6,455
6
1,273
88
14
1,299
100
288
814
2
50
8,558
6,300.00
108,504.00
274,904.00
170,640.00
8,300.00
24,790.00
509,240.00
323,900.00
24,000.00
98,800.00
76,960.00
108,680.00
31,260.00
52,800.00
134,088.00
201,960.00
76,000.00
56,850.00
65,100.00
176,540.00
2,137,300.00
324,000.00
29,400.00
59,340.00
60,000.00
251,680.00
244,550.00
69,120.00
51,000.00
324,300.00
1,693,020.00
116,190.00
43,116.00
80,199.00
28,160.00
72,800.00
109,116.00
123,000.00
411,840.00
844,118.00
41,614.00
30,800.00
325,204.00
19.00
2,447.00
4,646.00
604.00
100.00
80.00
175.00
108.00
990.00
540.00
1.00
54.00
1,180.00
140.00
53.00
39.00
3,165.00
1,000.00
54.00
50.00
772.00
33.00
9.00
75.00
130.00
850.00
60.00
2.00
185.00
100.00
55.00
47.00
54.00
26.00
40.00
255.00
108.00
2,515.00
70.00
1,390.00
2.00
900.00
87.00
10.00
4.00
320.00
34.00
37.00
8.00
114.00
2.00
11.00
85.00
3,028.00
8,550.00
176,184.00
130,088.00
144,960.00
6,100.00
6,640.00
6,475.00
321,840.00
114,840.00
110,700.00
4,000.00
20,520.00
61,360.00
34,580.00
82,839.00
62,400.00
75,960.00
122,000.00
213,840.00
3,800.00
127,380.00
37,521.00
1,953.00
13,650.00
15,730.00
187,000.00
180,000.00
9,800.00
23,865.00
60,000.00
20,350.00
67,210.00
90,450.00
49,920.00
52,000.00
25,500.00
248,400.00
264,075.00
5,670.00
25,020.00
14,372.00
56,700.00
27,840.00
2,200.00
20,800.00
26,880.00
41,820.00
52,910.00
420,000.00
118,218.00
41,614.00
37,906.00
52,360.00
115,064.00
450
72
28
240
61
83
37
2,980
116
205
4,000
380
52
247
1,563
1,600
24
122
3,960
76
165
1,137
217
182
121
220
3,000
4,900
129
600
370
1,430
1,675
1,920
1,300
100
2,300
105
81
18
7,186
63
320
220
5,200
84
1,230
1,430
52,500
1,037
20,807
3,446
616
38
100
7,000
17,000
2,000
300
500
2,000
200
15,000
2,000
5
1,300
7,000
300
100
200
25,000
3,000
500
13,600
270
12,000
200
2,000
200
80
500
300
500
720
200
50
2,000
1,020
24,400
4,000
3,000
13
7,000
1,350
2,200
5,000
264
50
1,500
300
300
27,400
450
72
28
240
61.00
83
37
2,980
116
150
4,000
380
52
247
1,563
1,600
24
122
3,960
76
165
1,137
217
182
121
120.00
3,000
4,900
110
600
370
1,430
1,675
1,920
1,300
100
1,438.00
108
81
18
7,186.00
63
320
220.00
5,200
84
1,230
1,430
52,500
1,037.00
25,630
3,446
616
34.00
45,000
504,000
476,000
480,000
18,300
41,500
74,000
596,000
1,740,000
300,000
20,000
494,000
364,000
74,100
156,300
320,000
600,000
366,000
1,980,000
2,244,000
306,990
2,184,000
24,200
240,000
600,000
392,000
55,000
180,000
185,000
1,029,600
335,000
96,000
200,000
1,466,760
2,635,200
324,000
54,000
93,418
441,000
432,000
484,000
420,000
377,520
2,625,000
1,555,500
1,033,800
184,800
931,600
55
8,762
25,784
3,315
100
205
1,845
288
11,440
4,120
10
780
3,910
380
173
198
29,567
1,198
405
295
7,554
320
59
11,836
270
12,170
295
68
945
500
455
659
256
78
40
1,595
979
36,269
4,070
7,740
17
6,998
1,525
2,210
9
5,129
108
589
58
1,888
4
311
435
24,906
24,750
630,864
721,952
795,600
6,100
17,015
68,265
858,240
1,327,040
734,600
40,000
296,400
203,320
93,860
270,399
316,800
709,608
146,156
1,603,800
22,420
1,246,410
363,840
12,803
2,154,152
32,670
2,516,900
885,000
333,200
116,205
300,000
168,350
942,370
428,800
149,760
52,000
159,500
1,622,440
3,861,135
329,670
139,320
122,162
440,874
488,000
486,200
46,800
430,836
132,840
842,270
3,045,000
1,957,856
83,228
1,071,706
267,960
893,148
78
2,192
5,680
300
475
1,000
20
8,940
2
834
5,750
500
74
4,185
2,802
200
755
6,818
33
250
1,209
60
395
73
20
200
100
284
144
34
1,170
290
6,770
3,105
4
2,175
9
1,490
26
540
14,080
247
252
253
256
1
4
11
17
28
31
32
35
38

Zinc 20 mg
Tab
Tab
Vial
Tab
42
23
6,750
475
Amitriptilin 25 mg.
Tab
Asam Folat
Tab
Btl
Loperamid 2 mg
Tab
Paracetamol (Dumin) 125 mg/2,5 ml RectTube
Piracetam 1200 mg
Tab
Piracetam Inj.
Amp
Simvastatin 10 mg
Tab
Valsartan 80 mg
Tab
190
11,730
18
105
44
6,235
114
100
1,900
80
7,980.00
269,790.00
121,500.00
10,500.00
83,600.00
9,120.00
11,740
776
5,000
242
13,980
10
5
28
117,400.00
25,000.00
391,440.00
70.00
5,020.00
2.00
355.00
1
140
20
5
8
20
450
3
80
2,940.00
115,460.00
13,500.00
168,625.00
2,100.00
19,800.00
18,705.00
9,120.00
11,740.00
108,640.00
100,000.00
1,210.00
111,840.00
42
23
6,750
475
400
23,000
25
3,000
108
300
15
500
310
28
42
23
6,750
475
105
44
6,235
114
11,740
776
5,000
169
13,980
16,800
529,000
168,750
1,425,000
673,380
34,200
176,100
388,000
52,390
391,440
660
35,685
45
2,310
120
2,320
111
260
26
640
25
315
64

