Form So Rutin Labuan Barat 2022

LAPORAN STOK OPNAME OBAT, VAKSIN DAN BAHAN MEDIS HABIS PAKAI ( BMHP )STOK KABUPATEN
DINAS KESEHATAN KABUPATEN KOTABARU

PUSKESMAS……………………………
PERIODE TAHUN 2022
JUMLAH PENGELUARAN EXPIRED DATE
JUMLAH SISA STOK PER

STOK AWAL JUMLAH TOTAL RATA-RATA TANGGAL 31
KODE NAMA OBAT/ BARANG SATUAN NO BATCH KET
TAHUN 2022 PENERIMAAN PERSEDIAAN PENGELUARAN DESEMBER
JUMLAH JUMLAH EXPIRED TOTAL TAHUN 2022 2022
BULAN (dalam angka) TAHUN (dalam angka)
PEMAKAIAN DATE PENGELUARAN
1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

GOLONGAN OBAT GENERIK / ESENSIAL
10.01.19.0422.0001 Alopurinol tablet 100 mg Tab - - - -
10.01.18.0520.0002 Alopurinol tablet 300 mg Tab - - - -
30.01.20.0521.0003 Aminofilin tablet 200 mg Tab - - - -
10.01.20.0821.0004 Aminofilin injeksi 24 mg/ml - 10 ml Amp - - - -
10.01.20.0224.0005 Amitriptilin HCl tab. Salut 25 mg Tab - - - -
10.01.19.0821.0193 Ampisilin serbuk injeksi 250 mg (Viccillin ) Amp - - - -
10.01.20.0522.0006 Amoksisilin Kaptab 500 mg Kapt - - - -
10.01.19.0522.0007 Amoksisillin 100mg Drop Amp - - - -
10.01.20.1022.0008 Amoksisilin sirup kering 125 mg / 5 ml Btl - - - -
10.01.20.1022.0009 Amoksisilin sirup kering 250 mg / 5 ml Btl - - - -
10.01.17.0319.0160 Amoxilin Injeksi 1000mg (Pehamoxil) Vial - - - -
10.01.20.0822.0010 Antasida Doen tablet kombinasi Tab - - - -
10.01.20.1121.0011 Antasida suspensi Btl - - - -
10.01.18.0822.0012 Antibakteri doen salep kombinasi (Bacitracin) Tub - - - -
10.01.20.1121.0013 Antihemoroid doen kombinasi Suppo - - - -
10.01.19.1022.0014 Antifungi doen kombinasi Pot - - - -
10.01.20.0323.0015 Antimigran doen kombinasi (Ergotamin) Tab - - - -
20.01.20.1222.0016 Aqua proinjeksi steril, bebas pirogen 25 ml Btl - - - -
10.01.20.0922.0017 Asam askorbat (vitamin c) tablet 50 mg Tab - - - -
10.01.20.0322.446 Asam askorbat (vitamin c) tablet 250 mg Tab - - - -
10.01.20.0122.0020 Asetosal 80 mg (Miniaspi) Tab - - - -
30.01.20.0624.506 Atropin Tab 0,5 mg Tab - - - -
10.01.18.1019.0021 Atropin sulfat injeksi 0,25 mg/ml - 1 ml Amp - - - -
10.01.20.0522.0022 Acetyl Cystein 200mg Kaps - - - -
30.01.20.0923.0023 Acyclovir Cream Tube - - - -
10.01.18.0322.0024 Acyclovir tablet 200 mg Tab - - - -
10.01.18.0722.0025 Acyclovir tablet 400 mg Tab - - - -
20.01.20.1022.0026 Ambroksol sirup 15mg / ml Btl - - - -
20.01.20.0722.0027 Ambroksol tablet 30mg Tab - - - -
20.01.21.0721.0028.HTMECA94883 Asam Mefenamat tablet 500 mg Tab - - - -
20.01.21.0721.0028.HTMECA94883 Asam Mefenamat tablet 500 mg (Pehastan) Tab
10.01.19.0222.0029 Asam Traneksamat Tablet 500 mg Tab - - - -
10.01.18.0722.0030 Asam Traneksamat 100 mg/5 ml Injeksi Amp - - - -
10.01.18.0920.0033 Amlodipin 5mg Tab - - - -
10.01.18.0821.0034 Amlodipin 10 mg Tab - - - -
30.01.20.0624.0510 Asam folat tab 400 mcg Tab - - - -
10.01.20.0822.0035 Asam folat tab 1 mg Tab - - - -
10.01.20.1226.0526.L146407 Azithromicin 500 mg Tab - - - -
10.01.20.0522.0036 Betametason krim 0,1 % Tub - - - -
10.01.19.1021.0037 Betahistin mesilate Hidroklorid tablet 6 mg Tab - - - -
10.01.19.1021.0037 Betahistin mesilate Hidroklorid tablet 24 mg Tab - - - -
20.01.21.1024.0038.K10556901 Bisoprolol Fumarate tab 5 mg Tab - - - -
20.01.21.1024.0038.K10556901 Cefadroxil 500 mg kaps Kaps - - - -
30.01.20.0520.0039 Cefadroxil sirup kering 125 mg/5ml Btl - - - -
10.01.19.0421.0039 Cefadroxil sirup kering 250 mg/5ml Btl - - - -
10.01.19.1223.0040 Captopril tablet 12,5 mg Tab - - - -
30.01.20.0624.0041 Captopril tablet 25 mg Tab - - - -
10.01.18.0921.0042 Captopril tablet 50 mg Tab - - - -
10.01.20.0122.0043 Ciprofloxacin tablet 500 mg Tab - - - -
10.01.18.1221.0044.26807001 Cetirizine Tab 10 mg Tab - - - -
10.01.20.0922.0045 Cetirizine Sirup 5mg/5ml Btl - - - -
10.01.20.0822.0046 Ceptriaxon injeksi 1000 mg Vial - - - -
10.01.19.0421.0047 Cefotaxime Sodium Serb.Inj 1000 mg Vial - - - -
10.01.20.0322.0048 Clindamicin 150 mg Tab - - - -
30.01.20.0624.0509 Clindamicin 300 mg Tab - - - -
10.01.20.0322.0447 Cimetidin Tab - - - -
10.01.20.0924.0049 Deksametason inj 5 mg/ml - 1 ml Amp - - - -
30.01.20.1022.0050 Deksametason tablet 0,5 mg Tab - - - -
10.01.20.0623.0051 Diazepam inj 5 mg/ml - 2 ml Amp - - - -
10.01.18.0822.0052 Diazepam tablet 5 mg Tab - - - -
10.01.19.0523.0053 Diazepam tablet 2 mg Tab - - - -
10.01.20.0523.0305 Diazepam enema 5mg/2,5 ml (Stesolid Rectal ) tube - - - -
30.01.20.0822.0054 Difenhidramin HCl inj 10 mg/ml - 1 ml Amp - - - -
10.01.19.0321.0055 Digoksin tablet 0,25 mg Tab - - - -
10.01.19.0124.0056 Diltiazem 30 mg Tab - - - -
10.01.19.0623.0057 Dimenhidrat Kaplet 50 mg Tab - - - -
10.01.19.0522.0058 Domperidone tablet 10 mg Tab - - - -
10.01.20.0422.0059 Domperidon suspensi 5 mg / 5 ml Btl - - - -
10.01.18.0720.0060 Doxycycline 100 mg Kaps - - - -
10.01.17.0219.0061 Efedrin HCl tablet 25 mg Tab - - - -
20.01.20.0722.0062.962000220A Epinefrin 1 mg/ml inj s.c/i.m Amp - - - -
30.01.18.1020.0063 Etakridin (rivanol) larutan 0,1 % Btl - - - -
20.01.18.0822.0064 Erytromicin kaplet 500 mg Kapl - - - -
10.01.20.0322.0448 Erytromicin Syrup 200 mg / 5 ml Botol - - - -
20.01.18.0522.0065 Etambutol tab 500mg ( HCL ) Tab - - - -
10.01.19.1123.0065 Etambutol tab 250mg ( HCL ) Tab - - - -
20.01.20.0424.0067.13052088 Etanol 70 % ( 1000 ML ) / Alkohol 70% Btl - - - -
30.01.19.0421.0067 Fenytoin Sodium 100 mg Kap - - - -
10.01.19.0321.0068 Fenol Gliserol Tetes Telinga 10% Btl - - - -
10.01.20.0523.0069 Fenobarbital injeksi 50 mg/ml - 2 ml Amp - - - -
10.01.18.0423.0070 Fenobarbital tablet 30 mg Tab - - - -

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

20.01.21.0722.0071.FV0678 Fitomenadion (Vit K 1) Injeksi 2mg/ml Amp - - - -
30.01.20.0624.0511 Fitomenadion (Vit K 1) Injeksi 10mg/ml Amp - - - -
10.01.19.0821.0072 Fitomenadion (vit K 1) tablet salut 10 mg Tab - - - -
10.01.19.0621.0073 Furosemid tablet 40 mg Tab - - - -
10.01.19.0621.0073 Furosemid tablet 40 mg (Farsiretik) Tab
10.01.20.0222.0074 Furosemid inj 10mg/ml amp - - - -
10.01.19.1021.0075 Garam Oralit 200 ml Sachet - - - -
10.01.19.0124.0076 Glibenklamid Tab - - - -
10.01.20.0723.0077 Glimepiride 2 mg Tab - - - -
10.01.19.0921.0078 Glimepiride 1 mg Tab - - - -
30.01.17.0921.0079 Gliseril guayakolat 100 mg Tab - - - -
30.01.20.0923.0080 Guaiafenesin 100 mg Tab - - - -
10.01.17.1121.0081 Gliserin / Gliserol Btl - - - -
10.01.20.0122.0082 Glukosa larutan infus 5 % steril Btl - - - -
10.01.18.0820.0083 Griseofulvin tablet 125 mg, micronized Tab - - - -
30.01.20.0624.0508 Griseofulvin tablet 250 mg Tab - - - -
10.01.19.0621.0084 Griseofulvin tablet 500 mg Tab - - - -
10.01.17.1119.0085 Gentamycin Sulfat Injeksi 2 ml Amp - - - -
20.01.20.1022.0086 Gentamycin tetes mata 0,3 % Botol - - - -
30.01.20.0224.453 Gentamycin Cream Kulit Tube - - - -
30.01.20.0224.453 Gentamycin Cream Kulit (Genalten) Tube
30.01.20.0224.453 Gentamycin Salep Mata Tube - - - -
10.01.19.0422.0088 Gemfibrozil 300 mg Kaps - - - -
10.01.20.0824.0089 Gentian Violet Larutan 1% Btl - - - -
20.01.21.0822.0090.A1804HX Haloperidol tablet 0,5 mg Tab - - - -
20.01.21.0822.0090.A1917HX Haloperidol tablet 1,5 mg Tab - - - -
10.01.18.0620.0092 Haloperidol tablet 5 mg Tab - - - -
10.01.19.0123.0093 Hidroklorotiazid (HCT) tablet 25 mg Tab - - - -
10.01.17.1022.0094 Hidrokortison krim 2,5 mg Tub - - - -
10.01.17.1022.0512 Hidrogen Peroksida 3 % Botol - - - -
30.01.20.0624.0507 Isoniazid tab 100 mg Tab - - - -
10.01.18.0420.0096 Ibuprofen syr 100mg/ 5 ml Botol - - - -
10.01.18.0420.0096 Ibuprofen syr 200mg/ 5 ml Botol - - - -
10.01.20.0322.443 Ibuprofen 200 mg Tab - - - -
20.01.20.0921.0097 Ibuprofen 400 mg Tab - - - -
10.01.18.0722.0098 Isosorbid dinitrat tablet sublingual 5 mg Tab - - - -
10.01.20.0825.0099 Ichtiol salep pot - - - -
10.01.20.0622.0100 Kalsium laktat (kalk) tablet 500 gram Tab - - - -
10.01.20.1122.0101 Karbamazepin tablet 200 gram Tab - - - -
20.01.21.0225.0102.36325001 Kloramfenikol kapsul 250 mg Kap - - - -
10.01.19.0122.0103 Kloramfenikol salep mata 1 % Tub - - - -
20.01.20.0221.0104 Kloramfenikol Tetes Mata 0,5 % Btl - - - -
20.01.20.0221.0104 Kloramfenikol Tetes Mata 0,5 % (Reco) Btl - - - -
30.01.20.0823.0105 Kloramfenikol Tetes Telinga 1% Btl - - - -
30.01.20.0823.0105 Kloramfenikol Tetes Telinga 1% (Reco) Btl - - - -
10.01.19.0921.0106 Kloramfenikol Suspensi 125 mg/5ml Btl - - - -
10.01.18.0522.0107 Klorfeniramin maleat (CTM) tablet 4 mg Tab - - - -
10.01.19.0422.0108 Kloramfenikol Salep 2% Tub - - - -
10.01.19.0422.0108 Kloramfenikol Salep 2% (Bufacetine) Tub - - - -
20.01.21.0823.452.36328002 Klorpromazin HCl tablet salut 25 mg Tab - - - -
30.01.20.1022.0109 Klorpromazin HCl tablet salut 100 mg Tab - - - -
10.01.17.0819.0115 Klorpromazine HCL inj 25mg/ml-1 ml injeksi Amp - - - -
10.01.20.0923.0110 Kodein HCl tablet 10 mg Tab - - - -
10.01.19.0522.0111 Kotrimoksazol suspensi 480 mg/5 ml Btl - - - -
10.01.20.1022.0111 Kotrimoksazol suspensi Forte Btl - - - -
10.01.19.0522.0112 Kotrimoxazol Tablet Tab - - - -
10.01.19.0822.0113 Ketokonazole cream Tub - - - -
10.01.20.0423.0114 Ketokonazole 200mg Tab Tab - - - -
10.01.19.1120.0116 Lactulose 3,335 g/5ml Btl - - - -
20.01.21.0922.0117.0178058 Lansoprazole Kap - - - -
10.01.18.0521.0118 Lidokain Injeksi Amp - - - -
10.01.18.0521.0118 Lidokain kompositum injeksi (Lidocain+epinerin) Amp - - - -
30.01.17.0000.0119 Lisol Btl - - - -
10.01.20.0822.0120 Loratadine 5 mg Tab - - - -
10.01.17.0220.0121 Lar anhydrous dextrose,Nacl,Kcl,Na laktat,(KAEN 3A) Btl - - - -
10.01.17.0220.0121 Lar anhydrous dextrose,Nacl,Kcl,Na laktat,(KAEN 3B) Btl - - - -
10.01.20.0822.0122 Mineral Mix Sach - - - -
10.01.20.0223.0123.FV0678 Metilergometrin maleat inj. 0,2 mg - 1 ml Amp - - - -
10.01.19.0122.0124 Metilergometrin maleat tablet 0,125 mg Tab - - - -
10.01.19.0322.0125 Miconazol 2 % cream Tub - - - -
10.01.19.0322.0125 Miconazol 2 % cream (Zolagel) Tub - - - -
10.01.18.0922.0126 Metoklopramide tablet 10 mg Tab - - - -
10.01.18.0922.0126 Metoklopramide tablet 10 mg (Norvom) Tab
10.01.19.0822.0127 Metoklopramide Syrup Btl - - - -
10.01.19.0822.0127 Metoklopramide Syrup Btl - - - -
10.01.19.0822.0127 Metoklopramide Syrup (Primpen sirup 5 mg/5ml ) Btl - - - -
10.01.19.0822.0127 Metoklopramide Syrup (Lexapharm sirup 5 mg/5ml ) Btl - - - -
10.01.19.0822.0127 Metoklopramide Syrup (Norvom sirup 5 mg/5ml ) Btl
10.01.19.0621.0128 Metoklopramide injeksi 5 mg/ml Amp - - - -
10.01.20.0322.450 Metronidazol Tablet 250 mg tablet Tab - - - -
20.01.20.1122.0129 Metronidazol Tablet 500 mg tablet Tab - - - -
10.01.20.0522.0130 Metronidazol larutan Infus 5 mg/ml @100 ml Btl - - - -
10.01.19.0122.0131 Metronidazol syrup 125 mg / 5 ml Btl - - - -
10.01.20.0522.0132 Metilprednisolon 4 mg Tab - - - -
10.01.19.0123.0133 Metilprednisolon 16 mg Tab - - - -
10.01.10.0822.0134 Metformin 500 mg Tab - - - -
30.01.18.0920.0135 Metformin 850 mg Tab - - - -
10.01.19.0321.0136 Metamizole Inj 500mg/ml Amp - - - -
10.01.19.0321.0136 Metamizole Inj 500mg/ml (Norages Injeksi) Amp - - - -

