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LAPORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN

KEGIATAN PENGADAAN OBAT DAN PERBEKALAN KESEHATAN


SUMBER DANA APBD UPT PUSKESMAS PENAJAM

BULAN : APRIL

NO

JENIS OBAT / BHP

1 Albendazol tablet 400 mg


2 Allupurinol tab 100 mg
3 Ambroxol sirup 15 mg/ml
4 Ambroxol tab 30 mg
5 Aminofillin Injeksi 24 mg/ml
6 Aminofillin tab 200 mg
7 Amitriptillin tab salut 25 mg ( HCl )
8 Amlodipin 5 mg
9 Amlodipin 10 mg
10 Amoksisillin kapsul 250 mg
11 Amoksisillin kaplet 500 mg
12 Amoksisillin serbuk injeksi 1000 mg
13 Amoksisillin sirup kering 125 mg / 5 ml
14 Ampisillin sirup kering 125 mg / 5 ml
15 Antasida DOEN I tablet kunyah
16 Antasida DOEN II suspensi
17 Anti bakteri DOEN salep
18 Anti fungi DOEN
19 Antihemoroid DOEN
20 Aqua pro injeksi steril, bebas pirogen
21 Asam askorbat ( Vit C ) tab 50 mg
22 Asam mefenamat kaplet 500 mg
23 Asiklovir krim 5 %
24 Asiklovir tab 200 mg
25 Asiklovir tab 400 mg

SALDO AWAL
JUMLAH
HARGA
a
b

NILAI
axb

JUMLAH
a
100
20,000
1,000
12,000
5,000
500
10,000
200
60,000
20,000
-

PENGADAAN
HARGA
b
446.67
145
3,600.00
137.5
3,300.00
124
132
1,056.00
1,862.00
317.5
407
8,250.00
4,060.00
4,830.00
178
4,234.00
2,768.00
1,889.17
2,200.00
6,050.00
35.2
193.6
3,300.00
427
628.4

PENGURANGAN
NILAI
axb
360,000
2,750,000
124,000
3,810,000
2,035,000
2,030,000
1,780,000
846,800
2,112,000
3,872,000
-

PUSBAN

POLINDES

20
700

40
100

100

360
900

600

40

30

300
40

600
25

2000
1200

1000
400

26 Besi II sulfat 200 mg + Asam folat 0,25 mg tab


27 Betametason krim 0,1 % ( sebagai valerat )
28 Bromheksin tab 8 mg
29 Betahistin masilat tab 6 mg
30 Cetirizine tab 10 mg
31 Deksametason injeksi i.v 5 mg/ml
32 Deksametason tab 0,5 mg
33 Dekstrometorfan sirup 10 mg/ 5 ml ( HBr )
34 Dekstrometorfan tab 15 mg ( HBr )
35 Diazepam tab 2 mg
36 Diazepam tab 5 mg
37 Difenhidramin injeksi i.m 10 mg/ml ( HCl )
38 Doksisiklin kapsul 100 mg
39 Domperidon suspensi 5 mg / 5 ml
40 Domperidon tab 10 mg
41 Epinefrin ( Adrenalin ) injeksi 0,1% (sebagai HCl )
42 Eritromisin kapsul 250 mg
43 Eritromisin kapsul 500 mg
44 Eritromisin sirup 200 mg / 5 ml
45 Etakridin larutan 0,1 %
46 Famotidine tab 40 mg
47 Famotidine tab 20 mg
48 Fenobarbital tab 30 mg
49 Fenol Gliserol tetes telinga 10%
50 Fitomenadion ( Vit.K1 ) tablet salut gula 10 mg
51 Fitomenadion ( Vit.K1 ) injeksi 10 mg/ml
52 Furosemid tab 40 mg
53 Garam oralit
54 Gentamisin salep kulit 0,1 %
55 Gentamisin sulfat tetes mata 0,3 %
56 Gentian violet larutan 1 %
57 Glibenclamid tab 5 mg
58 Gliseril guaiakolat tab 100 mg
59 Glukosa larutan infus 40 % steril
60 Glukosa larutan infus 5 % steril
61 Griseofulvin tab 125 mg

250
10,000
200
10,000
5,000
-

73.33
2,052.40
42
1,016.00
344.6
2,202.00
95.7
3,152.00
121
35
52.8
1,056.00
278
13,900.00
443.9
1,364.00
554.4
1,023.00
8,910.00
1,980.00
194
124.4
71
1,109.17
748
1,913.33
112.2
418
2,020.00
3,630.00
400
79.2
30.68
1,597.00
5,566.00
264

513,100
957,000
630,400
1,210,000
2,219,500
-

10

10

10
500

100

100

62 Haloperidol tab 0,5 mg


63 Hidrokortison krim 2,5 %
64 Ibuprofen tab 200 mg
65 Ibuprofen tab 400 mg
66 Ibuprofen suspensi 200 mg / 5 ml
67 Isosorbid dinitrat tab sublingual 5 mg
68 Kalsium laktat ( kalk ) tab 500 mg
69 Kaptopril tab 12,5 mg
70 Kaptopril tab 25 mg
71 Kaptopril tab 50 mg
72 Ketokonazol krim 2 %
73 Ketokonazol tab 200 mg
74 Ketorolac injeksi 10 mg
75 Klindamicin kapsul 150 mg
76 Kloramfenicol kapsul 250 mg
77 Kloramfenicol suspensi 125 mg / 5 ml
78 Kloramfenicol tetes mata 0,5 %
79 Kloramfenicol tetes telinga 3 %
80 Klorfeniramina maleat ( CTM ) tab 4 mg
81 Kloroquin tab 150 mg
82 Klorpromazin tab salut 100 mg ( HCL )
83 Kotrimoksazol tab DOEN I 480 mg
84 Kotrimoksazol tab DOEN II 120 mg
85 Kotrimoksazol suspensi 240 mg / 5 ml
86 Kuinin injeksi i.v 25 %( sebagai 2 HCl )
87 Kuinin tab 222 mg ( H2SO4, 7H2O )
88 Lanzoprazol kapsul 30 mg
89 Lidocain injeksi 2 % ( HCl )
90 Lidocain injeksi 2 % ( HCl ) + epinefrin 1:80.000 - 2 ml
91 Loratadin tab 10 mg
92 Meloksikam tab 15 mg
93 Metampiron tab 500 mg
94 Metformin HCl tab 500 mg
95 Metformin HCl tab 850 mg
96 Metilergometrin maleat tab salut 0,125 mg
97 Metilergometrin maleat injeksi 0,200 mg-1 ml

