LAPORAN PEMAKAIAN DAN PENGELUARAN OBAT

( LB 2 )

KODE PUSKESMAS : BULAN : Februari

PUSKESMAS : Sungai Bali TAHUN : 2020
KECAMATAN : Sebuku
KAB. / KODYA : Kotabaru
PROPINSI : Kalimantan Selatan

No STOK PENERIM PERSEDIA PEMAK SISA PEMBERIAN

KODE NAMA OBAT SATUAN KET
URUT AWAL AAN AN AIAN STOK INFRES ASKES APBD LAIN JML
1 2 3 4 5 6 7 8 11 12 13 14 15 16
GOLONGAN OBAT GENERIK / ESENSIAL
1 02182020 Alopurinol tablet 100 mg Tab 1000 0 1000 200 800
2 03180520 Alopurinol tablet 300 mg Tab 0 0 0 - -
3 01170720 Aminofilin tablet 200 mg Tab 0 0 0 - -
4 01170419 Aminofilin injeksi 24 mg/ml - 10 ml Amp 0 0 0 - -
5 01171119 Amitriptilin HCl tab. Salut 25 mg Tab 0 0 0 - -
6 03190221 Amoksisilin kaplet 500 mg Kapl 1300 0 1300 - 1,300
7 01180519 Amoksisilin sirup kering 125 mg / 5 ml Btl 57 0 57 8 49
8 02181019 Antasida Doen tablet kombinasi Tab 1800 0 1800 100 1,700
9 03180822 Antibakteri doen salep kombinasi (Bacitrac Tub 0 0 0 - -
10 01180222 Antihemoroid doen kombinasi Suppo 14 50 64 11 53
11 02180620 Antifungi doen kombinasi Pot 0 0 0 - -
12 03181019 Antimigran doen kombinasi (Ergotamin) Tab 0 0 0 - -
13 01180721 Antasida suspensi Btl 64 0 64 29 35
14 01180121 Aqua proinjeksi steril, bebas pirogen Btl 4 0 4 1 3
15 02180421 Asam askorbat (vit c) tablet 50 mg Tab 700 0 700 - 700
Asam askorbat (vit c) tablet 250 mg Tab 0 0 0 - -
16 03180520 Asetosal 80 mg (Miniaspi 80 mg) Tab 145 0 145 - 145
17 01181019 Atropin sulfat injeksi 0,25 mg/ml - 1 ml Amp 10 0 10 - 10
18 03181019 Acetyl Cystein 200mg Kaps 900 0 900 240 660
19 03180322 Acyclovir tablet 200 mg Tab 730 0 730 230 500
20 03180722 Acyclovir tablet 400 mg Tab 86 0 86 86 -
21 Acyclovir Cream Tube 0 0 0 - -
22 02181020 Ambroksol sirup Btl 0 0 0 - -
23 01170920 Ambroksol tablet 30mg Tab 0 400 400 - 400
24 03181520 Asam Mefenamat tablet 500 mg Tab 0 0 0 - -
25 03190222 Asam Traneksamat Tablet 500 mg Tab 155 0 155 55 100
26 03171119 Asam Traneksamat 100 mg/5 ml Injeksi Amp 0 0 0 - -
27 03190621 Asam Traneksamat 250 mg/5 ml Injeksi Amp 0 0 0 - -
28 03191021 Asam Traneksamat 500 mg/5 ml Injeksi Amp 0 0 0 - -
29 01180820 Asam folat tab 1 mg Tab 766 0 766 266 500
30 03180920 Amlodipin 5mg Tab 1200 0 1200 - 1,200
31 01180821 Amlodipin 10 mg Tab 0 0 0 - -
32 01170820 Betametason krim 0,1 % Tub 75 0 75 3 72
33 02181120 Betahistin mesilate tablet 6 mg Tab 500 0 500 200 300
34 01180820 Cefadroxil 500 mg kaps Kaps 1000 0 1000 - 1,000
35 03180820 Cefadroxil sirup kering 250 mg/5ml Btl 92 0 92 17 75
36 Captopril tablet 12,5 mg Tab 0 0 0 - -
37 02180820 Captopril tablet 25 mg Tab 1042 0 1042 342 700
38 03180821 Captopril tablet 50 mg Tab 0 0 0 - -
39 03180420 Ciprofloxacin tablet 500 mg Tab 100 0 100 100 -
40 01180320 Cetirizine Tab 10 mg Tab 400 0 400 300 100
41 Cetirizine Syrup Botol 0 50 50 - 50
42 Cefotaxim injeksi Vial 0 0 0 - -
43 03180920 Ceptriaxon injeksi Vial 0 0 0 - -
44 Cimetidin Tab 0 0 0 - -
45 Clyndamicin 150 mg Tab 0 0 0 - -
46 03180520 Deksametason inj 5 mg/ml - 1 ml Amp 127 0 127 67 60
47 03180520 Deksametason tablet 0,5 mg Tab 700 300 1000 100 900
48 01180220 Diazepam inj 5 mg/ml - 2 ml Amp 5 0 5 5 -
49 Diazepam rectal (Stesolid rectal 10 mg) Tube 6 0 6 - 6
50 Diazepam tablet 2 mg Tab 0 0 0 - -
51 03180822 Diazepam tablet 5 mg Tab 73 0 73 - 73
52 01180121 Difenhidramin HCl inj 10 mg/ml - 1 ml Amp 6 0 6 2 4
53 01180620 Digoksin tablet 0,25 mg Tab 0 0 0 - -
54 01180821 Domperidone tablet 10 mg Tab 107 0 107 7 100
55 03181020 Domperidon suspensi 5 mg / 5 ml Btl 11 0 11 11 -
56 03180720 Doxycycline 100 mg Kaps 0 0 0 - -
57 01170219 Efedrin HCl tablet 25 mg Tab 0 0 0 - -
58 03191120 Epinefrin 1 mg/ml inj s.c/i.m Amp 0 0 0 - -
59 01181020 Etakridin (rivanol) larutan 0,1 % Btl 3 0 3 - 3
60 02180822 Erytromicin kaplet 500 mg Kapl 0 0 0 - -
61 Erytromicin Syrup Botol 0 0 0 - -
62 02180522 Etambutol tab 500mg ( HCL ) Tab 0 0 0 - -
63 03171020 Etanol 70 % ( 1000 ML ) Btl 1 0 1 - 1
64 03180320 Fenotoin natrium kapsul 100 mg Kap 0 0 0 - -
65 02190720 Fenol Gliserol Tetes Telinga 10% Btl 4 0 4 4 -
66 03180520 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0 0 - -
67 03180423 Fenobarbital tablet 30 mg Tab 0 0 0 - -
68 03181119 Fitomenadion (vit K 1) injeksi 10 mg/ml - Amp 85 0 85 25 60
69 01181220 Fitomenadion (vit K 1) tablet salut 10 mg Tab 0 0 0 - -
70 01180121 Furosemid tablet 40 mg Tab 190 0 190 - 190
71 01180819 Furosemid inj 10mg/ml amp 0 0 0 - -
72 01180323 Glibenklamid Tab 300 0 300 100 200
73 03180323 Glibenklamid Tab 0 0 0 - -
74 03190921 Glimepiride 1 mg Tab 0 0 0 - -
75 03170121 Glimepiride 2 mg Tab 0 0 0 - -
76 01170921 Gliseril guayakolat 100 mg Tab 0 0 0 - -
77 03171121 Gliserin Btl 0 0 0 - -
78 03171219 Glukosa larutan infus 5 % steril Btl 38 0 38 22 16
79 03180620 Griseofulvin tablet 125 mg, micronized Tab 200 0 200 100 100
80 03171119 Gentamycin Sulfat Inj 2 ml Amp 0 0 0 - -
 81 01180521 Gentamycin tetes mata 0,3 % Btl 26 0 26 4 22
82 Gentian Violet Btl 0 0 0 - -
83 03170320 Haloperidol tablet 0,5 mg Tab 0 0 0 - -
84 02180719 Haloperidol tablet 1,5 mg Tab 0 0 0 - -
85 02190719 Haloperidol tablet 5 mg Tab 0 0 0 - -
86 03170522 Hidroklorotiazid (HCT) tablet 25 mg Tab 568 0 568 68 500
87 01180222 Hidrokortison krim 2,5 mg Tub 39 0 39 15 24
88 01170219 Isoniazid tab 300 mg Tab 0 0 0 - -
89 01180420 Ibuprofen syr 100mg/ 5 ml Botol 27 0 27 1 26
90 Ibuprofen200 mg Tab 0 0 0 - -
91 02190822 Ibuprofen400 mg Tab 0 0 0 - -
92 01180722 Isosorbid dinitrat tablet sublingual 5 mg Tab 675 0 675 75 600
93 03180220 Kalsium laktat (kalk) tablet 500 gram Tab 945 0 945 345 600
94 03170619 Karbamazepin tablet 200 gram Tab 0 0 0 - -
95 03180322 Kloramfenikol kapsul 250 mg Kap 0 0 0 - -
96 01180221 Kloramfenikol salep mata 1 % Tub 28 0 28 4 24
97 02190320 Kloramfenikol Tetes Mata Btl 0 0 0 - -
98 02190921 Kloramfenikol Tetes Telinga 1% Btl 0 0 0 - -
99 02170620 Kloramfenikol Suspensi 125 mg/5ml Btl 0 0 0 - -
100 03181022 Klorfeniramin maleat (CTM) tablet 4 mg Tab 1500 0 1500 300 1,200
101 Klorpromazin HCl tablet salut 25 mg Tab 0 0 0 - -
102 02180320 Klorpromazin HCl tablet salut 100 mg Tab 0 0 0 - -
103 01170819 Klorpromazine HCL inj 25mg/ml-1 ml in Amp 0 0 0 - -
104 01170720 Kodein HCl tablet 10 mg Tab 0 0 0 - -
105 03181221 Kodein HCl tablet 10 mg Tab 0 0 0 - -
106 Kotrimoksazol 480 mg Tab 600 0 600 - 600
107 01170420 Kotrimoksazol suspensi Btl 83 0 83 33 50
108 03180620 Ketokonazole 200mg Tab Tab 350 0 350 200 150
109 01180222 Ketokonazole cream Tub 25 25 50 13 37
110 03180521 Lidokain kompositum injeksi Amp 85 0 85 20 65
111 01170000 Lisol Btl 3 0 3 - 3
112 01170220 Lar anhydrous dextrose,Nacl,Kcl,Na lakt Btl 0 0 0 - -
113 03180821 Loratadine 5 mg Tab 400 0 400 50 350
114 03191120 Metilergometrin maleat inj. 0,2 mg - 1 ml Amp 0 0 0 - -
115 Metilergometrin maleat tablet 0,25 mg Tab 90 100 190 160 30
116 03170321 Miconazol 2 % cream Tub 26 0 26 2 24
117 03180922 Metoklopramide tablet 10 mg Tab 100 0 100 - 100
118 Metoklopramide Injeksi Amp 20 0 20 5 15
119 01180522 Metoklopramide sirup 5 mg/5ml (Primpen Btl 0 0 0 - -
120 Metronidazol Tab 500 mg Tab 0 0 0 - -
121 Metronidazol Tab 250 mg Tab 0 0 0 - -
122 Metronidazol Syrup Botol 0 0 0 - -
123 01170720 Metronidazol larutan Infus Btl 0 0 0 - -
124 03191120 Metronidazol larutan Infus 5 mg/ml Btl 0 0 0 - -
125 03180821 Metilprednisolon 4 mg Tab 1000 0 1000 400 600
126 03190123 Metilprednisolon 16 mg Tab 0 0 0 - -
127 03180920 Metformin 500 mg Tab 250 0 250 250 -
128 01180920 Metformin 850 mg Tab 0 0 0 - -
129 03190321 Metamizole Inj 500mg/ml Amp 20 0 20 8 12
130 01170320 Metoklopramide sir ( Norvom Syr) btl 29 0 29 5 24
131 Magnesium Sulfat 40% (MgSo4) Vial 2 0 2 - 2
132 02190820 Magnesium Sulfat 20% (MgSo4) Vial 0 0 0 - -
133 03191220 Natrium klorida larutan infus 0,9% steril Btl 31 0 31 9 22
134 01180220 Nistatin 100.000 iu/g tablet vaginal Tab 270 0 270 70 200
135 03180421 Nistatin 500.000 iu tablet salut Tab 0 0 0 - -
136 03180623 Natrium diclofenak 25 mg Tab 0 0 0 - -