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

10.01.19.1121.0137 Metamizole Sodium 500mg kaplet Kaplet - - - -
20.01.21.1021.0138 Magnesium Sulfat 20% (MgSo4) Vial - - - -
20.01.21.1021.0139.78J49A Magnesium Sulfat 40% (MgSo4) Vial - - - -
10.01.20.0322.0140 Natrium klorida larutan infus 0,9% steril (NaCl) 500 ml Btl - - - -
10.01.20.0322.0140 Natrium klorida larutan infus 0,9% steril (NaCl PB) 100 ml Btl - - - -
10.01.19.0722.0141 Nistatin 100.000 iu/g tablet vaginal Tab - - - -
10.01.18.0481.0142 Nistatin 500.000 iu tablet salut Tab - - - -
20.01.22.0923.0142.10429 Nistatin 100.000 iu Drop (Nystin) Botol - - - -
10.01.19.0521.0145.CM66377 Nifedipine Tab Tab - - - -
10.01.19.0521.0145.CM66377 Nifedipine Tab (Adalat Oros) Tab - - - -
10.01.20.0323.0143 Natrium diclofenak 25 mg Tab - - - -
10.01.20.0822.0144 Natrium diclofenak 50 mg Tab - - - -
30.01.20.0624.0146 Obat batuk hitam (o.b.h) sirup Btl - - - -
20.01.20.0823.0147 Oksitosin injeksi 10 iu/ml - ml Amp - - - -
30.01.20.0721.451 Oksitetrasiklin Salep Kulit Tub - - - -
10.01.19.0222.0148 Oksitetrasiklin Salep Mata Tub - - - -
10.01.19.0921.0149 Omeprazole kapsul/kaplet 20 mg Kap - - - -
10.01.19.0921.0150 Ondansetron Tablet 4 Mg Tab - - - -
10.01.19.0921.0150 Ondansetron Tablet 8 Mg Tab - - - -
10.01.20.0322.0517 Ondansetron Injeksi 2mg / ml Amp - - - -
20.01.21.0322.0151.SCD11749 Parasetamol tetes 100mg/ 0,6 ml Botol 15 ml - - - -
30.01.20.1022.0152 Parasetamol syr 120 mg / 5 ml Btl - - - -
30.01.20.0722.0153 Parasetamol tablet 500 mg Tab - - - -
30.01.20.0722.0153 Parasetamol tablet 500 mg (Kamolas) Tab
30.01.20.0624.503 Papeverin 40 mg Tab - - - -
10.01.17.0319.0154 Petidin HCl injeksi 50 mg/ml - 2 ml Amp - - - -
10.01.18.0121.0155 Piridoksin HCl tablet 10 mg Tab - - - -
10.01.18.0121.0316 Piridoksin HCl tablet 25 mg Tab - - - -
10.01.20.0322.0156 Prednison tablet 5 mg Tab - - - -
10.01.17.0120.0157 Primakuin tablet 15 mg Tab - - - -
30.01.17.0621.0158 Propiltiourasil tablet 100 mg Tab - - - -
10.01.18.0721.0159 Propranolol HCl tablet 10 mg Tab - - - -
10.01.17.0920.0161 Piracetam Injeksi 1g / 5 ml Vial - - - -
10.01.20.0322.454 Piracetam 800 mg tab Tab - - - -
10.01.18.0220.0162 Pirazinamide 500mg tab tab - - - -
10.01.19.0723.0163 Pirantel Pamoat 125 mg Tab - - - -
30.01.20.0624.505 Pirantel Pamoat 250 mg Tab - - - -
30.01.20.0624.505 Pirantel Pamoat 250 mg (Combantrin) Tab
30.01.19.0321.0164 Pirantel Pamoat Susp 125mg/5ml btl - - - -
20.01.20.1023.0165.201017 Piroksikam Tab - - - -
10.01.20.0723.0178 Permetrin krim Tub
10.01.20.0723.0178 Permetrin krim (Scabimite 5% ) Tub - - - -
10.01.18.0523.0166 Quinine 222 mg Tab - - - -
10.01.17.0220.0167 Ringer laktat larutan infus steril Btl - - - -
20.01.18.0523.0293 Ramipril 5 mg Tab - - - -
20.01.20.0822.0168 Ranitidin tablet 150 mg Tab - - - -
10.01.19.1220.0169 Ranitidin Injeksi 25mg/ml amp - - - -
10.01.20.0721.0170.19KG012 Retinol (vitamin A) kapsul 100.000 iu Kap - - - -
10.01.19.0421.0171 Retinol (vitamin A) kapsul 200.000 iu Kap - - - -
10.01.20.0322.455 Rifampisin kaplet 300 mg Tab - - - -
20.01.18.0422.0172 Rifampisin kaplet 600 mg Tab - - - -
10.01.18.0921.0173 Salbutamol tablet 2 mg Tab - - - -
30.01.20.0425.0173 Salbutamol tablet 2 mg (Lasal) Tab - - - -
30.01.17.0721.0174 Salbutamol tablet 4 mg Tab - - - -
10.01.19.0421.0175 Salbutamol 2mg/5ml Syrup Btl - - - -
10.01.19.0421.0175 Salbutamol/ Salbutamol Sulfate cairan ih 1 mg/mL Botol - - - -
30.01.20.0223.0303 Salbutamol aerosol 100mcg/dosis (Suprasma) Botol - - - -
10.01.19.0019.0176 Salep 2-4 kombinasi Pot - - - -
10.01.18.0420.0177 Salisil bedak 2 % 50 gr Ktk - - - -
20.01.21.0422.0179.4700220 Serum anti bisa ular polivalen inj. 5 ml (abu I) Vial - - - -
10.01.19.0820.0180 Serum anti tatanus inj. 1.500 iu/ampul (a.t.s I ) Amp - - - -
10.01.20.1021.0181 Sianokobalamin (Vit. B12) injeksi 500 mcg/ml Amp - - - -
10.01.19.0923.0182 Sianokobalamin (Vit. B12) tablet 50 mcg Tab - - - -
20.01.21.0622.0183.A8705FX Simvastatin tablet 10 mg Tab - - - -
10.01.19.0520.0184 Simvastatin tablet 20 mg Tab - - - -
10.01.19.0820.0516 Spironolactone 100 mg Tab - - - -
10.01.19.0820.0185 Spironolactone 25 mg Tab - - - -
10.01.19.0321.0186 Tablet tambah darah Tab - - - -
10.01.20.0322.456 Tetrasiklin 250 mg Tab - - - -
10.01.19.1021.0187 Tetrasiklin 500 mg Tab - - - -
10.01.20.0420.0188 Tiamin HCl (Vit. B1) inj. 100 mg/ml - 1 ml Amp - - - -
10.01.19.0923.0189 Tiamin HCl monohidrat (Vit. B1) tablet 50 mg Tab - - - -
10.01.18.0920.0190 Triheksifenidil hidroklorida tablet 2 mg Tab - - - -
30.01.20.0623.0190 Triheksifenidil hidroklorida tablet 2 mg (Hexymer) Tab - - - -
30.01.20.1021.0191 Thiamfenikol tab 500 mg Amp - - - -
20.01.20.0622.0192.F90908T Vitamin B kompleks tablet Tab - - - -
10.01.18.1219.0194 Wida Bes Infus Btl - - - -
10.01.18.0221.0195 Yodium povidon larutan 10 % 30 ml Btl - - - -
20.08.21.0320.0197.26496044 Zink Tablet 20 mg Tab - - - -
10.01.19.0221.0198 Zinc Sulfate Sirup 20mg/5ml Btl - - - -
GOLONGAN OBAT GIGI - - - -
Anastetik Lokal Gigi Kombinasi (Lidocain 2%+epinerin 1:80.000)
30.01.19.1122.0516 Pehacain amp - - - -
30.01.19.1020.0200 Bonding Kotak - - - -

30.01.19.1122.0199 Cholorophenol camphor menthol (chkm) Set - - - -
30.01.19.1020.0200 Cal Excel Kotak - - - -
30.01.19.0422.0201 Calform - RC Kotak - - - -