240
10,000
10,000
500
-

66
3,275.00
127.05
225.54
4,950.00
107
57.2
99
151.53
246.8
7,700.00
451
8,248.00
561
254.08
4,950.00
2,750.00
1,760.00
26.4
93.5
134
181.5
83.4
4,356.00
3,954.40
440
1,486.50
1,111.00
1,250.00
366.2
1,318.80
163.9
199.6
363
133.1
1,638.33

786,000
990,000
1,515,300
555,500
-

40

400
400

400

10

98 Metilprednisolon tab 4 mg
99 Metoklopramide injeksi 5 mg/ml
100 Metoklopramide tab 10 mg
101 Metronidazol tab 500 mg
102 Metronidazol tab 250 mg
103 Mikonazol krim / salep 2 % ( nitrat )
104 Natrium diklofenak tab 50 mg
105 Natrium diklofenak tab 25 mg
106 Natrium klorida larutan infus 0,9 %
107 Nifedipin tab 10 mg
108 Obat batuk hitam ( OBH ) cairan
109 Oksitetrasiklin HCl salep mata 1 %
110 Oksitetrasiklin HCl salep kulit 3 %
111 Omeprazol kapsul 20 mg
112 Papaverin tab 40 mg
113 Parasetamol sirup 120 mg / 5 ml
114 Parasetamol tab 500 mg
115 Pirantel tab score ( base ) 125 mg
116 Piridoksin ( Vit B6 ) tab 10 mg ( HCl )
117 Piroksikam tab 10 mg
118 Piroksikam tab 20 mg
119 Povidon iodida larutan 10 %
120 Prednison tab 5 mg
121 Propanolol tab 40 mg ( HCl )
122 Ranitidin injeksi 25 mg / 2 ml
123 Ranitidin tab 150 mg
124 Rifampisin tab salut 450 mg
125 Ringer laktat larutan infus
126 Salbutamol tab 2 mg ( sebagai sulfat )
127 Salbutamol tab 4 mg ( sebagai sulfat )
128 Salep 2-4
129 Salisil bedak 2 %
130 Sefadroksil sirup kering 125 mg / 5 ml
131 Sefadroksil kapsul 500 mg
132 Sianokobalamin ( vitamin B12 ) tab 50 mcg
133 Simetidin tab 200 mg

2,000
5,000
100
5,000
1,500
500
200
10,000
50,000
5,000
20
900
100
3,000
5,000
240
30,000
-

484.6
1,100.00
121
242
157.3
3,300.00
239.44
184.4
5,390.00
141.9
1,573.00
2,112.00
1,816.00
449
109.45
2,530.00
115.5
352
19.14
92.4
115.5
15,940.00
68.75
133.1
2,826.80
242
726
5,720.00
92.43
107.24
1,352.08
1,560.00
9,020.00
924
14.41
126.39

242,000
1,210,000
330,000
1,197,200
276,600
908,000
506,000
1,155,000
957,000
577,500
318,800
217,800
572,000
277,290
536,200
324,499
432,300
-

100

20

80

30

40
2600

40
1200

5000

1000

500
4

500

150

300

2000

1000

134 Simvastatin tab 10 mg


135 Siproloksasin tab 500 mg ( sebagai HCl )
136 Tetrasiklin kapsul 500 mg
137 Tiamin ( Vitamin B1 ) tab 50 mg ( HCl / Nitrat )
138 Tramadol injeksi 50 mg / ml
139 Tramadol tab 50 mg
140 Vitamin B kompleks tab
141 Zinc tab 20 mg
PERBEKALAN KESEHATAN
142 Alat suntik sekali pakai 1 ml
143 Alat suntik sekali pakai 2, 5 ml
144 Alat suntik sekali pakai 5 ml
145 Catgut / benang bedah No. 2/0 dengan jarum bedah
146 Catgut / benang bedah No. 3/0 dengan jarum bedah
147 Infusion set anak
148 Infusion set dewasa
149 IV catheter No. 20 G
150 IV catheter No. 22 G
151 IV catheter No. 24 G
152 Kapas pembalut / Absorben 250 gram
153 Kasa hidrofil steril Uk. 16 x 16 cm ( isi 16 lembar )
154 Kasa hidrofil steril Uk. 18 x 22 cm ( isi 12 lembar )
155 Kasa hidrofil Uk. 36m x 80cm
156 Kasa pembalut hidrofil 4m x 5cm
157 Kasa pembalut hidrofil 4m x 10cm
158 Kasa pembalut elastic 4 inch
159 Kasa pembalut elastic 3 inch
160 Pembalut gips 3 inch
161 Pembalut gips 4 inch
162 Pembalut gips 6 inch
163 Plester 5 yeards x 2 inch
164 Silk ( benang bedah sutera ) No. 3/0 dengan jarum bedah
165 Wing Needle No. 21 G
166 Wing Needle No. 23 G
167 Urine bag
168 Foley catheter 14

30,000
30,000
1,000

564.3
312.4
282.7
41.58
7,040.00
354
24.42
522.5

50
100
-

1,092.40
1,038.00
1,038.00
26,666.67
24,583.33
4,000.00
3,500.00
7,787.20
7,787.20
7,787.20
7,500.00
8,500.00
4,750.00
55,200.00
303.5
607
10,000.00
7,000.00
23,500.00
32,500.00
42,000.00
23,625.00
20,950.00
5,770.00
5,770.00
4,000.00
8,484.00

1,247,400
732,600
522,500
200,000
2,362,500
-

2000

3000

2000

4000

169 Foley catheter 16


170 Handscoon No. 6,5
171 Handscoon No. 7
172 Handscoon No. 7,5
173 Masker
OBAT GIGI
174 Etil klorida spray
175 Glass ionomer cement ART
176 Kalsium hidroksida pasta
177 Klorfenol kamfer menthol ( CHKM )
178 Mummifying pasta
179 Semen seng fosfat serbuk dan cairan
180 Eugenol cairan
181 Temporary stopping flecther serbuk dan cairan
182 Devitalisasi pasta ( non arsen )
JUMLAH

