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Page 1 DINAS KESEHATAN KABUPATEN INDRAMAYU UPTD PUSKESMAS SUKRA Jalan Raya Sukra Wetan No. 2 Telp

Page 1

DINAS KESEHATAN KABUPATEN INDRAMAYU

UPTD PUSKESMAS SUKRA

Jalan Raya Sukra Wetan No. 2

Telp / Fax .(0234) 272057

INDRAMAYU

BERITA ACARA STOK OPNAME OBAT DAN ALKES DI UPTD PUSKESMAS SUKRA PER 31 DESEMBER 2015 NOMOR

:

Pada hari ini selasa tanggal sembilan belas bulan januari Tahun Dua ribu enam belas (19 - 01 - 2016 ), yang bertanda tangan dibawah ini :

1

dr. Hj. Tuti Warnengsih NIP

: Ka UPTD Puskesmas Sukra : 19760202 200604 2 021

 

2

Sandy Amd.far NIP

: Petugas Pengelola Obat : 19900813 201101 1 001

3

Nafsiah, AMG

: Petugas Pengelola Obat Program Gizi

NIP

:

19780329 200501 2 004

4

Hj. Bawon Amd,keb

: Petugas Pengelola Obat Program KIA

NIP

:

19690709 198903 2 004

5

Tati Hikmah Am,kep

: Petugas Pengelola Obat Program Diare

NIP

:

19790714 200204 2 021

6

Toriah Am,kep

: Petugas Pengelola Obat Program ISPA

NIP

:

19730903 200604 2 013

Telah melaksanakan Stok Opname terhadap Obat-obatan dan Alat Kesehatan pada UPTD Puskesmas Sukra Dinas Kesehatan Kabupaten Indramayu dan telah ditemukan saldo

 

NO

NAMA OBAT

SATUAN

HARGA

STOK AWAL

 

PENERIMAAN

PENGELUARAN

STO

SATUAN

VOL

JUMLAH

VOL

JUMLAH

VOL

JUMLAH

VOL

1

Air Raksa Dental use

botol

103,536

  • - -

     

-

-

2

Alat suntik sekali pakai 1 ml

set

1,093

  • - -

     

-

-

367614542.xlsx

 

Page 2

3

Alat suntik sekali pakai 2,5 ml

set

1,038

 
  • 400 415,200.00

1,300

1,349,400

1,000

1,038,000

700

4

Alat suntik sekali pakai 5 ml

set

1,038

 
  • 800 830,400.00

 

-

200

207,600

600

5

Albendazol tablet 400 mg

tablet

407

-

-

 

-

 

-

-

6

Allopurinol tablet 100 mg

tablet

105

1,300

136,500.00

500

52,500

1,400

147,000

400

7

Aminofilin tablet 200 mg

tablet

87

-

-

 

-

 

-

-

8

Aminofilin injeksi 24 mg/ml

ampul

3,240

30

97,200.00

 

-

 

-

30

9

Amitripilin tablet salut 25 mg (HCL)

tablet

102

137

13,974.00

 

-

10

1,020

127

10

Amoksisillin kapsul 250 mg

kapsul

289

5,500

1,588,125.00

10,000

2,887,500

5,500

1,588,125

10,000

11

Amoksisillin kapsul 500 mg

kapsul

370

7,000

2,590,000.00

45,000

16,650,000

27,300

10,101,000

24,700

12

Amoksisillin sirup kering 125 mg/ 5 mg

botol

2,300

-

-

1,000

2,300,000

280

644,000

720

13

Ampisillin kapsul 500 mg

kapsul

 

-

-

 

-

 

-

-

14

Ampisillin sirup kering 125 mg/5 ml

botol

 

-

-

 

-

 

-

-

15

Antalgin tablet 500 mg

tablet

124

5,560

690,663.20

50,000

6,211,000

26,600

3,304,252

28,960

16

Antalgin injeksi 250 mg/ml

ampul

1,200

-

-

 

