PEMERINTAH KOTA MANADO

PUSKESMAS BUNAKEN
KECAMATAN BUNAKEN KEPULAUAN
Jl. Ketapang Kelurahan Bunaken Lk. V

BERITA ACARA OPNAME PERSEDIAAN

No: 120 / PKM-XVI / XII / 2018

Yang bertanda tangan di bawah ini :

1. Nama : Christiana Tamatompo
NIP :-
Jabatan : Ass. Apoteker, Penanggung Jawab Gudang Obat
Pada hari ini tanggal tiga puluh satu Desember dua ribu delapan belas telah melaksanakan opname barang persediaan
pada Puskesmas Wenang dengan sisa barang persediaan sebagai berikut :
JUMLAH
No. NAMA OBAT SATUAN BANYAKNYA HARGA SATUAN
1 2 3 4 5 6
1 Acyclovir 200 mg tablet - 649.00 -

2 Acyclovir 400 mg tablet 76,200.00

200 381.00

3 Acyclovir Krim tube 3,465.00 69,300.00

20

4 *Albendazole 400 mg tablet - 447.33 -

5 Allopurinol 100 mg tablet 226.00 25,764.00

114

6 Allopurinol 300 mg tablet 244.00 60,024.00

246

7 Alkohol 70% 1 L botol 20,460.00 40,920.00

2

8 Amalgam (powder & liquid) botol - 1,837,000.00 -

9 Ambroksol 30 mg tablet 34,650.00

252 137.50

10 Ambroksol Sirup botol 3,630.00 58,080.00

16

11 Aminofillin 200 mg tablet 253.00 25,300.00

100

12 Amlodipin Tablet 5 mg tablet 960.00 470,400.00

490

13 Amlodipin Tablet 10 mg tablet 1,693.00 50,790.00

30

14 *Amoksisillin 500 mg tablet 635.00 (248,920.00)

(392)

15 *Amoksisillin Sirup botol 5,800.00 40,600.00

7

16 Amoksisillin 500 mg, Asam Clavulanat 125 mg tablet 5,808.00 760,848.00

131

17 Ampisillin 500 mg tablet 440.00 69,080.00

157
18 Antalgin/Metampiron 500 mg tablet 44,880.00
240 187.00

19 Antasida Doen tablet 37,125.00

270 137.50

20 Antasida Sirup botol 6,000.00 48,000.00

8

21 Aqua pro Injeksi botol 1,364.00 2,728.00

2

22 Arsen botol - 522,500.00 -

23 Artesunate injeksi 60 mg ampul - 15,675.00 -

24 Asam Askorbat 50 mg tablet - -

120.00

25 Asam Mefenamat 500 mg tablet 220.00 50,160.00

228

26 Atorvastatin 40 mg tablet - -
10,120.00

27 Betahistin tablet 110,000.40

120 916.67

28 Betametason Krim tube - -

11,250.00

29 Bisoprolol Fumarate 5 mg tablet 399.00 11,970.00

30

30 Bromheksin 8 mg tablet 66,000.00

400 165.00

31 CHKM botol - 198,000.00 -

32 *Captopril 12,5 mg tablet 99.00 26,532.00

268

33 *Captopril 25 mg tablet - -
150.70

34 Captopril 50 mg tablet - -
143.00

35 Catgut Plain 2/0 buah 18,700.00 37,400.00

2

36 Catgut Plain 3/0 buah 17,490.00 34,980.00

2

37 Catgut Chromic 2/0 buah 17,050.00 34,100.00

2

38 Catgut Chromic 3/0 buah 17,600.00 35,200.00

2

39 Cefadroxil 500 mg kapsul 235,620.00

204 1,155.00

40 Cefadroxil sirup botol 8,470.00 93,170.00

11

41 Cetirizin 10 mg kapsul - 990.00 -

42 Cetirizin Syr botol 108,900.00

9 12,100.00

43 Ciprofloksasin 500 mg tablet 83,600.00

200 418.00
44 Colchicine 0.5 mg tablet 5,439.50 598,345.00
110

45 *Deksametason 0,5 mg tablet 209.00 209,000.00

1,000

46 Deksametason + Dekslorfeniramin tablet 249.70 217,239.00

870
Deksametason , Neomycin Sulfat,Polimiksin B
47 botol 125,235.00
TM 11 11,385.00

48 Dental Mercury (Air Raksa) botol - 770,000.00 -

49 Dentorit buah - 330,000.00 -

50 Devitalisasi Pasta/Caustiner buah - 891,000.00 -

51 Diazepam 5 mg tablet - 32.00 -

52 *Diazepam 5 mg/ml ampul - 787.86 -

53 Digoksin 0,25 mg tablet - -

157.30

54 Diltiazem 30 mg tablet - -
166.76

55 Difenhiramin Injeksi ampul - 758.26 -

56 Spuit / Disposible 0.05 ml buah - 2,970.00 -

57 Spuit / Disposible 0.5 ml buah - 2,970.00 -

58 Spuit / Disposible 1 ml buah 29,315.00

41 715.00

59 Spuit / Disposible 2,5 ml buah 45,760.00

64 715.00

60 Spuit / Disposible 5 ml buah 825.00 (8,250.00)

(10)