8,484.00
4,250.00
4,250.00
4,250.00
1,125.00

4
5
-

105,000.00
395,000.00
121,000.00
55,000.00
176,000.00
93,500.00
45,833.33
34,000.00
390,000.00

1,580,000
880,000
46,659,789

MENGETAHUI
KEPALA UPTD PUSKESMAS PENAJAM

PENAJ
PETUGA

HJ.SITI HAPSAH, AMD KEB


NIP.19601003 198112 2 013

YULIAST
NIP.1985

URANGAN
UGD

APOTIK

10
100

30
1,100

300

2,100

10

100

10

200
50

2,000
1,500

JUMLAH
a
18,000
900
11,640
1,100
320
8,900
75
55,000
16,900
-

SALDO AKHIR
HARGA
b
446.67
145
3,600.00
137.5
3,300.00
124
132
1,056.00
1,862.00
317.5
407
8,250.00
4,060.00
4,830.00
178
4,234.00
2,768.00
1,889.17
2,200.00
6,050.00
35.2
193.6
3,300.00
427
628.4

NILAI
axb
2,475,000
111,600
3,695,700
447,700
1,299,200
1,584,200
317,550
1,936,000
3,271,840
-

25

10
100

48
500

205
10,000
127
8,900
4,800
-

73.33
2,052.40
42
1,016.00
344.6
2,202.00
95.7
3,152.00
121
35
52.8
1,056.00
278
13,900.00
443.9
1,364.00
554.4
1,023.00
8,910.00
1,980.00
194
124.4
71
1,109.17
748
1,913.33
112.2
418
2,020.00
3,630.00
400
79.2
30.68
1,597.00
5,566.00
264

420,742
957,000
400,304
1,076,900
2,130,720
-

24

100

100

500

176
9,200
9,000
390
-

66
3,275.00
127.05
225.54
4,950.00
107
57.2
99
151.53
246.8
7,700.00
451
8,248.00
561
254.08
4,950.00
2,750.00
1,760.00
26.4
93.5
134
181.5
83.4
4,356.00
3,954.40
440
1,486.50
1,111.00
1,250.00
366.2
1,318.80
163.9
199.6
363
133.1
1,638.33

576,400
910,800
1,363,770
433,290
-

300

24

25

50

10

40
4,100

1,000

4,000
600

450

500
-

1,000

1,600
5,000
56
5,000
1,500
315
70
2,100
39,000
3,400
16
300
100
2,200
5,000
240
26,000
-

484.6
1,100.00
121
242
157.3
3,300.00
239.44
184.4
5,390.00
141.9
1,573.00
2,112.00
1,816.00
449
109.45
2,530.00
115.5
352
19.14
92.4
115.5
15,940.00
68.75
133.1
2,826.80
242
726
5,720.00
92.43
107.24
1,352.08
1,560.00
9,020.00
924
14.41
126.39

193,600
1,210,000
184,800
1,197,200
276,600
572,040
177,100
242,550
746,460
392,700
255,040
72,600
572,000
203,346
536,200
324,499
374,660
-

1,000

2,000

22,000
24,000
1,000

50

100

564.3
312.4
282.7
41.58
7,040.00
354
24.42
522.5

914,760
586,080
522,500

1,092.40
1,038.00
1,038.00
26,666.67
24,583.33
4,000.00
3,500.00
7,787.20
7,787.20
7,787.20
7,500.00
8,500.00
4,750.00
55,200.00
303.5
607
10,000.00
7,000.00
23,500.00
32,500.00
42,000.00
23,625.00
20,950.00
5,770.00
5,770.00
4,000.00
8,484.00

200,000
2,362,500
-

8,484.00
4,250.00
4,250.00
4,250.00
1,125.00

PENAJAM, 11 JUNI 2012


PETUGAS PENGELOLA OBAT

YULIASTUTI RAHMAH, AMD


NIP.19850728 200904 2 003

105,000.00
395,000.00
121,000.00
55,000.00
176,000.00
93,500.00
45,833.33
34,000.00
390,000.00

1,580,000
880,000
37,985,951

LAPORAN PERSEDIA
KEGIATAN PENGAD
SUMBER DAN
BULAN : MEI

NO

JENIS OBAT / BHP

1 Albendazol tablet 400 mg


2 Allupurinol tab 100 mg
3 Ambroxol sirup 15 mg/ml
4 Ambroxol tab 30 mg
5 Aminofillin Injeksi 24 mg/ml
6 Aminofillin tab 200 mg
7 Amitriptillin tab salut 25 mg ( HCl )
8 Amlodipin 5 mg
9 Amlodipin 10 mg
10 Amoksisillin kapsul 250 mg
11 Amoksisillin kaplet 500 mg
12 Amoksisillin serbuk injeksi 1000 mg
13 Amoksisillin sirup kering 125 mg / 5 ml
14 Ampisillin sirup kering 125 mg / 5 ml
15 Antasida DOEN I tablet kunyah
16 Antasida DOEN II suspensi
17 Anti bakteri DOEN salep
18 Anti fungi DOEN
19 Antihemoroid DOEN
20 Aqua pro injeksi steril, bebas pirogen
21 Asam askorbat ( Vit C ) tab 50 mg
22 Asam mefenamat kaplet 500 mg
23 Asiklovir krim 5 %
24 Asiklovir tab 200 mg
25 Asiklovir tab 400 mg
26 Besi II sulfat 200 mg + Asam folat 0,25 mg tab
27 Betametason krim 0,1 % ( sebagai valerat )
28 Bromheksin tab 8 mg
29 Betahistin masilat tab 6 mg
30 Cetirizine tab 10 mg
31 Deksametason injeksi i.v 5 mg/ml
32 Deksametason tab 0,5 mg
33 Dekstrometorfan sirup 10 mg/ 5 ml ( HBr )
34 Dekstrometorfan tab 15 mg ( HBr )
35 Diazepam tab 2 mg

JUMLAH
a
18,000
900
11,640
1,100
320
8,900
75
55,000
16,900
205
10,000
127
8,900
-

SALDO AWAL
HARGA
b
446.67
145
3,600.00
137.5
3,300.00
124
132
1,056.00
1,862.00
317.5
407
8,250.00
4,060.00
4,830.00
178
4,234.00
2,768.00
1,889.17
2,200.00
6,050.00
35.2
193.6
3,300.00
427
628.4
73.33
2,052.40
42
1,016.00
344.6
2,202.00
95.7
3,152.00
121
35

