Lplpo Lraya Belanti 2017 File Sali

LAPORAN PEMAKAIAN OBAT DAN LEMBAR PERMINTAAN OBAT (LPLPO)
KODE PUSKESMAS :
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Pe
KABUPATEN/KODYA : TAPIN Tahun
PROPINSI : KALIMANTAN SELATAN
STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

NAMA OBAT SATUAN SISA STOK
NO AWAL AAN AAN AN OPT. AAN
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
OBAT SANGAT-SANGAT ESENSIAL
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - - - - -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - - - -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - - - -
5 Kloramfenikol Kapsul 500 mg Tablet - - - - - -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - - - -
Kombinasi pirimetamin 25 mg + sulfadoksin 500
7 mg @ 100 Tab Tablet - - - - - -
8 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - - - - -
10 Kuinin (kina) tablet 200 mg Tablet - - - - - -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - - - -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - - - -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - - - -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - - - -
- -
SIRUP - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - - - -
2 Kotrimoksazole suspensi komb. Botol - - - - - -
- -
INJEKSI - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - - - -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - - - -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - - - - -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 Ampul - - - - - -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - - - -
6 Lidokain Komp. Inj Komb Ampul - - - - - -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - - - -
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU Vial - - - - - -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - - - -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - - - -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - - - -
12 Vaksin Rabies Vero (VAR) Vial - - - - - -
13 Tetagam Vial - - - - - -
- -
INFUS - -
1 Glukosa Larutan infus 10 % steril @ 20 fls fls - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
4 Ringer laktat larutan infus steril @ 20 fls fls - - - - - -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - - - -
- -
OBAT GIGI - -
1 Air raksa Dental Use Ktk - - - - - -
2 Devitalisasi pasta ktk - - - - - -
3 EtiL klorida semprot Botol - - - - - -
4 Forinekresol (pengganti TKF) ktk - - - - - -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - - - -
6 Kalsium hidroksi pasta ktk - - - - - -
7 Klorfenol kamfer menthol (CHKM) ktk - - - - - -
8 Mummiying Pasta ktk - - - - - -
9 Semen seng Fosfar serbuk & cairan ktk - - - - - -
10 Silver amalgam serbuk 65 - 75 % ktk - - - - - -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - - - -
12 Temporary Stoping Flecther serbuk & Cair set - - - - - -
- -
ALAT KESEHATAN - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - - - -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - - - -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - - - -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - - - - -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - - - -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - - - -
8 Infusion set anak Pcs - - - - - -
9 Infusion
Silk set dewasa
(benang bedah sutera) No. 3/0 dengan Pcs - - - - - -
10 jarum @ 36 pcs Pcs - - - - - -
- -
OBAT SANGAT ESENSIAL & ESENSIAL - -
TABLET - -
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - - - -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - - - -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - - - -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - - - -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - - - -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - - - -
Asam asetilsalisilat (asetosal) tablet 100 mg @
7 100 Tab Tablet - - - - - -
8 100 Tab Tablet - - - - - -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - - - -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - - - -
12 Diazepam tablet 2 mg Tablet - - - - - -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - - - -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - - - - -
17 Fenobarbital tablet 100 mg Tablet - - - - - -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - - - - -
Fitominadion (Vit K) tablet salut gula 10 mg @
21 100 Tab Tablet - - - - - -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - - - -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - - - -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - - - -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - - - -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - - - -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - - - -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - - - -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - - - -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - - - -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - - - -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - - - - -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - - - -
34 Karbamazepin tablet
Klorpeniramine Maleat200 mg @
(CTM) 100 4Tab
tablet mg @ 100 Tablet - - - - - -
35 Tab Tablet - - - - - -
36 Klorpromazine HCl tablet salut 100 mg Tablet - - - - - -
38 Magnesium sulfat serbuk 30 g Pot - - - - - -
39 Mebendazole tablet 100 mg Tablet - - - - - -
Metilergometrin maleat tab. Salut 0,25 mg @ 100
40 Tab Tablet - - - - - -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - - - -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - - - -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - - - -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - - - -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - - - -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - - - -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - - - -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - - - -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - - - -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - - - -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - - - -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - - - -
- -
SIRUP - -
1 Antasida DOEN Suspensi Komb Botol - - - - - -

2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - - - -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - - - -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - - - -
- -
INJEKSI - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - - - -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - - - -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - - - -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - - - -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - - - -
6 Fenobarbital injeksi Ampul - - - - - -
Fitominadion (Vit K) injeksi 10 mg/ml - 1 ml @ 30
7 Amp Ampul - - - - - -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - - - -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - - - -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - - - -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - - - -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - - - -
Sianokobalamin injeksi(Vit B12) 500 mcg - ml @
14 100 Amp Ampul - - - - - -
Tiamin HCl (Vit B1)inj 100 mg/ ml - 1 ml @ 30
15 Amp Ampul - - - - - -
- -
SALEP - -
Salep 2 - 4 :komb Asam salisilat 2 % + Belerang
1 endapan 4 % @ 24 Pot Pot - - - - - -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - - - -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - - - -
4 Antibakteri DOEN Komb. Pot - - - - - -
5 Antifungi DOEN Komb. Pot - - - - - -
- -
SALEP MATA - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - - - -
- -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
TETES MATA - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - - - -
- -
TETES TELINGA - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - - - -
2 Fenol gliserol TT Botol - - - - - -
- -
OBAT LUAR - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - - - -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - - - -
3 Gentian violet larutan 1 % Botol - - - - - -
4 Kalium Permanghanat serbuk Botol - - - - - -
5 Povidon Iodida 10 % 30 ml Botol - - - - - -
7 Salisilat Bedak 2 % Kotak - - - - - -
- -
OBAT GIGI - -
1 Eugenol cairan Botol - - - - - -
- -
ALAT KESEHATAN - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - - - -
2 Kasa kompres 40 / 40 steril Bks - - - - - -
3 Kasa pembalut 2 m x 80 cm Rol - - - - - -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - - - -
6 Pembalut gips Rol - - - - - -
7 Plester 5 yard x 2 inch Rol - - - - - -
- -
OBAT PENUNJANG - -
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - - - - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - - - -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - - - -
5 Alprazolam Tablet @ 100 Tab Tablet - - - - - -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - - - -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - - - -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 Tablet - - - - - -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - - - -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - - - -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - - - -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - - - -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
15 Aspilet tablet @ 100 Tab Tablet - - - - - -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - - - - -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - - - -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - - - -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - - - -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - - - -
21 Captopril tablet 25 mg @ 100 Tab Tablet - - - - - -
22 Cefadroksil tab 250 mg Tablet - - - - - -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - - - -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - - - -
25 Cetirizine tablet Tablet - - - - - -
26 Cimetidine tablet @ 100 Tab Tablet - - - - - -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - - - -
28 Clobazam tablet @ 100 Tab Tablet - - - - - -
29 Codein Tablet 10 mg Tablet - - - - - -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - - - -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - - - -
33 Dimenhidrinat tablet @ 100 Tab Tablet - - - - - -
34 Doksisiklin tablet @ 100 Tab Tablet - - - - - -
35 Domperidon Tablet @ 100 Tab Tablet - - - - - -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - - - -
37 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - - - -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - - - -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - - - -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - - - -
41 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - - - -
42 Glimepiride Tab 2 mg Tablet - - - - - -
Hyoscyamine N-Bbr 10 mg + PCT (Scopma Plus)
43 Tablet @ 100 Tab Tablet - - - - - -
44 Ketokonazole tablet @ 50 tab Tablet - - - - - -
45 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - - - -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - - - -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - - - -
49 Levofloksasin @ 30 Tab Tablet - - - - - -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - - - -
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - - - -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - - - -
53 Loratadine tablet 10 mg @ 50 tab Tablet - - - - - -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - - - - -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - - - -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
57 Mepromaag tablet @ 100 Tab Tablet - - - - - -
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - - - -
59 Methioson Tablet @ 30 Tab Tablet - - - - - -
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - - - -
61 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - - - -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - - - -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - - - -
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - - - -
65 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - - - - -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - - - -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - - - -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - - - -
69 Nifedipin Tablet @ 100 Tab Tablet - - - - - -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - - - -
71 Omeprazole kapsul @ 30 Kap Kapsul - - - - - -
72 Papaverin tablet @ 1000 Tab Tablet - - - - - -
73 Paraformaldehide tablet @ 100 Tab Tablet - - - - - -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - - - -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - - - - -
76 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - - - -
78 Propanolol 10 mg Tab Tablet - - - - - -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - - - -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - - - -
81 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Kapsul - - - - - -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - - - - -
83 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Ta Tablet - - - - - -
85 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - - - - -
86 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - - - - -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - - - -
89 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - - - -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - - - -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - - - - -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - - - -
93 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - - - -
94 Tramadol Tablet @ 50 Tab Tablet - - - - - -
- -
SIRUP - -
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - - - -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - - - -
4 Anti Diare (Arcapec) Sirup Botol - - - - - -
5 Anti sariawan (Enkasari) Sirup Botol - - - - - -
6 Batugin Elixier @ 120 ml botol - - - - - -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - - - -
8 Bromhexin (Phytovon) Sirup Botol - - - - - -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - - - -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - - - -
11 Cetirizine (Lerzin) Sirup Botol - - - - - -
12 Domperidon Sirup Botol - - - - - -
13 Domperidon Drop Botol - - - - - -
14 Erytromycin Sirup Botol - - - - - -
15 Fe Kombinasi (maltiron) Sirup Botol - - - - - -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - - - - -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - - - -
18 Gastrinal Suspensi Botol - - - - - -
19 Ibuprofen (Farsifen) Sirup Botol - - - - - -
20 Klorampenikol suspensi Botol - - - - - -
21 Lactulosa Sirup Botol - - - - - -
22 Laxadine Sirup @ 30 ml Botol - - - - - -
23 Metamizol (Norages) Sirup Botol - - - - - -
24 Metoklopropamid (Gavistal) Drop Botol - - - - - -
25 Metronidazole (Farizol) Sirup Botol - - - - - -
26 Metoklopropamid sirup Botol - - - - - -
27 Metronidazole Infus Botol - - - - - -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - - - -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - - - -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - - - -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - - - -
32 Nifuroxide (Nifudiar) Sirup Botol - - - - - -
33 Nistatin (Cazetin) Drop Botol - - - - - -
34 Parasetamol Drop Botol - - - - - -
35 Pseudoefedrin (Alco) Drop Botol - - - - - -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - - - -
37 Zinc drop Botol - - - - - -
38 Zinc Sirup Botol - - - - - -
- - -
INJEKSI - - -
1 Alinamin F injeksi @ 5 Amp Ampul - - - - - -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - - - -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - - - -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - - - -
5 Ceftriaxon Injeksi 1 gram @ 10 vial Vial - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - - - -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - - - -
8 Dopamin Injeksi Ampul - - - - - -
9 Furusemide Injeksi Ampul - - - - - -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - - - -
Hyoscyamine N-Butil bromide (Gitas)Injeksi @ 5
Ampul
11 Ampul - - - - - -
12 Kanamycin Inj vial - - - - - -
13 Kloramfenikol Injeksi Vial - - - - - -
Kombinasi Antalgin 250 mg + Pyramidon 500 mg
Vial
14 (Xylomidon) Inj @ 25 vial - - - - - -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - - - -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - - - -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - - - -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - - - -
19 Ondasentron Injeksi Ampul - - - - - -
20 Pethidin injeksi Ampul - - - - - -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - - - - -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - - - -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - - - -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - - - -
26 Xylocain Injeksi Ampul - - - - - -
27 Lidocain 2% Injeksi Ampul - - - - - -
INFUS - -
1 KAEN 3A fls - - - - - -
2 KAEN 3B fls - - - - - -
3 Glukosa 5% + 1/4 NS fls - - - - - -
4 Glukosa 5% + 1/2 NS fls - - - - - -
- -
SALEP/KRIM - -
1 Acyclovir cream @ 25 Tube tube - - - - - -
2 Bioplacenton Jelly tube - - - - - -
3 Gentamisin salep kulit @ 10 Tube tube - - - - - -
4 Ictiol salep Pot - - - - - -
5 Ketokonazole krim tube - - - - - -
6 Miconazole krim @ 24 Tube tube - - - - - -
7 Nostren Cream Tube - - - - - -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - - - -
9 Piroksikam (Infeld) Gel Tube - - - - - -
10 Scabimite cream @ 24 Tube tube - - - - - -
- -
SALEP MATA - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
1 Kloramfenikol Salep Mata tube - - - - - -
- -
TETES MATA - -
1 Cendo Catarelent Botol - - - - - -
2 Cendo Xitrol Botol - - - - - -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - - - -
4 Kloramfenikol Tetes Mata Botol - - - - - -
5 Tetrakain (Pantocain) TM Botol - - - - - -
- -
TETES HIDUNG - -
1 Iliadin Drop Botol - - - - - -
2 Iliadin Spray Botol - - - - - -
- -
TETES TELINGA - -
1 Otopain TT Botol - - - - - -
- -
OBAT LUAR / LAIN- LAIN - -
1 Anti sariawan (Albotyl) Sol Botol - - - - - -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - - - -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - - - -
4 Borax gliserin Botol - - - - - -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - - - -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - - - -
Fenoterol Hydrobromide 100 mcg (Berotec)
7 Semprot Spray kotak - - - - - -
8 Larutan Chlorhexide @ 500 ml Botol - - - - - -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - - - -
10 Salisil spritus Botol - - - - - -
- -
ALAT KESEHATAN - -
1 Bisturi @ 100 pcs pcs - - - - - -
2 Blood Lancet ss @ 100 pcs pcs - - - - - -
3 Daryan tulle @ 10 lbr Lembar - - - - - -
4 EKG Paper 80 x 30 Roll - - - - - -
5 EKG Paper 40 x 30 Roll - - - - - -
6 Foley cateter no. 16 @ 10 pcs pcs - - - - - -
7 Foley cateter no. 18 10 Pcs pcs - - - - - -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - - - -
9 Hand schoen no. 7 @ 50 psg psg - - - - - -
10 Hand schoen no. 7,5 @ 50 psg psg - - - - - -
11 Hand Schoen No. 8 @ 50 psg psg - - - - - -
12 Hand schoen steril no. 7 @ 50 psg psg - - - - - -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - - - -
16 Hypapix 5 x 1 m roll - - - - - -
17 Jarum Hecting Kulit lsn - - - - - -
18 Jarung Hecting Otot lsn - - - - - -
19 Kasa Hidrofil 40 x 80 pcs - - - - - -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - - - -
21 Kasa steril 16 x 16 pad roll - - - - - -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - - - -
23 Mami non waven @ 24 pcs pcs - - - - - -
24 Masker @ 100 pcs pcs - - - - - -
25 Needle No. 23 G @ 100 pcs pcs - - - - - -
26 Needle No. 25 G 100 pcs pcs - - - - - -
27 Optiva No. 20 @ 50 pcs pcs - - - - - -
28 Paket P3K pcs - - - - - -
29 Spuit Injeksi 10 ml pcs - - - - - -
30 Spuit Injeksi 50 ml Set - - - - - -
31 Surflo No. 20 @ 50 pcs pcs - - - - - -
32 Surflo No. 22 @ 50 pcs pcs - - - - - -
33 Surflo No. 24 @ 50 pcs pcs - - - - - -
34 Test Kehamilan Stik @ 50 pcs pcs - - - - - -
35 Ultrasonic Gel pcs - - - - - -
36 Urine bag Stik - - - - - -
37 USG Printing Paper UPP-110 HG pcs - - - - - -
38 Wing needle no. 21 pcs - - - - - -
40 Boor Diamond High Speed pcs - - - - - -
41 Boor Diamond Low Speed pcs - - - - - -
- -
OBAT PROGRAM - -
PROGRAM P2 MALARIA - -
1 Abate kg - - - - - -
2 ACT Tablet Ktk - - - - - -
3 Arsumodon tablet Tablet - - - - - -
4 Artem Injeksi Ktk - - - - - -
6 Artesdiaquine Tablet Ktk - - - - - -
7 Artesunate Injeksi ampul - - - - - -
8 Cynoff liter - - - - - -
9 Kelambu Pcs - - - - - -
10 Rafid Test Dengeu @ 25 test Pcs - - - - - -
11 RDT Chikungunya Pcs - - - - - -
12 RDT Malaria Pcs - - - - - -
13 RDT Salmonella Pcs - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - - - - -
- -
PROGRAM P2 IMUNISASI - -
1 Alat suntik sekali pakai 0.05 ml pcs - - - - - -
3 Safety Box Pcs - - - - - -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - - - -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - - - -
6 Vaksin Campak + Pelarut (10 dosis) vial - - - - - -
8 Vaksin DT Vial - - - - - -
9 Vaksin Hepatitis (HBO) ampul - - - - - -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - - - -
11 Vaksin Polio + Droper (10 Dosis) Vial - - - - - -
12 Vaksin Polio IPV 5 Dosis Vial - - - - - -
13 Vaksin Td vial - - - - - -
14 Vaksin TT Vial - - - - - -
15 Vaksin DPT HB HIB Vial - - - - - -
- -
PROGRAM P2 TB - -
1 Box Slides pcs - - - - - -
2 Bunsen Stainlestell ktk - - - - - -
3 FDC I ktk - - - - - -
4 FDC I & III ktk - - - - - -
5 FDC II siklus - - - - - -
6 Kaca Ose siklus - - - - - -
7 Kombipak kategori 1 ktk - - - - - -
8 Lampu Spritus siklus - - - - - -
9 Obat antituberkolosis Kategori Anak siklus - - - - - -
10 Obat antituberkolosis Kategori sisipan ktk - - - - - -
11 Pot Sputum ktk - - - - - -
12 Reagen Zn Neilson set - - - - - -
13 Slide mikroskop kotak - - - - - -
14 Spritus Botol - - - - - -
15 Masker N-95 pcs - - - - - -
16 Mikroskop Binoculer unit - - - -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - - - -
- -
PROGRAM P2 DIARE - -
1 Zn Tablet 500 mg Tablet - - - - - -
- -
PROGRAM P2 KUSTA - -
1 MDT MB Anak Strip - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
2 MDT MB Dewasa Strip - - - - - -
3 MDT PB Anak Strip - - - - - -
4 MDT PB Dewasa Strip - - - - - -
- -
PROGRAM KIA - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - - - -
2 Obat Suntik KB 1 Bulan @ 20 vial vial - - - - - -
4 Gluconas Calsicus vial - - - - - -
- -
REAGEN LABORATORIUM - -
1 Alkohol 70 % @ 1000 ml Botol - - - - - -
2 Alkohol 70% @ 100 ml Botol - - - - - -
3 Alkohol 95 % @ 1000 ml botol - - - - - -
4 Alkohol Swab @ 100 pcs Kotak - - - - - -
5 Coumbour 10 Parameter botol - - - - - -
6 EDTA 10 % botol - - - - - -
7 Gliserin Botol - - - - - -
8 Gluko dr Stik @ 25 Stik botol - - - - - -
9 Golongan Darah Test set - - - - - -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - - - -
11 Larutan Anisol botol - - - - - -
12 Larutan Asam Asetat 6% botol - - - - - -
13 Larutan Asam Sulfosalilisat botol - - - - - -
14 Larutan Barium Klorida 10 % botol - - - - - -
15 Larutan Benedict Botol - - - - - -
16 Larutan Buffer Ph botol - - - - - -
17 Larutan Carbol Gentian Violet botol - - - - - -
18 Larutan Drabkin Botol - - - - - -
19 Larutan Eosin 2 % Botol - - - - - -
20 Larutan Etanol Asam Botol - - - - - -
21 Larutan Foucet botol - - - - - -
22 Larutan Giemsa Stain Botol - - - - - -
23 Larutan H2SO4 p Botol - - - - - -
24 Larutan HCl 0,1% botol - - - - - -
25 Larutan HNO3 P Botol - - - - - -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - - - -
27 Larutan KOH 10 % Botol - - - - - -
28 Larutan Metelin Biru Botol - - - - - -
29 Larutan Turk Botol - - - - - -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - - - -
31 Metanol Botol - - - - - -
32 Na Citrat 3,8 % botol - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
33 Nesco Cholesterol Stik @ 10 Stik botol - - - - - -
34 Nesco Glucose Stik @ 25 Stik Botol - - - - - -
35 Nesco HB Stik @ 25 Botol - - - - - -
36 Nesco Uric Acid Stik @ 25 Stik botol - - - - - -
37 Oli Emersi botol - - - - - -
38 Rees Ecker botol - - - - - -
39 Trigeliserida Botol - - - - - -
40 Water Steril 500 ml Botol - - - - - -
42 widal Test Set - - - - - -
43 Xylol botol - - - - - -
44 Sungkup Bayi Pcs - - - - - -
45 NGT All Item Pcs - - - - - -
46 PP 3 juta Injeksi vial - - - - - -
47 Progesteron Injeksi Vial - - - - - -
48 Iodiom Test Pcs - - - - - -
49 Mineral Mix Bks - - - - - -
50 Eksavator Double Ended Pcs - - - - - -
51 Asetamivir tab Tablet - - - - - -
52 Natrium Tiroksin Pcs - - - - - -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - - - -
54 Stick Hemosmart Pcs - - - - - -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - - - -
56 Lab.Kit Paket - - - - - -
57 Blue Tips bks - - - - - -
58 Yellow Tips bks - - - - - -
59 Deck Glass ktk - - - - - -
60 Micro Hematokrit / Tabung Hematokrit pcs - - - - - -
61 Tissue Lensa bks - - - - - -
62 Stik HB Family Dr ktk - - - - - -
63 Tabung EDTA K3/Vacutainer pcs - - - - - -
64 Glukosa Stik Performa Accu Check kotak - - - - - -
65 Mikropipet (Microlit) 0-50 µl pcs - - - - - -
67 Glukosa Stik Active Accu Check Kotak - - - - - -
68 Kertas saring (isi 100 lbr) bks - - - - - -
69 Lidi Sputum (100 pcs) bks - - - - - -
70 Cotton Swab pcs - - - - - -
71 Specullum pcs - - - - - -
72 Eter Alkohol Botol - - - - - -
TOTAL
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
UMUM
JUMLAH KUNJUNGAN RESEP TIDAK ASKES JUMLAH
BAYAR
BAYAR
Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor

Kepala Dinas Kesehatan Kepala Instalasi Farmasi Kepala Puskesmas
Kab. Tapin Kab. Tapin Binuang,
H.Errani Martin,SKM.MM Septi Heryani, S. Farm, Apt Isrok Antariksa, SKM, M.Kes
NIP.19640314 198802 1 002 NIP 19890919 201402 2 006 NIP.19690928 198902 1 001
PERMINTAAN OBAT (LPLPO)
LB 2
Laporan/Permintaan : Desember / Januari

: 2017
PEMBERIA HARGA TOTAL EXP

BON
N SATUAN (Rp) HARGA (Rp.) DATE
11 12 13 (11 X 12) 14 15
207.00 -
233.00 -
317.00 -
275.00 -
1,155.00 -
93.50 -
520.30 -
77.00 -
158.00 -
641.00 -
105.00 -
318.00 -
125.00 -
246.40 -
2,200.00 -
2,225.00 -
1,740.00 -
2,604.90 -
1,056.00 -
2,354.00 -
6,820.00 -
2,122.00 -
1,900.00 -
520,300.00 -
193,470.80 -
139,150.00 -
401,092.00 -
174,500.00 -
170,000.00 -
6,270.00 -
1,597.60 -
: 2017

BON
11 12 13 (11 X 12) 14 15
6,900.00 -
7,150.00 -
6,410.00 -
103,536.00 -
293,498.00 -
99,000.00 -
185,900.00 -
306,427.00 -
242,000.00 -
56,441.40 -
137,853.00 -
93,500.00 -
408,792.00 -
14,053.63 -
158,042.00 -
1,540.00 -
957.00 -
2,049.00 -
7,201.04 -
7,201.04 -
8,896.88 -
7,286.25 -
7,920.00 -
7,920.00 -
5,743.86 -
95.00 -
86.00 -
123.00 -
163.90 -
64.00 -
149.00 -
96.80 -
157.30 -
120.00 -
66.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
48.00 -
46.00 -
52.80 -
108.00 -
146.00 -
80.00 -
100.00 -
64.83 -
257.40 -
456.50 -
796.00 -
84.00 -
126.00 -
108.00 -
224.00 -
62.00 -
76.00 -
105.00 -
171.00 -
121.00 -
133.00 -
98.00 -
169.00 -
306.00 -
47.50 -
162.00 -
39.93 -
1,129.30 -
231.00 -
169.00 -
98.00 -
15.73 -
857.00 -
602.00 -
34.51 -
136.00 -
114.00 -
351.00 -
82.00 -
114.00 -
167.20 -
: 2017

BON
11 12 13 (11 X 12) 14 15
325.00 -
91.00 -
97.00 -
132.00 -
2,300.00 -
1,573.00 -
3,740.00 -
1,119.00 -
4,204.00 -
1,345.00 -
5,800.00 -
1,210.00 -
20,857.00 -
1,930.00 -
1,914.00 -
1,210.00 -
724.00 -
2,800.00 -
3,500.00 -
1,527.70 -
2,970.00 -
1,226.00 -
843.33 -
2,200.00 -
2,712.00 -
1,435.00 -
2,767.00 -
4,782.00 -
1,640.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
3,549.00 -
1,759.00 -
2,246.00 -
3,502.00 -
5,500.00 -
2,178.00 -
6,529.00 -
2,344.00 -
15,950.00 -
1,066.00 -
20,815.00 -
14,187.50 -
1,984.03 -
8,739.41 -
2,740.50 -
760.91 -
6,071.00 -
25,987.00 -
272.00 -
628.46 -
258.74 -
2,200.00 -
990.00 -
155.30 -
163.00 -
105.00 -
5,283.00 -
173.00 -
139.00 -
150.00 -
113.00 -
1,540.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
123.00 -
170.00 -
230.00 -
695.00 -
121.00 -
69.00 -
72.00 -
564.00 -
557.00 -
899.00 -
154.00 -
115.50 -
298.00 -
1,120.00 -
630.00 -
-
1.00 -
126.00 -
107.00 -
250.00 -
133.00 -
509.00 -
766.00 -
1,210.00 -
1,100.00 -
683.00 -
245.00 -
296.00 -
1,925.00 -
292.00 -
660.00 -
405.00 -
4,813.00 -
341.00 -
581.00 -
410.00 -
660.00 -
90.00 -
170.00 -
726.00 -
462.00 -
292.60 -
: 2017

BON
11 12 13 (11 X 12) 14 15
495.00 -
118.50 -
1,026.00 -
230.00 -
140.00 -
100.00 -
102.00 -
220.00 -
560.00 -
167.00 -
193.00 -
440.00 -
123.00 -
700.00 -
164.00 -
125.00 -
7,700.00 -
1,485.00 -
360.80 -
97.02 -
102.37 -
85.00 -
242.00 -
119.00 -
286.00 -
505.00 -
68.00 -
84.00 -
58.00 -
135.00 -
252.00 -
1,525.00 -
350.00 -
100.00 -
73.73 -
88.00 -
615.38 -
2,680.00 -
3,791.00 -
4,147.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
21,450.00 -
16,500.00 -
12,760.00 -
20,352.00 -
3,594.00 -
6,050.00 -
6,285.00 -
7,960.00 -
7,756.00 -
3,180.00 -
17,939.00 -
8,090.00 -
19,250.00 -
16,500.00 -
11,550.00 -
24,200.00 -
2,560.00 -
4,000.00 -
14,500.00 -
12,450.00 -
33,000.00 -
5,830.00 -
3,800.00 -
2,750.00 -
12,980.00 -
22,000.00 -
24,200.00 -
10,902.00 -
7,354.00 -
38,500.00 -
32,120.00 -
5,980.00 -
64,350.00 -
20,350.00 -
11,700.00 -
6,500.00 -
14,972.60 -
5,610.00 -
2,536.00 -
9,350.00 -
11,000.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
33,000.00 -
3,578.00 -
10,219.00 -
2,012.00 -
3,415.00 -
4,950.00 -
6,610.80 -
10,790.00 -
5,555.00 -
8,800.00 -
6,600.00 -
5,500.00 -
9,570.00 -
2,400.00 -
14,509.10 -
3,300.00 -
17,088.00 -
1,600.00 -
2,680.00 -
4,000.00 -
40,000.00 -
875.00 -
10,000.00 -
10,050.00 -
9,350.00 -
9,400.00 -
2,997.00 -
13,200.00 -
1,835.16 -
4,300.00 -
2,605.00 -
3,737.00 -
12,100.00 -
1,649.36 -
19,058.00 -
12,155.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
1,640.00 -
22,000.00 -
26,812.00 -
4,600.00 -
2,750.00 -
11,500.00 -
30,305.00 -
36,000.00 -
35,145.00 -
23,100.00 -
5,800.00 -
5,670.00 -
1,899.00 -
18,458.00 -
12,749.00 -
80,000.00 -
73,443.75 -
66,000.00 -
5,430.00 -
770.00 -
221.00 -
16,500.00 -
45,375.00 -
27,500.00 -
10,318.00 -
9,080.00 -
737.74 -
4,675.00 -
4,675.00 -
4,675.00 -
6,325.00 -
6,325.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
6,325.00 -
6,050.00 -
12,650.00 -
24,200.00 -
24,200.00 -
119,174.19 -
1,957.50 -
7,480.40 -
3,960.00 -
1,210.00 -
425.60 -
660.00 -
660.00 -
15,400.00 -
311,900.00 -
1,393.90 -
5,693.00 -
8,355.00 -
8,355.00 -
8,355.00 -
1,564.20 -
27,500.00 -
3,404.00 -
320,000.00 -
2,145.00 -
2,145.00 -
440,000.00 -
330,000.00 -
99,220.00 -
36,300.00 -
3,566.78 -
14,868.83 -
125,400.00 -
38,999.00 -
387,800.00 -
1.00 -
57,200.00 -
55,000.00 -
40,700.00 -
66,000.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
79,200.00 -
1,900.00 -
1,448.00 -
23,000.00 -
45,100.00 -
45,100.00 -
22,527.00 -
41,998.00 -
14,487.00 -
18,750.00 -
23,782.00 -
16,203.00 -
137,610.00 -
14,250.00 -
11,913.00 -
43,900.00 -
-
100,000.00 -
82,500.00 -
395,900.00 -
396,000.00 -
1,379,984.00 -
265,000.00 -
317,015.00 -
69,000.00 -
247,229.00 -
176,000.00 -
2,930.00 -
236,500.00 -
27,500.00 -
27,500.00 -
21,420.00 -
1.00 -
1.00 -
512.00 -
14,862.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
30,595.00 -
7,462.00 -
8,323.00 -
2,298.00 -
6,249.95 -
6,249.95 -
1.00 -
24,222.22 -
2,625.00 -
48,400.00 -
128.97 -
220,000.00 -
66,000.00 -
5,203.00 -
309,500.00 -
385,000.00 -
618,750.00 -
120,000.00 -
20,400.00 -
69,300.00 -
11,000.00 -
75,625.00 -
61,250.00 -
70,000.00 -
122,195.00 -
230,000.00 -
41,700.00 -
199,100.00 -
77,500.00 -
41,255.00 -
8,470.00 -
55,000.00 -
28,400.00 -
44,550.00 -
20,900.00 -
17,900.00 -
64,300.00 -
30,400.00 -
8,000.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
150,000.00 -
103,400.00 -
148,500.00 -
82,500.00 -
313,500.00 -
74,800.00 -
418,000.00 -
5,500.00 -
24,750.00 -
440,000.00 -
27,500.00 -
220,000.00 -
1.00 -
1.00 -
1.00 -
1.00 -
2,475.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
105,875.00 -
139,700.00 -
38,500.00 -
363.00 -
48,400.00 -
357,500.00 -
1,507.00 -
420,000.00 -
- -
- -
170,500.00 -
53,900.00 -
36,300.00 -
7,700.00 -
1,000.00 -
78,100.00 -
-
: 2017

BON
11 12 13 (11 X 12) 14 15
Yang Menerima
Pengelola Obat
Puskesmas Binuang,
Mahdalena, S. Farm., Apt

NIP 19830909 201001 2 032
LAPORAN PEMAKAIAN OBAT DAN LEMBAR PERMINTAAN OBAT (LPL
KODE PUSKESMAS :
PUSKESMAS : Binuang
KECAMATAN : Binuang
KABUPATEN/KODYA : TAPIN
SATUA STOK PENERI PERSEDIA PEMAKAI

NAMA OBAT
NO N AWAL MAAN AN AN
1 2 3 4 5 6=(4+5) 7
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - - -
2 Amoksisilin kaplet 500 mg @ 100 Tab Kaplet - - - -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - -
5 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - -
Kombinasi pirimetamin 25 mg + sulfadoksin 500 mg
6 @ 100 Tab Tablet - - - -
7 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - - -
8 Kotrimoksazole tablet komb. 480 mg @ 100 Tab Tablet - - - -
9 Kuinin (kina) tablet 200 mg Tablet - - - -
10 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - -
11 Pirantel tablet 125 mg @ 100 Tab Tablet - - - -
12 Prednison tablet 5 mg @ 1000 Tab Tablet - - - -
13 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - -
- - - -
SIRUP - - - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - -
2 Kotrimoksazole suspensi komb. Botol - - - -
- - - -
INJEKSI - - - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - -
Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30
3 Amp Ampul - - - -
Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 % -
4 1 ml @ 30 Amp Ampul - - - -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - -
6 Lidokain Komp. Inj Komb Ampul - - - -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - -
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU I) Vial - - - -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - -
12 Vaksin Rabies Vero (VAR) Vial - - - -
13 Tetagam Vial - - - -
- - - -
INFUS - - - -
1 Glukosa Larutan infus 10 % steril @ 20 fls fls - - - -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - -
- - - -
OBAT GIGI - - - -
1 Air raksa Dental Use Ktk - - - -
2 Devitalisasi pasta ktk - - - -
3 Eti klorida semprot Botol - - - -
4 Forinekresol (pengganti TKF) ktk - - - -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - -
6 Kalsium hidroksi pasta ktk - - - -
7 Klorfenol kamfer menthol (CHKM) ktk - - - -
8 Mummiying Pasta ktk - - - -
9 Semen seng Fosfar serbuk & cairan ktk - - - -
10 Silver amalgam serbuk 65 - 75 % ktk - - - -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - -
12 Temporary Stoping Flecther serbuk & Cair set - - - -
- - - -
ALAT KESEHATAN - - - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - - -
5 Catgut Cromic No. 2/0 dengan jarum @ 24 pcs Pcs - - - -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - -
8 Infusion set anak Pcs - - - -
9 Silk
Infusion set dewasa
(benang bedah sutera) No. 3/0 dengan jarum @ Pcs - - - -
10 36 pcs Pcs - - - -
- - - -
OBAT SANGAT ESENSIAL & ESENSIAL - - - -
TABLET - - - -
1 Allopurinol tablet 100 mg @ 100 Tab Tablet - - - -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - -
Asam asetilsalisilat (asetosal) tablet 100 mg @ 100
7 Tab Tablet - - - -
Asam asetilsalisilat (asetosal) tablet 500 mg @ 100
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Tab Tablet - - - -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - -
12 Diazepam tablet 2 mg Tablet - - - -
13 Diazepam tablet 5 mg Tablet - - - -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - - -
16 Fenitoin Na Kapsul 30 mg @ 250 Kap Kapsul - - - -
17 Fenobarbital tablet 100 mg Tablet - - - -
18 Fenobarbital tablet 30 mg Tablet - - - -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - - -
20 Fenoksimetil penicillin tablet 500 mg @ 100 Tab Tablet - - - -
Fitominadion (Vit K) tablet salut gula 10 mg @ 100
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Tab Tablet - - - -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - -
35 Klorpeniramine Maleat (CTM) tablet 4 mg @ 100 Tab Tablet - - - -

36 Klorpromazine HCl tablet salut 100 mg Tablet - - - -
37 Klorpromazine HCl tablet salut 25 mg Tablet - - - -
38 Magnesium sulfat serbuk 30 g Pot - - - -
39 Mebendazole tablet 100 mg Tablet - - - -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - - -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - - -
52 Tetrasiklin HCl kapsul 500 mg @ 100 Kap Kapsul - - - -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - -
- - - -
SIRUP - - - -
1 Antasida DOEN Suspensi Komb Botol - - - -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - -
- - - -
INJEKSI - - - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - -
6 Fenobarbital injeksi Ampul - - - -
7 Amp Ampul - - - -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - - -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - -
13 Natrium tiosulfatinjeksi(Vit
Sianokobalamin 25 % 10 B12)
ml 500 mcg - ml @ 100 Ampul - - - -
14 Amp Ampul - - - -
15 Tiamin HCl (Vit B1)inj 100 mg/ ml - 1 ml @ 30 Amp Ampul - - - -

- - - -
SALEP - - - -
1 endapan 4 % @ 24 Pot Pot - - - -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - -
4 Antibakteri DOEN Komb. Pot - - - -
5 Antifungi DOEN Komb. Pot - - - -
- - - -
SALEP MATA - - - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - -
- - - -
TETES MATA - - - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - -
- - - -
TETES TELINGA - - - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - -
2 Fenol Gliserol Tetes Telinga Botol - - - -
- - - -
OBAT LUAR - - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - -
3 Gentian violet larutan 1 % Botol - - - -
4 Kalium Permanghanat serbuk Botol - - - -
5 Povidon Iodida 10 % 30 ml Botol - - - -

6 Povidon Iodida 10 % 300 ml Botol - - - -
7 Salisilat Bedak 2 % Kotak - - - -
- - - -
OBAT GIGI - - - -
1 Eugenol cairan Botol - - - -
- - - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - -

2 Kasa kompres 40 / 40 steril Bks - - - -
3 Kasa pembalut 2 m x 80 cm Rol - - - -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - -
6 Pembalut gips Rol - - - -
7 Plester 5 yard x 2 inch Rol - - - -
- - - -
OBAT PENUNNOVG - - - -
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - - -
2 Acyclovir tablet 400 mg @ 100 Tab Tablet - - - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - -
5 Alprazolam Tablet @ 100 Tab Tablet - - - -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - -
8 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 ta Tablet - - - -
9 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - -
10 Asam askorbat (Vitamin C) tablet 250 mg @ 250 tab Tablet - - - -

11 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - -
12 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - -
13 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - -
14 Aspilet tablet @ 100 Tab Tablet - - - -
15 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 Tab Tablet - - - -
16 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - -
17 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - -
18 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - -
19 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - -
20 Captopril tablet 25 mg @ 100 Tab Tablet - - - -
21 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - -
22 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - -
23 Cetirizine tablet Tablet - - - -
24 Cimetidine tablet @ 100 Tab Tablet - - - -
25 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - -
26 Clobazam tablet @ 100 Tab Tablet - - - -
27 Codein Tablet 10 mg Tablet - - - -
28 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - -
29 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - -
30 Dimenhidrinat tablet @ 100 Tab Tablet - - - -
31 Doksisiklin tablet @ 100 Tab Tablet - - - -
32 Domperidon Tablet @ 100 Tab Tablet - - - -
33 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - -
34 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - -
35 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - -
36 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Table Tablet - - - -
37 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - -
38 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - -
39 Tablet @ 100 Tab Tablet - - - -
40 Ketokonazole tablet @ 50 tab Tablet - - - -
41 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - -
42 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - -
43 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - -
44 Levofloksasin @ 30 Tab Tablet - - - -
45 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - -
46 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - -
47 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - -
48 Loratadine tablet 10 mg @ 50 tab Tablet - - - -
49 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Tab Tablet - - - -
50 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - -
51 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - -
52 Mepromaag tablet @ 100 Tab Tablet - - - -
53 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - -
54 Methioson Tablet @ 30 Tab Tablet - - - -
55 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - -
56 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - -
57 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - -
58 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - -
59 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - -
60 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 Tab Tablet - - - -

61 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - -
62 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - -
63 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - -
64 Nifedipin Tablet @ 100 Tab Tablet - - - -
65 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - -
66 Omeprazole kapsul @ 30 Kap Kapsul - - - -
67 Papaverin tablet @ 1000 Tab Tablet - - - -
68 Paraformaldehide tablet @ 100 Tab Tablet - - - -
69 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - -
70 Piracetam tablet 400 mg @ 100 Tab Tablet - - - -
71 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - -
72 Piroksikam tablet 20 mg @ 100 Tab Tablet - - - -
73 Propanolol 10 mg Tab Tablet - - - -
74 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - -
75 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - -
Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50
76 Soft Kap Kapsul - - - -
Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50
77 Soft Kap Kapsul - - - -
78 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Tab Tablet - - - -
79 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Tab Tablet - - - -
80 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - - -
81 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - -
82 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - -
83 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - -
84 Tablet tambah darah @ 30 Tab Sal Tablet - - - -
85 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - -
86 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - -
87 Tramadol Tablet @ 50 Tab Tablet - - - -
- - - -
SIRUP - - - -
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - -
4 Anti Diare (Arcapec) Sirup Botol - - - -
5 Anti sariawan (Enkasari) Sirup Botol - - - -
6 Batugin Elixier @ 120 ml botol - - - -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - -
8 Bromhexin (Phytovon) Sirup Botol - - - -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - -
11 Cetirizine (Lerzin) Sirup Botol - - - -
12 Domperidon Sirup Botol - - - -
13 Erytromycin Sirup Botol - - - -
14 Fe Kombinasi (maltiron) Sirup Botol - - - -

15 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Sirup Botol - - - -
16 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - -
17 Gastrinal Suspensi Botol - - - -
18 Ibuprofen (Farsifen) Sirup Botol - - - -
19 Klorampenikol suspensi Botol - - - -
20 Laxadine Sirup @ 30 ml Botol - - - -
21 Metamizol (Norages) Sirup Botol - - - -
22 Metoklopropamid (Gavistal) Drop Botol - - - -
23 Metronidazole (Farizol) Sirup Botol - - - -
24 Metoklopropamid sirup Botol - - - -
25 Metronidazole Infus Botol - - - -
26 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - -
27 Multivitamin + lisin (Supralysin)Drop Botol - - - -
28 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - -
29 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - -
30 Nifuroxide (Nifudiar) Sirup Botol - - - -
31 Nistatin (Cazetin) Drop Botol - - - -
32 Parasetamol Drop Botol - - - -
33 Pseudoefedrin (Alco) Drop Botol - - - -
34 Thiamfenikol (Nikolam) Sirup Kering Botol - - - -
35 Zinc Drop Botol - - - -
INJEKSI - - - -
1 Alinamin F injeksi @ 5 Amp Ampul - - - -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - -
5 Ceftriaxon Injeksi 1 gram @ 2 vial Vial - - - -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - -
8 Dopamin Injeksi Ampul - - - -
9 Furusemide Injeksi Ampul - - - -
10 Hyoscyamine N-Butil
Gentamisin injeksi 80bromide
mg @ 5 (Gitas)Injeksi
ampul @5 Ampul - - - -
11 Ampul Ampul - - - -
12 Kanamycin Inj vial - - - -
13 Kloramfenikol Injeksi Vial - - - -
14 (Xylomidon) Inj @ 25 vial Vial - - - -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - -
19 Ondasentron Injeksi Ampul - - - -
20 Pethidin injeksi Ampul - - - -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - - -
22 Piracetam injeksi 3 gram @ 4 Amp Ampul - - - -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - -
- - - -
INFUS - - - -
1 KAEN 3A fls - - - -
2 KAEN 3B fls - - - -
3 Glukosa 5% + 1/4 NS fls - - - -
- - - -
SALEP/KRIM - - - -
1 Acyclovir cream @ 25 Tube tube - - - -
2 Bioplacenton Jelly tube - - - -
3 Gentamisin salep kulit @ 10 Tube tube - - - -
4 Ictiol salep Pot - - - -
5 Ketokonazole krim tube - - - -
6 Miconazole krim @ 24 Tube tube - - - -
7 Nostren Cream Tube - - - -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - -
9 Piroksikam (Infeld) Gel Tube - - - -
10 Scabimite cream @ 24 Tube tube - - - -
- - - -
SALEP MATA - - - -
1 Kloramfenikol Salep Mata tube - - - -
- - - -
TETES MATA - - - -
1 Cendo Catarelent Botol - - - -
2 Cendo Xitrol Botol - - - -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - -
4 Kloramfenikol Tetes Mata Botol - - - -
5 Tetrakain (Pantocain) TM Botol - - - -
- - - -
TETES HIDUNG - - - -
1 Iliadin Drop Botol - - - -
- - - -
TETES TELINGA - - - -
1 Otopain TT Botol - - - -
- - - -
OBAT LUAR / LAIN- LAIN - - - -
1 Anti sariawan (Albotyl) Sol Botol - - - -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - -
4 Borax gliserin Botol - - - -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - -
Fenoterol Hydrobromide 100 mcg (Berotec) Semprot
7 Spray kotak - - - -
8 Larutan Chlorhexide @ 500 ml Botol - - - -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - -
10 Salisil spritus Botol - - - -
- - - -
1 Bisturi @ 100 pcs pcs - - - -
2 Blood Lancet ss @ 100 pcs pcs - - - -
3 Daryan tulle @ 10 lbr Lembar - - - -
4 EKG Paper 80 x 30 Roll - - - -
5 Foley cateter no. 16 @ 10 pcs pcs - - - -
6 Foley cateter no. 18 @ 10 Pcs pcs - - - -
7 Hand schoen Examination Uk M/L @ 50 psg psg - - - -
8 Hand schoen no. 7 @ 50 psg psg - - - -
9 Hand schoen no. 7,5 @ 50 psg psg - - - -
10 Hand Schoen No. 8 @ 50 psg psg - - - -
11 Hand schoen steril no. 7 @ 50 psg psg - - - -
12 Hand schoen steril no. 7,5 @ 50 psg psg - - - -
13 Hand schoen steril no. 8 @ 50 psg psg - - - -
14 Handschoen Steril No. 6,5 @ 50 psg psg - - - -
15 Hypapix 5 x 1 m roll - - - -
16 Jarum Hecting Kulit lsn - - - -
17 Jarung Hecting Otot lsn - - - -
18 Kasa Hidrofil 40 x 80 pcs - - - -
19 Kasa pembalut hidrofil 4 x 10 Roll - - - -
20 Kasa steril 16 x 16 pad roll - - - -
21 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - -
22 Mami non waven @ 24 pcs pcs - - - -
23 Masker @ 100 pcs pcs - - - -
24 Needle No. 23 G @ 100 pcs pcs - - - -
25 Needle No. 25 G 100 pcs pcs - - - -
26 Optiva No. 20 @ 50 pcs pcs - - - -
27 Paket P3K pcs - - - -
28 Spuit Injeksi 10 ml pcs - - - -
29 Spuit Injeksi 50 ml Set - - - -
30 Surflo No. 20 @ 50 pcs pcs - - - -
31 Surflo No. 22 @ 50 pcs pcs - - - -
32 Surflo No. 24 @ 50 pcs pcs - - - -
33 Test Kehamilan Stik @ 50 pcs pcs - - - -
34 Ultrasonic Gel pcs - - - -
35 Urine bag Stik - - - -
36 USG Printing Paper UPP-110 HG pcs - - - -
37 Wing needle no. 21 pcs - - - -
38 Wing needle no. 27 pcs - - - -
39 Boor Diamond High Speed pcs - - - -
40 Boor Diamond Low Speed pcs - - - -
- - - -
OBAT PROGRAM - - - -
PROGRAM P2 MALARIA - - - -
1 Abate kg - - - -
2 ACT Tablet Ktk - - - -
3 Arsumodon tablet tab - - - -
4 Artem Injeksi Ktk - - - -
6 Artesdiaquine Tablet Ktk - - - -
7 Artesunate Injeksi Kotak - - - -
8 Cynoff liter - - - -
9 Kelambu Pcs - - - -
10 Rafid Test Dengeu @ 25 test ktk - - - -
11 RDT Chikungunya ktk - - - -
12 RDT Malaria strip - - - -
13 RDT Salmonella ktk - - - -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik ktk - - - -
- - - -
PROGRAM P2 IMUNISASI - - - -
1 Alat suntik sekali pakai 0.05 ml pcs - - - -
2 Alat suntik sekali pakai 0.5 ml pcs - - - -
3 Safety Box Pcs - - - -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - -
6 Vaksin BCG + Pelarut (1 dosis) Botol - - - -
7 Vaksin Campak + Pelarut (10 dosis) vial - - - -
8 Vaksin Campak + Pelarut (20 dosis) vial - - - -
9 Vaksin DT Vial - - - -
10 Vaksin Hepatitis (HBO) ampul - - - -
11 Vaksin Polio + Droper ( 20 Dosis) Vial - - - -
12 Vaksin Polio + Droper (10 Dosis) Vial - - - -
13 Vaksin Td vial - - - -
14 Vaksin TT Vial - - - -
15 Vaksin DPT HB HIB Vial - - - -
- - - -
- - - -
PROGRAM P2 TB - - - -
1 Box Slides pcs - - - -
2 Bunsen Stainlestell ktk - - - -
3 FDC I ktk - - - -
4 FDC I & III ktk - - - -
5 FDC II siklus - - - -
6 Kaca Ose siklus - - - -
7 Kombipak kategori 1 ktk - - - -
8 Lampu Spritus siklus - - - -
9 Obat antituberkolosis Kategori Anak siklus - - - -
10 Obat antituberkolosis Kategori sisipan ktk - - - -
11 Pot Sputum ktk - - - -
12 Reagen Zn Neilson set - - - -
13 Slide mikroskop kotak - - - -
14 Spritus Botol - - - -
15 Masker N-95 pcs - - - -
- - - -
PROGRAM P2 DIARE - - - -
1 Zn Tablet 500 mg Tablet - - - -
- - - -
PROGRAM P2 KUSTA - - - -
1 MDT MB Anak Strip - - - -
2 MDT MB Dewasa Strip - - - -
3 MDT PB Anak Strip - - - -
4 MDT PB Dewasa Strip - - - -
- - - -
PROGRAM KIA - - - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - -
2 Obat Suntik KB 1 Bulan (Andalan) @ 20 vial vial - - - -
3 Obat Suntik KB 3 Bulan (Harmonis) @ 20 vial vial - - - -
4 Gluconas Calsicus vial - - - -
- - - -
REAGEN LABORATORIUM - - - -
1 Alkohol 70 % @ 1000 ml Botol - - - -
2 Alkohol 70% @ 100 ml Botol - - - -
3 Alkohol 95 % @ 1000 ml botol - - - -
4 Alkohol Swab @ 100 pcs Kotak - - - -
5 Coumbour 10 Parameter botol - - - -
6 EDTA 10 % botol - - - -
7 Gliserin Botol - - - -
8 Gluko dr Stik @ 25 Stik botol - - - -
9 Golongan Darah Test set - - - -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - -
11 Larutan Anisol botol - - - -
12 Larutan Asam Asetat 6% botol - - - -
13 Larutan Asam Sulfosalilisat botol - - - -
14 Larutan Barium Klorida 10 % botol - - - -
15 Larutan Benedict Botol - - - -
16 Larutan Buffer Ph botol - - - -
17 Larutan Carbol Gentian Violet botol - - - -
18 Larutan Drabkin Botol - - - -
19 Larutan Eosin 2 % Botol - - - -
20 Larutan Etanol Asam Botol - - - -
21 Larutan Foucet botol - - - -
22 Larutan Giemsa Stain Botol - - - -
23 Larutan H2SO4 p Botol - - - -
24 Larutan HCl 0,1% botol - - - -
25 Larutan HNO3 P Botol - - - -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - -
27 Larutan KOH 10 % Botol - - - -
28 Larutan Metelin Biru Botol - - - -
29 Larutan Turk Botol - - - -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - -
31 Metanol Botol - - - -
32 Na Citrat 3,8 % botol - - - -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - -
34 Nesco Glucose Stik @ 25 Stik Botol - - - -
35 Nesco HB Stik @ 25 Botol - - - -
36 Nesco Uric Acid Stik @ 25 Stik botol - - - -
37 Oli Emersi botol - - - -
38 Rees Ecker botol - - - -
39 Trigeliserida Botol - - - -
40 Water Steril 500 ml Botol - - - -
41 Water Steril 1000 ml Botol - - - -
42 widal Test Set - - - -
43 Xylol botol - - - -
54 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - -
55 Stick Hemosmart Pcs - - - -
56 Tas Alat deteksi resiko ibu Hamil Pcs - - - -
57 Cefadroksil tab 250 mg Tablet - - - -
58 Lab.Kit Paket - - - -
59 Domperidon Drop Botol - - - -
60 Zinc Sirup Botol - - - -
61 Xylocain Injeksi Ampul - - - -
62 Simvastatin tablet 20 mg @ 30/50 Tab Tablet - - - -
63 Lactulosa Sirup Botol - - - -
64 Stik HB Family Dr ktk - - - -
65 Glukosa Stik Active Accu Check Kotak - - - -
68 Amlodipin 5 mg Tablet @ 30 Tab vial - - - -
69 Blue Tips bks - - - -
70 Yellow Tips bks - - - -
71 Tabung EDTA K3/Vacutainer pcs - - - -
72 Kertas saring (isi 100 lbr) bks - - - -
73 Tissue Lensa lbr - - - -
74 Lidi Sputum (100 pcs) bks - - - -
75 Deck Glass pcs - - - -
76 Cotton Swab pcs - - - -
77 Specullum pcs - - - -
TOTAL
UMUM
BAYAR
BAYAR
-
Mengetahui/Menyetujui Yang Menyerahkan
Kepala Dinas Kesehatan Kepala Instalasi Farmasi
Kab. Tapin Kab. Tapin
H.Errani Martin,SKM.MM Hj. Renny Haslinda, S.Si, Apt

NIP.196403141988021002 NIP 19760126 200501 2 011
R PERMINTAAN OBAT (LPLPO)
LB 2
Laporan/Permintaan : November/Desember
Tahun : 2016
SISA STOK PERMINT PEMBERIA HARGA TOTAL EXP

BON
STOK OPT. AAN N SATUAN (Rp) HARGA (Rp.) DATE
8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - 220.00 -
- - - 279.00 -
- - - 418.00 -
- - - 254.10 -
- - - 93.50 -
- - - 520.30 -
- - - 77.00 -
- - - 152.00 -
- - - 641.00 -
- - - 88.00 -
- - - 318.00 -
- - - 167.20 -
- - - 246.40 -
-
-
- - - 2,560.00 -
- - - 2,298.00 -
-
-
- - - 1,738.00 -
- - - 2,604.90 -
- - - 1,160.00 -
- - - 8,910.00 -
- - - 6,820.00 -
- - - 1,250.00 -
- - - 2,750.00 -
- - - 361,411.80 -
- - - 193,470.80 -
- - - 67,457.00 -
- - - 60,579.00 -
- - - 556,600.00 -
- - - 17,000.00 -
-
-
- - - 6,270.00 -
- - - 1,597.60 -
- - - 5,566.00 -
- - - 5,720.00 -
- - - 5,170.00 -
-
-
- - - 103,536.00 -
- - - 429,000.00 -
- - - 115,000.00 -
- - - 185,900.00 -
- - - 434,500.00 -
- - - 242,000.00 -
- - - 87,000.00 -
- - - 137,853.00 -
- - - 93,500.00 -
- - - 408,792.00 -
- - - 14,053.63 -
- - - 34,000.00 -
-
-
- - - 848.25 -
- - - 848.25 -
- - - 978.75 -
- - - 8,896.88 -
- - - 8,458.33 -
- - - 8,896.88 -
- - - 7,286.25 -
- - - 4,567.50 -
- - - 4,176.00 -
- - - 5,743.86 -
-
- -
-
- - - 90.00 -
- - - 132.01 -
- - - 123.00 -
- - - 163.90 -
- - - 78.00 -
- - - 136.63 -
- - - 96.80 -
- - - 157.30 -
- - - 30.25 -
- - - 66.00 -
- - - 68.00 -
- - - 35.09 -
- - - 52.80 -
- - - 103.00 -
- - - 87.00 -
- - - 80.00 -
- - - 140.00 -
- - - 64.83 -
- - - 257.40 -
- - - 456.50 -
- - - 698.00 -
- - - 100.10 -
- - - 61.00 -
- - - 83.64 -
- - - 224.00 -
- - - 62.00 -
- - - 90.84 -
- - - 134.52 -
- - - 39.93 -
- - - 115.50 -
- - - 157.00 -
- - - 98.00 -
- - - 156.20 -
- - - 269.00 -
- - - 264.00 -
- - - 262.95 -
- - - 39.93 -
- - - 1,129.30 -
- - - 231.00 -
- - - 169.00 -
- - - 116.00 -
- - - 15.73 -
- - - 605.00 -
- - - 527.23 -
- - - 41.80 -
- - - 19.14 -
- - - 114.00 -
- - - 299.27 -
- - - 82.00 -
- - - 96.80 -
- - - 167.20 -
- - - 275.00 -
- - - 112.73 -
- - - 45.38 -
- - - 112.00 -
-
-
- - - 4,235.00 -
- - - 1,573.00 -
- - - 3,740.00 -
- - - 1,535.00 -
-
-
- - - 2,823.00 -
- - - 1,345.00 -
- - - 6,050.00 -
- - - 1,210.00 -
- - - 53,205.00 -
- - - 1,980.00 -
- - - 1,914.00 -
- - - 1,210.00 -
- - - 807.00 -
- - - 1,693.80 -
- - - 2,142.70 -
- - - 1,639.00 -
- - - 2,970.00 -
- - - 1,132.00 -
- - - 843.33 -
-
-
- - - 1,352.00 -
- - - 2,868.00 -
- - - 2,053.00 -
- - - 2,767.00 -
- - - 1,891.00 -
- - -
- - -
- - - 2,112.00 -
- - -
- - -
- - - 3,549.00 -
- - -
- - -
- - - 1,320.00 -
- - - 1,109.00 -
-
- - -
- - - 3,000.00 -
- - - 1,980.00 -
- - - 2,440.00 -
- - - 6,529.00 -
- - - 2,344.00 -
- - - 15,950.00 -
- - - 1,350.00 -
- - -
- - -
- - - 50,416.67 -
- - -
- - -
- - - 16,312.50 -
- - - 1,393.00 -
- - - 8,800.00 -
- - - 2,740.50 -
- - - 769.95 -
- - - 6,071.00 -
- - - 25,987.00 -
-
-
- - - 427.00 -
- - - 628.46 -
- - - 359.00 -
- - - 2,200.00 -
- - - 990.00 -
- - - 185.98 -
- - - 352.00 -
- - - 5,283.00 -
- - - 220.00 -
- - - 140.80 -
- - - 133.00 -
- - - 122.00 -
- - - 605.00 -
- - - 583.00 -
- - - 924.00 -
- - - 250.00 -
- - - 2,553.83 -
- - - 121.00 -
- - - 69.00 -
- - - 97.00 -
- - - 529.00 -
- - - 899.00 -
- - - 180.00 -
- - - 115.50 -
- - - 265.00 -
- - - 1,044.95 -
- - - 550.00 -
- - - 246.20 -
- - - 166.79 -
- - - 92.95 -
- - - 278.30 -
- - - 174.00 -
- - - 509.00 -
- - - 1,023.00 -
- - - 1,210.00 -
- - - 880.00 -
- - - 520.67 -
- - - 247.00 -
- - - 620.00 -
- - - 320.00 -
- - - 580.00 -
- - - 4,290.00 -
- - - 521.00 -
- - - 581.00 -
- - - 385.00 -
- - - 660.00 -
- - - 110.78 -
- - - 170.00 -
- - - 620.40 -
- - - 1,199.00 -
- - - 691.20 -
- - - 418.00 -
- - - 199.65 -
- - - 1,026.67 -
- - - 230.00 -
- - - 242.00 -
- - - 100.00 -
- - - 880.00 -
- - - 249.59 -
- - - 560.00 -
- - - 146.00 -
- - - 193.00 -
- - - 1,100.00 -
- - - 110.00 -
- - - 700.00 -
- - - 449.00 -
- - - 102.30 -
- - - 7,700.00 -
- - - 3,382.50 -
- - - 551.76 -
- - - 74.92 -
- - - 104.89 -
- - - 90.00 -
- - - 242.00 -
- - - 132.00 -
- - - 286.00 -
- - - 505.00 -
- - - 65.00 -
- - - 12.73 -
- - - 177.00 -
- - - 1,695.50 -
- - - 381.00 -
- - - 100.00 -
- - - 73.33 -
- - - 103.00 -
- - - 677.60 -
- - - 329.68 -
- - -
- - -
- - - 3,630.00 -
- - - 4,730.00 -
- - - 18,450.00 -
- - - 13,750.00 -
- - - 12,760.00 -
- - - 18,199.00 -
- - - 3,500.00 -
- - - 6,500.00 -
- - - 6,285.00 -
- - - 9,400.00 -
- - - 10,440.00 -
- - - 13,915.00 -
- - - 8,090.00 -
- - - 19,250.00 -
- - - 13,200.00 -
- - - 11,550.00 -
- - - 24,200.00 -
- - - 3,850.00 -
- - - 4,950.00 -
- - - 12,450.00 -
- - - 22,000.00 -
- - - 11,550.00 -
- - - 5,000.00 -
- - - 2,541.00 -
- - - 9,900.00 -
- - - 19,800.00 -
- - - 22,000.00 -
- - - 9,350.00 -
- - - 13,200.00 -
- - - 36,850.00 -
- - - 17,500.00 -
- - - 5,720.00 -
- - - 43,560.00 -
- - - 19,250.00 -
- - -
-
- - - 14,972.60 -
- - - 5,904.80 -
- - - 5,775.00 -
- - - 7,623.00 -
- - - 9,453.50 -
- - - 33,000.00 -
- - - 3,578.00 -
- - - 20,438.00 -
- - - 2,012.00 -
- - - 3,782.00 -
- - - 4,950.00 -
- - - 6,610.80 -
- - - 10,790.00 -
- - - 5,555.00 -
- - - 8,470.00 -
- - - 6,380.00 -
- - - 5,500.00 -
- - - 3,410.00 -
- - - 2,400.00 -
- - - 14,509.10 -
- - - 6,600.00 -
- - - 17,088.00 -
- - - 1,340.00 -
- - - 7,042.00 -
- - - 8,800.00 -
-
- - -
- - - 15,660.00 -
- - - 15,660.00 -
- - - 10,118.00 -
-
-
- - - 3,300.00 -
- - - 12,650.00 -
- - - 2,020.70 -
- - - 4,300.00 -
- - - 7,700.00 -
- - - 3,075.00 -
- - - 12,100.00 -
- - - 1,649.36 -
- - - 19,058.00 -
- - - 11,475.00 -
- - -
- - -
- - - 1,640.00 -
- - -
- - -
- - - 24,887.00 -
- - - 29,975.00 -
- - - 3,630.00 -
- - - 2,750.00 -
- - - 11,500.00 -
- - -
- - -
- - - 30,305.00 -
-
-
- - - 35,145.00 -
-
-
- - - 17,600.00 -
- - - 17,188.00 -
- - - 12,356.67 -
- - - 1,899.00 -
- - - 35,640.00 -
- - - 23,760.00 -
- - - 136,290.00 -
- - - 75,900.00 -
- - - 6,500.00 -
- - - 5,430.00 -
- - -
- - -
- - - 770.00 -
- - - 137.50 -
- - - 13,090.00 -
- - - 160,000.00 -
- - - 10,440.00 -
- - - 10,440.00 -
- - - 848.25 -
- - - 4,250.00 -
- - - 4,250.00 -
- - - 4,250.00 -
- - - 6,050.00 -
- - - 6,050.00 -
- - - 6,050.00 -
- - - 6,050.00 -
- - - 12,650.00 -
- - - 27,500.00 -
- - - 27,500.00 -
- - - 113,190.00 -
- - - 1,957.50 -
- - - 7,569.00 -
- - - 3,960.00 -
- - - 1,210.00 -
- - - 1,386.00 -
- - - 429.00 -
- - - 429.00 -
- - - 15,400.00 -
- - - 276,957.00 -
- - - 1,393.90 -
- - - 5,693.00 -
- - - 4,959.00 -
- - - 4,959.00 -
- - - 4,959.00 -
- - - 1,267.20 -
- - - 27,500.00 -
- - - 4,400.00 -
- - - 320,000.00 -
- - - 2,145.00 -
- - - 2,145.00 -
- - - 440,000.00 -
- - - 330,000.00 -
-
-
-
- - - 204,000.00 -
- - - 36,300.00 -
- - - 4,033.33 -
- - - 146,300.00 -
- - - 125,400.00 -
- - - 146,300.00 -
- - - 387,800.00 -
- - - 1.00 -
- - - 2,548,713.00 -
- - - 3,135,000.00 -
- - - 38,538.48 -
- - - 1,471,250.00 -
- - - 79,200.00 -
-
-
- - - 1,900.00 -
- - - 1,300.00 -
- - - 23,000.00 -
- - - 37,500.00 -
- - - 45,100.00 -
- - - 1.00 -
- - - 21,500.00 -
- - - 33,825.00 -
- - - 14,487.00 -
- - - 18,750.00 -
- - - 23,782.00 -
- - - 16,203.00 -
- - - 14,250.00 -
- - - 11,913.00 -
- - - 1.00 -
-
-
-
- - - 100,000.00 -
- - - 82,500.00 -
- - - 396,000.00 -
- - - 396,000.00 -
- - - 1,320,000.00 -
- - - 12,500.00 -
- - - 265,000.00 -
- - - 69,000.00 -
- - - 236,500.00 -
- - - 176,000.00 -
- - - 1,000.00 -
- - - 254,000.00 -
- - - 68,750.00 -
- - - 20,873.00 -
- - - 17,600.00 -
-
-
- - - 574.76 -
- - -
- - -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
-
-
- - - 4,000.00 -
- - - 6,249.95 -
- - - 6,249.95 -
- - - 7,800.00 -
-
-
- - - 33,275.00 -
- - - 2,625.00 -
- - - 60,500.00 -
- - - 254.00 -
- - - 220,000.00 -
- - - 66,000.00 -
- - - 5,203.00 -
- - - 309,500.00 -
- - - 330,000.00 -
- - - 618,750.00 -
- - - 120,000.00 -
- - - 16,350.00 -
- - - 181,500.00 -
- - - 11,000.00 -
- - - 35,400.00 -
- - - 61,250.00 -
- - - 28,400.00 -
- - - 122,195.00 -
- - - 126,500.00 -
- - - 25,300.00 -
- - - 72,000.00 -
- - - 77,500.00 -
- - - 41,255.00 -
- - - 8,470.00 -
- - - 55,000.00 -
- - - 8,500.00 -
- - - 18,860.00 -
- - - 20,900.00 -
- - - 24,199.00 -
- - - 64,300.00 -
- - - 30,400.00 -
- - - 8,000.00 -
- - - 164,450.00 -
- - - 104,500.00 -
- - - 176,000.00 -
- - - 104,500.00 -
- - - 154,000.00 -
- - - 34,500.00 -
- - - 295,000.00 -
- - - 5,500.00 -
- - - 9,900.00 -
- - - 679,961.90 -
- - - 27,500.00 -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
Yang Menerima/Melapor Yang Menerima
Kepala Puskesmas Pengelola Obat
Binuang, Puskesmas Binuang,
dr.Widhi Susanto Mahdalena, S. Farm., Apt

