LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN DI POLIN

KEGIATAN PENGADAAN OBAT DAN PERBEKALAN KESEHATA

UPT PKM SOTEK
BULAN DESEMBER TAHUN 2023

SALDO AWAL PENERIMAAN DARI GUDANG

SUMBER FARMASI PUSKESMAS
NO NAMA BARANG
DANA
KEMASAN
1-Dec-23
Jumlah Harga/ Nilai Jumlah Harga/ Nilai
DAK DAK DAK
1 Acetosal 500 mg DAK Ktk100 80 153.00 12,240.00 - 153.00
2 Acyclovir 400 mg DAK ktk 100 90 454.00 40,860.00 - 454.00 -
3 Albendazole Syr DAK Btl 1 4,300.00 4,300.00 - 4,300.00 -
4 Amoksisilin 500 mg DAK ktk 100 231.00 - 200 231.00 46,200.00
5 Amlodipin 5 mg DAK ktk 30 56.00 - 100 70.00 7,000.00
6 Antasida doen tab DAK ktk 100 20.00 - 200 117.00 23,400.00
7 Asam Askorbat (Vit C) 50 mg DAK KTK@100 46.00 - 200 46.00 9,200.00
8 Asam Mefenamat 500 mg DAK ktk 100 117.00 - 200 117.00 23,400.00
9 Betahistine 6 mg DAK ktk 30 93.00 - 200 93.00 18,600.00
10 Captopril 12,5 mg DAK ktk 100 68.00 - 200 68.00 13,600.00
11 Cyanocobalamin ( Vit B12 ) DAK Ktk 100 55 44.00 2,420.00 44.00 -
12 Deksamethasone DAK ktk 100 1,745.00 - 200 62.00 12,400.00
13 Domperidon 10 mg DAK ktk 100 30 75.00 2,250.00 75.00 -
14 Herbakof syr DAK Btl 14,273.00 - 5 14,273.00 71,365.00
15 Kalsium laktat 500 mg DAK Ktk100 30 61.00 1,830.00 200 61.00 12,200.00
16 Klorfeniramin Maleat (CTM) DAK ktk 100 24.00 - 200 24.00 4,800.00
17 Kotrimoksasol 480 mg DAK ktk 100 80 133.00 10,640.00 133.00 -
18 Metformin 500 mg DAK ktk 100 100 77.00 7,700.00 77.00 -
19 Metronidazol Sirup DAK btl 60 ml 2 3,756.00 7,512.00 3,756.00 -
20 Metronidazol 500 mg DAK ktk 100 160 140.00 22,400.00 140.00 -
21 Miconazole 2% krem DAK tube 1,900.00 - 5 1,900.00 9,500.00
22 Natrium diklofenak 50 mg DAK kotak 109.00 - 100 109.00 10,900.00
23 Nifedipin tab DAK ktk 100 100 123.00 12,300.00 123.00 -
24 Oxytetrasiklin salep mata DAK ktk 25 3 2,600.00 7,800.00 2,600.00 -
25 Paracetamol tab 500 mg DAK ktk 100 225.00 - 200 225.00 45,000.00
26 Phitomenadion Vit K DAK ktk 100 90 781.00 70,290.00 781.00 -
27 Ringer Laktat Infus DAK btl 2 7,703.00 15,406.00 7,703.00 -
28 Salbutamol 2 Mg DAK Ktk100 60 51.00 3,060.00 - 51.00 -
29 Tablet Tambah Darah DAK ktk 30 20 255.00 5,100.00 255.00 -
30 Vit B Komplek Tablet DAK btl 100 60.00 - 100 100.00 10,000.00
31 Zink tablet DAK Ktk 100 20 253.00 5,060.00 253.00 -
32 Hand Scoon M DAK ktk 100 20 1,392.00 27,840.00 100 1,392.00 139,200.00
33 Kasa steril 16 cmx16 cm DAK ktk 15,000.00 - 5 3,541.00 17,705.00
34 Masker Hijab DAK Ktk 50 70 1,448.00 101,360.00 1,448.00 -
TOTAL 360,368 - 474,470
APBD APBD APBD
35 Alat Suntik Sekali Pakai 3 ML APBD ktk 100 15 924.00 13,860.00
36 Ambroxol 30 mg APBD ktk 100 - 100 111.00 11,100.00
37 Ibu brofen 500 mg APBD ktk 100 - 100 401.00 40,100.00
38 Amoxillin syrup APBD botol - 10 10,850.00 108,500.00
39 simpastatitin APBD btl - 100 150.00 15,000.00
TOTAL - - 174,700
APBN APBN APBN
40 Tablet Tambah Darah APBN - 300 213.00 63,900.00
41 Zink tablet APBN ktk 100 - 100 153.00 15,300.00
TOTAL - - 79,200
JKN KAPITASI JKN KP JKN KP
42 Ambroxol 30 mg JKN KP Ktk 100 150.00 - - 150.00 -
43 Alkohol swab JKN KP Box100 143.00 - 100 143.00 14,300.00
44 Cat-Gut Chromic 3/0 JKN KP Ktk24 9,081.00 - 1 9,081.00 9,081.00
45 Thiamin HCl ( Vit B1) JKN KP ktk100 132.00 - 100 253.00 25,300.00
TOTAL - - 48,681.00
TOTAL KESELURUHAN TOTAL 360,368.00 TOTAL 777,051.00

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek

drg. Novi Heriyanto Soekri

NIP. 196711172000031004
ERBEKALAN KESEHATAN DI POLINDES SEPAN
BAT DAN PERBEKALAN KESEHATAN
PKM SOTEK
EMBER TAHUN 2023

SALDO AKHIR PERMIN

JLH TOTAL
OBAT PENGEL NILAI TAAN
ED UARAN 31-Dec-23 Jan-24

Jumlah Harga Nilai JUMLAH

DAK
- - 80 153.00 12,240.00
- - 90 454.00 40,860.00
1 4,300.00 4,300.00 - 5
50 11,550.00 150 231.00 34,650.00
30 1,680.00 70 56.00 3,920.00
40 800.00 160 20.00 3,200.00
50 2,300.00 150 46.00 6,900.00
50 5,850.00 150 117.00 17,550.00
- - 200 93.00 18,600.00
40 2,720.00 160 68.00 10,880.00
15 660.00 40 44.00 1,760.00
60 104,700.00 140 1,745.00 244,300.00
10 750.00 20 75.00 1,500.00
3 42,819.00 2 14,273.00 28,546.00 3
180 10,980.00 50 61.00 3,050.00
50 1,200.00 150 24.00 3,600.00
- - 80 133.00 10,640.00
- - 100 77.00 7,700.00
- - 2 3,756.00 7,512.00
- - 160 140.00 22,400.00
- - 5 1,900.00 9,500.00
40 4,360.00 60 109.00 6,540.00
40 4,920.00 60 123.00 7,380.00
- - 3 2,600.00 7,800.00
60 13,500.00 140 225.00 31,500.00
- - 90 781.00 70,290.00
- - 2 7,703.00 15,406.00 2
- - 60 51.00 3,060.00
- - 20 255.00 5,100.00
30 1,800.00 70 60.00 4,200.00
20 5,060.00 253.00 - 100
50 69,600.00 70 1,392.00 97,440.00
2 30,000.00 3 15,000.00
- - 70 1,448.00 101,360.00
319,549 839,384.00
APBD
5 4,620.00 10 924.00 9,240.00
100 11,100.00 111.00 -
55 22,055.00 45 401.00 18,045.00
 1 10,850.00 9 10,850.00 97,650.00
30 4,500.00 70 150.00 10,500.00
48,505 126,195.00
APBN
250 53,250.00 50 213.00 10,650.00
20 3,060.00 80 153.00 12,240.00
56,310 22,890.00
JKN KP
- - 150.00 -
40 5,720.00 60 143.00 8,580.00
1 9,081.00 9,081.00 -
80 10,560.00 20 132.00 2,640.00
25,361.00 11,220.00
449,725.00 TOTAL 999,689.00