36 Diazepam tab 5 mg
37 Difenhidramin injeksi i.m 10 mg/ml ( HCl )
38 Doksisiklin kapsul 100 mg
39 Domperidon suspensi 5 mg / 5 ml
40 Domperidon tab 10 mg
41 Epinefrin ( Adrenalin ) injeksi 0,1% (sebagai HCl )
42 Eritromisin kapsul 250 mg
43 Eritromisin kapsul 500 mg
44 Eritromisin sirup 200 mg / 5 ml
45 Etakridin larutan 0,1 %
46 Famotidine tab 40 mg
47 Famotidine tab 20 mg
48 Fenobarbital tab 30 mg
49 Fenol Gliserol tetes telinga 10%
50 Fitomenadion ( Vit.K1 ) tablet salut gula 10 mg
51 Fitomenadion ( Vit.K1 ) injeksi 10 mg/ml
52 Furosemid tab 40 mg
53 Garam oralit
54 Gentamisin salep kulit 0,1 %
55 Gentamisin sulfat tetes mata 0,3 %
56 Gentian violet larutan 1 %
57 Glibenclamid tab 5 mg
58 Gliseril guaiakolat tab 100 mg
59 Glukosa larutan infus 40 % steril
60 Glukosa larutan infus 5 % steril
61 Griseofulvin tab 125 mg
62 Haloperidol tab 0,5 mg
63 Hidrokortison krim 2,5 %
64 Ibuprofen tab 200 mg
65 Ibuprofen tab 400 mg
66 Ibuprofen suspensi 200 mg / 5 ml
67 Isosorbid dinitrat tab sublingual 5 mg
68 Kalsium laktat ( kalk ) tab 500 mg
69 Kaptopril tab 12,5 mg
70 Kaptopril tab 25 mg
71 Kaptopril tab 50 mg
72 Ketokonazol krim 2 %
73 Ketokonazol tab 200 mg
74 Ketorolac injeksi 10 mg
75 Klindamicin kapsul 150 mg
76 Kloramfenicol kapsul 250 mg
77 Kloramfenicol suspensi 125 mg / 5 ml
78 Kloramfenicol tetes mata 0,5 %
79 Kloramfenicol tetes telinga 3 %
80 Klorfeniramina maleat ( CTM ) tab 4 mg

4,800
176
9,200
9,000
-

52.8
1,056.00
278
13,900.00
443.9
1,364.00
554.4
1,023.00
8,910.00
1,980.00
194
124.4
71
1,109.17
748
1,913.33
112.2
418
2,020.00
3,630.00
400
79.2
30.68
1,597.00
5,566.00
264
66
3,275.00
127.05
225.54
4,950.00
107
57.2
99
151.53
246.8
7,700.00
451
8,248.00
561
254.08
4,950.00
2,750.00
1,760.00
26.4

81 Kloroquin tab 150 mg


82 Klorpromazin tab salut 100 mg ( HCL )
83 Kotrimoksazol tab DOEN I 480 mg
84 Kotrimoksazol tab DOEN II 120 mg
85 Kotrimoksazol suspensi 240 mg / 5 ml
86 Kuinin injeksi i.v 25 %( sebagai 2 HCl )
87 Kuinin tab 222 mg ( H2SO4, 7H2O )
88 Lanzoprazol kapsul 30 mg
89 Lidocain injeksi 2 % ( HCl )
90 Lidocain injeksi 2 % ( HCl ) + epinefrin 1:80.000 - 2 ml
91 Loratadin tab 10 mg
92 Meloksikam tab 15 mg
93 Metampiron tab 500 mg
94 Metformin HCl tab 500 mg
95 Metformin HCl tab 850 mg
96 Metilergometrin maleat tab salut 0,125 mg
97 Metilergometrin maleat injeksi 0,200 mg-1 ml
98 Metilprednisolon tab 4 mg
99 Metoklopramide injeksi 5 mg/ml
100 Metoklopramide tab 10 mg
101 Metronidazol tab 500 mg
102 Metronidazol tab 250 mg
103 Mikonazol krim / salep 2 % ( nitrat )
104 Natrium diklofenak tab 50 mg
105 Natrium diklofenak tab 25 mg
106 Natrium klorida larutan infus 0,9 %
107 Nifedipin tab 10 mg
108 Obat batuk hitam ( OBH ) cairan
109 Oksitetrasiklin HCl salep mata 1 %
110 Oksitetrasiklin HCl salep kulit 3 %
111 Omeprazol kapsul 20 mg
112 Papaverin tab 40 mg
113 Parasetamol sirup 120 mg / 5 ml
114 Parasetamol tab 500 mg
115 Pirantel tab score ( base ) 125 mg
116 Piridoksin ( Vit B6 ) tab 10 mg ( HCl )
117 Piroksikam tab 10 mg
118 Piroksikam tab 20 mg
119 Povidon iodida larutan 10 %
120 Prednison tab 5 mg
121 Propanolol tab 40 mg ( HCl )
122 Ranitidin injeksi 25 mg / 2 ml
123 Ranitidin tab 150 mg
124 Rifampisin tab salut 450 mg
125 Ringer laktat larutan infus

390
1,600
5,000
56
5,000
1,500
315
70
2,100
39,000
3,400
16
300
100

93.5
134
181.5
83.4
4,356.00
3,954.40
440
1,486.50
1,111.00
1,250.00
366.2
1,318.80
163.9
199.6
363
133.1
1,638.33
484.6
1,100.00
121
242
157.3
3,300.00
239.44
184.4
5,390.00
141.9
1,573.00
2,112.00
1,816.00
449
109.45
2,530.00
115.5
352
19.14
92.4
115.5
15,940.00
68.75
133.1
2,826.80
242
726
5,720.00

