Lplpo 2019

LAPORAN PEMAKA
DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN
KABUPATEN : MALAKA ( PUSKESMAS/PUSTU/POLINDES/LA
PROPINSI : NUSA TENGGARA TIMUR
STOK BULAN LALU

NO. NAMA OBAT SATUAN
AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN
1 2 3 4 5 6 7
1 Analgestik, Antipiretik,Antiinflamasi NonSteroid, Antipirai
1.1 Analgetik Narkotika

1.1.1 Petidin Injeksi 50 mg/ml Ampul
1.2 Analgetik Non Narkotik
1.2.1 Antalgin 500 mg Tablet 0 0 0 0
1.2.2 Antalgin Injeksi 250 mg/ml-2ml Ampul 3 0 3 2
1.2.3 Asam Mefenamat 500 mg Tablet 2000 3000 5000 2500
1.2.4 Ibuprofen SUSPENSI Botol 4 0 4 1
1.2.5 Ibuprofen 400 mg Tablet 0 0 0 0
1.2.6 Natrium Diklofenak 50 mg Tablet 0 500 500 0
1.2.7 Parasetamol 100 mg Tablet 0
1.2.8 Parasetamol 500 mg Tablet 4400 2000 6400 2500
1.2.9 Parasetamol drop 100 mg Botol 6 5 11 11
1.2.10 Parasetamol Syrup 120 mg/ml-2ml Botol 0 0 0 0
1.2.11 Piroksikam 20 mg Tablet 500 1000 1500 900
1:02:12 Ketorolak injeksi Injeksi 9 0 9 -
1.3 Antipirai
1.3.1 Alopurinol 100 mg Tablet 1200 0 1200 1000
1.3.2 Stik Pemeriksaan Asam Urat Strp
2.0 Anestetik
2.1 Anestetik Lokal
2.1.1 Lidokain Hcl injeksi 2 ml Ampul
2.1.2 Lidokain compositum injeksi 2 ml Ampul - 0 - -
2.1.3 Etil Klorida Semprot Botol
2.2 Anestetik Umum & Oksigen
2.2.1 Ketamin Hcl Injeksi 2 ml Vial
2.2.2 Morfin Injeksi 10 mg/ ml Ampul
2.2.3 Oksigen Gas Tabung
STOK BULAN LALU
1 2 3 4 5 6 7
3 Antialergi, Obat anafilaksis dan Kortikosteroid
3.1 Adrenalin/ Epinefrin Injeksi Ampul 12 0 12 6
3.2 Chloramfeniramin Maleat 4 mg (CTM) Tablet 2,500 2000 4,500 1,200
3.3 Deksametason 0,5 mg Tablet 1,100 3000 4,100 1,600
3.4 Deksametason Injeksi 1 ml Ampul 9 30 39 39
3.5 Difenhidramin Hcl Injeksi Ampul 25 30 55 45
3.6 loratadine 10 mg Tablet 450 1000 1,450 1,000
3.7 Prednison 5 mg Tablet 1,000 0 1,000 1,000
3.8 Cetirizine 10 mg Tablet 500 0 500 -
3.9 Cetirizine Syrup Botol 20 10 30 13
3,10 Methylprednisolone 4 mg Tablet 200 0 200 -
4 Antidotum dan Obat Lain Untuk Keracunan
4.1 Magnesium Sulfat injeksi 20%-25ml Ktg 30 mg 1 0 1 -
4.2 Magnesium Sulfat injeksi 40%-25ml Ampul 2 2 4 -
5 Antiepilepsi - Antikonvulsi
5.1 Fenobarbital Inj.50mg/ml-2ml Ampul 34 0 34 -
5.2 Fenobarbital 30 mg Tablet
6 Antelmintik
6.1 Albendazole 100 mg Tablet
6.2 Mebendazol 100 mg Tablet
6.3 Pirantel Pamoat 125 mg Tablet 0 0 0
7 Antifilaria
7.1 Dietilkarbamazin 50 mg Tablet
8 Antibakteri
8.1 Amoksisilin 250 mg Kapsul 500 0 500 400
8.2 Amoksisilin 500 mg Kaplet 1,700 2000 3700 2,900
8.3 Amoksisilin Syrup kering Botol - 0 0 -
8.4 Ampicilin 500 mg Kaplet 500 500 1000 0
8,4.1 Cefixime Kapsul 350 0 350 0
8.5 Cefadroxil 500 mg Tablet 200 500 700 500
8.6 Cefotaxim Inj.1 g Ampul - 0 0 -
8.7 Clyndamicin 300 mg Tablet 200 200 -
8.8 Cyprofloksacin 500 mg Tablet 400 0 400 -
8.9 Doksisiklin Tablet 200 0 200 0
8,10 Erytromicyn Syrup Tablet 18 0 18 4
STOK BULAN LALU
1 2 3 4 5 6 7
8,11 Erytromicyn 500 mg Tablet 300 0 300 100
8.11 Erytromicyn 60 ml Botol 9 0 9 0
8,12 Gentamicin TTS Mata Botol 25 0 25 8
8,13 Kloramfenikol 250 mg Kapsul 840 0 840 -
8,14 Kloramfenikol Salep Mata 1%-5g Tube 5 24 29 10
8,15 Kloramfenikol Tetes Telinga 3%-5ml Botol -
8,15.1 Phenol Gliser Tetes Telinga Botol - 0 - -
8.16 Kotrimoksazol Dewasa Kombinasi 480mg Tablet 600 1000 1,600 1000
8,17 Kotrimoksazol Pediatrik Kombinasi 120 mg Tablet 0 0 - 0
8,18 Kotrimoksazole Suspensi Botol 23 0 23 5
8,19 Metronidaszole 500 mg Tablet 1,000 0 1,000 300
8,20 Oksitetrasiklin Injeksi Vial - 0 - 0
8,21 Oksitetrasiklin Salep Kulit 3 %-5g Tube - 0 - 9
8,22 Oksitetrasiklin Salep Mata 1 %-5g Tube 5 0 5 0
8,23 Salep kulit Bacitrasin Tube 13 0 13 9
8,24 Tetrasiklin 500 mg Kapsul 300 300 0
8,25 Tetrasiklin HCL Kapsul 250 mg Kapsul 200 0 200 0
8.26 Prokain Benzil Penisilin Botol 17 0 17 0
8,27 Thiamfenikol 500 mg Tablet - 0 - 0
9 KUSTA
9.1 Obat Kusta MB Dewasa Blister 0 2 dos 2 dos
9.2 Obat Kusta MB Anak Blister
9.3 Obat Kusta PB Dewasa Blister
9.4 Obat Kusta PB anak Blister
10 Antituberculosis
10.1 OAT Kategori anak Paket
10.2 FDC 1 & III Paket 2 0 2 -
10.3 FDC 2 Paket
10.4 FDC 3 Paket
10.5 Kategor Sisipan Paket
10.6 Sputum pot Buah 15 0 15
10.7 Anisol 100 cc btl/100 cc 1 0 1 -
10.8 Zeil Nelson Paket 0 2 2 2
11 Antifungi
11.1 Gentian Viloet larutan 1% Botol - 10 10 -
11.2 Griseofulvin, micronized 250 mg Tablet
11.3 Kalium Permanganat Serbuk Pot - 0 - 0
11.4 Ketokonazol tab 200 mg Tablet 1,600 0 1,600 300
11.5 Ketokonazol krim 2 % Tube 25 0 25 13
STOK BULAN LALU

1 2 3 4 5 6 7
11.6 Miconazol cream Tube 16 0 16 -
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 0 200 200 -
11.8 Nistatin tablet Vaginal 100.000 IU Tab.Vagina - 100 100 -
11.9 Salep Kulit 2 - 4 % Pot 26 0 26 9
11.10 Salep Kulit 3 - 6 % Pot 22 5 27 -
12 Antimalaria ( Program Malaria )
12.1 Abatte Galon 25 kg

12.2 Artemeter injeksi 80mg/ml Ampul
12.3 Artesunat injeksi 60mg/ml Vial
12.4 ACT tab(ARTERAKINE)/Darpleks Paket 54 0 54 0
12.5 Blood Lancet Pcs 59 0 59 0
12.6 Kina injeksi 25 % - 25 ml Ampul
12.7 Kinina 222 mg/ tablet Tablet 60 0 60
12.8 Primakuin tablet 15 mg Tablet - 0 0
12.9 Rapid Test Malaria dos 390 0 390 0
12,10 Reagen Giemsa 500 cc btl/500 cc - 0 0
12,11 Slide (Obyek gelass) Pcs 0 -
12,11.1 KIT Malaria Paket - 0
12,12 Tisu Rol Roll 7 5 12 8
13 Antimigrein
13.1 Ergotamin 100 mg Tablet 0 0 0 0
14 Anti Anemia dan Roborantia
14.2 Fitommenadion 10 mg ( Vti.K ) Tablet - 0 -
14.3 Fitommenadion injeksi ( Vti.K inj ) Ampul - 0 - 0
14.4 Piridoksin HCl 10 mg Tablet - 0 - 0
14.5 Sianokobalamin 100 mg (Vit B12 ) tab Tablet 2,000 0 2,000 900
14.6 Sianokobalamin Injeksi (Vit B12 ) Ampul 49 50 99 49
14.7 Vitamin B 1 ( Thiamin HCl) 100 mg Tablet 1200 0 1,200 600
14.8 Vitamin B 1 ( Thiamin HCl) Injeksi Ampul 0 0 - 0
14.8.1 vitamin C Tablet 1900 0 1,900 500
14.9 Vitamin B Complek Tablet 1,100 2000 3,100 200
15 Obat - obat Program KIA / Gizi
15.1 Besi (II) Tablet salut kombinasi Tablet 1,440 2000 3,440 940
15.2 Calcium Gluconas Ampul
15.3 Iodiol Kapsul lunak Kapsul
15.4 Iodine Test Botol
15.5 Kalsium Laktat ( Kalak ) Tablet 800 1000 1,800 1,000
15.7 Larutan HCL 0,1 N Set 0 0
STOK BULAN LALU
1 2 3 4 5 6 7
15.9 Mineral Mix Saset
15.10 Natrium Glukonas Inj. Inj.
15.11 Retinol (Vit. A) caps. lunak 100.000 IU Kapsul
15.12 Retinol (Vit. A) caps. lunak 200.000 IU Kapsul
15.14 Urine test kehamilan 3 +++ Ktk 80 50 130 61
16 PROGRAM KB
16.1 Obat Suntik KB 3 bulanan Vial
16.2 Pil KB Kombinasi Strip
16.3 Susuk KB II - 3 tahunan Saset
17 Bahan serta Obat Gigi dan Mulut

17.1 Devitalisasi Paste Pot
17.2 Devitec Free Arsenic Pot
17.3 Eugenol Cairan Kotak 0
17.4 F400 Powder Btl
17.5 Fletcher serbuk + cair Paket
17.6 Fluor tablet 0, 5 mg Tablet
17.7 Fuji IX/glass ionemer/vitro molar Set 0 0 0 0
17.8 Kalsium Hidroksida Paste/Calcidor/hydcal Pot 0 0 0 0
17.9 Ketak Molar Tube
17,10 Monoklorkamfer mentol cairan ( CHKM ) Botol 0 0 0 0
17,11 Semen Seng Posfat serbuk + cairan Pot 0 0 0
17,12 Spongostan dental Use Kotak 0
18 Diuretika
18,1 Furosemida 40 mg Tablet 400 0 400 0
19 Antitiroxin
19.1 Propiltiuurasil 100 mg Tablet 500 500
20 Antidiabetes
20.1 Glibenklamid 5 mg Tablet 500 0 500 0
20.2 Metformin HCL tablet 500 mg Tablet 0 0 0 0
21 Antiseptik dan Desinfektan
21.1 Bayclin cairan 500 ml Botol 1 0 - 0
21.2 Bayclin cairan 1000 ml 0 0
21.3 Etakridin Laktat ( Rivanol ) 300 ml Botol - 5 5 0
STOK BULAN LALU

1 2 3 4 5 6 7
21.4 Etanol 70%(Alkohol ) Botol/300 ml 2 5 7 1
21.5 Lisol Cairan Btl/500 ml 2 0 2
21.6 Povidon Iodida 10%-30 ml Botol 16 0 16 -
21.7 Povidon Iodida 10%- 300 ml Botol - 0 - -
22 Program Promkes
22.1 Kaporit Galon15 kg
23 Program HIV / AIDS

23.1 Acyklovir 400 mg Tablet - 300 300 50
23.2 Acyklovir cream 5% Tube 8 0 8 4
23.3 Determinan Set
23.4 Oncoprobe Dos
23.5 Rapid Test Reagent HIV / AIDS dos 0 0 0
23.6 Reagen HIV 1/2.3 SD Dos/30
23.7 Reagen SIFILIS Dos 1 0 1
24 Antiangina, Antiaritmia, Antihipertensi, Gagal Jantung
24.1 Captopril 25 mg Tablet 600 0 600 200
24.3 HCT 25 mg Tablet
24.4 Isosorbit Dinitrat Sublingual 5 Mg Tablet 0 0
24.5 Nifedipin Tablet - 0 - 100
24.6 Amlodipine 10 mg Tablet - 0 - 0
25 Antiinflamasi dan Antipruritik

25.1 Betametason Salep Kulit Tube 10 0 10 2
25.2 Hidrokortison Salep Kulit 2,5% Tube 14 14 3
25.3 S.K Denomix Tube 15 20 35 22
26 Antiskabies dan Antipedikulosis
26.1 Peditox Botol 0 0 0 -
26.2 Gamexan krim 30 ml Botol
27 Keratolitik dan keratoplastik

27.1 Bedak salisilat serbuk 2 % Kotak - 16 0 -
28 Larutan Elektrolit, Nutrisi dan lain-lain
28.1 Air untuk injeksi 20 ml ampul 5 0 5 -
28.2 AIr untuk injeksi 5 ml ampul 2 0 2
28.3 Aqua dest steril 1000 ml Botol 0 0
28.4 Garam oralit 200 ml Sachet 0 0 0 45
28.5 Glukosa lar.infus 10%-25ml Flakon
STOK BULAN LALU
1 2 3 4 5 6 7
28.5 Glukosa lar.infus 5%-500 ml hitung dlu Flakon 10 0 10 4
28.6 NaCl 0,9%-500 ml lar.infus Flakon 24 - 24 5
28.7 Ringer laktat lar. 500 ml Flakon 18 40 58 18
28.8 Zinc Tablet 800 500 1,300 300
29 Oksitosik dan Relaksan uterus

29.1 Metilergometrin 0,200 mg inj. Ampul 19 0 19 16
29.2 Metilergometrin Maleat 0,125 mg Tablet 400 0 400 100
29.3 Oksitosin injeksi Ampul 51 0 51 4
30 Sedativa
30.1 Diazepam Injeksi 10mg/ml-2ml Ampul 0 5 5 -
30.2 Diazepam 2 mg Tablet
30.3 Diazepam 5 mg Injeksi Injeksi 10 0 10
30.4 Stesolid rektal 10mg Tube 10 0 10 0
31 Antidepresi dan Antimania

