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  • Upt Puskesmas Labuhan Maringgai: Dinas Kesehatan

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    Alief M. Zarendra
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    The document is a receipt for medical supplies issued from Puskesmas Labuhan Maringgai health center to several health clinics (Pustu) in Lampung Timur regency on various dates in January 2019. It lists 37 items including medications, medical equipment and supplies along with quantities issued. The items were sourced from the health center's own stock and BPJS (Indonesia's universal health coverage program). The receipt provides details of the items, quantities, sources of supply and signatures of the officials handling the transaction.

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    contoh sbbk pustu

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    Book1

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    The document is a receipt for medical supplies issued from Puskesmas Labuhan Maringgai health center to several health clinics (Pustu) in Lampung Timur regency on various dates in January 2019. It lists 37 items including medications, medical equipment and supplies along with quantities issued. The items were sourced from the health center's own stock and BPJS (Indonesia's universal health coverage program). The receipt provides details of the items, quantities, sources of supply and signatures of the officials handling the transaction.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    Download as xlsx, pdf, or txt
    26 views7 pages

    Upt Puskesmas Labuhan Maringgai: Dinas Kesehatan

    Uploaded by

    Alief M. Zarendra
    The document is a receipt for medical supplies issued from Puskesmas Labuhan Maringgai health center to several health clinics (Pustu) in Lampung Timur regency on various dates in January 2019. It lists 37 items including medications, medical equipment and supplies along with quantities issued. The items were sourced from the health center's own stock and BPJS (Indonesia's universal health coverage program). The receipt provides details of the items, quantities, sources of supply and signatures of the officials handling the transaction.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    of 7

    PEMERINTAH DAERAH KABUPATEN LAMPUNG TIMUR

    DINAS KESEHATAN
    UPT PUSKESMAS LABUHAN MARINGGAI
    KECAMATAN LABUHAN MARINGGAI
    Jln. Pramuka No. 03 Labuhan Maringgai 34198 Telp. (0725) 660304
    SURAT BUKTI BARANG KELUAR

    Nomor : 442 / / SBBK/ PKM.0101/ VIII / 2019


    Dikeluarkan oleh : : Puskesmas Labuhan Maringgai
    Kepada Instansi : Pustu Sukorahayu
    Pada hari / tanggal : Kamis, 25 Januari 2019

    SUMBER
    NO NAMA OBAT KEMASAN JUMLAH
    PKD BPJS
    1 Alat suntik 3 ml Pcs 500 v
    2 Alkohol btl 15 v
    3 Amoksisilin tab 500mg tablet 2000 v
    4 Amoksisilin syr 125mg/5ml btl 150 v
    5 Antasida DOEN Tablet tablet 1500 v
    6 Asam Mefenamat 500mg tablet 1500 v
    7 Captopril 25 mg tablet 300 v
    8 CTM tablet 1000 v
    9 Domperidon tab tablet 1000 v
    10 Furosemide tab tablet 500 v
    11 Hidrokortison 2,5?% tube 24 v
    12 Infus set dewasa Pcs 100 v
    13 Ketokonazole SK tube 25 v
    14 Kloramfenikol SK tube 24 v
    15 Lidocain compositum inj ampul 30 v
    16 Loperamide tablet 200 v
    17 Masker Pcs 100 v
    18 Metilergometrin inj ampul 30 v
    19 Metoklopramide tablet 0 v
    20 Ciprofloksasin tablet 500 v
    21 NaCl lart infus btl 20 v
    22 Natrium Diklofenak 25mg tablet 100 v
    23 Oksitosin inj ampul 30 v
    24 Parasetamol 500mg tablet 3500 v
    25 Parasetamol syr botol 60ml 300 v
    26 R/L Botol 60 v
    27 Salbutamol 2mg tablet 200 v
    28 Simvastatin 10mg tablet 150 v
    29 Alopurinol 100mg tablet 500 v
    30 Vitamin B6 tablet 500 v
    31 Vitamin C 50 mg tablet 500 v
    32 vitamin B1 tablet 500 v
    33 Ranitidin 150 mg tablet 300 v
    34 Metformin tablet 300 v
    35 Kapas Berlemak ball 1 v
    36 Sarung Tangan non steril pcs 100 v
    37 IV Catheter 20 pcs 50 v
    39 Bisacodyl supp 10 mg Pcs 50 v
    Yang menerima Yang Menyerahkan

    Suprih Alif Muklis Zarendra,S.Farm, Apt.