126 Salbutamol tab 2 mg ( sebagai sulfat )


127 Salbutamol tab 4 mg ( sebagai sulfat )
128 Salep 2-4
129 Salisil bedak 2 %
130 Sefadroksil sirup kering 125 mg / 5 ml
131 Sefadroksil kapsul 500 mg
132 Sianokobalamin ( vitamin B12 ) tab 50 mcg
133 Simetidin tab 200 mg
134 Simvastatin tab 10 mg
135 Siproloksasin tab 500 mg ( sebagai HCl )
136 Tetrasiklin kapsul 500 mg
137 Tiamin ( Vitamin B1 ) tab 50 mg ( HCl / Nitrat )
138 Tramadol injeksi 50 mg / ml
139 Tramadol tab 50 mg
140 Vitamin B kompleks tab
141 Zinc tab 20 mg
PERBEKALAN KESEHATAN
142 Alat suntik sekali pakai 1 ml
143 Alat suntik sekali pakai 2, 5 ml
144 Alat suntik sekali pakai 5 ml
145 Catgut / benang bedah No. 2/0 dengan jarum bedah
146 Catgut / benang bedah No. 3/0 dengan jarum bedah
147 Infusion set anak
148 Infusion set dewasa
149 IV catheter No. 20 G
150 IV catheter No. 22 G
151 IV catheter No. 24 G
152 Kapas pembalut / Absorben 250 gram
153 Kasa hidrofil steril Uk. 16 x 16 cm ( isi 16 lembar )
154 Kasa hidrofil steril Uk. 18 x 22 cm ( isi 12 lembar )
155 Kasa hidrofil Uk. 36m x 80cm
156 Kasa pembalut hidrofil 4m x 5cm
157 Kasa pembalut hidrofil 4m x 10cm
158 Kasa pembalut elastic 4 inch
159 Kasa pembalut elastic 3 inch
160 Pembalut gips 3 inch
161 Pembalut gips 4 inch
162 Pembalut gips 6 inch
163 Plester 5 yeards x 2 inch
164 Silk ( benang bedah sutera ) No. 3/0 dengan jarum bedah
165 Wing Needle No. 21 G
166 Wing Needle No. 23 G
167 Urine bag
168 Foley catheter 14
169 Foley catheter 16

2,200
5,000
240
26,000
22,000
24,000
1,000

92.43
107.24
1,352.08
1,560.00
9,020.00
924
14.41
126.39
564.3
312.4
282.7
41.58
7,040.00
354
24.42
522.5

50
100
-

1,092.40
1,038.00
1,038.00
26,666.67
24,583.33
4,000.00
3,500.00
7,787.20
7,787.20
7,787.20
7,500.00
8,500.00
4,750.00
55,200.00
303.5
607
10,000.00
7,000.00
23,500.00
32,500.00
42,000.00
23,625.00
20,950.00
5,770.00
5,770.00
4,000.00
8,484.00
8,484.00

170 Handscoon No. 6,5


171 Handscoon No. 7
172 Handscoon No. 7,5
173 Masker

4,250.00
4,250.00
4,250.00
1,125.00

OBAT GIGI
174 Etil klorida spray
175 Glass ionomer cement ART
176 Kalsium hidroksida pasta
177 Klorfenol kamfer menthol ( CHKM )
178 Mummifying pasta
179 Semen seng fosfat serbuk dan cairan
180 Eugenol cairan
181 Temporary stopping flecther serbuk dan cairan
182 Devitalisasi pasta ( non arsen )
JUMLAH

4
5
-

105,000.00
395,000.00
121,000.00
55,000.00
176,000.00
93,500.00
45,833.33
34,000.00
390,000.00

MENGETAHUI
KEPALA UPTD PUSKESMAS PENAJAM

HJ.SITI HAPSAH, AMD KEB


NIP.19601003 198112 2 013

APORAN PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN


EGIATAN PENGADAAN OBAT DAN PERBEKALAN KESEHATAN
SUMBER DANA APBD UPT PUSKESMAS PENAJAM

LDO AWAL
NILAI
axb
2,475,000
111,600
3,695,700
447,700
1,299,200
1,584,200
317,550
1,936,000
3,271,840
420,742
957,000
400,304
1,076,900
-

JUMLAH
a
16,700
300
20,000
500
5,000
250
9,500
-

PENGADAAN
HARGA
b
446.67
145
3,600.00
137.5
3,300.00
124
132
1,056.00
1,862.00
317.5
407
8,250.00
4,060.00
4,830.00
178
4,234.00
2,768.00
1,889.17
2,200.00
6,050.00
35.2
193.6
3,300.00
427
628.4
73.33
2,052.40
42
1,016.00
344.6
2,202.00
95.7
3,152.00
121
35

PENGURANGAN
NILAI
axb
6,796,900
1,270,200
3,872,000
1,650,000
2,135,000
513,100
909,150
-

PUSBAN

POLINDES

100

600

200

30
200

600
10
100

10

20

1000
100

2,130,720
576,400
910,800
1,363,770
-

60
5,000
50
5,000
300
5,000
200
40,000
-

52.8
1,056.00
278
13,900.00
443.9
1,364.00
554.4
1,023.00
8,910.00
1,980.00
194
124.4
71
1,109.17
748
1,913.33
112.2
418
2,020.00
3,630.00
400
79.2
30.68
1,597.00
5,566.00
264
66
3,275.00
127.05
225.54
4,950.00
107
57.2
99
151.53
246.8
7,700.00
451
8,248.00
561
254.08
4,950.00
2,750.00
1,760.00
26.4

81,840
5,115,000
99,000
3,740,000
1,089,000
635,250
45,108
2,288,000
-

100

26
400

400
400

100

300

433,290
193,600
1,210,000
184,800
1,197,200
276,600
572,040
177,100
242,550
746,460
392,700
255,040
72,600
572,000

4,800
200
3,000
20,000
500
10,700
10
20,000
-

93.5
134
181.5
83.4
4,356.00
3,954.40
440
1,486.50
1,111.00
1,250.00
366.2
1,318.80
163.9
199.6
363
133.1
1,638.33
484.6
1,100.00
121
242
157.3
3,300.00
239.44
184.4
5,390.00
141.9
1,573.00
2,112.00
1,816.00
449
109.45
2,530.00
115.5
352
19.14
92.4
115.5
15,940.00
68.75
133.1
2,826.80
242
726
5,720.00

871,200
790,880
1,320,000
2,189,000
1,265,000
1,235,850
159,400
1,375,000
-

500

200

200

10

20
600

10
400

1000

1000

1000

1000

203,346
536,200
324,499
374,660
914,760
586,080
522,500
200,000
2,362,500
-

515
45,000
-

92.43
107.24
1,352.08
1,560.00
9,020.00
924
14.41
126.39
564.3
312.4
282.7
41.58
7,040.00
354
24.42
522.5