522,817
dr Ni Luh Sustemy
Nip.197205042007012023
125.00
114.00
72.00
32.00
2,002.00
135.00
61.00
120.00
1,438.00
7,186.00
121.00
220.00
512.85
1,037.00
34.00
Made Sastramika
Nip.197506222007011017
27,720
820,755
303,750
1,097,250
12,600
102,080
692,085
29,640
305,240
496,640
125,000
53,600
894,720
4,065
1,045
30
200
-
31 Desember 2014
KET
JML HARGA (RP)
12
405,000
473,200
2,500
3,729,545
999,000
823,970
223,300
248,400
294,489
60,000
214,875
222,400
88,000
925,471
67,176
226,000
122,850
890,100
169,043
11,500
260,565
27,125
516,480
76,000
79,189
26,577
260,400
60,590
260,064
75,675
254,694
47,369
737,200
13
135
845
20
0
12905
270
5530
58
3450
117
30
125
6950
500
0
13813
36
10
1365
6450
19
0
100
0
0
0
2995
70
0
538
0
500
313
3
0
280
830
4644
75
374
469
1940
0
500
0
0
1440
0
0
100
6000
0
30
0
0
900
0
0
50
0
0
0
0
0
0
0
0
100
0
200
500
300
0
0
0
0
0
200
0
0
50
200
0
0
50
50
300
2000
6000
100
200
500
18000
200
4000
200
7200
300
100
1000
2000
500
3000
500
150
100
100
5000
1000
12000
200
12000
200
3600
100
50
50
100
50
3000
1000
2000
200
50
50
5000
2000
1000
2000
1000
200
200
50
1000
300
500
184
10
2000
5000
500
1000
5000
500
500
84
300
100
10
1000
5000
24
500
5000
500
500
168
100
100
300
200
10000
200
500
200
500
12
100
200
5000
200
200
150
500
300
150
300
300
12
300
200
500
5000
300
500
2400
500
2000
6
100
1000
5000
500
5000
50
200
300
1200
200
3300
7000
1000
49440
950
7600
600
13200
650
180
150
13000
9900
200
200
200
20
4000
20000
24
2600
2500
436
0
200
15000
1200
500
1200
1000
500
1300
30
0
800
2000
15000
100
400
1300
5600
35,100
157,824
159,040
18,300
39,425
37,000
59,600
1,037,040
8,000
316,920
299,000
123,500
118,400
100,440
341,844
792,000
57,380
1,124,970
37,521
54,250
220,038
7,260
47,400
219,000
98,000
22,000
37,000
406,120
241,200
65,280
117,000
417,020
731,160
55,890
28,744
137,025
46,800
125,160
31,980
559,980
478,720
78
2192
5680
0
300
475
1000
20
8940
0
2
834
5750
500
0
74
4185
2802
200
755
6818
33
250
1209
60
395
73
20
200
0
100
284
144
34
0
1170
290
6770
0
3105
4
2175
0
0
9
1490
26
0
0
540
0
0
0
14080
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
100
0
2000
90
0
1000
100
0
0
20
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
10
0
0
200
0
0
50
2000
500
100
50
1000
10000
1000
200
200
2000
100
5000
1000
1000
2000
2000
5000
500
300
50
50
10000
2000
5
300
5000
300
50
10000
1000
1000
2000
50
50
10000
2000
100
2000
2000
60
2000
2000
100
100
20
50
1000
50
5000
50
100
200
2000
30
5600
90
3000
3000
500
500
1000
50
40
500
300
100
120
200
100
120
120
100
360
200
50
100
14400
2000
2000
400
2000
3000
2
300
200
1000
1000
1000
264
10
500
5000
100
100
5000
420
10000
2
1000
3
2000
200
500
10
500
3
1000
1000
3000
150
200
1000
1000
10
500
10
3000
14400
200
100
7000
17000
2000
300
500
2000
200
15000
2000
5
1300
7000
300
100
200
25000
3000
500
0
13600
270
0
12000
200
2000
200
80
500
300
500
720
200
50
0
2000
1020
24400
4000
3000
13
7000
1350
2200
0
4000
0
264
50
1500
0
300
300
27400
93,495
496,375
1,320
22,800
-
0
4065
0
1045
0
30
0
200
0
0
0
0
0
200
0
0
1000
200
10000
100
30
10000
25
1000
5
100
10
200
60
28
3000
1000
48
50
200
5
200
60
60
100
400
23000
25
3000
0
0
108
300
15
500
0
310
28
Laporan Pemakaian dan Lembar Permin

