Obat

Persediaan Jumlah
No Nama Obat Satuan

Persediaan
Awal Tambahan 1 2
Air Raksa Dental Use Botol -
1 0
Albendazole Tablet 400 mg Tablet 100
2 100
Alopurinol Tablet 100 mg Tablet 64 100 164
3
Ambroksol Tablet 30 mg Tablet 78 78
4
Ambroksol sirup 15 mg/5 ml Botol 2 10 12
5
Aminofillin Injeksi 24 mg/ml-10 ml Ampul - -
6
Aminofillin Tablet 200 mg Tablet 20 20
7
Amitriptillin Hcl Tablet Salut 25 m Tablet - 100 100
8
Amlodipin Tablet 5 mg Tablet 43 100 143
9
Amlodipin Tablet 10 mg Tablet - -
10
Amoksisillin Kapsul 250 mg Kapsul 40 100 140
11
Amoksisillin Kaplet 500 mg Kaplet 55 500 555
12
Amoksisillin Serbuk Injeksi 1000 mg vial - -
13
Amoksisillin Sirup Kering 125 mg/5 Botol 8 15 23
14
Amoksisillin Double Strengh Sirup Botol
15 2 2
Kering 250 mg/5 ml
Ampisilin Kapsul 250 mg Kapsul - -
16
Ampisillin Kaplet 500 mg Tablet 42 42
17
Ampisilin Sirup 125 mg / 5 ml Botol - -
18
Ampisillin Injeksi 1000 mg Vial - -
19
Analgetik Plus Tablet 40 40
20
Antasida Doen Suspensi Botol 1 5 6
21
Kombinasi : Magnesium
Antasida Doen
200 Tablet, Kombinasi Tablet
22 Hidroksida
:Hidroksida
Magnesium
mg+ Alumunium 46 600 646
200 mg/5 ml 200 mg+
Hidroksida
Antasida Plus
Alumunium Tablet 200 mg
Hidroksida Tablet - -
23
Antalgin (Metampiron) Tablet 500 Tablet 40 40
24
Antalgin Injeksi 250 mg/ml-2ml Ampul - -
25
26 Anti Bakteri DOEN Salep Tube 4 4
Kombinasi :
Anti Hemoroid
Basitrasin Doen komb
500 IU/g + Supp - -
27
Polimiksin 1000 IU/g
Anti Fungi DOEN Kombinasi : Pot
28 - 5 5
Asam Benzoat
Antimigren 6% +
DOEN Asam Salisilat
Kombinasi : Tablet
29
3%
- -
Anti Diare Suspensi
Ergotamin Tartrat 1 mg + Kofein Botol - -
30
50 mg
Anti Diare Tablet Tablet 5 100 105
31
Anti Dotum Oral Tablet Tablet 70 70
32
Anti Hipertensi Kapsul Tablet - -
33
Antihistamin Tablet kombinasi Tablet 31 31
34
Antispasmodik Tablet Tablet 24 24
35
Antitusiva Sirup Botol 2 2
36
Antitusiva Tablet Tablet 20 20
37
Asam Folat Tablet 1 mg Tablet - -
38
Asam Askorbat 50 mg Tablet 80 80
39
Asam Mefenamat Kapsul 500 mg Kapsul 9 100 109
40
Asetosal 80 mg Tablet - -
41
Asetosal Tablet 100 mg Tablet - -
42
43
Asiklovir Krim 5 % Tube 2 2
44
Asiklovir Tablet 200 mg Tablet 7 50 57
45
Asiklovir Tablet 400 mg Tablet - -
46
Atropin Sulfat Injeksi 0,25 mg/ml- Ampul - -
47
Aqua Pro Injeksi Steril, bebas Piro Vial - -
48
Betahistin Mesilat 6 mg Tablet 4 100 104
49
Betametason Krim 0,1 %- 5g Tube 2 2
50
Bisakodil suppositoria 10 mg Supp - -
51
Bisoprolol Tablet 5 mg Tablet - -
52
Bromheksin 8 mg Tablet 30 30
53
Deksametason Injeksi 5mg/ml-1ml Ampul 2 2
54
Deksametason Tablet 0,5 mg Tablet 90 200 290
55
Devitalisasi Pasta (Non Arsen) Botol - -
56
Diazepam tablet 2 mg Tablet 28 28
57
Diazepam Injeksi i.v/i.m 5 mg/ml Ampul - -
58
Diazepam Larutan Rektal 5 mg/ml Supp - -
59
Dietilkarbamazin Sitrat Tablet 100 Tablet - -
60
Difenhidramin HCl Injeksi 10 mg/m Ampul 47 47
61
Digoksin Tablet 0,25 mg Tablet - -
62
Dimenhidrinat Tablet 50 mg Tablet - -
63
Domperidon Tablet 10 mg Tablet 40 40
64
Donperidon Suspensi 5 mg/5ml Botol 1 1
65
Efedrin Hcl Tablet 25 mg Tablet 60 60
66
Ekstrak Belladone Tablet 10 mg Tablet 282 282
67
Epinefrin HCl / Bitartrat Ampul
(Epinefrina / Adrenalina) Injeksi 5

68 0,1%/- 1ml 5
Eritromisin Kapsul 250 mg Kapsul - -
69
70
Eritromisin Sirup 200 mg / 5 ml Botol - -
71
Etambutol Tablet 500 mg Tablet - -
72
Etanol 70 % 100 ml Botol - -
73
Etil Klorida Semprot -100 ml Botol 1 1
74
Eugenol Cairan -10 ml Botol - -
75
Fenitoin Natrium Kapsul 100 mg Kapsul 100 100
76
Fenobarbital tablet 30 mg Tablet - -
77
Fenobarbital injeksi 50 mg / ml Ampul - -
78
Fenoksimeti Penisilin 250 mg table Tablet 100 100
79
Fenoksimeti Penisilin 500 mg tabl Tablet 70 70
80
Fitomenadion tablet 10 mg Tablet 85 85
81
Fitomenadion (Vit K1) Injeksi 2 m Ampul 3 3
82
Furosemid Tablet 40 mg Tablet 27 27
83
Garam Oralit I serbuk, Kantong
84
kombinasi :
89 89
Gemfibrozil( Tablet 600gr,
Nacl 0,52 mgKalium Tablet - -
85
Klorida 0,30 gr, Trinatrium Sitrat
Gentamisin injeksi 80 mg / 2 ml Vial - -
86 dihidrat 0,58 gr, Glukosa Anhidrat
2,70 g )200 ml Air
Gentamisin Salep Kulit 0,1 % Tube 2 2
87
Glibenklamid Tablet 5 mg Tablet 20 20
88
Glimepiride 2 mg Tablet - 100 100
89
Gliseril guayakolat tablet 100 mg Tablet 123 500 623
90
Gliseril Guayakolat sirup Botol 3 3
91
Glukonas Kalsikus injeksi Ampul - -
92
Glukosa Larutan Infus 5 % Botol 1 1
93
Glukosa Larutan Infus10 % Botol - -
94
Griseofulvin Tablet 125 mg,microni Tablet - 50 50
95
Haloperidol Tablet 0,5 mg Tablet 30 200 230
96
Haloperidol Tablet 1,5 mg Tablet 20 20
97
Haloperidol Tablet 5 mg Tablet - -
98
Hidrokloritiazid 25 mg Tablet 19 19
99
Hidrokortison Krim 2,5 % Tube 1 20 21
100
Ibuprofen Tablet 200 mg Tablet 92 100 192
101
Ibuprofen Tablet 400 mg Tablet - -
102
Ibuprofen Suspensi 100 mg/5 ml Botol 1 1
103
Ichtyol salep Kulit Pot - -
104
Ipatropium Bromide + Salbutamol Vial
-
105 Sulphate for inhalation 2,5 ml -
Isoniazid tablet 100 mg Tablet
-
106 -
Isosorbid Dinitrat 5 mg Tablet - -
107
Kalium Diklofenak Tablet 25 mg Tablet - -
108
Kalium Diklofenak Tablet 50 mg Tablet 47 50 97
109
Kalsium Hidroksida Pasta Tube - -
110
Kalsium Laktat Tablet 500 mg Tablet 96 200 296
111
Kaptopril 12,5 mg Tablet 52 200 252
112
Kaptopril 25 mg Tablet 5 5
113
Karbamazepin Tablet 200 mg Tablet - 50 50
114
Ketokonazole Krim 2 % - 15 gr Tube - 5 5
115
Ketokonazole Tablet 200 mg Tablet 12 12
116
Ketoprofen Tablet 100 mg Tablet - -
117
Ketoprofen Injeksi 100 mg / 1 ml Ampul - -
118
Ketorolac 10 mg injeksi Ampul - -
119
120
Klindamisin Kapsul 150 mg Kapsul - -
121
122
Kloramfenikol Kapsul 250 mg Kapsul 94 94
123
Kloramfenikol Salep Mata 1%-3,5 g Tube 1 1
124
Kloramfenikol Tetes Mata -5 ml Botol - 10 10
125
Kloramfenikol Tetes Telinga 3%-5 Botol - 5 5
126
Klorfeniramin Maleat (CTM) Tablet Tablet 92 600 692
127
Klorpromazin Hcl Tablet Salut 25 Tablet - -
128
Klorpromazin Hcl Tablet Salut 100 Tablet 66 50 116
129
Klorpromazin Hcl Injeksi 5 mg/ml- Ampul - -
130
Kotrimoksazol Pedriatik Tablet, Tablet
Kombinasi :
Sulfametoksazol 100 mg + -
Trimetroprim 20 mg
131 -
Kotrimoksazol Tablet, Kombinasi : Tablet
50
132 Sulfametoksazol 400 mg + 50
Trimetroprim
Kotrimoksazol80 mg
Suspensi Kombinasi Botol
: - 10
133 Sulfametoksazol 200 mg + 10
Lansoprazole 30
Trimetroprim 40 mg Kapsul
mg/5 ml Tablet - -
134
Larutan mengadung Elektrolit (Na Botol
130 mEq,Cl 109 mEq, Asetat 28 -
135 -
mEq) /Asering
Larutan mengadung Elektrolit Botol -
136 (Nacl 1,125 gr , Dekstrosa 18,75
-
Larutan
gr) mengadung Karbohidrat + Botol
Elektrolit -
137 (Nacl 1,75 gr, KCL 1,5 gr, Na
-
Lidokain
Lactat injeksi
2,24 2%
gr, Dekstrosa 27 gr) Tablet 1 1
138
139 Lidokain Komp Injeksi, Ampul - -
Kombinasi :
Loperamid Tablet 2 mg Tablet - -
140 Lidokain Hcl 2%
+Epinefrin 1 : 80.000-2
Loratadin tablet 10 mg ml Tablet
141 40 40
Magnesium Sulfat (IV) 20 %-25 ml Ampul - -
142
Meloksikam tablet 15 mg Tablet 42 42
143
Meloksikam Suppositoria Supp - -
144
Metformin Hcl Tablet 500 mg Tablet 20 50 70
145
Methisoprinol 500 mg Tablet - -
146
Metilergometrin Maleat (Metergin) Tablet - -
147
Metilergometrin Maleat Injeksi 0, Ampul 4 4
148
Metilprednisolon tablet 4 mg Tablet 48 48
149
Metoklopramid 10 mg Tablet 40
150 40
Metoklorpropamid Injeksi 5 mg/ 5 Ampul -
151 0
Metronidazol Tablet 250 mg Tablet 40
152 40
Metronidazole Tablet 500 mg Tablet 100 130
153 30
Metronidazole Infus 500 mg /100 m Ampul -
154 0
Mikonazole KrIm 2 % - 10 gr Tube 2
155 2
Multivitamin + Mineral tablet Tablet 100 122
156 22
Multivitamin sirup Botol 10 10
157 0
Natrium Bikarbonat Tablet 500 mg Tablet 140
158 140
Natrum Diklofenak Tablet 25 mg Tablet -
159 0
Natrium Diklofenak Tablet 50 mg Tablet 100 143
160 43
Natrium Klorida Larutan infus 0,9%- Botol 2
161 2
Nipedifin Tablet 10 mg Tablet 3
162 3
Nistatin 100.000 IU/gram Tablet V Tablet 9
163 9
Nistatin 500.000 IU/gram Tablet Sa Tablet 50
164 50
Obat Antitiuberkolosis Kategori A Paket -
165 0
Obat Antitiuberkolosis Kategori 1 Paket -
166 0
167 0
168 0
Obat Anti Tuberkulosis FDC Kat A Paket -
169 0
Obat Anti Tuberkulosis FDC Kat I & Paket -
170 0
171 0
Obat Anti Tuberkolosis FDC Sisipa Paket -
172 0
Obat Batuk Hitam (OBH) Cairan 10 Botol 20 20
173 0
Obat Batuk Cair Sirup (Ekspektoran Botol 2
174 2
Obat Batuk Hitam Plus Sirup Botol -
175 0
Obat Flu Sirup Botol -
176 0
Oksiterasiklin Hcl injeksi i.m.50 m Vial -
177 0
Oksiterasiklin Salep Mata 1%-3,5g Tube 5 5
178 0
Oksitetrasiklin Hcl Salep Kulit 3%-5 Tube 2
179 2
Oksitosin Injeksi 10 IU/ml-1ml Ampul 9
180 9
Omeprazole injeksi 40mg/10ml Ampul -
181 0
Omeprazole Kapsul 20 mg Tablet -
182 0
Ondansetron inj 4 mg/ 2 mL Ampul 0 -
183
Parasetamol drops Botol 0 1 1
184
Parasetamol Sirup 120 mg/5ml-60 Botol 5 35 40
185
Parasetamol Tablet 100 mg Tablet 0 -
186
Parasetamol Tablet 500 mg Tablet 63 1300 1,363
187
Pehacain injeksi Ampul 0 -
188
Perak Sulfadiazin krim 1 % 35 gr Tube 0 -
189
Piracetam 400 mg Tablet 0 -
190
Piracetam Tablet 800 mg Tablet 0 -
191
Piroksikam Tablet 20 mg Tablet 4 4
192
Pirantel Pamoat Tablet 365 mg (Se Tablet 80 80
193
Piridoksin Hcl (Vit.B6) Tablet 10 m Tablet 62 400 462
194
Polikresulen (Kondensasi Botol
Metakresol 0 -
195
Sulfonat dan Metanal) 360
Povidon
mg/g-10 Iodida
ml 10% 30 ml Botol 2 2
196
Povidon Iodida 10% 300 ml Botol 1 1
197
Primakuin tablet 15 mg Tablet 0 -
198
Propanolol Hcl Tablet 40 mg Tablet 0 10 10
199
Propilturasil Tablet 100 mg Tablet 0 -
200
Ranitidin Injeksi 25 mg / ml Ampul 0 -
201
Ranitidin Tablet 150 mg Tablet 9 150 159
202
Retinol (Vit.A) 100.000 IU Kapsul Kapsul 0 -
203
Retinol (Vit.A) 200.000 IU Kapsul Kapsul 186 186
204
Reserpin Tablet 0, 25 mg Tablet 40 40
205
Rifampisin Tablet 450 mg Tablet 0 -
206
Ringer Laktat Larutan Infus Steril Botol 3 3
207
Salbutamol Tablet 2 mg Tablet 3 50 53
208
Salbutamol Tablet 4 mg Tablet 0 -
209
Salbutamol solution for Inhalation Ampul 0 -
210
single dose units 2,5 ml
Salep 2-4 Kombinasi : Pot
211 0 -
Salisil Salisilat
Asam bedak 2% -50
2% gr
+ Belerang Kotak 2 20 22
212
Endap 4 % - 30 gram
Salep Luka Bakar Tube 1 1
213
Sefadroksil Sirup Kering 125 mg / Botol 0 -
214
Sefadroksil Tablet 500 mg Tablet 7 7
215
Sefiksim Kapsul 100 mg Kapsul 30 30
216
Sefotaksim Injeksi 1 gr Ampul 0 -
217
Seftriakson Injeksi 1 gr / vial Ampul 0 -
218
Semen Seng Fosfat Serbuk & Caira Botol 0 -
219
Setirizin Tablet 10 mg Tablet 62 62
220
Setirizin Sirup 5 mg / 5 ml Botol 4 4
221
Sianokobalamin Injeksi 500 mcg/m Ampul 21 21
222
Sianokobalamin Tablet 50 mcg Tablet 10 10
223
Silver Amalgam Serbuk 65-75% Botol 0 -
224
Simetidin 200 mg Tablet Tablet 80 80
225
Simvastatin Tablet 10 mg Tablet 25 50 75
226
Siprofloksasin 500mg Tablet 10 100 110
227
Spironolakton Tablet 25 mg Tablet 70 70
228
Sulfacetamid Tetes Mata 15 %-5ml Botol 0 -
229
Tablet Tambah Darah Kombinasi: Tablet
230 20 200 220
Temporary
Besi II SulfatStopping
200 mg Fletcher
+ Asam Folat Set
231 (Fletcher)
0,25 mg Serbuk & Cairan 0 -
Trikesol formalin ( T K F ) Cairan 1 Botol 0 -
232
Tetrasiklin Kapsul 250 mg Kapsul 10 10
233
Tetrasiklin Kapsul 500 mg Kapsul 0 -
234
Thiamin Hcl (Vit B1) Injeksi 100 m Ampul 0 -
235
Tiamin Hcl /Mononitrat (Vit.B1) Ta Tablet 184 184
236
Thiamfenikol Kapsul 500 mg Kapsul 0 100 100
237
Tramadol Injeksi 50 mg/ ml Ampul 0 -
238
Tramadol Tablet 50 mg Tablet 0 -
239
Triheksifenidil Hidroklorida Tablet Tablet 42 50 92
240
Vitamin B .Komplek Tablet Tablet 27 500 527
241
Vitamin Neurotropik Tablet Tablet 69 100 169
242
Zinc Tablet 20 mg Tablet 133 133
243
Prednisone 54mg Tablet 308 308
244
flunax sy Botol 0 -
245
Set 0 -
246
Set 0 -
247
Tablet 0 -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES 0 -
Abbocath No 18 ( IV Chateter 18 ) Buah 0 -
1
Abbocath No 20 ( IV Chateter 20 ) Buah 5 5
2
3
4
Alat Suntik Sekali Pakai 10 ml Set 7 7
5
6
Alat Suntik Sekali Pakai 2,5 ml Set 43 43
7
8
Alat Suntik Sekali Pakai 10 ml Set 0 -
9
Auto Disposable Syringe (ADS) 0,05 set 0 -
10
11
Auto Disposable Syringe (ADS) 5 ml set 0 -
12
Catgut/Benang Bedah No.2/0-3/0 ( Sachet 3 3
13
Etakridin Larutan (Rivanol) 0,1% - Botol 0 -
14
Etanol 70 % 1.000 ml Botol 0 -
15
Folley Catheter no 14 Set 0 -
16
17
Folley Catheter no 18 Set 2 2
18
Infus set Anak Set 0 -
19
Infus set Dewasa Set 7 7
20
Iodina Test Botol 1 1
21
Kassa Hidrofil Steril 16 x 16 Kotak 0 -
22
Kapas Berlemak 500 gram Bungkus 0 -
23
Kapas Pembalut / Adsorbens 250 g Bungkus 0 -
24
Kassa Kompres 40 x 40 steril Bungkus 0 -
25
Kassa Pembalut 2 m x 80 cm Rol 2 2
26
Kassa Pembalut Hidrofil 4 m x 3 c Rol 1 1
27
Kassa Pembalut Hidrofil 4 m x 15 Rol 0 -
28
Kertas Puyer Pcs 0 -
29
Lysol 1,000 ml Botol 0 -
30
Masker Buah 10 10
31
Plester 5 yard x 2 inchi Rol 1 1
32
Pot Dahak Pcs 0 -
33
Rapid HIV 1 (SD HIV) Pcs 0 -
34
Rapid HIV 2 (Intec HIV) Pcs 0 -
35
Rapid HIV 2 (Biomeriux HIV) Pcs 0 -
36
Rapid Test Syphilis Pcs 0 -
37
RPR Test Syphilis Pcs 0 -
38
Silk( Benang Bedah Sutra ) No 3/0 Sachet 4 4
39
Safety Box Pcs 0 -
40
Sarung tangan Steril No 6 Pcs 0 -
41
Sarung tangan Steril No 7 Pcs 3 3
42
Sarung tangan Steril No 7,5 Pcs 7 7
43
Sarung tangan Non Steril S Pcs 0 -
44
Sarung tangan Non Steril M Pcs 0 -
45
Sarung tangan Non Steril L Pcs 0 -
46
Urine Bag set 2 2
47
Wing Neddle No 23 Set 0 -
48
Anuscopi Yamato Unit 0 -
49
Kaca Slide Box 0 -
50
Reagen Ziehl Nielson Kit 0 -
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
Rapid HIV 3 (Oncoprobe HIV) Pcs 0 -
54
Sound Timer Buah 0 -
55
SD Syphilis Pcs 0 -
56
CATATAN HARIAN PEM
Bulan : Januari Ta
JUMLAH
3 4 5 6 7 8 9 10 11 12
10 20 10
10
1 2
10 10
10 30 10 10 10
10 10 10
20 50 20 20 40 20 20
1 1 1 1 1 1
10
1
50 10 10 10 10 50 10 20
1 1
20
12
1
32
10
4 10
18 3 6
20 10
20 35 4 10 10 10 15
1 1
10 10 10 10 10
2 1 1
10 10 10 30 10
30 20
20 7 10 22 10 15
10 10
1
1 1
36 75 9 16 18 22 33 25
5 5 20 10 5
12
10
10 10
10
10 20 10 15
1 1
10 10 12 10
1 1
2 1 1 1 3 1 1
80 60 30 50 58 82 70 40
30 20 45 10
10
18 20 10 6
1 1 1 3 1
1
10
20
10
10 10 10
10 30 20
10 10 10
10 10
30 26 20 40 26 30 15
20 25 10 10 22
10
10 10
AN HARIAN PEMAKAIAN OBAT
ulan : Januari Tahun : 2017
JUMLAH PEMAKAIAN JENIS OBAT PADA TANGGAL
13 14 15 16 17 18 19 20 21 22
5 20
10
10
10 10 10
10 10 10
20 20 10 30 20 70
1 1 1
1 1 1
20 50 30 20 10 10 20
10
10
1
1
10
5 10
20
6
30
10 5 19 20
20 10
2 9
10 10
8 8 10 8
30 40 20 20 40 6
10
10 15 25 41 25 72
10
1
10
10
10 20
1
10 10
10
1 3 2
1 2 1 1
10 10 48 60 45 76 40 40
20 20 50 38
10 10 10 10
10
1 1 1 1
10
10 10
10
20
30 40 20 20 10 30
10
10
10 10 40 20 20
8 6 10 10
90
Jumlah
Pemakaian
23 24 25 26 27 28 29 30 31
0
0
65
20
1 4
0
0
30
10 110
0
20 10 10 100
20 50 10 20 40 30 16 546
0
2 1 12
0
0
10
0
0
0
1 5
30 20 50 20 40 60 20 570
0
0
0
1 1
0
1 3
0
0
8 10 10 58
0
0
10 20
12
2
0
0
10 10 20
20 20
0
0
0
1
42
0
0
0
10 7 10 52
1 1 2
0
0
0
0
10 10 6 10 20 10 100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 10
0
0
6 5 6 50
0
0
0
10 10 20
60
10 25 10 9 212
2
0
0
0
10 10
20 20 10 30 160
0
0
10 10
1 16
10 10 10 10 130
0
0
0
0
0
0
10 8 8 68
0
206
20 10 10 20 154
0
10 30
1 2
10 10
0
0
0
0
0
0
0
0
1 2 1 6
1 1 4
56 36 10 35 30 15 10 614
0
15 10 5 20 105
0
0
10 22
2 2 6
0
0
0
0
0
0
0
0
0
10
0
30
0
0
0
10 18
10
0
0
10 10 60
0
0
55
1 1 1 6
18 38
0
10 20 10 92
0
0
0
0
0
0
0
0
0
0
0
0
1 2 2 1 14
1 1
0
0
0
1 2
0
0
0
0
0
1 1
2 1 7 5 6 36
0
88 50 68 60 100 106 36 1307
0
0
0
0
0
0
20 35 58 20 40 20 426
0
0
0
0
10
0
0
8 18 6 10 10 146
0
0
0
0
0
10
0
0
0
1 1 1 1 15
1
0
0
10 30
0
0
0
20 10 50
1 1
0
0
0
0
30
10 10 10 10 80
20
0
10 220
0
0
0
0
0
10 10 30 10 90
10
0
0
10 20 60
30 30 10 26 20 45 448
10 25 10 166
10
4 10 124
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Sisa Akhir
Bulan
-
100
99
58
8
-
20
70
33
-
40
9
-
11
2
-
32
-
-
40
1
76
-
40
-
3
-
2
-
-
47
70
-
11
12
-
20
-
60
89
-
-
-
1
15
-
-
-
52
-
-
-
30
2
190
-
28
-
-
-
47
-
-
40
1
60
282
5
-
-
-
-
-
1
-
100
-
-
100
70
75
3
27
39
-
-
2
-
40
411
1
-
1
-
40
70
20
-
9
5
62
-
1
-
-
-
-
29
-
90
98
5
20
3
2
-
-
-
-
-
-
94
1
4
1
78
-
11
-
-
28
4
-
-
-
-
1
-
-
40
-
32
-
40
-
-
4
30
30
-
40
70
-
2
67
4
102
-
51
2
3
9
50
-
-
-
-
-
-
-
-
6
1
-
-
-
3 7
2 2
9 9
-
-
-
-
4
-
56
-
-
-
-
4
80
36
-
2
1
-
-
-
-
13
-
186
40
-
3
43
-
-
-
7
-
-
7
-
-
-
-
12
3
21
10
-
80
45
30
50
-
-
-
-
10
-
-
94
90
-
-
32
79
3
123
184
-
-
-
-
-
-
-
-
-
-
-
-
5
-
-
7
3
43
3
-
-
-
-
3
-
-
-
-
2
-
7
1
-
-
-
-
2
1
-
-
-
10
1
-
-
-
-
-
-
4
-
-
3
7
-
-
-
2
-
-
-
-
-
-
-
-
-
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3 4
1 0
2 100
3
Ambroksol Tablet 30 mg Tablet 58 58 10
4
Ambroksol sirup 15 mg/5 ml Botol 8 8
5
Aminofillin Injeksi 24 mg/ml-10 m Ampul - -
6
7
Amitriptillin Hcl Tablet Salut 25 Tablet 70 70
8
Amlodipin Tablet 5 mg Tablet
9 33 100 133
10
Amoksisillin Kapsul 250 mg Kapsul 40 40
11
Amoksisillin Kaplet 500 mg Kaplet 9 600 609 10 50 50
12 10
Amoksisillin Serbuk Injeksi 1000 m vial - -
13
Amoksisillin Sirup Kering 125 mg/ Botol 11 20 31 1 3
14 2
Kering 250 mg/5 ml 2
15 2
Ampisilin Kapsul 250 mg Kapsul - -
16
Ampisillin Kaplet 500 mg Tablet 32 50 82
17
18
19
20
Antasida Doen Suspensi Botol
21 Hidroksida 200 mg+ Alumunium 1 8 9 1 1
Hidroksida 200 Tablet,
Antasida Doen mg/5 ml Tablet
Kombinasi : Magnesium 76 600 20 40 50 50
22 Hidroksida 200 mg+ Alumunium 676
Hidroksida 200Tablet
Antasida Plus mg Tablet
23 - -
24
25
Anti Bakteri DOEN Salep Tube
Kombinasi : 3
26 Basitrasin 500 IU/g + 3
Anti Hemoroid
Polimiksin 1000Doen
IU/g komb Supp - -
27
28 2 2 1
Antimigren DOEN Kombinasi : Tablet
29 Asam Benzoat 6% + Asam Salisilat - -
3%
Anti Diare Suspensi
Ergotamin Tartrat 1 mg + Kofein Botol - -
30
50 mg
Anti Diare Tablet Tablet 47 80 127 32
31
32
33
Antihistamin Tablet kombinasi Tablet 11 200 211 10 10
34 10
Antispasmodik Tablet Tablet 12 12
35
Antitusiva Sirup Botol - 5 5 1
36
Antitusiva Tablet Tablet 20 20 10
37
38
39
Asam Mefenamat Kapsul 500 mg Kapsul 89 50 139 10 10
40 60
41
42
43
44
Asiklovir Tablet 200 mg Tablet 15 15
45
46
Atropin Sulfat Injeksi 0,25 mg/ml Ampul - -
47
Aqua Pro Injeksi Steril, bebas Pir Vial - -
48
49 10 16
Betametason Krim 0,1 %- 5g Tube - 5 5
50
51
52
53
54
Deksametason Tablet 0,5 mg Tablet 190 190 6 10 10
55 10
56
57
58
Diazepam Larutan Rektal 5 mg/m Supp - -
59
60
Difenhidramin HCl Injeksi 10 mg/ Ampul 47 47
61
62
Dimenhidrinat Tablet 50 mg Tablet - 10 10
63
64
65
66
67
5
68 (Epinefrina / Adrenalina) 5
Eritromisin
Injeksi Kapsul
0,1%/- 1ml 250 mg Kapsul - -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
Furosemid Tablet 40 mg Tablet 27 27 10
83
kombinasi : ( Nacl 0,52 gr, 39 100
84 Kalium Klorida 0,30 gr, 139 5 12
Trinatrium
GemfibrozilSitrat dihidrat
Tablet 600 mg0,58 Tablet
85 gr, Glukosa Anhidrat 2,70 g )200 - -
ml A
Gentamisin injeksi 80 mg / 2 ml Vial
86 - -
Gentamisin Salep Kulit 0,1 % Tube 2 2 1
87
Glibenklamid Tablet 5 mg Tablet - 50 50 10
88
Glimepiride 2 mg Tablet 40 150 190 20
89
Gliseril guayakolat tablet 100 mg Tablet 411 411 23 25
90 10
Gliseril Guayakolat sirup Botol 1 1
91
92
93
94
Griseofulvin Tablet 125 mg,micron Tablet 40 40
95
Haloperidol Tablet 0,5 mg Tablet 70 100 170 10
96
97
98
Hidrokloritiazid 25 mg Tablet 9 50 59
99
Hidrokortison Krim 2,5 % Tube 5 10 15 1
100
Ibuprofen Tablet 200 mg Tablet 62 200 262 10
101 10
Ibuprofen Tablet 400 mg Tablet - -
102
103 1
104
Ipatropium Bromide + Vial
105 Salbutamol
- -
IsoniazidSulphate formg
tablet 100 inhalation Tablet - -
106 2,5 ml
107
108
Kalium Diklofenak Tablet 50 mg Tablet 29 50 79 8
109 10
110
Kalsium Laktat Tablet 500 mg Tablet 90 90
111
Kaptopril 12,5 mg Tablet 98 200 298 30 10 30
112
113
Karbamazepin Tablet 200 mg Tablet 20 50 70
114
Ketokonazole Krim 2 % - 15 gr Tube 3 3
115
116
117
118
119
120
121
122
123
Kloramfenikol Salep Mata 1%-3,5 g Tube 1 5 6
124
Kloramfenikol Tetes Mata -5 ml Botol 4 4 1
125
Kloramfenikol Tetes Telinga 3%-5 Botol 1 5 6 1
126
Klorfeniramin Maleat (CTM) Table Tablet 78 400 478 10 33 31
127 13
Klorpromazin Hcl Tablet Salut 25 Tablet - -
128
Klorpromazin Hcl Tablet Salut 100 Tablet 11 200 211 10
129
Klorpromazin Hcl Injeksi 5 mg/ml Ampul - -
130
Kombinasi : -
131 Sulfametoksazol 100 mg +
-
Kotrimoksazol
Trimetroprim 20Tablet,
mg Tablet
Kombinasi : 28
132 Sulfametoksazol 400 mg + 28 10
Kotrimoksazol
Trimetroprim 80Suspensi
mg Botol
Kombinasi : 4 10
133 14
Sulfametoksazol 200 mg +
Lansoprazole
Trimetroprim 30
40 mg Kapsul
mg/5 ml Tablet - -
134
Larutan mengadung Elektrolit Botol
(Na 130 mEq,Cl 109 mEq, Asetat -
135 28 mEq) /Asering -
(Nacl 1,125 gr , Dekstrosa 18,75 -
136 gr) -
Larutan mengadung Karbohidrat Botol
+ Elektrolit -
137 (Nacl 1,75 gr, KCL 1,5 gr, Na -
Lactat 2,24
Lidokain gr, Dekstrosa
injeksi 2% 27 gr) Tablet
138 1 3 4
Lidokain Komp Injeksi, Kombinasi Ampul
139 : - -
Lidokain
LoperamidHclTablet
2% +Epinefrin
2 mg 1: Tablet - -
140
80.000-2 ml
Loratadin tablet 10 mg Tablet 40 40
141
142
Meloksikam tablet 15 mg Tablet 32 32 10
143 10
144
Metformin Hcl Tablet 500 mg Tablet 40 100 140 10
145 30
146
147
148
Metilprednisolon tablet 4 mg Tablet 30 30 10
149
Metoklopramid 10 mg Tablet 10 40
150 30
Metoklorpropamid Injeksi 5 mg/ Ampul -
151 0
152 40
Metronidazole Tablet 500 mg Tablet 70
153 70
Metronidazole Infus 500 mg /100 Ampul -
154 0
Mikonazole KrIm 2 % - 10 gr Tube 3 5
155 2
Multivitamin + Mineral tablet Tablet 67
156 67
Multivitamin sirup Botol 4
157 4
158 102
159 0
Natrium Diklofenak Tablet 50 mg Tablet 51
160 51
Natrium Klorida Larutan infus 0,9% Botol 2
161 2
162 3
Nistatin 100.000 IU/gram Tablet V Tablet 10 19 6
163 9 6
Nistatin 500.000 IU/gram Tablet S Tablet 50
164 50
165 0
166 0
167 0
168 0
Obat Anti Tuberkulosis FDC Kat Paket -
169 0
Obat Anti Tuberkulosis FDC Kat I Paket -
170 0
Obat Anti Tuberkulosis FDC Kat I Paket -
171 0
Obat Anti Tuberkolosis FDC Sisip Paket -
172 0
Obat Batuk Hitam (OBH) Cairan 10 Botol 5 11 2
173 6
Obat Batuk Cair Sirup (Ekspektora Botol 5 6
174 1
Obat Batuk Hitam Plus Sirup Botol 15 15
175 0
176 0
Oksiterasiklin Hcl injeksi i.m.50 Vial -
177 0
178 3
Oksitetrasiklin Hcl Salep Kulit 3%- Tube 2
179 2
180 9
181 0
182 0
Ondansetron inj 4 mg/ 2 mL Ampul
183 0 -
Parasetamol drops Botol 0 -
184
Parasetamol Sirup 120 mg/5ml-60 Botol 4 50 54 2 1 3
185
Parasetamol Tablet 100 mg Tablet 0 -
186
Parasetamol Tablet 500 mg Tablet 56 1100 1,156 50 116 110
187
188
189
190
191
Piroksikam Tablet 20 mg Tablet 4 100 104 10
192
Pirantel Pamoat Tablet 365 mg (S Tablet 80 80
193
Piridoksin Hcl (Vit.B6) Tablet 10 Tablet 36 500 536 10 10 30 20
194
Metakresol
195 Sulfonat dan Metanal) 360 0 -
mg/g-10 ml
Povidon Iodida 10% 30 ml Botol
196 2 2
197
198
Propanolol Hcl Tablet 40 mg Tablet 0 50 50 10
199
200
201
Ranitidin Tablet 150 mg Tablet 13 100 113 10
202
203
204
205
206
207
Salbutamol Tablet 2 mg Tablet 43 43
208
209
Salbutamol solution for Ampul
Inhalation single dose units 2,5
ml
210 0 -
211
Asam Salisilat 2 % + Belerang
0 5 5
Salisil bedak 2% -50 gr Kotak 7 7
212 Endap 4 % - 30 gram
Salep Luka Bakar Tube 0 -
213
Sefadroksil Sirup Kering 125 mg / Botol 0 3 3
214
Sefadroksil Tablet 500 mg Tablet 7 50 57
215
Sefiksim Kapsul 100 mg Kapsul 0 30 30
216
217
218
219
Setirizin Tablet 10 mg Tablet 12 50 62
220
221
222
223
224
225
Simvastatin Tablet 10 mg Tablet 45 100 145 10 10
226
Siprofloksasin 500mg Tablet 30 100 130 10 10
227
228
229
230 0 60 60
Besi II Sulfat 200 mg + Asam
Temporary
Folat 0,25 mgStopping Fletcher Set
(Fletcher) Serbuk & Cairan
231 0 -
Trikesol formalin ( T K F ) Cairan Botol 0 -
232
Tetrasiklin Kapsul 250 mg Kapsul 10 50 60
233
Tetrasiklin Kapsul 500 mg Kapsul 0 -
234
Thiamin Hcl (Vit B1) Injeksi 100 Ampul 0 -
235
Tiamin Hcl /Mononitrat (Vit.B1) T Tablet 94 100 194 10 10
236
Thiamfenikol Kapsul 500 mg Kapsul 90 90
237
238
239
Triheksifenidil Hidroklorida Table Tablet 32 32
240
Vitamin B .Komplek Tablet Tablet 79 500 579 5 22 10 28
241
Vitamin Neurotropik Tablet Tablet 3 200 203 10 10 8
242
243
244
flunax sy Botol 0 -
245
Set 0 -
246
Set 0 -
247
Tablet 0 -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
Abbocath No 22 ( IV Chateter 22 Buah 0 -
3
4
5
6
7
8
9
10
11
Auto Disposable Syringe (ADS) 5 m set 0 -
12
Catgut/Benang Bedah No.2/0-3/0 Sachet 3 3
13
14
15
16
17
18
19
20
21
22
23
Kapas Pembalut / Adsorbens 250 Bungkus 0 -
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
CATATAN HARIAN PEMAKAIAN OBAT
Bulan : Desember Tahun : 2016
5 6 7 8 9 10 11 12 13 14 15 16
1 1
10
16 20 10 10
10 20 10
30 40 10 30 10 60 30 50
3 1 2 1 2 1
10
1 1
10 40 50 40 50 10 40 20 75
10
10 20 6 20
1 1
8 10
1 1
10 10 10
10 10
20 30
16 8 10 15 10 10 15
10 10
30 10 10
10
1 4
20 10 10 6 40 30
10 20
10
10 20 20 20 10 10 30
10
1
1
1
22 14 16 6 35 6 16 15 25
30 10 10 10
10
1 1 2 1
10
20
5 10 6
10 20 10
1 1
10 6
10 10
1 2 1
1 1 1 2 1
4 2 2 2 1 13
86 45 66 40 76 40 30 20 80
10 13 28 26 10 10 10 20
10 10
10
1 1 1
10
5 10 4 10
1
10 10 10
40 40 10
10 10 10
20
10 10
20 10 30 20
10 10
40 37 46 25 10 18 46 20
20 10 6 7
10
5 5 16
BAT PADA TANGGAL
17 18 19 20 21 22 23 24 25 26 27
10
10 10 10
1
10
10 10 10
10 20 20 10 40 10 20 30 20
3 3 1 2 1 1
20 10
1 2
10 30 30 30 10 10 30 10
10 10 20 10 10
30 10 10 10 10
10
10 10
6 10
10 10
8
10 10
12 12 12 6 6 4 6
30
4 10 10
10 10
20 10 20 10 30
1 2 1 1
20 20 10 20 30
20
10 10
10 30 20 10 10 10
10 10
1
2 1
1 1
1
15 30 34 20 10 17 29 16
20 20 20 10 30
1 1
10 10
10 10
6 8
10 10 10
1
10
1 1
1
2 1
2 1 1 1
3 1 2 1 3 2
40 30 130 40 40 30 10 40 10
10 20 10
10 20 38 10 40 10 10 20
10 10
10 10
1
1
10 10 10
10
10 6 20 6
10 30
10 10 10
20 10 10 10
10
10
20 10 26 30 30 26 10 36
15 10 10 7
10 10
10 6 14 7 7
Jumlah Sisa Akhir
Pemakaian Bulan
28
0 -
0 100
20 55 44
40 18
1 4 4
0 -
0 20
20 50
86 47
0 -
40 -
10 570 39
0 -
1 28 3
1 1
0 -
40 42
0 -
0 -
0 40
7 2
655 21
0 -
0 40
0 -
0 3
0 -
1 1
0 -
0 -
102 25
0 70
0 -
156 55
0 12
3 2
10 10
0 -
10 50
100 39
0 -
0 -
0 -
1 -
0 15
0 -
0 -
0 -
60 42
2 3
0 -
0 -
0 30
0 2
10 96 94
0 -
0 28
0 -
0 -
0 -
0 47
0 -
8 2
0 40
0 1
0 60
0 282
0 5
0 -
0 -
0 -
0 -
0 -
0 1
0 -
0 100
0 -
0 -
0 100
0 70
40 35
0 3
10 17
7 88 51
0 -
0 -
2 -
10 40
50 150 40
166 245
0 1
0 -
0 1
0 -
40 -
150 20
0 20
0 -
10 49
11 4
10 246 16
0 -
1 -
0 -
0 -
0 -
0 -
0 -
68 11
0 -
30 60
280 18
0 5
30 40
2 1
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 94
1 4 2
4 -
3 3
18 431 47
0 -
170 41
0 -
0 -
20 8
1 8 6
0 -
0 -
0 -
0 -
2 2
0 -
0 -
0 40
0 -
30 2
0 -
80 60
0 -
0 -
0 4
30 -
35 5
0 -
0 40
70 -
0 -
3 2
26 41
2 2
20 82
0 -
10 10 41
0 2
0 3
12 7
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
7 4
1 4 2
11 4
0 -
0 -
1 2 1 5
0 2 2
0 9 9
0 -
0 -
0 -
0 -
8 50 4
0 -
1129 27
0 -
0 -
0 -
0 -
56 48
0 80
355 181
0 -
0 2
0 1
0 -
10 40
0 -
0 -
50 63
0 -
0 186
0 40
0 -
0 3
30 13
0 -
0 -
4 1
1 6
0 -
1 2
30 27
10 20
0 -
0 -
0 -
29 33
1 2
0 21
0 10
0 -
30 50
20 140 5
92 38
20 30
0 -
40 20
0 -
0 -
50 10
0 -
0 -
150 44
10 80
0 -
0 -
30 2
16 511 68
113 90
5 35 88
70 114
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
Air Raksa Dental Use Botol - v vv
1 0
2 100
Alopurinol Tablet 100 mg Tablet 44 44
3
Ambroksol Tablet 30 mg Tablet 18 100 118 10
4 10 10
5
6
7
Amitriptillin Hcl Tablet Salut 25 m Tablet 50 50
8
9
10
Amoksisillin Kapsul 250 mg Kapsul - 100 100
11
Amoksisillin Kaplet 500 mg Kaplet 39 600 639 30
12 40 25
13
Amoksisillin Sirup Kering 125 mg/5 Botol 3 20 23 1
14 1 1
Kering 250 mg/5 ml 1 5
15 6
Ampisilin Kapsul 250 mg Kapsul - 100 100
16
17
18
19
20
Hidroksida 200 mg+ Alumunium
Hidroksida 200 mg/5 ml
21 2 40 42 11
Antasida Doen Tablet, Kombinasi Tablet
: Magnesium Hidroksida 200 mg+
Alumunium Hidroksida 200 mg 21 800 50 30
22 821
Antasida Plus Tablet Tablet - -
23
24
25
Kombinasi :
Basitrasin 500 IU/g + 3
26 3
Anti Hemoroid Doen komb Supp - -
27
Asam Benzoat 6% + Asam Salisilat 1

28 3% 1
Ergotamin Tartrat 1 mg + Kofein -

29 50 mg -
Anti Diare Suspensi Botol - -
30
Anti Diare Tablet Tablet 25 50 75
31 10
32
33
Antihistamin Tablet kombinasi Tablet 55 200 255 10
34 15 15
Antispasmodik Tablet/SCOPMA Tablet 12 50 62
35
Antitusiva Sirup Botol 2 2
36
Antitusiva Tablet Tablet 10 10
37
38
39
Asam Mefenamat Kapsul 500 mg Kapsul 39 39
40
41
42
43
Asiklovir Krim 5 % Tube - 5 5
44
45
46
Atropin Sulfat Injeksi 0,25 mg/ml- Ampul - -
47
Aqua Pro Injeksi Steril, bebas Piro Vial - -
48
Betahistin Mesilat 6 mg Tablet 42 42
49
Betametason Krim 0,1 %- 5g Tube 3 5 8
50
51
52
53
54
Deksametason Tablet 0,5 mg Tablet 94 94
55 10
56
57
58
59
60
Difenhidramin HCl Injeksi 10 mg/m Ampul 47 47
61
62
Dimenhidrinat Tablet 50 mg Tablet 2 50 52
63
64
65
66
67

