LAPORAN PEMAKAIAN OBAT TAHUN 2009

NO. NAMA OBAT KEMASAN PEMAKAIAN

1 Abbocath no.20 Buah 5
2 Abbocath no.22 Buah
3 Abbocath no.24 Buah 40
4 Adrenalin Ampl
5 Albotyl Btl 30 ml
6 Aethylis Carbonas Chinine (Eukinin) Btl 1000 2000
7 Acetosal 100 mg Ktk 100 1000
8 Alat suntik sekali pakai 1 ml 100 set 1000
9 Alat suntik sekali pakai 2.5 ml/3 ml 100 set 1800
10 Alat suntik sekali pakai 5 ml 100 set 900
11 Albendazole tab 400 mg Ktk 30
12 Allopurinol tab Ktk 100 1100
13 Aminofilin inj. Ktk 50 ampl 60
14 Aminofilin tab 200 mg Btl 100
15 Amitripilin HCL tab 25 mg Ktk 100 strip 1100
16 Amoksisilin sirup kering 125 mg/ 5 ml Btl 60 ml 360
17 Amoksilin kapsul 250 mg Ktk 100 480
18 Amoksilin kapsul 500 mg Ktk 100 28500
19 Kimoxil 500 mg Ktk 50 1800
20 Ampisilin 500 mg Ktk 100
21 Ampisilin inj. Ktk 10 ampl 70
22 Antalgin (metampiron) tab.500 mg Btl 1000
23 Antalgin inj.250 mg/ml-2ml Ktk 30 ampl
24 Antasida Doen tab kombinasi Btl 1000 28000
25 Anti Bakteri Doen Salep Ktk 25 tab 48
26 Anti Fungi Doen,salep komb. Ktk 24 pot 120
27 Anti Hemoroid Supp Ktk 30 strp 90
28 Anti Parkinson Doen,tab komb Ktk 100
29 Aziklovir Tab Ktk 30 strp 890
30 Aziklovir krim Ktk 24 pot 5
31 Ergotamin Caffein Btl 100 ml 1100
32 Aquadest Steril 25 ml Ktk 10 btl 1000
33 Asam Askorbat (Vit.C) tab 250 mg Btl 250 tab
34 Asam Askorbat (Vit.C) tab 50 mg Btl 1000 tab 5000
35 Asam Klorida 0.1 N Btl 60 ml
36 Asam Mefenamat tab. 500 mg Ktk 100 2500
37 Atropin Sulfat inj. 0.25 mg/ml Btl 500 ml
38 Besi Sulfat 200
39 Benzatin Bensil Penisilin inj. 1.2 juta IU/Vial Ktk 10 vial
40 Benzatin Bensil Penisilin inj. 2.4 juta IU/Vial Ktk 10 vial
41 Betametason Krim 0.1% Ktk 24 tube 314
42 Clonidin 0.15 mg Ktk 100 1000
43 Captopril Tab. 12.5 mg Ktk 60 tab
44 Captopril Tab. 25 mg Ktk 60 tab 500
45 Captopril tab.50 Ktk 60 tab
46 Catgut / benang bedah no.2/0-3/0 Ktk 24 96
47 Cateter no.18 Buah 50
48 Cateter no.20 Buah 25
49 Cateter no.22 Buah 5
 50 Cateter no.24 Buah 5
51 Cetrisin Buah 600
52 Cimetidin tab Ktk 30 500
53 Ciprofloxacin 500 mg Ktk 100 3500
54 Dexametasone inj. Ktk 100 ampl 390
55 Dexametasone Tab.0.5 mg Btl 1000 29000
56 Dextrometorfan HBr sirup 10 mg/ 5 ml Btl 60 ml
57 Dextrometorfan HBr Tab 15 mg Btl 1000 tab
58 Devatilasisasi Pasta Non Arsen (Devitasol) Ktk/btl
59 Diazepam Inj 5 mg /ml - 2 ml Ktk 30 ampl 30
60 Diazepam Tab.2 mg Btl 1000 15000
61 Diazepam Tab.5 mg Btl 250 tab 500
62 Dietilkarbamasepin Sitrat Tab.100 mg Ktk 100
63 Difenhidramin HCL Inj 10 mg/ml - 1 ml Ktk 30 ampl 140
64 Digoxin Tab. 0.25 mg Ktk 100
65 Efedrin HCL Tab.25 mg Btl 1000 9000
66 Ekstrak Belladona Tab Btl 1000
67 Epinefrin HCL Inj. 0.1 % Ktk 30 ampl 30
68 Eritromisin Kapsul 250 mg Ktk 120 1200
69 Eritromisin Kapsul 500 mg Ktk 100, strp
70 Etakridin (Rivanol) Lar.0.1 % Btl 300 ml
71 Etambutol Tab Ktk 200
72 Etanol 70 %/alkohol Btl 1000 ml 10
73 Etanol 70 % Btl 100 ml
74 Ethiprid Tab. 5 mg Ktk 20
75 Etil Klorida semprot Btl 100 ml 7
76 Eugenol Cairan Bks 12 btl 12
77 Fenitoin Natrium Inj. g/ml Btl 1000
78 Fenitoin Natrium kaps. 100 mg Btl 100
79 Fenobarbital Inj. 50mg/ml-2ml Ktk 30 ampl
80 Fenobarbital Tab.30 mg Btl 1000 8000
81 Fenobarbital Tab.100 mg Btl 250 tab
82 Fenoksimetil Penilisilina Tab.500 mg Btl 100 tab
83 Fenol Gliserol tetes telinga Ktk 24 btl 96
84 Ferolat Tab Ktk 30 tab
85 Fitomenadion (Vit.K) inj.10 mg/ml-1ml Ktk 30 ampl 60
86 Fitomenadion (Vit.K) Tablet 10 mg Btl 100 800
87 Fluor Tab. 0.5 mg Btl 100 tab
88 Forinokresol (pengganti TKF) Btl 10 ml
89 Furosemid tab.40 mg Ktk 100
90 Gameksan Emulsi 1% Btl 100 ml
91 Garam Oralit untul 200 ml air Ktk 100 sach 2200
92 Gentamisin inj ampul 30
93 Gentian violet larutan 1 % Btl 10 ml
94 Glass Ionomer Cement (gc ix) set
95 Glibenklamid Tab. 2 mg Btl 1700
96 Gliseril Guaiakolat tab. 100mg (GG) Btl 1000 20000
97 Glisrol (gliserin) Btl 100 ml
98 Glukosa Larutan Infus 5 % Steril Btl 500 ml 240
99 Glukosa Larutan Infus 10 % Steril Btl 500 ml
100 Glukosa Larutan Infus 40 % Steril Btl 25 ml
101 Griseofulvin Tab.125 mg Ktk 50 1000
102 Haloperidol Tab. 0.5 mg Ktk 100 tab 100
103 Haloperidol Tab. 1.5 mg Ktk 100 tab 100
104 Haloperidol Tab 5 mg Ktk 100 tab 600
105 Hidroklortiasid (HCT) Tab.25 mg Btl 1000
106 Hidrokortison Krim 2.5 mg Ktk 24 tube 264
107 Ibuprofen tab.200 mg Btl 100 300
108 Ibuprofen tab.400 mg Ktk 100 500
109 Infus Set Anak Set 80
110 Infus Set Dewasa Set 130
111 Insulin inj 10 ml Vial
112 Iodium Tes Btl 100 ml
113 Iodiol Kapsul lunak Btl 100 200
114 Insoniasid (INH) Tab.100 mg ktk 100
115 Insoniasid (INH) Tab.300 mg ktk 100
116 Isosorbit Dinitrat Tab. 5 mg ktk 100
117 Jarum Suntik 1 ml (27 G) ktk 100
118 Jarum Suntik 2.5 ml (23 G) ktk 100
119 Kalium Permanganat Serbuk Ktk 20 btl 44
120 Kalsium Hidroksida Pasta Ktk 2 tube
121 Kalsium Laktat Btl 1000 10000
122 Kanamycin Base 1 g inj Vial
123 Kapas 250 g Bks 55
124 Karbamazepin Tab. 200 mg Ktk 100 strp 500
125 Kasa Kompres 40/40 steril Bks 60
126 Kasa Pembalut 2 x 80 cm Rol
127 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 100
128 Kasa Pembalut Hidrofil 4 m x 3 cm Rol
129 Kasa Pembalut Hidrofil 16 x 16 cm Ktk
130 Ketokenazol 200 mg Ktk 50 600
131 Kloramfenikol Kaps 250 mg btl/250 tab 10000
132 Kloramfenikol Salep Mata 1 % Ktk 25 tube
133 Kloramfenikol Sirup Btl 60 ml
134 Kloramfenikol Tetes Telinga Ktk 24 btl 48
135 Klorfeniramin Maleat (Ctm) tab.4 mg Btl 1000 23000
136 Klorokuin Fosfat Tab. 150 mg Btl 1000 6000
137 Klorpromazin HCL inj 5 mg/ml-2ml Ktk 30 ampl
138 Klorpromazin HCL inj 25 mg/ml-2ml Ktk 30 ampl
139 Klorpromazin HCL 25 mg Btl 1000 6000
140 Klorpromazin HCL tab.100 mg Btl 250 tab
141 Klorpropamid Tab. 100 mg Btl 500
142 Kodein Fosfat Tab.10 mg Btl 250 2000
143 Komb.Pirimetamin 25 mg + Sulfadoksin 500 mg Btl 100 700
144 Kotrimoksazol Pediatrik Tab. 120 mg Btl 100 3600
145 Kotrimoksazol suspensi Btl 60 ml 313
146 Kotrimoksazol Dewasa Tab. 480 mg Ktk 100 3000
147 Kuinin dihiroklorida inj - 2 ml Ktk 30 ampl 120
