Stok Opname THN 2019

LAPORAN STOK OPNAME PUSKESMAS MALINJAK 2019
BULAN Oktober s/d Desember 2019
NO NAMA ITEM OBAT JUMLAH SATUAN HARGA PENERIM PENGELU SISA PENERIMA PENGELU SISA PENERIM PENGELU SISA SISA Desember
STOK SATUAN AAN ARAN Oktober AN ARAN Nofember AAN ARAN Desembe DALAM (Rp)
Septemb OBAT Oktober Oktober Nofember Nofember Desembe Desembe r
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Albendasol 15,470 tablet Rp 527 13,151 2319 - 1,423 860 - 860 Rp 453,220
2 Allopurinol 100 mg 300 tablet Rp 127 2,000 1,100 1200 1,000 900 1300 1,000 1,300 1000 Rp 127,000
3 Ambroksol sirup 100 botol Rp 4,000 100 0 - - 0 100 - 100 Rp 400,000
4 Ambroksol tablet 200 tablet Rp 150 5,500 2,500 3200 2,000 3,700 1500 3,000 2,900 1600 Rp 240,000
5 Aminophilin injeksi 24 mg / ml 0 ampul Rp 3,349 - 0 - 0 0 Rp -
6 Aminophilin tablet 200 mg 0 tablet Rp 180 - 100 - 100 - 100 Rp 18,000
7 Amitripilin tablet 25 mg 500 tablet Rp 220 - 500 - - 500 - 500 Rp 110,000
8 Amlodipin 10 mg 90 tablet Rp 110 1,000 590 500 2,000 1,300 1200 1,000 - 2200 Rp 242,000
9 Amoksisilin 500 mg 600 tablet Rp 245 6,500 4,100 3000 5,000 5,700 2300 5,000 4,500 2800 Rp 686,000
10 Amoksisilin sirup kering 125 mg/5 ml 80 botol Rp 4,183 50 80 50 100 70 80 65 15 Rp 62,745
11 Antalgin Injeksi 25 ampul Rp 520 - 0 0 - 0 Rp -
12 Antalgin Tablet 500 tablet Rp 145 2,000 1,400 1100 2,000 700 2400 900 1500 Rp 217,500
13 Antasida DOEN I tablet 800 tablet Rp 74 5,000 3,800 2000 4,000 3,300 2700 3,000 3,300 2400 Rp 177,600
14 Antasida DOEN II suspensi 0 botol Rp 2,500 0 0 - 0 Rp -
15 Antihemoroid 25 suppo Rp 3,806 10 15 50 - 65 65 Rp 247,390
16 Asam Ascorbat 50 mg 0 tablet Rp 130 5,000 4,400 600 6,000 5,900 700 6,000 4,400 2300 Rp 299,000
17 Asam Ascorbat 250 mg 0 tablet Rp 139 0 0 0 Rp -
18 Asam Folat 1 mg 900 tablet Rp 57 100 800 500 600 700 1,000 200 1500 Rp 85,500
19 Asam Mefenamat 500 mg 2800 tablet Rp 139 3,000 3,500 2300 4,000 3,700 2600 3,000 3,400 2200 Rp 305,800
20 Asam Traneksamat Injeksi 0 ampul Rp - 0 0 - 0 Rp -
21 Asiklovir Salep 25 tube Rp 5,000 15 10 48 10 48 - 48 Rp 240,000
22 Asiklovir 200 mg 400 tablet Rp 287 1,000 - 1400 300 1100 - 1100 Rp 315,700
23 Atapulgit (Akita) 400 tablet Rp 120 100 0 0 0 Rp -
24 Aqua Pro injeksi 10 vial Rp 2,400 - 10 5 5 - 5 Rp 12,000
25 Bedak salicyl serbuk 2 % 38 pot Rp 1,450 5 33 24 - 57 - 57 Rp 82,650
