LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PUSKESMAS

PUSKESMAS BATANG KUIS PELAPORAN BULAN/PERIODE MEI S/D JUNI 2020 DOKUMEN NOMOR DAN TANGGAL
KECAMATAN BATANG KUIS PERMINTAAN BULAN/PERIODE JUNI S/D JULI 2020 IFK 1190 7/9/2020
KABUPATEN DELI SERDANG PUSKESMAS

SUMBER ANGGARAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK STOK OPT PERMINTAAN
APBD II / DAK JKN APBD I APBN JUMLAH
OBAT APBD II

1 Acyclovir Krim Tube 335 50 385 142 243 90 100 100 100

2 Allopurinol 100 mg Tablet 10,089 5,000 15,089 5,306 9,783 3,360 5,000 5,000 5,000

3 Albendazole tablet 400 mg Tablet 15,990 15,990 2,200 13,790 1,393 - -

4 Amlodipine 5 mg Tablet 4,443 15,000 19,443 15,052 4,391 9,533 20,000 15,000 15,000

5 Amoksisilin 500 mg Kapsul 9,513 20,000 29,513 16,973 12,540 10,750 20,000 20,000 20,000

6 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 83 400 483 357 126 226 400 400 400

7 Amoksisilin Sirup 250 mg btl 60 ml 323 200 523 319 204 202 200 200 200

8 Antasida DOEN I Kombinasi Tablet 11,334 20,000 31,334 13,926 17,408 8,820 20,000 20,000 20,000

9 Antasida DOEN II Suppensi Kombinasi btl 60 ml 435 400 835 352 483 223 400 400 400

10 Anti Fungi DOEN Pot 79 100 179 77 102 49 100 100 100

11 Asam Askorbat (vit C) 50mg Tablet 9,428 10,000 19,428 7,583 11,845 4,803 10,000 7,000 7,000

12 Betametason krim 0,1% 5 gr Tube 122 200 322 255 67 162 400 200 200

13 Bisoprolol 5 mg Tablet 1,440 500 1,940 - 1,940 - 1,000 1,000 1,000

14 Cetrizin tablet Tablet 6,980 15,000 21,980 8,234 13,746 5,215 15,000 10,000 10,000

15 Cetrizin syrup Botol 123 100 223 107 116 68 100 100 100

16 Chloramfenicol salep mata 1 % Tube 98 98 8 90 5 100 -

17 Dextrofen syrup Botol 216 400 616 211 405 134 600 300 300

18 Diazepam 2 mg Tablet 2,669 2,669 480 2,189 304 - -

19 Deksametason inj 5mg /ml-1ml Ampul 190 300 490 430 60 272 400 200 200

20 Deksametason tablet 0,5 mg Tablet 6,811 10,000 16,811 10,840 5,971 6,865 10,000 10,000 10,000

21 Digoksin tablet 0,25 mg Tablet 628 628 - 628 - - -

22 Diphen Hidramin Inj 10 Ampul 86 300 386 241 145 153 300 300 300

23 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) Ampul 269 269 269 - 170 100 100 100

24 Eritromysin kapsul 500 mg Tablet 3,000 3,000 3,000

25 Eritromysin kapsul 500 mg Tablet 977 977 460 517 291 5,000 -

26 Flucort N Cream Tube 96 96 48 48 30 - -

27 Fito Menadione tablet 10 mg Tablet 1,330 300 1,630 190 1,440 120 1,000 1,000 1,000

28 Furosemid tablet 40 mg Tablet 1,723 1,723 1,120 603 709 1,000 1,000 1,000
29 Fenobarbital 30 mg Tablet 1,000 1,000 - 1,000 - - -