148 Kuinin Sulfat Tab. 222 mg Ktk 60 tab 1200
149 Larutan Benedict Btl 100 ml
150 Larutan Eosin 2% Btl 100 ml
151 Larutan Etanol Asam Btl 100 ml
152 Larutan Gimsa Stain Btl 100 ml
153 Larutan Karbol Fuchin Btl 100 ml
154 Larutan Metanol Btl 100 ml
155 Larutan Metilen Blue Btl 100 ml
156 Levofloxasin Ktk 100 2900
157 Lidokain Komp. Inj Ktk 100 ampl 780
158 Lisol Btl 1000 ml 10
159 Magasida Sirup Btl 150 ml
160 Magnesium Sulfat inj (IV) 20%-25 ml Btl 25 ml
161 Magnesium Sulfat inj (IV) 40%-25 ml Btl 25 ml
162 Mebendazol Sirup 100 mg / 5 ml Ktk 10 sach 5
163 Mebendazol 100 mg Btl 30 ml 120
164 Metilergometrin Maleat inj 0.200mg - 1 ml ktk 100 1080
165 Metilergometrin Maleat Tab.salut 0.125 Ktk 100 3600
166 Metoclorpamid Hcl ktk 100 1000
167 Metronidazol tab. 250 mg ktk 100 900
168 Metronidazol tab. 500 mg ktk 100 1400
169 Mikonazole Krim Ktk 24 tube 48
170 Monoklor Kamfer Mentol (CHKM) Btl 10 ml
171 Mummifying Pasta Btl 12
172 Natrium Bikarbonat inj. Btl 20 ml
173 Natrium Diklofenak 50 mg Ktk 50 200
174 Nacoflar Ktk 50
175 Natrium Klorida Lar.Infus steril 0.9 % Btl 50 ml 219
176 Natrium Tiosulfat inj 25%-10 ml Ktk 10 ampl
177 Neurophil inj 5000 Ktk 10 vial
178 Nifedipin tab 10 mg Ktk 100
179 Nistatin Tab.Vaginal 100.000 iu/g Ktk 100
180 Nistatin Tab. 500.000 iu/g Ktk 100 800
181 Novadryl Inj Vial
182 Novamydon inj Vial
183 Obat antituberkulosis kategori I Paket
184 Obat antituberkulosis kategori II Paket
185 Obat antituberkulosis kategori III Paket
186 Obat antituberkulosis Kategori Sisipan Paket
187 Obat antituberkulosis kategori anak Paket
188 OBH Cairan Btl 100 ml
189 OBH Plus Sirup Btl 100 ml 240
190 Oksitetrasiklin HCL inj.50 mg/ml-10 ml Ktk 10 vial 60
191 Oksitetrasiklin HCL salep kulit 3 % Ktk 25 tube
192 Oksitetrasiklin HCL Salep mata Ktk 25 tube 182
193 Oksitoksin inj iu / ml - ml Ktk 30 ampl 170
194 Paramidon inj Vial
195 Parasetamol Sirup 120 mg / 5 ml Btl 60 ml 100
196 Parasetamol Tab 100 mg Btl 100
197 Parasetamol Tab 500 mg Btl 1000 56000
198 Papaverin inj. Vial 10
199 Papaverin tab 40 mg Btl 100 ml 3000
200 Pembalut Gips Rol
201 Pirantel Pamoat tab 365 mg Ktk 60 tab
202 Piridoksin HCL (Vit. B6) tab 10 mg Btl 1000 9000
203 Piroxicam tab Btl 1000 1000
204 Plastik Obat Bks 100 sach 1000
205 Plester Rol 54
206 Primakuin 15 mg Btl 10 ml 4000
207 Petidin Inj Ktk 10 10
208 Prednison tab 5 mg Btl 1000 11000
209 Proasi Btl Btl 60 ml
210 Prokain Benzil Pinisilin Inj. 3 Juta Vial
211 Propil Tiourasil Tab 100 mg Btl 100 800
212 Propranolol HCL Tab. 40 mg Btl 100
213 Ranitidin inj Vial 350
214 Ranitidin tab 150 mg Ktk 100 1290
215 Ringer Laktat (RL) lar. Steril Btl 500 ml 160
216 Retinol (Vit.A) Kaps.100.000 IU Btl 50
217 Retinol (Vit.A) Kaps.200.000 IU Btl 50
218 Salbutamol Tab. 2 mg Ktk 100
219 Salbutamol Tab. 4 mg Ktk 100 500
220 Salep 2-4 komb Ktk 24 pot 24
221 Salisil Bedak 2 % 50 g 184
222 Salisil Spritus 10 % Ktk 10 btl
223 Sianokobalamin ( Vit. B12) inj. 500 mcg / ml Ktk 100 ampl 200
224 Sianokobalamin ( Vit. B12) Tab Btl 1000
225 Sillk ( benang bedah sutera) no. 3/0 Ktk 12 set
226 Sillk ( benang bedah sutera) no. 3/0 100 m Rol
227 Silver Amalgam Btl
228 Spons Gelatih Cubicles (Spongostan) Ktk 24 buah
229 Sulfadimidin Tab.500 mg Btl 1000 3000
230 Sulfasetamid Natrium Tetes Mata 0.5 % Ktk 24 btl 24
231 Tablet Tambah Darah Ktk 300 tab
232 Temporary Stopping Fletcher Set
233 Tetracain HCL Tetes Mata 0.5 % Btl
234 Tetrasiklin HCL Kaps. 250 mg Btl 1000 13000
235 Tetrasiklin HCL Kaps. 500 mg Ktk 100
236 Tiamin HCL (Vit.B1) Inj Ktk 30 ampl 160
237 Tiamin HCL (Vit.B1) Mononitrat Tab. 50 mg Btl 1000 10000
238 Transamin Tab. Ktk 100
239 Tensigard Ktk 30 600
240 Triheksifenidil HCL Tab. 2 mg Ktk 100 800
241 Trisulfa Tab.500 mg Btl 1000
242 Ulsikur Inj Ktk 5 ampl
243 Vaksin Anti Rabies (Verorab) Ampl
244 Vitamin B.Kompleks Tab Btl 1000 1000
245 Yodium povidon lar.10% Btl 30 ml 156
246 Yodium povidon lar.10% Btl 300 ml
247 Mata pisau karbon No.10 Pcs
248 Mata pisau karbon No.11 Pcs
249 Mata pisau karbon No.15 Pcs 50
250 Mata pisau karbon No.20 Pcs
251 Mata pisau karbon No.21 Pcs
252 Mata pisau karbon No.22 Pcs
253 Jarum Hecting jaringan otot Lusin
254 Jarum Hecting Kulit Lusin 24
255 Jarum Hecting Usus Lusin
256 Sarung tangan Pasang 20
257 Urine Bag 30
258 Cendo Flucain Ktk 100 96
 Pemakaian Bulan Juli Jmlh
NO Nama Obat Kemasan Ket
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ### 18 19 ### 21 22 ### 24 ### 26 ### 28 29 30 ### TOTAL
1 Abbocath no.18 Buah
2 Abbocath no.20 Buah
3 Abbocath no.24 Buah
4 Adrenalin Ampl
5 Albotyl Btl 30 ml
6 Aethylis Carbonas Chinine (Eukinin) Btl 1000
7 Air raksa dental use Btl 100
8 Alat suntik sekali pakai 1 ml 100 set
9 Alat suntik sekali pakai 2.5 ml 100 set
10 Alat suntik sekali pakai 5 ml 100 set
11 Albendazole tab 400 mg Ktk 30
12 Allopurinol tab Ktk 100
13 Aminofilin inj. Ktk 50 ampl
14 Aminofilin tab 200 mg Btl 100
15 Amitripilin HCL tab 25 mg Ktk 100 strip
16 Amoksisilin sirup kering 125 mg/ 5 ml Btl 60 ml
17 Amoksilin kapsul 250 mg Ktk 100
18 Amoksilin kapsul 500 mg Ktk 100
19 Ampisilin Kaplet 500 mg Ktk 100
20 Ampisilin sirup kering 125 mg/5 ml Ktk 100
21 Ampisilin inj. Ktk 10 ampl
22 Antalgin (metampiron) tab.500 mg Btl 1000
23 Antalgin inj.250 mg/ml-2ml Ktk 30 ampl
24 Antasida Doen tab kombinasi Btl 1000
25 Anti Bakteri Doen Salep Ktk 25 tab
26 Anti Fungi Doen,salep komb. Ktk 24 pot
27 Anti Hemoroid (Hemorogard) Ktk 30 strp
28 Anti Parkinson Doen,tab komb Ktk 100
29 Aziklovir Tab Ktk 30 strp
30 Aziklovir krim Ktk 24 pot
31 Aquadest Steril Btl 500 ml
32 Aquadest Steril 25 ml Ktk 10 btl
33 Asam Askorbat (Vit.C) tab 250 mg Btl 250 tab
34 Asam Askorbat (Vit.C) tab 50 mg Btl 1000 tab
35 Asam Klorida 0.1 N Btl 60 ml
36 Asam Mefenamat tab. 500 mg Ktk 100
37 Atropin Sulfat inj. 0.25 mg/ml Btl 500 ml
38 Besi Sulfat 200
39 Benzatin Bensil Penisilin inj. 1.2 juta IU/Vial Ktk 10 vial