Puskesmas
Puskesmas :
Kecamatan :
Pelaporan Bulan/Periode
Kab./Kodya :
Permintaan Bulan/Periode
No.
Nama Obat
Satuan
Abbocat set Anak
Buah
Abbocat set Dewasa
Buah
Tab
Acyclovir 5 % Cream
Tube
Btl
Bj
Bj
Bj
Tab
10 Alopurinol tablet 100 mg
Tab
11 Ambroxol 30 mg
Tab
12 Aminofilin injeksi 24 mg/ml-10ml
Amp
13 Aminofilin tablet 200 mg
Tab
14 Amoksisilin kapsul 250 mg
Kap
15 Amoksisilin kapsul 500 mg
Kap
16 Amoksisilin sirup kering 125 mg/5 ml
Btl
17 Ampisilin kapsul 250 mg
Kap
18 Ampisilin kapsul 500 mg
Kap
19 Ampisilin sirup kering 125mg/5 ml
Btl
20 Antalgin (Metampiron) injeksi 250 mg/ml-2ml
Amp
21 Antalgin (Metampiron) tablet 500 mg
Tab
22 Antasida DOEN suspensi btl. 60 ml
Btl
23 Antasida DOEN tablet 500 mg
Tab
24 Anti Bakteri DOEN Salep kombinasi
Pot
25 Anti Hemoroid DOEN kombinasi supp
Supp
26 Antifungi DOEN kombinasi (White Field Salep)
Pot
27 Anusol supp.
Supp
28 Aqua pro injeksi steril bebas pirogen
Vial
29 Artemeter Inj.
Amp
Stok
Awal
4
Penerimaan
Persediaan
6 (4 + 5)
30 Artesdiaquine
Tab
31 Artesunate Inj
Vial
32 Asam Askorbat (Vit. C) tablet 50 mg
Tab
33 Asam mefenamat 250 mg
Tab
34 Asam Mefenamat 500 mg
Tab
35 Asetosal tablet 100 mg
Tab
36 Asetosal tablet 500 mg
Tab
37 Atrofin Sulfat Injeksi 0,25 mg/ml-1 ml
Amp
38 Azithromycin/Zistic 500
Kap
39 Benzatin Benzil Penicillin Injeksi 1,2 juta iu/vial
Vial
40 Benzatin Benzil Penicillin Injeksi 2,4 juta iu/vial
Vial
41 Besi (II) Sulfat (Tambah darah) tablet
Tab
42 Betametason krim 0,1 %
Tube
43 Bioplacenton Jelly
Tube
44 Bromhexin 8 mg
Tab
45 Buscopan injeksi
Amp
46 Captopril 12,5 mg
Tab
47 Captopril 25 mg
Tab
48 Catgut/Benang Bedah No.2/0-3/0 + Jarum
Bj
49 Cefadroxil 500 mg
Kap
50 Cimetidine 200 mg tablet
Tab
51 Ciprofloxacin 500 mg kaptab
Tab
52 Clobazam (Frisium) 10 mg tablet
Tab
53 Dekstrometorfan Sirup 10mg/5ml
Btl
54 Dekstrometorfan Tablet 15 mg
Tab
55 Devitalisasi Pasta (Non Arsen)
Pot
56 Dexametason Injeksi Amp
Amp
57 Dexametason tablet 0,5 mg
Tab
58 Diapet kapsul
Kap
59 Diatab kapsul
Kap
60 Diazepam injeksi 5 mg/ml-2ml
Amp
61 Diazepam tablet 2 mg
Tab
62 Diazepam tablet 5 mg
Tab
63 Difenhidramin HCL injeksi 10 mg/ml-1ml
Amp
64 Digoksin tablet 0,25 mg
Tab
65 Diklofenak Kalium/Potasium 25 mg tablet
Tab
66 Diklofenak Kalium/Potasium 50 mg tablet
Tab
67 Diklofenak Natrium/Sodium 25 mg tablet
Tab
68 Diklofenak Natrium/Sodium 50 mg tablet
Tab
69 Diltiazem tablet
Tab
70 Doxyciclin 100 mg tablet
Tab
71 Dulcolax supp. Anak
Supp
72 Dulcolax supp. Dewasa
Supp
73 Duradryl injeksi
Vial
74 Efedrin HCL tablet 25 mg
Tab
75 Ekstrak Belladona tablet 10 mg
Tab
76 Epinefrina/Adrenalin HCL/Bitatrat inj.
Amp
77 Ergotamin Tartat/Antimigren DOEN Komb.
Tab
78 Erythromicin 250 mg
Kap
79 Erythromicin 500 mg
Kap
80 Erythromicin sirup
Btl
81 Etakridin (Rivanol) larutan 0,1%
Btl
82 Etanol 70 %
Btl
83 Ethambutol HCL tablet 250 mg
Tab
84 Etil Klorida semprot
Btl
85 Eugenol cairan
Btl
86 Fenitoin Natrium kapsul 100 mg
Kap
87 Fenitoin Natrium Kapsul 30 mg
Kap
88 Fenobarbital injeksi 50 mg/ml-2ml
Amp
89 Fenobarbital tablet 100 mg
Tab
90 Fenobarbital tablet 30 mg
Tab
91 Fenoksimetil Penisilin tablet 250 mg
Tab
92 Fenoksimetil Penisilin tablet 500 mg
Tab
93 Fenol Gliserol tetes telinga 10%
Btl
94 Fitomenadion (Vit. K1) inj. 10 mg/ml-1ml
Amp
95 Fitomenadion (Vit. K1) tab. salut gula 10 mg
Tab
96 Fluor tablet 0,5 mg
Tab
97 Furosemida tablet 40 mg
Tab
98 Gameksan emulsi 1%
Btl
99 Garam Oralit untuk 200 ml air
Sak
100 Gentamisin Sulfat 0,3% Tetes Mata
Btl
101 Gentian Violet larutan 1%
Btl
102 Glass Ionomer Cement (GC IX)
Set
103 Glibenklamid Tablet 5 mg
Tab
104 Gliseril Guaiakolat tablet 100 mg
Tab
105 Glukosa larutan infus 5% steril 500 ml
Btl
106 Griseofulvin tablet 125 mg
Tab
107 H2O2/Hidrogen Peroksida (Perhidrol) 3%
Btl
108 Haloperidol 0,5 mg tablet
Tab
109 Haloperidol 1,5 mg tablet
Tab
110 Haloperidol 5 mg tablet
Tab
111 Hidroklorotiazid (HCT) tablet 25 mg
Tab
112 Hidrokortison krim 2,5%
Tube
113 Ibuprofen tablet 200 mg
Tab
114 Ibuprofen tablet 400 mg
Tab
115 Infusion Set anak
Set
116 Infusion Set dewasa
Set
117 Iodiol kapsul lunak
Kap
118 Isoniazid tablet (INH) 100 mg
Tab
119 Isoniazid tablet (INH) 300 mg
Tab
120 Isosorbid Dinitrat (ISDN) tab. sublingual 5 mg
Tab
121 Jarum Disposible 23 G
Bj
122 Jarum Jahit (bedah) No. 9 s/d 14
Pack
123 Kaca Sediaan
Pcs
124 Kalsium Hidroksida Pasta/Cement
Btl
125 Kalsium Laktat (Kalk) tablet 500 mg
Tab
126 Kapas Pembalut/Absorben 250 g
Bks
127 Karbamazepin tablet 200 mg
Tab
128 Kasa Kompres 40/40 steril
Bks
129 Kasa Pembalut 2 m x 80 cm
Roll
130 Kasa Pembalut Hidrofil 4 x 15 cm
Roll
131 Kasa Pembalut Hidrofil 4 x 3 cm
Roll
132 Ketokonazol 2 % Krim.
Tube
133 Ketokonazol 200 mg tab.
Tab
134 Kloramfenikol kapsul 250 mg
Kap
135 Kloramfenikol salep mata 1%
Tube
136 Kloramfenikol tetes mata
Btl
137 Kloramfenikol tetes telinga 3 %
Btl
138 Klorfeniramin Maleat (CTM) tablet 4 mg
Tab
139 Klorokuin tablet 250 mg
Tab
140 Klorpromazin HCL injeksi 25 mg/ml-1ml
Amp
141 Klorpromazin HCL injeksi 5 mg/ml-2ml
Amp
142 Klorpromazin HCL tablet salut 100 mg
Tab
143 Klorpromazin HCL tablet salut 25 mg
Tab
144 Kotrimoksazol suspensi 240 mg/5ml
Btl
145 Kotrimoksazol tablet Pedriatik 120 mg
Tab
146 Kotrimoksazol tablet, 480 mg
Tab
147 Kuinina (Kina) tablet 222 mg
Tab
148 Kuinina Dihidroklorida Injeksi 25%-2ml
Amp
149 Larutan Asam Alkohol
