Anda di halaman 1dari 217

BUKU BANTU PENGELUARAN OBAT LPLPO

Nama Puskesmas : TANJUNG PINANG Bulan


Tahun

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore


NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

1 2 3 4 5 6 7 9
1 Air Raksa Dental Use Btl
2 Alat Suntik 1 ml Set
3 Alat Suntik 2.5 ml Set
4 Albendazol 400 mg Set
5 Alupurinol 100 mg Tab
6 Aminophylin 200 mg Tab
7 Aminophylin inj 24 mg/ml 10 ml Amp
8 Amitriptilin HCl tablet 25 mg Tab
9 Amoksisillin sirup kering 125 mg/5 ml Btl
10 Amoksisillin kapsul 250 mg Kap
11 Amoksisillin kaplet 500 mg Kap
12 Ampicillin kaplet 500 mg Kap
13 Ampicillin sirup kering 125 mg/5 ml Btl
14 Antalgin tablet 500 mg Tab
15 Antalgin injeksi Amp
16 Antasida DOEN tablet kombinasi Tab
17 Antibakteri DOEN salep kombinasi Pot
18 Antihemoroid DOEN kombinasi Pot
19 Antifungi DOEN kombinasi Pot
20 Antimigrain DOEN kombinasi Tab
21 Aqua proinjeksi bebas pirogen Amp
22 Aquadest steril Amp
23 Asam askorbat (vit C) 50 mg Tab
24 Asam askorbat (vit C)250 mg Tab
25 Asetosal tablet 100 mg Tab
26 Asetosal tablet 500 mg Tab
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp
28 Atropin sulfat tablet 0,5 mg Tab
29 Atropin sulfat tetes mata 0 5 % Btl
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp
31 Besi sirup Btl
32 Betametason krim 0,1 % Tube
33 Catgut/benang bedah no. 2/0 - 3/0 Sak
34 Captopril 12.5 mg tablet Tab
35 Captopril 25 mg tablet Tab
36 Deksametason injeksi 5 mg/ml - 1 ml Amp
37 Deksametason tablet 0,5 mg Tab
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl
39 Dekstromethorpan HBr tablet 15 mg Tab
40 Devitalisasi pasta Btl
41 Diazepam injeksi 5 mg/ml - 2 ml Amp
42 Diazepam 2 mg Tab
43 Diazepam 5 mg Tab
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp
45 Digoksin tablet 0,25 mg Tab
46 Efedrin HCl tablet 25 mg Tab
47 Ekstrak belladon tablet 10 mg Tab
48 Epinephrin HCl injeksi Amp
49 Etakridin (rivanol) larutan 0,1 Btl
50 Etambutol HCl 250 mg tablet Tab
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

51 Etambutol HCl 500 mg tablet Tab


52 Etil klorida semprot Btl
53 Eugenol cairan Btl
54 Fenitoin natrium kapsul 100 mg Kap
55 Fenitoin natrium kapsul 30 mg Kap
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp
57 Fenobarbital tablet 100 mg Tab
58 Fenobarbital tablet 30 mg Tab
59 Fenoksi metil penisillin tablet 250 mg Tab
60 Fenoksi metil penisillin tablet 500 mg Tab
61 Fenol gliserol tetes telinga 10 % Btl
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp
63 Fitomenadion (vit K) tablet salut 10 mg Tab
64 Furosemid tablet 40 mg Tab
65 Gameksan emulsi 1 % Btl
66 Garam oralit 200 ml air Sak
67 Gentian violet larutan 1 % Btl
68 Glass ionomer semen (gc ix) Btl
69 Glibenklamid tablet 5 mg Tab
70 Gliseril guayakolat tablet 100 mg Tab
71 Gliserin Btl
72 Glukosa Larutan Infus 5 % Steril Btl
73 Griseofulvin 125 mg micronized Tab
74 Halloperidol tablet 0,5 mg Tab
75 Halloperidol tablet 1,5 mg Tab
76 Halloperidol tablet 5 mg Tab
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab
78 Hidrokortison krim 2,5 % Pot
79 Ibuprofen tablet 200 mg Tab
80 Ibuprofen tablet 400 mg Tab
81 Infusion set anak Set
82 Infusion set dewasa Set
83 I N H tablet 100 mg Tab
84 I N H tablet 300 mg Tab
85 Isosorbit dinitrat tablet sublingual 5 mg Tab
86 Kalium permanganat serbuk Btl
87 Kalsium hidroksida pasta Tab
88 Kalsium Laktat ( Kalk ) 500 mg Tab
89 Kapas pembalut / Absorben 250 gram Rol
90 Karbamazepin tablet 200 mg Tab
91 Kasa kompres 40/40 steril Rol
92 Kasa pembalut hidrofil 4 m x 15 cm Rol
93 Kasa pembalut hidrofil 4 m x 3 cm Rol
94 Kloramfenikol 250 mg kapsul Kap
95 Kloramfenikol salep mata 1 % Pot
96 Kloramfenikol tetes telinga 3 % Btl
97 Klorfeniramine maleat tablet 4 mg Tab
98 Kloroquin pospat tablet 250 mg Tab
99 Klorpromazin hcl injeksi Amp
100 Klorfenol kamfermenthol (CHKM) Btl
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp
102 Klorpromazin hcl tablet salut 100 mg Tab
103 Klorpromazin hcl tablet salut 25 mg Tab
104 Kodein hcl tablet 10 mg Tab
105 Komb. primetamin 25 mg + suldok 500 mg Tab
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

106 Kotrimoksazol pediatrik tablet Tab


107 Kotrimoksazol suspensi Btl
108 Kotrimoksazol dewasa tablet Tab
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab
111 Lidokain Kompositum injeksi Amp
112 Magnesium sulfat inj. 20% - 25 ml Btl
113 Magnesium sulfat inj. 40% - 25 ml Btl
114 Mebendazol Syrup Tab
115 Metilergometrin tablet salut Tab
116 Metilergometrin Inj. Amp
117 Metronidazol tablet 250 mg Tab
118 Metronidazol tablet 500 mg Tab
119 Mummifying pasta Pot
120 Natrium bikarbonat tablet 500 mg Tab
121 Natrium klorida larutan infus 0,9 % steril Btl
122 Nistatin 100.000 iu/g tablet vaginal Tab
123 Nistatin 500.000 iu/g tablet salut Tab
124 Nifedipin tab Tab
125 Obat anti tuberkolusis katagori 1 Tab
126 Obat anti tuberkolusis katagori 2 Tab
127 Obat anti tuberkolusis katagori 3 Tab
128 Obat anti tuberkolusis sisipan Tab
129 Obat anti tuberkolosis anak Tab
130 Obat batuk hitam ( o b h ) cairan Btl
131 Oksitetrasiklin hcl inj. Amp
132 Oksitetrasiklin hcl salep kulit 3 % Pot
133 Oksitetrasiklin hcl salep mata 1 % Pot
134 Papaverin tablet Tab
135 Paraformaldehid tablet 1 gram Tab
136 Parasetamol sirup 120 mg/5ml Btl
137 Parasetamol tablet 100 mg Tab
138 Parasetamol tablet 500 mg Tab
139 Perfenazin tablet 4 mg Tab
140 Pirantel pamoat tablet 365 mg Tab
141 Piridoxin hcl tablet 10 mg Tab
142 Pyrazinamid tablet Tab
143 Plester 5 yard x 2 inch Rol
144 Polikresulen Btl
145 Prazikuantel tablet 600 mg Tab
146 Prednison tablet 5 mg Tab
147 Primaquin tablet 15 mg Tab
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp
149 Propiltiourasil tablet 100 mg Tab
150 Propanolol hcl tablet 40 mg Tab
151 Propanolol hcl tablet 10 mg Tab
152 Reserpin tablet 0,10 mg Tab
153 Reserpin tablet 0,25 mg Tab
154 Retinol ( Vit A ) 200.000 iu Kap
155 Retinol ( Vit A ) 100.000 iu Kap
156 Rifampisin kapsul 600 mg Kap
157 Rifampisin kapsul 450 mg Kap
158 Rifampisin kapsul 300 mg Kap
159 Ringer laktat infus steril Btl
160 Salbutamol tablet 2 mg Tab
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

161 Salep 2-4 Pot


162 Salisil bedak 2 % Sak
163 Salisil spritus 10 % Btl
164 Semen seng fosfat serbuk dan cairan Btl
165 Serum ABU polivalen inj. Amp
166 Serum ATS 1500 IU Amp
167 Serum ATS 20000 IU Amp
168 Simvastatin Tab
169 Sianokobalamin inj. 500 mcg/ml Amp
170 Silk (benang bedah sutera) no. 3/0 Rol
171 Silver amalgam serbuk 65 - 75 % Pot
172 Spons gelatin cublices 1x1x1 cm Sak
173 Streptomycin serbuk inj. 1000 mg/vial Amp
174 Sulfadimidin tablet 500 mg Tab
175 Sulfasetamid natrium tetes mata 15 % Btl
176 Tablet tambah darah kombinasi Tab
177 Temporary stoping fletcher dan cairan Btl
178 Tetrasiklin HCl kapsul 250 mg Kap
179 Tetrasiklin HCl kapsul 500 mg Kap
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp
181 Tiamin HCl mononitrat tablet 50 mg Tab
182 Triheksilfenidil HCl tablet 2 mg Tab
183 Trikresol formalin cairan Btl
184 Vaksin Rabies Vero Amp
185 Vitamin B komplek tablet Tab
186 Yodium povidon larutan 10 % - 30 ml Btl
187 Yodium povidon larutan 10 % - 300 ml Btl

1 Acyclovir tablet 200 mg Tab


2 Acyclovir cream Tube
3 Acyclovir tablet 400 mg Tab
4 Andalan Injeksi Amp
5 Asam mefenamat kapsul 250 mg Tab
6 Asam mefenamat tablet 500 mg Tab
7 Ampicilin injeksi 1 g Amp
8 Ambroxol Sirup Amp
9 Cefotaxime inj 1 gr Amp
10 Cimetidin tablet 200 mg Tab
11 Ciprofloxacin kaplet 500 mg Kap
12 Dasabion tab Tab
13 Domperidon tab Tab
14 Erytromycin caps 250 mg Kap
15 Erytromycin capt 500 mg Kap
16 Erytromycin Syr Btl
17 Etabion Cap Cap
18 Gentamycin injeksi Amp
19 Gentamycin salep kulit Pot
20 Gentamycin tetes mata Btl
21 H2O2 Btl
22 Ichtyol salap Pot
23 Levertran salep Pot
24 Kloramphenicol tetes mata Btl
25 Metoklorpropamide Hcl 10 mg Tab
26 Mikonazole cream Pot
27 Methyl Prednisolon tab 4 mg Tab
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

28 Nipedipin tablet Tab


29 Natrium Diklofenak 25 mg Tab
30 Obat Tambah Darah Indo tab
31 Obat Flu Indo Tab
32 Obat Maag indo Tab
33 Papaverin injeksi Amp
34 Papaverin tablet 40 mg Tab
35 Piperazin 500 mg Tab
36 Piperazin sirup Btl
37 Piroksikam tablet 10 mg Tab
38 Piroksikam tablet 20 mg Tab
39 Ranitidine 150 mg Tab
40 Stesolit Rectal supp Tube

1 Alkohol 70 % Btl
2 Anisol solution Btl
3 Asam Asetat Glasial Btl
4 Aqua destilata Btl
5 Asam Klorida 0.1 N Btl
6 Asam klorida 0,1 N Btl
7 Asam sulfosalisilat 20 % Btl
8 Barium Klorida Btl
9 Beker Glass Ktk
10 Blood Lancet Btl
11 Erlemeyer Btl
12 Etanol asam 3 % Btl
13 Etanol 70 % Btl
14 Fauchet Btl
15 Imersen Oil HB Rol
16 Kapas 1 KG Rol
17 Kertas Saring Whatman lbr
18 Kertas Perkamen Btl
19 Larutan Bupper PH 7.2 Set
20 Label Etiket Btl
21 Larutan Metanol Btl
22 Larutan Sulposalisilat Btl
23 Larutan Benedict Btl
24 Larutan Eosin 2 % Btl
25 Larutan Etanol Asam Btl
26 Larutan Giemsa Stalin Btl
27 Larutan Karbol Fuksin Btl
28 Larutan Metilen Biru Btl
29 Larutan Turk Btl
30 Lisol Btl
31 Metanol Btl
32 Natrium Sitrat 38 % Ktk
33 Objek Glass Set
34 Plastik Obat Ktk
35 Pipet Tetes Biasa Btl
36 Rees echer Ktk
37 Rak Pewarna kaca pipet Btl
38 Schlesinger Btl
39 Spiritus 100 ml Ktk
40 Tes Gol. Darah( A,B,AB) Ktk
41 Tes Kehamilan HCG Set
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

42 Tabung Reaksi Set


43 Tissue lensa pcs
44 Alat suntik 3 cc ktk
45 ACT amp
46 Artesunate tab
47 Ambroxol tab tube
48 Clindamicin caps
49 Cetrizin tab
50 Hemafort tab
51 Oxytocin inj amp
52 Pembalut gip bks
53 Salbutamol 4 mg tab
54 Antasida syrup pcs
55 Lysmin sirup lbr
56 Lytamin syrup Btl
57 Mecobion tab Tab
58 Bioplasenton jelly Tab
59 Dolodon 500 mg Tab
60 Metformin Tab
61 Meloxicam 7,5 mg Tab
62 Bisturi 10,11,20,22 Tab
63 Jarum jahit 10,11,12,13,14 Tab
64 Duo Care Gluko le st pcs
65 Stick Gula darah pcs
66 Hand scun Pcs
67 Cyproploxacin 250 mg Tbng
68 Asam Folat set
69 Omeprazole Caps
70 Zink Tab Tab
71 Doxycicklin 100mg Tab
72 Amlodipin 5 mg Caps
73 Dexanta Tab Tab
74 Viliron tab
75 Co Amoxiclav 625 mg Tab
76 Masker ktk
77 Kloramfenikol Syrup Btl
78 Depo Vial
79 Scabisid Tab
80 Glimepiride Tab
81 Interhistin Tab Tube
82 Neo Diaform Tube
83 Scanderma cream Tube
84 Fluconazol bks
85 Azhromycin sifiksim tab
: Maret
: 2014

Jumlah
9

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan
Tahun

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore


NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

1 2 3 4 5 6 7 9
1 Air Raksa Dental Use Btl 0
2 Alat Suntik 1 ml Set 60
3 Alat Suntik 2.5 ml Set 53 61 39 100
4 Albendazol 400 mg Set 23 60
5 Alupurinol 100 mg Tab 184 123 250 2300
6 Aminophylin 200 mg Tab 90 139 150 134 400
7 Aminophylin inj 24 mg/ml 10 ml Amp 0
8 Amitriptilin HCl tablet 25 mg Tab 720 0
9 Amoksisillin sirup kering 125 mg/5 ml Btl 44 15 26 10 400 3
10 Amoksisillin kapsul 250 mg Kap 500 420 677 326 960
11 Amoksisillin kaplet 500 mg Kap 560 416 703 196 10500 20
12 Ampicillin kaplet 500 mg Kap 37 310 335 800
13 Ampicillin sirup kering 125 mg/5 ml Btl 23 17 38 12 26
14 Antalgin tablet 500 mg Tab 399 385 439 752 4700
15 Antalgin injeksi Amp 30
16 Antasida DOEN tablet kombinasi Tab 722 1273 1329 1280 18300 30
17 Antibakteri DOEN salep kombinasi Pot 26 8 4 70
18 Antihemoroid DOEN kombinasi Pot 7 10 5 40
19 Antifungi DOEN kombinasi Pot 8 4 20 4 14
20 Antimigrain DOEN kombinasi Tab 0
21 Aqua proinjeksi bebas pirogen Amp 2 0
22 Aquadest steril Amp 0
23 Asam askorbat (vit C) 50 mg Tab 2555 1000 1261 716 3000 29
24 Asam askorbat (vit C)250 mg Tab 0
25 Asetosal tablet 100 mg Tab 160 300
26 Asetosal tablet 500 mg Tab 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0
28 Atropin sulfat tablet 0,5 mg Tab 0
29 Atropin sulfat tetes mata 0 5 % Btl 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0
31 Besi sirup Btl 0
32 Betametason krim 0,1 % Tube 6 6 2 0 1
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0
34 Captopril 12.5 mg tablet Tab 493 16 139 500
35 Captopril 25 mg tablet Tab 1085 178 76 2800 90
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 6 65
37 Deksametason tablet 0,5 mg Tab 228 1396 1259 484 9000
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 25 5 1 12 225
39 Dekstromethorpan HBr tablet 15 mg Tab 190 320 325 2300
40 Devitalisasi pasta Btl 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 0
42 Diazepam 2 mg Tab 900 0
43 Diazepam 5 mg Tab 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 32 9 23 330
45 Digoksin tablet 0,25 mg Tab 100 0
46 Efedrin HCl tablet 25 mg Tab 706 60 65 0
47 Ekstrak belladon tablet 10 mg Tab 138 231 126 0
48 Epinephrin HCl injeksi Amp 47
49 Etakridin (rivanol) larutan 0,1 Btl 1 2 1 7
50 Etambutol HCl 250 mg tablet Tab 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

51 Etambutol HCl 500 mg tablet Tab 150 100


52 Etil klorida semprot Btl 8
53 Eugenol cairan Btl 3
54 Fenitoin natrium kapsul 100 mg Kap 660 0
55 Fenitoin natrium kapsul 30 mg Kap 632 0
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0
57 Fenobarbital tablet 100 mg Tab 0
58 Fenobarbital tablet 30 mg Tab 914 0
59 Fenoksi metil penisillin tablet 250 mg Tab 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0
61 Fenol gliserol tetes telinga 10 % Btl 19 5 62
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 8 28
63 Fitomenadion (vit K) tablet salut 10 mg Tab 143 90 102 58 200
64 Furosemid tablet 40 mg Tab 55 200
65 Gameksan emulsi 1 % Btl 0
66 Garam oralit 200 ml air Sak 130 70 112 70 600
67 Gentian violet larutan 1 % Btl 33 4 8 4 24
68 Glass ionomer semen (gc ix) Btl 0
69 Glibenklamid tablet 5 mg Tab 294 1200
70 Gliseril guayakolat tablet 100 mg Tab 3016 3246 3401 1316 7000
71 Gliserin Btl 0
72 Glukosa Larutan Infus 5 % Steril Btl 0
73 Griseofulvin 125 mg micronized Tab 344 81 337 60 300
74 Halloperidol tablet 0,5 mg Tab 0
75 Halloperidol tablet 1,5 mg Tab 750 0
76 Halloperidol tablet 5 mg Tab 4 0
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 364 240 100 60 1000
78 Hidrokortison krim 2,5 % Pot 55 7 6 5 48 2
79 Ibuprofen tablet 200 mg Tab 714 366 379 377 400 29
80 Ibuprofen tablet 400 mg Tab 60 900
81 Infusion set anak Set 0
82 Infusion set dewasa Set 0
83 I N H tablet 100 mg Tab 995 0
84 I N H tablet 300 mg Tab 383 0
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 40 1900
86 Kalium permanganat serbuk Btl 0
87 Kalsium hidroksida pasta Tab 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 1408 790 467 742 1000 70
89 Kapas pembalut / Absorben 250 gram Rol 1 1 1 9
90 Karbamazepin tablet 200 mg Tab 240 0
91 Kasa kompres 40/40 steril Rol 0
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 2 7 4 35
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0
94 Kloramfenikol 250 mg kapsul Kap 70 0
95 Kloramfenikol salep mata 1 % Pot 0
96 Kloramfenikol tetes telinga 3 % Btl 3 6 10 2 0
97 Klorfeniramine maleat tablet 4 mg Tab 3305 4232 3516 1162 17000 35
98 Kloroquin pospat tablet 250 mg Tab 0
99 Klorpromazin hcl injeksi Amp 0
100 Klorfenol kamfermenthol (CHKM) Btl 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0
102 Klorpromazin hcl tablet salut 100 mg Tab 158 0
103 Klorpromazin hcl tablet salut 25 mg Tab 0
104 Kodein hcl tablet 10 mg Tab 146 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

106 Kotrimoksazol pediatrik tablet Tab 100 100 100 88 300


107 Kotrimoksazol suspensi Btl 35 20 46 31 525
108 Kotrimoksazol dewasa tablet Tab 484 383 273 184 3600
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0
111 Lidokain Kompositum injeksi Amp 4 5 34 60
112 Magnesium sulfat inj. 20% - 25 ml Btl 10
113 Magnesium sulfat inj. 40% - 25 ml Btl 10
114 Mebendazol Syrup Tab 0
115 Metilergometrin tablet salut Tab 155 100
116 Metilergometrin Inj. Amp 30
117 Metronidazol tablet 250 mg Tab 0
118 Metronidazol tablet 500 mg Tab 217 100 90 120 300
119 Mummifying pasta Pot 0
120 Natrium bikarbonat tablet 500 mg Tab 528 100 0
121 Natrium klorida larutan infus 0,9 % steril Btl 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 71 0
123 Nistatin 500.000 iu/g tablet salut Tab 0
124 Nifedipin tab Tab 94 0
125 Obat anti tuberkolusis katagori 1 Tab 0
126 Obat anti tuberkolusis katagori 2 Tab 0
127 Obat anti tuberkolusis katagori 3 Tab 0
128 Obat anti tuberkolusis sisipan Tab 0
129 Obat anti tuberkolosis anak Tab 0
130 Obat batuk hitam ( o b h ) cairan Btl 18 0
131 Oksitetrasiklin hcl inj. Amp 1 0
132 Oksitetrasiklin hcl salep kulit 3 % Pot 48 10 17 4 350
133 Oksitetrasiklin hcl salep mata 1 % Pot 21 25
134 Papaverin tablet Tab 751 40 0
135 Paraformaldehid tablet 1 gram Tab 0
136 Parasetamol sirup 120 mg/5ml Btl 38 17 4 5 150 4
137 Parasetamol tablet 100 mg Tab 0
138 Parasetamol tablet 500 mg Tab 2119 3146 5587 2545 22000 5
139 Perfenazin tablet 4 mg Tab 0
140 Pirantel pamoat tablet 365 mg Tab 87 80 8 8 0
141 Piridoxin hcl tablet 10 mg Tab 1901 1742 645 656 5000 70
142 Pyrazinamid tablet Tab 213 600
143 Plester 5 yard x 2 inch Rol 1 1 1 8
144 Polikresulen Btl 10
145 Prazikuantel tablet 600 mg Tab 0
146 Prednison tablet 5 mg Tab 1094 1528 356 694 5000 95
147 Primaquin tablet 15 mg Tab 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 30
149 Propiltiourasil tablet 100 mg Tab 222 600
150 Propanolol hcl tablet 40 mg Tab 0
151 Propanolol hcl tablet 10 mg Tab 150 700
152 Reserpin tablet 0,10 mg Tab 0
153 Reserpin tablet 0,25 mg Tab 123 1000
154 Retinol ( Vit A ) 200.000 iu Kap 0
155 Retinol ( Vit A ) 100.000 iu Kap 0
156 Rifampisin kapsul 600 mg Kap 213 0
157 Rifampisin kapsul 450 mg Kap 70 400
158 Rifampisin kapsul 300 mg Kap 79 0
159 Ringer laktat infus steril Btl 0
160 Salbutamol tablet 2 mg Tab 265 40 600
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

161 Salep 2-4 Pot 8 4 4 3 23


162 Salisil bedak 2 % Sak 19 6 11 4 125
163 Salisil spritus 10 % Btl 0
164 Semen seng fosfat serbuk dan cairan Btl 0
165 Serum ABU polivalen inj. Amp 0
166 Serum ATS 1500 IU Amp 5 6
167 Serum ATS 20000 IU Amp 0
168 Simvastatin Tab 129 400
169 Sianokobalamin inj. 500 mcg/ml Amp 115 71 86 390
170 Silk (benang bedah sutera) no. 3/0 Rol 1 2 2
171 Silver amalgam serbuk 65 - 75 % Pot 0
172 Spons gelatin cublices 1x1x1 cm Sak 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0
174 Sulfadimidin tablet 500 mg Tab 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0
176 Tablet tambah darah kombinasi Tab 868 365 874 422 4800
177 Temporary stoping fletcher dan cairan Btl 0
178 Tetrasiklin HCl kapsul 250 mg Kap 1787 930 0
179 Tetrasiklin HCl kapsul 500 mg Kap 180 110 3800
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 60
181 Tiamin HCl mononitrat tablet 50 mg Tab 1755 448 1087 405 3000 20
182 Triheksilfenidil HCl tablet 2 mg Tab 680 0
183 Trikresol formalin cairan Btl 0
184 Vaksin Rabies Vero Amp 0
185 Vitamin B komplek tablet Tab 1109 1230 1294 396 7000 18
186 Yodium povidon larutan 10 % - 30 ml Btl 1 14
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 14