Sotek, 31 Desember 2023

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN
KEGIATAN PENGADAAN OBAT DAN PERBEKALAN KE
UPT PKM SOTEK
BULAN JANUARI 2024

SALDO AWAL PENERIMAAN DARI GUDAN

SUMBER FARMASI PUSKESMAS
NO NAMA BARANG DANA KEMASAN
1-Jan-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Acetosal 500 mg DAK Ktk100 80 153.00 12,240.00
2 Acyclovir 400 mg DAK ktk 100 90 454.00 40,860.00
3 Albendazole Syr DAK Btl 1 4,300.00 4,300.00
4 Amoksisilin 500 mg DAK ktk 100 150 231.00 34,650.00
5 Amlodipin 5 mg DAK ktk 30 70 56.00 3,920.00
6 Antasida doen tab DAK ktk 100 160 20.00 3,200.00
7 Asam Askorbat (Vit C) 50 mg DAK KTK@100 150 46.00 6,900.00
8 Asam Mefenamat 500 mg DAK ktk 100 150 117.00 17,550.00
9 Betahistine 6 mg DAK ktk 30 200 93.00 18,600.00
10 Captopril 12,5 mg DAK ktk 100 160 68.00 10,880.00
11 Cyanocobalamin ( Vit B12 ) DAK Ktk 100 40 44.00 1,760.00
12 Deksamethasone DAK ktk 100 140 1,745.00 244,300.00
13 Domperidon 10 mg DAK ktk 100 20 75.00 1,500.00
14 Herbakof syr DAK Btl 2 14,273.00 28,546.00
15 Kalsium laktat 500 mg DAK Ktk100 50 61.00 3,050.00
16 Klorfeniramin Maleat (CTM) DAK ktk 100 150 24.00 3,600.00
17 Kotrimoksasol 480 mg DAK ktk 100 80 133.00 10,640.00
18 Metformin 500 mg DAK ktk 100 100 77.00 7,700.00
19 Metronidazol Sirup DAK btl 60 ml 2 3,756.00 7,512.00
20 Metronidazol 500 mg DAK ktk 100 160 140.00 22,400.00
21 Miconazole 2% krem DAK tube 5 1,900.00 9,500.00
22 Natrium diklofenak 50 mg DAK kotak 60 109.00 6,540.00
23 Nifedipin tab DAK ktk 100 60 123.00 7,380.00
24 Oxytetrasiklin salep mata DAK ktk 25 3 2,600.00 7,800.00
25 Paracetamol tab 500 mg DAK ktk 100 140 225.00 31,500.00
26 Phitomenadion Vit K DAK ktk 100 90 781.00 70,290.00
27 Ringer Laktat Infus DAK btl 2 7,703.00 15,406.00
28 Salbutamol 2 Mg DAK Ktk100 60 51.00 3,060.00
29 Tablet Tambah Darah DAK ktk 30 20 255.00 5,100.00
30 Vit B Komplek Tablet DAK btl 100 70 60.00 4,200.00
31 Zink tablet DAK Ktk 100 253.00 -
32 Hand Scoon M DAK Box100 70 1,392.00 97,440.00
33 Kasa steril 16 cmx16 cm DAK ktk 3 15,000.00
34 Masker Hijab DAK Ktk 50 70 1,448.00 101,360.00
TOTAL 843,684 TOTAL
APBD APBD APBD
35 Alat Suntik Sekali Pakai 3 ML APBD ktk 100 10 924.00
36 Ambroxol 30 mg APBD ktk 100 111.00 -
37 Ibu brofen 500 mg APBD ktk 100 45 401.00 18,045.00
38 Amoxillin syrup APBD botol 9 10,850.00 97,650.00
39 simpastatitin APBD btl 70 150.00 10,500.00
TOTAL 126,195.00 TOTAL
APBN APBN APBN
40 Tablet Tambah Darah APBN 50 213.00 10,650.00
41 Zink tablet APBN ktk 100 80 153.00 12,240.00
TOTAL 22,890
JKN KAPITASI JKN KP JKN KP
42 Ambroxol 30 mg JKN KP Ktk 100 150.00 -
43 Alkohol swab JKN KP Box100 60 143.00 8,580.00
44 Cat-Gut Chromic 3/0 JKN KP Ktk24 9,081.00 -
45 Thiamin HCl ( Vit B1) JKN KP ktk100 20 132.00 2,640.00
TOTAL 11,220.00
TOTAL KESELURUHAN TOTAL 1,003,989.00 TOTAL

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek

drg. Novi Heriyanto Soekri

NIP. 196711172000031004
N PERBEKALAN KESEHATAN DI POLINDES SEPAN
N OBAT DAN PERBEKALAN KESEHATAN
UPT PKM SOTEK
LAN JANUARI 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 31-Jan-24 Feb-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
153.00 80 12,240.00 153.00 -
Note : kolom Warna
454.00 - - - 90 454.00 40,860.00 kuning jangan di hapus
4,300.00 - 1 4,300.00 4,300.00 - 5 ada rumusnya
231.00 - 130 30,030.00 20 231.00 4,620.00 200
70.00 - 50 2,800.00 20 56.00 1,120.00 200
117.00 - 100 2,000.00 60 20.00 1,200.00
46.00 - 120 5,520.00 30 46.00 1,380.00 100
117.00 - 130 15,210.00 20 117.00 2,340.00 200
93.00 - 10 930.00 190 93.00 17,670.00
68.00 - - - 160 68.00 10,880.00
44.00 - - 40 44.00 1,760.00
62.00 - 100 174,500.00 40 1,745.00 69,800.00 200
75.00 - 20 1,500.00 75.00 - 100
14,273.00 - - - 2 14,273.00 28,546.00
61.00 - 50 3,050.00 61.00 - 300
24.00 - 90 2,160.00 60 24.00 1,440.00 100
133.00 - - - 80 133.00 10,640.00
77.00 - - - 100 77.00 7,700.00
3,756.00 - - - 2 3,756.00 7,512.00
140.00 - - - 160 140.00 22,400.00
1,900.00 - 3 5,700.00 2 1,900.00 3,800.00
109.00 - 60 6,540.00 - 109.00 - 200
123.00 - - - 60 123.00 7,380.00
2,600.00 - 1 2,600.00 2 2,600.00 5,200.00
225.00 - 135 30,375.00 5 225.00 1,125.00 200
781.00 - - - 90 781.00 70,290.00
7,703.00 - - - 2 7,703.00 15,406.00 2
51.00 - - - 60 51.00 3,060.00
255.00 - 20 5,100.00 255.00 - 300
100.00 - 30 1,800.00 40 60.00 2,400.00
253.00 - - - 253.00 - 100
1,392.00 - 5 6,960.00 65 1,392.00 90,480.00
3,541.00 - 1 15,000.00 2 15,000.00 30,000.00
 1,448.00 - 30 43,440.00 110 1,448.00 159,280.00
- 371,755 618,289.00
APBD
924.00 - 10 9,240.00 924.00 - 15
111.00 - - - 111.00 -
401.00 - 45 18,045.00 401.00 - 200
10,850.00 - 4 43,400.00 5 10,850.00 54,250.00
150.00 - 20 3,000.00 50 150.00 7,500.00
- 73,685.00 61,750.00
APBN
213.00 - 50 10,650.00 213.00 - 300
153.00 - 20 3,060.00 60 153.00 9,180.00
- 13,710 9,180.00
JKN KP
150.00 - - - 150.00 -
143.00 - 20 2,860.00 40 143.00 5,720.00
9,081.00 - - - 9,081.00 -
253.00 - 10 1,320.00 10 132.00 1,320.00
- 4,180.00 7,040.00
- 463,330.00 TOTAL 696,259.00