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
26 Betametason krim 25 tube Rp 3,500 50 - 75 50 100 25 100 25 100 Rp 350,000
27 Besi (II) sukfat 200 mg + asam folat 2700 tablet Rp 49 - 0 0 0 Rp -
28 Captopril 25 mg 1800 tablet Rp 457 2,000 300 3500 300 3200 1,300 1900 Rp 868,300
29 Clor Etil 2 botol Rp 12,000 2 - 2 1 1 Rp 12,000
30 Deksametason injeksi 0 ampul Rp 1,378 0 0 - 0 Rp -
31 Deksametason tablet 0,5 mg 500 tablet Rp 75 7,000 4,200 3300 6,000 5,400 3900 3,000 4,600 2300 Rp 172,500
32 Diazepam injeksi 5 mg / ml 0 ampul Rp 3,038 0 - 0 - 0 Rp -
33 Diazepam tablet 5 mg 35 tablet Rp 121 - 35 35 - 35 Rp 4,235
34 Difenhidramin injeksi 10 mg/ml 0 ampul Rp 1,260 0 0 - 0 Rp -
35 Domperidon suspensi 5 mg / 5 ml 0 botol Rp 16,400 0 0 0 Rp -
36 Domperidon tablet 10 mg 400 tablet Rp 190 200 200 500 - 700 600 100 Rp 19,000
37 Epinefrin (adrenalin) injeksi 30 ampul Rp 5,387 - 30 - 30 - 30 Rp 161,610
38 Eritromicin 500 mg 400 tablet Rp 128 200 200 1,000 200 1000 - 1000 Rp 128,000
39 Fenitoin Na kapsul 10 mg 0 kapsul Rp 545 0 0 0 Rp -
40 Fenobarbital 30 mg 390 tablet Rp 170 200 190 500 690 140 550 Rp 93,500
41 Ferro fumarat kapsul lunak 250 mg 0 kapsul Rp 350 0 2,000 500 1500 1,500 0 Rp -
42 Ferro Glukonat 250 mg (Etabion) 0 tablet Rp 580 0 0 0 Rp -
43 Fitomenadion injeksi 2 ml/mg 0 ampul Rp 4,100 0 0 0 Rp -
44 Fitomenadion tablet 10 mg 0 tablet Rp 866 0 0 0 Rp -
45 Furosemid tablet 40 mg 100 tablet Rp 102 100 - 200 - 200 100 100 Rp 10,200
46 Gentamicin injeksi 40 mg / ml 0 ampul Rp 3,854 0 0 0 Rp -
47 Gentamicin salep kulit 70 tube Rp 3,000 - 70 40 30 50 10 70 Rp 210,000
48 Gentamicin tetes mata 0,3% 0 botol Rp 3,832 - 0 0 0 Rp -
49 Glibenklamid 5 mg 300 tablet Rp 93 - 300 - 300 - 400 Rp 37,200
50 Gliseril Guaiakolat (GG) 3200 tablet Rp 450 3,000 2,800 3400 4,000 2,900 4500 3,000 2,800 4700 Rp 2,115,000
51 Griseovulvin 125 mg 500 tablet Rp 374 - 500 500 200 300 Rp 112,200
52 H2O2 1 vial Rp 55,000 - 1 2 1 2 1 1 Rp 55,000
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
53 Haloperdiol 0,5 mg 0 tablet Rp - 0 0 0 Rp -
54 Hidrokortison krim 24 tube Rp 3,047 48 24 48 24 24 24 0 Rp -
55 Ibuproven 200 mg 0 tablet Rp 117 0 0 0 Rp -
56 Ibuproven 400 mg 0 tablet Rp 143 7,000 3,800 3200 5,000 5,700 2500 5,000 4,200 3300 Rp 471,900
