LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS

CATEGORY : OBAT BEBAS REGION

LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

1 02000223 ABATE SACH; BOX/50 SACHET 1201120001
2 07000015 ACCUTREND CHOLESTEROL 25 STRIP STRIP -
3 02000085 ACNOL LOTION 10ML BOTTLE 360502
4 02000133 ACTIFED DM MERAH SYR 60ML BOTTLE 152D13
5 02000131 ACTIFED EXPEC HIJAU SYR 60ML BOTTLE 130D13
6 02000132 ACTIFED KUNING SYR 60ML BOTTLE 098C13
7 02000313 ADEM SARI 6`S SACHET 06766135
8 06000004 AKURAT TEST KEHAMILAN PIECES 0125
9 04000003 ALCOHOL 70% 100ML (CITO) BOTTLE -
10 02000982 ALINAMIN-F TABL ; BOX/100 STRIP CFED
11 04000020 ALKOHOL 70% 100 ML (MOLEX AYUS) BOTTLE VS031
12 02001040 ALKOHOL 70% 300 ML (MOLEX AYUS) BOTTLE -
13 02000119 ALPARA TABL (MOLEX AYUS) TABLET VA037
14 05000004 AMBEVEN @10CAPSUL STRIP 65DK01
15 02001016 ANACETIN SYR 60ML BOTTLE IT63230
16 02000950 ANAKONIDIN SYR 60ML BOTTLE SEP13A14
17 06000005 ANDALAN TES KEHAMILAN (LOOSE PACK) PIECES 09021
18 06000003 ANDALAN TES KEHAMILAN (WITH PACK) PACKAGE 04223
19 02000302 ANTANGIN GINGER MINT 15ML @10 SACHET SACHET W002FM
20 02000303 ANTANGIN GINGER MOCHA 15ML @10 SACHET SACHET Q004IM
21 05000042 ANTANGIN JRG SYRUP 15ML @10 SACHET SACHET A150EM
22 02000301 ANTANGIN JRG TABL (20X4`S) STRIP BAHM
23 02000030 ANTIMO @10TABLET STRIP 55002115
24 02000029 ANTIMO ANAK RASA JERUK 5ML SACHET 55107169
25 02000206 APIALYS SYRUP 100ML BOTTLE 30303
26 02001043 ASMASOHO 100 (4X25)TAB STRIP 13B0304
27 02000086 ASMASOLON @4TABLET STRIP 2151101
28 02000034 ASPILET CHEWABLE @10TABLET STRIP 3030001
29 02000963 AUTAN LOTION JUNIOR TUBE 50 GR TUBE M27081311
30 08000016 AVAIL (DAY USE) FC BIO SANITARY PAD PACKAGE 130610
31 08000010 AVAIL (PANTILINER) FC BIO SANITARY PAD PACKAGE -
32 02000252 BABY CREAM 50GR CARES&PROTECTS YELLOW (CUSSON BABY) JAR 071321
33 02000202 BABY WIPES 10`S PACKAGE -
34 02000069 BABY`S COUGH SYRUP 60 ML BOTTLE 26450
35 02000214 BALSAM BALPIRIK MKP 20 GR BOTTLE 1010124
36 02000003 BALSAM BALPIRIK X-TRA KUAT 20G BOTTLE 0103131
37 02000291 BALSAM GOSOK HIJAU CAP LANG 20 GR POT 44II0103
38 02000008 BALSEM OTOT GELIGA 10GR BOTTLE 43LM0124
39 02000266 BALSEM OTOT GELIGA CAP LANG 20GR BOTTLE 44ID0024
40 02000188 BATUGIN ELIXIR 300ML BOTTLE I131266B
41 03000065 BECOMBION SYR 110ML BOTTLE T1259458
42 02001029 BEDAK HEROCYN 150 GR BOTTLE I3D148
43 02000093 BEDAK HEROCYN 75GR BOTTLE I3D258
44 02001028 BEDAK HEROCYN BABY 100 GR BOTTLE K3K054
45 08000017 BEDAK MARCKS (CREAM) PACKAGE EC05815
46 08000018 BEDAK MARCKS (PINK) PACKAGE HC09965
47 02000038 BEDAK SALICYL KIMIA FARMA 60GR PACKAGE DC0409S
48 07000033 BENECHECK URIC ACID METER BOX -
49 07000034 BENECHECK URIC ACID STRIP (CEK ASAM URAT) STRIP -
50 07000035 BENECHECK URIC ACID STRIP; BOX/25 BOX -
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

51 05000055 BERSIH DARAH KEMBANG BULAN 12`S BOTTLE -
52 02000246 BETADINE FEMININE HYGINE 60ML MERAH JAMBU BOTTLE F13674
53 02000081 BETADINE OBAT KUMUR 100ML BOTTLE -
54 04000005 BETADINE SOL 15ML BOTTLE D13186
55 02000176 BETADINE SOL 30ML BOTTLE H13239
56 04000004 BETADINE SOL 5ML BOTTLE -
57 02000174 BETADINE VAGINAL DOUCHE ALAT 100ML BOTTLE E13591
58 02000175 BETADINE VAGINAL DOUCHE REFILL 100ML BOTTLE F13634A
59 03000017 BETOMINPLEX B+B12 @100TABLET ZAK 06131003
60 02000247 BIODIAR 630 MG TABL ; BOX/100 STRIP ID2997
61 02001044 BIODIAR 630 MG TABL ; BOX/60 STRIP -
62 02000015 BIOGESIC @4TABLET STRIP 13048501
63 03000009 BIOLYSIN KIDS STRAWB @30TABLET BOX TPE23242
64 03000010 BIOLYSIN SMART + AA&DHA 60ML BOTTLE SCF26742
65 05000054 BIOPROST CAPS ; BOX/30 STRIP 12120527
66 05000038 BIOVISION CAPS ; BOX/100 STRIP 1210015
67 03000051 BIOVISION KIDS SYRUP 100ML BOTTLE 1211009
68 02000183 BISOLVON 8MG TABL TABLET B13040478
69 02000222 BISOLVON EXTRA SYR 60 ML BOTTLE 13050690
70 02000182 BISOLVON FLU SYR 60ML BOTTLE 13050843
71 02001033 BISOLVON KIDS STRAWBERRY SYRUP 60ML BOTTLE 13050725
72 02000181 BISOLVON SYR 60ML BOTTLE 13030393
73 02000010 BODREX EXTRA @4KAPLET STRIP 040013
74 02000067 BODREX FLU&BATUK @4TABLET STRIP 050043
75 02000068 BODREX FLU&BTK BERDHAK @4TABLET STRIP 070023
76 02000011 BODREX MIGRA @4KAPLET STRIP 070063
77 02000270 BODREX TABLET (2X10`S) STRIP 0633
78 02000080 BODREXIN FLU & BATUK 56ML BOTTLE 090063
79 02000317 BODREXIN TABL (2X10`S) STRIP 060693
80 02000084 BORAX GLYCERINE 10% 8ML GOM BOTTLE -
81 03000056 BRAINVIT SYRUP 60 ML BOTTLE B13812
82 02000205 BREAST PUMP PLASTIC MADE PACKAGE -
83 02001070 BREAST PUMP WITH BOTTLE (DODORINDO) BOTTLE -
84 02000234 BYE BYE FEVER FOR CHILDREN ; BOX/5 PIECES N603D
85 02000094 CA D REDOXON EFF. TUBE CM17665
86 03000059 CAL D CHEWZ BOTTLE 059125RI
87 02001072 CAL-95 TABL ; BOX/30 STRIP I1803
88 02001041 CALADINE BABY LIQUID SOAP 100 ML BOTTLE I1301
89 02000035 CALADINE LOTION 60ML BOTTLE F1313
90 02000036 CALADINE POWDER 100GR BOTTLE C1301
91 02001007 CALCUSOL 30`S BOTTLE 020913
92 02000145 CALLUSOL LOTION 10 ML BOTTLE HK1481
93 03000023 CANDY VIT C BOTTLE -
94 02000277 CANESTEN CREAM KULIT 5GR TUBE BXPJH4B
95 02000403 CAVIPLEX KAPL (10 X 10`S) STRIP F1448150
96 03000044 CDR FORTOS EFF 10`S TUBE CM16266
97 03000043 CDR FRUIT PUNCH EFF 10`S TUBE CM14847
98 02000297 CEREBROFORT GOLD 200ML BOTTLE 525168
99 02000975 CEREBROFORT GOLD STRAWBERRY 100ML BOTTLE 527454
100 02000134 CEREBROFOT SYRUP 100 ML (AA+DHA) BOTTLE -
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

101 02000299 CEREBROVIT X-CEL KAPS 10`S PACKAGE 524765
102 08000009 CHARM (42CM) EXTRA NIGHT WING 8`S PACKAGE 20120910A1201
103 08000008 CHARM EXTRA MAXI NON WING 10`S PACKAGE 3041915
104 08000007 CHARM EXTRA MAXI WING 10`S PACKAGE 3071613
105 02001047 CHRYSANTHEMUM CRYSTALS SACHET A081302
106 02000095 CITO SALICYL TALK MENTHOL 50GR PACKAGE HM06B3
107 02000071 CITOCETIN SYR 60ML BOTTLE JL01S4
108 02000410 COD LIVER OIL (MINYAK IKAN) BTL CAPSULE 4902CL
109 02000096 COLDREXIN 60ML BOTTLE 01608303
110 02001080 COLFIN SYR 60ML BOTTLE -
111 09000024 COLUSMIN SUSU SKIM BUBUK SACHET 0910212
112 02000022 COMBANTRIN 125MG @4TABLET STRIP 22918114
113 02000224 COMBANTRIN 250MG ; BOX/50 STRIP 32918018
114 02000144 COMBANTRIN JERUK 125MG SYR 10ML BOTTLE 32918084
115 02000005 COPAL C/R BALSEM ANAK 25G TUBE TUBE 1211016
116 02000204 COTTON BALL PACKAGE -
117 02000203 COTTON SWAB 100PCS PACKAGE -
118 02000943 COUNTERPAIN COOL 15 GR TUBE 3F1211
119 02000232 COUNTERPAIN CR 15G TUBE 363481
120 02000138 COUNTERPAIN CR 30G TUBE -
121 02000091 CURCUMA @10TABLET STRIP 13N0211
122 02001065 CURCUMA PLUS (100ML) FRUIT & VEGGIE ORANGE BOTTLE 13I0376
123 02000118 CURCUMA PLUS EMULSION ORANGE 200 ML BOTTLE 13H0076
124 02000121 CURCUMA PLUS EMULSION STRAWBERRY 200 ML BOTTLE 13I0405
125 02001067 CURCUMA PLUS IMUNS SYR 60ML BOTTLE -
126 02001063 CURCUMA PLUS PREBIOTIK&DHA EPA ORANGE 120ML BOTTLE 13G0591
127 02001064 CURCUMA PLUS PREBIOTIK&DHA EPA STRAW 120ML BOTTLE -
128 02000092 CURCUMA PLUS SYR 60ML BOTTLE 13I0424
129 02001066 CURCUMA PLUS(200ML) FRUIT & VEGGIE ORANGE BOTTLE 13G0220
130 03000049 CURVIT SYR 60ML BOTTLE 13H0426
131 09000028 CUT GUT PLAIN 3/0 150 CM PIECES -
132 09000029 CUT GUT SILK 3/0 150 CM PIECES -
133 02000236 DAKTARIN CR 5GR TUBE 3H5051
134 02000098 DARSI @12KAPSUL PACKAGE 056BL04
135 02000076 DECOLGEN @4TABLET STRIP 13036101
136 05000050 DECOLGEN HERBAFLU SACHET 04G7AL
137 02000243 DECOLSIN @4KAPSUL STRIP 13055602
138 02000087 DEGIROL LOZENGES @4TABLET STRIP WV2A038
139 02000244 DERMATIX ULTRA GEL 7 GR TUBE 4756700
140 02000037 DETTOL 50 ML (D/H 60ML) BOTTLE 13F0185
141 02000212 DETTOL IHS ORIGINAL 50 ML BOTTLE 1101RRI
142 02000344 DEXANTA SUSP 100ML BOTTLE 2531040
143 02000384 DIABETASOL COKLAT 180G BOX 13S18AD
144 02000385 DIABETASOL VANILA 180G BOX 13T2501AD
145 02001069 DIAPET ANAK 6`S SACHET 13F06S
146 05000041 DIAPET KAPSUL (25X4`S) STRIP 13E0184
147 02000411 DIAPET NR KAPSUL (20 X 6`S) BLISTER 13E0236
148 02001068 DIAPET SYR 60ML BOTTLE 13J0193
149 09000027 DISP NEEDLE 23G; BOX/100 (TERUMO) PIECES -
150 12000003 DISP SYRINGE W/ NEEDLE 1CC TUBERCULIN ; BOX/100 PIECES -
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

