12.register LPLPO Desember

REGISTER OBAT HARIAN
UPT PUSKESMAS KLUNGKUNG I
Sub Unit : Ruang Farmasi

Bulan : Nopember
Tahun : 2017
NO NAMA OBAT/BARANG SATUAN Pemakaian (ta
SISA TERIMA
BULAN BULAN 26 28 30 1 3 5 7
LALU INI 27 29 31 2 4 6
Obat Formularium Nasional Untuk Puskesmas
1 ACT (Artesunat 50mg + amodiaquine 200mg) tablet -
2 Albendazol tablet 400mg tablet 17
3 Albendazol suspensi 200mg/5ml botol 10 ml -
4 Alopurinol tablet 100 mg tablet 116 200 30
5 Alopurinol tablet 300 mg tablet -
6 ALT (Artemeter 20mg + Lumefantrin 120mg) tablet -
7 Amilorid tablet 5mg tablet -
8 Aminofilin injeksi 24mg/ml Ampul -
9 Aminofilin tablet 150mg tablet -
10 Aminofilin tablet 200 mg tablet -
11 Amitripilin tablet salut 25 mg (HCL) tablet 100
12 Amlodipine tablet 10mg tablet 126 90 30 10 15 30
13 Amlodipine tablet 5mg tablet 110 60 30 14
14 Amoksisilin kaplet 500 mg tablet 788 2,700 109 132 141 9 39 46 18 18 108 75 31 193 144
15 Amoksisilin sirup forte 250 mg/5ml botol 60 ml 20 15 1 1 1 1
16 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/ml Vial -
17 Ampisilin serbuk injeksi i.m./i.v. 250 mg/ml vial -
Antasida DOEN I tablet kunyah, kombinasi :
18 Aluminium Hidroksida 200 mg + Magnesium Hidroksida 200 tablet
mg 411 600 5 14 5 9 9 36 27 45 36
19 Antasida DOEN sirup kombinasi botol 60 ml - 5
Anti Bakteri DOEN salep kombinasi :
20 tube
Basitrasin 500 IU/g + polimiksin 10.000 IU/g 17 25 1
21
Betametason + Neomicyn 15 10 1 1 2 4 3 1
Antifungi DOEN Kombinasi :
22 pot
Asam Benzoat 6% + Asam Salisilat 3% -
Antihemoroid DOEN kombinasi :
23 sup
Bismut Subgalat 150 mg + Heksaklorofen 250 mg 49 20
Antimalaria DOEN kombinasi :
24 tablet
Pirimatamin 25 mg + Sulfadoksin 500 mg -
Antimigren :
25 tablet
Ergotamin tartrat 1 mg + Kofein 50 mg 100
Antiparkinson DOEN tablet kombinasi :
26 tablet
Karbidopa 25 mg + Levodopa 250 mg -
27 Aqua Pro Injeksi Steril, bebas pirogen Vial -
28 Artesunat serbuk injeksi 60mg/ml Vial -
29 Arthemeter injeksi 80mg/ml vial -
30 Asam Asetil Salisilat tablet 80 mg tablet 60
31 Asam Askorbat (vitamin C) tablet 250 mg tablet -
32 Asam Askorbat (vitamin C) tablet 50 mg tablet 645 1,500 96 40 134 119 100 58 234 87
33 Asam Folat tablet 0,4 mg tablet -
34 Asam Folat tablet 1mg tablet 90 30
35 Asam Folat tablet 5 mg tablet -
36 Asam mefenamat tablet 250mg kapsul -
37 Asam mefenamat tablet 500mg tablet 421 900 63 54 54 64 9 18 18 37 27 18 50 36
38 Asam Salisilat larutan 0,1% pot 30 g -
39 Asiklovir tablet 200mg tablet 4
40 Asiklovir tablet 400 mg tablet 25 200 30 30
41 Atapulgit tablet tablet 364 9 9 9 9 9 9 9
42 Atenolol tablet 50 mg tablet -
ampul @ 1
43 Atropin injeksi i.m/i.v/s.k. 0,25 mg/mL (sulfat)
ml -
44 Atropin tablet 0,5 mg tablet -
45 Benzatin Bensil Penisilin inj. 1,2 jt IU/vial (im) Vial -
47 Betametason krim 0,1 % tube 13
48 Betametason tetes mata 1mg/ml botol -
49 Bisakodil sup 10 mg sup 14
50 Bisakodil sup 5 mg sup -
51 Bisakodil tablet 5mg tablet 198
52 Coal tar larutan 15% botol -
53 Dapson tablet 100mg tablet -
54 Deksametason Injeksi i.v. 5 mg/ml ampul @ 1ml
1
55 Deksametason tablet 0,5mg tablet 158 200 18 9 4
ampul @ 2
56 Diazepam Injeksi 5 mg/ml
ml 1
57 Diazepam Rectal 10mg/2,5ml sup 1
58 Diazepam Rectal 5mg/2,5ml sup - 1
59 Diazepam tablet 2mg tablet -
61 Dietil karbamazin sitrat tablet 100mg tablet -
ampul @ 1
62 Difenhidramin Injeksi i.m. 10 mg/ml (HCL)
ml 4
63 Digoksin tablet 0,25 mg tablet -
64 Diltiazem tablet 30 mg tablet -
65 Dimenhidrinat tablet 50 mg tablet 81 6 6
66 Doksisiklin kapsul 100mg kapsul -
67 Domperidon tablet 10mg tablet 120
68 Domperidon suspensi 5mg/5ml botol 5
ampul @ 1
69 Epinefrin (Adrenalin) injeksi 0,1% (sebagai HCL)
ml 1
70 Ergokalsiferol (Vit D2) kapsul 50.000 IU kapsul -
71 Ergokalsiferol (Vit D2) suspensi 10.000 IU botol 100 ml
-
72 Ergotamin tablet 1mg tablet -
73 Eritromisin kapsul 250 mg kapsul -
74 Eritromisin sirup 200 mg/ 5 ml btl 60 ml -
75 Etambutol tablet 250 mg tablet -
77 Etambutol tablet salut 500 mg (HCl) tablet -
78 Etanol 70% larutan btl 1000 ml -
79 Eugenol cairan btl 10 ml -
80 Fenitoin Natrium Injeksi 100 mg/2ml ampul -
81 Fenitoin Natrium Injeksi 50 mg/ml ampul -
82 Fenitoin Natrium kapsul 100 mg kapsul -
84 Fenobarbital injeksi50mg/ml ampul -
85 Fenobarbital tablet 100mg tablet -
86 Fenobarbital tablet 30 mg tablet 30
87 Fenoksimetil Penisilin tablet 250 mg tablet -
89 Ferro Fumarat kapsul lunak 300mg kapsul -
90 Ferro Sulfat sirup 15mg/5ml botol -
91 Ferro Sulfat tablet 300mg tablet -
ampul @ 1
92 Fitomenadion (Vit. K1) injeksi 2 mg/ml
ml 13 10
93 Fitomenadion (Vit. K1) tablet salut gula 10 mg tablet -
94 Fluphenaszine Decanoate i.m 25 mg/ml ampul 1 ml -
ampul @ 2
95 Furosemid injeksi i.v./i.m. 10 mg/ml
ml -
96 Furosemid tablet 40 mg tablet 100
97 Galactose microparticle 200-400mg micropart/ml botol -
Garam Oralit Kombinasi :
98 Natrium 0,70 g , Kalium klorida 0,30 g, Trinatrium Sitrat sachet
dihidrat 0,58 g 100 125 12 6 6 6 6 6 5
99 Glibenklamida tablet 2,5 mg tablet -
100 Glibenklamida tablet 5 mg tablet 28 300 10 20 5 20 5
101 Glimepirid tablet 1mg tablet -
102 Glimepirid tablet 2mg tablet 23 100
103 Glipzide tablet 5mg tablet -
104 Gliseril Trinitrat tablet sublingual 0,5mg tablet -
105 Gliserin tetes 100mg/ml botol -
106 Gliserin tetes 10mg/ml btl 100 ml -
107 Griseofulvin micronized tablet 125 mg tablet -
ampul @ 1
109 Haloperidol injeksi 5mg/ml (i.m)
ml -
110 Haloperidol tablet 0,5 mg tablet -
111 Haloperidol tablet 1,5 mg tablet 132
112 Haloperidol tablet 2 mg tablet -
113 Haloperidol tablet 5 mg tablet 155 30
114 Haloperidol tetes 2mg/ml botol -
115 Hexamin mandelatb tablet tablet -
116 Hidrogen Peroksida 3% botol 3 3
117 Hidroklorotiazida tablet 25 mg tablet 83 20
118 Hidrokortison krim 2,5% tube 8 1
119 Hidrokortison serbuk injeksi 100mg/vial vial -
120 Hyosine Butil Bromide tablet 10 mg tablet 100
121 Ibuprofen tablet 200 mg tablet 37 100 9 9 9
122 Ibuprofen tablet 400 mg tablet 552 300 9 27 9 27 18 9 9 36
123 Ibupropen sirup 100mg/5ml botol 60 ml 2 5
124 Ibupropen sirup 200mg/5ml botol 60 ml -
125 Ipratropim Bromide inhaler padat 20mg kapsul -
126 Ipratropim Bromide nebulizer 0,025% ampul -
127 Isoniazid tablet 100 mg tablet 100 10 10 10
128 Isoniazid tablet 300 mg tablet -
129 Isosorbid Dinitrat Tablet Sublingual 5 mg tablet -
130 Kalamin lotion botol -
131 Kalsium Glukonat inj 100mg/ml ampul -
132 Kalsium karbonat tablet 500mg tablet -
133 Kalsium Laktat (Kalk) tablet 500 mg tablet 469 1,100 60 90 75 45 120 30
134 Kaptopril tablet 12,5 mg tablet - 200
135 Kaptopril tablet 25 mg tablet 134 1,000 60 110 80 104
136 Karbamazepin sirup 100mg/5ml botol 120 ml