-

 

-

-

17

Antasida DOEN I tablet kunyah, kombinasi :Aluminium Hi

tablet

78

-

-

13,000

1,013,220

6,200

483,228

6,800

18

Antibakteri DOEN salep kombinasi : Basitrasin 500 IU/g + p

tube

2,491

190

473,290.00

250

622,750

170

423,470

270

19

Antihemoroid DOEN kombinasi : Bismut Subgalat 150 mg +

supp

200

20

4,000.00

50

10,000

30

6,000

40

20

Antifungi DOEN Kombinasi : Asam Benzoat 6% + Asam Sali

pot

1,904

-

-

 

-

 

-

-

21

Antimigren : Ergotamin tartrat 1 mg + Kofein 50 mg

tablet

 

-

-

 

-

 

-

-

22

Antiparkinson DOEN tablet kombinasi : Karbidopa 25 mg

tablet

 

-

-

 

-

 

-

-

23

Aqua Pro Injeksi Steril, bebas pirogen

vial

5,000

-

-

 

-

 

-

-

24

Aquadest steril - 500 ml

botol

 

-

-

 

-

 

-

-

25

Asam Askorbat tablet 50 mg

tablet

32

9,700

310,400.00

30,000

960,000

23,900

764,800

15,800

26

Asam Askorbat tablet 250 mg

tablet

 

-

-

 

-

 

-

-

27

Asam Klorida 0.1 N - 100 ml

botol

 

-

-

 

-

 

-

-

28

Asam Sulfosalisilat 20 % - 100 ml

botol

 

-

-

 

-

 

-

-

29

Asetosal tablet 100 mg

tablet

100

-

-

 

-

 

-

-

30

Asetosal tablet 500 mg

tablet

 

-

-

 

-

 

-

-

31

Atropin Sulfat tablet 0,5 mg

tablet

68

-

-

 

-

 

-

-

32

Atropin tetes mata 0,5%

botol

 

-

-

 

-

 

-

-

33

Atropin sulfat injeksi l.m/lv/s.k. 0,25 mg/mL - 1 mL

ampul

1,230

19

23,370.00

 

-

 

-

19

34

Benzatin Benzil Pen inj 1,2 jt IU/vial

ampul

 

-

-

 

-

 

-

-

35

Benzatin Benzil Pen inj 2,4 jt IU/vial

ampul

 

-

-

 

-

 

-

-

36

Besi sirup

botol

 

-

-

 

-

 

-

-

37

Betametason krim 0,1 %

tube

1,520

200

304,000.00

200

304,000

100

152,000

300

367614542.xlsx

Page 3

38

Catgut / Benang Bedah No. 2/0 - 3/0

set

2,667

27

17,280,000.00

240

640,080

144

384,048

123

39

Dapson tablet 100 mg

tablet

-

-

-

 

-

 

-

-

40

Deksametason Injeksi I.v. 5 mg/ml

ampul

1,400

-

-

 

-

 

-

-

41

Deksametason tablet 0,5 mg

tablet

53

3,050

160,369.00

35,000

1,840,300

29,300

1,540,594

8,750

42

Dekstran 70-larutan infus 6% steril

botol

39,079

-

-

 

-

 

-

-

43

Dekstrometorfan sirup 10 mg/5 ml (HBr)

botol

1,379

-

-

 

-

 

-

-

44

Dekstrometorfan tablet 15 mg (HBr)

tablet

90

-

-

 

-

 

-

-

45

Devitalisai Pasta (Non Arsen)

botol

390,000

-

-

 

-

 

-

-

46

Diazepam Injeksi 5mg/ml

ampul

2,344

120

281,280.00

 

-

 

-

120

47

Diazepam tablet 2 mg

tablet

35

2,751

96,285.00

 

-

 
  • 10 2,741

350

 

48

Diazepam tablet 5 mg

tablet

56

1,598

89,488.00

 

-

 