1 Acyclovir tablet 200 mg Tab 168 200 124 1050


2 Acyclovir cream Tube 27 8 4 296
3 Acyclovir tablet 400 mg Tab 300 100 160 300
4 Andalan Injeksi Amp 0
5 Asam mefenamat kapsul 250 mg Tab 0
6 Asam mefenamat tablet 500 mg Tab 304 430 222 5500 25
7 Ampicilin injeksi 1 g Amp 20
8 Ambroxol Sirup Amp 16 200
9 Cefotaxime inj 1 gr Amp 0
10 Cimetidin tablet 200 mg Tab 0
11 Ciprofloxacin kaplet 500 mg Kap 154 5000
12 Dasabion tab Tab 0
13 Domperidon tab Tab 248 1000
14 Erytromycin caps 250 mg Kap 80 900
15 Erytromycin capt 500 mg Kap 0
16 Erytromycin Syr Btl 0
17 Etabion Cap Cap 0
18 Gentamycin injeksi Amp 20
19 Gentamycin salep kulit Pot 26 98
20 Gentamycin tetes mata Btl 14 90
21 H2O2 Btl 3
22 Ichtyol salap Pot 0
23 Levertran salep Pot 0
24 Kloramphenicol tetes mata Btl 24 0
25 Metoklorpropamide Hcl 10 mg Tab 1400
26 Mikonazole cream Pot 36 120
27 Methyl Prednisolon tab 4 mg Tab 165 1500
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

28 Nipedipin tablet Tab 94 0


29 Natrium Diklofenak 25 mg Tab 160 1300
30 Obat Tambah Darah Indo tab 0
31 Obat Flu Indo Tab 0
32 Obat Maag indo Tab 0
33 Papaverin injeksi Amp 0
34 Papaverin tablet 40 mg Tab 751 1000
35 Piperazin 500 mg Tab 0
36 Piperazin sirup Btl 0
37 Piroksikam tablet 10 mg Tab 196 1100
38 Piroksikam tablet 20 mg Tab 50 0
39 Ranitidine 150 mg Tab 248 1300 80
40 Stesolit Rectal supp Tube 3 0

1 Alkohol 70 % Btl 1 1 1 3
2 Anisol solution Btl 0
3 Asam Asetat Glasial Btl 0
4 Aqua destilata Btl 0
5 Asam Klorida 0.1 N Btl 0
6 Asam klorida 0,1 N Btl 0
7 Asam sulfosalisilat 20 % Btl 0
8 Barium Klorida Btl 0
9 Beker Glass Ktk 0
10 Blood Lancet Btl 0
11 Erlemeyer Btl 0
12 Etanol asam 3 % Btl 0
13 Etanol 70 % Btl 0
14 Fauchet Btl 0
15 Imersen Oil HB Rol 0
16 Kapas 1 KG Rol 0
17 Kertas Saring Whatman lbr 0
18 Kertas Perkamen Btl 13 10 26 200
19 Larutan Bupper PH 7.2 Set 0
20 Label Etiket Btl 0
21 Larutan Metanol Btl 0
22 Larutan Sulposalisilat Btl 0
23 Larutan Benedict Btl 0
24 Larutan Eosin 2 % Btl 0
25 Larutan Etanol Asam Btl 0
26 Larutan Giemsa Stalin Btl 0
27 Larutan Karbol Fuksin Btl 0
28 Larutan Metilen Biru Btl 0
29 Larutan Turk Btl 0
30 Lisol Btl 1 1
31 Metanol Btl 0
32 Natrium Sitrat 38 % Ktk 0
33 Objek Glass Set 0
34 Plastik Obat Ktk 350 100 200 18000
35 Pipet Tetes Biasa Btl 0
36 Rees echer Ktk 0
37 Rak Pewarna kaca pipet Btl 0
38 Schlesinger Btl 0
39 Spiritus 100 ml Ktk 0
40 Tes Gol. Darah( A,B,AB) Ktk 0
41 Tes Kehamilan HCG Set 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG sore
NO NAMA OBAT KELAS SATUAN Apotik jaya I II PKM malam

42 Tabung Reaksi Set 0


43 Tissue lensa pcs 0
44 Alat suntik 3 cc ktk 0
45 ACT amp 0
46 Artesunate tab 0
47 Ambroxol tab tube 273 1600
48 Clindamicin caps 0
49 Cetrizin tab 151 100
50 Hemafort tab 0
51 Oxytocin inj amp 0
52 Pembalut gip bks 0
53 Salbutamol 4 mg tab 0
54 Antasida syrup pcs 0
55 Lysmin sirup lbr 0
56 Lytamin syrup Btl 7 24
57 Mecobion tab Tab 281 900
58 Bioplasenton jelly Tab 0
59 Dolodon 500 mg Tab 0
60 Metformin Tab 491 1400 80
61 Meloxicam 7,5 mg Tab 191 2450
62 Bisturi 10,11,20,22 Tab 0
63 Jarum jahit 10,11,12,13,14 Tab 9
64 Duo Care Gluko le st pcs 0
65 Stick Gula darah pcs 0
66 Hand scun Pcs 0
67 Cyproploxacin 250 mg Tbng 0
68 Asam Folat set 632 0
69 Omeprazole Caps 0
70 Zink Tab Tab 421 3000
71 Doxycicklin 100mg Tab 48 0
72 Amlodipin 5 mg Caps 165 1590
73 Dexanta Tab Tab 160 800
74 Viliron tab 0
75 Co Amoxiclav 625 mg Tab 60 0
76 Masker ktk 1
77 Kloramfenikol Syrup Btl 8 40
78 Depo Vial 0
79 Scabisid Tab 3 0
80 Glimepiride Tab 70 0
81 Interhistin Tab Tube 190 1800
82 Neo Diaform Tube 100 0
83 Scanderma cream Tube 2 0
84 Fluconazol bks 20 50
85 Azhromycin sifiksim tab 10 60
: Februari
: 2014

Jumlah
9

0
60
253
83
2857
913
0
720
498
2883
12395
1482
116
6675
30
22934
108
62
50
0
2
0
8561
0
460
0
0
0
0
0
0
15
0
1148
4229
71
12367
268
3135
0
0
900
0
394
100
831
495
47
11
0
Jumlah
250
8
3
660
632
0
0
914
0
0
86
36
593
255
0
982
73
0
1494
17979
0
0
1122
0
750
4
1764
123
2265
960
0
0
995
383
1940
0
0
4477
12
240
0
48
0
70
0
21
29250
0
0
0
0
158
0
146
0
Jumlah
688
657
4924
0
0
103
10
10
0
255
30
0
827
0
628
0
71
0
94
0
0
0
0
0
18
1
429
46
791
0
218
0
35402
0
183
10014
813
11
10
0
8767
0
30
822
0
850
0
1123
0
0
213
470
79
0
905
Jumlah
42
165
0
0
0
11
0
529
662
5
0
0
0
0
0
7329
0
2717
4090
60
6715
680
0
0
11047
15
16
0
1542
335
860
0
0
6481
20
216
0
0
5154
0
1248
980
0
0
0
20
124
104
3
0
0
24
1400
156
1665
Jumlah
94
1460
0
0
0
0
1751
0
0
1296
50
1628
3
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
249
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
18650
0
0
0
0
0
0
0
Jumlah
0
0
0
0
0
1873
0
251
0
0
0
0
0
0
31
1181
0
0
1971
2641
0
9
0
0
0
0
632
0
3421
48
1755
960
0
60
1
48
0
3
70
1990
100
2
70
70
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Januari
Tahun : 2014

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0


2 Alat Suntik 1 ml Set 60 60
3 Alat Suntik 2.5 ml Set 81 81 71 200 433
4 Albendazol 400 mg Set 23 60 83
5 Alupurinol 100 mg Tab 140 200 280 2400 3020
6 Aminophylin 200 mg Tab 147 326 180 216 500 1369
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 820 0 820
9 Amoksisillin sirup kering 125 mg/5 ml Btl 38 32 28 18 525 641
10 Amoksisillin kapsul 250 mg Kap 660 609 767 522 2400 4958
11 Amoksisillin kaplet 500 mg Kap 858 608 843 404 15500 18213
12 Ampicillin kaplet 500 mg Kap 42 455 505 800 1802
13 Ampicillin sirup kering 125 mg/5 ml Btl 23 33 38 18 26 138
14 Antalgin tablet 500 mg Tab 532 500 539 980 6100 8651
15 Antalgin injeksi Amp 30 30
16 Antasida DOEN tablet kombinasi Tab 410 2165 1518 1695 20800 26588
17 Antibakteri DOEN salep kombinasi Pot 28 8 5 70 111
18 Antihemoroid DOEN kombinasi Pot 11 10 7 60 88
19 Antifungi DOEN kombinasi Pot 4 7 20 4 23 58
20 Antimigrain DOEN kombinasi Tab 0 0
21 Aqua proinjeksi bebas pirogen Amp 5 5
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1721 1670 1579 1020 9000 14990
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 160 300 460
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 33 15 7 6 0 61
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 783 88 247 160 500 1778
35 Captopril 25 mg tablet Tab 795 80 70 3700 4645
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 8 65 73
37 Deksametason tablet 0,5 mg Tab 574 2223 1354 730 10200 15081
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 17 13 14 19 245 308
39 Dekstromethorpan HBr tablet 15 mg Tab 192 380 452 2800 3824
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 0 48
42 Diazepam 2 mg Tab 1104 0 1104
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 45 9 42 330 426
45 Digoksin tablet 0,25 mg Tab 100 0 100
46 Efedrin HCl tablet 25 mg Tab 808 70 74 0 952
47 Ekstrak belladon tablet 10 mg Tab 488 116 190 0 794
48 Epinephrin HCl injeksi Amp 47 47
49 Etakridin (rivanol) larutan 0,1 Btl 2 2 1 7 12
50 Etambutol HCl 250 mg tablet Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

51 Etambutol HCl 500 mg tablet Tab 150 100 250


52 Etil klorida semprot Btl 8 8
53 Eugenol cairan Btl 3 3
54 Fenitoin natrium kapsul 100 mg Kap 660 0 660
55 Fenitoin natrium kapsul 30 mg Kap 632 0 632
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 934 0 934
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 8 62 70
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 11 33 44
63 Fitomenadion (vit K) tablet salut 10 mg Tab 73 115 102 100 400 790
64 Furosemid tablet 40 mg Tab 85 200 285
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 80 95 135 100 1100 1510
67 Gentian violet larutan 1 % Btl 30 7 8 7 24 76
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 274 1400 1674
70 Gliseril guayakolat tablet 100 mg Tab 2544 4459 3594 1710 13000 25307
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 310 160 337 80 500 1387
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 985 0 985
76 Halloperidol tablet 5 mg Tab 4 0 4
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 522 250 100 88 1000 1960
78 Hidrokortison krim 2,5 % Pot 32 15 8 11 72 138
79 Ibuprofen tablet 200 mg Tab 650 561 379 593 1200 3383
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 1000 1000
84 I N H tablet 300 mg Tab 442 0 442
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 40 1900 1940
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 1333 1327 548 926 2000 6134
89 Kapas pembalut / Absorben 250 gram Rol 2 1 11 14
90 Karbamazepin tablet 200 mg Tab 298 0 298
91 Kasa kompres 40/40 steril Rol 0 0
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 4 7 7 45 63
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 0 0
95 Kloramfenikol salep mata 1 % Pot 23 3 2 0 28
96 Kloramfenikol tetes telinga 3 % Btl 19 9 11 4 0 43
97 Klorfeniramine maleat tablet 4 mg Tab 2561 6225 3953 2068 23000 37807
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 406 0 406
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 147 0 147
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

106 Kotrimoksazol pediatrik tablet Tab 265 100 140 600 1105
107 Kotrimoksazol suspensi Btl 30 35 47 41 600 753
108 Kotrimoksazol dewasa tablet Tab 391 565 283 370 4500 6109
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 5 5 36 60 106
112 Magnesium sulfat inj. 20% - 25 ml Btl 10 10
113 Magnesium sulfat inj. 40% - 25 ml Btl 10 10
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 195 100 295
116 Metilergometrin Inj. Amp 30 30
117 Metronidazol tablet 250 mg Tab 0 0
118 Metronidazol tablet 500 mg Tab 167 176 90 180 500 1113
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 528 100 0 628
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 74 0 74
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 94 0 94
125 Obat anti tuberkolusis katagori 1 Tab 3 0 3
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 9 2 2 45 58
131 Oksitetrasiklin hcl inj. Amp 2 0 2
132 Oksitetrasiklin hcl salep kulit 3 % Pot 26 19 21 7 400 473
133 Oksitetrasiklin hcl salep mata 1 % Pot 50 50
134 Papaverin tablet Tab 931 70 0 1001
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 23 33 9 10 226 301
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 1613 5073 6406 3610 34000 50702
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 100 85 9 12 0 206
141 Piridoxin hcl tablet 10 mg Tab 1807 2470 948 866 6000 12091
142 Pyrazinamid tablet Tab 246 600 846
143 Plester 5 yard x 2 inch Rol 1 2 8 11
144 Polikresulen Btl 10 10
145 Prazikuantel tablet 600 mg Tab 0 0
146 Prednison tablet 5 mg Tab 1099 2360 630 1000 6000 11089
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 30 30
149 Propiltiourasil tablet 100 mg Tab 172 800 972
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 160 800 960
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 571 1000 1571
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 216 0 216
157 Rifampisin kapsul 450 mg Kap 114 400 514
158 Rifampisin kapsul 300 mg Kap 79 0 79
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 280 80 600 960
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

161 Salep 2-4 Pot 5 7 6 4 28 50


162 Salisil bedak 2 % Sak 7 10 13 7 162 199
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 6 6 12
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 99 500 599
169 Sianokobalamin inj. 500 mcg/ml Amp 130 72 106 400 708
170 Silk (benang bedah sutera) no. 3/0 Rol 1 2 2 5
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0 0
176 Tablet tambah darah kombinasi Tab 1263 600 983 632 6600 10078
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 887 1000 0 1887
179 Tetrasiklin HCl kapsul 500 mg Kap 240 150 3800 4190
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 60 60
181 Tiamin HCl mononitrat tablet 50 mg Tab 1665 1275 1291 765 5000 9996
182 Triheksilfenidil HCl tablet 2 mg Tab 1020 0 1020
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 1395 2165 1693 704 10000 15957
186 Yodium povidon larutan 10 % - 30 ml Btl 1 14 15
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 15 17
0
1 Acyclovir tablet 200 mg Tab 168 200 160 1050 1578
2 Acyclovir cream Tube 24 8 9 311 352
3 Acyclovir tablet 400 mg Tab 130 100 170 500 900
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 372 500 272 6100 7244
7 Ampicilin injeksi 1 g Amp 20 20
8 Ambroxol Sirup Amp 8 240 248
9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 124 5200 5324
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 290 1000 1290
14 Erytromycin caps 250 mg Kap 100 900 1000
15 Erytromycin capt 500 mg Kap 14 0 14
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 20 20
19 Gentamycin salep kulit Pot 33 123 156
20 Gentamycin tetes mata Btl 14 90 104
21 H2O2 Btl 3 3
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 22 25 47
25 Metoklorpropamide Hcl 10 mg Tab 1400 1400
26 Mikonazole cream Pot 4 168 172
27 Methyl Prednisolon tab 4 mg Tab 170 1700 1870
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

28 Nipedipin tablet Tab 0 0


29 Natrium Diklofenak 25 mg Tab 200 1300 1500
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 1000 1000
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 198 1400 1598
38 Piroksikam tablet 20 mg Tab 66 0 66
39 Ranitidine 150 mg Tab 290 1800 2090
40 Stesolit Rectal supp Tube 3 0 3

1 Alkohol 70 % Btl 1 1 1 4 7
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
17 Kertas Saring Whatman lbr 0 0
18 Kertas Perkamen Btl 23 20 30 200 273
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 1 2
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 750 500 600 22000 23850
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

42 Tabung Reaksi Set 0 0


43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 257 2300 2557
48 Clindamicin caps 0 0
49 Cetrizin tab 172 400 572
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 0 0
54 Antasida syrup pcs 0 0
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 18 24 42
57 Mecobion tab Tab 224 1000 1224
58 Bioplasenton jelly Tab 0 0
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 366 2000 2366
61 Meloxicam 7,5 mg Tab 115 2850 2965
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 50 50
66 Hand scun Pcs 0 0
67 Cyproploxacin 250 mg Tbng 0 0
68 Asam Folat set 1142 0 1142
69 Omeprazole Caps 0 0
70 Zink Tab Tab 349 3700 4049
71 Doxycicklin 100mg Tab 104 0 104
72 Amlodipin 5 mg Caps 139 1680 1819
73 Dexanta Tab Tab 170 800 970
74 Viliron tab 0 0
75 Co Amoxiclav 625 mg Tab 60 0 60
76 Masker ktk 3 3
77 Kloramfenikol Syrup Btl 9 40 49
78 Depo Vial 1 0 1
79 Scabisid Tab 4 0 4
80 Glimepiride Tab 70 0 70
81 Interhistin Tab Tube 200 1800 2000
82 Neo Diaform Tube 1000 0 1000
83 Scanderma cream Tube 5 0 5
84 Fluconazol bks 20 50 70
85 Azhromycin sifiksim tab 10 60 70
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Desember
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 70 70
3 Alat Suntik 2.5 ml Set 13 102 0 115
4 Albendazol 400 mg Set 23 0 23
5 Alupurinol 100 mg Tab 150 161 100 300 711
6 Aminophylin 200 mg Tab 251 19 190 300 760
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 390 0 390
9 Amoksisillin sirup kering 125 mg/5 ml Btl 11 0 11
10 Amoksisillin kapsul 250 mg Kap 660 228 102 467 600 2057
11 Amoksisillin kaplet 500 mg Kap 377 205 743 7000 8325
12 Ampicillin kaplet 500 mg Kap 42 0 42
13 Ampicillin sirup kering 125 mg/5 ml Btl 23 22 24 69
14 Antalgin tablet 500 mg Tab 550 145 65 149 2800 3709
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 33 0 33
17 Antibakteri DOEN salep kombinasi Pot 2 2 8 55 67
18 Antihemoroid DOEN kombinasi Pot 10 0 10
19 Antifungi DOEN kombinasi Pot 7 1 21 14 43
20 Antimigrain DOEN kombinasi Tab 0 0
21 Aqua proinjeksi bebas pirogen Amp 0 0
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 301 285 234 0 820
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 160 300 460
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 14 1 2 0 17
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 298 27 2000 2325
35 Captopril 25 mg tablet Tab 895 25 32 1600 2552
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 8 65 73
37 Deksametason tablet 0,5 mg Tab 619 100 120 929 9700 11468
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 28 5 1 210 244
39 Dekstromethorpan HBr tablet 15 mg Tab 237 56 4000 4293
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 0 0
42 Diazepam 2 mg Tab 1269 0 1269
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 9 150 159
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

46 Efedrin HCl tablet 25 mg Tab 808 75 95 0 978


47 Ekstrak belladon tablet 10 mg Tab 755 166 0 921
48 Epinephrin HCl injeksi Amp 47 47
49 Etakridin (rivanol) larutan 0,1 Btl 1 2 12 15
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 660 0 660
55 Fenitoin natrium kapsul 30 mg Kap 666 0 666
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 1128 0 1128
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 0 0
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 4 15 19
63 Fitomenadion (vit K) tablet salut 10 mg Tab 200 50 20 102 200 572
64 Furosemid tablet 40 mg Tab 85 35 0 120
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 105 24 80 800 1009
67 Gentian violet larutan 1 % Btl 3 0 3
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 330 600 930
70 Gliseril guayakolat tablet 100 mg Tab 1549 1846 1085 17000 21480
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 125 337 0 462
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 175 0 175
76 Halloperidol tablet 5 mg Tab 64 0 64
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 690 255 22 100 0 1067
78 Hidrokortison krim 2,5 % Pot 7 0 7
79 Ibuprofen tablet 200 mg Tab 417 100 179 379 1900 2975
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 1000 1000
84 I N H tablet 300 mg Tab 478 0 478
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 0 0
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 1015 130 775 3000 4920
89 Kapas pembalut / Absorben 250 gram Rol 1 1 10 12
90 Karbamazepin tablet 200 mg Tab 343 0 343
91 Kasa kompres 40/40 steril Rol 24 24
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 7 60 67
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 247 176 250 673
95 Kloramfenikol salep mata 1 % Pot 9 2 24 35
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

96 Kloramfenikol tetes telinga 3 % Btl 14 1 6 24 45


97 Klorfeniramine maleat tablet 4 mg Tab 1656 1081 2028 2530 20000 27295
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 651 0 651
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 147 0 147
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 100 200 300
107 Kotrimoksazol suspensi Btl 39 2 475 516
108 Kotrimoksazol dewasa tablet Tab 410 205 15 3000 3630
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 5 6 5 0 16
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 205 100 305
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 0 0
118 Metronidazol tablet 500 mg Tab 140 33 30 100 303
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 0 0
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 77 0 77
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 90 200 290
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 20 4 11 20 55
131 Oksitetrasiklin hcl inj. Amp 3 0 3
132 Oksitetrasiklin hcl salep kulit 3 % Pot 21 3 1 1 100 126
133 Oksitetrasiklin hcl salep mata 1 % Pot 14 0 14
134 Papaverin tablet Tab 1088 0 1088
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 47 0 47
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 1781 598 1378 11000 14757
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 7 85 4 9 100 205
141 Piridoxin hcl tablet 10 mg Tab 1664 200 60 2000 3924
142 Pyrazinamid tablet Tab 251 600 851
143 Plester 5 yard x 2 inch Rol 1 1 4 6
144 Polikresulen Btl 0 0
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

146 Prednison tablet 5 mg Tab 1792 135 3 1000 2930


147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 142 600 742
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 200 500 700
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 772 1000 1772
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 216 0 216
157 Rifampisin kapsul 450 mg Kap 142 400 542
158 Rifampisin kapsul 300 mg Kap 80 0 80
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 0 0
161 Salep 2-4 Pot 7 1 7 48 63
162 Salisil bedak 2 % Sak 4 3 5 108 120
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 1 1
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 134 600 734
169 Sianokobalamin inj. 500 mcg/ml Amp 50 20 72 0 142
170 Silk (benang bedah sutera) no. 3/0 Rol 0 0
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0 0
176 Tablet tambah darah kombinasi Tab 906 226 438 1800 3370
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 1019 55 1000 2074
179 Tetrasiklin HCl kapsul 500 mg Kap 280 80 400 760
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 60 60
181 Tiamin HCl mononitrat tablet 50 mg Tab 1134 77 764 4000 5975
182 Triheksilfenidil HCl tablet 2 mg Tab 395 0 395
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 0 0
186 Yodium povidon larutan 10 % - 30 ml Btl 1 0 1
187 Yodium povidon larutan 10 % - 300 ml Btl 1 9 10

1 Acyclovir tablet 200 mg Tab 215 20 120 400 755


2 Acyclovir cream Tube 36 14 75 125
3 Acyclovir tablet 400 mg Tab 178 70 400 648
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 413 50 262 1100 1825
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

8 Ambroxol Sirup Amp 4 30 34


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 164 400 564
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 63 300 363
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 23 0 23
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 3 0 3
20 Gentamycin tetes mata Btl 9 0 9
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 5 0 5
25 Metoklorpropamide Hcl 10 mg Tab 400 400
26 Mikonazole cream Pot 16 48 64
27 Methyl Prednisolon tab 4 mg Tab 200 1500 1700
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 0 0
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 1088 1000 2088
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 0 0
38 Piroksikam tablet 20 mg Tab 76 0 76
39 Ranitidine 150 mg Tab 0 0
40 Stesolit Rectal supp Tube 3 0 3

1 Alkohol 70 % Btl 1 9 10
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 3 400 403
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 2 2
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 14000 14000
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 70 650 720
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 0 0
54 Antasida syrup pcs 0 0
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 2 0 2
57 Mecobion tab Tab 359 0 359
58 Bioplasenton jelly Tab 0 0
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 0 0
61 Meloxicam 7,5 mg Tab 0 0
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 50 50
66 Hand scun Pcs 300 300
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1484 0 1484
69 Omeprazole Caps 0 0
70 Zink Tab Tab 335 1200 1535
71 Doxycicklin 100mg Tab 142 142
72 Amlodipin 5 mg Caps 0 0
73 Dexanta Tab Tab 0 0
74 Viliron tab 0 0
75 Co Amoxiclav 625 mg Tab 60 0 60
76 Masker ktk 3 3
77 Kloramfenikol Syrup Btl 10 40 50
78 Depo Vial 8 60 68
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : November
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 165 165
3 Alat Suntik 2.5 ml Set 41 12 112 0 165
4 Albendazol 400 mg Set 26 0 26
5 Alupurinol 100 mg Tab 100 218 100 400 818
6 Aminophylin 200 mg Tab 220 118 190 400 928
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 486 0 486
9 Amoksisillin sirup kering 125 mg/5 ml Btl 6 14 0 20
10 Amoksisillin kapsul 250 mg Kap 370 400 330 547 2280 3927
11 Amoksisillin kaplet 500 mg Kap 640 394 200 939 11000 13173
12 Ampicillin kaplet 500 mg Kap 134 0 134
13 Ampicillin sirup kering 125 mg/5 ml Btl 10 5 24 48 87
14 Antalgin tablet 500 mg Tab 526 200 170 219 4000 5115
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 1292 280 0 1572
17 Antibakteri DOEN salep kombinasi Pot 5 4 8 55 72
18 Antihemoroid DOEN kombinasi Pot 2 10 0 12
19 Antifungi DOEN kombinasi Pot 10 1 3 21 14 49
20 Antimigrain DOEN kombinasi Tab 0 0
21 Aqua proinjeksi bebas pirogen Amp 0 0
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 840 500 489 823 1000 3652
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 160 300 460
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 33 9 4 25 71
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 639 50 48 2300 3037
35 Captopril 25 mg tablet Tab 510 55 80 2600 3245
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 10 65 75
37 Deksametason tablet 0,5 mg Tab 450 785 315 1045 11200 13795
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 17 6 12 11 230 276
39 Dekstromethorpan HBr tablet 15 mg Tab 150 160 11 4300 4621
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 0 0
42 Diazepam 2 mg Tab 1426 0 1426
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 12 9 9 150 180
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