Pemakaian Bulan Juli Jmlh

NO Nama Obat Kemasan Ket
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ### 18 19 ### 21 22 ### 24 ### 26 ### 28 29 30 ### TOTAL
40 Benzatin Bensil Penisilin inj. 2.4 juta IU/Vial Ktk 10 vial
41 Betametason Krim 0.1% Ktk 24 tube
42 Calcii Glukonas inj. ampul
43 Captopril Tab. 12.5 mg Ktk 60 tab
44 Captopril Tab. 25 mg Ktk 60 tab
45 Captopril tab.50 Ktk 60 tab
46 Catgut / benang bedah no.2/0-3/0 Ktk 24
47 Cateter no.16 Buah
48 Cateter no.18 Buah
49 Cateter no.20 Buah
50 Cateter no.22 Buah
51 Cateter no.24 Buah
52 Cetrizin Ktk 50
53 Cimetidin tab Ktk 100
54 Dexametasone inj. Ktk 100 ampl
55 Dexametasone Tab.0.5 mg Btl 1000
56 Dextrometorfan HBr sirup 10 mg/ 5 ml Btl 60 ml
57 Dextrometorfan HBr Tab 15 mg Btl 1000 tab
58 Devatilasisasi Pasta Non Arsen Ktk/btl
59 Diazepam Inj 5 mg /ml - 2 ml Ktk 30 ampl
60 Diazepam Tab.2 mg Btl 1000
61 Diazepam Tab.5 mg Btl 250 tab
62 Dietilkarbamasepin Sitrat Tab.100 mg Ktk 100
63 Difenhidramin HCL Inj 10 mg/ml - 1 ml Ktk 30 ampl
64 Digoxin Tab. 0.25 mg Ktk 100
65 Efedrin HCL Tab.25 mg Btl 1000
66 Ekstrak Belladona Tab Btl 1000
67 Epinefrin HCL Inj. 0.1 % Ktk 30 ampl
68 Eritromisin Kapsul 250 mg Ktk 120
69 Eritromisin Kapsul 500 mg Ktk 100, strp
70 Etakridin (Rivanol) Lar.0.1 % Btl 300 ml
71 Etambutol Tab Ktk 200
72 Etanol 70 % Btl 1000 ml
73 Etanol 70 % Btl 100 ml
74 Ethiprid Tab. 5 mg Ktk 20
75 Etil Klorida semprot Btl 100 ml
76 Eugenol Cairan Bks 12 btl

