Laporan Umum 2016

LAPORAN UMUM BULAN JUNI 2016
NO NAMA TANGGAL NAMA OBAT JUMLAH RETUR OBAT HARGA SATUAN HARGA SATUAN SUB TOTAL
PELAKSANAAN OBAT TERJUAL UMUM DPK TOTAL
Rp. Rp. Rp. Rp.
1 Ny. Chairani 5/31/2016 Inf RL 2 2 11600 23,200
Inf Set makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Ondan 4 mg Inj 2 2 0 7288 -
Ranitidin Inj 2 2 0 3746 -
Sp 5 cc 2 2 2478 4,956
ulsidex Tab 10 7 3 1484 4,452
SUB TOTAL 66,394
5/1/2016 Lansoprazol Tab 10 10 1855 18,550

Domperidon Tab 10 10 596 5,960
SUB TOTAL 24,510
TOTAL 90,904
2 Tn. Siman 5/30/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23500 23,500
Asering Inf 2 2 25000 50,000
Ceftriaxon Inj 2 2 25000 50,000
Buscopan Inj 2 2 28000 56,000
Tramadol Inj 1 1 13000 13,000
Aquadest Inj 1 1 5000 5,000
Sp 5 cc 3 3 2500 7,500
Sp 1 cc 1 1 2849 2,849
SUB TOTAL 218,449 SALAH
5/31/2016 Asering Inf 2 2 21725 43,450

Buscopan Inj 3 3 0 27825 -
Tramadol Inj 3 3 0 12521 -
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 96,796
5/31/2016 Tramadol Inj 6 6 0 12521 -

Metronidazol Inf 3 1 2 72875 145,750
Ranitidin Inj 2 2 3746 7,492
Ondan 8 mg Inj 1 1 11660 11,660
Coditam Tab 3 3 4810 14,430
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 181,810
6/1/2016 Coditam Tab 10 10 4810 48,100

Ranitidin Tab 10 10 321 3,210
Cefadroxil Tab 10 10 981 9,810
SUB TOTAL 61,120
TOTAL 558,175
3 Tn. Agus 6/1/2016 Amoxicilin tab 10 10 464 4,640

Mefinal Tab 10 10 1749 17,490
TOTAL 22,130
4 Ny. Puni 6/1/2016 Cefadoxil Tab 10 10 981 9,810

Asam Mefenamat 10 10 318 3,180
Lidocain Inj 2 2 2186 4,372
Sp 5 cc 1 1 2478 2,478
TOTAL 19,840
5 Ny. Sayuk 6/1/2016 Inf Set makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf RL 1 1 11600 11,600
Ketorolac Inj 1 1 21863 21,863
Sp 1 cc 1 1 2849 2,849
Sp 5 cc 1 1 2478 2,478
Elastis Verband 3 Inc 1 1 23320 23,320
Mefinal Tab 10 10 1749 17,490
Mp 4 mg 10 10 530 5,300
TOTAL 134,428
6 An. M Sholihudin 6/1/2016 Amoxicilin Tab 10 10 464 4,640

Ibu Profen Tab 5 5 331 1,655
Sp 5 cc 1 1 2478 2,478
Sp 1 cc 1 1 2849 2,849
TOTAL 37,128
7 Tn. Dalil 6/1/2016 Valesco Tab 20 20 11660 233,200

Spironolacton Tab 20 20 539 10,780
Ventolin Eks Syr 2 2 69019 138,038
TOTAL 382,018
8 Nn. Julia 5/30/2016 Inf Set makro 1 1 10600 10,600

Venflon 22 1 1 23500 23,500
Inf NS 3 3 11600 34,800
Pumpicel Inj 1 1 195500 195,500
Aquadest Inj 2 2 5000 10,000
Buscopan Inj 2 2 28000 56,000
Sp 5 cc 2 2 2500 5,000
Braxidin Tab 10 10 1200 12,000
SUB TOTAL 347,400
5/31/2016 Inf Ns 2 2 7721 15,442

Buscopan Inj 3 3 23625 70,875
Pumpicel Inj 1 1 195232 195,232
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 285,922
5/31/2016 Tradosik Inj 2 2 18550 37,100

Lafidryl Dmp Syr 1 1 6000 6,000
SUB TOTAL 43,100
6/1/2016 Inf NS 2 2 7721 15,442

Buscopan Inj 3 3 27825 83,475
SUB TOTAL 98,917
6/1/2016 Thramed Tab 10 10 3000 30,000

Scopamin Tab 10 10 2551 25,510
Braxidin Tab 10 10 1166 11,660
Lansoprazol Tab 5 5 1855 9,275
SUB TOTAL 76,445
TOTAL 851,784
9 Tn. Manwi 6/1/2016 Lansoprazol Tab 5 5 1855 9,275

Braxidin Tab 10 10 1166 11,660
Pregabalin Tab 10 10 8858 88,580
Ambroxol Tab 10 10 437 4,370
TOTAL 113,885
10 Tn. Edo 6/1/2016 Flamicort Inj 1 1 109180 109,180

TOTAL 109,180
11 An. Wahyu 6/1/2016 Lidocain Inj 1 1 2186 2,186

Sp 3 cc 1 1 1895 1,895
Amoxicilin Tab 10 10 500 5,000
Mefinal tab 10 10 1749 17,490
TOTAL 26,571
12 By. Veby 6/1/2016 Oralit Tab 5 5 1000 5,000

Domperidon Syr 1 1 7500 7,500
TOTAL 12,500
13 An. Evelin 6/2/2016 Oroprofen Syr 1 1 16000 16,000

TOTAL 16,000
14 Ny. Lusiana 6/2/2016 Ibuprofen Tab 10 10 400 4,000

Mp 8 mg Tab 10 10 1000 10,000
Captopril Tab 12,5 10 10 150 1,500
Sanmagh Tab 10 10 1100 11,000
TOTAL 26,500
15 Ny. Kamer 6/2/2016 Benodon Inj 2 2 1500 3,000

Sp 5 cc 1 1 2500 2,500
Analsik Tab 10 10 1600 16,000
Neuraxon Tab 10 10 2600 26,000
Flamar Gel 1 1 22000 22,000
TOTAL 88,500
16 By. Ikhsan 5/29/2016 Inf D5 1/4 Ns 1 1 19941 19,941

Cefotaxim Inj 1 1 15304 15,304
Dexa Inj 1 1 3177 3,177
Sp 1 cc 1 1 2849 2,849
Sp 10 cc 1 1 3286 3,286
Venflon 26 2 2 51013 102,026
Inf Set Mikro 1 1 10203 10,203
SUB TOTAL 156,786
5/30/2016 D5 1/4 Ns 1 1 19941 19,941

Sp 5 cc 2 2 2478 4,956
SUB TOTAL 40,201
5/31/2016 Cefotaxim Inj 2 2 15304 30,608

Ventolin Nebu 2 2 12476 24,952
Dexa Inj 2 2 3177 6,354
SUB TOAL 61,914
5/31/2016 Aquadest Inj 3 3 3312 9,936

Sp 10 cc 2 2 3286 6,572
Sp 1 cc 1 1 2849 2,849
Salbutamol Tab 2 2 133 266
Ambroxol tab 2 2 437 874
Apialys Syr 1 1 50350 50,350
SUB TOTAL 111,103
6/1/2016 Cefotaxim Inj 1 1 15304 15,304

Aquabidest Inj 2 2 3312 6,624
Sp 3 cc 2 2 1895 3,790
Inf D5 1/4 Ns 2 2 19941 39,882
SUB TOTAL 65,600
6/2/2016 Salbutamol Tab 2 2 133 266
Ambroxol Tab 2 2 437 874
Kalmetason Tab 2 2 133 266
Kertas Puyer 16 16 200 3,200
SUB TOTAL 4,606
TOTAL 440,210
17 An. Carolin 6/2/2016 Rifampisin Tab 3 3 2000 6,000

Pyrazinamid Tab 5 5 300 1,500
Inh Tab 3 3 200 600
Anvomer Tab 4 4 3500 14,000
Kertas Puyer 15 15 500 7,500
TOTAL 29,600
18 An. M Raihan 6/2/2016 Ventolin Nebu 1 1 13000 13,000

Bisolvon 6 6 1666 9,996
Sp 3 cc 1 1 2000 2,000
Ambroxol Tab 3 3 400 1,200
Kalmetason Tab 3 3 500 1,500
Salbutamol Tab 3 3 133 399
TOTAL 28,095
19 Tn. Surya 6/2/2016 Amoxicilin Tab 10 10 500 5,000

Mefinal Tab 10 10 2500 25,000
Pehacain Inj 1 1 3000 3,000
Kasa Steril 2 2 1500 3,000
TOTAL 36,000
20 Tn. Marwi 6/2/2016 Ulsidex Tab 10 10 1500 15,000

Ciprofloxacin Tab 10 10 800 8,000
Meloxicam Tab 15 mg 5 5 1400 7,000
TOTAL 36,000
21 Tn. Priyanto 6/2/2016 Mp 8 mg Tab 10 10 1000 10,000

Asam Mefenamat Tab 10 10 400 4,000
TOTAL 14,000
22 Tn. Saihan 6/2/2016 Lidocain Inj 2 2 2186 4,372

Sp 5 cc 2 2 2478 4,956
Nedle 23 1 1 875 875
Mefinal Tab 15 15 1749 26,235
TOTAL 46,248
23 Tn. Andri Y 6/2/2016 Calortusin tab 10 10 800 8,000

Yudavit Tab 10 10 800 8,000
Dexametason Tab 10 10 133 1,330
TOTAL 17,330
24 Tn. Irwan 6/2/2016 Amoxicilin Tab 10 10 500 5,000

Kasa Kecil 3 3 1500 4,500
TOTAL 19,500
25 Ny. Hanifah 6/2/2016 O2 100 100 250 25,000

Nasal Canul 1 1 14575 14,575
Venflon 20 1 1 23186 23,186
Isdn Tab 2 2 186 372
Cpg Tab 4 4 19432 77,728
Aspilet Tab 4 4 933 3,732
Simvastatin Tab 2 2 749 1,498
Valisanbe Tab 1 1 364 364
TOTAL 146,455
26 Tn. Yohanes 6/3/2016 Inf D5 % 2 2 7619 15,238

Inf Set makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Pumpitor Inj 1 1 92757 92,757
Sp 10 cc 1 1 3286 3,286
Ulsidex Tab 9 9 1484 13,356
SUB TOTAL 158,787
6/3/2016 Pumpitor Inj 1 1 0 92757 -

Valisanbe Tab 2 2 0 364 -
Inf D5 % 2 2 0 7619 -
SUB TOTAL -
TOTAL 158,787
27 Tn. Seven 6/2/2016 Elastis Verband 1 1 32926 32,926

Tramadol Inj 2 2 12521 25,042
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23163 23,163
Ranitidin Inj 2 1 1 3746 3,746
Camelox Tab 10 10 3352 33,520
Inf Ns 2 2 7721 15,442
Sp 5 cc 2 2 2478 4,956
SUB TOTAL 149,395
6/3/2016 Ranitidin Tab 1 1 0 3746 -

Tramadol Inj 6 4 2 12521 25,042
Inf Ns 2 2 0 7721 -
Venflon 22 1 1 23186 23,186
SUB TOTAL 48,228
TOTAL 197,623
28 Ny. Valentina 6/3/2016 Oralit 4 4 928 3,712

Loperamid tab 15 15 1200 18,000
Molagit Tab 15 15 636 9,540
Scopamin tab 10 10 2551 25,510
Metocloperamid Tab 10 10 146 1,460
TOTAL 58,222
29 Tn. Stevanus 6/3/2016 Pct Tab 10 10 138 1,380

Yudavit Tab 10 10 2300 23,000
TOTAL 24,380
30 An. Atiqa 6/3/2016 Pct Syr 1 1 3877 3,877

Promuxol Drop 1 1 44520 44,520
Amoxiclin Syr 1 1 8745 8,745
TOTAL 57,142
31 Tn. Maryadi 6/4/2016 Pct Tab 10 10 138 1,380

Tivomit Tab 10 10 1000 10,000
TOTAL 14,590
32 Nn. Yulia 6/4/2016 Mefinal tab 10 10 1749 17,490

TOTAL 17,490
33 Tn. Zainudin 6/4/2016 Flamar 50 mg Tab 5 5 2458 12,290

Myores Tab 10 10 6029 60,290
Valisanbe Tab 5 5 364 1,820
TOTAL 77,610
34 An. Kolan 6/1/2016 Inf Set Makro 1 1 10600 10,600
Inf D5 1/4 Ns 3 3 19941 59,823
Venflon 26 1 1 51013 51,013
Sp 10 cc 1 1 3286 3,286
Sp 3 cc 2 2 2849 5,698
Sp 1 cc 1 1 2849 2,849
Pct Syr 1 1 3231 3,231
SUB TOTAL 143,124
6/4/2016 Ceftriaxon Inj 1 1 24778 24,778

Inf D5 1/4 Ns 2 2 0 19941 -
Sp 10 cc 1 1 3286 3,286
SUB TOTAL 28,064
6/4/2016 Biothicol Syr 1 1 25988 25,988

SUB TOTAL 25,988
TOTAL 197,176
35 Ny. Ernawati 6/4/2016 Mp 4 mg Tab 10 10 600 6,000

Ambroxol Tab 10 10 500 5,000
Fartolin Tab 20 20 1000 20,000
Sp 5 cc 1 1 2500 2,500
TOTAL 46,000
36 Tn. Hendra S 6/4/2016 Dohixat Tab 10 10 1000 10,000

Metronidazol Tab 10 10 300 3,000
Kalmetason tab 10 10 200 2,000
TOTAL 15,000
37 By. Govir 6/3/2016 Inf D5 1/4 Ns 2 2 19941 39,882

Inf Set makro 1 1 10203 10,203
Venflon 26 1 1 51013 51,013
Ondan 4 mg Inj 1 1 7288 7,288
Sp 1 cc 1 1 2849 2,849
Zink Kid Syr 1 1 38491 38,491
L - Bio 6 6 9275 55,650
SUB TOTAL 205,376
6/3/2016 Inf D5 % 2 2 7619 15,238

Terfacef Inj 1 1 278383 278,383
Sp 1 cc 1 1 2849 2,849
Sp 10 cc 2 2 3286 6,572
Metronidazol Inf 1 1 72875 72,875
SUB TOTAL 375,917
5/3/2016 Inf D5 1/4 Ns 3 3 19941 59,823

L - Bio 2 2 9275 18,550
SUB TOTAL 78,373
6/3/2016 Ceftriaxon Inj 1 1 24778 24,778

Sp 1 cc 1 1 2849 2,849
Sp 10 cc 1 1 3286 3,286
SUB TOTAL 38,128
5/4/2016 Ondan 8 Mg Inj 1 1 11660 11,660

SUB TOTAL 11,660
TOTAL 709,454
38 An. Veby 6/3/2016 Inf D5 1/4 1 1 19941 19,941

Venflon 24 1 1 26235 26,235
Inf Set Makro 1 1 10203 10,203
Ondan 4 mg Inj 1 1 7288 7,288
Sp 1 cc 1 1 2849 2,849
Pct Syr 1 1 3231 3,231
SUB TOTAL 69,747
6/3/2016 Terfacef Inj 1 1 278383 278,383

Sp 1 cc 1 1 2849 2,849
Sp 10 cc 1 1 3286 3,286
Inf D5 1/4 Ns 2 2 20000 40,000
SUB TOTAL 324,518
6/4/2016 Ceftraixon Inj 1 1 24778 24,778

SUB TOTAL 24,778
6/4/2016 Ceftriaxon Inj 1 1 25000 25,000

SUB TOTAL 25,000
6/4/2016 Cefixime Syr 1 1 43000 43,000

SUB TOTAL 43,000
TOTAL 487,043
39 Tn. Dimas 6/4/2016 Baquinor Forte Tab 10 10 17934 179,340

Pct Tab 10 10 138 1,380
TOTAL 180,720
40 Tn. Sigit 6/4/2016 Tramenza Tab 10 10 1530 15,300

Trichodazol Tab 10 10 1855 18,550
Mefinal Tab 10 10 1749 17,490
Mp 8 mg Tab 10 10 928 9,280
TOTAL 60,620
41 Nn. Deby 6/4/2016 Inf Ns 4 4 11600 46,400

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23500 23,500
Ngt 18 1 1 25100 25,100
Sp 10 cc 1 1 3500 3,500
Sp 50 cc 1 1 40100 40,100
Sp 5 cc 2 2 2500 5,000
Sp 1 cc 1 1 3000 3,000
Pumpicel Inj 1 1 195500 195,500
Ceftriaxon Inj 2 1 1 25000 25,000
Sanmagh Syr 1 1 33000 33,000
Episan Syr 1 1 54000 54,000
SUB TOTAL 472,200
6/4/2016 Nasal Canul Dewasa 1 1 14575 14,575

O2 50 50 250 12,500
SUB TOTAL 27,075
6/5/2016 Inf Ns 2 2 7721 15,442

Pumpicel Inj 1 1 0 195232 -
Terfacef Inj 1 1 0 278383 -
SUB TOTAL 15,442
TOTAL 514,717
42 Ny. Sumini 6/5/2016 Mefinal Tab 10 10 1749 17,490

Clanexi Tab 10 10 15887 158,870
Amlodipin Tab 10 10 2465 24,650
Bisoprolol Tab 10 10 2200 22,000
TOTAL 223,010
43 Tn. Suwanto 6/5/2016 Thramed Tab 10 10 5000 50,000

Mp 4 mg Tab 10 10 530 5,300
TOTAL 55,300
44 An. Dzakaria 6/4/2016 Inf D5 % 1 1 7619 7,619

Inf Set mikro 1 1 10203 10,203
Venflon 24 1 1 26235 26,235
Venflon 26 1 1 51013 51,013
Kasa Gulung 2 2 4638 9,276
Inf RL 2 2 11600 23,200
Ondan 4 mg Inj 1 1 7288 7,288
Meropenem Inj 1 1 320650 320,650
Sp 10 cc 1 1 3286 3,286
Sp 1 cc 2 2 2849 5,698
SUB TOTAL 467,780
6/5/2016 Inf RL 2 2 16600 33,200

Ondan 4 mg Inj 1 1 7288 7,288
SUB TOTAL 40,488
6/5/2016 Cefixime Syr 1 1 42201 42,201

SUB TOTAL 42,201
TOTAL 550,469
45 Tn. Ahmad R 6/4/2016 Inf Ns 4 4 11,600 - 46,400

Inf Set makro 1 1 10,600 - 10,600
Venflon 20 1 1 23,500 - 23,500
Inj Tramadol 2 2 - 12,600 25,200
Inj ranitidin 2 2 4,000 - 8,000
Ceftriaxon Inj 2 2 25,000 - 50,000
Sp 5 cc 3 3 2,500 - 7,500
Sp 1 cc 1 1 3,000 - 3,000
Aquadest Inj 1 1 7,300 - 7,300
SUB TOTAL 181,500
6/5/2016 Inf Ns 2 2 0 7721 -
Inj Tramadol 2 2 0 12521 -
Aquadest 1 1 3312 3,312
SUB TOTAL 3,312
6/5/2016 Cefixime tab 100 mg 10 10 2968 29,680
Cinolon - N 1 1 23612 23,612
Mersibion tab 10 10 2250 22,500
SUB TOTAL 75,792
TOTAL 260,604
46 Ny. Is Prawanti 6/5/2016 Ciprofloxacin Tab 10 10 600 6,000

Metronidazol tab 15 15 292 4,380
Cameloc Tab 10 10 3352 33,520
Mp 8 mg Tab 10 10 928 9,280
TOTAL 56,390
47 Ny. Nirnawati 6/1/2016 Inf Set Makro 1 1 10600 10,600

Inf NS 2 2 7721 15,442
Venflon 20 1 1 23186 23,186
Sp 5 cc 2 2 2478 4,956
Ondan 4 mg Inj 1 1 7288 7,288
Mertigo Tab 10 10 4306 43,060
Curcuma Tab 10 10 1924 19,240
SUB TOTAL 127,518
6/2/2016 Ondan 4 mg Inj 1 1 7500 7,500

Mertigo Tab 3 3 4500 13,500
Curcuma Tab 3 3 2000 6,000
Sp 5 cc 2 2 2500 5,000
Inf NS 1 1 11600 11,600
SUB TOTAL 51,600
6/3/2016 Ranitidin Inj 2 2 3746 7,492

Inf NS 2 2 7721 15,442
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 26,724
6/3/2016 Pumpitor Inj 1 1 0 92757 -

Tranexid Inj 3 3 13913 41,739
Sp 5 cc 2 2 2478 4,956
Cymalium Tab 5 5 2041 10,205
SUB TOTAL 64,115
6/3/2016 Valisanbe Tab 1 1 500 500

SUB TOTAL 500
6/4/2016 Tranexid Inj 2 2 13913 27,826

O2 700 700 250 175,000
Curcuma Tab 3 3 1924 5,772
Valisanbe tab 2 2 364 728
Sp 5 cc 1 1 2478 2,478
Pumpitor Inj 1 1 95757 95,757
Inf Ns 2 2 0 7721 -
SUB TOTAL 307,561
6/5/2016 Inf NS 2 2 7721 15,442

Tranexid Inj 3 3 13913 41,739
Cymalium 1 1 2041 2,041
Curcuma Tab 3 3 1924 5,772
Pumpicel Inj 1 1 0 195232 -
SUB TOTAL 64,994
6/5/2016 Mertigo Tab 10 10 4500 45,000

Curcuma Tab 10 10 2000 20,000
O2 700 700 250 175,000
SUB TOTAL 250,000
TOTAL 893,012
48 An. Bayu 6/5/2016 Domperidon Tab 10 10 600 6,000

Biovitan Syr 1 1 15000 15,000
TOTAL 21,000
49 Nn. Putri 6/5/2016 Lansoprazol Tab 10 10 1855 18,550

Mersibion Tab 10 10 2268.8 22,688
O2 50 50 250 12,500
TOTAL 53,738
50 Ny. Marina 6/5/2016 Sanmagh Syr 1 1 32940 32,940

Braxidin Tab 10 10 1166 11,660
Pct Tab 10 10 138 1,380
TOTAL 45,980
51 An. Rafi 6/6/2016 Ranitidin Tab 10 10 321 3,210

Biovitan Syr 1 1 15000 15,000
Oroprofen Syr 1 1 15400 15,400
TOTAL 39,570
52 Tn. M Afif 6/6/2016 Cefotaxime Inj 1 1 15304 15,304

Sp 5 cc 1 1 2478 2,478
Sp 1 cc 1 1 2849 2,849
Baquinor 10 10 17934 179,340
Mefinal Tab 10 10 1749 17,490
Mesol 8 mg Tab 10 10 5472 54,720
TOTAL 279,396
53 Tn. Kariyono 6/6/2016 Cetirizin Tab 10 10 530 5,300

Mucohexin Tab 10 10 600 6,000
Grahabion Tab 10 10 730.1 7,301
TOTAL 18,601
54 Tn. Wahyudin 6/6/2016 Recodryl Inj 1 1 9275 9,275

Dexa Inj 1 1 3177 3,177
Sp 5 cc 1 1 2478 2,478
Sp 1 cc 1 1 2849 2,849
Topcort Zalf 1 1 29447 29,447
Ikamicetin Zalf 1 1 7600 7,600
Cetirizin 10 10 530 5,300
Clanexi Tab 10 10 15887 158,870
TOTAL 218,996
55 Tn. Priyanto 6/6/2016 Mesol Tab 10 10 5472 54,720

TOTAL 54,720
56 Nn. Yemi 6/6/2016 Clindamycin Tab 10 10 996 9,960

Mefinal Tab 10 10 1749 17,490
Flamar 50 mg Tab 10 10 2458 24,580
Kasa Steril 3 3 1200 3,600
TOTAL 58,413
57 Ny. Veronika 6/6/2016 Nadik 50 mg Tab 10 10 685 6,850
Cetirizin Tab 10 10 530 5,300
TOTAL 12,150
58 An. Theodore 6/6/2016 Pct Syr 1 1 3231 3,231

TOTAL 3,231
59 Nn. Julian 6/2/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Tramadol Inj 3 3 12521 37,563
Buscopan Inj 3 3 27825 83,475
Sp 5 cc 3 3 2478 7,434
Levofloxacin Inf 2 2 145750 291,500
SUB TOTAL 484,413
6/3/2016 Ranitidin Inj 1 1 3746 3,746

Buscopan Inj 2 2 27825 55,650
Tramadol Inj 6 6 12521 75,126
Ciprofloxacin Inj 1 1 67708 67,708
Inf NS 2 2 7721 15,442
SUB TOTAL 217,672
6/4/2016 Buscopan Inj 3 3 27825 83,475

SUB TOTAL 236,717
6/5/2016 Inf NS 2 2 7721 15,442

Buscopan Inj 3 3 27825 83,475
Braxidin Tab 1 1 1166 1,166
SUB TOTAL 253,325
6/6/2016 Inf Ns 2 2 7721 15,442

Buscopan Inj 3 2 1 27825 27,825
Levofloxacin Inf 1 1 0 145750 -
Tramadol Inj 2 1 1 12521 12,521
Braxidin Tab 10 10 1166 11,660
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 71,238
6/6/2016 Scopamin Tab 10 10 2551 25,510

Thramed Tab 10 10 2319 23,190
SUB TOTAL 51,910
TOTAL 1,315,275
60 Tn. Ahmad 6/4/2016 Inf Ns 2 2 11600 23,200

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23500 23,500
Tramadol Inj 2 2 12600 25,200
Sp 5 cc 3 3 2500 7,500
Sp 1 cc 1 1 3000 3,000
SUB TOTAL 158,500
6/5/2016 Inf Ns 2 2 7721 15,442

Thramadol Inj 2 2 12521 25,042
SUB TOTAL 51,288
6/5/2016 Opilax Syr 1 1 63998 63,998

SUB TOTAL 63,998
6/6/2016 Tramadol Inj 2 2 12521 25,042

Inf Ns 1 1 7721 7,721
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 93,601
6/6/2016 Ranitidin Tab 10 10 321 3,210

SUB TOTAL 3,210
TOTAL 370,597
61 Tn. Abdul 6/6/2016 Inf NS 1 1 11600 11,600

Venflon 20 1 1 23200 23,200
Inf Set Makro 1 1 10600 10,600
Buscopan Inj 1 1 27900 27,900
Sp 3 cc 3 3 2000 6,000
TOTAL 105,200
62 Nn. Deby 6/6/2016 Episan Syr 1 1 54000 54,000

Sanmagh Syr 1 1 33000 33,000
Spasmal Tab 10 10 600 6,000
TOTAL 112,000
63 Ny. Timbuk 6/6/2016 Inf NS 3 3 7721 23,163

Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Novaldo Inj 1 1 16692 16,692
Sp 5 cc 3 3 2478 7,434
Urotractin Tab 10 10 8599 85,990
Myores Tab 2 2 6029 12,058
Tramadol Inj 1 1 12521 12,521
TOTAL 199,136
64 Ny. Samsuharna 6/5/2016 Inf NS 1 1 11600 11,600

Inf Set Makro 1 1 10600 10,600
Venflon 20 2 2 23500 47,000
Nifedipin Tab 1 1 700 700
Pumpitor Inj 1 1 0 93000 -
Berotec Inj 0.8 0.8 12500 10,000
Sp 5 cc 1 1 2500 2,500
Amlodipin Tab 10 10 2500 25,000
Spironolacton Tab 25 mg 10 10 600 6,000
Isdn tab 10 10 200 2,000
SUB TOTAL 115,400
6/6/2016 Furosemid Inj 2 2 4638 9,276

Pumpicel Inj 1 1 195232 195,232
Valdic 80 Tab 2 2 8016 16,032
SUB TOTAL 223,852
6/6/2016 Pumpitor Inj 1 1 92757 92,757

Inf RL 1 1 11600 11,600
SUB TOTAL 104,357
6/7/2016 Ranitidin Tab 10 10 321 3,210

Spironolacton Tab 2 2 539 1,078
Valesco Tab 9 9 11660 104,940
Furosemid tab 10 10 268 2,680
SUB TOTAL 111,908
TOTAL 555,517
65 An. Sesina 6/7/2016 Zink Kid Syr 1 1 20000 20,000

TOTAL 20,000
66 Tn. Ardianto 6/7/2016 Sanprima Forte Tab 10 10 2551 25,510

TOTAL 25,510
67 Tn. Suwaji 6/7/2016 Ventolin Eks Syr 1 1 69019 69,019

Pct Tab 10 10 138 1,380
TOTAL 73,609
68 Tn. Mimin 6/7/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf RL 2 2 11600 23,200
Buscopan Inj 3 3 27825 83,475
Sp 3 cc 3 3 1895 5,685
Sanmagh Tab 10 10 1020 10,200
Episan Syr 1 1 53795 53,795
TOTAL 305,085
69 Tn. Anus 6/7/2016 Coditam Tab 10 10 4810 48,100
Grahabion Tab 10 10 600 6,000
TOTAL 54,100
70 Nn. Dwi 6/7/2016 Ranitidin Tab 10 10 321 3,210

Pct Tab 10 10 138 1,380
Yudavit Tab 10 10 1500 15,000
TOTAL 19,590
71 Tn. Rudy 6/7/2016 Sanmagh Tab 10 10 1020 10,200

TOTAL 10,200
72 Tn. Amlan 6/7/2016 Antasida Tab 10 10 56 560

Spasmal Tab 10 10 600 6,000
Curcuma Tab 10 10 1924 19,240
TOTAL 44,350
73 An. Iyas 6/7/2016 L - Bio 4 4 9275 37,100

TOTAL 37,100
74 An. Reno 6/7/2016 Bedak Salycil 1 1 20000 20,000

TOTAL 20,000
75 An. Afkar 6/8/2016 Amoxicilin Syr 1 1 8745 8,745

Remco Syr 1 1 6275 6,275
Ambroxol Syr 1 1 6956 6,956
TOTAL 21,976
76 Tn. Suwaji 6/8/2016 Coditam Tab 10 10 4810 48,100

Cavicur Tab 10 10 1000 10,000
TOTAL 64,060
77 Tn. Philipus 6/8/2016 Esperison 10 10 2041 20,410

Flamar 50 mg tab 10 10 2458 24,580
Tensinop Tab 5 mg 20 20 2968 59,360
TOTAL 107,560
78 Ny. Danit 6/8/2016 Ats Inj 1 1 167600 167,600

TOTAL 167,600
79 Tn. Yosi 6/8/2016 Cortidex Tab 10 10 364 3,640

Asam Mefenamat tab 10 10 318 3,180
Handscon 2 2 3000 6,000
TOTAL 12,820
80 An. Hadian 6/8/2016 Asam Mefenamat Tab 10 10 318 3,180

Amoxicilin tab 10 10 464 4,640
TOTAL 7,820
81 Ny. Ira 6/8/2016 Betametason Zalf 1 1 3308 3,308

TOTAL 3,308
82 Ny. Keisya 6/8/2016 Ranitidin Tab 5 5 321 1,605

TOTAL 4,585
83 An. Hamzah 6/9/2016 Oroprofen Syr 1 1 15400 15,400

Biovitan Syr 1 1 15000 15,000
TOTAL 32,005
84 Ny. Saharum 6/7/2016 Aquadest Inj 2 2 3312 6,624
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Inf Ns 4 4 7721 30,884
Dilavask Tab 1 1 2319 2,319
Ambroxol Tab 10 10 437 4,370
Metformin Tab 500 mg 10 10 265 2,650
Glimepirid Tab 2 mg 5 5 1378 6,890
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
SUB TOTAL 151,793
6/8/2016 Ranitidin Inj 2 2 3746 7,492

Ondan 8 mg Inj 1 1 11660 11,660
Sp 5 cc 1 1 2478 2,478
Noperten Tab 10 mg 5 5 6340 31,700
SUB TOTAL 53,330
6/8/2016 Sp 3 cc 1 1 3746 3,746

SUB TOTAL 5,641
6/9/2016 Lansoprazol Tab 10 10 1855 18,550

Metformin 500 mg Tab 10 10 265 2,650
Tensinop Tab 5 mg 8 8 2968 23,744
SUB TOTAL 44,944
TOTAL 255,708
85 Tn. Tuyansyah 6/7/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Rl 2 2 11600 23,200
Ondan 8 mg Inj 1 1 11660 11,660
Pct Tab 10 10 138 1,380
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 81,891
6/7/2016 Indexon Inj 4 4 8000 32,000

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 33,895
6/8/2016 Ranitidin Inj 2 2 3746 7,492

Ondan 8 mg Inj 1 1 11660 11,660
Dexametason Inj 2 2 3177 6,354
SUB TOTAL 25,506
6/8/2016 Ranitidin Inj 1 1 3746 3,746

Cortidex Inj 2 2 7500 15,000
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 20,641
6/9/2016 Cefadroxil 10 10 981 9,810

SUB TOTAL 17,810
TOTAL 179,743
86 Tn. Evan F 6/6/2016 Inf Ns 2 2 11600 23,200

Inf Set makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Neurosanbe Inj 1 1 6500 6,500
Sp 3 cc 3 3 2000 6,000
Sp 5 cc 1 1 2500 2,500
nadic 50 mg Tab 5 5 700 3,500
Lansprazol Tab 5 5 1900 9,500
SUB TOTAL 136,800
6/7/2016 Inf Ns 3 3 7721 23,163

Pumpicel Inj 1 1 195232 195,232
aquadest Inj 1 1 3312 3,312
Sp 10 cc 1 1 3286 3,286
Ondan 8 mg Inj 1 1 11660 11,660
Sanmagh Tab 4 4 1020 4,080
Pct Tab 3 3 138 414
SUB TOTAL 241,147
6/8/2016 Ondan 8 mg Inj 1 1 11660 11,660

Inf Ns 3 3 7721 23,163
Sanmagh Tab 6 6 1020 6,120
Celebrex tab 1 1 17693 17,693
SUB TOTAL 75,456
6/9/2016 Domperidon Tab 10 10 596 5,960

Sanmagh Tab 6 6 1020 6,120
Celebrex Tab 5 5 17693 88,465
Spasminal Tab 10 10 787 7,870
SUB TOTAL 111,625
TOTAL 565,028
87 Tn. Abai 6/9/2016 Lansoprazol Tab 10 10 1855 18,550
Cameloc Tab 10 10 3352 33,520
Eperison Tab 10 10 2041 20,410
Amitripilin Tab 5 5 163 815
TOTAL 73,295
88 Ny. Alfunsia 6/9/2016 Cefadroxil tab 10 10 981 9,810

Spasmal Tab 10 10 600 6,000
TOTAL 34,360
89 Tn. Jai 6/9/2016 Cefadroxil Tab 10 10 981 9,810

TOTAL 12,990
90 Nn. Ina 6/9/2016 Cefadroxil Tab 10 10 981 9,810

O2 30 30 250 7,500
TOTAL 20,490
91 Ny. Emiliana 6/9/2016 Metformin 500 mg Tab 15 15 265 3,975

Glimerep Tab 10 10 1378 13,780
Nadic Tab 15 15 685 10,275
TOTAL 28,030
92 Ny. Mincu 6/6/2016 Venflon 20 1 1 23186 23,186

Inf Set 1 1 10600 10,600
Inf Ns 3 3 7721 23,163
Novaldo Inj 1 1 16695 16,695
Ondan 8 mg Inj 1 1 11660 11,660
Sp 5 cc 2 2 2478 4,956
Sp 3 cc 2 2 1895 3,790
Sp 1 cc 1 1 2849 2,849
Pct Tab 5 5 138 690
SUB TOTAL 157,949
6/6/2016 Braxidin Tab 5 5 1166 5,830

SUB TOTAL 6,922
6/6/2016 Ceftriaxon Inj 1 1 25000 25,000

Ondan 8 mg inj 1 1 11700 11,700
SUB TOTAL 36,700
6/7/2016 Ceftriaxon Inj 2 2 0 24778 -

Ondan 8 mg Inj 1 1 0 11660 -
pct tab 1 1 138 138
SUB TOTAL 1,668
6/7/2016 Pumpicel Inj 1 1 197969 197,929

Sp 5 cc 1 1 2478 2,478
SUB TOTAL 203,719
6/8/2016 Coditam tab 10 10 4810 48,100

Venflon 22 1 1 23186 23,186
SUB TOTAL 71,286
6/8/2016 Ceftriaxon Inj 2 2 24778 49,556

Ondan 8mg Inj 1 1 11660 11,660
pct Tab 3 2 1 138 138
Pumpicel Inj 1 1 92757 92,757
SUB TOTAL 165,101
6/9/2016 Coditam Tab 3 3 4810 14,430

Braxidin Tab 10 10 1166 11,660
SUB TOTAL 36,457
6/9/2016 Ranitidin Inj 3 3 3764 11,292

Ondan 8 mg Inj 1 1 11660 11,660
SUB TOTAL 26,450
TOTAL 706,252
93 Nn. Lia 6/10/2016 Baquinor Forte 10 10 17934 179,340

Mefinal tab 5 5 1749 8,745
Mp 16 mg Tab 5 5 1391 6,955
Sp 1 cc 1 1 2849 2,849
TOTAL 200,075
94 Tn. Casanus 6/10/2016 Asam Mefenamat Tab 10 10 318 3,180

Mp 16 mg Tab 5 5 1391 6,955
Betametason Zalf 1 1 3896 3,896
Alprazolam Tab 2 2 1060 2,120
TOTAL 16,151
95 Tn. Sugiono 6/10/2016 Cortidex tab 2 2 8000 16,000

Sp 3 cc 1 1 1609 1,609
Licokalk Tab 10 10 325 3,250
Folaxin Tab 10 10 670 6,700
TOTAL 27,559
96 Tn. Hamdan 6/10/2016 Clindamycin 300 Tab 10 10 996 9,960

Kasa 3 3 1200 3,600
TOTAL 19,523
97 Tn. Mimin 6/10/2016 Eperison Tab 10 10 2041 20,410

Flamar Tab 50 mg 5 5 2412 12,060
TOTAL 47,705
98 An. Afiqa Putri 6/10/2016 Sanmol Drop 1 1 20551 20,551

TOTAL 33,027
99 Tn. Pilipus J 6/10/2016 O2 50 50 250 12,500

TOTAL 12,500
100 Tn. Rian 6/10/2016 Asam Mefenamat Tab 10 10 318 3,180

Cefadroxil tab 10 10 981 9,810
Mp 16 mg Tab 5 5 1391 6,955
TOTAL 19,945
101 Ny. Desi 6/11/2016 Cefadroxil tab 10 10 1000 10,000
Mp Tab 6 6 600 3,600
TOTAL 17,600
102 Ny. Siti Yani 6/11/2016 Lansoprazol tab 10 10 2000 20,000

Sanmagh tab 10 10 1100 11,000
Spasmal tab 10 10 600 6,000
TOTAL 37,000
103 Ny. Evi 2/11/2016 Cefadroxil Tab 10 10 1000 10,000

Calortusin Tab 10 10 1000 10,000
TOTAL 46,000
104 Tn. Derani 6/11/2016 Flamar 50 mg tab 10 10 2500 25,000

Grahabion tab 10 10 1000 10,000
TOTAL 55,000
105 Ny. Imah 6/7/2016 Transfusi Set 1 1 30608 30,608

Venflon 20 1 1 23186 23,186
Inf Ns 1 1 7721 7,721
Pumpicel Inj 1 1 195232 195,232
Piralen Inj 1 1 30608 30,608
Sp 10 cc 1 1 3286 3,286
Sp 3 cc 1 1 1895 1,895
Valesco tab 1 1 11660 11,660
SUB TOTAL 304,196
6/8/2016 Inf NS 2 2 7721 15,442
Dexa Inj 4 4 3177 12,708
Sp 3 cc 1 1 1895 1,895
Pumpicel Inj 1 1 195232 195,232
Valsartan Tab 80 mg 5 5 11660 58,300
SUB TOTAL 283,577
6/9/2016 Pumpicel Inj 1 1 195232 195,232

Inf NS 2 2 7721 15,442
Kalmetason Inj 4 4 8348 33,392
Valesco Tab 80 mg 1 1 11660 11,660
SUB TOTAL 255,726
6/10/2016 Rabnitidin Inj 2 2 3746 7,492

Sp 3 cc 1 1 1895 1,895
Valesco 80 mg tab 5 5 11660 58,300
SUB TOTAL 67,687
6/10/2016 Transfusi Set 1 1 30700 30,700

Venflon 20 1 1 23200 23,200
SUB TOTAL 53,900
6/11/2016 Ranitidin Inj 2 2 4000 8,000

Sp 3 cc 1 1 2000 2,000
Inf Ns 2 2 11600 23,200
SUB TOTAL 33,200
6/11/2016 Lansoprazol Tab 10 10 1855 18,550

Tivomid Tab 20 20 3900 78,000
Grahabion tab 20 20 800 16,000
SUB TOTAL 112,550
TOTAL 1,110,836
106 Tn. Hery 6/11/2016 Cefixime Tab 100 mg 10 10 2968 29,680
Sistenol Tab 10 10 2041 20,410
Ranitidin tab 10 10 321 3,210
Curcuma Tab 10 10 1924 19,240
Dextafen Tab 10 10 1603 16,030
TOTAL 94,530
107 Tn. Sumadi 6/11/2016 Pct Tab 10 10 138 1,380

Ambroxol tab 10 10 437 4,370
Curcuma Tab 10 10 1924 19,240
Inj Recodryl 2 2 9275 18,550
Benodon Inj 2 2 12521 25,042
Sp 3 cc 1 1 1895 1,895
TOTAL 76,437
108 Ny. Puput 6/11/2016 Sanmagh tab 10 10 1020 10,200

TOTAL 10,200
109 Ny. Krisiana 6/11/2016 Mersibion tab 10 10 5016 50,160

TOTAL 50,160
110 Tn. Iswanson 6/11/2016 Metronidazol Inf 1 1 72875 72,875

Clindamycin 300 mg Tab 10 10 996 9,960
Sp 3 cc 1 1 2478 2,478
Sistenol Tab 10 10 2041 20,410
TOTAL 105,723
111 An. Alika 6/12/2016 Ventolin Nebu 1 1 12476 12,476

Bisolvon 1 1 4638 4,638
Cefixime Syr 1 1 42201 42,201
Remco Syr 1 1 6267 6,267
Ventolin Expectoran Syr 1 1 69019 69,019
TOTAL 134,601
112 Ny. Wilda 6/12/2016 Braxidin tab 15 15 1166 17,490

Sanmagh Syr 1 1 32940 32,940
TOTAL 61,030
113 Tn. Samiran 6/10/2016 Inf NS 2 2 11600 23,200

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Buscopan Inj 2 2 28000 56,000
Sp 3 cc 2 2 2000 4,000
Tensinop Tab 5 mg 10 10 3000 30,000
SUB TOTAL 155,000
6/11/2016 Ranitidin Inj 2 2 4000 8,000

Buscopan Inj 2 2 27900 55,800
Inf Ns 2 2 11600 23,200
Sp 3 cc 2 2 2000 4,000
SUB TOTAL 91,000
6/11/2016 Venflon 20 1 1 23186 23,186

Sp 3 cc 1 1 1895 1,895
Urotractin Tab 10 10 8599 85,990
sanprima Forte 10 10 2551 25,510
Spasminal tab 10 10 787 7,870
SUB TOTAL 144,451
6/11/2016 Harnal Tab 10 10 14400 144,000
SUB TOTAL 144,000
6/12/2016 Ranitidin Tab 10 10 321 3,210

Tensinop Tab 5 mg 12 12 2968 35,616
Celebrex Tab 3 3 17693 53,079
SUB TOTAL 91,905
TOTAL 626,356
114 An. Winanda 6/12/2016 Cefixime Syr 1 1 42201 42,201

Pct Syr 1 1 3231 3,231
Imufor Plus 1 1 63998 63,998
TOTAL 109,430
115 Ny. Samsuharna 6/9/2016 O2 100 100 250 25,000

SUB TOTAL 25,000
6/9/2016 Inf NS 1 1 7721 7,721

Pumpitor Inj 1 1 92757 92,757
Inf Set makro 1 1 10600 10,600
Inf Set Mikro 1 1 10203 10,203
Venflon 20 1 1 23186 23,186
Nasal Canul Dewasa 1 1 14575 14,575
Sp 10 cc 1 1 3286 3,286
Sp 3 cc 1 1 1895 1,895
sanmagh Syr 1 1 32940 32,940
O2 100 100 250 25,000
Ambroxol Tab 10 8 2 437 874
SUB TOTAL 223,037
6/10/2016 Pumpicel Inj 1 1 195232 195,232

Ursidex Inj 1 1 8000 8,000
Sp 3 cc 1 1 1895 1,895
Ondan 8 mg Inj 2 2 11660 23,320
Sp 5 cc 1 1 2478 2,478
Sanmagh Tab 10 10 1020 10,200
SUB TOTAL 313,456
6/11/2016 Tensinop 2 2 2968 5,936

SUB TOTAL 5,936
6/11/2016 Uresix Inj 1 1 10000 10,000

Pumpicel Inj 1 1 195300 195,300
Ondan 8 mg Inj 1 1 11700 11,700
Sp 10 cc 1 1 3300 3,300
Sp 5 cc 1 1 2500 2,500
Sp 3 cc 1 1 2000 2,000
SUB TOTAL 224,800
6/12/2016 Domperidon tab 10 10 596 5,960

Sanmagh Tab 6 6 1020 6,120
SUB TOTAL 12,080
TOTAL 804,309
116 Tn. Rahmat 6/12/2016 Tramenza Tab 10 10 1600 16,000
Vectrin Tab 10 10 6900 69,000
Cortidex tab 10 10 400 4,000
Pct Tab 10 10 140 1,400
TOTAL 90,400
117 An. Agustian 6/12/2016 Topcort Zalf 1 1 30000 30,000

Cetirizin Syr 1 1 16500 16,500
TOTAL 46,500
118 Tn. Widodo 6/12/2016 Domperidon Tab 10 10 596 5,960

Acitral yr 1 1 32544 32,544
TOTAL 41,714
TOTAL 18,423,345
Sintang, Juni 2016

Bendahara Yanmasum Pembantu Bendahara
Yang Menerima Yang Menyerahkan
Rita Widiawati Warsidi

Sertu ( K ) NRP 21110271870489 Serma NRP 580944
LAPORAN UMUM BULAN JUNI 2016
Rp. Rp. Rp. Rp.
1 An. Nayla 6/13/2016 Psiidi Syr 1 1 38955 38,955
TOTAL 39,683
2 Tn. Marwi 6/13/2016 Ambroxol Tab 10 10 437 4,370

lansoprazol Tab 10 10 1855 18,550
Episan Syr 1 1 53795 53,795
TOTAL 82,015
3 Tn. M Afif 6/13/2016 Sp 1 cc 1 1 2849 2,849

TOTAL 2,849
4 Tn. Calek 6/10/2016 Ngt 1 1 25100 25,100

Inf Ns 2 2 11600 23,200
Inf Set makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Pumpicel Inj 4 4 99800 399,200
Piralen Inj 1 1 8500 8,500
Episan Syr 100 ml 1 1 53800 53,800
Noperten Tab 1 1 6400 6,400
Sp 50 cc 1 1 40100 40,100
Sp 5 cc 1 1 2500 2,500
Sp 3 cc 1 1 2000 2,000
SUB TOTAL 601,900
6/10/2016 Inf Ns 4 4 11600 46,400

O2 200 200 250 50,000
SUB TOTAL 111,000
6/11/2016 Pumpicel Inj 2 2 99800 199,600

Tensinop 5 mg Tab 2 2 2968 5,936
Inf Ns 6 6 11600 69,600
SUB TOTAL 275,136
6/11/2016 Sanmagh tab 10 10 1020 10,200

SUB TOTAL 10,200
6/11/2016 Ngt Tab 18 1 1 25043 25,043

SUB TOTAL 25,043
6/12/2016 Episan Syr 100 ml 1 1 54000 54,000

SUB TOTAL 54,000
6/12/2016 Inf Ns 5 5 7721 38,605

Pumpicel Inj 2 2 99800 199,600
Tensinop 5 mg Tab 2 2 2968 5,936
SUB TOTAL 244,141
6/13/2016 O2 5600 5600 250 1,400,000
SUB TOTAL 1,400,000
6/13/2016 Lansoprazol Tab 5 5 1855 9,275

Sanmagh Tab 10 10 1020 10,200
Tivomit Tab 10 10 500 5,000
Tensip 10 mg 5 5 5300 26,500
SUB TOTAL 50,975
TOTAL 2,772,395
5 An. Mikael 6/10/2016 Venflon 24 1 1 26500 26,500

SUB TOTAL 26,500
6/11/2016 Inf Set makro 1 1 10600 10,600

Venflon 24 1 1 26235 26,235
Inf D5 1/4 Ns 1 1 20000 20,000
Pct Syr 1 1 3231 3,231
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Valdimex Inj 1 1 10666 10,666
SUB TOTAL 86,178
6/11/2016 Valisanbe Tab 2 2 4000 8,000

Cefotaxime Inj 1 1 15400 15,400
Sp 10 cc 1 1 3500 3,500
Sp 1 cc 1 1 3000 3,000
Sp 3 cc 1 2 2000 4,000
Cortidex Inj 1 1 4000 4,000
Kertas Puyer 1 10 500 5,000
SUB TOTAL 50,200
6/13/2016 Curfos Syr 1 1 90100 90,100

SUB TOTAL 90,100
6/12/2016 Inf D5 1/4 Ns 2 2 19941 39,882

SUB TOTAL 43,059
TOTAL 296,037
6 An. Riska 6/9/2016 Inf Set makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf RL 3 3 8700 26,100
Pct Tab 10 10 138 1,380
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 70,653
6/10/2016 Ranitidin Inj 2 2 3746 7,492

Pct tab 4 4 158 632
SUB TOTAL 8,124
6/11/2016 Ranitidin Inj 2 2 4000 8,000

Sp 3 cc 1 1 2000 2,000
inf Rl 2 2 11600 23,200
SUB TOTAL 33,200
6/12/2016 Inf Rl 3 3 8700 26,100

dexa Inj 6 6 3177 19,062
SUB TOTAL 45,162
6/13/2016 Psidii Caps 10 10 5300 53,000
SUB TOTAL 53,000
TOTAL 210,139
7 Nn. Dwi 6/13/2016 Ketokonazol Zalf 1 1 9692 9,692

TOTAL 9,692
8 Ny. Bibiana 6/13/2016 glibenclamid 5 mg 10 10 808 8,080

Metformin 850 mg tab 20 20 530 10,600
TOTAL 28,130
9 Nn. Angel 6/13/2016 Pct Tab 10 10 138 1,380

Yudhavit tab 10 10 800 8,000
TOTAL 12,590
10 Ny. Sri Mulyani 6/13/2016 Sp 50 cc 1 1 40081 40,081

TOTAL 40,081
11 Tn. Firgin 6/13/2016 Yudavit tab 10 10 800 8,000

Sp 3cc 1 1 1895 1,895
Tuzalos 6 6 1020 6,120
TOTAL 16,015
12 An. Cristin 6/13/2016 Sanmol Drop 1 1 20600 20,600

TOTAL 37,100
13 Tn. Firgin 6/14/2016 Ramaflu 10 10 450 4,500

Cefixime 100 mg 10 10 2968 29,680
mp 16 mg tab 5 5 1391 6,955
TOTAL 41,135
14 By. Adly O 6/14/2016 Cetirizin tab 1 1 530 530

Topcort zalf 1 1 29442 29,442
Dextafen Tab 2 2 1603 3,206
kertas Puyer 18 18 200 3,600
TOTAL 36,778
15 Ny. Rantim 6/14/2016 Captopril 50 mg 10 10 297 2,970

Mersibion Tab 10 10 5500 55,000
TOTAL 57,970
16 Tn. Eka 6/14/2016 Clindamycin Tab 10 10 996 9,960

Thramed Tab 10 10 2511 25,110
Flamar 50 Mg Tab 10 10 2458 24,580
TOTAL 59,650
17 Tn. Gerson 6/13/2016 Inf Set makro 1 1 10600 10,600

SUB TOTAL 10,600
6/13/2016 Inf Ns 2 2 7721 15,442

Venflon 20 1 1 23186 23,186
Sp 10 cc 1 1 3286 3,286
Ambroxol Tab 10 10 437 4,370
Mp 8 mg 10 10 928 9,280
Pct Tab 10 10 138 1,380
SUB TOTAL 60,256
6/14/2016 Aquadest Inj 1 1 3312 3,312

Inf Ns 1 1 7721 7,721
SUB TOTAL 11,033
6/14/2016 Cefixime 100 mg Tab 10 10 2968 29,680

Mp 16 mg tab 5 5 1391 6,955
Ramaflu Tab 10 10 450 4,500
Ambroxol tab 10 10 437 4,370
SUB TOTAL 52,755
TOTAL 134,644
18 Tn. Sunardi 6/12/2016 Inf Ns 2 2 7721 15,442

Inf Set makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Pumpicel Inj 2 2 195232 390,464
Sistenol Tab 5 5 2041 10,205
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Sp 5 cc 2 2 2478 4,956
SUB TOTAL 509,153
6/13/2016 Ranitidin Inj 2 2 3746 7,492

Inf Ns 2 2 7721 15,442
Sistenol tab 2 2 2041 4,082
Sp 10 cc 1 1 3286 3,286
SUB TOTAL 83,170
6/14/2016 Aquadest Inj 1 1 3312 3,312

Sistenol Tab 3 3 2041 6,123
Inf Ns 1 1 7721 7,721
SUB TOTAL 17,156
6/14/2016 Sistenol Tab 8 8 2041 16,328

Cefixim Tab 10 10 2968 29,680
SUB TOTAL 53,718
TOTAL 663,197
19 An. Adit 6/14/2016 Metronidazol Tab 5 5 292 1,460

Provinas Tab 5 5 464 2,320
Bisturi 1 1 4638 4,638
Sp 1 cc 1 1 2849 2,849
TOTAL 13,453
20 Tn. Fransiskus 6/14/2016 Asam Mefenamat tab 10 10 318 3,180

Cortidex tab 10 10 364 3,640
TOTAL 6,820
21 Tn. Rio 6/14/2016 Cefadroxil Caps 10 10 981 9,810

TOTAL 12,990
22 An. Shafa 6/14/2016 Pct Syr 1 1 6493 6,493

Cortidex Tab 5 5 364 1,820
TOTAL 8,313
23 An. Miftahul 6/14/2016 Pct Tab 10 10 138 1,380

Grahabion tab 10 10 600 6,000
Psidii Tab 10 10 5300 53,000
TOTAL 60,380
24 Ny. Yohana 6/15/2016 Glucosamin Tab 15 15 2120 31,800

Flamar Gel 1 1 21571 21,571
Cameloc Tab 7,5 15 15 2113 31,695
Sanmagh tab 10 10 1020 10,200
TOTAL 95,266
25 Ny. Maria 6/15/2016 Cameloc Tab 7, 5 mg 10 10 2113 21,130

Mersibion Tab 10 10 2500 25,000
Sistenol Tab 10 10 2041 20,410
Ambroxol Tab 10 10 437 4,370
Flamar Gel 1 1 21571 21,571
TOTAL 92,481
26 Tn. Fajarudin 6/15/2016 Flamar Tab 50 mg 10 10 2458 24,580

Flamar Gel 1 1 21571 21,571
Mersibion Tab 10 10 2500 25,000
TOTAL 72,971
27 Ny.Mincu 6/12/2016 Inf Rl 2 2 8700 17,400

Venflon 20 1 1 23186 23,186
Novaldo Inj 1 1 16695 16,695
Ondan 8 mg Inj 1 1 11660 11,660
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 80,806
6/12/2016 Thiamfilex Tab 10 10 1455 14,550

SUB TOTAL 14,550
6/13/2016 Inf Rl 2 2 11600 23,200

Ondan 8 mg Inj 1 1 11660 11,660
Celebrex tab 1 1 17693 17,693
Sistenol tab 3 3 2041 6,123
SUB TOTAL 66,168
6/14/2016 Megabal Tab 3 3 2186 6,558

Pletaal Tab 2 2 9739 19,478
SUB TOTAL 26,036
6/14/2016 Ranitidin Inj 2 2 3180 6,360

Ondan 8 mg Inj 1 1 9900 9,900
Celebrex Tab 1 1 15022 15,022
Inf Rl 3 3 7500 22,500
SUB TOTAL 58,981
TOTAL 246,541
28 Ny. Kuswati 6/15/2016 Acarbose Tab 20 20 1206 24,120

TOTAL 39,100
29 Ny. Magdalena 6/15/2016 Levofloxacin Tab 20 20 1270 25,400

TOTAL 25,400
30 An. Abraham 6/15/2016 L - Bio 6 6 9275 55,650

TOTAL 55,650
31 Tn. Sunadi 6/15/2016 Analsik Tab 10 10 1589 15,890

Antasida Tab 10 10 56 560
TOTAL 40,960
32 Tn. Arliansyah 6/11/2016 Inf Rl 6 6 8700 52,200

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Sp 3 cc 2 2 1895 3,790
Paracetamol Tab 10 10 138 1,380
SUB TOTAL 156,745
6/11/2016 Cortidex Tab 10 10 8000 80,000

Sp 3 cc 1 1 1895 1,895
sistenol tab 5 5 2041 10,205
SUB TOTAL 92,100
6/12/2016 Inf Rl 4 4 8700 34,800

Psidii Caps 10 3 7 5300 37,100
SUB TOTAL 79,613
6/13/2016 inf Rl 4 2 2 11600 23,200

Cortidex 6 3 3 8000 24,000
SUB TOTAL 49,241
6/14/2016 Inf Rl 1 1 8700 8,700

Cortidex Inj 3 3 7500 22,500
SUB TOTAL 44,815
6/15/2016 Ranitidin Inj 2 2 3746 7,492

Cortidex Inj 3 3 7500 22,500
psiidii Tab 3 3 5300 15,900
Cetirizine Tab 1 1 530 530
SUB TOTAL 52,545
6/15/2016 Psiidi Caps 15 15 5300 79,500

SUB TOTAL 79,500
TOTAL 554,559
33 An. Laura 6/15/2016 Inf D5 1/4 Ns 1 1 20000 20,000

Inf Set Mikro 1 1 10300 10,300
Venflon 26 1 1 51100 51,100
Ondan 4 mg Inj 1 1 7300 7,300
Sp 1 cc 1 1 3000 3,000
Sanmol Drop 1 1 20600 20,600
TOTAL 112,300
34 By. Antonio 6/14/2016 D5 1/4 Ns 2 2 20000 40,000

Inf Set Mikro 1 1 10300 10,300
Venflon 26 2 2 51100 102,200
Ondan 4 mg Inj 1 1 7300 7,300
Sp 1 cc 1 1 3000 3,000
Sanmol Drop 1 1 20600 20,600
SUB TOTAL 183,400
6/15/2016 L- Bio 5 5 9275 46,375

SUB TOTAL 46,375
TOTAL 229,775
35 An. G. Jessica L 6/15/2016 Ceftriaxon Inj 2 2 24778 49,556

Sp 10 cc 2 2 3286 6,572
Sp 1 cc 2 2 2849 5,698
Cortidex Inj 2 2 7500 15,000
Inf Set Makro 1 1 10600 10,600
Inf Rl 2 2 8700 17,400
Sp 3 cc 2 2 1895 3,790
TOTAL 115,240
36 An. Zain 6/15/2016 Amoxicilin Syr 1 1 8745 8,745

Pamol Syr 1 1 19500 19,500
Sp 1 cc 1 1 2849 2,849
TOTAL 28,245
37 An. Lavina 6/16/2016 Zink Syr 1 1 38491 38,491

L- Bio 3 3 9275 27,825
Oralit 5 5 928 4,640
TOTAL 70,956
38 An. Adit 6/16/2016 Amoxicilin Tab 10 10 464 4,640

Sanmagh Tab 1 1 32940 32,940
TOTAL 43,540
39 An. Dahlia 6/16/2016 Interpect Syr 1 1 29785 29,785

TOTAL 29,785
40 An. Hafid 6/16/2016 Bioticol Syr 1 1 25042 25,042

Pamol Syr 1 1 19629 19,629
Biovitan Syr 1 1 5247 5,247
Dexametason Tab 3 3 510 1,530
Trifed Tab 1 1 1530 1,530
Kertas Putyer 12 12 100 1,200
TOTAL 55,489
41 An. Alfaro 6/16/2016 Zink Kid Syr 1 1 38491 38,491

TOTAL 38,491
42 An. Jesselin E 6/16/2016 Biovitan Syr 1 1 5247 5,247

TOTAL 5,247
43 An. Anindita 6/16/2016 Sanmol Drop 1 1 20551 20,551

Tremenza Tab 3 3 1530 4,590
Mp Tab 16 mg 1 1 1391 1,391
Kertas Puyer 12 12 100 1,200
TOTAL 27,732
44 Ny. Jamiah 6/13/2016 Inf Set Makro 1 1 10600 10,600

SUB TOTAL 10,600
6/13/2016 Inf Ns 2 2 7721 15,442

Venflon 20 1 1 23186 23,186
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 2 2 2849 5,698
Sagestam Zalf 1 1 16105 16,105
SUB TOTAL 168,474
6/14/2016 Ketorolac Inj 1 1 21863 21,863

Inf Ns 3 3 7721 23,163
SUB TOTAL 45,026
6/14/2016 Ranitidin Inj 2 2 3746 7,492

SUB TOTAL 7,492
6/15/2016 Ranitidin Inj 2 2 3746 7,492

Inf NS 2 2 7721 15,442
SUB TOTAL 138,079
6/16/2016 Cefadroxil Tab 10 10 981 9,810

Thramed Tab 10 10 2511 25,110
SUB TOTAL 34,920
TOTAL 404,591
45 Ny. Inawati 6/16/2016 Lansoprazol Tab 10 10 1855 18,550

Braxidin Tab 10 10 1166 11,660
Flamar 50 mg tab 10 10 2458 24,580
Sanmagh Tab 10 10 1020 10,200
Tensinop Tab 10 10 5936 59,360
TOTAL 124,350
46 Tn. Arup 6/15/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Novaldo Inj 1 1 16695 16,695
Sp 3 cc 2 2 1895 3,790
Celebrex Tab 2 2 17693 35,386
Disflatyl Tab 5 5 810 4,050
SUB TOTAL 124,362
6/16/2016 Ondan 8 mg Inj 1 1 11660 11,660

Disflatyl Tab 1 1 810 810
Celebrex Tab 1 1 17693 17,693
Mp 16 mg Tab 1 1 1391 1,391
Furosemid Inj 1 1 4638 4,638
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 42,460
TOTAL 166,822
47 An. Nur Fadilah 6/16/2016 Otopan Syr 1 1 14575 14,575

Biovitan Syr 1 1 15000 15,000
TOTAL 45,806
48 Ny. V Inawati 6/16/2016 Cetirizin tab 10 10 530 5,300

Cortidex tab 10 10 364 3,640
Recodryl Inj 1.5 1.5 9276 13,914
Sp 3 cc 1 1 1895 1,895
TOTAL 24,749
49 Ny. Arlatin 6/15/2016 Inf Ns 1 1 7721 7,721

Pumpitor Inj 1 1 99800 99,800
Venflon 20 1 1 23186 23,186
Inf Set makro 1 1 10600 10,600
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 155,045
6/16/2016 Urotractin Tab 5 5 8599 42,995

Inf Ns 2 2 11600 23,200
SUB TOTAL 66,195
6/17/2016 Lansoprazol Tab 10 10 1855 18,550

Spasmal Tab 10 10 600 6,000
SUB TOTAL 24,550
TOTAL 245,790
50 Tn. Aki 6/17/2016 Lansoprazol Tab 10 10 1855 18,550

TOTAL 18,550
51 Ny. Siswayati 6/17/2016 Inf Ns 2 2 11594 23,188

Ondan 8 mg Inj 1 1 11660 11,660
Pumpitor Inj 1 1 197929 197,929
Inf Set Makro 1 1 10600 10,600
Sp 5 cc 1 1 2478 2,478
Venflon 22 1 1 23186 23,186
TOTAL 269,041
52 Tn. Arab 6/13/2016 Inf Set makro 1 1 10600 10,600

Dilavask tab 10 mg 10 8 2 1577 3,154
SUB TOTAL 13,754
6/13/2016 Inf Ns 2 2 7721 15,442

Venflon 20 1 1 23186 23,186
Venflon 22 1 1 23186 23,186
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Sagestam Zalf 1 1 16105 16,105
SUB TOTAL 164,033
6/14/2016 Ketorolac Inj 1 1 21863 21,863

Novaldo Inj 1 1 16710 16,710
Sp 3 cc 1 1 1895 1,895
Inf Ns 3 3 7721 23,163
SUB TOTAL 63,631
6/14/2016 Ranitidin Inj 2 2 3746 7,492

SUB TOTAL 7,492
6/14/2016 Pct Tab 3 3 150 450

SUB TOTAL 450
6/15/2016 Ceftriaxon Inj 2 2 24778 49,556

Inf Ns 2 2 0 7721 -
SUB TOTAL 123,697
6/15/2016 Novaldo Inj 3 3 16710 50,130

SUB TOTAL 50,130
6/16/2016 Novaldo Inj 2 2 16695 33,390
Inf Ns 3 3 11600 34,800
SUB TOTAL 70,310
6/17/2016 Ranitidin Inj 4 4 3746 14,984

Novaldo Inj 3 3 0 16695 -
Sp 5 cc 1 1 0 2478 -
Sp 3 cc 1 1 0 1895 -
Aquadest Inj 1 1 0 3312 -
SUB TOTAL 14,984
TOTAL 508,481
53 Nn. Ayu 6/17/2016 Lidocain Inj 1 1 2186 2,186

Sp 1 cc 1 1 2849 2,849
Trichodazol Tab 10 10 1855 18,550
Mp 16 mg Tab 5 5 1391 6,955
TOTAL 33,720
54 By. Albertus 6/16/2016 Metronidazol Inf 1 1 72875 72,875

Sp 10 cc 1 1 3286 3,286
SUB TOTAL 76,161
6/16/2016 Venflon 26 2 2 51013 102,026

Sanmol Drop 1 1 20551 20,551
SUB TOTAL 122,577
6/17/2016 Ondan 4 Mg Inj 1 1 7288 7,288

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 9,183
TOTAL 207,921
55 Ny. Nuri 6/17/2016 Mp 16 mg tab 10 10 1391 13,910

TOTAL 13,910
56 Ny. Tina 6/17/2016 Neurosanbe Inj 1 1 6493 6,493

Sp 3 cc 1 1 1895 1,895
Flamar 50 mg Tab 10 10 2458 24,580
Valisanbe Tab 5 mg 5 5 364 1,820
Flamar Gel 1 1 21571 21,571
TOTAL 59,569
57 An. Maherza 6/17/2016 Sanmol Drop 1 1 21000 21,000

TOTAL 21,000
58 Ny. Siti 6/17/2016 Cortidex tab 10 10 370 3,700

TOTAL 3,700
59 An. Nyemas 6/18/2016 Cefadroxil tab 1 1 13037 13,037

ottopan Syr 1 1 14575 14,575
Mp 16 mg Tab 2 2 1391 2,782
Kertas Puyer 10 10 100 1,000
TOTAL 31,394
60 An. Aqila 6/18/2016 Cefadroxil Caps 1 1 13037 13,037

Tramenza Tab 5 5 1530 7,650
TOTAL 38,737
61 Tn. Daut 6/18/2016 Kasa Box 1 1 10500 10,500

Hansaplast 1 1 5000 5,000
TOTAL 15,500
62 Tn. Supranto 6/18/2016 Flamar 50 mg Tab 10 10 2500 25,000

Ottopan TT 1 1 48000 48,000
Sp 10 cc 1 1 3500 3,500
Inf Set Makro 1 1 10600 10,600
TOTAL 87,100
63 Tn. Aris 6/14/2016 Ats Inj 1 1 167613 167,613

Sp 1 cc 1 1 2849 2,849
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 172,357
6/14/2016 Inf Ns 1 1 7721 7,721

Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Sp 5 cc 2 2 2478 4,956
Sp 1 cc 2 2 2849 5,698
Sp 3 cc 2 2 1895 3,790
Ondan 8 mg Inj 1 1 11660 11,660
Tramadol Inj 2 2 3461 6,922
Piracetam Tab 400 mg 5 5 663 3,315
Paracetamol Tab 10 10 138 1,380
Ats Inj 1 1 167613 167,613
SUB TOTAL 265,457
6/15/2016 Piracetam Inj 3 3 18113 54,339

Tramadol Inj 1 1 3461 3,461
Sp 10 cc 1 1 3286 3,286
Sp 5 cc 1 1 1895 1,895
SUB TOTAL 70,473
6/15/2016 Cefotaxime Inj 2 2 15304 30,608

Ondan 4 mg Inj 1 1 7288 7,288
Thramed Tab 2 2 12521 25,042
SUB TOTAL 62,938
6/16/2016 Piracetam Inj 3 3 18113 54,339

Tramadol Inj 2 2 12521 25,042
SUB TOTAL 125,293
6/17/2016 Cefotaxime Inj 2 2 15304 30,608

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 32,503
6/18/2016 Ranitidin Tab 10 10 321 3,210

Eperison Tab 10 10 2041 20,410
Asam Mfenamat Tab 10 10 318 3,180
SUB TOTAL 31,440
TOTAL 760,461
64 Ny. Anut 6/18/2016 Folley Cateter 16 1 1 20405 20,405

TOTAL 37,675
65 Ny. Susanti 6/16/2016 Venflon 20 1 1 23186 23,186

Inf Ns 3 3 7721 23,163
Pumpicel Inj 1 1 99800 99,800
Uresix Inj 2 2 13250 26,500
Sp 1 cc 1 1 2849 2,849
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 179,871
6/17/2016 Inf Ns 1 1 7721 7,721

Pumpicel Inj 1 1 99800 99,800
Piralen Inj 3 3 9227 27,681
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 142,887
6/17/2016 Sp 5 cc 1 1 2478 2,478

Venflon 20 1 1 23186 23,186
Uresik Inj 2 2 13250 26,500
SUB TOTAL 52,164
6/18/2016 Pumpicel Inj 1 1 99800 99,800

Uresik Inj 1 1 13250 13,250
Inf Set makro 1 1 10600 10,600
Inf Ns 3 3 7721 23,163
SUB TOTAL 150,125
6/18/2016 Strocain Tab 10 10 2551 25,510

SUB TOTAL 25,510
6/19/2016 Lansoprazol Tab 10 10 2000 20,000

SUB TOTAL 20,000
TOTAL 570,557
66 An. Reza 6/19/2016 Acyclovir Tab 400 mg 20 20 800 16,000

Kertas Puyer 20 20 500 10,000
Biovitan Syr 1 1 5500 5,500
Anacetin Syr 1 1 10500 10,500
TOTAL 42,000
67 Ny. Susi Susanti 6/19/2016 Mertigo Tab 10 10 4400 44,000

Sistenol Tab 10 10 2100 21,000
TOTAL 65,000
68 Tn. Kerak 6/19/2016 Folley Cateter 1 1 20500 20,500

Urine Bag 1 1 7500 7,500
Sp 10 cc 1 1 3500 3,500
TOTAL 35,000
69 Tn. Oki 6/19/2016 Nuvamox Tab 10 10 1500 15,000

Flamar 50 mg Tab 10 10 2500 25,000
Sp 1 cc 1 1 3000 3,000
TOTAL 46,000
70 An. Keysha 6/19/2016 Biovitan Syr 1 1 5300 5,300

TOTAL 12,800
71 Tn. Edo 6/19/2016 Inf Set Makro 1 1 10600 10,600

Abocat 20 1 1 23200 23,200
Leukoplast 2,5 1 1 6700 6,700
TOTAL 40,500
72 Ny. Tjong 6/19/2016 Cortidex Tab 10 10 400 4,000

Ambroxol Tab 10 10 450 4,500
Fartolin Tab 2 mg 10 10 1000 10,000
TOTAL 18,500
73 Ny. Yasinta 6/19/2016 Tramenza Tab 10 10 1600 16,000

Ambroxol Tab 10 10 450 4,500
Analsik Tab 10 10 1600 16,000
Pct Tab 10 10 150 1,500
TOTAL 38,000
74 An. Irma 6/19/2016 Otopan Syr 1 1 15000 15,000

TOTAL 15,000
75 An. Tri Wira 6/19/2016 Oroprofen Syr 1 1 16000 16,000

TOTAL 16,000
76 Ny. Yohana 6/19/2016 Tensinop Tab 13 13 5300 68,900

TOTAL 90,900
77 An. Vania 6/19/2016 Cefixime Syr 1 1 42300 42,300

Kalmetason Tab 5 5 400 2,000
TOTAL 129,700
78 Ny. Nursiah 6/19/2016 Valisanbe Tab 4 4 364 1,456

Sistenol Tab 10 10 2041 20,410
Tensinop Tab 10 10 2968 29,680
TOTAL 54,756
TOTAL 10,915,364
Sintang, Juni 2016


LAPORAN UMUM BULAN JULI 2016
Rp. Rp. Rp. Rp.
1 Tn. Hery 6/19/2016 Inf Ns 3 3 11600 34,800
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Venflon 22 1 1 23200 23,200
Sp 3 cc 2 2 2000 4,000
Eperison Tab 10 10 2100 21,000
Nuvamox Tab 10 10 1500 15,000
Bisturi 1 1 5000 5,000
TOTAL 184,600
2 Ny. Suswanti 6/20/2016 Lansoprazol Tab 10 10 1855 18,550

Mersibion Tab 10 10 5016 50,160
TOTAL 68,710
3 An. Zeim Va 6/20/2016 Ventolin nebu 1 1 12476 12,476

Sp 3 cc 1 1 1895 1,895
Dexametason Tab 4 4 133 532
Kertas Puyer 12 12 100 1,200
TOTAL 92,990
4 Tn. Iyat 6/20/2016 Cameloc 15 mg Tab 10 10 3500 35,000

TOTAL 54,000
5 An. Cadriel 6/20/2016 Apialys Syr 1 1 33125 33,125

Dextafen Tab 12 12 1603 19,236
Acylovir Tab 15 15 742 11,130
TOTAL 63,491
6 Tn. Wawan 6/20/2016 Lamnsoprazol Tab 10 10 1855 18,550

Sanmagh Tab 15 15 1020 15,300
TOTAL 42,790
7 An. Sabian 6/20/2016 Clamixin Syr 1 1 66500 66,500

Kertas Puyer 12 12 100 1,200
TOTAL 68,792
8 An. Rizky 6/20/2016 L- Bio 4 4 9275 37,100

TOTAL 37,100
9 Tn. Darus 6/20/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Rl 1 1 8700 8,700
Inf Ns 1 1 7721 7,721
Canul O2 Dewasa 1 1 14575 14,575
O2 100 100 250 25,000
Tramadol Inj 1 1 12521 12,521
Sp 5 cc 1 1 2478 2,478
Bioplacenton Zalf 1 1 17490 17,490
Sp 1 cc 1 1 2849 2,849
Dc 16 1 1 20405 20,405
Urine Bag 1 1 7288 7,288
TOTAL 152,813
10 By. Yahiko Lin 6/18/2016 Inf Set Mikro 1 1 10203 10,203

Venflon 26 2 2 51013 102,026
Inf Rl 1 1 8700 8,700
Sanmol Drop 1 1 20551 20,551
SUB TOTAL 141,480
6/19/2016 Psidii Syr 1 1 39000 39,000

Sp 3 cc 1 1 2000 2,000
SUB TOTAL 41,000
TOTAL 182,480
11 Ny. Sri 6/18/2016 Inf Set Makro 1 1 10600 10,600

Venflon 22 2 2 23200 46,400
Inf Ns 3 3 11600 34,800
Novaldo Inj 1 1 16700 16,700
Terfacef Inj 2 2 130000 260,000
Sp 3 cc 2 2 2000 4,000
Sp 5 cc 1 1 2500 2,500
Sp 1 cc 1 1 3000 3,000
Pct Tab 5 5 150 750
SUB TOTAL 386,750
6/18/2016 Bioxon Inj 1 1 243854 243,854

Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
Inf Ns 3 3 0 7721 -
SUB TOTAL 252,277
6/19/2016 Buscopan Inj 3 3 27900 83,700
Terfacef Inj 2 2 128300 256,600
Pct Tab 2 2 150 300
Sp 3 cc 1 1 2000 2,000
SUB TOTAL 342,600
6/20/2016 Disflatyl Tab 4 4 810 3,240

SUB TOTAL 12,336
TOTAL 993,963
12 Ny. Rosa 6/20/2016 Cefadroxyl tab 10 10 981 9,810

Sanmagh Tab 10 10 1020 10,200
TOTAL 44,520
13 Ny. Tina 6/20/2016 Tensinop Tab 10 10 3000 30,000

Mersibion Tab 10 10 2500 25,000
Mirasic Tab 10 10 1000 10,000
TOTAL 65,000
14 Nn. Dian 6/20/2016 Tremenza Tab 5 5 1530 7,650

TOTAL 7,650
15 Tn. Robi 6/20/2016 Domperidon Tab 10 10 596 5,960

Sanmagh Tab 10 10 1020 10,200
TOTAL 19,370
16 Tn. Paulinus 6/21/2016 Valdix Tab 80 mg 30 30 8016 240,480
Dilavask Tab 5 mg 20 20 2319 46,380
Metformin 500 mg Tab 60 60 265 15,900
TOTAL 302,760
17 Tn. Fhaizal 6/21/2016 Pct Syr 1 1 3231 3,231

Clamixin Syr 1 1 65907 65,907
TOTAL 69,138
18 Tn. B Entawan 6/21/2016 Ranitidin Tab 15 15 321 4,815

Flamar 50 mg Tab 10 10 2458 24,580
Flamar Gel 1 1 21571 21,571
Mp 16 mg Tab 4 4 1391 5,564
Glukosamin Tab 10 10 2120 21,200
TOTAL 77,730
19 Tn. Sobiran 6/21/2016 Analsik Tab 15 15 1589 23,835

Eperison Tab 10 10 2041 20,410
TOTAL 47,455
20 Ny. Yeni K 6/19/2016 Inf Set Makro 1 1 10600 10,600

Inf Rl 3 3 11600 34,800
Ondan 8 mg Inj 1 1 11700 11,700
Sp 5 cc 1 1 2500 2,500
Sp 3 cc 2 2 2000 4,000
Venflon 22 2 2 23200 46,400
Novaldo Inj 1 1 16700 16,700
Sistenol Tab 5 5 2100 10,500
Simvastatin tab 10 10 800 8,000
Valisanbe 5 mg Tab 2 2 500 1,000
SUB TOTAL 146,200
6/20/2016 Piracetam Inj 12 gr 1 1 7420 7,420

SUB TOTAL 7,420
6/20/2016 Thiamfilex Tab 30 30 1455 43,650

Ondan 8 mg Inj 1 1 9900 9,900
Sistenol Tab 5 5 2041 10,205
Inf Rl 3 3 8700 26,100
SUB TOTAL 90,583
6/21/2016 Ranitidin Tab 10 10 321 3,210

SUB TOTAL 9,333
TOTAL 253,536
21 Ny. Asunda 6/21/2016 Lansoprazol tab 10 10 1855 18,550

Mertigo Tab 10 10 4306 43,060
Sanmagh Tab 10 10 1020 10,200
TOTAL 77,770
22 Tn. Mursaf 6/21/2016 Simvastatin Tab 10 10 749 7,490

Analsik Tab 10 10 1589 15,890
TOTAL 23,380
23 Ny. Lena 6/21/2016 Spasmal Tab 10 10 600 6,000

TOTAL 6,000
24 Tn. Andi 6/21/2016 Asam Mefenamat Tab 1 1 318 318

Eperison Tab 1 1 2041 2,041
TOTAL 2,359
25 Nn. Naumi 6/21/2016 Licoprox Tab 10 10 2500 25,000

Sanmagh Tab 10 10 1020 10,200
TOTAL 38,410
26 Nn. Danisa 6/21/2016 Sanmagh Syr 1 1 33000 33,000

Cavicur Tab 10 10 2000 20,000
TOTAL 53,000
27 Tn. Edo 6/21/2016 Lapibal Inj 1 1 37500 37,500

Sp 3 cc 2 2 4000 8,000
TOTAL 45,500
28 Ny. Kalimah 6/22/2016 Captopril tab 50 mg 10 10 297 2,970

Glibenclamid 5 mg Tab 20 20 808 16,160
Cameloc Tab 7,5 mg 10 10 2113 21,130
TOTAL 58,260
29 An. April 6/22/2016 Acitral Syr 1 1 33200 33,200

Scopamin Tab 3 3 2551 7,653
Kertas Puyer 9 9 100 900
TOTAL 41,753
30 An. April 6/22/2016 Mucera Syr 1 1 22500 22,500

TOTAL 22,500
31 Tn. Markus 6/22/2016 Flamar 50 mg Tab 10 10 2458 24,580

Flamar Gel 1 1 21571 21,571
Mp 8 mg Tab 10 10 928 9,280
TOTAL 55,431
32 Tn. Suminto 6/22/2016 Pct Tab 10 10 138 1,380

Braxidin tab 10 10 1166 11,660
TOTAL 13,040
33 Ny. Habibah 6/22/2016 Domperidon Tab 10 10 596 5,960

Mertigo Tab 10 10 4306 43,060
Dilavask Tab 10 mg 10 10 1577 15,770
TOTAL 64,790
34 Ny. Sunarsi 6/22/2016 Amlodipin Tab 10 mg 10 10 2465 24,650

TOTAL 29,680
35 An. Asita 6/22/2016 Apialys Drop 1 1 40000 40,000

TOTAL 40,000
36 Tn. P Kamar 6/20/2016 inf Rl 2 2 11600 23,200

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Ondan 4 mg Inj 3 3 7300 21,900
Sp 3 cc 2 2 2000 4,000
sp 1 cc 1 1 3000 3,000
Sanmagh Syr 1 1 33000 33,000
SUB TOTAL 126,900
6/21/2016 Ketorolac Inj 2 2 21863 43,726

SUB TOTAL 43,726
6/21/2016 Sp 3 cc 1 1 1895 1,895
Inf Ns 3 3 7721 23,163
Sanmagh Tab 10 10 1020 10,200
Celebrex Tab 3 3 17693 53,079
SUB TOTAL 97,870
6/22/2016 Eperison Tab 7 7 2041 14,287

Celebrex Tab 2 2 17693 35,386
SUB TOTAL 49,673
TOTAL 318,169
37 By. Azam 6/22/2016 Inf Set Mikro 1 1 10203 10,203

Venflon 26 6 6 51013 306,078
O2 50 50 250 12,500
TOTAL 328,781
38 An. Suci 6/22/2016 Domperidon Syr 1 1 7420 7,420

Cefadroxyl Syr 1 1 13037 13,037
Cefadroxyl Capsul 3 3 981 2,943
Ramadryl Syr 1 1 11400 11,400
TOTAL 50,200
39 dr. Adi 6/23/2016 Flamicort Inj 1 1 109180 109,180

Sp 1 cc 3 3 2849 8,547
TOTAL 117,727
40 Tn. Kamari 6/23/2016 Celebrex 1 1 17693 17,693

Megabal Tab 1 1 2186 2,186
TOTAL 19,879
41 An. Hanifah 6/23/2016 Domperidon Syr 1 1 7420 7,420
Acitral Syr 1 1 33200 33,200
Ottopan Syr 1 1 3231 3,231
Clamixin Syr 1 1 65907 65,907
Scopamin Tab 5 5 2551 12,755
TOTAL 122,513
42 Ny. Sari 6/23/2016 Folavit Tab 10 10 928 9,280

TOTAL 9,280
43 Nn. Septi 6/22/2016 NS Inf 0,9 % 2 2 7721 15,442

Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Ondan 8 mg Inj 2 2 11660 23,320
Buscopan Inj 2 1 1 27825 27,825
Sp 3 cc 1 1 1895 1,895
Pumpitor Inj 1 1 99800 99,800
Sp 5 cc 1 1 2478 2,478
Sp 10 cc 1 1 3286 3,286
SUB TOTAL 207,832
6/22/2016 Inf Rl 3 3 8700 26,100

Sp 3 cc 1 1 1895 1,895
Molagit Tab 10 10 636 6,360
Imodiat Tab 8 8 100 800
Braxidin Tab 10 10 1166 11,660
SUB TOTAL 54,307
6/23/2016 Inf Rl 1 1 8700 8,700

Ondan 8 mg Inj 1 1 11660 11,660
Molagit Tab 4 4 636 2,544
Spasmal Tab 10 10 600 6,000
SUB TOTAL 36,396
6/24/2016 Ranitidin Tab 10 10 321 3,210

Sanmagh Syr 1 1 32940 32,940
SUB TOTAL 45,926
TOTAL 344,461
44 Tn. M Arshad 6/22/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 19686 19,686
Inf Ns 3 3 7721 23,163
Ondan 8 mg Inj 1 1 11660 11,660
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
Celebrex Tab 1 1 17693 17,693
Sanmag Tab 3 3 1020 3,060
SUB TOTAL 97,727
6/23/2016 Inf Ns 2 2 7721 15,442

Ondan 8 mg Inj 1 1 11660 11,660
Celebrex Tab 1 1 17693 17,693
Sanmagh Tab 3 3 1020 3,060
SUB TOTAL 55,347
6/24/2016 Inf ns 3 3 0 7721 -

Ondan 4 mg Inj 2 2 0 7288 -
Celebrex Tab 1 1 17693 17,693
Sanmagh Tab 3 2 1 1020 1,020
SUB TOTAL 18,713
TOTAL 171,787
45 Nn. Marlya 6/24/2016 Handscon M 1 1 55000 55,000

Handscon Steril 3 3 8348 25,044
Masker Tali 1 1 35000 35,000
Urin Bag 1 1 7288 7,288
Folley Cateter 18 1 1 20405 20,405
TOTAL 142,737
46 By. Beatus 6/24/2016 Combivent Nebu 1 1 17490 17,490

TOTAL 24,446
47 Tn. Hairun 6/24/2016 Lidocain Inj 1 1 2186 2,186

Sp 3 cc 1 1 1895 1,895
TOTAL 11,901
48 An. Kevin 6/24/2016 Cefadroxyl Syr 1 1 13037 13,037

TOTAL 43,837
49 Ny. Tina 6/24/2016 Mertigo Tab 10 10 4306 43,060

Pct Tab 10 10 1380 13,800
TOTAL 56,860
50 Tn. Sutiyo 6/25/2016 Lisinopril Tab 20 20 994 19,880

Myores Tab 6 6 6029 36,174
TOTAL 63,544
51 An. Ferdi 6/25/2016 Ventolin Nebu 1 1 12476 12,476

Fartolin Tab 5 5 1265 6,325
Ambroxol tab 5 5 437 2,185
TOTAL 23,636
52 An. Faizal 6/23/2016 Inf Set makro 1 1 10600 10,600

Inf Rl 2 2 8700 17,400
Inf D5 1/4 Ns 2 2 19941 39,882
Venflon 22 1 1 23186 23,186
Pct Tab 6 6 138 828
Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
Inj Cortidex 1 1 7500 7,500
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 143,241
6/24/2016 Inf Rl 1 1 8700 8,700

SUB TOTAL 42,620
TOTAL 185,861
53 An. Arga 6/25/2016 Clamixin Syr 1 1 65907 66,250

Remco Syr 1 1 6267 6,267
Opinacea Syr 1 1 65907 66,250
TOTAL 138,767
54 Ny. Masnun 6/19/2016 Aquadest Inj 1 1 3312 3,312

Bioxan Inj 2 2 243854 487,708
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Tramadol inj 2 2 12521 25,042
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 2 2 1895 3,790
Sp 1 cc 1 1 2849 2,849
Coditam tab 10 10 4810 48,100
SUB TOTAL 631,320
6/19/2016 Ondan 8 mG inj 1 1 11700 11,700

Terfacef Inj 1 1 128300 128,300
Sp 5 cc 1 1 2500 2,500
SUB TOTAL 142,500
6/19/2016 Ondan 4 mg Inj 1 1 7300 7,300

SUB TOTAL 7,300
6/20/2016 Ondan 8 mg Inj 1 1 11660 11,660

Valsanbe Tab 3 3 364 1,092
Inf Ns 3 3 7721 23,163
SUB TOTAL 35,915
6/20/2016 Tramadol Inj 3 3 12521 37,563

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 39,458
6/21/2016 Ceftriaxon Inj 2 2 24778 49,556
Ondan 8 mg Inj 2 2 11660 23,320
Valisanbe Tab 5 mg 2 2 364 728
Coditam Tab 7 7 4810 33,670
Inf Ns 2 2 7721 15,442
SUB TOTAL 122,716
6/21/2016 Valisanbe Tab 45 mg 1 1 309 309

Sp 3 cc 1 1 1609 1,609
SUB TOTAL 1,918
6/22/2016 Ceftriaxon Inj 2 2 24778 49,556

Ondan 8 mg Inj 1 1 11660 11,660
Tramadol Inj 2 2 12251 24,502
SUB TOTAL 85,718
6/22/2016 Venflon 22 2 2 23186 46,372

SUB TOTAL 46,372
6/23/2016 Inf Ns 3 3 7721 23,163

SUB TOTAL 76,395
6/23/2016 Myores Tab 2 2 6029 12,058

SUB TOTAL 12,058
5/24/2016 Inf Ns 3 3 0 7721 -

Ondan 8 mg inj 1 1 0 11660 -
Valisanbe tab 5 mg 2 2 0 364 -
Coditam Tab 3 2 1 4810 4,810
Myores Tab 3 2 1 6029 6,029
Tramadol Inj 3 2 1 12521 12,521
SUB TOTAL 76,228
6/25/2016 Ranitidin Inj 2 2 3746 7,492

Tramadol Inj 2 2 12521 25,042
Valisanbe Tab 2 1 1 364 364
Coditam Tab 2 2 4810 9,620
SUB TOTAL 95,386
TOTAL 1,373,284
55 Ny. Yohana 6/25/2016 Biotichol Tab 30 30 3382 101,460

Sistenol Tab 10 10 2041 20,410
TOTAL 121,870
56 Ny. Dayang 6/24/2016 Inf Ns 5 5 7721 38,605

Odan 8 mg Inj 2 1 1 11660 11,660
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 63,547
6/25/2016 Sanmagh Tab 10 10 1020 10,200

Tensinop Tab 5 5 5300 26,500
SUB TOTAL 36,700
TOTAL 100,247
57 An. Mutia 6/25/2016 Remco Syr 1 1 6267 6,267
Ramoxyl Syr 1 1 14376 14,376
Opinacea Syr 1 1 65907 65,907
TOTAL 94,550
58 Ny. Nonong 6/24/2016 Folaxin Tab 10 10 928 9,280

Inf Ns 3 3 7721 23,163
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Piralen Inj 3 3 9227 27,681
Sanmagh Tab 10 10 1020 10,200
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 115,392
6/24/2016 Pumpitor Inj 1 1 99800 99,800

Sp 10 cc 1 1 3286 3,286
Inf Ns 1 1 7721 7,721
Piralen Inj 1 1 9227 9,227
SUB TOTAL 120,034
6/25/2016 Transfusi Set 1 1 30608 30,608

Pumpitor Inj 1 1 99800 99,800
SUB TOTAL 130,408
6/25/2016 Noflam Tab 10 10 5101 51,010

SUB TOTAL 51,010
TOTAL 416,844
59 Ny. Yuliana 6/25/2016 Sanmagh Tab 10 10 1020 10,200

Spasmal Tab 10 10 600 6,000
TOTAL 16,564
60 Tn. Hendro 6/25/2016 Neurosanbe Inj 1 1 6493 6,493

Sp 3 cc 1 1 1895 1,895
TOTAL 8,388
61 Tn. Miftahul 6/26/2016 Calortusin Tab 10 10 520 5,200

Tramenza Tab 10 10 1530 15,300
TOTAL 26,500
62 Tn. Astadino 6/20/2016 Inf Rl 2 2 11600 23,200