57 Kalsium Laktat 500 mg 1160 tablet Rp 83 360 800 1,000 300 1500 300 1200 Rp 99,600
58 Karbamazepin 200 mg 0 tablet Rp 1,936 500 - 500 - 500 - 500 Rp 968,000
59 Ketokenasol 200 mg 300 tablet Rp 205 - 300 300 0 0 Rp -
60 Ketokenasol krim 45 tube Rp 2,930 - 45 20 25 25 25 25 Rp 73,250
61 Ketorolac Injeksi 0 ampul Rp 1,450 12 - 12 12 0 12 12 Rp 17,400
62 Klindamisin 300 mg 1000 tablet Rp 678 - 0 0 0 Rp -
63 Kloramfenikol kapsul 250 mg 0 kapsul Rp 715 - 0 0 0 Rp -
64 Kloramfenikol salep kulit 49 tube Rp 7,433 50 24 75 75 0 100 36 64 Rp 475,712
65 Kloramfenikol tetes mata 0 botol Rp 10,780 - 0 0 0 Rp -
66 Kloramfenikol tetes telinga 3% 0 botol Rp 3,000 25 - 25 25 0 25 25 0 Rp -
67 Kloramfeniramina Maleat 4 mg (CTM) 2200 tablet Rp 43 6,000 4,800 3400 7,000 5,400 5000 5,000 3,400 6600 Rp 283,800
68 Kotrimoksasol tablet 480 mg 1000 tablet Rp 273 2,000 1,000 2000 900 1100 1,000 1,200 900 Rp 245,700
69 Kotrimoksasol suspensi 240 mg 50 botol Rp 5,500 - 50 240 30 260 60 0 Rp -
70 Larutan Glukosa 5% 117 botol Rp 6,900 20 80 40 40 40 40 40 Rp 276,000
71 Larutan Glukosa Infus 40% 0 botol Rp - 0 0 0 Rp -
72 Larutan NaCL 76 botol Rp 7,000 100 116 60 100 40 120 40 85 75 Rp 525,000
73 Larutan Ringer Laktat 0 botol Rp 7,000 100 40 60 40 80 20 240 106 154 Rp 1,078,000
74 Lidokain Injeksi 0 ampul Rp 1,026 - 0 0 0 Rp -
75 Loperamid 2 mg 100 tablet Rp 95 - 100 100 500 600 0 Rp -
76 Loratadin 10 mg 1550 tablet Rp 167 200 850 500 350 350 Rp 58,450
77 Magnesium Sulfat 20% (MgSO 20%) 0 vial Rp - 0 0 0 Rp -
78 Magnesium Sulfat 40% (MgSO 40%) 10 vial Rp 7,920 - 10 10 4 6 Rp 47,520
79 Metilergometrin Injeksi 0 ampul Rp 4,895 100 - 100 - 100 - 100 Rp 489,500
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
80 Metilergometrin Tablet 0 tablet Rp 352 - - 0 0 0 Rp -
81 Metilprednisolon 4 mg 400 tablet Rp 441 200 200 200 0 0 Rp -
82 Metformin HCL 500 mg 900 tablet Rp 113 - 900 200 700 - 700 Rp 79,100
83 Metoklopramide 10 mg 600 tablet Rp 120 - 600 600 600 Rp 72,000
84 Metronidasol 250 mg 0 tablet Rp - 0 0 0 Rp -
85 Metronidasol 500 mg 600 tablet Rp 151 2,000 900 1700 1,000 300 2400 1,000 1400 Rp 211,400
86 Mikonasol krim 19 tube Rp 4,060 24 - 43 0 19 24 Rp 97,440
87 Natrium diklofenak 50 mg 1000 tablet Rp 174 500 500 500 0 2,000 1,000 1000 Rp 174,000
88 Nifedipin 10 mg 300 tablet Rp 200 100 200 - 200 - 200 Rp 40,000
