REKAPITULASI PERSEDIAAN ALAT TULIS KANTOR (ATK)

PUSKESMAS PAGAR GUNUNG

TAHUN 2020

Stok awal
No Uraian Satuan Penerimaan Persediaan Pengeluaran
1/1/2020
1 2 3 4 5 6 7
1 Kertas HVS Dus - 38 38 38
2 Tinta Printer Epson Botol - 19 19 19
3 Tinta Printer Canon Botol - 19 19 19
4 Materai 6000 Buah - 133 133 133
5 Materai 3000 Buah - 135 135 135
6 Map Order Gobi Buah - 46 46 46
7 Buku Ekspedisi Buah - 1 1 1
8 Buku Polio Buah - 47 47 47
9 Type-X Buah - 27 27 27
10 Map Jepit Plastik Buah - 25 25 25
11 Staples Buah - 16 16 16
12 Isi Staples Kotak - 40 40 40
13 Box File Plastik Buah - 35 35 35
14 Spidol Permanen Buah - 45 45 45
15 Lack Band Buah - 18 18 18
16 Pensil Lusin - 5 5 5
17 Penghapus Pensil Buah - 10 10 10
18 Penggaris Buah - 10 10 10
19 Buku Kwitansi Buah - 5 5 5
20 Pena Baliner Lusin - 4 4 4
21 Buku Tulis SIDU Lusin - 5 5 5
22 Amplop Kotak - 5 5 5
23 Bantalan Cap Buah - 5 5 5
24 Tinta Stampel Botol - 6 6 6
25 Penghapus White Board Buah - 5 5 5
26 Binder Clip Kotak - 25 25 25
27 Kertas Kambing Lembar - 50 50 50
28 Plastik Mika Lembar - 50 50 50
29 Tulang Jilid Buah - 50 50 50
30 Business File Pak - 101 101 101
31 Stop Map Kertas Ball - 21 21 21
32 Trigonal Clip Box - 43 43 43
33 Gunting Sedang Buah - 10 10 10
34 Cutter Buah - 25 25 25
35 Pena Standard Lusin - 12 12 12
36 File Holder Buah - 1 1 1
37 Foto Copy Paket 12 12 12
Note
1 Penerimaan, persediaan, pengeluaran selama 1 tahun
2 Lampirkan data pendukung
K)

Sisa Stok Harga Satuan Jumlah

12/31/2020 (Rp) (Rp)
8 9 10
- 235,000 8,930,000
- 30,000 570,000
- 40,000 760,000
- 7,000 931,000
- 4,000 540,000
- 35,000 1,610,000
- 9,000 9,000
- 37,000 1,739,000
- 12,000 324,000
- 6,000 150,000
- 26,000 416,000
- 4,500 180,000
- 15,000 525,000
- 6,000 270,000
- 11,000 198,000
- 12,000 60,000
- 6,000 60,000
- 5,000 50,000
- 2,500 12,500
- 60,000 240,000
- 35,000 175,000
- 17,500 87,500
- 4,500 22,500
- 37,500 225,000
- 13,000 65,000
- 6,000 150,000
- 500 25,000
- 500 25,000
- 2,000 100,000
- 30,000 3,030,000
- 25,000 525,000
- 18,000 774,000
- 16,000 160,000
- 15,000 375,000
- 15,000 180,000
- 46,000 46,000
- - 1,995,700
 PERSEDIAAN OBAT, OBAT PENUNJANG, BAHAN DAN ALAT KESEHATAN HABIS PAKAI,
REAGENSIA/LABOR, VAKSIN/SERUM
TAHUN 2020