-
137 Karbamazepin tablet 200mg tablet 66
138 Karbogliserin tetes telinga 10% btl 5 ml -
139 Karbon adsorben tablet 0,5 mg kantong 30 g
-
140 Ketamin injeksi 100 mg/ml Vial @ 10 ml
-
141 Ketamin injeksi 50 mg/ml sebagai HCl Vial @ 20 ml
-
142 Ketokonazol tablet 200mg tablet 9
143 Klofazimin kapsul 100 mg micronize kapsul -
144 Kloramfenikol kapsul 250 mg kapsul 97
145 Kloramfenikol salep kulit 2% tube - 5
146 Kloramfenikol salep mata 1% tube 13 1 1 2 1 1 1
147 Kloramfenikol suspensi 125 mg/5 ml btl 60 ml -
148 Kloramfenikol Tetes mata 0,5% botol -
149 Kloramfenikol Tetes mata 1% botol -
150 Klorfeniramin mealeat (CTM) tablet 4 mg tablet 160 1,500 16 45 62 71 45 52 77 33
151 Klorhexidin larutan 7.5% 1 liter botol - 1
152 Klorhexidin larutan 15% botol -
ampul @ 2
153 Klorpromazin injeksi i.m 25 mg/ml (HCL)
ml -
154 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCL) ampul -
155 Klorpromazin tablet salut 100 mg (HCL) tablet 50 30 1
156 Klorpromazin tablet salut 25 mg (HCL) tablet -
157 Klortalidon tablet 50 mg tablet -
158 Kodein tablet 10 mg tablet -
160 Kombinasi Ipratropium 0,5mg dan Salbutamol 2,5mg nebulizer ampul -
161 Kombinasi Kaolin 550mg dan Pektin 20mg tablet tablet -
162 Kontrasepsi Injeksi vial -
163 Kontrasepsi Inplant etonogestrel 68 mg biji -
164 Kontrasepsi inplant levonorgestrel 75 mg biji -
165 Kontrasepsi Oral paket -
166 Kotrimoksazol Suspensi botol 60 ml 3 1
Kotrimosazol DOEN forte Kombinasi :
167 tablet
Sulfametoksazol 100 mg, Trimetoprim 20 mg -
Kotrimosazol DOEN I (dewasa) kombinasi :
168 tablet
Sulfametoksazol 400 mg, Trimetoprim 80 mg 224 10
169 Kuinin inj 25% ampul @ 2 ml -
170 Kuinin tablet 200mg tablet -
173 larutan Lugol botol -
174 Lidokain gel 2% Syringe @ 10 g -
175 Lidokain inj 2% ampul 8 50
176 Lidokain inj 1% ampul -
177 Lidokain injeksi 2% (HCL) + Epinefrin 1 : 80.000 ampul -
178 Lidokain Semprot 10% botol -
179 Loratadine tablet 10mg tablet 30 100 5
180 Magnesium Sulfat inj (IV) 20%-25 ml vial -
182 Magnesium Sulfat serbuk 30 gram sakset -
183 Mebendazol sirup 50 mg / ml btl 30 ml -
184 Mebendazol tablet 100 mg tablet -
186 Metformin HCl tablet 500 mg tablet 310 1,100 70 110 100 100 60 20
187 Metformin HCl tablet 850 mg tablet -
188 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg tablet
-
189 Metilergometrin Maleat injeksi 0,200 mg -1 ml ampul - 2
190 Metoklopramide HCl tablet 10mg tablet -
191 Metoklorpramide tablet 5mg tablet -
192 Metronidazol tablet 250 mg tablet -
193 Metronidasol tablet 500mg tablet 108 100 9 9 18
194 Metronidazol infus 500 mg/100 ml btl 100 ml -
195 Metronidazol sirup 125mg/5ml botol -
196 Metronidazole supp 500mg sup -
197 Mikonazol krim /salep 2 % tube 16 1 3
198 Mikonazol serbuk 2% botol -
199 Natrium Bikarbonat tablet 500 mg tablet -
200 Natrium Diklofenak tablet 25 mg tablet -
201 Natrium Diklofenak tablet 50 mg tablet 31 250 36 16 6 6 6 12 6
Natrium Thiosulfat injeksi i.v. 25 % ampul @ 10
202
ml -
203 Nikotinamide tablet 100mg tablet -
206 Nipedipin tablet 10mg tablet -
207 Nistatin suspensi 100.000 IU/ml botol -
208 Nistatin tablet salut 500.000 IU/g tablet -
209 Nistatin Vaginal tablet salut 100.000 IU/g tablet 3 5 5
210 Nitrofurantoin tablet 100 mg tablet -
211 Norepinefrin injeksi 1mg/ml ampul -
212 OAT FDC Anak paket -
213 OAT FDC I paket 4
214 OAT FDC II paket -
215 OAT FDC Sisipan paket -
216 OAT Kombipak I paket -
217 Oksigen Gas Dalam Tabung 1 kg -
219 Oksimetazolin tetes hidung 0,025% btl 10 ml -
221 Oksitosin injeksi 10 UI/ml-1 ml ampul 25 5 29
222 Olopatadin tetes mata 1% botol -
223 Omeprazol injeksi 40mg/10ml vial @ 40 mg
-
224 Omeprazol kapsul 20mg kapsul 19
225 Paraformaldehid tablet 1 gram tablet -
226 Parasetamol sirup 120 mg / 5 ml btl 60 ml 57 10 4 2 3 1 1 2 2 1
227 Parasetamol tablet 500mg tablet 825 2,600 91 156 143 9 113 44 18 10 101 141 11 150 88
228 Parasetamol tetes 60mg/0,6 ml botol 15 35 1 1 1 1
229 Perak Nitrat larutan 20% botol -
230 Perak Sulfadiazin krim 1% tube - 1
231 Permetrin krim 5% tube 4 1
232 Pirantel sirup 125 mg/5 ml btl 60 ml 4
233 Pirantel tab. Score (base) 125 mg tablet -
234 Pirantel tab. Score (base) 250 mg tablet 2
236 Pirazinamid tablet 500 mg tablet -
237 Piridoksin (Vitamin B6) tablet 10 mg (HCL) tablet 137 300 16 10 20 10 10 20
238 Piridoksin (Vitamin B6) tablet 20 mg (HCL) tablet -
239 Piridoksin injeksi 100mg/ml tablet -
240 Povidon Iodida larutan 10 % btl 30 ml -
241 Povidon Iodida larutan 10% botol 300ml - 2
242 Prazikuantel tablet 300 mg tablet -
244 Prednison tablet 5 mg tablet -
245 Primakuin tablet 125mg tablet -
246 Probenesid tab 500 mg tablet -
247 Procain Bensil Penisilin serbuk inj. 1 jt IU/vial (im) vial -
249 Propanolol tablet 10 mg (HCl) tablet -
250 Propillitiourasil tablet 100 mg tablet -
251 Ranitidin tablet 150mg tablet 421 12 36 18
252 Retinol (vitamin A) kapsul lunak 100.000IU kapsul -
253 Retinol kapsul 200.000 IU kapsul 54
254 Salbutamol inhaler 0,5% botol -
255 Salbutamol tablet 2 mg (sebagai sulfat) tablet 208 9 11
256 Salbutamol tablet 4 mg (sebagai sulfat) tablet 440 500 2 18
Salep 2-4, kombinasi :
257 pot
Asam Salisilat 2% + Belerang endap 4% 2
258 Salep Asam Salisilat 5% pot -
259 Salisil bedak 2% ktk 50 gram 3 15 3 1 2 2
260 Setrizine sirup 5mg/5ml botol -
261 Sianokobalamin (Vitamin B12) injeksi 500 mcg ampul -
262 Sianokobalamin (Vitamin B12) tablet 50 mcg tablet -
263 Simvastatin tablet 10 mg tablet -
264 Simvastatin tablet 20 mg tablet - 90
265 Siprofloksasin tablet 500mg tablet 154 10 10
266 Spironolakton tablet 25 mg tablet -
267 Streptomycin injeksi 1000 mg / vial visl -
268 Tablet Tambah Darah tablet 529 2,700 104 30 135 240 90 70 360 90
269 Tetrakain HCL tetes mata 0,5% botol -
270 Tetrasiklin kapsul 250 mg kapsul -
272 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) tablet 499 36 16 5 26 11 6 12
273 Triheksifenidil tablet 2 mg tablet 83 30
274 Tuberkulin injeksi 1 : 10 (i.k). vial -
275 Valproat sirup 250mg/5ml botol -
276 Valproat tablet salut 250mg tablet -
278 Vitamin B Kompleks tablet tablet 1,161 3,000 137 123 133 10 163 121 142 174 136
279 Zinc serbuk 10mg sakset -
280 Zinc sirup 20mg/5ml botol 60 ml 17 5 1
281 Zink Dispersible tablet 20mg tablet -
-
-
VAKSIN DAN SERUM -
1 Serum Anti Bisa Ular ABU I vial 4 ml -
2 Serum Anti Bisa Ular ABU II vial 50 ml -
3 Serum Antidifteri (ADS) inj 10.000 IU vial @ 50 ml -
4 Serum Antidifteri (ADS) inj 20.000 IU vial 5 ml -
5 Serum Antirabies inj 100 IU/ml vial # 20 ml -
6 Serum Antirabies inj 200 IU/ml -
7 Serum Antitetanus (ATS) 1.500 IU/amp amp 1 ml -
8 Serum Antitetanus (ATS) 10.000 IU/amp ampul @ 2 ml -
9 Serum Antitetanus (ATS) 20.000 IU/vial vial 5 ml -
10 Hepatitis B Imunoglobulin (Human) injeksi 0,5ml Vial 63 100 61
11 Human tetanus Imunoglobulin injeksi 250 IU (i.m) syringe 51 30
12 Human tetanus Imunoglobulin injeksi 500 IU (i.m) syringe -
13 Vaksin BCG vial 31 20 29
14 Vaksin campak vial 47 40 37
15 Vaksin kombinasi DPT+Hepatitis B vial 17 90 38
16 Vaksin jerap DT vial 78 62
17 Vaksin jerap DPT vial -
18 Vaksin jerap tetanus vial -
19 Vaksin polio vial 27 90 45
20 Vaksin rabies, untuk manusia 169
21 Tetanus Toxoid inj vial 142 20 114
-
-
OBAT GIGI -
1 Devitalisasi Pasta (Non Arsen) btl / ktk -
2 Etil Klorida spray btl 100 ml - 2 2
3 Glass Ionomer Cement ART set / botol -
4 Kalsium Hidroksida Pasta ktk 2 tube -
5 Klorfenol kamfer Menthol ( CHKM ) btl 10 ml -
6 Mummifying Pasta btl / kotak -
7 Semen Seng Fosfat serbuk dan cairan -
8 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan -
9 Formokresol cairan botol -
10 Gutta Percha dan paper point biji -
11 klorhexidin larutan 0,2% botol -
12 Natrium Hipoklorit cairan konsentrat 5% botol -
13 Nistatin Suspensi 100.000IU/ml botol -
14 Fluor tablet 0,5mg tablet -
15 Fluor tablet 1mg tablet -
16 Fluor Sediaan Topikal pot -
17 Pasta Pengisi Saluran Akar tablet -
18 Komposit Resin botol -
19 Articulating paper buah -
20 Lidokain pasta 5% tablet -
21 Fuji I botol -
22 Fuji IX botol -
23 Spongestan Gelatin buah -
24 Cavit G buah -
25 Avogyl buah -
26 Saliva Ejektotor biji -
27 TKF -
28 Ceivitron -
Lain-lain -
1 Acetylsystein 200mg kapsul 35 780 12 36 24 12 12 36 60 36
2 Alkohol 70 % 100 ml botol 1
3 Alprazolam 1 mg tablet -
4 Alprazolam 0.5 mg tablet - 100 3
5 Ambroxol Syrup 15mg/5ml btl/60ml 26 1 1 1
6 Ambroxol tablet 30 mg tablet 5 500 18 18 9 18 36
7 Amoksisilin sirup kering 125 mg/ 5 mg btl 60 ml 29 1 1 1
8 Aquadest steril botol 1000 ml -
9 Asam Asetisalisilat tablet 100 mg (Asetosal) tablet -
12 Asam Traneksamat injeksi 100mg ampul -
14 Asiklovir krim 5 % tube 5 gram 10 1 1
15 Azytromicn 500 mg tablet 20
16 Betahistin Metisalat tablet 6 mg tablet 100 60 6 6
17 Calcium Alginate (Bioplacenton) tulle sachet -
18 Cefixime 100 mg kapsul -
19 Cefixime 200 mg + Azitromycin 500 mh (Kombipak) paket -
20 Cetirizin kapsul 10 mg kapsul 100
21 Cimetidin tablet 200mg tablet -
22 Clavamox injeksi 1.000 IV 1,2 gr vial -
23 Clobazam tablet 10 mg tablet -
24 Co Amoxiclav capsul 625 mg capsul -
25 Digoksin 0,0625 mg tablet -
26 Digoksin injeksi 0,25 mg/ml ampul @ 2 ml -
27 Dopamin injeksi ampul -
28 Efedrin tablet 25 mg (HCL) tablet -
29 Ekstraks belladona tablet 10 mg tablet -
30 Erythromicin kapsul 500mg kapsul 4 100
31 Etakridin larutan 0,1% btl 300ml - 1
32 Fenilbutason tablet 200 mg tablet -
33 Fenitoin kapsul 30 mg (garam natrium) kapsul -
34 Fenol Gliserol TT 10% botol 1 10
35 Fitomenadion (Vit. K1) injeksi 10 mg/ml ampul @ 1 ml -
36 Flukonazol tablet 150 mg tablet -
37 Fluoksetine hcl 20mg kapsul
38 Fluoresein tetes mata 2,5mg/ml botol -
39 Framycetin sulfat lembar 70 30
40 Gentamicin krim 0,1% tube -
41 Gentamisin salep kulit 0,1% tube 11 1 2 4 1
42 Gentamisin Sulfat tetes mata 5 ml btl 10 ml - 5
43 Gentamycin injeksi 40mg/ml ampul @ 2 ml -
44 Gentian Violet 1% botol 1
45 Gliseril Gualakolat tablet 100 mg tablet 115 1,000 24 24 26 46 28 53 4 21
46 Glukosa larutan infus 10% btl 500 ml -
47 Glukosa larutan infus 40% ampul -
48 Glukosa larutan infus 5% btl 500 ml 2
49 Hyoscine N-Butylbromide injeksi 20mg/ml ampul @ 1 ml - 5
50 Ketokenazol krim 2% tube -
51 Ketoprofen injeksi ampul -
52 Ketoprofen sup 100mg sup -
54 Kloramfenikol Tetes Telinga 3% botol 3 1
55 Klozapine 25mg
56 Lansoprazol kapsul 30 mg kapsul 65
57 Lisol botol -
58 Lisol (Kresol tersaponifikai 50%) btl 1000 ml -
59 Meloksikam tablet 7,5 mg tablet -
60 Metakresol Sulfonat solution btl -
61 Metampiron 250mg, Aminofenazon 50mg, Silokain HCl 15mg inj vial -
62 Metampiron tablet 500 mg tablet -
63 Methylprednisolon tablet 4 mg tablet 100
65 Methylprednisolon tablet 16 mg tablet -
66 Metoklopramide HCl injeksi 5mg/ml10mg ampul - 5
67 Multivitamin sirup botol -
68 Natrium Bikarbonat injeksi (Meylon) ampul 25 ml -
69 Natrium Klorida larutan infus 0,9 % btl 500 ml 2 19
70 Natrium Klorida larutan infus 3% btl 500 ml -
71 Neomycin Sulfat 0,5%, placenta extr. 100mg/ml tube -
72 New diaform tablet -
73 Obat Batuk hitam ( O.B.H.) btl 100 ml -
74 Oksitetrasiklin HCL salep mata 1 % tube -
75 Oksitetrasiklin salep kulit tube 5 gram -
76 Ondancentron tablet 4mg tablet 30
77 Papaverin tablet tablet -
78 Parasetamol Rectal 125mg sup 20
79 Parasetamol tablet 100 mg tablet -
80 Pehacain injeksi ampul -
81 Petidin injeksi 50 mg/ml ampul @ 2 ml -
82 Pilokarpin tetes mata 2 % (HCL/Nitrat) btl 5 ml -
83 Pilokarpin tetes mata 4% btl 5 ml -
84 Piracetam injeksi 1 gr / 5ml ampul -
85 Piracetam tablet 800mg tablet -
86 Piroxicam kapsul 10mg tablet -
87 Piroxicam kapsul 20mg tablet - 100 5 5 5 10
88 Ranitidin injeksi 25mg/2ml ampul 5
89 Retinol (Vitamin A) tablet 50.000 IU tablet -
90 Rifampisin kaplet 600 mg tablet -
91 Rifampisin tablet salut 450 mg tablet -
92 Ringer Laktat larutan infus btl 500 ml 8 11
93 Risperdal tablet 2mg tablet -
94 Salbutamol inhaler botol -
95 Salbutamol Nebulizer 2,5mg/2,5ml ampul 14
96 Salbutamol Rotahaler pcs -
97 Salbutamol serbuk kapsul inhaler 200 mg kapsul -
98 Salbutamol sirup 2 mg / 5 ml botol -
99 Salicyl Spiritus btl -
100 Sefadroksil 500 mg tablet 22
101 Spironolakton tablet 100mg tablet -
102 Sulfadiazin tablet 500 mg tablet -
103 Sulfasetamida Natrium tetes mata 15 % botol 10 1
104 Thiamin HCl injeksi 100mg/ml-1ml ampul -
105 Tiamin (vitamin B1) tablet 100 mg (HCL/Nitrat) tablet -
106 Triflouperazin tablet 5 mg tablet -
107 Trimetoprim tablet scored 200 mg tablet -
108 Xilomidon inj vial -
109 Zinc sirup tetes 10mg/ml botol 15 ml -
110 Jelly USG -
-
PERBEKALAN KESEHATAN -
1 Alat suntik sekali pakai 0.05 pcs 983
2 Alat suntik sekali pakai 0.5 pcs 2,814
3 Alat suntik sekali pakai 1 ml pcs -
4 Alat suntik sekali pakai 2,5 ml pcs -
5 Alat suntik sekali pakai 3 ml pcs 68 80
6 Alat suntik sekali pakai 5 ml pcs 84
7 Alat Suntik Sekali Pakai 10 ml pcs -
8 Blood Lancet sakset 92 300
9 Blue Tip sakset 38
10 Catgut / Benang Bedah No. 1/0 dengan jarum bedah pcs -
11 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah pcs -
12 Cyro tube pcs 34
13 Foley Catheter 16 - 18 biji -
14 Foley Catheter no.22 pasang -
15 Handscoon biji 150 1,100
16 Handscoon Steril pasang - 150
17 Handscoon Gynaecolog (Panjang) Set /kantong -
18 Handscoon panjang Steril Set /kantong - 5
19 Infusion set anak buah 8
20 Infusion set dewasa buah 9 5
21 IV Catheter No. 14 G buah -
23 IV Catheter No. 18 G buah 11
24 IV Catheter No. 20 G buah 3 10
25 IV Catheter No. 22 G lusin 6
27 Jarum Jahid no 9 lusin -
33 Jarum Otot Besar No. 15 Bungkus -
34 Jarum Otot Kecil No. 9 Bungkus -
35 Kapas Berlemak 500 gram lembar -
36 Kapas Pembalut / Absorben 250 gram biji - 1
37 Kasa Hidrofil Steril uk. 16 x 16 rol -
38 Kasa Hidrofil Steril uk. 18 x 22 cm rol -
39 Kasa Hidrofil uk. 36 m x 80 cm rol 1 3
40 Kasa Pembalut Elastic 4 m x 3 cm rol -
42 Kasa Pembalut Elastic 4 m x 10 cm sak 5 40
43 Kasa Pembalut Elastic 4 m x 15 cm bungkus - 20
44 Kertas Perkamen bungkus -
45 Klip Obat Kecil buah 500 2,200
46 Klip Obat Tanggung pcs 200 100
47 Kotak Slide buah -
48 Masker buah - 500
49 Mikro Pipet 1000 rol -
50 Mikro Pipet 50-500 rol -
51 Needle 25 G (terumo) pcs 155
52 Nonwoven Fixattion 5x10 rol 3 4
53 Nonwoven Fixattion 10x10 rol 6
54 Pembalut Gips uk. 3" rol -
55 Pembalut Gips uk. 4" buah -
57 Pisau Operasi biji -
58 Plester 5 yards x 2 inch buah -
59 Polifix 5cm x 5m rol -
61 Pot Dahak sakset 16 50
62 Safety box kotak -
63 Sendok syrup biji -
64 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah biji 24 36
65 Slide Set /kantong 112 216
66 Tabung Darah EDTA (Tutup Ungu) pcs - 100
67 Tabung Darah Non EDTA (Tutup Merah) pcs - 100
68 Tranfusion Set biji - 5
69 Underpad biji 10 10
70 Tisue bal -
71 Ultrafix buah -
72 Urine Bag buah -
73 White Tip 2,575
74 Wing Needle No. 21 G -
75 Wing Needle No. 23 G 2
76 Wing Needle No. 25 G buah -
78 Yellow Tip biji 1,550
-
Bahan Laboratorium/Reagensia -
1 Alkohol Swab - 1,000
2 Aquabidest botol - 1
3 Aquadest 1000ml botol -
4 Bilirubin Direk (200ml) botol 200ml -
5 Bilirubin Total (200ml) botol 200ml -
6 Cat Giemsa botol 100ml -
7 Cat Gram kit -
8 Cholesterol Biosystem botol -
9 Cholesterol strip box 25 strip 20 190
10 Creatinin @00ml) Botol 1
11 EDTA 10% Botol -
12 Eosin 2% botol 250ml -
13 Gluco Protein Urine kotak 10 strip 3 100
14 Glukosa Darah Strip (Almedicus) strip -
15 Glukosa Darah Strip (Bene Check) strip 69 200
16 Glukosa Darah Strip (Gluco DR) strip -
17 HCl 0,1 N botol 500ml -
18 HDL Cholesterol (200ml) botol 200ml 1
19 Hematology Analyzer Reagen Set -
20 Hemoglobin Reagen botol 500ml -
21 HIV-Test -
Oncoprobe Anti HIV strip 42
SD Bio Line HIV 1/2 strip 88
SD Intec HIV 1/2 strip 95
Rapid Test Kit III (Tridot) strip 42
22 KOH 100ml botol 100ml -
23 Kolesterol Kit 200ml -
24 Kontrol Darah kit (3ml) -
25 Kontrol serum kit -
26 Larutan Buffer botol 1 liter -
27 Larutan Ressecker botol 100ml -
28 Larutan Turk botol 100ml -
29 Metanol Pro Analisa botol 1 liter -
30 Rapid Test Syphilis test -
31 Reagen Ziehl Neelsen (TBC) paket -
32 Rheumatoid Factor (RF) kit 50 test -
33 RPR Test test -
34 SGOT (200ml) botol -
35 SGPT (200ml) botol -
36 Spiritus botol 1 liter -
37 Stik Urinalisis U10 strip 86
38 Test Asam Urat strip 20 200
39 Test Golongan Darah -
a. Anti A botol 10 ml 0 10
b. Anti B botol 10 ml 0 10
c. Anti AB botol 10 ml 1
d. Anti D botol 10 ml 1
40 Test Kehamilan strip 2 10
41 Tryglicerida (200ml) botol -
42 Urea (200ml) botol -
43 Uric Acid (200ml) botol -
44 Widal Typhi O,H, Paratyphi A-O, B-O, C-O) set -
a. Salmonella Typhi O botol 5ml -
b. Salmonella Paratyphi A-O botol 5ml -
c. Salmonella Paratyphi B-O botol 5ml -
d. Salmonella Paratyphi C-O botol 5ml -
e. Salmonella Typhi H botol 5ml -
f. Salmonella Paratyphi A-H botol 5ml -
g. salmonella Paratyphy B-H botol 5ml -
h. Salmonella paratyphy C-H botol 5ml -
45 Vacutest Kima pcs 35
46 Vacutest 250 μL pcs 200
47 Xylol botol -
HARIAN
UNGKUNG I
Pemakaian (tanggal) JUMLAH SISA KETERAN