Pemakaian Bulan Juli Jmlh

NO Nama Obat Kemasan Ket
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ### 18 19 ### 21 22 ### 24 ### 26 ### 28 29 30 ### TOTAL
77 Fenitoin Natrium Inj. g/ml Btl 1000
78 Fenitoin Natrium kaps. 100 mg Btl 100
79 Fenobarbital Inj. 50mg/ml-2ml Ktk 30 ampl
80 Fenobarbital Tab.30 mg Btl 1000
81 Fenobarbital Tab.100 mg Btl 250 tab
82 Fenoksimetil Penilisilina Tab.500 mg Btl 100 tab
83 Fenol Gliserol tetes telinga Ktk 24 btl
84 Ferolat Tab Ktk 30 tab
85 Fitomenadion (Vit.K) inj.10 mg/ml-1ml Ktk 30 ampl
86 Fitomenadion (Vit.K) Tablet 10 mg Btl 100
87 Fluor Tab. 0.5 mg Btl 100 tab
88 Forinokresol (pengganti TKF) Btl 10 ml
89 Furosemid tab.40 mg Ktk 100
90 Gameksan Emulsi 1% Btl 100 ml
91 Garam Oralit untul 200 ml air Ktk 100 sach
92 Gentamisin inj ampul
93 Gentian violet larutan 1 % Btl 10 ml
94 Glass Ionomer Cement (gc ix) set
95 Glibenklamid Tab. 2 mg Btl
96 Gliseril Guaiakolat tab. 100mg (GG Btl 1000
97 Glisrol (gliserin) Btl 100 ml
98 Glukosa Larutan Infus 5 % Steril Btl 500 ml
99 Glukosa Larutan Infus 10 % Steril Btl 500 ml
100 Glukosa Larutan Infus 40 % Steril Btl 25 ml
101 Gravimin + DHA Tab Ktk 30
102 Griseofulvin Tab.125 mg Ktk 100 tab
103 Haloperidol Tab. 0.5 mg Ktk 100 tab
104 Haloperidol Tab. 1.5 mg Ktk 100 tab
105 Hidroklortiasid (HCT) Tab.25 mg Btl 1000
106 Hidrokortison Krim 2.5 mg Ktk 24 tube
107 Ibuprofen tab.200 mg Btl 100
108 Ibuprofen tab.400 mg Ktk 100
109 Infus Set Anak Set
110 Infus Set Dewasa Set
111 Insulin inj 10 ml Vial
112 Iodium Tes Btl 100 ml
113 Iodiol Kapsul lunak Btl 100

Pemakaian Bulan Juli Jmlh

NO Nama Obat Kemasan Ket
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ### 18 19 ### 21 22 ### 24 ### 26 ### 28 29 30 ### TOTAL
114 Insoniasid (INH) Tab.100 mg ktk 100
115 Insoniasid (INH) Tab.300 mg ktk 100
116 Isosorbit Dinitrat Tab. 5 mg ktk 100
117 Jarum Suntik 1 ml (27 G) ktk 100
118 Jarum Suntik 2.5 ml (23 G) ktk 100
119 Kalium Permanganat Serbuk Ktk 20 btl
120 Kalsium Hidroksida Pasta Ktk 2 tube
121 Kalsium Laktat Btl 1000
122 Kanamycin Base 1 g inj Vial
123 Kapas 250 g Bks
124 Karbamazepin Tab. 200 mg Ktk 100 strp
125 Kasa Kompres 40/40 steril Bks
126 Kasa Pembalut 2 x 80 cm Rol
127 Kasa Pembalut Hidrofil 4 m x 15 cm Rol
128 Kasa Pembalut Hidrofil 4 m x 3 cm Rol
129 Kasa Pembalut Hidrofil 16 x 16 cm Ktk
130 Kasa Steril 18 x 22 cm Ktk 16 lmbr
131 Kloramfenikol Kaps 250 mg btl/250 tab
132 Kloramfenikol Salep Mata 1 % Ktk 25 tube
133 Kloramfenikol Sirup Btl 60 ml
134 Kloramfenikol Tetes Telinga Ktk 24 btl
135 Klorfeniramin Maleat (Ctm) tab.4 mg Btl 1000
136 Klorokuin Fosfat Tab. 150 mg Btl 1000
137 Klorpromazin HCL inj 5 mg/ml-2ml Ktk 30 ampl
138 Klorpromazin HCL inj 25 mg/ml-2ml Ktk 30 ampl
139 Klorpromazin HCL 25 mg Btl 1000
140 Klorpromazin HCL tab.100 mg Btl 250 tab
141 Klorpropamid Tab. 100 mg Btl 500
142 Kodein Fosfat Tab.10 mg Btl 250
143 Komb.Pirimetamin 25mg+Suldoks 500 mg Btl 100
144 Kotrimoksazol Pediatrik Tab. 120 mg Btl 100
145 Kotrimoksazol suspensi Btl 60 ml
146 Kotrimoksazol Dewasa Tab. 480 mg Ktk 100
147 Kuinin dihiroklorida inj - 2 ml Ktk 30 ampl
148 Kuinin Sulfat Tab. 222 mg Ktk 60 tab
149 Larutan Benedict Btl 100 ml
150 Larutan Eosin 2% Btl 100 ml

Pemakaian Bulan Juli Jmlh

NO Nama Obat Kemasan Ket
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ### 18 19 ### 21 22 ### 24 ### 26 ### 28 29 30 ### TOTAL
151 Larutan Etanol Asam Btl 100 ml
152 Larutan Gimsa Stain Btl 100 ml
153 Larutan Karbol Fuchin Btl 100 ml
154 Larutan Metanol Btl 100 ml
155 Larutan Metilen Blue Btl 100 ml
156 Levofloxasin Ktk 100
157 Lidokain Komp. Inj Ktk 100 ampl
158 Lisol Btl 1000 ml
159 Magasida Sirup Btl 150 ml
160 Magnesium Sulfat inj (IV) 20%-25 ml Btl 25 ml
161 Magnesium Sulfat inj (IV) 40%-25 ml Btl 25 ml
162 Magnesium Sulfat Serbuk 30 g Ktk 10 sach
163 Mebendazol Sirup 100 mg / 5 ml Btl 30 ml
164 Metilergometrin Maleat inj 0.200mg - 1 ml ktk 100
165 Metilergometrin Maleat Tab.salut 0.125 Ktk 100
166 Metoclorpamid Hcl ktk 100
167 Metronidazol tab. 250 mg ktk 100
168 Metronidazol tab. 500 mg ktk 100
169 Mikonazole Krim Ktk 24 tube
170 Monoklor Kamfer Mentol (CHKM) Btl 10 ml
171 Mummifying Pasta Btl
172 Natrium Bikarbonat inj. Btl 20 ml
173 Natrium Bikarbonat tab.500 mg Btl 1000 ml
174 Nacoflar Ktk 50
175 Natrium Klorida Lar.Infus steril 0.9 % Btl 50 ml
176 Natrium Tiosulfat inj 25%-10 ml Ktk 10 ampl
177 Neurophil inj 5000 Ktk 10 vial
178 Nifedipin tab 10 mg Ktk 100
179 Nistatin Tab.Vaginal 100.000 iu/g Ktk 100
180 Nistatin Tab. 500.000 iu/g Ktk 100
181 Novadryl Inj Vial
182 Novamydon inj Vial
183 Obat antituberkulosis kategori I Paket
184 Obat antituberkulosis kategori II Paket
185 Obat antituberkulosis kategori III Paket
186 Obat antituberkulosis Kategori Sisipan Paket
187 Obat antituberkulosis kategori anak Paket