31,1 Halloperidol 0.5 mg Tablet 100 0 100
31,2 Karbamazepin tablet 200 mg Tablet 0 0 0
32 Antipsikosis
32.1 Klorpromazin HCl 25 mg Tablet
32,2 Klorpromazin HCl 100 mg Tablet
33 Antasida dan Antiulkus

33.1 Antasida DOEN 500 mg Tablet 400 1000 1,400 300
33.2 Antasida DOEN Suspensi Botol 4 0 4 -
33.3 Cimetidine 200 mg Tablet 400 0 400 -
33.4 Natrium Bikarbonat tablet Tablet 500 0 500
33.5 Omeprazole 20 mg Tablet 630 0 630 420
33.6 Ranitidin 150 mg Tablet - 500 500 -
33.7 Ranitidin Injeksi Ampul 0 0 0 -
34 AntiDiare
34.1 New Antides Tablet 500 0 500 100
34.2 Loperamid tablet 2 mg Tablet
35 Antispasmodik
35,1 Atropin Injeksi 1 ml Ampul
35,2 Extrak Beladona 10 mg Tablet
STOK BULAN LALU

1 2 3 4 5 6 7
35,3 Papaverin tablet Tablet 500 0 500 0
36 Antiasma
36.1 Aminofilin 24 mg Injeksi Ampul 0 0 0
36.2 Aminofilin 200 mg Tablet 1,900 0 1900 -
36.5 Efedrin 25 mg Tablet 500 0 500
36.6 Salbutamol 4 mg Tablet 1,600 0 1600 600
37 Antitusive dan Expectoran
37,1 Ambroxol 30 mg Tablet 800 1000 1,800 700
37,2 Ambroxol Syrup 60 ml Botol 0 10 10 0
37,3 Glyseril Guayakolat 100 mg Tablet 600 0 600 -
37.4 Kodein 10 mg Tablet - 0 - -
38 Antiemetik
38.1 Domperidon tablet Tablet 300 0 300 200
38,2 Domperidon Syrup Botol 6 0 6 3
38.3 Ondansetron 4 mg Tablet 72 0 72 36
38.4 Ondancentron injeksi ampul 15 0 15 -
38.5 Metoklorpramid tab Tablet 0 0 0 0
39 Rantai Dingin (Chold Chain)
39.1 Serum anti bisa ular polivalen inj. 5 ml (ABU I) Vial 2 0 2 0
39.2 Serum anti Tetanus inj. 1.500 IU/amp. (ATS) Ampul 2 0 2 0
39.3 Sumbu chold chain wick aladin Buah
39.4 Vaksin BCG Vial
39.5 Vaksin Campak Vial
39.6 Vaksin DPT Vial
39.7 Vaksin DPT-HB Vial
39,8 Vaksin DT Vial
39,9 Vaksin Hepatitis B 0.5 Vial
39,10 Vaksin Meningitis Vial
39,11 Vaksin Polio Vial
39,12 Vaksin Rabies Kering untuk manusia Vial
39,13 Vaksin TT Vial
40 Alat - alat kesehatan
40.1 Abocath no 18 Pcs 13 50 63 54
40.2 Abocath no 20 Pcs 21 50 71 38
40.3 Abocath no 22 Pcs 40 0 40 18
40.4 Abocath no 24 Pcs 24 0 24 0
STOK BULAN LALU
1 2 3 4 5 6 7
40.5 Bisturi No. 10 Pcs 0 0 0 2
40.6 Cat gut chromic No.2/0 - 3/0 Set 12 24 36 12
40.7 Cat gut plain No.2/0 - 3/0 Set 10 24 34 18
40.8 Disposible 1 ml Pcs 88 0 88 21
4.11 Folley Catheter 2 way no. 18 pcs 10 0 10 0
4.11.1 Jelly Kateter Tube 5 0 5 0
4.12 Hanschoen no:6,5 Psg 35 0 35 3
4.13 Hanschoen no:7 Buah 11 50 61 11
4.14 Hanschoen no:7,5 Buah 11 50 61 54
4.15 Sarung Tangan Panjang no.7 psg 32 0 32
4.16 Handshoen Sensi Pcs - 0 0 0
4.17 Infus set Anak Pcs 31 0 31 6
4.18 Infus set Dewasa Pcs 31 0 31 27
4.19 Kain kasa roll panjang 40 X 80 Roll 1 0 1 1
4.20 Kapas pembalut / adsorben 250 g Roll 2 0 2 1
4.21 Kasa pembalut hidrofil 16 X 16 cm ( steril ) Kotak 24 35 59 42
4.22 Kasa Pembalut hidrofil 18 x 22 cm Roll 0
4.23 Kasa Hidrofil 4 x 10 cm Roll - 50 50 30
4.24 Kantong Urine Dewasa Psc 9 0 9 0
4.25 Masker Mulut Pcs 550 0 550 300
4.26 Plester 5 yard X 2 Inchi Roll 3 0 3 3
4.27 Silk (benang bedah sutera) no. 3/0 Set 19 36 55 0
4.28 Transfusi set Set -
4.29 Kasa Kompres 16 x 16 pca
41 Anti Kolesterol
41.1 Simvastin tablet Tablet 0 0 0
42 Antihemaroid
42.1 Laktulosa Syrup 333 mg Botol 0 0 2
42.2 Antihemaroid suppositoria Supp 20 0 20 -
STOK BULAN LALU

1 2 3 4 5 6 7
42 Lain - lain
42.1 Fenol Gliseril TT Botol
42.2 Plastik Klips uk. 6 x 4 (kecil) Pak 200 0 200 100
42.3 Plastik Klips uk. 8 x 5 (sedang) Pak 100 0 100 100
42.4 Plastik Klips uk. 11 x 17 (besar) Pak 200 0 200 200
42.5 Reagen Golongan Darah Set 0 0 1 0
42.6 Stik Pemeriksaan Cholestrol strip
42.7 Syphilis Test Card Pcs 1 1 1
42.9 selang Suction bayi
TOTAL
KUNJUN
JUMLAH KUNJUNGAN UMUM KTP KIS
Mengetahui/Menyutujui Mengetahui
Kepala Dinas Kesehatan Kab. Malaka Kepala Puskesmas
drg. Paskalia Frida Fahik Blasius Bria Nahak,SKM.

NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )
: PUSKESMAS WEKMIDAR BULAN : DESEMBER

MAS/PUSTU/POLINDES/LAINNYA) TAHUN : 2018
EXPIRE SISA TOTAL STOK

HARGA PERMINTAA
PEMBERIAN
DATE STOK SATUAN HARGA OPTIMUM N DAK/DAU JAMKESMAS BUFFER DLL
8 9 10 11 12 13 14 15 16 17
Oct-21 0 120 - 1,150 3000

1 34.5 30
Jan-20 2500 139 347,500 3000
3 10
0 171 - 575 3000
Jun-19 500 211 - 1,150 3000
Oct-19 3900 96 240,000 2,300 2000

Sep-18 0 - 30
Apr-19 0 1,425 - - 30
Feb-19 600 200 180,000 3000
9
Jan-20 200 100 100,000 3000

1
- 1,635
Jun-20 - 2,308 - 30
- 2
5
HARGA PERMINTAA
PEMBERIAN
8 9 10 11 12 13 14 15 16 17
6
Jun-20 3,300 48 57,600 1,150 2000
Nov-20 2,500 75 120,000 1,150 3000
Apr-19 - 1,897 73,983 23 30
10 1,469 34.5 30
Nov-18 450 185 185,000 230 1000
Sep-20 - 100 100,000 2,300 3000
500 157 - 575 2000
17 8,431 109,603 10
Jul-20 200 240 -
-
1 6,000 -
4 6,000 -
34 - -
- 190 -
-
-
- - -
- - -
362 0 50
-
-
- - -
-
-
Jun-20 100 224 89,600 1,500 2000
800 288 835,200 1,150 3000
Oct-20 - 5 16.5 30
1,000 - 500
350
May-20 200 618 309,000 1,150 500
- 4,918 - 2
200 720 -
Jun-20 400 700 - 575
Aug-20 200 336 -
14 7,575 30,300
HARGA PERMINTAA
PEMBERIAN
8 9 10 11 12 13 14 15 16 17
Dec-19 200 0 0 575
9
17 5,020
Oct-21 840 590 - 552
Jan-00 19 1,990 19,900 24 24
- 10
- 10
Sep-19 600 166 166,000 1,150 1000
Oct-18 - 110 - 500
Sep-19 18 2,590 12,950 11.5 20
Nov-20 700 176 52,800 575 1000
- 9,100 - 10
Aug-19 - 4,800 43,200 24
Jun-18 5 4,800 - 24
Jul-18 4 3,019 27,171 24
Jul-20 300 357 - 575
200 270 - 575
17
Jun-18 - 88 575
-
2
-
-
-
-
-
-
Jul-20 2 -
-
-
-
15 2,548 -
1 175,000 2
LAB
-
10 2,220 -
May-18 - 263 500
Jun-18 - 7,290 -
Jan-20 1,300 380 114,000 575
12

HARGA PERMINTAA
PEMBERIAN
8 9 10 11 12 13 14 15 16 17
Jun-20 16 4,060 -
200 768 - 575
100 628 -
Jun-19 17 2,400 21,600 27.6
Jun-20 27 7,291 -
- -
-
-
Aug-19 54 4,400 - 10
59 150 -
- -
60 804
- 293 - 100
390 36,000
-
305,555
4 4,990 39,920 5.75 5

-
162 - 500
-
Apr-19 - 200
Oct-20 - 4,100 - 30
Feb-19 - 24 -
Apr-21 1,100 60 54,000 2,300 2000
Feb-20 50 1,150 56,350 57.5 100
Dec-19 600 88 52,800 2000
- 7,100 - 1,600 30
1,400 2000
Jun-19 2,900 144 28,800 2,300 1000
-
Sep-19 2,500 60 56,400 2000
- -
-
-
Oct-18 800 75 75,000 2,300 1000
150,000 -
HARGA PERMINTAA
PEMBERIAN
8 (1) 10 11 12 13 14 15 16 17
-
-
-
-
Jan-18 69 1,939 118,279 57.5 50
-
-
-
-
-
-
-
- 373,630
-
Apr-19 56,200 -
- 765,000
-
362,720 -
275,000 -
-
75,000 -
150,000 -
- 77,000
-
-
400 100
-
500 383 -
-
500 70 0
Apr-19 - 3,450 - 115 500
-
0 - 18,560 0 5
- 17,000 -
Sep-18 5 3,900 - 5

HARGA PERMINTAA
PEMBERIAN
DATE SATUAN HARGA OPTIMUM N DAK/DAU JAMKESMAS BUFFER DLL
STOK
8 9 10 11 12 13 14 15 16 17
Feb-20 6 21,500 21,500
Oct-18 2 41,000 - 5
16 2,900
Sep-19 - 17,006 - 23
-
-
- -
-
-
250 - 1000
Apr-19 4 3,818 15,272 23 10
-
-
- 2 dos
- 2 dos
1
-
400 82 - 1,000 2000
May-21 - 470 -
Jul-19 107 -
Jul-20 139 13,900
- 168 - 300
-
-
May-19 8 1,444 2,888 28.75
Aug-20 11 1,860 5,580
13
-
- 4,760 11.5 5
-
-
-
Sep-18 16 1,450 -
-
5 2,400
2
Aug-19 18,000 -
278 12,510 100
- 6,840
HARGA PERMINTAA
PEMBERIAN
STOK
8 9 10 11 12 13 14 15 16 17
Feb-19 6 6,840 27,360
Apr-19 19 5,640 28,200
40 6,240 112,320
Sep-18 1,000 568 170,400 500
-
-
3 6,074 20
300 185
47 880 3,520 11.5
-
-
5 5
100 100
10 146
10 69,520 -
-
-
100 71
- 333
-
- 100
- 100
-
-
Aug-19 1,100 85
4
Mar-19 400 110 -
500 73
Aug-20 210 184 77,280 690 600
500 140 -
- 20
400 219 575

- 100
-
-
- 38

HARGA PERMINTAA
PEMBERIAN
STOK
8 9 10 11 12 13 14 15 16 17
Oct-19 500 170 -
-
230
Sep-17 1,900 -
500 190 7,379
Jul-21 1,000 95 57,000 1,700 500
-
Aug-21 1,100 300 210,000 575 2000
10 4,450 - 30
Oct-19 600 48 - 575 3000
18-Sep - 688 100
-
Jun-20 100 144 28,800
3 3,450 10,350 10
Aug-19 36 590 21,240
15
Apr-20 - 130 -
-
Aug-18 2 636,360 -
Jun-18 2 186,370 -
-
-
-
-
-
-
-
-
-
-
-
Apr-21 9 3,800 205,200 50 50

Mar-21 33 3,800 144,400 50
Apr-21 22 3,800 68,400 50 50
Apr-21 24 3,800 - 50 50
HARGA PERMINTAA
PEMBERIAN
STOK
8 9 10 11 12 13 14 15 16 17
- 3,181 6,362
May-21 24 5,583 66,996 27.6
May-21 16 5,583 100,494 27.6 24
Feb-00 67 1,540 32,340
Sep-20 10 650 65,000 115 100
54 750 -
63 750 -
Jan-21 10 8,000 -
5
Jun-21 32 6,985 20,955 25
Jan-21 50 6,985 25
Sep-18 7 6,985 377,190 50
Jun-20 32 31,550
- 583 115 500
Jan-20 25 3,500 21,000
4 3,200 86,400 50
- 105,000 105,000 5.75 4
1 12,500 12,500 2 4
17 5,800 243,600 57.5 30
- 5,900 -
20 1,500 45,000 57.5 50
9 3,000 -
250 330 99,000 575 300
Jul-19 - - 2 5
Sep-18 55 3,055 - 41.4
- 3,600 -
- 5,500
-
Sep-18 136
-
May-20 20 3,806 - 20

HARGA PERMINTAA
PEMBERIAN
STOK
8 9 10 11 12 13 14 15 16 17
- 1,200
100 591 5,910 575
- 3,909 39,090 575
- 10,864 217,280 690
515,000 1
- 1
1
- 5
KUNJUNGAN JUMLAH
ASKES BPJS JAMKESMAS JKN GRATIS
Wekmidar, 31 Desember 2018

Yang Menerima/Melapor
Pengelola Obat Pusk.
a Nahak,SKM. Elisabeth E. Bano, Amd. kep

