Pengujian Stock Opname B

Penerimaan Bahan Kim

Stock Opname per 31-12-2022
tanggal 2-….... Januari 2
NAMA PABRIK /
NO. NAMA BARANG KEMASAN SATUAN TERKECIL
MERK
Lab Gudang Total Lab

1 2 3 4 5 6 7 8=6+7 9

AccuCheck Performa PT.Roche 100 Strip/box (2

1 Box 1 - 1 -
Strip Indonesia Tube@50 Strip)
AccuCheck Softelix Uno PT.Roche
2 200 Pcs/Box Box 1 - 1 -
Lancet Indonesia
PT. Jayamas
3 Alkohol Swab 100 Pcs/Kotak Box 25 - 25 -
Onemed
4 Glucose Test Strip Pt.NIPRO 50 Test/kotak Test Strip 4 - 4 -
5 Asam Sulfosalisilat Indoreagen Botol/100ml Botol - - 0 -
6 Asam Urat Greiner PT.Greiner 2x100 ml Botol 1 - 1 -
7 Cholesterol Greiner PT.Greiner 4x100ml Botol 2.00 - 2 -
Cholesterol Test Strip PT.Mitra Asa
8 10 Test Strip/Box Test Strip - - 0 -
Benecheck Pratama
R1 1x100 ml,R2
9 Creatinine Greiner PT.Greiner KIT - - 0 -
x100 ml
10 Disposible Westergren Assistant Pak@10Pcs PAK - - 0 -
11 Gol.Darah Anti A PT.DIALAB Botol @ 10 ml Botol 2.00 - 2 -
12 Gol.Darah Anti B PT.DIALAB Botol @ 10 ml Botol 2.00 - 2 -
13 Gol.Darah Anti AB PT.DIALAB Botol @ 10 ml Botol - - 0 -
Gol.Darah Anti D Botol @ 10 ml
14 PT.DIALAB Botol - - 0 -
(IgM/IgG)
PT.Jayamas Box @ 200 Pcs
15 Plesterin Bulat BOX 7.00 - 7 -
Onemed

PT.Multi Sarana
16 Reagen Salmonella AH Botol @ 5 ml Botol - - 0 -
Medika

PT.Multi Sarana
17 Reagen Salmonella AO Botol @ 5 ml Botol - - 0 -
Medika

PT.Multi Sarana
18 Reagen Salmonella BH Botol @ 5 ml Botol - - 0 -
Medika

PT.Multi Sarana
19 Reagen Salmonella BO Botol @ 5 ml Botol - - 0 -
Medika

PT.Multi Sarana
20 Reagen Salmonella CH Botol @ 5 ml Botol - - 0 -
Medika

PT.Multi Sarana
21 Reagen Salmonella CO Botol @ 5 ml Botol - - 0 -
Medika

PT.Multi Sarana
22 Reagen Salmonella H Botol @ 5 ml Botol - - 0 -
Medika

PT.Multi Sarana
23 Reagen Salmonella O Botol @ 5 ml Botol - - 0 -
Medika

24 SGOT PT.DIALAB 2x62,5 ml KIT 1.00 - 1 -

25 SGPT PT.DIALAB 2x62,5 ml KIT 1.00 - 1 -
Tabung EDTA K3 (3 ML) PT.Endo
26 Pack / 100 ml PCS 100.00 - 100 -
ENDO Indonesia

Tabung Plain/SST with PT.Hospi Medik

27 100 Pcs/Pack PCS 100.00 - 100 -
Gel 3-3,5 ml Vacuisera Indonesia

PT.Jayamas
28 Tip Biru 500 Pcs/PAK PAK 450.00 - 450 -
Medica
PT.Jayamas
29 Tip Kuning 501 Pcs/PAK PAK 325.00 - 325 -
Medica
PT.Jayamas
30 Tip Putih 502 Pcs/PAK PAK 300.00 - 300 -
Medica
31 Triglyserida PT.Dialab 1 KIT @ 5 Btl Botol 1.00 - 1 -
R1a 1x100ml,R1b
32 Urea Greiner PT.Greiner KIT - - 0 -
1x1,6,R2 2x70 ml
Urine Test Strip 10
33 Cybow 100 Strip/Btl Botol - - 0 -
Parameter
HBSag Strip PT.Indec
34 25 Strip/Box Test Strip - - 0 -
(Verocheck) Diagnostic

