LAPORAN PENGGUNAAN PSIKOTROPIKA

Nama Apotek
Nomor SIA
Alamat & Telepon

:
:
:
:
:

Kabupaten
Bulan
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

NAMA SEDIAAN
Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg
Frisium

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Jan-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Tablet

163
171
135
330
0
0
0
0
18
32
256
0
0
540
0
250
58
36
27
22
0
0
19
19
0
0
20
472
0
30
7

PENERIMA PENGELUA
AN
RAN
5
500
900
100

124
105
372
360

250

4
8

310
2
1
25

28
11
7
6
28

17

70
10

39

STOK
AKHIR
44
566
644
70
0
0
0
0
264
32
248
0
0
230
0
224
47
30
21
19
0
0
19
2
0
0
20
402
0
1
7

Tembusan :
1. Yth Dinas Kesehatan Tk I Propinsi

Sengata,03 Februari 2016

2. Yth Balai POM

3. Arsip

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

engata,03 Februari 2016

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

LAPORAN PENGGUNAAN PSIKOTROPIKA

Nama Apotek
Nomor SIA
Alamat & Telepon

Kabupaten
Bulan
No

NAMA SEDIAAN

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

Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg
Frisium
Persidal
Prohiper

Tembusan :

:
:
:
:
:

Apotek Rumah Sakit Prima Senga

440.445/16/Yankes-DKKT/VIII/201
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Feb-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet

44
566
644
70
0
0
0
0
264
32
248
0
0
230
0
224
47
30
21
19
0
0
19
2
0
0
20
402
0
1
7
20
40

PENERIMA PENGELUAR
AN
AN
44
190
121
70

6
50
5

38

232

27
35

33
27
5
29
28

300
20

273
5
3

200

60
170

470

32
3
5
10

STOK
AKHIR
0
376
523
0
0
0
0
0
258
82
243
0
0
36
0
191
20
25
19
26
0
27
14
19
0
140
20
232
0
439
4
15
30

1. Yth Dinas Kesehatan Tk I Propinsi

2. Yth Balai POM
3. Arsip

Sengata,01 Maret 2016

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

engata,01 Maret 2016

Apoteker

achel Randa,Ssi,Apt
o.SIPA:446/015/SDK

LAPORAN PENGGUNAAN PSIKOTROPIKA

Nama Apotek
Nomor SIA
Alamat & Telepon

Kabupaten
Bulan
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

NAMA SEDIAAN
Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg
Frisium
Persidal
Prohiper

Tembusan :

:
:
:
:
:

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Mar-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet

0
376
523
0
0
0
0
0
258
82
243
0
0
36
0
191
20
25
19
26
0
27
14
19
0
140
20
232
0
439
4
15
30

PENERIMA PENGELUA
AN
RAN

500

123
567

16
3
6

160

81

25
8

25
25

14
8
26
19
14

100
138
5
10

STOK
AKHIR
0
253
456
0
0
0
0
0
242
79
237
0
0
115
0
166
12
25
30
43
0
1
14
0
0
126
20
132
0
301
4
10
20

1. Yth Dinas Kesehatan Tk I Propinsi

2. Yth Balai POM
3. Arsip

Sengata,01 April 2016

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

engata,01 April 2016

Apoteker

achel Randa,Ssi,Apt
o.SIPA:446/015/SDK

LAPORAN PENGGUNAAN PSIKOTROPIKA

Nama Apotek
Nomor SIA
Alamat & Telepon

:
:
:
:
:

Kabupaten
Bulan
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

NAMA SEDIAAN
Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Apr-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet

0
253
456
0
0
0
0
0
242
79
237
0
0
115
0
166
12
25
30
43
0
1
14
0
0
126
20
132
0
301