Stok awal Penerimaan Pengeluaran Sisa Stok

Total Total Total
No Nama Obat Satuan Ket
1/1/2020 Triwulan I Triwulan 2 Triwulan 3 Triwulan 4 Penerimaan Persediaan Triwulan I Triwulan 2 Triwulan 3 Triwulan 4 Pengeluaran 12/31/2020
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
OBAT
1 Air Untuk Injeksi 25 ml ampul - - - - - - - - - - - - -
2 Albendazol Tab tablet - 900 - - - 900 900 - 900 - - 900 -
3 Alopurinol Tablet 100 mg tablet 800 2,000 - - 3,000 5,000 5,800 600 400 400 800 2,200 3,600
4 Ambroksol Sirup botol 229 100 - - 200 300 529 194 135 - - 329 200
5 Ambroksol Tablet 30 mg tablet 7,600 - - - - 7,600 3,000 600 500 1,600 5,700 1,900
6 Aminofilin Tablet 200mg tablet - - - - 100 100 100 - - - - - 100
7 Aminofilin Tablet 150 mg tablet - - - - - - - - - - - - -
8 Albendazole Sirup botol - - - - 10 10 10 - - - - - 10
9 Amoksisilin Kapsul 250 mg kapsul 4,300 1,000 - 1,000 5,300 300 800 500 2,900 4,500 800
10 Amoksisilin Kapsul 500 mg kapsul 12,900 5,000 3,000 10,000 5,000 23,000 35,900 8,600 6,200 5,300 4,100 24,200 11,700
11 Amoksisilin Sirup Kering 125mg / 60 ml botol - 100 300 180 240 820 820 100 140 208 132 580 240
12 Amlodipin Tablet 5 mg tablet 7,800 - 3,000 3,000 6,000 13,800 7,800 - 930 1,770 10,500 3,300
13 Ampicilin Serbuk injeksi 1000 mg botol 5 - - - - - 5 - - - - - 5
14 Antasida DOEN tablet 400 mg tablet - 12,000 5,000 5,000 22,000 22,000 4,100 4,100 5,400 3,400 17,000 5,000
15 Antasida Doen II Suspensi 200 mg / 60 ml botol - 500 300 800 800 233 155 112 72 572 228
16 Antibakteri DOEN salep Kombinasi tube 5 5 - - - - 5 - - - - - -
17 Antihemoroid Kombinasi pcs 80 - - - - 80 80 - - 80 - 80 -