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Sp 10 cc 1 1 3500 3,500
Sp 5 cc 1 1 2500 2,500
Sp 3 cc 1 1 2000 2,000
Citicolin Inj 4 4 39800 159,200
SUB TOTAL 246,100
6/21/2016 Ketorolac Inj 2 1 1 21863 21,863

Citicolin Inj 2 2 39750 79,500
Inf Ns 3 3 7721 23,163
SUB TOTAL 124,526
6/21/2016 Ranitidin Inj 2 2 3746 7,492

Sp 3 cc 2 2 1895 3,790
SUB TOTAL 11,282
6/22/2016 Citicolin Inj 250 mg 6 6 39750 238,500

SUB TOTAL 238,500
6/22/2016 Ventolin Nebu 2 2 15000 30,000

Sp 3 cc 3 3 1895 5,685
SUB TOTAL 35,685
6/22/2016 Citicolin Inj 2 2 39750 79,500

SUB TOTAL 86,992
6/23/2016 Inf Rl 3 3 8700 26,100

SUB TOTAL 33,592
6/24/2016 Citicolin Inj 250 Mg 2 2 39750 79,500

SUB TOTAL 79,500
6/24/2016 Inf Rl 3 3 8700 26,100

SUB TOTAL 33,592
6/25/2016 Ranitidin Inj 2 2 3746 7,492

Amlodipin Tab 10 mg 5 5 2465 12,325
SUB TOTAL 19,817
TOTAL 909,586
63 By. Adiba 6/26/2016 Ventolin Nebu 1 1 12476 12,476

Sanmol Drop 1 1 20551 20,551
TOTAL 33,027
64 An. Faizal 6/26/2016 Tiamfilex Tab 30 30 1455 43,650

Sistenol Tab 8 8 2041 16,328
TOTAL 59,978
65 Tn. Slamet 6/26/2016 Pct Tab 10 10 138 1,380

Mersibion Tab 10 10 5016 50,160
TOTAL 57,500
66 Tn. Eka 6/26/2016 Calortusin tab 10 10 520 5,200

Cortusin tab 10 10 364 3,640
TOTAL 8,840
67 Tn. Sobikun 6/26/2016 Pct Tab 15 15 138 2,070

Noervom Tab 10 10 278 2,780
TOTAL 11,120
68 Nn. Lili 6/26/2016 Asam Mefenamat Tab 10 10 318 3,180

Cortidex Tab 10 10 364 3,640
TOTAL 6,820
69 By. Aditya 6/26/2016 Ventolin Nebu 1 1 12476 12,476

Cefixime Syr 1 1 42201 42,201
Sp 3 cc 1 1 1895 1,895
TOTAL 56,572
70 dr. Daniel 6/27/2016 Recodryl Inj 1 1 9275 9,275

Sp 1 cc 2 2 2849 5,698
Sp 3 cc 2 2 1895 3,790
TOTAL 18,763
71 Tn. Nofriandi 6/27/2016 Lansoprazol Tab 10 10 1855 18,550

Sanmagh Tab 10 10 1020 10,200
TOTAL 28,750
72 Tn. Mulyana 6/27/2016 Mesol Tab 8 mg 10 10 5472 54,720

TOTAL 54,720
73 Ny. Siti 6/27/2016 Dulcolac Tab 5 5 1391 6,955

TOTAL 6,955
74 Ny. Mariani 6/24/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Ketorolac Inj 6 6 21863 131,178
Buscopan Inj 2 2 27825 55,650
Sp 3 cc 3 3 1895 5,685
Metformin Tab 500 mg 2 2 265 530
O2 50 50 250 12,500
SUB TOTAL 269,984
6/25/2016 Inf Ns 2 2 7721 15,442

Ranitidn Inj 2 2 3746 7,492
Buscopan Inj 3 3 27825 83,475
SUB TOTAL 194,391
6/26/2016 Ranitidin Inj 2 2 3746 7,492

Buscopan Inj 2 2 27825 55,650
Inf Ns 2 2 7721 15,442
Metformin Tab 500 mg 5 5 265 1,325
SUB TOTAL 79,909
6/27/2016 Inf Ns 2 2 6409 12,818
Ketorolac Inj 2 2 0 18563 -
Sp 3 cc 2 2 1609 3,218
SUB TOTAL 16,036
6/27/2016 Lansoprazol Tab 10 10 1855 18,550

Nadik 50 mg Tab 10 10 685 6,850
Metformin 500 mg tab 17 17 265 4,505
SUB TOTAL 35,905
TOTAL 596,225
75 An. Yunda Ayu 6/27/2016 Cefadroxyl Tab 5 5 981 4,905

TOTAL 20,305
76 Tn. Teguh 6/27/2016 Flamar Gel 1 1 21571 21,571

Mesol Tab 8 mg 10 10 5472 54,720
Captopril Tab 12,5 mg 10 10 133 1,330
TOTAL 77,621
77 Tn. Syahrul 6/27/2016 Clindamycin tab 10 10 996 9,960

Celebrex tab 6 6 17693 106,158
TOTAL 116,118
78 Tn. Lim Kun 6/27/2016 Valdix Tab 80 mg 10 10 8016 80,160

Letonal Tab 25 mg 10 10 1484 14,840
O2 25 25 250 6,250
Nasal Canul 1 1 14575 14,575
TOTAL 115,825
79 Ny. Lidya 6/27/2016 Lisinopril Tab 10 10 994 9,940
Spasmal Tab 10 10 600 6,000
Molagit Tab 10 10 636 6,360
Vomitraz Tab 4 mg 10 10 1458 14,580
TOTAL 40,090
80 An. Siti 6/27/2016 Ondan 4 mg Inj 1 1 7288 7,288

Sp 3 cc 1 1 1895 1,895
Pct Tab 5 5 138 690
TOTAL 17,293
81 Tn. Sukarli 6/27/2016 Domperidon Tab 10 10 600 6,000

Mertigo Tab 6 mg 10 10 4400 44,000
Sistenol Tab 10 10 2100 21,000
TOTAL 71,000
82 Ny. Rendita 6/27/2016 Tramenza Tab 20 20 1550 31,000

Celebrex Tab 2 2 17700 35,400
TOTAL 66,400
83 An. Rivi 6/27/2016 Mecodiar Tab 5 5 1000 5,000

Molagit Tab 10 10 650 6,500
Oralit Bungkus 5 5 1000 5,000
TOTAL 23,500
84 An. Delsa 6/28/2016 Apialys Drop 1 1 41700 41,700

TOTAL 41,700
85 Tn. Markus 6/28/2016 Cefadroxil Tab 10 10 981 9,810
Flamar 50 mg Tab 10 10 685 6,850
Mp 16 mg Tab 8 8 1391 11,128
TOTAL 51,108
86 Nn. Kiki 6/28/2016 Acylovir Zalf 6 6 3611 21,666

TOTAL 21,666
87 Tn. Topan 6/28/2016 Mertigo Sr 10 10 6029 60,290

Cymalium Tab 10 10 1802 18,020
Sanmagh Tab 10 10 1020 10,200
Ondan 4 mg Inj 2 1 1 7288 7,288
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Inf RL 2 2 8700 17,400
TOTAL 155,103
88 Nn. Nova 6/28/2016 Cefadroxyl Syr 1 1 13037 13,037

Pct Syr 1 1 3231 3,231
TOTAL 18,088
89 Ny. Hatniah 6/26/2016 Inf Set makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Ondan 4 mg Inj 2 2 7288 14,576
Sp 5 cc 2 2 2478 4,956
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Pct Tab 5 5 138 690
Imodiat 10 10 159 1,590
SUB TOTAL 143,865
6/27/2016 Ranitidin Inj 2 2 3746 7,492

Ondan 4 mg Inj 2 2 7288 14,576
Pct Tab 1 1 138 138
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 29,891
6/28/2016 Inf Ns 3 3 0 7721 -

ranitidin Inj 2 2 0 3746 -
Ondan 4 mg Inj 2 2 0 7288 -
Pct Tab 3 3 138 414
SUB TOTAL 8,067
6/28/2016 Cefadroxil Tab 4 4 981 3,924

SUB TOTAL 13,812
TOTAL 195,635
90 Nn. Mardiana 6/28/2016 Ranitidin Tab 10 10 321 3,210

Sanmagh Tab 10 10 1020 10,200
Spasmal Tab 10 10 600 6,000
Metronidazol Tab 500 mg 10 10 250 2,500
TOTAL 27,870
91 Tn. Dedi 6/24/2016 Venflon 20 2 2 23186 46,372

Inf Set Makro 1 1 10600 10,600
Inf Rl 3 3 8700 26,100
Ondan 4 mg Inj 2 2 7288 14,576
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1609 1,609
Sistenol Tab 5 5 2041 10,205
Celebrex Tab 1 1 17693 17,693
SUB TOTAL 137,125
6/25/2016 Inf Rl 2 2 8700 17,400

Ondan 4 mg Inj 4 4 7288 29,152
Sistenol Tab 5 5 2041 10,205
Sanmagh Tab 10 10 1020 10,200
SUB TOTAL 74,449
6/26/2016 Nadic Tab 5 5 685 3,425

Clanexi Tab 10 10 15887 158,870
Ondan 4 mg Inj 4 4 7288 29,152
Inf Rl 2 2 8700 17,400
SUB TOTAL 216,339
6/27/2016 Venflon 22 1 1 23186 23,186

SUB TOTAL 23,186
6/27/2016 Inf Ns 2 2 7721 15,442
Dexa Inj 2 2 0 3177 -
Sp 3 cc 1 1 1895 1,895
Novaldo Inj 2 1 1 16695 16,695
Sp 5 cc 1 1 2478 2,478
Ondan 4 mg Inj 4 1 3 7288 21,864
Sistenol Tab 10 10 2041 20,410
SUB TOTAL 82,530
6/28/2016 Domperidon tab 10 10 596 5,960

Sanmagh Tab 5 5 1020 5,100
Clanexi Tab 3 3 15887 47,661
Nadik 50 mg Tab 3 3 687 2,061
Cortidex Tab 1 1 364 364
Kapsul 6 6 500 3,000
SUB TOTAL 64,146
TOTAL 597,775
92 Ny. Novi 6/28/2016 Tramenza Tab 10 10 1530 15,300

Ramaflu tab 10 10 450 4,500
TOTAL 19,800
93 Tn. Turis 6/28/2016 Urotractin Tab 10 10 8599 85,990

Spasmal Tab 12 12 600 7,200
TOTAL 96,400
TOTAL 11,355,547
Sintang, Juli 2016

Kiki Indrawan Warsidi

Serda NRP 21150228870193 Serma NRP 580944
SALAH
SALAH
salah hitung dan salah retur
7,388,102
tidak ad braxidin
NO NAMA TANGGAL NAMA OBAT JUMLAH RETUR OBAT HARGA SATUAN HARGA SATUAN SUB
Rp. Rp. Rp.
1 Tn. Hery 6/19/2016 Inf Ns 3 3 11600 34,800
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Venflon 22 1 1 23200 23,200
Sp 3 cc 2 2 2000 4,000
Eperison Tab 10 10 2100 21,000
Nuvamox Tab 10 10 1500 15,000
Bisturi 1 1 5000 5,000
TOTAL
2 Ny. Suswanti 6/20/2016 Lansoprazol Tab 10 10 1855 18,550

Mersibion Tab 10 10 5016 50,160
TOTAL
3 An. Zeim Va 6/20/2016 Ventolin nebu 1 1 12476 12,476

Sp 3 cc 1 1 1895 1,895
Dexametason Tab 4 4 133 532
Kertas Puyer 12 12 100 1,200
TOTAL
4 Tn. Iyat 6/20/2016 Cameloc 15 mg Tab 10 10 3500 35,000

TOTAL
5 An. Cadriel 6/20/2016 Apialys Syr 1 1 33125 33,125

Dextafen Tab 12 12 1603 19,236
Acylovir Tab 15 15 742 11,130
TOTAL
6 Tn. Wawan 6/20/2016 Lamnsoprazol Tab 10 10 1855 18,550

Sanmagh Tab 15 15 1020 15,300
TOTAL
7 An. Sabian 6/20/2016 Clamixin Syr 1 1 66500 66,500

Kertas Puyer 12 12 100 1,200
TOTAL
8 An. Rizky 6/20/2016 L- Bio 4 4 9275 37,100

TOTAL
9 Tn. Darus 6/20/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Rl 1 1 8700 8,700
Inf Ns 1 1 7721 7,721
Canul O2 Dewasa 1 1 14575 14,575
O2 100 100 250 25,000
Tramadol Inj 1 1 12521 12,521
Sp 5 cc 1 1 2478 2,478
Bioplacenton Zalf 1 1 17490 17,490
Sp 1 cc 1 1 2849 2,849
Dc 16 1 1 20405 20,405
Urine Bag 1 1 7288 7,288
TOTAL
10 By. Yahiko Lin 6/18/2016 Inf Set Mikro 1 1 10203 10,203

Venflon 26 2 2 51013 102,026
Inf Rl 1 1 8700 8,700
Sanmol Drop 1 1 20551 20,551
SUB TOTAL 141,480
6/19/2016 Psidii Syr 1 1 39000 39,000

Sp 3 cc 1 1 2000 2,000
SUB TOTAL 41,000
TOTAL
11 Ny. Sri 6/18/2016 Inf Set Makro 1 1 10600 10,600

Venflon 22 2 2 23200 46,400
Inf Ns 3 3 11600 34,800
Novaldo Inj 1 1 16700 16,700
Terfacef Inj 2 2 130000 260,000
Sp 3 cc 2 2 2000 4,000
Sp 5 cc 1 1 2500 2,500
Sp 1 cc 1 1 3000 3,000
Pct Tab 5 5 150 750
SUB TOTAL 386,750
6/18/2016 Bioxon Inj 1 1 243854 243,854

Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
Inf Ns 3 3 0 7721 -
SUB TOTAL 252,277
6/19/2016 Buscopan Inj 3 3 27900 83,700
Terfacef Inj 2 2 128300 256,600
Pct Tab 2 2 150 300
Sp 3 cc 1 1 2000 2,000
SUB TOTAL 342,600
6/20/2016 Disflatyl Tab 4 4 810 3,240

SUB TOTAL 12,336
TOTAL
12 Ny. Rosa 6/20/2016 Cefadroxyl tab 10 10 981 9,810

Sanmagh Tab 10 10 1020 10,200
TOTAL
13 Ny. Tina 6/20/2016 Tensinop Tab 10 10 3000 30,000

Mersibion Tab 10 10 2500 25,000
Mirasic Tab 10 10 1000 10,000
TOTAL
14 Nn. Dian 6/20/2016 Tremenza Tab 5 5 1530 7,650

TOTAL
15 Tn. Robi 6/20/2016 Domperidon Tab 10 10 596 5,960

Sanmagh Tab 10 10 1020 10,200
TOTAL
16 Tn. Paulinus 6/21/2016 Valdix Tab 80 mg 30 30 8016 240,480
Dilavask Tab 5 mg 20 20 2319 46,380
Metformin 500 mg Tab 60 60 265 15,900
TOTAL
17 Tn. Fhaizal 6/21/2016 Pct Syr 1 1 3231 3,231

Clamixin Syr 1 1 65907 65,907
TOTAL
18 Tn. B Entawan 6/21/2016 Ranitidin Tab 15 15 321 4,815

Flamar 50 mg Tab 10 10 2458 24,580
Flamar Gel 1 1 21571 21,571
Mp 16 mg Tab 4 4 1391 5,564
Glukosamin Tab 10 10 2120 21,200
TOTAL
19 Tn. Sobiran 6/21/2016 Analsik Tab 15 15 1589 23,835

Eperison Tab 10 10 2041 20,410
TOTAL
20 Ny. Yeni K 6/19/2016 Inf Set Makro 1 1 10600 10,600

Inf Rl 3 3 11600 34,800
Ondan 8 mg Inj 1 1 11700 11,700
Sp 5 cc 1 1 2500 2,500
Sp 3 cc 2 2 2000 4,000
Venflon 22 2 2 23200 46,400
Novaldo Inj 1 1 16700 16,700
Sistenol Tab 5 5 2100 10,500
Simvastatin tab 10 10 800 8,000
Valisanbe 5 mg Tab 2 2 500 1,000
SUB TOTAL 146,200
6/20/2016 Piracetam Inj 12 gr 1 1 7420 7,420

SUB TOTAL 7,420
6/20/2016 Thiamfilex Tab 30 30 1455 43,650

Ondan 8 mg Inj 1 1 9900 9,900
Sistenol Tab 5 5 2041 10,205
Inf Rl 3 3 8700 26,100
SUB TOTAL 90,583
6/21/2016 Ranitidin Tab 10 10 321 3,210

SUB TOTAL 9,333
TOTAL
21 Ny. Asunda 6/21/2016 Lansoprazol tab 10 10 1855 18,550

Mertigo Tab 10 10 4306 43,060
Sanmagh Tab 10 10 1020 10,200
TOTAL
22 Tn. Mursaf 6/21/2016 Simvastatin Tab 10 10 749 7,490

Analsik Tab 10 10 1589 15,890
TOTAL
23 Ny. Lena 6/21/2016 Spasmal Tab 10 10 600 6,000

TOTAL
24 Tn. Andi 6/21/2016 Asam Mefenamat Tab 1 1 318 318

TOTAL
25 Nn. Naumi 6/21/2016 Licoprox Tab 10 10 2500 25,000

Sanmagh Tab 10 10 1020 10,200
TOTAL
26 Nn. Danisa 6/21/2016 Sanmagh Syr 1 1 33000 33,000

Cavicur Tab 10 10 2000 20,000
TOTAL
27 Tn. Edo 6/21/2016 Lapibal Inj 1 1 37500 37,500

Sp 3 cc 2 2 4000 8,000
TOTAL
28 Ny. Kalimah 6/22/2016 Captopril tab 50 mg 10 10 297 2,970

Glibenclamid 5 mg Tab 20 20 808 16,160
Cameloc Tab 7,5 mg 10 10 2113 21,130
TOTAL
29 An. April 6/22/2016 Acitral Syr 1 1 33200 33,200

Kertas Puyer 9 9 100 900
TOTAL
30 An. April 6/22/2016 Mucera Syr 1 1 22500 22,500

TOTAL
31 Tn. Markus 6/22/2016 Flamar 50 mg Tab 10 10 2458 24,580

Flamar Gel 1 1 21571 21,571
Mp 8 mg Tab 10 10 928 9,280
TOTAL
32 Tn. Suminto 6/22/2016 Pct Tab 10 10 138 1,380

Braxidin tab 10 10 1166 11,660
TOTAL
33 Ny. Habibah 6/22/2016 Domperidon Tab 10 10 596 5,960

Mertigo Tab 10 10 4306 43,060
Dilavask Tab 10 mg 10 10 1577 15,770
TOTAL
34 Ny. Sunarsi 6/22/2016 Amlodipin Tab 10 mg 10 10 2465 24,650

TOTAL
35 An. Asita 6/22/2016 Apialys Drop 1 1 40000 40,000

TOTAL
36 Tn. P Kamar 6/20/2016 inf Rl 2 2 11600 23,200

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Ondan 4 mg Inj 3 3 7300 21,900
Sp 3 cc 2 2 2000 4,000
sp 1 cc 1 1 3000 3,000
Sanmagh Syr 1 1 33000 33,000
SUB TOTAL 126,900
6/21/2016 Ketorolac Inj 2 2 21863 43,726

SUB TOTAL 43,726
6/21/2016 Sp 3 cc 1 1 1895 1,895
Inf Ns 3 3 7721 23,163
Sanmagh Tab 10 10 1020 10,200
Celebrex Tab 3 3 17693 53,079
SUB TOTAL 97,870
6/22/2016 Eperison Tab 7 7 2041 14,287

Celebrex Tab 2 2 17693 35,386
SUB TOTAL 49,673
TOTAL
37 By. Azam 6/22/2016 Inf Set Mikro 1 1 10203 10,203

Venflon 26 6 6 51013 306,078
O2 50 50 250 12,500
TOTAL
38 An. Suci 6/22/2016 Domperidon Syr 1 1 7420 7,420

Cefadroxyl Syr 1 1 13037 13,037
Cefadroxyl Capsul 3 3 981 2,943
Ramadryl Syr 1 1 11400 11,400
TOTAL
39 dr. Adi 6/23/2016 Flamicort Inj 1 1 109180 109,180

Sp 1 cc 3 3 2849 8,547
TOTAL
40 Tn. Kamari 6/23/2016 Celebrex 1 1 17693 17,693

Megabal Tab 1 1 2186 2,186
TOTAL
41 An. Hanifah 6/23/2016 Domperidon Syr 1 1 7420 7,420
Acitral Syr 1 1 33200 33,200
Ottopan Syr 1 1 3231 3,231
Clamixin Syr 1 1 65907 65,907
Scopamin Tab 5 5 2551 12,755
TOTAL
42 Ny. Sari 6/23/2016 Folavit Tab 10 10 928 9,280

TOTAL
43 Nn. Septi 6/22/2016 NS Inf 0,9 % 2 2 7721 15,442

Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Ondan 8 mg Inj 2 2 11660 23,320
Buscopan Inj 2 1 1 27825 27,825
Sp 3 cc 1 1 1895 1,895
Pumpitor Inj 1 1 99800 99,800
Sp 5 cc 1 1 2478 2,478
Sp 10 cc 1 1 3286 3,286
SUB TOTAL 207,832
6/22/2016 Inf Rl 3 3 8700 26,100

Sp 3 cc 1 1 1895 1,895
Molagit Tab 10 10 636 6,360
Imodiat Tab 8 8 100 800
Braxidin Tab 10 10 1166 11,660
SUB TOTAL 54,307
6/23/2016 Inf Rl 1 1 8700 8,700

Ondan 8 mg Inj 1 1 11660 11,660
Spasmal Tab 10 10 600 6,000
SUB TOTAL 36,396
6/24/2016 Ranitidin Tab 10 10 321 3,210

Sanmagh Syr 1 1 32940 32,940
SUB TOTAL 45,926
TOTAL
44 Tn. M Arshad 6/22/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 19686 19,686
Inf Ns 3 3 7721 23,163
Ondan 8 mg Inj 1 1 11660 11,660
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
Celebrex Tab 1 1 17693 17,693
Sanmag Tab 3 3 1020 3,060
SUB TOTAL 97,727
6/23/2016 Inf Ns 2 2 7721 15,442

Ondan 8 mg Inj 1 1 11660 11,660
Celebrex Tab 1 1 17693 17,693
Sanmagh Tab 3 3 1020 3,060
SUB TOTAL 55,347
6/24/2016 Inf ns 3 3 0 7721 -

Ondan 4 mg Inj 2 2 0 7288 -
Celebrex Tab 1 1 17693 17,693
Sanmagh Tab 3 2 1 1020 1,020
SUB TOTAL 18,713
TOTAL
45 Nn. Marlya 6/24/2016 Handscon M 1 1 55000 55,000

Handscon Steril 3 3 8348 25,044
Masker Tali 1 1 35000 35,000
Urin Bag 1 1 7288 7,288
Folley Cateter 18 1 1 20405 20,405
TOTAL
46 By. Beatus 6/24/2016 Combivent Nebu 1 1 17490 17,490

TOTAL
47 Tn. Hairun 6/24/2016 Lidocain Inj 1 1 2186 2,186

Sp 3 cc 1 1 1895 1,895
TOTAL
48 An. Kevin 6/24/2016 Cefadroxyl Syr 1 1 13037 13,037

TOTAL
49 Ny. Tina 6/24/2016 Mertigo Tab 10 10 4306 43,060

Pct Tab 10 10 1380 13,800
TOTAL
50 Tn. Sutiyo 6/25/2016 Lisinopril Tab 20 20 994 19,880

Myores Tab 6 6 6029 36,174
TOTAL
51 An. Ferdi 6/25/2016 Ventolin Nebu 1 1 12476 12,476

Fartolin Tab 5 5 1265 6,325
TOTAL
52 An. Faizal 6/23/2016 Inf Set makro 1 1 10600 10,600

Inf Rl 2 2 8700 17,400
Inf D5 1/4 Ns 2 2 19941 39,882
Venflon 22 1 1 23186 23,186
Pct Tab 6 6 138 828
Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
Inj Cortidex 1 1 7500 7,500
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 143,241
6/24/2016 Inf Rl 1 1 8700 8,700

SUB TOTAL 42,620
TOTAL
53 An. Arga 6/25/2016 Clamixin Syr 1 1 65907 66,250

Remco Syr 1 1 6267 6,267
Opinacea Syr 1 1 65907 66,250
TOTAL
54 Ny. Masnun 6/19/2016 Aquadest Inj 1 1 3312 3,312

Bioxan Inj 2 2 243854 487,708
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Tramadol inj 2 2 12521 25,042
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 2 2 1895 3,790
Sp 1 cc 1 1 2849 2,849
Coditam tab 10 10 4810 48,100
SUB TOTAL 631,320
6/19/2016 Ondan 8 mG inj 1 1 11700 11,700

Terfacef Inj 1 1 128300 128,300
Sp 5 cc 1 1 2500 2,500
SUB TOTAL 142,500
6/19/2016 Ondan 4 mg Inj 1 1 7300 7,300

SUB TOTAL 7,300
6/20/2016 Ondan 8 mg Inj 1 1 11660 11,660

Valsanbe Tab 3 3 364 1,092
Inf Ns 3 3 7721 23,163
SUB TOTAL 35,915
6/20/2016 Tramadol Inj 3 3 12521 37,563

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 39,458
6/21/2016 Ceftriaxon Inj 2 2 24778 49,556
Ondan 8 mg Inj 2 2 11660 23,320
Coditam Tab 7 7 4810 33,670
Inf Ns 2 2 7721 15,442
SUB TOTAL 122,716
6/21/2016 Valisanbe Tab 45 mg 1 1 309 309

Sp 3 cc 1 1 1609 1,609
SUB TOTAL 1,918
6/22/2016 Ceftriaxon Inj 2 2 24778 49,556

Ondan 8 mg Inj 1 1 11660 11,660
Tramadol Inj 2 2 12251 24,502
SUB TOTAL 85,718
6/22/2016 Venflon 22 2 2 23186 46,372

SUB TOTAL 46,372
6/23/2016 Inf Ns 3 3 7721 23,163

SUB TOTAL 76,395
6/23/2016 Myores Tab 2 2 6029 12,058

SUB TOTAL 12,058
5/24/2016 Inf Ns 3 3 0 7721 -

Ondan 8 mg inj 1 1 0 11660 -
Valisanbe tab 5 mg 2 2 0 364 -
Coditam Tab 3 2 1 4810 4,810
Myores Tab 3 2 1 6029 6,029
Tramadol Inj 3 2 1 12521 12,521
SUB TOTAL 76,228
6/25/2016 Ranitidin Inj 2 2 3746 7,492

Tramadol Inj 2 2 12521 25,042
Valisanbe Tab 2 1 1 364 364
Coditam Tab 2 2 4810 9,620
SUB TOTAL 95,386
TOTAL
55 Ny. Yohana 6/25/2016 Biotichol Tab 30 30 3382 101,460

Sistenol Tab 10 10 2041 20,410
TOTAL
56 Ny. Dayang 6/24/2016 Inf Ns 5 5 7721 38,605

Odan 8 mg Inj 2 1 1 11660 11,660
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 63,547
6/25/2016 Sanmagh Tab 10 10 1020 10,200

Tensinop Tab 5 5 5300 26,500
SUB TOTAL 36,700
TOTAL
57 An. Mutia 6/25/2016 Remco Syr 1 1 6267 6,267
Ramoxyl Syr 1 1 14376 14,376
Opinacea Syr 1 1 65907 65,907
TOTAL
58 Ny. Nonong 6/24/2016 Folaxin Tab 10 10 928 9,280

Inf Ns 3 3 7721 23,163
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Piralen Inj 3 3 9227 27,681
Sanmagh Tab 10 10 1020 10,200
Sp 3 cc 2 2 1895 3,790
SUB TOTAL 115,392
6/24/2016 Pumpitor Inj 1 1 99800 99,800

Sp 10 cc 1 1 3286 3,286
Inf Ns 1 1 7721 7,721
Piralen Inj 1 1 9227 9,227
SUB TOTAL 120,034
6/25/2016 Transfusi Set 1 1 30608 30,608

Pumpitor Inj 1 1 99800 99,800
SUB TOTAL 130,408
6/25/2016 Noflam Tab 10 10 5101 51,010

SUB TOTAL 51,010
TOTAL
59 Ny. Yuliana 6/25/2016 Sanmagh Tab 10 10 1020 10,200

Spasmal Tab 10 10 600 6,000
TOTAL
60 Tn. Hendro 6/25/2016 Neurosanbe Inj 1 1 6493 6,493

Sp 3 cc 1 1 1895 1,895
TOTAL
61 Tn. Miftahul 6/26/2016 Calortusin Tab 10 10 520 5,200

Tramenza Tab 10 10 1530 15,300
TOTAL
62 Tn. Astadino 6/20/2016 Inf Rl 2 2 11600 23,200

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23200 23,200
Sp 10 cc 1 1 3500 3,500
Sp 5 cc 1 1 2500 2,500
Sp 3 cc 1 1 2000 2,000
Citicolin Inj 4 4 39800 159,200
SUB TOTAL 246,100
6/21/2016 Ketorolac Inj 2 1 1 21863 21,863

Citicolin Inj 2 2 39750 79,500
Inf Ns 3 3 7721 23,163
SUB TOTAL 124,526
6/21/2016 Ranitidin Inj 2 2 3746 7,492

Sp 3 cc 2 2 1895 3,790
SUB TOTAL 11,282
6/22/2016 Citicolin Inj 250 mg 6 6 39750 238,500

SUB TOTAL 238,500
6/22/2016 Ventolin Nebu 2 2 15000 30,000

Sp 3 cc 3 3 1895 5,685
SUB TOTAL 35,685
6/22/2016 Citicolin Inj 2 2 39750 79,500

SUB TOTAL 86,992
6/23/2016 Inf Rl 3 3 8700 26,100

SUB TOTAL 33,592
6/24/2016 Citicolin Inj 250 Mg 2 2 39750 79,500

SUB TOTAL 79,500
6/24/2016 Inf Rl 3 3 8700 26,100

SUB TOTAL 33,592
6/25/2016 Ranitidin Inj 2 2 3746 7,492

Amlodipin Tab 10 mg 5 5 2465 12,325
SUB TOTAL 19,817
TOTAL
63 By. Adiba 6/26/2016 Ventolin Nebu 1 1 12476 12,476

Sanmol Drop 1 1 20551 20,551
TOTAL
64 An. Faizal 6/26/2016 Tiamfilex Tab 30 30 1455 43,650

Sistenol Tab 8 8 2041 16,328
TOTAL
65 Tn. Slamet 6/26/2016 Pct Tab 10 10 138 1,380

Mersibion Tab 10 10 5016 50,160
TOTAL
66 Tn. Eka 6/26/2016 Calortusin tab 10 10 520 5,200

Cortusin tab 10 10 364 3,640
TOTAL
67 Tn. Sobikun 6/26/2016 Pct Tab 15 15 138 2,070

Noervom Tab 10 10 278 2,780
TOTAL
68 Nn. Lili 6/26/2016 Asam Mefenamat Tab 10 10 318 3,180

Cortidex Tab 10 10 364 3,640
TOTAL
69 By. Aditya 6/26/2016 Ventolin Nebu 1 1 12476 12,476

Cefixime Syr 1 1 42201 42,201
Sp 3 cc 1 1 1895 1,895
TOTAL
70 dr. Daniel 6/27/2016 Recodryl Inj 1 1 9275 9,275

Sp 1 cc 2 2 2849 5,698
Sp 3 cc 2 2 1895 3,790
TOTAL
71 Tn. Nofriandi 6/27/2016 Lansoprazol Tab 10 10 1855 18,550

Sanmagh Tab 10 10 1020 10,200
TOTAL
72 Tn. Mulyana 6/27/2016 Mesol Tab 8 mg 10 10 5472 54,720

TOTAL
73 Ny. Siti 6/27/2016 Dulcolac Tab 5 5 1391 6,955

TOTAL
74 Ny. Mariani 6/24/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Ketorolac Inj 6 6 21863 131,178
Buscopan Inj 2 2 27825 55,650
Sp 3 cc 3 3 1895 5,685
O2 50 50 250 12,500
SUB TOTAL 269,984
6/25/2016 Inf Ns 2 2 7721 15,442

Ranitidn Inj 2 2 3746 7,492
Buscopan Inj 3 3 27825 83,475
SUB TOTAL 194,391
6/26/2016 Ranitidin Inj 2 2 3746 7,492

Buscopan Inj 2 2 27825 55,650
Inf Ns 2 2 7721 15,442
Metformin Tab 500 mg 5 5 265 1,325
SUB TOTAL 79,909
6/27/2016 Inf Ns 2 2 6409 12,818
Ketorolac Inj 2 2 0 18563 -
Sp 3 cc 2 2 1609 3,218
SUB TOTAL 16,036
6/27/2016 Lansoprazol Tab 10 10 1855 18,550

Nadik 50 mg Tab 10 10 685 6,850
Metformin 500 mg tab 17 17 265 4,505
SUB TOTAL 35,905
TOTAL
75 An. Yunda Ayu 6/27/2016 Cefadroxyl Tab 5 5 981 4,905

TOTAL
76 Tn. Teguh 6/27/2016 Flamar Gel 1 1 21571 21,571

Mesol Tab 8 mg 10 10 5472 54,720
Captopril Tab 12,5 mg 10 10 133 1,330
TOTAL
77 Tn. Syahrul 6/27/2016 Clindamycin tab 10 10 996 9,960

Celebrex tab 6 6 17693 106,158
TOTAL
78 Tn. Lim Kun 6/27/2016 Valdix Tab 80 mg 10 10 8016 80,160

Letonal Tab 25 mg 10 10 1484 14,840
O2 25 25 250 6,250
Nasal Canul 1 1 14575 14,575
TOTAL
79 Ny. Lidya 6/27/2016 Lisinopril Tab 10 10 994 9,940
Spasmal Tab 10 10 600 6,000
Molagit Tab 10 10 636 6,360
Vomitraz Tab 4 mg 10 10 1458 14,580
TOTAL
80 An. Siti 6/27/2016 Ondan 4 mg Inj 1 1 7288 7,288

Sp 3 cc 1 1 1895 1,895
Pct Tab 5 5 138 690
TOTAL
81 Tn. Sukarli 6/27/2016 Domperidon Tab 10 10 600 6,000

Mertigo Tab 6 mg 10 10 4400 44,000
Sistenol Tab 10 10 2100 21,000
TOTAL
82 Ny. Rendita 6/27/2016 Tramenza Tab 20 20 1550 31,000

Celebrex Tab 2 2 17700 35,400
TOTAL
83 An. Rivi 6/27/2016 Mecodiar Tab 5 5 1000 5,000

Molagit Tab 10 10 650 6,500
Oralit Bungkus 5 5 1000 5,000
TOTAL
84 An. Delsa 6/28/2016 Apialys Drop 1 1 41700 41,700

TOTAL
85 Tn. Markus 6/28/2016 Cefadroxil Tab 10 10 981 9,810
Flamar 50 mg Tab 10 10 685 6,850
Mp 16 mg Tab 8 8 1391 11,128
TOTAL
86 Nn. Kiki 6/28/2016 Acylovir Zalf 6 6 3611 21,666

TOTAL
87 Tn. Topan 6/28/2016 Mertigo Sr 10 10 6029 60,290

Cymalium Tab 10 10 1802 18,020
Sanmagh Tab 10 10 1020 10,200
Ondan 4 mg Inj 2 1 1 7288 7,288
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Inf RL 2 2 8700 17,400
TOTAL
88 Nn. Nova 6/28/2016 Cefadroxyl Syr 1 1 13037 13,037

Pct Syr 1 1 3231 3,231
TOTAL
89 Ny. Hatniah 6/26/2016 Inf Set makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Ondan 4 mg Inj 2 2 7288 14,576
Sp 5 cc 2 2 2478 4,956
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Pct Tab 5 5 138 690
Imodiat 10 10 159 1,590
SUB TOTAL 143,865
6/27/2016 Ranitidin Inj 2 2 3746 7,492

Ondan 4 mg Inj 2 2 7288 14,576
Pct Tab 1 1 138 138
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 29,891
6/28/2016 Inf Ns 3 3 0 7721 -

ranitidin Inj 2 2 0 3746 -
Ondan 4 mg Inj 2 2 0 7288 -
Pct Tab 3 3 138 414
SUB TOTAL 8,067
6/28/2016 Cefadroxil Tab 4 4 981 3,924

SUB TOTAL 13,812
TOTAL
90 Nn. Mardiana 6/28/2016 Ranitidin Tab 10 10 321 3,210

Sanmagh Tab 10 10 1020 10,200
Spasmal Tab 10 10 600 6,000
Metronidazol Tab 500 mg 10 10 250 2,500
TOTAL
91 Tn. Dedi 6/24/2016 Venflon 20 2 2 23186 46,372

Inf Set Makro 1 1 10600 10,600
Inf Rl 3 3 8700 26,100
Ondan 4 mg Inj 2 2 7288 14,576
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1609 1,609
Sistenol Tab 5 5 2041 10,205
Celebrex Tab 1 1 17693 17,693
SUB TOTAL 137,125
6/25/2016 Inf Rl 2 2 8700 17,400

Ondan 4 mg Inj 4 4 7288 29,152
Sistenol Tab 5 5 2041 10,205
Sanmagh Tab 10 10 1020 10,200
SUB TOTAL 74,449
6/26/2016 Nadic Tab 5 5 685 3,425

Clanexi Tab 10 10 15887 158,870
Ondan 4 mg Inj 4 4 7288 29,152
Inf Rl 2 2 8700 17,400
SUB TOTAL 216,339
6/27/2016 Venflon 22 1 1 23186 23,186

SUB TOTAL 23,186
6/27/2016 Inf Ns 2 2 7721 15,442
Dexa Inj 2 2 0 3177 -
Sp 3 cc 1 1 1895 1,895
Novaldo Inj 2 1 1 16695 16,695
Sp 5 cc 1 1 2478 2,478
Ondan 4 mg Inj 4 1 3 7288 21,864
Sistenol Tab 10 10 2041 20,410
SUB TOTAL 82,530
6/28/2016 Domperidon tab 10 10 596 5,960

Sanmagh Tab 5 5 1020 5,100
Clanexi Tab 3 3 15887 47,661
Nadik 50 mg Tab 3 3 687 2,061
Cortidex Tab 1 1 364 364
Kapsul 6 6 500 3,000
SUB TOTAL 64,146
TOTAL
92 Ny. Novi 6/28/2016 Tramenza Tab 10 10 1530 15,300

Ramaflu tab 10 10 450 4,500
TOTAL
93 Tn. Turis 6/28/2016 Urotractin Tab 10 10 8599 85,990

Spasmal Tab 12 12 600 7,200
TOTAL
TOTAL
Sintang, Juli 2016

Rp. Rp. Rp.
1 Ny. Habibah 6/25/2016 Venflon 20 1 1 23186 23,186

Inf Set Makro 1 1 10600 10,600
Inf Ns 1 1 7721 7,721
Ondan 4 mg Inj 2 2 7288 14,576
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
Sanmagh Tab 3 3 1020 3,060
Glukosamin + 30 30 2120 63,600
Tensinop Tab 10 mg 10 10 5300 53,000
SUB TOTAL 187,608
6/26/2016 Inf Ns 1 1 7721 7,721

Ondan 8 mg Inj 1 1 11660 11,660
Sanmagh Tab 2 2 1020 2,040
Celebrex Tab 1 1 17693 17,693
Mertigo Sr 5 5 6029 30,145
SUB TOTAL 76,751
6/27/2016 Piracetam 3 Gr Inj 1 1 18113 18,113

Ondan 4 mg Inj 2 2 7288 14,576
Celebrex Tab 1 1 17693 17,693
Sanmagh Tab 3 3 1020 3,060
SUB TOTAL 60,934
6/28/2016 Piracetam Inj 3 Gr 1 1 18113 18,113

Ondan 4 mg Inj 2 2 7288 14,576
Celebrex Tab 1 1 17693 17,693
Mertigo Sr 1 1 6029 6,029
Sanmagh Tab 3 3 1020 3,060
Venflon 20 1 1 23186 23,186
Venflon 22 1 1 23186 23,186
Inf Ns 1 1 7721 7,721
SUB TOTAL 117,310
6/28/2016 Sp 5 cc 1 1 2478 2,478

Piracetam 3 Gr Inj 1 1 18113 18,113
SUB TOTAL 20,591
6/29/2016 Ranitidin Tab 10 10 321 3,210

Celebrex Caps 5 5 17693 88,465
Mertigo Sr 5 5 6029 30,145
Sanmagh Tab 10 10 1020 10,200
Ketoprofen Amp 1 1 7553 7,553
SUB TOTAL 143,149
TOTAL
2 Ny. Romy 6/29/2016 Valesco Tab 80 mg 20 20 11660 233,200

Simvastatin Tab 10 mg 20 20 749 14,980
Tramed Tab 50 mg 10 10 2511 25,110
TOTAL
3 Ny. Kuswati 6/29/2016 Glibenclamid Tab 20 20 808 16,160

Acarbose Tab 20 20 1206 24,120
Simvastatin Tab 10 mg 30 30 749 22,470
TOTAL
4 Tn. Lukas 6/29/2016 Amoxicilin Tab 10 10 464 4,640

Tramed Tab 50 mg 10 10 2511 25,110
TOTAL
5 Ny. Eva 6/29/2016 Inf RL 2 2 8700 17,400
Ondan 4 mg Inj 4 4 7288 29,152
Pumpitor Inj 2 1 1 99800 99,800
Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Sp 3 cc 1 1 1895 1,895
Sp 5 cc 1 1 2478 2,478
Sanmagh Syr 1 1 32940 32,940
Pct Tab 10 10 138 1,380
Terfacef Inj 2 2 128248 256,496
Sp 10 cc 1 1 3286 3,286
O2 50 50 250 12,500
SUB TOTAL 509,000
6/29/2016 Nasal Canul 1 1 14575 14,575

Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Stesolid 10 mg 1 1 31482 31,482
Ngt 18 1 1 25043 25,043
Inf RL 1 1 11600 11,600
SUB TOTAL 116,486
6/29/2016 Buscopan Inj 1 1 27825 27,825

Pumpicel Inj 2 2 99800 199,600
Inf NS 3 2 1 7721 7,721
Sp 10 cc 1 1 3286 3,286
Braxidin Tab 10 10 1166 11,660
Sp 3 cc 1 1 1895 1,895
Novo Twist 5 5 3061 15,305
SUB TOTAL 273,916
6/29/2016 Ceftriaxon Inj 2 2 11925 23,850

Ondan 4 mg Inj 2 2 7288 14,576
Inf Set Makro 1 1 10600 10,600
Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
Inf Rl 2 2 8700 17,400
SUB TOTAL 72,561
6/29/2016 O2 2000 2000 250 500,000

SUB TOTAL 500,000
TOTAL
6 Tn. Hairil 6/29/2016 Amoxicilin Tab 10 10 464 4,640

Nadik 50 mg Tab 5 5 685 3,425
Cinolon N Zalf 1 1 23612 23,612
TOTAL
7 Ny. Kartina 6/29/2016 Cefadroxyl Tab 10 10 981 9,810

Nadik 50 mg Tab 5 5 685 3,425
Mp 16 mg Tab 4 4 1391 5,564
TOTAL
8 Tn. Emperiang 6/29/2016 Dilavask Tab 5 mg 10 10 2319 23,190

TOTAL
9 An. Wulan 6/30/2016 Oroprofen Syr 1 1 15400 15,400

Apialys Syr 1 1 33125 33,125
Remco Syr 1 1 6267 6,267
TOTAL
10 An. Fatir 6/26/2016 Inf RL 2 2 8700 17,400
Inf Set Makro 1 1 10600 10,600
Venflon 24 2 2 26235 52,470
Ondan 4 mg Inj 3 3 7288 21,864
Pct Tab 5 5 138 690
Zinc Tab 10 10 557 5,570
Venflon 22 1 1 23186 23,186
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 133,675
6/26/2016 L- Bio Sach 5 5 9275 46,375

Pct Syr 1 1 3231 3,231
SUB TOTAL 49,606
6/27/2016 Inf Rl 2 2 8700 17,400

Ondan 4 mg Inj 2 2 7288 14,576
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 33,871
6/28/2016 Ondan 4 mg Inj 2 2 7288 14,576

Inf RL 2 2 8700 17,400
SUB TOTAL 31,976
6/29/2016 Inf RL 2 2 8700 17,400

Ondan 4 mg Inj 2 2 7288 14,576
Pct Syr 1 1 3231 3,231
SUB TOTAL 35,207
TOTAL
11 Ny. Sumini 6/30/2016 Cefadroxyl Tab 10 10 981 9,810

Nadik 50 mg Tab 10 10 685 6,850
TOTAL
12 Tn. Tumar 6/30/2016 Bicnat Tab 20 20 300 6,000

Kalnex Tab 15 15 2785 41,775
Spasmal Tab 15 15 600 9,000
TOTAL
13 Tn. Antonius 6/30/2016 Simvastatin Tab 20 20 749 14,980

Allupurinol Tab 10 10 928 9,280
TOTAL
14 By. Pridikta 6/29/2016 Sp 10 cc 1 1 3286 3,286

D5 1/4 NS 1 1 19941 19,941
TOTAL
15 By. Ny Susana 6/28/2016 Inf D5 % 1 1 7619 7,619

Venflon 26 2 2 51013 102,026
Terfacef Inj 1 1 128248 128,248
Sp 1 cc 1 1 2849 2,849
Sp 10 cc 1 1 3286 3,286
SUB TOTAL 247,340
6/29/2016 Ceftriaxon Inj 1 1 11925 11,925

Dexa Inj 1 1 3975 3,975
Inf D5 % 2 2 7619 15,238
SUB TOTAL 31,138
6/30/2016 Ceftriaxon Inj 1 1 11925 11,925

Dexa Inj 1 1 3975 3,975
Inf D5% 1 1 7619 7,619
SUB TOTAL 23,519
TOTAL
16 Tn. Maselinus 6/30/2016 Lansoprazol Tab 10 10 1855 18,550

Sanmagh Syr 1 1 32940 32,940
TOTAL
17 An. Arsaka 6/30/2016 Salbutamol Tab 2 mg 2 2 133 266

Ambroxol Tab 2 2 437 874
Kertas Puyer 10 10 200 2,000
Topcort Zalf 1 1 29442 29,442
Sp 3 cc 1 1 1895 1,895
TOTAL
18 An. Marvin 7/1/2016 Cefixime Tab 4 4 2968 11,872

Apialys Syr 1 1 33125 33,125
TOTAL
19 An. Sakinah 6/29/2016 Ceftriaxon Inj 1 1 24778 24,778

SUB TOTAL 28,090
6/29/2016 Venflon 26 2 2 51013 102,026

Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
SUB TOTAL 108,161
6/30/2016 Ceftriaxon Inj 2 2 11925 23,850
Dexa Inj 1 1 3975 3,975
Inf D5 % 1 1 7619 7,619
SUB TOTAL 35,444
TOTAL
20 Ny. Tuminah 6/29/2016 Inf Ns 2 2 7721 15,442

Pumpicel Inj 1 1 99800 99,800
Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23186 23,186
Sp 5 cc 1 1 2478 2,478
Domperidon Tab 10 5 5 596 2,980
Sanmagh Syr 1 1 32940 32,940
SUB TOTAL 195,378
6/30/2016 Buscopan Inj 3 3 22578 67,734

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 69,629
7/1/2016 Pumpicel Inj 1 1 0 99800 -

Sanmagh Tab 3 2 1 1020 1,020
Inf Ns 2 2 7721 15,442
SUB TOTAL 16,462
7/1/2016 Lansoprazole Tab 10 10 1855 18,550

Scopamin Tab 10 10 2226 22,260
Sanmagh Tab 10 10 1020 10,200
SUB TOTAL 52,830
TOTAL
21 An. Alvin 7/1/2016 Ranitidin Tab 4 4 321 1,284

Vometraz Tab 3 3 1458 4,374
Kertas Puyer 10 10 200 2,000
Sanmol Drop 1 1 20551 20,551
TOTAL
22 Tn. Jab An 6/30/2016 Coditam Tab 3 3 4810 14,430

Inf Set Makro 1 1 10600 10,600
Venflon 20 1 1 23188 23,188
Inf Ns 1 1 7721 7,721
Nasal Canul 1 1 14575 14,575
Sp 3 cc 1 1 1895 1,895
O2 50 50 250 12,500
SUB TOTAL 132,029
7/1/2016 Ranitidin Inj 2 2 3746 7,492

Coditam Tab 3 3 4810 14,430
Inf NS 2 2 7721 15,442
SUB TOTAL 62,316
TOTAL
23 Ny. Hana 7/1/2016 Cefadroxyl Tab 10 10 981 9,810

Nadik 50 mg Tab 10 10 685 6,850
TOTAL
24 Tn. Rudini 7/1/2016 Asam Mefenamat Tab 10 10 400 4,000
Cefadroxyl Tab 10 10 981 9,810
TOTAL
25 Tn. Maulana 7/1/2016 Ciprofloxacin Tab 10 10 627 6,270

Thramed Tab 10 10 2511 25,110
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
TOTAL
26 Tn. Rodi 7/1/2016 Ciprofloxacin Tab 10 10 627 6,270

Thiamfilex Tab 10 10 1455 14,550
TOTAL
27 Tn. Timotius Adi 7/1/2016 Lansoprazol Tab 10 10 1855 18,550

Sanmagh Syr 1 1 32940 32,940
TOTAL
28 An. Risya 6/29/2016 Venflon 26 2 2 51013 102,026

Venflon 24 1 1 26235 26,235
Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
SUB TOTAL 149,633
6/30/2016 Inf D5 % 2 2 8312 16,624

Sp 10 cc 1 1 3286 3,286
SUB TOTAL 19,910
7/1/2016 Inf D5 % 1 1 8312 8,312
Dexa Inj 2 2 7500 15,000
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 58,332
TOTAL
29 Tn. Suntaro 7/2/2016 Dohixat Tab 10 10 947 9,470

TOTAL
30 Tn. Sukanto 7/2/2016 Cefadroxil Tab 10 10 981 9,810

Bronkipect Tab 10 10 602 6,020
Tramenza Tab 10 10 1530 15,300
TOTAL
31 Ny. Sumidah 7/2/2016 Lansoprazol Tab 10 10 1855 18,550

Sanmagh Tab 10 10 1020 10,200
TOTAL
32 Tn. H Minun 7/1/2016 Inf D10 % 1 1 18550 18,550

Inf D5 % 1 1 8312 8,312
Pumpitor Inj 1 1 99800 99,800
Venflon 20 1 1 23188 23,188
Inf Set Makro 1 1 10600 10,600
Neurobion Inj 1 1 10600 10,600
Sp 10 cc 1 1 3286 3,286
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 176,231
7/1/2016 Neurobion Inj 2 1 1 6493 6,493

SUB TOTAL 6,493
7/1/2016 Ondan 4 mg Inj 2 2 7288 14,576

Sp 5 cc 1 1 2478 2,478
SUB TOTAL 17,054
7/1/2016 Ceftriaxon Inj 2 2 33125 66,250

Aquadest Inj 2 1 1 3312 3,312
Sp 1 cc 1 1 2849 2,849
Sp 10 cc 1 1 3286 3,286
SUB TOTAL 75,697
7/2/2016 Pumpitor Inj 1 1 0 99800 -

Neurobion Inj 3 3 0 6493 -
Ondan 4 mg Inj 2 2 0 7288 -
Ceftriaxon Inj 2 2 0 24778 -
Aquadest Inj 1 1 0 3312 -
Inf D5 % 3 3 0 8312 -
SUB TOTAL -
7/2/2016 Lansoprazol Tab 10 10 1855 18,550

Harnal Tab 5 5 16960 84,800
SUB TOTAL 103,350
TOTAL
33 Ny. Anisah 7/2/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Rl 1 1 8700 8,700
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 3 3 1895 5,685
Sp 1 cc 2 2 2849 5,698
Ats Inj 1 1 152375 152,375
SUB TOTAL 302,835
7/2/2016 Cefadroxyl Tab 10 10 981 9,810

SUB TOTAL 9,810
TOTAL
34 An. Grace N 7/2/2016 Sp 3 cc 1 1 1895 1,895

Bisolvon Drop 4 4 4638 18,552
TOTAL
35 Tn. Januardi 7/2/2016 Spasmal Tab 10 10 600 6,000

Sanmagh Tab 10 10 1020 10,200
TOTAL
36 Tn. Efrata 7/2/2016 Paracetamol Syr 1 1 6493 6,493

TOTAL
37 Ny. Angela 7/2/2016 Mecodiar Tab 10 10 1256 12,560

Scopamin Tab 10 10 1391 13,910
TOTAL
38 Tn. Sumarto 7/3/2016 Pct Tab 10 10 138 1,380

Mecodiar Tab 10 10 1256 12,560
Nadik 50 mg Tab 5 5 685 3,425
TOTAL
39 Nn. Desy 7/3/2016 Cefadroxyl Tab 10 10 981 9,810
TOTAL
40 An. Kristio Willy 7/3/2016 Otopain TT 1 1 47700 47,700

Amoxicilin Syr 1 1 8745 8,745
TOTAL
41 Tn. Arman 7/3/2016 Cetirizin Tab 10 10 450 4,500

Cortidex Tab 10 10 309 3,090
Mersibion Tab 10 10 5016 50,160
TOTAL
42 Tn. Yosun 7/3/2016 Cetirizin Tab 10 10 530 5,300

Mefinal Tab 10 10 1749 17,490
TOTAL
43 Nn. Lorensia 7/4/2016 Analsik Tab 10 10 1589 15,890

TOTAL
44 Tn. Timotius 7/2/2016 Inf Ns 3 3 7721 23,163

Ondan 4 mg Inj 4 4 7288 29,152
Pumpitor Inj 1 1 99800 99,800
Venflon 22 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Sp 5 cc 2 2 2478 4,956
SUB TOTAL 194,169
7/2/2016 Ondan 4 mg Inj 2 2 7288 14,576
Sanmagh Tab 3 3 1020 3,060
Spasmal Tab 3 3 600 1,800
SUB TOTAL 19,436
7/3/2016 Inf Ns 2 2 7721 15,442

Ondan 4 mg Inj 4 4 7288 29,152
Pumpitor Inj 1 1 99800 99,800
Sanmagh Tab 3 3 1020 3,060
Spasmal Tab 3 3 600 1,800
SUB TOTAL 149,254
7/4/2016 Lansoprazol Tab 10 10 1855 18,550

SUB TOTAL 18,550
TOTAL
45 Tn. Ravail 7/4/2016 Mefinal Tab 10 10 1749 17,490

Dextafen Tab 10 10 1458 14,580
TOTAL
46 An. Zaki 7/4/2016 Venflon 26 1 1 51013 51,013

Sp 1 cc 1 1 1895 1,895
TOTAL
47 Nn. Resti 7/4/2016 Cefixime 100 mg Tab 10 10 2968 29,680

Mefinal Tab 10 10 1749 17,490
Mersibion Tab 10 10 5016 50,160
TOTAL
48 Tn. Khoirul 7/4/2016 Allupurinol Tab 300 10 10 928 9,280

TOTAL
49 Nn. Wasti 7/4/2016 Inf Rl 2 2 8700 17,400
Venflon 22 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Ondan 4 mg Inj 4 4 7288 29,152
Pumpitor Inj 1 1 99800 99,800
Sp 5 cc 2 2 2478 4,956
Sanmagh Syr 1 1 32940 32,940
Pct Tab 10 10 138 1,380
SUB TOTAL 219,414
7/4/2016 Inf Rl 4 4 7500 30,000

Ondan 4 mg Inj 4 4 7288 29,152
RanitidinInj 2 2 3746 7,492
Sp 3 cc 2 2 1609 3,218
Loperamid Tab 10 10 135 1,350
Thiamfilex Tab 10 10 1455 14,550
SUB TOTAL 85,762
TOTAL
50 An. Natanoel 7/5/2016 Apialys Drop 1 1 39750 39,750

Xepa Gel 1 1 182500 182,500
TOTAL
51 An. Resky 7/5/2016 Psidii Syr 1 1 38955 38,955

Inf Set Makro 1 1 10203 10,203
Venflon 24 1 1 26235 26,235
Inf Rl 4 4 8700 34,800
Acitral Syr 1 1 33000 33,000
TOTAL
52 Tn. Paulus 7/5/2016 Inf Ns 1 1 6409 6,409

Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10203 10,203
Adalat Oros 30 1 1 8629 8,629
TOTAL
53 An. Rosi 7/5/2016 Venflon 22 1 1 23186 23,186

Inf RL 3 3 8700 26,100
Inf Set Makro 1 1 10203 10,203
TOTAL
54 Tn. Dehar 7/5/2016 Bisturi 2 2 5000 10,000

Benang 1 1 10000 10,000
Lidocain Inj 9 9 2186 19,674
TOTAL
55 An. Falentino 7/5/2016 Sanmol Drop 1 1 17449 17,449

Kertas Puyer 10 10 250 2,500
TOTAL
56 An. Nadita 7/5/2016 Remco Syr 1 1 10000 10,000

Provinas Tab 4 4 464 1,856
Mp 16 mg Tab 2 2 1391 2,782
Kertas Puyer 20 20 200 4,000
TOTAL
57 An. Gibran 7/5/2016 Remco Syr 1 1 10000 10,000

TOTAL
58 Tn. Edo 7/5/2016 Cetirizin Tab 10 10 530 5,300

Cortison Acetat 1 1 25506 25,506
Sp 3 cc 2 2 1895 3,790
TOTAL
59 An. Erwin 7/6/2016 Mp 16 mg Tab 5 5 1391 6,955

Nadik 25 mg Tab 5 5 685 3,425
TOTAL
60 Tn. Azuardi 7/6/2016 Mefinal Tab 1 1 1749 1,749

TOTAL
61 An. Raffa 7/6/2016 Acylovir Zalf 20 20 649 12,980

Nyndia Drop 1 1 51304 51,304
TOTAL
62 An. Kinar 7/6/2016 Cefixime Syr 1 1 42201 42,201

Topcort Zalf 1 1 29442 29,442
TOTAL
63 Nn. Ratih 7/6/2016 Cinolon N Zalf 1 1 23612 23,612

Ikamycetin 1 1 10000 10,000
Mefinal Tab 10 10 1749 17,490
Kasa Steril 1 1 10203 10,203
TOTAL
64 Tn. Ahmad 7/6/2016 Amoxicilin Tab 10 10 464 4,640

Ramaflu 10 10 600 6,000
TOTAL
65 An. Uri 7/6/2016 Mefinal Tab 10 10 1749 17,490

Mp 16 mg Tab 5 5 1391 6,955
Opineacea Syr 1 1 66250 66,250
TOTAL
66 Tn. Sekius 7/5/2016 Inf Set Makro 1 1 10203 10,203

Venflon no 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Buscopan Inj 3 3 27825 83,475
Aquiadest Inj 1 1 3312 3,312
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 2 2 1895 3,790
Sp 1 cc 1 1 2849 2,849
SUB TOTAL 226,198
7/6/2016 Buscopan Inj 3 3 27825 83,475

Inf ns 2 2 7721 15,442
Venflon 20 1 1 23186 23,186
Venflon 22 1 1 23186 23,186
SUB TOTAL 152,781
7/6/2016 Simvastatin Tab 10 10 749 7,490

SUB TOTAL 7,490
TOTAL
67 Tn. Simon 7/6/2016 Lafidryl Syr 1 1 5172 5,172

Mefinal Tab 10 10 1749 17,490
Mp 16 mg Tab 5 5 1391 6,955
TOTAL
68 Ny. Musinah 7/6/2016 Inf Ns 2 2 7721 15,442

Venflon 20 1 1 23186 23,186
Inj Ceftriaxon 2 2 33125 66,250
Ondan 4 mg Inj 3 3 7288 21,864
Pct Tab 10 10 138 1,380
Inf Set Makro 1 1 10600 10,600
Sp 3 cc 2 2 1895 3,790
Sp 1 cc 1 1 2849 2,849
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 158,643
7/7/2016 Ranitidin Inj 2 2 3746 7,492

Ondan 4 mg Inj 2 2 7288 14,576
Inf Ns 1 1 7721 7,721
Sp 3 cc 2 2 1895 3,790
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 105,619
TOTAL
69 Tn. Samsudin 7/6/2016 Inf Rl 2 2 8700 17,400

Sp 1 cc 1 1 2849 2,849
Sp 5 cc 1 1 2478 2,478
Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Pumpicel Inj 1 1 99800 99,800
Sanmagh Tab 10 10 1020 10,200
SUB TOTAL 169,825
7/7/2016 Pumpicel Inj 1 1 99800 99,800

Ondan 4 mg Inj 2 2 7288 14,576
Sanmagh Tab 3 3 1020 3,060
Sp 5 cc 2 2 2478 4,956
Inf RL 3 3 8700 26,100
SUB TOTAL 148,492
TOTAL
70 An. Izamsyah 7/7/2016 Sanmol Drop 1 1 20551 20,551

Cefixime 5 5 2968 14,840
Ikamicetin 1 1 8000 8,000
TOTAL
71 Tn. Simpiang 7/7/2016 Penagon 10 10 1749 17,490

Lipitor Tab 20 mg 10 10 19941 199,410
TOTAL
72 Tn. Mujianto 7/7/2016 Lansoprazol Tab 10 10 1855 18,550

Mefinal Tab 10 10 1749 17,490
Zycin Tab 4 4 20306 81,224
TOTAL
73 An. Reisya 7/7/2016 Lafidryl Dmp Syr 1 1 5712 5,712

TOTAL
74 An. Firmus 7/7/2016 Promuxol Drop 1 1 44520 44,520
Pct Tab 3 3 138 414
Ctm Tab 3 3 46 138
Kertas Puyer 10 10 250 2,500
Mucohexin Syr 1 1 19610 19,610
TOTAL
75 Ny. Sunarti 02//07/2016 Inf Rl 4 4 8700 34,800

Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Ondan 4 mg Inj 3 3 7288 21,864
Sp 3 cc 2 2 1895 3,790
Loperamid Tab 10 10 159 1,590
Spasmal Tab 10 10 600 6,000
SUB TOTAL 109,322
7/3/2016 Ondan 4 mg Inj 2 2 7288 14,576

Pct Tab 5 5 138 690
Inf Rl 3 3 8700 26,100
SUB TOTAL 48,858
7/3/2016 Pumpitor Inj 1 1 99800 99,800

SUB TOTAL 99,800
7/4/2016 Ondan 4 mg Inj 4 4 7288 29,152

Loperamid Tab 5 5 135 675
Molagit Tab 10 10 636 6,360
Sp 5 cc 1 1 2478 2,478
Inf Rl 4 4 7500 30,000
Tranexid Inj 5 5 13913 69,565
SUB TOTAL 151,552
7/5/2016 Disflatyl Tab 5 5 810 4,050

Ondan 4 mg Inj 4 4 7288 29,152
Molagit Tab 10 10 636 6,360
Mecodiar Tab 3 3 0 1800 -
Inf Rl 3 3 8700 26,100
SUB TOTAL 76,160
7/6/2016 Ondan 4 mg Inj 4 4 7288 29,152

Kalnex Inj 3 2 1 13500 13,500
SUB TOTAL 46,150
7/6/2016 Pumpitor Inj 1 1 99800 99,800

Sp 10 cc 1 1 3286 3,286
SUB TOTAL 103,086
7/7/2016 Ondan 4 mg Inj 4 4 0 7288 -

Moolagit Tab 10 8 2 636 1,272
Mecodiar Tab 10 10 0 1500 -
Inf Rl 3 3 0 8700 -
SUB TOTAL 4,868
TOTAL
76 An. Angel 7/7/2016 Cefixime 100 mg Tab 10 10 2968 29,680
Cinolon N Zalf 1 1 23612 23,612
Kasa Steril 1 1 13000 13,000
TOTAL
77 Ny. Sri Pardiawati 7/7/2016 Profinas Tab 15 15 464 6,960

TOTAL
78 Tn. Apryanto 7/8/2016 Mefinal Tab 10 10 1749 17,490

TOTAL
79 Tn. Eko 7/8/2016 Tramenza Tab 10 10 1530 15,300

TOTAL
80 Tn. Benardus 7/8/2016 Mefinal Tab 10 10 1749 17,490

Cinolon N 1 1 23612 23,612
Sp 1 cc 1 1 2849 2,849
O2 50 50 250 12,500
TOTAL
81 Tn. Iskandar 7/8/2016 Psidii Tab 10 10 5300 53,000

Mersibion Tab 10 10 5016 50,160
TOTAL
82 Tn. Azimi 7/8/2016 Cetirizin Tab 10 10 530 5,300

Ketokonazol Zalf 2 2 9692 19,384
Ikamicetin 1 1 8000 8,000
TOTAL
83 Ny. Marlina 7/8/2016 Xepa Gel 1 1 182200 182,200

TOTAL
84 An. Jeni 7/8/2016 Ventolin Nebu 1 1 12476 12,476

Bisolvon 5 5 5000 25,000
Ctm Tab 5 5 46 230
TOTAL
85 By. Dasnhaldi 7/8/2016 Amoxicilin Syr 1 1 8745 8,745

Pamol Drop 1 1 37300 37,300
TOTAL
86 Tn. Bero 7/8/2016 Spironolacton 100 1 1 1460 1,460

Valdix Tab 1 1 8016 8,016
Nasal Canul 1 1 14575 14,575
O2 150 150 250 37,500
Venflon 20 1 1 23186 23,186
TOTAL
87 An. Ami 7/6/2016 Inf Rl 1 1 8700 8,700

Venflon 24 1 1 26235 26,235
Inf Set Makro 1 1 10600 10,600
Sp 1 cc 1 1 2849 2,849
Ondan 4 mg Inj 1 1 11000 11,000
Pct Syr 1 1 5000 5,000
SUB TOTAL 68,130
7/6/2016 L- Bio 2 2 9275 18,550

Zink Kid Syr 1 1 20000 20,000
Oralit 2 2 928 1,856
SUB TOTAL 40,406
7/7/2016 Ranitidin Inj 1 1 3746 3,746

Ondan 4 mg Inj 1 1 7288 7,288
L- Bio 2 2 9275 18,550
Oralit 2 2 928 1,856
Inf Rl 1 1 8700 8,700
Sp 3 cc 2 2 1895 3,790
Sp 1 cc 2 2 2849 5,698
SUB TOTAL 49,628
7/8/2016 D5 1/4 Ns 1 1 17159 17,159

Ampicilin Inj 1 1 24778 24,778
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 47,727
TOTAL
88 Tn. Sanin 7/9/2016 Amoxicilin Tab 10 10 464 4,640

Mefinal Tab 10 10 1749 17,490
Kasa Steril 1 1 10203 10,203
Leukoplast 1 1 6625 6,625
TOTAL
89 Tn. Wansyah 7/9/2016 Sp 10 cc 1 1 3286 3,286

Venflon 18 1 1 24115 24,115
TOTAL
90 An. Rajam 7/9/2016 Pamol Drop 1 1 37300 37,300

Zink Kid Syr 1 1 20000 20,000
Oralit 3 3 928 2,784
L- Bio 6 6 9275 55,650
TOTAL
91 Nn. Nurulia 7/9/2016 Cefadroxyl Caps 10 10 981 9,810

Cortidex Tab 10 10 364 3,640
Syr Mucohexin 1 1 19610 19,610
TOTAL
92 Tn. Andi 7/9/2016 Cateter 18 1 1 20405 20,405

Urine Bag 1 1 7288 7,288
Aquadest 1 1 3312 3,312
Sp 10 cc 1 1 3286 3,286
TOTAL
93 Tn. Nur A 7/9/2016 Trombo Aspilet Tab 10 10 933 9,330

Brainact Tab 10 10 14284 142,840
TOTAL
94 Tn. Edi 7/9/2016 Lansoprazol Tab 5 5 1855 9,275

Scopamin Tab 10 10 2551 25,510
Braxidin Tab 10 10 1166 11,660
TOTAL
95 Ny. Risnaniah 7/9/2016 Mertigo Tab 10 10 4306 43,060

TOTAL
96 Tn. Zainudin 7/9/2016 Pct Tab 10 10 138 1,380

Cavicur Tab 10 10 1577 15,770
TOTAL
97 An. Cika 7/10/2016 Pct Syr 1 1 6493 6,493

Apyalis Syr 1 1 33125 33,125
TOTAL
98 An. Priyo 7/10/2016 Apyalis Drop 1 1 39750 39,750

TOTAL
99 An. Andika 7/10/2016 Zink Kid Syr 1 1 20000 20,000

TOTAL
100 By. Ricardo 7/10/2016 Novax Syr 1 1 25970 25,970

Kertas Puyer 10 10 200 2,000
TOTAL
101 Ny. Dwi Ayu 7/10/2016 Mersibion Tab 10 10 5016 50,160

Coditam Tab 10 10 4810 48,100
TOTAL
102 An. Stenley 7/10/2016 Apyalis Syr 1 1 33125 33,125

Pct Syr 1 1 6493 6,493
TOTAL
103 Ny. Saratul 7/8/2016 Valisanbe Tab 3 3 364 1,092
SUB TOTAL 1,092
7/8/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 23186 23,186
Inf Ns 3 3 7721 23,163
Sp 5 cc 1 1 2478 2,478
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 156,266
7/9/2016 Ranitidin Inj 2 2 3746 7,492

Inf Ns 1 1 7721 7,721
SUB TOTAL 58,939
7/10/2016 Lansoprazol Tab 10 10 1855 18,550

Analsik 10 10 1589 15,890
SUB TOTAL 34,440
7/10/2016 Inf Ns 2 2 7721 15,442

SUB TOTAL 67,388
TOTAL
104 Tn. Filipus 7/10/2016 Cefadroxyl Tab 10 10 981 9,810

Mefinal Tab 10 10 1749 17,490
Mp Tab 10 10 1391 13,910
TOTAL
105 Tn. Potjen 7/10/2016 Inf Ns 1 1 7721 7,721

Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Sp 10 cc 1 1 3286 3,286
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Nasal Canul 1 1 14575 14,575
O2 50 50 250 12,500
TOTAL
106 Ny. Sri P 7/8/2016 Inf Set Makro 1 1 10600 10,600

Venflon 22 1 1 23186 23,186
inf Ns 3 3 7721 23,163
Pct Inf 2 1 1 65588 65,588
Ciprofloxacin Inf 2 2 67708 135,416
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 267,340
7/9/2016 Coditam Tab 5 5 4810 24,050

Sp 3 cc 2 2 1895 3,790
SUB TOTAL 31,586
7/9/2016 Ciprofloxacin Inf 2 2 67708 135,416

SUB TOTAL 135,416
7/9/2016 Inf Set Makro 1 1 10600 10,600
SUB TOTAL 10,600
7/10/2016 Ranitidin Inj 1 1 0 3746 -

Inf Ns 3 3 0 7721 -
SUB TOTAL -
TOTAL
107 Tn. Jero 7/10/2016 Kandystatin Drop 1 1 51476 51,476
108 An. Nita 7/10/2016 Mucohexin Syr 1 1 19610 19,610

Pct Tab 10 10 138 1,380
TOTAL
109 Nn. Icha 7/10/2016 Sufratule 1 1 20405 20,405

TOTAL
110 An. Ahmad 7/10/2016 Amoxicilin Syr 1 1 8745 8,745

Cinolon N Zalf 1 1 23618 23,618
Cetirizine Syr 1 1 16231 16,231
TOTAL
111 Tn. Sudaryo 7/10/2016 Amoxicilin Tab 10 10 464 4,640

Mefinal Tab 10 10 1749 17,490
TOTAL
112 Tn. Martinus 7/10/2016 Cefadroxyl Tab 10 10 981 9,810

Mefinal Tab 10 10 1749 17,490
TOTAL
113 By. Rayyan 7/10/2016 Bisolvon 1 1 15000 15,000
Sp 1 cc 1 1 2849 2,849
TOTAL
114 An. Giovani 7/10/2016 Ramaflu Tab 10 10 500 5,000

Mp 16 mg Tab 5 5 1391 6,955
TOTAL
115 An. Olivia 7/10/2016 Acylovir 200 mg Tab 13 13 649 8,437

Pct Syr 1 1 6493 6,493
Cinolon N 1 1 23612 23,612
TOTAL
116 Ny. Juminem 7/11/2016 Amlodipin Tab 10 10 2464 24,640

TOTAL
117 Ny. Habibah 7/7/2016 Inf Ns 1 1 7721 7,721

Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Ondan 4 mg Inj 4 4 7288 29,152
Pumpitor Inj 1 1 78755 78,755
Sp 10 cc 1 1 3286 3,286
Sp 5 cc 1 1 2478 2,478
Mertigo 10 10 4306 43,060
SUB TOTAL 198,238
7/7/2016 Cymalium Tab 5 5 1802 9,010

Celebrex Tab 2 2 17693 35,386
SUB TOTAL 44,396
7/8/2016 Valisanbe Tab 3 3 364 1,092
SUB TOTAL 1,092
7/8/2016 Ondan 4 mg Inj 4 4 7288 29,152

Pumpitor Inj 1 1 99800 99,800
Cymalium tab 1 1 1802 1,802
SUB TOTAL 130,754
7/9/2016 Amitripilin Tab 25 mg 5 5 163 815

SUB TOTAL 815
7/9/2016 Ondan 4 mg Inj 4 4 7288 29,152

Pumpitor Inj 1 1 99800 99,800
Cymalium Tab 2 2 2041 4,082
Celebrex Tab 1 1 17693 17,693
Venflon 22 2 2 23186 46,372
Sp 5 cc 1 1 2478 2,478
Inf NS 1 1 7721 7,721
SUB TOTAL 207,662
7/10/2016 Ondan 8 mg Inj 1 1 11660 11,660

SUB TOTAL 11,660
7/10/2016 Inf Ns 2 2 7721 15,442

Ondan 4 mg Inj 2 2 7288 14,576
Pumpitor Inj 1 1 99800 99,800
Mertigo Sr 3 3 6029 18,087
Cymalium Tab 2 2 2041 4,082
Celebrex Tab 1 1 17693 17,693
Amitripilin Tab 3 3 163 489
SUB TOTAL 170,897
7/11/2016 Amitripilin Tab 25 mg 10 10 163 1,630

Mertigo 10 10 4306 43,060
Celebrex Tab 5 5 17693 88,465
SUB TOTAL 144,250
TOTAL
118 Tn. Wahono 7/8/2016 Inf Rl 2 2 8700 17,400

Venflon 20 1 1 23186 23,186
inf Set Makro 1 1 10600 10,600
Terfacef Inj 2 2 128248 256,496
Sp 10 cc 1 1 3286 3,286
Sp 3 cc 1 1 2849 2,849
Sp 1 cc 1 1 2849 2,849
Pct Tab 1 1 138 138
Metformin 850 mg 10 10 530 5,300
Aquadest 1 1 3312 3,312
SUB TOTAL 352,518
7/9/2016 Ceftriaxon Inj 2 2 24778 49,556

Pct Tab 3 3 138 414
Inf Rl 3 3 8700 26,100
SUB TOTAL 83,562
7/9/2016 Glibenclamid Tab 3 3 808 2,424

SUB TOTAL 2,424
7/10/2016 Coditam Tab 5 5 4810 24,050

SUB TOTAL 24,050
7/10/2016 Ceftriaxon Inj 2 2 24778 49,556

Pct Inf 2 2 138 276
Inf Rl 3 3 8700 26,100
SUB TOTAL 83,424
7/11/2016 Coditam Tab 5 5 4810 24,050

Metformin 850 10 10 538 5,380
Glibenclamid Tab 5 5 808 4,040
SUB TOTAL 42,950
TOTAL
119 An. Philadepia 7/11/2016 Zink Kid Syr 1 1 20000 20,000

L- Bio 3 3 9275 27,825
Pct Syr 1 1 6493 6,493
Mucera Tab 2 2 1060 2,120
Tramenza 2 2 1670 3,340
Kertas Puyer 10 10 200 2,000
TOTAL
120 Ny. Sardimah 7/11/2016 Loperamid Tab 10 10 159 1,590

Spasmal Tab 10 10 787 7,870
TOTAL
121 Ny. Yuni S 7/11/2016 Mefinal Tab 10 10 1749 17,490
TOTAL
122 tn. Edi K 7/11/2016 Clindamycin 300 mg 10 10 996 9,960

Mefinal Tab 10 10 1749 17,490
TOTAL
123 An. Atifa 7/11/2016 Kandistatin Drop 1 1 38955 38,955

TOTAL
124 An. Urai 7/11/2016 Zink Kid Syr 1 1 20000 20,000

Oralit 1 1 9275 9,275
TOTAL
125 An. Lionel 7/11/2016 Interpec Syr 1 1 29800 29,800

TOTAL
TOTAL
Sintang, Juli 2016

Rp. Rp. Rp.
1 An. Kevin 7/12/2016 Oralit 3 3 928 2,784
TOTAL
2 An. Ramadhani 7/12/2016 Cefixime Tab 10 10 2968 29,680

Profenal Tab 10 10 1789 17,890
TOTAL
3 Tn. Bambang 7/11/2016 Inf Rl 1 1 8700 8,700

Ondan 4 mg 4 4 7288 29,152
Pumpitor Inj 1 1 99800 99,800
Venflon 20 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Sp 10 cc 2 2 3286 6,572
Sp 5 cc 1 1 2478 2,478
Sp 1 cc 1 1 2849 2,849
SUB TOTAL 216,462
7/11/2016 Buscopan Inj 2 2 27825 55,650

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 57,545
7/11/2016 Urotractin Tab 10 10 8599 85,990

SUB TOTAL 85,990
7/12/2016 Spasmal Tab 10 10 600 6,000

SUB TOTAL 9,210
TOTAL
4 Tn. Jodhi Cris 7/12/2016 Mefinal Tab 10 10 1485 14,850

TOTAL
5 Nn. Desi S 7/12/2016 Cefixime 100 mg 20 20 2968 59,360
Pct Tab 10 10 138 1,380
TOTAL
6 An. Lionel 7/12/2016 Ventolin 1 1 12500 12,500

Bisolvon 6 6 5000 30,000
Pct Syr 1 1 4000 4,000
TOTAL
7 Tn. Joni 7/12/2016 Amoxicilin Tab 10 10 464 4,640

Mefinal Tab 10 10 1749 17,490
Kasa 3 3 1200 3,600
TOTAL
8 Ny. Maria 7/12/2016 Domperidon Ta 10 10 596 5,960

Valesco Tab 80 mg 10 10 11660 116,600
TOTAL
9 Tn. Jeffrey S 7/12/2016 Decadoxin Tab 30 30 649 19,470

Rifampisin Tab 450 30 30 1855 55,650
Tibigon 45 45 1299 58,455
Pyrazinamid Tab 90 90 464 41,760
TOTAL
10 An. M Hanif 7/12/2016 Lidocain Inj 1 1 2186 2,186

Sp 1 cc 1 1 2849 2,849
TOTAL
11 Ny. Tri Haryati 7/12/2016 Mefinal Tab 10 10 1749 17,490
Psidii Tab 10 10 5300 53,000
TOTAL
12 An. Surya Adi 7/12/2016 Remco Syr 1 1 8400 8,400

Sanmol Drop 1 1 20551 20,551
Cefixime Syr 1 1 42201 42,201
TOTAL
13 An. Stanley 7/11/2016 Indexon Inj 1 1 8000 8,000

Sp 3 cc 2 2 1895 3,790
SUB TOTAL 15,536
7/11/2016 D5 1/4 Ns 3 3 17159 51,477

Inf Set Makro 1 1 10600 10,600
Venflon 24 2 2 26235 52,470
Kandistatin Drop 1 1 51476 51,476
SUB TOTAL 166,023
7/12/2016 Dexa iNj 1 1 0 3000 -

Indexon Inj 1 1 0 9275 -
Sp 3 cc 2 2 1895 3,790
Inf D5 1/4 Ns 3 3 19941 59,823
SUB TOTAL 67,359
7/12/2016 Venflon 24 4 4 26235 104,940

SUB TOTAL 104,940
TOTAL
14 An. Indra 7/12/2016 Inf Rl 1 1 8700 8,700
Venflon 24 1 1 26235 26,235
TOTAL
15 An. Fransiskus 7/7/2016 Inf D5 % 2 2 8312 16,624

Inf Set Mikro 1 1 10600 10,600
Venflon 24 2 2 26235 52,470
Pct Inf 1 1 65588 65,588
Sp 1 cc 2 2 2849 5,698
Sp 10 cc 1 1 3286 3,286
Zink Kid Syr 1 1 20000 20,000
Ondan 4 mg Inj 1 1 7288 7,288
SUB TOTAL 200,170
7/8/2016 Cefotaxime Inj 1 1 15304 15,304

Sp 1 cc 1 1 2849 2,849
Sp 10 cc 1 1 3286 3,286
Oralit 5 5 928 4,640
SUB TOTAL 29,391
7/9/2016 Inj Cefotaxime 1 1 15304 15,304

Inj Ondan 1 1 7288 7,288
SUB TOTAL 22,592
7/9/2016 L- Bio Sach 2 2 9275 18,550

SUB TOTAL 18,550
7/10/2016 Inj Ceftriaxon 1 1 24778 24,778
Inf Rl 2 2 8700 17,400
Inj Ondan 4 mg 1 1 7288 7,288
L- Bio 1 1 9275 9,275
SUB TOTAL 58,741
7/10/2016 Amoxicilin Syr 1 1 8745 8,745

Zink Kid Syr 1 1 20000 20,000
SUB TOTAL 28,745
7/11/2016 L- Bio 1 1 9275 9,275

SUB TOTAL 9,275
TOTAL
16 An. Benediktus 7/9/2016 Inf D5 1/4 Ns 2 2 19941 39,882

Inf Set Makro 1 1 10600 10,600
Venflon 24 1 1 26235 26,235
Sp 1 cc 1 1 2849 2,849
Sp 10 cc 1 1 3286 3,286
Pamol Syr 1 1 19700 19,700
SUB TOTAL 138,989
7/9/2016 Ranitidin Inj 1 1 3746 3,746

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 5,641
7/10/2016 Inf D5 1/4 Ns 1 1 17159 17,159

Inf Rl 1 1 8700 8,700
SUB TOTAL 54,383
7/11/2016 Inf D5 1/4 Ns 1 1 19941 19,941

Venflon 24 1 1 26235 26,235
Venflon 26 1 1 51013 51,013
Inf Rl 1 1 8700 8,700
SUB TOTAL 142,760
7/11/2016 Apialys Drop 1 1 33125 33,125

SUB TOTAL 33,125
7/12/2016 Inf D5 1/4 Ns 1 1 14569 14,569

inf Rl 1 1 7500 7,500
SUB TOTAL 22,069
7/13/2016 Inf D5 1/4 Ns 1 1 17159 17,159

Inf Rl 1 1 8700 8,700
SUB TOTAL 25,859
TOTAL
17 Tn. Alan 7/13/2016 Omeprazol Tab 10 10 1475 14,750

Pct Tab 10 10 138 1,380
Mecodiar Tab 10 10 1500 15,000
Sanmagh Tab 5 5 1020 5,100
TOTAL
18 Ny. Ira 7/13/2016 Mefinal Tab 10 10 1749 17,490

Anacetin Syr 2 2 10000 20,000
TOTAL
19 Tn. Usman 7/13/2016 Lipitor Tab 10 10 19941 199,410

Amlodipin Tab 10 10 2465 24,650
omeprazol Tab 10 10 1475 14,750
TOTAL
20 Ny. Pariem 7/13/2016 Lipitor Tab 10 10 19941 199,410

Valesco 80 mg Tab 10 10 11660 116,600
Omeprazol Tab 10 10 1475 14,750
TOTAL
21 Tn. Andrianus 7/13/2016 Mefinal Tab 10 10 1749 17,490

TOTAL
22 Ny. Bun Miau 7/13/2016 Mefinal Tab 10 10 1749 17,490

Mp 16 mg tab 5 5 1391 6,955
TOTAL
23 Ny. Serina 7/13/2016 Pct Tab 10 10 138 1,380

Omeprazol Tab 10 10 1475 14,750
Psidii Tab 10 10 5300 53,000
TOTAL
24 Tn. Florus 7/13/2016 Amoxicilin Tab 20 10 464 4,640

Mefinal Tab 10 10 1749 17,490
Kasa 3 3 1200 3,600
TOTAL
25 Ny. Sediar 7/13/2016 Inf Ns 3 3 7721 23,163
Inf Set Makro 1 1 10600 10,600
Venflon 22 2 2 23186 46,372
Ceftriaxon Inj 2 1 1 24778 24,778
Pumpitor Inj 1 1 99800 99,800
Ondan 4 mg Inj 1 1 7288 7,288
Sp 10 cc 1 1 3286 3,286
Sp 5 cc 1 1 2478 2,478
Sp 1 cc 1 1 2849 2,849
Antasida 10 10 56 560
Lisinoril 10 10 994 9,940
Ventolin Nebu 2 2 0 12476 -
TOTAL
26 Tn. Enggap 7/13/2016 Lisinopril Tab 10 10 994 9,940

Flamar 50 mg Tab 10 10 2200 22,000
Mersibion Tab 10 10 5016 50,160
TOTAL
27 Tn. Aden 7/14/2016 Cefixime 100 mg Tab 10 10 2968 29,680
TOTAL
28 An. Rayhan 7/14/2016 Remco Syr 1 1 8400 8,400

TOTAL
29 An. Suhendra 7/14/2016 Zink Kid Syr 1 1 20000 20,000

Sanmol Drop 1 1 20551 20,551
Ctm 3 3 46 138
Kertas Puyer 10 10 500 5,000
Hydrocortison Zalf 1 1 5101 5,101
TOTAL
30 An. Rafael 7/14/2016 Biothicol Syr 1 1 25420 25,420

opineacea syr 1 1 66250 66,250
Zink Kid Syr 1 1 20000 20,000
oralit 3 3 928 2,784
TOTAL
31 An. Bima 7/14/2016 Zink Kid Syr 1 1 20000 20,000

L- Bio 5 5 9275 46,375
oralit 4 4 928 3,712
TOTAL
32 Tn. Lukas 7/14/2016 Asam Mefenamat Tab 10 10 400 4,000

Amoxicili Tab 10 10 464 4,640
TOTAL
33 An. Najla 7/14/2016 Valisanbe Tab 3 3 364 1,092

Ottopan Drop 1 1 23850 23,850
Apialys Drop 1 1 39750 39,750
TOTAL
34 Ny. Iin 7/14/2016 Clindamycin 300 mg 10 10 996 9,960

Mefinal Tab 10 10 1749 17,490
TOTAL
35 Ny. Pairah 7/12/2016 Inf Rl 2 2 8700 17,400

Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Ondan 4 mg Inj 4 4 7288 29,152
Pumpitor Inj 1 1 99800 99,800
Sp 5 cc 1 1 2478 2,478
Sp 10 cc 2 2 2286 4,572
Terfacef Inj 2 2 128248 256,496
SUB TOTAL 443,684
7/13/2016 Ceftriaxon Inj 2 2 33125 66,250

Pumpitor Inj 1 1 99800 99,800
Sp 5 cc 2 2 1609 3,218
Inf RL 4 4 8700 34,800
SUB TOTAL 204,068
7/13/2016 Inf Set Makro 1 1 10600 10,600

SUB TOTAL 10,600
7/14/2016 Domperidon Tab 10 10 596 5,960

Omeprazol Tab 10 10 1475 14,750
Sanmagh Tab 10 10 1020 10,200
Inf Rl 2 2 8700 17,400
SUB TOTAL 48,310
TOTAL
36 An. Benediktus 7/14/2016 Zink Kid Syr 1 1 20000 20,000

TOTAL
37 An. Kristian 7/14/2016 Zink Kid Syr 1 1 20000 20,000

Oralit 3 3 928 2,784
TOTAL
38 An. Aini 7/14/2016 Cinolon - N Zalf 1 1 23612 23,612
Novax Syr 1 1 25970 25,970
TOTAL
39 Tn. Fery 7/14/2016 Domperidon Tab 10 10 596 5,960

Mucohexime Syr 1 1 19610 19,610
TOTAL
40 Tn. Narsin 7/14/2016 Inf Ns 1 1 7721 7,721

Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Nasal Canul 1 1 14575 14,575
TOTAL
41 An. Hafiza 7/14/2016 Oroprofen Syr 1 1 15000 15,000

Sp 3 cc 1 1 1895 1,895
Venflon 24 1 1 26235 26,235
TOTAL
42 An. Lionel 7/12/2016 D5 1/4 Ns 2 2 17159 34,318

Cortidex Inj 1 1 7500 7,500
Venflon 24 2 2 26235 52,470
Inf Set Mikro 1 1 1895 1,895
SUB TOTAL 96,183
7/13/2016 Inf Set Makro 1 1 10600 10,600

Bisolvon 12 12 5000 60,000
Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
SUB TOTAL 111,139
7/13/2016 Inf D5 1/4 Ns 3 3 17159 51,477

Indexon Inj 1 1 9275 9,275
SUB TOTAL 63,752
7/13/2016 Ventolin Nebu 1 1 12476 12,476

SUB TOTAL 31,092
7/15/2016 Salycyl Talk 1 1 9000 9,000

SUB TOTAL 9,000
TOTAL
43 Tn. Fransiskus 7/12/2016 Inf RL 2 2 8700 17,400

Venflon 22 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Sp 3 cc 1 1 1895 1,895
Pct tab 10 10 138 1,380
SUB TOTAL 77,817
7/13/2016 Ramaflu Tab 10 10 750 7,500

SUB TOTAL 7,500
7/13/2016 Ranitidin Inj 2 2 3746 7,492

Pct Tab 3 3 138 414
Inf Rl 1 1 8700 8,700
Sp 3 cc 1 1 1895 1,895
SUB TOTAL 18,501
7/14/2016 Mecodiar Tab 3 3 1500 4,500

Diaramid Tab 2 2 1500 3,000
SUB TOTAL 7,500
7/14/2016 Ranitidin Inj 2 2 3746 7,492

Ramaflu Tab 3 3 450 1,350
Inf Rl 2 2 8700 17,400
SUB TOTAL 26,242
7/15/2016 Ramaflu Inf 10 10 450 4,500

Psidii Tab 10 10 5300 53,000
SUB TOTAL 57,500
TOTAL
44 Ny. Ayang 7/14/2016 Inf Ns 1 1 7721 7,721

Spironolacton 25 mg 10 10 539 5,390
Pumpitor Inj 1 1 99800 99,800
Sp 10 cc 1 1 3286 3,286
Venflon 22 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
Isdn Tab 10 10 186 1,860
SUB TOTAL 151,843
7/15/2016 Pumpitor Inj 1 1 99800 99,800

Inf Ns 2 2 7721 15,442
SUB TOTAL 115,242
TOTAL
45 Tn. Jumari 7/15/2016 Domperidon Tab 10 10 596 5,960

TOTAL
46 Ny. Minah 7/15/2016 Valesco Tab 10 10 11660 116,600

Flamar Tab 50 mg 10 10 2200 22,000
TOTAL
47 Tn. Gundul 7/15/2016 Domperidon Tab 10 10 596 5,960

TOTAL
48 An. Mustakim 7/15/2016 Lidocain Inj 1 1 2186 2,186

Sp 1 cc 1 1 2849 2,849
Bisturi 1 1 4638 4,638
Cefadroxil Syr 1 1 13037 13,037
TOTAL
49 An. Rini S 7/15/2016 Combantrin Syr 1 1 20000 20,000

Sp 10 cc 1 1 3286 3,286
TOTAL
50 Tn. Ravail 7/15/2016 Spasmal Tab 10 10 600 6,000

Lokev Tab 10 10 1708 17,080
Antasida Doen 10 10 56 560
TOTAL
51 Ny. Tri 7/16/2016 Coditam Tab 10 10 4810 48,100

TOTAL
52 An. Rosi 7/16/2016 Pct Tab 10 10 138 1,380

Erysanbe Tab 20 20 2968 59,360
TOTAL
53 An. Kristian 7/14/2016 Cefotaxime Inj 1 1 15304 15,304

Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
Oralit 1 1 0 10000 -
SUB TOTAL 24,751
7/14/2016 Inf Ns 1 1 7721 7,721

Inf RL 2 2 8700 17,400
Inf Set Mikro 1 1 10203 10,203
Venflon 26 1 1 51013 51,013
Ondan 4 mg Inj 1 1 7288 7,288
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 0 2849 -
SUB TOTAL 95,520
7/15/2016 Cefotaxime Inj 2 1 1 15304 15,304

Sp 10 cc 1 1 0 3286 -
SUB TOTAL 18,625
7/16/2016 L- Bio 1 1 0 9275 -

SUB TOTAL -
TOTAL
54 An. Surya 7/14/2016 Inf Set Makro 1 1 10600 10,600

Venflon 24 2 2 26235 52,470
Apialys Syr 1 1 33125 33,125
Inf Rl 1 1 8700 8,700
SUB TOTAL 104,895
7/15/2016 Cefotaxime Inj 1 1 15304 15,304

Sp 10 cc 1 1 3286 3,286
Sp 1 cc 2 2 2849 5,698
SUB TOTAL 27,600
7/16/2016 Cefotaxime Inj 1 1 15304 15,304

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 20,511
TOTAL
55 Ny. Semani 7/14/2016 Inf Ns 2 2 7721 15,442

Ondan 8 mg 1 1 11660 11,660
Pumpitor Inj 1 1 99800 99,800
Venflon 22 1 1 23186 23,186
Inf Set Mikro 1 1 10600 10,600
Sp 5 cc 2 2 2478 4,956
Amlodipin 10 mg 10 10 2465 24,650
Sanmagh Tab 10 10 1020 10,200
Metformin 850 mg 10 10 530 5,300
SUB TOTAL 205,794
7/15/2016 Inf Ns 2 2 0 7721 -

Pumpitor Inj 1 1 99800 99,800
SUB TOTAL 99,800
7/16/2016 Pumpitor Inj 1 1 0 99800 -
SUB TOTAL -
7/16/2016 Metformin 850 mg 20 20 530 10,600

SUB TOTAL 10,600
TOTAL
56 An. Farsa 7/15/2016 Valisanbe Tab 1 1 364 364

Apialys Drop 1 1 39750 39,750
Pamol Drop 1 1 37300 37,300
TOTAL
57 An. Andreano 7/11/2016 Inf D5 1/4 Ns 1 1 17759 17,759

Inf Rl 3 3 8700 26,100
Inf Set Makro 1 1 10600 10,600
Venflon 24 Inj 2 2 26235 52,470
Sp 10 cc 2 2 3286 6,572
Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Indexon Inj 1 1 9275 9,275
Pct Inf 1 1 65588 65,588
Zink Kid Syr 1 1 20000 20,000
L- Bio 4 4 9275 37,100
Oralit 4 4 928 3,712
Valisanbe 3 3 364 1,092
SUB TOTAL 295,949
7/12/2016 Inf D5 1/4 Ns 1 1 14569 14,569

Inf Rl 2 2 7500 15,000
L- Bio 4 4 7875 31,500
Dexa Inj 1 1 2400 2,400
Sp 3 cc 1 1 1609 1,609
Sp 10 cc 1 1 2790 2,790
Oralit 2 2 788 1,576
SUB TOTAL 82,438
7/14/2016 Ceftriaxon Inj 1 1 24778 24,778

Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
Sp 3 cc 2 2 1895 3,790
Dulcolax Syr 1 1 90100 90,100
SUB TOTAL 153,724
7/13/2016 Cefotaxime Inj 2 2 15304 30,608

Cortidex Inj 2 2 7500 15,000
Sp 5 cc 1 1 2478 2,478
Sp 1 cc 2 2 2849 5,698
L- Bio 2 2 9275 18,550
Oralit 2 2 928 1,856
Inf Rl 1 1 8700 8,700
Inf D5 1/4 Ns 1 1 17159 17,159
SUB TOTAL 103,361
7/14/2016 Biothicol Syr 1 1 25042 25,042

Apialys Syr 1 1 33125 33,125
Mucera Syr 1 1 22525 22,525
SUB TOTAL 80,692
7/14/2016 Cefotaxime Inj 1 1 15304 15,304

L- Bio 3 3 9275 27,825
SUB TOTAL 44,221
2/15/2016 Cefotaxime Inj 1 1 15304 15,304

Sp 10 cc 1 1 3286 3,286
Sp 3 cc 1 1 1895 1,895
L - Bio 4 4 9275 37,100
SUB TOTAL 64,643
7/16/2016 Cefotaxime Inj 1 1 28125 28,125

Sp 3 cc 1 1 1609 1,609
Inf D5 1/4 Ns 1 1 17159 17,159
SUB TOTAL 50,205
TOTAL
58 An. M Afri 7/16/2016 Domperidon Syr 1 1 7420 7,420

Apyalis Syr 1 1 33125 33,125
TOTAL
59 An. Qilla 7/16/2016 Oroprofen Syr 1 1 15400 15,400

Cinolon - N 1 1 23612 23,612
Cefixime Syr 1 1 42201 42,201
TOTAL
60 Tn. Heri 7/16/2016 Pct Tab 10 10 138 1,380
Ciprofloxacin 10 10 627 6,270
Mefinal Tab 10 10 1749 17,490
TOTAL
61 Ny. Lusia 7/16/2016 Ramaflu 10 10 800 8,000

Loratadin Tab 5 5 441 2,205
TOTAL
62 An. Arya 7/16/2016 Stesolid Supp 2 2 35000 70,000

Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Sanmol Syr 1 1 15231 15,231
TOTAL
63 Ny. Wartini 7/14/2016 Inf Rl 1 1 8700 8,700

Terfacef Inj 1 1 128248 128,248
Bisturi 1 1 4638 4,638
Ondan 4 mg Inj 2 2 7288 14,576
Sp 1 cc 1 1 2849 2,849
Sp 3 cc 2 2 1895 3,790
Sp 10 cc 1 1 3286 3,286
Nasal Canul 1 1 14575 14,575
Piracetam 400 mg Tab 20 20 663 13,260
Venflon 22 1 1 23186 23,186
Inf Set Makro 1 1 10600 10,600
SUB TOTAL 271,434
7/14/2016 Terfacef Inj 1 1 128248 128,248

SUB TOTAL 150,111
7/15/2016 Terfacef Inj 2 2 128248 256,496
Inf Ns 2 2 7721 15,442
SUB TOTAL 315,664
7/15/2016 Mertigo 10 10 4306 43,060

Glibenclamid tab 10 10 808 8,080
SUB TOTAL 51,140
7/15/2016 Inf Ns 4 4 7721 30,884

SUB TOTAL 30,884
7/16/2016 Ketorolac Inj 2 2 21863 43,726

SUB TOTAL 43,726
7/16/2016 Metformin 850 20 20 530 10,600

Glibenclamid Tab 10 10 808 8,080
SUB TOTAL 18,680
TOTAL
64 An. Rifat 7/16/2016 Sanmol Syr 1 1 15321 15,321

Biothicol 2 2 25045 50,090
TOTAL
65 Tn. Prayitno 7/16/2016 Lokev Tab 10 10 1900 19,000

Braxidin Tab 10 10 1166 11,660
Antasida Doen Tab 10 10 56 560
TOTAL
66 An. Najwa 7/15/2016 Inf Set Mikro 1 1 10203 10,203

Inf RL 2 2 8700 17,400
Venflon 26 1 1 51013 51,013
Sp 10 cc 1 1 3286 3,286
Sp 1 cc 1 1 2849 2,849
Zink Kid Syr 1 1 20000 20,000
L- Bio 2 2 9275 18,550
Oralit 3 3 928 2,784
Progesik Syr 1 1 29150 29,150
SUB TOTAL 173,851
7/16/2016 Cefotaxime Inj 1 1 15304 15,304

Sp 1 cc 1 1 2849 2,849
Oralit 2 2 928 1,856
Inf RL 2 2 8700 17,400
SUB TOTAL 40,721
TOTAL
67 Tn. Masma 7/15/2016 Inf Rl 1 1 8700 8,700

Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Pumpitor Inj 1 1 99800 99,800
Sp 10 cc 1 1 3286 3,286
Berotec 2 2 5000 10,000
Bisolvon 3 3 5000 15,000
Fartolin Tab 20 20 741 14,820
Cortidex Tab 10 10 364 3,640
SUB TOTAL 208,642
7/16/2016 Pumpitor Inj 1 1 99800 99,800

Inf Rl 3 3 8700 26,100
SUB TOTAL 125,900
7/16/2016 Domperidon Tab 10 10 596 5,960

SUB TOTAL 7,052
7/16/2016 Venflon 20 1 1 23186 23,186

Venflon 22 1 1 23186 23,186
SUB TOTAL 46,372
7/16/2016 Venflon 22 1 1 23186 23,186

Inf Set Makro 1 1 10600 10,600
SUB TOTAL 33,786
TOTAL
68 Tn. Heni P 7/16/2016 Inf Ns 2 2 7721 15,442

Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Sp 3 cc 2 2 1895 3,790
Sp 1 cc 1 1 2849 2,849
Sp 5 cc 1 1 2478 2,478
SUB TOTAL 184,294
7/16/2016 Novaldo Inj 1 1 18000 18,000

Sp 3 cc 1 1 1895 1,895
SUB TOTAL 19,895
TOTAL
69 Ny. Lasiyem 7/15/2016 Terfacef Inj 2 2 128248 256,496
Pumpitor Inj 1 1 99800 99,800
Inf Set Makro 1 1 10600 10,600
Venflon 22 1 1 23186 23,186
Sp 10 cc 2 2 3286 6,572
Sp 1 cc 1 1 2849 2,849
Inf Rl 3 3 8700 26,100
SUB TOTAL 431,563
7/16/2016 Sanmagh Tab 3 3 1020 3,060

SUB TOTAL 3,060
7/16/2016 Terfacef Inj 2 2 128248 256,496

Pumpitor Inj 1 1 99800 99,800
Inf Ns 2 2 7721 15,442
SUB TOTAL 375,050
TOTAL
70 Ny. Ratna 7/17/2016 Cefadroxil Caps 10 10 981 9,810

Nadic 50 mg 10 10 685 6,850
TOTAL
71 An. Ahmad 7/17/2016 Cefadroxil Caps 1 1 13037 13,037

Pct Tab 3 3 138 414
Roverton Tab 3 3 1700 5,100
Kertas Puyer 12 12 100 1,200
Yarizine 1 1 40000 40,000
TOTAL
72 An. Kayla 7/17/2016 Licoprim Syr 1 1 10000 10,000

Domperidon 1 1 7420 7,420
L- Bio 4 4 9275 37,100
TOTAL
73 Tn. Tri S 7/17/2016 Cefadroxil Caps 10 10 981 9,810

TOTAL
74 Tn. Hendro 7/17/2016 Sp 50 cc 2 2 40081 80,162

TOTAL
75 An. Yesi 7/17/2016 Mucohexin Syr 1 1 19610 19,610

Salbutamol Syr 1 1 6600 6,600
Bisolvon 1.5 1.5 10000 15,000
TOTAL
76 Tn. Virgilius 7/17/2016 Molagit Tab 10 10 636 6,360

TOTAL
77 Tn. Tri 7/17/2016 Cortidex Tab 10 10 364 3,640

Cinolon - N 1 1 23612 23,612
TOTAL
78 An. Reswara 7/18/2016 Tramenza Tab 3 3 1530 4,590

Mucera Tab 3 3 1060 3,180
Kertas Puyer 12 12 200 2,400
TOTAL
79 An. Mario E 7/18/2016 Tramenza Tab 2 2 1530 3,060

Mucera Tab 2 2 1060 2,120
Kertas Puyer 12 12 200 2,400
TOTAL
80 An. Vika 7/18/2016 Ottopain TT 1 1 47700 47,700

TOTAL
81 By. Sagitalia 7/18/2016 Promuxol Drop 1 1 44250 44,250

TOTAL
82 Ny. Suharti 7/18/2016 Inf Set Makro 1 1 10600 10,600

Venflon 20 1 1 32186 32,186
Manitol 1 1 74200 74,200
Ngt 16 1 1 25043 25,043
Sp 10 cc 2 2 3286 6,572
Sp 3 cc 1 1 1895 1,895
Kateter 16 1 1 20405 20,405
Urine Bag 1 1 7288 7,288
SUB TOTAL 188,993
7/18/2016 Ngt Tab 1 1 25043 25,043

SUB TOTAL 25,043
TOTAL
83 An. Danu 7/18/2016 Ranitidin Tab 5 5 321 1,605
Pct Syr 1 1 6493 6,493
TOTAL
84 Tn. Maulana 7/18/2016 Clindamycin Tab 10 10 1749 17,490

Mefinal Tab 10 10 996 9,960
TOTAL
85 Ny. Dewi 7/18/2016 Cinolon - N 1 1 23612 23,612

TOTAL
86 An. Kenzie 7/16/2016 Inf Set Mikro 1 1 10203 10,203

Venflon 26 1 1 51013 51,013
Inf D5 1/4 Ns 2 2 17159 34,318
Ondan 4 mg 1 1 7288 7,288
Sp 1 cc 1 1 2849 2,849
Sanmol Syr 1 1 15231 15,231
SUB TOTAL 120,902
7/17/2016 Ondan 4 mg Inj 2 2 7288 14,576

Sp 3 cc 1 1 1895 1,895
Sp 1 cc 1 1 2849 2,849
Venflon 26 2 2 0 51013 -
Inf D5 1/4 Ns 2 2 0 17159 -
SUB TOTAL 19,320
7/17/2016 Venflon 26 1 1 51013 51,013

Hico Gel 1 1 28753 28,753
SUB TOTAL 79,766
7/18/2016 Interzink Syr 1 1 40612 40,612
L- Bio 3 3 9275 27,825
SUB TOTAL 68,437
TOTAL
87 An. M Nazwan 7/18/2016 Clanexi Tab 10 10 15875 158,750

TOTAL
88 Tn. Yanus 7/18/2016 Nadic Tab 50 mg 10 10 685 6,850

Megabal Tab 10 10 2186 21,860
Eperison Tab 10 10 2041 20,410
TOTAL
89 Tn. Sitigen 7/18/2016 Allupurinol Tab 5 5 928 4,640

Gembifrozil Tab 15 15 464 6,960
TOTAL
90 Ny. Munai 7/18/2016 Nadic 50 mg Tab 10 10 685 6,850

Cetirizine Tab 10 10 530 5,300
Lisinopril Tab 30 30 994 29,820
Dilavask Tab 5 mg 30 30 2319 69,570
TOTAL
91 An. Nafiza S 7/18/2016 L- Bio 4 4 9275 37,100

Oralit 5 5 1000 5,000
TOTAL
92 An. Aura 7/18/2016 Ventolin 1 1 12476 12,476

Bisolvon 2 2 10000 20,000
Salbutamol 1 1 6600 6,600
Mucera Tab 4 4 1060 4,240
Kertas Puyer 12 12 200 2,400
TOTAL
93 An. Dayang 7/18/2016 Fartolin Tab 20 20 741 14,820

Berotec 10 10 500 5,000
Inf Ns 2 2 2500 5,000
TOTAL
94 Ny. Nila 7/18/2016 Analsik Tab 10 10 1598 15,980

TOTAL
TOTAL
Sintang, Juli 2016

TOTAL
Rp.
184,600
68,710
92,990
54,000
63,491
42,790
68,792
37,100
152,813
182,480
993,963
44,520
65,000
7,650
19,370
302,760
69,138
77,730
47,455
253,536
77,770
23,380
6,000
2,359
38,410
53,000
45,500
58,260
41,753
22,500
55,431
13,040
64,790
29,680
40,000
318,169
328,781
50,200
117,727
19,879
122,513
9,280
344,461
171,787
142,737
24,446
11,901
43,837
56,860
63,544
23,636
185,861
138,767
1,373,284
121,870
100,247
94,550
416,844
16,564
8,388
26,500
909,586
33,027
59,978
57,500
8,840
11,120
6,820
56,572
18,763
28,750
54,720
6,955
596,225
20,305
77,621
116,118
115,825
40,090
17,293
71,000
66,400
23,500
41,700
51,108
21,666
155,103
18,088
195,635
27,870
597,775
19,800
96,400
11,355,547
Sintang, Juli 2016
Pembantu Bendahara
Yang Menyerahkan
Warsidi
Serma NRP 580944
TOTAL
Rp.
606,343
275,110
62,750
29,750
1,471,963
31,677
18,799
23,190
54,792
284,335
16,660
56,775
26,080
26,539
301,997
57,450
52,929
44,997
171,695
334,299
28,209
194,345
19,870
13,810
38,310
20,820
57,450
227,875
9,470
38,380
34,710
378,825
312,645
20,447
22,160
6,493
32,430
19,185
13,810
71,845
57,750
26,686
19,100
381,409
32,070
52,908
97,330
9,280
305,176
222,250
143,193
48,427
59,489
39,674
24,539
21,581
10,000
38,492
20,190
1,749
80,515
87,874
61,305
10,640
90,695
386,469
38,127
264,262
318,317
43,391
218,720
123,264
76,742
67,182
639,796
70,292
12,920
26,370
15,300
76,132
103,160
32,684
182,200
82,226
46,045
97,213
205,891
46,958
27,401
123,154
51,610
34,291
152,170
50,207
54,270
20,360
47,038
39,750
20,000
28,698
98,260
39,618
318,125
41,210
126,999
444,942
51,476
30,800
20,405
48,594
22,130
27,300
37,459
17,841
38,542
43,190
909,764
588,928
64,694
12,380
17,490
27,450
44,787
29,275
29,800
14,405,610 14,405,610
Sintang, Juli 2016

Pembantu Bendahara
Yang Menyerahkan
Warsidi
Serma NRP 580944
TOTAL
Rp.
2,784
47,570
369,207
14,850
61,832
46,500
28,730
122,560
194,945
29,180
70,490
137,402
353,858
34,935
367,464
422,826
43,480
37,490
238,810
330,760
17,490
24,445
88,740
28,513
254,036
85,310
29,680
8,400
95,310
118,350
78,832
8,640
67,692
27,450
706,662
20,000
30,204
64,982
28,780
56,082
43,130 4,838,401
311,166
195,060
267,085
5,960
158,210
5,960
38,110
38,686
23,640
48,100
60,740
138,896
153,006
316,194
80,414
875,233
40,545
81,213
25,140
10,205
89,975
881,639
65,411
31,220
214,572
421,752
204,189
809,673
19,310
64,341
54,520
13,810
80,162
53,686
30,870
37,138
10,686
10,496
47,700
44,250
214,036
15,518
27,450
23,612
288,425
158,750
49,120
11,600
115,920
42,100
53,292
30,820
23,230
11,951,237
11,951,237
LAPORAN UMUM BULAN AGUSTUS 2016
NO NAMA TANGGAL NAMA OBAT JML RETUR OBAT HARGA HARGA JUMLAH JUMLAH
PELAKSANAAN OBAT TERJUAL SATUAN SATUAN HARGA HARGA TOTAL
UMUM DPK
UMUM DPK UMUM DPK Rp.
Rp. Rp. Rp. Rp.
1 Tn. Jumari 7/19/2016 Lansoprazole Tab 10 10 1,855 18,550 -
Sanmagh Tab 10 10 1,020 10,200 -
Molagit Tab 10 10 636 6,360 -
Valesco Tab 10 10 11,660 116,600 -
SUB TOTAL 151,710 - 151,710
2 Nn. Dena 7/19/2016 Lidocain Inj 1 1 2186 2,186 -

Sp 3 cc 1 1 1895 1,895 -
Mefinal Tab 10 10 1749 17,490 -
Metronidazol Tab 10 10 292 2,920 -
Cortidex Tab 10 10 364 3,640 -
SUB TOTAL 28,131 28,131
3 An. Slamet Riyaden 7/19/2016 Diazepam Tab 1 1 364 364 -

Apialys Drop 1 1 39750 39,750 -
SUB TOTAL 40,114 40,114
4 Tn. Lukas 7/19/2016 Clindamycin Tab 10 10 996 9,960 -

Asam Mefenamat 10 10 400 4,000 -
Pehacain Inj 1 1 2783 2,783 -
Kasa 3 3 1300 3,900 -
SUB TOTAL 20,643 20,643
5 An. Salwa 7/19/2016 Ventolin Nebu 1 1 12476 12,476 -

Bisolvon 4 4 5000 20,000 -
Progesic 1 1 29150 29,150 -
Interpec Tab 3 3 13537 40,611 -
Fartolin Tab 3 3 928 2,784 -
Dextafen Tab 2 2 1458 2,916 -
SUB TOTAL 107,937 107,937
6 Tn. Kasin 7/19/2016 Valesco Tab 80 mg 10 10 11660 116,600 -

Cetirizine Tab 10 10 530 5,300 -
Dexa Tab 10 10 133 1,330 -
SUB TOTAL 123,230 123,230
7 Tn. Beni 7/18/2016 Inf Ns 1 1 7721 7,721 -

Ketorolac Inj 2 2 21863 43,726 -
Sp 3 cc 1 1 1895 1,895 -
Inf Set makro 1 1 10600 10,600 -
Venflon 22 1 1 23186 23,186 -
Mertigo Tab 10 10 4306 43,060 -
SUB TOTAL 133,108 133,108
8 Tn. Ajwin 7/19/2016 Mefinal Tab 10 10 1749 17,490 -

Metformin Tab 500 10 10 265 2,650 -
Cortidex tab 10 10 364 3,640 -
SUB TOTAL 23,780 23,780
9 Tn. Kasin 7/19/2016 Ramaflu Tab 10 10 800 8,000 -

SUB TOTAL 8,000 8,000
10 Tn. Petrus 7/19/2016 Vip Albumin 30 30 8049 241,470 -

SUB TOTAL 241,470 241,470
11 Nn. Nisa 7/18/2016 Inf Ns 1 1 7721 7,721 -

Ondan 4 mg 2 2 7288 14,576 -
Pumpitor Inj 1 1 99800 99,800 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 22 1 1 23186 23,186 -
Terfacef Inj 2 2 128,248 256,496 -
Sp 1 cc 1 1 2,849 2,849 -
Sp 10 cc 1 1 3,286 3,286 -
Sp 5 cc 2 2 2,478 4,956 -
Domperidon Tab 10 10 596 5,960 -
SUB TOTAL 429,430 - 429,430
7/19/2016 Ondan 4 mg Inj 1 1 7,288 7,288 -

Terfacef Inj 2 2 0 128,248 - -
Inf Ns 2 2 0 7,721 - -
SUB TOTAL 7,288 - 7,288
GRAND TOTAL -
12 Ny. Supi 7/19/2016 Cateter Urine 18 1 1 20,405 20,405 -

Cateter urine 16 1 1 20,405 20,405 -
Urine Bag 1 1 7,288 7,288 -
SUB TOTAL 48,098 - 48,098
13 An. Septina 7/19/2016 Oroprofen Syr 1 1 20,000 - 20,000

Opineacea 1 1 66,250 66,250 -
SUB TOTAL 66,250 20,000 86,250
14 Nn. Norafita 7/19/2016 Folaxin Tab 30 30 1,000 - 30,000

Masker 10 10 1,000 10,000 -
SUB TOTAL 10,000 30,000 40,000
15 Ny. Rabiah 7/17/2016 Inf Set Makro 1 1 10,600 10,600 -

Venflon 20 1 1 23,186 23,186 -
Inf Rl 3 3 8,700 26,100 -
Pumpicel Inj 1 1 99,800 99,800 -
Ondan 4 mg Inj 2 2 6,188 12,376 -
Ceftriaxon Inj 2 2 24,778 49,556 -
Aquadest Inj 1 1 3,312 3,312 -
Sp 10 cc 1 1 3,286 3,286 -
Sp 5 cc 2 2 2,478 4,956 -
Sp 1 cc 1 1 2,849 2,849 -
Sp 3 cc 1 1 1,895 1,895 -
Pct Tab 10 10 138 1,380 -
SUB TOTAL 239,296 - 239,296
7/18/2016 Ranitidin Inj 2 2 3746 7,492 -

Ceftriaxon Inj 2 2 24778 49,556 -
Ondan 4 mg Inj 2 2 7288 14,576 -
Urotractin Tab 10 10 8599 85,990 -
Inf Rl 1 1 8700 8,700 -
SUB TOTAL 166,314 - 166,314
7/19/2016 Lokev Tab 10 10 1670 16,700 -

SUB TOTAL 16,700 - 16,700
GRAND TOTAL
16 Tn. Abang R 7/20/2016 Cetirizine Tab 10 10 530 5,300 -

Cortidex Tab 10 10 364 3,640 -
Dipenhidramin 1 1 15000 15,000 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 26,789 - 26,789
17 Tn. Ray Kamar 7/17/2016 Ranitidin Inj 2 2 3746 7,492 -

Ketorolac Inj 3 3 21863 65,589 -
Opilax Syr 60 mgl 1 1 58300 58,300 -
Ceftriaxon Inj 2 2 24778 49,556 -
Spironolacton Tab 1 1 539 539 -
Ramaflu Tab 10 10 800 - 8,000
Sp 3 cc 3 3 1895 5,685 -
Sp 5 cc 2 2 2478 4,956 -
Sp 1 cc 1 1 2849 2,849 -
Venflon 22 1 1 23186 23,186 -
SUB TOTAL 218,152 8,000 226,152
7/17/2016 Eperison Tab 5 5 2041 10,205 - -

SUB TOTAL 10,205 - 10,205
7/18/2016 Spironolacton 25 Tab 2 2 539 1,078 -

Ketorolac Inj 3 3 21863 65,589 -
Ceftriaxon Inj 2 2 24778 49,556 -
Ranitidin Inj 3 3 3746 11,238 -
Isdn Tab 2 2 186 372 -
Valisanbe Tab 3 3 364 1,092 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 132,237 - 132,237
7/18/2016 Mucohexin Syr 1 1 19610 19,610 -

Venflon 20 1 1 23188 23,188 -
SUB TOTAL 42,798 - 42,798
7/18/2016 Venflon 22 1 1 23186 23,186 -

SUB TOTAL 23,186 - 23,186
7/19/2016 Spironolacton 25 mg tab 10 10 539 5,390 -

SUB TOTAL 5,390 - 5,390
GRAND TOTAL
18 Ny. Katini 7/20/2016 Amoxicilin Tab 10 10 464 4,640 -
Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 22,130 - 22,130
19 Tn. Sinun 7/20/2016 Sanmagh Tab 10 10 1020 10,200 -

Valisanbe Tab 5 mg 5 5 364 1,820 -
Molagit Tab 10 10 636 6,360 -
SUB TOTAL 18,380 - 18,380
20 Tn. Heri 7/20/2016 Trichodazole Tab 10 10 1855 18,550 -

Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 36,040 - 36,040
21 Ny. Yesi 7/20/2016 Amoxicilin Tab 10 10 464 4,640 -

Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 22,130 - 22,130
22 An. Aerylin 7/20/2016 Apialys Drop 1 1 39750 39,750 -

Biothicol Syr 1 1 25042 25,042 -
SUB TOTAL 64,792 - 64,792
23 Tn. Pardi 7/20/2016 Ciprofloxacin Tab 10 10 627 - 6,270

Ranitidin Tab 10 10 321 3,210 -
Spasmal Tab 15 15 600 9,000 -
SUB TOTAL 12,210 6,270 18,480
24 Tn. Hardi 7/20/2016 Antasida Doen Tab 10 10 470 4,700 -

SUB TOTAL 4,700 - 4,700
25 Ny. Lena 7/18/2016 Pct Tab 10 6 4 138 552 -

Psidii Tab 10 5 5 5300 26,500 -
Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 1 1 1895 1,895 -
Sp 1 cc 1 1 2849 2,849 -
ketorolac Inj 2 2 21863 43,726 -
Terfacef Inj 2 1 1 128248 128,248 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 22 1 1 32186 32,186 -
Inf Ns 1 1 7721 7,721 -
SUB TOTAL 257,563 - 257,563
7/19/2016 Folley Cat 16 1 1 20405 20,405 -

Urine Bag 1 1 7288 7,288 -
Sp 10 cc 1 1 3286 3,286 -
Aquadest inj 1 1 3312 3,312 -
Domperidon Tab 10 7 3 596 1,788 -
Pumpicel Inj 1 1 0 99800 - -
Urotractin Tab 10 6 4 8599 34,396 -
Terfacef Inj 2 2 128248 256,496 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 342,413 - 342,413
7/20/2016 Sanmagh Tab 10 9 1 1020 1,020 -

SUB TOTAL 1,020 - 1,020
GRAND TOTAL
26 By. Kristian 7/17/2016 Inf D5 1/4 Ns 1 1 17159 17,159 -

Venflon 24 1 1 26235 26,235 -
Inf Set Mikro 1 1 10203 10,203 -
Inf RA 3 3 8700 26,100 -
Cefotaxim Inj 1 1 15304 15,304 -
Ondan 4 mg Inj 1 1 11660 11,660 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 2 2 3286 6,572 -
Sp 1 cc 2 2 2849 5,698 -
Pct Inf 1 1 65588 65,588 -
SUB TOTAL 187,831 - 187,831
7/18/2016 Cefotaxime Inj 1 1 0 15304 - -

Ondan 4 mg Inj 1 1 7288 7,288 -
SUB TOTAL 7,288 - 7,288
7/19/2016 Inf RA 3 3 8700 26,100 -

SUB TOTAL 26,100 - 26,100
GRAND TOTAL
27 Tn. Ari 7/20/2016 Dexa Inj 1 1 7500 7,500 -

Sp 3 cc 1 1 1895 1,895 -
Cortidex Inj 10 10 364 3,640 -
Hidrocortison Zalf 1 1 5101 5,101 -
SUB TOTAL 22,136 - 22,136
28 Nn. Linda 7/21/2016 Urotractin Tab 10 10 8599 85,990 -

Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 103,480 - 103,480
29 Ny. Nica 7/21/2016 Mefinal 10 10 1749 17,490 -

Valisanbe Tab 5 mg 5 5 364 1,820 -
SUB TOTAL 19,310 - 19,310
30 Tn. Asrizal 7/18/2016 Inf Ns 1 1 7721 7,721 -

Ketoral Inj 2 2 21863 43,726 -
Sp 3 cc 1 1 1895 1,895 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 22 1 1 23186 23,186 -
Mertigo 10 10 4306 43,060 -
Meronidazole tab 10 10 292 2,920 -
SUB TOTAL 133,108 - 133,108
7/19/2016 Ketorolac Inj 2 2 21863 43,726 -

Cortidex Tab 10 10 364 3,640 -
SUB TOTAL 47,366 - 47,366
7/20/2016 Painkila 1 1 13243 - 13,243

SUB TOTAL - 13,243 13,243
7/21/2016 Mertigo Tab 1 1 4306 4,306 -

Metronidazole Tab 1 1 292 292 -
Inf NS 3 3 7721 23,163 -
SUB TOTAL 27,761 - 27,761
7/21/2016 Mucohexime Tab 10 10 600 6,000 -

SUB TOTAL 6,000 - 6,000
GRAND TOTAL
31 Nn. Rita 7/21/2016 Asam Mefenamat Tab 10 10 300 3,000 -

SUB TOTAL 3,000 - 3,000
32 Tn. Tri H 7/21/2016 Clindamycin Tab 300 mg 10 10 996 9,960 -

Flamar 50 mg 10 10 2200 22,000 -
Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 49,450 - 49,450
33 Tn. Jumadi 7/21/2016 Pain Kila 1 1 13913 - 13,913

Flamar 50 mg 10 10 2200 22,000 -
Metformin 500 mg 30 30 265 7,950 -
Valesco Tab 80 mg 10 10 11660 116,600 -
SUB TOTAL 146,550 13,913 160,463
34 An. Izamsyah 7/20/2016 L- Bio Sach 4 4 9275 37,100 -

L- Zink Syr 1 1 35245 35,245 -
Oralit 3 3 928 2,784 -
Inf RA 2 2 8700 17,400 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 24 1 1 23188 23,188 -
Ondan 4 mg Inj 1 1 7288 7,288 -
Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 135,500 - 135,500
7/20/2016 Pct Syr 1 1 5513 5,513 -

SUB TOTAL 5,513 - 5,513
7/21/2016 Amoxicilin Syr 1 1 8745 8,745 -

SUB TOTAL 8,745 - 8,745
GRAND TOTAL
35 Tn. Suparmin 7/22/2016 Mucohexin Tab 10 10 600 6,000 -

Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 30,610 - 30,610
36 By. Josefa 7/22/2016 Ctm Tab 2 2 47 94 -

Pamol Drop 1 1 37300 37,300 -
Amoxicilin Syr 1 1 464 464 -
Kertas puyer 20 20 250 5,000 -
SUB TOTAL 42,858 - 42,858
37 Ny. Nur 7/22/2016 Cetirizine Tab 10 10 530 5,300 -

Dexa Inj 1 1 3000 3,000 -
Recodryl Inj 1 1 9275 9,275 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 21,948 - 21,948
38 Nn. Yesy 7/22/2016 Clindamycin Tab 10 10 996 9,960 -

Mefinal Tab 10 10 1749 17,490 -
Pehacain Inj 1 1 3000 3,000 -
Kassa 3 3 1200 3,600 -
SUB TOTAL 34,050 - 34,050
39 Tn. Sukito 7/22/2016 Neurosanbe Inj 1 1 6493 6,493 -

Sp 3 cc 1 1 2849 2,849 -
SUB TOTAL 9,342 - 9,342
40 Tn. Poltak 7/22/2016 Neurosanbe Inj 1 1 6493 6,493 -

Sp 3 cc 1 1 2848 2,848 -
SUB TOTAL 9,341 - 9,341
41 An. Grace 7/22/2016 Oroprofen Syr 1 1 15400 - 15,400

Lafidryl Syr 1 1 5712 - 5,712
SUB TOTAL - 21,112 21,112
42 Ny. Misti 7/22/2016 Mefinal Tab 10 10 1749 17,490 -

Trombo Aspilet 5 5 933 4,665 -
SUB TOTAL 28,115 - 28,115
43 Nn. Sumami 7/23/2016 Ciprofloxacin Tab 10 10 627 6,270 -

Spasmal Tab 15 15 600 9,000 -
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 18,480 - 18,480
44 Ny. Marselina 7/23/2016 Scopamin Tab 10 10 2551 25,510 -

Strocain Tab 10 10 2551 25,510 -
Mefinal Tab 10 10 1749 17,490 -
Megabal Tab 10 10 2186 21,860 -
Dilavask Tab 5 5 2319 11,595 -
SUB TOTAL 101,965 - 101,965
45 Tn. Gayu 7/23/2016 Ramaflu Tab 10 10 450 - 4,500

Mp 4 mg Tab 10 10 530 5,300 -
SUB TOTAL 5,300 4,500 9,800
46 An. Ilva 7/23/2016 Amoxicilin Syr 1 1 8745 8,745 -

Cetirizine Syr 1 1 16231 16,231 -
Remco Syr 1 1 8400 - 8,400
Cinolon - N 1 1 23612 23,612 -
SUB TOTAL 48,588 8,400 56,988
47 Ny. Lie Sui Lan 7/23/2016 Furosemid Tab 5 5 300 1,500 -

Spironolacton Tab 10 10 1460 14,600 -
Fargoxin Tab 10 10 400 - 4,000
Valesco Tab 80 mg 10 10 11660 116,600 -
Grahabion Tab 10 10 725 - 7,250
SUB TOTAL 132,700 11,250 143,950
48 Ny. Tjong See 7/23/2016 Dilavask Tab 10 10 2319 23,190 -

Lokev Tab 10 10 1900 19,000 -
Strocain Tab 20 20 2551 51,020 -
Valisanbe Tab 10 10 364 3,640 -
SUB TOTAL 96,850 - 96,850
49 Tn. Dhani 7/23/2016 Mucera 15 15 1060 15,900 -
Strocain Tab 15 15 2551 38,265 -
Lostacef Tab 10 10 3150 31,500 -
Loratadin Tab 5 5 441 2,205 -
SUB TOTAL 87,870 - 87,870
50 Ny. Maria 7/22/2016 Ceftriaxon Inj 2 2 33125 66,250 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Aquadest Inj 1 1 3312 3,312 -
Cortidex Inj 3 3 7500 22,500 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 164,550 - 164,550
7/23/2016 Ceftriaxon Inj 2 2 24778 49,556 -

Cortidex Inj 2 2 7500 15,000 -
Inf Rl 3 3 8700 26,100 -
SUB TOTAL 90,656 - 90,656
7/23/2016 Cefixime Inj 10 10 2968 29,680 -

Mp 4 mg Tab 10 10 530 5,300 -
SUB TOTAL 37,630 - 37,630
GRAND TOTAL
51 Ny. Maida 7/23/2016 Asam Mefenamat Tab 10 10 400 4,000 -

Amoxicilin Tab 10 10 464 4,640 -
Dexa Tab 10 10 364 3,640 -
Cinolon - N 1 1 23612 23,612 -
SUB TOTAL 35,892 - 35,892
52 An. Zahir 7/23/2016 Apialys Syr 1 1 33125 33,125 -

Pct Syr 1 1 6493 6,493 -
Tramenza Tab 3 3 1530 4,590 -
Kertas Puyer 10 10 500 5,000 -
Biothicol Syr 1 1 25042 25,042 -
SUB TOTAL 74,250 - 74,250
53 An. Renita 7/23/2016 Inf D5 1/4 Ns 1 1 19941 19,941 -

Transfusi Set 1 1 30608 30,608 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23188 23,188 -
Venflon 24 1 1 23188 23,188 -
Venflon 18 1 1 23188 23,188 -
Canul Anak 1 1 14575 14,575 -
SUB TOTAL 145,288 - 145,288
54 Ny. Emiliana 7/23/2016 Mefinal Tab 10 10 1749 17,490 -

Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 20,700 - 20,700
55 Tn. W Manik 7/23/2016 Domperidon Tab 10 10 596 5,960 -

SUB TOTAL 5,960 - 5,960
56 Ny. Suprapti 7/23/2016 Alprazolam Tab 10 10 1060 10,600 -

Mersibion Tab 10 10 5016 - 50,160
Santa E 8 8 4267 34,136 -
SUB TOTAL 44,736 50,160 94,896
57 Tn. Pance 7/23/2016 Terfacef Inj 1 1 128248 128,248 -

Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
Pct Tab 10 10 1380 13,800 -
SUB TOTAL 148,183 - 148,183
58 Ny. Dewi 7/23/2016 Mefinal Tab 10 10 1749 17,490 -

Calnexi Tab 6 6 15887 95,322 -
Bisturi 1 1 4638 4,638 -
Lidocain Inj 1 1 2186 2,186 -
Sp 3 cc 1 1 1895 1,895 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 124,380 - 124,380
59 Tn. Ignasius 7/23/2016 Lidocain Inj 1 1 2186 2,186 -

Sp 1 cc 1 1 2849 2,849 -
Bisturi 1 1 4638 4,638 -
Cortidex Tab 10 10 364 3,640 -
Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 33,723 - 33,723
60 An. Zhahir 5/24/2016 Cetirizine Syr 1 1 16231 16,231 -

SUB TOTAL 16,231 - 16,231
61 Tn. Yayan 7/24/2016 Braxidine Tab 10 10 1160 11,600 -

SUB TOTAL 17,560 - 17,560
62 Tn. Setia B 7/24/2016 Mecodiar Tab 10 10 1000 10,000 -

Molagit Tab 20 20 636 12,720 -
Pct tab 10 10 138 1,380 -
Opiphen Tab 10 10 4220 42,200 -
Oralit 5 5 928 4,640 -
SUB TOTAL 70,940 - 70,940
63 Ny. Nurhayati 7/24/2016 Mertigo Tab 10 10 4306 43,060 -

Disflatyl Tab 10 10 810 8,100 -
Analsik Tab 5 5 1589 7,945 -
SUB TOTAL 59,105 - 59,105
64 An. Naufal 7/23/2016 Venflon 24 1 1 26235 26,235 -

Inf D5 1/4 Ns 2 2 17159 34,318 -
Inf Set Makro 1 1 10600 10,600 -
Otopan Drop 1 1 23850 23,850 -
Acyclovir 200 5 5 649 3,245 -
Kertas Puyer 10 10 250 2,500 -
SUB TOTAL 100,748 - 100,748
7/24/2016 AcyLovir 400 3 3 742 2,226 -

Kertas Puyer 12 12 250 3,000 -
SUB TOTAL 5,226 - 5,226
GRAND TOTAL
65 An. Juwanti 7/24/2016 Asam Mefenamat Tab 5 5 400 2,000 -

Domperidon tab 10 10 596 5,960 -
Grahabion Tab 5 5 800 - 4,000
SUB TOTAL 5,960 4,000 9,960
66 Tn. Johan 7/24/2016 Strocain Tab 8 8 2551 20,408 -

Ranitidin Tab 8 8 250 2,000 -
Kapsul Kosong 15 15 500 7,500 -
Curcuma Tab 10 10 1924 19,240 -
Dilavask 5 mg 5 5 2319 11,595 -
Opilax Syr 1 1 58300 58,300 -
SUB TOTAL 120,863 - 120,863
67 Ny. Misti 7/23/2016 Inf Ns 3 2 1 7721 7,721 -

Venflon 22 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Pantomet Inj 1 1 92625 92,625 -
Ondan 4 mg Inj 2 2 7288 14,576 -
Sp 5 cc 2 2 2478 4,956 -
Aquadest Inj 1 1 3312 3,312 -
Tensinop 10 mg Tab 3 3 5300 15,900 -
SUB TOTAL 172,876 - 172,876
7/23/2016 Ketorolac Inj 1 1 13669 13,669 -

Sp 3 cc 2 2 1609 3,218 -
Tramadol Inj 1 1 10631 - 10,631
SUB TOTAL 16,887 10,631 27,518
7/24/2016 Ondan 4 mg Inj 2 2 0 7288 - -

Pantomet Inj 1 1 0 73125 - -
Ketorolac Inj 2 2 0 16100 - -
Inf Ns 1 1 0 7721 - -
SUB TOTAL - - -
7/24/2016 Analsik Tab 10 10 1589 15,890 -

Omeprazol Tab 10 10 1475 14,750 -
Braxidin Tab 10 10 1166 11,660 -
Tensinop Tab 8 8 2968 23,744 -
SUB TOTAL 66,044 - 66,044
GRAND TOTAL
68 An. Najwa 7/24/2016 Berotec 8 8 1250 10,000 -
Mucohexime Syr 1 1 19610 19,610 -
Tramenza Tab 3 3 1530 4,590 -
Kertas Puyer 9 9 250 2,250 -
SUB TOTAL 36,450 - 36,450
69 Tn. Emanuel 7/21/2016 Inf Ns 0,9 % 1 1 7721 7,721 -

Pantomet Inj 1 1 73125 73,125 -
Ondan 4 mg Inj 2 2 7288 14,576 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 22 1 1 23186 23,186 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 142,853 - 142,853
7/21/2016 Stolax Supp 4 4 6694 26,776 -

Kateter 18 1 1 20405 20,405 -
Urine Bag 1 1 7288 7,288 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Urotractin Tab 2 2 8599 17,198 -
SUB TOTAL 78,265 - 78,265
7/22/2016 Pantomet Inj 1 1 92625 92,625 -

Ondan 4 mg Inj 6 6 7288 43,728 -
Inf Ns 3 3 7721 23,163 -
SUB TOTAL 176,714 - 176,714
7/23/2016 Pantomet Inj 1 1 0 73125 - -

Ondan 4 mg Inj 3 2 1 7288 7,288 -
Inf Ns 0,9% 4 3 1 7721 7,721 -
SUB TOTAL 32,207 - 32,207
7/24/2016 Pantomet Inj 1 1 73125 73,125 -

Ondan 4 mg Inj 1 1 7288 7,288 -
Inf Ns 0,9% 1 1 7721 7,721 -
SUB TOTAL 106,524 - 106,524
7/24/2016 Domperidon Tab 10 10 596 5,960 -

SUB TOTAL 5,960 - 5,960
GRAND TOTAL
70 Tn. Popo 7/24/2016 Trichodazole Tab 10 10 1855 - 18,550

Tranec Tab 10 10 3432 - 34,320
Molagit Tab 10 10 636 6,360 -
SUB TOTAL 6,360 52,870 59,230
71 An. Yanuaris 7/25/2016 Sanmol Drop 1 1 20551 20,551 -

Promuxol Drop 1 1 44520 44,520 -
Berotex 4 4 5000 20,000 -
SUB TOTAL 85,071 - 85,071
72 An. Rifad 7/25/2016 Oroprofen Syr 1 1 15400 - 15,400

Kassa Steril 1 1 10203 10,203 -
SUB TOTAL 10,203 15,400 25,603
73 Tn. Gusti Fajar 7/25/2016 Profenal Tab 10 10 1788 17,880 -

Thiamfilex Tab 10 10 1455 - 14,550
Tramenza Tab 10 10 1530 15,300 -
Grahabion Tab 10 10 725 - 7,250
SUB TOTAL 33,180 21,800 54,980
74 Tn. Tri Hari 7/25/2016 Clindamycin Tab 10 10 996 9,960 -
Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 27,450 - 27,450
75 An. Risqi 7/25/2016 Oroprofen Syr 1 1 15400 - 15,400

Amoxicilin Syr 1 1 8745 8,745 -
Tramenza Tab 3 3 1530 4,590 -
Kertas Puyer 10 10 250 2,500 -
SUB TOTAL 15,835 15,400 31,235
76 Tn. Popo S 7/25/2016 Spasmal Tab 10 10 600 6,000 -

SUB TOTAL 6,000 - 6,000
77 Ny. Sujiem 7/25/2016 Mefinal Tab 15 15 1749 26,235 -

SUB TOTAL 26,235 - 26,235
78 Ny. Maida 7/25/2016 Clindamycin Tab 10 10 996 9,960 -

Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 27,450 - 27,450
79 An. Erwin 7/23/2016 Inf Ns 2 2 7721 15,442 -

Venflon 22 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Ceftriaxon Inj 1 1 24778 24,778 -
Ondan 4 mg 2 2 7288 14,576 -
Ranitidin Inj 1 1 3746 3,746 -
Sp 3 cc 2 2 1895 3,790 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2419 2,419 -
Aquadest Inj 1 1 3312 3,312 -
Pct Tab 10 10 138 1,380 -
Molagit Tab 5 5 636 3,180 -
SUB TOTAL 115,655 - 115,655
7/24/2016 Ceftriaxon Inj 1 1 24778 24,778 -

Ondan 4 mg Inj 2 2 7288 14,576 -
Pct Tab 4 4 138 552 -
Molagit Tab 2 2 636 1,272 -
Inf Ns 4 4 7721 30,884 -
Sp 3 cc 2 2 1895 3,790 -
SUB TOTAL 81,386 - 81,386
7/25/2016 Cefixime Syr 1 1 42201 42,201 -

Opinecea 1 1 66250 66,250 -
SUB TOTAL 108,451 - 108,451
GRAND TOTAL
80 Nn. Anisa 7/26/2016 Ketokonazole Zalf 1 1 9692 9,692 -

Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 12,902 - 12,902
81 Tn. Rubiyo 7/26/2016 Amlodipin Tab 10 10 2465 24,650 -

Mertigo Tab 10 10 4306 43,060 -
Alprazolam Tab 5 5 1060 5,300 -
Nifedipin Tab 5 mg 1 1 186 186 -
SUB TOTAL 73,196 - 73,196
82 An. Christin 7/20/2016 Inf Rl 3 3 8700 26,100 -

Mucera Tab 2 2 1060 2,120 -
Dextafen Tab 2 2 1458 2,916 -
Kertas Puyer 12 12 100 1,200 -
SUB TOTAL 32,336 - 32,336
7/23/2016 Ceftriaxon Inj 1 1 24778 24,778 -

Ondan 4 mg Inj 1 1 7288 7,288 -
Inf D5% 3 1 2 8312 16,624 -
L- Bio 4 4 9275 37,100 -
SUB TOTAL 89,536 - 89,536
7/24/2016 Ceftriaxon Inj 1 1 0 24778 - -

Ondan 4 mg Inj 1 1 0 7288 - -
Ranitidin Inj 1 1 0 3746 - -
Inf D5 % 1 1 0 8312 - -
SUB TOTAL - - -
7/24/2016 Venflon 24 2 2 26235 52,470 -

Venflon 26 1 1 51013 51,013 -
SUB TOTAL 103,483 - 103,483
7/26/2016 Ceftriaxon Inj 1 1 33125 33,125 -

L- Bio 2 2 9275 18,550 -
Aquadest Inj 2 2 3312 6,624 -
Sp 3 cc 2 2 1895 3,790 -
Inf D5 1/4 Ns 2 1 1 17159 17,159 -
SUB TOTAL 79,248 - 79,248
GRAND TOTAL
83 Tn. Khoirul 7/26/2016 Captopril Tab 25 10 10 182 1,820 -

SUB TOTAL 1,820 - 1,820
84 Tn. Ignatius 7/26/2016 Indexon Tab 10 10 4467 44,670 -
Kalnex Tab 10 10 2785 27,850 -
SUB TOTAL 72,520 - 72,520
85 Tn. Frendi 7/26/2016 Clindamycin Tab 10 10 996 9,960 -

Mefinal 10 10 1749 17,490 -
SUB TOTAL 27,450 - 27,450
86 An. Izamsyah 7/26/2016 Apialys Syr 1 1 33125 33,125 -

SUB TOTAL 33,125 - 33,125
87 Nn. Kiki 7/25/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 22 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Ketorolac Inj 3 3 16100 48,300 -
Sp 3 cc 2 2 1895 3,790 -
SUB TOTAL 119,468 - 119,468
7/26/2016 Ketorolac Inj 3 3 16100 48,300 -

Aquadest Inj 2 2 3312 6,624 -
Inf Rl 3 3 8700 26,100 -
SUB TOTAL 87,384 - 87,384
7/26/2016 Indexon Tab 10 10 4467 44,670 -

Analsik Tab 10 10 1589 15,890 -
Pain Kila 1 1 13913 - 13,913
SUB TOTAL 60,560 13,913 74,473
GRAND TOTAL
88 Nn. Hijriyanti 7/26/2016 Mefinal Tab 10 10 1749 17,490 -
Indexon Tab 10 10 4467 44,670 -
SUB TOTAL 62,160 - 62,160
89 Tn. Suparno 7/27/2016 Berotec 15 15 9275 139,125 -

Inf Ns 2 2 500 1,000 -
Fartolin 4 mg 10 10 928 - 9,280
Indexon Tab 10 10 4467 44,670 -
Mucohexin Tab 10 10 600 6,000 -
SUB TOTAL 190,795 9,280 200,075
90 Ny. Siti 7/27/2016 Amlodipin Tab 10 mg 10 10 2465 24,650 -

Lansoprazole 10 10 1855 18,550 -
SUB TOTAL 49,160 - 49,160
91 Ny. Marselina 7/27/2016 Amlodipin 10 mg Tab 10 10 2465 24,650 -

Lansoprazole tab 10 10 1855 18,550 -
Trombo Aspilet tab 10 10 933 9,330 -
SUB TOTAL 58,490 - 58,490
92 An. Grace 7/27/2016 Tramenza Tab 3 3 1530 4,590 -

Mucera Tab 4 4 1060 4,240 -
Cetirizine tab 3 3 530 1,590 -
Mp 4 mg Tab 3 3 530 1,590 -
Kertas Puyer 12 12 250 3,000 -
Salbutamol Syr 1 1 6600 6,600 -
Opineacea Syr 1 1 66250 66,250 -
Sanmol Syr 1 1 15231 15,231 -
Ventolin Nebu 1 1 12476 12,476 -
SUB TOTAL 115,567 - 115,567
93 Tn. Yos 7/27/2016 Tramenza Tab 10 10 1530 15,300 -
Mucohexin tab 10 10 600 6,000 -
Cefixime 100 mg 10 10 2968 29,680 -
Opineacea Syr 1 1 66250 66,250 -
SUB TOTAL 117,230 - 117,230
94 Ny. Dewi 7/27/2016 Urotractin Tab 10 10 8599 85,990 -

Analsik Tab 10 10 1589 15,890 -
Omeprazole Caps 10 10 1475 14,750 -
Spasmal Tab 10 10 600 6,000 -
SUB TOTAL 128,590 - 128,590
95 Tn. Agustinus 7/27/2016 Opineacea Syr 1 1 66250 66,250 -

Mersibion Tab 10 10 2500 - 25,000
Valesco Tab 10 10 11660 116,600 -
SUB TOTAL 182,850 25,000 207,850
96 An. Grace 7/27/2016 Ventolin Nebu 1 1 12476 12,476 -

Biothicol Syr 1 1 25042 25,042 -
SUB TOTAL 37,518 - 37,518
97 Tn. Agus 7/27/2016 Celebrex Tab 10 10 17693 176,930 -

Mersibon Tab 10 10 2500 25,000 -
Megabal Tab 10 10 2186 21,860 -
SUB TOTAL 223,790 - 223,790
98 Ny. Dayuna 7/27/2016 Grazol 10 10 4910 49,100 -

Ketokonazole Zalf 1 1 9692 9,692 -
Cinolon N Zalf 1 1 23612 23,612 -
SUB TOTAL 87,704 - 87,704
99 Tn. Liaw 7/24/2016 Venflon 20 1 1 23188 23,188 -

Inf Set Makro 1 1 10600 10,600 -
Inf Ns 0,9% 3 3 7721 23,163 -
Ceftriaxon Inj 2 2 24778 49,556 -
Ketorolac Inj 1 1 16100 16,100 -
Aquadest Inj 1 1 3312 3,312 -
Sp 5 cc 1 1 2478 2,478 -
Sp 3 cc 2 2 1895 3,790 -
Sp 1 cc 1 1 2849 2,849 -
Adalat Oros 30 mg 4 4 10163 40,652 -
Opilax Syr 1 1 58300 58,300 -
Disflatyl Tab 4 4 810 3,240 -
SUB TOTAL 244,720 - 244,720
7/25/2016 Ranitidin Inj 2 2 3746 7,492 -

Ceftriaxon Inj 2 2 24778 49,556 -
Inf Ns 2 2 0 7721 - -
Adalat Oros 30 mg 1 1 10163 10,163 -
Disflatyl 1 1 810 810 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 71,333 - 71,333
7/25/2016 Ceftriaxon Inj 2 2 0 33125 - -

Opilax Syr 1 1 58300 58,300 -
SUB TOTAL 61,480 - 61,480
7/26/2016 Neurosanbe Inj 3 3 0 6493 - -

Celebrex tab 5 5 17693 88,465 -
SUB TOTAL 88,465 - 88,465
7/26/2016 Ranitidin Inj 2 2 3180 6,360 -

Ceftriaxon Inj 2 2 33125 66,250 -
Adalat Oros 2 2 10163 20,326 -
Aquadest inj 2 2 0 3312 - -
Inf Ns 3 3 7721 23,163 -
SUB TOTAL 117,719 - 117,719
7/27/2016 Ranitidin Inj 2 1 1 3746 3,746 -

Ceftriaxon Inj 2 2 24778 49,556 -
Adalat Oros 2 2 10163 20,326 -
Neurosanbe Inj 2 2 6493 12,986 -
SUB TOTAL 88,234 - 88,234
7/27/2016 Disflatyl Tab 10 10 810 8,100 -

Adalat Oros 10 10 8533 85,330 -
SUB TOTAL 93,430 - 93,430
GRAND TOTAL
100 Ny. Septiany 7/26/2016 Venflon 20 1 1 23186 23,186 -

Venflon 22 1 1 23186 23,186 -
inf Set Makro 1 1 10600 10,600 -
Inf Ns 3 3 7721 23,163 -
Ketorolac Inj 3 3 16100 48,300 -
Cortidex Inj 3 3 7500 22,500 -
Sp 3 cc 3 3 1895 5,685 -
SUB TOTAL 164,112 - 164,112
7/26/2016 Ranitidin Inj 2 2 3746 7,492 -
Ketorolac Inj 3 3 0 16100 - -
Cortidex Inj 3 3 7500 22,500 -
Inf Rl 2 2 8700 17,400 -
O2 200 200 250 50,000 -
SUB TOTAL 97,392 - 97,392
7/27/2016 Analsik Tab 10 10 1589 15,890 -

Indexon Tab 10 10 4467 44,670 -
Suprabion Tab 10 10 1759.8 17,598 -
SUB TOTAL 78,158 - 78,158
GRAND TOTAL
101 Tn. Budiman 7/27/2016 Amitripilin Tab 10 10 163 1,630 -

Allupurinol Tab 5 5 928 4,640 -
Simvastatin Tab 10 10 749 7,490 -
SUB TOTAL 13,760 7,250 21,010
102 Tn. Kasin 7/28/2016 Valesco 80 mg Tab 10 10 11660 116,600 -

Ramaflu Tab 8 8 1000 - 8,000
Lansoprazol Tab 10 10 1855 18,550 -
SUB TOTAL 140,450 8,000 148,450
103 Nn. Feti R 7/27/2016 Inf Set makro 1 1 10600 10,600 -

Venflon 22 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 68,141 - 68,141
7/28/2016 Ranitidin Inj 2 2 3746 7,492 -
SUB TOTAL 7,492 - 7,492
GRAND TOTAL
104 Tn. Entry 7/28/2016 Amlodipin Tab 10 mg 10 10 2465 24,650 -

Celebrex Tab 10 10 17693 176,930 -
Ranitidin Tab 10 10 321 3,210 -
Mersibion Tab 10 10 5016 - 50,160
SUB TOTAL 204,790 50,160 254,950
105 An. Gilbert 7/28/2016 Stesolid Supp 1 1 31482 31,482 -

SUB TOTAL 31,482 31,482
106 Nn. Dwi 7/28/2016 Tramenza Tab 2 2 1530 3,060 -

SUB TOTAL 3,060 3,060
107 Nn. Dwi 7/28/2016 Aquadest Inj 1 1 3312 3,312 -

Folley Cateter 16 1 1 20405 20,405 -
Sp 10 cc 1 1 3286 3,286 -
Urine Bag 1 1 7288 7,288 -
SUB TOTAL 34,291 34,291
108 An. Rafi 7/29/2016 Ventolin Nebu 1 1 12476 12,476 -

Bisolvon 4 4 5000 20,000 -
SUB TOTAL 32,476 32,476
109 Ny. Maria 7/29/2016 Amlodipin tab 10 mg 20 20 2465 49,300 -

Pct 10 10 138 1,380 -
SUB TOTAL 69,230 69,230
110 Ny. Sudarmi 7/29/2016 Ats Inj 1 1 152375 152,375 -

Lidocain Inj 2 2 2186 4,372 -
Sp 1 cc 2 2 2849 5,698 -
Sp 3 cc 1 1 1895 1,895 -
Aquadest Inj 1 1 3312 3,312 -
Bisturi 1 1 4638 4,638 -
Ragyl Tab 10 10 1000 10,000 -
Mefinal Tab 10 10 1749 17,490 -
Metformin 500 10 10 265 2,650 -
Glibenclamid tab 10 10 808 8,080 -
Tetagam Inj 1 1 250000 250,000 -
SUB TOTAL 460,510 460,510
111 Ny. Laisa 7/29/2016 Lansoprazole Tab 10 10 1855 18,550 -

Episan Syr 1 1 53795 53,795 -
SUB TOTAL 72,345 72,345
112 By. Meriani 7/27/2016 Venflon 26 1 1 51013 51,013 -

Inf D5 1/4 Ns 1 1 19941 19,941 -
Inf Set Mikro 1 1 10203 10,203 -
Cortidex Inj 1 1 7500 7,500 -
Sp 1 cc 2 2 2849 5,698 -
Ventolin Nebu 1 1 12476 12,476 -
SUB TOTAL 106,831 106,831
7/28/2016 Ceftriaxon Inj 1 1 33125 33,125 -

Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
Sp 3 cc 3 3 1895 5,685 -
Ventolin Nebu 5 5 12476 62,380 -
SUB TOTAL 107,325 107,325
7/28/2016 Dexa Inj 1 1 3000 3,000 -

SUB TOTAL 3,000 3,000
7/29/2016 Dexa Inj 1 1 3000 3,000 -

Ceftriaxon Inj 1 1 24778 24,778 -
SUB TOTAL 27,778 27,778
7/29/2016 Feding Tube 1 1 30000 30,000 -

SUB TOTAL 30,000 30,000
GRAND TOTAL
113 Ny. MungChin 7/27/2016 Venflon 20 1 1 23186 23,186 -

Inf Ns 2 2 7721 15,442 -
Inf Set Makro 1 1 10600 10,600 -
Citicolin Inj 2 2 39750 79,500 -
Sp 3 cc 2 2 1895 3,790 -
Aspilet Tab 3 3 933 2,799 -
Lisinopril Tab 3 3 901 2,703 -
SUB TOTAL 138,020 138,020
7/27/2016 Citicolin Inj 4 4 39750 159,000 -

Inf Ns 2 2 7721 15,442 -
SUB TOTAL 174,442 174,442
7/28/2016 Venflon 20 2 2 23186 46,372 -

SUB TOTAL 46,372 46,372
7/28/2016 Lapibal Inj 2 2 28885 57,770 -

Sp 3 cc 2 2 1895 3,790 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 64,846 64,846
7/29/2016 Lapibal Inj 3 3 28885 86,655 -

Adalat Oros 1 1 10163 10,163 -
Inf Ns 1 1 7721 7,721 -
SUB TOTAL 104,539 104,539
GRAND TOTAL
114 Nn. Yanti 7/29/2016 Cortidex Tab 10 10 364 3,640 -

Clindamycin Tab 10 10 996 9,960 -
SUB TOTAL 13,600 13,600
115 Ny. Nek Mah 7/30/2016 Lansoprazol Tab 10 10 1855 18,550 -

Episan Syr 1 1 53795 53,795 -
SUB TOTAL 78,305 78,305
116 Nn. Icha 7/30/2016 Thiamfilex Tab 10 10 1455 14,550 -

Mucohexin Tab 10 10 600 6,000 -
Tramenza Tab 10 10 1530 15,300 -
Pct Tab 10 10 138 1,380 -
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 40,440 40,440
117 An. Aura 7/30/2016 Ventolin Nebu 1 1 12456 12,456 -

Inf Ns 2 2 500 1,000 -
Fartolin Tab 5 5 928 - 4,640
Ambroxol Tab 5 5 437 2,185 -
Kertas Puyer 10 10 500 5,000 -
Cetirizine Syr 1 1 16231 16,231 -
SUB TOTAL 36,872 36,872
118 Ny. Winarsih 7/30/2016 Fartolin 2 2 4560 9,120 -

Inf Ns 2 2 500 1,000 -
Fartolin 14 14 928 12,992 -
Mucohexin Tab 10 10 600 6,000 -
Indexon 10 10 4467 44,670 -
Lansoprazole Tab 10 10 1855 18,550 -
SUB TOTAL 101,342 101,342
119 Tn. Sungki 7/27/2016 Inf Ns 0,9 1 1 7721 7,721 -

Venflon 22 1 1 23186 23,186 -
Venflon 20 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Nuurosanbe Inj 1 1 6493 6,493 -
Pumpitor Inj 1 1 99800 99,800 -
Sp 5 cc 2 2 2478 4,956 -
Metformin 500 mg 10 10 265 2,650 -
Glibenclamid Tab 10 10 808 8,080 -
SUB TOTAL 186,672 186,672
7/28/2016 Mucohexin Tab 10 10 600 6,000 -

SUB TOTAL 6,000 6,000
7/28/2016 Pumpitor Inj 1 1 99800 99,800 -

Inf Ns 3 3 7721 23,163 -
SUB TOTAL 129,416 129,416
7/29/2016 Pumpitor Inj 1 1 99800 99,800 -

Inf Ns 1 1 7721 7,721 -
SUB TOTAL 114,014 114,014
7/30/2016 Mucohexin Tab 10 10 600 6,000 -

Metformin Tab 20 20 265 5,300 -
SUB TOTAL 11,300 11,300
GRAND TOTAL
120 An. Riski 7/28/2016 Apyalis Drop 1 1 39750 39,750 -

Inf Set Mikro 1 1 10203 10,203 -
Venflon 26 1 1 51013 51,013 -
D5 1/4 Ns 1 1 19941 19,941 -
Kertas Puyer 4 4 250 1,000 -
SUB TOTAL 122,271 122,271
7/29/2016 Ceftrixone Inj 1 1 24778 24,778 -

Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 2 2 2849 5,698 -
Dexa inj 1 1 3000 3,000 -
Ventolin Nebu 2 2 12476 24,952 -
Ngt No 5 1 1 30000 30,000 -
SUB TOTAL 95,026 95,026
GRAND TOTAL
121 Tn. Irwan 7/30/2016 Asam Mefenamat Tab 10 10 400 4,000 -

Antasid Syr 1 1 5101 5,101 -
SUB TOTAL 13,741 13,741
122 Tn. Bambang 7/30/2016 Bicnat Tab 15 15 25 375 -

Urotractin Tab 10 10 8599 85,990 -
SUB TOTAL 104,915 104,915
123 Ny. Resti 7/30/2016 Sagestam Zalf 1 10 16105 16,105 -

SUB TOTAL 16,105 16,105
124 An. Wahyuni 7/30/2016 Cetirizine Syr 1 1 16231 16,231 -

SUB TOTAL 16,231 16,231
125 Tn. Jumadi 7/30/2016 Gastrolan Tab 10 10 15489 154,890 -

Episan Syr 1 1 53795 53,795 -
Allupurinol Tab 10 10 928 9,280 -
Avesco Tab 10 10 9328 93,280 -
SUB TOTAL 311,245 311,245
126 Ny. Mariani 7/30/2016 Lisinopril Tab 10 10 901 9,010 -

Fenofibrate 300 10 10 5101 51,010 -
Metformin Tab 500 10 10 265 2,650 -
SUB TOTAL 76,050 76,050
127 Nn. Nuraini 7/28/2016 Inf Set makro 1 1 10600 10,600 -

Venflon 22 2 2 23186 46,372 -
Inf Rl 2 2 8700 17,400 -
Pumpitor Inj 1 1 99800 99,800 -
Piralen Inj 3 3 9227 27,681 -
Buscopan Inj 3 3 27825 - 83,475
Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 2 2 1895 3,790 -
Episan Syr 1 1 53793 53,793 -
SUB TOTAL 262,722 83,475 346,197
7/29/2016 Sanmagh Tab 10 10 1020 10,200 -

SUB TOTAL 10,200 10,200
7/29/2016 Pumpitor Inj 1 1 99800 99,800 -
Piralen Inj 3 3 9227 27,681 -
Buscopan Inj 3 3 27825 - 83,475
SUB TOTAL 127,481 83,475 210,956
7/30/2016 Pumpitor Inj 1 1 99800 99,800 -

Piralen Inj 3 2 1 9227 9,227 -
Buscopan Inj 3 2 1 27825 - 27,825
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 124,469 27,825 152,294
7/30/2016 Domperidon Tab 15 15 596 8,940 -

Episan syr 1 1 53795 53,795 -
SUB TOTAL 62,735 - 62,735
GRAND TOTAL
128 Tn. Masma Anwar 7/27/2016 Ranitidin Inj 2 2 3746 7,492 -

Ondan 4 mg 2 2 7288 14,576 -
Ceftriaxon Inj 2 2 33125 66,250 -
mp Inj 1 1 0 51675 - -
Inf Rl 2 2 8700 17,400 -
Venflon 20 1 1 23186 23,186 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
Sp 3 cc 2 2 1895 3,790 -
Sp 5 cc 2 2 2478 4,956 -
Aminopilin Inj 2 2 8198 16,396 -
Aquadest Inj 2 2 3312 6,624 -
Inf Set Makro 1 1 10600 10,600 -
Ventolin Nebu 3 3 12476 37,428 -
Nasal Canul 1 1 14575 14,575 -
Venflon 22 2 2 23186 46,372 -
SUB TOTAL 275,780 - 275,780
7/28/2016 Pumpitor Inj 1 1 99800 99,800 -

Ondan 4 mg Inj 2 2 7288 14,576 -
Ceftriaxon Inj 2 2 0 24778 - -
Flamar 50 2 2 2200 4,400 -
Ventolin Nebu 1 1 12476 12,476 -
Sp 10 cc 1 1 3286 3,286 -
Aminopilin Inj 2 2 0 8198 - -
SUB TOTAL 134,538 - 134,538
7/28/2016 Venflon 22 1 1 23186 23,186 -

SUB TOTAL 23,186 - 23,186
7/29/2016 Pumpitor Inj 1 1 99800 99,800 -

Ondan 4 mg Inj 2 2 7288 14,576 -
Ceftriaxon Inj 1 1 24778 24,778 -
Mp Inj 1 1 61675 61,675 -
Ventolin Nebu 3 3 12476 37,428 -
SUB TOTAL 238,257 - 238,257
7/29/2016 Ambroxol Tab 10 10 437 4,370 -

SUB TOTAL 4,370 - 4,370
7/29/2016 Pumpitor Inj 1 1 99800 99,800 -

Ondan 4 mg Inj 2 2 7288 14,576 -
Inf Ns 1 1 4721 4,721 -
SUB TOTAL 119,097 - 119,097
GRAND TOTAL
129 Tn. Edo 7/30/2016 Flamicort Inj 2 2 20000 40,000 -

SUB TOTAL 40,000 - 40,000
130 Tn. Rahmat 7/30/2016 Novo Twist 5 5 3061 15,305 -
SUB TOTAL 15,305 - 15,305
131 Ny. Syarifah 7/30/2016 Mefinal Tab 10 10 1749 17,490 -

SUB TOTAL 17,490 - 17,490
132 Tn. Ignatius 7/30/2016 Cefadroxil caps 10 10 981 9,810 -

Asam Mefenamat Tab 10 10 400 4,000 -
SUB TOTAL 13,810 - 13,810
133 Nn. Julita 7/30/2016 Cefadroxil Caps 10 10 17581 175,810 -

Pct Tab 10 10 138 1,380 -
SUB TOTAL 177,190 - 177,190
134 An. Zaki 7/30/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 24 1 1 26235 26,235 -
Inf Rl 1 1 8700 8,700 -
Farizol Syr 1 1 6493 6,493 -
Inter ZinkSyr 1 1 40612 40,612 -
L- Bio 5 5 9275 46,375 -
SUB TOTAL 139,015 - 139,015
135 Nn. Dwi 7/30/2016 Tramenza Tab 10 10 1530 15,300 -

Grahabion Tab 10 10 725 - 7,250
SUB TOTAL 15,300 7,250 22,550
136 Ny. Misti 7/28/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 20 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Tramadol Inj 3 3 12521 - 37,563
Pumpitor Inj 1 1 99800 99,800 -
Ondan 8 mg Inj 2 2 7288 14,576 -
Eperison Inj 10 10 2041 20,410 -
Sp 10 cc 1 1 3286 3,286 -
Sp 5 cc 2 2 2478 4,956 -
SUB TOTAL 202,914 37,563 240,477
7/29/2016 Pumpitor Inj 1 1 99800 99,800 -

Ondan 4 mg Inj 1 1 7288 7,288 -
Analsik 3 3 1589 4,767 -
Eperison Tab 3 3 2041 6,123 -
Braxidin Tab 3 3 1166 3,498 -
Venflon 20 1 1 23186 23,186 -
Venflon 22 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
SUB TOTAL 193,948 - 193,948
7/29/2016 Pct Inf 3 3 65588 196,764 -

Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 200,050 - 200,050
7/29/2016 Eperison Tab 3 3 2041 6,123 -

Pumpitor Inj 1 1 99800 99,800 -
Sp 10 cc 1 1 3286 3,286 -
Valisanbe Tab 5 mg 2 2 364 728 -
SUB TOTAL 109,937 - 109,937
7/29/2016 Episan Syr 1 1 53795 53,795 -

SUB TOTAL 53,795 - 53,795
7/29/2016 Pumpitor Inj 2 2 99800 199,600 -

Pct Inf 1 1 65588 65,588 -
SUB TOTAL 267,718 - 267,718
7/30/2016 Pct Inf 1 1 65588 65,588 -

SUB TOTAL 65,588 - 65,588
GRAND TOTAL
137 Nn. Ayu 7/31/2016 Sanmagh Tab 10 10 1020 10,200 -

SUB TOTAL 28,750 - 28,750
138 An. Juwanti 7/31/2016 Sanmagh Tab 10 10 1020 10,200 -

SUB TOTAL 16,160 - 16,160
139 An. Putra 7/31/2016 Ventolin Nebu 1 1 12476 12,476 -

Remco Syr 1 1 8900 - 8,900
Salbutamol Syr 1 1 6600 6,600 -
SUB TOTAL 19,076 8,900 27,976
140 Tn. Wendi 7/31/2016 Venflon 22 1 1 23186 23,186 -

Calfera Tab 10 10 750 - 7,500
SUB TOTAL 23,186 7,500 30,686
141 Ny. Sumini 7/31/2016 Topcort Zalf 1 1 29442 29,442 -

SUB TOTAL 29,442 - 29,442
142 An. Maisya 7/31/2016 Molagit Tab 10 10 636 6,360 -

Domperidon Syr 1 1 7480 7,480 -
Pct Tab 10 10 138 1,380 -
Oralit 3 3 928 2,784 -
SUB TOTAL 18,004 - 18,004
143 Tn. Ichsan 7/31/2016 Analsik Tab 15 15 1589 23,835 -
Amitripilin Tab 15 15 163 2,445 -
Pregabalin Tab 10 10 8858 88,580 -
SUB TOTAL 114,860 - 114,860
144 Nn. Valena 7/31/2016 Cefixime Tab 10 10 2968 29,680 -

Spasmal Tab 10 10 600 6,000 -
SUB TOTAL 36,772 - 36,772
145 Tn. Antonius 7/31/2016 Cefadroxil caps 10 10 17581 175,810 -

Flamar 50 10 10 2200 22,000 -
Mp 4 mg Tab 10 10 530 5,300 -
SUB TOTAL 203,110 - 203,110
146 An. Aulia 7/31/2016 Ambroxol Tab 10 10 437 4,370 -

Tramenza 10 10 1530 15,300 -
Pct Tab 10 10 138 1,380 -
SUB TOTAL 21,050 - 21,050
147 An. Habib 7/31/2016 Sanprima Syr 1 1 28753 28,753 -

Interzink Syr 1 1 40612 40,612 -
L- Bio 5 5 9275 46,375 -
Tramenza Tab 3 3 1530 4,590 -
Pct Tab 3 3 138 414 -
Kertas Puyer 12 12 250 3,000 -
SUB TOTAL 123,744 - 123,744
148 An. Hafia 7/29/2016 Inf Set Makro 1 1 10600 10,600 -

Inf D5 % 2 2 8312 16,624 -
Cortidex Inj 2 2 7500 15,000 -
Ceftriaxon Inj 2 2 33125 66,250 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 117,921 - 117,921
7/29/2016 Ondan 4 mg Inj 1 1 7288 7,288 -

Sp 1cc 1 1 2849 2,849 -
Sp 3 cc 1 1 1895 1,895 -
Canul Anak 1 1 14575 14,575 -
O2 50 50 250 12,500 -
SUB TOTAL 39,107 - 39,107
7/30/2016 Ceftriaxon Inj 2 1 1 33125 33,125 -

Cortidex Inj 3 1 2 7500 15,000 -
Aquadest Inj 1 1 3312 3,312 -
Inf D5 % 2 2 8312 16,624 -
SUB TOTAL 68,061 - 68,061
7/30/2016 Inf D5 % 2 2 8312 16,624 -

Ceftriaxon Inj 2 2 24778 49,556 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3086 3,086 -
O2 1000 1000 250 250,000 -
SUB TOTAL 322,578 - 322,578
7/31/2016 Cefixime Syr 1 1 42201 42,201 -

SUB TOTAL 42,201 - 42,201
GRAND TOTAL
149 An. Resti 7/24/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 24 2 2 26235 52,470 -
Inf Rl 3 3 8700 26,100 -
Ondan 4 mg Inj 2 2 7280 14,560 -
Sp 3 cc 2 2 1895 3,790 -
Sp 10 cc 1 1 3286 3,286 -
Pct Inf 1 1 65588 65,588 -
SUB TOTAL 180,140 - 180,140
7/24/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 24 2 2 26235 52,470 -
Inf Rl 2 2 8700 17,400 -
SUB TOTAL 80,470 - 80,470
7/25/2016 Ondan 4 mg Inj 2 2 7288 14,576 -

Sp 3 cc 2 2 1895 3,790 -
Oralit 4 4 928 3,712 -
Cefotaxime Inj 2 2 15304 30,608 -
Aquadest Inj 2 2 3312 6,624 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 70,088 - 70,088
7/26/2016 Ondan 4 mg Inj 2 2 7288 14,576 -

Cefotaxime Inj 2 2 15304 30,608 -
Venflon 22 1 1 23186 23,186 -
SUB TOTAL 72,116 - 72,116
7/27/2016 Cefotaxime Inj 2 2 15304 30,608 -

Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
Inf D5 1/4 Ns 2 2 17159 34,318 -
Ondan 4 mg Inj 2 2 0 7288 - -
Oralit 3 3 928 2,784 -
SUB TOTAL 80,903 - 80,903
7/27/2016 Acitral Syr 1 1 33167 33,167 -

Interzink Syr 1 1 40612 40,612 -
Ceftriaxon Inj 2 2 24778 49,556 -
Aquadest Inj 2 2 3312 6,624 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 136,094 - 136,094
7/28/2016 Ranitidin Inj 1 1 3746 3,746 -

Ceftriaxon Inj 2 2 24778 49,556 -
SUB TOTAL 53,302 - 53,302
7/28/2016 Cortidex Inj 1 1 7500 7,500 -

Pct Syr 1 1 15231 15,231 -
SUB TOTAL 22,731 - 22,731
7/29/2016 Ceftriaxon Inj 2 2 24728 49,456 -

Dexa Inj 2 2 3000 6,000 -
SUB TOTAL 55,456 - 55,456
7/30/2016 Ceftriaxon Inj 2 2 33125 66,250 -

Aquadest Inj 1 1 3312 3,312 -
Cortidex Inj 3 3 7500 22,500 -
Inf Rl 2 2 8700 17,400 -
SUB TOTAL 109,462 - 109,462
7/30/2016 Inf Rl 2 2 8700 17,400 -
Ceftri Inj 2 1 1 24778 24,778 -
Cortidex Inj 1 1 0 7500 - -
Aquadest Inj 1 1 3312 3,312 -
Sp 1 cc 1 1 2849 2,849 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 51,625 - 51,625
7/31/2016 Cefixime Syr 1 1 42201 42,201 -

SUB TOTAL 42,201 - 42,201
GRAND TOTAL
150 Tn. Erwin 7/31/2016 Kandistatin Drop 1 1 51476 51,476 -

SUB TOTAL 51,476 - 51,476
TOTAL
Bendahara Yanmasum Sintang, Agustus 2016

Yang Menerima Pembantu Bendahara
Yang Menyerahkan
Kiki Indrawan
Serda NRP 21150228870193 Warsidi
Serma NRP 580944
UMUM DPK
UMUM DPK
Rp. Rp. Rp. Rp.