9 11 13 15 17 19 21 23 25 PEMAKAI BULAN INI GAN
8 10 12 14 16 18 20 22 24 AN
- -
- 17
- -
54 28 10 122 194
- -
- -
- -
- -
- -
- -
- 100
10 40 10 5 14 31 195 21
30 24 20 20 14 152 18
127 91 36 18 36 96 98 108 159 125 120 52 153 152 150 105 128 123 2,940 548
4 2 1 1 1 1 1 1 2 18 17
- -
- -
36 10 18 36 9 36 23 14 10 45 9 18 44 30 37 561 450
1 1 1 1 1 5 -
3 3 5 3 2 2 1 3 2 2 1 28 14
2 1 1 2 18 7
- -
3 3 6 63
- -
- 100
- -
- -
- -
- -
- 60
- -
48 54 151 194 77 52 56 20 112 14 95 120 101 74 2,036 109
- -
30 60 30
- -
- -
45 36 18 18 18 27 27 54 63 18 18 9 36 36 36 36 36 36 1,015 306
- -
- 4
30 30 30 150 75
10 10 10 19 18 11 141 223
- -
- -
- -
- -
- -
1 1 2 1 1 2 1 1 2 12 1
- -
- 14
- -
- 198
- -
- -
- 1
46 14 9 5 9 9 21 134 278 80
- 1
- 1
- 1
- -
- -
- -
- 4
- -
- -
6 6 24 57
- -
2 3 5 115
1 1 2 3
- 1
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 30
- -
- -
- -
- -
- -
1 1 2 21
- -
- -
- -
- 100
- -
10 10 6 5 10 12 10 10 10 10 140 85
- -
15 15 35 20 10 5 10 38 208 120
- -
30 10 40 83
- -
- -
- -
- -
- -
- -
- -
- -
- 132
- -
57 87 68
- -
- -
- 6
4 15 5 44 39
2 1 1 1 2 8 -
- -
- 100
18 18 63 74
36 18 9 27 36 9 18 9 36 9 27 36 9 9 10 442 410
1 1 1 3 4
- -
- -
- -
10 10 50 50
- -
- -
- -
- -
- -
30 45 135 120 90 30 30 90 15 90 90 65 60 1,310 259
60 60 140
30 1 34 60 20 82 30 50 20 60 60 801 333
- -
- 66
- -
- -
- -
- -
5 5 4
- -
- 97
1 1 2 3
1 2 1 1 12 1
- -
- -
- -
44 32 68 55 72 61 47 32 48 50 20 64 52 28 1,074 586
1 1 -
- -
- -
- -
19 50 -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
1 2 1
- -
32 42 182
- -
- -
- -
- -
- -
- -
43 43 15
- -
- -
- -
12 5 5 5 10 5 15 5 10 77 53
- -
- -
- -
- -
- -
- -
60 80 120 160 100 20 50 11 180 1,241 169
- -
- -
- 2
- -
- -
- -
17 9 27 89 119
- -
- -
- -
1 1 1 1 1 9 7
- -
- -
- -
6 30 10 6 18 12 12 6 18 6 6 9 227 54
- -
- -
- -
- -
- -
- -
- -
3 8 -
- -
- -
- -
- 4
- -
- -
- -
- -
- -
- -
- -
1 30 -
- -
- -
10 10 9
- -
5 3 1 1 1 3 3 3 1 1 3 1 2 3 3 4 54 13
117 83 27 9 149 133 185 190 165 271 28 195 126 109 88 113 100 3,163 262
10 4 2 1 10 1 6 38 12
- -
1 1 -
1 1 1 4 -
- 4
- -
- 2
- -
- -
10 10 20 18 12 9 10 10 10 19 20 234 203
- -
- -
- -
- 2
- -
- -
- -
- -
- -
- -
- -
- -
- -
6 10 6 6 6 6 6 6 6 6 130 291
- -
54 54 - ED
- -
18 3 6 47 161
9 9 10 9 9 9 75 865
- 2
- -
1 1 1 2 1 14 4
- -
- -
- -
- -
30 30 60
10 10 6 6 52 102
- -
- -
97 90 330 255 150 30 30 78 10 130 180 120 120 120 2,859 370
- -
- -
- -
6 13 24 6 6 18 15 6 14 18 238 261
20 50 33
- -
- -
- -
- -
180 114 224 173 282 200 172 160 228 150 137 139 142 211 3,651 510
- -
1 2 1 3 8 14
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
61 102
26 26 55
- -
29 22
37 50
38 69
62 16
- -
- -
45 72
17 17 152
114 48
- -
2 -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
12 6 54 24 24 36 24 6 48 18 42 18 25 19 584 231
1 1 -
- -
3 97
3 4 1 1 12 14
36 18 59 45 27 18 18 18 9 18 18 9 392 113
1 1 2 4 11 18
- -
- -
- -
- -
- -
- -
1 1 4 6
- 20
10 6 12 10 6 56 104
- -
- -
5 5 95
- -
- -
- -
- -
- -
- -
- -
- -
- -
6 6 98
1 1 -
- -
- -
2 1 1 1 2 7 4
- -
- -
- -
- 100
- -
2 1 11 -
1 1 4
- -
- 1
36 16 6 68 24 33 20 32 14 27 33 110 30 40 715 400
- -
- -
- 2
- 5
- -
- -
- -
- -
1 2
- 65
- -
- -
- -
- -
- -
- -
20 6 6 6 6 6 6 6 62 38
6 2 8 91
- -
- 5
- -
- -
16 16 5
- -
- -
- -
- -
- -
- -
- 30
- -
- 20
- -
- -
- -
- -
- -
- -
- -
- -
5 5 5 5 5 50 50
- 5
- -
- -
- -
10 10 9
- -
- -
- 14
- -
- -
- -
- -
2 2 20
- -
- -
2 1 1 1 6 4
- -
- -
- -
- -
- -
- -
- -
- 983
- 2,814
- -
- -
68 68 80
- 84
- -
250 250 142
- 38
- -
- -
- 34
- -
- -
1250 1,250 -
50 50 100
- -
3 3 2
- 8
6 6 8
- -
- -
- 11
7 7 6
2 2 4
1 1 5
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 1
- -
- -
- 4
- -
- -
45 45 -
20 20 -
- -
### 2,200 500
300 300 -
- -
500 500 -
- -
- -
- 155
6 6 1
6 6 -
- -
- -
- -
- -
- -
- -
- -
41 41 25
- -
- -
20 20 40
150 150 178
- 100
- 100
- 5
5 5 15
- -
- -
100 100 2,475
- -
1 1 1
- -
- -
25 25 1,525
750 750 250

- 1
- -
- -
- -
- -
- -
- -
91 91 119
- 1
- -
- -
95 95 8
- -
30 30 239
- -
- -
- 1
- -
- -
- 42
- 88
- 95
- 42
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
12 12 74
110 110 110
1 1 9
1 1 9
- 1
- 1
7 7 5
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
35 35 -
- 200
- -
REGISTER OBAT HARIAN
UPT PUSKESMAS KLUNGKUN