Pemakaian Bulan Juli Jmlh

NO Nama Obat Kemasan Ket
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ### 18 19 ### 21 22 ### 24 ### 26 ### 28 29 30 ### TOTAL
188 OBH Cairan Btl 100 ml
189 OBH Plus Sirup Btl 100 ml
190 Oksitetrasiklin HCL inj.50 mg/ml-10 ml Ktk 10 vial
191 Oksitetrasiklin HCL salep kulit 3 % Ktk 25 tube
192 Oksitetrasiklin HCL Salep mata Ktk 25 tube
193 Oksitoksin inj iu / ml - ml Ktk 30 ampl
194 Paramidon inj Vial
195 Parasetamol Sirup 120 mg / 5 ml Btl 60 ml
196 Parasetamol Tab 100 mg Btl 100
197 Parasetamol Tab 500 mg Btl 1000
198 Papaverin inj. Vial
199 Papaverin tab 40 mg Btl 100 ml
200 Pembalut Gips Rol
201 Pirantel Pamoat tab 365 mg Ktk 60 tab
202 Piridoksin HCL (Vit. B6) tab 10 mg Btl 1000
203 Piroxicam tab Btl 1000
204 Plastik Obat Bks 100 sach
205 Plester Rol
206 Polikresulen 360 mg/g Btl 10 ml
207 Prazikuantel tab Ktk 100
208 Prednison tab 5 mg Btl 1000
209 Proasi Btl Btl 60 ml
210 Prokain Benzil Pinisilin Inj. 3 Juta Vial
211 Propil Tiourasil Tab 100 mg Btl 100
212 Propranolol HCL Tab. 40 mg Btl 100
213 Ranitidin inj Vial
214 Ranitidin tab 150 mg Ktk 100
215 Ringer Laktat (RL) lar. Steril Btl 500 ml
216 Retinol (Vit.A) Kaps.100.000 IU Btl 50
217 Retinol (Vit.A) Kaps.200.000 IU Btl 50
218 Salbutamol Tab. 2 mg Ktk 100
219 Salbutamol Tab. 4 mg Ktk 100
220 Salep 2-4 komb Ktk 24 pot
221 Salisil Bedak 2 % 50 g
222 Salisil Spritus 10 % Ktk 10 btl
223 Sianokobalamin (Vit. B12) inj.500 mcg / ml Ktk 100 ampl
224 Sianokobalamin (Vit. B12) Tab Btl 1000

Pemakaian Bulan Juli Jmlh

NO Nama Obat Kemasan Ket
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ### 18 19 ### 21 22 ### 24 ### 26 ### 28 29 30 ### TOTAL
225 Sillk ( benang bedah sutera) no. 3/0 Ktk 12 set
226 Sillk ( benang bedah sutera) no.3/0 100 m Rol
227 Silver Amalgam Btl
228 Spons Gelatih Cubicles (Spongostan) Ktk 24 buah
229 Sulfadimidin Tab.500 mg Btl 1000
230 Sulfasetamid Natrium Tetes Mata 0.5 % Ktk 24 btl
231 Tablet Tambah Darah Ktk 300 tab
232 Temporary Stopping Fletcher Set
233 Tetracain HCL Tetes Mata 0.5 % Btl
234 Tetrasiklin HCL Kaps. 250 mg Btl 1000
235 Tetrasiklin HCL Kaps. 500 mg Ktk 100
236 Tiamin HCL (Vit.B1) Inj Ktk 30 ampl
237 Tiamin HCL(Vit.B1) Mononitrat Tab. 50 mg Btl 1000
238 Transamin Tab. Ktk 100
239 Tensigard Ktk 30
240 Triheksifenidil HCL Tab. 2 mg Ktk 100 strp
241 Trisulfa Tab.500 mg Btl 1000
242 Ulsikur Inj Ktk 5 ampl
243 Vaksin Anti Rabies (Verorab) Ampl
244 Vitamin B.Kompleks Tab Btl 1000
245 Yodium povidon lar.10% Btl 30 ml
246 Yodium povidon lar.10% Btl 300 ml
247 Mata pisau karbon No.10 Pcs
248 Mata pisau karbon No.11 Pcs
249 Mata pisau karbon No.15 Pcs
250 Mata pisau karbon No.20 Pcs
251 Mata pisau karbon No.21 Pcs
252 Mata pisau karbon No.22 Pcs
253 Jarum Hecting jaringan otot Lusin
254 Jarum Hecting Kulit Lusin
255 Jarum Hecting Usus Lusin
256 Sarung tangan No.7 Pasang
257 Hustab syr Btl 60 ml
256 Norvastan Ktk 100
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
LPLPO
PUSKESMAS : TENTENA
KECAMATAN : PAMONA UATARA BULAN : JULI
KAB/KODYA : POSO TAHUN : 2010
PROPINSI : SULAWESI TENGAH HARI/TGL : ……