89 Nistatin tablet 100.000 IU/g 0 tablet Rp 444 0 0 0 Rp -
90 Nistatin tablet 500.000 IU/g 0 tablet Rp 720 0 0 0 Rp -
91 OBH 90 botol Rp 2,500 - 90 26 64 - 64 Rp 160,000
92 Oksitetrasiklin HCL injeksi 0 ampul Rp - 0 0 0 Rp -
93 Oksitetrasiklin Salep Mata 0 tube Rp 4,400 0 50 25 25 25 0 Rp -
94 Oksitocyn injeksi 0 ampul Rp 1,900 100 10 90 13 77 16 61 Rp 115,900
95 Omeprasol 20 mg 300 kapsul Rp 161 960 640 620 960 1,280 300 1,500 870 930 Rp 149,730
96 Ondansetron Injeksi 0 ampul Rp 1,925 0 0 0 Rp -
97 Ondansetron Tablet 0 tablet Rp 590 0 0 0 Rp -
98 Oralit 140 sac Rp 460 40 0 0 500 200 300 Rp 138,000
99 OTSU KCL injeksi 0 botol Rp 7,920 0 0 0 Rp -
100 Parasetamol drop 18 botol Rp 8,900 18 0 0 0 Rp -
101 Parasetamol sirup 120 mg 0 botol Rp 3,520 0 0 0 Rp -
102 Parasetamol tablet 100 mg 0 tablet Rp 96 0 0 0 Rp -
103 Parasetamol tablet 500 mg 2500 tablet Rp 135 7,000 4,300 5200 6,000 4,200 7000 2,000 3,000 6000 Rp 810,000
104 Phenitoin 100 mg 0 tablet Rp 545 200 - 200 200 100 Rp 54,500
105 Pirantel Pamoat 125 mg 400 tablet Rp 655 - 400 - 400 - 400 Rp 262,000
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
106 Piroxicam 1500 tablet Rp 183 2,000 500 3000 800 2200 700 1500 Rp 274,500
107 Piridoksin 10 mg (Vitamin B6) 500 tablet Rp 67 500 300 700 700 0 1,000 700 300 Rp 20,100
108 Povidon Iodida 30 ml 92 botol Rp 6,400 - 92 - 0 0 Rp -
109 Povidon Iodida 60 ml 0 botol Rp 7,532 0 0 0 Rp -
110 Povidon Iodida 300 ml 16 botol Rp 22,600 3 13 3 0 0 Rp -
111 Propanolol 10 mg 500 tablet Rp 130 0 500 500 0 500 Rp 65,000
112 Propiltiaurasil 100 mg 600 tablet Rp 675 300 300 300 300 0 Rp -
113 Ranitidin Injeksi 15 ampul Rp 3,099 0 0 0 15 15 0 Rp -
114 Ranitidin 150 mg 700 tablet Rp 343 2,000 0 0 2,700 700 2000 Rp 686,000
115 Retinol 100.000 (Vitamin A Biru) 50 kapsul Rp 355 0 50 50 0 50 Rp 17,750
116 Retinol 200.000 (Vitamin A Merah) 50 kapsul Rp 636 0 50 50 50 0 Rp -
117 Salbutamol tablet 2 mg 0 tablet Rp 108 0 0 0 Rp -
118 Salbutamol tablet 4 mg 800 tablet Rp 108 2,000 1700 1100 2,000 700 2400 1,000 1400 2000 Rp 216,000
119 Salep 24 24 pot Rp 3,040 0 24 0 24 0 24 Rp 72,960
120 Sefadroksil 0 tablet Rp 616 1,000 900 100 1,000 800 300 1,000 400 900 Rp 554,400
121 Seftriakson injeksi 0 ampul Rp 5,688 0 0 0 Rp -
122 Sianokobalamin tablet (Vitamin B12) 2000 tablet Rp 69 5,000 3900 3100 5,000 2000 6100 3,000 3600 5500 Rp 379,500