30 Glibenclamida 5 mg Tablet 11,855 15,000 26,855 8,720 18,135 5,523 15,000 15,000 15,000

31 Glukosa 5% Larutan Infus Botol 20 20 - 20 - 40 40 40

32 Glimipiride 1 mg Tablet 800 1,000 1,800 1,000 800 633 1,000 1,000 1,000

33 Griseofulvin 125 mg Tablet Tablet - - - - - 10,000 500 500

34 Haloperidol tablet 0,5 mg Tablet 6,610 6,610 1,430 5,180 906 - -

35 Hidrokortison Cream 2.5 % Tube 413 300 713 234 479 148 300 300 300

36 Hidrokloratiazid 25 mg Tablet 2,000 2,000 - 2,000 - - -

37 Isosorbit Dinitrat tablet sublingual 5 mg Tablet 1,870 1,870 - 1,870 - - -

38 Iliadin Spray Botol 17 20 37 22 15 14 20 20 20

39 Iliadin Drop Botol 8 8 - 8 - 20 -

40 Kalsium Laktas 500 mg Tablet 15,423 10,000 25,423 8,810 16,613 5,580 10,000 10,000 10,000

41 Karbamazepin tablet 200 mg Tablet - - - - - -

42 Kaptopril 12,5 mg Tablet 8,701 15,000 23,701 7,920 15,781 5,016 - -

43 Kaptopril 25 mg Tablet 756 756 - 756 - 5,000 -

44 Klorpramazine HCl 100 mg Tablet - - - - - 1,000 -

45 Kloramfeniramin Maleat (CTM) 4 mg Tablet 8,532 15,000 23,532 11,783 11,749 7,463 15,000 15,427 15,427

46 Kotrimoksazole Suspensi btl 60ml 564 564 564 - 357 400 400 400

47 Kotrimoksazol 480 mg komb (DW) Tablet 5,300 19,000 24,300 7,184 17,116 4,550 10,000 10,359 10,359

48 Lidokain Injeksi Ampul 275 100 375 145 230 92 100 100 100

49 Metformin tablet 500 mg Tablet 7,513 10,000 17,513 8,530 8,983 5,402 10,000 1,225 1,225

50 Metil Ergometrin Maleat 0,125 mg Tablet 1,470 500 1,970 400 1,570 253 500 500 500

51 Metoclorpramid HCL 10 mg Tablet 924 3,000 3,924 2,350 1,574 1,488 3,000 3,000 3,000

52 Metronidazol 500 mg Tablet 9,598 1,000 10,598 6,400 4,198 4,053 10,000 5,000 5,000

53 Metronidazole syirup Botol - - - - - 100 -

54 Mikonazol Cream 2 % Tube 387 300 687 203 484 129 300 300 300

55 Natrium Diklofenak tablet 50 mg Tablet 8,320 10,000 18,320 12,032 6,288 7,620 2,800 2,800 2,800

56 Natrium Klorida larutan infus 0,9% Botol 400 400 220 180 139 200 200 200

57 Nistatin tablet salut 100.000 IU/g Tablet 466 466 10 456 6 - -

58 Nistatin tablet salut 500.000 IU/g Tablet 952 952 - 952 - - -

59 Oksitetrasiklin salep mata 1 % Tube 149 50 199 123 76 78 100 100 100

60 Oksitoksin injeksi 10 iv/ml Ampul 96 200 296 296 - 187 200 200 200

61 Paracetamol 500 mg (lanamol) Tablet 5,071 5,071 5,071 - 3,212 20,000 20,000 20,000

62 Paracetamol sirup 120 mg/5ml Botol 66 500 566 493 73 312 500 500 500

63 Pehacain Injeksi Ampul 200 500 700 400 300 253 500 500 500

64 Pirantel tablet score 125 mg Tablet - - - - - - -

65 Pyridoksin HCI (Vit B6) Tablet Tablet 9,528 10,000 19,528 6,058 13,470 3,837 10,000 10,000 10,000
66 Prednison 5 mg Tablet Tablet 3,045 10,000 13,045 6,034 7,011 3,822 10,000 10,000 10,000