harga stok peneri perse pema sisa stok stok permintaa Pemberian Harga
NO Nama Obat Kemasan Ket
satuan awal maan diaan kaian optimu n Askes DAU Lain2 Jml Total
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) m
10 11 12 13 14 15 16 17
1 Abbocath no.20 Buah 220 0 220 0 220
2 Abbocath no.22 Buah 40 0 40 0 40
3 Abbocath no.24 Buah 120 0 120 0 120
4 Albotyl / Polikresulen 360 g/mg Btl 10 ml 0 0 0 0 0 20
5 Aethylis Carbonas Chinine (Eukinin) Btl 1000 0 0 0 0 0 6000
6 Air raksa dental use Btl 100 g 0 0 0 0 0
7 Acetosal Ktk 100 200 0 200 0 200
8 Alat suntik sekali pakai 1 ml Ktk 100 0 0 0 0 0 500
9 Alat suntik sekali pakai 2.5 ml/3 ml Ktk 100 400 0 400 100 300
10 Alat suntik sekali pakai 5 ml Ktk 100 600 0 600 60 540
11 Alkohol 70 % Btl 1000ml 0 0 0 0 0 20
12 Albendazole tab 400 mg Ktk 30 0 0 0 0 0
13 Allopurinol tab Ktk 100 300 300 600 100 500 500
14 Aminofilin inj. Ktk 50Amp 10 30 40 0 40
15 Aminofilin tab 200 mg Btl 100 0 0 0 0 0 5000
16 Amitripilin HCL tab 25 mg Ktk 100 200 300 500 0 500
17 Amoksisilin sirup kering 125 mg/ 5 ml Btl 60 ml 0 0 0 0 0 100
18 Amoksilin kapsul 250 mg Ktk 100 0 0 0 0 0 1000
19 Amoksilin kapsul 500 mg Ktk 100 0 0 0 0 0 5000
20 Ampisilin Kaplet 500 mg Ktk 100 0 0 0 0 0 1000
21 Ampisilin sirup kering 125 mg/5 ml Btl 60 ml 0 0 0 0 0
22 Ampisilin inj. Ktk 50Amp 0 0 0 0 0 50
23 Antalgin (metampiron) tab.500 mg Btl 1000 1000 0 1000 0 1000
24 Antalgin inj.250 mg/ml-2ml Ktk 50Amp 0 30 30 0 30
25 Antasida Doen tab kombinasi Btl 1000 0 10000 10000 6000 4000 6000
26 Anti Bakteri Doen Salep Ktk 25 tube 100 0 100 25 75
27 Anti Fungi Doen,salep komb. Ktk 24 pot 0 120 120 0 120
28 Anti Hemoroid (Hemorogard) Ktk 30 0 0 0 0 0 500
29 Anti Hemoroid Suppositoria Ktk 10 Sup 50 0 50 0 50
9 Anti Parkinson Doen,tab komb Ktk 100 300 0 300 0 300
31 Anti Migren DOEN/ergotamin Caffein Btl 100 0 500 500 200 300 1000
32 Acyclovir tab 400 mg Ktk 100 100 0 100 0 100 500
harga stok peneri perse pema sisa stok stok permintaa Pemberian Harga
NO Nama Obat Kemasan Ket
satuan awal maan diaan kaian optimu n Askes DAU Lain2 Jml Total
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) m
10 11 12 13 14 15 16 17
33 Acyclovir cream Ktk 25 tube 0 0 0 0 0 75
34 Aquadest Steril 25 ml Ktk 10 btl 10 100 110 0 110
35 Asam Askorbat (Vit.C) tab 250 mg Btl 1000 0 0 0 0 0 5000
36 Asam Askorbat (Vit.C) tab 50 mg Btl 1000 0 0 0 0 0 10000
37 Asam Klorida 0.1 N Dos 25 0 0 0 0 0
38 Asam Mefenamat tab. 500 mg Ktk 100 0 0 0 0 0 1000
39 Atropin Sulfat inj. 0.25 mg/ml Ktk 50Amp 0 60 60 0 60
40 Benzatin Bensil Penisilin inj. 1.2 juta IU/Vial Ktk 10 vial 0 0 0 0 0
41 Benzatin Bensil Penisilin inj. 2.4 juta IU/Vial Ktk 10 vial 0 0 0 0 0
42 Betametason Krim 0.1% Ktk 25 tube 50 0 50 25 25
43 Clonidin 0,15 Ktk 100 500 0 500 0 500
44 Captopril Tab. 12.5 mg Ktk 100 0 0 0 0 0 1000
45 Captopril Tab. 25 mg Ktk 100 0 0 0 0 0 1000
46 Catapres inj Ampul 0 0 0 0 0 30
47 Catgut / benang bedah no.2/0-3/0 Ktk 24 48 0 48 0 48
48 Cateter no.18 Dos 15 7 0 7 0 7
49 Cateter no.20 Dos 15 10 0 10 0 10
50 Cateter no.22 Dos 15 7 0 7 0 7
51 Cateter no.24 Dos 15 8 0 8 0 8
52 Cetoconazole tab Ktk 100 0 0 0 0 0 1000
53 Cetrizin Ktk 100 500 0 500 200 300
54 Cimetidin tab Ktk 100 0 0 0 0 0 1000
55 Ciprofloxacin 500 mg Ktk 100 0 0 0 0 0 1000
56 Dexametasone inj. Ktk 100 0 200 200 80 120
57 Dexametasone Tab.0.5 mg Btl 1000 0 0 0 0 0 10000
58 Dextrometorfan HBr sirup 10 mg/ 5 ml Btl 60 ml 0 0 0 0 0 100
59 Dextrometorfan HBr Tab 15 mg Btl 1000 1000 0 1000 0 1000
60 Devatilasisasi Pasta Non Arsen KTk/Btl 0 0 0 0 0
61 Diazepam Inj 5 mg /ml - 2 ml Ampul 17 0 17 0 17
62 Diazepam Tab.2 mg Btl 1000 2000 0 2000 1000 1000
63 Diazepam Tab.5 mg Btl 1000 500 0 500 0 500
64 Dietilkarbamasepin Sitrat Tab.100 mg Ktk 100 0 0 0 0 0
65 Difenhidramin HCL Inj 10 mg/ml - 1 ml Vial 30 0 30 0 30
66 Digoxin Tab. 0.25 mg Ktk 100 0 0 0 0 0 500
67 Efedrin HCL Tab.25 mg Btl 1000 0 0 0 0 0 5000
68 Ekstrak Belladona Tab Btl 1000 4000 0 4000 1000 3000
69 Epinefrin HCL Inj. 0.1 % Ampul 25 0 25 0 25
70 Eritromisin Kapsul 250 mg Ktk 100 0 0 0 0 0 1000
71 Eritromisin Kapsul 500 mg Ktk 100 0 0 0 0 0 1000
72 Etakridin (Rivanol) Lar.0.1 % Btl 300 ml 12 0 12 0 12
73 Etambutol Tab Ktk 100 0 0 0 0 0
harga stok peneri perse pema sisa stok stok permintaa Pemberian Harga
NO Nama Obat Kemasan Ket
satuan awal maan diaan kaian optimu n Askes DAU Lain2 Jml Total
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) m
10 11 12 13 14 15 16 17
74 Ethiprid Tab. 5 mg Ktk 100 0 0 0 0 0
75 Etil Klorida semprot BTl 100 ml 4 0 4 0 4
76 Eugenol Cairan BKs 12 btl 0 0 0 0 0 20
77 Fenitoin Natrium Inj. g/ml Btl 1000 0 0 0 0 0
78 Fenitoin Natrium kaps. 100 mg Btl 100 0 0 0 0 0
79 Fenobarbital Inj. 50mg/ml-2ml KTk 30 Amp 30 0 30 0 30
80 Fenobarbital Tab.30 mg Btl 1000 3000 0 3000 1000 2000
81 Fenobarbital Tab.100 mg Btl 1000 0 0 0 0 0 2000
82 Fenoksimetil Penilisilina Tab.500 mg Btl 100 0 0 0 0 0
83 Fenol Gliserol tetes telinga Ktk 24 btl 0 48 48 18 30
84 Ferolat Tab Ktk 30 tab 0 0 0 0 0
85 Fitomenadion (Vit.K) inj.10 mg/ml-1ml aKtk 30 Amp 30 0 30 0 30
86 Fitomenadion (Vit.K) Tablet 10 mg Btl 100 300 500 800 200 600
87 Fluor Tab. 0.5 mg Btl 100 0 0 0 0 0
88 Forinokresol (pengganti TKF) Btl 10 ml 0 0 0 0 0
89 Furosemid tab.40 mg Ktk 100 600 0 600 0 600
90 Garam Oralit untul 200 ml air Dos 100 200 0 200 0 200
91 Gentamisin tts mata/genoin tts mata ktk 24 btl 0 0 0 0 0 48
92 Gentamisin inj/Etigent inj Ampul 0 0 0 0 0
93 Gentian violet larutan 1 % btl 100 ml 0 0 0 0 0 50