-

1,598

49

Dietilkarbamazin Sitrat tablet 100 mg

tablet

 

-

-

 

-

 

-

-

50

Difenhidramin injeksi I.M. 10 mg/ml (HCL)

ampul

960

300

288,000.00

 

-

 

-

300

51

Digoksin tablet 0,25 mg

tablet

91

-

-

 

-

 

-

-

52

Efedrin tablet 25 mg (HCL)

tablet

51

-

-

 

-

 

-

-

53

Ekstrak Belladona tablet 10 mg

tablet

 

-

-

 

-

 

-

-

54

Epinefrin (Adrenalin) injeksi 0,1% (sebagai HCL)

ampul

1,500

-

-

 

-

 

-

-

55

Etakridin larutan 0,1%

botol

2,212

-

-

 

-

 

-

-

56

Etambutol HCl tablet 250 mg

tablet

 

-

-

 

-

 

-

-

57

Etanol 70%

botol

14,959

-

-

20

299,178

 
  • 13 194,466

7

58

Eter Anestetik

botol

 

-

-

 

-

 

-

-

59

Etil Klorida

botol

105,000

8

840,000.00

5

525,000

6

630,000

7

60

Eugenol cairan

botol

45,833

-

-

 

-

 

-

-

61

Fenitoin Natrium Injeksi 50 mg/ml

ampul

 

-

-

 

-

 

-

-

62

Fenitoin Natrium kapsul 100 mg

kapsul

73

-

-

 

-

 

-

-

63

Fenitoin Natrium Injeksi 30 mg

ampul

121

-

-

 

-

 

-

-

64

Fenobarbital injeksi I.m/I.v 50 mg/ml

ampul

1,716

-

-

 

-

 

-

-

65

Fenobarbital tablet 100 mg

tablet

144

-

-

 

-

 

-

-

66

Fenobarbital tablet 30 mg

tablet

61

10,990

670,390.00

 

-

 

-

10,990

67

Fenoksimetil Pen tablet 250 mg

tablet

 

-

-

 

-

 

-

-

68

Fenoksimetil Pen tablet 500 mg

tablet

 

-

-

 

-

 

-

-

69

Fenol Gliserol tetes telinga 10%

botol

1,008

-

-

 

-

 

-

-

70

Fitomenadion injeksi 10 mg/ml

ampul

1,566

-

-

90

140,940

 

-

90

71

Fitomenadion tablet salut 10 mg

tablet

579

-

-

 

-

 

-

-

72

Fluor tablet 0,5 mg

tablet

 

-

-

 

-

 

-

-

 

367614542.xlsx

 

Page 4

73

Furosemid tablet 40 mg

tablet

78

200

15,600.00

1,000

78,000

 
  • 600 46,800

600

74

Ferinokresol

botol

 

-

-

 

-

 

-

-

75

Gameksan lotion 1 %

botol

 

-

-

 

-

 

-

-

76

Garam Oralit 200 ml air

kantong

992

16,200

16,070,400.00

 

-

 
  • 900 892,800

15,300

77

Garam Oralit 1000 ml air

kantong

 

-

-

 

-

 

-

-

78

Gentian Violet Larutan 1 %

botol

895

-

-

96

85,920

72

64,440

24

79

Glass Ionomer Cement (GC IX)

set

395,000

-

-

 

-

 

-

-

80

Glibenklamida tablet 5 mg

tablet

54

-

-

1,000

54,000

500

27,000

500

81

Gliseril Guayakolat tablet 100 mg

tablet

28

6,000

167,400.00

45,000

1,255,500

36,000

1,004,400

15,000

82

Gliserin

botol

 

-

-

 

-

 

-

-

83

Glukosa larutan infus 5%

botol

5,313

20

106,260.00

 

-

 

-

20

84

Glukosa larutan infus 10%

botol

5,727

134

767,418.00

 

-

 

-

134

85

Glukosa larutan infus 40% steril

botol

1,960

-

-

 

-

 