Bulan : Desember
Tahun : 2017
NO NAMA OBAT/BARANG SATUAN P
SISA TERIMA
BULAN BULAN 26 28 30 1 3 5 7
LALU INI 27 29 31 2 4 6
2 Albendazol tablet 400mg tablet 17
3 Albendazol suspensi 200mg/5ml botol 10 ml -
4 Alopurinol tablet 100 mg tablet 194 200 20 40 15 55
5 Alopurinol tablet 300 mg tablet -
6 ALT (Artemeter 20mg + Lumefantrin 120mg) tablet -
7 Amilorid tablet 5mg tablet -
8 Aminofilin injeksi 24mg/ml Ampul -
9 Aminofilin tablet 150mg tablet -
10 Aminofilin tablet 200 mg tablet -
11 Amitripilin tablet salut 25 mg (HCL) tablet 100
12 Amlodipine tablet 10mg tablet 21 480 30 35 30
13 Amlodipine tablet 5mg tablet 18 180 5 20 30 10 10 5
14 Amoksisilin kaplet 500 mg tablet 548 3,000 164 128 110 54 66 103 59 80 75
15 Amoksisilin sirup forte 250 mg/5ml botol 60 ml 17 30 3 4 1 1 1
16 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/ml Vial -
17 Ampisilin serbuk injeksi i.m./i.v. 250 mg/ml vial -
mg 450 300 27 27 36 27 18 36 27 18 9
19 Antasida DOEN sirup kombinasi botol 60 ml - 20 2
20 tube
Basitrasin 500 IU/g + polimiksin 10.000 IU/g 14 15 1 1 1 1 1
21
Betametason + Neomicyn 7 57 1 1 5 1 5 2 1
22 pot
Asam Benzoat 6% + Asam Salisilat 3% -
23 sup
Bismut Subgalat 150 mg + Heksaklorofen 250 mg 63 3 3 3
24 tablet
Pirimatamin 25 mg + Sulfadoksin 500 mg -
Antimigren :
25 tablet
Ergotamin tartrat 1 mg + Kofein 50 mg 100
26 tablet
Karbidopa 25 mg + Levodopa 250 mg -
27 Aqua Pro Injeksi Steril, bebas pirogen Vial -
28 Artesunat serbuk injeksi 60mg/ml Vial -
29 Arthemeter injeksi 80mg/ml vial -
30 Asam Asetil Salisilat tablet 80 mg tablet 60
32 Asam Askorbat (vitamin C) tablet 50 mg tablet 109 2,500 81 107 61 51 126 69 44 94 41
33 Asam Folat tablet 0,4 mg tablet -
34 Asam Folat tablet 1mg tablet 30 100
35 Asam Folat tablet 5 mg tablet -
36 Asam mefenamat tablet 250mg kapsul -
37 Asam mefenamat tablet 500mg tablet 306 1,300 54 45 45 36 18 18 18 27 27
38 Asam Salisilat larutan 0,1% pot 30 g -
39 Asiklovir tablet 200mg tablet 4
41 Atapulgit tablet tablet 223 200 9 18 9 9 9 9 9
42 Atenolol tablet 50 mg tablet -
ampul @ 1
ml -
44 Atropin tablet 0,5 mg tablet -
47 Betametason krim 0,1 % tube 1 25 1 1 1
48 Betametason tetes mata 1mg/ml botol -
49 Bisakodil sup 10 mg sup 14
50 Bisakodil sup 5 mg sup -
51 Bisakodil tablet 5mg tablet 198
52 Coal tar larutan 15% botol -
53 Dapson tablet 100mg tablet -
1
55 Deksametason tablet 0,5mg tablet 80 200 5 18 23 9 9
ampul @ 2
ml 1
61 Dietil karbamazin sitrat tablet 100mg tablet -
ampul @ 1
ml 4
63 Digoksin tablet 0,25 mg tablet -
64 Diltiazem tablet 30 mg tablet -
65 Dimenhidrinat tablet 50 mg tablet 57
66 Doksisiklin kapsul 100mg kapsul -
67 Domperidon tablet 10mg tablet 115 1
68 Domperidon suspensi 5mg/5ml botol 3 5 1
ampul @ 1
ml 1
70 Ergokalsiferol (Vit D2) kapsul 50.000 IU kapsul -
-
72 Ergotamin tablet 1mg tablet -
73 Eritromisin kapsul 250 mg kapsul -
74 Eritromisin sirup 200 mg/ 5 ml btl 60 ml -
77 Etambutol tablet salut 500 mg (HCl) tablet -
78 Etanol 70% larutan btl 1000 ml - 1
79 Eugenol cairan btl 10 ml -
80 Fenitoin Natrium Injeksi 100 mg/2ml ampul -
81 Fenitoin Natrium Injeksi 50 mg/ml ampul -
84 Fenobarbital injeksi50mg/ml ampul -
85 Fenobarbital tablet 100mg tablet -
86 Fenobarbital tablet 30 mg tablet 30
89 Ferro Fumarat kapsul lunak 300mg kapsul -
90 Ferro Sulfat sirup 15mg/5ml botol -
91 Ferro Sulfat tablet 300mg tablet -
ampul @ 1
ml 21 2
93 Fitomenadion (Vit. K1) tablet salut gula 10 mg tablet -
94 Fluphenaszine Decanoate i.m 25 mg/ml ampul 1 ml - 8
ampul @ 2
ml -
96 Furosemid tablet 40 mg tablet 100
97 Galactose microparticle 200-400mg micropart/ml botol -
dihidrat 0,58 g 85 125 11 10 10 18 6 6
99 Glibenklamida tablet 2,5 mg tablet -
100 Glibenklamida tablet 5 mg tablet 120 100 3 20 8 15
101 Glimepirid tablet 1mg tablet -
102 Glimepirid tablet 2mg tablet 83 15
103 Glipzide tablet 5mg tablet -
104 Gliseril Trinitrat tablet sublingual 0,5mg tablet -
105 Gliserin tetes 100mg/ml botol -
106 Gliserin tetes 10mg/ml btl 100 ml -
ampul @ 1
ml -
110 Haloperidol tablet 0,5 mg tablet -
111 Haloperidol tablet 1,5 mg tablet 132
112 Haloperidol tablet 2 mg tablet -
113 Haloperidol tablet 5 mg tablet 68 300 90 20
114 Haloperidol tetes 2mg/ml botol -
115 Hexamin mandelatb tablet tablet -
116 Hidrogen Peroksida 3% botol 6
117 Hidroklorotiazida tablet 25 mg tablet 39 100 15
118 Hidrokortison krim 2,5% tube - 15
119 Hidrokortison serbuk injeksi 100mg/vial vial -
120 Hyosine Butil Bromide tablet 10 mg tablet 100
121 Ibuprofen tablet 200 mg tablet 74 9
122 Ibuprofen tablet 400 mg tablet 410 600 9 27 27 63 27 36
123 Ibupropen sirup 100mg/5ml botol 60 ml 4
124 Ibupropen sirup 200mg/5ml botol 60 ml -
125 Ipratropim Bromide inhaler padat 20mg kapsul -
126 Ipratropim Bromide nebulizer 0,025% ampul -
127 Isoniazid tablet 100 mg tablet 50 100 20 5 10
128 Isoniazid tablet 300 mg tablet -
129 Isosorbid Dinitrat Tablet Sublingual 5 mg tablet -
130 Kalamin lotion botol -
131 Kalsium Glukonat inj 100mg/ml ampul -
132 Kalsium karbonat tablet 500mg tablet -
133 Kalsium Laktat (Kalk) tablet 500 mg tablet 259 900 65 70 45 30 90 40 30 75
134 Kaptopril tablet 12,5 mg tablet 140 200 10 60
135 Kaptopril tablet 25 mg tablet 333 600 30 20 10 40 20 30 60
-
137 Karbamazepin tablet 200mg tablet 66
138 Karbogliserin tetes telinga 10% btl 5 ml -
-
-
-
142 Ketokonazol tablet 200mg tablet 4 50
143 Klofazimin kapsul 100 mg micronize kapsul -
144 Kloramfenikol kapsul 250 mg kapsul 97
145 Kloramfenikol salep kulit 2% tube 3
146 Kloramfenikol salep mata 1% tube 1 19 1 2 1 1 2
147 Kloramfenikol suspensi 125 mg/5 ml btl 60 ml -
148 Kloramfenikol Tetes mata 0,5% botol -
149 Kloramfenikol Tetes mata 1% botol -
150 Klorfeniramin mealeat (CTM) tablet 4 mg tablet 586 1,200 55 91 72 28 39 59 56 25 39
151 Klorhexidin larutan 7.5% 1 liter botol -
152 Klorhexidin larutan 15% botol -
ampul @ 2
ml -
154 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCL) ampul -
155 Klorpromazin tablet salut 100 mg (HCL) tablet - 300 30 20
156 Klorpromazin tablet salut 25 mg (HCL) tablet -
157 Klortalidon tablet 50 mg tablet -
160 Kombinasi Ipratropium 0,5mg dan Salbutamol 2,5mg nebulizer ampul -
161 Kombinasi Kaolin 550mg dan Pektin 20mg tablet tablet -
162 Kontrasepsi Injeksi vial -
163 Kontrasepsi Inplant etonogestrel 68 mg biji -
164 Kontrasepsi inplant levonorgestrel 75 mg biji -
165 Kontrasepsi Oral paket -
166 Kotrimoksazol Suspensi botol 60 ml 1 5 1
167 tablet
Sulfametoksazol 100 mg, Trimetoprim 20 mg -
168 tablet
Sulfametoksazol 400 mg, Trimetoprim 80 mg 182
169 Kuinin inj 25% ampul @ 2 ml -
173 larutan Lugol botol -
174 Lidokain gel 2% Syringe @ 10 g -
175 Lidokain inj 2% ampul 15 60
176 Lidokain inj 1% ampul -
177 Lidokain injeksi 2% (HCL) + Epinefrin 1 : 80.000 ampul -
178 Lidokain Semprot 10% botol -
179 Loratadine tablet 10mg tablet 53 5 15
182 Magnesium Sulfat serbuk 30 gram sakset -
183 Mebendazol sirup 50 mg / ml btl 30 ml -
186 Metformin HCl tablet 500 mg tablet 169 1,100 70 30 30 100 30 60
187 Metformin HCl tablet 850 mg tablet -
-
189 Metilergometrin Maleat injeksi 0,200 mg -1 ml ampul 2 3
190 Metoklopramide HCl tablet 10mg tablet -
191 Metoklorpramide tablet 5mg tablet -
192 Metronidazol tablet 250 mg tablet -
193 Metronidasol tablet 500mg tablet 119 100 18 9 13 9
194 Metronidazol infus 500 mg/100 ml btl 100 ml -
195 Metronidazol sirup 125mg/5ml botol -
196 Metronidazole supp 500mg sup -
197 Mikonazol krim /salep 2 % tube 7 5
198 Mikonazol serbuk 2% botol -
199 Natrium Bikarbonat tablet 500 mg tablet -
200 Natrium Diklofenak tablet 25 mg tablet -
201 Natrium Diklofenak tablet 50 mg tablet 54 350 12 12 22 6 6 34 16
Natrium Thiosulfat injeksi i.v. 25 % ampul @ 10
202
ml -
206 Nipedipin tablet 10mg tablet -
207 Nistatin suspensi 100.000 IU/ml botol -
208 Nistatin tablet salut 500.000 IU/g tablet -
209 Nistatin Vaginal tablet salut 100.000 IU/g tablet -
210 Nitrofurantoin tablet 100 mg tablet -
211 Norepinefrin injeksi 1mg/ml ampul -
212 OAT FDC Anak paket -
213 OAT FDC I paket 4
214 OAT FDC II paket -
215 OAT FDC Sisipan paket -
216 OAT Kombipak I paket -
221 Oksitosin injeksi 10 UI/ml-1 ml ampul - 10 2
222 Olopatadin tetes mata 1% botol -
-
224 Omeprazol kapsul 20mg kapsul 9 60 5 5
225 Paraformaldehid tablet 1 gram tablet -
226 Parasetamol sirup 120 mg / 5 ml btl 60 ml 13 100 2 8 6 1 3 4 2 3 6
227 Parasetamol tablet 500mg tablet 262 3,300 163 170 113 63 132 154 127 137 69
228 Parasetamol tetes 60mg/0,6 ml botol 12 40 7 2 1 6 2
229 Perak Nitrat larutan 20% botol -
230 Perak Sulfadiazin krim 1% tube - 1 1
231 Permetrin krim 5% tube - 11 1 1 1
232 Pirantel sirup 125 mg/5 ml btl 60 ml 4
234 Pirantel tab. Score (base) 250 mg tablet 2
236 Pirazinamid tablet 500 mg tablet -
237 Piridoksin (Vitamin B6) tablet 10 mg (HCL) tablet 203 200 20 16 10 10 10
238 Piridoksin (Vitamin B6) tablet 20 mg (HCL) tablet -
239 Piridoksin injeksi 100mg/ml tablet -
240 Povidon Iodida larutan 10 % btl 30 ml -
241 Povidon Iodida larutan 10% botol 300ml 2 2
244 Prednison tablet 5 mg tablet -
245 Primakuin tablet 125mg tablet -
246 Probenesid tab 500 mg tablet -
249 Propanolol tablet 10 mg (HCl) tablet -
250 Propillitiourasil tablet 100 mg tablet -
251 Ranitidin tablet 150mg tablet 291 200 18 6 24 12 6 12
252 Retinol (vitamin A) kapsul lunak 100.000IU kapsul -
253 Retinol kapsul 200.000 IU kapsul - 100
254 Salbutamol inhaler 0,5% botol -
255 Salbutamol tablet 2 mg (sebagai sulfat) tablet 161 2
256 Salbutamol tablet 4 mg (sebagai sulfat) tablet 865 9 2 2 9 9 9
257 pot
Asam Salisilat 2% + Belerang endap 4% 2 2
258 Salep Asam Salisilat 5% pot -
259 Salisil bedak 2% ktk 50 gram 4 40 1 1 1 3 2 2
260 Setrizine sirup 5mg/5ml botol - 5
261 Sianokobalamin (Vitamin B12) injeksi 500 mcg ampul -
262 Sianokobalamin (Vitamin B12) tablet 50 mcg tablet -
263 Simvastatin tablet 10 mg tablet - 30
264 Simvastatin tablet 20 mg tablet 60
265 Siprofloksasin tablet 500mg tablet 102 100 6 10 6 10 10
266 Spironolakton tablet 25 mg tablet -
267 Streptomycin injeksi 1000 mg / vial visl -
268 Tablet Tambah Darah tablet 370 1,700 60 80 105 70 120 60 110 150
269 Tetrakain HCL tetes mata 0,5% botol -
272 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) tablet 261 5 6 12 18 6
273 Triheksifenidil tablet 2 mg tablet 33 300 30 20
274 Tuberkulin injeksi 1 : 10 (i.k). vial -
275 Valproat sirup 250mg/5ml botol -
278 Vitamin B Kompleks tablet tablet 510 4,000 140 211 150 112 265 168 136 133 124
279 Zinc serbuk 10mg sakset -
280 Zinc sirup 20mg/5ml botol 60 ml 14 5 1 3 2
281 Zink Dispersible tablet 20mg tablet - 100
-
-
VAKSIN DAN SERUM -
1 Serum Anti Bisa Ular ABU I vial 4 ml -
2 Serum Anti Bisa Ular ABU II vial 50 ml -
3 Serum Antidifteri (ADS) inj 10.000 IU vial @ 50 ml -
4 Serum Antidifteri (ADS) inj 20.000 IU vial 5 ml -
5 Serum Antirabies inj 100 IU/ml vial # 20 ml -
6 Serum Antirabies inj 200 IU/ml -
7 Serum Antitetanus (ATS) 1.500 IU/amp amp 1 ml -
8 Serum Antitetanus (ATS) 10.000 IU/amp ampul @ 2 ml -
9 Serum Antitetanus (ATS) 20.000 IU/vial vial 5 ml -
10 Hepatitis B Imunoglobulin (Human) injeksi 0,5ml Vial 102
11 Human tetanus Imunoglobulin injeksi 250 IU (i.m) syringe 55
12 Human tetanus Imunoglobulin injeksi 500 IU (i.m) syringe -
13 Vaksin BCG vial 22
14 Vaksin campak vial 50
15 Vaksin kombinasi DPT+Hepatitis B vial 69
16 Vaksin jerap DT vial 16
17 Vaksin jerap DPT vial -
18 Vaksin jerap tetanus vial -
19 Vaksin polio vial 72
20 Vaksin rabies, untuk manusia 152
21 Tetanus Toxoid inj vial 48
-
-
OBAT GIGI -
1 Devitalisasi Pasta (Non Arsen) btl / ktk -
2 Etil Klorida spray btl 100 ml - 3
3 Glass Ionomer Cement ART set / botol -
4 Kalsium Hidroksida Pasta ktk 2 tube -
5 Klorfenol kamfer Menthol ( CHKM ) btl 10 ml -
6 Mummifying Pasta btl / kotak -
7 Semen Seng Fosfat serbuk dan cairan -
8 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan -
9 Formokresol cairan botol -
10 Gutta Percha dan paper point biji -
11 klorhexidin larutan 0,2% botol -
12 Natrium Hipoklorit cairan konsentrat 5% botol -
13 Nistatin Suspensi 100.000IU/ml botol -
14 Fluor tablet 0,5mg tablet -
15 Fluor tablet 1mg tablet -
16 Fluor Sediaan Topikal pot -
17 Pasta Pengisi Saluran Akar tablet -
18 Komposit Resin botol -
19 Articulating paper buah -
20 Lidokain pasta 5% tablet -
21 Fuji I botol -
22 Fuji IX botol -
23 Spongestan Gelatin buah -
24 Cavit G buah -
25 Avogyl buah -
26 Saliva Ejektotor biji -
27 TKF -
28 Ceivitron -
Lain-lain -
1 Acetylsystein 200mg kapsul 231 240 18 34 12 18 24 30 30 6 6
2 Alkohol 70 % 100 ml botol -
3 Alprazolam 1 mg tablet -
4 Alprazolam 0.5 mg tablet 97
6 Ambroxol tablet 30 mg tablet 113 800 18 18 18 18 45 9
8 Aquadest steril botol 1000 ml -
14 Asiklovir krim 5 % tube 5 gram 6 2
15 Azytromicn 500 mg tablet 20
16 Betahistin Metisalat tablet 6 mg tablet 104 150 12 6 6 24 9 6
17 Calcium Alginate (Bioplacenton) tulle sachet -
18 Cefixime 100 mg kapsul -
19 Cefixime 200 mg + Azitromycin 500 mh (Kombipak) paket -
20 Cetirizin kapsul 10 mg kapsul 95 10
21 Cimetidin tablet 200mg tablet -
22 Clavamox injeksi 1.000 IV 1,2 gr vial -
23 Clobazam tablet 10 mg tablet - 100
24 Co Amoxiclav capsul 625 mg capsul -
25 Digoksin 0,0625 mg tablet -
26 Digoksin injeksi 0,25 mg/ml ampul @ 2 ml -
27 Dopamin injeksi ampul -
28 Efedrin tablet 25 mg (HCL) tablet -
29 Ekstraks belladona tablet 10 mg tablet -
30 Erythromicin kapsul 500mg kapsul 98
31 Etakridin larutan 0,1% btl 300ml - 2
32 Fenilbutason tablet 200 mg tablet -
33 Fenitoin kapsul 30 mg (garam natrium) kapsul -
34 Fenol Gliserol TT 10% botol 4 5 1
35 Fitomenadion (Vit. K1) injeksi 10 mg/ml ampul @ 1 ml - 5
36 Flukonazol tablet 150 mg tablet -
37 Fluoksetine hcl 20mg kapsul 90
38 Fluoresein tetes mata 2,5mg/ml botol -
39 Framycetin sulfat lembar 100
40 Gentamicin krim 0,1% tube -
41 Gentamisin salep kulit 0,1% tube -
42 Gentamisin Sulfat tetes mata 5 ml btl 10 ml 4 5 1 1
43 Gentamycin injeksi 40mg/ml ampul @ 2 ml -
44 Gentian Violet 1% botol 1
45 Gliseril Gualakolat tablet 100 mg tablet 400 1,400 39 66 34 30 39 33 39 76 23
46 Glukosa larutan infus 10% btl 500 ml -
47 Glukosa larutan infus 40% ampul -
48 Glukosa larutan infus 5% btl 500 ml 2
49 Hyoscine N-Butylbromide injeksi 20mg/ml ampul @ 1 ml 5
50 Ketokenazol krim 2% tube -
51 Ketoprofen injeksi ampul -
54 Kloramfenikol Tetes Telinga 3% botol 2
55 Klozapine 25mg tablet - 100
56 Lansoprazol kapsul 30 mg kapsul 65
57 Lisol botol -
58 Lisol (Kresol tersaponifikai 50%) btl 1000 ml -
59 Meloksikam tablet 7,5 mg tablet -
60 Metakresol Sulfonat solution btl -
61 Metampiron 250mg, Aminofenazon 50mg, Silokain HCl 15mg inj vial -
62 Metampiron tablet 500 mg tablet -
63 Methylprednisolon tablet 4 mg tablet 38 100 9
64 Methylprednisolon tablet 8 mg tablet 91 6
65 Methylprednisolon tablet 16 mg tablet -
66 Metoklopramide HCl injeksi 5mg/ml10mg ampul 5
67 Multivitamin sirup botol -
68 Natrium Bikarbonat injeksi (Meylon) ampul 25 ml -
69 Natrium Klorida larutan infus 0,9 % btl 500 ml 5 19
70 Natrium Klorida larutan infus 3% btl 500 ml -
71 Neomycin Sulfat 0,5%, placenta extr. 100mg/ml tube -
72 New diaform tablet -
73 Obat Batuk hitam ( O.B.H.) btl 100 ml - 5
74 Oksitetrasiklin HCL salep mata 1 % tube -
75 Oksitetrasiklin salep kulit tube 5 gram -
76 Ondancentron tablet 4mg tablet 30
77 Papaverin tablet tablet -
78 Parasetamol Rectal 125mg sup 20 12
79 Parasetamol tablet 100 mg tablet -
80 Pehacain injeksi ampul -
81 Petidin injeksi 50 mg/ml ampul @ 2 ml -
82 Pilokarpin tetes mata 2 % (HCL/Nitrat) btl 5 ml -
83 Pilokarpin tetes mata 4% btl 5 ml -
84 Piracetam injeksi 1 gr / 5ml ampul -
85 Piracetam tablet 800mg tablet -
86 Piroxicam kapsul 10mg tablet -
87 Piroxicam kapsul 20mg tablet 50 100 8 10 5 5 5
88 Ranitidin injeksi 25mg/2ml ampul 5
89 Retinol (Vitamin A) tablet 50.000 IU tablet -
90 Rifampisin kaplet 600 mg tablet -
91 Rifampisin tablet salut 450 mg tablet -
92 Ringer Laktat larutan infus btl 500 ml 9 5
93 Risperidone tablet 2mg tablet - 200
94 Salbutamol inhaler botol -
95 Salbutamol Nebulizer 2,5mg/2,5ml ampul 14
96 Salbutamol Rotahaler pcs -
97 Salbutamol serbuk kapsul inhaler 200 mg kapsul -
98 Salbutamol sirup 2 mg / 5 ml botol -
99 Salicyl Spiritus btl -
100 Sefadroksil 500 mg tablet 20
101 Spironolakton tablet 100mg tablet -
102 Sulfadiazin tablet 500 mg tablet -
103 Sulfasetamida Natrium tetes mata 15 % botol 4 5 1 1 2
104 Thiamin HCl injeksi 100mg/ml-1ml ampul -
105 Tiamin (vitamin B1) tablet 100 mg (HCL/Nitrat) tablet -
106 Triflouperazin tablet 5 mg tablet - 200
107 Trimetoprim tablet scored 200 mg tablet -
108 Xilomidon inj vial -
109 Zinc sirup tetes 10mg/ml botol 15 ml - 14
110 Jelly USG -
-
PERBEKALAN KESEHATAN -
1 Alat suntik sekali pakai 0.05 pcs 983
2 Alat suntik sekali pakai 0.5 pcs 2,814
3 Alat suntik sekali pakai 1 ml pcs -
4 Alat suntik sekali pakai 2,5 ml pcs -
5 Alat suntik sekali pakai 3 ml pcs 80 155
7 Alat Suntik Sekali Pakai 10 ml pcs -
8 Blood Lancet sakset 142
9 Blue Tip sakset 38
10 Catgut / Benang Bedah No. 1/0 dengan jarum bedah pcs -
11 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah pcs - 24
12 Cyro tube pcs 34
13 Foley Catheter 16 - 18 biji -
14 Foley Catheter no.22 pasang -
15 Handscoon biji - 1,800
16 Handscoon Steril pasang 100 250
17 Handscoon Gynaecolog (Panjang) Set /kantong - 5
18 Handscoon panjang Steril Set /kantong 2
19 Infusion set anak buah 8
20 Infusion set dewasa buah 8
25 IV Catheter No. 22 G lusin 4 2
26 IV Catheter No. 24 G lusin 5 2
33 Jarum Otot Besar No. 15 Bungkus -
34 Jarum Otot Kecil No. 9 Bungkus -
35 Kapas Berlemak 500 gram lembar -
36 Kapas Pembalut / Absorben 250 gram biji 1
37 Kasa Hidrofil Steril uk. 16 x 16 rol -
38 Kasa Hidrofil Steril uk. 18 x 22 cm rol -
39 Kasa Hidrofil uk. 36 m x 80 cm rol 4 4
41 Kasa Pembalut Elastic 4 m x 5 cm rol - 75
42 Kasa Pembalut Elastic 4 m x 10 cm sak - 15
43 Kasa Pembalut Elastic 4 m x 15 cm bungkus -
44 Kertas Perkamen bungkus - 2
45 Klip Obat Kecil buah 500 1,300
46 Klip Obat Tanggung pcs - 500
47 Kotak Slide buah -
48 Masker buah - 1,250
49 Mikro Pipet 1000 rol -
50 Mikro Pipet 50-500 rol -
51 Needle 25 G (terumo) pcs 155
52 Nonwoven Fixattion 5x10 rol 1 1
53 Nonwoven Fixattion 10x10 rol - 1
55 Pembalut Gips uk. 4" buah -
57 Pisau Operasi biji - 90
58 Plester 5 yards x 2 inch buah -
61 Pot Dahak sakset 25 45
62 Safety box kotak -
63 Sendok syrup biji -
64 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah biji 40
65 Slide Set /kantong 178
66 Tabung Darah EDTA (Tutup Ungu) pcs 100
67 Tabung Darah Non EDTA (Tutup Merah) pcs 100
68 Tranfusion Set biji 5
69 Underpad biji 15 10
70 Tisue bal - 3
71 Ultrafix buah -
72 Urine Bag buah -
73 White Tip 2,475
74 Wing Needle No. 21 G -
75 Wing Needle No. 23 G 1
78 Yellow Tip biji 1,525
-
Bahan Laboratorium/Reagensia -
1 Alkohol Swab 250 300
2 Aquabidest botol 1
3 Aquadest 1000ml botol -
4 Bilirubin Direk (200ml) botol 200ml -
5 Bilirubin Total (200ml) botol 200ml -
6 Cat Giemsa botol 100ml -
7 Cat Gram kit -
8 Cholesterol Biosystem botol -
9 Cholesterol strip box 25 strip 119 10
10 Creatinin @00ml) Botol 1
11 EDTA 10% Botol -
12 Eosin 2% botol 250ml -
13 Gluco Protein Urine kotak 10 strip 8 50
14 Glukosa Darah Strip (Almedicus) strip -
15 Glukosa Darah Strip (Bene Check) strip 239 100
16 Glukosa Darah Strip (Gluco DR) strip -
17 HCl 0,1 N botol 500ml -
18 HDL Cholesterol (200ml) botol 200ml 1
19 Hematology Analyzer Reagen Set -
20 Hemoglobin Reagen botol 500ml -
21 HIV-Test -
Oncoprobe Anti HIV strip 42
SD Bio Line HIV 1/2 strip 88 200
SD Intec HIV 1/2 strip 95
Rapid Test Kit III (Tridot) strip 42
22 KOH 100ml botol 100ml -
23 Kolesterol Kit 200ml -
24 Kontrol Darah kit (2.5ml) - 1
25 Kontrol serum kit -
26 Larutan Buffer botol 1 liter -
27 Larutan Ressecker botol 100ml -
28 Larutan Turk botol 100ml -
29 Metanol Pro Analisa botol 1 liter -
30 Rapid Test Syphilis test -
31 Reagen Ziehl Neelsen (TBC) paket - 1
32 Rheumatoid Factor (RF) kit 50 test -
33 RPR Test test -
34 SGOT (200ml) botol -
35 SGPT (200ml) botol -
36 Spiritus botol 1 liter -
37 Stik Urinalisis U10 strip 74
38 Test Asam Urat strip 110
39 Test Golongan Darah -
a. Anti A botol 10 ml 9
b. Anti B botol 10 ml 9
c. Anti AB botol 10 ml 1
d. Anti D botol 10 ml 1
40 Test Kehamilan strip 5
41 Tryglicerida (200ml) botol -
42 Urea (200ml) botol -
43 Uric Acid (200ml) botol -
44 Widal Typhi O,H, Paratyphi A-O, B-O, C-O) set -
a. Salmonella Typhi O botol 5ml -
b. Salmonella Paratyphi A-O botol 5ml -
c. Salmonella Paratyphi B-O botol 5ml -
d. Salmonella Paratyphi C-O botol 5ml -
e. Salmonella Typhi H botol 5ml -
f. Salmonella Paratyphi A-H botol 5ml -
g. salmonella Paratyphy B-H botol 5ml -
h. Salmonella paratyphy C-H botol 5ml -
45 Vacutest Kima pcs -
46 Vacutest 250 μL pcs 200
47 Xylol botol -
R OBAT HARIAN
MAS KLUNGKUNG I
Pemakaian (tanggal) JUMLAH SISA KETERAN