94 Glass Ionomer Cement (gc ix) set 0 0 0 0 0 2
95 Glibenklamid Tab. 2 mg dos 100 100 0 100 100 0 1000
96 Gliseril Guaiakolat tab. 100mg (GG btl 1000 4000 0 4000 3000 1000 6000
97 Glisrol (gliserin) btl 100 ml 0 7 7 1 6
98 Glukosa Larutan Infus 5 % Steril 500 ml 40 0 40 0 40
99 Glukosa Larutan Infus 10 % Steril 500 ml 0 0 0 0 0
100 Glukosa Larutan Infus 40 % Steril 500 ml 18 0 18 0 18
101 Gravimin + DHA Tab ktk 30 0 0 0 0 0 500
102 Griseofulvin Tab.125 mg ktk 100 0 0 0 0 0 800
103 Haloperidol Tab. 0.5 mg ktk 100 100 0 100 100 0 500
104 Haloperidol Tab. 1.5 mg ktk 100 100 0 100 0 100 500
105 Haloperidol tab 5 mg ktk 100 100 0 100 0 100 500
106 Hidroklortiasid (HCT) Tab.25 mg btl 1000 3000 0 3000 0 3000
107 Hidrokortison Krim 2.5 mg dos 25 0 0 0 0 0 100
108 Hustab syr Dos 50 0 0 0 0 0 200
109 Ibuprofen tab.200 mg Ktk 100 0 0 0 0 0
110 Ibuprofen tab.400 mg ktk 100 0 0 0 0 0 1000
111 Infus Set Anak set 0 0 0 0 0 50
112 Infus Set Dewasa set 0 0 0 0 0 50
113 Insulin inj 10 ml vial 0 0 0 0 0
114 Iodium Tes btl 10 ml 0 0 0 0 0
harga stok peneri perse pema sisa stok stok permintaa Pemberian Harga
NO Nama Obat Kemasan Ket
satuan awal maan diaan kaian optimu n Askes DAU Lain2 Jml Total
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) m
10 11 12 13 14 15 16 17
115 Iodiol Kapsul lunak btl 100 200 0 200 100 100
116 Insoniasid (INH) Tab.100 mg btl 100 0 0 0 0 0
117 Insoniasid (INH) Tab.300 mg ktk 100 0 0 0 0 0
118 Isosorbit Dinitrat Tab. 5 mg ktk 100 0 300 300 0 300 ED. 09 2010
119 Kalium Permanganat Serbuk Ktk 24 pot 0 0 0 0 0 72
120 Kalsium Hidroksida Pasta ktk 2 tube 0 0 0 0 0
121 Kalsium Laktat btl 1000 5000 0 5000 0 5000
122 Kanamycin Base 1 g inj vial 0 0 0 0 0 30
123 Kapas 250 g bungkus 13 0 13 3 10
124 Karbamazepin Tab. 200 mg ktk 100 200 0 200 0 200 500
125 Kasa Kompres 40/40 steril ktk 0 0 0 0 0
126 Kasa Pembalut 2 x 80 cm bks 0 0 0 0 0 100
127 Kasa Pembalut Hidrofil 4 m x 15 cm rol 0 0 0 0 0 100
128 Kasa Pembalut Hidrofil 4 m x 3 cm bks 0 3 3 3 0 100
129 Kasa Pembalut Hidrofil 16 x 16 cm ktk 0 0 0 0 0
130 Kasa Steril 18 x 22 cm ktk 16 lmbr 0 0 0 0 0
131 Kloramfenikol Kaps 250 mg btl 1000 0 750 750 750 0 5000
132 Kloramfenikol Salep Mata 1 % ktk 25 tube 0 0 0 0 0 75
133 Kloramfenikol Sirup btl 60 ml 0 0 0 0 0 75
134 Kloramfenikol Tetes Telinga ktk 30 btl 24 24 48 24 24
135 Klorfeniramin Maleat (Ctm) tab.4 mg btl 1000 5000 0 5000 4000 1000
136 Klorokuin Fosfat Tab. 150 mg btl 1000 1000 3000 4000 0 4000
137 Klorpromazin HCL inj 5 mg/ml-2ml ktk 30 amp 30 0 30 0 30
138 Klorpromazin HCL inj 25 mg/ml-2ml ktk 30 amp 58 0 58 0 58
139 Klorpromazin HCL 25 mg btl 1000 1900 0 1900 900 1000
140 Klorpromazin HCL tab.100 mg btl 1000 1800 0 1800 800 1000
141 Klorpropamid Tab. 100 mg btl 500 0 0 0 0 0
142 Kodein Fosfat Tab.10 mg btl 1000 250 0 250 250 0 500
143 Komb.Pirimetamin 25mg+Suldoks 500 mg ktk 100 500 0 500 100 400
144 Kotrimoksazol Pediatrik Tab. 120 mg btl 100 0 600 600 100 500
145 Kotrimoksazol suspensi btl 60 ml 0 50 50 50 0 100
146 Kotrimoksazol Dewasa Tab. 480 mg ktk 100 300 0 300 0 300 1000
147 Kuinin dihiroklorida inj - 2 ml ktk 30 amp 30 0 30 0 30 ED. 08 2010
148 Kuinin Sulfat Tab. 222 mg ktk 60 300 0 300 0 300
149 Larutan Benedict btl 100 0 0 0 0 0
150 Larutan Eosin 2% btl 100 0 0 0 0 0
151 Larutan Etanol Asam btl 100 0 0 0 0 0
152 Larutan Gimsa Stain btl 100 0 0 0 0 0
153 Larutan Karbol Fuchin btl 100 0 0 0 0 0
154 Larutan Metanol btl 100 0 0 0 0 0
155 Larutan Metilen Blue btl 100 0 0 0 0 0
harga stok peneri perse pema sisa stok stok permintaa Pemberian Harga
NO Nama Obat Kemasan Ket
satuan awal maan diaan kaian optimu n Askes DAU Lain2 Jml Total
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) m
10 11 12 13 14 15 16 17
156 Levofloxasin Ktk 50 0 0 0 0 0 1000
157 Lidokain Komp. Inj ktk 30 amp 0 200 200 60 140
158 Lisol btl 1000 ml 0 0 0 0 0 12
159 Magasida Sirup btl 60 ml 0 0 0 0 0 100
160 Magnesium Sulfat inj (IV) 20%-25 ml btl 30 6 0 6 0 6
161 Magnesium Sulfat inj (IV) 40%-25 ml btl 30 26 0 26 0 26
162 Magnesium Sulfat Serbuk 30 g ktk 100 sach 0 0 0 0 0
163 Mebendazol Sirup 100 mg / 5 ml btl 30 ml 0 0 0 0 0
164 Mebendazol tab 100 mg ktk 50 60 0 60 0 60
165 Metilergometrin Maleat inj 0.200mg - 1 ml ktk 30 amp 0 0 0 0 0 100
166 Metilergometrin Maleat Tab.salut 0.125 ktk 100 200 0 200 0 200
167 Metoclopramid Hcl ktk 100 0 300 300 100 200 1000
168 Metronidazol tab. 250 mg ktk 100 0 0 0 0 0 1000
169 Metronidazol tab. 500 mg ktk 100 0 0 0 0 0 1000
170 Mikonazole Krim ktk 30 tube 0 0 0 0 0 120
171 Monoklor Kamfer Mentol (CHKM) btl 10 ml 0 0 0 0 0
172 Mummifying Pasta btl 0 0 0 0 0
173 Natrium Phenitoin btl 20 0 20 0 20
174 Natrium Bikarbonat tab.500 mg btl 1000 0 0 0 0 0
175 Natrium diklofenak 50 mg ktk 50 0 0 0 0 0 1000
176 Nacoflar ktk 100 0 0 0 0 0 1000
177 Natrium Klorida Lar.Infus steril 0.9 % dos 25 40 0 40 0 40
178 Natrium Tiosulfat inj 25%-10 ml ktk 10 amp 0 0 0 0 0
179 Neurophil inj 5000 ktk 10 vial 0 0 0 0 0 60
180 Nifedipin tab 10 mg ktk 100 0 0 0 0 0 500
181 Nistatin Tab.Vaginal 100.000 iu/g ktk 100 0 0 0 0 0 500
182 Nistatin Tab. 500.000 iu/g ktk 100 0 0 0 0 0 500
183 Novadryl Inj vial 0 0 0 0 0 90
184 Novamydon inj vial 0 0 0 0 0 90
185 Obat antituberkulosis kategori I paket 0 0 0 0 0
186 Obat antituberkulosis kategori II paket 0 0 0 0 0
187 Obat antituberkulosis kategori III paket 0 0 0 0 0
188 Obat antituberkulosis Kategori Sisipan paket 0 0 0 0 0
189 Obat antituberkulosis kategori anak paket 0 0 0 0 0