67 Propanolol HCL 10 mg Tablet 2,800 2,800 - 2,800 - - -

68 Ranitidin tablet 150 mg (HCL) Tablet 14,795 20,000 34,795 13,338 21,457 8,447 15,000 15,000 15,000

69 Ranitidin Injeksi 25 mg Ampul 200 300 500 430 70 272 300 300 300

70 Ringer Laktat laturan infus steril Botol 540 200 740 280 460 177 200 200 200

71 Salbutamol tablet 2 mg Tablet 3,275 3,000 6,275 917 5,358 581 3,000 3,000 3,000

72 Salbutamol syrup Botol 19 19 11 8 7 - -

73 Serum ATS 1.500 IU Injeksi Ampul 3 3 2 1 1 10 5 5

74 Sianokobalamin (Vit B12) tablet 50 mg Tablet 3,204 3,204 1,710 1,494 1,083 10,000 500 500

75 Sianokobalamin (Vit B12) injeksi Ampul 245 1,000 1,245 545 700 345 800 800 800

76 Simvastatin tablet 10 mg Tablet 6,790 5,000 11,790 7,780 4,010 4,927 5,000 2,000 2,000

77 Simvastatin tablet 20 mg Tablet 3,400 3,000 6,400 1,200 5,200 760 3,000 3,000 3,000

78 Siprofloksasin 500 MG Tablet 2,828 5,000 7,828 5,805 2,023 3,677 5,000 5,000 5,000

79 Tetrasiklin 500 mg Kapsul 1,162 5,000 6,162 3,340 2,822 2,115 2,700 2,700 2,700

80 Vitamin B komplek Tablet Tablet 12,373 10,000 22,373 9,194 13,179 5,823 10,000 10,000 10,000

81 Wida Bes Asetat Ringer Infus Botol 360 100 460 120 340 76 - -

82 Zink Tablet Tablet 2,560 3,500 6,060 1,610 4,450 1,020 5,000 -

BAHAN MEDIS HABIS PAKAI - - - - -

83 Accu Check safe T Pro Uno Dus 3 2 5 3 2 - 5 1 1

84 Autocheck Blood Glucose Test Strip Box - 10 10 10 - 6 20 10 10

85 Autocheck Blood Cholesterol Test Strip Box - - - - 20 10 10

86 Autocheck Urid Acid Test Strip Box - 10 10 10 - 6 20 10 10

87 Abbocath No.20 G Buah 200 200 400 100 300 - 100 100 100

88 Abbocath No.22 G Buah 500 200 700 100 600 63 200 200 200

89 Abbocath No.24 G Buah 250 100 350 150 200 95 100 100 100

90 Abbocath No.18 G Buah - 100 100 50 50 32 100 100 100

91 Alat suntik 3 ml 24 G X1 Buah 500 1,000 1,500 1,000 500 633 1,000 1,000 1,000

92 Alkohol Sweb 2 Ply Buah 2,100 1,000 3,100 2,300 800 1,457 2,000 2,000 2,000

93 Aseptan Gel 500 cc + Dispenser Botol - - - - 20 -

94 Cat Gut /benang bedah Plain no . 2/0 Buah 60 48 108 72 36 46 48 48 48

95 Cat Gut /benang bedah Plain no .3/0 Buah 36 48 84 60 24 38 48 48 48

96 Etanol 70 % Botol 5 5 5

97 Infusion Set Anak Set 50 50 100 - 100 - 50 50 50

98 Infusion Set Dewasa Set 125 100 225 75 150 48 100 100 100

99 Kapas Pembalut 250 g Buah 6 6 6 - 4 10 -

100 Kapas Pembalut 500 g Buah 11 10 21 11 10 7 10 10 10

101 Lisol 100 % Botol 10 5 15 6 9 4 3 3 3

102 Masker Tie On Buah - - - - 3,000 -

103 Masker 3 Ply Tie On Buah - - - - 3,000 -

104 Masker 3 Ply Earloop With Ear Loop Buah - - - - 3,000 -

105 Masker 3 Ply Earloop Buah - 100 100 100 - 63 3,000 -

106 Masker 3 Ply Earlop Evomed Plus White buah 100 100

107 Masker Headloop Buah 100 100

108 Pharfix 15 cm x 5 m Roll 12 5 17 11 6 7 10 -

109 Pharfix 10 cm x 5 m Roll 10 5 15 10 5 6 10 3 3

110 Pharfix 5 cm x 5 m Roll 16 5 21 8 13 5 5 5 5

111 Povidon Iodida 10 % 300 ml Botol 21 21 15 6 10 20 20 20

112 USG GEL Botol 14 24 38 8 30 5 10 10 10

OBAT GIGI - - - - -

113 Eugenol cairan Botol 8 8 - 8 - - -

114 ENDO ICE Botol - - - - 4 -

115 Articulating Pcs 3 3 - 3 - - -

116 61104 Ketac Universal HM Intro Kit A3 Dus 3 3 - 3 - - -

117 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 3 3 - 3 - - -

118 1470A2 Z250 XT Rest Syr 3 G La Apac Mea Dus 3 3 - 3 - - -

119 Cresotin Liquid II Tehnodent Botol 3 3 - 3 - - -

120 Guta Percha Point #15-40 Box 3 3 - 3 - - -

121 Guta Percha Point #45-80 Box 3 3 - 3 - - -

122 Denpro Cal LC Dus 3 3 - 3 - - -

123 Paramono Cloofenol (CHKM) Dus 3 3 - 3 - - -

124 PULP - X Dus 3 3 - 3 - - -

125 Asam Mefenamat 500mg Tablet 159 7,000 7,159 5,676 1,483 - 15,000 7,000 7,000

126 Adalat Oros 20mg Tablet 173 173 80 93 - 300 -

127 chloramex Capsul 500mg Kapsul 2,973 2,973 2,055 918 - 5,000 -

128 Cefadroxil 250mg/5ml syr Botol - - - - 200 -

129 Cefadroxil 500mg Tablet - - - - 3,000 -