-

-

86

Griseofulvin tablet 125 mg

tablet

228

660

150,480.00

 

-

60

13,680

600

87

Gutta Percha Points

stik

 

-

-

 

-

 

-

-

88

Haloperidol tablet 0,5 mg

tablet

53

67

3,518.84

100

5,252

30

1,576

137

89

Haloperidol tablet 1,5 mg

tablet

60

-

-

 

-

 

-

-

90

Hidroklortiazida tablet 25 mg

tablet

36

-

-

 

-

 

-

-

91

Hidrokortison krim 2,5%

tube

2,541

72

182,952.00

360

914,760

206

523,446

226

92

Ibuprofen tablet 200 mg

tablet

93

-

-

 

-

 

-

-

93

Ibuprofen tablet 400 mg

tablet

145

29,100

4,219,500.00

10,000

1,450,000

4,900

710,500

34,200

94

Infusion set anak

set

4,000

-

-

100

400,000

50

200,000

50

95

Infusion set dewasa

set

3,500

300

1,050,000.00

600

2,100,000

250

875,000

650

96

Insulin Reguler injeksi 40 IU/ml

vial

 

-

-

 

-

 

-

-

97

Idiol Kapsul Lunak

kapsul

 

-

-

 

-

 

-

-

98

Ipeka 0,14 % syr

botol

 

-

-

 

-

 

-

-

99

Isoniazid tablet 300 mg

tablet

 

-

-

 

-

 

-

-

100

Isosorbid Dinitrat tab subl 5 mg

tablet

92

-

-

 

-

 

-

-

101

Jarum jahit (Bedah No. 9 s/d 14)

kotak

 

-

-

 

-

 

-

-

102

Kalium Permanganat serbuk - 5 mg

set

 

-

-

 

-

 

-

-

103

Kalsium Hidroksida Pasta

kotak

242,000

-

-

 

-

 

-

-

104

Kalsium Laktat tablet 500 mg

tablet

52

2,400

124,800.00

 

-

 

-

2,400

105

Kapas Berlemak 500 gram

roll

 

-

-

 

-

 

-

-

106

Kapas Pembalut/Absorben 250 g

roll

7,500

7

52,500.00

10

75,000

12

90,000

5

107

Karbamazepin tablet 200 mg

tablet

243

-

-

 

-

 

-

-

 

367614542.xlsx

Page 5

108

Kasa Hidrofil 18 m x 22 cm

roll

1,386

120

166,320.00

 

-

 

-

120

109

Kasa Hidrofil Steril 80 cm x 36 cm

roll

5,500

-

-

6

33,000

6

33,000

-

110

Kasa Pembalut Hidrofil 4 m x 10 cm

roll

550

-

-

 

-

 

-

-

111

Kasa Pembalut Hidrofil 4 m x 5 cm

roll

2,200

50

110,000.00

 

-

 

-

50

112

Ketamin Injeksi 10 mg/ml

vial

 

-

-

 

-

 

-

-

113

Klofazimin kapsul 100 mg microzine

kapsul

 

-

-

 

-

 

-

-

114

Kloramfenikol kapsul 250 mg

kapsul

240

1,000

240,000.00

3,000

720,000

2,750

660,000

1,250

115

Kloramfenikol salep mata 1%

tube

1,562

-

-

 

-

 

-

-

116

Kloramfenikol tetes telinga 3 %

botol

1,599

-

-

 

-

 

-

-

117

Klorfeniramin maleat (CTM) tab 4 mg

tablet

26

-

-

60,000

1,560,000

30,400

790,400

29,600

118

Kloroquin Fosfat tablet 250 mg

tablet

 

-

-

 

-

 

-

-

119

Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL)

ampul

1,021

-

-

 

-

 

-

-

120

Klorpromazin injeksi i.m 5 mg/ml (HCL)

ampul

950

-

-

 

-

 

-

-

121

Klorpromazin tablet salut 25 mg (HCL)

tablet

45

-

-

 