624 199603 1 004
KODE UNIT PELAYANAN : 5306010201
SUMBER DANA
PAD NON
PAD JKN PAD BHP SILPA DAU KET
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
SUMBER DANA
PAD NON
KAPITASI
18 19 20 21 22 23 24
Betun,……………………..
Yang Menyerahkan
Petugas IFK Malaka
(………………………………………..)
Nip.
DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN : PUSKESMAS WEKMIDAR BULAN : JANUARI
KABUPATEN : MALAKA ( PUSKESMAS/PUSTU/POLINDES/LAINNYA) TAHUN : 2019
STOK TOTAL
BULAN LALU EXPIRE SISA HARGA STOK SUMBER DANA
NO. NAMA OBAT SATUAN PERMINTAAN PEMBERIAN
SATUAN JAMKES PAD NON
AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN DATE STOK HARGA OPTIMUM DAK/DAU BUFFER DLL PAD JKN PAD BHP SILPA DAU KET
MAS KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1.2.1 Antalgin 500 mg Tablet 0 1000 1000 0 Oct-21 1000 120 - 1,150
1.2.2 Antalgin Injeksi 250 mg/ml-2ml Ampul 1 30 31 1 30 34.5
1.2.3 Asam Mefenamat 500 mg Tablet 2500 3000 5500 500 Jan-20 5000 139 347,500
1.2.4 Ibuprofen SUSPENSI Botol 3 10 13 5 8 20
1.2.5 Ibuprofen 400 mg Tablet 0 0 0 0 0 171 - 575 3000
1.2.6 Natrium Diklofenak 50 mg Tablet 500 1000 1500 0 Jun-19 1500 211 - 1,150 1000
1.2.7 Parasetamol 100 mg Tablet 0 0 0 0 0
1.2.8 Parasetamol 500 mg Tablet 3900 500 4400 1600 Oct-19 2800 96 240,000 2,300 2000
1.2.9 Parasetamol drop 100 mg Botol 0 0 0 0 Sep-18 0 - 30
1.2.10 Parasetamol Syrup 120 mg/ml-2ml Botol 0 0 0 0 Apr-19 0 1,425 - - 30
1.2.11 Piroksikam 20 mg Tablet 600 3000 3600 600 Feb-19 3000 200 180,000 2000
1:02:12 Ketorolak injeksi Injeksi 9 0 9 1 8
1.3 Antipirai
1.3.1 Alopurinol 100 mg Tablet 200 3000 3200 Jan-20 3200 100 100,000 3000
1.3.2 Stik Pemeriksaan Asam Urat Strp 1
2.0 Anestetik
2.1 Anestetik Lokal
2.1.1 Lidokain Hcl injeksi 2 ml Ampul - 1,635
2.1.2 Lidokain compositum injeksi 2 ml Ampul - 20 20 - Jun-20 20 2,308 - 20
2.1.3 Etil Klorida Semprot Botol 0 0 0 - 2
2.2.2 Morfin Injeksi 10 mg/ ml Ampul 5

STOK TOTAL
MAS KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
3.1 Adrenalin/ Epinefrin Injeksi Ampul 6 0 6 - 6 20
3.2 Chloramfeniramin Maleat 4 mg (CTM) Tablet 3,300 2000 5300 1,200 Jun-20 4100 48 57,600 1,150 500
3.3 Deksametason 0,5 mg Tablet 2,500 3000 5500 2,800 Nov-20 2700 75 120,000 1,150 3000
3.4 Deksametason Injeksi 1 ml Ampul - 30 30 11 Apr-19 19 1,897 73,983 23 30
3.5 Difenhidramin Hcl Injeksi Ampul 10 0 10 6 4 1,469 34.5 30
3.6 loratadine 10 mg Tablet 1350 2000 3350 550 2800 185 185,000 230 1000
3.7 Prednison 5 mg Tablet - 500 500 100 Sep-20 400 100 100,000 2,300 3000
3.8 Cetirizine 10 mg Tablet 500 2000 2500 - 2500 157 - 575 1000
3.9 Cetirizine Syrup Botol 17 10 27 1 26 8,431 109,603 10
3,10 Methylprednisolone 4 mg Tablet 200 0 200 - Jul-20 200 240 -
4.1 Magnesium Sulfat injeksi 20%-25ml Ktg 30 mg 1 0 1 - 1 6,000 -
4.2 Magnesium Sulfat injeksi 40%-25ml Ampul 4 0 4 - 4 6,000 -
5.1 Fenobarbital Inj.50mg/ml-2ml Ampul 34 0 34 - 34 - -
5.2 Fenobarbital 30 mg Tablet 0 190 -
6 Antelmintik
6.1 Albendazole 100 mg Tablet 0 0 - -
6.2 Mebendazol 100 mg Tablet 0 0 - -
6.3 Pirantel Pamoat 125 mg Tablet 0 0 0 0 362 0 50
7 Antifilaria
7.1 Dietilkarbamazin 50 mg Tablet 0 0 - -
8 Antibakteri -
8.1 Amoksisilin 250 mg Kapsul 100 2000 2100 - Jun-20 2100 224 89,600 1,500 1000
8.2 Amoksisilin 500 mg Kaplet 800 3000 3800 1,500 2300 288 835,200 1,150 2000
8.3 Amoksisilin Syrup kering Botol - 0 0 - Oct-20 0 5 16.5 30
8.4 Ampicilin 500 mg Kaplet 1,000 0 1000 100 900 - 500
8,4.1 Cefixime Kapsul 350 0 350 0 350
8.5 Cefadroxil 500 mg Tablet 200 500 700 100 May-20 600 618 309,000 1,150 1000
8.6 Cefotaxim Inj.1 g Ampul - 0 0 - 0 4,918 - 2
8.7 Clyndamicin 300 mg Tablet 200 0 200 100 100 720 -
8.8 Cyprofloksacin 500 mg Tablet 400 0 400 100 Jun-20 300 700 - 575
8.9 Doksisiklin Tablet 200 0 200 0 Aug-20 200 336 -
8,10 Erytromicyn Syrup 60 ml Botol 9 0 9 - 9 7,575 30,300

STOK TOTAL
MAS KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
8,11 Erytromicyn 500 mg Tablet 200 0 200 100 Dec-19 100 0 0 575
8.11 Erytromicyn 60 ml Botol 9 0 9 0 9
8,12 Gentamicin TTS Mata Botol 17 0 17 - 17 5,020 24
8,13 Kloramfenikol 250 mg Kapsul 740 0 740 140 Oct-21 600 590 - 552
8,14 Kloramfenikol Salep Mata 1%-5g Tube 18 24 42 2 Jan-00 40 1,990 19,900 24
8,15 Kloramfenikol Tetes Telinga 3%-5ml Botol - 10 10 4 6 10
8,15.1 Phenol Gliser Tetes Telinga Botol - 0 0 - 0 10

Kotrimoksazol Dewasa Kombinasi 480mg 1100
8.16 Tablet 900 1000 1900 800 Sep-19 166 166,000 1,150 2000
8,17 Kotrimoksazol Pediatrik Kombinasi 120 mg Tablet 0 0 0 0 Oct-18 0 110 - 500
8,18 Kotrimoksazole Suspensi Botol 18 20 38 29 Sep-19 9 2,590 12,950 11.5 20
8,19 Metronidaszole 500 mg Tablet 700 1000 1700 0 Nov-20 1700 176 52,800 575 1000
8,20 Oksitetrasiklin Injeksi Vial - 0 0 0 0 9,100 - 10
8,21 Oksitetrasiklin Salep Kulit 3 %-5g Tube - 0 0 0 Aug-19 0 4,800 43,200 24
8,22 Oksitetrasiklin Salep Mata 1 %-5g Tube 4 25 29 4 Jun-18 25 4,800 -
8,23 Salep kulit Bacitrasin Tube 4 0 4 4 Jul-18 0 3,019 27,171 24
8,24 Tetrasiklin 500 mg Kapsul 300 0 300 0 Jul-20 300 357 - 575
8,25 Tetrasiklin HCL Kapsul 250 mg Kapsul 200 0 200 100 100 270 - 575
8.26 Prokain Benzil Penisilin Botol 17 0 17 0 17
8,27 Thiamfenikol 500 mg Tablet - 0 0 0 Jun-18 0 88 575
9 KUSTA
9.1 Obat Kusta MB Dewasa Blister 0 2 dos 2 dos 2
9.2 Obat Kusta MB Anak Blister -
9.3 Obat Kusta PB Dewasa Blister -
9.4 Obat Kusta PB anak Blister -
10 Antituberculosis
10.1 OAT Kategori anak Paket -
10.2 FDC 1 & III Paket 2 0 2 - Jul-20 2 -
10.3 FDC 2 Paket -
10.4 FDC 3 Paket -
10.5 Kategor Sisipan Paket -
10.6 Sputum pot Buah 15 0 15 15 2,548 -
10.7 Anisol 100 cc btl/100 cc 1 0 1 - 1 175,000 2
11 Antifungi
11.1 Gentian Viloet larutan 1% Botol 10 0 10 - 10 2,220 -
11.2 Griseofulvin Tablet May-18 0 263 500
11.3 Kalium Permanganat Serbuk Pot - 0 - 0 Jun-18 0 7,290 -
11.4 Ketokonazol tab 200 mg Tablet 1,300 0 1300 - Jan-20 1300 380 114,000 575
11.5 Ketokonazol krim 2 % Tube 12 0 12 3 9 24

11.6 micronized 250 mg tablet 500
STOK TOTAL
MAS KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
11.6 Miconazol cream Tube 16 0 16 - Jun-20 16 4,060 -
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 200 0 200 100 100 768 - 575 500
11.8 Nistatin tablet Vaginal 100.000 IU Tab.Vagina 100 0 100 - 100 628 -
11.9 salep 2-4 Pot 17 0 17 4 Jun-19 13 2,400 21,600 27.6
11.10 Salep Kulit 3 - 6 % Pot 20 0 20 5 Jun-20 15 7,291 -
12.1 Abatte Galon 25 kg - 0 - - 0 -
12.2 Artemeter injeksi 80mg/ml Ampul 0 0 0 0 0
12.3 Artesunat injeksi 60mg/ml Vial 0 0 0 0 0
12.4 ACT tab(ARTERAKINE)/Darpleks Paket 54 0 54 0 Aug-19 54 4,400 - 10
12.5 Blood Lancet Pcs 59 0 59 0 59 150 -
12.6 Kina injeksi 25 % - 25 ml Ampul - 0 0 0 0 -
12.7 Kinina 222 mg/ tablet Tablet 60 0 60 0 60 804
12.8 Primakuin tablet 15 mg Tablet 100 0 100 0 100 293 -
12.9 Rapid Test Malaria dos 250 0 250 0 250 36,000
12,10 Reagen Giemsa 500 cc btl/500 cc - 0 0 0 0
12,11 Slide (Obyek gelass) Pcs - 0 0 0 0 305,555
12,11.1 KIT Malaria Paket - 0 0 0 0
12,12 Tisu Rol Roll 4 5 9 2 7 4,990 39,920 5.75 5
13 Antimigrein
13.1 Ergotamin 100 mg Tablet 0 0 0 0 0 162 - 500
14.2 Fitommenadion 10 mg ( Vti.K ) Tablet - 200 200 100 Apr-19 100 - 500
14.3 Fitommenadion injeksi ( Vti.K inj ) Ampul - 20 20 10 Oct-20 10 4,100 - 20
14.4 Piridoksin HCl 10 mg Tablet - 0 0 0 Feb-19 0 24 - 500
14.5 Sianokobalamin 100 mg (Vit B12 ) tab Tablet 1,100 0 1100 400 Apr-21 700 60 54,000 2,300 3000
14.6 Sianokobalamin Injeksi (Vit B12 ) Ampul 50 20 70 30 Feb-20 40 1,150 56,350 57.5 50
14.7 Vitamin B 1 ( Thiamin HCl) 100 mg Tablet 600 2000 2700 600 Dec-19 2100 88 52,800 2000
14.8 Vitamin B 1 ( Thiamin HCl) Injeksi Ampul 0 10 10 6 4 7,100 - 1,600 10
14.8.1 vitamin C Tablet 1400 2000 3400 300 3100
14.9 Vitamin B Complek Tablet 2,900 1000 3900 700 Jun-19 3200 144 28,800 2,300
15.1 Besi (II) Tablet salut kombinasi Tablet 2,500 2000 4500 1,100 Sep-19 3400 60 56,400
15.2 Calcium Gluconas Ampul - -
15.3 Iodiol Kapsul lunak Kapsul -
15.4 Iodine Test Botol -
15.5 Kalsium Laktat ( Kalak ) Tablet 800 2000 2,800 100 Oct-18 2700 75 75,000 2,300
15.7 Larutan HCL 0,1 N Set 0 0 150,000 -

STOK TOTAL
MAS KAPITASI
1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
15.9 Mineral Mix Saset -
15.10 Natrium Glukonas Inj. Inj. -
15.11 Retinol (Vit. A) caps. lunak 100.000 IU Kapsul -
15.14 Urine test kehamilan 3 +++ Ktk 69 100 169 - Jan-18 169 1,939 118,279 57.5
16 PROGRAM KB
17.1 Devitalisasi Paste Pot - 373,630
17.2 Devitec Free Arsenic Pot -
17.3 Eugenol Cairan Kotak Apr-19 56,200 -
17.5 Fletcher serbuk + cair Paket - 765,000
17.6 Fluor tablet 0, 5 mg Tablet -
17.7 Fuji IX/glass ionemer/vitro molar Set 0 0 0 0 362,720 -
17.8 Kalsium Hidroksida Paste/Calcidor/hydcal Pot 0 0 0 0 275,000 -
17.9 Ketak Molar Tube -
17,10 Monoklorkamfer mentol cairan ( CHKM ) Botol 0 0 0 0 75,000 -
17,11 Semen Seng Posfat serbuk + cairan Pot 0 0 0 150,000 -
17,12 Spongostan dental Use Kotak 0 - 77,000
18 Diuretika
18,1 Furosemida 40 mg Tablet 400 0 400 200 200 100
19 Antitiroxin
19.1 Propiltiuurasil 100 mg Tablet 500 500 500 383 -
20 Antidiabetes
20.1 Glibenklamid 5 mg Tablet 500 0 500 0 500 70 0
20.2 Metformin HCL tablet 500 mg 200 0 200 200 0 Apr-19 200 3,450 - 115
21.1 Bayclin cairan 500 ml Botol - 2 2 1 1 18,560 0 5
21.2 Bayclin cairan 1000 ml 0 0 0 0 0 17,000 -
21.3 Etakridin Laktat ( Rivanol ) 300 ml Botol 5 5 10 0 Sep-18 10 3,900 -