130 septriaxon inj Vial 20 20 10 10 - 40 -

131 Metoclorpramid HCL 10 mg/2ml inj Ampul 20 20 - 20 - 50 -

132 Becefort syr Botol 15 15 15 - - 200 -

133 Ketoconazole 200mg Tablet 770 770 662 108 - 2,000 -

134 Attapulgit tablet Tablet 277 277 221 56 - 5,000 -

135 Gentamicin inj 40mg Ampul 25 25 - 25 - 30 -

136 Methilergometrin inj Ampul 80 80 - 80 - 100 -

137 Ca Gluconas Inj Ampul - - - - - -

138 Ampicillin inj Vial 18 18 - 18 - 50 -

139 MgSo4 20% inj fls 96 96 96 - - 50 -

140 MgSo4 40% inj fls - - - - 50 -

141 Eritromisin syr botol 1 1 - 1 - 200 -

142 Garam Oralit sachet 3,695 3,695 2,190 1,505 - 2,000 -

143 Glucosa 10% Botol 40 40 40 - - 40 10 10

144 Hustab P Tablet Tablet 4,113 4,113 300 3,813 - 6,000 -

145 Hustab Tablet Tablet 2,230 3,000 5,230 4,930 300 - 6,000 3,000 3,000

146 Hustab Syr Botol - 400 400 157 243 - 400 300 300

147 INH Tablet - - - - - - -

148 kodein 10 mg tablet 80 80 80 - - 500 -

149 Retinol 200000 (vit A kapsul Merah) Kapsul 2,021 2,021 - 2,021 - - -

150 Retinol 100000 (vit A kapsul Biru) Kapsul - - - - - - -

151 Tablet Tambah Darah Tablet 5,959 5,959 1,206 4,753 - - -

152 Thiamin HCL Tablet - - - - 20,000 20,000 20,000

153 Zircum kid Syr Botol 2 2 2 - - 50 50 50

154 ABN Hands Rubb 500ml Botol - 10 10 10 - - 50 -

155 Acticare Handrub Botol 30 30 30

156 Foley Cateter No 18 Pcs 40 40 40 - - -

157 Foley Cateter No 16 Pcs 90 90 40 50 - - -

158 Sarung Tangan 7,5 psg - - - - 1,000 1,000 1,000

159 Sarung tangan L buah - - - - 2,000 -

160 Sarung Tangan M tanpa tepung buah 100 1,000 1,100 1,100 - - 2,000 -

161 Silk 2/0 Pcs 48 48 24 24 - 48 48 48

162 silk 3/0 Pcs 60 60 24 36 - 48 48 48

163 Cat Gut Chromic 2/0 Pcs 24 24 24 - - 48 48 48

164 Cat Gut Chromix 3/0 Pcs - - - - 48 48 48

165 Skin Clean 500ml ktk - - - - 20 -

166 mineral Mix sachet 471 471 - 471 - - -

167 Diazepam 2 mg injeksi ampul 1 1 - 1 - 5 -

168 Kasa steril 7,5x7,5 pcs - - - - 200 -

169 Klindamisin 150mg Tablet - - - - 2,000 -

170 Lidocain Carpuull Ampul - 200 200 - 200 - 200 -

171 Glimeperida 2mg Tablet 2,640 2,640 1,040 1,600 - 2,000 -

VAKSIN - - - - -

172 BCG Vial 15 40 55 47 8 - -

173 DPTHB-HIB Vial 39 120 159 151 8 - -

174 HB-PID(HBO) Vial 17 200 217 217 - - -

175 MR Vial 18 40 58 45 13 - -

176 POLIO (bopv) Vial 66 110 176 150 26 - -

177 POLIO (IPV) Vial - - - - - - -

178 Td Vial 16 30 46 30 16 - -
179 DT Vial 8 - 8 - 8 - -
KB - - - - -

180 IUD COPPER T set 20 - 20 6 14 - -

181 PIL KB Kom.I (DP Pst) cycle 682 500 1,182 220 962 - -

182 SUNTIK KB (DP Pst) Vial 14 500 514 124 390 - -

183 KONDOM (DP Pst) gross 10 60 70 38 32 - -

184 SUSUK KB II 3 TAHUN set 11 100 111 70 41 - -

185 SPUITS buah 23 23 - 23 - -

REAGEN HIV - - - - -

186 Rapid Sifilis Trepochek test 225 225 - 225 - -

187 Rapid Test I (SD HIV 1/2) test 300 300 125 175 - -

188 Rapid Test II ( FOKUS ) test - - - - - -

189 Rapid Test III (Vikia HIV 1/2) test - - - - - -

190 Alkohol Sweb 2 Ply Buah 400 400 100 300 - -

191 Sarung tangan/Hancun Kotak 9 9 - 9 - -

192 Masker plus 3 fly ear loop pcs - - - - -

193 KONDOM Buah 144 144 - 144 - -

Obat TB PARU - - - - -

194 OAT KAT I PAKET 16 16 6 10 - -

195 OAT KAT II PAKET 1 4 5 3 2 - -

196 OAT KAT ANAK PAKET - - - - - -

197 OAT KOMBIPAK I PAKET 1 5 6 3 3 - -

198 Alat suntik 5 ml 24 G X1 Pcs - - - - 2,000 -

199 Pot Sputum buah 400 400 400 - -

200 RDT Covid test - 54 54 54 - -

VAKSIN HAJI -

201 Vaksin Meningitis Formening PCS - - - -

202 Alat Suntik 1ml PCS - - - -

203 Jarum Suntik PCS - - - -

204 Alkohol Sweb 2 Ply PCS - - - -

205 Syring intro set 1 1 1

206 chamfenol botol 2 2 2

207 Dental Needle Uk 16 buah 90 90 90

208 Dental Needle Uk 21 buah - - - 90 90 90

209 Etyl klorida botol 2 2 2

210 Glas ionomer komp + liq set 2 2 2

JUMLAH KUNJUNGAN 2494 Orang Batang Kuis, 09 Juli 2020

Mengetahui/menyetujui : Yang menyerahkan : Yang meminta : Yang menerima :