61 Doksisiklin 100 mg tablet 253.00 25,300.00

100

62 Domperidon 10 mg tablet - 440.00 -

63 Efedrin HCl 25 mg tablet - 56.39 -

64 *Ephineprin Injeksi ampul 2,354.00 7,062.00

3

65 Erytromicin 500 mg kapsul 2,072.00 217,560.00

105

66 Erytromicin Sirup botol 7,039.00 35,195.00

5

67 Etakridin Liquid /Rivanol botol 2,933.00 8,799.00

3

68 Etil Klorida botol 118,800.00 237,600.00

2

69 Eugenol cairan botol - 71,500.00 -

70 Fenobarbital 30 mg tablet - 34.00 -

71 Fitomenadion tablet - -
619.00

72 *Fitomenadion Injeksi ampul - 2,200.00 -

73 Fletcher serbuk & Cairan botol - 37,400.00 -

74 Folic Acid tablet 672.00 134,400.00

200

75 Foley Catheter buah - 8,470.00 -

 76 Formaldehyd Phenol Liquid / Cresophen botol - -
310,011.02

77 Fuji GC 1x Mini/Glass Ionomer buah - 550,000.00 -

78 Fuji GC IX Universal buah - 1,045,000.00 -

79 *Furosemida 40 mg tablet 1,210.00

10 121.00

80 *Garam Oralit sak - -

418.00

81 Gemfibrosil 300 mg tablet 24,520.65

84 291.91

82 Gentamisin Sulfat Tetes mata botol - 58,300.00 -

83 *Glibenklamide 5 mg tablet 352.00 35,200.00

100

84 Gliseril Guaiakolat 30 mg tablet 23.98 43,883.40

1,830

85 Glukose 40 % botol - 7,590.00 -

86 Glukose 5 % botol 6,900.00 13,800.00

2

87 Griseofulvin 125 mg tablet 264.00 (5,280.00)

(20)