123 Sianokobalamin injeksi (Vitamin B12) 25 ampul Rp 1,100 5 20 20 20 0 Rp -
124 Simetidin 100 tablet Rp 220 0 0 0 0 Rp -
125 Simvastatin 20 mg 450 tablet Rp 250 0 450 450 0 450 Rp 112,500
126 Siprofloksasin tablet score 500 mg 600 tablet Rp 276 2,000 800 1800 500 1300 1,000 500 1800 Rp 496,800
127 Tiamin injeksi 30 ampul Rp 3,800 0 30 0 30 30 0 Rp -
128 Tiamin tablet 50 mg (Vitamin B1) 1700 tablet Rp 40 300 1400 300 1100 800 300 Rp 12,000
129 Vitamin B Kompleks 300 botol Rp 54 7,000 6000 1300 6,000 7300 0 8,000 5800 2200 Rp 118,800
130 Zink sirup 20 mg / 5 ml 0 tablet Rp 17,976 0 0 0 Rp -
131 Zink tablet 20 mg 900 tablet Rp 644 1,000 500 1400 800 600 2,000 1,100 1500 Rp 966,000
132 Ventolin 0 ampul Rp 4,400 - 0 0 0 Rp -
133 Neurodex 0 tablet 0 0 Rp -
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
134 Lodecon Forte 0 tablet Rp 864 2,000 2,000 0 5,000 3,100 1900 2,000 2,400 1500 Rp 1,296,000
135 Solvitron 0 tablet Rp 176 0 0 Rp -
136 Truvit sirup 30 botol Rp 14,245 60 50 40 60 60 40 120 40 120 Rp 1,709,400
137 Cetrizine 10 mg 400 tablet Rp 438 - 400 200 200 200 Rp -
OBAT PROGRAM, VAKSIN DAN

PERBEKALAN KESEHATAN
1 Air Sound Timer 0 buah Rp 48,840 0 0 0 Rp -
2 Azithromycin 0 tablet Rp 176 0 0 Rp -
3 Batrai Air Sound Timer 0 buah Rp - 0 0 Rp -
4 Calcii Glukonas 5 vial Rp 7,967 - 5 5 5 Rp 39,835
5 Dietil Karbamezapin 43231 tablet Rp 119 34,699 8532 1,423 7109 7109 Rp 845,971
6 Gimza 1 botol Rp 1,451,000 1 1 1 Rp 1,451,000
7 Lancet 0 pcs Rp 176 0 5,800 5800 Rp 1,020,800
8 Lysol 100 % 0 botol Rp 53,300 0 0 Rp -
9 Malaria HRP2 (RDT) 175 kotak Rp 5,271 175 175 750 889 36 Rp 189,756
10 Obat Anti Malaria 855 tablet Rp 864 27 828 - 828 - 828 Rp 715,392
11 Paket Kategori I 1 paket Rp 409,075 10 3 8 2 6 4 4 6 Rp 2,454,450
12 Paket Kategori II 0 paket Rp - 0 0 Rp -
13 Paket Stop TB OAT Anak 0 paket Rp 203,259 0 0 Rp -
14 Pot Dahak 400 pot Rp 5,000 - 400 - 400 400 Rp 2,000,000
15 Primaquin 200 tablet Rp 280 50 150 - 150 - 150 Rp 42,000
16 Rapit Test 0 paket Rp 20,216 100 20 80 100 180 180 0 Rp -
17 Reagen Golongan Darah 0 paket Rp - 0 0 Rp -
18 Smart Diagnostic (Reagen HIV) 0 paket Rp - 0 0 Rp -
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
19 Ziehl Neelsen 0 paket Rp 276,500 2 2 2 Rp 553,000
20 HB o 64 Bungkus Rp 20,900 20 21 63 13 50 50 Rp 1,045,000