Kepala Dinas Kesehatan Kepala Instalasi Farmasi Kepala Puskesmas Batang Kuis Pengelola Obat Puskesmas
Kabupaten Deli Serdang, Kabupaten Deli Serdang, Kecamatan Batang Kuis Puskesmas Batang Kuis

dr. Ade Budi Krista Hedni Febrianty Sembiring, S.Farm, Apt dr. Aguswan Syafni Gusmalinda, S.Farm.,Apt
NIP : 197103132007011026 NIP . 198202032000122003 NIP : 197808192010011011 NIP : 198508312019032001
 71 2 12 7 90 180

2,653 88 442 265 3,360 6,721

1,100 37 183 110 1,393 2,787

7,526 251 1,254 753 9,533 19,066

8,487 283 1,414 849 10,750 21,499

179 6 30 18 226 452

160 5 27 16 202 404

6,963 232 1,161 696 8,820 17,640

176 6 29 18 223 446

39 1 6 4 49 98
3,792 126 632 379 4,803 9,605

128 4 21 13 162 323

- - - - - -
4,117 137 686 412 5,215 10,430

54 2 9 5 68 136

4 0 1 0 5 10

106 4 18 11 134 267

240 8 40 24 304 608

215 7 36 22 272 545

5,420 181 903 542 6,865 13,731

- - - - - -
121 4 20 12 153 305

135 4 22 13 170 341

230 8 38 23 291 583

24 1 4 2 30 61

95 3 16 10 120 241

560 19 93 56 709 1,419

 - - - - - -

4,360 145 727 436 5,523 11,045

- - - - - -
500 17 83 50 633 1,267

- - - - - -

715 24 119 72 906 1,811

117 4 20 12 148 296

- - - - - -

- - - - - -

11 0 2 1 14 28

- - - - - -
4,405 147 734 441 5,580 11,159

- - - - - -

3,960 132 660 396 5,016 10,032

- - - - - -
- - - - - -

5,892 196 982 589 7,463 14,925

282 9 47 28 357 714

3,592 120 599 359 4,550 9,100

73 2 12 7 92 184

4,265 142 711 427 5,402 10,805

200 7 33 20 253 507

1,175 39 196 118 1,488 2,977

3,200 107 533 320 4,053 8,107

- - - - - -

102 3 17 10 129 257

6,016 201 1,003 602 7,620 15,241

110 4 18 11 139 279

5 0 1 1 6 13
- - - - - -

62 2 10 6 78 156

148 5 25 15 187 375

2,536 85 423 254 3,212 6,423

247 8 41 25 312 624

200 7 33 20 253 507

- - - - - -

3,029 101 505 303 3,837 7,673

3,017 101 503 302 3,822 7,643

- - - - - -

6,669 222 1,112 667 8,447 16,895

215 7 36 22 272 545

140 5 23 14 177 355

459 15 76 46 581 1,162

6 0 1 1 7 14
1 0 0 0 1 3

855 29 143 86 1,083 2,166

273 9 45 27 345 690

3,890 130 648 389 4,927 9,855

600 20 100 60 760 1,520

2,903 97 484 290 3,677 7,353

1,670 56 278 167 2,115 4,231

4,597 153 766 460 5,823 11,646

60 2 10 6 76 152

805 27 134 81 1,020 2,039

5 0 1 1 6 13

- - - - - -

5 0 1 1 6 13

50 2 8 5 63 127

75 3 13 8 95 190

25 1 4 3 32 63
500 17 83 50 633 1,267

1,150 38 192 115 1,457 2,913

- - - - - -
36 1 6 4 46 91

30 1 5 3 38 76

- - - - - -
38 1 6 4 48 95

3 0 1 0 4 8

6 0 1 1 7 14

3 0 1 0 4 8
- - - - - -

- - - - - -

- - - - - -
50 2 8 5 63 127

6 0 1 1 7 14

5 0 1 1 6 13

4 0 1 0 5 10

8 0 1 1 10 19
4 0 1 0 5 10

- - - - - -

- - - - - -

- - - - - -
- - - - - -

- - - - - -

- - - - - -

- - - - - -
- - - - - -

- - - - - -

- - - - - -

- - - - - -

- - - - - -

- - - - - -
 PEMERINTAH KABUPATEN DELI SERDANG
DINAS KESEHATAN
UPT. PUSKESMAS BATANG KUIS
KECAMATAN BATANG KUIS
Jl. Pancasila no. 26 Batang Kuis Kode Pos 20372
Email : puskesmas.batangkuis@gmail.com, Telp: (061) 7383720
BERITA ACARA PENERIMAAN APD HIBAH
NOMOR : 830/PKMBK/ VII/2020