NIP.198305132011011006 NIP 19830909 201001 2 032
- - - 1,129.3
#REF!
inter
KODE PUSKESMAS : LB 2
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : Januari / Februari
KABUPATEN/KODYA : TAPIN Tahun : 2017
STOK PENERIM PERSEDI PEMAKAI STOK PERMINT PEMBERIA HARGA TOTAL EXP
NAMA OBAT SATUAN SISA STOK BON
NO AWAL AAN AAN AN OPT. AAN N SATUAN (Rp) HARGA (Rp.) DATE
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - - 0 - - - - 207.00 -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - 0 - - - - 317.00 -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - 0 - - - 275.00 -
5 Kloramfenikol Kapsul 500 mg Tablet - - - 0 - - - - 1,155.00 -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - 0 - - - - 93.50 -
7 mg @ 100 Tab Tablet - - - 0 - - - - 520.30 -
8 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - - 0 - - - 77.00 -
9 Kotrimoksazole tablet komb. 480 mg @ 100 Tab Tablet - - - 0 - - - - 158.00 -
10 Kuinin (kina) tablet 200 mg Tablet - - - 0 - - - - 641.00 -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 105.00 -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - 0 - - - 318.00 -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - 0 - - - - 125.00 -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - 0 - - - - 246.40 -
- - 0 - -
SIRUP - - 0 -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - 0 - - - - 2,200.00 -
2 Kotrimoksazole suspensi komb. Botol - - - 0 - - - - 2,225.00 -
- - 0 - -
INJEKSI - - 0 -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - 0 - - - - 1,740.00 -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - 0 - - - - 2,604.90 -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - - 0 - - - - 1,056.00 -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 Ampul - - - 0 - - - 2,354.00 -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - 0 - - - - 6,820.00 -
6 Lidokain Komp. Inj Komb Ampul - - - 0 - - - - 2,122.00 -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - 0 - - - - 1,900.00 -
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU Vial - - - 0 - - - 520,300.00 -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - 0 - - - - 193,470.80 -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - 0 - - - - 139,150.00 -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - 0 - - - - 401,092.00 -
12 Vaksin Rabies Vero (VAR) Vial - - - 0 - - - 174,500.00 -
13 Tetagam Vial - - - 0 - - - - 170,000.00 -
- - 0 - -
INFUS - - 0 - -
1 Glukosa Larutan infus 10 % steril @ 20 fls fls - - - 0 - - - 6,270.00 -
2 Glukosa Larutan infus 40 % steril @ 10 fls fls - - - 0 - - - - 1,597.60 -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - 0 - - - - 7,150.00 -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - 0 - - - 6,410.00 -
- - 0 - -
OBAT GIGI - - 0 - -
1 Air raksa Dental Use Ktk - - - 0 - - - - 103,536.00 -
2 Devitalisasi pasta ktk - - - 0 - - - 293,498.00 -
3 EtiL klorida semprot Botol - - - 0 - - - - 99,000.00 -
4 Forinekresol (pengganti TKF) ktk - - - 0 - - - - 185,900.00 -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - 0 - - - - 306,427.00 -
6 Kalsium hidroksi pasta ktk - - - 0 - - - 242,000.00 -
7 Klorfenol kamfer menthol (CHKM) ktk - - - 0 - - - - 56,441.40 -
8 Mummiying Pasta ktk - - - 0 - - - - 137,853.00 -
9 Semen seng Fosfar serbuk & cairan ktk - - - 0 - - - - 93,500.00 -
10 Silver amalgam serbuk 65 - 75 % ktk - - - 0 - - - 408,792.00 -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - 0 - - - - 14,053.63 -
12 Temporary Stoping Flecther serbuk & Cair set - - - 0 - - - - 158,042.00 -
- - 0 - -
ALAT KESEHATAN - - 0 -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - 0 - - - - 1,540.00 -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - 0 - - - - 957.00 -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - 0 - - - - 2,049.00 -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - 7,201.04 -
5 Catgut Cromic No. 2/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - - 7,201.04 -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - - 8,896.88 -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - - 7,286.25 -
8 Infusion set anak Pcs - - - 0 - - - 7,920.00 -
9 Infusion set dewasa Pcs - - - 0 - - - - 7,920.00 -
Silk (benang bedah sutera) No. 3/0 dengan
10 jarum @ 36 pcs Pcs - - - 0 - - - - 5,743.86 -
- - 0 - -
OBAT SANGAT ESENSIAL & ESENSIAL - - 0 - -
TABLET - - 0 - -
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - 0 - - - - 95.00 -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - 0 - - - - 86.00 -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - 0 - - - 123.00 -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 163.90 -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - 0 - - - - 64.00 -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - 0 - - - - 149.00 -
7 100 Tab Tablet - - - 0 - - - 96.80 -
8 100 Tab Tablet - - - 0 - - - - 157.30 -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - 0 - - - - 120.00 -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - 0 - - - - 66.00 -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - 0 - - - 48.00 -
12 Diazepam tablet 2 mg Tablet - - - 0 - - - - 46.00 -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - 0 - - - - 108.00 -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - - 0 - - - 146.00 -
16 Fenitoin Na Kapsul 30 mg @ 250 Kap Kapsul - - - 0 - - - - 80.00 -
17 Fenobarbital tablet 100 mg Tablet - - - 0 - - - - 100.00 -
18 Fenobarbital tablet 30 mg Tablet - - - 0 - - - - 64.83 -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - - 0 - - - 257.40 -
20 Fenoksimetil penicillin tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 456.50 -
21 100 Tab Tablet - - - 0 - - - - 796.00 -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - 0 - - - - 84.00 -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - 0 - - - 126.00 -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - 0 - - - - 108.00 -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - 0 - - - - 224.00 -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - 0 - - - - 62.00 -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - 0 - - - 76.00 -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - 0 - - - - 105.00 -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - 0 - - - - 171.00 -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - 0 - - - - 121.00 -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - 0 - - - 133.00 -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - - 0 - - - - 98.00 -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - 0 - - - - 169.00 -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - 0 - - - - 306.00 -
35 Klorpeniramine Maleat (CTM) tablet 4 mg @ 100 T Tablet - - - 0 - - - 47.50 -
36 Klorpromazine HCl tablet salut 100 mg Tablet - - - 0 - - - - 162.00 -
38 Magnesium sulfat serbuk 30 g Pot - - - 0 - - - - 1,129.30 -
39 Mebendazole tablet 100 mg Tablet - - - 0 - - - 231.00 -
40 Tab Tablet - - - 0 - - - - 169.00 -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - 0 - - - - 98.00 -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - 0 - - - - 15.73 -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - 0 - - - 857.00 -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - 0 - - - - 602.00 -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - - 0 - - - - 34.51 -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - 0 - - - - 136.00 -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - 0 - - - 114.00 -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - 0 - - - - 351.00 -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - 0 - - - - 82.00 -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - 0 - - - - 114.00 -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - - 0 - - - 167.20 -
52 Tetrasiklin HCl kapsul 500 mg @ 100 Kap Kapsul - - - 0 - - - - 325.00 -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - 0 - - - - 91.00 -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - 0 - - - - 97.00 -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - 0 - - - 132.00 -
- - 0 - -
SIRUP - - 0 - -
1 Antasida DOEN Suspensi Komb Botol - - - 0 - - - - 2,300.00 -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - 0 - - - 1,573.00 -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - 0 - - - - 3,740.00 -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - 0 - - - - 1,119.00 -
- - 0 - -
INJEKSI - - 0 -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - 0 - - - - 4,204.00 -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - 0 - - - - 1,345.00 -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - 0 - - - - 5,800.00 -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - 0 - - - 1,210.00 -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - 0 - - - - 20,857.00 -
6 Fenobarbital injeksi Ampul - - - 0 - - - - 1,930.00 -
7 Amp Ampul - - - 0 - - - - 1,914.00 -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - 0 - - - 1,210.00 -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - 0 - - - - 724.00 -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - 0 - - - - 2,800.00 -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - - 0 - - - - 3,500.00 -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - 0 - - - 1,527.70 -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - 0 - - - - 2,970.00 -
14 100 Amp Ampul - - - 0 - - - - 1,226.00 -
15 Amp Ampul - - - 0 - - - - 843.33 -
- - 0 -
SALEP - - 0 - -
1 endapan 4 % @ 24 Pot Pot - - - 0 - - - - 2,200.00 -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - 0 - - - - 2,712.00 -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - 0 - - - 1,435.00 -
4 Antibakteri DOEN Komb. Pot - - - 0 - - - - 2,767.00 -
5 Antifungi DOEN Komb. Pot - - - 0 - - - - 4,782.00 -
- - 0 - -
SALEP MATA - - 0 -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - 0 - - - - 1,640.00 -
- - 0 - -
TETES MATA - - 0 - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - 0 - - - 3,549.00 -
- - 0 - -
TETES TELINGA - - 0 - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - 0 - - - - 1,759.00 -
2 Fenol gliserol TT Botol - - - 0 - - - 2,246.00 -
- - 0 - -
OBAT LUAR - - 0 - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - 0 - - - - 3,502.00 -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - 0 - - - 5,500.00 -
3 Gentian violet larutan 1 % Botol - - - 0 - - - - 2,178.00 -
4 Kalium Permanghanat serbuk Botol - - - 0 - - - - 6,529.00 -
5 Povidon Iodida 10 % 30 ml Botol - - - 0 - - - - 2,344.00 -
6 Povidon Iodida 10 % 300 ml Botol - - - 0 - - - 15,950.00 -
7 Salisilat Bedak 2 % Kotak - - - 0 - - - - 1,066.00 -
- - 0 - -
OBAT GIGI - - 0 - -
1 Eugenol cairan Botol - - - 0 - - - 20,815.00 -
- - 0 - -
ALAT KESEHATAN - - 0 - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - 0 - - - - 14,187.50 -
2 Kasa kompres 40 / 40 steril Bks - - - 0 - - - 1,984.03 -
3 Kasa pembalut 2 m x 80 cm Rol - - - 0 - - - - 8,739.41 -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - 0 - - - - 2,740.50 -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - 0 - - - - 760.91 -
6 Pembalut gips Rol - - - 0 - - - 6,071.00 -
7 Plester 5 yard x 2 inch Rol - - - 0 - - - - 25,987.00 -
- - 0 - -
OBAT PENUNJANG - - 0 - -
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 272.00 -
2 Acyclovir tablet 400 mg @ 100 Tab Tablet - - - 0 - - - - 628.46 -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - 0 - - - - 258.74 -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - 0 - - - - 2,200.00 -
5 Alprazolam Tablet @ 100 Tab Tablet - - - 0 - - - 990.00 -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - 0 - - - - 155.30 -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - 0 - - - - 163.00 -
8 Amlodipin 5 mg Tablet @ 30 Tab Tablet - - - 0 - - - - 105.00 -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 Tablet - - - 0 - - - 5,283.00 -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - 0 - - - - 173.00 -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - 0 - - - - 139.00 -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - 0 - - - - 150.00 -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 113.00 -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 1,540.00 -
15 Aspilet tablet @ 100 Tab Tablet - - - 0 - - - - 123.00 -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - - 0 - - - - 170.00 -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - 0 - - - 230.00 -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - 0 - - - - 695.00 -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - 0 - - - - 121.00 -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - 0 - - - - 69.00 -
21 Captopril tablet 25 mg @ 100 Tab Tablet - - - 0 - - - 72.00 -
22 Cefadroksil tab 250 mg Tablet - - - 0 0 0 - - 564.00 -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - 0 - - - - 557.00 -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - 0 - - - - 899.00 -
25 Cetirizine tablet Tablet - - - 0 - - - 154.00 -
26 Cimetidine tablet @ 100 Tab Tablet - - - 0 - - - - 115.50 -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - 0 - - - - 298.00 -
28 Clobazam tablet @ 100 Tab Tablet - - - 0 - - - - 1,120.00 -
29 Codein Tablet 10 mg Tablet - - - 0 - - - 630.00 -
30 Codein Tablet 20 mg Tablet - - - 0 - - - - -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - 0 - - - - 1.00 -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - 0 - - - - 126.00 -
33 Dimenhidrinat tablet @ 100 Tab Tablet - - - 0 - - - 107.00 -
34 Doksisiklin tablet @ 100 Tab Tablet - - - 0 - - - - 250.00 -
35 Domperidon Tablet @ 100 Tab Tablet - - - 0 - - - - 133.00 -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - 0 - - - - 509.00 -
37 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - 0 - - - 766.00 -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - 0 - - - - 1,210.00 -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - 0 - - - - 1,100.00 -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - 0 - - - - 683.00 -
41 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - 0 - - - 245.00 -
42 Glimepiride Tab 2 mg Tablet - - - 0 - - - - 296.00 -
43 Tablet @ 100 Tab Tablet - - - 0 - - - - 1,925.00 -
44 Ketokonazole tablet @ 50 tab Tablet - - - 0 - - - - 292.00 -
45 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - 0 - - - 660.00 -
46 Klindamisin tablet 150 mg @ 50 Tab Tablet - - - 0 - - - - 405.00 -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - 0 - - - - 4,813.00 -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - 0 - - - - 341.00 -
49 Levofloksasin @ 30 Tab Tablet - - - 0 - - - 581.00 -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - 0 - - - - 410.00 -
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - 0 - - - - 660.00 -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - 0 - - - - 90.00 -
53 Loratadine tablet 10 mg @ 50 tab Tablet - - - 0 - - - 170.00 -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - - 0 - - - - 726.00 -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - 0 - - - - 462.00 -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - 0 - - - - 292.60 -
57 Mepromaag tablet @ 100 Tab Tablet - - - 0 - - - 495.00 -
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 118.50 -
59 Methioson Tablet @ 30 Tab Tablet - - - 0 - - - - 1,026.00 -
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - 0 - - - - 230.00 -
61 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 140.00 -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - 0 - - - - 100.00 -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - 0 - - - - 102.00 -
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - 0 - - - - 220.00 -
65 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - - 0 - - - 560.00 -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - 0 - - - - 167.00 -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - 0 - - - - 193.00 -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - 0 - - - - 440.00 -
69 Nifedipin Tablet @ 100 Tab Tablet - - - 0 - - - 123.00 -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - 0 - - - - 700.00 -
71 Omeprazole kapsul @ 30 Kap Kapsul - - - 0 - - - - 164.00 -
72 Papaverin tablet @ 1000 Tab Tablet - - - 0 - - - - 125.00 -
73 Paraformaldehide tablet @ 100 Tab Tablet - - - 0 - - - 7,700.00 -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - 0 - - - - 1,485.00 -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - - 0 - - - - 360.80 -
76 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - 0 - - - - 97.02 -
77 Piroksikam tablet 20 mg @ 100 Tab Tablet - - - 0 - - - 102.37 -
78 Propanolol 10 mg Tab Tablet - - - 0 - - - - 85.00 -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 242.00 -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - 0 - - - - 119.00 -
81 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Kapsul - - - 0 - - - 286.00 -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - - 0 - - - - 505.00 -
83 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Ta Tablet - - - 0 - - - - 68.00 -
84 Salbutamol tablet 4 mg (sebagai sulfat) @ 100 Ta Tablet - - - 0 - - - - 84.00 -
85 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - - 0 - - - 58.00 -
86 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - - 0 - - - - 135.00 -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - 0 - - - - 1,525.00 -
89 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - 0 - - - 350.00 -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 100.00 -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - - 0 - - - - 73.73 -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - 0 - - - - 88.00 -
93 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 615.38 -
94 Tramadol Tablet @ 50 Tab Tablet - - - 0 - - - - 2,680.00 -
- - 0 - -
SIRUP - - 0 - -
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - 0 - - - 3,791.00 -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - 0 - - - - 4,147.00 -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - 0 - - - - 21,450.00 -
4 Anti Diare (Arcapec) Sirup Botol - - - 0 - - - - 16,500.00 -
5 Anti sariawan (Enkasari) Sirup Botol - - - 0 - - - 12,760.00 -
6 Batugin Elixier @ 120 ml botol - - - 0 - - - - 20,352.00 -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - 0 - - - - 3,594.00 -
8 Bromhexin (Phytovon) Sirup Botol - - - 0 - - - - 6,050.00 -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - 0 - - - 6,285.00 -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - 0 - - - - 7,960.00 -
11 Cetirizine (Lerzin) Sirup Botol - - - 0 - - - - 7,756.00 -
12 Domperidon Sirup Botol - - - 0 - - - - 3,180.00 -
13 Domperidon Drop Botol - - - 0 - - - 17,939.00 -
14 Erytromycin Sirup Botol - - - 0 - - - - 8,090.00 -
15 Fe Kombinasi (maltiron) Sirup Botol - - - 0 - - - - 19,250.00 -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - - 0 - - - - 16,500.00 -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - 0 - - - 11,550.00 -
18 Gastrinal Suspensi Botol - - - 0 - - - - 24,200.00 -
19 Ibuprofen (Farsifen) Sirup Botol - - - 0 - - - - 2,560.00 -
20 Klorampenikol suspensi Botol - - - 0 - - - - 4,000.00 -
21 Lactulosa Sirup Botol - - - 0 - - - 14,500.00 -
22 Laxadine Sirup @ 30 ml Botol - - - 0 - - - - 12,450.00 -
23 Metamizol (Norages) Sirup Botol - - - 0 - - - - 33,000.00 -
24 Metoklopropamid (Gavistal) Drop Botol - - - 0 - - - - 5,830.00 -
25 Metronidazole (Farizol) Sirup Botol - - - 0 - - - 3,800.00 -
26 Metoklopropamid sirup Botol - - - 0 - - - - 2,750.00 -
27 Metronidazole Infus Botol - - - 0 - - - - 12,980.00 -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - 0 - - - - 22,000.00 -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - 0 - - - 24,200.00 -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - 0 - - - - 10,902.00 -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - 0 - - - - 7,354.00 -
32 Nifuroxide (Nifudiar) Sirup Botol - - - 0 - - - - 38,500.00 -
33 Nistatin (Cazetin) Drop Botol - - - 0 - - - 32,120.00 -
34 Parasetamol Drop Botol - - - 0 - - - - 5,980.00 -
35 Pseudoefedrin (Alco) Drop Botol - - - 0 - - - - 64,350.00 -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - 0 - - - - 20,350.00 -
37 Zinc drop Botol - - - 0 - - - 11,700.00 -
38 Zinc Sirup Botol - - - 0 - - - - 6,500.00 -
- - 0 - -
INJEKSI - - 0 - -
1 Alinamin F injeksi @ 5 Amp Ampul - - - 0 - - - 14,972.60 -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - 0 - - - - 5,610.00 -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - 0 - - - - 2,536.00 -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - 0 - - - - 9,350.00 -
5 Ceftriaxon Injeksi 1 gram @ 10 vial Vial - - - 0 - - - 11,000.00 -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - 0 - - - - 33,000.00 -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - 0 - - - - 3,578.00 -
8 Dopamin Injeksi Ampul - - - 0 - - - - 10,219.00 -
9 Furusemide Injeksi Ampul - - - 0 - - - 2,012.00 -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - 0 - - - - 3,415.00 -
Ampul
11 Ampul - - - 0 - - - - 4,950.00 -
12 Kanamycin Inj vial - - - 0 - - - - 6,610.80 -
13 Kloramfenikol Injeksi Vial - - - 0 - - - 10,790.00 -
Vial
14 (Xylomidon) Inj @ 25 vial - - - 0 - - - - 5,555.00 -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - 0 - - - - 8,800.00 -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - 0 - - - - 6,600.00 -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - 0 - - - 5,500.00 -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - 0 - - - - 9,570.00 -
19 Ondasentron Injeksi Ampul - - - 0 - - - - 2,400.00 -
20 Pethidin injeksi Ampul - - - 0 - - - - 14,509.10 -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - - 0 - - - 3,300.00 -
22 Piracetam injeksi 3 gram @ 4 Amp Ampul - - - 0 - - - - 17,088.00 -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - 0 - - - - 1,600.00 -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - 0 - - - - 2,680.00 -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - 0 - - - 4,000.00 -
26 Xylocain Injeksi Ampul - - - 0 - - - - 40,000.00 -
27 Lidocain 2% Injeksi Ampul - - - 0 - - - - 875.00 -
INFUS - - 0 - -
1 KAEN 3A fls - - - 0 - - - 10,000.00 -
2 KAEN 3B fls - - - 0 - - - - 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - 0 - - - - 9,350.00 -
4 Glukosa 5% + 1/2 NS fls - - - 0 - - - - 9,400.00 -
- - 0 -
SALEP/KRIM - - 0 - -
1 Acyclovir cream @ 25 Tube tube - - - 0 - - - - 2,997.00 -
2 Bioplacenton Jelly tube - - - 0 - - - - 13,200.00 -
3 Gentamisin salep kulit @ 10 Tube tube - - - 0 - - - 1,835.16 -
4 Ictiol salep Pot - - - 0 - - - - 4,300.00 -
5 Ketokonazole krim tube - - - 0 - - - - 2,605.00 -
6 Miconazole krim @ 24 Tube tube - - - 0 - - - - 3,737.00 -
7 Nostren Cream Tube - - - 0 - - - 12,100.00 -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - 0 - - - - 1,649.36 -
9 Piroksikam (Infeld) Gel Tube - - - 0 - - - - 19,058.00 -
10 Scabimite cream @ 24 Tube tube - - - 0 - - - - 12,155.00 -
- - 0 -
SALEP MATA - - 0 - -
1 Kloramfenikol Salep Mata tube - - - 0 - - - - 1,640.00 -
- - 0 - -
TETES MATA - - 0 -
1 Cendo Catarelent Botol - - - 0 - - - - 22,000.00 -
2 Cendo Xitrol Botol - - - 0 - - - - 26,812.00 -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - 0 - - - - 4,600.00 -
4 Kloramfenikol Tetes Mata Botol - - - 0 - - - 2,750.00 -
5 Tetrakain (Pantocain) TM Botol - - - 0 - - - - 11,500.00 -
- - 0 - -
TETES HIDUNG - - 0 - -
1 Iliadin Drop Botol - - - 0 - - - 30,305.00 -
2 Iliadin Spray Botol - - - 0 - - - - 36,000.00 -
- - 0 - -
1 Otopain TT Botol - - - 0 - - - 35,145.00 -
- - 0 - -
OBAT LUAR / LAIN- LAIN - - 0 - -
1 Anti sariawan (Albotyl) Sol Botol - - - 0 - - - - 23,100.00 -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - 0 - - - 5,800.00 -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - 0 - - - - 5,670.00 -
4 Borax gliserin Botol - - - 0 - - - - 1,899.00 -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - 0 - - - - 18,458.00 -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - 0 - - - 12,749.00 -
7 Semprot Spray kotak - - - 0 - - - - 80,000.00 -
8 Larutan Chlorhexide @ 500 ml Botol - - - 0 - - - - 73,443.75 -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - 0 - - - - 66,000.00 -
10 Salisil spritus Botol - - - 0 - - - 5,430.00 -
- - 0 - -
ALAT KESEHATAN - - 0 - -
1 Bisturi @ 100 pcs pcs - - - 0 - - - - 770.00 -
2 Blood Lancet ss @ 100 pcs pcs - - - 0 - - - 221.00 -
3 Daryan tulle @ 10 lbr Lembar - - - 0 - - - - 16,500.00 -
4 EKG Paper 80 x 30 Roll - - - 0 - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - 0 - - - - 27,500.00 -
6 Foley cateter no. 16 @ 10 pcs pcs - - - 0 - - - 10,318.00 -
7 Foley cateter no. 18 10 Pcs pcs - - - 0 - - - - 9,080.00 -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - 0 - - - - 737.74 -
9 Hand schoen no. 7 @ 50 psg psg - - - 0 - - - - 4,675.00 -
10 Hand schoen no. 7,5 @ 50 psg psg - - - 0 - - - 4,675.00 -
11 Hand Schoen No. 8 @ 50 psg psg - - - 0 - - - - 4,675.00 -
12 Hand schoen steril no. 7 @ 50 psg psg - - - 0 - - - - 6,325.00 -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - 0 - - - - 6,325.00 -
14 Hand schoen steril no. 8 @ 50 psg psg - - - 0 - - - 6,325.00 -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - 0 - - - - 6,050.00 -
16 Hypapix 5 x 1 m roll - - - 0 - - - - 12,650.00 -
17 Jarum Hecting Kulit lsn - - - 0 - - - - 24,200.00 -
18 Jarung Hecting Otot lsn - - - 0 - - - 24,200.00 -
19 Kasa Hidrofil 40 x 80 pcs - - - 0 - - - - 119,174.19 -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - 0 - - - - 1,957.50 -
21 Kasa steril 16 x 16 pad roll - - - 0 - - - - 7,480.40 -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - 0 - - - 3,960.00 -
23 Mami non waven @ 24 pcs pcs - - - 0 - - - - 1,210.00 -
24 Masker @ 100 pcs pcs - - - 0 - - - - 425.60 -
25 Needle No. 23 G @ 100 pcs pcs - - - 0 - - - - 660.00 -
26 Needle No. 25 G 100 pcs pcs - - - 0 - - - 660.00 -
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - - - 15,400.00 -
28 Paket P3K pcs - - - 0 - - - - 311,900.00 -
29 Spuit Injeksi 10 ml pcs - - - 0 - - - - 1,393.90 -
30 Spuit Injeksi 50 ml Set - - - 0 - - - 5,693.00 -
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - - - 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - 0 - - - - 8,355.00 -
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - - - 8,355.00 -
34 Test Kehamilan Stik @ 50 pcs pcs - - - 0 - - - 1,564.20 -
35 Ultrasonic Gel pcs - - - 0 - - - - 27,500.00 -
36 Urine bag Stik - - - 0 - - - - 3,404.00 -
37 USG Printing Paper UPP-110 HG pcs - - - 0 - - - - 320,000.00 -
38 Wing needle no. 21 pcs - - - 0 - - - 2,145.00 -
39 Wing needle no. 27 pcs - - - 0 - - - - 2,145.00 -
40 Boor Diamond High Speed pcs - - - 0 - - - - 440,000.00 -
41 Boor Diamond Low Speed pcs - - - 0 - - - - 330,000.00 -
- - 0 -
OBAT PROGRAM - - 0 - -
PROGRAM P2 MALARIA - - 0 - -
1 Abate kg - - - 0 - - - - 99,220.00 -
2 ACT Tablet Ktk - - - 0 - - - 36,300.00 -
3 Arsumodon tablet Tablet - - - 0 - - - - 3,566.78 -
4 Artem Injeksi Ktk - - - 0 - - - - 14,868.83 -
6 Artesdiaquine Tablet Ktk - - - 0 - - - - 125,400.00 -
7 Artesunate Injeksi ampul - - - 0 - - - 38,999.00 -
8 Cynoff liter - - - 0 - - - - 387,800.00 -
9 Kelambu Pcs - - - 0 - - - - 1.00 -
10 Rafid Test Dengeu @ 25 test Pcs - - - 0 - - - - 57,200.00 -
11 RDT Chikungunya Pcs - - - 0 - - - 55,000.00 -
12 RDT Malaria Pcs - - - 0 - - - - 40,700.00 -
13 RDT Salmonella Pcs - - - 0 - - - - 66,000.00 -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - - 0 - - - - 79,200.00 -
- - 0 -
PROGRAM P2 IMUNISASI - - 0 - -
1 Alat suntik sekali pakai 0.05 ml pcs - - - 0 - - - - 1,900.00 -
2 Alat suntik sekali pakai 0.5 ml pcs - - - 0 - - - - 1,448.00 -
3 Safety Box Pcs - - - 0 - - - 23,000.00 -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - 0 - - - - 45,100.00 -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - 0 - - - - 45,100.00 -
6 Vaksin Campak + Pelarut (10 dosis) vial - - - 0 - - - - 22,527.00 -
7 Vaksin Campak + Pelarut (20 dosis) vial - - - 0 - - - 41,998.00 -
8 Vaksin DT Vial - - - 0 - - - - 14,487.00 -
9 Vaksin Hepatitis (HBO) ampul - - - 0 - - - - 18,750.00 -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - 0 - - - - 23,782.00 -
11 Vaksin Polio + Droper (10 Dosis) Vial - - - 0 - - - 16,203.00 -
12 Vaksin Polio IPV 5 Dosis Vial - - - 0 - - - - 137,610.00 -
13 Vaksin Td vial - - - 0 - - - - 14,250.00 -
14 Vaksin TT Vial - - - 0 - - - - 11,913.00 -
15 Vaksin DPT HB HIB Vial - - - 0 - - - 43,900.00 -
- - 0 - -
PROGRAM P2 TB - - - 0 - - - - -
1 Box Slides pcs - - - 0 - - - - 100,000.00 -
2 Bunsen Stainlestell ktk - - - 0 - - - 82,500.00 -
3 FDC I ktk - - - 0 - - - - 395,900.00 -
4 FDC I & III ktk - - - 0 - - - - 396,000.00 -
5 FDC II siklus - - - 0 - - - - 1,379,984.00 -
6 Kaca Ose siklus - - - 0 - - - 265,000.00 -
7 Kombipak kategori 1 ktk - - - 0 - - - - 317,015.00 -
8 Lampu Spritus siklus - - - 0 - - - - 69,000.00 -
9 Obat antituberkolosis Kategori Anak siklus - - - 0 - - - - 247,229.00 -
10 Obat antituberkolosis Kategori sisipan ktk - - - 0 - - - 176,000.00 -
11 Pot Sputum ktk - - - 0 - - - - 2,930.00 -
12 Reagen Zn Neilson set - - - 0 - - - - 236,500.00 -
13 Slide mikroskop kotak - - - 0 - - - - 27,500.00 -
14 Spritus Botol - - - 0 - - - 27,500.00 -
15 Masker N-95 pcs - - - 0 - - - - 21,420.00 -
16 Mikroskop Binoculer unit - - - 0 0 0 - - 1.00 -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - 0 - - - - 1.00 -
- - - 0 -
PROGRAM P2 DIARE - - - 0 - -
1 Zn Tablet 500 mg Tablet - - - 0 - - - - 512.00 -
- - 0 - -
PROGRAM P2 KUSTA - - 0 -
1 MDT MB Anak Strip - - - 0 - - - - 14,862.00 -
2 MDT MB Dewasa Strip - - - 0 - - - - 30,595.00 -
3 MDT PB Anak Strip - - - 0 - - - - 7,462.00 -
4 MDT PB Dewasa Strip - - - 0 - - - 8,323.00 -
- - 0 - -
PROGRAM KIA - - 0 - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - 0 - - - - 2,298.00 -
2 Obat Suntik KB 1 Bulan @ 20 vial vial - - - 0 - - - 6,249.95 -
3 Obat Suntik KB 3 Bulan @ 20 vial vial - - - 0 - - - - 6,249.95 -
4 Gluconas Calsicus vial - - - 0 - - - - 1.00 -
- - 0 - -
REAGEN LABORATORIUM - - 0 -
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - - - 24,222.22 -
2 Alkohol 70% @ 100 ml Botol - - - 0 - - - - 2,625.00 -
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - - - 48,400.00 -
4 Alkohol Swab @ 100 pcs Kotak - - - 0 - - - 128.97 -
5 Coumbour 10 Parameter botol - - - 0 - - - - 220,000.00 -
6 EDTA 10 % botol - - - 0 - - - - 66,000.00 -
7 Gliserin Botol - - - 0 - - - - 5,203.00 -
8 Gluko dr Stik @ 25 Stik botol - - - 0 - - - 309,500.00 -
9 Golongan Darah Test set - - - 0 - - - - 385,000.00 -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - 0 - - - - 618,750.00 -
11 Larutan Anisol botol - - - 0 - - - - 120,000.00 -
12 Larutan Asam Asetat 6% botol - - - 0 - - - 20,400.00 -
13 Larutan Asam Sulfosalilisat botol - - - 0 - - - - 69,300.00 -
14 Larutan Barium Klorida 10 % botol - - - 0 - - - - 11,000.00 -
15 Larutan Benedict Botol - - - 0 - - - - 75,625.00 -
16 Larutan Buffer Ph botol - - - 0 - - - 61,250.00 -
17 Larutan Carbol Gentian Violet botol - - - 0 - - - - 70,000.00 -
18 Larutan Drabkin Botol - - - 0 - - - - 122,195.00 -
19 Larutan Eosin 2 % Botol - - - 0 - - - - 230,000.00 -
20 Larutan Etanol Asam Botol - - - 0 - - - 41,700.00 -
21 Larutan Foucet botol - - - 0 - - - - 199,100.00 -
22 Larutan Giemsa Stain Botol - - - 0 - - - - 77,500.00 -
23 Larutan H2SO4 p Botol - - - 0 - - - - 41,255.00 -
24 Larutan HCl 0,1% botol - - - 0 - - - 8,470.00 -
25 Larutan HNO3 P Botol - - - 0 - - - - 55,000.00 -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - 0 - - - - 28,400.00 -
27 Larutan KOH 10 % Botol - - - 0 - - - - 44,550.00 -
28 Larutan Metelin Biru Botol - - - 0 - - - 20,900.00 -
29 Larutan Turk Botol - - - 0 - - - - 17,900.00 -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - 0 - - - - 64,300.00 -
31 Metanol Botol - - - 0 - - - - 30,400.00 -
32 Na Citrat 3,8 % botol - - - 0 - - - 8,000.00 -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - 0 - - - - 150,000.00 -
34 Nesco Glucose Stik @ 25 Stik Botol - - - 0 - - - - 103,400.00 -
35 Nesco HB Stik @ 25 Botol - - - 0 - - - - 148,500.00 -
36 Nesco Uric Acid Stik @ 25 Stik botol - - - 0 - - - 82,500.00 -
37 Oli Emersi botol - - - 0 - - - - 313,500.00 -
38 Rees Ecker botol - - - 0 - - - - 74,800.00 -
39 Trigeliserida Botol - - - 0 - - - - 418,000.00 -
40 Water Steril 500 ml Botol - - - 0 - - - 5,500.00 -
41 Water Steril 1000 ml Botol - - - 0 - - - - 24,750.00 -
42 widal Test Set - - - 0 - - - - 440,000.00 -
43 Xylol botol - - - 0 - - - - 27,500.00 -
44 Sungkup Bayi Pcs - - - 0 - - - 220,000.00 -
45 NGT All Item Pcs - - - 0 - - - - 1.00 -
46 PP 3 juta Injeksi vial - - - 0 - - - - 1.00 -
47 Progesteron Injeksi Vial - - - 0 - - - - 1.00 -
48 Iodiom Test Pcs - - - 0 - - - 1.00 -
49 Mineral Mix Bks - - - 0 - - - - 2,475.00 -
50 Eksavator Double Ended Pcs - - - 0 - - - - 1.00 -
51 Asetamivir tab Tablet - - - 0 - - - - 1.00 -
52 Natrium Tiroksin Pcs - - - 0 - - - 1.00 -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - 0 - - - - 1.00 -
54 Stick Hemosmart Pcs - - - 0 - - - - 1.00 -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - 0 - - - - 1.00 -
56 Lab.Kit Paket - - - 0 - - - 1.00 -
57 Blue Tips bks - - - 0 - - - - 105,875.00 -
58 Yellow Tips bks - - - 0 - - - - 139,700.00 -
59 Deck Glass ktk - - - 0 - - - - 38,500.00 -
60 Micro Hematokrit / Tabung Hematokrit pcs - - - 0 - - - 363.00 -
61 Tissue Lensa bks - - - 0 - - - - 48,400.00 -
62 Stik HB Family Dr ktk - - - 0 - - - - 357,500.00 -
63 Tabung EDTA K3/Vacutainer pcs - - - 0 - - - - 1,507.00 -
64 Glukosa Stik Performa Accu Check kotak - - - 0 - - - 420,000.00 -
65 Mikropipet (Microlit) 0-50 µl pcs - - - 0 - - - - - -
67 Glukosa Stik Active Accu Check Kotak - - - 0 - - - - 170,500.00 -
68 Kertas saring (isi 100 lbr) bks - - - 0 - - - 53,900.00 -
69 Lidi Sputum (100 pcs) bks - - - 0 - - - - 36,300.00 -
70 Cotton Swab pcs - - - 0 - - - - 7,700.00 -
71 Specullum pcs - - - 0 - - - - 1,000.00 -
72 Eter Alkohol Botol - - - 0 - - - 78,100.00 -
TOTAL -
UMUM
BAYAR
BAYAR
Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor Yang Menerima

Kepala Dinas Kesehatan PLT.Kepala Instalasi Farmasi Kepala Puskesmas Pengelola Obat
Kab. Tapin Kab. Tapin Binuang, Puskesmas Binuang,
H.Errani Martin,SKM.MM Hj. Renny Haslinda, S.Si.MM, Apt Isrok Antariksa, SKM, M.Kes Mahdalena, S. Farm., Apt
NIP.19640314 198802 1 002 19760126 2000501 2 011 NIP.19690928 198902 1 001 NIP 19830909 201001 2 032
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : Februari / Maret
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
2 Amoksisilin kaplet 500 mg @ 100 Tab Kaplet - - - - - - 233.00 -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - 0 - - 317.00 -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - 0 - - - - 275.00 -
5 Kloramfenikol Kapsul 500 mg Tablet - - - 0 - - - - 1,155.00 -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - - - - 93.50 -
7 mg @ 100 Tab Tablet - - - 0 - - 520.30 -
10 Kuinin (kina) tablet 200 mg Tablet - - - - - - 641.00 -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - 0 - - 105.00 -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - 0 - - - - 318.00 -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - 0 - - - - 125.00 -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - - - - 246.40 -
- - 0 - -
SIRUP - - 0 - - - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - 0 - - - - 2,200.00 -
2 Kotrimoksazole suspensi komb. Botol - - - - - - 2,225.00 -
- - 0 - -
INJEKSI - - 0 - - - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - 0 - - - - 1,740.00 -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - - - - 2,604.90 -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - - 0 - - 1,056.00 -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 Ampul - - - 0 - - - - 2,354.00 -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - 0 - - - - 6,820.00 -
6 Lidokain Komp. Inj Komb Ampul - - - - - - 2,122.00 -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - 0 - - 1,900.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU Vial - - - 0 - - - - 520,300.00 -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - 0 - - - - 193,470.80 -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - - - - 139,150.00 -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - 0 - - 401,092.00 -
12 Vaksin Rabies Vero (VAR) Vial - - - 0 - - - - 174,500.00 -
13 Tetagam Vial - - - 0 - - - - 170,000.00 -
- - - - -
INFUS - - 0 - -
3 Glukosa Larutan infus 5 % steril @ 20 fls fls - - - - - - 6,900.00 -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - 0 - - 7,150.00 -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - 0 - - - - 6,410.00 -
- - 0 - - - -
OBAT GIGI - - - - -
1 Air raksa Dental Use Ktk - - - 0 - - 103,536.00 -
2 Devitalisasi pasta ktk - - - 0 - - - - 293,498.00 -
3 EtiL klorida semprot Botol - - - 0 - - - - 99,000.00 -
4 Forinekresol (pengganti TKF) ktk - - - - - - 185,900.00 -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - 0 - - 306,427.00 -
6 Kalsium hidroksi pasta ktk - - - 0 - - - - 242,000.00 -
7 Klorfenol kamfer menthol (CHKM) ktk - - - 0 - - - - 56,441.40 -
8 Mummiying Pasta ktk - - - - - - 137,853.00 -
9 Semen seng Fosfar serbuk & cairan ktk - - - 0 - - 93,500.00 -
10 Silver amalgam serbuk 65 - 75 % ktk - - - 0 - - - - 408,792.00 -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - 0 - - - - 14,053.63 -
12 Temporary Stoping Flecther serbuk & Cair set - - - - - - 158,042.00 -
- - 0 - -
ALAT KESEHATAN - - 0 - - - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - 0 - - - - 1,540.00 -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - - - - 957.00 -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - 0 - - 2,049.00 -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - - - - 8,896.88 -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - 7,286.25 -
8 Infusion set anak Pcs - - - 0 - - - - 7,920.00 -
9 Infusion set dewasa Pcs - - - 0 - - - - 7,920.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
10 jarum @ 36 pcs Pcs - - - - - - 5,743.86 -
- - 0 - -
OBAT SANGAT ESENSIAL & ESENSIAL - - 0 - - - - -
TABLET - - 0 - - - -
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - - - - 95.00 -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - 0 - - 86.00 -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - 0 - - - - 123.00 -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 163.90 -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - - - - 64.00 -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - 0 - - 149.00 -
7 100 Tab Tablet - - - 0 - - - - 96.80 -
8 100 Tab Tablet - - - 0 - - - - 157.30 -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - - - - 120.00 -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - 0 - - 66.00 -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - 0 - - - - 48.00 -
13 Diazepam tablet 5 mg Tablet - - - - - - 52.80 -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - 0 - - 108.00 -
17 Fenobarbital tablet 100 mg Tablet - - - - - - 100.00 -
18 Fenobarbital tablet 30 mg Tablet - - - 0 - - 64.83 -
21 100 Tab Tablet - - - - - - 796.00 -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - 0 - - 84.00 -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - 0 - - - - 126.00 -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - 0 - - - - 108.00 -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - - - - 224.00 -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - 0 - - 62.00 -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - 0 - - - - 76.00 -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - 0 - - - - 105.00 -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - - - - 171.00 -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - 0 - - 121.00 -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - 0 - - - - 133.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - - 0 - - - - 98.00 -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - - - - 169.00 -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - 0 - - 306.00 -
35 Klorpeniramine Maleat (CTM) tablet 4 mg @ 100 T Tablet - - - 0 - - - - 47.50 -
37 Klorpromazine HCl tablet salut 25 mg Tablet - - - - - - 39.93 -
38 Magnesium sulfat serbuk 30 g Pot - - - 0 - - 1,129.30 -
39 Mebendazole tablet 100 mg Tablet - - - 0 - - - - 231.00 -
40 Tab Tablet - - - 0 - - - - 169.00 -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - - - - 98.00 -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - 0 - - 15.73 -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - 0 - - - - 857.00 -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - 0 - - - - 602.00 -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - - - - - 34.51 -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - 0 - - 136.00 -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - 0 - - - - 114.00 -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - 0 - - - - 351.00 -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - - - - 82.00 -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - 0 - - 114.00 -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - - - - 91.00 -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - 0 - - 97.00 -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - 0 - - - - 132.00 -
- - 0 - - - -
SIRUP - - - - -
1 Antasida DOEN Suspensi Komb Botol - - - 0 - - 2,300.00 -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - 0 - - - - 1,573.00 -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - 0 - - - - 3,740.00 -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - - - - 1,119.00 -
- - 0 - -
INJEKSI - - 0 - - - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - 0 - - - - 4,204.00 -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - - - - 1,345.00 -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - 0 - - 5,800.00 -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - 0 - - - - 1,210.00 -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - 0 - - - - 20,857.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
6 Fenobarbital injeksi Ampul - - - - - - 1,930.00 -
7 Amp Ampul - - - 0 - - 1,914.00 -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - 0 - - - - 1,210.00 -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - 0 - - - - 724.00 -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - - - - 2,800.00 -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - - 0 - - 3,500.00 -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - 0 - - - - 1,527.70 -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - 0 - - - - 2,970.00 -
14 100 Amp Ampul - - - - - - 1,226.00 -
15 Amp Ampul - - - 0 - - 843.33 -
- - 0 - - - -
SALEP - - 0 - - - -
1 endapan 4 % @ 24 Pot Pot - - - - - - 2,200.00 -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - 0 - - 2,712.00 -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - 0 - - - - 1,435.00 -
4 Antibakteri DOEN Komb. Pot - - - 0 - - - - 2,767.00 -
5 Antifungi DOEN Komb. Pot - - - - - - 4,782.00 -
- - 0 - -
SALEP MATA - - 0 - - - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - 0 - - - - 1,640.00 -
- - - - -
TETES MATA - - 0 - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - 0 - - - - 3,549.00 -
- - 0 - - - -
TETES TELINGA - - - - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - 0 - - 1,759.00 -
2 Fenol gliserol TT Botol - - - 0 - - - - 2,246.00 -
- - 0 - - - -
OBAT LUAR - - - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - 0 - - 3,502.00 -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - 0 - - - - 5,500.00 -
3 Gentian violet larutan 1 % Botol - - - 0 - - - - 2,178.00 -
4 Kalium Permanghanat serbuk Botol - - - - - - 6,529.00 -
5 Povidon Iodida 10 % 30 ml Botol - - - 0 - - 2,344.00 -
6 Povidon Iodida 10 % 300 ml Botol - - - 0 - - - - 15,950.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
7 Salisilat Bedak 2 % Kotak - - - 0 - - - - 1,066.00 -
- - - - -
OBAT GIGI - - 0 - -
1 Eugenol cairan Botol - - - 0 - - - - 20,815.00 -
- - 0 - - - -
ALAT KESEHATAN - - - - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - 0 - - 14,187.50 -
2 Kasa kompres 40 / 40 steril Bks - - - 0 - - - - 1,984.03 -
3 Kasa pembalut 2 m x 80 cm Rol - - - 0 - - - - 8,739.41 -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - - - - 2,740.50 -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - 0 - - 760.91 -
6 Pembalut gips Rol - - - 0 - - - - 6,071.00 -
7 Plester 5 yard x 2 inch Rol - - - 0 - - - - 25,987.00 -
- - - - -
OBAT PENUNJANG - - 0 - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - - - - 258.74 -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - 0 - - 2,200.00 -
5 Alprazolam Tablet @ 100 Tab Tablet - - - 0 - - - - 990.00 -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - 0 - - - - 155.30 -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - - - - 163.00 -
8 Amlodipin 5 mg Tablet @ 30 Tab Tablet - - - 0 - - 105.00 -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 Tablet - - - 0 - - - - 5,283.00 -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - 0 - - - - 173.00 -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - - - - 139.00 -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - 0 - - 150.00 -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 113.00 -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 1,540.00 -
15 Aspilet tablet @ 100 Tab Tablet - - - - - - 123.00 -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - - 0 - - 170.00 -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - 0 - - - - 230.00 -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - 0 - - - - 695.00 -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - - - - 121.00 -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - 0 - - 69.00 -
21 Captopril tablet 25 mg @ 100 Tab Tablet - - - 0 - - - - 72.00 -
22 Cefadroksil tab 250 mg Tablet - - - 0 - - - - 564.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - - - - 557.00 -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - 0 - - 899.00 -
25 Cetirizine tablet Tablet - - - 0 - - - - 154.00 -
26 Cimetidine tablet @ 100 Tab Tablet - - - 0 - - - - 115.50 -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - - - - 298.00 -
28 Clobazam tablet @ 100 Tab Tablet - - - 0 - - 1,120.00 -
29 Codein Tablet 10 mg Tablet - - - 0 - - - - 630.00 -
30 Codein Tablet 20 mg Tablet - - - 0 - - - - -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - - - - 1.00 -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - 0 - - 126.00 -
33 Dimenhidrinat tablet @ 100 Tab Tablet - - - 0 - - - - 107.00 -
34 Doksisiklin tablet @ 100 Tab Tablet - - - 0 - - - - 250.00 -
35 Domperidon Tablet @ 100 Tab Tablet - - - - - - 133.00 -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - 0 - - 509.00 -
37 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - 0 - - - - 766.00 -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - 0 - - - - 1,210.00 -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - - - - 1,100.00 -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - 0 - - 683.00 -
41 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - 0 - - - - 245.00 -
42 Glimepiride Tab 2 mg Tablet - - - 0 - - - - 296.00 -
43 Tablet @ 100 Tab Tablet - - - - - - 1,925.00 -
44 Ketokonazole tablet @ 50 tab Tablet - - - 0 - - 292.00 -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - - - - 4,813.00 -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - 0 - - 341.00 -
49 Levofloksasin @ 30 Tab Tablet - - - 0 - - - - 581.00 -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - 0 - - - - 410.00 -
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - - - - 660.00 -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - 0 - - 90.00 -
53 Loratadine tablet 10 mg @ 50 tab Tablet - - - 0 - - - - 170.00 -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - - 0 - - - - 726.00 -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - - - - 462.00 -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - 0 - - 292.60 -
57 Mepromaag tablet @ 100 Tab Tablet - - - 0 - - - - 495.00 -
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 118.50 -
59 Methioson Tablet @ 30 Tab Tablet - - - - - - 1,026.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - 0 - - 230.00 -
61 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 140.00 -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - 0 - - - - 100.00 -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - - - - 102.00 -
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - 0 - - 220.00 -
65 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - - 0 - - - - 560.00 -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - 0 - - - - 167.00 -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - - - - 193.00 -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - 0 - - 440.00 -
69 Nifedipin Tablet @ 100 Tab Tablet - - - 0 - - - - 123.00 -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - 0 - - - - 700.00 -
71 Omeprazole kapsul @ 30 Kap Kapsul - - - - - - 164.00 -
72 Papaverin tablet @ 1000 Tab Tablet - - - 0 - - 125.00 -
73 Paraformaldehide tablet @ 100 Tab Tablet - - - 0 - - - - 7,700.00 -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - 0 - - - - 1,485.00 -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - - - - - 360.80 -
76 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - 0 - - 97.02 -
77 Piroksikam tablet 20 mg @ 100 Tab Tablet - - - 0 - - - - 102.37 -
78 Propanolol 10 mg Tab Tablet - - - 0 - - - - 85.00 -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - - - - 242.00 -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - 0 - - 119.00 -
81 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Kapsul - - - 0 - - - - 286.00 -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - - 0 - - - - 505.00 -
83 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Ta Tablet - - - - - - 68.00 -
84 Salbutamol tablet 4 mg (sebagai sulfat) @ 100 Ta Tablet - - - 0 - - 84.00 -
85 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - - 0 - - - - 58.00 -
87 Simvastatin tablet 20 mg @ 30/50 Tab Tablet - - - - - - 252.00 -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - 0 - - 1,525.00 -
89 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - 0 - - - - 350.00 -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 100.00 -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - - - - - 73.73 -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - 0 - - 88.00 -
93 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - 0 - - - - 615.38 -
94 Tramadol Tablet @ 50 Tab Tablet - - - 0 - - - - 2,680.00 -
- - - - -
SIRUP - - 0 - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - 0 - - - - 3,791.00 -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - 0 - - - - 4,147.00 -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - - - - 21,450.00 -
4 Anti Diare (Arcapec) Sirup Botol - - - 0 - - 16,500.00 -
5 Anti sariawan (Enkasari) Sirup Botol - - - 0 - - - - 12,760.00 -
6 Batugin Elixier @ 120 ml botol - - - 0 - - - - 20,352.00 -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - - - - 3,594.00 -
8 Bromhexin (Phytovon) Sirup Botol - - - 0 - - 6,050.00 -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - 0 - - - - 6,285.00 -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - 0 - - - - 7,960.00 -
11 Cetirizine (Lerzin) Sirup Botol - - - - - - 7,756.00 -
12 Domperidon Sirup Botol - - - 0 - - 3,180.00 -
13 Domperidon Drop Botol - - - 0 - - - - 17,939.00 -
14 Erytromycin Sirup Botol - - - 0 - - - - 8,090.00 -
15 Fe Kombinasi (maltiron) Sirup Botol - - - - - - 19,250.00 -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - - 0 - - 16,500.00 -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - 0 - - - - 11,550.00 -
18 Gastrinal Suspensi Botol - - - 0 - - - - 24,200.00 -
19 Ibuprofen (Farsifen) Sirup Botol - - - - - - 2,560.00 -
20 Klorampenikol suspensi Botol - - - 0 - - 4,000.00 -
21 Lactulosa Sirup Botol - - - 0 - - - - 14,500.00 -
22 Laxadine Sirup @ 30 ml Botol - - - 0 - - - - 12,450.00 -
23 Metamizol (Norages) Sirup Botol - - - - - - 33,000.00 -
24 Metoklopropamid (Gavistal) Drop Botol - - - 0 - - 5,830.00 -
25 Metronidazole (Farizol) Sirup Botol - - - 0 - - - - 3,800.00 -
26 Metoklopropamid sirup Botol - - - 0 - - - - 2,750.00 -
27 Metronidazole Infus Botol - - - - - - 12,980.00 -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - 0 - - 22,000.00 -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - 0 - - - - 24,200.00 -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - 0 - - - - 10,902.00 -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - - - - 7,354.00 -
32 Nifuroxide (Nifudiar) Sirup Botol - - - 0 - - 38,500.00 -
33 Nistatin (Cazetin) Drop Botol - - - 0 - - - - 32,120.00 -
34 Parasetamol Drop Botol - - - 0 - - - - 5,980.00 -
35 Pseudoefedrin (Alco) Drop Botol - - - - - - 64,350.00 -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - 0 - - 20,350.00 -
37 Zinc drop Botol - - - 0 - - - - 11,700.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
38 Zinc Sirup Botol - - - 0 - - - - 6,500.00 -
- - - - -
INJEKSI - - 0 - -
1 Alinamin F injeksi @ 5 Amp Ampul - - - 0 - - - - 14,972.60 -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - 0 - - - - 5,610.00 -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - - - - 2,536.00 -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - 0 - - 9,350.00 -
5 Ceftriaxon Injeksi 1 gram @ 10 vial Vial - - - 0 - - - - 11,000.00 -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - 0 - - - - 33,000.00 -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - - - - 3,578.00 -
8 Dopamin Injeksi Ampul - - - 0 - - 10,219.00 -
9 Furusemide Injeksi Ampul - - - 0 - - - - 2,012.00 -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - 0 - - - - 3,415.00 -
Ampul
11 Ampul - - - - - - 4,950.00 -
12 Kanamycin Inj vial - - - 0 - - 6,610.80 -
13 Kloramfenikol Injeksi Vial - - - 0 - - - - 10,790.00 -
Vial
14 (Xylomidon) Inj @ 25 vial - - - 0 - - - - 5,555.00 -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - - - - 8,800.00 -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - 0 - - 6,600.00 -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - 0 - - - - 5,500.00 -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - 0 - - - - 9,570.00 -
19 Ondasentron Injeksi Ampul - - - - - - 2,400.00 -
20 Pethidin injeksi Ampul - - - 0 - - 14,509.10 -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - - - - 1,600.00 -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - 0 - - 2,680.00 -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - 0 - - - - 4,000.00 -
26 Xylocain Injeksi Ampul - - - 0 - - - - 40,000.00 -
27 Lidocain 2% Injeksi Ampul - - - - - - 875.00 -
INFUS - - 0 - -
1 KAEN 3A fls - - - 0 - - - - 10,000.00 -
2 KAEN 3B fls - - - 0 - - - - 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - - - - 9,350.00 -
4 Glukosa 5% + 1/2 NS fls - - - 0 - - 9,400.00 -
- - 0 - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
SALEP/KRIM - - 0 - - - -
1 Acyclovir cream @ 25 Tube tube - - - - - - 2,997.00 -
2 Bioplacenton Jelly tube - - - 0 - - 13,200.00 -
3 Gentamisin salep kulit @ 10 Tube tube - - - 0 - - - - 1,835.16 -
4 Ictiol salep Pot - - - 0 - - - - 4,300.00 -
5 Ketokonazole krim tube - - - - - - 2,605.00 -
6 Miconazole krim @ 24 Tube tube - - - 0 - - 3,737.00 -
7 Nostren Cream Tube - - - 0 - - - - 12,100.00 -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - 0 - - - - 1,649.36 -
9 Piroksikam (Infeld) Gel Tube - - - - - - 19,058.00 -
10 Scabimite cream @ 24 Tube tube - - - 0 - - 12,155.00 -
- - 0 - - - -
SALEP MATA - - 0 - - - -
1 Kloramfenikol Salep Mata tube - - - - - - 1,640.00 -
- - 0 - -
TETES MATA - - 0 - - - -
1 Cendo Catarelent Botol - - - 0 - - - - 22,000.00 -
2 Cendo Xitrol Botol - - - - - - 26,812.00 -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - 0 - - 4,600.00 -
4 Kloramfenikol Tetes Mata Botol - - - 0 - - - - 2,750.00 -
5 Tetrakain (Pantocain) TM Botol - - - 0 - - - - 11,500.00 -
- - - - -
TETES HIDUNG - - 0 - -
1 Iliadin Drop Botol - - - 0 - - - - 30,305.00 -
2 Iliadin Spray Botol - - - 0 - - - - 36,000.00 -
- - - - -
1 Otopain TT Botol - - - 0 - - - - 35,145.00 -
- - 0 - - - -
OBAT LUAR / LAIN- LAIN - - - - -
1 Anti sariawan (Albotyl) Sol Botol - - - 0 - - 23,100.00 -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - 0 - - - - 5,800.00 -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - 0 - - - - 5,670.00 -
4 Borax gliserin Botol - - - - - - 1,899.00 -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - 0 - - 18,458.00 -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - 0 - - - - 12,749.00 -
7 Semprot Spray kotak - - - 0 - - - - 80,000.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
8 Larutan Chlorhexide @ 500 ml Botol - - - - - - 73,443.75 -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - 0 - - 66,000.00 -
10 Salisil spritus Botol - - - 0 - - - - 5,430.00 -
- - 0 - - - -
ALAT KESEHATAN - - - - -
1 Bisturi @ 100 pcs pcs - - - 0 - - 770.00 -
2 Blood Lancet ss @ 100 pcs pcs - - - 0 - - - - 221.00 -
3 Daryan tulle @ 10 lbr Lembar - - - 0 - - - - 16,500.00 -
4 EKG Paper 80 x 30 Roll - - - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - 0 - - 27,500.00 -
6 Foley cateter no. 16 @ 10 pcs pcs - - - 0 - - - - 10,318.00 -
7 Foley cateter no. 18 10 Pcs pcs - - - 0 - - - - 9,080.00 -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - - - - 737.74 -
9 Hand schoen no. 7 @ 50 psg psg - - - 0 - - 4,675.00 -
10 Hand schoen no. 7,5 @ 50 psg psg - - - 0 - - - - 4,675.00 -
11 Hand Schoen No. 8 @ 50 psg psg - - - 0 - - - - 4,675.00 -
12 Hand schoen steril no. 7 @ 50 psg psg - - - - - - 6,325.00 -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - 0 - - 6,325.00 -
14 Hand schoen steril no. 8 @ 50 psg psg - - - 0 - - - - 6,325.00 -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - 0 - - - - 6,050.00 -
16 Hypapix 5 x 1 m roll - - - - - - 12,650.00 -
17 Jarum Hecting Kulit lsn - - - 0 - - 24,200.00 -
18 Jarung Hecting Otot lsn - - - 0 - - - - 24,200.00 -
19 Kasa Hidrofil 40 x 80 pcs - - - 0 - - - - 119,174.19 -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - - - - 1,957.50 -
21 Kasa steril 16 x 16 pad roll - - - 0 - - 7,480.40 -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - 0 - - - - 3,960.00 -
23 Mami non waven @ 24 pcs pcs - - - 0 - - - - 1,210.00 -
24 Masker @ 100 pcs pcs - - - - - - 425.60 -
25 Needle No. 23 G @ 100 pcs pcs - - - 0 - - 660.00 -
26 Needle No. 25 G 100 pcs pcs - - - 0 - - - - 660.00 -
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - - - 15,400.00 -
28 Paket P3K pcs - - - - - - 311,900.00 -
29 Spuit Injeksi 10 ml pcs - - - 0 - - 1,393.90 -
30 Spuit Injeksi 50 ml Set - - - 0 - - - - 5,693.00 -
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - - - 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - 8,355.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - 8,355.00 -
34 Test Kehamilan Stik @ 50 pcs pcs - - - 0 - - - - 1,564.20 -
35 Ultrasonic Gel pcs - - - 0 - - - - 27,500.00 -
36 Urine bag Stik - - - - - - 3,404.00 -
37 USG Printing Paper UPP-110 HG pcs - - - 0 - - 320,000.00 -
40 Boor Diamond High Speed pcs - - - - - - 440,000.00 -
41 Boor Diamond Low Speed pcs - - - 0 - - 330,000.00 -
- - 0 - - - -
OBAT PROGRAM - - 0 - - - -
PROGRAM P2 MALARIA - - - - -
1 Abate kg - - - 0 - - 99,220.00 -
2 ACT Tablet Ktk - - - 0 - - - - 36,300.00 -
3 Arsumodon tablet Tablet - - - 0 - - - - 3,566.78 -
4 Artem Injeksi Ktk - - - - - - 14,868.83 -
6 Artesdiaquine Tablet Ktk - - - 0 - - 125,400.00 -
7 Artesunate Injeksi ampul - - - 0 - - - - 38,999.00 -
8 Cynoff liter - - - 0 - - - - 387,800.00 -
9 Kelambu Pcs - - - - - - 1.00 -
10 Rafid Test Dengeu @ 25 test Pcs - - - 0 - - 57,200.00 -
11 RDT Chikungunya Pcs - - - 0 - - - - 55,000.00 -
12 RDT Malaria Pcs - - - 0 - - - - 40,700.00 -
13 RDT Salmonella Pcs - - - - - - 66,000.00 -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - - 0 - - 79,200.00 -
- - 0 - - - -
PROGRAM P2 IMUNISASI - - 0 - - - -
1 Alat suntik sekali pakai 0.05 ml pcs - - - - - - 1,900.00 -
2 Alat suntik sekali pakai 0.5 ml pcs - - - 0 - - 1,448.00 -
3 Safety Box Pcs - - - 0 - - - - 23,000.00 -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - 0 - - - - 45,100.00 -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - - - - 45,100.00 -
6 Vaksin Campak + Pelarut (10 dosis) vial - - - 0 - - 22,527.00 -
7 Vaksin Campak + Pelarut (20 dosis) vial - - - 0 - - - - 41,998.00 -
8 Vaksin DT Vial - - - 0 - - - - 14,487.00 -
9 Vaksin Hepatitis (HBO) ampul - - - - - - 18,750.00 -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - 0 - - 23,782.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
11 Vaksin Polio + Droper (10 Dosis) Vial - - - 0 - - - - 16,203.00 -
12 Vaksin Polio IPV 5 Dosis Vial - - - 0 - - - - 137,610.00 -
13 Vaksin Td vial - - - - - - 14,250.00 -
14 Vaksin TT Vial - - - 0 - - 11,913.00 -
15 Vaksin DPT HB HIB Vial - - - 0 - - - - 43,900.00 -
- - 0 - - - -
PROGRAM P2 TB - - - - - - -
1 Box Slides pcs - - - 0 - - 100,000.00 -
2 Bunsen Stainlestell ktk - - - 0 - - - - 82,500.00 -
3 FDC I ktk - - - 0 - - - - 395,900.00 -
4 FDC I & III ktk - - - - - - 396,000.00 -
5 FDC II siklus - - - 0 - - 1,379,984.00 -
6 Kaca Ose siklus - - - 0 - - - - 265,000.00 -
7 Kombipak kategori 1 ktk - - - 0 - - - - 317,015.00 -
8 Lampu Spritus siklus - - - - - - 69,000.00 -
9 Obat antituberkolosis Kategori Anak siklus - - - 0 - - 247,229.00 -
10 Obat antituberkolosis Kategori sisipan ktk - - - 0 - - - - 176,000.00 -
11 Pot Sputum ktk - - - 0 - - - - 2,930.00 -
12 Reagen Zn Neilson set - - - - - - 236,500.00 -
13 Slide mikroskop kotak - - - 0 - - 27,500.00 -
14 Spritus Botol - - - 0 - - - - 27,500.00 -
15 Masker N-95 pcs - - - 0 - - - - 21,420.00 -
16 Mikroskop Binoculer unit - - - - - - 1.00 -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - 0 - - 1.00 -
- - - 0 - - - -
PROGRAM P2 DIARE - - - 0 - - - -
1 Zn Tablet 500 mg Tablet - - - - - - 512.00 -
- - 0 - -
PROGRAM P2 KUSTA - - 0 - - - -
1 MDT MB Anak Strip - - - 0 - - - - 14,862.00 -
2 MDT MB Dewasa Strip - - - - - - 30,595.00 -
3 MDT PB Anak Strip - - - 0 - - 7,462.00 -
4 MDT PB Dewasa Strip - - - 0 - - - - 8,323.00 -
- - 0 - - - -
PROGRAM KIA - - - - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - 0 - - 2,298.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
4 Gluconas Calsicus vial - - - - - - 1.00 -
- - 0 - -
REAGEN LABORATORIUM - - 0 - - - -
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - - - 24,222.22 -
2 Alkohol 70% @ 100 ml Botol - - - - - - 2,625.00 -
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - 48,400.00 -
4 Alkohol Swab @ 100 pcs Kotak - - - 0 - - - - 128.97 -
5 Coumbour 10 Parameter botol - - - 0 - - - - 220,000.00 -
6 EDTA 10 % botol - - - - - - 66,000.00 -
7 Gliserin Botol - - - 0 - - 5,203.00 -
8 Gluko dr Stik @ 25 Stik botol - - - 0 - - - - 309,500.00 -
9 Golongan Darah Test set - - - 0 - - - - 385,000.00 -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - - - - 618,750.00 -
11 Larutan Anisol botol - - - 0 - - 120,000.00 -
12 Larutan Asam Asetat 6% botol - - - 0 - - - - 20,400.00 -
13 Larutan Asam Sulfosalilisat botol - - - 0 - - - - 69,300.00 -
14 Larutan Barium Klorida 10 % botol - - - - - - 11,000.00 -
15 Larutan Benedict Botol - - - 0 - - 75,625.00 -
16 Larutan Buffer Ph botol - - - 0 - - - - 61,250.00 -
17 Larutan Carbol Gentian Violet botol - - - 0 - - - - 70,000.00 -
18 Larutan Drabkin Botol - - - - - - 122,195.00 -
19 Larutan Eosin 2 % Botol - - - 0 - - 230,000.00 -
20 Larutan Etanol Asam Botol - - - 0 - - - - 41,700.00 -
21 Larutan Foucet botol - - - 0 - - - - 199,100.00 -
22 Larutan Giemsa Stain Botol - - - - - - 77,500.00 -
23 Larutan H2SO4 p Botol - - - 0 - - 41,255.00 -
24 Larutan HCl 0,1% botol - - - 0 - - - - 8,470.00 -
25 Larutan HNO3 P Botol - - - 0 - - - - 55,000.00 -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - - - - 28,400.00 -
27 Larutan KOH 10 % Botol - - - 0 - - 44,550.00 -
28 Larutan Metelin Biru Botol - - - 0 - - - - 20,900.00 -
29 Larutan Turk Botol - - - 0 - - - - 17,900.00 -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - - - - 64,300.00 -
31 Metanol Botol - - - 0 - - 30,400.00 -
32 Na Citrat 3,8 % botol - - - 0 - - - - 8,000.00 -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - 0 - - - - 150,000.00 -
34 Nesco Glucose Stik @ 25 Stik Botol - - - - - - 103,400.00 -
35 Nesco HB Stik @ 25 Botol - - - 0 - - 148,500.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
36 Nesco Uric Acid Stik @ 25 Stik botol - - - 0 - - - - 82,500.00 -
37 Oli Emersi botol - - - 0 - - - - 313,500.00 -
38 Rees Ecker botol - - - - - - 74,800.00 -
39 Trigeliserida Botol - - - 0 - - 418,000.00 -
42 widal Test Set - - - - - - 440,000.00 -
43 Xylol botol - - - 0 - - 27,500.00 -
44 Sungkup Bayi Pcs - - - 0 - - - - 220,000.00 -
45 NGT All Item Pcs - - - 0 - - - - 1.00 -
46 PP 3 juta Injeksi vial - - - - - - 1.00 -
47 Progesteron Injeksi Vial - - - 0 - - 1.00 -
48 Iodiom Test Pcs - - - 0 - - - - 1.00 -
49 Mineral Mix Bks - - - 0 - - - - 2,475.00 -
50 Eksavator Double Ended Pcs - - - - - - 1.00 -
51 Asetamivir tab Tablet - - - 0 - - 1.00 -
52 Natrium Tiroksin Pcs - - - 0 - - - - 1.00 -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - 0 - - - - 1.00 -
54 Stick Hemosmart Pcs - - - - - - 1.00 -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - 0 - - 1.00 -
56 Lab.Kit Paket - - - 0 - - - - 1.00 -
57 Blue Tips bks - - - 0 - - - - 105,875.00 -
58 Yellow Tips bks - - - - - - 139,700.00 -
59 Deck Glass ktk - - - 0 - - 38,500.00 -
60 Micro Hematokrit / Tabung Hematokrit pcs - - - 0 - - - - 363.00 -
61 Tissue Lensa bks - - - 0 - - - - 48,400.00 -
62 Stik HB Family Dr ktk - - - - - - 357,500.00 -
63 Tabung EDTA K3/Vacutainer pcs - - - 0 - - 1,507.00 -
64 Glukosa Stik Performa Accu Check kotak - - - 0 - - - - 420,000.00 -
66 Mikropipet (Microlit) 10-100 µl pcs - - - - - - - -
67 Glukosa Stik Active Accu Check Kotak - - - 0 - - 170,500.00 -
68 Kertas saring (isi 100 lbr) bks - - - 0 - - - - 53,900.00 -
69 Lidi Sputum (100 pcs) bks - - - 0 - - - - 36,300.00 -
70 Cotton Swab pcs - - - - - - 7,700.00 -
71 Specullum pcs - - - 0 - - 1,000.00 -
72 Eter Alkohol Botol - - - 0 - - - - 78,100.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TOTAL -
UMUM
ASKES/
JUMLAH KUNJUNGAN RESEP TIDAK JUMLAH
BAYAR BPJS
BAYAR
0 0 -