151 12000004 DISP SYRINGE W/ NEEDLE 3CC ; BOX/100 PIECES -
152 02000004 DRAGON MENTHOL 100% 8GR TUBE -
153 02000054 DULCOLAX @4TABLET STRIP 13050751
154 01000623 DULCOLAX ADULT SUPPOS SUPPOSITORY 130216
155 02000990 DUMIN SYR 60 ML BOTTLE -
156 02000335 DUMIN TABL 500MG ; BOX/100 STRIP N2334109
157 03000001 DUMOCALCIN PEPPERMINT @10TABLET STRIP M203202
158 02000363 DUREX EXTRA SAFE ; PACK/3 PACKAGE 0010802206
159 02000368 DUREX TOGETHER ; PACK/3 PACKAGE 0010792612
160 03000015 ELKANA FILM COATED TABLET TABLET OF2162
161 02000099 EM KAPSUL @12KAPSUL PACKAGE 008BM10
162 03000020 ENERVON C @4TABLET STRIP 13170704
163 03000053 ENERVON C PLUS SYR 120ML BOTTLE 12370VC
164 02000215 ENERVON C TABL ; BTL/30 BOTTLE KPC05842
165 05000017 ENKASARI 120ML BOTTLE D130523B
166 02000024 ENTROSTOP @12TABLET STRIP 53698
167 02000295 ENTROSTOP GINGER (24X4’S) STRIP 431566
168 02000025 ENTROSTOP HERBAL ANAK @10ML SACHET DF004A
169 02000045 ENZYPLEX @4TABLET STRIP 13092001
170 02000999 EQUAL TABL ; BTL/100 BOTTLE 201039
171 02000405 EVER E 250IU @12 KAPS DUS JUL13A01
172 02000985 EVER E 250IU @30 KAPS BOTTLE MAY13A10
173 07000051 FAMILY DR URIC ACID STRIP; BOX/25 (CEK ASAM URAT) STRIP -
174 03000005 FATIGON @4TABLET STRIP 184239
175 02000298 FATIGON C PLUS KAPSUL (15X4’S) STRIP 182005
176 03000006 FATIGON SPIRIT @5TABLET STRIP 184164
177 02000014 FEMINAX @4TABLET STRIP FEB13A03
178 05000011 FEMMY MENSANA 6 SACHET X 15ML SACHET DG005A
179 08000013 FERTITEST UJI KESUBURAN @ 6 STRIP STRIP 5L05103
180 02001034 FISHERMAN`S FRIEND ORIGINAL ZAK -
181 03000052 FISHQUA 30`S BOTTLE -
182 03000011 FITKOM GUMMY BOX 13D0021
183 03000061 FITKOM GUMMY CALCIUM 5 SACHET @ 3GUMMY BOX 13I0211
184 03000062 FITKOM GUMMY FRUIT & VEGGIE 5 SACHET @ 3GUMMY BOX 13E0151
185 03000063 FITKOM GUMMY GO 5 SACHET @ 3GUMMY BOX 13D0048
186 03000064 FITKOM GUMMY OMEGA 5 SACHET @ 3GUMMY BOX 13F0024
187 02000962 FLUDANE PLUS SYR 60ML BOTTLE D1310084
188 02000961 FLUDANE PLUS TABL ; BOX/25 STRIP 71390029
189 07000039 FOUR A DAILY CLASSIC PILL REMINDER (KOTAK PENGINGAT MINUM OB PIECES -
190 02000001 FRESH CARE PIECES 033256
191 02000369 FRESH CARE HOT PIECES 073723
192 02000980 FRESH CARE TEENS (BUBBLE GUM) + FRESHOLDER BOTTLE B093027
193 02000979 FRESH CARE TEENS (HAPPY CHERRY) + FRESHOLDER BOTTLE B093025
194 02000981 FRESH CARE TEENS (PASSION FRUIT) + FRESHOLDER BOTTLE B093026
195 02001077 FRUIT 18 JR 30`S BOTTLE 5331523C
196 03000021 FUNDAMEN E @4TABLET STRIP QY2A032
197 02000033 FUNGIDERM 5GR TUBE SEP12A03
198 02001054 GARCIA EXTRAK KULIT MANGGIS 60`S BOTTLE I1191013
199 02000952 GAZERO 10ML SACHET DF002B
200 02001055 GENTONG MAS 200GR BOX GN241
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

201 02001048 GLYDERM STRECTH MARK CREAM TUBE 009
202 02001021 GUANISTREP SYRUP 60 ML BOTTLE 310127
203 04000027 HANSAPLAST FUN KAIN ELASTIS 8`S PACKAGE 25078748
204 04000021 HANSAPLAST JUMBO PACKAGE -
205 04000011 HANSAPLAST K.ELASTIS 10`S 2613 PACKAGE 25018348
206 04000026 HANSAPLAST KOYO HANGAT 10`S PACKAGE 33846148
207 04000025 HANSAPLAST KOYO PANAS 10`S PACKAGE 31871248
208 04000007 HANSAPLAST ROLL 1,25CMX1M 1989 PIECES -
209 03000018 HEMAVITON ACTION @5KAPSUL STRIP O50603
210 02001011 HEMAVITON CARDIO 10`S ; BOX/10 STRIP STRIP 060013
211 03000033 HEMAVITON SKIN NUTRIENT 5`S ; BOX/10 STRIP @5 KAPSUL STRIP 030013
212 03000040 HEMAVITON STAMINA PLUS (10X5`S) STRIP O30013
213 02000413 HUFAGRIP BP (HIJAU) SYR 60 ML BOTTLE A82013
214 02000044 HUFAGRIP PILEK SYRUP 60ML BOTTLE C60403
215 02000414 HUFAGRIP SYRUP 60 ML BOTTLE A91463
216 02000017 HUFAGRIPP TMP 100MG/5ML SYR 60ML BOTTLE B00023
217 02000415 HUFALYSIN SYR (PENAMBAH NAFSU MAKAN) 60 ML BOTTLE B40063
218 08000014 HYGIENEX TRAVEL PACK PACKAGE -
219 04000019 HYPAFIX 5CM X 1M ROLL 3145023
220 02001006 IKADRYL SYRUP 60ML BOTTLE 630323
221 02000173 IMBOOST FORCE SYR 60ML BOTTLE 13C0186
222 02000238 IMBOOST FORCE TABL ; BOX/30 TABLET 12K0504A
223 02001020 IMBOOST SYRUP 60ML BOTTLE 13F0496
224 03000031 IMUNOS KAPLET; BOX/5 BLISTER F0343
225 02000150 INDO OBAT ASMA @6TABL (INDOSERBU) STRIP 1111002
226 02000152 INDO OBAT BATUK &FLU @6TABL (INDOSERBU) STRIP 1102001
227 02000153 INDO OBAT BATUK BERDAHAK @6TABL (INDOSERBU) STRIP 1101001
228 02000154 INDO OBAT BATUK CAIR SIRUP (INDOSERBU) SACHET -
229 02000155 INDO OBAT CACING (INDOSERBU) SACHET -
230 02000156 INDO OBAT CACING ANAK SUSP (INDOSERBU) SACHET 1101004
231 02000157 INDO OBAT FLU @6TABL (INDOFARMA) STRIP 1101003
232 02000158 INDO OBAT MAAG @6TABL (INDOSERBU) STRIP 1012018
233 02000160 INDO OBAT PENURUN PANAS @8TABL (INDOSERBU) STRIP -
234 02000161 INDO OBAT SAKIT KEPALA @6TABL (INDOSERBU) STRIP 1101010
235 02000162 INDO OBAT TAMBAH DARAH @6TABL (INDOSERBU) STRIP -
236 02000159 INDO PENURUN PANAS ANAK 250MG/7ML (INDOSERBU) PACKAGE -
237 02000042 INHALER CAP LANG PIECES 40L00104
238 02000028 INSTO 7,5ML BOTTLE X015KO
239 02001035 INSTO MOIST 7,5ML BOTTLE X035JP
240 02001015 INZA TABL (50X4`S) STRIP 3UL13A33
241 02001023 INZANA TABL (50X4`S) STRIP AUG13A33
242 02001027 JESSCOOL 6`S SACHET SEP13A02
243 09000006 JF SULFUR ACNE SKIN CARE 90GR ; ORANGE PIECES D1301
244 02000049 KALPANAX CAIR 10ML /DH 15ML BOTTLE 526175
245 02000050 KALPANAX KRIM 5GR TUBE 527236
246 02000976 KANNA CREAM 30GR TUBE S0E263
247 02000100 KAOTIN SYRUP 60ML BOTTLE 1148101
248 08000011 KAPAS KECANTIKAN WELLNESS PIECES -
249 07000007 KASA ADINDA 16X16 PACK PACKAGE -
250 04000013 KASA STERIL HUSADA 16/16 PACK PACKAGE 000230513
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

251 05000051 KEJI BELING 10 STRIP @ 10 KAPSUL (JAMU BOROBUDUR) STRIP 030BL23
252 05000005 KEJI BELING 10 STRIP@10 KAPSUL (PHYTO CHEMINDO) STRIP -
253 05000021 KIRANTI DATANG BULAN 150 ML BOTTLE B1E
254 02000217 KOMIX DT 3`S PACKAGE BM0ID
255 02000062 KOMIX G KID MADU 10 SACHET SACHET DM0IJ
256 02000063 KOMIX G PEPPERMINT SACHET SACHET OG010
257 02000300 KOMIX OBH G-FORMULA 30 SACHET SACHET DF345
258 02000409 KONDOM FIESTA BANANA 3`S PACKAGE 11F3399
259 06000009 KONDOM FIESTA DOTTED 3`S BOX 12N1973
260 06000011 KONDOM FIESTA STRAWBERRY 3`S BOX -
261 09000017 KONDOM SUTRA (12X12`S) PACKAGE T17130225
262 06000001 KONDOM SUTRA 3`S PACKAGE T02111106
263 06000013 KONDOM SUTRA OK (12X12`S) PACKAGE C19130826
264 06000002 KONDOM SUTRA OK 3`S PACKAGE C15120305
265 02000356 KONIDIN TABLET STRIP MAY13A01
266 02000002 KOOL FEVER (KOMPRES DEMAM ) PIECES 10115941
267 07000043 KOTAK P3K BOX 19.07.1388
268 02000101 KOYO CABE SACHET -
269 02000046 KOYO SALONPAS HOT MERAH (NEW) PACKAGE 5901
270 02000047 KOYO SALONPAS SUPER BIRU (NEW) PACKAGE 3204
271 02000227 LACTACYD BABY 60ML BOTTLE 1306034
272 02000130 LACTACYD VAGINAL ANTISEPTIC 60ML BOTTLE 1303061
273 02000122 LACTO-B SACHET -
274 05000039 LANCAR ASI ; BOX/ 5 STRIP @6 TABLET BOX 045306
275 02000947 LARUTAN PENYEGAR (ANGGUR) CAP BADAK KALENG CAN -
276 02000966 LARUTAN PENYEGAR (APEL) CAP BADAK KALENG CAN -
277 02000946 LARUTAN PENYEGAR (JAMBU) CAP BADAK KALENG CAN -
278 02000967 LARUTAN PENYEGAR (JERUK) CAP BADAK KALENG CAN -
279 02000102 LARUTAN PENYEGAR (LYCHEE) CAP BADAK KALENG CAN 30812013
280 02000949 LARUTAN PENYEGAR (MELON) CAP BADAK KALENG CAN -
281 02000948 LARUTAN PENYEGAR (STRAWBERRY) CAP BADAK KALENG CAN -
282 05000018 LARUTAN PENYEGAR CAP BADAK BOTOL 200ML BOTTLE 3047005
283 02000041 LASERIN MADU ANAK-ANAK 60ML BOTTLE 008302
284 02000287 LASERIN SYR 110 ML BOTTLE 128303
285 02000040 LASERIN SYR 60ML BOTTLE 217211
286 08000003 LAURIEL SUPER MAXI 10`S PACKAGE -
287 08000005 LAURIER SUPER SLIM GUARD 22.5 20`S PACKAGE 130710D14
288 08000012 LAURIER ULTRA SLIM 8`S PACKAGE 130420325
289 08000004 LAURIER ULTRA SLIM 9`S PACKAGE 130410335
290 02001018 LAXADINE SYR 30ML BOTTLE G1301
291 05000006 LAXING 400MG @4KAPSUL STRIP 13C0185
292 02000978 L-BIO ; BOX/30 SACHET 0153
293 09000004 LELAP TABL @4TABLET STRIP 12D0352A
294 04000024 LEUKOMED (UK.5 X 7.2 CM) ROLL -
295 04000023 LEUKOMED (UK.8X10 CM) ROLL -
296 04000014 LEUKOPLAST 1,25CM X 4,5M ROLL -
297 04000009 LIFERESOURCES ALKOHOL SWAB PIECES -
298 07000001 LIFERESOURCES DIGITAL THERMOMETER HARD TIP PIECES -
299 04000010 LIFERESOURCES FACE MASK PIECES -
300 04000022 LIFERESOURCES HIGH ELASTIC BANDAGE 3" PIECES -
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