    NIP.196401271987031017

    Mengetahui,
    Plt.Ka.UPTD Puskesmas Lab.Maringgai

    Sambiati S. St.
    NIP 196709051987112001
    PEMERINTAH DAERAH KABUPATEN LAMPUNG TIMUR
    DINAS KESEHATAN
    UPT PUSKESMAS LABUHAN MARINGGAI
    KECAMATAN LABUHAN MARINGGAI
    Jln. Pramuka No. 03 Labuhan Maringgai 34198 Telp. (0725) 660304
    SURAT BUKTI BARANG KELUAR

    Nomor : 442 / / SBBK/ PKM.0101/ VIII / 2019


    Dikeluarkan oleh : : Puskesmas Labuhan Maringgai
    Kepada Instansi : Pustu Karang Anyar
    Pada hari / tanggal : Kamis, 4 Januari 2019

    SUMBER
    NO NAMA OBAT KEMASAN JUMLAH
    PKD BPJS
    1 Alat suntik 3 ml Pcs 500 v
    2 Alkohol btl 10 v
    3 Amoksisilin tab 500mg tablet 2500 v
    4 Amoksisilin syr 125mg/5ml btl 150 v
    5 Antasida DOEN Tablet tablet 2000 v
    6 Asam Mefenamat 500mg tablet 2000 v
    7 Captopril 25 mg tablet 400 v
    8 CTM tablet 1000 v
    9 Domperidon tab tablet 1000 v
    10 Furosemide tab tablet 500 v
    11 Hidrokortison 2,5?% tube 24 v
    12 Infus set dewasa Pcs 100 v
    13 Ketokonazole SK tube 25 v
    14 Kloramfenikol SK tube 24 v
    15 Lidocain compositum inj ampul 30 v
    16 Loperamide tablet 4000 v
    17 Masker Pcs 100 v
    18 Metilergometrin inj ampul 30 v
    19 Metoklopramide tablet 0 v
    20 Ciprofloksasin tablet 500 v
    21 NaCl lart infus btl 20 v
    22 Natrium Diklofenak 25mg tablet 100 v
    23 Oksitosin inj ampul 30 v
    24 Parasetamol 500mg tablet 5000 v
    25 Parasetamol syr botol 60ml 300 v
    26 R/L Botol 60 v
    27 Salbutamol 2mg tablet 200 v
    28 Simvastatin 10mg tablet 150 v
    29 Alopurinol 100mg tablet 500 v
    30 Vitamin B6 tablet 500 v
    31 Vitamin C 50 mg tablet 500 v
    32 vitamin B1 tablet 500 v
    33 Ranitidin 150 mg tablet 300 v
    34 Metformin tablet 300 v
    35 Kapas Berlemak ball 1 v
    36 Sarung Tangan non steril pcs 100 v
    37 IV Catheter 20 pcs 50 v
    39 Bisacodyl supp 10 mg Pcs 50 v
    Yang menerima Yang Menyerahkan

    Nurhayani, A.Md,Kep. Alif Muklis Zarendra,S.Farm, Apt.


    NIP. 19740916 200604 2 003

    Mengetahui,
    Plt.Ka.UPTD Puskesmas Lab.Maringgai

    Sambiati S. St.
    NIP 196709051987112001
    PEMERINTAH DAERAH KABUPATEN LAMPUNG TIMUR
    DINAS KESEHATAN
    UPT PUSKESMAS LABUHAN MARINGGAI
    KECAMATAN LABUHAN MARINGGAI
    Jln. Pramuka No. 03 Labuhan Maringgai 34198 Telp. (0725) 660304
    SURAT BUKTI BARANG KELUAR

    Nomor : 442 / / SBBK/ PKM.0101/ VIII / 2019


    Dikeluarkan oleh : : Puskesmas Labuhan Maringgai
    Kepada Instansi : Pustu Srigading
    Pada hari / tanggal : Kamis, 4 Januari 2019