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

30.01.19.1220.0202 Ceivtron( tambalan sementara ) ktk - - - -
30.01.19.1220.0202 Composite (Tamball Permanen) A2 Kotak - - - -
30.01.19.1220.0202 A3 Kotak - - - -
30.01.19.0521.0203 Devitalisasi Arsen (Devit Ars) Kotak - - - -
10.01.20.0322.458 Devitalisasi pasta (non arsen) kotak - - - -
30.01.19.0921.0204 Etil klorida semprot Kaleng - - - -
30.01.19.0000.0205 Eugenol cairan Btl - - - -
30.01.19.1121.0206 Elite Cement Kotak - - - -
30.01.19.1121.0206 Etching Kotak - - - -
30.01.19.1121.0514 Flour Kaplet - - - -
30.01.19.1121.0513 Formokresol Botol - - - -
10.01.20.0322.459 kalsium hidroksida pasta tube - - - -
30.01.19.0121.0207 Glass Ionomer Cement (GK-Fuji IX) Kotak - - - -
10.01.20.0322.460 Iodoform paste Ktk - - - -
10.01.20.0322.461 Mummifying pasta / tempophore btl - - - -
30.01.19.0921.0208 Oco ktk - - - -
30.01.19.0921.0515 Resin Set - - - -
30.01.19.0221.0209 Semen Seng Fosfat serbuk dan cairan kotak - - - -
10.01.20.0322.462 Spons gelatin Cubicles 1 x 1 x 1 Cm Ktk - - - -
10.01.20.0322.462 Spongostan Ktk - - - -
10.01.20.0322.463 Temporary stopingfletcher serbuk dan cairan Set - - - -
30.01.19.0000.0210 Trikresol formalin (TKF) cairan Btl - - - -
GOLONGAN OBAT BAHAN HABIS PAKAI - - - -
20.01.21.0425.0211.20200420 Alkohol Swab Pcs - - - -
20.01.20.0921.0212 Asam Asetat 6% Btl - - - -
10.01.20.0820.0213 Anti septic Poliwash (Chlorhexidine) Botol - - - -
10.01.18.0221.0214 Aseptic Gel / Hand sanitaizer Botol - - - -
20.01.20.0521.440 Antiseptic dan Desinfektan (Odex) Botol - - - -
20.01.20.0521.440 Antiseptic dan Desinfektan Spray (Baymed) Botol - - - -
10.01.21.0123.520.XXXXX Blood Lancet Pcs - - - -
20.01.21.0924.0215.1908133 Catgut/benang bedah no.2/0 Plain Sak - - - -
20.01.20.0421.0215 Catgut/benang bedah no.2/0 Chromic Sak - - - -
20.01.21.0525.0215.2004053 Catgut/benang bedah no.3/0 Plain Sak - - - -
10.01.17.1119.0216 Catgut/benang bedah no. 3/0 chromic Sak - - - -
10.01.19.1223.0217 Disposable Syringe 1 cc pcs - - - -
10.01.19.0423.0218 Disposable Syringe 2,5 cc pcs - - - -
10.01.17.0521.0219 Disposable Syringe 3 cc Pcs - - - -
10.01.17.0322.0223 Elastic band / Perban Elastis 7,5 cm x 1,5 m roll - - - -
10.01.19.0321.0224 Folley catheter no.16 Pcs - - - -
10.01.19.0421.0225 Folley catheter no.18 pcs - - - -
10.01.17.1121.0226 Folley catheter no.20 Pcs - - - -
10.01.19.0823.0227 Infus set anak pcs - - - -
20.01.21.1223.0228.19A21L1J Infus set dewasa pcs - - - -
10.01.20.1022.0254 IV Catheter No. 26 G Pcs - - - -
20.01.20.0424.0257 IV Catheter No 20G Pcs - - - -
10.01.19.1022.0258 IV Catheter No 18 G Pcs - - - -
30.01.17.0922.0229 Kapas berlemak 500 gram Bks - - - -
20.01.18.1021.0230 Kapas pembalut/absorben 250 gram Bks - - - -
20.01.20.0222.0231 Kapas pembalut 250 gram Bks - - - -
10.01.19.0223.0232 Kasa kompres 40cm /40 cm Rol - - - -
20.01.21.0525.0233.02062088 Kasa Steril 16x16 cm kotak - - - -
10.01.19.0523.0234 Kasa pembalut 36 m x 80 cm Rol - - - -
20.01.21.1225.0235.xxxxxxxx Kasa pembalut 40 m x 80 cm Rol - - - -
20.01.19.0224.0236 Kasa pembalut 2m x 80 cm Rol - - - -
20.01.19.1020.0237 Kasa Pembalut 40 m x 40 cm Rol - - - -
10.01.18.0422.0238 Kasa pembalut hidrofil 4 m x 10 cm Rol - - - -
20.01.20.0821.0239 Kasa pembalut 4 m x 15 cm Rol - - - -
20.01.21.1225.0240.xxxxxx Kasa Pembalut hidrofil 4 x 3 Rol - - - -
10.01.19.1023.0242 Kasa Pembalut hidrofil 3,6m x 12cm Rol - - - -
10.01.19.1023.0242 Kasa Pembalut hidrofil 3 yard x 5cm Rol - - - -
10.01.19.1023.0242 Kasa Pembalut hidrofil 3 yard x 10cm Rol - - - -
10.01.18.0423.0243 Kasa steril Kasa Steril 10 x 10, 8ply, 1x10's Pcs - - - -
10.01.21.0322.xxxx.xxxxxx Mask Surgical (Earloop/Hijab/Tie On) Pcs - - - -
10.01.21.0322.xxxx.xxxxxx Mask Surgical (Hijab) Pcs - - - -
10.01.21.0322.xxxx.xxxxxx Mask Surgical (Earloop) Pcs - - - -
10.01.19.0125.0249 Masker N95 Pcs - - - -
10.01.21.1122.0247. Mask Nasal Oxygen Cannula Infant (anak) Pcs - - - -
10.01.18.1122.0248 Mask Nasal Oxygen Cannula Adult (dewasa) Pcs - - - -
10.01.19.1022.0250 Nebulizer Masker Infant Pcs - - - -
20.01.21.0523.0251.FY1803071 Nebulizer Masker Adult Pcs - - - -
20.01.22.0323.0520.180415 Needle 22 G x 1 1/2 Pcs - - - -
20.01.22.0624.0521.190720 Needle 23 G x 1 1/4 Pcs - - - -
20.01.22.1123.0520.181220 Needle 25 G x 5/8 Pcs - - - -
10.01.19.0622.0252 Optime 2/0 Pcs - - - -
10.01.19.1122.0253 Optime 3/0 Pcs - - - -
10.01.19.1022.0259 Polid Aid / Enzymax Instrument Cleaner 1000 ml Botol - - - -
20.01.22.0524.0518.14061988 Penutup luka Lebar (Hypapix/Dermafix) 15 cm x 10m Bungkus - - - -
20.01.21.1225.0260.A081DROB Pembalut gips 3 inchi Rol - - - -
20.01.20.0122.0261 Pap Smear kit Steril (L) set - - - -
30.01.18.0323.0262 Pap Smear kit Steril (M) set - - - -
10.01.18.0623.0263 Pap Smear kit Steril (S) set - - - -
10.01.18.0922.0264 Pharmafix 15x 500 cm Rol - - - -

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

30.01.18.0000.0267 Sarung Tangan Non Steril Ukuran S pcs - - - -
20.01.20.0824.0268 Sarung Tangan Non Steril Ukuran M pcs - - - -
20.01.20.0824.0269 Sarung Tangan Non Steril Ukuran L Pcs - - - -
30.01.19.0823.0270 Sarung Tangan Steril (Surgical gloves) 7,5 Pair - - - -
30.01.18.0822.0271 Sarung Tangan Steril (Surgical gloves) 6.5 Pair - - - -
10.01.19.0723.0272 Sarung Tangan Steril (Surgical gloves) 7 Pair - - - -
10.01.20.0322.444 Sarung Tangan Steril (Surgical gloves) 8 Pair - - - -
20.01.20.0219.0273 Surgical Blade No 15 Pcs - - - -
10.01.17.0821.0275 Silk (benang bedah sutera) no. 3/0 Box - - - -
30.01.20.0621.0276 Stik Kolesterol Pcs - - - -
30.01.19.1220.0277 Stik Asam Urat Pcs - - - -
30.01.19.0521.0278 Stik Gula Darah Pcs - - - -
20.01.20.0422.436 Spekulum Vagina Ukuran S Set - - - -
20.01.20.1122.437 Spekulum Vagina Ukuran M Set - - - -
20.01.20.0422.438 Spekulum Vagina Ukuran L Set - - - -
10.01.20.0322.445 Steril Lubricant Jelly Botol - - - -
10.01.20.0921.0279 Ultrasonic gel 250 ml Galon - - - -
20.01.18.0523.0280 Umbilical Cord Nylon OM Pcs - - - -
20.01.20.0921.439 Underpad Pcs - - - -
10.01.21.0722.0281.26382013-1 Urine bag Steril Pcs - - - -
10.01.21.0722.0281.26382013-1 VTM (Virus Transport Media) Set - - - -
10.01.22.0623.0519.21071888 Wing Needle No 25 Pcs - - - -
GOLONGAN BMHP POSBINDU - - - -
30.01.19.0521.0278 Stik Gula Darah Pcs - - - -
20.01.21.0425.0211.20200420 Alkohol Swab Pcs - - - -
10.01.21.0123.520.XXXXX Blood Lancet Pcs - - - -
GOLONGAN OBAT PROGRAM MALARIA DAN DBD - - - -
10.02.19.0621.0314 Artesunate Inj, vial 60 mg / ml vial - - - -
10.02.19.0621.0314 Artesunate Inj, vial 60 mg / ml (Artesun) vial
10.02.19.0621.0315 Abate (Botol / 1 kg) Botol - - - -
10.02.19.0621.0316 Bactivec Botol - - - -
10.01.21.0123.520.XXXXX Blood Lancet Kotak - - - -
10.02.20.0000.0317 Cynoff 25 UL Botol - - - -
10.01.21.0923.499.GMS1138 Giemsa Botol - - - -
10.01.21.1023.519.IMR1034 Imersion Oil Botol - - - -
10.02.18.0000.0318 Kaca Slide (objek glass frosted 7105 one) Pcs - - - -
10.02.19.0621.0319 Kuinin (kina) tab 222 mg tablet - - - -
10.02.22.0000.0528.0619ID Kelambu Insektisida / LLINS Pcs - - - -
10.02.21.0222.0320.XXXXXXX LABORATORY KID PAKET - - - -
10.02.19.0621.0321 Mikroskop + Box Nikon Eclipse E-100 Unit - - - -
10.02.19.0000.0322 Malation Liter - - - -
10.02.20.1021.0323 Obat Anti Malaria DHP (Dihydroartemisinin) Tablet - - - -
10.02.20.0823.0324.36386001-1 Primakuin tab 15 mg tablet - - - -
10.02.20.0422.0325 Rapid Test Malaria (pf/PAN) combo Test - - - -
10.02.19.0621.0326 RDT DBD Combo TEST - - - -
10.02.21.0425.0327.XXXXXXX Slide Box Buah - - - -
10.02.17.0000.0327. Kotak Slide BUAH - - - -
10.02.19.0621.0328 Sipermetrin zeta 15 UL (botol / 5 Liter) Galon - - - -
GOLONGAN OBAT PROGRAM FILARIASIS - - - -
10.02.17.0620.0329 Albendazole 400 mg tablet - - - -
10.01.20.0322.442 Albendazole 200 mg / 5 ml sirup Botol - - - -
10.02.18.0820.0330 Dietil karbamazepin Sitrat tab 100 mg tablet - - - -
GOLONGAN OBAT PROGRAM TB PARU - - - -
10.01.20.0821.500 Catridge TCM / Gene Xpert MTB / RIF Paket - - - -
10.02.19.0824.0333 Masker Surgical pcs - - - -
10.02.22.1123.0333.AP0028 Masker N95 pcs - - - -
10.02.22.0123.0528.K202012050 Masker MEO1L - K TYPE IIR TB Pcs - - - -
20.02.21.0523.0526.A003039 Obat Anti tuberkulosis FDC Kategori Harian Paket - - - -
10.02.21.0722.0334.20PK1052 Obat Anti tuberkulosis FDC I Paket - - - -
10.02.18.0521.0335 Obat Anti tuberkulosis FDC II Paket - - - -
10.02.21.1121.0336.29493062 Obat Anti tuberkulosis Anak Paket - - - -
20.02.21.1022.0335.1810022 Obat Anti TBC FDC Kombipak kategori I Paket - - - -
10.02.19.0120.0338 Pot Sputum pot - - - -
10.02.22.0323.0524.NRT2118D Rifampicin 75 mg/ Isoniazid 50 mg GF Kotak / 84 Tablet Paket - - - -
10.02.22.0723.0525.NIE2120A Rifapentin 300 mg/ Isoniazid 300 mg GF Kotak / 36 Tablet Paket - - - -
10.02.21.0721.0339.LOT023/201 Reagen Zn kit - - - -
GOLONGAN OBAT PROGRAM DIARE - - - -
10.02.19.0322.0340 Garam Oralit 200 ml Sac - - - -
10.02.21.1022.0341.26496056 ZINK Tablet 200 mg tablet - - - -
GOLONGAN OBAT PROGRAM ISPA - - - -
10.02.18.0720.0342 mineral Mix Pcs - - - -
10.02.18.0720.0343 Pulse Oxtmetri Portable Unit - - - -
10.02.17.0000.0344 Sound Timer Unit - - - -
GOLONGAN OBAT PROGRAM KUSTA - - - -
10.02.21.0323.0345.BJW0295 MB.Dewasa blister - - - -
10.02.21.1122.0345.XXXXXX MB. Anak blister - - - -
10.02.21.0323.0346.BJX3012 PB.Dewasa blister - - - -
10.02.19.0820.0347 PB.Anak blister - - - -
GOLONGAN OBAT PROGRAM IMUNISASI - - - -
10.02.21.0224.0348.19002 ADS .0,05 ml Pcs - - - -
10.02.21.0224.0349.19002 ADS.0,5 ml pcs - - - -
10.02.20.0724.0350 ADS 5 ml pcs - - - -
10.02.21.0122.0351.'0379G185 BCG (10 doses) vial - - - -