301 04000006 LIFERESOURCES HIGH ELASTIC BANDAGE 4" PIECES -
302 02000358 LIFREE (UK. L) PANTS EXTRA DAYA SERAP 4`S PACKAGE 801181
303 02000362 LIFREE (UK. L) POPOK DEWASA TIPE PEREKAT 8`S PACKAGE 08515X150513
304 02000359 LIFREE (UK. M) PANTS EXTRA DAYA SERAP 5`S PACKAGE 301261
305 02000361 LIFREE (UK. M) POPOK DEWASA TIPE PEREKAT 9`S PACKAGE 303241
306 02000360 LIFREE (UK. XL) PANTS EXTRA DAYA SERAP 3`S PACKAGE 303291
307 01000852 LINEX FORTE TABL; BOX/14 TABLET C16067
308 02000953 LIPCARE ESSENTIAL CARE PIECES 24826610
309 02000179 LISTERINE COOL MINT 80 ML BOTTLE CR11435
310 03000002 LIVRON B PLEX @10TABLET STRIP 45036017
311 02000009 M.S SITRONELA CAP ELANG 30ML BOTTLE O91K0131
312 02000998 MADU SUPER NUSANTARA 250ML BOTTLE -
313 02001052 MADU SYAMIL KIDS 125ML BOTTLE P210.07.23
314 02000944 MADURASA JERUK SACHET 2FZAY
315 02000957 MADURASA JERUK 250ML BOTTLE RDZAF
316 02001062 MAGIC POWER MERAH BOX -
317 02001057 MAMY POKO PANTS STANDART L8 PACKAGE 31105223
318 02001056 MAMY POKO PANTS STANDART M9 PACKAGE 31105225
319 05000052 MANGOSTEEN TEA SACHET -
320 02000986 MAXIMUS 30`S BOX C3G7876
321 02000163 MELANOX CLEANSING GEL TUBE -
322 02000164 MELANOX SKIN TONER BOTTLE -
323 02000165 MELANOX UV TUBE NV002A
324 02001053 MELIA PROPOLIS 6ML BOTTLE -
325 05000044 MERIT NATURAL BODY SLIMMING 10 SACH PACKAGE 1212.06.03
326 02001012 MEXAQUIN ; BOX/100 STRIP APR13A01
327 02000072 MEXTRIL @4TABLET STRIP -
328 02001073 MEXTRIL SYR ANTITUSSIVE 60ML BOTTLE 2423F3
329 02000053 MICROLAX GEL OBAT PENCAHAR 5ML TUBE C3152714
330 04000002 MINOL @5ML (MINYAK OBAT LUKA) BOTTLE 740.20.901
331 02000228 MINOSEP GARGLE 2% 60ML BOTTLE -
332 02000104 MINYAK ANGIN KAPAK 10ML BOTTLE 1130743
333 02000056 MINYAK CAP KAPAK 3ML BOTTLE 1130104
334 02001003 MINYAK CAP KAPAK 28ML BOTTLE 1130532
335 02001004 MINYAK CAP KAPAK 56ML BOTTLE -
336 02000994 MINYAK GANDAPURA 100 ML BOTTLE 430464
337 02000991 MINYAK GANDAPURA 30 ML BOTTLE 430506
338 02000992 MINYAK GANDAPURA 60 ML BOTTLE 430523
339 02000273 MINYAK KAYU PUTIH 60ML (KONICARE) BOTTLE A07
340 02000973 MINYAK KAYU PUTIH AROMATHERAPHY 120 ML BOTTLE 17LM0234
341 02000971 MINYAK KAYU PUTIH AROMATHERAPHY 30 ML BOTTLE O91R0134
342 02000972 MINYAK KAYU PUTIH AROMATHERAPHY 60 ML BOTTLE 131C0134
343 02000057 MINYAK KAYU PUTIH CAP ELANG 30ML BOTTLE O91C0101
344 02000190 MINYAK KAYU PUTIH CAP LANG 120 ML BOTTLE 171D0201
345 02000225 MINYAK KAYU PUTIH CAP LANG 60 ML BOTTLE 131A0101
346 05000002 MINYAK TAWON DD 30ML BOTTLE 13072
347 02000285 MINYAK TAWON FF 90 ML BOTTLE -
348 02000274 MINYAK TELON 125ML (KONICARE) BOTTLE 13A18
349 02000272 MINYAK TELON 60ML (KONICARE) BOTTLE 12A06
350 02000058 MINYAK TELON CAP ELANG 30ML BOTTLE O9LE0111
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

351 02000264 MINYAK TELON CAP LANG 60ML BOTTLE 131C0111
352 02000105 MINYAK TELON CITO 60ML BOTTLE KM01F2A
353 02000286 MINYAK TELON GAJAH 60ML BOTTLE OO76T363047
354 02000271 MINYAK TELON PLUS 60ML (MY BABY) BOTTLE O60492
355 02000007 MINYAK URUT GPU CAP LANG 30ML BOTTLE IC05104
356 02000265 MINYAK URUT GPU CAP LANG 60ML BOTTLE IT00805
357 02000079 MIXAGRIP @4TABLET STRIP 183.2.48
358 02000304 MIXAGRIP FLU&BATUK (25X4`S) STRIP 184099
359 02000106 MIXAGRIP PEGAL LINU SACHET SACHET -
360 02001045 MIXAGRIP RHEMA (25X4`S) STRIP 181001
361 02000107 MNYK KAYU PUTIH GAJAH 60ML BOTTLE 283108
362 02000945 MOMILEN DIAPER RASH CREAM 15 GR TUBE -
363 02001049 MOMILEN NURSING CREAM 15 GR TUBE 836
364 03000004 MULTIVIRAL 60 TAB BOTTLE O312023
365 02000018 MYLANTA @10TABLET STRIP CR12680
366 02000020 MYLANTA LIQUID 50ML BOTTLE -
367 03000066 NAT C YUMMY GUMMYZ BOX -
368 03000016 NATUR E @16SOFT CAPSUL PACKAGE O88IRC
369 03000008 NEO HORMOVITON @5KAPSUL STRIP O90042
370 02000987 NEO NAPACIN STRIP A57
371 02000061 NEO RHEUMACYL @10TABLET STRIP O70263
372 02000082 NEO RHEUMACYL CREAM 30GR TUBE O60043
373 02000016 NEO RHEUMACYL NEURO @10TABLET STRIP O20063
374 02000078 NEOZEP FORTE @4TABLET STRIP 13054401
375 02001017 NEPHROLIT (25X4`S) STRIP 305075
376 03000024 NEUROBION 1BOX @25STRIP @10TAB STRIP T0782733
377 03000028 NEUROBION 5000; 250 TAB STRIP T0326851
378 03000027 NEURODEX TABL ; BOX/200 TABLET 4406638
379 02000026 NEW DIATAB @4TABLET STRIP -
380 03000060 NNO CAPSUL 30`S BOX 3H01E1
381 05000003 NORIT CAP ELANG TUBE @40TAB TUBE 711A0120
382 02000268 NOURISH SKIN ADVANCE SKIN NUTRIENT 15`S BOX C3F663F
383 02000267 NOURISH SKIN ULTIMATE 15`S BOX -
384 05000045 NUTRIMAX (BOTOL) COFLUSIN ADULT TABL @ 30 TABL BOTTLE 1104233
385 05000047 NUTRIMAX (BOTOL) DIAGARD @ 30 CAPS BOTTLE 2602748
386 05000046 NUTRIMAX (BOTOL) ULTRA GARLIC 2000 @ 30 TABL BOTTLE 5905333
387 05000025 NUTRIMAX COFLUSIN ADULT TABL TABLET CFS-1111410
388 05000036 NUTRIMAX DIAGARD CAPS CAPSULE NDGR-1111405
389 05000026 NUTRIMAX LIVER & KIDNEY DUO CAPS CAPSULE LKD-1111421
390 05000032 NUTRIMAX NEW STOMACH CARE TABL TABLET NSG-1111415
391 05000034 NUTRIMAX ULTRA GARLIC 2000 CAPS CAPSULE UGC-1111420
392 05000033 NUTRIMAX URICARE TABL TABLET GRL-1111419
393 02000400 NUTRIVE BENECOL ORANGE NAS ; PACK/6X100ML BOTTLE -
394 02000398 NUTRIVE BENECOL STRAWBERRY NAS ; PACK/6X100ML BOTTLE -
395 02000959 OB HERBAL 60ML BOTTLE M032GM
396 05000048 OBAT BATUK IBU DAN ANAK 75 ML BOTTLE B1302171D3
397 02001013 OBAT SAKIT GIGI CAP BURUNG KAKAK TUA BOTTLE 1601CF
398 02000064 OBH COMBI BATUK BERDAHAK MENTHOL 100 ML BOTTLE 507109
399 02000275 OBH COMBI BATUK+FLU MENTHOL 100ML BOTTLE 506183
400 02000065 OBH COMBI BATUK+FLU MENTHOL 60 ML BOTTLE R10014
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

401 02000066 OBH COMBI PLUS STRAWBERRY 60ML BOTTLE 503174
402 02000305 OBH NELLCO SPECIAL SYR 100ML BOTTLE 203121
403 02001031 OBH SURYA ITRA SYRUP 100ML BOTTLE 308073
404 02000348 OBH TROPICA EXPECTORANT MENTHOL 100 ML BOTTLE PEU681
405 02000292 OBH TROPICA PLS SYR ANAK STAW 60 ML BOTTLE OL1561
406 02000346 OBH TROPICA PLUS MENTHOL 100 ML BOTTLE OL0911
407 02000347 OBH TROPICA PLUS MENTHOL 60 ML BOTTLE OL1281
408 02000250 OIL 50ML SOFT&SMOOTH PINK (CUSSON BABY) BOTTLE MFG050213
409 02000318 OMEPROS 30`S BOTTLE 130591P
410 07000004 ONE TOUCH SELECT SIMPLE METERS (BUNDLING) PIECES 51211141X
411 07000005 ONE TOUCH SELECT STRIP BOX 3460554
412 07000006 ONE TOUCH ULTRASOFT LANCETS BOX W334030
413 02000191 ORODIN SPRAY 15ML BOTTLE PVL11075
414 03000054 OSFIT DHA SOFT CAPSULE ; BOX/30 TABLET D1048
415 02000242 OSKADON @4TABLET STRIP 90453
416 02000406 OSKADON SP TABL (25 X 4`S) STRIP D40493
417 07000041 OXYCAN BOTTLE -
418 02000166 PABANOX CREAM 20 GR TUBE -
419 07000010 PAKET PENGECEKAN GULA DARAH 200`S STRIP -
420 02001030 PAMOL TABL 500MG (25X4`S) STRIP T083C018
421 02001005 PANADOL CHEWABLE ANAK STRIP 752E 131
422 02000230 PANADOL COLD AND FLU ; BOX/100 STRIP X039KE
423 02000012 PANADOL DROPS 15ML BOTTLE 395G12
424 02000229 PANADOL EXTRA TABL ; BOX/100 STRIP -
425 02000269 PANADOL SYRUP 60ML BOTTLE 18OE13
426 02000209 PANADOL TABL STRIP X013JF
427 05000001 PARAM KOCOK B. 75, AIR MANCUR BOTTLE WGZCJ
428 02000039 PARAMEX @4TABLET STRIP 13A39
429 02000974 PARAMEX FLU & BATUK STRIP 13A04
430 02000167 PARASOL CREAM 20 GR TUBE -
431 02000169 PARASOL CRM SPF 33 TUBE -
432 02000170 PARASOL LOT SPF 15 BOTTLE EV001A
433 02000168 PARASOL LOT SPF 30 BOTTLE KU0U1A
434 02000073 PARATUSIN @10TABLET STRIP SY2A042
435 02000316 PARATUSIN SYR 60 ML BOTTLE O654RC
436 02000213 PEDITOX 50 ML BOTTLE -
437 02000951 PERMEN TOLAK ANGIN SACHET 13080101
438 02000293 PHARMATON FORMULA EKS.GNSENG (10 X 5`s) STRIP O850RC
439 02001074 PHISOHEX 110ML BOTTLE 1319022
440 05000053 PIL TUNTAS ; BOX/12 PIL BOX FAEM
441 02000108 PILKITA @2TABLET STRIP -
442 02000357 PIMTRAKOL LEMON SYR 60 ML BOTTLE 32306033
443 02001061 PLANTACID TABL STRIP 527609
444 26000001 PLASTIK BELANJA (MEDIUM) PIECES -
445 26000002 PLASTIK BELANJA (SMALL) PIECES -
446 26000003 PLASTIK KLIP PIECES -
447 02000958 POLDANMIG TABL ; BOX/25 STRIP OE8234
448 02001014 POLIDENT DENTURE ADHESIVE CREAM 15GR TUBE -
449 02000019 POLYSILANE MAX TABLET (MINT) STRIP C3E125F
450 02000147 POLYSILANE SUSP 100ML BOTTLE C369386
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