Antimalaria DOEN komb. Sulfadoxin500 mg

18 tablet - - - - - 100
+ Pirimetarin 25 mg
100 - - 100 - 100 -
19 Asam Ascorbat (Vit C) 50 mg tablet 14,600 3,000 7,000 - 7,000 17,000 31,600 7,200 6,600 5,700 5,200 24,700 6,900
20 Asam Mefenamat 500 mg tablet 15,500 2,000 - 14,000 - 16,000 31,500 1,300 5,000 11,600 4,900 22,800 8,700
21 Asam Valproat 250 mg tablet - - - - - - - - - - - - -
22 Asiklovir Tablet 200 mg tablet 700 - - - - - 700 - 500 200 - 700 -
23 Asiklovir Tablet 400 mg tablet 600 - - - - - 600 600 - - - 600 -
24 Asiklovir krim 5% tube 135 - - - - - 135 85 50 - - 135 -
25 Bedak Salisil Serbuk 2% kotak - - - - - - - - - - - - -
26 Betametason Krim 0,1% tube 10 100 50 50 50 200 260 37 49 27 71 184 76
27 Betahistin Mesilat Tablet 6 mg tablet 7,300 3,000 - - 2,000 5,000 12,300 400 2,900 5,000 1,900 10,200 2,100
28 Bisoprolol 5 mg tablet 300 - - - 180 180 480 - - 300 - 300 180
29 Dexametasone Injeksi 5mg/ml ampul 141 - - 30 20 50 191 141 - 10 20 171 20
30 Dexametasone 0,5 mg tablet 3,300 - 3,000 2,000 5,000 8,300 1,300 2,000 1,200 1,300 5,800 2,500
31 Diazepam Tablet 2 mg tablet - - - - - - - - - - - - -
32 Diazepam Larutan Rektal 2mg/2,5 ml suppos 2 - - 5 10 15 17 - 2 3 2 7 10
33 Diazepam Injeksi 5mg/ml ampul - - - - - - - - - - - - -
34 Dipenhidramin HCL Injeksi 10mg/ml ampul 36 - - - - - 36 36 - - - 36 -
35 Digoksin Tablet 0,25 mg tablet - - - - 300 300 300 - - - - - 300
36 Domperidone Tablet 10 mg tablet 4,000 2,000 - - - 2,000 6,000 - 200 - 200 400 5,600
37 Epinefrin Adrenalin Injeksi ampul 100 - - - - - 100 20 5 - 75 100 -
38 Fenobarbital Tablet 30 mg tablet - 100 - - - - 100 - - - - - 100
39 Fenobarbital Injeksi 50 mg ampul - 30 - - - 30 30 - 15 - - 15 15
40 Fenofibrat Kaps 300 mg kapsul - - - - - - - - - - - - -
41 Fitomenadion (Vit K) Inj 2 mg/ml ampul 7 30 30 60 30 150 157 17 25 15 25 82 75
42 Fitomenadion (Vit K) Tablet Salut 10 mg tablet 100 - - - 2,000 2,000 2,100 70 - 30 200 300 1,800
43 Fenol Gliserol Tetes Telinga 10% botol 32 24 - - 48 72 104 - 23 28 34 85 19
44 Furosemide Tablet 40 mg tablet 5,000 - - 500 - 500 5,500 - 5,000 100 200 5,300 200
45 Garam Oralit Serbuk Kombinasi sachet 2,200 2,000 - - - 2,000 4,200 600 500 600 800 2,500 1,700
46 Gentamisin Injeksi 40 mg/ml ampul - - - - - - - - - - - - -
47 Gentamisin Tetes Mata 0,3% botol 49 96 48 48 - 145 241 54 48 35 56 193 48
48 Glibenklamid 5 mg tablet 300 - - 500 500 800 200 100 - 300 600 200
49 Glukosa Larutan Infus 5% steril botol 12 - - 40 - 40 52 12 - - - 12 40
50 Glukosa Larutan Infus 10% steril botol 20 - - 20 - 20 40 - 20 - - 20 20
51 Griseovulfin 125 mg tablet 300 - - - - - 300 - - - - - 300
52 Guaifenisin tablet - - - 1,000 2,000 3,000 3,000 - - 700 600 1,300 1,700
53 Haloperidol Tablet 5 mg tablet 12,840 - - 10,000 - 10,000 22,840 12,840 - 380 870 14,090 8,750
54 Haloperidol Injeksi 50mg/ml ampul - - - - - - - - - - - - -
55 Hidrokortison Krim 2,5% tube - 96 48 48 48 240 240 21 82 33 48 184 56
56 Hidroklorotiazid Tablet 25 mg tablet 100 - - - - - 100 - - - - - 100
57 Ibuprofen Tablet 400 mg tablet - - - - - - - - - - - - -
58 Ibuprofen Tablet 200 mg tablet - - - - - - - - - - - - -
59 Isosorbit Dinitrat Tablet Sublingual 5 mg tablet 300 - - - - - 300 - 100 - - 100 200
60 Kalsium Laktat Tablet 500 mg tablet - 4,000 3,000 - 3,000 10,000 10,000 900 1,600 2,900 2,000 7,400 2,600
61 Kalsium Glukonas Injeksi 100 mg/ml ampul - - - - - - - - - - - - -