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

10.02.19.1221.0352 DT vial - - - -
20.02.21.1221.0353.5041919 DPT-HB-HIB vial - - - -
10.02.21.0922.0354.3652420 HB-PID vial - - - -
20.02.21.0322.0355.C799020 HEPATITIS B DEWASA syringe - - - -
20.02.21.1123.0355.H2MAE0006 HBIG Amp - - - -
10.02.20.1121.0356 IPV Polio vial - - - -
10.02.21.1222.0357.2050320 Polio BOVP 10 doses vial - - - -
10.02.22.0325.0527.GE4177 PCV (Pneumococcal Conjugate Vaccine) vial - - - -
10.02.18.0422.0358 Spidol Pen Marker Pcs - - - -
10.02.20.0000.0359.XXXXXX Safety box Pcs - - - -
10.02.18.1120.0360 Rabies Immune Globulin (Human) Vial - - - -
10.02.18.1120.0360 VAR (Verorab) Vial - - - -
10.02.18.1120.0360 VAR (Rabipur) Vial - - - -
10.02.19.0620.0361 Tuberkulin Inj vial - - - -
20.02.20.0821.0362.04120918 TD vial - - - -
10.02.21.0621.0363.R1F422M2 VAR (Verorab) Amp - - - -
20.02.21.0522.0364.0129N265 Vaksin Measles and Rubella 10 DS vial - - - -
10.02.20.0820.0577 Vaksin Influenza Vial - - - -
10.02.20.0221.0365 Vaksin Meningitis (menivax) Vial - - - -
GOLONGAN OBAT PROGRAM GIZI - - - -
10.02.18.1120.0366 Ampisilin Serbuk injeksi i.m/i.v 1000mg vial - - - -
10.02.20.0522.0367 Besi (II) Sulphate (Tablet tambah darah Ibu Nifas) Tab - - - -
10.02.20.0522.0367 Besi (II) Sulphate (Tablet tambah darah Remaja) Tab - - - -
10.02.18.1021.0368 Diazepam injeksi 5 mg/ml Amp - - - -
10.02.18.0520.0369 Fenobarbital 50 mg injeksi Amp - - - -
10.02.18.1021.0370 Gentamisin Sulfat Injeksi 40 mg/ml Amp - - - -
10.02.19.0820.0371 Glukonas Kalsikus 1 gr Amp - - - -
10.01.20.0322.465 Iodine Test Btl - - - -
10.02.18.0820.0372 Mineral Mix Sach - - - -
10.02.18.1120.0374 Magnesium Sulfat 40% (MgSo4) Btl - - - -
10.01.20.0322.466 MP ASI Biskuit Bks - - - -
10.02.19.0821.0375 Oksitetrasiklin Salep Mata Tub - - - -
10.02.18.0819.0376 Prokain Penisillin 3 juta IU vial - - - -
10.02.18.0420.0377 Phytomenadion 2 mg/ml Amp - - - -
10.02.21.0322.0378.20KC003 Vitamin A 200.000 IU (Retinol) Kap - - - -
10.02.19.0820.0379 Vitamin A 100.000 IU (Retinol) Kap - - - -
GOLONGAN OBAT PROGRAM KIA - - - -
10.01.20.0322.467 Ampicillin Injeksi 100 mg Vial - - - -
10.01.20.0322.468 Calsium Gluconas 100 mg/ml Injeksi Amp - - - -
10.02.19.0820.0380 Deteksi tes kehamilan Paket - - - -
10.01.20.0322.469 Diazepam inj 5 mg/ ml amp - - - -
10.01.20.0322.470 Fitomenadion 10 mg/ vit K inj amp - - - -
10.01.22.0523.0069.26803002 Fenobarbital injeksi 50 mg/ml - 2 ml amp - - - -
10.02.19.0820.0381 Glukonas Kalsikus 1 00 mg injeksi Amp - - - -
10.02.22.0123.0371.9620A0046A Glukonas Kalsikus 1 gr Injeksi (10%) amp - - - -
10.01.20.0322.471 Gentamicin 80 mg inj amp - - - -
10.01.20.0322.472 Implant KB buah - - - -
10.01.20.0322.473 IV catheter 18 pcs - - - -
10.02.22.0624.0529.G017M4 Levothyroxine sodium 50 mg (Euthyrox) Tab - - - -
20.01.20.0520.441 Masker Ibu Bersalin Pcs - - - -
10.02.19.1120.0382 Methylergometrin Injeksi 0,2 mg/1 ml Amp - - - -
10.01.20.0322.474 Metil ergometrine Maleat 125 mg tablet tab - - - -
10.01.20.0322.475 Mg Sulfat 20% 25 ml Vial - - - -
10.01.20.0322.476 Mg Sulfat 40% 25 ml Vial - - - -
10.01.22.0424.0130.QX2E104 Metronidazol larutan Infus 5 mg/ml @ 100 ml Vial - - - -
10.01.20.0322.477 Natrium Tiroksin / Tyhrax tab tab - - - -
10.01.20.0322.478 Oksitosin Inj 10 IU 1 ml amp - - - -
10.01.22.0626.0148.E20989W Oksitetrasiklin Salep Mata Tube - - - -
10.01.20.0322.479 Prokain Penisiline 3 ml unit inj Vial - - - -
10.01.20.0322.480 Progesteron Depot Inj 1 ml Vial - - - -
10.01.20.0322.481 Pil KB Kombinasi cycles - - - -
10.01.20.0322.482 Urine Strip strip - - - -
GOLONGAN OBAT PROGRAM JIWA - - - -
10.01.20.0322.483 Amitripilin HCL 25 mg tablet tablet - - - -
20.01.22.0223.0191.A00446 Alprazolam HCL 0,5 mg tablet tablet - - - -
10.01.20.0623.0051 Diazepam inj 5 mg/ml - 2 ml Amp - - - -
10.01.20.0322.484 Fluoksetin 10 mg tablet tablet - - - -
10.01.20.0322.485 Haloperidol 0,5 mg Tab - - - -
20.01.22.0822.486.A1917HX Haloperidol 1.5 mg Tab - - - -
10.01.20.0322.487 Haloperidol 5 mg Tab - - - -
10.01.20.0322.488 Haloperidol inj 5 mg/ml ampul - - - -
10.01.20.0322.489 Haloperidol dekanoat inj 50 mg/ml ampul - - - -
10.01.20.0322.490 Imipramin HCL 25 mg tablet tablet - - - -
10.02.19.1120.0383 Karbamazepin 200 mg Tab - - - -
10.01.20.0322.491 Klobazam 10 mg tablet tablet - - - -
10.01.20.0322.492 Klorpromazin 100 mg tablet tablet - - - -
10.01.20.0322.493 Klozapin 25 mg tablet tablet - - - -
10.01.20.0322.494 Metadon HCL 50 mg/5 ml btl 1 L - - - -
10.01.20.0322.495 Risperidon 2 mg Tablet tablet - - - -
10.01.20.0322.496 Triheksifenidil hidroklorida tablet 2 mg Tab - - - -
10.01.22.0322.497.A00442 Trifluoperazine HCL 5 mg tablet tablet - - - -
GOLONGAN OBAT PROGRAM HIV DAN SIFILIS - - - -
10.01.20.0421.0418 Azithromicyn 1000mg + Cefixime 400mg Paket - - - -
10.01.20.0421.0419 Benzatin Penicillin 2,4 Juta IU vial - - - -
10.01.20.0421.0420 Blue Tipe (Mikropipet) Pcs - - - -
10.01.20.0421.0421 Efavirenz 600 mg Tab - - - -
10.01.20.0222.0525.B80304J Fluconazole Tab - - - -

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

10.01.20.0421.0422 Human Hexagon Sypilis Test - - - -
10.01.20.1121.0423.M30161208 Kondom Sutra Pcs - - - -
10.01.20.0421.0424 Lubricant Sutra Pcs - - - -
10.01.20.0421.0425 Latex Sarung Tangan Pcs - - - -
10.01.20.1021.0524.0274501 Mycamine (micafungin) 50 mg amp - - - -
10.01.21.1021.0426.03ADE054A Rapid I (SD Bioline HIV 1/2.) Pcs - - - -
10.01.20.0521.0427.401190912 Rapid 2 HIV Pcs - - - -
10.01.20.0721.0428.1907099 Rapid Test HIV 3 Pcs - - - -
10.01.22.0522.0428.D21007 Rapid Test HCV Pcs - - - -
10.01.21.1021.0426.03ADE054A Alere Determine HIV-1/2 Set - - - -
10.01.21.1021.0426.03ADE054A Alere Determine Combo 20T Set - - - -
10.01.21.0322.0428.BDE151B Rapid Test HCV Test - - - -
20.01.21.0322.0429.C20020 Rapid Test HBSAg Test - - - -
10.01.20.0421.0430 RPR Sypilis Frambusia Trepocheck Syphilis Test - - - -
10.01.20.0421.0430 RPR Sypilis Test - - - -
10.01.21.0721.0431.827001 RPR Sypilis RB Test - - - -
10.01.20.0821.0432.6521513 Swab Desinfektan Pcs - - - -
10.01.20.0421.0432 Swab Desinfektan (Descoderm) Pcs - - - -
10.01.20.0421.0433 Tipe Ukuran 61 Pcs - - - -
10.01.20.0421.0434 Tipe Ukuran 60 Pcs - - - -
10.01.20.0421.0435 Yellow Tipe (mikropipet) Pcs - - - -
GOLONGAN OBAT TAMBAHAN - - - -
20.01.18.0523.0282 Asifit Tab - - - -
10.01.18.0821.0283 Atapulgit (New Antides ) Tab - - - -
20.01.20.0122.0284 Aerius Amp - - - -
20.01.20.0122.0284 Bromheksin tablet 8 mg (HUSTAB ) Tab - - - -
10.01.18.0720.0285 Bisacodyl 5 mg Tab - - - -
10.01.18.1122.0286 Bisacodyl suppositoria 10 mg Supp - - - -
10.01.18.1122.0286 Bioplacenton salep Tube - - - -
20.01.18.0523.0287 Counterpain cream tube - - - -
30.01.20.0723.0288 Curcuma FTC Tab - - - -
20.01.18.0523.0289 Cernevit injeksi Vial - - - -
30.01.22.0922.0523.OXO331 Cendo Xitrol Tetes mata Botol - - - -
20.01.18.0523.0289 Cendo Hyalub Tetes mata Botol - - - -
20.01.18.0523.0289 Dextamine Tablet Tab - - - -
20.01.18.0523.0290 Dextamine syr Btl - - - -
20.01.22.1124.0290.46016024 Dextrofen syr Btl - - - -
30.01.20.0624.0504 Ester C Tab - - - -
20.01.18.0523.0291 FG Troches tab - - - -
20.01.19.0421.0292 Hefagard Kap - - - -
20.01.20.0622.0294 Hyosine N Butil Bromide (Spashy) Tab - - - -
20.01.18.0523.0295 Imunos Kap - - - -
30.01.20.0322.501 Imboost Kap - - - -
10.01.20.1022.0296 Kaolin Pektin Syrup (Novadiar syrup ) btl - - - -
10.01.20.1022.0296 Kaolin Pektin Syrup (Envios syrup ) btl - - - -
10.01.20.1022.0296 Kaolin Pektin Syrup (Guanistrip syrup ) btl - - - -
30.01.20.1022.0297 Ketosic Injeksi 30 mg/ ml Amp - - - -
30.01.20.1022.0297 Loperamid tab - - - -
30.01.20.1022.0297 Loperamid (Primordiar) tab - - - -
30.01.20.1022.0297 Loperamid (Colidium) tab - - - -
30.01.17.0422.0298 Levetran salep Pot - - - -
20.01.20.0922.0299 Noza Tab - - - -
20.01.18.0523.0300 Osteotin Tab - - - -
20.01.21.0223.0301.66908005 Obat Flu Batuk Anak (Pimtracol syrup) Botol - - - -
20.01.18.0523.0301 Obat Flu Batuk Anak (Solafluz syrup) Botol - - - -
30.01.20.0424.502 Obat Flu Batuk Anak (Hufagrip Sirup) Btl - - - -
30.01.20.0424.502 Obat Flu Batuk Anak Sirup (Novatusin Syrup) Btl - - - -
20.01.18.0523.0302 Obat Flu Batuk Neonatus (baby Cough) Btl - - - -
20.01.18.0523.0304 Rhinos SR Kaps - - - -
20.01.18.0523.0304 Sakatonik abc tab - - - -
20.01.19.0422.0306 Tensigard Kaps Tab - - - -
30.01.19.0621.0315 Tramadol injeksi - - - -
20.01.18.0523.0307 Thromboflash cream Tube - - - -
20.01.18.0523.0308 Thrombopob Cream tube - - - -
20.01.18.0523.0309 Vitamin Neutropik Injeksi (Neurobion) Ampul - - - -
20.01.18.0523.0309 Vitamin Neutropik (Bioron) Tab - - - -
20.01.21.0822.0310.361800006 Vitamin Tambah Darah (Hemafort) Tab - - - -
20.01.18.0523.0311 Vitamin Anak syrup (Tialisin) btl - - - -
20.01.21.0823.0518.IH249A Vitamin Anak Syrup (Curviplex) btl - - - -
20.01.21.0823.0518.IH249A Vitamin Anak Syrup (Curbexon) btl - - - -
20.01.21.0823.0518.IH249A Vitamin Anak Drop (Solvita) btl - - - -
20.01.18.0523.0312 Vitamin Dewasa (Becefort tablet ) Tab - - - -
10.01.22.0523.0312.52D0794 Vitamin Dewasa (Stimuno tablet ) Tab - - - -
10.01.20.0322.465 Vital Ear Drop Botol - - - -
20.01.21.0622.0313.F90908T Ventolin Nebules 2,5 mg Amp - - - -
20.01.21.0622.0313.F90908T Voltaren Gel Tube - - - -
30.01.19.0621.0314 Valisanbe (Diazepam Inj) Amp - - - -
Mengetahui Kotabaru,…………….
Kepala Puskesmas Pengelola Obat
…………………………. Puskesmas…………………
isi dengan scan ttd kepala pkm dan cap stempel Isi dengan scan tanda tangan pengelola obat
……………………………… …………………………..
Nip……………………………. Nip……………………….