451 02000146 POLYSILANE TABL STRIP C3D770E
452 08000022 POND`S SHAKE & CLEAN CLEAR SOLUTION 100ML TUBE -
453 08000021 POND`S SHAKE & CLEAN WHITE BEAUTY 100ML TUBE 182019P
454 02000251 POWDER 200GR SOFT&SMOOTH (CUSSON BABY) BOTTLE MFG050513
455 07000045 PRO CREEPE 3" PIECES 33027
456 07000044 PRO CREEPE 4" PIECES 43025
457 02000296 PROCOLD KAPLET (24X6`S) STRIP 52380
458 02001024 PROLACTA WITH DHA FOR BABY TABL (5X10`S) TABLET 15H143
459 03000055 PROLACTA WITH DHA FOR MOTHER (6 X 10`S) TABLET 15H148
460 05000062 PROLIPID 60`S BOTTLE -
461 02000021 PROMAG @12TAB STRIP DE03
462 02000125 PRORIS SYR SUSPENSI BOTTLE C3H012H
463 02000294 PROTECAL SOLID (TUBE) TUBE 12A04
464 02001000 PUYER OBAT SAKIT KEPALA BINTANG TOEDJOE NO.16 SACHET -
465 05000043 RAPET WANGI JAMU; BOX/12 PIL BOX GAFL
466 02000192 REDOXON DOUBLE ACTION @10 TUBE CM13885
467 02000276 REDOXON DOUBLE ACTION BLACKCURRANT EFF 10`S TUBE CM07296
468 05000014 REMUFIT 4GR JAMBU BIJI SACHET -
469 02001032 RENOVIT TABL (25X4`S) STRIP AUG13A01
470 02000088 RHEUMACYL PEGAL LINU 20 X 4`S PACKAGE AUG13A01
471 02000089 RHEUMACYL SIRUP PEGAL LINU 10S SACHET -
472 02000109 RHEUMASON CREAM 18GR BOTTLE G120534
473 02000139 RIVANOL ONE MED 100 ML BOTTLE 31071388
474 02000231 ROHTO COOL BOTTLE DHRF036
475 02000954 SABUN DETTOL (COOL) 70 GR BAR 13H0192B
476 02000955 SABUN DETTOL (FRESH) 70 GR BAR 13K0188A
477 02000942 SABUN HIJAU 100 GR BAR 8130552
478 02001038 SACCORIT POT POT -
479 02000941 SAFE CARE BOTTLE 111305308
480 02000110 SAKATONIK 310ML BOTTLE DH309
481 03000003 SAKATONIK ABC STRAWBERY @30TABLET BOTTLE D603
482 03000007 SAKATONIK LIVER 100 ML BOTTLE DE002
483 02000977 SAKATONIK LIVER TABL ; BOX/10 STRIP 370ID3
484 02000031 SALEP KULIT 88 6GR TUBE O250713
485 02000111 SALICYL MENTHOL GAJAH PACKAGE 306344
486 02000311 SALONPAS GEL 30 ML BOTTLE 5904
487 02000006 SALONPAS LINIMENT 30ML BOTTLE 5702
488 02000112 SAMURAT @4KAPSUL STRIP KDBA4
489 02000995 SANADRYL DMP SYR 120ML BOTTLE OE9780
490 02000993 SANADRYL DMP SYR 60ML BOTTLE OE9769
491 02000997 SANADRYL EXPECTORANT SYR 120ML BOTTLE OE1782
492 02000996 SANADRYL EXPECTORANT SYR 60ML BOTTLE OE1669
493 02000988 SANAFLU STRIP OD8145
494 03000013 SANGOBION @10KAPSUL STRIP S0199797
495 02000254 SANGOBION KIDS SYRUP 100ML BOTTLE -
496 02000135 SANMOL 120 MG/5 ML X 60 ML BOTTLE OF9825
497 02000136 SANMOL 60MG/0.6ML DROPS 15ML BOTTLE OG1972
498 02000315 SANMOL SYR 60 ML BOTTLE -
499 02000404 SANMOL TABL 500 MG (25 X 4`S) STRIP OJ-8065
500 02001076 SANTA E 400IU ; BOX/100 STRIP -
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

501 05000056 SARI AYU LANCAR DATANG BULAN BOTTLE OO4063
502 08000006 SARI AYU TISSUE SIRIH WANGI FEMININE HYGIENE PIECES O809053
503 05000061 SARI KURMA KAROMAH 250 GR BOTTLE 120913
504 02001025 SARIDON TABL (30X4`S) STRIP M13314
505 07000019 SARUNG TANGAN MAXTER (M) PIECES -
506 02001058 SCOTT`S COD LIVER OIL CAPSULE BOTTLE XAF017
507 03000050 SCOTT`S EMULSION ORIGINAL 400ML BOTTLE R130526
508 03000014 SCOTT`S EMULSION VITA 200ML BOTTLE 5120740
509 03000038 SCOTT`S EMULSION VITA ORANGE 400ML BOTTLE 5130390I
510 03000039 SCOTTS CHEWYVIT C BLACKCURRANT BOX 270513D
511 08000015 SENSITIF STRETCH MARK CREAM TUBE 1512002M
512 07000020 SENSITIF UJI KEHAMILAN STRIP @ 25 STRIP STRIP B0125
513 02000984 SENSODYNE FRESHMINT 100GR TUBE O50113
514 02000983 SENSODYNE ORIGINAL 100GR TUBE 3420413
515 07000040 SEVEN DAILY AM/PM PILL REMINDER (KOTAK PENGINGAT MINUM OBAT) PIECES -
516 02000248 SHAMPOO 100ML CARES&PROTECTS (CUSSON BABY) BOTTLE MFG6040711
517 07000053 SIKU KAIN PEMBALUT KASA HUSADA (MITELA) PIECES -
518 02001002 SILADEX BATUK & PILEK 30 ML BOTTLE 13A01
519 02001001 SILADEX BATUK & PILEK 60 ML BOTTLE 13A03
520 02000245 SILADEX EXPECT HIJAU 60 ML BOTTLE 13A05
521 02001022 SILEX SYRUP 100 ML BOTTLE O9684C
522 05000040 SLIMMING TEA MUSTIKA RATU BOX O307BR
523 02000345 SOAP 75GR CARES&PROTECTS (CUSSONS BABY) BAR MFG091112
524 02000249 SOAP 80GR CARES&PROTECTS (CUSSON BABY) BAR -
525 02000210 SOFRA-TULLE 10CMX10CM ; BOX/10 PIECES -
526 08000020 SOFTEX MATERNITY 10`S PACKAGE -
527 02000218 SP THROCHES (STRAWBERRY) TABL; BOX 120 PACKAGE 13.33.2
528 02000126 STIMUNO FORTE CAPS BOX 4407175
529 02000090 STIMUNO IMUNOMODULATOR 60ML BOTTLE 2521608
530 02000279 STOP COLD TABLET (15X4`S) STRIP OO67 PC
531 02000956 STREPSIL ORIGINAL 12 X 6`S SACHET 947VVI
532 01001182 STROCAIN TABL ; BOX/100 TABLET 3173001
533 02001075 SUMAGESIC TABL 600MG ; BOX/100 STRIP 3173001
534 03000030 SUPER ESTER C TABL ; BOX/48 STRIP 13T04194
535 02000226 SUPER ESTER C TABL ; BTL/30 BOTTLE 13T07164
536 02000113 SUPRAVIT @60TABLET BOTTLE 154816
537 02001042 SURBEX-T TABL ; BOX/30 TABLET 28383XP
538 07000011 SURESOFT HOSP GENTLE 200S (LANCET J&J) PIECES -
539 02000257 TEMPRA DROPS BOTTLE 3E8671
540 02000256 TEMPRA SYR 60ML BOTTLE 397731
541 07000012 TENSIMETER AND UA-621 UNIT -
542 06000007 TES KEHAMILAN ONE MED; BOX/50 STRIP 2-07203
543 03000035 THERMOLYTE PLUS 10`S BOX C2K368B
544 03000034 THERMOLYTE PLUS 30`S PACKAGE C2H955M
545 02000059 THERMOREX PLUS 60ML BOTTLE 13A17
546 02000013 THERMOREX SYR 60ML BOTTLE 12ADA
547 02000128 THROMBOPHOB GEL 20GR TUBE 258013
548 05000008 TOLAK ANGIN @4TABLET STRIP E0062
549 05000007 TOLAK ANGIN + HONEY 15ML SACHET 29H/R6224
550 05000009 TOLAK ANGIN CAIR FLU 15ML SACHET O6J4
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

551 05000010 TOLAK ANGIN KIDDIES SACHETS SACHET 11DIR0148
552 02000278 TONIKUM BAYER 330ML BOTTLE CR12946
553 02001078 TREMENZA SYR 60ML BOTTLE -
554 02001059 TRIAMINIC BATUK & PILEK 60 ML BOTTLE 13091372
555 02000141 TRIAMINIC EXPECTORANT & PILEK 60 ML BOTTLE 13091374
556 02001060 TRIAMINIC PILEK 60 ML BOTTLE 13091373
557 02000939 TROPICANA SLIM SWEETENER 2,5 GR @ 25 SACH BOX N091057
558 02000407 TROPICANA SLIM SWEETENER 2,5 GR @ 50 SACH SACHET N0911DA
559 02000940 TROPICANA SLIM SWEETENER DIABETICS @ 25 SACHET BOX N0913EC
560 02000408 TROPICANA SLIM SWEETENER DIABETICS @ 50 SACHET SACHET -
561 02000241 ULTRAFLU KAPLET ; BOX/25 STRIP O15016
562 02000023 UPIXON TUTTI FRUTTY 10ML BOTTLE CR11069
563 08000019 VEET HAIR REMOVAL CREAM (NORMAL SKIN) 25GR TUBE BUNO57
564 03000048 VEGEBLEND 21 JR 30`S BOTTLE C3E290F
565 05000049 VEGETA HERBAL 6`S SACHET OO25D13
566 02000314 VEGETA JERUK 6`S SACHET OOO3C13
567 02001036 VENARON CAP 300MG (5X4`S) STRIP T33460762
568 04000012 VERBAND HUSADA 4x6 PIECES -
569 02001008 VERILE ACNE GEL TUBE KD137
570 02000055 VERMINT 12 KAPSUL @ 250 MG BOTTLE 7000613101
571 02000970 VERMINT 30 KAPSUL @ 250 MG BOTTLE 668041301
572 02000280 VICEE LEMON (50X2`S) STRIP 34019
573 02000074 VICKS FORMULA 44 27ML BOTTLE 3074P2A1
574 02000283 VICKS FORMULA 44 ANAK STRAWBERRY 54ML BOTTLE 3200P2G1
575 02000282 VICKS FORMULA 44 DEWASA 54ML BOTTLE -
576 02000075 VICKS FORMULA 44 DT 27ML BOTTLE 3067P2P1
577 02000114 VICKS INHALER PIECES 31691
578 02000048 VICKS VAPORUB 10GR BOTTLE 3197FP2Y1
579 02000284 VICKS VAPORUB 50GR POT 3140P2X1
580 03000041 VIDORAN PLUS SYRUP JERUK 120ML BOTTLE O90062
581 03000012 VIDORAN SMART PLUS STRAW @30TABLET BOTTLE O70012
582 01000938 VIOSTIN DS CAPL ; BOX/30 CAPLET 3H295H
583 03000058 VIPRO G JERUK (5 X 2`S) STRIP V02G05
584 03000057 VIPRO G ORIGINAL (5 X 2`S) STRIP -
585 02001079 VIRGIN SUPER COCONUT OIL CAIR 80 ML BOTTLE -
586 02000189 VISINE 6 ML BOTTLE 329-67018
587 02001046 VISINE TEARS 6 ML BOTTLE 329-67004
588 02000968 VIT. A IPI @50 TABLET BOTTLE O20023
589 02000969 VIT. B KOMPLEKS IPI 50`S X 12 BOTTLE O40043
590 02000115 VIT. C IPI @50TABLET BOTTLE O50133
591 03000026 VITACIMIN 500 MG; BOX/100 STRIP FFFH11
592 02000207 VITAL 10 ML BOTTLE DP3501
593 03000036 VITALONG C 500MG (25X4`S); BOX/100 STRIP KP011842
594 03000037 VITALONG C 500MG; BTL/30 BOTTLE 13133403
595 22000005 VOUCHER PEMERIKSAAN PAP SMEAR (PRAMITA) PIECES -
596 02000989 WAISAN @12 SACH SACHET DE03
597 07000048 WOMAN CHOICE MIDSTREAM PIECES -
598 07000046 WOMAN CHOICE STRIP STRIP -
599 07000047 WOMAN CHOICE STRIP + WADAH PIECES -
600 02000220 WOOD`S PEPPERMINT ANTITUSIF 60 ML BOTTLE 526171
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT BEBAS
CATEGORY : OBAT BEBAS REGION
LOCATION