190 OBH Cairan btl 100 ml 0 0 0 0 0
191 OBH Plus Sirup btl 100 ml 0 0 0 0 0 200
192 Oksitetrasiklin HCL inj.50 mg/ml-10 ml ktk 10 vial 0 0 0 0 0 50
193 Oksitetrasiklin HCL salep kulit 3 % ktk 25 tube 0 0 0 0 0 50
194 Oksitetrasiklin HCL Salep mata ktk 25 tube 0 0 0 0 0
195 Oksitoksin inj iu / ml - ml/Pitogin ktk 30 amp 0 0 0 0 0 200
196 Paramidon inj vial 0 0 0 0 0
harga stok peneri perse pema sisa stok stok permintaa Pemberian Harga
NO Nama Obat Kemasan Ket
satuan awal maan diaan kaian optimu n Askes DAU Lain2 Jml Total
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) m
10 11 12 13 14 15 16 17
197 Parasetamol Sirup 120 mg / 5 ml btl 60 ml 20 0 20 20 0 200
198 Parasetamol Tab 100 mg btl 100 0 0 0 0 0
199 Parasetamol Tab 500 mg btl 1000 0 0 0 0 0 10000
200 Papaverin inj. ktk 30 100 0 100 0 100
201 Papaverin tab 40 mg btl 1000 4000 0 4000 0 4000
202 Pembalut Gips ktk 60 ml 0 0 0 0 0 0
203 Pirantel Pamoat tab 365 mg ktk 100 0 0 0 0 0 1000
204 Piridoksin HCL (Vit. B6) tab 10 mg btl 1000 1000 0 1000 1000 0 5000
205 Piroxicam tab ktk 100 0 0 0 0 0 700
206 Plastik Obat bks 100 sac 0 0 0 0 0 500
207 Plester rol 6 12 18 6 12 12
208 Petidin Inj ampl 1 0 1 1 0
209 Phenoxymetil Penicillin ktk 100 0 500 500 100 400
210 Prednison tab 5 mg btl 1000 0 0 0 0 0 10000
211 Primakina tab 15 mg btl 1000 1500 0 1500 0 1500
212 Prokain Benzil Pinisilin Inj. 3 Juta vial 0 0 0 0 0
213 Propil Tiourasil Tab 100 mg btl 100 400 500 900 100 800
214 Propranolol HCL Tab. 40 mg ktk 100 200 0 200 0 200 500
215 Ranitidin inj amp 0 0 0 0 0 200
216 Ranitidin tab 150 mg ktk 30 0 0 0 0 0 1000
217 Rifamoisin Kaps 450 mg ktk 100 0 0 0 0 0
218 Ringer Laktat (RL) lar. Steril 500 ml 0 0 0 0 0 100
219 Retinol (Vit.A) Kaps.100.000 IU btl 50 0 0 0 0 0
220 Retinol (Vit.A) Kaps.200.000 IU btl 50 0 0 0 0 0
221 Salbutamol Tab. 2 mg ktk 100 0 0 0 0 0
222 Salbutamol Tab. 4 mg ktk 100 100 0 100 100 0 500
223 Salep 2-4 komb dos 24 pot 0 0 0 0 0 50
224 Salisil Bedak 2 % 50 gr 0 0 0 0 0 100
225 Salisil Spritus 10 % ktk 10 btl 0 0 0 0 0
226 Sianokobalamin (Vit. B12) inj.500 mcg / ml ampl 100 0 100 80 20 200
227 Sianokobalamin (Vit. B12) Tab btl 1000 0 0 0 0 0 3000
228 Sillk ( benang bedah sutera) no. 3/0 rol 36 0 36 0 36
229 Sillk ( benang bedah sutera) no.3/0 100 m rol 0 0 0 0 0
230 Silver Amalgam btl 0 0 0 0 0 2
231 Spons Gelatih Cubicles (Spongostan) ktk 24 buah 0 0 0 0 0
232 Sulfadimidin Tab.500 mg btl 1000 1000 0 1000 0 1000
233 Sulfasetamid Natrium Tetes Mata 0.5 % ktk 24 btl 0 24 24 0 24
234 Tablet Tambah Darah ktk 3000 btl 1235 0 1235 0 1235
235 Temporary Stopping Fletcher set 0 0 0 0 0
236 Tetracain HCL Tetes Mata 0.5 % btl 10 0 10 0 10
237 Tetrasiklin HCL Kaps. 250 mg btl 1000 0 0 0 0 0 8000
harga stok peneri perse pema sisa stok stok permintaa Pemberian Harga
NO Nama Obat Kemasan Ket
satuan awal maan diaan kaian optimu n Askes DAU Lain2 Jml Total
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) m
10 11 12 13 14 15 16 17
238 Tetrasiklin HCL Kaps. 500 mg ktk 100 0 0 0 0 0
239 Tiamin HCL (Vit.B1) Inj ktk 30 amp 25 0 25 25 0 100
240 Tiamin HCL(Vit.B1) Mononitrat Tab. 50 mg btl 1000 2000 0 2000 1000 1000 5000
241 Transamin Tab. ktk 100 0 0 0 0 0 500
242 Tensigard ktk 50 0 0 0 0 0 1000
243 Triheksifenidil HCL Tab. 2 mg ktk 100 500 0 500 0 500 ED Sep 2010
244 Trisulfa Tab.500 mg btl 1000 0 0 0 0 0
245 Ulsikur Inj ktk 5 amp 0 0 0 0 0
246 Vaksin Anti Rabies (Verorab) amp 0 0 0 0 0
247 Vitamin B.Kompleks Tab btl 1000 6000 0 6000 2000 4000
248 Yodium povidon lar.10% Btl 30 ml 80 0 80 10 70
249 Yodium povidon lar.10% btl 1000 ml 0 0 0 0 0 5
250 Mata pisau karbon No.10 pcs 0 0 0 0 0
251 Mata pisau karbon No.11 pcs 0 0 0 0 0
252 Mata pisau karbon No.15 pcs 0 0 0 0 0 100
253 Mata pisau karbon No.20 pcs 0 0 0 0 0 100
254 Mata pisau karbon No.21 pcs 0 0 0 0 0
255 Dopamin ktk amp 0 0 0 0 0
256 Jarum Hecting otot lusin 12 0 12 2 10
257 Jarum Hecting kulit lusin 24 0 24 4 20
258 Sarung tangan No.7 pasang 0 0 0 0 0 100
259 Urine bag buah 0 0 0 0 0
260 Cendo Flucain blt 10 ml 40 0 40 0 40
261 Bio ATP ktk 100 0 0 0 0 0 1000
262 Dasabion ktk 100 0 0 0 0 0 1000
263 Hemaford ktk 100 0 0 0 0 0 1000
264 Pehavral ktk 100 0 0 0 0 0 1000
265 H2O2 btl 100 ml 0 0 0 0 0 10
UMUM
Askes Jumlah
Jumlah Pasien / Resep Bayar LAIN-LAIN JPS No Jenis Penyakit Jumlah
556 15 662 262 1495 1 ISPA 375
2 Gastritis 193
Mengetahui / Menyetujui : Yang Menyerahkan Yang Melapor Penerima Obat 3 Karies gigi 137
Kepala Dinas Kesehatan Kepala GFK Poso Kepala Puskesmas Petugas Puskesmas 4 Gingvitas & P. periodenta 101
 Kabupaten Poso, 5 Malaria Klinis 74
6 Kecelakaan&ruda Paksa 68
7 Hipertensi 61
8 P Pulpa&Jar Peripikal 58
Drg. Urip Heriyanto, M.Kes Sri Agus Purwati, SE dr. Albertus R. Bouw Fredrik Nesi,S.si,Apt 9 Diare 49
NIP.19590721 198603 1 012 NIP.19630817 19811 2 005 NIP.19710612 200502 1 004 NIP.19830506 200903 1 002 10 Malaria Vivax 39
 FORM REKAPETULASI LAPORAN NARKOTIKA PUSKESMAS TENTENA

Kabupaten : POSO Propinsi : Sulawesi Tengah

Bulan Juli Tahun : 2010

Pemasukan Penggunaan
No Narkotika Satuan Saldo Awal Persediaan Saldo Akhir
Dari Jumlah Untuk Jumlah
1 Codein 10 mg tablet Tablet 250 0 250 250 0
2 Pethidine HCL 50 mg/ml Inj Ampul 1 0 1 1 0

Catatan : Laporan Masuk Paling Lambat tgl.25 bulan berjalan

Poso,………………..……………………….
Mengetahui
Kepala Puskesmas Tentena Pengelola Obat Puskesmas

dr. Albertus R. Bouw Fredrik Nesi, S.Si., Apt

NIP. 19710612 200502 1 004 NIP. 19830506 200903 1 002