137 03180621 Natrium diclofenak 50 mg Tab 2000 0 2000 100 1,900
138 02190521 Nifedipine Tab 0 0 0 - -
139 02171020 Obat batuk hitam (o.b.h) cairan Btl 13 0 13 1 12
140 03191120 Oksitosin injeksi 10 iu/ml - ml Amp 0 0 0 - -
141 Oksitetrasiklin Salep kulit Tube 0 0 0 - -
142 02190721 Oksitetrasiklin Salep Mata Tub 20 0 20 - 20
143 03191020 Omeprazole kapsul/kaplet 20 mg Kap 137 90 227 107 120
144 03180000 Parasetamol syr 120 mg / 5 ml Btl 47 0 47 39 8
145 03191220 Parasetamol tablet 500 mg Tab 3500 0 3500 300 3,200
146 01180319 Parasetamol tetes 60mg/ 0,6 ml Botol 15 ml 64 0 64 12 52
147 Papaverin Tablet 40 mg Tab 105 0 105 5 100
148 01170319 Petidin HCl injeksi 50 mg/ml - 2 ml Amp 0 0 0 - -
149 03180121 Piridoksin HCl tablet 10 mg Tab 100 0 100 100 -
150 03180720 Prednison tablet 5 mg Tab 537 0 537 237 300
151 03170919 Primakuin tablet 15 mg Tab 0 0 0 - -
152 01170621 Propiltiourasil tablet 100 mg Tab 285 700 985 465 520
153 03180721 Propranolol HCl tablet 10 mg Tab 366 0 366 166 200
154 01170319 Pehamoxil injeksi (Amoxilin Injeksi) Vial 0 0 0 - -
155 Piracetam Injeksi 1g / ml vial 0 0 0 - -
156 02180820 Piracetam 800mg Tab 0 0 0 - -
157 02180220 Pirazinamide 500mg tab Tab 0 0 0 - -
158 Pyroxicam tablet 20 mg Tab 0 0 0 - -
159 Pyrantel Pamoat 125 mg Tab 100 0 100 - 100
160 03180523 Quinine 222 mg Tab 0 0 0 - -
161 03170222 Ringer laktat larutan infus steril Btl 24 100 124 36 88
162 03181120 Ranitidin tablet 150 mg Tab 335 0 335 - 335
163 03190920 Ranitidin Injeksi 50mg/2ml Amp 3 0 3 - 3
164 03170420 Retinol (vitamin A) kapsul 100.000 iu Kap 0 0 0 - -
165 Retinol (vitamin A) kapsul 200.000 iu Kap 0 0 0 - -
166 Rifampisin kaplet 300 mg Tab 0 0 0 - -
167 02180422 Rifampisin kaplet 600 mg Tab 0 0 0 - -
168 03180921 Salbutamol tablet 2 mg Tab 700 0 700 100 600
169 01170721 Salbutamol tablet 4 mg Tab 144 0 144 144 -
170 01180921 Salep 2-4 kombinasi Pot 0 0 0 - -
171 01180420 Salisil bedak 2 % Ktk 6 0 6 1 5
172 02180720 Serum anti bisa ular polivalen inj. 5 ml (ab Vial 0 0 0 - -
173 01181219 Serum anti tatanus inj. 1.500 iu/ampul (a.t.s Amp 0 0 0 - -
174 01180521 Sianokobalamin (Vit. B12) inj. 500 mcg/m Amp 14 0 14 - 14
175 03180123 Sianokobalamin (Vit. B12) tablet 50 mcg Tab 500 0 500 100 400
176 03180720 Simvastatin tablet 10 mg Tab 0 0 0 - -
 177 01180720 Simvastatin tablet 10 mg Tab 1680 0 1680 300 1,380
178 03190520 Simvastatin tablet 20 mg Tab 0 0 0 - -
179 03190820 Spironolactone 25 mg Tab 0 0 0 - -
Tetrasiklin 250 mg Kaps 0 0 0 - -
180 Tetrasiklin 500 mg Kaps 0 0 0 - -
181 01170420 Tiamin HCl (Vit. B1) inj. 100 mg/ml - 1 m Amp 0 90 90 90 -
182 03180320 Tiamin HCl monohidrat (Vit. B1) tablet 50 Tab 200 100 300 - 300
183 03180920 Triheksifenidil hidroklorida tablet 2 mg Tab 0 0 0 - -
184 01170920 Thiamfenikol tab 500 mg Tab 0 0 0 - -
185 03180221 Tramadol Injeksi 100mg/2ml Amp 0 0 0 - -
186 03180221 Vitamin B kompleks tablet Tab 1600 0 1600 100 1,500
187 03190821 Viccillin Ampisilin serbuk injeksi 250 mg Amp 0 0 0 - -
188 01181219 Wida Bes Btl 0 0 0 - -
189 Yodium povidon larutan 10 % 30 ml Btl 7 0 7 - 7
190 Yodium povidon larutan 10 % 60 ml Btl 0 0 0 - -
191 03180321 Yodium povidon larutan 10 % 300 ml Btl 0 0 0 - -
192 01180320 Zink Tablet 20 mg Tab 745 0 745 345 400
Gentamisin salep kulit - 0 0 - -
Ichtiol salep - 0 0 - -
Lansoprazol 220 0 220 20 200
Tablet tambah darah 420 0 420 320 100
GOLONGAN OBAT GIGI 0 0 -
1 01170720 Cholorophenol camphor menthol (chkm) ktk 0 0 0 - -
2 Arsen / Caustinerf rapide Btl 0 0 0 - -
3 Devitalisasi pasta (non arsen) caustinerf forte 0 0 0 - -
4 02180523 Etil klorida semprot Kaleng 0 0 0 - -
5 01170000 Eugenol cairan Btl 2 0 2 - 2
6 Glass Ionomer (gcix) / Fuji IX set 0 0 0 - -
7 Iodoform paste Ktk 0 0 0 - -
8 kalsium hidroksida pasta tube 0 0 0 - -
9 Mummifying pasta / tempophore btl 0 0 0 - -
10 Semen seng fosfat serbuk dan cairan 0 0 0 - -
 11 Spons gelatin Cubicles 1 x 1 x 1 Cm Ktk 0 0 0 - -
12 Temporary stopingfletcher serbuk dan cair set 0 0 0 - -
13 01170720 Trikresol formalin (TKF) cairan Btl 0 0 0 - -
14 01170319 Ceivtron( tambalan sementara ) ktk 0 1 1 1 -
GOLONGAN OBAT BAHAN HABIS PAKAI 0 0 -
1 03181120 Alkohol Swab Pcs 300 0 300 - 300
2 Bisturi No 11 Pcs 0 100 100 - 100
3 Bisturi No 15 Pcs 0 0 0 - -
4 Bisturi No 20 Pcs 0 0 0 - -
5 01171119 Catgut/benang bedah no.2/0 plain Sak 0 0 0 - -
6 01171119 Catgut/benang bedah no.2/0 chromic sak 0 0 0 - -
7 01171119 Catgut/benang bedah no. 3/0 chromic Sak 0 0 0 - -
8 01170322 Elastic band roll 1 0 1 - 1
9 03170321 Folley catheter no.16 pcs 9 0 9 1 8
10 03170421 Folley catheter no.18 Pcs 11 2 13 - 13
11 03171121 Folley catheter no.20 Pcs 30 0 30 - 30
12 02170119 Infusion set anak Set 8 0 8 - 8
13 01170922 Kapas berlemak 500 gram Bks 0 0 0 - -
14 03180721 Kapas pembalut/absorben 250 gram Bks 3 0 3 - 3
15 03180122 Kasa kompres 40/40 steril Rol 0 0 0 - -
16 03180721 Kasa Steril 16x16 cm kotak 0 0 0 - -
17 03180322 Kasa pembalut 36 m x 80 cm Rol 2 0 2 - 2
18 03171021 Kasa pembalut 40 m x 80 cm Rol 0 0 0 - -
19 03180422 Kasa pembalut 2ml x 80 cm Rol 0 0 0 - -
20 02190224 Kasa pembalut 2ml x 80 cm Rol 0 0 0 - -
21 02191020 Kasa Pembalut 40 m x 40 cm Rol 0 0 0 - -
22 03180422 Kasa pembalut hidrofil 4 m x 10 cm Rol 30 0 30 - 30
23 03180322 Kasa Pembalut hidrofil 4 x 3 pack 0 0 0 - -
24 02180423 Kasa steril Kasa Steril 10 x 10, 8ply, 1x10' Pcs 0 0 0 - -
25 01180323 Masker Karet (ear loop) Kotak 0 0 0 - -
26 02170322 Masker Karet Pcs 0 0 0 - -
27 03170322 Masker Hijab Pcs 1200 0 1200 100 1,100
28 02170921 Optiva No.20 ( Cathy IV. Cannula 20 G ) Set 31 0 31 9 22
29 02170321 Optiva No.22 ( Cathy IV. Cannula 22 G ) Set 18 0 18 18 -
30 02170621 Optiva No.24 ( Cathy IV. Cannula 24 G ) Set 0 0 0 - -
31 01170320 Pembalut gips 3 inchi Rol 1 0 1 - 1
32 03170821 Silk (benang bedah sutera) no. 3/0 Box 25 0 25 9 16
33 03170219 Ultrasonic gel galon 5 liter OM Galon 0 0 0 - -
34 03180722 Umbrical Cord Nylon OM Pcs 27 0 27 4 23
35 03170122 Urine bag Steril Pcs 32 0 32 10 22
36 03170422 Sarung Tangan Non Steril Pcs 900 0 900 100 800
37 01170422 Polid Aid Botol 0 0 0 - -
38 03180221 Aseptic Gel Botol 6 0 6 - 6
39 02170119 Alat Suntik 10 ml Set 0 0 0 - -
40 01190523 Polyflex IV. Cannula 24G (Optiva 24G) Pcs 0 50 50 - 50
41 01190523 Polyflex IV. Cannula 22G (Optiva 22G) Pcs 0 40 40 - 40
42 01190323 Polywin IV. Cannula 26G (Optiva 26G) Pcs 0 0 0 - -
43 01190622 Polyflex IV. Cannula 20G (Optiva 20G) Pcs 0 0 0 - -
44 01180000 Sarung Tangan Steril ( Mas Surgical Glove pcs 300 0 300 100 200
45 01190623 Sarung Tangan Steril ( Mas Surgical Glov pcs 0 0 0 - -
46 01181122 Mas Nasal Oxygen Cannula Infant (anak) Pcs 0 0 0 - -
47 01181122 Mas Nasal Oxygen Cannula Adult (dewasa Pcs 0 0 0 - -
48 01190823 Sarung Tangan Steril (Surgical gloves) 7,5 Pair 0 0 0 - -
49 01180822 Sarung Tangan Steril (Surgical gloves) 6.5 Pair 0 0 0 - -
50 01190723 Sarung Tangan Steril (Surgical gloves) 7 Pair 23 0 23 - 23
51 01180722 Spuit 1 cc pcs 76 100 176 36 140
52 01180122 Spuit 2,5 cc pcs 0 0 0 - -
53 03170521 Spuit 3 cc ( STERA ) Pcs 23 100 123 28 95
54 Spuit 5 cc Pcs 31 0 31 15 16
55 01180022 Spuit 20 cc pcs 0 0 0 - -
56 01180022 Infus set anak pcs 10 0 10 2 8
57 01190823 Infus set dewasa pcs 45 25 70 20 50
58 02181222 Pap Smear kit Steril (L) set 0 0 0 - -
59 02180323 Pap Smear kit Steril (M) set 0 0 0 - -
 60 02180623 Pap Smear kit Steril (S) set 0 0 0 - -
61 01180322 Imaske Surgical Face mask tie on Pcs 0 0 0 - -
62 02180523 Umbilical Cord Nylon OM Pcs 27 0 27 4 23
63 03180622 Pharmafix 15x 500 cm Rol 2 3 5 1 4
64 01190823 Pharmafix 5x 500 cm Rol 0 0 0 - -
65 01190623 Pharmafix 10x 500 cm Rol 0 0 0 - -
66 01180622 Optime 2/0 Pcs 61 0 61 36 25
67 01191222 Optime 3/0 Pcs 36 0 36 - 36
68 01180123 IV Catheter No. 24 G Pcs 0 0 0 - -
69 01180123 IV Catheter No. 22 G Pcs 0 0 0 - -
GOLONGAN OBAT TAMBAHAN 0 0 -
1 02170720 Calsidol syr/Biovitan Syr/Solvita syr btl 0 0 0 - -
2 02190919 Hemafort Tab 109 0 109 109 -
3 03180720 Bisacodyl 5 mg Tab 21 0 21 - 21
4 01170422 Levetran salep Pot 0 0 0 - -