Btl
150 Larutan Asam Klorida 0,1 N
Btl
151 Larutan Asam Sulfosalisilat 20% reagen
Btl
152 Larutan Benedict
Btl
153 Larutan Eosin 2%
Btl
154 Larutan Eter Alkohol
Btl
155 Larutan Gabbet
Btl
156 Larutan Giemsa Stain
Btl
157 Larutan Karbol Puksin
Btl
158 Larutan Metanol
Btl
159 Larutan Methylen Blue
Btl
160 Larutan Turk
Btl
161 Levertran Zalf 15 g
Pot
162 Lidokain Komb.inj.; Lidokain HCL 2% + Epinefrin
Amp
163 Livron B plex tablet
Tab
164 Lizol mengandung Kresol tersabun 50 %
Btl
165 Mebendazol tablet 100 mg
Tab
166 Metformin 500
Tab
167 Metilergometrin Maleat inj. 0,200 mg 1ml
Amp
168 Metilergometrin Maleat tablet salut 0,125 mg
Tab
169 Metronidazol tablet 250 mg
Tab
170 Metronidazol tablet 500 mg
Tab
171 Miconazole 2% Cream
Tube
172 Monoklorkamfer Mentol cairan (CHKM)
Btl
173 Mummifying Pasta/Iodoform Pasta
Btl
174 Natrium Bikarbonat tablet 500 mg
Tab
175 Natrium Klorida (NaCl) infus 0,9%
Btl
176 Natrium Tiosulfat injeksi 25%-10ml
Vial
177 Neurotropin/Neuroboran Injeksi
Vial
178 Nifedipin 10 mg tablet
Tab
179 Nistatin tablet salut 500.000 iu
Tab
180 Nistatin tablet Vaginal 100.000 iu/g
Tab
181 Obat Antituberkulosis FDC Katagori 1 & 3 Paket
Paket
182 Obat Antituberkulosis FDC Katagori 2 Paket
Paket
183 Obat Antituberkulosis Kategori Anak Paket
Paket
184 Obat Antituberkulosis Kategori Sisipan Paket
Paket
185 Obat Batuk Hitam (OBH) sirup
Btl
186 Obat Kusta MB & PB Treatment/MDT Anak
Paket
187 Obat Kusta MB & PB Treatment/MDT Dewasa
Paket
188 Ofloxacin 400 mg
Tab
189 Oksigen gas dalam tabung (Oxycan)
Tabung
190 Oksitetrasiklin HCL injeksi i.m 50 mg/ml 10 ml
Vial
191 Oksitetrasiklin HCL salep kulit 3%
Tube
192 Oksitetresiklin HCL salep mata 1%
Tube
193 Oksitosin injeksi 10iu/ml-1ml
Amp
194 Oseltamivir 75 mg
Tab
195 Papaverin Injeksi
Amp
196 Papaverin tablet 40 mg
Tab
197 Paraformaldehida tablet 1 gam
Tab
198 Parasetamol Sirup 120 mg/5 ml
Btl
199 Parasetamol tablet 100 mg
Tab
200 Parasetamol tablet 500 mg
Tab
201 Phenylbutason 200
tab
202 Piridoksin HCL (Vit. B6) Tablet 10 mg
Tab
203 Piroxicam 10 mg
Kap
204 Piroxicam 20 mg
Kap
205 Plester 5 Yard x 2 Inch
Roll
206 Polikresulen (Albothyl) 10 ml
Btl
207 Pot Dahak
Pot
208 Prazikuantel tablet 600 mg
Tab
209 Prednison tablet 5 mg
Tab
210 Primaquin tablet 15 mg
Tab
211 Procain Benzil Penisilin injeksi 3 juta iu/vial
Vial
212 Propanolol 10 mg tablet
Tab
213 Propanolol 40 mg tablet
Tab
214 Propil Tiourasil (PTU) 100 mg tablet
Tab
215 Pyrantel Pamoat 125 mg tablet
Tab
216 Ranitidin (Radin) 150 mg tablet
Tab
217 Reserpin Tablet 0,10 mg
Tab
218 Reserpin Tablet 0,25 mg
Tab
219 Retinol (Vit.A ) kapsul 100.000 iu
Kap
220 Retinol (Vit.A ) kapsul 200.000 iu
Kap
221 Rifampisin Kapsul 300 mg
Kap
Kap
Kap
224 Ringer Laktat larutan Infus Steril
Btl
225 Salbutamol tablet 2 mg
Tab
226 Salbutamol tablet 4 mg
Tab
227 Salep 2-4, Komb; As. Salisilat 2% + Sulfur 4%
Pot
228 Salisil Bedak 2 %
Pot
229 Salisil Spiritus 10 %
Btl
230 Sarung Tangan Karet (Hand Scund)
Pcs
231 Semen Zeng Fosfat serbuk dan cairan
Btl
232 Serum Anti bisa Ular Polivalen Injeksi 5 ml
Vial
233 Serum Anti Tetanus (ATS) injeksi 1.500 iu/amp
Amp
234 Sianokobalamin (Vit. B12) inj. 500 mcg/ml-1ml
Amp
235 Silk (Benang Bedah Sutera )
Sak
236 Silver Amalgam Serbuk
Btl
237 Stesolid Rectal Anak (Diazepam 5 mg/2,5 ml)
Tube
238 Stesolid Rectal Dewasa (Diazepam 10 mg/2,5 ml)
Tube
239 Streptomisin Sulfat serbuk injeksi 1.000 mg/vial
Vial
240 Streptomisin Sulfat serbuk injeksi 1.500 mg/vial
Vial
241 Sulfasetamida Natrium tetes mata 15%-5ml
Btl
242 Systabon injeksi
Amp
243 Tablet Tambah Darah Kombinasi
Tab
244 Temporary Stopping (Fletcher) Serbuk dan Cairan
Set
245 Tetrasiklin HCL kapsul 250 mg
Kap
246 Tetrasiklin HCL Kapsul 500 mg
Kap
247 Thiamphenicol 250 mg kapsul
Kap
248 Thiamphenicol 500 mg kapsul
Kap
249 Tiamin HCL/Monotatrat (Vit. B1) Tablet 50 mg
Tab
250 Triheksilfenidil (THP) Hidroklorida tablet 2 mg
Tab
251 Trikresol Formalin (TKF) Cairan
Btl
252 Valium/Diazepam inj. 10mg/ml
Amp
253 Ventolin Inhaler
Btl
254 Ventolin Nebolizer
Btl
255 Vitamin B Complex tablet
Tab
256 Xylomidon Injeksi vial
Vial
257 Yodium Povidon larutan 10% 30 ml
Btl
258 Yodium Povidon larutan 10% 300 ml
Btl
259 Zinc 20 mg
Tab
Obat diluar LPLPO
1 Amitriptilin 25 mg.
Tab
2 Amlodipin
Tab
3 Asam Asetil Salisilat (Aspilet) 80 mg.
Tab
4 Asam Folat
Tab
5 Asam Traneksamat Tab.
Tab
6 Asam Traneksamat Inj.
Amp
7 Betahistine Mesilat
Tab
8 Bisoprolol 5 mg.
Tab
9 Borax Gliserin
Btl
10 Desoksimetason + Neomicin Cream
Tube
11 Domperidon Syr 60 ml
Btl
12 Ketoprofen 100 mg
Tab
13 Ketoprofen 100 mg (Profenid) Suppo.
Supo
14 Ketorolac 10 mg/ml Inj.
Amp
15 Lanzoprazol
Tab
16 Lisinopril 10 mg
Tab
17 Loperamid 2 mg
Tab
18 Loratadin 10 mg
Tab
19 MgSO4 20% Inj.
Vial
20 MgSO4 40% Inj.
Vial
21 Meloxicam 15 mg
Tab
22 Metil Prednisolon 4 mg
Tab
23 Metoclopramid 10 mg
Tab
24 Metoclopramid Inj.
Amp
25 Nistatin Drop
Btl
26 Omeprazol 20 mg.
Tab
27 Ondansetron 4 mg/ml Inj
Amp
28 Paracetamol (Dumin) 125 mg/2,5 ml Rectal
Tube
29 Paracetamol (Dumin) 250 mg/4 ml Rectal
Tube
30 Permetrin 5% Salep
Tube
31 Piracetam 1200 mg
Tab
32 Piracetam Inj.
Amp
33 Placenta + Neomycin Cream
Tube
34 Ranitidin Inj.
Amp
35 Simvastatin 10 mg
Tab
36 Spironolacton 100 mg.
Tab
37 Tramadol 50 mg
Tab
38 Valsartan 80 mg
Tab
39 Vit. K Infant Inj.
Amp
Bahan Habis Pakai