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

KERTAS KERJA SISA STOK OBAT, VAKSIN DAN BAHAN MEDIS HABIS PAKAI ( BMHP )
DINAS KESEHATAN KABUPATEN KOTABARU
PUSKESMAS……………………………
PERIODE TAHUN 2022
SISA STOK 31 DESEMBER TAHUN 2022 EXPIRED DATE
TOTALSISA
KODE NAMA OBAT/ BARANG SATUAN STOK 31 NO BATCH KET
DESEMBER 2022
PUSKESMAS Ds. Tengah` Tj. Nyiur Labuan Barat Teluk Sungai Maradapan BULAN (dalam angka) TAHUN (dalam angka)
GOLONGAN OBAT GENERIK / ESENSIAL

10.01.19.0422.0001 Alopurinol tablet 100 mg Tab 70 Tab
10.01.18.0520.0002 Alopurinol tablet 300 mg Tab -
30.01.20.0521.0003 Aminofilin tablet 200 mg Tab -
10.01.20.0821.0004 Aminofilin injeksi 24 mg/ml - 10 ml Amp -
Amitriptilin HCl tab. Salut 25 mg Tab 30 Tab
10.01.19.0821.0193 Ampisilin serbuk injeksi 250 mg (Viccillin ) Amp -
10.01.20.0522.0006 Amoksisilin Kaptab 500 mg Kapt 100 Tab
10.01.19.0522.0007 Amoksisillin 100mg Drop Amp -
10.01.20.1022.0008 Amoksisilin sirup kering 125 mg / 5 ml Btl -
10.01.20.1022.0009 Amoksisilin sirup kering 250 mg / 5 ml Btl 8 BOTOL
10.01.17.0319.0160 Amoxilin Injeksi 1000mg (Pehamoxil) Vial -
10.01.20.0822.0010 Antasida Doen tablet kombinasi Tab -
10.01.20.1121.0011 Antasida suspensi Btl 7 BOTOL
10.01.18.0822.0012 Antibakteri doen salep kombinasi (Bacitracin) Tub -
10.01.20.1121.0013 Antihemoroid doen kombinasi Suppo -
10.01.19.1022.0014 Antifungi doen kombinasi Pot -
10.01.20.0323.0015 Antimigran doen kombinasi (Ergotamin) Tab -
20.01.20.1222.0016 Aqua proinjeksi steril, bebas pirogen 25 ml Btl -
10.01.20.0922.0017 Asam askorbat (vitamin c) tablet 50 mg Tab 300 Tab
10.01.20.0322.446 Asam askorbat (vitamin c) tablet 250 mg Tab -
10.01.20.0122.0020 Asetosal 80 mg (Miniaspi) Tab -
30.01.20.0624.506 Atropin Tab 0,5 mg Tab -
10.01.18.1019.0021 Atropin sulfat injeksi 0,25 mg/ml - 1 ml Amp -
10.01.20.0522.0022 Acetyl Cystein 200mg Kaps -
30.01.20.0923.0023 Acyclovir Cream Tube -
10.01.18.0322.0024 Acyclovir tablet 200 mg Tab -
10.01.18.0722.0025 Acyclovir tablet 400 mg Tab -
20.01.20.1022.0026 Ambroksol sirup 15mg / ml Btl 5 BOTOL
20.01.20.0722.0027 Ambroksol tablet 30mg Tab 200 Tab
20.01.21.0721.0028.HTMECA94883 Asam Mefenamat tablet 500 mg Tab 100 Tab
20.01.21.0721.0028.HTMECA94883 Asam Mefenamat tablet 500 mg (Pehastan) Tab -
10.01.19.0222.0029 Asam Traneksamat Tablet 500 mg Tab -
10.01.18.0722.0030 Asam Traneksamat 100 mg/5 ml Injeksi Amp -
10.01.18.0920.0033 Amlodipin 5mg Tab 30 Tab
10.01.18.0821.0034 Amlodipin 10 mg Tab 20 Tab
30.01.20.0624.0510 Asam folat tab 400 mcg Tab -
10.01.20.0822.0035 Asam folat tab 1 mg Tab -
10.01.20.1226.0526.L146407 Azithromicin 500 mg Tab -
10.01.20.0522.0036 Betametason krim 0,1 % Tub -
10.01.19.1021.0037 Betahistin mesilate Hidroklorid tablet 6 mg Tab -
10.01.19.1021.0037 Betahistin mesilate Hidroklorid tablet 24 mg Tab -
20.01.21.1024.0038.K10556901 Bisoprolol Fumarate tab 5 mg Tab -
20.01.21.1024.0038.K10556901 Cefadroxil 500 mg kaps Kaps 50 Tab
30.01.20.0520.0039 Cefadroxil sirup kering 125 mg/5ml Btl -
10.01.19.0421.0039 Cefadroxil sirup kering 250 mg/5ml Btl -
10.01.19.1223.0040 Captopril tablet 12,5 mg Tab 3 Botol
30.01.20.0624.0041 Captopril tablet 25 mg Tab -
10.01.18.0921.0042 Captopril tablet 50 mg Tab -
10.01.20.0122.0043 Ciprofloxacin tablet 500 mg Tab -
10.01.18.1221.0044.26807001 Cetirizine Tab 10 mg Tab -
10.01.20.0922.0045 Cetirizine Sirup 5mg/5ml Btl 9 Botol
10.01.20.0822.0046 Ceptriaxon injeksi 1000 mg Vial -
10.01.19.0421.0047 Cefotaxime Sodium Serb.Inj 1000 mg Vial -
10.01.20.0322.0048 Clindamicin 150 mg Tab -
30.01.20.0624.0509 Clindamicin 300 mg Tab -
10.01.20.0322.0447 Cimetidin Tab -
10.01.20.0924.0049 Deksametason inj 5 mg/ml - 1 ml Amp -
30.01.20.1022.0050 Deksametason tablet 0,5 mg Tab -
10.01.20.0623.0051 Diazepam inj 5 mg/ml - 2 ml Amp -
10.01.18.0822.0052 Diazepam tablet 5 mg Tab -
10.01.19.0523.0053 Diazepam tablet 2 mg Tab -
10.01.20.0523.0305 Diazepam enema 5mg/2,5 ml (Stesolid Rectal ) tube -
30.01.20.0822.0054 Difenhidramin HCl inj 10 mg/ml - 1 ml Amp -
10.01.19.0321.0055 Digoksin tablet 0,25 mg Tab -
10.01.19.0124.0056 Diltiazem 30 mg Tab -
10.01.19.0623.0057 Dimenhidrat Kaplet 50 mg Tab -
10.01.19.0522.0058 Domperidone tablet 10 mg Tab 100 tab
10.01.20.0422.0059 Domperidon suspensi 5 mg / 5 ml Btl -
10.01.18.0720.0060 Doxycycline 100 mg Kaps -
10.01.17.0219.0061 Efedrin HCl tablet 25 mg Tab -
20.01.20.0722.0062.962000220A Epinefrin 1 mg/ml inj s.c/i.m Amp -
30.01.18.1020.0063 Etakridin (rivanol) larutan 0,1 % Btl -
20.01.18.0822.0064 Erytromicin kaplet 500 mg Kapl -
10.01.20.0322.0448 Erytromicin Syrup 200 mg / 5 ml Botol -
20.01.18.0522.0065 Etambutol tab 500mg ( HCL ) Tab -
10.01.19.1123.0065 Etambutol tab 250mg ( HCL ) Tab -
20.01.20.0424.0067.13052088 Etanol 70 % ( 1000 ML ) / Alkohol 70% Btl 1 btl
30.01.19.0421.0067 Fenytoin Sodium 100 mg Kap -
10.01.19.0321.0068 Fenol Gliserol Tetes Telinga 10% Btl -
10.01.20.0523.0069 Fenobarbital injeksi 50 mg/ml - 2 ml Amp -
10.01.18.0423.0070 Fenobarbital tablet 30 mg Tab -
20.01.21.0722.0071.FV0678 Fitomenadion (Vit K 1) Injeksi 2mg/ml Amp 2 amp
TOTALSISA
DESEMBER 2022
30.01.20.0624.0511 Fitomenadion (Vit K 1) Injeksi 10mg/ml Amp -

10.01.19.0821.0072 Fitomenadion (vit K 1) tablet salut 10 mg Tab -
10.01.19.0621.0073 Furosemid tablet 40 mg Tab -
10.01.19.0621.0073 Furosemid tablet 40 mg (Farsiretik) Tab -
10.01.20.0222.0074 Furosemid inj 10mg/ml amp -
10.01.19.1021.0075 Garam Oralit 200 ml Sachet
10.01.19.0124.0076 Glibenklamid Tab 350 Tab
10.01.20.0723.0077 Glimepiride 2 mg Tab -
10.01.19.0921.0078 Glimepiride 1 mg Tab -
30.01.17.0921.0079 Gliseril guayakolat 100 mg Tab
30.01.20.0923.0080 Guaiafenesin 100 mg Tab 30 Tab
10.01.17.1121.0081 Gliserin / Gliserol Btl -
10.01.20.0122.0082 Glukosa larutan infus 5 % steril Btl 10 Botol
10.01.18.0820.0083 Griseofulvin tablet 125 mg, micronized Tab -
30.01.20.0624.0508 Griseofulvin tablet 250 mg Tab -
10.01.19.0621.0084 Griseofulvin tablet 500 mg Tab -
10.01.17.1119.0085 Gentamycin Sulfat Injeksi 2 ml Amp -
20.01.20.1022.0086 Gentamycin tetes mata 0,3 % Botol -
30.01.20.0224.453 Gentamycin Cream Kulit Tube -
30.01.20.0224.453 Gentamycin Cream Kulit (Genalten) Tube -
30.01.20.0224.453 Gentamycin Salep Mata Tube 10 tube
10.01.19.0422.0088 Gemfibrozil 300 mg Kaps -
10.01.20.0824.0089 Gentian Violet Larutan 1% Btl -
20.01.21.0822.0090.A1804HX Haloperidol tablet 0,5 mg Tab -
20.01.21.0822.0090.A1917HX Haloperidol tablet 1,5 mg Tab -
10.01.18.0620.0092 Haloperidol tablet 5 mg Tab -
10.01.19.0123.0093 Hidroklorotiazid (HCT) tablet 25 mg Tab -
10.01.17.1022.0094 Hidrokortison krim 2,5 mg Tub -
10.01.17.1022.0512 Hidrogen Peroksida 3 % Botol -
30.01.20.0624.0507 Isoniazid tab 100 mg Tab -
10.01.18.0420.0096 Ibuprofen syr 100mg/ 5 ml Botol -
10.01.18.0420.0096 Ibuprofen syr 200mg/ 5 ml Botol -
10.01.20.0322.443 Ibuprofen 200 mg Tab -
20.01.20.0921.0097 Ibuprofen 400 mg Tab 50 Tab
10.01.18.0722.0098 Isosorbid dinitrat tablet sublingual 5 mg Tab -
10.01.20.0825.0099 Ichtiol salep pot -
10.01.20.0622.0100 Kalsium laktat (kalk) tablet 500 gram Tab 300 Tab
10.01.20.1122.0101 Karbamazepin tablet 200 gram Tab -
20.01.21.0225.0102.36325001 Kloramfenikol kapsul 250 mg Kap -
10.01.19.0122.0103 Kloramfenikol salep mata 1 % Tub -
20.01.20.0221.0104 Kloramfenikol Tetes Mata 0,5 % Btl -
20.01.20.0221.0104 Kloramfenikol Tetes Mata 0,5 % (Reco) Btl -
30.01.20.0823.0105 Kloramfenikol Tetes Telinga 1% Btl -
30.01.20.0823.0105 Kloramfenikol Tetes Telinga 1% (Reco) Btl -
10.01.19.0921.0106 Kloramfenikol Suspensi 125 mg/5ml Btl -
10.01.18.0522.0107 Klorfeniramin maleat (CTM) tablet 4 mg Tab 300 Tab
10.01.19.0422.0108 Kloramfenikol Salep 2% Tub -
10.01.19.0422.0108 Kloramfenikol Salep 2% (Bufacetine) Tub -
20.01.21.0823.452.36328002 Klorpromazin HCl tablet salut 25 mg Tab -
30.01.20.1022.0109 Klorpromazin HCl tablet salut 100 mg Tab -
10.01.17.0819.0115 Klorpromazine HCL inj 25mg/ml-1 ml injeksi Amp -
10.01.20.0923.0110 Kodein HCl tablet 10 mg Tab -
10.01.19.0522.0111 Kotrimoksazol suspensi 480 mg/5 ml Btl -
10.01.20.1022.0111 Kotrimoksazol suspensi Forte Btl -
10.01.19.0522.0112 Kotrimoxazol Tablet Tab -
10.01.19.0822.0113 Ketokonazole cream Tub 20 tub
10.01.20.0423.0114 Ketokonazole 200mg Tab Tab -
10.01.19.1120.0116 Lactulose 3,335 g/5ml Btl -
20.01.21.0922.0117.0178058 Lansoprazole Kap 50 Tab
10.01.18.0521.0118 Lidokain Injeksi Amp 7 Amp
10.01.18.0521.0118 Lidokain kompositum injeksi (Lidocain+epinerin) Amp -
30.01.17.0000.0119 Lisol Btl -
10.01.20.0822.0120 Loratadine 5 mg Tab -
10.01.17.0220.0121 Lar anhydrous dextrose,Nacl,Kcl,Na laktat,(KAEN 3A) Btl -
10.01.17.0220.0121 Lar anhydrous dextrose,Nacl,Kcl,Na laktat,(KAEN 3B) Btl -
10.01.20.0822.0122 Mineral Mix Sach 30 Sach
10.01.20.0223.0123.FV0678 Metilergometrin maleat inj. 0,2 mg - 1 ml Amp -
10.01.19.0122.0124 Metilergometrin maleat tablet 0,125 mg Tab -
10.01.19.0322.0125 Miconazol 2 % cream Tub -
10.01.19.0322.0125 Miconazol 2 % cream (Zolagel) Tub -
10.01.18.0922.0126 Metoklopramide tablet 10 mg Tab 100 tab
10.01.18.0922.0126 Metoklopramide tablet 10 mg (Norvom) Tab -
10.01.19.0822.0127 Metoklopramide Syrup Btl -
10.01.19.0822.0127 Metoklopramide Syrup Btl -
10.01.19.0822.0127 Metoklopramide Syrup (Primpen sirup 5 mg/5ml ) Btl -
10.01.19.0822.0127 Metoklopramide Syrup (Lexapharm sirup 5 mg/5ml ) Btl -
10.01.19.0822.0127 Metoklopramide Syrup (Norvom sirup 5 mg/5ml ) Btl -
10.01.19.0621.0128 Metoklopramide injeksi 5 mg/ml Amp -
10.01.20.0322.450 Metronidazol Tablet 250 mg tablet Tab -
20.01.20.1122.0129 Metronidazol Tablet 500 mg tablet Tab -
10.01.20.0522.0130 Metronidazol larutan Infus 5 mg/ml @100 ml Btl -
10.01.19.0122.0131 Metronidazol syrup 125 mg / 5 ml Btl -
10.01.20.0522.0132 Metilprednisolon 4 mg Tab 70 Tab
10.01.19.0123.0133 Metilprednisolon 16 mg Tab -
10.01.10.0822.0134 Metformin 500 mg Tab 100 tab
30.01.18.0920.0135 Metformin 850 mg Tab -
10.01.19.0321.0136 Metamizole Inj 500mg/ml Amp -
10.01.19.0321.0136 Metamizole Inj 500mg/ml (Norages Injeksi) Amp -
10.01.19.1121.0137 Metamizole Sodium 500mg kaplet Kaplet -
20.01.21.1021.0138 Magnesium Sulfat 20% (MgSo4) Vial -
TOTALSISA
DESEMBER 2022
20.01.21.1021.0139.78J49A Magnesium Sulfat 40% (MgSo4) Vial -