5 01170921 Tyalisin plus syr Btl 30 0 30 6 24
6 01170920 Novadiar syrup btl 72 0 72 19 53
7 02180922 Noza tablet/ Supra Flu Tab 0 0 0 - -
8 01170920 Pimtrakol sirup/Clortusin Syr/Novatusin syr Btl 0 48 48 9 39
9 03171019 Ventolin Nebules 2,5 mg Amp 10 0 10 - 10
10 02180821 Baby cough Btl 0 0 0 - -
11 02171020 Zolagel Pot 0 0 0 - -
12 02170921 Solafluz Sirup Botol 11 0 11 9 2
13 03180821 New Antides Tablet (atapulgit) Tab 0 0 0 - -
14 02180622 Dextamine syr Btl 20 0 20 2 18
15 Bioron Tab 0 0 0 - -
16 Becefort Tab 0 0 0 - -
17 Vital Tetes Telinga Btl 0 0 0 - -
18 Hustab Tab 0 0 0 - -
19 Scopma Tab 0 0 0 - -
Loperamide 105 0 105 5 100
20 Scabimite 5% (Permetrin krim) tube 22 0 22 11 11
 Bupacetin 22 0 22 1 21
Hepagard 30 0 30 - 30
Tensigard 30 0 30 - 30
Amox 100 mg/ml 11 0 11 - 11
GOLONGAN OBAT PROGRAM MALARIA 0 0 - -
1 04190521 Primakuin tab 15 mg tablet 0 0 0 - -
2 04191022 Kuinin (kina) tab 222 mg tablet 0 0 0 - -
3 04190621 Artesunate Inj, vial 60 mg vial 0 0 0 - -
4 04170000 LABORATORY KID PAKET 0 0 0 - -
5 04170000 SLIDE BOX BUAH 0 0 0 - -
6 04190519 Obat Anti Malaria DHP (Dihydroartemisin Tablet 0 0 0 - -
7 04170000 Cynoff 25 UL Botol 0 0 0 - -
8 04180419 Bactivec Botol 0 0 0 - -
9 04180419 RDT DBD Combo TEST 0 0 0 - -
10 04180000 Sipermetrin zeta 15 UL Galon 0 0 0 - -
11 04190000 Kaca Slide (objek glass frosted 7105 one) Pcs 0 0 0 - -
12 04181120 SD HBsAG WB (Multi) TEST 0 0 0 - -
13 04180000 Mikroskop optical olympus Pcs 0 0 0 - -
14 04190000 Mikroskop + Box Nikon Eclipse E-100 Unit 0 0 0 - -
15 ACT (Artesunate + Amodiaquin) blister 0 0 0 - -
16 Artemeter injeksi 1 ml : 80 mg ampul 0 0 0 - -
17 Kloroquin tab 250 mg tablet 0 0 0 - -
18 Kuinin (kina) inj 25% - 2ml ampul 0 0 0 - -
19 Besi II sulfat 200 mg sac 0 0 0 - -
24 ACT ANAK BLISTER 0 0 0 - -
25 ACT REMAJA BLISTER 0 0 0 - -
26 ACT DEWASA BLISTER 0 0 0 - -
27 RDT/HRP2 Malaria TEST 0 0 0 - -
28 INSEKTISIDA KOTAK 0 0 0 - -
29 KELAMBU BUAH 0 0 0 - -
30 BLOOD SLIDE BOX 0 0 0 - -
31 GIEMSA BOX 0 0 0 - -
 32 IMERSION OIL BOTOL 0 0 0 - -
33 VACCINOSTYL BOX 0 0 0 - -
34 Darplex / OAM KOTAK 0 0 0 - -
35 Obat Anti Malaria DHP (Dihydroartemisin Tablet 0 0 0 - -
36 Abate 1 kg Galon 0 0 0 - -
37 RDT Dengue Igg/ Igm TEST 0 0 0 - -
38 RDT Degue NS I antigen Box 0 0 0 - -
39 Blood Lancet TEST 0 0 0 - -
40 Mikropipet single channel pipettor Pcs 0 0 0 - -
41 Mikroskop Malaria Leica/DM 500 Pcs 0 0 0 - -
GOLONGAN OBAT PROGRAM FILARIASIS 0 0 - -
1 04180820 Dietil karbamazepin Sitrat tab 100 mg tablet 0 0 0 - -
2 04170622 Albendazole 400 mg tablet 0 0 0 - -
3 Oseltamivir tab tablet 0 0 0 - -
4 FTS (Filariasis Test Strip) test 0 0 0 - -
5 Lancet Fastclick/BD Microtainer pcs 0 0 0 - -
6 RDT Brugia Filariasis pcs 0 0 0 - -
7 Betason N cream tube 0 0 0 - -
GOLONGAN OBAT PROGRAM TB PARU 0 0 - -
1 04190320 Obat Anti tuberkulosis FDC I Paket 0 1 1 - 1
2 04180521 Obat Anti tuberkulosis FDC II Paket 0 0 0 - -
3 04180220 Obat Anti tuberkulosis Anak Paket 0 0 0 - -
4 04190722 Obat Anti TBC FDC Kombipak kategori I Paket 0 0 0 - -
5 Obat Anti tuberkulosis katagori 1 Paket 0 0 0 - -
6 Obat Anti tuberkulosis sisipan Paket 0 0 0 - -
7 Streptomisin serbuk injeksi i.v 1000mg/ml vial 0 0 0 - -
8 04190820 Reagen Zn kit 0 0 0 - -
9 04180123 Pot Sputum pot 0 0 0 - -
10 04180220 Isoniazid tab 100 mg Tab 0 0 0 - -
GOLONGAN OBAT PROGRAM DIARE 0 0 - -
1 04190423 Garam Oralit 200 ml sac 121 0 121 4 117
2 04180720 ZINK Tablet 20 mg tablet 0 0 0 - -
GOLONGAN OBAT PROGRAM ISPA 0 0 - -
1 04170721 Masker N95 Pcs 0 0 0 - -
2 04170000 Sound Timer Unit 0 0 0 - -
3 04170000 Pulse Oxtmetri Portable Unit 0 0 0 - -
4 04170000 Buku Lembar Balik ISPA Pcs 0 0 0 - -
GOLONGAN OBAT PROGRAM KUSTA 0 0 - -
1 04181221 MB.Dewasa blister 0 0 0 - -
2 04180121 MB. Anak blister 0 0 0 - -
PB.Anak Blister 0 0 0 - -
3 04180820 PB.Dewasa blister 0 0 0 - -
GOLONGAN OBAT PROGRAM IMUNISASI 0 0 - -
1 04180223 ADS .0,05 ml pcs 0 0 0 - -
2 04180222 ADS.0,5 ml pcs 0 0 0 - -
3 ADS.2,5 ml pcs 0 0 0 - -
4 04180323 ADS 5 ml pcs 0 0 0 - -
5 DPT-HB-HIB vial 0 0 0 - -
6 HB-PID vial 0 0 0 - -
7 Buku infomasi dan Edukasi Imunisasi pcs 0 0 0 - -
8 Spanduk Imunisasi pcs 0 0 0 - -
9 X-Banner Imunisasi pcs 0 0 0 - -
10 VAR (verorab) vial 0 0 0 - -
11 Rabies Immune Globulin (Human) vial 0 0 0 - -
12 Campak 10 doses vial 0 0 0 - -
13 Campak 20 doses vial 0 0 0 - -
14 Campak Bias vial 0 0 0 - -
15 Vaksin Flubio vial 0 0 0 - -
16 04180000 Safety box Pcs 0 0 0 - -
17 04181219 BCG (10 doses) vial 0 0 0 - -
18 00000000 Polio BOVP 10 doses vial 0 0 0 - -
19 04190420 IPV Polio vial 0 0 0 - -
20 04180421 DT vial 0 0 0 - -
21 04180321 TD Bumil vial 0 0 0 - -
 22 04190721 TD vial 0 0 0 - -
23 04180719 VAR (verorab) Vial 0 0 0 - -
24 04181120 Rabies Immune Globulin (Human) Vial 0 0 0 - -
25 041804223Spidol Pen Marker Pcs 0 0 0 - -
26 04180120 Vaksin Measles and Rubella 10 DS vial 0 0 0 - -
27 04190619 Vaksin Menivax Paket 0 0 0 - -
28 04180820 HBIG Amp 0 0 0 - -
GOLONGAN OBAT PROGRAM GIZI 0 0 - -
1 04180420 Besi (II) Sulphate (Tablet tambah darah Ib Tab 200 0 200 200
2 04180220 Vitamin A 200.000 IU Kap 648 0 648 648 -
3 04180221 Vitamin A 100.000 IU Kap 193 0 193 193 -
4 04180820 Mineral Mix Sach 0 0 0 - -
5 04180520 Fenobarbital 50 mg injeksi Amp 0 0 0 - -
6 04181020 Gentamisin Sulfat Injeksi 40 mg/ml Amp 0 0 0 - -
7 04180920 Glukonas Kalsikus 1 gr Amp 15 0 15 - 15
8 04181120 Magnesium Sulfat 40% (MgSo4) Btl 0 0 0 - -
9 04180819 Prokain Penisillin 3 juta IU vial 0 0 0 - -
10 04180420 Phytomenadion 2 mg/ml Amp 0 0 0 - -
11 04181120 Ampisilin Serbuk injeksi i.m/i.v 1000mg vial 0 0 0 - -
12 Iodine Test Btl 0 0 0 - -
13 MP ASI Biskuit Bks 0 0 0 - -
14 04181021 Diazepam injeksi 5 mg/ml Amp 0 0 0 - -
GOLONGAN OBAT PROGRAM KIA 0 0 - -
1 04180000 Deteksi tes kehamilan Paket 0 0 0 - -
2 Calsium Gluconas 100 mg/ml Injeksi Amp 0 0 0 - -
3 Oksitosin Inj 10 IU 1 ml amp 0 0 0 - -
4 Fitomenadion 10 mg/ vit K inj amp 0 0 0 - -
5 Progesteron Depot Inj 1 ml Vial 0 0 0 - -
6 Ampicillin Inj Vial 0 0 0 - -
7 Pil KB Kombinasi cycles 0 0 0 - -
8 Urine Strip strip 0 0 0 - -
9 Diazepam inj 5 mg/ ml amp 0 0 0 - -
 10 Natrium Tiroksin / Tyhrax tab tab 0 0 0 - -
11 Gentamicin 80 mg inj amp 0 0 0 - -
12 Implant KB buah 0 0 0 - -
13 Prokain Penisiline 3 ml unit inj Vial 0 0 0 - -
14 Metil ergometrine Maleat 0,2 mg/1 ml inj amp 0 0 0 - -
15 Metil ergometrine Maleat 125 mg tab 0 0 0 - -
16 Mg Sulfat 20% 25 ml Vial 0 0 0 - -
17 Mg Sulfat 40% 25 ml Vial 0 0 0 - -
18 Albendazol 400 mg tab 0 0 0 - -
19 IV catheter 18 pcs 0 0 0 - -
20 Ampicillin Inj Vial 0 0 0 - -
GOLONGAN OBAT PROGRAM JIWA 0 0 - -
1 04180620 Haloperidol 0,5 mg Tab 0 0 0 - -
2 Haloperidol 1.5 mg Tab 0 0 0 - -
3 Haloperidol 5 mg Tab 0 0 0 - -
4 Haloperidol inj 5 mg/ml ampul 0 0 0 - -
5 Haloperidol dekanoat inj 50 mg/ml ampul 0 0 0 - -
6 04181019 Karbamazepin 200 mg Tab 0 0 0 - -
7 Triheksifenidil hidroklorida tablet 2 mg Tab 0 0 0 - -
8 Klobazam 10 mg tablet tablet 0 0 0 - -
9 Amitripilin HCL 25 mg tablet tablet 0 0 0 - -
10 Klorpromazin 100 mg tablet tablet 0 0 0 - -
11 Risperidon 2 mg Tablet tablet 0 0 0 - -
12 Klozapin 25 mg tablet tablet 0 0 0 - -
13 Trifluoperazine HCL 5 mg tablet tablet 0 0 0 - -
14 Imipramin HCL 25 mg tablet tablet 0 0 0 - -
15 Fluoksetin 10 mg tablet tablet 0 0 0 - -
16 Metadon HCL 50 mg/5 ml btl 1 L 0 0 0 - -
GOLONGAN OBAT PROGRAM HIV 0 0 - -
1 04191020 Rapid I (SD Bioline HIV 1/2.3.0 Multi Pcs 0 0 0 - -
2 04190720 Rapid 2 HIV Anti HIV 1/2 Cassette PDI Pcs 0 0 0 - -
3 04190620 Rapid Test HIV 3 (Biomerux/Vikia/HIV 1/ Pcs 0 0 0 - -
 4 04180000 RPR Sypilis Test 0 0 0 - -
5 04180000 Swab Desinfektan (Descoderm) Pcs 0 0 0 - -
6 04181021 Latex Sarung Tangan Pcs 0 0 0 - -
7 04181222 Yellow Tipe (mikropipet) Pcs 0 0 0 - -
8 04180922 Blue Tipe (Mikropipet) Pcs 0 0 0 - -
9 04180519 Human Hexagon Sypilis Test 0 0 0 - -
10 Tabung Vacuntainer Plast 5 ml Buah 0 0 0 -
11 Vacum Blood Collection Needle 22 G buah 0 0 0 -
12 Tipe Ukuran 61 Pcs 0 0 0 -
13 04180000 Tipe Ukuran 60 Pcs 0 0 0 -