Kepala Dinas Kesehatan PLT. Kepala Instalasi Farmasi Kepala Puskesmas Pengelola Obat
H.Errani Martin,SKM.MM Hj. Renny Haslinda, S.Si.MM., Apt Isrok Antariksa, SKM, M.Kes Mahdalena, S. Farm., Apt
NIP.19640314 198802 1 002 NIP. 19760126 200501 2 011 NIP.19690928 198902 1 001 NIP 19830909 201001 2 032
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : Maret / April
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - - 0 - - - 0 207.00 -
2 Amoksisilin kaplet 500 mg @ 100 Tab Kaplet - - - - - - - - 233.00 -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - 0 - - - 0 317.00 -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - 0 - - - 0 275.00 -
5 Kloramfenikol Kapsul 500 mg Tablet - - - 0 - - - 0 1,155.00 -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - - - - - - 93.50 -
7 mg @ 100 Tab Tablet - - - 0 - - - 0 520.30 -
8 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - - 0 - - - 0 77.00 -
9 Kotrimoksazole tablet komb. 480 mg @ 100 Tab Tablet - - - 0 - - - 0 158.00 -
10 Kuinin (kina) tablet 200 mg Tablet - - - - - - - - 641.00 -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 105.00 -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - 0 - - - 0 318.00 -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - 0 - - - 0 125.00 -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - - - - - - 246.40 -
- - 0 - - - 0
SIRUP - - 0 - - - 0
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - 0 - - - 0 2,200.00 -
2 Kotrimoksazole suspensi komb. Botol - - - - - - - - 2,225.00 -
- - 0 - - - 0
INJEKSI - - 0 - - - 0
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - 0 - - - 0 1,740.00 -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - - - - - - 2,604.90 -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - - 0 - - - 0 1,056.00 -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 Ampul - - - 0 - - - 0 2,354.00 -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - 0 - - - 0 6,820.00 -
6 Lidokain Komp. Inj Komb Ampul - - - - - - - - 2,122.00 -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - 0 - - - 0 1,900.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU Vial - - - 0 - - - 0 520,300.00 -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - 0 - - - 0 193,470.80 -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - - - - - - 139,150.00 -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - 0 - - - 0 401,092.00 -
12 Vaksin Rabies Vero (VAR) Vial - - - 0 - - - 0 174,500.00 -
13 Tetagam Vial - - - 0 - - - 0 170,000.00 -
- - - - - - -
INFUS - - 0 - - - 0
1 Glukosa Larutan infus 10 % steril @ 20 fls fls - - - 0 - - - 0 6,270.00 -
2 Glukosa Larutan infus 40 % steril @ 10 fls fls - - - 0 - - - 0 1,597.60 -
3 Glukosa Larutan infus 5 % steril @ 20 fls fls - - - - - - - - 6,900.00 -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - 0 - - - 0 7,150.00 -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - 0 - - - 0 6,410.00 -
- - 0 - - - 0
OBAT GIGI - - - - - - -
1 Air raksa Dental Use Ktk - - - 0 - - - 0 103,536.00 -
2 Devitalisasi pasta ktk - - - 0 - - - 0 293,498.00 -
3 EtiL klorida semprot Botol - - - 0 - - - 0 99,000.00 -
4 Forinekresol (pengganti TKF) ktk - - - - - - - - 185,900.00 -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - 0 - - - 0 306,427.00 -
6 Kalsium hidroksi pasta ktk - - - 0 - - - 0 242,000.00 -
7 Klorfenol kamfer menthol (CHKM) ktk - - - 0 - - - 0 56,441.40 -
8 Mummiying Pasta ktk - - - - - - - - 137,853.00 -
9 Semen seng Fosfar serbuk & cairan ktk - - - 0 - - - 0 93,500.00 -
10 Silver amalgam serbuk 65 - 75 % ktk - - - 0 - - - 0 408,792.00 -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - 0 - - - 0 14,053.63 -
12 Temporary Stoping Flecther serbuk & Cair set - - - - - - - - 158,042.00 -
- - 0 - - - 0
ALAT KESEHATAN - - 0 - - - 0
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - 0 - - - 0 1,540.00 -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - - - - - - 957.00 -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - 0 - - - 0 2,049.00 -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - 0 7,201.04 -
5 Catgut Cromic No. 2/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - 0 7,201.04 -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - - - - - - 8,896.88 -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - 0 7,286.25 -
8 Infusion set anak Pcs - - - 0 - - - 0 7,920.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
9 Infusion set dewasa Pcs - - - 0 - - - 0 7,920.00 -
10 jarum @ 36 pcs Pcs - - - - - - - - 5,743.86 -
- - 0 - - - 0
OBAT SANGAT ESENSIAL & ESENSIAL - - 0 - - - 0 -
TABLET - - 0 - - - 0
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - - - - - - 95.00 -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 0 86.00 -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - 0 - - - 0 123.00 -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 163.90 -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - - - - - - 64.00 -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - 0 - - - 0 149.00 -
7 100 Tab Tablet - - - 0 - - - 0 96.80 -
8 100 Tab Tablet - - - 0 - - - 0 157.30 -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - - - - - - 120.00 -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - 0 - - - 0 66.00 -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - 0 - - - 0 48.00 -
12 Diazepam tablet 2 mg Tablet - - - 0 - - - 0 46.00 -
13 Diazepam tablet 5 mg Tablet - - - - - - - - 52.80 -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - 0 - - - 0 108.00 -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - - 0 - - - 0 146.00 -
16 Fenitoin Na Kapsul 30 mg @ 250 Kap Kapsul - - - 0 - - - 0 80.00 -
17 Fenobarbital tablet 100 mg Tablet - - - - - - - - 100.00 -
18 Fenobarbital tablet 30 mg Tablet - - - 0 - - - 0 64.83 -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - - 0 - - - 0 257.40 -
20 Fenoksimetil penicillin tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 456.50 -
21 100 Tab Tablet - - - - - - - - 796.00 -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - 0 - - - 0 84.00 -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - 0 - - - 0 126.00 -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - 0 - - - 0 108.00 -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - - - - - - 224.00 -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - 0 - - - 0 62.00 -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - 0 - - - 0 76.00 -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - 0 - - - 0 105.00 -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - - - - - - 171.00 -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 0 121.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - 0 - - - 0 133.00 -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - - 0 - - - 0 98.00 -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - - - - - - 169.00 -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 0 306.00 -
35 Klorpeniramine Maleat (CTM) tablet 4 mg @ 100 T Tablet - - - 0 - - - 0 47.50 -
36 Klorpromazine HCl tablet salut 100 mg Tablet - - - 0 - - - 0 162.00 -
37 Klorpromazine HCl tablet salut 25 mg Tablet - - - - - - - - 39.93 -
38 Magnesium sulfat serbuk 30 g Pot - - - 0 - - - 0 1,129.30 -
39 Mebendazole tablet 100 mg Tablet - - - 0 - - - 0 231.00 -
40 Tab Tablet - - - 0 - - - 0 169.00 -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - - - - - - 98.00 -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - 0 - - - 0 15.73 -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - 0 - - - 0 857.00 -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - 0 - - - 0 602.00 -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - - - - - - - 34.51 -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - 0 - - - 0 136.00 -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - 0 - - - 0 114.00 -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - 0 - - - 0 351.00 -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - - - - - - 82.00 -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - 0 - - - 0 114.00 -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - - 0 - - - 0 167.20 -
52 Tetrasiklin HCl kapsul 500 mg @ 100 Kap Kapsul - - - 0 - - - 0 325.00 -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - - - - - - 91.00 -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - 0 - - - 0 97.00 -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - 0 - - - 0 132.00 -
- - 0 - - - 0
SIRUP - - - - - - -
1 Antasida DOEN Suspensi Komb Botol - - - 0 - - - 0 2,300.00 -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - 0 - - - 0 1,573.00 -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - 0 - - - 0 3,740.00 -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - - - - - - 1,119.00 -
- - 0 - - - 0
INJEKSI - - 0 - - - 0
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - 0 - - - 0 4,204.00 -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - - - - - - 1,345.00 -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - 0 - - - 0 5,800.00 -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - 0 - - - 0 1,210.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - 0 - - - 0 20,857.00 -
6 Fenobarbital injeksi Ampul - - - - - - - - 1,930.00 -
7 Amp Ampul - - - 0 - - - 0 1,914.00 -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - 0 - - - 0 1,210.00 -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - 0 - - - 0 724.00 -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - - - - - - 2,800.00 -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - - 0 - - - 0 3,500.00 -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - 0 - - - 0 1,527.70 -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - 0 - - - 0 2,970.00 -
14 100 Amp Ampul - - - - - - - - 1,226.00 -
15 Amp Ampul - - - 0 - - - 0 843.33 -
- - 0 - - - 0
SALEP - - 0 - - - 0
1 endapan 4 % @ 24 Pot Pot - - - - - - - - 2,200.00 -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - 0 - - - 0 2,712.00 -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - 0 - - - 0 1,435.00 -
4 Antibakteri DOEN Komb. Pot - - - 0 - - - 0 2,767.00 -
5 Antifungi DOEN Komb. Pot - - - - - - - - 4,782.00 -
- - 0 - - - 0
SALEP MATA - - 0 - - - 0
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - 0 - - - 0 1,640.00 -
- - - - - - -
TETES MATA - - 0 - - - 0
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - 0 - - - 0 3,549.00 -
- - 0 - - - 0
TETES TELINGA - - - - - - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - 0 - - - 0 1,759.00 -
2 Fenol gliserol TT Botol - - - 0 - - - 0 2,246.00 -
- - 0 - - - 0
OBAT LUAR - - - - - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - 0 - - - 0 3,502.00 -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - 0 - - - 0 5,500.00 -
3 Gentian violet larutan 1 % Botol - - - 0 - - - 0 2,178.00 -
4 Kalium Permanghanat serbuk Botol - - - - - - - - 6,529.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
5 Povidon Iodida 10 % 30 ml Botol - - - 0 - - - 0 2,344.00 -
6 Povidon Iodida 10 % 300 ml Botol - - - 0 - - - 0 15,950.00 -
7 Salisilat Bedak 2 % Kotak - - - 0 - - - 0 1,066.00 -
- - - - - - -
OBAT GIGI - - 0 - - - 0
1 Eugenol cairan Botol - - - 0 - - - 0 20,815.00 -
- - 0 - - - 0
ALAT KESEHATAN - - - - - - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - 0 - - - 0 14,187.50 -
2 Kasa kompres 40 / 40 steril Bks - - - 0 - - - 0 1,984.03 -
3 Kasa pembalut 2 m x 80 cm Rol - - - 0 - - - 0 8,739.41 -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - - - - - - 2,740.50 -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - 0 - - - 0 760.91 -
6 Pembalut gips Rol - - - 0 - - - 0 6,071.00 -
7 Plester 5 yard x 2 inch Rol - - - 0 - - - 0 25,987.00 -
- - - - - - -
OBAT PENUNJANG - - 0 - - - 0
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 0 272.00 -
2 Acyclovir tablet 400 mg @ 100 Tab Tablet - - - 0 - - - 0 628.46 -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - - - - - - 258.74 -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - 0 - - - 0 2,200.00 -
5 Alprazolam Tablet @ 100 Tab Tablet - - - 0 - - - 0 990.00 -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - 0 - - - 0 155.30 -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - - - - - - 163.00 -
8 Amlodipin 5 mg Tablet @ 30 Tab Tablet - - - 0 - - - 0 105.00 -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 Tablet - - - 0 - - - 0 5,283.00 -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - 0 - - - 0 173.00 -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - - - - - - 139.00 -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - 0 - - - 0 150.00 -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 113.00 -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 1,540.00 -
15 Aspilet tablet @ 100 Tab Tablet - - - - - - - - 123.00 -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - - 0 - - - 0 170.00 -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - 0 - - - 0 230.00 -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - 0 - - - 0 695.00 -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - - - - - - 121.00 -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - 0 - - - 0 69.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
21 Captopril tablet 25 mg @ 100 Tab Tablet - - - 0 - - - 0 72.00 -
22 Cefadroksil tab 250 mg Tablet - - - 0 - - - 0 564.00 -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - - - - - - 557.00 -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - 0 - - - 0 899.00 -
25 Cetirizine tablet Tablet - - - 0 - - - 0 154.00 -
26 Cimetidine tablet @ 100 Tab Tablet - - - 0 - - - 0 115.50 -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - - - - - - 298.00 -
28 Clobazam tablet @ 100 Tab Tablet - - - 0 - - - 0 1,120.00 -
29 Codein Tablet 10 mg Tablet - - - 0 - - - 0 630.00 -
30 Codein Tablet 20 mg Tablet - - - 0 - - - 0 -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - - - - - - 1.00 -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - 0 - - - 0 126.00 -
33 Dimenhidrinat tablet @ 100 Tab Tablet - - - 0 - - - 0 107.00 -
34 Doksisiklin tablet @ 100 Tab Tablet - - - 0 - - - 0 250.00 -
35 Domperidon Tablet @ 100 Tab Tablet - - - - - - - - 133.00 -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - 0 - - - 0 509.00 -
37 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - 0 - - - 0 766.00 -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - 0 - - - 0 1,210.00 -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - - - - - - 1,100.00 -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - 0 - - - 0 683.00 -
41 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - 0 - - - 0 245.00 -
42 Glimepiride Tab 2 mg Tablet - - - 0 - - - 0 296.00 -
43 Tablet @ 100 Tab Tablet - - - - - - - - 1,925.00 -
44 Ketokonazole tablet @ 50 tab Tablet - - - 0 - - - 0 292.00 -
45 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - 0 - - - 0 660.00 -
46 Klindamisin tablet 150 mg @ 50 Tab Tablet - - - 0 - - - 0 405.00 -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - - - - - - 4,813.00 -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - 0 - - - 0 341.00 -
49 Levofloksasin @ 30 Tab Tablet - - - 0 - - - 0 581.00 -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - 0 - - - 0 410.00 -
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - - - - - - 660.00 -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - 0 - - - 0 90.00 -
53 Loratadine tablet 10 mg @ 50 tab Tablet - - - 0 - - - 0 170.00 -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - - 0 - - - 0 726.00 -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - - - - - - 462.00 -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - 0 - - - 0 292.60 -
57 Mepromaag tablet @ 100 Tab Tablet - - - 0 - - - 0 495.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 118.50 -
59 Methioson Tablet @ 30 Tab Tablet - - - - - - - - 1,026.00 -
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - 0 - - - 0 230.00 -
61 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 140.00 -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - 0 - - - 0 100.00 -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - - - - - - 102.00 -
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - 0 - - - 0 220.00 -
65 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - - 0 - - - 0 560.00 -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - 0 - - - 0 167.00 -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - - - - - - 193.00 -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - 0 - - - 0 440.00 -
69 Nifedipin Tablet @ 100 Tab Tablet - - - 0 - - - 0 123.00 -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - 0 - - - 0 700.00 -
71 Omeprazole kapsul @ 30 Kap Kapsul - - - - - - - - 164.00 -
72 Papaverin tablet @ 1000 Tab Tablet - - - 0 - - - 0 125.00 -
73 Paraformaldehide tablet @ 100 Tab Tablet - - - 0 - - - 0 7,700.00 -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - 0 - - - 0 1,485.00 -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - - - - - - - 360.80 -
76 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - 0 - - - 0 97.02 -
77 Piroksikam tablet 20 mg @ 100 Tab Tablet - - - 0 - - - 0 102.37 -
78 Propanolol 10 mg Tab Tablet - - - 0 - - - 0 85.00 -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - - - - - - 242.00 -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - 0 - - - 0 119.00 -
81 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Kapsul - - - 0 - - - 0 286.00 -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - - 0 - - - 0 505.00 -
83 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Ta Tablet - - - - - - - - 68.00 -
84 Salbutamol tablet 4 mg (sebagai sulfat) @ 100 Ta Tablet - - - 0 - - - 0 84.00 -
85 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - - 0 - - - 0 58.00 -
86 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - - 0 - - - 0 135.00 -
87 Simvastatin tablet 20 mg @ 30/50 Tab Tablet - - - - - - - - 252.00 -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - 0 - - - 0 1,525.00 -
89 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - 0 - - - 0 350.00 -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 100.00 -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - - - - - - - 73.73 -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - 0 - - - 0 88.00 -
93 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 0 615.38 -
94 Tramadol Tablet @ 50 Tab Tablet - - - 0 - - - 0 2,680.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - - - - -
SIRUP - - 0 - - - 0
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - 0 - - - 0 3,791.00 -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - 0 - - - 0 4,147.00 -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - - - - - - 21,450.00 -
4 Anti Diare (Arcapec) Sirup Botol - - - 0 - - - 0 16,500.00 -
5 Anti sariawan (Enkasari) Sirup Botol - - - 0 - - - 0 12,760.00 -
6 Batugin Elixier @ 120 ml botol - - - 0 - - - 0 20,352.00 -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - - - - - - 3,594.00 -
8 Bromhexin (Phytovon) Sirup Botol - - - 0 - - - 0 6,050.00 -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - 0 - - - 0 6,285.00 -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - 0 - - - 0 7,960.00 -
11 Cetirizine (Lerzin) Sirup Botol - - - - - - - - 7,756.00 -
12 Domperidon Sirup Botol - - - 0 - - - 0 3,180.00 -
13 Domperidon Drop Botol - - - 0 - - - 0 17,939.00 -
14 Erytromycin Sirup Botol - - - 0 - - - 0 8,090.00 -
15 Fe Kombinasi (maltiron) Sirup Botol - - - - - - - - 19,250.00 -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - - 0 - - - 0 16,500.00 -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - 0 - - - 0 11,550.00 -
18 Gastrinal Suspensi Botol - - - 0 - - - 0 24,200.00 -
19 Ibuprofen (Farsifen) Sirup Botol - - - - - - - - 2,560.00 -
20 Klorampenikol suspensi Botol - - - 0 - - - 0 4,000.00 -
21 Lactulosa Sirup Botol - - - 0 - - - 0 14,500.00 -
22 Laxadine Sirup @ 30 ml Botol - - - 0 - - - 0 12,450.00 -
23 Metamizol (Norages) Sirup Botol - - - - - - - - 33,000.00 -
24 Metoklopropamid (Gavistal) Drop Botol - - - 0 - - - 0 5,830.00 -
25 Metronidazole (Farizol) Sirup Botol - - - 0 - - - 0 3,800.00 -
26 Metoklopropamid sirup Botol - - - 0 - - - 0 2,750.00 -
27 Metronidazole Infus Botol - - - - - - - - 12,980.00 -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - 0 - - - 0 22,000.00 -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - 0 - - - 0 24,200.00 -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - 0 - - - 0 10,902.00 -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - - - - - - 7,354.00 -
32 Nifuroxide (Nifudiar) Sirup Botol - - - 0 - - - 0 38,500.00 -
33 Nistatin (Cazetin) Drop Botol - - - 0 - - - 0 32,120.00 -
34 Parasetamol Drop Botol - - - 0 - - - 0 5,980.00 -
35 Pseudoefedrin (Alco) Drop Botol - - - - - - - - 64,350.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - 0 - - - 0 20,350.00 -
37 Zinc drop Botol - - - 0 - - - 0 11,700.00 -
38 Zinc Sirup Botol - - - 0 - - - 0 6,500.00 -
- - - - - - -
INJEKSI - - 0 - - - 0
1 Alinamin F injeksi @ 5 Amp Ampul - - - 0 - - - 0 14,972.60 -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - 0 - - - 0 5,610.00 -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - - - - - - 2,536.00 -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - 0 - - - 0 9,350.00 -
5 Ceftriaxon Injeksi 1 gram @ 10 vial Vial - - - 0 - - - 0 11,000.00 -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - 0 - - - 0 33,000.00 -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - - - - - - 3,578.00 -
8 Dopamin Injeksi Ampul - - - 0 - - - 0 10,219.00 -
9 Furusemide Injeksi Ampul - - - 0 - - - 0 2,012.00 -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - 0 - - - 0 3,415.00 -
Ampul
11 Ampul - - - - - - - - 4,950.00 -
12 Kanamycin Inj vial - - - 0 - - - 0 6,610.80 -
13 Kloramfenikol Injeksi Vial - - - 0 - - - 0 10,790.00 -
Vial
14 (Xylomidon) Inj @ 25 vial - - - 0 - - - 0 5,555.00 -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - - - - - - 8,800.00 -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - 0 - - - 0 6,600.00 -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - 0 - - - 0 5,500.00 -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - 0 - - - 0 9,570.00 -
19 Ondasentron Injeksi Ampul - - - - - - - - 2,400.00 -
20 Pethidin injeksi Ampul - - - 0 - - - 0 14,509.10 -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - - 0 - - - 0 3,300.00 -
22 Piracetam injeksi 3 gram @ 4 Amp Ampul - - - 0 - - - 0 17,088.00 -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - - - - - - 1,600.00 -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - 0 - - - 0 2,680.00 -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - 0 - - - 0 4,000.00 -
26 Xylocain Injeksi Ampul - - - 0 - - - 0 40,000.00 -
27 Lidocain 2% Injeksi Ampul - - - - - - - - 875.00 -
INFUS - - 0 - - - 0
1 KAEN 3A fls - - - 0 - - - 0 10,000.00 -
2 KAEN 3B fls - - - 0 - - - 0 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - - - - - - 9,350.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
4 Glukosa 5% + 1/2 NS fls - - - 0 - - - 0 9,400.00 -
- - 0 - - - 0
SALEP/KRIM - - 0 - - - 0
1 Acyclovir cream @ 25 Tube tube - - - - - - - - 2,997.00 -
2 Bioplacenton Jelly tube - - - 0 - - - 0 13,200.00 -
3 Gentamisin salep kulit @ 10 Tube tube - - - 0 - - - 0 1,835.16 -
4 Ictiol salep Pot - - - 0 - - - 0 4,300.00 -
5 Ketokonazole krim tube - - - - - - - - 2,605.00 -
6 Miconazole krim @ 24 Tube tube - - - 0 - - - 0 3,737.00 -
7 Nostren Cream Tube - - - 0 - - - 0 12,100.00 -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - 0 - - - 0 1,649.36 -
9 Piroksikam (Infeld) Gel Tube - - - - - - - - 19,058.00 -
10 Scabimite cream @ 24 Tube tube - - - 0 - - - 0 12,155.00 -
- - 0 - - - 0
SALEP MATA - - 0 - - - 0
1 Kloramfenikol Salep Mata tube - - - - - - - - 1,640.00 -
- - 0 - - - 0
TETES MATA - - 0 - - - 0
1 Cendo Catarelent Botol - - - 0 - - - 0 22,000.00 -
2 Cendo Xitrol Botol - - - - - - - - 26,812.00 -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - 0 - - - 0 4,600.00 -
4 Kloramfenikol Tetes Mata Botol - - - 0 - - - 0 2,750.00 -
5 Tetrakain (Pantocain) TM Botol - - - 0 - - - 0 11,500.00 -
- - - - - - -
TETES HIDUNG - - 0 - - - 0
1 Iliadin Drop Botol - - - 0 - - - 0 30,305.00 -
2 Iliadin Spray Botol - - - 0 - - - 0 36,000.00 -
- - - - - - -
TETES TELINGA - - 0 - - - 0
1 Otopain TT Botol - - - 0 - - - 0 35,145.00 -
- - 0 - - - 0
OBAT LUAR / LAIN- LAIN - - - - - - -
1 Anti sariawan (Albotyl) Sol Botol - - - 0 - - - 0 23,100.00 -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - 0 - - - 0 5,800.00 -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - 0 - - - 0 5,670.00 -
4 Borax gliserin Botol - - - - - - - - 1,899.00 -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - 0 - - - 0 18,458.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - 0 - - - 0 12,749.00 -
7 Semprot Spray kotak - - - 0 - - - 0 80,000.00 -
8 Larutan Chlorhexide @ 500 ml Botol - - - - - - - - 73,443.75 -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - 0 - - - 0 66,000.00 -
10 Salisil spritus Botol - - - 0 - - - 0 5,430.00 -
- - 0 - - - 0
ALAT KESEHATAN - - - - - - -
1 Bisturi @ 100 pcs pcs - - - 0 - - - 0 770.00 -
2 Blood Lancet ss @ 100 pcs pcs - - - 0 - - - 0 221.00 -
3 Daryan tulle @ 10 lbr Lembar - - - 0 - - - 0 16,500.00 -
4 EKG Paper 80 x 30 Roll - - - - - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - 0 - - - 0 27,500.00 -
6 Foley cateter no. 16 @ 10 pcs pcs - - - 0 - - - 0 10,318.00 -
7 Foley cateter no. 18 10 Pcs pcs - - - 0 - - - 0 9,080.00 -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - - - - - - 737.74 -
9 Hand schoen no. 7 @ 50 psg psg - - - 0 - - - 0 4,675.00 -
10 Hand schoen no. 7,5 @ 50 psg psg - - - 0 - - - 0 4,675.00 -
11 Hand Schoen No. 8 @ 50 psg psg - - - 0 - - - 0 4,675.00 -
12 Hand schoen steril no. 7 @ 50 psg psg - - - - - - - - 6,325.00 -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - 0 - - - 0 6,325.00 -
14 Hand schoen steril no. 8 @ 50 psg psg - - - 0 - - - 0 6,325.00 -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - 0 - - - 0 6,050.00 -
16 Hypapix 5 x 1 m roll - - - - - - - - 12,650.00 -
17 Jarum Hecting Kulit lsn - - - 0 - - - 0 24,200.00 -
18 Jarung Hecting Otot lsn - - - 0 - - - 0 24,200.00 -
19 Kasa Hidrofil 40 x 80 pcs - - - 0 - - - 0 119,174.19 -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - - - - - - 1,957.50 -
21 Kasa steril 16 x 16 pad roll - - - 0 - - - 0 7,480.40 -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - 0 - - - 0 3,960.00 -
23 Mami non waven @ 24 pcs pcs - - - 0 - - - 0 1,210.00 -
24 Masker @ 100 pcs pcs - - - - - - - - 425.60 -
25 Needle No. 23 G @ 100 pcs pcs - - - 0 - - - 0 660.00 -
26 Needle No. 25 G 100 pcs pcs - - - 0 - - - 0 660.00 -
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - - 0 15,400.00 -
28 Paket P3K pcs - - - - - - - - 311,900.00 -
29 Spuit Injeksi 10 ml pcs - - - 0 - - - 0 1,393.90 -
30 Spuit Injeksi 50 ml Set - - - 0 - - - 0 5,693.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - - 0 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - - - 8,355.00 -
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - - 0 8,355.00 -
34 Test Kehamilan Stik @ 50 pcs pcs - - - 0 - - - 0 1,564.20 -
35 Ultrasonic Gel pcs - - - 0 - - - 0 27,500.00 -
36 Urine bag Stik - - - - - - - - 3,404.00 -
37 USG Printing Paper UPP-110 HG pcs - - - 0 - - - 0 320,000.00 -
38 Wing needle no. 21 pcs - - - 0 - - - 0 2,145.00 -
39 Wing needle no. 27 pcs - - - 0 - - - 0 2,145.00 -
40 Boor Diamond High Speed pcs - - - - - - - - 440,000.00 -
41 Boor Diamond Low Speed pcs - - - 0 - - - 0 330,000.00 -
- - 0 - - - 0
OBAT PROGRAM - - 0 - - - 0
PROGRAM P2 MALARIA - - - - - - -
1 Abate kg - - - 0 - - - 0 99,220.00 -
2 ACT Tablet Ktk - - - 0 - - - 0 36,300.00 -
3 Arsumodon tablet Tablet - - - 0 - - - 0 3,566.78 -
4 Artem Injeksi Ktk - - - - - - - - 14,868.83 -
6 Artesdiaquine Tablet Ktk - - - 0 - - - 0 125,400.00 -
7 Artesunate Injeksi ampul - - - 0 - - - 0 38,999.00 -
8 Cynoff liter - - - 0 - - - 0 387,800.00 -
9 Kelambu Pcs - - - - - - - - 1.00 -
10 Rafid Test Dengeu @ 25 test Pcs - - - 0 - - - 0 57,200.00 -
11 RDT Chikungunya Pcs - - - 0 - - - 0 55,000.00 -
12 RDT Malaria Pcs - - - 0 - - - 0 40,700.00 -
13 RDT Salmonella Pcs - - - - - - - - 66,000.00 -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - - 0 - - - 0 79,200.00 -
- - 0 - - - 0
PROGRAM P2 IMUNISASI - - 0 - - - 0
1 Alat suntik sekali pakai 0.05 ml pcs - - - - - - - - 1,900.00 -
2 Alat suntik sekali pakai 0.5 ml pcs - - - 0 - - - 0 1,448.00 -
3 Safety Box Pcs - - - 0 - - - 0 23,000.00 -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - 0 - - - 0 45,100.00 -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - - - - - - 45,100.00 -
6 Vaksin Campak + Pelarut (10 dosis) vial - - - 0 - - - 0 22,527.00 -
7 Vaksin Campak + Pelarut (20 dosis) vial - - - 0 - - - 0 41,998.00 -
8 Vaksin DT Vial - - - 0 - - - 0 14,487.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
9 Vaksin Hepatitis (HBO) ampul - - - - - - - - 18,750.00 -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - 0 - - - 0 23,782.00 -
11 Vaksin Polio + Droper (10 Dosis) Vial - - - 0 - - - 0 16,203.00 -
12 Vaksin Polio IPV 5 Dosis Vial - - - 0 - - - 0 137,610.00 -
13 Vaksin Td vial - - - - - - - - 14,250.00 -
14 Vaksin TT Vial - - - 0 - - - 0 11,913.00 -
15 Vaksin DPT HB HIB Vial - - - 0 - - - 0 43,900.00 -
- - 0 - - - 0
PROGRAM P2 TB - - - - - - - - -
1 Box Slides pcs - - - 0 - - - 0 100,000.00 -
2 Bunsen Stainlestell ktk - - - 0 - - - 0 82,500.00 -
3 FDC I ktk - - - 0 - - - 0 395,900.00 -
4 FDC I & III ktk - - - - - - - - 396,000.00 -
5 FDC II siklus - - - 0 - - - 0 1,379,984.00 -
6 Kaca Ose siklus - - - 0 - - - 0 265,000.00 -
7 Kombipak kategori 1 ktk - - - 0 - - - 0 317,015.00 -
8 Lampu Spritus siklus - - - - - - - - 69,000.00 -
9 Obat antituberkolosis Kategori Anak siklus - - - 0 - - - 0 247,229.00 -
10 Obat antituberkolosis Kategori sisipan ktk - - - 0 - - - 0 176,000.00 -
11 Pot Sputum ktk - - - 0 - - - 0 2,930.00 -
12 Reagen Zn Neilson set - - - - - - - - 236,500.00 -
13 Slide mikroskop kotak - - - 0 - - - 0 27,500.00 -
14 Spritus Botol - - - 0 - - - 0 27,500.00 -
15 Masker N-95 pcs - - - 0 - - - 0 21,420.00 -
16 Mikroskop Binoculer unit - - - - - - - - 1.00 -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - 0 - - - 0 1.00 -
- - - 0 - - - 0
PROGRAM P2 DIARE - - - 0 - - - 0
1 Zn Tablet 500 mg Tablet - - - - - - - - 512.00 -
- - 0 - - - 0
PROGRAM P2 KUSTA - - 0 - - - 0
1 MDT MB Anak Strip - - - 0 - - - 0 14,862.00 -
2 MDT MB Dewasa Strip - - - - - - - - 30,595.00 -
3 MDT PB Anak Strip - - - 0 - - - 0 7,462.00 -
4 MDT PB Dewasa Strip - - - 0 - - - 0 8,323.00 -
- - 0 - - - 0
PROGRAM KIA - - - - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - 0 - - - 0 2,298.00 -
2 Obat Suntik KB 1 Bulan @ 20 vial vial - - - 0 - - - 0 6,249.95 -
3 Obat Suntik KB 3 Bulan @ 20 vial vial - - - 0 - - - 0 6,249.95 -
4 Gluconas Calsicus vial - - - - - - - - 1.00 -
- - 0 - - - 0
REAGEN LABORATORIUM - - 0 - - - 0
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - - 0 24,222.22 -
2 Alkohol 70% @ 100 ml Botol - - - - - - - - 2,625.00 -
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - - 0 48,400.00 -
4 Alkohol Swab @ 100 pcs Kotak - - - 0 - - - 0 128.97 -
5 Coumbour 10 Parameter botol - - - 0 - - - 0 220,000.00 -
6 EDTA 10 % botol - - - - - - - - 66,000.00 -
7 Gliserin Botol - - - 0 - - - 0 5,203.00 -
8 Gluko dr Stik @ 25 Stik botol - - - 0 - - - 0 309,500.00 -
9 Golongan Darah Test set - - - 0 - - - 0 385,000.00 -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - - - - - - 618,750.00 -
11 Larutan Anisol botol - - - 0 - - - 0 120,000.00 -
12 Larutan Asam Asetat 6% botol - - - 0 - - - 0 20,400.00 -
13 Larutan Asam Sulfosalilisat botol - - - 0 - - - 0 69,300.00 -
14 Larutan Barium Klorida 10 % botol - - - - - - - - 11,000.00 -
15 Larutan Benedict Botol - - - 0 - - - 0 75,625.00 -
16 Larutan Buffer Ph botol - - - 0 - - - 0 61,250.00 -
17 Larutan Carbol Gentian Violet botol - - - 0 - - - 0 70,000.00 -
18 Larutan Drabkin Botol - - - - - - - - 122,195.00 -
19 Larutan Eosin 2 % Botol - - - 0 - - - 0 230,000.00 -
20 Larutan Etanol Asam Botol - - - 0 - - - 0 41,700.00 -
21 Larutan Foucet botol - - - 0 - - - 0 199,100.00 -
22 Larutan Giemsa Stain Botol - - - - - - - - 77,500.00 -
23 Larutan H2SO4 p Botol - - - 0 - - - 0 41,255.00 -
24 Larutan HCl 0,1% botol - - - 0 - - - 0 8,470.00 -
25 Larutan HNO3 P Botol - - - 0 - - - 0 55,000.00 -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - - - - - - 28,400.00 -
27 Larutan KOH 10 % Botol - - - 0 - - - 0 44,550.00 -
28 Larutan Metelin Biru Botol - - - 0 - - - 0 20,900.00 -
29 Larutan Turk Botol - - - 0 - - - 0 17,900.00 -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - - - - - - 64,300.00 -
31 Metanol Botol - - - 0 - - - 0 30,400.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
32 Na Citrat 3,8 % botol - - - 0 - - - 0 8,000.00 -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - 0 - - - 0 150,000.00 -
34 Nesco Glucose Stik @ 25 Stik Botol - - - - - - - - 103,400.00 -
35 Nesco HB Stik @ 25 Botol - - - 0 - - - 0 148,500.00 -
36 Nesco Uric Acid Stik @ 25 Stik botol - - - 0 - - - 0 82,500.00 -
37 Oli Emersi botol - - - 0 - - - 0 313,500.00 -
38 Rees Ecker botol - - - - - - - - 74,800.00 -
39 Trigeliserida Botol - - - 0 - - - 0 418,000.00 -
40 Water Steril 500 ml Botol - - - 0 - - - 0 5,500.00 -
41 Water Steril 1000 ml Botol - - - 0 - - - 0 24,750.00 -
42 widal Test Set - - - - - - - - 440,000.00 -
43 Xylol botol - - - 0 - - - 0 27,500.00 -
44 Sungkup Bayi Pcs - - - 0 - - - 0 220,000.00 -
45 NGT All Item Pcs - - - 0 - - - 0 1.00 -
46 PP 3 juta Injeksi vial - - - - - - - - 1.00 -
47 Progesteron Injeksi Vial - - - 0 - - - 0 1.00 -
48 Iodiom Test Pcs - - - 0 - - - 0 1.00 -
49 Mineral Mix Bks - - - 0 - - - 0 2,475.00 -
50 Eksavator Double Ended Pcs - - - - - - - - 1.00 -
51 Asetamivir tab Tablet - - - 0 - - - 0 1.00 -
52 Natrium Tiroksin Pcs - - - 0 - - - 0 1.00 -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - 0 - - - 0 1.00 -
54 Stick Hemosmart Pcs - - - - - - - - 1.00 -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - 0 - - - 0 1.00 -
56 Lab.Kit Paket - - - 0 - - - 0 1.00 -
57 Blue Tips bks - - - 0 - - - 0 105,875.00 -
58 Yellow Tips bks - - - - - - - - 139,700.00 -
59 Deck Glass ktk - - - 0 - - - 0 38,500.00 -
60 Micro Hematokrit / Tabung Hematokrit pcs - - - 0 - - - 0 363.00 -
61 Tissue Lensa bks - - - 0 - - - 0 48,400.00 -
62 Stik HB Family Dr ktk - - - - - - - - 357,500.00 -
63 Tabung EDTA K3/Vacutainer pcs - - - 0 - - - 0 1,507.00 -
64 Glukosa Stik Performa Accu Check kotak - - - 0 - - - 0 420,000.00 -
65 Mikropipet (Microlit) 0-50 µl pcs - - - 0 - - - 0 - -
66 Mikropipet (Microlit) 10-100 µl pcs - - - - - - - - - -
67 Glukosa Stik Active Accu Check Kotak - - - 0 - - - 0 170,500.00 -
68 Kertas saring (isi 100 lbr) bks - - - 0 - - - 0 53,900.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
69 Lidi Sputum (100 pcs) bks - - - 0 - - - 0 36,300.00 -
70 Cotton Swab pcs - - - - - - - - 7,700.00 -
71 Specullum pcs - - - 0 - - - 0 1,000.00 -
72 Eter Alkohol Botol - - - 0 - - - 0 78,100.00 -
73 Alat Nesco pcs - - - 0 - - - 0 1.00 -
74 Alat Multicare pcs - - - - - - - - 1.00 -
TOTAL -
UMUM
BAYAR
BAYAR
0 0 -

Kepala Dinas Kesehatan PLT. Kepala Instalasi Farmasi Kepala Puskesmas Pengelola Obat
H.Errani Martin,SKM.MM Hj. Renny Haslinda, S.Si.MM., Apt H. Isrok Antariksa, SKM, M.Kes Mahdalena, S. Farm., Apt
NIP.19640314 198802 1 002 NIP. 19760126 200501 2 011 NIP.19690928 198902 1 001 NIP. 19830909 201001 2 032
KODE PUSKESMAS :
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Per

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - - 0 - - -
2 Amoksisilin kaplet 500 mg @ 100 Tab Kaplet - - - - - - -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - 0 - - -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - 0 - - -
5 Kloramfenikol Kapsul 500 mg Tablet - - - 0 - - -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - - - - -
7 mg @ 100 Tab Tablet - - - 0 - - -
8 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - - 0 - - -
9 Kotrimoksazole tablet komb. 480 mg @ 100 Tab Tablet - - - 0 - - -
10 Kuinin (kina) tablet 200 mg Tablet - - - - - - -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - 0 - - -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - 0 - - -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - - - - -
- - 0 - - -
SIRUP - - 0 - - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - 0 - - -
2 Kotrimoksazole suspensi komb. Botol - - - - - - -
- - 0 - - -
INJEKSI - - 0 - - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - 0 - - -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - - - - -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - - 0 - - -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 Ampul - - - 0 - - -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - 0 - - -
6 Lidokain Komp. Inj Komb Ampul - - - - - - -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - 0 - - -
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU Vial - - - 0 - - -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - 0 - - -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - - - - -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - 0 - - -
12 Vaksin Rabies Vero (VAR) Vial - - - 0 - - -
13 Tetagam Vial - - - 0 - - -
- - - - - -
INFUS - - 0 - - -
1 Glukosa Larutan infus 10 % steril @ 20 fls fls - - - 0 - - -
2 Glukosa Larutan infus 40 % steril @ 10 fls fls - - - 0 - - -
3 Glukosa Larutan infus 5 % steril @ 20 fls fls - - - - - - -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - 0 - - -
- - 0 - - -
OBAT GIGI - - - - - -
1 Air raksa Dental Use Ktk - - - 0 - - -
2 Devitalisasi pasta ktk - - - 0 - - -
3 EtiL klorida semprot Botol - - - 0 - - -
4 Forinekresol (pengganti TKF) ktk - - - - - - -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - 0 - - -
6 Kalsium hidroksi pasta ktk - - - 0 - - -
7 Klorfenol kamfer menthol (CHKM) ktk - - - 0 - - -
8 Mummiying Pasta ktk - - - - - - -
9 Semen seng Fosfar serbuk & cairan ktk - - - 0 - - -
10 Silver amalgam serbuk 65 - 75 % ktk - - - 0 - - -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - 0 - - -
12 Temporary Stoping Flecther serbuk & Cair set - - - - - - -
- - 0 - - -
ALAT KESEHATAN - - 0 - - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - 0 - - -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - - - - -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - 0 - - -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - -
5 Catgut Cromic No. 2/0 dengan jarum @ 24 pcs Pcs - - - 0 - - -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - - - - -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - -
8 Infusion set anak Pcs - - - 0 - - -
9 Infusion set dewasa Pcs - - - 0 - - -
10 jarum @ 36 pcs Pcs - - - - - - -
- - 0 - - -
OBAT SANGAT ESENSIAL & ESENSIAL - - 0 - - -
TABLET - - 0 - - -
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - - - - -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - 0 - - -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - 0 - - -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - - - - -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - 0 - - -
7 100 Tab Tablet - - - 0 - - -
8 100 Tab Tablet - - - 0 - - -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - - - - -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - 0 - - -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - 0 - - -
12 Diazepam tablet 2 mg Tablet - - - 0 - - -
13 Diazepam tablet 5 mg Tablet - - - - - - -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - 0 - - -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - - 0 - - -
16 Fenitoin Na Kapsul 30 mg @ 250 Kap Kapsul - - - 0 - - -
17 Fenobarbital tablet 100 mg Tablet - - - - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
18 Fenobarbital tablet 30 mg Tablet - - - 0 - - -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - - 0 - - -
20 Fenoksimetil penicillin tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
21 100 Tab Tablet - - - - - - -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - 0 - - -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - 0 - - -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - 0 - - -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - - - - -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - 0 - - -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - 0 - - -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - 0 - - -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - - - - -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - 0 - - -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - 0 - - -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - - 0 - - -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - - - - -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - 0 - - -
35 Klorpeniramine Maleat (CTM) tablet 4 mg @ 100 T Tablet - - - 0 - - -
36 Klorpromazine HCl tablet salut 100 mg Tablet - - - 0 - - -
37 Klorpromazine HCl tablet salut 25 mg Tablet - - - - - - -
38 Magnesium sulfat serbuk 30 g Pot - - - 0 - - -
39 Mebendazole tablet 100 mg Tablet - - - 0 - - -
40 Tab Tablet - - - 0 - - -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - - - - -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - 0 - - -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - 0 - - -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - 0 - - -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - - - - - -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - 0 - - -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - 0 - - -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - 0 - - -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - - - - -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - 0 - - -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - - 0 - - -
52 Tetrasiklin HCl kapsul 500 mg @ 100 Kap Kapsul - - - 0 - - -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - - - - -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - 0 - - -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - 0 - - -
- - 0 - - -
SIRUP - - - - - -
1 Antasida DOEN Suspensi Komb Botol - - - 0 - - -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - 0 - - -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - 0 - - -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - - - - -
- - 0 - - -
INJEKSI - - 0 - - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - 0 - - -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - 0 - - -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - 0 - - -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - 0 - - -
6 Fenobarbital injeksi Ampul - - - - - - -
7 Amp Ampul - - - 0 - - -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - 0 - - -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - 0 - - -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - - - - -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - - 0 - - -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - 0 - - -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - 0 - - -
14 100 Amp Ampul - - - - - - -
15 Amp Ampul - - - 0 - - -
- - 0 - - -
SALEP - - 0 - - -
1 endapan 4 % @ 24 Pot Pot - - - - - - -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - 0 - - -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - 0 - - -
4 Antibakteri DOEN Komb. Pot - - - 0 - - -
5 Antifungi DOEN Komb. Pot - - - - - - -
- - 0 - - -
SALEP MATA - - 0 - - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - 0 - - -
- - - - - -
TETES MATA - - 0 - - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - 0 - - -
- - 0 - - -
TETES TELINGA - - - - - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - 0 - - -
2 Fenol gliserol TT Botol - - - 0 - - -
- - 0 - - -
OBAT LUAR - - - - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - 0 - - -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - 0 - - -
3 Gentian violet larutan 1 % Botol - - - 0 - - -
4 Kalium Permanghanat serbuk Botol - - - - - - -
5 Povidon Iodida 10 % 30 ml Botol - - - 0 - - -
6 Povidon Iodida 10 % 300 ml Botol - - - 0 - - -
7 Salisilat Bedak 2 % Kotak - - - 0 - - -
- - - - - -
OBAT GIGI - - 0 - - -
1 Eugenol cairan Botol - - - 0 - - -
- - 0 - - -
ALAT KESEHATAN - - - - - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - 0 - - -
2 Kasa kompres 40 / 40 steril Bks - - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
3 Kasa pembalut 2 m x 80 cm Rol - - - 0 - - -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - - - - -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - 0 - - -
6 Pembalut gips Rol - - - 0 - - -
7 Plester 5 yard x 2 inch Rol - - - 0 - - -
- - - - - -
OBAT PENUNJANG - - 0 - - -
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - - 0 - - -
2 Acyclovir tablet 400 mg @ 100 Tab Tablet - - - 0 - - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - - - - -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - 0 - - -
5 Alprazolam Tablet @ 100 Tab Tablet - - - 0 - - -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - 0 - - -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - - - - -
8 Amlodipin 5 mg Tablet @ 30 Tab Tablet - - - 0 - - -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 Tablet - - - 0 - - -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - 0 - - -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - - - - -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - 0 - - -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
15 Aspilet tablet @ 100 Tab Tablet - - - - - - -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - - 0 - - -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - 0 - - -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - 0 - - -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - - - - -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - 0 - - -
21 Captopril tablet 25 mg @ 100 Tab Tablet - - - 0 - - -
22 Cefadroksil tab 250 mg Tablet - - - 0 - - -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - - - - -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - 0 - - -
25 Cetirizine tablet Tablet - - - 0 - - -
26 Cimetidine tablet @ 100 Tab Tablet - - - 0 - - -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - - - - -
28 Clobazam tablet @ 100 Tab Tablet - - - 0 - - -
29 Codein Tablet 10 mg Tablet - - - 0 - - -
Codein Tablet 20 mg Tablet - - - 0 - - -
30 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - - - - -
31 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - 0 - - -
32 Dimenhidrinat tablet @ 100 Tab Tablet - - - 0 - - -
33 Doksisiklin tablet @ 100 Tab Tablet - - - 0 - - -
34 Domperidon Tablet @ 100 Tab Tablet - - - - - - -
35 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - 0 - - -
36 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - 0 - - -
37 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - 0 - - -
38 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - - - - -
39 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - 0 - - -
40 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - 0 - - -
41 Glimepiride Tab 2 mg Tablet - - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
42 Tablet @ 100 Tab Tablet - - - - - - -
43 Ketokonazole tablet @ 50 tab Tablet - - - 0 - - -
44 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - 0 - - -
45 Klindamisin tablet 150 mg @ 50 Tab Tablet - - - 0 - - -
46 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - - - - -
47 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - 0 - - -
48 Levofloksasin @ 30 Tab Tablet - - - 0 - - -
49 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - 0 - - -
50 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - - - - -
51 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - 0 - - -
52 Loratadine tablet 10 mg @ 50 tab Tablet - - - 0 - - -
53 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - - 0 - - -
54 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - - - - -
55 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - 0 - - -
56 Mepromaag tablet @ 100 Tab Tablet - - - 0 - - -
57 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
58 Methioson Tablet @ 30 Tab Tablet - - - - - - -
59 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - 0 - - -
60 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
61 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - 0 - - -
62 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - - - - -
63 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - 0 - - -
64 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - - 0 - - -
65 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - 0 - - -
66 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - - - - -
67 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - 0 - - -
68 Nifedipin Tablet @ 100 Tab Tablet - - - 0 - - -
69 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - 0 - - -
70 Omeprazole kapsul @ 30 Kap Kapsul - - - - - - -
71 Papaverin tablet @ 1000 Tab Tablet - - - 0 - - -
72 Paraformaldehide tablet @ 100 Tab Tablet - - - 0 - - -
73 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - 0 - - -
74 Piracetam tablet 400 mg @ 100 Tab Tablet - - - - - - -
75 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - 0 - - -
76 Piroksikam tablet 20 mg @ 100 Tab Tablet - - - 0 - - -
77 Propanolol 10 mg Tab Tablet - - - 0 - - -
78 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - - - - -
79 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - 0 - - -
80 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Kapsul - - - 0 - - -
81 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - - 0 - - -
82 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Ta Tablet - - - - - - -
83 Salbutamol tablet 4 mg (sebagai sulfat) @ 100 Ta Tablet - - - 0 - - -
84 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - - 0 - - -
85 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - - 0 - - -
86 Simvastatin tablet 20 mg @ 30/50 Tab Tablet - - - - - - -
87 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - 0 - - -
88 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - 0 - - -
89 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
90 Tablet tambah darah @ 30 Tab Sal Tablet - - - - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
91 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - 0 - - -
92 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - 0 - - -
93 Tramadol Tablet @ 50 Tab Tablet - - - 0 - - -
- - - - - -
SIRUP - - 0 - - -
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - 0 - - -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - 0 - - -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - - - - -
4 Anti Diare (Arcapec) Sirup Botol - - - 0 - - -
5 Anti sariawan (Enkasari) Sirup Botol - - - 0 - - -
6 Batugin Elixier @ 120 ml botol - - - 0 - - -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - - - - -
8 Bromhexin (Phytovon) Sirup Botol - - - 0 - - -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - 0 - - -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - 0 - - -
11 Cetirizine (Lerzin) Sirup Botol - - - - - - -
12 Domperidon Sirup Botol - - - 0 - - -
13 Domperidon Drop Botol - - - 0 - - -
14 Erytromycin Sirup Botol - - - 0 - - -
15 Fe Kombinasi (maltiron) Sirup Botol - - - - - - -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - - 0 - - -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - 0 - - -
18 Gastrinal Suspensi Botol - - - 0 - - -
19 Ibuprofen (Farsifen) Sirup Botol - - - - - - -
20 Klorampenikol suspensi Botol - - - 0 - - -
21 Lactulosa Sirup Botol - - - 0 - - -
22 Laxadine Sirup @ 30 ml Botol - - - 0 - - -
23 Metamizol (Norages) Sirup Botol - - - - - - -
24 Metoklopropamid (Gavistal) Drop Botol - - - 0 - - -
25 Metronidazole (Farizol) Sirup Botol - - - 0 - - -
26 Metoklopropamid sirup Botol - - - 0 - - -
27 Metronidazole Infus Botol - - - - - - -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - 0 - - -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - 0 - - -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - 0 - - -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - - - - -
32 Nifuroxide (Nifudiar) Sirup Botol - - - 0 - - -
33 Nistatin (Cazetin) Drop Botol - - - 0 - - -
34 Parasetamol Drop Botol - - - 0 - - -
35 Pseudoefedrin (Alco) Drop Botol - - - - - - -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - 0 - - -
37 Zinc drop Botol - - - 0 - - -
38 Zinc Sirup Botol - - - 0 - - -
- - - - - -
INJEKSI - - 0 - - -
1 Alinamin F injeksi @ 5 Amp Ampul - - - 0 - - -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - 0 - - -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - - - - -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
5 Ceftriaxon Injeksi 1 gram @ 10 vial Vial - - - 0 - - -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - 0 - - -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - - - - -
8 Dopamin Injeksi Ampul - - - 0 - - -
9 Furusemide Injeksi Ampul - - - 0 - - -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - 0 - - -
Ampul
11 Ampul - - - - - - -
12 Kanamycin Inj vial - - - 0 - - -
13 Kloramfenikol Injeksi Vial - - - 0 - - -
Vial
14 (Xylomidon) Inj @ 25 vial - - - 0 - - -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - - - - -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - 0 - - -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - 0 - - -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - 0 - - -
19 Ondasentron Injeksi Ampul - - - - - - -
20 Pethidin injeksi Ampul - - - 0 - - -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - - 0 - - -
22 Piracetam injeksi 3 gram @ 4 Amp Ampul - - - 0 - - -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - - - - -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - 0 - - -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - 0 - - -
26 Xylocain Injeksi Ampul - - - 0 - - -
27 Lidocain 2% Injeksi Ampul - - - - - - -
INFUS - - 0 - - -
1 KAEN 3A fls - - - 0 - - -
2 KAEN 3B fls - - - 0 - - -
3 Glukosa 5% + 1/4 NS fls - - - - - - -
4 Glukosa 5% + 1/2 NS fls - - - 0 - - -
- - 0 - - -
SALEP/KRIM - - 0 - - -
1 Acyclovir cream @ 25 Tube tube - - - - - - -
2 Bioplacenton Jelly tube - - - 0 - - -
3 Gentamisin salep kulit @ 10 Tube tube - - - 0 - - -
4 Ictiol salep Pot - - - 0 - - -
5 Ketokonazole krim tube - - - - - - -
6 Miconazole krim @ 24 Tube tube - - - 0 - - -
7 Nostren Cream Tube - - - 0 - - -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - 0 - - -
9 Piroksikam (Infeld) Gel Tube - - - - - - -
10 Scabimite cream @ 24 Tube tube - - - 0 - - -
- - 0 - - -
1 Kloramfenikol Salep Mata tube - - - - - - -
- - 0 - - -
1 Cendo Catarelent Botol - - - 0 - - -
2 Cendo Xitrol Botol - - - - - - -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
4 Kloramfenikol Tetes Mata Botol - - - 0 - - -
5 Tetrakain (Pantocain) TM Botol - - - 0 - - -
- - - - - -
TETES HIDUNG - - 0 - - -
1 Iliadin Drop Botol - - - 0 - - -
2 Iliadin Spray Botol - - - 0 - - -
- - - - - -
TETES TELINGA - - 0 - - -
1 Otopain TT Botol - - - 0 - - -
- - 0 - - -
OBAT LUAR / LAIN- LAIN - - - - - -
1 Anti sariawan (Albotyl) Sol Botol - - - 0 - - -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - 0 - - -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - 0 - - -
4 Borax gliserin Botol - - - - - - -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - 0 - - -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - 0 - - -
7 Semprot Spray kotak - - - 0 - - -
8 Larutan Chlorhexide @ 500 ml Botol - - - - - - -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - 0 - - -
10 Salisil spritus Botol - - - 0 - - -
- - 0 - - -
1 Bisturi @ 100 pcs pcs - - - 0 - - -
2 Blood Lancet ss @ 100 pcs pcs - - - 0 - - -
3 Daryan tulle @ 10 lbr Lembar - - - 0 - - -
4 EKG Paper 80 x 30 Roll - - - - - - -
5 EKG Paper 40 x 30 Roll - - - 0 - - -
6 Foley cateter no. 16 @ 10 pcs pcs - - - 0 - - -
7 Foley cateter no. 18 10 Pcs pcs - - - 0 - - -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - - - - -
9 Hand schoen no. 7 @ 50 psg psg - - - 0 - - -
10 Hand schoen no. 7,5 @ 50 psg psg - - - 0 - - -
11 Hand Schoen No. 8 @ 50 psg psg - - - 0 - - -
12 Hand schoen steril no. 7 @ 50 psg psg - - - - - - -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - 0 - - -
14 Hand schoen steril no. 8 @ 50 psg psg - - - 0 - - -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - 0 - - -
16 Hypapix 5 x 1 m roll - - - - - - -
17 Jarum Hecting Kulit lsn - - - 0 - - -
18 Jarung Hecting Otot lsn - - - 0 - - -
19 Kasa Hidrofil 40 x 80 pcs - - - 0 - - -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - - - - -
21 Kasa steril 16 x 16 pad roll - - - 0 - - -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - 0 - - -
23 Mami non waven @ 24 pcs pcs - - - 0 - - -
24 Masker @ 100 pcs pcs - - - - - - -
25 Needle No. 23 G @ 100 pcs pcs - - - 0 - - -
26 Needle No. 25 G 100 pcs pcs - - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - -
28 Paket P3K pcs - - - - - - -
29 Spuit Injeksi 10 ml pcs - - - 0 - - -
30 Spuit Injeksi 50 ml Set - - - 0 - - -
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - -
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - -
34 Test Kehamilan Stik @ 50 pcs pcs - - - 0 - - -
35 Ultrasonic Gel pcs - - - 0 - - -
36 Urine bag Stik - - - - - - -
37 USG Printing Paper UPP-110 HG pcs - - - 0 - - -
38 Wing needle no. 21 pcs - - - 0 - - -
39 Wing needle no. 27 pcs - - - 0 - - -
40 Boor Diamond High Speed pcs - - - - - - -
41 Boor Diamond Low Speed pcs - - - 0 - - -
- - 0 - - -
OBAT PROGRAM - - 0 - - -
PROGRAM P2 MALARIA - - - - - -
1 Abate kg - - - 0 - - -
2 ACT Tablet Ktk - - - 0 - - -
3 Arsumodon tablet Tablet - - - 0 - - -
4 Artem Injeksi Ktk - - - - - - -
6 Artesdiaquine Tablet Ktk - - - 0 - - -
7 Artesunate Injeksi ampul - - - 0 - - -
8 Cynoff liter - - - 0 - - -
9 Kelambu Pcs - - - - - - -
10 Rafid Test Dengeu @ 25 test Pcs - - - 0 - - -
11 RDT Chikungunya Pcs - - - 0 - - -
12 RDT Malaria Pcs - - - 0 - - -
13 RDT Salmonella Pcs - - - - - - -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - - 0 - - -
- - 0 - - -
PROGRAM P2 IMUNISASI - - 0 - - -
1 Alat suntik sekali pakai 0.05 ml pcs - - - - - - -
2 Alat suntik sekali pakai 0.5 ml pcs - - - 0 - - -
3 Safety Box Pcs - - - 0 - - -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - 0 - - -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - - - - -
6 Vaksin Campak + Pelarut (10 dosis) vial - - - 0 - - -
7 Vaksin Campak + Pelarut (20 dosis) vial - - - 0 - - -
8 Vaksin DT Vial - - - 0 - - -
9 Vaksin Hepatitis (HBO) ampul - - - - - - -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - 0 - - -
11 Vaksin Polio + Droper (10 Dosis) Vial - - - 0 - - -
12 Vaksin Polio IPV 5 Dosis Vial - - - 0 - - -
13 Vaksin Td vial - - - - - - -
14 Vaksin TT Vial - - - 0 - - -
15 Vaksin DPT HB HIB Vial - - - 0 - - -
- - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
PROGRAM P2 TB - - - - - - -
1 Box Slides pcs - - - 0 - - -
2 Bunsen Stainlestell ktk - - - 0 - - -
3 FDC I ktk - - - 0 - - -
4 FDC I & III ktk - - - - - - -
5 FDC II siklus - - - 0 - - -
6 Kaca Ose siklus - - - 0 - - -
7 Kombipak kategori 1 ktk - - - 0 - - -
8 Lampu Spritus siklus - - - - - - -
9 Obat antituberkolosis Kategori Anak siklus - - - 0 - - -
10 Obat antituberkolosis Kategori sisipan ktk - - - 0 - - -
11 Pot Sputum ktk - - - 0 - - -
12 Reagen Zn Neilson set - - - - - - -
13 Slide mikroskop kotak - - - 0 - - -
14 Spritus Botol - - - 0 - - -
15 Masker N-95 pcs - - - 0 - - -
16 Mikroskop Binoculer unit - - - - - - -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - 0 - - -
- - - 0 - - -
PROGRAM P2 DIARE - - - 0 - - -
1 Zn Tablet 500 mg Tablet - - - - - - -
- - 0 - - -
PROGRAM P2 KUSTA - - 0 - - -
1 MDT MB Anak Strip - - - 0 - - -
2 MDT MB Dewasa Strip - - - - - - -
3 MDT PB Anak Strip - - - 0 - - -
4 MDT PB Dewasa Strip - - - 0 - - -
- - 0 - - -
PROGRAM KIA - - - - - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - 0 - - -
2 Obat Suntik KB 1 Bulan @ 20 vial vial - - - 0 - - -
3 Obat Suntik KB 3 Bulan @ 20 vial vial - - - 0 - - -
4 Gluconas Calsicus vial - - - - - - -
- - 0 - - -
REAGEN LABORATORIUM - - 0 - - -
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - -
2 Alkohol 70% @ 100 ml Botol - - - - - - -
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - -
4 Alkohol Swab @ 100 pcs Kotak - - - 0 - - -
5 Coumbour 10 Parameter botol - - - 0 - - -
6 EDTA 10 % botol - - - - - - -
7 Gliserin Botol - - - 0 - - -
8 Gluko dr Stik @ 25 Stik botol - - - 0 - - -
9 Golongan Darah Test set - - - 0 - - -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - - - - -
11 Larutan Anisol botol - - - 0 - - -
12 Larutan Asam Asetat 6% botol - - - 0 - - -
13 Larutan Asam Sulfosalilisat botol - - - 0 - - -
14 Larutan Barium Klorida 10 % botol - - - - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
15 Larutan Benedict Botol - - - 0 - - -
16 Larutan Buffer Ph botol - - - 0 - - -
17 Larutan Carbol Gentian Violet botol - - - 0 - - -
18 Larutan Drabkin Botol - - - - - - -
19 Larutan Eosin 2 % Botol - - - 0 - - -
20 Larutan Etanol Asam Botol - - - 0 - - -
21 Larutan Foucet botol - - - 0 - - -
22 Larutan Giemsa Stain Botol - - - - - - -
23 Larutan H2SO4 p Botol - - - 0 - - -
24 Larutan HCl 0,1% botol - - - 0 - - -
25 Larutan HNO3 P Botol - - - 0 - - -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - - - - -
27 Larutan KOH 10 % Botol - - - 0 - - -
28 Larutan Metelin Biru Botol - - - 0 - - -
29 Larutan Turk Botol - - - 0 - - -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - - - - -
31 Metanol Botol - - - 0 - - -
32 Na Citrat 3,8 % botol - - - 0 - - -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - 0 - - -
34 Nesco Glucose Stik @ 25 Stik Botol - - - - - - -
35 Nesco HB Stik @ 25 Botol - - - 0 - - -
36 Nesco Uric Acid Stik @ 25 Stik botol - - - 0 - - -
37 Oli Emersi botol - - - 0 - - -
38 Rees Ecker botol - - - - - - -
39 Trigeliserida Botol - - - 0 - - -
40 Water Steril 500 ml Botol - - - 0 - - -
41 Water Steril 1000 ml Botol - - - 0 - - -
42 widal Test Set - - - - - - -
43 Xylol botol - - - 0 - - -
44 Sungkup Bayi Pcs - - - 0 - - -
LB 2
ermintaan : April / Mei