46 Efedrin HCl tablet 25 mg Tab 809 80 115 0 1004


47 Ekstrak belladon tablet 10 mg Tab 756 13 166 0 935
48 Epinephrin HCl injeksi Amp 47 47
49 Etakridin (rivanol) larutan 0,1 Btl 1 1 2 12 16
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 660 0 660
55 Fenitoin natrium kapsul 30 mg Kap 687 0 687
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 1248 0 1248
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 0 0
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 6 15 21
63 Fitomenadion (vit K) tablet salut 10 mg Tab 204 75 20 102 300 701
64 Furosemid tablet 40 mg Tab 100 0 100
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 145 60 60 100 1200 1565
67 Gentian violet larutan 1 % Btl 8 4 0 12
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 230 1200 1430
70 Gliseril guayakolat tablet 100 mg Tab 2126 3000 1349 62 21000 27537
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 260 43 337 0 640
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 310 0 310
76 Halloperidol tablet 5 mg Tab 154 0 154
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 785 260 50 100 0 1195
78 Hidrokortison krim 2,5 % Pot 2 7 2 7 0 18
79 Ibuprofen tablet 200 mg Tab 585 391 384 397 3200 4957
80 Ibuprofen tablet 400 mg Tab 50 900 950
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 1000 1000
84 I N H tablet 300 mg Tab 539 0 539
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 100 0 100
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 783 288 346 881 4000 6298
89 Kapas pembalut / Absorben 250 gram Rol 1 1 12 14
90 Karbamazepin tablet 200 mg Tab 426 0 426
91 Kasa kompres 40/40 steril Rol 36 36
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 3 2 7 75 87
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 304 283 250 837
95 Kloramfenikol salep mata 1 % Pot 24 4 1 24 53
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

96 Kloramfenikol tetes telinga 3 % Btl 25 4 8 24 61


97 Klorfeniramine maleat tablet 4 mg Tab 507 2959 2973 3114 26000 35553
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 886 0 886
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 167 0 167
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 100 200 300
107 Kotrimoksazol suspensi Btl 17 17 550 584
108 Kotrimoksazol dewasa tablet Tab 308 350 104 51 3500 4313
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 6 8 5 30 49
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 215 100 315
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 0 0
118 Metronidazol tablet 500 mg Tab 245 80 60 100 485
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 640 0 640
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 77 0 77
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 176 300 476
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 7 16 11 14 60 108
131 Oksitetrasiklin hcl inj. Amp 5 0 5
132 Oksitetrasiklin hcl salep kulit 3 % Pot 32 12 5 7 125 181
133 Oksitetrasiklin hcl salep mata 1 % Pot 17 1 0 18
134 Papaverin tablet Tab 158 0 158
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 10 75 85
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 1755 974 1492 2372 20000 26593
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 23 89 4 10 100 226
141 Piridoxin hcl tablet 10 mg Tab 1526 200 307 3000 5033
142 Pyrazinamid tablet Tab 266 600 866
143 Plester 5 yard x 2 inch Rol 1 1 4 6
144 Polikresulen Btl 1 1
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

146 Prednison tablet 5 mg Tab 726 820 265 573 3000 5384
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 312 600 912
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 240 600 840
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 860 1000 1860
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 216 0 216
157 Rifampisin kapsul 450 mg Kap 182 400 582
158 Rifampisin kapsul 300 mg Kap 79 0 79
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 0 0
161 Salep 2-4 Pot 4 3 7 57 71
162 Salisil bedak 2 % Sak 4 7 2 7 155 175
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 1 1
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 70 800 870
169 Sianokobalamin inj. 500 mcg/ml Amp 70 37 72 55 234
170 Silk (benang bedah sutera) no. 3/0 Rol 0 0
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0 0
176 Tablet tambah darah kombinasi Tab 877 83 466 628 3000 5054
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 980 91 1000 2071
179 Tetrasiklin HCl kapsul 500 mg Kap 210 123 600 933
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 60 60
181 Tiamin HCl mononitrat tablet 50 mg Tab 1601 200 367 1043 6000 9211
182 Triheksilfenidil HCl tablet 2 mg Tab 660 0 660
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 229 0 229
186 Yodium povidon larutan 10 % - 30 ml Btl 1 2 3
187 Yodium povidon larutan 10 % - 300 ml Btl 1 9 10

1 Acyclovir tablet 200 mg Tab 149 120 500 769


2 Acyclovir cream Tube 3 4 16 125 148
3 Acyclovir tablet 400 mg Tab 81 70 90 600 841
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 398 75 312 1800 2585
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

8 Ambroxol Sirup Amp 8 80 88


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 150 600 750
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 276 300 576
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 35 0 35
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 16 30 46
20 Gentamycin tetes mata Btl 10 10 20
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 14 0 14
25 Metoklorpropamide Hcl 10 mg Tab 400 400
26 Mikonazole cream Pot 30 48 78
27 Methyl Prednisolon tab 4 mg Tab 205 1500 1705
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 0 0
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 2000 2000
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 0 0
38 Piroksikam tablet 20 mg Tab 76 0 76
39 Ranitidine 150 mg Tab 0 0
40 Stesolit Rectal supp Tube 3 0 3

1 Alkohol 70 % Btl 1 1 10 12
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 6 5 400 411
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 3 3
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 150 50 50 19000 19250
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 141 750 891
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 0 0
54 Antasida syrup pcs 0 0
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 2 22 24
57 Mecobion tab Tab 224 600 824
58 Bioplasenton jelly Tab 0 0
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 215 0 215
61 Meloxicam 7,5 mg Tab 0 0
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 100 100
66 Hand scun Pcs 300 300
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1580 0 1580
69 Omeprazole Caps 60 0 60
70 Zink Tab Tab 247 1700 1947
71 Doxycicklin 100mg Tab 200 142 342
72 Amlodipin 5 mg Caps 0 0
73 Dexanta Tab Tab 0 0
74 Viliron tab 0 0
75 Co Amoxiclav 625 mg Tab 60 0 60
76 Masker ktk 3 3
77 Kloramfenikol Syrup Btl 10 40 50
78 Depo Vial 11 80 91
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Oktober
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 200 200
3 Alat Suntik 2.5 ml Set 72 129 30 200 431
4 Albendazol 400 mg Set 38 0 38
5 Alupurinol 100 mg Tab 195 285 100 400 980
6 Aminophylin 200 mg Tab 101 307 190 600 1198
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 636 0 636
9 Amoksisillin sirup kering 125 mg/5 ml Btl 32 16 120 168
10 Amoksisillin kapsul 250 mg Kap 415 579 652 538 3840 6024
11 Amoksisillin kaplet 500 mg Kap 541 607 1119 410 14800 17477
12 Ampicillin kaplet 500 mg Kap 232 0 232
13 Ampicillin sirup kering 125 mg/5 ml Btl 16 6 28 12 48 110
14 Antalgin tablet 500 mg Tab 505 265 289 262 5000 6321
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 1047 750 232 1500 3529
17 Antibakteri DOEN salep kombinasi Pot 5 8 5 55 73
18 Antihemoroid DOEN kombinasi Pot 10 4 0 14
19 Antifungi DOEN kombinasi Pot 11 3 22 5 14 55
20 Antimigrain DOEN kombinasi Tab 31 0 31
21 Aqua proinjeksi bebas pirogen Amp 0 0
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 2074 815 1229 708 4000 8826
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 160 300 460
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 24 18 4 50 96
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 374 78 128 2900 3480
35 Captopril 25 mg tablet Tab 228 75 137 3700 4140
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 12 65 77
37 Deksametason tablet 0,5 mg Tab 588 1422 1190 501 12500 16201
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 25 10 16 18 244 313
39 Dekstromethorpan HBr tablet 15 mg Tab 296 97 252 4300 4945
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 0 0
42 Diazepam 2 mg Tab 1586 0 1586
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 23 9 19 150 201
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

46 Efedrin HCl tablet 25 mg Tab 829 85 115 0 1029


47 Ekstrak belladon tablet 10 mg Tab 855 199 13 0 1067
48 Epinephrin HCl injeksi Amp 48 48
49 Etakridin (rivanol) larutan 0,1 Btl 2 2 1 12 17
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 200 100 300
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 660 0 660
55 Fenitoin natrium kapsul 30 mg Kap 701 0 701
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 1318 0 1318
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 0 0
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 9 15 24
63 Fitomenadion (vit K) tablet salut 10 mg Tab 299 110 102 30 300 841
64 Furosemid tablet 40 mg Tab 100 0 100
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 60 96 113 90 1700 2059
67 Gentian violet larutan 1 % Btl 35 4 0 39
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 315 1200 1515
70 Gliseril guayakolat tablet 100 mg Tab 3905 4054 338 1590 23000 32887
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 200 80 347 200 827
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 505 0 505
76 Halloperidol tablet 5 mg Tab 204 0 204
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 1047 265 100 82 0 1494
78 Hidrokortison krim 2,5 % Pot 23 16 7 6 24 76
79 Ibuprofen tablet 200 mg Tab 275 623 415 624 5100 7037
80 Ibuprofen tablet 400 mg Tab 50 900 950
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 1000 1000
84 I N H tablet 300 mg Tab 599 0 599
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 120 0 120
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 321 681 1086 588 5000 7676
89 Kapas pembalut / Absorben 250 gram Rol 1 1 13 15
90 Karbamazepin tablet 200 mg Tab 464 0 464
91 Kasa kompres 40/40 steril Rol 36 36
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 5 7 3 75 90
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 305 350 250 905
95 Kloramfenikol salep mata 1 % Pot 11 6 11 48 76
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

96 Kloramfenikol tetes telinga 3 % Btl 51 7 9 3 24 94


97 Klorfeniramine maleat tablet 4 mg Tab 2483 4948 3541 3860 29000 43832
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 1039 0 1039
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 178 0 178
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 100 200 300
107 Kotrimoksazol suspensi Btl 50 36 4 600 690
108 Kotrimoksazol dewasa tablet Tab 476 500 99 242 3700 5017
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 6 5 8 50 69
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 165 200 365
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 0 0
118 Metronidazol tablet 500 mg Tab 65 145 90 300 600
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 640 0 640
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 90 0 90
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 196 300 496
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 3 38 15 17 110 183
131 Oksitetrasiklin hcl inj. Amp 6 0 6
132 Oksitetrasiklin hcl salep kulit 3 % Pot 40 20 9 8 150 227
133 Oksitetrasiklin hcl salep mata 1 % Pot 5 2 20 27
134 Papaverin tablet Tab 202 15 38 0 255
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 73 100 173
137 Parasetamol tablet 100 mg Tab 1000 1000
138 Parasetamol tablet 500 mg Tab 455 2866 3170 2344 31000 39835
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 32 89 12 4 100 237
141 Piridoxin hcl tablet 10 mg Tab 2515 675 116 582 3000 6888
142 Pyrazinamid tablet Tab 187 700 887
143 Plester 5 yard x 2 inch Rol 1 1 1 3
144 Polikresulen Btl 2 2
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

146 Prednison tablet 5 mg Tab 1775 1515 955 633 3000 7878
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 257 900 1157
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 260 800 1060
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 912 1000 1912
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 216 0 216
157 Rifampisin kapsul 450 mg Kap 136 500 636
158 Rifampisin kapsul 300 mg Kap 82 0 82
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 0 0
161 Salep 2-4 Pot 4 7 5 67 83
162 Salisil bedak 2 % Sak 10 10 8 4 193 225
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 1 1
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 80 800 880
169 Sianokobalamin inj. 500 mcg/ml Amp 82 72 55 155 364
170 Silk (benang bedah sutera) no. 3/0 Rol 0 0
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0 0
176 Tablet tambah darah kombinasi Tab 900 410 838 686 4800 7634
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 1014 289 1000 2303
179 Tetrasiklin HCl kapsul 500 mg Kap 244 165 600 1009
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 60 60
181 Tiamin HCl mononitrat tablet 50 mg Tab 734 673 1331 673 8000 11411
182 Triheksilfenidil HCl tablet 2 mg Tab 855 0 855
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 1689 0 1689
186 Yodium povidon larutan 10 % - 30 ml Btl 1 2 3
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 9 11

1 Acyclovir tablet 200 mg Tab 114 120 600 834


2 Acyclovir cream Tube 10 6 18 150 184
3 Acyclovir tablet 400 mg Tab 85 100 100 700 985
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 188 100 352 2500 3140
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

8 Ambroxol Sirup Amp 13 150 163


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 130 700 830
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 58 600 658
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 108 0 108
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 15 60 75
20 Gentamycin tetes mata Btl 7 10 17
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 14 15 29
25 Metoklorpropamide Hcl 10 mg Tab 400 400
26 Mikonazole cream Pot 15 72 87
27 Methyl Prednisolon tab 4 mg Tab 235 1500 1735
28 Nipedipin tablet Tab 196 0 196
29 Natrium Diklofenak 50 mg Tab 114 0 114
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 202 2000 2202
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 0 0
38 Piroksikam tablet 20 mg Tab 76 0 76
39 Ranitidine 150 mg Tab 62 200 262
40 Stesolit Rectal supp Tube 3 0 3

1 Alkohol 70 % Btl 1 1 1 10 13
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 10 7 400 417
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 3 3
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 250 200 200 25000 25650
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 50 900 950
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 0 0
54 Antasida syrup pcs 1 0 1
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 5 42 47
57 Mecobion tab Tab 136 0 136
58 Bioplasenton jelly Tab 0 0
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 430 500 930
61 Meloxicam 7,5 mg Tab 0 0
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 100 100
66 Hand scun Pcs 300 300
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1629 0 1629
69 Omeprazole Caps 113 0 113
70 Zink Tab Tab 294 2300 2594
71 Doxycicklin 100mg Tab 142 142
72 Amlodipin 5 mg Caps 0 0
73 Dexanta Tab Tab 0 0
74 Viliron tab 0 0
75 Co Amoxiclav 625 mg Tab 60 0 60
76 Masker ktk 3 3
77 Kloramfenikol Syrup Btl 10 40 50
78 Depo Vial 21 5 100 126
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : September
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 0 0
3 Alat Suntik 2.5 ml Set 95 0 95
4 Albendazol 400 mg Set 26 0 26
5 Alupurinol 100 mg Tab 320 140 400 860
6 Aminophylin 200 mg Tab 187 200 59 190 0 636
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 116 0 116
9 Amoksisillin sirup kering 125 mg/5 ml Btl 19 0 19
10 Amoksisillin kapsul 250 mg Kap 310 200 108 322 3120 4060
11 Amoksisillin kaplet 500 mg Kap 893 200 25 855 9000 10973
12 Ampicillin kaplet 500 mg Kap 20 133 79 0 232
13 Ampicillin sirup kering 125 mg/5 ml Btl 3 4 96 103
14 Antalgin tablet 500 mg Tab 492 200 209 2200 3101
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 0 0
17 Antibakteri DOEN salep kombinasi Pot 14 2 4 15 35
18 Antihemoroid DOEN kombinasi Pot 6 10 0 16
19 Antifungi DOEN kombinasi Pot 11 1 22 0 34
20 Antimigrain DOEN kombinasi Tab 31 0 31
21 Aqua proinjeksi bebas pirogen Amp 1 0 1
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1039 1784 0 2823
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 160 300 460
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 25 2 0 27
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 664 40 700 1404
35 Captopril 25 mg tablet Tab 0 0
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 5 75 80
37 Deksametason tablet 0,5 mg Tab 428 657 256 900 7000 9241
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 23 6 5 2 224 260
39 Dekstromethorpan HBr tablet 15 mg Tab 382 90 117 1600 2189
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 0 0
42 Diazepam 2 mg Tab 801 0 801
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 8 10 120 138
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

46 Efedrin HCl tablet 25 mg Tab 829 90 133 0 1052


47 Ekstrak belladon tablet 10 mg Tab 250 13 226 0 489
48 Epinephrin HCl injeksi Amp 48 48
49 Etakridin (rivanol) larutan 0,1 Btl 1 1 2 6 10
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 660 0 660
55 Fenitoin natrium kapsul 30 mg Kap 701 0 701
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 368 0 368
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 0 0
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 6 20 26
63 Fitomenadion (vit K) tablet salut 10 mg Tab 144 50 40 102 0 336
64 Furosemid tablet 40 mg Tab 100 0 100
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 90 32 22 38 400 582
67 Gentian violet larutan 1 % Btl 2 4 0 6
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 385 200 585
70 Gliseril guayakolat tablet 100 mg Tab 2624 1182 976 582 19000 24364
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 40 25 347 0 412
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 0 0
76 Halloperidol tablet 5 mg Tab 258 0 258
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 294 270 100 1000 1664
78 Hidrokortison krim 2,5 % Pot 2 3 0 5
79 Ibuprofen tablet 200 mg Tab 263 251 362 142 5000 6018
80 Ibuprofen tablet 400 mg Tab 50 900 950
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 8 0 8
84 I N H tablet 300 mg Tab 642 0 642
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 60 0 60
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 642 73 840 445 3000 5000
89 Kapas pembalut / Absorben 250 gram Rol 1 12 13
90 Karbamazepin tablet 200 mg Tab 486 0 486
91 Kasa kompres 40/40 steril Rol 0 0
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 3 7 45 55
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 305 160 500 965
95 Kloramfenikol salep mata 1 % Pot 14 3 1 0 18
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

96 Kloramfenikol tetes telinga 3 % Btl 8 4 4 24 40


97 Klorfeniramine maleat tablet 4 mg Tab 1561 901 1792 2147 16000 22401
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 175 0 175
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 177 0 177
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 100 0 100
107 Kotrimoksazol suspensi Btl 39 6 225 270
108 Kotrimoksazol dewasa tablet Tab 424 242 110 137 1600 2513
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 2 10 90 102
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 190 200 390
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 7 0 7
118 Metronidazol tablet 500 mg Tab 240 100 30 200 570
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 0 0
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 90 0 90
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 237 300 537
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 8 5 2 7 80 102
131 Oksitetrasiklin hcl inj. Amp 2 5 7
132 Oksitetrasiklin hcl salep kulit 3 % Pot 40 3 2 75 120
133 Oksitetrasiklin hcl salep mata 1 % Pot 13 3 25 41
134 Papaverin tablet Tab 0 0
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 83 150 233
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 1702 600 158 928 0 3388
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 74 104 4 14 100 296
141 Piridoxin hcl tablet 10 mg Tab 1011 870 429 0 2310
142 Pyrazinamid tablet Tab 115 800 915
143 Plester 5 yard x 2 inch Rol 1 1 2
144 Polikresulen Btl 2 2
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

146 Prednison tablet 5 mg Tab 570 300 86 484 4000 5440


147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 12 300 312
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 80 100 180
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 0 0
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 216 0 216
157 Rifampisin kapsul 450 mg Kap 181 300 481
158 Rifampisin kapsul 300 mg Kap 88 0 88
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 17 0 17
161 Salep 2-4 Pot 9 2 2 7 48 68
162 Salisil bedak 2 % Sak 4 1 6 0 11
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 2 2
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 120 800 920
169 Sianokobalamin inj. 500 mcg/ml Amp 70 53 76 200 399
170 Silk (benang bedah sutera) no. 3/0 Rol 0 0
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0 0
176 Tablet tambah darah kombinasi Tab 1560 25 272 428 0 2285
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 4 376 0 380
179 Tetrasiklin HCl kapsul 500 mg Kap 300 100 200 600
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 90 90
181 Tiamin HCl mononitrat tablet 50 mg Tab 1122 71 666 6000 7859
182 Triheksilfenidil HCl tablet 2 mg Tab 0 0
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 520 0 520
186 Yodium povidon larutan 10 % - 30 ml Btl 1 2 3
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 0 2

1 Acyclovir tablet 200 mg Tab 198 53 120 100 471


2 Acyclovir cream Tube 32 4 13 125 174
3 Acyclovir tablet 400 mg Tab 5 25 0 30
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 200 30 100 2600 2930
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

8 Ambroxol Sirup Amp 0 0


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 172 200 372
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 70 400 470
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 85 0 85
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 0 0
20 Gentamycin tetes mata Btl 10 20 30
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 12 25 37
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 31 24 55
27 Methyl Prednisolon tab 4 mg Tab 255 500 755
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 152 100 252
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 307 40 1000 1347
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 10 0 10
38 Piroksikam tablet 20 mg Tab 86 0 86
39 Ranitidine 150 mg Tab 73 0 73
40 Stesolit Rectal supp Tube 3 0 3

1 Alkohol 70 % Btl 8 8
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 4 3 400 407
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 0 0
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 0 0
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 127 0 127
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 0 0
54 Antasida syrup pcs 9 0 9
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 3 44 47
57 Mecobion tab Tab 0 0
58 Bioplasenton jelly Tab 3 0 3
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 205 900 1105
61 Meloxicam 7,5 mg Tab 4 0 4
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 0 0
66 Hand scun Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
II I PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1660 0 1660
69 Omeprazole Caps 113 6 0 119
70 Zink Tab Tab 0 0
71 Doxycicklin 100mg Tab 40 300 340
72 Amlodipin 5 mg Caps 0 0
73 Dexanta Tab Tab 199 125 154 0 478
74 Viliron tab 0 0
75 Co Amoxiclav 625 mg Tab 60 0 60
76 Masker ktk 0 0
77 Depo Vial 25 8 10 140 183
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Agustus
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 0 0
3 Alat Suntik 2.5 ml Set 11 100 200 311
4 Albendazol 400 mg Set 26 0 26
5 Alupurinol 100 mg Tab 155 175 400 730
6 Aminophylin 200 mg Tab 79 328 190 137 100 834
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 250 0 250
9 Amoksisillin sirup kering 125 mg/5 ml Btl 3 24 0 27
10 Amoksisillin kapsul 250 mg Kap 450 322 392 294 4200 5658
11 Amoksisillin kaplet 500 mg Kap 1330 324 1145 216 12000 15015
12 Ampicillin kaplet 500 mg Kap 75 233 184 100 592
13 Ampicillin sirup kering 125 mg/5 ml Btl 13 10 7 8 130 168
14 Antalgin tablet 500 mg Tab 372 300 359 136 3600 4767
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 0 0
17 Antibakteri DOEN salep kombinasi Pot 32 5 3 15 55
18 Antihemoroid DOEN kombinasi Pot 10 8 0 18
19 Antifungi DOEN kombinasi Pot 3 7 22 3 12 47
20 Antimigrain DOEN kombinasi Tab 41 0 41
21 Aqua proinjeksi bebas pirogen Amp 2 1 3
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1026 2305 165 2000 5496
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 160 300 460
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 26 9 50 85
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 1130 2000 3130
35 Captopril 25 mg tablet Tab 0 0
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 8 75 83
37 Deksametason tablet 0,5 mg Tab 385 1294 1080 524 8500 11783
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 29 10 9 11 244 303
39 Dekstromethorpan HBr tablet 15 mg Tab 202 217 238 1900 2557
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 0 0
42 Diazepam 2 mg Tab 1108 0 1108
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 15 10 10 120 155
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 929 95 151 0 1175


47 Ekstrak belladon tablet 10 mg Tab 289 316 53 0 658
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 1 2 1 7 11
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 660 0 660
55 Fenitoin natrium kapsul 30 mg Kap 715 0 715
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 452 0 452
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 0 0
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 8 20 28
63 Fitomenadion (vit K) tablet salut 10 mg Tab 100 75 122 50 300 647
64 Furosemid tablet 40 mg Tab 100 0 100
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 86 75 78 50 1200 1489
67 Gentian violet larutan 1 % Btl 4 4 6 2 0 16
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 235 500 735
70 Gliseril guayakolat tablet 100 mg Tab 2013 2210 942 1355 23000 29520
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 40 60 347 0 447
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 0 0
76 Halloperidol tablet 5 mg Tab 390 0 390
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 327 275 100 17 1000 1719
78 Hidrokortison krim 2,5 % Pot 44 8 4 5 0 61
79 Ibuprofen tablet 200 mg Tab 447 414 236 594 6000 7691
80 Ibuprofen tablet 400 mg Tab 50 900 950
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 32 0 32
84 I N H tablet 300 mg Tab 691 0 691
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 60 0 60
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 1155 295 705 1044 3000 6199
89 Kapas pembalut / Absorben 250 gram Rol 1 1 13 15
90 Karbamazepin tablet 200 mg Tab 540 0 540
91 Kasa kompres 40/40 steril Rol 6 6
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 4 7 2 47 60
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 305 186 500 991
95 Kloramfenikol salep mata 1 % Pot 10 4 2 24 40
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 27 7 6 2 24 66