9 11 13 15 17 19 21 23 25 27 29 31 PEMAKAI BULAN INI GAN
8 10 12 14 16 18 20 22 24 26 28 30 AN
- -
- 17
- -
40 30 70 100 60 430 (36)
- -
- -
- -
- -
- -
- -
- 100
5 20 5 30 15 5 40 60 20 5 35 10 60 405 96
5 15 15 30 5 15 165 33
72 53 134 161 107 53 54 117 135 113 113 152 89 101 159 2,452 1,096
1 2 1 1 1 6 22 25
- -
- -
9 9 54 37 18 36 27 9 9 9 9 36 36 27 550 200
1 1 3 1 1 9 11
2 1 2 1 2 2 1 16 13
4 2 1 1 2 1 6 4 2 3 2 2 46 18
- -
2 11 52
- -
- 100
- -
- -
- -
- -
- 60
- -
95 34 178 48 148 33 89 88 18 35 97 79 47 126 1,789 820
- -
- 130
30 30 (30)
- -
27 33 30 54 36 27 21 81 54 27 18 45 51 45 54 891 715
- -
- 4
15 30 105 70
9 9 9 9 9 9 10 19 155 268
- -
- -
- -
- -
- -
1 2 1 1 1 2 1 12 14
- -
- 14
- -
- 198
- -
- -
- 1
9 9 4 3 9 18 18 134 146
- 1
- 1
- 1
- -
- -
- -
- 4
- -
- -
- 57
- -
5 3 9 106
1 1 1 4 4
- 1
- -
- -
- -
- -
- -
- -
- -
- -
- 1
- -
- -
- -
- -
- -
- -
- -
- 30
- -
- -
- -
- -
- -
2 19
- -
1 1 7
- -
- 100
- -
6 10 5 6 20 6 4 9 127 83
- -
15 15 15 18 10 23 142 78
- -
5 20 63
- -
- -
- -
- -
- -
- -
- -
- -
- 132
- -
30 140 228
- -
- -
- 6
15 15 45 94
1 1 1 2 5 10
- -
- 100
9 9 9 36 38
9 72 27 36 9 9 27 9 18 9 9 423 587
1 1 3
- -
- -
- -
10 5 10 60 90
- -
- -
- -
- -
- -
60 120 15 75 60 30 30 35 60 90 1,020 139
100 20 20 210 130
80 30 40 1 60 30 60 60 571 362
- -
- 66
- -
- -
- -
- -
7 7 47
- -
- 97
- 3
1 1 1 2 1 13 7
- -
- -
- -
69 32 64 62 33 50 27 59 55 53 57 58 89 77 92 1,341 445
- -
- -
- -
- -
30 80 220
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
1 2 4
- -
20 20 162
- -
- -
- -
- -
- -
- -
- 75
- -
- -
- -
5 10 35 18
- -
- -
- -
- -
- -
- -
10 60 120 136 10 75 70 134 20 2 957 312
- -
- -
- 5
- -
- -
- -
9 5 6 4 10 11 1 95 124
- -
- -
- -
2 1 1 1 2 7 5
- -
- -
- -
6 18 6 24 12 22 6 6 12 38 10 24 18 310 94
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 4
- -
- -
- -
- -
- -
- -
- -
2 8
- -
- -
5 5 10 5 5 40 29
- -
3 1 1 3 12 3 2 5 1 4 2 1 5 1 5 84 29
61 37 166 164 110 82 104 106 110 91 156 118 92 142 179 2,846 716
6 1 1 2 8 36 16
- -
1 -
3 6 5
1 1 3
- -
- 2
- -
- -
10 10 8 30 10 5 23 10 10 182 221
- -
- -
- -
- 4
- -
- -
- -
- -
- -
- -
- -
- -
- -
6 6 12 12 36 6 6 6 14 6 6 15 12 221 270
- -
- 100 ED
- -
9 11 150
12 18 14 4 9 9 9 115 750
2 -
- -
2 1 1 3 2 2 2 1 1 4 29 15
1 1 4
- -
- -
10 5 45 (45)
- 60
20 10 10 10 30 20 142 60
- -
- -
90 10 255 15 90 10 60 97 60 67 105 30 120 1,764 306
- -
- -
- -
16 6 16 10 15 6 6 12 134 127
44 10 10 44 158 175
- -
- -
- -
- -
75 56 128 241 225 76 111 133 182 193 94 100 125 145 234 3,557 953
- -
6 13
- 100
-
-
-
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 102
- 55
- -
- 22
- 50
- 69
- 16
- -
- -
- 72
- 152
- 48
-
-
-
- -
- 3
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
-
6 36 11 6 12 6 12 24 291 180
- -
- -
- 97
1 1 1 1 2 2 1 1 1 2 16 12
27 10 9 104 9 9 36 27 45 9 9 9 18 447 466
2 2 3 1 1 12 16
- -
- -
- -
- -
- -
- -
1 1 4 2
- 20
12 9 6 6 12 9 6 12 6 141 113
- -
-
- -
10 5 10 5 5 45 50
- -
- -
- 100
- -
- -
- -
- -
- -
- -
- 98
- 2
- -
- -
2 1 4 5
- 5
- -
- -
- 100
- -
- -
1 1 2 1 7 2
- -
- 1
74 3 49 59 103 68 61 113 147 88 71 106 99 90 113 1,623 177
- -
- -
- 2
- 5
- -
- -
- -
- -
- 2
- 65
- -
- -
- -
- -
- -
- -
6 9 9 6 39 99
10 4 3 23 68
- -
- 5
- -
- -
- 24
- -
- -
- -
3 2 5 -
- -
- -
- 30
- -
1 1 31
- -
- -
- -
- -
- -
- -
- -
- -
5 10 5 5 5 10 10 15 98 52
- 5
- -
- -
- -
- 14
- 200
- -
- 14
- -
- -
- -
- -
- 20
- -
- -
1 5 4
- -
- -
20 10 14 44 156
- -
- -
3 3 11
- -
-
-
- 983
- 2,814
- -
- -
- 235
- 84
- -
- 142
- 38
- -
- 24
- 34
- -
- -
- 1,800
- 350
- 5
- 2
- 8
- 8
- -
- -
- 13
- 16
- 6
- 7
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 1
- -
- -
- 8
- -
- 75
- 15
- -
- 2
- 1,800
- 500
- -
- 1,250
- -
- -
- 155
- 2
- 1
- -
- -
- -
- 90
- -
- -
- -
- 70
- -
- -
- 40
- 178
- 100
- 100
- 5
- 25
-
- -
- -
- 2,475
- -
- 1
- -
- -
- 1,525
-
-
- 550
- 1
- -
- -
- -
- -
- -
- -
- 129
- 1
- -
- -
- 58
- -
- 339
- -
- -
- 1
- -
- -
-
- 42
- 288
- 95
- 42
- -
- -
- 1
- -
- -
- -
- -
- -
- -
- 1
- -
- -
- -
- -
- -
- 74
- 110
-
- 9
- 9
- 1
- 1
- 5
- -
- -
- -
-
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 200
-
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Pelaporan Bulan : Desember 2017
Permintaan Bulan : Januari 2018
Nomor Dokumen :
NO NAMA OBAT/BARANG SATUAN
STOK PENERI PERSED PEMAK
AWAL MAAN IAAN AIAN

1 ACT (Artesunat 50mg + amodiaquine 200mg) tablet - - - -
2 Albendazol tablet 400mg tablet 17 - 17 -
3 Albendazol suspensi 200mg/5ml botol 10 ml - - - -
4 Alopurinol tablet 100 mg tablet 194 200 394 430
5 Alopurinol tablet 300 mg tablet - - - -
6 ALT (Artemeter 20mg + Lumefantrin 120mg) tablet - - - -
7 Amilorid tablet 5mg tablet - - - -
8 Aminofilin injeksi 24mg/ml Ampul - - - -
9 Aminofilin tablet 150mg tablet - - - -
10 Aminofilin tablet 200 mg tablet - - - -
11 Amitripilin tablet salut 25 mg (HCL) tablet 100 - 100 -
14 Amoksisilin kaplet 500 mg tablet 548 3,000 3,548 2,452
15 Amoksisilin sirup forte 250 mg/5ml botol 60 ml 17 30 47 22
16 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/ml Vial - - - -
17 Ampisilin serbuk injeksi i.m./i.v. 250 mg/ml vial - - - -
mg 450 300 750 550
19 Antasida DOEN sirup kombinasi botol 60 ml - 20 20 9
20 tube
Basitrasin 500 IU/g + polimiksin 10.000 IU/g 14 15 29 16
21 0
Betametason + Neomicyn 7 57 64 46
22 pot
Asam Benzoat 6% + Asam Salisilat 3% - - - -
23 sup
Bismut Subgalat 150 mg + Heksaklorofen 250 mg 63 - 63 11
24 tablet
Pirimatamin 25 mg + Sulfadoksin 500 mg - - - -
Antimigren :
25 tablet
Ergotamin tartrat 1 mg + Kofein 50 mg 100 - 100 -
26 tablet
Karbidopa 25 mg + Levodopa 250 mg - - - -
27 Aqua Pro Injeksi Steril, bebas pirogen Vial - - - -
28 Artesunat serbuk injeksi 60mg/ml Vial - - - -
29 Arthemeter injeksi 80mg/ml vial - - - -
30 Asam Asetil Salisilat tablet 80 mg tablet 60 - 60 -
31 Asam Askorbat (vitamin C) tablet 250 mg tablet - - - -
32 Asam Askorbat (vitamin C) tablet 50 mg tablet 109 2,500 2,609 1,789
33 Asam Folat tablet 0,4 mg tablet - - - -
34 Asam Folat tablet 1mg tablet 30 100 130 -
35 Asam Folat tablet 5 mg tablet - - - 30
36 Asam mefenamat tablet 250mg kapsul - - - -
37 Asam mefenamat tablet 500mg tablet 306 1,300 1,606 891
38 Asam Salisilat larutan 0,1% pot 30 g - - - -
39 Asiklovir tablet 200mg tablet 4 - 4 -
41 Atapulgit tablet tablet 223 200 423 155
42 Atenolol tablet 50 mg tablet - - - -
ampul @ 1
ml - - - -
44 Atropin tablet 0,5 mg tablet - - - -
45 Benzatin Bensil Penisilin inj. 1,2 jt IU/vial (im) Vial - - - -
46 Benzatin Bensil Penisilin inj. 2,4 jt IU/vial (im) Vial - - - -
47 Betametason krim 0,1 % tube 1 25 26 12
48 Betametason tetes mata 1mg/ml botol - - - -
49 Bisakodil sup 10 mg sup 14 - 14 -
50 Bisakodil sup 5 mg sup - - - -
51 Bisakodil tablet 5mg tablet 198 - 198 -
52 Coal tar larutan 15% botol - - - -
53 Dapson tablet 100mg tablet - - - -
1 - 1 -
55 Deksametason tablet 0,5mg tablet 80 200 280 134
ampul @ 2
ml 1 - 1 -
57 Diazepam Rectal 10mg/2,5ml sup 1 - 1 -
58 Diazepam Rectal 5mg/2,5ml sup 1 - 1 -
59 Diazepam tablet 2mg tablet - - - -
60 Diazepam tablet 5mg tablet - - - -
61 Dietil karbamazin sitrat tablet 100mg tablet - - - -
ampul @ 1
ml 4 - 4 -
63 Digoksin tablet 0,25 mg tablet - - - -
64 Diltiazem tablet 30 mg tablet - - - -
65 Dimenhidrinat tablet 50 mg tablet 57 - 57 -
66 Doksisiklin kapsul 100mg kapsul - - - -
67 Domperidon tablet 10mg tablet 115 - 115 9
68 Domperidon suspensi 5mg/5ml botol 3 5 8 4
ampul @ 1
ml 1 - 1 -
70 Ergokalsiferol (Vit D2) kapsul 50.000 IU kapsul - - - -
- - - -
72 Ergotamin tablet 1mg tablet - - - -
73 Eritromisin kapsul 250 mg kapsul - - - -
74 Eritromisin sirup 200 mg/ 5 ml btl 60 ml - - - -
75 Etambutol tablet 250 mg tablet - - - -
76 Etambutol tablet 400 mg tablet - - - -
77 Etambutol tablet salut 500 mg (HCl) tablet - - - -
78 Etanol 70% larutan btl 1000 ml - 1 1 -
79 Eugenol cairan btl 10 ml - - - -
80 Fenitoin Natrium Injeksi 100 mg/2ml ampul - - - -
81 Fenitoin Natrium Injeksi 50 mg/ml ampul - - - -
82 Fenitoin Natrium kapsul 100 mg kapsul - - - -
83 Fenitoin Natrium kapsul 50 mg kapsul - - - -
84 Fenobarbital injeksi50mg/ml ampul - - - -
85 Fenobarbital tablet 100mg tablet - - - -
86 Fenobarbital tablet 30 mg tablet 30 - 30 -
87 Fenoksimetil Penisilin tablet 250 mg tablet - - - -
88 Fenoksimetil Penisilin tablet 500 mg tablet - - - -
89 Ferro Fumarat kapsul lunak 300mg kapsul - - - -
90 Ferro Sulfat sirup 15mg/5ml botol - - - -
91 Ferro Sulfat tablet 300mg tablet - - - -
ampul @ 1
ml 21 - 21 2
93 Fitomenadion (Vit. K1) tablet salut gula 10 mg tablet - - - -
94 Fluphenaszine Decanoate i.m 25 mg/ml ampul 1 ml - 8 8 1
ampul @ 2
ml - - - -
96 Furosemid tablet 40 mg tablet 100 - 100 -
97 Galactose microparticle 200-400mg micropart/ml botol - - - -
dihidrat 0,58 g 85 125 210 127
99 Glibenklamida tablet 2,5 mg tablet - - - -
100 Glibenklamida tablet 5 mg tablet 120 100 220 142
101 Glimepirid tablet 1mg tablet - - - -
102 Glimepirid tablet 2mg tablet 83 - 83 20
103 Glipzide tablet 5mg tablet - - - -
104 Gliseril Trinitrat tablet sublingual 0,5mg tablet - - - -
105 Gliserin tetes 100mg/ml botol - - - -
106 Gliserin tetes 10mg/ml btl 100 ml - - - -
107 Griseofulvin micronized tablet 125 mg tablet - - - -
108 Griseofulvin micronized tablet 250 mg tablet - - - -
ampul @ 1
ml - - - -
110 Haloperidol tablet 0,5 mg tablet - - - -
111 Haloperidol tablet 1,5 mg tablet 132 - 132 -
112 Haloperidol tablet 2 mg tablet - - - -
113 Haloperidol tablet 5 mg tablet 68 300 368 140
114 Haloperidol tetes 2mg/ml botol - - - -
115 Hexamin mandelatb tablet tablet - - - -
116 Hidrogen Peroksida 3% botol 6 - 6 -
117 Hidroklorotiazida tablet 25 mg tablet 39 100 139 45
118 Hidrokortison krim 2,5% tube - 15 15 5
119 Hidrokortison serbuk injeksi 100mg/vial vial - - - -
120 Hyosine Butil Bromide tablet 10 mg tablet 100 - 100 -
121 Ibuprofen tablet 200 mg tablet 74 - 74 36
122 Ibuprofen tablet 400 mg tablet 410 600 1,010 423
123 Ibupropen sirup 100mg/5ml botol 60 ml 4 - 4 1
124 Ibupropen sirup 200mg/5ml botol 60 ml - - - -
125 Ipratropim Bromide inhaler padat 20mg kapsul - - - -
126 Ipratropim Bromide nebulizer 0,025% ampul - - - -
127 Isoniazid tablet 100 mg tablet 50 100 150 60
128 Isoniazid tablet 300 mg tablet - - - -
129 Isosorbid Dinitrat Tablet Sublingual 5 mg tablet - - - -
130 Kalamin lotion botol - - - -
131 Kalsium Glukonat inj 100mg/ml ampul - - - -
132 Kalsium karbonat tablet 500mg tablet - - - -
133 Kalsium Laktat (Kalk) tablet 500 mg tablet 259 900 1,159 1,020
134 Kaptopril tablet 12,5 mg tablet 140 200 340 210
135 Kaptopril tablet 25 mg tablet 333 600 933 571
- - - -
137 Karbamazepin tablet 200mg tablet 66 - 66 -
138 Karbogliserin tetes telinga 10% btl 5 ml - - - -
- - - -
- - - -
- - - -
142 Ketokonazol tablet 200mg tablet 4 50 54 7
143 Klofazimin kapsul 100 mg micronize kapsul - - - -
144 Kloramfenikol kapsul 250 mg kapsul 97 - 97 -
145 Kloramfenikol salep kulit 2% tube 3 - 3 -
146 Kloramfenikol salep mata 1% tube 1 19 20 13
147 Kloramfenikol suspensi 125 mg/5 ml btl 60 ml - - - -
148 Kloramfenikol Tetes mata 0,5% botol - - - -
149 Kloramfenikol Tetes mata 1% botol - - - -
150 Klorfeniramin mealeat (CTM) tablet 4 mg tablet 586 1,200 1,786 1,341
151 Klorhexidin larutan 7.5% 1 liter botol - - - -
152 Klorhexidin larutan 15% botol - - - -
ampul @ 2
ml - - - -
154 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCL) ampul - - - -
155 Klorpromazin tablet salut 100 mg (HCL) tablet - 300 300 80
156 Klorpromazin tablet salut 25 mg (HCL) tablet - - - -
157 Klortalidon tablet 50 mg tablet - - - -
158 Kodein tablet 10 mg tablet - - - -
159 Kodein tablet 20 mg tablet - - - -
160 Kombinasi Ipratropium 0,5mg dan Salbutamol 2,5mg nebulizer ampul
- - - -
161 Kombinasi Kaolin 550mg dan Pektin 20mg tablet tablet - - - -
162 Kontrasepsi Injeksi vial - - - -
163 Kontrasepsi Inplant etonogestrel 68 mg biji - - - -
164 Kontrasepsi inplant levonorgestrel 75 mg biji - - - -
165 Kontrasepsi Oral paket - - - -
166 Kotrimoksazol Suspensi botol 60 ml 1 5 6 2
167 tablet
Sulfametoksazol 100 mg, Trimetoprim 20 mg - - - -
168 tablet
Sulfametoksazol 400 mg, Trimetoprim 80 mg 182 - 182 20
ampul @ 2
169 Kuinin inj 25%
ml - - - -
170 Kuinin tablet 200mg tablet - - - -
173 larutan Lugol botol - - - -
Syringe @
174 Lidokain gel 2%
10 g - - - -
175 Lidokain inj 2% ampul 15 60 75 -
176 Lidokain inj 1% ampul - - - -
177 Lidokain injeksi 2% (HCL) + Epinefrin 1 : 80.000 ampul - - - -
178 Lidokain Semprot 10% botol - - - -
179 Loratadine tablet 10mg tablet 53 - 53 35
180 Magnesium Sulfat inj (IV) 20%-25 ml vial - - - -
181 Magnesium Sulfat inj (IV) 40%-25 ml vial - - - -
182 Magnesium Sulfat serbuk 30 gram sakset - - - -
183 Mebendazol sirup 50 mg / ml btl 30 ml - - - -
184 Mebendazol tablet 100 mg tablet - - - -
185 Mebendazol tablet 500 mg tablet - - - -
186 Metformin HCl tablet 500 mg tablet 169 1,100 1,269 957
187 Metformin HCl tablet 850 mg tablet - - - -
- - - -
189 Metilergometrin Maleat injeksi 0,200 mg -1 ml ampul 2 3 5 -
190 Metoklopramide HCl tablet 10mg tablet - - - -
191 Metoklorpramide tablet 5mg tablet - - - -
192 Metronidazol tablet 250 mg tablet - - - -
193 Metronidasol tablet 500mg tablet 119 100 219 95
194 Metronidazol infus 500 mg/100 ml btl 100 ml - - - -
195 Metronidazol sirup 125mg/5ml botol - - - -
196 Metronidazole supp 500mg sup - - - -
197 Mikonazol krim /salep 2 % tube 7 5 12 7
198 Mikonazol serbuk 2% botol - - - -
199 Natrium Bikarbonat tablet 500 mg tablet - - - -
200 Natrium Diklofenak tablet 25 mg tablet - - - -
201 Natrium Diklofenak tablet 50 mg tablet 54 350 404 310
ampul @ 10
202 Natrium Thiosulfat injeksi i.v. 25 %
ml - - - -
203 Nikotinamide tablet 100mg tablet - - - -
206 Nipedipin tablet 10mg tablet - - - -
207 Nistatin suspensi 100.000 IU/ml botol - - - -
208 Nistatin tablet salut 500.000 IU/g tablet - - - -
209 Nistatin Vaginal tablet salut 100.000 IU/g tablet - - - -
210 Nitrofurantoin tablet 100 mg tablet - - - -
211 Norepinefrin injeksi 1mg/ml ampul - - - -
212 OAT FDC Anak paket - - - -
213 OAT FDC I paket 4 - 4 -
214 OAT FDC II paket - - - -
215 OAT FDC Sisipan paket - - - -
216 OAT Kombipak I paket - - - -
217 Oksigen Gas Dalam Tabung 1 kg - - - -
218 Oksigen Gas Dalam Tabung 6 kg - - - -
219 Oksimetazolin tetes hidung 0,025% btl 10 ml - - - -
220 Oksimetazolin tetes hidung 0,050% btl 10 ml - - - -
221 Oksitosin injeksi 10 UI/ml-1 ml ampul - 10 10 2
222 Olopatadin tetes mata 1% botol - - - -
- - - -
224 Omeprazol kapsul 20mg kapsul 9 60 69 40
225 Paraformaldehid tablet 1 gram tablet - - - -
226 Parasetamol sirup 120 mg / 5 ml btl 60 ml 13 100 113 84
227 Parasetamol tablet 500mg tablet 262 3,300 3,562 2,846
228 Parasetamol tetes 60mg/0,6 ml botol 12 40 52 36
229 Perak Nitrat larutan 20% botol - - - -
230 Perak Sulfadiazin krim 1% tube - 1 1 1
231 Permetrin krim 5% tube - 11 11 6
232 Pirantel sirup 125 mg/5 ml btl 60 ml 4 - 4 1
233 Pirantel tab. Score (base) 125 mg tablet - - - -
234 Pirantel tab. Score (base) 250 mg tablet 2 - 2 -
235 Pirantel tab. Score (base) 500 mg tablet - - - -
236 Pirazinamid tablet 500 mg tablet - - - -
237 Piridoksin (Vitamin B6) tablet 10 mg (HCL) tablet 203 200 403 182
238 Piridoksin (Vitamin B6) tablet 20 mg (HCL) tablet - - - -
239 Piridoksin injeksi 100mg/ml tablet - - - -
240 Povidon Iodida larutan 10 % btl 30 ml - - - -
241 Povidon Iodida larutan 10% botol 300ml 2 2 4 -
242 Prazikuantel tablet 300 mg tablet - - - -
243 Prazikuantel tablet 600 mg tablet - - - -
244 Prednison tablet 5 mg tablet - - - -
245 Primakuin tablet 125mg tablet - - - -
246 Probenesid tab 500 mg tablet - - - -
247 Procain Bensil Penisilin serbuk inj. 1 jt IU/vial (im) vial - - - -
248 Procain Bensil Penisilin serbuk inj. 3 jt IU/vial (im) vial - - - -
249 Propanolol tablet 10 mg (HCl) tablet - - - -
250 Propillitiourasil tablet 100 mg tablet - - - -
251 Ranitidin tablet 150mg tablet 291 200 491 221
252 Retinol (vitamin A) kapsul lunak 100.000IU kapsul - - - -
253 Retinol kapsul 200.000 IU kapsul - 100 100 -
254 Salbutamol inhaler 0,5% botol - - - -
255 Salbutamol tablet 2 mg (sebagai sulfat) tablet 161 - 161 11
256 Salbutamol tablet 4 mg (sebagai sulfat) tablet 865 - 865 115
257 pot
Asam Salisilat 2% + Belerang endap 4% 2 - 2 2
258 Salep Asam Salisilat 5% pot - - - -
259 Salisil bedak 2% ktk 50 gram 4 40 44 29
260 Setrizine sirup 5mg/5ml botol - 5 5 1
261 Sianokobalamin (Vitamin B12) injeksi 500 mcg ampul - - - -
262 Sianokobalamin (Vitamin B12) tablet 50 mcg tablet - - - -
263 Simvastatin tablet 10 mg tablet - - - 45
264 Simvastatin tablet 20 mg tablet 60 - 60 -
265 Siprofloksasin tablet 500mg tablet 102 100 202 142
266 Spironolakton tablet 25 mg tablet - - - -
267 Streptomycin injeksi 1000 mg / vial visl - - - -
268 Tablet Tambah Darah tablet 370 1,700 2,070 1,764
269 Tetrakain HCL tetes mata 0,5% botol - - - -
270 Tetrasiklin kapsul 250 mg kapsul - - - -
271 Tetrasiklin kapsul 500 mg kapsul - - - -
272 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) tablet 261 - 261 134
273 Triheksifenidil tablet 2 mg tablet 33 300 333 158
274 Tuberkulin injeksi 1 : 10 (i.k). vial - - - -
275 Valproat sirup 250mg/5ml botol - - - -
276 Valproat tablet salut 250mg tablet - - - -
277 Valproat tablet salut 500mg tablet - - - -
278 Vitamin B Kompleks tablet tablet 510 4,000 4,510 3,557
279 Zinc serbuk 10mg sakset - - - -
280 Zinc sirup 20mg/5ml botol 60 ml 14 5 19 6
281 Zink Dispersible tablet 20mg tablet - 100 100 -
VAKSIN DAN SERUM