50
100
-

1,092.40
1,038.00
1,038.00
26,666.67
24,583.33
4,000.00
3,500.00
7,787.20
7,787.20
7,787.20
7,500.00
8,500.00
4,750.00
55,200.00
303.5
607
10,000.00
7,000.00
23,500.00
32,500.00
42,000.00
23,625.00
20,950.00
5,770.00
5,770.00
4,000.00
8,484.00
8,484.00

803,400
1,098,900
200,000
2,362,500
-

10

2000

1000

2000

1000

1,580,000
880,000
37,985,951

4,250.00
4,250.00
4,250.00
1,125.00

4
5
-

105,000.00
395,000.00
121,000.00
55,000.00
176,000.00
93,500.00
45,833.33
34,000.00
390,000.00

1,580,000
880,000
46,370,678

PENAJAM, 1
PETUGAS PEN

YULIASTUTI R
NIP.19850728

PENGURANGAN
UGD

APOTIK

100

1,300

360
400

1,200
5,400

10

160

200

1,500
60

500
100

6,000
2,000
50
800

75

68
1,100

JUMLAH
a
16,500
900
10,080
11,200
120
7,000
315
48,000
33,700
440
4,000
370
19,500
39
7,800
-

SALDO AKHIR
HARGA
b
446.67
145
3,600.00
137.5
3,300.00
124
132
1,056.00
1,862.00
317.5
407
8,250.00
4,060.00
4,830.00
178
4,234.00
2,768.00
1,889.17
2,200.00
6,050.00
35.2
193.6
3,300.00
427
628.4
73.33
2,052.40
42
1,016.00
344.6
2,202.00
95.7
3,152.00
121
35

NILAI
axb
2,268,750
111,600
3,200,400
4,558,400
487,200
1,246,000
1,333,710
1,689,600
6,524,320
1,452,000
1,708,000
759,388
1,866,150
122,928
943,800
-

1,000
10
600

10

20

150
1,300

200
300

1,200
1,500

3,800
50
4,300
50
5,000
270
3,200
200
40,000
7,100
6,800
-

52.8
1,056.00
278
13,900.00
443.9
1,364.00
554.4
1,023.00
8,910.00
1,980.00
194
124.4
71
1,109.17
748
1,913.33
112.2
418
2,020.00
3,630.00
400
79.2
30.68
1,597.00
5,566.00
264
66
3,275.00
127.05
225.54
4,950.00
107
57.2
99
151.53
246.8
7,700.00
451
8,248.00
561
254.08
4,950.00
2,750.00
1,760.00
26.4

1,686,820
68,200
4,398,900
99,000
3,740,000
980,100
406,560
45,108
2,288,000
702,900
1,030,404
-

1,300

100
100

200
1,200

10

46
900
200

200

125

10
200

100
5,300
6,000

100

1,100

90
15

3,000
200
3,000
390
1,300
3,500
3,900
1,100
180
20,000
430
6,300
31,000
2,200
26
18,000
210
80

93.5
134
181.5
83.4
4,356.00
3,954.40
440
1,486.50
1,111.00
1,250.00
366.2
1,318.80
163.9
199.6
363
133.1
1,638.33
484.6
1,100.00
121
242
157.3
3,300.00
239.44
184.4
5,390.00
141.9
1,573.00
2,112.00
1,816.00
449
109.45
2,530.00
115.5
352
19.14
92.4
115.5
15,940.00
68.75
133.1
2,826.80
242
726
5,720.00

544,500
790,880
1,320,000
433,290
157,300
847,000
933,816
202,840
326,880
2,189,000
1,087,900
727,650
593,340
254,100
414,440
1,237,500
50,820
457,600

200
-

4,000

11,000

4,000
100

2,000
5,000
240
500
19,000
10,000
63,000
900

50

100

92.43
107.24
1,352.08
1,560.00
9,020.00
924
14.41
126.39
564.3
312.4
282.7
41.58
7,040.00
354
24.42
522.5

184,860
536,200
324,499
780,000
273,790
415,800
1,538,460
470,250

1,092.40
1,038.00
1,038.00
26,666.67
24,583.33
4,000.00
3,500.00
7,787.20
7,787.20
7,787.20
7,500.00
8,500.00
4,750.00
55,200.00
303.5
607
10,000.00
7,000.00
23,500.00
32,500.00
42,000.00
23,625.00
20,950.00
5,770.00
5,770.00
4,000.00
8,484.00
8,484.00

200,000
2,362,500
-

4,250.00
4,250.00
4,250.00
1,125.00

PENAJAM, 11 JUNI 2012


PETUGAS PENGELOLA OBAT

YULIASTUTI RAHMAH, AMD


NIP.19850728 200904 2 003

105,000.00
395,000.00
121,000.00
55,000.00
176,000.00
93,500.00
45,833.33
34,000.00
390,000.00

1,580,000
880,000
65,833,453

PEMERINTAH KABUPATEN PENAJAM PASER UTARA

DINAS KESEHATAN KABUPATEN PENAJAM PASER UTARA

UPTD PUSKESMAS PENAJAM

Jl.Propinsi RT. 025 Kel. Penajam TELP. (0542) 7200768 Kab. PPU Email : penajampuskesmas@yahoo.co.uk TELP.( 0542 ) 720

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PUSKESMAS PEMBANTU


PUSKESMAS
KECAMATAN
KAB/KOTA
NO

:
:
:
NAMA OBAT

1 Albendazol tablet 400 mg


2 Allupurinol tab 100 mg
3 Ambroxol sirup 15 mg/ml
4 Ambroxol tab 30 mg
5 Aminofillin Injeksi 24 mg/ml
6 Aminofillin tab 200 mg
7 Amitriptillin tab salut 25 mg ( HCl )
8 Amlodipin 5 mg
9 Amlodipin 10 mg
10 Amoksisillin kapsul 250 mg
11 Amoksisillin kaplet 500 mg
12 Amoksisillin serbuk injeksi 1000 mg
13 Amoksisillin sirup kering 125 mg / 5 ml
14 Ampisillin sirup kering 125 mg / 5 ml
15 Antasida DOEN I tablet kunyah
16 Antasida DOEN II suspensi
17 Anti bakteri DOEN salep
18 Anti fungi DOEN
19 Antihemoroid DOEN
20 Aqua pro injeksi steril, bebas pirogen
21 Asam askorbat ( Vit C ) tab 50 mg
22 Asam mefenamat kaplet 500 mg
23 Asiklovir krim 5 %
24 Asiklovir tab 200 mg
25 Asiklovir tab 400 mg