JUMLAH KUNJUNGAN RESEP UMUM BPJS

381 369 12

Sebuku, 28 Februari 2020

Pengelola Obat Instalasi
Farmasi Puskesmas Sungai Bali
Plt. Kepala Puskesmas Sungai Bali
Kecamatan Pulau Sebuku
Nilam Cahaya, S.Farm.,Apt
NRPTT. 6302.440.02.047.17

Sayuk Yuswanto, S.Kep. Ners

NIP. 197805212006041016

Keterangan Kode : 01/𝐴,18/𝐵 , 02/𝐶 , 20/𝐷

A. Dua digit pertama ─˃ (01;APBD II, 02;Buffer Stok,
03;DAK, 04;Program)
B. Dua digit Kedua ─˃ (Tahun Pengadaan)
C. Dua digit Ketiga ─˃ (Bulan Expired)
D. Dua digit Keempat ─˃ (Tahun Expired)
Keterangan Kode : 01/𝐴,18/𝐵 , 02/𝐶 , 20/𝐷
A. Dua digit pertama ─˃ (01;APBD II, 02;Buffer Stok,
03;DAK, 04;Program)
B. Dua digit Kedua ─˃ (Tahun Pengadaan)
C. Dua digit Ketiga ─˃ (Bulan Expired)
D. Dua digit Keempat ─˃ (Tahun Expired)
 LAPORAN PEMAKAIAN DAN PENGELUARAN OBAT
( LPLPO )

KODE PUSKESMAS : BULAN : Januari

PUSKESMAS : Sungai Bali TAHUN : 2020
KECAMATAN : Sebuku
KAB. / KODYA : Kotabaru
PROPINSI : Kalimantan Selatan