: 2017

BON
11 12 13 (11 X 12) 14 15
207.00 -
233.00 -
- 317.00 -
275.00 -
1,155.00 -
93.50 -
- 520.30 -
77.00 -
158.00 -
641.00 -
- 105.00 -
318.00 -
125.00 -
246.40 -
-
2,200.00 -
2,225.00 -
-
1,740.00 -
2,604.90 -
- 1,056.00 -
2,354.00 -
6,820.00 -
2,122.00 -
- 1,900.00 -
520,300.00 -
193,470.80 -
139,150.00 -
- 401,092.00 -
174,500.00 -
170,000.00 -
-
6,270.00 -
1,597.60 -
6,900.00 -
- 7,150.00 -
BON
11 12 13 (11 X 12) 14 15
6,410.00 -
- 103,536.00 -
293,498.00 -
99,000.00 -
185,900.00 -
- 306,427.00 -
242,000.00 -
56,441.40 -
137,853.00 -
- 93,500.00 -
408,792.00 -
14,053.63 -
158,042.00 -
-
1,540.00 -
957.00 -
- 2,049.00 -
7,201.04 -
7,201.04 -
8,896.88 -
- 7,286.25 -
7,920.00 -
7,920.00 -
5,743.86 -
-
-
95.00 -
- 86.00 -
123.00 -
163.90 -
64.00 -
- 149.00 -
96.80 -
157.30 -
120.00 -
- 66.00 -
48.00 -
46.00 -
52.80 -
- 108.00 -
146.00 -
80.00 -
100.00 -
BON
11 12 13 (11 X 12) 14 15
- 64.83 -
257.40 -
456.50 -
796.00 -
- 84.00 -
126.00 -
108.00 -
224.00 -
- 62.00 -
76.00 -
105.00 -
171.00 -
- 121.00 -
133.00 -
98.00 -
169.00 -
- 306.00 -
47.50 -
162.00 -
39.93 -
- 1,129.30 -
231.00 -
169.00 -
98.00 -
- 15.73 -
857.00 -
602.00 -
34.51 -
- 136.00 -
114.00 -
351.00 -
82.00 -
- 114.00 -
167.20 -
325.00 -
91.00 -
- 97.00 -
132.00 -
- 2,300.00 -
1,573.00 -
3,740.00 -
1,119.00 -
-
4,204.00 -
1,345.00 -
BON
11 12 13 (11 X 12) 14 15
- 5,800.00 -
1,210.00 -
20,857.00 -
1,930.00 -
- 1,914.00 -
1,210.00 -
724.00 -
2,800.00 -
- 3,500.00 -
1,527.70 -
2,970.00 -
1,226.00 -
- 843.33 -
2,200.00 -
- 2,712.00 -
1,435.00 -
2,767.00 -
4,782.00 -
-
1,640.00 -
-
3,549.00 -
- 1,759.00 -
2,246.00 -
- 3,502.00 -
5,500.00 -
2,178.00 -
6,529.00 -
- 2,344.00 -
15,950.00 -
1,066.00 -
-
20,815.00 -
- 14,187.50 -
1,984.03 -
BON
11 12 13 (11 X 12) 14 15
8,739.41 -
2,740.50 -
- 760.91 -
6,071.00 -
25,987.00 -
-
272.00 -
628.46 -
258.74 -
- 2,200.00 -
990.00 -
155.30 -
163.00 -
- 105.00 -
5,283.00 -
173.00 -
139.00 -
- 150.00 -
113.00 -
1,540.00 -
123.00 -
- 170.00 -
230.00 -
695.00 -
121.00 -
- 69.00 -
72.00 -
564.00 -
557.00 -
- 899.00 -
154.00 -
115.50 -
298.00 -
- 1,120.00 -
630.00 -
-
1.00 -
- 126.00 -
107.00 -
250.00 -
133.00 -
- 509.00 -
766.00 -
1,210.00 -
1,100.00 -
- 683.00 -
245.00 -
296.00 -
BON
11 12 13 (11 X 12) 14 15
1,925.00 -
- 292.00 -
660.00 -
405.00 -
4,813.00 -
- 341.00 -
581.00 -
410.00 -
660.00 -
- 90.00 -
170.00 -
726.00 -
462.00 -
- 292.60 -
495.00 -
118.50 -
1,026.00 -
- 230.00 -
140.00 -
100.00 -
102.00 -
- 220.00 -
560.00 -
167.00 -
193.00 -
- 440.00 -
123.00 -
700.00 -
164.00 -
- 125.00 -
7,700.00 -
1,485.00 -
360.80 -
- 97.02 -
102.37 -
85.00 -
242.00 -
- 119.00 -
286.00 -
505.00 -
68.00 -
- 84.00 -
58.00 -
135.00 -
252.00 -
- 1,525.00 -
350.00 -
100.00 -
73.73 -
BON
11 12 13 (11 X 12) 14 15
- 88.00 -
615.38 -
2,680.00 -
-
3,791.00 -
4,147.00 -
21,450.00 -
- 16,500.00 -
12,760.00 -
20,352.00 -
3,594.00 -
- 6,050.00 -
6,285.00 -
7,960.00 -
7,756.00 -
- 3,180.00 -
17,939.00 -
8,090.00 -
19,250.00 -
- 16,500.00 -
11,550.00 -
24,200.00 -
2,560.00 -
- 4,000.00 -
14,500.00 -
12,450.00 -
33,000.00 -
- 5,830.00 -
3,800.00 -
2,750.00 -
12,980.00 -
- 22,000.00 -
24,200.00 -
10,902.00 -
7,354.00 -
- 38,500.00 -
32,120.00 -
5,980.00 -
64,350.00 -
- 20,350.00 -
11,700.00 -
6,500.00 -
-
14,972.60 -
5,610.00 -
2,536.00 -
- 9,350.00 -
BON
11 12 13 (11 X 12) 14 15
11,000.00 -
33,000.00 -
3,578.00 -
- 10,219.00 -
2,012.00 -
3,415.00 -
4,950.00 -
- 6,610.80 -
10,790.00 -
5,555.00 -
8,800.00 -
- 6,600.00 -
5,500.00 -
9,570.00 -
2,400.00 -
- 14,509.10 -
3,300.00 -
17,088.00 -
1,600.00 -
- 2,680.00 -
4,000.00 -
40,000.00 -
875.00 -
-
10,000.00 -
10,050.00 -
9,350.00 -
- 9,400.00 -
2,997.00 -
- 13,200.00 -
1,835.16 -
4,300.00 -
2,605.00 -
- 3,737.00 -
12,100.00 -
1,649.36 -
19,058.00 -
- 12,155.00 -
1,640.00 -
-
22,000.00 -
26,812.00 -
- 4,600.00 -
BON
11 12 13 (11 X 12) 14 15
2,750.00 -
11,500.00 -
-
30,305.00 -
36,000.00 -
-
35,145.00 -
- 23,100.00 -
5,800.00 -
5,670.00 -
1,899.00 -
- 18,458.00 -
12,749.00 -
80,000.00 -
73,443.75 -
- 66,000.00 -
5,430.00 -
- 770.00 -
221.00 -
16,500.00 -
45,375.00 -
- 27,500.00 -
10,318.00 -
9,080.00 -
737.74 -
- 4,675.00 -
4,675.00 -
4,675.00 -
6,325.00 -
- 6,325.00 -
6,325.00 -
6,050.00 -
12,650.00 -
- 24,200.00 -
24,200.00 -
119,174.19 -
1,957.50 -
- 7,480.40 -
3,960.00 -
1,210.00 -
425.60 -
- 660.00 -
660.00 -
BON
11 12 13 (11 X 12) 14 15
15,400.00 -
311,900.00 -
- 1,393.90 -
5,693.00 -
8,355.00 -
8,355.00 -
- 8,355.00 -
1,564.20 -
27,500.00 -
3,404.00 -
- 320,000.00 -
2,145.00 -
2,145.00 -
440,000.00 -
- 330,000.00 -
- 99,220.00 -
36,300.00 -
3,566.78 -
14,868.83 -
- 125,400.00 -
38,999.00 -
387,800.00 -
1.00 -
- 57,200.00 -
55,000.00 -
40,700.00 -
66,000.00 -
- 79,200.00 -
1,900.00 -
- 1,448.00 -
23,000.00 -
45,100.00 -
45,100.00 -
- 22,527.00 -
41,998.00 -
14,487.00 -
18,750.00 -
- 23,782.00 -
16,203.00 -
137,610.00 -
14,250.00 -
- 11,913.00 -
43,900.00 -
BON
11 12 13 (11 X 12) 14 15
-
- 100,000.00 -
82,500.00 -
395,900.00 -
396,000.00 -
- 1,379,984.00 -
265,000.00 -
317,015.00 -
69,000.00 -
- 247,229.00 -
176,000.00 -
2,930.00 -
236,500.00 -
- 27,500.00 -
27,500.00 -
21,420.00 -
1.00 -
- 1.00 -
512.00 -
-
14,862.00 -
30,595.00 -
- 7,462.00 -
8,323.00 -
- 2,298.00 -
6,249.95 -
6,249.95 -
1.00 -
-
24,222.22 -
2,625.00 -
- 48,400.00 -
128.97 -
220,000.00 -
66,000.00 -
- 5,203.00 -
309,500.00 -
385,000.00 -
618,750.00 -
- 120,000.00 -
20,400.00 -
69,300.00 -
11,000.00 -
BON
11 12 13 (11 X 12) 14 15
- 75,625.00 -
61,250.00 -
70,000.00 -
122,195.00 -
- 230,000.00 -
41,700.00 -
199,100.00 -
77,500.00 -
- 41,255.00 -
8,470.00 -
55,000.00 -
28,400.00 -
- 44,550.00 -
20,900.00 -
17,900.00 -
64,300.00 -
- 30,400.00 -
8,000.00 -
150,000.00 -
103,400.00 -
- 148,500.00 -
82,500.00 -
313,500.00 -
74,800.00 -
- 418,000.00 -
5,500.00 -
24,750.00 -
440,000.00 -
- 27,500.00 -
220,000.00 -
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : Mei / Juni
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - - 0 - - - 207.00 -
2 Amoksisilin kaplet 500 mg @ 100 Tab Kaplet - - - - - - - 233.00 -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - 0 - - - 317.00 -
5 Kloramfenikol Kapsul 500 mg Tablet - - - 0 - - - 1,155.00 -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - - - - - 93.50 -
7 mg @ 100 Tab Tablet - - - 0 - - - 520.30 -
10 Kuinin (kina) tablet 200 mg Tablet - - - - - - - 641.00 -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 105.00 -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - 0 - - - 125.00 -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - - - - - 246.40 -
- - 0 - - -
SIRUP - - 0 - - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - 0 - - - 2,200.00 -
2 Kotrimoksazole suspensi komb. Botol - - - - - - - 2,225.00 -
- - 0 - - -
INJEKSI - - 0 - - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - 0 - - - 1,740.00 -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - - - - - 2,604.90 -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - - 0 - - - 1,056.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - 0 - - - 6,820.00 -
6 Lidokain Komp. Inj Komb Ampul - - - - - - - 2,122.00 -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - 0 - - - 1,900.00 -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - 0 - - - 193,470.80 -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - - - - - 139,150.00 -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - 0 - - - 401,092.00 -
13 Tetagam Vial - - - 0 - - - 170,000.00 -
14 pehacain inj (lidokain+adrenalin) Ampul - - - - - -
INFUS - - 0 - - -
3 Glukosa Larutan infus 5 % steril @ 20 fls fls - - - - - - - 6,900.00 -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - 0 - - - 7,150.00 -
- - 0 - - -
OBAT GIGI - - - - - -
1 Air raksa Dental Use Ktk - - - 0 - - - 103,536.00 -
3 EtiL klorida semprot Botol - - - 0 - - - 99,000.00 -
4 Forinekresol (pengganti TKF) ktk - - - - - - - 185,900.00 -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - 0 - - - 306,427.00 -
7 Klorfenol kamfer menthol (CHKM) ktk - - - 0 - - - 56,441.40 -
8 Mummiying Pasta ktk - - - - - - - 137,853.00 -
9 Semen seng Fosfar serbuk & cairan ktk - - - 0 - - - 93,500.00 -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - 0 - - - 14,053.63 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
12 Temporary Stoping Flecther serbuk & Cair set - - - - - - - 158,042.00 -
- - 0 - - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - 0 - - - 1,540.00 -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - - - - - 957.00 -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - 0 - - - 2,049.00 -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - - - - - 8,896.88 -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - 0 - - - 7,286.25 -
9 Infusion set dewasa Pcs - - - 0 - - - 7,920.00 -
10 jarum @ 36 pcs Pcs - - - - - - - 5,743.86 -
- - 0 - - -
OBAT SANGAT ESENSIAL & ESENSIAL - - 0 - - - -
TABLET - - 0 - - -
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - - - - - 95.00 -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 86.00 -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 163.90 -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - - - - - 64.00 -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - 0 - - - 149.00 -
7 100 Tab Tablet - - - 0 - - - 96.80 -
8 100 Tab Tablet - - - 0 - - - 157.30 -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - - - - - 120.00 -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - 0 - - - 66.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
12 Diazepam tablet 2 mg Tablet - - - 0 - - - 46.00 -
13 Diazepam tablet 5 mg Tablet - - - - - - - 52.80 -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - 0 - - - 108.00 -
17 Fenobarbital tablet 100 mg Tablet - - - - - - - 100.00 -
18 Fenobarbital tablet 30 mg Tablet - - - 0 - - - 64.83 -
21 100 Tab Tablet - - - - - - - 796.00 -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - 0 - - - 84.00 -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - 0 - - - 108.00 -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - - - - - 224.00 -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - 0 - - - 62.00 -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - 0 - - - 105.00 -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - - - - - 171.00 -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 121.00 -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - - 0 - - - 98.00 -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - - - - - 169.00 -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - 0 - - - 306.00 -
36 Klorpromazine HCl tablet salut 100 mg Tablet - - - 0 - - - 162.00 -
37 Klorpromazine HCl tablet salut 25 mg Tablet - - - - - - - 39.93 -
38 Magnesium sulfat serbuk 30 g Pot - - - 0 - - - 1,129.30 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
40 Tab Tablet - - - 0 - - - 169.00 -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - - - - - 98.00 -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - 0 - - - 15.73 -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - 0 - - - 602.00 -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - - - - - - 34.51 -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - 0 - - - 136.00 -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - 0 - - - 351.00 -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - - - - - 82.00 -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - 0 - - - 114.00 -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - - - - - 91.00 -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - 0 - - - 97.00 -
- - 0 - - -
SIRUP - - - - - -
1 Antasida DOEN Suspensi Komb Botol - - - 0 - - - 2,300.00 -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - 0 - - - 3,740.00 -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - - - - - 1,119.00 -
- - 0 - - -
INJEKSI - - 0 - - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - 0 - - - 4,204.00 -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - - - - - 1,345.00 -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - 0 - - - 5,800.00 -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - 0 - - - 20,857.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
6 Fenobarbital injeksi Ampul - - - - - - - 1,930.00 -
7 Amp Ampul - - - 0 - - - 1,914.00 -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - 0 - - - 724.00 -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - - - - - 2,800.00 -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - - 0 - - - 3,500.00 -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - 0 - - - 2,970.00 -
14 100 Amp Ampul - - - - - - - 1,226.00 -
15 Amp Ampul - - - 0 - - - 843.33 -
- - 0 - - -
SALEP - - 0 - - -
1 endapan 4 % @ 24 Pot Pot - - - - - - - 2,200.00 -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - 0 - - - 2,712.00 -
4 Antibakteri DOEN Komb. Pot - - - 0 - - - 2,767.00 -
5 Antifungi DOEN Komb. Pot - - - - - - - 4,782.00 -
- - 0 - - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - 0 - - - 1,640.00 -
- - - - - -
- - 0 - - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - 0 - - - 1,759.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - 0 - - -
OBAT LUAR - - - - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - 0 - - - 3,502.00 -
3 Gentian violet larutan 1 % Botol - - - 0 - - - 2,178.00 -
4 Kalium Permanghanat serbuk Botol - - - - - - - 6,529.00 -
7 Salisilat Bedak 2 % Kotak - - - 0 - - - 1,066.00 -
- - - - - -
OBAT GIGI - - 0 - - -
- - 0 - - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - 0 - - - 14,187.50 -
3 Kasa pembalut 2 m x 80 cm Rol - - - 0 - - - 8,739.41 -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - - - - - 2,740.50 -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - 0 - - - 760.91 -
7 Plester 5 yard x 2 inch Rol - - - 0 - - - 25,987.00 -
- - - - - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - - - - - 258.74 -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - 0 - - - 2,200.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - 0 - - - 155.30 -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - - - - - 163.00 -
8 Amlodipin 5 mg Tablet @ 30 Tab Tablet - - - 0 - - - 105.00 -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - 0 - - - 173.00 -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - - - - - 139.00 -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - 0 - - - 150.00 -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 1,540.00 -
15 Aspilet tablet @ 100 Tab Tablet - - - - - - - 123.00 -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - - 0 - - - 170.00 -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - 0 - - - 695.00 -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - - - - - 121.00 -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - 0 - - - 69.00 -
22 Cefadroksil tab 250 mg Tablet - - - 0 - - - 564.00 -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - - - - - 557.00 -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - 0 - - - 899.00 -
26 Cimetidine tablet @ 100 Tab Tablet - - - 0 - - - 115.50 -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - - - - - 298.00 -
28 Clobazam tablet @ 100 Tab Tablet - - - 0 - - - 1,120.00 -
30 Codein Tablet 20 mg Tablet - - - 0 - - - -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - - - - - 1.00 -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - 0 - - - 126.00 -
34 Doksisiklin tablet @ 100 Tab Tablet - - - 0 - - - 250.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
35 Domperidon Tablet @ 100 Tab Tablet - - - - - - - 133.00 -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - 0 - - - 509.00 -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - 0 - - - 1,210.00 -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - - - - - 1,100.00 -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - 0 - - - 683.00 -
42 Glimepiride Tab 2 mg Tablet - - - 0 - - - 296.00 -
43 Tablet @ 100 Tab Tablet - - - - - - - 1,925.00 -
44 Ketokonazole tablet @ 50 tab Tablet - - - 0 - - - 292.00 -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - - - - - 4,813.00 -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - 0 - - - 341.00 -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - 0 - - - 410.00 -
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - - - - - 660.00 -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - 0 - - - 90.00 -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - - 0 - - - 726.00 -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - - - - - 462.00 -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - 0 - - - 292.60 -
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 118.50 -
59 Methioson Tablet @ 30 Tab Tablet - - - - - - - 1,026.00 -
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - 0 - - - 230.00 -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - 0 - - - 100.00 -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - - - - - 102.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - 0 - - - 220.00 -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - 0 - - - 167.00 -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - - - - - 193.00 -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - 0 - - - 440.00 -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - 0 - - - 700.00 -
71 Omeprazole kapsul @ 30 Kap Kapsul - - - - - - - 164.00 -
72 Papaverin tablet @ 1000 Tab Tablet - - - 0 - - - 125.00 -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - 0 - - - 1,485.00 -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - - - - - - 360.80 -
78 Propanolol 10 mg Tab Tablet - - - 0 - - - 85.00 -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - - - - - 242.00 -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - 0 - - - 119.00 -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - - 0 - - - 505.00 -
83 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Ta Tablet - - - - - - - 68.00 -
84 Salbutamol tablet 4 mg (sebagai sulfat) @ 100 Ta Tablet - - - 0 - - - 84.00 -
86 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - - 0 - - - 135.00 -
87 Simvastatin tablet 20 mg @ 30/50 Tab Tablet - - - - - - - 252.00 -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - 0 - - - 1,525.00 -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 100.00 -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - - - - - - 73.73 -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - 0 - - - 88.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
94 Tramadol Tablet @ 50 Tab Tablet - - - 0 - - - 2,680.00 -
- - - - - -
SIRUP - - 0 - - -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - 0 - - - 4,147.00 -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - - - - - 21,450.00 -
4 Anti Diare (Arcapec) Sirup Botol - - - 0 - - - 16,500.00 -
6 Batugin Elixier @ 120 ml botol - - - 0 - - - 20,352.00 -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - - - - - 3,594.00 -
8 Bromhexin (Phytovon) Sirup Botol - - - 0 - - - 6,050.00 -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - 0 - - - 7,960.00 -
11 Cetirizine (Lerzin) Sirup Botol - - - - - - - 7,756.00 -
12 Domperidon Sirup Botol - - - 0 - - - 3,180.00 -
14 Erytromycin Sirup Botol - - - 0 - - - 8,090.00 -
15 Fe Kombinasi (maltiron) Sirup Botol - - - - - - - 19,250.00 -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - - 0 - - - 16,500.00 -
18 Gastrinal Suspensi Botol - - - 0 - - - 24,200.00 -
19 Ibuprofen (Farsifen) Sirup Botol - - - - - - - 2,560.00 -
20 Klorampenikol suspensi Botol - - - 0 - - - 4,000.00 -
22 Laxadine Sirup @ 30 ml Botol - - - 0 - - - 12,450.00 -
23 Metamizol (Norages) Sirup Botol - - - - - - - 33,000.00 -
24 Metoklopropamid (Gavistal) Drop Botol - - - 0 - - - 5,830.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
26 Metoklopropamid sirup Botol - - - 0 - - - 2,750.00 -
27 Metronidazole Infus Botol - - - - - - - 12,980.00 -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - 0 - - - 22,000.00 -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - 0 - - - 10,902.00 -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - - - - - 7,354.00 -
32 Nifuroxide (Nifudiar) Sirup Botol - - - 0 - - - 38,500.00 -
34 Parasetamol Drop Botol - - - 0 - - - 5,980.00 -
35 Pseudoefedrin (Alco) Drop Botol - - - - - - - 64,350.00 -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - 0 - - - 20,350.00 -
37 Zinc drop Botol - - - 0 - - - 11,700.00 -
38 Zinc Sirup Botol - - - 0 - - - 6,500.00 -
- - - - - -
INJEKSI - - 0 - - -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - 0 - - - 5,610.00 -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - - - - - 2,536.00 -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - 0 - - - 9,350.00 -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - 0 - - - 33,000.00 -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - - - - - 3,578.00 -
8 Dopamin Injeksi Ampul - - - 0 - - - 10,219.00 -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - 0 - - - 3,415.00 -
Ampul
11 Ampul - - - - - - - 4,950.00 -
12 Kanamycin Inj vial - - - 0 - - - 6,610.80 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
Vial
14 (Xylomidon) Inj @ 25 vial - - - 0 - - - 5,555.00 -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - - - - - 8,800.00 -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - 0 - - - 6,600.00 -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - 0 - - - 9,570.00 -
19 Ondasentron Injeksi Ampul - - - - - - - 2,400.00 -
20 Pethidin injeksi Ampul - - - 0 - - - 14,509.10 -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - - - - - 1,600.00 -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - 0 - - - 2,680.00 -
26 Xylocain Injeksi Ampul - - - 0 - - - 40,000.00 -
27 Lidocain 2% Injeksi Ampul - - - - - - - 875.00 -
INFUS - - 0 - - -
1 KAEN 3A fls - - - 0 - - - 10,000.00 -
2 KAEN 3B fls - - - 0 - - - 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - - - - - 9,350.00 -
4 Glukosa 5% + 1/2 NS fls - - - 0 - - - 9,400.00 -
- - 0 - - -
1 Acyclovir cream @ 25 Tube tube - - - - - - - 2,997.00 -
2 Bioplacenton Jelly tube - - - 0 - - - 13,200.00 -
4 Ictiol salep Pot - - - 0 - - - 4,300.00 -
5 Ketokonazole krim tube - - - - - - - 2,605.00 -
6 Miconazole krim @ 24 Tube tube - - - 0 - - - 3,737.00 -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - 0 - - - 1,649.36 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
9 Piroksikam (Infeld) Gel Tube - - - - - - - 19,058.00 -
10 Scabimite cream @ 24 Tube tube - - - 0 - - - 12,155.00 -
- - 0 - - -
1 Kloramfenikol Salep Mata tube - - - - - - - 1,640.00 -
- - 0 - - -
1 Cendo Catarelent Botol - - - 0 - - - 22,000.00 -
2 Cendo Xitrol Botol - - - - - - - 26,812.00 -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - 0 - - - 4,600.00 -
5 Tetrakain (Pantocain) TM Botol - - - 0 - - - 11,500.00 -
- - - - - -
2 Iliadin Spray Botol - - - 0 - - - 36,000.00 -
- - - - - -
1 Otopain TT Botol - - - 0 - - - 35,145.00 -
- - 0 - - -
1 Anti sariawan (Albotyl) Sol Botol - - - 0 - - - 23,100.00 -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - 0 - - - 5,670.00 -
4 Borax gliserin Botol - - - - - - - 1,899.00 -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - 0 - - - 18,458.00 -
7 Semprot Spray kotak - - - 0 - - - 80,000.00 - 3
8 Larutan Chlorhexide @ 500 ml Botol - - - - - - - 73,443.75 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
9 Larutan Chlorin 5,25 % 500 ml Botol - - - 0 - - - 66,000.00 -
- - 0 - - -
1 Bisturi @ 100 pcs pcs - - - 0 - - - 770.00 -
3 Daryan tulle @ 10 lbr Lembar - - - 0 - - - 16,500.00 -
4 EKG Paper 80 x 30 Roll - - - - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - 0 - - - 27,500.00 -
7 Foley cateter no. 18 10 Pcs pcs - - - 0 - - - 9,080.00 -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - - - - - 737.74 -
9 Hand schoen no. 7 @ 50 psg psg - - - 0 - - - 4,675.00 -
11 Hand Schoen No. 8 @ 50 psg psg - - - 0 - - - 4,675.00 -
12 Hand schoen steril no. 7 @ 50 psg psg - - - - - - - 6,325.00 -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - 0 - - - 6,325.00 -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - 0 - - - 6,050.00 -
16 Hypapix 5 x 1 m roll - - - - - - - 12,650.00 -
17 Jarum Hecting Kulit lsn - - - 0 - - - 24,200.00 -
19 Kasa Hidrofil 40 x 80 pcs - - - 0 - - - 119,174.19 -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - - - - - 1,957.50 -
21 Kasa steril 16 x 16 pad roll - - - 0 - - - 7,480.40 -
23 Mami non waven @ 24 pcs pcs - - - 0 - - - 1,210.00 -
24 Masker @ 100 pcs pcs - - - - - - - 425.60 -
25 Needle No. 23 G @ 100 pcs pcs - - - 0 - - - 660.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - - 15,400.00 -
28 Paket P3K pcs - - - - - - - 311,900.00 -
29 Spuit Injeksi 10 ml pcs - - - 0 - - - 1,393.90 -
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - - 8,355.00 -
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
35 Ultrasonic Gel pcs - - - 0 - - - 27,500.00 -
36 Urine bag Stik - - - - - - - 3,404.00 -
37 USG Printing Paper UPP-110 HG pcs - - - 0 - - - 320,000.00 -
40 Boor Diamond High Speed pcs - - - - - - - 440,000.00 -
41 Boor Diamond Low Speed pcs - - - 0 - - - 330,000.00 -
- - 0 - - -
1 Abate kg - - - 0 - - - 99,220.00 -
2 ACT Tablet Ktk - - - 0 - - - 36,300.00 -
3 Arsumodon tablet Tablet - - - 0 - - - 3,566.78 -
4 Artem Injeksi Ktk - - - - - - - 14,868.83 -
6 Artesdiaquine Tablet Ktk - - - 0 - - - 125,400.00 -
8 Cynoff liter - - - 0 - - - 387,800.00 -
9 Kelambu Pcs - - - - - - - 1.00 -
10 Rafid Test Dengeu @ 25 test Pcs - - - 0 - - - 57,200.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
12 RDT Malaria Pcs - - - 0 - - - 40,700.00 -
13 RDT Salmonella Pcs - - - - - - - 66,000.00 -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - - 0 - - - 79,200.00 -
- - 0 - - -
1 Alat suntik sekali pakai 0.05 ml pcs - - - - - - - 1,900.00 -
2 Alat suntik sekali pakai 0.5 ml pcs - - - 0 - - - 1,448.00 -
3 Safety Box Pcs - - - 0 - - - 23,000.00 -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - 0 - - - 45,100.00 -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - - - - - 45,100.00 -
8 Vaksin DT Vial - - - 0 - - - 14,487.00 -
9 Vaksin Hepatitis (HBO) ampul - - - - - - - 18,750.00 -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - 0 - - - 23,782.00 -
12 Vaksin Polio IPV 5 Dosis Vial - - - 0 - - - 137,610.00 -
13 Vaksin Td vial - - - - - - - 14,250.00 -
14 Vaksin TT Vial - - - 0 - - - 11,913.00 -
- - 0 - - -
PROGRAM P2 TB - - - - - - - -
1 Box Slides pcs - - - 0 - - - 100,000.00 -
3 FDC I ktk - - - 0 - - - 395,900.00 -
4 FDC I & III ktk - - - - - - - 396,000.00 -
5 FDC II siklus - - - 0 - - - 1,379,984.00 -
6 Kaca Ose siklus - - - 0 - - - 265,000.00 -
7 Kombipak kategori 1 ktk - - - 0 - - - 317,015.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
8 Lampu Spritus siklus - - - - - - - 69,000.00 -
9 Obat antituberkolosis Kategori Anak siklus - - - 0 - - - 247,229.00 -
11 Pot Sputum ktk - - - 0 - - - 2,930.00 -
12 Reagen Zn Neilson set - - - - - - - 236,500.00 -
13 Slide mikroskop kotak - - - 0 - - - 27,500.00 -
14 Spritus Botol - - - 0 - - - 27,500.00 -
15 Masker N-95 pcs - - - 0 - - - 21,420.00 -
16 Mikroskop Binoculer unit - - - - - - - 1.00 -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - 0 - - - 1.00 -
- - - 0 - - -
1 Zn Tablet 500 mg Tablet - - - - - - - 512.00 -
- - 0 - - -
1 MDT MB Anak Strip - - - 0 - - - 14,862.00 -
2 MDT MB Dewasa Strip - - - - - - - 30,595.00 -
3 MDT PB Anak Strip - - - 0 - - - 7,462.00 -
- - 0 - - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - 0 - - - 2,298.00 -
4 Gluconas Calsicus vial - - - - - - - 1.00 -
- - 0 - - -
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - - 24,222.22 -
2 Alkohol 70% @ 100 ml Botol - - - - - - - 2,625.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - - 48,400.00 -
5 Coumbour 10 Parameter botol - - - 0 - - - 220,000.00 -
6 EDTA 10 % botol - - - - - - - 66,000.00 -
7 Gliserin Botol - - - 0 - - - 5,203.00 -
9 Golongan Darah Test set - - - 0 - - - 385,000.00 -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - - - - - 618,750.00 -
11 Larutan Anisol botol - - - 0 - - - 120,000.00 -
13 Larutan Asam Sulfosalilisat botol - - - 0 - - - 69,300.00 -
14 Larutan Barium Klorida 10 % botol - - - - - - - 11,000.00 -
15 Larutan Benedict Botol - - - 0 - - - 75,625.00 -
17 Larutan Carbol Gentian Violet botol - - - 0 - - - 70,000.00 -
18 Larutan Drabkin Botol - - - - - - - 122,195.00 -
19 Larutan Eosin 2 % Botol - - - 0 - - - 230,000.00 -
21 Larutan Foucet botol - - - 0 - - - 199,100.00 -
22 Larutan Giemsa Stain Botol - - - - - - - 77,500.00 -
23 Larutan H2SO4 p Botol - - - 0 - - - 41,255.00 -
25 Larutan HNO3 P Botol - - - 0 - - - 55,000.00 -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - - - - - 28,400.00 -
27 Larutan KOH 10 % Botol - - - 0 - - - 44,550.00 -
29 Larutan Turk Botol - - - 0 - - - 17,900.00 -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - - - - - 64,300.00 -
31 Metanol Botol - - - 0 - - - 30,400.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
32 Na Citrat 3,8 % botol - - - 0 - - - 8,000.00 -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - 0 - - - 150,000.00 -
34 Nesco Glucose Stik @ 25 Stik Botol - - - - - - - 103,400.00 -
35 Nesco HB Stik @ 25 Botol - - - 0 - - - 148,500.00 -
37 Oli Emersi botol - - - 0 - - - 313,500.00 -
38 Rees Ecker botol - - - - - - - 74,800.00 -
39 Trigeliserida Botol - - - 0 - - - 418,000.00 -
42 widal Test Set - - - - - - - 440,000.00 -
43 Xylol botol - - - 0 - - - 27,500.00 -
44 Sungkup Bayi Pcs - - - 0 - - - 220,000.00 -
45 NGT All Item Pcs - - - 0 - - - 1.00 -
46 PP 3 juta Injeksi vial - - - - - - - 1.00 -
47 Progesteron Injeksi Vial - - - 0 - - - 1.00 -
48 Iodiom Test Pcs - - - 0 - - - 1.00 -
49 Mineral Mix Bks - - - 0 - - - 2,475.00 -
50 Eksavator Double Ended Pcs - - - - - - - 1.00 -
51 Asetamivir tab Tablet - - - 0 - - - 1.00 -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - 0 - - - 1.00 -
54 Stick Hemosmart Pcs - - - - - - - 1.00 -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - 0 - - - 1.00 -
56 Lab.Kit Paket - - - 0 - - - 1.00 -
57 Blue Tips bks - - - 0 - - - 105,875.00 -
58 Yellow Tips bks - - - - - - - 139,700.00 -
59 Deck Glass ktk - - - 0 - - - 38,500.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
61 Tissue Lensa bks - - - 0 - - - 48,400.00 -
62 Stik HB Family Dr ktk - - - - - - - 357,500.00 -
63 Tabung EDTA K3/Vacutainer pcs - - - 0 - - - 1,507.00 -
65 Mikropipet (Microlit) 0-50 µl pcs - - - 0 - - - - -
66 Mikropipet (Microlit) 10-100 µl pcs - - - - - - - - -
67 Glukosa Stik Active Accu Check Kotak - - - 0 - - - 170,500.00 -
69 Lidi Sputum (100 pcs) bks - - - 0 - - - 36,300.00 -
70 Cotton Swab pcs - - - - - - - 7,700.00 -
71 Specullum pcs - - - 0 - - - 1,000.00 -
73 nitrousoxida Tabung - - - 0 - - - 1.00 -
74 Alat Nesco pcs - - - - - - - 1.00 -
75 Alat Multicare pcs - - - 0 - - - 1.00 -
76 aseptic gel Botol - - - 0 - - - 28,710.00 -
77 Minyak Angin Safecare Botol - - - 0 - - - 15,000.00 -
78 Thrombophob Gel tube - - - - - - - 63,043.00 -
TOTAL -
UMUM
BAYAR
BAYAR
1589 441 2,030

PUSKESMAS : BINUANG
NAMA OBAT SATUAN STOK PENERIM PERSEDI PEMAKAI SISA STOK STOK PERMINT PEMBERIA HARGA TOTAL
BON
EXP
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
Kepala Dinas Kesehatan Kepala Instalasi Farmasi Kepala Puskesmas Pengelola Obat
H.Errani Martin,SKM.MM Septi Heryani, S. Farm, Apt H. Isrok Antarikso, SKM, M.Kes Mahdalena, S. Farm., Apt
NIP.19640314 198802 1 002 NIP 19890919 201402 2 006 NIP.19680928 198902 1 001 NIP 19830909 201001 2 032
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : Juni / Juli
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
7 mg @ 100 Tab Tablet - - - 0 - - - 520.30 -
- - 0 - - -
SIRUP - - 0 - - -
- - 0 - - -
INJEKSI - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
13 Tetagam Vial - - - 0 - - - 170,000.00 -
14 pehacain inj (lidokain+adrenalin) Ampul - - - - - -
INFUS - - 0 - - -
- - 0 - - -
OBAT GIGI - - - - - -
- - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
10 jarum @ 36 pcs Pcs - - - - - - - 5,743.86 -
- - 0 - - -
TABLET - - 0 - - -
7 100 Tab Tablet - - - 0 - - - 96.80 -
8 100 Tab Tablet - - - 0 - - - 157.30 -
21 100 Tab Tablet - - - - - - - 796.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
40 Tab Tablet - - - 0 - - - 169.00 -
- - 0 - - -
SIRUP - - - - - -
- - 0 - - -
INJEKSI - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
7 Amp Ampul - - - 0 - - - 1,914.00 -
14 100 Amp Ampul - - - - - - - 1,226.00 -
15 Amp Ampul - - - 0 - - - 843.33 -
- - 0 - - -
SALEP - - 0 - - -
1 endapan 4 % @ 24 Pot Pot - - - - - - - 2,200.00 -
- - 0 - - -
- - - - - -
- - 0 - - -
- - 0 - - -
OBAT LUAR - - - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - - - -
OBAT GIGI - - 0 - - -
- - 0 - - -
- - - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - - - -
SIRUP - - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
37 Zinc drop Botol - - - 0 - - - 11,700.00 -
38 Zinc Sirup Botol - - - 0 - - - 6,500.00 -
- - - - - -
INJEKSI - - 0 - - -
Ampul
11 Ampul - - - - - - - 4,950.00 -
Vial
INFUS - - 0 - - -
1 KAEN 3A fls - - - 0 - - - 10,000.00 -
2 KAEN 3B fls - - - 0 - - - 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - - - - - 9,350.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
4 Glukosa 5% + 1/2 NS fls - - - 0 - - - 9,400.00 -
- - 0 - - -
4 Ictiol salep Pot - - - 0 - - - 4,300.00 -
- - 0 - - -
- - 0 - - -
- - - - - -
- - - - - -
1 Otopain TT Botol - - - 0 - - - 35,145.00 -
- - 0 - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
7 Semprot Spray kotak - - - 0 - - - 80,000.00 -
- - 0 - - -
1 Bisturi @ 100 pcs pcs - - - 0 - - - 770.00 -
4 EKG Paper 80 x 30 Roll - - - - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - 0 - - - 27,500.00 -
16 Hypapix 5 x 1 m roll - - - - - - - 12,650.00 -
24 Masker @ 100 pcs pcs - - - - - - - 425.60 -
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - - 15,400.00 -
28 Paket P3K pcs - - - - - - - 311,900.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - - 8,355.00 -
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
36 Urine bag Stik - - - - - - - 3,404.00 -
- - 0 - - -
1 Abate kg - - - 0 - - - 99,220.00 -
2 ACT Tablet Ktk - - - 0 - - - 36,300.00 -
8 Cynoff liter - - - 0 - - - 387,800.00 -
9 Kelambu Pcs - - - - - - - 1.00 -
12 RDT Malaria Pcs - - - 0 - - - 40,700.00 -
- - 0 - - -
3 Safety Box Pcs - - - 0 - - - 23,000.00 -
8 Vaksin DT Vial - - - 0 - - - 14,487.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
13 Vaksin Td vial - - - - - - - 14,250.00 -
14 Vaksin TT Vial - - - 0 - - - 11,913.00 -
- - 0 - - -
PROGRAM P2 TB - - - - - - - -
1 Box Slides pcs - - - 0 - - - 100,000.00 -
3 FDC I ktk - - - 0 - - - 395,900.00 -
4 FDC I & III ktk - - - - - - - 396,000.00 -
5 FDC II siklus - - - 0 - - - 1,379,984.00 -
6 Kaca Ose siklus - - - 0 - - - 265,000.00 -
11 Pot Sputum ktk - - - 0 - - - 2,930.00 -
14 Spritus Botol - - - 0 - - - 27,500.00 -
15 Masker N-95 pcs - - - 0 - - - 21,420.00 -
0 - - -
PROGRAM P2 DIARE 0 - - -
- - 0 - - -
1 MDT MB Anak Strip - - - 0 - - - 14,862.00 -
3 MDT PB Anak Strip - - - 0 - - - 7,462.00 -
0 - - -
PROGRAM KIA - - - -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - 0 - - -
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - - 24,222.22 -
2 Alkohol 70% @ 100 ml Botol - - - - - - - 2,625.00 -
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - - 48,400.00 -
6 EDTA 10 % botol - - - - - - - 66,000.00 -
7 Gliserin Botol - - - 0 - - - 5,203.00 -
31 Metanol Botol - - - 0 - - - 30,400.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
32 Na Citrat 3,8 % botol - - - 0 - - - 8,000.00 -
37 Oli Emersi botol - - - 0 - - - 313,500.00 -
38 Rees Ecker botol - - - - - - - 74,800.00 -
42 widal Test Set - - - - - - - 440,000.00 -
43 Xylol botol - - - 0 - - - 27,500.00 -
44 Sungkup Bayi Pcs - - - 0 - - - 220,000.00 -
45 NGT All Item Pcs - - - 0 - - - 1.00 -
48 Iodiom Test Pcs - - - 0 - - - 1.00 -
49 Mineral Mix Bks - - - 0 - - - 2,475.00 -
56 Lab.Kit Paket - - - 0 - - - 1.00 -
57 Blue Tips bks - - - 0 - - - 105,875.00 -
58 Yellow Tips bks - - - - - - - 139,700.00 -
59 Deck Glass ktk - - - 0 - - - 38,500.00 -
61 Tissue Lensa bks - - - 0 - - - 48,400.00 -
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
70 Cotton Swab pcs - - - - - - - 7,700.00 -
71 Specullum pcs - - - 0 - - - 1,000.00 -
74 Alat Nesco pcs - - - - - - - 1.00 -
76 aseptic gel Botol - - - 0 - - - 28,710.00 172,260
77 Minyak Angin Safecare Botol - - - 0 - - - 15,000.00 75,000
78 Thrombophob Gel tube - - - - - - - 63,043.00 189,129
TOTAL -
UMUM
BAYAR
BAYAR
0 0 -

H.Errani Martin,SKM.MM Septi Heryani, S. Farm, Apt Isrok Antarikso, SKM, M.Kes Mahdalena, S. Farm., Apt
NIP.19640314 198802 1 002 NIP. 19890919 201402 2 006 NIP.19690928 198902 1 001 NIP. 19830909 201001 2 032
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : Juli / Agustus
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - 0 - - - 93.50 -
7 mg @ 100 Tab Tablet - - - - - - - 520.30 -
10 Kuinin (kina) tablet 200 mg Tablet - - - 0 - - - 641.00 -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - - - - - 318.00 -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - 0 - - - 246.40 -
- - 0 - - -
SIRUP - - 0 - - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - - - - - 2,200.00 -
2 Kotrimoksazole suspensi komb. Botol - - - 0 - - - 2,225.00 -
- - 0 - - -
INJEKSI - - 0 - - -
6 Lidokain Komp. Inj Komb Ampul - - - 0 - - - 2,122.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - - - - - 1,900.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - 0 - - - 139,150.00 -
12 Vaksin Rabies Vero (VAR) Vial - - - - - - - 174,500.00 -
13 Tetagam Vial - - - 0 - - - 170,000.00 -
- - 0 - - -
INFUS - - 0 - - -
- - 0 - - -
OBAT GIGI - - - - - -
4 Forinekresol (pengganti TKF) ktk - - - 0 - - - 185,900.00 -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - - - - - 306,427.00 -
8 Mummiying Pasta ktk - - - 0 - - - 137,853.00 -
10 Silver amalgam serbuk 65 - 75 % ktk - - - - - - - 408,792.00 -
12 Temporary Stoping Flecther serbuk & Cair set - - - 0 - - - 158,042.00 -
- - 0 - - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - - - - - 1,540.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - 0 - - - 957.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
10 jarum @ 36 pcs Pcs - - - 0 - - - 5,743.86 -
- - - - - -
TABLET - - 0 - - -
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - 0 - - - 95.00 -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - - - - - 123.00 -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - 0 - - - 64.00 -
7 100 Tab Tablet - - - 0 - - - 96.80 -
8 100 Tab Tablet - - - - - - - 157.30 -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - 0 - - - 120.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
21 100 Tab Tablet - - - 0 - - - 796.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - - - - - 126.00 -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - 0 - - - 224.00 -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - - - - - 105.00 -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - 0 - - - 171.00 -
Klorpeniramine Maleat (CTM) tablet 4 mg @ 100
35 Tab Tablet - - - 0 - - - 47.50 -
38 Magnesium sulfat serbuk 30 g Pot - - - - - - - 1,129.30 -
40 Tab Tablet - - - 0 - - - 169.00 -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - 0 - - - 98.00 -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - - - - - 857.00 -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - - - - - 351.00 -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - 0 - - - 82.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - 0 - - -
SIRUP - - 0 - - -
1 Antasida DOEN Suspensi Komb Botol - - - - - - - 2,300.00 -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - 0 - - - 1,119.00 -
- - 0 - - -
INJEKSI - - - - - -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - 0 - - - 1,345.00 -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - - - - - 20,857.00 -
6 Fenobarbital injeksi Ampul - - - 0 - - - 1,930.00 -
7 Amp Ampul - - - 0 - - - 1,914.00 -
14 100 Amp Ampul - - - 0 - - - 1,226.00 -
15 Amp Ampul - - - - - - - 843.33 -
- - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
SALEP - - 0 - - -
1 endapan 4 % @ 24 Pot Pot - - - 0 - - - 2,200.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - - - - - 1,435.00 -
5 Antifungi DOEN Komb. Pot - - - 0 - - - 4,782.00 -
- - 0 - - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - - - - - 1,640.00 -
- - 0 - - -
- - 0 - - -
- - 0 - - -
OBAT LUAR - - 0 - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - - - - - 3,502.00 -
4 Kalium Permanghanat serbuk Botol - - - 0 - - - 6,529.00 -
6 Povidon Iodida 10 % 300 ml Botol - - - - - - - 15,950.00 -
- - 0 - - -
OBAT GIGI - - 0 - - -
- - - - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - 0 - - -
OBAT PENUNJANG - - - - - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - 0 - - - 258.74 -
5 Alprazolam Tablet @ 100 Tab Tablet - - - - - - - 990.00 -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - - - - - 173.00 -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - 0 - - - 139.00 -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - 0 - - - 121.00 -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - - - - - 69.00 -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - 0 - - - 557.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
25 Cetirizine tablet Tablet - - - - - - - 154.00 -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - 0 - - - 298.00 -
Codein Tablet 20 mg Tablet - - - - - - - -
30 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - 0 - - - 1.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
38 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - 0 - - - 1,100.00 -
39 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - - - - - 683.00 -
42 Tablet @ 100 Tab Tablet - - - 0 - - - 1,925.00 -
44 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - - - - - 660.00 -
46 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - 0 - - - 4,813.00 -
49 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - - - - - 410.00 -
50 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - 0 - - - 660.00 -
58 Methioson Tablet @ 30 Tab Tablet - - - 0 - - - 1,026.00 -
59 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - - - - - 230.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
62 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - 0 - - - 102.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
64 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - - - - - - 560.00 -
66 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - 0 - - - 193.00 -
69 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - - - - - 700.00 -
70 Omeprazole kapsul @ 30 Kap Kapsul - - - 0 - - - 164.00 -
78 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - 0 - - - 242.00 -
79 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - - - - - 119.00 -
84 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - - - - - - 58.00 -
89 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - - - - - 100.00 -
90 Tablet tambah darah @ 30 Tab Sal Tablet - - - 0 - - - 73.73 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
SIRUP - - 0 - - -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - 0 - - - 21,450.00 -
4 Anti Diare (Arcapec) Sirup Botol - - - - - - - 16,500.00 -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - 0 - - - 3,594.00 -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - - - - - 6,285.00 -
11 Cetirizine (Lerzin) Sirup Botol - - - 0 - - - 7,756.00 -
14 Erytromycin Sirup Botol - - - - - - - 8,090.00 -
15 Fe Kombinasi (maltiron) Sirup Botol - - - 0 - - - 19,250.00 -
23 Metamizol (Norages) Sirup Botol - - - 0 - - - 33,000.00 -
24 Metoklopropamid (Gavistal) Drop Botol - - - - - - - 5,830.00 -
27 Metronidazole Infus Botol - - - 0 - - - 12,980.00 -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - - - - - 24,200.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - 0 - - - 7,354.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
34 Parasetamol Drop Botol - - - - - - - 5,980.00 -
35 Pseudoefedrin (Alco) Drop Botol - - - 0 - - - 64,350.00 -
37 Zinc drop Botol - - - 0 - - - 11,700.00 -
38 Zinc Sirup Botol - - - 0 - - - 6,500.00 -
- - - - - -
INJEKSI - - 0 - - -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - 0 - - - 2,536.00 -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - - - - - 9,350.00 -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - 0 - - - 3,578.00 -
9 Furusemide Injeksi Ampul - - - - - - - 2,012.00 -
Ampul
11 Ampul - - - 0 - - - 4,950.00 -
Vial
14 (Xylomidon) Inj @ 25 vial - - - - - - - 5,555.00 -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - 0 - - - 8,800.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - 0 - - - 1,600.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - - - - - 2,680.00 -
27 Lidocain 2% Injeksi Ampul - - - 0 - - - 875.00 -
INFUS - - 0 - - -
1 KAEN 3A fls - - - - - - - 10,000.00 -
2 KAEN 3B fls - - - 0 - - - 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - 0 - - - 9,350.00 -
4 Glukosa 5% + 1/2 NS fls - - - 0 - - - 9,400.00 -
- - 0 - - -
SALEP/KRIM - - - - - -
1 Acyclovir cream @ 25 Tube tube - - - 0 - - - 2,997.00 -
4 Ictiol salep Pot - - - 0 - - - 4,300.00 -
9 Piroksikam (Infeld) Gel Tube - - - 0 - - - 19,058.00 -
10 Scabimite cream @ 24 Tube tube - - - - - - - 12,155.00 -
- - 0 - - -
1 Kloramfenikol Salep Mata tube - - - 0 - - - 1,640.00 -
- - 0 - - -
TETES MATA - - - - - -
2 Cendo Xitrol Botol - - - 0 - - - 26,812.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
5 Tetrakain (Pantocain) TM Botol - - - - - - - 11,500.00 -
- - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - - - -
1 Otopain TT Botol - - - 0 - - - 35,145.00 -
- - 0 - - -
OBAT LUAR / LAIN- LAIN - - 0 - - -
1 Anti sariawan (Albotyl) Sol Botol - - - - - - - 23,100.00 -
4 Borax gliserin Botol - - - 0 - - - 1,899.00 -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - - - - - 12,749.00 -
8 Larutan Chlorhexide @ 500 ml Botol - - - 0 - - - 73,443.75 -
- - - - - -
1 Bisturi @ 100 pcs pcs - - - 0 - - - 770.00 -
4 EKG Paper 80 x 30 Roll - - - - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - 0 - - - 27,500.00 -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - 0 - - - 737.74 -
9 Hand schoen no. 7 @ 50 psg psg - - - - - - - 4,675.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
16 Hypapix 5 x 1 m roll - - - 0 - - - 12,650.00 -
19 Kasa Hidrofil 40 x 80 pcs - - - - - - - 119,174.19 -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - 0 - - - 1,957.50 -
24 Masker @ 100 pcs pcs - - - - - - - 425.60 -
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - - 15,400.00 -
28 Paket P3K pcs - - - 0 - - - 311,900.00 -
29 Spuit Injeksi 10 ml pcs - - - - - - - 1,393.90 -
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
34 Test Kehamilan Stik @ 50 pcs pcs - - - - - - - 1,564.20 -
36 Urine bag Stik - - - 0 - - - 3,404.00 -
39 Wing needle no. 27 pcs - - - - - - - 2,145.00 -
40 Boor Diamond High Speed pcs - - - 0 - - - 440,000.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
42 Needle No. 24 G @ 100 pcs - - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
1 Abate kg - - - 0 - - - 99,220.00 -
2 ACT Tablet Ktk - - - 0 - - - 36,300.00 -
4 Artem Injeksi Ktk - - - 0 - - - 14,868.83 -
6 Artesdiaquine Tablet Ktk - - - - - - - 125,400.00 -
8 Cynoff liter - - - 0 - - - 387,800.00 -
9 Kelambu Pcs - - - 0 - - - 1.00 -
11 RDT Chikungunya Pcs - - - - - - - 55,000.00 -
12 RDT Malaria Pcs - - - 0 - - - 40,700.00 -
13 RDT Salmonella Pcs - - - 0 - - - 66,000.00 -
- - 0 - - -
PROGRAM P2 IMUNISASI - - - - - -
3 Safety Box Pcs - - - 0 - - - 23,000.00 -
8 Vaksin DT Vial - - - 0 - - - 14,487.00 -
9 Vaksin Hepatitis (HBO) ampul - - - 0 - - - 18,750.00 -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - - - - - 23,782.00 -
13 Vaksin Td vial - - - 0 - - - 14,250.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
14 Vaksin TT Vial - - - 0 - - - 11,913.00 -
15 Vaksin DPT HB HIB Vial - - - - - - - 43,900.00 -
- - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
PROGRAM P2 TB - - - 0 - - - -
1 Box Slides pcs - - - 0 - - - 100,000.00 -
3 FDC I ktk - - - - - - - 395,900.00 -
4 FDC I & III ktk - - - 0 - - - 396,000.00 -
5 FDC II siklus - - - 0 - - - 1,379,984.00 -
6 Kaca Ose siklus - - - 0 - - - 265,000.00 -
11 Pot Sputum ktk - - - 0 - - - 2,930.00 -
12 Reagen Zn Neilson set - - - 0 - - - 236,500.00 -
13 Slide mikroskop kotak - - - - - - - 27,500.00 -
14 Spritus Botol - - - 0 - - - 27,500.00 -
15 Masker N-95 pcs - - - 0 - - - 21,420.00 -
16 Mikroskop Binoculer unit - - - 0 - - - 1.00 -
- - - - - - -
1 Zn Tablet 500 mg Tablet - - - 0 - - - 512.00 -
- - 0 - - -
1 MDT MB Anak Strip - - - - - - - 14,862.00 -
2 MDT MB Dewasa Strip - - - 0 - - - 30,595.00 -
3 MDT PB Anak Strip - - - 0 - - - 7,462.00 -
- - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
4 Gluconas Calsicus vial - - - 0 - - - 1.00 -
- - - - - -
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - - 24,222.22 -
2 Alkohol 70% @ 100 ml Botol - - - 0 - - - 2,625.00 -
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - - 48,400.00 -
4 Alkohol Swab @ 100 pcs Kotak - - - - - - - 128.97 -
6 EDTA 10 % botol - - - 0 - - - 66,000.00 -
7 Gliserin Botol - - - 0 - - - 5,203.00 -
9 Golongan Darah Test set - - - - - - - 385,000.00 -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - 0 - - - 618,750.00 -
18 Larutan Drabkin Botol - - - 0 - - - 122,195.00 -
19 Larutan Eosin 2 % Botol - - - - - - - 230,000.00 -
22 Larutan Giemsa Stain Botol - - - 0 - - - 77,500.00 -
24 Larutan HCl 0,1% botol - - - - - - - 8,470.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
26 Larutan karbol Fuchsin @ 100 ml Botol - - - 0 - - - 28,400.00 -
29 Larutan Turk Botol - - - - - - - 17,900.00 -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - 0 - - - 64,300.00 -
31 Metanol Botol - - - 0 - - - 30,400.00 -
32 Na Citrat 3,8 % botol - - - 0 - - - 8,000.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
37 Oli Emersi botol - - - 0 - - - 313,500.00 -
38 Rees Ecker botol - - - 0 - - - 74,800.00 -
39 Trigeliserida Botol - - - - - - - 418,000.00 -
42 widal Test Set - - - 0 - - - 440,000.00 -
43 Xylol botol - - - 0 - - - 27,500.00 -
44 Sungkup Bayi Pcs - - - - - - - 220,000.00 -
45 NGT All Item Pcs - - - 0 - - - 1.00 -
46 PP 3 juta Injeksi vial - - - 0 - - - 1.00 -
48 Iodiom Test Pcs - - - 0 - - - 1.00 -
49 Mineral Mix Bks - - - - - - - 2,475.00 -
50 Eksavator Double Ended Pcs - - - 0 - - - 1.00 -
56 Lab.Kit Paket - - - 0 - - - 1.00 -
57 Blue Tips bks - - - 0 - - - 105,875.00 -
58 Yellow Tips bks - - - 0 - - - 139,700.00 -
59 Deck Glass ktk - - - - - - - 38,500.00 -
61 Tissue Lensa bks - - - 0 - - - 48,400.00 -
62 Stik HB Family Dr ktk - - - 0 - - - 357,500.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
64 Glukosa Stik Performa Accu Check kotak - - - - - - - 420,000.00 -
69 Lidi Sputum (100 pcs) bks - - - - - - - 36,300.00 -
70 Cotton Swab pcs - - - 0 - - - 7,700.00 -
71 Specullum pcs - - - 0 - - - 1,000.00 -
74 Alat Nesco pcs - - - - - - - 1.00 -
76 aseptic gel Botol - - - 0 - - - 28,710.00 -
77 Minyak Angin Safecare Botol - - - 0 - - - 15,000.00 -
78 Thrombophob Gel tube - - - 0 - - - 63,043.00 -
TOTAL -
UMUM
BAYAR
BAYAR

PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
H.Errani Martin,SKM.MM Septi Heryani, S. Farm, Apt Isrok Antarikso, SKM, M.Kes Mahdalena, S. Farm., Apt
NIP.19640314 198802 1 002 NIP 19890919 201402 2 006 NIP.19690928 198902 1 001 NIP 19830909 201001 2 032
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : Agustus / September
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
7 mg @ 100 Tab Tablet - - - 0 - - - 520.30 -
- - 0 - - -
SIRUP - - 0 - - -
- - 0 - - -
INJEKSI - - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
13 Tetagam Vial - - - 0 - - - 170,000.00 -
- - - - - -
INFUS - - 0 - - -
- - 0 - - -
OBAT GIGI - - - - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - 0 - - -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - 0 - - - - 2,049.00 -
10 jarum @ 36 pcs Pcs - - - - - - - 5,743.86 -
- - 0 - - -
TABLET - - 0 - - -
7 100 Tab Tablet - - - 0 - - - 96.80 -
8 100 Tab Tablet - - - 0 - - - 157.30 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
21 100 Tab Tablet - - - - - - - 796.00 -
35 Tab Tablet - - - 0 - - - 47.50 -
40 Tab Tablet - - - 0 - - - 169.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - 0 - - -
SIRUP - - - - - -
- - 0 - - -
INJEKSI - - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
7 Amp Ampul - - - 0 - - - 1,914.00 -
14 100 Amp Ampul - - - - - - - 1,226.00 -
15 Amp Ampul - - - 0 - - - 843.33 -
- - 0 - - -
SALEP - - 0 - - -
1 endapan 4 % @ 24 Pot Pot - - - - - - - 2,200.00 -
- - 0 - - -
- - - - - -
- - 0 - - -
- - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
OBAT LUAR - - - - - -
- - - - - -
OBAT GIGI - - 0 - - -
- - 0 - - -
- - - - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - - - -
SIRUP - - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
37 Zinc drop Botol - - - 0 - - - 11,700.00 -
38 Zinc Sirup Botol - - - 0 - - - 6,500.00 -
- - - - - -
INJEKSI - - 0 - - -
Ampul
11 Ampul - - - - - - - 4,950.00 -
Vial
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
INFUS - - 0 - - -
1 KAEN 3A fls - - - 0 - - - 10,000.00 -
2 KAEN 3B fls - - - 0 - - - 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - - - - - 9,350.00 -
4 Glukosa 5% + 1/2 NS fls - - - 0 - - - 9,400.00 -
- - 0 - - -
4 Ictiol salep Pot - - - 0 - - - 4,300.00 -
- - 0 - - -
- - 0 - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - - - -
- - - - - -
1 Otopain TT Botol - - - 0 - - - 35,145.00 -
- - 0 - - -
- - 0 - - -
1 Bisturi @ 100 pcs pcs - - - 0 - - - 770.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
4 EKG Paper 80 x 30 Roll - - - - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - 0 - - - 27,500.00 -
16 Hypapix 5 x 1 m roll - - - - - - - 12,650.00 -
24 Masker @ 100 pcs pcs - - - - - - - 425.60 -
27 Optiva No. 20 @ 50 pcs pcs - - - 0 - - - 15,400.00 -
28 Paket P3K pcs - - - - - - - 311,900.00 -
31 Surflo No. 20 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - - 8,355.00 -
33 Surflo No. 24 @ 50 pcs pcs - - - 0 - - - 8,355.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
36 Urine bag Stik - - - - - - - 3,404.00 -
- - 0 - - -
1 Abate kg - - - 0 - - - 99,220.00 -
2 ACT Tablet Ktk - - - 0 - - - 36,300.00 -
8 Cynoff liter - - - 0 - - - 387,800.00 -
9 Kelambu Pcs - - - - - - - 1.00 -
12 RDT Malaria Pcs - - - 0 - - - 40,700.00 -
- - 0 - - -
3 Safety Box Pcs - - - 0 - - - 23,000.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
8 Vaksin DT Vial - - - 0 - - - 14,487.00 -
13 Vaksin Td vial - - - - - - - 14,250.00 -
14 Vaksin TT Vial - - - 0 - - - 11,913.00 -
- - 0 - - -
PROGRAM P2 TB - - - - - - - -
1 Box Slides pcs - - - 0 - - - 100,000.00 -
3 FDC I ktk - - - 0 - - - 395,900.00 -
4 FDC I & III ktk - - - - - - - 396,000.00 -
5 FDC II siklus - - - 0 - - - 1,379,984.00 -
6 Kaca Ose siklus - - - 0 - - - 265,000.00 -
11 Pot Sputum ktk - - - 0 - - - 2,930.00 -
14 Spritus Botol - - - 0 - - - 27,500.00 -
15 Masker N-95 pcs - - - 0 - - - 21,420.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - 0 - - -
- - 0 - - -
1 MDT MB Anak Strip - - - 0 - - - 14,862.00 -
3 MDT PB Anak Strip - - - 0 - - - 7,462.00 -
- - 0 - - -
- - 0 - - -
1 Alkohol 70 % @ 1000 ml Botol - - - 0 - - - 24,222.22 -
2 Alkohol 70% @ 100 ml Botol - - - - - - - 2,625.00 -
3 Alkohol 95 % @ 1000 ml botol - - - 0 - - - 48,400.00 -
6 EDTA 10 % botol - - - - - - - 66,000.00 -
7 Gliserin Botol - - - 0 - - - 5,203.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
31 Metanol Botol - - - 0 - - - 30,400.00 -
32 Na Citrat 3,8 % botol - - - 0 - - - 8,000.00 -
37 Oli Emersi botol - - - 0 - - - 313,500.00 -
38 Rees Ecker botol - - - - - - - 74,800.00 -
42 widal Test Set - - - - - - - 440,000.00 -
43 Xylol botol - - - 0 - - - 27,500.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
44 Sungkup Bayi Pcs - - - 0 - - - 220,000.00 -
45 NGT All Item Pcs - - - 0 - - - 1.00 -
48 Iodiom Test Pcs - - - 0 - - - 1.00 -
49 Mineral Mix Bks - - - 0 - - - 2,475.00 -
56 Lab.Kit Paket - - - 0 - - - 1.00 -
57 Blue Tips bks - - - 0 - - - 105,875.00 -
58 Yellow Tips bks - - - - - - - 139,700.00 -
59 Deck Glass ktk - - - 0 - - - 38,500.00 -
61 Tissue Lensa bks - - - 0 - - - 48,400.00 -
70 Cotton Swab pcs - - - - - - - 7,700.00 -
71 Specullum pcs - - - 0 - - - 1,000.00 -
TOTAL -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
UMUM
BAYAR
BAYAR
0 0 -