68 0,1%/- 1ml 5
69
70
71
72
73
74
75
76
77
78
Fenoksimeti Penisilin 250 mg table Tablet 100 100
79
80
81
82
83
kombinasi :
( Nacl 0,52 gr, Kalium
dihidrat 0,58 gr, Glukosa Anhidrat 51
2,70 g )200 ml Air
84 51 6 4
Gemfibrozil Tablet 600 mg Tablet - -
85
86
Gentamisin Salep Kulit 0,1 % Tube - 5 5
87
88
Glimepiride 2 mg Tablet 40 50 90
89
90
Gliseril Guayakolat sirup Botol 1 25 26
91 25
92
93
94
Griseofulvin Tablet 125 mg,microni Tablet - 100 100
95 10
96 40
97 10
98
99
Hidrokortison Krim 2,5 % Tube 4 10 14 1
100 3
101 20
Ibuprofen Tablet 400 mg Tablet - 200 200
102 10
Ibuprofen Suspensi 100 mg/5 ml Botol - 5 5
103 1
104
Sulphate for inhalation 2,5 ml -

105 -
Isoniazid tablet 100 mg Tablet - -
106
107
108
Kalium Diklofenak Tablet 50 mg Tablet 11 100 111
109
110
111
112 10 40
113
Karbamazepin Tablet 200 mg Tablet 40 40
114 10
Ketokonazole Krim 2 % - 15 gr Tube 1 5 6
115
Ketokonazole Tablet 200 mg Tablet 2 100 102
116
117
118
119
120
121
122
123
Kloramfenikol Salep Mata 1%-3,5 g Tube 2 2
124
Kloramfenikol Tetes Mata -5 ml Botol - 5 5
125
Kloramfenikol Tetes Telinga 3%-5 Botol 3 3
126
Klorfeniramin Maleat (CTM) Tablet Tablet 47 400 447 4
127 20
Klorpromazin Hcl Tablet Salut 25 Tablet - 100 100
128 40
Klorpromazin Hcl Tablet Salut 100 Tablet 41 41
129
Klorpromazin Hcl Injeksi 5 mg/ml- Ampul - -
130
Kombinasi :
Sulfametoksazol 100 mg + -
Trimetroprim 20 mg
131 -
Sulfametoksazol 400 mg + 8 100

Trimetroprim 80 mg
132 108 10
Kotrimoksazol Suspensi Kombinasi Botol
:
Sulfametoksazol 200 mg + 6 5
Trimetroprim 40 mg/5 ml
133 11 1
Lansoprazole 30 mg Kapsul Tablet - 50 50
134
130 mEq,Cl 109 mEq, Asetat 28
mEq) /Asering -
135 -
(Nacl 1,125 gr , Dekstrosa 18,75
gr) -
136 -
Larutan mengadung Karbohidrat + Botol
Elektrolit
(Nacl 1,75 gr, KCL 1,5 gr, Na
Lactat 2,24 gr, Dekstrosa 27 gr) -
137 -
Lidokain injeksi 2 % Tablet 2 2
138
Lidokain Komp Injeksi, Ampul
Kombinasi :
Lidokain Hcl 2% -
+Epinefrin 1 : 80.000-2 ml
139 -
140
141
142
143 20
144
Metformin Hcl Tablet 500 mg Tablet 60 60
145
146
147
148
Metilprednisolon tablet 4 mg Tablet - -
149
Metoklopramid 10 mg Tablet 50 55
150 5
151 0
152 40
153 0
154 0
Mikonazole KrIm 2 % - 10 gr Tube 2
155 2 1
Multivitamin + Mineral tablet Tablet 41
156 41 10
Multivitamin sirup Botol 10 12
157 2
158 82
159 0
160 41 10
Natrium Klorida Larutan infus 0,9%- Botol 2
161 2
Nipedifin Tablet 10 mg Tablet 30 33
162 3
Nistatin 100.000 IU/gram Tablet V Tablet 7
163 7
Nistatin 500.000 IU/gram Tablet Sa Tablet 50
164 50
165 0
166 0
167 0
168 0
169 0
170 0
171 0
172 0
Obat Batuk Hitam (OBH) Cairan 10 Botol 4
173 4
Obat Batuk Cair Sirup (Ekspektoran Botol 10 12
174 2
Obat Batuk Hitam Plus Sirup Botol 6 10
175 4 1 1
Obat Flu Sirup/flutrop-c Botol 5 5
176 0
177 0
178 1
Oksitetrasiklin Hcl Salep Kulit 3%-5 Tube 2
179 2
180 9
181 0
Omeprazole Kapsul 20 mg Tablet 1100 1,100 10
182 0
Ondansetron inj 4 mg/ 2 mL Ampul 0 -
183
Parasetamol drops Botol 0 3 3 1
184
Parasetamol Sirup 120 mg/5ml-60 Botol 4 50 54 1 3
185
Parasetamol Tablet 100 mg Tablet 0 100 100 70
186
Parasetamol Tablet 500 mg Tablet 27 1500 1,527 70 20
187
188
189
190
191
Piroksikam Tablet 20 mg Tablet 48 100 148
192
Pirantel Pamoat Tablet 365 mg (Se Tablet 80 80
193
Piridoksin Hcl (Vit.B6) Tablet 10 m Tablet 181 300 481 40 30 10
194
Metakresol
mg/g-10 ml
195 0 -
196
197
198
Propanolol Hcl Tablet 40 mg Tablet 40 40
199
200
201
Ranitidin Tablet 150 mg Tablet 63 63
202
203
204
205
206
207
208
209
Salbutamol solution for Inhalation Ampul
210 0 -

211 Endap 4 % - 30 gram 1 3 4
Salisil bedak 2% -50 gr Kotak 6 8 14 2
212
Salep Luka Bakar Tube 0 -
213
Sefadroksil Sirup Kering 125 mg / Botol 2 2
214
215
216
217
218
219
220
221
222
223
224
Simetidin 200 mg Tablet Tablet 50 50 10
225
226
Siprofloksasin 500mg Tablet 38 38
227
228
229
Besi II Sulfat 200 mg + Asam Folat

0,25 mg
230 20 60 80
Temporary Stopping Fletcher Set
231 0 -
Trikesol formalin ( T K F ) Cairan 1 Botol 0 -
232
233
234
Thiamin Hcl (Vit B1) Injeksi 100 m Ampul 0 100 100
235
Tiamin Hcl /Mononitrat (Vit.B1) Ta Tablet 44 100 144
236
237
238
239
Triheksifenidil Hidroklorida Tablet Tablet 2 2
240
Vitamin B .Komplek Tablet Tablet 68 400 468 40
241
Vitamin Neurotropik Tablet Tablet 90 200 290 20 20
242
Zinc Tablet 20 mg Tablet 88 88 7
243
244
flunax sy Botol 0 -
245
Dextrofen sy botol 0 3 3
246
Set 0 -
247
Tablet 0 -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
Alat Suntik Sekali Pakai 2,5 ml Set 43 43 2
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Iodina Test Botol 1 4 5
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
CATATAN HARIAN PEMAKAIAN OBA
Bulan : Maret Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
10 10
1 1
10
10 20
20 30 40 40 50 40 10
3 2 2 1
10
20 50 20 45 90 70
1
4
18 5 10 20 10 10
10
10
10 10
1 1
6
1 2
10 14
8
7
15 10 4 10 35
10
20 40
1 1 1
10 30 30
10 10
10
20 20 10 15 10
10 10
1
10
1 3
31 23 10 8 10 30 20
10 20
2
1 1
10
10
20
1
6 10 10
1 3
27 10
10
1
1 1 1
1
1 1
5 10 2 4 2 1 1
40 10 40 50 66 60 70 110
8 10 10
20 20 30 30 10 30
10
10 10
10
1
1 1 1 2
10
20
10 10
14
10 10
30
10
10 30
10 20 10 30 10 30
16 20 40 10 20
10
6 10 10
3 1 1
4
N PEMAKAIAN OBAT
ret Tahun : 2017
14 15 16 17 18 19 20 21 22 23
10
10
2 1 2
10 10 20
20 30 20 60 10 40
1 1 1 2
1 1 2
10
10
1 10
60 20 20 10 30 40 10
1
10 10
20 10 30
1 1
10
8 10
10
10 6 10 10 10 20 29
20 40
10 10 10
2 1 1 1
10 10
10 10 10
10
10 10 10 10 20 10
1 1
10 34 10 10 6 48 25 15
10 10
5 5 5
2 2
10
1 1
10 10
1 1 1 2
1 1 2 1
1 1
10
2 1 10 2 1 2 3
60 20 400 50 70 40 20 50 50
10 10
30 10 10 18 50 20 10
10
1
1 1
7
10
10
10
30 20 20 20 20 10 20 10 20
10 20 10 10
10
6 18
1 1
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 100
10 20 24
10 70 48
1 8 6
0 -
0 20
10 10 40
10 20 10 5 95 52
0 -
1 10 10 51 49
10 30 20 10 30 605 34
0 -
16 7
5 1
10 90
10 10 30 12
0 -
0 -
0 40
1 33 9
40 10 20 50 60 10
755 66
0 -
0 40
0 -
1 2 1
0 -
1 -
0 -
0 -
10 44 31
0 70
0 -
20 10 15 10 10 238 17
20 30 32
0 2
0 10
0 -
10 20 30
20 19
0 -
0 -
0 -
3 2
0 15
0 -
0 -
0 -
10 16 26
1 6 2
0 -
0 -
0 30
0 2
10 10 64 30
0 -
20 20 8
0 -
0 -
0 -
0 47
0 -
26 26
0 40
0 1
0 60
0 282
0 5
0 -
0 -
0 -
0 -
0 -
0 1
0 -
0 100
0 -
0 -
0 100
0 70
0 35
0 3
0 17
6 23 28
0 -
0 -
1 4
10 10 30
10 30 50 40
10 10 192 53
25 1
0 -
0 1
0 -
20 80
20 180 40
10 50 20
0 -
10 10 39
1 13 1
20 96
10 10 10 130 70
1 4
0 -
0 -
0 -
0 -
0 -
10 10 10 80 31
0 -
20 40
30 20 30 275 43
0 5
30 10
1 2 4
6 96
0 -
0 -
0 -
0 -
0 -
0 -
10 84
0 2
4 1
2 1
10 30 20 374 73
90 10
5 5 25 16
0 -
0 -
10 10 30 78
7 4
6 10 16 34
0 -
0 -
0 -
2 -
0 -
0 -
0 40
0 -
20 32
0 -
30 10 50 10
0 -
0 -
0 4
0 -
10 45
0 -
0 40
30 70
0 -
2 -
36 5
1 2 9 3
0 82
0 -
67 74
0 2
10 23
0 7
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 3
1 1 10 2
8 2
1 3 2
0 -
2 2
0 2
0 9
0 -
30 50 1,050
0 -
1 2
1 1 52 2
70 30
50 10 40 45 10 65 1516 11
0 -
0 -
0 -
0 -
30 10 88 60
0 80
20 10 30 428 53
0 -
0 2
0 1
0 -
10 30
0 -
0 -
10 40 23
0 -
0 186
0 40
0 -
0 3
10 3
0 -
0 -
2 2
1 1 1 12 2
0 -
0 2
10 17
20 -
0 -
0 -
0 -
20 40 93
1 1 1
0 21
0 10
0 -
31 19
10 30 50 55
10 30 8
0 30
0 -
30 50
0 -
0 -
0 10
10 90
10 90
20 70 74
0 80
0 -
0 -
0 2
10 10 40 380 88
30 10 30 20 286 4
27 61
50 64
0 -
1 1 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
1 1 2 2 15 28
0 3
0 -
0 -
0 -
0 -
1 2
0 -
0 -
0 -
0 -
0 2
0 -
0 7
4 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
Air Raksa Dental Use Botol - -
1 0
Albendazole Tablet 400 mg Tablet - 100
2 100
3 100
Ambroksol Tablet 30 mg Tablet 48 - 48
4
5
Aminofillin Injeksi 24 mg/ml-10 ml Ampul - - -
6
Aminofillin Tablet 200 mg Tablet 20 - 20
7
Amitriptillin Hcl Tablet Salut 25 mg Tablet 40 - 40
8
9 5
Amlodipin Tablet 10 mg Tablet - - -
10
Amoksisillin Kapsul 250 mg Kapsul 49 - 49
11 10
12
Amoksisillin Serbuk Injeksi 1000 mg vial - - -
13
Amoksisillin Sirup Kering 125 mg/5ml Botol 7 20 27
14 1
Amoksisillin Double Strengh Sirup Kering 250 Botol
mg/5 ml 1 10
15 11
Ampisilin Kapsul 250 mg Kapsul 90 - 90
16
17
Ampisilin Sirup 125 mg / 5 ml Botol - - -
18
Ampisillin Injeksi 1000 mg Vial - - -
19
Analgetik Plus Tablet 40 - 40
20
Antasida Doen Suspensi Kombinasi : Botol
Magnesium Hidroksida 200 mg+ Alumunium
21 9 10 19
Antasida Doen Tablet, Kombinasi : Tablet
Hidroksida 200 mg 66 1,000 60
22 1,066
Antasida Plus Tablet/TRIANTA Tablet - 50 50
23
Antalgin (Metampiron) Tablet 500 mg Tablet 40 - 40
24
Antalgin Injeksi 250 mg/ml-2ml Ampul - - -
25
Anti Bakteri DOEN Salep Kombinasi : Tube
Basitrasin 500 IU/g +
Polimiksin 1000 IU/g 1 3
26 4
Anti Hemoroid Doen komb Supp - - -
27
Asam Benzoat 6% + Asam - 3
28 Salisilat 3% 3
Ergotamin Tartrat 1 mg + Kofein - -
29 50 mg -
Anti Diare Suspensi/Novadiar Botol - 3 3
30
Anti Diare Tablet/New Diaform Tablet 31 30 61
31
Anti Dotum Oral Tablet Tablet 70 - 70
32
Anti Hipertensi Kapsul Tablet - - -
33
Antihistamin Tablet kombinasi/SOLDEXTAM Tablet 17 200 217
34
35
Antitusiva Sirup/DEXTROFEN SY Botol 2 5 7
36
Antitusiva Tablet Tablet 10 - 10
37
38
Asam Askorbat 50 mg/Vitamin c Tablet 30 100 130
39
40
Asetosal 80 mg Tablet - - -
41
Asetosal Tablet 100 mg Tablet - - -
42
43
Asiklovir Krim 5 % Tube 2 3 5
44
Asiklovir Tablet 200 mg Tablet 15 - 15
45
Asiklovir Tablet 400 mg Tablet - - -
46
Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul - - -
47
Aqua Pro Injeksi Steril, bebas Pirogen 20 ml Vial - - -
48
49
50 1
Bisakodil suppositoria 10 mg Supp - - -
51
Bisoprolol Tablet 5 mg Tablet - - -
52
Bromheksin 8 mg Tablet 30 - 30
53
Deksametason Injeksi 5mg/ml-1ml Ampul 2 - 2
54
Deksametason Tablet 0,5 mg/FLACOID Tablet 30 100 130
55 10
Devitalisasi Pasta (Non Arsen) Botol - - -
56
Diazepam tablet 2 mg Tablet 8 100 108
57
Diazepam Injeksi i.v/i.m 5 mg/ml Ampul - - -
58
Diazepam Larutan Rektal 5 mg/ml Supp - - -
59
Dietilkarbamazin Sitrat Tablet 100 mg Tablet - - -
60
Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul 47 - 47
61
Digoksin Tablet 0,25 mg Tablet - - -
62
63
Domperidon Tablet 10 mg Tablet 40 100 140
64
Donperidon Suspensi 5 mg/5ml Botol 1 - 1
65
Efedrin Hcl Tablet 25 mg Tablet 60 - 60
66
67
(Epinefrina /
Adrenalina) Injeksi 0,1%/- 1ml 5 -
68 5
Eritromisin Kapsul 250 mg Kapsul - - -
69
70
Eritromisin Sirup 200 mg / 5 ml Botol 0 - -
71
Etambutol Tablet 500 mg Tablet 0 - -
72
Etanol 70 % 100 ml Botol 0 - -
73
Etil Klorida Semprot -100 ml Botol 1 - 1
74
Eugenol Cairan -10 ml Botol 0 - -
75
Fenitoin Natrium Kapsul 100 mg Kapsul 100 - 100
76
Fenobarbital tablet 30 mg Tablet 0 - -
77
Fenobarbital injeksi 50 mg / ml Ampul 0 - -
78
Fenoksimeti Penisilin 250 mg tablet Tablet 100 - 100
79
80
Fitomenadion tablet 10 mg Tablet 35 - 35
81
Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 3 - 3
82
Furosemid Tablet 40 mg Tablet 17 - 17
83
Garam Oralit I serbuk, kombinasi : Kantong
Klorida 0,30 gr, Trinatrium Sitrat dihidrat 20
0,58 gr, Glukosa Anhidrat 2,70 g )200 ml Air
84 28 48
Gemfibrozil Tablet 600 mg Tablet 0 - -
85
Gentamisin injeksi 80 mg / 2 ml Vial 0 - -
86
87
Glibenklamid Tablet 5 mg Tablet 30 100 130
88
Glimepiride 2 mg Tablet 40 - 40
89
90 30
Gliseril Guayakolat sirup Botol 1 - 1
91
Glukonas Kalsikus injeksi Ampul 0 - -
92
Glukosa Larutan Infus 5 % Botol 1 - 1
93
Glukosa Larutan Infus10 % Botol 0 - -
94
Griseofulvin Tablet 125 mg,micronized Tablet 80 - 80
95
96
97 10
Haloperidol Tablet 5 mg Tablet 0 50 50
98
Hidrokloritiazid 25 mg Tablet 39 - 39
99
100 1
Ibuprofen Tablet 200 mg Tablet 96 - 96
101
102
Ibuprofen Suspensi 100 mg/5 ml Botol 4 - 4
103
Ichtyol salep Kulit Pot 0 - -
104
Sulphate for inhalation 2,5 -
105 ml 0 -
Isoniazid tablet 100 mg Tablet 0 - -
106
Isosorbid Dinitrat 5 mg Tablet 0 - -
107
Kalium Diklofenak Tablet 25 mg Tablet 0 - -
108
Kalium Diklofenak Tablet 50 mg/KADITIC Tablet 31 350 381
109 5
Kalsium Hidroksida Pasta Tube 0 - -
110
111
112
Kaptopril 25 mg Tablet 5 100 105
113
114
Ketokonazole Krim 2 % - 15 gr Tube 4 - 4
115 1
Ketokonazole Tablet 200 mg Tablet 96 - 96
116
Ketoprofen Tablet 100 mg Tablet 0 - -
117
Ketoprofen Injeksi 100 mg / 1 ml Ampul 0 - -
118
Ketorolac 10 mg injeksi Ampul 0 - -
119
120
Klindamisin Kapsul 150 mg Kapsul 0 - -
121
122
Kloramfenikol Kapsul 250 mg Kapsul 84 - 84
123
124
Kloramfenikol Tetes Mata -5 ml/RECO Botol 1 6 7
125 2
Kloramfenikol Tetes Telinga 3%-5 ml Botol 1 2 3
126
Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 73 300 373
127 16
Klorpromazin Hcl Tablet Salut 25 mg Tablet 10 120 130
128
129 5
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 0 - -
130
Kotrimoksazol Pedriatik Tablet, Kombinasi : Tablet
Trimetroprim 20 mg 20
131 0 20
132 78 108
Kotrimoksazol Suspensi Kombinasi : Botol
Trimetroprim 40 mg/5 ml 7
133 4 11
Lansoprazole 30 mg Kapsul Tablet 34 - 34
134
Larutan mengadung Elektrolit (Na 130 mEq,Cl Botol
109 mEq, Asetat 28 mEq) /Asering
-
135 0 -
Larutan mengadung Elektrolit (Nacl 1,125 gr , Botol
Dekstrosa 18,75 gr) -
136 0 -
Larutan mengadung Karbohidrat + Elektrolit Botol
(Nacl 1,75 gr, KCL 1,5
gr, Na Lactat 2,24 gr, Dekstrosa 27 gr) -
137 0 -
Lidokain injeksi 2 % Tablet 0 - -
138
Lidokain Komp Injeksi, Kombinasi : Ampul
Lidokain Hcl 2% +Epinefrin
1 : 80.000-2 ml -
139 0 -
Loperamid Tablet 2 mg Tablet 0 - -
140
Loratadin tablet 10 mg Tablet 40 - 40
141
Magnesium Sulfat (IV) 20 %-25 ml Ampul 0 - -
142
143
Meloksikam Suppositoria Supp 0 - -
144
145
Methisoprinol 500 mg Tablet 0 - -
146
Metilergometrin Maleat (Metergin) Tablet 0,1 Tablet 0 20 20
147
Metilergometrin Maleat Injeksi 0,200 mg-1ml Ampul 4 - 4
148
149
Metoklopramid 10 mg/xilastin Tablet 45 - 45
150
Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul 0 - -
151
Metronidazol Tablet 250 mg Tablet 40 - 40
152
Metronidazole Tablet 500 mg Tablet 70 - 70
153
Metronidazole Infus 500 mg /100 ml Ampul 0 - -
154
Mikonazole KrIm 2 % - 10 gr Tube 0 5 5
155
Multivitamin + Mineral tablet/HEMAFORT Tablet 5 35 40
156
Multivitamin sirup/RECOVIT Botol 3 10 13
157
Natrium Bikarbonat Tablet 500 mg Tablet 82 - 82
158
Natrum Diklofenak Tablet 25 mg Tablet 0 - -
159
Natrium Diklofenak Tablet 50 mg Tablet 74 100 174
160 10
Natrium Klorida Larutan infus 0,9%-Steril 500 m Botol - -
161
Nipedifin Tablet 10 mg Tablet - 23
162 23
Nistatin 100.000 IU/gram Tablet Vagina Tablet - 7
163 7
Nistatin 500.000 IU/gram Tablet Salut Tablet - 50
164 50
Obat Antitiuberkolosis Kategori Anak Paket - -
165 0
Obat Antitiuberkolosis Kategori 1 Dewasa Paket -
166 0 -
167 0 -
168 0 -
Obat Anti Tuberkulosis FDC Kat Anak Paket -
169 0 -
Obat Anti Tuberkulosis FDC Kat I & II Paket -
170 0 -
Obat Anti Tuberkulosis FDC Kat I & III Paket - -
171 0
Obat Anti Tuberkolosis FDC Sisipan Dewasa Paket - -
172 0
Obat Batuk Hitam (OBH) Cairan 100 ml/BERLIC Botol 10 13
173 3
Obat Batuk Cair Sirup (Ekspektoran)/COREDRY Botol 25 27
174 2
Obat Batuk Hitam Plus Sirup/INDOPLUS Botol 7 9
175 2
Obat Flu Sirup/ FLUTOP-C Botol 15 17
176 2 1
Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 ml Vial - -
177 0
Oksiterasiklin Salep Mata 1%-3,5g Tube - 2
178 2
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube - 2
179 2
Oksitosin Injeksi 10 IU/ml-1ml Ampul - 9
180 9
Omeprazole injeksi 40mg/10ml Ampul 0 -
181 0
Omeprazole Kapsul 20 mg Tablet 30 58
182 28
Ondansetron inj 4 mg/ 2 mL Ampul 0 0 -
183
184
Parasetamol Sirup 120 mg/5ml-60 ml Botol 2 22 24
185
Parasetamol Tablet 100 mg Tablet 30 0 30
186
Parasetamol Tablet 500 mg Tablet 11 1700 1,711 68
187
Pehacain injeksi Ampul 0 0 -
188
Perak Sulfadiazin krim 1 % 35 gr Tube 0 0 -
189
Piracetam 400 mg Tablet 0 0 -
190
Piracetam Tablet 800 mg Tablet 0 0 -
191
192
Pirantel Pamoat Tablet 365 mg (Setara dng 125 Tablet 80 0 80
193
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 53 520 573 20
194
Polikresulen (Kondensasi Metakresol Botol
195 mg/g-10 ml 0 0 -
Povidon Iodida 10% 30 ml Botol 2 0 2
196
197
Primakuin tablet 15 mg Tablet 0 0 -
198
199
Propilturasil Tablet 100 mg Tablet 0 0 -
200
Ranitidin Injeksi 25 mg / ml Ampul 0 0 -
201
202
Retinol (Vit.A) 100.000 IU Kapsul Kapsul 0 0 -
203
Retinol (Vit.A) 200.000 IU Kapsul Kapsul 186 0 186
204
Reserpin Tablet 0, 25 mg Tablet 40 0 40
205
Rifampisin Tablet 450 mg Tablet 0 0 -
206
Ringer Laktat Larutan Infus Steril 500 ml Botol 3 0 3
207
Salbutamol Tablet 2 mg Tablet 3 70 73 20
208
209
Salbutamol solution for Inhalation single dose Ampul
units 2,5 ml
210 0 0 -
Asam Salisilat 2 % +
Belerang Endap 4 % - 30 gram
211 2 25 27
212
Salep Luka Bakar Tube 0 0 -
213
Sefadroksil Sirup Kering 125 mg / 5 ml sirup Botol 2 0 2
214
215
216
Sefotaksim Injeksi 1 gr Ampul 0 0 -
217
Seftriakson Injeksi 1 gr / vial Ampul 0 0 -
218
Semen Seng Fosfat Serbuk & Cairan Botol 0 0 -
219
Setirizin Tablet 10 mg Tablet 93 50 143 10
220
Setirizin Sirup 5 mg / 5 ml Botol 1 2 3
221
Sianokobalamin Injeksi 500 mcg/ml-1ml/Vit B1 Ampul 21 0 21
222
Sianokobalamin Tablet 50 mcg Tablet 10 0 10
223
Silver Amalgam Serbuk 65-75% Botol 0 0 -
224
225
226
227
Spironolakton Tablet 25 mg Tablet 30 0 30
228
Sulfacetamid Tetes Mata 15 %-5ml Botol 0 2 2
229
Besi II Sulfat 200 mg +
Asam Folat 0,25 mg
230 50 150 200
Temporary Stopping Fletcher (Fletcher) Set
Serbuk & Cairan
231 0 0 -
Trikesol formalin ( T K F ) Cairan 10 ml Botol 0 0 -
232
233
234
Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1ml Ampul 90 0 90
235
Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 74 400 474
236
237
Tramadol Injeksi 50 mg/ ml Ampul 0 0 -
238
Tramadol Tablet 50 mg Tablet 0 0 -
239
Triheksifenidil Hidroklorida Tablet 2 mg Tablet 2 50 52 20
240
241
Vitamin Neurotropik Tablet Tablet 4 370 374 45
242
243
Prednisone 5 mg Tablet 64 0 64
244
flunax sy Botol 0 0 -
245
vit k Set 2 30 32
246
Gentian Violet Botol 6 4 10
247
Kloramfenikol 500 Tablet 100 0 100
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
Abbocath No 18 ( IV Chateter 18 ) Buah 0 0 -
1
Abbocath No 20 ( IV Chateter 20 ) Buah 5 5 10
2
3
4
Alat Suntik Sekali Pakai 10 ml Set 7 0 7
5
6
7
8
Alat Suntik Sekali Pakai 10 ml Set 0 0 -
9
Auto Disposable Syringe (ADS) 0,05 ml set 0 0 -
10
11
Auto Disposable Syringe (ADS) 5 ml set 0 0 -
12
Catgut/Benang Bedah No.2/0-3/0 (Plain & Cro Sachet 2 0 2
13
Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 0 0 -
14
Etanol 70 % 1.000 ml Botol 0 0 -
15
Folley Catheter no 14 Set 0 0 -
16
17
Folley Catheter no 18 Set 2 0 2
18
Infus set Anak Set 0 0 -
19
Infus set Dewasa Set 7 0 7
20
21
Kassa Hidrofil Steril 16 x 16 Kotak 0 5 5
22
Kapas Berlemak 500 gram Bungkus 0 0 -
23
Kapas Pembalut / Adsorbens 250 gram Bungkus 0 0 -
24
Kassa Kompres 40 x 40 steril Bungkus 0 0 -
25
Kassa Pembalut 2 m x 80 cm Rol 2 0 2
26
Kassa Pembalut Hidrofil 4 m x 3 cm Rol 1 0 1
27
Kassa Pembalut Hidrofil 4 m x 15 cm Rol 0 0 -
28
Kertas Puyer Pcs 0 0 -
29
Lysol 1,000 ml Botol 0 0 -
30
Masker Buah 10 0 10
31
Plester 5 yard x 2 inchi Rol 1 0 1
32
Pot Dahak Pcs 0 0 -
33
Rapid HIV 1 (SD HIV) Pcs 0 0 -
34
Rapid HIV 2 (Intec HIV) Pcs 0 0 -
35
Rapid HIV 2 (Biomeriux HIV) Pcs 0 0 -
36
Rapid Test Syphilis Pcs 0 0 -
37
RPR Test Syphilis Pcs 0 0 -
38
Silk( Benang Bedah Sutra ) No 3/0 Sachet 4 0 4
39
Safety Box Pcs 0 0 -
40
Sarung tangan Steril No 6 Pcs 0 0 -
41
Sarung tangan Steril No 7 Pcs 3 0 3
42
Sarung tangan Steril No 7,5 Pcs 7 0 7
43
Sarung tangan Non Steril S Pcs 0 0 -
44
Sarung tangan Non Steril M Pcs 0 0 -
45
Sarung tangan Non Steril L Pcs 0 0 -
46
Urine Bag set 2 0 2
47
Wing Neddle No 23 Set 0 0 -
48
Anuscopi Yamato Unit 0 0 -
49
Kaca Slide Box 0 0 -
50
Reagen Ziehl Nielson Kit 0 0 -
51
Rotator Unit 0 0 -
52
RTD Malaria Tes 0 0 -
53
Rapid HIV 3 (Oncoprobe HIV) Pcs 0 0 -
54
Sound Timer Buah 0 0 -
55
SD Syphilis Pcs 0 0 -
56
CATATAN HARIAN PEMAKAIAN O
Bulan : April Tahun : 2017
JUMLAH PEMA
3 4 5 6 7 8 9 10 11 12 13
17
10
1 1
10 5 30 10 30 10 10
10
30 10 20 10 30 40
1 10 1 1 1 1
1 2 2
20
10 40
1 1 1 1 4
60 30 10 10 10 10 30 30 66 20
10 5 10
20 23 13 10 20
10 10 8
1 1 1
10 10
10 10
2 2 1
16 16
10
12
6 6
1
20
3 6 3 3 8 20 13
10 20 20 20 20 20
10 10 10 20
20 10 10 10 20
1
10 10 10 10 10 10 20 18
10 8 20
10 10 40 40 20 20 10
10
10
1
10
1 2
1 1
20 13 20 3 11 13 10 8 4
10 10 5 5 5 10 5 10
20
1 1 2 1
20
10
1
10 10 10
2 1 2 2 1 1
10
1 2 1 1
1 1
1 1 1
2 2 1 1 1 1
10 10
2 1 1 1 3 2 2
40 70 50 70 36 40 48 40 90 70
20 10
30 20 6 10 40
30 10 20
10 10
10
2 1 1 4 3 2
1 1 1 1 1
10 10
10 10 10
1 1
10 12
20
20
30 10
10 10
20 10 20
10
23 40 30 10 60 18 10 10
26 10 10 20 10 10 32
10
10 10 10 10
10
1
2
1
PEMAKAIAN OBAT
Tahun : 2017
14 15 16 17 18 19 20 21 22 23
10 30 20
10 10
1
10 20 20 10
30 20 50 10
1 2 1
1 1 1
1 1 1 1 3
50 100 50 20 350 30 10
10
1
8
3 20 20 20
8
2 1
20 10 8 10
10 10
1 1
30
60
10 20 20
5 17 6
110
13 13 10
10
40 40 10 10 20
1 1 1
10 10
10 76 10
10 10 178
10 10
10 30 20 291 10
10 20 10
20
1 1
1
38 18 13 53 10 10
30 10 10 20
10
10 10
1 1 1 1
20 44 10
10 120
10
2
10
1
10
138 10
1 1 1 1 2
20 1 1
2
2 1 1
1 1
10
1
1 1 2 1 1
83 125 100 33 396 60 65

10 10
70 30 10 230 30
10 20
10
20 10
1 3 7 1
2
10 10 10
1 1
10 10 10
10 20
10 10
1
30
20 10 360 10
10
18 30 20 3 396 10 6
20 20 40 6 107 10
10
5
3
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 100
177 47
8 38 10
3 6
0 -
0 20
0 40
170 82
0 -
20 29
20 20 10 300 34
0 -
1 2 1 2 26 1
1 1 10 1
20 70
50 62
0 -
0 -
0 40
2 17 2
20 30 10 10 20
1036 30
10 40
0 40
0 -
0 4
0 -
1 1 2
0 -
1 2
8 41 20
0 70
0 -
20 10 179 38
6 42 90
6 1
0 10
0 -
68 62
40 9
0 -
0 -
0 -
2 3
0 15
0 -
0 -
0 -
8 8 16 40
7 1
0 -
0 -
0 30
0 2
6 78 52
0 -
64 44
0 -
0 -
0 -
0 47
0 -
60 16
12 128
0 1
60 -
0 282
0 5
0 -
0 -
0 -
0 -
0 -
0 1
0 -
0 100
0 -
0 -
0 100
0 70
0 35
0 3
0 17
40 8
0 -
0 -
1 3
130 -
0 40
4 10 136 17
0 1
0 -
0 1
0 -
10 70
10 240 -
60 60
10 10 40
0 39
1 6 5
20 76
20 10 10 206 14
1 3
0 -
0 -
0 -
0 -
0 -
10 8 20 339 42
0 -
10 8 18 94 46
10 10 10 541 102
20 70 35
5 10 45 5
2 2
10 86
0 -
0 -
0 -
0 -
0 -
0 -
0 84
3 2 7 1
1 7 -
2 1
10 10 14 18 10 322 51
20 20 10 120 10
75 41
0 -
8 12
10 50 58
1 10 1
0 34
0 -
0 -
0 -
0 -
0 -
0 -
0 40
0 -
74 18
0 -
150 60
0 -
10 10
0 4
2 10 22 8
5 8 37
0 -
0 40
10 20 30 40
0 -
3 2
40 -
1 1 12 1
10 72
0 -
168 6
0 -
0 23
0 7
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
11 2
1 25 2
1 2 8 1
1 1 15 2
0 -
2 -
0 2
0 9
0 -
30 28
0 -
1 3
1 1 1 1 22 2
0 30
20 60 40 30 20 1654 57
0 -
0 -
0 -
0 -
10 5 65 25
0 80
10 20 10 20 556 17
0 -
0 2
0 1
0 -
0 30
0 -
0 -
8 30 128 95
0 -
0 186
0 40
0 -
0 3
10 60 13
40 10
0 -
25 2
2 10 2
0 -
2 -
0 17
20 10
0 -
0 -
0 -
30 100 43
2 1
2 19
0 10
0 -
10 62 7
30 25
10 50 58
20 10
1 1
60 10 10 150 50
0 -
0 -
0 10
0 90
10 10 40 50
10 460 14
0 80
0 -
0 -
40 12
30 36 34 10 10 819 69
10 376 (2)
10 51
50 14
0 -
10 22
2 8
10 10 90
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 7
0 3
1 1 9 19
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
4 1
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
4
2
9
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
Albendazole Tablet 400 mg Tablet -
2
Alopurinol Tablet 100 mg Tablet -
3
Ambroksol Tablet 30 mg Tablet -
4
Ambroksol sirup 15 mg/5 ml Botol -
5
Aminofillin Injeksi 24 mg/ml-10 ml Ampul -
6
Aminofillin Tablet 200 mg Tablet -
7
Amitriptillin Hcl Tablet Salut 25 m Tablet -
8
Amlodipin Tablet 5 mg Tablet -
9
10
Amoksisillin Kapsul 250 mg Kapsul -
11
Amoksisillin Kaplet 500 mg Kaplet -
12
Amoksisillin Serbuk Injeksi 1000 mg vial -
13
Amoksisillin Sirup Kering 125 mg/5 Botol -
14
Kering 250 mg/5 ml
15 -
Ampisilin Kapsul 250 mg Kapsul -
16
Ampisillin Kaplet 500 mg Tablet -
17
Ampisilin Sirup 125 mg / 5 ml Botol -
18
Ampisillin Injeksi 1000 mg Vial -
19
Analgetik Plus Tablet -
20
21 -
Alumunium Hidroksida 200 mg
22 -
Antasida Plus Tablet Tablet -
23
Antalgin (Metampiron) Tablet 500 Tablet -
24
Antalgin Injeksi 250 mg/ml-2ml Ampul -
25
Kombinasi :
26 -
Anti Hemoroid Doen komb Supp -
27
Asam Benzoat 6% + Asam Salisilat

28 3% -
Ergotamin Tartrat 1 mg + Kofein

29 50 mg -
Anti Diare Suspensi Botol -
30
Anti Diare Tablet Tablet -
31
Anti Dotum Oral Tablet Tablet -
32
Anti Hipertensi Kapsul Tablet -
33
Antihistamin Tablet kombinasi Tablet -
34
Antispasmodik Tablet Tablet -
35
Antitusiva Sirup Botol -
36
Antitusiva Tablet Tablet -
37
Asam Folat Tablet 1 mg Tablet -
38
Asam Askorbat 50 mg Tablet -
39
Asam Mefenamat Kapsul 500 mg Kapsul -
40
Asetosal 80 mg Tablet -
41
Asetosal Tablet 100 mg Tablet -
42
43
Asiklovir Krim 5 % Tube -
44
Asiklovir Tablet 200 mg Tablet -
45
46
Atropin Sulfat Injeksi 0,25 mg/ml- Ampul -
47
Aqua Pro Injeksi Steril, bebas Piro Vial -
48
Betahistin Mesilat 6 mg Tablet -
49
Betametason Krim 0,1 %- 5g Tube -
50
Bisakodil suppositoria 10 mg Supp -
51
Bisoprolol Tablet 5 mg Tablet -
52
Bromheksin 8 mg Tablet -
53
Deksametason Injeksi 5mg/ml-1ml Ampul -
54
Deksametason Tablet 0,5 mg Tablet -
55
Devitalisasi Pasta (Non Arsen) Botol -
56
Diazepam tablet 2 mg Tablet -
57
Diazepam Injeksi i.v/i.m 5 mg/ml Ampul -
58
Diazepam Larutan Rektal 5 mg/ml Supp -
59
Dietilkarbamazin Sitrat Tablet 100 Tablet -
60
Difenhidramin HCl Injeksi 10 mg/m Ampul -
61
Digoksin Tablet 0,25 mg Tablet -
62
Dimenhidrinat Tablet 50 mg Tablet -
63
Domperidon Tablet 10 mg Tablet -
64
Donperidon Suspensi 5 mg/5ml Botol -
65
Efedrin Hcl Tablet 25 mg Tablet -
66
Ekstrak Belladone Tablet 10 mg Tablet -
67
(Epinefrina / Adrenalina) Injeksi

68 0,1%/- 1ml -
Eritromisin Kapsul 250 mg Kapsul -
69
70
Eritromisin Sirup 200 mg / 5 ml Botol -
71
Etambutol Tablet 500 mg Tablet -
72
Etanol 70 % 100 ml Botol -
73
Etil Klorida Semprot -100 ml Botol -
74
Eugenol Cairan -10 ml Botol -
75
Fenitoin Natrium Kapsul 100 mg Kapsul -
76
Fenobarbital tablet 30 mg Tablet -
77
Fenobarbital injeksi 50 mg / ml Ampul -
78
Fenoksimeti Penisilin 250 mg table Tablet -
79
Fenoksimeti Penisilin 500 mg tabl Tablet -
80
Fitomenadion tablet 10 mg Tablet -
81
Fitomenadion (Vit K1) Injeksi 2 m Ampul -
82
Furosemid Tablet 40 mg Tablet -
83
kombinasi :
dihidrat 0,58 gr, Glukosa Anhidrat
2,70 g )200 ml Air
84 -
Gemfibrozil Tablet 600 mg Tablet -
85
Gentamisin injeksi 80 mg / 2 ml Vial -
86
Gentamisin Salep Kulit 0,1 % Tube -
87
Glibenklamid Tablet 5 mg Tablet -
88
Glimepiride 2 mg Tablet -
89
Gliseril guayakolat tablet 100 mg Tablet -
90
Gliseril Guayakolat sirup Botol -
91
Glukonas Kalsikus injeksi Ampul -
92
Glukosa Larutan Infus 5 % Botol -
93
Glukosa Larutan Infus10 % Botol -
94
Griseofulvin Tablet 125 mg,microni Tablet -
95
Haloperidol Tablet 0,5 mg Tablet -
96
97
Haloperidol Tablet 5 mg Tablet -
98
Hidrokloritiazid 25 mg Tablet -
99
Hidrokortison Krim 2,5 % Tube -
100
Ibuprofen Tablet 200 mg Tablet -
101
102
Ibuprofen Suspensi 100 mg/5 ml Botol -
103
Ichtyol salep Kulit Pot -
104
Sulphate for inhalation 2,5 ml

105 -
Isoniazid tablet 100 mg Tablet -
106
Isosorbid Dinitrat 5 mg Tablet -
107
Kalium Diklofenak Tablet 25 mg Tablet -
108
109
Kalsium Hidroksida Pasta Tube -
110
Kalsium Laktat Tablet 500 mg Tablet -
111
Kaptopril 12,5 mg Tablet -
112
Kaptopril 25 mg Tablet -
113
Karbamazepin Tablet 200 mg Tablet -
114
Ketokonazole Krim 2 % - 15 gr Tube -
115
Ketokonazole Tablet 200 mg Tablet -
116
Ketoprofen Tablet 100 mg Tablet -
117
Ketoprofen Injeksi 100 mg / 1 ml Ampul -
118
Ketorolac 10 mg injeksi Ampul -
119
120
Klindamisin Kapsul 150 mg Kapsul -
121
122
Kloramfenikol Kapsul 250 mg Kapsul -
123
Kloramfenikol Salep Mata 1%-3,5 g Tube -
124
Kloramfenikol Tetes Mata -5 ml Botol -
125
Kloramfenikol Tetes Telinga 3%-5 Botol -
126
Klorfeniramin Maleat (CTM) Tablet Tablet -
127
Klorpromazin Hcl Tablet Salut 25 Tablet -
128
129
Klorpromazin Hcl Injeksi 5 mg/ml- Ampul -
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
Lansoprazole 30 mg Kapsul Tablet -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
Lactat 2,24 gr, Dekstrosa 27 gr)
137 -
Lidokain injeksi 2 % Tablet -
138
Kombinasi :
Lidokain Hcl 2%
139 -
Loperamid Tablet 2 mg Tablet -
140
Loratadin tablet 10 mg Tablet -
141
Magnesium Sulfat (IV) 20 %-25 ml Ampul -
142
Meloksikam tablet 15 mg Tablet -
143
Meloksikam Suppositoria Supp -
144
Metformin Hcl Tablet 500 mg Tablet -
145
Methisoprinol 500 mg Tablet -
146
Metilergometrin Maleat (Metergin) Tablet -
147
Metilergometrin Maleat Injeksi 0, Ampul -
148
Metilprednisolon tablet 4 mg Tablet -
149
Metoklopramid 10 mg Tablet -
150
151
Metronidazol Tablet 250 mg Tablet -
152
Metronidazole Tablet 500 mg Tablet -
153
154
Mikonazole KrIm 2 % - 10 gr Tube -
155
Multivitamin + Mineral tablet Tablet -
156
Multivitamin sirup Botol -
157
Natrium Bikarbonat Tablet 500 mg Tablet -
158
159
Natrium Diklofenak Tablet 50 mg Tablet -
160
Natrium Klorida Larutan infus 0,9%- Botol -
161
Nipedifin Tablet 10 mg Tablet -
162
Nistatin 100.000 IU/gram Tablet V Tablet -
163
Nistatin 500.000 IU/gram Tablet Sa Tablet -
164
165
166
167
168
169
170
171
172
Obat Batuk Hitam (OBH) Cairan 10 Botol -
173
Obat Batuk Cair Sirup (Ekspektoran Botol -
174
175
176
177
Oksiterasiklin Salep Mata 1%-3,5g Tube -
178
Oksitetrasiklin Hcl Salep Kulit 3%-5 Tube -
179
Oksitosin Injeksi 10 IU/ml-1ml Ampul -
180
181
182
Ondansetron inj 4 mg/ 2 mL Ampul -
183
Parasetamol drops Botol -
184
Parasetamol Sirup 120 mg/5ml-60 Botol -
185
Parasetamol Tablet 100 mg Tablet -
186
187
Pehacain injeksi Ampul -
188
Perak Sulfadiazin krim 1 % 35 gr Tube -
189
Piracetam 400 mg Tablet -
190
Piracetam Tablet 800 mg Tablet -
191
Piroksikam Tablet 20 mg Tablet -
192
Pirantel Pamoat Tablet 365 mg (Se Tablet -
193
Piridoksin Hcl (Vit.B6) Tablet 10 m Tablet -
194
Metakresol
mg/g-10 ml
195 -
Povidon Iodida 10% 30 ml Botol -
196
197
Primakuin tablet 15 mg Tablet -
198
Propanolol Hcl Tablet 40 mg Tablet -
199
Propilturasil Tablet 100 mg Tablet -
200
Ranitidin Injeksi 25 mg / ml Ampul -
201
Ranitidin Tablet 150 mg Tablet -
202
Retinol (Vit.A) 100.000 IU Kapsul Kapsul -
203
204
Reserpin Tablet 0, 25 mg Tablet -
205
Rifampisin Tablet 450 mg Tablet -
206
Ringer Laktat Larutan Infus Steril Botol -
207
Salbutamol Tablet 2 mg Tablet -
208
209
210 -