No STOK PENERI PERSEDI PEMAK SISA STOK PERMIN PEMBERIAN

KODE NAMA OBAT SATUAN KET
URUT AWAL MAAN AAN AIAN STOK OPT TAAN
INFRES ASKES APBD LAIN JML
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
GOLONGAN OBAT GENERIK / ESENSIAL
1 02182020 Alopurinol tablet 100 mg Tab 1000 0 1000 0 1000 0 0
2 03180520 Alopurinol tablet 300 mg Tab 0 0 0 0 0 0 0
3 01170720 Aminofilin tablet 200 mg Tab 0 0 0 0 0 0 0
4 01170419 Aminofilin injeksi 24 mg/ Amp 0 0 0 0 0 0 0
5 01171119 Amitriptilin HCl tab. Salu Tab 0 0 0 0 0 0 0
6 03190221 Amoksisilin kaplet 500 m Kapl 1400 0 1400 100 1300 153 (1096)
7 01180519 Amoksisilin sirup kering Btl 0 60 60 11 49 16.83 (26)
8 02181019 Antasida Doen tablet komb Tab 1200 700 1900 100 1800 153 (1596)
9 03180822 Antibakteri doen salep kom Tub 0 0 0 0 0 0 0
10 01180222 Antihemoroid doen kombi Suppo 23 0 23 16 7 24.48 26
11 02180620 Antifungi doen kombinasi Pot 0 0 0 0 0 0 0
12 03181019 Antimigran doen kombinas Tab 0 0 0 0 0 0 0
13 01180721 Antasida suspensi Btl 50 50 100 0 100 0 (100)
14 01180121 Aqua proinjeksi steril, be Btl 4 0 4 1 3 1.53 (1)
15 02180421 Asam askorbat (vit c) tabl Tab 800 0 800 100 700 153 (496)
Asam askorbat (vit c) tabl Tab 0 0 0 0 0 0 0
16 03180520 Asetosal 80 mg (Miniaspi Tab 200 0 200 55 145 84.15 (33)
17 01181019 Atropin sulfat injeksi 0,2 Amp 10 0 10 0 10 0 (10)
18 03181019 Acetyl Cystein 200mg Kaps 0 900 900 60 840 91.8 (717)
19 03180322 Acyclovir tablet 200 mg Tab 230 500 730 130 600 198.9 (335)
20 03180722 Acyclovir tablet 400 mg Tab 86 0 86 0 86 0 (86)
21 Acyclovir tablet Cream Tube 0 0 0 0 0 0 0
22 02181020 Ambroksol sirup Btl 0 0 0 0 0 0 0
23 01170920 Ambroksol tablet 30mg Tab 0 0 0 0 0 0 0
24 03181520 Asam Mefenamat tablet 5 Tab 0 0 0 0 0 0 0
25 03190222 Asam Traneksamat Tablet Tab 200 0 200 100 100 153 0
26 03171119 Asam Traneksamat 100 mg/ Amp 0 0 0 0 0 0 0
27 03190621 Asam Traneksamat 250 mg/ Amp 0 0 0 0 0 0 0
28 03191021 Asam Traneksamat 500 mg/ Amp 0 0 0 0 0 0 0
29 01180820 Asam folat tab 1 mg Tab 700 66 766 66 700 100.98 (565)
30 03180920 Amlodipin 5mg Tab 300 900 1200 0 1200 0 (1200)
31 01180821 Amlodipin 10 mg Tab 0 0 0 0 0 0 0
32 01170820 Betametason krim 0,1 % Tub 23 75 98 26 72 39.78 (19)
33 02181120 Betahistin mesilate tablet Tab 0 500 500 100 400 153 (196)
34 01180820 Cefadroxil 500 mg kaps Kaps 1000 0 1000 0 1000 0 (1000)
35 03180820 Cefadroxil sirup kering 2 Btl 94 0 94 4 90 6.12 (82)
36 Captopril tablet 12,5 mg Tab 0 0 0 0 0 0 0
37 02180820 Captopril tablet 25 mg Tab 1200 0 1200 200 1000 306 (592)
38 03180821 Captopril tablet 50 mg Tab 0 0 0 0 0 0 0
39 03180420 Ciprofloxacin tablet 500 Tab 200 0 200 100 100 153 104
40 01180320 Cetirizine Tab 10 mg Tab 400 100 500 400 100 612 716 masih ad loratadine
41 Cetirizine Syrup Botol 2 0 2 2 0 3.06 4
42 Cefotaxim injeksi Vial 0 0 0 0 0 0 0
43 03180920 Ceptriaxon injeksi Vial 0 0 0 0 0 0 0
44 Cimetidin Tab 0 0 0 0 0 0 0
45 Clyndamicin 150 mg Tab 0 0 0 0 0 0 0
46 03180520 Deksametason inj 5 mg/ml Amp 128 0 128 0 128 0 (128)
47 03180520 Deksametason tablet 0,5 Tab 300 500 800 300 500 459 112 masih ada stok bantuan
48 01180220 Diazepam inj 5 mg/ml - 2 Amp 5 0 5 0 5 0 (5)
49 Diazepam rectal (Stesolid Tube 2 5 7 1 6 1.53 (4)
50 Diazepam tablet 2 mg Tab 0 0 0 0 0 0 0
51 03180822 Diazepam tablet 5 mg Tab 73 0 73 0 73 0 (73)
52 01180121 Difenhidramin HCl inj 10 Amp 11 0 11 7 4 10.71 0
53 01180620 Digoksin tablet 0,25 mg Tab 0 0 0 0 0 0 0
54 01180821 Domperidone tablet 10 mg Tab 107 0 107 7 100 10.71 0
55 03181020 Domperidon suspensi 5 mg Btl 11 0 11 3 8 4.59 (2)
56 03180720 Doxycycline 100 mg Kaps 0 0 0 0 0 0 0
57 01170219 Efedrin HCl tablet 25 mg Tab 0 0 0 0 0 0 0
58 03191120 Epinefrin 1 mg/ml inj s.c/ Amp 0 0 0 0 0 0 0
59 01181020 Etakridin (rivanol) laruta Btl 1 2 3 0 3 0 (3)
60 02180822 Erytromicin kaplet 500 mg Kapl 0 0 0 0 0 0 0
61 Erytromicin Syrup Botol 0 0 0 0 0 0 0
62 02180522 Etambutol tab 500mg ( HC Tab 0 0 0 0 0 0 0
63 03171020 Etanol 70 % ( 1000 ML ) Btl 3 0 3 2 1 3.06 3
64 03180320 Fenotoin natrium kapsul Kap 0 0 0 0 0 0 0
65 02190720 Fenol Gliserol Tetes Teli Btl 4 0 4 1 3 1.53 (1)
66 03180520 Fenobarbital injeksi 50 mg Amp 0 0 0 0 0 0 0
67 03180423 Fenobarbital tablet 30 mg Tab 0 0 0 0 0 0 0
68 03181119 Fitomenadion (vit K 1) inj Amp 90 0 90 17 73 26.01 (38)
69 01181220 Fitomenadion (vit K 1) tab Tab 300 0 300 300 0 459 100
70 01180121 Furosemid tablet 40 mg Tab 190 0 190 0 190 0 (190)
71 01180819 Furosemid inj 10mg/ml amp 0 0 0 0 0 0 0
72 01180323 Glibenklamid Tab 300 0 300 100 200 153 4
73 03180323 Glibenklamid Tab 0 0 0 0 0 0 0
74 03190921 Glimepiride 1 mg Tab 0 0 0 0 0 0 0
75 03170121 Glimepiride 2 mg Tab 0 0 0 0 0 0 0
76 01170921 Gliseril guayakolat 100 m Tab 0 0 0 0 0 0 0
77 03171121 Gliserin Btl 0 0 0 0 0 0 0
78 03171219 Glukosa larutan infus 5 % Btl 40 0 40 4 36 6.12 (28)
79 03180620 Griseofulvin tablet 125 m Tab 200 100 300 100 200 153 4
80 03171119 Gentamycin Sulfat Inj 2 m Amp 0 0 0 0 0 0 0
81 01180521 Gentamycin tetes mata 0, Btl 26 0 26 2 24 3.06 (20)
82 Gentian Violet Btl 0 0 0 0 0 0 0
83 03170320 Haloperidol tablet 0,5 mg Tab 0 0 0 0 0 0 0
84 02180719 Haloperidol tablet 1,5 mg Tab 0 0 0 0 0 0 0
85 02190719 Haloperidol tablet 5 mg Tab 0 0 0 0 0 0 0
86 03170522 Hidroklorotiazid (HCT) ta Tab 568 0 568 68 500 104.04 (361)
87 01180222 Hidrokortison krim 2,5 m Tub 42 0 42 18 24 27.54 13 masih ada dari bantuan
88 01170219 Isoniazid tab 300 mg Tab 0 0 0 0 0 0 0
89 01180420 Ibuprofen syr 100mg/ 5 m Botol 35 0 35 9 26 13.77 (7)
90 Ibuprofen200 mg Tab 0 0 0 0 0 0 0
91 02190822 Ibuprofen400 mg Tab 0 0 0 0 0 0 0
92 01180722 Isosorbid dinitrat tablet s Tab 675 0 675 75 600 114.75 (447)
93 03180220 Kalsium laktat (kalk) tabl Tab 945 0 945 145 800 221.85 (504)
94 03170619 Karbamazepin tablet 200 Tab 20 0 20 20 0 30.6 200
95 03180322 Kloramfenikol kapsul 250 Kap 0 0 0 0 0 0 0
96 01180221 Kloramfenikol salep mata Tub 28 0 28 4 24 6.12 (16)
97 02190320 Kloramfenikol Tetes Mata Btl 0 0 0 0 0 0 0
98 02190921 Kloramfenikol Tetes Teli Btl 0 0 0 0 0 0 0
99 02170620 Kloramfenikol Suspensi Btl 0 0 0 0 0 0 0
100 03181022 Klorfeniramin maleat (CT Tab 1600 0 1600 100 1500 153 (1296)
101 Klorpromazin HCl tablet Tab 0 0 0 0 0 0 0
102 02180320 Klorpromazin HCl tablet Tab 0 0 0 0 0 0 0
103 01170819 Klorpromazine HCL inj 2 Amp 0 0 0 0 0 0 0
104 01170720 Kodein HCl tablet 10 mg Tab 70 0 70 70 0 107.1 0
105 03181221 Kodein HCl tablet 10 mg Tab 0 0 0 0 0 0 0