    SUMBER
    NO NAMA OBAT KEMASAN JUMLAH
    PKD BPJS
    1 Alat suntik 3 ml Pcs 500 v
    2 Alkohol btl 20 v
    3 Amoksisilin tab 500mg tablet 2500 v
    4 Amoksisilin syr 125mg/5ml btl 150 v
    5 Antasida DOEN Tablet tablet 2000 v
    6 Asam Mefenamat 500mg tablet 2000 v
    7 Attapulgit tablet 50 v
    8 Captopril 25 mg tablet 400 v
    9 CTM tablet 1000 v
    10 Domperidon tab tablet 1000 v
    11 Furosemide tab tablet 500 v
    12 Hidrokortison 2,5?% tube 24 v
    13 Infus set dewasa Pcs 100 v
    14 Ketokonazole SK tube 25 v
    15 Kloramfenikol SK tube 24 v
    16 Lidocain compositum inj ampul 30 v
    17 Loperamide tablet 300 v
    18 Masker Pcs 100 v
    19 Metilergometrin inj ampul 30 v
    20 Metoklopramide tablet 0 v
    21 Ciprofloksasin tablet 500 v
    22 NaCl lart infus btl 20 v
    23 Natrium Diklofenak 25mg tablet 100 v
    24 Oksitosin inj ampul 30 v
    25 Parasetamol 500mg tablet 4000 v
    26 Parasetamol syr botol 60ml 300 v
    27 R/L Botol 60 v
    28 Salbutamol 2mg tablet 200 v
    29 Simvastatin 10mg tablet 150 v
    30 Alopurinol 100mg tablet 500 v
    31 Vitamin B6 tablet 500 v
    32 Vitamin C 50 mg tablet 500 v
    33 vitamin B1 tablet 500 v
    34 Ranitidin 150 mg tablet 300 v
    35 Metformin tablet 300 v
    36 Kapas Berlemak ball 1 v
    37 Sarung Tangan non steril pcs 100 v
    38 IV Catheter 20 pcs 50 v
    39 Bisacodyl supp 10 mg Pcs 50 v
    Yang menerima Yang Menyerahkan

    Samini Alif Muklis Zarendra,S.Farm, Apt.


    NIP. 19690405 198812 2 001

    Mengetahui,
    Plt.Ka.UPTD Puskesmas Lab.Maringgai

    Sambiati S. St.
    NIP. 196709051987112001
    PEMERINTAH DAERAH KABUPATEN LAMPUNG TIMUR
    DINAS KESEHATAN
    UPT PUSKESMAS LABUHAN MARINGGAI
    KECAMATAN LABUHAN MARINGGAI
    Jln. Pramuka No. 03 Labuhan Maringgai 34198 Telp. (0725) 660304
    SURAT BUKTI BARANG KELUAR

    Nomor : 442 / / SBBK/ PKM.0101/ VIII / 2019


    Dikeluarkan oleh : : Puskesmas Labuhan Maringgai
    Kepada Instansi : Pustu Margasari
    Pada hari / tanggal : Kamis, 4 Januari 2019

    SUMBER
    NO NAMA OBAT KEMASAN JUMLAH
    PKD BPJS
    1 Alat suntik 3 ml Pcs 500 v
    2 Alkohol btl 20 v
    3 Amoksisilin tab 500mg tablet 3000 v
    4 Amoksisilin syr 125mg/5ml btl 150 v
    5 Antasida DOEN Tablet tablet 2000 v
    6 Asam Mefenamat 500mg tablet 2000 v
    7 Attapulgit tablet 50 v
    8 Captopril 25 mg tablet 400 v
    9 CTM tablet 1000 v
    10 Domperidon tab tablet 1000 v
    11 Furosemide tab tablet 500 v
    12 Hidrokortison 2,5?% tube 24 v
    13 Infus set dewasa Pcs 100 v
    14 Ketokonazole SK tube 25 v
    15 Kloramfenikol SK tube 24 v
    16 Lidocain compositum inj ampul 30 v
    17 Loperamide tablet 300 v
    18 Masker Pcs 100 v
    19 Metilergometrin inj ampul 30 v
    20 Metoklopramide tablet 0 v
    21 Ciprofloksasin tablet 500 v
    22 NaCl lart infus btl 20 v
    23 Natrium Diklofenak 25mg tablet 100 v
    24 Oksitosin inj ampul 30 v
    25 Parasetamol 500mg tablet 4500 v
    26 Parasetamol syr botol 60ml 300 v
    27 R/L Botol 60 v
    28 Salbutamol 2mg tablet 200 v
    29 Simvastatin 10mg tablet 150 v
    30 Alopurinol 100mg tablet 500 v
    31 Vitamin B6 tablet 500 v
    32 Vitamin C 50 mg tablet 500 v
    33 vitamin B1 tablet 500 v
    34 Ranitidin 150 mg tablet 300 v
    35 Metformin tablet 300 v
    36 Kapas Berlemak ball 1 v
    37 Sarung Tangan non steril pcs 100 v
    38 IV Catheter 20 pcs 50 v
    39 Bisacodyl supp 10 mg Pcs 50 v
    Yang menerima Yang Menyerahkan

    Nyi Ayu Hafizah, SST Alif Muklis Zarendra,S.Farm, Apt.


    NIP.19710112 198912 2 002

    Mengetahui,
    Plt.Ka.UPTD Puskesmas Lab.Maringgai

    Sambiati S. St.
    NIP 196709051987112001

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