1 Ny. Rutwati 8/1/2016 Mefinal Tab 10 10 1,749 17,490 -
Indexon Tab 10 10 4,467 44,670 -
SUB TOTAL 62,160 - 62,160
2 Ny. Subhatun 8/1/2016 Letonal Tab 100 10 10 5466 54,660 -

Baquinor Tab 10 10 17934 179,340 -
SUB TOTAL 252,550 - 252,550
3 An. Bagus 8/1/2016 Pct Tab 10 10 138 1,380 -

Opinaeacea 1 1 66250 66,250 -
Indexon Tab 5 5 4467 22,335 -
SUB TOTAL 95,925 - 95,925
4 Tn. Sumarno 8/1/2016 Mesibion Tab 10 10 5016 50,160 -

SUB TOTAL 53,340 - 53,340
5 Nn. Nuril 8/1/2016 Inf Rl 1 1 8700 8,700 -

Venflon 20 1 1 23186 23,186 -
Venflon 22 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Pumpitor Inj 1 1 99800 99,800 -
Granon Inj 1 1 160325 160,325 -
Sp 10 cc 1 1 3286 3,286 -
Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 331,561 - 331,561
6 An. Maulia 7/27/2016 Inf Set Makro 1 1 9000 9,000 -

Venflon 24 1 1 22275 22,275 -
Inf D5 1/4 Ns 2 2 16931 33,862 -
Ketorolac Inj 1 1 13669 13,669 -
Sp 1 cc 2 2 2419 4,838 -
SUB TOTAL 86,824 - 86,824
7/28/2016 Cortidex Inj 1 1 7500 7,500 -

Pct Syr 1 1 15231 15,231 -
SUB TOTAL 22,731 - 22,731
7/28/2016 Cefotaxime Inj 1 1 15304 15,304 -

SUB TOTAL 15,304 - 15,304
7/29/2016 Cefotaxime Inj 2 2 24778 49,556 -

Dexa Inj 1 1 3000 3,000 -
SUB TOTAL 52,556 - 52,556
7/30/2016 Cefotaxime Inj 1 1 15304 15,304 -

Cortidex Inj 3 3 7500 22,500 -
Pct Syr 1 1 19700 19,700 -
Aquadest Inj 1 1 3312 3,312 -
Inf D5 % 2 2 8312 16,624 -
SUB TOTAL 77,440 - 77,440
7/31/2016 Inf D5 % 2 2 8312 16,624 -

Cefotaxime Inj 1 1 15304 15,304 -
Cortidex Inj 1 1 7500 7,500 -
Aquades Inj 1 1 3312 3,312 -
Sp 10 Cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 48,875 - 48,875
8/1/2016 Cefadroxyl Syr 1 1 13037 13,037 -
SUB TOTAL 13,037 - 13,037
GRAND TOTAL
7 An. Aqila 8/1/2016 Sanmol Syr 1 1 15231 15,231 -

Mucera Syr 1 1 22525 22,525 -
Biothicol Syr 1 1 25042 25,042 -
SUB TOTAL 62,798 - 62,798
8 Tn. Martinus 8/1/2016 Valesco Tab 10 10 11660 116,600 -

Strocain Tab 10 10 2551 25,510 -
Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 178,150 - 178,150
9 By. Erilin 8/1/2016 Domperidon Syr 1 1 7420 7,420 -

SUB TOTAL 7,420 - 7,420
10 Ny. Susilawati 7/31/2016 Inf Set makro 1 1 10600 10,600 -

Venflon 20 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Piralen Inj 3 3 9227 27,681 -
Recodryl 1 1 9275 9,275 -
Mertigo Sr 2 2 6029 12,058 -
Xepalium Tab 3 3 10931 32,793 -
Sp 5 cc 1 1 2478 2,478 -
Sp 3 cc 2 2 1895 3,790 -
SUB TOTAL 155,453 - 155,453
8/1/2016 Ranitidin Inj 2 2 3500 7,000 -

Mertigo 2 2 4306 8,612 -
Cymalium Tab 2 2 2041 - 4,082
Piralen Inj 2 2 9227 18,454 -
Inf Rl 3 3 8700 26,100 -
SUB TOTAL 66,126 4,082 70,208
8/2/2016 Lansoprazole 10 10 1855 18,550 -

Mertigo Sr 6 6 6029 36,174 -
Cymalium Tab 6 6 2041 - 12,246
SUB TOTAL 54,724 12,246 66,970
GRAND TOTAL
11 Ny. Veronika 8/2/2016 Mucohexin Tab 10 10 600 6,000 -

Cefixime Tab 10 10 2968 29,680 -
Opinacea Syr 1 1 66250 66,250 -
Indexon Tab 5 5 4467 22,335 -
SUB TOTAL 124,265 - 124,265
12 Tn. Rio 8/2/2016 Ciprofloxacin Tab 10 10 627 6,270 -

SUB TOTAL 6,270 - 6,270
13 An. Bayu 8/2/2016 Kalnex tab 10 10 2785 - 27,850

Mefinal Tab 10 10 1749 17,490 -
Indexon Tab 10 10 4467 44,670 -
SUB TOTAL 62,160 27,850 90,010
14 Tn. Tri H 8/2/2016 Clindamycin Tab 10 10 996 9,960 -

Pehacain Inj 1 1 2782 2,782 -
Kasa 3 3 1200 3,600 -
SUB TOTAL 20,342 - 20,342
15 Ny. Winarsih 8/2/2016 Fartolin Tab 20 20 928 - 18,560
Mucohexin Tab 10 10 600 6,000 -
Indexon Tab 10 10 4467 44,670 -
Lafidryl Syr 1 1 5712 - 5,712
SUB TOTAL 50,670 24,272 74,942
16 Ny. Sri Mulyani 8/2/2016 Isdn Tab 10 10 186 1,860 -

Trombo Aspilet 10 10 933 9,330 -
SUB TOTAL 35,700 - 35,700
17 Ny. Ani 8/1/2016 Inf Rl 3 3 8700 26,100 -

Inf Set makro 1 1 10600 10,600 -
Venflon 20 2 2 23186 46,372 -
Venflon 22 1 1 23186 23,186 -
Ondan 4 mg Inj 2 2 9275 18,550 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
Lodia Tab 10 10 16397 163,970 -
Molagit Tab 10 10 636 6,360 -
SUB TOTAL 307,003 - 307,003
8/2/2016 Inf Rl 2 2 8700 17,400 -

Ondan 4 mg Inj 2 2 7288 14,576 -
Sp 5 cc 1 1 2478 2,478 -
Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 43,841 - 43,841
8/2/2016 Molagit Tab 10 10 636 6,360 -

Vialop 5 5 500 - 2,500
SUB TOTAL 6,360 2,500 8,860
GRAND TOTAL
18 Tn. Dengue 8/3/2016 Celebrex Tab 10 10 17693 176,930 -

Mersibion Tab 10 10 5016 50,160 -
Amlodipin tab 10 10 2465 24,650 -
Flamar Gel 1 1 21500 21,500 -
SUB TOTAL 273,240 - 273,240
19 Ny. Sam 8/3/2016 Mucohexin Tab 10 10 600 6,000 -

Indexon Tab 10 10 4467 44,670 -
Cetirizine tab 10 10 530 5,300 -
Lafidryl Syr 1 1 5712 - 5,712
Opinacea Tab 10 10 750 7,500 -
SUB TOTAL 63,470 5,712 69,182
20 Ny. Florentina 8/3/2016 Flamar Tab 10 10 2200 22,000 -

Flamar Gel 1 1 21500 21,500 -
Lisinopril 10 mg Tab 10 10 901 9,010 -
Omeyus 10 10 800 - 8,000
SUB TOTAL 52,510 8,000 60,510
21 Ny. Musini 8/3/2016 Metformin 20 20 265 5,300 -

Mertigo Tab 10 10 4306 43,060 -
SUB TOTAL 57,370 - 57,370
22 An. Aura 7/30/2016 Inf D5 1/4 Ns 1 1 17159 17,159 -

Venflon 24 1 1 26235 26,235 -
Inf Set Makro 1 1 10600 10,600 -
Cefotaxime Inj 1 1 15304 15,304 -
Aquadest 1 1 3312 3,312 -
Sp 1 cc 1 1 2849 2,849 -
Sp 10 cc 1 1 3286 3,286 -
cortidex Inj 1 1 7500 7,500 -
SUB TOTAL 86,245 - 86,245
7/31/2016 Inf D5 1/2 Ns 2 2 19941 39,882 -

Cefotaxime Inj 1 1 15304 15,304 -
Dexa Inj 1 1 3000 3,000 -
Ventolin Nebu 2 2 12476 24,952 -
Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 1 1 1895 1,895 -
Venflon 26 1 1 51013 51,013 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 142,644 - 142,644
8/1/2016 Cefotaxime Inj 2 2 15304 30,608 -

Cortidex inj 2 2 7500 15,000 -
Inf D5 1/4 Ns 2 2 17159 34,318 -
SUB TOTAL 79,926 - 79,926
8/2/2016 Inf D5 1/4 Ns 2 2 17159 34,318 -

Indexon Inj 1 1 9275 9,275 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 49,728 - 49,728
8/2/2016 Cefadroxyl Syr 1 1 13037 13,037 -

SUB TOTAL 13,037 - 13,037
GRAND TOTAL
23 Ny. Sri 8/2/2016 Ptu 30 30 557 16,710 -

Bisoprolol Tab 10 10 2200 22,000 -
SUB TOTAL 38,710 - 38,710
24 Tn. Suhadi 7/31/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 20 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Citicolin Inj 125 mg 4 4 44387 177,548 -
Lapibal Inj 1 1 28885 28,885 -
Sp 5 cc 1 1 2478 2,478 -
Sp 3 cc 1 1 1895 1,895 -
Trombo Aspilet 1 1 933 933 -
SUB TOTAL 271,989 - 271,989
7/31/2016 Piracetam Inj 2 2 18113 36,226 -

Sp 20 cc 2 2 9275 18,550 -
Nedle 23 1 1 875 875 -
Citicolin Inj 1 1 44387 44,387 -
Sp 10 cc 1 1 3286 3,286 -
Pct Tab 3 3 138 414 -
SUB TOTAL 103,738 - 103,738
7/31/2016 Valisanbe Tab 1 1 364 364 -

SUB TOTAL 364 - 364
8/1/2016 Incelin Inj 1 1 44397 44,397 -

Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 47,683 - 47,683
8/1/2016 Lapibal Inj 1 1 28885 28,885 -

Piracetam Inj 1 1 18113 18,113 -
Trombo Aspilet Tab 1 1 933 933 -
Pct Tab 3 3 138 414 -
SUB TOTAL 48,345 - 48,345
8/2/2016 Citicolin Tab 10 10 7884 78,840 -

Piracetam Tab 30 30 11704 351,120 -
SUB TOTAL 429,960 - 429,960
8/2/2016 Inf Rl 2 2 8700 17,400 -

Incelin Inj 4 4 44387 177,548 -
Pct Tab 3 3 138 414 -
Sp 5 cc 1 1 2478 2,478 -
Sp 10 cc 2 2 3286 6,572 -
Sp 3 cc 1 1 3286 3,286 -
SUB TOTAL 208,995 - 208,995
GRAND TOTAL
25 Ny. Paula 8/2/2016 Painkila 1 1 13913 - 13,913

Analsik Tab 20 20 1589 31,780 -
Mp 4 mg Tab 20 20 530 10,600 -
SUB TOTAL 42,380 13,913 56,293
26 An. Kevin 8/2/2016 Sanmol Syr 1 1 15231 15,231 -

Apialys Syr 1 1 33125 33,125 -
SUB TOTAL 48,356 - 48,356
27 An. Lutfi 8/1/2016 Inf D5 1/4 Ns 2 2 17159 34,318 -

Venflon 24 1 1 26235 26,235 -
Inf Set Makro 1 1 10600 10,600 -
Oroprofen Syr 1 1 15400 - 15,400
SUB TOTAL 71,153 15,400 86,553
8/1/2016 Inf Rl 3 3 8700 26,100 -
Sp 10 cc 1 1 3286 3,286 -
Psiidii 1 1 38955 38,955 -
Nofebril Inf 1 1 93420 - 93,420
SUB TOTAL 68,341 93,420 161,761
8/2/2016 Inf Hes 6% 1 1 300000 300,000 -

Sp 3 cc 1 1 1895 1,895 -
Farmadol Inf 2 2 93500 187,000 -
SUB TOTAL 492,641 - 492,641
GRAND TOTAL
28 Tn. Sugeng 8/1/2016 Buscopan Inj 1 1 27825 - 27,825

Sp 3 cc 1 1 1895 1,895 -
Valisanbe Tab 5 mg 1 1 364 364 -
SUB TOTAL 2,259 27,825 30,084
8/1/2016 Inf Rl 1 1 8700 8,700 -

Venflon 24 1 1 26235 26,235 -
Inf Set Makro 1 1 10600 10,600 -
Pumpitor Inj 1 1 99800 99,800 -
Sp 10 cc 1 1 3286 3,286 -
Braxidin Tab 2 2 1166 2,332 -
SUB TOTAL 156,913 - 156,913
8/2/2016 Pumpitor Inj 1 1 99800 99,800 -

Buscopan Inj 2 2 27825 - 55,650
Episan Syr 1 1 53795 53,795 -
SUB TOTAL 179,197 55,650 234,847
GRAND TOTAL
29 Ny. Darmi 8/1/2016 Inf Rl 3 3 8700 26,100 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 22 2 2 23186 46,372 -
Venflon 20 1 1 23186 23,186 -
Inj Ceftriaxon Inj 2 2 33125 66,250 -
Aquadest Inj 1 1 3746 3,746 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
Sp 3 cc 1 1 1895 1,895 -
Inj Ranitidin Inj 1 1 3312 3,312 -
SUB TOTAL 193,556 - 193,556
8/2/2016 Spasmal Tab 10 10 600 6,000 -

SUB TOTAL 6,000 - 6,000
8/2/2016 Inf Rl 2 2 8700 17,400 -

Ceftriaxon Inj 2 2 33125 66,250 -
Aquadest Inj 1 1 3312 3,312 -
Sp 3 cc 1 1 1895 1,895 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 99,198 - 99,198
8/3/2016 Cefixime Tab 10 10 2986 29,860 -

Omeyus Tab 10 10 800 8,000 -
SUB TOTAL 37,860 - 37,860
GRAND TOTAL
30 An. Alfaiza S 8/3/2016 Nasal Canul 1 1 14575 14,575 -

O2 50 50 250 12,500 -
Inf Ns 2 2 500 1,000 -
Berotec 8 8 5000 40,000 -
Fartolin Tab 20 20 928 - 18,560
Dexclosan Tab 10 10 500 - 5,000
Cetirizin Tab 10 10 530 5,300 -
SUB TOTAL 73,375 23,560 96,935
31 Tn. Iskandar 8/3/2016 Ragyl 10 10 800 - 8,000

Flamar Tab 10 10 2200 22,000 -
Flamar Gel 1 1 21500 21,500 -
Indexon Tab 10 10 4467 44,670 -
SUB TOTAL 88,170 8,000 96,170
32 Tn. Edy 8/3/2016 Inf Ns 1 1 7721 7,721 -

Pumpitor Inj 1 1 99800 99,800 -
Granon Inj 1 1 160325 160,325 -
Ceftriaxon Inj 2 2 33125 66,250 -
Venflon 20 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Sp 10 cc 2 2 3286 6,572 -
Sp 1 cc 1 1 2846 2,846 -
Sp 5 cc 1 1 2478 2,478 -
Aquadest Inj 1 1 3312 3,312 -
O2 50 50 250 12,500 -
Nasal Canul 1 1 14575 14,575 -
Omeyus 10 10 1475 - 14,750
Ragyl 10 10 800 - 8,000
SUB TOTAL 416,125 22,750 438,875
33 Ny. Rici 8/3/2016 Amlodipin Tab 10 10 2465 24,650 -

Episan Syr 1 1 53795 53,795 -
Spasminal Tab 10 10 787 7,870 -
Omeyus 10 10 800 - 8,000
SUB TOTAL 86,315 8,000 94,315
34 Ny. Rosmiyanti 8/3/2016 Braxidin 10 10 1166 11,660 -

Omeyus 10 10 1475 - 14,750
SUB TOTAL 11,660 14,750 26,410
35 Tn. Abdul B 8/3/2016 Baquinor Forte 10 10 17934 179,340 -

Spasmal Tab 10 10 600 6,000 -
Braxidin Tab 10 10 1166 11,660 -
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 200,210 - 200,210
36 Tn. Asep 8/3/2016 Tramenza Tab 10 10 1530 15,300 -

Interpec Tab 10 10 13537 135,370 -
Samconal Tab 10 10 6493 64,930 -
SUB TOTAL 215,600 - 215,600
37 Tn. Jungki 8/4/2016 Domperidon Tab 10 10 596 5,960 -

Episan Syr 1 1 53795 53,795 -
Metformin Tab 500 20 20 265 5,300 -
SUB TOTAL 73,135 - 73,135
38 Tn. Habib 8/4/2016 Thramed Tab 10 10 2511 - 25,110

SUB TOTAL - 25,110 25,110
39 Tn. Erwin 8/4/2016 Mucohexin Tab 10 10 600 6,000 -
Tramenza Tab 10 10 1530 15,300 -
Pct Tab 10 10 138 1,380 -
Opinacea 1 1 66250 66,250 -
Cefixime Tab 10 10 2968 29,680 -
SUB TOTAL 118,610 - 118,610
40 Tn. M Badri 8/4/2016 Celebrex Tab 10 10 17693 176,930 -

Neurosanbe Tab 10 10 1385 13,850 -
Mucohexin Tab 10 10 600 6,000 -
SUB TOTAL 196,780 - 196,780
41 Ny. Tumini 8/4/2016 Metformin 500 20 20 265 5,300 -

Neurosanbe Tab 10 10 1385 13,850 -
Analsik Tab 10 10 1589 15,890 -
SUB TOTAL 35,040 - 35,040
42 Tn. Budi U 8/4/2016 Clidamycin Tab 10 10 996 9,960 -

Mefinal Tab 10 10 1745 17,450 -
SUB TOTAL 27,410 - 27,410
43 Tn. Yudik 8/4/2016 Elastis Verband 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
44 Tn. Ardian 8/4/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
45 Tn. Irwan 8/4/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
46 Tn. Lamijan 7/31/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 20 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Ondan 4 mg Inj 2 2 7288 14,576 -
Pantomet Inj 1 1 73125 73,125 -
Aquadest Inj 1 1 3312 3,312 -
Sp 5 cc 2 2 2478 4,956 -
Mertigo 5 5 4306 21,530 -
SUB TOTAL 177,385 - 177,385
8/1/2016 Ondan 4 mg Inj 2 2 7288 14,576 -

Pantomet Inj 1 1 92625 92,625 -
Mertigo Tab 1 1 4306 4,306 -
SUB TOTAL 111,507 - 111,507
8/2/2016 Inf Ns 2 2 7721 15,442 -

Ondan 4 mg Inj 2 2 7288 14,576 -
Pantomet Inj 1 1 92625 92,625 -
Mertigo 3 3 4306 12,918 -
Mefinal Tab 6 6 1749 10,494 -
Sp 5 cc 1 1 2478 2,478 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 151,819 - 151,819
8/2/2016 Thramadol Inj 3 3 12521 - 37,563

Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 1,895 37,563 39,458
8/3/2016 Pantoprazol Inj 1 1 102025 102,025 -

Tramadol Inj 2 2 12521 - 25,042
Mertigo 3 3 4306 12,918 -
SUB TOTAL 114,943 25,042 139,985
8/3/2016 Ondan 4 mg Inj 4 4 9800 39,200 -

Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 48,587 - 48,587
8/4/2016 Ondan 4 mg Inj 4 4 9800 39,200 -

Pantoprazole Inj 1 1 102025 102,025 -
Tramadol Inj 3 3 12521 - 37,563
Venflon 22 1 1 23186 23,186 -
SUB TOTAL 171,903 37,563 209,466
8/4/2016 Thramed Tab 10 10 2511 25,110 -

Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 34,280 - 34,280
GRAND TOTAL
47 Tn. Al- Rizki 8/4/2016 Verband Elastis 3 Inc 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
48 Tn. M Seger 8/4/2016 Benodon Inj 1.5 1.5 12666 18,999 -

Recodryl 1.5 1.5 10000 15,000 -
Sp 3 cc 1 1 1895 1,895 -
Nedle 23 1 1 875 875 -
Cefadroxil Tab 10 10 981 9,810 -
Pct Tab 10 10 138 1,380 -
Ramadexon Tab 10 10 600 - 6,000
SUB TOTAL 47,959 6,000 53,959
49 Tn. Jumali 8/4/2016 Ketorolac Inj 1 1 16100 16,100 -

Sp1 cc 1 1 2849 2,849 -
Sp 3 cc 1 1 1895 1,895 -
Analsik Tab 15 15 1589 23,835 -
Mp 4 mg Tab 15 15 530 7,950 -
Metformin Tab 10 10 265 2,650 -
SUB TOTAL 63,064 - 63,064
50 Tn. Gilang 8/4/2016 Tem Digital 1 1 26500 26,500 -

SUB TOTAL 26,500 - 26,500
51 Ny. Lilis 8/5/2016 Inf Rl 11 11 8700 95,700 -

SUB TOTAL 95,700 - 95,700
52 Ny. Siti M 8/5/2016 Alinamin F 1 1 21333 21,333 -

SUB TOTAL 21,333 - 21,333
53 Ny. Natalia 8/5/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 20 1 1 23186 23,186 -
Inf Ns 3 3 7721 23,163 -
Tramadol Inj 3 3 12521 - 37,563
Buscopan Inj 3 3 27825 - 83,475
Ranitidin Inj 3 3 3746 11,238 -
Piralen Inj 3 3 9227 27,681 -
Sp 3 cc 4 4 1895 7,580 -
SUB TOTAL 103,448 121,038 224,486
8/5/2016 Inf Ns 2 2 7721 15,442 -

Tramadol Inj 3 3 12521 - 37,563
Buscopan Inj 3 3 27825 - 83,475
Piralen Inj 3 3 9227 27,681 -
SUB TOTAL 50,615 121,038 171,653
8/5/2016 Scopamin Tab 20 20 2551 51,020 -
Thramed Tab 20 20 2511 - 50,220
Ciprofloxacin Tab 10 10 627 - 6,270
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 54,230 56,490 110,720
GRAND TOTAL
54 An. Valentina 8/5/2016 Kandistatin Drop 1 1 51476 51,476 -

Apyalis Drop 1 1 39750 39,750 -
SUB TOTAL 91,226 - 91,226
55 An. Greenelia 8/5/2016 Mucera Syr 1 1 22525 22,525 -

Pct Syr 1 1 6493 6,493 -
Cefixime 100 mg 10 10 2968 29,680 -
Opineacea Syr 1 1 66250 66,250 -
SUB TOTAL 124,948 - 124,948
56 Nn. Alfaiza 8/3/2016 Ventolin Nebu 3 3 12476 37,428 -

Inf Rl 3 3 8700 26,100 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 22 1 1 23186 23,186 -
Indexon Inj 3 3 9275 27,825 -
Sp 1 cc 1 1 2849 2,849 -
Cetirizin Tab 2 2 530 1,060 -
SUB TOTAL 129,048 - 129,048
8/4/2016 Indexon Inj 3 3 9275 27,825 -

Ventolin Nebu 3 3 12476 37,428 -
O2 1000 1000 250 250,000 -
SUB TOTAL 315,253 - 315,253
8/5/2016 Inf Rl 2 2 8700 17,400 -
Indexon In 1 1 9275 9,275 -
Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 28,570 - 28,570
05/082016 Mp 4 mg Tab 10 10 530 5,300 -

Ventolin Inhaler 1 1 84469 84,469 -
SUB TOTAL 89,769 - 89,769
GRAND TOTAL
57 An. Zahrotul 8/3/2016 Inf D5 % 2 2 8312 16,624 -

Inf Set Mikro 1 1 10203 10,203 -
Venflon 24 1 1 26235 26,235 -
Cefotaxim Inj 2 2 15304 30,608 -
aquadest Inj 2 2 3312 6,624 -
Sp 10 cc 2 2 3286 6,572 -
Sp 1 cc 1 1 2849 2,849 -
Ambroxol Tab 3 3 437 1,311 -
Methylprednisolon Tab 3 3 530 1,590 -
Apialis Syr 1 1 33125 33,125 -
Pct Inf 1 1 80000 80,000 -
Kertas Puyer 9 9 500 4,500 -
SUB TOTAL 221,831 - 221,831
8/3/2016 Pct Syr 1 1 6492 6,492 -

Inf Rl 3 3 7500 22,500 -
SUB TOTAL 28,992 - 28,992
8/4/2016 Stolax Supp 1 1 7884 7,884 -

SUB TOTAL 7,884 - 7,884
8/4/2016 Cefotaxime Inj 1 1 33125 33,125 -
Inf Rl 1 1 8700 8,700 -
SUB TOTAL 41,825 - 41,825
8/5/2016 Inf D5 % 2 2 8312 16,624 -

Cefotaxime Inj 2 2 15304 30,608 -
SUB TOTAL 47,232 - 47,232
GRAND TOTAL
58 Tn. Habib 8/5/2016 mefinal Tab 10 10 1749 17,490 -

SUB TOTAL 17,490 - 17,490
59 Ny. Dayang 8/5/2016 Lisinopril Tab 10 10 994 9,940 -

Ranitidin Tab 10 10 321 3,210 -
Mersibion Tab 10 10 5500 - 55,000
Thramed Tab 10 10 2600 - 26,000
SUB TOTAL 13,150 81,000 94,150
60 Ny. Aisyah 8/5/2016 Mucera Tab 2 2 1060 2,120 -

Tramenza Tab 2 2 1530 3,060 -
Cetirizin Tab 2 2 530 1,060 -
Kertas Puyer 12 12 500 6,000 -
Apialys Drop 1 1 39750 39,750 -
SUB TOTAL 51,990 - 51,990
61 An. Firman 8/5/2016 Oroprofen Syr 1 1 15000 - 15,000

Cefixime Syr 1 1 42201 42,201 -
Cetirizin Syr 1 1 16231 16,231 -
Ambroxol Syr 1 1 6956 6,956 -
Sagestam Zalf 1 1 16105 16,105 -
SUB TOTAL 81,493 15,000 96,493
62 An. Ali 8/5/2016 Oroprofen Syr 1 1 15000 - 15,000
Cefixime Syr 1 1 42201 42,201 -
Sagestam Zalf 1 1 16105 16,105 -
SUB TOTAL 58,306 15,000 73,306
63 An. Brian 8/6/2016 Molagit Tab 10 10 636 6,360 -

Oralit 5 5 928 - 4,640
Vialop 10 10 600 - 6,000
SUB TOTAL 12,320 10,640 22,960
64 Tn. Edo 8/6/2016 Nedle 23 3 3 875 2,625 -

Sp 3 cc 2 2 1895 3,790 -
SUB TOTAL 6,415 - 6,415
65 By. Ikram 8/6/2016 Mucera Drop 1 1 58300 58,300 -

SUB TOTAL 58,300 - 58,300
66 Tn. Suryanto 8/6/2016 Interpec Tab 10 10 13537 135,370 -

Fartolin Tab 10 10 928 - 9,280
Molagit Tab 10 10 636 6,360 -
SUB TOTAL 141,730 9,280 151,010
67 Ny. Siti M 8/6/2016 Alinamin F Inj 2 2 21333 42,666 -

SUB TOTAL 42,666 - 42,666
68 Tn. Hamidi 8/6/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 22 1 1 23186 23,186 -
Inf Ns 3 3 7721 23,163 -
Recodryl 1 1 9275 9,275 -
Pantomed Inj 1 1 92625 92,625 -
Aquadest Inj 1 1 3312 3,312 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 169,184 - 169,184
8/6/2016 Pantomed Inj 1 1 92625 92,625 -

Inf Ns 2 2 7721 15,442 -
SUB TOTAL 113,715 - 113,715
8/6/2016 Disflatyl Tab 10 10 810 8,100 -

Lapraz 10 10 15503 155,030 -
SUB TOTAL 163,130 - 163,130
GRAND TOTAL
69 Tn. Vitalis 8/4/2016 Inf Ns 1 1 7721 7,721 -

Venflon 20 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Ketorolac Inj 3 3 16100 48,300 -
Sp 3 cc 2 2 1896 3,792 -
Buscopan Inj 2 2 27825 - 55,650
Renax Tab 10 10 8700 87,000 -
SUB TOTAL 180,599 55,650 236,249
8/5/2016 Buscopan Inj 2 1 1 27825 - 27,825

Ketorolac Inj 3 2 1 16101 16,101 -
Inf Ns 3 2 1 7721 7,721 -
SUB TOTAL 23,822 27,825 51,647
8/6/2016 Renax Tab 10 10 8700 87,000 -

SUB TOTAL 87,000 - 87,000
GRAND TOTAL
70 Tn. Ivananda 8/6/2016 Ibuprofen tab 10 10 331 3,310 -
Ambroxol Tab 10 10 437 4,370 -
SUB TOTAL 7,680 - 7,680
71 An. Salwa 8/6/2016 Ventolin Nebu 1 1 12476 12,476 -

Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 15,762 - 15,762
72 An. Veronika 8/6/2016 Remco Syr 1 1 8400 - 8,400

SUB TOTAL 5,960 8,400 14,360
73 Tn. Budi 8/6/2016 Celebrex Tab 5 5 17693 88,465 -

Flamar Gel 1 1 21500 21,500 -
SUB TOTAL 109,965 - 109,965
74 Ny. Wahdah 8/7/2016 Cefadroxil Tab 10 10 981 9,810 -

SUB TOTAL 13,810 - 13,810
75 Ny. Siti M 8/7/2016 Alinamin F Inj 2 2 21333 42,666 -

SUB TOTAL 42,666 - 42,666
76 An. Alexander 8/7/2016 Sanmol Syr 1 1 15231 15,231 -

SUB TOTAL 23,976 - 23,976
77 An. Aufa 8/7/2016 Sanmol Syr 1 1 15231 15,231 -

Norvom Syr 1 1 14694 14,694 -
Ambroxol Tab 3 3 437 1,311 -
Tramenza Tab 3 3 1530 4,590 -
Ramadexon Tab 6 6 5962 - 35,772
Kertas Puyer 12 12 250 3,000 -
SUB TOTAL 38,826 35,772 74,598
78 Tn. Hendri 8/7/2016 Ctm Tab 10 10 46 460 -

Baquinor Forte 10 10 17934 179,340 -
Sagestam Zalf 1 1 16105 16,105 -
SUB TOTAL 195,905 - 195,905
79 Tn. Akiang 8/7/2016 Omeyus 10 10 1400 - 14,000

Episan 1 1 53795 53,795 -
Mucohexin 1 1 19610 19,610 -
Ramadexon Tab 10 10 800 - 8,000
Neurosanbe 1 1 6493 - 6,493
Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 75,300 28,493 103,793
80 Tn. Randy 8/7/2016 Sanmagh Syr 1 1 32940 32,940 -

Omeyus Tab 10 10 1400 - 14,000
Spasmal Tab 10 10 600 6,000 -
SUB TOTAL 38,940 14,000 52,940
81 An. Sean Agung 8/7/2016 Sanmol Syr 1 1 15231 15,231 -

Apialys Syr 1 1 33125 33,125 -
Yarzin Syr 1 1 40000 40,000 -
SUB TOTAL 88,356 - 88,356
82 Ny. Sri 8/5/2016 Piralen Inj 3 3 9227 27,681 -

Sp 3 cc 3 3 1895 5,685 -
Inf Set Makro 1 1 10203 10,203 -
Venflon 22 1 1 23186 23,186 -
Inf Rl 4 4 8700 34,800 -
Buscopan Inj 1 1 27825 - 27,825
Molagit tab 10 10 636 6,360 -
SUB TOTAL 115,407 27,825 143,232
8/6/2016 Piralen Inj 2 2 9227 18,454 -

Molagit Tab 8 8 636 5,088 -
Sp 3 cc 2 2 1895 3,790 -
Inf Rl 2 2 8700 17,400 -
SUB TOTAL 52,224 - 52,224
8/7/2016 Piralen Inj 3 3 9227 27,681 -

Molagit Tab 8 8 636 5,088 -
Inf Rl 2 2 8700 17,400 -
SUB TOTAL 57,661 - 57,661
8/7/2016 Ranitidin Inj 10 10 321 3,210 -

Cavicur 10 10 2500 25,000 -
O2 500 500 250 125,000 -
SUB TOTAL 153,210 - 153,210
GRAND TOTAL
83 Ny. Suti 8/8/2016 Ciprofoxacin Tab 6 6 627 - 3,762

Scopamin Tab 10 10 2551 25,510 -
Adalat Oros 10 10 10163 101,630 -
SUB TOTAL 127,140 3,762 130,902
84 Ny. Satijem 8/8/2016 Clindamycin Tab 10 10 996 9,960 -

Ciprofloxacin Tab 10 10 627 - 6,270
Sagestam Zalf 1 1 16105 16,105 -
SUB TOTAL 30,065 6,270 36,335
85 Tn. Satiyo 8/8/2016 Cefadroxil 500 10 10 981 9,810 -

Ketorolac Inj 1 1 16100 16,100 -
Sp 3 cc 1 1 1895 1,895 -
Novlam Tab 15 15 5101 76,515 -
SUB TOTAL 104,320 - 104,320
86 Tn. Habib 8/8/2016 Clindamycin Tab 10 10 996 9,960 -

SUB TOTAL 9,960 - 9,960
87 Tn. Dwindra 8/8/2016 Verband Elastis 15x4,9 2 2 32926 65,852 -

SUB TOTAL 65,852 - 65,852
88 Tn. Wahyu 8/8/2016 Verband Elastis 15x4,9 2 2 32926 65,852 -

SUB TOTAL 65,852 - 65,852
89 Tn. M Hidayat 8/8/2016 Verband Elastis 7,5x4,5 1 1 23320 23,320 -

Verband Elastis 15x4,5 1 1 32926 32,926 -
SUB TOTAL 56,246 - 56,246
90 Ny. Siti M 8/8/2016 Alinamin F 2 2 21333 42,666 -

Avesco 20 mg Tab 1 1 9328 9,328 -
SUB TOTAL 51,994 - 51,994
91 Tn. Habib 8/8/2016 Rivanol 1 1 4638 4,638 -

SUB TOTAL 4,638 - 4,638
92 An. Danang 8/8/2016 Ventolin Nebu 1 1 12476 12,476 -

Sp 3 cc 1 1 1895 1,895 -
Ambroxol Tab 3 3 437 1,311 -
Fartolin Tab 5 5 928 - 4,640
Kertas Puyer 10 10 250 2,500 -
Apialys Syr 1 1 33125 33,125 -
SUB TOTAL 51,307 4,640 55,947
93 An. Ellen 8/6/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 26 1 1 23186 23,186 -
Inf D5 % 1 1 8312 8,312 -
Pct Inf 1 1 65588 65,588 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 110,972 - 110,972
8/6/2016 Cefotaxime Inj 2 2 15304 30,608 -

Aquadest Inj 2 2 3312 6,624 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 43,367 - 43,367
8/7/2016 Cefotaxime Inj 2 2 15304 30,608 -

SUB TOTAL 30,608 - 30,608
8/7/2016 Ranitidin Inj 1 1 3746 3,746 -

Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 5,641 - 5,641
8/8/2016 Cefotaxime Inj 2 2 33125 66,250 -

Inf D5 % 3 2 1 8312 8,312 -
SUB TOTAL 78,308 - 78,308
GRAND TOTAL
94 An. Danang 8/8/2016 D5 1/2 Ns 2 2 17159 34,318 -

Inf Set Mikro 1 1 10203 10,203 -
Venflon 26 1 1 51013 51,013 -
Ceftriaxon Inj 1 1 28125 28,125 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
Cortidex Inj 1 1 7500 7,500 -
Sp 3 cc 1 1 1895 1,895 -
Nasal Canul 1 1 14575 14,575 -
SUB TOTAL 157,076 - 157,076
8/8/2016 Ventolin Nebu 1 1 12476 12,476 -

Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 14,954 - 14,954
GRAND TOTAL
95 Tn. Dwindra 8/9/2016 Amoxicilin Tab 10 10 464 4,640 -

Pehacain Inj 1 1 2783 2,783 -
Kasa 3 3 1200 3,600 -
SUB TOTAL 15,023 - 15,023
96 Tn. Masma 8/4/2016 Inf Ns 4 4 7721 30,884 -

Inf Set makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Ondan 4 mg Inj 2 2 7288 14,576 -
Pumpitor Inj 1 1 99800 99,800 -
Sp 5 cc 2 2 2478 4,956 -
Molagit Tab 3 3 636 1,908 -
SUB TOTAL 185,910 - 185,910
8/4/2016 Ceftriaxon Inj 2 2 33125 66,250 -

Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 75,697 - 75,697
8/4/2016 Inf Ns 2 2 7721 15,442 -

Molagit Tab 1 1 636 636 -
SUB TOTAL 16,078 - 16,078
8/4/2016 Pumpitor Inj 1 1 99800 99,800 -

SUB TOTAL 99,800 - 99,800
8/5/2016 Ceftriaxon Inj 2 2 33125 66,250 -

Pumpitor Inj 1 1 99800 99,800 -
Molagit tab 3 3 636 1,908 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 183,400 - 183,400
8/5/2016 Spasminal Tab 3 3 600 1,800 -

Gastrolan Tab 5 5 15489 77,445 -
SUB TOTAL 79,245 - 79,245
8/6/2016 Domperidon Tab 3 3 596 1,788 -

Spasmal Tab 2 2 600 1,200 -
Braxidin Tab 3 3 1166 3,498 -
Ceftriaxon Inj 1 1 33125 33,125 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 55,053 - 55,053
8/7/2016 Lansoprazole Inj 1 1 1855 1,855 -

Spaminal Tab 3 3 787 2,361 -
Braxidin Tab 3 3 1166 3,498 -
SUB TOTAL 9,502 - 9,502
8/7/2016 Nasal Canul 1 1 14575 14,575 -

SUB TOTAL 14,575 - 14,575
8/8/2016 Venflon 22 1 1 23186 23,186 -

Braxidin Tab 3 3 1166 3,498 -
SUB TOTAL 26,684 - 26,684
8/8/2016 Lapraz Tab 1 1 15503 15,503 -

Spasmal Tab 3 3 600 1,800 -
Inf Ns 3 3 7721 23,163 -
SUB TOTAL 41,658 - 41,658
8/9/2016 O2 50 50 250 12,500 -

O2 500 500 250 125,000 -
O2 2000 2000 250 500,000 -
O2 1500 1500 250 375,000 -
SUB TOTAL 1,012,500 - 1,012,500
8/9/2016 Inf Rl 2 2 8700 17,400 -

Spasmal Tab 3 3 600 1,800 -
Braxidin Tab 3 3 1166 3,498 -
SUB TOTAL 24,486 - 24,486
GRAND TOTAL
97 Tn. Idi 8/9/2016 Analsik Tab 10 10 1589 15,890 -

Baquinor Forte 10 10 17934 179,340 -
SUB TOTAL 195,230 - 195,230
98 Ny. Tjong Mui 8/9/2016 Braxidin Tab 30 30 1166 34,980 -
SUB TOTAL 34,980 - 34,980
99 Nn. Aster 8/9/2016 Molagit Tab 10 10 636 6,360 -

SUB TOTAL 6,360 - 6,360
100 An. Riska 8/9/2016 Sanmol Drop 1 1 20551 20,551 -

Oralit 10 10 928 9,280 -
SUB TOTAL 29,831 - 29,831
101 Tn. Fauzan 8/9/2016 Amoxicilin Tab 10 10 464 4,640 -

Pct Tab 10 10 138 1,380 -
Ragyl Tab 10 10 800 8,000 -
SUB TOTAL 14,020 - 14,020
102 Tn. Andri 8/10/2016 Tramenza Tab 10 10 1530 15,300 -

Cefixime 100 mg 10 10 2968 29,680 -
Mucohexin Tab 8 8 600 4,800 -
Imunos Tab 5 5 7656 38,280 -
SUB TOTAL 88,060 - 88,060
103 Tn. Surojo 8/10/2016 Sp 10 cc 1 1 3286 3,286 -

Abocat 18 1 1 23188 23,188 -
SUB TOTAL 26,474 - 26,474
104 Tn. Alwi 8/10/2016 Nadik 50 20 20 685 13,700 -

SUB TOTAL 13,700 - 13,700
105 Tn. Handrianus 8/10/2016 Amoxicilin Tab 10 10 464 4,640 -

Mefinal Tab 10 10 1749 17,490 -
Lidocain Inj 1 1 2186 2,186 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 27,165 - 27,165
106 An. Febri 8/10/2016 Ambroxol Tab 3 3 437 1,311 -

Fartolin Tab 8 8 928 - 7,424
Erysanbe 500 15 15 2968 44,520 -
Kertas puyer 40 40 500 20,000 -
SUB TOTAL 65,831 7,424 73,255
107 Ny. Supraptini 8/10/2016 Flamar 50 10 10 2200 22,000 -

Mersibion Tab 10 10 5016 - 50,160
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 25,210 50,160 75,370
108 Nn. Fitri 8/10/2016 Omeprazole 10 10 1475 14,750 -

Braxidin Tab 10 10 1166 11,660 -
SUB TOTAL 26,410 - 26,410
109 An. Gerind 8/11/2016 Ventolin Nebu 1 1 12476 12,476 -

Sp 3 cc 1 1 1895 1,895 -
Sanmol Drop 1 1 20551 20,551 -
Mucera Syr 1 1 22525 22,525 -
Cetirizin Syr 1 1 16231 16,231 -
SUB TOTAL 73,678 - 73,678
TOTAL

Yang Menyerahkan
Kiki Indrawan
Serma NRP 580944
UMUM DPK
Rp. Rp. Rp. Rp.
1 Nn. Trias 8/9/2016 Venflon 22 1 1 23,186 23,186 -
Inf Rl 3 3 8,700 26,100 -
Pantopain Inj 3 3 16,100 48,300 -
Pantomet Inj 2 2 92,625 185,250 -
Sp 3 cc 3 3 1895 5,685 -
Sp 5 cc 1 1 2478 2,478 -
Inf Set Makro 1 1 10600 10,600 -
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 304,809 - 304,809
8/9/2016 Buscopan Inj 1 1 27825 - 27,825

Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 1,895 27,825 29,720
8/10/2016 Ketorolac Inj 3 3 13669 41,007 -

Pantomet Inj 2 2 73123 146,246 -
Imunos Tab 2 2 7656 15,312 -
Inf Rl 2 2 7500 15,000 -
SUB TOTAL 217,565 - 217,565
8/10/2016 Ondan 8 mg Inj 1 1 11660 11,660 -

Episan Syr 1 1 53793 53,793 -
Braxidin Tab 10 10 1166 11,660 -
Analsik Tab 10 10 1589 15,890 -
SUB TOTAL 93,003 - 93,003
8/11/2016 Lapraz Tab 15 15 15503 232,545 -

Braxidin Tab 5 5 116 580 -
SUB TOTAL 242,065 - 242,065
GRAND TOTAL
2 Tn. Kholil 8/11/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 22 1 1 23186 23,186 -
Inf Rl 1 1 8700 8,700 -
Ketorolac Inj 2 2 16100 32,200 -
Ceftriaxon Inj 1 1 33125 33,125 -
Sp 5 cc 1 1 2478 2,478 -
Sp 3 cc 2 2 1895 3,790 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 120,674 - 120,674
3 Ny. Sri 8/11/2016 Lansoprazol Tab 10 10 1855 18,550 -

Sanmagh Tab 10 10 1020 10,200 -
SUB TOTAL 39,260 - 39,260
4 By. Abian 8/8/2016 Inf Set Mikro 1 1 10203 10,203 -

Venflon 24 1 1 26235 26,235 -
Inf D5 % 3 3 8312 24,936 -
SUB TOTAL 61,374 - 61,374
8/8/2016 Venflon 26 2 2 51013 102,026 -

SUB TOTAL 102,026 - 102,026
8/8/2016 Ceftriaxon Inj 1 1 33125 33,125 -

Cortidex Inj 1 1 7500 7,500 -
Sp 5 cc 1 1 2478 2,478 -
Sp 1 cc 5 5 2849 14,245 -
Nasal Canul Anak 1 1 14575 14,575 -
SUB TOTAL 71,923 - 71,923
8/9/2016 Ranitidin Inj 2 2 0 3746 - -

Travensis Inj 2 2 0 7425 - -
Ventolin Nebu 3 1 2 12475 24,950 -
Inf D5 1/4 Ns 2 2 17159 34,318 -
SUB TOTAL 59,268 - 59,268
8/9/2016 Domperidon Tab 20 20 596 11,920 -
Venflon 24 2 2 26235 52,470 -
SUB TOTAL 64,390 - 64,390
8/10/2016 Cortidex Inj 2 2 0 7500 - -

Ceftriaxon Inj 1 1 24778 24,778 -
Ventolin Nebu 2 2 0 12476 - -
Inf D5% 2 2 8312 16,624 -
Berotec 4 4 9275 37,100 -
SUB TOTAL 78,502 - 78,502
8/11/2016 Ceftriaxon Inj 1 1 0 33125 - -

Sp 10 cc 1 1 3286 3,286 -
Inf D5 % 2 2 8312 16,624 -
SUB TOTAL 19,910 - 19,910
GRAND TOTAL
5 Tn. Ramli 8/11/2016 Lidocain Inj 3 3 2186 6,558 -

Sp 3 cc 2 2 1895 3,790 -
Inj Ats 1 1 152375 152,375 -
Sp 1 cc 2 2 2849 5,698 -
Pct Tab 10 10 138 1,380 -
SUB TOTAL 174,441 - 174,441
6 An. Refan 8/11/2016 Sagestam Zalf 1 1 16105 16,105 -

Ats Inj 1 1 152375 152,375 -
Sp 1 cc 2 2 2849 5,698 -
SUB TOTAL 174,178 - 174,178
7 An. Raehan 8/11/2016 Pct Syr 1 1 6493 6,493 -
Mucera Syr 1 1 22525 22,525 -
SUB TOTAL 29,018 - 29,018
8 Ny. Ngasah Sen 8/11/2016 Celebrex Tab 10 10 17693 176,930 -

Flamaer Zalf 1 1 21500 21,500 -
SUB TOTAL 198,430 - 198,430
9 Nn. Sella 8/11/2016 Nadik 50 Tab 10 10 685 6,850 -

Neurosanbe Tab 10 10 1385 13,850 -
SUB TOTAL 20,700 - 20,700
10 Nn. Retno 8/11/2016 Cefadroxyl Tab 10 10 981 9,810 -

Mp 4 mg tab 10 10 530 5,300 -
Mefinal Tab 10 10 1749 17,490 -
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 41,770 - 41,770
11 Ny. Fitriah 8/12/2016 Omeparazole Caps 10 10 1475 14,750 -

Spasmal Tab 10 10 600 6,000 -
SUB TOTAL 20,750 - 20,750
12 An. Heru 8/12/2016 Salbutamol Tab 5 5 928 4,640 -

Ambroxol Tab 3 3 437 1,311 -
Kertas Puyer 10 10 500 5,000 -
SUB TOTAL 19,446 - 19,446
13 An. Ki'ai 8/12/2016 Cefixime Tab 10 10 2968 29,680 -

Sanmagh Tab 1 1 32940 32,940 -
Samconal Tab 10 10 1000 10,000 -
Apialys Syr 1 1 33125 33,125 -
SUB TOTAL 105,745 - 105,745
14 Tn. Gombang 8/11/2016 Inf Rl 2 2 8700 17,400 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Nasal Canul Dewasa 1 1 14575 14,575 -
Ngt 18 1 1 25043 25,043 -
Sp 50 cc 1 1 40081 40,081 -
Sp 3 cc 1 1 1895 1,895 -
Aspilet Tab 3 3 933 2,799 -
Plavix Tab 4 4 30608 122,432 -
Isdn Tab 3 3 186 558 -
Lisinopril Tab 1 1 901 901 -
SUB TOTAL 263,216 - 263,216
8/12/2016 Folley Cat 18 1 1 20405 20,405 -

Urine Bag 1 1 7288 7,288 -
Sp 10 cc 1 1 3286 3,286 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 34,291 - 34,291
8/12/2016 Ranitidin Inj 2 2 3746 7,492 -

Plavix Tab 1 1 30608 30,608 -
Isdn Tab 3 3 186 558 -
Liosinopril 1 1 901 901 -
SUB TOTAL 40,492 - 40,492
8/12/2016 O2 500 500 250 125,000 -

SUB TOTAL 125,000 - 125,000
GRAND TOTAL
15 Nn. Dwi 8/10/2016 Inf Rl 1 1 8700 8,700 -

Venflon 22 2 2 23186 46,372 -
Inf Set Mikro 1 1 10203 10,203 -
Buscopan Inj 3 3 27825 - 83,475
Pantomet Inj 1 1 73125 73,125 -
Ceftriaxon Inj 2 2 24778 49,556 -
Aquadest Inj 1 1 3312 3,312 -
Sp 3 cc 1 1 1896 1,896 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 201,777 83,475 285,252
8/11/2016 Buscopan Inj 3 3 27825 - 83,475

Pantomet Inj 1 1 92625 92,625 -
Inf Rl 2 2 8700 17,400 -
Sp 3 cc 1 1 1895 1,895 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 115,206 83,475 198,681
8/12/2016 Buscopan Inj 3 3 27825 - 83,475

Pantomet Inj 1 1 92625 92,625 -
Sp 10 cc 1 1 3286 3,286 -
Sp 5 cc 1 1 2478 2,478 -
Inf Rl 3 3 8700 26,100 -
SUB TOTAL 124,489 83,475 207,964
GRAND TOTAL
16 Ny. Lestiana 8/12/2016 Analsik Tab 10 10 1589 15,890 -

Avesco Tab 10 10 9328 93,280 -
Mertigo Tab 10 10 4306 43,060 -
SUB TOTAL 152,230 152,230
17 Tn. Zainal 8/12/2016 Amlodipin Tab 10 mg 5 5 2465 12,325 -

Mefinal Tab 10 10 1749 17,490 -
Topcort Cream 1 1 29442 29,442 -
SUB TOTAL 59,257 59,257
18 An. Farel 8/12/2016 Molagit Tab 10 10 636 6,360 -

Oralit 8 8 928 7,424 -
Pct tab 10 10 138 1,380 -
Norvom Tab 10 10 278 2,780 -
SUB TOTAL 17,944 17,944
19 Tn. Efendi 8/12/2016 Analsik Tab 10 10 1589 15,890 -

SUB TOTAL 23,380 23,380
20 Ny. Veronika 8/12/2016 Alinamin F 1 1 21333 21,333 -

SUB TOTAL 21,333 21,333
21 Tn. Hendra 8/10/2016 Inf Ns 1 1 7721 7,721 -

Venflon 20 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Ceftriaxon Inj 2 2 33125 66,250 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10b cc 1 1 3286 3,286 -
Sp 3 cc 2 2 1895 3,790 -
Sp 1 cc 1 1 2849 2,849 -
Curcuma Tab 10 10 1924 19,240 -
Pct Tab 10 10 138 1,380 -
SUB TOTAL 149,106 149,106
8/11/2016 Pantomet Inj 1 1 92625 92,625 -

Sp 10 cc 1 1 3286 3,286 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 99,223 99,223
8/11/2016 Bioxon Inj 2 2 245125 490,250 -

Ondan 4 mg Inj 2 2 9794 19,588 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 2 2 947 1,894 -
Inf Ns 2 2 3860 7,720 -
SUB TOTAL 533,542 533,542
8/12/2016 Terfacef Inj 1 1 128248 128,248 -

Trovensis Inj 2 2 6188 12,376 -
Pantomet Inj 1 1 92625 92,625 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 256,183 256,183
8/12/2016 Venflon 22 2 2 23186 46,372 -

Nasal Canul 1 1 14575 14,575 -
O2 100 100 250 25,000 -
SUB TOTAL 85,947 85,947
GRAND TOTAL
22 Dr. Viona 8/13/2016 Imunos Tab 4 4 7656 30,624 -

SUB TOTAL 30,624 30,624
23 Tn. Pamudi 8/13/2016 Inf Rl 3 3 8700 26,100 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Ondan 4 mg 1 1 7288 7,288 -
Sp 3 cc 3 3 1895 5,685 -
SUB TOTAL 76,605 76,605
24 Ny. Veronika 8/13/2016 Alinamin F 3 3 21333 63,999 -

SUB TOTAL 63,999 63,999
25 Ny. Tjong 8/13/2016 Braxidin Tab 10 10 1166 11,660 -

Omeparzole Tab 10 10 1475 14,750 -
Antasida Doen Syr 1 1 5101 5,101 -
SUB TOTAL 31,511 31,511
26 Ny. Veronika Diana 8/13/2016 Alprazolam Tab 5 5 1060 5,300 -

SUB TOTAL 5,300 5,300
27 By. M Farrel 8/13/2016 Ottopan Drop 1 1 23850 23,850 -

SUB TOTAL 32,595 32,595
28 Ny. Kholifah 8/12/2016 Inf Rl 3 3 8700 26,100 -

Venflon 22 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Tramadol Inj 3 3 18550 - 55,650
Ketorolac Inj 1 1 11100 11,100 -
Sp 3 cc 2 2 1895 3,790 -
SUB TOTAL 82,268 55,650 137,918
8/13/2016 Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 17,490 17,490
8/13/2016 Ranitidin Inj 2 2 3746 7,492 -

Inf Rl 3 2 1 8700 8,700 -
SUB TOTAL 16,192 16,192
GRAND TOTAL
29 Ny.Tresia S 8/13/2016 Cefadroxil 15 15 981 14,715 -

Cameloc 7,5 mg Tab 10 10 2130 21,300 -
Antasida Syr 1 1 5101 5,101 -
Ambroxol Tab 10 10 437 4,370 -
SUB TOTAL 45,486 45,486
30 Ny. Rita N 8/11/2016 Nifedipin Tab 1 1 186 186 -

Inf Ns 3 3 7721 23,163 -
Ketorolac Inj 1 1 16100 16,100 -
Ranitidin Inj 3 3 3746 11,238 -
Pantomet Inj 2 2 92625 185,250 -
Sp 3 cc 4 4 1895 7,580 -
Sp 5 cc 5 5 2478 12,390 -
Isdn Tab 10 10 186 1,860 -
Venflon 22 1 1 23186 23,186 -
Inf Set makro 1 1 10600 10,600 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 294,865 294,865
8/12/2016 Strocain Tab 5 5 2551 12,755 -

SUB TOTAL 12,755 12,755
8/12/2016 Ketorolac Inj 3 3 16100 48,300 -

Ranitidin Inj 3 3 3746 11,238 -
Pumpitor Inj 1 1 99800 99,800 -
Sp 3 cc 2 2 1895 3,790 -
Inf Ns 3 3 7721 23,163 -
SUB TOTAL 186,291 186,291
8/13/2016 Inf Ns 3 3 7721 23,163 -

Omeprazol Inj 1 1 73736 73,736 -
SUB TOTAL 96,899 96,899
8/13/2016 Lansoprazol Tab 10 10 1850 18,500 -

Isdn Tab 10 10 186 1,860 -
Strocain Tab 10 10 2551 25,510 -
O2 2000 2000 250 500,000 -
SUB TOTAL 545,870 545,870
GRAND TOTAL
31 Tn. Samin 8/13/2016 Ats Inj 1 1 152375 152,375 -

SUB TOTAL 152,375 152,375
32 Tn. Randhini 8/13/2016 Cefadroxil Tab 15 15 981 14,715 -

Tranec Tab 10 10 3432 34,320 -
Ambroxol Tab 10 10 437 4,370 -
SUB TOTAL 53,405 53,405
33 Tn. Aji 8/13/2016 Inf D5% 2 2 8312 16,624 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 22 2 2 23186 46,372 -
Opineacea Syr 1 1 66250 66,250 -
Analsik Tab 10 10 1589 15,890 -
SUB TOTAL 155,736 155,736
34 Nn. Mita 8/13/2016 Inf D5 % 2 2 8312 16,624 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Opinecea 1 1 66250 66,250 -
Analsik Tab 10 10 1589 15,890 -
SUB TOTAL 132,550 132,550
35 Ny. Sukardi 8/13/2016 Amlodipin Tab 10 mg 10 10 2465 24,650 -

Metformin Tab 20 20 265 5,300 -
Cavicur Tab 10 10 2500 25,000 -
Pct Tab 10 10 138 1,380 -
SUB TOTAL 56,330 56,330
36 Tn. Luk 8/11/2016 Inf Rl 3 3 8700 26,100 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Cefotaxime Inj 3 3 15304 45,912 -
Sp 10 cc 3 3 3286 9,858 -
Sp 3 cc 4 4 1895 7,580 -
Ketorolac Inj 4 3 1 16100 16,100 -
SUB TOTAL 139,336 139,336
8/12/2016 Ranitidin Inj 2 2 3746 7,492 -

Sp 3 cc 1 1 1895 1,895 -
Mersibion Tab 2 2 5016 - 10,032
Venflon 22 1 1 23186 23,186 -
SUB TOTAL 34,361 10,032 44,393
8/12/2016 Glimepiride Tab 1 1 1378 1,378 -

Metformin 500 mg 2 2 265 530 -
SUB TOTAL 1,908 1,908
8/13/2016 Cefotaxime Inj 2 2 0 15304 - -
Ranitidin Inj 2 2 0 3746 - -
Glimepiride 2 mg Tab 1 1 1378 1,378 -
Metformin Tab 2 2 265 530 -
Inf Rl 1 1 8700 8,700 -
SUB TOTAL 12,396 12,396
8/13/2016 Ciprofloxacin Tab 10 10 627 6,270 -

Avesco Tab 10 10 9328 93,280 -
SUB TOTAL 99,550 99,550
GRAND TOTAL
37 Tn. Hadi P 8/10/2016 Inf Rl 3 3 8700 26,100 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Pantomet Inj 1 1 92625 92,625 -
Ceftriaxon Inj 2 2 33125 66,250 -
Sp 10 cc 1 1 3286 3,286 -
Sp 5 cc 1 1 2478 2,478 -
Sp 1 cc 1 1 2849 2,849 -
Aquadest Inj 1 1 3312 3,312 -
Pct Tab 3 3 138 414 -
SUB TOTAL 231,100 231,100
8/11/2016 Ceftriaxon Inj 2 1 1 33125 33,125 -

Inf Rl 2 2 8700 17,400 -
Pantomet Inj 1 1 0 92625 - -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 50,525 50,525
8/11/2016 Omeprazol Tab 2 2 1475 2,950 -
Molagit Tab 5 5 636 3,286 -
SUB TOTAL 6,236 6,236
8/12/2016 Omeprazole Inj 1 1 73736 73,736 -

Terfacef Inj 1 1 128248 128,248 -
Molagit Tab 1 1 636 636 -
Inf Rl 3 3 8700 26,100 -
SUB TOTAL 228,720 228,720
8/13/2016 Cefat Tab 10 10 13300 133,000 -

Cavicur Tab 10 10 2500 25,000 -
Omeprazole Tab 10 10 1475 14,750 -
SUB TOTAL 172,750 172,750
GRAND TOTAL
38 Tn. Edi 8/13/2016 Opinecea 1 1 66250 66,250 -

Pct Tab 10 10 138 1,380 -
Mucohexin Tab 10 10 600 6,000 -
Cefadroxil 10 10 981 9,810 -
SUB TOTAL 83,440 83,440
39 Tn. Timotius 8/13/2016 Opineacea 1 1 66250 66,250 -

Omeprazole Inj 10 10 1475 14,750 -
SUB TOTAL 86,300 86,300
40 An. Daffa 8/13/2016 Remco Syr 1 1 10000 - 10,000

Opineacea 1 1 66250 66,250 -
Ramadexon Tab 5 5 800 - 4,000
Oroprofen Syr 1 1 15000 - 15,000
SUB TOTAL 66,250 29,000 95,250
41 Tn. Abd Rohim 8/13/2016 Lapraz Tab 10 10 15503 155,030 -
SUB TOTAL 160,990 - 160,990
42 Nn. Cindy 8/13/2016 Analsik Tab 10 10 1589 15,890 -

SUB TOTAL 15,890 - 15,890
43 Nn. Lisa 8/13/2016 Analsik Tab 10 10 1589 15,890 -

Ramadexon Tab 10 10 800 - 8,000
Hico Gel 1 1 28753 - 28,753
SUB TOTAL 15,890 36,753 52,643
44 Ny. Lilis 8/14/2016 Sagestam Zalf 2 2 16105 32,210 -

SUB TOTAL 32,210 - 32,210
45 An. Caca 8/14/2016 Sanmol Drop 1 1 20551 20,551 -

Interpec Syr 1 1 29800 29,800 -
Cetirizine Syr 1 1 16231 16,231 -
SUB TOTAL 66,582 - 66,582
46 Tn. Asrimudin 8/14/2016 Amlodipin Tab 10 mg 10 10 2465 24,650 -

SUB TOTAL 24,650 - 24,650
47 Tn. Mario H 8/14/2016 Pct Tab 15 15 138 2,070 -

Ciprofloxacin Tab 21 21 627 13,167 -
Sanmagh Tab 1 1 32940 32,940 -
Calfera Tab 10 10 1000 10,000 -
SUB TOTAL 58,177 - 58,177
48 By. Ozil 8/14/2016 Sanmol Drop 1 1 20551 20,551 -

Cetirizine Syr 1 1 16231 16,231 -
SUB TOTAL 45,567 - 45,567
49 Tn. Dede 8/13/2016 Ranitidin Inj 1 1 3746 3,746 -

Lidocain Inj 1 1 2186 2,186 -
Sp 3 cc 4 4 1895 7,580 -
Sp 1 cc 1 1 2849 2,849 -
Inf Ns 1 1 7721 7,721 -
Inf Set makro 1 1 10203 10,203 -
Venflon 20 1 1 23186 23,186 -
Ketorolac Inj 2 2 16100 32,200 -
Ats Inj 1 1 152375 152,375 -
Cefadroxil Tab 10 10 981 9,810 -
Bisturi 1 1 4638 4,638 -
SUB TOTAL 256,494 - 256,494
8/13/2016 Lidocain Inj 1 1 2186 2,186 -

Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 4,081 - 4,081
8/14/2016 Mefinal Tab 10 10 1749 17,490 -

SUB TOTAL 17,490 - 17,490
GRAND TOTAL
50 Nn. Leny 8/13/2016 Ranitidin Inj 1 1 3746 3,746 -

Inf Ns 1 1 7721 7,721 -
Ketorolac Inj 1 1 16100 16,100 -
Ats Inj 1 1 152375 152,375 -
Lidocain Inj 1 1 2186 2,186 -
Bisturi 1 1 4638 4,638 -
Sp 3 cc 4 4 1895 7,580 -
Sp 1 cc 1 1 2849 2,849 -
Venflon 20 1 1 23186 23,186 -
Inf Set Mikro 1 1 10203 10,203 -
Cefadroxil 10 10 981 9,810 -
SUB TOTAL 240,394 - 240,394
8/14/2016 Mefinal Tab 10 10 1749 17,490 -

Flamar Gel 1 1 21500 21,500 -
SUB TOTAL 38,990 - 38,990
GRAND TOTAL
51 Tn. Suparno 8/14/2016 Lansoprazole Tab 10 10 1855 18,550 -

Sanmagh Tab 10 10 1020 10,200 -
Braxidin Tab 10 10 1166 11,660 -
Nadic 50 mg Tab 10 10 685 6,850 -
SUB TOTAL 47,260 - 47,260
52 Nn. Diana 8/15/2016 Lansoprazole Tab 10 10 1855 18,550 -

Sanamgh Tab 10 10 1020 10,200 -
Spasmal Tab 10 10 600 6,000 -
SUB TOTAL 34,750 - 34,750
53 Tn. Dwi 8/15/2016 Elastic Verband 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
54 Tn. Ibnu 8/15/2016 Amoxicilin 10 10 464 4,640 -

Mefinal Tab 10 10 1749 17,490 -
SUB TOTAL 22,130 - 22,130
55 Tn. Muhwardi 8/15/2016 Ciprofloxacin Tab 10 10 627 - 6,270

Kateter 16 1 1 20405 20,405 -
Urine Bag 1 1 7288 7,288 -
Sp 10 cc 1 1 3286 3,286 -
Aquadest Inj 1 1 3312 3,312 -
SUB TOTAL 38,291 6,270 44,561
56 Tn. Kornelius 8/15/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
57 Tn. Ari 8/15/2016 Verband Elastic 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
58 Tn. Wahyu 8/15/2016 Verband Elastic 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
59 Tn. Willy 8/15/2016 Verband Elastic 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
60 Ny. Kasiyem 8/15/2016 Megabal 10 10 2186 21,860 -

Mersibion Tab 10 10 5016 - 50,160
Analsik Tab 10 10 1589 15,890 -
SUB TOTAL 37,750 50,160 87,910
61 An. Latifah 8/15/2016 Tramenza Tab 2 2 1530 3,060 -

Ambroxol tab 2 2 437 874 -
Mp 4 mg Tab 2 2 530 1,060 -
Kertas Puyer 10 10 500 5,000 -
L- Bio 3 3 9275 27,825 -
Oralit 3 3 928 2,784 -
SUB TOTAL 40,603 - 40,603
62 An. Resha 8/15/2016 Ottopan TT 1 1 47700 47,700 -

Cetirizine Syr 1 1 16231 16,231 -
Epexol Syr 1 1 30000 30,000 -
Amoxan Syr 1 1 53900 53,900 -
SUB TOTAL 147,831 - 147,831
63 An. Farel 8/13/2016 Inf Rl 2 2 8700 17,400 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 22 1 1 23186 23,186 -
Sp 3 cc 1 1 1895 1,895 -
Sanprima Syr 1 1 28753 28,753 -
SUB TOTAL 81,834 - 81,834
8/14/2016 Ondan Inj 1 1 9794 9,794 -

SUB TOTAL 9,794 - 9,794
8/14/2016 Metronidazol Inf 1 1 72875 72,875 -

L- Bio 2 2 9275 18,550 -
Sp 10 cc 1 1 3286 3,286 -
Inf D5 1/2 Ns 2 2 17159 34,318 -
SUB TOTAL 129,029 - 129,029
8/15/2016 Metronidazole Inf 1 1 72875 72,875 -

L- Bio 1 1 9275 9,275 -
Inf D5 1/2 Ns 2 2 17159 34,318 -
SUB TOTAL 116,468 - 116,468
GRAND TOTAL
64 An. Orcin 8/16/2016 Inf Rl 1 1 8700 8,700 -

Inf Set makro 1 1 10600 10,600 -
Sp 3 cc 2 2 1895 3,790 -
Ondan 4 mg Inj 1 1 7288 7,288 -
Venflon 24 3 3 26235 78,705 -
SUB TOTAL 112,829 - 112,829
8/16/2016 Ceftriaxon Inj 1 1 33125 33,125 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Sp 1 cc 1 1 2849 2,849 -
SUB TOTAL 42,572 - 42,572
8/16/2016 Ceftriaxon Inj 1 1 33125 33,125 -

Inf D5 1/2 Ns 2 2 17159 34,318 -
Inf Set Makro 1 1 19875 19,875 -
SUB TOTAL 91,064 - 91,064
8/16/2016 If D5 1/2 Ns 2 2 17159 34,318 -

Inf Set Mikro 1 1 19875 19,875 -
Inf Set Makro 1 1 10600 10,600 -
SUB TOTAL 64,793 - 64,793
GRAND TOTAL
65 Ny. Mey 8/16/2016 Kateter 18 1 1 20405 20,405 -

Urine Bag 1 1 7288 7,288 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Kasa Steril 1 1 8384 8,384 -
Inf Rl 6 6 8700 52,200 -
SUB TOTAL 94,875 - 94,875
66 Ny. Ira 8/16/2016 Nadik 50 mg 20 20 685 13,700 -

Betametason 1 1 3896 3,896 -
Calfera 10 10 1006.3 - 10,063
Anacetine Syr 1 1 13250 - 13,250
SUB TOTAL 17,596 23,313 40,909
67 An. Abid 8/16/2016 Amoxan Syr 1 1 53900 53,900 -
Apialys Syr 1 1 39750 39,750 -
SUB TOTAL 93,650 - 93,650
68 Ny. Wati 8/14/2016 Inf Set Makro 1 1 10203 10,203 -

Venflon 20 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Ketorolac Inj 6 6 16100 96,600 -
Pantomet Inj 1 1 92625 92,625 -
Analsik Tab 3 3 1589 4,767 -
Sanmagh Tab 3 3 1020 3,060 -
Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 264,200 - 264,200
8/15/2016 Pantomet Inj 1 1 92625 92,625 -

Sanmagh 2 2 1020 2,040 -
Analsik Tab 2 2 1589 3,178 -
Inf Rl 2 2 8700 17,400 -
Sp 5 cc 1 1 2478 2,478 -
Ketorolac Inj 2 2 16100 32,200 -
SUB TOTAL 149,921 - 149,921
8/16/2016 Lansoprazole Tab 10 10 1855 18,550 -

Sanmagh Tab 10 10 1020 10,200 -
Analsik Tab 10 10 1589 15,890 -
SUB TOTAL 50,600 - 50,600
GRAND TOTAL
69 Ny. Mistin 8/16/2016 Opilax Syr 1 1 53000 53,000 -
Mertigo Sr 5 5 8967 44,835 -
Cymalium 5 5 10931 54,655 -
SUB TOTAL 152,490 - 152,490
70 Tn. Rimbun 8/16/2016 Verband Elastic 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
71 Ny. Romim 8/13/2016 Inf Rl 2 2 8700 17,400 -

Lapibal Inj 3 3 0 28885 - -
Sp 3 cc 2 2 1895 3,790 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
SUB TOTAL 54,976 - 54,976
8/13/2016 D40% 1 1 4638 4,638 -

Inf Ns 2 2 7721 15,442 -
Sp 3 cc 1 1 1895 1,895 -
Sp 1 cc 1 1 2849 2,849 -
Fargoxin Tab 3 3 345 - 1,035
SUB TOTAL 24,824 1,035 25,859
8/14/2016 Aspilet 3 3 933 2,799 -

SUB TOTAL 2,799 - 2,799
8/15/2016 Inf Ns 3 3 7721 23,163 -

Venflon 22 1 1 23186 23,186 -
SUB TOTAL 46,349 - 46,349
8/15/2016 Kcl Inf 2 1 1 4638 4,638 -

Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 2 2 0 1895 - -
SUB TOTAL 15,416 - 15,416
8/16/2016 Ranitidin Inj 2 2 0 3746 - -

Kcl 2 2 0 4638 - -
Fargoxin Tab 1 1 345 - 345
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 15,442 345 15,787
GRAND TOTAL
72 Nn. Ester 8/16/2016 Flamar 50 mg Tab 1 1 1000 1,000 -

Inf Set Makro 1 1 10600 10,600 -
Inf Ns 1 1 7721 7,721 -
Venflon 20 1 1 23186 23,186 -
Ceftriaxon Inj 2 2 33125 66,250 -
Sp 5 cc 2 2 2478 4,956 -
Sp 3 cc 3 3 1895 5,685 -
Sp 1 cc 1 1 2845 2,845 -
Piralen Inj 1 1 5000 5,000 -
SUB TOTAL 134,735 - 134,735
73 Tn. M Azmi 8/16/2016 Cetirizine tab 10 10 530 - 5,300

Ramadexon Tab 10 10 596 5,960 -
SUB TOTAL 5,960 5,300 11,260
74 Nn. Maya 8/16/2016 Lansoprazol Tab 10 10 1855 18,550 -

Sanmol Tab 10 10 1020 10,200 -
Mertigo Tab 10 10 4306 43,060 -
SUB TOTAL 71,810 - 71,810
75 An. Misi 8/16/2016 Apialys Drop 1 1 39750 39,750 -

SUB TOTAL 39,750 - 39,750
76 Tn. Muhammad A 8/16/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
77 Ny. Warsila 8/13/2016 Inf Ns 1 1 7721 7,721 -

Transfusi Set 1 1 30608 30,608 -
Venflon 20 1 1 23186 23,186 -
Terfacef Inj 1 1 128248 128,248 -
Pantomet Inj 1 1 92625 92,625 -
Sp 10 cc 2 2 3286 6,572 -
Sp 1 cc 1 1 2849 2,849 -
Aquadest Inj 1 1 3312 3,312 -
Psiidi 10 10 5300 53,000 -
SUB TOTAL 354,081 - 354,081
8/14/2016 Neurosanbe Inj 2 2 6493 12,986 -

Sp 3 cc 1 1 1895 1,895 -
Folavit 10 10 928 9,280 -
Ceftriaxon Inj 2 2 33125 66,250 -
Pantomet Inj 1 1 92625 92,625 -
Aquadest Inj 1 1 3312 3,312 -
Sp 10 cc 1 1 3286 3,286 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 205,076 - 205,076
8/14/2016 Venflon 20 1 1 23186 23,186 -

SUB TOTAL 23,186 - 23,186
8/15/2016 Ceftriaxon Inj 2 2 33125 66,250 -

Pantomet Inj 1 1 92625 92,625 -
Sp 10 cc 2 2 3286 6,572 -
Sp 3 cc 1 1 1895 1,895 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 182,784 - 182,784
8/16/2016 Ceftriaxon Inj 2 2 33125 66,250 -

Aquadest Inj 1 1 3312 3,312 -
Inf Ns 3 3 7721 23,163 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
Venflon 20 2 2 23186 46,372 -
SUB TOTAL 149,430 - 149,430
8/16/2016 Ciprofloxacin Tab 20 20 627 - 12,540

Mersibion Tab 30 30 2500 - 75,000
Folavit Tab 20 20 928 - 18,560
SUB TOTAL - 106,100 106,100
GRAND TOTAL
78 Tn. Aton 8/16/2016 Mersibion Tab 10 10 5500 - 55,000

Flamar Tab 10 10 2200 22,000 -
Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 25,210 55,000 80,210
79 An. Krisologus 8/16/2016 Ambroxol tab 2 2 437 874 -

Fartolin tab 4 4 1000 - 4,000
Kertas Puyer 10 10 250 2,500 -
Cetirizine Syr 1 1 16231 16,231 -
Gentamicin Zalf 1 1 16105 16,105 -
SUB TOTAL 44,455 4,000 48,455
80 An. Nyemas 8/16/2016 Apialys Syr 1 1 33125 33,125 -
Sanmol Syr 1 1 15231 15,231 -
SUB TOTAL 48,356 - 48,356
81 An. Safira 8/16/2016 Xepafen Syr 2 2 29150 58,300 -

Hico Gel 1 1 28753 28,753 -
SUB TOTAL 95,798 - 95,798
82 Ny. Biku 8/12/2016 Inf Rl 2 2 8700 17,400 -

Inf Set makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Tramadol Inj 1 1 18550 - 18,550
Sp 3 cc 1 1 1895 1,895 -
Lisinopril Tab 1 1 901 901 -
Megabal tab 3 3 2186 6,558 -
SUB TOTAL 60,540 18,550 79,090
8/12/2016 Tramadol Inj 3 3 18550 - 55,650

Inf Rl 2 2 8700 17,400 -
SUB TOTAL 17,400 55,650 73,050
8/13/2016 Inf Rl 2 2 8700 17,400 -

Lapibal Inj 3 3 2186 6,558 -
SUB TOTAL 23,958 - 23,958
8/13/2016 Terfacef Inj 2 2 128248 256,496 -

Sp 1 cc 1 1 2849 2,849 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 262,631 - 262,631
8/14/2016 Terfacef Inj 2 2 128248 256,496 -
SUB TOTAL 258,945 - 258,945
8/14/2016 Kcl 4 4 4638 18,552 -

Sp 20 cc 1 1 9275 9,275 -
Nedle 1 1 875 875 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 44,144 - 44,144
8/15/2016 Ceftriaxon Inj 2 2 33125 66,250 -

Kcl 3 3 4638 13,914 -
Inf Rl 3 3 8700 26,100 -
SUB TOTAL 106,264 - 106,264
8/16/2016 Terfacef Inj 1 1 128248 128,248 -

Kcl 4 4 4638 18,552 -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 162,242 - 162,242
8/17/2016 Amlodipin Tab 5 5 2465 12,325 -

Megabal Tab 15 15 2186 32,790 -
SUB TOTAL 45,115 - 45,115
GRAND TOTAL
83 Ny. Maryati 8/17/2016 Asam Mefenamat Tab 10 10 400 4,000 -

Acylovir Tab 70 70 742 51,940 -
Acylovir Zalf 1 1 3611 3,611 -
SUB TOTAL 59,551 - 59,551
84 Tn. M Arifin 8/17/2016 Sp 10 cc 1 1 3286 3,286 -

Abocat 18 1 1 23188 - 23,188
Reco TTM 1 1 9275 9,275 -
SUB TOTAL 16,561 23,188 39,749
85 Tn. Farid 8/17/2016 Reco TTM 1 1 9275 9,275 -

Indexon Tab 10 10 4467 44,670 -
SUB TOTAL 57,945 - 57,945
86 Tn. Paskalis 8/17/2016 Lisinopril tab 30 30 901 27,030 -

Letonal Tab 10 10 1484 14,840 -
Furosemid Tab 10 10 268 2,680 -
SUB TOTAL 63,100 - 63,100
87 Nn. Saraswati 8/17/2016 Mucohexin Tab 10 10 600 6,000 -

Mp 8 mg Tab 10 10 928 9,280 -
Cefat Tab 10 10 12786 127,860 -
SUB TOTAL 143,140 - 143,140
88 Ny. Nani 8/17/2016 Thramed Tab 10 10 2319 - 23,190

Ranitidin Tab 10 10 321 3,210 -
Buscopan Inj 1 1 27285 - 27,285
Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 5,105 50,475 55,580
89 Tn. Bambang 8/17/2016 Samconal tab 10 10 5644 56,440 -

Indexon Tab 10 10 4467 44,670 -
SUB TOTAL 101,110 - 101,110
90 Ny. Roni 8/17/2016 Allupurinol Tab 10 10 928 9,280 -

Cavicur 10 10 1924 19,240 -
SUB TOTAL 28,520 - 28,520
91 Ny. Nani 8/18/2016 Tivomit Tab 10 10 500 5,000 -

SUB TOTAL 5,000 - 5,000
92 Tn. Maulana 8/18/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
93 Tn. Amaral 8/18/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
94 Tn. Suhardi 8/18/2016 Lidocain Inj 1 1 2186 2,186 -

Sp 1 cc 2 2 2849 5,698 -
Ragyl Forte 500 10 10 1000 - 10,000
SUB TOTAL 11,884 10,000 21,884
95 Tn. Supriyadi 8/18/2016 Ats Inj 1 1 152375 152,375 -

Lidocain Inj 1 1 2186 2,186 -
Sp 1 cc 2 2 2849 5,698 -
Inf Ns 1 1 6409 6,409 -
Ragyl Forte 10 10 1000 10,000 -
Indexon Tab 10 10 4467 44,670 -
SUB TOTAL 225,338 - 225,338
96 Tn. Tri 8/18/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
97 Tn. Yilyanus 8/18/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
98 Nn. Siti R 8/17/2016 Inf Ns 2 2 7721 15,442 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Nasal Canul 1 1 14575 14,575 -
Omeprazole Inj 2 1 1 93500 93,500 -
Sp 10 cc 2 2 3280 6,560 -
O2 50 50 250 12,500 -
SUB TOTAL 176,363 - 176,363
8/18/2016 Omz Inj 2 2 0 73736 - -

Inf Ns 2 2 7721 15,442 -
SUB TOTAL 15,442 - 15,442
8/18/2016 Inf Set Makro 1 1 10600 10,600 -

Sp 5 cc 1 1 2478 2,478 -
Inf Ns 1 1 7721 7,721 -
SUB TOTAL 20,799 - 20,799
8/18/2016 Lansoprazole tab 10 10 1855 18,550 -

Sanmagh Tab 10 10 1020 10,200 -
SUB TOTAL 28,750 - 28,750
GRAND TOTAL
99 Tn. Ali 8/18/2016 Amlodipin 10 mg Tab 15 15 2465 36,975 -

Mersibion tab 10 10 5010 50,100 -
Renax Tab 20 20 8700 174,000 -
Trombo Aspilet 15 15 933 13,995 -
SUB TOTAL 280,760 - 280,760
100 Tn. Theodoros 8/18/2016 Samconal Tab 10 10 564.4 5,644 -

Opinecea Syr 1 1 66250 66,250 -
SUB TOTAL 77,194 - 77,194
101 Tn. M Fadel 8/18/2016 Cetirizine Tab 10 10 530 5,300 -

Ranitidin Tab 10 10 321 3,210 -
Omz Tab 10 10 1475 14,750 -
SUB TOTAL 29,220 - 29,220
102 Tn. Hamdan 8/18/2016 Verband Elastis 2 2 23320 46,640 -

SUB TOTAL 46,640 - 46,640
103 Nn. Niki R 8/17/2016 Braxidin Tab 2 2 1166 2,332 -

SUB TOTAL 2,332 - 2,332
8/17/2016 Cymalium Tab 2 2 10931 - 21,862

Analsik Tab 3 3 1589 4,767 -
Spasminal Tab 3 3 787 2,361 -
SUB TOTAL 7,128 21,862 28,990
8/18/2016 Pantomet Inj 1 1 92625 92,625 -

Xepalium Tab 10 10 10931 109,310 -
Analsik Tab 10 10 1589 15,890 -
Spasmal Tab 10 10 600 6,000 -
Inf Ns 3 1 2 7721 15,442 -
SUB TOTAL 239,267 - 239,267
8/18/2016 Venflon 22 1 1 23186 23,186 -

Inf Set Makro 1 1 10600 10,600 -
Pantomet Inj 1 1 0 92625 - -
Sp 10 cc 1 1 3286 3,286 -
Aquadest Inj 1 1 3312 3,312 -
Sp 3 cc 1 1 1895 1,895 -
Braxidin Tab 3 3 1166 3,498 -
Inf Ns 2 2 0 7721 - -
SUB TOTAL 45,777 - 45,777
8/18/2016 Ondan 4 mg Inj 10 10 7288 72,880 -

Omz Tab 10 10 1475 14,750 -
SUB TOTAL 87,630 - 87,630
GRAND TOTAL
104 An. Mathias 8/18/2016 Xepafen Syr 1 1 36437 36,437 -

Opinecea Syr 1 1 66250 66,250 -
SUB TOTAL 102,687 - 102,687
105 Nn. Aster 8/18/2016 Salbutamol Tab 4 4 133 532 -

SUB TOTAL 532 - 532
106 Tn. Feriansyah 8/18/2016 Lidocain Inj 1 1 2186 2,186 -

Sp 1 cc 1 1 2849 2,849 -
Cefat Tab 10 10 12786 127,860 -
SUB TOTAL 136,895 - 136,895
107 Ny. Wahiddiana 8/18/2016 Ventolin Nebu 1 1 12476 12,476 -

Ramadexon Tab 10 10 500 - 5,000
Ventolin Eks Syr 1 1 69019 69,019 -
SUB TOTAL 81,495 5,000 86,495
108 Tn. Antonius 8/19/2016 Mucohexin Tab 10 10 600 6,000 -

Baquinor Tab 10 10 17934 179,340 -
SUB TOTAL 190,640 - 190,640
109 Ny. Martinah 8/14/2016 Transfusi Set 1 1 30608 30,608 -
Venflon 20 1 1 23186 23,186 -
Inf Rl 2 2 8700 17,400 -
Pregabalin Tab 1 1 8858 8,858 -
Ranitidin Tab 2 2 3746 7,492 -
Sp 3 cc 3 3 1895 5,685 -
Mp 4 mg Tab 3 3 530 1,590 -
SUB TOTAL 94,819 - 94,819
8/14/2016 Ranitidin Inj 1 1 3746 3,746 -

SUB TOTAL 27,371 - 27,371
8/15/2016 Pregabalin Tab 2 2 8858 17,716 -

Sp 3 cc 6 6 1895 11,370 -
Sp 10 cc 1 1 3286 3,286 -
SUB TOTAL 39,864 - 39,864
8/16/2016 Ketorolac Inj 2 2 16100 32,200 -

Inf Rl 2 2 8700 17,400 -
Sp 3 cc 1 1 1895 1,895 -
Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 61,465 - 61,465
8/17/2016 Lapibal Inj 3 3 28885 86,655 -

Inf Ns 2 2 7721 15,442 -
SUB TOTAL 127,305 - 127,305
8/18/2016 Ranitidin Inj 2 2 3180 6,360 -
Inf Rl 2 2 8700 17,400 -
SUB TOTAL 41,476 - 41,476
GRAND TOTAL
110 Tn. Ikhsan 8/18/2016 Inf RL 1 1 8700 8,700 -

Venflon 20 1 1 23186 23,186 -
Inf Set Makro 1 1 10600 10,600 -
Sp 5 cc 1 1 2478 2,478 -
Citicolin Tab 10 10 7884 78,840 -
Aspilet Tab 10 10 933 9,330 -
Mersibion Tab 10 10 5010 - 50,100
SUB TOTAL 142,144 50,100 192,244
8/19/2016 Citicolin Tab 10 10 7884 78,840 -

Aspilet Tab 10 10 933 9,330 -
SUB TOTAL 94,911 - 94,911
GRAND TOTAL
111 Tn. Wawan 8/19/2016 Clanexi Tab 6 6 15887 95,322 -

Flamar 50 mg Tab 10 10 2200 22,000 -
SUB TOTAL 117,322 - 117,322
112 An. Slamet 8/19/2016 Clanexi Syr 1 1 66250 66,250 -

Mucera Tab 4 4 1060 4,240 -
Tramenza Tab 4 4 1530 6,120 -
Dextafen Tab 2 2 1458 2,916 -
Kertas Puyer 16 16 250 4,000 -
Apialys Syr 1 1 33125 33,125 -
Ventolin Nebu 1 1 12476 12,476 -
Bisolvon 4 4 4638 18,552 -
SUB TOTAL 147,679 - 147,679
113 Nn. Nova 8/19/2016 Cetirizine Tab 10 10 530 5,300 -

Ramadexon Tab 10 10 600 - 6,000
SUB TOTAL 5,300 6,000 11,300
114 Tn. Endra 8/19/2016 Clindamycin Tab 10 10 996 9,960 -

SUB TOTAL 13,960 - 13,960
115 Tn. Abdul 8/19/2016 Nifedipin Tab 1 1 186 186 -

Amlodipin Tab 10 mg 10 10 2465 24,650 -
Flamar Tab 10 10 2200 22,000 -
Neurosanbe Tab 10 10 1385 13,850 -
Letonal Tab 10 10 1484 14,840 -
SUB TOTAL 75,526 - 75,526
116 Ny. Tri N 8/19/2016 Handscon Steril 1 1 8384 8,384 -

Lidocain Inj 1 1 2186 2,186 -
Sp 1 cc 1 1 2849 2,849 -
Cefat Tab 10 10 12786 127,860 -
SUB TOTAL 147,279 - 147,279
117 Nn. Diana 8/19/2016 Sanmagh Tab 15 15 1020 15,300 -

Spasmal Tab 15 15 600 9,000 -
Propepsa Syr 1 1 82150 82,150 -
SUB TOTAL 106,450 - 106,450
118 Ny. Pansu 8/18/2016 Inf Ns 2 2 7721 15,442 -

Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Ondan 4 mg 2 2 6188 12,376 -
Furosemid Inj 3 3 4638 13,914 -
Nasal Canul Dewasa 1 1 14575 14,575 -
Ventolin Nebu 1 1 12476 12,476 -
Mucohexin Syr 1 1 19610 19,610 -
Fargoxin Tab 1 1 345 - 345
Letonal Tab 25 mg 1 1 1484 1,484 -
O2 50 50 250 12,500 -
SUB TOTAL 143,655 345 144,000
8/19/2016 Ranitidin Inj 2 2 3746 7,492 -

Furosemid Inj 2 2 4638 9,276 -
Fargoxin Tab 3 3 345 - 1,035
Spiriva 3 3 539 1,617 -
Ventolin Nebu 3 3 0 12476 - -
Inf Ns 2 2 7721 15,442 -
SUB TOTAL 33,827 1,035 34,862
8/19/2016 O2 500 500 250 125,000 -

SUB TOTAL 125,000 - 125,000
GRAND TOTAL
119 Ny. Mistin 8/18/2016 Inf Ns 3 3 7721 23,163 -

Inf Set makro 1 1 10600 10,600 -
Venflon 22 1 1 23186 23,186 -
Venflon 20 1 1 23186 23,186 -
Sp 3 cc 2 2 1895 3,790 -
Opilax Syr 1 1 58300 58,300 -
Dulcolax Sup 2 2 22724 45,448 -
SUB TOTAL 195,165 - 195,165
8/19/2016 Ranitidin Inj 2 1 1 3746 3,746 -

Mertigo Sr 3 3 6029 18,087 -
Xepalium 4 4 10931 43,724 -
Inf Ns 3 2 1 7721 7,721 -
SUB TOTAL 73,278 - 73,278
8/19/2016 Domperidon Tab 10 10 596 5,960 -

SUB TOTAL 5,960 - 5,960
GRAND TOTAL
120 An. Rio 8/19/2016 Tem Digital 1 1 25000 25,000 -

SUB TOTAL 25,000 - 25,000
121 Tn. Yosua 8/19/2016 Ranitidin Tab 10 10 321 3,210 -

Norvom Tab 10 10 278 2,780 -
SUB TOTAL 5,990 - 5,990
122 Tn. Buyung 8/20/2016 Cefat 10 10 12786 127,860 -

SUB TOTAL 131,860 - 131,860
123 Tn. Rio 8/20/2016 Asam Mefenamat Tab 10 10 400 4,000 -

Ranitidin Tab 10 10 321 3,210 -
SUB TOTAL 14,170 - 14,170
124 Nn. Susan 8/20/2016 Mertigo Tab 10 10 4306 43,060 -

Profonal Tab 10 10 1789 17,890 -
Ondan 4 mg Tab 10 10 2500 25,000 -
SUB TOTAL 85,950 - 85,950
125 Ny. Dominica 8/18/2016 Inf Rl 1 1 8700 8,700 -

Pantomet Inj 1 1 92625 92,625 -
Inf Set Makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 1 1 1895 1,895 -
Mertigo Tab 10 10 4306 43,060 -
SUB TOTAL 189,312 - 189,312
8/19/2016 Inf Rl 2 2 8700 17,400 -

Ondan 8 mg Inj 1 1 9794 9,794 -
Pantomet Inj 1 1 92625 92,625 -
SUB TOTAL 119,819 - 119,819
8/20/2016 Domperidon Tab 10 10 596 5,960 -

Lapraz Tab 10 10 15503 155,030 -
SUB TOTAL 160,990 - 160,990
GRAND TOTAL
126 Tn. Aqlakul 8/20/2016 Lidocain Inj 1 1 2186 2,186 -

Sp 1 cc 1 1 2849 2,849 -
Ragyl Tab 10 10 1000 - 10,000
SUB TOTAL 18,315 10,000 28,315
127 Tn. Moh R 8/20/2016 Amoxicilin Tab 20 20 464 9,280 -

Kasa Gulung 1 1 4638 4,638 -
SUB TOTAL 17,918 - 17,918
128 Tn. James 8/19/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 20 1 1 23186 23,186 -
Inf Rl 3 3 8700 26,100 -
Piralen Inj 3 3 9227 27,681 -
Buscopan Inj 3 3 27825 - 83,475
Sp 3 cc 3 3 1895 5,685 -
Lodia 10 10 1639.7 16,397 -
Molagit Tab 10 10 636 6,360 -
Samconal Tab 3 3 5665 16,995 -
SUB TOTAL 140,496 83,475 223,971
8/20/2016 Spasmal Tab 10 10 600 6,000 -

Ranitidin Tab 10 10 321 3,210 -
Domperidon tab 10 10 596 5,960 -
SUB TOTAL 15,170 - 15,170
GRAND TOTAL
129 Nn. Stefby 8/20/2016 Samconal Tab 8 8 800 6,400 -

Imunos 4 4 7656 30,624 -
Ondan 4 mg Tab 10 10 2500 25,000 -
SUB TOTAL 62,024 - 62,024
130 Ny. Liuk 8/20/2016 Valesco Tab 10 10 11665 116,650 -

Braxidin tab 10 10 1660 16,600 -
Ambroxol Tab 10 10 437 4,370 -
SUB TOTAL 137,620 - 137,620
131 An. Aditya 8/20/2016 Ats Inj 1 1 152375 152,375 -

Bisturi 1 1 4638 4,638 -
SUB TOTAL 157,013 - 157,013
132 An. Syahira 8/20/2016 Xepafen Syr 1 1 29150 29,150 -

Biothicol syr 1 1 25042 25,042 -
SUB TOTAL 54,192 - 54,192
133 Tn. Hendra 8/19/2016 Inf Ns 3 3 7721 23,163 -

Tramadol Inj 3 3 12521 - 37,563
Cefotaxime inj 3 3 15304 45,912 -
Inf Set makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
Sp 3 cc 4 4 1895 7,580 -
Sp 10 cc 3 3 3286 9,858 -
Samconal Tab 10 10 564.4 5,644 -
Lidocain Inj 1 1 2186 2,186 -
SUB TOTAL 128,129 37,563 165,692
8/20/2016 Ketorolac Inj 3 3 9275 27,825 -

SUB TOTAL 27,825 - 27,825
8/20/2016 Kalnex Tab 2 2 3339 6,678 -

Sp 5 cc 1 1 2478 2,478 -
Sp 3 cc 1 1 1895 1,895 -
SUB TOTAL 18,543 - 18,543
8/20/2016 Thramed Tab 15 15 2511 37,665 -

Ranitidin Tab 10 10 321 3,210 -
Cefixime Tab 10 10 2968 29,680 -
SUB TOTAL 70,555 - 70,555
GRAND TOTAL
134 Nn. Veronika 8/20/2016 Celebrex Tab 10 10 17693 176,930 -
SUB TOTAL 176,930 - 176,930
135 Tn. Elias 8/20/2016 O2 640 640 250 160,000 -

SUB TOTAL 160,000 - 160,000
TOTAL

Yang Menyerahkan
Kiki Indrawan
Serma NRP 580944
Domperidon Tab
Sp 3 cc
Sp 5 cc
aquadest Inj GRAND TOTAL 50,000 1,728,485
1,678,485
SUB TOTAL - -
GRAND TOTAL -
7/15/2016 Lansoprazol Tab 10 10 1000 - 10,000

SUB TOTAL 10,000 12,000
GRAND TOTAL 2,000
7/16/2016 Lansoprazol Tab 15 15 200 3,000 -

Domperidon Tab 15 15 500 - 7,500
SUB TOTAL 7,500 10,500
GRAND TOTAL 3,000
HARGA
TOTAL
Rp.
151,710
28,131
40,114
20,643
107,937
123,230
133,108
23,780
8,000
241,470
429,430
7,288
436,718
48,098
86,250
40,000
239,296
166,314
16,700
422,310
26,789
226,152
10,205
132,237
42,798
23,186
5,390
439,968
22,130
18,380
36,040
22,130
64,792
18,480
4,700
257,563
342,413
1,020
600,996
187,831
7,288
26,100
221,219
22,136
103,480
19,310
133,108
47,366
13,243
27,761
6,000
227,478
3,000
49,450
160,463
135,500
5,513
8,745
149,758
30,610
42,858
21,948
34,050
9,342
9,341
21,112
28,115
18,480
101,965
9,800
56,988
143,950
96,850
87,870
164,550
90,656
37,630
292,836
35,892
74,250
145,288
20,700
5,960
94,896
148,183
124,380
33,723
16,231
17,560
70,940
59,105
100,748
5,226
105,974
9,960
120,863
172,876
27,518
66,044
266,438
36,450
142,853
78,265
176,714
32,207
106,524
5,960
542,523
59,230
85,071
25,603
54,980
27,450
31,235
6,000
26,235
27,450
115,655
81,386
108,451
305,492
7,706,375
12,902
73,196
32,336
89,536
103,483
79,248
304,603
1,820
72,520
27,450
33,125
119,468
87,384
74,473
281,325
62,160
200,075
49,160
58,490
115,567
117,230
128,590
207,850
37,518
223,790
87,704
244,720
71,333
61,480
88,465
117,719
88,234
93,430
765,381
164,112
97,392
78,158
339,662
21,010 10,927,503
148,450
68,141
7,492
75,633
254,950
31,482
3,060
34,291
32,476
69,230
460,510
72,345
106,831
107,325
3,000
27,778
30,000
274,934
138,020
174,442
46,372
64,846
104,539
528,219
13,600
78,305
40,440
36,872
101,342
186,672
6,000
129,416
114,014
11,300
447,402
122,271
95,026
217,297
13,741
104,915
16,105
16,231
311,245
76,050
346,197 kk li2s
10,200
210,956
152,294
62,735
782,382
275,780
134,538
23,186
238,257
4,370
119,097
795,228
40,000
15,305
17,490
13,810
177,190
139,015
22,550
240,477
193,948
200,050
109,937
53,795
267,718
65,588
1,131,513
28,750
16,160
27,976
30,686
29,442
18,004
114,860
36,772
203,110
21,050
123,744
117,921
39,107
68,061
322,578
42,201
589,868
180,140
80,470
70,088
72,116
80,903
136,094
53,302
22,731
55,456
109,462
51,625
42,201
954,588
51,476
19,767,597
HARGA
TOTAL
Rp.
62,160
252,550
95,925
53,340
331,561
86,824
22,731
15,304
52,556
77,440
48,875
13,037
316,767
62,798
178,150
7,420
155,453
70,208
66,970
292,631
124,265
6,270
90,010
20,342
74,942
35,700
307,003
43,841
8,860
359,704
273,240
69,182
60,510
57,370
86,245
142,644
79,926
49,728
13,037
371,580
38,710
271,989
103,738
364
47,683
48,345
429,960
208,995
1,111,074
56,293
48,356
86,553
161,761
492,641
740,955
30,084
156,913
234,847
421,844
193,556
6,000
99,198
37,860
336,614
96,935
96,170
438,875
94,315
26,410
200,210
215,600
73,135
25,110
118,610
196,780
35,040
27,410
46,640
46,640
46,640
177,385
111,507
151,819
39,458
139,985
48,587
209,466
34,280
912,487
46,640
53,959
63,064
26,500
95,700
21,333
224,486
171,653
110,720
506,859
91,226
124,948
129,048
315,253
28,570
89,769
562,640
221,831
28,992
7,884
41,825
47,232
347,764
17,490
94,150
51,990
96,493
73,306
22,960
6,415
58,300
151,010
42,666
169,184
113,715
163,130
446,029
236,249
51,647
87,000
374,896
7,680
15,762
14,360
109,965
13,810
42,666
23,976
74,598
195,905
103,793
52,940
88,356
143,232
52,224
57,661
153,210
406,327
130,902
36,335
104,320
9,960
65,852
65,852
56,246
51,994
4,638
55,947
110,972
43,367
30,608
5,641
78,308
268,896
157,076
14,954
172,030
15,023
185,910
75,697
16,078
99,800
183,400
79,245
55,053
9,502
14,575
26,684
41,658
1,012,500
24,486
1,824,588
195,230
34,980
6,360
29,831
14,020
88,060
26,474
13,700
27,165
73,255
75,370
26,410
73,678
16,720,862
HARGA
TOTAL
Rp.
304,809
29,720
217,565
93,003
242,065
887,162
120,674
39,260
61,374
102,026
71,923
59,268
64,390
78,502
19,910
457,393
174,441
174,178
29,018
198,430
20,700
41,770
20,750
19,446
105,745
263,216
34,291
40,492
125,000
462,999
285,252
198,681
207,964
691,897
152,230
59,257
17,944
23,380
21,333
149,106
99,223
533,542
256,183
85,947
1,124,001
30,624
76,605
63,999
31,511
5,300
32,595
137,918
17,490
16,192
171,600
45,486
294,865
12,755
186,291
96,899
545,870
1,136,680
152,375
53,405
155,736
132,550
56,330
139,336
44,393
1,908
12,396
99,550
297,583
231,100
50,525
6,236
228,720
172,750
689,331
83,440
86,300
95,250
160,990
15,890
52,643
32,210
66,582
24,650
58,177
45,567
256,494
4,081
17,490
278,065
240,394
38,990
279,384
47,260
34,750
46,640
22,130
44,561
46,640
46,640
46,640
46,640
87,910
40,603
147,831
81,834
9,794
129,029
116,468
337,125
112,829
42,572
91,064
64,793
311,258
94,875
40,909
93,650
264,200
149,921
50,600
464,721
152,490
46,640
54,976
25,859
2,799
46,349
15,416
15,787
161,186
134,735
11,260
71,810
39,750
46,640
354,081
205,076
23,186
182,784
149,430
106,100
1,020,657
80,210
48,455
48,356
95,798
79,090
73,050
23,958
262,631
258,945
44,144
106,264
162,242
45,115
1,055,439
59,551
39,749
57,945
63,100
143,140
55,580
101,110
28,520
5,000
46,640
46,640
21,884
225,338
46,640
46,640
176,363
15,442
20,799
28,750
241,354
280,760
77,194
29,220
46,640
2,332
28,990
239,267
45,777
87,630
403,996
102,687
532
136,895
86,495
190,640
94,819
27,371
39,864
61,465
127,305
41,476
392,300
192,244
94,911
287,155
117,322
147,679
11,300
13,960
75,526
147,279
106,450
144,000
34,862
125,000
303,862
195,165
73,278
5,960
274,403
25,000
5,990
131,860
14,170
85,950
189,312
119,819
160,990
470,121
28,315
17,918
223,971
15,170
239,141
62,024
137,620
157,013
54,192
165,692
27,825
18,543
70,555
282,615
176,930
160,000
20,777,060
1,287,080
20,643
12,000
10,500
LAPORAN UMUM BULAN SEPTEMBER 2016
PELAKSANAAN OBAT TERJUAL SATUAN SATUAN HARGA HARGA
UMUM DPK
UMUM DPK UMUM DPK
Rp. Rp. Rp. Rp.
1 An.Alfaro 8/19/2016 Apialys Drop 1 1 39,750 39,750 -
Thiamfenikol Syr 1 1 37,905 37,905 -
SUB TOTAL 77,655
2 An. M Yusuf 8/21/2016 Amoxicilin Tab 10 10 464 4,640 -

Ambroxol tab 1 1 437 437 -
Tremenza Tab 1 1 1530 1,530 -
Pct Tab 1 1 138 138 -
Kapsul 10 10 500 5,000 -
Fartolin Tab 5 5 928 - 4,640
Cetirizin Kaps 5 5 530 2,650 -
SUB TOTAL 14,395 4,640
3 Nn.Jesi 8/21/2016 Nacl 2 2 7721 15,442

Metronidazole inf 1 1 72875 72,875
SUB TOTAL 88,317
4 Ny.Nuning 8/21/2016 Indexon tab 10 10 4467 44,670

Ibuprofen tab 10 10 331 3,310
SUB TOTAL 47,980
5 Tn.Choky 8/21/2016 Paracetamol tab 10 10 138 1,380

Neostoplu tab 10 10 159 1,590
Indexone tab 10 10 4467 44,670
SUB TOTAL 46,050 1,590
6 An.Parli 8/21/2016 Sanmol Syr 1 1 15231 15,231

Acyclovir 200 mg 20 20 649 12,980
Acyclovir salep 1 1 3611 3,611
SUB TOTAL 31,822
7 An.Clara 8/21/2016 Norvom Syr 1 1 15000 15,000

Ranitidine tab 10 10 321 3,210
SUB TOTAL 18,210
8 Nn.Fitri 8/21/2016 Asam mefenamat 10 10 400 4,000

Amoxicillin tab 15 15 464 6,960
Abbocath 20 1 1 23188 23,188
SUB TOTAL 34,148
9 An.Tasya 8/21/2016 Opinacea Syr 1 1 66,250 66,250

SUB TOTAL 66,250
10 Tn.Paskalis 8/22/2016 Analsik tab 15 15 1589 23,835

Sanmaag tab 10 10 1020 10,200
Spasmal 15 15 600 9,000
SUB TOTAL 43,035
11 Ny.Iis Wastika 8/18/2016 Rl 1 1 8700 8,700

Pantomet inj 1 1 92625 92,625
Vemplon 20 1 1 19686 19,686
Infus set Makro 1 1 10600 10,600
Spuit 10 cc 2 2 3286 6,572
Aspilet 10 10 933 9,330
Citicolin 500 mg tab 10 10 7884 78,840
Lisinopril 10 mg 10 10 901 9,010
Metformin 500 mg 10 10 265 2,650
SUB TOTAL 238,013
8/19/2016 Nacl 2 2 6409 12,818

Piracetam 3 gr inj 2 2 15379 30,758
Pantomet inj 1 1 73125 73,125
Spuit 3 cc 1 1 1609 1,609
Aquadest 1 1 2750 2,750
SUB TOTAL 121,060
8/20/2016 Infus set makro 1 1 10600 10,600

SUB TOTAL 10,600
8/20/2016 Spuit 20 cc 4 4 9275 37,100

Needle 23 1 1 875 875
Thrombo Aspilet 1 1 933 933
Plavix 1 1 30608 30,608
Piracetam 3 gr inj 4 4 34200 136,800
SUB TOTAL 206,316
8/20/2016 Vemplon 22 1 1 23186 23,186