211 Endap 4 % - 30 gram -
Salisil bedak 2% -50 gr Kotak -
212
Salep Luka Bakar Tube -
213
Sefadroksil Sirup Kering 125 mg / Botol -
214
Sefadroksil Tablet 500 mg Tablet -
215
Sefiksim Kapsul 100 mg Kapsul -
216
Sefotaksim Injeksi 1 gr Ampul -
217
Seftriakson Injeksi 1 gr / vial Ampul -
218
Semen Seng Fosfat Serbuk & Caira Botol -
219
Setirizin Tablet 10 mg Tablet -
220
Setirizin Sirup 5 mg / 5 ml Botol -
221
Sianokobalamin Injeksi 500 mcg/m Ampul -
222
Sianokobalamin Tablet 50 mcg Tablet -
223
Silver Amalgam Serbuk 65-75% Botol -
224
Simetidin 200 mg Tablet Tablet -
225
Simvastatin Tablet 10 mg Tablet -
226
Siprofloksasin 500mg Tablet -
227
Spironolakton Tablet 25 mg Tablet -
228
Sulfacetamid Tetes Mata 15 %-5ml Botol -
229

0,25 mg
230 -
231 -
Trikesol formalin ( T K F ) Cairan 1 Botol -
232
Tetrasiklin Kapsul 250 mg Kapsul -
233
234
Thiamin Hcl (Vit B1) Injeksi 100 m Ampul -
235
Tiamin Hcl /Mononitrat (Vit.B1) Ta Tablet -
236
Thiamfenikol Kapsul 500 mg Kapsul -
237
Tramadol Injeksi 50 mg/ ml Ampul -
238
Tramadol Tablet 50 mg Tablet -
239
Triheksifenidil Hidroklorida Tablet Tablet -
240
Vitamin B .Komplek Tablet Tablet -
241
Vitamin Neurotropik Tablet Tablet -
242
Zinc Tablet 20 mg Tablet -
243
Prednisone 54mg Tablet -
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : Mei Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
ei Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Kering 250 mg/5 ml
15 -
16
17
18
19
20
21 -
22 -
23
24
25
Kombinasi :
26 -
27

28 3% -

29 50 mg -
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67

68 0,1%/- 1ml -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
kombinasi :
2,70 g )200 ml Air
84 -
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

105 -
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
137 -
138
Kombinasi :
Lidokain Hcl 2%
139 -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
Metakresol
mg/g-10 ml
195 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210 -

211 Endap 4 % - 30 gram -
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

0,25 mg
230 -
231 -
232
233
234
235
236
237
238
239
240
241
242
243
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : Juni Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
ni Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Kering 250 mg/5 ml
15 -
16
17
18
19
20
21 -
22 -
23
24
25
Kombinasi :
26 -
27

28 3% -

29 50 mg -
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67

68 0,1%/- 1ml -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
kombinasi :
2,70 g )200 ml Air
84 -
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

105 -
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
137 -
138
Kombinasi :
Lidokain Hcl 2%
139 -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
Metakresol
mg/g-10 ml
195 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210 -

211 Endap 4 % - 30 gram -
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

0,25 mg
230 -
231 -
232
233
234
235
236
237
238
239
240
241
242
243
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : Juli Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
li Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Kering 250 mg/5 ml
15 -
16
17
18
19
20
21 -
22 -
23
24
25
Kombinasi :
26 -
27

28 3% -

29 50 mg -
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67

68 0,1%/- 1ml -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
kombinasi :
2,70 g )200 ml Air
84 -
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

105 -
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
137 -
138
Kombinasi :
Lidokain Hcl 2%
139 -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
Metakresol
mg/g-10 ml
195 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210 -

211 Endap 4 % - 30 gram -
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

0,25 mg
230 -
231 -
232
233
234
235
236
237
238
239
240
241
242
243
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : Agustus Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
stus Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
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0 -
0 -
0 -
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0 -
0 -
0 -
0 -
0 -
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0 -
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0 -
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0 -
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0 -
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0 -
0 -
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0 -
0 -
0 -
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0 -
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0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Kering 250 mg/5 ml
15 -
16
17
18
19
20
21 -
22 -
23
24
25
Kombinasi :
26 -
27

28 3% -

29 50 mg -
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67

68 0,1%/- 1ml -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
kombinasi :
2,70 g )200 ml Air
84 -
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

105 -
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
137 -
138
Kombinasi :
Lidokain Hcl 2%
139 -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
Metakresol
mg/g-10 ml
195 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210 -

211 Endap 4 % - 30 gram -
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

0,25 mg
230 -
231 -
232
233
234
235
236
237
238
239
240
241
242
243
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : September Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
mber Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Kering 250 mg/5 ml
15 -
16
17
18
19
20
21 -
22 -
23
24
25
Kombinasi :
26 -
27

28 3% -

29 50 mg -
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67

68 0,1%/- 1ml -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
kombinasi :
2,70 g )200 ml Air
84 -
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

105 -
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
137 -
138
Kombinasi :
Lidokain Hcl 2%
139 -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
Metakresol
mg/g-10 ml
195 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210 -

211 Endap 4 % - 30 gram -
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

0,25 mg
230 -
231 -
232
233
234
235
236
237
238
239
240
241
242
243
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : Oktober Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
ober Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Kering 250 mg/5 ml
15 -
16
17
18
19
20
21 -
22 -
23
24
25
Kombinasi :
26 -
27

28 3% -

29 50 mg -
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67

68 0,1%/- 1ml -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
kombinasi :
2,70 g )200 ml Air
84 -
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

105 -
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
137 -
138
Kombinasi :
Lidokain Hcl 2%
139 -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
Metakresol
mg/g-10 ml
195 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210 -

211 Endap 4 % - 30 gram -
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

0,25 mg
230 -
231 -
232
233
234
235
236
237
238
239
240
241
242
243
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : November Tahun : 2017
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
mber Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Kering 250 mg/5 ml
15 -
16
17
18
19
20
21 -
22 -
23
24
25
Kombinasi :
26 -
27

28 3% -

29 50 mg -
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67

68 0,1%/- 1ml -
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
kombinasi :
2,70 g )200 ml Air
84 -
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

105 -
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Kombinasi :
Trimetroprim 20 mg
131 -
Trimetroprim 80 mg
132 -
:
133 -
134
mEq) /Asering
135 -
gr)
136 -
Elektrolit
137 -
138
Kombinasi :
Lidokain Hcl 2%
139 -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
Metakresol
mg/g-10 ml
195 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210 -

211 Endap 4 % - 30 gram -
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

0,25 mg
230 -
231 -
232
233
234
235
236
237
238
239
240
241
242
243
244
flunax sy Botol -
245
Set -
246
Set -
247
Tablet -
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 10
31
32
Pot Dahak Pcs 0 -
33
34
35
36
37
38
39
Safety Box Pcs 0 -
40
41
42
43
44
45
46
Urine Bag set 2 2
47
48
49
Kaca Slide Box 0 -
50
51
Rotator Unit 0 -
52
RTD Malaria Tes 0 -
53
54
55
SD Syphilis Pcs 0 -
56
JUMLAH PEMAKAIAN JE
4 5 6 7 8 9 10 11 12 13
N PEMAKAIAN OBAT
mber Tahun : 2017
14 15 16 17 18 19 20 21 22 23
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5
0 -
0 -
0 7
0 3
0 43
0 3
0 -
0 -
0 -
0 -
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
0 -
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0
0
0
jumlah Antispasmodik Tablet
pemaka Sisa 35 30 32
No Nama Obat
ian stok 36
Antitusiva Sirup 0 2
Air Raksa Dental Use Antitusiva Tablet
1 0 0 37 0 10
Albendazole Tablet 400 mg Asam Folat Tablet 1 mg
2 0 100 38 0 0
Alopurinol Tablet 100 mg Asam Askorbat 50 mg
3 20 24 39 20 30
Ambroksol Tablet 30 mg 70 48 Asam Mefenamat Kapsul 500 mg 20 19
4 40
Ambroksol sirup 15 mg/5 ml 8 6 Asetosal 80 mg 0 0
5 41
Aminofillin Injeksi 24 mg/ml-10 ml 0 0 Asetosal Tablet 100 mg 0 0
6 42
Aminofillin Tablet 200 mg 0 20 Asetosal Tablet 500 mg 0 0
7 43
Amitriptillin Hcl Tablet Salut 25 mg 10 40 Asiklovir Krim 5 % 3 2
8 44
Amlodipin Tablet 5 mg 95 52 Asiklovir Tablet 200 mg 0 15
9 45
10 46
Amoksisillin Kapsul 250 mg 51 49 Atropin Sulfat Injeksi 0,25 mg/ml 0 0
11 47
Amoksisillin Kaplet 500 mg 605 34 Aqua Pro Injeksi Steril, bebas Pir 0 0
12 48
Amoksisillin Serbuk Injeksi 1000 mg Betahistin Mesilat 6 mg
13 0 0 49 16 26
Amoksisillin Sirup Kering 125 mg/5ml 16 7 Betametason Krim 0,1 %- 5g 6 2
14 50
Amoksisillin Double Strengh Sirup Bisakodil suppositoria 10 mg
Kering 250 mg/5 ml
15 5 1 51 0 0
Ampisilin Kapsul 250 mg 10 90 Bisoprolol Tablet 5 mg 0 0
16 52
Ampisillin Kaplet 500 mg 30 12 Bromheksin 8 mg 0 30
17 53
Ampisilin Sirup 125 mg / 5 ml 0 0 Deksametason Injeksi 5mg/ml-1m 0 2
18 54
Ampisillin Injeksi 1000 mg 0 0 Deksametason Tablet 0,5 mg 64 30
19 55
Analgetik Plus Devitalisasi Pasta (Non Arsen)
20 0 40 56 0 0
Antasida Doen Suspensi Kombinasi : Diazepam tablet 2 mg
Magnesium Hidroksida 200 mg+
21 Alumunium Hidroksida 200 mg/5 ml 33 9 57 20 8
Antasida Doen Tablet, Kombinasi : Diazepam Injeksi i.v/i.m 5 mg/ml
22
755 66 58 0 0
Antasida Plus Tablet Diazepam Larutan Rektal 5 mg/m
23 0 0 59 0 0
Antalgin (Metampiron) Tablet 500 mg Dietilkarbamazin Sitrat Tablet 1
24 0 40 60 0 0
Antalgin Injeksi 250 mg/ml-2ml Difenhidramin HCl Injeksi 10 mg/
25 0 0 61 0 47
Anti Bakteri DOEN Salep Kombinasi : Digoksin Tablet 0,25 mg
Basitrasin 500 2 1 0 0
26 62
IU/g + Polimiksin 1000 IU/g
Anti Hemoroid Doen komb Dimenhidrinat Tablet 50 mg
27 0 0 63 26 26
Anti Fungi DOEN Kombinasi : Domperidon Tablet 10 mg
Asam
28
Benzoat 6% + Asam Salisilat 3%
1 0 64 0 40
Antimigren DOEN Kombinasi : Donperidon Suspensi 5 mg/5ml
29 Ergotamin Tartrat 0 0 65 0 1
1 mgDiare
Anti + Kofein 50 mg
Suspensi Efedrin Hcl Tablet 25 mg
30 0 0 66 0 60
Anti Diare Tablet Ekstrak Belladone Tablet 10 mg
31 44 31 67 0 282
Anti Dotum Oral Tablet Epinefrin HCl / Bitartrat
32 0 70 68 0 5
Anti Hipertensi Kapsul (Epinefrina
Eritromisin / Adrenalina)
Kapsul 250 mg
33 0 0 69 Injeksi 0,1%/- 1ml 0 0
Antihistamin Tablet kombinasi Eritromisin Kapsul 500 mg
34 238 17 70 0 0
Eritromisin Sirup 200 mg / 5 ml 0 0 Ketokonazole Tablet 200 mg 6 96
71 116
Etambutol Tablet 500 mg 0 0 Ketoprofen Tablet 100 mg 0 0
72 117
Etanol 70 % 100 ml 0 0 Ketoprofen Injeksi 100 mg / 1 ml 0 0
73 118
Etil Klorida Semprot -100 ml 0 1 Ketorolac 10 mg injeksi 0 0
74 119
Eugenol Cairan -10 ml 0 0 Ketorolac 30 mg injeksi 0 0
75 120
Fenitoin Natrium Kapsul 100 mg 0 100 Klindamisin Kapsul 150 mg 0 0
76 121
Fenobarbital tablet 30 mg 0 0 Klindamisin Kapsul 300 mg 0 0
77 122
Fenobarbital injeksi 50 mg / ml 0 0 Kloramfenikol Kapsul 250 mg 10 84
78 123
Fenoksimeti Penisilin 250 mg tablet 0 100 Kloramfenikol Salep Mata 1%-3,5 0 2
79 124
Fenoksimeti Penisilin 500 mg tablet 0 70 Kloramfenikol Tetes Mata -5 ml 4 1
80 125
Fitomenadion tablet 10 mg 0 35 Kloramfenikol Tetes Telinga 3%-5 2 1
81 126
Fitomenadion (Vit K1) Injeksi 2 mg/ml- 0 3 Klorfeniramin Maleat (CTM) Table 374 73
82 127
Furosemid Tablet 40 mg 0 17 Klorpromazin Hcl Tablet Salut 25 90 10
83 128
Garam Oralit I serbuk, kombinasi : Klorpromazin Hcl Tablet Salut 10
84
( Nacl
23 28 129 25 16
Gemfibrozil
0,52 Tablet
gr, Kalium 600 0,30
Klorida mg gr, 0 0 Klorpromazin Hcl Injeksi 5 mg/ml 0 0
85 130
Trinatrium Sitrat dihidrat 0,58 gr,
Gentamisin injeksi 80 mg / 2 ml Kotrimoksazol Pedriatik Tablet,
86 Glukosa Anhidrat 2,70 g )200 ml Air 0 0 131
Kombinasi :
0 0
87 Gentamisin Salep Kulit 0,1 % 1 4 132 Kotrimoksazol
Sulfametoksazol Tablet,
100 mg Kombinasi
+ 30 78
:Trimetroprim 20 mg
Glibenklamid Tablet 5 mg Kotrimoksazol Suspensi
88 10 30 133 Sulfametoksazol 400 mg +
Kombinasi :
7 4
Glimepiride 2 mg Trimetroprim 30
Lansoprazole 80 mg Kapsul
89 50 40 134 Sulfametoksazol mg 200 mg + 16 34
Gliseril guayakolat tablet 100 mg 192 53 Larutan mengadung Elektrolit 0 0
90 135
(Na 130 mEq,Cl 109 mEq, Asetat
91 Gliseril Guayakolat sirup 25 1 136 Larutan
28 mEq) mengadung
/Asering Elektrolit 0 0
Glukonas Kalsikus injeksi 0 0 Larutan mengadung Karbohidrat 0 0
92 137 gr)
+ Elektrolit
Glukosa Larutan Infus 5 % 0 1 Lidokain injeksi
(Nacl 1,75 gr,2KCL
% 1,5 gr, Na 2 0
93 138
Glukosa Larutan Infus10 % Lactat 2,24
Lidokain Kompgr, Injeksi,
Dekstrosa 27 gr)
94 0 0 139 0 0
Kombinasi :
Griseofulvin Tablet 125 mg,micronized 20 80 LoperamidLidokain
Tablet 2Hcl
mg2% 0 0
95 140
Haloperidol Tablet 0,5 mg +Epinefrin
Loratadin tablet 10 mg ml
1 : 80.000-2
96 180 40 141 0 40
Haloperidol Tablet 1,5 mg 50 20 Magnesium Sulfat (IV) 20 %-25 ml 0 0
97 142
Haloperidol Tablet 5 mg 0 0 Meloksikam tablet 15 mg 20 32
98 143
Hidrokloritiazid 25 mg 10 39 Meloksikam Suppositoria 0 0
99 144
Hidrokortison Krim 2,5 % 13 1 Metformin Hcl Tablet 500 mg 50 10
100 145
Ibuprofen Tablet 200 mg 20 96 Methisoprinol 500 mg 0 0
101 146
Ibuprofen Tablet 400 mg 130 70 Metilergometrin Maleat (Metergin 0 0
102 147
Ibuprofen Suspensi 100 mg/5 ml 1 4 Metilergometrin Maleat Injeksi 0 0 4
103 148
Ichtyol salep Kulit 0 0 Metilprednisolon tablet 4 mg 0 0
104 149
105 Ipatropium Bromide + Salbutamol 0 0 150 Metoklopramid 10 mg 10 45
Sulphate for
106 Isoniazid
inhalationtablet
2,5 ml100 mg 0 0 151 Metoklorpropamid Injeksi 5 mg/ 0 0
Isosorbid Dinitrat 5 mg 0 0 Metronidazol Tablet 250 mg 0 40
107 152
Kalium Diklofenak Tablet 25 mg 0 0 Metronidazole Tablet 500 mg 30 70
108 153
Kalium Diklofenak Tablet 50 mg 80 31 Metronidazole Infus 500 mg /100 0 0
109 154
Kalsium Hidroksida Pasta 0 0 Mikonazole KrIm 2 % - 10 gr 2 0
110 155
Kalsium Laktat Tablet 500 mg 20 40 Multivitamin + Mineral tablet 36 5
111 156
Kaptopril 12,5 mg 275 43 Multivitamin sirup 9 3
112 157
Kaptopril 25 mg 0 5 Natrium Bikarbonat Tablet 500 m 0 82
113 158
Karbamazepin Tablet 200 mg 30 10 Natrum Diklofenak Tablet 25 mg 0 0
114 159
Ketokonazole Krim 2 % - 15 gr 2 4 Natrium Diklofenak Tablet 50 mg 67 74
115 160
Natrium Klorida Larutan infus 0,9%-Steril 500 ml Rifampisin Tablet 450 mg 0 0
161 206
Nipedifin Tablet 10 mg 10 23 Ringer Laktat Larutan Infus Steril 0 3
162 207
Nistatin 100.000 IU/gram Tablet Vagina 0 7 Salbutamol Tablet 2 mg 10 3
163 208
Nistatin 500.000 IU/gram Tablet Salut 0 50 Salbutamol Tablet 4 mg 0 0
164 209
165 Obat Antitiuberkolosis Kategori Anak 0 0 210 Salbutamol solution for 0 0
166 Obat Antitiuberkolosis Kategori 1 Dewa 0 0 211 Salep
ml 2-4 Kombinasi : 2 2
Obat Antitiuberkolosis Kategori 2 Dewa 0 0 Salisil bedak 2% -50 gr 12 2
167 212 Asam Salisilat 2 % + Belerang
Obat Antitiuberkolosis Kategori 3 Dewa Endap 4 % -Bakar
Salep Luka 30 gram
168 0 0 213 0 0
Obat Anti Tuberkulosis FDC Kat Anak 0 0 Sefadroksil Sirup Kering 125 mg / 0 2
169 214
Obat Anti Tuberkulosis FDC Kat I & II 0 0 Sefadroksil Tablet 500 mg 10 17
170 215
Obat Anti Tuberkulosis FDC Kat I & III 0 0 Sefiksim Kapsul 100 mg 20 0
171 216
Obat Anti Tuberkolosis FDC Sisipan Dew 0 0 Sefotaksim Injeksi 1 gr 0 0
172 217
Obat Batuk Hitam (OBH) Cairan 100 ml 1 3 Seftriakson Injeksi 1 gr / vial 0 0
173 218
Obat Batuk Cair Sirup (Ekspektoran) 10 2 Semen Seng Fosfat Serbuk & Cair 0 0
174 219
Obat Batuk Hitam Plus Sirup 8 2 Setirizin Tablet 10 mg 40 93
175 220
176 Obat Flu Sirup 3 2 221 Setirizin Sirup 5 mg / 5 ml 1 1
Oksiterasiklin Hcl injeksi i.m.50 mg/ml 0 0 Sianokobalamin Injeksi 500 mcg/ 0 21
177 222
Oksiterasiklin Salep Mata 1%-3,5g 2 2 Sianokobalamin Tablet 50 mcg 0 10
178 223
Oksitetrasiklin Hcl Salep Kulit 3%-5g 0 2 Silver Amalgam Serbuk 65-75% 0 0
179 224
Oksitosin Injeksi 10 IU/ml-1ml 0 9 Simetidin 200 mg Tablet 31 19
180 225
Omeprazole injeksi 40mg/10ml 0 0 Simvastatin Tablet 10 mg 50 55
181 226
Omeprazole Kapsul 20 mg 1072 28 Siprofloksasin 500mg 30 8
182 227
183 Ondansetron inj 4 mg/ 2 mL 0 0 228 Spironolakton Tablet 25 mg 0 30
184 Parasetamol drops 1 2 229 Sulfacetamid Tetes Mata 15 %-5m 0 0
Parasetamol Sirup 120 mg/5ml-60 ml 52 2 Tablet Tambah Darah 30 50
185 230
Kombinasi:
186 Parasetamol Tablet 100 mg 70 30 231 TemporaryBesi
Stopping Fletcher
II Sulfat 200 mg + 0 0
(Fletcher)
Asam FolatSerbuk
0,25 mg & Cairan
Parasetamol Tablet 500 mg 1516 11 Trikesol formalin ( T K F ) Cairan 0 0
187 232
Pehacain injeksi 0 0 Tetrasiklin Kapsul 250 mg 0 10
188 233
Perak Sulfadiazin krim 1 % 35 gr 0 0 Tetrasiklin Kapsul 500 mg 10 90
189 234
Piracetam 400 mg 0 0 Thiamin Hcl (Vit B1) Injeksi 100 10 90
190 235
Piracetam Tablet 800 mg 0 0 Tiamin Hcl /Mononitrat (Vit.B1) 70 74
191 236
Piroksikam Tablet 20 mg 88 60 Thiamfenikol Kapsul 500 mg 0 80
192 237
Pirantel Pamoat Tablet 365 mg (Setara Tramadol Injeksi 50 mg/ ml
193
dng 125 mg Basa)
0 80 238 0 0
Piridoksin Hcl (Vit.B6) Tablet 10 mg 428 53 Tramadol Tablet 50 mg 0 0
194 239
Polikresulen (Kondensasi Metakresol Triheksifenidil Hidroklorida Table
195 Sulfonat dan
0 0 240 0 2
Povidon
Metanal)Iodida 10% 30 ml
360 mg/g-10 0 2 Vitamin B .Komplek Tablet 380 88
196 241
Povidon Iodida 10% 300 ml 0 1 Vitamin Neurotropik Tablet 286 4
197 242
Primakuin tablet 15 mg 0 0 Zinc Tablet 20 mg 27 61
198 243
Propanolol Hcl Tablet 40 mg 10 30 Prednisone 54mg 50 64
199 244
Propilturasil Tablet 100 mg 0 0 flunax sy 0 0
200 245
Ranitidin Injeksi 25 mg / ml 0 0 spasminal 1 2
201 246
Ranitidin Tablet 150 mg 40 23
202 247
Retinol (Vit.A) 100.000 IU Kapsul 0 0
203 248
204 249
Reserpin Tablet 0, 25 mg 0 40
205 250
B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES Urine Bag 0 2

no 47
Abbocath No 18 ( IV Chateter 18 ) 0 0 Wing Neddle No 23 0 0
1 48
Abbocath No 20 ( IV Chateter 20 ) 0 5 Anuscopi Yamato 0 0
2 49
Abbocath No 22 ( IV Chateter 22 ) 0 0 Kaca Slide 0 0
3 50
Abbocath No 24 ( IV Chateter 24 ) 0 0 Reagen Ziehl Nielson 0 0
4 51
Alat Suntik Sekali Pakai 10 ml 0 7 Rotator 0 0
5 52
Alat Suntik Sekali Pakai 1 ml 0 3 RTD Malaria 0 0
6 53
Alat Suntik Sekali Pakai 2,5 ml 15 28 Rapid HIV 3 (Oncoprobe HIV) 0 0
7 54
Alat Suntik Sekali Pakai 5 ml 0 3 Sound Timer 0 0
8 55
Alat Suntik Sekali Pakai 10 ml 0 0 SD Syphilis 0 0
9 56
Auto Disposable Syringe (ADS) 0,05 ml 0 0
10
11
Auto Disposable Syringe (ADS) 5 ml 0 0
12
Catgut/Benang Bedah No.2/0-3/0 (Plain 1 2
13
Etakridin Larutan (Rivanol) 0,1% - 300 m 0 0
14
Etanol 70 % 1.000 ml 0 0
15
Folley Catheter no 14 0 0
16
17
Folley Catheter no 18 0 2 .l,
18
Infus set Anak 0 0
19
Infus set Dewasa 0 7
20
Iodina Test 4 1
21
Kassa Hidrofil Steril 16 x 16 0 0
22
Kapas Berlemak 500 gram 0 0
23
Kapas Pembalut / Adsorbens 250 gram 0 0
24
Kassa Kompres 40 x 40 steril 0 0
25
26 Kassa Pembalut 2 m x 80 cm 0 2
27 Kassa Pembalut Hidrofil 4 m x 3 cm 0 1
28 Kassa Pembalut Hidrofil 4 m x 15 cm 0 0
29 Kertas Puyer 0 0
30 Lysol 1,000 ml 0 0
31 Masker 0 10
32 Plester 5 yard x 2 inchi 0 1
33 Pot Dahak 0 0
34 Rapid HIV 1 (SD HIV) 0 0
Rapid HIV 2 (Intec HIV) 0 0
35
Rapid HIV 2 (Biomeriux HIV) 0 0
36
37 Rapid Test Syphilis 0 0
38 RPR Test Syphilis 0 0
39 Silk( Benang Bedah Sutra ) No 3/0 0 4
40 Safety Box 0 0
41 Sarung tangan Steril No 6 0 0
42 Sarung tangan Steril No 7 0 3
43 Sarung tangan Steril No 7,5 0 7
44 Sarung tangan Non Steril S 0 0
45 Sarung tangan Non Steril M 0 0
46 Sarung tangan Non Steril L 0 0
pemaka Sisa 35 42
No Nama Obat
ian stok 36
Antitusiva Sirup 6
Air Raksa Dental Use 0 0 Antitusiva Tablet 0
1 37
Albendazole Tablet 400 mg 0 100 Asam Folat Tablet 1 mg 0
2 38
Alopurinol Tablet 100 mg 177 47 Asam Askorbat 50 mg 68
3 39
Ambroksol Tablet 30 mg 38 10 Asam Mefenamat Kapsul 500 mg 40
4 40
Ambroksol sirup 15 mg/5 ml 3 6 Asetosal 80 mg 0
5 41
Aminofillin Injeksi 24 mg/ml-10 ml 0 0 Asetosal Tablet 100 mg 0
6 42
Aminofillin Tablet 200 mg 0 20 Asetosal Tablet 500 mg 0
7 43
Amitriptillin Hcl Tablet Salut 25 mg 0 40 Asiklovir Krim 5 % 2
8 44
Amlodipin Tablet 5 mg 170 82 Asiklovir Tablet 200 mg 0
9 45
Amlodipin Tablet 10 mg 0 0 Asiklovir Tablet 400 mg 0
10 46
Amoksisillin Kapsul 250 mg 20 29 Atropin Sulfat Injeksi 0,25 mg/ml 0
11 47
Amoksisillin Kaplet 500 mg 300 34 Aqua Pro Injeksi Steril, bebas Pir 0
12 48
Amoksisillin Serbuk Injeksi 1000 mg 0 0 Betahistin Mesilat 6 mg 16
13 49
Amoksisillin Sirup Kering 125 mg/5ml 26 1 Betametason Krim 0,1 %- 5g 7
14 50
Amoksisillin Double Strengh Sirup Kering 250 mg/5 ml Bisakodil suppositoria 10 mg
15 10 1 51 0
Ampisilin Kapsul 250 mg 20 70 Bisoprolol Tablet 5 mg 0
16 52
Ampisillin Kaplet 500 mg 50 62 Bromheksin 8 mg 0
17 53
Ampisilin Sirup 125 mg / 5 ml 0 0 Deksametason Injeksi 5mg/ml-1m 0
18 54
Ampisillin Injeksi 1000 mg 0 0 Deksametason Tablet 0,5 mg 78
19 55
Analgetik Plus 0 40 Devitalisasi Pasta (Non Arsen) 0
20 56
Antasida Doen Suspensi Kombinasi : Magnesium Diazepam tablet 2 mg
Hidroksida 200 mg+ Alumunium Hidroksida 200 mg/5 ml
21 17 2 57 64
Antasida Doen Tablet, Kombinasi : Magnesium Diazepam Injeksi i.v/i.m 5 mg/ml
Hidroksida 200 mg+ Alumunium Hidroksida 200 mg
22 1036 30 58 0
Antasida Plus Tablet 10 40 Diazepam Larutan Rektal 5 mg/m 0
23 59
Antalgin (Metampiron) Tablet 500 mg 0 40 Dietilkarbamazin Sitrat Tablet 1 0
24 60
Antalgin Injeksi 250 mg/ml-2ml 0 0 Difenhidramin HCl Injeksi 10 mg/ 0
25 61
Anti Bakteri DOEN Salep Kombinasi : Digoksin Tablet 0,25 mg
Basitrasin 500 IU/g + Polimiksin 1000 IU/g
26 0 4 62 0
Anti Hemoroid Doen komb 0 0 Dimenhidrinat Tablet 50 mg 60
27 63
Asam Benzoat 6% + Asam Salisilat 3%
28 1 2 64 12
Ergotamin Tartrat 1 mg + Kofein 50 mg
29 0 0 65 0
Anti Diare Suspensi 1 2 Efedrin Hcl Tablet 25 mg 60
30 66
Anti Diare Tablet 41 20 Ekstrak Belladone Tablet 10 mg 0
31 67
(Epinefrina / Adrenalina)
32 0 70 68 Injeksi 0,1%/- 1ml 0
Anti Hipertensi Kapsul 0 0 Eritromisin Kapsul 250 mg 0
33 69
Antihistamin Tablet kombinasi 179 38 Eritromisin Kapsul 500 mg 0
34 70
Page 443
Eritromisin Sirup 200 mg / 5 ml 0 0 Ketokonazole Tablet 200 mg 10
71 116
Etambutol Tablet 500 mg 0 0 Ketoprofen Tablet 100 mg 0
72 117
Etanol 70 % 100 ml 0 0 Ketoprofen Injeksi 100 mg / 1 ml 0
73 118
Etil Klorida Semprot -100 ml 0 1 Ketorolac 10 mg injeksi 0
74 119
Eugenol Cairan -10 ml 0 0 Ketorolac 30 mg injeksi 0
75 120
Fenitoin Natrium Kapsul 100 mg 0 100 Klindamisin Kapsul 150 mg 0
76 121
Fenobarbital tablet 30 mg 0 0 Klindamisin Kapsul 300 mg 0
77 122
Fenobarbital injeksi 50 mg / ml 0 0 Kloramfenikol Kapsul 250 mg 0
78 123
Fenoksimeti Penisilin 250 mg tablet 0 100 Kloramfenikol Salep Mata 1%-3,5 7
79 124
Fenoksimeti Penisilin 500 mg tablet 0 70 Kloramfenikol Tetes Mata -5 ml 7
80 125
Fitomenadion tablet 10 mg 0 35 Kloramfenikol Tetes Telinga 3%-5 2
81 126
Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml 0 3 Klorfeniramin Maleat (CTM) Table 322
82 127
Furosemid Tablet 40 mg 0 17 Klorpromazin Hcl Tablet Salut 25 120
83 128
Garam Oralit I serbuk, kombinasi : Klorpromazin Hcl Tablet Salut 10
( Nacl 0,52 gr, Kalium Klorida 0,30 gr,
Trinatrium Sitrat dihidrat 0,58 gr, Glukosa Anhidrat 2,70
g )200 ml Air
84 40 8 129 75
Gemfibrozil Tablet 600 mg 0 0 Klorpromazin Hcl Injeksi 5 mg/ml 0
85 130
Kombinasi :
Trimetroprim 20 mg
86 0 0 131 8
Gentamisin Salep Kulit 0,1 % Kotrimoksazol Tablet, Kombinasi
:
Trimetroprim 80 mg
87 1 3 132 50
Kombinasi :
88 130 0 133 10
Glimepiride 2 mg 0 40 Lansoprazole 30 mg Kapsul 0
89 134
Gliseril guayakolat tablet 100 mg Larutan mengadung Elektrolit
28 mEq) /Asering
90 136 17 135 0
Gliseril Guayakolat sirup Larutan mengadung Elektrolit
gr)
91 0 1 136 0
Glukonas Kalsikus injeksi Larutan mengadung Karbohidrat
+ Elektrolit
92 0 0 137 0
Glukosa Larutan Infus 5 % 0 1 Lidokain injeksi 2 % 0
93 138
Glukosa Larutan Infus10 % Lidokain Komp Injeksi,
Kombinasi :
Lidokain Hcl 2%
94 0 0 139 0
Page 444
Griseofulvin Tablet 125 mg,micronized 10 70 Loperamid Tablet 2 mg 0
95 140
Haloperidol Tablet 0,5 mg 240 0 Loratadin tablet 10 mg 0
96 141
Haloperidol Tablet 1,5 mg 60 60 Magnesium Sulfat (IV) 20 %-25 ml 0
97 142
Haloperidol Tablet 5 mg 10 40 Meloksikam tablet 15 mg 74
98 143
Hidrokloritiazid 25 mg 0 39 Meloksikam Suppositoria 0
99 144
Hidrokortison Krim 2,5 % 6 5 Metformin Hcl Tablet 500 mg 150
100 145
Ibuprofen Tablet 200 mg 20 76 Methisoprinol 500 mg 0
101 146
Ibuprofen Tablet 400 mg 206 14 Metilergometrin Maleat (Metergin 10
102 147
Ibuprofen Suspensi 100 mg/5 ml 1 3 Metilergometrin Maleat Injeksi 0 0
103 148
Ichtyol salep Kulit 0 0 Metilprednisolon tablet 4 mg 22
104 149
Ipatropium Bromide + Salbutamol Metoklopramid 10 mg
105 0 0 150 8
Isoniazid tablet 100 mg 0 0 Metoklorpropamid Injeksi 5 mg/ 0
106 151
Isosorbid Dinitrat 5 mg 0 0 Metronidazol Tablet 250 mg 0
107 152
Kalium Diklofenak Tablet 25 mg 0 0 Metronidazole Tablet 500 mg 30
108 153
Kalium Diklofenak Tablet 50 mg 339 42 Metronidazole Infus 500 mg /100 0
109 154
Kalsium Hidroksida Pasta 0 0 Mikonazole KrIm 2 % - 10 gr 3
110 155
Kalsium Laktat Tablet 500 mg 94 46 Multivitamin + Mineral tablet 40
111 156
Kaptopril 12,5 mg 541 102 Multivitamin sirup 12
112 157
Kaptopril 25 mg 70 35 Natrium Bikarbonat Tablet 500 m 10
113 158
Karbamazepin Tablet 200 mg 45 5 Natrum Diklofenak Tablet 25 mg 0
114 159
Ketokonazole Krim 2 % - 15 gr 2 2 Natrium Diklofenak Tablet 50 mg 168
115 160
Natrium Klorida Larutan infus 0,9%-Steril 500 ml 0 0 Rifampisin Tablet 450 mg 0
161 206
Nipedifin Tablet 10 mg 0 23 Ringer Laktat Larutan Infus Steril 0
162 207
Nistatin 100.000 IU/gram Tablet Vagina 0 7 Salbutamol Tablet 2 mg 60
163 208
Nistatin 500.000 IU/gram Tablet Salut 0 50 Salbutamol Tablet 4 mg 40
164 209
Obat Antitiuberkolosis Kategori Anak Salbutamol solution for
ml
165 0 0 210 0
Obat Antitiuberkolosis Kategori 1 Dewasa Salep 2-4 Kombinasi :

166 0 0 211 Endap 4 % - 30 gram 25
Obat Antitiuberkolosis Kategori 2 Dewasa 0 0 Salisil bedak 2% -50 gr 10
167 212
Obat Antitiuberkolosis Kategori 3 Dewasa 0 0 Salep Luka Bakar 0
168 213
Obat Anti Tuberkulosis FDC Kat Anak 0 0 Sefadroksil Sirup Kering 125 mg / 2
169 214
Obat Anti Tuberkulosis FDC Kat I & II 0 0 Sefadroksil Tablet 500 mg 0
170 215
Obat Anti Tuberkulosis FDC Kat I & III 0 0 Sefiksim Kapsul 100 mg 20
171 216
Obat Anti Tuberkolosis FDC Sisipan Dewasa 0 0 Sefotaksim Injeksi 1 gr 0
172 217
Obat Batuk Hitam (OBH) Cairan 100 ml 11 2 Seftriakson Injeksi 1 gr / vial 0
173 218
Obat Batuk Cair Sirup (Ekspektoran) 25 2 Semen Seng Fosfat Serbuk & Cair 0
174 219
Obat Batuk Hitam Plus Sirup 8 1 Setirizin Tablet 10 mg 100
175 220
Obat Flu Sirup 15 2 Setirizin Sirup 5 mg / 5 ml 2
176 221
Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 ml 0 0 Sianokobalamin Injeksi 500 mcg/ 2
177 222
Oksiterasiklin Salep Mata 1%-3,5g 2 0 Sianokobalamin Tablet 50 mcg 0
178 223
Page 445
Oksitetrasiklin Hcl Salep Kulit 3%-5g 0 2 Silver Amalgam Serbuk 65-75% 0
179 224
Oksitosin Injeksi 10 IU/ml-1ml 0 9 Simetidin 200 mg Tablet 62
180 225
Omeprazole injeksi 40mg/10ml 0 0 Simvastatin Tablet 10 mg 30
181 226
Omeprazole Kapsul 20 mg 30 28 Siprofloksasin 500mg 50
182 227
Ondansetron inj 4 mg/ 2 mL 0 0 Spironolakton Tablet 25 mg 20
183 228
Parasetamol drops 1 3 Sulfacetamid Tetes Mata 15 %-5m 1
184 229
Parasetamol Sirup 120 mg/5ml-60 ml Tablet Tambah Darah
Kombinasi:
Asam Folat 0,25 mg
185 22 2 230 150
Parasetamol Tablet 100 mg Temporary Stopping Fletcher
186 0 30 231 0
Parasetamol Tablet 500 mg 1654 57 Trikesol formalin ( T K F ) Cairan 0
187 232
Pehacain injeksi 0 0 Tetrasiklin Kapsul 250 mg 0
188 233
Perak Sulfadiazin krim 1 % 35 gr 0 0 Tetrasiklin Kapsul 500 mg 0
189 234
Piracetam 400 mg 0 0 Thiamin Hcl (Vit B1) Injeksi 100 40
190 235
Piracetam Tablet 800 mg 0 0 Tiamin Hcl /Mononitrat (Vit.B1) 460
191 236
Piroksikam Tablet 20 mg 65 25 Thiamfenikol Kapsul 500 mg 0
192 237
Pirantel Pamoat Tablet 365 mg (Setara dng 125 mg Basa) Tramadol Injeksi 50 mg/ ml
193 0 80 238 0
Piridoksin Hcl (Vit.B6) Tablet 10 mg 556 17 Tramadol Tablet 50 mg 0
194 239
Polikresulen (Kondensasi Metakresol Triheksifenidil Hidroklorida Table
Sulfonat dan Metanal) 360 mg/g-10 ml
195 0 0 240 40
Povidon Iodida 10% 30 ml 0 2 Vitamin B .Komplek Tablet 819
196 241
Povidon Iodida 10% 300 ml 0 1 Vitamin Neurotropik Tablet 376
197 242
Primakuin tablet 15 mg 0 0 Zinc Tablet 20 mg 10
198 243
Propanolol Hcl Tablet 40 mg 0 30 Prednisone 54mg 50
199 244
Propilturasil Tablet 100 mg 0 0 flunax sy 0
200 245
Ranitidin Injeksi 25 mg / ml 0 0 vit k 10
201 246
Ranitidin Tablet 150 mg 128 95 gentian violet 2
202 247
Retinol (Vit.A) 100.000 IU Kapsul 0 0 kloramfenikol 500 10
203 248
204 249
205 250
B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES Urine Bag 0

no 47
Abbocath No 18 ( IV Chateter 18 ) 0 0 Wing Neddle No 23 0
1 48
Abbocath No 20 ( IV Chateter 20 ) 0 10 Anuscopi Yamato 0
2 49
Abbocath No 22 ( IV Chateter 22 ) 0 0 Kaca Slide 0
3 50
Abbocath No 24 ( IV Chateter 24 ) 0 0 Reagen Ziehl Nielson 0
4 51
Alat Suntik Sekali Pakai 10 ml 0 7 Rotator 0
5 52
Alat Suntik Sekali Pakai 1 ml 0 3 RTD Malaria 0
6 53
Alat Suntik Sekali Pakai 2,5 ml 9 19 Rapid HIV 3 (Oncoprobe HIV) 0
7 54
Alat Suntik Sekali Pakai 5 ml 0 3 Sound Timer 0
8 55
Alat Suntik Sekali Pakai 10 ml 0 0 SD Syphilis 0
9 56
Page 446
10
11
12
Catgut/Benang Bedah No.2/0-3/0 (Plain & Cromic) 0 2
13
Etakridin Larutan (Rivanol) 0,1% - 300 ml 0 0
14
Etanol 70 % 1.000 ml 0 0
15
16
17
18
Infus set Anak 0 0
19
20
Iodina Test 0 1
21
22
23
Kapas Pembalut / Adsorbens 250 gram 0 0
24
25
Kassa Pembalut 2 m x 80 cm 0 2
26
Kassa Pembalut Hidrofil 4 m x 3 cm 0 1
27
Kassa Pembalut Hidrofil 4 m x 15 cm 0 0
28
Kertas Puyer 0 0
29
Lysol 1,000 ml 0 0
30
Masker 0 10
31
Plester 5 yard x 2 inchi 0 1
32
Pot Dahak 0 0
33
Rapid HIV 1 (SD HIV) 0 0
34
35
36
Rapid Test Syphilis 0 0
37
RPR Test Syphilis 0 0
38
Silk( Benang Bedah Sutra ) No 3/0 0 4
39
Safety Box 0 0
40
Sarung tangan Steril No 6 0 0
41
42
Sarung tangan Steril No 7,5 0 7
43
Sarung tangan Non Steril S 0 0
44
Sarung tangan Non Steril M 0 0
45
Sarung tangan Non Steril L 0 0
46
Page 447
90
1
10
0
62
9
0
0
0
3
15
0
0
0
40
1
0
0
30
2
52
0
44
0
0
0
47
0
16
128
1
0
282
5
0
0
Page 448
86
0
0
0
0
0
0
84
1
0
1
51
10
41
0
12
58
1
34
0
0
Page 449
0
40
0
18
0
60
0
10
4
8
37
0
40
40
0
2
0
1
72
0
6
0
3
13
10
2
2
0
0
17
10
0
0
0
43
1
19
10
Page 450
0
7
25
58
10
1
50
0
0
10
90
50
14
80
0
0
12
69
-2
51
14
0
22
8
90
2
0
0
0
0
0
0
0
0
0
Page 451
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 0
2 100
3 100
4
5
6
7
8
9 5
10
11 10
12
13
14 1
mg/5 ml 1 10
15 11
16
17
18
19
Analgetik Plus Tablet 40 - 40
20
21 9 10 19
Hidroksida 200 mg 66 1,000 60
22 1,066
Antasida Plus Tablet/TRIANTA Tablet - 50 50
23
24
25
Polimiksin 1000 IU/g 1 3
26 4
27
Asam Benzoat 6% + Asam - 3
28 Salisilat 3% 3
29 50 mg -
Anti Diare Suspensi/Novadiar Botol - 3 3
30
31
32
Anti Hipertensi Kapsul Tablet - - -
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50 1
51
52
53
54
55 10
56
57
58
59
60
61
62
63
Domperidon Tablet 10 mg Tablet 40 100 140
64
65
Efedrin Hcl Tablet 25 mg Tablet 60 - 60
66
67
(Epinefrina /
68 5
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84 28 48
85
86
87
88
89
90 30
91
92
93
94
95
96
97 10
98
99
100 1
101
102
103
104
105 ml 0 -
106
107
108
109 5
110
111
112
113
114
115 1
116
117
118
119
120
121
122
123
124
125 2
126
127 16
128
129 5
130
131 0 20
132 78 108
133 4 11
134
-
135 0 -
136 0 -
137 0 -
138
1 : 80.000-2 ml -
139 0 -
140
141
142
143
144
145
146
Metilergometrin Maleat (Metergin) Tablet 0,1 Tablet 0 20 20
147
148
149
150
151
152
153
154
155
Multivitamin + Mineral tablet/HEMAFORT Tablet 5 35 40
156
157
158
159
160 10
161
162 23
163 7
164 50
165 0
166 0 -
167 0 -
168 0 -
169 0 -
170 0 -
171 0
172 0
173 3
174 2
175 2
176 2 1
177 0
178 2
179 2
180 9
181 0
182 28
183
184
185
186
187
188
189
190
191
192
193
194
195 mg/g-10 ml 0 0 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
units 2,5 ml
210 0 0 -
211 2 25 27
212
Salep Luka Bakar Tube 0 0 -
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
Asam Folat 0,25 mg
230 50 150 200
Serbuk & Cairan
231 0 0 -
232
233
234
235
236
237
238
239
240
241
242
243
244
245
vit k Set 2 30 32
246
247
248
Tablet 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs 0 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit 0 0 -
52
53
54
55
56
Bulan : April Tahun : 2017
JUMLAH PEMA
3 4 5 6 7 8 9 10 11 12 13
17
10
1 1
10 5 30 10 30 10 10
10
30 10 20 10 30 40
1 10 1 1 1 1
1 2 2
20
10 40
1 1 1 1 4
60 30 10 10 10 10 30 30 66 20
10 5 10
20 23 13 10 20
10 10 8
1 1 1
10 10
10 10
2 2 1
16 16
10
12
6 6
1
20
3 6 3 3 8 20 13
10 20 20 20 20 20
10 10 10 20
20 10 10 10 20
1
10 10 10 10 10 10 20 18
10 8 20
10 10 40 40 20 20 10
10
10
1
10
1 2
1 1
20 13 20 3 11 13 10 8 4
10 10 5 5 5 10 5 10
20
1 1 2 1
20
10
1
10 10 10
2 1 2 2 1 1
10
1 2 1 1
1 1
1 1 1
2 2 1 1 1 1
10 10
2 1 1 1 3 2 2
40 70 50 70 36 40 48 40 90 70
20 10
30 20 6 10 40
30 10 20
10 10
10
2 1 1 4 3 2
1 1 1 1 1
10 10
10 10 10
1 1
10 12
20
20
30 10
10 10
20 10 20
10
23 40 30 10 60 18 10 10
26 10 10 20 10 10 32
10
10 10 10 10
10
1
2
1
PEMAKAIAN OBAT
Tahun : 2017
14 15 16 17 18 19 20 21 22 23
10 30 20
10 10
1
10 20 20 10
30 20 50 10
1 2 1
1 1 1
1 1 1 1 3
50 100 50 20 350 30 10
10
1
8
3 20 20 20
8
2 1
20 10 8 10
10 10
1 1
30
60
10 20 20
5 17 6
110
13 13 10
10
40 40 10 10 20
1 1 1
10 10
10 76 10
10 10 178
10 10
10 30 20 291 10
10 20 10
20
1 1
1
38 18 13 53 10 10
30 10 10 20
10
10 10
1 1 1 1
20 44 10
10 120
10
2
10
1
10
138 10
1 1 1 1 2
20 1 1
2
2 1 1
1 1
10
1
1 1 2 1 1
83 125 100 33 396 60 65