62 Katopril Tablet 12,5 mg tablet 1,200 2,000 - - - 2,000 3,200 700 400 430 570 2,100 1,100
63 Katopril Tablet 25 mg tablet 5,500 - - 2,000 2,000 4,000 9,500 2,900 - 3,600 1,200 7,700 1,800
64 Karbamazepin Tablet 200 mg tablet - - - - - - - - - - - - -
65 Ketorolak Injeksi 30 mg /ml ampul 70 - - - - - 70 70 - - - 70 -
66 Klozapin Tablet 25 mg tablet 100 - - - - - 100 - - - - - 100
67 Klobazam 10 mg tablet 20 100 - - - 100 120 27 61 32 - 120 -
68 Kloramfenikol Kapsul 250 mg kapsul 100 - - - - - 100 - - - - - 100
69 Kloramfenikol Salep Mata 1 % tube - 96 - - 96 192 192 29 36 20 23 108 84
70 Kloramfenikol Salep Kulit 2% tube - - - - - - - - - - - - -
71 Kloramfenikol Tetes Mata botol - - - - - - - - - - - - -
72 Ketokonazole Krim 2% tube - - - - - - - - - - - - -
73 Klonidin Tablet 0,15 mg tablet - - - - - - - - - - - - -
74 Klorfeniramine Maleate (CTM) 4 mg tablet 6,200 - - 4,000 2,000 6,000 12,200 2,600 2,200 1,500 1,200 7,500 4,700
75 Klorpomazine HCL Tablet Salut 100 mg tablet 12,499 - - - 8,000 8,000 20,499 12,499 - - 38 12,537 7,962
Kombinasi Tablet Tambah Darah : Fero
76 tablet 6,480 4,320 1,000 10,350 6,900 22,570 29,050
Fumarate 60 mg + Asam Folat 0,4 mg 8,640 2,660 3,590 6,660 21,550 7,500
Kotrimoktazole Suspensi Kombinasi :
77 Sulfametoksazol 250 mg + Trimetroprim 40 botol 215 100 - - 100 200 415
mg / ml 25 225 35 70 355 60
78 Kotrimoktasol Tablet 480 mg tablet 1,800 3,000 500 - 2,000 5,500 7,300 2,600 800 500 1,000 4,900 2,400
79 Lansoprazole Kapsul 30 mg kapsul 4,380 - - 2,000 2,000 6,380 2,500 1,880 - 820 5,200 1,180
80 Lidokain Injeksi 2 % (HCL) ampul 89 200 100 - 200 500 589 90 83 116 33 322 267
81 Lisinopril 10 mg tablet - - - - - - - - - - - - -
82 Loratadin Tablet 10 mg tablet - -
83 Loperamid Tablet 2 mg tablet - - - 60 60 60 - - - - 12 12 48
84 Magnesium Sulfat Injeksi 20 % ampul - 10 - - - 10 10 5 - - 5 10 -
85 Magnesium Sulfat Injeksi 40 % ampul - 10 - - 10 20 20 5 - - 9 14 6
86 Meloksikam Tablet 15 mg tablet - - - - - - - - - - - - -
87 Merlopam 0,5 mg tablet - - - - - - - - - - - - -
88 Metilprednisolon Tablet 4 mg tablet 12,000 3,000 8,000 2,000 - 13,000 25,000 4,900 5,700 8,900 1,100 20,600 4,400
89 Metilergometrine Injeksi 0,2mg/ml ampul - 100 - - - - 100 - - - 100 100 -
90 Metronidazole Tablet 250 mg tablet - - - - - - - - - - - - -
91 Metronidazol Tablet 50 mg tablet 5,600 - - - - - 5,600 300 300 900 1,100 2,600 3,000
92 Metronidazol Infus 500mg /100ml botol - - - - - - - - - - - - -
93 Metformin HCL Tablet 500 mg tablet 1,400 - - 5,000 5,000 10,000 11,400 600 800 1,100 1,600 4,100 7,300
94 Metoklopramid Tablet 5 mg tablet - - - - 100 100 100 - - - - - 100
95 Mikonazole Krim 2% tube 14 24 - - 24 48 62 1 31 6 11 49 13
96 Natrium Diklofenak Tablet 50 mg tablet 10,450 5,600 3,500 - 8,000 17,100 27,550 3,800 4,000 3,250 11,700 22,750 4,800
97 Natrium Klorida Larutan Inf 0,9% botol 20 200 - 77 277 297 40 20 60 126 246 51
98 Nistatin Tablet Salut 500.000 IU tablet 120 120 120 30 10 - 40 80
99 Nistatin Tablet Salut Vaginal 100.000 IU teblet 130 130 40 30 15 85 45
Obat Antimalaria (dhp) Frimal Kombinasi:
100 Dihidroartimisinin 40 mg + Piperakuin 320 tablet 63 63 63
mg 63 63 -
101 Obat Antituberkulosis (OAT) Kategori 1 paket - - - - - - - - - - - - -
102 Obat Antituberkulosis (OAT) Kategori 2 paket - - - - - - - - - - - - -
103 Obat Antituberkulosis (OAT) Anak paket - - - - - - - - - - - - -
104 Oksitosin Injeksi 10 IU / ml ampul 170 100 100 270 22 158 26 47 253 17