Sotek, 31 Januari 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek

Novi Heriyanto Soekri

96711172000031004
 Note : kolom Warna
kuning jangan di hapus
ada rumusnya
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHA
KEGIATAN PENGADAAN OBAT DAN PERBEKALA
UPT PKM SOTEK
BULAN FEBRUARI 2024

SALDO AWAL PENERIMAAN DAR

SUMBER FARMASI PUSK
NO NAMA BARANG DANA KEMASAN
1-Feb-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Acetosal 500 mg DAK Ktk100 153.00 -
2 Acyclovir 400 mg DAK ktk 100 90 454.00 40,860.00
3 Albendazole Syr DAK Btl 4,300.00 -
4 Amoksisilin 500 mg DAK ktk 100 20 231.00 4,620.00
5 Amlodipin 5 mg DAK ktk 30 20 56.00 1,120.00
6 Antasida doen tab DAK ktk 100 60 20.00 1,200.00
7 Asam Askorbat (Vit C) 50 mg DAK KTK@100 30 46.00 1,380.00
8 Asam Mefenamat 500 mg DAK ktk 100 20 117.00 2,340.00
9 Betahistine 6 mg DAK ktk 30 190 93.00 17,670.00
10 Captopril 12,5 mg DAK ktk 100 160 68.00 10,880.00
11 Cyanocobalamin ( Vit B12 ) DAK Ktk 100 40 44.00 1,760.00
12 Deksamethasone DAK ktk 100 40 1,745.00 69,800.00
13 Domperidon 10 mg DAK ktk 100 75.00 -
14 Herbakof syr DAK Btl 2 14,273.00 28,546.00
15 Kalsium laktat 500 mg DAK Ktk100 61.00 - 300
16 Klorfeniramin Maleat (CTM) DAK ktk 100 60 24.00 1,440.00
17 Kotrimoksasol 480 mg DAK ktk 100 80 133.00 10,640.00
18 Metformin 500 mg DAK ktk 100 100 77.00 7,700.00
19 Metronidazol Sirup DAK btl 60 ml 2 3,756.00 7,512.00
20 Metronidazol 500 mg DAK ktk 100 160 140.00 22,400.00
21 Miconazole 2% krem DAK tube 2 1,900.00 3,800.00
22 Natrium diklofenak 50 mg DAK kotak - 109.00 -
23 Nifedipin tab DAK ktk 100 60 123.00 7,380.00
24 Oxytetrasiklin salep mata DAK ktk 25 2 2,600.00 5,200.00
25 Paracetamol tab 500 mg DAK ktk 100 5 225.00 1,125.00
26 Phitomenadion Vit K DAK ktk 100 90 781.00 70,290.00
27 Ringer Laktat Infus DAK btl 2 7,703.00 15,406.00
28 Salbutamol 2 Mg DAK Ktk100 60 51.00 3,060.00
29 Tablet Tambah Darah DAK ktk 30 255.00 -
30 Vit B Komplek Tablet DAK btl 100 40 60.00 2,400.00
31 Zink tablet DAK Ktk 100 253.00 -
32 Hand Scoon M DAK Box100 65 1,392.00 90,480.00
33 Kasa steril 16 cmx16 cm DAK ktk 2 15,000.00 30,000.00
34 Masker Hijab DAK Ktk 50 110 1,448.00 159,280.00
TOTAL 618,289 TOTAL
APBD APBD APBD
35 Alat Suntik Sekali Pakai 3 ML APBD ktk 100 924.00 - 4
36 Amoksisilin 500 mg apbd APBD - 200
37 Ambroxol 30 mg APBD ktk 100 111.00 -
38 chlorpheniramine Maleat 4 mg (ctm) APBD - 100
39 Domperidon 10 mg APBD ktk 100 - 100
40 Ibu brofen 500 mg APBD ktk 100 401.00 -
41 Natrium diklofenak 50 mg APBD Ktk 50 - 200
42 Amoxillin syrup APBD botol 5 10,850.00 54,250.00
43 simpastatitin APBD btl 50 150.00 7,500.00
TOTAL 61,750.00 TOTAL
APBN APBN APBN
44 Tablet Tambah Darah APBN 213.00 - 300
45 Zink tablet APBN ktk 100 - 100
46 Zink tablet APBN ktk 100 60 153.00 9,180.00
TOTAL 9,180 TOTAL
BUFFER STOK BUFFER STOK BUFFER STOK
47 Amlidipin 5 mg Bs BUFFER STOK ktk 100 - 100
48 Asam Askorbat (Vit C) 50 mg BUFFER STOK - 100
49 Deksamethasone 0,5 mg BUFFER STOK - 100
50 Paracetamol tab 500 mg BUFFER STOK ktk 100 - 200
TOTAL -
JKN KAPITASI JKN KP JKN KP
51 Ambroxol 30 mg JKN KP Ktk 100 150.00 -
52 Alkohol swab JKN KP Box100 40 143.00 5,720.00
53 Cat-Gut Chromic 3/0 JKN KP Ktk24 9,081.00 -
54 Thiamin HCl ( Vit B1) JKN KP ktk100 10 132.00 1,320.00
TOTAL 7,040.00 TOTAL
TOTAL KESELURUHAN TOTAL 696,259.00 TOTAL