10 10
70 30 10 230 30
10 20
10
20 10
1 3 7 1
2
10 10 10
1 1
10 10 10
10 20
10 10
1
30
20 10 360 10
10
18 30 20 3 396 10 6
20 20 40 6 107 10
10
5
3
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 100
177 47
8 38 10
3 6
0 -
0 20
0 40
170 82
0 -
20 29
20 20 10 300 34
0 -
1 2 1 2 26 1
1 1 10 1
20 70
50 62
0 -
0 -
0 40
2 17 2
20 30 10 10 20
1036 30
10 40
0 40
0 -
0 4
0 -
1 1 2
0 -
1 2
8 41 20
0 70
0 -
20 10 179 38
6 42 90
6 1
0 10
0 -
68 62
40 9
0 -
0 -
0 -
2 3
0 15
0 -
0 -
0 -
8 8 16 40
7 1
0 -
0 -
0 30
0 2
6 78 52
0 -
64 44
0 -
0 -
0 -
0 47
0 -
60 16
12 128
0 1
60 -
0 282
0 5
0 -
0 -
0 -
0 -
0 -
0 1
0 -
0 100
0 -
0 -
0 100
0 70
0 35
0 3
0 17
40 8
0 -
0 -
1 3
130 -
0 40
4 10 136 17
0 1
0 -
0 1
0 -
10 70
10 240 -
60 60
10 10 40
0 39
1 6 5
20 76
20 10 10 206 14
1 3
0 -
0 -
0 -
0 -
0 -
10 8 20 339 42
0 -
10 8 18 94 46
10 10 10 541 102
20 70 35
5 10 45 5
2 2
10 86
0 -
0 -
0 -
0 -
0 -
0 -
0 84
3 2 7 1
1 7 -
2 1
10 10 14 18 10 322 51
20 20 10 120 10
75 41
0 -
8 12
10 50 58
1 10 1
0 34
0 -
0 -
0 -
0 -
0 -
0 -
0 40
0 -
74 18
0 -
150 60
0 -
10 10
0 4
2 10 22 8
5 8 37
0 -
0 40
10 20 30 40
0 -
3 2
40 -
1 1 12 1
10 72
0 -
168 6
0 -
0 23
0 7
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
11 2
1 25 2
1 2 8 1
1 1 15 2
0 -
2 -
0 2
0 9
0 -
30 28
0 -
1 3
1 1 1 1 22 2
0 30
20 60 40 30 20 1654 57
0 -
0 -
0 -
0 -
10 5 65 25
0 80
10 20 10 20 556 17
0 -
0 2
0 1
0 -
0 30
0 -
0 -
8 30 128 95
0 -
0 186
0 40
0 -
0 3
10 60 13
40 10
0 -
25 2
2 10 2
0 -
2 -
0 17
20 10
0 -
0 -
0 -
30 100 43
2 1
2 19
0 10
0 -
10 62 7
30 25
10 50 58
20 10
1 1
60 10 10 150 50
0 -
0 -
0 10
0 90
10 10 40 50
10 460 14
0 80
0 -
0 -
40 12
30 36 34 10 10 819 69
10 376 (2)
10 51
50 14
0 -
10 22
2 8
10 10 90
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 7
0 3
1 1 9 19
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
4 1
0 -
0 -
0 -
0 2
0 1
0 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
4
2
9
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 0
2 100
3
4
5
6
7
8 10
Amlodipin Tablet 5 mg Tablet 82 - 82
9
10
11
12 20
13
14 1
mg/5 ml 1 25
15 26
16
Ampisillin Kaplet 500 mg Tablet 62 - 62
17
18
19
Analgetik Plus /Neurovar Tablet 40 160 200
20
21 2 5 7 1
Hidroksida 200 mg 30 700 55
22 730
Antasida Plus Tablet/TRIANTA Tablet 40 100 140
23
24
25
Polimiksin 1000 IU/g 4 -
26 4
27
Asam Benzoat 6% + Asam 2 5
28 Salisilat 3% 7
29 50 mg -
Anti Diare Suspensi/Novadiar Botol 2 3 5
30
31 10
Anti Dotum Oral Tablet Tablet 70 100 170
32
Anti Hipertensi Kapsul/Tensigard Tablet - 60 60
33
34
Antispasmodik Tablet/SCOPMA Tablet 90 - 90
35
36
37
Asam Folat Tablet 1 mg Tablet - - -
38
39 10
Asam Mefenamat Kapsul 500 mg Kapsul 9 - 9
40
41
42
43
44
Asiklovir Tablet 200 mg Tablet 15 100 115
45
46
47
48
49
50
51
52
53
54
55
56
Diazepam tablet 2 mg Tablet 44 - 44
57
58
59
60
61
62
63 10
Domperidon Tablet 10 mg Tablet 128 - 128
64
Donperidon Suspensi 5 mg/5ml Botol 1 3 4
65
Efedrin Hcl Tablet 25 mg Tablet - 60 60
66
Ekstrak Belladone Tablet 10 mg Tablet 282 - 282
67
(Epinefrina /
68 5
69
70
71
72
73
74
75
76
77
78
79
80
Fitomenadion tablet 10 mg Tablet 35 100 135
81
82
83
84 8 58
85
86
87
Glibenklamid Tablet 5 mg Tablet 0 - -
88
89
90
91
92
93
94
95
96
Haloperidol Tablet 1,5 mg Tablet 60 - 60
97
98 30
99
100
101
102 10
Ibuprofen Suspensi 100 mg/5 ml Botol 3 3 6
103
104
105 ml 0 -
106
107
108
109
110
Kalsium Laktat Tablet 500 mg Tablet 46 - 46
111
112 30
113
114
115
116
117
118
119
120
Klindamisin Kapsul 150 mg Kapsul 0 - 40
121
122
123
124 2
Kloramfenikol Tetes Mata -5 ml/RECO Botol 0 - -
125
126 1
127 10
128 40
129
130
Trimetroprim 20 mg -
131 12 12
132 58 58 5
133 1 11
134
-
135 0 -
136 0 -
137 0 -
Lidokain injeksi 2 % Tablet 0 2 2
138
1 : 80.000-2 ml
139 0 -
140
141
142
143
144
Metformin Hcl Tablet 500 mg Tablet 60 - 60
145 10
146
Metilergometrin Maleat (Metergin) Tablet 0,1 Tablet 10 - 10
147
148
149
Metoklopramid 10 mg/xilastin Tablet 37 100 137
150
151
152
153
Metronidazole Infus 500 mg /100 ml Ampul 0 10 10
154
155
Multivitamin + Mineral tablet/HEMAFORT Tablet 0 - -
156
157
Natrium Bikarbonat Tablet 500 mg Tablet 72 100 172
158
159
160
161 0
162 23
163 7
164 50
165 0
166 0 -
167 0 -
168 0 -
169 0 -
170 0 -
171 0
172 0
173 2 1
174 2
175 1
176 2 1
177 0
178 0
179 2
180 9
181 0
182 28
183
184
185
186
187
188
189
190
191
192
193
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 17 300 317
194
195 mg/g-10 ml 0 0 -
196
197
198
199
200
201
202
203
204
205
206
207
208
209
units 2,5 ml
210 0 0 -
211 2 2 4
212
Salep Luka Bakar/neocenta Tube 0 2 2
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
Asam Folat 0,25 mg
230 50 210 260
Serbuk & Cairan
231 0 0 -
232
233
234
235
236
237
238
239
240
241
Vitamin Neurotropik Tablet Tablet -2 80 78
242
243
244
245
vit k Set 22 0 22
246
247
248
Teramysin salep mata tube 0 1 1
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs 0 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit 0 0 -
52
53
54
55
SD Syphilis Pcs 0 -
56
Bulan : Mei Tahun : 2017
JUMLAH PEMA
3 4 5 6 7 8 9 10 11 12 13
10
10 2 10 10
1
10 10 5
10 20
20 10 40 10 40 20 40 60
1 2
10 1 1
30 30 40 20 40 10 70 10 10
20 10
1
10 15 10 10
10
10 10
8 10 10
1 1
10 10 20
10 10
30 6 10
10 6 10 20 60
15
10 10
10
6 11
1 1
10 10 10 30 10
10
5 5 15 10 5
2 1 1
10
10 30 10 20 10
1
20 10 10 10
20 30 20 10 10 20 30 10
10 10
10
1
24 19 10 15 20 41 40 60
10 20 30
10
1
5
10
1
10 10
1
10 10 10
1 2 2 1 2
1 1 1 2 1
1 1 1 1
1 1 1
1 1 1 1
60 83 60 56 40 105 110 100 110

20 10 10 20 35 10 10
10 20 20
10
1 1 1 2
10
10 10
10
1 1
20 40 10
10 10 10 30 20 30
10 10
20 10 10 46 20 20 10 30
5 10 20 10 20
10
3 10 10
1
PEMAKAIAN OBAT
Tahun : 2017
14 15 16 17 18 19 20 21 22 23
10 10
1 1
10 10
10 10
50 30 60 10 10 10
2 1 1 1
10
10
40 30 20 30 10
10 10
10
10 10
20 10
1
10
1 1 1
18 20 5 10 20
1
10 10
1 1
5 5
20
1 2
10
20
10 10 20 20
10
20 10 10
10 10 10 10 20
10
1
1
10 25 20 5 20
5 10 5
2 1 1
10
10
10
10 10
10 10
2
10 6 6
10 10
1 1 1 1
1
1
1 2 1 1 1
1 1 1 1 6
110 90 20 10 60 20 70 20
10
40 20 10 20
10 10
10 10
5
1
1 1
10
10
10
20
10 10 40 70 10
10 30 10 20 36
10
10 5 10 10 10 10
10
10 20
1 1
4 1 2 1 2
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 100
20 10 20 30 90 57
10 10 10 20 102 8
1 4 5
0 -
0 20
10 30
10 10 65 17
0 -
50 79
10 20 20 10 20 70 580 154
0 -
2 1 12 4
3 2 1 20 6
0 70
10 52
0 -
0 -
200 -
1 3 4
30 20 40 10
545 185
40 90 50
40 -
0 -
1 4 -
0 -
1 6
0 -
1 4
65 55
0 170
30 30
10 10 40 198
6 34 56
4 2
10 -
0 -
6 500 62
9 -
0 -
0 -
0 -
2 4
10 105
0 -
0 -
0 -
8 54 16
1 4 2
0 -
0 -
0 30
0 2
8 8 195 57
0 -
15 29
0 -
0 -
0 -
1 46
0 -
30 86
0 128
0 4
60 -
282 -
0 5
0 -
0 -
0 -
0 -
0 -
1 -
0 -
0 100
0 -
0 -
0 100
0 70
40 95
0 3
10 7
5 6 28 30
0 -
0 -
4 4
0 -
20 10 20 50 20
10 90 27
1 -
0 -
0 1
0 -
10 60
20 80
0 60
20 20 15 130 10
0 39
2 3 12 3
20 56
10 120 94
1 5
0 -
0 -
0 -
0 -
0 -
110 32
0 -
10 20 26
10 26 10 266 36
10 10 10 10 30 130 5
10 40 65
1 1 3 2
8 18 68
0 -
0 -
0 -
0 -
0 40
0 -
0 84
1 6 2
0 -
3 1
20 10 20 42 24 75 510 141
100 10
20 15 10 65 76
0 -
0 12
15 43
1 6 5
0 34
0 -
0 -
0 -
2 -
0 -
0 -
0 40
0 -
10 58
0 -
10 20 40
0 -
10 -
0 4
4 6 8
8 10 43 94
0 -
0 40
10 10 30
10 -
1 2 3
10 20 0 -
1 4 -
0 172
0 -
10 10 72 34
0 -
20 103
0 7
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 2 2 1 19 3
1 8 1
1 1 1 8 5
1 1 1 13 1
0 -
1 1
0 2
0 9
0 -
0 28
0 -
3 -
3 1 1 1 20 2
30 -
50 60 40 40 50 100 1544 113
0 -
0 -
0 -
0 -
10 10 30 95
0 80
10 10 60 10 10 305 12
0 -
0 2
0 1
0 -
0 30
0 -
0 -
8 78 17
0 -
0 186
0 40
0 -
0 3
8 10 10 58 55
10 15 25
0 -
1 1 3
1 1 9 3
2 -
2 -
10 20 97
10 10 50
0 -
0 -
0 -
10 30 113
0 1
0 19
0 10
0 -
30 77
0 25
10 30 28
20 -
2 -
20 30 260 -
0 -
0 -
0 10
0 90
0 50
20 10 10 256 58
0 80
0 -
0 -
10 10 60 52
10 8 10 10 299 -
78 -
10 41
18 10 15 96 18
0 -
0 22
1 4 4
0 90
1 1 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 17
0 3
1 1 13 6
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
1 1
0 -
0 -
0 -
0 2
0 1
5 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
3
2
9
REKAPITULASI PENGELUARAN HARIAN APOTEK (Berdasarkan Jenis Pasien)
UPTD PUSKESMAS CIBEUREUM
BULAN : MARET 2017
1 2 3 4
No. Nama Obat Satuan
Umum JKN Umum JKN Umum JKN Umum JKN
A. O B A T
1 Air Raksa Dental Use Botol
2 Albendazole Tablet 400 mg Tablet
3 Alopurinol Tablet 100 mg Tablet 10 50 10
4 Alopurinol Tablet 300 mg Tablet
5 Alprazolam tablet 1 mg Tablet
6 Ambroksol Tablet 30 mg Tablet 10 10 20 5 10 10
7 Ambroksol sirup 15 mg/5 ml Botol 1 3 4 3 1
8 Aminofillin Injeksi 24 mg/ml-10 ml Ampul
9 Aminofillin Tablet 200 mg Tablet
10 Amitriptillin Hcl Tablet Salut 25 mg Tablet
11 Amlodipin Tablet 5 mg Tablet 15 20 10
12 Amlodipin Tablet 10 mg Tablet 10 5
13 Amoksisillin Kapsul 250 mg Kapsul 20 10 10
14 Amoksisillin Kaplet 500 mg Kaplet 40 20 70 10 50 30 60 10
15 Amoksisillin Serbuk Injeksi 1000 mg vial
16 Amoksisillin Sirup Kering 125 mg/5ml Botol 3 5 5 2 2
Amoksisillin Double Strengh Sirup Kering 250 mg/5

17 Botol 1 1 1
ml
18 Ampisilin Kapsul 250 mg Kapsul

19 Ampisillin Kaplet 500 mg Tablet
20 Ampisilin Sirup 125 mg / 5 ml Botol
21 Ampisillin Injeksi 1000 mg Vial
22 Analgetik Plus Tablet 10
Antasida Doen Suspensi Kombinasi : Magnesium

23 Hidroksida 200 mg+ Alumunium Hidroksida 200 Botol 1 1 1 1
mg/5 ml
Antasida Doen Tablet, Kombinasi : Magnesium

24 Tablet 60 20 60 40 90 30 30 30
Hidroksida 200 mg+ Alumunium Hidroksida 200 mg
25 Antasida Plus Tablet Tablet 10 10

26 Antalgin (Metampiron) Tablet 500 mg Tablet
27 Antalgin Injeksi 250 mg/ml-2ml Ampul
Anti Bakteri DOEN Salep Kombinasi :
28 Basitrasin 500 IU/g + Polimiksin 1000 Tube
IU/g
29 Anti Hemoroid Doen komb Supp 3 17
Anti Fungi DOEN Kombinasi :

30 Pot 1 1
Asam Benzoat 6% + Asam Salisilat 3%
Antimigren DOEN Kombinasi :

31 Tablet
Ergotamin Tartrat 1 mg + Kofein 50 mg
32 Anti Diare Suspensi Botol

33 Anti Diare Tablet Tablet
34 Anti Dotum Oral Tablet Tablet
35 Anti Hipertensi Kapsul Tablet
36 Antihistamin Tablet kombinasi Tablet 10
37 Antispasmodik Tablet Tablet
38 Antitusiva Sirup Botol
39 Antitusiva Tablet Tablet
40 Asam Folat Tablet 1 mg Tablet
41 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 45 20 10 19 68 3
42 Asam Mefenamat Kapsul 500 mg Kapsul 5
43 Asetosal Tablet 80 mg Tablet
46 Asiklovir Krim 5 % Tube 1 2
47 Asiklovir Tablet 200 mg Tablet
48 Asiklovir Tablet 400 mg Tablet
49 Attapulgit Tablet 10 10
50 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul
51 Aqua Pro Injeksi Steril, bebas Pirogen 20 ml Vial
52 Bahan Tambal Sementara Set
53 Betahistin Mesilat 6 mg Tablet
54 Betametason Krim 0,1 %- 5g Tube 5 5 1
55 Bisakodil suppositoria 10 mg Supp
56 Bisoprolol Tablet 5 mg Tablet
57 Bromheksin 8 mg Tablet
58 Deksametason Injeksi 5mg/ml-1ml Ampul
59 Deksametason Tablet 0,5 mg Tablet 90 20 64 50 82 5 25 28
60 Devitalisasi Pasta (Non Arsen) Botol
61 Diazepam tablet 2 mg Tablet
62 Diazepam tablet 5 mg Tablet
63 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul
64 Diazepam Larutan Rektal 5 mg/ml Supp
65 Diazepam Larutan Rektal 10 mg/ml Supp
66 Dietilkarbamazin Sitrat Tablet 100 mg Tablet
67 Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul
68 Digoksin Tablet 0,25 mg Tablet
69 Dimenhidrinat Tablet 50 mg Tablet 6
70 Domperidon Tablet 10 mg Tablet 10 10
71 Domperidon Suspensi 5 mg/5ml Botol 1
72 Efedrin Hcl Tablet 25 mg Tablet 46
73 Ekstrak Belladone Tablet 10 mg Tablet
Epinefrin HCl / Bitartrat
74 (Epinefrina / Adrenalina) Injeksi Ampul
0,1%/- 1ml
75 Eritromisin Kapsul 250 mg Kapsul
76 Eritromisin Kapsul 500 mg Kapsul
77 Eritromisin Sirup 200 mg / 5 ml Botol
78 Etambutol Tablet 500 mg Tablet
79 Etanol 70 % 100 ml Botol
80 Etil Klorida Semprot -100 ml Botol
81 Eugenol Cairan -10 ml Botol
82 Fenitoin Natrium Kapsul 100 mg Kapsul
83 Fenobarbital tablet 30 mg Tablet
84 Fenobarbital injeksi 50 mg / ml Ampul
85 Fenoksimeti Penisilin 250 mg tablet Tablet
86 Fenoksimeti Penisilin 500 mg tablet Tablet
87 Fenol Gliserol TK Botol
88 Fitomenadion tablet 10 mg Tablet
89 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul
90 Furosemid Tablet 40 mg Tablet
91 Furosemid injeksi Ampul
Garam Oralit I serbuk, kombinasi :

( Nacl 0,52 gr, Kalium Klorida 0,30
92 Kantong 12 6
gr, Trinatrium Sitrat dihidrat 0,58 gr, Glukosa
Anhidrat 2,70 g )200 ml Air
93 Gemfibrozil Tablet 600 mg Tablet

94 Gentian Violet Botol 2
95 Gentamisin injeksi 80 mg / 2 ml Vial
96 Gentamisin Salep Kulit 0,1 % Tube 2 8 1
97 Glass Ionomer Set
98 Glibenklamid Tablet 5 mg Tablet 20 10
99 Glimepiride 2 mg Tablet 30
100 Gliseril Guayakolat Tablet 100 mg Tablet 27 13 52 5 9
101 Gliseril Guayakolat sirup Botol 4
102 Glukonas Kalsikus injeksi Ampul
103 Glukosa Larutan Infus 5 % Botol
104 Glukosa Larutan Infus10 % Botol
105 Griseofulvin Tablet 125 mg,micronized Tablet 10
106 Haloperidol Tablet 0,5 mg Tablet
107 Haloperidol Tablet 1,5 mg Tablet 13
108 Haloperidol Tablet 5 mg Tablet
109 Hidroklortiazid (HCT) Tablet 25 mg Tablet
110 Hidrokortison Krim 2,5 % Tube 3 1 1 1
111 Ibuprofen Tablet 200 mg Tablet
112 Ibuprofen Tablet 400 mg Tablet 20 10 40 30 20 10
113 Ibuprofen Suspensi 100 mg/5 ml Botol
114 Ichtyol salep Kulit Pot
115 Isoniazid tablet 100 mg Tablet
116 Isosorbid Dinitrat 5 mg Tablet
117 Kalium Diklofenak Tablet 25 mg Tablet
118 Kalium Diklofenak Tablet 50 mg Tablet
119 Kalsium Hidroksida Pasta Tube
120 Kalsium Laktat Tablet 500 mg Tablet 10 7 20 10
121 Kaptopril 12,5 mg Tablet
122 Kaptopril 25 mg Tablet
123 Karbamazepin Tablet 200 mg Tablet
124 Ketokonazole Krim 2 % - 15 gr Tube 1
125 Ketokonazole Tablet 200 mg Tablet
126 Ketoprofen Tablet 100 mg Tablet
127 Ketoprofen Injeksi 100 mg / 1 ml Ampul
128 Ketorolac 10 mg injeksi Ampul
129 Ketorolac 30 mg injeksi Ampul
130 Klindamisin Kapsul 150 mg Kapsul
131 Klindamisin Kapsul 300 mg Kapsul
132 Kloramfenikol Kapsul 250 mg Kapsul 10
133 Kloramfenikol suspensi125mg/5 ml Botol
134 Kloramfenikol Salep Mata 1%-3,5 g Tube 1 1
135 Kloramfenikol Salep Kulit 2% Tube
136 Kloramfenikol Tetes Mata -5 ml Botol 1 1
137 Kloramfenikol Tetes Telinga 3%-5 ml Botol 1 1
138 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 115 45 79 46 111 23 96 33
139 Klorpromazin Hcl Tablet Salut 25 mg Tablet
140 Klorpromazin Hcl Tablet Salut 100 mg Tablet 13
141 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul
Kombinasi Ipatropium Bromide + Salbutamol
142 Sulphate for inhalation 2,5 Vial
ml
143 Kombipak Cefixime+ Azithromisin Kotak
Kotrimoksazol Pedriatik Tablet, Kombinasi :

144 Tablet
Sulfametoksazol 100 mg + Trimetroprim 20 mg
Kotrimoksazol Tablet, Kombinasi :

145 Tablet 10 10
Sulfametoksazol 400 mg + Trimetroprim 80 mg
Kotrimoksazol Suspensi Kombinasi :

146 Sulfametoksazol 200 mg + Trimetroprim 40 Botol 1 1 1 1
mg/5 ml
147 Lansoprazole 30 mg Kapsul Tablet
Larutan mengadung Elektrolit

148 (Na 130 mEq,Cl 109 mEq, Asetat Botol
28 mEq) /Asering
Larutan mengadung Elektrolit

149 Botol
(Nacl 1,125 gr , Dekstrosa 18,75 gr)
Larutan mengadung Karbohidrat + Elektrolit

150 (Nacl 1,75 gr, KCL 1,5 gr, Na Botol
151 Lidokain injeksi 2 % Tablet

Lidokain Komp Injeksi, Kombinasi :
152 Lidokain Hcl 2% +Epinefrin 1 : 80.000- Ampul
2 ml
153 Loperamid Tablet 2 mg Tablet
154 Loratadin tablet 10 mg Tablet
155 Magnesium Sulfat (IV) 20 %-25 ml Ampul
156 Magnesium Sulfat (IV) 40 %-25 ml Ampul
157 Meloksikam tablet 15 mg Tablet 16 10 20
158 Meloksikam Suppositoria Supp
159 Metformin Hcl Tablet 500 mg Tablet
160 Methisoprinol 500 mg Tablet
Metilergometrin Maleat (Metergin) Tablet 0,125

161 Tablet
mg
162 Metilergometrin Maleat Injeksi 0,200 mg-1ml Ampul

163 Metilprednisolon tablet 4 mg Tablet
164 Metoklopramid 10 mg Tablet
165 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul
166 Metronidazol Tablet 250 mg Tablet
167 Metronidazole Tablet 500 mg Tablet 10
168 Metronidazole sirup 125 mg/ml Botol 1
169 Metronidazole Infus 500 mg /100 ml Ampul
170 Mikonazole KrIm 2 % - 10 gr Tube 1
171 Multivitamin + Mineral tablet Tablet 10 10
172 Multivitamin sirup Botol 1
173 Mummifying Pasta Botol
174 Natrium Bikarbonat Tablet 500 mg Tablet
175 Natrum Diklofenak Tablet 25 mg Tablet
176 Natrium Diklofenak Tablet 50 mg Tablet 10 20 20
177 Natrium Klorida Larutan infus 0,9%-Steril 500 ml Botol
178 Nipedifin Tablet 10 mg Tablet

179 Nistatin 100.000 IU/gram Tablet Vagina Tablet
180 Nistatin 500.000 IU/gram Tablet Salut Tablet
181 Obat Antitiuberkolosis Kategori Anak Paket
182 Obat Antitiuberkolosis Kategori 1 Dewasa Paket
185 Obat Anti Tuberkulosis FDC Kat Anak Paket
186 Obat Anti Tuberkulosis FDC Kat I & II Paket
187 Obat Anti Tuberkulosis FDC Kat I & III Paket
188 Obat Anti Tuberkolosis FDC Sisipan Dewasa Paket
189 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 1 3 8 2 2 1
190 Obat Batuk Cair Sirup (Ekspektoran) Botol 1
191 Obat Batuk Hitam Plus Sirup Botol 1 2
192 Obat Flu Sirup Botol 2 3 3 4
193 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 ml Vial
194 Oksiterasiklin Salep Mata 1%-3,5g Tube
195 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube
196 Oksitosin Injeksi 10 IU/ml-1ml Ampul
197 Omeprazole injeksi 40mg/10ml Ampul
198 Omeprazole Kapsul 20 mg Tablet 6 6 6
199 Ondansetron inj 4 mg/ 2 mL Ampul
Parasetamol drop 100 mg/ml btl @15ml
200 Botol
(60mg/0,6ml)
201 Parasetamol Sirup 120 mg/5ml-60 ml Botol 3 1 5 4 1

202 Parasetamol Tablet 100 mg Tablet
203 Parasetamol Tablet 500 mg Tablet 141 58 92 70 148 30 132 45
204 Pehacain injeksi Ampul
205 Perak Sulfadiazin krim 1 % 35 gr Tube
206 Permetrin krim 5 % Tube 1 1
207 Piracetam 400 mg Tablet
208 Piracetam Tablet 800 mg Tablet
209 Piroksikam Tablet 20 mg Tablet 10
Pirantel Pamoat Tablet 365 mg (Setara dng 125 mg

210 Tablet
Basa)
211 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 20 3 5 32 20 10
Polikresulen (Kondensasi Metakresol

212 Botol
Sulfonat dan Metanal) 360 mg/g-10 ml
213 Povidon Iodida 10% 30 ml Botol

216 Prednison Tablet 5 mg Tablet 60 10 10
217 Primakuin tablet 15 mg Tablet
218 Prokain Benzil Penisilin Injeksi 3,000,000 IU Vial
219 Propanolol Hcl Tablet 40 mg Tablet
220 Propilturasil Tablet 100 mg Tablet
221 Ranitidin Injeksi 25 mg / ml Ampul
222 Ranitidin Tablet 150 mg Tablet 10 20 10
223 Retinol (Vit. A) 100.000 IU Kapsul Kapsul
224 Retinol (Vit. A) 200.000 IU Kapsul Kapsul
225 Reserpin Tablet 0, 25 mg Tablet
226 Rifampisin Tablet 450 mg Tablet
227 Ringer Laktat Larutan Infus Steril 500 ml Botol
228 Salbutamol Tablet 2 mg Tablet 10 10 10
229 Salbutamol Tablet 4 mg Tablet
Salbutamol solution for Inhalation single dose units

230 Ampul
2,5 ml
Salep 2-4 Kombinasi :

231 Asam Salisilat 2 % + Belerang Pot
Endap 4 % - 30 gram
232 Salisil bedak 2% -50 gr Kotak 1 3 1

233 Salep Luka Bakar Tube
234 Sefadroksil Sirup Kering 125 mg / 5 ml sirup Botol
235 Sefadroksil Tablet 500 mg Tablet 30 6
236 Sefiksim Kapsul 100 mg Kapsul
237 Sefotaksim Injeksi 1 gr Ampul
238 Seftriakson Injeksi 1 gr / vial Ampul
239 Semen Seng Fosfat Serbuk & Cairan Botol
240 Setirizin Tablet 10 mg Tablet 10 10 10 6
241 Setirizin Sirup 5 mg / 5 ml Botol
242 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul
243 Sianokobalamin Tablet 50 mcg Tablet
244 Silver Amalgam Serbuk 65-75% Botol
245 Simetidin 200 mg Tablet Tablet 10 10
246 Simvastatin Tablet 10 mg Tablet 12 5
247 Siprofloksasin 500mg Tablet 10
248 Spironolakton Tablet 25 mg Tablet
249 Sulfacetamid Tetes Mata 15 %-5ml Botol
Tablet Tambah Darah Kombinasi:
250 Besi II Sulfat 200 mg + Asam Folat 0,25 Tablet
mg
Temporary Stopping Fletcher (Fletcher) Serbuk &
251 Set
Cairan
252 Trikesol formalin ( T K F ) Cairan 10 ml Botol

253 Tetrasiklin Kapsul 250 mg Kapsul
254 Tetrasiklin Kapsul 500 mg Kapsul
255 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1ml Ampul
256 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 30 20 30 10 10 20
257 Thiamfenikol Kapsul 500 mg Kapsul
258 Tramadol Injeksi 50 mg/ ml Ampul
259 Tramadol Tablet 50 mg Tablet
260 Triheksifenidil Hidroklorida Tablet 2 mg Tablet
261 Vitamin B .Komplek Tablet Tablet 31 30 10 55 40 52 10
262 Vitamin Neurotropik Tablet Tablet 10 20 30 10 45 15 5 15
263 Zinc Tablet 20 mg Tablet 10 10
B. BAHAN MEDIS HABIS PAKAI (BMHP)
264 Abbocath No 18 ( IV Chateter 18 ) Buah

268 Alat Gula, Kolesterol, Asam Urat Unit
269 Alat Suntik Sekali Pakai 1 ml Set
270 Alat Suntik Sekali Pakai 2,5 ml Set
273 Alkohol Swab Kotak
274 Auto Disposable Syringe (ADS) 0,05 ml set
275 Auto Disposable Syringe (ADS) 0,5 ml set
276 Auto Disposable Syringe (ADS) 5 ml set
277 Catgut/Benang Bedah No.2/0-3/0 (Plain & Cromic) Sachet
278 Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol

279 Etanol 70 % 1.000 ml Botol
280 Folley Catheter no 14 Set
283 Infus set Anak Set
284 Infus set Dewasa Set
285 Iodina Test Botol
286 Kapas Berlemak 500 gram Bungkus
287 Kapas Pembalut / Adsorbens 250 gram Bungkus
288 Kassa Pembalut 2 m x 80 cm Rol
289 Kassa Pembalut Hidrofil 4 m x 3 cm Rol
290 Kassa Pembalut Hidrofil 4 m x 15 cm Rol
291 Kassa Hidrofil Steril 16 x 16 Kotak
292 Kassa Kompres 40 x 40 steril Bungkus
293 Kertas Puyer Pcs
294 Lysol 1,000 ml Botol
295 Masker Buah
296 Plester 5 yard x 2 inchi Rol
297 Polifix 5 cm x 5 m Rol
298 Pot Dahak Pcs
299 Rapid HIV 1 (SD HIV) Pcs
300 Rapid HIV 2 (Intec HIV) Pcs
301 Rapid HIV 2 (Biomeriux HIV) Pcs
302 Rapid Test Syphilis Pcs
303 RPR Test Syphilis Pcs
304 Silk( Benang Bedah Sutra ) No 3/0 Sachet
305 Safety Box Pcs
306 Sarung tangan Steril No 6 Pcs
307 Sarung tangan Steril No 7 Pcs
308 Sarung tangan Steril No 7,5 Pcs
309 Sarung tangan Non Steril S Pcs
310 Sarung tangan Non Steril M Pcs
311 Sarung tangan Non Steril L Pcs
312 Stik Pemeriksaan Gula Darah Test
313 Stik Pemeriksaan Kolesterol Test
314 Stik Pemeriksaan Asam Urat Test
315 Supratul Kotak
316 Urine Bag set
317 Wing Neddle No 23 Set
318 Cairan antiseptik Hands Rub Botol
C. VAKSIN DAN SERUM

319 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (ABU I ) Vial
320 Serum Anti Tetanus (ATS) Injeksi 1.500 IU/ampul Ampul
5 6 7 8 9 10 11 12 13
Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum
5 20 5 10 20 30 20 20 10
20 7 30 20 30 10 15
1 2 1 3 1
7
24 6 16 5 15
10 10 15 5 6
10 10 10 40
80 10 60 20 30 20 70 20 70 10 20 20 50
3 6 2 5 1 3 1 3
2 1 1 1 1
10
1 3 1 1 4 1 2 1 3
40 10 70 20 30 10 30 50 40 20 100 60 50
20 20 10 20
1
40 20 16 20 16
10
40 30 10 61 17 10
2 1
12 14
10 10 20 10 10 10
5 4 1 1 2 2
10 5
57 42 26 39 21 60 20 35 44 64
5 20 60
10 10 10
6 10 12
3 1
20 10
20
10
10 5
10 5 5
6 24 70 6 12 12
3 1 3 4 1 1 1
10 10
10 20 10
95 2 69 10 26 20 27 10 18 18 45
2 1 1 1 2 2 3 5 1
20 10
14 20
60
2 1 1 1
10 10
30 30 10 40 20 10 30
2
5 5
20 10 5 23 20 10 15
10
6 10
1 2 1
10
10 10 10
1 1 1 2
1 1 1 1 1
119 12 159 45 76 5 157 65 84 18 99 16 102
14 10
30
10 12 12 12
3 1 1 4 2 2
15 20
10 10 5 10
20
20
10 10 6 20 10 10
3 1 1
10 10 20 30 50 10 30 10 20
5 3 1 3 1
20 10 3
10 10 20 10 10 20 20 10
10 10
1 1 2 2 1 1 2 2 2 2 5 1 3
4 1 1
2 3 3
1 10 2 2 1 10
2 3
1
6 22 10 5 5 5 5 11
4 1 4 9 3 3 6 7
172 56 209 65 122 45 208 40 110 40 147 70 176
2 1
22
33 10 10 40 10 95 20 10 10 50 30 12
20 10 10 10
28 12 6 22 10 10 10
10 10 9 12 29
10 12
1 1 1
1 4 2 2 1 1 4
1
16 6 6 12 6 10 10
16
5 10 5
1
6 6 12
5 35
10 10 10
10 30 30
20 5 40 30
145 30 38 35 43 40 10 30 78 20 62 10 35
20 10 10 20 20 30 15 5 20 26
10 30 20
13 14 15 16 17 18 19 20 21
JKN Umum JKN Umum JKN Umum JKN Dinkes JKN Umum JKN Umum JKN Umum JKN Umum JKN
10 20 10 40 5 10 10 10 20 15 10
30 10 4 15 10 30 10 20
4 2 2 1 1
15
5 5 5 15 10 10 30 10 20 25 10 10 10
10 5 5 30 20 5
20 20 20 10 10 10 10 10 10
20 60 20 80 20 20 20 50 10 30 20 90 10 40
4 12 3 8 1 6 1 7 2 7 1
1 2 2 1 1
1 2 1 2 2 1 1 1 5 1 2
20 40 100 80 170 30 40 40 80 120 100 110 30 50 30
10 10
1
12 15 10
5 10
26 18 25 6 33 16 52 20 50 20 4
1 2
12
10
1 2 2 4 2 1
10 20 10 10 10 40
40 45 58 80 49 71 33 27 10 66 23 113 51 127 15
10
10 10
10 10 10 26
1 1 1 1 1 1
10
20
5 5
12 6 6 12 6 24
1 1 1 1
10
10
10 228 3 35 30 20 23 59 20 21 16 339 18 5
2 1 4 1 6 2 1 4 1
30 15
15
50
2 1 3 2 1 2 1 1
30
10 20 10 10 30 20 30 20 10 60 50 30 30 30 20
1 1 1
10 10 10 10
10 90 10 10 20 10
10 10
50 20
1 1 1 1
2 1 1
1 1 1 1
1 2
57 78 92 135 141 52 18 143 61 149 75 131 74 68 15
30
15 30
14 20 22 20 30
3 2 1 6 2 5 2
5 15 10 20
10
5 5 10 5
10 (10)
16 16 10
1 1
10 10 10 6 10 20 10 10
2 1 1 2 1 1 2
3 110 10
10 22 10 40 10 10 10 16 10
1 2 2 5 2 1 2 4 2 2 2 3 4 2
1 1 1 1 1
1 2
1 3 1 2 2 1 1
15 5 5 5 20
3 2 5 1 2 5 9 2 10 1 1 1
60 178 110 199 191 55 34 142 135 127 195 244 72 99 10
20 10 10 10
19 20 10 13 10 20 47 10 80 13 10
10 10 10 30 10 10 10 10 10
26 6 10 16 10 16 30 26 36 20
10 10 4 10 10
23 10
1 1 2 1 1 1
2 1 1 1 2 1 1 1
20 10 4
10
6 5 10
6 10 10 10 16 10 32
30 30
30 50 10 70 14 10 20 40 30 50 20 20
15
40 29 50 62 90 15 5 22 10 19 39 82 45
10 5 10 12 15 5 10 35 70 50 68 57 30 5 5
10 10 10 20 10 30
22 23 24 25 26 27 28 29 30
Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum JKN Umum
10 10 10 70 10 10 15 10 10
20 15 10
1 1 2 1 1
15
10 35 20 5 10 32 10 10
5 5 5 10 10 10 11
30 10 30 10 20 10 10 20
20 40 40 50 50 10 50 50 120 60 40 30 90
3 5 3 1 1 7 1 4 1 5
1 2
3 1 1 1 1 3
40 20 20 20 70 30 20 20 50 40 30 40
10 10
1
20 10 20
1 2
22 20 48 27 10 5 15 6
1 1
1 3 1 2 3 1 1 4
10 10 30 10 20 10 10
42 36 75 10 91 10 76 50 119 39 92 30 78
20 2
10 10 10 10
12
1 1
10
5
5 16
12 18 6
1 1 3
10 10
5 28 10 11 24 20 172 3 24 13 34
3 2 4 6 3
12 34 10 20 10 10
30
30
3 1 1 1 1 2 2 2
20 10 24 20
20 20 20 10 20 40 70 30 20 40 100
10 10
4 70 20 20 10 30 10
10
20 10
2 3 1 1
26 15
20 30
1 1 2 1
1 1 2 2 1 1
2 1
102 16 39 30 118 25 80 10 193 33 101 58 123
30 30
10 10
2 1
10 10 10 5 10
10 10
5 10 10 20 10
10
10
10 10 6 16
1 1 1
20 70 20 10 10 30 20 30 10 10
1 1 1 3 5 1
10 30 10 10 10 10
3 4 2 4 1 3 2 2 2 3 2
1 1 1 1 1
1 1 1 1 1 1
1 1
5 5
5 4 2 4 7 6 3
93 50 96 35 136 25 84 20 240 50 69 48 85
10 20 30 10
34 10 24 10 30 30 10 10 22
23 10 20 10 10 10 22 40
10 40 50 10 10 40 16 10 10 40
10 10 40 20 10
1 2 1 1
1 2 1 1 2 1
1
10 16 6 6
20 15
1
10 10
10 20 5 10 5
10 10 10 6 16 10 10
120 30 30 30
20 30 10 10 10 20 30
36 40 27 10 34 20 4 48 40 32 10 50
5 16 30 20 22 12 30 20 35 15 35
10 10 10 10
2
30 31 Jumlah Jumlah
Jumlah Total
JKN Umum JKN Umum JKN
- - -
- - -
10 280 255 535
- - -
- - -
256 115 371
2 28 10 38
- - -
- - -
37 - 37
5 248 165 413
10 5 107 100 207
10 270 110 380
10 30 40 1,410 580 1,990
- - -
4 115 13 128
1 13 7 20
- - -
- - -
- - -
- - -
10 10 20
1 1 34 18 52
20 50 150 1,400 1,150 2,550
20 10 90 70 160
- - -
- - -
- - -
8 20 28
4 2 6
- - -
1 1 2
- - -
- - -
- - -
10 147 72 219
5 20 25
1 2 3
- - -
- - -
10 15 654 127 781
5 - 5
- - -
- - -
- - -
1 9 3 12
- - -
14 24 38
10 10 80 40 120
- - -
- - -
- - -
- - -
1 45 10 55
- - -
- - -
155 60 215
- - -
10 87 56 1,775 706 2,481
- - -
27 85 112
- - -
- - -
- - -
- - -
- - -
- - -
- 10 10
60 36 96
10 10 96 40 136
1 8 6 14
46 - 46
- - -
- - -
- - -
40 10 50
- - -
- - -
- - -
- - -
- - -
30 70 - 70
- - -
- - -
- - -
10 - 10
- - -
25 - 25
- - -
10 51 10 61
- - -
6 6 226 36 262
- - -
- 2 2
- - -
23 11 34
- - -
50 30 80
80 - 80
35 16 1,452 216 1,668
1 1 54 10 64
- - -
- - -
- - -
106 30 136
- - -
94 28 122
10 - 115 115
50 - 50
2 22 17 39
74 50 124
20 650 440 1,090
3 2 5
- - -
- - -
- - -
- - -
45 25 70
- - -
10 10 239 245 484
30 10 40
100 16 116
- - -
2 1 13 6 19
20 15 71 15 86
- - -
- - -
- - -
- - -
- - -
60 20 80
- 10 10
- - -
1 9 5 14
- - -
1 13 7 20
9 4 13
10 123 122 2,832 1,145 3,977
84 30 114
10 - 98 98
- - -
- - -
- - -
- - -
10 128 74 202
3 39 5 44
15 10 80 75 155
- - -
- - -
- - -
- - -
- - -
10 - 10
10 10 20
- - -
- - -
20 101 80 181
- - -
10 20 30
- - -
10 20 30
- - -
- - -
- - -
- - -
- - -
6 110 56 166
1 - 1
- - -
6 5 11
286 240 526
31 5 36
- - -
126 30 156
- - -
10 166 222 388
- - -
10 10 20
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
5 - 5
- - -
1 4 7 68 48 116
13 4 17
1 17 4 21
1 1 37 16 53
- - -
1 7 - 7
- 1 1
- - -
- - -
59 88 147
- - -
- - -
4 1 119 10 129
- - -
40 156 200 3,660 1,794 5,454
- - -
- - -
7 - 7
- - -
- - -
52 100 152
- - -
20 10 676 206 882
- - -
- - -
- - -
- - -
10 235 160 395
- - -
- - -
- - -
- - -
- - -
10 358 222 580
- - -
- - -
- - -
- - -
- - -
10 145 99 244
12 43 55
3 4 - 4
11 4 15
29 9 38
1 1 2
- - -
76 64 140
16 - 16
- - -
- - -
- - -
54 71 125
1 2 1 3
- - -
- - -
- - -
32 42 74
10 42 96 138
150 56 206
- - -
- - -
30 190 180 370
- - -
- - -
- - -
- - -
- - -
10 20 50 409 380 789
- - -
- - -
- - -
- 15 15
43 60 1,082 684 1,766
25 5 30 562 451 1,013
190 20 210
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 2 2
- - -
- - -
No Nama Obat
ian stok 36
Air Raksa Dental Use 0 0 Antitusiva Tablet 10 0
1 37
Albendazole Tablet 400 mg 0 100 Asam Folat Tablet 1 mg 0 0
2 38
Alopurinol Tablet 100 mg 90 57 Asam Askorbat 50 mg 500 62
3 39
4 40
5 41
6 42
7 43
Amitriptillin Hcl Tablet Salut 25 m 10 30 Asiklovir Krim 5 % 2 4
8 44
9 45
10 46
11 47
12 48
Amoksisillin Serbuk Injeksi 1000 mg 0 0 Betahistin Mesilat 6 mg 54 16
13 49
Amoksisillin Sirup Kering 125 mg/5 12 4 Betametason Krim 0,1 %- 5g 4 2
14 50
Kering 250 mg/5 ml
15 20 6 51 0 0
16 52
17 53
18 54
19 55
Analgetik Plus 200 0 Devitalisasi Pasta (Non Arsen) 0 0
20 56
Antasida Doen Suspensi Diazepam tablet 2 mg
21 3 4 57 15 29
Antasida Doen Tablet, Kombinasi Diazepam Injeksi i.v/i.m 5 mg/ml
22 545 185 58 0 0
Antasida Plus Tablet 90 50 Diazepam Larutan Rektal 5 mg/m 0 0
23 59
Antalgin (Metampiron) Tablet 500 40 0 Dietilkarbamazin Sitrat Tablet 1 0 0
24 60
Antalgin Injeksi 250 mg/ml-2ml 0 0 Difenhidramin HCl Injeksi 10 mg/ 1 46
25 61
Anti Bakteri DOEN Salep Digoksin Tablet 0,25 mg
Kombinasi :
26 4 0 62 0 0
Anti Hemoroid Doen komb 0 0 Dimenhidrinat Tablet 50 mg 30 86
27 63