105 Oksitetrasiklin SM 1 % tube - 100 100 100 6 - 2 17 25 75
106 Kombipak Kategori 1 paket - - - - - - - - - - - - -
107 Parasetamol Drops 100 mg/ml botol - - - - - - - - - - - - -
108 Parasetamol Sirup 120 mg/5ml botol - 800 100 400 1,300 1,300 358 258 284 100 1,000 300
109 Parasetamol Tablet 500 mg botol 17,700 10,000 5,000 5,000 20,000 37,700 2,100 4,800 24,200 5,600 36,700 1,000
110 Piridoksin HCL (Vit B6) Tablet 10mg tablet 3,700 1,000 1,000 4,700 3,700 - 400 4,100 600
111 Piroksikam Tablet 10 mg tablet - - - - - - - - - - - - -
112 Pirantel Pamoat Tablet 125 mg tablet - 100 - - 100 100 - - 4 4 8 92
113 Povidon Iodida Lar. 10 % 1 Liter botol - 12 12 12 - - - 4 4 8
114 Povidon Iodida Lar. 10 % 30 ml botol - - - - - - - - - - - - -
115 Povidon Iodida Lar. 10 % 300 ml botol 20 20 20 4 10 6 20 -
116 Povidon Iodida Lar. 10 % 60 ml botol - - - - - - - - - - - - -
117 Prednison Tablet 5 mg tablet 4,000 3,000 3,000 7,000 1,400 2,600 500 4,500 2,500
118 Propanolol Tablet 10 mg tablet - - - - 500 500 500 - - - - - 500
119 Ranitidin Injeksi 25 mg/2 ml ampul 207 100 - 200 - 300 507 112 195 200 - 507 -
120 Ranitidin Tablet 150 mg tablet - 1,000 1,000 1,000 - - 1,000 - 1,000 -
121 Ristonat 35 mg tablet - - - - - - - - - - - - -
122 Risperidone Tablet 2 mg tablet 280 6,500 2,000 8,500 8,780 - 34 40 30 104 8,676
123 Retinol (Vit A) 100.000 IU kapsul 1,450 500 - 1,000 - 1,500 2,950 950 50 800 - 1,800 1,150
124 Retinol (Vit A) 200.000 IU kapsul 950 300 - 2,000 - 2,300 3,250 1,250 - 750 300 2,300 950
125 Ringer Laktat Larutan Infus Steril botol 106 380 - 240 200 820 926 212 174 220 160 766 160
126 Simvastatin Tablet 10 mg tablet 3,410 - - - - - 3,410 1,070 2,250 90 - 3,410 -
127 Salbutamol 2 mg tablet 1,700 2,000 2,000 4,000 5,700 1,300 600 300 900 3,100 2,600
128 Salep 2-4 Kombinasi pot 14 - - 48 - 48 62 - 14 9 30 53 9
129 Sefadroksil Kaplet 500 mg kaplet - - - 1,000 2,000 3,000 3,000 - - 1,000 100 1,100 1,900
130 Sefadroksil Sirup Kering 125mg / 5ml botol - - - 60 60 120 120 - - 15 45 60 60
131 Setirizin Tablet 10 mg tablet 6,000 - - 3,000 2,000 5,000 11,000 6,000 500 1,800 8,300 2,700
132 Sianokobalamin(Vit B12) Injeksi 500 mcg ampul 19 - - - - - 19 19 - - 19 -
133 Sianokobalamin(Vit B12) Tablet tablet 2,300 1,000 1,000 3,300 1,000 300 1,000 500 2,800 500
134 Sifrofloksasin Tablet 500 mg tablet 5,000 2,000 2,000 7,000 5,000 700 1,200 6,900 100
135 Thiamin HCL (Vit B1) Injeksi 100 mg/ml ampul - - - - - - - - - - - - -
136 Thiamin HCL (Vit B1) Tablet 50 mg tablet 3,500 - 3,500 100 - 800 900 2,600
137 Triheksilfenidil Tablet 2 mg tablet 11,890 500 7,000 7,500 19,390 1,474 666 10,165 205 12,510 6,880
138 Trifluoferazin Tablet 5 mg tablet - - - - - - - - - - - - -
139 Ulsidex 500 mg tablet - - - - - - - - - - - - -
140 Vitamin B Komplek tablet 12,200 2,000 5,000 5,000 12,000 24,200 8,300 5,900 1,600 5,200 21,000 3,200
141 Zink Syrup botol 162 36 36 198 23 71 30 20 144 54
142 Zink Tablet tablet 2,200 - 2,000 2,000 4,200 1,500 100 400 300 2,300 1,900
143 Povidon Iodida Lar. 10 % 15 ml botol - - - - 48 48 48 - - - 18 18 30
OBAT PENUNJANG 200
143 Erlamycetin Tetes Telinga Botol 0 0 0 0 0 - - - - - - - -
144 OBH botol 75 0 0 0 0 - 75 - - 50 25 75
145 Biocombin Injeksi ampul 0 0 0 0 0 - - - - - - -
146 Bioplacenton tube 0 0 0 0 0 - - - - - - -
147 Pehavral tablet 0 2000 0 0 0 2,000 2,000 500 1,000 500 - 2,000 -
148 Livron B.Plex tablet 0 0 0 2000 3000 5,000 5,000 2,000 600 2,600 2,400