1 Serum Anti Bisa Ular ABU I vial 4 ml - - - -
2 Serum Anti Bisa Ular ABU II vial 50 ml - - - -
Serum Antidifteri (ADS) inj 10.000 IU vial @ 50 ml
3 - - - -
4 Serum Antidifteri (ADS) inj 20.000 IU vial 5 ml - - - -
5 Serum Antirabies inj 100 IU/ml vial # 20 ml - - - -
6 Serum Antirabies inj 200 IU/ml 0 - - - -
7 Serum Antitetanus (ATS) 1.500 IU/amp amp 1 ml - - - -
ampul @ 2
Serum Antitetanus (ATS) 10.000 IU/amp
8 ml - - - -
9 Serum Antitetanus (ATS) 20.000 IU/vial vial 5 ml - - - -
10 Hepatitis B Imunoglobulin (Human) injeksi 0,5ml Vial 102 - 102 -
11 Human tetanus Imunoglobulin injeksi 250 IU (i.m) syringe 55 - 55 -
12 Human tetanus Imunoglobulin injeksi 500 IU (i.m) syringe - - - -
13 Vaksin BCG vial 22 - 22 -
14 Vaksin campak vial 50 - 50 -
15 Vaksin kombinasi DPT+Hepatitis B vial 69 - 69 -
16 Vaksin jerap DT vial 16 - 16 -
17 Vaksin jerap DPT vial - - - -
18 Vaksin jerap tetanus vial - - - -
19 Vaksin polio vial 72 - 72 -
20 Vaksin rabies, untuk manusia 0 152 - 152 -
21 Tetanus Toxoid inj vial 48 - 48 -
OBAT GIGI
1 Devitalisasi Pasta (Non Arsen) btl / ktk - - - -
2 Etil Klorida spray btl 100 ml - 3 3 -
3 Glass Ionomer Cement ART set / botol - - - -
4 Kalsium Hidroksida Pasta ktk 2 tube - - - -
5 Klorfenol kamfer Menthol ( CHKM ) btl 10 ml - - - -
6 Mummifying Pasta btl / kotak - - - -
7 Semen Seng Fosfat serbuk dan cairan 0 - - - -
Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0
8 - - - -
9 Formokresol cairan botol - - - -
10 Gutta Percha dan paper point biji - - - -
11 klorhexidin larutan 0,2% botol - - - -
12 Natrium Hipoklorit cairan konsentrat 5% botol - - - -
13 Nistatin Suspensi 100.000IU/ml botol - - - -
14 Fluor tablet 0,5mg tablet - - - -
15 Fluor tablet 1mg tablet - - - -
16 Fluor Sediaan Topikal pot - - - -
17 Pasta Pengisi Saluran Akar tablet - - - -
18 Komposit Resin botol - - - -
19 Articulating paper buah - - - -
20 Lidokain pasta 5% tablet - - - -
21 Fuji I botol - - - -
22 Fuji IX botol - - - -
23 Spongestan Gelatin buah - - - -
24 Cavit G buah - - - -
25 Avogyl buah - - - -
26 Saliva Ejektotor biji - - - -
27 TKF 0 - - - -
28 Ceivitron 0 - - - -
Lain-lain
1 Acetylsystein 200mg kapsul 231 240 471 291
2 Alkohol 70 % 100 ml botol - - - -
3 Alprazolam 1 mg tablet - - - -
4 Alprazolam 0.5 mg tablet 97 - 97 -
6 Ambroxol tablet 30 mg tablet 113 800 913 447
Aquadest steril botol 1000 ml
8 - - - -
9 Asam Asetisalisilat tablet 100 mg (Asetosal) tablet - - - -
10 Asam Asetisalisilat tablet 500 mg (Asetosal) tablet - - - -
11 Asam Askorbat (vitamin C) tablet 100 mg tablet - - - -
12 Asam Traneksamat injeksi 100mg ampul - - - -
13 Asam Traneksamat injeksi 250mg ampul - - - -
Asiklovir krim 5 % tube 5 gram
14 6 - 6 4
15 Azytromicn 500 mg tablet 20 - 20 -
16 Betahistin Metisalat tablet 6 mg tablet 104 150 254 141
17 Calcium Alginate (Bioplacenton) tulle sachet - - - -
18 Cefixime 100 mg kapsul - - - -
19 Cefixime 200 mg + Azitromycin 500 mh (Kombipak) paket - - - -
20 Cetirizin kapsul 10 mg kapsul 95 - 95 45
21 Cimetidin tablet 200mg tablet - - - -
22 Clavamox injeksi 1.000 IV 1,2 gr vial - - - -
23 Clobazam tablet 10 mg tablet - 100 100 -
24 Co Amoxiclav capsul 625 mg capsul - - - -
25 Digoksin 0,0625 mg tablet - - - -
ampul @ 2
Digoksin injeksi 0,25 mg/ml
26 ml - - - -
27 Dopamin injeksi ampul - - - -
28 Efedrin tablet 25 mg (HCL) tablet - - - -
29 Ekstraks belladona tablet 10 mg tablet - - - -
30 Erythromicin kapsul 500mg kapsul 98 - 98 -
31 Etakridin larutan 0,1% btl 300ml - 2 2 -
32 Fenilbutason tablet 200 mg tablet - - - -
33 Fenitoin kapsul 30 mg (garam natrium) kapsul - - - -
34 Fenol Gliserol TT 10% botol 4 5 9 4
ampul @ 1
Fitomenadion (Vit. K1) injeksi 10 mg/ml
35 ml - 5 5 -
36 Flukonazol tablet 150 mg tablet - - - -
37 Fluoresein tetes mata 2,5mg/ml botol - - - -
38 Framycetin sulfat lembar 100 - 100 -
39 Gentamicin krim 0,1% tube - - - -
40 Gentamisin salep kulit 0,1% tube - - - -
41 Gentamisin Sulfat tetes mata 5 ml btl 10 ml 4 5 9 7
ampul @ 2
Gentamycin injeksi 40mg/ml
42 ml - - - -
43 Gentian Violet 1% botol 1 - 1 -
44 Gliseril Gualakolat tablet 100 mg tablet 400 1,400 1,800 1,623
45 Glukosa larutan infus 10% btl 500 ml - - - -
46 Glukosa larutan infus 40% ampul - - - -
47 Glukosa larutan infus 5% btl 500 ml 2 - 2 -
ampul @ 1
Hyoscine N-Butylbromide injeksi 20mg/ml
48 ml 5 - 5 -
49 Ketokenazol krim 2% tube - - - -
50 Ketoprofen injeksi ampul - - - -
51 Ketoprofen sup 100mg sup - - - -
52 Ketoprofen sup 100mg sup - - - -
53 Kloramfenikol Tetes Telinga 3% botol 2 - 2 -
54 Lansoprazol kapsul 30 mg kapsul 65 - 65 -
55 Lisol botol - - - -
56 Lisol (Kresol tersaponifikai 50%) btl 1000 ml - - - -
57 Meloksikam tablet 7,5 mg tablet - - - -
58 Metakresol Sulfonat solution btl - - - -
Metampiron 250mg, Aminofenazon 50mg, Silokain HCl 15mg
vial
59 inj. - - - -
60 Metampiron tablet 500 mg tablet - - - -
61 Methylprednisolon tablet 4 mg tablet 38 100 138 39
62 Methylprednisolon tablet 8 mg tablet 91 - 91 23
63 Methylprednisolon tablet 16 mg tablet - - - -
64 Metoklopramide HCl injeksi 5mg/ml10mg ampul 5 - 5 -
65 Multivitamin sirup botol - - - -
Natrium Bikarbonat injeksi (Meylon) ampul 25 ml
66 - - - -
67 Natrium Klorida larutan infus 0,9 % btl 500 ml 5 19 24 -
68 Natrium Klorida larutan infus 3% btl 500 ml - - - -
69 Neomycin Sulfat 0,5%, placenta extr. 100mg/ml tube - - - -
70 New diaform tablet - - - -
71 Obat Batuk hitam ( O.B.H.) btl 100 ml - 5 5 5
72 Oksitetrasiklin HCL salep mata 1 % tube - - - -
Oksitetrasiklin salep kulit tube 5 gram
73 - - - -
74 Ondancentron tablet 4mg tablet 30 - 30 -
75 Papaverin tablet tablet - - - -
76 Parasetamol Rectal 125mg sup 20 12 32 1
77 Parasetamol tablet 100 mg tablet - - - -
78 Pehacain injeksi ampul - - - -
ampul @ 2
Petidin injeksi 50 mg/ml
79 ml - - - -
80 Pilokarpin tetes mata 2 % (HCL/Nitrat) btl 5 ml - - - -
81 Pilokarpin tetes mata 4% btl 5 ml - - - -
82 Piracetam injeksi 1 gr / 5ml ampul - - - -
83 Piracetam tablet 800mg tablet - - - -
84 Piroxicam kapsul 10mg tablet - - - -
85 Piroxicam kapsul 20mg tablet 50 100 150 98
86 Ranitidin injeksi 25mg/2ml ampul 5 - 5 -
87 Retinol (Vitamin A) tablet 50.000 IU tablet - - - -
88 Rifampisin kaplet 600 mg tablet - - - -
89 Rifampisin tablet salut 450 mg tablet - - - -
90 Ringer Laktat larutan infus btl 500 ml 9 5 14 -
91 Risperidone tablet 2mg tablet - 200 200 -
92 Salbutamol inhaler botol - - - -
93 Salbutamol Nebulizer 2,5mg/2,5ml ampul 14 - 14 -
94 Salbutamol Rotahaler pcs - - - -
95 Salbutamol serbuk kapsul inhaler 200 mg kapsul - - - -
96 Salbutamol sirup 2 mg / 5 ml botol - - - -
97 Salicyl Spiritus btl - - - -
98 Sefadroksil 500 mg tablet 20 - 20 -
99 Spironolakton tablet 100mg tablet - - - -
100 Sulfadiazin tablet 500 mg tablet - - - -
101 Sulfasetamida Natrium tetes mata 15 % botol 4 5 9 5
102 Thiamin HCl injeksi 100mg/ml-1ml ampul - - - -
103 Tiamin (vitamin B1) tablet 100 mg (HCL/Nitrat) tablet - - - -
104 Triflouperazin tablet 5 mg tablet - 200 200 44
105 Trimetoprim tablet scored 200 mg tablet - - - -
106 Xilomidon inj vial - - - -
107 Zinc sirup tetes 10mg/ml botol 15 ml - 14 14 3
108 Jelly USG 0 - - - -
PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 0.05 pcs 983 - 983 -
2 Alat suntik sekali pakai 0.5 pcs 2,814 - 2,814 -
3 Alat suntik sekali pakai 1 ml pcs - - - -
4 Alat suntik sekali pakai 2,5 ml pcs - - - -
5 Alat suntik sekali pakai 3 ml pcs 80 155 235 -
6 Alat suntik sekali pakai 5 ml pcs 84 - 84 -
7 Alat Suntik Sekali Pakai 10 ml pcs - - - -
8 Blood Lancet sakset 142 - 142 -
9 Blue Tip sakset 38 - 38 -
10 Catgut / Benang Bedah No. 1/0 dengan jarum bedah pcs - - - -
Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah pcs
11 - 24 24 -
12 Cyro tube pcs 34 - 34 -
13 Foley Catheter 16 - 18 biji - - - -
14 Foley Catheter no.22 pasang - - - -
15 Handscoon biji - 1,800 1,800 -
16 Handscoon Steril pasang 100 250 350 -
Handscoon Gynaecolog (Panjang) Set /kantong
17 - 5 5 -
Handscoon panjang Steril Set /kantong
18 2 - 2 -
19 Infusion set anak buah 8 - 8 -
20 Infusion set dewasa buah 8 - 8 -
21 IV Catheter No. 14 G buah - - - -
22 IV Catheter No. 16 G buah - - - -
23 IV Catheter No. 18 G buah 11 2 13 -
24 IV Catheter No. 20 G buah 6 10 16 -
25 IV Catheter No. 22 G lusin 4 2 6 -
26 IV Catheter No. 24 G lusin 5 2 7 -
27 Jarum Jahid no 9 lusin - - - -
33 Jarum Otot Besar No. 15 Bungkus - - - -
34 Jarum Otot Kecil No. 9 Bungkus - - - -
35 Kapas Berlemak 500 gram lembar - - - -
36 Kapas Pembalut / Absorben 250 gram biji 1 - 1 -
37 Kasa Hidrofil Steril uk. 16 x 16 rol - - - -
38 Kasa Hidrofil Steril uk. 18 x 22 cm rol - - - -
39 Kasa Hidrofil uk. 36 m x 80 cm rol 4 4 8 -
40 Kasa Pembalut Elastic 4 m x 3 cm rol - - - -
41 Kasa Pembalut Elastic 4 m x 5 cm rol - 75 75 -
42 Kasa Pembalut Elastic 4 m x 10 cm sak - 15 15 -
43 Kasa Pembalut Elastic 4 m x 15 cm bungkus - - - -
44 Kertas Perkamen bungkus - 2 2 -
45 Klip Obat Kecil buah 500 1,300 1,800 -
46 Klip Obat Tanggung pcs - 500 500 -
47 Kotak Slide buah - - - -
48 Masker buah - 1,250 1,250 -
49 Mikro Pipet 1000 rol - - - -
50 Mikro Pipet 50-500 rol - - - -
51 Needle 25 G (terumo) pcs 155 - 155 -
52 Nonwoven Fixattion 5x10 rol 1 1 2 -
53 Nonwoven Fixattion 10x10 rol - 1 1 -
54 Pembalut Gips uk. 3" rol - - - -
55 Pembalut Gips uk. 4" buah - - - -
56 Pembalut Gips uk. 6" rol - - - -
57 Pisau Operasi biji - 90 90 -
58 Plester 5 yards x 2 inch buah - - - -
59 Polifix 5cm x 5m rol - - - -
60 Polifix 10cm x 5m rol - - - -
61 Pot Dahak sakset 25 45 70 -
62 Safety box kotak - - - -
63 Sendok syrup biji - - - -
Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah biji
64 40 - 40 -
Slide Set /kantong
65 178 - 178 -
66 Tabung Darah EDTA (Tutup Ungu) pcs 100 - 100 -
67 Tabung Darah Non EDTA (Tutup Merah) pcs 100 - 100 -
68 Tranfusion Set biji 5 - 5 -
69 Underpad biji 15 10 25 -
70 Tisue bal - 3 3 -
71 Ultrafix buah - - - -
72 Urine Bag buah - - - -
73 White Tip 0 2,475 - 2,475 -
74 Wing Needle No. 21 G 0 - - - -
75 Wing Needle No. 23 G 0 1 - 1 -
76 Wing Needle No. 25 G buah - - - -
77 Wing Needle No. 27 G buah - - - -
78 Yellow Tip biji 1,525 - 1,525 -
Bahan Laboratorium/Reagensia
1 Alkohol Swab 0 250 300 550 -
2 Aquabidest botol 1 - 1 -
3 Aquadest 1000ml botol - - - -
4 Bilirubin Direk (200ml) botol 200ml - - - -
5 Bilirubin Total (200ml) botol 200ml - - - -
6 Cat Giemsa botol 100ml - - - -
7 Cat Gram kit - - - -
8 Cholesterol Biosystem botol - - - -
9 Cholesterol strip box 25 strip 119 10 129 -
10 Creatinin @00ml) Botol 1 - 1 -
11 EDTA 10% Botol - - - -
12 Eosin 2% botol 250ml - - - -
Gluco Protein Urine kotak 10 strip
13 8 50 58 -
14 Glukosa Darah Strip (Almedicus) strip - - - -
15 Glukosa Darah Strip (Bene Check) strip 239 100 339 -
16 Glukosa Darah Strip (Gluco DR) strip - - - -
17 HCl 0,1 N botol 500ml - - - -
18 HDL Cholesterol (200ml) botol 200ml 1 - 1 -
19 Hematology Analyzer Reagen Set - - - -
20 Hemoglobin Reagen botol 500ml - - - -
21 HIV-Test 0 - - - -
Oncoprobe Anti HIV strip 42 - 42 -
SD Bio Line HIV 1/2 strip 88 200 288 -
SD Intec HIV 1/2 strip 95 - 95 -
Rapid Test Kit III (Tridot) strip 42 - 42 -
22 KOH 100ml botol 100ml - - - -
23 Kolesterol Kit 200ml - - - -
24 Kontrol Darah kit (2.5ml) - 1 1 -
25 Kontrol serum kit - - - -
26 Larutan Buffer botol 1 liter - - - -
27 Larutan Ressecker botol 100ml - - - -
28 Larutan Turk botol 100ml - - - -
29 Metanol Pro Analisa botol 1 liter - - - -
30 Rapid Test Syphilis test - - - -
31 Reagen Ziehl Neelsen (TBC) paket - 1 1 -
32 Rheumatoid Factor (RF) kit 50 test - - - -
33 RPR Test test - - - -
34 SGOT (200ml) botol - - - -
35 SGPT (200ml) botol - - - -
36 Spiritus botol 1 liter - - - -
37 Stik Urinalisis U10 strip 74 - 74 -
38 Test Asam Urat strip 110 - 110 -
39 Test Golongan Darah 0 - - - -
a. Anti A botol 10 ml 9 - 9 -
b. Anti B botol 10 ml 9 - 9 -
c. Anti AB botol 10 ml 1 - 1 -
d. Anti D botol 10 ml 1 - 1 -
40 Test Kehamilan strip 5 - 5 -
41 Tryglicerida (200ml) botol - - - -
42 Urea (200ml) botol - - - -
43 Uric Acid (200ml) botol - - - -
44 Widal Typhi O,H, Paratyphi A-O, B-O, C-O) set - - - -
a. Salmonella Typhi O botol 5ml - - - -
b. Salmonella Paratyphi A-O botol 5ml - - - -
c. Salmonella Paratyphi B-O botol 5ml - - - -
d. Salmonella Paratyphi C-O botol 5ml - - - -
e. Salmonella Typhi H botol 5ml - - - -
f. Salmonella Paratyphi A-H botol 5ml - - - -
g. salmonella Paratyphy B-H botol 5ml - - - -
h. Salmonella paratyphy C-H botol 5ml - - - -
45 Vacutest Kima pcs - - - -
46 Vacutest 250 μL pcs 200 - 200 -
47 Xylol botol - - - -
UMUM PBI NON JUMLAH