NO SKU DESCRIPTION PACK NAME NO BATCH

601 02000221 WOOD`S PEPPERMINT EXPECTORANT 60 ML BOTTLE 527510
602 02000219 WOOD`S PEPPERMINT LOZENGES SACHET -
603 03000022 XON CE RASA JERUK @2TABLET STRIP 523632
604 02000960 Y-RINS BOTTLE RE2971
605 03000045 ZEVIT C TIME-RELEASED @4CAPS STRIP -
606 03000032 ZEVIT GROW SACH; BOX/5 SACHET 120072
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
8
25
3
4
2
3
10
3
-
3
10
-
40
7
3
4
7
9
10
5
28
19
6
10
1
5
5
7
2
3
-
2
-
4
2
3
4
3
3
3
2
3
5
2
2
2
5
1
12
-
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
-
2
-
2
2
-
1
1
4
14
-
6
2
3
1
2
2
11
5
2
2
2
12
9
3
10
14
2
3
-
2
1
1
2
8
1
2
2
11
3
2
1
-
1
8
1
2
3
3
-
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
2
2
1
1
6
3
2
29
7
-
2
2
6
5
2
1
1
3
3
-
3
2
2
2
-
2
-
2
1
2
-
-
3
1
10
3
11
8
2
3
3
2
1
1
6
3
5
2
-
-
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
-
6
12
5
-
1
8
2
2
30
-
21
2
4
2
1
4
-
4
1
2
1
25
10
2
5
4
3
2
-
-
6
3
5
6
2
2
5
2
2
5
1
2
1
1
4
3
2
14
1
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
1
3
2
16
7
1
2
-
6
5
3
8
4
3
3
2
1
7
3
1
2
11
1
4
7
8
9
-
-
7
10
9
-
10
-
-
4
3
2
2
3
6
3
15
7
2
6
1
-
12
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
4
-
3
2
10
8
19
2
3
-
2
3
3
5
6
13
1
-
5
6
2
2
-
1
-
-
-
-
12
-
-
8
4
4
1
-
2
2
1
2
14
8
6
1
2
3
34
-
30
1
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
-
1
1
1
1
1
28
2
3
6
3
-
1
10
2
1
1
1
-
2
-
-
1
2
2
1
-
1
9
2
2
2
3
2
-
2
2
2
2
2
1
2
4
4
10
9
-
2
2
2
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
4
2
3
3
2
5
27
16
-
6
3
-
1
2
10
-
-
6
2
7
11
2
11
3
3
23
15
44
-
1
2
2
-
1
1
1
10
17
20
15
29
19
-
-
3
2
2
4
3
1
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
6
5
1
3
3
3
1
2
2
2
2
1
3
28
28
6
1
-
89
7
7
3
3
-
1
7
1
40
19
-
-
1
1
5
3
-
2
5
1
3
-
18
2
57
-
650
10
-
3
1
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
2
-
1
1
1
2
4
10
10
-
28
6
2
5
2
3
1
-
5
1
-
2
7
5
2
3
5
-
2
3
3
4
1
4
1
2
1
8
2
1
2
2
8
9
-
8
4
-
5
-
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
2
3
3
4
8
1
2
3
1
3
2
4
1
1
2
1
3
1
1
6
1
2
2
-
-
2
6
1
4
1
10
30
4
6
1
3
12
241
2
1
1
43
2
1
5
2
2
4
73
16
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
49
3
-
1
1
2
3
50
3
-
13
2
2
2
18
7
2
-
2
3
3
15
5
2
-
6
1
4
2
2
1
72
8
-
-
9
1
2
4
6
16
1
7
3
-
12
1
3
2
2
ACARA PENGALIHAN OBAT BEBAS
: JAWA TIMUR
: VG BANYUURIP

JUMLAH
4
-
12
2
-
25
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

1 01000709 ACARBOSE 100 MG TAB TABLET 4304350 10
2 01000708 ACARBOSE 50 MG TAB TABLET 4401376 20
3 01000917 ACETYLCYSTEIN 200 MG TABLET 1204003 11
4 01000264 ACYCLOVIR KRIM 5% 5GR (INDOFARMA) TUBE 1211096 6
5 01000267 ACYCLOVIR TABL 200MG (INDOFARMA) TABLET 1112041 6
6 01000270 ACYCLOVIR TABL 400MG (INDOFARMA) TABLET 130302121 50
7 01001109 ADALAT OROS 30 MG TABLET CR11995 20
8 01000933 AERIUS TAB 5MG/30`S TABLET 2STBAB3A01 14
9 01001181 AKRINOR TABL ; BOX/100 TABLET AL0502 8
10 01000123 ALBENDAZOLE TABL 400MG KUNYAH RASA JERUK (INDOFARMA) TABLET 106007 17
11 01000699 ALBOTHYL CONCENTRATE 10ML BOTTLE - -
12 01000253 ALBOTHYL CONCENTRATE 5ML BOTTLE C3H210H 8
13 01000465 ALCO DROPS BOTTLE 5054C002 2
14 01001175 ALLERON TABL ; BOX/200 STRIP 106357 4
15 01000482 ALLOPURINOL TABL 100MG (INDOFARMA) TABLET TR3F6B 140
16 01000481 ALLOPURINOL TABL 300 MG (HEXAFARMA) TABLET 310060 104
17 01001233 ALLORIS TABL 10MG ; BOX/100 TABLET 002681 10
18 01001172 AMARYL 1 MG ; BOX/50 TABLET 002681 10
19 01001171 AMARYL 2 MG ; BOX/50 TABLET 091L073 20
20 01001227 AMARYL 4 MG ; BOX/30 TABLET 243L060 10
21 01000934 AMARYL M2 TABLET 120.90.79 15
22 01000384 AMBROXOL SYR 15MG/ML 60ML (INDOFARMA) BOTTLE 30.400.143 3
23 01000385 AMBROXOL TABL 30MG (INDOFARMA) TABLET 130400143 90
24 01000527 AMINOFILIN TABL 200MG TABLET ID3467 110
25 01000185 AMITRIPTILIN TABL 25MG (HCL) TABLET ID3553 20
26 01001047 AMLODIPINE TABL 10MG (HEXPHARM) TABLET 522383 180
27 01000089 AMLODIPINE TABL 10MG (INDOFARMA) TABLET - -
28 01000087 AMLODIPINE TABL 5MG (INDOFARMA) TABLET - -
29 01001046 AMLODIPINE TABL 5MG ; BOX/30 (HEXPHARM) TABLET 1208046 74
30 01000514 AMOXAN CAPS 500MG CAPSULE 0F6255 32
31 01000515 AMOXAN FORTE 250MG/5ML DRY SYR 60ML BOTTLE - -
32 01000507 AMOXICILLIN KAPL 500MG (INDOFARMA) CAPLET OD6878 823
33 01000506 AMOXICILLIN KAPS 250MG (INDOFARMA) CAPSULE OF6105 19
34 01000502 AMOXICILLIN SYR 125MG/5ML 60ML (INDOFARMA) BOTTLE 185037 4
35 01000504 AMPICILLIN KAPL 500MG (INDOFARMA) CAPLET 1308176 30
36 01001138 ANALSIK CAPS ; BOX/100 CAPSULE - -
37 01000497 ANDALAN PIL KB (2 X 28) (DKT INDONESIA) STRIP 1112208 27
38 01001092 ANDALAN PIL LAKTASI ; BOX/30 STRIP STRIP 1206019 3
39 01000067 ANTALGIN TABL 500MG (INDOFARMA) TABLET 65312035 261
40 01000095 ANTASID TABL (KIMIA FARMA) TABLET 273.16.13 130
41 01000094 ANTASIDA SUSPENSI 60ML (DEXA MEDICA) BOTTLE 2L399106 2
42 01000588 APIALYS DROPS BOTTLE 91539 3
43 01001187 ARDIUM HD; BOX/36 TABLET 120506120 13
44 01000061 ASAM MEFENAMAT TAB 500MG (INDOFARMA) CAPSULE J121528B 681
45 01000930 ASTHIN FORCE TABLET 2230421 6
46 01000929 ATIVAN 0.5MG TAB TABLET - -
47 01000466 ATORVASTATIN TABL 20MG (YARINDO) TABLET A0472 25
48 01000366 AZITHROMYSIN TABL 500MG (KIMIA FARMA) TABLET GY3A011 16
49 01001239 BAQUINOR 0.3% EYE DROP 5 ML BOTTLE OG3519 1
50 01001190 BAYCUTEN-N CREAM 5GR TUBE 35O8E20 2
51 01001166 BENOSON N CREAM 15GR TUBE OG2330A 1
52 01001165 BENOSON N CREAM 5GR TUBE LCH20441 5
53 01000924 BEROTEC INHALER 10 ML UNIT LCH06942 1
54 01001195 BETABLOK TABL 50MG; BOX/30 TABLET 202509 20
55 01000837 BETADINE SALEP 10GR TUBE 523172 2
56 01000450 BETAHISTIN MESILAT TABL 6MG TABLET J12568 17
57 01000350 BETASON CREAM 5GR (KIMIA FARMA) TUBE 15EO86 6
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

58 01000351 BETASON N CREAM 5GR (KIMIA FARMA) TUBE 111143T 13
59 01001191 BINOTAL TABL 500 MG; BOX/50 TABLET 101140T 14
60 01001177 BIO-ATP ; BOX/100 TABLET N2463108 26
61 01000183 BIOPLACENTON GEL (KALBE FARMA) TUBE 65006002 6
62 01001200 BIOTHICOL SYRUP 60 ML BOTTLE 523347 2
63 01000522 BISOPROLOL TABL 5MG (DEXA MEDICA) TABLET OG9244 60
64 01000877 BORRAGINOL-N SUPP ; BOX/10 SUPPOSITORY OD9061 5
65 01000879 BORRAGINOL-S SUPP ; BOX/10 SUPPOSITORY 2631345 5
66 01001204 BRAINACT TABL 500 MG; BOX/30 TABLET DFE22 10
67 01001162 BRONCHITIN SYR 50ML BOTTLE LFL41 2
68 01000894 BUSCOPAN PLUS TABL ; BOX/100 TABLET 183087 9
69 01000707 CANDESARTAN 16 MG TAB TABLET 4302305 10
70 01000706 CANDESARTAN 8 MG TABLET - -
71 01000140 CAPTOPRIL TABL 12,5MG (INDOFARMA) TABLET 1203014 84
72 01000144 CAPTOPRIL TABL 25MG (INDOFARMA) TABLET 1306022 435
73 01000145 CAPTOPRIL TABL 50MG (INDOFARMA) TABLET 1310015 80
74 01000487 CARBAMAZEPINE TABL 200MG (INDOFARMA) TABLET 30402347 60
75 01001127 CARDIO ASPIRIN 100MG ; BOX/30 TABLET - -
76 01000749 CARMED 10% CREAM TUBE - -
77 01000291 CARPIATON TABL 100MG (FAHRENHEIT) TABLET IV001B 10
78 01000292 CARPIATON TABL 25MG (FAHRENHEIT) TABLET HA2461 25
79 01001007 CATAFLAM 25MG TABL ; BOX/50 TABLET HL2381 11
80 01001008 CATAFLAM 50MG TABL ; BOX/50 TABLET ID3249 18
81 01000567 CEFADROXIL KAPS 500MG (INDOFARMA) CAPSULE ID3422 10
82 01000556 CEFADROXIL SYR 125MG/5ML 60ML (INDOFARMA) BOTTLE BF2D010 2
83 01001192 CEFAT KAPSUL 500 MG; BOX/100 TABLET BF2IO31 10
84 01000562 CEFIXIME KAPS 100MG (INDOFARMA) CAPSULE OF4907 21
85 01000564 CEFIXIME SYR KERING 100MG/5ML 30ML (INDOFARMA) BOTTLE BF2JO30 1
86 01000920 CELEBREX 100 MG; BOX/30 TABLET - -
87 01000201 CELESTAMINE SYR 30ML BOTTLE 3YEEE004 2
88 01000200 CELESTAMINE TABL; BOX/30 TABLET 2Y0050B 22
89 01001246 CENDO AUGENTONIC EYE DROPS 5ML BOTTLE 3AU1008 2
90 01001105 CENDO CATARLENT EYE DROPS 15 ML BOTTLE 3CN0412 3
91 01001245 CENDO CENFRESH EYE DROPS 5ML BOTTLE 3C09B3 2
92 01001219 CENDO EYE FRESH DROP 5ML BOTTLE 3EH0531 2
93 01000821 CENDO EYE FRESH EYE DROPS MINIDOSE ; STRIP/5 STRIP - -
94 01000731 CENDO FENICOL 0,25% EYE DROPS 5ML BOTTLE 2FZ1204 2
95 01001244 CENDO GENTAMICIN EYE DROPS 5 ML BOTTLE 3CN0312 2
96 01001113 CENDO LYTEERS EYE DROPS 15ML BOTTLE 3L0730 2
97 01001247 CENDO STATROL EYE DROPS 5ML BOTTLE 351016 2
98 01001126 CENDO TIMOL 0,5% EYE DROPS 5ML BOTTLE 3TM0716 2
99 01000703 CENDO XITROL EYE DROPS 5ML BOTTLE 3XO627 6
100 01000560 CEPHALEXIN KAPS 500MG (INDOFARMA) CAPSULE BF2D003 10
101 01000192 CETIRIZINE DROPS (INDOFARMA) BOTTLE 1211009 1
102 01000206 CETIRIZINE SIRUP 5MG/5ML 60ML (INDOFARMA) BOTTLE NMF3C003 1
103 01001111 CETIRIZINE TABL 10 MG ; BOX/50 (HEXPHARM) TABLET 306007 280
104 01000209 CETIRIZINE TABL 10MG (INDOFARMA) TABLET - -
105 01000160 CHLORAMPHECORT CR (KIMIA FARMA) TUBE AB0048J 3
106 01000161 CHLORAMPHECORT H CR (KIMIA FARMA) TUBE BB03851 3
107 01000337 CHLORAMPHENICOL KAPS 250MG (INDOFARMA) CAPSULE 110502248 24
108 01000214 CHLORAMPHENICOL SALEP MATA 1% 5GR (KIMIA FARMA) TUBE 081044W 3
109 01000334 CHLORAMPHENICOL SUSPENSI 125MG/5ML 60ML (KIMIA FARMA) BOTTLE A1100968 3
110 01000164 CHLORAMPHENICOL TETES TELINGA 3% 5ML (KIMIA FARMA) BOTTLE - -
111 01001012 CHLORPHENIRAMINE 4 MG TABLET 121134 547
112 01000193 CHLORPHENON 4MG TABLET - -
113 01000247 CHLORPROMAZINE TABLET SALUT 100MG (HCL) (KIMIA FARMA) TABLET D120633B 10
114 01001234 CHOLESTAT 10 MG ; BOX/30 TABLET 528032 10
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