-

 

-

-

122

Klorpromazin tablet salut 100 mg (HCl)

tablet

 

-

-

 

-

 

-

-

123

Klorpropamid tablet 100 mg

tablet

 

-

-

 

-

 

-

-

124

Kodein HCl tablet 10 mg

tablet

470

-

-

 

-

 

-

-

125

Kombinasi Pirimetamin 25 mg + Sulfadoksin 500 mg

tablet

 

-

-

 

-

 

-

-

126

Kotrimoksazol pedia tablet 120 mg

tablet

76

-

-

 

-

 

-

-

127

Kotrimoksazol suspensi 240 mg

botol

2,574

460

1,184,040.00

800

2,059,200

100

257,400

1,160

128

Kotrimoksazol tablet 480 mg

tablet

148

2,500

370,000.00

5,000

740,000

2,200

325,600

5,300

129

Kuinin Di HCl injeksi 25%-2 ml

ampul

 

-

-

 

-

 

-

-

130

Kuinin (kina) tablet 200 mg

tablet

 

-

-

 

-

 

-

-

131

Larutan Benedict

botol

27,445

-

-

 

-

 

-

-

132

Larutan Eosin 2%

botol

105,036

-

-

 

-

 

-

-

133

Larutan Etanol Asam

botol

29,216

-

-

 

-

 

-

-

134

Larutan Gabbet

botol

-

-

-

 

-

 

-

-

135

Larutan Giemsa Stain

botol

137,033

-

-

 

-

 

-

-

136

Larutan Karbol Fuksin

botol

50,256

-

-

 

-

 

-

-

137

Larutan Kinyoun

botol

-

-

-

 

-

 

-

-

138

Larutan Metilen Biru

botol

21,580

-

-

 

-

 

-

-

139

Larutan Turk

botol

20,749

-

-

 

-

 

-

-

140

Lidokain comp injeksi 2% (HCL) + Epinefrin 1 : 80.000-2 ml

ampul

1,295

-

-

300

388,500

200

259,000

100

141

Lisol

botol

41,385

4

165,541.20

 

-

2

82,771

2

142

Magnesium Sulfat inj (IV) 20%-25 ml

vial

2,078

400

831,200.00

 

-

 

-

400

 

367614542.xlsx

Page 6

143

Magnesium Sulfat inj (IV) 40%-25 ml

vial

2,629

400

1,051,600.00

 

-

 

-

400

144

Magnesium Sulfat serbuk 30 gram

kotak

 

-

-

 

-

 

-

-

145

Mebendazol sirup 100 mg / 5 ml

botol

 

-

-

 

-

 

-

-

146

Mebendazol tablet 100 mg

tablet

 

-

-

 

-

 

-

-

147

Metanol

botol

 

-

-

 

-

 

-

-

148

Metilergometrin Maleat tablet salut 0,125 mg

tablet

140

-

-

 

-

 

-

-

149

Metilergometrin Maleat injeksi 0,200 mg -1 ml

ampul

1,490

-

-

 

-

 

-

-

150

Metronidazol tablet 250 mg

tablet

123

1,160

142,448.00

 

-

1,000

122,800

160

151

Monoklor Kamfer Menthol ( CHKM )

botol

44,000

-

-

 

-

 

-

-

152

Mummifying Pasta

kotak

140,800

-

-

 

-

 

-

-

153

Natrium Bikarbonat tablet 500 mg

tablet

14

-

-

 

-

 

-

-

154

Natrium Fluoresein tetes mata 2 %

botol

 

-

-

 

-

 

-

-

155

Natrium Klorida larutan infus 0,9 %

botol

4,900

20

98,000.00

 

-

4

19,600

16

156

Natrium Thiosulfat injeksi I.v. 25 %

ampul

 

-

-

 

-

 

-

-

157

Nistatin tablet salut 500.000 IU/g

tablet

640

60

38,400.00

 