106 Kotrimoksazol 480 mg Tab 100 500 600 0 600 0 (600)
107 01170420 Kotrimoksazol suspensi Btl 33 50 83 18 65 27.54 (28)
108 03180620 Ketokonazole 200mg Tab Tab 400 0 400 0 400 0 (400)
109 01180222 Ketokonazole cream Tub 0 25 25 9 16 13.77 3
110 03180521 Lidokain kompositum inje Amp 35 50 85 0 85 0 (85)
111 01170000 Lisol Btl 4 0 4 1 3 1.53 (1)
112 01170220 Lar anhydrous dextrose,N Btl 0 0 0 0 0 0 0
113 03180821 Loratadine 5 mg Tab 650 150 800 0 800 0 (800)
114 03191120 Metilergometrin maleat inj Amp 0 0 0 0 0 0 0
115 Metilergometrin maleat ta Tab 90 0 90 60 30 91.8 100
116 03170321 Miconazol 2 % cream Tub 28 0 28 4 24 6.12 (16)
117 03180922 Metoklopramide tablet 10 Tab 100 0 100 0 100 0 (100)
118 Metoklopramide Injeksi Amp 0 20 20 5 15 7.65 0
119 01180522 Metoklopramide sirup 5 Btl 0 0 0 0 0 0 0
120 Metronidazol Tab 500 mg Tab 0 0 0 0 0 0 0
121 Metronidazol Tab 250 mg Tab 0 0 0 0 0 0 0
122 Metronidazol Syrup Botol 0 0 0 0 0 0 0
123 01170720 Metronidazol larutan Infu Btl 0 0 0 0 0 0 0
124 03191120 Metronidazol larutan Infu Btl 0 0 0 0 0 0 0
125 03180821 Metilprednisolon 4 mg Tab 500 500 1000 0 1000 0 (1000)
126 03190123 Metilprednisolon 16 mg Tab 0 0 0 0 0 0 0
127 03180920 Metformin 500 mg Tab 300 0 300 200 100 306 308 masih ada dari bantuan
128 01180920 Metformin 850 mg Tab 0 0 0 0 0 0 0
129 03190321 Metamizole Inj 500mg/ml Amp 20 0 20 8 12 12.24 5
130 01170320 Metoklopramide sir ( Nor btl 29 0 29 3 26 4.59 (20)
131 Magnesium Sulfat 40% ( Vial 2 0 2 0 2 0 (2)
132 02190820 Magnesium Sulfat 20% ( Vial 0 0 0 0 0 0 0
133 03191220 Natrium klorida larutan in Btl 37 0 37 8 29 12.24 (12)
134 01180220 Nistatin 100.000 iu/g table Tab 70 200 270 70 200 107.1 (57)
135 03180421 Nistatin 500.000 iu tablet Tab 0 0 0 0 0 0 0
136 03180623 Natrium diclofenak 25 mg Tab 0 0 0 0 0 0 0
137 03180621 Natrium diclofenak 50 mg Tab 1000 1000 2000 0 2000 0 (2000)
138 02190521 Nifedipine Tab 0 0 0 0 0 0 0
139 02171020 Obat batuk hitam (o.b.h) c Btl 25 0 25 13 12 19.89 0
140 03191120 Oksitosin injeksi 10 iu/ml Amp 0 0 0 0 0 0 0
141 Oksitetrasiklin Salep kulit Tube 0 0 0 0 0 0 0
142 02190721 Oksitetrasiklin Salep Mata Tub 25 0 25 5 20 7.65 (10)
143 03191020 Omeprazole kapsul/kaplet Kap 0 150 150 60 90 91.8 33
144 03180000 Parasetamol syr 120 mg / Btl 91 0 91 64 27 97.92 104
145 03191220 Parasetamol tablet 500 mg Tab 1500 2000 3500 200 3300 306 (2892)
146 01180319 Parasetamol tetes 60mg/ 0 Botol 15 ml 11 56 67 20 47 30.6 (6)
147 Papaverin Tablet 40 mg Tab 105 0 105 5 100 7.65 (90)
148 01170319 Petidin HCl injeksi 50 m Amp 0 0 0 0 0 0 0
149 03180121 Piridoksin HCl tablet 10 Tab 100 0 100 0 100 0 (100)
150 03180720 Prednison tablet 5 mg Tab 537 0 537 37 500 56.61 (424)
151 03170919 Primakuin tablet 15 mg Tab 0 0 0 0 0 0 0
152 01170621 Propiltiourasil tablet 100 Tab 300 0 300 300 0 459 612
153 03180721 Propranolol HCl tablet 10 Tab 390 0 390 10 380 15.3 (359)
154 01170319 Pehamoxil injeksi (Amoxil Vial 0 0 0 0 0 0 0
155 Piracetam Injeksi 1g / ml vial 0 0 0 0 0 0 0
156 02180820 Piracetam 800mg Tab 0 0 0 0 0 0 0
157 02180220 Pirazinamide 500mg tab Tab 0 0 0 0 0 0 0
158 Pyroxicam tablet 20 mg Tab 0 0 0 0 0 0 1000
159 Pyrantel Pamoat 125 mg Tab 100 0 100 0 100 0 0
160 03180523 Quinine 222 mg Tab 0 0 0 0 0 0 0
161 03170222 Ringer laktat larutan infus Btl 71 0 71 65 6 99.45 100
162 03181120 Ranitidin tablet 150 mg Tab 0 335 335 0 335 0 (335)
163 03190920 Ranitidin Injeksi 50mg/2m Amp 0 3 3 0 3 0 (3)
164 03170420 Retinol (vitamin A) kapsu Kap 0 0 0 0 0 0 0
165 Retinol (vitamin A) kapsu Kap 0 0 0 0 0 0 0
166 Rifampisin kaplet 300 mg Tab 0 0 0 0 0 0 0
167 02180422 Rifampisin kaplet 600 mg Tab 0 0 0 0 0 0 0
168 03180921 Salbutamol tablet 2 mg Tab 600 100 700 0 700 0 (700)
169 01170721 Salbutamol tablet 4 mg Tab 200 0 200 100 100 153 104 masih ada bantuan
170 01180921 Salep 2-4 kombinasi Pot 0 0 0 0 0 0 0
171 01180420 Salisil bedak 2 % Ktk 9 0 9 3 6 4.59 0
172 02180720 Serum anti bisa ular poliva Vial 0 0 0 0 0 0 0
173 01181219 Serum anti tatanus inj. 1.5 Amp 0 0 0 0 0 0 0
174 01180521 Sianokobalamin (Vit. B12) Amp 32 0 32 18 14 27.54 23 masih ada stok bantuan
175 03180123 Sianokobalamin (Vit. B12) Tab 300 200 500 0 500 0 (500)
176 03180720 Simvastatin tablet 10 mg Tab 0 0 0 0 0 0 0
177 01180720 Simvastatin tablet 10 mg Tab 210 1680 1890 330 1560 504.9 (887)
178 03190520 Simvastatin tablet 20 mg Tab 0 0 0 0 0 0 0
179 03190820 Spironolactone 25 mg Tab 0 0 0 0 0 0 0
Tetrasiklin 250 mg Kaps 0 0 0 0 0 0 0
180 Tetrasiklin 500 mg Kaps 0 0 0 0 0 0 0
181 01170420 Tiamin HCl (Vit. B1) inj. Amp 0 0 0 0 0 0 0
 18203180320 Tiamin HCl monohidrat (Vi Tab 100 200 300 100 200 153 4
18303180920 Triheksifenidil hidroklori Tab 0 0 0 0 0 0 0
18401170920 Thiamfenikol tab 500 mg Tab 0 0 0 0 0 0 0
18503180221 Tramadol Injeksi 100mg Amp 0 0 0 0 0 0 0
18603180221 Vitamin B kompleks table Tab 300 1500 1800 300 1500 459 (888)
18703190821 Viccillin Ampisilin serbuk Amp 0 0 0 0 0 0 0
18801181219 Wida Bes Btl 0 0 0 0 0 0 0
189 Yodium povidon larutan 1 Btl 4 5 9 2 7 3.06 (3)
190 Yodium povidon larutan 1 Btl 0 0 0 0 0 0 0
19103180321 Yodium povidon larutan 1 Btl 0 0 0 0 0 0 0
19201180320 Zink Tablet 20 mg Tab 745 0 745 45 700 68.85 (608)
Gentamisin salep kulit 0 0 0 0
Ichtiol salep 0 0 0 0
Lansoprazol 300 0 220 (220)
Tablet tambah darah 420 0 200 (200)
GOLONGAN OBAT GIGI 0 0 0
1 01170720 Cholorophenol camphor m ktk 0 0 0 0 0 0 0
2 Arsen / Caustinerf rapide Btl 0 0 0 0 0 0 0
3 Devitalisasi pasta (non arsen) caustinerf 0 0 0 0 0 0 0
4 02180523 Etil klorida semprot Kaleng 0 0 0 0 0 0 0
5 01170000 Eugenol cairan Btl 2 0 2 0 2 2 (2)
6 Glass Ionomer (gcix) / Fuj set 0 0 0 0 0 0 0
7 Iodoform paste Ktk 0 0 0 0 0 0 0
8 kalsium hidroksida pasta tube 0 0 0 0 0 0 0
9 Mummifying pasta / temp btl 0 0 0 0 0 0 0
10 Semen seng fosfat serbuk dan cairan 0 0 0 0 0 0 0
11 Spons gelatin Cubicles 1 Ktk 0 0 0 0 0 0 0
12 Temporary stopingfletcher set 0 0 0 0 0 0 0
13 01170720 Trikresol formalin (TKF) Btl 0 0 0 0 0 0 0
14 01170319 Ceivtron( tambalan sement ktk 0 0 0 0 0 0 1
GOLONGAN OBAT BAHAN HABIS PAKAI 0 0 0 0 0 0 0
1 03181120 Alkohol Swab Pcs 400 300 700 200 500 306 (92)
2 Bisturi No 11 Pcs 0 0 0 0 0 0 100
 3 Bisturi No 15 Pcs 0 0 0 0 0 0 0
4 Bisturi No 20 Pcs 0 0 0 0 0 0 0
5 01171119 Catgut/benang bedah no.2/ Sak 19 0 19 19 29.07 39 masih ada stok bantuan
6 01171119 Catgut/benang bedah no.2 sak 0 0 0 0 0 0 0
7 01171119 Catgut/benang bedah no. 3 Sak 16 0 16 16 0 24.48 33 masih ada stok bantuan