10.01.20.0322.0140 Natrium klorida larutan infus 0,9% steril (NaCl) 500 ml Btl 2 btl
10.01.20.0322.0140 Natrium klorida larutan infus 0,9% steril (NaCl PB) 100 ml Btl -
10.01.19.0722.0141 Nistatin 100.000 iu/g tablet vaginal Tab -
10.01.18.0481.0142 Nistatin 500.000 iu tablet salut Tab -
20.01.22.0923.0142.10429 Nistatin 100.000 iu Drop (Nystin) Botol -
10.01.19.0521.0145.CM66377 Nifedipine Tab Tab -
10.01.19.0521.0145.CM66377 Nifedipine Tab (Adalat Oros) Tab -
10.01.20.0323.0143 Natrium diclofenak 25 mg Tab 100 Tab
10.01.20.0822.0144 Natrium diclofenak 50 mg Tab 30 Tab
30.01.20.0624.0146 Obat batuk hitam (o.b.h) sirup Btl -
20.01.20.0823.0147 Oksitosin injeksi 10 iu/ml - ml Amp -
30.01.20.0721.451 Oksitetrasiklin Salep Kulit Tub -
10.01.19.0222.0148 Oksitetrasiklin Salep Mata Tub -
10.01.19.0921.0149 Omeprazole kapsul/kaplet 20 mg Kap 2 box
10.01.19.0921.0150 Ondansetron Tablet 4 Mg Tab -
10.01.19.0921.0150 Ondansetron Tablet 8 Mg Tab -
10.01.20.0322.0517 Ondansetron Injeksi 2mg / ml Amp -
20.01.21.0322.0151.SCD11749 Parasetamol tetes 100mg/ 0,6 ml Botol 15 ml -
30.01.20.1022.0152 Parasetamol syr 120 mg / 5 ml Btl 10 Botol
30.01.20.0722.0153 Parasetamol tablet 500 mg Tab 100 Tab
30.01.20.0722.0153 Parasetamol tablet 500 mg (Kamolas) Tab -
30.01.20.0624.503 Papeverin 40 mg Tab -
10.01.17.0319.0154 Petidin HCl injeksi 50 mg/ml - 2 ml Amp -
10.01.18.0121.0155 Piridoksin HCl tablet 10 mg Tab -
10.01.18.0121.0316 Piridoksin HCl tablet 25 mg Tab -
10.01.20.0322.0156 Prednison tablet 5 mg Tab 100 Tab
10.01.17.0120.0157 Primakuin tablet 15 mg Tab -
30.01.17.0621.0158 Propiltiourasil tablet 100 mg Tab -
10.01.18.0721.0159 Propranolol HCl tablet 10 mg Tab -
10.01.17.0920.0161 Piracetam Injeksi 1g / 5 ml Vial -
10.01.20.0322.454 Piracetam 800 mg tab Tab -
10.01.18.0220.0162 Pirazinamide 500mg tab tab -
10.01.19.0723.0163 Pirantel Pamoat 125 mg Tab -
30.01.20.0624.505 Pirantel Pamoat 250 mg Tab -
30.01.20.0624.505 Pirantel Pamoat 250 mg (Combantrin) Tab -
30.01.19.0321.0164 Pirantel Pamoat Susp 125mg/5ml btl -
20.01.20.1023.0165.201017 Piroksikam Tab 70 Tab
10.01.20.0723.0178 Permetrin krim Tub -
10.01.20.0723.0178 Permetrin krim (Scabimite 5% ) Tub -
10.01.18.0523.0166 Quinine 222 mg Tab -
10.01.17.0220.0167 Ringer laktat larutan infus steril Btl 3 btl
20.01.18.0523.0293 Ramipril 5 mg Tab -
20.01.20.0822.0168 Ranitidin tablet 150 mg Tab -
10.01.19.1220.0169 Ranitidin Injeksi 25mg/ml amp -
10.01.20.0721.0170.19KG012 Retinol (vitamin A) kapsul 100.000 iu Kap -
10.01.19.0421.0171 Retinol (vitamin A) kapsul 200.000 iu Kap -
10.01.20.0322.455 Rifampisin kaplet 300 mg Tab -
20.01.18.0422.0172 Rifampisin kaplet 600 mg Tab -
10.01.18.0921.0173 Salbutamol tablet 2 mg Tab -
30.01.20.0425.0173 Salbutamol tablet 2 mg (Lasal) Tab -
30.01.17.0721.0174 Salbutamol tablet 4 mg Tab 20 tab
10.01.19.0421.0175 Salbutamol 2mg/5ml Syrup Btl -
10.01.19.0421.0175 Salbutamol/ Salbutamol Sulfate cairan ih 1 mg/mL Botol -
30.01.20.0223.0303 Salbutamol aerosol 100mcg/dosis (Suprasma) Botol -
10.01.19.0019.0176 Salep 2-4 kombinasi Pot -
10.01.18.0420.0177 Salisil bedak 2 % 50 gr Ktk -
20.01.21.0422.0179.4700220 Serum anti bisa ular polivalen inj. 5 ml (abu I) Vial -
10.01.19.0820.0180 Serum anti tatanus inj. 1.500 iu/ampul (a.t.s I ) Amp -
10.01.20.1021.0181 Sianokobalamin (Vit. B12) injeksi 500 mcg/ml Amp -
10.01.19.0923.0182 Sianokobalamin (Vit. B12) tablet 50 mcg Tab -
20.01.21.0622.0183.A8705FX Simvastatin tablet 10 mg Tab 2 box
10.01.19.0520.0184 Simvastatin tablet 20 mg Tab -
10.01.19.0820.0516 Spironolactone 100 mg Tab -
10.01.19.0820.0185 Spironolactone 25 mg Tab -
10.01.19.0321.0186 Tablet tambah darah Tab 200 Tab
10.01.20.0322.456 Tetrasiklin 250 mg Tab -
10.01.19.1021.0187 Tetrasiklin 500 mg Tab -
10.01.20.0420.0188 Tiamin HCl (Vit. B1) inj. 100 mg/ml - 1 ml Amp -
10.01.19.0923.0189 Tiamin HCl monohidrat (Vit. B1) tablet 50 mg Tab -
10.01.18.0920.0190 Triheksifenidil hidroklorida tablet 2 mg Tab -
30.01.20.0623.0190 Triheksifenidil hidroklorida tablet 2 mg (Hexymer) Tab -
30.01.20.1021.0191 Thiamfenikol tab 500 mg Amp -
20.01.20.0622.0192.F90908T Vitamin B kompleks tablet Tab 150 Tab
10.01.18.1219.0194 Wida Bes Infus Btl -
10.01.18.0221.0195 Yodium povidon larutan 10 % 30 ml Btl -
10.01.20.0322.457 Yodium povidon larutan 10 % 60 ml Btl 1 btl
10.01.18.0321.0196 Yodium povidon larutan 10 % 300 ml Btl -
20.08.21.0320.0197.26496044 Zink Tablet 20 mg Tab -
10.01.19.0221.0198 Zinc Sulfate Sirup 20mg/5ml Btl -
GOLONGAN OBAT GIGI
Anastetik Lokal Gigi Kombinasi (Lidocain 2%+epinerin 1:80.000)
30.01.19.1122.0516 Pehacain amp -
30.01.19.1020.0200 Bonding Kotak -

30.01.19.1122.0199 Cholorophenol camphor menthol (chkm) Set -
30.01.19.1020.0200 Cal Excel Kotak -
30.01.19.0422.0201 Calform - RC Kotak -
30.01.19.1220.0202 Ceivtron( tambalan sementara ) ktk -
30.01.19.1220.0202 Composite (Tamball Permanen) A2 Kotak -
30.01.19.1220.0202 A3 Kotak -
TOTALSISA
DESEMBER 2022
30.01.19.0521.0203 Devitalisasi Arsen (Devit Ars) Kotak -