97 Klorfeniramine maleat tablet 4 mg Tab 2087 2328 2705 2817 20000 29937
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 350 0 350
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 197 0 197
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 100 0 100
107 Kotrimoksazol suspensi Btl 32 8 300 340
108 Kotrimoksazol dewasa tablet Tab 446 362 152 290 2100 3350
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 2 10 120 132
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 200 200 400
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 17 0 17
118 Metronidazol tablet 500 mg Tab 110 163 90 300 663
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 0 0
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 96 0 96
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 247 300 547
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 13 23 9 9 100 154
131 Oksitetrasiklin hcl inj. Amp 3 5 8
132 Oksitetrasiklin hcl salep kulit 3 % Pot 43 9 2 5 125 184
133 Oksitetrasiklin hcl salep mata 1 % Pot 22 4 1 25 52
134 Papaverin tablet Tab 90 36 0 126
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 40 250 290
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 2056 1627 1760 1023 2000 8466
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 91 104 14 4 100 313
141 Piridoxin hcl tablet 10 mg Tab 842 340 825 1222 1000 4229
142 Pyrazinamid tablet Tab 164 800 964
143 Plester 5 yard x 2 inch Rol 1 1 1 1 4
144 Polikresulen Btl 2 2
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 703 925 1108 432 5000 8168
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 262 400 662
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 378 100 478
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 98 27 0 125
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 224 0 224
157 Rifampisin kapsul 450 mg Kap 123 400 523
158 Rifampisin kapsul 300 mg Kap 91 0 91
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 54 6 0 60
161 Salep 2-4 Pot 3 3 7 2 57 72
162 Salisil bedak 2 % Sak 7 8 4 25 44
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 5 5
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 140 800 940
169 Sianokobalamin inj. 500 mcg/ml Amp 85 76 77 200 438
170 Silk (benang bedah sutera) no. 3/0 Rol 0 0
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0 0
176 Tablet tambah darah kombinasi Tab 718 225 628 512 0 2083
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 4 448 0 452
179 Tetrasiklin HCl kapsul 500 mg Kap 360 133 200 693
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 90 90
181 Tiamin HCl mononitrat tablet 50 mg Tab 759 372 1085 431 8000 10647
182 Triheksilfenidil HCl tablet 2 mg Tab 193 0 193
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 1504 549 0 2053
186 Yodium povidon larutan 10 % - 30 ml Btl 1 1 1 2 5
187 Yodium povidon larutan 10 % - 300 ml Btl 1 0 1

1 Acyclovir tablet 200 mg Tab 274 80 160 100 614


2 Acyclovir cream Tube 17 6 14 140 177
3 Acyclovir tablet 400 mg Tab 5 50 96 0 151
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 297 50 200 2900 3447
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 0 0


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 214 300 514
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 158 400 558
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 115 0 115
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 0 0
20 Gentamycin tetes mata Btl 10 20 30
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 11 40 51
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 37 24 61
27 Methyl Prednisolon tab 4 mg Tab 275 500 775
28 Nipedipin tablet Tab 247 0 247
29 Natrium Diklofenak 50 mg Tab 152 100 252
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 427 1000 1427
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 20 0 20
38 Piroksikam tablet 20 mg Tab 106 0 106
39 Ranitidine 150 mg Tab 455 0 455
40 Stesolit Rectal supp Tube 3 0 3

1 Alkohol 70 % Btl 1 1 9 11
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 11 5 500 516
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 0 0
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 6000 6000
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 117 60 177
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 1 0 1
54 Antasida syrup pcs 9 0 9
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 4 64 68
57 Mecobion tab Tab 118 0 118
58 Bioplasenton jelly Tab 4 0 4
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 35 1500 1535
61 Meloxicam 7,5 mg Tab 413 150 563
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 0 0
66 Hand scun Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1755 0 1755
69 Omeprazole Caps 118 10 0 128
70 Zink Tab Tab 75 0 75
71 Doxycicklin 100mg Tab 42 300 342
72 Amlodipin 5 mg Caps 0 0
73 Dexanta Tab Tab 416 500 469 260 800 2445
74 Viliron tab 0 0
75 Co Amoxiclav 625 mg Tab 60 0 60
76 Masker ktk 0 0
77 Depo Vial 30 20 18 140 208
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Juli
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 0 0
3 Alat Suntik 2.5 ml Set 38 121 300 459
4 Albendazol 400 mg Set 27 0 27
5 Alupurinol 100 mg Tab 170 212 400 782
6 Aminophylin 200 mg Tab 195 478 221 190 200 1284
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 410 0 410
9 Amoksisillin sirup kering 125 mg/5 ml Btl 80 26 50 156
10 Amoksisillin kapsul 250 mg Kap 930 498 510 432 4560 6930
11 Amoksisillin kaplet 500 mg Kap 660 506 414 1275 15800 18655
12 Ampicillin kaplet 500 mg Kap 75 368 294 100 837
13 Ampicillin sirup kering 125 mg/5 ml Btl 14 33 18 10 130 205
14 Antalgin tablet 500 mg Tab 758 402 308 484 4000 5952
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 0 0
17 Antibakteri DOEN salep kombinasi Pot 34 4 5 15 58
18 Antihemoroid DOEN kombinasi Pot 27 10 10 0 47
19 Antifungi DOEN kombinasi Pot 7 10 5 22 18 62
20 Antimigrain DOEN kombinasi Tab 41 0 41
21 Aqua proinjeksi bebas pirogen Amp 3 1 4
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1719 358 2901 4000 8978
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 160 300 460
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 34 17 75 126
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 940 3000 3940
35 Captopril 25 mg tablet Tab 0 0
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 11 75 86
37 Deksametason tablet 0,5 mg Tab 744 2031 801 1230 9500 14306
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 19 16 18 16 264 333
39 Dekstromethorpan HBr tablet 15 mg Tab 336 374 287 2000 2997
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 48
42 Diazepam 2 mg Tab 1331 0 1331
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 25 19 10 120 174
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 839 100 178 0 1117


47 Ekstrak belladon tablet 10 mg Tab 299 95 379 0 773
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 2 1 2 7 12
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 660 0 660
55 Fenitoin natrium kapsul 30 mg Kap 715 0 715
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 502 0 502
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 1 0 1
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 11 20 31
63 Fitomenadion (vit K) tablet salut 10 mg Tab 203 100 60 122 300 785
64 Furosemid tablet 40 mg Tab 110 0 110
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 100 100 77 112 1600 1989
67 Gentian violet larutan 1 % Btl 15 6 3 6 10 40
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 295 800 1095
70 Gliseril guayakolat tablet 100 mg Tab 1719 3537 1717 1168 25000 33141
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 130 88 401 0 619
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 30 0 30
76 Halloperidol tablet 5 mg Tab 470 0 470
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 422 280 64 100 1000 1866
78 Hidrokortison krim 2,5 % Pot 30 15 9 4 48 106
79 Ibuprofen tablet 200 mg Tab 468 603 808 263 6400 8542
80 Ibuprofen tablet 400 mg Tab 50 900 950
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 133 0 133
84 I N H tablet 300 mg Tab 708 0 708
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 100 0 100
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 748 622 1242 974 4000 7586
89 Kapas pembalut / Absorben 250 gram Rol 1 1 1 15 18
90 Karbamazepin tablet 200 mg Tab 560 0 560
91 Kasa kompres 40/40 steril Rol 12 12
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 6 4 7 50 67
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 305 213 500 1018
95 Kloramfenikol salep mata 1 % Pot 26 6 3 24 59
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 18 10 3 6 48 85


97 Klorfeniramine maleat tablet 4 mg Tab 2003 4121 3479 3024 24000 36627
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 529 0 529
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 206 0 206
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 16 20 100 0 136
107 Kotrimoksazol suspensi Btl 49 9 350 408
108 Kotrimoksazol dewasa tablet Tab 655 484 474 172 2600 4385
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 3 10 120 133
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 210 200 410
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 27 0 27
118 Metronidazol tablet 500 mg Tab 115 200 150 400 865
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 695 837 0 1532
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 100 0 100
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 257 300 557
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 22 47 17 12 120 218
131 Oksitetrasiklin hcl inj. Amp 4 5 9
132 Oksitetrasiklin hcl salep kulit 3 % Pot 40 18 7 6 150 221
133 Oksitetrasiklin hcl salep mata 1 % Pot 23 6 2 25 56
134 Papaverin tablet Tab 540 60 76 0 676
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 97 250 347
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 1869 2766 1537 2264 7000 15436
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 101 107 6 14 100 328
141 Piridoxin hcl tablet 10 mg Tab 1564 1067 1548 1023 1000 6202
142 Pyrazinamid tablet Tab 126 900 1026
143 Plester 5 yard x 2 inch Rol 1 1 1 2 5
144 Polikresulen Btl 3 3
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 1724 1648 696 1443 5000 10511
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 262 600 862
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 368 300 668
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 645 52 0 697
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 127 0 127
157 Rifampisin kapsul 450 mg Kap 172 400 572
158 Rifampisin kapsul 300 mg Kap 96 0 96
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 82 6 0 88
161 Salep 2-4 Pot 6 5 3 7 57 78
162 Salisil bedak 2 % Sak 11 10 7 12 40 80
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 5 5
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 210 800 1010
169 Sianokobalamin inj. 500 mcg/ml Amp 100 98 76 200 474
170 Silk (benang bedah sutera) no. 3/0 Rol 0 0
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 0 0
176 Tablet tambah darah kombinasi Tab 734 450 742 818 1200 3944
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 556 0 556
179 Tetrasiklin HCl kapsul 500 mg Kap 380 170 200 750
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 90 90
181 Tiamin HCl mononitrat tablet 50 mg Tab 850 909 695 1265 9000 12719
182 Triheksilfenidil HCl tablet 2 mg Tab 341 0 341
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 1800 734 0 2534
186 Yodium povidon larutan 10 % - 30 ml Btl 1 1 1 3 6
187 Yodium povidon larutan 10 % - 300 ml Btl 1 0 1

1 Acyclovir tablet 200 mg Tab 214 100 160 300 774


2 Acyclovir cream Tube 28 10 16 140 194
3 Acyclovir tablet 400 mg Tab 5 70 116 0 191
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 409 80 280 3300 4069
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 20 23 43


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 116 600 716
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 230 500 730
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 60 100 160
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 14 10 24
20 Gentamycin tetes mata Btl 10 20 30
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 19 40 59
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 45 24 69
27 Methyl Prednisolon tab 4 mg Tab 80 800 880
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 152 100 252
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 1000 1000
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 0 0
38 Piroksikam tablet 20 mg Tab 92 30 136 0 258
39 Ranitidine 150 mg Tab 304 400 704
40 Stesolit Rectal supp Tube 3 0 3

1 Alkohol 70 % Btl 1 1 10 12
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 18 7 4 500 529
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 1
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 12000 12000
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 54 330 384
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 1 0 1
54 Antasida syrup pcs 17 0 17
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 13 74 87
57 Mecobion tab Tab 436 200 636
58 Bioplasenton jelly Tab 5 0 5
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 425 1800 2225
61 Meloxicam 7,5 mg Tab 150 850 1000
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 0 0
66 Hand scun Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1805 0 1805
69 Omeprazole Caps 125 14 0 139
70 Zink Tab Tab 470 200 670
71 Doxycicklin 100mg Tab 72 300 372
72 Amlodipin 5 mg Caps 0 0
73 Dexanta Tab Tab 702 900 555 659 1600 4416
74 Viliron tab 0 0
75 Co Amoxiclav 625 mg Tab 60 0 60
76 Masker ktk 0 0
Depo 38 28 30
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Juni
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 0 0
3 Alat Suntik 2.5 ml Set 67 130 10 220 427
4 Albendazol 400 mg Set 30 0 30
5 Alupurinol 100 mg Tab 190 57 100 200 547
6 Aminophylin 200 mg Tab 81 55 190 300 626
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 40 0 40
9 Amoksisillin sirup kering 125 mg/5 ml Btl 39 38 40 4 200 321
10 Amoksisillin kapsul 250 mg Kap 542 80 492 102 0 1216
11 Amoksisillin kaplet 500 mg Kap 488 99 845 0 1432
12 Ampicillin kaplet 500 mg Kap 80 113 400 593
13 Ampicillin sirup kering 125 mg/5 ml Btl 16 25 12 3 78 134
14 Antalgin tablet 500 mg Tab 405 580 6200 7185
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 0 0
17 Antibakteri DOEN salep kombinasi Pot 17 1 50 68
18 Antihemoroid DOEN kombinasi Pot 6 4 30 40
19 Antifungi DOEN kombinasi Pot 5 3 22 2 20 52
20 Antimigrain DOEN kombinasi Tab 66 0 66
21 Aqua proinjeksi bebas pirogen Amp 5 5
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1975 3184 614 5000 10773
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 300 300
26 Asetosal tablet 500 mg Tab 180 0 180
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 0 0
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 158 185 0 343
35 Captopril 25 mg tablet Tab 0 0
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 4 85 89
37 Deksametason tablet 0,5 mg Tab 528 894 1355 20 4000 6797
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 8 2 17 1 179 207
39 Dekstromethorpan HBr tablet 15 mg Tab 112 392 20 2900 3424
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 48
42 Diazepam 2 mg Tab 604 0 604
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 10 10 60 80
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 939 105 184 0 1228


47 Ekstrak belladon tablet 10 mg Tab 399 406 60 0 865
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 1 2 11 14
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 160 500 660
55 Fenitoin natrium kapsul 30 mg Kap 215 500 715
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 542 0 542
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 7 2 0 9
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 4 0 4
63 Fitomenadion (vit K) tablet salut 10 mg Tab 18 25 128 70 300 541
64 Furosemid tablet 40 mg Tab 114 0 114
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 140 32 155 10 200 537
67 Gentian violet larutan 1 % Btl 11 2 7 0 20
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 340 400 740
70 Gliseril guayakolat tablet 100 mg Tab 2496 1314 1102 14000 18912
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 140 18 401 200 759
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 105 100 205
76 Halloperidol tablet 5 mg Tab 0 0
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 721 285 28 0 1034
78 Hidrokortison krim 2,5 % Pot 11 5 0 16
79 Ibuprofen tablet 200 mg Tab 622 218 308 4100 5248
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 259 0 259
84 I N H tablet 300 mg Tab 751 0 751
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 0 0
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 446 1073 474 2000 3993
89 Kapas pembalut / Absorben 250 gram Rol 1 1 11 13
90 Karbamazepin tablet 200 mg Tab 300 0 300
91 Kasa kompres 40/40 steril Rol 0 0
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 2 7 16 25
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 314 750 1064
95 Kloramfenikol salep mata 1 % Pot 8 3 0 11
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 13 48 61


97 Klorfeniramine maleat tablet 4 mg Tab 2066 1257 10000 13323
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 724 0 724
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 78 100 0 178
107 Kotrimoksazol suspensi Btl 11 0 11
108 Kotrimoksazol dewasa tablet Tab 781 326 182 32 1300 2621
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 4 10 0 14
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 140 300 440
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 27 0 27
118 Metronidazol tablet 500 mg Tab 195 190 90 600 1075
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 715 837 0 1552
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 0 0
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 245 400 645
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 22 2 70 94
131 Oksitetrasiklin hcl inj. Amp 10 10
132 Oksitetrasiklin hcl salep kulit 3 % Pot 21 5 2 0 28
133 Oksitetrasiklin hcl salep mata 1 % Pot 12 2 1 17 32
134 Papaverin tablet Tab 729 80 0 809
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 56 2 12 2 300 372
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 1136 826 1000 2962
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 15 7 16 6 300 344
141 Piridoxin hcl tablet 10 mg Tab 1435 1874 1172 865 1000 6346
142 Pyrazinamid tablet Tab 149 700 849
143 Plester 5 yard x 2 inch Rol 1 1 3 5
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 498 1457 698 64 3000 5717


147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 258 300 558
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 297 500 797
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 370 1000 1370
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 146 100 246
157 Rifampisin kapsul 450 mg Kap 0 0
158 Rifampisin kapsul 300 mg Kap 131 0 131
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 90 7 16 0 113
161 Salep 2-4 Pot 3 2 7 24 36
162 Salisil bedak 2 % Sak 4 3 0 7
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 5 5
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 60 450 510
169 Sianokobalamin inj. 500 mcg/ml Amp 15 70 24 300 409
170 Silk (benang bedah sutera) no. 3/0 Rol 3 3
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 4 0 4
176 Tablet tambah darah kombinasi Tab 1152 363 352 600 2467
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 105 601 0 706
179 Tetrasiklin HCl kapsul 500 mg Kap 210 100 200 510
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 90 90
181 Tiamin HCl mononitrat tablet 50 mg Tab 512 523 1364 975 7000 10374
182 Triheksilfenidil HCl tablet 2 mg Tab 36 500 536
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 926 135 0 1061
186 Yodium povidon larutan 10 % - 30 ml Btl 8 8
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 2 4

1 Acyclovir tablet 200 mg Tab 234 100 70 100 504


2 Acyclovir cream Tube 38 3 18 50 109
3 Acyclovir tablet 400 mg Tab 135 116 100 351
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 308 30 1200 1538
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 20 71 91


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 100 300 400
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 78 300 378
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 173 100 273
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 0 0
20 Gentamycin tetes mata Btl 0 0
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 5 13 18
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 31 24 55
27 Methyl Prednisolon tab 4 mg Tab 80 900 980
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 62 0 62
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 0 0
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 40 0 40
38 Piroksikam tablet 20 mg Tab 432 136 0 568
39 Ranitidine 150 mg Tab 262 0 262
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 1 1 0 2
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 2 500 502
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 1
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 18000 18000
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 142 0 142
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 2 0 2
54 Antasida syrup pcs 22 0 22
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 9 70 79
57 Mecobion tab Tab 0 0
58 Bioplasenton jelly Tab 5 0 5
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 20 0 20
61 Meloxicam 7,5 mg Tab 50 0 50
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 50 50
66 Hand scun Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1805 0 1805
69 Omeprazole Caps 123 20 0 143
70 Zink Tab Tab 638 700 1338
71 Doxycicklin 100mg Tab 100 300 400
72 Amlodipin 5 mg Caps 5 0 5
73 Dexanta Tab Tab 462 275 555 174 2400 3866
74 Viliron tab 55 0 55
Air Raksa Dental Use
Alat Suntik 1 ml
Alat Suntik 2.5 ml
Albendazol 400 mg
Alupurinol 100 mg
Aminophylin 200 mg
Aminophylin inj 24 mg/ml 10 ml
Amitriptilin HCl tablet 25 mg
Amoksisillin sirup kering 125 mg/5 ml
Amoksisillin kapsul 250 mg
Amoksisillin kaplet 500 mg
Ampicillin kaplet 500 mg
Ampicillin sirup kering 125 mg/5 ml
Antalgin tablet 500 mg
Antalgin injeksi
Antasida DOEN tablet kombinasi
Antibakteri DOEN salep kombinasi
Antihemoroid DOEN kombinasi
Antifungi DOEN kombinasi
Antimigrain DOEN kombinasi
Aqua proinjeksi bebas pirogen
Aquadest steril
Asam askorbat (vit C) 50 mg
Asam askorbat (vit C)250 mg
Asetosal tablet 100 mg
Asetosal tablet 500 mg
Atropin sulfat injeksi 0,25 mg/ml - ml
Atropin sulfat tablet 0,5 mg
Atropin sulfat tetes mata 0 5 %
Benzatin benzil penicillin inj. 2,4 juta IU/vial
Besi sirup
Betametason krim 0,1 %
Catgut/benang bedah no. 2/0 - 3/0
Captopril 12.5 mg tablet
Captopril 25 mg tablet
Deksametason injeksi 5 mg/ml - 1 ml
Deksametason tablet 0,5 mg
Dekstromethorpan HBr sirup 10 mg/5 ml
Dekstromethorpan HBr tablet 15 mg
Devitalisasi pasta
Diazepam injeksi 5 mg/ml - 2 ml
Diazepam 2 mg
Diazepam 5 mg
Difenhidramin HCl injeksi 10 mg/ml - ml
Digoksin tablet 0,25 mg
Efedrin HCl tablet 25 mg
Ekstrak belladon tablet 10 mg
Epinephrin HCl injeksi
Etakridin (rivanol) larutan 0,1
Etambutol HCl 250 mg tablet
Etambutol HCl 500 mg tablet
Etil klorida semprot
Eugenol cairan
Fenitoin natrium kapsul 100 mg
Fenitoin natrium kapsul 30 mg
Fenobarbital injeksi 50 mg/ml - 2 ml
Fenobarbital tablet 100 mg
Fenobarbital tablet 30 mg
Fenoksi metil penisillin tablet 250 mg
Fenoksi metil penisillin tablet 500 mg
Fenol gliserol tetes telinga 10 %
Fitomenadion (vit K) inj. 10 mg/ml - 1 ml
Fitomenadion (vit K) tablet salut 10 mg
Furosemid tablet 40 mg
Gameksan emulsi 1 %
Garam oralit 200 ml air
Gentian violet larutan 1 %
Glass ionomer semen (gc ix)
Glibenklamid tablet 5 mg
Gliseril guayakolat tablet 100 mg
Gliserin
Glukosa Larutan Infus 5 % Steril
Griseofulvin 125 mg micronized
Halloperidol tablet 0,5 mg
Halloperidol tablet 1,5 mg
Halloperidol tablet 5 mg
Hidroklrotiazed ( hct ) tablet 25 mg
Hidrokortison krim 2,5 %
Ibuprofen tablet 200 mg
Ibuprofen tablet 400 mg
Infusion set anak
Infusion set dewasa
I N H tablet 100 mg
I N H tablet 300 mg
Isosorbit dinitrat tablet sublingual 5 mg
Kalium permanganat serbuk
Kalsium hidroksida pasta
Kalsium Laktat ( Kalk ) 500 mg
Kapas pembalut / Absorben 250 gram
Karbamazepin tablet 200 mg
Kasa kompres 40/40 steril
Kasa pembalut hidrofil 4 m x 15 cm
Kasa pembalut hidrofil 4 m x 3 cm
Kloramfenikol 250 mg kapsul
Kloramfenikol salep mata 1 %
Kloramfenikol tetes telinga 3 %
Klorfeniramine maleat tablet 4 mg
Kloroquin pospat tablet 250 mg
Klorpromazin hcl injeksi
Klorfenol kamfermenthol (CHKM)
Klorpromazin hcl injeksi 5 mg/ml - 1 ml
Klorpromazin hcl tablet salut 100 mg
Klorpromazin hcl tablet salut 25 mg
Kodein hcl tablet 10 mg
Komb. primetamin 25 mg + suldok 500 mg
Kotrimoksazol pediatrik tablet
Kotrimoksazol suspensi
Kotrimoksazol dewasa tablet
Kuinin dihidroklorida injeksi 25 % - 2 ml
Kuinin sulfat tablet 222 mg ( 7H2O )
Lidokain Kompositum injeksi
Magnesium sulfat inj. 20% - 25 ml
Magnesium sulfat inj. 40% - 25 ml
Mebendazol Syrup
Metilergometrin tablet salut
Metilergometrin Inj.
Metronidazol tablet 250 mg
Metronidazol tablet 500 mg
Mummifying pasta
Natrium bikarbonat tablet 500 mg
Natrium klorida larutan infus 0,9 % steril
Nistatin 100.000 iu/g tablet vaginal
Nistatin 500.000 iu/g tablet salut
Nifedipin tab
Obat anti tuberkolusis katagori 1
Obat anti tuberkolusis katagori 2
Obat anti tuberkolusis katagori 3
Obat anti tuberkolusis sisipan
Obat anti tuberkolosis anak
Obat batuk hitam ( o b h ) cairan
Oksitetrasiklin hcl inj.
Oksitetrasiklin hcl salep kulit 3 %
Oksitetrasiklin hcl salep mata 1 %
Papaverin tablet
Paraformaldehid tablet 1 gram
Parasetamol sirup 120 mg/5ml
Parasetamol tablet 100 mg
Parasetamol tablet 500 mg
Perfenazin tablet 4 mg
Pirantel pamoat tablet 365 mg
Piridoxin hcl tablet 10 mg
Pyrazinamid tablet
Plester 5 yard x 2 inch
Polikresulen
Prazikuantel tablet 600 mg
Prednison tablet 5 mg
Primaquin tablet 15 mg
Prokain benzyl penisillin 3 juta iu/vial inj.
Propiltiourasil tablet 100 mg
Propanolol hcl tablet 40 mg
Propanolol hcl tablet 10 mg
Reserpin tablet 0,10 mg
Reserpin tablet 0,25 mg
Retinol ( Vit A ) 200.000 iu
Retinol ( Vit A ) 100.000 iu
Rifampisin kapsul 600 mg
Rifampisin kapsul 450 mg
Rifampisin kapsul 300 mg
Ringer laktat infus steril
Salbutamol tablet 2 mg
Salep 2-4
Salisil bedak 2 %
Salisil spritus 10 %
Semen seng fosfat serbuk dan cairan
Serum ABU polivalen inj.
Serum ATS 1500 IU
Serum ATS 20000 IU
Simvastatin
Sianokobalamin inj. 500 mcg/ml
Silk (benang bedah sutera) no. 3/0
Silver amalgam serbuk 65 - 75 %
Spons gelatin cublices 1x1x1 cm
Streptomycin serbuk inj. 1000 mg/vial
Sulfadimidin tablet 500 mg
Sulfasetamid natrium tetes mata 15 %
Tablet tambah darah kombinasi
Temporary stoping fletcher dan cairan
Tetrasiklin HCl kapsul 250 mg
Tetrasiklin HCl kapsul 500 mg
Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml
Tiamin HCl mononitrat tablet 50 mg
Triheksilfenidil HCl tablet 2 mg
Trikresol formalin cairan
Vaksin Rabies Vero
Vitamin B komplek tablet
Yodium povidon larutan 10 % - 30 ml
Yodium povidon larutan 10 % - 300 ml