STOK TOTAL
SATUAN PAD NON
AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN DATE HARGA OPTIMUM DAK/DAU JAMKESMASBUFFER DLL PAD JKN PAD BHP SILPA DAU KET
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
21.4 Etanol 70%(Alkohol ) Botol/300 ml 6 5 11 5 Feb-20 6 21,500 21,500
21.5 Lisol Cairan Btl/500 ml 2 0 2 2 Oct-18 0 41,000 - 5
21.6 Povidon Iodida 10%-30 ml Botol 16 0 16 11 5 2,900 30
21.7 Povidon Iodida 10%- 300 ml Botol - 0 0 - Sep-19 0 17,006 - 23 10
22 Program Promkes
22.1 Kaporit Galon15 kg - -
23.1 Acyklovir 400 mg Tablet 250 500 750 150 600 -
23.2 Acyklovir cream 5% Tube 4 10 14 4 Apr-19 10 3,818 15,272 23 10
23.3 Determinan Set -
23.4 Oncoprobe Dos -
23.5 Rapid Test Reagent HIV / AIDS dos 0 0 0 - 2 dos
23.6 Reagen HIV 1/2.3 SD Dos/30 - 2 dos
23.7 Reagen SIFILIS Dos 1 0 1 1
24.1 Captopril 25 mg Tablet 400 1000 1400 300 1100 82 - 1,000
24.3 HCT 25 mg Tablet May-21 - 470 -
24.4 Isosorbit Dinitrat Sublingual 5 Mg Tablet 0 0 Jul-19 107 -
24.5 Nifedipin Tablet - 0 0 0 Jul-20 0 139 13,900
24.6 Amlodipine 10 mg Tablet - 0 0 0 - 168 - 500
25.1 Betametason Salep Kulit Tube 8 0 5 2 May-19 3 1,444 2,888 28.75 24
25.2 Hidrokortison Salep Kulit 2,5% Tube 11 0 11 5 Aug-20 6 1,860 5,580 24
25.3 S.K Denomix Tube 13 0 13 5 8 24
25.4 s.K Skabies Tube 5 0 5 3 2
26.1 Peditox Botol 0 5 5 - 5 4,760 11.5
26.2 Gamexan krim 30 ml Botol 0
27.1 Bedak salisilat serbuk 2 % Kotak 16 0 16 6 Sep-18 10 1,450 -
28.1 Air untuk injeksi 20 ml ampul 5 0 5 - 5 2,400
28.2 AIr untuk injeksi 5 ml ampul 2 0 2 2
28.3 Aqua dest steril 1000 ml Botol 0 0 Aug-19 18,000 -
28.4 Garam oralit 200 ml Sachet 0 0 0 45 278 12,510 100
28.5 Glukosa lar.infus 10%-25ml Flakon - 6,840

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
28.5 Glukosa lar.infus 5%-500 ml Flakon 6 0 6 0 Feb-19 6 6,840 27,360 ED 25
28.6 NaCl 0,9%-500 ml lar.infus Flakon 19 - 19 6 Apr-19 13 5,640 28,200 20
28.7 Ringer laktat lar. 500 ml Flakon 40 0 40 - 40 6,240 112,320
28.8 Zinc Tablet 1000 500 1500 100 Sep-18 1400 568 170,400 1000
29.1 Metilergometrin 0,200 mg inj. Ampul 3 0 3 - 3 6,074 20
29.2 Metilergometrin Maleat 0,125 mg Tablet 300 0 300 - 300 185
29.3 Oksitosin injeksi Ampul 47 10 57 - 57 880 3,520 11.5
30 Sedativa
30.1 Diazepam Injeksi 10mg/ml-2ml Ampul 5 5 10 - 10
30.2 Diazepam 2 mg Tablet 100 100
30.3 Diazepam 5 mg Injeksi Injeksi 10 0 10 10 146
30.4 Stesolid rektal 10mg Tube 10 0 10 0 10 69,520 -
31,1 Halloperidol 0.5 mg Tablet 100 0 100 100 71
31,2 Karbamazepin tablet 200 mg Tablet 0 0 0 - 333
32 Antipsikosis
32.1 Klorpromazin HCl 25 mg Tablet - 100
32,2 Klorpromazin HCl 100 mg Tablet - 100
33.1 Antasida DOEN 500 mg Tablet 1,100 0 1100 900 Aug-19 200 85 1000
33.2 Antasida DOEN Suspensi Botol 4 0 4 - 4 20
33.3 Cimetidine 200 mg Tablet 400 0 400 100 Mar-19 300 110 -
33.4 Natrium Bikarbonat tablet Tablet 500 0 500 500 73
33.5 Omeprazole 20 mg Tablet 210 600 810 450 Aug-20 360 184 77,280 690 1200
33.6 Ranitidin 150 mg Tablet 500 0 500 200 300 140 - 500
33.7 Ranitidin Injeksi Ampul 0 20 20 5 15 20
34 AntiDiare
34.1 New Antides Tablet 400 0 400 100 300 219 575
34.2 Loperamid tablet 2 mg Tablet - 100
35 Antispasmodik
35,1 Atropin Injeksi 1 ml Ampul -
35,2 Extrak Beladona 10 mg Tablet - 38

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
35,3 Papaverin tablet Tablet 500 0 500 200 Oct-19 300 170 -
36 Antiasma
36.1 Aminofilin 24 mg Injeksi Ampul 0 0 0 230
36.2 Aminofilin 200 mg Tablet 1,900 0 1900 100 Sep-17 1800 -
36.5 Efedrin 25 mg Tablet 500 0 500 500 190 7,379
36.6 Salbutamol 4 mg Tablet 1,000 500 1500 100 Jul-21 1400 95 57,000 1,700 1000
37,1 Ambroxol 30 mg Tablet 1,100 2000 3100 500 Aug-21 2600 300 210,000 575
37,2 Ambroxol Syrup 60 ml Botol 10 30 40 7 33 4,450 - 20
37,3 Glyseril Guayakolat 100 mg Tablet 600 3000 3600 600 Oct-19 3000 48 - 575
37.4 Kodein 10 mg Tablet - 100 100 - 18-Sep 100 688
38 Antiemetik
38.1 Domperidon tablet Tablet 100 0 100 0 Jun-20 100 144 28,800
38,2 Domperidon Syrup Botol 3 0 3 2 1 3,450 10,350 30
38.3 Ondansetron 4 mg Tablet 72 0 72 36 Aug-19 36 590 21,240
38.4 Ondancentron injeksi ampul 15 0 15 1 14
38.5 Metoklorpramid tab Tablet 0 0 0 0 Apr-20 0 130 -
39.1 Serum anti bisa ular polivalen inj. 5 ml (ABU I) Vial 2 0 2 0 Aug-18 2 636,360 -
39.2 Serum anti Tetanus inj. 1.500 IU/amp. (ATS) Ampul 2 0 2 0 Jun-18 2 186,370 -
39.3 Sumbu chold chain wick aladin Buah -
39.4 Vaksin BCG Vial -
39.5 Vaksin Campak Vial -
39.6 Vaksin DPT Vial -
39.7 Vaksin DPT-HB Vial -
39,8 Vaksin DT Vial -
39,9 Vaksin Hepatitis B 0.5 Vial -
39,10 Vaksin Meningitis Vial -
39,11 Vaksin Polio Vial -
39,12 Vaksin Rabies Kering untuk manusia Vial -
39,13 Vaksin TT Vial -
40.1 Abocath no 18 Pcs 9 50 59 5 Apr-21 54 3,800 205,200 50
40.2 Abocath no 20 Pcs 33 50 83 38 Mar-21 45 3,800 144,400 50
40.4 Abocath no 24 Pcs 24 50 74 24 Apr-21 50 3,800 - 50

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
40.5 Bisturi No. 10 Pcs 0 0 0 0 0 3,181 6,362 100
40.6 Cat gut chromic No.2/0 - 3/0 Set 24 0 24 0 May-21 24 5,583 66,996 27.6 24
40.7 Cat gut plain No.2/0 - 3/0 Set 16 24 40 25 May-21 15 5,583 100,494 27.6 24
40.8 Disposible 1 ml Pcs 67 0 67 12 Feb-00 55 1,540 32,340
40.9 Disposible 3 ml Pcs 10 100 110 31 Sep-20 79 650 65,000 115 100
4.1 Disposible 5 ml Pcs 54 0 54 16 38 750 -
4.2 Disposible 10 ml Pcs - 0 0 0 0 750 -
4.11 Folley Catheter 2 way no. 18 pcs 10 0 10 0 Jan-21 10 8,000 -
4.11.1 Jelly Kateter Tube 5 0 5 1 4
4.12 Hanschoen no:6,5 Psg 32 50 82 0 Jun-21 82 6,985 20,955 20
4.13 Hanschoen no:7 Buah 50 50 100 13 Jan-21 87 6,985 20
4.14 Hanschoen no:7,5 Buah 7 50 57 7 Sep-18 50 6,985 377,190 20
4.15 Sarung Tangan Panjang no.7 psg 32 0 32 Jun-20 32 31,550
4.16 Handshoen Sensi Pcs - 500 500 0 500 583 115
4.17 Infus set Anak Pcs 25 0 25 0 Jan-20 25 3,500 21,000
4.18 Infus set Dewasa Pcs 27 50 77 24 53 3,200 86,400
4.19 Kain kasa roll panjang 40 X 80 Roll - 4 4 0 4 105,000 105,000 5.75
4.20 Kapas pembalut / adsorben 250 g Roll 1 4 5 0 5 12,500 12,500 2
4.21 Kasa pembalut hidrofil 16 X 16 cm ( steril ) Kotak 17 20 37 0 37 5,800 243,600 57.5
4.22 Kasa Pembalut hidrofil 18 x 22 cm Roll 0 0 5,900 -
4.23 Kasa Hidrofil 4 x 10 cm Roll 20 50 70 0 70 1,500 45,000 57.5
4.24 Kantong Urine Dewasa Psc 9 0 9 0 9 3,000 -
4.25 Masker Mulut Pcs 250 300 550 0 550 330 99,000 575
4.26 Plester 5 yard X 2 Inchi Roll - 5 5 0 Jul-19 5 - 2
4.27 Silk (benang bedah sutera) no. 3/0 Set 55 0 55 0 Sep-18 55 3,055 - 41.4
4.28 Transfusi set Set - - 3,600 -
4.29 Kasa Kompres 16 x 16 pca - 5,500
41 Anti Kolesterol
41.1 Simvastin tablet Tablet 0 0 0 Sep-18 136
42 Antihemaroid
42.2 Antihemaroid suppositoria Supp 20 0 20 - May-20 20 3,806 - 20

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
42 Lain - lain
42.1 Fenol Gliseril TT Botol 0 1,200
42.2 Plastik Klips uk. 6 x 4 (kecil) Pak 100 0 100 100 0 591 5,910 575 500
42.3 Plastik Klips uk. 8 x 5 (sedang) Pak 0 0 0 0 0 3,909 39,090 575 500
42.4 Plastik Klips uk. 11 x 17 (besar) Pak 300 0 300 100 200 10,864 217,280 690 500
42.5 Reagen Golongan Darah Set 0 1 1 0 1 515,000
42.6 Stik Pemeriksaan Cholestrol strip - 0 0 - 0 1
42.7 Syphilis Test Card Pcs 2 0 2 - 2
42.9 selang Suction bayi 0 0 0 - 0 5
TOTAL
KUNJUNGAN JUMLAH
JUMLAH KUNJUNGAN UMUM KTP KIS ASKES BPJS JAMKESMAS JKN GRATIS
Wekmidar, 31 Januari 2019
Mengetahui/Menyutujui Mengetahui Yang Menerima/Melapor Betun,……………………..
Kepala Dinas Kesehatan Kab. Malaka Kepala Puskesmas Pengelola Obat Puskesmas Yang Menyerahkan
Petugas IFK Malaka
drg. Paskalia Frida Fahik Blasius Bria Nahak,SKM. Imelda Marni H. Nahak, Amd. Kep (………………………………………..)
NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004 Nip.

DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN : PUSKESMAS WEKMIDAR BULAN : FEBRUARI
STOK TOTAL
SATUAN PAD NON
AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN DATE STOK HARGA OPTIMUM DAK/DAU JAMKESMAS BUFFER DLL PAD JKN PAD BHP SILPA DAU KET
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1.2.1 Antalgin 500 mg Tablet 1000 0 1000 900 Oct-21 100 120 - 1,150 5000
1.2.2 Antalgin Injeksi 250 mg/ml-2ml Ampul 30 0 30 17 13 34.5 50
1.2.3 Asam Mefenamat 500 mg Tablet 5000 0 5000 2600 Jan-20 2400 139 347,500 5000
1:02:12 Ketorolak injeksi Injeksi 8 0 8 2 6 20
1.3 Antipirai
1.3.1 Alopurinol 100 mg Tablet 3200 500 3700 0 Jan-20 3700 100 100,000 3000
1.3.2 Stik Pemeriksaan Asam Urat Strp 0 0 0 - 0 2
2.0 Anestetik
2.1 Anestetik Lokal
2.1.1 Lidokain Hcl injeksi 2 ml Ampul - 1,635
2.1.2 Lidokain compositum injeksi 2 ml Ampul 20 0 20 - Jun-20 20 2,308 -
2.1.3 Etil Klorida Semprot Botol 0 0 0 0 - 2

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
3.1 Adrenalin/ Epinefrin Injeksi Ampul 6 6 - 6 20 ED
3.2 Chloramfeniramin Maleat 4 mg (CTM) Tablet 4,100 500 4600 900 Jun-20 3700 48 57,600 1,150 2000
3.4 Deksametason Injeksi 1 ml Ampul 19 30 49 43 Apr-19 6 1,897 73,983 23 100
3.5 Difenhidramin Hcl Injeksi Ampul 4 30 34 4 30 1,469 34.5
3.6 loratadine 10 mg Tablet 2800 150 2950 500 2450 185 185,000 230 2000
3.7 Prednison 5 mg Tablet 400 3000 3400 1,400 Sep-20 2000 100 100,000 2,300 2000
3.8 Cetirizine 10 mg Tablet 2,500 1000 3500 700 2800 157 - 575 2000
3.9 Cetirizine Syrup Botol 26 10 36 2 34 8,431 109,603
4.2 Magnesium Sulfat injeksi 40%-25ml Ampul 4 0 4 - 4 6,000 -
6 Antelmintik
7 Antifilaria
8 Antibakteri -
8.1 Amoksisilin 250 mg Kapsul 2100 1000 3100 - Jun-20 3100 224 89,600 1,500
8.2 Amoksisilin 500 mg Kaplet 2,300 1000 3300 3,200 100 288 835,200 1,150 5000
8.4 Ampicilin 500 mg Kaplet 900 500 1400 900 500 - 500
8,4.1 Cefixime Kapsul 350 0 350 0 350
8.7 Clyndamicin 300 mg Tablet 100 0 100 50 50 720 - 200
8.8 Cyprofloksacin 500 mg Tablet 300 0 300 200 Jun-20 100 700 - 575 500
8,10 Erytromicyn Syrup 60 ml Botol 9 0 9 4 5 7,575 30,300