Pada hari ini , JUMAT Tangga SEPULUH Bulan JULI Tahun DUA RIBU DUA PULUH kami yang bertanda
tangan dibawah ini , Kepala Puskesmas dan Pengelola Obat Puskesmas pada :
Puskesmas BATANG KUIS
Kecamatan BATANG KUIS

Telah melakukan Pemeriksaan dan Penerimaan APD HIBAH dari DPD GOLKAR DELI SERDANG tanggal 10 JULI 2020 dalam keadaan baik dan cukup

aftar APD HIBAH adalah sebagai berikut :

NO NAMA APD JUMLAH

1 Baju Coverall 5 buah
2 MASKER 2 kotak
3 Face Shilde 5 pcs
4 Sabun Anti Septik 92 buah
Batang Kuis, 10 JULI 2020

Diketahui oleh : Yang menerima :

Kepala Puskesmas Batang Kuis Pengelola Obat Puskesmas
Kecamatan Batang Kuis Puskesmas Batang Kuis

dr. Aguswan Syafni Gusmalinda, S.Farm.,Apt

NIP : 197808192010011011 NIP : 198508312019032001
1 Acyclovir Krim tube 8,580
2 Allopurinol 100 mg tablet 104
3 Albendazole tablet 400 mg tablet 423
tablet 73
4 Amlodipine 5 mg tablet/ H
110
Baru
kapsul 245
5 Amoksisilin 500 mg
kapsul 260
6 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 3,324
7 Amoksisilin Sirup 250 mg btl 60 ml 3,670
tablet 56
8 Antasida DOEN I Kombinasi
tablet 60
btl 60 ml 2,051
9 Antasida DOEN II Suppensi Kombinasi
btl 60 ml 2,189
10 Anti Fungi DOEN pot 5,038
tablet 109
11 Asam Askorbat (vit C) 50mg
tablet 110
12 Betametason krim 0,1% 5 gr tube 3,350
13 Bisoprolol 5 mg tablet 237
tablet 94
14 Cetrizin tablet
tablet 101
15 Cetrizin syrup botol 2,973
16 Chloramfenicol salep mata 1 % tube 2,007
17 Dextrofen syrup botol 11,550
18 Diazepam 2 mg tablet 86
19 Deksametason inj 5mg /ml-1ml ampul 1,152
tablet 33
20 Deksametason tablet 0,5 mg tablet/ H.
143
Baru
21 Digoksin tablet 0,25 mg tablet 104
22 Diphen Hidramin Inj 10 ampul 1,228
23 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 1,408
24 tablet 765
Eritromysin kapsul 500 mg
25 tablet 785
26 Flucort N Cream Tube 18,844
27 tablet/ H.
Fito Menadione tablet 10 mg 797
baru
28 Furosemid tablet 40 mg tablet 77
29 Fenobarbital 30 mg tablet 180
tablet 125
30 Glibenclamida 5 mg tablet/ H.
125
Baru
31 Glukosa 5% Larutan Infus botol 7,363
32 Glimipiride 1 mg tablet 174
33 Griseofulvin 125 mg Tablet tablet 217
34 Haloperidol tablet 0,5 mg tablet 62
35 Hidrokortison Cream 2.5 % tube 2,475
36 Hidrokloratiazid 25 mg tablet 163
37 Isosorbit Dinitrat tablet sublingual 5 mg tablet 91
38 Iliadin Spray botol 36,036
39 Iliadin Drop botol 34,177
40 Kalsium Laktas 500 mg tablet 63
41 Karbamazepin tablet 200 mg tablet 231
42 Kaptopril 12,5 mg tablet 64
43 Kaptopril 25 mg tablet 71
44 Klorpramazine HCl 100 mg tablet 155
45 Kloramfeniramin Maleat (CTM) 4 mg tablet 25
46 Kotrimoksazole Suspensi btl 60ml 2,952
47 Kotrimoksazol 480 mg komb (DW) APBD 2019 133
ampul 1,210
48 Lidokain Injeksi Carpull/H
3,114
baru
49 Metformin tablet 500 mg tablet 106
50 Metil Ergometrin Maleat 0,125 mg tablet 222
51 Metoclorpramid HCL 10 mg tablet 85
52 Metronidazol 500 mg tablet 264
53 Metronidazole syirup botol 3,950
54 Mikonazol Cream 2 % tube 3,585
55 Natrium Diklofenak tablet 50 mg tablet 136
56 botol/ H.
Natrium Klorida larutan infus 0,9% 6,840
Baru
tablet 590
57 Nistatin tablet salut 100.000 IU/g tablet/ H
630
Baru
tablet 886
58 Nistatin tablet salut 500.000 IU/g tablet/ H
886
Baru