1 Catgut Chromic Rol 100 m
Rol
2 Catgut Plain Rol 100 m
Rol
3 Folly Kateter
Pcs
4 Kapas Lidi Steril
Bks
5 Kassa Gulung 40 Y x 80 cm
Rol
6 Kassa Hidropil 16 x 16
Pcs
7 Kertas Puyer
Bks
8 Klorin 5,25 %
Btl
9 KY Jely USG
Btl
10 Masker
Pcs
11 Masker N 95
Pcs
12 Muchus Suction (Penghisap Lendir)
Pcs
13 Pisau Bedah
Pcs
14 Plastik Klip
Bks
15 Pot Salep 20 Gr
Pcs
16 Sabun Anti Bakteri
Btl
17 Sarung Tangan Obgyn
Pasang
18 Sarung Tangan Steril No. 7
Pasang
19 Silk (Benang Sutra) Rol 100 m
Rol
20 Tissue
Box
21 Umbilical Cord Clamp
Pcs
22 Underpad
Pcs
23 Urobag
Pcs
24 Wing Nedle 19 G
Buah
25 Wing Nedle 23 G
Buah
26 Wing Nedle 25 G
Buah
Bahan Laboratorium
1 Aseptik gel
botol
2 Cuka dixi
botol
3 Gliserin
botol
4 Larutan KOH 1%
botol
5 Cito brush (pembersih tabung)
buah
6 Metilin blue
botol
7 PH paper 3,8 - 5,4
roll
8 Cover glass
set
9 Torniquet
buah
10 Reagensia ABX 60 atphalyse
liter
11 Reagensia ABX 60 cleaner
liter
12 Reagensia ABX 60 minilidi
liter
13 Jarum vanoject/Vacuntainer
pcs
14 Safety box
buah
15 Tabung criyo 15 ml
tube
16 Tabung vacuntainer EDTA
pcs
17 Tabung vancuntainer 5 cc
pcs
18 Holder
buah
19 Yelow tip isi 1000 pcs
pcs
Jumlah Kunjungan Resep
Umum
Askes
JKBM
Mengetahui/Menyetujui
Yang Menyerahkan
Ka. Dinas Kesehatan Kab. Buleleng
Petugas Depo Farmasi
(
NIP.
(
NIP.
Form.: LPLPO Puskesmas
n dan Lembar Permintaan Obat