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
8,11 Erytromicyn 500 mg Tablet 100 0 100 100 Dec-19 0 0 0 575 500
8.11 Erytromicyn 60 ml Botol 9 0 9 0 9
8,12 Gentamicin TTS Mata Botol 17 24 41 12 29 5,020
8,13 Kloramfenikol 250 mg Kapsul 600 0 600 - Oct-21 600 590 - 552
8,14 Kloramfenikol Salep Mata 1%-5g Tube 40 0 40 15 Jan-00 25 1,990 19,900 - 20
8,15 Kloramfenikol Tetes Telinga 3%-5ml Botol 6 20 26 22 4 20

Kotrimoksazol Dewasa Kombinasi 480mg 2200
8.16 Tablet 1100 2000 3100 900 Sep-19 166 166,000 1,150 3000
8,18 Kotrimoksazole Suspensi Botol 9 20 29 5 Sep-19 24 2,590 12,950 11.5
8,19 Metronidaszole 500 mg Tablet 1,700 1000 2700 100 Nov-20 2600 176 52,800 575
8,22 Oksitetrasiklin Salep Mata 1 %-5g Tube 25 0 25 10 Jun-18 15 4,800 - 24
8,23 Salep kulit Bacitrasin Tube - 0 0 0 Jul-18 0 3,019 27,171 24
8,25 Tetrasiklin HCL Kapsul 250 mg Kapsul 100 0 100 100 0 270 - 575
9 KUSTA
10 Antituberculosis
10.2 FDC 1 & III Paket 2 0 2 - Jul-20 2 -
10.3 FDC 2 Paket -
10.4 FDC 3 Paket -
10.6 Sputum pot Buah 15 0 15 15 2,548 -
10.7 Anisol 100 cc btl/100 cc 1 0 1 - 1 175,000 2
11 Antifungi
11.2 Griseofulvin Tablet - May-18 0 263 500
11.4 Ketokonazol tab 200 mg Tablet 1,300 0 1300 100 Jan-20 1200 380 114,000 575
11.5 Ketokonazol krim 2 % Tube 9 25 34 9 25

11.6 micronized 250 mg tablet 500
STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
11.6 Miconazol cream Tube 16 0 16 4 Jun-20 12 4,060 -
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 100 0 100 100 0 768 - 575 1000
11.9 salep 2 - 4 Pot 13 0 13 9 Jun-19 4 2,400 21,600 27.6 24
12.1 Abatte Galon 25 kg - 0 - - 0 -
12.5 Blood Lancet Pcs 59 0 59 0 59 150 -
12.7 Kinina 222 mg/ tablet Tablet 60 0 60 0 60 804
12,12 Tisu Rol Roll 7 0 7 0 7 4,990 39,920 5.75 5
13 Antimigrein
14.2 Fitommenadion 10 mg ( Vti.K ) Tablet 100 0 100 100 Apr-19 0 - 2000
14.3 Fitommenadion injeksi ( Vti.K inj ) Ampul 10 20 30 10 Oct-20 20 4,100 - 0
14.4 Piridoksin HCl 10 mg ( Vit. B 6) Tablet - 500 500 200 Feb-19 300 24 - 2000
14.5 Sianokobalamin 100 mg (Vit B12 ) tab Tablet 700 0 700 600 Apr-21 100 60 54,000 2,300 4000
14.8.1 vitamin C Tablet 3100 0 3100 600 2500 1000
14.9 Vitamin B Complek Tablet 3,200 0 3200 2200 Jun-19 1000 144 28,800 2,300 3000
15.1 Besi (II) Tablet salut kombinasi Tablet 3,400 0 3400 1,300 Sep-19 2100 60 56,400 3000
15.5 Kalsium Laktat ( Kalak ) Tablet 2,700 0 2,700 600 Oct-18 2100 75 75,000 2,300 3000
15.7 Larutan HCL 0,1 N Set 0 0 150,000 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
15.14 Urine test kehamilan 3 +++ Ktk 169 0 169 25 Jan-18 144 1,939 118,279 57.5
16 PROGRAM KB
18 Diuretika
19 Antitiroxin
20 Antidiabetes
20.2 Metformin HCL tablet 500 mg 200 200 0 200 100 Apr-19 100 3,450 - 115
21.1 Bayclin cairan 500 ml Botol 1 2 3 0 3 18,560 0
21.3 Etakridin Laktat ( Rivanol ) 300 ml Botol 10 0 10 0 Sep-18 10 3,900 - ED JAN 2019
STOK TOTAL
SATUAN PAD NON
AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN DATE HARGA OPTIMUM DAK/DAU JAMKESMAS BUFFER DLL PAD JKN PAD BHP SILPA DAU KET
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
21.5 Lisol Cairan Btl/500 ml - 2 2 0 Oct-18 2 41,000 -
21.6 Povidon Iodida 10%-30 ml Botol 5 30 35 11 24 2,900
21.7 Povidon Iodida 10%- 300 ml Botol - 5 5 1 Sep-19 4 17,006 - 23
22 Program Promkes
23.1 Acyklovir 400 mg Tablet 600 0 600 0 600 -
23.8 Reagen test HBsAg Dos 0 2 2 2
24.1 Captopril 25 mg Tablet 1,100 0 1100 500 600 82 - 1,000 4000
24.3 HCT 25 mg Tablet May-21 - 470 -
25.2 Hidrokortison Salep Kulit 2,5% Tube 6 24 30 10 Aug-20 20 1,860 5,580
25.3 Salep Denomix Tube 8 0 8 1 7 24
25.4 Salep Skabies Tube 2 0 2 - 2
26.1 Peditox Botol 5 0 5 - 5 4,760 11.5
28.2 AIr untuk injeksi 5 ml ampul 2 0 2 2 0

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
28.5 Glukosa lar.infus 5%-500 ml Flakon - 0 0 0 Feb-19 0 6,840 27,360 25 ED
28.6 NaCl 0,9%-500 ml lar.infus Flakon 13 20 33 10 Apr-19 23 5,640 28,200
28.7 Ringer laktat lar. 500 ml Flakon 40 0 40 34 6 6,240 112,320 20
28.8 Zinc Tablet 1400 1000 2400 600 Sep-18 1800 568 170,400 2000
29.1 Metilergometrin 0,200 mg inj. Ampul 3 20 23 2 21 6,074
29.3 Oksitosin injeksi Ampul 57 0 57 38 19 880 3,520 11.5 20
30 Sedativa
30.2 Diazepam 2 mg Tablet 100 100
32 Antipsikosis
33.1 Antasida DOEN 500 mg Tablet 200 1000 1200 800 Aug-19 400 85 5000
33.2 Antasida DOEN Suspensi Botol 4 20 24 8 16 20
33.3 Cimetidine 200 mg Tablet 300 0 300 - Mar-19 300 110 -
33.5 Omeprazole 20 mg Tablet 360 1200 1800 450 Aug-20 1350 184 77,280 690 2400
33.6 Ranitidin 150 mg Tablet 300 0 300 - 300 140 - 2000
33.7 Ranitidin Injeksi Ampul 15 20 35 1 34
34 AntiDiare
34.1 New Antides Tablet 300 0 300 - 300 219 575
35 Antispasmodik

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
36 Antiasma
36.2 Aminofilin 200 mg Tablet 1,800 0 1800 - Sep-17 1800 -
37,1 Ambroxol 30 mg Tablet 2,600 0 2600 900 Aug-21 1700 300 210,000 575 2000
37,2 Ambroxol Syrup 60 ml Botol 33 20 53 2 51 4,450 -
37,3 Glyseril Guayakolat 100 mg Tablet 3,000 0 2000 600 Oct-19 1400 48 - 500 2000
37.4 OBH Botol - 0 0 - 0 10
37.5 Kodein 10 mg Tablet 100 0 100 - 18-Sep 100 688
38 Antiemetik
38.1 Domperidon tablet Tablet 100 0 100 100 Jun-20 0 144 28,800 1000
38.3 Ondansetron 4 mg Tablet 36 0 36 36 Aug-19 0 590 21,240 360
40.2 Abocath no 20 Pcs 45 0 45 9 Mar-21 36 3,800 144,400 50
40.4 Abocath no 24 Pcs 50 50 100 5 Apr-21 95 3,800 -

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
40.5 Bisturi No. 10 Pcs 0 0 0 0 0 3,181 6,362 100
40.6 Cat gut chromic No.2/0 - 3/0 Set 24 24 48 14 May-21 34 5,583 66,996 27.6
40.7 Cat gut plain No.2/0 - 3/0 Set 15 24 39 0 May-21 39 5,583 100,494 27.6
4.12 Hanschoen no:6,5 Psg 82 50 132 1 Jun-21 131 6,985 20,955
4.13 Hanschoen no:7 Buah 87 50 137 12 Jan-21 125 6,985
4.14 Hanschoen no:7,5 Buah 50 50 100 22 Sep-18 78 6,985 377,190
4.16 Handshoen Sensi Pcs 500 0 500 200 300 583 115
4.19 Kain kasa roll panjang 40 X 80 Roll 4 0 4 0 4 105,000 105,000 5.75
4.21 Kasa pembalut hidrofil 16 X 16 cm ( steril ) Kotak 37 0 37 28 9 5,800 243,600 57.5 30
4.25 Masker Mulut Pcs 550 0 550 14 536 330 99,000 575
4.26 Plester 5 yard X 2 Inchi Roll 5 0 5 0 Jul-19 5 - 2
41 Anti Kolesterol
41.1 Simvastin tablet Tablet 0 0 0 Sep-18 136
42 Antihemaroid

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
42 Lain - lain
42.5 Reagen Golongan Darah Set 1 0 1 1 0 515,000 2 set
42.6 Stik Pemeriksaan Cholestrol strip - 0 0 - 0 1
42.8 Selang 02 Nasal Kanul 0 0 0 - 0 10
42.9 Selang 02 masker 0 0 0 - 0 5
TOTAL
KUNJUNGAN JUMLAH
Wekmidar, 28 Februari 2019
Petugas IFK Malaka
NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004 Nip.

DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN : PUSKESMAS WEKMIDAR BULAN : MARET

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1:02:12 Ketorolak injeksi Injeksi 6 10 16 6 10 20
1.3 Antipirai
1.3.2 Stik Pemeriksaan Asam Urat Strp 0 2 Box 2 Box - 2 Box
2.0 Anestetik
2.1 Anestetik Lokal
2.1.1 Lidokain Hcl injeksi 2 ml Ampul 0 0 0 - 0 1,635
2.1.2 Lidokain compositum injeksi 2 ml Ampul 20 0 20 14 Jun-20 6 2,308 - 40

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
3.1 Adrenalin/ Epinefrin Injeksi Ampul 6 10 16 6 10 20 ED
3.6 loratadine 10 mg Tablet 2450 500 2950 650 Apr-19 2300 185 185,000 230 2000
3.7 Prednison 5 mg Tablet 2,000 2000 4000 - Sep-20 4000 100 100,000 2,300 2000
3.9 Cetirizine Syrup Botol 34 34 9 25 8,431 109,603 20
4.2 Magnesium Sulfat injeksi 40%-25ml Ampul 4 0 4 - 4 6,000 - 5 ED
6 Antelmintik
7 Antifilaria
8 Antibakteri -
8.1 Amoksisilin 250 mg Kapsul 3100 3100 1,900 Jun-20 1200 224 89,600 1,500
8,4.1 Cefixime Kapsul 350 0 350 0 350
Cefadroxil 250 mg Tablet 0 500 500 100 400 3000
8.7 Clyndamicin 300 mg Tablet 50 0 50 - 50 720 - 500
8.8 Cyprofloksacin 500 mg Tablet 100 0 100 100 Jun-20 0 700 - 575 2000
8.9 Doksisiklin Tablet 200 0 200 0 Aug-20 200 336 - 500
8,10 Erytromicyn Syrup 60 ml Botol 5 0 5 2 3 7,575 30,300 10

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
8,11 Erytromicyn 500 mg Tablet - 0 0 0 Dec-19 0 0 0 575 500
8,12 Gentamicin TTS Mata Botol 29 0 29 2 27 5,020 10
8.16 Kotrimoksazol Dewasa Kombinasi 480mg Tablet 2200 1000 3200 600 Sep-19 2600 166 166,000 1,150 3000
8,19 Metronidaszole 500 mg Tablet 2,600 0 2600 1100 Nov-20 1500 176 52,800 575 1000
8,25 Tetrasiklin HCL Kapsul 250 mg Kapsul - 0 0 0 0 270 - 575
9 KUSTA
10 Antituberculosis
10.2 FDC 1 & III Paket 2 0 2 - Jul-20 2 -
10.3 FDC 2 Paket -
10.4 FDC 3 Paket -
10.6 Sputum pot Buah 15 0 15 15 2,548 -
10.7 Anisol 100 cc btl/100 cc 1 0 1 - 1 175,000 2
11 Antifungi
11.6 Micronized 250 mg tablet 500

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
11.6 Miconazol cream Tube 12 0 12 - Jun-20 12 4,060 - 24
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 100 500 600 - 600 768 - 575 1000
11.9 salep 2 - 4 Pot 4 24 28 10 Jun-19 18 2,400 21,600 27.6 24
11.10 Salep Kulit 3 - 6 % Pot 14 0 14 6 Jun-20 8 7,291 - 24
12.1 Abatte Galon 25 kg - 0 - - 0 -
12.5 Blood Lancet Pcs 59 0 59 0 59 150 -
12.7 Qunine 222 mg/ tablet Tablet 60 0 60 0 60 804
12,12 Tisu Rol Roll 7 0 7 2 5 4,990 39,920 5.75 10
13 Antimigrein
14.4 Piridoksin HCl 10 mg ( Vit. B 6) Tablet 300 2000 2300 200 Feb-19 2100 24 - 2000
14.5 Sianokobalamin 100 mg (Vit B12 ) tab Tablet 100 0 100 100 Apr-21 0 60 54,000 2,300 5000
14.8.1 vitamin C Tablet 2500 1000 3500 900 2600 1000
15.7 Larutan HCL 0,1 N Set 0 0 150,000 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
15.14 Urine test kehamilan 3 +++ Ktk 169 0 169 25 Jan-18 144 1,939 118,279 57.5
16 PROGRAM KB
18 Diuretika
19 Antitiroxin
20 Antidiabetes
20.2 Metformin HCL tablet 500 mg 200 100 0 100 100 Apr-19 0 3,450 - 115 2000
21.1 Bayclin cairan 500 ml Botol 3 0 3 2 1 18,560 0 5
21.3 Etakridin Laktat ( Rivanol ) 300 ml Botol - 0 0 0 Sep-18 0 3,900 - 20 ED JAN 2019
STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
21.4 Etanol 70%(Alkohol ) Botol/300 ml 3 0 3 1 Feb-20 2 21,500 21,500 10
21.5 Lisol Cairan Btl/500 ml 2 2 0 Oct-18 2 41,000 -
21.6 Povidon Iodida 10%-30 ml Botol 24 0 24 - 24 2,900
21.7 Povidon Iodida 10%- 300 ml Botol - 5 5 1 Sep-19 4 17,006 - 23
22 Program Promkes
23.1 Acyklovir 400 mg Tablet 600 0 600 100 500 - 500
24.1 Captopril 25 mg Tablet 600 1000 1600 400 1200 82 - 1,000 4000
24.3 HCT 25 mg Tablet May-21 - 470 -
24.5 Nifedipin Tablet - 0 0 0 Jul-20 0 139 13,900 2000
25.3 Salep Denomix Tube 7 0 7 7 0 24
25.4 Salep Skabimite Tube 2 0 2 1 1 24
26.1 Peditox Botol 5 0 5 - 5 4,760 11.5
27.1 Bedak salisilat serbuk 2 % Kotak 5 0 5 5 Sep-18 0 1,450 - 20
28.2 AIr untuk injeksi 5 ml ampul 2 0 2 2 0