59 Oksitetrasiklin salep mata 1 % tube 2,774
ampul 1,199
60 Oksitoksin injeksi 10 iv/ml ampul/H
1,199
baru
61 Paracetamol 500 mg (lanamol) tablet 165
botol 1,184
62 Paracetamol sirup 120 mg/5ml
botol 1,184
63 Pehacain Injeksi ampul 3,114
64 Pirantel tablet score 125 mg tablet 302
tablet 138
65 Pyridoksin HCI (Vit B6) Tablet
tablet 138
66 Prednison 5 mg Tablet tablet 76
67 Propanolol HCL 10 mg tablet 60
tablet 191
68 Ranitidin tablet 150 mg (HCL)
68 Ranitidin tablet 150 mg (HCL)
tablet 191
69 Ranitidin Injeksi 25 mg Ampul 1,188
70 Ringer Laktat laturan infus steril botol 7,630
71 Salbutamol tablet 2 mg tablet 67
72 Salbutamol syrup botol 4,446
73 Serum ATS 1.500 IU Injeksi ampul 188,663
74 Sianokobalamin (Vit B12) tablet 50 mg tablet 47
75 Sianokobalamin (Vit B12) injeksi ampul 1,065
76 Simvastatin tablet 10 mg tablet 117
77 Simvastatin tablet 20 mg tablet 226
tablet 880
78 Siprofloksasin 500 MG
tablet 880
79 Tetrasiklin 500 mg kapsul 323
80 Vitamin B komplek Tablet tablet 123
81 Wida Bes Asetat Ringer Infus Botol 10,293
82 Zink Tablet Tablet 551
BAHAN MEDIS HABIS PAKAI -
83 Accu Check safe T Pro Uno Dus 127,050
84 Autocheck Blood Glucose Test Strip box 137,500
85 Autocheck Blood Cholesterol Test Strip box 368,500
86 Autocheck Urid Acid Test Strip box 178,750
87 Abbocath No.20 G buah 4,180
88 Abbocath No.22 G buah 4,180
89 Abbocath No.24 G buah 4,180
90 Abbocath No.18 G buah 4,180
91 Alat suntik 3 ml 24 G X1 buah 924
92 Alkohol Sweb 2 Ply buah 110
93 Aseptan Gel 500 cc + Dispenser botol 66,700
94 Cat Gut /benang bedah Plain no . 2/0 buah 33,538
95 Cat Gut /benang bedah Plain no .3/0 buah 34,004
96 Infusion Set Anak set 3,500
97 Infusion Set Dewasa set 3,200
98 Kapas Pembalut 250 g buah 13,750
99 Kapas Pembalut 500 g buah 30,008
100 Lisol 100 % botol 41,000
101 Masker Tie On buah 461
102 Masker 3 Ply Tie On buah 399
103 Masker 3 Ply Earloop With Ear Loop buah 399
104 Object Glass Kotak 19,365
105 Pharfix 15 cm x 5 m rol/ H. baru 81,955
106 Pharfix 10 cm x 5 m rol/ H. baru 56,435
107 Pharfix 5 cm x 5 m rol/ H. baru 28,286
108 Povidon Iodida 10 % 300 ml botol 21,375
109 USG GEL botol 14,472
OBAT GIGI -
110 Eugenol cairan botol 19,005
111 ENDO ICE Botol 352,000
112 Articulating Pcs 181,500
113 61104 Ketac Universal HM Intro Kit A3 Dus 437,547
114 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 186,766
115 1470A2 Z250 XT Rest Syr 3 G La Apac Mea Dus 186,766
116 Cresotin Liquid II Tehnodent Botol 164,774
117 Guta Percha Point #15-40 Box 45,000
118 Guta Percha Point #45-80 Box 45,000
119 Denpro Cal LC Dus 183,000
120 Paramono Cloofenol (CHKM) Dus 65,000
121 PULP - X Dus 217,000
122 Iodotin Tehnoden Pot 96,500
Acyclovir Krim Tube
Allopurinol 100 mg Tablet
Albendazole tablet 400 mg Tablet
Amlodipine 5 mg Tablet
Amoksisilin 500 mg Kapsul
Amoksisilin Sirup kering 125 mg/5ml btl 60 ml
Amoksisilin Sirup 250 mg btl 60 ml
Antasida DOEN I Kombinasi Tablet
Antasida DOEN II Suppensi Kombinasi btl 60 ml
Anti Fungi DOEN Pot
Asam Askorbat (vit C) 50mg Tablet
Betametason krim 0,1% 5 gr Tube
Bisoprolol 5 mg Tablet
Cetrizin tablet Tablet
Cetrizin syrup Botol
Chloramfenicol salep mata 1 % Tube
Dextrofen syrup Botol
Diazepam 2 mg Tablet