H.Errani Martin,SKM.MM Septi Heryani, S. Farm, Apt H. Isrok Antarikso, SKM, M.Kes Mahdalena, S. Farm., Apt
NIP.19640314 198802 1 002 NIP 19890919 201402 2 006 NIP.19690928 198902 1 001 NIP 19830909 201001 2 032
PUSKESMAS : BINUANG
KECAMATAN : BINUANG Laporan/Permintaan : September / Oktober
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
TABLET
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - - - - 317.00 -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - - - - 275.00 -
5 Kloramfenikol Kapsul 500 mg Tablet - - - - - - 1,155.00 -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - - - - 93.50 -
7 mg @ 100 Tab Tablet - - - - - - 520.30 -
8 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - - - - - 77.00 -
9 Kotrimoksazole tablet komb. 480 mg @ 100 Tab Tablet - - - - - - 158.00 -
10 Kuinin (kina) tablet 200 mg Tablet - - - - - - 641.00 -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - - - - 318.00 -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - - - - 125.00 -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - - - - 246.40 -
- - -
SIRUP - - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - - - - 2,200.00 -
2 Kotrimoksazole suspensi komb. Botol - - - - - - 2,225.00 -
- - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
INJEKSI - - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - - - - 1,740.00 -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - - - - 2,604.90 -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - - - - - 1,056.00 -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 Ampul - - - - - - 2,354.00 -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - - - - 6,820.00 -
6 Lidokain Komp. Inj Komb Ampul - - - - - - 2,122.00 -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - - - - 1,900.00 -
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU Vial - - - - - - 520,300.00 -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - - - - 193,470.80 -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - - - - 139,150.00 -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - - - - 401,092.00 -
12 Vaksin Rabies Vero (VAR) Vial - - - - - - 174,500.00 -
13 Tetagam Vial - - - - - - 170,000.00 -
- - -
INFUS - - -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - - - - 7,150.00 -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - - - - 6,410.00 -
- - -
OBAT GIGI - - -
1 Air raksa Dental Use Ktk - - - - - - 103,536.00 -
2 Devitalisasi pasta ktk - - - - - - 293,498.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
3 EtiL klorida semprot Botol - - - - - - 99,000.00 -
4 Forinekresol (pengganti TKF) ktk - - - - - - 185,900.00 -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - - - - 306,427.00 -
6 Kalsium hidroksi pasta ktk - - - - - - 242,000.00 -
7 Klorfenol kamfer menthol (CHKM) ktk - - - - - - 56,441.40 -
8 Mummiying Pasta ktk - - - - - - 137,853.00 -
9 Semen seng Fosfar serbuk & cairan ktk - - - - - - 93,500.00 -
10 Silver amalgam serbuk 65 - 75 % ktk - - - - - - 408,792.00 -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - - - - 14,053.63 -
12 Temporary Stoping Flecther serbuk & Cair set - - - - - - 158,042.00 -
- - -
ALAT KESEHATAN - - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - - - - 1,540.00 -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - - - - 957.00 -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - - - - 2,049.00 -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - - - - - 7,201.04 -
5 Catgut Cromic No. 2/0 dengan jarum @ 24 pcs Pcs - - - - - - 7,201.04 -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - - - - 8,896.88 -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - - - - 7,286.25 -
8 Infusion set anak Pcs - - - - - - 7,920.00 -
9 Infusion set dewasa Pcs - - - - - - 7,920.00 -
10 jarum @ 36 pcs Pcs - - - - - - 5,743.86 -
- - -
OBAT SANGAT ESENSIAL & ESENSIAL - - - -
TABLET - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - - - - - 95.00 -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - - - - 86.00 -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - - - - 123.00 -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - - - - 163.90 -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - - - - 64.00 -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - - - - 149.00 -
7 100 Tab Tablet - - - - - - 96.80 -
8 100 Tab Tablet - - - - - - 157.30 -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - - - - - 120.00 -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - - - - 66.00 -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - - - - 48.00 -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - - - - 108.00 -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - - - - - 146.00 -
16 Fenitoin Na Kapsul 30 mg @ 250 Kap Kapsul - - - - - - 80.00 -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - - - - - 257.40 -
20 Fenoksimetil penicillin tablet 500 mg @ 100 Tab Tablet - - - - - - 456.50 -
21 100 Tab Tablet - - - - - - 796.00 -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - - - - 84.00 -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - - - - 126.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - - - - 108.00 -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - - - - 224.00 -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - - - - 62.00 -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - - - - 76.00 -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - - - - 105.00 -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - - - - 171.00 -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - - - - 121.00 -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - - - - 133.00 -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - - - - - 98.00 -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - - - - 169.00 -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - - - - 306.00 -
35 Tab Tablet - - - - - - 47.50 -
38 Magnesium sulfat serbuk 30 g Pot - - - - - - 1,129.30 -
39 Mebendazole tablet 100 mg Tablet - - - - - - 231.00 -
40 Tab Tablet - - - - - - 169.00 -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - - - - 98.00 -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - - - - 15.73 -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - - - - 857.00 -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - - - - 602.00 -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - - - - 136.00 -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - - - - 114.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - - - - 351.00 -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - - - - 82.00 -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - - - - 114.00 -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - - - - - 167.20 -
52 Tetrasiklin HCl kapsul 500 mg @ 100 Kap Kapsul - - - - - - 325.00 -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - - - - 91.00 -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - - - - 97.00 -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - - - - 132.00 -
- - -
SIRUP - - -
1 Antasida DOEN Suspensi Komb Botol - - - - - - 2,300.00 -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - - - - 1,573.00 -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - - - - 3,740.00 -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - - - - 1,119.00 -
- - -
INJEKSI - - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - - - - 4,204.00 -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - - - - 1,345.00 -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - - - - 5,800.00 -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - - - - 1,210.00 -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - - - - 20,857.00 -
6 Fenobarbital injeksi Ampul - - - - - - 1,930.00 -
7 Amp Ampul - - - - - - 1,914.00 -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - - - - 1,210.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - - - - 724.00 -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - - - - 1,527.70 -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - - - - 2,970.00 -
14 100 Amp Ampul - - - - - - 1,226.00 -
15 Amp Ampul - - - - - - 843.33 -
- - -
SALEP - - -
1 endapan 4 % @ 24 Pot Pot - - - - - - 2,200.00 -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - - - - 2,712.00 -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - - - - 1,435.00 -
4 Antibakteri DOEN Komb. Pot - - - - - - 2,767.00 -
5 Antifungi DOEN Komb. Pot - - - - - - 4,782.00 -
- - -
SALEP MATA - - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - - - - 1,640.00 -
- - -
TETES MATA - - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - - - - 3,549.00 -
- - -
TETES TELINGA - - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - - - - 1,759.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
2 Fenol gliserol TT Botol - - - - - - 2,246.00 -
- - -
OBAT LUAR - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - - - - 3,502.00 -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - - - - 5,500.00 -
3 Gentian violet larutan 1 % Botol - - - - - - 2,178.00 -
4 Kalium Permanghanat serbuk Botol - - - - - - 6,529.00 -
5 Povidon Iodida 10 % 30 ml Botol - - - - - - 2,344.00 -
6 Povidon Iodida 10 % 300 ml Botol - - - - - - 15,950.00 -
7 Salisilat Bedak 2 % Kotak - - - - - - 1,066.00 -
- - -
OBAT GIGI - - -
1 Eugenol cairan Botol - - - - - - 20,815.00 -
- - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - - - - 14,187.50 -
2 Kasa kompres 40 / 40 steril Bks - - - - - - 1,984.03 -
3 Kasa pembalut 2 m x 80 cm Rol - - - - - - 8,739.41 -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - - - - 2,740.50 -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - - - - 760.91 -
6 Pembalut gips Rol - - - - - - 6,071.00 -
7 Plester 5 yard x 2 inch Rol - - - - - - 25,987.00 -
- - -
OBAT PENUNJANG - - -
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - - - - - 272.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
2 Acyclovir tablet 400 mg @ 100 Tab Tablet - - - - - - 628.46 -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - - - - 258.74 -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - - - - 2,200.00 -
5 Alprazolam Tablet @ 100 Tab Tablet - - - - - - 990.00 -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - - - - 155.30 -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 Tablet - - - - - - 5,283.00 -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - - - - 173.00 -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - - - - - 139.00 -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - - - - 150.00 -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - - - - 113.00 -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - - - - 1,540.00 -
15 Aspilet tablet @ 100 Tab Tablet - - - - - - 123.00 -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - - - - - 170.00 -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - - - - 230.00 -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - - - - 695.00 -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - - - - 121.00 -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - - - - 69.00 -
21 Captopril tablet 25 mg @ 100 Tab Tablet - - - - - - 72.00 -
22 Cefadroksil tab 250 mg Tablet - - - - 564.00 -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - - - - 557.00 -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - - - - 899.00 -
25 Cetirizine tablet Tablet - - - - - - 154.00 -
26 Cimetidine tablet @ 100 Tab Tablet - - - - - - 115.50 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - - - - 298.00 -
28 Clobazam tablet @ 100 Tab Tablet - - - - - - 1,120.00 -
29 Codein Tablet 10 mg Tablet - - - - - - 630.00 -
30 Codein Tablet 20 mg Tablet - - - - - - -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - - - - 1.00 -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - - - - 126.00 -
33 Dimenhidrinat tablet @ 100 Tab Tablet - - - - - - 107.00 -
34 Doksisiklin tablet @ 100 Tab Tablet - - - - - - 250.00 -
35 Domperidon Tablet @ 100 Tab Tablet - - - - - - 133.00 -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - - - - 509.00 -
37 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - - - - 766.00 -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - - - - 1,210.00 -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - - - - - 1,100.00 -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - - - - 683.00 -
41 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - - - - 245.00 -
42 Glimepiride Tab 2 mg Tablet - - - - - - 296.00 -
43 Tablet @ 100 Tab Tablet - - - - - - 1,925.00 -
44 Ketokonazole tablet @ 50 tab Tablet - - - - - - 292.00 -
45 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - - - - 660.00 -
46 Klindamisin tablet 150 mg @ 50 Tab Tablet - - - - - - 405.00 -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - - - - 4,813.00 -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - - - - 341.00 -
49 Levofloksasin @ 30 Tab Tablet - - - - - - 581.00 -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - - - - 410.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - - - - 660.00 -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - - - - 90.00 -
53 Loratadine tablet 10 mg @ 50 tab Tablet - - - - - - 170.00 -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - - - - - 726.00 -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - - - - 462.00 -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - - - - 292.60 -
57 Mepromaag tablet @ 100 Tab Tablet - - - - - - 495.00 -
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - - - - 118.50 -
59 Methioson Tablet @ 30 Tab Tablet - - - - - - 1,026.00 -
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - - - - 230.00 -
61 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - - - - 140.00 -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - - - - 100.00 -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - - - - 102.00 -
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - - - - 220.00 -
65 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - - - - - 560.00 -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - - - - 167.00 -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - - - - 193.00 -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - - - - 440.00 -
69 Nifedipin Tablet @ 100 Tab Tablet - - - - - - 123.00 -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - - - - 700.00 -
71 Omeprazole kapsul @ 30 Kap Kapsul - - - - - - 164.00 -
72 Papaverin tablet @ 1000 Tab Tablet - - - - - - 125.00 -
73 Paraformaldehide tablet @ 100 Tab Tablet - - - - - - 7,700.00 -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - - - - 1,485.00 -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - - - - - 360.80 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
76 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - - - - 97.02 -
77 Piroksikam tablet 20 mg @ 100 Tab Tablet - - - - - - 102.37 -
78 Propanolol 10 mg Tab Tablet - - - - - - 85.00 -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - - - - 242.00 -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - - - - 119.00 -
81 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Kapsul - - - - - - 286.00 -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - - - - - 505.00 -
85 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - - - - - 58.00 -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - - - - 1,525.00 -
89 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - - - - 350.00 -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - - - - 100.00 -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - - - - - 73.73 -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - - - - 88.00 -
93 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - - - - 615.38 -
94 Tramadol Tablet @ 50 Tab Tablet - - - - - - 2,680.00 -
- - -
SIRUP - - -
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - - - - 3,791.00 -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - - - - 4,147.00 -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - - - - 21,450.00 -
4 Anti Diare (Arcapec) Sirup Botol - - - - - - 16,500.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
5 Anti sariawan (Enkasari) Sirup Botol - - - - - - 12,760.00 -
6 Batugin Elixier @ 120 ml botol - - - - - - 20,352.00 -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - - - - 3,594.00 -
8 Bromhexin (Phytovon) Sirup Botol - - - - - - 6,050.00 -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - - - - 6,285.00 -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - - - - 7,960.00 -
11 Cetirizine (Lerzin) Sirup Botol - - - - - - 7,756.00 -
12 Domperidon Sirup Botol - - - - - - 3,180.00 -
13 Domperidon Drop Botol - - - - - - 17,939.00 -
14 Erytromycin Sirup Botol - - - - - - 8,090.00 -
15 Fe Kombinasi (maltiron) Sirup Botol - - - - - - 19,250.00 -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - - - - - 16,500.00 -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - - - - 11,550.00 -
18 Gastrinal Suspensi Botol - - - - - - 24,200.00 -
19 Ibuprofen (Farsifen) Sirup Botol - - - - - - 2,560.00 -
20 Klorampenikol suspensi Botol - - - - - - 4,000.00 -
21 Lactulosa Sirup Botol - - - - - - 14,500.00 -
22 Laxadine Sirup @ 30 ml Botol - - - - - - 12,450.00 -
23 Metamizol (Norages) Sirup Botol - - - - - - 33,000.00 -
24 Metoklopropamid (Gavistal) Drop Botol - - - - - - 5,830.00 -
25 Metronidazole (Farizol) Sirup Botol - - - - - - 3,800.00 -
26 Metoklopropamid sirup Botol - - - - - - 2,750.00 -
27 Metronidazole Infus Botol - - - - - - 12,980.00 -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - - - - 22,000.00 -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - - - - 24,200.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - - - - 10,902.00 -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - - - - 7,354.00 -
32 Nifuroxide (Nifudiar) Sirup Botol - - - - - - 38,500.00 -
33 Nistatin (Cazetin) Drop Botol - - - - - - 32,120.00 -
34 Parasetamol Drop Botol - - - - - - 5,980.00 -
35 Pseudoefedrin (Alco) Drop Botol - - - - - - 64,350.00 -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - - - - 20,350.00 -
37 Zinc drop Botol - - - - - - 11,700.00 -
38 Zinc Sirup Botol - - - - - - 6,500.00 -
- - -
INJEKSI - - -
1 Alinamin F injeksi @ 5 Amp Ampul - - - - - - 14,972.60 -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - - - - 5,610.00 -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - - - - 2,536.00 -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - - - - 9,350.00 -
5 Ceftriaxon Injeksi 1 gram @ 10 vial Vial - - - - - - 11,000.00 -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - - - - 33,000.00 -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - - - - 3,578.00 -
8 Dopamin Injeksi Ampul - - - - - - 10,219.00 -
9 Furusemide Injeksi Ampul - - - - - - 2,012.00 -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - - - - 3,415.00 -
Ampul
11 Ampul - - - - - - 4,950.00 -
12 Kanamycin Inj vial - - - - - - 6,610.80 -
13 Kloramfenikol Injeksi Vial - - - - - - 10,790.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
Vial
14 (Xylomidon) Inj @ 25 vial - - - - - - 5,555.00 -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - - - - 8,800.00 -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - - - - 6,600.00 -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - - - - 5,500.00 -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - - - - 9,570.00 -
19 Ondasentron Injeksi Ampul - - - - - - 2,400.00 -
20 Pethidin injeksi Ampul - - - - - - 14,509.10 -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - - - - - 3,300.00 -
22 Piracetam injeksi 3 gram @ 4 Amp Ampul - - - - - - 17,088.00 -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - - - - 1,600.00 -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - - - - 2,680.00 -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - - - - 4,000.00 -
26 Xylocain Injeksi Ampul - - - - - - 40,000.00 -
27 Lidocain 2% Injeksi Ampul - - - - - - 875.00 -
INFUS - - -
1 KAEN 3A fls - - - - - - 10,000.00 -
2 KAEN 3B fls - - - - - - 10,050.00 -
3 Glukosa 5% + 1/4 NS fls - - - - - - 9,350.00 -
4 Glukosa 5% + 1/2 NS fls - - - - - - 9,400.00 -
- - -
SALEP/KRIM - - -
1 Acyclovir cream @ 25 Tube tube - - - - - - 2,997.00 -
2 Bioplacenton Jelly tube - - - - - - 13,200.00 -
3 Gentamisin salep kulit @ 10 Tube tube - - - - - - 1,835.16 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
4 Ictiol salep Pot - - - - - - 4,300.00 -
5 Ketokonazole krim tube - - - - - - 2,605.00 -
6 Miconazole krim @ 24 Tube tube - - - - - - 3,737.00 -
7 Nostren Cream Tube - - - - - - 12,100.00 -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - - - - 1,649.36 -
9 Piroksikam (Infeld) Gel Tube - - - - - - 19,058.00 -
10 Scabimite cream @ 24 Tube tube - - - - - - 12,155.00 -
- - -
SALEP MATA - - -
1 Kloramfenikol Salep Mata tube - - - - - - 1,640.00 -
- - -
TETES MATA - - -
1 Cendo Catarelent Botol - - - - - - 22,000.00 -
2 Cendo Xitrol Botol - - - - - - 26,812.00 -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - - - - 4,600.00 -
4 Kloramfenikol Tetes Mata Botol - - - - - - 2,750.00 -
5 Tetrakain (Pantocain) TM Botol - - - - - - 11,500.00 -
- - -
TETES HIDUNG - - -
1 Iliadin Drop Botol - - - - - - 30,305.00 -
2 Iliadin Spray Botol - - - - - - 36,000.00 -
- - -
TETES TELINGA - - -
1 Otopain TT Botol - - - - - - 35,145.00 -
- - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
OBAT LUAR / LAIN- LAIN - - -
1 Anti sariawan (Albotyl) Sol Botol - - - - - - 23,100.00 -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - - - - 5,800.00 -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - - - - 5,670.00 -
4 Borax gliserin Botol - - - - - - 1,899.00 -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - - - - 18,458.00 -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - - - - 12,749.00 -
7 Semprot Spray kotak - - - - - - 80,000.00 -
8 Larutan Chlorhexide @ 500 ml Botol - - - - - - 73,443.75 -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - - - - 66,000.00 -
10 Salisil spritus Botol - - - - - - 5,430.00 -
- - -
1 Bisturi @ 100 pcs pcs - - - - - - 770.00 -
2 Blood Lancet ss @ 100 pcs pcs - - - - - - 221.00 -
3 Daryan tulle @ 10 lbr Lembar - - - - - - 16,500.00 -
4 EKG Paper 80 x 30 Roll - - - - - - 45,375.00 -
5 EKG Paper 40 x 30 Roll - - - - - - 27,500.00 -
6 Foley cateter no. 16 @ 10 pcs pcs - - - - - - 10,318.00 -
7 Foley cateter no. 18 10 Pcs pcs - - - - - - 9,080.00 -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - - - - - 737.74 -
9 Hand schoen no. 7 @ 50 psg psg - - - - - - 4,675.00 -
10 Hand schoen no. 7,5 @ 50 psg psg - - - - - - 4,675.00 -
11 Hand Schoen No. 8 @ 50 psg psg - - - - - - 4,675.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - - - - 6,325.00 -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - - - - 6,050.00 -
16 Hypapix 5 x 1 m roll - - - - - - 12,650.00 -
17 Jarum Hecting Kulit lsn - - - - - - 24,200.00 -
18 Jarung Hecting Otot lsn - - - - - - 24,200.00 -
19 Kasa Hidrofil 40 x 80 pcs - - - - - - 119,174.19 -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - - - - 1,957.50 -
21 Kasa steril 16 x 16 pad roll - - - - - - 7,480.40 -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - - - - 3,960.00 -
23 Mami non waven @ 24 pcs pcs - - - - - - 1,210.00 -
24 Masker @ 100 pcs pcs - - - - - - 425.60 -
25 Needle No. 23 G @ 100 pcs pcs - - - - - - 660.00 -
26 Needle No. 25 G 100 pcs pcs - - - - - - 660.00 -
27 Optiva No. 20 @ 50 pcs pcs - - - - - - 15,400.00 -
28 Paket P3K pcs - - - - - - 311,900.00 -
29 Spuit Injeksi 10 ml pcs - - - - - - 1,393.90 -
30 Spuit Injeksi 50 ml Set - - - - - - 5,693.00 -
31 Surflo No. 20 @ 50 pcs pcs - - - - - - 8,355.00 -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - 8,355.00 -
33 Surflo No. 24 @ 50 pcs pcs - - - - - - 8,355.00 -
34 Test Kehamilan Stik @ 50 pcs pcs - - - - - - 1,564.20 -
35 Ultrasonic Gel pcs - - - - - - 27,500.00 -
36 Urine bag Stik - - - - - - 3,404.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
37 USG Printing Paper UPP-110 HG pcs - - - - - - 320,000.00 -
38 Wing needle no. 21 pcs - - - - - - 2,145.00 -
39 Wing needle no. 27 pcs - - - - - - 2,145.00 -
40 Boor Diamond High Speed pcs - - - - - - 440,000.00 -
41 Boor Diamond Low Speed pcs - - - - - - 330,000.00 -
- - -
OBAT PROGRAM - - -
PROGRAM P2 MALARIA - - -
1 Abate kg - - - - - - 99,220.00 -
2 ACT Tablet Ktk - - - - - - 36,300.00 -
3 Arsumodon tablet Tablet - - - - - - 3,566.78 -
4 Artem Injeksi Ktk - - - - - - 14,868.83 -
6 Artesdiaquine Tablet Ktk - - - - - - 125,400.00 -
7 Artesunate Injeksi ampul - - - - - - 38,999.00 -
8 Cynoff liter - - - - - - 387,800.00 -
9 Kelambu Pcs - - - - - - 1.00 -
10 Rafid Test Dengeu @ 25 test Pcs - - - - - - 57,200.00 -
11 RDT Chikungunya Pcs - - - - - - 55,000.00 -
12 RDT Malaria Pcs - - - - - - 40,700.00 -
13 RDT Salmonella Pcs - - - - - - 66,000.00 -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - - - - - 79,200.00 -
- - -
PROGRAM P2 IMUNISASI - - -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
3 Safety Box Pcs - - - - - - 23,000.00 -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - - - - 45,100.00 -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - - - - 45,100.00 -
6 Vaksin Campak + Pelarut (10 dosis) vial - - - - - - 22,527.00 -
7 Vaksin Campak + Pelarut (20 dosis) vial - - - - - - 41,998.00 -
8 Vaksin DT Vial - - - - - - 14,487.00 -
9 Vaksin Hepatitis (HBO) ampul - - - - - - 18,750.00 -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - - - - - 23,782.00 -
11 Vaksin Polio + Droper (10 Dosis) Vial - - - - - - 16,203.00 -
12 Vaksin Polio IPV 5 Dosis Vial - - - - - - 137,610.00 -
13 Vaksin Td vial - - - - - - 14,250.00 -
14 Vaksin TT Vial - - - - - - 11,913.00 -
15 Vaksin DPT HB HIB Vial - - - - - - 43,900.00 -
- - -
PROGRAM P2 TB - - - - - - -
1 Box Slides pcs - - - - - - 100,000.00 -
2 Bunsen Stainlestell ktk - - - - - - 82,500.00 -
3 FDC I ktk - - - - - - 395,900.00 -
4 FDC I & III ktk - - - - - - 396,000.00 -
5 FDC II siklus - - - - - - 1,379,984.00 -
6 Kaca Ose siklus - - - - - - 265,000.00 -
7 Kombipak kategori 1 ktk - - - - - - 317,015.00 -
8 Lampu Spritus siklus - - - - - - 69,000.00 -
9 Obat antituberkolosis Kategori Anak siklus - - - - - - 247,229.00 -
10 Obat antituberkolosis Kategori sisipan ktk - - - - - - 176,000.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
11 Pot Sputum ktk - - - - - - 2,930.00 -
12 Reagen Zn Neilson set - - - - - - 236,500.00 -
13 Slide mikroskop kotak - - - - - - 27,500.00 -
14 Spritus Botol - - - - - - 27,500.00 -
15 Masker N-95 pcs - - - - - - 21,420.00 -
16 Mikroskop Binoculer unit - - - - 1.00 -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - - - - 1.00 -
- - - -
1 Zn Tablet 500 mg Tablet - - - - - - 512.00 -
- - -
PROGRAM P2 KUSTA - - -
1 MDT MB Anak Strip - - - - - - 14,862.00 -
2 MDT MB Dewasa Strip - - - - - - 30,595.00 -
3 MDT PB Anak Strip - - - - - - 7,462.00 -
4 MDT PB Dewasa Strip - - - - - - 8,323.00 -
- - -
PROGRAM KIA - - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - - - - 2,298.00 -
2 Obat Suntik KB 1 Bulan @ 20 vial vial - - - - - - 6,249.95 -
3 Obat Suntik KB 3 Bulan @ 20 vial vial - - - - - - 6,249.95 -
4 Gluconas Calsicus vial - - - - - - 1.00 -
- - -
REAGEN LABORATORIUM - - -
1 Alkohol 70 % @ 1000 ml Botol - - - - - - 24,222.22 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
2 Alkohol 70% @ 100 ml Botol - - - - - - 2,625.00 -
3 Alkohol 95 % @ 1000 ml botol - - - - - - 48,400.00 -
4 Alkohol Swab @ 100 pcs Kotak - - - - - - 128.97 -
5 Coumbour 10 Parameter botol - - - - - - 220,000.00 -
6 EDTA 10 % botol - - - - - - 66,000.00 -
7 Gliserin Botol - - - - - - 5,203.00 -
8 Gluko dr Stik @ 25 Stik botol - - - - - - 309,500.00 -
9 Golongan Darah Test set - - - - - - 385,000.00 -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - - - - 618,750.00 -
11 Larutan Anisol botol - - - - - - 120,000.00 -
12 Larutan Asam Asetat 6% botol - - - - - - 20,400.00 -
13 Larutan Asam Sulfosalilisat botol - - - - - - 69,300.00 -
14 Larutan Barium Klorida 10 % botol - - - - - - 11,000.00 -
15 Larutan Benedict Botol - - - - - - 75,625.00 -
16 Larutan Buffer Ph botol - - - - - - 61,250.00 -
17 Larutan Carbol Gentian Violet botol - - - - - - 70,000.00 -
18 Larutan Drabkin Botol - - - - - - 122,195.00 -
19 Larutan Eosin 2 % Botol - - - - - - 230,000.00 -
20 Larutan Etanol Asam Botol - - - - - - 41,700.00 -
21 Larutan Foucet botol - - - - - - 199,100.00 -
22 Larutan Giemsa Stain Botol - - - - - - 77,500.00 -
23 Larutan H2SO4 p Botol - - - - - - 41,255.00 -
24 Larutan HCl 0,1% botol - - - - - - 8,470.00 -
25 Larutan HNO3 P Botol - - - - - - 55,000.00 -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - - - - 28,400.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
27 Larutan KOH 10 % Botol - - - - - - 44,550.00 -
28 Larutan Metelin Biru Botol - - - - - - 20,900.00 -
29 Larutan Turk Botol - - - - - - 17,900.00 -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - - - - 64,300.00 -
31 Metanol Botol - - - - - - 30,400.00 -
32 Na Citrat 3,8 % botol - - - - - - 8,000.00 -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - - - - 150,000.00 -
34 Nesco Glucose Stik @ 25 Stik Botol - - - - - - 103,400.00 -
35 Nesco HB Stik @ 25 Botol - - - - - - 148,500.00 -
36 Nesco Uric Acid Stik @ 25 Stik botol - - - - - - 82,500.00 -
37 Oli Emersi botol - - - - - - 313,500.00 -
38 Rees Ecker botol - - - - - - 74,800.00 -
39 Trigeliserida Botol - - - - - - 418,000.00 -
40 Water Steril 500 ml Botol - - - - - - 5,500.00 -
41 Water Steril 1000 ml Botol - - - - - - 24,750.00 -
42 widal Test Set - - - - - - 440,000.00 -
43 Xylol botol - - - - - - 27,500.00 -
44 Sungkup Bayi Pcs - - - - - - 220,000.00 -
45 NGT All Item Pcs - - - - - - 1.00 -
46 PP 3 juta Injeksi vial - - - - - - 1.00 -
47 Progesteron Injeksi Vial - - - - - - 1.00 -
48 Iodiom Test Pcs - - - - - - 1.00 -
49 Mineral Mix Bks - - - - - - 2,475.00 -
50 Eksavator Double Ended Pcs - - - - - - 1.00 -
51 Asetamivir tab Tablet - - - - - - 1.00 -
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
52 Natrium Tiroksin Pcs - - - - - - 1.00 -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - - - - 1.00 -
54 Stick Hemosmart Pcs - - - - - - 1.00 -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - - - - 1.00 -
56 Lab.Kit Paket - - - - - - 1.00 -
57 Blue Tips bks - - - - - - 105,875.00 -
58 Yellow Tips bks - - - - - - 139,700.00 -
59 Deck Glass ktk - - - - - - 38,500.00 -
60 Micro Hematokrit / Tabung Hematokrit pcs - - - - - - 363.00 -
61 Tissue Lensa bks - - - - - - 48,400.00 -
62 Stik HB Family Dr ktk - - - - - - 357,500.00 -
63 Tabung EDTA K3/Vacutainer pcs - - - - - - 1,507.00 -
64 Glukosa Stik Performa Accu Check kotak - - - - - - 420,000.00 -
67 Glukosa Stik Active Accu Check Kotak - - - - - - 170,500.00 -
68 Kertas saring (isi 100 lbr) bks - - - - - - 53,900.00 -
69 Lidi Sputum (100 pcs) bks - - - - - - 36,300.00 -
70 Cotton Swab pcs - - - - - - 7,700.00 -
71 Specullum pcs - - - - - - 1,000.00 -
TOTAL -
UMUM
BAYAR
BAYAR
PUSKESMAS : BINUANG
1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima

Kepala Puskesmas Apoteker Pengelola Obat Puskesdes Raya Belanti
Binuang, Puskesmas Binuang Puskesmas Binuang,
Isrok Antariksa, SKM, M.Kes Mahdalena, S. Farm., Apt Bayu Hermawan Prasetyo Muryanto, A. Md. Kep
NIP.19690928 198902 1 001 NIP. 19830909 201001 2 032 NIP. 19850701 201101 1 008
KODE PUSKESMAS :
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
TABLET
7 mg @ 100 Tab Tablet - - - - - -
- - -
SIRUP - - -
- - -
INJEKSI - - -
- - -
INFUS - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
OBAT GIGI - - -
- - -
9 Infusion set dewasa Pcs - - - - - -
10 jarum @ 36 pcs Pcs - - - - - -
- - -
OBAT SANGAT ESENSIAL & ESENSIAL - - -
TABLET - - -
7 100 Tab Tablet - - - - - -
8 100 Tab Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
21 100 Tab Tablet - - - - - -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - - - -
35 Tab Tablet - - - - - -
40 Tab Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
SIRUP - - -
- - -
INJEKSI - - -
7 Amp Ampul - - - - - -
14 100 Amp Ampul - - - - - -
15 Amp Ampul - - - - - -
- - -
SALEP - - -
1 endapan 4 % @ 24 Pot Pot - - - - - -
- - -
SALEP MATA - - -
- - -
TETES MATA - - -
- - -
TETES TELINGA - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
OBAT LUAR - - -
- - -
OBAT GIGI - - -
- - -
- - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
Codein Tablet 20 mg Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
SIRUP - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
INJEKSI - - -
Ampul
11 Ampul - - - - - -
Vial
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
INFUS - - -
1 KAEN 3A fls - - - - - -
2 KAEN 3B fls - - - - - -
3 Glukosa 5% + 1/4 NS fls - - - - - -
4 Glukosa 5% + 1/2 NS fls - - - - - -
- - -
SALEP/KRIM - - -
- - -
SALEP MATA - - -
- - -
TETES MATA - - -
- - -
TETES HIDUNG - - -
- - -
TETES TELINGA - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
- - -
1 Bisturi @ 100 pcs pcs - - - - - -
4 EKG Paper 80 x 30 Roll - - - - - -
5 EKG Paper 40 x 30 Roll - - - - - -
16 Hypapix 5 x 1 m roll - - - - - -
24 Masker @ 100 pcs pcs - - - - - -
27 Optiva No. 20 @ 50 pcs pcs - - - - - -
28 Paket P3K pcs - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
31 Surflo No. 20 @ 50 pcs pcs - - - - - -
32 Surflo No. 22 @ 50 pcs pcs - - - - - -
33 Surflo No. 24 @ 50 pcs pcs - - - - - -
- - -
OBAT PROGRAM - - -
1 Abate kg - - - - - -
- - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
PROGRAM P2 TB - - - - - -
3 FDC I ktk - - - - - -
4 FDC I & III ktk - - - - - -
15 Masker N-95 pcs - - - - - -
- - - -
- - -
- - -
PROGRAM KIA - - -
- - -
1 Alkohol 70 % @ 1000 ml Botol - - - - - -
2 Alkohol 70% @ 100 ml Botol - - - - - -
3 Alkohol 95 % @ 1000 ml botol - - - - - -
6 EDTA 10 % botol - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
32 Na Citrat 3,8 % botol - - - - - -
43 Xylol botol - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
LB 2
ermintaan : Oktober / November

: 2017

BON
11 12 13 (11 X 12) 14 15
207.00 -
233.00 -
317.00 -
275.00 -
1,155.00 -
93.50 -
520.30 -
77.00 -
158.00 -
641.00 -
105.00 -
318.00 -
125.00 -
246.40 -
2,200.00 -
2,225.00 -
1,740.00 -
2,604.90 -
1,056.00 -
2,354.00 -
6,820.00 -
2,122.00 -
1,900.00 -
520,300.00 -
193,470.80 -
139,150.00 -
401,092.00 -
174,500.00 -
170,000.00 -
6,270.00 -
1,597.60 -
6,900.00 -
7,150.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
6,410.00 -
103,536.00 -
293,498.00 -
99,000.00 -
185,900.00 -
306,427.00 -
242,000.00 -
56,441.40 -
137,853.00 -
93,500.00 -
408,792.00 -
14,053.63 -
158,042.00 -
1,540.00 -
957.00 -
2,049.00 -
7,201.04 -
7,201.04 -
8,896.88 -
7,286.25 -
7,920.00 -
7,920.00 -
5,743.86 -
95.00 -
86.00 -
123.00 -
163.90 -
64.00 -
149.00 -
96.80 -
157.30 -
120.00 -
66.00 -
48.00 -
46.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
52.80 -
108.00 -
146.00 -
80.00 -
100.00 -
64.83 -
257.40 -
456.50 -
796.00 -
84.00 -
126.00 -
108.00 -
224.00 -
62.00 -
76.00 -
105.00 -
171.00 -
121.00 -
133.00 -
98.00 -
169.00 -
306.00 -
47.50 -
162.00 -
39.93 -
1,129.30 -
231.00 -
169.00 -
98.00 -
15.73 -
857.00 -
602.00 -
34.51 -
136.00 -
114.00 -
351.00 -
82.00 -
114.00 -
167.20 -
325.00 -
91.00 -
97.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
132.00 -
2,300.00 -
1,573.00 -
3,740.00 -
1,119.00 -
4,204.00 -
1,345.00 -
5,800.00 -
1,210.00 -
20,857.00 -
1,930.00 -
1,914.00 -
1,210.00 -
724.00 -
2,800.00 -
3,500.00 -
1,527.70 -
2,970.00 -
1,226.00 -
843.33 -
2,200.00 -
2,712.00 -
1,435.00 -
2,767.00 -
4,782.00 -
1,640.00 -
3,549.00 -
1,759.00 -
2,246.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
3,502.00 -
5,500.00 -
2,178.00 -
6,529.00 -
2,344.00 -
15,950.00 -
1,066.00 -
20,815.00 -
14,187.50 -
1,984.03 -
8,739.41 -
2,740.50 -
760.91 -
6,071.00 -
25,987.00 -
272.00 -
628.46 -
258.74 -
2,200.00 -
990.00 -
155.30 -
163.00 -
105.00 -
5,283.00 -
173.00 -
139.00 -
150.00 -
113.00 -
1,540.00 -
123.00 -
170.00 -
230.00 -
695.00 -
121.00 -
69.00 -
72.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
564.00 -
557.00 -
899.00 -
154.00 -
115.50 -
298.00 -
1,120.00 -
630.00 -
-
1.00 -
126.00 -
107.00 -
250.00 -
133.00 -
509.00 -
766.00 -
1,210.00 -
1,100.00 -
683.00 -
245.00 -
296.00 -
1,925.00 -
292.00 -
660.00 -
405.00 -
4,813.00 -
341.00 -
581.00 -
410.00 -
660.00 -
90.00 -
170.00 -
726.00 -
462.00 -
292.60 -
495.00 -
118.50 -
1,026.00 -
230.00 -
140.00 -
100.00 -
102.00 -
220.00 -
560.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
167.00 -
193.00 -
440.00 -
123.00 -
700.00 -
164.00 -
125.00 -
7,700.00 -
1,485.00 -
360.80 -
97.02 -
102.37 -
85.00 -
242.00 -
119.00 -
286.00 -
505.00 -
68.00 -
84.00 -
58.00 -
135.00 -
252.00 -
1,525.00 -
350.00 -
100.00 -
73.73 -
88.00 -
615.38 -
2,680.00 -
3,791.00 -
4,147.00 -
21,450.00 -
16,500.00 -
12,760.00 -
20,352.00 -
3,594.00 -
6,050.00 -
6,285.00 -
7,960.00 -
7,756.00 -
3,180.00 -
17,939.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
8,090.00 -
19,250.00 -
16,500.00 -
11,550.00 -
24,200.00 -
2,560.00 -
4,000.00 -
14,500.00 -
12,450.00 -
33,000.00 -
5,830.00 -
3,800.00 -
2,750.00 -
12,980.00 -
22,000.00 -
24,200.00 -
10,902.00 -
7,354.00 -
38,500.00 -
32,120.00 -
5,980.00 -
64,350.00 -
20,350.00 -
11,700.00 -
6,500.00 -
14,972.60 -
5,610.00 -
2,536.00 -
9,350.00 -
11,000.00 -
33,000.00 -
3,578.00 -
10,219.00 -
2,012.00 -
3,415.00 -
4,950.00 -
6,610.80 -
10,790.00 -
5,555.00 -
8,800.00 -
6,600.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
5,500.00 -
9,570.00 -
2,400.00 -
14,509.10 -
3,300.00 -
17,088.00 -
1,600.00 -
2,680.00 -
4,000.00 -
40,000.00 -
875.00 -
10,000.00 -
10,050.00 -
9,350.00 -
9,400.00 -
2,997.00 -
13,200.00 -
1,835.16 -
4,300.00 -
2,605.00 -
3,737.00 -
12,100.00 -
1,649.36 -
19,058.00 -
12,155.00 -
1,640.00 -
22,000.00 -
26,812.00 -
4,600.00 -
2,750.00 -
11,500.00 -
30,305.00 -
36,000.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
35,145.00 -
23,100.00 -
5,800.00 -
5,670.00 -
1,899.00 -
18,458.00 -
12,749.00 -
80,000.00 -
73,443.75 -
66,000.00 -
5,430.00 -
770.00 -
221.00 -
16,500.00 -
45,375.00 -
27,500.00 -
10,318.00 -
9,080.00 -
737.74 -
4,675.00 -
4,675.00 -
4,675.00 -
6,325.00 -
6,325.00 -
6,325.00 -
6,050.00 -
12,650.00 -
24,200.00 -
24,200.00 -
119,174.19 -
1,957.50 -
7,480.40 -
3,960.00 -
1,210.00 -
425.60 -
660.00 -
660.00 -
15,400.00 -
311,900.00 -
1,393.90 -
: 2017

BON
11 12 13 (11 X 12) 14 15
5,693.00 -
8,355.00 -
8,355.00 -
8,355.00 -
1,564.20 -
27,500.00 -
3,404.00 -
320,000.00 -
2,145.00 -
2,145.00 -
440,000.00 -
330,000.00 -
99,220.00 -
36,300.00 -
3,566.78 -
14,868.83 -
125,400.00 -
38,999.00 -
387,800.00 -
1.00 -
57,200.00 -
55,000.00 -
40,700.00 -
66,000.00 -
79,200.00 -
1,900.00 -
1,448.00 -
23,000.00 -
45,100.00 -
45,100.00 -
22,527.00 -
41,998.00 -
14,487.00 -
18,750.00 -
23,782.00 -
16,203.00 -
137,610.00 -
14,250.00 -
11,913.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
43,900.00 -
-
100,000.00 -
82,500.00 -
395,900.00 -
396,000.00 -
1,379,984.00 -
265,000.00 -
317,015.00 -
69,000.00 -
247,229.00 -
176,000.00 -
2,930.00 -
236,500.00 -
27,500.00 -
27,500.00 -
21,420.00 -
1.00 -
1.00 -
512.00 -
14,862.00 -
30,595.00 -
7,462.00 -
8,323.00 -
2,298.00 -
6,249.95 -
6,249.95 -
1.00 -
24,222.22 -
2,625.00 -
48,400.00 -
128.97 -
220,000.00 -
66,000.00 -
5,203.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
309,500.00 -
385,000.00 -
618,750.00 -
120,000.00 -
20,400.00 -
69,300.00 -
11,000.00 -
75,625.00 -
61,250.00 -
70,000.00 -
122,195.00 -
230,000.00 -
41,700.00 -
199,100.00 -
77,500.00 -
41,255.00 -
8,470.00 -
55,000.00 -
28,400.00 -
44,550.00 -
20,900.00 -
17,900.00 -
64,300.00 -
30,400.00 -
8,000.00 -
150,000.00 -
103,400.00 -
148,500.00 -
82,500.00 -
313,500.00 -
74,800.00 -
418,000.00 -
5,500.00 -
24,750.00 -
440,000.00 -
27,500.00 -
220,000.00 -
1.00 -
1.00 -
1.00 -
1.00 -
2,475.00 -
1.00 -
1.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
1.00 -
1.00 -
KODE PUSKESMAS :
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
TABLET
7 mg @ 100 Tab Tablet - - - - - -
- - -
SIRUP - - -
- - -
INJEKSI - - -
- - -
INFUS - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
OBAT GIGI - - -
- - -
9 Infusion set dewasa Pcs - - - - - -
10 jarum @ 36 pcs Pcs - - - - - -
- - -
OBAT SANGAT ESENSIAL & ESENSIAL - - -
TABLET - - -
7 100 Tab Tablet - - - - - -
8 100 Tab Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
21 100 Tab Tablet - - - - - -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - - - -
35 Tab Tablet - - - - - -
40 Tab Tablet - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
SIRUP - - -
- - -
INJEKSI - - -
7 Amp Ampul - - - - - -
14 100 Amp Ampul - - - - - -
15 Amp Ampul - - - - - -
- - -
SALEP - - -
1 endapan 4 % @ 24 Pot Pot - - - - - -
- - -
SALEP MATA - - -
- - -
TETES MATA - - -
- - -
TETES TELINGA - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
OBAT LUAR - - -
- - -
OBAT GIGI - - -
- - -
- - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
SIRUP - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
INJEKSI - - -
Ampul
11 Ampul - - - - - -
Vial
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
INFUS - - -
1 KAEN 3A fls - - - - - -
2 KAEN 3B fls - - - - - -
3 Glukosa 5% + 1/4 NS fls - - - - - -
4 Glukosa 5% + 1/2 NS fls - - - - - -
- - -
SALEP/KRIM - - -
- - -
SALEP MATA - - -
- - -
TETES MATA - - -
- - -
TETES HIDUNG - - -
- - -
TETES TELINGA - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
- - -
1 Bisturi @ 100 pcs pcs - - - - - -
4 EKG Paper 80 x 30 Roll - - - - - -
5 EKG Paper 40 x 30 Roll - - - - - -
16 Hypapix 5 x 1 m roll - - - - - -
24 Masker @ 100 pcs pcs - - - - - -
27 Optiva No. 20 @ 50 pcs pcs - - - - - -
28 Paket P3K pcs - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
31 Surflo No. 20 @ 50 pcs pcs - - - - - -
32 Surflo No. 22 @ 50 pcs pcs - - - - - -
33 Surflo No. 24 @ 50 pcs pcs - - - - - -
- - -
OBAT PROGRAM - - -
1 Abate kg - - - - - -
- - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
- - -
PROGRAM P2 TB - - - - - -
3 FDC I ktk - - - - - -
4 FDC I & III ktk - - - - - -
15 Masker N-95 pcs - - - - - -
- - - -
- - -
- - -
PROGRAM KIA - - -
- - -
1 Alkohol 70 % @ 1000 ml Botol - - - - - -
2 Alkohol 70% @ 100 ml Botol - - - - - -
3 Alkohol 95 % @ 1000 ml botol - - - - - -
6 EDTA 10 % botol - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
32 Na Citrat 3,8 % botol - - - - - -
43 Xylol botol - - - - - -
PUSKESMAS : BINUANG

1 2 3 4 5 6=(4+5) 7 8 = (6-7) 9 10
54 Stick Hemosmart Pcs - - - - - -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - - - -
56 Lab.Kit Paket - - - - - -
57 Blue Tips bks - - - - - -
58 Yellow Tips bks - - - - - -
59 Deck Glass ktk - - - - - -
60 Micro Hematokrit / Tabung Hematokrit pcs - - - - - -
61 Tissue Lensa bks - - - - - -
62 Stik HB Family Dr ktk - - - - - -
63 Tabung EDTA K3/Vacutainer pcs - - - - - -
64 Glukosa Stik Performa Accu Check kotak - - - - - -
67 Glukosa Stik Active Accu Check Kotak - - - - - -
68 Kertas saring (isi 100 lbr) bks - - - - - -
69 Lidi Sputum (100 pcs) bks - - - - - -
70 Cotton Swab pcs - - - - - -
71 Specullum pcs - - - - - -
72 Eter Alkohol Botol Err:509 - Err:509 Err:509 - Err:509
TOTAL
UMUM
BAYAR
BAYAR
Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor

Kepala Dinas Kesehatan Kepala Instalasi Farmasi Kepala Puskesmas
Kab. Tapin Kab. Tapin Binuang,
H.Errani Martin,SKM.MM Septi Heryani, S. Farm, Apt Isrok Antariksa, SKM, M.Kes
NIP.19640314 198802 1 002 NIP 19890919 201402 2 006 NIP.19690928 198902 1 001
LB 2
ermintaan : November / Desember

: 2017

BON
11 12 13 (11 X 12) 14 15
207.00 -
233.00 -
317.00 -
275.00 -
1,155.00 -
93.50 -
520.30 -
77.00 -
158.00 -
641.00 -
105.00 -
318.00 -
125.00 -
246.40 -
2,200.00 -
2,225.00 -
1,740.00 -
2,604.90 -
1,056.00 -
2,354.00 -
6,820.00 -
2,122.00 -
1,900.00 -
520,300.00 -
193,470.80 -
139,150.00 -
401,092.00 -
174,500.00 -
170,000.00 -
6,270.00 -
1,597.60 -
6,900.00 -
7,150.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
6,410.00 -
103,536.00 -
293,498.00 -
99,000.00 -
185,900.00 -
306,427.00 -
242,000.00 -
56,441.40 -
137,853.00 -
93,500.00 -
408,792.00 -
14,053.63 -
158,042.00 -
1,540.00 -
957.00 -
2,049.00 -
7,201.04 -
7,201.04 -
8,896.88 -
7,286.25 -
7,920.00 -
7,920.00 -
5,743.86 -
95.00 -
86.00 -
123.00 -
163.90 -
64.00 -
149.00 -
96.80 -
157.30 -
120.00 -
66.00 -
48.00 -
46.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
52.80 -
108.00 -
146.00 -
80.00 -
100.00 -
64.83 -
257.40 -
456.50 -
796.00 -
84.00 -
126.00 -
108.00 -
224.00 -
62.00 -
76.00 -
105.00 -
171.00 -
121.00 -
133.00 -
98.00 -
169.00 -
306.00 -
47.50 -
162.00 -
39.93 -
1,129.30 -
231.00 -
169.00 -
98.00 -
15.73 -
857.00 -
602.00 -
34.51 -
136.00 -
114.00 -
351.00 -
82.00 -
114.00 -
167.20 -
325.00 -
91.00 -
97.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
132.00 -
2,300.00 -
1,573.00 -
3,740.00 -
1,119.00 -
4,204.00 -
1,345.00 -
5,800.00 -
1,210.00 -
20,857.00 -
1,930.00 -
1,914.00 -
1,210.00 -
724.00 -
2,800.00 -
3,500.00 -
1,527.70 -
2,970.00 -
1,226.00 -
843.33 -
2,200.00 -
2,712.00 -
1,435.00 -
2,767.00 -
4,782.00 -
1,640.00 -
3,549.00 -
1,759.00 -
2,246.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
3,502.00 -
5,500.00 -
2,178.00 -
6,529.00 -
2,344.00 -
15,950.00 -
1,066.00 -
20,815.00 -
14,187.50 -
1,984.03 -
8,739.41 -
2,740.50 -
760.91 -
6,071.00 -
25,987.00 -
272.00 -
628.46 -
258.74 -
2,200.00 -
990.00 -
155.30 -
163.00 -
105.00 -
5,283.00 -
173.00 -
139.00 -
150.00 -
113.00 -
1,540.00 -
123.00 -
170.00 -
230.00 -
695.00 -
121.00 -
69.00 -
72.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
564.00 -
557.00 -
899.00 -
154.00 -
115.50 -
298.00 -
1,120.00 -
630.00 -
-
1.00 -
126.00 -
107.00 -
250.00 -
133.00 -
509.00 -
766.00 -
1,210.00 -
1,100.00 -
683.00 -
245.00 -
296.00 -
1,925.00 -
292.00 -
660.00 -
405.00 -
4,813.00 -
341.00 -
581.00 -
410.00 -
660.00 -
90.00 -
170.00 -
726.00 -
462.00 -
292.60 -
495.00 -
118.50 -
1,026.00 -
230.00 -
140.00 -
100.00 -
102.00 -
220.00 -
560.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
167.00 -
193.00 -
440.00 -
123.00 -
700.00 -
164.00 -
125.00 -
7,700.00 -
1,485.00 -
360.80 -
97.02 -
102.37 -
85.00 -
242.00 -
119.00 -
286.00 -
505.00 -
68.00 -
84.00 -
58.00 -
135.00 -
252.00 -
1,525.00 -
350.00 -
100.00 -
73.73 -
88.00 -
615.38 -
2,680.00 -
3,791.00 -
4,147.00 -
21,450.00 -
16,500.00 -
12,760.00 -
20,352.00 -
3,594.00 -
6,050.00 -
6,285.00 -
7,960.00 -
7,756.00 -
3,180.00 -
17,939.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
8,090.00 -
19,250.00 -
16,500.00 -
11,550.00 -
24,200.00 -
2,560.00 -
4,000.00 -
14,500.00 -
12,450.00 -
33,000.00 -
5,830.00 -
3,800.00 -
2,750.00 -
12,980.00 -
22,000.00 -
24,200.00 -
10,902.00 -
7,354.00 -
38,500.00 -
32,120.00 -
5,980.00 -
64,350.00 -
20,350.00 -
11,700.00 -
6,500.00 -
14,972.60 -
5,610.00 -
2,536.00 -
9,350.00 -
11,000.00 -
33,000.00 -
3,578.00 -
10,219.00 -
2,012.00 -
3,415.00 -
4,950.00 -
6,610.80 -
10,790.00 -
5,555.00 -
8,800.00 -
6,600.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
5,500.00 -
9,570.00 -
2,400.00 -
14,509.10 -
3,300.00 -
17,088.00 -
1,600.00 -
2,680.00 -
4,000.00 -
40,000.00 -
875.00 -
10,000.00 -
10,050.00 -
9,350.00 -
9,400.00 -
2,997.00 -
13,200.00 -
1,835.16 -
4,300.00 -
2,605.00 -
3,737.00 -
12,100.00 -
1,649.36 -
19,058.00 -
12,155.00 -
1,640.00 -
22,000.00 -
26,812.00 -
4,600.00 -
2,750.00 -
11,500.00 -
30,305.00 -
36,000.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
35,145.00 -
23,100.00 -
5,800.00 -
5,670.00 -
1,899.00 -
18,458.00 -
12,749.00 -
80,000.00 -
73,443.75 -
66,000.00 -
5,430.00 -
770.00 -
221.00 -
16,500.00 -
45,375.00 -
27,500.00 -
10,318.00 -
9,080.00 -
737.74 -
4,675.00 -
4,675.00 -
4,675.00 -
6,325.00 -
6,325.00 -
6,325.00 -
6,050.00 -
12,650.00 -
24,200.00 -
24,200.00 -
119,174.19 -
1,957.50 -
7,480.40 -
3,960.00 -
1,210.00 -
425.60 -
660.00 -
660.00 -
15,400.00 -
311,900.00 -
1,393.90 -
: 2017

BON
11 12 13 (11 X 12) 14 15
5,693.00 -
8,355.00 -
8,355.00 -
8,355.00 -
1,564.20 -
27,500.00 -
3,404.00 -
320,000.00 -
2,145.00 -
2,145.00 -
440,000.00 -
330,000.00 -
99,220.00 -
36,300.00 -
3,566.78 -
14,868.83 -
125,400.00 -
38,999.00 -
387,800.00 -
1.00 -
57,200.00 -
55,000.00 -
40,700.00 -
66,000.00 -
79,200.00 -
1,900.00 -
1,448.00 -
23,000.00 -
45,100.00 -
45,100.00 -
22,527.00 -
41,998.00 -
14,487.00 -
18,750.00 -
23,782.00 -
16,203.00 -
137,610.00 -
14,250.00 -
11,913.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
43,900.00 -
-
100,000.00 -
82,500.00 -
395,900.00 -
396,000.00 -
1,379,984.00 -
265,000.00 -
317,015.00 -
69,000.00 -
247,229.00 -
176,000.00 -
2,930.00 -
236,500.00 -
27,500.00 -
27,500.00 -
21,420.00 -
1.00 -
1.00 -
512.00 -
14,862.00 -
30,595.00 -
7,462.00 -
8,323.00 -
2,298.00 -
6,249.95 -
6,249.95 -
1.00 -
24,222.22 -
2,625.00 -
48,400.00 -
128.97 -
220,000.00 -
66,000.00 -
5,203.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
309,500.00 -
385,000.00 -
618,750.00 -
120,000.00 -
20,400.00 -
69,300.00 -
11,000.00 -
75,625.00 -
61,250.00 -
70,000.00 -
122,195.00 -
230,000.00 -
41,700.00 -
199,100.00 -
77,500.00 -
41,255.00 -
8,470.00 -
55,000.00 -
28,400.00 -
44,550.00 -
20,900.00 -
17,900.00 -
64,300.00 -
30,400.00 -
8,000.00 -
150,000.00 -
103,400.00 -
148,500.00 -
82,500.00 -
313,500.00 -
74,800.00 -
418,000.00 -
5,500.00 -
24,750.00 -
440,000.00 -
27,500.00 -
220,000.00 -
1.00 -
1.00 -
1.00 -
1.00 -
2,475.00 -
1.00 -
1.00 -
: 2017

BON
11 12 13 (11 X 12) 14 15
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
105,875.00 -
139,700.00 -
38,500.00 -
363.00 -
48,400.00 -
357,500.00 -
1,507.00 -
420,000.00 -
- -
- -
170,500.00 -
53,900.00 -
36,300.00 -
7,700.00 -
1,000.00 -
78,100.00 -
-
Yang Menerima
Pengelola Obat
Puskesmas Binuang,
Mahdalena, S. Farm., Apt

NIP 19830909 201001 2 032
- - - 1,129.3
#REF!
Pemerintah Kabupaten T
INVENTARISASI POS-POS NERACA TA
Per 31 Desember 201
Pos : PERSEDIAAN - (b) Barang atau perlengkapan (Supplies) yang digun
Nama SKPD : Dinas Kesehatan (Puskesmas BINUANG)

Tahun
Peroleha LOKASI
No Jenis dan Nama Barang Sumber Dana n/ Satuan PUSLIN
Pembelia PKM PUSTU
G
n

TABLET
1 Amoksisilin kaplet 250 mg DAK-e SST 2016 Kaplet
DAK-e IGM 2014 Kaplet
2 Amoksisilin kaplet 500 mg DAK-e IGM 2014 Kaplet

DAK-e MUP 2015 Kaplet 1005
DAK-e KF 2016 Kaplet
JKN 2016 Kaplet 15600
3 Garam Oralit untuk 200 ml air PROGRAM 2016 sacchet

PROGRAM 2016 sacchet
PROGRAM 2016 sacchet 245
JKN 2016 sacchet 400
4 Kloramfenikol kapsul 250 mg PROV 2015 kapsul
5 Kloramfenikol kapsul 500 mg PROV 2016 kapsul
6 Klorokuin tablet 150 mg Tablet

Kombinasi pirimetamin 25 mg +
7 Tablet
sulfadoksin 500 mg
8 Kotrimoksazole tablet komb. 120 mg Tablet
9 Kotrimoksazole tablet komb. 480 mg DAK-e SST 2016 Tablet 240

DAK-e KF 2015 Tablet
DAK-e SST 2014 Tablet
JKN 2016 Tablet 400
10 Kuinin (kina) tablet 200 mg Tablet
11 Parasetamol tablet 500 mg DAK-e MUP 2016 Tablet 1487 90 100

DAK-e MUP 2016 Tablet
12 Pirantel tablet 125 mg PROV 2015 Tablet 100

PROV 2014 Tablet
DAK 2012 Tablet
13 Prednison tablet 5 mg PROV 2016 Tablet

PROV 2016 Tablet 300
PROV 2016 Tablet
DAK-L RNI 2014 Tablet
14 Primakuin tablet 15 mg DAK-L RNI 2014 Tablet 64

SIRUP
1 Amoksisilin sirup kering 125 mg / 5 ml DAK-e SST 2016 Botol 32
DAK-e SST 2016 Botol
DAK-e IGM 2015 Botol
DAK 2014 Botol
JKN 2016 Botol 330
2 Kotrimoksazole (Etamoxul) suspensi kombDAK-e SST 2016 Botol

DAK-e SBF 2015 Botol 4
DAK-e SBF 2015 Botol
INJEKSI
1 Deksametason inj.5 mg / ml -1 ml PROV 2016 Ampul
DAK-e IGM 2015 Ampul
PROV 2014 Ampul
DAK 2013 Ampul 11
2 Diazepam Injeksi 5 mg/ ml - 2 ml PROGRAM 2013 Ampul 2
Difenhidramin HCL Injeksi 10

3 mg/ ml - 1 ml PROV 2014 Ampul
DAK 2013 Ampul
DAK 2013 Ampul
Efineprina HCl/Bitartat
4 (adrenalina ) Injeksi 0,1 % - 1
ml DAK-e PPG 2016 Ampul
PROV 2016 Ampul
PROV 2015 Ampul 25
5 Kuinin Dihidroklorida inj 25 % - 2 ml PROV 2014 Ampul
6 Lidokain Komp. Inj PROV 2016 Ampul

DAK-e SST 2016 Ampul
JKN 2016 Ampul 60
7 Oksitoksin injeksi 10 IU / ml - 1 ml DAK-e PPG 2016 Ampul
Serum Anti Bisa Ular Polivalen

8 Injeksi 5 ml (SABU I) PROV 2016 Vial
PROV 2015 Vial
Serum Anti Bisa Ular Polivalen

9 Injeksi 50 ml (SABU II) Vial
Serum Anti Difteri InjeKsi

10 20.000 IU (ADS) Vial
Serum Anti Tetanus Injeksi

11 1.500 IU (ATS) PROV 2016 Vial
Serum Anti Tetanus Injeksi

12 20.000 IU/amp (ATS) Vial
13 Vaksin Rabies Vero (VAR) PROV 2016 Vial
14 Tetagam DAK-e AAM 2015 Vial
INFUS
1 Glukosa Larutan infus 10 % steril PROV 2015 fls
PROV 2014 fls
DAK-e IGM 2014 fls
2 Glukosa Larutan infus 40 % steril DAK 2012 fls
3 Glukosa Larutan infus 5 % steril DAK-e IGM 2016 fls

PROV 2014 fls
4 Ringer laktat larutan infus steril DAK-e IGM 2016 fls 6

DAK-e RNI 2014 fls 20
5 Natrium Klorida infus 0.9 % steril DAK-e IGM 2016 fls
DAK-e IGM 2014 fls 3
DAK-e IGM 2014 fls
Obat Gigi PKD

1 Air raksa Dental Use
2 Devitalisasi pasta DAK-e COBRA 2016 ktk
3 Etil klorida semprot DAK-e KPP 2016 Botol

DAK-e KPP 2016 Botol 1
APBD BERKAH 2015 Botol
APBD DAK-L RNI 2014 Botol
4 Forinekresol (pengganti TKF) ktk
5 Glass Inomer Cement ( GC IX ) /ART DAK-e COBRA 2016 ktk

DAK-L 2014 ktk
6 Kalsium hidroksi pasta ktk
7 Klorfenol kamfer menthol (CHKM) DAK-e COBRA 2016 ktk

DAK-L RNI 2014 ktk
8 Mummiying Pasta ktk
9 Semen seng Fosfar serbuk & cairan ktk
10 Silver amalgam serbuk 65 - 75 % ktk
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs

12 Temporary Stoping Flecther serbuk & Cai DAK-e COBRA 2016 set
ALAT KESEHATAN PKD

1 Alat Suntik sekali pakai 1 ml DAK-e APL 2016 Pcs
PROV 2016 Pcs
2 Alat Suntik sekali pakai 2,5 / 3 ml DAK-e APL 2016 Pcs 155
DAK-e APL 2015 Pcs
DAK-e APL 2015 Pcs
DAK-e APL 2015 Pcs
3 Alat Suntik sekali pakai 5 ml PROGRAM 2016 Pcs

PROGRAM 2016 Pcs
DAK-e APL 2015 Pcs
PROGRAM 2015 Pcs 100
PROGRAM 2015 Pcs
4 Catgut Cromic No. 2/0 dengan jarum DAK-e KPP 2015 Pcs 3
DAK-e KPP 2015 Pcs
5 Catgut Cromic No. 3/0 dengan jarum DAK KPP 2015 Pcs
DAK 2012 Pcs
6 Catgut plain 2/0 dengan jarum DAK 2013 Pcs 3
7 Catgut Plain 3/0 dengan jarum PROV 2015 Pcs 4

PROV 2015 Pcs
DAK-E KPP 2014 Pcs
DAK 2013 Pcs
8 Infusion set anak DAK-e MUP 2016 Pcs

DAK-e MUP 2015 Pcs
DAK-e KALICA 2014 Pcs
PROV 2015 Pcs
9 Infusion set dewasa DAK-e MUP 2016 Pcs
DAK-e MUP 2016 Pcs
DAK-e MUP 2015 Pcs
PROV 2015 Pcs
PROV 2015 Pcs
Silk (benang bedah sutera) No.

10 3/0 dengan jarum DAK-e BERKAH 2016 Pcs
OBAT SANGAT ESENSIAL & ESENSIAL

1 Allupurinol tablet 100 mg DAK-e SST 2016 Tablet
DAK-e MBS 2015 Tablet 250
DAK-e MBS 2015 Tablet
2 Aminofillin tablet 200 mg PROV 2016 Tablet

PROV 2015 Tablet
3 Amitriptilin HCl tablet salut 25 mg PROV 2016 Tablet

PROV 2015 Tablet
PROV 2014 Tablet
4 Antalgin (metapiron) tablet 500 mg DAK 2012 Tablet
5 Antasida DOEN tab Komb. DAK-e MPI 2016 Tablet

DAK-e MPI 2016 Tablet
DAK-e IGM 2015 Tablet
DAK-e IGM 2015 Tablet 1848 40
DAK-e IGM 2014 Tablet 130
JKN 2016 Tablet 4000
6 Antimigrein DOEN Komb. DAK-e KF 2015 Tablet
Asam asetilsalisilat (asetosal)

7 tablet 100 mg Tablet
Asam asetilsalisilat (asetosal)
8 tablet 500 mg Tablet
9 Asam Askorbat ( Vit C ) Tablet 50 mg DAK-e KF 2016 Tablet 490
10 Atropin sulfat tablet 0.5 mg PUSAT Tablet
11 Deksametasone tablet 0.5 mg DAK-e 2016 Tablet

DAK-e 2016 Tablet 405 90
PROV 2015 Tablet
DAK-e 2014 Tablet
13 Diazepam tablet 2 mg PROV 2015 Tablet
14 Diazepam tablet 5 mg Tablet
15 Digoksin tablet 0.25 mg DAK-e RNI 2016 Tablet

DAK-e RNI 2014 Tablet
16 Fenitoin Na tablet 30 mg Tablet
17 Fenitoin Na tablet 100 mg DAK-e KF 2015 Tablet
18 Fenobarbital tablet 100 mg Tablet
19 Fenobarbital tablet 30 mg DAK-L 2014 Tablet
20 Fenoksimetil penicillin tablet 250 mg Tablet

Tablet
21 Fenoksimetil penicillin tablet 500 mg Tablet
Tablet
Fitominadion (Vit K) tablet salut

22 gula 10 mg DAK-e RNI 2016 Tablet
JKN 2016 Tablet 300
23 Furusemide tablet 40 mg PROV 2016 Tablet

PROV 2016 Tablet
24 Glibenklamide tablet 5 mg DAK-e KF 2015 Tablet

DAK-e KF 2015 Tablet 100
25 Gliserilguayakolat tablet 100 mg PROGRAM 2016 Tablet

26 Gresiofulvin tablet 125 mg Tablet 150

PROV 2016 Tablet
27 Haloperidol tablet 0,5 mg Tablet

PROV 2014 Tablet
28 Haloperidol tablet 1.5 mg Tablet

PROV 2013 Tablet
PROV 2015 Tablet 50
JKN 2016 Tablet 800
29 Haloperidol tablet 5 mg Tablet
30 Hidrokloriazide (HCT) Tablet 25 mg DAK-e 2016 Tablet

DAK 2013 Tablet
31 Ibuprofen tablet 200 mg DAK-e RNI 2015 Tablet

32 Ibupropen tablet 400 mg DAK-e KF 2016 Tablet

33 Isosorbit dinitrat tablet sublingual 5 mg PROV 2016 Tablet

PROV 2015 Tablet 90
DAK-e 2013 Tablet
34 Kalsium laktat (Kalk) tablet 500 mg DAK-e MUP 2016 Tablet 400
PROV 2016 Tablet
35 Karbamazepin tablet 200 mg PROV 2016 Tablet

Klorpeniramine Maleat (CTM)

36 tablet 4 mg DAK-e SST 2015 Tablet
DAK-e SST 2015 Tablet 940 80
37 Klorpromazine HCl tablet salut 25 mg Tablet

Tablet
38 Klorpromazine HCl tablet salut 100 mg DAK-e MUP 2016 Tablet

PROV 2016 Tablet
39 Magnesium sulfat serbuk 30 g Pot

Pot
40 Mebendazole tablet 100 mg Tablet

Tablet
Metilergometrin maleat tab.