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
28.5 Glukosa lar.infus 5%-500 ml Flakon - 0 0 0 Feb-19 0 6,840 27,360 25
28.7 Ringer laktat lar. 500 ml Flakon 6 20 26 - 26 6,240 112,320
28.8 Zinc Tablet 1800 1000 2800 - Sep-18 2800 568 170,400 2000
29.1 Metilergometrin 0,200 mg inj. Ampul 21 0 21 - 21 6,074
30 Sedativa
30.2 Diazepam 2 mg Tablet 100
32 Antipsikosis
33.1 Antasida DOEN 500 mg Tablet 400 2000 2400 600 Aug-19 1800 85 5000
33.3 Cimetidine 200 mg Tablet - 0 0 - Mar-19 0 110 - 1000
33.5 Omeprazole 20 mg Tablet 1,350 600 1950 300 Aug-20 1650 184 77,280 690 600
33.6 Ranitidin 150 mg Tablet 300 1000 1300 300 1000 140 - 2000
33.7 Ranitidin Injeksi Ampul 34 0 34 10 24 20
34 AntiDiare
35 Antispasmodik

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
35,3 Papaverin tablet Tablet 200 0 200 100 Oct-19 100 170 - 500
36 Antiasma
37,3 Glyseril Guayakolat 100 mg Tablet 1,400 1000 2400 1,300 Oct-19 1100 48 - 500 2000
37.4 OBH Botol - 10 10 2 8 10
38 Antiemetik
38.3 Ondansetron 4 mg Tablet 0 360 360 60 Aug-19 300 590 21,240 240
40.1 Abocath no 18 Pcs 90 50 140 0 Apr-21 140 3,800 205,200 50 0
40.2 Abocath no 20 Pcs 36 50 86 1 Mar-21 85 3,800 144,400 50 0

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
40.5 Bisturi No. 10 Pcs 0 0 0 0 0 3,181 6,362 100
40.8 Disposible 1 ml Pcs 22 0 22 6 Feb-00 16 1,540 32,340 100
4.1 Disposible 5 ml Pcs 30 0 30 7 23 750 - 300
4.25 Masker Mulut Pcs 536 0 536 36 500 330 99,000 575
4.26 Plester 5 yard X 2 Inchi Roll 5 0 5 2 Jul-19 3 - 2 10
4.27 Silk (benang bedah sutera) no. 3/0 Set 53 0 53 17 Sep-18 36 3,055 - 41.4 24
41 Anti Kolesterol
41.1 Simvastin tablet Tablet 0 0 0 Sep-18 136 2000
42 Antihemaroid

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
42 Lain - lain
42.6 EDTA Botol 0 0 0 0 0 100 cc
42.7 Paket HB Sahli Set 0 0 0 0 2 Set
42.8 Stik Pemeriksaan Cholestrol Box - 2 box 2 box -
42.10 Selang 02 Nasal Kanul 0 5 5 - 5
42.11 Selang 02 masker 0 5 5 - 5
TOTAL
KUNJUNGAN JUMLAH
Wekmidar, 31 Maret 2019
Petugas IFK Malaka
NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004 Nip.

DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN : PUSKESMAS WEKMIDAR BULAN : APRIL

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1:02:12 Ketorolak injeksi Injeksi 10 20 30 - 30
1.3 Antipirai
1.3.1 Alopurinol 100 mg Tablet 4300 0 4300 0 Jan-20 4300 100 100,000
1.3.2 Stik Pemeriksaan Asam Urat Strp 0 2 Box 2 Box - 2 Box
2.0 Anestetik
2.1 Anestetik Lokal
2.1.2 Lidokain compositum injeksi 2 ml Ampul 6 20 26 6 Jun-20 20 2,308 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
3.1 Adrenalin/ Epinefrin Injeksi Ampul 0 0 0 - 0 20 ED JAN 2019
3.2 Ephedrine Hcl Injeksi Ampul 0 20 20 - 20
3.5 Deksametason Injeksi 1 ml Ampul 44 30 74 19 Apr-19 55 1,897 73,983 23
3.7 Loratadine 10 mg Tablet 2300 500 2800 250 Apr-19 550 185 185,000 230 2000 2000 ED
3.8 Prednison 5 mg Tablet 4,000 0 4000 200 Sep-20 3800 100 100,000 2,300
3.10 Cetirizine Syrup Botol 25 10 35 5 30 8,431 109,603
3.11 Methylprednisolone 4 mg Tablet 200 0 200 - Jul-20 200 240 -
4.1 Magnesium Sulfat injeksi 20%-25ml Ktg 30 mg 0 0 0 - 0 6,000 - 5 ED
5.1 Fenobarbital Inj.50mg/ml-2ml Ampul 34 0 34 4 30 - -
6 Antelmintik
6.1 Albendazole 100 mg Tablet 0 0 0 - - 1000
6.2 Mebendazol 100 mg Tablet 0 0 0 - - 1000
7 Antifilaria
8 Antibakteri -
8.1 Amoksisilin 250 mg Kapsul 1200 0 1200 800 Jun-20 400 224 89,600 1,500 3000
8.4 Ampicilin 500 mg Kaplet 1,000 0 1000 0 1000 -
8,4.1 Cefixime Kapsul 350 0 350 0 350
8.6 Cefadroxil 250 mg Tablet 400 0 400 100 300 3000
8.9 Cyprofloksacin 500 mg Tablet - 2000 2000 200 Jun-20 1800 700 - 575

8.12 Erytromicyn Syrup 60 ml Botol 3 10 13 3 10 7,575 30,300
STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
8,11 Erytromicyn 500 mg Tablet - 500 500 0 Dec-19 500 0 0 575
8,12 Gentamicin TTS Mata Botol 27 24 51 4 47 5,020
8,22 Oksitetrasiklin Salep Mata 1 %-5g Tube 40 25 65 26 Jun-18 39 4,800 -
9 KUSTA
10 Antituberculosis
10.2 FDC 1 & III Paket 2 2 4 3 Jul-20 1 - 5
10.3 FDC 2 Paket -
10.4 FDC 3 Paket -
10.6 Sputum pot Buah 15 0 15 15 2,548 -
10.7 Anisol 100 cc btl/100 cc 1 2 3 - 3 175,000
11 Antifungi
11.1 Gentian Viloet larutan 1% Botol 10 0 10 3 7 2,220 -
11.4 Ketokonazol tab 200 mg Tablet 1,050 0 1050 Jan-20 1050 380 114,000 575

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
11.6 Miconazol cream Tube 12 24 36 7 Jun-20 29 4,060 -
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 600 1000 1600 200 1400 768 - 575
11.9 salep 2 - 4 Pot 18 24 42 11 Jun-19 31 2,400 21,600 27.6
12.1 Abatte Galon 25 kg - 0 - - 0 -
12.5 Blood Lancet Pcs 59 0 59 0 59 150 -
12,12 Tisu Rol Roll 5 10 15 4 11 4,990 39,920 5.75
13 Antimigrein
14.4 Piridoksin HCl 10 mg ( Vit. B 6) Tablet 2,100 500 2600 300 Feb-19 2300 24 -
14.5 Sianokobalamin 100 mg (Vit B12 ) tab Tablet - 0 0 0 Apr-21 0 60 54,000 2,300 3000
14.6 Sianokobalamin Injeksi (Vit B12 ) Ampul 80 50 130 23 Feb-20 107 1,150 56,350 57.5
14.7 Vitamin B 1 ( Thiamin HCl) 100 mg Tablet 3700 1000 4700 800 Dec-19 3900 88 52,800
14.8 Vitamin B 1 ( Thiamin HCl) Injeksi Vial 6 10 16 7 9 7,100 - 1,600 10
14.8.1 vitamin C Tablet 2600 500 3100 1000 2100 1000
15.1 Besi (II) Tablet salut kombinasi Tablet 3,500 3000 6500 900 Sep-19 5600 60 56,400
15.7 Larutan HCL 0,1 N Set 0 0 150,000 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
15.14 Urine test kehamilan 3 +++ Ktk - 0 0 25 Jan-18 0 1,939 118,279 57.5 ED
16 PROGRAM KB
18 Diuretika
19 Antitiroxin
20 Antidiabetes
20.1 Glibenklamid 5 mg Tablet 400 0 400 0 400 70 0 500
STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
21.5 Lisol Cairan Btl/500 ml 2 0 2 0 Oct-18 2 41,000 -
21.6 Povidon Iodida 10%-30 ml Botol 24 0 24 6 18 2,900 10
21.7 Povidon Iodida 10%- 300 ml Botol - 5 5 1 Sep-19 4 17,006 - 23 20
22 Program Promkes
23.1 Acyklovir 400 mg Tablet 500 500 1000 100 900 - 500
23.2 Acyklovir cream 5% Tube 19 20 39 6 Apr-19 33 3,818 15,272 23
24.3 HCT 25 mg Tablet May-21 - 470 -
25.1 Betametason Salep Kulit Tube 30 25 55 17 May-19 38 1,444 2,888 28.75
25.3 Salep Denomix Tube 0 0 0 - 0 24
25.4 Salep Skabimite Tube 1 10 11 1 10 24
26.1 Peditox Botol 5 0 5 - 5 4,760 11.5
27.1 Bedak salisilat serbuk 2 % Kotak - 12 12 1 Sep-18 11 1,450 -
28.2 AIr untuk injeksi 5 ml ampul 0 0 0 - 0

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
28.5 Glukosa lar.infus 5%-500 ml Flakon - 20 20 0 Feb-19 20 6,840 27,360
28.6 NaCl 0,9%-500 ml lar.infus Flakon 20 - 20 - Apr-19 20 5,640 28,200
28.8 Zinc Tablet 2800 0 2800 - Sep-18 2800 568 170,400
30 Sedativa
32 Antipsikosis
33.1 Antasida DOEN 500 mg Tablet 1,800 2000 3800 500 Aug-19 3300 85
33.4 Natrium Bikarbonat tablet Tablet - 0 0 0 73
33.5 Omeprazole 20 mg Tablet 1,650 0 1650 270 Aug-20 1380 184 77,280 690
33.6 Ranitidin 150 mg Tablet 1,000 1000 2000 300 1700 140 -
34 AntiDiare
34.1 New Antides Tablet 300 0 300 200 100 219 575 500
35 Antispasmodik

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
36 Antiasma
36.5 Efedrin 25 mg Tablet - 0 0 0 190 7,379
37,3 Glyseril Guayakolat 100 mg Tablet 1,100 2000 3100 1,000 Oct-19 2100 48 - 500
37.4 OBH Botol 8 12 20 2 18
38 Antiemetik
38.4 Ondancentron injeksi ampul 10 0 10 1 9 20

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
40.5 Bisturi No. 10 Pcs 0 0 0 0 0 3,181 6,362 100
40.8 Disposible 1 ml Pcs 16 0 16 15 Feb-00 1 1,540 32,340 100
40.9 Disposible 3 ml Pcs 133 200 333 20 Sep-20 313 650 65,000 115
4.16 Handshoen Sensi Pcs 100 0 100 100 0 583 115 1000
4.20 Kapas pembalut / adsorben 250 g Roll 5 0 5 3 2 12,500 12,500 2 10
4.21 Kasa pembalut hidrofil 16 X 16 cm ( steril ) Kotak 25 30 55 15 40 5,800 243,600 57.5
4.22 Kasa Pembalut hidrofil 18 x 22 cm Roll 0 0 0 0 5,900 -
4.23 Kasa Hidrofil 4 x 10 cm Roll 45 0 45 31 14 1,500 45,000 57.5 100
4.25 Masker Mulut Pcs 500 0 500 36 400 330 99,000 575
41 Anti Kolesterol
42 Antihemaroid
42.2 Antihemaroid suppositoria Supp 20 20 40 - May-20 40 3,806 -

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
42 Lain - lain
42.1 Fenol Gliseril TT Botol - 0 0 1,200
42.2 Plastik Klips uk. 6 x 4 (kecil) Pak 600 500 1100 400 700 591 5,910 575
42.3 Plastik Klips uk. 8 x 5 (sedang) Pak 900 500 1400 100 1300 3,909 39,090 575
42.4 Plastik Klips uk. 11 x 17 (besar) Pak 700 500 1200 400 800 10,864 217,280 690
42.6 EDTA Botol 0 0 0 0 0 100 cc
42.7 Paket HB Sahli Set 0 0 0 0
42.8 Stik Pemeriksaan Cholestrol Box 2 0 2 box - 2
42.10 Selang 02 Nasal Kanul 5 0 5 5 0 20
42.11 Selang 02 masker 5 0 5 1 4
42.12 Test Mantoux 0 0 0 - 0 10
TOTAL
KUNJUNGAN JUMLAH
Wekmidar, 30 April 2019
Petugas IFK Malaka
NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004 Nip.

DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN : PUSKESMAS WEKMIDAR BULAN : MEI

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1.3 Antipirai
1.3.2 Stik Pemeriksaan Asam Urat Strp 2 0 2 Box - 2 Box
2.0 Anestetik
2.1 Anestetik Lokal

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
3.1 Adrenalin/ Epinefrin Injeksi Ampul 0 20 20 - 20 ED JAN 2019
3.9 Cetirizine 10 mg Tablet 3,000 1000 4000 1,000 3000 157 - 575 1000
4.1 Magnesium Sulfat injeksi 20%-25ml Ktg 30 mg 0 5 5 1 4 6,000 - 5 ED
6 Antelmintik
6.1 Albendazole 100 mg Tablet 0 500 500 500 - -
7 Antifilaria
8 Antibakteri -
8.1 Amoksisilin 250 mg Kapsul 400 0 400 400 Jun-20 0 224 89,600 1,500 3000
8.4 Ampicilin 500 mg Kaplet 1,000 0 1000 600 400 - 1000
8,4.1 Cefixime Kapsul 350 0 350 0 350
8.5 Cefadroxil 500 mg Tablet 0 0 0 - May-20 0 618 309,000 1,150 3000
8.6 Cefadroxil 250 mg Tablet 300 0 300 300 0 3000
8.9 Cyprofloksacin 500 mg Tablet 1,800 0 1800 200 Jun-20 1600 700 - 575
8.12 Erytromicyn Syrup 60 ml Botol 10 0 10 8 2 7,575 30,300 30

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
8,12 Gentamicin TTS Mata Botol 47 0 47 47 0 5,020 ED Mei 2019
8,14 Kloramfenikol Salep Mata 1%-5g Tube - 0 0 - Jan-00 0 1,990 19,900 - 24
8.26 Prokain Benzil Penisilin Botol - 0 0 0 0
9 KUSTA
9.1 Obat Kusta MB Dewasa Blister 0 0 0 - 0
10 Antituberculosis
10.2 FDC 1 & III Paket 1 5 6 - Jul-20 6 -
10.3 FDC 2 Paket -
10.4 FDC 3 Paket -
10.6 Sputum pot Buah 15 0 15 9 6 2,548 - 20
10.7 Anisol 100 cc btl/100 cc 2 0 2 - 2 175,000
10.8 Zeil Nelson Paket 0 0 0 - 2
11 Antifungi
11.2 Griseofulvin Tablet - 100 100 May-18 100 263

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
11.6 Miconazol cream Tube 29 0 29 20 Jun-20 9 4,060 - 24
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 1400 0 1400 - 1400 768 - 575
11.9 salep 2 - 4 Pot 31 0 31 18 Jun-19 13 2,400 21,600 27.6 24
11.10 Salep Kulit 3 - 6 % Pot 29 0 29 5 Jun-20 24 7,291 - 24
12.1 Abatte Galon 25 kg - 0 - - 0 -
12.5 Blood Lancet Pcs 59 0 59 0 59 150 -
12,12 Tisu Rol Roll 11 0 11 6 5 4,990 39,920 5.75 10
13 Antimigrein
14.6 Sianokobalamin Injeksi (Vit B12 ) Ampul 107 0 107 42 Feb-20 65 1,150 56,350 57.5
14.8 Vitamin B 1 ( Thiamin HCl) Injeksi Vial 9 10 19 2 17 7,100 - 1,600
14.8.1 vitamin C Tablet 2100 1000 3100 1300 1800 1000
15.5 Kalsium Laktat ( Kalak ) Tablet 2,800 1000 3,800 400 Oct-18 3400 75 75,000 2,300
15.7 Larutan HCL 0,1 N Set 0 0 150,000 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
15.14 Urine test kehamilan 3 +++ Ktk - 0 0 25 Jan-18 0 1,939 118,279 57.5 100 ED
16 PROGRAM KB
18 Diuretika
19 Antitiroxin
20 Antidiabetes
STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
21.4 Etanol 70%(Alkohol ) Botol/300 ml 5 4 9 7 Feb-20 2 21,500 21,500 5
21.6 Povidon Iodida 10%-30 ml Botol 18 11 29 2 27 2,900
21.7 Povidon Iodida 10%- 300 ml Botol - 24 24 - Sep-19 24 17,006 - 23
22 Program Promkes
23.1 Acyklovir 400 mg Tablet 900 500 1400 1400 -
23.2 Acyklovir cream 5% Tube 33 0 33 9 Apr-19 24 3,818 15,272 23
24.1 Captopril 25 mg Tablet 1,200 1000 2200 1,400 800 82 - 1,000 3000
24.3 HCT 25 mg Tablet May-21 - 470 -
24.5 Nifedipin Tablet 1,000 0 1000 0 Jul-20 1000 139 13,900
25.4 Salep Skabimite Tube 10 20 30 2 28
26.1 Peditox Botol 5 0 5 - 5 4,760 11.5
27.1 Bedak salisilat serbuk 2 % Kotak 11 0 11 5 Sep-18 6 1,450 - 12


STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
28.5 Glukosa lar.infus 5%-500 ml Flakon 20 0 20 5 Feb-19 15 6,840 27,360
28.6 NaCl 0,9%-500 ml lar.infus Flakon 20 - 20 - Apr-19 20 5,640 28,200
28.8 Zinc Tablet 2800 0 2800 400 Sep-18 2400 568 170,400
30 Sedativa
32 Antipsikosis
33.1 Antasida DOEN 500 mg Tablet 3,300 0 3300 1,000 Aug-19 2300 85 1000
33.5 Omeprazole 20 mg Tablet 1,380 0 1380 420 Aug-20 960 184 77,280 690 1000
34 AntiDiare
35 Antispasmodik

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
35,3 Papaverin tablet Tablet 500 0 500 100 Oct-19 400 170 - 1000
36 Antiasma
37,1 Ambroxol 30 mg Tablet 1,800 1000 2800 1,000 Aug-21 1800 300 210,000 575 2000
37.4 OBH Botol 18 0 18 10 8
38 Antiemetik
40.5 Abocath no 26 Pcs - 0 0 0 0 50

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
40.5 Bisturi No. 10 Pcs 0 0 0 0 0 3,181 6,362 100
4.11.1 Jelly Kateter Tube 4 0 4 1 3 10
4.13 Hanschoen no:7 Buah 85 0 85 42 Jan-21 43 6,985 50
4.14 Hanschoen no:7,5 Buah 57 0 57 20 Sep-18 37 6,985 377,190 50

4.16 Handshoen Sensi Pcs - 200 200 200 0 583 115 1000

4.19 Kain kasa roll panjang 40 X 80 Roll 2 0 2 1 1 105,000 105,000 5.75 5
4.20 Kapas pembalut / adsorben 250 g Roll 2 10 12 12 12,500 12,500 2


4.23 Kasa Hidrofil 4 x 10 cm Roll 14 100 114 24 90 1,500 45,000 57.5 50

4.25 Masker Mulut Pcs 400 0 400 300 100 330 99,000 575 1000

41 Anti Kolesterol
42 Antihemaroid

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
42 Lain - lain
42.6 EDTA Botol 0 0 0 0 0 100 cc
42.8 Stik Pemeriksaan Cholestrol Box 2 0 2 1 1 2
42.9 Stik Pemeriksaan Asam Urat Box - 0 0 - 0 2
42.12 Selang 02 masker 4 0 4 1 3 20
42.13 Test Mantoux 0 0 0 - 0 10
TOTAL
KUNJUNGAN JUMLAH
Wekmidar, 31 Mei 2019
Petugas IFK Malaka
NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004 Nip.

DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN : PUSKESMAS WEKMIDAR BULAN : JUNI

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1:02:12 Ketorolak injeksi Injeksi 29 0 29 - 29
1.3 Antipirai
1.3.2 Stik Pemeriksaan Asam Urat Strp 2 0 2 2 0 2
2.0 Anestetik
2.1 Anestetik Lokal

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
3.3 Chloramfeniramin Maleat 4 mg (CTM) Tablet 3,100 500 3600 500 Jun-20 3100 48 57,600 1,150 500
3.9 Cetirizine 10 mg Tablet 3,000 1000 4000 1,000 3000 157 - 575 1000
4.1 Magnesium Sulfat injeksi 20%-25ml Ktg 30 mg 4 0 4 - 4 6,000 - 10 ED
6 Antelmintik
7 Antifilaria
8 Antibakteri -
8.2 Amoksisilin 500 mg Kaplet 200 1500 1700 700 1000 288 835,200 1,150 3000
8,4.1 Cefixime Kapsul 350 0 350 350 0 1000 ED JUNI 2019
8.6 Cefadroxil 250 mg Tablet 0 0 0 - 0 3000
8.8 Clyndamicin 300 mg Tablet 50 0 50 50 0 720 - 1000
8.9 Cyprofloksacin 500 mg Tablet 1,600 0 1600 - Jun-20 1600 700 - 575

8.12 Erytromicyn Syrup 60 ml Botol 2 30 32 2 30 7,575 30,300 10
STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
8,12 Gentamicin TTS Mata Botol - 0 0 - 0 5,020 ED Mei 2019
8,13 Gentamicin Salep Mata Tube - 24 24 - 24
8,15.1 Kloramfenikol Tetes Telinga 3%-5ml Botol 2 0 2 2 0 20
8.16 Phenol Gliser Tetes Telinga Botol - 0 0 - 0 20
8,17 Kotrimoksazol Dewasa Kombinasi 480mg Tablet 3200 1000 4200 400 Sep-19 3800 166 166,000 1,150
8.26 Tetrasiklin HCL Kapsul 250 mg Kapsul - 0 0 0 0 270 - 575
8,27 Prokain Benzil Penisilin Botol - 0 0 0 0
8.28 Thiamfenikol 500 mg Tablet - 0 0 0 Jun-18 0 88 575
9 KUSTA
10 Antituberculosis
10.2 FDC 1 & III Paket 6 0 6 3 Jul-20 3 - 10
10.3 FDC 2 Paket -
10.4 FDC 3 Paket -
10.6 Sputum pot Buah 6 20 26 - 26 2,548 -
10.7 Anisol 100 cc btl/100 cc 2 0 2 - 2 175,000
11 Antifungi
11.1 Gentian Viloet larutan 1% Botol 7 0 7 2 5 2,220 - 10
11.2 Griseofulvin Tablet 100 0 100 May-18 100 263 500
11.4 Ketokonazol tab 200 mg Tablet 750 0 750 - Jan-20 750 380 114,000 575

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
11.6 Miconazol cream Tube 9 0 9 5 Jun-20 4 4,060 - 24 24
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 1400 0 1400 - 1400 768 - 575
11.9 salep 2 - 4 Pot 13 24 37 5 Jun-19 32 2,400 21,600 27.6
12.1 Abatte Galon 25 kg - 0 - - 0 -
12.4 ACT tab(ARTERAKINE)/Darpleks Paket 36 0 36 36 Aug-19 0 4,400 - 10 500 ED Mei 2019
12.5 Blood Lancet Pcs 59 0 59 0 59 150 -
12,12 Tisu Rol Roll 5 3 8 6 2 4,990 39,920 5.75 20
13 Antimigrein
14.6 Sianokobalamin Injeksi (Vit B12 ) Ampul 65 0 65 8 Feb-20 57 1,150 56,350 57.5 100 ED JULI 2019
14.8 Vitamin B 1 ( Thiamin HCl) Injeksi Vial 17 0 17 1 16 7,100 - 1,600 10
14.8.1 vitamin C Tablet 1800 1000 2800 500 2300 1000
15.7 Larutan HCL 0,1 N Set 0 0 150,000 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
15.14 Urine test kehamilan 3 +++ Ktk - 50 50 10 Jan-18 40 1,939 118,279 57.5 100 ED
16 PROGRAM KB
18 Diuretika
19 Antitiroxin
20 Antidiabetes
STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
21.6 Povidon Iodida 10%-30 ml Botol 27 0 27 27 0 2,900 25 ED Juni 2019
21.7 Povidon Iodida 10%- 300 ml Botol 24 0 24 2 Sep-19 22 17,006 - 23
22 Program Promkes
23.1 Acyklovir 400 mg Tablet 1,400 0 1400 300 1100 -
23.7 Reagen SIFILIS Dos 1 0 1 1 0 2 Dos ED JUNI 2019
24.1 Captopril 25 mg Tablet 800 500 1300 100 1200 82 - 1,000 3000
24.3 HCT 25 mg Tablet May-21 - 470 -
25.1 Betametason Salep Kulit Tube 15 0 15 15 May-19 0 1,444 2,888 28.75 24 ED MEI 2019
25.4 Salep Skabimite Tube 28 0 28 - 28
26.1 Peditox Botol 5 0 5 - 5 4,760 11.5
28.1 Air untuk injeksi 20 ml ampul 5 0 5 1 4 2,400 10


STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
28.5 Glukosa lar.infus 5%-500 ml Flakon 15 0 15 0 Feb-19 15 6,840 27,360 24
28.6 NaCl 0,9%-500 ml lar.infus Flakon 20 - 20 5 Apr-19 15 5,640 28,200 24
28.7 Ringer laktat lar. 500 ml Flakon 11 24 35 11 24 6,240 112,320
28.8 Zinc Tablet 2400 0 2400 100 Sep-18 2300 568 170,400
29.2 Metilergometrin Maleat 0,125 mg Tablet 300 0 300 100 200 185
29.3 Oksitosin injeksi Ampul 39 0 39 10 29 880 3,520 11.5
30 Sedativa
32 Antipsikosis
33.1 Antasida DOEN 500 mg Tablet 2,300 1000 3300 400 Aug-19 2900 85 1000
33.5 Omeprazole 20 mg Tablet 960 900 1860 240 Aug-20 1620 184 77,280 690
33.7 Ranitidin Injeksi Ampul 24 0 24 - 24
34 AntiDiare
34.1 New Antides Tablet 600 0 600 100 500 219 575
35 Antispasmodik

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
36 Antiasma
36.2 Aminofilin 200 mg Tablet 1,800 0 1800 1,800 Sep-17 0 - ED JULI 2019
36.6 Salbutamol 4 mg Tablet 2,200 1000 3200 200 Jul-21 3000 95 57,000 1,700
37,3 Glyseril Guayakolat 100 mg Tablet 1,000 2000 3000 500 Oct-19 2500 48 - 500 1000
37.4 OBH Botol 8 0 8 3 5 10
38 Antiemetik
40.5 Abocath no 26 Pcs - 0 0 0 0 50

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
40.5 Bisturi No. 10 Pcs 0 0 0 0 0 3,181 6,362 100
40.6 Cat gut chromic No.2/0 - 3/0 Set 33 0 33 4 May-21 29 5,583 66,996 27.6 24
40.7 Cat gut plain No.2/0 - 3/0 Set 30 0 30 0 May-21 30 5,583 100,494 27.6 24
4.16 Handshoen Sensi Pcs - 1000 1000 200 800 583 115
4.17 Infus set Anak Pcs 17 0 17 0 Jan-20 17 3,500 21,000 30
4.18 Infus set Dewasa Pcs 23 0 23 5 18 3,200 86,400 30

4.20 Kapas pembalut / adsorben 250 g Roll 12 0 12 12 12,500 12,500 2

4.25 Masker Mulut Pcs 100 500 600 100 500 330 99,000 575 1000
4.27 Silk (benang bedah sutera) no. 3/0 Set 60 0 60 8 Sep-18 52 3,055 - 41.4 50

41 Anti Kolesterol
42 Antihemaroid
42.2 Antihemaroid suppositoria Supp 60 0 60 20 May-20 40 3,806 -

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
42 Lain - lain
42.6 EDTA Botol 0 0 0 0 0 100 cc
42.8 Stik Pemeriksaan Cholestrol Box 1 0 1 1 0 2 Box
42.9 Stik Pemeriksaan Asam Urat Box - 0 0 - 0 2 Box
42.12 Selang 02 masker 3 0 3 - 3 20
42.13 Test Mantoux 0 0 0 - 0 10
TOTAL
KUNJUNGAN JUMLAH
Wekmidar, 30 Juni 2019
Petugas IFK Malaka
drg. Paskalia Frida Fahik Blasius Bria Nahak,SKM Imelda Marni H. Nahak, Amd. Kep (………………………………………..)
NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004 Nip.