115 01000918 CILOSTAZOL 100 MG; BOX/30 TABLET TPB04241 10
116 01000099 CIMETIDINE TABL 200MG (KIMIA FARMA) TABLET A13009B 40
117 01001149 CINOLON-N CREAM 10GR TUBE OG9722 2
118 01000361 CIPROFLOXACIN TABL 500MG (INDOFARMA) TABLET 1305005 29
119 01001210 CITICOLINE TABL 500 MG ; BOX/30 TABLET TP08742 10
120 01000174 CLINDAMYCIN KAPS 150MG (INDOFARMA) CAPSULE 1204003 20
121 01001224 CLINDAMYCIN KAPS 150MG ; BOX/100 (DEXA MEDICA) CAPSULE 4408161 15
122 01000172 CLINDAMYCIN KAPS 300MG (INDOFARMA) CAPSULE 130501048 60
123 01001225 CLINDAMYCIN KAPS 300MG ; BOX/100 (DEXA MEDICA) CAPSULE 2831849 10
124 01000155 CLONIDINE TABL 0,15MG (INDOFARMA) TABLET 1111052 20
125 01000225 CLOPIDOGREL TABL 75MG (DEXA MEDICA) TABLET 4311229 8
126 01000508 CO AMOXICLAV TABL 625MG (INDOFARMA) TABLET AC2L152 9
127 01001237 CORTIDEX TABL ; BOX/100 TABLET 1607003 10
128 01000340 COTRIMOXAZOLE ANAK 120MG TABL (INDOFARMA) TABLET 1108004 10
129 01000339 COTRIMOXAZOLE DEWASA 480MG TABL (INDOFARMA) TABLET 1109051 40
130 01000341 COTRIMOXAZOLE SUSPENSI 60ML (INDOFARMA) BOTTLE 1205017 2
131 01000932 CRESTOR 10MG TAB TABLET KB596 18
132 01000967 CYCLOGESTON INJEKSI 0,5ML VIAL - 10
133 01001213 DAKTARIN ORAL GEL 10GR TUBE 3F1001 1
134 01001214 DAKTARIN ORAL GEL 20GR TUBE - -
135 01000387 DECADRYL EXP SYR 60ML BOTTLE 25204108 2
136 01000662 DEMACOLIN BOTOL (KIMIA FARMA) TABLET - -
137 01000661 DEMACOLIN STRIP TABLET A3A057 200
138 01001102 DEMACOLIN SYR 60 ML BOTTLE D3C006 5
139 01000968 DEPOGESTON INJEKSI 3ML VIAL - 9
140 01000750 DESOLEX CREAM 10 GR TUBE - -
141 01000317 DEXAMETHASONE 0,75MG TABL (HARSEN) TABLET 3H330129 100
142 01000796 DEXAMETHASONE 5 MG/ML INJEKSI 1ML ; BOX/100 AMPOULE 1207027 5
143 01000309 DEXAMETHASONE TABL 0,5MG (INDOFARMA) TABLET 1212027 451
144 01001158 DEXANTA TABL ; BOX/100 TABLET 4406493 90
145 01000928 DEXTAMINE TAB TABLET 65014002 35
146 01000158 DEXTEEM PLUS TABL TABLET T0613200 100
147 01001139 DEXTRAL SYR 100ML BOTTLE VL005 2
148 01001146 DEXTRAL TABL ; BOX/150 TABLET - -
149 01000454 DEXTROMETHORPHAN SYR 10MG/5ML 60ML (INDOFARMA) BOTTLE - -
150 01000453 DEXTROMETHORPHAN TABL 15MG (HBR) (INDOFARMA) TABLET - -
151 01000931 Diamicron MR 60 MG TABLET 922791 15
152 01000622 DIANE 35 PACKAGE 24178A 5
153 01000483 DIGOXIN TABL 0,25MG (INDOFARMA) TABLET - -
154 01000091 DILTIAZEM HCL TABL 30MG (INDOFARMA) TABLET - -
155 01000927 DIOVAN 40MG TABLET B8005 8
156 01001040 DIPHENHYDRAMINE HCL 10 MG/ML AMPOULE 553420072 3
157 01001125 DIPROGENTA CREAM 5 GR TUBE 3ASEA005 2
158 01001167 DOLO-NEUROBION TABL ; BOX/100 STRIP C3I67OH 3
159 01000544 DOMPERIDON SUSPENSI 5MG/5ML 60ML BOTTLE TO44506B 2
160 01000545 DOMPERIDON TABL 10MG (INDOFARMA) TABLET 305201 30
161 01000342 DOXYCYCLINE KAPS 100MG (INDOFARMA) CAPSULE 1212028 4
162 01001251 DOXYCYLINE KAPS 100MG ; BOX/100 (DEXAMEDICA) CAPSULE 1208028 20
163 01001097 DRAMAMINE TABL; BOX/100 STRIP 4411223 5
164 01001173 DUMOCYCLINE 250MG ; BOX/500 TABLET 12IO525 20
165 01000815 DUPHASTON 10MG TABL ; BOX/20 TABLET 13020216 17
166 01001202 ENBATIC SACHET 3GR SACHET M2036141 3
167 01000551 EPERISONE HCI TABL 50MG (MEDIKON PRIMA LABORATORIES) TABLET 342542 20
168 01001160 EPEXOL SYR 120ML BOTTLE PO54852 2
169 01001159 EPEXOL TABL ; BOX/100 TABLET DA09130 88
170 01000762 EPINEPHRINE / ADRENALINE 0,1% INJ ; BOX/100 AMPOULE OF1653 3
171 01000163 ERLAMYCETIN 1 % EAR DROP 10 ML BOTTLE - -
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

172 01000836 ERLAMYCETIN EYE DROP (PLUS) BOTTLE D114838 3
173 01000381 ERYTHROMYCIN KAPS 250MG (INDOFARMA) CAPSULE OF2022 13
174 01000383 ERYTHROMYCIN SYR 200MG/5ML 60ML (INDOFARMA) BOTTLE OF2171B 2
175 01001241 ESPERS0N OINT 0,25% 5GR TUBE 130200503 1
176 01000444 ETHAMBUTOL TABLET SALUT 500MG (HCL) (INDOFARMA) TABLET 1210082 30
177 01001212 FAKTU OINTMENT 20GR TUBE - -
178 01000826 FAKTU SUPP ; BOX/10 SUPPOSITORY 1307007 14
179 01000093 FAMOTIDINE TABL 20MG (INDOFARMA) TABLET 090840 15
180 01000092 FAMOTIDINE TABL 40MG (INDOFARMA) TABLET C3K340I 10
181 01001232 FARMOTEN TABL 25MG ; BOX/100 TABLET C3D537E 20
182 02001026 FENISTIL ORAL 0.1% DROP 10ML BOTTLE 1109015 1
183 01000227 FENITOIN KAPS 100MG (IKAPHARMINDO) CAPSULE 1203004 80
184 01001249 FENOFIBRATE KAPS 100MG ; BOX/ 30 (HEXPHARM) CAPSULE RF1961 10
185 01000478 FENOFIBRATE KAPS 200MG (MEDIKON PRIMA LABORATORIES) CAPSULE RF1281 20
186 01001250 FENOFIBRATE KAPS 300MG ; BOX/30 (HEXPHARM) CAPSULE 320716 10
187 01000542 FG THROCHES TABL TABLET 527002 9
188 01000175 FLAGYL FORTE TABL 500MG TABLET 30202131 10
189 01000627 FLAGYSTATIN VAGINAL SUPPOS SUPPOSITORY 527001 6
190 01000139 FLUCONAZOLE TABL 150MG (KIMIA FARMA) TABLET 122042W 12
191 01000717 FLUIMUCIL CAPS 200MG; BOX/60 CAPSULE 13932 13
192 01000718 FLUIMUCIL SYR 75 ML BOTTLE 256L451 2
193 01000919 FLUNARIZINE 5 MG; BOX/30 TABLET 068L221 11
194 01000776 FOLAVIT 400MCG TABL ; BOX/100 TABLET OH2534 20
195 01001142 FORUMEN TETES TELINGA BOTTLE OE1607 2
196 01000295 FUROSEMIDE TABL 40MG (INDOFARMA) TABLET - -
197 01000715 FUSON CREAM 5 GR TUBE - -
198 01000716 FUSON OINT 5 GR TUBE - -
199 01001096 GARAMYCIN CREAM 5 GR TUBE 3YHCZ013 2
200 01000477 GEMFIBROZIL KAPS 300MG (INDOFARMA) CAPSULE 1307008 72
201 01001164 GEMFIBROZIL KAPS 300MG (PHAPROS) TABLET - -
202 01000180 GENTAMICIN SALEP KULIT 0,1% 5GR (INDOFARMA) TUBE 1111022 5
203 01000212 GENTAMISIN SULFAT TETES MATA 0,3% 5ML ; BOX/10 BOTTLE - -
204 01000022 GENTIEN VIOLET LARUTAN 1% 10ML BOTTLE MO7093 3
205 01000399 GLIBENCLAMIDE TABL 5MG (INDOFARMA) TABLET 1307035 1,040
206 01000400 GLIMEPIRIDE TABL 1MG (DEXA MEDICA) TABLET 4310334 50
207 01000404 GLIMEPIRIDE TABL 2MG (DEXA MEDICA) TABLET 4406238 35
208 01000406 GLIMEPIRIDE TABL 3MG (DEXA MEDICA) TABLET 4308187 25
209 01000408 GLIMEPIRIDE TABL 4MG (DEXA MEDICA) TABLET 4309302 16
210 01000403 GLIQUIDON TABL 30MG (DEXA MEDICA) TABLET 4402088 10
211 01001206 GLUCOBAY TAB 50MG ; BOX/50 STRIP CR12989 2
212 01001134 GLUCODEX TABL ; BOX/100 TABLET 4405206 20
213 01000885 GLUCOPHAGE 500MG TABL ; BOX/100 TABLET T0248727 20
214 01000895 GLUCOPHAGE 500MG XR TABL ; BOX/120 TABLET T0065137 32
215 01000614 GLUCOSAMIN + CHONDROITIN + VITAMIN C @30TABL (INDOFARMA) BOTTLE 1203002 1
216 01000485 GLUCOSAMIN TABL 500MG (MEDIKON PRIMA LABORATORIES) TABLET 31311 40
217 01000925 GLUCOVANCE 2.5 MG; BOX/100 TABLET T0100123 10
218 01001107 GLUCOVANCE 5/500 MG; BOX/100 TABLET TOO86096 10
219 01001136 GLUDEPATIC 500MG TABL ; BOX/100 TABLET S1465095 20
220 01000159 GLYCERIL GUAICOLAT TABL 100MG (KIMIA FARMA) TABLET RA2921 54
221 01001236 GRAFACHLOR TABL ; BOX/100 TABLET TG352G 30
222 01001240 GRAFAMIC TABL ; BOX/100 TABLET TE018G 30
223 01001163 GRANTUSIF TABL ; BOX/100 TABLET TC2386 50
224 01000138 GRISEOFULVIN TABL 125MG (INDOFARMA) TABLET 1112032 20
225 01000136 GRISEOFULVIN TABL 500MG TABLET - -
226 01001186 GRIVIN FORTE TABL 500MG ; BOX/100 TABLET 55024002 18
227 01000722 HEPTASAN 4 MG TABL TABLET DD6933 26
228 01000358 HIDROKORTISON KRIM 1% 5GR TUBE 522165 3
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