28 3% 1 6 64 0 128

29 50 mg 0 0 65 0 4
Anti Diare Suspensi 1 4 Efedrin Hcl Tablet 25 mg 60 0
30 66
Anti Diare Tablet 65 55 Ekstrak Belladone Tablet 10 mg 282 0
31 67
32 0 170 68 Injeksi 0,1%/- 1ml 0 5
Anti Hipertensi Kapsul 30 30 Eritromisin Kapsul 250 mg 0 0
33 69
Antihistamin Tablet kombinasi 40 198 Eritromisin Kapsul 500 mg 0 0
34 70
71 116
72 117
73 118
74 119
75 120
76 121
77 122
78 123
Fenoksimeti Penisilin 250 mg table 0 100 Kloramfenikol Salep Mata 1%-3,5 6 2
79 124
Fenoksimeti Penisilin 500 mg tabl 0 70 Kloramfenikol Tetes Mata -5 ml 0 0
80 125
81 126
Fitomenadion (Vit K1) Injeksi 2 m 0 3 Klorfeniramin Maleat (CTM) Table 510 141
82 127
83 128
Garam Oralit I serbuk, Klorpromazin Hcl Tablet Salut 10
kombinasi :
2,70 g )200 ml Air
84 28 30 129 65 76
Gemfibrozil Tablet 600 mg 0 0 Klorpromazin Hcl Injeksi 5 mg/ml 0 0
85 130
Kombinasi :
Trimetroprim 20 mg
86 0 0 131 0 12
:
Trimetroprim 80 mg
87 4 4 132 15 43
Kombinasi :
88 0 0 133 6 5
Glimepiride 2 mg 50 20 Lansoprazole 30 mg Kapsul 0 34
89 134
28 mEq) /Asering
90 90 27 135 0 0
gr)
91 1 0 136 0 0
+ Elektrolit
92 0 0 137 0 0
Glukosa Larutan Infus 5 % 0 1 Lidokain injeksi 2 % 2 0
93 138
Kombinasi :
Lidokain Hcl 2%
94 0 0 139 0 0
Griseofulvin Tablet 125 mg,microni 10 60 Loperamid Tablet 2 mg 0 0
95 140
Haloperidol Tablet 0,5 mg 20 80 Loratadin tablet 10 mg 0 40
96 141
97 142
98 143
99 144
100 145
101 146
102 147
103 148
104 149

105 0 0 150 43 94
Isoniazid tablet 100 mg 0 0 Metoklorpropamid Injeksi 5 mg/ 0 0
106 151
107 152
108 153
109 154
110 155
111 156
112 157
113 158
114 159
115 160
Natrium Klorida Larutan infus 0,9%- 0 0 Rifampisin Tablet 450 mg 0 0
161 206
162 207
Nistatin 100.000 IU/gram Tablet V 0 7 Salbutamol Tablet 2 mg 58 55
163 208
Nistatin 500.000 IU/gram Tablet Sa 0 50 Salbutamol Tablet 4 mg 15 25
164 209
Obat Antitiuberkolosis Kategori A Salbutamol solution for
ml
165 0 0 210 0 0
Obat Antitiuberkolosis Kategori 1 Salep 2-4 Kombinasi :

166 0 0 211 Endap 4 % - 30 gram 1 3
Obat Antitiuberkolosis Kategori 2 0 0 Salisil bedak 2% -50 gr 9 3
167 212
Obat Antitiuberkolosis Kategori 3 0 0 Salep Luka Bakar 2 0
168 213
Obat Anti Tuberkulosis FDC Kat A 0 0 Sefadroksil Sirup Kering 125 mg / 2 0
169 214
Obat Anti Tuberkulosis FDC Kat I & 0 0 Sefadroksil Tablet 500 mg 20 97
170 215
Obat Anti Tuberkulosis FDC Kat I & 0 0 Sefiksim Kapsul 100 mg 10 50
171 216
Obat Anti Tuberkolosis FDC Sisipa 0 0 Sefotaksim Injeksi 1 gr 0 0
172 217
Obat Batuk Hitam (OBH) Cairan 10 19 3 Seftriakson Injeksi 1 gr / vial 0 0
173 218
Obat Batuk Cair Sirup (Ekspektoran 8 1 Semen Seng Fosfat Serbuk & Cair 0 0
174 219
175 220
Obat Flu Sirup 13 1 Setirizin Sirup 5 mg / 5 ml 0 1
176 221
Oksiterasiklin Hcl injeksi i.m.50 m 0 0 Sianokobalamin Injeksi 500 mcg/ 0 19
177 222
178 223
Oksitetrasiklin Hcl Salep Kulit 3%-5 0 2 Silver Amalgam Serbuk 65-75% 0 0
179 224
180 225
181 226
182 227
Ondansetron inj 4 mg/ 2 mL 0 0 Spironolakton Tablet 25 mg 20 0
183 228
Parasetamol drops 3 0 Sulfacetamid Tetes Mata 15 %-5m 2 0
184 229
Parasetamol Sirup 120 mg/5ml-60 Tablet Tambah Darah
Kombinasi:
Asam Folat 0,25 mg
185 20 2 230 260 0
186 30 0 231 0 0
187 232
188 233
189 234
190 235
191 236
192 237
Pirantel Pamoat Tablet 365 mg Tramadol Injeksi 50 mg/ ml
(Setara dng 125 mg Basa)
193 0 80 238 0 0
Piridoksin Hcl (Vit.B6) Tablet 10 m 305 12 Tramadol Tablet 50 mg 0 0
194 239
Polikresulen (Kondensasi Triheksifenidil Hidroklorida Table
Metakresol
mg/g-10 ml
195 0 0 240 60 52
Povidon Iodida 10% 30 ml 0 2 Vitamin B .Komplek Tablet 299 0
196 241
197 242
198 243
199 244
200 245
Ranitidin Injeksi 25 mg / ml 0 0 vit k 0 22
201 246
Ranitidin Tablet 150 mg 78 17 gentian violet 4 4
202 247
Retinol (Vit.A) 100.000 IU Kapsul 0 0 kloramfenikol 500 0 90
203 248
Retinol (Vit.A) 200.000 IU Kapsul 0 186 Teramysin sm 1 0
204 249
205 250

no 47
1 48
2 49
3 50
4 51
5 52
6 53
7 54
8 55
9 56
Auto Disposable Syringe (ADS) 0,05 0 0
10
11
12
Catgut/Benang Bedah No.2/0-3/0 ( 0 2
13
Etakridin Larutan (Rivanol) 0,1% - 0 0
14
Etanol 70 % 1.000 ml 0 0
15
16
17
18
Infus set Anak 0 0
19
20
Iodina Test 0 1
21
22
23
Kapas Pembalut / Adsorbens 250 g 0 0
24
25
26
Kassa Pembalut Hidrofil 4 m x 3 c 0 1
27
Kassa Pembalut Hidrofil 4 m x 15 5 0
28
Kertas Puyer 0 0
29
Lysol 1,000 ml 0 0
30
Masker 0 10
31
32
Pot Dahak 0 0
33
34
35
36
37
38
39
Safety Box 0 0
40
41
42
43
44
45
46
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 0
2 100
3
4
Ambroksol sirup 15 mg/5 ml Botol 5 - 5
5
6
7
8
9
10
11
12
13
14
mg/5 ml 6 5
15 11
16
17
18
19
Analgetik Plus /Neurovar Tablet - - -
20
21 4 5 9
22 685
Antasida Plus Tablet/TRIANTA Tablet 50 - 50
23
Antalgin (Metampiron) Tablet 500 mg Tablet - 40 40
24
25
Polimiksin 1000 IU/g - 4
26 4
27
Asam Benzoat 6% + Asam 6 -
28 Salisilat 3% 6
29 50 mg -
30 1
Anti Diare Tablet/New Diaform Tablet 55 - 55
31
32
Anti Hipertensi Kapsul/Tensigard Tablet 30 - 30
33
Antihistamin Tablet kombinasi/SOLDEXTAM Tablet 198 198
34
35
36
Antitusiva Tablet Tablet - 10 10
37
38
39 10
Asam Mefenamat Kapsul 500 mg Kapsul - 9 9
40
41
42
43
Asiklovir Krim 5 % Tube 4 - 4
44
45
46
47
48
Betahistin Mesilat 6 mg Tablet 16 - 16
49
50
Bisakodil suppositoria 10 mg/dulcolax Supp - 5 5
51
52
53
54
55
56
57
58
59
60
61
62
Dimenhidrinat Tablet 50 mg Tablet 86 - 86
63
64
65
66
Ekstrak Belladone Tablet 10 mg Tablet - 282 282
67
(Epinefrina /
68 5
69
70
71
72
73
Etil Klorida Semprot -100 ml Botol 0 1 1
74
75
76
77
78
79
80
81
82
83
84 30 80
85
86
87
88
89
90 10
Gliseril Guayakolat sirup Botol 0 1 1
91
92
93
94
95
96
97
98
99
100 2
101
102
103
Ichtyol salep Kulit Pot 0 3 3
104
105 ml 0 -
106
107
108
109
110
111
112
113
Karbamazepin Tablet 200 mg Tablet 65 - 65
114
115
116
117
118
119
120
121
122
123
Kloramfenikol Salep Mata 1%-3,5 g Tube 2 - 2
124
Kloramfenikol Tetes Mata -5 ml/RECO Botol 0 - -
125
126
127 10
Klorpromazin Hcl Tablet Salut 25 mg Tablet 10 - 10
128
Klorpromazin Hcl Tablet Salut 100 mg Tablet 76 - 76
129
130
131 12 12
132 43 43
133 5 15 1
134
-
135 0 -
136 0 -
137 0 -
138
1 : 80.000-2 ml -
139 0 -
140
141
142
Meloksikam tablet 15 mg Tablet 58 - 58
143
144
145
146
Metilergometrin Maleat (Metergin) Tablet 0,1 Tablet 0 - -
147
148
Metilprednisolon tablet 4 mg Tablet 8 - 8
149
150
151
152
153
154
Mikonazole KrIm 2 % - 10 gr Tube 3 - 3
155
Multivitamin + Mineral tablet/HEMAFORT Tablet 0 - -
156
Multivitamin sirup/RECOVIT Botol 0 - -
157
158
159
160
161 0
162 103
Nistatin 100.000 IU/gram Tablet Vagina Tablet 20 27
163 7
164 50
165 0
166 0 -
167 0 -
168 0 -
169 0 -
170 0 -
171 0
172 0
173 3
174 1
175 5
176 1 2
177 0
178 1
179 2
180 9
181 0
182 28
183
184
185
Parasetamol Tablet 100 mg Tablet 0 0 -
186
187
188
189
190
191
192
193
194
195 mg/g-10 ml 0 1 1
196
197
198
199
200
201
202
203
204
205
206
207
208
209
units 2,5 ml
210 0 0 -
211 3 0 3
Salisil bedak 2% -50 gr Kotak 3 5 8
212
Salep Luka Bakar/neocenta Tube 0 0 -
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
Asam Folat 0,25 mg
230 0 140 140
Serbuk & Cairan
231 0 0 -
232
233
234
235
236
237
238
239
Triheksifenidil Hidroklorida Tablet 2 mg Tablet 52 0 52
240
241
Vitamin Neurotropik Tablet Tablet 0 78 78
242
243
Prednisone 5 mg Tablet 18 100 118 10
244
245
vit k Set 22 0 22
246
247
248
Teramysin salep mata tube 0 0 -
249
Kotak 0 -
250
251 Ampul 0 -
252 Tablet 0 -
253 Vial 0 -
0 -
1
2
3
4
5
6
Alat Suntik Sekali Pakai 2,5 ml Set 6 20 26 2
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs 0 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit 0 0 -
52
53
54
55
56
Bulan : Juni Tahun : 2017
JUMLAH PEMA
3 4 5 6 7 8 9 10 11 12 13
10 10
10 20 10
1 1
10
30 10 30 30 20 50 5 50 20
1 1 1 1 1
1 1
1 1
20 40 80 60 30 50 10 90
10 10
10 10 20 5 20
8
1
20 12 10
1
10
10
1 1
8 3 10
8 10 10 10
6 8 10
10
10 30 5
10 15 5 10 10 10
10
1 1 1 1
10
10 10 40 10 30 20
1
20 10 10 18 10
10
10 10 10 50
16 50 20 10 10 20
10
12
1 1
30 10 20 30 13 35 5 5
5 15 5 5 5
1 1 1
10 10
4
10 10
1 2 1 1 1 2
1 1
2 1
1 1 1 1
1 1 1 4 2 1
60 90 70 70 70 95 35 80 20
10
46 20 20 20 40 20 10 90 20
6 10 10
10 10
1
1 2
10
10 10
10 10
38
20 20 20 20 10 20
10
10
10 10
1 2 1 2 1 1
PEMAKAIAN OBAT
i Tahun : 2017
14 15 16 17 18 19 20 21 22 23
20 20
20
20 20 10 26 30 10
1 1 1 1
1 1
10 20 10 20 50 30 10
1
10
10
10
1 2
1 1 1
3 2
10 18 10
20 10 8
20
20
6 6
50
20 3 10 2
20
10 10 10 20 10
10 10
10 10 10 20 10 10
10
10
1 1
1 1 1
15 13 10 10 26 12 10
5 15
1 1 1 1 1 1
10
10
10 10
18 8
10 10
1 1 1
1
1 1
5 2 1 1 1 3
30 20 30 20 64 20 40 20 20
10 10
10 20 36 10 10
10
1 1
10
20
10 10 10
1
10
10
20
1
30 30 10
20
10 10 10
10
10 10 20
5
2 1 1
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 100
60 47
10 50 58
3 2
0 -
0 20
0 30
20 7
0 -
10 69
10 10 10 10 401 53
0 -
2 8 6
6 5
0 70
0 52
0 -
0 -
0 -
4 5
10 10 10 10
580 105
20 30
40 -
0 -
4 -
0 -
0 6
0 -
2 5
10 45
0 170
0 30
6 81 117
18 88
1 5 2
10 -
0 -
10 20 500 62
9 -
0 -
0 -
0 -
1 3
10 95
0 -
0 -
0 -
10 6
1 2 8 2
5 -
0 -
0 30
0 2
10 10 79 28
0 -
0 29
0 -
0 -
0 -
0 46
0 -
30 56
24 104
0 4
60 -
282 -
0 5
0 -
0 -
0 -
0 -
0 -
1 -
0 -
20 80
0 -
0 -
0 100
0 70
10 40 55
0 3
0 57
6 18 62
0 -
0 -
1 8
0 100
50 20
4 94 33
1 -
0 -
0 1
0 -
0 60
0 80
0 60
80 30
10 29
7 1
10 46
20 200 14
1 4
0 3
0 -
0 -
0 -
0 -
88 44
0 -
10 116
10 10 170 66
12 148 57
20 45
0 2
0 68
0 -
0 -
0 -
0 -
0 -
0 -
12 72
2 -
0 -
5 1
10 26 6 20 10 326 15
0 10
55 21
0 -
0 12
0 43
1 1 12 3
0 34
0 -
0 -
0 -
0 -
0 -
0 -
0 40
0 -
10 48
0 -
20 20
0 -
0 -
0 4
8 -
10 84
0 -
0 40
0 30
0 -
0 3
10 0 -
0 -
0 172
0 -
46 38
0 -
10 30 73
0 27
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 1 13 5
2 -
4 2
8 1
0 -
1 -
0 2
0 9
0 -
0 28
0 -
3 -
3 1 1 28 4
0 -
20 20 30 10 20 40 1004 109
0 -
0 -
0 -
0 -
30 65
0 80
10 6 30 10 428 84
1 -
0 2
0 1
0 -
0 30
0 -
0 -
36 31
0 -
0 186
0 40
0 -
0 3
10 30 25
0 25
0 -
1 2
1 6 2
0 -
2 -
10 87
20 30
0 -
0 -
0 -
40 73
1 3
0 19
0 10
0 -
20 57
10 15
20 30 18
20 -
1 -
10 40 140 -
0 -
0 -
0 10
0 90
58 -
30 170 88
0 80
0 -
0 -
20 32
10 30 20
12 10 78 -
5 36
30 88
0 -
0 22
4 -
0 90
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 17
0 3
1 1 2 18 8
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
1 5
0 -
0 -
0 -
0 2
0 1
5 (5)
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
No Nama Obat
ian stok 36
1 37
2 38
3 39
4 40
5 41
6 42
7 43
8 44
9 45
10 46
11 47
12 48
13 49
14 50
Kering 250 mg/5 ml
15 6 5 51 5 0
16 52
17 53
18 54
19 55
20 56
21 4 5 57 0 29
22 580 105 58 0 0
23 59
24 60
25 61
Kombinasi :
26 4 0 62 0 0
27 63

28 3% 0 6 64 24 104

29 50 mg 0 0 65 0 4
30 66
Anti Diare Tablet 10 45 Ekstrak Belladone Tablet 10 mg 282 0
31 67
32 0 170 68 Injeksi 0,1%/- 1ml 0 5
33 69
34 70
71 116
72 117
73 118
74 119
75 120
76 121
77 122
78 123
79 124
80 125
81 126
82 127
83 128
kombinasi :
2,70 g )200 ml Air
84 18 62 129 55 21
85 130
Kombinasi :
Trimetroprim 20 mg
86 0 0 131 0 12
:
Trimetroprim 80 mg
87 1 8 132 0 43
Kombinasi :
88 0 100 133 12 3
89 134
28 mEq) /Asering
90 94 33 135 0 0
gr)
91 1 0 136 0 0
+ Elektrolit
92 0 0 137 0 0
93 138
Kombinasi :
Lidokain Hcl 2%
94 0 0 139 0 0
95 140
96 141
97 142
98 143
99 144
100 145
101 146
102 147
103 148
104 149

105 0 0 150 10 84
106 151
107 152
108 153
109 154
110 155
111 156
112 157
113 158
114 159
115 160
161 206
162 207
163 208
164 209
ml
165 0 0 210 0 0

166 0 0 211 Endap 4 % - 30 gram 1 2
167 212
168 213
169 214
170 215
171 216
172 217
173 218
174 219
175 220
176 221
177 222
178 223
179 224
180 225
181 226
182 227
183 228
184 229
Kombinasi:
Asam Folat 0,25 mg
185 28 4 230 140 0
186 0 0 231 0 0
187 232
188 233
189 234
190 235
191 236
192 237
193 0 80 238 0 0
194 239
Metakresol
mg/g-10 ml
195 1 0 240 20 32
196 241
197 242
198 243
199 244
200 245
201 246
202 247
203 248
204 249
205 250

no 47
1 48
2 49
3 50
4 51
5 52
6 53
7 54
8 55
9 56
10
11
12
13
14
Etanol 70 % 1.000 ml 0 0
15
16
17
18
Infus set Anak 0 0
19
20
Iodina Test 0 1
21
22
23
24
25
26
27
Kassa Pembalut Hidrofil 4 m x 15 5 -5
28
Kertas Puyer 0 0
29
Lysol 1,000 ml 0 0
30
Masker 0 10
31
32
Pot Dahak 0 0
33
34
35
36
37
38
39
Safety Box 0 0
40
41
42
43
44
45
46
Persediaan
Jumlah
No Nama Obat Satuan 1
Persediaan
Awal Tambahan UMUM JKN
1 -
2 100
Alopurinol Tablet 100 mg Tablet 47 47
3
Ambroksol Tablet 30 mg Tablet 58 58
4
Ambroksol sirup 15 mg/5 ml Botol 2 2
5
6
7
Amitriptillin Hcl Tablet Salut 25 mg Tablet 30 30
8
Amlodipin Tablet 5 mg Tablet 7 7
9
10
Amoksisillin Kapsul 250 mg Kapsul 69 69
11
Amoksisillin Kaplet 500 mg Kaplet 53 53
12
13
Amoksisillin Sirup Kering 125 mg/5ml Botol 6 6
14
Kering 250 mg/5 ml 5
15 5
Ampisilin Kapsul 250 mg Kapsul 70 70
16
17
18
19
Analgetik Plus Tablet - -
20
Alumunium Hidroksida 200 mg/5 ml
21 5 5
Alumunium Hidroksida 200 mg 105
22 105
Antasida Plus Tablet/TRIANTA Tablet 30 30
23
Antalgin (Metampiron) Tablet 500 mg Tablet - -
24
25
Basitrasin
500 IU/g + Polimiksin 1000 IU/g -
26 -
Anti Hemoroid Doen komb Supp - -
27
Asam
Benzoat 6% + Asam Salisilat 3% 6
28 6
Ergotamin
Tartrat 1 mg + Kofein 50 mg -
29 -
Anti Diare Suspensi/Novadiar Botol 5 5
30
Anti Diare Tablet/New Diaform Tablet 45 45
31
32
Anti Hipertensi Kapsul Tablet 30 30
33
Antihistamin Tablet kombinasi/SOLDE Tablet 117 117
34
Antispasmodik Tablet/SCOPMA Tablet 88 88
35
Antitusiva Sirup/DEXTROFEN SY Botol 2 2
36
Antitusiva Tablet Tablet - -
37
38
Asam Askorbat 50 mg/Vitamin c Tablet 62 62
39
Asam Mefenamat Kapsul 500 mg Kapsul - -
40
41
42
43
44
45
46
Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul - -
47
Aqua Pro Injeksi Steril, bebas Pirogen Vial - -
48
Betahistin Mesilat 6 mg Tablet 6 6
49
Betametason Krim 0,1 %- 5g Tube 2 2
50
51
52
53
54
Deksametason Tablet 0,5 mg/FLACOID Tablet 28 28
55
56
57
58
59
Dietilkarbamazin Sitrat Tablet 100 mg Tablet - -
60
Difenhidramin HCl Injeksi 10 mg/ml-1 Ampul 46 46
61
62
Dimenhidrinat Tablet 50 mg Tablet 56 56
63
64
65
Efedrin Hcl Tablet 25 mg Tablet - -
66
Ekstrak Belladone Tablet 10 mg Tablet - -
67

68 0,1%/- 1ml 5
69
70
71
72
73
Etil Klorida Semprot -100 ml Botol - -
74
75
76
77
78
Fenoksimeti Penisilin 250 mg tablet Tablet 100 100
79
Fenoksimeti Penisilin 500 mg tablet Tablet 70 70
80
81
Fitomenadion (Vit K1) Injeksi 2 mg/ml Ampul 3 3
82
83
( Nacl
0,52 gr, Kalium Klorida 0,30 gr,
Trinatrium Sitrat dihidrat 0,58 gr,
Glukosa Anhidrat 2,70 g )200 ml Air
84 62 62
Gemfibrozil Tablet 600 mg Tablet - -
85
86
87
88
Glimepiride 2 mg Tablet 20 20
89
Gliseril guayakolat tablet 100 mg Tablet 33 33
90
Gliseril Guayakolat sirup Botol - -
91
92
93
94
Griseofulvin Tablet 125 mg,micronized Tablet 60 60
95
96
97
Haloperidol Tablet 5 mg Tablet 30 30
98
99
Hidrokortison Krim 2,5 % Tube 1 1
100
Ibuprofen Tablet 200 mg Tablet 46 46
101
Ibuprofen Tablet 400 mg Tablet 14 14
102
103
Ichtyol salep Kulit Pot 3 3
104
Sulphate
105 for inhalation 2,5 ml - -
Isoniazid tablet 100 mg Tablet - -
106
107
108
Kalium Diklofenak Tablet 50 mg/KADIT Tablet 44 44
109
110
111
Kaptopril 12,5 mg Tablet 66 66
112
113
Karbamazepin Tablet 200 mg Tablet 45 45
114
Ketokonazole Krim 2 % - 15 gr Tube 2 2
115
116
117
118
119
120
121
122
123
Kloramfenikol Salep Mata 1%-3,5 g Tube - -
124
Kloramfenikol Tetes Mata -5 ml/RECO Botol - -
125
Kloramfenikol Tetes Telinga 3%-5 ml Botol 1 1
126
Klorfeniramin Maleat (CTM) Tablet 4 m Tablet 15 15
127
Klorpromazin Hcl Tablet Salut 25 mg Tablet 10 10
128
Klorpromazin Hcl Tablet Salut 100 mg Tablet 21 21
129
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul - -
130
Kombinasi :
Trimetroprim 20 mg
131 12 12
Sulfametoksazol
400 mg + Trimetroprim 80 mg
132 43 43
Sulfametoksazol 200
mg + Trimetroprim 40 mg/5 ml
133 3 3
Lansoprazole 30 mg Kapsul Tablet 34 34
134
Larutan mengadung Elektrolit (Na 130 Botol
mEq,Cl 109 mEq, Asetat 28 mEq)
/Asering
135 - -
Larutan mengadung Elektrolit (Nacl Botol
1,125 gr , Dekstrosa 18,75 gr)
136 - -
Elektrolit
(Nacl 1,75 gr, KCL 1,5 gr, Na Lactat
2,24 gr, Dekstrosa 27 gr)
137 - -
Lidokain injeksi 2 % Ampul - -
138
Lidokain
Hcl 2% +Epinefrin 1 : 80.000-2 ml
139 - -
140
141
142
Meloksikam tablet 15 mg Tablet 48 48
143
144
Metformin Hcl Tablet 500 mg Tablet 20 20
145
146
Metilergometrin Maleat (Metergin) Ta Tablet - -
147
Metilergometrin Maleat Injeksi 0,200 Ampul 4 4
148
Metilprednisolon tablet 4 mg Tablet - -
149
Metoklopramid 10 mg/xilastin Tablet 84 84
150
Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul - -
151
Metronidazol Tablet 250 mg Tablet 40 40
152
153
Metronidazole Infus 500 mg /100 ml Ampul - -
154
Mikonazole KrIm 2 % - 10 gr Tube 3 3
155
Multivitamin + Mineral tablet/HEMAF Tablet - -
156
Multivitamin sirup/RECOVIT Botol - -
157
Natrium Bikarbonat Tablet 500 mg Tablet 172 172
158
Natrum Diklofenak Tablet 25 mg Tablet - -
159
160
Natrium Klorida Larutan infus 0,9%-Ste Botol -
161 -
162 73
Nistatin 100.000 IU/gram Tablet Vagin Tablet 27
163 27
Nistatin 500.000 IU/gram Tablet Salut Tablet 50
164 50
Obat Antitiuberkolosis Kategori Anak Paket -
165 -
Obat Antitiuberkolosis Kategori 1 Dew Paket -
166 -
167 -
168 -
169 -
170 -
Obat Anti Tuberkulosis FDC Kat I & III Paket -
171 -
Obat Anti Tuberkolosis FDC Sisipan De Paket -
172 -
Obat Batuk Hitam (OBH) Cairan 100 m Botol 5
173 5
Obat Batuk Cair Sirup (Ekspektoran)/ Botol -
174 -
Obat Batuk Hitam Plus Sirup/INDOPL Botol 2
175 2
Obat Flu Sirup/ FLUTOP-C Botol 1
176 1
Oksiterasiklin Hcl injeksi i.m.50 mg/m Vial -
177 -
178 -
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2
179 2
180 9
181 -
Omeprazole Kapsul 20 mg Tablet 28
182 28
Ondansetron inj 4 mg/ 2 mL Ampul - -
183
Parasetamol drops Botol - -
184
Parasetamol Sirup 120 mg/5ml-60 ml Botol 4 4
185
Parasetamol Tablet 100 mg Tablet - -
186
187
Pehacain injeksi Ampul - -
188
Perak Sulfadiazin krim 1 % 35 gr Tube - -
189
Piracetam 400 mg Tablet - -
190
Piracetam Tablet 800 mg Tablet - -
191
Piroksikam Tablet 20 mg Tablet 65 65
192
Pirantel Pamoat Tablet 365 mg (Setara Tablet 80 80
193
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 84 84
194
Sulfonat dan
Metanal) 360 mg/g-10 ml
195 - -
196
197
Primakuin tablet 15 mg Tablet - -
198
Propanolol Hcl Tablet 40 mg Tablet 30 30
199
Propilturasil Tablet 100 mg Tablet - -
200
Ranitidin Injeksi 25 mg / ml Ampul - -
201
202
Retinol (Vit.A) 100.000 IU Kapsul Kapsul - -
203
204
205
Rifampisin Tablet 450 mg Tablet - -
206
Ringer Laktat Larutan Infus Steril 500 Botol 3 3
207
208
209
210 - -
Asam
Salisilat 2 % + Belerang Endap 4 % - 30
211 gram 2 2
Salisil bedak 2% -50 gr Kotak 2 2
212
Salep Luka Bakar Tube - -
213
Sefadroksil Sirup Kering 125 mg / 5 ml Botol - -
214
215
216
Sefotaksim Injeksi 1 gr Ampul - -
217
Seftriakson Injeksi 1 gr / vial Ampul - -
218
Semen Seng Fosfat Serbuk & Cairan Botol - -
219
Setirizin Tablet 10 mg Tablet 73 73
220
221
Sianokobalamin Injeksi 500 mcg/ml-1m Ampul 19 19
222
223
Silver Amalgam Serbuk 65-75% Botol - -
224
225
Simvastatin Tablet 10 mg Tablet 15 15
226
Siprofloksasin 500mg Tablet 18 18
227
Spironolakton Tablet 25 mg Tablet - -
228
Sulfacetamid Tetes Mata 15 %-5ml Botol - -
229
Besi II
Sulfat 200 mg + Asam Folat 0,25 mg
230 - -
231 - -
Trikesol formalin ( T K F ) Cairan 10 ml Botol - -
232
233
234
Thiamin Hcl (Vit B1) Injeksi 100 mg/m Ampul - -
235
Tiamin Hcl /Mononitrat (Vit.B1) Table Tablet 88 88
236
237
Tramadol Injeksi 50 mg/ ml Ampul - -
238
Tramadol Tablet 50 mg Tablet - -
239
Triheksifenidil Hidroklorida Tablet 2 m Tablet 32 32
240
Vitamin B .Komplek Tablet Tablet 20 20
241
Vitamin Neurotropik Tablet Tablet - -
242
243
Prednisone 5 mg Tablet 88 88
244
flunax sy Botol - -
245
vit k Set 22 22
246
Gentian Violet Botol - -
247
Kloramfenikol 500 Tablet 90 90
248
Kloramfenikol Salep Mata 1%-3,5 g Tablet - -
249
Kotak -
250
251 Ampul -
252 Tablet -
253 Vial -
-
B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES -
Abbocath No 18 ( IV Chateter 18 ) Buah - -
1
2
3
4
5
6
7
8
Alat Suntik Sekali Pakai 10 ml Set - -
9
Auto Disposable Syringe (ADS) 0,05 ml set - -
10
Auto Disposable Syringe (ADS) 0,5 ml set - -
11
Auto Disposable Syringe (ADS) 5 ml set - -
12
Catgut/Benang Bedah No.2/0-3/0 (Plai Sachet 2 2
13
Etakridin Larutan (Rivanol) 0,1% - 300 Botol - -
14
Etanol 70 % 1.000 ml Botol - -
15
Folley Catheter no 14 Set - -
16
Folley Catheter no 16 Set - -
17
18
Infus set Anak Set - -
19
20
21
Kassa Hidrofil Steril 16 x 16 Kotak 5 5
22
Kapas Berlemak 500 gram Bungkus - -
23
Kapas Pembalut / Adsorbens 250 gram Bungkus - -
24
Kassa Kompres 40 x 40 steril Bungkus - -
25
26
Kassa Pembalut Hidrofil 4 m x 3 cm Rol 1 1
27
Kassa Pembalut Hidrofil 4 m x 15 cm Rol (5) (5)
28
Kertas Puyer Pcs - -
29
Lysol 1,000 ml Botol - -
30
Masker Buah 10 10
31
32
Pot Dahak Pcs - -
33
Rapid HIV 1 (SD HIV) Pcs - -
34
Rapid HIV 2 (Intec HIV) Pcs - -
35
Rapid HIV 2 (Biomeriux HIV) Pcs - -
36
Rapid Test Syphilis Pcs - -
37
RPR Test Syphilis Pcs - -
38
39
Safety Box Pcs - -
40
Sarung tangan Steril No 6 Pcs - -
41
42
43
Sarung tangan Non Steril S Pcs - -
44
Sarung tangan Non Steril M Pcs - -
45
Sarung tangan Non Steril L Pcs - -
46
Urine Bag set 2 2
47
Wing Neddle No 23 Set - -
48
Anuscopi Yamato Unit - -
49
Kaca Slide Box - -
50
Reagen Ziehl Nielson Kit - -
51
Rotator Unit - -
52
RTD Malaria Tes - -
53
Rapid HIV 3 (Oncoprobe HIV) Pcs - -
54
Sound Timer Buah
55 - -
SD Syphilis Pcs
56 - -
2 3 4 5 6
UMUM JKN UMUM JKN UMUM JKN UMUM JKN UMUM JKN
7 8 9 10 11
CATATAN HARIAN PEMAKAIAN OBAT
Bulan : JULI Tahun : 2017
JUMLAH PEMAKAIAN JENIS OBAT PADA TANGGA
12 13 14 15 16
OBAT
NIS OBAT PADA TANGGAL