Rapid Test HIV/Syphilis

35 SD-Bioline Box @ 25 Test Strip Test Strip - - 0 -
Duo (SD Bioline)

PT.Fokus
Rapid Tes HIV 2
36 Diagnostic Card-Device/Box Card/Device 1.00 - 1 -
(FOKUS)
Indonesia
PT.Fokus
37 RPR Test (FOKUS) Diagnostic 101 Test / Kit KIT - - 0 -
Indonesia
Deck Glass /Cover PT.Jayamas
38 100 Pcs/Kotak Kotak 1.00 - 1 -
Glass Onemed
PT.Jayamas
39 Object Glass/Slide Kotak Kotak 12.00 - 12 -
Medika
40 Pot Dahak Steril 200 Box/Pcs PCS 460.00 - 460 220
41 Tissue Lensa Kimtech Kotak Kotak 4.00 - 4 -
42 Botol semprot Lokal Pcs PCS - - 0 -
PT.Royal
43 Kartu Golongan Darah Artomoro Pak @ 100 Lembar PAK 1.00 - 1 -
Sukses
44 Ose Bulat Lokal Pcs PCS - - 0 -
45 Penjepit Tabung Lokal Pcs PCS - - 0 -
PT.Royal
46 Plat widal Artomoro Pcs PCS - - 0 -
Sukses
47 RDT Covid -19 Sd-Biosensor Box Test - - 0 -
48 Tabung reaksi 4 ml Pyrex Pcs PCS - - 0 -
49 Tabung reaksi 7 ml Pyrex Pcs PCS - - 0 -
PT.Arkan
Viral Transport Medium
50 Indoplast Pcs PCS 73.00 - 73 -
(VTM)
Utama
PT.Fokus
51 Test Kehamilan (Fokus) Diagnostic 25 Test Strip/Box Test Strip - - 0 -
Indonesia
Rapid Tes DBD Dengue
52 Duo (NS1Ag+ SD-Biolone Box @ 25 Test Strip Test Strip - - 0 -
AbCombo)
JUMLAH

Mengetahui
Kepala Puskesmas Penanggung Jawab Kimia

dr.Elly Herawati Panggabean Amalia Fitri Audina

NIP. 197611262006042005 NIP.
ujian Stock Opname Bahan Kimia di Puskesmas …… (APBD)

Penerimaan Bahan Kimia Pengeluaran Tangggal 2-…...

Saldo opname per …..... Januari 2023
tanggal 2-….... Januari 2023 Jan 2023
Pengujian Selisih
Gudang Total Lab Gudang Total Lab Gudang Total

10 11=9+10 12 13 14=12+11 15 16 17=15+16 18=(14+17)-11 19=8-18

- 0 0 1 - 1 1 0

- 0 0 0 1 - 1 1 0

- 0 0 25 - 25 25 0

- 0 0 4 - 4 4 0
- 0 0 - - 0 0 0
- 0 0 1 - 1 1 0
- 0 0 2 - 2 2 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0
- 0 0 2 - 2 2 0
- 0 0 2 - 2 2 0
- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 3 3 4 - 4 7 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 1 - 1 1 0
- 0 0 1 - 1 1 0

- 0 0 100 - 100 100 0

- 0 0 100 - 100 100 0

- 0 0 450 - 450 450 0

- 0 0 325 - 325 325 0

- 0 0 300 - 300 300 0

- 0 0 1 - 1 1 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 1 - 1 1 0

- 0 0 - - 0 0 0

- 0 0 1 - 1 1 0

- 0 0 12 - 12 12 0

- 220 0 0 680 - 680 460 0

- 0 0 4 - 4 4 0
- 0 0 - - 0 0 0

- 0 0 1 - 1 1 0

- 0 0 - - 0 0 0
- 0 0 - - 0 0 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0
- 0 0 - - 0 0 0
- 0 0 - - 0 0 0