KEMASAN
ktk 5 x 6 tab
ktk 10 x 10 tab
botol 60 ml
ktk 10 x 10 tab
ktk 30 ampul @10 ml
botol 100 tab
ktk 10 x 10 tab
ktk 5 x 10 tab
ktk 5 x 10 tab
ktk 12 x 10 kapsul
ktk 10 x 10 tab
ktk 10 vial
botol 60 ml
ktk 10 x 10 tab
ktk 10 x 10 tab
btl 60 ml
ktk 25 tube @ 5 gram
ktk 24 pot @ 30 gram
ktk 10 supp
ktk 10 vial@ 20 ml
btl 1000 tab
ktk 10 x 10 kaplet
ktk 25 tube @ 5 gram
ktk 10 x 10 tab
ktk 10 x 10 tab

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN SISA STOK STOK OP

26 Besi II sulfat 200 mg + Asam folat 0,25 mg tab


27 Betametason krim 0,1 % ( sebagai valerat )
28 Bromheksin tab 8 mg
29 Betahistin masilat tab 6 mg
30 Cetirizine tab 10 mg
31 Deksametason injeksi i.v 5 mg/ml
32 Deksametason tab 0,5 mg
33 Dekstrometorfan sirup 10 mg/ 5 ml ( HBr )
34 Dekstrometorfan tab 15 mg ( HBr )
35 Diazepam tab 2 mg
36 Diazepam tab 5 mg
37 Difenhidramin injeksi i.m 10 mg/ml ( HCl )
38 Doksisiklin kapsul 100 mg
39 Domperidon suspensi 5 mg / 5 ml
40 Domperidon tab 10 mg
41 Epinefrin ( Adrenalin ) injeksi 0,1% (sebagai HCl )
42 Eritromisin kapsul 250 mg
43 Eritromisin kapsul 500 mg
44 Eritromisin sirup 200 mg / 5 ml
45 Etakridin larutan 0,1 %
46 Famotidine tab 40 mg
47 Famotidine tab 20 mg
48 Fenobarbital tab 30 mg
49 Fenol Gliserol tetes telinga 10%
50 Fitomenadion ( Vit.K1 ) tablet salut gula 10 mg
51 Fitomenadion ( Vit.K1 ) injeksi 10 mg/ml
52 Furosemid tab 40 mg
53 Garam oralit
54 Gentamisin salep kulit 0,1 %
55 Gentamisin sulfat tetes mata 0,3 %
56 Gentian violet larutan 1 %
57 Glibenclamid tab 5 mg
58 Gliseril guaiakolat tab 100 mg
59 Glukosa larutan infus 40 % steril
60 Glukosa larutan infus 5 % steril
61 Griseofulvin tab 125 mg
62 Haloperidol tab 0,5 mg

1 sase @ 30 tab
ktk 25 tube @ 5 gram
ktk 10 x 10 tab
ktk 3 x 10 tab
ktk 5 x 10 tab
ktk 100 ampul @ 1 ml
ktk 10 x 10 tab
btl 60 ml
ktk 10 x10 tab
btl 100 tab
btl 100 tab
ktk 30 ampul @ 1 ml
ktk 10 x 10 kapsul
btl 60 ml
ktk 10 x 10 tab
ktk 30 ampul @ 1 ml
ktk 10 x 10 kapsul
ktk 10 x 10 kapsul
btl 60 ml
botol
ktk 5 x 10 tab
ktk 5 x 10 tab
btl 100 tab
ktk 24 btl @ 5 ml
btl 100 tab
ktk 30 ampul @ 1 ml
ktk 10 x 10 tab
ktk 100 sachet
ktk 25 tube @ 5 gram
ktk 10 btl @ 5 ml
btl 10 ml
ktk 10 x 10 tab
btl 1000 tab
ktk 10 ampul @ 25 ml
btl 500 ml
ktk 10 x 10 tab
ktk 10 x 10 tab

63 Hidrokortison krim 2,5 %


64 Ibuprofen tab 200 mg
65 Ibuprofen tab 400 mg
66 Ibuprofen suspensi 200 mg / 5 ml
67 Isosorbid dinitrat tab sublingual 5 mg
68 Kalsium laktat ( kalk ) tab 500 mg
69 Kaptopril tab 12,5 mg
70 Kaptopril tab 25 mg
71 Kaptopril tab 50 mg
72 Ketokonazol krim 2 %
73 Ketokonazol tab 200 mg
74 Ketorolac injeksi 10 mg
75 Klindamicin kapsul 150 mg
76 Kloramfenicol kapsul 250 mg
77 Kloramfenicol suspensi 125 mg / 5 ml
78 Kloramfenicol tetes mata 0,5 %
79 Kloramfenicol tetes telinga 3 %
80 Klorfeniramina maleat ( CTM ) tab 4 mg
81 Kloroquin tab 150 mg
82 Klorpromazin tab salut 100 mg ( HCL )
83 Kotrimoksazol tab DOEN I 480 mg
84 Kotrimoksazol tab DOEN II 120 mg
85 Kotrimoksazol suspensi 240 mg / 5 ml
86 Kuinin injeksi i.v 25 %( sebagai 2 HCl )
87 Kuinin tab 222 mg ( H2SO4, 7H2O )
88 Lanzoprazol kapsul 30 mg
89 Lidocain injeksi 2 % ( HCl )
90 Lidocain injeksi 2 % ( HCl ) + epinefrin 1:80.000 - 2 ml
91 Loratadin tab 10 mg
92 Meloksikam tab 15 mg
93 Metampiron tab 500 mg
94 Metformin HCl tab 500 mg
95 Metformin HCl tab 850 mg
96 Metilergometrin maleat tab salut 0,125 mg
97 Metilergometrin maleat injeksi 0,200 mg-1 ml
98 Metilprednisolon tab 4 mg
99 Metoklopramide injeksi 5 mg/ml

ktk 24 tube @ 5 gram


btl 100 tab
ktk 10 x 10 tab
btl 60 ml
ktk 10 x 10 tab
btl 1000 tab
ktk 10 x 10 tab
ktk 10 x 10 tab
ktk 10 x 10 tab
tube 15 gram
ktk 5 x 10 tab
ktk 5 ampul @ 1 ml
ktk 10 x 10 kapsul
btl 250 tab
btl 60 ml
btl 5 ml
btl 5 ml
btl 1000 tab
btl 1000 tab
btl 250 tab
ktk 10 x 10 tab
ktk 10 x 10 tab
btl 60 ml
ktk 100 ampul @ 2 ml
btl 1000 tab
ktk 2 x 10 kapsul
ktk 100 ampul @ 2 ml
ktk 30 ampul @ 2 ml
ktk 5 x 10 tab
ktk 5 x 10 tab
ktk 10 x10 tab
ktk 10 x 10 tab
ktk 10 x 10 tab
ktk 10 x 10 tab
ktk 30 ampul
ktk 10 x 10 tab
ktk 10 ampul @ 2 ml