Acyclovir tablet 200 mg


Acyclovir cream
Acyclovir tablet 400 mg
Andalan Injeksi
Asam mefenamat kapsul 250 mg
Asam mefenamat tablet 500 mg
Ampicilin injeksi 1 g
Ambroxol Sirup
Cefotaxime inj 1 gr
Cimetidin tablet 200 mg
Ciprofloxacin kaplet 500 mg
Dasabion tab
Domperidon tab
Erytromycin caps 250 mg
Erytromycin capt 500 mg
Erytromycin Syr
Etabion Cap
Gentamycin injeksi
Gentamycin salep kulit
Gentamycin tetes mata
H2O2
Ichtyol salap
Levertran salep
Kloramphenicol tetes mata
Metoklorpropamide Hcl 10 mg
Mikonazole cream
Methyl Prednisolon tab 4 mg
Nipedipin tablet
Natrium Diklofenak 50 mg
Obat Tambah Darah Indo
Obat Flu Indo
Obat Maag indo
Papaverin injeksi
Papaverin tablet 40 mg
Piperazin 500 mg
Piperazin sirup
Piroksikam tablet 10 mg
Piroksikam tablet 20 mg
Ranitidine 150 mg
Stesolit Rectal supp

Alkohol 70 %
Anisol solution
Asam Asetat Glasial
Aqua destilata
Asam Klorida 0.1 N
Asam klorida 0,1 N
Asam sulfosalisilat 20 %
Barium Klorida
Beker Glass
Blood Lancet
Erlemeyer
Etanol asam 3 %
Etanol 70 %
Fauchet
Imersen Oil HB
Kapas 1 KG
Kertas Saring Whatman
Kertas Perkamen
Larutan Bupper PH 7.2
Label Etiket
Larutan Metanol
Larutan Sulposalisilat
Larutan Benedict
Larutan Eosin 2 %
Larutan Etanol Asam
Larutan Giemsa Stalin
Larutan Karbol Fuksin
Larutan Metilen Biru
Larutan Turk
Lisol
Metanol
Natrium Sitrat 38 %
Objek Glass
Plastik Obat
Pipet Tetes Biasa
Rees echer
Rak Pewarna kaca pipet
Schlesinger
Spiritus 100 ml
Tes Gol. Darah( A,B,AB)
Tes Kehamilan HCG
Tabung Reaksi
Tissue lensa
Alat suntik 3 cc
ACT
Artesunate
Ambroxol tab
Clindamicin
Cetrizin
Hemafort
Oxytocin inj
Pembalut gip
Salbutamol 4 mg
Antasida syrup
Lysmin sirup
Lytamin syrup
Mecobion tab
Bioplasenton jelly
Dolodon 500 mg
Metformin
Meloxicam 7,5 mg
Bisturi 10,11,20,22
Jarum jahit 10,11,12,13,14
Duo Care Gluko le st
Stick Gula darah
Hand scun
Cyproploxacin 250 mg
Asam Folat
Omeprazole
Zink Tab
Doxycicklin 100mg
Amlodipin 5 mg
Dexanta Tab
Viliron tab
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : mei
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 100 100
3 Alat Suntik 2.5 ml Set 97 134 44 560 835
4 Albendazol 400 mg Set 45 0 45
5 Alupurinol 100 mg Tab 170 120 100 300 690
6 Aminophylin 200 mg Tab 111 242 190 28 400 971
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 140 100 240
9 Amoksisillin sirup kering 125 mg/5 ml Btl 42 55 48 14 400 559
10 Amoksisillin kapsul 250 mg Kap 917 300 532 332 960 3041
11 Amoksisillin kaplet 500 mg Kap 919 294 1010 205 3500 5928
12 Ampicillin kaplet 500 mg Kap 80 300 15 400 795
13 Ampicillin sirup kering 125 mg/5 ml Btl 16 41 12 11 78 158
14 Antalgin tablet 500 mg Tab 525 580 104 7500 8709
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 100 220 0 320
17 Antibakteri DOEN salep kombinasi Pot 20 3 65 88
18 Antihemoroid DOEN kombinasi Pot 14 6 40 60
19 Antifungi DOEN kombinasi Pot 4 5 23 4 24 60
20 Antimigrain DOEN kombinasi Tab 66 0 66
21 Aqua proinjeksi bebas pirogen Amp 2 5 7
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1027 3395 930 9000 14352
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 190 300 490
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 9 9 0 18
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 1094 400 43 58 500 2095
35 Captopril 25 mg tablet Tab 100 0 100
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 6 85 91
37 Deksametason tablet 0,5 mg Tab 520 1781 1455 225 5700 9681
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 18 6 29 8 179 240
39 Dekstromethorpan HBr tablet 15 mg Tab 152 471 145 2900 3668
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 48
42 Diazepam 2 mg Tab 852 0 852
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 25 10 8 60 103
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 851 110 194 0 1155


47 Ekstrak belladon tablet 10 mg Tab 399 406 155 0 960
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 2 2 1 11 16
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 0
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 160 500 660
55 Fenitoin natrium kapsul 30 mg Kap 215 500 715
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 628 0 628
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 4 5 12 21
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 7 0 7
63 Fitomenadion (vit K) tablet salut 10 mg Tab 112 65 128 90 400 795
64 Furosemid tablet 40 mg Tab 127 0 127
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 55 75 206 42 600 978
67 Gentian violet larutan 1 % Btl 21 5 7 3 0 36
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 350 600 950
70 Gliseril guayakolat tablet 100 mg Tab 1696 1050 1476 1532 18000 23754
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 240 50 401 45 200 936
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 105 300 405
76 Halloperidol tablet 5 mg Tab 8 0 8
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 782 290 52 0 1124
78 Hidrokortison krim 2,5 % Pot 34 6 5 3 24 72
79 Ibuprofen tablet 200 mg Tab 544 445 335 130 5100 6554
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 418 0 418
84 I N H tablet 300 mg Tab 766 0 766
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 0 0
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 437 378 1323 702 3000 5840
89 Kapas pembalut / Absorben 250 gram Rol 1 1 1 13 16
90 Karbamazepin tablet 200 mg Tab 130 200 330
91 Kasa kompres 40/40 steril Rol 10 10
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 3 7 2 26 38
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 314 750 1064
95 Kloramfenikol salep mata 1 % Pot 16 5 0 21
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 24 48 72


97 Klorfeniramine maleat tablet 4 mg Tab 2431 1618 14000 18049
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 1005 0 1005
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 200 250 100 35 0 585
107 Kotrimoksazol suspensi Btl 13 0 13
108 Kotrimoksazol dewasa tablet Tab 521 500 214 162 2200 3597
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 4 12 60 76
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 250 300 550
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 20 27 0 47
118 Metronidazol tablet 500 mg Tab 242 245 140 600 1227
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 695 837 0 1532
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 0 0
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 190 500 690
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 15 7 3 105 130
131 Oksitetrasiklin hcl inj. Amp 10 10
132 Oksitetrasiklin hcl salep kulit 3 % Pot 28 5 11 5 50 99
133 Oksitetrasiklin hcl salep mata 1 % Pot 14 3 4 17 38
134 Papaverin tablet Tab 850 100 0 950
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 30 19 26 11 400 486
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 1192 329 230 7200 8951
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 32 10 16 6 300 364
141 Piridoxin hcl tablet 10 mg Tab 1393 2772 1346 1075 2000 8586
142 Pyrazinamid tablet Tab 115 800 915
143 Plester 5 yard x 2 inch Rol 1 1 1 4 7
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 558 2349 1110 404 4000 8421
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 362 400 762
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 232 700 932
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 579 1000 1579
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 178 100 278
157 Rifampisin kapsul 450 mg Kap 3 0 3
158 Rifampisin kapsul 300 mg Kap 200 0 200
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 100 10 16 16 0 142
161 Salep 2-4 Pot 6 2 8 2 24 42
162 Salisil bedak 2 % Sak 8 7 4 1 23 43
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 5 5
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 160 450 610
169 Sianokobalamin inj. 500 mcg/ml Amp 30 76 53 300 459
170 Silk (benang bedah sutera) no. 3/0 Rol 1 3 4
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 11 0 11
176 Tablet tambah darah kombinasi Tab 340 200 458 562 2400 3960
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 375 747 0 1122
179 Tetrasiklin HCl kapsul 500 mg Kap 40 150 400 590
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 90 90
181 Tiamin HCl mononitrat tablet 50 mg Tab 1130 1400 1589 1327 8000 13446
182 Triheksilfenidil HCl tablet 2 mg Tab 175 500 675
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 1186 445 0 1631
186 Yodium povidon larutan 10 % - 30 ml Btl 8 8
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 1 2 5

1 Acyclovir tablet 200 mg Tab 234 150 85 100 569


2 Acyclovir cream Tube 47 6 26 50 129
3 Acyclovir tablet 400 mg Tab 130 138 200 468
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 8 90 1900 1998
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 19 129 148


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 95 400 495
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 52 400 452
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 119 200 319
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 0 0
20 Gentamycin tetes mata Btl 0 0
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 4 23 27
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 4 72 76
27 Methyl Prednisolon tab 4 mg Tab 90 900 990
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 62 0 62
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 0 0
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 0 0
38 Piroksikam tablet 20 mg Tab 465 50 146 200 861
39 Ranitidine 150 mg Tab 90 500 590
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 1 1 1 3 6
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 8 3 3 600 614
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 1
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 23000 23000
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 0 0
48 Clindamicin caps 0 0
49 Cetrizin tab 85 150 235
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 7 0 7
54 Antasida syrup pcs 15 10 25
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 10 88 98
57 Mecobion tab Tab 13 0 13
58 Bioplasenton jelly Tab 5 0 5
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 330 100 430
61 Meloxicam 7,5 mg Tab 50 0 50
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 100 100
66 Hand scun Pcs 100 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1815 0 1815
69 Omeprazole Caps 123 30 0 153
70 Zink Tab Tab 372 1400 1772
71 Doxycicklin 100mg Tab 100 300 400
72 Amlodipin 5 mg Caps 205 0 205
73 Dexanta Tab Tab 487 1000 681 380 4500 7048
74 Viliron tab 300 240 540
Air Raksa Dental Use
Alat Suntik 1 ml
Alat Suntik 2.5 ml
Albendazol 400 mg
Alupurinol 100 mg
Aminophylin 200 mg
Aminophylin inj 24 mg/ml 10 ml
Amitriptilin HCl tablet 25 mg
Amoksisillin sirup kering 125 mg/5 ml
Amoksisillin kapsul 250 mg
Amoksisillin kaplet 500 mg
Ampicillin kaplet 500 mg
Ampicillin sirup kering 125 mg/5 ml
Antalgin tablet 500 mg
Antalgin injeksi
Antasida DOEN tablet kombinasi
Antibakteri DOEN salep kombinasi
Antihemoroid DOEN kombinasi
Antifungi DOEN kombinasi
Antimigrain DOEN kombinasi
Aqua proinjeksi bebas pirogen
Aquadest steril
Asam askorbat (vit C) 50 mg
Asam askorbat (vit C)250 mg
Asetosal tablet 100 mg
Asetosal tablet 500 mg
Atropin sulfat injeksi 0,25 mg/ml - ml
Atropin sulfat tablet 0,5 mg
Atropin sulfat tetes mata 0 5 %
Benzatin benzil penicillin inj. 2,4 juta IU/vial
Besi sirup
Betametason krim 0,1 %
Catgut/benang bedah no. 2/0 - 3/0
Captopril 12.5 mg tablet
Captopril 25 mg tablet
Deksametason injeksi 5 mg/ml - 1 ml
Deksametason tablet 0,5 mg
Dekstromethorpan HBr sirup 10 mg/5 ml
Dekstromethorpan HBr tablet 15 mg
Devitalisasi pasta
Diazepam injeksi 5 mg/ml - 2 ml
Diazepam 2 mg
Diazepam 5 mg
Difenhidramin HCl injeksi 10 mg/ml - ml
Digoksin tablet 0,25 mg
Efedrin HCl tablet 25 mg
Ekstrak belladon tablet 10 mg
Epinephrin HCl injeksi
Etakridin (rivanol) larutan 0,1
Etambutol HCl 250 mg tablet
Etambutol HCl 500 mg tablet
Etil klorida semprot
Eugenol cairan
Fenitoin natrium kapsul 100 mg
Fenitoin natrium kapsul 30 mg
Fenobarbital injeksi 50 mg/ml - 2 ml
Fenobarbital tablet 100 mg
Fenobarbital tablet 30 mg
Fenoksi metil penisillin tablet 250 mg
Fenoksi metil penisillin tablet 500 mg
Fenol gliserol tetes telinga 10 %
Fitomenadion (vit K) inj. 10 mg/ml - 1 ml
Fitomenadion (vit K) tablet salut 10 mg
Furosemid tablet 40 mg
Gameksan emulsi 1 %
Garam oralit 200 ml air
Gentian violet larutan 1 %
Glass ionomer semen (gc ix)
Glibenklamid tablet 5 mg
Gliseril guayakolat tablet 100 mg
Gliserin
Glukosa Larutan Infus 5 % Steril
Griseofulvin 125 mg micronized
Halloperidol tablet 0,5 mg
Halloperidol tablet 1,5 mg
Halloperidol tablet 5 mg
Hidroklrotiazed ( hct ) tablet 25 mg
Hidrokortison krim 2,5 %
Ibuprofen tablet 200 mg
Ibuprofen tablet 400 mg
Infusion set anak
Infusion set dewasa
I N H tablet 100 mg
I N H tablet 300 mg
Isosorbit dinitrat tablet sublingual 5 mg
Kalium permanganat serbuk
Kalsium hidroksida pasta
Kalsium Laktat ( Kalk ) 500 mg
Kapas pembalut / Absorben 250 gram
Karbamazepin tablet 200 mg
Kasa kompres 40/40 steril
Kasa pembalut hidrofil 4 m x 15 cm
Kasa pembalut hidrofil 4 m x 3 cm
Kloramfenikol 250 mg kapsul
Kloramfenikol salep mata 1 %
Kloramfenikol tetes telinga 3 %
Klorfeniramine maleat tablet 4 mg
Kloroquin pospat tablet 250 mg
Klorpromazin hcl injeksi
Klorfenol kamfermenthol (CHKM)
Klorpromazin hcl injeksi 5 mg/ml - 1 ml
Klorpromazin hcl tablet salut 100 mg
Klorpromazin hcl tablet salut 25 mg
Kodein hcl tablet 10 mg
Komb. primetamin 25 mg + suldok 500 mg
Kotrimoksazol pediatrik tablet
Kotrimoksazol suspensi
Kotrimoksazol dewasa tablet
Kuinin dihidroklorida injeksi 25 % - 2 ml
Kuinin sulfat tablet 222 mg ( 7H2O )
Lidokain Kompositum injeksi
Magnesium sulfat inj. 20% - 25 ml
Magnesium sulfat inj. 40% - 25 ml
Mebendazol Syrup
Metilergometrin tablet salut
Metilergometrin Inj.
Metronidazol tablet 250 mg
Metronidazol tablet 500 mg
Mummifying pasta
Natrium bikarbonat tablet 500 mg
Natrium klorida larutan infus 0,9 % steril
Nistatin 100.000 iu/g tablet vaginal
Nistatin 500.000 iu/g tablet salut
Nifedipin tab
Obat anti tuberkolusis katagori 1
Obat anti tuberkolusis katagori 2
Obat anti tuberkolusis katagori 3
Obat anti tuberkolusis sisipan
Obat anti tuberkolosis anak
Obat batuk hitam ( o b h ) cairan
Oksitetrasiklin hcl inj.
Oksitetrasiklin hcl salep kulit 3 %
Oksitetrasiklin hcl salep mata 1 %
Papaverin tablet
Paraformaldehid tablet 1 gram
Parasetamol sirup 120 mg/5ml
Parasetamol tablet 100 mg
Parasetamol tablet 500 mg
Perfenazin tablet 4 mg
Pirantel pamoat tablet 365 mg
Piridoxin hcl tablet 10 mg
Pyrazinamid tablet
Plester 5 yard x 2 inch
Polikresulen
Prazikuantel tablet 600 mg
Prednison tablet 5 mg
Primaquin tablet 15 mg
Prokain benzyl penisillin 3 juta iu/vial inj.
Propiltiourasil tablet 100 mg
Propanolol hcl tablet 40 mg
Propanolol hcl tablet 10 mg
Reserpin tablet 0,10 mg
Reserpin tablet 0,25 mg
Retinol ( Vit A ) 200.000 iu
Retinol ( Vit A ) 100.000 iu
Rifampisin kapsul 600 mg
Rifampisin kapsul 450 mg
Rifampisin kapsul 300 mg
Ringer laktat infus steril
Salbutamol tablet 2 mg
Salep 2-4
Salisil bedak 2 %
Salisil spritus 10 %
Semen seng fosfat serbuk dan cairan
Serum ABU polivalen inj.
Serum ATS 1500 IU
Serum ATS 20000 IU
Simvastatin
Sianokobalamin inj. 500 mcg/ml
Silk (benang bedah sutera) no. 3/0
Silver amalgam serbuk 65 - 75 %
Spons gelatin cublices 1x1x1 cm
Streptomycin serbuk inj. 1000 mg/vial
Sulfadimidin tablet 500 mg
Sulfasetamid natrium tetes mata 15 %
Tablet tambah darah kombinasi
Temporary stoping fletcher dan cairan
Tetrasiklin HCl kapsul 250 mg
Tetrasiklin HCl kapsul 500 mg
Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml
Tiamin HCl mononitrat tablet 50 mg
Triheksilfenidil HCl tablet 2 mg
Trikresol formalin cairan
Vaksin Rabies Vero
Vitamin B komplek tablet
Yodium povidon larutan 10 % - 30 ml
Yodium povidon larutan 10 % - 300 ml

Acyclovir tablet 200 mg


Acyclovir cream
Acyclovir tablet 400 mg
Andalan Injeksi
Asam mefenamat kapsul 250 mg
Asam mefenamat tablet 500 mg
Ampicilin injeksi 1 g
Ambroxol Sirup
Cefotaxime inj 1 gr
Cimetidin tablet 200 mg
Ciprofloxacin kaplet 500 mg
Dasabion tab
Domperidon tab
Erytromycin caps 250 mg
Erytromycin capt 500 mg
Erytromycin Syr
Etabion Cap
Gentamycin injeksi
Gentamycin salep kulit
Gentamycin tetes mata
H2O2
Ichtyol salap
Levertran salep
Kloramphenicol tetes mata
Metoklorpropamide Hcl 10 mg
Mikonazole cream
Methyl Prednisolon tab 4 mg
Nipedipin tablet
Natrium Diklofenak 50 mg
Obat Tambah Darah Indo
Obat Flu Indo
Obat Maag indo
Papaverin injeksi
Papaverin tablet 40 mg
Piperazin 500 mg
Piperazin sirup
Piroksikam tablet 10 mg
Piroksikam tablet 20 mg
Ranitidine 150 mg
Stesolit Rectal supp

Alkohol 70 %
Anisol solution
Asam Asetat Glasial
Aqua destilata
Asam Klorida 0.1 N
Asam klorida 0,1 N
Asam sulfosalisilat 20 %
Barium Klorida
Beker Glass
Blood Lancet
Erlemeyer
Etanol asam 3 %
Etanol 70 %
Fauchet
Imersen Oil HB
Kapas 1 KG
Kertas Saring Whatman
Kertas Perkamen
Larutan Bupper PH 7.2
Label Etiket
Larutan Metanol
Larutan Sulposalisilat
Larutan Benedict
Larutan Eosin 2 %
Larutan Etanol Asam
Larutan Giemsa Stalin
Larutan Karbol Fuksin
Larutan Metilen Biru
Larutan Turk
Lisol
Metanol
Natrium Sitrat 38 %
Objek Glass
Plastik Obat
Pipet Tetes Biasa
Rees echer
Rak Pewarna kaca pipet
Schlesinger
Spiritus 100 ml
Tes Gol. Darah( A,B,AB)
Tes Kehamilan HCG
Tabung Reaksi
Tissue lensa
Alat suntik 3 cc
ACT
Artesunate
Ambroxol tab
Clindamicin
Cetrizin
Hemafort
Oxytocin inj
Pembalut gip
Salbutamol 4 mg
Antasida syrup
Lysmin sirup
Lytamin syrup
Mecobion tab
Bioplasenton jelly
Dolodon 500 mg
Metformin
Meloxicam 7,5 mg
Bisturi 10,11,20,22
Jarum jahit 10,11,12,13,14
Duo Care Gluko le st
Stick Gula darah
Hand scun
Cyproploxacin 250 mg
Asam Folat
Omeprazole
Zink Tab
Doxycicklin 100mg
Amlodipin 5 mg
Dexanta Tab
Viliron tab
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : April
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 170 170
3 Alat Suntik 2.5 ml Set 127 142 80 670 1019
4 Albendazol 400 mg Set 45 540 585
5 Alupurinol 100 mg Tab 211 183 100 300 794
6 Aminophylin 200 mg Tab 158 435 190 76 500 1359
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 100 300 400
9 Amoksisillin sirup kering 125 mg/5 ml Btl 50 73 52 25 585 785
10 Amoksisillin kapsul 250 mg Kap 287 481 683 550 2880 4881
11 Amoksisillin kaplet 500 mg Kap 3 500 1246 420 8500 10669
12 Ampicillin kaplet 500 mg Kap 100 525 95 400 1120
13 Ampicillin sirup kering 125 mg/5 ml Btl 16 57 15 20 78 186
14 Antalgin tablet 500 mg Tab 360 630 364 8900 10254
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 974 51 455 0 1480
17 Antibakteri DOEN salep kombinasi Pot 12 5 81 98
18 Antihemoroid DOEN kombinasi Pot 14 8 50 72
19 Antifungi DOEN kombinasi Pot 2 8 24 5 33 72
20 Antimigrain DOEN kombinasi Tab 66 0 66
21 Aqua proinjeksi bebas pirogen Amp 3 5 8
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1265 3856 1216 13000 19337
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 190 300 490
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 56 18 4 0 78
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 464 566 480 130 1800 3440
35 Captopril 25 mg tablet Tab 180 12 0 192
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 8 90 98
37 Deksametason tablet 0,5 mg Tab 240 2666 1551 457 7700 12614
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 14 12 35 14 201 276
39 Dekstromethorpan HBr tablet 15 mg Tab 279 491 289 2900 3959
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 48
42 Diazepam 2 mg Tab 109 1000 1109
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 40 10 20 90 160
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 967 115 200 0 1282


47 Ekstrak belladon tablet 10 mg Tab 409 406 235 0 1050
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 3 2 1 11 17
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 1 1
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 160 500 660
55 Fenitoin natrium kapsul 30 mg Kap 215 500 715
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 690 0 690
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 12 8 12 32
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 10 0 10
63 Fitomenadion (vit K) tablet salut 10 mg Tab 161 100 128 100 500 989
64 Furosemid tablet 40 mg Tab 140 0 140
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 80 100 216 78 1100 1574
67 Gentian violet larutan 1 % Btl 9 8 11 5 28 61
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 270 800 1070
70 Gliseril guayakolat tablet 100 mg Tab 1645 3223 1659 1984 22000 30511
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 300 87 401 83 200 1071
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 150 300 450
76 Halloperidol tablet 5 mg Tab 113 0 113
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 841 295 777 76 0 1989
78 Hidrokortison krim 2,5 % Pot 30 15 5 9 72 131
79 Ibuprofen tablet 200 mg Tab 95 730 380 272 7100 8577
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 746 0 746
84 I N H tablet 300 mg Tab 791 0 791
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 15 0 15
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 264 893 1500 948 4000 7605
89 Kapas pembalut / Absorben 250 gram Rol 2 1 1 15 19
90 Karbamazepin tablet 200 mg Tab 260 200 460
91 Kasa kompres 40/40 steril Rol 10 10
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 6 7 4 26 43
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 84 1000 1084
95 Kloramfenikol salep mata 1 % Pot 14 7 19 40
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 12 72 84