229 01000299 HYDROCHLORTHIAZIDE TABL 25MG (INDOFARMA) TABLET - -
230 01000360 HYDROCORTISONE KRIM 2,5% 5GR (INDOFARMA) TUBE 1203008 3
231 01000419 IBUPROFEN SUSPENSI 100MG/5ML 60ML BOTTLE 1305005 2
232 01000420 IBUPROFEN SUSPENSI 200MG/5ML 60ML BOTTLE 1212041 3
233 01000421 IBUPROFEN TABL 200MG (INDOFARMA) TABLET CD1J013 12
234 01000422 IBUPROFEN TABL 400MG (INDOFARMA) TABLET 130100349 70
235 01000254 ICHTYOL 10% ZALF 15GR TUBE 60Z1A 1
236 01000286 ILIADIN KINDER 0.025% DROP 10ML BOTTLE TO341385 2
237 01000825 IMODIUM TABLET ; BOX/100 TABLET 353051 17
238 01000807 INCIDAL-OD 10MG CAPS ; BOX/50 CAPSULE CR14389 58
239 01001099 INERSON SALEP 15 GR TUBE C004C079 2
240 01000104 INPEPSA 500MG/5ML SYR 100ML BOTTLE RA0871 1
241 01000985 INTERHISTIN TABL 50MG ; BOX/100 TABLET T024C019 27
242 01000680 INTUNAL-F TABLET 3331303 92
243 01001123 IODINE POVIDONE LAR 10% (KIMIA FARMA) 300ML BOTTLE 4217500 3
244 01000084 IRBESARTAN TABL 300MG (INDOFARMA) TABLET 1211007 8
245 01000440 ISONIAZID TABL 100MG (KIMIA FARMA) TABLET I111543B 43
246 01000441 ISONIAZID TABL 300MG (INDOFARMA) TABLET 1204001 10
247 01000445 ISOSORBIDE DINITRATE TABL SUBLINGUAL 5MG (INDOFARMA) TABLET 1208058 115
248 01000724 ISPRINOL 250 MG/5 ML SYR 60 ML BOTTLE 155098 2
249 01000772 ISPRINOL 500 MG TABL ; BOX/8 TABLET ISD140 4
250 01001151 KALCINOL N CREAM 10GR TUBE 526707 2
251 01001150 KALCINOL N CREAM 5GR TUBE 526709 1
252 01000425 KALIUM DIKLOFENAK TABL 25MG (DEXA MEDICA) TABLET 4402170 50
253 01000426 KALIUM DIKLOFENAK TABL 50MG (DEXA MEDICA) TABLET 4402424 136
254 01000327 KALK 500MG TABL (KIMIA FARMA) TABLET C30318T 29
255 01000998 KALMETHASON 0,5MG TABL; BOX/200 STRIP 526647 14
256 01000333 KALMICETINE 125MG/5ML SYR 60ML BOTTLE 422115 2
257 01000182 KALMICETINE 2% OINT 15GR (KALBE FARMA) TUBE 425231 2
258 01000332 KALMICETINE CAPS 250MG CAPSULE 328204 10
259 01001230 KALNEX TABL 250MG ; BOX/100 TABLET 525309 10
260 01001228 KALNEX TABL 500MG ; BOX/100 TABLET 528584 10
261 01001216 KALTROFEN 100MG TABL ; BOX/30 TABLET 521207 10
262 01001217 KALTROFEN 50MG TABL ; BOX/30 TABLET 527195 10
263 01000131 KANDISTATIN DROP 12ML BOTTLE 330630702 3
264 01001194 KENACORT TABL 4 MG; BOX/100 TABLET 3E0481 20
265 01000982 KENALOG IN ORABASE GEL TUBE 3D7431 1
266 01000719 KETOCID KAPLET; BOX/100 CAPLET FY121 10
267 01000220 KETOKONAZOLE KRIM 2% 10GR (DEXA MEDICA) TUBE 3222397 2
268 01000135 KETOKONAZOLE TABL 200MG (DEXA MEDICA) TABLET 2230395 31
269 01000755 KETOMED SS 60 ML BOTTLE CU001A 1
270 01001048 KETOPROFEN INJ 50 MG/2ML (HEXPHARM JAYA) AMPOULE - 3
271 01000423 KETOPROFEN TABL 100MG (DEXA MEDICA) TABLET 4309113 20
272 01000746 KLODERMA CREAM 10 GR TUBE - -
273 01000745 KLODERMA CREAM 5 GR TUBE - -
274 01000748 KLODERMA OINT 10 GR TUBE - -
275 01000747 KLODERMA OINT 5 GR TUBE IV001A 2
276 01001243 LAMESON TABL 16MG ; BOX/100 TABLET T1082198 10
277 01001198 LAMESON TABL 4MG ; BOX/100 STRIP 50053 2
278 01001242 LAMESON TABL 8MG ; BOX/100 TABLET 1143 10
279 01001112 LANSOPRAZOLE KAPS 30 MG ; BOX/20 (HEXPHARM) TABLET 49143 15
280 01000098 LANSOPRAZOLE KAPS 30MG (INDOFARMA) CAPSULE - -
281 01001093 LASAL EXPEC SYR 100ML BOTTLE 3133 2
282 01001211 LASIX 40MG TABL ; BOX/100 TABLET 154L172R 14
283 01000814 LEMOCIN CITRON TABL ; BOX/16 TABLET - -
284 01001114 LESICHOL 300MG ; BOX/60 TABLET 16C081 20
285 01000364 LEVOFLOXACIN TABL 500MG (INDOFARMA) TABLET 1201004 21
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

286 01000981 LIDOCAIN 2% 2ML INJ;BOX/100 (KIMIA FARMA) AMPOULE 16C081 10
287 01000743 LIDOCAINE COMPOSITUM 2%/2 ML INJEKSI (INDOFARMA) AMPOULE - 10
288 01000168 LINCOMYCIN KAPS 500MG (INDOFARMA) CAPSULE 12-0.7018 16
289 01001129 LIPITOR 10MG TABL ; BOX/30 TABLET 112.00.52 12
290 01001130 LIPITOR 20MG TABL ; BOX/30 TABLET 120501203 10
291 01000148 LISINOPRIL TABL 10MG TABLET CL6867 20
292 01000147 LISINOPRIL TABL 5MG TABLET 737042 20
293 01000125 LOPAMID 2MG TABL TABLET 1125032 13
294 01000204 LORATADINE TABL 10 MG (INDOFARMA) TABLET 15B085 35
295 01000937 LOSARTAN 50MG TAB TABLET 15A113 8
296 01001101 MARVELON GOLD TABL; BOX/84 STRIP 3A350115 3
297 01000391 MECOBALAMIN 500MCG KAPS CAPSULE 1309010 25
298 01000685 MEDIAMER B6 TABL (DARYA VARIA) TABLET 427012 20
299 01000751 MEDIKLIN GEL 15 GR TUBE DVL06A1 2
300 01001229 MEDIKLIN TR 15 GR TUBE NVL01A1 1
301 01001135 MEFINAL CAPS 500MG ; BOX/100 CAPSULE DJ8604 131
302 01001122 MELANOX CREAM 15 GR TUBE 0VL02B1 1
303 01000412 MELOXICAM 15MG SUPPOSITORIA (DEXA MEDICA) SUPPOSITORY 3022011 6
304 01000413 MELOXICAM TABL 15MG (INDOFARMA) TABLET 1211012 21
305 01000417 MELOXICAM TABL 7,5MG (INDOFARMA) TABLET 1109008 23
306 01000799 MERTIGO 6MG TABL ; BOX/100 TABLET 150513 30
307 01001091 METFORMIN HCI TABL 500MG (HEXPHARM) TABLET 4402201 160
308 01000884 METFORMIN HCI TABL 500MG (INDOFARMA) TABLET 306526 160
309 01000411 METFORMIN HCI TABL 850MG (DEXA MEDICA) TABLET 130400354 40
310 01000315 METHYLPREDNISOLONE TABL 16MG (INDOFARMA) TABLET - -
311 01000312 METHYLPREDNISOLONE TABL 4MG (INDOFARMA) TABLET 1201001 40
312 01000314 METHYLPREDNISOLONE TABL 8MG (DEXA MEDICA) TABLET 1305001 25
313 01000489 METILERGOMETRIN 0,125MG TABL (KIMIA FARMA) TABLET 4407487 20
314 01000547 METOKLOPRAMID TABL 10MG (KIMIA FARMA) TABLET AB0197 60
315 01000169 METRONIDAZOLE TABL 250MG (KIMIA FARMA) TABLET C110404B 30
316 01000170 METRONIDAZOLE TABL 500MG (INDOFARMA) TABLET - -
317 01001148 MICARDIS PLUS 40MG ; BOX/20 TABLET 1211013 10
318 01001147 MICARDIS TABL 40MG ; BOX/20 TABLET 202000 10
319 01000223 MICONAZOLE KRIM 2% (NITRAT) 10GR (KIMIA FARMA) TUBE 207040 4
320 01000347 MICROGYNON LIBI 25`S STRIP 101260W 18
321 01000349 MOFACORT CREAM 10GR TUBE - -
322 01000348 MOFACORT CREAM 5GR TUBE C3H039H 1
323 01001028 MOLAGIT TABL BOX/150 TABLET TV001A 55
324 01000688 MOLOCO B12 TABL (DARYA VARIA) TABLET - -
325 01001120 MUCOHEXIN TABL ; BOX/100 STRIP VF006 24
326 01001169 MUCOPECT 15MG/5ML PEDIATRIC SYRUP 60ML BOTTLE 13020202 1
327 01001170 MUCOPECT 30MG/5ML SYRUP 60ML BOTTLE 13040601 1
328 01001218 MUCOPECT 7.5MG/ML DROP 20ML BOTTLE 13060926 1
329 01000390 MUCOS 15MG/ML DROP 20ML BOTTLE 2341303 1
330 01000464 MUCOSOLVAN TAB TABLET 522305 80
331 01001215 MYCORAL CREAM 2% 5GR TUBE 528539 2
332 01001110 MYCORAL TAB 200 MG TABLET 526626 7
333 01000129 MYCOSTATIN 100000UI/ML DROP 12ML BOTTLE 3C6531 2
334 01000790 NACL 500ML BOTTLE - -
335 01000689 NALGESTAN TABL TABLET 3019661 8
336 01000415 NATRIUM DIKLOFENAK TABL 25MG (KIMIA FARMA) TABLET IA3297J 70
337 01000638 NATRIUM DIKLOFENAK TABL 50MG (KIMIA FARMA) TABLET KC2975J 190
338 01000866 NEBACETIN OINT 5GR TUBE C31714H 2
339 01000184 NEBACETINE POWDER BOTTLE C3E295F 2
340 01001103 NEO ULTRASILINE CREAM 5 GR TUBE - -
341 01001104 NEOSANMAG FAST TABL; BOX/16 TABLET OG2253 14
342 01000690 NEURALGIN RX TABL TABLET 522760 92
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