17 18 19 20 21
22 23 24 25 26
27 28 29 30 31
jumlah jumlah
Jumlah Sisa Akhir
Pemakaian Bulan
umum jkn
- 0 - -
- 0 0 100
- 0 0 47
- 0 0 58
- 0 0 2
- 0 0 -
- 0 0 20
- 0 0 30
- 0 0 7
- 0 0 -
- 0 0 69
- 0 0 53
- 0 0 -
- 0 0 6
- 0 0 5
- 0 0 70
- 0 0 52
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 5
- 0 0 105
- 0 0 30
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 6
- 0 0 -
- 0 0 5
- 0 0 45
- 0 0 170
- 0 0 30
- 0 0 117
- 0 0 88
- 0 0 2
- 0 0 -
- 0 0 -
- 0 0 62
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 3
- 0 0 95
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 6
- 0 0 2
- 0 0 -
- 0 0 -
- 0 0 30
- 0 0 2
- 0 0 28
- 0 0 -
- 0 0 29
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 46
- 0 0 -
- 0 0 56
- 0 0 104
- 0 0 4
- 0 60 (60)
- 0 0 -
- 0 0 5
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 80
- 0 0 -
- 0 0 -
- 0 0 100
- 0 0 70
- 0 0 55
- 0 0 3
- 0 0 57
- 0 0 62
- 0 0 -
- 0 0 -
- 0 0 8
- 0 0 100
- 0 0 20
- 0 0 33
- 0 0 -
- 0 0 -
- 0 0 1
- 0 0 -
- 0 0 60
- 0 0 80
- 0 0 60
- 0 0 30
- 0 0 29
- 0 0 1
- 0 0 46
- 0 0 14
- 0 0 4
- 0 0 3
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 44
- 0 0 -
- 0 0 116
- 0 0 66
- 0 0 57
- 0 0 45
- 0 0 2
- 0 0 68
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 72
- 0 0 -
- 0 0 -
- 0 0 1
- 0 0 15
- 0 0 10
- 0 0 21
- 0 0 -
- 0 0 12
- 0 0 43
- 0 0 3
- 0 0 34
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 40
- 0 0 -
- 0 0 48
- 0 0 -
- 0 0 20
- 0 0 -
- 0 0 -
- 0 0 4
- 0 0 -
- 0 0 84
- 0 0 -
- 0 0 40
- 0 0 30
- 0 0 -
- 0 0 3
- 0 0 -
- 0 0 -
- 0 0 172
- 0 0 -
- 0 0 38
- 0 0 -
- 0 0 73
- 0 0 27
- 0 0 50
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 5
- 0 0 -
- 0 0 2
- 0 0 1
- 0 0 -
- 0 0 - 0
- 0 0 2 2
- 0 0 9 9
- 0 0 -
- 0 0 28
- 0 0 -
- 0 0 -
- 0 0 4
- 0 0 -
30 0 0 109
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 65
- 0 0 80
- 0 0 84
- 0 0 -
- 0 0 2
- 0 0 1
- 0 0 -
- 0 0 30
- 0 0 -
- 0 0 -
6 0 0 31
- 0 0 -
- 0 0 186
- 0 0 40
- 0 0 -
- 0 0 3
- 0 0 25
- 0 0 25
- 0 0 -
- 0 0 2
- 0 0 2
- 0 0 -
- 0 2 (2)
- 0 0 87
- 0 0 30
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 73
- 0 0 3
- 0 0 19
- 0 0 10
- 0 0 -
- 0 0 57
- 0 0 15
- 0 0 18
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 10
- 0 0 90
- 0 0 -
- 0 0 88
- 0 0 80
- 0 0 -
- 0 0 -
- 0 0 32
- 0 0 20
- 0 0 -
- 0 0 36
- 0 0 88
- 0 0 -
- 0 0 22
- 0 0 -
- 0 0 90
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 10
- 0 0 -
- 0 0 -
- 0 0 17
- 0 0 3
- 0 0 8
- 0 0 3
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 2
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 2
- 0 0 -
- 0 0 7
- 0 0 1
- 0 0 5
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 2
- 0 0 1
- 0 0 (5)
- 0 0 -
- 0 0 -
- 0 0 10
- 0 0 1
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 4
- 0 0 -
- 0 0 -
- 0 0 3
- 0 0 7
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 2
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
- 0 0 -
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 -
2 100
3
4 10
5
6
7
8
9
10
11
12 10
13
14
mg/5 ml 5 10
15 15
16
17
18
19
20
21 5 0 5
22 705
23
24
25
26 4
27
28 Salisilat 3% 6
29 50 mg -
Anti Diare Suspensi/Novadiar Botol 5 - 5
30
31
32
33
Antihistamin Tablet kombinasi/SOLDEXTAM Tablet 117 117
34 12
35
Antitusiva Sirup/DEXTROFEN SY Botol 2 - 2
36 1
Antitusiva Tablet Tablet - 10 10
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
Deksametason Tablet 0,5 mg/FLACOID Tablet 28 1,000 1,028
55
56
57
58
59
60
61
Digoksin Tablet 0,25 mg Tablet - 50 50
62
63
64
65
66
Ekstrak Belladone Tablet 10 mg Tablet - - -
67
(Epinefrina /
68 5
69
70
Eritromisin Sirup 200 mg / 5 ml Botol - - -
71
Etambutol Tablet 500 mg Tablet - - -
72
Etanol 70 % 100 ml Botol - - -
73
Etil Klorida Semprot -100 ml Botol - 1 1
74
Eugenol Cairan -10 ml Botol - - -
75
76
Fenobarbital tablet 30 mg Tablet - - -
77
Fenobarbital injeksi 50 mg / ml Ampul - - -
78
79
80
81
Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 3 7 10
82
83
Klorida 0,30 gr, Trinatrium Sitrat dihidrat -
84 62 62
Gemfibrozil Tablet 600 mg Tablet - - -
85
Gentamisin injeksi 80 mg / 2 ml Vial - - -
86
Gentamisin Salep Kulit 0,1 % Tube 8 - 8
87
Glibenklamid Tablet 5 mg Tablet 100 - 100
88
89
Gliseril guayakolat tablet 100 mg Tablet 33 1,000 1,033
90
Gliseril Guayakolat sirup Botol - 1 1
91
Glukonas Kalsikus injeksi Ampul - - -
92
93
Glukosa Larutan Infus10 % Botol - - -
94
95
96
97
98
99
100
101
102 10
103
Ichtyol salep Kulit Pot 3 - 3
104
105 ml - -
Isoniazid tablet 100 mg Tablet - - -
106
Isosorbid Dinitrat 5 mg Tablet - - -
107
Kalium Diklofenak Tablet 25 mg Tablet - - -
108
109
Kalsium Hidroksida Pasta Tube - - -
110
111
112
113
Karbamazepin Tablet 200 mg Tablet 45 - 45
114
115
116
Ketoprofen Tablet 100 mg Tablet - - -
117
Ketoprofen Injeksi 100 mg / 1 ml Ampul - - -
118
Ketorolac 10 mg injeksi Ampul - - -
119
120
Klindamisin Kapsul 150 mg Kapsul - - -
121
122
123
Kloramfenikol Salep Mata 1%-3,5 g Tube - 3 3
124
Kloramfenikol Tetes Mata -5 ml/RECO Botol - - -
125
126
127
128
129
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul - - -
130
131 12 12
132 43 93
133 3 13
134
-
135 - -
136 - -
137 - -
Lidokain injeksi 2 % Tablet - - -
138
1 : 80.000-2 ml -
139 - -
Loperamid Tablet 2 mg Tablet - - -
140
141
Magnesium Sulfat (IV) 20 %-25 ml Ampul - - -
142
143
Meloksikam Suppositoria Supp - - -
144
145
Methisoprinol 500 mg Tablet - - -
146
Metilergometrin Maleat (Metergin) Tablet 0,1 Tablet - - -
147
148
Metilprednisolon tablet 4 mg Tablet - 8 8
149
150
Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul - - -
151
152
153
Metronidazole Infus 500 mg /100 ml Ampul - - -
154
155
Multivitamin + Mineral tablet/HEMAFORT Tablet - - -
156
Multivitamin sirup/RECOVIT Botol - - -
157
158
Natrum Diklofenak Tablet 25 mg Tablet - - -
159
160
161 -
162 73
163 27
164 50
165 -
166 - -
167 - -
168 - -
169 - -
170 - -
171 -
172 -
173 5 1
Obat Batuk Cair Sirup (Ekspektoran)/COREDRY Botol - -
174 -
175 2
176 1
177 -
178 -
179 2
180 9
181 -
182 28
Ondansetron inj 4 mg/ 2 mL Ampul - 0 -
183
Parasetamol drops Botol - 3 3
184
185
Parasetamol Tablet 100 mg Tablet - 0 -
186
Parasetamol Tablet 500 mg Tablet 109 0 109 30
187
Pehacain injeksi Ampul - 0 -
188
Perak Sulfadiazin krim 1 % 35 gr Tube - 0 -
189
Piracetam 400 mg Tablet - 0 -
190
Piracetam Tablet 800 mg Tablet - 0 -
191
192
193
194
195 mg/g-10 ml - 1 1
196
197
Primakuin tablet 15 mg Tablet - 0 -
198
199
Propilturasil Tablet 100 mg Tablet - 0 -
200
Ranitidin Injeksi 25 mg / ml Ampul - 0 -
201
202
Retinol (Vit.A) 100.000 IU Kapsul Kapsul - 0 -
203
204
205
Rifampisin Tablet 450 mg Tablet - 0 -
206
207
208
209
units 2,5 ml
210 - 0 -
211 2 15 17
212
Salep Luka Bakar/neocenta Tube - 1 1
213
Sefadroksil Sirup Kering 125 mg / 5 ml sirup Botol - 2 2
214
215
216
Sefotaksim Injeksi 1 gr Ampul - 0 -
217
Seftriakson Injeksi 1 gr / vial Ampul - 0 -
218
Semen Seng Fosfat Serbuk & Cairan Botol - 0 -
219
220
221
222
223
Silver Amalgam Serbuk 65-75% Botol - 0 -
224
225
226
Siprofloksasin 500mg Tablet 18 0 18 10
227
Spironolakton Tablet 25 mg Tablet - 0 -
228
Sulfacetamid Tetes Mata 15 %-5ml Botol - 2 2
229
Asam Folat 0,25 mg
230 - 0 -
Serbuk & Cairan
231 - 0 -
Trikesol formalin ( T K F ) Cairan 10 ml Botol - 0 -
232
233
234
Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1ml Ampul - 0 -
235
Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 88 300 388 10
236
237
Tramadol Injeksi 50 mg/ ml Ampul - 0 -
238
Tramadol Tablet 50 mg Tablet - 0 -
239
240
241
Vitamin Neurotropik Tablet Tablet - 78 78
242
243
244
flunax sy Botol - 0 -
245
vit k Set 22 0 22
246
Gentian Violet Botol - 4 4
247
248
Teramysin salep mata tube - 0 -
249
Kotak - -
250
251 Ampul - -
252 Tablet - -
253 Vial - -
- -
B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES - -
Abbocath No 18 ( IV Chateter 18 ) Buah - 0 -
1
2
3
4
5
6
7
8
Alat Suntik Sekali Pakai 10 ml Set - 0 -
9
Auto Disposable Syringe (ADS) 0,05 ml set - 0 -
10
11
Auto Disposable Syringe (ADS) 5 ml set - 0 -
12
13
Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol - 0 -
14
Etanol 70 % 1.000 ml Botol - 0 -
15
Folley Catheter no 14 Set - 0 -
16
17
18
Infus set Anak Set - 0 -
19
20
21
22
Kapas Berlemak 500 gram Bungkus - 0 -
23
Kapas Pembalut / Adsorbens 250 gram Bungkus - 0 -
24
Kassa Kompres 40 x 40 steril Bungkus - 0 -
25
26
27
Kassa Pembalut Hidrofil 4 m x 15 cm Rol (5) 15 10
28
Kertas Puyer Pcs - 0 -
29
Lysol 1,000 ml Botol - 0 -
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs - 0 -
33
Rapid HIV 1 (SD HIV) Pcs - 0 -
34
Rapid HIV 2 (Intec HIV) Pcs - 0 -
35
Rapid HIV 2 (Biomeriux HIV) Pcs - 0 -
36
Rapid Test Syphilis Pcs - 0 -
37
RPR Test Syphilis Pcs - 0 -
38
39
Safety Box Pcs - 0 -
40
Sarung tangan Steril No 6 Pcs - 0 -
41
42
43
Sarung tangan Non Steril S Pcs - 0 -
44
Sarung tangan Non Steril M Pcs - 0 -
45
Sarung tangan Non Steril L Pcs - 0 -
46
Urine Bag set 2 0 2
47
Wing Neddle No 23 Set - 0 -
48
Anuscopi Yamato Unit - 0 -
49
Kaca Slide Box - 0 -
50
Reagen Ziehl Nielson Kit - 0 -
51
Rotator Unit - 0 -
52
RTD Malaria Tes - 0 -
53
Rapid HIV 3 (Oncoprobe HIV) Pcs - 0 -
54
Sound Timer Buah - 0 -
55
SD Syphilis Pcs - 0 -
56
Bulan : Juli Tahun : 2017
JUMLAH PEMA
3 4 5 6 7 8 9 10 11 12 13
15 10 10
10 10 10
1 1
20 20 70 50 60 30 30 50
1 1 1
2 1 1 2 1
20
1 1
70 30 30 40 40 20 10 20
1 1 1
20 10 10
10 10
10
1
10 20 5
8 10
2 1 2
7
50 30 10 20 10 10 20
10
10 10
30
10
10
10 10 10 30 40 10
10
10 10 10 30
8
12 2
30 10 10 10
10 10 10 10
10 30 18
30 10 10 5 20 10
30 10 10 8 20 20
10
1
7 7
1 1
33 10 86 20 30 50 53 15 10 20
20 5 15
20
1 1
8 10
10 30
40 10
2 1 1
8 10 8
8 18 10
18 2
1 1 1 3
2 1 2 1
1 1 1 1 1
10
1 1 1 1 1 1 2 4 2
70 16 30 50 90 90 35 20 60
90 20 36 10 10 10 6
10
8 10
20 10
3
1
1
10
20
20
30
1
10 10 10 20 10
10
10 10 16 10 41 10
20 5 6 10
2 1 1 1
PEMAKAIAN OBAT
Tahun : 2017
14 15 16 17 18 19 20 21 22 23
10
10
10
30 10 20 10 10 20
2 1 1 1
1 1
40
20 20 10 10 50 10 10
10 20
10 10
10 6 10 6
30 5
1 1
18 15 10
8 6 8 16 8
1
10
10 3 10 5
10 5
1 1 1
8
10
1
10
20 10 10
10 30 12 10
1
20 3 29 20 20 20 15
10 5
10
10
1
8 8 8
1 1 3
2
2 2
1 1 5 1 1 5
60 10 20 40 58 55 33
10 10 5
6 6 30 10 16
10 10 18 6 10
10
1 1 1
10
10
10 10
1
10
10 18 16 18 30 20 10
10
10 24 4
3 6 10
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 100
45 52
10 60 98
1 1 4 3
0 -
0 20
3 27
0 7
0 -
10 20 49
20 20 130 40 20 10 30 710 43
0 -
2 2 12 4
9 6
0 70
60 42
0 -
0 -
0 -
1 4 1
30 10 50 30 20 10 30
580 125
0 30
40 -
0 -
4 -
0 -
4 2
0 -
1 1 4
70 25
0 170
0 30
6 58 59
16 58 30
2 -
10 -
0 -
20 30 10 500 62
9 -
0 -
0 -
0 -
1 2 4
0 95
0 -
0 -
0 -
18 -
6 1 14 3
7 -
0 -
0 30
0 2
125 10 10 8 346 682
0 -
0 29
0 -
0 -
0 -
0 46
10 40
30 26
0 104
1 3
60 -
282 (282)
0 5
0 -
0 -
0 -
0 -
0 -
1 -
0 -
30 50
0 -
0 -
0 100
0 70
0 55
10 -
10 47
3 6 20 42
0 -
0 -
1 2 6
0 100
10 10
20 40 10 10 6 224 809
1 -
0 -
0 1
0 -
10 50
0 80
0 60
5 5 85 45
8 21
1 4 2 2 26 5
20 88 58
22 16 98 16
1 3
0 3
0 -
0 -
0 -
0 -
10 78 16
0 -
0 116
10 135 31
5 10 10 185 22
10 20 25
1 3 2
14 54
0 -
0 -
0 -
0 -
0 -
0 -
12 12 60
1 2
0 -
1 3 3
36 30 146 10 6 682 33
36 36 -
5 5 65 56
0 -
0 12
10 10 50 43
1 1 1 1 7 6
0 34
0 -
0 -
0 -
0 -
0 -
0 -
0 40
0 -
28 20
0 -
40 80
0 -
0 -
0 4
8 -
1 51 33
0 -
0 40
0 30
0 -
1 6 2
0 -
0 -
26 146
0 -
20 6 86 52
0 -
0 73
20 7
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
2 1 1 1 1 18 2
0 -
8 4
1 1 11 5
0 -
1 2
0 2
0 9
0 -
10 18
0 -
3 -
2 1 3 1 1 36 (32)
0 -
48 50 68 56 58 30 56 1133 (1,024)
0 -
0 -
0 -
0 -
25 40
0 80
3 20 10 40 10 333 51
1 -
0 2
0 1
0 -
10 20
0 -
0 -
6 16 100 31
0 -
0 186
0 40
0 -
0 3
5 10 45 80
2 12 13
0 -
10 13 4
2 6 1
1 -
2 -
20 67
10 40 20
0 -
0 -
0 -
30 43
0 3
0 19
0 10
0 -
6 26 31
30 15
10 8
0 -
2 -
0 -
0 -
0 -
10 -
0 90
0 -
40 20 10 20 10 20 312 76
0 80
0 -
0 -
20 12
6 16 20 177 43
78 -
0 36
10 3 73 15
0 -
0 22
4 -
0 90
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 17
0 3
3 3 11 2
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
1 4
0 -
0 -
0 -
0 2
0 1
5 5
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
No Nama Obat
ian stok 36
1 37
2 38
3 39
4 40
5 41
6 42
7 43
8 44
9 45
10 46
11 47
12 48
13 49
14 50
Kering 250 mg/5 ml
15 9 6 51 7 0
16 52
17 53
18 54
19 55
20 56
21 4 1 57 0 29
22 580 125 58 0 0
23 59
24 60
25 61
Kombinasi :
26 4 0 62 10 40
27 63

28 3% 4 2 64 0 104

29 50 mg 0 0 65 1 3
30 66
Anti Diare Tablet 70 25 Ekstrak Belladone Tablet 10 mg 282 -282
31 67
32 0 170 68 Injeksi 0,1%/- 1ml 0 5
33 69
34 70
71 116
72 117
73 118
74 119
75 120
76 121
77 122
78 123
79 124
80 125
81 126
82 127
83 128
kombinasi :
2,70 g )200 ml Air
84 20 42 129 65 56
85 130
Kombinasi :
Trimetroprim 20 mg
86 0 0 131 0 12
:
Trimetroprim 80 mg
87 2 6 132 50 43
Kombinasi :
88 0 100 133 7 6
89 134
28 mEq) /Asering
90 224 809 135 0 0

gr)
91 1 0 136 0 0
+ Elektrolit
92 0 0 137 0 0
93 138
Kombinasi :
Lidokain Hcl 2%
94 0 0 139 0 0
95 140
96 141
97 142
98 143
99 144
100 145
101 146
102 147
103 148
104 149

105 0 0 150 51 33
106 151
107 152
108 153
109 154
110 155
111 156
112 157
113 158
114 159
115 160
161 206
162 207
163 208
164 209
ml
165 0 0 210 0 0

166 0 0 211 Endap 4 % - 30 gram 13 4
167 212
168 213
169 214
170 215
171 216
172 217
173 218
174 219
175 220
176 221
177 222
178 223
179 224
180 225
181 226
182 227
183 228
184 229
Kombinasi:
Asam Folat 0,25 mg
185 36 -32 230 0 0
186 0 0 231 0 0
Parasetamol Tablet 500 mg 1133 -1024 Trikesol formalin ( T K F ) Cairan 0 0
187 232
188 233
189 234
190 235
191 236
192 237
193 0 80 238 0 0
194 239
Metakresol
mg/g-10 ml
195 1 0 240 20 12
196 241
197 242
198 243
199 244
200 245
201 246
202 247
203 248
204 249
205 250
no 47
1 48
2 49
3 50
4 51
5 52
6 53
7 54
8 55
9 56
10
11
12
13
14
Etanol 70 % 1.000 ml 0 0
15
16
17
18
Infus set Anak 0 0
19
20
Iodina Test 0 1
21
22
23
24
25
26
27
Kassa Pembalut Hidrofil 4 m x 15 5 5
28
Kertas Puyer 0 0
29
Lysol 1,000 ml 0 0
30
Masker 0 10
31
32
Pot Dahak 0 0
33
34
35
36
37
38
39
Safety Box 0 0
40
41
42
43
44
45
46
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 -
2 100
Alopurinol Tablet 100 mg Tablet 52 - 52
3
4
5
6
7
8
9
10
11
12 10 10
13
14 1
mg/5 ml 6 10
15 16
16
17
18
19
20
21 1 10 11
Hidroksida 200 mg 125 600 30 20
22 725
23
24
25
26 5
27
28 Salisilat 3% 2
29 50 mg -
30 1
31
32
33
34
35
Antitusiva Sirup/DEXTROFEN SY Botol - 5 5
36
37
38
39 10
Asam Mefenamat Kapsul 500 mg Kapsul - - -
40
41
42
43
44
45
Asiklovir Tablet 400 mg Tablet - 100 100
46
47
48
Betahistin Mesilat 6 mg Tablet - - -
49
50 1 1
Bisakodil suppositoria 10 mg/dulcolax Supp - - -
51
52
53
54
Deksametason Tablet 0,5 mg/FLACOID Tablet 682 - 682
55
56
57
58
59
60
61
Digoksin Tablet 0,25 mg Tablet 40 - 40
62
63 8
64
65
Efedrin Hcl Tablet 25 mg Tablet - - -
66
67
(Epinefrina /
68 5
69
70
71
72
73
Etil Klorida Semprot -100 ml Botol - - -
74
75
Fenitoin Natrium Kapsul 100 mg Kapsul 50 50 100
76
77
78
79
80
81 10
Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul - - -
82
83
Klorida 0,30 gr, Trinatrium Sitrat dihidrat -
84 42 42 6
85
86
87
88 10
89
Gliseril guayakolat tablet 100 mg Tablet 809 - 809
90 16
Gliseril Guayakolat sirup Botol - - -
91
92
93
94
95
96
97
98 5 10
99
100 2 1
101 10
102 20
103
104
105 ml - -
106
107
108
109
110
111
112 40
Kaptopril 25 mg Tablet 22 - 22
113 20
114
115
116
117
118
119
120
121
122
123
124
125
Kloramfenikol Tetes Telinga 3%-5 ml Botol 3 - 3
126
127 5 10
Klorpromazin Hcl Tablet Salut 25 mg Tablet - - -
128
129 5 10
130
131 12 12
132 43 43
Trimetroprim 40 mg/5 ml -
133 6 6 1
134
-
135 - -
136 - -
137 - -
138
1 : 80.000-2 ml -
139 - -
140
141
142
143
144
145 10
146
Metilergometrin Maleat (Metergin) Tablet 0,1 Tablet - - -
147
148
Metilprednisolon tablet 4 mg Tablet - - -
149
150
151
152
153
154
155
156
157
158
159
Natrium Diklofenak Tablet 50 mg Tablet 52 - 52
160
161 -
162 73 10
163 7
164 50
165 -
166 - -
167 - -
168 - -
169 - -
170 - -
171 -
172 -
173 2
Obat Batuk Cair Sirup (Ekspektoran)/COREDRY Botol - -
174 -
175 4
176 5 1
177 -
178 2
179 2
180 9
181 -
182 18
183
Parasetamol drops Botol - 0 -
184
Parasetamol Sirup 120 mg/5ml-60 ml Botol (32) 70 38 1
185
186
Parasetamol Tablet 500 mg Tablet (1,024) 2300 1,276 58 54
187
188
189
190
191
192
193
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 51 400 451 6 20
194
195 mg/g-10 ml - 1 1
196
197
198
199
200
201
202
203
204
205
206
207
208
209
units 2,5 ml
210 - 0 -
211 4 0 4
212
Salep Luka Bakar/neocenta Tube - 0 -
213
Sefadroksil Sirup Kering 125 mg / 5 ml sirup Botol - 3 3
214
215
216
217
218
219
220
221
222
223
224
225
226
227
Spironolakton Tablet 25 mg Tablet - 0 -
228
229
Asam Folat 0,25 mg
230 - 40 40
Serbuk & Cairan
231 - 0 -
232
Tetrasiklin Kapsul 250 mg Kapsul - 0 -
233
234
235
236
237
238
239
240
241
Vitamin Neurotropik Tablet Tablet - 0 -
242
243
244
245
vit k Set 22 100 100
246
Gentian Violet Botol - 0 -
247
248
Rivanol 300 ml Kotak - 2 2
249
Alkohol 70%100 ml - 1 1
250 Ampul
251 Tablet - -
252 Vial - -
- -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs - 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit - 0 -
52
53
54
55
56
Bulan : Agustus Tahun : 2017
JUMLAH PEMA
3 4 5 6 7 8 9 10 11 12 13
16
10
10 10
1 1 1
10 20
10
30 10 20 10 10 10 20 10
1 2 2 1 1 1 1
1 2
26 10 20 30 20 10 30 30
20
8 10 10
10
10 5 10
6 6
1
10 20 10 10
12
1 1
10 10 5 8
10
30
10 10
12 6 6
10 35 10 10
5 5 10 10 20
7 7
3 1 1 1
10 10 10 10
10
20 10 10
8 10
20 10 30 10
10 10 20 10 10 10
10
24 10 32 9 10 16
5 5 5 5 5 10
30 10
6
8 12
1 1 1
1 1
2 2
1 4 3 1 1
52 20 20 25 76 30 36 70 40
10
16 10 40 10 20 10
10 12
10
5
2 1 1 1
10 10 10
6
10
8
1 1
18 16 20 5 10 30 10
10
6 30
11 10
1 2 1
PEMAKAIAN OBAT
tus Tahun : 2017
14 15 16 17 18 19 20 21 22 23
10
20 10
1 1
10
10 50 30 20 40 30 38
2 2 1
2 1
10
1 1
20 30 30 10 20 40 30 20
10
10
5 10 20
5 30 20 8
12
10
8 8
6
14 10 10
10 5 15 7
1 2 1
10 20 30
10 18 10
10
20 20 10 20 20 10
1 1
24 10 20 10 20 20 10 18
10 5 10
20
10
20
1 3 1
2 1
1
4 2 1
50 80 70 50 20 50 62 40
10 10
40 30 20 20 30 30 10
6 10 10
5 10
1 1 1
10
10 10
50 40 20 10 20
10 15 10
6 10 17
1
1
2 2 1
1
Jumlah Sisa Akhir
Pemakaian Bulan
24 25 26 27 28 29 30 31
0 -
0 100
10 30 22
10 60 38
1 2 8 5
0 -
0 20
30 -
10 10 -
0 -
10 30 119
30 10 20 40 40 30 528 115
0 -
1 3 1 1 1 22 7
1 2 1 2 12 4
10 60
0 42
0 -
0 -
0 -
2 1 1 7 4
20 20 10 30 38 10
554 171
20 10
40 -
0 -
4 1
0 -
1 1
0 -
1 3
38 37
0 170
20 10
5 20 10 95 164
8 20 10
1 2 3
0 -
0 -
10 10 500 62
0 -
0 -
0 -
0 -
1 3
12 83
12 88
0 -
0 -
0 -
1 1 7 2
0 -
0 -
0 30
0 2
10 10 10 73 609
0 -
0 29
0 -
0 -
0 -
0 46
0 40
30 96
0 104
0 3
0 -
0 -
0 5
0 -
0 -
0 -
0 -
0 -
0 -
0 -
30 60 40
0 -
0 -
0 100
0 70
30 25
0 -
10 13 34
6 42 -
0 -
0 -
0 6
10 90
0 10
6 6 10 13 150 659
0 -
0 -
0 1
0 -
0 50
0 80
0 60
10 15 5 132 13
14 7
1 1 15 5
10 10 6 20 158 -
16 -
0 3
0 3
0 -
0 -
0 -
0 -
8 10 20 20 30 16 182 34
0 -
28 88
10 10 10 20 10 10 280 51
22 -
30 40 15
0 2
0 54
0 -
0 -
0 -
0 -
0 -
0 -
0 60
1 3 -
0 -
1 1 2
3 10 6 20 10 3 300 33
0 -
10 5 5 95 61
0 -
0 12
10 10 33
2 6 -
0 34
0 -
0 -
0 -
0 -
0 -
0 -
0 40
0 -
0 20
0 -
20 90 90
0 -
0 -
0 4
0 -
5 21 12
0 -
10 10 30
0 30
0 -
0 2
0 -
0 -
8 138
0 -
10 36 16
0 -
30 43
0 7
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 1 3 3 16 1
0 -
1 1 1 8 1
1 1 1 9 1
0 -
1 1 1 1
0 2
0 9
0 -
0 18
0 -
0 -
2 3 1 1 6 3 3 37 1
0 -
44 30 60 50 46 36 48 1217 59
0 -
0 -
0 -
0 -
30 10
0 80
25 20 30 20 407 44
1 -
0 2
0 1
0 -
0 20
0 -
0 -
20 10 78 53
0 -
0 186
0 40
0 -
0 3
10 70
10 30 33
0 -
0 4
1 1 10 1
0 -
1 1 1 2 1
0 67
10 10 10
0 -
0 -
0 -
10 43 -
0 3
0 19
0 10
0 -
10 16 15
10 10 30 15
10 28 -
0 -
2 -
10 10 40 -
0 -
0 -
0 -
0 90
0 -
10 20 20 20 20 18 12 385 91
0 80
0 -
0 -
10 72 -
30 6 12 17 10 143 -
0 -
0 36
30 85
0 -
30 70
0 -
0 90
1 2 -
1 -
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 17
0 3
2 1 12 10
0 3
0 -
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 2
0 -
0 7
0 1
1 1 3
0 -
0 -
0 -
0 2
0 1
5 -
0 -
0 -
0 10
0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 4
0 -
0 -
0 3
0 7
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
STOK HARIAN BULAN AGUSTUS TAHUN 2017
NO NAMA OBAT SATUAN PEMAKAIAN SISA STOK
UMUM JKN
1 Air Raksa Dental Use Botol 0 0 -
2 Albendazole Tablet 400 mg Tablet 0 0 100
4 Ambroksol Tablet 30 mg Tablet 60 0 38
5 Ambroksol sirup 15 mg/5 ml Botol 8 0 5
6 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 0 0 -
7 Aminofillin Tablet 200 mg Tablet 0 0 20
8 Amitriptillin Hcl Tablet Salut 25 mg Tablet 0 30 -
9 Amlodipin Tablet 5 mg Tablet 10 0 -
10 Amlodipin Tablet 10 mg Tablet 0 0 -
12 Amoksisillin Kaplet 500 mg Kaplet 528 0 115
13 Amoksisillin Serbuk Injeksi 1000 mg vial 0 0 -
14 Amoksisillin Sirup Kering 125 mg/5ml Botol 22 0 7
15 Amoksisillin Double Strengh Sirup Kering Botol 12 0 4
16 Ampisilin Kapsul 250 mg Kapsul 10 0 60
17 Ampisillin Kaplet 500 mg Tablet 0 0 42
18 Ampisilin Sirup 125 mg / 5 ml Botol 0 0 -
19 Ampisillin Injeksi 1000 mg Vial 0 0 -
20 Analgetik Plus Tablet 0 0 -
21 Antasida Doen Suspensi Kombinasi : Mag Botol 7 0 4
22 Antasida Doen Tablet, Kombinasi : Magn Tablet 554 0 171
23 Antasida Plus Tablet Tablet 20 0 10
24 Antalgin (Metampiron) Tablet 500 mg Tablet 40 0 -
25 Antalgin Injeksi 250 mg/ml-2ml Ampul 0 0 -
26 Anti Bakteri DOEN Salep Kombinasi : Tube 4 0 1
27 Anti Hemoroid Doen komb Supp 0 0 -
28 Anti Fungi DOEN Kombinasi : Pot 1 0 1
29 Antimigren DOEN Kombinasi : Tablet 0 0 -
30 Anti Diare Suspensi Botol 1 0 3
31 Anti Diare Tablet Tablet 0 38 37
32 Anti Dotum Oral Tablet Tablet 0 0 170
33 Anti Hipertensi Kapsul Tablet 20 0 10
34 Antihistamin Tablet kombinasi Tablet 95 0 164
35 Antispasmodik Tablet Tablet 20 0 10
36 Antitusiva Sirup Botol 2 0 3
37 Antitusiva Tablet Tablet 0 0 -
38 Asam Folat Tablet 1 mg Tablet 0 0 -
39 Asam Askorbat 50 mg Tablet 500 0 62
40 Asam Mefenamat Kapsul 500 mg Kapsul 0 0 -
41 Asetosal 80 mg Tablet 0 0 -
42 Asetosal Tablet 100 mg Tablet 0 0 -
44 Asiklovir Krim 5 % Tube 1 0 3
45 Asiklovir Tablet 200 mg Tablet 12 0 83
47 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 0 0 -
48 Aqua Pro Injeksi Steril, bebas Pirogen 20 mVial 0 0 -
49 Betahistin Mesilat 6 mg Tablet 0 0 -
51 Bisakodil suppositoria 10 mg Supp 0 0 -
52 Bisoprolol Tablet 5 mg Tablet 0 0 -
53 Bromheksin 8 mg Tablet 0 0 30
54 Deksametason Injeksi 5mg/ml-1ml Ampul 0 0 2
55 Deksametason Tablet 0,5 mg Tablet 73 0 609
56 Devitalisasi Pasta (Non Arsen) Botol 0 0 -
57 Diazepam tablet 2 mg Tablet 0 0 29
58 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul 0 0 -
59 Diazepam Larutan Rektal 5 mg/ml Supp 0 0 -
60 Dietilkarbamazin Sitrat Tablet 100 mg Tablet 0 0 -
61 Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul 0 0 46
62 Digoksin Tablet 0,25 mg Tablet 0 0 40
63 Dimenhidrinat Tablet 50 mg Tablet 30 0 96
64 Domperidon Tablet 10 mg Tablet 0 0 104
65 Donperidon Suspensi 5 mg/5ml Botol 0 0 3
66 Efedrin Hcl Tablet 25 mg Tablet 0 0 -
67 Ekstrak Belladone Tablet 10 mg Tablet 0 0 -
68 Epinefrin HCl / Bitartrat Ampul 0 0 5
69 Eritromisin Kapsul 250 mg Kapsul 0 0 -
71 Eritromisin Sirup 200 mg / 5 ml Botol 0 0 -
72 Etambutol Tablet 500 mg Tablet 0 0 -
73 Etanol 70 % 100 ml Botol 0 0 -
74 Etil Klorida Semprot -100 ml Botol 0 0 -
75 Eugenol Cairan -10 ml Botol 0 0 -
76 Fenitoin Natrium Kapsul 100 mg Kapsul 0 60 40
77 Fenobarbital tablet 30 mg Tablet 0 0 -
78 Fenobarbital injeksi 50 mg / ml Ampul 0 0 -
79 Fenoksimeti Penisilin 250 mg tablet Tablet 0 0 100
81 Fitomenadion tablet 10 mg Tablet 30 0 25
82 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1mlAmpul 0 0 -
83 Furosemid Tablet 40 mg Tablet 13 0 34
84 Garam Oralit I serbuk, kombinasi : Kantong 42 0 -
85 Gemfibrozil Tablet 600 mg Tablet 0 0 -
86 Gentamisin injeksi 80 mg / 2 ml Vial 0 0 -
88 Glibenklamid Tablet 5 mg Tablet 10 0 90
89 Glimepiride 2 mg Tablet 0 0 10
90 Gliseril guayakolat tablet 100 mg Tablet 150 0 659
91 Gliseril Guayakolat sirup Botol 0 0 -
92 Glukonas Kalsikus injeksi Ampul 0 0 -
93 Glukosa Larutan Infus 5 % Botol 0 0 1
94 Glukosa Larutan Infus10 % Botol 0 0 -
95 Griseofulvin Tablet 125 mg,micronized Tablet 0 0 50
96 Haloperidol Tablet 0,5 mg Tablet 0 0 80
98 Haloperidol Tablet 5 mg Tablet 132 0 13
99 Hidrokloritiazid 25 mg Tablet 14 0 7
100 Hidrokortison Krim 2,5 % Tube 15 0 5
101 Ibuprofen Tablet 200 mg Tablet 0 158 -
102 Ibuprofen Tablet 400 mg Tablet 16 0 -
103 Ibuprofen Suspensi 100 mg/5 ml Botol 0 0 3
104 Ichtyol salep Kulit Pot 0 0 3
105 Ipatropium Bromide + Salbutamol Vial 0 0 -
106 Isoniazid tablet 100 mg Tablet 0 0 -
107 Isosorbid Dinitrat 5 mg Tablet 0 0 -
108 Kalium Diklofenak Tablet 25 mg Tablet 0 0 -
109 Kalium Diklofenak Tablet 50 mg Tablet 182 0 34
110 Kalsium Hidroksida Pasta Tube 0 0 -
111 Kalsium Laktat Tablet 500 mg Tablet 28 0 88
112 Kaptopril 12,5 mg Tablet 280 0 51
113 Kaptopril 25 mg Tablet 22 0 -
114 Karbamazepin Tablet 200 mg Tablet 40 0 15
115 Ketokonazole Krim 2 % - 15 gr Tube 0 0 2
116 Ketokonazole Tablet 200 mg Tablet 0 0 54
117 Ketoprofen Tablet 100 mg Tablet 0 0 -
118 Ketoprofen Injeksi 100 mg / 1 ml Ampul 0 0 -
119 Ketorolac 10 mg injeksi Ampul 0 0 -
121 Klindamisin Kapsul 150 mg Kapsul 0 0 -
123 Kloramfenikol Kapsul 250 mg Kapsul 0 0 60
124 Kloramfenikol Salep Mata 1%-3,5 g Tube 3 0 -
125 Kloramfenikol Tetes Mata -5 ml Botol 0 0 -
126 Kloramfenikol Tetes Telinga 3%-5 ml Botol 1 0 2
127 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 300 0 33
128 Klorpromazin Hcl Tablet Salut 25 mg Tablet 0 0 -
129 Klorpromazin Hcl Tablet Salut 100 mg Tablet 95 0 61
130 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 0 0 -
131 Kotrimoksazol Pedriatik Tablet, Kombinasi :Tablet 0 0 12
132 Kotrimoksazol Tablet, Kombinasi : Tablet 0 10 33
133 Kotrimoksazol Suspensi Kombinasi : Botol 6 0 -
134 Lansoprazole 30 mg Kapsul Tablet 0 0 34
135 Larutan mengadung Elektrolit (Na 130 mEqBotol 0 0 -
136 Larutan mengadung Elektrolit (Nacl 1,125 grBotol 0 0 -
137 Larutan mengadung Karbohidrat + ElektrolitBotol 0 0 -
138 Lidokain injeksi 2 % Tablet 0 0 -
139 Lidokain Komp Injeksi, Kombinasi : Ampul 0 0 -
140 Loperamid Tablet 2 mg Tablet 0 0 -
141 Loratadin tablet 10 mg Tablet 0 0 40
142 Magnesium Sulfat (IV) 20 %-25 ml Ampul 0 0 -
144 Meloksikam Suppositoria Supp 0 0 -
145 Metformin Hcl Tablet 500 mg Tablet 90 0 90
146 Methisoprinol 500 mg Tablet 0 0 -
147 Metilergometrin Maleat (Metergin) TabletTablet 0 0 -
148 Metilergometrin Maleat Injeksi 0,200 mg- Ampul 0 0 4
149 Metilprednisolon tablet 4 mg Tablet 0 0 -
150 Metoklopramid 10 mg Tablet 21 0 12
151 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul 0 0 -
152 Metronidazol Tablet 250 mg Tablet 10 0 30
153 Metronidazole Tablet 500 mg Tablet 0 0 30
154 Metronidazole Infus 500 mg /100 ml Ampul 0 0 -
155 Mikonazole KrIm 2 % - 10 gr Tube 0 0 2
156 Multivitamin + Mineral tablet Tablet 0 0 -
157 Multivitamin sirup Botol 0 0 -
158 Natrium Bikarbonat Tablet 500 mg Tablet 8 0 138
159 Natrum Diklofenak Tablet 25 mg Tablet 0 0 -
161 Natrium Klorida Larutan infus 0,9%-Steril Botol 0 0 -
162 Nipedifin Tablet 10 mg Tablet 30 0 43
163 Nistatin 100.000 IU/gram Tablet Vagina Tablet 0 0 7
164 Nistatin 500.000 IU/gram Tablet Salut Tablet 0 0 50
165 Obat Antitiuberkolosis Kategori Anak Paket 0 0 -
166 Obat Antitiuberkolosis Kategori 1 Dewasa Paket 0 0 -
169 Obat Anti Tuberkulosis FDC Kat Anak Paket 0 0 -
170 Obat Anti Tuberkulosis FDC Kat I & II Paket 0 0 -
171 Obat Anti Tuberkulosis FDC Kat I & III Paket 0 0 -
172 Obat Anti Tuberkolosis FDC Sisipan DewasaPaket 0 0 -
173 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 16 0 1
174 Obat Batuk Cair Sirup (Ekspektoran) Botol 0 0 -
175 Obat Batuk Hitam Plus Sirup Botol 8 0 1
176 Obat Flu Sirup Botol 0 9 1
177 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 Vial 0 0 -
178 Oksiterasiklin Salep Mata 1%-3,5g Tube 1 0 1
179 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 0 0 2
180 Oksitosin Injeksi 10 IU/ml-1ml Ampul 0 0 9
181 Omeprazole injeksi 40mg/10ml Ampul 0 0 -
183 Ondansetron inj 4 mg/ 2 mL Ampul 0 0 -
184 Parasetamol drops Botol 0 0 -
185 Parasetamol Sirup 120 mg/5ml-60 ml Botol 37 0 1
186 Parasetamol Tablet 100 mg Tablet 0 0 -
187 Parasetamol Tablet 500 mg Tablet 1217 0 59
188 Pehacain injeksi Ampul 0 0 -
189 Perak Sulfadiazin krim 1 % 35 gr Tube 0 0 -
190 Piracetam 400 mg Tablet 0 0 -
191 Piracetam Tablet 800 mg Tablet 0 0 -
192 Piroksikam Tablet 20 mg Tablet 30 0 10
193 Pirantel Pamoat Tablet 365 mg (Setara dngTablet 0 0 80
194 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 407 0 44
195 Polikresulen (Kondensasi Metakresol Botol 1 0 -
196 Povidon Iodida 10% 30 ml Botol 0 0 2
198 Primakuin tablet 15 mg Tablet 0 0 -
199 Propanolol Hcl Tablet 40 mg Tablet 0 0 20
200 Propilturasil Tablet 100 mg Tablet 0 0 -
201 Ranitidin Injeksi 25 mg / ml Ampul 0 0 -
203 Retinol (Vit.A) 100.000 IU Kapsul Kapsul 0 0 -
204 Retinol (Vit.A) 200.000 IU Kapsul Kapsul 0 0 186
205 Reserpin Tablet 0, 25 mg Tablet 0 0 40
206 Rifampisin Tablet 450 mg Tablet 0 0 -
207 Ringer Laktat Larutan Infus Steril 500 ml Botol 0 0 3
210 Salbutamol solution for Inhalation single doAmpul 0 0 -
211 Salep 2-4 Kombinasi : Pot 0 0 4
213 Salep Luka Bakar Tube 0 0 -
214 Sefadroksil Sirup Kering 125 mg / 5 ml siruBotol 2 0 1
215 Sefadroksil Tablet 500 mg Tablet 0 0 67
216 Sefiksim Kapsul 100 mg Kapsul 0 10 10
217 Sefotaksim Injeksi 1 gr Ampul 0 0 -
218 Seftriakson Injeksi 1 gr / vial Ampul 0 0 -
219 Semen Seng Fosfat Serbuk & Cairan Botol 0 0 -
220 Setirizin Tablet 10 mg Tablet 0 43 -
221 Setirizin Sirup 5 mg / 5 ml Botol 0 0 3
222 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul 0 0 19
223 Sianokobalamin Tablet 50 mcg Tablet 0 0 10
224 Silver Amalgam Serbuk 65-75% Botol 0 0 -
225 Simetidin 200 mg Tablet Tablet 16 0 15
226 Simvastatin Tablet 10 mg Tablet 30 0 15
227 Siprofloksasin 500mg Tablet 0 28 -
228 Spironolakton Tablet 25 mg Tablet 0 0 -
229 Sulfacetamid Tetes Mata 15 %-5ml Botol 2 0 -
230 Tablet Tambah Darah Kombinasi: Tablet 40 0 -
231 Temporary Stopping Fletcher (Fletcher) Se Set 0 0 -
232 Trikesol formalin ( T K F ) Cairan 10 ml Botol 0 0 -
233 Tetrasiklin Kapsul 250 mg Kapsul 0 0 -
234 Tetrasiklin Kapsul 500 mg Kapsul 0 0 90
235 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1mlAmpul 0 0 -
236 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 Tablet 0 386 91
237 Thiamfenikol Kapsul 500 mg Kapsul 0 0 80
238 Tramadol Injeksi 50 mg/ ml Ampul 0 0 -
239 Tramadol Tablet 50 mg Tablet 0 0 -
240 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 72 0 -
241 Vitamin B .Komplek Tablet Tablet 0 143 -
242 Vitamin Neurotropik Tablet Tablet 0 0 -
243 Zinc Tablet 20 mg Tablet 0 30 36
244 Prednisone 54mg Tablet 30 0 85
245 flunax sy Botol 0 0 -
246 vit k tablet 30 0 70
247 gentian violet Botol 0 0 -
248 kloramfenikol 500 Tablet 0 0 90
249 Rivanol 300 ml Botol 2 0 -
250 Alkohol 70%100 ml Botol 1 0 -
no B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES

UMUM JKN
1 Abbocath No 18 ( IV Chateter 18 ) Buah 0 0 -
2 Abbocath No 20 ( IV Chateter 20 ) Buah 0 0 10
5 Alat Suntik Sekali Pakai 10 ml Set 0 0 17
7 Alat Suntik Sekali Pakai 2,5 ml Set 0 0 10
9 Alat Suntik Sekali Pakai 10 ml Set 0 0 -
10 Auto Disposable Syringe (ADS) 0,05 ml set 0 0 -
12 Auto Disposable Syringe (ADS) 5 ml set 0 0 -
13 Catgut/Benang Bedah No.2/0-3/0 (Plain & Sachet 0 0 2
14 Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 0 0 -
15 Etanol 70 % 1.000 ml Botol 0 0 -
16 Folley Catheter no 14 Set 0 0 -
18 Folley Catheter no 18 Set 0 0 2
19 Infus set Anak Set 0 0 -
20 Infus set Dewasa Set 0 0 7
21 Iodina Test Botol 0 0 1
22 Kassa Hidrofil Steril 16 x 16 Kotak 0 0 3
23 Kapas Berlemak 500 gram Bungkus 1 0 -
24 Kapas Pembalut / Adsorbens 250 gram Bungkus 0 0 -
25 Kassa Kompres 40 x 40 steril Bungkus 0 0 -
26 Kassa Pembalut 2 m x 80 cm Rol 0 0 2
27 Kassa Pembalut Hidrofil 4 m x 3 cm Rol 0 0 1
28 Kassa Pembalut Hidrofil 4 m x 15 cm Rol 0 0 -
29 Kertas Puyer Pcs 5 0 -
30 Lysol 1,000 ml Botol 0 0 -
31 Masker Buah 0 0 10
32 Plester 5 yard x 2 inchi Rol 0 0 1
33 Pot Dahak Pcs 0 0 -
34 Rapid HIV 1 (SD HIV) Pcs 0 0 -
35 Rapid HIV 2 (Intec HIV) Pcs 0 0 -
36 Rapid HIV 2 (Biomeriux HIV) Pcs 0 0 -
37 Rapid Test Syphilis Pcs 0 0 -
38 RPR Test Syphilis Pcs 0 0 -
39 Silk( Benang Bedah Sutra ) No 3/0 Sachet 0 0 4
40 Safety Box Pcs 0 0 -
41 Sarung tangan Steril No 6 Pcs 0 0 -
42 Sarung tangan Steril No 7 Pcs 0 0 3
43 Sarung tangan Steril No 7,5 Pcs 0 0 7
44 Sarung tangan Non Steril S Pcs 0 0 -
45 Sarung tangan Non Steril M Pcs 0 0 -
46 Sarung tangan Non Steril L Pcs 0 0 -
47 Urine Bag set 0 0 2
48 Wing Neddle No 23 Set 0 0 -
49 Anuscopi Yamato Unit 0 0 -
50 Kaca Slide Box 0 0 -
51 Reagen Ziehl Nielson Kit 0 0 -
52 Rotator Unit 0 0 -
53 RTD Malaria Tes 0 0 -
54 Rapid HIV 3 (Oncoprobe HIV) Pcs 0 0 -
55 Sound Timer Buah 0 0 -
56 SD Syphilis Pcs 0 0 -
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 -
2 100
3
4
Ambroksol sirup 15 mg/5 ml Botol 5 - 5
5
6
7
Amitriptillin Hcl Tablet Salut 25 mg Tablet - 100 100
8
Amlodipin Tablet 5 mg Tablet - 90 90
9
Amlodipin Tablet 10 mg Tablet - 60 60
10
11
12 20
13
14 1
Amoksisillin Double Strengh Sirup Kering Botol
250 mg/5 ml 4 10
15 14
16
17
18
19
20
21 4 15 19 1
22 871
Antasida Plus Tablet/TRIANTA Tablet 10 100 110
23
24
25
Polimiksin 1000 IU/g - -
26 -
27
Asam Benzoat 6% + 1 -
28 Asam Salisilat 3% 1
Ergotamin Tartrat 1 mg + - -
29 Kofein 50 mg -
30
31 10
32
Anti Hipertensi Kapsul/Tensigard Tablet - - -
33
34
35
36
37
38
39 6
Asam Mefenamat Kapsul 500 mg Kapsul - - -
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
(Epinefrina /
68 5
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
( Nacl 0,52 gr,
Kalium Klorida 0,30 gr, Trinatrium Sitrat 100
dihidrat 0,58 gr, Glukosa Anhidrat 2,70 g )
200 ml Air
84 - 100 6
85
86
87
88
89
90 10
91
92
93
94
95
96
97
98
99
100
101
102
103
104
Sulphate for inhalation -
105 2,5 ml - -
106
107
108
109
110
111
112 17
Kaptopril 25 mg Tablet - 100 100
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127 10
128
129
130
Kombinasi : Sulfametoksazol
100 mg + Trimetroprim 20 mg -
131 12 12
132 33 133 12
133 - 5
134
mEq,Cl 109 mEq, Asetat 28 mEq) /Asering
-
135 - -
Larutan mengadung Elektrolit (Nacl 1,125 Botol
gr , Dekstrosa 18,75 gr) -
136 - -
Elektrolit (Nacl
1,75 gr, KCL 1,5 gr, Na Lactat 2,24 gr, -
Dekstrosa 27 gr)
137 - -
138
Lidokain Hcl 2%
+Epinefrin 1 : 80.000-2 ml -
139 - -
140
141
142
143
144
145
146
Metilergometrin Maleat (Metergin) Tablet 0 Tablet - - -
147
148
Metilprednisolon tablet 4 mg Tablet - 100 100
149
Metoklopramid 10 mg/xilastin Tablet 12 100 112
150
151
152
153
154
155
156
157
158
159
160
Natrium Klorida Larutan infus 0,9%-Steril 50 Botol - -
161 -
162 43
Nistatin 100.000 IU/gram Tablet Vagina Tablet 5 12
163 7
164 50
165 -
166 - -
167 - -
168 - -
169 - -
170 - -
171 -
172 -
Obat Batuk Hitam (OBH) Cairan 100 ml/BERL Botol 6 7
173 1
Obat Batuk Cair Sirup (Ekspektoran)/CORED Botol - -
174 -
175 1
176 1 2
Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 m Vial - -
177 -
178 1
179 2
180 9
181 -
182 18
183
184
185
186
187
188
189
190
191
192
Pirantel Pamoat Tablet 365 mg (Setara dng Tablet 80 0 80
193
194
Sulfonat dan Metanal)
195 360 mg/g-10 ml - 1 1
196
197
198
199
200
201
202
203
204
205
206
207
Salbutamol Tablet 2 mg Tablet - 0 -
208
209
Salbutamol solution for Inhalation single Ampul
dose units 2,5 ml
210 - 0 -
Asam Salisilat 2 %
+ Belerang Endap 4 % - 30 gram
211 4 0 4
212
213
214
215
216
217
218
219
Setirizin Tablet 10 mg Tablet - 43 43
220
221
Sianokobalamin Injeksi 500 mcg/ml-1ml/Vit Ampul 19 0 19
222
223
224
225
Simvastatin Tablet 10 mg Tablet 15 30 45 10
226
Siprofloksasin 500mg Tablet - 100 100
227
Spironolakton Tablet 25 mg Tablet - 100 100
228
Sulfacetamid Tetes Mata 15 %-5ml Botol - 0 -
229
Asam Folat 0,25 mg
230 - 0 -
Serbuk & Cairan
231 - 0 -
232
233
234
235
Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 m Tablet 91 400 491 10
236
237
238
239
Triheksifenidil Hidroklorida Tablet 2 mg Tablet - 100 100
240
Vitamin B .Komplek Tablet Tablet - 200 200 26
241
242
243
244
245
vit k Set 70 0 100
246
247
248
Rivanol 300 ml Kotak - 0 -
249
Alkohol 70%100 ml - 0 -
250 Ampul
251 Tablet - -
252 Vial - -
- -
1
2
3
4
5
6
7
8
9
10
11
12
Catgut/Benang Bedah No.2/0-3/0 (Plain & C Sachet 2 0 2
13
14
Etanol 70 % 1.000 ml Botol - 1 1
15
16
17
18
19
20
21
22
23
24
25
26
27
Kassa Pembalut Hidrofil 4 m x 15 cm Rol - 5 5
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs - 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
Sarung tangan Non Steril L Pcs - 100 100
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit - 0 -
52
53
54
55
56
supraptul/bioplacenton tule lembar - 1 1
57
CATATAN HARIAN PEMAKAIA
Bulan : September Tahun : 2
JUMLAH PE
3 4 5 6 7 8 9 10 11 12
10
1
20 10 10
60 80 40 30 20 10
2 2
1 1 2 1
40 30 40 10 60 10 40 20
10
20 10
10 55 10 20 10
10 6 6
1
10 20
20 10
1
10
1 1
10 20 6 10 6
8
10
6
1
10
45 5 10 10
5 10 20
1 1 1
10 20 6
10 10 8 12 16
6 16 10
8
30 45 80 22 30
10 5 5 20
12
6 8
10 10
10 6 15
1 1
1 1
3 1
64 126 82 96 70 77 25
5 10
10 26 10 20 20 20
16 8
20
1 1
10 6 6
10
10
10 32 10 50 26 8 5 8
10 10
10 30 12 15 20 6 21 6
10 6 4 10
1 2 1
1
HARIAN PEMAKAIAN OBAT
: September Tahun : 2017
13 14 15 16 17 18 19 20 21 22
10 10 20
18 10
10 20
30
10
40 40 20 60 20 10 40
1 1
2 1 1
1 1 1 1 3
30 50 10 20 16 30 60 50
10 10
10 10 10 10 5 20
6 10
1 1
20 10
10
16 24 10
8 10
20
6 6
10 20
10 10 10 20
20 5 5
1 1 3 1
10 10 10
8 18 10 38 10
10
10 10 10
10 10
10 20
1 1
1
38 10 13 20 16 30
20 5 5
12
2 1
8 10
10
6 6 8 6 8
10 8
10
1 1
3 1
1 1 2
1 1 1
66 10 20 40 30 46 45 58
38 20 40 6 25 20
10 10 10 8
5 10
1
1 1 1 1
10
10 10
10
10
10 10 10 20 10
10
26 14 3 10 12 6 34 32
12 30 20 6 5
1 1
Jumlah
Pemakaian
23 24 25 26 27 28 29 30 31
0
0
40
10 10 58
1
0
0
30
20 20 70
30
10 60
80 20 30 10 20 650
0
1 1 9
3 1 2 1 12
0
0
0
0
0
2 1 2 18
5 60 30 40 10 10 170
871
10 20
40
0
0
0
0
1 1 2
10 70
0
0
10 20 10 210
38
3
0
0
10 30 10 10 500
10 10 0
0
0
0
3
10
0
0
0
0
1 4
0
0
0
0
20 122
0
10 10
0
0
0
0
0
10 20 30
10
0
0
0
0
0
0
0
0
0
0
0
10 10
0
0
0
0
10 10
0
20
6 6 6 42
0
0
1 1 3
40
0
5 20 30 185
0
0
0
0
0
0
10 20 10 20 60
5 70
0
3 1 13
50 158
10 16
1 1
0
0
0
0
0
140
0
10
79
10 31 10 15 20 91 22
10 10 10 10 70
1 3
10 18
0
0
0
0
0
0
0
2
0
1
15 20 10 16 5 410
0
5 5 10 5 10 105
0
10 46
1 4
0
0
0
0
0
0
0
18
0
10
0
0
0
10 10
6 54
0
0
0
0
1 1 3
0
0
0
0
22 20 80
0
41
4 4 8
12 17
0
0
0
0
0
0
0
0
1 1 1 7
1 0
2 1 9
1 2 2 15
0
1 1 1 1
0
0
0
0
0
0
1 2 1 9
0
77 136 40 46 6 46 160 4116
0
0
0
0
20 30 65
0
25 50 30 10 16 40 436
1
0
0
0
0
0
0
20 10 20 10 132
0
0
0
0
0
0
5 40
1
1 8
0
2
10 20
10 10 20
0
0
0
10 10 43
0
0
0
0
6 28
30
10 20 20 28
20 10 50
0
0
0
0
0
0
30 132 20 8 10 10 30 459
0
0
0
10 10 72
31 32 10 10 20 6 130 143
0
0
10 10 10 30
0
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 9
0
0
0
0
0
0
0
1
0
0
0
0
0
0
3
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
1 1
Sisa Akhir
Bulan
-
100
82
80
4
-
20
70
20
30
59
65
-
3
2
60
42
-
-
-
-
90
-
-
-
-
-
1
17
170
-
54
72
-
-
-
62
-
-
-
-
-
73
88
-
-
-
3
-
-
30
2
487
-
19
-
-
-
46
40
66
94
3
-
-
5
-
-
-
-
-
-
-
30
-
-
100
70
15
-
14
58
-
-
3
50
10
474
-
-
1
-
50
80
-
-
7
2
42
84
2
3
-
-
-
-
44
-
78
-
78
45
-
36
-
-
-
-
-
-
60
-
-
1
123
-
56
-
12
87
1
34
-
-
-
-
40
-
2
-
80
-
-
4
90
58
-
30
30
-
2
-
-
138
-
36
-
2
4
33
-
-
-
-
-
-
-
-
-
-
2
1
-
-
2
9
-
18
-
-
2
-
43
-
-
-
-
45
80
108
-
2
1
-
20
-
-
21
-
186
40
-
3
-
93
3
3
-
4
47
-
-
-
-
-
3
19
10
-
87
15
72
50
-
-
-
-
90
-
32
80
-
-
28
57
-
36
55
-
70
-
90
-
-
-
-
-
-
-
10
-
-
17
3
1
3
-
-
-
-
2
-
-
-
-
2
-
7
1
2
-
-
-
2
1
-
-
-
10
1
-
-
-
-
-
-
4
-
-
3
7
-
-
-
2
-
-
-
-
-
-
-
-
-
-
STOK HARIAN BULAN AGUSTUS TAHUN 2017
UMUM JKN
1 Air Raksa Dental Use Botol 0 0 -
2 Albendazole Tablet 400 mg Tablet 0 0 100
4 Ambroksol Tablet 30 mg Tablet 58 0 80
5 Ambroksol sirup 15 mg/5 ml Botol 1 0 4
6 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 0 0 -
7 Aminofillin Tablet 200 mg Tablet 0 0 20
8 Amitriptillin Hcl Tablet Salut 25 mg Tablet 30 0 70
12 Amoksisillin Kaplet 500 mg Kaplet 650 0 65
13 Amoksisillin Serbuk Injeksi 1000 mg vial 0 0 -
14 Amoksisillin Sirup Kering 125 mg/5ml Botol 9 0 3
15 Amoksisillin Double Strengh Sirup Kering Botol 12 0 2
16 Ampisilin Kapsul 250 mg Kapsul 0 0 60
17 Ampisillin Kaplet 500 mg Tablet 0 0 42
18 Ampisilin Sirup 125 mg / 5 ml Botol 0 0 -
19 Ampisillin Injeksi 1000 mg Vial 0 0 -
20 Analgetik Plus Tablet 0 0 -
21 Antasida Doen Suspensi Kombinasi : Mag Botol 18 0 1
22 Antasida Doen Tablet, Kombinasi : Magn Tablet 871 0 -
23 Antasida Plus Tablet Tablet 20 0 90
24 Antalgin (Metampiron) Tablet 500 mg Tablet 40 0 -
25 Antalgin Injeksi 250 mg/ml-2ml Ampul 0 0 -
26 Anti Bakteri DOEN Salep Kombinasi : Tube 0 0 -
27 Anti Hemoroid Doen komb Supp 0 0 -
28 Anti Fungi DOEN Kombinasi : Pot 0 0 1
29 Antimigren DOEN Kombinasi : Tablet 0 0 -
30 Anti Diare Suspensi Botol 0 2 1
31 Anti Diare Tablet Tablet 70 0 17
32 Anti Dotum Oral Tablet Tablet 0 0 170
33 Anti Hipertensi Kapsul Tablet 0 0 -
34 Antihistamin Tablet kombinasi Tablet 210 0 54
35 Antispasmodik Tablet Tablet 38 0 72
36 Antitusiva Sirup Botol 3 0 -
37 Antitusiva Tablet Tablet 0 0 -
38 Asam Folat Tablet 1 mg Tablet 0 0 -
39 Asam Askorbat 50 mg Tablet 500 0 62
40 Asam Mefenamat Kapsul 500 mg Kapsul 0 0 -
41 Asetosal 80 mg Tablet 0 0 -
44 Asiklovir Krim 5 % Tube 3 0 -
47 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 0 0 -
48 Aqua Pro Injeksi Steril, bebas Pirogen 20 mVial 0 0 -
49 Betahistin Mesilat 6 mg Tablet 0 0 -
52 Bisoprolol Tablet 5 mg Tablet 0 0 -
53 Bromheksin 8 mg Tablet 0 0 30
54 Deksametason Injeksi 5mg/ml-1ml Ampul 0 0 2
55 Deksametason Tablet 0,5 mg Tablet 122 0 487
56 Devitalisasi Pasta (Non Arsen) Botol 0 0 -
57 Diazepam tablet 2 mg Tablet 10 0 19
58 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul 0 0 -
59 Diazepam Larutan Rektal 5 mg/ml Supp 0 0 -
60 Dietilkarbamazin Sitrat Tablet 100 mg Tablet 0 0 -
61 Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul 0 0 46
62 Digoksin Tablet 0,25 mg Tablet 0 0 40
63 Dimenhidrinat Tablet 50 mg Tablet 30 0 66
64 Domperidon Tablet 10 mg Tablet 10 0 94
65 Donperidon Suspensi 5 mg/5ml Botol 0 0 3
66 Efedrin Hcl Tablet 25 mg Tablet 0 0 -
67 Ekstrak Belladone Tablet 10 mg Tablet 0 0 -
68 Epinefrin HCl / Bitartrat Ampul 0 0 5
71 Eritromisin Sirup 200 mg / 5 ml Botol 0 0 -
72 Etambutol Tablet 500 mg Tablet 0 0 -
73 Etanol 70 % 100 ml Botol 0 0 -
74 Etil Klorida Semprot -100 ml Botol 0 0 -
75 Eugenol Cairan -10 ml Botol 0 0 -
76 Fenitoin Natrium Kapsul 100 mg Kapsul 10 0 30
77 Fenobarbital tablet 30 mg Tablet 0 0 -
78 Fenobarbital injeksi 50 mg / ml Ampul 0 0 -
82 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1mlAmpul 0 0 -
83 Furosemid Tablet 40 mg Tablet 20 0 14
84 Garam Oralit I serbuk, kombinasi : Kantong 42 0 58
85 Gemfibrozil Tablet 600 mg Tablet 0 0 -
86 Gentamisin injeksi 80 mg / 2 ml Vial 0 0 -
88 Glibenklamid Tablet 5 mg Tablet 40 0 50
89 Glimepiride 2 mg Tablet 0 0 10
90 Gliseril guayakolat tablet 100 mg Tablet 185 0 474
91 Gliseril Guayakolat sirup Botol 0 0 -
92 Glukonas Kalsikus injeksi Ampul 0 0 -
93 Glukosa Larutan Infus 5 % Botol 0 0 1
94 Glukosa Larutan Infus10 % Botol 0 0 -
95 Griseofulvin Tablet 125 mg,micronized Tablet 0 0 50
97 Haloperidol Tablet 1,5 mg Tablet 60 0 -
98 Haloperidol Tablet 5 mg Tablet 70 0 -
99 Hidrokloritiazid 25 mg Tablet 0 0 7
100 Hidrokortison Krim 2,5 % Tube 13 0 2
101 Ibuprofen Tablet 200 mg Tablet 158 0 42
102 Ibuprofen Tablet 400 mg Tablet 16 0 84
103 Ibuprofen Suspensi 100 mg/5 ml Botol 1 0 2
104 Ichtyol salep Kulit Pot 0 0 3
105 Ipatropium Bromide + Salbutamol Vial 0 0 -
106 Isoniazid tablet 100 mg Tablet 0 0 -
107 Isosorbid Dinitrat 5 mg Tablet 0 0 -
108 Kalium Diklofenak Tablet 25 mg Tablet 0 0 -
109 Kalium Diklofenak Tablet 50 mg Tablet 140 0 44
110 Kalsium Hidroksida Pasta Tube 0 0 -
111 Kalsium Laktat Tablet 500 mg Tablet 10 0 78
112 Kaptopril 12,5 mg Tablet 79 0 -
113 Kaptopril 25 mg Tablet 22 0 78
114 Karbamazepin Tablet 200 mg Tablet 70 0 45
115 Ketokonazole Krim 2 % - 15 gr Tube 3 0 -
116 Ketokonazole Tablet 200 mg Tablet 18 0 36
117 Ketoprofen Tablet 100 mg Tablet 0 0 -
118 Ketoprofen Injeksi 100 mg / 1 ml Ampul 0 0 -
123 Kloramfenikol Kapsul 250 mg Kapsul 0 0 60
124 Kloramfenikol Salep Mata 1%-3,5 g Tube 2 0 -
125 Kloramfenikol Tetes Mata -5 ml Botol 0 0 -
126 Kloramfenikol Tetes Telinga 3%-5 ml Botol 1 0 1
127 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 410 0 123
128 Klorpromazin Hcl Tablet Salut 25 mg Tablet 0 0 -
129 Klorpromazin Hcl Tablet Salut 100 mg Tablet 105 0 56
130 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 0 0 -
131 Kotrimoksazol Pedriatik Tablet, Kombinasi :Tablet 0 0 12
133 Kotrimoksazol Suspensi Kombinasi : Botol 4 0 1
134 Lansoprazole 30 mg Kapsul Tablet 0 0 34
135 Larutan mengadung Elektrolit (Na 130 mEqBotol 0 0 -
136 Larutan mengadung Elektrolit (Nacl 1,125 grBotol 0 0 -
137 Larutan mengadung Karbohidrat + ElektrolitBotol 0 0 -
138 Lidokain injeksi 2 % Tablet 0 0 -
139 Lidokain Komp Injeksi, Kombinasi : Ampul 0 0 -
140 Loperamid Tablet 2 mg Tablet 0 0 -
141 Loratadin tablet 10 mg Tablet 0 0 40
142 Magnesium Sulfat (IV) 20 %-25 ml Ampul 0 0 -
144 Meloksikam Suppositoria Supp 0 0 -
145 Metformin Hcl Tablet 500 mg Tablet 10 0 80
146 Methisoprinol 500 mg Tablet 0 0 -
147 Metilergometrin Maleat (Metergin) TabletTablet 0 0 -
148 Metilergometrin Maleat Injeksi 0,200 mg- Ampul 0 0 4
149 Metilprednisolon tablet 4 mg Tablet 10 0 90
150 Metoklopramid 10 mg Tablet 54 0 58
151 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul 0 0 -
152 Metronidazol Tablet 250 mg Tablet 0 0 30
153 Metronidazole Tablet 500 mg Tablet 0 0 30
154 Metronidazole Infus 500 mg /100 ml Ampul 0 0 -
155 Mikonazole KrIm 2 % - 10 gr Tube 0 3 2
156 Multivitamin + Mineral tablet Tablet 0 0 -
157 Multivitamin sirup Botol 0 0 -
158 Natrium Bikarbonat Tablet 500 mg Tablet 0 0 138
159 Natrum Diklofenak Tablet 25 mg Tablet 0 0 -
161 Natrium Klorida Larutan infus 0,9%-Steril Botol 0 0 -
162 Nipedifin Tablet 10 mg Tablet 41 0 2
163 Nistatin 100.000 IU/gram Tablet Vagina Tablet 8 0 4
164 Nistatin 500.000 IU/gram Tablet Salut Tablet 17 0 33
165 Obat Antitiuberkolosis Kategori Anak Paket 0 0 -
169 Obat Anti Tuberkulosis FDC Kat Anak Paket 0 0 -
170 Obat Anti Tuberkulosis FDC Kat I & II Paket 0 0 -
171 Obat Anti Tuberkulosis FDC Kat I & III Paket 0 0 -
172 Obat Anti Tuberkolosis FDC Sisipan DewasaPaket 0 0 -
173 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 7 0 -
174 Obat Batuk Cair Sirup (Ekspektoran) Botol 0 0 -
175 Obat Batuk Hitam Plus Sirup Botol 9 0 2
177 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 Vial 0 0 -
178 Oksiterasiklin Salep Mata 1%-3,5g Tube 1 0 -
179 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 0 0 2
180 Oksitosin Injeksi 10 IU/ml-1ml Ampul 0 0 9
181 Omeprazole injeksi 40mg/10ml Ampul 0 0 -
183 Ondansetron inj 4 mg/ 2 mL Ampul 0 0 -
184 Parasetamol drops Botol 0 0 -
185 Parasetamol Sirup 120 mg/5ml-60 ml Botol 9 0 2
186 Parasetamol Tablet 100 mg Tablet 0 0 -
188 Pehacain injeksi Ampul 0 0 -
189 Perak Sulfadiazin krim 1 % 35 gr Tube 0 0 -
190 Piracetam 400 mg Tablet 0 0 -
191 Piracetam Tablet 800 mg Tablet 0 0 -
192 Piroksikam Tablet 20 mg Tablet 65 0 45
193 Pirantel Pamoat Tablet 365 mg (Setara dngTablet 0 0 80
194 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 436 0 108
195 Polikresulen (Kondensasi Metakresol Botol 1 0 -
198 Primakuin tablet 15 mg Tablet 0 0 -
199 Propanolol Hcl Tablet 40 mg Tablet 0 0 20
200 Propilturasil Tablet 100 mg Tablet 0 0 -
201 Ranitidin Injeksi 25 mg / ml Ampul 0 0 -
203 Retinol (Vit.A) 100.000 IU Kapsul Kapsul 0 0 -
204 Retinol (Vit.A) 200.000 IU Kapsul Kapsul 0 0 186
205 Reserpin Tablet 0, 25 mg Tablet 0 0 40
206 Rifampisin Tablet 450 mg Tablet 0 0 -
207 Ringer Laktat Larutan Infus Steril 500 ml Botol 0 0 3
208 Salbutamol Tablet 2 mg Tablet 0 0 -
210 Salbutamol solution for Inhalation single doAmpul 0 0 -
211 Salep 2-4 Kombinasi : Pot 1 0 3
213 Salep Luka Bakar Tube 0 0 -
214 Sefadroksil Sirup Kering 125 mg / 5 ml siruBotol 2 0 4
215 Sefadroksil Tablet 500 mg Tablet 20 0 47
216 Sefiksim Kapsul 100 mg Kapsul 0 20 -
217 Sefotaksim Injeksi 1 gr Ampul 0 0 -
218 Seftriakson Injeksi 1 gr / vial Ampul 0 0 -
219 Semen Seng Fosfat Serbuk & Cairan Botol 0 0 -
220 Setirizin Tablet 10 mg Tablet 43 0 -
222 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul 0 0 19
223 Sianokobalamin Tablet 50 mcg Tablet 0 0 10
224 Silver Amalgam Serbuk 65-75% Botol 0 0 -
225 Simetidin 200 mg Tablet Tablet 28 0 87
227 Siprofloksasin 500mg Tablet 0 28 72
228 Spironolakton Tablet 25 mg Tablet 50 0 50
229 Sulfacetamid Tetes Mata 15 %-5ml Botol 0 0 -
230 Tablet Tambah Darah Kombinasi: Tablet 0 0 -
231 Temporary Stopping Fletcher (Fletcher) Se Set 0 0 -
232 Trikesol formalin ( T K F ) Cairan 10 ml Botol 0 0 -
233 Tetrasiklin Kapsul 250 mg Kapsul 0 0 -
234 Tetrasiklin Kapsul 500 mg Kapsul 0 0 90
235 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1mlAmpul 0 0 -
236 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 Tablet 0 459 32
237 Thiamfenikol Kapsul 500 mg Kapsul 0 0 80
238 Tramadol Injeksi 50 mg/ ml Ampul 0 0 -
239 Tramadol Tablet 50 mg Tablet 0 0 -
240 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 72 0 28
241 Vitamin B .Komplek Tablet Tablet 143 0 57
242 Vitamin Neurotropik Tablet Tablet 0 0 -
243 Zinc Tablet 20 mg Tablet 0 0 36
244 Prednisone 54mg Tablet 30 0 55
245 flunax sy Botol 0 0 -
246 vit k tablet 30 0 70
247 gentian violet Botol 0 0 -
248 kloramfenikol 500 Tablet 0 0 90
249 Rivanol 300 ml Botol 0 0 -
250 Alkohol 70%100 ml Botol 0 0 -
no B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES

UMUM JKN
15 Etanol 70 % 1.000 ml Botol 1 0 -
22 Kassa Hidrofil Steril 16 x 16 Kotak 3 0 2
57 supraptul/bioplacenton tulle lembar 1 0 -
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 -
2 100
3
4
5
6
7
8
9
10
11
12 20
13
14 1
Amoksisillin Double Strengh Sirup Kering Botol
250 mg/5 ml 2 15
15 17
16
17
18
19
20
21 1 25 26 1
Hidroksida 200 mg - 900 30
22 900
23
Antalgin (Metampiron) Tablet 500 mg Tablet - - -
24
25
26 -
27
Asam Benzoat 6% + 1 3
28 Asam Salisilat 3% 4
Ergotamin Tartrat 1 mg + - -
29 Kofein 50 mg -
30
31 10
32
33
34
35
36
37
38
39 6
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
(Epinefrina /
68 5
69
70
71
72
73
74
75
Fenitoin Natrium Kapsul 100 mg Kapsul 30 20 50
76
77
78
79
80
Fitomenadion tablet 10 mg Tablet 15 100 115
81
82
83
( Nacl 0,52 gr,
Kalium Klorida 0,30 gr, Trinatrium Sitrat -
dihidrat 0,58 gr, Glukosa Anhidrat 2,70 g )
200 ml Air
84 58 58 6
85
86
87
88
89
90 10
91
92
93
94
95
96
Haloperidol Tablet 1,5 mg Tablet - 100 100
97
Haloperidol Tablet 5 mg Tablet - 200 200
98
99
100
101
102
103
104
Sulphate for inhalation -
105 2,5 ml - -
106
107
108
109
110
111
Kaptopril 12,5 mg Tablet - 100 100
112 17
Kaptopril 25 mg Tablet 78 - 78
113
114
Ketokonazole Krim 2 % - 15 gr Tube - - -
115
116
117
118
119
120
121
122
123
Kloramfenikol Salep Mata 1%-3,5 g Tube - - -
124
125
126
127 10
128
129
130
Kombinasi : Sulfametoksazol
100 mg + Trimetroprim 20 mg -
131 12 12
132 87 87 12
133 1 11
134
mEq,Cl 109 mEq, Asetat 28 mEq) /Asering
-
135 - -
Larutan mengadung Elektrolit (Nacl 1,125 Botol
gr , Dekstrosa 18,75 gr) -
136 - -
Elektrolit (Nacl
1,75 gr, KCL 1,5 gr, Na Lactat 2,24 gr, -
Dekstrosa 27 gr)
137 - -
138
Lidokain Hcl 2%
+Epinefrin 1 : 80.000-2 ml -
139 - -
140
141
142
143
144
145
146
Metilergometrin Maleat (Metergin) Tablet 0 Tablet - 100 100
147
148
149
150
151
152
153
154
155
156
157
158
159
Natrium Diklofenak Tablet 50 mg Tablet 36 - 36
160
Natrium Klorida Larutan infus 0,9%-Steril 50 Botol - -
161 -
162 2
163 4
164 33
165 -
166 - -
167 - -
168 - -
169 - -
170 - -
171 -
172 -
Obat Batuk Hitam (OBH) Cairan 100 ml/BERL Botol 10 10
173 -
Obat Batuk Cair Sirup (Ekspektoran)/CORED Botol - -
174 -
175 2
176 1 2
Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 m Vial - -
177 -
178 -
179 2
180 9
181 -
182 18
183
184
185
186
187
188
189
190
191
192
Pirantel Pamoat Tablet 365 mg (Setara dng Tablet 80 0 80
193
194
Sulfonat dan Metanal)
195 360 mg/g-10 ml - 0 -
196
197
198
199
200
201
202
203
204
205
206
207
Salbutamol Tablet 2 mg Tablet - 7 7
208
209
Salbutamol solution for Inhalation single Ampul
dose units 2,5 ml
210 - 0 -
Asam Salisilat 2 %
+ Belerang Endap 4 % - 30 gram
211 3 0 3
212
Salep Luka Bakar/neocenta Tube - 11 11
213
214
215
Sefiksim Kapsul 100 mg Kapsul - 0 -
216
217
218
219
220
221
Sianokobalamin Injeksi 500 mcg/ml-1ml/Vit Ampul 19 0 19
222
223
224
225
Simvastatin Tablet 10 mg Tablet 15 0 15 10
226
227
228
229
Asam Folat 0,25 mg
230 - 120 120
Serbuk & Cairan
231 - 0 -
232
233
234
235
Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 m Tablet 32 400 432 10
236
237
238
239
240
241
242
243
244
245
vit k Set 70 0 100
246
247
248
249
Alkohol 70%100 ml - 0 -
250 Ampul
251 Tablet - -
252 Vial - -
- -
1
2
3
4
5
6
7
8
9
10
11
12
Catgut/Benang Bedah No.2/0-3/0 (Plain & C Sachet 2 0 2
13
Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol - 1 1
14
15
16
17
18
19
20
21
22
23
24
25
26
27
Kassa Pembalut Hidrofil 4 m x 15 cm Rol - 5 5
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs - 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
Sarung tangan Non Steril L Pcs - 100 100
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit - 0 -
52
53
54
55
56
supraptul/bioplacenton tule lembar - 0 -
57
CATATAN HARIAN PEMAKAIA
Bulan : Oktober Tahun : 201
JUMLAH PE
3 4 5 6 7 8 9 10 11 12
10 20 10 20
1 1 1
10 10 20 10 10
10 10
10 20
70 30 60 30 20 10 30 10 40
1 2 1 1 2 1
2 1 1 3
1 1 1 1
30 30 10 20 40 20 40 70
20 20
1 1
10 10 20 10
20 25 15 20
20 10 10
20 6 10 10 10
10 10 10
2 1 2
10
6 16 6
30 4
8 30 8 10
10
6
12 6 6
1
10
10
1 2 1
10
20
10 5 5 5 10
2 2 2 1
10
10 10 10
18 21 8 6 10
20
20 10 30
10 10 10
10
30 3 20 2 24 10 40
10 10 5 5 10
10
1 2
10
10
6
1 2 2
10
10
1 1 2
2 1 1 1
1 1 1 1 1 1 2
1 1 2 1
56 46 65 45 56 50 35 112 86
10 10
16 15 10 20 20 30
10 20 10 16
2 5
6 5
2 2 2 3
1 10
10 10 20
10 8 10
10
1
10 10
10 10 8 30 10 10 10 10
10 20
16 21 42 18 20 30 15 20 34
10 10
10 20
1
1
HARIAN PEMAKAIAN OBAT
an : Oktober Tahun : 2017
13 14 15 16 17 18 19 20 21 22
10
10 10 10 6
1 1
30 30 10 10
10 10 10
10
30 10 50 20 40 20
1 2 1 1
1 1 1 1 1
1 1 2 2
20 10 30 10 30 50 5 10
10 20 10
1 1
10 12 10
10 16
10 10 10
10 40
10 10 10
3 10
10 10 10
1
10
10
6 12 6
20
10 50
2
15 10 5
1 1
10 10
10 10 10 10
1
6 10 6
20 10
1
15 10 30 20 26 10
10 10 5
1 1
20
20 20
5 6
10 10
1 1
1
1 1 2 1
10
1 1 4 2
66 34 40 35 85 50 51 30
30
20 10 40 50 10
10 10
4 10
1 1 3
1
20
10
10 10 10
1
10
10 10 30 50 10
10
50 10 10 34 10 21 20
10
40 10
1 3 1 2
Jumlah
Pemakaian
23 24 25 26 27 28 29 30 31
0
0
10
10 106
3 8
0
0
30
20 20 180
10 10 10 80
10 10 60
10 10 30 40 20 40 20 60 720
0
1 2 1 1 19
1 1 1 15
0
0
0
0
0
2 2 1 1 1 2 2 2 24
40 60 70 30 40 50 50 10
805
10 90
0
0
0
0
0
2
92
0
0
10 5 10 131
6 8 54
2 2
0
0
10 10 10 122
80
0
0
0
1 1
10 10
0
0
0
0
1 1 8
0
0
10 20
0
8 10 6 18 100
0
47
0
0
0
0
0
10 6 102
10 20
1
0
0
0
0
0
0
0
0
0
0
40 50
0
0
0
0
10 26
0
0
54
0
0
1
10 40
0
20 10 110
1 0
0
0
0
10
0
20
10 5 15 20 115
0
2 2 2 15
10 10 30 20 10 20 130
10 20 10 10 10 130
1 2
0
0
0
0
0
10 10 10 93
0
10 10
37
25 20 20 5 22
60
0
10
0
0
0
0
0
0
0
0
0
1
5 40 16 41 16 40 10 10 428
0
5 5 15 20 110
0
10 32
1 1 7
20
0
0
0
0
0
0
10 10
0
40
0
10
0
10
8 25
0
0
0
0
1 1 9
0
0
10 40
0
6 10 10 36
0
0
2
0
0
0
0
0
0
0
0
0
1 1 1 9
1 0
1 1 1 1 1 11
1 3 19
0
1
2
0
0
10 20
0
0
1 1 4 1 1 21
0
68 97 46 40 90 90 61 56 1540
0
0
0
0
10 60
0
6 30 10 40 10 8 355
0
0
0
0
0
0
0
20 10 30 10 8 164
0
0
0
0
0
7
4 10 39
0
1 1 1 18
11
1
10 70
0
0
0
0
10 50
0
0
0
0
10 10 8 10 10 48
10
10 10 60
0
1 1 4
30 10 40 10 120
0
0
0
0
0
70 30 50 20 388
0
0
0
20 60
20 10 26 26 20 36 46 10 591
0
10 40
4 5 89
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 11
0
0
0
0
0
0
1
0
0
0
0
0
0
0
5
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
Sisa Akhir
Bulan
-
100
72
74
1
-
20
40
40
10
99
45
-
4
2
60
42
-
-
-
95
-
-
-
-
-
-
2
25
170
-
23
18
3
-
-
40
20
-
-
-
2
63
88
-
-
-
5
-
-
10
2
387
-
-
-
-
-
46
40
64
74
2
-
-
5
-
-
-
-
-
-
-
-
-
-
100
70
89
-
14
4
-
-
2
10
10
364
-
-
1
-
40
80
80
85
7
2
-
-
-
3
-
-
-
-
51
-
68
63
56
-
-
26
-
-
-
-
-
-
60
-
-
-
95
-
46
-
12
55
4
14
-
-
-
-
40
-
2
-
40
-
90
4
80
33
-
30
30
-
3
-
-
98
-
-
-
2
2
33
-
-
-
-
-
-
-
-
1
-
1
2
-
-
-
9
-
28
-
-
-
-
3
-
-
-
-
35
80
53
-
2
1
-
20
-
-
57
-
186
40
-
3
-
54
3
5
-
3
77
-
-
-
-
-
3
19
10
-
39
5
12
50
-
-
-
-
90
-
44
80
-
-
68
66
-
-
66
-
100
-
90
-
-
-
-
-
-
-
10
-
-
17
3
10
3
-
-
-
-
2
-
-
-
-
2
-
7
1
-
-
-
-
2
1
-
-
-
10
1
-
-
-
-
-
-
4
-
-
3
7
-
-
-
2
-
-
-
-
-
-
-
-
-
-
STOK HARIAN BULAN OKTOBER TAHUN 2017
UMUM JKN
1 Air Raksa Dental Use Botol 0 -
2 Albendazole Tablet 400 mg Tablet 0 100
4 Ambroksol Tablet 30 mg Tablet 106 74
5 Ambroksol sirup 15 mg/5 ml Botol 8 1
6 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 0 -
7 Aminofillin Tablet 200 mg Tablet 0 20
8 Amitriptillin Hcl Tablet Salut 25 mg Tablet 30 40
11 Amoksisillin Kapsul 250 mg Kapsul 60 99
12 Amoksisillin Kaplet 500 mg Kaplet 720 45
13 Amoksisillin Serbuk Injeksi 1000 mg vial 0 -
14 Amoksisillin Sirup Kering 125 mg/5ml Botol 19 4
15 Amoksisillin Double Strengh Sirup Kering Botol 15 2
16 Ampisilin Kapsul 250 mg Kapsul 0 60
17 Ampisillin Kaplet 500 mg Tablet 0 42
18 Ampisilin Sirup 125 mg / 5 ml Botol 0 -
19 Ampisillin Injeksi 1000 mg Vial 0 -
20 Analgetik Plus Tablet 0 -
21 Antasida Doen Suspensi Kombinasi : Mag Botol 24 2
22 Antasida Doen Tablet, Kombinasi : Magn Tablet 805 95
23 Antasida Plus Tablet Tablet 90 -
24 Antalgin (Metampiron) Tablet 500 mg Tablet 0 -
25 Antalgin Injeksi 250 mg/ml-2ml Ampul 0 -
26 Anti Bakteri DOEN Salep Kombinasi : Tube 0 -
27 Anti Hemoroid Doen komb Supp 0 -
28 Anti Fungi DOEN Kombinasi : Pot 2 2
29 Antimigren DOEN Kombinasi : Tablet 0 -
30 Anti Diare Suspensi Botol 2 2
31 Anti Diare Tablet Tablet 92 25
32 Anti Dotum Oral Tablet Tablet 0 170
33 Anti Hipertensi Kapsul Tablet 0 -
34 Antihistamin Tablet kombinasi Tablet 131 23
35 Antispasmodik Tablet Tablet 54 18
36 Antitusiva Sirup Botol 2 3
37 Antitusiva Tablet Tablet 0 -
38 Asam Folat Tablet 1 mg Tablet 0 -
39 Asam Askorbat 50 mg Tablet 122 40
40 Asam Mefenamat Kapsul 500 mg Kapsul 80 20
41 Asetosal 80 mg Tablet 0 -
42 Asetosal Tablet 100 mg Tablet 0 -
45 Asiklovir Tablet 200 mg Tablet 10 63
47 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 0 -
48 Aqua Pro Injeksi Steril, bebas Pirogen 20 mVial 0 -
49 Betahistin Mesilat 6 mg Tablet 0 -
50 Betametason Krim 0,1 %- 5g Tube 8 5
51 Bisakodil suppositoria 10 mg Supp 0 -
52 Bisoprolol Tablet 5 mg Tablet 0 -
53 Bromheksin 8 mg Tablet 20 10
54 Deksametason Injeksi 5mg/ml-1ml Ampul 0 2
55 Deksametason Tablet 0,5 mg Tablet 100 387
56 Devitalisasi Pasta (Non Arsen) Botol 0 -
57 Diazepam tablet 2 mg Tablet 47 -
58 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul 0 -
59 Diazepam Larutan Rektal 5 mg/ml Supp 0 -
60 Dietilkarbamazin Sitrat Tablet 100 mg Tablet 0 -
61 Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul 0 46
62 Digoksin Tablet 0,25 mg Tablet 0 40
63 Dimenhidrinat Tablet 50 mg Tablet 102 64
65 Donperidon Suspensi 5 mg/5ml Botol 1 2
66 Efedrin Hcl Tablet 25 mg Tablet 0 -
67 Ekstrak Belladone Tablet 10 mg Tablet 0 -
68 Epinefrin HCl / Bitartrat Ampul 0 5
69 Eritromisin Kapsul 250 mg Kapsul 0 -
71 Eritromisin Sirup 200 mg / 5 ml Botol 0 -
72 Etambutol Tablet 500 mg Tablet 0 -
73 Etanol 70 % 100 ml Botol 0 -
74 Etil Klorida Semprot -100 ml Botol 0 -
75 Eugenol Cairan -10 ml Botol 0 -
76 Fenitoin Natrium Kapsul 100 mg Kapsul 50 -
77 Fenobarbital tablet 30 mg Tablet 0 -
78 Fenobarbital injeksi 50 mg / ml Ampul 0 -
79 Fenoksimeti Penisilin 250 mg tablet Tablet 0 100
81 Fitomenadion tablet 10 mg Tablet 26 89
82 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1mlAmpul 0 -
83 Furosemid Tablet 40 mg Tablet 0 14
84 Garam Oralit I serbuk, kombinasi : Kantong 54 4
85 Gemfibrozil Tablet 600 mg Tablet 0 -
86 Gentamisin injeksi 80 mg / 2 ml Vial 0 -
87 Gentamisin Salep Kulit 0,1 % Tube 1 2
89 Glimepiride 2 mg Tablet 0 10
90 Gliseril guayakolat tablet 100 mg Tablet 110 364
91 Gliseril Guayakolat sirup Botol 0 -
92 Glukonas Kalsikus injeksi Ampul 0 -
93 Glukosa Larutan Infus 5 % Botol 0 1
94 Glukosa Larutan Infus10 % Botol 0 -
95 Griseofulvin Tablet 125 mg,micronized Tablet 10 40
96 Haloperidol Tablet 0,5 mg Tablet 0 80
98 Haloperidol Tablet 5 mg Tablet 115 85
99 Hidrokloritiazid 25 mg Tablet 0 7
100 Hidrokortison Krim 2,5 % Tube 15 2
101 Ibuprofen Tablet 200 mg Tablet 130 -
103 Ibuprofen Suspensi 100 mg/5 ml Botol 2 -
104 Ichtyol salep Kulit Pot 0 3
105 Ipatropium Bromide + Salbutamol Vial 0 -
106 Isoniazid tablet 100 mg Tablet 0 -
107 Isosorbid Dinitrat 5 mg Tablet 0 -
108 Kalium Diklofenak Tablet 25 mg Tablet 0 -
109 Kalium Diklofenak Tablet 50 mg Tablet 93 51
110 Kalsium Hidroksida Pasta Tube 0 -
111 Kalsium Laktat Tablet 500 mg Tablet 10 68
112 Kaptopril 12,5 mg Tablet 37 63
113 Kaptopril 25 mg Tablet 22 56
114 Karbamazepin Tablet 200 mg Tablet 60 -
115 Ketokonazole Krim 2 % - 15 gr Tube 0 -
116 Ketokonazole Tablet 200 mg Tablet 10 26
117 Ketoprofen Tablet 100 mg Tablet 0 -
118 Ketoprofen Injeksi 100 mg / 1 ml Ampul 0 -
119 Ketorolac 10 mg injeksi Ampul 0 -
121 Klindamisin Kapsul 150 mg Kapsul 0 -
123 Kloramfenikol Kapsul 250 mg Kapsul 0 60
124 Kloramfenikol Salep Mata 1%-3,5 g Tube 0 -
125 Kloramfenikol Tetes Mata -5 ml Botol 0 -
126 Kloramfenikol Tetes Telinga 3%-5 ml Botol 1 -
127 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 428 95
128 Klorpromazin Hcl Tablet Salut 25 mg Tablet 0 -
129 Klorpromazin Hcl Tablet Salut 100 mg Tablet 110 46
130 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 0 -
131 Kotrimoksazol Pedriatik Tablet, Kombinasi :Tablet 0 12
132 Kotrimoksazol Tablet, Kombinasi : Tablet 32 55
133 Kotrimoksazol Suspensi Kombinasi : Botol 7 4
134 Lansoprazole 30 mg Kapsul Tablet 20 14
135 Larutan mengadung Elektrolit (Na 130 mEqBotol 0 -
136 Larutan mengadung Elektrolit (Nacl 1,125 grBotol 0 -
137 Larutan mengadung Karbohidrat + ElektrolitBotol 0 -
138 Lidokain injeksi 2 % Tablet 0 -
139 Lidokain Komp Injeksi, Kombinasi : Ampul 0 -
140 Loperamid Tablet 2 mg Tablet 0 -
141 Loratadin tablet 10 mg Tablet 0 40
142 Magnesium Sulfat (IV) 20 %-25 ml Ampul 0 -
143 Meloksikam tablet 15 mg Tablet 10 2
144 Meloksikam Suppositoria Supp 0 -
145 Metformin Hcl Tablet 500 mg Tablet 40 40
146 Methisoprinol 500 mg Tablet 0 -
147 Metilergometrin Maleat (Metergin) TabletTablet 10 90
148 Metilergometrin Maleat Injeksi 0,200 mg- Ampul 0 4
149 Metilprednisolon tablet 4 mg Tablet 10 80
150 Metoklopramid 10 mg Tablet 25 33
151 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul 0 -
152 Metronidazol Tablet 250 mg Tablet 0 30
153 Metronidazole Tablet 500 mg Tablet 0 30
154 Metronidazole Infus 500 mg /100 ml Ampul 0 -
155 Mikonazole KrIm 2 % - 10 gr Tube 9 3
156 Multivitamin + Mineral tablet Tablet 0 -
157 Multivitamin sirup Botol 0 -
158 Natrium Bikarbonat Tablet 500 mg Tablet 40 98
159 Natrum Diklofenak Tablet 25 mg Tablet 0 -
160 Natrium Diklofenak Tablet 50 mg Tablet 36 -
161 Natrium Klorida Larutan infus 0,9%-Steril Botol 0 -
162 Nipedifin Tablet 10 mg Tablet 0 2
163 Nistatin 100.000 IU/gram Tablet Vagina Tablet 2 2
164 Nistatin 500.000 IU/gram Tablet Salut Tablet 0 33
165 Obat Antitiuberkolosis Kategori Anak Paket 0 -
166 Obat Antitiuberkolosis Kategori 1 Dewasa Paket 0 -
169 Obat Anti Tuberkulosis FDC Kat Anak Paket 0 -
170 Obat Anti Tuberkulosis FDC Kat I & II Paket 0 -
171 Obat Anti Tuberkulosis FDC Kat I & III Paket 0 -
172 Obat Anti Tuberkolosis FDC Sisipan DewasaPaket 0 -
173 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 9 1
174 Obat Batuk Cair Sirup (Ekspektoran) Botol 0 -
176 Obat Flu Sirup Botol 19 2
177 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 Vial 0 -
178 Oksiterasiklin Salep Mata 1%-3,5g Tube 1 -
179 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2 -
180 Oksitosin Injeksi 10 IU/ml-1ml Ampul 0 9
181 Omeprazole injeksi 40mg/10ml Ampul 0 -
182 Omeprazole Kapsul 20 mg Tablet 20 28
183 Ondansetron inj 4 mg/ 2 mL Ampul 0 -
184 Parasetamol drops Botol 0 -
185 Parasetamol Sirup 120 mg/5ml-60 ml Botol 21 -
186 Parasetamol Tablet 100 mg Tablet 0 -
187 Parasetamol Tablet 500 mg Tablet 1540 3
188 Pehacain injeksi Ampul 0 -
189 Perak Sulfadiazin krim 1 % 35 gr Tube 0 -
190 Piracetam 400 mg Tablet 0 -
191 Piracetam Tablet 800 mg Tablet 0 -
192 Piroksikam Tablet 20 mg Tablet 60 35
193 Pirantel Pamoat Tablet 365 mg (Setara dngTablet 0 80
194 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 355 53
195 Polikresulen (Kondensasi Metakresol Botol 0 -
196 Povidon Iodida 10% 30 ml Botol 0 2
198 Primakuin tablet 15 mg Tablet 0 -
199 Propanolol Hcl Tablet 40 mg Tablet 0 20
200 Propilturasil Tablet 100 mg Tablet 0 -
201 Ranitidin Injeksi 25 mg / ml Ampul 0 -
202 Ranitidin Tablet 150 mg Tablet 164 57
203 Retinol (Vit.A) 100.000 IU Kapsul Kapsul 0 -
204 Retinol (Vit.A) 200.000 IU Kapsul Kapsul 0 186
205 Reserpin Tablet 0, 25 mg Tablet 0 40
206 Rifampisin Tablet 450 mg Tablet 0 -
207 Ringer Laktat Larutan Infus Steril 500 ml Botol 0 3
208 Salbutamol Tablet 2 mg Tablet 7 -
209 Salbutamol Tablet 4 mg Tablet 39 54
210 Salbutamol solution for Inhalation single doAmpul 0 -
211 Salep 2-4 Kombinasi : Pot 0 3
212 Salisil bedak 2% -50 gr Kotak 18 5
213 Salep Luka Bakar Tube 11 -
214 Sefadroksil Sirup Kering 125 mg / 5 ml siruBotol 1 3
216 Sefiksim Kapsul 100 mg Kapsul 0 -
217 Sefotaksim Injeksi 1 gr Ampul 0 -
218 Seftriakson Injeksi 1 gr / vial Ampul 0 -
219 Semen Seng Fosfat Serbuk & Cairan Botol 0 -
220 Setirizin Tablet 10 mg Tablet 50 -
221 Setirizin Sirup 5 mg / 5 ml Botol 2 3
222 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul 0 19
223 Sianokobalamin Tablet 50 mcg Tablet 0 10
224 Silver Amalgam Serbuk 65-75% Botol 0 -
227 Siprofloksasin 500mg Tablet 60 12
228 Spironolakton Tablet 25 mg Tablet 0 50
229 Sulfacetamid Tetes Mata 15 %-5ml Botol 4 -
230 Tablet Tambah Darah Kombinasi: Tablet -
231 Temporary Stopping Fletcher (Fletcher) Se Set 0 -
232 Trikesol formalin ( T K F ) Cairan 10 ml Botol 0 -
233 Tetrasiklin Kapsul 250 mg Kapsul 0 -
234 Tetrasiklin Kapsul 500 mg Kapsul 0 90
235 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1mlAmpul 0 -
236 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 Tablet 388 44
237 Thiamfenikol Kapsul 500 mg Kapsul 0 80
238 Tramadol Injeksi 50 mg/ ml Ampul 0 -
239 Tramadol Tablet 50 mg Tablet 0 -
240 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 60 68
241 Vitamin B .Komplek Tablet Tablet 591 66
242 Vitamin Neurotropik Tablet Tablet 0 -
243 Zinc Tablet 20 mg Tablet -
244 Prednisone 54mg Tablet 89 66
245 flunax sy Botol 0 -
246 vit k tablet 0 100
247 gentian violet Botol 0 -
248 kloramfenikol 500 Tablet 0 90
249 Rivanol 300 ml Botol 0 -
250 Alkohol 70%100 ml Botol 0 -
B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES

UMUM JKN
15 Etanol 70 % 1.000 ml Botol 0 0 -
22 Kassa Hidrofil Steril 16 x 16 Kotak 5 0 -
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 -
2 100
3
4
5 1
6
7
8
9
10 10
11
12 20 30
13
14 1
mg/5 ml 2 15
15 17 1
16
17
18
19
20
21 2 10 12 1
Hidroksida 200 mg 95 600 30 30
22 695
Antasida Plus Tablet/TRIANTA Tablet - - -
23
24
25
26 -
27
28 Salisilat 3% 2
29 50 mg -
30
31 20
32
33
34
35 6
36
37
38
39 20 10
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55 10
56
Diazepam tablet 2 mg Tablet - 107 107
57 10
58
59
60
61
62
63 10 10
64
65
66
67
(Epinefrina /
68 5
69
70
71
72
73
74
75
Fenitoin Natrium Kapsul 100 mg Kapsul - - -
76
77
78
79
80
Fitomenadion tablet 10 mg/vit K Tablet 89 - 89
81 10
82
83
Klorida 0,30 gr, Trinatrium Sitrat dihidrat 0,58 70
gr, Glukosa Anhidrat 2,70 g )200 ml Air
84 4 74 6
85
86
87
88
89
90 10
91
92
93
94
95
96
97
98 20 10
99
100 1
101
102
103 1
104
105 - -
106
Isosorbid Dinitrat 5 mg Tablet - 10 10
107
108
109 10
110
111
Kaptopril 12,5 mg Tablet 63 - 63
112
113
114 10
Ketokonazole Krim 2 % - 15 gr Tube - 3 3
115
116
117
118
119
120
121
122
123
124
Kloramfenikol Tetes Mata -5 ml/RECO Botol - 3 3
125
Kloramfenikol Tetes Telinga 3%-5 ml Botol - 13 13
126
127 17 15
128
129 20 10
130
131 12 12
132 55 55
133 4 10 1
134
109 mEq, Asetat 28 mEq) /Asering -
135 - -
136 - -
(Nacl 1,75 gr, KCL 1,5 gr,
Na Lactat 2,24 gr, Dekstrosa 27 gr) -
137 - -
138
Lidokain Hcl 2% +Epinefrin 1 -
139 : 80.000-2 ml - -
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
Natrium Diklofenak Tablet 50 mg Tablet - 150 150
160
161 -
162 2
163 2
164 33
165 -
166 - -
167 - -
168 - -
169 - -
170 - -
171 -
172 -
Obat Batuk Hitam (OBH) Cairan 100 ml/BERLIC Botol - 1
173 1 1
Obat Batuk Cair Sirup (Ekspektoran)/COREDRYL Botol - -
174 -
175 1
176 2
177 -
178 -
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 3 3
179 -
180 9
181 -
182 28
183
184
Parasetamol Sirup 120 mg/5ml-60 ml Botol - 0 -
185
186
Parasetamol Tablet 500 mg Tablet 3 1200 1,203 66 30
187
188
189
190
191
Piroksikam Tablet 20 mg Tablet 35 100 135 20
192
193
194
195 mg/g-10 ml - 1 1
196
197
198
199
200
201
202
203
204
205
206
207
208
209
units 2,5 ml
210 - 0 -
211 3 0 3
212
213
214
Sefadroksil Tablet 500 mg Tablet 77 0 77 10
215
Sefiksim Kapsul 100 mg Kapsul - 0 -
216
217
218
219
220
221
222
223
224
225
226
227
Spironolakton Tablet 25 mg Tablet 50 0 50 10
228
229
Folat 0,25 mg
230 - 0 -
Serbuk & Cairan
231 - 0 -
232
233
234
235
236
237
238
239
240
Vitamin B .Komplek Tablet Tablet 66 400 466 20 36
241
Vitamin Neurotropik Tablet Tablet - 100 100
242
Zinc Tablet 20 mg Tablet - 15 15
243
Prednisone 5 mg Tablet 66 0 66 3
244
245
vit k Set 100 0 100
246
247
248
249
Alkohol 70%100 ml - 0 -
250 Ampul
251 Tablet - -
252 Vial - -
- -
1
2
3
4
5
6
7
8
9
10
11
12
Catgut/Benang Bedah No.2/0-3/0 (Plain & Crom Sachet 2 0 2
13
14
15
16
17
18
19
20
21
Kassa Hidrofil Steril 16 x 16 Kotak - 0 -
22
23
24
25
26
27
Kassa Pembalut Hidrofil 4 m x 15 cm Rol - 0 -
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs - 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit - 0 -
52
53
54
55
56
57
CATATAN HARIAN PEMAKAIAN
Bulan : November Tahun : 201
JUMLAH PE
3 4 5 6 7 8 9 10 11 12
10
10
10 30
20 10 30 40 20 20
1 2 1 1
3 4 2
1 2
50 10 30 10 50 10
10 8
6 10 10 6 20
10 5
10 10 24 6
1 1
2 1
20 8
10
20 30
10
11 6 6
10
10 20 30 20 10 11
10 10
1
10 10 10
10
1
10
18
10 1
10 10 10 5
20
1 11 1
5 20 6 15 28 10 10 6
5 10
1 1 1
10
10 8 8
10 10
1
1 1 1 1
2 1 10 1
60 40 30 11 94 76 20 40
10 10
10 10
10 12
10 20 5
1
10
10
10 10 10 10 10
10 20 10 10
10 10 21 5 72 50 2
6 10
10
10
ARIAN PEMAKAIAN OBAT
: November Tahun : 2017
13 14 15 16 17 18 19 20 21 22
10 20
10
1
20 15 10 10
10
10 20 20
20 10 10 20 10 80 10 10
1 2 1
1 1 2
10 30 16 20 30 50 40 40
10 10
15 10
6 6 27
1 1
20
1 1
10 6 10 18
40 20 4
30 8 16
10 10
10
10 10 3 3 20
10 15 10
1 1 1 2
20 10 10
20 10 10
1
10 18
12
26 6 40 10 10
20
1
10 16 9 3 20 28 30
5 15 15
2 1
20 10
6 8
30 8
20 8 38
1 1 1
1 1 1 1
4 1 1
1
1
85 10 46 77 101 52 16
10 10 5
20 20 30 16
6 10 6 8
20 15
1 1
1
10
30
10 10
10
20 10 10 10 20 18 30 18
10 12 10 26 10 10
7 10
10 9 4
1 1
Jumlah
Pemakaian
23 24 25 26 27 28 29 30 31
0
0
10 50
10
1 1 5
0
0
0
10 75
10 30
10 100
10 20 40 20 20 20 490
0
3 1 1 2 1 18
1 1 12
0
0
0
0
0
1 1 1 11
20 20 40 20 30 20 10
616
0
0
0
0
0
0
0
10 10 10 88
0
0
20 10 10 117
6 51
3
0
0
10 55
70
0
0
0
2
0
0
0
0
0
1 1 6
3
0
0
0
10 92
0
20 3 107
0
0
0
0
0
124
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 10 60
0
0
11 6 52
0
0
0
10 30
0
10 10 10 187
22 0
0
0
0
0
0
0
10 15 20 130
0
1 8
10 5 10 95
50
1 1 5
0
0
0
10
0
56
0
23
0
15 142
10 60
1 2
0
0
0
0
0
0
0
0
1
1 1
13
22 5 5 28 308
0
15 10 105
0
10 10 20
2 1 10
0
0
0
0
0
0
0
0
0
40
0
0
0
0
14
0
0
0
0
0
0
0
64
0
10 8 18 108
0
20
0
0
0
0
0
0
0
0
0
0
1
2 0
2 10
1 2 1 1 1 26
0
1
2
0
0
0
0
0
0
0
57 70 45 40 33 46 1145
0
0
0
0
10 75
0
1 10 40 20 207
1
0
0
0
0
0
0
20 82
0
0
0
0
1
0
20 10 6 116
0
1 2 7
0
2 4
30
0
0
0
0
10 40
1 1
0
0
0
10 20
20
60
10
0
0
0
0
0
0
0
10 20 10 10 10 246
0
0
0
20 40 80
22 25 10 5 18 11 395
10 10 53
5 15
36
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Sisa Akhir
Bulan
-
100
22
64
1
-
20
40
25
10
100
55
-
1
5
60
42
-
-
-
79
-
-
-
-
-
-
2
37
170
-
106
67
-
-
-
85
50
-
-
-
-
63
88
-
-
-
4
-
-
10
2
295
-
-
-
-
-
46
40
40
74
2
-
-
5
-
-
-
-
-
-
-
-
-
-
100
70
29
-
14
22
-
-
2
80
10
177
-
-
1
-
40
80
80
55
7
4
5
-
-
3
-
-
-
-
-
-
45
63
14
-
1
26
-
-
-
-
-
-
60
2
2
-
87
-
-
-
12
35
-
14
-
-
-
-
40
-
2
-
-
-
90
4
80
19
-
30
30
-
3
-
-
34
-
42
-
82
2
33
-
-
-
-
-
-
-
-
-
-
1
1
-
2
1
9
-
28
-
-
-
-
58
-
-
-
-
60
80
46
-
2
1
-
20
-
-
75
-
186
40
-
2
-
38
3
3
-
2
47
-
-
-
-
60
2
19
10
-
19
15
52
40
-
-
-
-
-
90
-
98
80
-
-
88
71
47
-
30
-
100
-
90
-
-
-
-
-
-
-
10
-
-
17
3
8
3
-
-
-
-
2
-
-
-
-
2
-
7
1
-
-
-
-
2
1
-
-
-
10
1
-
-
-
-
-
-
4
-
-
3
7
-
-
-
2
-
-
-
-
-
-
-
-
-
-
STOK HARIAN BULAN NOVEMBER TAHUN 2017
UMUM JKN
3 Alopurinol Tablet 100 mg Tablet 50 22
21 Antasida Doen Suspensi Kombinasi : Mag Botol 11 1
27 Anti Hemoroid Doen komb Supp 0 -
36 Antitusiva Sirup Botol 3 -
44 Asiklovir Krim 5 % Tube 2 -
49 Betahistin Mesilat 6 mg Tablet 0 -
57 Diazepam tablet 2 mg Tablet 107 -
98 Haloperidol Tablet 5 mg Tablet 130 55
101 Ibuprofen Tablet 200 mg Tablet 95 5
103 Ibuprofen Suspensi 100 mg/5 ml Botol 0 5 -
107 Isosorbid Dinitrat 5 mg Tablet 10 -
115 Ketokonazole Krim 2 % - 15 gr Tube 2 1
126 Kloramfenikol Tetes Telinga 3%-5 ml Botol 13 -
129 Klorpromazin Hcl Tablet Salut 100 mg Tablet 105 (59)
133 Kotrimoksazol Suspensi Kombinasi : Botol 10 (6)
145 Metformin Hcl Tablet 500 mg Tablet 40 -
158 Natrium Bikarbonat Tablet 500 mg Tablet 64 34
173 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 1 -
178 Oksiterasiklin Salep Mata 1%-3,5g Tube 1 2
179 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2 1
184 Parasetamol drops Botol 0 -
185 Parasetamol Sirup 120 mg/5ml-60 ml Botol 0 -
195 Polikresulen (Kondensasi Metakresol Botol 1 -
216 Sefiksim Kapsul 100 mg Kapsul 0 -
220 Setirizin Tablet 10 mg Tablet 40 60
230 Tablet Tambah Darah Kombinasi: Tablet 0 -
233 Tetrasiklin Kapsul 250 mg Kapsul 0 -
242 Vitamin Neurotropik Tablet Tablet 53 47
243 Zinc Tablet 20 mg Tablet 15 -

UMUM JKN
15 Etanol 70 % 1.000 ml Botol 0 0 -
22 Kassa Hidrofil Steril 16 x 16 Kotak 0 0 -
Persediaan Jumlah
No Nama Obat Satuan
Persediaan
Awal Tambahan 1 2
1 -
2 100
3
4
5
6
7
8
9
10
11
12 10
13
14
mg/5 ml 5 15
15 20
16
17
18
19
20
21 1 10 11 1
22 879
Antasida Plus Tablet/TRIANTA Tablet - - -
23
24
25
26 1
Anti Hemoroid Doen komb Supp - 1 1
27
28 Salisilat 3% 2
29 50 mg -
30 1
31 10
32
33
34
35
36
37
38
39 10
40 10
41
42
43
44
45
46
47
48
Betahistin Mesilat 6 mg Tablet - 10 10
49
50
51
52
53
54
55
56
Diazepam tablet 2 mg Tablet - 200 200
57
58
Diazepam Larutan Rektal 5 mg/ml(Stesolid) Supp - 1 1
59
60
61
62
63
64
65
66
67
(Epinefrina /
68 5
69
70
71
72
73
74
75
Fenitoin Natrium Kapsul 100 mg Kapsul - - -
76
77
78
79
80
Fitomenadion tablet 10 mg/vit K Tablet 29 100 129
81
82
83 10
Klorida 0,30 gr, Trinatrium Sitrat dihidrat 0,58 70
gr, Glukosa Anhidrat 2,70 g )200 ml Air
84 22 92
85
86
87
88
89
90
91
92
93
94
95
96
97
98
Hidrokloritiazid 25 mg Tablet 7 100 107
99
100
101
102 10
103
104
105 - -
106
Isosorbid Dinitrat 5 mg Tablet - 10 10
107
108
Kalium Diklofenak Tablet 50 mg/KADITIC Tablet - 50 50
109
110
111
Kaptopril 12,5 mg Tablet 63 - 63
112
113
114
115 1
116
117
118
119
120
121
122
123
124
125 1
Kloramfenikol Tetes Telinga 3%-5 ml Botol - 13 13
126
127
Klorpromazin Hcl Tablet Salut 25 mg Tablet - 170 170
128
Klorpromazin Hcl Tablet Salut 100 mg Tablet - 30 30
129
130
131 12 12
132 35 135 10
133 - 10
134
109 mEq, Asetat 28 mEq) /Asering -
135 - -
136 - -
(Nacl 1,75 gr, KCL 1,5 gr,
Na Lactat 2,24 gr, Dekstrosa 27 gr) -
137 - -
Lidokain injeksi 2 % Tablet - 1 1
138
Lidokain Hcl 2% +Epinefrin 1 -
139 : 80.000-2 ml - -
140
141
142
143
144
Metformin Hcl Tablet 500 mg Tablet - 40 40
145
146
147
148
149
150
151
152
153
154
155
156
157
Natrium Bikarbonat Tablet 500 mg Tablet 34 4 38
158 10
159
160
161 -
162 82
163 2
164 33
165 -
166 - -
167 - -
168 - -
169 - -
170 - -
171 -
172 -
173 - 1
Obat Batuk Cair Sirup (Ekspektoran)/COREDRYL Botol - -
174 -
175 1 2
176 1 1
177 -
178 2
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 3 4
179 1
180 9
181 -
182 28
183
Parasetamol drops(Fasidol) Botol - 5 5
184
Parasetamol Sirup 120 mg/5ml-60 ml Botol - 20 20
185
186
187
188
189
190
191
192
193
194
195 mg/g-10 ml - 1 1
196
197
198
199
200
201
202
203
204
205
206
207
208
209
units 2,5 ml
210 - 0 -
211 3 0 3
212
213
214
Sefadroksil Tablet 500 mg Tablet 47 0 47 10
215
Sefiksim Kapsul 100 mg Kapsul - 100 100
216
217
218
219
220
221
222
223
224
225
226
227
228
229
Folat 0,25 mg
230 - 200 200
Serbuk & Cairan
231 - 0 -
232
Tetrasiklin Kapsul 250 mg Kapsul - 100 100
233
234
235
236
237
238
239
240
241
242
Zinc Tablet 20 mg Tablet - 15 15
243
244
245
vit k Set 100 0 100
246
247
248
249
Alkohol 70%100 ml - 0 -
250 Ampul
251 Tablet - -
252 Vial - -
- -
1
2
3
4
5
6
7
8
9
10
11
12
Catgut/Benang Bedah No.2/0-3/0 (Plain & Crom Sachet 2 0 2
13
14
15
16
17
18
19
20
21
Kassa Hidrofil Steril 16 x 16 Kotak - 1 1
22
23
24
25
26
27
Kassa Pembalut Hidrofil 4 m x 15 cm Rol - 0 -
28
29
30
Masker Buah 10 0 10
31
32
Pot Dahak Pcs - 0 -
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Urine Bag set 2 0 2
47
48
49
50
51
Rotator Unit - 0 -
52
53
54
55
56
57
CATATAN HARIAN PEMAKAIAN
JUMLAH PE
3 4 5 6 7 8 9 10 11 12
20 30
20 10 10 10
10 10 10 20
1 1
1 2 1 2 2
30 30 30 20 30 30 20 70
2
10 10 10
10 10 6 10
10
1
10 20 4 20
10 10
10 10 8
10 20 10
8 10 18
10
5 8
10
20 10 10
10
15 10 10 10 10
1
10
10
10
10 5 10 30
20 10
1 1
1 2 1
10 10 10 20
10 10
15 5
10
1 1
6
10
5 30 18 10 80
1 1 1
1 1 1
1 1 1 2
70 30 40 70 44 56 30 105
10 10 10 10 10
10 23 10 20 40 10 29
10 10 20 6 12 8 16
10
10 5
10 10
10 20
30 30 30 10 10 10
10 30 30 90
20
30 10 30 32 30 10 6 30
10 5 10 20 10 10 12 30
10
1 1 1
ARIAN PEMAKAIAN OBAT
n : Desember Tahun : 2017
13 14 15 16 17 18 19 20 21 22
30 10 10
10
30 10 10 7
20
10
20 20 20 10 20 40 10 20
1 1 1
2 1 2
70 40 80 30 30 40 20 30 10
10 10
10 10 10 5
10 10 10 10 10
10
6
1 1 1
10 6
10 40
10
10 8
6
10 10
5 10
10 10
30 5 10
1 1
10
5 20 5 35 5
8
1 1
10 10
1 2
10 10
33 5 10 5 15 10 6
20 30
2
10
1 1
1 1
10 10 21 15 20 30 10
10 10 40 10 20
5
10 10
1 2
10
10
1
8 10
30 20 10 10 10 20 20
10
1 2
1
4 2 1 1
2 1 1 1 2
1 1
2 1
120 60 60 40 60 80 50 40 41
15 10 10 10 20
20 10 25 12 20 10 30 10 10
10 30 10 20
10 10
2 1 1 1 1 1
10
10 10
6 10 10 10
10 10 10
10 10 20
10
30 50 10 10 10 10 30 10 40
20 30
30 55 10 10 10 15 20
10 50 10 10 10 7 10 5
6 10 10
1 32 1 2 6
1
Jumlah
Pemakaian
23 24 25 26 27 28 29 30 15-Nov
0
0
10 20 130
10
1 1 2
0
0
0
10 10 40 167
10 30 60
20 30
10 20 60 40 10 360
0
1 1 7
1 1 2 10
0
0
0
0
0
1 11
10 40 20 50 80 10
850
0
0
0
1
0
0
2 5
10 10 10 20 110
0
0
20 91
100 110
1 2
0
0
114
10 10 60
0
0
0
1 1 2
0
0
0
0
6
1 2 1 8
0
0
0
0
6 10 60
0
96 186
0
1
0
0
10
10 8 72
10 16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 10 40
0
10 45
8 10 20 5 11 6 73
0
0
1 1
10 10 50
0
10 50 10 6 161
0
0
0
0
20
0
0
20 15 5 5 170
8
2 5
10 10 10 20 30 90
10 40
3
0
0
0
0
0
30
0
10 20
0
5 20 30 30 224
20 100
1 1 1 8
10 20
0
0
0
0
0
0
0
0
1 4
6
20 33 18 30 267
30 30 170
5 30
0
10 10 10 70
1 1 1 8
0
0
1
0
0
10
0
10 10
0
10 10 10 40
0
0
0
0
0
0
5 11
0
0
1
0
0
38
0
14 10 38 20 5 350
0
40 50
0
0
0
0
0
0
0
0
0
0
4
1 0
1 1 3 18
2 1 16
0
1
1 2
0
0
10 56 66
0
1 3
3 1 1 3 15
0
30 70 50 70 70 30 1352
0
0
0
0
10 10 20 10 165
0
20 25 10 10 20 25 425
0
0
0
0
0
0
0
10 10 182
0
0
0
0
0
0
5 35
1 2
1 1 1 10
0
0
10
10 20
0
0
0
10 45
0
1
0
0
10 66
40 10 50
60
0
0
30 190
0
0
10
10 10
0
18 20 20 50 50 534
0
0
0
10 10 90
5 16 6 30 10 10 415
6 10 30 30 305
5 5
70 6 10 5 127
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 1 1 49
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Sisa Akhir
Bulan
-
100
42
54
4
-
20
40
8
10
170
195
-
9
10
60
42
-
-
-
29
-
-
-
-
1
-
2
27
170
-
215
57
3
-
-
71
90
-
-
-
3
63
88
-
-
4
1
5
-
10
2
235
-
14
-
-
-
46
30
68
58
2
-
-
5
-
-
-
-
-
-
-
-
-
-
100
70
89
-
69
19
-
-
1
130
10
16
-
-
1
-
20
80
80
-
99
9
15
10
2
3
-
-
10
-
20
-
25
63
90
-
3
6
-
-
-
-
-
-
60
5
3
7
120
-
-
-
12
65
2
14
-
-
-
-
30
-
2
-
-
-
90
4
80
19
-
19
30
-
2
-
-
-
-
42
-
132
2
33
-
-
-
-
-
-
-
-
-
-
3
10
-
4
2
9
-
22
-
2
5
-
106
-
-
-
-
45
80
21
1
2
1
-
20
-
-
43
-
186
40
-
2
-
103
1
5
-
5
37
80
-
-
-
115
2
18
10
-
53
25
92
40
-
10
-
-
90
80
-
64
80
-
-
98
56
92
10
3
-
100
-
90
-
-
-
-
-
-
-
10
-
-
17
3
9
3
-
-
-
-
2
-
-
-
-
2
-
7
1
-
-
-
-
2
1
-
-
-
10
1
-
-
-
-
-
-
4
-
-
3
7
-
-
-
2
-
-
-
-
-
-
-
-
-
-
pemaka Sisa 35
No Nama Obat
ian stok 36
Antitusiva Sirup
Air Raksa Dental Use Antitusiva Tablet
1 37
Albendazole Tablet 400 mg Asam Folat Tablet 1 mg
2 38
Alopurinol Tablet 100 mg Asam Askorbat 50 mg
3 39
Ambroksol Tablet 30 mg Asam Mefenamat Kapsul 500 mg
4 40
Ambroksol sirup 15 mg/5 ml Asetosal 80 mg
5 41
Aminofillin Injeksi 24 mg/ml-10 ml Asetosal Tablet 100 mg
6 42
Aminofillin Tablet 200 mg Asetosal Tablet 500 mg
7 43
Amitriptillin Hcl Tablet Salut 25 mg Asiklovir Krim 5 %
8 44
Amlodipin Tablet 5 mg Asiklovir Tablet 200 mg
9 45
Amlodipin Tablet 10 mg Asiklovir Tablet 400 mg
10 46
Amoksisillin Kapsul 250 mg Atropin Sulfat Injeksi 0,25 mg/ml-1ml
11 47
Amoksisillin Kaplet 500 mg Aqua Pro Injeksi Steril, bebas Pirogen 20 ml
12 48
Amoksisillin Serbuk Injeksi 1000 mg Betahistin Mesilat 6 mg
13 49
Amoksisillin Sirup Kering 125 mg/5ml Betametason Krim 0,1 %- 5g
14 50
Kering 250 mg/5 ml
15 51
Ampisilin Kapsul 250 mg Bisoprolol Tablet 5 mg
16 52
Ampisillin Kaplet 500 mg Bromheksin 8 mg
17 53
Ampisilin Sirup 125 mg / 5 ml Deksametason Injeksi 5mg/ml-1ml
18 54
Ampisillin Injeksi 1000 mg Deksametason Tablet 0,5 mg
19 55
Analgetik Plus Devitalisasi Pasta (Non Arsen)
20 56
21 57
22 58
Antasida Plus Tablet Diazepam Larutan Rektal 5 mg/ml
23 59
Antalgin (Metampiron) Tablet 500 mg Dietilkarbamazin Sitrat Tablet 100 mg
24 60
Antalgin Injeksi 250 mg/ml-2ml Difenhidramin HCl Injeksi 10 mg/ml-1ml
25 61
Kombinasi :
26 62
Anti Hemoroid Doen komb Dimenhidrinat Tablet 50 mg
27 63

28 3% 64

29 50 mg 65
Anti Diare Suspensi Efedrin Hcl Tablet 25 mg
30 66
Anti Diare Tablet Ekstrak Belladone Tablet 10 mg
31 67
32 68 Injeksi 0,1%/- 1ml
Anti Hipertensi Kapsul Eritromisin Kapsul 250 mg
33 69
Antihistamin Tablet kombinasi Eritromisin Kapsul 500 mg
34 70
Eritromisin Sirup 200 mg / 5 ml Ketokonazole Tablet 200 mg
71 116
Etambutol Tablet 500 mg Ketoprofen Tablet 100 mg
72 117
Etanol 70 % 100 ml Ketoprofen Injeksi 100 mg / 1 ml
73 118
Etil Klorida Semprot -100 ml Ketorolac 10 mg injeksi
74 119
Eugenol Cairan -10 ml Ketorolac 30 mg injeksi
75 120
Fenitoin Natrium Kapsul 100 mg Klindamisin Kapsul 150 mg
76 121
Fenobarbital tablet 30 mg Klindamisin Kapsul 300 mg
77 122
Fenobarbital injeksi 50 mg / ml Kloramfenikol Kapsul 250 mg
78 123
Fenoksimeti Penisilin 250 mg tablet Kloramfenikol Salep Mata 1%-3,5 g
79 124
Fenoksimeti Penisilin 500 mg tablet Kloramfenikol Tetes Mata -5 ml
80 125
Fitomenadion tablet 10 mg Kloramfenikol Tetes Telinga 3%-5 ml
81 126
Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Klorfeniramin Maleat (CTM) Tablet 4 mg
82 127
Furosemid Tablet 40 mg Klorpromazin Hcl Tablet Salut 25 mg
83 128
Garam Oralit I serbuk, Klorpromazin Hcl Tablet Salut 100 mg
kombinasi :
2,70 g )200 ml Air
84 129
Gemfibrozil Tablet 600 mg Klorpromazin Hcl Injeksi 5 mg/ml-2ml
85 130
Kombinasi :
Trimetroprim 20 mg
86 131
:
Trimetroprim 80 mg
87 132
Kombinasi :
88 133
Glimepiride 2 mg Lansoprazole 30 mg Kapsul
89 134
28 mEq) /Asering
90 135
gr)
91 136
+ Elektrolit
92 137
Glukosa Larutan Infus 5 % Lidokain injeksi 2 %
93 138
Kombinasi :
Lidokain Hcl 2%
94 139
Griseofulvin Tablet 125 mg,micronized Loperamid Tablet 2 mg
95 140
Haloperidol Tablet 0,5 mg Loratadin tablet 10 mg
96 141
Haloperidol Tablet 1,5 mg Magnesium Sulfat (IV) 20 %-25 ml
97 142
Haloperidol Tablet 5 mg Meloksikam tablet 15 mg
98 143
Hidrokloritiazid 25 mg Meloksikam Suppositoria
99 144
Hidrokortison Krim 2,5 % Metformin Hcl Tablet 500 mg
100 145
Ibuprofen Tablet 200 mg Methisoprinol 500 mg
101 146
Ibuprofen Tablet 400 mg Metilergometrin Maleat (Metergin) Tablet 0,125 mg
102 147
Ibuprofen Suspensi 100 mg/5 ml Metilergometrin Maleat Injeksi 0,200 mg-1ml
103 148
Ichtyol salep Kulit Metilprednisolon tablet 4 mg
104 149

105 150
Isoniazid tablet 100 mg Metoklorpropamid Injeksi 5 mg/ 5 ml
106 151
Isosorbid Dinitrat 5 mg Metronidazol Tablet 250 mg
107 152
Kalium Diklofenak Tablet 25 mg Metronidazole Tablet 500 mg
108 153
Kalium Diklofenak Tablet 50 mg Metronidazole Infus 500 mg /100 ml
109 154
Kalsium Hidroksida Pasta Mikonazole KrIm 2 % - 10 gr
110 155
Kalsium Laktat Tablet 500 mg Multivitamin + Mineral tablet
111 156
Kaptopril 12,5 mg Multivitamin sirup
112 157
Kaptopril 25 mg Natrium Bikarbonat Tablet 500 mg
113 158
Karbamazepin Tablet 200 mg Natrum Diklofenak Tablet 25 mg
114 159
Ketokonazole Krim 2 % - 15 gr Natrium Diklofenak Tablet 50 mg
115 160
Natrium Klorida Larutan infus 0,9%-Steril 500 ml Rifampisin Tablet 450 mg
161 206
Nipedifin Tablet 10 mg Ringer Laktat Larutan Infus Steril 500 ml
162 207
Nistatin 100.000 IU/gram Tablet Vagina Salbutamol Tablet 2 mg
163 208
Nistatin 500.000 IU/gram Tablet Salut Salbutamol Tablet 4 mg
164 209
Obat Antitiuberkolosis Kategori Anak Salbutamol solution for
ml
165 210
Obat Antitiuberkolosis Kategori 1 Dewasa Salep 2-4 Kombinasi :

166 211 Endap 4 % - 30 gram
Obat Antitiuberkolosis Kategori 2 Dewasa Salisil bedak 2% -50 gr
167 212
Obat Antitiuberkolosis Kategori 3 Dewasa Salep Luka Bakar
168 213
Obat Anti Tuberkulosis FDC Kat Anak Sefadroksil Sirup Kering 125 mg / 5 ml sirup
169 214
Obat Anti Tuberkulosis FDC Kat I & II Sefadroksil Tablet 500 mg
170 215
Obat Anti Tuberkulosis FDC Kat I & III Sefiksim Kapsul 100 mg
171 216
Obat Anti Tuberkolosis FDC Sisipan Dewasa Sefotaksim Injeksi 1 gr
172 217
Obat Batuk Hitam (OBH) Cairan 100 ml Seftriakson Injeksi 1 gr / vial
173 218
Obat Batuk Cair Sirup (Ekspektoran) Semen Seng Fosfat Serbuk & Cairan
174 219
Obat Batuk Hitam Plus Sirup Setirizin Tablet 10 mg
175 220
Obat Flu Sirup Setirizin Sirup 5 mg / 5 ml
176 221
Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 ml Sianokobalamin Injeksi 500 mcg/ml-1ml
177 222
Oksiterasiklin Salep Mata 1%-3,5g Sianokobalamin Tablet 50 mcg
178 223
Oksitetrasiklin Hcl Salep Kulit 3%-5g Silver Amalgam Serbuk 65-75%
179 224
Oksitosin Injeksi 10 IU/ml-1ml Simetidin 200 mg Tablet
180 225
Omeprazole injeksi 40mg/10ml Simvastatin Tablet 10 mg
181 226
Omeprazole Kapsul 20 mg Siprofloksasin 500mg
182 227
Ondansetron inj 4 mg/ 2 mL Spironolakton Tablet 25 mg
183 228
Parasetamol drops Sulfacetamid Tetes Mata 15 %-5ml
184 229
Parasetamol Sirup 120 mg/5ml-60 ml Tablet Tambah Darah
Kombinasi:
Asam Folat 0,25 mg
185 230
186 231
Parasetamol Tablet 500 mg Trikesol formalin ( T K F ) Cairan 10 ml
187 232
Pehacain injeksi Tetrasiklin Kapsul 250 mg
188 233
Perak Sulfadiazin krim 1 % 35 gr Tetrasiklin Kapsul 500 mg
189 234
Piracetam 400 mg Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1ml
190 235
Piracetam Tablet 800 mg Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg
191 236
Piroksikam Tablet 20 mg Thiamfenikol Kapsul 500 mg
192 237
193 238
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tramadol Tablet 50 mg
194 239
Polikresulen (Kondensasi Triheksifenidil Hidroklorida Tablet 2 mg
Metakresol
mg/g-10 ml
195 240
Povidon Iodida 10% 30 ml Vitamin B .Komplek Tablet
196 241
Povidon Iodida 10% 300 ml Vitamin Neurotropik Tablet
197 242
Primakuin tablet 15 mg Zinc Tablet 20 mg
198 243
Propanolol Hcl Tablet 40 mg Prednisone 54mg
199 244
Propilturasil Tablet 100 mg flunax sy
200 245
Ranitidin Injeksi 25 mg / ml vit k
201 246
Ranitidin Tablet 150 mg gentian violet
202 247
Retinol (Vit.A) 100.000 IU Kapsul kloramfenikol 500
203 248
Retinol (Vit.A) 200.000 IU Kapsul Teramysin sm
204 249
Reserpin Tablet 0, 25 mg
205 250
B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES Urine Bag
no 47
Abbocath No 18 ( IV Chateter 18 ) Wing Neddle No 23
1 48
Abbocath No 20 ( IV Chateter 20 ) Anuscopi Yamato
2 49
Abbocath No 22 ( IV Chateter 22 ) Kaca Slide
3 50
Abbocath No 24 ( IV Chateter 24 ) Reagen Ziehl Nielson
4 51
Alat Suntik Sekali Pakai 10 ml Rotator
5 52
Alat Suntik Sekali Pakai 1 ml RTD Malaria
6 53
Alat Suntik Sekali Pakai 2,5 ml Rapid HIV 3 (Oncoprobe HIV)
7 54
Alat Suntik Sekali Pakai 5 ml Sound Timer
8 55
Alat Suntik Sekali Pakai 10 ml SD Syphilis
9 56
Auto Disposable Syringe (ADS) 0,05 ml
10
Auto Disposable Syringe (ADS) 0,5 ml
11
Auto Disposable Syringe (ADS) 5 ml
12
Catgut/Benang Bedah No.2/0-3/0 (Plain & Cromic)
13
Etakridin Larutan (Rivanol) 0,1% - 300 ml
14
Etanol 70 % 1.000 ml
15
Folley Catheter no 14
16
17
18
Infus set Anak
19
Infus set Dewasa
20
Iodina Test
21
Kassa Hidrofil Steril 16 x 16
22
Kapas Berlemak 500 gram
23
Kapas Pembalut / Adsorbens 250 gram
24
Kassa Kompres 40 x 40 steril
25
Kassa Pembalut 2 m x 80 cm
26
Kassa Pembalut Hidrofil 4 m x 3 cm
27
Kassa Pembalut Hidrofil 4 m x 15 cm
28
Kertas Puyer
29
Lysol 1,000 ml
30
Masker
31
Plester 5 yard x 2 inchi
32
Pot Dahak
33
Rapid HIV 1 (SD HIV)
34
Rapid HIV 2 (Intec HIV)
35
Rapid HIV 2 (Biomeriux HIV)
36
Rapid Test Syphilis
37
RPR Test Syphilis
38
Silk( Benang Bedah Sutra ) No 3/0
39
Safety Box
40
Sarung tangan Steril No 6
41
Sarung tangan Steril No 7
42
Sarung tangan Steril No 7,5
43
Sarung tangan Non Steril S
44
Sarung tangan Non Steril M
45
Sarung tangan Non Steril L
46
STOK HARIAN BULAN DESEMBER TAHUN 2017
UMUM JKN
3 Alopurinol Tablet 100 mg Tablet 130 42
21 Antasida Doen Suspensi Kombinasi : Mag Botol 11 -
27 Anti Hemoroid Doen komb Supp 0 1
36 Antitusiva Sirup Botol 2 3
49 Betahistin Mesilat 6 mg Tablet 6 4
51 Bisakodil suppositoria 10 mg Supp 0 5
57 Diazepam tablet 2 mg Tablet 186 14
81 Fitomenadion tablet 10 mg Tablet 40 89
98 Haloperidol Tablet 5 mg Tablet 170 -
103 Ibuprofen Suspensi 100 mg/5 ml Botol 3 2
107 Isosorbid Dinitrat 5 mg Tablet 0 10
109 Kalium Diklofenak Tablet 50 mg Tablet 30 20
115 Ketokonazole Krim 2 % - 15 gr Tube 8 3
126 Kloramfenikol Tetes Telinga 3%-5 ml Botol 6 7
132 Kotrimoksazol Tablet, Kombinasi : Tablet 70 65
133 Kotrimoksazol Suspensi Kombinasi : Botol 8 2
145 Metformin Hcl Tablet 500 mg Tablet 40 -
158 Natrium Bikarbonat Tablet 500 mg Tablet 38 -
160 Natrium Diklofenak Tablet 50 mg Tablet 350 42
173 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 4 -
176 Obat Flu Sirup Botol 16 10
178 Oksiterasiklin Salep Mata 1%-3,5g Tube 1 4
179 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2 2
184 Parasetamol drops Botol 3 2
185 Parasetamol Sirup 120 mg/5ml-60 ml Botol 15 5
187 Parasetamol Tablet 500 mg Tablet 1352 106
195 Polikresulen (Kondensasi Metakresol Botol 0 1
212 Salisil bedak 2% -50 gr Kotak 10 5
216 Sefiksim Kapsul 100 mg Kapsul 20 80
220 Setirizin Tablet 10 mg Tablet 45 115
221 Setirizin Sirup 5 mg / 5 ml Botol 0 2
230 Tablet Tambah Darah Kombinasi: Tablet 190 10
242 Vitamin Neurotropik Tablet Tablet 305 92
243 Zinc Tablet 20 mg Tablet 5 10

UMUM JKN
1 Abbocath No 18 ( IV Chateter 18 ) Buah 0 -
2 Abbocath No 20 ( IV Chateter 20 ) Buah 0 10
5 Alat Suntik Sekali Pakai 10 ml Set 0 17
7 Alat Suntik Sekali Pakai 2,5 ml Set 49 9
9 Alat Suntik Sekali Pakai 10 ml Set 0 -
10 Auto Disposable Syringe (ADS) 0,05 ml set 0 -
11 Auto Disposable Syringe (ADS) 0,5 ml set 0 -
12 Auto Disposable Syringe (ADS) 5 ml set 0 -
13 Catgut/Benang Bedah No.2/0-3/0 (Plain & Sachet 0 2
14 Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 0 -
15 Etanol 70 % 1.000 ml Botol 0 -
16 Folley Catheter no 14 Set 0 -
17 Folley Catheter no 16 Set 0 -
18 Folley Catheter no 18 Set 0 2
19 Infus set Anak Set 0 -
20 Infus set Dewasa Set 0 7
21 Iodina Test Botol 0 1
22 Kassa Hidrofil Steril 16 x 16 Kotak 1 -
23 Kapas Berlemak 500 gram Bungkus 0 -
24 Kapas Pembalut / Adsorbens 250 gram Bungkus 0 -
25 Kassa Kompres 40 x 40 steril Bungkus 0 -
26 Kassa Pembalut 2 m x 80 cm Rol 0 2
27 Kassa Pembalut Hidrofil 4 m x 3 cm Rol 0 1
28 Kassa Pembalut Hidrofil 4 m x 15 cm Rol 0 -
29 Kertas Puyer Pcs 0 -
30 Lysol 1,000 ml Botol 0 -
31 Masker Buah 0 10
32 Plester 5 yard x 2 inchi Rol 0 1
33 Pot Dahak Pcs 0 -
34 Rapid HIV 1 (SD HIV) Pcs 0 -
35 Rapid HIV 2 (Intec HIV) Pcs 0 -
36 Rapid HIV 2 (Biomeriux HIV) Pcs 0 -
37 Rapid Test Syphilis Pcs 0 -
38 RPR Test Syphilis Pcs 0 -
39 Silk( Benang Bedah Sutra ) No 3/0 Sachet 0 4
40 Safety Box Pcs 0 -
41 Sarung tangan Steril No 6 Pcs 0 -
42 Sarung tangan Steril No 7 Pcs 0 3
43 Sarung tangan Steril No 7,5 Pcs 0 7
44 Sarung tangan Non Steril S Pcs 0 -
45 Sarung tangan Non Steril M Pcs 0 -
46 Sarung tangan Non Steril L Pcs 0 -
47 Urine Bag set 0 2
48 Wing Neddle No 23 Set 0 -
49 Anuscopi Yamato Unit 0 -
50 Kaca Slide Box 0 -
51 Reagen Ziehl Nielson Kit 0 -
52 Rotator Unit 0 -
53 RTD Malaria Tes 0 -
54 Rapid HIV 3 (Oncoprobe HIV) Pcs 0 -
55 Sound Timer Buah 0 -
56 SD Syphilis Pcs 0 -
57 supraptul/bioplacenton tulle lembar 0 -

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(Epinefrina / Adrenalina) Injeksi 5

Asam Benzoat 6% + Asam Salisilat 1

Ergotamin Tartrat 1 mg + Kofein -

(Epinefrina / Adrenalina) Injeksi 5

Sulphate for inhalation 2,5 ml -

Sulfametoksazol 400 mg + 8 100

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

83 125 100 33 396 60 65

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

Asam Benzoat 6% + Asam Salisilat

Ergotamin Tartrat 1 mg + Kofein

(Epinefrina / Adrenalina) Injeksi

Sulphate for inhalation 2,5 ml

Asam Salisilat 2 % + Belerang

Besi II Sulfat 200 mg + Asam Folat

B. BAHAN MEDIS HABIS PAKAI (BMHP) DAN ALKES Urine Bag 0 2

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83 125 100 33 396 60 65