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek

drg. Novi Heriyanto Soekri

NIP. 196711172000031004
 PERBEKALAN KESEHATAN DI POLINDES SEPAN
OBAT DAN PERBEKALAN KESEHATAN
PT PKM SOTEK
N FEBRUARI 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 28-Feb-24 Mar-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
153.00 - - 153.00 -
454.00 - 40 18,160.00 50 454.00 22,700.00
4,300.00 - - - 4,300.00 - 5
231.00 - 20 4,620.00 - 231.00 - 200
70.00 - 20 1,400.00 - 70.00 - 200
117.00 - 60 7,020.00 117.00 -
46.00 - - - 30 46.00 1,380.00 100
117.00 - 20 2,340.00 117.00 - 200
93.00 - 100 9,300.00 90 93.00 8,370.00
68.00 - 100 6,800.00 60 68.00 4,080.00
44.00 - 40 1,760.00 44.00 -
62.00 - 40 2,480.00 62.00 - 200
75.00 - - - 75.00 - 100
14,273.00 - 2 28,546.00 14,273.00 -
61.00 18,300.00 300 18,300.00 61.00 - 300
24.00 - 60 1,440.00 24.00 - 100
133.00 - 80 10,640.00 133.00 -
77.00 - 100 7,700.00 77.00 -
3,756.00 - 2 7,512.00 3,756.00 -
140.00 - 130 18,200.00 30 140.00 4,200.00
1,900.00 - 2 3,800.00 1,900.00 -
109.00 - - - 109.00 - 200
123.00 - 60 7,380.00 123.00 -
2,600.00 - 2 5,200.00 2,600.00 -
225.00 - 5 1,125.00 225.00 - 200
781.00 - 90 70,290.00 781.00 -
7,703.00 - 2 15,406.00 7,703.00 - 2
51.00 - 60 3,060.00 51.00 -
255.00 - - - 255.00 - 300
100.00 - 40 4,000.00 100.00 -
253.00 - - - 253.00 - 100
1,392.00 - 65 90,480.00 1,392.00 -
3,541.00 - 2 7,082.00 3,541.00 -
1,448.00 - 110 159,280.00 1,448.00 -
18,300 513,321 40,730.00
APBD
924.00 3,696.00 4 3,696.00 924.00 - 15
 550.00 110,000.00 200 110,000.00 550.00 -
111.00 - - - 111.00 -
63.00 6,300.00 100 6,300.00 63.00 -
160.00 16,000.00 100 16,000.00 160.00 -
401.00 - - - 401.00 - 200
153.00 30,600.00 200 30,600.00 153.00 -
10,850.00 - 5 54,250.00 10,850.00 -
150.00 - 50 7,500.00 150.00 -
166,596.00 228,346.00 -
APBN
255.00 76,500.00 200 51,000.00 100 255.00 25,500.00 300
253.00 25,300.00 80 20,240.00 20 253.00 5,060.00
153.00 - 60 9,180.00 153.00 -
101,800 80,420 30,560.00
BUFFER STOK BUFFER STOK
70 7,000.00 100 7,000.00 70 - 100
72 7,200.00 100 7,200.00 72 -
62 6,200.00 100 6,200.00 62 -
160 32,000.00 200 32,000.00 160 -
52,400 52,400 -
JKN KP
150.00 - - - 150.00 -
143.00 - 40 5,720.00 143.00 -
9,081.00 - - - 9,081.00 -
253.00 - 10 2,530.00 253.00 -
- 8,250.00 -
286,696.00 830,337.00 TOTAL 71,290.00

Sotek, 28 Februari 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek

Novi Heriyanto Soekri

196711172000031004
 Note : kolom Warna
kuning jangan di hapus
ada rumusnya
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN
KEGIATAN PENGADAAN OBAT DAN PERBEKALAN
UPT PKM SOTEK
BULAN MARET 2024

SALDO AWAL PENERIMAAN DARI GU

SUMBER FARMASI PUSKESM
NO NAMA BARANG DANA KEMASAN
1-Mar-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Acyclovir 400 mg DAK ktk 100 50 454.00 22,700.00
2 Asam Askorbat (Vit C) 50 mg DAK KTK@100 30 46.00 1,380.00
3 Betahistine 6 mg DAK ktk 30 90 93.00 8,370.00
4 Captopril 12,5 mg DAK ktk 100 60 68.00 4,080.00
5 Metronidazol 500 mg DAK ktk 100 30 140.00 4,200.00
TOTAL 40,730 TOTAL
APBD APBD APBD
6 Amoksisilin 500 mg apbd APBD 550.00 -
7 Ambroxol 30 mg APBD ktk 100 111.00 -
TOTAL - TOTAL
APBN APBN APBN
8 Tablet Tambah Darah APBN 100 255.00 25,500.00
9 Zink tablet APBN ktk 100 20 253.00 5,060.00
TOTAL 30,560 TOTAL
BUFFER STOK BUFFER STOK BUFFER STOK
10 Amlidipin 5 mg Bs BUFFER STOK ktk 100 70 -
TOTAL -
JKN KAPITASI JKN KP JKN KP
11 Ambroxol 30 mg JKN KP Ktk 100 150.00 -
12 Thiamin HCl ( Vit B1) JKN KP ktk100 253.00 -
TOTAL - TOTAL
TOTAL KESELURUHAN TOTAL 71,290.00 TOTAL

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek
drg. Novi Heriyanto Soekri
NIP. 196711172000031004
 PERBEKALAN KESEHATAN DI POLINDES SEPAN
OBAT DAN PERBEKALAN KESEHATAN
PT PKM SOTEK
AN MARET 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 31-Mar-24 Mar-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
454.00 - 50 22,700.00 454.00 -
46.00 - 30 1,380.00 46.00 - 100
93.00 - 90 8,370.00 93.00 -
68.00 - 60 4,080.00 68.00 -
140.00 - 30 4,200.00 140.00 -
- 40,730 -
APBD
550.00 - - - 550.00 -
111.00 - - - 111.00 -
- - -
APBN
255.00 - - - 100 255.00 25,500.00 300
253.00 - - - 20 253.00 5,060.00
- - 30,560.00
BUFFER STOK BUFFER STOK
70 - - - 70 - 100
- - -
JKN KP
150.00 - - - 150.00 -
253.00 - - - 253.00 -
- - -
- 40,730.00 TOTAL 30,560.00

Sotek, 31 Maret 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek
Novi Heriyanto Soekri
196711172000031004
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN
KEGIATAN PENGADAAN OBAT DAN PERBEKALAN
UPT PKM SOTEK
BULAN APRIL 2024

SALDO AWAL PENERIMAAN DARI GU

SUMBER FARMASI PUSKESM
NO NAMA BARANG DANA KEMASAN
1-Apr-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Albendazole Syr DAK Btl 4,300.00 -
2 Amoksisilin 500 mg DAK ktk 100 - 231.00 -
3 Amlodipin 5 mg DAK ktk 30 - 70.00 -
4 Antasida doen tab DAK ktk 100 117.00 -
5 Asam Askorbat (Vit C) 50 mg DAK KTK@100 46.00 -
TOTAL - TOTAL
APBD APBD APBD
6 Amoksisilin 500 mg apbd APBD 550.00 -
7 Ambroxol 30 mg APBD ktk 100 111.00 -
TOTAL - TOTAL
APBN APBN APBN
8 Tablet Tambah Darah APBN 100 255.00 25,500.00
9 Zink tablet APBN ktk 100 20 253.00 5,060.00
TOTAL 30,560 TOTAL
BUFFER STOK BUFFER STOK BUFFER STOK
10 Amlidipin 5 mg Bs BUFFER STOK ktk 100 70 -
TOTAL -
JKN KAPITASI JKN KP JKN KP
11 Ambroxol 30 mg JKN KP Ktk 100 150.00 -
12 Thiamin HCl ( Vit B1) JKN KP ktk100 253.00 -
TOTAL - TOTAL
TOTAL KESELURUHAN TOTAL 30,560.00 TOTAL

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek
drg. Novi Heriyanto Soekri
NIP. 196711172000031004
 PERBEKALAN KESEHATAN DI POLINDES SEPAN
OBAT DAN PERBEKALAN KESEHATAN
PT PKM SOTEK
AN APRIL 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 31/04/2024 May-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
4,300.00 - - - 4,300.00 - 5
231.00 - - - - 231.00 - 200
70.00 - - - - 70.00 - 200
117.00 - - - 117.00 -
46.00 - - - 46.00 - 100
- - -
APBD
550.00 - - - 550.00 -
111.00 - - - 111.00 -
- - -
APBN
255.00 - - - 100 255.00 25,500.00 300
253.00 - - - 20 253.00 5,060.00
- - 30,560.00
BUFFER STOK BUFFER STOK
70 - - - 70 - 100
- - -
JKN KP
150.00 - - - 150.00 -
253.00 - - - 253.00 -
- - -
- - TOTAL 30,560.00