SUB TOTAL 23,186
8/21/2016 Rl 1 1 8700 8,700

Plavix 3 3 30608 91,824
SUB TOTAL 100,524
GRAND TOTAL
12 Tn.Suryanto 8/22/2016 Flamar 50 tab 10 10 2200 22,000

Suprabion 10 10 1000 10,000
M.P 4 mg 10 10 530 5,300
SUB TOTAL 27,300 10,000
13 Ny.Pelangi 8/22/2016 Nasal Canul Dewasa 1 1 14575 14,575

Infus set makro 1 1 10600 10,600
Vemplon 20 1 1 23186 23,186
Rl 1 1 7500 7,500
Ranitidine inj 2 2 3746 7,492
Recodryl inj 1 1 9275 9,275
Ceftriaxone inj 1 1 24778 24,778
Cortidex inj 1 1 7500 7,500
Spuit 5 cc 1 1 2478 2,478
Spuit 3 cc 3 3 1895 5,685
Spuit 1 cc 1 1 2849 2,849
SUB TOTAL 108,418 7,500
8/22/2016 Vemplon 20 1 1 23186 23,186

O2 50 50 250 12,500
SUB TOTAL 35,686
GRAND TOTAL
14 Ny.Ngaisah 8/22/2016 Furosemid tab 15 15 268 4,020

Valesco 30 30 11660 349,800
Omeyus tab 10 10 1000 10,000
SUB TOTAL 353,820 10,000
15 Tn.Tiarsih 8/22/2016 Thrombo Aspilets 15 15 933 13,995

Plavix 15 15 30608 459,120
Captopril 50 mg 3 3 297 891
Metformin 500 mg 30 30 265 7,950
Omeyus 10 10 1000 10,000
Kapsul kosong 12 12 500 6,000
SUB TOTAL 487,956 10,000
16 Tn.Cato 8/22/2016 Omeyus 10 10 1000 10,000

ISDN 15 15 186 2,790
T.Aspilet 15 15 933 13,995
Furosemid tab 15 15 268 4,020
SUB TOTAL 20,805 10,000
17 An.Navisah 8/19/2016 RL 1 1 8700 8,700

Vemplon 24 1 1 26235 26,235
Infus set makro 1 1 10600 10,600
Ondan 4 mg 1 1 9794 9,794
Paracetamol inf 1 1 83952 83,952
Cefotaxime inj 1 1 15304 15,304
Aquadest 1 1 3312 3,312
Spuit 1 cc 1 1 2849 2,849
Spuit 3cc 1 1 1895 1,895
Spuit 10 cc 2 2 3286 6,572
Remco syr 1 1 8400 - 8,400
SUB TOTAL 169,213 8,400
8/19/2016 Valisanbe 2 mg 3 3 364 1,092

Kertas puyer 6 6 250 1,500
SUB TOTAL 2,592
8/20/2016 Cefotaxime inj 1 1 15304 15,304

RL 2 2 8700 17,400
SUB TOTAL 32,704
8/21/2016 Cefotaxime inj 1 1 15304 15,304

RL 2 2 8700 17,400
SUB TOTAL 32,704
8/22/2016 Sporetik Syr 1 1 100038 100,038

Dextafen tab 3 3 1458 4,374
Tremenza 3 3 1530 4,590
Kertas puyer 12 12 250 3,000
Opinacea syr 1 1 66250 66,250
SUB TOTAL 193,908
GRAND TOTAL
18 An.Hapsa 8/22/2016 Amoxan syr 1 1 36475 36,475

M.P 4 mg 4 4 530 2,120
Tremenza 4 4 1530 6,120
Paracetamol tab 5 5 138 690
Kertas Puyer 15 15 250 3,750
SUB TOTAL 49,155
19 Tn.Yosef Effendi 8/20/2016 Infus set makro 1 1 10600 10,600

Vemplon 20 1 1 23186 23,186
RL 4 4 8700 34,800
Piralen inj 3 3 9227 27,681
Spuit 3 cc 2 2 1895 3,790
Mertigo 5 5 4306 21,530
Cymalium 5 5 1802 9,010
SUB TOTAL 129,079 9,010
8/21/2016 Piralen inj 2 2 0 9227 -

Ranitidine inj 2 2 0 3746 -
Mertigo 3 3 4306 12,918
RL 3 2 1 8700 8,700
SUB TOTAL 21,618
8/22/2016 Mertigo SR 5 5 6029 30,145

Ranitidine tab 10 10 321 3,210
Disflathyl 10 10 810 8,100
SUB TOTAL 41,455
GRAND TOTAL
20 An Daffa 8/23/2016 Oraprofen syr 1 1 15400 15,400

Kertas puyer 10 10 200 2,000
Opinacea syr 1 1 66250 66,250
SUB TOTAL 69,534 15,400
21 An.Iqbal 8/20/2016 Infus Set Makro 1 1 10600 10,600

Vemplon 24 1 1 26235 26,235
D5 1/2 Ns 2 2 17159 34,318
Aquades 1 1 3312 3,312
Spuit 10 cc 1 1 3286 3,286
Spuit 1 cc 2 2 2849 5,698
Progesic Syr 1 1 29150 29,150
Mucera syr 1 1 22525 22,525
SUB TOTAL 201,374 -
8/21/2016 Ceftriaxone inj 1 1 33125 33,125

Spuit 5 cc 1 1 2478 2,478
Aquadest 1 1 3312 3,312
SUB TOTAL 38,915 -
8/23/2016 Sanmol Syr 2 2 15231 30,462

SUB TOTAL 30,462 -
GRAND TOTAL
22 Tn,Nof 8/23/2016 Flamar Gel 1 1 21500 21,500

Flamar 50 tab 10 10 22000 22,000
Valisanbe 5 mg 5 5 364 1,820
SUB TOTAL 45,320 -
23 Tn.Suparno 8/23/2016 Captopril 50 mg 10 10 182 1,820

Ciprofloxacim tab 10 10 627 6,270
Flamar Tab 10 10 2200 22,000
Neurosanbe Plus 10 10 1385 13,850
SUB TOTAL 43,940 -
24 An.Beni 8/23/2016 Ventolin Nebu 1 1 12476 12,476

Spuit 5 cc 1 1 2478 2,478
Ambroxol tab 2 2 437 874
Fartolin tab 5 5 928 4,640
CTM 2 2 46 92
Kertas Puyer 10 10 200 2,000
SUB TOTAL 22,560 -
25 dr.Birawa 8/23/2016 Apialys Drop 1 1 39750 39,750

Interizin Drop 1 1 100000 100,000
SUB TOTAL 139,750 -
26 By.Kenisha 8/24/2016 Apialys Drop 1 1 39750 39,750

Xepa gel 1 1 182187 182,187
SUB TOTAL 221,937 -
27 Ny.Suwanti 8/23/2016 RL 1 1 8700 8,700

Infus Set Makro 1 1 10600 10,600
Vemplon 20 1 1 23186 23,186
Omeprazole inj 1 1 73736 73,736
Granon inj 1 1 160325 160,325
Spuit 5 cc 1 1 2478 2,478
Spuit 3 cc 1 1 1895 1,895
Domperidone tab 10 10 596 5,960
SUB TOTAL 286,880 -
8/24/2016 Infus set makro 2 2 10600 21,200

Venflon 22 1 1 23186 23,186
SUB TOTAL 44,386 -
GRAND TOTAL
28 Nn.Tri Ningsih 8/24/2016 Asam Mefenamat 10 10 400 4,000

SUB TOTAL 4,000 -
29 Tn.Rai Kamar 8/24/2016 Analsik tab 10 10 1589 15,890

SUB TOTAL 15,890 -
30 Tn.Usman 8/24/2016 Samconal tab 10 10 5644 5,644

Fartolin 15 15 928 13,920
GG 12 12 100 1,200
CTM 8 8 46 368
Aminophilyn tab 6 6 289 1,734
Kertas Puyer 10 10 200 2,000
SUB TOTAL 19,222 5,644
31 Ny.Jariyah 8/23/2016 RL 1 1 8700 8,700

Vemflon 20 1 1 23186 23,186
Pantoprazole inj 1 1 102025 102,025
Granon inj 1 1 160325 160,325
Aquadest 1 1 3312 3,312
Spuit 10 cc 1 1 3286 3,286
Spuit 5 cc 2 2 2478 4,956
Spuit 1 cc 1 1 2846 2,846
SUB TOTAL 374,752 -
8/24/2016 RL 2 2 8700 17,400

Ondan 4 mg inj 4 4 7288 29,152
Aquadest 2 2 3312 6,624 -
Spuit 10 cc 1 1 3286 3,286
Spuit 5 cc 1 1 2478 2,478
SUB TOTAL 229,003 -
8/24/2016 Cefxime 100 mg 10 10 2968 29,680

Omeprazole tab 10 10 1475 14,750
SUB TOTAL 50,390 -
GRAND TOTAL
32 By.Aerylin 8/22/2016 Sanmol Drop 1 1 20551 20,551

Vemplon 26 2 2 51013 102,026
Aquadest 1 1 3312 3,312
Spuit 10 cc 1 1 3286 3,286
Spuit 1 cc 1 1 2849 2,849
SUB TOTAL 165,149 -
8/23/2016 Ceftriaxone inj 2 2 24778 49,556

D5 1/2 NS 2 2 17159 34,318
SUB TOTAL 83,874 -
GRAND TOTAL
33 Ny.Kristiana 8/24/2016 Ramadexone 10 10 1000 10,000
SUB TOTAL 4,000 10,000
34 Tn.Yonas 8/24/2016 Gemfbrozile 10 10 464 4,640

Penagon 5 5 1749 8,745
Braxidine 10 10 1166 11,660
SUB TOTAL 16,300 8,745
35 An.Yusia 8/24/2016 Sanmaag Syr 1 1 32940 32,940

SUB TOTAL 32,940 -
36 An.Aditya 8/24/2016 Amoxicillin tab 5 5 464 2,320

SUB TOTAL 4,320 -
37 Tn.Sulaiman 8/24/2016 Ambroxol tab 10 10 437 4,370

Tranec tab 10 10 3432 34,320
Scopamin 10 10 2551 25,510
Lansoprazole tab 10 10 1855 18,550
SUB TOTAL 82,750 -
38 An.Bening 8/23/2016 D5 1/2 NS 1 1 17159 17,159

Vemflon 24 1 1 26235 26,235
Zink Syr 1 1 20000 20,000
Sanmol Drop 1 1 20551 20,551
Oralit 5 5 1000 5,000
SUB TOTAL 99,545 -
8/23/2016 Ceftriaxone inj 1 1 33125 33,125

Aquadest 1 1 3312 3,312
Spuit 10 cc 1 1 3286 3,286
Spuit 1 cc 1 1 2849 2,849
Spuit 3 cc 1 1 1895 1,895
SUB TOTAL 44,467 -
8/23/2016 Ceftriaxone inj 1 1 33125 33,125

D5 1/ 2 NS 2 2 17159 34,318
SUB TOTAL 67,443 -
8/23/2016 Cefadroxyl Syr 1 1 13037 13,037

Sanmol Forte syr 1 1 15231 15,231
SUB TOTAL 28,268 -
8/24/2016 D5 1/2 NS 2 2 17159 34,318

Ondan 4 mg 1 1 7288 7,288
Aquadest 1 1 3312 3,312
Spuit 10 cc 1 1 3286 3,286
Spuit 3 cc 1 1 1895 1,895
Spuit 1 cc 1 1 2849 2,849
SUB TOTAL 86,073 -
GRAND TOTAL
39 Tn.Maulana 8/25/2016 Hico gel 1 1 28753 28,753

SUB TOTAL 28,753 -
40 Om.Suryani 8/25/2016 Superhoid Supp 6 6 3658 21,948

SUB TOTAL 21,948 -
41 An.Fio 8/25/2016 Ventolin Nebu 1 1 12476 12,476

Nacl 2 2 15 30
Fartolin 20 20 928 18,560
Cetirizin tab 10 10 530 5,300
SUB TOTAL 36,366 -
42 Tn.Ari 8/25/2016 Neurosanbe plus tab 10 10 1385 13,850

Flamar gel 1 1 21500 21,500
Pregabalin 10 10 8858 88,580
SUB TOTAL 123,930 -
43 Tn.Yahusin 8/25/2016 Urine Bag 1 1 7288 7,288

Folley Cateter 16 1 1 20405 20,405
Spuit 10 cc 1 1 3286 3,286
Aquadest 1 1 3312 3,312
SUB TOTAL 34,291 -
44 Tn.Yulyanus 8/25/2016 Hico gel 1 1 28753 28,753

SUB TOTAL 28,753 -
45 An.Daffa 8/25/2016 CTM 5 5 46 230

Kertas Puyer 10 10 250 2,500
Hydrocortison salep 1 1 5101 5,101
SUB TOTAL 7,831 -
46 An.Seisya 8/25/2016 Mucera Syr 1 1 42400 42,400

Apialys syr 1 1 39750 39,750
SUB TOTAL 82,150 -
47 Ny.Nasita 8/25/2016 Analsik tab 10 10 1589 15,890

Omeyus tab 10 10 1175 11,759
Flamar gel 1 1 21500 21,500
SUB TOTAL 37,390 11,759
48 Ny.Upik 8/25/2016 Analsik tab 10 10 1589 15,890

Flamar gel 1 1 21500 21,500
SUB TOTAL 37,390 -
49 Ny.Duri 8/25/2016 Baquinor Forte 10 10 17934 179,340

Mucohexin tab 20 20 600 12,000
Remco syr 1 1 8400 8,400
SUB TOTAL 196,640 8,400
50 Tn.Syaifudin 8/25/2016 Superhoid supp 3 3 3658 10,974

Samconal tab 10 10 5644 5,644
SUB TOTAL 10,974 5,644
51 Ny.Sukarti 8/25/2016 Cetirizine kaps 5 5 530 2,650

Dilavask 5 mg 10 10 2319 23,190
M.P 4 mg 10 10 530 5,300
SUB TOTAL 31,140 -
52 Ny.Suharti 8/25/2016 Cortidex inj 1 1 7500 7,500

Recodryl inj 2 2 9275 18,550
Spuit 3 cc 2 2 1895 3,790
SUB TOTAL 22,340 7,500
53 Tn.Anastri 8/22/2016 Infus Set Makro 1 1 10600 10,600
Vemplon 20 1 1 23186 23,186
RL 3 3 8700 26,100
Terfacef inj 1 1 128248 128,248
Piralen inj 3 3 9227 27,681
Paramol tab 10 10 500 5,000
Sanmaag tab 3 3 1020 3,060
Analsik 3 3 1589 4,767
Spuit 10 cc 1 1 3286 3,286
Spuit 5 cc 1 1 2478 2,478
Spuit 3 cc 1 1 1895 1,895
Spuit 1 cc 1 1 2849 2,849
Aquadest 1 1 3312 3,312
SUB TOTAL 369,265 -
8/23/2016 Ceftriaxone inj 2 2 24778 49,556

Piralen inj 1 1 9227 9,227
Sanmaag tab 3 3 1020 3,060
Analsik 3 3 1589 4,767
RL 2 2 8700 17,400
SUB TOTAL 186,035 -
8/23/2016 Nistatin Drop 1 1 51304 51,304

Spuit 5 cc 1 1 2478 2,478
SUB TOTAL 53,782 -
8/23/2016 Ranitidin inj 2 2 3746 7,492

Cortidek inj 3 3 7500 22,500
Eperison tab 3 3 2041 6,123
Spuit 10 cc 2 2 3286 6,572
Spuit 3 cc 5 5 1895 9,475
SUB TOTAL 79,218 22,500
8/24/2016 Ranitidin inj 1 1 3746 3,746

Cortidek inj 2 2 7500 15,000
RL 1 1 8700 8,700
Esperison 2 2 2041 4,082
Sanmaag tab 3 3 1020 3,060
Analsik 3 3 1589 4,767
SUB TOTAL 24,355 15,000
8/24/2016 Piralen inj 2 2 9227 18,454

Aquadest 2 2 3312 6,624
SUB TOTAL 25,078 -
8/25/2016 Terfacef inj 2 2 128248 256,496

RL 3 3 8700 26,100
Piralen inj 3 3 9227 27,681
Indexone inj 3 3 9275 27,825
Spuit 5 cc 3 3 2478 7,434
Spuit 1 cc 3 3 2849 8,547
Esperison tab 3 3 2041 6,123
Sanmaag tab 3 3 1020 3,060
Analsik tab 1 1 1589 1,589
SUB TOTAL 372,347 -
8/26/2016 Opixime tab 15 15 7433 111,495

Analsik 15 15 1589 23,835
Lansoprazole 10 10 1855 18,550
SUB TOTAL 153,880 -
GRAND TOTAL
54 Tn.Santana 8/26/2016 Ventolin Nebu 1 1 12476 12,476

Nacl 2 2 15 30
Fartolin tab 10 10 928 9,280
Indexone tab 10 10 4467 44,670
Mucohexin tab 10 10 600 6,000
Samconal tab 10 10 564 5644
Opinacea syr 1 1 66250 66,250
SUB TOTAL 138,706 5,644
55 Tn.Supriyadi 8/26/2016 Flamar gel 1 1 21500 21,500

Indexone tab 10 10 4467 44,670
SUB TOTAL 66,170 5,644
56 By.Leonardo 8/26/2016 Termometer 1 1 35000 35,000
SUB TOTAL 35,000 -
57 Tn.Widakso 8/26/2016 Supratule 1 1 20405 20,405

Lidocain inj 1 1 2186 2,186
Spuit 1 cc 1 1 2849 2,849
Amoxicillin tab 10 10 464 4,640
SUB TOTAL 34,080 -
58 Ny.Umi 8/26/2016 M.P 4 mg 3 3 530 1,590

SUB TOTAL 1,590 -
59 Tn.Abdul Rohim 8/26/2016 Scopamin plus 10 10 2551 25,510

Meloxicam 7,5 mg 10 10 928 9,280
Antasida doen 10 10 56 560
SUB TOTAL 38,560 -
60 Tn.Imam Muslim 8/26/2016 Samconal tab 15 15 566 8,490

Cefat 500 mg 15 15 12786 191,790
Tremenza 10 10 1530 15,300
Interpec tab 10 10 13537 135,370
Rindobion 10 10 3498 34,980
SUB TOTAL 342,460 43,470
61 Tn.Jaelani 8/26/2016 Stolax supp 1 1 22724 22,724

SUB TOTAL 22,724
62 Ny.Herlina 8/26/2016 Analsik 10 10 1589 15,890

Ciprofloxacim 10 10 627 6,270
Scopamin 10 10 2551 25,510
SUB TOTAL 41,400 6,270
63 Tn. Gabriel 8/27/2016 Opixime tab 10 10 7433 74,330

Tremenza 10 10 1530 15,300
Ambroxol 10 10 437 4,370
SUB TOTAL 99,300
64 Tn. Jumar 8/27/2016 Superhoid supp 5 5 3658 18,290
Anadium 15 15 10666 159,990
Flamar tab 10 10 2200 22,000
SUB TOTAL 200,280
65 Tn. Jaelani 8/26/2016 Infus Set Makro 2 2 10600 21,200

venflon 22 2 2 23186 46,372
Nacl 1 1 7721 7,721
Buscopan inj 2 1 1 27825 27,825
Piralen inj 3 1 2 9227 18,454
spuit 3cc 2 2 1895 3,790
Dulcolax 10 10 1391 13,910
Opilax syr 1 1 58300 58,300
SUB TOTAL 197,572
8/27/2016 omeprazole 10 10 1475 14,750

SUB TOTAL 14,750
GRAND TOTAL
66 Tn. Oksen 8/27/2016 Acyclovir tab 40 40 742 29,680

Acyclovir salep 2 2 3611 7,222
samconal 10 10 564 5,640
cetirizin 10 10 530 5,300
SUB TOTAL 47,842
67 Tn. Patris 8/26/2016 RL 1 1 8700 8,700

venflon 22 1 1 10600 10,600
Tramadol inj 3 3 12521 37,563
ATS 1 1 152375 152,375
spuit 10cc 1 1 3286 3,286
spuit 5cc 1 1 2478 2,478
spuit 3cc 1 1 1895 1,895
spuit 1cc 2 2 2849 5,698
Aquadest 1 1 3312 3,312
lidocain inj 1 1 2186 2,186
Bisturi 1 1 4638 4,638
Analsik 10 10 1589 15,890
SUB TOTAL 352,632
8/27/2016 starxone inj 1 1 0 347979 -

Terfacef inj 1 1 128248 128,248
Tramadol 3 2 1 12521 12,521
RL 2 2 8700 17,400
SUB TOTAL 158,169
8/27/2016 analsik 10 10 1589 15,890

ragyl 10 10 1000 10,000
pain kila tube 1 1 13913 13,913
m.p 8mg 20 20 928 18,560
SUB TOTAL 34,450 23,913
GRAND TOTAL
68 Ny. Tjong 8/27/2016 profenal 10 10 1788 17,880

Tremenza 10 10 1530 15,300
Indexon tab 10 10 4467 44,670
SUB TOTAL 77,850 -
69 Tn. Taufk E 8/27/2016 lidocain inj 2 2 2186 4,372

spuit 1cc 2 2 2849 5,698
supratul 1 1 20405 20,405
SUB TOTAL 30,475 -
70 An. Fio I 8/27/2016 RL 1 1 8700 8,700

venflon 22 1 1 23186 23,186
Cortidek inj 2 2 7500 15,000
spuit 3cc 2 2 1895 3,790
ventolin nebu 2 2 12496 24,952
cetirizin syr 1 1 16231 16,231
Ambroxol 10 10 437 4,370
SUB TOTAL 221,318 -
8/27/2016 Farbivent amp 1 1 17490 17,490

Nasal Canul Anak 1 1 14575 14,575
SUB TOTAL 32,065 -
8/27/2016 Fartolin 8 8 928 7,424
O2 300 300 250 75,000
SUB TOTAL 82,424 -
GRAND TOTAL
71 Nn. Veronika 8/27/2016 cefadroxil tab 10 10 981 9,810

Lidocain inj 1 1 2186 2,186
kasa gulung kecil 1 1 4638 4,638
Bioplacenton 1 1 17490 17,490
leukoplas kecil 1 1 6625 6,625
Nacl 1 1 8700 8,700
SUB TOTAL 49,449 -
13 tn.hanafi 8/24/2016 o2 100 100 250 25,000

rawat inap rl 3 3 8700 26,100
venflon 20 1 1 23186 23,186
venflon 22 2 2 23186 46,372
infus set makro 1 1 10600 10,600
cortidex inj 3 3 7500 22,500
spuit 3 cc 2 2 1895 3,790
spuit 10 cc 1 1 3286 3,286
nasal canul 1 1 14575 14,575
pantoprazole inj 2 2 102025 204,050
aquadest 2 2 3312 6,624
captropril 12.5 6 6 182 1,092
metformin 6 6 265 1,590
ondansentron tab 6 6 7288 43,728
ambroxol 6 6 437 2,622
SUB TOTAL 472,543 -
8/25/2016 Indexon inj 1 1 9275 9,275

pantoprazole inj 1 1 102025 102,025
spuit 5cc 3 3 2478 7,434
rl 3 3 8700 26,100
SUB TOTAL 144,834 -
8/25/2016 metformin 850 2 2 530 1,060

valesco 80mg 2 2 11660 23,320
SUB TOTAL 24,380 -
8/26/2016 terfacef inj 1 1 128248 128,248
spuit 5cc 1 1 2478 2,478
spuit 1cc 1 1 2849 2,849
SUB TOTAL 133,575 -
8/26/2016 samconal 6 6 564 3,384

SUB TOTAL 3,384 -
8/26/2016 rl 3 3 8700 26,100

metformin 850 2 2 530 1,060
valesco 2 2 11660 23,320
SUB TOTAL 75,432 -
8/27/2016 samconal 6 6 564 3,384

rl 2 2 8700 17,400
pantomet inj 1 1 92625 92,625
SUB TOTAL 163,313 -
8/27/2016 ketorolak inj 4 4 16100 64,400

spuit 3cc 3 3 1895 5,685
ranitidin inj 2 2 3746 7,492
SUB TOTAL 77,577 -
8/28/2016 ranitidin inj 2 2 3746 7,492

samconal 6 6 1000 6,000
SUB TOTAL 38,444
8/28/2016 masker kanul 1 1 29216 29,216

oksigen 3000 3000 250 750,000
SUB TOTAL 779,216
GRAND TOTAL
ny. Aisyah 8/28/2016 xepalium 10 10 10931 109,310

SUB TOTAL 109,310
ny. Tina 8/28/2016 samconal 10 10 1000 10,000

ambroxol 10 10 437 4,370
lansoprazole 10 10 1855 18,550
SUB TOTAL 32,920
ny. Tatik 8/28/2016 tremenza 10 10 1530 15,300

SUB TOTAL 15,300
ny. Herlina 8/27/2016 venflon 22 1 1 23186 23,186

inf set makro 1 1 10600 10,600
rl 3 3 8700 26,100
piralen inj 3 3 9227 27,681
buscopan inj 3 3 27825 83,475 83,475
spuit 1cc 1 1 2849 2,849
spuit 5cc 1 1 2478 2,478
spuit 3cc 3 3 1895 5,685
braxidin 5 5 1166 5,830
ceftriaxon inj 1 1 33125 33,125
aquades 1 1 3312 3,312
SUB TOTAL 148,338 83,475
8/27/2016 rl 2 2 8700 17,400

piralen inj 1 1 9227 9,227
buscopan inj 1 1 27825 27,825 27,825
terfacef inj 1 1 128248 128,248
SUB TOTAL 158,621 27,825
8/27/2016 ketorolac inj 1 1 9275 9,275

spuit 3cc 1 1 2849 2,849
SUB TOTAL 12,124 -
8/28/2016 rl 2 2 8700 17,400

piralen inj 3 3 9227 27,681
buscopan inj 3 3 27825 83,475 83,475
braxidin 3 3 1166 3,498
SUB TOTAL 122,321 83,475
8/28/2016 cefixim 100mg 10 10 2968 29,680
ranitidin tab 10 10 321 3,210
SUB TOTAL 32,890 -
GRAND TOTAL
an. Arif 8/28/2016 acyclovir 400 30 30 742 21,720

cetirizin 10 10 530 5,300
samconal 10 10 1000 10,000
SUB TOTAL 37,020 -
tn. Sarwato 8/28/2016 berotex 18 18 9275 9,275

bisolvon 10 10 45448 45,448
ns 2 2 1000 1,000
baquinor 10 10 17934 179,340
mucohexin 10 10 600 6,000
fartolin 2mg 20 20 928 18,560 18,560
SUB TOTAL 241,063 18,560
tn. Supianto 8/28/2016 santadex T.T 1 1 17490 17,490

asmef 10 10 400 4,000
cloramfenikol T.T 1 1 10348 10,348
SUB TOTAL 31,838 -
an. Raffa 8/29/2016 ottopan syr 1 1 14600 14,600

zinkid syr 1 1 21834 21,834
oralit 10 10 928 9,280
l-bio 10 10 9275 92,750
SUB TOTAL 138,464 -
by. Syazia 8/29/2016 l-bio 3 3 9275 27,825

oralit 3 3 928 2,784
SUB TOTAL 30,609 -
an. Aisyah U 8/29/2016 ambroxol tab 4 4 437 1,748

dextafen 4 4 1458 5,832
fartolin 4 4 928 3,712
kertas puyer 12 12 500 6,000
sporetik 1 1 100038 100,038
SUB TOTAL 117,330 -
an. Widia 8/27/2016 d5 1/2 ns 2 2 17159 34,318
rawat inap inf set makro 1 1 10600 10,600
kassa steril 2 2 10203 20,406
spuit 10cc 1 1 3286 3,286
spuit 1cc 2 2 2849 5,698
opinecea tab 10 10 7500 75,000
kindastatin 1 1 51476 51,476
venflon 24 2 2 26235 52,470
SUB TOTAL 319,504 -
8/28/2016 d51/2 ns 2 2 17159 34,318

SUB TOTAL 34,318 -
8/28/2016 cefotaxim inj 1 1 15304 15,304

coetidex 1 1 7500 7,500
spuit 10cc 1 1 3286 3,286
spuit 1cc 1 1 2849 2,849
spuit 3cc 1 1 1895 1,895
aquades 1 1 3312 3,312
SUB TOTAL 34,146 -
8/29/2016 claneksi syr 1 1 67686 67,686

SUB TOTAL 67,686 -
GRAND TOTAL
tn. Tukimim 8/29/2016 isosobid dinitrat 10 10 186 1,860

thrombo aspilet 10 10 939 9,390
SUB TOTAL 11,250 -
Ny.Tri ningsih 8/29/2016 asmef 15 15 400 6,000

lidocain inj 1 1 2186 2,186
spuit 1cc 1 1 2849 2,849
ragyl 10 10 1000 10,000
SUB TOTAL 21,035 -
tn. Satam 8/29/2016 furosemid tab 10 10 268 2,680

mp. 4mg 10 10 530 5,300
SUB TOTAL 11,190 -
an. Tutik 8/29/2016 valisanbe 5 mg 10 10 364 3,640
salbutamol syr 1 1 6600 6,600
cortidex 1 1 7500 7,500
nacl 2 2 7721 15,442
oksigen 1 1 250 50,000
nasal canul 1 1 14575 14,575
vemflon 22 1 1 23186 23,186
spuit 3 cc 1 1 1895 1,895
farbiven amp 1 1 112625 112,625
ambroxol 10 10 437 4,370
SUB TOTAL 250,433 -
Tn. Ramadan 8/27/2016 ketorolac inj 2 2 16100 32,200

spuit 3cc 4 4 1895 7,850
inf set makro 1 1 10600 10,600
venflon 20 1 1 23186 23,186
ns 2 2 7721 15,442
buscopan inj 1 1 27825 27,825 27,825
opilax syr 1 1 58300 58,300
scopamin 10 10 2551 25,510
SUB TOTAL 180,580 27,825
8/28/2016 ns 3 3 7721 23,163

aquades 1 1 3312 3,312
rocer inj 1 1 165625 165,625
buscopan inj 2 2 27825 55,650 55,650
spuit 10cc 2 2 3286 6,572
spuit 1cc 1 1 2849 2,849
domperidon tab 10 10 596 5,960
renax tab 10 10 8700 87,000
SUB TOTAL 327,606 55,650
8/28/2016 ketorolak inj 3 3 16100 48,300

SUB TOTAL 55,792 -
8/29/2016 ns 1 1 7721 7,721
aquades 1 1 3312 3,312
rocer inj 1 1 165625 165,625
buscopan inj 2 2 27825 55,650 55,650
spuit 3cc 2 2 1895 3,790
SUB TOTAL 287,315 55,650
8/29/2016 renax 10 10 8700 43,500

omeprazol 10 10 1475 14,750
spasmal 10 10 600 6,000
SUB TOTAL 64,250 -
GRAND TOTAL
ny. Siti 8/29/2016 rl 1 1 8700 8,700

ranap ceftriaxone inj 3 3
ranituidin inj 2 2 3746 7,492
SUB TOTAL 16,192 -
ny. Siti 8/29/2016 samconal 4 4 1000 4,000

ranap SUB TOTAL 4,000 -
ny. Siti 8/29/2016 curcuma 10 10 2000 20,000

ranap
SUB TOTAL 20,000 -
ny. Asni 8/29/2016 RL 1 1 8700 8,700

ranap vemflon 22 2 2 23186 46,372
rocer 1 1 165625 165,625
spuit 10 cc 2 2 3286 6,572
spuit 3 cc 2 2 1895 3,790
spuit 1 cc 1 1 2849 2,849
oksigen 100 100 250 25,000
nasal canul 1 1 14575 14,575
SUB TOTAL 1,232,326 -
tn. Kristoporus 8/29/2016 clindamycin 300 mg 10 10 996 9,960
amoxicilin 10 10 464 4,640
pehacain 1 1 2363 2,363
kassa 3 3 1200 3,600
SUB TOTAL 20,563 -
ny. Siti 8/29/2016 metronidazol inf 3 3 72875 218,625

SUB TOTAL 218,625 -
tn.andi 8/29/2016 o2 600 600 250 150,000

SUB TOTAL 150,000 -
ny.darmiyah 8/29/2016 amlodipin 10 mg 10 10 2465 24,650

lipitor 10 10 19941 199,410
valisanbe 10 10 364 3,640
SUB TOTAL 227,700 -
tn.hoktua 8/29/2016 cefixime 100 mg 10 10 2968 29,680

indexon tab 10 10 4467 44,670
asam mefenamat 10 10 400 4,000
SUB TOTAL 78,350 -
ny.sunami 8/29/2016 asam mefenamat 10 10 400 4,000

bistury 1 1 4,638
lidocain inj 1 1 2,186
spuit 1 cc 2 2 5,698
ats 1 1 152,375
spuit 3 cc 1 1 1,895
ragyl forte 10 10 1000 10,000
indexon tab 10 10 2267 44,670
SUB TOTAL 225,462 -
an.tuti 8/30/2016 neuragel 1 1 324 324

antasida doen 1 1 5101 5,101
mucera syr 1 1 22525 22,525
salbutamol 1 1 6600 6,600
SUB TOTAL 34,550 -
an.alivia 8/30/2016 ambroxol 2 2 437 874

fartolin 2 2 928 1,846
tremenza 2 2 1530 3,060
dextafen 2 2 1450 2,916
kertas puyer 10 10 500 5,000
brotec 3 3 Rp 9,275
bisolvon 3 3 9,275
amoxan drop 1 1 33,000
SUB TOTAL 65,246 -
tn.samali 8/30/2016 na.dic 10 10 685 6,850

sanmag syr 1 1 Rp 32,940
ranitidin tab 10 10 321 3,210
SUB TOTAL 43,000 -
tn.paskalis 8/30/2016 furosemide 20 20 268 5,360

lisinopril 20 20 901 18,020
spironolakton 25 mg 20 20 539 10,780
na.dic 50 10 10 685 6,850
lansoprazole 10 10 1855 18,550
SUB TOTAL 59,560 -
nn.sariani 8/30/2016 o2 20 20 5,000

omeyus 10 10 24,000
sanmag syr 1 1 32,940
nasal canul 1 1 14,757
SUB TOTAL 76,697 -
tn.widakso 8/30/2016 asam mefenamat 10 10 400 4,000

SUB TOTAL 4,000 -
ny.tuti 8/30/2016 allopurinol 300 mg 10 10 928 9,280

na.dic 10 10 685 6,850
SUB TOTAL 49,070 -
tn.rusman 8/30/2016 allopurinol 300 mg 10 10 928 9,280

gemfibrozil 10 10 464 4,640
avesco 20 mg 10 10 9328 93,280
SUB TOTAL 107,200 -
nn.naumi 8/30/2016 paramol 10 10 1000 10,000
opinacea tab 10 10 7500 75,000
SUB TOTAL 117,940 -
tn.mahmudi 8/30/2016 asam mefenamat 10 10 400 4,000

amoxicilin 10 10 400 4,000
SUB TOTAL 40,940 -
tn.irham 8/30/2016 clindamycin 10 10 996 9,960

asam mefenamat 10 10 400 4,000
pehacaine 1 1 2,783
kasa 3 3 1200 3,600
SUB TOTAL 20,343 -
tn.enda 8/30/2016 ceftriaxone 2 2 33125 66,250

cortidex inj 2 2 7500 15,000
ns 2 2 7721 15,442
kcl 3 3 4638 13,914
megabal 10 10 2186 21,860
SUB TOTAL 139,958 -
ny.siti 8/30/2016 inf set makro 3 3 10600 31,800

spuit 3 cc 2 2 1895 3,790
certriaxone 2 2 33125 66,250
aquades 2 2 6,624
spuit 10 cc 1 1 3,286
metronidazole 1 1 72,875
rl 1 1 8,700
d5% 2 2 8312 16,624
ketorolac 3 3 16100 48,300
spuit 5 cc 2 2 2478 4,966
SUB TOTAL 270,707 -
ny.asni 8/30/2016 ondansentrin 8 mg 1 1 9,047

ranap rocer inj 1 1 165,625
ceftriaxone 2 2 33125 66,250
SUB TOTAL 240,922 -
ny asni 8/30/2016 omeyus 10 10 11,759

SUB TOTAL 11,759 -
tn.randy 8/30/2016 samconal 20 20 1000 20,000

cetirizin 10 10 530 5,300
SUB TOTAL 25,300 -
KAMIS, 01-09-2016
1 ny. Enda 8/26/2016 spuit 1cc 1 1 2849 2,849
spuit 10cc 1 1 3286 3,286
inf set makro 1 1 10600 10,600
aquades 1 1 3312 3,312
nacl 2 2 7712 15,442
venflon 22 1 1 23186 23,186
megabal 10 10 2186 21,860
amlodipin 10mg 5 5 2465 12,325
indexon inj 2 2 9275 18,550
spuit 3cc 3 3 1895 5,685
SUB TOTAL 174,143 -
8/26/2016 alinamin -f 3 3 21333 63,999

spuit 20cc 4 4 9275 37,100
spuit 10cc 1 1 3286 3,286
needle 23 4 4 875 3,500
nacl 1 1 7721 7,721
megabal 3 3 2186 6,558
kcl 3 3 4638 13,914
SUB TOTAL 98,978 37,100
8/27/2016 terfacef inj 1 1 128248 128,248

nacl 3 3 7721 23,163
kcl 1 1 4638 4,638
cortidex inj 2 2 7500 15,000
alinamin-f inj 2 2 21333 42,666
SUB TOTAL 221,207 -
8/28/2016 ceftriaxon inj 2 2 33125 66,250

cortidex inj 2 2 7500 15,000
alinamin -f 1 1 21333 21,333
nacl 2 2 7721 15,442
venflon 22 1 1 23186 23,186
SUB TOTAL 148,703 -
8/29/2016 ceftriaxon inj 2 2 33125 66,250

cortidex inj 2 2 7500 15,000
kcl 2 2 4638 9,276
SUB TOTAL 98,018 -
8/30/2016 ceftriaxon inj 2 2 33125 66,250

cortidex inj 2 2 7500 15,000
nacl 2 2 7721 15,442
kcl 3 3 4638 13,914
megabal 10 10 2186 21,860
SUB TOTAL 139,958 -
8/31/2016 cefadroxil 5 5 981 4,905

SUB TOTAL 4,905 -
GRAND TOTAL
2 An. Grace 9/1/2016 apialys syr 1 1 33125 33,125

sendok 1 1 500 500
SUB TOTAL 33,625 -
3 an. Diego 9/1/2016 asmef 10 10 400 4,000

amoxicillin tab 10 10 464 4,640
SUB TOTAL 8,640 -
4 tn. Slamet m 9/1/2016 mertigo sr 10 10 6029 60,290

PT. ADI KARYA cymalium 5 5 1802 9,010
BELUM BAYAR vesperum 10 10 2000 20,000
SUB TOTAL 89,300 -
5 ny. Ayli 9/1/2016 captopril 25mg 5 5 182 910

SUB TOTAL 910 -
6 by. Alfariz 8/30/2016 rl 3 3 8700 26,100

inf set mikro 1 1 10203 10,203
venflon 26 2 2 51013 102,026
cefotaxim inj 1 1 15304 15,304
ondan 8mg 1 1 11660 11,660
nacl 1 1 7721 7,721
spuit 10cc 1 1 3286 3,286
spuit 1cc 2 2 2849 5,698
aquades 1 1 3312 3,312
oralit 5 5 928 4,640
zinkid syr 1 1 20000 20,000
l-bio 3 3 9275 27,825
sanmol drop 1 1 20551 20,551
mucera drop 1 1 22525 22,525
SUB TOTAL 276,211 4,640
8/31/2016 metronidazole inf 1 1 47965 47,965

spuit 10cc 1 1 3286 3,286
d5 1/2 ns 1 1 17158 17,158
SUB TOTAL 68,409 -
8/31/2016 cefotaxim inj 2 2 0 15304 30,608

ondan 4mg 2 1 1 7288 14,576
fartolin 1 1 18000 18,000
rl 3 3 8700 26,100
aquades 2 2 0 3312 6,624
SUB TOTAL 95,908 -
8/31/2016 cefotaxim inj 2 1 1 15304 30,608

ondan 4mg 2 2 0 7288 14,576
fartolin 1 1 0 20000 20,000
aquades 2 0 2 3312 6,624
SUB TOTAL 71,808 -
GRAND TOTAL
7 tn. Ali suharman 9/1/2016 clindamycin 10 10 996 9,960
asmef 10 10 400 4,000
pehacain inj 1 1 2783 2,783
kassa 3 3 1200 3,600 -
SUB TOTAL 20,343 -
8 Tn. Wawan 8/31/2016 Inf Set Makro 1 1 10600 10,600 -

Venflon 20 2 2 23186 46,372 -
Inf Ns 2 2 7721 15,442 -
Recodryl Inj 1 1 9275 9,275 -
Ondan 8 mg Inj 1 1 33500 33,500 -
Sp 5 cc 1 1 2478 2,478 -
Vastigo 3 3 1312 3,936 -
Sanmagh Tab 3 3 1020 3,060 -
SUB TOTAL 124,663 -
8/31/2016 Ranitidin Inj 2 2 3746 7,492 -

Recodryl Inj 1 1 9275 9,275 -
Sp 3 cc 5 5 1895 9,475 -
Xepalium 6 6 8500 51,000 -
SUB TOTAL 77,242 -
9/1/2016 Ondan 4 mg Inj 3 3 9794 29,382 -

Recodryl Inj 1 1 9275 9,275 -
Inf Ns 2 2 7721 15,442 -
Sp 3 cc 2 2 1895 3,790 -
Sanmagh Tab 3 3 1020 3,060 -
Mertigo Sr 3 3 6029 18,087 -
SUB TOTAL 79,036 -
9/1/2016 Cymalium Tab 10 10 1900 19,000 -

Mertigo Sr 10 10 6100 61,000 -
SUB TOTAL 80,000 -
GRAND TOTAL
9 Ny. Oci 9/1/2016 O2 500 500 250 125,000 -

SUB TOTAL 125,000 -
10 Tn. Suyono 9/1/2016 Lexadon Tab 10 10 1500 15,000 -

Ranitidin Tab 10 10 321 3,210 -
Sanmagh Syr 1 1 32940 32,940 -
L- Bio 5 5 9275 46,375 -
Molagit 10 10 636 6,360 -
Licoprox Tab 10 10 2500 25,000 -
SUB TOTAL 128,885 -
11 Ny.Siti 8/28/2016 Nasal Canul O2 1 1 14575 14,575 -

Infus set makro 1 1 10600 10,600 -
Vemplon 22 3 3 23186 69,558 -
Nacl 1 1 7721 7,721 -
Ceftriaxone inj 1 1 33125 33,125 -
Ranitidine inj 1 1 3746 3,746 -
Farsix inj 2 2 8348 16,696 -
Valdix tab 1 1 8016 8,016 -
Spuit 5 cc 1 1 2478 2,478 -
Spuit 3 cc 2 2 1895 3,790 -
Spuit 1 cc 1 1 2849 2,849 -
Aquadest 1 1 3312 3,312 -
SUB TOTAL 176,466
8/28/2016 Nasal Kanul O2 1 1 14575 14,575 -

Masker O2 1 1 29216 29,216 -
SUB TOTAL 43,791
8/29/2016 Samconal tab 4 4 1000 - 4,000

SUB TOTAL 4,000
8/29/2016 Curcuma tab 10 10 2000 20,000 -

SUB TOTAL 20,000
8/29/2016 Metronidazole inf 3 3 72875 218,625 -

SUB TOTAL 218,625
8/29/2016 RL 1 1 8700 8,700 -

Ranitidin inj 2 2 3746 7,492 -
SUB TOTAL 115,567
8/30/2016 Infus Set Makro 3 3 10600 31,800 -

Spuit 3 cc 2 2 1895 3,790 -
Aquadest 2 2 3312 6,624 -
Spuit 10 cc 1 1 3286 3,286 -
Metronidazole inf 1 1 72875 72,875 -
RL 1 1 8700 8,700 -
D5% 2 2 8312 16,624 -
Ketorolac inj 3 3 16100 48,300 -
Spuit 5cc 2 2 2478 4,956 -
SUB TOTAL 270,697

SUB TOTAL 145,750

Urdahex tab 3 3 11902 35,706 -
Masker O2 1 1 84403 84,403 -
SUB TOTAL 265,859
8/31/2016 O2 1400 1400 250 350,000 -

SUB TOTAL 350,000
GRAND TOTAL
12 Ny.Yamini 9/2/2016 Mucohexin tab 10 10 600 6,000 -

Ciprofloxacim tab 10 10 627 6,270 -
Samconal tab 10 10 1000 - 10,000
M.P 16 mg 10 10 1391 13,910 -
SUB TOTAL 26,180 10,000
13 Tn.Petrus 9/2/2016 Clindamycin tab 10 10 996 9,960 -

Asam.Mefenamat 10 10 400 4,000 -
SUB TOTAL 13,960
14 Tn.Ngatman 9/2/2016 Lisinopril 10 mg 10 10 901 9,010 -

Mucohexim tab 10 10 600 6,000 -
Omeyus tab 10 10 1000 - 10,000
SUB TOTAL 15,010 10,000
15 Tn.Muhammad.N 9/2/2016 Clindamycin tab 10 10 996 9,960 -

SUB TOTAL 13,960
16 Tn.Tedi.Dwi.W 9/2/2016 Clindamycin tab 10 10 996 9,960 -

SUB TOTAL 13,960
17 Tn. Hendro 9/2/2016 Ragyl 10 10 1000 10,000

Asmef 10 10 400 4,000 -
Mp 4mg 10 10 530 5,300 -
SUB TOTAL 9,300 10,000
18 Tn. Widakso 9/2/2016 Ragyl 10 10 1000 - 10,000

Mp 4mg 10 10 530 5,300 -
SUB TOTAL 5,300 10,000
19 Tn. Leo 9/2/2016 Amoxicillin 10 10 464 4,640 -

Asmef 10 10 400 4,000 -
SUB TOTAL 8,640 -
20 An. Hapit 9/2/2016 Paracetamol syr 1 1 3900 3,900 -

Amoxan syr 1 1 54000 54,000 -
SUB TOTAL 57,900 -
21 Tn. Yulius 9/2/2016 Pangon 10 10 1749 17,490 -

Braxidin 10 10 1166 11,660 -
SUB TOTAL 29,150 -
22 An. Fita 9/2/2016 Loratadine 3 3 441 1,323 -

Mucohexin syr 1 1 19610 19,610 -
SUB TOTAL 20,933 -
23 Nn. Noviza 9/2/2016 Lidocain inj 1 1 2186 2,186 -

Spuit 1cc 1 1 2849 2,849 -
Supratul 1 1 20405 20,405 -
Ciprofloxacin tab 6 6 627 - 3,762
Asmef 10 10 400 4,000 -
Indexone 7 7 4467 31,269 -
SUB TOTAL 60,709 3,762
24 An. Nur Fadilah 8/31/2016 D5 1/2 NS 1 1 17159 17,159 -

Venflon 24 1 1 26235 26,235 -
Inf set makro 1 1 10600 10,600 -
Spuit 3cc 1 1 1895 1,895 -
Ottopan syr 1 1 14575 14,575 -
SUB TOTAL 70,464 -
9/1/2016 Ranitidin inj 1 1 3746 3,746 -

Spuit 3cc 1 1 1895 1,895 -
Apialys syr 1 1 33125 33,125 -
D5 1/2 NS 1 1 8312 8,312 -
SUB TOTAL 47,078 -
9/2/2016 Ranitidin inj 2 2 0 3746 - -

SUB TOTAL - -
GRAND TOTAL
25 Tn. Mambai 9/2/2016 Ketorolac inj 1 1 16100 16,100 -

Spuit 3cc 1 1 1859 1,859 -
Analsik 10 10 1589 15,890 -
Indexone tab 10 10 4467 44,670 -
SUB TOTAL 78,519
26 Tn. Apriyadi 9/2/2016 Ciprofloxacin tab 6 6 627 - 3,762

Analsik Tab 10 10 1589 15,890 -
SUB TOTAL 15,890
27 Tn.Slamet 9/3/2016 Ibuprofen tab 10 10 331 3,310 -

Norvom tab 10 10 278 2,780 -
Mersibion tab 10 10 5016 - 50,160
SUB TOTAL 6,090 50,160
28 Tn.Yusdipa 9/1/2016 Nacl 3 3 7721 23,163 -

Vemplon 20 1 1 23186 23,186 -
Infus Set Makro 1 1 10600 10,600 -
Ondan 4 mg 3 3 7288 21,864 -
Ottozole inj 1 1 182187 182,187 -
Spuit 3 cc 3 3 1895 5,685 -
Spuit 10 cc 1 1 3286 3,286 -
pct tab 10 10 1000 10,000 -
L- Bio 5 5 9275 46,375 -
Sanmaag syr 1 1 32940 32,940 -
Molagit tab 10 10 636 6,360 -
SUB TOTAL 365,646
9/2/2016 Ottozole inj 1 1 182187 182,187 -

Ondan 4 mg inj 3 3 7288 21,864 -
SUB TOTAL 204,051
9/2/2016 Ranitidin inj 2 2 3746 7,492 -

Spuit 3 cc 2 2 1895 3,790 -
Lodia tab 10 10 1639 16,390 -
Buscopan inj 3 3 27825 83,475 -
SUB TOTAL 114,937
9/2/2016 Spuit 3 cc 2 2 1895 3,790 -

SUB TOTAL 3,790
GRAND TOTAL
29 Tn.Heri 9/3/2016 Cefadroxyl syr 1 1 13037 13,037 -

SUB TOTAL 13,037
30 Ny.Lempap 9/3/2016 Spasmal tab 10 10 600 6,000 -

Ciprofloxacim tab 10 10 627 6,270 -
Ranitidin tab 10 10 321 3,210 -
SUB TOTAL 15,480
31 Tn.Suwandi 9/3/2016 Lidocain inj 1 1 2186 2,186 -

Spuit 3 cc 1 1 1895 1,895 -
Cefat 500 tab 6 6 12786 76,716 -
SUB TOTAL 84,797
32 An.Zulfa 9/3/2016 Xetapen syr 1 1 36437 36,437 -

Loratadin tab 2 2 441 882 -
Kertas puyer 5 5 200 1,000 -
SUB TOTAL 38,319
33 Tn.Widodo 9/3/2016 Ketorolac inj 1 1 16100 16,100 -

Spuit 3 cc 1 1 1895 1,895 -
SUB TOTAL 17,995
34 Tn.Hendra 9/3/2016 Ambroxol tab 10 10 437 4,370 -
Antasida tab 10 10 56 560 -
Scopamin plus 10 10 2226 22,260 -
SUB TOTAL 27,190
35 An.Fiona 9/3/2016 Anacetin syr 1 1 13250 13,250 -

Zink kid syr 1 1 21834 21,834 -
Oralit 5 5 928 4,640 -
Opinacea syr 1 1 66250 66,250 -
SUB TOTAL 105,974
36 An.Bayu 9/3/2016 Ottopan syr 1 1 14575 14,575 -

Amoxicillin syr 1 1 8745 8,745 -
Lidocain inj 1 1 2186 2,186 -
Spuit 3 cc 1 1 1895 1,895 -
SUB TOTAL 27,401
37 An. Atin 9/3/2016 Cetirizin syr 1 1 16231 16,231 -

Opinecea syr 1 1 66250 66,250 -
Ottopan syr 1 1 14575 14,575 -
SUB TOTAL 97,056
38 Nn. Dea 9/3/2016 D5 1/4 NS 2 2 17159 34,318 -

SUB TOTAL 34,318
39 An.Wisnu 9/4/2016 Amoxicillin tab 10 10 464 4,640 -

Asam mefenamat 10 10 400 4,000 -
SUB TOTAL 8,640
40 An.Hanif 9/4/2016 Lostacef kaps 10 10 3200 - 32,000

Kalnex tab 10 10 2785 - 27,850
M.P 4 mg 10 10 530 5,300 -
SUB TOTAL 9,300 59,850
41 Nn.Titin 9/4/2016 Noflam tab 10 10 5101 51,010 -

Amoxicillin tab 10 10 464 4,640 -
M.P 4 mg 10 10 530 5,300 -
Verban Elastis 3 inci 1 1 23320 23,320 -
SUB TOTAL 84,270
42 Nn.Nia 9/4/2016 Lostacef kaps 10 10 3200 - 32,000

Flamar 50 tab 10 10 2200 22,000 -
SUB TOTAL 22,000 32000
43 Ny. Tarwati 9/1/2016 Venflon 20 1 1 23186 23,186 -

Pletaal 50mg 5 5 9739 48,695 -
metformin 500mg 5 5 265 1,325 -
SUB TOTAL 73,206
9/2/2016 Serfac 500 4 4 79500 318,000 -

Megabal 3 3 2186 6,558 -
Pletaal 50mg 2 2 9739 19,478 -
metformin 500mg 3 3 265 795 -
SUB TOTAL 344,831
9/3/2016 Serfac 500 4 4 79500 318,000 -

SUB TOTAL 318,000
9/4/2016 Citicolin 500mg 20 20 7884 157,680 -

Pletaal 50mg 20 20 9739 194,780 -
Lisinopril 10 10 901 9,010 -
SUB TOTAL 361,470
GRAND TOTAL
44 An. Ello 9/4/2016 Amoxan syr 1 1 54000 54,000 -

Ottopan syr 1 1 14575 14,575 -
Interpec syr 1 1 29800 29,800 -
SUB TOTAL 98,375
45 An. Michael 9/4/2016 Amoxan syr 1 1 54000 54,000 -

Xepafen syr 1 1 29150 29,150 -
SUB TOTAL 83,150
46 Ny. Winarsih 9/4/2016 Salbutamol syr 1 1 6600 6,600 -

Ambroxol 10 10 437 4,370 -
Flamar 50mg 10 10 2200 22,000 -
M.P 4mg 10 10 530 5,300 -
Ferbiven Nebu 1 1 112625 112,625 -
SUB TOTAL 150,895
47 Nn. Indah Ayu 9/4/2016 Amoxan tab 10 10 19544 195,440 -

Flamar 50mg 10 10 2200 22,000 -
M.P 4mg 10 10 530 5,300 -
Ambroxol 10 10 437 4,370 -
SUB TOTAL 227,110
48 An. Bima 9/4/2016 Ragyl 10 10 1000 - 10,000

SUB TOTAL 10,000
49 Tn. Sucipto 9/4/2016 Nasal Kanul 1 1 14575 14,575 -

Ephineprin inj 1 1 2319 2,319 -
Spuit 3cc 1 1 1895 1,895 -
Oksigen 50 50 250 12,500 -
Ferbiven 1 1 112625 112,625 -
SUB TOTAL 143,914
50 dr. Dita 9/5/2016 cetirizin tab 10 10 530 5,300 -

SUB TOTAL 5,300
51 Tn.Chakra 9/4/2016 RL 1 1 8700 8,700 -

Infus set makro 1 1 10600 10,600 -
Vemplon 20 1 1 23186 23,186 -
Ottozol inj 1 1 182187 182,187 -
Buscopan inj 2 2 0 27825 - -
Ondan 8 mg inj 1 1 11660 11,660 -
Spuit 10 cc 1 1 3286 3,286 -
Spuit 3 cc 2 2 1895 3,790 -
Lexadon 10 10 1000 10,000 -
SUB TOTAL 253,409
9/4/2016 Onda 4m Inj 2 2 9794 19,588 -

Buscopan Inj 3 3 27825 83,475 -
Otozol Inj 1 1 182187 182,187 -
Episan Syr 1 1 53795 53,795 -
Rl 2 2 8700 17,400 -
SUB TOTAL 356,445
9/4/2016 Alprazolone 0.5 2 2 1060 2,120 -
Buscopan Inj 1 1 27825 27,825 -
SUB TOTAL 29,945
9/5/2016 Spasmal 10 10 600 6,000 -

Omejus 10 10 1000 10,000 -
SUB TOTAL 16,000
GRAND TOTAL
52 Tn. Matari 9/2/2016 Rl 1 1 8700 8,700 -

Venflon 20 1 1 23186 23,186 -
Inf Set makro 1 1 10600 10,600 -
Ottozole Inj 1 1 182187 182,187 -
Aquades 1 1 3312 3,312 -
Ondan 4 mg 2 2 7288 14,576 -
sp 10 cc 1 1 3286 3,286 -
sp 3 cc 2 2 1895 3,790 -
Buscopan Inj 2 2 27825 55,650 -
Lexadon 10 10 1000 10,000 -
SUB TOTAL 315,287
9/2/2016 NGT 18 1 1 25043 25,043 -

SUB TOTAL 25,043
9/3/2016 Rl 2 2 8700 17,400 -

Ottozole 1 1 182187 182,187 -
Buscopan Inj 3 3 27825 83,475 -
Ondancentron 4 mg Inj 2 2 7288 14,576 -
SUB TOTAL 297,638
9/4/2016 Rl 2 2 8700 17,400 -

Ottozole 1 1 182187 182,187 -
Buscopan Inj 3 3 27825 83,475 -
Ondancentron 4 mg Inj 2 2 9794 19,588 -
Pain kila 1 1 13913 13,913 -
SUB TOTAL 316,563
9/4/2016 Valisanbe 5 mg 5 5 364 1,820 -

Nuerosanbe plus 3 3 6493 19,479 -
Spuit 3 cc 1 1 1895 1,895 -
Samconal 10 10 1000 10,000 -
SUB TOTAL 33,194
9/4/2016 Nasal Kanul Dewasa 1 1 14575 14,575 -

SUB TOTAL 14575
9/5/2016 Spsmal 10 10 600 6,000 -

Nexium 40 mg 5 5 24778 123,890 -
Episan Syr 1 1 53795 53,795 -
Domperidone 10 10 596 5,960 -
O2 2000 2000 250 500,000 -
SUB TOTAL 689,645
GRAND TOTAL
53 Tn.Sanwiarto 9/5/2016 Flamar tab 50 10 10 2200 22,000 -

Valisanbe 5 mg 10 10 364 3,640 -
SUB TOTAL 25,640
54 An.Arbiola 9/5/2016 Amoxan syr 1 1 53809 53,809 -

Xepafen syr 1 1 36437 36,437 -
Anacetin syr 1 1 13250 13,250 -
SUB TOTAL 103,496
55 Tn.Panijo 9/5/2016 Celebrex tab 10 10 17693 176,930 -

Amlodipin 10 mg 15 15 2465 36,975 -
Lipitor 20 mg 10 10 19941 199,410 -
SUB TOTAL 413,315
56 Tn.Rio 9/5/2016 Opixime tab 10 10 7433 74,330 -

M.P 16 mg 10 10 1391 13,910 -
SUB TOTAL 88,240
57 Tn.Tri Hartadi 9/5/2016 Clindamicin 300 mg 10 10 846 8,460 -

Pehacain inj 1 1 2363 2,363 -
Kassa 3 3 1200 3,600 -
SUB TOTAL 17,423
58 Om.Khairul 9/5/2016 Ranitidin tab 20 20 321 6,420 -

SUB TOTAL 6,420
59 Tn.Heri 9/5/2016 Termometer Digital 1 1 35000 35,000 -
SUB TOTAL 35,000
60 Tn.Kadau 9/5/2016 Ciprofloxacim tab 10 10 627 6,270 -

Analsik tab 10 10 1589 15,890 -
Mersibion tab 10 10 5016 50,160 -
Pain kila 1 1 13913 13,913 -
SUB TOTAL 86,233
61 Nn.Nuryuni 9/5/2016 M.P 8 mg 5 5 928 4,640 -

Flamar 50 10 10 2200 22,000 -
Eperison tab 10 10 2041 20,410 -
SUB TOTAL 47,050
62 An. Syafitriah 9/5/2016 xepafen syr 1 1 36437 36,437 -

SUB TOTAL 36,437
63 Tn. Indriadi 9/5/2016 amoxicilin 15 15 464 6,960 -

as. Mefenamat 15 15 400 6,000 -
SUB TOTAL 12,960
64 Tn. M. Ainun 9/5/2016 amoxicilin 10 10 464 4,640 -

noflam 10 10 5101 51,010 -
methil prednisolon 4 mg 10 10 530 5,300 -
SUB TOTAL 60,950
65 An. Susilawati 9/5/2016 episan 1 1 53795 53,795 -

mefinal 2 2 1749 3,498 -
valisanbe 3 3 364 1,092 -
samconal 3 3 500 1,500 -
claneksi syr 1 1 67686 67,686 -
opinacea 1 1 66250 66,250 -
kertas puyer 6 6 200 1,200 -
SUB TOTAL 195,021
66 Tn. Ade Sumardi 9/5/2016 samconal 10 10 500 5,000 -

ranitidin 10 10 321 3,210 -
ciprofloxacin 14 14 627 - 8,778
SUB TOTAL 8,210 8,778
67 Ny. Ngatmi 8/5/2016 nacl 4 4 7721 30,884 -
vemflon 20 1 1 23186 23,186 -
cefotaxime 2 2 15304 30,608 -
metronidazol inf 1 1 72875 72,875 -
spiut 10 cc 1 1 3286 3,286 -
spuit 1 cc 1 1 2849 2,849 -
infus set makro 1 1 10600 10,600 -
aquadest 1 1 3312 3,312 -
samconal 10 10 500 - 5,000
SUB TOTAL 177,600 5,000
68 an. Albara putra 9/5/2016 anacetin 1 1 15000 - 15,000

interpec 1 1 29800 29,800 -
SUB TOTAL 29,800 15,000
69 An. Yogi 9/6/2016 Samconal 10 10 500 5,000 -

Sagestam salep 1 1 16105 16,105 -
SUB TOTAL 21,105
70 Tn. Azis 9/6/2016 Nadic 50mg 10 10 685 6,850 -

Ranitidin tab 10 10 321 3,210 -
Dexlosan 10 10 1000 - 10,000
SUB TOTAL 10,060 10,000
71 Nn. Irma 9/6/2016 Ciprofloxacin tab 6 6 627 3,762 -

Ambroxol 10 10 437 4,370 -
Ibuprofen tab 10 10 331 - 3,310
SUB TOTAL 8,132 3,310
72 Tn. Sukemi 9/6/2016 Sagestam salep 1 1 16105 16,105 -

Betamethason salep 1 1 3896 3,896 -
Pot salep 1 1 5000 5,000 -
Dexlosan 10 10 1000 - 10,000
SUB TOTAL 25,001 10,000
73 Nn. Triningsih 9/6/2016 Sagestam salep 1 1 16105 16,105 -

SUB TOTAL 16,105
74 Tn. Andi 9/6/2016 Opixime 100 14 14 31000 434,000 -

Ambroxol tab 10 10 437 4,370 -
Dexlosan 15 15 1000 - 15,000
SUB TOTAL 438,370 15,000
75 Ny. Rita 9/6/2016 Samconal 10 10 1000 10,000 -

Omeyus 10 10 1000 - 10,000
Norvom 10 10 278 2,780 -
SUB TOTAL 12,780 10,000
76 Nn. Okta 9/5/2016 infus set makro 1 1 10600 10,600 -

vemflon 20 1 1 23186 23,186 -
RL 1 1 8700 8,700 -
pumpitor 1 1 99800 99,800 -
sanmag syr 1 1 32940 32,940 -
valisanbe tab 1 1 14840 14,840 -
spuit 10 cc 2 2 3286 6,572 -
NGT 16 1 1 25043 25,043 -
SUB TOTAL 221,681
77 An. Virgin 9/3/2016 Paracetamol inf 1 1 56312 56,312 -

Inf set makro 1 1 10600 10,600 -
Venflon 24 2 2 26235 52,470 -
Venflon 26 1 1 51013 51,013 -
D5 1/4 NS 2 2 19941 39,882 -
Cefotaxime 2 2 15304 30,608 -
Aquades 1 1 3312 3,312 -
Spuit 10cc 1 1 3286 3,286 -
Spuit 1cc 1 1 2849 2,849 -
Paracetamol syr 1 1 3900 3,900 -
Sporetik syr 1 1 100038 100,038 -
SUB TOTAL 354,270
9/3/2016 Biocef inj 1 1 172250 172,250 -

Aqudes 1 1 3312 3,312 -
Spuit 10cc 1 1 3286 3,286 -
Spuit 1cc 1 1 2849 2,849 -
Opinacea syr 1 1 66250 66,250 -
Spuit 3cc 1 1 1895 1,895 -
SUB TOTAL 253,588
9/4/2016 D5 1/4 NS 2 2 17159 34,318 -
Inf set makro 1 1 10600 10,600 -
SUB TOTAL 48,664
9/5/2016 Aquades 1 1 3312 3,312 -

Cefotaxime 2 2 15304 30,608 -
Spuit 3cc 1 1 1895 1,895 -
Spuit 1cc 1 1 2849 2,849 -
SUB TOTAL 38,664
9/6/2016 Spuit 3cc 1 1 1895 1,895 -

Spuit 1cc 1 1 2849 2,849 -
Sporetik syr 1 1 100038 100,038 -
SUB TOTAL 104,782
GRAND TOTAL
78 An. Valerio 9/4/2016 D5 1/2 NS 1 1 17159 17,159 -

Venflon 22 1 1 23186 23,186 -
Inf set makro 1 1 10600 10,600 -
Cefotaxime 2 2 15304 30,608 -
Spuit 3cc 1 1 1895 1,895 -
Spuit 1cc 1 1 2849 2,849 -
Spuit 10cc 1 1 3286 3,286 -
Sendok syr 1 1 500 500 -
Aquadest 1 1 3312 3,312 -
Oraprofen syr 1 1 14500 14,500 -
SUB TOTAL 115,387
9/4/2016 Cefotaxime 2 2 0 - -
D5 1/2 NS 2 2 17159 34,318 -
Aquades 2 2 3312 6,624 -
SUB TOTAL 48,434
9/4/2016 Biocef inj 2 2 172250 344,500 -

Aqudes 2 2 3312 6,624 -
Spuit 10cc 2 2 3286 6,572 -
Ottopan syr 1 1 14757 14,757 -
Opinacea syr 1 1 66250 66,250 -
Spuit 3cc 2 2 1895 3,790 -
Paracetamol inf 1 1 0 56312 - -
Dulcolactol syr 1 1 82150 82,150 -
Cortidex inj 1 1 7500 7,500 -
SUB TOTAL 535,889
9/6/2016 Sporetik syr 1 1 100038 100,038 -

SUB TOTAL 100,038
GRAND TOTAL
79 Tn. Fery 9/6/2016 lapidril dmp 1 1 5712 - 5,712

loratadin 5 5 441 2,205 -
mp 4mg 15 15 530 7,950 -
sendok 1 1 500 500 -
SUB TOTAL 16,367 5,712
80 Ny. Sumi 9/6/2016 vastigo 10 10 1312 13,120 -

eprisone 6 6 2041 12,246 -
cymalium 6 6 1802 - 10,812
SUB TOTAL 25,366 10,812
81 Tn. Yanto 9/6/2016 Nacl 3 3 7867 23,601 -

Inf set makro 1 1 10600 10,600 -
Venflon 20 1 1 23186 23,186 -
ketorolac inj 3 3 16100 48,300 -
Dexamethason inj 3 3 5300 15,900 -
Ranitidin inj 3 3 3746 11,238 -
Spuit 3cc 8 8 1895 15,160 -
Ibuprofen tab 10 10 331 3,310 -
SUB TOTAL 151,295 -
9/6/2016 Oksigen 50 50 250 12,500 -

SUB TOTAL 12,500 -
GRAND TOTAL
82 Tn. Syahrul 9/6/2016 dexamethason inj 3 3 7500 22,500 -

SUB TOTAL 22,500 -
83 Ny.Zawindar 9/6/2016 RL 1 1 8700 8,700 -
Infusset makro 1 1 10600 10,600 -
O2 20 20 250 5,000 -
Vemplon 20 1 1 23186 23,186 -
Nassal canul O2 1 1 14575 14,575 -
Cefotaxim inj 1 1 15304 15,304 -
Pumpitor inj 1 1 99800 99,800 -
Farbiven inj 3 3 112625 337,875 -
Spuit 10 cc 2 2 3286 6,572 -
Spuit 1 cc 1 1 2849 2,849 -
Spuit 3 cc 1 1 1895 1,895 -
Aquadest 1 1 3312 3,312 -
Amlodipin tab 5 5 2465 12,325 -
Lisinopril 10 mg 5 5 994 4,970 -
Ambroxol tab 8 8 437 3,496 -
Cetirizin tab 3 3 530 1,590 -
M.P 4 mg 10 10 530 5,300 -
Capsul kosong 10 10 500 5,000 -
SUB TOTAL 562,349
9/6/2016 Farbivent nebu 3 2 1 112625 112,625 -

Cefotaxim inj 2 2 15304 30,608 -
Aquadest 1 1 3312 3,312 -
Spuit 10 cc 2 2 3286 6,572 -
Spuit 5 cc 1 1 2478 2,478 -
Spuit 3 cc 1 1 1895 1,895 -
O2 600 600 250 150,000 -
Amlodipi tab 1 1 901 901 -
Lisinopril 10 mg 1 1 2465 2,465 -
Pumpitor inj 1 1 0 99800 - -
SUB TOTAL 310,856
9/6/2016 M.P Inj 1 1 51675 51,675 -

Spuit 3 cc 2 2 1895 3,790 -
Aminophilin inj 2 2 8198 16,396 -
Spuit 3 cc 1 1 3286 3,286 -
SUB TOTAL 75,147
9/7/2016 Lisinopril 10 mg 10 10 901 9,010 -

Amlodipin 10 10 2465 24,650 -
SUB TOTAL 33,660
GRAND TOTAL
84 Tn. Sudjak 9/6/2016 infus set makro 1 1 10600 10,600 -

vemflon 20 1 1 23186 23,186 -
RL 2 2 8700 17,400 -
pct inf 1 1 65588 65,588 -
wiacid (ranitidin) 2 2 25000 50,000 -
ondan 4 mg 2 2 9794 19,588 -
cefotaxime 2 2 15304 30,608 -
aquadest 1 1 3312 3,312 -
spuit 1 cc 1 1 2849 2,849 -
spuit 3 cc 2 2 1895 3,790 -
spuit 5 cc 1 1 2478 2,478 -
spuit 10 cc 1 1 3286 3,286 -
sanmaag 10 10 1020 10,200 -
SUB TOTAL 242,885
85 An.Noviza 9/7/2016 Kasa Steril 1 1 10203 10,203 -

Betadine 1 1 7420 7,420 -
Amoxilin tab 10 10 464 4,640 -
SUB TOTAL 22,263
86 Nn.Dwi 9/7/2016 Analsik 3 3 1589 4,767 -

SUB TOTAL 4,767
87 Ny.Tina 9/7/2016 Valisanbe tab 2 2 364 728 -

SUB TOTAL 728
88 Ny.Istiani 9/7/2016 Clindamicyn tab 10 10 996 9,960 -

SUB TOTAL 13,960
89 Ny.Sumini 9/7/2016 Omeyus tab 10 10 1000 10,000 -

Amlodipin 10 5 5 2465 12,325 -
Sanmaag syr 1 1 29945 29,945 -
SUB TOTAL 52,270
90 Tjong Nyen Fun 9/7/2016 Alprazolam 10 10 1060 10,600 -

Braxidin 10 10 1166 11,660 -
Celebrex 10 10 17693 176,930 -
Trombo aspilet 10 10 933 9,330 -
Fargoxin 10 10 788 7,880 -
SUB TOTAL 216,400
91 Tn.Juma Ali 9/7/2016 Braxidin 10 10 1166 11,660 -

Omeyus 10 10 1000 10,000 -
Domperidone tab 10 10 596 5,960 -
SUB TOTAL 27,620
92 Tn.Johan 9/7/2016 Analsik tab 10 10 1589 15,890 -

SUB TOTAL 15,890
93 Ny. Eni endrawati 9/7/2016 ambroxol 15 15 437 6,555 -

cetirizin 5 5 530 2,650 -
dexclosan 15 15 500 7,500 -
amoxicilin 15 15 464 6,960 -
SUB TOTAL 23,665
94 Nn. Elisabeth 9/7/2016 samconal 15 15 1000 15,000 -

ondan 4 mg 10 10 7288 72,880 -
lodia 6 6 1500 9,000 -
molagit 15 15 636 9,540 -
neuraxon 10 10 2500 25,000 -
SUB TOTAL 131,420
95 An. Saffa 9/8/2016 ondan 4 mg 5 5 7288 36,440 -

apialys 1 1 33125 33,125 -
L-bio 3 3 9275 27,825 -
zinkid 1 1 21834 21,834 -
SUB TOTAL 119,224
96 Tn. Fajar 9/8/2016 Cendocytrol IM 1 1 45540 45,540 -

Mefinal 10 10 1749 17,490 -
Opinacea Syr 1 1 66250 66,250 -
SUB TOTAL 129,280
97 Tn. Budhi 9/8/2016 Clindamycin 300 mg 10 10 996 9,960 -

Dexclosan 10 10 133 1,330 -
Mefinal 500 mg 10 10 1749 17,490 -
SUB TOTAL 28,780
98 Tn. Sumarto 9/7/2016 pct infus 3 3 85588 256,764

ondan 4 mg Inj 3 3 9794 29,382 -
Wiacid Inj 2 2 6300 12,600 -
Cefotaxime Inj 3 3 15304 45,912 -
SUB TOTAL 344,658
177,043
9/7/2016 Cipro Infus 2 2 76172 152,344 -
Spuit 1 cc 1 1 2849 2,849 -
Domperidone tab 10 10 596 5,960 -
Analsik 10 10 1589 15,890 -
SUB TOTAL 177,043
9/8/2016 Ciprofloxacin 500 mg 15 15 627 9,405 -

Ranitidin 150 tab 10 10 321 3,210 -
SUB TOTAL 12615
GRAND TOTAL
99 An.Sean Agung 9/8/2016 Opinacea syr 1 1 66250 66,250

SUB TOTAL 66,250
100 Nn.Yohana 9/8/2016 Vastigo tab 10 10 1312 13,120 -

Analsik 10 10 1589 15,890 -
Braxidin 10 10 1166 11,660 -
SUB TOTAL 40,670
101 Tn.Widakso 9/8/2016 Glibenclamid 5 mg 10 10 808 8,080 -

0 SUB TOTAL 8,080
102 Ny.Nurul 9/8/2016 Strocain tab 10 10 2551 25,510 -

SUB TOTAL 25,510
103 Ny.Nita 9/8/2016 Analsik tab 10 10 1589 15,890 -

Rindobion tab 10 10 3498 34,980 -
SUB TOTAL 50,870
104 Tn. Daniel 9/8/2016 M.P 16mg 10 10 1391 13,910 -

Mefinal 10 10 1749 17,490 -
SUB TOTAL 31,400
105 Tn.Iran 9/8/2016 Cetirizin kaps 10 10 530 5,300 - -

SUB TOTAL 5,300
106 dr.Birawa 9/8/2016 Apialys drop 1 1 39750 39,750 -

SUB TOTAL 39,750
107 Nn.Aling 9/8/2016 Kalnex tab 10 10 2785 27,850 -

Amoxicillin tab 10 10 464 4,640 -
SUB TOTAL 36,490
108 Nn. Agustina 9/8/2016 ranitidin 10 10 321 3,210 -

tomit 10 10 500 5,000 -
neurosanbe plus 10 10 1385 13,850 -
ibuprofen 10 10 331 3,310 -
SUB TOTAL 25,370
109 Ny. Ernawati 9/9/2016 farbiven nebu 1 1 112625 112,625 -

spuit 3 cc 1 1 1895 1,895 -
salbron 5 5 500 2,500 -
cetirizin 3 3 530 1,590 -
ambroxol 8 8 437 3,496 -
mp 4 mg 10 10 530 5,300 -
capsul kosong 10 10 500 5,000 -
SUB TOTAL 132,406
110 Tn. M. Bakri 9/9/2016 Nepidipin 10mg 1 1 186 186 -

Captopril 25mg 5 5 182 910 -
Asmef 10 10 400 4,000 -
SUB TOTAL 5,096
111 Nn. Vika 9/9/2016 Amoxicillin tab 10 10 464 4,640 -

Asmef 10 10 400 4,000 -
SUB TOTAL 8,640
112 An. Virgin 9/9/2016 Apialys syr 1 1 33125 33,125 -

Dexclosan 10 10 1000 10,000
Sendok 1 1 500 500 -
SUB TOTAL 33,625 10,000
113 An. Nayma 9/9/2016 Apialys syr 1 1 33125 33,125 -

Anacetin syr 1 1 15000 - 15,000
SUB TOTAL 33,125 15,000
114 Tn. P. Polo 9/9/2016 Clindamyci 300 10 10 996 9,960 -

Mefinal 10 10 1749 17,490 -
SUB TOTAL 27,450 -
115 By. Sebastian 9/5/2016 Dexamthason inj 1 1 3000 3,000 -

Farbiven nebu 2 2 112625 225,250 -
Spuit 3cc 1 1 1895 1,895 -
SUB TOTAL 230,145 -
9/6/2016 Venflon 26 1 1 22275 22,275 -

SUB TOTAL 22,275 -
9/6/2016 Starxone inj 1 1 24778 24,778 -

Aquades 1 1 3312 3,312 -
Dexamthason inj 1 1 5300 5,300 -
Farbiven nebu 1 1 112625 112,625 -
SUB TOTAL 146,015 -
9/7/2016 Ceftriaxone inj 1 1 33125 33,125 -

Farbiven nebu 2 2 112625 225,250 -
Venflon 26 1 1 51013 51,013 -
D5 1/2 NS 2 2 19941 39,882 -
SUB TOTAL 359,870 -
9/8/2016 Ceftriaxone inj 1 1 24778 24,778 -

Combiven 1 1 17490 17,490 -
D5 1/2 NS 1 1 17159 17,159 -
SUB TOTAL 62,427 -
GRAND TOTAL
116 Tn. Edo 9/9/2016 Rl 1 1 8700 8,700 -

spuit 3cc 2 2 1895 3,790 -
SUB TOTAL 19,982 -
117 Tn. Prima 9/9/2016 Amoxicillin 10 10 464 4,640 -

Mefinal 10 10 1749 17,490 -
SUB TOTAL 22,130 -
118 Tn. Doni 9/9/2016 Amoxicillin 10 10 464 4,640 -

Mefinal 10 10 1749 17,490 -
SUB TOTAL 22,130 -
119 An salfaraz 9/7/2016 Farbiven nebu 4 4 112625 450,500 -

nacl 2 2 16 32 -
bisolvon 5 5 10000 50,000 -
d5 % 2 2 8312 16,624 -
inf set makro 1 1 10600 10,600 -
venflon 24 2 2 26235 52,470 -
SUB TOTAL 580,226 -
9/8/2016 ceftriaxon inj 1 1 33125 33,125 -

dexa inj 3 3 5300 15,900 -
spuit 10cc 1 1 3286 3,286 -
spuit 1cc 2 2 2849 5,698 -
ottopan syr 1 1 14575 14,575 -
mucera syr 1 1 22525 22,525 -
SUB TOTAL 95,109 -
9/8/2016 spiuy 3cc 2 2 1895 3,790 -

SUB TOTAL 3,790 -
9/8/2016 d5 % 2 2 7058 14,116 -

Farbiven nebu 3 3 112625 337,875 -
SUB TOTAL 351,991 -
9/9/2016 terfacef inj 1 1 253738 253,738 -

dexa inj 2 2 5300 10,600 -
aquades 1 1 2750 2,750 -
d5 % 2 2 8312 16,624 -
SUB TOTAL 283,712 -
GRAND TOTAL
120 Nn. Dwi 9/9/2016 Santa e 10 10 4267 42,670 -
SUB TOTAL 42,670 -
121 Ny. Sutarti 9/9/2016 omeyus 10 10 1000 10,000 -

braxidin 10 10 1166 11,660 -
spasmal 10 10 600 6,000 -
lisinopril 10 mg 10 10 994 9,940 -
SUB TOTAL 37,600 -
ny. Tri 9/10/2016 braxidin 10 10 1166 11,660 -

omeyus 10 10 1200 12,000 -
opinacea 1 1 66250 66,250 -
SUB TOTAL 89,910 -
nn diana 9/10/2016 omeyus 10 10 1200 12,000 -

sanmaag 10 10 1020 10,200 -
braxidin 10 10 1166 11,660 -
ranitidin 1 1 3746 3,746 -
spuit 3 cc 1 1 1895 1,895 -
SUB TOTAL 39,501 -
ny. Juni 9/10/2016 forumen TT 1 1 32860 32,860 -

SUB TOTAL 32,860 -
by. Aqillah 9/10/2016 nyndia drop 1 1 51304 51,304 -

sanmol drop 1 1 20551 20,551 -
ambroxol 3 3 437 1,311 -
tremenza 3 3 1530 4,590 -
dextafen 3 3 1458 4,374 -
kertas puyer 12 12 250 3,000 -
SUB TOTAL 85,130 -
122 Nn. Yuvita 9/10/2016 noflam 15 15 5101 76,515 -

samconal 15 15 1000 15,000 -
mp 4 mg 15 15 530 7,950 -
SUB TOTAL 99,465 -
123 Tn. Edo 9/10/2016 spuit 3 cc 2 2 1895 3,790 -

RL 1 1 8700 8,700 -
SUB TOTAL 12,490 -
124 Tn. Widi 9/10/2016 samconal 10 10 1000 10,000 -

amoxicilin 15 15 464 6,960 -
sagestam 1 1 16105 16,105 -
kassa steril 1 1 10203 10,203 -
SUB TOTAL 43,268 -
125 Tn. Amin 9/10/2016 samconal 10 10 1000 10,000 -

sagestam 1 1 16105 16,105 -
amoxcilin 15 15 464 6,960 -
lidocain 1 1 2186 2,186 -
spuit 3 cc 1 1 1895 1,895 -
SUB TOTAL 37,146 -
126 ny. Musriah 9/11/2016 omeyus 10 10 1000 10,000 -

ranitidin 10 10 321 3,210 -
tomit 10 10 500 5,000 -
profenal 10 10 1789 17,890 -
acylovir zalf 1 1 3611 3,611 -
sagestam 1 1 16105 16,105 -
SUB TOTAL 55,816 -
127 Nn. Boni pasia 9/8/2016 Rl 3 3 8700 26,100 -

Inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
dexamethasone inj 1 1 3000 3,000 -
asam traneksamat 3 3 11900 35,700 -
spuit 3cc 1 1 1895 1,895 -
spuit 5cc 3 3 2478 7,434 -
samconal 10 10 1000 10,000 -
SUB TOTAL 117,915 -
9/9/2016 wiacid inj 2 2 5300 10,600 -

asam traneksamat 2 2 11900 23,800 -
spuit 3cc 2 2 1895 3,790 -
spuit 5cc 2 2 2478 4,956 -
SUB TOTAL 43,146 -
9/10/2016 tranexid inj 4 4 13913 55,652 -

rl 3 3 8700 26,100 -
SUB TOTAL 81,752 -
9/11/2016 oksigen 1500 1500 250 375,000 -

SUB TOTAL 375,000 -
GRAND TOTAL
128 Ny. Martina 9/11/2016 analsik 10 10 1589 15,890 -

lisinopril 10 mg 10 10 994 9,940 -
braxidin 10 10 1166 11,660 -
allopurinol 300 mg 10 10 928 9,280 -
SUB TOTAL 46,770 -
129 tn. Dhanum 9/11/2016 lidocain 1 1 2186 2,186 -

spuit 3 cc 2 2 1895 3,790 -
spuit 1 cc 1 1 2849 2,849 -
ATS 1 1 152375 152,375 -
needle 23 1 1 875 875 -
baquinor forte 10 10 17934 179,340 -
mefinal 10 10 1749 17,490 -
SUB TOTAL 358,905 -
130 Ny. Ida 9/11/2016 RL 1 1 8700 8,700 -

D 10% 1 1 18550 18,550 -
vemflon 20 1 1 23186 23,186 -
infus set makro 1 1 10600 10,600 -
pumpisel 1 1 177484 177,484 -
aquadest 1 1 3312 3,312 -
ondan 8 mg 1 1 11880 11,880 -
terfacef 1 1 128248 128,248 -
spuit 10 cc 2 2 3286 6,572 -
spuit 5 cc 1 1 2478 2,478 -
spuit 1 cc 1 1 2849 2,849 -
SUB TOTAL 393,859 -
131 nn. Claudia 9/11/2016 sanmaag 10 10 1020 10,200 -

spasmal 10 10 600 6,000 -
SUB TOTAL 16,200 -
132 tn. Iqbal 9/11/2016 sanmaag 10 10 1020 10,200 -

spasmal 10 10 600 6,000 -
SUB TOTAL 16,200 -
133 An. Ari 9/11/2016 bioplacenton zalf 1 1 17490 17,490 -

SUB TOTAL 17,490 -
134 Ny. Ida 9/11/2016 aquadest 1 1 3312 3,312 -

spuit 3 cc 1 1 1895 1,895 -
SUB TOTAL 5,207 -
135 Tn. Iskandar 9/11/2016 asam mefenamat 10 10 400 4,000 -

amoxicilin 10 10 464 4,640 -
SUB TOTAL 8,640 -
136 An zakaria 9/11/2016 nyndia drop 1 1 51304 51,304 -

SUB TOTAL 51,304 -
137 Pak Rahardyan 9/11/2016 kassa steril 1 1 10203 10,203 -

leokoplas 2.5 cm 1 1 6625 6,625 -
sagestam zalf 1 1 16105 16,105 -
SUB TOTAL 32,933 -
138 tn. Edo 9/11/2016 RL 1 1 8700 8,700 -

SUB TOTAL 8,700 -
139 an. Ben 9/12/2016 pct syr 1 1 3900 3,900 -

cetirizine syr 1 1 16231 16,231 -
SUB TOTAL 20,131 -
140 tn. M. Saifudin 9/12/2016 spasmal 10 10 321 3,210 -

ranitidin 10 10 600 6,000 -
SUB TOTAL 9,210 -
141 an. Fauzi 9/12/2016 anacetin 1 1 15000 15,000 -

amoxicilin 1 1 8745 8,745 -
interpec 1 1 29800 29,800 -
SUB TOTAL 53,545 -
142 tn. Ragimin 9/12/2016 pct 10 10 1000 10,000 -
metformin 500 10 10 265 2,650 -
SUB TOTAL 12,650 -
143 Ny. Hamidah 9/11/2016 D5 1/2 NS 8 8 17159 137,272 -
vemflon 22 1 1 23186 23,186 -
infus set makro 1 1 10600 10,600 -
pumpisel 1 1 177484 177,484 -
cefotaxime 3 3 15304 45,912 -
ondan 8 mg 2 2 11880 23,760 -
spuit 10 cc 2 2 3286 6,572 -
spuit 5 cc 1 1 2478 2,478 -
spuit 1 cc 1 1 2849 2,849 -
aquadest 1 1 3312 3,312 -
episan syr 1 1 58565 58,565 -
lodia 10 10 1500 15,000 -
molagit 10 10 636 6,360 -
SUB TOTAL 513,350 -
9/12/2016 D5 1/2% 2 2 17159 34,318 -

pumpisel 1 1 177484 177,484 -
ondan 8 mg 2 2 11880 23,760 -
cefotaxime 3 3 15304 45,912 -
molagit 2 2 636 1,272 -
SUB TOTAL 282,746 -
9/12/2016 lexadon 10 10 1000 10,000 -

ciprofloxacin 10 10 627 6,270 -
molagit 5 5 630 3,150 -
SUB TOTAL 19,420 -
GRAND TOTAL
144 Tn. Landi 9/11/2016 nacl 2 2 7867 15,734 -

infus set makro 1 1 10600 10,600 -
vemflon 20 1 1 23186 23,186 -
wiacid 2 2 6200 12,400 -
pumpisel 1 1 177484 177,484 -
aquadest 1 1 3312 3,312 -
spuit 5 cc 1 1 2478 2,478 -
spuit 3 cc 1 1 1895 1,895 -
episan syr 1 1 58565 58,565 -
SUB TOTAL 305,654 -
9/12/2016 wiacid 2 2 6300 12,600 -
pumpisel 1 1 177484 177,484 -
aquadest 1 1 3312 3,312 -
nacl 2 2 7867 15,734 -
SUB TOTAL 209,130 -
9/12/2016 braxidin 10 10 1166 11,660 -

spasmal 10 10 600 6,000 -
SUB TOTAL 17,660 -
GRAND TOTAL
145 tn. Giayato 9/12/2016 urotractin 10 10 8599 85,990 -

sanprima 10 10 2551 25,510 -
spasmal 10 10 600 6,000 -
metformin 500 20 20 265 5,300 -
SUB TOTAL 122,800 -
146 an. Akwila 9/12/2016 farbiven 1 1 15000 15,000 -

cefadroxil 1 1 13037 13,037 -
lostacef 3 3 3500 10,500 -
anacetin 1 1 15000 15,000 -
salbron 4 mg 8 8 1000 8,000 -
declosan 5 5 1000 5,000 -
ambroxol 5 5 437 2,185 -
tremenza 3 3 1530 4,590 -
kertas puyer 10 10 200 2,000 -
SUB TOTAL 75,312 -
147 tn. Sunardi 9/12/2016 furosemid 5 5 268 1,340 -

spasmal 10 10 600 6,000 -
sanmaag 10 10 1020 10,200 -
SUB TOTAL 17,540 -
148 ny. Asi 9/12/2016 novotwist 2 2 3061 6,122 -

SUB TOTAL 6,122 -
149 An. Hafid 9/12/2016 oralit 10 10 928 9,280 -

l-bio 2 2 9275 18,550 -
domperidom 10 10 596 5,960 -
zinc 20mg 10 10 557 5,570 -
apialys syr 1 1 33125 33,125 -
episan syr 1 1 58565 58,565 -
sendok 1 1 1000 1,000 -
SUB TOTAL 132,050 -
150 Tn. Patar 9/13/2016 Episan syr 1 1 58565 58,565 -

wiacid inj 1 1 6200 6,200 -
buscopan inj 2 2 27825 55,650 -
inf set makro 1 1 10600 10,600 -
venflon 22 2 2 23186 46,372 -
spuit 3cc 4 4 1895 7,580 -
rl 2 2 8700 17,400 -
ondan 4mg inj 1 1 9794 9,794 -
SUB TOTAL 212,161 -
151 tn. Sukarman 9/13/2016 amoxicilin 10 10 464 4,640 -

mefinal 10 10 1749 17,490 -
SUB TOTAL 22,130 -
152 tn. Ciswoyo 9/13/2016 analsik 10 10 1589 15,890 -

braxidin 10 10 1166 11,660 -
omeyus 10 10 1500 15,000 -
avesco 10 10 9328 93,280 -
SUB TOTAL 135,830 -
153 tn. Suwarsoh 9/13/2016 lisinopril 10 mg 10 10 901 9,010 -

cerini 20 20 4108 82,160 -
tremenza 10 10 1530 15,300 -
SUB TOTAL 106,470 -
154 an. Agnes 9/13/2016 lostacef 20 20 3200 64,000 -