97 Klorfeniramine maleat tablet 4 mg Tab 1817 282 1994 0 0 4093
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 157 1000 1157
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 243 400 100 87 300 1130
107 Kotrimoksazol suspensi Btl 56 15 0 71
108 Kotrimoksazol dewasa tablet Tab 233 654 232 330 3100 4549
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 5 13 90 108
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 180 300 480
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 20 200 33 0 253
118 Metronidazol tablet 500 mg Tab 215 180 700 1095
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 715 837 0 1552
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 0 0
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 190 500 690
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 32 14 13 9 120 188
131 Oksitetrasiklin hcl inj. Amp 10 10
132 Oksitetrasiklin hcl salep kulit 3 % Pot 41 18 13 8 100 180
133 Oksitetrasiklin hcl salep mata 1 % Pot 17 5 6 17 45
134 Papaverin tablet Tab 923 115 0 1038
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 38 36 36 20 500 630
137 Parasetamol tablet 100 mg Tab 1500 0 1500
138 Parasetamol tablet 500 mg Tab 2618 2216 349 555 0 5738
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 45 12 16 8 300 381
141 Piridoxin hcl tablet 10 mg Tab 1350 3664 1568 1299 3000 10881
142 Pyrazinamid tablet Tab 97 1000 1097
143 Plester 5 yard x 2 inch Rol 1 1 2 4 8
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 1986 3228 1284 768 4000 11266
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 134 800 934
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 92 900 992
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 864 1000 1864
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 181 100 281
157 Rifampisin kapsul 450 mg Kap 128 0 128
158 Rifampisin kapsul 300 mg Kap 200 0 200
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 15 16 40 100 171
161 Salep 2-4 Pot 9 4 8 3 24 48
162 Salisil bedak 2 % Sak 6 10 7 4 49 76
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 5 5
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 150 500 650
169 Sianokobalamin inj. 500 mcg/ml Amp 45 76 87 400 608
170 Silk (benang bedah sutera) no. 3/0 Rol 1 3 4
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 14 0 14
176 Tablet tambah darah kombinasi Tab 792 560 604 802 3000 5758
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 574 822 0 1396
179 Tetrasiklin HCl kapsul 500 mg Kap 90 200 400 690
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 90 90
181 Tiamin HCl mononitrat tablet 50 mg Tab 1832 2278 1793 1705 9000 16608
182 Triheksilfenidil HCl tablet 2 mg Tab 125 700 825
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 270 1340 731 0 2341
186 Yodium povidon larutan 10 % - 30 ml Btl 8 8
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 1 3 6

1 Acyclovir tablet 200 mg Tab 110 180 115 300 705


2 Acyclovir cream Tube 24 9 30 95 158
3 Acyclovir tablet 400 mg Tab 150 138 200 488
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 251 130 2200 2581
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 27 194 221


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 355 400 755
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 118 500 618
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 75 300 375
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 3 10 13
20 Gentamycin tetes mata Btl 0 0
21 H2O2 Btl 0 0
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 6 33 39
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 17 72 89
27 Methyl Prednisolon tab 4 mg Tab 100 900 1000
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 62 0 62
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 0 0
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 70 0 70
38 Piroksikam tablet 20 mg Tab 146 900 1046
39 Ranitidine 150 mg Tab 296 700 996
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 2 1 2 5 10
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 15 5 5 600 625
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 1
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 100 100 28000 28200
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 170 0 170
48 Clindamicin caps 0 0
49 Cetrizin tab 55 240 295
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 41 0 41
54 Antasida syrup pcs 22 10 32
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 14 96 110
57 Mecobion tab Tab 208 600 808
58 Bioplasenton jelly Tab 8 0 8
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 300 800 1100
61 Meloxicam 7,5 mg Tab 50 200 250
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 150 150
66 Hand scun Pcs 300 300
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1860 0 1860
69 Omeprazole Caps 63 40 60 163
70 Zink Tab Tab 170 2300 2470
71 Doxycicklin 100mg Tab 100 300 400
72 Amlodipin 5 mg Caps 80 300 380
73 Dexanta Tab Tab 210 1000 800 620 7000 9630
74 Viliron tab 60 540 600
Air Raksa Dental Use
Alat Suntik 1 ml
Alat Suntik 2.5 ml
Albendazol 400 mg
Alupurinol 100 mg
Aminophylin 200 mg
Aminophylin inj 24 mg/ml 10 ml
Amitriptilin HCl tablet 25 mg
Amoksisillin sirup kering 125 mg/5 ml
Amoksisillin kapsul 250 mg
Amoksisillin kaplet 500 mg
Ampicillin kaplet 500 mg
Ampicillin sirup kering 125 mg/5 ml
Antalgin tablet 500 mg
Antalgin injeksi
Antasida DOEN tablet kombinasi
Antibakteri DOEN salep kombinasi
Antihemoroid DOEN kombinasi
Antifungi DOEN kombinasi
Antimigrain DOEN kombinasi
Aqua proinjeksi bebas pirogen
Aquadest steril
Asam askorbat (vit C) 50 mg
Asam askorbat (vit C)250 mg
Asetosal tablet 100 mg
Asetosal tablet 500 mg
Atropin sulfat injeksi 0,25 mg/ml - ml
Atropin sulfat tablet 0,5 mg
Atropin sulfat tetes mata 0 5 %
Benzatin benzil penicillin inj. 2,4 juta IU/vial
Besi sirup
Betametason krim 0,1 %
Catgut/benang bedah no. 2/0 - 3/0
Captopril 12.5 mg tablet
Captopril 25 mg tablet
Deksametason injeksi 5 mg/ml - 1 ml
Deksametason tablet 0,5 mg
Dekstromethorpan HBr sirup 10 mg/5 ml
Dekstromethorpan HBr tablet 15 mg
Devitalisasi pasta
Diazepam injeksi 5 mg/ml - 2 ml
Diazepam 2 mg
Diazepam 5 mg
Difenhidramin HCl injeksi 10 mg/ml - ml
Digoksin tablet 0,25 mg
Efedrin HCl tablet 25 mg
Ekstrak belladon tablet 10 mg
Epinephrin HCl injeksi
Etakridin (rivanol) larutan 0,1
Etambutol HCl 250 mg tablet
Etambutol HCl 500 mg tablet
Etil klorida semprot
Eugenol cairan
Fenitoin natrium kapsul 100 mg
Fenitoin natrium kapsul 30 mg
Fenobarbital injeksi 50 mg/ml - 2 ml
Fenobarbital tablet 100 mg
Fenobarbital tablet 30 mg
Fenoksi metil penisillin tablet 250 mg
Fenoksi metil penisillin tablet 500 mg
Fenol gliserol tetes telinga 10 %
Fitomenadion (vit K) inj. 10 mg/ml - 1 ml
Fitomenadion (vit K) tablet salut 10 mg
Furosemid tablet 40 mg
Gameksan emulsi 1 %
Garam oralit 200 ml air
Gentian violet larutan 1 %
Glass ionomer semen (gc ix)
Glibenklamid tablet 5 mg
Gliseril guayakolat tablet 100 mg
Gliserin
Glukosa Larutan Infus 5 % Steril
Griseofulvin 125 mg micronized
Halloperidol tablet 0,5 mg
Halloperidol tablet 1,5 mg
Halloperidol tablet 5 mg
Hidroklrotiazed ( hct ) tablet 25 mg
Hidrokortison krim 2,5 %
Ibuprofen tablet 200 mg
Ibuprofen tablet 400 mg
Infusion set anak
Infusion set dewasa
I N H tablet 100 mg
I N H tablet 300 mg
Isosorbit dinitrat tablet sublingual 5 mg
Kalium permanganat serbuk
Kalsium hidroksida pasta
Kalsium Laktat ( Kalk ) 500 mg
Kapas pembalut / Absorben 250 gram
Karbamazepin tablet 200 mg
Kasa kompres 40/40 steril
Kasa pembalut hidrofil 4 m x 15 cm
Kasa pembalut hidrofil 4 m x 3 cm
Kloramfenikol 250 mg kapsul
Kloramfenikol salep mata 1 %
Kloramfenikol tetes telinga 3 %
Klorfeniramine maleat tablet 4 mg
Kloroquin pospat tablet 250 mg
Klorpromazin hcl injeksi
Klorfenol kamfermenthol (CHKM)
Klorpromazin hcl injeksi 5 mg/ml - 1 ml
Klorpromazin hcl tablet salut 100 mg
Klorpromazin hcl tablet salut 25 mg
Kodein hcl tablet 10 mg
Komb. primetamin 25 mg + suldok 500 mg
Kotrimoksazol pediatrik tablet
Kotrimoksazol suspensi
Kotrimoksazol dewasa tablet
Kuinin dihidroklorida injeksi 25 % - 2 ml
Kuinin sulfat tablet 222 mg ( 7H2O )
Lidokain Kompositum injeksi
Magnesium sulfat inj. 20% - 25 ml
Magnesium sulfat inj. 40% - 25 ml
Mebendazol Syrup
Metilergometrin tablet salut
Metilergometrin Inj.
Metronidazol tablet 250 mg
Metronidazol tablet 500 mg
Mummifying pasta
Natrium bikarbonat tablet 500 mg
Natrium klorida larutan infus 0,9 % steril
Nistatin 100.000 iu/g tablet vaginal
Nistatin 500.000 iu/g tablet salut
Nifedipin tab
Obat anti tuberkolusis katagori 1
Obat anti tuberkolusis katagori 2
Obat anti tuberkolusis katagori 3
Obat anti tuberkolusis sisipan
Obat anti tuberkolosis anak
Obat batuk hitam ( o b h ) cairan
Oksitetrasiklin hcl inj.
Oksitetrasiklin hcl salep kulit 3 %
Oksitetrasiklin hcl salep mata 1 %
Papaverin tablet
Paraformaldehid tablet 1 gram
Parasetamol sirup 120 mg/5ml
Parasetamol tablet 100 mg
Parasetamol tablet 500 mg
Perfenazin tablet 4 mg
Pirantel pamoat tablet 365 mg
Piridoxin hcl tablet 10 mg
Pyrazinamid tablet
Plester 5 yard x 2 inch
Polikresulen
Prazikuantel tablet 600 mg
Prednison tablet 5 mg
Primaquin tablet 15 mg
Prokain benzyl penisillin 3 juta iu/vial inj.
Propiltiourasil tablet 100 mg
Propanolol hcl tablet 40 mg
Propanolol hcl tablet 10 mg
Reserpin tablet 0,10 mg
Reserpin tablet 0,25 mg
Retinol ( Vit A ) 200.000 iu
Retinol ( Vit A ) 100.000 iu
Rifampisin kapsul 600 mg
Rifampisin kapsul 450 mg
Rifampisin kapsul 300 mg
Ringer laktat infus steril
Salbutamol tablet 2 mg
Salep 2-4
Salisil bedak 2 %
Salisil spritus 10 %
Semen seng fosfat serbuk dan cairan
Serum ABU polivalen inj.
Serum ATS 1500 IU
Serum ATS 20000 IU
Simvastatin
Sianokobalamin inj. 500 mcg/ml
Silk (benang bedah sutera) no. 3/0
Silver amalgam serbuk 65 - 75 %
Spons gelatin cublices 1x1x1 cm
Streptomycin serbuk inj. 1000 mg/vial
Sulfadimidin tablet 500 mg
Sulfasetamid natrium tetes mata 15 %
Tablet tambah darah kombinasi
Temporary stoping fletcher dan cairan
Tetrasiklin HCl kapsul 250 mg
Tetrasiklin HCl kapsul 500 mg
Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml
Tiamin HCl mononitrat tablet 50 mg
Triheksilfenidil HCl tablet 2 mg
Trikresol formalin cairan
Vaksin Rabies Vero
Vitamin B komplek tablet
Yodium povidon larutan 10 % - 30 ml
Yodium povidon larutan 10 % - 300 ml

Acyclovir tablet 200 mg


Acyclovir cream
Acyclovir tablet 400 mg
Andalan Injeksi
Asam mefenamat kapsul 250 mg
Asam mefenamat tablet 500 mg
Ampicilin injeksi 1 g
Ambroxol Sirup
Cefotaxime inj 1 gr
Cimetidin tablet 200 mg
Ciprofloxacin kaplet 500 mg
Dasabion tab
Domperidon tab
Erytromycin caps 250 mg
Erytromycin capt 500 mg
Erytromycin Syr
Etabion Cap
Gentamycin injeksi
Gentamycin salep kulit
Gentamycin tetes mata
H2O2
Ichtyol salap
Levertran salep
Kloramphenicol tetes mata
Metoklorpropamide Hcl 10 mg
Mikonazole cream
Methyl Prednisolon tab 4 mg
Nipedipin tablet
Natrium Diklofenak 50 mg
Obat Tambah Darah Indo
Obat Flu Indo
Obat Maag indo
Papaverin injeksi
Papaverin tablet 40 mg
Piperazin 500 mg
Piperazin sirup
Piroksikam tablet 10 mg
Piroksikam tablet 20 mg
Ranitidine 150 mg
Stesolit Rectal supp

Alkohol 70 %
Anisol solution
Asam Asetat Glasial
Aqua destilata
Asam Klorida 0.1 N
Asam klorida 0,1 N
Asam sulfosalisilat 20 %
Barium Klorida
Beker Glass
Blood Lancet
Erlemeyer
Etanol asam 3 %
Etanol 70 %
Fauchet
Imersen Oil HB
Kapas 1 KG
Kertas Saring Whatman
Kertas Perkamen
Larutan Bupper PH 7.2
Label Etiket
Larutan Metanol
Larutan Sulposalisilat
Larutan Benedict
Larutan Eosin 2 %
Larutan Etanol Asam
Larutan Giemsa Stalin
Larutan Karbol Fuksin
Larutan Metilen Biru
Larutan Turk
Lisol
Metanol
Natrium Sitrat 38 %
Objek Glass
Plastik Obat
Pipet Tetes Biasa
Rees echer
Rak Pewarna kaca pipet
Schlesinger
Spiritus 100 ml
Tes Gol. Darah( A,B,AB)
Tes Kehamilan HCG
Tabung Reaksi
Tissue lensa
Alat suntik 3 cc
ACT
Artesunate
Ambroxol tab
Clindamicin
Cetrizin
Hemafort
Oxytocin inj
Pembalut gip
Salbutamol 4 mg
Antasida syrup
Lysmin sirup
Lytamin syrup
Mecobion tab
Bioplasenton jelly
Dolodon 500 mg
Metformin
Meloxicam 7,5 mg
Bisturi 10,11,20,22
Jarum jahit 10,11,12,13,14
Duo Care Gluko le st
Stick Gula darah
Hand scun
Cyproploxacin 250 mg
Asam Folat
Omeprazole
Zink Tab
Doxycicklin 100mg
Amlodipin 5 mg
Dexanta Tab
Viliron tab
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Maret
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 200 200
3 Alat Suntik 2.5 ml Set 57 53 15 0 125
4 Albendazol 400 mg Set 39 540 579
5 Alupurinol 100 mg Tab 126 123 10 600 859
6 Aminophylin 200 mg Tab 163 220 90 66 200 739
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 230 100 330
9 Amoksisillin sirup kering 125 mg/5 ml Btl 27 28 58 5 225 343
10 Amoksisillin kapsul 250 mg Kap 320 54 213 180 0 767
11 Amoksisillin kaplet 500 mg Kap 799 60 589 15 3600 5063
12 Ampicillin kaplet 500 mg Kap 182 165 100 447
13 Ampicillin sirup kering 125 mg/5 ml Btl 18 25 19 4 0 66
14 Antalgin tablet 500 mg Tab 539 180 68 11200 11987
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 1824 227 671 0 2722
17 Antibakteri DOEN salep kombinasi Pot 16 2 86 104
18 Antihemoroid DOEN kombinasi Pot 17 40 57
19 Antifungi DOEN kombinasi Pot 8 2 25 1 0 36
20 Antimigrain DOEN kombinasi Tab 66 0 66
21 Aqua proinjeksi bebas pirogen Amp 0 0
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1101 2324 461 15000 18886
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 190 300 490
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 49 2 2 0 53
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 519 241 3900 4660
35 Captopril 25 mg tablet Tab 505 245 48 22 0 820
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 0 0
37 Deksametason tablet 0,5 mg Tab 454 526 1048 199 1500 3727
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 16 3 7 3 276 305
39 Dekstromethorpan HBr tablet 15 mg Tab 110 50 241 3900 4301
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 48
42 Diazepam 2 mg Tab 501 0 501
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 25 10 0 35
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 1167 120 0 1287


47 Ekstrak belladon tablet 10 mg Tab 409 156 80 500 1145
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 1 1 1 3
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 2 2
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 160 0 160
55 Fenitoin natrium kapsul 30 mg Kap 215 0 215
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 742 0 742
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 9 1 32 42
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 13 0 13
63 Fitomenadion (vit K) tablet salut 10 mg Tab 120 30 144 20 900 1214
64 Furosemid tablet 40 mg Tab 170 0 170
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 35 241 26 600 902
67 Gentian violet larutan 1 % Btl 13 1 6 48 68
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 260 1000 1260
70 Gliseril guayakolat tablet 100 mg Tab 1212 2375 2088 1419 15000 22094
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 130 12 421 23 0 586
74 Halloperidol tablet 0,5 mg Tab 0 0
75 Halloperidol tablet 1,5 mg Tab 0 0
76 Halloperidol tablet 5 mg Tab 148 100 248
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 1049 200 777 0 2026
78 Hidrokortison krim 2,5 % Pot 34 3 0 37
79 Ibuprofen tablet 200 mg Tab 500 274 107 6300 7181
80 Ibuprofen tablet 400 mg Tab 111 900 1011
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 145 1000 1145
84 I N H tablet 300 mg Tab 800 0 800
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 90 0 90
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 976 428 813 1232 2000 5449
89 Kapas pembalut / Absorben 250 gram Rol 1 21 22
90 Karbamazepin tablet 200 mg Tab 110 400 510
91 Kasa kompres 40/40 steril Rol 0 0
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 3 7 1 46 57
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 84 0 84
95 Kloramfenikol salep mata 1 % Pot 27 4 0 31
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 7 96 103


97 Klorfeniramine maleat tablet 4 mg Tab 730 2157 2462 531 3000 8880
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 394 0 394
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 243 22 47 500 812
107 Kotrimoksazol suspensi Btl 35 2 17 2 50 106
108 Kotrimoksazol dewasa tablet Tab 511 289 132 10 2400 3342
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 1 8 0 9
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 110 200 310
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 100 43 108 51 0 302
118 Metronidazol tablet 500 mg Tab 25 1300 1325
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 837 0 837
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 50 0 50
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 95 100 195
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 17 2 17 1 85 122
131 Oksitetrasiklin hcl inj. Amp 0 0
132 Oksitetrasiklin hcl salep kulit 3 % Pot 47 5 2 2 75 131
133 Oksitetrasiklin hcl salep mata 1 % Pot 20 4 3 25 52
134 Papaverin tablet Tab 1077 40 0 1117
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 31 1 4 125 161
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 697 3069 437 43 1000 5246
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 80 16 18 10 0 124
141 Piridoxin hcl tablet 10 mg Tab 1229 1491 932 504 9000 13156
142 Pyrazinamid tablet Tab 33 800 833
143 Plester 5 yard x 2 inch Rol 1 7 8
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 1022 1103 813 148 4000 7086
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 118 200 318
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 326 0 326
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 1020 1000 2020
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 181 100 281
157 Rifampisin kapsul 450 mg Kap 73 200 273
158 Rifampisin kapsul 300 mg Kap 100 100 200
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 4 20 16 50 100 190
161 Salep 2-4 Pot 4 0 4
162 Salisil bedak 2 % Sak 5 3 2 0 10
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 0 0
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 190 0 190
169 Sianokobalamin inj. 500 mcg/ml Amp 10 80 65 0 155
170 Silk (benang bedah sutera) no. 3/0 Rol 4 4
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 20 0 20
176 Tablet tambah darah kombinasi Tab 884 190 150 458 2450 4132
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 935 822 0 1757
179 Tetrasiklin HCl kapsul 500 mg Kap 140 20 600 760
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 0 0
181 Tiamin HCl mononitrat tablet 50 mg Tab 811 1095 12000 13906
182 Triheksilfenidil HCl tablet 2 mg Tab 85 0 85
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 930 1128 1528 976 3000 7562
186 Yodium povidon larutan 10 % - 30 ml Btl 8 8
187 Yodium povidon larutan 10 % - 300 ml Btl 1 6 7

1 Acyclovir tablet 200 mg Tab 185 100 145 200 630


2 Acyclovir cream Tube 25 6 9 0 40
3 Acyclovir tablet 400 mg Tab 210 15 148 0 373
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 73 50 1800 1923
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 22 192 214


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 170 500 670
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 157 600 757
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 116 300 416
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 14 50 64
20 Gentamycin tetes mata Btl 1 0 1
21 H2O2 Btl 1 0 1
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 50 50
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 32 24 56
27 Methyl Prednisolon tab 4 mg Tab 0 0
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 144 0 144
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 0 0
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 85 46 0 131
38 Piroksikam tablet 20 mg Tab 0 0
39 Ranitidine 150 mg Tab 200 200
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 1 1 11 13
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 2 200 202
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 3 1 4
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 18000 18000
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 290 500 790
48 Clindamicin caps 0 0
49 Cetrizin tab 65 300 365
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 67 0 67
54 Antasida syrup pcs 24 10 34
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 9 67 76
57 Mecobion tab Tab 66 0 66
58 Bioplasenton jelly Tab 3 0 3
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 175 600 775
61 Meloxicam 7,5 mg Tab 220 0 220
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 150 150
66 Hand scun Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1880 0 1880
69 Omeprazole Caps 68 20 90 178
70 Zink Tab Tab 170 2900 3070
71 Doxycicklin 100mg Tab 100 300 400
72 Amlodipin 5 mg Caps 90 90 180
73 Dexanta Tab Tab 237 3500 3737
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Februari
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 240 240
3 Alat Suntik 2.5 ml Set 8 47 70 0 125
4 Albendazol 400 mg Set 49 540 589
5 Alupurinol 100 mg Tab 51 186 40 700 977
6 Aminophylin 200 mg Tab 166 413 146 90 300 1115
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 185 300 485
9 Amoksisillin sirup kering 125 mg/5 ml Btl 19 45 15 62 375 516
10 Amoksisillin kapsul 250 mg Kap 360 249 380 368 1080 2437
11 Amoksisillin kaplet 500 mg Kap 1369 249 200 816 6300 8934
12 Ampicillin kaplet 500 mg Kap 184 275 40 100 599
13 Ampicillin sirup kering 125 mg/5 ml Btl 6 41 11 22 15 95
14 Antalgin tablet 500 mg Tab 462 85 225 240 12500 13512
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 270 2704 1146 490 900 5510
17 Antibakteri DOEN salep kombinasi Pot 16 3 86 105
18 Antihemoroid DOEN kombinasi Pot 23 40 63
19 Antifungi DOEN kombinasi Pot 9 5 3 28 0 45
20 Antimigrain DOEN kombinasi Tab 91 0 91
21 Aqua proinjeksi bebas pirogen Amp 2 0 2
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1729 681 2610 17000 22020
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 200 300 500
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 23 11 2 6 50 92
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 459 321 4300 5080
35 Captopril 25 mg tablet Tab 1070 320 73 163 900 2526
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 0 0
37 Deksametason tablet 0,5 mg Tab 366 1421 546 1251 3300 6884
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 18 11 11 17 296 353
39 Dekstromethorpan HBr tablet 15 mg Tab 97 405 170 4000 4672
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 48
42 Diazepam 2 mg Tab 898 0 898
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 40 14 10 0 64
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 1167 125 58 0 1350


47 Ekstrak belladon tablet 10 mg Tab 659 120 500 1279
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 1 1 1 3
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 4 4
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 160 0 160
55 Fenitoin natrium kapsul 30 mg Kap 235 0 235
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 775 0 775
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 19 4 32 55
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 16 0 16
63 Fitomenadion (vit K) tablet salut 10 mg Tab 129 60 20 164 1000 1373
64 Furosemid tablet 40 mg Tab 180 0 180
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 145 70 53 316 1000 1584
67 Gentian violet larutan 1 % Btl 9 4 2 6 60 81
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 120 1300 1420
70 Gliseril guayakolat tablet 100 mg Tab 2126 3668 1861 2294 17000 26949
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 160 47 43 421 0 671
74 Halloperidol tablet 0,5 mg Tab 60 0 60
75 Halloperidol tablet 1,5 mg Tab 83 0 83
76 Halloperidol tablet 5 mg Tab 38 300 338
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 85 205 777 1000 2067
78 Hidrokortison krim 2,5 % Pot 31 5 10 1 48 95
79 Ibuprofen tablet 200 mg Tab 506 501 190 224 7000 8421
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 401 1000 1401
84 I N H tablet 300 mg Tab 801 0 801
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 130 0 130
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 640 1126 1512 1019 3000 7297
89 Kapas pembalut / Absorben 250 gram Rol 2 1 22 25
90 Karbamazepin tablet 200 mg Tab 150 400 550
91 Kasa kompres 40/40 steril Rol 0 0
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 5 3 7 46 61
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 84 0 84
95 Kloramfenikol salep mata 1 % Pot 6 2 38 46
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 20 96 116