343 01001189 NEUROSANBE 5000 TABL ; BOX/100 TABLET OG23128 20
344 01001226 NEUROSANBE PLUS TABLET - -
345 01000974 NEUROTROPIC INJ 9 ML VIAL - 1
346 01001100 NEW SKELAN KAPS; BOX/100 CAPSULE - -
347 01000768 NEXIUM 20 MG TABL ; BOX/28 TABLET BCVN 14
348 01000086 NIFEDIPIN TABL 10MG (DEXA MEDICA) TABLET 4309298 470
349 01001178 NIFUDIAR SYRUP 60ML BOTTLE 2301303 2
350 01000833 NIPE DROPS 15ML BOTTLE CK0802 3
351 01000224 NIZORAL CR 5GR TUBE 3G3511 2
352 01000130 NIZORAL TABL 200MG; BOX/30 TABLET 3K8442 10
353 01000431 NONFLAMIN CAPS CAPSULE LFML 4
354 01001153 NOPERTEN TABL 10MG (DEXAMEDICA) TABLET 4404067 13
355 01001154 NOPERTEN TABL 5MG (DEXAMEDICA) TABLET - -
356 01001106 NORVASK 5 MG TABLET 22905032 25
357 01001161 NOVALGIN TABL ; BOX/100 TABLET - -
358 01001203 NUFACORT TUBE TUBE 3091006-3 1
359 01000037 OBH CITO 100ML BOTTLE - -
360 01001041 OBH SYR 100 ML (ERELA) BOTTLE 254738 4
361 01000373 OFLOXACIN TABL 200MG (INDOFARMA) TABLET 1108005 10
362 01000374 OFLOXACIN TABL 400MG (INDOFARMA) TABLET 1203003 16
363 01000101 OMEPRAZOLE KAPS 20MG STRIP (INDOFARMA) CAPSULE 186229 10
364 01000190 ONDANSETRON TABL 4MG (INDOFARMA) TABLET 1305010 6
365 01000191 ONDANSETRON TABL 8MG (INDOFARMA) TABLET 1302004 12
366 01001144 OPINEURON TABL ; BOX/100 TABLET - -
367 01000492 ORALIT 200ML SERBUK SACH (INDOFARMA) SACHET - -
368 01001140 OSTE FORTE TABL ; BOX/30 TABLET 13E04578 11
369 01001141 OTOLIN EAR DROPS BOTTLE - -
370 01000782 OTOPAIN EAR DROPS BOTTLE 526232 2
371 01000038 OXYTETRACYCLINE HCL SALEP KULIT 3% 5GR (INDOFARMA) TUBE D003C003 2
372 01000215 OXYTETRACYCLINE HCL SALEP MATA 1% 3,5GR (KIMIA FARMA) TUBE 1206003 3
373 01000048 P.K (PERMANGANAS KALIUM) (CIUBROS FARMA) POT 062132W 8
374 01001183 PANTOPRAZOL TABL 20MG ; BOX/10 TABLET M22091 7
375 01001184 PANTOPRAZOL TABL 40MG ; BOX/10 TABLET A13782 10
376 01000055 PARACETAMOL SYR 120MG/5ML 60ML (INDOFARMA) BOTTLE A13785 8
377 01000057 PARACETAMOL TABL 500MG (INDOFARMA) TABLET 1212099 127
378 01000493 PEDIALYTE UNFLAVOURED 500ML BOTTLE 553740358F 1
379 01001222 PEHADOXIN TABL ; BTL/1500 TABLET CD2I104 50
380 01001039 PIL KB PLANOTAP; BOX/20 STRIP 29506XP 6
381 01001209 PIPET TETES PLASTIK 3ML PIECES - 3
382 01000393 PIRACETAM TABL 1200MG (INDOFARMA) TABLET - -
383 01001044 PIRACETAM TABL 400 MG (HEXPHARM) TABLET 181001 20
384 01000395 PIRACETAM TABL 400MG (DEXA MEDICA) TABLET - -
385 01000397 PIRACETAM TABL 800MG (DEXA MEDICA) TABLET 4305190 14
386 01000429 PIROXICAM KAPS 10MG (INDOFARMA) CAPSULE 1205019 1
387 01000427 PIROXICAM KAPS 20MG (INDOFARMA) CAPSULE 1308099 288
388 01000798 PONSTAN 500MG TABL ; BOX/100 TABLET 32930023A 85
389 01001208 POSTINOR-2 TABL ; BOX/2 TABLET T2B768 2
390 01000474 PRAVASTATIN TABL 20MG ; BOX/50 TABLET - -
391 01000318 PREDNISON TABL 5MG (KIMIA FARMA) TABLET - -
392 01000633 PRIMOLUT N TABLET TABLET WEH805 12
393 01001121 PRIMPERAN SYR 50ML BOTTLE 13D0266 2
394 01000634 PROFENID 100MG SUPPOS SUPPOSITORY 135L147 5
395 01000693 PROFERTIL TABL (KALBE FARMA) TABLET 527392 10
396 01001145 PRONALGES SUPP ; BOX/10 SUPPOSITORY 2430688 3
397 01001010 PRONICY 4MG KAPLET ; BOX/100 TABLET - -
398 01000521 PROPRANOLOL TABL 10MG (HCL) (DEXA MEDICA) TABLET 4310138 30
399 01000520 PROPRANOLOL TABL 40MG (HCL) (DEXA MEDICA) TABLET 4310140 20
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

400 01000447 PROPYLTHIOURACYL TABL 100MG (INDOFARMA) TABLET - -
401 01000430 PRORIS FORTE 200MG/5ML SYR BOTTLE C3K961H 2
402 01000865 PRORIS KAPLET 200MG STRIP C2F200H 2
403 01000433 PYRAZINAMIDE TABL 500MG (INDOFARMA) TABLET 1111046 20
404 01000103 RANITIDIN TABL 150MG (INDOFARMA) TABLET 1209023 194
405 01000752 REFAQUIN CREAM 15 GR TUBE - -
406 01001231 RENABETIC TABL 5MG ;BOX/100 TABLET R12001 30
407 01001115 RENADINAC 25 MG ; BOX/100 TABLET RD1661 60
408 01001116 RENADINAC 50 MG ; BOX/100 TABLET RG3461 50
409 01000853 RESTOR TABL; BOX/30 TABLET PA0201 20
410 01001168 RHINOFED SUSP 60ML BOTTLE - -
411 01000828 RHINOFED TABL ; BOX/50 TABLET 4405306 10
412 01000455 RHINOS JUNIOR SYR 60ML BOTTLE 2530888 2
413 01000456 RHINOS SR CAPS CAPSULE 2530888 11
414 01000434 RIFAMPICIN KAPLET 600MG (INDOFARMA) CAPLET 1201001 35
415 01000435 RIFAMPICIN KAPS 300MG (INDOFARMA) CAPSULE 1206004 30
416 01000437 RIFAMPICIN TABLET SALUT 450MG (INDOFARMA) TABLET - -
417 01001207 RIFAMPICIN TABLET SALUT 450MG ; BOX/100 (HEXPHARM) TABLET 308290 10
418 01000856 RIMSTAR 4 FDC TABL; BOX/30 TABLET D16816 10
419 01000240 RISPERIDON TABL 2MG (DEXA MEDICA) TABLET 4401224 20
420 01000457 SALBUTAMOL 2MG TABL (INDOFARMA) TABLET 1306025 47
421 01000461 SALBUTAMOL 2MG/5ML SYR 100ML (INDOFARMA) BOTTLE 1205004 2
422 01000458 SALBUTAMOL 4MG TABL (INDOFARMA) TABLET 1209038 28
423 01000923 SANPRIMA TABLET; BOX/100 TABLET NE2894 23
424 01001098 SCABICID CREAM 10 GR TUBE NG2894 2
425 01000880 SERETIDE 125 INHALER UNIT CCD172J 1
426 01000469 SIMVASTATIN TABL 10MG (DEXA MEDICA) TABLET - -
427 01001045 SIMVASTATIN TABL 10MG (HEXPHARM) TABLET 308103 154
428 01000471 SIMVASTATIN TABL 20MG (KIMIA FARMA) TABLET 305076 75
429 01000156 SKIZON CREAM 10GR *NEW PACK TUBE G1310018 3
430 01001152 SOHOBION 5000 TABL @10KAPS STRIP 425132 3
431 01000379 SPIRAMYCIN TABL 500MG (INDOFARMA) TABLET 13C04474 28
432 01000298 SPIRONOLAKTON TABL 100MG TABLET RY2A048 20
433 01000293 SPIRONOLAKTON TABL 25MG TABLET 305043 20
434 01000082 STESOLID SUPPOS 5MG/2.5ML SUPPOSITORY - -
435 01000080 STESOLID TABL 2MG TABLET - -
436 01001238 STUGERON TABL 25MG ; BOX/250 (10X25 STRIP) TABLET 4408091 10
437 01000446 SULFASALAZIN TABL 500MG TABLET TSE32140 50
438 01001108 SUPER TETRA KAPS CAPSULE 1277VC 62
439 01000936 SYMBICORT TURB 160 DOS 60 TUBE XABE 1
440 01000921 TANAPRESS 5 MG; BOX/30 TABLET JI900 10
441 01001205 TENSIVASK TABL 10 MG; BOX/50 TABLET 265L022 10
442 01000533 TEOSAL TAB (DEXA MEDICA) TABLET 440112 120
443 01001174 TERRACORTIL SALEP MATA TUBE 4409175 2
444 01001196 TERRACORTRIL SALEP KULIT TUBE 2-95007 2
445 01000571 TETRACYCLINE KAPS 250MG (KIMIA FARMA) CAPSULE 1-95007 93
446 01000331 THIAMPHENICOL KAPS 500MG (INDOFARMA) CAPSULE LA3967J 140
447 01001179 THIAMYCIN SYRUP 60ML BOTTLE - -
448 01001185 THIAMYCIN TABL ; BOX/100 TABLET KO21C004 17
449 01000873 THROMBO ASPILETS TABL ;BOX/150 TABLET 3051402 90
450 01000062 TRAMADOL KAPS 50MG (INDOFARMA) CAPSULE 1208015 25
451 01000697 TRANSAMIN 500 MG (DAIICHI SANKYO) TABLET 3B0373 11
452 01000700 TRANSPULMIN BB BALSAM 10GR TUBE CD1602 2
453 01001143 TRAVOCORT CREAM 5 GR TUBE 283C 2
454 01000462 TREMENZA TABL TABLET - -
455 01000664 TRIAMCINOLONE 4MG TABL TABLET ES1107 10
456 02001037 TRIFED TAB (5X10`S) TABLET OF8334 20
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT KERAS
CATEGORY : OBAT KERAS REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

457 01001157 TUZALOS STRIP 14961A 16
458 01001128 ULTRAPROCT N SUPP ; BOX/6 SUPPOSITORY 144E 5
459 01001176 ULTRAPROCT OINTMENT 10GR TUBE 1308005 2
460 01001223 URISPAS TABL 200MG ; BOX/30 TABLET OC2426 10
461 01001137 UROTRACTIN CAPS ; BOX/60 CAPSULE B5033E 30
462 01001156 VALSARTAN TABL 160MG (NOVARTIS) TABLET B5044B 20
463 01001155 VALSARTAN TABL 80MG (NOVARTIS) TABLET 4406214 25
464 01000770 VENTOLIN INHALER UNIT JV5685 3
465 01000284 VENTOLIN NEBULES AMPOULE - -
466 01000085 VERAPAMIL TABL 80MG (HCL) (KIMIA FARMA) TABLET C120477B 10
467 01000111 VERMOX TABL 500MG TABLET 3G3001 1
468 01000857 VIMAX 100 TABL; BOX/4 TABLET *00003 5
469 01000899 VIMAX 50MG TABL; BOX/4 TABLET *00005 2
470 01000600 VIT A 6000 IU (KIMIA FARMA) TABLET 3H295H 64
471 01000304 VIT K3 10MG TABL (KIMIA FARMA) TABLET EA18515 30
472 01000765 VITACID CREAM 0.05% TUBE - -
473 01000608 VITAMIN B KOMPLEKS TABL (KIMIA FARMA) TABLET - 940
474 01000605 VITAMIN B1 100MG TABL (KIMIA FARMA) TABLET - 49
475 01000604 VITAMIN B1 50MG TABL (KIMIA FARMA) TABLET - 20
476 01000606 VITAMIN B12 50MCG TABL (KIMIA FARMA) TABLET - 28
477 01000601 VITAMIN B6 10MG TABL (KIMIA FARMA) TABLET - 32
478 01000612 VITAMIN C 100MG TABL (KIMIA FARMA) TABLET - 43
479 01000613 VITAMIN C 50MG TABL (KIMIA FARMA) TABLET - 1
480 01001201 VITAQUIN CREAM 5% 15 GR TUBE - -
481 01000812 VOLTADEX 50MG TABL ; BOX/50 TABLET 4407181 60
482 01000735 VOLTADEX GEL1% 20GR TUBE 2721396 1
483 01001118 VOLTAREN 25MG TABL ; BOX/50 TABLET ID3278 11
484 01001119 VOLTAREN 50MG TABL ; BOX/50 TABLET ID3285 34
485 01001117 VOLTAREN GEL 10GR TUBE 13071221 1
486 01000732 VOLTAREN GEL 20GR TUBE 13050773 2
487 01000871 VOMETA 5 MG/1ML DROPS 10 ML BOTTLE - -
488 01000797 VOMETA FLASH 10MG ; BOX/50 TABLET 2631369 22
489 01001124 VOSEA SYR 30ML BOTTLE 4405501 3
490 01001221 XENICAL TABL 120 MG ;BOX/21 TABLET TB0036 21
491 01000910 YASMIN TAB PACKAGE M2034M4 2
492 01001197 YUSIMOX 125 MG/5 ML SYRUP 60 ML BOTTLE 24126J 1
493 01000926 ZADITEN SYR BOTTLE 35809 1
494 01001180 ZALDIAR TABL ; BOX/10 TABLET H0098 10
495 01000126 ZINC TABL 20MG (INDOFARMA) TABLET C363126 25
496 01000800 ZINKID 100ML SYR BOTTLE 1202006 1
497 01000900 ZUMAFIB MICRO 160MG TABL; BOX/30 TABLET 1305024 6
498 01001188 ZYLORIC TAB 100MG ; BOX/200 TABLET 120305B 23
499 01001220 ZYLORIC TABL 300MG ; BOX/100 TABLET 794F13 8
 LAMPIRAN BERITA ACARA PENGALIHAN OBAT PSIKOTROPIK
CATEGORY : OBAT PSIKOTROPIK REGION : JAWA TIMUR
LOCATION : VG BANYUURIP

NO SKU DESCRIPTION PACK NAME NO BATCH JUMLAH

1 01000935 SPASMAL TAB TABLET RY2A048 28
2 01000696 SPASMINAL TABL (HEXPHARM JAYA) TABLET 305043 20