PENERIMA PENGELUA
AN
RAN
118
456

6
50
5

60

20

27
24

75
75

11
16

2
20

1
11
16
94
102

STOK
AKHIR
0
135
0
0
0
0
0
0
236
129
232
0
0
55
0
139
8
25
94
102
0
1
15
9
0
110
20
38
0
199

Tembusan :
1. Yth Dinas Kesehatan Tk I Propinsi
2. Yth Balai POM
3. Arsip

Sengata,01 Mei 2016

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

engata,01 Mei 2016

Apoteker

achel Randa,Ssi,Apt
o.SIPA:446/015/SDK

LAPORAN PENGGUNAAN PSIKOTROPIKA

Nama Apotek
Nomor SIA
Alamat & Telepon

Kabupaten
Bulan
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

NAMA
SEDIAAN
Alprazolam
Alprazolam
Analsik
Braxidin
Cepezet Inj
Diazepam 2
Fortanes inj
Fortanes inj
Hexymer ta
Lodomer tab
Meprosetil
Opineuron
Phenobarbita
Phenobarbit
Phental 100
Risperidon
Sedacum
Sibital Inj
Stesolid 10
Stesolid 5 m
Stesolid 2 m
Stesolid 5 m
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2
Valisanbe in
Zypras 0.5
Zypras 1 mg
Valisanbe 5
Miloz

:
:
:
:
:

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
May-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Injeksi

0
135
0
0
0
0
0
0
236
129
232
0
0
55
0
139
8
25
94
102
0
1
15
9
0
110
20
38
0
199

PENERIMA PENGELUA
AN
RAN
500

190

2
5

55

4
13
10

20

20

1
11
57
5
38
145
12

STOK
AKHIR

KET

0
445
0
0
0
0
0
0
234
129
227
0
0
0
0
139
0
21
82
92
0
1
14
18
0
53
17
0
0
54
8

Tembusan :
1. Yth Dinas Kesehatan Tk I P
2. Yth Balai POM

Sengata,05 Juni 2016

Apoteker

3. Arsip
Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

Juni 2016

LAPORAN PENGGUNAAN PSIKOTROPIKA

Nama Apotek
Nomor SIA
Alamat & Telepon

:
:
:
:
:

Kabupaten
Bulan
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

NAMA SEDIAAN
Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg
Miloz 5 ml
Miloz 15 ml

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Jun-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Injeksi
Injeksi

0
445
0
0
0
0
0
0
234
129
227
0
0
0
0
139
0
21
82
92
0
1
14
18
0
53
17
0
0
54
8

PENERIMA PENGELUA
AN
RAN
310

14
227

160

81
30
3
14
17
1
1
13

15

67

45

79
8
1

10

STOK
AKHIR
0
135
0
0
0
0
0
0
220
129
0
0
0
79
0
109
0
18
68
87
0
0
13
5
0
1
17
0
0
20
0
9

Tembusan :
1. Yth Dinas Kesehatan Tk I Propinsi
2. Yth Balai POM

Sengata,05 Juli 2016

Apoteker

3. Arsip
Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

exp

engata,05 Juli 2016

Apoteker

achel Randa,Ssi,Apt
o.SIPA:446/015/SDK

Nama Apotek
Nomor SIA
Alamat & Telepon

:
:
:
:
:

Kabupaten
Bulan
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

NAMA SEDIAAN
Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg
Miloz 5 ml
Miloz 15 ml

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Jul-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Injeksi
Injeksi

0
135
0
0
0
0
0
0
220
129
0
0
0
79
0
109
0
18
68
87
0
0
13
5
0
1
17
0
0
20
0

PENERIMA PENGELUA
AN
RAN
130

99
135

17
30

5
7
65

60
2
5
1

120

44
4

STOK
AKHIR
31
0
0
0
0
0
0
0
216
129
0
0
0
62
0
79
0
18
63
80
0
5
11
0
0
0
17
0
0
96
0
5

Tembusan :
1. Yth Dinas Kesehatan Tk I Propinsi
2. Yth Balai POM
3. Arsip

Sengata,05 Agustus 201

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

engata,05 Agustus 2016

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

Nama Apotek
Nomor SIA
Alamat & Telepon

Kabupaten
Bulan
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

NAMA
SEDIAAN
Alprazolam
Alprazolam
Analsik
Braxidin
Cepezet Inj
Diazepam 2
Fortanes inj
Fortanes inj
Hexymer ta
Lodomer tab
Meprosetil
Opineuron
Phenobarbita
Phenobarbit
Phental 100
Risperidon
Sedacum
Sibital Inj
Stesolid 10
Stesolid 5 m
Stesolid 2 m
Stesolid 5 m
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2
Valisanbe in
Zypras 0.5
Zypras 1 mg
Valisanbe 5
Miloz 5 ml
Miloz 15 ml