Sotek, 31 April 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek
Novi Heriyanto Soekri
196711172000031004
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN
KEGIATAN PENGADAAN OBAT DAN PERBEKALAN
UPT PKM SOTEK
BULAN Mei 2024

SALDO AWAL PENERIMAAN DARI GU

SUMBER FARMASI PUSKESM
NO NAMA BARANG DANA KEMASAN
1-May-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Acyclovir 400 mg DAK ktk 100 454.00 -
2 Albendazole Syr DAK Btl 4,300.00 -
3 Amoksisilin 500 mg DAK ktk 100 - 231.00 -
4 Amlodipin 5 mg DAK ktk 30 - 70.00 -
5 Antasida doen tab DAK ktk 100 117.00 -
TOTAL - TOTAL
APBD APBD APBD
6 Amoksisilin 500 mg apbd APBD 550.00 -
7 Ambroxol 30 mg APBD ktk 100 111.00 -
TOTAL - TOTAL
APBN APBN APBN
8 Tablet Tambah Darah APBN 100 255.00 25,500.00
9 Zink tablet APBN ktk 100 20 253.00 5,060.00
TOTAL 30,560 TOTAL
BUFFER STOK BUFFER STOK BUFFER STOK
10 Amlidipin 5 mg Bs BUFFER STOK ktk 100 70 -
TOTAL -
JKN KAPITASI JKN KP JKN KP
11 Ambroxol 30 mg JKN KP Ktk 100 150.00 -
12 Thiamin HCl ( Vit B1) JKN KP ktk100 253.00 -
TOTAL - TOTAL
TOTAL KESELURUHAN TOTAL 30,560.00 TOTAL

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek
drg. Novi Heriyanto Soekri
NIP. 196711172000031004
 PERBEKALAN KESEHATAN DI POLINDES SEPAN
OBAT DAN PERBEKALAN KESEHATAN
PT PKM SOTEK
LAN Mei 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 31-May-24 Jun-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
454.00 - - - 454.00 -
4,300.00 - - - 4,300.00 - 5
231.00 - - - - 231.00 - 200
70.00 - - - - 70.00 - 200
117.00 - - - 117.00 -
- - -
APBD
550.00 - - - 550.00 -
111.00 - - - 111.00 -
- - -
APBN
255.00 - - - 100 255.00 25,500.00 300
253.00 - - - 20 253.00 5,060.00
- - 30,560.00
BUFFER STOK BUFFER STOK
70 - - - 70 - 100
- - -
JKN KP
150.00 - - - 150.00 -
253.00 - - - 253.00 -
- - -
- - TOTAL 30,560.00

Sotek, 31 Mei 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek
Novi Heriyanto Soekri
196711172000031004
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHA
KEGIATAN PENGADAAN OBAT DAN PERBEKALA
UPT PKM SOTEK
BULAN JUNI 2024

SALDO AWAL PENERIMAAN DAR

SUMBER FARMASI PUSK
NO NAMA BARANG DANA KEMASAN
01-Jun-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Acetosal 500 mg DAK Ktk100 153.00 - -
2 Acyclovir 400 mg DAK ktk 100 454.00 - -
3 Albendazole Syr DAK Btl 4,300.00 - -
4 Amoksisilin 500 mg DAK ktk 100 - 231.00 - 200
5 Amlodipin 5 mg DAK ktk 30 - 70.00 - 200
6 Antasida doen tab DAK ktk 100 117.00 -
7 Asam Askorbat (Vit C) 50 mg DAK KTK@100 46.00 -
8 Asam Mefenamat 500 mg DAK ktk 100 117.00 -
9 Betahistine 6 mg DAK ktk 30 93.00 -
10 Captopril 12,5 mg DAK ktk 100 68.00 -
11 Cyanocobalamin ( Vit B12 ) DAK Ktk 100 44.00 -
12 Deksamethasone DAK ktk 100 62.00 -
13 Domperidon 10 mg DAK ktk 100 75.00 -
14 Herbakof syr DAK Btl 14,273.00 -
15 Kalsium laktat 500 mg DAK Ktk100 61.00 -
16 Klorfeniramin Maleat (CTM) DAK ktk 100 24.00 -
17 Kotrimoksasol 480 mg DAK ktk 100 133.00 -
18 Metformin 500 mg DAK ktk 100 77.00 -
19 Metronidazol Sirup DAK btl 60 ml 3,756.00 -
20 Metronidazol 500 mg DAK ktk 100 140.00 -
21 Miconazole 2% krem DAK tube 1,900.00 -
22 Natrium diklofenak 50 mg DAK kotak 109.00 -
23 Nifedipin tab DAK ktk 100 123.00 -
24 Oxytetrasiklin salep mata DAK ktk 25 2,600.00 -
25 Paracetamol tab 500 mg DAK ktk 100 225.00 -
26 Phitomenadion Vit K DAK ktk 100 781.00 -
27 Ringer Laktat Infus DAK btl 7,703.00 -
28 Salbutamol 2 Mg DAK Ktk100 51.00 - -
29 Tablet Tambah Darah DAK ktk 30 255.00 -
30 Vit B Komplek Tablet DAK btl 100 100.00 -
31 Zink tablet DAK Ktk 100 253.00 -
32 Hand Scoon M DAK Box100 1,392.00 -
33 Kasa steril 16 cmx16 cm DAK ktk 3,541.00 -
34 Masker Hijab DAK Ktk 50 1,448.00 -
35 Ceterizine DAK ktk 100
TOTAL - -
APBD APBD APBD
36 Alat Suntik Sekali Pakai 3 ML APBD ktk 100 924.00 -
37 Amoksisilin 500 mg apbd APBD 550.00 -
38 Ambroxol 30 mg APBD ktk 100 111.00 -
39 chlorpheniramine Maleat 4 mg (ctm) APBD 63.00 - 200
40 Domperidon 10 mg APBD ktk 100 160.00 - 100
41 Ibu brofen 500 mg APBD ktk 100 401.00 - 200
42 Natrium diklofenak 50 mg APBD Ktk 50 153.00 -
43 Amoxillin syrup APBD botol 10,850.00 -
44 simpastatitin APBD btl 150.00 -
44 asam mefenamat 500 mg APBD ktk 100 225.00 - 200
45 Dexamethasone 0,5 mg APBD ktk 100 71.00 - 200
46 Kalsium laktat 500 mg APBD ktk 100 223.00 - 200
TOTAL - -
APBN APBN APBN
48 Tablet Tambah Darah APBN 100 255.00 25,500.00 200
49 Zink tablet APBN ktk 100 20 253.00 5,060.00
50 Zink tablet APBN ktk 100 153.00 -
TOTAL 30,560 -
BUFFER STOK BUFFER STOK BUFFER STOK
51 Amlodipin 5 mg Bs BUFFER STOK ktk 100 70 -
52 Asam Askorbat (Vit C) 50 mg BUFFER STOK ktk 100 72 - 200
53 Deksamethasone 0,5 mg BUFFER STOK 62 -
54 Paracetamol tab 500 mg BUFFER STOK ktk 100 160 - 200
54 Natrium diklofenak 50 mg BUFFER STOK ktk 25 156 250
55 ZInk tablet BS BUFFER STOK ktk 100 141 200
TOTAL -
JKN KAPITASI JKN KP JKN KP
57 Ambroxol 30 mg JKN KP Ktk 100 150.00 - -
58 Alkohol swab JKN KP Box100 143.00 -
59 Cat-Gut Chromic 3/0 JKN KP Ktk24 9,081.00 -
60 Thiamin HCl ( Vit B1) JKN KP ktk100 253.00 -
TOTAL -
TOTAL KESELURUHAN TOTAL 30,560.00 TOTAL