Puskesmas
Dokumen
Depo Farm
Puskesmas
Pemakaian
7
Sisa
Stok
Stok
Optimum
8 (6 - 7)
9 ((7x3)-8)
Permintaan
10
Nomor
Tanggal
Pemberian
APBD
Lain-lain
Jumlah
11
12
13 (11 + 12)
Ket.
14
Jamkesmas
UKS
Lain-lain
Jumlah
Yang Meminta
Yang Menerima
Ka. Puskesmas:
Petugas Puskesmas
(
NIP.
(
NIP.

ATK ,CETAK , ALAT RUMAH TANGGA DAN QUASI
REKAP
PUSKESMAS BULELENG II
NO
KOD
UR
E
UT
URAIAN (NAMA BARANG)
SATUA
N
(BUAH,
LUSIN,
SET,
UNIT)

Harga
Satuan
/Nominal
Harga
Satuan
Cetak
JML
BARANG
JUMLAH
SALDO HARGA (RP)
AWAL
8. Pusk Buleleng II
Barang Kuasi
* Perda
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
0001
0002
0003
0004
0005
0006
0007
0008
0009
0010
0011
0012
0013
0014
0015
- K.Rawat jalan
Lembar
-K.Rawat Inap
Lembar
-K.T.Medik Operatif Kecil
Lembar
-K.T.Medik Operatif Sedang
Lembar
-K.Persalinan di Puskesmas Lembar
-K.Tindakan Medik Gigi Kecil Lembar
-K.Tindakan. Medik Gigi Sedan Lembar
-K.Pemeriksaan Lab Sederhan Lembar
-K.Pemeriksaan Lab Sedang Lembar
-K.Ultra Sono Grafi
Lembar
-K.Surat Ket Sehat SIM / Seko Lembar
-K.Sehat Pekerjaan
Lembar
-K.Kes.Asuransi
Lembar
-K.Surat Ket Kes Luar Negeri Lembar
-K.karcis Visum
Lembar
JUMLAH
10,000
37,000
30,000
42,000
225,000
18,000
30,000
5,000
14,000
40,000
3,500
7,500
62.15
62.15
62.15
62.15
62.15
62.15
62.15
62.15
62.15
62.15
62.15
62.15
2,056
240
500
359
196
42
145
3,538
Barang Kuasi
* Pergub /JKBM
1 0001 -K.Pemeriksaan dan
Pengobatan oleh Dokter
Umum
2 0002 -K.Tindakan Medik Kecil
Rawat Jalan
3 0003 -K.Biaya Penunjang
Diagnostik Sederhana
4 0004 -K.Tindakan Medik Kecil
Rawat Inap
5 0005 -K.Biaya Tindakan Medik
Kecil
6 0006 -K.Biaya Tindakan Medik
Kecil Rawat Gigi
7 0007 -K.Pemeriksaan dan
Pengobatan Dokter Gigi
JML
BARANG
SALDO
AWAL
BERTAMBAH
JML BARANG
127,780.40
14,916.00
31,075.00
22,311.85
12,181.40
2,610.30
9,011.75
219,886.70
-
2,056
240
500
356
196
42
145
3,535
Lembar
Lembar
Lembar
Lembar
Lembar
62.15
2,074
128,899.10
25,000.00
62.15
10,000.00
62.15
25,000.00
62.15
25,000.00
62.15
741
46,053.15
741.00
25,000.00
62.15
2,476
153,883.40
2,476.00
25,000.00
62.15
240
14,916.00
240.00
JML HARGA
(RP)
JML
BARANG
JML HARGA
(RP)
JML
JML
BARANG
BARANG Seharusn
ya
Nilai Perolehan KE
Seharusnya
T
1,000
300
300
1,600
10,000
10,000.00
BERKURANG
Lembar
Lembar
KEADAAN PER 31
Desember 2014
62,150.00
18,645.00
18,645.00
99,440.00
621,500.00
352
80
151
583
11,699
21,876.80
4,972.00
9,384.65
36,233.45
727,092.85
2,704
240
500
356
196
262
294
4,552
375
168,053.60
14,916.00
31,075.00
22,125.40
12,181.40
16,283.30
18,272.10
282,906.80
23,306.25
SA+PENBBER
2,704
240
500
356
196
262
294
4,552
375
2,074.00
-
1,000
62,150.00
1,557
96,767.55
184
11,435.60
184
1,000
62,150.00
1,432
88,998.80
2,044
127,034.60
2,044
1,100
68,365.00
1,260
78,309.00
80
4,972.00
80
240
4,552
8 0008 -K.Biaya Perawatan dan

Akomodasi Rawa Inap
9 0009
-K.Biaya Visite Dokter Umum
Lembar
Lembar
75,000.00
62.15
10,000.00
62.15
JUMLAH
TOTAL
Kepala Puskesmas Buleleng II
dr Ni Luh Sustemy
Nip.197205042007012023
5,531
343,751.65
5,531
13,100
814,165.00
15,948
991,168.20
2,683
166,748.45
9,069
563,638.35
9,066
14,700
913,605.00
16,531
1,027,401.65
7,235
449,655.25

Made Sastramika
Nip.197506222007011017
2,683
SELISIH
TOTAL PERDA
DAN PERGUB
PUSKESMAS
7,235

ATK ,CETAK , ALAT RUMAH TANGGA DAN QUASI
REKAP
PUSKESMAS BULELENG II
NO
KOD
UR
E
UT
1
8
URAIAN (NAMA BARANG)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Kartu surat Masuk

Kartu Surat Masuk
Kartu Surat Masuk
Kartu surat Keluar
Kartu Surat keluar
Kartu Surat keluar
Lembar Disposisi
Lembar Disposisi
Lembar Disposisi
Formulir Lembar Pengantar Surat
Formulir Lembar Pengantar
Formulir Lembar Pengantar
Register Rawat Jalan Warna Hijau
jilid
Register Rawat Jalan
Register Rawat Jalan
Rujukan Askes
Rujukan Askes
Rujukan Askes

SATUAN
(BUAH,L
USIN,
JML
SET,
BARANG
JUMLAH
Harga Satuan
UNIT)
SALDO
HARGA (RP) Selisih
AWAL
Br
4
22,727.00
4.00
90,908.00
Buku
22,727.00
Buku
22,720.00
24,545.00
4.00
98,180.00
Buku
24,545.00
Buku
24,540.00
41,818.00
1.00
41,818.00
Buku
41,818.00
Buku
41,800.00
52,727.00
1.00
52,727.00
Buku
52,727.00
Buku
52,700.00
64,545.00
Selisih
Uang
Harga Satuan
/Harga
Perolehan
64,545.00
65,000.00
25,000.00
Buku
Buku
25,000.00
24,900.00
2,000.00
2,000.00
25,000.00
1.00
25,000.00
22,727
2
4
24,545
2
4
41,818
2
3
52,727
2
6
64,545
25,000
2,000
25,000
1,000
Lembar
Lembar
Rajal Warna Merah

Kartu Rawat Jalan Warna Merah
Kartu Rawat Jalan Warna Merah
1,000.00
990.00
1,000.00
1,000
Lembar
Lembar
1,000.00
990.00
1,000.00
1,000.00
990.00
91.00
1,000
91
91.00
90.00
4
14
406
2
6
Rajal Warna Kuning

Kartu Rawat Jalan Warna Kuning
Kartu Rawat Jalan Warna Kuning
Lembar
Lembar
JML HARGA (RP)
BERKURANG
JML
BARANG
25,000.00
24,900.00
1,000.00
Lembar
Lembar
JML
BARANG
Buku
Buku
Rajal Warna Putih

Kartu Rawat Jalan Warna Putih
Kartu Rawat Jalan Warna Putih
Kartu Indek Pasien
Kartu Indek Pasien
Kartu Indek Pasien
BERTAMABAH
1
4
Buku
Buku
Family Folder
Family Folder
SBBK
Buku SBBK
Buku SBBK
KEADAAN PER 31 Desember

2014
108
412
108
412
108
412
32
120
45,454
90,880
49,090
98,160
83,636
125,400
105,454
316,200
64,545
260,000
100,000
348,600
812,000
50,000
149,400
108,000
407,880
108,000
407,880
108,000
407,880
2,912
10,800
JML HARGA (RP)
JML
BARANG
JML HARGA (RP)
Seharusny
a
10
4
2
4
4
2
4
1
2
3
1
2
6
90,908
45,454
90,880
98,180
49,090
98,160
41,818
83,636
125,400
52,727
105,454
316,200
64,545
260,000
100,000
348,600
812,000
25,000
50,000
149,400
108,000
407,880
108,000
407,880
108,000
407,880
2,912
10,800
1
4
4
14
406
1
2
6
108
412
108
412
108
412
32
120
11
KE
T
13
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
BukuPengeluaran Barang
Buku Pengeluaran barang
Buku Pengeluaran barang
Buku
Buku
BukuPenerimaan Barang
Buku Penerimaan barang
Buku Penerimaan barang
25,000.00
24,900.00
25,000.00
Buku
Buku
25,000.00
24,900.00
25,000.00
Buku
12,499.00
12,500.00
227.00
Lembar
Lembar
227.00
225.00
227.00
227.00
225.00
60,000.00
Resep 1/3
Resep Obat
Resep Obat
Belangko Keterangan Sehat
Belangko Keterangan Sakit
Register Pasien
Register Pasien
Regiter Obat
Cetak register obat
Rujulkan Jamkesmas
Rujukan Jamkesmas
Rujukan Jamkesmas
Rujukan Umum
Rujukan Umum
Rujukan Umum
25,000.00
Lembar
Lembar
Buku Barang Inventaris