97 Klorfeniramine maleat tablet 4 mg Tab 1751 4292 1748 2826 7000 17617
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 654 0 654
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 253 187 117 500 1057
107 Kotrimoksazol suspensi Btl 28 21 8 24 150 231
108 Kotrimoksazol dewasa tablet Tab 426 434 170 215 2900 4145
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 3 8 7 30 48
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 110 200 310
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 160 88 121 138 0 507
118 Metronidazol tablet 500 mg Tab 25 1300 1325
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 705 837 0 1542
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 50 0 50
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 100 100 200
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 24 24 10 22 100 180
131 Oksitetrasiklin hcl inj. Amp 0 0
132 Oksitetrasiklin hcl salep kulit 3 % Pot 43 14 4 8 100 169
133 Oksitetrasiklin hcl salep mata 1 % Pot 9 6 6 45 66
134 Papaverin tablet Tab 142 50 30 0 222
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 34 17 11 11 225 298
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 618 1919 1114 1450 10400 15501
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 6 18 10 20 100 154
141 Piridoxin hcl tablet 10 mg Tab 1163 2380 714 1249 10000 15506
142 Pyrazinamid tablet Tab 90 800 890
143 Plester 5 yard x 2 inch Rol 0,5 1 1 7 9
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 924 1992 564 1228 5000 9708
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 106 600 706
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 380 200 770
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 155 2000 2155
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 191 100 291
157 Rifampisin kapsul 450 mg Kap 137 200 337
158 Rifampisin kapsul 300 mg Kap 113 100 213
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 36 30 80 26 100 272
161 Salep 2-4 Pot 2 2 6 0 10
162 Salisil bedak 2 % Sak 2 7 2 3 40 54
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 1 1
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 60 200 260
169 Sianokobalamin inj. 500 mcg/ml Amp 30 83 86 0 199
170 Silk (benang bedah sutera) no. 3/0 Rol 1 4 5
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 23 0 23
176 Tablet tambah darah kombinasi Tab 801 821 688 525 3300 6135
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 626 70 880 1000 2576
179 Tetrasiklin HCl kapsul 500 mg Kap 170 60 600 830
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 0 0
181 Tiamin HCl mononitrat tablet 50 mg Tab 1677 665 1475 12000 15817
182 Triheksilfenidil HCl tablet 2 mg Tab 170 200 370
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 2009 2088 1493 1839 6000 13429
186 Yodium povidon larutan 10 % - 30 ml Btl 8 8
187 Yodium povidon larutan 10 % - 300 ml Btl 1 6 7

1 Acyclovir tablet 200 mg Tab 120 170 165 300 755


2 Acyclovir cream Tube 21 10 17 25 73
3 Acyclovir tablet 400 mg Tab 265 50 148 0 463
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 153 90 2100 2343
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 29 217 246


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 110 700 810
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 158 700 858
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 116 300 416
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 17 60 77
20 Gentamycin tetes mata Btl 15 0 15
21 H2O2 Btl 1 1 2
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 50 50
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 20 48 68
27 Methyl Prednisolon tab 4 mg Tab 0 0
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 164 0 164
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 1000 1000
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 330 120 66 0 516
38 Piroksikam tablet 20 mg Tab 0 0
39 Ranitidine 150 mg Tab 166 400 566
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 2 1 1 12 16
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 4 3 6 200 213
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 3 1 4
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 50 23000 23050
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 185 1100 1285
48 Clindamicin caps 0 0
49 Cetrizin tab 90 300 390
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 97 0 97
54 Antasida syrup pcs 25 10 35
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 10 72 82
57 Mecobion tab Tab 120 100 220
58 Bioplasenton jelly Tab 3 0 3
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 85 1500 1585
61 Meloxicam 7,5 mg Tab 90 450 540
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 200 200
66 Hand scun Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1900 0 1900
69 Omeprazole Caps 73 40 90 203
70 Zink Tab Tab 245 3500 3745
71 Doxycicklin 100mg Tab 100 300 400
72 Amlodipin 5 mg Caps 30 240 270
73 Dexanta Tab Tab 130 4800 4930
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Januari
Tahun : 2013

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 265 265
3 Alat Suntik 2.5 ml Set 118 89 71 265 543
4 Albendazol 400 mg Set 57 540 597
5 Alupurinol 100 mg Tab 248 60 800 1108
6 Aminophylin 200 mg Tab 12 600 90 246 400 1348
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 105 500 605
9 Amoksisillin sirup kering 125 mg/5 ml Btl 63 70 25 550 708
10 Amoksisillin kapsul 250 mg Kap 470 481 452 590 2400 4393
11 Amoksisillin kaplet 500 mg Kap 806 462 546 390 11300 13504
12 Ampicillin kaplet 500 mg Kap 182 472 100 90 100 944
13 Ampicillin sirup kering 125 mg/5 ml Btl 3 60 23 19 35 140
14 Antalgin tablet 500 mg Tab 640 205 310 415 13500 15070
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 272 3596 818 1592 3000 9278
17 Antibakteri DOEN salep kombinasi Pot 15 3 5 90 113
18 Antihemoroid DOEN kombinasi Pot 6 3 60 69
19 Antifungi DOEN kombinasi Pot 5 8 8 5 33 59
20 Antimigrain DOEN kombinasi Tab 125 3 0 128
21 Aqua proinjeksi bebas pirogen Amp 0 0
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 1114 2941 887 21000 25942
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 200 300 500
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 43 20 10 7 50 130
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 229 400 4900 5529
35 Captopril 25 mg tablet Tab 475 410 281 131 1800 3097
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 0 0
37 Deksametason tablet 0,5 mg Tab 260 2314 3420 860 5000 11854
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 20 15 27 18 320 400
39 Dekstromethorpan HBr tablet 15 mg Tab 142 230 520 4200 5092
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 48 48
42 Diazepam 2 mg Tab 194 1000 1194
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 55 18 28 0 101
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 1172 130 87 0 1389


47 Ekstrak belladon tablet 10 mg Tab 659 47 180 500 1386
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 2 1 1 4
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 4 4
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 250 250
55 Fenitoin natrium kapsul 30 mg Kap 250 0 250
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 3 3
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 1235 0 1235
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 13 7 42 62
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 20 0 20
63 Fitomenadion (vit K) tablet salut 10 mg Tab 104 95 164 40 1100 1503
64 Furosemid tablet 40 mg Tab 80 100 180
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 160 95 77 1800 2132
67 Gentian violet larutan 1 % Btl 16 7 6 4 70 103
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 244 1300 1544
70 Gliseril guayakolat tablet 100 mg Tab 740 4979 2504 2351 22000 32574
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 115 77 202 83 400 877
74 Halloperidol tablet 0,5 mg Tab 120 300 420
75 Halloperidol tablet 1,5 mg Tab 128 0 128
76 Halloperidol tablet 5 mg Tab 68 300 368
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 145 210 777 4 1000 2136
78 Hidrokortison krim 2,5 % Pot 10 15 6 19 96 146
79 Ibuprofen tablet 200 mg Tab 380 733 267 350 8000 9730
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 800 1000 1800
84 I N H tablet 300 mg Tab 807 0 807
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 50 100 150
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 293 1839 1172 1737 4000 9041
89 Kapas pembalut / Absorben 250 gram Rol 3 1 1 23 28
90 Karbamazepin tablet 200 mg Tab 180 400 580
91 Kasa kompres 40/40 steril Rol 10 10
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 7 8 5 56 76
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 104 53 0 157
95 Kloramfenikol salep mata 1 % Pot 8 5 38 51
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 19 5 4 120 148


97 Klorfeniramine maleat tablet 4 mg Tab 977 6474 2415 3040 14000 26906
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 833 0 833
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 271 350 182 500 1303
107 Kotrimoksazol suspensi Btl 73 39 28 18 200 358
108 Kotrimoksazol dewasa tablet Tab 314 577 235 368 3500 4994
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 30 30
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 60 60
111 Lidokain Kompositum injeksi Amp 4 7 10 60 81
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 50 300 350
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 300 128 138 181 0 747
118 Metronidazol tablet 500 mg Tab 50 1300 1350
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 705 837 0 1542
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 153 0 153
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 80 200 280
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 19 44 20 17 138 238
131 Oksitetrasiklin hcl inj. Amp 1 0 1
132 Oksitetrasiklin hcl salep kulit 3 % Pot 43 23 24 8 125 223
133 Oksitetrasiklin hcl salep mata 1 % Pot 27 7 10 45 89
134 Papaverin tablet Tab 0 0
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 50 36 38 19 350 493
137 Parasetamol tablet 100 mg Tab 0 0
138 Parasetamol tablet 500 mg Tab 492 6908 2225 2279 10400 22304
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 48 18 23 10 100 199
141 Piridoxin hcl tablet 10 mg Tab 887 3272 1460 882 11000 17501
142 Pyrazinamid tablet Tab 152 800 952
143 Plester 5 yard x 2 inch Rol 1 1 1 7 10
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 1196 2865 566 944 7000 12571
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 10 1000 1010
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 160 600 770
152 Reserpin tablet 0,10 mg Tab 223 0 223
153 Reserpin tablet 0,25 mg Tab 355 2000 2355
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 191 100 291
157 Rifampisin kapsul 450 mg Kap 56 300 356
158 Rifampisin kapsul 300 mg Kap 181 200 381
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 96 45 46 100 100 387
161 Salep 2-4 Pot 3 4 4 2 8 21
162 Salisil bedak 2 % Sak 11 11 6 6 48 82
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 2 2
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 60 200 260
169 Sianokobalamin inj. 500 mcg/ml Amp 50 95 163 100 408
170 Silk (benang bedah sutera) no. 3/0 Rol 1 7 8
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 3 0 3
176 Tablet tambah darah kombinasi Tab 304 1413 855 878 4500 7950
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 666 100 880 1000 2646
179 Tetrasiklin HCl kapsul 500 mg Kap 180 100 600 880
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 0 0
181 Tiamin HCl mononitrat tablet 50 mg Tab 536 2073 89 1895 14000 18593
182 Triheksilfenidil HCl tablet 2 mg Tab 163 400 563
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 809 3042 2136 1985 11000 18972
186 Yodium povidon larutan 10 % - 30 ml Btl 31-Dec 8 9
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 8 10

1 Acyclovir tablet 200 mg Tab 170 200 185 300 855


2 Acyclovir cream Tube 8 13 18 65 104
3 Acyclovir tablet 400 mg Tab 105 85 148 300 638
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 53 120 80 2500 2753
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 9 280 289


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 190 700 890
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 82 900 982
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 116 300 416
16 Erytromycin Syr Btl 0 0
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 6 90 96
20 Gentamycin tetes mata Btl 28 0 28
21 H2O2 Btl 1 1 2
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 50 50
25 Metoklorpropamide Hcl 10 mg Tab 300 300
26 Mikonazole cream Pot 13 72 85
27 Methyl Prednisolon tab 4 mg Tab 0 0
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 64 100 164
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 202 70 80 1000 1352
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 315 150 92 600 1157
38 Piroksikam tablet 20 mg Tab 0 0
39 Ranitidine 150 mg Tab 308 500 808
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 2 1 1 15 19
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 7 10 4 200 221
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 1 2
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 300 100 200 28000 28600
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 0 0
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 195 1900 2095
48 Clindamicin caps 0 0
49 Cetrizin tab 60 330 390
50 Hemafort tab 0 0
51 Oxytocin inj amp 0 0
52 Pembalut gip bks 0 0
53 Salbutamol 4 mg tab 98 0 98
54 Antasida syrup pcs 21 20 41
55 Lysmin sirup lbr 0 0
56 Lytamin syrup Btl 21 72 93
57 Mecobion tab Tab 90 300 390
58 Bioplasenton jelly Tab 4 0 4
59 Dolodon 500 mg Tab 0 0
60 Metformin Tab 145 2000 2145
61 Meloxicam 7,5 mg Tab 40 500 540
62 Bisturi 10,11,20,22 Tab 0 0
63 Jarum jahit 10,11,12,13,14 Tab 9 9
64 Duo Care Gluko le st pcs 0 0
65 Stick Gula darah pcs 200 200
66 Hand scun Pcs 100 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Cyproploxacin 250 mg Tbng 0 0


68 Asam Folat set 1975 0 1975
69 Omeprazole Caps 73 50 90 213
70 Zink Tab Tab 330 3900 4230
71 Doxycicklin 100mg Tab 100 300 400
72 Amlodipin 5 mg Caps 70 240 310
73 Dexanta Tab Tab 140 4800 4940
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Desember
Tahun : 2012

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 100 100
3 Alat Suntik 2.5 ml Set 48 0 48
4 Albendazol 400 mg Set 60 240 300
5 Alupurinol 100 mg Tab 117 100 90 500 807
6 Aminophylin 200 mg Tab 68 183 90 66 400 807
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 125 200 325
9 Amoksisillin sirup kering 125 mg/5 ml Btl 43 29 76 4 100 252
10 Amoksisillin kapsul 250 mg Kap 10 98 182 170 2760 3220
11 Amoksisillin kaplet 500 mg Kap 670 55 206 7500 8431
12 Ampicillin kaplet 500 mg Kap 182 157 20 600 959
13 Ampicillin sirup kering 125 mg/5 ml Btl 17 16 27 3 60 123
14 Antalgin tablet 500 mg Tab 527 313 140 140 10700 11820
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 586 1475 548 1155 7500 11264
17 Antibakteri DOEN salep kombinasi Pot 16 5 2 95 118
18 Antihemoroid DOEN kombinasi Pot 17 7 30 54
19 Antifungi DOEN kombinasi Pot 9 1 8 2 48 68
20 Antimigrain DOEN kombinasi Tab 144 100 244
21 Aqua proinjeksi bebas pirogen Amp 5 0 5
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 658 440 2525 1153 20000 24776
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 200 300 500
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 22 4 12 3 25 66
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 214 85 5900 6199
35 Captopril 25 mg tablet Tab 205 93 223 3700 4221
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 0 0
37 Deksametason tablet 0,5 mg Tab 440 1203 545 733 4000 6921
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 24 29 6 280 339
39 Dekstromethorpan HBr tablet 15 mg Tab 322 350 645 3200 4517
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 50 50
42 Diazepam 2 mg Tab 426 1000 1426
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 41 14 90 145
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 1167 135 152 0 1454


47 Ekstrak belladon tablet 10 mg Tab 925 47 500 1472
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 1 1 1 4 7
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 1 1
53 Eugenol cairan Btl 0 0
54 Fenitoin natrium kapsul 100 mg Kap 155 250 405
55 Fenitoin natrium kapsul 30 mg Kap 0 0
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 6 6
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 432 1000 1432
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 23 4 0 27
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 23 180 203
63 Fitomenadion (vit K) tablet salut 10 mg Tab 132 30 164 50 1300 1676
64 Furosemid tablet 40 mg Tab 0 0
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 55 15 7 600 677
67 Gentian violet larutan 1 % Btl 5 4 7 1 65 82
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 294 1300 1594
70 Gliseril guayakolat tablet 100 mg Tab 1319 3277 3225 1886 10000 19707
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 115 5 202 13 300 635
74 Halloperidol tablet 0,5 mg Tab 600 600
75 Halloperidol tablet 1,5 mg Tab 268 0 268
76 Halloperidol tablet 5 mg Tab 98 300 398
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 160 215 787 16 1000 2178
78 Hidrokortison krim 2,5 % Pot 17 9 4 72 102
79 Ibuprofen tablet 200 mg Tab 551 358 339 30 9800 11078
80 Ibuprofen tablet 400 mg Tab 60 900 960
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 800 3000 3800
84 I N H tablet 300 mg Tab 922 0 922
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 80 100 180
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 1004 517 324 997 2000 4842
89 Kapas pembalut / Absorben 250 gram Rol 1 18 19
90 Karbamazepin tablet 200 mg Tab 0 0
91 Kasa kompres 40/40 steril Rol 0 0
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 3 9 2 79 93
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 128 108 0 236
95 Kloramfenikol salep mata 1 % Pot 7 5 2 0 14
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 20 24 44


97 Klorfeniramine maleat tablet 4 mg Tab 637 2597 2981 412 10000 16627
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 1006 0 1006
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 288 5 54 1200 1547
107 Kotrimoksazol suspensi Btl 47 5 11 3 150 216
108 Kotrimoksazol dewasa tablet Tab 460 209 150 34 2000 2853
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 4 7 10 120 141
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 60 300 360
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 260 83 138 63 400 944
118 Metronidazol tablet 500 mg Tab 160 1300 1460
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 735 837 0 1572
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 16 200 216
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 200 200
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 20 2 12 2 140 176
131 Oksitetrasiklin hcl inj. Amp 2 2
132 Oksitetrasiklin hcl salep kulit 3 % Pot 33 6 10 1 75 125
133 Oksitetrasiklin hcl salep mata 1 % Pot 22 4 3 35 64
134 Papaverin tablet Tab 507 0 507
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 17 3 15 2 350 387
137 Parasetamol tablet 100 mg Tab 1000 1000
138 Parasetamol tablet 500 mg Tab 1511 2887 2452 575 0 7425
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 48 20 25 12 100 205
141 Piridoxin hcl tablet 10 mg Tab 771 1111 1836 1070 9000 13788
142 Pyrazinamid tablet Tab 0 0
143 Plester 5 yard x 2 inch Rol 1 1 1 4 7
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 394 698 640 417 6000 8149
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 209 100 309
150 Propanolol hcl tablet 40 mg Tab 0 0
151 Propanolol hcl tablet 10 mg Tab 130 400 770
152 Reserpin tablet 0,10 mg Tab 223 0 223
153 Reserpin tablet 0,25 mg Tab 484 1000 1484
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 24 100 124
157 Rifampisin kapsul 450 mg Kap 141 0 141
158 Rifampisin kapsul 300 mg Kap 181 200 381
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 156 60 56 40 200 512
161 Salep 2-4 Pot 9 4 4 1 14 32
162 Salisil bedak 2 % Sak 7 4 5 50 66
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 2 2
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 90 200 290
169 Sianokobalamin inj. 500 mcg/ml Amp 70 32 250 352
170 Silk (benang bedah sutera) no. 3/0 Rol 1 8 9
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 20 2 24 46
176 Tablet tambah darah kombinasi Tab 625 198 6000 6823
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 666 150 880 1000 2696
179 Tetrasiklin HCl kapsul 500 mg Kap 190 35 700 925
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 0 0
181 Tiamin HCl mononitrat tablet 50 mg Tab 722 260 385 10000 11367
182 Triheksilfenidil HCl tablet 2 mg Tab 177 0 177
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 749 980 1496 500 6000 9725
186 Yodium povidon larutan 10 % - 30 ml Btl 31-Dec 1 2
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 2

1 Acyclovir tablet 200 mg Tab 180 100 185 400 865


2 Acyclovir cream Tube 30 5 18 75 128
3 Acyclovir tablet 400 mg Tab 190 15 148 400 753
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 48 55 64 1900 2067
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 10 220 230


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 60 600 660
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 100 900 1000
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 150 300 450
16 Erytromycin Syr Btl 22 20 42
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 12 70 82
20 Gentamycin tetes mata Btl 10 30 40
21 H2O2 Btl 1 1 2
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 0 0
25 Metoklorpropamide Hcl 10 mg Tab 74 0 74
26 Mikonazole cream Pot 21 72 93
27 Methyl Prednisolon tab 4 mg Tab 0 0
28 Nipedipin tablet Tab 107 0 107
29 Natrium Diklofenak 50 mg Tab 200 200
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 1000 1000
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 336 50 110 0 496
38 Piroksikam tablet 20 mg Tab 0 0
39 Ranitidine 150 mg Tab 258 300 558
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 1 1 0 2
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 300 300
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 2 3
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 12000 12000
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 1 0 1
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 148 1500 1648
48 Basitrasin SK caps 0 0
49 Clindamicin tab 0 0
50 Cetrizin tab 30 390 420
51 Hemafort amp 0 0
52 Oxytocin inj bks 0 0
53 Pembalut gip tab 0 0
54 Salbutamol 4 mg pcs 98 0 98
55 Kantong plastik lbr 0 0
56 Antasida syrup Btl 28 20 48
57 Lysmin sirup Tab 0 0
58 Lytamin syrup Tab 0 0
59 Mecobion tab Tab 210 300 510
60 Bismecon jelly Tab 6 0 6
61 Dolodon 500 mg Tab 0 0
62 Metformin Tab 160 1200 1360
63 Meloxicam 7,5 mg Tab 40 0 40
64 Bisturi 10,11,20,22 pcs 0 0
65 Jarum jahit 10,11,12,13,14 pcs 9 9
66 Duo Care Gluko le st Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Stick Gula darah Tbng 0 0


68 Hand scun set 100 100
69 Cyproploxacin 250 mg Caps 0 0
70 Asam Folat Tab 0 0
71 Omeprazole Tab 73 30 120 223
72 Docyciklin tab Caps 100 300 400
73 Zink Tab Tab 105 2800 2905
74 Amlodipine Tab 10 360 370
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : November
Tahun : 2012

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 113 113
3 Alat Suntik 2.5 ml Set 80 36 16 45 177
4 Albendazol 400 mg Set 58 240 298
5 Alupurinol 100 mg Tab 107 181 100 600 988
6 Aminophylin 200 mg Tab 175 457 100 152 400 1284
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0
8 Amitriptilin HCl tablet 25 mg Tab 265 200 465
9 Amoksisillin sirup kering 125 mg/5 ml Btl 24 47 80 14 300 465
10 Amoksisillin kapsul 250 mg Kap 115 294 272 360 3960 5001
11 Amoksisillin kaplet 500 mg Kap 1328 290 351 160 10500 12629
12 Ampicillin kaplet 500 mg Kap 182 342 44 185 600 1353
13 Ampicillin sirup kering 125 mg/5 ml Btl 14 33 30 9 66 152
14 Antalgin tablet 500 mg Tab 340 470 170 315 12000 13295
15 Antalgin injeksi Amp 0 0
16 Antasida DOEN tablet kombinasi Tab 125 2369 719 1781 10000 14994
17 Antibakteri DOEN salep kombinasi Pot 16 6 3 95 120
18 Antihemoroid DOEN kombinasi Pot 28 9 30 67
19 Antifungi DOEN kombinasi Pot 5 3 8 3 55 74
20 Antimigrain DOEN kombinasi Tab 145 100 245
21 Aqua proinjeksi bebas pirogen Amp 7 2 9
22 Aquadest steril Amp 0 0
23 Asam askorbat (vit C) 50 mg Tab 803 1175 2965 1390 23000 29333
24 Asam askorbat (vit C)250 mg Tab 0 0
25 Asetosal tablet 100 mg Tab 200 300 500
26 Asetosal tablet 500 mg Tab 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0
31 Besi sirup Btl 0 0
32 Betametason krim 0,1 % Tube 16 13 14 11 50 104
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0
34 Captopril 12.5 mg tablet Tab 500 130 5900 6530
35 Captopril 25 mg tablet Tab 215 158 335 44 4300 5052
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 0 0
37 Deksametason tablet 0,5 mg Tab 519 2099 790 1098 5200 9706
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 24 15 35 11 300 385
39 Dekstromethorpan HBr tablet 15 mg Tab 239 400 750 3400 4789
40 Devitalisasi pasta Btl 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 50 50
42 Diazepam 2 mg Tab 575 1000 1575
43 Diazepam 5 mg Tab 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 58 30 90 178
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 1167 140 174 0 1481


47 Ekstrak belladon tablet 10 mg Tab 935 56 500 1491
48 Epinephrin HCl injeksi Amp 49 49
49 Etakridin (rivanol) larutan 0,1 Btl 2 1 1 6 10
50 Etambutol HCl 250 mg tablet Tab 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 3 3
53 Eugenol cairan Btl 2 2
54 Fenitoin natrium kapsul 100 mg Kap 240 250 490
55 Fenitoin natrium kapsul 30 mg Kap 0 0
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 6 6
57 Fenobarbital tablet 100 mg Tab 0 0
58 Fenobarbital tablet 30 mg Tab 550 1000 1550
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0
61 Fenol gliserol tetes telinga 10 % Btl 25 2 0 27
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 26 180 206
63 Fitomenadion (vit K) tablet salut 10 mg Tab 202 75 164 70 1300 1811
64 Furosemid tablet 40 mg Tab 200 200
65 Gameksan emulsi 1 % Btl 0 0
66 Garam oralit 200 ml air Sak 240 75 28 800 1143
67 Gentian violet larutan 1 % Btl 6 7 8 4 96 121
68 Glass ionomer semen (gc ix) Btl 0 0
69 Glibenklamid tablet 5 mg Tab 334 1300 1634
70 Gliseril guayakolat tablet 100 mg Tab 577 4612 3567 2448 15000 26204
71 Gliserin Btl 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0
73 Griseofulvin 125 mg micronized Tab 165 52 202 38 300 757
74 Halloperidol tablet 0,5 mg Tab 600 600
75 Halloperidol tablet 1,5 mg Tab 128 300 428
76 Halloperidol tablet 5 mg Tab 128 300 428
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 165 220 787 34 1000 2206
78 Hidrokortison krim 2,5 % Pot 11 8 10 11 120 160
79 Ibuprofen tablet 200 mg Tab 543 588 357 192 10800 12480
80 Ibuprofen tablet 400 mg Tab 100 900 1000
81 Infusion set anak Set 0 0
82 Infusion set dewasa Set 0 0
83 I N H tablet 100 mg Tab 820 3000 3820
84 I N H tablet 300 mg Tab 1027 0 1027
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 90 100 190
86 Kalium permanganat serbuk Btl 0 0
87 Kalsium hidroksida pasta Tab 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 573 1210 484 1289 3000 6556
89 Kapas pembalut / Absorben 250 gram Rol 1 19 20
90 Karbamazepin tablet 200 mg Tab 0 0
91 Kasa kompres 40/40 steril Rol 5 5
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 6 9 4 89 108
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0
94 Kloramfenikol 250 mg kapsul Kap 128 170 0 298
95 Kloramfenikol salep mata 1 % Pot 20 8 5 0 33
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 10 48 58