- 0 0 73 - 73 73 0

- 0 0 - - 0 0 0

- 0 0 - - 0 0 0
Tangerang, 23 Januari 2023
Tim Pemeriksa :
1. Drs. Ibrahim, M.Si (Pem. Penanggung Jawab)

2. Chandra Mundiyana, SE, M.AB, Ak, CA (Pengendali Teknis)

3. Dewi Oktavia Purba, SE (Ketua Tim)

4.Bahtiar, SH (Anggota Tim)

5. Neneng Kulsum, SE (Anggota Tim)

6. ….................... (Anggota Tim)

 Nominal
Nominal
Nominal Bahan Nominal Persediaan Pengeluaran
Harga Satuan Nominal Penerimaan Bahan
(Rp)
Kimia per 31 Des
Selisih (Rp)
Bahan Kimia per Bahan Kimia per
2022 (Rp) Kimia per tanggal
tanggal 31 Des 2022 tanggal 2-….... Jan
2-…... Jan 2023
2023
20 21=8x20 23 =20x21 24 = 8*20 25 = 11*20 26 = 14*20

320,000 320,000.00 0.00

320,000.00 - -

128,000 128,000.00 0.00

128,000.00 - -

12,000 300,000.00 0.00

300,000.00 - -
2,442 9,768.00 0.00 9,768.00 - -
270,000 0.00 0.00 - - -
650,000 650,000.00 0.00 650,000.00 - -
435,000 870,000.00 0.00 870,000.00 - -

25,000 0.00 0.00

- - -

710,000 0.00 0.00

- - -
48,000 0.00 0.00 - - -
29,100 58,200.00 0.00 58,200.00 - -
44,100 88,200.00 0.00 88,200.00 - -
29,100 0.00 0.00 - - -

79,100 0.00 0.00

- - -

35,000 245,000.00 0.00

245,000.00 - 105,000.00

63,800 0.00 0.00

- - -

63,800 0.00 0.00

- - -

63,800 0.00 0.00

- - -

63,800 0.00 0.00

- - -

63,800 0.00 0.00

- - -

63,800 0.00 0.00

- - -

63,800 0.00 0.00

- - -

63,800 0.00 0.00

- - -
383,500 383,500.00 0.00 383,500.00 - -
401,500 401,500.00 0.00 401,500.00 - -

870 87,000.00 0.00

87,000.00 - -

1,820 182,000.00 0.00

182,000.00 - -

42,200 18,990,000.00 0.00

18,990,000.00 - -

32,370 10,520,250.00 0.00

10,520,250.00 - -

32,370 9,711,000.00 0.00

9,711,000.00 - -
111,200 111,200.00 0.00 111,200.00 - -

423,000 0.00 0.00

- - -

136,158 0.00 0.00

- - -

7,940 0.00 0.00

- - -

17,564 0.00 0.00

- - -

13,900 13,900.00 0.00

13,900.00 - -

412,000 0.00 0.00

- - -

12,574 12,574.30 0.00

12,574.30 - -

15,350 184,200.00 0.00

184,200.00 - -
2,200 1,012,000.00 0.00 1,012,000.00 484,000.00 -
32,000 128,000.00 0.00 128,000.00 - -
11,317 0.00 0.00 - - -

- 0.00 0.00
- - -
4,500 0.00 0.00 - - -
4,500 0.00 0.00 - - -

- 0.00 0.00
- - -
135,000 0.00 0.00 - - -
4,200 0.00 0.00 - - -
8,500 0.00 0.00 - - -

16,500 1,204,500.00 0.00

1,204,500.00 - -

4,300 0.00 0.00

- - -

58,359 0.00 0.00

- - -
 45,610,792.30 45,610,792.30 484,000.00 105,000.00

anggung Jawab)
 Nominal Saldo Nominal Saldo
menurut laporan menurut fisik per
Selisih
per tanggal ….... tanggal ….... Jan
Jan 2023 2023