Cetak buku blanko rawat inap
Belangko Rawat Inap
Reka Consent
Inform consent
Jumlah
125,000.00
5.00
125,000.00
1
2
3
4
5
6
7
8
9
10
11
Kertas HVS 70 gr
Tinta Data Print Injektion
Spidol White Board
SteplesIsi Max no 30
Spidol 12 Warna
Bolpoin
Pensil 2B
Buku Kwarto (100)
Buku Tulis Folio (100)
Bantalan Stempel
Map Kertas Folio
5,007.00
9,929,996.00
5,117.00
10,558,378.00
3
6
-
87.00
19,749.00
25,000
227
227
60,000
60,000
Buku
60,000.00
25,000.00
2.00
25,000
Buku
Buku
25,000.00
24,900.00
25,000.00
Buku
Buku
25,000.00
24,900.00
25,000.00
Buku
Buku
25,000.00
24,900.00
990.00
36,350.00
6,363.00
6,360.00
990.00
990.00
25,000.00
54,545.00
38,455.00
8,636.00
6,182.00
6,364.00
3,273.00
4,182.00
13,636.00
25,455.00
8,727.00
527.00
65
52
87
65
240
65
240
8
8
2
2
6
2
6
2
6
47
1
1,000
1,000
125,000
75,000
149,400
125,000
75,000
149,400
812,435
650,000
19,749
14,755
54,000
14,755
54,000
480,000
480,000
50,000
50,000
149,400
50,000
149,400
50,000
149,400
46,530
36,350
990,000
990,000
25,000
60,000.00
60,000.00
Buku
Buku
Buku
Lembar
Lembar
2
6
47
1
1,000
1,000
75,000
149,400
75,000
149,400
812,435
650,000
14,755
54,000
14,755
54,000
480,000
480,000
50,000
149,400
50,000
149,400
50,000
149,400
46,530
36,350
990,000
990,000
25,000
3
6
50,000.00
65
52
65
240
65
240
8
8
2
6
25,000
2
6
110.00
628,382.00
ATK PUSKESMAS
Buku
Register Luar Gedung

Register luar gedung
Register luar gedung
Kartu Barang
5.00
10.00
20.00
4.00
6.00
5.00
6.00
4.00
4.00
150.00
545,450.00
769,100.00
34,544.00
38,184.00
16,365.00
25,092.00
54,544.00
101,820.00
79,050.00
25,000
531,907.00
54,545
38,455
8,636
6,182
6,364
3,273
4,182
13,636
25,455
8,727
527
5
3
6
5
3
6
10
20
4
6
5
6
4
4
150
545,450
769,100
34,544
38,184
16,365
25,092
54,544
101,820
79,050
12
13
14
15
16
17
18
19
20
21
22
23
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Map Jepit Plastik snell

Klip Jepit kecil
Penghapus Stedler kecil
Tipe Ex Kenko Bolpoin
Tinta stemple Yamura
Steples alat Max no 10 ( K )
Steples alat Max no 30
Spidol Permanen G 12
Map File/Metal clip Bintek 3260
Steples Isi Max no 10
Map Plastik Microtop 8800
Klip Jepit sedang
Kertas HVS 70 gr folio
Tinta printer
Spidol white board
Steples isi max no.30
Spidol 12 warna
Bolpoint
Pensil MMR 2B
Buku kwarto (100)
Buku folio (100)
Bantalan stempel
Map kertas folio
Map plastik biasa jepit
Klip jepit kecil
Penghapus
Tipe ex
Tinta yamura
Spidol permanen G 12
Map file / metal clip bantex 3260
Steples isi max no.10
Map plastik microtop 8800
Klip jepit sedang
Steples Alat Max no 10 Asli
Steples alat Max no 30
Jumlah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Buah
9,909.00
3,273.00
4,182.00
5,364.00
5,100.00
19,500.00
69,727.00
8,455.00
14,909.00
3,000.00
22,727.00
4,909.00
59,090.91
59,090.91
9,090.91
6,818.18
6,363.64
3,636.36
4,545.45
14,090.91
26,818.18
9,545.45
545.45
10,909.09
3,636.36
4,545.45
6,363.64
5,454.55
9,090.91
16,363.64
3,181.82
25,000.00
5,454.55
76,363.64
21,363.64
55.00
20.00
6.00
1.00
20.00
544,995.00
65,460.00
25,092.00
14,909.00
98,180.00
1
2
3
4
5
14
11
4
311.00
2,412,785.00
Lampu Essensial
Lampu Dop Pijar
Kabel Rol
Isolasi
Lampu Tl/ 54
Jumlah
38,000.00
5,000.00
30,000.00
8,000.00
27,000.00
Pembersih Lantai (SOS) @ 800 ml
19,909.00
1.00
19,909.00
2
3
4
sapu Ijuk Plasti Kipas

Pebersih Kaca Cling @ 425 ml
Pembersih Tangan Doremi @ 225
ml
18,545.00
23,182.00
13,636.00
1.00
1.00
1.00
18,545.00
23,182.00
13,636.00
9,909
3,273
4,182
5,364
5,100
19,500
69,727
8,455
14,909
3,000
22,727
4,909
25
16
17
56
8
52
10
341,037.00
38,000
5,000
30,000
8,000
27,000
300
52
47
8
10
3
1
4
32
4
71
0
0
745.00
1,477,273
945,455
154,545
381,818
50,909
189,091
45,455
197,273
295,000
38,182
163,635
567,273
170,909
36,364
63,636
16,364
9,091
65,455
101,818
100,000
387,273
-
55
20
6
1
20
25
16
17
56
8
52
10
14
11
4
300
52
47
8
10
3
1
4
32
4
71
-
544,995
65,460
25,092
14,909
98,180
1,477,273
945,455
154,545
381,818
50,909
189,091
45,455
197,273
295,000
38,182
163,635
567,273
170,909
36,364
63,636
16,364
9,091
65,455
101,818
100,000
387,273
-
5,456,816.73
1,056.00
7,869,601.73
1
1
1
1
19,909
18,545
23,182
13,636
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
Pembersih Keramik @ 1000 ml