-

60

38,400

-

158

Nistatin Vaginal tablet salut 100.000 IU/g

tablet

407

-

-

 

-

 

-

-

159

OAT Katagori 1 dewasa

paket

 

-

-

 

-

 

-

-

160

OAT Katagori 2 dewasa

paket

 

-

-

 

-

 

-

-

161

OAT Katagori 3 dewasa

paket

 

-

-

 

-

 

-

-

162

OAT Sisipan dewasa

paket

 

-

-

 

-

 

-

-

163

OAT Katagori anak

paket

 

-

-

 

-

 

-

-

164

Obat Batuk Hitam ( O.B.H.)

botol

1,259

600

251,790.00

 
  • 600 755,370

600

755,370

600

165

Oksigen Gas dalam tabung

tabung

 

-

-

 

-

 

-

-

166

Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml

vial

3,100

-

-

 

-

 

-

-

167

Oksitetrasiklin HCL salep mata 1 %

tube

2,350

     

-

 

-

-

168

Oksitetrasiklin HCL salep kulit 3 %

tube

1,529

200

305,800.00

 
  • 200 305,800

225

344,025

175

169

Oksitosin injeksi 10 UI/ml-1 ml

ampul

1,785

600

1,071,000.00

 

-

 

-

600

170

Paraformaldehid tablet 1 g

tablet

 

-

-

 

-

 

-

-

171

Parasetamol sirup 120 mg / 5 ml

botol

1,319

168

221,575.20

1,700

2,242,130

1,112

1,466,617

756

172

Parasetamol tablet 100 mg

tablet

32

-

-

 

-

 

-

-

173

Parasetamol tablet 500 mg

tablet

84

46,360

3,890,994.80

37,100

3,113,803

15,600

1,309,308

67,860

174

Pembalut Gips

roll

 

-

-

 

-

 

-

-

175

Perfenazin tablet 4 mg

tablet

 

-

-

 

-

 

-

-

176

Perfenazin tablet 16 mg

tablet

 

-

-

 

-

 

-

-

177

Petidin HCl injeksi 50 mgml - 2 ml

ampul

13,191

-

-

 

-

 

-

-

 

367614542.xlsx

Page 7

178

Pilokarpin tetes mata 2 % (HCL/Nitrat)

botol

 

-

-

 

-

 

-

-

179

Piperazin sirup 20 %

botol

 

-

-

 

-

 

-

-

180

Piperazin tablet 500 mg

tablet

 

-

-

 

-

 

-

-

181

Pirantel tab score (base) 125 mg

tablet

311

-

-

 

-

 

-

-

182

Piridoksin tablet 10 mg (HCl)

tablet

17

10,000

174,000.00

40,000

696,000

26,000

452,400

24,000

183

Plester 5 yards x 2 inch

roll

23,625

18

425,250.00

6

141,750

3

70,875

21

184

Polikresulen

botol

 

-

-

 

-

 

-

-

185

Polipeptida kombinasi DOEN Lar infus

botol

 

-

-

 

-

 

-

-

186

Povidon Iodida lar 10 % - 10 ml

botol

 

-

-

 

-

 

-

-

187

Povidon Iodida lar 10 % - 30 ml

botol

2,000

17

16,000.00

 

-

8

16,000

9

188

Povidon Iodida lar 10 % - 300 ml

botol

14,000

8

112,000.00

5

70,000

10

140,000

3

189

Povidon Iodida lar 10 % - 1000 ml

botol

 

-

-

 

-

 

-

-

190

Prazikuantel tablet 600 mg

tablet

 

-

-

 

-

 

-

-

191

Prednison tablet 5 mg

tablet

52

-

-

3,000

156,000

1,100

57,200

1,900

192

Primakuin tablet 15 mg

tablet

109

-

-

 

-

 

-

-

193

Prokain Benzil Pen 3 jt IU / vial inj

vial

6,100

-

-

 

-

 

-

-

194

Propanolol tablet 40 mg (HCL)

tablet

108

100

10,800.00