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek

drg. Novi Heriyanto Soekri

NIP. 196711172000031004
 PERBEKALAN KESEHATAN DI POLINDES SEPAN
OBAT DAN PERBEKALAN KESEHATAN
PT PKM SOTEK
LAN JUNI 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 31/06/2024 Jul-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
153.00 - - 153.00 -
454.00 - - - 454.00 -
4,300.00 - - - 4,300.00 - 5
551.00 110,200.00 60 13,860.00 140 231.00 32,340.00
324.00 64,800.00 100 7,000.00 100 70.00 7,000.00
117.00 - - - 117.00 -
46.00 - - - 46.00 -
117.00 - - - 117.00 -
93.00 - - - 93.00 -
68.00 - - - 68.00 -
44.00 - - - 44.00 -
62.00 - - - 62.00 - 200
75.00 - - - 75.00 - 100
14,273.00 - - - 14,273.00 -
61.00 - - - 61.00 - 300
24.00 - - - 24.00 - 100
133.00 - - - 133.00 -
77.00 - - - 77.00 -
3,756.00 - - - 3,756.00 -
140.00 - - - 140.00 -
1,900.00 - - - 1,900.00 -
109.00 - - - 109.00 - 200
123.00 - - - 123.00 -
2,600.00 - - - 2,600.00 -
225.00 - - - 225.00 - 200
781.00 - - - 781.00 -
7,703.00 - - - 7,703.00 - 2
51.00 - - - 51.00 -
255.00 - - - 255.00 - 300
100.00 - - - 100.00 -
253.00 - - - 253.00 - 100
1,392.00 - - - 1,392.00 -
3,541.00 - - - 3,541.00 -
1,448.00 - - - 1,448.00 -
- - 200
175,000 20,860 39,340.00
APBD
 924.00 - - - 924.00 - 15
550.00 - - - 550.00 -
111.00 - - - 111.00 -
63.00 12,600.00 10 630.00 190 63.00 11,970.00
160.00 16,000.00 10 1,600.00 90 160.00 14,400.00
333.00 66,600.00 60 24,060.00 140 401.00 56,140.00
153.00 - - - 153.00 -
10,850.00 - - - 10,850.00 -
150.00 - - - 150.00 -
225.00 45,000.00 20 4,500.00 180 225.00 40,500.00
71.00 14,200.00 80 5,680.00 120 71.00 8,520.00
223.00 44,600.00 30 6,690.00 170 223.00 37,910.00
95,200.00 26,290.00 82,510.00
APBN
72.00 14,400.00 130 33,150.00 170 255.00 43,350.00
253.00 - - - 20 253.00 5,060.00
153.00 - - - 153.00 -
14,400 33,150 48,410.00
BUFFER STOK BUFFER STOK
70 - - - 70 - 100
72 14,400.00 40 2,880.00 160 72 11,520.00
62 - - - 62 -
160 32,000.00 40 6,400.00 160 160 25,600.00
156 39,000.00 60 9,360.00 190 156
141 28,200.00 - - 200 141
46,400 9,280 37,120
JKN KP
150.00 - - - 150.00 -
143.00 - - - 143.00 -
9,081.00 - - - 9,081.00 -
253.00 - - - 253.00 -
- - -
284,600.00 80,300.00 TOTAL 207,380.00

Sotek, 30 Juni 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek

Novi Heriyanto Soekri

196711172000031004
 Note : kolom Warna
kuning jangan di hapus
ada rumusnya
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHA
KEGIATAN PENGADAAN OBAT DAN PERBEKALA
UPT PKM SOTEK
BULAN JULI 2024

SALDO AWAL PENERIMAAN DAR

SUMBER FARMASI PUSK
NO NAMA BARANG DANA KEMASAN
01-Jul-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Acetosal 500 mg DAK Ktk100 153.00 - -
2 Acyclovir 400 mg DAK ktk 100 454.00 - -
3 Albendazole Syr DAK Btl 4,300.00 - -
4 Amoksisilin 500 mg DAK ktk 100 140 231.00 32,340.00
5 Amlodipin 5 mg DAK ktk 30 100 70.00 7,000.00 100
6 Antasida doen tab DAK ktk 100 117.00 -
7 Asam Askorbat (Vit C) 50 mg DAK KTK@100 46.00 -
8 Asam Mefenamat 500 mg DAK ktk 100 117.00 -
9 Betahistine 6 mg DAK ktk 30 93.00 -
10 Captopril 12,5 mg DAK ktk 100 68.00 -
11 Cyanocobalamin ( Vit B12 ) DAK Ktk 100 44.00 -
12 Deksamethasone DAK ktk 100 62.00 -
13 Domperidon 10 mg DAK ktk 100 75.00 -
14 Herbakof syr DAK Btl 14,273.00 -
15 Kalsium laktat 500 mg DAK Ktk100 61.00 -
16 Klorfeniramin Maleat (CTM) DAK ktk 100 24.00 -
17 Kotrimoksasol 480 mg DAK ktk 100 133.00 -
18 Metformin 500 mg DAK ktk 100 77.00 -
19 Metronidazol Sirup DAK btl 60 ml 3,756.00 -
20 Metronidazol 500 mg DAK ktk 100 140.00 -
21 Miconazole 2% krem DAK tube 1,900.00 -
22 Natrium diklofenak 50 mg DAK kotak 109.00 -
23 Nifedipin tab DAK ktk 100 123.00 -
24 Oxytetrasiklin salep mata DAK ktk 25 2,600.00 -
25 Paracetamol tab 500 mg DAK ktk 100 225.00 -
26 Phitomenadion Vit K DAK ktk 100 781.00 -
27 Ringer Laktat Infus DAK btl 7,703.00 -
28 Salbutamol 2 Mg DAK Ktk100 51.00 - -
29 Tablet Tambah Darah DAK ktk 30 255.00 -
30 Vit B Komplek Tablet DAK btl 100 100.00 -
31 Zink tablet DAK Ktk 100 253.00 -
32 Hand Scoon M DAK Box100 1,392.00 -
33 Kasa steril 16 cmx16 cm DAK ktk 3,541.00 -
34 Masker Hijab DAK Ktk 50 1,448.00 -
35 Ceterizine DAK ktk 100
TOTAL 39,340 -
APBD APBD APBD
36 Alat Suntik Sekali Pakai 3 ML APBD ktk 100 924.00 -
37 Amoksisilin 500 mg apbd APBD 550.00 -
38 Ambroxol 30 mg APBD ktk 100 111.00 -
39 chlorpheniramine Maleat 4 mg (ctm) APBD 190 63.00 11,970.00 200
40 Domperidon 10 mg APBD ktk 100 90 160.00 14,400.00 100
41 Ibu brofen 500 mg APBD ktk 100 140 401.00 56,140.00 200
42 Natrium diklofenak 50 mg APBD Ktk 50 153.00 -
43 Amoxillin syrup APBD botol 10,850.00 -
44 simpastatitin APBD btl 150.00 -
44 asam mefenamat 500 mg APBD ktk 100 180 225.00 40,500.00 200
45 Dexamethasone 0,5 mg APBD ktk 100 120 71.00 8,520.00 200
46 Kalsium laktat 500 mg APBD ktk 100 170 223.00 37,910.00 200
TOTAL 82,510.00 -
APBN APBN APBN
48 Tablet Tambah Darah APBN ktk 100 170 255.00 43,350.00 200
49 Zink tablet APBN ktk 100 20 253.00 5,060.00
50 Zink tablet APBN ktk 100 153.00 -
TOTAL 48,410 -
BUFFER STOK BUFFER STOK BUFFER STOK
51 Amlodipin 5 mg Bs BUFFER STOK ktk 100 70 -
52 Asam Askorbat (Vit C) 50 mg BUFFER STOK ktk 100 160 72 11,520.00 200
53 Deksamethasone 0,5 mg BUFFER STOK 62 -
54 Paracetamol tab 500 mg BUFFER STOK ktk 100 160 160 25,600.00 200
54 Natrium diklofenak 50 mg BUFFER STOK ktk 25 190 156 250
55 ZInk tablet BS BUFFER STOK ktk 100 200 141 200
TOTAL 37,120
JKN KAPITASI JKN KP JKN KP
57 Ambroxol 30 mg JKN KP Ktk 100 150.00 - -
58 Alkohol swab JKN KP Box100 143.00 -
59 Cat-Gut Chromic 3/0 JKN KP Ktk24 9,081.00 -
60 Thiamin HCl ( Vit B1) JKN KP ktk100 253.00 -
TOTAL -
TOTAL KESELURUHAN TOTAL 207,380.00 TOTAL