88 Hidroklorotiaside 25 mg tablet - 20.00 -

89 Hidrokortison krim tube 2,731.67 109,266.80

40

90 Ibuprofen 200 mg tablet 10,857.00

94 115.50

91 Ibuprofen 400 mg tablet - -

198.00

92 Infusion set adult Pcs - 3,465.00 -

93 Infusion Set Pediatric Pcs - 3,960.00 -

94 Iodoform Pastae/Mumyfing buah - 495,000.00 -

95 Ipratropium Bromida+Salbutamol Sulfat tablet - 13,530.00 -

96 Isosorbid Dinitrat tablet - -

107.09

97 Kalsium Hidroksida Pasta buah - 352,000.00 -

98 Kalsium Laktat 500 mg tablet 209,000.00

500 418.00

99 Kapas 250 mg buah 13,750.00 27,500.00

2

100 Kasa Kompres 40x40 buah 1,760.00 21,120.00

12

101 Kasa Pembalut 4 x 15 buah 2,310.00 23,100.00

10

102 Kasa Steril 16 x 16 (isi 16 lembar) buah 6,380.00 31,900.00

5

103 Ketokonazole 200 mg tablet 409.20 49,104.00

120

104 Ketokonazole Krim tube - 7,700.00 -

105 Klindamisin 150 mg kapsul - -

561.00
106 Kloramfenikol 250 mg kapsul 540.98 135,245.00
250

107 Kloramfenikol Salep Mata tube - -

1,719.30

108 Kloramfenikol sirup botol 12,650.00 25,300.00

2

109 Kloramfenikol Tetes Mata botol - 9,480.02 -

110 Kloramfenikol Tetes Telinga botol - -

12,100.00

111 Klorfeniramin Maleat 4 mg tablet 24.00 22,368.00

932

112 Kotrimoksasol 120 mg tablet - 77.00 -

113 Kotrimoksasol 480 mg tablet - 385.00 -

114 Kotrimoksasol Sirup botol 3,850.00 19,250.00

5

115 Lanzoprasol 30 mg tablet 1,350.00 40,500.00

30

116 Larutan Benedict botol - 88,550.00 -

117 Larutan H2O2 3 % botol 39,809.00 39,809.00

1

118 Larutan NaCl Infus botol 6,410.00 44,870.00

7

119 Lidokain Comp. Injeksi botol 6,820.00

6 1,136.67

120 Lincomisin 500 mg ampul - 2,383.26 -

121 Lisol kapsul 49,200.00 49,200.00

1

122 Loperamide 2mg botol - -

100.71

123 Loratadine 10 mg tablet 330.00 90,090.00

273

124 *Magnesium Sulfat 20 % botol - -

-

125 Masker tablet 18,150.00

1 18,150.00

126 Meloksikam 15 mg buah - -

-

127 Meloksikam 7,5 mg tablet 726.00 14,520.00

20

128 Metformin 500 mg botol - -

119.00

129 Metilergometrin botol - -

120.96

130 *Metilergometrin Injeksi tablet - 2,684.00 -

131 Metilprednisolon tablet 4 mg ampul 538.45 53,845.00

100

132 Miconazole Krim tablet 3,300.00 33,000.00

10
133 Multivitamin sirup botol 19,800.00 138,600.00
7

134 Multivitamin tablet tablet - 1,320.00 -

135 Multivitamin Ibu hamil tablet 84,643.35

129 656.15

136 Natrium Diklofenak 50 mg tablet 239.45 69,919.40

292

137 Neomycin Sulfat, Placenta Extract (Bioplacenton) tube 14,850.00 44,550.00

3

138 Nifedipin 10 mg tablet 24,600.00

200 123.00

139 Nistatin Vaginal 100,000 ui tablet - 257.00 -

140 *Obat Anti Tubercolosis Paket - 413,984.00 -

141 Ofloksasin 400 mg tablet 960.30 43,213.50

45

142 Oksitetrasiklin Salep 3% Salep Kulit tube - 2,200.00 -

143 Oksitetrasiklin Salep 1% Salep Mata tube - 3,520.00 -

144 *Oksitocin Injeksi ampul - 1,963.50 -

145 Omeprasole 20 mg kapsul 45,815.34

102 449.17

146 Papaverin 40mg kapsul - -

102.30

147 *Parasetamol 500 mg tablet (3,289.00)

(23) 143.00

148 Parasetamol Sirup tablet 2,530.00 25,300.00

10

149 Piracetam 800 mg botol - 760.00 -

150 Pirantel 125 mg tablet 379.50 26,565.00

70

151 Piridoksin 10 mg tablet - -

15.73

152 Piroksikam 20 mg tablet 32,538.00

204 159.50

153 Plester 5 x 2 tablet - 25,300.00 -

154 Policresulen Liquid ( Albothyl) botol - 26,400.00 -

155 Povidon Iodida 30 ml buah - 2,200.00 -

156 Povidon Iodida 300 ml botol 13,182.00

1 13,182.00

157 Povidon Iodida 60 ml botol - 4,440.00 -

158 Prednison 5 mg botol - 63.25 -

159 Propanolol 40 mg tablet - -

133.10

160 Pseudoefedrin + Tripolidin tablet - 1,265.00 -

161 Ranitidin 150 mg tablet 253.00 70,840.00

280

162 Ringer Laktat Infus tablet 7,150.00 35,750.00

5

163 Salbutamol 2 mg botol 92.40 9,240.00

100
164 Salbutamol 4 mg tablet 21,448.00
200 107.24

165 Salep 2-4 Salep kulit tablet 1,352.08 9,464.56

7

166 Salisil Bedak buah - 3,740.00 -

167 Sarung Tangan pasang 4,598.00 50,578.00

11

168 Sefiksim 100 mg buah - 2,392.00 -

169 Sefiksim sirup kapsul - 30,220.00 -

170 Semen Seng Fosfat Serbuk&Cairan botol - 396,000.00 -

171 Sianokobalamin 50 mcg buah - 25.30 -

172 Simetidin 200 mg tablet 25,575.00

150 170.50

173 Simvastatin 10 mg tablet 564.30 169,290.00

300

174 *Sulfas Ferrosus 300 mg buah - 24.05 -

175 Tetrasiklin 250 mg ampul - -

167.20

176 Tramadol 50 mg tablet 354.20 70,840.00

200

177 Urine Bag buah - 3,960.00 -

178 Valsartan 80 mg buah 1,800.00 194,400.00

108

179 Vitamin B1 / Thiamin HCl 50 mg tablet 41,492.00

920 45.10

180 Vitamin B Kompleks tablet - 24.42 -

181 Vitamin B1, B6, B12/ Neurotropik tablet 693.00 373,527.00

539

182 Zinc 20 mg tablet 545.60 91,115.20

167

183 Obat Batuk Kombinasi (Tilomix) Tablet 311,607.45

255 1,221.99

184 Telmisartan 80 mg Tablet - -

-

Obat kesehatan Mulut dan Tenggorokan - -

-
Amlodipine Besylate 10 mg Tablet - 1,283.00 -
Obat Batuk Kombinasi (Pacdin Cough) Botol - 9,185.00 -
Parasetamol Drops Botol - 17,600.00 -