149 Fludane tablet 0 0 0 0 0 - - - - - - - -
150 Hustab botol 1000 0 0 0 0 1,000 1,000 1,000 - - - 1,000 -
151 Alphamol botol 0 0 0 0 0 - - - - - - - -
152 Mineral Mix sachet 40 0 0 0 0 40 40 - - - - - 40
153 Molexflu tablet 0 1500 4950 3000 0 9,450 9,450 900 1,800 1,950 2,550 7,200 2,250
154 Supralisyn Sirup botol 140 0 0 0 0 140 140 140 - - - 140 -
155 Bioron Injeksi ampul 3 0 0 0 0 3 3 - 3 - - 3 -
156 Dextrofen Syrup botol 23 0 0 0 0 23 23 - - 3 - 3 20
157 Melocid tablet 2800 2000 0 0 0 2,000 4,800 200 2,800 670 1,130 4,800 -
BAHAN DAN ALAT KESEHATAN HABIS PAKAI
158 Alat Suntik Sekali Pakai 1 ml pcs 215 100 100 315 10 75 15 81 181 134
159 Alat Suntik Sekali Pakai 3 ml pcs 2760 500 500 1,000 3,760 730 550 430 520 2,230 1,530
160 Alat Suntik Sekali Pakai 5 ml pcs 879 2,000 879 - 879
161 Alat Suntik Sekali Pakai 0,5 ml pcs 0 1,000 1,000 - 2,000 200 300 100 600 1,400
162 Alat Suntik Sekali Pakai 0,05 ml pcs 0 - -
163 T - Plain Catgut Plain 3.0 pcs 0 36 36 36 16 16 20
Chirurgic Gloves (Sarung Tangan Steril) Size
164 pcs 200 200 100 100 400 600 200 150 170
7.0 520 80
165 Dermafix T 10 x 20 cm pcs 0 - -
166 Dermafix T 10 X 8 cm pcs 0 -
167 I.V Cateter NP No. 18 G pcs 170 170 10 10 20 150
168 I.V Cateter NP No. 20 G pcs 30 100 50 150 180 30 13 60 103 77
169 I.V Cateter NP No. 22 G pcs 0 100 50 150 150 50 50 100
170 I.V Cateter No. 24 G pcs 212 50 50 262 12 76 74 50 212 50
171 I.V Cateter No. 26 G pcs 219 50 50 269 19 30 15 55 119 150
172 Infuset Anak pcs 146 - 146 94 12 10 116 30
173 Infuset Dewasa pcs 51 200 60 260 311 51 100 60 211 100
174 Kapas Pembalut 250 mg Roll 6 - 6 1 1 5
175 Kapas Pembalut 500 mg Roll 5 5 1 6 11 1 4 5 6
176 Kasa Hidrofil 30 cm x 10 cm Pack 30 50 50 100 130 30 20 19 26 95 35
177 Kasa Pembalut Hidrofil 4 m x 10 cm Roll 7 - 7 7 7 -
178 Kasa Hidrofil 4 m x 80 cm Roll 0 10 5 15 15 2 2 6 2 12 3
179 Kasa Steril 5 x 5 cm Pack 0 - -
180 Kasa Steril 16 x 16 cm Box 40 200 20 220 260 23 77 98 58 256 4
181 Kasa Kompres Steril 40 x 40 cm Roll 0 - - -
182 Leukoplas 1625 H (3x5) Roll 19 5 20 10 - 54 2 10 9 8 29 25
183 Oksigen Kubik 0 - - -
Sarung Tangan (Examination/Handscone)
184 pcs 3000 3,000 3,000 3,000 900 9,900 12,900 1,600 5,800 3,300 1,700
Non Steril 12,400 500
185 T - Silk - Silk Sutera 3.0 pcs 0 36 36 36 - - - - - 36
186 Face Mask (Masker) pcs 250 500 300 400 1,200 1,450 750 300 120 1,170 280
187 Chlinical Termometer pices 0 - -
188 Folley Catheter pcs 12 - 12 4 6 2 12 -
189 Folley Catheter No. 20 pcs 0 10 10 20 20 2 4 4 10 10
190 Folley Catheter No. 22 pcs 0 10 10 10 2 2 8
191 Folley Catheter No. 24 pcs 0 10 10 10 1 1 9
192 Urine Bag Steril With Hanger pcs 10 2 20 50 10 82 92 8 9 2 19 73
193 Non Woven Fikation 20 cm x 10 m Roll 13 13 13 13 -
194 Papet Tape 2,5 cm x 9,14 cm pcs 0
195 Swab 4 Play pcs 1200 2,000 550 2,550 3,750 1,200 700 1,050 600 3,550 200
196 Test Strip Gula Darah Box 2 5 15 20 22 1 2 4 5 12 10
197 Test Strip Asam Urat Box 6 3 15 18 24 2 2 1 19 24 -
198 Test Strip Kolesterol Box 5 3 15 10 28 33 7 10 7 9 33 -
199 Cuticell Clasic 10x 10 cm pcs 0
200 DOCARE Safety box 5 Liter pcs 0 12 12 12 12
210 Scalvein 23 G pcs 0
202 Stomach Tube No. 22 pcs 0
REAGENSIA / LABOR
203 Alkohol / Etanol 70% botol 16 - 6 12 - 18 34 3 16 10 4 33 1
204 Anti A Monoclonal Gol. Darah vial 6 - - - 6 4 2 6 -
205 Anti B Monoclonal Gol. Darah vial 6 - - - 6 4 2 6 -
206 Anti AB Monoclonal Gol. Darah vial 6 - - - 6 6 6 -
207 Anti D Monoclonal Gol. Darah vial 8 - - - 8 6 2 8 -