MP 4 mg 10 10 530 5,300 -
tremenza 5 5 1530 7,650 -
opinacea syr 1 1 66250 66,250 -
SUB TOTAL 143,200 -
155 tn. Toz 9/13/2016 lisinopril 10 mg 10 10 994 9,940 -

braxidin 10 10 1166 11,660 -
episan syr 1 1 58565 58,565 -
SUB TOTAL 80,165 -
156 an. Zaskia 9/13/2016 apyalis drop 1 1 39750 39,750 -
L-bio 3 3 27825 83,475 -
zink syr 1 1 21834 21,834 -
SUB TOTAL 145,059 -
157 an. M. Hafiz 9/13/2016 cetirizin 1 1 530 530 -

dextafen 1 1 1458 1,458 -
farsycol 1 1 15000 15,000 -
topcort 1 1 29442 29,442 -
SUB TOTAL 46,430 -
158 tn. Darsono 9/13/2016 braxidin 10 10 1166 11,660 -

omeyus 10 10 1500 15,000 -
allopurinol 300 10 10 928 9,280 -
SUB TOTAL 35,940 -
159 ny. Mariyah 9/13/2016 braxidin 10 10 1166 11,660 -

ciprofloxacin 20 20 627 12,540 -
opinacea 1 1 66250 66,250 -
SUB TOTAL 90,450 -
160 tn. Bujang 9/11/2016 kateter 16 1 1 20405 20,405 -

kateter 18 1 1 20405 20,405 -
spuit 10 cc 2 2 3286 6,572 -
aquades 2 2 3312 6,624 -
inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
thrombo aspilet 4 4 933 3,732 -
ns 1 1 7867 7,867 -
pct inf 2 2 0 65588 - -
spuit 5cc 1 1 2478 2,478 -
terpacef 2 2 253075 506,150 -
ranitidin 1 1 6200 6,200 -
spuit 1cc 1 1 2849 2,849 -
spuit 3cc 1 1 1895 1,895 -
nasal kanul 1 1 14575 14,575 -
oksigen 20 20 250 5,000 -
xylocain 1 1 82316 82,316 -
nyndia drop 1 1 51304 51,304 -
SUB TOTAL 772,158 -
9/12/2016 terfacef 3 3 253075 759,225 -

pct inf 1 1 65588 65,588 -
ranitidin 2 2 6200 12,400 -
nacl 2 2 7867 15,734 -
SUB TOTAL 852,947 -
9/12/2016 opinacea 1 1 66250 66,250 -

SUB TOTAL 66,250 -
GRAND TOTAL
161 tn. Filemomon t 9/12/2016 inf set makro 1 1 10600 10,600 -

wiacid 2 1 1 6200 6,200 -
piralen 3 1 2 9227 18,454 -
ketorolak 4 2 2 21863 43,726 -
spuit 3cc 3 3 1895 5,685 -
analsik 10 10 1589 15,890 -
sanmag 10 10 1206 12,060 -
SUB TOTAL 112,615 -
GRAND TOTAL
162 ny. Rima 9/13/2016 amlodipin 10 mg 20 20 2465 49,300 -

SUB TOTAL 49,300 -
163 ny. Djahya 9/11/2016 pumpitor 1 1 179953 179,953 -

spuit 10cc 1 1 3286 3,286 -
inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
ns 1 1 7868 7,868 -
ondan 4mg 1 1 9794 9,794 -
spuit 3cc 1 1 1895 1,895 -
SUB TOTAL 236,582 -
9/12/2016 alprazolam 1 1 1060 1,060 -

SUB TOTAL 1,060 -
9/12/2016 sanmag 10 10 1020 10,200 -

SUB TOTAL 10,200 -
9/12/2016 pumpitor 1 1 99800 99,800 -
ondan 4 mg 4 4 9794 39,176 -
nacl 2 2 7867 15,734 -
SUB TOTAL 154,710 -
9/13/2016 alprazolam 3 3 1060 3,180 -

SUB TOTAL 3,180 -
GRAND TOTAL
164 tn. Prima 9/13/2016 mefinal 10 10 1749 17,490 -

SUB TOTAL 17,490 -
165 an. Alda pratiwi 9/13/2016 zinc tab 10 10 557 5,570 -

samconal 5 5 1000 5,000 -
dexa tab 5 5 133 665 -
amoxicilin 1 1 8745 8,745 -
L-bio 10 10 9275 92,750 -
kertas puyer 10 10 200 2,000 -
SUB TOTAL 114,730 -
166 an. Alifa 9/14/2016 apyalis drop 1 1 39750 39,750 -

valeptil syr 1 1 127532 127,532 -
spuit 3 cc 1 1 1895 1,895 -
SUB TOTAL 169,177
167 an. Zaski 9/14/2016 claneksi syr 1 1 67686 67,686 -

oralit 2 2 928 1,856 -
SUB TOTAL 69,542
168 tn. Tri sutrisno 9/14/2016 sagestam zalf 1 1 16105 16,105 -

amoxicilin 15 15 464 6,960 -
SUB TOTAL 23,065
169 ny. Jamiah 9/14/2016 cerini 15 15 4108 61,620 -

amlodipin 10 mg 10 10 2465 24,650 -
SUB TOTAL 86,270
170 tn. Syaparudin 9/14/2016 cerini 10 10 4108 41,080 -

topcort 1 1 29442 29,442 -
ketoconazole 1 1 12000 12,000 -
SUB TOTAL 82,522
171 an. Iqbal 9/14/2016 tremenza 10 10 1530 15,300 -

pct syr 1 1 3900 3,900 -
SUB TOTAL 19,200
172 tn. Yohanes 9/14/2016 ciprofloxacin 15 15 627 9,405 -

samconal 10 10 1000 10,000 -
dexanta 10 10 253 2,530 -
SUB TOTAL 21,935
173 ny. Sri mulyani 6/14/2016 spuit 50 cc 1 1 40081 40,081 -

SUB TOTAL 40,081
174 Ny. Melati 9/11/2016 nacl 2 2 7867 15,734 -

infus set makro 1 1 10600 10,600 -
vemflon 20 2 2 23186 46,372 -
ketorolac 2 2 21863 43,726 -
wiacid 2 2 6200 12,400 -
spuit 3 cc 2 2 1895 3,790 -
sanmaag 10 2 8 1020 8,160 -
SUB TOTAL 140,782 -
9/12/2016 ketorolac 3 3 21863 65,589 -

ranitidin 2 2 6200 12,400 -
nacl 2 2 7867 15,734 -
SUB TOTAL 93,723 -
9/13/2016 pumpitor 1 1 99800 99,800 -

spuit 10 cc 1 1 3286 3,286 -
ketorolac 6 4 2 21863 43,726 -
SUB TOTAL 146,812 -
9/14/2016 pumpisel 1 1 0 177484 - -

sanmag 1 1 1020 1,020 -
SUB TOTAL 1,020 -
9/14/2016 lostacef 10 10 3200 32,000 -

costam 10 10 1000 10,000 -
omeyus 10 10 1156 11,560 -
episan 1 1 58565 58,565 -
SUB TOTAL 112,125
GRAND TOTAL
175 Nn. Hesti 9/14/2016 Ranitidin tab 10 10 321 3,210 -

omeprazole 10 10 1478 14,780 -
ciprofloxacin tab 14 14 627 8,778 -
scopamin tab 10 10 2551 25,510 -
SUB TOTAL 52,278
176 Tn. Wawan 9/13/2016 oksigen 50 50 250 12,500 -

rl 3 3 8700 26,100 -
recodryl inj 1 1 9275 9,275 -
wiacid 2 2 6200 12,400 -
ondan 4 mg inj 3 3 9794 29,382 -
spuit 10cc 3 3 3286 9,858 -
spuit 3cc 2 2 1895 3,790 -
ibuprofen tab 10 10 331 3,310 -
ceftriaxone inj 2 2 24778 49,556 -
inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
SUB TOTAL 189,957
9/14/2016 recodryl inj 2 2 9275 18,550 -

wiacid 1 1 6200 6,200 -
ondan 4 mg inj 3 3 9794 29,382 -
SUB TOTAL 54,132
9/14/2016 mertigo 10 10 4306 43,060 -

SUB TOTAL 43,060
GRAND TOTAL
177 An. M Nizam 9/13/2016 Sp 1 cc 1 1 2849 2,849 -

Inf D5 1/2 Ns 2 2 17159 34,318 -
Inf Set makro 1 1 10600 10,600 -
Venflon 24 1 1 26235 26,235 -
Ondan 4 mg Inj 2 2 9794 19,588 -
Ceftriaxon Inj 1 1 24778 24,778 -
Sp 10 cc 1 1 3286 3,286 -
Sp 3 cc 2 2 1895 3,790 -
Zink Tab 10 10 557 5,570 -
SUB TOTAL 131,014
9/13/2016 Inj Wiacid Inj 1 1 6200 6,200 -

Sp 3 cc 1 1 1895 1,895 -
Inf Set Makro 1 1 10600 10,600 -
Inj Cefotaxime 2 2 15304 30,608 -
Aquadest Inj 2 2 3312 6,624 -
Sp 1 cc 1 1 2849 2,849 -
Sp 10 cc 1 1 3286 3,286 -
Oralit 2 2 928 1,856 -
Otopan Syr 1 1 14575 14,575 -
SUB TOTAL 78,493
9/14/2016 D5 1/2% 2 2 17159 34,318 -

wiacid 1 1 6100 6,100 -
spuit 3 cc 1 1 1895 1,895 -
cefotaxime 1 1 15304 15,304 -
aquadest 1 1 3312 3,312 -
oralit 2 2 928 1,856 -
opinacea 1 1 66250 66,250 -
SUB TOTAL 129,035
GRAND TOTAL
178 By. Clara 9/11/2016 venflon 26 1 1 51013 51,013 -

inf set miklro 1 1 19875 19,875 -
d5 % 1 1 8384 8,384 -
dexa inj 1 1 5300 5,300 -
terfacef inj 1 1 253075 253,075 -
farbiven 2 2 12000 24,000 -
spuit 5cc 1 1 2478 2,478 -
spuit 1cc 1 1 2849 2,849 -
spuit 10cc 1 1 3286 3,286 -
pct syr 1 1 3900 3,900 -
nasal kanul anak-anak 1 1 14575 14,575 -
SUB TOTAL 388,735 -
9/12/2016 dexa inj 2 2 5300 10,600 -

terfacef inj 1 1 128248 128,248 -
farbiven 4 4 15000 60,000 -
aquades 1 1 3312 3,312 -
SUB TOTAL 202,160 -
9/12/2016 ottopan drop 1 1 23288 23,288 -

SUB TOTAL 23,288 -
9/13/2016 ambroxol 1 1 437 437 -

dextafen 1 1 1458 1,458 -
kertas puyer 6 6 200 1,200 -
apyalis drop 1 1 39750 39,750 -
cetirizin 1 1 530 530 -
SUB TOTAL 43,375 -
9/13/2016 dexa inj 2 2 5300 10,600 -

farbiven 4 4 15000 60,000 -
vemflon 26 6 6 51013 306,078 -
infus set mikro 1 1 19875 19,875 -
SUB TOTAL 396,553 -
9/13/2016 clanexi syr 1 1 67686 67,686 -

oralit 2 2 1000 2,000 -
SUB TOTAL 69,686 -
GRAND TOTAL
179 Tn. Panijo 9/15/2016 celebrex 10 10 17693 176,930 -

alluporinol 300mg 10 10 928 9,280 -
m.p 4mg 10 10 530 5,300 -
lisinopril 10mg 10 10 994 9,940 -
dilavas 5mgx 5 5 2319 11,595 -
SUB TOTAL 213,045 -
180 An. Yosef 9/15/2016 Cinolon N 1 1 21465 21,465 -

Dextafen Tab 5 5 1458 7,290 -
Kertas Puyer 10 10 250 2,500 -
Curfos Syr 1 1 92055 92,055 -
SUB TOTAL 125,960 -
181 An. Shanum 9/15/2016 Sanmol syr 1 1 20551 20,551 -

SUB TOTAL 20,551 -
182 An. Mutia 9/16/2016 anacetin 1 1 15000 15,000 -
cefxime syr 1 1 42201 42,201 -
MP 4 mg 10 10 530 5,300 -
opinacea syr 1 1 66250 66,250 -
SUB TOTAL 128,751 -
183 Tn. Gunadi 9/16/2016 bisturi 1 1 4638 4,638 -

spuit 1cc 1 1 2849 2,849 -
mefinal 15 15 1749 26,235 -
SUB TOTAL 33,722 -
184 Tn. Parton 9/16/2016 berotec 20 20 1855 37,100 -

bisolvon 10 10 1855 18,550 -
nacl 2 2 175 350 -
oksigen 100 100 250 25,000 -
lisinopril 20 20 994 19,880 -
salbron 10 10 2000 20,000 -
m.p 8mg 10 10 928 9,280 -
furosemide 10 10 268 2,680 -
letonal 25 10 10 1484 14,840 -
fargoxin 10 10 600 6,000 -
kertas puyer 10 10 250 2,500 -
SUB TOTAL 156,180 -
185 ny. Anyam 9/14/2016 RL 1 1 8700 8,700 -

wiacid 2 2 6100 12,200 -
ondan 4 mg 2 2 9794 19,588 -
recodryl 1 1 9275 9,275 -
spuit 5 cc 3 3 2478 7,434 -
mertigo 10 10 6029 60,290 -
avesco 5 5 9328 46,640 -
xepalium 10 10 10931 109,310 -
SUB TOTAL 273,437
9/14/2016 vemflon 20 1 1 23186 23,186 -

infus set makro 1 1 10600 10,600 -
SUB TOTAL 33,786
9/15/2016 wiacid 2 2 6200 12,400 -

ondan 4mg 3 3 9794 29,382 -
rl 1 1 8700 8,700 -
SUB TOTAL 50,482
9/15/2016 Inf Rl 3 3 8700 26,100 -

SUB TOTAL 26,100 -
9/16/2016 mertigo SR 10 10 6029 60,290 -

xepalium 6 6 10931 65,586 -
SUB TOTAL 125,876 -
GRAND TOTAL
186 an. Atiqah 9/16/2016 anacetin 1 1 15000 15,000 -

SUB TOTAL 15,000 -
187 an. Clara 9/16/2016 fabiven 1 1 15000 15,000 -

ambroxol 1 1 437 437 -
dextafen 1 1 1458 1,458 -
cetirizin 1 1 530 530 -
kertas puyer 7 7 250 1,750 -
SUB TOTAL 19,175 -
189 Nn. Kristina 9/16/2016 lafdry 1 1 10000 10,000 -

cetirizin 10 10 530 5,300 -
opinacea tab 10 10 7500 75,000 -
lostacef 10 10 3200 32,000 -
SUB TOTAL 122,300 -
160 Tn. Edo 9/16/2016 rl 1 1 8700 8,700 -

SUB TOTAL 8,700 -
190 tn. Petrus 9/16/2016 cerini 10 10 4011 40,110 -

SUB TOTAL 40,110 -
191 An.Vigindoergana 9/16/2016 Tem Digital 1 1 35000 35,000 -

SUB TOTAL 35,000 -
192 Ny. Anamisan 9/16/2016 Omeyus Tab 10 10 1000 - 10,000

Sanmagh Tab 15 15 1020 15,300 -
Braxidin Tab 15 15 1166 17,490 -
SUB TOTAL 42,790 10,000
193 An. Asih 9/16/2016 Mefnal tab 10 10 1749 17,490 -

Painkila 1 1 40000 - 40,000
SUB TOTAL 57,490 40,000
194 An. Desi 9/16/2016 Mefnal tab 10 10 1749 17,490 -

SUB TOTAL 17,490 -
195 by. Vigindoergano 9/16/2016 D5 1/2 NS 1 1 17159 17,159 -

vemflon 26 1 1 51013 51,013 -
vemflon 24 1 1 26235 26,235 -
infus set mikro 1 1 19875 19,875 -
ceftriaxone 1 1 24778 24,778 -
ondan 8 1 1 11880 11,880 -
valisanbe inj 1 1 17358 17,358 -
spuit 10 cc 1 1 3286 3,286 -
spuit 5 cc 1 1 2478 2,478 -
spuit 1 cc 1 1 2849 2,849 -
sanmol drop 1 1 20551 20,551 -
zink syr 1 1 21834 21,834 -
cetirizin syr 1 1 16231 16,231 -
valisanbe tab 5 5 364 1,820 -
oralit 5 5 928 4,640 -
D5 1/4 NS 1 1 17159 17,159 -
SUB TOTAL 259,146 -
196 ny. Nurhayati 9/17/2016 infus set makro 1 1 10600 10,600 -

vemflon 20 1 1 23186 23,186 -
nacl 1 1 7867 7,867 -
nasal canul 1 1 14575 14,575 -
ondan 8 mg 1 1 11880 11,880 -
wiacid 1 1 6200 6,200 -
aspilet 4 4 933 3,732 -
isdn 1 1 186 186 -
propanolol 40 mg 1 1 176 176 -
SUB TOTAL 78,402 -
197 an. Alya 9/17/2016 anacetin 1 1 15000 15,000 -

amoxicilin 1 1 8745 8,745 -
curfos 1 1 92055 92,055 -
SUB TOTAL 115,800 -
198 ny. Sugiyem 9/17/2016 flamar 50 mg 5 5 2200 11,000 -

mp 4 mg 15 15 530 7,950 -
amlodipin 10 mg 3 3 2465 7,395 -
glibenclamid 5 5 808 4,040 -
pain kila 1 1 13913 13,913 -
hidrocortison 1 1 5101 5,101 -
SUB TOTAL 49,399 -
199 Ny. Sumiati 9/16/2016 spuitb 10 cc 2 2 2478 4,956 -

spuit 5 cc 1 1 2849 2,849 -
spuit 1 cc 2 2 3286 6,572 -
infus set makro 1 1 10600 10,600 -
vemflon 20 1 1 23186 23,186 -
RL 3 3 8700 26,100 -
ketorolak inj 3 3 21863 65,589 -
wiacid inj 2 2 6200 12,400 -
terpacef inj 2 2 253075 506,150 -
ibuprofen tab 10 10 331 3,310 -
valisanbe 2mg 2 2 364 728 -
captopril 25mg 5 5 182 910 -
SUB TOTAL 663,350 -
GRAND TOTAL
200 Ny. Siti 9/16/2016 RL 3 3 8700 26,100 -

vemflon 22 2 2 23186 46,372 -
infus set makro 1 1 10600 10,600 -
pumpitor 1 1 99800 99,800 -
ondan 8 mg 1 1 11880 11,880 -
buscopan 3 3 27825 83,475 -
ceftriaxon 2 2 24778 49,556 -
aquadest 1 1 3312 3,312 -
spuitb 10 cc 2 2 3286 6,572 -
spuit 5 cc 1 1 2478 2,478 -
spuit 1 cc 1 1 2849 2,849 -
domperidon tab 10 10 596 5,960 -
episan 1 1 58568 58,568 -
molagit 10 10 636 6,360 -
SUB TOTAL 413,882 -
oksigen 2100 2100 250 525,000 -

SUB TOTAL 525,000 -
GRAND TOTAL
201 an. Vegi 9/17/2016 loratadin 5 5 441 2,205 -

declosan 5 5 1000 5,000 -
SUB TOTAL 7,205 -
202 tn. Khairul huda 9/17/2016 ciprofloxacin 15 15 627 9,405 -

pct 15 15 500 7,500 -
sanmaag syr 1 1 29945 29,945 -
opinacea 10 10 7500 75,000 -
SUB TOTAL 121,850 -
203 an. Kenzia 9/17/2016 pct syr 1 1 3900 3,900 -

zink 1 1 21834 21,834 -
apyalis drop 1 1 39750 39,750 -
SUB TOTAL 65,484 -
204 nn. Yurita 9/17/2016 pct 10 10 500 5,000 -

mp 4 mg 10 10 530 5,300 -
meloxicam 7.5 mg 10 10 928 9,280 -
SUB TOTAL 19,580 -
205 ny. Berliana 9/17/2016 ambroxol 8 8 437 3,496 -

cetirizin 2 2 530 1,060 -
dexa 10 10 1500 15,000 -
capsul 10 10 500 5,000 -
SUB TOTAL 24,556 -
206 An. Alfren wijaya 9/17/2016 segestam selep 1 1 16105 16,105 -

pct syr 1 1 3900 3,900 -
sendok 1 1 1000 1,000 -
SUB TOTAL 21,005 -
207 Ny. Fui moi 9/18/2016 ns 2 2 7868 15,736 -

inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
wiacid inj 1 1 6200 6,200 -
pumpisel inj 1 1 177484 177,484 -
uresix inj 1 1 50018 50,018 -
spuit 5cc 3 3 2478 7,434 -
captopril 25mg 3 3 182 546 -
pct tab 10 10 500 5,000 -
ambroxol tab 3 3 437 1,311 -
dulcolax tab 2 2 1391 2,782 -
terpacef inj 1 1 253075 253,075 -
spuit 10cc 1 1 2478 2,478 -
spuit 1 cc 1 1 2849 2,849 -
SUB TOTAL 558,699 -
GRAND TOTAL
208 nn.maria 9/18/2016 cerini tab 10 10 4108 41,080 -

lafidry -dmp 1 1 15000 15,000 -
SUB TOTAL 56,080 -
209 An. Anbaes 9/16/2016 Inf Rl 3 3 8700 26,100 -

Venflon 24 1 1 26235 26,235 -
Inf Set makro 1 1 10600 10,600 -
Pct Inf 1 1 65588 65,588 -
Sp 10 cc 1 1 3286 3,286 -
Zink Kid Syr 1 1 21834 21,834 -
SUB TOTAL 153,643 -
9/16/2016 Inf Set makro 1 1 10600 10,600 -

dexa inj 1 1 5300 5,300 -
biocef inj 1 1 172250 172,250 -
aquadest 1 1 3312 3,312 -
spuitb 10 cc 1 1 3286 3,286 -
spuit 5 cc 2 2 2475 4,950 -
spuit 1 cc 3 3 2849 8,547 -
wiacid 1 1 6200 6,200 -
l-bio 3 3 9275 27,825 -
oralit 3 3 928 2,784 -
episan 1 1 58565 58,565 -
SUB TOTAL 303,619 -
9/17/2016 dexa inj 1 1 5300 5,300 -
SUB TOTAL 5,300 -
9/17/2016 wiacid 1 1 6200 6,200 -

cefotaxime 1 1 15304 15,304 -
SUB TOTAL 21,504 -
9/17/2016 D5 1/2 NS 1 1 17159 17,159 -

SUB TOTAL 17,159 -
9/18/2016 aquades 1 1 3312 3,312 -

rl 1 1 8700 8,700 -
d5 1/2 ns 1 1 19941 19,941 -
SUB TOTAL 31,953 -
GRAND TOTAL
210 ny.enda 9/18/2016 dilavast 5 mg 10 10 2319 23,190 -

provinas 10 10 2396 23,960 -
SUB TOTAL 47,150 -
211 Ny. Kristina 9/18/2016 pct tab 10 10 500 5,000 -

folaxin 10 10 1000 10,000 -
ondan 4mg 5 5 7288 36,440 -
SUB TOTAL 51,440 -
212 Ny. Yuliana 9/18/2016 rl 2 2 8700 17,400 -

inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
ondan 8mg inj 2 2 11880 23,760 -
wiacid inj 1 1 6200 6,200 -
lodia 5 5 1700 8,500 -
molagit 10 10 636 6,360 -
antasida doen tab 10 10 56 560 -
spuit 5cc 3 3 2478 7,434 -
venflon 22 1 1 23186 23,186 -
cefotaxim inj 1 1 15304 15,304 -
spuit 1cc 1 1 2849 2,849 -
aquades 1 1 3312 3,312 -
SUB TOTAL 148,651 -
9/18/2016 pct tab 10 10 500 5,000 -
SUB TOTAL 5,000 -
9/18/2016 rl 2 2 8700 17,400 -

cefotaxime inj 2 2 15304 30,608 -
ondan 8 mg inj 3 3 11880 35,640 -
wiacid inju 2 2 6200 12,400 -
spuit 5cc 1 1 2478 2,478 -
SUB TOTAL 98,526 -
9/18/2016 lexadon 10 10 1000 10,000 -

sanmag tab 10 10 1020 10,200 -
SUB TOTAL 20,200 -
GRAND TOTAL
213 an. Aira 9/18/2016 berotec 1 1 9275 9,275 -

bisolvon 1 1 9275 9,275 -
interfec syr 1 1 29800 29,800 -
cefxim syr 1 1 42201 42,201 -
spuit 5cc 1 1 2478 2,478 -
SUB TOTAL 93,029 -
214 Nn. Tra 9/18/2016 norvom tab 10 10 278 2,780 -

ranitidin tab 6 6 321 1,926 -
molagit 10 10 636 6,360 -
SUB TOTAL 11,066 -
215 Tn. Zahariyudi 9/17/2016 nacl 3 3 7867 23,601 -

infus set makro 1 1 10600 10,600 -
vemflon 20 1 1 23186 23,186 -
vemflon 22 1 1 23186 23,186 -
lidocain 1 1 2186 2,186 -
spuit 1 cc 2 2 2849 5,698 -
ketorolac 3 3 21863 65,589 -
wiacid 2 2 6200 12,400 -
spuit 5 cc 5 5 2478 12,390 -
nasal canul 1 1 14575 14,575 -
sagestam 1 1 16105 16,105 -
SUB TOTAL 209,516 -
9/17/2016 mp 8 mg 10 10 928 9,280 -
baquinor forte 10 10 17934 179,340 -
oksigen 500 500 250 125,000 -
SUB TOTAL 313,620 -
9/17/2016 RL 1 1 8700 8,700 -

vemflon 20 2 2 23186 46,372 -
infus set makro 1 1 10600 10,600 -
ketorolac 3 3 21863 65,589 -
wiacid 2 2 6200 12,400 -
nasal canul 1 1 14575 14,575 -
oksigen 100 100 250 25,000 -
citicolin 250 1 1 39750 39,750 -
spuit 5 cc 3 3 2478 7,434 -
SUB TOTAL 230,420 -
9/18/2016 ns 2 1 1 7867 7,867 -

ketorolak 3 2 1 21863 21,863 -
wiacid 2 2 6200 12,400 -
SUB TOTAL 42,130 -
9/18/2016 mefnal 10 10 1749 17,490 -

SUB TOTAL 17,490 -
GRAND TOTAL
216 an. Meisie 9/18/2016 pct tab 10 10 500 5,000 -

loratadin 2 2 441 882 -
acyclovir 400 25 25 742 18,550 -
SUB TOTAL 24,432 -
217 ny. Rumini 9/19/2016 mersibion tab 10 10 5500 55,000 -

meloxixam 7,5 mg 10 10 928 9,280 -
mp 4 mg tab 5 10 530 5,300 -
SUB TOTAL 69,580 -
218 Tn. Angga 9/19/2016 Spasmal tab 10 10 600 6,000 -

omeprazol tab 10 10 1475 - 14,750
Lexadon tab 10 10 500 - 5,000
Lodia 10 10 1700 17,000 -
SUB TOTAL 42,750 19,750
219 Ny. Ruati 9/19/2016 Lodia Tab 10 10 1700 17,000 -
Molagit 10 10 636 6,360 -
Pct tab 10 10 500 5,000 -
Lexadon Tab 10 10 500 - 5,000
SUB TOTAL 33,360 5,000
220 Ny. Sesilia 9/19/2016 Clindamycin 10 10 996 9,960 -

Mefnal Tab 10 10 1749 17,490 -
Pehacain Inj 2 2 2783 5,566 -
Kasa 3 3 1200 3,600 -
SUB TOTAL 36,616 -
221 Ny. Sutyani 9/19/2016 Cendo Xitrol Ttm 1 1 45540 - 45,540

Flamar 50 mg 10 10 2200 22,000 -
SUB TOTAL 67,540 45,540
222 Tn. Paulus 9/19/2016 Mp Tab 4 mg 15 15 530 7,950 -

Nuvamox Tab 10 10 2000 - 20,000
SUB TOTAL 27,950 20,000
223 Tn. Aki 9/19/2016 Omeyus Tab 10 10 1500 - 15,000

Sanmagh Tab 15 15 1020 15,300 -
Braxidin tab 15 15 1166 17,490 -
SUB TOTAL 47,790 15,000
224 Ny. Ita 9/19/2016 Helixime Tab 10 10 5727 - 57,270

Spasmal Tab 10 10 600 6,000 -
SUB TOTAL 63,270 57,270
225 Tn. Egi 9/17/2016 rl 1 1 8700 8,700 -

venflon 20 2 2 23186 46,372 -
inf set makro 1 1 10600 10,600 -
ketorolac in j 3 3 21863 65,589 -
wiacid inj 2 2 6200 12,400 -
nasalkanul 1 1 14575 14,575 -
oksigen 100 100 250 25,000 -
serfac 250mg inj 1 1 39750 39,750 -
spuit 5cc 3 3 2478 7,434 -
SUB TOTAL 230,420 -
9/18/2016 rl 2 2 8700 17,400 -
ketorolac inj 3 3 21863 65,589 -
wiacid inj 2 2 6200 12,400 -
serfac 500 1 1 90567 90,567 -
o2 300 300 250 75,000 -
spuit 5cc 1 1 2478 2,478 -
SUB TOTAL 263,434 -
9/18/2016 valisanbe 1 1 355 355 -

citicolin 500 2 2 76500 153,000 -
spuit 10 cc 1 1 3209 3,209 -
SUB TOTAL 156,564 -
9/19/2016 Inf Rl 2 2 8700 17,400 -

Ketorolac Inj 1 1 21863 21,863 -
Wiacid Inj 2 2 3746 7,492 -
Serfac Inj 500 mg 1 1 87450 87,450 -
Sp 5 cc 1 1 2478 2,478 -
SUB TOTAL 136,683 -
9/20/2016 flamar 50 mg 10 10 2200 22,000 -

opixime 100 mg 10 10 23375 233,750 -
citicolin 500 10 10 7884 78,840 -
SUB TOTAL 334,590 -
GRAND TOTAL
226 an. Dini 9/20/2016 anacetin 1 1 15000 15,000 -

cefxim 1 1 42201 42,201 -
yarizin 1 1 48000 48,000 -
salbron 5 5 1000 5,000 -
kertas puyer 10 10 250 2,500 -
SUB TOTAL 112,701 -
227 nn. Della 9/20/2016 tremenza 10 10 1530 15,300 -

lafdryl syr 1 1 15000 15,000 -
cerini tab 10 10 4108 41,080 -
mp 8 mg 10 10 928 9,280 -
SUB TOTAL 80,660 -
228 tn. Ahmad adimin 9/20/2016 celebrex 10 10 17693 176,930 -
mp 4 mg 20 20 450 9,000 -
omeyus 10 10 1500 15,000 -
SUB TOTAL 200,930 -
229 by. Abiyan 9/20/2016 apyalis drop 1 1 39750 39,750 -

SUB TOTAL 39,750 -
230 an. Diva 9/20/2016 otopan syr 1 1 14575 14,575 -

amoxicilin syr 1 1 8745 8,745 -
SUB TOTAL 23,320 -
231 nn. Wartini 9/20/2016 urotractin 10 10 8599 85,990 -

mefnal 10 10 1749 17,490 -
SUB TOTAL 103,480 -
232 ny. Maria 9/19/2016 infus set makro 1 1 10600 10,600 -

vemflon 20 1 1 23186 23,186 -
RL 2 2 8700 17,400 -
serfac 500 1 1 0 87450 - -
valesco 2 2 11660 23,320 -
thrombo aspilet 1 1 933 933 -
spuit 10 cc 1 1 3286 3,286 -
spuit 5 cc 3 3 2478 7,434 -
ondan 8 mg 1 1 11880 11,880 -
ranitidin 2 2 5500 11,000 -
SUB TOTAL 109,039 -
9/19/2016 aspilet 2 2 933 1,866 -

clopidogrel 4 4 19432 77,728 -
simvastatin 2 2 749 1,498 -
SUB TOTAL 81,092 -
9/20/2016 citicolin 1 1 80325 80,325 -

aspilet 1 1 933 933 -
avesco 1 1 9328 9,328 -
RL 2 2 8700 17,400 -
SUB TOTAL 107,986 -
9/20/2016 Citicolin Tab 10 10 7884 78,840 -

Aspilet tab 10 10 933 9,330 -
SUB TOTAL 88,170 -
GRAND TOTAL
233 ny.krispina 9/18/2016 terfacef inj 2 2 128248 256,496 -

nacl 3 3 7867 23,601 -
infus set macro 1 1 10600 10,600 -
venplon 20 1 1 23186 23,186 -
pumpitor inj 2 2 99800 199,600 -
ketorolac inj 3 3 21863 65,589 -
spuit 10cc 2 2 3286 6,572 -
spuit 5cc 3 3 2478 7,434 -
ondan 8 mg inj 2 2 11880 23,760 -
spuit 1cc 2 2 2849 5,698 -
braxidine tab 10 10 1166 11,660 -
sanmaag tab 10 6 4 1020 4,080 -
pct tab 10 10 500 5,000 -
SUB TOTAL 643,276 -
9/18/2016 terfacef inj 2 2 128248 256,496 -

ketorolac inj 3 2 1 21863 21,863 -
ondan 8 mg inj 2 1 1 11880 11,880 -
nacl 3 3 0 7867 - -
aquadest 1 1 3312 3,312 -
SUB TOTAL 293,551 -
9/20/2016 ketorolac 3 3 21863 65,589 -

terfacef 1 1 128248 128,248 -
pumpitor 1 1 99800 99,800 -
nacl 3 3 7867 23,601 -
SUB TOTAL 317,238 -
9/20/2016 Braxidin tab 5 5 1166 5,830

Vocefa Tab 4 4 13602 54,408
Celebrex tab 5 5 17693 88,465
SUB TOTAL 153,563 -
GRAND TOTAL
234 Ny.Darsini 9/21/2016 Loratadin 10 mg 15 15 441 6,615 -

Amlodipin 10 mg 15 15 2465 36,975 -
M.P mg 35 35 530 18,550 -
Cinolon cream 1 1 21465 21,465 -
Dexametasone tab 2 2 5300 10,600 -
Spuit 5 cc 1 1 2478 2,478 -
SUB TOTAL 96,683 -
235 Tn.Yahusin 9/21/2016 Folley Cateter 16 1 1 20405 20,405 -

Urine bag 1 1 7288 7,288 -
Spuit 10 cc 1 1 3286 3,286 -
SUB TOTAL 30,979 -
236 Nn.Lunaisih 9/21/2016 Novamox 500 10 10 1530 15,300 -

Bisturi 1 1 4638 4,638 -
Spuit 1 cc 1 1 2849 2,849 -
Lidocain inj 1 1 2186 2,186 -
SUB TOTAL 28,973 -
237 Tn.Eko 9/21/2016 Metformin 500 15 15 265 3,975 -

Glimepirid 10 10 1378 13,780 -
Flamar 50 10 10 2200 22,000 -
Gemfbrozil 10 10 464 4,640 -
SUB TOTAL 44,395 -
238 ny. Simah 9/21/2016 lantus insulin pen 1 1 112625 112,625 -

nacl 2 2 7867 15,734 -
gentamisin zalf 1 1 10000 10,000 -
novotwist 3 3 3061 9,183 -
SUB TOTAL 147,542 -
239 ny. Santi 9/21/2016 mefnal 30 30 1749 52,470 -

SUB TOTAL 52,470 -
240 nn. Edeltrudis 9/21/2016 mefnal 10 10 1749 17,490 -

claneksi 10 10 15817 158,170 -
braxidin 10 10 1166 11,660 -
SUB TOTAL 187,320 -
241 an. Dionisius 9/21/2016 ranitidin 5 5 321 1,605 -

ondan tab 5 5 7288 36,440 -
kertas puyer 10 10 250 2,500 -
zink syr 1 1 21834 21,834 -
L-bio 6 6 9275 55,650 -
SUB TOTAL 118,029 -
242 tn. Hai hoi 9/21/2016 mertigo SR 10 10 6029 60,290 -

xepalium 10 10 10931 109,310 -
domperidon 10 10 596 5,960 -
SUB TOTAL 175,560 -
243 tn. Efendy 9/21/2016 sanmaag 10 10 1020 10,200 -

SUB TOTAL 10,200 -
244 ny. Siti aisyah 9/21/2016 episan syr 1 1 58656 58,565 -

flamar 50 10 10 2200 22,000 -
pain kila 1 1 13913 13,913 -
SUB TOTAL 94,478 -
245 Tn. Abdul Kasim 9/22/2016 Inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
ns 1 1 7867 7,867 -
nasal kanul dewasa 1 1 14575 14,575 -
spironolakton 25mg 1 1 539 539 -
thrombo aspilet 2 2 933 1,866 -
isdn10mg 1 1 186 186 -
oksigen 50 50 250 12,500 -
SUB TOTAL 71,319 -
246 Tn. Misjani 9/22/2016 flamar 50mg 10 10 2200 22,000 -

pct tab 10 10 500 5,000 -
ranitidin tab 10 10 321 3,210 -
SUB TOTAL 30,210 -
247 Tn. Riki 9/22/2016 valisanbe 5mg 10 10 364 3,640 -

flamar 50mg 10 10 2200 22,000 -
mersibion tab 5 5 5500 - 27,500
SUB TOTAL 25,640 27,500
248 Ny. Atminah 9/22/2016 loratadin tab 10 10 441 4,410 -

mp. 8mg 8 8 928 7,424 -
dexa inj 1 1 5300 5,300 -
spuit 1cc 1 1 2849 2,849 -
SUB TOTAL 19,983 -
249 An. Leontius 9/22/2016 tremenza tab 2 2 1530 3,060 -

kertas puyer 10 10 250 2,500 -
sanbe- plex drop 1 1 20670 20,670 -
SUB TOTAL 26,230 -
250 An. Mokorius 9/22/2016 apialys syr 1 1 33125 33,125 -

sendok 1 1 1000 1,000 -
SUB TOTAL 34,125 -
251 An. Nomerio 9/22/2016 apialys syr 1 1 33125 33,125 -

sendok 1 1 1000 1,000 -
SUB TOTAL 34,125 -
252 An. Teodora 9/22/2016 edimin drop 1 1 50200 50,200 -

SUB TOTAL 50,200 -
253 An. Muhammad A 9/22/2016 l-bio 3 3 9275 27,825 -

apialys drop 1 1 39750 39,750 -
SUB TOTAL 67,575 -
254 an yufka 9/21/2016 Inf Set Makro 1 1 10600 10,600 -

venflon 22 1 1 23186 23,186 -
rl 2 2 8700 17,400 -
ranitidin inj 2 2 5500 11,000 -
spuit 3cc 1 1 1895 1,895 -
pct tab 10 10 138 1,380 -
SUB TOTAL 65,461 -
9/21/2016 cefotaxim inj 2 2 15304 30,608 -

aquades 2 2 3312 6,624 -
spuit 1cc 1 1 2849 2,849 -
spuit 10cc 2 2 3286 6,572 -
opinecea syr 1 1 66250 66,250 -
SUB TOTAL 112,903 -
GRAND TOTAL
255 an. Ferdy 9/20/2016 infus set macro 1 1 10600 10,600 -
vemflon 22 1 1 23186 23,186 -
RL 1 1 8700 8,700 -
cefotaxim 2 2 15304 30,608 -
aquadest 2 2 3312 6,624 -
spuit 1 cc 1 1 2849 2,849 -
spuit 10 cc 2 2 3286 6,572 -
ondan 8 mg 1 1 11880 11,880 -
ranitidin inj 1 1 5500 5,500 -
spuit 5 cc 2 2 2478 4,956 -
pct inf 1 1 65588 65,588 -
opinacea syr 1 1 66250 66,250 -
SUB TOTAL 243,313 -
9/22/2016 claneksi syr 1 1 67686 67,686 -

SUB TOTAL 67,686 -
GRAND TOTAL
256 tn. M jaif 9/22/2016 amoxicilin 10 10 464 4,640 -

as. Mefenamat 10 10 400 4,000 -
lidocain 6 6 2186 13,116 -
spuit 5 cc 2 2 2478 4,956 -
SUB TOTAL 26,712 -
257 Ny. Nuraini 9/23/2016 Omeyus Kaps 14 14 2000 - 28,000

Ranitidin Tab 20 20 500 - 10,000
SUB TOTAL 18,072 38,000
258 Nn. Nuraiza 9/23/2016 Nuvamox Tab 15 15 2000 - 30,000

Betadin Botol 1 1 8000 8,000 -
Hydrokortison Zalf 1 1 6000 6,000 -
Kassa 1 1 15000 15,000 -
SUB TOTAL 29,000 30,000
259 Tn. Bambang 9/23/2016 Braxidin tab 15 15 1166 17,490 -

SUB TOTAL 25,970 -
260 An. Siti Hawa 3/23/2016 Cefadroxil Syr 1 1 45448 45,448 -
Opineacea Syr 1 1 66250 66,250 -
Anacetin Syr 1 1 15000 - 15,000
SUB TOTAL 111,698 15,000
261 tn. Suyono 9/19/2016 infus set makro 1 1 10600 10,600 -

vemflon 22 1 1 23186 23,186 -
RL 2 2 8700 17,400 -
ranitidin 2 2 5500 11,000 -
MP inj 1 1 51675 51,675 -
spuit 5 cc 2 2 2478 4,956 -
spuit 1 cc 1 1 2849 2,849 -
cerini 10 10 4108 41,080 -
clindamycin 300 mg 10 10 1000 10,000 -
amlodipin 10 mg 1 1 2465 2,465 -
sagestam 1 1 16105 16,105 -
SUB TOTAL 191,316 -
9/20/2016 ranitidin 1 1 5500 5,500 -

amlodipin 10 mg 1 1 2465 2,465 -
RL 2 2 8700 17,400 -
SUB TOTAL 25,365 -
9/20/2016 ketorolak inj 3 3 21863 65,589 -

spuit 3cc 1 1 1895 1,895 -
SUB TOTAL 67,484 -
9/21/2016 ceftriaxon inj 2 2 24778 49,556 -

ranitidin inj 1 1 5500 5,500 -
MP inj 1 1 51675 51,675 -
ketorolak inj 6 6 21863 131,178 -
amlodipin 10 mg 5 5 2463 12,315 -
mycozid 200 5 5 2400 12,000 -
RL 3 3 8700 26,100 -
SUB TOTAL 288,324 -
9/23/2016 Amlodipin Tab 5 5 2465 12,325 -

Lostacef Tab 10 10 3200 - 32,000
Mp 8 mg 20 20 928 18,560 -
SUB TOTAL 38,835 32,000
GRAND TOTAL
262 Tn. Akiun 9/19/2016 Aminophylline inj 3 3 8004 24,012 -

tranex inj 3 3 8559 25,677 -
inf set makro 1 1 10600 10,600 -
venflon 20 1 1 23186 23,186 -
rl 3 3 8700 26,100 -
farbiven inj 2 2 15000 30,000 -
spuit 10cc 2 2 3286 6,572 -
spuit 5cc 1 1 2478 2,478 -
nasal kanul dewasa 1 1 14575 14,575 -
amlodipin 10mg 5 5 2465 12,325 -
lisinopril 10mg 5 5 996 4,980 -
SUB TOTAL 180,505 -
9/20/2016 ranitidin 2 2 5500 11,000 -

tranexid 3 3 13913 41,739 -
farbiven nebu 3 3 15000 45,000 -
RL 2 2 8700 17,400 -
aminophilin 3 3 8198 24,594 -
oksigen 400 400 250 100,000 -
SUB TOTAL 239,733 -
9/20/2016 handscoon steril 1 1 12449 12,449 -

lidocain 10 10 21860 218,600 -
spuit 10 cc 1 1 3286 3,286 -
spuit 5 cc 1 1 2478 2,478 -
tranfusi set 1 1 30608 30,608 -
bisturi 1 1 4638 4,638 -
SUB TOTAL 272,059 -
9/20/2016 Pct Tab 6 6 500 3,000 -

Ambroxol Tab 3 3 437 1,311 -
Aminopilin Inj 3 3 8198 24,594 -
SUB TOTAL 28,905 -
9/22/2016 Ranitidin inj 2 2 3746 7,492 -

Ketorolac inj 4 4 21863 87,452 -
Ambroxol tab 3 3 437 1,311 -
Tropigesik 6 6 1000 6,000 -
Alprazolam 1 1 1060 1,060 -
Amitripilin 1 1 163 163 -
Retapyl 2 2 4300 8,600 -
Rl 2 2 8700 17,400 -
SUB TOTAL 129,478 -
9/23/2016 Inf Rl 1 1 8700 8,700 -

Inj Keto 4 4 21863 87,452 -
Retapyl 5 5 3800 19,000 -
Amitripilin 5 5 163 815 -
Ambroxol tab 10 10 437 4,370 -
SUB TOTAL 128,889 -
GRAND TOTAL
HARGA
TOTAL TOTAL
Rp. Rp.
77,655 77,655
19,035 19,035
88,317 88,317
47,980 47,980
47,640 47,640
31,822 31,822
18,210 18,210
34,148 34,148
66,250 66,250
43,035 43,035
238,013 238,013
121,060 121,060
10,600 10,600
206,316 206,316
23,186 23,186
100,524 100,524
699,699
37,300 37,300
115,918 115,918
35,686 35,686
188,904
363,820 363,820
497,956 497,956
30,805 30,805
177,613 177,613
2,592 2,592
32,704 32,704
32,704 32,704
193,908 193,908
439,521
49,155 49,155
138,089 138,089
21,618 21,618
-
41,455 41,455
201,162
84,934 84,934
201,374 201,374
38,915 38,915
30,462 30,462
270,751
45,320 45,320
43,940 43,940
22,560 22,560
139,750 139,750
221,937 221,937
286,880 286,880
44,386 44,386
331,266
4,000 4,000
15,890 15,890
24,866 24,866
374,752 374,752
229,003 229,003
50,390 50,390
654,145
165,149 165,149
83,874 83,874
249,023
14,000 14,000
25,045 25,045
32,940 32,940
4,320 4,320
82,750 82,750
99,545 99,545
44,467 44,467
67,443 67,443
28,268 28,268
86,073 86,073
325,796
28,753 28,753
21,948 21,948
36,366 36,366
123,930 123,930
34,291 34,291
28,753 28,753
7,831 7,831
82,150 82,150
49,149 49,149
37,390 37,390
205,040 205,040
16,618 16,618
31,140 31,140
29,840 29,840
369,265 369,265
186,035 186,035
53,782 53,782
101,718 101,718
39,355 39,355
25,078 25,078
372,347 372,347
153,880 153,880
1,301,460
144,350 144,350
71,814 71,814
35,000 35,000
34,080 34,080
1,590 1,590
38,560 38,560
385,930 385,930
22,724 22,724
47,670 47,670
99,300 99,300
200,280 200,280
197,572 197,572
14,750 14,750
212,322
47,842 47,842
352,632 352,632
158,169 158,169
58,363 58,363
569,164
77,850 77,850
30,475 30,475
221,318 221,318
32,065 32,065
82,424 82,424
335,807
49,449 49,449
472,543 472,543
144,834 144,834
24,380 24,380
133,575 133,575
3,384 3,384
75,432 75,432
163,313 163,313
77,577 77,577
38,444 38,444
779,216 779,216
1,912,698
109,310 109,310
32,920 32,920
15,300 15,300
231,813 231,813
186,446 186,446
12,124 12,124
205,796 205,796
32,890 32,890
669,069
37,020 37,020
259,623 259,623
31,838 31,838
138,464 138,464
30,609 30,609
117,330 117,330
319,504 319,504
34,318 34,318
34,146 34,146
67,686 67,686
455,654
11,250 11,250
21,035 21,035
11,190 11,190
250,433 250,433
180,580 208,405
327,606 383,256
55,792 55,792
287,315 342,965
64,250 64,250
208,405
16,192 16,192
4,000 4,000
20,000 20,000
1,232,326 1,232,326
20,563 41,126
218,625 437,250
150,000 300,000
227,700 455,400
78,350 156,700
225,462 450,924
34,550 34,550
65,246 65,246
43,000 43,000
59,560 59,560
76,697 76,697
4,000 4,000
49,070 49,070
107,200 107,200
117,940 117,940
40,940 40,940
20,343 20,343
139,958 139,958
270,707 270,707
240,922 240,922
11,759 11,759
25,300 25,300
174,143 174,143
98,978 136,078
221,207 221,207
148,703 148,703
98,018 98,018
139,958 139,958
4,905 4,905
824,994
33,625 33,625
8,640 8,640
89,300 89,300
910 910
276,211 280,851
68,409 68,409
95,908 95,908
71,808 71,808
516,976
20,343 20,343
124,663 124,663
77,242 77,242
79,036 79,036
80,000 80,000
360,941
125,000 125,000
128,885 128,885
176,466 176,466
43,791 43,791
4,000 4,000
20,000 20,000
218,625 218,625
115,567 115,567
270,697 270,697
145,750 145,750
265,859 265,859
350,000 350,000
1,610,755
36,180 36,180
13,960 13,960
25,010 25,010
13,960 13,960
13,960 13,960
19,300 19,300
15,300 15,300
8,640 8,640
57,900 57,900
29,150 29,150
20,933 20,933
64,471 64,471
70,464 70,464
47,078 47,078
- -
117,542
78,519 78,519
15,890 15,890
56,250 56,250
365,646 365,646
204,051 204,051
114,937 114,937
3,790 3,790
688,424
13,037 13,037
15,480 15,480
84,797 84,797
38,319 38,319
17,995 17,995
27,190 27,190
105,974 105,974
27,401 27,401
97,056 97,056
34,318 34,318
8,640 8,640
69,150 69,150
84,270 84,270
54,000 54,000
73,206 73,206
344,831 344,831
318,000 318,000
361,470 361,470
1,097,507
-
98,375 98,375
83,150 83,150
150,895 150,895
227,110 227,110
10,000 10,000
143,914 143,914
5,300 5,300
253,409 253,409
356,445 356,445
29,945 29,945
16,000 16,000
655,799
315,287 315,287
25,043 25,043
297,638 297,638
316,563 316,563
33,194 33,194
14,575 14,575
689,645 689,645
1,691,945
25,640 25,640
103,496 103,496
413,315 413,315
88,240 88,240
17,423 17,423
6,420 6,420
35,000 35,000
86,233 86,233
- -
47,050 47,050
36,437 36,437
12,960 12,960
60,950 60,950
195,021 195,021
16,988 16,988
182,600 182,600
44,800 44,800
21,105 21,105
20,060 20,060
11,442 11,442
35,001 35,001
16,105 16,105
453,370 453,370
22,780 22,780
221,681 221,681
354,270 354,270
253,588 253,588
48,664 48,664
38,664 38,664
104,782 104,782
799,968
115,387 115,387
48,434 48,434
535,889 535,889
100,038 100,038
799,748
22,079 22,079
36,178 25,366
151,295 151,295
12,500 12,500
163,795
22,500 22,500
562,349 562,349
310,856 310,856
75,147 75,147
33,660 33,660
982,012
242,885 242,885
22,263 22,263
4,767 4,767
728 728
13,960 13,960
52,270 52,270
216,400 216,400
27,620 27,620
15,890 15,890
23,665 23,665
131,420 131,420
119,224 119,224
129,280 129,280
-
28,780 28,780
344,658 344,658
177,043 177,043
12,615 12,615
534,316
66,250 66,250
40,670 40,670
8,080 8,080
25,510 25,510
50,870 50,870
31,400 31,400
5,300 5,300
39,750 39,750
36,490 36,490
25,370 25,370
132,406 132,406
5,096 5,096
8,640 8,640
43,625 43,625
48,125 48,125
27,450 27,450
230,145 230,145
22,275 22,275
146,015 146,015
359,870 359,870
62,427 62,427
820,732
19,982 19,982
22,130 22,130
22,130 22,130
580,226 580,226
95,109 95,109
3,790 3,790
351,991 351,991
283,712 283,712
1,314,828
42,670 42,670
37,600 37,600
89,910 89,910
39,501 39,501
32,860 32,860
85,130 85,130
99,465 99,465
12,490 12,490
43,268 43,268
37,146 37,146
55,816 55,816
117,915 117,915
43,146 43,146
81,752 81,752
375,000 375,000
617,813
46,770 46,770
358,905 358,905
393,859 393,859
16,200 16,200
16,200 16,200
17,490 17,490
5,207 5,207
8,640 8,640
51,304 51,304
32,933 32,933
8,700 8,700
20,131 20,131
9,210 9,210
53,545 53,545
12,650 12,650
513,350 513,350
282,746 282,746
19,420 19,420
815,516
305,654 305,654
209,130 209,130
17,660 17,660
532,444
122,800 122,800
75,312 75,312
17,540 17,540
6,122 6,122
132,050 132,050
212,161 212,161
22,130 22,130
135,830 135,830
106,470 106,470
143,200 143,200
80,165 80,165
145,059 145,059
46,430 46,430
35,940 35,940
90,450 90,450
772,158 772,158
852,947 852,947
66,250 66,250
1,691,355
112,615 112,615
112,615
49,300 49,300
236,582 236,582
1,060 1,060
10,200 10,200
154,710 154,710
3,180 3,180
405,732
17,490 17,490
114,730 114,730
169,177 169,177
69,542 69,542
23,065 23,065
86,270 86,270
82,522 82,522
19,200 19,200
21,935 21,935
40,081 40,081
140,782 140,782
93,723 93,723
146,812 146,812
1,020 1,020
112,125 112,125
494,462
52,278 52,278
189,957 189,957
54,132 54,132
43,060 43,060
287,149
131,014 131,014
78,493 78,493
129,035 129,035
338,542
388,735 388,735
202,160 202,160
23,288 23,288
43,375 43,375
396,553 396,553
69,686 69,686
1,123,797
213,045 213,045
125,960 125,960
20,551 20,551
128,751 128,751
33,722 33,722
156,180 156,180
273,437 273,437
33,786 33,786
50,482 50,482
26,100 26,100
125,876 125,876
509,681
15,000 15,000
19,175 19,175
122,300 122,300
8,700 8,700
40,110 40,110
35,000 35,000
52,790 52,790
97,490 97,490
17,490 17,490
259,146 259,146
78,402 78,402
115,800 115,800
49,399 49,399
663,350 663,350
663,350
413,882 413,882
525,000 525,000
938,882
7,205 7,205
121,850 121,850
65,484 65,484
19,580 19,580
24,556 24,556
21,005 21,005
558,699 558,699
558,699
56,080 56,080
153,643 153,643
303,619 303,619
5,300 5,300
21,504 21,504
17,159 17,159
31,953 31,953
533,178
47,150 47,150
51,440 51,440
148,651 148,651
5,000 5,000
98,526 98,526
20,200 20,200
272,377
93,029 93,029
11,066 11,066
209,516 209,516
313,620 313,620
230,420 230,420
42,130 42,130
17,490 17,490
813,176
24,432 24,432
69,580 69,580
62,500 62,500
38,360 38,360
36,616 36,616
113,080 113,080
47,950 47,950
62,790 62,790
120,540 120,540
230,420 230,420
263,434 263,434
156,564 156,564
136,683 136,683
334,590 334,590
1,121,691
112,701 112,701
80,660 80,660
200,930 200,930
39,750 39,750
23,320 23,320
103,480 103,480
109,039 109,039
81,092 81,092
107,986 107,986
88,170 88,170
386,287
643,276 643,276
293,551 293,551
317,238 317,238
153,563 153,563
1,407,628
96,683 96,683
30,979 30,979
28,973 28,973
44,395 44,395
147,542 147,542
52,470 52,470
187,320 187,320
118,029 118,029
175,560 175,560
10,200 10,200
94,478 94,478
71,319 71,319
30,210 30,210
53,140 53,140
19,983 19,983
26,230 26,230
34,125 34,125
34,125 34,125
50,200 50,200
67,575 67,575
65,461 65,461
112,903 112,903
178,364
243,313 243,313
67,686 67,686
310,999
26,712 26,712
56,072 56,072
59,000 59,000
25,970 25,970
126,698 126,698
191,316 191,316
25,365 25,365
67,484 67,484
288,324 288,324
70,835 70,835
643,324
180,505 180,505
239,733 239,733
272,059 272,059
28,905 28,905
129,478 129,478
128,889 128,889
979,569
MEN KESEHATAN WILAYAH 12 04 01 Sublampiran H
AH SAKIT TK.IV 12 07 02 SINTANG Lampiran Peraturan Kasad
Nomor Perkasad/24/IX/2012
Tanggal 26 September 2012
BUKU KAS UMUM

DANA PNBP YANMASUM RUMKIT
HARI SELASA BULAN JUNI TA. 2016
NO. URAIAN DEBET KREDIT KET

1 2 3 4 5
1 Diterima Setoran Pasien A.n Ny. Chairani Rp 90,904
2 Diterima Setoran Pasien A.n Tn. Siman Rp 558,175
3 Diterima Setoran Pasien A.n Tn. Agus Rp 22,130
4 Diterima Setoran Pasien A.n Ny. Puni Rp 19,840
5 Diterima Setoran Pasien A.n Ny. Sayuk Rp 134,428
6 Diterima Setoran Pasien A.n An. M Sholihudin Rp 37,128
7 Diterima Setoran Pasien A.n Tn. Dalil Rp 382,018
8 Diterima Setoran Pasien A.n Nn. Julia Rp 851,784
9 Diterima Setoran Pasien A.n Tn. Manwi Rp 113,885
10 Diterima Setoran Pasien A.n Tn. Edo Rp 109,180
11 Diterima Setoran Pasien A.n An. Wahyu Rp 26,571
12 Diterima Setoran Pasien A.n By. Veby Rp 12,500
13 Diterima Setoran Pasien A.n An. Evelin Rp 16,000
14 Diterima Setoran Pasien A.n Ny. Lusiana Rp 26,500
15 Diterima Setoran Pasien A.n Ny. Kamer Rp 88,500
16 Diterima Setoran Pasien A.n By. Ikhsan Rp 440,210
17 Diterima Setoran Pasien A.n An. Carolin Rp 29,600
18 Diterima Setoran Pasien A.n An. M Raihan Rp 28,095
19 Diterima Setoran Pasien A.n Tn. Surya Rp 36,000
20 Diterima Setoran Pasien A.n Tn. Marwi Rp 36,000
21 Diterima Setoran Pasien A.n Tn. Priyanto Rp 14,000
22 Diterima Setoran Pasien A.n Tn. Saihan Rp 46,248
23 Diterima Setoran Pasien A.n Tn. Andri Y Rp 17,330
24 Diterima Setoran Pasien A.n Tn. Irwan Rp 19,500
25 Diterima Setoran Pasien A.n Ny. Hanifah Rp 146,455
26 Diterima Setoran Pasien A.n Tn. Yohanes Rp 158,787
27 Diterima Setoran Pasien A.n Tn. Seven Rp 197,623
28 Diterima Setoran Pasien A.n Ny. Valentina Rp 58,222
29 Diterima Setoran Pasien A.n Tn. Stevanus Rp 24,380
30 Diterima Setoran Pasien A.n An. Atiqa Rp 57,142
31 Diterima Setoran Pasien A.n Tn. Maryadi Rp 14,590
32 Diterima Setoran Pasien A.n Nn. Yulia Rp 17,490
33 Diterima Setoran Pasien A.n Tn. Zainudin Rp 77,610
34 Diterima Setoran Pasien A.n An. Kolan Rp 197,176
35 Diterima Setoran Pasien A.n Ny. Ernawati Rp 46,000
36 Diterima Setoran Pasien A.n Tn. Hendra S Rp 15,000
37 Diterima Setoran Pasien A.n By. Govir Rp 709,454
38 Diterima Setoran Pasien A.n An. Veby Rp 487,043
39 Diterima Setoran Pasien A.n Tn. Dimas Rp 180,720
40 Diterima Setoran Pasien A.n Tn. Sigit Rp 60,620
41 Diterima Setoran Pasien A.n Nn. Deby Rp 514,717
42 Diterima Setoran Pasien A.n Ny. Sumini Rp 223,010
43 Diterima Setoran Pasien A.n Tn. Suwanto Rp 55,300
44 Diterima Setoran Pasien A.n An. Dzakaria Rp 550,469
45 Diterima Setoran Pasien A.n Tn. Ahmad R Rp 260,604
46 Diterima Setoran Pasien A.n Ny. Is Prawanti Rp 56,390
47 Diterima Setoran Pasien A.n Ny. Nirnawati Rp 893,012
48 Diterima Setoran Pasien A.n An. Bayu Rp 21,000
49 Diterima Setoran Pasien A.n Nn. Putri Rp 53,738
50 Diterima Setoran Pasien A.n Ny. Marina Rp 45,980
51 Diterima Setoran Pasien A.n An. Rafi Rp 39,570
52 Diterima Setoran Pasien A.n Tn. M Afif Rp 279,396
53 Diterima Setoran Pasien A.n Tn. Kariyono Rp 18,601
54 Diterima Setoran Pasien A.n Tn. Wahyudin Rp 218,996
55 Diterima Setoran Pasien A.n Tn. Priyanto Rp 54,720
56 Diterima Setoran Pasien A.n Nn. Yemi Rp 58,413
57 Diterima Setoran Pasien A.n Ny. Veronika Rp 12,150
58 Diterima Setoran Pasien A.n An. Theodore Rp 3,231
59 Diterima Setoran Pasien A.n Nn. Julian Rp 1,315,275
60 Diterima Setoran Pasien A.n Tn. Ahmad Rp 370,597
61 Diterima Setoran Pasien A.n Tn. Abdul Rp 105,200
62 Diterima Setoran Pasien A.n Nn. Deby Rp 112,000
63 Diterima Setoran Pasien A.n Ny. Timbuk Rp 199,136
64 Diterima Setoran Pasien A.n Ny. Samsuharna Rp 555,517
65 Diterima Setoran Pasien A.n An. Sesina Rp 20,000
66 Diterima Setoran Pasien A.n Tn. Ardianto Rp 25,510
67 Diterima Setoran Pasien A.n Tn. Suwaji Rp 73,609
68 Diterima Setoran Pasien A.n Tn. Mimin Rp 305,085
69 Diterima Setoran Pasien A.n Tn. Anus Rp 54,100
70 Diterima Setoran Pasien A.n Nn. Dwi Rp 19,590
71 Diterima Setoran Pasien A.n Tn. Rudy Rp 10,200
72 Diterima Setoran Pasien A.n Tn. Amlan Rp 44,350
73 Diterima Setoran Pasien A.n An. Iyas Rp 37,100
74 Diterima Setoran Pasien A.n An. Reno Rp 20,000
75 Diterima Setoran Pasien A.n An. Afkar Rp 21,976
76 Diterima Setoran Pasien A.n Tn. Suwaji Rp 64,060
77 Diterima Setoran Pasien A.n Tn. Philipus Rp 107,560
78 Diterima Setoran Pasien A.n Ny. Danit Rp 167,600
79 Diterima Setoran Pasien A.n Tn. Yosi Rp 12,820
80 Diterima Setoran Pasien A.n An. Hadian Rp 7,820
81 Diterima Setoran Pasien A.n Ny. Ira Rp 3,308
82 Diterima Setoran Pasien A.n Ny. Keisya Rp 4,585
83 Diterima Setoran Pasien A.n An. Hamzah Rp 32,005
84 Diterima Setoran Pasien A.n Ny. Saharum Rp 255,708
85 Diterima Setoran Pasien A.n Tn. Tuyansyah Rp 179,743
86 Diterima Setoran Pasien A.n Tn. Evan F Rp 565,028
87 Diterima Setoran Pasien A.n Tn. Abai Rp 73,295
88 Diterima Setoran Pasien A.n Ny. Alfunsia Rp 34,360
89 Diterima Setoran Pasien A.n Tn. Jai Rp 12,990
90 Diterima Setoran Pasien A.n Nn. Ina Rp 20,490
91 Diterima Setoran Pasien A.n Ny. Emiliana Rp 28,030
92 Diterima Setoran Pasien A.n Ny. Mincu Rp 706,252
93 Diterima Setoran Pasien A.n Nn. Lia Rp 200,075
94 Diterima Setoran Pasien A.n Tn. Casanus Rp 16,151
95 Diterima Setoran Pasien A.n Tn. Sugiono Rp 27,559
96 Diterima Setoran Pasien A.n Tn. Hamdan Rp 19,523
97 Diterima Setoran Pasien A.n Tn. Mimin Rp 47,705
98 Diterima Setoran Pasien A.n An. Afiqa Putri Rp 33,027
99 Diterima Setoran Pasien A.n Tn. Philipus J Rp 12,500
100 Diterima Setoran Pasien A.n Tn. Rian Rp 19,945
101 Diterima Setoran Pasien A.n Ny. Desi Rp 17,600
102 Diterima Setoran Pasien A.n Ny. Siti Yani Rp 37,000
103 Diterima Setoran Pasien A.n Ny. Evi Rp 46,000
104 Diterima Setoran Pasien A.n Tn. Derani Rp 55,000
105 Diterima Setoran Pasien A.n Ny. Imah Rp 1,110,836
106 Diterima Setoran Pasien A.n Tn. Hery Rp 94,530
107 Diterima Setoran Pasien A.n Tn. Sumadi Rp 76,437
108 Diterima Setoran Pasien A.n Ny. Puput Rp 10,200
109 Diterima Setoran Pasien A.n Ny. Krisiana Rp 50,160
110 Diterima Setoran Pasien A.n Tn. Iswanson Rp 105,723
111 Diterima Setoran Pasien A.n An. Alika Rp 134,601
112 Diterima Setoran Pasien A.n Ny. Wilda Rp 61,030
113 Diterima Setoran Pasien A.n Tn. Samiran Rp 626,356
114 Diterima Setoran Pasien A.n An. Winanda Rp 109,430
115 Diterima Setoran Pasien A.n Ny. Samsuharna Rp 804,309
116 Diterima Setoran Pasien A.n Tn. Rahmat Rp 90,400
117 Diterima Setoran Pasien A.n An. Agustian Rp 46,500
118 Diterima Setoran Pasien A.n Tn. Widodo Rp 41,714
Kepada bendahara Rumkit disetor penerimaan Rp 18,423,345

Instalasi Farmasi tgl 14 Juni 2016
An Ny. Chairani dkk 117 Org

BUKU KAS UMUM

HARI SELASA BULAN JUNI TA. 2016

1 2 3 4 5
1 Diterima Setoran Pasien A.n An. Nayla Rp 39,683
2 Diterima Setoran Pasien A.n Tn. Marwi Rp 82,015
3 Diterima Setoran Pasien A.n Tn. M Afif Rp 2,849
4 Diterima Setoran Pasien A.n Tn. Calek Rp 2,772,395
5 Diterima Setoran Pasien A.n An. Mikael Rp 296,037
6 Diterima Setoran Pasien A.n An. Riska Rp 210,139
8 Diterima Setoran Pasien A.n Ny. Bibiana Rp 28,130
9 Diterima Setoran Pasien A.n Nn. Angel Rp 12,590
10 Diterima Setoran Pasien A.n Ny. Sri Mulyani Rp 40,081
11 Diterima Setoran Pasien A.n Tn. Firgin Rp 16,015
12 Diterima Setoran Pasien A.n An. Cristin Rp 37,100
13 Diterima Setoran Pasien A.n Tn. Firgin Rp 41,135
14 Diterima Setoran Pasien A.n By. Adly Rp 36,778
15 Diterima Setoran Pasien A.n Ny. Rantim Rp 57,970
16 Diterima Setoran Pasien A.n Tn. Eka Rp 59,650
17 Diterima Setoran Pasien A.n Tn. Gerson Rp 134,644
18 Diterima Setoran Pasien A.n Tn. Sunardi Rp 663,197
19 Diterima Setoran Pasien A.n An. Adit Rp 13,453
20 Diterima Setoran Pasien A.n Tn. Fransiskus Rp 6,820
21 Diterima Setoran Pasien A.n Tn. Rio Rp 12,990
22 Diterima Setoran Pasien A.n An. Shafa Rp 8,313
23 Diterima Setoran Pasien A.n An. Miftahul Rp 60,380
24 Diterima Setoran Pasien A.n Ny. Yohana Rp 95,266
25 Diterima Setoran Pasien A.n Ny. Maria Rp 92,481
26 Diterima Setoran Pasien A.n Tn. Fajarudin Rp 72,971
27 Diterima Setoran Pasien A.n Ny. Mincu Rp 246,541
28 Diterima Setoran Pasien A.n Ny. Kuswati Rp 39,100
29 Diterima Setoran Pasien A.n Ny. Magdalena Rp 25,400
30 Diterima Setoran Pasien A.n An. Abraham Rp 55,650
31 Diterima Setoran Pasien A.n Tn. Sunadi Rp 40,960
32 Diterima Setoran Pasien A.n Tn. Arliyansyah Rp 554,559
33 Diterima Setoran Pasien A.n An. Laura Rp 112,300
34 Diterima Setoran Pasien A.n By. Antonio Rp 229,775
35 Diterima Setoran Pasien A.n An. G. Jesica Rp 115,240
36 Diterima Setoran Pasien A.n An. Zain Rp 28,245
37 Diterima Setoran Pasien A.n An. Lavina Rp 70,956
38 Diterima Setoran Pasien A.n An. Adit Rp 43,540
39 Diterima Setoran Pasien A.n An. Dahlia Rp 29,785
40 Diterima Setoran Pasien A.n An. Hafid Rp 55,489
41 Diterima Setoran Pasien A.n An. Alfaro Rp 38,491
42 Diterima Setoran Pasien A.n An. Jeselin Rp 5,247
43 Diterima Setoran Pasien A.n An. Anindita Rp 27,732
44 Diterima Setoran Pasien A.n Ny. Jamiah Rp 404,591
45 Diterima Setoran Pasien A.n Ny. Inawati Rp 124,350
46 Diterima Setoran Pasien A.n Tn. Arup Rp 166,822
47 Diterima Setoran Pasien A.n An. Nurfadilah Rp 45,806
48 Diterima Setoran Pasien A.n Ny. V Inawati Rp 24,749
49 Diterima Setoran Pasien A.n Ny. Arlatin Rp 245,790
50 Diterima Setoran Pasien A.n Tn. Aki Rp 18,550
51 Diterima Setoran Pasien A.n Ny. Siswayati Rp 269,041
52 Diterima Setoran Pasien A.n Tn. Arab Rp 508,481
53 Diterima Setoran Pasien A.n Nn. Ayu Rp 33,720
54 Diterima Setoran Pasien A.n By. Albertus Rp 207,921
55 Diterima Setoran Pasien A.n Ny. Nuri Rp 13,910
56 Diterima Setoran Pasien A.n Ny. Tina Rp 59,569
57 Diterima Setoran Pasien A.n An. Maherza Rp 21,000
58 Diterima Setoran Pasien A.n Ny. Siti Rp 3,700
59 Diterima Setoran Pasien A.n An. Nyemas Rp 31,394
60 Diterima Setoran Pasien A.n An. Aqila Rp 38,737
61 Diterima Setoran Pasien A.n Tn. Daut Rp 15,500
62 Diterima Setoran Pasien A.n Tn. Supranto Rp 87,100
63 Diterima Setoran Pasien A.n Tn. Aris Rp 760,461
64 Diterima Setoran Pasien A.n Ny. Anut Rp 37,675
65 Diterima Setoran Pasien A.n Ny. Susanti Rp 570,557
66 Diterima Setoran Pasien A.n An. Reza Rp 42,000
67 Diterima Setoran Pasien A.n Ny. Susi Susanti Rp 65,000
68 Diterima Setoran Pasien A.n Tn. Kerak Rp 35,000
69 Diterima Setoran Pasien A.n Tn. Oki Rp 46,000
70 Diterima Setoran Pasien A.n An. Kesyha Rp 12,800
72 Diterima Setoran Pasien A.n Ny. Tjong Rp 18,500
73 Diterima Setoran Pasien A.n Ny. Yasinta Rp 38,000
74 Diterima Setoran Pasien A.n An. Irma Rp 15,000
75 Diterima Setoran Pasien A.n An. Tri Wira Rp 16,000
77 Diterima Setoran Pasien A.n An. Vania Rp 129,700
78 Diterima Setoran Pasien A.n Ny. Nursiah Rp 54,756

Instalasi Farmasi tgl 20 Juni 2016
An An. Nayla dkk 77 Org

BUKU KAS UMUM

HARI JUM'AT BULAN JULI TA. 2016

1 2 3 4 5
1 Diterima Setoran Pasien A.n Tn. Hery Rp 184,600
2 Diterima Setoran Pasien A.n Ny. Suswanty Rp 68,710
3 Diterima Setoran Pasien A.n An. Zeim Va Rp 92,990
4 Diterima Setoran Pasien A.n Tn. Iyat Rp 54,000
5 Diterima Setoran Pasien A.n An. Cadriel Rp 63,491
6 Diterima Setoran Pasien A.n Tn. Wawan Rp 42,790
7 Diterima Setoran Pasien A.n An. Sabian Rp 68,792
8 Diterima Setoran Pasien A.n An. Rizky Rp 37,100
9 Diterima Setoran Pasien A.n Tn. Darus Rp 152,813
10 Diterima Setoran Pasien A.n By. Yahiko Lin Rp 182,480
11 Diterima Setoran Pasien A.n Ny. Sri Rp 993,963
12 Diterima Setoran Pasien A.n Ny. Rosa Rp 44,520
14 Diterima Setoran Pasien A.n Nn. Dian Rp 7,650
15 Diterima Setoran Pasien A.n Tn. Robi Rp 19,370
16 Diterima Setoran Pasien A.n Tn. Paulinus Rp 302,760
17 Diterima Setoran Pasien A.n Tn. Fhaizal Rp 69,138
18 Diterima Setoran Pasien A.n Tn. B Entawan Rp 77,730
19 Diterima Setoran Pasien A.n Tn. Sobiran Rp 47,455
20 Diterima Setoran Pasien A.n Ny. Yeni K Rp 253,536
21 Diterima Setoran Pasien A.n Ny. Asunda Rp 77,770
22 Diterima Setoran Pasien A.n Tn. Mursaf Rp 23,380
23 Diterima Setoran Pasien A.n Ny. Lena Rp 6,000
24 Diterima Setoran Pasien A.n Tn. Andi Rp 2,359
25 Diterima Setoran Pasien A.n Nn. Naumi Rp 38,410
26 Diterima Setoran Pasien A.n Nn. Danisa Rp 53,000
28 Diterima Setoran Pasien A.n Ny. Kalimah Rp 58,260
29 Diterima Setoran Pasien A.n An. April Rp 41,753
30 Diterima Setoran Pasien A.n An. April Rp 22,500
31 Diterima Setoran Pasien A.n Tn. Markus Rp 55,431
32 Diterima Setoran Pasien A.n Tn. Suminto Rp 13,040
33 Diterima Setoran Pasien A.n Ny. Habibah Rp 64,790
34 Diterima Setoran Pasien A.n Ny. Sunarsi Rp 29,680
35 Diterima Setoran Pasien A.n An. Asita Rp 40,000
36 Diterima Setoran Pasien A.n Tn. P Kamar Rp 318,169
37 Diterima Setoran Pasien A.n By. Azam Rp 328,781
38 Diterima Setoran Pasien A.n An. Suci Rp 50,200
39 Diterima Setoran Pasien A.n dr. Adi Rp 117,727
40 Diterima Setoran Pasien A.n Tn. Kamari Rp 19,879
41 Diterima Setoran Pasien A.n An. Hanifah Rp 122,513
42 Diterima Setoran Pasien A.n Ny. Sari Rp 9,280
43 Diterima Setoran Pasien A.n Nn. Septi Rp 344,461
44 Diterima Setoran Pasien A.n Tn. M Arshad Rp 171,787
45 Diterima Setoran Pasien A.n Nn. Marlya Rp 142,737
46 Diterima Setoran Pasien A.n By. Beatus Rp 24,446
47 Diterima Setoran Pasien A.n Tn. Hairun Rp 11,901
48 Diterima Setoran Pasien A.n An. Kevin Rp 43,837
50 Diterima Setoran Pasien A.n Tn. Sutiyo Rp 63,544
51 Diterima Setoran Pasien A.n An. Ferdi Rp 23,636
52 Diterima Setoran Pasien A.n An. Faizal Rp 185,861
53 Diterima Setoran Pasien A.n An. Arga Rp 138,767
54 Diterima Setoran Pasien A.n Ny. Masnun Rp 1,373,284
56 Diterima Setoran Pasien A.n Ny. Dayang Rp 100,247
57 Diterima Setoran Pasien A.n An. Mutia Rp 94,550
58 Diterima Setoran Pasien A.n Ny. Nonong Rp 416,844
59 Diterima Setoran Pasien A.n Ny. Yuliana Rp 16,564
60 Diterima Setoran Pasien A.n Tn. Hendro Rp 8,388
61 Diterima Setoran Pasien A.n Tn. Miftahul Rp 26,500
62 Diterima Setoran Pasien A.n Tn. Astadino Rp 909,586
63 Diterima Setoran Pasien A.n By. Adiba Rp 33,027
64 Diterima Setoran Pasien A.n An. Faizal Rp 59,978
65 Diterima Setoran Pasien A.n Tn. Slamet Rp 57,500
66 Diterima Setoran Pasien A.n Tn. Eka Rp 8,840
67 Diterima Setoran Pasien A.n Tn. Sobikun Rp 11,120
68 Diterima Setoran Pasien A.n Nn. Lili Rp 6,820
69 Diterima Setoran Pasien A.n By. Aditya Rp 56,572
70 Diterima Setoran Pasien A.n dr. Daniel Rp 18,763
71 Diterima Setoran Pasien A.n Tn. Nofriandi Rp 28,750
72 Diterima Setoran Pasien A.n Tn. Mulyana Rp 54,720
74 Diterima Setoran Pasien A.n Ny. Mariani Rp 596,225
75 Diterima Setoran Pasien A.n An. Yunda Ayu Rp 20,305
76 Diterima Setoran Pasien A.n Tn. Teguh Rp 77,621
77 Diterima Setoran Pasien A.n Tn. Syahrul Rp 116,118
78 Diterima Setoran Pasien A.n Tn. Lim Kun Rp 115,825
79 Diterima Setoran Pasien A.n Ny. Lidya Rp 40,090
80 Diterima Setoran Pasien A.n An. Siti Rp 17,293
81 Diterima Setoran Pasien A.n Tn. Sukarli Rp 71,000
82 Diterima Setoran Pasien A.n Ny. Rendita Rp 66,400
83 Diterima Setoran Pasien A.n An. Rivi Rp 23,500
84 Diterima Setoran Pasien A.n An. Delsa Rp 41,700
85 Diterima Setoran Pasien A.n Tn. Markus Rp 51,108
86 Diterima Setoran Pasien A.n Nn. Kiki Rp 21,666
87 Diterima Setoran Pasien A.n Tn. Topan Rp 155,103
88 Diterima Setoran Pasien A.n Nn. Nova Rp 18,088
89 Diterima Setoran Pasien A.n Ny. Hatniah Rp 195,635
90 Diterima Setoran Pasien A.n Nn. Mardiana Rp 27,870
91 Diterima Setoran Pasien A.n Tn. Dedi Rp 597,775

92 Diterima Setoran Pasien A.n Ny. Novi Rp 19,800
93 Diterima Setoran Pasien A.n Tn. Turis Rp 96,400

Instalasi Farmasi tgl 01 Juli 2016
An Tn. Hery dkk 92 Org


BUKU KAS UMUM
HARI KAMIS BULAN JULI TA. 2016

1 2 3 4 5
2 Diterima Setoran Pasien A.n Ny. Romy Rp 275,110
3 Diterima Setoran Pasien A.n Ny. Kuswati Rp 62,750
4 Diterima Setoran Pasien A.n Tn. Lukas Rp 29,750
5 Diterima Setoran Pasien A.n Ny. Eva Rp 1,471,963
6 Diterima Setoran Pasien A.n Tn. Hairil Rp 31,677
7 Diterima Setoran Pasien A.n Ny. Kartina Rp 18,799
8 Diterima Setoran Pasien A.n Tn. Emperiang Rp 23,190
9 Diterima Setoran Pasien A.n An. Wulan Rp 54,792
10 Diterima Setoran Pasien A.n An. Fatir Rp 284,335
12 Diterima Setoran Pasien A.n Tn. Tumar Rp 56,775
13 Diterima Setoran Pasien A.n Tn. Antonius Rp 26,080
14 Diterima Setoran Pasien A.n By. Pridikta Rp 26,539
15 Diterima Setoran Pasien A.n By. Ny Susana Rp 301,997
16 Diterima Setoran Pasien A.n Tn. Marselinus Rp 57,450
17 Diterima Setoran Pasien A.n An. Arsaka Rp 52,929
18 Diterima Setoran Pasien A.n An. Marvin Rp 44,997
19 Diterima Setoran Pasien A.n An. Sakinah Rp 171,695
20 Diterima Setoran Pasien A.n Ny. Tuminah Rp 334,299
21 Diterima Setoran Pasien A.n An. Alvin Rp 28,209
22 Diterima Setoran Pasien A.n Tn. Jab An Rp 194,345
23 Diterima Setoran Pasien A.n Ny. Hana Rp 19,870
24 Diterima Setoran Pasien A.n Tn. Rudini Rp 13,810
25 Diterima Setoran Pasien A.n Tn. Maulana Rp 38,310
26 Diterima Setoran Pasien A.n Tn. Rodi Rp 20,820
27 Diterima Setoran Pasien A.n Tn. Timotius Adi Rp 57,450
28 Diterima Setoran Pasien A.n An. Risya Rp 227,875
29 Diterima Setoran Pasien A.n Tn. Suntaro Rp 9,470
30 Diterima Setoran Pasien A.n Tn. Sukanto Rp 38,380
31 Diterima Setoran Pasien A.n Ny. Sumidah Rp 34,710
32 Diterima Setoran Pasien A.n Tn. H Minun Rp 378,825
33 Diterima Setoran Pasien A.n Ny. Anisah Rp 312,645
34 Diterima Setoran Pasien A.n An. Grace N Rp 20,447
35 Diterima Setoran Pasien A.n Tn. Januardi Rp 22,160
36 Diterima Setoran Pasien A.n Tn. Efrata Rp 6,493
37 Diterima Setoran Pasien A.n Ny. Angela Rp 32,430
38 Diterima Setoran Pasien A.n Tn. Sumarto Rp 19,185
39 Diterima Setoran Pasien A.n Nn. Desy Rp 13,810
40 Diterima Setoran Pasien A.n An. Kristio W Rp 71,845
41 Diterima Setoran Pasien A.n Tn. Arman Rp 57,750
42 Diterima Setoran Pasien A.n Tn. Yosun Rp 26,686
43 Diterima Setoran Pasien A.n Nn. Lorensia Rp 19,100
44 Diterima Setoran Pasien A.n Tn. Timotius Adi Rp 381,409
45 Diterima Setoran Pasien A.n Tn. Ravail Rp 32,070
46 Diterima Setoran Pasien A.n An. Zaki Rp 52,908
47 Diterima Setoran Pasien A.n Nn. Resti Rp 97,330
48 Diterima Setoran Pasien A.n Tn. Khoirul Rp 9,280
49 Diterima Setoran Pasien A.n nn. Wasti Rp 305,176
50 Diterima Setoran Pasien A.n An. Natanoel Rp 222,250
51 Diterima Setoran Pasien A.n An. Resky Rp 143,193
52 Diterima Setoran Pasien A.n Tn. Paulus Rp 48,427
53 Diterima Setoran Pasien A.n An. Rosi Rp 59,489
54 Diterima Setoran Pasien A.n Tn. Dehar Rp 39,674
55 Diterima Setoran Pasien A.n An. Falentino Rp 24,539
56 Diterima Setoran Pasien A.n An. Nadita Rp 21,581
57 Diterima Setoran Pasien A.n An. Gibran Rp 10,000
59 Diterima Setoran Pasien A.n An. Erwin Rp 20,190
60 Diterima Setoran Pasien A.n Tn. Azuardi Rp 1,749
61 Diterima Setoran Pasien A.n An. Raffa Rp 80,515
62 Diterima Setoran Pasien A.n An. Kinar Rp 87,874
63 Diterima Setoran Pasien A.n Nn. Ratih Rp 61,305
64 Diterima Setoran Pasien A.n Tn. Ahmad Rp 10,640
65 Diterima Setoran Pasien A.n An. Uri Rp 90,695
66 Diterima Setoran Pasien A.n Tn. Sekius Rp 386,469
67 Diterima Setoran Pasien A.n Tn. Simon Rp 38,127
68 Diterima Setoran Pasien A.n Ny. Musinah Rp 264,262
69 Diterima Setoran Pasien A.n Tn. Samsudin Rp 318,317
70 Diterima Setoran Pasien A.n An. Izamsyah Rp 43,391
71 Diterima Setoran Pasien A.n Tn. Simpiang Rp 218,720
72 Diterima Setoran Pasien A.n Tn. Mujianto Rp 123,264
73 Diterima Setoran Pasien A.n An. Reisya Rp 76,742
74 Diterima Setoran Pasien A.n An. Firmus Rp 67,182
75 Diterima Setoran Pasien A.n Ny. Sunarti Rp 639,796
76 Diterima Setoran Pasien A.n An. Angel Rp 70,292
77 Diterima Setoran Pasien A.n Ny. Sri P Rp 12,920
78 Diterima Setoran Pasien A.n Tn. Apryanto Rp 26,370
79 Diterima Setoran Pasien A.n Tn. Eko Rp 15,300
80 Diterima Setoran Pasien A.n Tn. Benardus Rp 76,132
81 Diterima Setoran Pasien A.n Tn. Iskandar Rp 103,160
82 Diterima Setoran Pasien A.n Tn. Azimi Rp 32,684
83 Diterima Setoran Pasien A.n Ny. Marlina Rp 182,200
84 Diterima Setoran Pasien A.n An. Jeni Rp 82,226
85 Diterima Setoran Pasien A.n By. Desn haldi Rp 46,045
86 Diterima Setoran Pasien A.n Tn. Bero Rp 97,213
87 Diterima Setoran Pasien A.n An. Ami Rp 205,891
88 Diterima Setoran Pasien A.n Tn. Sanin Rp 46,958
89 Diterima Setoran Pasien A.n Tn. Wansyah Rp 27,401
90 Diterima Setoran Pasien A.n An. Rajam Rp 123,154
91 Diterima Setoran Pasien A.n Nn. Nurulia Rp 51,610
92 Diterima Setoran Pasien A.n Tn. Andi Rp 34,291
93 Diterima Setoran Pasien A.n Tn. Nur A Rp 152,170
94 Diterima Setoran Pasien A.n Tn. Edi Rp 50,207
95 Diterima Setoran Pasien A.n Ny. Risnaniah Rp 54,270
96 Diterima Setoran Pasien A.n Tn. Zainudin Rp 20,360
97 Diterima Setoran Pasien A.n An. Cika Rp 47,038
98 Diterima Setoran Pasien A.n An. Priyo Rp 39,750
99 Diterima Setoran Pasien A.n An. Andika Rp 20,000
100 Diterima Setoran Pasien A.n By. Ricardo Rp 28,698
101 Diterima Setoran Pasien A.n Ny. Dwi Ayu Rp 98,260
102 Diterima Setoran Pasien A.n An. Stenley Rp 39,618
103 Diterima Setoran Pasien A.n Ny. Saratul Rp 318,125
104 Diterima Setoran Pasien A.n Tn. Filipus Rp 41,210
105 Diterima Setoran Pasien A.n Tn. Potjen Rp 126,999
106 Diterima Setoran Pasien A.n Ny. Sri P Rp 444,942
107 Diterima Setoran Pasien A.n Tn. Jero Rp 51,476
108 Diterima Setoran Pasien A.n An. Nita Rp 30,800
109 Diterima Setoran Pasien A.n Nn. Icha Rp 20,405
110 Diterima Setoran Pasien A.n An. Ahmad Rp 48,594
111 Diterima Setoran Pasien A.n Tn. Sudaryo Rp 22,130
112 Diterima Setoran Pasien A.n Tn. Martinus Rp 27,300
113 Diterima Setoran Pasien A.n By. Rayyan Rp 37,459
114 Diterima Setoran Pasien A.n An. Giovani Rp 17,841
115 Diterima Setoran Pasien A.n An. Olivia Rp 38,542
116 Diterima Setoran Pasien A.n Ny. Juminem Rp 43,190
118 Diterima Setoran Pasien A.n Tn. Wahono Rp 588,928
119 Diterima Setoran Pasien A.n An. Philadepia Rp 64,694
120 Diterima Setoran Pasien A.n Ny. Sardimah Rp 12,380
121 Diterima Setoran Pasien A.n Ny. Yuni S Rp 17,490
122 Diterima Setoran Pasien A.n Tn. Edi K Rp 27,450
123 Diterima Setoran Pasien A.n An. Atifa Rp 44,787
124 Diterima Setoran Pasien A.n An. Urai Rp 29,275
125 Diterima Setoran Pasien A.n An. Lionel Rp 29,800

An Ny. Habibah dkk 124 Org


BUKU KAS UMUM

HARI RABU BULAN JULI TA. 2016

1 2 3 4 5
2 Diterima Setoran Pasien A.n An. Ramadhani Rp 47,570
3 Diterima Setoran Pasien A.n Tn. Bambang Rp 369,207
4 Diterima Setoran Pasien A.n Tn. Jodhi Cris Rp 14,850
5 Diterima Setoran Pasien A.n Nn. Desi Rp 61,832
7 Diterima Setoran Pasien A.n Tn. Joni Rp 28,730
9 Diterima Setoran Pasien A.n Tn. Jeffrey S Rp 194,945
10 Diterima Setoran Pasien A.n An. M Hanif Rp 29,180
11 Diterima Setoran Pasien A.n Ny. Tri Haryati Rp 70,490
12 Diterima Setoran Pasien A.n An. Surya Adi Rp 137,402
13 Diterima Setoran Pasien A.n An. Stanley Rp 353,858
14 Diterima Setoran Pasien A.n An. Indra Rp 34,935
15 Diterima Setoran Pasien A.n An. Fransiskus Rp 367,464
16 Diterima Setoran Pasien A.n An. Benediktus Rp 422,826
17 Diterima Setoran Pasien A.n Tn. Alan Rp 43,480
19 Diterima Setoran Pasien A.n Tn. Usman Rp 238,810
20 Diterima Setoran Pasien A.n Ny. Pariem Rp 330,760
21 Diterima Setoran Pasien A.n Tn. Andrianus Rp 17,490
22 Diterima Setoran Pasien A.n Ny. Bun Miau Rp 24,445
23 Diterima Setoran Pasien A.n Ny. Serina Rp 88,740
24 Diterima Setoran Pasien A.n Tn. Florus Rp 28,513
25 Diterima Setoran Pasien A.n Ny. Sediar Rp 254,036
26 Diterima Setoran Pasien A.n Tn. Enggap Rp 85,310
27 Diterima Setoran Pasien A.n Tn. Aden Rp 29,680
28 Diterima Setoran Pasien A.n An. Rayhan Rp 8,400
29 Diterima Setoran Pasien A.n An. Suhendra Rp 95,310
30 Diterima Setoran Pasien A.n An. Rafael Rp 118,350
31 Diterima Setoran Pasien A.n An. Bima Rp 78,832
33 Diterima Setoran Pasien A.n An. Najla Rp 67,692
34 Diterima Setoran Pasien A.n Ny. Iin Rp 27,450
35 Diterima Setoran Pasien A.n Ny. Pairah Rp 706,662
36 Diterima Setoran Pasien A.n An. Benediktus Rp 20,000
37 Diterima Setoran Pasien A.n An. Kristian Rp 30,204
38 Diterima Setoran Pasien A.n An. Aini Rp 64,982
39 Diterima Setoran Pasien A.n Tn. Fery Rp 28,780
40 Diterima Setoran Pasien A.n Tn. Narsin Rp 56,082
41 Diterima Setoran Pasien A.n An. Hafiza Rp 43,130
43 Diterima Setoran Pasien A.n Tn. Fransiskus Rp 195,060
44 Diterima Setoran Pasien A.n Ny. Ayang Rp 267,085
45 Diterima Setoran Pasien A.n Tn. Jumari Rp 5,960
46 Diterima Setoran Pasien A.n Ny. Minah Rp 158,210
47 Diterima Setoran Pasien A.n Tn. Gundul Rp 5,960
48 Diterima Setoran Pasien A.n An. Mustakim Rp 38,110
49 Diterima Setoran Pasien A.n An. Rini S Rp 38,686
50 Diterima Setoran Pasien A.n Tn. Ravail Rp 23,640
51 Diterima Setoran Pasien A.n Ny. Tri Haryati Rp 48,100
52 Diterima Setoran Pasien A.n An. Rosi Rp 60,740
53 Diterima Setoran Pasien A.n An. Kristian Rp 138,896
54 Diterima Setoran Pasien A.n An. Surya Rp 153,006
55 Diterima Setoran Pasien A.n Ny. Semani Rp 316,194
56 Diterima Setoran Pasien A.n An. Farsa Rp 80,414
57 Diterima Setoran Pasien A.n An. Andreano Rp 875,233
58 Diterima Setoran Pasien A.n An. M Afri Rp 40,545
59 Diterima Setoran Pasien A.n An. Qilla Rp 81,213
60 Diterima Setoran Pasien A.n Tn. Heri Rp 25,140
61 Diterima Setoran Pasien A.n Ny. Lusia Rp 10,205
62 Diterima Setoran Pasien A.n An. Arya Rp 89,975
63 Diterima Setoran Pasien A.n Ny. Wartini Rp 881,639
64 Diterima Setoran Pasien A.n An. Rifat Rp 65,411
65 Diterima Setoran Pasien A.n Tn. Prayitno Rp 31,220
66 Diterima Setoran Pasien A.n An. Najwa Rp 214,572
67 Diterima Setoran Pasien A.n Tn. Masma Rp 421,752
68 Diterima Setoran Pasien A.n Tn. Heni P Rp 204,189
69 Diterima Setoran Pasien A.n Ny. Lasiyem Rp 809,673
70 Diterima Setoran Pasien A.n Ny. Ratna Rp 19,310
71 Diterima Setoran Pasien A.n An. Ahmad Rp 64,341
72 Diterima Setoran Pasien A.n An. Kayla Rp 54,520
73 Diterima Setoran Pasien A.n Tn. Tri S Rp 13,810
74 Diterima Setoran Pasien A.n Tn. Hendro Rp 80,162
75 Diterima Setoran Pasien A.n An. Yesi Rp 53,686
76 Diterima Setoran Pasien A.n Tn. Virgilius Rp 30,870
77 Diterima Setoran Pasien A.n Tn. Tri Rp 37,138
78 Diterima Setoran Pasien A.n An. Reswara Rp 10,686
79 Diterima Setoran Pasien A.n An. Mario E Rp 10,496
80 Diterima Setoran Pasien A.n An. Vika Rp 47,700
81 Diterima Setoran Pasien A.n By. Sagitalia Rp 44,250
82 Diterima Setoran Pasien A.n Ny. Suharti Rp 214,036
83 Diterima Setoran Pasien A.n An. Danu Rp 15,518
85 Diterima Setoran Pasien A.n Ny. Dewi Rp 23,612
86 Diterima Setoran Pasien A.n An. Kenzie Rp 288,425
87 Diterima Setoran Pasien A.n An. M Nazwan Rp 158,750
88 Diterima Setoran Pasien A.n Tn. Yanus Rp 49,120
89 Diterima Setoran Pasien A.n Tn. Sitigen Rp 11,600
90 Diterima Setoran Pasien A.n Ny. Munai Rp 115,920
91 Diterima Setoran Pasien A.n An. Nafiza S Rp 42,100