41 Salut 0,25 mg Tablet
42 Metronidazol tablet 250 mg Tablet

PROV 2015 Tablet
43 Natrium Bicarbonat tablet 500 mg Tablet

Tablet
44 Nistatin tablet salut 500.000 IU Tablet

PROV 2016 Tablet
45 Nistatin tablet Vaginal 100.000 IU / g PROV 2016 Tablet

46 Parasetamol tablet 100 mg Tablet

Tablet
47 Piridoksin HCl ( Vit.B6) tablet 10 mg DAK-e KF 2016 Tablet
48 Propiltiourasil tablet 100 mg Tablet

49 Propanolol tablet 40 mg Tablet

DAK-e SST 2015 Tablet 90
50 Reserpine tablet 0.1 mg Tablet

Tablet
51 Reserpine tablet 0.25 mg DAK 2013 Tablet

DAK 2013 Tablet
52 Tetrasiklin HCl kapsul 250 mg Kapsul

Kapsul
53 Tetrasiklin HCl kapsul 500 mg DAK-e SST 2016 Kapsul

PROV 2016 Kapsul
PROV 2015 Kapsul
54 Tiamin (Vit B1)tablet mono 50 mg DAK-e SST 2016 Tablet

Tablet
55 Trihexlypenidil (Hexymer) tablet 2 mg Tablet

DAK-e MUP 2016 Tablet 70
APBD RNI 2015 Tablet 100
PROV 2015 Tablet
56 Vitamin B komplek tablet DAK-e KF 2016 Tablet

SIRUP
1 Antasida DOEN Suspensi Komb PROV 2016 Botol
2 Obat Batuk Hitam ( OBH ) cairan Botol
3 Mebendazole sirup 100 mg/ 5 ml Botol
4 Parasetamol sirup 120 mg / 5 ml DAK-e MPI 2016 Botol

DAK-e MPI 2016 Botol
DAK-e MPI 2016 Botol 39
JKN 2014 Botol 200
INJEKSI
1 Aminofillin Injeksi 24 mg / ml - 10 ml PROV 2015 Ampul
2 Antalgin injeksi 250 mg / ml 2 ml Ampul

Ampul
3 Aqua pro injeksi steril, bebas pirogen DAK 2013 Fls

DAK 2013 Fls
4 Atropin sulfat injeksi 0.25 mg/ml Ampul

Ampul
5 Fenitoin Na injeksi 50 mg / ml DAK-e MUP 2016 Ampul
6 Fenobarbital injeksi Ampul

DAK-e RNI 2014 Ampul
DAK-e RNI 2014 Ampul
Fitominadion (Vit K) injeksi 10

7 mg/ml - 1 ml Ampul
DAK-L RNI 2014 Ampul
Klorpromazine HCl Injeksi 25

8 mg/ ml - 2 ml Ampul
Klorpromazine HCl Injeksi 5

9 mg/ml - 2 ml Ampul
Ampul
Magnesium Sulfat inj (IV)20 %

10 ml - 25 ml Fls
DAK-e MUP 2015 Fls
Magnesium Sulfat inj (IV)40 %

11 ml - 25 ml Fls
DAK-e MUP 2015 Fls
Metilergometrin maleat injeksi

12 0.200 mg - 1 ml Ampul
APBD RNI 2014 Ampul
13 Natrium tiosulfat 25 % 10 ml Ampul
Sianokobalamin injeksi(Vit B12)

14 500 mcg - ml Ampul
DAK-e SST 2016 Ampul
DAK-L RNI 2014 Ampul 15
DAK-L RNI 2014 Ampul
Tiamin HCl (Vit B1)inj 100 mg/

15 ml - 1 ml Ampul
Ampul
SALEP
Salep 2 - 4 :komb Asam salisilat

1 Pot
2 % + Belerang endapan 4 %
PROV 2015 Pot 7
2 Hidrokortisone krim 2.5 % Tube

DAK-e KF 2016 Tube 10
DAK-e KF 2015 Tube
3 Betametasone krim 0.1 % DAK-e SST 2016 Tube

DAK-e SST 2016 Tube
4 Antibakteri DOEN Komb. Pot

DAK-e IGM 2014 Pot
5 Antifungi DOEN Komb. DAK-e SST 2016 Pot

Pot
SALEP MATA
1 Oksitetrasiklin HCl Salep Mata 1 % Tube
Tube
TETES MATA
1 Sulfasetamida Natrium TM 15 % Botol
Botol
TETES TELINGA
1 Kloramfenikol Tetes Telinga 3 % Botol
Botol
2 Fenol gliserol tetes telinga 10 % DAK-e IGM 2015 Botol

JKN 2016 Botol 35
OBAT LUAR
1 Antihemoroid DOEN Supp komb. Supp
DAK-e KF 2016 Supp 10
DAK-e KF 2016 Supp
2 Etakridin (Rivanol) Larutan 0.1 % DAK BERKAH 2015 Botol

DAK BERKAH 2015 Botol
3 Gentian violet larutan 1 % Botol

4 Kalium Permanghanat serbuk PROV 2009 Botol

PROV 2009 Botol
5 Povidon Iodida 10 % 30 ml DAK-e SST 2015 Botol 5

PROV 2015 Botol
6 Povidon Iodida 10 % 300 ml DAK 2011 Botol

DAK 2011 Botol
7 Salisilat Bedak 2 % DAK-e SST 2016 Kotak

DAK-e SST 2016 Kotak
DAK-e SST 2016 Kotak
DAK 2013 Kotak
DAK-e IGM 2015 Kotak
DAK-e IGM 2015 Kotak 8
OBAT GIGI
1 Eugenol cairan Botol
DAK-e KF 2016 Botol
DAK-e KF 2015 Botol
ALAT KESEHATAN
1 Kapas pembalut/Adsorben 250 mg DAK-e KPP 2016 Rol 2
DAK-e KPP 2016 Rol
DAK-e IGM 2015 Rol
DAK-e IGM 2015 Rol
2 Kasa kompres 40 / 40 steril Bks

APBD 2013 Bks
DAK-e IGM 2015 Bks 1
3 Kasa pembalut 2 m x 80 cm DAK-e KPP 2016 Rol

DAK 2011 Rol
Kasa pembalut Hidrofil 4 x 15

4 cm elastic DAK-e KALICA 2014 Rol
DAK-e KALICA 2014 Rol
5 Kasa pembalut Hidrofil 4 x 3 cm elastic DAK-e KPP 2015 Rol

PROV 2015 Rol
DAK-e KALICA 2014 Rol
6 Pembalut gips Rol

Rol
7 Plester 5 yard x 2 inch APBD RNI 2014 Rol

APBD RNI 2014 Rol
OBAT PENUNJANG
1 Acyclovir tablet 200 mg Tablet
PROV 2015 Tablet
2 Acyclovir tablet 400 mg DAK 2012 Tablet 100

DAK 2012 Tablet
3 Albendazole tablet 400 mg PUSAT 2016 Tablet

PROV 2015 Tablet
PUSAT 2014 Tablet
PUSAT 2014 Tablet
PUSAT 2014 Tablet
4 Allyestrenol 5 mg tablet @ 30 tablet DAK 2013 Tablet
5 Alprazolam Tablet Tablet
6 Ambroksol tablet 30 mg Tablet

7 Amlodipin 10 mg Tablet DAK-e KF 2016 Tablet

7 Amlodipin 5 mg Tablet DAK-e KF 2016 Tablet

Amoksisilin + Asam klavulanat

8 Tablet
625 mg tablet @ 30 tablet
Tablet
9 Anti Diare (Arcapec/Pularex) Tablet DAK-e IGM 2016 Tablet

JKN 2016 Tablet 500
10 Asam askorbat (Vitamin C) tablet 250 mg Tablet

Tablet
Asam mefenamat 250 mg Tablet

11 @ 120 tablet DAK-e IGM 2016 Tablet 180
12 Asam mefenamat tablet 500 mg DAK-e MPI 2016 Tablet 320

DAK-e EPM 2015 Tablet
DAK-e PARAZ 2014 Tablet
13 Asam Traneksamat tablet 500 mg DAK-e SSS 2016 Tablet

DAK-e MDI 2015 Tablet
14 Asetosal 80 mg (Aspilet/Miniaspi) tablet DAK-e MUP 2016 Tablet

DAK-e MUP 2015 Tablet 200
15 Betahistin Mesilat tablet 5 mg DAK-e MUP 2016 Tablet

DAK-e AAM 2015 Tablet
16 Bisacodil tablet 5 mg (Laxana) APBD RNI 2015 Tablet

17 Bisoprolol tablet 5 mg Tablet

18 Bromhexin 8 mg (Lexavon) Tablet Tablet

Tablet
19 Catopril tablet 12,5 mg DAK-e RNI 2016 Tablet

20 Catopril tablet 25 mg DAK-e MPI 2016 Tablet 685 40 50

21 Cefadroksil tablet 500 mg Tablet

DAK-e SST 2016 Tablet 60
21 Cefadroksil tablet 250 mg PROV 2016 Tablet

PROV 2016 Tablet
22 Cefixime Kapsul kapsul

DAK-e PARAZ 2014 kapsul
23 Cetirizine Tablet DAK-e MBS 2016 Tablet

24 Cimetidine tablet Tablet

Tablet
25 Ciprofloksasin tablet 500 mg Tablet

JKN 2016 Tablet 600
26 Clobazam tablet Tablet

27 Codein Tablet 10 mg DAK-e KF 2016 Tablet

PROV 2015 Tablet
28 Dietil karbamazin sitrat tablet 100 mg PROV 2016 Tablet

DAK 2013 Tablet
PROV 2015 Tablet
PROV 2015 Tablet
PUSAT 2015 Tablet
DAK 2013 Tablet
PUSAT 2015 Tablet
29 Diltiazem HCl tablet 30 mg Tablet

DAK 2013 Tablet
DAK 2013 Tablet
30 Dimenhidrinat tablet Tablet

DAK 2013 Tablet
31 Doksisiklin tablet Tablet

PROGRAM 2013 Tablet 200
32 Domperidon Tablet DAK-e SST 2016 Tablet

DAK-e 2014 Tablet `180
DAK-e 2014 Tablet
33 Erytromycin kapsul 250 mg Kapsul

DAK-e KF 2015 Kapsul
DAK-e 2014 Kapsul
34 Erytromycin Kapsul 500 mg Kapsul

DAK-e SST 2016 Kapsul
DAK-e 2014 Kapsul
Fe Kombinasi (Maltiron Plus)
35 Tablet @ 100 Tablet Tablet
Tablet
36 Flu Kombinasi (Eflin) Tablet APBD RNI 2015 Tablet

APBD RNI 2015 Tablet
37 Flu Kombinasi (Alpara) tablet APBD RNI 2016 Tablet 590 90

38 Glikazide (Glicab) tablet 80 mg Tablet

DAK-e TEMPO 2016 Tablet
DAK-e TEMPO 2015 Tablet 100
38 Glimepiride tablet 2 mg DAK-e KF 2016 Tablet

Hyoscyamine N-Bbr 10 mg +
39 PCT (Spasmolit FC) Tablet APBD RNI 2016 Tablet 190
APBD KF 2013 Tablet
40 Ketokonazole tablet DAK-e SST 2016 Tablet

PROV 2015 Tablet
41 Klindamisin tablet 300 mg Tablet

DAK-e PARA 2014 Tablet 90
Lactobacilus Kombinasi (Lacto-

42 B) @ 30 Sacc Tablet
43 Lanzoprazol kapsul 30 mg DAK-e EPM 2016 Tablet

44 Levofloksasin 500 mg Tablet Tablet

PROV 2015 Tablet
45 Lisinopril 5 mg Tablet DAK-e AAM 2016 Tablet 200

46 Lisinopril 10 Mg Tablet DAK-e IGM 2015 Tablet

47 Loperamid 2 mg tablet DAK-e IGM 2016 Tablet

48 Loratadine tablet 10 mg DAK-e SST 2014 Tablet 100

Mebhedrolin Napadisilat
49 (Interhistin) Tablet APBD RNI 2016 Tablet
50 Meloxicam tablet 15 mg DAK-e EPM 2016 Tablet

51 Meloxicam tablet 7,5 mg DAK-e EPM 2016 Tablet 100

52 Mepromaag tablet APBD RNI 2016 Tablet

53 Metformin Hcl Tablet 500 mg DAK-e PI 2015 Tablet 340

DAK-e PI 2015 Tablet
54 Methioson Tablet Tablet

Tablet
55 Metilprednisolone tablet 4 mg DAK-e PI 2015 Tablet

DAK-e PI 2015 Tablet
DAK-e PI 2015 Tablet 50
56 Metronidazole tablet 500 mg DAK-e KF 2016 Tablet

57 Metoklopropamid 10 mg tablet DAK-e RNI 2015 Tablet 90

Multivitamin (Hemafort) Tablet

58 @ 100 Tablet APBD RNI 2016 Tablet
PROV 2016 Tablet
PROV 2015 Tablet
APBD RNI 2015 Tablet 1400 30
PROV 2015 Tablet
59 Multivitamin (Livron B Plek) tablet Tablet

Tablet
Multivitamin Bumil (Prenatin

60 Plus) Tablet Tablet
Tablet
61 Na diklopenak tablet 25 mg DAK-e RNI 2016 Tablet
62 Na diklopenak Tablet 50 mg DAK-e RNI 2015 Tablet 570 40

63 Neurotropic (Molaneuron) Tablet DAK-e 2016 Tablet 1150

DAK-e 2016 Tablet
64 Nifedipin Tablet DAK-e AAM 2016 Tablet 610 80 40

65 Ofloksasin tablet 400 mg Tablet

DAK 2013 Tablet
66 Omeprazole kapsul DAK-e MPI 2016 Kapsul 50

DAK-e MPI 2016 Kapsul
DAK-e IGM 2015 Kapsul
JKN 2015 Kapsul 990
67 Papaverin tablet Tablet

DAK 2013 Tablet
68 Paraformaldehide Tablet Tablet

APBD Tablet
69 Pipemidic Acid (Urinter/Urotractin) kapsulDAK-e EPM 2016 Kapsul

DAK-e BSP 2015 Kapsul
DAK-e BSP 2015 Kapsul 60
70 Piracetam tablet 400 mg Kapsul

DAK-e EPM 2015 Kapsul 100
71 Piroksikam tablet 10 mg DAK-e KF 2015 Tablet

DAK 2013 Tablet
72 Piroksikam tablet 20 mg DAK-e KF 2015 Tablet

DAK-e KF 2015 Tablet 100 50
73 Propanolol tablet 10 mg Tablet

DAK 2013 Tablet
74 Pyrazinamida tablet 500 mg Tablet

Tablet
75 Ranitidin tablet 150 mg DAK-e AAM 2016 Tablet

DAK-e AAM 2015 Tablet 100
DAK-e AAM 2016 Tablet 100
Retinol (Vitamin A) kapsul lunak

76 100.000 IU Kapsul
Retinol (Vitamin A) Kapsul lunak
77 200.000 IU Kapsul
PROV 2016 Kapsul
Salbutamol tablet 2 mg (sebagai

78 sulfat) DAK-e RNI 2016 Tablet
DAK-e RNI 2016 Tablet 278 110
Salbutamol tablet 4 mg (sebagai

78 sulfat) DAK-e KF 2016 Tablet
79 Sianokobalamin tablet (Vit B12) 10 mg DAK-e IGM 2016 Tablet

Tablet
80 Simvastatin tablet 10 mg DAK-e MBS 2016 Tablet

DAK-e PI 2015 Tablet 50
80 Simvastatin tablet 20 mg DAK-e KF 2016 Tablet

81 Spiramisin tablet 500 mg Tablet

DAK 2013 Tablet
82 Sprinolakton 25 g tablet @ 100 table Tablet

PROV 2015 Tablet
83 Sulfadimidin Tablet Tablet

Tablet
84 Tablet tambah darah PROV 2016 Tablet

85 Terbutalin Tablet (Molasma) DAK-e IGM 2016 Tablet

PROV 2015 Tablet
PROV 2014 Tablet
APBD 2013 Tablet
86 Tiamfenikol tablet 500 mg Tablet

DAK-L 2014 Tablet 50
87 Tramadol Tablet Tablet

88 Natrium Tiroksin Tablet

Tablet
89 Klindamisin 150 mg Tablet Tablet

DAK-E IGM 2015 Tablet
SIRUP
1 Ambroksol sirup 15 mg/ 5 ml DAK-e KF 2016 Botol 30
DAK-e KF 2016 Botol
2 Amoksisilin 250 mg Sirup PROV 2016 Botol

PROV 2016 Botol
PROV 2015 Botol
APBD 2013 Botol
3 Amoksilin 100 mg (Supramox) Dr APBD RNI 2016 Botol
APBD RNI 2016 Botol
4 Anti Diare (Arcapec) Sirup APBD RNI 2016 Botol 16

APBD RNI 2016 Botol
APBD RNI 2015 Botol
5 Anti sariawan (Enkasari) Sirup Botol

Botol
6 Batugin Elixier APBD RNI 2016 Botol 3

APBD RNI 2016 Botol
APBD RNI 2015 Botol
7 Baby Cough Sirup APBD RNI 2016 Botol 40 2

APBD RNI 2016 Botol
APBD RNI 2016 Botol
APBD RNI 2016 Botol
APBD RNI 2016 Botol
APBD RNI 2016 Botol
APBD RNI 2015 Botol
APBD RNI 2015 Botol
APBD RNI 2015 Botol
APBD RNI 2015 Botol
8 Bromhexin (Lexavon) Sirup APBD 2013 Botol

APBD 2013 Botol
9 Cefadroksil sirup kering 250 mg / 5 ml DAK-e SST 2015 Botol

10 Cefixime Sirup DAK-e KF 2016 Botol

DAK-e KF 2016 Botol
DAK-e 2014 Botol
11 Cetirizine Sirup DAK-e IGM 2016 Botol

DAK-e IGM 2016 Botol 8
12 Domperidon Sirup DAK-e SST 2016 Botol 15

12 Domperidon Drop 5 mg/ml DAK-e MDI 2016 Botol

DAK-e MDI 2016 Botol 2
13 Erytromycin Sirup DAK-e KF 2015 Botol

DAK-e KF 2015 Botol
DAK-e KF 2014 Botol
DAK-e KF 2014 Botol 8
14 Fe Kombinasi (maltiron) Sirup Botol

Botol
15 Flu Kombinasi (Eflin) Sirup APBD RNI 2016 Botol

APBD RNI 2016 Botol
APBD RNI 2015 Botol
16 Flu Pilek Kombinasi (Intunal) Syr APBD RNI 2016 Botol 54

APBD RNI 2016 Botol
APBD RNI 2015 Botol
APBD RNI 2015 Botol
APBD 2014 Botol
APBD 2014 Botol
17 Gastrinal Suspensi APBD RNI 2016 Botol

APBD RNI 2015 Botol
APBD RNI 2015 Botol
18 Ibuprofen Sirup DAK-e SST 2016 Botol 15
Botol
19 Klorampenikol suspensi DAK-e MPI 2016 Botol

20 Laxadine Sirup Botol

PROV 2015 Botol
20 Laktulosa Sirup 3,335 g/5 ml DAK-e KF 2016 Botol

DAK-e KF 2016 Botol
21 Metamizol (Norages) Sirup APBD RNI 2016 Botol

APBD RNI 2016 Botol
APBD RNI 2015 Botol
22 Metoklopropamid (Gavistal) Drop Botol

23 Metronidazole (Farizol) Sirup DAK-e SST 2016 Botol

24 Metoklopropamid (Lexapram) sirup DAK-e IGM 2016 Tablet 9

25 Metronidazole Infus Botol

DAK-e 2015 Botol
26 Mutivtamin + Lsin (Supralysin) Sirup Botol

APBD RNI 2016 Botol
27 Multivitamin + lisin (Supralysin) APBD RNI 2015 Botol
APBD RNI 2016 Botol
28 Multivitamin (Xanvit/Hufalysin Ne APBD RNI 2016 Botol 7

APBD RNI 2016 Botol
APBD RNI 2015 Botol
29 Multivitamin Daya Tahan Tubuh ( APBD RNI 2016 Botol 4

APBD RNI 2016 Botol
30 Nifuroxide (Nifudiar) Sirup APBD RNI 2016 Botol 7

APBD RNI 2015 Botol
31 Nistatin (Nocandis) Drop APBD RNI 2016 Botol 9

APBD RNI 2016 Botol
APBD RNI 2015 Botol
32 Parasetamol Drop DAK-e IGM 2016 Botol

33 Pseudoefedrin (Alco) Drop APBD RNI 2016 Botol

APBD RNI 2016 Botol
APBD RNI 2015 Botol
APBD RNI 2015 Botol
34 Tiamfenikol (Nikolam) Sirup APBD RNI 2016 Botol

APBD RNI 2015 Botol
APBD RNI 2016 Botol 3
35 Zinc Drop DAK-e APL 2016 Botol

DAK-e APL 2016 Botol
JKN 2016 Botol 50
35 Zinc Sirup (Zircum Kid) DAK-e SST 2016 Botol
DAK-e SST 2016 Botol 24
JKN 2016 Botol 24
INJEKSI
1 Alinamin F injeksi Ampul
APBD RNI 2015 Ampul
2 Ampicillin Injeksi 1000 mg Vial

DAK-e PI 2015 Vial
3 Asam Traneksamat Injeksi 500 mg Ampul

DAK-e AAM 2016 Ampul
4 Cefotaxime Injeksi 1 gram DAK-e EPM 2016 Vial

DAK-e EPM 2015 Vial
DAK-e EPM 2015 Vial
5 Ceftriaxon Injeksi 1 gram DAK-e EPM 2016 Vial

DAK-e EPM 2016 Vial
DAK-e EPM 2015 Vial
6 Citicolin 125 mg/ 2 ml inj Ampul

Ampul
7 Difenhidramin HCl (Duradryl) injeksi Vial

Vial
8 Dopamin Injeksi 10 mg/ ml ampul

ampul
9 Furusemide Injeksi Ampul

PROV 2014 Ampul
10 Gentamisin injeksi 80 mg Ampul
DAK 2012 Ampul
11 Hyoscyamine N-Butil bromide (Gitas)Injek DAK-e MBS 2014 Ampul

DAK-e MBS 2014 Ampul
12 Kanamycin Inj vial

vial
13 Kloramfenikol Injeksi Vial

Vial
Kombinasi Antalgin 250 mg +

14 Pyramidon 500 mg (Xylomidon) Vial
Inj
Vial
15 Metamizol (Norages) Injeksi APBD RNI 2016 Ampul

APBD RNI 2016 Ampul
APBD RNI 2015 Ampul
16 Metoklopropamid (Gavistal) Injeks APBD RNI 2016 Ampul

APBD RNI 2016 Ampul
APBD RNI 2015 Ampul
APBD 2013 Ampul
17 Neurotropic (Biocombin) Injeksi APBD RNI 2016 Ampul

APBD RNI 2016 Ampul
APBD RNI 2015 Ampul
18 Oksitetrasiklin HCL Injeksi 50 mg/ml Vial

Vial
19 Ondasentron Injeksi Ampul

20 Pethidin injeksi Ampul
APBD KF 2012 Ampul
21 Piracetam injeksi 1 gram DAK-e EPM 2016 Ampul

DAK-e EPM 2016 Ampul
DAK-e EPM 2015 Ampul
DAK-e AAM 2015 Ampul
22 Piracetam injeksi 3 gram Ampul

Ampul
23 Ranitidin injeksi DAK-e DNR 2016 Ampul

DAK-e PI 2015 Ampul
24 Tramadol Injeksi Ampul

DAK-e PI 2015 Ampul
25 Salbutamol (Ventolin) Nebulizier DAK-e APL 2016 Ampul

DAK-e APL 2015 Ampul
26 Xylocain Jelly 2% (Lidocain HCl mg/g) DAK-e APL 2016 Ampul

DAK-e APL 2016 Ampul
INFUS
1 KAEN 3A fls
DAK-e MUP 2015 fls
DAK-e MUP 2015 fls
DAK-e MUP 2015 fls
DAK-e MUP 2015 fls
2 KAEN 3B fls
DAK-e MUP 2016 fls
3 Glukosa 5% + 1/4 NS DAK-e IGM 2016 Tablet

4 Glukosa 5% + 1/2 NS DAK-e IGM 2016 Tablet

Salep
1 Acyclovir Cream @ 25 Tube Tube
DAK-e IGM 2015 Tube
2 Bioplacenton Jelly APBD RNI 2016 tube

APBD RNI 2015 tube 4
3 Gentamisin salep kulit DAK-e IGM 2015 tube 19

DAK-e IGM 2015 tube
4 Ictiol salep APBD 2013 Pot

APBD 2013 Pot
APBD 2013 Pot
5 Ketokonazole krim DAK-e KF 2016 tube

DAK-e EPM 2015 tube
6 Miconazole krim DAK-e KF 2016 tube

DAK-e KF 2015 tube 12
DAK-e KF 2015 tube 10
DAK-e KF 2015 tube
JKN 2016 60
7 Nostren Cream APBD RNI 2016 Tube 2

APBD RNI 2016 Tube
APBD RNI 2015 Tube
8 Oksitetrasiklin salep kulit 3 % DAK-e IGM 2015 tube 1

DAK-L RNI 2014 tube
9 Piroksikam (Infeld) Gel Tube
Tube
10 Permetrin krim 5% (Scabimite) DAK-e SST 2016 tube

DAK-e SST 2016 tube
DAK-e SBF 2015 tube
DAK-e SBF 2015 tube
SALEP MATA
1 Kloramfenikol Salep Mata PROV 2015 tube
PROV 2015 tube
DAK-e KF 2015 tube
DAK-e KF 2015 tube
TETES MATA
1 Cendo Catarelent APBD RNI 2016 Botol
APBD RNI 2016 Botol
APBD RNI 2015 Botol
2 Cendo Xitrol APBD RNI 2016 Botol 4

APBD RNI 2016 Botol
APBD RNI 2015 Botol
3 Gentamisin Tetes Mata DAK-e IGM 2016 Botol

DAK 2013 Botol
4 Kloramfenikol Tetes Mata Botol

Botol
5 Tetrakain (Pantocain) TM Botol

JKN 2016 Botol 10
TETES HIDUNG
1 Iliadin Drop Botol
1 Iliadin Spray Botol

TETES TELINGA
1 Otopain TT Botol
APBD RNI 2014 Botol
OBAT LUAR / LAIN-LAIN

1 Anti sariawan (Alboty/Aptil) Sol APBD RNI 2016 Botol
APBD RNI 2016 Botol
APBD KF 2013 Botol
2 Bisacodil (Dulcolax )supp 10 mg DAK-e TEMPO 2016 Supp

DAK-e TEMPO 2016 Supp
APBD 2013 Supp 10
3 Bisacodil (Dulcolax)supp 5 mg DAK-e TEMPO 2016 Supp

DAK-e TEMPO 2016 Supp
PROV 2015 Supp
PROV 2015 Supp
4 Borax gliserin Botol

APBD 2012 Botol
5 Diazepam rectal 10 mg (stesolid) Tube

PROV 2016 Tube
DAK-e AAM 2016 Tube
6 Diazepam rectal 5 mg (stesolid) DAK-e AAM 2016 Rectal

DAK-e AAM 2016 Rectal
7 Fenoterol Hydrobromide 100 mcg (Berote DAK-e TEMPO 2016 kotak

DAK-e TEMPO 2016 kotak 2
8 Larutan Chlorhexide DAK-e 2016 Botol
DAK-e 2016 Botol
DAK-e EPM 2015 Botol
9 Larutan Chlorin 5,25 % APBD CSL 2016 Botol

APBD CSL 2016 Botol
10 Salisil Spritus Botol
ALAT KESEHATAN
1 Bisturi APBD RNI 2016 pcs
APBD RNI 2016 pcs
APBD RNI 2015 pcs
APBD RNI 2015 pcs
2 Blood Lancet ss APBD BERKAH 2015 pcs

APBD BERKAH 2015 pcs 100
APBD RNI 2015 pcs
APBD BERKAH 2015 pcs
3 Daryan tulle Lembar

APBD KF 2013 Lembar
4 EKG Paper 80 x 30 APBD CSL 2016 Roll

APBD CSL 2016 Roll
5 EKG Paper 40 x 30 Roll

APBD BERKAH 2014 Roll
5 Foley cateter no. 16 DAK-e KPP 2015 pcs

DAK-e KPP 2014 pcs
6 Foley cateter no. 18 DAK-e KPP 2016 pcs

DAK-e KPP 2016 pcs
DAK-e KPP 2015 pcs
7 Hand schoen Examination Uk M/L DAK-e KPP 2016 psg

DAK-e KPP 2016 psg
DAK-e KPP 2016 psg
DAK-e KPP 2015 psg
DAK-e KPP 2015 psg 45
DAK-e KPP 2015 psg
DAK-e KPP 2015 psg
8 Hand schoen no. 7 psg

psg
9 Hand schoen no. 7,5 DAK 2013 psg

DAK 2013 psg
10 Hand Schoen No. 8 DAK 2013 psg

DAK 2013 psg
11 Hand schoen steril no. 7 DAK-e APL 2016 psg

DAK-e APL 2016 psg
APBD KF 2013 psg
12 Hand schoen steril no. 7,5 DAK-e APL 2016 psg

DAK-e APL 2016 psg
13 Hand schoen steril no. 8 DAK-e APL 2016 psg

DAK-e APL 2016 psg
APBD KF 2013 psg
14 Handschoen Steril No. 6,5 psg

psg
15 Hypapix 5 x 1 m APBD 2013 roll 1

APBD 2013 roll
16 Jarung Hecting Otot APBD CSL 2016 lsn
APBD CSL 2016 lsn
17 Jarum Hecting Kulit APBD CSL 2016 lsn

APBD CSL 2016 lsn
15 Kasa Hidrofil 40 x 80 DAK-e KPP 2016 psg

DAK-e KPP 2016 psg
19 Kasa pembalut hidrofil 4 x 10 DAK-e KALICA 2014 Roll

DAK-e KALICA 2014 Roll
20 Kasa steril 16 x 16 pad DAK-e KPP 2015 roll 8

DAK-e KALICA 2014 roll
DAK-e KALICA 2014 roll
17 Larutan Hidrogen peroksida 2 % kotak

DAK-L RNI 2014 kotak 5
18 Mami non waven pcs

pcs
19 Masker DAK-e KPP 2015 pcs 20

DAK-e KPP 2015 pcs
20 Needle No. 23 G APBD CSL 2016 pcs

APBD KF 2013 pcs
APBD KF 2013 pcs
21 Needle No. 25 G APBD CSL 2016 pcs

DAK-L RNI 2014 pcs
22 Optiva No. 20 APBD 2011 pcs
36 Paket P3K APBD RNI 2016 pcs

APBD RNI 2015 pcs
25 Spuit Injeksi 10 ml pcs

pcs
26 Spuit Injeksi 50 ml pcs

pcs
27 Surflo No. 20 DAK-e KALICA 2014 pcs

DAK-e MBS 2015 pcs
DAK-e KALICA 2014 pcs
28 Surflo No. 22 DAK-e MBS 2016 pcs

DAK-e MBS 2015 pcs
DAK-e 2014 pcs
DAK 2013 pcs
DAK 2013 pcs
29 Surflo No. 24 DAK-e MBS 2016 pcs

DAK-e MBS 2016 pcs
DAK-e MBS 2015 pcs
DAK-e 2014 pcs
30 Test Kehamilan Stik PROV 2016 pcs

APBD CSL 2016 pcs
APBD BERKAH 2015 pcs 200
31 Ultrasonic Gel APBD BERKAH 2015 pcs

APBD 2014 pcs
APBD 2014 pcs
32 Urine bag DAK-e KPP 2016 pcs
DAK-e KPP 2016 pcs
33 USG Printing Paper UPP-110 HG pcs

2012 pcs
34 Wing needle no. 21 pcs

pcs
35 Wing needle no. 27 pcs

pcs
36 Eksvator Double pcs

pcs
37 Boor Diamond High Speed APBD BERKAH 2015 set

APBD BERKAH 2015 set
37 Boor Diamond Low Speed APBD BERKAH 2015 set

APBD BERKAH 2015 set
OBAT PROGRAM
PROGRAM P2 MALARIA
1 Abate APBD CSL 2016 kg
APBD CSL 2016 kg
2 ACT Tablet Pcs

Pcs
3 DHP tablet PROV 2016 Tablet

PROV 2016 Tablet 27
PROV 2015 Tablet
4 Artemer 80 mg Injeksi vial
vial
5 Artemer 40 mg Injeksi vial

vial
6 Artesunate 60 mg Injeksi PROV 2016 ampul

PROV 2016 ampul
7 Cynoff liter
liter
8 Kelambu bh
bh
9 Rafid Test Dengeu (25 Test) APBD CSL 2016 stik

APBD CSL 2016 stik
10 RDT Chikungunya (30 Test) stik

APBD CSL 2016 stik
11 RDT Malaria APBD CSL 2016 stik

PROGRAM 2016 stik
PROGRAM 2016 stik
PROGRAM 2016 stik
12 RDT Salmonella stik

APBD CSL 2016 stik
PROGRAM P2 IMUNISASI
1 Alat suntik sekali pakai 0.05 ml pcs
PROGRAM 2016 pcs
PROGRAM 2014 pcs 110
2 Alat suntik sekali pakai 0.5 ml pcs
PROGRAM 2016 pcs
PROGRAM 2016 pcs
PROGRAM 2016 pcs 150
PROGRAM 2014 pcs
3 Safety Box pcs

PROGRAM 2016 pcs
PROGRAM 2012 pcs
4 Vaksin BCG 10 Dosis + Pelarut ampul

ampul
5 Vaksin BCG 20 Dosis + Pelarut ampul

PROGRAM 2016 ampul
PROGRAM 2016 ampul
PROGRAM 2016 ampul 15
6 Vaksin Campak 10 Dosis + Pelarut ampul

PROGRAM 2016 ampul 10
7 Vaksin Campak 20 Dosis + Pelarut pcs

PROGRAM 2016 pcs
8 Vaksin DT Vial
PROGRAM 2016 Vial
PROGRAM 2016 Vial
9 Vaksin Hepatitis (Hbo) ampul 15

PROGRAM 2016 ampul
PROGRAM 2016 ampul
PROGRAM 2016 ampul
10 Vaksin Polio (10 dosis) + Droper Vial 18

PROGRAM 2016 Vial
PROGRAM 2016 Vial
PROGRAM 2016 Vial
11 Vaksin Polio (20 dosis) + Droper Vial
Vial
12 Vaksin Td Vial
PROGRAM 2016 Vial
PROGRAM 2016 Vial
13 Vaksin TT Vial
PROGRAM 2016 Vial
PROGRAM 2016 Vial
PROGRAM 2015 Vial
14 Vaksin DPT - HB Vial

Vial
15 Vaksin DPT - HB - HIB Vial

PROGRAM 2016 Vial
PROGRAM 2016 Vial 15
PROGRAM P2 TB
1 Box Slides pcs
pcs
2 Bunsen Stainlestell ktk

ktk
3 FDC I PROV 2016 paket

PROV 2016 paket
PROV 2015 paket 2
PROV 2015 paket
PROV 2015 paket
4 FDC I & III paket

paket
5 FDC II paket
PROGRAM 2016 paket
PROGRAM 2016 paket
PROGRAM 2016 paket
2014 paket
6 Kaca Ose
7 Kombipak kategori 1 paket

PROGRAM 2016 paket
8 Lampu Spritus bh
bh
9 Obat antituberkolosis Kategori Anak paket

PROGRAM 2016 paket
PROGRAM 2016 paket
10 Obat antituberkolosis Kategori sisipan paket

PROV 2015 paket
11 Pot Sputum PROGRAM 2016 bh

PROGRAM 2016 bh
12 Reagen ziehl Nelsen APBD CSL 2016 Vial

PROV 2015 Vial
13 Slide mikroskop APBD CSL 2016 Ktk

APBD CSL 2016 Ktk
14 Spritus Botol
APBD CSL 2016 Botol
15 Masker N-95 pcs

pcs
16 Isoniazid (INH) 100 mg Tablet

1600 PROGRAM 2016 Tablet
PROGRAM 2015 Tablet
PROGRAM P2 DIARE
1 Zn Tablet 500 mg PROGRAM 2016 Tablet
PROGRAM 2016 Tablet
PROGRAM 2016 Tablet
PROGRAM 2016 Tablet
JKN 2016 Tablet 600
PROGRAM P2 KUSTA
1 MDT MB Anak Strip
2014 Strip
2 MDT MB Dewasa Strip

PROGRAM 2016 Strip
PROV 2015 Strip 3
3 MDT PB Anak Strip

Strip
4 MDT PB Dewasa Strip

Strip
PROGRAM KIA
1 Pil KB Kombinasi (Andalan) DAK-e KF 2015 kpg
DAK-L RNI 2014 kpg
DAK-L RNI 2014 kpg
DAK-L RNI 2014 kpg
2 Obat Suntik KB 1 bulan DAK-L RNI 2014 vial

DAK-L RNI 2014 vial
DAK-L RNI 2014 vial
3 Obat Suntik KB 3 bulan DAK-L 2014 vial
DAK-L 2014 vial
DAK-L 2014 vial
4 Gluconas Kalsikus 10 % injeksi Vial

Vial
5 Procain Penisilin 3 Juta unit Injeksi Vial

Vial
6 Progesteron Depot Injeksi Vial

Vial
7 Sungkup Bayi set

APBD KF 2012 set
Rafid test (Glukosa + Protein

8 Urin) ktk
ktk
REAGEN LABORATORIUM
1 Etanol 70 % 1000 ML DAK-e IGM 2016 Botol 2
DAK-e KPP 2015 Botol
APBD 2014 Botol
2 Etanol 70 % 100 ML DAK-e IGM 2015 Botol 10

3 Alkohol 95 % APBD CSL 2016 botol

APBD CSL 2016 botol
APBD RNI 2015 botol
4 Alkohol Swab APBD BERKAH 2015 botol

DAK-e KPP 2015 botol
DAK-e KPP 2015 botol
5 Coumbour 10 Parameter botol

PROGRAM 2016 botol
6 EDTA 10 % botol
2014 botol
7 Gliserin Botol
PUSAT Botol
8 Gluko dr Stik botol

botol
9 Golongan Darah Test set

APBD RNI 2015 set
10 HB (Stat Site) Stik Botol

Botol
11 Lar Anisol botol

botol
12 Lar Asam Asetat 6% APBD BERKAH 2015 botol 2

APBD RNI 2014 botol
13 Lar Asam Sulfosalilisat botol

DAK-e 2016 botol
APBD BERKAH 2015 botol
14 Lar Barium Klorida 10 % botol

botol
15 Larutan Benedict APBD BERKAH 2015 Botol
16 Lar Buffer Ph botol

botol
17 Lar Carbol Gentian Violet botol

APBD 2010 botol
18 Lar Drabkin Botol
19 Larutan Eosin 2 % Botol
20 Larutan Etanol Asam Botol
21 Lar Foucet APBD CSL 2016 botol
22 Larutan Giemsa Stain Botol
23 H2SO4 p Botol
APBD 2011 Botol
24 HCl 0,1% botol

botol
25 HNO3 P Botol
2011 Botol
26 Larutan karbol Fuchsin Botol

27 KOH 10 % APBD BERKAH 2015 Set
APBD BERKAH 2015 Set
APBD BERKAH 2015 Set
28 Larutan Metelin Biru Botol
29 Larutan Turk Botol
Lisol, mengandung kresol

30 tersabun 50 % PUSAT 2008 Botol 1
31 Metanol Botol
32 Na Citrat 3,8 % botol

botol
33 Cholesterol (Nesco) Stik APBD RNI 2015 botol

APBD CSL 2016 botol
DAK-e BERKAH 2016 botol
DAK-e BERKAH 2016 botol
34 Glucose (Nesco) Stik APBD CSL 2016 botol 3

35 Nesco HB Stik @ 25 APBD CSL 2016 Botol

APBD RNI 2015 Botol
APBD RNI 2015 Botol
36 Uric Acid (Nesco) Stik botol

APBD CSL 2016 botol
APBD RNI 2015 botol
37 Oli Emersi botol
APBD RNI 2015 botol
38 Rees Ecker APBD 2016 botol

APBD CSL 2016 botol
39 Triglisiride Multicare APBD BERKAH 2015 ktk

APBD BERKAH 2015 ktk
40 Water Steril 500 ml Botol

Botol
41 Water Steril 1000 ml APBD CSL 2016 Botol

APBD CSL 2016 Botol
42 Widal Test Set 1

APBD CSL 2016 Set
43 Xylol APBD RNI 2014 botol

APBD RNI 2014 botol
LAIN-LAIN
1 Iodine Test Botol
Botol
2 Mineral Mix Sacchet

Sacchet
3 Aseltamivir kapsul 75 mg
4 Glukosa Stik Performa Accu Check DAK-e EPM 2016 Kotak
Kotak
5 Blue Tips APBD CSL 2016 Bks

APBD CSL 2016 Bks
6 Yellow Tips APBD CSL 2016 Bks

APBD CSL 2016 Bks
7 Deck Glass APBD CSL 2016 Ktk

APBD CSL 2016 Ktk
8 Micro Hematokrit / Tabung HematAPBD CSL 2016 Pcs

APBD CSL 2016 Pcs
9 Tabung EDTA K3/Vacutainer APBD CSL 2016 Pcs

APBD CSL 2016 Pcs
10 Tissue Lensa APBD CSL 2016 Bks

APBD CSL 2016 Bks
11 Lidi Sputum APBD CSL 2016 Bks

APBD CSL 2016 Bks
12 Kertas Saring APBD CSL 2016 Bks

APBD CSL 2016 Bks
13 Eter Alkohol APBD CSL 2016 Btl

APBD CSL 2016 Btl
14 Stik HB Family Dr APBD CSL 2016 Ktk

APBD CSL 2016 Ktk
15 Glukosa Stik Active Accu Check APBD CSL 2016 Ktk

APBD CSL 2016 Ktk
TOTAL
Mengetahui :
Kepala Puskesamas BINUANG
………………………………
NIP.
Pemerintah Kabupaten Tapin
ISASI POS-POS NERACA TAHUN BUKU 2016
Per 31 Desember 2016
apan (Supplies) yang digunakan dalam rangka kegiatan operasional pemerintah
Jumlah
LOKASI Jumlah Per
Harga Satuan Harga Satuan Tahun Kondisi Barang
Tahun
Jumlah Per Tahun Tahun Perolehan Perolehan
DLL Perolehan
Perolehan (Rp.) Terakhir (Rp.) Terakhir B RR RB
(Rp.)
(Rp.)
- 207.00 - 207.00 -
- 220.00 - 207.00 -
-
- 279.00 - 221.81 -
1,005 279.00 280,395.00 221.81 222,919.05
- 233.00 - 221.81 -
15,600 221.81 3,460,236.00 221.81 ###
16,605
- 317.00 - 274.00 -
- 317.00 - 274.00 -
- 317.00 - 274.00 -
- 317.00 - 274.00 -
- 317.00 - 274.00 -
- 317.00 - 274.00 -
- 317.00 - 274.00 -
- 317.00 - 274.00 -
- 317.00 - 274.00 -
245 317.00 77,665.00 274.00 67,130.00
400 274.00 109,600.00 274.00 109,600.00
645
- 275.00 - 275.00 -
-
- 1,155.00 - 1,155.00 -
-
- 93.50 - 93.50 -
-
- 520.30 - 520.30
-
-
- 77.00 - 77.00 -
-
240 158.00 37,920.00 158.00 37,920.00

- 152.00 - 158.00 -
- 152.00 - 158.00 -
400 158.00 63,200.00 158.00 63,200.00
640
- 641.00 - 641.00 -
-
1,677 58.00 97,266.00 105.00 176,085.00

- 58.00 - 105.00 -
- 58.00 - 105.00 -
- 58.00 - 105.00 -
- 105.00 - 105.00 -
- 105.00 - 105.00 -
- 58.00 - 105.00 -
- 88.00 - 105.00 -
- 88.00 - 105.00 -
- 88.00 - 105.00 -
- 88.00 - 105.00 -
- 88.00 - 105.00 -
- 88.00 - 105.00 -
1,677
100 318.00 31,800.00 318.00 31,800.00

- 343.00 - 318.00 -
- 352.00 - 318.00 -
100
- 125.00 - 125.00 -
300 125.00 37,500.00 125.00 37,500.00
- 125.00 - 125.00 -
- 167.20 - 125.00 -
- 167.20 - 125.00 -
300
100 246.40 24,640.00 246.40 24,640.00

100
32 2,200.00 70,400.00 2,200.00 70,400.00

- 2,200.00 - 2,200.00 -
- 2,560.00 - 2,200.00 -
- 2,560.00 - 2,200.00 -
330 2,200.00 726,000.00 2,200.00 726,000.00
362
- 2,225.00 - 2,225.00 -
4 4,070.00 16,280.00 2,225.00 8,900.00
- 2,225.00 - 2,225.00 -
- 4,070.00 - 2,225.00 -
4
- 1,740.00 - 1,740.00 -
- 1,738.00 - 1,740.00 -
- 1,738.00 - 1,740.00 -
11 1,738.00 19,118.00 1,740.00 19,140.00
11
2 2,604.90 5,209.80 2,604.90 5,209.80

2
- 1,160.00 - 1,160.00 -
- 1,056.00 - 1,160.00 -
- 1,056.00 - 1,160.00 -
-
- 2,354.00 - 2,354.00 -
- 2,354.00 - 2,354.00 -
25 8,910.00 222,750.00 2,354.00 58,850.00
25
- 6,820.00 - 6,820.00 -
-
- 3,113.05 - 2,122.00 -
- 2,122.00 - 2,122.00 -
60 2,122.00 127,320.00 2,122.00 127,320.00
60
- 1,900.00 - 1,900.00 -
-
- 520,300.00 - 520,300.00 -
- 520,300.00 - 520,300.00 -
-
- 26,983,968.00 - 26,983,968.00 -
-
- 193,470.80 - 193,470.80 -
-
- 139,150.00 - 139,150.00 -
-
- 401,092.00 - 401,092.00 -
-
- 174,500.00 - 174,500.00 -
-
- 170,000.00 - 170,000.00 -
-
- 6,270.00 - 6,270.00 -
- 6,270.00 - 6,270.00 -
- 6,270.00 - 6,270.00 -
-
- 1,597.60 - 1,597.60 -
-
- 6,900.00 - 6,900.00 -
- 5,720.00 - 6,900.00 -
-
6 7,150.00 42,900.00 7,150.00 42,900.00

20 5,720.00 114,400.00 7,150.00 143,000.00
26
- 6,410.00 - 6,410.00 -
3 5,170.00 15,510.00 6,410.00 19,230.00
- 5,170.00 - 6,410.00 -
3
- 103,536.00 - 103,536.00 -
-
- 293,498.00 - 293,498.00 -
-
- 99,000.00 - 99,000.00 -
1 99,000.00 99,000.00 99,000.00 99,000.00
- 104,500.00 - 99,000.00 -
- 104,500.00 - 99,000.00 -
- 115,500.00 - 99,000.00 -
1
- 185,900.00 - 185,900.00 -
-
- 306,427.00 - 306,427.00 -
- 434,500.00 - 306,427.00 -
-
- 242,000.00 - 242,000.00 -
-
- 56,441.40 - 56,441.40 -
- 87,000.00 - 56,441.40 -
-
- 137,853.00 - 137,853.00 -
-
- 93,500.00 - 93,500.00 -
-
- 408,792.00 - 408,792.00 -
-
- 14,053.63 - 14,053.63 -
-
- 158,042.00 - 158,042.00 -
-
- 1,540.00 - 1,540.00 -
- 854.00 - 1,540.00 -
-
155 957.00 148,335.00 957.00 148,335.00

- 957.00 - 957.00 -
- 957.00 - 957.00 -
- 957.00 - 957.00 -
155
- 2,049.00 - 2,049.00 -
- 2,049.00 - 2,049.00 -
- 1,348.00 - 2,049.00 -
100 1,950.00 195,000.00 2,049.00 204,900.00
- 1,950.00 - 2,049.00 -
100
3 7,201.39 21,604.17 7,201.39 21,604.17

- 7,201.39 - 7,201.39 -
3
- 7,201.04 - 7,201.04 -
- 8,896.88 - 7,201.04 -
-
3 8,896.88 26,690.63 8,896.88 26,690.63

3
4 7,286.25 29,145.00 7,286.25 29,145.00

- 7,286.25 - 7,286.25 -
- 7,286.25 - 7,286.25 -
- 8,896.88 - 7,286.25 -
4
- 7,920.00 - 7,920.00 -
- 7,920.00 - 7,920.00 -
- 4,675.50 - 7,920.00 -
- 4,568.00 - 7,920.00 -
-
- 7920.00 - 7920.00 -
- 7920.00 - 7920.00 -
- 7920.00 - 7920.00 -
- 4176.00 - 7920.00 -
- 4176.00 - 7920.00 -
-
- 5,743.86 - 5,743.86 -
-
- 95.00 - 95.00 -
- 95.00 - 95.00 -
250 90.00 22,500.00 95.00 23,750.00
- 90.00 - 95.00 -
250
- 86.00 - 86.00 -
- 86.00 - 86.00 -
-
- 123.00 - 123.00 -
- 123.00 - 123.00 -
- 123.00 - 123.00 -
-
- 163.90 - 163.90 -
-
- 64.00 - 64.00 -
- 64.00 - 64.00 -
- 78.00 - 64.00 -
- 78.00 - 64.00 -
1,888 78.00 147,264.00 64.00 120,832.00
130 78.00 10,140.00 64.00 8,320.00
4,000 64.00 256,000.00 64.00 256,000.00
6,018
- 149.00 - 149.00 -
-
- 96.80 - 96.80 -
-
- 157.30 - 157.30 -
-
490 120.00 58,800.00 120.00 58,800.00

490
- 66.00 - 66.00 -
-
- 48.00 - 48.00 -
495 48.00 23,760.00 48.00 23,760.00
- 87.00 - 48.00 -
- 111.00 - 48.00 -
- 68.00 - 48.00 -
- 68.00 - 48.00 -
495
- 46.00 - 46.00 -
-
- 52.80 - 52.80 -
-
- 108.00 - 108.00 -
- 103.00 - 108.00 -
-
- 80.00 - 80.00 -
-
- 146.00 - 146.00 -
-
- 140.00 - 140.00 -
-
- 64.83 - 64.83 -
-
- 257.40 - 257.40 -
- 257.40 - 257.40 -
-
- 456.50 - 456.50 -
- 456.50 - 456.50 -
-
- 796.00 - 796.00 -
- 698.00 - 796.00 -
50 698.00 34,900.00 796.00 39,800.00
300 796.00 238,800.00 796.00 238,800.00
350
- 84.00 - 84.00 -
- 84.00 - 84.00 -
-
- 126.00 - 126.00 -
100 126.00 12,600.00 126.00 12,600.00
- 126.00 - 126.00 -
- 86.35 - 126.00 -
- 86.35 - 126.00 -
100
- - 108.00 -
- 108.00 - 108.00 -
- 92.00 - 108.00 -
- 83.64 - 108.00 -
-
150 224.00 33,600.00 224.00 33,600.00

- 224.00 - 224.00 -
- 224.00 - 224.00 -
150
- 62.00
- 62.00 - 62.00 -
- 62.00 - 62.00 -
- 62.00 - 62.00 -
-
- 64.43 - 74.00 -
- 64.43 - 74.00 -
50 76.00 3,800.00 74.00 3,700.00
800 74.00 59,200.00 74.00 59,200.00
850
- 105.00 - 105.00 -
- 105.00 - 105.00 -
100 105.00 10,500.00 105.00 10,500.00
100
- 171.00 - 171.00 -
- 94.21 - 171.00 -
-
- 121.00 - 121.00 -
- 121.00 - 121.00 -
-
- 133.00 - 133.00 -
130 157.00 20,410.00 133.00 17,290.00
- 157.00 - 133.00 -
130
- 98.00 - 98.00 -
90 98.00 8,820.00 98.00 8,820.00
- 98.00 - 98.00 -
- 101.00 - 98.00 -
90
400 169.00 67,600.00 169.00 67,600.00

- 169.00 - 169.00 -
- 169.00 - 169.00 -
- 169.00 - 169.00 -
- 76.00 - 169.00 -
400
- 306.00 - 306.00 -
190 306.00 58,140.00 306.00 58,140.00
- 269.00 - 306.00 -
190
- 47.50 - 47.50 -
- 47.50 - 47.50 -
- 47.50 - 47.50 -
- 47.50 - 47.50 -
- 47.50 - 47.50 -
- 47.50 - 47.50 -
- 47.50 - 47.50 -
- 47.50 - 47.50 -
1,020 47.50 48,450.00 47.50 48,450.00
- 47.50 - 47.50 -
1,020
- 39.93 - 39.93 -
- 39.93
-
- 179.00 - 162.00 -
- 162.00 - 162.00 -
-
- 1,129.30 - 1,129.30 -
- 1,129.30
-
- 231.00 - 231.00 -
- 231.00
-
- 1,209.60 - 169.00 -
- 169.00 - 169.00 -
-
- - -
- 98.00 - 98.00 -
- 116.00 - 98.00 -
-
- 15.73 - 15.73 -
- 15.73 - 15.73 -
-
- - -
- 857.00 - 857.00 -
- 704.00 - 857.00 -
-
- 602.00 - 602.00 -
- 527.23 - 602.00 -
-
- 34.51 - 34.51 -
- 34.51 - 34.51 -
-
- 136.00 - 136.00 -
240 121.00 29,040.00 136.00 32,640.00
- 121.00 - 136.00 -
240
- -
- 351.00 - 351.00 -
- 351.00 - 351.00 -
- -
- -
90 114.00 10,260.00 114.00 10,260.00
- 114.00 - 114.00 -
90
- 82.00 - 82.00 -
- 82.00 - 82.00 -
-
- 114.00 - 114.00 -
- 114.00 - 114.00 -
-
- 167.20 - 167.20 -
- 167.20 - 167.20 -
-
- 325.00 - 325.00 -
- 325.00 - 325.00 -
- 325.00 - 325.00 -
-
- 91.00 - 91.00 -
- 91.00 - 91.00 -
-
97.00 - 97.00 -
70 97.00 6,790.00 97.00 6,790.00
100 297.00 29,700.00 97.00 9,700.00
- 326.70 - 97.00 -
170 - -
- 132.00 - 120.00 -
- 112.00 - 120.00 -
2,000 120.00 240,000.00
2,000 -
- 2,300.00 - 2,300.00 -
- 2,106.00 - 2,300.00 -
-
- 1,573.00 - 1,573.00 -
-
- 3,740.00 - 3,740.00 -
-
- 1,119.00 - 1,119.00 -
- 1,119.00 - 1,119.00 -
39 1,119.00 43,641.00 1,119.00 43,641.00
- 1,535.00 - 1,119.00 -
- 1,535.00 - 1,119.00 -
- 1,535.00 - 1,119.00 -
- 1,535.00 - 1,119.00 -
200 1,119.00 223,799.00 1,119.00 223,800.00
239
- 4,204.00 - 4,204.00 -
-
- 1,345.00 - 1,345.00 -
- 1,345.00 1,345.00
-
- 5,800.00 - 5,800.00 -
- 5,800.00 - 5,800.00 -
-
- 1,210.00 - 1,210.00 -
- 1,210.00 1,210.00
-
- 20,857.00 - 20,857.00 -
-
1,930.00
- 1,930.00 - 1,930.00 -
- 1,930.00 - 1,930.00 -
-
- 1,914.00 - 1,914.00 -
- 1,914.00 - 1,914.00 -
-
- 1,210.00 - 1,210.00 -
-
- 724.00 - 724.00 -
- 724.00 - 724.00 -
-
- 2,800.00 2,800.00
- 2,800.00 - 2,800.00 -
-
- 3,500.00 3,500.00
- 3,500.00 - 3,500.00 -
-
- 1,527.70 1,527.70
- 1,527.70 - 1,527.70 -
-
- 2,970.00 - 2,970.00 -
-
-
- - -
- 1,226.00 - 1,226.00 -
15 1,132.00 16,980.00 1,226.00 18,390.00
- 1,132.00 - 1,226.00 -
15
- 843.00 - 843.00 -
- 843.00 - 843.00 -
-
-
7 2,200.00 15,400.00 2,200.00 15,400.00
7
- - -
10 2,712.00 27,120.00 2,712.00 27,120.00
- 2,868.00 - 2,712.00 -
10
- 1,435.00 - 1,435.00 -
- 1,435.00 - 1,435.00 -
-
- 2,767.00 - 2,767.00 -
- 2,767.00 - 2,767.00 -
-
- 4,782.00 - 4,782.00 -
- 4,782.00 - 4,782.00 -
-
- 1,640.00 - 1,640.00 -
- 1,640.00 - 1,640.00 -
-
- 3,549.00 - 3,549.00 -
- 3,549.00 - 3,549.00 -
-
- 1,759.00 - 1,759.00 -
- 1,759.00 - 1,759.00 -
-
- 1,109.00 - 2,500.00 -
- 2,246.00 - 2,500.00 -
35 2,500.00 87,500.00 2,500.00 87,500.00
35
- - -
10 3,502.00 35,020.00 3,502.00 35,020.00
- 3,502.00 - 3,502.00 -
10
- 5,500.00 - 5,500.00 -
- 5,500.00 - 5,500.00 -
-
- 2,178.00
- 2,178.00 - 2,178.00 -
-
- 6,529.00 - 6,529.00 -
- 6,529.00 - 6,529.00 -
-
5 2,344.00 11,720.00 2,344.00 11,720.00

- 2,344.00 - 2,344.00 -
- 2,344.00 - 2,344.00 -
5
- 15,950.00 - 15,950.00 -
- 15,950.00 - 15,950.00 -
-
- 1,066.00 - 1,066.00 -
- 1,066.00 - 1,066.00 -
- 1,066.00 - 1,066.00 -
- 1,350.00 - 1,066.00 -
- 1,350.00 - 1,066.00 -
8 1,350.00 10,800.00 1,066.00 8,528.00
- 1,350.00 - 1,066.00 -
- 1,350.00 - 1,066.00 -
8
- - -
- 20,815.00 - 20,815.00 -
- 18,333.00 - 20,815.00 -
-
-
2 14,187.50 28,375.00 14,187.50 28,375.00
- 14,187.50 - 14,187.50 -
- 15,872.01 - 14,187.50 -
- 15,740.00 - 14,187.50 -
2
- - -
- 1,393.00 - 1,984.03 -
1 1,984.03 1,984.03 1,984.03 1,984.03
1
- 8,739.41 - 8,739.41 -
- 8,800.00 - 8,739.41 -
-
- 2,740.50 - 2,740.50 -
- 2,740.50 - 2,740.50 -
-
- 760.91 - 760.91 -
- 770.00 - 760.91 -
- 770.00 - 760.91 -
-
- 6,071.00 - 6,071.00 -
- 6,071.00
- 25,987.00 - 25,987.00 -
- 25,987.00 - 25,987.00 -
-
- - -
- 272.00 - 272.00 -
- 245.00 - 272.00 -
-
100 628.46 62,846.00 628.46 62,846.00

- 628.46 - 628.46 -
100
- 258.74 - 258.74 -
- 230.98 - 258.74 -
- 359.00 - 258.74 -
- 359.00 - 258.74 -
- 359.00 - 258.74 -
-
- 2,200.00 - 2,200.00 -
-
-
-
- - -
- 155.30 - 149.74
- 124.94 - 149.74 -
7,000 149.74 1,048,180.00 149.74 ###
7,000
- 163.00 - 163.00 -
- 163.00 - 163.00 -
- 163.00 - 163.00 -
35 163.00 5,705.00 163.00 5,705.00
- 163.00 - 163.00 -
35
- 105.00 - 105.00 -
- 105.00 - 105.00 -
-
5,283.00 - 5,283.00
- -
- 5,283.00 - 5,283.00 -
-
- 173.00 - 173.00 -
- 173.00 - 173.00 -
120 220.00 26,400.00 173.00 20,760.00
- 220.00 - 173.00 -
- 220.00 - 173.00 -
500 173.00 86,500.00 173.00 86,500.00
620
- 139.00 - 139.00 -
- 139.00 - 139.00 -
-
180 150.00 27,000.00 150.00 27,000.00

- 150.00 - 150.00 -
- 175.00 - 150.00 -
180
320 113.00 36,160.00 113.00 36,160.00

- 113.00 - 113.00 -
- 122.00 - 113.00 -
- 122.00 - 113.00 -
1,800 113.00 203,400.00 113.00 203,400.00
2,120
- 1,540.00 - 1,540.00 -
- 1,540.00 - 1,540.00 -
-
- 123.00 - 123.00 -
200 163.00 32,600.00 123.00 24,600.00
200
- 170.00 - 170.00 -
- 863.08 - 170.00 -
-
- 230.00 - 230.00 -
46 250.00 11,500.00 230.00 10,580.00
46
- - -
- 695.00 - 695.00 -
- 695.00 - 695.00 -
-
- 121.00 - 121.00 -
- 121.00 - 121.00 -
-
- 69.00 - 69.00 -
- 69.00 - 69.00 -
- 69.00 - 69.00 -
25 69.00 1,725.00 69.00 1,725.00
25
775 72.00 55,800.00 72.00 55,800.00

- 72.00 - 72.00 -
- 72.00 - 72.00 -
- 97.00 - 72.00 -
- 97.00 - 72.00 -
4,000 72.00 288,000.00 72.00 288,000.00
4,780
- -
60 557.00 33,420.00 33,420.00
- 550.03 - 557.00 -
60 557.00
- 564.00 - -
- 564.00 - 564.00 -
- 564.00
- 899.00 - -
- 899.00 - 899.00 -
- 899.00
- 154.00 - -
- 154.00 - 154.00 -
- 154.00
- 115.50 - -
- 115.50 115.50
- 115.50
- - -
- 298.00 - 298.00 -
- 473.00 - 298.00 -
- 283.71 - 298.00 -
600 298.00 178,800.00 298.00 178,800.00
600 298.00
- - -
- 1,120.00 - 1,120.00 -
- 950.00 - 1,120.00 -
- 1,120.00
- 630.00 - -
- 550.00 - 630.00 -
- 630.00
- 1.00 - -
- 246.20 - 1.00 -
- 246.20 - 1.00 -
- 470.00 - 1.00 -
- 152.00 - 1.00 -
- 152.00 - 1.00 -
- 261.50 - 1.00 -
- 470.00 - 1.00 -
- 261.50 - 1.00 -
- 1.00
- - -
- 126.00 - -
- 126.00 - 126.00 -
- 126.00
- - -
- 107.00 - -
- 97.00 - 107.00 -
- 107.00
- 250.00
200 250.00 50,000.00 250.00 50,000.00
200 250.00
- 133.00 - -
- 174.00 - 133.00 -
- 174.00 - 133.00 -
- 174.00 - 133.00 -
- 174.00 - 133.00 -
- 174.00 - 133.00 -
- 133.00
- 509.00 - -
- 509.00 - 509.00 -
- 509.00 - 509.00 -
- 509.00 - 509.00 -
- 509.00 - 509.00 -
- 509.00
- - -
- 766.00 - 766.00 -
- 1,023.00 - 766.00 -
- 766.00
- 1,210.00 - -
- 1,210.00 - 1,210.00 -
- 1,210.00
- 1,100.00 - -
- 1,100.00 - 1,100.00 -
- 1,100.00
680 683.00 464,440.00 464,440.00

- 683.00 - 683.00 -
- 594.00 - 683.00 -
680 683.00
-
- 245.00 - -
100 247.00 24,700.00 245.00 24,500.00
100 245.00
- 296.00 - -
- 296.00 - 296.00 -
- 296.00
190 1,925.00 365,750.00 365,750.00

- 1,925.00 - 1,925.00 -
- 2,079.00 - 1,925.00 -
- 620.00 - 1,925.00 -
- 577.50 - 1,925.00 -
190 1,925.00
- 292.00 - -
- 320.00 - 292.00 -
- 292.00
- - -
- 660.00 - 660.00 -
90 580.00 52,200.00 660.00 59,400.00
90 660.00
- 4,813.00 - -
17 4,813.00 81,821.00 4,813.00 81,821.00
17 4,813.00
- 521.00 - -
- 521.00 - 521.00 -
- 521.00 - 521.00 -
- 521.00
- 581.00 - -
- 581.00 - 581.00 -
- 581.00
200 410.00 82,000.00 82,000.00

- 410.00 - 410.00 -
- 385.00 - 410.00 -
200 410.00
- 660.00 - -
- 660.00 - 660.00 -
- 660.00 - 660.00 -
- 660.00
- 90.00 - -
- 90.00 - 90.00 -
- 90.00
100 170.00 17,000.00 17,000.00

- 170.00 - 170.00 -
100 170.00
- 726.00 - -
- 726.00 - 726.00 -
- 632.00 - 726.00 -
- 632.00 - 726.00 -
- 726.00
- 462.00 - -
- 462.00 - 462.00 -
- 839.30 - 462.00 -
- 462.00
100 292.60 29,260.00 29,260.00

- 484.33 - 292.60 -
- 484.33 - 292.60 -
- 418.00 - 292.60 -
100 292.60
- 495.00 - -
180 495.00 89,100.00 495.00 89,100.00
- 495.00 - 495.00 -
180 495.00
340 118.50 40,290.00 40,290.00

- 118.50 - 118.50 -
340 118.50
- 1,026.00 - -
- 1,026.00 - 1,026.00 -
- 1,026.00
- 230.00 - -
- 230.00 - 230.00 -
50 230.00 11,500.00 230.00 11,500.00
50 230.00
- 140.00 - -
100 169.00 16,900.00 140.00 14,000.00
- 169.00 - 140.00 -
- 169.00 - 140.00 -
100 140.00
90 100.00 9,000.00 9,000.00

- 100.00 - 100.00 -
90 100.00
- 835.00 - -
- 835.00 - 102.00 -
- 835.00 - 102.00 -
- 835.00 - 102.00 -
- 102.00 - 102.00 -
- 798.60 - 102.00 -
1,430 726.00 1,038,180.00 102.00 145,860.00
- 726.00 - 102.00 -
- 798.60 - 102.00 -
1,430 102.00
- 220.00 - -
- 220.00 220.00
- 220.00
- 560.00 - -
- 560.00 560.00
- 560.00
- 167.00 - -
- 167.00 - 167.00 -
- 167.00 - 167.00 -
- 167.00 - 167.00 -
- 146.00 - 167.00 -
- 146.00 - 167.00 -
- 146.00 - 167.00 -
- 167.00
610 193.00 117,730.00 161.00 98,210.00

- 193.00 - 161.00 -
- 193.00 - 161.00 -
- 193.00 - 161.00 -
2,400 161.00 386,400.00 161.00 386,400.00
3,010
1,150 440.00 506,000.00 440.00 506,000.00

- 440.00 - 440.00 -
- 440.00 - 440.00 -
1,150
730 123.00 89,790.00 89,790.00

- 123.00 - 123.00 -
- 110.00 - 123.00 -
- 110.00 - 123.00 -
730 123.00
- 700.00
- 700.00 - 700.00 -
- 720.00 - 700.00 -
- 700.00
50 164.00 8,200.00 164.00 8,200.00

- 164.00 - 164.00 -
- 221.00 - 164.00 -
990 164.00 162,360.00 164.00 162,360.00
1,040
- 125.00 - -
- 125.00 - 125.00 -
- 125.00
- 7,700.00 - -
- 7,700.00 - 7,700.00 -
- 7,700.00
- 1,485.00 - -
- 1,815.00 - 1,485.00 -
60 1,815.00 108,900.00 1,485.00 89,100.00
60 1,485.00
- 360.80 - -
100 360.80 36,080.00 360.80 36,080.00
100 360.80
- 97.02 - -
- 97.02 - 97.02 -
- 97.02 - 97.02 -
- 72.47 - 97.02 -
- 97.02
- 102.37 - -
150 102.37 15,355.50 102.37 15,355.50
150 102.37
- 85.00 -
- 85.00 - 85.00 -
- 85.00
- 242.00 - -
- 242.00 - 242.00 -
- 242.00
- 119.00 - -
- 140.00 - 119.00 -
- 140.00 - 119.00 -
100 132.00 13,200.00 119.00 11,900.00
- 132.00 - 119.00 -
- 119.00 - 119.00 -
- 132.00 - 119.00 -
100 119.00 11,900.00 119.00 11,900.00
200 119.00
- 286.00
- 286.00 - 286.00 -
- 286.00 - 286.00 -
- 286.00
- 505.00 - -
- 505.00 - 505.00 -
- 505.00
- 68.00 - -
388 68.00 26,384.00 68.00 26,384.00
- 65.00 - 68.00 -
388 68.00
- 84.00 - -
- 84.00 - 84.00 -
- 84.00 - 84.00 -
- 84.00
- 58.00 - -
- 58.00 - 58.00 -
- 58.00
- 135.00 - -
- 135.00 - 135.00 -
50 177.00 8,850.00 135.00 6,750.00
50 135.00
- 252.00 - -
- 252.00 - 252.00 -
- 252.00
- 1,525.00 - -
- 1,525.00 - 1,525.00 -
- 1,525.00
- 350.00 - -
- 350.00 - 350.00 -
- 350.00
- -
- -
-
- 55.00 - -
- 73.73 - 73.73 -
- 73.73 - 73.73 -
300 45.00 13,500.00 73.73 22,120.00
300 73.73
- 88.00 - -
- 88.00 - 88.00 -
- 103.00 - 88.00 -
- 103.00 - 88.00 -
- 154.00 - 88.00 -
- 88.00
- 615.38
- 615.38 - 615.38 -
50 677.60 33,880.00 615.38 30,769.00
50 615.38
- 2,680.00 - -
- 2,680.00 - 2,680.00 -
- 2,680.00 - 2,680.00 -
- 2,680.00
- - -
- - -
-
- 405.00
- 405.00 - 405.00 -
- 405.00
30 3,791.00 113,730.00 113,730.00

- 3,791.00 - 3,791.00 -
- 3,297.00 - 3,791.00 -
30 3,791.00
- 4,147.00 - -
- 4,147.00 - 4,147.00 -
- 4,147.00 - 4,147.00 -
- 4,730.00 - 4,147.00 -
- 4,730.00 - 4,147.00 -
- 4,730.00 - 4,147.00 -
- 4,730.00 - 4,147.00 -
- 4,730.00 - 4,147.00 -
- 10,285.00 - 4,147.00 -
- 4,147.00
- 21,450.00 - -
- 21,450.00 - 21,450.00 -
- 21,450.00
16 16,500.00 264,000.00 264,000.00

- 16,500.00 - 16,500.00 -
- 16,500.00 - 16,500.00 -
16 16,500.00
- 12,760.00 - -
- 12,760.00 - 12,760.00 -
- 12,760.00
3 20,352.00 61,056.00 61,056.00

- 20,352.00 - 20,352.00 -
- 19,200.00 - 20,352.00 -
3 20,352.00
42 3,594.00 150,948.00 150,948.00

- 3,594.00 - 3,594.00 -
- 3,594.00 - 3,594.00 -
- 3,594.00 - 3,594.00 -
- 3,594.00 - 3,594.00 -
- 3,594.00 - 3,594.00 -
- 3,500.00 - 3,594.00 -
- 3,500.00 - 3,594.00 -
- 3,500.00 - 3,594.00 -
- 3,500.00 - 3,594.00 -
42 3,594.00
- 6,050.00 - -
- 6,050.00 - 6,050.00 -
- 6,050.00
- 6,285.00 - -
- 6,285.00 - 6,285.00 -
- 6,285.00 - 6,285.00 -
- 6,285.00 - 6,285.00 -
- 6,285.00
- 7,960.00 - -
- 7,960.00 - 7,960.00 -
- 9,400.00 - 7,960.00 -
- 9,400.00 - 7,960.00 -
- 9,400.00 - 7,960.00 -
- 7,960.00
- 7,756.00 - -
- 7,756.00 - 7,756.00 -
8 7,756.00 62,048.00 7,756.00 62,048.00
- 8,799.00 - 7,756.00 -
8 7,756.00
15 3,180.00 47,700.00 47,700.00

- 3,180.00 - 3,180.00 -
- 3,490.00 - 3,180.00 -
15 3,180.00
- 17,939.00 - -
2 17,939.00 35,878.00 17,939.00 35,878.00
2 17,939.00
- 8,090.00 - -
- 8,090.00 - 8,090.00 -
- 8,090.00 - 8,090.00 -
8 8,090.00 64,720.00 8,090.00 64,720.00
8 8,090.00
- 19,250.00 - -
- 19,250.00 - 19,250.00 -
- 19,250.00
- 16,500.00 - -
- 16,500.00 - 16,500.00 -
- 16,500.00 - 16,500.00 -
- 16,500.00
54 11,550.00 623,700.00 623,700.00

- 11,550.00 - 11,550.00 -
- 11,550.00 - 11,550.00 -
- 11,550.00 - 11,550.00 -
- 11,550.00 - 11,550.00 -
- 11,550.00 - 11,550.00 -
54 11,550.00
- 24,200.00 - -
- 24,200.00 - 24,200.00 -
- 24,200.00 - 24,200.00 -
- 24,200.00
15 2,560.00 38,400.00 38,400.00
- 2,560.00 - 2,560.00 -
- 2,560.00 - 2,560.00 -
- 3,811.00 - 2,560.00 -
15 2,560.00
- 4,000.00 - -
- 4,000.00 - 4,000.00 -
- 4,000.00
- 12,450.00
- 12,450.00 - 12,450.00 -
- 12,450.00
- 14,500.00 - -
- 14,500.00 - 14,500.00 -
- 14,500.00
- 33,000.00 - -
- 33,000.00 - 33,000.00 -
- 33,000.00 - 33,000.00 -
- 33,000.00
- 5,830.00
- 5,830.00 - 5,830.00 -
- 5,830.00
- 3,800.00 - -
- 4,350.00 - 3,800.00 -
- 3,800.00
9 2,750.00 24,750.00 24,750.00