100 Metoklopramide tab 10 mg


101 Metronidazol tab 500 mg
102 Metronidazol tab 250 mg
103 Mikonazol krim / salep 2 % ( nitrat )
104 Natrium diklofenak tab 50 mg
105 Natrium diklofenak tab 25 mg
106 Natrium klorida larutan infus 0,9 %
107 Nifedipin tab 10 mg
108 Obat batuk hitam ( OBH ) cairan
109 Oksitetrasiklin HCl salep mata 1 %
110 Oksitetrasiklin HCl salep kulit 3 %
111 Omeprazol kapsul 20 mg
112 Papaverin tab 40 mg
113 Parasetamol sirup 120 mg / 5 ml
114 Parasetamol tab 500 mg
115 Pirantel tab score ( base ) 125 mg
116 Piridoksin ( Vit B6 ) tab 10 mg ( HCl )
117 Piroksikam tab 10 mg
118 Piroksikam tab 20 mg
119 Povidon iodida larutan 10 %
120 Prednison tab 5 mg
121 Propanolol tab 40 mg ( HCl )
122 Ranitidin injeksi 25 mg / 2 ml
123 Ranitidin tab 150 mg
124 Rifampisin tab salut 450 mg
125 Ringer laktat larutan infus
126 Salbutamol tab 2 mg ( sebagai sulfat )
127 Salbutamol tab 4 mg ( sebagai sulfat )
128 Salep 2-4
129 Salisil bedak 2 %
130 Sefadroksil sirup kering 125 mg / 5 ml
131 Sefadroksil kapsul 500 mg
132 Sianokobalamin ( vitamin B12 ) tab 50 mcg
133 Simetidin tab 200 mg
134 Simvastatin tab 10 mg
135 Siproloksasin tab 500 mg ( sebagai HCl )
136 Tetrasiklin kapsul 500 mg

ktk 10 x 10 tab
ktk 10 x 10 tab
ktk 10 x 10 tab
tube 10 gram
ktk 5 x 10 tab
ktk 5 x 10 tab
btl 500 ml
ktk 10 x 10 tab
btl 100 ml
ktk 25 tube @ 3,5 gram
ktk 25 tube @ 5 gram
ktk 3 x 10 kapsul
btl 1000 tab
btl 60 ml
ktk 10 x 10 tab
ktk 25 x 4 tab score
btl 1000 tab
ktk 10 x 10 tab
ktk 10 x 10 tab
btl 300 ml
btl 1000 tab
btl 1000 tab
btl 100 tab
ktk 25 ampul @ 2 ml
ktk 10 x 10 tab
ktk 10 x 10 tab
btl 500 ml
ktk 10 x 10 tab
ktk 10 x 10 tab
ktk 24 pot @ 30 gram
ktk 50 gram
btl 60 ml
ktk 10 x 10 tab
btl 1000 tab
ktk 10 x 10 tab
ktk 5 x 10 tab
ktk 10 x 10 tab

137 Tiamin ( Vitamin B1 ) tab 50 mg ( HCl / Nitrat )


138 Tramadol injeksi 50 mg / ml
139 Tramadol tab 50 mg
140 Vitamin B kompleks tab
141 Zinc tab 20 mg
PERBEKALAN KESEHATAN
142 Alat suntik sekali pakai 1 ml
143 Alat suntik sekali pakai 2, 5 ml
144 Alat suntik sekali pakai 5 ml
145 Catgut / benang bedah No. 2/0 dengan jarum bedah
146 Catgut / benang bedah No. 3/0 dengan jarum bedah
147 Infusion set anak
148 Infusion set dewasa
149 IV catheter No. 20 G
150 IV catheter No. 22 G
151 IV catheter No. 24 G
152 Kapas pembalut / Absorben 250 gram
153 Kasa hidrofil steril Uk. 16 x 16 cm ( isi 16 lembar )
154 Kasa hidrofil steril Uk. 18 x 22 cm ( isi 12 lembar )
155 Kasa hidrofil Uk. 36m x 80cm
156 Kasa pembalut hidrofil 4m x 5cm
157 Kasa pembalut hidrofil 4m x 10cm
158 Kasa pembalut elastic 4 inch
159 Kasa pembalut elastic 3 inch
160 Pembalut gips 3 inch
161 Pembalut gips 4 inch
162 Pembalut gips 6 inch
163 Plester 5 yeards x 2 inch
164 Silk ( benang bedah sutera ) No. 3/0 dengan jarum bedah
165 Wing Needle No. 21 G
166 Wing Needle No. 23 G
167 Urine bag
168 Foley catheter 14
169 Foley catheter 16
170 Handscoon No. 6,5
171 Handscoon No. 7
172 Handscoon No. 7,5

ktk 10 x 10 kapsul
btl 1000 tab
ktk 5 x 10 tab
btl 1000 tab
ktk 10 x 10 tab
100 set / kotak
100 set / kotak
100 set / kotak
24 x 75 cm/kotak
24 x 75 cm/kotak
set/kantong
set/kantong
50 buah/kotak
50 buah/kotak
50 buah/kotak
bungkus
kotak
kotak
rol
rol/100
rol/50
rol
rol
rol
rol
rol
100 buah/kotak
12 x 3 x 75 cm/ kotak
pcs
pcs
pcs
pcs
pcs
50 pasang/kotak
50 pasang/kotak
50 pasang/kotak

173 Masker

20 pcs/kotak

( 0542 ) 7200768

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