92 Diterima Setoran Pasien A.n An. Aura Rp 53,292
93 Diterima Setoran Pasien A.n An. Dayang Rp 30,820
94 Diterima Setoran Pasien A.n Ny. Nila Rp 23,230

An An. Kevin dkk 93 Org


BUKU KAS UMUM

1 2 3 4 5
1 Diterima Setoran Pasien A.n Tn. Jumari Rp 151,710
2 Diterima Setoran Pasien A.n Nn. Dena Rp 28,131
3 Diterima Setoran Pasien A.n An. Slamet Riyaden Rp 40,114
5 Diterima Setoran Pasien A.n An. Salwa Rp 107,937
6 Diterima Setoran Pasien A.n Tn. Kasih Rp 123,230
7 Diterima Setoran Pasien A.n Tn. Beni Rp 133,108
8 Diterima Setoran Pasien A.n Tn. Ajwin Rp 23,780
9 Diterima Setoran Pasien A.n Tn. Kasin Rp 8,000
10 Diterima Setoran Pasien A.n Tn. Petrus Rp 241,470
11 Diterima Setoran Pasien A.n Nn. Nisa Rp 436,718
12 Diterima Setoran Pasien A.n Ny. Supi Rp 48,098
13 Diterima Setoran Pasien A.n An. Septina Rp 86,250
14 Diterima Setoran Pasien A.n Nn. Norafita Rp 40,000
15 Diterima Setoran Pasien A.n Ny. Rabiah Rp 422,310
16 Diterima Setoran Pasien A.n Tn. Abang R Rp 26,789
17 Diterima Setoran Pasien A.n Tn. Ray Kamar Rp 439,968
18 Diterima Setoran Pasien A.n Ny. Katini Rp 22,130
19 Diterima Setoran Pasien A.n Tn. Sinun Rp 18,380
20 Diterima Setoran Pasien A.n Tn. Heri Rp 36,040
21 Diterima Setoran Pasien A.n Ny. Yesi Rp 22,130
22 Diterima Setoran Pasien A.n An. Aerlyn Rp 64,792
23 Diterima Setoran Pasien A.n Tn. Pardi Rp 18,480
24 Diterima Setoran Pasien A.n Tn. Hardi Rp 4,700
25 Diterima Setoran Pasien A.n Ny. Lena Rp 600,996
26 Diterima Setoran Pasien A.n By. Kristian Rp 221,219
27 Diterima Setoran Pasien A.n Tn. Ari Rp 22,136
28 Diterima Setoran Pasien A.n Nn. Linda Rp 103,480
29 Diterima Setoran Pasien A.n Ny. Nica Rp 19,310
30 Diterima Setoran Pasien A.n Tn. Asrizal Rp 227,478
31 Diterima Setoran Pasien A.n Nn. Rita Rp 3,000
32 Diterima Setoran Pasien A.n Tn. Tri H Rp 49,450
33 Diterima Setoran Pasien A.n Tn. Jumadi Rp 160,463
35 Diterima Setoran Pasien A.n Tn. Suparmin Rp 30,610
36 Diterima Setoran Pasien A.n By. Josefa Rp 42,858
37 Diterima Setoran Pasien A.n Ny. Nur Rp 21,948
38 Diterima Setoran Pasien A.n Nn. Yesy Rp 34,050
39 Diterima Setoran Pasien A.n Tn. Sukito Rp 9,342
40 Diterima Setoran Pasien A.n Tn. Poltak Rp 9,341
41 Diterima Setoran Pasien A.n An. Grace Rp 21,112
42 Diterima Setoran Pasien A.n Ny. Misti Rp 28,115
43 Diterima Setoran Pasien A.n Nn. Sumami Rp 18,480
44 Diterima Setoran Pasien A.n Ny. Marselina Rp 101,965
45 Diterima Setoran Pasien A.n Tn. Gayu Rp 9,800
46 Diterima Setoran Pasien A.n An. Ilva Rp 56,988
47 Diterima Setoran Pasien A.n Ny. Lie Sui Lan Rp 143,950
48 Diterima Setoran Pasien A.n Ny. Tjong See Rp 96,850
49 Diterima Setoran Pasien A.n Tn. Dhani Rp 87,870
51 Diterima Setoran Pasien A.n Ny. Maida Rp 35,892
52 Diterima Setoran Pasien A.n An. Zahir Rp 74,250
53 Diterima Setoran Pasien A.n An. Renita Rp 145,288
54 Diterima Setoran Pasien A.n Ny. Emiliana Rp 20,700
55 Diterima Setoran Pasien A.n Tn. W Manik Rp 5,960
56 Diterima Setoran Pasien A.n Ny. Suprapti Rp 94,896
57 Diterima Setoran Pasien A.n Tn. Pance Rp 148,183
59 Diterima Setoran Pasien A.n Tn. Ignasius Rp 33,723
60 Diterima Setoran Pasien A.n An. Zhahir Rp 16,231
61 Diterima Setoran Pasien A.n Tn. Yayan Rp 17,560
62 Diterima Setoran Pasien A.n Tn. Setia b Rp 70,940
63 Diterima Setoran Pasien A.n Ny. Nurhayati Rp 59,105
64 Diterima Setoran Pasien A.n An. Naufal Rp 105,974
65 Diterima Setoran Pasien A.n An. Juwanti Rp 9,960
66 Diterima Setoran Pasien A.n Tn. Johan Rp 120,863
67 Diterima Setoran Pasien A.n Ny. Misti Rp 266,438
68 Diterima Setoran Pasien A.n An. Najwa Rp 36,450
69 Diterima Setoran Pasien A.n Tn. Emanuel Rp 542,523
70 Diterima Setoran Pasien A.n Tn. Popo Rp 59,230
71 Diterima Setoran Pasien A.n An. Yanuaris Rp 85,071
72 Diterima Setoran Pasien A.n An. Rifad Rp 25,603
73 Diterima Setoran Pasien A.n Tn. Gusti Fajar Rp 54,980
74 Diterima Setoran Pasien A.n Tn. Tri Hari Rp 27,450
75 Diterima Setoran Pasien A.n An. Risqi Rp 31,235
76 Diterima Setoran Pasien A.n Tn. Popo S Rp 6,000
77 Diterima Setoran Pasien A.n Ny. Sujiem Rp 26,235
78 Diterima Setoran Pasien A.n Ny. Maida Rp 27,450
79 Diterima Setoran Pasien A.n An. Erwin Rp 305,492
80 Diterima Setoran Pasien A.n Nn. Anisa Rp 12,902
81 Diterima Setoran Pasien A.n Tn. Rubiyo Rp 73,196
82 Diterima Setoran Pasien A.n An. Christin Rp 304,603
83 Diterima Setoran Pasien A.n Tn. Khoirul Rp 1,820
84 Diterima Setoran Pasien A.n Tn. Ignatius Rp 72,520
85 Diterima Setoran Pasien A.n Tn. Frendi Rp 27,450
87 Diterima Setoran Pasien A.n Nn. Kiki Rp 281,325
88 Diterima Setoran Pasien A.n Nn. Hijriyanti Rp 62,160
89 Diterima Setoran Pasien A.n Tn. Suparno Rp 200,075
91 Diterima Setoran Pasien A.n Ny. Marselina Rp 58,490
93 Diterima Setoran Pasien A.n Tn. Yos Rp 117,230
95 Diterima Setoran Pasien A.n Tn. Agustinus Rp 207,850
97 Diterima Setoran Pasien A.n Tn. Agus Rp 223,790
98 Diterima Setoran Pasien A.n Ny. Dayuna Rp 87,704
99 Diterima Setoran Pasien A.n Tn. Liaw Rp 765,381
100 Diterima Setoran Pasien A.n Ny. Septiany Rp 339,662
101 Diterima Setoran Pasien A.n Tn. Budiman Rp 21,010
102 Diterima Setoran Pasien A.n Tn. Kasin Rp 148,450
103 Diterima Setoran Pasien A.n Nn. Feti R Rp 75,633
104 Diterima Setoran Pasien A.n Tn. Entry Rp 254,950
105 Diterima Setoran Pasien A.n An. Gilbert Rp 31,482
108 Diterima Setoran Pasien A.n An. Rafi Rp 32,476
110 Diterima Setoran Pasien A.n Ny. Sudarmi Rp 460,510
111 Diterima Setoran Pasien A.n Ny. Laisa Rp 72,345
112 Diterima Setoran Pasien A.n By. Meriani Rp 274,934
113 Diterima Setoran Pasien A.n Ny. Mung Chin Rp 528,219
114 Diterima Setoran Pasien A.n Nn. Yanti Rp 13,600
115 Diterima Setoran Pasien A.n Ny. Nek Mah Rp 78,305
116 Diterima Setoran Pasien A.n Nn. Icha Rp 40,440
118 Diterima Setoran Pasien A.n Ny. Winarsih Rp 101,342
119 Diterima Setoran Pasien A.n Tn. Sungki Rp 447,402
120 Diterima Setoran Pasien A.n An. Riski Rp 217,297
123 Diterima Setoran Pasien A.n Ny. Resti Rp 16,105
124 Diterima Setoran Pasien A.n An. Wahyuni Rp 16,231
125 Diterima Setoran Pasien A.n Tn. Jumadi Rp 311,245
126 Diterima Setoran Pasien A.n Ny. Mariani Rp 76,050
127 Diterima Setoran Pasien A.n Nn. Nur'aini Rp 782,382
128 Diterima Setoran Pasien A.n Tn. Masma Rp 795,228
130 Diterima Setoran Pasien A.n Tn. Rahmat Rp 15,305
131 Diterima Setoran Pasien A.n Ny. Syarifah Rp 17,490
132 Diterima Setoran Pasien A.n Tn. Ignatius Rp 13,810
133 Diterima Setoran Pasien A.n Nn. Julita Rp 177,190
134 Diterima Setoran Pasien A.n An. Zaki Rp 139,015
136 Diterima Setoran Pasien A.n Ny. Misti Rp 1,131,513
137 Diterima Setoran Pasien A.n Nn. Ayu Rp 28,750
138 Diterima Setoran Pasien A.n An. Juwanti Rp 16,160
139 Diterima Setoran Pasien A.n An. Putra Rp 27,976
140 Diterima Setoran Pasien A.n Tn. Wendi Rp 30,686
142 Diterima Setoran Pasien A.n An. Maisya Rp 18,004
143 Diterima Setoran Pasien A.n Tn. Ichsan Rp 114,860
144 Diterima Setoran Pasien A.n Nn. Valena Rp 36,772
146 Diterima Setoran Pasien A.n An. Aulia Rp 21,050
147 Diterima Setoran Pasien A.n An. Habib Rp 123,744
148 Diterima Setoran Pasien A.n An. Hafia Rp 589,868
149 Diterima Setoran Pasien A.n An. Resti Rp 954,588
150 Diterima Setoran Pasien A.n Tn. Erwin Rp 51,476

Instalasi Farmasi tgl 03 Agustus 2016
An Tn. Jumari dkk 149 Org

BUKU KAS UMUM


1 2 3 4 5
1 Diterima Setoran Pasien A.n Ny. Rutwati Rp 62,160
2 Diterima Setoran Pasien A.n Ny. Subhatun Rp 252,550
3 Diterima Setoran Pasien A.n An. Bagus Rp 95,925
4 Diterima Setoran Pasien A.n Tn. Sumarno Rp 53,340
5 Diterima Setoran Pasien A.n Nn. Nuril Rp 331,561
6 Diterima Setoran Pasien A.n An. Maulia Rp 316,767
7 Diterima Setoran Pasien A.n An. Aqila Rp 62,798
8 Diterima Setoran Pasien A.n Tn. Martinus Rp 178,150
9 Diterima Setoran Pasien A.n By. Erilin Rp 7,420
10 Diterima Setoran Pasien A.n Ny. Susilawati Rp 292,631
13 Diterima Setoran Pasien A.n An. Bayu Rp 90,010
14 Diterima Setoran Pasien A.n Tn. Tri H Rp 20,342
15 Diterima Setoran Pasien A.n Ny. Winarsih Rp 74,942
16 Diterima Setoran Pasien A.n Ny. Sri Mulyani Rp 35,700
17 Diterima Setoran Pasien A.n Ny. Ani Rp 359,704
18 Diterima Setoran Pasien A.n Tn. Dengue Rp 273,240
19 Diterima Setoran Pasien A.n Ny. Sam Rp 69,182
20 Diterima Setoran Pasien A.n Ny. Florentina Rp 60,510
21 Diterima Setoran Pasien A.n Ny. Musini Rp 57,370
24 Diterima Setoran Pasien A.n Tn. Suhadi Rp 1,111,074
25 Diterima Setoran Pasien A.n Ny. Paula Rp 56,293
27 Diterima Setoran Pasien A.n An. Lutfi Rp 740,955
28 Diterima Setoran Pasien A.n Tn. Sugeng Rp 421,844
29 Diterima Setoran Pasien A.n Ny. Darmi Rp 336,614
30 Diterima Setoran Pasien A.n An. Alfaiza S Rp 96,935
31 Diterima Setoran Pasien A.n Tn. Iskandar Rp 96,170
32 Diterima Setoran Pasien A.n Tn. Edy Rp 438,875
33 Diterima Setoran Pasien A.n Ny. Rici Rp 94,315
34 Diterima Setoran Pasien A.n Ny. Rosmiyanti Rp 26,410
35 Diterima Setoran Pasien A.n Tn. Abdul B Rp 200,210
36 Diterima Setoran Pasien A.n Tn. Asep Rp 215,600
37 Diterima Setoran Pasien A.n Tn. Jungki Rp 73,135
38 Diterima Setoran Pasien A.n Tn. Habib Rp 25,110
39 Diterima Setoran Pasien A.n Tn. Erwin Rp 118,610
40 Diterima Setoran Pasien A.n Tn. M Badri Rp 196,780
41 Diterima Setoran Pasien A.n Ny. Tumini Rp 35,040
42 Diterima Setoran Pasien A.n Tn. Budi U Rp 27,410
43 Diterima Setoran Pasien A.n Tn. Yudik Rp 46,640
44 Diterima Setoran Pasien A.n Tn. Ardian Rp 46,640
46 Diterima Setoran Pasien A.n Tn. Lamijan Rp 912,487
47 Diterima Setoran Pasien A.n Tn. Al Rizki Rp 46,640
48 Diterima Setoran Pasien A.n Tn. M Seger Rp 53,959
49 Diterima Setoran Pasien A.n Tn. Jumali Rp 63,064
50 Diterima Setoran Pasien A.n Tn. Gilang Rp 26,500
51 Diterima Setoran Pasien A.n Ny. Lilis Rp 95,700
52 Diterima Setoran Pasien A.n Ny. Siti M Rp 21,333
53 Diterima Setoran Pasien A.n Ny. Natalia Rp 506,859
54 Diterima Setoran Pasien A.n An. Valentina Rp 91,226
55 Diterima Setoran Pasien A.n An. Greenelia Rp 124,948
56 Diterima Setoran Pasien A.n Nn. Alfaiza Rp 562,640
57 Diterima Setoran Pasien A.n An. Zahrotul Rp 347,764
59 Diterima Setoran Pasien A.n Ny. Dayang Rp 94,150
60 Diterima Setoran Pasien A.n Ny. Aisyah Rp 51,990
61 Diterima Setoran Pasien A.n An. Firman Rp 96,493
62 Diterima Setoran Pasien A.n An. Ali Rp 73,306
63 Diterima Setoran Pasien A.n An. Brian Rp 22,960
65 Diterima Setoran Pasien A.n By. Ikram Rp 58,300
66 Diterima Setoran Pasien A.n Tn. Suryanto Rp 151,010
68 Diterima Setoran Pasien A.n Tn. Hamidi Rp 446,029
69 Diterima Setoran Pasien A.n Tn. Vitalis Rp 374,896
70 Diterima Setoran Pasien A.n Tn. Ivananda Rp 7,680
71 Diterima Setoran Pasien A.n An. Salwa Rp 15,762
72 Diterima Setoran Pasien A.n An. Veronika Rp 14,360
73 Diterima Setoran Pasien A.n Tn. Budi Rp 109,965
74 Diterima Setoran Pasien A.n Ny. Wahdah Rp 13,810
76 Diterima Setoran Pasien A.n Tn. Alexander Rp 23,976
77 Diterima Setoran Pasien A.n An. Aufa Rp 74,598
78 Diterima Setoran Pasien A.n Tn. Hendri Rp 195,905
79 Diterima Setoran Pasien A.n Tn. Akiang Rp 103,793
80 Diterima Setoran Pasien A.n Tn. Randy Rp 52,940
81 Diterima Setoran Pasien A.n An. Sean Agung Rp 88,356
83 Diterima Setoran Pasien A.n Ny. Suti Rp 130,902
84 Diterima Setoran Pasien A.n Ny. Satijem Rp 36,335
85 Diterima Setoran Pasien A.n Tn. Satiyo Rp 104,320
87 Diterima Setoran Pasien A.n Tn. Dwindra Rp 65,852
88 Diterima Setoran Pasien A.n Tn. Wahyu Rp 65,852
89 Diterima Setoran Pasien A.n Tn. M Hidayat Rp 56,246
92 Diterima Setoran Pasien A.n An. Danang Rp 55,947
93 Diterima Setoran Pasien A.n An. Ellen Rp 268,896
94 Diterima Setoran Pasien A.n An. Danang Rp 172,030
95 Diterima Setoran Pasien A.n Tn. Dwindra Rp 15,023
96 Diterima Setoran Pasien A.n Tn. Masma Rp 1,824,588
97 Diterima Setoran Pasien A.n Tn. Idi Rp 195,230
98 Diterima Setoran Pasien A.n Ny. Tjong Mui Rp 34,980
99 Diterima Setoran Pasien A.n Nn. Aster Rp 6,360
100 Diterima Setoran Pasien A.n An. Riska Rp 29,831
101 Diterima Setoran Pasien A.n Tn. Fauzan Rp 14,020
102 Diterima Setoran Pasien A.n Tn. Andri Rp 88,060
103 Diterima Setoran Pasien A.n Tn. Surojo Rp 26,474
104 Diterima Setoran Pasien A.n Tn. Alwi Rp 13,700
105 Diterima Setoran Pasien A.n Tn. Handrianus Rp 27,165
106 Diterima Setoran Pasien A.n An. Febri Rp 73,255
107 Diterima Setoran Pasien A.n Ny. Supraptini Rp 75,370
108 Diterima Setoran Pasien A.n Nn. Fitri Rp 26,410
109 Diterima Setoran Pasien A.n An. Gerind Rp 73,678

An Tn. Jumari dkk 149 Org


BUKU KAS UMUM

HARI RABU BULAN JULI TA. 2016

1 2 3 4 5
1 Diterima Setoran Pasien A.n Ny. Trias Rp 887,162
2 Diterima Setoran Pasien A.n Tn. Kholil Rp 120,674
4 Diterima Setoran Pasien A.n By. Abian Rp 457,393
5 Diterima Setoran Pasien A.n Tn. Ramli Rp 174,441
6 Diterima Setoran Pasien A.n An. Refan Rp 174,178
7 Diterima Setoran Pasien A.n An. Raehan Rp 29,018
8 Diterima Setoran Pasien A.n Ny. Ngasah Sen Rp 198,430
9 Diterima Setoran Pasien A.n Nn. Sella Rp 20,700
10 Diterima Setoran Pasien A.n Nn. Retno Rp 41,770
11 Diterima Setoran Pasien A.n Ny. Fitriah Rp 20,750
12 Diterima Setoran Pasien A.n An. Heru Rp 19,446
13 Diterima Setoran Pasien A.n An. Ki'ai Rp 105,745
14 Diterima Setoran Pasien A.n Tn. Gombang Rp 462,999
16 Diterima Setoran Pasien A.n Ny. Lestiana Rp 152,230
17 Diterima Setoran Pasien A.n Tn. Zainal Rp 59,257
18 Diterima Setoran Pasien A.n An. Farel Rp 17,944
19 Diterima Setoran Pasien A.n Tn. Efendi Rp 23,380
21 Diterima Setoran Pasien A.n Tn. Hendra Rp 1,124,001
22 Diterima Setoran Pasien A.n Dr. Viona Rp 30,624
23 Diterima Setoran Pasien A.n Tn. Pamudi Rp 76,605
25 Diterima Setoran Pasien A.n Ny. Tjong Rp 31,511
26 Diterima Setoran Pasien A.n Ny. Veronika Diana Rp 5,300
27 Diterima Setoran Pasien A.n By. M Farel Rp 32,595
28 Diterima Setoran Pasien A.n Ny. Kholifah Rp 171,600
29 Diterima Setoran Pasien A.n Ny. Teresia Rp 45,486
30 Diterima Setoran Pasien A.n Ny. Rita Rp 1,136,680
31 Diterima Setoran Pasien A.n Tn. Samin Rp 152,375
32 Diterima Setoran Pasien A.n Tn. Randhini Rp 53,405
33 Diterima Setoran Pasien A.n Tn. Aji Rp 155,736
34 Diterima Setoran Pasien A.n Nn. Mita Rp 132,550
35 Diterima Setoran Pasien A.n Ny. Sukradi Rp 56,330
36 Diterima Setoran Pasien A.n Tn. Luk Rp 297,583
37 Diterima Setoran Pasien A.n Tn. Hadi P Rp 689,331
38 Diterima Setoran Pasien A.n Tn. Edi Rp 83,440
39 Diterima Setoran Pasien A.n Tn. Timotius Rp 86,300
40 Diterima Setoran Pasien A.n An. Daffa Rp 95,250
41 Diterima Setoran Pasien A.n Tn. Abd Rohim Rp 160,990
42 Diterima Setoran Pasien A.n Nn. Cindy Rp 15,890
43 Diterima Setoran Pasien A.n Nn. Lisa Rp 52,643
44 Diterima Setoran Pasien A.n Ny. Lilis Rp 32,210
45 Diterima Setoran Pasien A.n An. Caca Rp 66,582
46 Diterima Setoran Pasien A.n Tn. Asrimudin Rp 24,650
47 Diterima Setoran Pasien A.n Tn. Mario H Rp 58,177
48 Diterima Setoran Pasien A.n By. Ozil Rp 45,567
49 Diterima Setoran Pasien A.n Tn. Dede Rp 278,065
50 Diterima Setoran Pasien A.n Nn. Leny Rp 279,384
51 Diterima Setoran Pasien A.n Tn. Suparno Rp 47,260
52 Diterima Setoran Pasien A.n Nn. Diana Rp 34,750
53 Diterima Setoran Pasien A.n Tn. Dwi Rp 46,640
54 Diterima Setoran Pasien A.n Tn. Ibnu Rp 22,130
55 Diterima Setoran Pasien A.n Tn. Muhwardi Rp 44,561
56 Diterima Setoran Pasien A.n Tn. Kornelius Rp 46,640
57 Diterima Setoran Pasien A.n Tn. Ari Rp 46,640
58 Diterima Setoran Pasien A.n Tn. Wahyu Rp 46,640
59 Diterima Setoran Pasien A.n Tn. Willy Rp 46,640
60 Diterima Setoran Pasien A.n Ny. Kasiyem Rp 87,910
61 Diterima Setoran Pasien A.n An. Latifa Rp 40,603
62 Diterima Setoran Pasien A.n An. Resha Rp 147,831
63 Diterima Setoran Pasien A.n An. Farel Rp 337,125
64 Diterima Setoran Pasien A.n An. Orcin Rp 311,258
65 Diterima Setoran Pasien A.n Ny. Mey Rp 94,875
67 Diterima Setoran Pasien A.n An. Abid Rp 93,650
68 Diterima Setoran Pasien A.n Ny. Wati Rp 464,721
69 Diterima Setoran Pasien A.n Ny. Mistin Rp 152,490
70 Diterima Setoran Pasien A.n Tn. Rimbun Rp 46,640
71 Diterima Setoran Pasien A.n Ny. Romim Rp 161,186
72 Diterima Setoran Pasien A.n Nn. Ester Rp 134,735
73 Diterima Setoran Pasien A.n Tn. M Azmi Rp 11,260
74 Diterima Setoran Pasien A.n Nn. Maya Rp 71,810
75 Diterima Setoran Pasien A.n An. Misi Rp 39,750
76 Diterima Setoran Pasien A.n Tn. Muhammad A Rp 46,640
77 Diterima Setoran Pasien A.n Ny. Warsila Rp 1,020,657
78 Diterima Setoran Pasien A.n Tn. Aton Rp 80,210
79 Diterima Setoran Pasien A.n An. Krisologus Rp 48,455
80 Diterima Setoran Pasien A.n An. Nyemas Rp 48,356
81 Diterima Setoran Pasien A.n An. Safira Rp 95,798
82 Diterima Setoran Pasien A.n Ny. Biku Rp 1,055,439
83 Diterima Setoran Pasien A.n Ny. Maryati Rp 59,551
84 Diterima Setoran Pasien A.n Tn. M Arifin Rp 39,749
85 Diterima Setoran Pasien A.n Tn. Farid Rp 57,945
86 Diterima Setoran Pasien A.n Tn. Paskalis Rp 63,100
87 Diterima Setoran Pasien A.n Nn. Saraswati Rp 143,140
88 Diterima Setoran Pasien A.n Ny. Nani Rp 55,580
90 Diterima Setoran Pasien A.n Ny. Roni Rp 28,520
91 Diterima Setoran Pasien A.n Ny. Nani Rp 5,000
93 Diterima Setoran Pasien A.n Tn. Amaral Rp 46,640
94 Diterima Setoran Pasien A.n Tn. Suhardi Rp 21,884
95 Diterima Setoran Pasien A.n Tn. Supriyadi Rp 225,338
96 Diterima Setoran Pasien A.n Tn. Tri Rp 46,640
97 Diterima Setoran Pasien A.n Tn. Yilyanus Rp 46,640
98 Diterima Setoran Pasien A.n Nn. Siti R Rp 241,354
99 Diterima Setoran Pasien A.n Tn. Ali Rp 280,760
100 Diterima Setoran Pasien A.n Tn. Theodoros Rp 77,194
101 Diterima Setoran Pasien A.n Tn. M Fadel Rp 29,220
102 Diterima Setoran Pasien A.n Tn. Hamdan Rp 46,640
103 Diterima Setoran Pasien A.n Nn. Niki R Rp 403,996
104 Diterima Setoran Pasien A.n An. Mathias Rp 102,687
105 Diterima Setoran Pasien A.n Nn. Aster Rp 532
106 Diterima Setoran Pasien A.n Tn. Feriansyah Rp 136,895
107 Diterima Setoran Pasien A.n Ny. Wahiddiana Rp 86,495
109 Diterima Setoran Pasien A.n Ny. Martinah Rp 392,300
110 Diterima Setoran Pasien A.n Tn. Ikhsan Rp 287,155
111 Diterima Setoran Pasien A.n Tn. Wawan Rp 117,322
112 Diterima Setoran Pasien A.n An. Slamet Rp 147,679
113 Diterima Setoran Pasien A.n Nn. Nova Rp 11,300
114 Diterima Setoran Pasien A.n Tn. Endra Rp 13,960
115 Diterima Setoran Pasien A.n Tn. Abdul Rp 75,526
116 Diterima Setoran Pasien A.n Ny. Tri N Rp 147,279
117 Diterima Setoran Pasien A.n Nn. Diana Rp 106,450
118 Diterima Setoran Pasien A.n Ny. Pansu Rp 303,862
119 Diterima Setoran Pasien A.n Ny. Mistin Rp 274,403
120 Diterima Setoran Pasien A.n An. Rio Rp 25,000
121 Diterima Setoran Pasien A.n Tn. Yosua Rp 5,990
122 Diterima Setoran Pasien A.n Tn. Buyung Rp 131,860
124 Diterima Setoran Pasien A.n Nn. Susan Rp 85,950
125 Diterima Setoran Pasien A.n Ny. Dominica Rp 470,121
126 Diterima Setoran Pasien A.n Tn. Aqlakul Rp 28,315
127 Diterima Setoran Pasien A.n Tn. Moh R Rp 17,918
128 Diterima Setoran Pasien A.n Tn. James Rp 239,141
129 Diterima Setoran Pasien A.n Nn. Stefby Rp 62,024
130 Diterima Setoran Pasien A.n Ny. Liuk Rp 137,620
131 Diterima Setoran Pasien A.n An. Aditya Rp 157,013
132 Diterima Setoran Pasien A.n An. Syahira Rp 54,192
133 Diterima Setoran Pasien A.n Tn. Hendra Rp 282,615
134 Diterima Setoran Pasien A.n Nn. Veronika Rp 176,930
135 Diterima Setoran Pasien A.n Tn. Elias Rp 160,000

An Ny. Trias dkk 134 Org


ad
012
012
7388102
Rp 4,838,401
Rp 7,706,375
Rp 10,927,503
DETASEMEN KESEHATAN WILAYAH 12 04 01 Bukti kas No:
RUMAH SAKIT TK IV 12 07 02 SINTANG Bentuk : KU - 17
NO ADM. .................. Lembar : Kesatu
: Kedua
: Ketiga
: Keempat
KUITANSI
Tahun Anggaran : 2016

Mata Anggaran : Dana Non APBN 0547
Jenis pengeluaran : Penerimaan Instalasi Farmasi
Terima dari : Bendahara Pembantu Rumkit Tk IV Sintang ………………………

Uang sejumlah : Rp. 18.687.568,- ( Delapan belas juta enam ratus delapan puluh tujuh ribu
lima ratus enam puluh delapan rupiah )
Untuk keperluan : Setoran An An. Alfaro dkk 113 Org Tgl 01-09-2016
Keterangan : Disebelah terlampir ………….. Helai Surat/Tanda bukti Pembayaran ………

Sintang, 01 September 2016 Sintang, 01 September 2016
Nama : Kiki Indrawan Nama : Warsidi

Pangkat : Serda NRP 21150228870193 Pangkat : Serma
Jabatan : Bendahara NRP/NIP : 580944
Alamat : Rumkit Tingkat IV Sintang Jabatan : Bendahara Pembantu
Rumkit Tingkat IV Sintang
NO NAMA TANGGAL NAMA OBAT JML RETUR OBAT HARGA

PELAKSANAAN OBAT TERJUAL SATUAN
UMUM
Rp.
1 Tn. Gabriel 8/27/2016 Ofixim 10 10 7433
tremenza 10 10 1530
ambroxol 10 10 437
cetirizin 10 10 530
2 Tn. Jumar 8/27/2016 suporoid supp 5 5 3658

anadium 15 15 10666
flamar 50 10 10 2200
3 Tn. Jaelani 8/26/2016 inf set makro 2 2 10600

venflon 22 2 2 23186
nacl 1 1 7721
buscopan inj 2 1 1 27825
piralen inj 3 1 2 9227
spuit 3cc 2 2 1895
dulcolax tab 10 10 1391
opilax syr 1 1 58300
8/27/2016 omeprazole 10 10 1475
4 Tn. Oksen 8/27/2016 acyclovir 400 40 40 742

acyclovir salep 2 2 3611
samconal 10 10 564
cetirizin 10 10 530
5 Tn. Patris 8/26/2016 rl 1 1 8700

inf set makro 1 1 23186
venflon 22 1 1 10600
Ceftriaxone inj 2 2 33125
tramadol inj 3 3 12521
ats 1 1 152375
spuit 10cc 1 1 3286
spuit 5cc 1 1 2478
spuit 3cc 1 1 1895
spuit 1cc 2 2 2849
aquades 1 1 3312
lidocain inj 1 1 2186
bisturi 1 1 4638
nasal kanul dewasa 1 1 14575
analsik 10 10 1589
8/27/2016 starxone inj 1 1 1 347979

terfacef 1 1 128248
tramadol inj 3 2 3 12521
rl 2 2 8700
8/27/2016 analsik 10 10 1589

ragyl 10 10
pain kila tube 1 1 13913
m.p 8mg 20 20 928
6 Ny. Tjong 8/27/2016 profenal 10 10 1788

tremenza 10 10 1530
indexon tab 10 10 4467
7 Tn. Taufik E 8/27/2016 lidocain inj 2 2 2186

spuit 1cc 2 2 2849
supratul 1 1 20405
8 An. Fio I 8/27/2016 rl 1 1 8700

venflon 22 1 1 23186
cortodex inj 2 2 7500
spuit 3cc 2 2 1895
ventolin nebu 2 2 12496
cetirizin syr 1 1 16231
ambroxol tab 10 10 437
8/27/2016 ferbiven inj 1 1 17490

nasal kanul anak2 1 1 14575
8/27/2016 fartolin 8 8 928

oksigen 300 300 250
9 Nn. Veronika 8/27/2016 cefadroxil tab 10 10 981
kasa gulung kecil 1 1 4638
bioplacenton 1 1 17490
leukoplas kecil 1 1 6625
ns 1 1 8700
10 Tn. Ramadan 8/27/2016 ketorolac inj 2 2 16100

rawat inap spuit 3cc 4 4 1895
venflon 20 1 1 23186
ns 2 2 7721
ranitidin inj 2 2 3746
buscopan inj 1 1
scopamin 10 10 2551
12 ny. Herlina 8/27/2016 ketorolac inj 1 1 9275

rawat inap spuit 3cc 1 1 2849
13 tn.hanafi 8/24/2016 o2 100 L 100 L 250

rawat inap rl 3 3 8700
venflon 20 1 1 23186
venflon 22 2 2 23186
infus set makro 1 1 10600
cortidex inj 3 3 7500
spuit 3 cc 2 2 1895
spuit 10 cc 1 1 3286
nasal canul 1 1 14575
pantoprazole inj 2 2 102025
aquadest 2 2 3312
captropril 12.5 6 6 182
metformin 6 6 265
ondansentron tab 6 6 7288
ambroxol 6 6 437
8/25/2016 Indexon inj 1 1 9275

spuit 5cc 3 3 2478
rl 3 3 8700
8/25/2016 metformin 850 2 2 530
valesco 80mg 2 2 11660
8/26/2016 terfacef inj 1 1 128248

spuit 5cc 1 1 2478
spuit 1cc 1 1 2849
8/26/2016 samconal 6 6 564
8/26/2016 rl 3 3 8700
metformin 850 2 2 530
valesco 2 2 11660
1 an. Raffa 8/29/2016 ottopan syr 1 1 14600

zinkid syr 1 1 21834
oralit 10 10 928
l-bio 10 10 9275
2 by. Syazia 8/29/2016 l-bio 3 3 9275

oralit 3 3 928
3 an. Aisyah U 8/29/2016 ambroxol tab 4 4 437

dextafen 4 4 1458
fartolin 4 4 928
kertas puyer 12 12 500
sporetik 1 1 100038
4 an. Widia 8/27/2016 d5 1/2 ns 2 2 17159
rawat inap inf set makro 1 1 10600
kassa steril 2 2 10203
ceftriaxon inj 2 2 33125
spuit 10cc 1 1 3286
spuit 1cc 2 2 2849
opinecea tab 10 10 7500
kindastatin 1 1 51476
venflon 24 2 2 26235
8/28/2016 d51/2 ns 2 2 17159
8/28/2016 cefotaxim inj 1 1 15304

coetidex 1 1 7500
spuit 10cc 1 1 3286
spuit 1cc 1 1 2849
spuit 3cc 1 1 1895
aquades 1 1 3312
8/29/2016 claneksi syr 1 1 67686
5 tn. Tukimim 8/29/2016 isosobid dinitrat 10 10 186

thrombo aspilet 10 10 939
6 Ny.Tri ningsih 8/29/2016 asmef 15 15 400

spuit 1cc 1 1 2849
ragyl 10 10 1000
7 tn. Satam 8/29/2016 furosemid tab 10 10 268

mp. 4mg 10 10 530
ny. Siti 8/29/2016 rl 1 1 8700

ranap ceftriaxone inj 3 3
ranituidin inj 2 2 3746
ny. Siti 8/29/2016 samconal 4 4 1000

ranap
ny. Siti 8/29/2016 curcuma 10 10 2000

ranap
tn. Ramadanur 8/29/2016 renax 10 10 8700

ranap omeprazol 10 10 1475
spasmal 10 10 600
an. Tutik 8/29/2016 valisanbe 5 mg 10 10 364

salbutamol syr 1 1 6600
cortidex 1 1 7500
nacl 2 2 7721
oksigen 1 200 250
vemflon 22 1 1 23186
spuit 3 cc 1 1 1895
farbiven amp 1 1 112625
ambroxol 10 10 437
ny. Asni 8/29/2016 RL 1 1 8700

ranap vemflon 22 2 2 23186
rocer 1 1 165625
spuit 10 cc 2 2 3286
spuit 3 cc 2 2 1895
spuit 1 cc 1 1 2849
oksigen 100 100 250
tn. Kristoporus 8/29/2016 clindamycin 300 mg 10 10 996

amoxicilin 10 10 464
pehacain 1 1 2363
kassa 3 3 1200
ny. Siti 8/29/2016 metronidazol inf 3 3 72875
by. Alfariz 8/30/2016 RL 3 3 8700

infus set mikro 1 1 10203
vemflon 26 2 2 51013
cefotaxim 1 1 15304
ondan 8 mg 1 1 11660
nacl 1 1 7721
spuit 10 cc 1 1 3286
spuit 1 cc 2 2 2849
aquadest 1 1 3312
oralit 5 5 928
zinkid zinc 1 1 20000
l-bio 3 3 9275
sanmol drop 1 1 20551
mucera drop 1 1 22525
ny. Siti metronidazol inf 2 2 72875
tn.efendi 8/31/2016 analsik 10 10 1589

flamar 50 10 10 2200
sanmag tab 10 10 1020
ny.jong 8/31/2016 isdn 10 10 186

braxidin 30 30 1166
omeyus 10 10 1000
an.bima 8/31/2016 apialys syr 1 1

tremenza tab 10 10 1530
ny fety 8/31/2016 lansoprazole 10 10 1855

ranitidin tab 20 20 321
cefixime 100 mg 10 10 2968
nacl 1 1
inf set makro 1 1
venflon 22 1 1
otozol inj 1 1
ranitidin inj 1 1
spuit 3 cc 1 1
spuit 5 cc 1 1
o2 50 l 50 l 250
8/31/2016 scopamin 10 10 2551
An. Nur fadilah 8/31/2016 D5 1/2 NS 1 1 17159

vemflon 24 1 1 26235
spuit 3 cc 1 1 1895
ottopan syr 1 1 14575
ny. Enda 8/31/2016 cefadroxil 5 5 981
nn. Rika 8/31/2016 valisanbe 5 mg 10 10 364

scopamin 10 10 2551
Tn. Wawan 8/31/2016 ranitidin 2 2 3746

recodryl 1 1 9275
spuit 3 cc 5 5 1895
xepalium 6 6 8500
an. Amira 8/31/2016 vometraz 4 mg 3 3 1458

ranitidin 2 2 321
zinkid syr 1 1
sendok obat 1 1
tn. Minhad 8/31/2016 braxidin 10 10 1166

lansoprazol 10 10 1855
13 ny.sri 8/28/2016 nasal canul 02 1 1 14575

rawat inap infus set macro 1 1 10600
venplon 22 3 3 23186
nacl 1 1 7721
ceftriaxone inj 1 1 33125
ranitidine inj 1 1 3746
farsik inj 2 2 8348
valdix tab 1 1 8016
dispo 5cc 1 1 2478
dispo 3cc 2 2 1895
dispo 1cc 1 1 2849
aguadest 1 1 3312
14 NY.AISYAHJ 8/28/2016 Xepalium 10 10 10931
15 tn.ramadanus 8/28/2016 ketorolac inj 3 3 16100

rawat inap ranitidine inj 2 2 3746
16 ny.herlina 8/28/2016 piralen inj 3 3 9227

rawat inap ranitidine inj 2 2 3746
buscopan inj 3 3 77825
braxidin tab 3 3 1166
rl 2 2 8700
17 ny.enda 8/28/2016 ceftriaxone inj 2 2 33125

rawat inap cortidex inj 2 2 7500
alinamin f inj 1 1 21333
nacl 2 2 15442
venflon 22 1 1 23186
18 an.widia 8/28/2016 d51/2 ns 2 2 17159

rawat inap
19 an.widya 8/28/2016 cefotaxime 1 1 15304

rawat inap cortidex 1 1 7500
spuit 10 cc 1 1 3286
spuit 1 cc 1 1 2849
spuit 3 cc 1 1 1895
aquadest 1 1 3312
20 An. Raffa 8/29/2016 ottopan syr 1 1 14600

oralit 10 10 928
l-bio 10 10 9275
N SEPTEMBER 2016
HARGA JUMLAH JUMLAH HARGA

SATUAN HARGA HARGA TOTAL TOTAL
UMUM DPK
DPK UMUM DPK Rp. Rp.
Rp. Rp. Rp.
74,330
15,300
4,370
5,300
SUB TOTAL 99,300 99,300 99,300
18,290
159,990
22,000
SUB TOTAL 200,280 200,280 200,280
21,200
46,372
7,721
55,650
27,681
3,790
13,910
58,300
SUB TOTAL 234,624 234,624 234,624
14,750
SUB TOTAL 14,750 14,750 14,750
GRAND TOTAL 249,374
29,680
7,222
5,640
5,300
SUB TOTAL 47,842 47,842 47,842
8,700
23,186
10,600
66,250
37,563
152,375
3,286
2,478
1,895
5,698
3,312
2,186
4,638
14,575
15,890
SUB TOTAL 352,632 352,632 352,632
347,979
128,248
37,563
17,400
SUB TOTAL 531,190 531,190 531,190
15,890
1000 10,000
13,913
18,560
SUB TOTAL 34,450 23,913 34,450 34,450
GRAND TOTAL 918,272
17,880
15,300
44,670
SUB TOTAL 77,850 - 77,850 77,850
4,372
5,698
20,405
SUB TOTAL 30,475 - 30,475 30,475
8,700
10,600
23,186
15,000
3,790
24,952
16,231
4,370
SUB TOTAL 106,829 - 106,829 106,829
17,490
14,575
SUB TOTAL 32,065 - 32,065 32,065
7,424
75,000
SUB TOTAL 82,424 - 82,424 82,424
GRAND TOTAL 221,318
9,810
2,189
4,638
17,490
6,625
8,700
SUB TOTAL 49,452 - 49,452 49,452
32,200
7,850
10,600
23,186
15,442
7,492
27825 27,825 27,825
58,300
25,510
SUB TOTAL 180,580 27,825 180,580 180,580
9,275
2,849
SUB TOTAL 12,124 - 12,124 12,124
25,000
26,100
23,186
46,372
10,600
22,500
3,790
3,286
37,428
14,575
204,050
6,624
1,092
1,590
43,728
2,622
SUB TOTAL 472,543 - 472,543 472,543
9,275
102,025
7,434
26,100
SUB TOTAL 144,834 - 144,834 144,834
1,060
23,320
SUB TOTAL 24,380 - 24,380 24,380
128,248
2,478
2,849
SUB TOTAL 133,575 - 133,575 133,575
3,384
SUB TOTAL 3,384 - 3,384 3,384
26,100
1,060
24,952
23,320
SUB TOTAL 75,432 75,432 75,432
14,600
21,834
9,280
92,750
SUB TOTAL 138,464 - 138,464 138,464
27,825
2,784
SUB TOTAL 30,609 - 30,609 30,609
1,748
5,832
3,712
6,000
100,038
SUB TOTAL 117,330 - 117,330 117,330
34,318
10,600
20,406
66,250
3,286
5,698
75,000
51,476
52,470
SUB TOTAL 319,504 - 319,504 319,504
34,318
SUB TOTAL 34,318 - 34,318 34,318
15,304
7,500
3,286
2,849
1,895
3,312
SUB TOTAL 34,146 - 34,146 34,146
67,686
SUB TOTAL 67,686 - 67,686 67,686
GRAND TOTAL 455,654
1,860
9,390
SUB TOTAL 11,250 - 11,250 11,250
6,000
2,186
2,849
10,000
SUB TOTAL 21,035 - 21,035 21,035
2,680
3,210
5,300
SUB TOTAL 11,190 - 11,190 11,190
8,700
7,492
SUB TOTAL 16,192 - 16,192 16,192
4,000
SUB TOTAL 4,000 - 4,000 4,000
20,000
SUB TOTAL 20,000 - 20,000 20,000
43,500
14,750
6,000
SUB TOTAL 64,250 - 64,250 64,250
3,640
6,600
7,500
15,442
50,000
14,575
10,600
23,186
1,895
112,625
4,370
SUB TOTAL 250,433 - 250,433 250,433
8,700
46,372
10,600
165,625
6,572
3,790
2,849
25,000
14,575
SUB TOTAL 284,083 - 284,083 284,083
9,960
4,640
2,363
3,600
SUB TOTAL 20,563 - 20,563 41,126
218,625
SUB TOTAL 218,625 - 218,625 437,250
26,100
10,203
102,026
15,304
11,660
7,721
3,286
5,698
3,312
4,640
20,000
27,825
20,551
22,525
SUB TOTAL 280,851 - 280,851 280,851
145,750
SUB TOTAL 145,750 - 145,750 145,750
Rp 15,890
Rp 22,000
Rp 10,200
SUB TOTAL 48,090 - 48,090 48,090
Rp 1,860
Rp 34,980
Rp 10,000
SUB TOTAL 46,840 - 46,840 46,840
Rp 33,125
Rp 15,300
SUB TOTAL 48,425 - 48,425 48,425
Rp 18,550
Rp 6,420
Rp 29,680
Rp 7,721
Rp 10,600
Rp 23,186
Rp 182,187
Rp 3,746
Rp 1,895
Rp 2,478
Rp 12,500
SUB TOTAL 298,963 - 298,963 298,963
Rp 25,510
SUB TOTAL 25,510 - 25,510 25,510
17,159
26,235
10,600
1,895
14,575
SUB TOTAL 70,464 - 70,464 70,464
4,905
SUB TOTAL 4,905 - 4,905 4,905
3,640
25,510
SUB TOTAL 29,150 - 29,150 29,150
7,492
9,275
9,475
51,000
SUB TOTAL 77,242 - 77,242 77,242
4,374
642
2,000
20,000
500
SUB TOTAL 27,516 - 27,516 27,516
11,660
18,550
SUB TOTAL 30,210 - 30,210 30,210
14,575
10,600
69,558
7,721
33,125
3,746
16,696
8,016
2,478
3,790
2,849
3,312
SUB TOTAL 176,466 176,466 176,466
109,310
SUB TOTAL 109,310 109,310 109,310
48,300
7,492
SUB TOTAL 55,792 55,792 55,792
27,681
7,492
83,475
66,250
3,498
17,400
SUB TOTAL 205,796 205,796 205,796
66,250
15,000
7,492
21,333
15,442
23,186
SUB TOTAL 148,703 148,703 148,703
34,318
SUB TOTAL 34,318 34,318 34,318
15,304
7,500
3,286
2,849
1,895
3,312
SUB TOTAL 34,146 34,318 34,318
14,600
21,834
9,280
92,750
SUB TOTAL 138,464 34,318 34,318
NO NAMA TANGGAL NAMA OBAT JML RETUR OBAT HARGA HARGA

PELAKSANAAN OBAT TERJUAL SATUAN SATUAN
UMUM DPK
Rp. Rp.
1 An.Alfaro 8/19/2016 Apialys Drop 1 1 39,750
Thiamfenikol Syr 1 1 37,905
2 An. M Yusuf 8/21/2016 Amoxicilin Tab 10 10 464

Ambroxol tab 1 1 437
Tremenza Tab 1 1 1530
Pct Tab 1 1 138
Kapsul 10 10 500
Fartolin Tab 5 5 928
Cetirizin Kaps 5 5 530
3 Nn.Jesi 8/21/2016 Nacl 2 2 7721

Metronidazole inf 1 1 72875
4 Ny.Nuning 8/21/2016 Indexon tab 10 10 4467

Ibuprofen tab 10 10 331
5 Tn.Choky 8/21/2016 Paracetamol tab 10 10 138

Neostoplu tab 10 10 159
Indexone tab 10 10 4467
6 An.Parli 8/21/2016 Sanmol Syr 1 1 15231

Acyclovir 200 mg 20 20 649
Acyclovir salep 1 1 3611
7 An.Clara 8/21/2016 Norvom Syr 1 1 15000

Ranitidine tab 10 10 321
8 Nn.Fitri 8/21/2016 Asam mefenamat 10 10 400

Amoxicillin tab 15 15 464
Abbocath 20 1 1 23188
9 An.Tasya 8/21/2016 Opinacea Syr 1 1 66,250
10 Tn.Paskalis 8/22/2016 Analsik tab 15 15 1589

Sanmaag tab 10 10 1020
Spasmal 15 15 600
11 Ny.Iis Wastika 8/18/2016 Rl 1 1 8700

Pantomet inj 1 1 92625
Vemplon 20 1 1 19686
Infus set Makro 1 1 10600
Spuit 10 cc 2 2 3286
Aspilet 10 10 933
Citicolin 500 mg tab 10 10 7884
Lisinopril 10 mg 10 10 901
Metformin 500 mg 10 10 265
8/19/2016 Nacl 2 2 6409

Piracetam 3 gr inj 2 2 15379
Pantomet inj 1 1 73125
Spuit 3 cc 1 1 1609
Aquadest 1 1 2750
8/20/2016 Infus set makro 1 1 10600
8/20/2016 Spuit 20 cc 4 4 9275

Needle 23 1 1 875
Thrombo Aspilet 1 1 933
Plavix 1 1 30608
Piracetam 3 gr inj 4 4 34200
8/20/2016 Vemplon 22 1 1 23186
8/21/2016 Rl 1 1 8700
Plavix 3 3 30608
12 Tn.Suryanto 8/22/2016 Flamar 50 tab 10 10 2200

Suprabion 10 10 1000
M.P 4 mg 10 10 530
13 Ny.Pelangi 8/22/2016 Nasal Canul Dewasa 1 1 14575

Infus set makro 1 1 10600
Vemplon 20 1 1 23186
Rl 1 1 7500
Ranitidine inj 2 2 3746
Recodryl inj 1 1 9275
Cortidex inj 1 1 7500
Spuit 5 cc 1 1 2478
Spuit 3 cc 3 3 1895
Spuit 1 cc 1 1 2849
8/22/2016 Vemplon 20 1 1 23186

O2 50 50 250
14 Ny.Ngaisah 8/22/2016 Furosemid tab 15 15 268
Valesco 30 30 11660
Omeyus tab 10 10 1000
15 Tn.Tiarsih 8/22/2016 Thrombo Aspilets 15 15 933

Plavix 15 15 30608
Captopril 50 mg 3 3 297
Metformin 500 mg 30 30 265
Omeyus 10 10 1000
Kapsul kosong 12 12 500
16 Tn.Cato 8/22/2016 Omeyus 10 10 1000

ISDN 15 15 186
T.Aspilet 15 15 933
Furosemid tab 15 15 268
17 An.Navisah 8/19/2016 RL 1 1 8700

Vemplon 24 1 1 26235
Ondan 4 mg 1 1 9794
Paracetamol inf 1 1 83952
Cefotaxime inj 1 1 15304
Aquadest 1 1 3312
Spuit 1 cc 1 1 2849
Spuit 3cc 1 1 1895
Spuit 10 cc 2 2 3286
Remco syr 1 1 8400
8/19/2016 Valisanbe 2 mg 3 3 364

Kertas puyer 6 6 250
8/20/2016 Cefotaxime inj 1 1 15304

RL 2 2 8700
8/21/2016 Cefotaxime inj 1 1 15304

RL 2 2 8700
8/22/2016 Sporetik Syr 1 1 100038

Dextafen tab 3 3 1458
Tremenza 3 3 1530
Opinacea syr 1 1 66250
Ventolin Nebu 1 1 12476
18 An.Hapsa 8/22/2016 Amoxan syr 1 1 36475

M.P 4 mg 4 4 530
Tremenza 4 4 1530
Paracetamol tab 5 5 138
Kertas Puyer 15 15 250
19 Tn.Yosef Effendi 8/20/2016 Infus set makro 1 1 10600

Vemplon 20 1 1 23186
RL 4 4 8700
Piralen inj 3 3 9227
Spuit 3 cc 2 2 1895
Mertigo 5 5 4306
Cymalium 5 5 1802
8/21/2016 Piralen inj 2 2 0 9227

Ranitidine inj 2 2 0 3746
Mertigo 3 3 4306
RL 3 2 1 8700
8/22/2016 Mertigo SR 5 5 6029

Ranitidine tab 10 10 321
Disflathyl 10 10 810
20 An Daffa 8/23/2016 Oraprofen syr 1 1 15400

Ranitidin tab 4 4 321
21 An.Iqbal 8/20/2016 Infus Set Makro 1 1 10600

Vemplon 24 1 1 26235
D5 1/2 Ns 2 2 17159
Aquades 1 1 3312
Spuit 10 cc 1 1 3286
Spuit 1 cc 2 2 2849
Progesic Syr 1 1 29150
Mucera syr 1 1 22525
8/21/2016 Ceftriaxone inj 1 1 33125

Spuit 5 cc 1 1 2478
Aquadest 1 1 3312
8/23/2016 Sanmol Syr 2 2 15231
22 Tn,Nof 8/23/2016 Flamar Gel 1 1 21500

Flamar 50 tab 10 10 22000
Valisanbe 5 mg 5 5 364
23 Tn.Suparno 8/23/2016 Captopril 50 mg 10 10 182
Ciprofloxacim tab 10 10 627
Flamar Tab 10 10 2200
Neurosanbe Plus 10 10 1385
24 An.Beni 8/23/2016 Ventolin Nebu 1 1 12476

Spuit 5 cc 1 1 2478
Fartolin tab 5 5 928
CTM 2 2 46
25 dr.Birawa 8/23/2016 Apialys Drop 1 1 39750

Interizin Drop 1 1 100000
26 By.Kenisha 8/24/2016 Apialys Drop 1 1 39750

Xepa gel 1 1 182187
27 Ny.Suwanti 8/23/2016 RL 1 1 8700

Infus Set Makro 1 1 10600
Vemplon 20 1 1 23186
Omeprazole inj 1 1 73736
Granon inj 1 1 160325
Spuit 5 cc 1 1 2478
Spuit 3 cc 1 1 1895
Domperidone tab 10 10 596
8/24/2016 Infus set makro 2 2 10600

Venflon 22 1 1 23186
28 Nn.Tri Ningsih 8/24/2016 Asam Mefenamat 10 10 400
29 Tn.Rai Kamar 8/24/2016 Analsik tab 10 10 1589
30 Tn.Usman 8/24/2016 Samconal tab 10 10 5644

Fartolin 15 15 928
GG 12 12 100
CTM 8 8 46
Aminophilyn tab 6 6 289
31 Ny.Jariyah 8/23/2016 RL 1 1 8700

Vemflon 20 1 1 23186
Pantoprazole inj 1 1 102025
Granon inj 1 1 160325
Aquadest 1 1 3312
Spuit 10 cc 1 1 3286
Spuit 5 cc 2 2 2478
Spuit 1 cc 1 1 2846
8/24/2016 RL 2 2 8700
Ondan 4 mg inj 4 4 7288
Aquadest 2 2 3312
Spuit 10 cc 1 1 3286
Spuit 5 cc 1 1 2478
8/24/2016 Cefxime 100 mg 10 10 2968

Omeprazole tab 10 10 1475
32 By.Aerylin 8/22/2016 Sanmol Drop 1 1 20551

Vemplon 26 2 2 51013
Aquadest 1 1 3312
Spuit 10 cc 1 1 3286
Spuit 1 cc 1 1 2849

D5 1/2 NS 2 2 17159
33 Ny.Kristiana 8/24/2016 Ramadexone 10 10 1000

Asam Mefenamat 10 10 400
34 Tn.Yonas 8/24/2016 Gemfbrozile 10 10 464

Penagon 5 5 1749
Braxidine 10 10 1166
35 An.Yusia 8/24/2016 Sanmaag Syr 1 1 32940
36 An.Aditya 8/24/2016 Amoxicillin tab 5 5 464

37 Tn.Sulaiman 8/24/2016 Ambroxol tab 10 10 437

Tranec tab 10 10 3432
Scopamin 10 10 2551
Lansoprazole tab 10 10 1855
38 An.Bening 8/23/2016 D5 1/2 NS 1 1 17159
Vemflon 24 1 1 26235
Zink Syr 1 1 20000
Sanmol Drop 1 1 20551
Oralit 5 5 1000

Aquadest 1 1 3312
Spuit 10 cc 1 1 3286
Spuit 1 cc 1 1 2849
Spuit 3 cc 1 1 1895

D5 1/ 2 NS 2 2 17159
8/23/2016 Cefadroxyl Syr 1 1 13037

Sanmol Forte syr 1 1 15231
8/24/2016 D5 1/2 NS 2 2 17159

Ondan 4 mg 1 1 7288
Aquadest 1 1 3312
Spuit 10 cc 1 1 3286
Spuit 3 cc 1 1 1895
Spuit 1 cc 1 1 2849
39 Tn.Maulana 8/25/2016 Hico gel 1 1 28753
40 Om.Suryani 8/25/2016 Superhoid Supp 6 6 3658
41 An.Fio 8/25/2016 Ventolin Nebu 1 1 12476

Nacl 2 2 15
Fartolin 20 20 928
Cetirizin tab 10 10 530
42 Tn.Ari 8/25/2016 Neurosanbe plus tab 10 10 1385

Flamar gel 1 1 21500
Pregabalin 10 10 8858
43 Tn.Yahusin 8/25/2016 Urine Bag 1 1 7288

Folley Cateter 16 1 1 20405
Spuit 10 cc 1 1 3286
Aquadest 1 1 3312
44 Tn.Yulyanus 8/25/2016 Hico gel 1 1 28753
45 An.Daffa 8/25/2016 CTM 5 5 46

Hydrocortison salep 1 1 5101
46 An.Seisya 8/25/2016 Mucera Syr 1 1 42400

Apialys syr 1 1 39750
47 Ny.Nasita 8/25/2016 Analsik tab 10 10 1589

48 Ny.Upik 8/25/2016 Analsik tab 10 10 1589

49 Ny.Duri 8/25/2016 Baquinor Forte 10 10 17934

Mucohexin tab 20 20 600
Remco syr 1 1 8400
50 Tn.Syaifudin 8/25/2016 Superhoid supp 3 3 3658

Samconal tab 10 10 5644
51 Ny.Sukarti 8/25/2016 Cetirizine kaps 5 5 530

Dilavask 5 mg 10 10 2319
M.P 4 mg 10 10 530
52 Ny.Suharti 8/25/2016 Cortidex inj 1 1 7500

Recodryl inj 2 2 9275
Spuit 3 cc 2 2 1895
53 Tn.Anastri 8/22/2016 Infus Set Makro 1 1 10600

Vemplon 20 1 1 23186
RL 3 3 8700
Terfacef inj 1 1 128248
Paramol tab 10 10 500
Analsik 3 3 1589
Spuit 10 cc 1 1 3286
Spuit 5 cc 1 1 2478
Spuit 3 cc 1 1 1895
Spuit 1 cc 1 1 2849
Aquadest 1 1 3312
Analsik 3 3 1589
RL 2 2 8700
8/23/2016 Nistatin Drop 1 1 51304

Spuit 5 cc 1 1 2478
8/23/2016 Ranitidin inj 2 2 3746

Cortidek inj 3 3 7500
Eperison tab 3 3 2041
Spuit 10 cc 2 2 3286
Spuit 3 cc 5 5 1895
8/24/2016 Ranitidin inj 1 1 3746

RL 1 1 8700
Esperison 2 2 2041
Analsik 3 3 1589
8/24/2016 Piralen inj 2 2 9227

Aquadest 2 2 3312
8/25/2016 Terfacef inj 2 2 128248

RL 3 3 8700
Indexone inj 3 3 9275
Spuit 5 cc 3 3 2478
Spuit 1 cc 3 3 2849
Esperison tab 3 3 2041
Analsik tab 1 1 1589
8/26/2016 Opixime tab 15 15 7433

Analsik 15 15 1589
Lansoprazole 10 10 1855
54 Tn.Santana 8/26/2016 Ventolin Nebu 1 1 12476

Nacl 2 2 15
Fartolin tab 10 10 928
Mucohexin tab 10 10 600
Samconal tab 10 10 564
55 Tn.Supriyadi 8/26/2016 Flamar gel 1 1 21500

56 By.Leonardo 8/26/2016 Termometer 1 1 35000
57 Tn.Widakso 8/26/2016 Supratule 1 1 20405

Lidocain inj 1 1 2186
Spuit 1 cc 1 1 2849
58 Ny.Umi 8/26/2016 M.P 4 mg 3 3 530
59 Tn.Abdul Rohim 8/26/2016 Scopamin plus 10 10 2551

Meloxicam 7,5 mg 10 10 928
Antasida doen 10 10 56
60 Tn.Imam Muslim 8/26/2016 Samconal tab 15 15 566

Cefat 500 mg 15 15 12786
Tremenza 10 10 1530
Interpec tab 10 10 13537
Rindobion 10 10 3498
61 Tn.Jaelani 8/26/2016 Stolax supp 1 1 22724
62 Ny.Herlina 8/26/2016 Analsik 10 10 1589

Ciprofloxacim 10 10 627
Scopamin 10 10 2551
63 Tn. Gabriel 8/27/2016 Opixime tab 10 10 7433

Tremenza 10 10 1530
Ambroxol 10 10 437
64 Tn. Jumar 8/27/2016 Superhoid supp 5 5 3658

Anadium 15 15 10666
Flamar tab 10 10 2200
65 Tn. Jaelani 8/26/2016 Infus Set Makro 2 2 10600

venflon 22 2 2 23186
Nacl 1 1 7721
Buscopan inj 2 1 1 27825
Piralen inj 3 1 2 9227
spuit 3cc 2 2 1895
Dulcolax 10 10 1391
Opilax syr 1 1 58300
8/27/2016 omeprazole 10 10 1475
66 Tn. Oksen 8/27/2016 Acyclovir tab 40 40 742

Acyclovir salep 2 2 3611
samconal 10 10 564
cetirizin 10 10 530
67 Tn. Patris 8/26/2016 RL 1 1 8700

venflon 22 1 1 10600
Tramadol inj 3 3 12521
ATS 1 1 152375
spuit 10cc 1 1 3286
spuit 5cc 1 1 2478
spuit 3cc 1 1 1895
spuit 1cc 2 2 2849
Aquadest 1 1 3312
Bisturi 1 1 4638
Nasal Canul Dewasa 1 1 14575
Analsik 10 10 1589
8/27/2016 starxone inj 1 1 0 347979

Terfacef inj 1 1 128248
Tramadol 3 2 1 12521
RL 2 2 8700
8/27/2016 analsik 10 10 1589

ragyl 10 10 1000
pain kila tube 1 1 13913
m.p 8mg 20 20 928
68 Ny. Tjong 8/27/2016 profenal 10 10 1788

Tremenza 10 10 1530
Indexon tab 10 10 4467
69 Tn. Taufk E 8/27/2016 lidocain inj 2 2 2186

spuit 1cc 2 2 2849
supratul 1 1 20405
70 An. Fio I 8/27/2016 RL 1 1 8700

venflon 22 1 1 23186
spuit 3cc 2 2 1895
Ambroxol 10 10 437
8/27/2016 Farbivent amp 1 1 17490

Nasal Canul Anak 1 1 14575
8/27/2016 Fartolin 8 8 928

O2 300 300 250
71 Nn. Veronika 8/27/2016 cefadroxil tab 10 10 981

kasa gulung kecil 1 1 4638
Bioplacenton 1 1 17490
leukoplas kecil 1 1 6625
Nacl 1 1 8700
13 tn.hanafi 8/24/2016 o2 100 100 250

rawat inap rl 3 3 8700
venflon 20 1 1 23186
venflon 22 2 2 23186
spuit 3 cc 2 2 1895
spuit 10 cc 1 1 3286
aquadest 2 2 3312
captropril 12.5 6 6 182
metformin 6 6 265
ondansentron tab 6 6 7288
ambroxol 6 6 437
8/25/2016 Indexon inj 1 1 9275

spuit 5cc 3 3 2478
rl 3 3 8700
8/25/2016 metformin 850 2 2 530

valesco 80mg 2 2 11660
8/26/2016 terfacef inj 1 1 128248

spuit 5cc 1 1 2478
spuit 1cc 1 1 2849
8/26/2016 samconal 6 6 564
8/26/2016 rl 3 3 8700
metformin 850 2 2 530
valesco 2 2 11660
8/27/2016 samconal 6 6 564

rl 2 2 8700
pantomet inj 1 1 92625
8/27/2016 ketorolak inj 4 4 16100

spuit 3cc 3 3 1895
8/28/2016 ranitidin inj 2 2 3746

samconal 6 6 1000
8/28/2016 masker kanul 1 1 29216

oksigen 3000 l 3000 l 250
ny. Aisyah 8/28/2016 xepalium 10 10 10931
ny. Tina 8/28/2016 samconal 10 10 1000

ambroxol 10 10 437
lansoprazole 10 10 1855
ny. Tatik 8/28/2016 tremenza 10 10 1530
ny. Herlina 8/27/2016 venflon 22 1 1 23186

rl 3 3 8700
piralen inj 3 3 9227
spuit 1cc 1 1 2849
spuit 5cc 1 1 2478
spuit 3cc 3 3 1895
braxidin 5 5 1166
aquades 1 1 3312
8/27/2016 rl 2 2 8700
terfacef inj 1 1 128248
8/27/2016 ketorolac inj 1 1 9275

spuit 3cc 1 1 2849
8/28/2016 rl 2 2 8700
braxidin 3 3 1166
8/28/2016 cefixim 100mg 10 10 2968

an. Arif 8/28/2016 acyclovir 400 30 30 742

cetirizin 10 10 530
samconal 10 10 1000
tn. Sarwato 8/28/2016 berotex 18 18 9275

bisolvon 10 10 45448
ns 2 2 1000
baquinor 10 10 17934
mucohexin 10 10 600
fartolin 2mg 20 20 928
tn. Supianto 8/28/2016 santadex T.T 1 1 17490

asmef 10 10 400
cloramfenikol T.T 1 1 10348
an. Raffa 8/29/2016 ottopan syr 1 1 14600

oralit 10 10 928
l-bio 10 10 9275
by. Syazia 8/29/2016 l-bio 3 3 9275

oralit 3 3 928
an. Aisyah U 8/29/2016 ambroxol tab 4 4 437

dextafen 4 4 1458
fartolin 4 4 928
sporetik 1 1 100038
an. Widia 8/27/2016 d5 1/2 ns 2 2 17159
rawat inap inf set makro 1 1 10600
kassa steril 2 2 10203
spuit 10cc 1 1 3286
spuit 1cc 2 2 2849
opinecea tab 10 10 7500
kindastatin 1 1 51476
venflon 24 2 2 26235
8/28/2016 d51/2 ns 2 2 17159
8/28/2016 cefotaxim inj 1 1 15304

coetidex 1 1 7500
spuit 10cc 1 1 3286
spuit 1cc 1 1 2849
spuit 3cc 1 1 1895
aquades 1 1 3312
8/29/2016 claneksi syr 1 1 67686
tn. Tukimim 8/29/2016 isosobid dinitrat 10 10 186

Ny.Tri ningsih 8/29/2016 asmef 15 15 400

spuit 1cc 1 1 2849
ragyl 10 10 1000
tn. Satam 8/29/2016 furosemid tab 10 10 268

mp. 4mg 10 10 530
an. Tutik 8/29/2016 valisanbe 5 mg 10 10 364

salbutamol syr 1 1 6600
cortidex 1 1 7500
nacl 2 2 7721
oksigen 1 200 250
vemflon 22 1 1 23186
spuit 3 cc 1 1 1895
farbiven amp 1 1 112625
ambroxol 10 10 437
Tn. Ramadan 8/27/2016 ketorolac inj 2 2 16100

spuit 3cc 4 4 1895
venflon 20 1 1 23186
ns 2 2 7721
scopamin 10 10 2551
8/28/2016 ns 3 3 7721
aquades 1 1 3312
rocer inj 1 1 165625
spuit 10cc 2 2 3286
spuit 1cc 1 1 2849
domperidon tab 10 10 596
renax tab 10 10 8700
8/28/2016 ketorolak inj 3 3 16100

8/29/2016 ns 1 1 7721
aquades 1 1 3312
spuit 3cc 2 2 1895
8/29/2016 renax 10 10 8700

omeprazol 10 10 1475
spasmal 10 10 600
ny. Siti 8/29/2016 rl 1 1 8700

ceftriaxone inj 3 3
ranituidin inj 2 2 3746
ny. Siti 8/29/2016 samconal 4 4 1000

ranap
ny. Siti 8/29/2016 curcuma 10 10 2000

ranap
tn. Kristoporus 8/29/2016 clindamycin 300 mg 10 10 996

pehacain 1 1 2363
kassa 3 3 1200
ny. Siti 8/29/2016 metronidazol inf 3 3 72875
tn.andi 8/29/2016 o2 600 600 250
ny.darmiyah 8/29/2016 amlodipin 10 mg 10 10 2465

lipitor 10 10 19941
valisanbe 10 10 364
tn.hoktua 8/29/2016 cefixime 100 mg 10 10 2968

asam mefenamat 10 10 400
ny.sunami 8/29/2016 asam mefenamat 10 10 400

bistury 1 1
lidocain inj 1 1
spuit 1 cc 2 2
ats 1 1
spuit 3 cc 1 1
ragyl forte 10 10 1000
ny. Asni 8/29/2016 RL 1 1 8700

vemflon 22 2 2 23186
rocer 1 1 165625
spuit 10 cc 2 2 3286
spuit 3 cc 2 2 1895
spuit 1 cc 1 1 2849
oksigen 100 100 250
8/30/2016 ondansentrin 8 mg 1 1 9047

ceftriaxone 2 2 33125
8/30/2016 omeyus 10 10 11759
an.tuti 8/30/2016 neuragel 1 1 324

antasida doen 1 1 5101
mucera syr 1 1 22525
salbutamol 1 1 6600
an.alivia 8/30/2016 ambroxol 2 2 437

fartolin 2 2 928
tremenza 2 2 1530
dextafen 2 2 1450
brotec 3 3
bisolvon 3 3
amoxan drop 1 1
tn.samali 8/30/2016 na.dic 10 10 685

sanmag syr 1 1
tn.paskalis 8/30/2016 furosemide 20 20 268

lisinopril 20 20 901
spironolakton 25 mg 20 20 539
na.dic 50 10 10 685
lansoprazole 10 10 1855
nn.sariani 8/30/2016 o2 20 20
omeyus 10 10
sanmag syr 1 1
nasal canul 1 1
tn.widakso 8/30/2016 asam mefenamat 10 10 400
ny.tuti 8/30/2016 allopurinol 300 mg 10 10 928

na.dic 10 10 685
sanmag syr 1 1
tn.rusman 8/30/2016 allopurinol 300 mg 10 10 928

gemfibrozil 10 10 464
avesco 20 mg 10 10 9328
nn.naumi 8/30/2016 paramol 10 10 1000

sanmag syr 1 1
opinacea tab 10 10 7500
tn.mahmudi 8/30/2016 asam mefenamat 10 10 400

sanmag syr 1 1
tn.irham 8/30/2016 clindamycin 10 10 996

asam mefenamat 10 10 400
pehacaine 1 1
kasa 3 3 1200
tn.enda 8/30/2016 ceftriaxone 2 2 33125

ns 2 2 7721
kcl 3 3 4638
megabal 10 10 2186
ny.siti 8/30/2016 inf set makro 3 3 10600
spuit 3 cc 2 2 1895
certriaxone 2 2 33125
aquades 2 2
spuit 10 cc 1 1
metronidazole 1 1
rl 1 1
d5% 2 2 8312
ketorolac 3 3 16100
spuit 5 cc 2 2 2478
tn.randy 8/30/2016 samconal 20 20 1000

cetirizin 10 10 530
Ny. Sri Inf D5 % 1 3 8312

3
8/8/2016 Venflon 26 2 51013

2
By. Abian 8/8/2016 Ceftriaxon Inj 1 33125

Cortidex Inj 1 1 7500
Sp 5 cc 1 1 2478
Sp 1 cc 1 5 2849
Nasal Canul Anak 5 1 14575
1
8/9/2016 Ranitidin Inj 2 0 3746

Travensis Inj 2 2 0 7425
Ventolin Nebu 2 1 2 12475
Inf D5 1/4 Ns 3 2 17159
2
8/9/2016 Domperidon Tab 20 596

Venflon 24 20 2 26235
2
8/10/2016 Cortidex Inj 2 0 7500
Ceftriaxon Inj 2 1 24778
Ventolin Nebu 1 2 0 12476
Inf D5% 2 2 8312
Berotec 2 4 9275
4
8/11/2016 Ceftriaxon Inj 1 0 33125

Sp 10 cc 1 1 3286
Inf D5 % 1 2 8312
2
EPTEMBER 2016
JUMLAH JUMLAH HARGA

HARGA HARGA TOTAL TOTAL
UMUM DPK
UMUM DPK Rp. Rp.
Rp. Rp.
39,750 -
37,905 -
SUB TOTAL 77,655 77,655 77,655
4,640 -
437 -
1,530 -
138 -
5,000 -
- 4,640
2,650 -
SUB TOTAL 14,395 4,640 19,035 19,035
15,442
72,875
SUB TOTAL 88,317 88,317 88,317
44,670
3,310
SUB TOTAL 47,980 47,980 47,980
1,380
1,590
44,670
SUB TOTAL 46,050 1,590 47,640 47,640
15,231
12,980
3,611
SUB TOTAL 31,822 31,822 31,822
15,000
3,210
SUB TOTAL 18,210 18,210 18,210
4,000
6,960
23,188
SUB TOTAL 34,148 34,148 34,148
66,250
SUB TOTAL 66,250 66,250 66,250
23,835
10,200
9,000
SUB TOTAL 43,035 43,035 43,035
8,700
92,625
19,686
10,600
6,572
9,330
78,840
9,010
2,650
SUB TOTAL 238,013 238,013 238,013
12,818
30,758
73,125
1,609
2,750
SUB TOTAL 121,060 121,060 121,060
10,600
SUB TOTAL 10,600 10,600 10,600
37,100
875
933
30,608
136,800
SUB TOTAL 206,316 206,316 206,316
23,186
SUB TOTAL 23,186 23,186 23,186
8,700
91,824
SUB TOTAL 100,524 100,524 100,524
GRAND TOTAL Rp 699,699
22,000
10,000
5,300
SUB TOTAL 27,300 10,000 37,300 37,300
14,575
10,600
23,186
7,500
7,492
9,275
24,778
7,500
2,478
5,685
2,849
SUB TOTAL 108,418 7,500 115,918 115,918
23,186
12,500
SUB TOTAL 35,686 35,686 35,686
GRAND TOTAL 188,904
4,020
349,800
10,000
SUB TOTAL 353,820 10,000 363,820 363,820
13,995
459,120
891
7,950
10,000
6,000
SUB TOTAL 487,956 10,000 497,956 497,956
10,000
2,790
13,995
4,020
SUB TOTAL 20,805 10,000 30,805 30,805
8,700
26,235
10,600
9,794
83,952
15,304
3,312
2,849
1,895
6,572
- 8,400
SUB TOTAL 169,213 8,400 177,613 177,613
1,092
1,500
SUB TOTAL 2,592 2,592 2,592
15,304
17,400
SUB TOTAL 32,704 32,704 32,704
15,304
17,400
SUB TOTAL 32,704 32,704 32,704
100,038
3,180
4,374
4,590
3,000
66,250
12,476
SUB TOTAL 193,908 193,908 193,908
GRAND TOTAL 439,521
36,475
2,120
6,120
690
3,750
SUB TOTAL 49,155 49,155 49,155
10,600
23,186
34,800
27,681
7,492
3,790
21,530
9,010
SUB TOTAL 129,079 9,010 138,089 138,089
-
-
12,918
8,700
SUB TOTAL 21,618 21,618 21,618
-
30,145
3,210
8,100
SUB TOTAL 41,455 41,455 41,455
GRAND TOTAL 201,162
15,400
1,284
2,000
66,250
SUB TOTAL 69,534 15,400 84,934 84,934
10,600
26,235
34,318
66,250
3,312
3,286
5,698
29,150
22,525
SUB TOTAL 201,374 - 201,374 201,374
33,125
2,478
3,312
SUB TOTAL 38,915 - 38,915 38,915
30,462
SUB TOTAL 30,462 - 30,462 30,462
GRAND TOTAL 270,751
21,500
22,000
1,820
SUB TOTAL 45,320 - 45,320 45,320
1,820
6,270
22,000
13,850
SUB TOTAL 43,940 - 43,940 43,940
12,476
2,478
874
4,640
92
2,000
SUB TOTAL 22,560 - 22,560 22,560
39,750
100,000
SUB TOTAL 139,750 - 139,750 139,750
39,750
182,187
SUB TOTAL 221,937 - 221,937 221,937
8,700
10,600
23,186
73,736
160,325
2,478
1,895
5,960
SUB TOTAL 286,880 - 286,880 286,880
21,200
23,186
SUB TOTAL 44,386 - 44,386 44,386
GRAND TOTAL 331,266
4,000
SUB TOTAL 4,000 - 4,000 4,000
15,890
SUB TOTAL 15,890 - 15,890 15,890
5,644
13,920
1,200
368
1,734
2,000
SUB TOTAL 19,222 5,644 24,866 24,866
8,700
10,600
23,186
102,025
160,325
49,556
3,312
3,286
4,956
2,846
5,960
SUB TOTAL 374,752 - 374,752 374,752
17,400
102,025
66,250
29,152
6,624 -
3,286
2,478
1,788
SUB TOTAL 229,003 - 229,003 229,003
29,680
14,750
5,960
SUB TOTAL 50,390 - 50,390 50,390
GRAND TOTAL 654,145
20,551
102,026
33,125
3,312
3,286
2,849
SUB TOTAL 165,149 - 165,149 165,149
49,556
34,318
SUB TOTAL 83,874 - 83,874 83,874
GRAND TOTAL 249,023
10,000
4,000
SUB TOTAL 4,000 10,000 14,000 14,000
4,640
8,745
11,660
SUB TOTAL 16,300 8,745 25,045 25,045
32,940
SUB TOTAL 32,940 - 32,940 32,940
2,320
2,000
SUB TOTAL 4,320 - 4,320 4,320
4,370
34,320
25,510
18,550
SUB TOTAL 82,750 - 82,750 82,750
17,159
10,600
26,235
20,000
20,551
5,000
SUB TOTAL 99,545 - 99,545 99,545
33,125
3,312
3,286
2,849
1,895
SUB TOTAL 44,467 - 44,467 44,467
33,125
34,318
SUB TOTAL 67,443 - 67,443 67,443
13,037
15,231
SUB TOTAL 28,268 - 28,268 28,268
34,318
33,125
7,288
3,312
3,286
1,895
2,849
SUB TOTAL 86,073 - 86,073 86,073
GRAND TOTAL 325,796
28,753
SUB TOTAL 28,753 - 28,753 28,753
21,948
SUB TOTAL 21,948 - 21,948 21,948
12,476
30
18,560
5,300
SUB TOTAL 36,366 - 36,366 36,366
13,850
21,500
88,580
SUB TOTAL 123,930 - 123,930 123,930
7,288
20,405
3,286
3,312
SUB TOTAL 34,291 - 34,291 34,291
28,753
SUB TOTAL 28,753 - 28,753 28,753
230
2,500
5,101
SUB TOTAL 7,831 - 7,831 7,831
42,400
39,750
SUB TOTAL 82,150 - 82,150 82,150
15,890
11,759
21,500
SUB TOTAL 37,390 11,759 49,149 49,149
15,890
21,500
SUB TOTAL 37,390 - 37,390 37,390
179,340
12,000
5,300
8,400
SUB TOTAL 196,640 8,400 205,040 205,040
10,974
5,644
SUB TOTAL 10,974 5,644 16,618 16,618
2,650
23,190
5,300
SUB TOTAL 31,140 - 31,140 31,140
7,500
18,550
3,790
SUB TOTAL 22,340 7,500 29,840 29,840
10,600
23,186
26,100
24,778
128,248
27,681
102,025
5,000
3,060
4,767
3,286
2,478
1,895
2,849
3,312
SUB TOTAL 369,265 - 369,265 369,265
49,556
102,025
9,227
3,060
4,767
17,400
SUB TOTAL 186,035 - 186,035 186,035
51,304
2,478
SUB TOTAL 53,782 - 53,782 53,782
7,492
22,500
6,123
49,556
6,572
9,475
SUB TOTAL 79,218 22,500 101,718 101,718
3,746
15,000
8,700
4,082
3,060
4,767
SUB TOTAL 24,355 15,000 39,355 39,355
18,454
6,624
SUB TOTAL 25,078 - 25,078 25,078
256,496
26,100
27,681
7,492
27,825
7,434
8,547
6,123
3,060
1,589
SUB TOTAL 372,347 - 372,347 372,347
111,495
23,835
18,550
SUB TOTAL 153,880 - 153,880 153,880
GRAND TOTAL 1,301,460
12,476
30
9,280
44,670
6,000
5644
66,250
SUB TOTAL 138,706 5,644 144,350 144,350
21,500
44,670
SUB TOTAL 66,170 5,644 71,814 71,814
35,000
SUB TOTAL 35,000 - 35,000 35,000
20,405
2,186
2,849
4,000
4,640
SUB TOTAL 34,080 - 34,080 34,080
1,590
SUB TOTAL 1,590 - 1,590 1,590
25,510
3,210
9,280
560
SUB TOTAL 38,560 - 38,560 38,560
8,490
191,790
15,300
135,370
34,980
SUB TOTAL 342,460 43,470 385,930 385,930
22,724
SUB TOTAL 22,724 22,724 22,724
15,890
6,270
25,510
SUB TOTAL 41,400 6,270 47,670 47,670
74,330
15,300
4,370
5,300
SUB TOTAL 99,300 99,300 99,300
18,290
159,990
22,000
SUB TOTAL 200,280 200,280 200,280
21,200
46,372
7,721
27,825
18,454
3,790
13,910
58,300
SUB TOTAL 197,572 197,572 197,572
14,750
SUB TOTAL 14,750 14,750 14,750
GRAND TOTAL 212,322
29,680
7,222
5,640
5,300
SUB TOTAL 47,842 47,842 47,842
8,700
23,186
10,600
66,250
37,563
152,375
3,286
2,478
1,895
5,698
3,312
2,186
4,638
14,575
15,890
SUB TOTAL 352,632 352,632 352,632
-
128,248
12,521
17,400
SUB TOTAL 158,169 158,169 158,169
15,890
10,000
13,913
18,560
SUB TOTAL 34,450 23,913 58,363 58,363
GRAND TOTAL 569,164
17,880
15,300
44,670
SUB TOTAL 77,850 - 77,850 77,850
4,372
5,698
20,405
SUB TOTAL 30,475 - 30,475 30,475
8,700
10,600
23,186
15,000
3,790
24,952
16,231
4,370
SUB TOTAL 221,318 - 221,318 221,318
17,490
14,575
SUB TOTAL 32,065 - 32,065 32,065
7,424
75,000
SUB TOTAL 82,424 - 82,424 82,424
GRAND TOTAL 335,807
9,810
2,186
4,638
17,490
6,625
8,700
SUB TOTAL 49,449 - 49,449 49,449
25,000
26,100
23,186
46,372
10,600
22,500
3,790
3,286
37,428
14,575
204,050
6,624
1,092
1,590
43,728
2,622
SUB TOTAL 472,543 - 472,543 472,543
9,275
102,025
7,434
26,100
SUB TOTAL 144,834 - 144,834 144,834
1,060
23,320
SUB TOTAL 24,380 - 24,380 24,380
128,248
2,478
2,849
SUB TOTAL 133,575 - 133,575 133,575
3,384
SUB TOTAL 3,384 - 3,384 3,384
26,100
1,060
24,952
23,320
SUB TOTAL 75,432 - 75,432 75,432
3,384
49,904
17,400
92,625
SUB TOTAL 163,313 - 163,313 163,313
64,400
5,685
7,492
SUB TOTAL 77,577 - 77,577 77,577
7,492
6,000
24,952
SUB TOTAL 38,444 38,444 38,444
29,216
750,000
SUB TOTAL 779,216 779,216 779,216
109,310
SUB TOTAL 109,310 109,310 109,310
10,000
4,370
18,550
SUB TOTAL 32,920 32,920 32,920
15,300
SUB TOTAL 15,300 15,300 15,300
23,186
10,600
26,100
27,681
7,492
83,475 83,475
2,849
2,478
5,685
5,830
33,125
3,312
SUB TOTAL 148,338 83,475 231,813 231,813
17,400
9,227
3,746
27,825 27,825
128,248
SUB TOTAL 158,621 27,825 186,446 186,446
9,275
2,849
SUB TOTAL 12,124 - 12,124 12,124
17,400
27,681
7,492
83,475 83,475
3,498
66,250
SUB TOTAL 122,321 83,475 205,796 205,796
29,680
3,210
SUB TOTAL 32,890 - 32,890 32,890
GRAND TOTAL 669,069
21,720
5,300
10,000
SUB TOTAL 37,020 - 37,020 37,020
9,275
45,448
1,000
179,340
6,000
18,560 18,560
SUB TOTAL 241,063 18,560 259,623 259,623
17,490
4,000
10,348
SUB TOTAL 31,838 - 31,838 31,838
14,600
21,834
9,280
92,750
SUB TOTAL 138,464 - 138,464 138,464
27,825
2,784
SUB TOTAL 30,609 - 30,609 30,609
1,748
5,832
3,712
6,000
100,038
SUB TOTAL 117,330 - 117,330 117,330
34,318
10,600
20,406
66,250
3,286
5,698
75,000
51,476
52,470
SUB TOTAL 319,504 - 319,504 319,504
34,318
SUB TOTAL 34,318 - 34,318 34,318
15,304
7,500
3,286
2,849
1,895
3,312
SUB TOTAL 34,146 - 34,146 34,146
67,686
SUB TOTAL 67,686 - 67,686 67,686
GRAND TOTAL 455,654
1,860
9,390
SUB TOTAL 11,250 - 11,250 11,250
6,000
2,186
2,849
10,000
SUB TOTAL 21,035 - 21,035 21,035
2,680
3,210
5,300
SUB TOTAL 11,190 - 11,190 11,190
3,640
6,600
7,500
15,442
50,000
14,575
10,600
23,186
1,895
112,625
4,370
SUB TOTAL 250,433 - 250,433 250,433
32,200
7,850
10,600
23,186
15,442
7,492
27,825 27,825
58,300
25,510
SUB TOTAL 180,580 27,825 180,580 208,405
23,163
33,125
3,312
165,625
55,650 55,650
6,572
2,849
5,960
87,000
SUB TOTAL 327,606 55,650 327,606 383,256
48,300
7,492
SUB TOTAL 55,792 - 55,792 55,792
7,721
99,375
3,312
165,625
55,650 55,650
3,790
SUB TOTAL 287,315 55,650 287,315 342,965
43,500
14,750
6,000
SUB TOTAL 64,250 - 64,250 64,250
GRAND TOTAL 208,405
8,700
7,492
SUB TOTAL 16,192 - 16,192 16,192
4,000
SUB TOTAL 4,000 - 4,000 4,000
20,000
SUB TOTAL 20,000 - 20,000 20,000
9,960
4,640
2,363
3,600
SUB TOTAL 20,563 - 20,563 41,126
218,625
SUB TOTAL 218,625 - 218,625 437,250
150,000
SUB TOTAL 150,000 - 150,000 300,000
24,650
199,410
3,640
SUB TOTAL 227,700 - 227,700 455,400
29,680
44,670
4,000
SUB TOTAL 78,350 - 78,350 156,700
4,000
4,638
2,186
5,698
152,375
1,895
10,000
44,670
SUB TOTAL 225,462 - 225,462 450,924
8,700
46,372
10,600
165,625
6,572
3,790
2,849
25,000
14,575
SUB TOTAL 284,083 - 284,083 284,083
9,047
165,625
66,250
SUB TOTAL 240,922 - 240,922 240,922
11,759
SUB TOTAL 11,759 - 11,759 11,759
GRAND TOTAL 536,764
324
5,101
22,525
6,600
SUB TOTAL 34,550 - 34,550 34,550
874
1,846
3,060
2,916
5,000
Rp 9,275
9,275
33,000
SUB TOTAL 65,246 - 65,246 65,246
6,850
Rp 32,940
3,210
SUB TOTAL 43,000 - 43,000 43,000
5,360
18,020
10,780
6,850
18,550
SUB TOTAL 59,560 - 59,560 59,560
5,000
24,000
32,940
14,757
SUB TOTAL 76,697 - 76,697 76,697
4,000
SUB TOTAL 4,000 - 4,000 4,000
9,280
6,850
32,940
SUB TOTAL 49,070 - 49,070 49,070
9,280
4,640
93,280
SUB TOTAL 107,200 - 107,200 107,200
10,000
32,940
75,000
SUB TOTAL 117,940 - 117,940 117,940
4,000
4,000
32,940
SUB TOTAL 40,940 - 40,940 40,940
9,960
4,000
2,783
3,600
SUB TOTAL 20,343 - 20,343 20,343
66,250
7,492
15,000
15,442
13,914
21,860
SUB TOTAL 139,958 - 139,958 139,958
31,800
7,492
3,790
66,250
6,624
3,286
72,875
8,700
16,624
48,300
4,966
SUB TOTAL 270,707 - 270,707 270,707
20,000
5,300
SUB TOTAL 25,300 - 25,300 25,300
24,936 -
SUB TOTAL 24,936 - 24,936 24,936
102,026 -
SUB TOTAL 102,026 - 102,026 102,026
33,125 -
7,500 -
2,478 -
14,245 -
14,575 -
SUB TOTAL 71,923 - 71,923 71,923
- -
- -
24,950 -
34,318 -
SUB TOTAL 59,268 - 59,268 59,268
11,920 -
52,470 -
SUB TOTAL 64,390 - 64,390 64,390
- -
24,778 -
- -
16,624 -
37,100 -
SUB TOTAL 78,502 - 78,502 78,502
- -
3,286 -
16,624 -
SUB TOTAL 19,910 - 19,910 19,910
GRAND TOTAL 420,955
NO NAMA TANGGAL NAMA OBAT JML RETUR OBAT HARGA