27=17*20 28 29=27-28

320,000.00 320,000.00 -

128,000.00 128,000.00 -

300,000.00 300,000.00 -
9,768.00 9,768.00 -
- - -
650,000.00 650,000.00 -
870,000.00 870,000.00 -

- - -

- - -
- - -
58,200.00 58,200.00 -
88,200.00 88,200.00 -
- - -

- - -

140,000.00 140,000.00 -

- - -

- - -

- - -

- - -

- - -

- - -

- - -

- - -
383,500.00 383,500.00 -
 401,500.00 401,500.00 -

87,000.00 87,000.00 -

182,000.00 182,000.00 -

18,990,000.00 18,990,000.00 -

10,520,250.00 10,520,250.00 -

9,711,000.00 9,711,000.00 -
111,200.00 111,200.00 -

- - -

- - -

- - -

- - -

13,900.00 13,900.00 -

- - -

12,574.30 12,574.30 -

184,200.00 184,200.00 -
1,496,000.00 1,496,000.00 -
128,000.00 128,000.00 -
- - -

- - -
- - -
- - -

- - -
- - -
- - -
- - -

1,204,500.00 1,204,500.00 -

- - -

- - -
45,989,792.30 45,989,792.30 -
 Pengujian Stock Opname Bahan Kimia di Puskesmas ….............. (BLUD)

Penerimaan Bahan Kimia Pengeluaran Tangggal 2-…...

Stock Opname per 31-12-2022 Saldo opname per …..... Januari 2023
tanggal 2-….... Januari 2023 Jan 2023 Nominal Bahan
Nominal Selisih
NO. NAMA BARANG NAMA PABRIK / MERK KEMASAN SATUAN TERKECIL Pengujian Selisih Harga Satuan (Rp) Kimia per 31 Des
(Rp)
2022 (Rp)
Lab Gudang Total Lab Gudang Total Lab Gudang Total Lab Gudang Total

1 2 3 4 5 6 7 8=6+7 9 10 11=9+10 12 13 14=12+11 15 16 17=15+16 18=(14+17)-11 19=8-18 20 21=8x20 23 =20x21

Cleaner PT. ABBOTT Botol 960 ml Botol 1.00 - 1.00 - - 0 0 0 1 - 1 1 0 3,131,865.00 3,131,865.00 0.00
Diluent PT. ABBOTT Botol 10 Liter Botol 1.00 - 1 - - 0 0 0 1 - 1 1 0 4,695,744.00 4,695,744.00 0.00
Lyse PT. ABBOTT Botol 960 ml Botol 1.00 - 1 - - 0 0 0 1 - 1 1 0 5,087,463.00 5,087,463.00 0.00
Benecheck Plus Total Cholesterol Test Strip 10s BeneCheck 1 Pak 7.00 - 7 - - 0 4 4 3 - 3 7 0 250,000.00 1,750,000.00 0.00
Benecheck Plus Uric Acid Test Strip 25s BeneCheck 1 Pak 4.00 - 4 - - 0 3 3 1 - 1 4 0 150,000.00 600,000.00 0.00
Ceracheck Glucose Test Strip PT Royal Artomoro 1 Pak 20.00 - 20 - - 0 0 0 20 - 20 20 0 277,500.00 5,550,000.00 0.00
JUMLAH 20,815,072.00

Tangerang, 23 Januari 2023

Mengetahui Tim Pemeriksa :
Kepala Puskesmas Penanggung Jawab Kimia 1. Drs. Ibrahim, M.Si (Pem. Penanggung Jawab)

2. Chandra Mundiyana, SE, M.AB, Ak, CA (Pengendali Teknis)

3. Dewi Oktavia Purba, SE (Ketua Tim)

4.Bahtiar, SH (Anggota Tim)

dr.Elly Herawati Panggabean Amalia Fitri Audina 5. Neneng Kulsum, SE (Anggota Tim)
NIP. 197611262006042005 NIP. -
6. ….................... (Anggota Tim)