208 Seftalcan Alkohol Free Cleaner Desinfectan botol - 10 10 10 - - - -

- - 10
209 Lisol botol 18 - - 18 18 3 7 4 3 17 1
210 Policlean Handscrub botol 8 - - 8 8 8 - - - 8 -
211 Acticare Handscrub botol 10 - 12 12 22 10 1 11 11
212 Aseptan Gel Pembersih Tangan botol - - - - - - - - - - - - -
213 Hcl 0,1 N botol - - -
214 Larutan H202 3% botol - - -
215 Larutan Turk botol - - -
216 Larutan Bennedict botol - - -
217 Rivanol 300 cc botol - - -
218 Pewarna Giemsa botol - - -
219 Immersion Oil botol - - -
220 Stericide 3 Surface Desinfectant Galon 5 Liter - - -
Obat Gigi
221 Etil Klorida Semprot botol 2 2 - - - 2 4 - - - - - 4
222 Xiloaine (Lidocaine Spray) 10% botol 2 - - - - - 2 - - - - - 2
223 Fuji 1x6 p 1-1 Porterior set - - - - - - - - - - - - -
224 Object Glass box - - - - - - - - - - - - -
225 Cover Glass pack - - - - - - - - - - - - -
226 Eugenol 20 gram botol - - - - - - - - - - - - -
227 Caviton botol - - - - - - - - - - - - -
Vaksin/ Serum

228 DPT Combo vial 120 120 150 80 470 470 120 120 150 80
- 470 -

229 Polio vial 120 120 150 80 470 470 120 120 150 80
- 470 -
230 Hb 0 vial - 60 60 90 60 270 270 60 60 90 45 255 15
231 IPV vial - 90 90 90 90 360 360 90 90 90 78 348 12
232 BCG vial - 90 90 120 90 390 390 90 90 120 90 390 -
233 MR vial - 120 120 120 120 480 480 120 120 120 120 480 -
234 DT vial - - - 252 - 252 252 - - - 230 230 22
235 TD vial - 30 30 464 - 524 524 30 30 - 441 501 23
236 Biosave Serum Anti Bisa Ular (ABU) Injeksi vial - - 2 3 5 7 2 - 2 -
2 4 3
Biosat 1,5 Serum Anti Tetanus (ATS) 1500
237 ampul - - 2 5 7 7 - - 2 1
IU/ml Injeksi - 3 4
Mengetahui
Kepala/pimpinan PKM Pengelola Obat

SAPTROSAH, SKM .MM KRISTINA H. AM.Keb

NIP. 198012132005011005 NIP 198405152017042011