Bisakodil 5 mg Tablet - -
317.00
Heparin Sodium Gel Tube - 27,500.00 -
Kaolin Pektin Sirup Botol - 7,557.00 -
Kombinasi Krim Metil Salisiat + Eugenol +
Tube - 16,203.00 -
Menthol
Salep Mometasone Furoate Tube - 55,000.00 -
Dexametasone + Deksklorfeniramin Maleat Sirup - 16,500.00 -
Antifungi Salep DOEN Pot - 4,972.00 -
Glimepiride 1 mg Tablet 45,240.00
260 174.00
Obucort Budesonid Inhaler Botol - 105,000.00 -
Vitamin Kombinasi (Imboost) Tablet - 6,150.00 -
Kaolin Pektin Tablet Tablet - 440.00 -
Rosuvastatin Calcium 20 mg Tablet - 16,500.00 -

Atorvastatin Calcium 20 mg Tablet - -

1,199.00
Handscoen Non Steril Kotak - 39,182.00 -

Catgut Kromic 2/0 Pcs - -

6,141.67

Catgut Kromic 3/0 Pcs - -

6,141.67

Disposible 10 ml Pcs - -
1,017.50
Alprazolam 0,5 mg Tablet - 88.00 -
Asam Asetilsalisilat 80 mg Tablet - 99.00 -

Masker N95 Kotak - -

18,150.00
Ibuprofen Suspensi 100 mg / 5 ml Botol - 2,678.00 -
Cefadroksil 250 mg / 5 ml Botol - 5,460.00 -
Metronidazole Suspensi 125 mg / 5 ml Botol - 3,950.00 -

Amoxicillin 250 mg Kaplet - -

196.00
Domperidon Suspensi 5 mg / 5 ml Botol - 2,862.00 -
Glimepiride 2 mg Tablet - 207.00 -
Kloramfenikol Salep Kulit 2% Tube - 3,360.00 -

Dimenhidrinat 50 mg Tablet - -
121.00
Metronidazole 250 mg Tablet - 93.00 -

Isoniazid 300 mg Tablet - -

170.00
Zink Sulfate Drops 10 mg / ml Botol - 6,281.00 -
Metoklopramide 10 mg Tablet - 87.00 -
Mebendazole 500 mg Tablet - 9,150.00 -

Ranitidin HCl Injeksi 25 mg / ml Ampul - -

1,155.00
Erythromisin 250 mg Kapsul - 636.00 -
Kombinasi Tablet Tambah Darah (Etabion) Tablet - 539.00 -
Klindamisin 300 mg Kapsul - 1,837.00 -
Kotrimoksasol 960 mg Tablet - 770.00 -
Natrium Bicarbonat 500 mg Tablet - 594.00 -
Natrium Diklofenak 25 mg Tablet - 324.50 -
Nistatin Suspensi 100.000 IU Botol - 41,030.00 -

Kombinasi Salep Antifungi (Pi Kang Suang) Tube - -

11,880.00

Atalpugit 600 mg + Pektin 50 mg Tablet - -

-
Betametason + Neomycin Krim Tube - 9,064.00 -
 Curcuma Tablet - 1,078.00 -
Hiosine Butilbromida Injeksi Ampul - 37,807.00 -
Hiosine Butilbromida + Parasetamol Tablet - 2,160.40 -
Gentamisin Sulfat Salep Kulit 0,1% Tube - 2,585.00 -
Gentian Violet Botol - 1,936.00 -
Ichtiyol Salep Pot - 6,479.00 -
Kalium Permanganat Botol - 10,802.00 -
Parasetamol Rektal 125 mg Tube - 17,490.00 -
Lidokain + Ephinefrin Injeksi (Pehacain) Ampul - 3,883.00 -

Piroksikam 10 mg Tablet - -
159.50

Permethrin Krim 5% Tube - -

51,810.00
Daryantulle Pcs - 23,760.00 -

Rapid Borax Kit - -

-

Rapid Formalin Kit - -

-

Rhodamin Tes Kit - -

-

Methanil Yellow Tes Kit - -

-

Rapid Hydrogen Peroksida Kit - -

-

Asam Askorbat 50 mg (btl) Tablet - -

187.00

JUMLAH Rp 7,730,155.05

Demikian berita acara opname persediaan dibuat dengan sebenar-benarnya untuk dapat dipergunakan sebagaimana
mestinya.

Mengetahui,
Kepala puskesmas wenang Penanggung Jawab Gudang Obat

Antonius G. Roring, SKM Christiana Tamatompo

NIP. 19630510 198801 1 001 NIP.