- 2,750.00 - 2,750.00 -
- 2,750.00 - 2,750.00 -
- 2,900.00 - 2,750.00 -
9 2,750.00
- 12,980.00
- 12,980.00 - 12,980.00 -
- 12,980.00
- 22,000.00 - -
- 22,000.00 - 22,000.00 -
- 22,000.00
- 24,200.00 - -
- 24,200.00 - 24,200.00 -
- 24,200.00
7 10,902.00 76,314.00 76,314.00

- 10,902.00 - 10,902.00 -
- 9,350.00 - 10,902.00 -
7 10,902.00
4 7,354.00 29,416.00 29,416.00

- 7,354.00 - 7,354.00 -
4 7,354.00
7 38,500.00 269,500.00 269,500.00

- 38,500.00 - 38,500.00 -
7 38,500.00
9 32,120.00 289,080.00 289,080.00

- 32,120.00 - 32,120.00 -
- 17,500.00 - 32,120.00 -
9 32,120.00
- 5,980.00 - -
- 5,720.00 - 5,980.00 -
- 5,720.00 - 5,980.00 -
- 5,980.00
- 64,350.00 - -
- 64,350.00 - 64,350.00 -
- 44,649.00 - 64,350.00 -
- 44,649.00 - 64,350.00 -
- 64,350.00
- 20,350.00 - -
- 20,350.00 - 20,350.00 -
3 20,350.00 61,050.00 20,350.00 61,050.00
3 20,350.00
- 11,700.00 - -
- 11,700.00 - 11,700.00 -
50 11,700.00 585,000.00 11,700.00 585,000.00
50
- 6,500.00 - -
24 6,500.00 156,000.00 6,500.00 156,000.00
24 6,500.00 156,000.00 6,500.00 156,000.00
48
- 14,972.00
- 14,972.00 - 14,972.00 -
- 14,972.00
- 5,610.00
- 5,610.00 - 5,610.00 -
- 5,610.00
- 2,536.00 - -
- 2,536.00 - 2,536.00 -
- 2,536.00
- 9,350.00 - -
- 6,050.00 - 9,350.00 -
- 6,050.00 - 9,350.00 -
- 9,350.00
- 11,000.00 - -
- 11,000.00 - 11,000.00 -
- 3,700.00 - 11,000.00 -
- 11,000.00
- 33,000.00 - -
- 33,000.00 - 33,000.00 -
- 33,000.00
- 3,578.00 - -
- 3,234.00 - 3,578.00 -
- 3,578.00
- 10,219.00 - -
- 10,219.00 - 10,219.00 -
- 10,219.00
- 2,012.00 - -
- 2,012.00 - 2,012.00 -
- 2,012.00
- 3,415.00 - -
- 3,415.00 - 3,415.00 -
- 3,415.00
- 4,950.00 - -
- 4,950.00 - 4,950.00 -
- 4,950.00
- 6,610.80 - -
- 6,610.80 - 6,610.80 -
- 6,610.80
- 10,790.00 - -
- 10,790.00 - 10,790.00 -
- 10,790.00
5,555.00 -
- -
- 5,555.00 - 5,555.00 -
- 5,555.00
- 8,800.00 - -
- 8,800.00 - 8,800.00 -
- 8,800.00 - 8,800.00 -
- 8,800.00
- 6,600.00 - -
- 6,600.00 - 6,600.00 -
- 6,600.00 - 6,600.00 -
- 6,325.00 - 6,600.00 -
- 6,600.00
- 5,500.00
- 5,500.00 5,500.00
- 5,500.00 - 5,500.00 -
- 5,500.00
- 9,570.00 - -
- 9,570.00 - 9,570.00 -
- 9,570.00
- 2,400.00
- 2,400.00 - 2,400.00 -
- 2,400.00 - 2,400.00 -
- 2,400.00
- 14,509.10 - -
- 14,509.10 - 14,509.10 -
- 14,509.10
- 3,300.00 - -
- 3,300.00 - 3,300.00 -
- 4,400.00 - 3,300.00 -
- 3,932.50 - 3,300.00 -
- 3,300.00
- 17,088.00 - -
- 17,088.00 - 17,088.00 -
- 17,088.00
- 1,600.00 - -
- 1,340.00 - 1,600.00 -
- 1,600.00
- 2,680.00 - -
- 2,680.00 - 2,680.00 -
- 2,680.00
- 4,000.00 - -
- 7,260.00 - 4,000.00 -
- 4,000.00
- 40,000.00 - -
- 40,000.00 - 40,000.00 -
- 40,000.00
-
- 10,000.00 - 10,000.00 -
- 10,000.00 - 10,000.00 -
- 10,000.00 - 10,000.00 -
- 10,000.00 - 10,000.00 -
- 10,000.00
- 10,050.00 - -
- 10,050.00 - 10,050.00 -
- 10,050.00
- 9,350.00 - -
- 9,350.00 - 9,350.00 -
- 8,470.00 - 9,350.00 -
- 9,350.00
- 9,400.00 - -
- 8,470.00 - 9,400.00 -
- 9,400.00
- 2,997.00 - -
- 2,997.00 - 2,997.00 -
- 2,997.00
- 13,200.00 - -
4 13,200.00 52,800.00 13,200.00 52,800.00
4 13,200.00
19 1,835.16 34,868.04 34,868.04

- 1,835.16 - 1,835.16 -
19 1,835.16
- 4,300.00 - -
- 4,300.00 - 4,300.00 -
- 4,300.00 - 4,300.00 -
- 4,300.00
- 2,605.00 - -
- 3,135.00 - 2,605.00 -
- 2,605.00
- 3,737.00 - -
12 3,075.00 36,900.00 3,397.00 40,764.00
10 3,075.00 30,750.00 3,397.00 33,970.00
- 3,075.00 - 3,397.00 -
60 3,397.00 203,820.00 3,397.00 203,820.00
3,737.00
82
2 12,100.00 24,200.00 24,200.00

- 12,100.00 - 12,100.00 -
- 12,100.00 - 12,100.00 -
2 12,100.00
1 1649.36 1,649.36 1,649.00 1,649.36

- 1649.36 - 1649.36 -
1
- 19,058.00 - -
- 19,058.00 - 19,058.00
- 19,058.00
- 12,155.00 - -
- 12,155.00 - 12,155.00 -
- 11,475.00 - 12,155.00 -
- 11,475.00 - 12,155.00 -
- 12,155.00
- 1,640.00 - -
- 1,640.00 - 1,640.00 -
- 1,640.00 - 1,640.00 -
- 1,640.00 - 1,640.00 -
- 1,640.00
- 22,000.00 - -
- 22,000.00 - 24,887.00 -
- 24,887.00 - 24,887.00 -
- 24,887.00
4 26,812.00 107,248.00 26,812.00 107,248.00

- 26,812.00 - 26,812.00 -
- 29,975.00 - 26,812.00 -
4
- 4,600.00 - -
- 3,194.00 - 4,600.00 -
- 4,600.00
- 2,750.00 - -
- 2,750.00 2,750.00
- 2,750.00
- 11,500.00 - 11,500.50 -
- 11,500.00 - 11,500.50 -
10 11,500.50 115,005.00 11,500.50 115,005.00
10
- 30,305.00
- 30,305.00 - 30,305.00 -
- 30,305.00 - 30,305.00 -
- 30,305.00
- 36,000.00 - -
- 36,000.00 - 36,000.00 -
- 36,000.00
- 35,145.00
- 35,145.00 - 35,145.00 -
- 35,145.00
- 23,100.00 - -
- 23,100.00 - 23,100.00 -
- 17,600.00 - 23,100.00 -
- 23,100.00
- 5,800.00 - -
- 5,800.00 - 5,800.00 -
10 15,356.00 153,560.00 5,800.00 58,000.00
10 5,800.00
- 5,670.00 - -
- 5,670.00 - 5,670.00 -
- 4,990.00 - 5,670.00 -
- 4,990.00 - 5,670.00 -
- 5,670.00
- 1,899.00
- 1,899.00 - 1,899.00 -
- 1,899.00
- 35,640.00 - -
- 18,461.00 - 18,458.00 -
- 18,458.00 - 18,458.00 -
- 18,458.00
- 12,749.00 - -
- 12,749.00 - 12,749.00 -
- 12,749.00
- 80,000.00 - -
2 80,000.00 160,000.00 80,000.00 160,000.00
2 80,000.00
- 83,443.75 - -
- 83,443.75 - 83,443.75 -
- 83,443.75 - 83,443.75 -
- 83,443.75
- 66,000.00 - -
- 66,000.00 - 66,000.00 -
- 66,000.00
- 5,430.00 - -
- 5,430.00
-
- 770.00 - -
- 770.00 - 770.00 -
- 770.00 - 770.00 -
- 770.00 - 770.00 -
- 770.00
- 221.00 - -
100 221.00 22,100.00 221.00 22,100.00
- 226.00 - 221.00 -
- 221.00 - 221.00 -
100 221.00
- 16,500.00
- 16,500.00 - 16,500.00 -
- 16,500.00
- 45,375.00 - -
- 45,375.00 - 45,375.00 -
- 45,375.00
- 27,500.00
- 27,500.00 - 27,500.00 -
- 27,500.00
- 10,318.00 - -
- 10,440.00 - 10,318.00 -
- 10,318.00
- 9,080.00 - -
- 9,080.00 - 9,080.00 -
- 10,318.00 - 9,080.00 -
- 9,080.00
- 737.74 - -
- 737.74 - 737.74 -
- 737.74 - 737.74 -
- 838.34 - 737.74 -
45 838.34 37,725.30 737.74 33,198.23
- 838.34 - 737.74 -
- 838.34 - 737.74 -
45 737.74
- 4,675.00 - -
- 4,675.00 4,675.00
- 4,675.00
- 4,675.00 - -
- 4,675.00 - 4,675.00 -
- 4,675.00
- 4,675.00 - -
- 4,675.00 - 4,675.00 -
- 4,675.00
- 6,325.00 - -
- 6,325.00 - 6,325.00 -
- 6,050.00 - 6,325.00 -
- 6,325.00
- 6,325.00 - -
- 6,325.00 - 6,325.00 -
- 6,325.00
- 6,325.00 - -
- 6,325.00 - 6,325.00 -
- 6,050.00 - 6,325.00 -
- 6,325.00
- 6,050.00 - -
- 6,050.00 - 6,050.00 -
- 6,050.00
1 12,650.00 12,650.00 12,650.00

- 12,650.00 - 12,650.00 -
1 12,650.00
- 24,200.00 - -
- 24,200.00 - 24,200.00 -
- 24,200.00
- 24,200.00 - -
- 27,500.00 - 24,200.00 -
- 24,200.00
- 119,174.19 - -
- 119,174.19 - 119,174.19 -
- 119,174.19
- 1,957.50 - -
- 1,957.50 - 1,957.50 -
- 1,957.50
8 7,480.50 59,844.00 59,843.20

- 7,569.00 - 7,480.40 -
- 7,569.00 - 7,480.40 -
8 7,480.40
- 3,960.00
5 3,960.00 19,800.00 3,960.00 19,800.00
5 3,960.00
- 1,210.00 - -
- 1,210.00 - 1,210.00 -
- 1,210.00
20 425.60 8,512.00 8,512.00

- 425.60 - 425.60 -
20 425.60
- 660.00 - -
- 473.00 - 660.00 -
- 473.00 - 660.00 -
- 473.00 - 660.00 -
- 429.00 - 660.00 -
- 429.00 - 660.00 -
- 660.00
- 660.00 - -
- 429.00 - 660.00 -
- 660.00
- 15,400.00 - -
- 15,400.00
- 311,900.00 - -
- 315,128.03 - 311,900.00 -
- 311,900.00
- 1,393.90 - -
- 1,393.90 1,393.90
- 1,393.90
- 5,693.00 - -
- 5,693.00 5,693.00
- 5,693.00
- 4,959.00 - -
- 8,355.00 - 8,355.00 -
- 4,959.00 - 8,355.00 -
- 8,355.00
- 8,355.00 - -
- 8,355.00 - 8,355.00 -
- 4,959.00 - 8,355.00 -
- 8,566.24 - 8,355.00 -
- 8,566.24 - 8,355.00 -
- 8,355.00
- 8,355.00 - -
- 8,355.00 - 8,355.00 -
- 8,355.00 - 8,355.00 -
- 4,959.00 - 8,355.00 -
- 8,355.00
- - -
- 1,564.20 - 1,564.20 -
200 1,276.00 255,200.00 1,564.20 312,840.00
200 1,564.20
- 27,500.00 - -
- 27,500.00 - 27,500.00 -
- 27,500.00 - 27,500.00 -
- 27,500.00 - 27,500.00 -
- 27,500.00
- 3,404.00 - -
- 3,404.00 - 3,404.00 -
- 3,404.00
- 320,000.00
- 320,000.00 - 320,000.00 -
- 320,000.00
- 2,145.00 - -
- 2,145.00 2,145.00
- 2,145.00
- 2,145.00 - -
- 2,145.00 2,145.00
- 2,145.00
- 28,600.00 - -
- 28,600.00 28,600.00
- 28,600.00
- 440,000.00 - -
- 440,000.00 - 440,000.00 -
- 440,000.00
- 330,000.00 - -
- 330,000.00 - 330,000.00 -
- 330,000.00
- 99,220.00 - -
- 99,220.00 - 99,220.00 -
- 99,220.00
- 36,300.00 - -
- 36,300.00 36,300.00
- 36,300.00
- 3,566.78 - -
27 3,566.78 96,303.00 3,566.78 96,303.00
- 3,000.00 - 3,566.78 -
27 3,566.78
- 14,868.83 - -
- 14,868.83 14,868.83
- 14,868.83
- 12,500.00 -
- 12,500.00 12,500.00
- 12,500.00
- 38,999.00 - -
- 38,999.00 - 38,999.00 -
- 38,999.00
- 387,800.00
- 387,800.00 - 387,800.00 -
- 387,800.00
-
-
-
- 57,200.00 - -
- - 57,200.00 -
- 57,200.00
- 55,000.00 - -
- 55,000.00 - 55,000.00 -
- 55,000.00
- 40,700.00 - -
- 19,854.92 - 40,700.00 -
- 5,400.00 - 40,700.00 -
- 5,400.00 - 40,700.00 -
- 40,700.00
- 66,000.00 - -
- 66,000.00 - 66,000.00 -
- 66,000.00
- 1,900.00 - -
- 1,900.00 - 1,900.00 -
110 1,900.00 209,000.00 1,900.00 209,000.00
110 1,900.00
- 1,300.00 - -
- 1,240.00 - 1,448.00 -
- 1,240.00 - 1,448.00 -
150 1,448.00 217,200.00 1,448.00 217,200.00
- 1,300.00 - 1,448.00 -
150 1,448.00
- 23,000.00 - -
- 23,000.00 - 23,000.00 -
- 23,000.00 - 23,000.00 -
- 23,000.00
- 45,100.00 - -
- 45,100.00 45,100.00
- 45,100.00
- 45,100.00 - -
- 45,100.00 - 45,100.00 -
- 45,100.00 - 45,100.00 -
15 45,100.00 676,500.00 45,100.00 676,500.00
15 45,100.00
- 22,527.00
10 22,527.00 225,270.00 22,527.00 225,270.00
10 22,527.00
- 41,998.00 - -
- 41,998.00 - 41,998.00 -
- 41,998.00
- 14,487.00 - -
- 14,487.00 - 14,487.00 -
- 14,487.00 - 14,487.00 -
- 14,487.00
15 18,750.00 281,250.00 281,250.00

- 18,750.00 - 18,750.00 -
- 18,750.00 - 18,750.00 -
- 18,750.00 - 18,750.00 -
15 18,750.00
18 16,203.00 291,654.00 291,654.00

- 16,203.00 - 16,203.00 -
- 16,203.00 - 16,203.00 -
- 16,203.00 - 16,203.00 -
18 16,203.00
- 23,782.00 - -
- 23,782.00 23,782.00
- 23,782.00
- 14,250.00 - -
- 14,250.00 - 14,250.00 -
- 14,250.00 - 14,250.00 -
- 14,250.00
- 11,913.00 - -
- 11,913.00 - 11,913.00 -
- 11,913.00 - 11,913.00 -
- 11,913.00 - 11,913.00 -
- 11,913.00
- 43,900.00 - -
- 43,900.00 43,900.00
- 43,900.00
- 43,900.00 - -
- 43,900.00 - 43,900.00 -
15 43,900.00 658,500.00 43,900.00 658,500.00
15 43,900.00
- 100,000.00 - -
- 100,000.00 100,000.00
- 100,000.00
- 82,500.00 - -
- 82,500.00 82,500.00
- 82,500.00
- 395,900.00 - -
- 395,900.00 - 395,900.00 -
2 395,900.00 791,800.00 395,900.00 791,800.00
- 395,900.00 - 395,900.00 -
- 395,900.00 - 395,900.00 -
2 395,900.00
- 396,000.00 - -
- 396,000.00 396,000.00
- 396,000.00
- 1,320,000.00 - -
- 1,379,984.00 - 1,379,984.00 -
- 1,379,984.00 - 1,379,984.00 -
- 1,379,984.00 - 1,379,984.00 -
- 1,320,000.00 - 1,379,984.00 -
- 1,379,984.00
-
-
- 317,015.00 - -
- 317,015.00 - 317,015.00 -
- 317,015.00
- 69,000.00 - -
- 69,000.00 69,000.00
- 69,000.00
- 236,490.00 - -
- 247,229.00 - 247,229.00 -
- 247,229.00 - 247,229.00 -
- 247,229.00
- 176,000.00 - -
- 176,000.00 - 176,000.00 -
- 176,000.00
- 2,930.00 - -
- 2,930.00 - 2,930.00 -
- 2,930.00
- 236,500.00 - -
- 276,500.00 - 236,500.00 -
- 236,500.00
- 27,500.00 - -
- 27,500.00 - 27,500.00 -
- 27,500.00
- 27,500.00 - -
- 27,500.00 - 27,500.00 -
- 27,500.00
- 17,600.00 - -
- 17,600.00 17,600.00
- 17,600.00
- 72.00 - -
- 1.00 - 1.00 -
- 72.00 - 1.00 -
- 1.00
- 512.00 - -
- 512.00 - 588.18 -
- 512.00 - 588.18 -
- 512.00 - 588.18 -
600 588.18 352,908.00 588.18 352,908.00
600
- 14,862.00
- 14,862.00 - 14,862.00 -
- 14,862.00
- 20,906.00 - -
- 30,595.00 - 30,595.00 -
3 20,906.00 62,718.00 30,595.00 91,785.00
3 30,595.00
- 7,462.00 - -
- 7,462.00 7,462.00
- 7,462.00
- 8,323.00 - -
- 8,323.00 8,323.00
- 8,323.00
- 2,298.00 - -
- 4,000.00 - 2,298.00 -
- 4,000.00 - 2,298.00 -
- 4,000.00 - 2,298.00 -
- 2,298.00
- 6249.95 - -
- 6249.95 - 6249.95 -
- 6249.95 - 6249.95 -
- 6249.95
- 6249.95 - -
- 6249.95 6249.95
- 6249.95 6249.95
- 6249.95
- 1.00 - -
- 1.00 1.00
- 1.00
- 1.00 - -
- 1.00 1.00
- 1.00
- 1.00 - -
- 1.00 1.00
- 1.00
- 220,000.00
- 220,000.00 - 220,000.00 -
- 220,000.00
79,200.00
- - -
- 79,200.00 79,200.00
- 79,200.00
2 24,222.22 48,444.44 48,444.44

- 24,222.22 - 24,222.22 -
- 27,729.65 - 24,222.22 -
- 33,275.00 - 27,729.65 -
2 27,729.65
10 2,625.00 26,250.00 26,250.00

- 2,625.00 - 2,625.00 -
10 2,625.00
- 48,400.00 - -
- 48,400.00 - 48,400.00 -
- 42,372.00 - 48,400.00 -
- 48,400.00
- 254.00 - -
- 128.97 - 128.97 -
- 128.97 - 128.97 -
- 128.97
- 220,000.00 - -
- 220,000.00 220,000.00 -
- 220,000.00
- 66,000.00
- 66,000.00 - 66,000.00 -
- 66,000.00
- 5,203.00
- 5,203.00 - 5,203.00 -
- 5,203.00
- 309,500.00 - -
- 309,500.00 309,500.00
- 309,500.00
- 385,000.00 - -
- 385,000.00 - 385,000.00 -
- 385,000.00
-
- 618,750.00 - -
- 618,750.00 618,750.00
- 618,750.00
- 120,000.00 - -
- 120,000.00 120,000.00
- 120,000.00
2 20,400.00 40,800.00 40,800.00

- 16,350.00 - 20,400.00 -
2 20,419.00
- 69,300.00 - -
- 69,300.00 - 69,300.00 -
- 181,500.00 - 69,300.00 -
- 181,500.00 - 69,300.00 -
- 69,300.00
- 11,000.00 - -
- 11,000.00 11,000.00
- 11,000.00
- 75,625.00 - -
- 75,625.00 - 75,625.00 -
- 75,625.00 - 75,625.00 -
- 75,625.00 - 75,625.00 -
- 75,625.00
- 61,250.00 - -
- 61,250.00 61,250.00
- 61,250.00
- 70,000.00
- 70,000.00 - 70,000.00 -
- 70,000.00
- 122,195.00 - -
- 122,195.00
- 230,000.00 - -
- 230,000.00
- 41,700.00 - -
- 41,700.00
- 199,100.00 - -
- 199,100.00
- 77,500.00 - -
- 77,500.00
- 41,255.00
- 41,255.00 - 41,255.00 -
- 41,255.00
- 8,470.00 - -
- 8,470.00 8,470.00
- 8,470.00
- 55,000.00
- 55,000.00 - 55,000.00 -
- 55,000.00
- 28,400.00 - -
- 28,400.00
- 44,550.00 - -
- 44,550.00 - 44,550.00 -
- 44,550.00 - 44,550.00 -
- 44,550.00
- 20,900.00 - -
- 20,900.00
- 17,900.00 - -
- 17,900.00
1 64,300.00 64,300.00 64,300.00

1 64,300.00
- 30,400.00 - -
- 30,400.00
- 8,000.00 - -
- 8,000.00 - 8,000.00 -
- 8,000.00
- 164,484.00 - -
- 164,450.00 - 121,000.00 -
- 164,450.00 - 121,000.00 -
- 121,000.00 - 121,000.00 -
- 150,000.00 - 121,000.00 -
- 150,000.00 - 121,000.00 -
- 121,000.00
3 103,400.00 310,200.00 310,200.00

- 99,000.00 - 103,400.00 -
- 99,000.00 - 103,400.00 -
3 103,400.00
- 148,500.00 - -
- 148,500.00 - 148,500.00 -
- 148,500.00 - 148,500.00 -
- 148,500.00
- - -
- 104,500.00 - -
- 99,000.00 - -
- 99,000.00 - 99,000.00 -
- 99,000.00
- 313,500.00
- 313,500.00 - 313,500.00 -
- 313,500.00
- - -
- 74,800.00 - 74,800.00 -
- 38,500.00 - 74,800.00 -
- 38,500.00 - 74,800.00 -
- 38,500.00 - 74,800.00 -
- 74,800.00
- 418,000.00 - -
- 418,000.00 - 418,000.00 -
- 418,000.00
- 5,500.00 - -
- 5,500.00 5,500.00
- 5,500.00
- 24,750.00 - -
- 24,750.00 - 24,750.00 -
- 24,750.00
1 440,000.00 440,000.00 440,000.00

- 440,000.00 - 440,000.00 -
- 440,000.00
- 27,500.00 - -
- 27,500.00 - 27,500.00 -
- 27,500.00
- 1.00 - -
- 1.00 - 1.00 -
- 1.00
- 2,475.00 - -
- 2,475.00 - 2,475.00 -
- 2,475.00
- 1.00 - -
- 1.00 - 1.00 -
- 1.00
- 420,000.00 - -
- 420,000.00 - 420,000.00 -
- 420,000.00
- 105,875.00 - -
- 105,875.00 - 105,875.00 -
- 105,875.00
- 139,700.00 - -
- 139,700.00 - 139,700.00 -
- 139,700.00
- 38,500.00 - -
- 38,500.00 - 38,500.00 -
- 38,500.00
- 363.00 - -
- 363.00 - 363.00 -
- 363.00
- 1,507.00 - -
- 1,507.00 - 1,507.00 -
- 1,507.00
- 48,400.00 - -
- 48,400.00 - 48,400.00 -
- 48,400.00
- 36,300.00 - -
- 36,300.00 - 36,300.00 -
- 36,300.00
- 53,900.00 - -
- 53,900.00 - 53,900.00 -
- 53,900.00
- 78,100.00 - -
- 78,100.00 - 78,100.00 -
- 78,100.00
- 357,500.00 - -
- 357,500.00 - 357,500.00 -
- 357,500.00
- 170,500.00 - -
- 170,500.00 - 170,500.00 -
- 170,500.00
23,281,023.27 21,933,922.45
Rantau, 31 Desember 2016

Pengelola Obat Puskesmas BINUAN
………………………………….
NIP.
Ket Bacth
May-21 16050851
Sep-18 1409010
Sep-18 240516
Apr-19 250156 MERAPI 92200
Feb-20 PB018027
Nop-20 260583
Aug-17 75373300
Aug-17 75373301
Aug-17 75373002
Aug-17 75373304
Aug-17 75373305
Aug-17 75373306
Aug-17 75373307
Aug-17 75373309
Aug-17 75373311
Aug-17 75373299
Nov-19 75325006
Jul-19 T2388130
KF 16800
Jun-18 1606138
Mar-19 05215C0020
May-18 521450130
Okto 18 1610195
Sep-18 161106
Sep-18 161108
Sep-18 161109
Sep-18 161124
Jul-21 H60950T KF 226400
Jul-21 H60951T KF 226400
Sep-18 161106 KF 226400
May-20 00815E0290 KF 226400
May-20 00815E0300
May-20 00815E0310
May-20 00815E0350
Jul-19 00814G0310
Jul-19 0081460290 prov 1000
Dec-17 1412019
Mar-17 1403076
Jan-17 A1201098
Jun-20 95385002
Aug-20 95385003
Aug-20 95385003
Dec-17 65385040
Dec-17 65385040
Sep-17 75386003
IGM 4528
Oct-19 D51024AF
Jul-19 D51004AF
May-18 1505-11-96
Jul-17 1407-5498
Mei-20 DS11008AF SURYA 4000
SURYA 4000
Aug-19 S3053AF
Nov-18 KF2150
Aug-19 S3053AF
Nov-18 KF2148
igm 500
Apr-19 953310122
Jan-19 1412114
Nov-17 1311038
May-17 1305026
Jun-18 1306004
Sep-17 131C019
Sep-17 65342024-1
Jun-17 65342018-1
360
Aug-19
Feb-19 97KA0074
Jun-17 75344012-2
Jan-17 AD0143J
Jul-18
Feb-19 161B002
Sep-20
3 8
Aug-19 97KG0095
Sep-17 4701115
30
Aug-17 L14461
Sep-17 33145851E
Dec-19 250121
Jun-19 240619
Apr-17 220509
Jul-18 80644
Nov-20 251218
Dec-18 240112
Jan-18 460202
Sep-19 341018
Jan-21 160209
Jun-19 140714
Jul-19 140809
Jul-19 21201608 82 BERKAH

82 BERKAH
82 BERKAH
Feb-18 150251
Feb-19 160296
Apr-18 150459
Mar-18 150356
Mar-17 140313
Jun-17 1408081
Feb-17 004162
Apr-19 246/16
May-17 15228
May-18 1605121
Dec-20 1601050
APL 19000
Jan-21 160202M
Mar-20 150427M
Jan-20 150228M
Apr-20 150513
Apr-20 15501
Jan-21
Feb-20 150307R KPP 312
May-19 14501
Sep-18 01101388
KPP 72
Mar-20 20042015
Sep-18 30102013
Mar-20 20042015
Sep-17 120988
504
Sep-17 120988
Mar-20 20042015
Nov-19 31122014
Jun-19 15072014 RNI
Feb-18 130188
Nov-20 181K45H
Sep-20 177145H
Jul-19 28081488
Jan-20 25021588 RNI 800
1800 PROV
Mar-21 17404614
Feb-21 180846M
Sep-20 I90145M1
Aug-19 14091488
Jan-20
Feb-18 130188
MBS 40000
MBS 25400
May-19 T2179AF
Jun-19 T2262AF
Mar-19 180025 2700
Mar-18 17C034
1000 PROV
Nov-17
Dec-18 1411021
Dec-18 1411021
Feb-18 1311019
Aug-19 BG1157
Aug-19 BG1158
Dec-17 TS549722
Dec-17 TS549723
Dec-17 TS549704
Jul-17 TS5549278
Juni 20 KG1290
Oct-17 J14128413
Aug-19 H1601881
KF 24400
- 904021 BOTOL KF
5900
Jun-19 00716F0050
May-19 00716E0480
Jun-20 F150931B 1100
Jun-20 F150929B
Feb-18 00715B0080
Jun-17 00714F0120
Jun-17 6010680
Feb-20 A7803AT
Feb-18 A1610BR KF 750
Mar-17 BC1006
Nov-18 1310008
May-19 15CH006
May-18 461605144
Sep-17 95381007
igm 600 IGM 3100

Oct-21 D37063 IGM 600
Jun-20 IE2149J
Aug-20 IE2149J
Aug-20 IE2149J
Jun-20 1504057 7900 KF
Nov-20 1510079
Jul-20 H50901T
Nov-18 M31365T
17-Apr
Feb-18 95354001
Dec-18 L131532B
Nov-18 131005 pro 5900

Aug-18 1305005
Aug-18 1305006
pro 1900
Jul-18 A1907FQ
Sep-18 1403018
Jul-18 1406005
Aug-17 1306010 RNI 102800
May-21 E160425B IGM 83900

Jul-18 G13098213 IGM 83900
IGM 83900
Jun-19 A7934FS
Jun-19 A7935FS
pro 2000
Apr-20 AD911913
Aug-19 1508-09-134
Aug-19 1508-09-134
SST 22400
Jun-20 1605023
Feb-19 1502003
Mar-18 1401008 SST 22400
Jul-17 1305016
Aug-18 161087
Oct-18 161278 IGM 5500
Aug-18 161087
Sep-17
Mar-18 B30502 SST 300000
SST 300000
SST 300000
SST 300000
Jun-18 160627 SST 300000
Jan-19 1412006 SST 300000
SST 300000
SST 300000
Jan-20 TAW21 SST 300000

Jan-20 TAW32 SST 300000
Apr-20 TFW11
Apr-20 TFW29
Apr-20 TFW7/TFW8
Apr-20 TFW30
Apr-20 TFW31
Apr-20 TFW34
Feb-20 TBW1
Apr-20 TFW6/TFW7
Jul-19 150534
3100
Feb-18 BC0274J
Jan-20 AA91273
Jul-18 YG912717
RNI 100
Feb-19 95371001
Nov-17 75371007
Jan-20 95372001 KF 185000

Jul-17 65372017
KF 185000
5500
Feb-18 B150225B
Feb-18 B150224B
7200 SST
Mar-20 1502002
Nov-18 1310012
May-18 1505122
Aug-17 1408004
300
May-20 16071252
Oct-17 133410
25000
KF 109500
KF 109500
Jun-18 160576
Mar-19 150171
May-19 150294
400
Mar-18 C50345T
Juni -18 G50703T
Aug-19 16SE172
Apr-19 S2010AF
IGM 1380
IGM 1500
Oct-19 DG2083
Oct-19 DG2085 3 KTK
Oct-19 DG2084
May-19 1505-0786
Aug-19 1508-7686
Sep-18 1409-2186
Sep-18 1409-0686
Juni-20 LB2668
Oct-18 14IJ026
Jul-17 PIG48942
Jun-17 PIC48242
Aug-17 658030032
Aug-18 75803001
MUP 40
MUP 40
May-17 91E45A
Jun-17 93F45A
Jul-17 14F0305
Aug-18 151H025
Nov-18 1311038 prov 400
Nov-18 1311038
KF 2946
KF 2946
Oct-18 1816101414
Aug-20 161065T
Apr-19 050465T
Jan-19 K3991AF
Mar-18 1402001
May-20 16SE050
1244 IGM
Jul-17 15LG003 BERKAH 280

Jul-17 15CG004
Sep-17
SST 950
Aug-19 085097W
Aug-20 086204W
Jul-18 03081588
Jul-18 03081588 535 SST
535 SST
180 prov
Jan-18 3501001
IK3705T
- IK3705T
Nov-17 J38409
Nov-17 J48417 IGM 2984
Nov-17 338409 IGM 2984
IGM 2984
IGM 2984
Oct-19 A80JFS0490
Oct-19 A80JFU0510
Oct-19 A80JFW0530 KF 7
Sep-18 ICI0785
May-18 A80IDI0800
May-18 A80EE00480
May-18 A80IDI0800
May-18 A80EER0220
IGM 209
50
Sep-20 096141W
Oct-18 104028W
Sep-18 05042018
- 000120615
Sep-18 -
- 000180615 KPP 275
PRO 271
042188MX
- 081988MX
- 081988MX
121888MX
- 022088MX
000180615
- 2300
Jan-19 C07021488
Jan-19 C07021488
200000
Jan-19 A1301AS
May-19 EO0539J
May-17 EB1856J
May-17 EB1856J
Feb-20 344044
Feb-19 333211
Dec-18 L131514
Jun-18 327676
Jun-18 327676 50000 IGM
MBS 9600
RNI 30000
Dec-17 DL0501 MBS 9600

Jul-19 1506048 RNI 30000
Oct-18 PK098022
Oct-18 PK098020
Oct-18 PK098023
Aug-18 PH098010
Aug-18 PH098010
IGM 15350
IGM 8200
Jun-18
10920 SST
May-20 AC0181 10920 SST
May-20 AC0181
Jul-17 12207503
May-17 12205507
May-17 12207503
May-17 AE0181
ENS 75000
May-20 E13606
May-20 E13606
Aug-19 H13513
4800
Aug-19 BG1178
Aug-19 BG1178 AAM 4500
Sep-20 509450
Sep-19 TKS75243
Mei 20 KG1399 RNI 1600
Oct-19 60309
Aug-18 TSJ82644
RNI 1170
RNI 600
Mar-20 160236
Jun-19 150337
Jun-19
Dec-17 BN4600206
Jan-19 50101 IGM 58700

Sep-18 40108 IGM 58700
IGM 58700
Oct-17 NS0971
Dec-16 EL0761
RNI 47100
PARA 6500
Sep-21 8532300Z 15000
Dec-20 85323006ZN
Dec-20 85323006ZN
Feb-19 1501002
PARA 6500
Dec-19 FG1532
Mar-20 IG1050
Dec-19 FG1532
Oct-20 8532405
Jun-19 75324019
Mei 20 KG1270
Dec-19 6605011
Sep-19 205243
Jun-18 193004 16900 ENS

16900 ENS
Jul-17 KPH29643
Sep-20 191041 AAM 1000

Sep-20 191041
Jul-20 160715108
Aug-19 204005
Apr-18 1505004 95000
Oct0 20 1610.13.108
dirjen p2 500000
Feb-20 47A0444
Jul-19 4690260
Sep-18 KD2024D
KF 2600
Nov-19 1411017
Nov-19 1411017
Sep-18 TR3G005
Jul-18 1507210
Nov-17 P14377
Dec-17 P15003
Sep-18 TR3G005
Dec-17 PI5002
IGM 85000
IGM 85000
IGM 85000
Dec-17 L121786B
Jul-17 G121086B
Jan-20 81500328 KF 8300

Apr-18 D13051213
Aug-17 1304010-48
Apr-20 160410149
Apr-19 150416149
Apr-19 150417149
Apr-19 150418149
Jul-18 1407-12149
Jul-18 1407-12149
26700 RNI
Apr-18 DE0812J
Apr-18 DE0888J
Apr-18 DE0891J
Apr-17 DD0597J
Nov-19 T2137AF
Nov-18 1410015 tempo
tempo
tempo
tempo
Oct-17 A5D256
Oct-17 A5D256
3000
Jun-18 YU088
Jun-18 YU088
Jun-17 XV082
pro 4450
Jan-19 010026
Mar-18 040015
960
Apr-19 A6D884
Apr-19 A6D884
May-17 T082ED08
Jul-18 41307
Jul-17 31907
Apr-20
Jan-19 150108103 pro 1250
pro 1250
Jun-18 160516 1800

Apr-17 KPE16843 1800
igm 6480
igm 21660
igm 21660
igm 21660
Sep-18 215147
Jul-19 1506055
Jun-19 1506036
Jun-17 F140611B
Mar-18 4700591
Mar-18 4700591 19800
Apr-17 17D051 19800
Jun-17 17F153
Jun-17 17F154
Jun-17 17F153
9900 ENS
Feb-19 60502
Feb-19 60502
ENS 8650
Jul-17 10214G0040 ENS 8650
Jul-17 10214G0040 ENS 8650
May-20 T024F005 60000 PV

May-20 T024F005 60000 PV
Jan-19 T024E001 60000 PV
Jan-19 T024E002
MDI 10000
Aug-18 214060 MDI 10000
Aug-18 214060
Aug-17 204074
Aug-18 214034
Oct-17 205038
Aug-17 204038 MDI 40000
Aug-17 204033 MDI 40000
May-18 A6E001
Aug-17 A5B076
Aug-17 A5B076
KF 22900
Jul-19 TPH55044
Jul-19 TPH55044
6800
8700
Sep-17 310046512
Sep-17 J10046511
Sep-17 J10046512
pro 62600
Apr-20 AD91267 204100 RNI

Mar-19 2C91264 pro 62600
Feb-19 2B912613
Feb-19 2B912614
Jul-17 85485004
Jul-17 85485004
Apr-20 9502016
Apr-20 9502018
May-20 95026023
May-20 95026024
Sep-19 85026025
Jun-19 85026007
Jul-19 85026015
Jul-19 85026013
Jun-19 85026007
RNI 86650
RNI 86650
55600 RNI
55600 RNI
Jan-21 95364002 55600 RNI
Feb-21 95364004
May-21 95364012
Jan-21 95364002 AAM 22600
May-20 85364018 AAM 22600
Jun-19 75364010 AAM 11900
Jun-19 75364010 AAM 22600
Sep-18 85365032
Sep-18 85365032
May-18 85365011
Aug-18 85365018
Okt0 19 9536504
Jun-19 YU017 IGM 10020

Jun-19 YU017
Aug-18 XG025
Nov-19 46L4142
Aug-19 46H4166
Feb-19 4601
Mar-19 4603593
Apr-18 E7006 BSP 3240

May-17 130300
Dec-19 FG1519
Dec-19 FG1519 ENS 8400
Apr-19 1504-17-53 1500
KF 45000
KF 45000
May-18 E130697B
- KF 90000
- KF 90000
May-20 K039F017
Oct-18 PK2049
Oct-18 PK2048
Aug-17 204005
Jun-20 F150866B ENS 70000

Jul-20 G151035R
Jun-20 F150866B
May-17 130502143
Jul-20 G151048B
Jul-20 G151026B
KF 13900
IGM 12500
Aug-18 47F4187 RNI 34500

Nov-17 46H413X
Nov-17 46H4139 RNI 34500
Aug-18 508607
Aug-18 508608
Aug-18 47F4187 RNI 34500
Aug-18 508607 RNI 34500
May-18 47D4140 RNI 34500
Jun-18 065039W
May-18 055075W
PARA 15000
PARA 15000
May-18 14KK015 PARA 15000
Jun-20 A8224FT PARA 15000

May-20 A8218ET PARA 15000
Jun-19 A8223FS
Jun-20 A8224FT
May-20 A8218ET
May-20 A8218ET
prov 1800
prov 1800
Jan-20 A20608
Aug-18 19H140
Aug-18 19F020
Jun-17 F10296505
IGM 150000
Jan-19 A160037B
Jul-17 1305001 pro 300
4000 IGM
Jan-20 124167W
Aug-20 085051W
Aug-20 026051W
Apr-19 1550017
Apr-19 VA002
Apr-19 VA002
Mar-18 XM002
Jan-17 WJ001
Jul-16 VL001
Sep-19 1501002
Dec-17 43106 IGM 1499
May-18 4506126
Jun-18 4507268
SST 200
Mar-18 1502007
May-19 E160593B
May-19 E160593B PV 802
Sep-18 1510068 PV 802
PV 802
Dec-17 55120108
Jul-18 5607001
Dec-17 55120108
Feb-19 5507007
Jun-18 5412013
Nov-18 5505016
Nov-18 5505016
Nov-18 5505025 100
Sep-17 5403019
Dec-19 C6F775
Dec-19 C6F775
Jul-19 C6F773
Jul-19 C6F773
Jul-18 C5G361
Jun-19 F160771B
Jun-19 F160771B
Feb-18 B150205B
610 SST
610 SST
Apr-19 290349
Apr-19 290350
Apr-19 290352
Apr-19 290353
Apr-19 290354
Apr-19 290344
Nov-17 270751 IGM 120
Nov-17 270758 IGM 60
Nov-17 270760
Nov-17 270759
135 IGM
May-19 6511002
Sep-18 6503021
May-19 6511002 IGM 521
Aug-18 6502022
IGM 521
Aug-18 PH358046
May-17 50405
Jul-17 50607 KF 464
Jan-17 40307 KF 464
Apr-18 1604073
Feb-18 1602043
Oct-17 1510050
May-20 1605-16-186A 131 RNI

May-20 1605-16-186A 131 RNI
Apr-19 1504-30-186
Sep-17 BNSCK3
4700 RNI
4700 RNI
Nov-17 YH320316 700
Nov-17 YH920316 700
Aug-17 YE92033
Apr-17 YA92034
3016
Jun-18 E6F738
Jun-18 E6F738
Feb-19 E5H295
Jun-19 E6F758
Jun-19 E6F758 1478 PV
Jul-18 E4G263
Jul-18 E4G265
Aug-17 E4H271
Aug-17 E4H271 30
Feb-19 ESH806
Feb-18 E5H308 30
Feb-18 E5H308
May-19 S2026AF
May-19 S2040AF
May-19 S2025AF
340 SST
Jun-19 FG2155
775 IGM
480 PV
Nov-17 K1401
Apr-18 660420 IGM 266
May-19 E6E688
May-19 E6E688 para 50
May-18 E5E163
PV 10772
Jul-18 E5G262
PV 4821
Feb-19 E6B478
Jul-18 50307
Apr-20 YA013
Apr-20 YA015 4292 RNI
Apr-20 YA012
Mar-19 XM012
400 PV
May-18 E10176534
295 PV
633 RNI
Feb-17 E5H314 633 RNI
Aug-19 B200026 IGM 1822

Aug-19 B200026
Aug-17 15D0581 IGM 42795
Nov-19 E6E686
Jul-19 B700036 724
Nov-19 E6E686
Feb-19 E5H295
PV 1478
Jun-19 52016016
Jun-19 52016016
Sep-18 50209
Apr-18 1605026
Aug-17 1508042
Mar-17 1503006
Nov-17 S054E050
Nov-17 S054E050
Apr-17 5054E012 40
Mar-17 S054E009
May-18 C6E739 PARA 370

Jun-18 C5F324
May-18 C6E739
Sep-17 U09027
Maret 18 A03001 ENS 908
ENS 908
ENS 908
Apr-19 E60546
Apr-19 E6D545
Agus 19 EGH801
AAM 540
Nov-16 MHC06
May-18 PSF20344
Sep-18 215446
Sep-17 205444
Sep-17 205444
Mar-19 215222
Mar-19 215222
Oct-18 46F0592
Dec-17 IL3K005
1400 PV
Jun-17 4F0648
Mar-17 4C0245 200 PV
670
IGM 25
Jun-19 F6F465 IGM 5
Jun-19 F6F465
May-18 F5E103
Jun-19 F6F443
Jun-19 F6F443
Apr-18 F5D076
Jan-16 8141212
60 ENS
60 AAM
Jul-18 F66472
Jul-18 F66472
Jul-17 F5G137
MDI 3920
MDI 3920
Feb-18 1502012 pro 30

Apr-18 1504057 MDI 30
Jan-19 AD01365 APL300
Apr-19 2120042 APL300

Feb-18 2250316
Feb-18 201002
MERAPI 100
MERAPI 100
MERAPI 100
MERAPI 100
Aug-19 H10356612
Jun-18 F10356504
MERAPI 300
Sep-19 210346503
IGM 200
Sep-17 YW0492
IGM 200
IGM 750
Feb-17 42896
Apr-17 42D80
Jun-17 42F75 1099 RNI
Dec-17 44L90
3500 IGM
Mar-19 46C79A
May-21 260614
Dec-19 250105
May-21 260616 1333

Apr-19 241204
KF 1368
Jul-19 1508060 KF 1800
Apr-18 KCBPCA62320
Jul-19 727023
254 PV
Jul-18 1507010
Jul-18 1507010
IGM 750
Jul-18 GN23ZIA
Oct-18 DN13ZIA
Jul-18 GN23ZIA
Mar-20 C60252T
Mar-18 723712
SBF 400
Aug-20 086098W
Feb-19 02504W
Jan-19 015134W
Feb-18 124140W
nop 20 K60237W
KF2946 pro 546

KF2946 pro 546
May-19 H6E106
May-19 H6E106
Feb-18 H5B006
PV 86
PV 86
Aug-18 1508005
Dec-16 1312017
PV 400
PV 400
Jul-21 C083G1602
Jul-21 C083G1602
Dec-19 C083L1407
Dec-19 C083L1407
Nov-17 114240W
Nov-17 114240W
Aug-17 084074W 45 SST
Aug-17 084074W
Dec-18 6CA6061 APL50

Dec-18 6CA6061 APL50
Jan-18 53A0729
Feb-19 6X60803 APL50

Feb-19 6X60803
Feb-18 5X0803
May-19 0251012
Dec-17 4P11103
Juli 19 6P10714
Apr-17 L0449399
Aug-17 U1004408 150
Dec-17 20077455
May-21 CGE476E
May-21 CGE476E
Sep-18 C31730H
Feb-19 15020451
Feb-19 15020451 tempo
Feb-17 13030295
Jan-19 15020295
Jan-19 15020295 80 ENS
Dec-18 15010146
Feb-18 14020182
Jul-18 M03072
May-17 R23691705
Apr-18 T23691704
Nov-17 R23681717 200 RNI

Nov-17 R23681717
BERKAH 260
BERKAH 32400
Aug-17 505724 4800 RNI
BERKAH 32400
Mar-19 20041688
Mar-19 20041688
Apr-17 150407
Jun-17 27071688
Jun-17 27071688
KPP 50
Mar-18 12634
Mar-18 12634
Nov-19 15122014
Jun-20 31072015
KPP 50
Mar-19 26041488
Feb-19 14015
Jan-19 130120
Feb-19 14015
KPP 9850
Nov-17 18860C
Apr-20 15G01E
Dec-18 14G064
Nov-20 15G01M
Nov-20 15G01M
Apr-20 15C01E
Oct-20 35700055
Apr-20 12225932
Jan-20 00810051
Jan-20 01201500810119
Sep-19 09201480710698
Nov-19 11201488111610
Nov-19 11201488111610
Aug-19 6537791228
Aug-18 130915010175
Aug-18 13095010180
Aug-18 13095010180
Jun-20 507903670
Jun-20 507903670
Aug-18 130915010170
May-20 506903675
May-20 506903675 KPP 53
Jun-20 507903480 IGM 432

Jun-20 507903480
Aug-18 130915010180
KPP 1250
Apr-18 31920230
Apr-18 31920230
26300
KPP 25700 15000
IGM 9750
BERKAH 3500
- 081988MX
- 081988MX
Jan-20 02021588
Sep-19 0110488
Feb-19 01101488
May-17 17061488
rincian p 285500 pct 58 50 2900
40 RNI as mef 113 50 5650
antasida 78 50 3900
May-20 01061588
Mar-20 150413B
Oct-19 141105B
Aug-19 140904B MBS 100
Apr-18 1051388
Apr-18 1051388
Jun-19 21071488
May-18 01061389
MBS 1200
- MBS 400
BERKAH 70
BERKAH 30
BERKAH 30
Aug-19 40502
Jun-19 1407305A
Aug-19 092014
Dec-19 150107SC
Jul-19 1408165D
Aug-19 092011
May-18 130626SB
May-18 130626SB
Nov-20 151211SE
Nov-20 151211SE
Sep-19 141013SC
Aug-19 092014
Mar-19 01041688
May-17 2-09304
Nov-17 151105K10
Nov-17 151105K10
May-17 28061488
May-17 120510
Oct-20 02111588
Aug-17 90150807 250 AAM

Jul-16
100 AAM
125 AAM
Aug-17 LA140940
Mar-18 20160319
Apr-18 46ADB002A
Oct-17 69109155
Dec-17 MR15G02
Dec-17 MR15G01
Mar-18 1603189
Jan-20 15001
Apr-19 14001
Mar-20 15107
Mar-20 15106
Jan-18 13105
- -
Feb-17 GSV012
Nov-17 0724715
Oct-17 037G5230
Oct-18 2508415
Jun-18 0400816
Jun-17 3651015
JUNI 17 3650915
Nov-16 3654514
Des 17 2050815
Feb-18 2051616
May-18 2053016
Mar-18 0410215
May-19 0412516
May-18 0201215
Jun-18
Mar-18 200215
May-17 5042415
Mar-18 85449005
Mar-18 85449029
Dec-17 75446076
Mar-18 85449029
Aug-17 75449096
May-19 1605035
May-18 1605001
Oct-16 1405001
Nov-17 1508002 RNI 85
May-17 1505005
Mar-18 BG0174J
Jul-16 1305050
Nov-18
Oct-18
Jun-19 A403472
Jul-19 A403473
Sep-17 1408036 KF 10000

Sep-17 1408040
Sep-17 1408041
Sep-17 1408038
Mei 18 EG0919
Feb-19 FE2910
Apr-18 BEJ3393
Feb-20 B15B013B
Oct-19 4J399103
Sep-19 4J399102
Oct-19 4J399107
Jun-19 AF703119
Jun-19 AF703119
Sep-17 411712123
Apr-19 A1712123
Feb-19 48703107
Jun-19 4F03119 KPP 172
IGM 500
IGM 500
RNI 21
BERKAH35000
KPP 30000
Aug-19 090816
Aug-19 090816
Nov-18 01121488
Aug-18 10111488
Apr-19 1504-76-209
Apr-19 1504-76-209
Jun-20 22071688
Jun-20 22071688 18 RNI
Apr-19
Apr-19 20140420
Jun-18 03081588
Jun-18 03081588
BERKAH 9
Apr-17 19051488
BERKAH 8
BERKAH 8
BERKAH 9
BERKAH 9
BERKAH 9
BERKAH 9
May-18 29061588
Apr-17 210514BB
Sep-17
Nov-17 05121488
Nov-17 09121488
Sep-18 24101588
Sep-17 14101488
Oct-17 03111488
Feb-18 19031588
-
BERKAH 2
BERKAH 2
-
73
73
Nov-17 05121488
Nov-17 05121488 40
Aug-17 25091488
BERKAH 120=160
BERKAH 50
132 RNI
132 RNI
BERKAH 80=98
RNI
RNI 2
Dec-16 CHS15706A714
Jan-17 CHS1580689F
Jan-17 CHS15825A9L
Sep-17
Jan-18 CHS16809A9M
Sep-17 CHS16418A4R BERK 13
BERK 13
Mar-18 G0S16428A50
Jun-17 G0S15709A7R 1=50
Apr-17 GOS15709A7R 1=50
Sep-16 HBS14804ABH
Mar-16 HBS14422AAT
Sep-18 UAS16A28ABF
May-17 UAS15622A79
Mar-17 UAS15427C5D
-
Sep-18 2210588
Apr-19 155031625
Sep-18 2210588
Oct-17 12111488
Feb-17 26031488
Jul-17 1131122B
Mar-17 1131122AL
Mar-18 18041688
Mar-18 18041688
Jul-17
Jul-17
Sep-17 475125
Oct-20 20151018
Nov-17 1512004
FL33532B
Mar-17 MRM164NIH
Apr-17 24650721
antau, 31 Desember 2016

engelola Obat Puskesmas BINUANG
……………………………….
LAPORAN PEMAKAIAN OBAT DAN LEMBAR PERMINTAAN OBAT (LPLP
KODE PUSKESMAS :
PUSKESMAS : BINUANG
KECAMATAN : BINUANG
KABUPATEN/KODYA : TAPIN
STOK PENERIM PERSEDI PEMAKAI

NAMA OBAT SATUAN
NO AWAL AAN AAN AN
1 2 3 4 5 6=(4+5) 7
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - -
2 Amoksisilin kaplet 500 mg @ 100 Tab Kaplet - - -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - -
5 Kloramfenikol Kapsul 500 mg Tablet - - -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - -
7 mg @ 100 Tab Tablet - - -
8 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - -
9 Kotrimoksazole tablet komb. 480 mg @ 100 Tab Tablet - - -
10 Kuinin (kina) tablet 200 mg Tablet - - -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - -
- -
SIRUP - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - -
2 Kotrimoksazole suspensi komb. Botol - - -
- -
INJEKSI - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Ampul - - -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 Ampul - - -
5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - -
6 Lidokain Komp. Inj Komb Ampul - - -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - -
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU Vial - - -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - -
12 Vaksin Rabies Vero (VAR) Vial - - -
13 Tetagam Vial - - -
- -
INFUS - -
1 Glukosa Larutan infus 10 % steril @ 20 fls fls - - -
4 Ringer laktat larutan infus steril @ 20 fls fls - - -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - -
- -
OBAT GIGI - -
1 Air raksa Dental Use Ktk - - -
2 Devitalisasi pasta ktk - - -
3 EtiL klorida semprot Botol - - -
4 Forinekresol (pengganti TKF) ktk - - -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - -
6 Kalsium hidroksi pasta ktk - - -
7 Klorfenol kamfer menthol (CHKM) ktk - - -
8 Mummiying Pasta ktk - - -
9 Semen seng Fosfar serbuk & cairan ktk - - -
10 Silver amalgam serbuk 65 - 75 % ktk - - -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - -
12 Temporary Stoping Flecther serbuk & Cair set - - -
- -
ALAT KESEHATAN - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - -
5 Catgut Cromic No. 2/0 dengan jarum @ 24 pcs Pcs - - -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - -
8 Infusion set anak Pcs - - -
9 Infusion set dewasa Pcs - - -
10 jarum @ 36 pcs Pcs - - -
- -
OBAT SANGAT ESENSIAL & ESENSIAL - -
TABLET - -
1 Allupurinol tablet 100 mg @ 100 Tab Tablet - - -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - -
7 100 Tab Tablet - - -
8 100 Tab Tablet - - -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Ta Tablet - - -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - -
12 Diazepam tablet 2 mg Tablet - - -
13 Diazepam tablet 5 mg Tablet - - -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - -
16 Fenitoin Na Kapsul 30 mg @ 250 Kap Kapsul - - -
17 Fenobarbital tablet 100 mg Tablet - - -
18 Fenobarbital tablet 30 mg Tablet - - -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - -
20 Fenoksimetil penicillin tablet 500 mg @ 100 Tab Tablet - - -
21 100 Tab Tablet - - -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Ta Tablet - - -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - -
35 Tab Tablet - - -
36 Klorpromazine HCl tablet salut 100 mg Tablet - - -
37 Klorpromazine HCl tablet salut 25 mg Tablet - - -
38 Magnesium sulfat serbuk 30 g Pot - - -
39 Mebendazole tablet 100 mg Tablet - - -
40 Tab Tablet - - -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - -
42 Natrium Bicarbonat tablet 500 mg Tablet - - -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - -
52 Tetrasiklin HCl kapsul 500 mg @ 100 Kap Kapsul - - -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - -
- -
SIRUP - -
1 Antasida DOEN Suspensi Komb Botol - - -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - -
4 Parasetamol sirup 120 mg / 5 ml Botol - - -
- -
INJEKSI - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - -
6 Fenobarbital injeksi Ampul - - -
7 Amp Ampul - - -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - -
13 Natrium tiosulfat 25 % 10 ml Ampul - - -
14 100 Amp Ampul - - -
15 Amp Ampul - - -
- -
SALEP - -
1 endapan 4 % @ 24 Pot Pot - - -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - -
4 Antibakteri DOEN Komb. Pot - - -
5 Antifungi DOEN Komb. Pot - - -
- -
SALEP MATA - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - -
- -
TETES MATA - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - -
- -
TETES TELINGA - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - -
2 Fenol gliserol TT Botol - - -
- -
OBAT LUAR - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - -
3 Gentian violet larutan 1 % Botol - - -
4 Kalium Permanghanat serbuk Botol - - -
5 Povidon Iodida 10 % 30 ml Botol - - -
6 Povidon Iodida 10 % 300 ml Botol - - -
7 Salisilat Bedak 2 % Kotak - - -
- -
OBAT GIGI - -
1 Eugenol cairan Botol - - -
- -
ALAT KESEHATAN - -
1 Kapas pembalut/Adsorben 250 mg Rol - - -
2 Kasa kompres 40 / 40 steril Bks - - -
3 Kasa pembalut 2 m x 80 cm Rol - - -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - -
6 Pembalut gips Rol - - -
7 Plester 5 yard x 2 inch Rol - - -
- -
OBAT PENUNJANG - -
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - -
2 Acyclovir tablet 400 mg @ 100 Tab Tablet - - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - -
5 Alprazolam Tablet @ 100 Tab Tablet - - -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - -
8 Amlodipin 5 mg Tablet @ 30 Tab Tablet - - -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 Tablet - - -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 t Tablet - - -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - -
15 Aspilet tablet @ 100 Tab Tablet - - -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 T Tablet - - -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - -
21 Captopril tablet 25 mg @ 100 Tab Tablet - - -
22 Cefadroksil tab 250 mg Tablet - - -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - -
25 Cetirizine tablet Tablet - - -
26 Cimetidine tablet @ 100 Tab Tablet - - -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - -
28 Clobazam tablet @ 100 Tab Tablet - - -
29 Codein Tablet 10 mg Tablet - - -
30 Codein Tablet 20 mg Tablet - - -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - -
33 Dimenhidrinat tablet @ 100 Tab Tablet - - -
34 Doksisiklin tablet @ 100 Tab Tablet - - -
35 Domperidon Tablet @ 100 Tab Tablet - - -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - -
37 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Ta Tablet - - -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - -
41 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - -
42 Glimepiride Tab 2 mg Tablet - - -
43 Tablet @ 100 Tab Tablet - - -
44 Ketokonazole tablet @ 50 tab Tablet - - -
45 Klindamisin tablet 300 mg @ 50 Tab Tablet - - -
46 Klindamisin tablet 150 mg @ 50 Tab Tablet - - -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - -
49 Levofloksasin @ 30 Tab Tablet - - -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - -
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - -
53 Loratadine tablet 10 mg @ 50 tab Tablet - - -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Ta Tablet - - -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - -
57 Mepromaag tablet @ 100 Tab Tablet - - -
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - -
59 Methioson Tablet @ 30 Tab Tablet - - -
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - -
61 Metronidazole tablet 500 mg @ 100 Tab Tablet - - -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - -
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - -
65 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 T Tablet - - -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - -
69 Nifedipin Tablet @ 100 Tab Tablet - - -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - -
71 Omeprazole kapsul @ 30 Kap Kapsul - - -
72 Papaverin tablet @ 1000 Tab Tablet - - -
73 Paraformaldehide tablet @ 100 Tab Tablet - - -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - -
76 Piroksikam tablet 10 mg @ 100 Tab Tablet - - -
77 Piroksikam tablet 20 mg @ 100 Tab Tablet - - -
78 Propanolol 10 mg Tab Tablet - - -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - -
81 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Kapsul - - -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Kapsul - - -
83 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Ta Tablet - - -
84 Salbutamol tablet 4 mg (sebagai sulfat) @ 100 Ta Tablet - - -
85 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Ta Tablet - - -
86 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - -
87 Simvastatin tablet 20 mg @ 30/50 Tab Tablet - - -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - -
89 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - -
93 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - -
94 Tramadol Tablet @ 50 Tab Tablet - - -
- -
SIRUP - -
1 Ambroksol sirup 15 mg/ 5 ml Botol - - -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - -
4 Anti Diare (Arcapec) Sirup Botol - - -
5 Anti sariawan (Enkasari) Sirup Botol - - -
6 Batugin Elixier @ 120 ml botol - - -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - -
8 Bromhexin (Phytovon) Sirup Botol - - -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - -
10 Cefixime Sirup 100 mg / 5 ml Botol - - -
11 Cetirizine (Lerzin) Sirup Botol - - -
12 Domperidon Sirup Botol - - -
13 Domperidon Drop Botol - - -
14 Erytromycin Sirup Botol - - -
15 Fe Kombinasi (maltiron) Sirup Botol - - -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Si Botol - - -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - -
18 Gastrinal Suspensi Botol - - -
19 Ibuprofen (Farsifen) Sirup Botol - - -
20 Klorampenikol suspensi Botol - - -
21 Lactulosa Sirup Botol - - -
22 Laxadine Sirup @ 30 ml Botol - - -
23 Metamizol (Norages) Sirup Botol - - -
24 Metoklopropamid (Gavistal) Drop Botol - - -
25 Metronidazole (Farizol) Sirup Botol - - -
26 Metoklopropamid sirup Botol - - -
27 Metronidazole Infus Botol - - -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - -
29 Multivitamin + lisin (Supralysin)Drop Botol - - -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - -
32 Nifuroxide (Nifudiar) Sirup Botol - - -
33 Nistatin (Cazetin) Drop Botol - - -
34 Parasetamol Drop Botol - - -
35 Pseudoefedrin (Alco) Drop Botol - - -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - -
37 Zinc drop Botol - - -
38 Zinc Sirup Botol - - -
- -
INJEKSI - -
1 Alinamin F injeksi @ 5 Amp Ampul - - -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - -
5 Ceftriaxon Injeksi 1 gram @ 10 vial Vial - - -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - -
8 Dopamin Injeksi Ampul - - -
9 Furusemide Injeksi Ampul - - -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - -
Ampul
11 Ampul - - -
12 Kanamycin Inj vial - - -
13 Kloramfenikol Injeksi Vial - - -
Vial
14 (Xylomidon) Inj @ 25 vial - - -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - -
19 Ondasentron Injeksi Ampul - - -
20 Pethidin injeksi Ampul - - -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - -
22 Piracetam injeksi 3 gram @ 4 Amp Ampul - - -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - -
26 Xylocain Injeksi Ampul - - -
27 Lidocain 2% Injeksi Ampul - - -
INFUS - -
1 KAEN 3A fls - - -
2 KAEN 3B fls - - -
3 Glukosa 5% + 1/4 NS fls - - -
4 Glukosa 5% + 1/2 NS fls - - -
- -
SALEP/KRIM - -
1 Acyclovir cream @ 25 Tube tube - - -
2 Bioplacenton Jelly tube - - -
3 Gentamisin salep kulit @ 10 Tube tube - - -
4 Ictiol salep Pot - - -
5 Ketokonazole krim tube - - -
6 Miconazole krim @ 24 Tube tube - - -
7 Nostren Cream Tube - - -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - -
9 Piroksikam (Infeld) Gel Tube - - -
10 Scabimite cream @ 24 Tube tube - - -
- -
SALEP MATA - -
1 Kloramfenikol Salep Mata tube - - -
- -
TETES MATA - -
1 Cendo Catarelent Botol - - -
2 Cendo Xitrol Botol - - -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - -
4 Kloramfenikol Tetes Mata Botol - - -
5 Tetrakain (Pantocain) TM Botol - - -
- -
TETES HIDUNG - -
1 Iliadin Drop Botol - - -
2 Iliadin Spray Botol - - -
- -
TETES TELINGA - -
1 Otopain TT Botol - - -
- -
OBAT LUAR / LAIN- LAIN - -
1 Anti sariawan (Albotyl) Sol Botol - - -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - -
4 Borax gliserin Botol - - -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - -
7 Semprot Spray kotak - - -
8 Larutan Chlorhexide @ 500 ml Botol - - -
9 Larutan Chlorin 5,25 % 500 ml Botol - - -
10 Salisil spritus Botol - - -
- -
ALAT KESEHATAN - -
1 Bisturi @ 100 pcs pcs - - -
2 Blood Lancet ss @ 100 pcs pcs - - -
3 Daryan tulle @ 10 lbr Lembar - - -
4 EKG Paper 80 x 30 Roll - - -
5 EKG Paper 40 x 30 Roll - - -
6 Foley cateter no. 16 @ 10 pcs pcs - - -
7 Foley cateter no. 18 10 Pcs pcs - - -
8 Hand schoen Examination Uk M/L @ 100 pcs kotak - - -
9 Hand schoen no. 7 @ 50 psg psg - - -
10 Hand schoen no. 7,5 @ 50 psg psg - - -
11 Hand Schoen No. 8 @ 50 psg psg - - -
12 Hand schoen steril no. 7 @ 50 psg psg - - -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - -
14 Hand schoen steril no. 8 @ 50 psg psg - - -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - -
16 Hypapix 5 x 1 m roll - - -
17 Jarum Hecting Kulit lsn - - -
18 Jarung Hecting Otot lsn - - -
19 Kasa Hidrofil 40 x 80 pcs - - -
20 Kasa pembalut hidrofil 4 x 10 Roll - - -
21 Kasa steril 16 x 16 pad roll - - -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - -
23 Mami non waven @ 24 pcs pcs - - -
24 Masker @ 100 pcs pcs - - -
25 Needle No. 23 G @ 100 pcs pcs - - -
26 Needle No. 25 G 100 pcs pcs - - -
27 Optiva No. 20 @ 50 pcs pcs - - -
28 Paket P3K pcs - - -
29 Spuit Injeksi 10 ml pcs - - -
30 Spuit Injeksi 50 ml Set - - -
31 Surflo No. 20 @ 50 pcs pcs - - -
34 Test Kehamilan Stik @ 50 pcs pcs - - -
35 Ultrasonic Gel pcs - - -
36 Urine bag Stik - - -
37 USG Printing Paper UPP-110 HG pcs - - -
38 Wing needle no. 21 pcs - - -
39 Wing needle no. 27 pcs - - -
40 Boor Diamond High Speed pcs - - -
41 Boor Diamond Low Speed pcs - - -
- -
OBAT PROGRAM - -
PROGRAM P2 MALARIA - -
1 Abate kg - - -
2 ACT Tablet Ktk - - -
3 Arsumodon tablet Tablet - - -
4 Artem Injeksi Ktk - - -
6 Artesdiaquine Tablet Ktk - - -
7 Artesunate Injeksi ampul - - -
8 Cynoff liter - - -
9 Kelambu Pcs - - -
10 Rafid Test Dengeu @ 25 test Pcs - - -
11 RDT Chikungunya Pcs - - -
12 RDT Malaria Pcs - - -
13 RDT Salmonella Pcs - - -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik Pcs - - -
- -
PROGRAM P2 IMUNISASI - -
1 Alat suntik sekali pakai 0.05 ml pcs - - -
2 Alat suntik sekali pakai 0.5 ml pcs - - -
3 Safety Box Pcs - - -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - -
5 Vaksin BCG + Pelarut (20 dosis) vial - - -
6 Vaksin Campak + Pelarut (10 dosis) vial - - -
7 Vaksin Campak + Pelarut (20 dosis) vial - - -
8 Vaksin DT Vial - - -
9 Vaksin Hepatitis (HBO) ampul - - -
10 Vaksin Polio + Droper ( 20 Dosis) Vial - - -
11 Vaksin Polio + Droper (10 Dosis) Vial - - -
12 Vaksin Polio IPV 5 Dosis Vial - - -
13 Vaksin Td vial - - -
14 Vaksin TT Vial - - -
15 Vaksin DPT HB HIB Vial - - -
- -
PROGRAM P2 TB - - -
1 Box Slides pcs - - -
2 Bunsen Stainlestell ktk - - -
3 FDC I ktk - - -
4 FDC I & III ktk - - -
5 FDC II siklus - - -
6 Kaca Ose siklus - - -
7 Kombipak kategori 1 ktk - - -
8 Lampu Spritus siklus - - -
9 Obat antituberkolosis Kategori Anak siklus - - -
10 Obat antituberkolosis Kategori sisipan ktk - - -
11 Pot Sputum ktk - - -
12 Reagen Zn Neilson set - - -
13 Slide mikroskop kotak - - -
14 Spritus Botol - - -
15 Masker N-95 pcs - - -
16 Mikroskop Binoculer unit - - -
17 Isoniazid (INH) 100 mg Tablet Tablet - - -
- - -
PROGRAM P2 DIARE - - -
1 Zn Tablet 500 mg Tablet - - -
- -
PROGRAM P2 KUSTA - -
1 MDT MB Anak Strip - - -
2 MDT MB Dewasa Strip - - -
3 MDT PB Anak Strip - - -
4 MDT PB Dewasa Strip - - -
- -
PROGRAM KIA - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - -
2 Obat Suntik KB 1 Bulan @ 20 vial vial - - -
3 Obat Suntik KB 3 Bulan @ 20 vial vial - - -
4 Gluconas Calsicus vial - - -
- -
REAGEN LABORATORIUM - -
1 Alkohol 70 % @ 1000 ml Botol - - -
2 Alkohol 70% @ 100 ml Botol - - -
3 Alkohol 95 % @ 1000 ml botol - - -
4 Alkohol Swab @ 100 pcs Kotak - - -
5 Coumbour 10 Parameter botol - - -
6 EDTA 10 % botol - - -
7 Gliserin Botol - - -
8 Gluko dr Stik @ 25 Stik botol - - -
9 Golongan Darah Test set - - -
10 HB (Stat Site) Stik @ 25 Stik Botol - - -
11 Larutan Anisol botol - - -
12 Larutan Asam Asetat 6% botol - - -
13 Larutan Asam Sulfosalilisat botol - - -
14 Larutan Barium Klorida 10 % botol - - -
15 Larutan Benedict Botol - - -
16 Larutan Buffer Ph botol - - -
17 Larutan Carbol Gentian Violet botol - - -
18 Larutan Drabkin Botol - - -
19 Larutan Eosin 2 % Botol - - -
20 Larutan Etanol Asam Botol - - -
21 Larutan Foucet botol - - -
22 Larutan Giemsa Stain Botol - - -
23 Larutan H2SO4 p Botol - - -
24 Larutan HCl 0,1% botol - - -
25 Larutan HNO3 P Botol - - -
26 Larutan karbol Fuchsin @ 100 ml Botol - - -
27 Larutan KOH 10 % Botol - - -
28 Larutan Metelin Biru Botol - - -
29 Larutan Turk Botol - - -
30 Lisol, mengandung kresol tersabun 50 % Botol - - -
31 Metanol Botol - - -
32 Na Citrat 3,8 % botol - - -
33 Nesco Cholesterol Stik @ 10 Stik botol - - -
34 Nesco Glucose Stik @ 25 Stik Botol - - -
35 Nesco HB Stik @ 25 Botol - - -
36 Nesco Uric Acid Stik @ 25 Stik botol - - -
37 Oli Emersi botol - - -
38 Rees Ecker botol - - -
39 Trigeliserida Botol - - -
40 Water Steril 500 ml Botol - - -
41 Water Steril 1000 ml Botol - - -
42 widal Test Set - - -
43 Xylol botol - - -
44 Sungkup Bayi Pcs - - -
45 NGT All Item Pcs - - -
46 PP 3 juta Injeksi vial - - -
47 Progesteron Injeksi Vial - - -
48 Iodiom Test Pcs - - -
49 Mineral Mix Bks - - -
50 Eksavator Double Ended Pcs - - -
51 Asetamivir tab Tablet - - -
52 Natrium Tiroksin Pcs - - -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - -
54 Stick Hemosmart Pcs - - -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - -
56 Lab.Kit Paket - - -
57 Blue Tips bks - - -
58 Yellow Tips bks - - -
59 Deck Glass ktk - - -
60 Micro Hematokrit / Tabung Hematokrit pcs - - -
61 Tissue Lensa bks - - -
62 Stik HB Family Dr ktk - - -
63 Tabung EDTA K3/Vacutainer pcs - - -
64 Glukosa Stik Performa Accu Check kotak - - -
65 Mikropipet (Microlit) 0-50 µl pcs - - -
66 Mikropipet (Microlit) 10-100 µl pcs - - -
67 Glukosa Stik Active Accu Check Kotak - - -
68 Kertas saring (isi 100 lbr) bks - - -
69 Lidi Sputum (100 pcs) bks - - -
70 Cotton Swab pcs - - -
71 Specullum pcs - - -
72 Eter Alkohol Botol Err:509 - Err:509
TOTAL
UMUM
BAYAR
BAYAR
Mengetahui/Menyetujui Yang Menyerahkan