8 01170322 Elastic band roll 1 0 1 0 1 0 (1)
9 03170321 Folley catheter no.16 pcs 9 0 9 1 8 1.53 (6)
10 03170421 Folley catheter no.18 Pcs 11 0 11 -3 14 -4.59 (20)
11 03171121 Folley catheter no.20 Pcs 30 0 30 0 30 0 (30)
12 02170119 Infusion set anak Set 17 0 17 2 15 3.06 (11)
13 01170922 Kapas berlemak 500 gram Bks 0 0 0 0 0 0 0
14 03180721 Kapas pembalut/absorben Bks 3 0 3 0 3 0 (3)
15 03180122 Kasa kompres 40/40 steril Rol 0 0 0 0 0 0 0
16 03180721 Kasa Steril 16x16 cm kotak 15 0 15 15 0 22.95 31
17 03180322 Kasa pembalut 36 m x 80 Rol 1 2 3 1 2 1.53 0
18 03171021 Kasa pembalut 40 m x 80 Rol 0 0 0 0 0 0 0
19 03180422 Kasa pembalut 2ml x 80 Rol 0 0 0 0 0 0 0
20 02190224 Kasa pembalut 2ml x 80 Rol 0 0 0 0 0 0 0
21 02191020 Kasa Pembalut 40 m x 40 Rol 0 0 0 0 0 0 0
22 03180422 Kasa pembalut hidrofil 4 Rol 45 0 45 15 30 22.95 1
23 03180322 Kasa Pembalut hidrofil 4 pack 0 0 0 0 0 0 0
24 02180423 Kasa steril Kasa Steril 10 Pcs 0 0 0 0 0 0 0
25 01180323 Masker Karet (ear loop) Kotak 0 0 0 0 0 0 0
26 02170322 Masker Karet Pcs 0 0 0 0 0 0 0
27 03170322 Masker Hijab Pcs 400 1000 1400 300 1100 459 (488)
28 02170921 Optiva No.20 ( Cathy IV. Set 38 0 38 12 26 18.36 (1)
29 02170321 Optiva No.22 ( Cathy IV. Set 24 0 24 20 4 30.6 37
30 02170621 Optiva No.24 ( Cathy IV. Set 21 0 21 21 0 32.13 43
31 01170320 Pembalut gips 3 inchi Rol 1 0 1 0 1 0 (1)
32 03170821 Silk (benang bedah sutera) Box 29 0 29 8 21 12.24 (4)
33 03170219 Ultrasonic gel galon 5 lit Galon 0 0 0 0 0 0 0
34 03180722 Umbrical Cord Nylon OM Pcs 27 0 27 2 25 3.06 (21)
35 03170122 Urine bag Steril Pcs 33 0 33 1 32 1.53 (30)
36 03170422 Sarung Tangan Non Steril Pcs 900 200 1100 0 1100 0 (1100)
37 01170422 Polid Aid Botol 0 0 0 0 0 0 0
38 03180221 Aseptic Gel Botol 7 0 7 1 6 1.53 (4)
39 02170119 Alat Suntik 10 ml Set 0 0 0 0 0 0 0
40 01190523 Polyflex IV. Cannula 24G Pcs 0 0 0 0 0 0 0
41 01190523 Polyflex IV. Cannula 22G Pcs 0 0 0 0 0 0 0
42 01190323 Polywin IV. Cannula 26G Pcs 0 0 0 0 0 0 0
43 01190622 Polyflex IV. Cannula 20G Pcs 0 0 0 0 0 0 0
44 01180000 Sarung Tangan Steril ( Ma pcs 0 300 300 0 300 0 (300)
45 01190623 Sarung Tangan Steril ( Ma pcs 0 0 0 0 0 0 0
46 01181122 Mas Nasal Oxygen Cannula Pcs 0 0 0 0 0 0 0
47 01181122 Mas Nasal Oxygen Cannul Pcs 0 0 0 0 0 0 0
48 01190823 Sarung Tangan Steril (Surg Pair 0 0 0 0 0 0 0
49 01180822 Sarung Tangan Steril (Surg Pair 0 0 0 0 0 0 0
50 01190723 Sarung Tangan Steril (Surg Pair 35 0 35 12 23 18.36 2
51 01180722 Spuit 1 cc pcs 94 0 94 43 51 65.79 37
52 01180122 Spuit 2,5 cc pcs 0 0 0 0 0 0 0
53 03170521 Spuit 3 cc ( STERA ) Pcs 93 0 93 90 3 137.7 181
54 Spuit 5 cc Pcs 32 0 32 6 26 9.18 (14)
55 01180022 Spuit 20 cc pcs 0 0 0 0 0 0 0
56 01180022 Infus set anak pcs 0 0 0 -10 10 -15.3 (30)
57 01190823 Infus set dewasa pcs 72 0 72 27 45 41.31 10
58 02181222 Pap Smear kit Steril (L) set 0 0 0 0 0 0 0
59 02180323 Pap Smear kit Steril (M) set 0 0 0 0 0 0 0
60 02180623 Pap Smear kit Steril (S) set 0 0 0 0 0 0 0
61 01180322 Imaske Surgical Face mask Pcs 0 0 0 0 0 0 0
62 02180523 Umbilical Cord Nylon O Pcs 27 0 27 2 25 3.06 (21)
63 03180622 Pharmafix 15x 500 cm Rol 3 0 3 2 1 3.06 3
64 01190823 Pharmafix 5x 500 cm Rol 0 0 0 0 0 0 0
65 01190623 Pharmafix 10x 500 cm Rol 0 0 0 0 0 0 0
66 01180622 Optime 2/0 Pcs 25 36 61 0 61 0 (61)
67 01191222 Optime 3/0 Pcs 0 36 36 0 36 0 (36)
68 01180123 IV Catheter No. 24 G Pcs 0 0 0 0 0 0 0
 69 01180123 IV Catheter No. 22 G Pcs 0 0 0 0 0 0 0
GOLONGAN OBAT TAMBAHAN 0 0 0
1 02170720 Calsidol syr/Biovitan Syr/ btl 0 0 0 0 0 0 0
2 02190919 Hemafort Tab 200 0 200 200 0 306 408
3 03180720 Bisacodyl 5 mg Tab 30 0 30 9 21 13.77 (2)
4 01170422 Levetran salep Pot 0 0 0 0 0 0 0
5 01170921 Tyalisin plus syr Btl 40 0 40 14 26 21.42 3 masih ada stok bantuan
6 01170920 Novadiar syrup btl 65 7 72 19 53 29.07 (14)
7 02180922 Noza tablet/ Supra Flu Tab 0 0 0 0 0 0 0
8 01170920 Pimtrakol sirup/Clortusin Syr/Novatusin
Btl syr0 0 0 0 0 0 0
9 03171019 Ventolin Nebules 2,5 mg Amp 15 0 15 5 10 7.65 0
10 02180821 Baby cough Btl 0 0 0 0 0 0 0
11 02171020 Zolagel Pot 0 0 0 0 0 0 0
12 02170921 Solafluz Sirup Botol 33 0 33 31 2 47.43 61
13 03180821 New Antides Tablet (atapu Tab 0 0 0 0 0 0 0
14 02180622 Dextamine syr Btl 27 0 27 8 19 12.24 (2)
15 Bioron Tab 0 0 0 0 0 0 0
16 Becefort Tab 0 0 0 0 0 0 0
17 Vital Tetes Telinga Btl 0 0 0 0 0 0 0
18 Hustab Tab 0 0 0 0 0 0 0
19 Scopma Tab 0 0 0 0 0 0 0
Loperamide 105 0 105 5 100 7.65 (90)
Scabimite 5% (Permetrin krim) 26 0 26 10 16 15.3 0
Buvacetin 22 0 22 1 21 1.53 (19)
Hepagard 30 0 30 - 30 0 (30)
Tensigard 30 0 30 - 30 0 (30)
Amox 100 mg/ml 11 0 11 - 11 0 (11)
GOLONGAN OBAT PROGRAM MALARIA 0 0 0
1 04190521 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0
2 04191022 Kuinin (kina) tab 222 mg tablet 0 0 0 0 0 0 0
3 04190621 Artesunate Inj, vial 60 mg vial 0 0 0 0 0 0 0
4 04170000 LABORATORY KID PAKET 0 0 0 0 0 0 0
5 04170000 SLIDE BOX BUAH 0 0 0 0 0 0 0
 6 04190519 Obat Anti Malaria DHP (D Tablet 0 0 0 0 0 0 0
7 04170000 Cynoff 25 UL Botol 0 0 0 0 0 0 0
8 04180419 Bactivec Botol 0 0 0 0 0 0 0
9 04180419 RDT DBD Combo TEST 0 0 0 0 0 0 0
10 04180000 Sipermetrin zeta 15 UL Galon 0 0 0 0 0 0 0
11 04190000 Kaca Slide (objek glass fr Pcs 0 0 0 0 0 0 0
12 04181120 SD HBsAG WB (Multi) TEST 0 0 0 0 0 0 0
13 04180000 Mikroskop optical olympu Pcs 0 0 0 0 0 0 0
14 04190000 Mikroskop + Box Nikon Ec Unit 0 0 0 0 0 0 0
15 ACT (Artesunate + Amodi blister 0 0 0 0 0 0 0
16 Artemeter injeksi 1 ml : 8 ampul 0 0 0 0 0 0 0
17 Kloroquin tab 250 mg tablet 0 0 0 0 0 0 0
18 Kuinin (kina) inj 25% - 2 ampul 0 0 0 0 0 0 0
19 Besi II sulfat 200 mg sac 0 0 0 0 0 0 0
24 ACT ANAK BLISTER 0 0 0 0 0 0 0
25 ACT REMAJA BLISTER 0 0 0 0 0 0 0
26 ACT DEWASA BLISTER 0 0 0 0 0 0 0
27 RDT/HRP2 Malaria TEST 0 0 0 0 0 0 0
28 INSEKTISIDA KOTAK 0 0 0 0 0 0 0
29 KELAMBU BUAH 0 0 0 0 0 0 0
30 BLOOD SLIDE BOX 0 0 0 0 0 0 0
31 GIEMSA BOX 0 0 0 0 0 0 0
32 IMERSION OIL BOTOL 0 0 0 0 0 0 0
33 VACCINOSTYL BOX 0 0 0 0 0 0 0
34 Darplex / OAM KOTAK 0 0 0 0 0 0 0
35 Obat Anti Malaria DHP (D Tablet 0 0 0 0 0 0 0
36 Abate 1 kg Galon 0 0 0 0 0 0 0
37 RDT Dengue Igg/ Igm TEST 0 0 0 0 0 0 0
38 RDT Degue NS I antigen Box 0 0 0 0 0 0 0
39 Blood Lancet TEST 0 0 0 0 0 0 0
40 Mikropipet single channel Pcs 0 0 0 0 0 0 0
41 Mikroskop Malaria Leica Pcs 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM FILARIASIS 0 0 0
 1 04180820 Dietil karbamazepin Sitra tablet 0 0 0 0 0 0 0