Deksametason inj 5mg /ml-1ml Ampul
Deksametason tablet 0,5 mg Tablet
Digoksin tablet 0,25 mg Tablet
Diphen Hidramin Inj 10 Ampul
Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) Ampul
Eritromysin kapsul 500 mg Tablet
Flucort N Cream Tube
Fito Menadione tablet 10 mg Tablet
Furosemid tablet 40 mg Tablet
Fenobarbital 30 mg Tablet
Glibenclamida 5 mg Tablet
Glukosa 5% Larutan Infus Botol
Glimipiride 1 mg Tablet
Griseofulvin 125 mg Tablet Tablet
Haloperidol tablet 0,5 mg Tablet
Hidrokortison Cream 2.5 % Tube
Hidrokloratiazid 25 mg Tablet
Isosorbit Dinitrat tablet sublingual 5 mg Tablet
Iliadin Spray Botol
Iliadin Drop Botol
Kalsium Laktas 500 mg Tablet
Karbamazepin tablet 200 mg Tablet
Kaptopril 12,5 mg Tablet
Kaptopril 25 mg Tablet
Klorpramazine HCl 100 mg Tablet
Kloramfeniramin Maleat (CTM) 4 mg Tablet
Kotrimoksazole Suspensi btl 60ml
Kotrimoksazol 480 mg komb (DW) Botol
Lidokain Injeksi Ampul
Metformin tablet 500 mg Tablet
Metil Ergometrin Maleat 0,125 mg Tablet
Metoclorpramid HCL 10 mg Tablet
Metronidazol 500 mg Tablet
Metronidazole syirup Botol
Mikonazol Cream 2 % Tube
Natrium Diklofenak tablet 50 mg Tablet
Natrium Klorida larutan infus 0,9% Botol
Nistatin tablet salut 100.000 IU/g Tablet
Nistatin tablet salut 500.000 IU/g Tablet
Oksitetrasiklin salep mata 1 % Tube
Oksitoksin injeksi 10 iv/ml Ampul
Paracetamol 500 mg (lanamol) Tablet
Paracetamol sirup 120 mg/5ml Botol
Pehacain Injeksi Ampul
Pirantel tablet score 125 mg Tablet
Pyridoksin HCI (Vit B6) Tablet Tablet
Prednison 5 mg Tablet Tablet
Propanolol HCL 10 mg Tablet
Ranitidin tablet 150 mg (HCL) Tablet
Ranitidin Injeksi 25 mg Ampul
Ringer Laktat laturan infus steril Botol
Salbutamol tablet 2 mg Tablet
Salbutamol syrup Botol
Serum ATS 1.500 IU Injeksi Ampul
Sianokobalamin (Vit B12) tablet 50 mg Tablet
Sianokobalamin (Vit B12) injeksi Ampul
Simvastatin tablet 10 mg Tablet
Simvastatin tablet 20 mg Tablet
Siprofloksasin 500 MG Tablet
Tetrasiklin 500 mg Kapsul
Vitamin B komplek Tablet Tablet
Wida Bes Asetat Ringer Infus Botol
Zink Tablet Tablet
BAHAN MEDIS HABIS PAKAI
Accu Check safe T Pro Uno Dus
Autocheck Blood Glucose Test Strip Box
Autocheck Blood Cholesterol Test Strip Box
Autocheck Urid Acid Test Strip Box
Abbocath No.20 G Buah
Abbocath No.22 G Buah
Abbocath No.24 G Buah
Abbocath No.18 G Buah
Alat suntik 3 ml 24 G X1 Buah
Alkohol Sweb 2 Ply Buah
Aseptan Gel 500 cc + Dispenser Botol
Cat Gut /benang bedah Plain no . 2/0 Buah
Cat Gut /benang bedah Plain no .3/0 Buah
Infusion Set Anak Set
Infusion Set Dewasa Set
Kapas Pembalut 250 g Buah
Kapas Pembalut 500 g Buah
Lisol 100 % Botol
Masker Tie On Buah
Masker 3 Ply Tie On Buah
Masker 3 Ply Earloop With Ear Loop Buah
Object Glass Kotak
Pharfix 15 cm x 5 m Roll
Pharfix 10 cm x 5 m Roll
Pharfix 5 cm x 5 m Roll
Povidon Iodida 10 % 300 ml Botol
USG GEL Botol
OBAT GIGI
Eugenol cairan Botol
ENDO ICE Botol
Articulating Pcs
61104 Ketac Universal HM Intro Kit A3 Dus

1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus

1470A2 Z250 XT Rest Syr 3 G La Apac Mea Dus

Cresotin Liquid II Tehnodent Botol

Guta Percha Point #15-40 Box
Guta Percha Point #45-80 Box
Denpro Cal LC Dus
Paramono Cloofenol (CHKM) Dus
PULP - X Dus
Iodotin Tehnoden Pot