JUMLAH KUNJUNGAN PBI
-
RESEP GENERIK
RESEP NON GENERIK
TOTAL RESEP -
Mengetahui/Menyetujui Yang Menyerahkan

Kepala UPT Puskesmas Klungkung I Petugas Gudang Farmasi
drg. I.B. Putra Dwipayana Kadek Eddy Dwi Cahyadi, S.Farm.,Apt.

NIP. 19750427 200312 1 005 NIP. 19851215 201101 1 015
MINTAAN OBAT
: Ruang Farmasi
: Desember 2017
: Januari 2018
SISA PERMI PEMBE KET

STOK NTAAN RIAN
-
17
-
(36) 100
-
-
-
-
-
-
100
96 180
33 180
1,096 1500
25 15
-
-
200 300
11 10
13 25
18 25
52
100
-
-
-
-
60
-
820 1500
-
130 100
(30)
-
715 500
-
4
70
268 100
-
-
-
-
-
14 25
-
14
-
198
-
-
1
146 100
1
1
1
-
-
-
4
-
-
57
-
106
4
1
-
-
-
-
-
-
-
-
1
-
-
-
-
-
-
-
30
-
-
-
-
-
19
-
7
-
100
-
83 100
-
78 200
-
63
-
-
-
-
-
-
-
-
132
-
228
-
-
6
94 100
10 25
-
100
38
587 200
3
-
-
-
90
-
-
-
-
-
139 1500
130 200
362 500
-
66
-
-
47
-
97
3
7 25
-
-
-
445 500
-
-
-
-
220
-
-
-
-
-
-
-
-
-
-
4
162
-
-
-
-
-
-
75
-
-
-
18
-
-
-
-
-
-
312 1000
-
-
5
-
-
-
124
-
-
-
5
-
-
-
94 100
-
-
-
-
-
-
-
-
-
-
-
4
-
-
-
-
-
-
-
8
-
-
29
-
29 50
716 2000
16 50
-
-
5 5
3
-
2
-
-
221 200
-
-
-
4
-
-
-
-
-
-
-
-
-
270
-
100
-
150
750
-
-
15 10
4
-
-
(45)
60
60
-
-
306 2000
-
-
-
127 100
175
-
-
-
-
953 3000
-
13
100
-
-
-
-
-
-
-
-
-
102
55
-
22
50
69
16
-
-
72
152
48
-
3
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
180 240
-
-
97
12 10
466 200
16 10
-
-
-
-
-
-
2
20
113 100
-
-
-
50
-
-
100
-
-
-
-
-
-
98
2
-
-
5
5
-
-
100
-
- 10
2
-
1
177 300
-
-
2
5
-
-
-
-
2
65
-
-
-
-
-
-
99
68
-
5
-
-
24
-
-
-
-
-
-
30
-
31
-
-
-
-
-
-
-
-
52 100
5
-
-
-
14
200
-
14
-
-
-
-
20
-
-
4
-
-
156
-
-
11
-
983
2,814
-
-
235
84
-
142
38
-
24
34
-
-
1,800
350
2
8
8
-
-
13
16
6
7
-
-
-
-
-
-
-
-
-
1
-
-
8
-
75
15
-
2
1,800
500
-
1,250
-
-
155
2
1
-
-
-
90
-
-
-
70
-
-
40
178
100
100
5
25
-
-
-
2,475
-
1
-
-
1,525
550
1
-
-
-
-
-
-
129
1
-
-
58
-
339
-
-
1
-
-
-
42
288
95
42
-
-
1
-
-
-
-
-
-
1
-
-
-
-
-
74
110
-
9
9
1
1
5
-
-
-
-
-
-
-
-
-
-
-
-
-
200
-
Yang Melapor/Meminta
Ruang Farmasi
Ni Putu Wiwin Sofi Martianti, Amd.Keb.

NIP.
FORM STOCK OPNAME
SUB UNIT : RUANG FARMASI

BULAN : DESEMBER
TAHUN : 2017
SISA KET

1 ACT (Artesunat 50mg + amodiaquine 200mg) tablet
2 Albendazol tablet 400mg tablet
3 Albendazol suspensi 200mg/5ml botol 10 ml
4 Alopurinol tablet 100 mg tablet
5 Alopurinol tablet 300 mg tablet
6 ALT (Artemeter 20mg + Lumefantrin 120mg) tablet
7 Amilorid tablet 5mg tablet
8 Aminofilin injeksi 24mg/ml Ampul
9 Aminofilin tablet 150mg tablet
10 Aminofilin tablet 200 mg tablet
11 Amitripilin tablet salut 25 mg (HCL) tablet
12 Amlodipine tablet 10mg tablet
13 Amlodipine tablet 5mg tablet
14 Amoksisilin kaplet 500 mg tablet
15 Amoksisilin sirup forte 250 mg/5ml botol 60 ml
16 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/ml Vial
17 Ampisilin serbuk injeksi i.m./i.v. 250 mg/ml vial

18 tablet
Aluminium Hidroksida 200 mg + Magnesium Hidroksida 200 mg
19 Antasida DOEN sirup kombinasi botol 60 ml

20 tube
Basitrasin 500 IU/g + polimiksin 10.000 IU/g
21 -
Betametason + Neomicyn
22 pot
Asam Benzoat 6% + Asam Salisilat 3%
23 sup
Bismut Subgalat 150 mg + Heksaklorofen 250 mg
24 tablet
Pirimatamin 25 mg + Sulfadoksin 500 mg
Antimigren :
25 tablet
Ergotamin tartrat 1 mg + Kofein 50 mg
26 tablet
Karbidopa 25 mg + Levodopa 250 mg
27 Aqua Pro Injeksi Steril, bebas pirogen Vial
28 Artesunat serbuk injeksi 60mg/ml Vial
29 Arthemeter injeksi 80mg/ml vial
30 Asam Asetil Salisilat tablet 80 mg tablet
31 Asam Askorbat (vitamin C) tablet 250 mg tablet
33 Asam Folat tablet 0,4 mg tablet
34 Asam Folat tablet 1mg tablet
35 Asam Folat tablet 5 mg tablet
36 Asam mefenamat tablet 250mg kapsul
37 Asam mefenamat tablet 500mg tablet
38 Asam Salisilat larutan 0,1% pot 30 g
39 Asiklovir tablet 200mg tablet
40 Asiklovir tablet 400 mg tablet
41 Atapulgit tablet tablet
42 Atenolol tablet 50 mg tablet
43 Atropin injeksi i.m/i.v/s.k. 0,25 mg/mL (sulfat) ampul @ 1 ml
44 Atropin tablet 0,5 mg tablet
45 Benzatin Bensil Penisilin inj. 1,2 jt IU/vial (im) Vial
46 Benzatin Bensil Penisilin inj. 2,4 jt IU/vial (im) Vial
47 Betametason krim 0,1 % tube
48 Betametason tetes mata 1mg/ml botol
49 Bisakodil sup 10 mg sup
50 Bisakodil sup 5 mg sup
51 Bisakodil tablet 5mg tablet
52 Coal tar larutan 15% botol
53 Dapson tablet 100mg tablet
55 Deksametason tablet 0,5mg tablet
56 Diazepam Injeksi 5 mg/ml ampul @ 2 ml
57 Diazepam Rectal 10mg/2,5ml sup
58 Diazepam Rectal 5mg/2,5ml sup
59 Diazepam tablet 2mg tablet
60 Diazepam tablet 5mg tablet
61 Dietil karbamazin sitrat tablet 100mg tablet
62 Difenhidramin Injeksi i.m. 10 mg/ml (HCL) ampul @ 1 ml
63 Digoksin tablet 0,25 mg tablet
64 Diltiazem tablet 30 mg tablet
65 Dimenhidrinat tablet 50 mg tablet
66 Doksisiklin kapsul 100mg kapsul
67 Domperidon tablet 10mg tablet
68 Domperidon suspensi 5mg/5ml botol
69 Epinefrin (Adrenalin) injeksi 0,1% (sebagai HCL) ampul @ 1 ml
70 Ergokalsiferol (Vit D2) kapsul 50.000 IU kapsul
72 Ergotamin tablet 1mg tablet
73 Eritromisin kapsul 250 mg kapsul
74 Eritromisin sirup 200 mg/ 5 ml btl 60 ml
75 Etambutol tablet 250 mg tablet
76 Etambutol tablet 400 mg tablet
77 Etambutol tablet salut 500 mg (HCl) tablet
78 Etanol 70% larutan btl 1000 ml
79 Eugenol cairan btl 10 ml
80 Fenitoin Natrium Injeksi 100 mg/2ml ampul
81 Fenitoin Natrium Injeksi 50 mg/ml ampul
82 Fenitoin Natrium kapsul 100 mg kapsul
83 Fenitoin Natrium kapsul 50 mg kapsul
84 Fenobarbital injeksi50mg/ml ampul
85 Fenobarbital tablet 100mg tablet
86 Fenobarbital tablet 30 mg tablet
87 Fenoksimetil Penisilin tablet 250 mg tablet
88 Fenoksimetil Penisilin tablet 500 mg tablet
89 Ferro Fumarat kapsul lunak 300mg kapsul
90 Ferro Sulfat sirup 15mg/5ml botol
91 Ferro Sulfat tablet 300mg tablet
92 Fitomenadion (Vit. K1) injeksi 2 mg/ml ampul @ 1 ml
93 Fitomenadion (Vit. K1) tablet salut gula 10 mg tablet
94 Fluphenaszine Decanoate i.m 25 mg/ml ampul 1 ml
95 Furosemid injeksi i.v./i.m. 10 mg/ml ampul @ 2 ml
96 Furosemid tablet 40 mg tablet
97 Galactose microparticle 200-400mg micropart/ml botol
98 Natrium 0,70 g , Kalium klorida 0,30 g, Trinatrium Sitrat dihidrat 0,58 g sachet
99 Glibenklamida tablet 2,5 mg tablet