2 04170622 Albendazole 400 mg tablet 0 0 0 0 0 0 0
3 Oseltamivir tab tablet 0 0 0 0 0 0 0
4 FTS (Filariasis Test Strip) test 0 0 0 0 0 0 0
5 Lancet Fastclick/BD Micro pcs 0 0 0 0 0 0 0
6 RDT Brugia Filariasis pcs 0 0 0 0 0 0 0
7 Betason N cream tube 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM TB PARU 0 0 0
1 04190320 Obat Anti tuberkulosis FD Paket 0 0 0 0 0 0 0
2 04180521 Obat Anti tuberkulosis FD Paket 0 0 0 0 0 0 0
3 04180220 Obat Anti tuberkulosis An Paket 0 0 0 0 0 0 0
4 04190722 Obat Anti TBC FDC Kombi Paket 0 2 2 2 0 3.06 1
5 Obat Anti tuberkulosis kat Paket 0 0 0 0 0 0 0
6 Obat Anti tuberkulosis sis Paket 0 0 0 0 0 0 0
7 Streptomisin serbuk injek vial 0 0 0 0 0 0 0
8 04190820 Reagen Zn kit 0 0 0 0 0 0 0
9 04180123 Pot Sputum pot 0 0 0 0 0 0 0
10 04180220 Isoniazid tab 100 mg Tab 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM DIARE 0 0 0
1 04190423 Garam Oralit 200 ml sac 0 0 0 -117 117 -179.01 (355)
2 04180720 ZINK Tablet 20 mg tablet 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM ISPA 0 0 0
1 04170721 Masker N95 Pcs 21 100 121 121 0 185.13 0
2 04170000 Sound Timer Unit 0 0 0 0 0 0 0
3 04170000 Pulse Oxtmetri Portable Unit 0 0 0 0 0 0 0
4 04170000 Buku Lembar Balik ISPA Pcs 0 20 20 20 0 30.6 0
GOLONGAN OBAT PROGRAM KUSTA 0 0 0
1 04181221 MB.Dewasa blister 0 0 0 0 0 0 0
2 04180121 MB. Anak blister 0 0 0 0 0 0 0
PB.Anak Blister 0 0 0 0 0 0 0
3 04180820 PB.Dewasa blister 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM IMUNISASI 0 0 0
1 04180223 ADS .0,05 ml pcs 0 0 0 0 0 0 0
 2 04180222 ADS.0,5 ml pcs 0 0 0 0 0 0 0
3 ADS.2,5 ml pcs 0 0 0 0 0 0 0
4 04180323 ADS 5 ml pcs 0 0 0 0 0 0 0
5 DPT-HB-HIB vial 0 0 0 0 0 0 0
6 HB-PID vial 0 0 0 0 0 0 0
7 Buku infomasi dan Edukas pcs 0 0 0 0 0 0 0
8 Spanduk Imunisasi pcs 0 0 0 0 0 0 0
9 X-Banner Imunisasi pcs 0 0 0 0 0 0 0
10 VAR (verorab) vial 0 0 0 0 0 0 0
11 Rabies Immune Globulin vial 0 0 0 0 0 0 0
12 Campak 10 doses vial 0 0 0 0 0 0 0
13 Campak 20 doses vial 0 0 0 0 0 0 0
14 Campak Bias vial 0 0 0 0 0 0 0
15 Vaksin Flubio vial 0 0 0 0 0 0 0
16 04180000 Safety box Pcs 0 0 0 0 0 0 0
17 04181219 BCG (10 doses) vial 0 0 0 0 0 0 0
18 00000000 Polio BOVP 10 doses vial 0 0 0 0 0 0 0
19 04190420 IPV Polio vial 0 0 0 0 0 0 0
20 04180421 DT vial 0 0 0 0 0 0 0
21 04180321 TD Bumil vial 0 0 0 0 0 0 0
22 04190721 TD vial 0 0 0 0 0 0 0
23 04180719 VAR (verorab) Vial 0 0 0 0 0 0 0
24 04181120 Rabies Immune Globulin Vial 0 0 0 0 0 0 0
25 041804223Spidol Pen Marker Pcs 0 0 0 0 0 0 0
26 04180120 Vaksin Measles and Rubel vial 0 0 0 0 0 0 0
27 04190619 Vaksin Menivax Paket 0 0 0 0 0 0 0
28 04180820 HBIG Amp 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM GIZI 0 0 0
1 04180420 Besi (II) Sulphate (Table Tab 0 0 0 0 0 0 0
2 04180220 Vitamin A 200.000 IU Kap 0 0 0 0 0 0 0
3 04180221 Vitamin A 100.000 IU Kap 0 0 0 0 0 0 0
4 04180820 Mineral Mix Sach 0 0 0 0 0 0 0
5 04180520 Fenobarbital 50 mg injeks Amp 0 0 0 0 0 0 0
 6 04181020 Gentamisin Sulfat Injeksi Amp 0 0 0 0 0 0 0
7 04180920 Glukonas Kalsikus 1 gr Amp 0 0 0 -15 15 -22.95 0
8 04181120 Magnesium Sulfat 40% ( Btl 0 0 0 0 0 0 0
9 04180819 Prokain Penisillin 3 juta I vial 0 0 0 0 0 0 0
10 04180420 Phytomenadion 2 mg/ml Amp 0 0 0 0 0 0 0
11 04181120 Ampisilin Serbuk injeksi vial 0 0 0 0 0 0 0
12 Iodine Test Btl 0 0 0 0 0 0 1
13 MP ASI Biskuit Bks 0 0 0 0 0 0 0
14 04181021 Diazepam injeksi 5 mg/ml Amp 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM KIA 0 0 0
1 04180000 Deteksi tes kehamilan Paket 0 0 0 0 0 0 0
2 Calsium Gluconas 100 mg/ Amp 0 0 0 0 0 0 0
3 Oksitosin Inj 10 IU 1 ml amp 0 0 0 0 0 0 0
4 Fitomenadion 10 mg/ vit K amp 0 0 0 0 0 0 0
5 Progesteron Depot Inj 1 m Vial 15 0 15 15 0 22.95 0
6 Ampicillin Inj Vial 0 0 0 0 0 0 0
7 Pil KB Kombinasi cycles 0 0 0 0 0 0 0
8 Urine Strip strip 0 0 0 0 0 0 0
9 Diazepam inj 5 mg/ ml amp 0 0 0 0 0 0 0
10 Natrium Tiroksin / Tyhrax tab 0 0 0 0 0 0 0
11 Gentamicin 80 mg inj amp 0 0 0 0 0 0 0
12 Implant KB buah 0 0 0 0 0 0 0
13 Prokain Penisiline 3 ml uni Vial 0 0 0 0 0 0 0
14 Metil ergometrine Maleat amp 0 0 0 0 0 0 0
15 Metil ergometrine Maleat tab 0 0 0 0 0 0 0
16 Mg Sulfat 20% 25 ml Vial 0 0 0 0 0 0 0
17 Mg Sulfat 40% 25 ml Vial 0 0 0 0 0 0 0
18 Albendazol 400 mg tab 0 0 0 0 0 0 0
19 IV catheter 18 pcs 0 0 0 0 0 0 0
20 Ampicillin Inj Vial 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM JIWA 0 0 0
1 04180620 Haloperidol 0,5 mg Tab 0 0 0 0 0 0 0
2 Haloperidol 1.5 mg Tab 0 0 0 0 0 0 0
 3 Haloperidol 5 mg Tab 0 0 0 0 0 0 0
4 Haloperidol inj 5 mg/ml ampul 0 0 0 0 0 0 0
5 Haloperidol dekanoat inj ampul 0 0 0 0 0 0 0
6 04181019 Karbamazepin 200 mg Tab 0 0 0 0 0 0 0
7 Triheksifenidil hidroklori Tab 0 0 0 0 0 0 0
8 Klobazam 10 mg tablet tablet 0 0 0 0 0 0 0
9 Amitripilin HCL 25 mg tab tablet 0 0 0 0 0 0 0
10 Klorpromazin 100 mg tabl tablet 0 0 0 0 0 0 0
11 Risperidon 2 mg Tablet tablet 0 0 0 0 0 0 0
12 Klozapin 25 mg tablet tablet 0 0 0 0 0 0 0
13 Trifluoperazine HCL 5 mg tablet 0 0 0 0 0 0 0
14 Imipramin HCL 25 mg tab tablet 0 0 0 0 0 0 0
15 Fluoksetin 10 mg tablet tablet 0 0 0 0 0 0 0
16 Metadon HCL 50 mg/5 ml btl 1 L 0 0 0 0 0 0 0
GOLONGAN OBAT PROGRAM HIV 0 0 0 0 0
1 04191020 Rapid I (SD Bioline HIV 1 Pcs 0 0 0 0 0 0 0
2 04190720 Rapid 2 HIV Anti HIV 1/2 Pcs 0 0 0 0 0 0 0
3 04190620 Rapid Test HIV 3 (Biomer Pcs 0 0 0 0 0 0 0
4 04180000 RPR Sypilis Test 0 0 0 0 0 0 0
5 04180000 Swab Desinfektan (Desco Pcs 0 0 0 0 0 0 0
6 04181021 Latex Sarung Tangan Pcs 0 0 0 0 0 0 0
7 04181222 Yellow Tipe (mikropipet) Pcs 0 0 0 0 0 0 0
8 04180922 Blue Tipe (Mikropipet) Pcs 0 0 0 0 0 0 0
9 04180519 Human Hexagon Sypilis Test 0 0 0 0 0 0 0
10 Tabung Vacuntainer Plast Buah 0 0 0 0 0 0 0
11 Vacum Blood Collection buah 0 0 0 0 0 0 0
12 Tipe Ukuran 61 Pcs 0 0 0 0 0 0 0
13 04180000 Tipe Ukuran 60 Pcs 0 0 0 0 0 0 0
0 0
JUMLAH KUNJUNGAN RESEP UMUM BPJS JUMLAH
346 12 358
Mengetahui / Menyetujui
Kepala Dinas Kesehatan Kepala IFK Plt. Kepala Puskesmas Sungai Bali Sebuku, 31 Januari 2020
Kecamatan Pulau Sebuku Pengelola Obat Instalasi
Farmasi Puskesmas Sungai Bali

…………………………………………….. Sayuk Yuswanto, S.Kep. Ners Nilam Cahaya, S.Farm.,Apt

NIP……………………………………. NIP. 197805212006041016 NRPTT. 6302.440.02.047.17

Keterangan Kode : 01/𝐴,18/𝐵 ,

02/𝐶 , 20/𝐷
A. Dua digit pertama ─˃ (01;APBD II,
02;Buffer Stok, 03;DAK, 04;Program)
B. Dua digit Kedua ─˃ (Tahun
Pengadaan)
C. Dua digit Ketiga ─˃ (Bulan Expired)
D. Dua digit Keempat ─˃ (Tahun Expired)