Kepala Dinas Kesehatan Kepala Instalasi Farmasi
Kab. Tapin Kab. Tapin
H.Errani Martin,SKM.MM Septi Heryani, S. Farm, Apt

NIP.19640314 198802 1 002 NIP 19890919 201402 2 006
BAR PERMINTAAN OBAT (LPLPO)
LB 2

Tahun : 2018
STOK PERMINT PEMBERIA HARGA TOTAL EXP

SISA STOK BON
OPT. AAN N SATUAN (Rp) HARGA (Rp.) DATE
8 = (6-7) 9 10 11 12 13 (11 X 12) 14 15
- - - 207.00 -
- - - 233.00 -
- - - 317.00 -
- - - 275.00 -
- - - 1,155.00 -
- - - 93.50 -
- - - 520.30 -
- - - 77.00 -
- - - 158.00 -
- - - 641.00 -
- - - 105.00 -
- - - 318.00 -
- - - 125.00 -
- - - 246.40 -
-
-
- - - 2,200.00 -
- - - 2,225.00 -
-
-
- - - 1,740.00 -
- - - 2,604.90 -
- - - 1,056.00 -
- - - 2,354.00 -
- - - 6,820.00 -
- - - 2,122.00 -
- - - 1,900.00 -
- - - 520,300.00 -
- - - 193,470.80 -
- - - 139,150.00 -
- - - 401,092.00 -
- - - 174,500.00 -
- - - 170,000.00 -
-
-
- - - 6,270.00 -
- - - 1,597.60 -
- - - 6,900.00 -
- - - 7,150.00 -
- - - 6,410.00 -
-
-
- - - 103,536.00 -
- - - 293,498.00 -
- - - 99,000.00 -
- - - 185,900.00 -
- - - 306,427.00 -
- - - 242,000.00 -
- - - 56,441.40 -
- - - 137,853.00 -
- - - 93,500.00 -
- - - 408,792.00 -
- - - 14,053.63 -
- - - 158,042.00 -
-
-
- - - 1,540.00 -
- - - 957.00 -
- - - 2,049.00 -
- - - 7,201.04 -
- - - 7,201.04 -
- - - 8,896.88 -
- - - 7,286.25 -
- - - 7,920.00 -
- - - 7,920.00 -
- - - 5,743.86 -
-
- -
-
- - - 95.00 -
- - - 86.00 -
- - - 123.00 -
- - - 163.90 -
- - - 64.00 -
- - - 149.00 -
- - - 96.80 -
- - - 157.30 -
- - - 120.00 -
- - - 66.00 -
- - - 48.00 -
- - - 46.00 -
- - - 52.80 -
- - - 108.00 -
- - - 146.00 -
- - - 80.00 -
- - - 100.00 -
- - - 64.83 -
- - - 257.40 -
- - - 456.50 -
- - - 796.00 -
- - - 84.00 -
- - - 126.00 -
- - - 108.00 -
- - - 224.00 -
- - - 62.00 -
- - - 76.00 -
- - - 105.00 -
- - - 171.00 -
- - - 121.00 -
- - - 133.00 -
- - - 98.00 -
- - - 169.00 -
- - - 306.00 -
- - - 47.50 -
- - - 162.00 -
- - - 39.93 -
- - - 1,129.30 -
- - - 231.00 -
- - - 169.00 -
- - - 98.00 -
- - - 15.73 -
- - - 857.00 -
- - - 602.00 -
- - - 34.51 -
- - - 136.00 -
- - - 114.00 -
- - - 351.00 -
- - - 82.00 -
- - - 114.00 -
- - - 167.20 -
- - - 325.00 -
- - - 91.00 -
- - - 97.00 -
- - - 132.00 -
-
-
- - - 2,300.00 -
- - - 1,573.00 -
- - - 3,740.00 -
- - - 1,119.00 -
-
-
- - - 4,204.00 -
- - - 1,345.00 -
- - - 5,800.00 -
- - - 1,210.00 -
- - - 20,857.00 -
- - - 1,930.00 -
- - - 1,914.00 -
- - - 1,210.00 -
- - - 724.00 -
- - - 2,800.00 -
- - - 3,500.00 -
- - - 1,527.70 -
- - - 2,970.00 -
- - - 1,226.00 -
- - - 843.33 -
-
-
- - - 2,200.00 -
- - - 2,712.00 -
- - - 1,435.00 -
- - - 2,767.00 -
- - - 4,782.00 -
-
-
- - - 1,640.00 -
-
-
- - - 3,549.00 -
-
-
- - - 1,759.00 -
- - - 2,246.00 -
-
-
- - - 3,502.00 -
- - - 5,500.00 -
- - - 2,178.00 -
- - - 6,529.00 -
- - - 2,344.00 -
- - - 15,950.00 -
- - - 1,066.00 -
-
-
- - - 20,815.00 -
-
-
- - - 14,187.50 -
- - - 1,984.03 -
- - - 8,739.41 -
- - - 2,740.50 -
- - - 760.91 -
- - - 6,071.00 -
- - - 25,987.00 -
-
-
- - - 272.00 -
- - - 628.46 -
- - - 258.74 -
- - - 2,200.00 -
- - - 990.00 -
- - - 155.30 -
- - - 163.00 -
- - - 105.00 -
- - - 5,283.00 -
- - - 173.00 -
- - - 139.00 -
- - - 150.00 -
- - - 113.00 -
- - - 1,540.00 -
- - - 123.00 -
- - - 170.00 -
- - - 230.00 -
- - - 695.00 -
- - - 121.00 -
- - - 69.00 -
- - - 72.00 -
- 564.00 -
- - - 557.00 -
- - - 899.00 -
- - - 154.00 -
- - - 115.50 -
- - - 298.00 -
- - - 1,120.00 -
- - - 630.00 -
- - - -
- - - 1.00 -
- - - 126.00 -
- - - 107.00 -
- - - 250.00 -
- - - 133.00 -
- - - 509.00 -
- - - 766.00 -
- - - 1,210.00 -
- - - 1,100.00 -
- - - 683.00 -
- - - 245.00 -
- - - 296.00 -
- - - 1,925.00 -
- - - 292.00 -
- - - 660.00 -
- - - 405.00 -
- - - 4,813.00 -
- - - 341.00 -
- - - 581.00 -
- - - 410.00 -
- - - 660.00 -
- - - 90.00 -
- - - 170.00 -
- - - 726.00 -
- - - 462.00 -
- - - 292.60 -
- - - 495.00 -
- - - 118.50 -
- - - 1,026.00 -
- - - 230.00 -
- - - 140.00 -
- - - 100.00 -
- - - 102.00 -
- - - 220.00 -
- - - 560.00 -
- - - 167.00 -
- - - 193.00 -
- - - 440.00 -
- - - 123.00 -
- - - 700.00 -
- - - 164.00 -
- - - 125.00 -
- - - 7,700.00 -
- - - 1,485.00 -
- - - 360.80 -
- - - 97.02 -
- - - 102.37 -
- - - 85.00 -
- - - 242.00 -
- - - 119.00 -
- - - 286.00 -
- - - 505.00 -
- - - 68.00 -
- - - 84.00 -
- - - 58.00 -
- - - 135.00 -
- - - 252.00 -
- - - 1,525.00 -
- - - 350.00 -
- - - 100.00 -
- - - 73.73 -
- - - 88.00 -
- - - 615.38 -
- - - 2,680.00 -
-
-
- - - 3,791.00 -
- - - 4,147.00 -
- - - 21,450.00 -
- - - 16,500.00 -
- - - 12,760.00 -
- - - 20,352.00 -
- - - 3,594.00 -
- - - 6,050.00 -
- - - 6,285.00 -
- - - 7,960.00 -
- - - 7,756.00 -
- - - 3,180.00 -
- - - 17,939.00 -
- - - 8,090.00 -
- - - 19,250.00 -
- - - 16,500.00 -
- - - 11,550.00 -
- - - 24,200.00 -
- - - 2,560.00 -
- - - 4,000.00 -
- - - 14,500.00 -
- - - 12,450.00 -
- - - 33,000.00 -
- - - 5,830.00 -
- - - 3,800.00 -
- - - 2,750.00 -
- - - 12,980.00 -
- - - 22,000.00 -
- - - 24,200.00 -
- - - 10,902.00 -
- - - 7,354.00 -
- - - 38,500.00 -
- - - 32,120.00 -
- - - 5,980.00 -
- - - 64,350.00 -
- - - 20,350.00 -
- - - 11,700.00 -
- - - 6,500.00 -
-
-
- - - 14,972.60 -
- - - 5,610.00 -
- - - 2,536.00 -
- - - 9,350.00 -
- - - 11,000.00 -
- - - 33,000.00 -
- - - 3,578.00 -
- - - 10,219.00 -
- - - 2,012.00 -
- - - 3,415.00 -
- - - 4,950.00 -
- - - 6,610.80 -
- - - 10,790.00 -
- - - 5,555.00 -
- - - 8,800.00 -
- - - 6,600.00 -
- - - 5,500.00 -
- - - 9,570.00 -
- - - 2,400.00 -
- - - 14,509.10 -
- - - 3,300.00 -
- - - 17,088.00 -
- - - 1,600.00 -
- - - 2,680.00 -
- - - 4,000.00 -
- - - 40,000.00 -
- - - 875.00 -
-
- - - 10,000.00 -
- - - 10,050.00 -
- - - 9,350.00 -
- - - 9,400.00 -
-
-
- - - 2,997.00 -
- - - 13,200.00 -
- - - 1,835.16 -
- - - 4,300.00 -
- - - 2,605.00 -
- - - 3,737.00 -
- - - 12,100.00 -
- - - 1,649.36 -
- - - 19,058.00 -
- - - 12,155.00 -
-
-
- - - 1,640.00 -
-
-
- - - 22,000.00 -
- - - 26,812.00 -
- - - 4,600.00 -
- - - 2,750.00 -
- - - 11,500.00 -
-
-
- - - 30,305.00 -
- - - 36,000.00 -
-
-
- - - 35,145.00 -
-
-
- - - 23,100.00 -
- - - 5,800.00 -
- - - 5,670.00 -
- - - 1,899.00 -
- - - 18,458.00 -
- - - 12,749.00 -
- - - 80,000.00 -
- - - 73,443.75 -
- - - 66,000.00 -
- - - 5,430.00 -
-
-
- - - 770.00 -
- - - 221.00 -
- - - 16,500.00 -
- - - 45,375.00 -
- - - 27,500.00 -
- - - 10,318.00 -
- - - 9,080.00 -
- - - 737.74 -
- - - 4,675.00 -
- - - 4,675.00 -
- - - 4,675.00 -
- - - 6,325.00 -
- - - 6,325.00 -
- - - 6,325.00 -
- - - 6,050.00 -
- - - 12,650.00 -
- - - 24,200.00 -
- - - 24,200.00 -
- - - 119,174.19 -
- - - 1,957.50 -
- - - 7,480.40 -
- - - 3,960.00 -
- - - 1,210.00 -
- - - 425.60 -
- - - 660.00 -
- - - 660.00 -
- - - 15,400.00 -
- - - 311,900.00 -
- - - 1,393.90 -
- - - 5,693.00 -
- - - 8,355.00 -
- - - 8,355.00 -
- - - 8,355.00 -
- - - 1,564.20 -
- - - 27,500.00 -
- - - 3,404.00 -
- - - 320,000.00 -
- - - 2,145.00 -
- - - 2,145.00 -
- - - 440,000.00 -
- - - 330,000.00 -
-
-
-
- - - 99,220.00 -
- - - 36,300.00 -
- - - 3,566.78 -
- - - 14,868.83 -
- - - 125,400.00 -
- - - 38,999.00 -
- - - 387,800.00 -
- - - 1.00 -
- - - 57,200.00 -
- - - 55,000.00 -
- - - 40,700.00 -
- - - 66,000.00 -
- - - 79,200.00 -
-
-
- - - 1,900.00 -
- - - 1,448.00 -
- - - 23,000.00 -
- - - 45,100.00 -
- - - 45,100.00 -
- - - 22,527.00 -
- - - 41,998.00 -
- - - 14,487.00 -
- - - 18,750.00 -
- - - 23,782.00 -
- - - 16,203.00 -
- - - 137,610.00 -
- - - 14,250.00 -
- - - 11,913.00 -
- - - 43,900.00 -
-
- - - -
- - - 100,000.00 -
- - - 82,500.00 -
- - - 395,900.00 -
- - - 396,000.00 -
- - - 1,379,984.00 -
- - - 265,000.00 -
- - - 317,015.00 -
- - - 69,000.00 -
- - - 247,229.00 -
- - - 176,000.00 -
- - - 2,930.00 -
- - - 236,500.00 -
- - - 27,500.00 -
- - - 27,500.00 -
- - - 21,420.00 -
- 1.00 -
- - - 1.00 -
-
-
- - - 512.00 -
-
-
- - - 14,862.00 -
- - - 30,595.00 -
- - - 7,462.00 -
- - - 8,323.00 -
-
-
- - - 2,298.00 -
- - - 6,249.95 -
- - - 6,249.95 -
- - - 1.00 -
-
-
- - - 24,222.22 -
- - - 2,625.00 -
- - - 48,400.00 -
- - - 128.97 -
- - - 220,000.00 -
- - - 66,000.00 -
- - - 5,203.00 -
- - - 309,500.00 -
- - - 385,000.00 -
- - - 618,750.00 -
- - - 120,000.00 -
- - - 20,400.00 -
- - - 69,300.00 -
- - - 11,000.00 -
- - - 75,625.00 -
- - - 61,250.00 -
- - - 70,000.00 -
- - - 122,195.00 -
- - - 230,000.00 -
- - - 41,700.00 -
- - - 199,100.00 -
- - - 77,500.00 -
- - - 41,255.00 -
- - - 8,470.00 -
- - - 55,000.00 -
- - - 28,400.00 -
- - - 44,550.00 -
- - - 20,900.00 -
- - - 17,900.00 -
- - - 64,300.00 -
- - - 30,400.00 -
- - - 8,000.00 -
- - - 150,000.00 -
- - - 103,400.00 -
- - - 148,500.00 -
- - - 82,500.00 -
- - - 313,500.00 -
- - - 74,800.00 -
- - - 418,000.00 -
- - - 5,500.00 -
- - - 24,750.00 -
- - - 440,000.00 -
- - - 27,500.00 -
- - - 220,000.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 2,475.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 1.00 -
- - - 105,875.00 -
- - - 139,700.00 -
- - - 38,500.00 -
- - - 363.00 -
- - - 48,400.00 -
- - - 357,500.00 -
- - - 1,507.00 -
- - - 420,000.00 -
- - - - -
- - - - -
- - - 170,500.00 -
- - - 53,900.00 -
- - - 36,300.00 -
- - - 7,700.00 -
- - - 1,000.00 -
Err:509 - Err:509 78,100.00 -
-
Yang Menerima/Melapor Yang Menerima

Kepala Puskesmas Pengelola Obat
Binuang, Puskesmas Binuang,
Isrok Antariksa, SKM, M.Kes Mahdalena, S. Farm., Apt

NIP.19690928 198902 1 001 NIP 19830909 201001 2 032
- - - 1,129.3
#REF!
PEMAKAIAN RATA-RATA PUSKESMAS BINUANG TAHUN 2017
NAMA OBAT SATUAN JAN FEB MAR APR MEI JUN JUL AGT SEP OKT
NO
1 2 3 4 5 6 7 8 9 10 11 12 13
TABLET
1 Amoksisilin kaplet 250 mg @ 120 Tab Kaplet - - - - - - - - - -
2 Amoksisilin kaplet 500 mg @ 100 Tab Kaplet - - - - - - - - - -
3 Garam Oralit untuk 200 ml air @ 100 bks sacchet - - - - - - - - - -
4 Kloramfenikol kapsul 250 mg @ 250 Kap kapsul - - - - - - - - - -
5 Kloramfenikol Kapsul 500 mg Tablet - - - - - - - - - -
6 Klorokuin tablet 150 mg @ 1000 Tab Tablet - - - - - - - - - -
7 Kombinasi pirimetamin 25 mg + sulfadoksin 500 mg @ 100 Tab Tablet - - - - - - - - - -
8 Kotrimoksazole tablet komb. 120 mg @ 100 Tab Tablet - - - - - - - - - -
9 Kotrimoksazole tablet komb. 480 mg @ 100 Tab Tablet - - - - - - - - - -
10 Kuinin (kina) tablet 200 mg Tablet - - - - - - - - - -
11 Parasetamol tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
12 Pirantel tablet 125 mg @ 100 Tab Tablet - - - - - - - - - -
13 Prednison tablet 5 mg @ 1000 Tab Tablet - - - - - - - - - -
14 Primakuin tablet 15 mg @ 1000 Tab Tablet - - - - - - - - - -
- - - - - - - - - -
SIRUP - - - - - - - - - -
1 Amoksisilin sirup kering 125 mg / 5 ml Botol - - - - - - - - - -
2 Kotrimoksazole suspensi komb. Botol - - - - - - - - - -
- - - - - - - - - -
INJEKSI - - - - - - - - - -
1 Deksametason inj.5 mg / ml -1 ml @ 100 Amp Ampul - - - - - - - - - -
2 Diazepam Injeksi 5 mg/ ml - 2 ml @ 30 Amp Ampul - - - - - - - - - -
3 Difenhidramin HCL Injeksi 10 mg/ ml - 1 ml @ 30 Amp Ampul - - - - - - - - - -
4 Efineprina HCl/Bitartat (Adrenalina ) Injeksi 0,1 % - 1 ml @ 30 Amp Ampul - - - - - - - - - -

5 Kuinin Dihidroklorida inj 25 % - 2 ml Ampul - - - - - - - - - -
6 Lidokain Komp. Inj Komb Ampul - - - - - - - - - -
7 Oksitoksin injeksi 10 IU / ml - 1 ml Ampul - - - - - - - - - -
8 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (SABU I) Vial - - - - - - - - - -
9 Serum Anti Difteri Injeksi 20.000 IU (ADS) Vial - - - - - - - - - -
10 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Vial - - - - - - - - - -
11 Serum Anti Tetanus Injeksi 20.000 IU/amp (ATS) Vial - - - - - - - - - -
12 Vaksin Rabies Vero (VAR) Vial - - - - - - - - - -
13 Tetagam Vial - - - - - - - - - -
- - - - - - - - - -
INFUS - - - - - - - - - -
1 Glukosa Larutan infus 10 % steril @ 20 fls fls - - - - - - - - - -
4 Ringer laktat larutan infus steril @ 20 fls fls - - - - - - - - - -
5 Natrium Klorida infus 0.9 % steril @ 20 fls fls - - - - - - - - - -
- - - - - - - - - -
OBAT GIGI - - - - - - - - - -
1 Air raksa Dental Use Ktk - - - - - - - - - -
2 Devitalisasi pasta ktk - - - - - - - - - -
3 Eti klorida semprot Botol - - - - - - - - - -
4 Forinekresol (pengganti TKF) ktk - - - - - - - - - -
5 Glass Inomer Cement ( GC IX ) /ART ktk - - - - - - - - - -
6 Kalsium hidroksi pasta ktk - - - - - - - - - -
7 Klorfenol kamfer menthol (CHKM) ktk - - - - - - - - - -
8 Mummiying Pasta ktk - - - - - - - - - -
9 Semen seng Fosfar serbuk & cairan ktk - - - - - - - - - -
10 Silver amalgam serbuk 65 - 75 % ktk - - - - - - - - - -
11 Spons Gelatin Cubicles 1 x 1 x 1 cm pcs - - - - - - - - - -
12 Temporary Stoping Flecther serbuk & Cair set - - - - - - - - - -
- - - - - - - - - -
ALAT KESEHATAN - - - - - - - - - -
1 Alat Suntik sekali pakai 1 ml @ 100 Pcs Pcs - - - - - - - - - -
2 Alat Suntik sekali pakai 2,5 ml @ 100 pcs Pcs - - - - - - - - - -
3 Alat Suntik sekali pakai 5 ml @ 100 pcs Pcs - - - - - - - - - -
4 Catgut Cromic No. 3/0 dengan jarum @ 24 pcs Pcs - - - - - - - - - -
5 Catgut Cromic No. 2/0 dengan jarum @ 24 pcs Pcs - - - - - - - - - -
6 Catgut plain 2/0 dengan jarum @ 24 pcs Pcs - - - - - - - - - -
7 Catgut Plain 3/0 dengan jarum @ 24 pcs Pcs - - - - - - - - - -
8 Infusion set anak Pcs - - - - - - - - - -
9 Infusion set dewasa Pcs - - - - - - - - - -
10 Silk (benang bedah sutera) No. 3/0 dengan jarum @ 36 pcs Pcs - - - - - - - - - -
- - - - - - - - - -
OBAT SANGAT ESENSIAL & ESENSIAL - - - - - - - - - -
TABLET - - - - - - - - - -
1 Allopurinol tablet 100 mg @ 100 Tab Tablet - - - - - - - - - -
2 Aminofillin tablet 200 mg @ 100 Tab Tablet - - - - - - - - - -
3 Amitriptilin HCl tablet salut 25 mg @ 100 Tab Tablet - - - - - - - - - -
4 Antalgin (metapiron) tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
5 Antasida DOEN tab Komb. @ 100 Tab Tablet - - - - - - - - - -
6 Antimigrein DOEN Komb. @ 100 Tab Tablet - - - - - - - - - -
7 Asam asetilsalisilat (asetosal) tablet 100 mg @ 100 Tab Tablet - - - - - - - - - -
8 Asam asetilsalisilat (asetosal) tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
9 Asam Askorbat ( Vit C ) Tablet 50 mg @ 1000 Tab Tablet - - - - - - - - - -
10 Atropin sulfat tablet 0.5 mg @ 500 Tab Tablet - - - - - - - - - -
11 Deksametasone tablet 0.5 mg @ 100 Tab Tablet - - - - - - - - - -
12 Diazepam tablet 2 mg Tablet - - - - - - - - - -
13 Diazepam tablet 5 mg Tablet - - - - - - - - - -
14 Digoksin tablet 0.25 mg @ 100 Tab Tablet - - - - - - - - - -
15 Fenitoin Na Kapsul 100 mg @ 250 Kap Kapsul - - - - - - - - - -
16 Fenitoin Na Kapsul 30 mg @ 250 Kap Kapsul - - - - - - - - - -
17 Fenobarbital tablet 100 mg Tablet - - - - - - - - - -
18 Fenobarbital tablet 30 mg Tablet - - - - - - - - - -
19 Fenoksimetil penicillin tablet 250 mg @ 100 Tab Tablet - - - - - - - - - -
20 Fenoksimetil penicillin tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
21 Fitominadion (Vit K) tablet salut gula 10 mg @ 100 Tab Tablet - - - - - - - - - -
22 Furusemide tablet 40 mg @ 200 Tab Tablet - - - - - - - - - -
23 Glibenklamide tablet 5 mg @ 100 Tab Tablet - - - - - - - - - -
24 Gliserilguayakolat tablet 100 mg @ 1000 Tab Tablet - - - - - - - - - -
25 Gresiofulvin tablet 125 mg @ 100 Tab Tablet - - - - - - - - - -
26 Haloperidol tablet 0,5 mg @ 100 Tab Tablet - - - - - - - - - -
27 Haloperidol tablet 1.5 mg @ 100 Tab Tablet - - - - - - - - - -
28 Haloperidol tablet 5 mg @ 100 Tab Tablet - - - - - - - - - -
29 Hidrokloriazide (HCT) Tablet 25 mg @ 1000 Tab Tablet - - - - - - - - - -
30 Ibuprofen tablet 200 mg @ 100 Tab Tablet - - - - - - - - - -
31 Ibupropen tablet 400 mg @ 100 Tab Tablet - - - - - - - - - -
32 Isosorbit dinitrat tablet sublingual 5 mg @ 100 Tab Tablet - - - - - - - - - -
33 Kalsium laktat (Kalk) tablet 500 mg @ 1000 Tab Tablet - - - - - - - - - -
34 Karbamazepin tablet 200 mg @ 100 Tab Tablet - - - - - - - - - -
35 Klorpeniramine Maleat (CTM) tablet 4 mg @ 100 Tab Tablet - - - - - - - - - -
36 Klorpromazine HCl tablet salut 100 mg Tablet - - - - - - - - - -
37 Klorpromazine HCl tablet salut 25 mg Tablet - - - - - - - - - -
38 Magnesium sulfat serbuk 30 g Pot - - - - - - - - - -
39 Mebendazole tablet 100 mg Tablet - - - - - - - - - -
40 Metilergometrin maleat tab. Salut 0,125 mg @ 100 Tab Tablet - - - - - - - - - -
41 Metronidazol tablet 250 mg @ 100 Tab Tablet - - - - - - - - - -
42 Natrium Bicarbonat tablet 500 mg Tablet - - - - - - - - - -
43 Nistatin tablet salut 500.000 IU @ 100 Tab Tablet - - - - - - - - - -
44 Nistatin tablet Vaginal 100.000 IU / g @ 100 Tab Tablet - - - - - - - - - -
45 Parasetamol tablet 100 mg @ 100 Tab Tablet - - - - - - - - - -
46 Piridoksin HCl ( Vit.B6) tablet 10 mg @ 1000 Tab Tablet - - - - - - - - - -
47 Propanolol tablet 40 mg @ 100 Tab Tablet - - - - - - - - - -
48 Propiltiourasil tablet 100 mg @ 100 Tab Tablet - - - - - - - - - -
49 Reserpine tablet 0.1 mg @ 250 Tab Tablet - - - - - - - - - -
50 Reserpine tablet 0.25 mg @ 1000 tab Tablet - - - - - - - - - -
51 Tetrasiklin HCl kapsul 250 mg @ 1000 Kap Kapsul - - - - - - - - - -
52 Tetrasiklin HCl kapsul 500 mg @ 100 Kap Kapsul - - - - - - - - - -
53 Tiamin (Vit B1)tablet mono 50 mg @ 1000 Tab Tablet - - - - - - - - - -
54 Trihexlypenidil tablet 2 mg @ 100 Tab Tablet - - - - - - - - - -
55 Vitamin B komplek tablet @ 1000 Tab Tablet - - - - - - - - - -
- - - - - - - - - -
SIRUP - - - - - - - - - -
1 Antasida DOEN Suspensi Komb Botol - - - - - - - - - -
2 Obat Batuk Hitam ( OBH ) cairan @ 100 ml Botol - - - - - - - - - -
3 Mebendazole sirup 100 mg/ 5 ml Botol - - - - - - - - - -
4 Parasetamol sirup 120 mg / 5 ml Botol - - - - - - - - - -
- - - - - - - - - -
INJEKSI - - - - - - - - - -
1 Aminofillin Injeksi 24 mg / ml - 10 ml @ 30 Amp Ampul - - - - - - - - - -
2 Antalgin injeksi 250 mg / ml 2 ml @ 30 Amp Ampul - - - - - - - - - -
3 Aqua pro injeksi steril, bebas pirogen @ 10 fls Fls - - - - - - - - - -
4 Atropin sulfat injeksi 0.25 mg/ml @ 30 Amp Ampul - - - - - - - - - -
5 Fenitoin Na injeksi 50 mg / ml Ampul - - - - - - - - - -
6 Fenobarbital injeksi Ampul - - - - - - - - - -
7 Fitominadion (Vit K) injeksi 10 mg/ml - 1 ml @ 30 Amp Ampul - - - - - - - - - -
8 Klorpromazine HCl Injeksi 25 mg/ ml - 2 ml Ampul - - - - - - - - - -
9 Klorpromazine HCl Injeksi 5 mg/ml - 2 ml Ampul - - - - - - - - - -
10 Magnesium Sulfat inj (IV)20 % ml - 25 ml Fls - - - - - - - - - -
11 Magnesium Sulfat inj (IV)40 % ml - 25 ml Fls - - - - - - - - - -
12 Metilergometrin maleat injeksi 0.200 mg - 1 ml Ampul - - - - - - - - - -
13 Natrium tiosulfat 25 % 10 ml Ampul - - - - - - - - - -
14 Sianokobalamin injeksi(Vit B12) 500 mcg - ml @ 100 Amp Ampul - - - - - - - - - -
15 Tiamin HCl (Vit B1)inj 100 mg/ ml - 1 ml @ 30 Amp Ampul - - - - - - - - - -
- - - - - - - - - -
SALEP - - - - - - - - - -
Salep 2 - 4 :komb Asam salisilat 2 % + Belerang endapan 4 % @ 24
1 Pot Pot - - - - - - - - - -
2 Hidrokortisone krim 2.5 % @ 24 Tube Tube - - - - - - - - - -
3 Betametasone krim 0.1 % @ 25 Tube Tube - - - - - - - - - -
4 Antibakteri DOEN Komb. Pot - - - - - - - - - -
5 Antifungi DOEN Komb. Pot - - - - - - - - - -
- - - - - - - - - -
SALEP MATA - - - - - - - - - -
1 Oksitetrasiklin HCl Salep Mata 1 % @ 25 Tube Tube - - - - - - - - - -
- - - - - - - - - -
TETES MATA - - - - - - - - - -
1 Sulfasetamida Natrium TM 15 % @ 24 btl Botol - - - - - - - - - -
- - - - - - - - - -
TETES TELINGA - - - - - - - - - -
1 Kloramfenikol Tetes Telinga 3 % @ 24 Btl Botol - - - - - - - - - -
2 Fenol Gliserol Tetes Telinga Botol - - - - - - - - - -
- - - - - - - - - -
OBAT LUAR - - - - - - - - - -
1 Antihemoroid DOEN Supp komb. @ 10 Supp Supp - - - - - - - - - -
2 Etakridin (Rivanol) Larutan 0.1 % @ 300 ml Botol - - - - - - - - - -
3 Gentian violet larutan 1 % Botol - - - - - - - - - -
4 Kalium Permanghanat serbuk Botol - - - - - - - - - -
5 Povidon Iodida 10 % 30 ml Botol - - - - - - - - - -
6 Povidon Iodida 10 % 300 ml Botol - - - - - - - - - -
7 Salisilat Bedak 2 % Kotak - - - - - - - - - -
- - - - - - - - - -
OBAT GIGI - - - - - - - - - -
1 Eugenol cairan Botol - - - - - - - - - -
- - - - - - - - - -
ALAT KESEHATAN - - - - - - - - - -
1 Kapas pembalut/Adsorben 250 mg Rol - - - - - - - - - -
2 Kasa kompres 40 / 40 steril Bks - - - - - - - - - -
3 Kasa pembalut 2 m x 80 cm Rol - - - - - - - - - -
4 Kasa pembalut Hidrofil 4 x 15 cm elastic Rol - - - - - - - - - -
5 Kasa pembalut Hidrofil 4 x 3 cm elastic Rol - - - - - - - - - -
6 Pembalut gips Rol - - - - - - - - - -
7 Plester 5 yard x 2 inch Rol - - - - - - - - - -
- - - - - - - - - -
OBAT PENUNJANG - - - - - - - - - -
1 Acyclovir tablet 200 mg @ 100 Tab Tablet - - - - - - - - - -
2 Acyclovir tablet 400 mg @ 100 Tab Tablet - - - - - - - - - -
3 Albendazole tablet 400 mg @ 30 Tab Tablet - - - - - - - - - -
4 Allyestrenol 5 mg tablet @ 30 tablet Tablet - - - - - - - - - -
5 Alprazolam Tablet @ 100 Tab Tablet - - - - - - - - - -
6 Ambroksol tablet 30 mg @ 100 Tab Tablet - - - - - - - - - -
7 Amlodipin 10 mg Tablet @ 30 Tab Tablet - - - - - - - - - -
8 Amlodipin 5 mg Tablet @ 30 Tab Tablet - - - - - - - - - -
9 Amoksisilin + Asam klavulanat 625 mg tablet @ 30 tablet Tablet - - - - - - - - - -
10 Anti Diare (Arcapec) Tablet @ 100 Tab Tablet - - - - - - - - - -
11 Asam askorbat (Vitamin C) tablet 250 mg @ 250 tab Tablet - - - - - - - - - -
12 Asam mefenamat 250 mg Tablet @ 120 tablet Tablet - - - - - - - - - -
13 Asam mefenamat tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
14 Asam Traneksamat tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
15 Aspilet tablet @ 100 Tab Tablet - - - - - - - - - -
16 Betahistin Mesilat (Interhistin) tablet 5 mg @ 30 Tab Tablet - - - - - - - - - -
17 Bisacodil (laxana) tablet 5 mg @ 100 Tab Tablet - - - - - - - - - -
18 Bisoprolol tablet 5 mg @ 30 Tab Tablet - - - - - - - - - -
19 Bromhexin 8 mg (Lexavon) Tablet @ 100 Tab Tablet - - - - - - - - - -
20 Captopril tablet 12,5 mg @ 100 Tab Tablet - - - - - - - - - -
21 Captopril tablet 25 mg @ 100 Tab Tablet - - - - - - - - - -
22 Cefadroksil tab 250 mg Tablet - - - - - - - - - -
23 Cefadroksil tablet 500 mg @ 50 Tab Tablet - - - - - - - - - -
24 Cefixime 100 mg Kapsul @ 30 Kap Tablet - - - - - - - - - -
25 Cetirizine tablet Tablet - - - - - - - - - -
26 Cimetidine tablet @ 100 Tab Tablet - - - - - - - - - -
27 Ciprofloksasin tablet 500 mg 50 Tab Tablet - - - - - - - - - -
28 Clobazam tablet @ 100 Tab Tablet - - - - - - - - - -
29 Codein Tablet 10 mg Tablet - - - - - - - - - -
30 Codein Tablet 20 mg Tablet - - - - - - - - - -
31 Dietil karbamazin sitrat tablet 100 mg @ 100 Tab Tablet - - - - - - - - - -
32 Diltiazem HCl tablet 30 mg @ 100 Tab Tablet - - - - - - - - - -
33 Dimenhidrinat tablet @ 100 Tab Tablet - - - - - - - - - -
34 Doksisiklin tablet @ 100 Tab Tablet - - - - - - - - - -
35 Domperidon Tablet @ 100 Tab Tablet - - - - - - - - - -
36 Erytromycin kapsul 250 mg @ 100 Tab Kapsul - - - - - - - - - -
37 Erytromycin Kapsul 500 mg @ 100 Tab Kapsul - - - - - - - - - -
38 Fe Kombinasi (Maltiron Plus) Tablet @ 100 Tablet Tablet - - - - - - - - - -
39 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Tablet Tablet - - - - - - - - - -
40 Flu Kombinasi (Alpara) tablet @ 100 Tab Tablet - - - - - - - - - -
41 Glikazide (Glicab) tablet 80 mg @ 100 Tab Tablet - - - - - - - - - -
42 Glimepiride Tab 2 mg Tablet - - - - - - - - - -
43 Hyoscyamine N-Bbr 10 mg + PCT (Scopma Plus) Tablet @ 100 Tab Tablet - - - - - - - - - -

44 Ketokonazole tablet @ 50 tab Tablet - - - - - - - - - -
45 Klindamisin tablet 300 mg @ 50 Tab Tablet - - - - - - - - - -
46 Klindamisin tablet 150 mg @ 50 Tab Tablet - - - - - - - - - -
47 Lactobacilus Kombinasi (L-Bio) @ 30 Sacc Tablet - - - - - - - - - -
48 Lanzoprazol kapsul 30 mg @ 20 Kap Tablet - - - - - - - - - -
49 Levofloksasin @ 30 Tab Tablet - - - - - - - - - -
50 Lisinopril 5 mg (Interpril) Tablet @ 30 Tab Tablet - - - - - - - - - -
51 Lisinopril 10 Mg (Interpril) Tablet @ 30 tab Tablet - - - - - - - - - -
52 Loperamid 2 mg (Novadium) tablet @ 100 Tab Tablet - - - - - - - - - -
53 Loratadine tablet 10 mg @ 50 tab Tablet - - - - - - - - - -
54 Mebhedrolin Napadisilat (Incitin) Tablet @ 100 Tab Tablet - - - - - - - - - -
55 Meloxicam tablet 15 mg @ 50 Tab Tablet - - - - - - - - - -
56 Meloxicam tablet 7,5 mg @ 50 Tab Tablet - - - - - - - - - -
57 Mepromaag tablet @ 100 Tab Tablet - - - - - - - - - -
58 Metformin Hcl Tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
59 Methioson Tablet @ 30 Tab Tablet - - - - - - - - - -
60 Metilprednisolone tablet 4 mg @ 100 Tab Tablet - - - - - - - - - -
61 Metronidazole tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
62 Metoklopropamid 10 mg tablet @ 100 Tab Tablet - - - - - - - - - -
63 Multivitamin (Hemafort) Tablet @ 100 Tablet Tablet - - - - - - - - - -
64 Multivitamin (Livron B Plek) tablet @ 100 Tab Tablet - - - - - - - - - -
65 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 Tab Tablet - - - - - - - - - -
66 Na diklopenak tablet 25 mg @ 50 tab Tablet - - - - - - - - - -
67 Na diklopenak Tablet 50 mg @ 50 tab Tablet - - - - - - - - - -
68 Neurotropic (Sohobion)Tablet @ 100 Tab Tablet - - - - - - - - - -
69 Nifedipin Tablet @ 100 Tab Tablet - - - - - - - - - -
70 Ofloksasin tablet 400 mg @ 50 tab Tablet - - - - - - - - - -
71 Omeprazole kapsul @ 30 Kap Kapsul - - - - - - - - - -
72 Papaverin tablet @ 1000 Tab Tablet - - - - - - - - - -
73 Paraformaldehide tablet @ 100 Tab Tablet - - - - - - - - - -
74 Pipemidic Acid (Urinter) kapsul @ 100 Kap Kapsul - - - - - - - - - -
75 Piracetam tablet 400 mg @ 100 Tab Tablet - - - - - - - - - -
76 Piroksikam tablet 10 mg @ 100 Tab Tablet - - - - - - - - - -
77 Piroksikam tablet 20 mg @ 100 Tab Tablet - - - - - - - - - -
78 Propanolol 10 mg Tab Tablet - - - - - - - - - -
79 Pyrazinamida tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
80 Ranitidin tablet 150 mg @ 100 Tab Tablet - - - - - - - - - -
81 Retinol (Vitamin A) kapsul lunak 100.000 IU @ 50 Soft Kap Kapsul - - - - - - - - - -
82 Retinol (Vitamin A) Kapsul lunak 200.000 IU @ 50 Soft Kap Kapsul - - - - - - - - - -
83 Salbutamol tablet 2 mg (sebagai sulfat) @ 100 Tab Tablet - - - - - - - - - -
84 Salbutamol tablet 4 mg (sebagai sulfat) @ 100 Tab Tablet - - - - - - - - - -
85 Sianokobalamin tablet (Vit B12) 10 mg @ 1000 Tab Tablet - - - - - - - - - -
86 Simvastatin tablet 10 mg @ 30/50 Tab Tablet - - - - - - - - - -
87 Simvastatin tablet 20 mg @ 30/50 Tab Tablet - - - - - - - - - -
88 Spiramisin tablet 500 mg @ 50 Tab Tablet - - - - - - - - - -
89 Sprinolakton 25 mg tablet @ 100 tablet Tablet - - - - - - - - - -
90 Sulfadimidin tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
91 Tablet tambah darah @ 30 Tab Sal Tablet - - - - - - - - - -
92 Terbutalin (Terasma) tablet @ 100 Tab Tablet - - - - - - - - - -
93 Tiamfenikol tablet 500 mg @ 100 Tab Tablet - - - - - - - - - -
94 Tramadol Tablet @ 50 Tab Tablet - - - - - - - - - -
- - - - - - - - - -
SIRUP - - - - - - - - - -
1 Ambroksol sirup 15 mg/ 5 ml Botol - - - - - - - - - -
2 Amoksisilin 250 mg/5 ml Sirup Botol - - - - - - - - - -
3 Amoksisilin 100 mg (Supramox) Drop Botol - - - - - - - - - -
4 Anti Diare (Arcapec) Sirup Botol - - - - - - - - - -
5 Anti sariawan (Enkasari) Sirup Botol - - - - - - - - - -
6 Batugin Elixier @ 120 ml botol - - - - - - - - - -
7 Batuk Pilek Komb Bayi (Baby Cough) Sirup Botol - - - - - - - - - -
8 Bromhexin (Phytovon) Sirup Botol - - - - - - - - - -
9 Cefadroksil sirup kering 250 mg / 5 ml Botol - - - - - - - - - -
10 Cefixime Sirup 100 mg / 5 ml Botol - - - - - - - - - -
11 Cetirizine (Lerzin) Sirup Botol - - - - - - - - - -
12 Domperidon Sirup Botol - - - - - - - - - -
13 Domperidon Drop Botol - - - - - - - - - -
14 Erytromycin Sirup Botol - - - - - - - - - -
15 Fe Kombinasi (maltiron) Sirup Botol - - - - - - - - - -
16 Flu Kombinasi Pseudoefedrin + Tripolidin (Eflin) Sirup Botol - - - - - - - - - -
17 Flu Pilek Kombinasi (Intunal) Syrup Botol - - - - - - - - - -
18 Gastrinal Suspensi Botol - - - - - - - - - -
19 Ibuprofen (Farsifen) Sirup Botol - - - - - - - - - -
20 Klorampenikol suspensi Botol - - - - - - - - - -
21 Lactulosa Sirup Botol - - - - - - - - - -
22 Laxadine Sirup @ 30 ml Botol - - - - - - - - - -
23 Metamizol (Norages) Sirup Botol - - - - - - - - - -
24 Metoklopropamid (Gavistal) Drop Botol - - - - - - - - - -
25 Metronidazole (Farizol) Sirup Botol - - - - - - - - - -
26 Metoklopropamid sirup Botol - - - - - - - - - -
27 Metronidazole Infus Botol - - - - - - - - - -
28 Mutivtamin + Lisin (Supralysin) Sirup Botol - - - - - - - - - -
29 Multivitamin + lisin (Supralysin)Drop Botol - - - - - - - - - -
30 Multivitamin + Curcuminoid (Xanvit) sirup Botol - - - - - - - - - -
31 Mutivitamin Daya Tahan (Ekinase) Sirup Botol - - - - - - - - - -
32 Nifuroxide (Nifudiar) Sirup Botol - - - - - - - - - -
33 Nistatin (Cazetin) Drop Botol - - - - - - - - - -
34 Parasetamol Drop Botol - - - - - - - - - -
35 Pseudoefedrin (Alco) Drop Botol - - - - - - - - - -
36 Thiamfenikol (Nikolam) Sirup Kering Botol - - - - - - - - - -
37 Zinc drop Botol - - - - - - - - - -
38 Zinc Sirup Botol - - - - - - - - - -
- - - - - - - - - -
INJEKSI - - - - - - - - - -
1 Alinamin F injeksi @ 5 Amp Ampul - - - - - - - - - -
2 Ampicillin Injeksi 1000 mg @ 10 Vial Vial - - - - - - - - - -
3 Asam Traneksamat Injeksi 500 mg @ 10 Amp Ampul - - - - - - - - - -
4 Cefotaxime Injeksi 1 gram @ 2 vial Vial - - - - - - - - - -
5 Ceftriaxon Injeksi 1 gram @ 2 vial Vial - - - - - - - - - -
6 Citicolin 125 mg/ 2 ml inj @ 5 ampul Ampul - - - - - - - - - -
7 Difenhidramin HCl (Duradryl) injeksi @ 25 Vial Vial - - - - - - - - - -
8 Dopamin Injeksi Ampul - - - - - - - - - -
9 Furusemide Injeksi Ampul - - - - - - - - - -
10 Gentamisin injeksi 80 mg @ 5 ampul Ampul - - - - - - - - - -
11 Hyoscyamine N-Butil bromide (Gitas)Injeksi @ 5 Ampul Ampul - - - - - - - - - -
12 Kanamycin Inj vial - - - - - - - - - -
13 Kloramfenikol Injeksi Vial - - - - - - - - - -
Kombinasi Antalgin 250 mg + Pyramidon 500 mg (Xylomidon) Inj @
14 25 vial Vial - - - - - - - - - -
15 Metamizol (Norages) Injeksi @ 5 amp Ampul - - - - - - - - - -
16 Metoklopropamid (Gavistal) Injeksi @ 5 amp Ampul - - - - - - - - - -
17 Neurotropic (Biocombin) Injeksi @ 10 Amp Ampul - - - - - - - - - -
18 Oksitetrasiklin HCl Inj IM 50 mg/ml 10 ml Vial - - - - - - - - - -
19 Ondasentron Injeksi Ampul - - - - - - - - - -
20 Pethidin injeksi Ampul - - - - - - - - - -
21 Piracetam injeksi 1 gram @ 5 Amp Ampul - - - - - - - - - -
22 Piracetam injeksi 3 gram @ 4 Amp Ampul - - - - - - - - - -
23 Ranitidin injeksi @ 5 / 25 Amp Ampul - - - - - - - - - -
24 Tramadol Injeksi @ 5/25 Amp Ampul - - - - - - - - - -
25 Salbutamol (Ventolin) Nebulizier @ 20 Amp Ampul - - - - - - - - - -
26 Xylocain Injeksi Ampul - - - - - - - - - -
27 Lidocain 2% Injeksi Ampul - - - - - - - - - -
INFUS - - - - - - - - - -
1 KAEN 3A fls - - - - - - - - - -
2 KAEN 3B fls - - - - - - - - - -
3 Glukosa 5% + 1/4 NS fls - - - - - - - - - -
4 Glukosa 5% + 1/2 NS fls - - - - - - - - - -
- - - - - - - - - -
SALEP/KRIM - - - - - - - - - -
1 Acyclovir cream @ 25 Tube tube - - - - - - - - - -
2 Bioplacenton Jelly tube - - - - - - - - - -
3 Gentamisin salep kulit @ 10 Tube tube - - - - - - - - - -
4 Ictiol salep Pot - - - - - - - - - -
5 Ketokonazole krim tube - - - - - - - - - -
6 Miconazole krim @ 24 Tube tube - - - - - - - - - -
7 Nostren Cream Tube - - - - - - - - - -
8 Oksitetrasiklin salep kulit 3 % @ 25 Tube tube - - - - - - - - - -
9 Piroksikam (Infeld) Gel Tube - - - - - - - - - -
10 Scabimite cream @ 24 Tube tube - - - - - - - - - -
- - - - - - - - - -
SALEP MATA - - - - - - - - - -
1 Kloramfenikol Salep Mata tube - - - - - - - - - -
- - - - - - - - - -
TETES MATA - - - - - - - - - -
1 Cendo Catarelent Botol - - - - - - - - - -
2 Cendo Xitrol Botol - - - - - - - - - -
3 Gentamisin Tetes Mata @ 10 Btl Botol - - - - - - - - - -
4 Kloramfenikol Tetes Mata Botol - - - - - - - - - -
5 Tetrakain (Pantocain) TM Botol - - - - - - - - - -
- - - - - - - - - -
TETES HIDUNG - - - - - - - - - -
1 Iliadin Drop Botol - - - - - - - - - -
2 Iliadin Spray Botol - - - - - - - - - -
- - - - - - - - - -
TETES TELINGA - - - - - - - - - -
1 Otopain TT Botol - - - - - - - - - -
- - - - - - - - - -
OBAT LUAR / LAIN- LAIN - - - - - - - - - -
1 Anti sariawan (Albotyl) Sol Botol - - - - - - - - - -
2 Bisacodil (Dulcolax )supp 10 mg @ 5 Supp Supp - - - - - - - - - -
3 Bisacodil (Dulcolax)supp 5 mg @ 6 Supp Supp - - - - - - - - - -
4 Borax gliserin Botol - - - - - - - - - -
5 Diazepam rectal 10 mg (stesolid) @ 5 Tube tube - - - - - - - - - -
6 Diazepam rectal 5 mg (stesolid) @ 5 Tube Rectal - - - - - - - - - -
7 Fenoterol Hydrobromide 100 mcg (Berotec) Semprot Spray kotak - - - - - - - - - -
8 Larutan Chlorhexide @ 500 ml Botol - - - - - - - - - -
9 Larutan Chlorin 5,25 % 500 ml Botol - - - - - - - - - -
10 Salisil spritus Botol - - - - - - - - - -
- - - - - - - - - -
ALAT KESEHATAN - - - - - - - - - -
1 Bisturi @ 100 pcs pcs - - - - - - - - - -
2 Blood Lancet ss @ 100 pcs pcs - - - - - - - - - -
3 Daryan tulle @ 10 lbr Lembar - - - - - - - - - -
4 EKG Paper 80 x 30 Roll - - - - - - - - - -
5 EKG Paper 40 x 30 Roll - - - - - - - - - -
6 Foley cateter no. 16 @ 10 pcs pcs - - - - - - - - - -
7 Foley cateter no. 18 @ 10 Pcs pcs - - - - - - - - - -
8 Hand schoen Examination Uk M/L @ 50 psg psg - - - - - - - - - -
9 Hand schoen no. 7 @ 50 psg psg - - - - - - - - - -
10 Hand schoen no. 7,5 @ 50 psg psg - - - - - - - - - -
11 Hand Schoen No. 8 @ 50 psg psg - - - - - - - - - -
12 Hand schoen steril no. 7 @ 50 psg psg - - - - - - - - - -
13 Hand schoen steril no. 7,5 @ 50 psg psg - - - - - - - - - -
14 Hand schoen steril no. 8 @ 50 psg psg - - - - - - - - - -
15 Handschoen Steril No. 6,5 @ 50 psg psg - - - - - - - - - -
16 Hypapix 5 x 1 m roll - - - - - - - - - -
17 Jarum Hecting Kulit lsn - - - - - - - - - -
18 Jarung Hecting Otot lsn - - - - - - - - - -
19 Kasa Hidrofil 40 x 80 pcs - - - - - - - - - -
20 Kasa pembalut hidrofil 4 x 10 Roll - - - - - - - - - -
21 Kasa steril 16 x 16 pad roll - - - - - - - - - -
22 Larutan Hidrogen peroksida 2 % @ 100 ml Botol - - - - - - - - - -
23 Mami non waven @ 24 pcs pcs - - - - - - - - - -
24 Masker @ 100 pcs pcs - - - - - - - - - -
25 Needle No. 23 G @ 100 pcs pcs - - - - - - - - - -
26 Needle No. 25 G 100 pcs pcs - - - - - - - - - -
27 Optiva No. 20 @ 50 pcs pcs - - - - - - - - - -
28 Paket P3K pcs - - - - - - - - - -
29 Spuit Injeksi 10 ml pcs - - - - - - - - - -
30 Spuit Injeksi 50 ml Set - - - - - - - - - -
31 Surflo No. 20 @ 50 pcs pcs - - - - - - - - - -
32 Surflo No. 22 @ 50 pcs pcs - - - - - - - - - -
33 Surflo No. 24 @ 50 pcs pcs - - - - - - - - - -
34 Test Kehamilan Stik @ 50 pcs pcs - - - - - - - - - -
35 Ultrasonic Gel pcs - - - - - - - - - -
36 Urine bag Stik - - - - - - - - - -
37 USG Printing Paper UPP-110 HG pcs - - - - - - - - - -
38 Wing needle no. 21 pcs - - - - - - - - - -
39 Wing needle no. 27 pcs - - - - - - - - - -
40 Boor Diamond High Speed pcs - - - - - - - - - -
41 Boor Diamond Low Speed pcs - - - - - - - - - -
- - - - - - - - - -
OBAT PROGRAM - - - - - - - - - -
PROGRAM P2 MALARIA - - - - - - - - - -
1 Abate kg - - - - - - - - - -
2 ACT Tablet Ktk - - - - - - - - - -
3 Arsumodon tablet Ktk - - - - - - - - - -
4 Artem Injeksi Ktk - - - - - - - - - -
6 Artesdiaquine Tablet Ktk - - - - - - - - - -
7 Artesunate Injeksi Kotak - - - - - - - - - -
8 Cynoff liter - - - - - - - - - -
9 Kelambu Pcs - - - - - - - - - -
10 Rafid Test Dengeu @ 25 test ktk - - - - - - - - - -
11 RDT Chikungunya ktk - - - - - - - - - -
12 RDT Malaria ktk - - - - - - - - - -
13 RDT Salmonella ktk - - - - - - - - - -
14 Rapid Test (Glukosa+Protein Urin) @ 50 stik ktk - - - - - - - - - -
- - - - - - - - - -
PROGRAM P2 IMUNISASI - - - - - - - - - -
1 Alat suntik sekali pakai 0.05 ml pcs - - - - - - - - - -
2 Alat suntik sekali pakai 0.5 ml pcs - - - - - - - - - -
3 Safety Box Pcs - - - - - - - - - -
4 Vaksin BCG + Pelarut (10 Dosis) ampul - - - - - - - - - -
5 Vaksin BCG + Pelarut (20 dosis) vial - - - - - - - - - -
6 Vaksin Campak + Pelarut (10 dosis) Botol - - - - - - - - - -
7 Vaksin Campak + Pelarut (20 dosis) vial - - - - - - - - - -
8 Vaksin DT vial - - - - - - - - - -
9 Vaksin Hepatitis (HBO) Vial - - - - - - - - - -
10 Vaksin Polio + Droper ( 20 Dosis) ampul - - - - - - - - - -
11 Vaksin Polio + Droper (10 Dosis) Vial - - - - - - - - - -
12 Vaksin Polio IPV 5 Dosis Vial - - - - - - - - - -
13 Vaksin Td vial - - - - - - - - - -
14 Vaksin TT Vial - - - - - - - - - -
15 Vaksin DPT HB HIB Vial - - - - - - - - - -
- - - - - - - - - -
PROGRAM P2 TB - - - - - - - - - -
1 Box Slides pcs - - - - - - - - - -
2 Bunsen Stainlestell ktk - - - - - - - - - -
3 FDC I ktk - - - - - - - - - -
4 FDC I & III ktk - - - - - - - - - -
5 FDC II siklus - - - - - - - - - -
6 Kaca Ose siklus - - - - - - - - - -
7 Kombipak kategori 1 ktk - - - - - - - - - -
8 Lampu Spritus siklus - - - - - - - - - -
9 Obat antituberkolosis Kategori Anak siklus - - - - - - - - - -
10 Obat antituberkolosis Kategori sisipan ktk - - - - - - - - - -
11 Pot Sputum ktk - - - - - - - - - -
12 Reagen Zn Neilson set - - - - - - - - - -
13 Slide mikroskop kotak - - - - - - - - - -
14 Spritus Botol - - - - - - - - - -
15 Masker N-95 pcs - - - - - - - - - -
16 Mikroskop Binoculer unit - - - - - - - - - -
17 Isoniazid (INH) 100 mg Tablet Tablet - - - - - - - - - -
- - - - - - - - - -
PROGRAM P2 DIARE - - - - - - - - - -
1 Zn Tablet 500 mg Tablet - - - - - - - - - -
- - - - - - - - - -
PROGRAM P2 KUSTA - - - - - - - - - -
1 MDT MB Anak Strip - - - - - - - - - -
2 MDT MB Dewasa Strip - - - - - - - - - -
3 MDT PB Anak Strip - - - - - - - - - -
4 MDT PB Dewasa Strip - - - - - - - - - -
- - - - - - - - - -
PROGRAM KIA - - - - - - - - - -
1 Pil KB Kombinasi (Andalan) @30 strip strip - - - - - - - - - -
2 Obat Suntik KB 1 Bulan (Andalan) @ 20 vial vial - - - - - - - - - -
3 Obat Suntik KB 3 Bulan (Harmonis) @ 20 vial vial - - - - - - - - - -
4 Gluconas Calsicus vial - - - - - - - - - -
- - - - - - - - - -
REAGEN LABORATORIUM - - - - - - - - - -
1 Alkohol 70 % @ 1000 ml Botol - - - - - - - - - -
2 Alkohol 70% @ 100 ml Botol - - - - - - - - - -
3 Alkohol 95 % @ 1000 ml botol - - - - - - - - - -
4 Alkohol Swab @ 100 pcs Kotak - - - - - - - - - -
5 Coumbour 10 Parameter botol - - - - - - - - - -
6 EDTA 10 % botol - - - - - - - - - -
7 Gliserin Botol - - - - - - - - - -
8 Gluko dr Stik @ 25 Stik botol - - - - - - - - - -
9 Golongan Darah Test set - - - - - - - - - -
10 HB (Stat Site) Stik @ 25 Stik Botol - - - - - - - - - -
11 Larutan Anisol botol - - - - - - - - - -
12 Larutan Asam Asetat 6% botol - - - - - - - - - -
13 Larutan Asam Sulfosalilisat botol - - - - - - - - - -
14 Larutan Barium Klorida 10 % botol - - - - - - - - - -
15 Larutan Benedict Botol - - - - - - - - - -
16 Larutan Buffer Ph botol - - - - - - - - - -
17 Larutan Carbol Gentian Violet botol - - - - - - - - - -
18 Larutan Drabkin Botol - - - - - - - - - -
19 Larutan Eosin 2 % Botol - - - - - - - - - -
20 Larutan Etanol Asam Botol - - - - - - - - - -
21 Larutan Foucet botol - - - - - - - - - -
22 Larutan Giemsa Stain Botol - - - - - - - - - -
23 Larutan H2SO4 p Botol - - - - - - - - - -
24 Larutan HCl 0,1% botol - - - - - - - - - -
25 Larutan HNO3 P Botol - - - - - - - - - -
26 Larutan karbol Fuchsin @ 100 ml Botol - - - - - - - - - -
27 Larutan KOH 10 % Botol - - - - - - - - - -
28 Larutan Metelin Biru Botol - - - - - - - - - -
29 Larutan Turk Botol - - - - - - - - - -
30 Lisol, mengandung kresol tersabun 50 % Botol - - - - - - - - - -
31 Metanol Botol - - - - - - - - - -
32 Na Citrat 3,8 % botol - - - - - - - - - -
33 Nesco Cholesterol Stik @ 10 Stik botol - - - - - - - - - -
34 Nesco Glucose Stik @ 25 Stik Botol - - - - - - - - - -
35 Nesco HB Stik @ 25 Botol - - - - - - - - - -
36 Nesco Uric Acid Stik @ 25 Stik botol - - - - - - - - - -
37 Oli Emersi botol - - - - - - - - - -
38 Rees Ecker botol - - - - - - - - - -
39 Trigeliserida Botol - - - - - - - - - -
40 Water Steril 500 ml Botol - - - - - - - - - -
41 Water Steril 1000 ml Botol - - - - - - - - - -
42 widal Test Set - - - - - - - - - -
43 Xylol botol - - - - - - - - - -
44 Sungkup Bayi Pcs - - - - - - - - - -
45 NGT All Item Pcs - - - - - - - - - -
46 PP 3 juta Injeksi vial - - - - - - - - - -
47 Progesteron Injeksi Vial - - - - - - - - - -
48 Iodiom Test Pcs - - - - - - - - - -
49 Mineral Mix Bks - - - - - - - - - -
50 Eksavator Double Ended Pcs - - - - - - - - - -
51 Asetamivir tab Tablet - - - - - - - - - -
52 Natrium Tiroksin Pcs - - - - - - - - - -
53 Alat HB Sahli Merk Afexbio/Hemosmart Pcs - - - - - - - - - -
54 Stick Hemosmart Pcs - - - - - - - - - -
55 Tas Alat deteksi resiko ibu Hamil Pcs - - - - - - - - - -
56 Lab.Kit Paket - - - - - - - - - -
57 Blue Tips bks - - - - - - - - - -
58 Yellow Tips bks - - - - - - - - - -
59 Deck Glass ktk - - - - - - - - - -
60 Micro Hematokrit / Tabung Hematokrit pcs - - - - - - - - - -
61 Tissue Lensa bks - - - - - - - - - -
62 Stik HB Family Dr ktk - - - - - - - - - -
63 Tabung EDTA K3/Vacutainer pcs - - - - - - - - - -
64 Glukosa Stik Performa Accu Check kotak - - - - - - - - - -
67 Glukosa Stik Active Accu Check Kotak - - - - - - - - - -
68 Kertas saring (isi 100 lbr) bks - - - - - - - - - -
69 Lidi Sputum (100 pcs) bks - - - - - - - - - -
70 Cotton Swab pcs - - - - - - - - - -
71 Specullum pcs - - - - - - - - - -
72 Eter Alkohol Botol - - - - - - - - - -
NOP DES JMH RATA
14 15 16 17
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Lplpo Lraya Belanti 2017 File Sali

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LAPORAN PEMAKAIAN OBAT DAN LEMBAR PERMINTAAN OBAT (LPLPO)

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

1 Antasida DOEN Suspensi Komb Botol - - - - - -

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor

Laporan/Permintaan : Desember / Januari

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

PEMBERIA HARGA TOTAL EXP

Mahdalena, S. Farm., Apt

SATUA STOK PENERI PERSEDIA PEMAKAI

35 Klorpeniramine Maleat (CTM) tablet 4 mg @ 100 Tab Tablet - - - -

15 Tiamin HCl (Vit B1)inj 100 mg/ ml - 1 ml @ 30 Amp Ampul - - - -

5 Povidon Iodida 10 % 30 ml Botol - - - -

1 Kapas pembalut/Adsorben 250 mg Rol - - - -

10 Asam askorbat (Vitamin C) tablet 250 mg @ 250 tab Tablet - - - -

60 Multivitamin Bumil (Prenatin Plus) Tablet @ 100 Tab Tablet - - - -

14 Fe Kombinasi (maltiron) Sirup Botol - - - -

H.Errani Martin,SKM.MM Hj. Renny Haslinda, S.Si, Apt

SISA STOK PERMINT PEMBERIA HARGA TOTAL EXP

dr.Widhi Susanto Mahdalena, S. Farm., Apt

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor Yang Menerima

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor Yang Menerima

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor Yang Menerima

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

ermintaan : April / Mei

PEMBERIA HARGA TOTAL EXP

1589 441 2,030

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor Yang Menerima

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor Yang Menerima

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor Yang Menerima

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT

STOK PENERIM PERSEDI PEMAKAI STOK PERMINT