100 Glibenklamida tablet 5 mg tablet
101 Glimepirid tablet 1mg tablet
102 Glimepirid tablet 2mg tablet
103 Glipzide tablet 5mg tablet
104 Gliseril Trinitrat tablet sublingual 0,5mg tablet
105 Gliserin tetes 100mg/ml botol
106 Gliserin tetes 10mg/ml btl 100 ml
107 Griseofulvin micronized tablet 125 mg tablet
108 Griseofulvin micronized tablet 250 mg tablet
109 Haloperidol injeksi 5mg/ml (i.m) ampul @ 1 ml
110 Haloperidol tablet 0,5 mg tablet
111 Haloperidol tablet 1,5 mg tablet
112 Haloperidol tablet 2 mg tablet
113 Haloperidol tablet 5 mg tablet
114 Haloperidol tetes 2mg/ml botol
115 Hexamin mandelatb tablet tablet
116 Hidrogen Peroksida 3% botol
117 Hidroklorotiazida tablet 25 mg tablet
118 Hidrokortison krim 2,5% tube
119 Hidrokortison serbuk injeksi 100mg/vial vial
120 Hyosine Butil Bromide tablet 10 mg tablet
121 Ibuprofen tablet 200 mg tablet
122 Ibuprofen tablet 400 mg tablet
123 Ibupropen sirup 100mg/5ml botol 60 ml
124 Ibupropen sirup 200mg/5ml botol 60 ml
125 Ipratropim Bromide inhaler padat 20mg kapsul
126 Ipratropim Bromide nebulizer 0,025% ampul
127 Isoniazid tablet 100 mg tablet
128 Isoniazid tablet 300 mg tablet
129 Isosorbid Dinitrat Tablet Sublingual 5 mg tablet
130 Kalamin lotion botol
131 Kalsium Glukonat inj 100mg/ml ampul
132 Kalsium karbonat tablet 500mg tablet
133 Kalsium Laktat (Kalk) tablet 500 mg tablet
134 Kaptopril tablet 12,5 mg tablet
135 Kaptopril tablet 25 mg tablet
137 Karbamazepin tablet 200mg tablet
138 Karbogliserin tetes telinga 10% btl 5 ml
142 Ketokonazol tablet 200mg tablet
143 Klofazimin kapsul 100 mg micronize kapsul
144 Kloramfenikol kapsul 250 mg kapsul
145 Kloramfenikol salep kulit 2% tube
146 Kloramfenikol salep mata 1% tube
147 Kloramfenikol suspensi 125 mg/5 ml btl 60 ml
148 Kloramfenikol Tetes mata 0,5% botol
149 Kloramfenikol Tetes mata 1% botol
150 Klorfeniramin mealeat (CTM) tablet 4 mg tablet
151 Klorhexidin larutan 7.5% 1 liter botol
152 Klorhexidin larutan 15% botol
153 Klorpromazin injeksi i.m 25 mg/ml (HCL) ampul @ 2 ml
154 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCL) ampul
155 Klorpromazin tablet salut 100 mg (HCL) tablet
156 Klorpromazin tablet salut 25 mg (HCL) tablet
157 Klortalidon tablet 50 mg tablet
158 Kodein tablet 10 mg tablet
159 Kodein tablet 20 mg tablet
160 Kombinasi Ipratropium 0,5mg dan Salbutamol 2,5mg nebulizer ampul
161 Kombinasi Kaolin 550mg dan Pektin 20mg tablet tablet
162 Kontrasepsi Injeksi vial
163 Kontrasepsi Inplant etonogestrel 68 mg biji
164 Kontrasepsi inplant levonorgestrel 75 mg biji
165 Kontrasepsi Oral paket
166 Kotrimoksazol Suspensi botol 60 ml
167 tablet
Sulfametoksazol 100 mg, Trimetoprim 20 mg
168 tablet
Sulfametoksazol 400 mg, Trimetoprim 80 mg
169 Kuinin inj 25% ampul @ 2 ml
170 Kuinin tablet 200mg tablet
173 larutan Lugol botol
174 Lidokain gel 2% Syringe @ 10 g
175 Lidokain inj 2% ampul
176 Lidokain inj 1% ampul
177 Lidokain injeksi 2% (HCL) + Epinefrin 1 : 80.000 ampul
178 Lidokain Semprot 10% botol
179 Loratadine tablet 10mg tablet
180 Magnesium Sulfat inj (IV) 20%-25 ml vial
181 Magnesium Sulfat inj (IV) 40%-25 ml vial
182 Magnesium Sulfat serbuk 30 gram sakset
183 Mebendazol sirup 50 mg / ml btl 30 ml
184 Mebendazol tablet 100 mg tablet
185 Mebendazol tablet 500 mg tablet
186 Metformin HCl tablet 500 mg tablet
187 Metformin HCl tablet 850 mg tablet
189 Metilergometrin Maleat injeksi 0,200 mg -1 ml ampul
190 Metoklopramide HCl tablet 10mg tablet
191 Metoklorpramide tablet 5mg tablet
192 Metronidazol tablet 250 mg tablet
193 Metronidasol tablet 500mg tablet
194 Metronidazol infus 500 mg/100 ml btl 100 ml
195 Metronidazol sirup 125mg/5ml botol
196 Metronidazole supp 500mg sup
197 Mikonazol krim /salep 2 % tube
198 Mikonazol serbuk 2% botol
199 Natrium Bikarbonat tablet 500 mg tablet
200 Natrium Diklofenak tablet 25 mg tablet
201 Natrium Diklofenak tablet 50 mg tablet
202 Natrium Thiosulfat injeksi i.v. 25 % ampul @ 10 ml
203 Nikotinamide tablet 100mg tablet
206 Nipedipin tablet 10mg tablet
207 Nistatin suspensi 100.000 IU/ml botol
208 Nistatin tablet salut 500.000 IU/g tablet
209 Nistatin Vaginal tablet salut 100.000 IU/g tablet
210 Nitrofurantoin tablet 100 mg tablet
211 Norepinefrin injeksi 1mg/ml ampul
212 OAT FDC Anak paket
213 OAT FDC I paket
214 OAT FDC II paket
215 OAT FDC Sisipan paket
216 OAT Kombipak I paket
217 Oksigen Gas Dalam Tabung 1 kg
218 Oksigen Gas Dalam Tabung 6 kg
219 Oksimetazolin tetes hidung 0,025% btl 10 ml
220 Oksimetazolin tetes hidung 0,050% btl 10 ml
221 Oksitosin injeksi 10 UI/ml-1 ml ampul
222 Olopatadin tetes mata 1% botol
224 Omeprazol kapsul 20mg kapsul
225 Paraformaldehid tablet 1 gram tablet
226 Parasetamol sirup 120 mg / 5 ml btl 60 ml
227 Parasetamol tablet 500mg tablet
228 Parasetamol tetes 60mg/0,6 ml botol
229 Perak Nitrat larutan 20% botol
230 Perak Sulfadiazin krim 1% tube
231 Permetrin krim 5% tube
232 Pirantel sirup 125 mg/5 ml btl 60 ml
233 Pirantel tab. Score (base) 125 mg tablet
236 Pirazinamid tablet 500 mg tablet
237 Piridoksin (Vitamin B6) tablet 10 mg (HCL) tablet
238 Piridoksin (Vitamin B6) tablet 20 mg (HCL) tablet
239 Piridoksin injeksi 100mg/ml tablet
240 Povidon Iodida larutan 10 % btl 30 ml
241 Povidon Iodida larutan 10% botol 300ml
242 Prazikuantel tablet 300 mg tablet
243 Prazikuantel tablet 600 mg tablet
244 Prednison tablet 5 mg tablet
245 Primakuin tablet 125mg tablet
246 Probenesid tab 500 mg tablet
247 Procain Bensil Penisilin serbuk inj. 1 jt IU/vial (im) vial
248 Procain Bensil Penisilin serbuk inj. 3 jt IU/vial (im) vial
249 Propanolol tablet 10 mg (HCl) tablet
250 Propillitiourasil tablet 100 mg tablet
251 Ranitidin tablet 150mg tablet
252 Retinol (vitamin A) kapsul lunak 100.000IU kapsul
253 Retinol kapsul 200.000 IU kapsul
254 Salbutamol inhaler 0,5% botol
255 Salbutamol tablet 2 mg (sebagai sulfat) tablet
256 Salbutamol tablet 4 mg (sebagai sulfat) tablet
257 pot
Asam Salisilat 2% + Belerang endap 4%
258 Salep Asam Salisilat 5% pot
259 Salisil bedak 2% ktk 50 gram
260 Setrizine sirup 5mg/5ml botol
261 Sianokobalamin (Vitamin B12) injeksi 500 mcg ampul
262 Sianokobalamin (Vitamin B12) tablet 50 mcg tablet
263 Simvastatin tablet 10 mg tablet
264 Simvastatin tablet 20 mg tablet
265 Siprofloksasin tablet 500mg tablet
266 Spironolakton tablet 25 mg tablet
267 Streptomycin injeksi 1000 mg / vial visl
268 Tablet Tambah Darah tablet
269 Tetrakain HCL tetes mata 0,5% botol
270 Tetrasiklin kapsul 250 mg kapsul
271 Tetrasiklin kapsul 500 mg kapsul
272 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) tablet
273 Triheksifenidil tablet 2 mg tablet
274 Tuberkulin injeksi 1 : 10 (i.k). vial
275 Valproat sirup 250mg/5ml botol
276 Valproat tablet salut 250mg tablet
277 Valproat tablet salut 500mg tablet
278 Vitamin B Kompleks tablet tablet
279 Zinc serbuk 10mg sakset
280 Zinc sirup 20mg/5ml botol 60 ml
281 Zink Dispersible tablet 20mg tablet
- - -
1 Acetylsystein 200mg kapsul
2 Alkohol 70 % 100 ml botol
3 Alprazolam 1 mg tablet
4 Alprazolam 0.5 mg tablet
5 Ambroxol Syrup 15mg/5ml btl/60ml
6 Ambroxol tablet 30 mg tablet
7 Amoksisilin sirup kering 125 mg/ 5 mg btl 60 ml
8 Aquadest steril botol 1000 ml
9 Asam Asetisalisilat tablet 100 mg (Asetosal) tablet
10 Asam Asetisalisilat tablet 500 mg (Asetosal) tablet
12 Asam Traneksamat injeksi 100mg ampul
13 Asam Traneksamat injeksi 250mg ampul
14 Asiklovir krim 5 % tube 5 gram
15 Azytromicn 500 mg tablet
16 Betahistin Metisalat tablet 6 mg tablet
17 Calcium Alginate (Bioplacenton) tulle sachet
18 Cefixime 100 mg kapsul
19 Cefixime 200 mg + Azitromycin 500 mh (Kombipak) paket
20 Cetirizin kapsul 10 mg kapsul
21 Cimetidin tablet 200mg tablet
22 Clavamox injeksi 1.000 IV 1,2 gr vial
23 Clobazam tablet 10 mg tablet
24 Co Amoxiclav capsul 625 mg capsul
25 Digoksin 0,0625 mg tablet
26 Digoksin injeksi 0,25 mg/ml ampul @ 2 ml
27 Dopamin injeksi ampul
28 Efedrin tablet 25 mg (HCL) tablet
29 Ekstraks belladona tablet 10 mg tablet
30 Erythromicin kapsul 500mg kapsul
31 Etakridin larutan 0,1% btl 300ml
32 Fenilbutason tablet 200 mg tablet
33 Fenitoin kapsul 30 mg (garam natrium) kapsul
34 Fenol Gliserol TT 10% botol
35 Fitomenadion (Vit. K1) injeksi 10 mg/ml ampul @ 1 ml
36 Flukonazol tablet 150 mg tablet
37 Fluoksetine hcl 20mg kapsul
38 Fluoresein tetes mata 2,5mg/ml botol
39 Framycetin sulfat lembar
40 Gentamicin krim 0,1% tube
41 Gentamisin salep kulit 0,1% tube
42 Gentamisin Sulfat tetes mata 5 ml btl 10 ml
43 Gentamycin injeksi 40mg/ml ampul @ 2 ml
44 Gentian Violet 1% botol
45 Gliseril Gualakolat tablet 100 mg tablet
46 Glukosa larutan infus 10% btl 500 ml
47 Glukosa larutan infus 40% ampul
48 Glukosa larutan infus 5% btl 500 ml
49 Hyoscine N-Butylbromide injeksi 20mg/ml ampul @ 1 ml
50 Ketokenazol krim 2% tube
51 Ketoprofen injeksi ampul
52 Ketoprofen sup 100mg sup
53 Ketoprofen sup 100mg sup
54 Kloramfenikol Tetes Telinga 3% botol
55 Klozapine 25mg tablet
56 Lansoprazol kapsul 30 mg kapsul
57 Lisol botol
58 Lisol (Kresol tersaponifikai 50%) btl 1000 ml
59 Meloksikam tablet 7,5 mg tablet
60 Metakresol Sulfonat solution btl
61 Metampiron 250mg, Aminofenazon 50mg, Silokain HCl 15mg inj. vial
62 Metampiron tablet 500 mg tablet

63 Methylprednisolon tablet 4 mg tablet
66 Metoklopramide HCl injeksi 5mg/ml10mg ampul
67 Multivitamin sirup botol
68 Natrium Bikarbonat injeksi (Meylon) ampul 25 ml
69 Natrium Klorida larutan infus 0,9 % btl 500 ml
70 Natrium Klorida larutan infus 3% btl 500 ml
71 Neomycin Sulfat 0,5%, placenta extr. 100mg/ml tube
72 New diaform tablet
73 Obat Batuk hitam ( O.B.H.) btl 100 ml
74 Oksitetrasiklin HCL salep mata 1 % tube
75 Oksitetrasiklin salep kulit tube 5 gram
76 Ondancentron tablet 4mg tablet
77 Papaverin tablet tablet
78 Parasetamol Rectal 125mg sup
79 Parasetamol tablet 100 mg tablet
80 Pehacain injeksi ampul
81 Petidin injeksi 50 mg/ml ampul @ 2 ml
82 Pilokarpin tetes mata 2 % (HCL/Nitrat) btl 5 ml

83 Pilokarpin tetes mata 4% btl 5 ml
84 Piracetam injeksi 1 gr / 5ml ampul
85 Piracetam tablet 800mg tablet
86 Piroxicam kapsul 10mg tablet
87 Piroxicam kapsul 20mg tablet
88 Ranitidin injeksi 25mg/2ml ampul
89 Retinol (Vitamin A) tablet 50.000 IU tablet
90 Rifampisin kaplet 600 mg tablet
91 Rifampisin tablet salut 450 mg tablet
92 Ringer Laktat larutan infus btl 500 ml
93 Risperidone tablet 2mg tablet
94 Salbutamol inhaler botol
95 Salbutamol Nebulizer 2,5mg/2,5ml ampul
96 Salbutamol Rotahaler pcs
97 Salbutamol serbuk kapsul inhaler 200 mg kapsul
98 Salbutamol sirup 2 mg / 5 ml botol
99 Salicyl Spiritus btl
100 Sefadroksil 500 mg tablet
101 Spironolakton tablet 100mg tablet
102 Sulfadiazin tablet 500 mg tablet
103 Sulfasetamida Natrium tetes mata 15 % botol
104 Thiamin HCl injeksi 100mg/ml-1ml ampul
105 Tiamin (vitamin B1) tablet 100 mg (HCL/Nitrat) tablet
106 Triflouperazin tablet 5 mg tablet
107 Trimetoprim tablet scored 200 mg tablet
108 Xilomidon inj vial
109 Zinc sirup tetes 10mg/ml botol 15 ml
110 Jelly USG -
BUKU PENERIMAAN OBAT
SUB UNIT : RUANG FARMASI

BULAN : DESEMBER
TAHUN : 2017
TERIMA KET

2 Acetylsystein 200mg kapsul 240
4 Alkohol Swab 300
5 Alopurinol tablet 100 mg tablet 200
6 Ambroxol Syrup 15mg/5ml btl/60ml 14
7 Ambroxol tablet 30 mg tablet 800
8 Amlodipine tablet 10mg tablet 480
9 Amlodipine tablet 5mg tablet 180
10 Amoksisilin kaplet 500 mg tablet 3,000
11 Amoksisilin sirup forte 250 mg/5ml botol 60 ml 30
12 Amoksisilin sirup kering 125 mg/ 5 mg btl 60 ml 10
13 tablet
Aluminium Hidroksida 200 mg + Magnesium Hidroksida 200 mg
300
14 Antasida DOEN sirup kombinasi botol 60 ml 20
15 tube
Basitrasin 500 IU/g + polimiksin 10.000 IU/g 15
16
Betametason + Neomicyn 57
17 Asam Askorbat (vitamin C) tablet 50 mg tablet 2,500
18 Asam mefenamat tablet 500mg tablet 1,300
19 Asiklovir tablet 400 mg tablet 100
20 Atapulgit tablet tablet 200
21 Betahistin Metisalat tablet 6 mg tablet 150
22 Betametason krim 0,1 % tube 25
23 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah pcs 24
24 Cholesterol strip box 25 strip 10
25 Clobazam tablet 10 mg tablet 100
26 Deksametason tablet 0,5mg tablet 200
27 Domperidon suspensi 5mg/5ml botol 5
28 Etakridin larutan 0,1% btl 300ml 2
29 Etanol 70% larutan btl 1000 ml 1
30 Etil Klorida spray btl 100 ml 3
31 Fitomenadion (Vit. K1) injeksi 10 mg/ml ampul @ 1 ml 5
32 Fluoksetine hcl 20mg kapsul 90
33 Fluphenaszine Decanoate i.m 25 mg/ml ampul 1 ml 8
34 Natrium 0,70 g , Kalium klorida 0,30 g, Trinatrium Sitrat dihidrat 0,58 g sachet
125
35 Gentamisin Sulfat tetes mata 5 ml btl 10 ml 5
36 Glibenklamida tablet 5 mg tablet 100
37 Gliseril Gualakolat tablet 100 mg tablet 1,400
38 Gluco Protein Urine kotak 10 strip 50
39 Glukosa Darah Strip (Bene Check) strip 100
40 Haloperidol tablet 5 mg tablet 300
41 Handscoon biji 1,800
42 Handscoon Gynaecolog (Panjang) Set /kantong 5
43 Handscoon Steril pasang 250
44 Hidroklorotiazida tablet 25 mg tablet 100
45 Hidrokortison krim 2,5% tube 15
46 Ibuprofen tablet 400 mg tablet 600
47 Isoniazid tablet 100 mg tablet 100
52 Kalsium Laktat (Kalk) tablet 500 mg tablet 900
53 Kaptopril tablet 12,5 mg tablet 200
54 Kaptopril tablet 25 mg tablet 600
55 Kasa Hidrofil uk. 36 m x 80 cm rol 4
56 Kasa Pembalut Elastic 4 m x 10 cm sak 15
57 Kasa Pembalut Elastic 4 m x 5 cm rol 75
58 Kertas Perkamen bungkus 2
59 Ketokonazol tablet 200mg tablet 50
60 Klip Obat Kecil buah 1,300
61 Klip Obat Tanggung pcs 500
62 Kloramfenikol salep mata 1% tube 19
63 Klorfeniramin mealeat (CTM) tablet 4 mg tablet 1,200
64 Klorpromazin tablet salut 100 mg (HCL) tablet 300
65 Klozapine 25mg tablet 100
66 Kontrol Darah kit (2.5ml) 1
67 Kotrimoksazol Suspensi botol 60 ml 5
68 Lidokain inj 2% ampul 60
69 Masker buah 1,250
70 Metformin HCl tablet 500 mg tablet 1,100
72 Metilergometrin Maleat injeksi 0,200 mg -1 ml ampul 3
73 Metronidasol tablet 500mg tablet 100
74 Mikonazol krim /salep 2 % tube 5
75 Natrium Diklofenak tablet 50 mg tablet 350
76 Natrium Klorida larutan infus 0,9 % btl 500 ml 19
79 Obat Batuk hitam ( O.B.H.) btl 100 ml 5
80 Oksitosin injeksi 10 UI/ml-1 ml ampul 10
81 Omeprazol kapsul 20mg kapsul 60
82 Parasetamol Rectal 125mg sup 12
83 Parasetamol sirup 120 mg / 5 ml btl 60 ml 100
84 Parasetamol tablet 500mg tablet 3,300
85 Parasetamol tetes 60mg/0,6 ml botol 40
86 Perak Sulfadiazin krim 1% tube 1
87 Permetrin krim 5% tube 11
88 Piridoksin (Vitamin B6) tablet 10 mg (HCL) tablet 200
89 Piroxicam kapsul 20mg tablet 100
90 Pisau Operasi biji 90
91 Pot Dahak sakset 45
92 Povidon Iodida larutan 10% botol 300ml 2
93 Ranitidin tablet 150mg tablet 200
94 Reagen Ziehl Neelsen (TBC) paket 1
95 Retinol kapsul 200.000 IU kapsul 100
96 Ringer Laktat larutan infus btl 500 ml 5
Risperidone tablet 2mg tablet 200
Salisil bedak 2% ktk 50 gram 40
SD Bio Line HIV 1/2 strip 200
Setrizine sirup 5mg/5ml botol 5
Siprofloksasin tablet 500mg tablet 100
Sulfasetamida Natrium tetes mata 15 % botol 5
Tablet Tambah Darah tablet 1,700
Tisue bal 3
Triflouperazin tablet 5 mg tablet 200
Triheksifenidil tablet 2 mg tablet 300
Underpad biji 10
Vitamin B Kompleks tablet tablet 4,000
Zinc sirup 20mg/5ml botol 60 ml 5
Zinc sirup tetes 10mg/ml botol 15 ml 14
Zink Dispersible tablet 20mg tablet 100

12.register LPLPO Desember

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12.register LPLPO Desember

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UPT PUSKESMAS KLUNGKUNG I

Sub Unit : Ruang Farmasi

136 Karbamazepin sirup 100mg/5ml botol 120 ml

Pemakaian (tanggal) JUMLAH SISA KETERAN

750 750 250

Sub Unit : Ruang Farmasi

Pemakaian (tanggal) JUMLAH SISA KETERAN

Sub Unit : Ruang Farmasi

Obat Formularium Nasional Untuk Puskesmas

VAKSIN DAN SERUM

UMUM PBI NON JUMLAH

Mengetahui/Menyetujui Yang Menyerahkan

drg. I.B. Putra Dwipayana Kadek Eddy Dwi Cahyadi, S.Farm.,Apt.

SISA PERMI PEMBE KET

Ni Putu Wiwin Sofi Martianti, Amd.Keb.

SUB UNIT : RUANG FARMASI

Obat Formularium Nasional Untuk Puskesmas

Antasida DOEN I tablet kunyah, kombinasi :

19 Antasida DOEN sirup kombinasi botol 60 ml

99 Glibenklamida tablet 2,5 mg tablet

61 Metampiron 250mg, Aminofenazon 50mg, Silokain HCl 15mg inj. vial

62 Metampiron tablet 500 mg tablet

81 Petidin injeksi 50 mg/ml ampul @ 2 ml

82 Pilokarpin tetes mata 2 % (HCL/Nitrat) btl 5 ml

SUB UNIT : RUANG FARMASI

Obat Formularium Nasional Untuk Puskesmas

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