10.01.20.0322.458 Devitalisasi pasta (non arsen) kotak -
30.01.19.0921.0204 Etil klorida semprot Kaleng -
30.01.19.0000.0205 Eugenol cairan Btl -
30.01.19.1121.0206 Elite Cement Kotak -
30.01.19.1121.0206 Etching Kotak -
30.01.19.1121.0514 Flour Kaplet -
30.01.19.1121.0513 Formokresol Botol -
10.01.20.0322.459 kalsium hidroksida pasta tube -
30.01.19.0121.0207 Glass Ionomer Cement (GK-Fuji IX) Kotak -
10.01.20.0322.460 Iodoform paste Ktk -
10.01.20.0322.461 Mummifying pasta / tempophore btl -
30.01.19.0921.0208 Oco ktk -
30.01.19.0921.0515 Resin Set -
30.01.19.0221.0209 Semen Seng Fosfat serbuk dan cairan kotak -
10.01.20.0322.462 Spons gelatin Cubicles 1 x 1 x 1 Cm Ktk -
10.01.20.0322.462 Spongostan Ktk -
10.01.20.0322.463 Temporary stopingfletcher serbuk dan cairan Set -
30.01.19.0000.0210 Trikresol formalin (TKF) cairan Btl -
GOLONGAN OBAT BAHAN HABIS PAKAI
20.01.21.0425.0211.20200420 Alkohol Swab Pcs -
20.01.20.0921.0212 Asam Asetat 6% Btl -
10.01.20.0820.0213 Anti septic Poliwash (Chlorhexidine) Botol -
10.01.18.0221.0214 Aseptic Gel / Hand sanitaizer Botol 1 Btl
20.01.20.0521.440 Antiseptic dan Desinfektan (Odex) Botol -
20.01.20.0521.440 Antiseptic dan Desinfektan Spray (Baymed) Botol
10.01.21.0123.520.XXXXX Blood Lancet Pcs -
20.01.21.0924.0215.1908133 Catgut/benang bedah no.2/0 Plain Sak 3 bks
20.01.20.0421.0215 Catgut/benang bedah no.2/0 Chromic Sak -
20.01.21.0525.0215.2004053 Catgut/benang bedah no.3/0 Plain Sak -
10.01.17.1119.0216 Catgut/benang bedah no. 3/0 chromic Sak -
10.01.19.1223.0217 Disposable Syringe 1 cc pcs -
10.01.19.0423.0218 Disposable Syringe 2,5 cc pcs -
10.01.17.0521.0219 Disposable Syringe 3 cc Pcs -
10.01.17.0322.0223 Elastic band / Perban Elastis 7,5 cm x 1,5 m roll -
10.01.19.0321.0224 Folley catheter no.16 Pcs -
10.01.19.0421.0225 Folley catheter no.18 pcs -
10.01.17.1121.0226 Folley catheter no.20 Pcs -
10.01.19.0823.0227 Infus set anak pcs 7 pcs
20.01.21.1223.0228.19A21L1J Infus set dewasa pcs 8 Pcs
10.01.20.1022.0254 IV Catheter No. 26 G Pcs -
20.01.20.0424.0257 IV Catheter No 20G Pcs -
10.01.19.1022.0258 IV Catheter No 18 G Pcs -
30.01.17.0922.0229 Kapas berlemak 500 gram Bks -
20.01.18.1021.0230 Kapas pembalut/absorben 250 gram Bks -
20.01.20.0222.0231 Kapas pembalut 250 gram Bks -
10.01.19.0223.0232 Kasa kompres 40cm /40 cm Rol -
20.01.21.0525.0233.02062088 Kasa Steril 16x16 cm kotak -
10.01.19.0523.0234 Kasa pembalut 36 m x 80 cm Rol -
20.01.21.1225.0235.xxxxxxxx Kasa pembalut 40 m x 80 cm Rol -
20.01.19.0224.0236 Kasa pembalut 2m x 80 cm Rol -
20.01.19.1020.0237 Kasa Pembalut 40 m x 40 cm Rol -
10.01.18.0422.0238 Kasa pembalut hidrofil 4 m x 10 cm Rol -
20.01.20.0821.0239 Kasa pembalut 4 m x 15 cm Rol -
20.01.21.1225.0240.xxxxxx Kasa Pembalut hidrofil 4 x 3 Rol -
10.01.19.1023.0242 Kasa Pembalut hidrofil 3,6m x 12cm Rol -
10.01.19.1023.0242 Kasa Pembalut hidrofil 3 yard x 5cm Rol -
10.01.19.1023.0242 Kasa Pembalut hidrofil 3 yard x 10cm Rol -
10.01.18.0423.0243 Kasa steril Kasa Steril 10 x 10, 8ply, 1x10's Pcs -
10.01.21.0322.xxxx.xxxxxx Mask Surgical (Earloop/Hijab/Tie On) Pcs -
10.01.21.0322.xxxx.xxxxxx Mask Surgical (Hijab) Pcs -
10.01.21.0322.xxxx.xxxxxx Mask Surgical (Earloop) Pcs -
10.01.19.0125.0249 Masker N95 Pcs -
10.01.21.1122.0247. Mask Nasal Oxygen Cannula Infant (anak) Pcs -
10.01.18.1122.0248 Mask Nasal Oxygen Cannula Adult (dewasa) Pcs -
10.01.19.1022.0250 Nebulizer Masker Infant Pcs -
20.01.21.0523.0251.FY1803071 Nebulizer Masker Adult Pcs 5 pcs
20.01.22.0323.0520.180415 Needle 22 G x 1 1/2 Pcs -
20.01.22.0624.0521.190720 Needle 23 G x 1 1/4 Pcs -
20.01.22.1123.0520.181220 Needle 25 G x 5/8 Pcs -
10.01.19.0622.0252 Optime 2/0 Pcs -
10.01.19.1122.0253 Optime 3/0 Pcs -
10.01.19.1022.0259 Polid Aid / Enzymax Instrument Cleaner 1000 ml Botol -
20.01.22.0524.0518.14061988 Penutup luka Lebar (Hypapix/Dermafix) 15 cm x 10m Bungkus -
20.01.21.1225.0260.A081DROB Pembalut gips 3 inchi Rol -
20.01.20.0122.0261 Pap Smear kit Steril (L) set -
30.01.18.0323.0262 Pap Smear kit Steril (M) set -
10.01.18.0623.0263 Pap Smear kit Steril (S) set -
10.01.18.0922.0264 Pharmafix 15x 500 cm Rol -
30.01.18.0000.0267 Sarung Tangan Non Steril Ukuran S pcs -
20.01.20.0824.0268 Sarung Tangan Non Steril Ukuran M pcs -
20.01.20.0824.0269 Sarung Tangan Non Steril Ukuran L Pcs 5 pcs
TOTALSISA
DESEMBER 2022
30.01.19.0823.0270 Sarung Tangan Steril (Surgical gloves) 7,5 Pair -

30.01.18.0822.0271 Sarung Tangan Steril (Surgical gloves) 6.5 Pair -
10.01.19.0723.0272 Sarung Tangan Steril (Surgical gloves) 7 Pair -
10.01.20.0322.444 Sarung Tangan Steril (Surgical gloves) 8 Pair 2 Pcs
20.01.20.0219.0273 Surgical Blade No 15 Pcs -
10.01.17.0821.0275 Silk (benang bedah sutera) no. 3/0 Box -
30.01.20.0621.0276 Stik Kolesterol Pcs -
30.01.19.1220.0277 Stik Asam Urat Pcs -
30.01.19.0521.0278 Stik Gula Darah Pcs -
20.01.20.0422.436 Spekulum Vagina Ukuran S Set -
20.01.20.1122.437 Spekulum Vagina Ukuran M Set -
20.01.20.0422.438 Spekulum Vagina Ukuran L Set -
10.01.20.0322.445 Steril Lubricant Jelly Botol -
10.01.20.0921.0279 Ultrasonic gel 250 ml Galon -
20.01.18.0523.0280 Umbilical Cord Nylon OM Pcs -
20.01.20.0921.439 Underpad Pcs -
10.01.21.0722.0281.26382013-1 Urine bag Steril Pcs -
10.01.21.0722.0281.26382013-1 VTM (Virus Transport Media) Set -
10.01.22.0623.0519.21071888 Wing Needle No 25 Pcs -
GOLONGAN BMHP POSBINDU
30.01.19.0521.0278 Stik Gula Darah Pcs -
20.01.21.0425.0211.20200420 Alkohol Swab Pcs -
10.01.21.0123.520.XXXXX Blood Lancet Pcs -
GOLONGAN OBAT PROGRAM MALARIA DAN DBD
10.02.19.0621.0314 Artesunate Inj, vial 60 mg / ml vial -
10.02.19.0621.0314 Artesunate Inj, vial 60 mg / ml (Artesun) vial -
10.02.19.0621.0315 Abate (Botol / 1 kg) Botol -
10.02.19.0621.0316 Bactivec Botol -
10.01.21.0123.520.XXXXX Blood Lancet Kotak -
10.02.20.0000.0317 Cynoff 25 UL Botol -
10.01.21.0923.499.GMS1138 Giemsa Botol -
10.01.21.1023.519.IMR1034 Imersion Oil Botol -
10.02.18.0000.0318 Kaca Slide (objek glass frosted 7105 one) Pcs -
10.02.19.0621.0319 Kuinin (kina) tab 222 mg tablet -
10.02.22.0000.0528.0619ID Kelambu Insektisida / LLINS Pcs -
10.02.21.0222.0320.XXXXXXX LABORATORY KID PAKET -
10.02.19.0621.0321 Mikroskop + Box Nikon Eclipse E-100 Unit -
10.02.19.0000.0322 Malation Liter -
10.02.20.1021.0323 Obat Anti Malaria DHP (Dihydroartemisinin) Tablet -
10.02.20.0823.0324.36386001-1 Primakuin tab 15 mg tablet -
10.02.20.0422.0325 Rapid Test Malaria (pf/PAN) combo Test -
10.02.19.0621.0326 RDT DBD Combo TEST $ test
10.02.21.0425.0327.XXXXXXX Slide Box Buah -
10.02.17.0000.0327. Kotak Slide BUAH -
10.02.19.0621.0328 Sipermetrin zeta 15 UL (botol / 5 Liter) Galon -
GOLONGAN OBAT PROGRAM FILARIASIS
10.02.17.0620.0329 Albendazole 400 mg tablet 20 tablet
10.01.20.0322.442 Albendazole 200 mg / 5 ml sirup Botol -
10.02.18.0820.0330 Dietil karbamazepin Sitrat tab 100 mg tablet -
GOLONGAN OBAT PROGRAM TB PARU
10.01.20.0821.500 Catridge TCM / Gene Xpert MTB / RIF Paket -
10.02.19.0824.0333 Masker Surgical pcs -
10.02.22.1123.0333.AP0028 Masker N95 pcs -
10.02.22.0123.0528.K202012050 Masker MEO1L - K TYPE IIR TB Pcs -
20.02.21.0523.0526.A003039 Obat Anti tuberkulosis FDC Kategori Harian Paket -
10.02.21.0722.0334.20PK1052 Obat Anti tuberkulosis FDC I Paket -
10.02.18.0521.0335 Obat Anti tuberkulosis FDC II Paket -
10.02.21.1121.0336.29493062 Obat Anti tuberkulosis Anak Paket -
20.02.21.1022.0335.1810022 Obat Anti TBC FDC Kombipak kategori I Paket -
10.02.19.0120.0338 Pot Sputum pot -
10.02.22.0323.0524.NRT2118D Rifampicin 75 mg/ Isoniazid 50 mg GF Kotak / 84 Tablet Paket -
10.02.22.0723.0525.NIE2120A Rifapentin 300 mg/ Isoniazid 300 mg GF Kotak / 36 Tablet Paket -
10.02.21.0721.0339.LOT023/201 Reagen Zn kit -
GOLONGAN OBAT PROGRAM DIARE
10.02.19.0322.0340 Garam Oralit 200 ml Sac 1 box
10.02.21.1022.0341.26496056 ZINK Tablet 200 mg tablet -
GOLONGAN OBAT PROGRAM ISPA
10.02.18.0720.0342 mineral Mix Pcs 5 box
10.02.18.0720.0343 Pulse Oxtmetri Portable Unit -
10.02.17.0000.0344 Sound Timer Unit -
GOLONGAN OBAT PROGRAM KUSTA
10.02.21.0323.0345.BJW0295 MB.Dewasa blister - -
10.02.21.1122.0345.XXXXXX MB. Anak blister - -
10.02.21.0323.0346.BJX3012 PB.Dewasa blister - -
10.02.19.0820.0347 PB.Anak blister - -
GOLONGAN OBAT PROGRAM IMUNISASI
10.02.21.0224.0348.19002 ADS .0,05 ml Pcs -
10.02.21.0224.0349.19002 ADS.0,5 ml pcs -
10.02.20.0724.0350 ADS 5 ml pcs -
10.02.21.0122.0351.'0379G185 BCG (10 doses) vial -
10.02.19.1221.0352 DT vial -
20.02.21.1221.0353.5041919 DPT-HB-HIB vial -
10.02.21.0922.0354.3652420 HB-PID vial -
20.02.21.0322.0355.C799020 HEPATITIS B DEWASA syringe -
20.02.21.1123.0355.H2MAE0006 HBIG Amp -
TOTALSISA
DESEMBER 2022
10.02.20.1121.0356 IPV Polio vial -