Penharum Ruangan @ 250 ml
Kapur Barus Warna @ 150 gr
Lap Pel G.A Biru
Sikat WC
Lap Tangan
Sapu Bulu Ayam
Sapu lidi Taman
Sapu lidi Biasa
Tempat Sampah
Pembersih Keramik @ 500 ml
Keset Welcome 1 Meter
Serok Plastik Halus
Tisu Roll Poli
Ember Plastik 4 Galon
Keranjang Sampah
Ember Plastik 1 Galon
Pemutih @ 500 ml
Pembersih lantai
Sapu ijuk plastik kipas
Pembersih kaca
Pembersih tangan
Prostek
Pengharum ruangan
Kapur barus warna
Lap pel G.A biru / putih
Sikat WC biasa
Lap tangan
Sapu bulu ayam besar
Sapu lidi taman
Sapu lidi biasa
Tissue kotak tipis
Keset welcome besar
Serok sampah plastik
Tissue roll
Ember plastik kecil 4 galon
Ember plastik kecil 1 galon
Bayclin
Jumlah
TOTAL
27,273.00
26,182.00
13,091.00
12,000.00
12,545.00
18,182.00
19,909.00
16,545.00
5,273.00
21,182.00
86,273.00
11,909.00
6,636.00
21,909.00
9,273.00
2,455.00
15,727.00
21,800.00
20,450.00
25,450.00
13,600.00
30,000.00
28,600.00
14,000.00
14,500.00
13,600.00
18,100.00
21,800.00
18,100.00
5,450.00
15,900.00
94,500.00
12,700.00
7,200.00
24,000.00
2,700.00
17,200.00
2.00
1.00
2.00
1.00
2.00
1.00
-
54,546.00
26,182.00
26,182.00
12,000.00
25,090.00
19,909.00
-
###
###
###
###
###
###
###
###
###
###
###
###
###
###
###
###
###
###
###
###
13.00
434.00
239,181.00
3,280,348.00
Kepala Puskesmas Buleleng II
419,650.00
5
2
5
5
5
5
5
5
5
5
2
2
2
2
2
2
2
1
1
2
65.00
5,817.00
109,000
40,900
127,250
68,000
150,000
143,000
70,000
72,500
68,000
90,500
43,600
36,200
10,900
31,800
189,000
25,400
14,400
24,000
2,700
34,400
1,351,550.00
16,738,362.73
2
1
2
1
2
1
5
2
5
5
5
5
5
5
5
5
2
2
2
2
2
2
2
1
1
2
78.00
6,251.00
54,546
26,182
26,182
12,000
25,090
19,909
109,000
40,900
127,250
68,000
150,000
143,000
70,000
72,500
68,000
90,500
43,600
36,200
10,900
31,800
189,000
25,400
14,400
24,000
2,700
34,400
1,590,731.00
20,018,710.73

dr Ni Luh Sustemy
Nip.197205042007012023
Made Sastramika
Nip.197506222007011017
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
(628,382)
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
(2,412,785)
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
(239,181)
#VALUE!
PEMERINTAH KABUPATEN BULELENG
PERSEDIAAN
PER 31 DESEMBER 2014
Puskesmas : Buleleng II
No
Nama Jenis Persediaan
Satuan
Kuntitas
Volume
Totan Nilai
ATK
Barang Cetakan
Barang Kuasi / Karcis
Perlengkapan Rumah Tangga
Obat obat /Alat Kesehatan
Bibit Tanaman
Hewan Ternak
Spare Part Kendaraan /Mesin
Lain Lain
JUMLAH
Mengetahui :
Kepala Puskesmas
Buleleng II
dr.Ni Luh Sustemi

Nip: 19720504 200701 2 023
Lembar
7,235
449,655
7,235
449,655.25

Mader Sastramika
Nip : 19750622 200701 1 017

Berita Acara Koreksi 2014

Uploaded by

Copyright:

Available Formats

You might also like

Berita Acara Koreksi 2014

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Berita Acara Koreksi 2014

Uploaded by

Copyright:

Available Formats

LAMPIRAN BERITA ACARA KOREKSI

Haloperidol 1,5 mg tablet

LAPORAN MUTASI BARANG PERSEDIAAN

KEADAAN PER 31 DESEMBER 2012

MUTASI / PERUBAHAN 1 Januari S/D 31 Desember 2013

KEADAAN PER 31 Desember 2013

JML HARGA (RP)

JML HARGA (RP)

JML HARGA (RP)

Pyrantel Pamoat 125 mg tablet

dr.Ni Luh Sustemi

Singaraja, 31 Desember 2013

Nip: 19720504 200701 2 023

Nip.19750622 200701 1 017

Abbocat set Anak

Abbocat set Dewasa

Acyclovir 200 mg tab.

Air Raksa dental use

Alat suntik sekali pakai 2,5 ml

Alat suntik sekali pakai 3 ml

Alat suntik sekali pakai 5 ml

Albendazol tablet 400 mg

Alopurinol tablet 100 mg

Aminofilin injeksi 24 mg/ml-10ml

Aminofilin tablet 200 mg

Amoksisilin kapsul 250 mg

Amoksisilin kapsul 500 mg

Amoksisilin sirup kering 125 mg/5 ml

Ampisilin kapsul 250 mg

Ampisilin kapsul 500 mg

Ampisilin sirup kering 125mg/5 ml

Antalgin (Metampiron) injeksi 250 mg/ml-2ml

Antalgin (Metampiron) tablet 500 mg

Antasida DOEN suspensi btl. 60 ml

Antasida DOEN tablet 500 mg

Anti Bakteri DOEN Salep kombinasi

Anti Hemoroid DOEN kombinasi supp

Antifungi DOEN kombinasi (White Field Salep)

Aqua pro injeksi steril bebas pirogen

Asam Askorbat (Vit. C) tablet 50 mg

Asam mefenamat 250 mg

Asam Mefenamat 500 mg

Asetosal tablet 100 mg

Asetosal tablet 500 mg

Atrofin Sulfat Injeksi 0,25 mg/ml-1 ml

Benzatin Benzil Penicillin Injeksi 1,2 juta iu/vial

Benzatin Benzil Penicillin Injeksi 2,4 juta iu/vial

Besi (II) Sulfat (Tambah darah) tablet

Betametason krim 0,1 %

Catgut/Benang Bedah No.2/0-3/0 dengan Jarum Bedah

Cimetidine 200 mg tablet

Ciprofloxacin 500 mg kaptab

Clobazam (Frisium) 10 mg tablet

Dekstrometorfan Sirup 10mg/5ml

Devitalisasi Pasta (Non Arsen)

Dexametason Injeksi Amp

Dexametason tablet 0,5 mg

Diazepam injeksi 5 mg/ml-2ml