Mengetahui,
Apoteker Penanggung Jawab

apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek

drg. Novi Heriyanto Soekri

NIP. 196711172000031004
 PERBEKALAN KESEHATAN DI POLINDES SEPAN
OBAT DAN PERBEKALAN KESEHATAN
PT PKM SOTEK
LAN JULI 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 31-Jul-24 Aug-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
153.00 - - 153.00 -
454.00 - - - 454.00 -
4,300.00 - - - 4,300.00 - 5
551.00 - 40 9,240.00 100 231.00 23,100.00
324.00 32,400.00 120 8,400.00 80 70.00 5,600.00
117.00 - - - 117.00 - 100
46.00 - - - 46.00 -
117.00 - - - 117.00 -
93.00 - - - 93.00 -
68.00 - - - 68.00 -
44.00 - - - 44.00 -
62.00 - - - 62.00 - 200
75.00 - - - 75.00 - 100
14,273.00 - - - 14,273.00 -
61.00 - - - 61.00 - 300
24.00 - - - 24.00 - 100
133.00 - - - 133.00 -
77.00 - - - 77.00 -
3,756.00 - - - 3,756.00 -
140.00 - - - 140.00 -
1,900.00 - - - 1,900.00 -
109.00 - - - 109.00 - 200
123.00 - - - 123.00 -
2,600.00 - - - 2,600.00 -
225.00 - - - 225.00 - 200
781.00 - - - 781.00 -
7,703.00 - - - 7,703.00 - 2
51.00 - - - 51.00 -
255.00 - - - 255.00 - 300
100.00 - - - 100.00 -
253.00 - - - 253.00 - 100
1,392.00 - - - 1,392.00 -
3,541.00 - - - 3,541.00 -
1,448.00 - - - 1,448.00 -
- - 200
32,400 17,640 28,700.00
APBD
 924.00 - - - 924.00 - 15
550.00 - - - 550.00 -
111.00 - - - 111.00 -
63.00 12,600.00 160 10,080.00 230 63.00 14,490.00
160.00 16,000.00 70 11,200.00 120 160.00 19,200.00
333.00 66,600.00 90 36,090.00 250 401.00 100,250.00
153.00 - - - 153.00 -
10,850.00 - - - 10,850.00 -
150.00 - - - 150.00 -
225.00 45,000.00 300 67,500.00 80 225.00 18,000.00
71.00 14,200.00 180 12,780.00 140 71.00 9,940.00
223.00 44,600.00 260 57,980.00 110 223.00 24,530.00
95,200.00 57,370.00 133,940.00
APBN
72.00 14,400.00 120 30,600.00 250 255.00 63,750.00
253.00 - - - 20 253.00 5,060.00
153.00 - - - 153.00 -
14,400 30,600 68,810.00
BUFFER STOK BUFFER STOK
70 - - - 70 - 100
72 14,400.00 200 14,400.00 160 72 11,520.00
62 - - - 62 -
160 32,000.00 200 32,000.00 160 160 25,600.00
156 39,000.00 250 39,000.00 190 156 100
141 28,200.00 200 28,200.00 200 141
46,400 46,400 37,120
JKN KP
150.00 - - - 150.00 -
143.00 - - - 143.00 - 1 ktk
9,081.00 - - - 9,081.00 -
253.00 - - - 253.00 - 100
- - -
142,000.00 105,610.00 TOTAL 268,570.00

Sotek, 30 Juli 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek

Novi Heriyanto Soekri

196711172000031004
 Note : kolom Warna
kuning jangan di hapus
ada rumusnya
 LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHA
KEGIATAN PENGADAAN OBAT DAN PERBEKALA
UPT PKM SOTEK
BULAN AGUSTUS 2024