10.02.21.1222.0357.2050320 Polio BOVP 10 doses vial -
10.02.22.0325.0527.GE4177 PCV (Pneumococcal Conjugate Vaccine) vial -
10.02.18.0422.0358 Spidol Pen Marker Pcs -
10.02.20.0000.0359.XXXXXX Safety box Pcs -
10.02.18.1120.0360 Rabies Immune Globulin (Human) Vial -
10.02.18.1120.0360 VAR (Verorab) Vial -
10.02.18.1120.0360 VAR (Rabipur) Vial -
10.02.19.0620.0361 Tuberkulin Inj vial -
20.02.20.0821.0362.04120918 TD vial -
10.02.21.0621.0363.R1F422M2 VAR (Verorab) Amp -
20.02.21.0522.0364.0129N265 Vaksin Measles and Rubella 10 DS vial -
10.02.20.0820.0577 Vaksin Influenza Vial -
10.02.20.0221.0365 Vaksin Meningitis (menivax) Vial -
GOLONGAN OBAT PROGRAM GIZI
10.02.18.1120.0366 Ampisilin Serbuk injeksi i.m/i.v 1000mg vial -
10.02.20.0522.0367 Besi (II) Sulphate (Tablet tambah darah Ibu Nifas) Tab -
10.02.20.0522.0367 Besi (II) Sulphate (Tablet tambah darah Remaja) Tab -
10.02.18.1021.0368 Diazepam injeksi 5 mg/ml Amp -
10.02.18.0520.0369 Fenobarbital 50 mg injeksi Amp -
10.02.18.1021.0370 Gentamisin Sulfat Injeksi 40 mg/ml Amp -
10.02.19.0820.0371 Glukonas Kalsikus 1 gr Amp -
10.01.20.0322.465 Iodine Test Btl -
10.02.18.0820.0372 Mineral Mix Sach 20 sach
10.02.18.1120.0374 Magnesium Sulfat 40% (MgSo4) Btl -
10.01.20.0322.466 MP ASI Biskuit Bks -
10.02.19.0821.0375 Oksitetrasiklin Salep Mata Tub -
10.02.18.0819.0376 Prokain Penisillin 3 juta IU vial -
10.02.18.0420.0377 Phytomenadion 2 mg/ml Amp -
10.02.21.0322.0378.20KC003 Vitamin A 200.000 IU (Retinol) Kap -
10.02.19.0820.0379 Vitamin A 100.000 IU (Retinol) Kap -
GOLONGAN OBAT PROGRAM KIA
10.01.20.0322.467 Ampicillin Injeksi 100 mg Vial -
10.01.20.0322.468 Calsium Gluconas 100 mg/ml Injeksi Amp -
10.02.19.0820.0380 Deteksi tes kehamilan Paket -
10.01.20.0322.469 Diazepam inj 5 mg/ ml amp -
10.01.20.0322.470 Fitomenadion 10 mg/ vit K inj amp -
10.01.22.0523.0069.26803002 Fenobarbital injeksi 50 mg/ml - 2 ml amp -
10.02.19.0820.0381 Glukonas Kalsikus 1 00 mg injeksi Amp -
10.02.22.0123.0371.9620A0046A Glukonas Kalsikus 1 gr Injeksi (10%) amp -
10.01.20.0322.471 Gentamicin 80 mg inj amp -
10.01.20.0322.472 Implant KB buah -
10.01.20.0322.473 IV catheter 18 pcs -
10.02.22.0624.0529.G017M4 Levothyroxine sodium 50 mg (Euthyrox) Tab -
20.01.20.0520.441 Masker Ibu Bersalin Pcs 3 Pcs
10.02.19.1120.0382 Methylergometrin Injeksi 0,2 mg/1 ml Amp -
10.01.20.0322.474 Metil ergometrine Maleat 125 mg tablet tab -
10.01.20.0322.475 Mg Sulfat 20% 25 ml Vial -
10.01.20.0322.476 Mg Sulfat 40% 25 ml Vial -
10.01.22.0424.0130.QX2E104 Metronidazol larutan Infus 5 mg/ml @ 100 ml Vial -
10.01.20.0322.477 Natrium Tiroksin / Tyhrax tab tab -
10.01.20.0322.478 Oksitosin Inj 10 IU 1 ml amp 5 amt
10.01.22.0626.0148.E20989W Oksitetrasiklin Salep Mata Tube -
10.01.20.0322.479 Prokain Penisiline 3 ml unit inj Vial -
10.01.20.0322.480 Progesteron Depot Inj 1 ml Vial -
10.01.20.0322.481 Pil KB Kombinasi cycles 35 cycles
10.01.20.0322.482 Urine Strip strip -
GOLONGAN OBAT PROGRAM JIWA
10.01.20.0322.483 Amitripilin HCL 25 mg tablet tablet -
20.01.22.0223.0191.A00446 Alprazolam HCL 0,5 mg tablet tablet -
10.01.20.0623.0051 Diazepam inj 5 mg/ml - 2 ml Amp -
10.01.20.0322.484 Fluoksetin 10 mg tablet tablet -
10.01.20.0322.485 Haloperidol 0,5 mg Tab -
20.01.22.0822.486.A1917HX Haloperidol 1.5 mg Tab -
10.01.20.0322.487 Haloperidol 5 mg Tab -
10.01.20.0322.488 Haloperidol inj 5 mg/ml ampul -
10.01.20.0322.489 Haloperidol dekanoat inj 50 mg/ml ampul -
10.01.20.0322.490 Imipramin HCL 25 mg tablet tablet -
10.02.19.1120.0383 Karbamazepin 200 mg Tab -
10.01.20.0322.491 Klobazam 10 mg tablet tablet -
10.01.20.0322.492 Klorpromazin 100 mg tablet tablet -
10.01.20.0322.493 Klozapin 25 mg tablet tablet -
10.01.20.0322.494 Metadon HCL 50 mg/5 ml btl 1 L -
10.01.20.0322.495 Risperidon 2 mg Tablet tablet -
10.01.20.0322.496 Triheksifenidil hidroklorida tablet 2 mg Tab -
10.01.22.0322.497.A00442 Trifluoperazine HCL 5 mg tablet tablet -
GOLONGAN OBAT PROGRAM HIV DAN SIFILIS
10.01.20.0421.0418 Azithromicyn 1000mg + Cefixime 400mg Paket -
10.01.20.0421.0419 Benzatin Penicillin 2,4 Juta IU vial -
10.01.20.0421.0420 Blue Tipe (Mikropipet) Pcs -
10.01.20.0421.0421 Efavirenz 600 mg Tab -
10.01.20.0222.0525.B80304J Fluconazole Tab -
10.01.20.0421.0422 Human Hexagon Sypilis Test -
10.01.20.1121.0423.M30161208 Kondom Sutra Pcs -
10.01.20.0421.0424 Lubricant Sutra Pcs -
10.01.20.0421.0425 Latex Sarung Tangan Pcs -
10.01.20.1021.0524.0274501 Mycamine (micafungin) 50 mg amp -
10.01.21.1021.0426.03ADE054A Rapid I (SD Bioline HIV 1/2.) Pcs -
TOTALSISA
DESEMBER 2022
10.01.20.0521.0427.401190912 Rapid 2 HIV Pcs -

10.01.20.0721.0428.1907099 Rapid Test HIV 3 Pcs -
10.01.22.0522.0428.D21007 Rapid Test HCV Pcs -
10.01.21.1021.0426.03ADE054A Alere Determine HIV-1/2 Set -
10.01.21.1021.0426.03ADE054A Alere Determine Combo 20T Set -
10.01.21.0322.0428.BDE151B Rapid Test HCV Test -
20.01.21.0322.0429.C20020 Rapid Test HBSAg Test -
10.01.20.0421.0430 RPR Sypilis Frambusia Trepocheck Syphilis Test -
10.01.20.0421.0430 RPR Sypilis Test -
10.01.21.0721.0431.827001 RPR Sypilis RB Test -
10.01.20.0821.0432.6521513 Swab Desinfektan Pcs -
10.01.20.0421.0432 Swab Desinfektan (Descoderm) Pcs -
10.01.20.0421.0433 Tipe Ukuran 61 Pcs -
10.01.20.0421.0434 Tipe Ukuran 60 Pcs -
10.01.20.0421.0435 Yellow Tipe (mikropipet) Pcs -
GOLONGAN OBAT TAMBAHAN
20.01.18.0523.0282 Asifit Tab -
10.01.18.0821.0283 Atapulgit (New Antides ) Tab -
20.01.20.0122.0284 Aerius Amp -
20.01.20.0122.0284 Bromheksin tablet 8 mg (HUSTAB ) Tab -
10.01.18.0720.0285 Bisacodyl 5 mg Tab -
10.01.18.1122.0286 Bisacodyl suppositoria 10 mg Supp -
10.01.18.1122.0286 Bioplacenton salep Tube -
20.01.18.0523.0287 Counterpain cream tube -
30.01.20.0723.0288 Curcuma FTC Tab -
20.01.18.0523.0289 Cernevit injeksi Vial -
30.01.22.0922.0523.OXO331 Cendo Xitrol Tetes mata Botol -
20.01.18.0523.0289 Cendo Hyalub Tetes mata Botol -
20.01.18.0523.0289 Dextamine Tablet Tab -
20.01.18.0523.0290 Dextamine syr Btl -
20.01.22.1124.0290.46016024 Dextrofen syr Btl -
30.01.20.0624.0504 Ester C Tab -
20.01.18.0523.0291 FG Troches tab -
20.01.19.0421.0292 Hefagard Kap -
20.01.20.0622.0294 Hyosine N Butil Bromide (Spashy) Tab -
20.01.18.0523.0295 Imunos Kap -
30.01.20.0322.501 Imboost Kap -
10.01.20.1022.0296 Kaolin Pektin Syrup (Novadiar syrup ) btl -
10.01.20.1022.0296 Kaolin Pektin Syrup (Envios syrup ) btl -
10.01.20.1022.0296 Kaolin Pektin Syrup (Guanistrip syrup ) btl -
30.01.20.1022.0297 Ketosic Injeksi 30 mg/ ml Amp -
30.01.20.1022.0297 Loperamid tab -
30.01.20.1022.0297 Loperamid (Primordiar) tab -
30.01.20.1022.0297 Loperamid (Colidium) tab -
30.01.17.0422.0298 Levetran salep Pot -
20.01.20.0922.0299 Noza Tab -
20.01.18.0523.0300 Osteotin Tab -
20.01.21.0223.0301.66908005 Obat Flu Batuk Anak (Pimtracol syrup) Botol -
20.01.18.0523.0301 Obat Flu Batuk Anak (Solafluz syrup) Botol -
30.01.20.0424.502 Obat Flu Batuk Anak (Hufagrip Sirup) Btl -
30.01.20.0424.502 Obat Flu Batuk Anak Sirup (Novatusin Syrup) Btl -
20.01.18.0523.0302 Obat Flu Batuk Neonatus (baby Cough) Btl -
20.01.18.0523.0304 Rhinos SR Kaps -
20.01.18.0523.0304 Sakatonik abc tab -
20.01.19.0422.0306 Tensigard Kaps Tab -
30.01.19.0621.0315 Tramadol injeksi -
20.01.18.0523.0307 Thromboflash cream Tube -
20.01.18.0523.0308 Thrombopob Cream tube -
20.01.18.0523.0309 Vitamin Neutropik Injeksi (Neurobion) Ampul -
20.01.18.0523.0309 Vitamin Neutropik (Bioron) Tab -
20.01.21.0822.0310.361800006 Vitamin Tambah Darah (Hemafort) Tab -
20.01.18.0523.0311 Vitamin Anak syrup (Tialisin) btl -
20.01.21.0823.0518.IH249A Vitamin Anak Syrup (Curviplex) btl -
20.01.21.0823.0518.IH249A Vitamin Anak Syrup (Curbexon) btl -
20.01.21.0823.0518.IH249A Vitamin Anak Drop (Solvita) btl -
20.01.18.0523.0312 Vitamin Dewasa (Becefort tablet ) Tab -
10.01.22.0523.0312.52D0794 Vitamin Dewasa (Stimuno tablet ) Tab -
10.01.20.0322.465 Vital Ear Drop Botol -
20.01.21.0622.0313.F90908T Ventolin Nebules 2,5 mg Amp -
20.01.21.0622.0313.F90908T Voltaren Gel Tube -
30.01.19.0621.0314 Valisanbe (Diazepam Inj) Amp -
Mengetahui Kotabaru,…………….
Kepala Puskesmas Pengelola Obat
…………………………. Puskesmas…………………
isi dengan scan ttd kepala pkm dan cap stempel Isi dengan scan tanda tangan pengelola obat
……………………………… …………………………..
Nip……………………………. Nip……………………….

Form So Rutin Labuan Barat 2022

Diunggah oleh

Informasi Dokumen

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

Form So Rutin Labuan Barat 2022

Diunggah oleh

Hak Cipta:

Format Tersedia

LAPORAN STOK OPNAME OBAT, VAKSIN DAN BAHAN MEDIS HABIS PAKAI ( BMHP )STOK KABUPATEN

DINAS KESEHATAN KABUPATEN KOTABARU

JUMLAH PENGELUARAN EXPIRED DATE

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

30.01.19.1020.0200 Bonding Kotak - - - -

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

JUMLAH SISA STOK PER

1 2 3 4 5 6 = 4+5 7=9-8 8 9=6-11 10=9 / 12 bulan 11 12 13 14

SISA STOK 31 DESEMBER TAHUN 2022 EXPIRED DATE

GOLONGAN OBAT GENERIK / ESENSIAL

30.01.20.0624.0511 Fitomenadion (Vit K 1) Injeksi 10mg/ml Amp -

20.01.21.1021.0139.78J49A Magnesium Sulfat 40% (MgSo4) Vial -

30.01.19.1020.0200 Bonding Kotak -

30.01.19.0521.0203 Devitalisasi Arsen (Devit Ars) Kotak -

30.01.19.0823.0270 Sarung Tangan Steril (Surgical gloves) 7,5 Pair -

10.02.20.1121.0356 IPV Polio vial -

10.01.20.0521.0427.401190912 Rapid 2 HIV Pcs -

Anda mungkin juga menyukai