:
:
:
:
:

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Aug-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Injeksi
Injeksi

31
0
0
0
0
0
0
0
216
129
0
0
0
62
0
79
0
18
63
80
0
5
11
0
0
0
17
0
0
96
0

PENERIMA PENGELUA
AN
RAN
1090

262

15
30
30

3
5
8

40

32
4

100

196

STOK
AKHIR

KET

859
0
0
0
0
0
0
0
212
129
0
0
0
47
0
49
0
45
58
72
0
13
7
0
0
0
17
0
0
0
0
0

Tembusan :
1. Yth Dinas Kesehatan Tk I P
2. Yth Balai POM
3. Arsip

Sengata,05 September 2016

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

September 2016

Nama Apotek
Nomor SIA
Alamat & Telepon

:
:
:
:
:

Kabupaten
Bulan
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

NAMA SEDIAAN
Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg
Miloz 5 ml
Miloz 15 ml

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Sep-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Injeksi
Injeksi

859
0
0
0
0
0
0
0
212
129
0
0
0
47
0
49
0
45
58
72
0
13
7
0
0
0
17
0
0
0
0
0

PENERIMA PENGELUA
AN
RAN
282

20

30
15
50
9
14
105
30

115
2
4

100

100

STOK
AKHIR
577
0
0
0
0
0
0
0
192
129
0
0
0
17
0
34
50
45
49
58
0
3
5
26
0
0
17
0
0
0
0
1

Tembusan :
1. Yth Dinas Kesehatan Tk I Propinsi
2. Yth Balai POM
3. Arsip

Sengata,05 Oktober 201

Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

engata,05 Oktober 2016

Apoteker

achel Randa,Ssi,Apt
o.SIPA:446/015/SDK

Nama Apotek
Nomor SIA
Alamat & Telepon

:
:
:
:
:

Kabupaten
Bulan
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

NAMA SEDIAAN
Alprazolam 0.5 mg
Alprazolam 1 mg
Analsik
Braxidin
Cepezet Inj
Diazepam 2 mg
Fortanes inj
Fortanes inj 15 mg
Hexymer tab 2 mg
Lodomer tab 2 mg
Meprosetil 100 mg
Opineuron
Phenobarbital Inj
Phenobarbital 30 mg
Phental 100
Risperidon Tab 2 mg
Sedacum
Sibital Inj
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Stesolid 2 mg tablet
Stesolid 5 mg tablet
Stesolid Inj
Stesolid Syr
Trazep 5 mg
Valisanbe 2 mg
Valisanbe inj
Zypras 0.5 mg
Zypras 1 mg
Valisanbe 5 mg
Miloz 5 ml
Miloz 15 ml

Apotek Rumah Sakit Prima Seng

440.445/16/Yankes-DKKT/VIII/20
Jl.Yos Sudarso I,No.1Sengata
Telp (0549)24555

Kutai Timur
Oct-16

SATUAN

STOK AWAL

Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Tablet
Tablet
Tablet
Tablet
Injeksi
Tablet
Injeksi
Tablet
Injeksi
Injeksi
Rectal
Rectal
Tablet
Tablet
Injeksi
Syrup
Rectal
Tablet
Injeksi
Tablet
Tablet
Tablet
Injeksi
Injeksi

577
0
0
0
0
0
0
0
192
129
0
0
0
17
0
34
50
45
49
58
0
3
5
26
0
0
17
0
0
0
0

PENERIMA PENGELUA
AN
RAN
6

234

400
230

165
220

21

17

1
13
4

25
19

250
250
1000

17
29
38
166

STOK
AKHIR
349
0
235
10
0
0
0
0
171
129
0
0
0
0
0
34
50
44
36
54
0
0
30
7
0
0
0
221
212
834
0
1

Tembusan :
1. Yth Dinas Kesehatan Tk I Propinsi
2. Yth Balai POM
3. Arsip

Sengata,05 November 2
Apoteker

Rachel Randa,Ssi,Apt
No.SIPA:446/015/SDK

KET

engata,05 November 2016

Apoteker

achel Randa,Ssi,Apt
o.SIPA:446/015/SDK