97 Klorfeniramine maleat tablet 4 mg Tab 1358 4722 3492 1822 15000 26394
98 Kloroquin pospat tablet 250 mg Tab 0 0
99 Klorpromazin hcl injeksi Amp 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 144 1000 1144
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0
104 Kodein hcl tablet 10 mg Tab 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0
106 Kotrimoksazol pediatrik tablet Tab 300 130 102 1200 1732
107 Kotrimoksazol suspensi Btl 11 20 14 10 250 305
108 Kotrimoksazol dewasa tablet Tab 370 401 150 232 3000 4153
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0
111 Lidokain Kompositum injeksi Amp 4 8 12 150 174
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0
114 Mebendazol Syrup Tab 0 0
115 Metilergometrin tablet salut Tab 100 300 400
116 Metilergometrin Inj. Amp 0 0
117 Metronidazol tablet 250 mg Tab 160 155 138 123 500 1076
118 Metronidazol tablet 500 mg Tab 148 1400 1548
119 Mummifying pasta Pot 0 0
120 Natrium bikarbonat tablet 500 mg Tab 765 837 0 1602
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 21 200 221
123 Nistatin 500.000 iu/g tablet salut Tab 0 0
124 Nifedipin tab Tab 100 300 400
125 Obat anti tuberkolusis katagori 1 Tab 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0
129 Obat anti tuberkolosis anak Tab 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 18 26 16 9 180 249
131 Oksitetrasiklin hcl inj. Amp 1 2 3
132 Oksitetrasiklin hcl salep kulit 3 % Pot 16 16 18 4 125 179
133 Oksitetrasiklin hcl salep mata 1 % Pot 23 5 6 35 69
134 Papaverin tablet Tab 587 20 0 607
135 Paraformaldehid tablet 1 gram Tab 0 0
136 Parasetamol sirup 120 mg/5ml Btl 41 23 28 7 400 499
137 Parasetamol tablet 100 mg Tab 1000 1000
138 Parasetamol tablet 500 mg Tab 1438 4854 3473 2002 10000 21767
139 Perfenazin tablet 4 mg Tab 0 0
140 Pirantel pamoat tablet 365 mg Tab 105 23 27 16 100 271
141 Piridoxin hcl tablet 10 mg Tab 722 2006 2222 1294 10000 16244
142 Pyrazinamid tablet Tab 46 0 46
143 Plester 5 yard x 2 inch Rol 1 1 1 4 7
144 Polikresulen Btl 4 4
145 Prazikuantel tablet 600 mg Tab 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 1378 1523 984 879 6000 10764
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 168 300 468
150 Propanolol hcl tablet 40 mg Tab 700 0
151 Propanolol hcl tablet 10 mg Tab 70 0 770
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 582 1000 1582
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 58 100 158
157 Rifampisin kapsul 450 mg Kap 214 0 214
158 Rifampisin kapsul 300 mg Kap 181 200 381
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 70 78 66 60 350 624
161 Salep 2-4 Pot 14 6 5 3 14 42
162 Salisil bedak 2 % Sak 5 7 8 2 70 92
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 3 3
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 40 300 340
169 Sianokobalamin inj. 500 mcg/ml Amp 85 52 250 387
170 Silk (benang bedah sutera) no. 3/0 Rol 1 8 9
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 0 0
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 17 6 38 61
176 Tablet tambah darah kombinasi Tab 710 300 60 384 6600 8054
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 725 200 880 1000 2805
179 Tetrasiklin HCl kapsul 500 mg Kap 160 60 800 1020
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 120 120
181 Tiamin HCl mononitrat tablet 50 mg Tab 1773 277 610 865 10000 13525
182 Triheksilfenidil HCl tablet 2 mg Tab 135 200 335
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 1405 1853 1748 1046 9000 15052
186 Yodium povidon larutan 10 % - 30 ml Btl 1-Jan 31-Dec 1 4
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 2

1 Acyclovir tablet 200 mg Tab 110 130 185 500 925


2 Acyclovir cream Tube 19 8 19 100 146
3 Acyclovir tablet 400 mg Tab 120 60 148 500 828
4 Andalan Injeksi Amp 0 0
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 149 80 134 2100 2463
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 7 268 275


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 160 600 760
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 1000 1000
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 100 400 500
16 Erytromycin Syr Btl 23 20 43
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 7 80 87
20 Gentamycin tetes mata Btl 12 30 42
21 H2O2 Btl 1 1 2
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 0 0
24 Kloramphenicol tetes mata Btl 0 0
25 Metoklorpropamide Hcl 10 mg Tab 136 0 136
26 Mikonazole cream Pot 6 96 102
27 Methyl Prednisolon tab 4 mg Tab 0 0
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 20 200 220
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 1000 1000
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 152 70 120 480 822
38 Piroksikam tablet 20 mg Tab 0 0
39 Ranitidine 150 mg Tab 54 700 754
40 Stesolit Rectal supp Tube 0 0

1 Alkohol 70 % Btl 1 1 1 0 3
2 Anisol solution Btl 0 0
3 Asam Asetat Glasial Btl 0 0
4 Aqua destilata Btl 0 0
5 Asam Klorida 0.1 N Btl 0 0
6 Asam klorida 0,1 N Btl 0 0
7 Asam sulfosalisilat 20 % Btl 0 0
8 Barium Klorida Btl 0 0
9 Beker Glass Ktk 0 0
10 Blood Lancet Btl 0 0
11 Erlemeyer Btl 0 0
12 Etanol asam 3 % Btl 0 0
13 Etanol 70 % Btl 0 0
14 Fauchet Btl 0 0
15 Imersen Oil HB Rol 0 0
16 Kapas 1 KG Rol 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

17 Kertas Saring Whatman lbr 0 0


18 Kertas Perkamen Btl 400 400
19 Larutan Bupper PH 7.2 Set 0 0
20 Label Etiket Btl 0 0
21 Larutan Metanol Btl 0 0
22 Larutan Sulposalisilat Btl 0 0
23 Larutan Benedict Btl 0 0
24 Larutan Eosin 2 % Btl 0 0
25 Larutan Etanol Asam Btl 0 0
26 Larutan Giemsa Stalin Btl 0 0
27 Larutan Karbol Fuksin Btl 0 0
28 Larutan Metilen Biru Btl 0 0
29 Larutan Turk Btl 0 0
30 Lisol Btl 1 2 3
31 Metanol Btl 0 0
32 Natrium Sitrat 38 % Ktk 0 0
33 Objek Glass Set 0 0
34 Plastik Obat Ktk 150 85 18000 18235
35 Pipet Tetes Biasa Btl 0 0
36 Rees echer Ktk 0 0
37 Rak Pewarna kaca pipet Btl 0 0
38 Schlesinger Btl 0 0
39 Spiritus 100 ml Ktk 0 0
40 Tes Gol. Darah( A,B,AB) Ktk 0 0
41 Tes Kehamilan HCG Set 1 2 0 3
42 Tabung Reaksi Set 0 0
43 Tissue lensa pcs 0 0
44 Alat suntik 3 cc ktk 0 0
45 ACT amp 0 0
46 Artesunate tab 0 0
47 Ambroxol tab tube 160 2000 2160
48 Basitrasin SK caps 0 0
49 Clindamicin tab 0 0
50 Cetrizin tab 60 390 450
51 Hemafort amp 0 0
52 Oxytocin inj bks 0 0
53 Pembalut gip tab 0 0
54 Salbutamol 4 mg pcs 101 0 101
55 Kantong plastik lbr 0 0
56 Antasida syrup Btl 17 35 52
57 Lysmin sirup Tab 0 0
58 Lytamin syrup Tab 0 0
59 Mecobion tab Tab 180 500 680
60 Bismecon jelly Tab 7 0 7
61 Dolodon 500 mg Tab 0 0
62 Metformin Tab 170 1800 1970
63 Meloxicam 7,5 mg Tab 40 0 40
64 Bisturi 10,11,20,22 pcs 0 0
65 Jarum jahit 10,11,12,13,14 pcs 9 9
66 Duo Care Gluko le st Pcs 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

67 Stick Gula darah Tbng 0 0


68 Hand scun set 200 200
69 Cyproploxacin 250 mg Caps 0 0
70 Asam Folat Tab 0 0
71 Omeprazole Tab 73 40 120 233
72 Docyciklin tab Caps 100 300 400
73 Zink Tab Tab 280 3000 3280
74 Amlodipine 30 360 390
BUKU BANTU PENGELUARAN OBAT LPLPO
Nama Puskesmas : TANJUNG PINANG Bulan : Oktober
Tahun : 2012

PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG


NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

1 2 3 4 5 6 7 9 9

1 Air Raksa Dental Use Btl 0 0


2 Alat Suntik 1 ml Set 0 150 150
3 Alat Suntik 2.5 ml Set 0 109 49 37 155 350
4 Albendazol 400 mg Set 54 240 294
5 Alupurinol 100 mg Tab 155 223 110 600 1088
6 Aminophylin 200 mg Tab 52 600 100 248 600 1600
7 Aminophylin inj 24 mg/ml 10 ml Amp 0 0 0
8 Amitriptilin HCl tablet 25 mg Tab 166 400 566
9 Amoksisillin sirup kering 125 mg/5 ml Btl 29 62 84 23 500 698
10 Amoksisillin kapsul 250 mg Kap 135 483 422 550 5400 6990
11 Amoksisillin kaplet 500 mg Kap 1004 473 442 370 14800 17089
12 Ampicillin kaplet 500 mg Kap 178 517 119 313 600 1727
13 Ampicillin sirup kering 125 mg/5 ml Btl 20 49 30 17 66 182
14 Antalgin tablet 500 mg Tab 400 573 294 503 13500 15270
15 Antalgin injeksi Amp 0 0 0
16 Antasida DOEN tablet kombinasi Tab 240 3194 863 2346 12000 18643
17 Antibakteri DOEN salep kombinasi Pot 16 8 5 95 124
18 Antihemoroid DOEN kombinasi Pot 25 11 40 76
19 Antifungi DOEN kombinasi Pot 8 4 8 5 55 80
20 Antimigrain DOEN kombinasi Tab 145 100 245
21 Aqua proinjeksi bebas pirogen Amp 0 9 3 12
22 Aquadest steril Amp 0 0 0
23 Asam askorbat (vit C) 50 mg Tab 2018 1702 3649 1642 25000 34011
24 Asam askorbat (vit C)250 mg Tab 0 0 0
25 Asetosal tablet 100 mg Tab 200 300 500
26 Asetosal tablet 500 mg Tab 0 0 0
27 Atropin sulfat injeksi 0,25 mg/ml - ml Amp 0 0 0
28 Atropin sulfat tablet 0,5 mg Tab 0 0 0
29 Atropin sulfat tetes mata 0 5 % Btl 0 0 0
30 Benzatin benzil penicillin inj. 2,4 juta IU/vial Amp 0 0 0
31 Besi sirup Btl 0 0 0
32 Betametason krim 0,1 % Tube 14 21 18 19 75 147
33 Catgut/benang bedah no. 2/0 - 3/0 Sak 0 0 0
34 Captopril 12.5 mg tablet Tab 232 170 6400 6802
35 Captopril 25 mg tablet Tab 220 200 405 116 5000 5941
36 Deksametason injeksi 5 mg/ml - 1 ml Amp 0 0 0
37 Deksametason tablet 0,5 mg Tab 122 2936 951 1480 7200 12689
38 Dekstromethorpan HBr sirup 10 mg/5 ml Btl 20 20 45 18 320 423
39 Dekstromethorpan HBr tablet 15 mg Tab 388 490 876 3400 5154
40 Devitalisasi pasta Btl 0 0 0
41 Diazepam injeksi 5 mg/ml - 2 ml Amp 0 50 50
42 Diazepam 2 mg Tab 849 1000 1849
43 Diazepam 5 mg Tab 0 0 0
44 Difenhidramin HCl injeksi 10 mg/ml - ml Amp 0 70 31 49 90 240
45 Digoksin tablet 0,25 mg Tab 100 0 100
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

46 Efedrin HCl tablet 25 mg Tab 1167 145 273 0 1585


47 Ekstrak belladon tablet 10 mg Tab 945 83 500 1528
48 Epinephrin HCl injeksi Amp 0 51 51
49 Etakridin (rivanol) larutan 0,1 Btl 0 3 1 1 6 11
50 Etambutol HCl 250 mg tablet Tab 0 0 0
51 Etambutol HCl 500 mg tablet Tab 150 100 250
52 Etil klorida semprot Btl 0 4 4
53 Eugenol cairan Btl 0 2 2
54 Fenitoin natrium kapsul 100 mg Kap 250 250 500
55 Fenitoin natrium kapsul 30 mg Kap 0 0 0
56 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 6 6
57 Fenobarbital tablet 100 mg Tab 0 0 0
58 Fenobarbital tablet 30 mg Tab 631 1000 1631
59 Fenoksi metil penisillin tablet 250 mg Tab 0 0 0
60 Fenoksi metil penisillin tablet 500 mg Tab 0 0 0
61 Fenol gliserol tetes telinga 10 % Btl 27 8 0 35
62 Fitomenadion (vit K) inj. 10 mg/ml - 1 ml Amp 0 28 190 218
63 Fitomenadion (vit K) tablet salut 10 mg Tab 155 100 164 90 1400 1909
64 Furosemid tablet 40 mg Tab 0 200 200
65 Gameksan emulsi 1 % Btl 0 0 0
66 Garam oralit 200 ml air Sak 76 95 71 67 1600 1909
67 Gentian violet larutan 1 % Btl 8 10 8 7 108 141
68 Glass ionomer semen (gc ix) Btl 0 0 0
69 Glibenklamid tablet 5 mg Tab 204 1500 1704
70 Gliseril guayakolat tablet 100 mg Tab 1264 5743 3828 2990 18000 31825
71 Gliserin Btl 0 0 0
72 Glukosa Larutan Infus 5 % Steril Btl 0 0 0
73 Griseofulvin 125 mg micronized Tab 187 80 212 70 300 849
74 Halloperidol tablet 0,5 mg Tab 0 600 600
75 Halloperidol tablet 1,5 mg Tab 59 500 559
76 Halloperidol tablet 5 mg Tab 78 400 478
77 Hidroklrotiazed ( hct ) tablet 25 mg Tab 185 225 787 70 1000 2267
78 Hidrokortison krim 2,5 % Pot 23 16 17 19 144 219
79 Ibuprofen tablet 200 mg Tab 270 780 384 350 11800 13584
80 Ibuprofen tablet 400 mg Tab 100 900 1000
81 Infusion set anak Set 0 0 0
82 Infusion set dewasa Set 0 0 0
83 I N H tablet 100 mg Tab 820 3000 3820
84 I N H tablet 300 mg Tab 172 1000 1172
85 Isosorbit dinitrat tablet sublingual 5 mg Tab 90 100 190
86 Kalium permanganat serbuk Btl 0 0 0
87 Kalsium hidroksida pasta Tab 0 0 0
88 Kalsium Laktat ( Kalk ) 500 mg Tab 310 1837 682 1595 4000 8424
89 Kapas pembalut / Absorben 250 gram Rol 0 1 1 20 22
90 Karbamazepin tablet 200 mg Tab 171 0 171
91 Kasa kompres 40/40 steril Rol 0 10 10
92 Kasa pembalut hidrofil 4 m x 15 cm Rol 0 8 10 7 89 114
93 Kasa pembalut hidrofil 4 m x 3 cm Rol 0 0 0
94 Kloramfenikol 250 mg kapsul Kap 128 205 0 333
95 Kloramfenikol salep mata 1 % Pot 24 10 7 24 65
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

96 Kloramfenikol tetes telinga 3 % Btl 0 72 72


97 Klorfeniramine maleat tablet 4 mg Tab 816 6759 3913 3182 21000 35670
98 Kloroquin pospat tablet 250 mg Tab 0 0 0
99 Klorpromazin hcl injeksi Amp 0 0 0
100 Klorfenol kamfermenthol (CHKM) Btl 0 0 0
101 Klorpromazin hcl injeksi 5 mg/ml - 1 ml Amp 0 0 0
102 Klorpromazin hcl tablet salut 100 mg Tab 249 1000 1249
103 Klorpromazin hcl tablet salut 25 mg Tab 0 0 0
104 Kodein hcl tablet 10 mg Tab 0 0 0
105 Komb. primetamin 25 mg + suldok 500 mg Tab 0 0 0
106 Kotrimoksazol pediatrik tablet Tab 300 255 132 1200 1887
107 Kotrimoksazol suspensi Btl 50 34 20 18 300 422
108 Kotrimoksazol dewasa tablet Tab 222 548 170 428 3000 4368
109 Kuinin dihidroklorida injeksi 25 % - 2 ml Amp 0 0 0
110 Kuinin sulfat tablet 222 mg ( 7H2O ) Tab 0 0 0
111 Lidokain Kompositum injeksi Amp 0 4 8 14 180 206
112 Magnesium sulfat inj. 20% - 25 ml Btl 0 0 0
113 Magnesium sulfat inj. 40% - 25 ml Btl 0 0 0
114 Mebendazol Syrup Tab 0 0 0
115 Metilergometrin tablet salut Tab 70 300 370
116 Metilergometrin Inj. Amp 0 0 0
117 Metronidazol tablet 250 mg Tab 80 200 160 195 600 1235
118 Metronidazol tablet 500 mg Tab 5 1700 1705
119 Mummifying pasta Pot 0 0 0
120 Natrium bikarbonat tablet 500 mg Tab 765 837 0 1602
121 Natrium klorida larutan infus 0,9 % steril Btl 0 0 0
122 Nistatin 100.000 iu/g tablet vaginal Tab 38 200 238
123 Nistatin 500.000 iu/g tablet salut Tab 0 0 0
124 Nifedipin tab Tab 30 400 430
125 Obat anti tuberkolusis katagori 1 Tab 0 0 0
126 Obat anti tuberkolusis katagori 2 Tab 0 0 0
127 Obat anti tuberkolusis katagori 3 Tab 0 0 0
128 Obat anti tuberkolusis sisipan Tab 0 0 0
129 Obat anti tuberkolosis anak Tab 0 0 0
130 Obat batuk hitam ( o b h ) cairan Btl 22 42 21 19 195 299
131 Oksitetrasiklin hcl inj. Amp 0 2 2 4
132 Oksitetrasiklin hcl salep kulit 3 % Pot 9 24 19 8 175 235
133 Oksitetrasiklin hcl salep mata 1 % Pot 24 6 10 35 75
134 Papaverin tablet Tab 708 35 0 16 0 759
135 Paraformaldehid tablet 1 gram Tab 0 0 0
136 Parasetamol sirup 120 mg/5ml Btl 74 39 50 16 450 629
137 Parasetamol tablet 100 mg Tab 0 1000 1000
138 Parasetamol tablet 500 mg Tab 972 6651 4158 4600 22000 38381
139 Perfenazin tablet 4 mg Tab 0 0 0
140 Pirantel pamoat tablet 365 mg Tab 48 23 28 18 180 297
141 Piridoxin hcl tablet 10 mg Tab 960 2795 2500 1510 11000 18765
142 Pyrazinamid tablet Tab 95 100 195
143 Plester 5 yard x 2 inch Rol 0 1 1 1 7 10
144 Polikresulen Btl 0 5 5
145 Prazikuantel tablet 600 mg Tab 0 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

146 Prednison tablet 5 mg Tab 504 2336 1327 1372 8000 13539
147 Primaquin tablet 15 mg Tab 0 0
148 Prokain benzyl penisillin 3 juta iu/vial inj. Amp 0 0
149 Propiltiourasil tablet 100 mg Tab 124 500 624
150 Propanolol hcl tablet 40 mg Tab 700 700
151 Propanolol hcl tablet 10 mg Tab 200 0 200
152 Reserpin tablet 0,10 mg Tab 0 0
153 Reserpin tablet 0,25 mg Tab 706 223 1000 1929
154 Retinol ( Vit A ) 200.000 iu Kap 0 0
155 Retinol ( Vit A ) 100.000 iu Kap 0 0
156 Rifampisin kapsul 600 mg Kap 14 200 214
157 Rifampisin kapsul 450 mg Kap 99 200 299
158 Rifampisin kapsul 300 mg Kap 171 200 371
159 Ringer laktat infus steril Btl 0 0
160 Salbutamol tablet 2 mg Tab 106 90 66 80 350 692
161 Salep 2-4 Pot 9 8 5 4 24 50
162 Salisil bedak 2 % Sak 3 10 11 6 92 122
163 Salisil spritus 10 % Btl 0 0
164 Semen seng fosfat serbuk dan cairan Btl 0 0
165 Serum ABU polivalen inj. Amp 0 0
166 Serum ATS 1500 IU Amp 3 3
167 Serum ATS 20000 IU Amp 0 0
168 Simvastatin Tab 40 300 340
169 Sianokobalamin inj. 500 mcg/ml Amp 100 80 75 250 505
170 Silk (benang bedah sutera) no. 3/0 Rol 1 9 10
171 Silver amalgam serbuk 65 - 75 % Pot 0 0
172 Spons gelatin cublices 1x1x1 cm Sak 12 12
173 Streptomycin serbuk inj. 1000 mg/vial Amp 0 0
174 Sulfadimidin tablet 500 mg Tab 0 0
175 Sulfasetamid natrium tetes mata 15 % Btl 18 8 38 64
176 Tablet tambah darah kombinasi Tab 584 562 365 554 7800 9865
177 Temporary stoping fletcher dan cairan Btl 0 0
178 Tetrasiklin HCl kapsul 250 mg Kap 725 262 940 1000 2927
179 Tetrasiklin HCl kapsul 500 mg Kap 140 80 900 1120
180 Tiamin HCl (vit B1) inj. 100 mg/ml - 1ml Amp 120 120
181 Tiamin HCl mononitrat tablet 50 mg Tab 560 2009 863 1255 12000 16687
182 Triheksilfenidil HCl tablet 2 mg Tab 95 400 495
183 Trikresol formalin cairan Btl 0 0
184 Vaksin Rabies Vero Amp 0 0
185 Vitamin B komplek tablet Tab 490 2751 1908 1668 14000 20817
186 Yodium povidon larutan 10 % - 30 ml Btl 1-Jan 1-Jan 4 8
187 Yodium povidon larutan 10 % - 300 ml Btl 1 1 2 4

1 Acyclovir tablet 200 mg Tab 95 150 185 600 1030


2 Acyclovir cream Tube 31 10 19 125 185
3 Acyclovir tablet 400 mg Tab 81 85 148 600 914
4 Andalan Injeksi Amp 80 80
5 Asam mefenamat kapsul 250 mg Tab 0 0
6 Asam mefenamat tablet 500 mg Tab 20 100 174 2500 2794
7 Ampicilin injeksi 1 g Amp 0 0
PEMAKIAN Pustu Ksg Pustu sjj Pustu sjj GDNG
NO NAMA OBAT KELAS SATUAN Apotik jaya
Jumlah
I II PKM

8 Ambroxol Sirup Amp 17 320 337


9 Cefotaxime inj 1 gr Amp 0 0
10 Cimetidin tablet 200 mg Tab 0 0
11 Ciprofloxacin kaplet 500 mg Kap 800 800
12 Dasabion tab Tab 0 0
13 Domperidon tab Tab 1000 1000
14 Erytromycin caps 250 mg Kap 0 0
15 Erytromycin capt 500 mg Kap 160 400 560
16 Erytromycin Syr Btl 24 20 44
17 Etabion Cap Cap 0 0
18 Gentamycin injeksi Amp 0 0
19 Gentamycin salep kulit Pot 16 80 96
20 Gentamycin tetes mata Btl 13 30 43
21 H2O2 Btl 1 1 2
22 Ichtyol salap Pot 0 0
23 Levertran salep Pot 6 0 6
24 Kloramphenicol tetes mata Btl 5 20 25
25 Metoklorpropamide Hcl 10 mg Tab 194 0 194
26 Mikonazole cream Pot 18 96 114
27 Methyl Prednisolon tab 4 mg Tab 0 0
28 Nipedipin tablet Tab 0 0
29 Natrium Diklofenak 50 mg Tab 60 200 260
30 Obat Tambah Darah Indo tab 0 0
31 Obat Flu Indo Tab 0 0
32 Obat Maag indo Tab 0 0
33 Papaverin injeksi Amp 0 0
34 Papaverin tablet 40 mg Tab 1000 1000
35 Piperazin 500 mg Tab 0 0
36 Piperazin sirup Btl 0 0
37 Piroksikam tablet 10 mg Tab 48 90 120 900 1158
38 Piroksikam tablet 20 mg Tab 0 0
39 Ranitidine 150 mg