SALDO AWAL PENERIMAAN DAR

SUMBER FARMASI PUSK
NO NAMA BARANG DANA KEMASAN
01-Aug-24
Jumlah Harga/ Nilai Jumlah
DAK DAK DAK
1 Acetosal 500 mg DAK Ktk100 153.00 - -
2 Acyclovir 400 mg DAK ktk 100 454.00 - -
3 Albendazole Syr DAK Btl 4,300.00 - -
4 Amoksisilin 500 mg DAK ktk 100 100 231.00 23,100.00
5 Amlodipin 5 mg DAK ktk 30 80 70.00 5,600.00
6 Antasida doen tab DAK ktk 100 117.00 -
7 Asam Askorbat (Vit C) 50 mg DAK KTK@100 46.00 -
8 Asam Mefenamat 500 mg DAK ktk 100 117.00 -
9 Betahistine 6 mg DAK ktk 30 93.00 -
10 Captopril 12,5 mg DAK ktk 100 68.00 -
11 Cyanocobalamin ( Vit B12 ) DAK Ktk 100 44.00 -
12 Deksamethasone DAK ktk 100 62.00 -
13 Domperidon 10 mg DAK ktk 100 75.00 -
14 Herbakof syr DAK Btl 14,273.00 -
15 Kalsium laktat 500 mg DAK Ktk100 61.00 -
16 Klorfeniramin Maleat (CTM) DAK ktk 100 24.00 -
17 Kotrimoksasol 480 mg DAK ktk 100 133.00 -
18 Metformin 500 mg DAK ktk 100 77.00 -
19 Metronidazol Sirup DAK btl 60 ml 3,756.00 -
20 Metronidazol 500 mg DAK ktk 100 140.00 -
21 Miconazole 2% krem DAK tube 1,900.00 -
22 Natrium diklofenak 50 mg DAK kotak 109.00 -
23 Nifedipin tab DAK ktk 100 123.00 -
24 Oxytetrasiklin salep mata DAK ktk 25 2,600.00 -
25 Paracetamol tab 500 mg DAK ktk 100 225.00 -
26 Phitomenadion Vit K DAK ktk 100 781.00 -
27 Ringer Laktat Infus DAK btl 7,703.00 -
28 Salbutamol 2 Mg DAK Ktk100 51.00 - -
29 Tablet Tambah Darah DAK ktk 30 255.00 -
30 Vit B Komplek Tablet DAK btl 100 100.00 -
31 Zink tablet DAK Ktk 100 253.00 -
32 Hand Scoon M DAK Box100 1,392.00 -
33 Kasa steril 16 cmx16 cm DAK ktk 3,541.00 -
34 Masker Hijab DAK Ktk 50 1,448.00 -
35 Ceterizine DAK ktk 100 -
TOTAL 28,700 -
APBD APBD APBD
36 Alat Suntik Sekali Pakai 3 ML APBD ktk 100 924.00 -
37 Amoksisilin 500 mg apbd APBD 550.00 -
38 Ambroxol 30 mg APBD ktk 100 111.00 -
39 chlorpheniramine Maleat 4 mg (ctm) APBD 230 63.00 14,490.00
40 Domperidon 10 mg APBD ktk 100 120 160.00 19,200.00
41 Ibu brofen 500 mg APBD ktk 100 250 401.00 100,250.00
42 Natrium diklofenak 50 mg APBD Ktk 50 153.00 -
43 Amoxillin syrup APBD botol 10,850.00 -
44 simpastatitin APBD btl 150.00 -
44 asam mefenamat 500 mg APBD ktk 100 80 225.00 18,000.00
45 Dexamethasone 0,5 mg APBD ktk 100 140 71.00 9,940.00
46 Kalsium laktat 500 mg APBD ktk 100 110 223.00 24,530.00
47 Nyastatin /vag APBD ktk 100 15
TOTAL 133,940.00 -
APBN APBN APBN
49 Tablet Tambah Darah APBN ktk 100 250 255.00 63,750.00 300
50 Zink tablet APBN ktk 100 20 253.00 5,060.00
51 Zink tablet APBN ktk 100 153.00 -
TOTAL 68,810 -
BUFFER STOK BUFFER STOK BUFFER STOK
52 Amlodipin 5 mg Bs BUFFER STOK ktk 100 70 -
53 Asam Askorbat (Vit C) 50 mg BUFFER STOK ktk 100 160 72 11,520.00
54 Deksamethasone 0,5 mg BUFFER STOK 62 -
55 Paracetamol tab 500 mg BUFFER STOK ktk 100 160 160 25,600.00
54 Natrium diklofenak 50 mg BUFFER STOK ktk 25 190 156
55 ZInk tablet BS BUFFER STOK ktk 100 200 141
TOTAL 37,120
JKN KAPITASI JKN KP JKN KP
58 Ambroxol 30 mg JKN KP Ktk 100 150.00 - -
59 Alkohol swab JKN KP Box100 143.00 -
60 Cat-Gut Chromic 3/0 JKN KP Ktk24 9,081.00 -
61 Thiamin HCl ( Vit B1) JKN KP ktk100 253.00 -
TOTAL -
TOTAL KESELURUHAN TOTAL 268,570.00 TOTAL

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apt. Tri Sutrisno, [Link]

NIP.
Mengetahui,
Kepala UPT PKM Sotek

drg. Novi Heriyanto Soekri

NIP. 196711172000031004
 PERBEKALAN KESEHATAN DI POLINDES SEPAN
OBAT DAN PERBEKALAN KESEHATAN
PT PKM SOTEK
N AGUSTUS 2024

PENERIMAAN DARI GUDANG SALDO AKHIR PERMIN

JLH TOTAL
FARMASI PUSKESMAS OBAT PENGEL NILAI TAAN
ED UARAN 31-Aug-24 Sep-24
Harga/ Nilai Jumlah Harga Nilai JUMLAH
DAK
153.00 - - 153.00 -
454.00 - - - 454.00 -
4,300.00 - - - 4,300.00 - 5
551.00 - 80 18,480.00 20 231.00 4,620.00
324.00 - 40 2,800.00 40 70.00 2,800.00
117.00 - - - 117.00 - 100
46.00 - - - 46.00 -
117.00 - - - 117.00 -
93.00 - - - 93.00 -
68.00 - - - 68.00 - 100
44.00 - - - 44.00 -
62.00 - - - 62.00 - 200
75.00 - - - 75.00 - 100
14,273.00 - - - 14,273.00 -
61.00 - - - 61.00 - 300
24.00 - - - 24.00 - 100
133.00 - - - 133.00 -
77.00 - - - 77.00 -
3,756.00 - - - 3,756.00 -
140.00 - - - 140.00 -
1,900.00 - - - 1,900.00 -
109.00 - - - 109.00 - 200
123.00 - - - 123.00 -
2,600.00 - - - 2,600.00 -
225.00 - - - 225.00 - 200
781.00 - - - 781.00 -
7,703.00 - - - 7,703.00 - 2
51.00 - - - 51.00 -
255.00 - - - 255.00 - 300
100.00 - - - 100.00 -
253.00 - - - 253.00 - 100
1,392.00 - - - 1,392.00 -
3,541.00 - - - 3,541.00 -
1,448.00 - - - 1,448.00 -
- - 200
- 21,280 7,420.00
APBD
 924.00 - - - 924.00 - 15
550.00 - - - 550.00 -
111.00 - - - 111.00 -
63.00 - 40 2,520.00 190 63.00 11,970.00
160.00 - 30 4,800.00 90 160.00 14,400.00
333.00 - 190 76,190.00 60 401.00 24,060.00 100
153.00 - - - 153.00 -
10,850.00 - - - 10,850.00 -
150.00 - - - 150.00 -
225.00 - 60 13,500.00 20 225.00 4,500.00 100
71.00 - 90 6,390.00 50 71.00 3,550.00
223.00 - 40 8,920.00 70 223.00 15,610.00
1,832.00 27,480.00 - 15
- 83,510.00 50,430.00
APBN
72.00 21,600.00 440 112,200.00 110 255.00 28,050.00
253.00 - - - 20 253.00 5,060.00
153.00 - - - 153.00 -
21,600 112,200 33,110.00
BUFFER STOK BUFFER STOK
70 - - - 70 - 100
72 - 30 2,160.00 130 72 9,360.00
62 - - - 62 -
160 - 90 14,400.00 70 160 11,200.00
156 - 135 21,060.00 55 156 100
141 - 50 7,050.00 150 141
- 16,560 20,560
JKN KP
150.00 - - - 150.00 -
143.00 - - - 143.00 - 1 ktk
9,081.00 - - - 9,081.00 -
253.00 - - - 253.00 - 100
- - -
21,600.00 216,990.00 TOTAL 111,520.00

Sotek, 30 Agustus 2024

Petugas Polindes Sepan

Yuliana Amd,Keb
NIP. 198512072017052001
Mengetahui,
pala UPT PKM Sotek

Novi Heriyanto Soekri

196711172000031004
 Note : kolom Warna
kuning jangan di hapus
ada rumusnya