DINAS : KESEHATAN
SATUAN KERJA : GUDANG FARMASI/UNIT PELAYANAN : PUSKESMAS WEKMIDAR BULAN : JULI KODE UNIT PELAYANAN : 5306010201

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1.2.1 Antalgin 500 mg Tablet 3200 1500 4700 1600 Oct-21 3100 120 - 1,150
1.2.6 Natrium Diklofenak 50 mg Tablet 1950 1000 2950 750 Jun-19 2200 211 - 1,150
1.3 Antipirai
1.3.2 Stik Pemeriksaan Asam Urat Strp 0 2 2 1 1
2.0 Anestetik
2.1 Anestetik Lokal
2.1.2 Lidokain compositum injeksi 2 ml Ampul 19 60 79 23 Jun-20 56 2,308 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
3.7 Loratadine 10 mg Tablet 350 0 350 300 Apr-19 50 185 185,000 230 2000
3.9 Cetirizine 10 mg Tablet 3,000 500 3500 100 3400 157 - 575
4.1 Magnesium Sulfat injeksi 20%-25ml Ktg 30 mg 4 0 4 4 0 6,000 - 10 ED Juni 2019
4.2 Magnesium Sulfat injeksi 40%-25ml Ampul 0 0 0 - 0 6,000 - 5
6 Antelmintik
6.3 Pirantel Pamoat 125 mg Tablet 0 0 0 362 0 500
7 Antifilaria
8 Antibakteri -
8.4 Ampicilin 500 mg Kaplet 1,100 1000 2100 0 2100 -
8,4.1 Cefixime Kapsul - 0 0 0 0 500 ED JUNI 2019
8.6 Cefadroxil 250 mg Tablet 0 0 0 - 0 3000
8.8 Clyndamicin 300 mg Tablet - 0 0 - 0 720 - 1000
8.9 Cyprofloksacin 500 mg Tablet 1,600 0 1600 200 Jun-20 1400 700 - 575
8.11 Doksisiklin Tablet 1,200 0 1200 0 Aug-20 1200 336 -
8.12 Erytromicyn Syrup 60 ml Botol 30 10 40 - 40 7,575 30,300

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
8,11 Erytromicyn 500 mg Tablet 100 500 600 0 Dec-19 600 0 0 575
8,12 Gentamicin TTS Mata Botol - 0 0 - 0 5,020 ED Mei 2019
8,13 Gentamicin Salep Mata Tube 24 0 24 4 20
8,15.1 Kloramfenikol Tetes Telinga 3%-5ml Botol - 0 0 - 0 20
8.16 Phenol Gliser Tetes Telinga Botol - 0 0 - 0 20
8,17 Kotrimoksazol Dewasa Kombinasi 480mg Tablet 3800 0 3800 3800 Sep-19 0 166 166,000 1,150 3000 ED 08/2019
8.26 Tetrasiklin HCL Kapsul 250 mg Kapsul - 0 0 0 0 270 - 575
8,27 Prokain Benzil Penisilin Botol - 0 0 0 0
8.28 Thiamfenikol 500 mg Tablet - 0 0 0 Jun-18 0 88 575
9 KUSTA
10 Antituberculosis
10.2 FDC 1 & III Paket 3 5 8 1 Jul-20 7 -
10.3 FDC 2 Paket -
10.4 FDC 3 Paket -
10.6 Sputum pot Buah 26 0 26 2 24 2,548 -
10.7 Anisol 100 cc btl/100 cc 2 0 2 - 2 175,000
11 Antifungi
11.1 Gentian Viloet larutan 1% Botol 5 0 5 2 3 2,220 - 10
11.2 Griseofulvin Tablet 100 0 100 May-18 100 263 500
11.4 Ketokonazol tab 200 mg Tablet 750 0 750 100 Jan-20 650 380 114,000 575

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
11.6 Miconazol cream Tube 4 24 28 4 Jun-20 24 4,060 - 24
11.7 Nistatin tablet salut 500.000 IU Tab.Salut 1400 0 1400 300 1100 768 - 575
11.9 salep 2 - 4 Pot 32 0 32 5 Jun-19 27 2,400 21,600 27.6
11.10 Salep Kulit 3 - 6 % Pot 43 0 43 - Jun-20 43 7,291 -

Galon 25
12.1 Abatte kg - 0 - - 0 -
12.4 ACT tab(ARTERAKINE)/Darpleks Paket - 495 495 0 Aug-19 495 4,400 - 10 ED Mei 2019
12.5 Blood Lancet Pcs 59 0 59 0 59 150 -
12.9 Rapid Test Malaria dos 250 0 250 250 0 36,000 10 ED 08/2019
12,12 Tisu Rol Roll 2 10 12 12 0 4,990 39,920 5.75 20
13 Antimigrein
14.3 Fitommenadion injeksi ( Vti.K inj ) Ampul 20 20 40 10 Oct-20 30 4,100 -
14.6 Sianokobalamin Injeksi (Vit B12 ) Ampul 57 0 57 46 Feb-20 11 1,150 56,350 57.5 50 ED JULI 2019
14.8 Vitamin B 1 ( Thiamin HCl) Injeksi Vial 16 0 16 4 12 7,100 - 1,600
14.8.1 vitamin C Tablet 2300 2000 4300 1300 3000
14.9 Vitamin B Complek Tablet 3,100 3000 6100 2300 Jun-19 3800 144 28,800 2,300
15.7 Larutan HCL 0,1 N Set 0 0 150,000 -

STOK TOTAL
SATUAN PAD NON
KAPITASI
1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
15.14 Urine test kehamilan 3 +++ Ktk 40 100 140 11 Jan-18 129 1,939 118,279 57.5 ED
16 PROGRAM KB
18 Diuretika
19 Antitiroxin
20 Antidiabetes
STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
21.5 Lisol Cairan Btl/500 ml 2 0 2 2 Oct-18 0 41,000 - 5
21.6 Povidon Iodida 10%-30 ml Botol - 0 0 - 0 2,900 ED Juni 2019
21.7 Povidon Iodida 10%- 300 ml Botol 22 5 27 2 Sep-19 25 17,006 - 23
22 Program Promkes
23.1 Acyklovir 400 mg Tablet 1,100 0 1100 50 1050 -
23.5 One Step Anti HIV1/2 Test dos 0 200 200 6 194
23.6 Fokus Diagnostik Dos 0 2 2 - 2
23.7 BioMerieux Dos 0 2 2 - 2
23.8 Reagen HIV 1/2.3 SD Dos/30 0 2 2 - 2
23.9 Reagen SIFILIS Dos 0 0 0 - 0 2 Dos ED JUNI 2019
24.3 HCT 25 mg Tablet May-21 - 470 -
25.1 Betametason Salep Kulit Tube - 0 0 - May-19 0 1,444 2,888 28.75 24 ED MEI 2019
25.4 Salep Skabimite Tube 28 0 28 3 25
26.1 Peditox Botol 5 0 5 1 4 4,760 11.5
28.1 Air untuk injeksi 20 ml ampul 4 10 14 14 0 2,400 10 ED Juli 2019

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
28.5 Glukosa lar.infus 5%-500 ml Flakon 15 20 35 7 Feb-19 28 6,840 27,360
28.7 Ringer laktat lar. 500 ml Flakon 24 20 44 20 24 6,240 112,320
28.8 Zinc Tablet 2300 500 2800 800 Sep-18 2000 568 170,400
29.3 Oksitosin injeksi Ampul 29 0 29 2 27 880 3,520 11.5
30 Sedativa
32 Antipsikosis
33.1 Antasida DOEN 500 mg Tablet 2,900 2000 4900 1,100 Aug-19 3800 85
33.2 Antasida DOEN Suspensi Botol 21 40 61 22 39
33.5 Omeprazole 20 mg Tablet 1,620 300 1920 300 Aug-20 1620 184 77,280 690
33.6 Ranitidin 150 mg Tablet 1,100 0 1100 300 800 140 - 1000
34 AntiDiare
35 Antispasmodik

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
35,3 Papaverin tablet Tablet 1,200 500 1700 400 Oct-19 1300 170 -
36 Antiasma
36.2 Aminofilin 200 mg Tablet - 0 0 - Sep-17 0 - ED JULI 2019
36.6 Salbutamol 4 mg Tablet 3,000 0 3000 600 Jul-21 2400 95 57,000 1,700
37,1 Ambroxol 30 mg Tablet 1,500 0 1500 1,100 Aug-21 400 300 210,000 575 3000
37.4 OBH Botol 5 12 17 11 6 10
38 Antiemetik
38.3 Ondansetron 4 mg Tablet 240 0 240 240 Aug-19 0 590 21,240 240 ED 08/2019
38.4 Ondancentron injeksi ampul 22 0 22 - 22
40.5 Abocath no 26 Pcs - 0 0 0 0 50

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
40.5 Bisturi No. 10 Pcs 0 0 0 0 0 3,181 6,362 100
4.18 Infus set Dewasa Pcs 18 0 18 18 0 3,200 86,400 50


4.25 Masker Mulut Pcs 500 250 750 150 600 330 99,000 575
4.29 Kasa Kompres 16 x 16 pca 0 20 20 20 0 5,500 50
41 Anti Kolesterol
42 Antihemaroid

STOK TOTAL
SATUAN PAD NON
STOK KAPITASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
42 Lain - lain
42.6 EDTA Botol 0 0 0 0 0 100 cc
42.8 Stik Pemeriksaan Cholestrol Box - 0 0 - 0 2 Box
42.9 Stik Pemeriksaan Asam Urat Box - 2 2 1 1
42.1 selang Suction bayi set 0 0 0 - 0 10
42.11 Selang 02 Nasal Kanul anak set 0 10 10 - 10
42.12 Selang 02 Masker bayi set 0 10 10 - 10
42.13 Selang 02 Masker Dewasa set 3 0 3 1 2 10
42.14 Selang 02 Nasal Kanul Dewasa set 4 10 14 10 4 10
42.15 Test Mantoux set 0 0 0 - 0 10
TOTAL
KUNJUNGAN JUMLAH
Wekmidar, 31 Juli 2019
Petugas IFK Malaka
drg. Paskalia Frida Fahik Blasius Bria Nahak,SKM Imelda Marni H. Nahak, Amd. Kep (………………………………………..)
NIP. 19710410 200501 2 011 NIP. 19770624 199603 1 004 Nip.

Lplpo 2019

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LAPORAN PEMAKA

STOK BULAN LALU

1.1 Analgetik Narkotika

STOK BULAN LALU

12.1 Abatte Galon 25 kg

17 Bahan serta Obat Gigi dan Mulut

STOK BULAN LALU

23 Program HIV / AIDS

25 Antiinflamasi dan Antipruritik

27 Keratolitik dan keratoplastik

29 Oksitosik dan Relaksan uterus

31 Antidepresi dan Antimania

33 Antasida dan Antiulkus

STOK BULAN LALU

STOK BULAN LALU

drg. Paskalia Frida Fahik Blasius Bria Nahak,SKM.

: PUSKESMAS WEKMIDAR BULAN : DESEMBER

EXPIRE SISA TOTAL STOK

Oct-21 0 120 - 1,150 3000

Oct-19 3900 96 240,000 2,300 2000

Jan-20 200 100 100,000 3000

EXPIRE SISA TOTAL STOK

4 4,990 39,920 5.75 5

EXPIRE SISA TOTAL STOK

400 219 575

EXPIRE SISA TOTAL STOK

Apr-21 9 3,800 205,200 50 50

EXPIRE SISA TOTAL STOK

Wekmidar, 31 Desember 2018

a Nahak,SKM. Elisabeth E. Bano, Amd. kep

1 Analgestik, Antipiretik,Antiinflamasi NonSteroid, Antipirai

1.1 Analgetik Narkotika

1.1.1 Petidin Injeksi 50 mg/ml Ampul

1.2 Analgetik Non Narkotik

1.2.2 Antalgin Injeksi 250 mg/ml-2ml Ampul 1 30 31 1 30 34.5

1.2.4 Ibuprofen SUSPENSI Botol 3 10 13 5 8 20

1.2.5 Ibuprofen 400 mg Tablet 0 0 0 0 0 171 - 575 3000

1.2.7 Parasetamol 100 mg Tablet 0 0 0 0 0

1.2.9 Parasetamol drop 100 mg Botol 0 0 0 0 Sep-18 0 - 30

1.2.10 Parasetamol Syrup 120 mg/ml-2ml Botol 0 0 0 0 Apr-19 0 1,425 - - 30

1:02:12 Ketorolak injeksi Injeksi 9 0 9 1 8

1.3.2 Stik Pemeriksaan Asam Urat Strp 1

2.1 Anestetik Lokal

2.1.1 Lidokain Hcl injeksi 2 ml Ampul - 1,635

2.1.2 Lidokain compositum injeksi 2 ml Ampul - 20 20 - Jun-20 20 2,308 - 20

2.1.3 Etil Klorida Semprot Botol 0 0 0 - 2

2.2 Anestetik Umum & Oksigen

2.2.1 Ketamin Hcl Injeksi 2 ml Vial

2.2.2 Morfin Injeksi 10 mg/ ml Ampul 5

2.2.3 Oksigen Gas Tabung

3 Antialergi, Obat anafilaksis dan Kortikosteroid

3.1 Adrenalin/ Epinefrin Injeksi Ampul 6 0 6 - 6 20

3.4 Deksametason Injeksi 1 ml Ampul - 30 30 11 Apr-19 19 1,897 73,983 23 30

3.5 Difenhidramin Hcl Injeksi Ampul 10 0 10 6 4 1,469 34.5 30

3.9 Cetirizine Syrup Botol 17 10 27 1 26 8,431 109,603 10

3,10 Methylprednisolone 4 mg Tablet 200 0 200 - Jul-20 200 240 -

4 Antidotum dan Obat Lain Untuk Keracunan

4.1 Magnesium Sulfat injeksi 20%-25ml Ktg 30 mg 1 0 1 - 1 6,000 -

4.2 Magnesium Sulfat injeksi 40%-25ml Ampul 4 0 4 - 4 6,000 -

5.1 Fenobarbital Inj.50mg/ml-2ml Ampul 34 0 34 - 34 - -

5.2 Fenobarbital 30 mg Tablet 0 190 -

6.1 Albendazole 100 mg Tablet 0 0 - -

6.2 Mebendazol 100 mg Tablet 0 0 - -