PELAKSANAAN OBAT TERJUAL SATUAN
UMUM
Rp.
1 Tn. Panijo 9/15/2016 celebrex 10 10 17693
alluporinol 300mg 10 10 928
m.p 4mg 10 10 530
lisinopril 10mg 10 10 994
dilavas 5mgx 5 5 2319
2 Tn. Frans 9/15/2016 Costan 10 10 1060.9

Amoxicilin Tab 10 10 400
3 An. Shanum 9/15/2016 Sanmol syr 1 1 20551
4 An. Yosef 9/15/2016 Cinolon N 1 1 21465

Dextafen Tab 5 5 1458
Cetirizine Tab 5 5 530
Curfos Syr 1 1 92055
5 An. Mutia 9/16/2016 anacetin 1 1 15000

cefxime syr 1 1 42201
MP 4 mg 10 10 530
opinacea syr 1 1 66250
6 an. Atiqah 9/16/2016 anacetin 1 1 15000
7 tn. Petrus 9/16/2016 cerini 10 10 4011
8 An.Vigindoergana 9/16/2016 Tem Digital 1 1 35000
9 Ny. Anamisan 9/16/2016 Omeyus Tab 10 10

Sanmagh Tab 15 15 1020
Braxidin Tab 15 15 1166
11 An. Asih 9/16/2016 Mefnal tab 10 10 1749
Painkila 1 1
12 An. Desi 9/16/2016 Mefnal tab 10 10 1749
13 Tn. Gunadi 9/16/2016 bisturi 1 1 4638

spuit 1cc 1 1 2849
mefinal 15 15 1749
14 Tn. Parton 9/16/2016 berotec 20 20 1855

bisolvon 10 10 1855
nacl 2 2 175
oksigen 100 100 250
lisinopril 20 20 994
salbron 10 10 2000
m.p 8mg 10 10 928
furosemide 10 10 268
letonal 25 10 10 1484
fargoxin 10 10 600
15 an. Clara 9/16/2016 fabiven 1 1 15000

ambroxol 1 1 437
dextafen 1 1 1458
cetirizin 1 1 530
16 Nn. Kristina 9/16/2016 lafdry 1 1 10000

cetirizin 10 10 530
opinacea tab 10 10 7500
lostacef 10 10 3200
17 an. Vegi 9/17/2016 loratadin 5 5 441

declosan 5 5 1000
18 tn. Ibrahim 9/17/2016 lafdryl dmp 1 1 15000

PT ADHI KARYA loratadin 5 5 431
19 ny. Sugiyem 9/17/2016 flamar 50 mg 5 5 2200

mp 4 mg 15 15 530
amlodipin 10 mg 3 3 2465
glibenclamid 5 5 808
pain kila 1 1 13913
hidrocortison 1 1 5101
20 an. Alya 9/17/2016 anacetin 1 1 15000

amoxicilin 1 1 8745
curfos 1 1 92055
21 ny. Nurhayati 9/17/2016 infus set makro 1 1 10600

vemflon 20 1 1 23186
nacl 1 1 7867
ondan 8 mg 1 1 11880
wiacid 1 1 6200
aspilet 4 4 933
isdn 1 1 186
propanolol 40 mg 1 1 176
22 tn. Khairul huda 9/17/2016 ciprofloxacin 15 15 627

pct 15 15 500
sanmaag syr 1 1 29945
opinacea 10 10 7500
23 ny. Berliana 9/17/2016 ambroxol 8 8 437

cetirizin 2 2 530
dexa 10 10 1500
capsul 10 10 500
24 nn. Yurita 9/17/2016 pct 10 10 500

mp 4 mg 10 10 530
meloxicam 7.5 mg 10 10 928
25 an. Kenzia 9/17/2016 pct syr 1 1 3900

zink 1 1 21834
apyalis drop 1 1 39750
26 An. Alfren wijaya 9/17/2016 segestam selep 1 1 16105

pct syr 1 1 3900
sendok 1 1 1000
27 nn.maria 9/18/2016 cerini tab 10 10 4108
lafidry -dmp 1 1 15000
28 ny.enda 9/18/2016 dilavast 5 mg 10 10 2319

provinas 10 10 2396
29 Ny. Kristina 9/18/2016 pct tab 10 10 500

folaxin 10 10 1000
ondan 4mg 5 5 7288
30 an. Aira 9/18/2016 berotec 1 1 9275

bisolvon 1 1 9275
interfec syr 1 1 29800
cefxim syr 1 1 42201
spuit 5cc 1 1 2478
31 Nn. Tra 9/18/2016 norvom tab 10 10 278

molagit 10 10 636
32 an. Meisie 9/18/2016 pct tab 10 10 500

loratadin 2 2 441
acyclovir 400 25 25 742
33 tn. Agus 9/18/2016 provinas 10 10 464

opixime 6 6 7433
ambroxol 10 10 437
34 an. Rikky 9/18/2016 opinacea 1 1 66250

provinas 7 7 464
35 om khairul 9/18/2016 D5 % 1 1 8312

vemflon 24 2 2 26235
vesperum 10 10 1500
36 ny.rumini 9/18/2016 mersibion tab 10 10 5500

meloxixam 7,5 mg 10 10 928
mp 4 mg tab 5 10 530
37 Tn. Angga 9/19/2016 Spasmal tab 10 10 600

omeprazol tab 10 10
Lexadon tab 10 10
Lodia 10 10 1700
38 Ny. Ruati 9/19/2016 Lodia Tab 10 10 1700

Molagit 10 10 636
Pct tab 10 10 500
Lexadon Tab 10 10
39 Ny. Sesilia 9/19/2016 Clindamycin 10 10 996

Mefnal Tab 10 10 1749
Pehacain Inj 2 2 2783
Kasa 3 3 1200
40 Ny. Sutyani 9/19/2016 Cendo Xitrol Ttm 1 1

Flamar 50 mg 10 10 2200
41 Tn. Paulus 9/19/2016 Mp Tab 4 mg 15 15 530

Nuvamox Tab 10 10
42 Tn. Aki 9/19/2016 Omeyus Tab 10 10

Braxidin tab 15 15 1166
43 Ny. Ita 9/19/2016 Helixime Tab 10 10

Spasmal Tab 10 10 600
44 nn. Agustina 9/19/2016 lostacef 10 10 3500
45 by. Abiyan 9/20/2016 apyalis drop 1 1 39750
46 tn. Ahmad adimin 9/20/2016 celebrex 10 10 17693

mp 4 mg 20 20 450
omeyus 10 10 1500
47 nn. Della 9/20/2016 tremenza 10 10 1530
lafdryl syr 1 1 15000
cerini tab 10 10 4108
mp 8 mg 10 10 928
48 an. Dini 9/20/2016 anacetin 1 1 15000

cefxim 1 1 42201
yarizin 1 1 48000
salbron 5 5 1000
49 nn. Wartini 9/20/2016 urotractin 10 10 8599

mefnal 10 10 1749
50 an. Diva 9/20/2016 otopan syr 1 1 14575

amoxicilin syr 1 1 8745
51 ny. Simah 9/21/2016 lantus insulin pen 1 1 112625

nacl 2 2 7867
gentamisin zalf 1 1 10000
novotwist 3 3 3061
52 nn. Edeltrudis 9/21/2016 mefnal 10 10 1749

claneksi 10 10 15817
braxidin 10 10 1166
53 ny. Santi 9/21/2016 mefnal 30 30 1749
54 an. Dionisius 9/21/2016 ranitidin 5 5 321

ondan tab 5 5 7288
zink syr 1 1 21834
L-bio 6 6 9275
55 ny. Siti aisyah 9/21/2016 episan syr 1 1 58656

flamar 50 10 10 2200
pain kila 1 1 13913
56 tn. Efendy 9/21/2016 sanmaag 10 10 1020
57 tn. Hai hoi 9/21/2016 mertigo SR 10 10 6029

xepalium 10 10 10931
domperidon 10 10 596
Ny.Darsini 9/21/2016 Loratadin 10 mg 15 15 441

Amlodipin 10 mg 15 15 2465
M.P mg 35 35 530
Cinolon cream 1 1 21465
Dexametasone tab 2 2 5300
Spuit 5 cc 1 1 2478
Tn.Yahusin 9/21/2016 Folley Cateter 16 1 1 20405

Urine bag 1 1 7288
Spuit 10 cc 1 1 3286
Nn.Lunaisih 9/21/2016 Novamox 500 10 10 1530

Asam mefenamat 10 10 400
Bisturi 1 1 4638
Spuit 1 cc 1 1 2849
Tn.Eko 9/21/2016 Metformin 500 15 15 265

Glimepirid 10 10 1378
Flamar 50 10 10 2200
Gemfbrozil 10 10 464
58 Tn. Misjani 9/22/2016 flamar 50mg 10 10 2200

pct tab 10 10 500
59 Tn. Abdul Kasim 9/22/2016 Inf set makro 1 1 10600

venflon 20 1 1 23186
ns 1 1 7867
spironolakton 25mg 1 1 539
isdn10mg 1 1 186
oksigen 50 50 250
60 Tn. Riki 9/22/2016 valisanbe 5mg 10 10 364
flamar 50mg 10 10 2200
mersibion tab 5 5
61 An. Muhammad A 9/22/2016 l-bio 3 3 9275

apialys drop 1 1 39750
62 Ny. Atminah 9/22/2016 loratadin tab 10 10 441

mp. 8mg 8 8 928
dexa inj 1 1 5300
spuit 1cc 1 1 2849
63 An. Leontius 9/22/2016 tremenza tab 2 2 1530

sanbe- plex drop 1 1 20670
64 An. Mokorius 9/22/2016 apialys syr 1 1 33125

sendok 1 1 1000
65 An. Nomerio 9/22/2016 apialys syr 1 1 33125

sendok 1 1 1000
66 An. Teodora 9/22/2016 edimin drop 1 1 50200
69 Tn.Sugiono 9/22/2016 M.P inj 1 1 51675

Aquadest 1 1 3312
Rl 3 3 8700
71 tn. M jaif 9/22/2016 amoxicilin 10 10 464

as. Mefenamat 10 10 400
lidocain 6 6 2186
spuit 5 cc 2 2 2478
72 Tn. Ova 9/23/2016 Pct Tab 15 15 500

Cerini 5 5 4108
Ambroxol 15 15 437
Carbidu Tab 15 15
Lostacef 10 10
Mersibion Tab 10 10
73 Ny. Nuraini 9/23/2016 Omeyus Kaps 14 14

Ranitidin Tab 20 20
74 Nn. Nuraiza 9/23/2016 Nuvamox Tab 15 15

Betadin Botol 1 1 8000
Hydrokortison Zalf 1 1 6000
Kassa 1 1 15000
75 Tn. Bambang 9/23/2016 Braxidin tab 15 15 1166

Alprazolam Tab 8 8 1060
76 An. Siti Hawa 3/23/2016 Cefadroxil Syr 1 1 45448

Opineacea Syr 1 1 66250
Anacetin Syr 1 1
77 Ny.Anie 9/23/2016 Opixime tab 10 10 390

Profenal tab 15 15 1789
78 nn. Marin 9/24/2016 carbidu 15 15 1000

cetirizin 10 10 530
braxidin 2 2 1166
spuit 3 cc 1 1 1895
dexa ink 1 1 6000
79 by. Rafa 9/24/2016 anacetin 1 1 15000

opinacea 1 1 66250
cendo xitrol 1 1 45540
0
0
80 an. Faids 9/24/2016 carbidu 10 10 1500
81 an. Faids 9/24/2016 cetirizin 10 10 530
82 ny. Klenteng 9/24/2016 ranitidin 14 14 321

omeyus 7 7 1500
mersibion 20 20 5500
83 ny. Sulastri 9/24/2016 simvastatin 5 5 749

metformin 500 20 20 265
ibuprofen 15 15 331
glibenclamid 5 mg 10 10 808
braxidin 10 10 1166
84 An.Jesika 9/24/2016 Ottopan syr 1 1 14575

Mucera syr 1 1 22525
Cetirizin syr 1 1 16231
Amoxan syr 1 1 49200
85 Nn.Tri 9/24/2016 Mersibion tab 5 5 5016
89 Tn. Sarmo 9/25/2016 dilavas 5 mg 10 10 2319
90 An.Aziz 9/25/2016 Anacetin syr 1 1 15000
91 by.arif 9/25/2016 ottopan syp 1 1 14575

zinkkid syp 1 1 20000
oralit 5 5 4640
92 Nn.Ambar 9/25/2016 Tremenza 10 10 1530

Profenal tab 10 10 1789
Carbidu tab 10 10 1000
Imunos tab 5 5 7656
93 An. Sannum 9/25/2016 sanmol drop 1 1 20551
94 An. Biandra 9/25/2016 cefadroxil syr 1 1 13037

acyclovir salep 2 2 3611
yarizin syr 1 1 39750
95 Nn. Yulia 9/25/2016 flamar 50mg 10 10 2200

ambroxol 10 10 437
cetirizin 5 5 530
96 An.Tasya 9/25/2016 Amoxan 250 tab 20 20 2000
97 Tn.M.Rizal 9/26/2016 Braxidin tab 10 10 1166

98 tn.parto 9/26/2016 mp 8 mg tab 5 5 46450
99 tn.asep 9/26/2016 cefadroxil caps 10 10 981

as.mef 10 10 1000
dispo 3cc 1 1 1895
100 an.zaskia 9/26/2016 dextafen tab 1 1 1458

pedimine drop 1 1 50200
rifampicin tab 4 4 1855
inh 4 4 1000
pyrazinamide 5 5 464
101 tn.paskalis 9/26/2016 spironolactone tab 30 30 700

lisinopril tab 30 30 1484
dicloflam 30 30 500
omeyus 15 15 1500
102 an.alifa 9/26/2016 l-bio 3 3 9275

oralit 2 2 928
103 Ny. Yohana 9/26/2016 Cefadroxil Caps 10 10 981

Mp 8 mg Tab 5 5 928
104 An. Felix 9/26/2016 Kalnex Tab 5 5
105 Ny. Samsuhana 9/26/2016 Furosemid tab 10 10 Rp 268

Fargoxin Tab 10 10 Rp 788
Lisinopril Tab 5 5 Rp 901
Spironolacton Tab 10 10 Rp 554
Omeyus Tab 10 10
106 An. Zhain 9/26/2016 Tramenza Tab 4 4 1530

Ambroxol Tab 4 4 437
Dextafen Tab 4 4 1458
Cetirizin Tab 3 3 530
107 An. Orva 9/26/2016 Omeyus Tab 10 10

Domperidon Tab 10 10 596
Atmacid Syr 1 1
108 An. Danang 9/26/2016 Cerini Tab 2 2 4108

Dextafen tab 2 2 1458
Topcort Zalf 1 1 29442
Farsycol Zalf 1 1
109 Ny. Umiatiah 9/26/2016 Ranitidin Tab 10 10 321

Atmacid Syr 1 1
110 An. Andien 9/26/2016 Ottopan Syr 1 1 14575
111 Tn. Bong Nyi 9/26/2016 Flamar 50 mg Tab 10 10 2200

Omeyus Tab 10 10
112 Ny. Anui 9/26/2016 cefadroxil tab 10 10 981

pct tab 10 10 300
omeyus tab 10 10
mersibion tab 10 10
113 Tn. Tutun 9/26/2016 Omeyus Tab 10 10

pct tab 10 10 500
114 Tn. Arlingga 9/26/2016 lidocain inj 4 4 2186
spuit 3cc 2 2 1895
spuit 1cc 1 1 2849
cefadroxil tab 10 10 981
asmef tab 15 15 400
ats 1 1 152375
115 Nn. Stefby 9/26/2016 omeyus 10 10 1500

pct tab 10 10 500
lodia 20 20 1200
116 Tn. Gumanto 9/27/2016 Braxidin Tab 10 10 1166
117 An. Abdul razak 9/27/2016 Decadexon Tab 3 3 649

Rifampisin Tab 5 5 1855
Pyrazinamid Tab 5 5 464
118 An. Guntur 9/27/2016 Sporetik Syr 1 1 99375

Mp 8 mg Tab 5 5 928
lafdryl Syr 1 1
Oroprofen Syr 1 1
119 Tn. Alok 9/27/2016 Renax Tab 15 15 15500

Ciprofloxacin Tab 10 10
Lisinopril Tab 20 20 901
120 Tn. Iskandar 9/27/2016 Braxidin tab 10 10 1166

Lafdryl Syr 1 1
121 Tn. Marthen 9/27/2016 clindamycin 300 10 10 1600

cetirizin 10 10 530
dextafen 10 10 1458
xepagel 1 1 182187
122 An. Lidya 9/27/2016 xepafen syr 1 1 29150

opinecea syr 1 1 66250
opiphen syr 1 1 26500
123 Tn. Deni 9/27/2016 mefnal 10 10 1749

spuit 3cc 1 1 1895
124 Tn.Puguh 9/27/2016 Valisanbe 2 mg 10 10 212

Penagon tab 10 10 2500
Vastigo tab 10 10 1312
125 An.Aisyah 9/27/2016 Zink kid syr 1 1 20000

L-Bio 3 3 9275
Norvom syr 1 1 5565
Oralit 3 3 1500
126 By.Adibah 9/27/2016 Interpec syr 1 1 29800

Spuit 3 cc 1 1 1895
127 Ny.Titik.S 9/27/2016 Cefadroxyl tab 6 6 981

Loratadin 3 3 441
128 Nn.Rizki 9/28/2016 Scopamin 10 10 2551

129 an.afkar 9/28/2016 opinacea syp 1 1 66250

ottopan syp 1 1 14575
ctm 2 2 92
130 ny.ajang 9/28/2016 meloxicam 15 tab 10 10 1577

ranitidine tab 10 10 321
mersibio 10 10 5500
131 An. Steven 9/28/2016 Ottopan Syr 1 1 14575

Opineacea Syr 1 1 66250
lafdryl Syr 1 1 15000
132 Ny. Haisyah 9/28/2016 Profnas Tab 10 10 464
Mersibion Tab 10 10
133 Ny. Sepiah 9/28/2016 Meloxicam 15 mg Tab 10 10 1577

Ranitidin Tab 10 10 321
Glukosamin Tab 10 10 3498
134 An. Alifa 9/28/2016 Pedimin Drop 1 1 50200
135 Ny. Ely k 9/28/2016 metformin 500 30 30 265

glibenclamid 5mg 10 10 808
omeprazole 20 20 1500
simvastatin 10mg 20 20 749
lapibal inj 1 1 28885
spuit 3cc 1 1 1895
Tn. Rahardyan 9/28/2016 cendo xitrol 1 1 45540
135 Tn. Diomedes 9/28/2016 pct tab 10 10 500

neurosanben tab 10 10 1385
An. Fahri 9/28/2016 anacetin syr 1 1

Tn. Putra 9/28/2016 amoxicillin tab 10 10 464

costam tab 10 10
iondone povidon 1 1 7420
Tn. David 9/28/2016 cefadroxil tab 6 6 981

costam tab 10 10
cinolon -n salep 1 1 23612
An. Arabella 9/28/2016 pedimine drop 1 1 51200

salicyl talk 1 1 10000
tn.zulfani 9/28/2016 kanamycin inj 10 10

ny.keslin 9/28/2016 lafdryl syp 1 1
ranitidine tab 10 10 321
curcuma tab 10 10 2000
mersibion tab 10 10
tn.sukir 9/28/2016 spuit 10cc 1 1 3286

venplon 20 1 1 32186
reco t.m 1 1 9275
an.krisha 9/28/2016 l-bio 10 10 9275

zinkkid syp 1 1 20000
amoxan syp 1 1 49200
oralit 10 10 928
pct drop 1 1 20551
tn.sumato 9/28/2016 na.dic 10 10 1000

ranitidine 10 10 321
dexa tab 10 10 2000
glukosamine 10 10 1623
SEPTEMBER 2016
HARGA JUMLAH JUMLAH HARGA

SATUAN HARGA HARGA TOTAL TOTAL
UMUM DPK
DPK UMUM DPK Rp. Rp.
Rp. Rp. Rp.
176,930 -
9,280 -
5,300 -
9,940 -
11,595 -
SUB TOTAL 213,045 - 213,045 213,045
10,609 -
4,000 -
SUB TOTAL 14,609 - 14,609 14,609
20,551 -
SUB TOTAL 20,551 - 20,551 20,551
21,465 -
7,290 -
2,650 -
2,500 -
92,055 -
SUB TOTAL 125,960 - 125,960 125,960
15,000 -
42,201 -
5,300 -
66,250 -
SUB TOTAL 128,751 - 128,751 128,751
15,000 -
SUB TOTAL 15,000 - 15,000 15,000
40,110 -
SUB TOTAL 40,110 - 40,110 40,110
35,000 -
SUB TOTAL 35,000 - 35,000 35,000
1000 - 10,000
15,300 -
17,490 -
SUB TOTAL 32,790 10,000 42,790 42,790
17,490 -
40000 - 40,000
SUB TOTAL 17,490 40,000 57,490 57,490
17,490 -
SUB TOTAL 17,490 - 17,490 17,490
4,638 -
2,849 -
26,235 -
SUB TOTAL 33,722 - 33,722 33,722
37,100 -
18,550 -
350 -
25,000 -
19,880 -
20,000 -
9,280 -
2,680 -
14,840 -
6,000 -
2,500 -
SUB TOTAL 156,180 - 156,180 156,180
15,000 -
437 -
1,458 -
530 -
1,750 -
SUB TOTAL 19,175 - 19,175 19,175
10,000 -
5,300 -
75,000 -
32,000 -
SUB TOTAL 122,300 - 122,300 122,300
2,205 -
5,000 -
SUB TOTAL 7,205 - 7,205 7,205
15,000 -
2,155 -
SUB TOTAL 17,155 - 17,155 17,155
11,000 -
7,950 -
7,395 -
4,040 -
13,913 -
5,101 -
SUB TOTAL 49,399 - 49,399 49,399
15,000 -
8,745 -
92,055 -
SUB TOTAL 115,800 - 115,800 115,800
10,600 -
23,186 -
7,867 -
14,575 -
11,880 -
6,200 -
3,732 -
186 -
176 -
SUB TOTAL 78,402 - 78,402 78,402
9,405 -
7,500 -
29,945 -
75,000 -
SUB TOTAL 121,850 - 121,850 121,850
3,496 -
1,060 -
15,000 -
5,000 -
SUB TOTAL 24,556 - 24,556 24,556
5,000 -
5,300 -
9,280 -
SUB TOTAL 19,580 - 19,580 19,580
3,900 -
21,834 -
39,750 -
SUB TOTAL 65,484 - 65,484 65,484
16,105 -
3,900 -
1,000 -
SUB TOTAL 21,005 - 21,005 21,005
41,080 -
15,000 -
SUB TOTAL 56,080 - 56,080 56,080
23,190 -
23,960 -
SUB TOTAL 47,150 - 47,150 47,150
5,000 -
10,000 -
36,440 -
SUB TOTAL 51,440 - 51,440 51,440
9,275 -
9,275 -
29,800 -
42,201 -
2,478 -
SUB TOTAL 93,029 - 93,029 93,029
2,780 -
1,926 -
6,360 -
SUB TOTAL 11,066 - 11,066 11,066
5,000 -
882 -
18,550 -
SUB TOTAL 24,432 - 24,432 24,432
4,640 -
44,598 -
4,370 -
SUB TOTAL 53,608 53,608 53,608
66,250 -
3,248 -
SUB TOTAL 69,498 - 69,498 69,498
8,312 -
10,600 -
52,470 -
15,000 -
SUB TOTAL 86,382 - 86,382 86,382
55,000 -
9,280 -
5,300 -
SUB TOTAL 69,580 - 69,580 69,580
6,000 -
1475 - 14,750
500 - 5,000
17,000 -
SUB TOTAL 42,750 5,000 47,750 47,750
17,000 -
6,360 -
5,000 -
500 - 5,000
SUB TOTAL 33,360 5,000 38,360 38,360
9,960 -
17,490 -
5,566 -
3,600 -
SUB TOTAL 36,616 - 36,616 36,616
45540 - 45,540
22,000 -
SUB TOTAL 67,540 45,540 113,080 113,080
7,950 -
2000 - 20,000
SUB TOTAL 27,950 20,000 47,950 47,950
1500 - 15,000
15,300 -
17,490 -
SUB TOTAL 47,790 - 47,790 47,790
5727 - 57,270
6,000 -
SUB TOTAL 63,270 57,270 120,540 120,540
35,000 -
SUB TOTAL 35,000 - 35,000 35,000
39,750 -
SUB TOTAL 39,750 - 39,750 39,750
176,930 -
9,000 -
15,000 -
SUB TOTAL 200,930 - 200,930 200,930
15,300 -
15,000 -
41,080 -
9,280 -
SUB TOTAL 80,660 - 80,660 80,660
15,000 -
42,201 -
48,000 -
5,000 -
2,500 -
SUB TOTAL 112,701 - 112,701 112,701
85,990 -
17,490 -
SUB TOTAL 103,480 - 103,480 103,480
14,575 -
8,745 -
SUB TOTAL 23,320 - 23,320 23,320
112,625 -
15,734 -
10,000 -
9,183 -
SUB TOTAL 147,542 - 147,542 147,542
17,490 -
158,170 -
11,660 -
SUB TOTAL 187,320 - 187,320 187,320
52,470 -
SUB TOTAL 52,470 - 52,470 52,470
1,605 -
36,440 -
2,500 -
21,834 -
55,650 -
SUB TOTAL 118,029 - 118,029 118,029
58,565 -
22,000 -
13,913 -
SUB TOTAL 94,478 - 94,478 94,478
10,200 -
SUB TOTAL 10,200 - 10,200 10,200
60,290 -
109,310 -
5,960 -
SUB TOTAL 175,560 - 175,560 175,560
6,615 -
36,975 -
18,550 -
21,465 -
10,600 -
2,478 -
SUB TOTAL 96,683 - 96,683 96,683
20,405 -
7,288 -
3,286 -
SUB TOTAL 30,979 - 30,979 30,979
15,300 -
4,000 -
4,638 -
2,849 -
2,186 -
SUB TOTAL 28,973 - 28,973 28,973
3,975 -
13,780 -
22,000 -
4,640 -
SUB TOTAL 44,395 - 44,395 44,395
22,000 -
5,000 -
3,210 -
SUB TOTAL 30,210 - 30,210 30,210
10,600 -
23,186 -
7,867 -
14,575 -
539 -
1,866 -
186 -
12,500 -
SUB TOTAL 71,319 - 71,319 71,319
3,640 -
22,000 -
5500 - 27,500
SUB TOTAL 25,640 27,500 53,140 53,140
27,825 -
39,750 -
SUB TOTAL 67,575 - 67,575 67,575
4,410 -
7,424 -
5,300 -
2,849 -
SUB TOTAL 19,983 - 19,983 19,983
3,060 -
2,500 -
20,670 -
SUB TOTAL 26,230 - 26,230 26,230
33,125 -
1,000 -
SUB TOTAL 34,125 - 34,125 34,125
33,125 -
1,000 -
SUB TOTAL 34,125 - 34,125 34,125
50,200 -
SUB TOTAL 50,200 - 50,200 50,200
51,675 -
66,250 -
3,312 -
7,492 -
26,100 -
SUB TOTAL 154,829 - 154,829 154,829
4,640 -
4,000 -
13,116 -
4,956 -
SUB TOTAL 26,712 - 26,712 26,712
7,500 -
20,540 -
6,555 -
8800 - 132,000
3200 - 32,000
5500 - 55,000
SUB TOTAL 34,595 219,000 253,595 253,595
2000 - 28,000
500 - 10,000
SUB TOTAL - 38,000 38,000 38,000
2000 - 30,000
8,000 -
6,000 -
15,000 -
SUB TOTAL 29,000 30,000 59,000 59,000
17,490 -
8,480 -
SUB TOTAL 25,970 - 25,970 25,970
45,448 -
66,250 -
15000 - 15,000
SUB TOTAL 111,698 15,000 126,698 126,698
503,263
3,900 -
26,835 -
17,490 -
SUB TOTAL 48,225 - 48,225 48,225
15,000 -
5,300 -
2,332 -
1,895 -
6,000 -
SUB TOTAL 30,527 - 30,527 30,527
15,000 -
66,250 -
45,540 -
SUB TOTAL 126,790 - 126,790 126,790
15,000 -
SUB TOTAL 15,000 - 15,000 15,000
5,300 -
SUB TOTAL 5,300 - 5,300 5,300
4,494 -
10,500 -
110,000 -
8,940 -
SUB TOTAL 133,934 - 133,934 133,934
3,745 -
5,300 -
4,965 -
8,080 -
11,660 -
SUB TOTAL 33,750 - 33,750 33,750
14,575 -
22,525 -
16,231 -
49,200 -
66,250 -
SUB TOTAL 168,781 - 168,781 168,781
25,080 -
SUB TOTAL 25,080 - 25,080 25,080
23,190 -
SUB TOTAL 23,190 - 23,190 23,190
15,000 -
SUB TOTAL 15,000 - 15,000 15,000
14,575
20,000
23,200
SUB TOTAL 57,775 57,775 57,775
15,300 -
17,890 -
10,000 -
38,280 -
SUB TOTAL 81,470 81,470 81,470
20,551 -
SUB TOTAL 20,551 20,551 20,551
13,037 -
7,222 -
39,750 -
SUB TOTAL 60,009 60,009 60,009
22,000 -
4,370 -
2,650 -
SUB TOTAL 29,020 29,020 29,020
40,000 -
SUB TOTAL 40,000 40,000 40,000
11,660 -
11,480 -
5,960 -
SUB TOTAL 29,100 29,100 29,100
46450
SUB TOTAL 46,450 46,450 46,450
9810
10000
4372
1895
SUB TOTAL 26,077 26,077 26,077
1458
5250
50200
7420
4000
2320
SUB TOTAL 70,648 70,648 70,648
21000
44520
15000
22500
SUB TOTAL 103,020 103,020 103,020
27825
1856
SUB TOTAL 29,681 29,681 29,681
9,810 -
4,640 -
SUB TOTAL 14,450 - 14,450 14,450
4000 - 20,000
SUB TOTAL - 20,000 20,000 20,000
2,680 -
7,880 -
4,505 -
5,540 -
1500 - 15,000
SUB TOTAL 20,605 15,000 35,605 35,605
6,120 -
1,748 -
5,832 -
1,590 -
3,000 -
SUB TOTAL 18,290 - 18,290 18,290
1500 - 15,000
5,960 -
15000 - 15,000
SUB TOTAL 5,960 30,000 35,960 35,960
8,216 -
2,916 -
2,500 -
29,442 -
10000 - 10,000
SUB TOTAL 43,074 10,000 53,074 53,074
3,210 -
5,960 -
15000 - 15,000
SUB TOTAL 9,170 15,000 24,170 24,170
14,575 -
SUB TOTAL 14,575 - 14,575 14,575
22,000 -
10,200 -
1500 - 15,000
SUB TOTAL 32,200 15,000 47,200 47,200
9,810 -
4,370 -
3,000 -
1500 - 15,000
5200 - 52,000
SUB TOTAL 17,180 67,000 84,180 84,180
1500 - 15,000
5,960 -
10,200 -
5,000 -
SUB TOTAL 21,160 15,000 36,160 36,160
8,744 -
3,790 -
2,849 -
9,810 -
6,000 -
152,375 -
SUB TOTAL 183,568 - 183,568 183,568
15,000 -
15,300 -
8,940 -
5,000 -
24,000 -
SUB TOTAL 68,240 - 68,240 68,240
11,660 -
SUB TOTAL 11,660 - 11,660 11,660
1,947 -
9,275 -
2,320 -
3,750 -
SUB TOTAL 17,292 - 17,292 17,292
99,375 -
4,640 -
2,500 -
15000 - 15,000
20000 - 20,000
SUB TOTAL 106,515 35,000 141,515 141,515
232,500 -
1000 - 10,000
18,020 -
SUB TOTAL 250,520 10,000 260,520 260,520
11,660 -
15000 - 15,000
SUB TOTAL 11,660 15,000 26,660 26,660
16,000 -
5,300 -
14,580 -
182,187 -
SUB TOTAL 218,067 - 218,067 218,067
29,150 -
66,250 -
26,500 -
SUB TOTAL 121,900 - 121,900 121,900
17,490 -
4,372 -
1,895 -
SUB TOTAL 23,757 - 23,757 23,757
2,120 -
25,000 -
13,120 -
SUB TOTAL 40,240 - 40,240 40,240
20,000 -
27,825 -
5,565 -
4,500 -
SUB TOTAL 57,890 - 57,890 57,890
29,800 -
1,895 -
SUB TOTAL 31,695 - 31,695 31,695
5,886 -
1,323 -
SUB TOTAL 7,209 - 7,209 7,209
25,510 -
3,210 -
SUB TOTAL 28,720 - 28,720 28,720
66,250 -
14,575 -
3,933 -
184 -
25,000 -
SUB TOTAL 109,942 - 109,942 109,942
15,770 -
3,210 -
55,000 -
SUB TOTAL 73,980 - 73,980 73,980
14,575 -
66,250 -
15,000 -
SUB TOTAL 95,825 - 95,825 95,825
4,640 -
5500 - 55,000
SUB TOTAL 4,640 55,000 59,640 59,640
15,770 -
3,210 -
34,980 -
SUB TOTAL 53,960 - 53,960 53,960
50,200 -
SUB TOTAL 50,200 - 50,200 50,200
7,950 -
8,080 -
30,000 -
14,980 -
28,885 -
1,895 -
SUB TOTAL 91,790 - 91,790 91,790
45,540 -
SUB TOTAL 45,540 - 45,540 45,540
5,000 -
13,850 -
SUB TOTAL 18,850 - 18,850 18,850
13500 - 13,500
66,250 -
SUB TOTAL 66,250 13,500 79,750 79,750
4,640 -
1000 - 10,000
7,420 -
SUB TOTAL 12,060 10,000 22,060 22,060
5,886 -
1000 - 10,000
23,612 -
SUB TOTAL 29,498 10,000 39,498 39,498
51200
10000
SUB TOTAL 61,200 61,200 61,200
11200 112000
SUB TOTAL 112,000 112,000 112,000 112,000
15000 15000
3210
20000
5500 55000
SUB TOTAL 93,210 70,000 93,210 93,210
3286
32186
9275
SUB TOTAL 44,747 44,747 44,747
92750
20000
49200
9280
20551
SUB TOTAL 191,781 191,781 191,781
10000
3210
20000
16230
SUB TOTAL 49,440 49,440 49,440
NO NAMA TANGGAL NAMA OBAT JML RETUR OBAT HARGA HARGA

PELAKSANAAN OBAT TERJUAL SATUAN SATUAN
UMUM DPK
Rp. Rp.
1 By. Clara 9/11/2016 venflon 26 1 1 51013
inf set miklro 1 1 19875
d5 % 1 1 8384
dexa inj 1 1 5300
farbiven 2 2 12000
spuit 5cc 1 1 2478
spuit 1cc 1 1 2849
spuit 10cc 1 1 3286
pct syr 1 1 3900
nasal kanul anak-anak 1 1 14575
9/12/2016 dexa inj 2 2 5300

farbiven 4 4 15000
aquades 1 1 3312
9/12/2016 ottopan drop 1 1 23288
9/13/2016 ambroxol 1 1 437

dextafen 1 1 1458
apyalis drop 1 1 39750
cetirizin 1 1 530
9/13/2016 dexa inj 2 2 5300

farbiven 4 4 15000
vemflon 26 6 6 51013
9/13/2016 clanexi syr 1 1 67686

oralit 2 2 1000
2 ny. Anyam 9/14/2016 RL 1 1 8700
wiacid 2 2 6100
ondan 4 mg 2 2 9794
recodryl 1 1 9275
spuit 5 cc 3 3 2478
mertigo 10 10 6029
avesco 5 5 9328
xepalium 10 10 10931
9/14/2016 vemflon 20 1 1 23186

9/15/2016 wiacid 2 2 6200

ondan 4mg 3 3 9794
rl 1 1 8700
9/15/2016 Inf Rl 3 3 8700
9/16/2016 mertigo SR 10 10 6029

xepalium 6 6 10931
3 by. Vigindoergano 9/16/2016 D5 1/2 NS 1 1 17159

vemflon 26 1 1 51013
vemflon 24 1 1 26235
ceftriaxone 1 1 24778
ondan 8 1 1 11880
valisanbe inj 1 1 17358
spuit 10 cc 1 1 3286
spuit 5 cc 1 1 2478
spuit 1 cc 1 1 2849
sanmol drop 1 1 20551
zink syr 1 1 21834
valisanbe tab 5 5 364
oralit 5 5 928
D5 1/4 NS 1 1 17159
4 Ny. Siti 9/16/2016 RL 3 3 8700

vemflon 22 2 2 23186
pumpitor 1 1 99800
ondan 8 mg 1 1 11880
buscopan 3 3 27825
ceftriaxon 2 2 24778
aquadest 1 1 3312
spuitb 10 cc 2 2 3286
spuit 5 cc 1 1 2478
spuit 1 cc 1 1 2849
episan 1 1 58568
molagit 10 10 636
oksigen 2100 2100 250
5 An. Anbaes 9/16/2016 Inf Rl 3 3 8700

Venflon 24 1 1 26235
Inf Set makro 1 1 10600
Pct Inf 1 1 65588
Sp 10 cc 1 1 3286
Zink Kid Syr 1 1 21834
9/16/2016 Inf Set makro 1 1 10600

dexa inj 1 1 5300
biocef inj 1 1 172250
aquadest 1 1 3312
spuitb 10 cc 1 1 3286
spuit 5 cc 2 2 2475
spuit 1 cc 3 3 2849
wiacid 1 1 6200
l-bio 3 3 9275
oralit 3 3 928
episan 1 1 58565
9/17/2016 dexa inj 1 1 5300
9/17/2016 wiacid 1 1 6200

cefotaxime 1 1 15304
9/17/2016 D5 1/2 NS 1 1 17159
9/18/2016 aquades 1 1 3312

rl 1 1 8700
d5 1/2 ns 1 1 19941
6 Ny. Sumiati 9/16/2016 spuitb 10 cc 2 2 2478

spuit 5 cc 1 1 2849
spuit 1 cc 2 2 3286
vemflon 20 1 1 23186
RL 3 3 8700
ketorolak inj 3 3 21863
wiacid inj 2 2 6200
terpacef inj 2 2 253075
ibuprofen tab 10 10 331
valisanbe 2mg 2 2 364
captopril 25mg 5 5 182
7 Tn. Zahariyudi 9/17/2016 nacl 3 3 7867

vemflon 20 1 1 23186
vemflon 22 1 1 23186
lidocain 1 1 2186
spuit 1 cc 2 2 2849
ketorolac 3 3 21863
wiacid 2 2 6200
spuit 5 cc 5 5 2478
sagestam 1 1 16105
9/17/2016 mp 8 mg 10 10 928
baquinor forte 10 10 17934
oksigen 500 500 250
9/17/2016 RL 1 1 8700
vemflon 20 2 2 23186
ketorolac 3 3 21863
wiacid 2 2 6200
oksigen 100 100 250
citicolin 250 1 1 39750
spuit 5 cc 3 3 2478
9/18/2016 ns 2 1 1 7867
ketorolak 3 2 1 21863
wiacid 2 2 6200
9/18/2016 mefnal 10 10 1749
8 Ny. Fui moi 9/18/2016 ns 2 2 7868

venflon 20 1 1 23186
wiacid inj 1 1 6200
pumpisel inj 1 1 177484
uresix inj 1 1 50018
spuit 5cc 3 3 2478
captopril 25mg 3 3 182
pct tab 10 10 500
dulcolax tab 2 2 1391
terpacef inj 1 1 253075
spuit 10cc 1 1 2478
spuit 1 cc 1 1 2849
9 Ny. Yuliana 9/18/2016 rl 2 2 8700

venflon 20 1 1 23186
ondan 8mg inj 2 2 11880
wiacid inj 1 1 6200
lodia 5 5 1700
molagit 10 10 636
antasida doen tab 10 10 56
spuit 5cc 3 3 2478
venflon 22 1 1 23186
cefotaxim inj 1 1 15304
spuit 1cc 1 1 2849
aquades 1 1 3312
9/18/2016 pct tab 10 10 500
9/18/2016 rl 2 2 8700
cefotaxime inj 2 2 15304
ondan 8 mg inj 3 3 11880
wiacid inju 2 2 6200
spuit 5cc 1 1 2478
9/18/2016 lexadon 10 10 1000

10 Tn. Egi 9/17/2016 rl 1 1 8700

venflon 20 2 2 23186
ketorolac in j 3 3 21863
wiacid inj 2 2 6200
nasalkanul 1 1 14575
oksigen 100 100 250
serfac 250mg inj 1 1 39750
spuit 5cc 3 3 2478
9/18/2016 rl 2 2 8700
ketorolac inj 3 3 21863
wiacid inj 2 2 6200
serfac 500 1 1 90567
o2 300 300 250
spuit 5cc 1 1 2478
9/18/2016 valisanbe 1 1 355

citicolin 500 2 2 76500
spuit 10 cc 1 1 3209
9/19/2016 Inf Rl 2 2 8700

Ketorolac Inj 1 1 21863
Wiacid Inj 2 2 3746
Serfac Inj 500 mg 1 1 87450
Sp 5 cc 1 1 2478
9/20/2016 flamar 50 mg 10 10 2200

opixime 100 mg 10 10 23375
citicolin 500 10 10 7884
11 ny.krispina 9/18/2016 terfacef inj 2 2 128248

nacl 3 3 7867
infus set macro 1 1 10600
venplon 20 1 1 23186
pumpitor inj 2 2 99800
ketorolac inj 3 3 21863
spuit 10cc 2 2 3286
spuit 5cc 3 3 2478
spuit 1cc 2 2 2849
braxidine tab 10 10 1166
sanmaag tab 10 6 4 1020
pct tab 10 10 500
9/18/2016 terfacef inj 2 2 128248

ketorolac inj 3 2 1 21863
ondan 8 mg inj 2 1 1 11880
nacl 3 3 0 7867
aquadest 1 1 3312
9/20/2016 ketorolac 3 3 21863

terfacef 1 1 128248
pumpitor 1 1 99800
nacl 3 3 7867
9/20/2016 Braxidin tab 5 5 1166
Disflatyl Tab 6 6 810
Vocefa Tab 4 4 13602
Celebrex tab 5 5 17693
12 Tn. Akiun 9/19/2016 Aminophylline inj 3 3 8004

tranex inj 3 3 8559
venflon 20 1 1 23186
rl 3 3 8700
farbiven inj 2 2 15000
spuit 10cc 2 2 3286
spuit 5cc 1 1 2478
amlodipin 10mg 5 5 2465
9/20/2016 ranitidin 2 2 5500

tranexid 3 2 1 13913
farbiven nebu 3 3 15000
RL 2 2 8700
aminophilin 3 3 8198
oksigen 400 400 250
9/20/2016 handscoon steril 1 1 13449

lidocain 10 4 6 2186
spuit 10 cc 1 1 3286
spuit 5 cc 1 1 2478
tranfusi set 1 1 0 30608
bisturi 1 1 4628
9/20/2016 Pct Tab 6 6 500

Ambroxol Tab 3 3 437
Aminopilin Inj 3 3 0 8198
9/21/2016 ketorolac inj 4 2 2 21863

rethapyl 1 1 5000
alprazolam 1 1 1060
Amitripilin 1 1 163
Ranitidin inj 6 5 1 3746
farbiven nebu 3 3 15000
Rl 2 2 8700
durogesik 25 1 1 273613
spuit 5cc 3 3 2478
9/22/2016 Ranitidin inj 2 2 3746

Ketorolac inj 4 4 0 21863
Tropigesik 6 6 1000
Alprazolam 1 1 1060
Amitripilin 1 1 163
Retapyl 2 2 4300
Rl 2 2 8700
9/23/2016 Inf Rl 1 1 8700

Ranitidin Inj 2 2 3746
Inj Keto 4 4 21863
Retapyl 5 5 3800
Amitripilin 5 5 163
Alprazolam Tab 1 1 1060
9/23/2016 dulcolax tab 10 10 1358

retapyl tab 10 10 3800
13 ny. Maria 9/19/2016 infus set makro 1 1 10600

vemflon 20 1 1 23186
RL 2 2 8700
serfac 500 1 1 0 87450
valesco 2 2 11660
spuit 10 cc 1 1 3286
spuit 5 cc 3 3 2478
ondan 8 mg 1 1 11880
ranitidin 2 2 5500
9/19/2016 aspilet 2 2 933

clopidogrel 4 4 19432
simvastatin 2 2 749
9/20/2016 citicolin 1 1 80325

aspilet 1 1 933
avesco 1 1 9328
RL 2 2 8700
9/20/2016 Citicolin Tab 10 10 7884

Aspilet tab 10 10 933
14 tn. Suyono 9/19/2016 infus set makro 1 1 10600

vemflon 22 1 1 23186
RL 2 2 8700
ranitidin 2 2 5500
MP inj 1 1 51675
spuit 5 cc 2 2 2478
spuit 1 cc 1 1 2849
cerini 10 10 4108
clindamycin 300 mg 10 10 1000
sagestam 1 1 16105
9/20/2016 ranitidin 1 1 5500

RL 2 2 8700
9/20/2016 ketorolak inj 3 3 21863

spuit 3cc 1 1 1895
9/21/2016 ceftriaxon inj 2 2 24778

MP inj 1 1 51675
ketorolak inj 6 6 21863
mycozid 200 5 5 2400
RL 3 3 8700
9/23/2016 Amlodipin Tab 5 5 2465

Lostacef Tab 10 10 3200
Mp 8 mg 20 20 928
Cetirizine Tab 15 15 530
15 an. Ferdy 9/20/2016 infus set macro 1 1 10600

vemflon 22 1 1 23186
RL 1 1 8700
cefotaxim 2 2 15304
aquadest 2 2 3312
spuit 1 cc 1 1 2849
spuit 10 cc 2 2 3286
ondan 8 mg 1 1 11880
spuit 5 cc 2 2 2478
pct inf 1 1 65588
9/22/2016 claneksi syr 1 1 67686
16 Tn. Juandang 9/20/2016 Inf Set Makro 1 1 10600

Venflon 20 1 1 23186
Inf Rl 3 3 8700
Ondan 8 mg Inj 2 2 11880
Metro Inf 3 3 72875
Sp 5 cc 1 1 2478
Molagit Tab 10 10 636
Lodia Tab 10 10 1700
9/22/2016 Ranitidine inj 4 4 3746

Ondan 8 mg 4 4 11880
Metronidazole inf 3 3 72875
Rl 3 3 8700
9/22/2016 Vastigo 6 6 1312

Xepalium 4 4 8539
9/23/2016 Inj Trovensis 4 mg 2 2 82481

Inf Rl 2 2 8700
Vastigo 5 5 1312
9/23/2016 Spuit 5 cc 3 3 2478
9/24/2016 RL 2 2 8700
ranitidin 2 2 5500
trovesis 4 mgf 3 3 82481
flunarizin 6 6 3000
9/24/2016 Megabal 3 3 2186
9/25/2016 Spuit 3 cc 2 2 1895

Ranitidin inj 2 2 3746
Vemplon 22 1 1 23186
Megabal tab 2 2 2186
9/26/2016 Inf Rl 2 2 8700

Trovensis 8 mg Inj 1 1 40474
Mertigo Sr 2 2 6029
Pct Tab 2 2 800
Megabal 2 2 2186
9/27/2016 Ranitidin Inj 2 2 3746

Trovensis 4 mg 1 1 82481
Megabal Tab 2 2 2186
Mertigo Sr 3 3 6029
Venflon 20 2 2 23186
Venflon 22 3 3 23186
9/28/2016 Ranitidin Inj 2 2 3746

Inf Rl 2 2 8700
Trovensis Inj 2 2 82481
Funar 10 10 7363
Mecobalamin Tab 10 10 2186
Vastigo Tab 10 10 1312
21 tn. Jatmo 9/21/2016 aquadest 1 1 3312

nacl 3 3 7867
vemflon 20 1 1 23186
spuit 10 cc 2 2 3286
spuit 5 cc 1 1 2478
spuit 1 cc 1 1 2849
citicolin 500 10 10 7884
rindobion 10 10 3200

Aquadest 1 1 3312
Nacl 2 2 7721
Folley cateter 16 1 1 20405
Urine bag 1 1 7288
Spuit 10 cc 1 1 3286
9/23/2016 Inj Citicolin 2 2 39750

Inf Ns 2 2 7721
Sp 3 cc 2 2 1895
9/23/2016 Amlodipin 10 mg 1 1 2465
9/24/2016 dilavas 5 mg 1 1 2319

nacl 3 3 7721
9/24/2016 CPG 10 10 19432
Aspilet 10 10 911
Simvastatin 10 10 10 731
Citicolin 500 tab 20 20 7884
22 an yufka 9/21/2016 Inf Set Makro 1 1 10600

venflon 22 1 1 23186
rl 2 2 8700
spuit 3cc 1 1 1895
pct tab 10 10 138
9/21/2016 cefotaxim inj 2 2 15304

aquades 2 2 3312
spuit 1cc 1 1 2849
spuit 10cc 2 2 3286
opinecea syr 1 1 66250
23 Tn. Najawar 9/22/2016 Inf set makro 1 1 10600

venflon 20 1 1 23186
rl 1 1 8700
spuit 5cc 3 3 2478
strocain 3 3 2551
braxidin 3 3 1166
9/23/2016 Inf Rl 3 3 8700

Inj Keto 6 6 21863
Syr Pralax 1 1 87450
Sp 5 cc 1 1 2478
Sp 1 cc 1 1 2849
Inj Pumpicel 1 1 200200
Ondan 8 2 2 11880
Buscopan Inj 3 3 27825
Sanmagh 3 3 1020
Braxidin Tab 3 3 1166
9/23/2016 Domperidone tab 10 10 596
Omeyus 10 10 1148
Stolax supp 1 1 7884
9/24/2016 NGT 18 1 1 25043

aquadest 1 1 3312
spuit 10 cc 1 1 3286
24 ny. Poniyah 9/22/2016 infus set makro 1 1 10600

vemflon 20 1 1 23186
nacl 3 3 7721
citicolin 250 mg 4 4 39750
serfac 500 2 2 81000
spuit 10 cc 5 5 3286
avesco 5 5 9328
9/23/2016 Inj Citicolin 250 mg 4 4 39750

Inf Ns 2 2 7721
9/24/2016 nacl 2 2 7721

9/24/2016 KSR 3 3 6000
9/25/2016 Vemplon 20 2 2 23186
9/26/2016 Ksr Tab 3 3 4770
9/27/2016 Citicolin 500 tab 20 20 7884

CPG 10 10 19500
Aspilet tab 10 10 933
Simvastatin tab 10 10 1000
25 ny. Laksmi 9/22/2016 ondan 8 mg 1 1 11880

nacl 3 3 7721
vemflon 20 1 1 23186
ranitidin 2 2 3746
pumpisel 2 2 200200
spuit 10 cc 2 2 3286
spuit 5 cc 2 2 2478
9/23/2016 Inf Ns 3 3 7,721

Inj Ranitidin 2 2 3,746
Inj Trovensis 4 mg 3 3 82,481
9/24/2016 dexa inj 3 3 5000

mefnal 3 3 1749
carbidu 1 1 2500
ranitidin 2 2 5500
trovesis 4 mg 2 2 82481
nacl 2 2 7721
9/24/2016 Flamar 50 5 5 2200

Carbidu tab 5 5 2500
26 An.Abdul.R 9/22/2016 Infus set mikro 1 1 19875

Vemplon 24 1 1 26235
D5 1/4 NS 1 1 17159
Cefotaxim inj 1 1 15304
Spuit 10 cc 1 1 3286
Spuit 1 cc 1 1 2849
Barotec 4 4 5000
Bisolvon 1 1 10000
9/22/2016 Paracetamol inf 1 1 65588
D5 1/4 NS 1 1 17159
Aquadest 1 1 3312
Spuit 10 cc 2 2 3286
Dexametason inj 1 1 5300
Spuit 5 cc 1 1 2478
Apialys drop 1 1 39750
Dextafen 1 1 1458
Cerini 1 1 4108
Valisanbe 2 mg 1 1 212
9/23/2016 Inj Cefotaxime 1 1 15304

Inf D5 1/4 Ns 2 2 17159
Berotec 1 1 9275
Bisolvon 1 1 9275
9/24/2016 Rifamfsin 1 1 1855

INH 4 4 182
Pyrazinamid 3 3 464
Aquadest 1 1 3312
Spuit 1 cc 1 1 2849
Spuit 10 cc 1 1 3286
28 ny. Cong bui cu 9/23/2016 nacl 1 1 7721

vemflon 20 1 1 23186
ondan 8 mg 1 1 11880
ranitidin 2 2 5500
spuit 5 cc 3 3 2478
vastigo 10 10 1312
xepalium 1 1 9500
recodryl 1 1 9275
9/23/2016 Inj Trofensis 4 mg Tab 3 3 82481
Inj Ranitidin 1 1 3746
Inf Ns 2 2 7721
29 an. Calysta 9/23/2016 D5 1/4 NS 1 1 17159

vemflon 24 1 1 26235
ondan 8 mg 1 1 11880
pct syr 1 1 6000
zink syr 1 1 20000
9/23/2016 Opinecea Syur 1 1 66250

Aquadest Inj 2 2 3312
Sp 1 cc 1 1 2849
Sp 10 cc 1 1 3286
Sp 3 cc 1 1 1859
Ottopan Syr 1 1 14575
9/24/2016 pct inf 1 1 65588

spuit 10 cc 1 1 3286
9/24/2016 sporetik 1 1 99375
30 Ny. Rabibah 9/23/2016 Inf Ns 4 4 7721

Venflon 20 1 1 23186
Sagestam Inj 1 1 11130
Dopamin Inj 1 1 169733
Sp 10 cc 1 1 2386
Sp 5 cc 2 2 2478
Sp 1 cc 2 2 2849
9/23/2016 urotractin 2 2 16814

9/24/2016 ceftriaxon 2 2 24778
sagestam 2 2 11130
9/24/2016 RL 2 2 8700
sagestam 2 2 11130
urotractin 2 2 8599
9/24/2016 sanmaag 10 10 1020

omeyus 10 10 1500

Sagestam inj 2 2 11130
Urotractin 1 1 8599
Rl 1 1 8700
Spuit 5 cc 3 3 2478
31 Tn.Ransang 9/23/2016 Rl 2 2 8700

Vemplon 20 1 1 23186
Ketorolac inj 3 3 21863
Spuit 3 cc 2 2 1895
Urotractin 10 10 8599
9/24/2016 stolax supp 1 1 7884

ketorolac 3 3 21863
urotractin 2 2 8599
rl 3 3 8700
9/24/2016 Bic.Nat 3 3 500
9/25/2016 Rl 2 2 8700
Ketorolac inj 3 3 21863
Bic.Nat 3 3 500
9/25/2016 stolax supp 1 1 7698
32 An.Gregorius 9/23/2016 Infus set makro 1 1 8700

Spuit 10 cc 1 1 3286
Vemplon 24 1 1 26235
Aquadest 1 1 3312
Spuit 1cc 1 1 2849
Dexametasone inj 1 1 5300
Spuit 3 cc 3 3 1895
Ondan 8 mg 1 1 11880
9/24/2016 D5 1/2 NS 2 2 17159

aquadest 1 1 3312
aspuit 10 cc 1 1 3286
dexa inj 1 1 5000
spuit 3 cc 2 2 1895
cefotaxim 1 1 15304
ranitidin 1 1 5500
9/24/2016 Cefotaxim inj 1 1 15304

Ranitidin in j 2 2 3746
Ondan 4 mg 2 2 9794
D51/2 Ns 3 3 17159
Spuit 1 cc 3 3 2849
33 An.Siti Hawa 9/23/2016 Vemplon 26 1 1 51013

Infus set mikro 1 1 19875
D5 1/4 NS 2 2 17159
Dexametasone inj 1 1 5300
Aquadest 1 1 3312
Spuit 10 cc 1 1 3286
Spuit 1 cc 2 2 2849
Ottopan syr 1 1 14575
9/23/2016 pctn inf 1 1 65588

spuit 10 cc 1 1 3286
ambroxol 2 2 437
dextafen 2 2 1458
tremenza 2 2 1530
valisanbe 2 2 364
9/24/2016 D5 1/4 NS 2 2 17159

dexa inj 1 1 5000
spuit 3 cc 1 1 1895
9/25/2016 Cefotaxim inj 3 3 15304

D5 1/2 Ns 3 3 17159
Spuit 1 cc 3 3 2849
9/25/2016 claneksi syr 1 1 67686

l-bio 3 3 9275
oralit 3 3 928
pyrazinamid 12 12 464
rifampicin 450 10 10 1855
decadoxin 8 8 649
34 tn. Zulfan 9/24/2016 braxidin 10 10 1166

omeprazol 10 10 1512
nacl 1 1 7618
vemflon 20 1 1 23186
pumpisel 1 1 200200
ondan 8 mg 2 2 11880
spuit 10 cc 1 1 3286
spuit 5 cc 1 1 2478
alprazolam 2 2 1060
35 An. Justin leoimanuel 9/25/2016 D5 1/2 Ns 1 1 17159

pct inf 1 1 65588
spuit 3cc 1 1 1895
venflon 24 1 1 26235
pct syr 1 1 3900
oralit 8 8 1500
rl 1 1 8700
spuit 10cc 1 1 3286
spuit 1cc 1 1 2849
9/26/2016 rl 2 2 8700
spuit 3cc 2 2 1895
cefotaxime inj 2 2 15304
aquadest 2 2 3312
spuit 1cc 1 1 2849
spuit 10cc 1 1 3286
l-bio 6 6 9275
oralit 3 3 928
9/26/2016 cefotaxime inj 1 1 33125

aquadest 1 1 3312
spuit 1cc 1 1 2849
spuit 10cc 1 1 3286
ctm 1 1 46
9/26/2016 Pct inf 1 1 65588

Spuit 10 cc 2 2 3286
Spuit 1 cc 1 1 2849
Aquadest 1 1 3312
9/27/2016 Trovensis 8 Mg Inj 1 1 82841
Ceftriaxon Inj 1 1 0 24778
Inf Rl 2 2 8700
Inf D5 1/4 Ns 1 1 19941
9/28/2016 Ondan 8 mg Inj 1 1 11880

Terfacef Inj 1 1 0 122257
Inf Rl 2 2 0 8700
Ceftriaxon Inj 1 1 0 24778
36 Ny. Laksmi 9/25/2016 inf set makro 1 1 10600

venflon 20 1 1 23186
rl 3 3 8700
ondan 4mg inj 3 1 2 9794
alprazolam 1 1 1060
braxidin 10 10 1166
spuit 10cc 1 1 3286
spuit 3cc 1 1 1895
9/26/2016 trovesis 2 ml 3 2 1 40479

alprazolame tab 1 1 1060
pumpicel inj 2 2 99800
rl 3 3 8700
clindamycin 3 3 1600
9/27/2016 Ranitidin Inj 2 2 0 3746

Sp 3 cc 1 1 1895
9/27/2016 Ondan 4 mg Inj 2 2 9794

Clindamycin Tab 3 3 1600
Nexium Tab 40 mg 3 3 24778
Inf Rl 3 3 8700
9/27/2016 Mucosta 100 mg 10 10 7100

Episan syr 1 1 57400
9/28/2016 Inj Ranitidin 2 2 3500
Inj Trovensis 2 2 82481
Domperidon tab 1 1 596
Clindamycin Tab 2 2 1600
Inf Rl 2 2 8700
9/28/2016 nexium 40 6 6 24778

domperidone tab 20 20 596
braxidine tab 18 18 1166
clindamycin 300 8 8 1600
37 Tn. Hendra 9/25/2016 inf set makro 1 1 10600

venflon 20 1 1 23186
rl 3 3 8700
braxidin 10 10 1166
spuit 10cc 1 1 3286
keltropen supp 1 1 33523
9/26/2016 Pumpisel Inj 1 1 99800

Inf Rl 3 3 8700
Ketorolac Inj 3 3 21863
Sp 1 cc 1 1 2849
38 tn.cong sin cux 9/26/2016 infus set macro 1 1 10600

venplon 20 1 1 23186
rl 1 1 8700
spuit 10cc 2 2 6572
spuit 5cc 1 1 2478
aquadest 1 1 3312
pumpicel inj 1 1 99800
serfac 1000 2 2 204050
o2 50 50 12500
39 tn.partro 9/26/2016 infus set macro 1 1 10600
venplon 20 1 1 23186
rl 1 1 8700
lapibal inj 1 1 28885
dispo 3cc 2 2 1895
9/26/2016 ranitidin tab 10 10 321

letonal 25mg 5 5 1484
kalnex tab 10 10 780
41 An. Fiki 9/26/2016 Inf Set Makro 1 1 10600

Venflon 22 3 3 23186
Inf Rl 3 3 8700
Ranitidinj Inj 2 2 3746
Ondan 8 mg Inj 3 3 7116
Sp 3 cc 2 2 1895
Antasida Syr 1 1 10000
9/26/2016 Ceftriaxon Inj 2 2 24778

Sp 5 cc 1 1 2478
Sp 1 cc 1 1 2849
9/26/2016 Inf Set Makro 1 1 10600

Venflon 22 2 2 23186
9/27/2016 zink tab 10 10 557

cefadroxil caps 10 10 981
42 An. Ali Wafa 9/26/2016 Inf Set Makro 1 1 10600

venflon 24 1 1 26235
d5 1/2 ns 1 1 17159
l-bio 3 3 9275
spuit 1cc 2 2 2849
9/26/2016 ceftriaxon inj 1 1 24778

spuit 10cc 1 1 3286
spuit 1cc 1 1 2849
9/26/2016 Sanmol drop 1 1 20551
9/26/2016 Rl 2 2 8700
Spuit 3 cc 2 2 1895
Oralit 2 2 928
Pct inf 1 1 65588
Spuit 10 cc 1 1 3286
Ny.Siti ( ibunya Ali ) 9/27/2016 Domperidone tab 10 10 596

Strocain tab 10 10 2551
An.Gregorius 9/27/2016 Inf Rl 3 3 8700

Psidii Syr 1 1 38955
44 Ny. Deri 9/27/2016 Nasal Canul 1 1 14575

Inf Rl 1 1 8700
Venflon 22 1 1 23186
Inf Set Makro 1 1 10600
Pumpitor Inj 1 1 99800
Sp 10 cc 1 1 3286
O2 50 50 250
Isdn 5 mg Tab 1 1 186
Cpg Tab 3 3 19923
45 Ny. Katimah 9/27/2016 Inf Rl 3 3 8700

Venflon 22 1 1 23186
Spuit 3 cc 2 2 1895
9/28/2016 Inf Rl 2 2 8700

9/28/2016 wiacid inj 1 1 6200

Spuit 3 cc 2 2 1895
46 Ny. Sumiati 9/27/2016 Inf Rl 1 1 8700

Venflon 22 1 1 23186
pumpitor inj 1 1 99800
spuit 10cc 2 2 3286
spuit 1cc 1 1 2849
urutractin 10 10 8599
9/28/2016 Terfacef Inj 1 1 122257

Dotramadol 10 10 2511
Inf Rl 2 2 8700
47 Tn.Hadi 9/27/2016 Infus set makro 1 1 10600

Vemplon 20 1 1 23186
Nacl 3 3 7721
Pumpisel inj 2 2 99800
Aquadest 1 1 3312
Spuit 5 cc 1 1 2478
Domperidon tab 10 10 596
Lisinopril tab 5 5 901
9/28/2016 Paracetamol Inf 1 1 92625
Inf Ns 2 2 7618
48 An.Gebi 9/27/2016 D5 % 1 1 8312

Vemplon 24 1 1 26235
Spuit 3 cc 1 1 1895
Aquadest 1 1 3312
Spuit 1 cc 1 1 2849
9/28/2016 l - bio 2 2 9275
9/28/2016 pct inf 1 1 92625

spuit 10cc 1 1 3286
Ny. Saniyem 9/28/2016 rl 1 1 8700

venflon 22 2 2 23186
spuit 10cc 1 1 3286
spuit 1cc 1 1 2849
aquades 1 1 3312
9/28/2016 amlodipin 10mg 10 10 2465

glibenclamid 5mg 10 10 808
BER 2016
JUMLAH JUMLAH UMUM DPK HARGA

HARGA HARGA TOTAL TOTAL
UMUM DPK Rp. Rp.
Rp. Rp.
51,013 -
19,875 -
8,384 -
5,300 -
253,075 -
24,000 -
2,478 -
2,849 -
3,286 -
3,900 -
14,575 -
SUB TOTAL 388,735 - 388,735 388,735
10,600 -
128,248 -
60,000 -
3,312 -
SUB TOTAL 202,160 - 202,160 202,160
23,288 -
SUB TOTAL 23,288 - 23,288 23,288
437 -
1,458 -
1,200 -
39,750 -
530 -
SUB TOTAL 43,375 - 43,375 43,375
10,600 -
60,000 -
306,078 -
19,875 -
SUB TOTAL 396,553 - 396,553 396,553
67,686 -
2,000 -
SUB TOTAL 69,686 - 69,686 69,686
8,700 -
12,200 -
19,588 -
9,275 -
7,434 -
60,290 -
46,640 -
109,310 -
SUB TOTAL 273,437 - 273,437 273,437
23,186 -
10,600 -
SUB TOTAL 33,786 - 33,786 33,786
12,400 -
29,382 -
8,700 -
SUB TOTAL 50,482 - 50,482 50,482
26,100 -
SUB TOTAL 26,100 - 26,100 26,100
60,290 -
65,586 -
SUB TOTAL 125,876 125,876 251,752 251,752
GRAND TOTAL 635,557
17,159 -
51,013 -
26,235 -
19,875 -
24,778 -
11,880 -
17,358 -
3,286 -
2,478 -
2,849 -
20,551 -
21,834 -
16,231 -
1,820 -
4,640 -
17,159 -
SUB TOTAL 259,146 - 259,146 259,146
26,100 -
46,372 -
10,600 -
99,800 -
11,880 -
83,475 -
49,556 -
3,312 -
6,572 -
2,478 -
2,849 -
5,960 -
58,568 -
6,360 -
SUB TOTAL 413,882 - 413,882 413,882
525,000 -
SUB TOTAL 525,000 - 525,000 525,000
GRAND TOTAL 938,882
26,100 -
26,235 -
10,600 -
65,588 -
3,286 -
21,834 -
SUB TOTAL 153,643 - 153,643 153,643
10,600 -
5,300 -
172,250 -
3,312 -
3,286 -
4,950 -
8,547 -
6,200 -
27,825 -
2,784 -
58,565 -
SUB TOTAL 303,619 - 303,619 303,619
5,300 -
SUB TOTAL 5,300 - 5,300 5,300
6,200 -
15,304 -
SUB TOTAL 21,504 - 21,504 21,504
17,159 -
SUB TOTAL 17,159 - 17,159 17,159
3,312 -
8,700 -
19,941 -
SUB TOTAL 31,953 - 31,953 31,953
GRAND TOTAL 533,178
4,956 -
2,849 -
6,572 -
10,600 -
23,186 -
26,100 -
65,589 -
12,400 -
506,150 -
3,310 -
728 -
910 -
SUB TOTAL 663,350 - 663,350 663,350
GRAND TOTAL 663,350
23,601 -
10,600 -
23,186 -
23,186 -
2,186 -
5,698 -
65,589 -
12,400 -
12,390 -
14,575 -
16,105 -
SUB TOTAL 209,516 - 209,516 209,516
9,280 -
179,340 -
125,000 -
SUB TOTAL 313,620 - 313,620 313,620
8,700 -
46,372 -
10,600 -
65,589 -
12,400 -
14,575 -
25,000 -
39,750 -
7,434 -
SUB TOTAL 230,420 - 230,420 230,420
7,867 -
21,863 -
12,400 -
SUB TOTAL 42,130 - 42,130 42,130
17,490 -
SUB TOTAL 17,490 - 17,490 17,490
GRAND TOTAL 813,176
15,736 -
10,600 -
23,186 -
6,200 -
177,484 -
50,018 -
7,434 -
546 -
5,000 -
1,311 -
2,782 -
253,075 -
2,478 -
2,849 -
SUB TOTAL 558,699 - 558,699 558,699
17,400 -
10,600 -
23,186 -
23,760 -
6,200 -
8,500 -
6,360 -
560 -
7,434 -
23,186 -
15,304 -
2,849 -
3,312 -
SUB TOTAL 148,651 - 148,651 148,651
5,000 -
SUB TOTAL 5,000 - 5,000 5,000
17,400 -
30,608 -
35,640 -
12,400 -
2,478 -
SUB TOTAL 98,526 - 98,526 98,526
10,000 -
10,200 -
SUB TOTAL 20,200 - 20,200 20,200
GRAND TOTAL 272,377
8,700 -
46,372 -
10,600 -
65,589 -
12,400 -
14,575 -
25,000 -
39,750 -
7,434 -
SUB TOTAL 230,420 - 230,420 230,420
17,400 -
65,589 -
12,400 -
90,567 -
75,000 -
2,478 -
SUB TOTAL 263,434 - 263,434 263,434
355 -
153,000 -
3,209 -
SUB TOTAL 156,564 - 156,564 156,564
17,400 -
21,863 -
7,492 -
87,450 -
2,478 -
SUB TOTAL 136,683 - 136,683 136,683
22,000 -
233,750 -
78,840 -
SUB TOTAL 334,590 - 334,590 334,590
256,496 -
23,601 -
10,600 -
23,186 -
199,600 -
65,589 -
6,572 -
7,434 -
23,760 -
5,698 -
11,660 -
4,080 -
5,000 -
SUB TOTAL 643,276 - 643,276 643,276
256,496 -
21,863 -
11,880 -
- -
3,312 -
SUB TOTAL 293,551 - 293,551 293,551
65,589 -
128,248 -
99,800 -
23,601 -
SUB TOTAL 317,238 - 317,238 317,238
5,830
4,860
54,408
88,465
SUB TOTAL 153,563 - 153,563 153,563
24,012 -
25,677 -
10,600 -
23,186 -
26,100 -
30,000 -
6,572 -
2,478 -
14,575 -
12,325 -
4,980 -
SUB TOTAL 180,505 - 180,505 180,505
11,000 -
13,913 -
45,000 -
17,400 -
24,594 -
100,000 -
SUB TOTAL 211,907 - 211,907 211,907
13,449 -
13,116 -
3,286 -
2,478 -
- -
4,628 -
SUB TOTAL 36,957 - 36,957 36,957
3,000 -
1,311 -
- -
SUB TOTAL 4,311 - 4,311 4,311
43,726 -
5,000 -
1,060 -
163 -
1,311 -
3,746 -
45,000 -
17,400 -
273,613 -
7,434 -
SUB TOTAL 398,453 - 398,453 398,453
7,492 -
- -
1,311 -
6,000 -
1,060 -
163 -
8,600 -
17,400 -
SUB TOTAL 42,026 - 42,026 42,026
8,700 -
7,492 -
87,452 -
19,000 -
815 -
1,060 -
4,370 -
SUB TOTAL 128,889 - 128,889 128,889
13,580 -
3,210 -
38,000 -
SUB TOTAL 54,790 - 54,790 54,790
10,600 -
23,186 -
17,400 -
- -
23,320 -
933 -
3,286 -
7,434 -
11,880 -
11,000 -
SUB TOTAL 109,039 - 109,039 109,039
1,866 -
77,728 -
1,498 -
SUB TOTAL 81,092 - 81,092 81,092
80,325 -
933 -
9,328 -
17,400 -
SUB TOTAL 107,986 - 107,986 107,986
78,840 -
9,330 -
SUB TOTAL 88,170 - 88,170 88,170
GRAND TOTAL 386,287
10,600 -
23,186 -
17,400 -
11,000 -
51,675 -
4,956 -
2,849 -
41,080 -
10,000 -
2,465 -
16,105 -
SUB TOTAL 191,316 - 191,316 191,316
5,500 -
2,465 -
17,400 -
SUB TOTAL 25,365 - 25,365 25,365
65,589 -
1,895 -
SUB TOTAL 67,484 - 67,484 67,484
49,556 -
5,500 -
51,675 -
131,178 -
12,315 -
12,000 -
26,100 -
SUB TOTAL 288,324 - 288,324 288,324
12,325 -
- 32,000
18,560 -
7,950 -
SUB TOTAL 38,835 32,000 70,835 70,835
GRAND TOTAL 643,324
10,600 -
23,186 -
8,700 -
30,608 -
6,624 -
2,849 -
6,572 -
11,880 -
5,500 -
4,956 -
65,588 -
66,250 -
SUB TOTAL 243,313 - 243,313 243,313
67,686 -
SUB TOTAL 67,686 - 67,686 67,686
GRAND TOTAL 310,999
10,600 -
23,186 -
26,100 -
23,760 -
218,625 -
2,478 -
6,360 -
17,000 -
SUB TOTAL 328,109 - 328,109 328,109
14,984 -
47,520 -
218,625 -
26,100 -
SUB TOTAL 307,229 - 307,229 307,229
7,872 -
34,156 -
SUB TOTAL 42,028 - 42,028 42,028
164,962 -
17,400 -
6,560 -
SUB TOTAL 188,922 - 188,922 188,922
7,434 -
SUB TOTAL 7,434 - 7,434 7,434
17,400 -
11,000 -
247,443 -
18,000 -
SUB TOTAL 293,843 - 293,843 293,843
6,558 -
SUB TOTAL 6,558 - 6,558 6,558
3,790 -
7,492 -
23,186 -
10,600 -
4,372 -
SUB TOTAL 49,440 - 49,440 49,440
17,400 -
7,492 -
40,474 -
12,058 -
1,600 -
4,372 -
SUB TOTAL 83,396 - 83,396 83,396
7,492 -
82,481 -
4,372 -
18,087 -
46,372 -
69,558 -
SUB TOTAL 228,362 - 228,362 228,362
7,492 -
17,400 -
164,962 -
73,630 -
21,860 -
13,120 -
SUB TOTAL 298,464 - 298,464 298,464
3,312 -
23,601 -
23,186 -
49,556 -
6,572 -
2,478 -
2,849 -
9,330 -
194,320 -
78,840 -
32,000 -
SUB TOTAL 426,044 - 426,044 426,044
66,250 -
3,312 -
15,442 -
20,405 -
7,288 -
3,286 -
SUB TOTAL 115,983 - 115,983 115,983
79,500 -
15,442 -
3,790 -
SUB TOTAL 98,732 - 98,732 98,732
2,465 -
SUB TOTAL 2,465 - 2,465 2,465
2,319 -
23,163 -
SUB TOTAL 25,482 - 25,482 25,482
194,320 -
9,110 -
7,310 -
157,680 -
SUB TOTAL 368,420 - 368,420 368,420
10,600 -
23,186 -
17,400 -
11,000 -
1,895 -
1,380 -
SUB TOTAL 65,461 - 65,461 65,461
30,608 -
6,624 -
2,849 -
6,572 -
66,250 -
SUB TOTAL 112,903 - 112,903 112,903
GRAND TOTAL 178,364
10,600 -
23,186 -
8,700 -
7,492 -
23,760 -
83,475 -
7,434 -
7,653 -
3,498 -
SUB TOTAL 175,798 - 175,798 175,798
26,100 -
131,178 -
87,450 -
2,478 -
2,849 -
200,200 -
23,760 -
- 83,475
3,060 -
3,498 -
SUB TOTAL 564,048 564,048 564,048
5,960 -
- 11,480
7,884 -
SUB TOTAL 25,324 25,324
25,043 -
3,312 -
3,286 -
SUB TOTAL 31,641 31,641
GRAND TOTAL 796,811
10,600 -
23,186 -
23,163 -
159,000 -
162,000 -
16,430 -
4,665 -
97,500 -
46,640 -
SUB TOTAL 543,184 - 543,184 543,184
159,000 -
15,442 -
SUB TOTAL 174,442 - 174,442 174,442
15,442 -
10,600 -
SUB TOTAL 26,042 - 26,042 26,042
18,000 -
SUB TOTAL 18,000 - 18,000 18,000
46,372 -
SUB TOTAL 46,372 - 46,372 46,372
14,310 -
SUB TOTAL 14,310 - 14,310 14,310
157,680 -
195,000 -
9,330 -
10,000 -
SUB TOTAL 372,010 - 372,010 372,010
11,880 -
23,163 -
23,186 -
10,600 -
7,492 -
400,400 -
6,572 -
4,956 -
5,960 -
SUB TOTAL 494,209 - 494,209 494,209
23,163 -
7,492 -
247,443 -
SUB TOTAL 278,098 - 278,098 278,098
15,000 -
5,247 -
2,500 -
11,000 -
164,962 -
15,442 -
SUB TOTAL 214,151 - 214,151 214,151
11,000 -
12,500 -
4,640 -
SUB TOTAL 28,140 - 28,140 28,140
19,875 -
26,235 -
17,159 -
15,304 -
3,286 -
2,849 -
20,000 -
10,000 -
SUB TOTAL 114,708 - 114,708 114,708
65,588 -
17,159 -
15,304 -
3,312 -
6,572 -
5,300 -
2,478 -
39,750 -
437 -
1,458 -
4,108 -
2,500 -
212 -
SUB TOTAL 164,178 - 164,178 164,178
15,304 -
34,318 -
9,275 -
9,275 -
SUB TOTAL 68,172 - 68,172 68,172
1,855 -
728 -
1,392 -
3,750 -
24,778 -
3,312 -
2,849 -
3,286 -
SUB TOTAL 41,950 - 41,950 41,950
GRAND TOTAL 389,008
7,721 -
23,186 -
10,600 -
11,880 -
11,000 -
7,434 -
13,120 -
9,500 -
9,275 -
SUB TOTAL 103,716 - 103,716 103,716
247,443 -
3,746 -
15,442 -
SUB TOTAL 266,631 - 266,631 266,631
GRAND TOTAL 370,347
17,159 -
26,235 -
10,600 -
11,880 -
6,000 -
20,000 -
SUB TOTAL 91,874 - 91,874 91,874
66,250 -
6,624 -
2,849 -
3,286 -
1,859 -
14,575 -
SUB TOTAL 95,443 - 95,443 95,443
65,588 -
3,286 -
SUB TOTAL 68,874 - 68,874 68,874
99,375 -
SUB TOTAL 99,375 - 99,375 99,375
GRAND TOTAL 355,566
30,884 -
10,600 -
23,186 -
33,125 -
11,130 -
169,733 -
2,386 -
4,956 -
5,698 -
SUB TOTAL 291,698 - 291,698 291,698
33,628 -
SUB TOTAL 33,628 - 33,628 33,628
49,556 -
22,260 -
SUB TOTAL 71,816 - 71,816 71,816
17,400 -
49,556 -
22,260 -
17,198 -
SUB TOTAL 106,414 - 106,414 106,414
10,200 -
15,000 -
SUB TOTAL 25,200 - 25,200 25,200
49,556 -
22,260 -
8,599 -
8,700 -
7,434 -
SUB TOTAL 89,115 - 89,115 89,115
17,400 -
10,600 -
23,186 -
7,492 -
65,589 -
3,790 -
85,990 -
SUB TOTAL 214,047 - 214,047 214,047
7,884 -
7,492 -
65,589 -
17,198 -
26,100 -
SUB TOTAL 124,263 - 124,263 124,263
1,500 -
SUB TOTAL 1,500 - 1,500 1,500
17,400 -
7,492 -
65,589 -
1,500 -
SUB TOTAL 91,981 - 91,981 91,981
7,698 -
SUB TOTAL 7,698 - 7,698 7,698
8,700 -
3,286 -
26,235 -
24,778 -
3,312 -
2,849 -
5,300 -
5,685 -
11,880 -
3,746 -
SUB TOTAL 95,771 - 95,771 95,771
34,318 -
3,312 -
3,286 -
5,000 -
3,790 -
15,304 -
5,500 -
SUB TOTAL 70,510 - 70,510 70,510
15,304 -
SUB TOTAL 15,304 - 15,304 15,304
24,778 -
7,492 -
19,588 -
51,477 -
8,547 -
SUB TOTAL 111,882 - 111,882 111,882
GRAND TOTAL 293,467
51,013 -
19,875 -
34,318 -
5,300 -
15,304 -
3,312 -
3,286 -
5,698 -
14,575 -
SUB TOTAL 152,681 - 152,681 152,681
65,588 -
3,286 -
874 -
2,916 -
3,060 -
2,500 -
728 -
1,500 -
SUB TOTAL 80,452 - 80,452 80,452
34,318 -
5,000 -
1,895 -
SUB TOTAL 41,213 - 41,213 41,213
45,912 -
51,477 -
8,547 -
SUB TOTAL 105,936 - 105,936 105,936
67,686 -
20,000 -
27,825 -
2,784 -
5,568 -
18,550 -
5,192 -
7,500 -
SUB TOTAL 155,105 - 155,105 155,105
GRAND TOTAL 535,387
11,660 -
15,120 -
5,960 -
7,618 -
23,186 -
10,600 -
200,200 -
23,760 -
3,286 -
2,478 -
2,120 -
SUB TOTAL 305,988 - 305,988 305,988
17,159 -
65,588 -
19,588 -
1,895 -
26,235 -
10,600 -
3,900 -
20,000 -
12,000 -
66,250 -
8,700 -
3,286 -
2,849 -
SUB TOTAL 258,050 - 258,050 258,050
17,400 -
23,760 -
3,746 -
3,790 -
30,608 -
6,624 -
2,849 -
3,286 -
55,650 -
2,784 -
SUB TOTAL 150,497 - 150,497 150,497
33,125 -
3,312 -
2,849 -
3,286 -
46 -
SUB TOTAL 42,618 - 42,618 42,618
65,588 -
6,572 -
24,778 -
2,849 -
3,312 -
SUB TOTAL 103,099 - 103,099 103,099
82,841 -
3,746 -
- -
17,400 -
19,941 -
SUB TOTAL 123,928 - 123,928 123,928
11,880 -
- -
- -
- -
SUB TOTAL 11,880 - 11,880 11,880
GRAND TOTAL 690,072
10,600 -
23,186 -
26,100 -
99,800 -
19,588 -
5,960 -
1,060 -
11,660 -
3,286 -
1,895 -
SUB TOTAL 203,135 - 203,135 203,135
40479
1060
199600
26100
4800
SUB TOTAL 272,039 272,039 272,039
- -
1,895 -
SUB TOTAL 1,895 - 1,895 1,895
19,588 -
4,800 -
74,334 -
26,100 -
SUB TOTAL 124,822 - 124,822 124,822
71,000 -
57,400 -
SUB TOTAL 128,400 - 128,400 128,400
7,000 -
164,962 -
596 -
2,332 -
3,200 -
17,400 -
SUB TOTAL 195,490 - 195,490 195,490
148668
11920
20988
12800
SUB TOTAL 194,376 194,376 194,376
10,600 -
23,186 -
26,100 -
99,800 -
5,960 -
11,660 -
3,286 -
33,523 -
SUB TOTAL 214,115 - 214,115 214,115
99,800 -
26,100 -
65,589 -
2,849 -
SUB TOTAL 194,338 - 194,338 194,338
GRAND TOTAL 408,453
10,600 -
23,186 -
8,700 -
13,144 -
33,125 -
2,478 -
3,312 -
99,800 -
408,100 -
14,575 -
625,000 -
SUB TOTAL 1,242,020 - 1,242,020 1,242,020
10,600 -
23,186 -
8,700 -
3,746 -
28,885 -
9,010 -
3,790 -
SUB TOTAL 87,917 - 87,917 87,917
3,210 -
7,420 -
- 7,800
SUB TOTAL 10,630 7,800 18,430 18,430
GRAND TOTAL 106,347
10,600 -
69,558 -
26,100 -
7,492 -
21,348 -
3,790 -
- 10,000
SUB TOTAL 138,888 10,000 148,888 148,888
49,556 -
2,478 -
2,849 -
SUB TOTAL 54,883 - 54,883 54,883
10,600 -
46,372 -
SUB TOTAL 56,972 - 56,972 56,972
5570
9810
5960
SUB TOTAL 21,340 21,340 21,340
GRAND TOTAL 282,083
10,600 -
26,235 -
17,159 -
3,500 -
19,588 -
27,825 -
20,000 -
5,698 -
SUB TOTAL 130,605 - 130,605 130,605
24,778 -
3,286 -
2,849 -
SUB TOTAL 30,913 - 30,913 30,913
20,551 -
SUB TOTAL 20,551 - 20,551 20,551
17,400 -
5,300 -
3,790 -
1,856 -
65,588 -
3,286 -
SUB TOTAL 97,220 - 97,220 97,220
5,960 -
57,400 -
25,510 -
SUB TOTAL 88,870 - 88,870 88,870
GRAND TOTAL 368,159
26,100 -
38,955 -
SUB TOTAL 65,055 - 65,055 65,055
GRAND TOTAL 65,055
14,575 -
8,700 -
23,186 -
10,600 -
99,800 -
3,286 -
12,500 -
186 -
59,769 -
SUB TOTAL 232,602 - 232,602 232,602
26,100 -
23,186 -
10,600 -
7,000 -
3,790 -
SUB TOTAL 70,676 - 70,676 70,676
17,400 -
7,408 -
21,200 -
SUB TOTAL 46,008 - 46,008 46,008
6,200 -
3,790 -
9,227 -
10,200 -
SUB TOTAL 29,417 - 29,417 29,417
8,700 -
23,186 -
10,600 -
99,800 -
66,250 -
6,572 -
2,849 -
85,990 -
SUB TOTAL 303,947 - 303,947 303,947
122,257 -
- 25,110
17,400 -
24,778 -
SUB TOTAL 164,435 25,110 189,545 189,545
10,600 -
23,186 - -
23,163 -
199,600 -
3,312 -
2,478 -
5,960 -
57,400 -
4,505 -
SUB TOTAL 330,204 - 330,204 330,204
92,625 -
15,236 -
SUB TOTAL 107,861 107,861 107,861
8,312 -
10,600 -
26,235 -
1,895 -
3,312 -
10,600 -
2,849 -
SUB TOTAL 171,664 - 171,664 171,664
18,550 -
SUB TOTAL 18,550 - 18,550 18,550
92,625 -
3,286 -
SUB TOTAL 95,911 - 95,911 95,911
8,700 -
46,372 -
10,600 -
66,250 -
3,286 -
2,849 -
3,312 -
SUB TOTAL 141,369 - 141,369 141,369
24,650 -
8,080 -
SUB TOTAL 32,730 - 32,730 32,730

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LAPORAN UMUM BULAN JUNI 2016

5/1/2016 Lansoprazol Tab 10 10 1855 18,550

2 Tn. Siman 5/30/2016 Inf Set Makro 1 1 10600 10,600

5/31/2016 Asering Inf 2 2 21725 43,450

5/31/2016 Tramadol Inj 6 6 0 12521 -

6/1/2016 Coditam Tab 10 10 4810 48,100

3 Tn. Agus 6/1/2016 Amoxicilin tab 10 10 464 4,640

4 Ny. Puni 6/1/2016 Cefadoxil Tab 10 10 981 9,810

5 Ny. Sayuk 6/1/2016 Inf Set makro 1 1 10600 10,600

6 An. M Sholihudin 6/1/2016 Amoxicilin Tab 10 10 464 4,640

7 Tn. Dalil 6/1/2016 Valesco Tab 20 20 11660 233,200

8 Nn. Julia 5/30/2016 Inf Set makro 1 1 10600 10,600

5/31/2016 Inf Ns 2 2 7721 15,442

5/31/2016 Tradosik Inj 2 2 18550 37,100

6/1/2016 Inf NS 2 2 7721 15,442

6/1/2016 Thramed Tab 10 10 3000 30,000

9 Tn. Manwi 6/1/2016 Lansoprazol Tab 5 5 1855 9,275

10 Tn. Edo 6/1/2016 Flamicort Inj 1 1 109180 109,180

11 An. Wahyu 6/1/2016 Lidocain Inj 1 1 2186 2,186

12 By. Veby 6/1/2016 Oralit Tab 5 5 1000 5,000

13 An. Evelin 6/2/2016 Oroprofen Syr 1 1 16000 16,000

14 Ny. Lusiana 6/2/2016 Ibuprofen Tab 10 10 400 4,000

15 Ny. Kamer 6/2/2016 Benodon Inj 2 2 1500 3,000

16 By. Ikhsan 5/29/2016 Inf D5 1/4 Ns 1 1 19941 19,941

5/30/2016 D5 1/4 Ns 1 1 19941 19,941

5/31/2016 Cefotaxim Inj 2 2 15304 30,608

5/31/2016 Aquadest Inj 3 3 3312 9,936

6/1/2016 Cefotaxim Inj 1 1 15304 15,304

17 An. Carolin 6/2/2016 Rifampisin Tab 3 3 2000 6,000

18 An. M Raihan 6/2/2016 Ventolin Nebu 1 1 13000 13,000

19 Tn. Surya 6/2/2016 Amoxicilin Tab 10 10 500 5,000

20 Tn. Marwi 6/2/2016 Ulsidex Tab 10 10 1500 15,000

21 Tn. Priyanto 6/2/2016 Mp 8 mg Tab 10 10 1000 10,000

22 Tn. Saihan 6/2/2016 Lidocain Inj 2 2 2186 4,372

23 Tn. Andri Y 6/2/2016 Calortusin tab 10 10 800 8,000

24 Tn. Irwan 6/2/2016 Amoxicilin Tab 10 10 500 5,000

25 Ny. Hanifah 6/2/2016 O2 100 100 250 25,000

26 Tn. Yohanes 6/3/2016 Inf D5 % 2 2 7619 15,238

6/3/2016 Pumpitor Inj 1 1 0 92757 -

27 Tn. Seven 6/2/2016 Elastis Verband 1 1 32926 32,926

6/3/2016 Ranitidin Tab 1 1 0 3746 -

28 Ny. Valentina 6/3/2016 Oralit 4 4 928 3,712

29 Tn. Stevanus 6/3/2016 Pct Tab 10 10 138 1,380

30 An. Atiqa 6/3/2016 Pct Syr 1 1 3877 3,877

31 Tn. Maryadi 6/4/2016 Pct Tab 10 10 138 1,380

32 Nn. Yulia 6/4/2016 Mefinal tab 10 10 1749 17,490

33 Tn. Zainudin 6/4/2016 Flamar 50 mg Tab 5 5 2458 12,290

6/4/2016 Ceftriaxon Inj 1 1 24778 24,778

6/4/2016 Biothicol Syr 1 1 25988 25,988

35 Ny. Ernawati 6/4/2016 Mp 4 mg Tab 10 10 600 6,000

36 Tn. Hendra S 6/4/2016 Dohixat Tab 10 10 1000 10,000

37 By. Govir 6/3/2016 Inf D5 1/4 Ns 2 2 19941 39,882

6/3/2016 Inf D5 % 2 2 7619 15,238

5/3/2016 Inf D5 1/4 Ns 3 3 19941 59,823

6/3/2016 Ceftriaxon Inj 1 1 24778 24,778

5/4/2016 Ondan 8 Mg Inj 1 1 11660 11,660

38 An. Veby 6/3/2016 Inf D5 1/4 1 1 19941 19,941

6/3/2016 Terfacef Inj 1 1 278383 278,383

6/4/2016 Ceftraixon Inj 1 1 24778 24,778

6/4/2016 Ceftriaxon Inj 1 1 25000 25,000

6/4/2016 Cefixime Syr 1 1 43000 43,000

39 Tn. Dimas 6/4/2016 Baquinor Forte Tab 10 10 17934 179,340

40 Tn. Sigit 6/4/2016 Tramenza Tab 10 10 1530 15,300