21 BCG 1 ml/pelarut 23 Vial Rp 5,450 17 6 50 14 42 42 Rp 228,900
25 Polio 4 Vial Rp 19,954 4 50 16 34 20 54 Rp 1,077,516
27 DPT/Pentabion 12 Vial Rp 70,232 20 24 8 50 21 37 20 54 Rp 3,792,528
28 Campak/pelarut/MR 17 Vial Rp 25,640 20 21 16 50 16 50 50 Rp 1,282,000
30 Dt 0 Vial Rp 15,550 30 25 5 5 Rp 77,750
31 Td/Tt 33 Vial Rp 15,000 3 100 55 45 45 Rp 675,000
32 IPV 5 Vial Rp 137,610 20 2 23 2 21 10 31 Rp 4,265,910
33 Spuit 0,05 225 Dos Rp 1,995 25 200 27 173 300 473 Rp 943,635
34 Supit 0,5 130 Dos Rp 1,448 500 330 300 1,000 1,000 300 300 600 Rp 868,800
35 Saftey Box 48 pak Rp 1,448 16 32 32 32 Rp 46,336
36 Hexagon syphilis 0 Rp 26,889 0 1 Rp 26,889
37 Spirtus 2 Rp 68,000 2 1 1 1 Rp 68,000
38 susu 0 Rp 135,000 0 0 Rp -
39 Slide 0 Rp 1,111 0 3,744 3744 Rp 4,159,584
40 Box Slide 0 Rp - 0 0 Rp -
41 Oil Emersian 0 Rp - 0 0 Rp -
42 Tamblet Tambah Darah Program (Ferro Fum 28800 Rp 444 660 28140 4,710 23430 2,510 20510 Rp 9,106,440
43 Alat Deteksi Resiko kehamilan 0 Paket Rp 422,980 1 1 1 0 Rp -
44 Anti HIV 1/2 Cassette 0 Pcs Rp 1,448 0 0 Rp -
45 RDT Hepatitis 0 Pcs 0 0 Rp -
46 Klonazepam 0 Tablet 0 0 Rp -
47 Resperidon 0 Tablet Rp 240 0 0 Rp -
48 Clorpromazine(CPZ) 0 Tablet Rp 197 0 0 Rp -
49 Fluoxentin 0 Tablet 0 0 Rp -
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
50 Isosorbid Dinitrit Tablet Rp 172 500 500 500 500 Rp 86,000
-
PERBEKALAN KESEHATAN Rp -
1 Alat suntik sekali pakai 0,5 ml 200 pcs Rp 1,448 200 200 0 Rp -
2 Alat suntik sekali pakai 0,05 ml 0 pcs Rp 1,995 0 0 Rp -
3 Alat suntik sekali pakai 1 ml 100 pcs Rp 1,000 100 100 100 0 Rp -
4 Alat suntik sekali pakai 2,5 ml 0 pcs Rp 900 0 300 200 200 Rp 180,000
5 Alat suntik sekali pakai 3 ml 300 pcs Rp 900 200 100 300 300 100 0 Rp -
6 Alat suntik sekali pakai 5 ml 100 pcs Rp 2,049 100 300 - 300 - 300 Rp 614,700
7 Alat test kehamilan 50 pcs Rp 975 100 100 50 200 50 200 - 200 Rp 195,000
8 Alkohol 70% 27 botol Rp 43,000 4 23 12 11 9 2 Rp 86,000
9 Benang kulit 1 pcs Rp 13,860 - 12 3 9 9 0 Rp -
10 Benang otot 1 pcs Rp 13,860 - 12 2 10 - 10 Rp 138,600
11 Bisturi No. 10 G 200 pcs Rp 1,450 - 200 100 100 100 100 100 Rp 145,000
12 IV Chateter No. 20 Gx11/4 0 pcs Rp 15,000 - 0 - 0 Rp -
13 IV Chateter No. 22 Gx11/4 55 pcs Rp 9,345 55 200 100 100 50 50 Rp 467,250
14 IV Chateter No. 24 Gx11/4 100 pcs Rp 9,345 50 50 100 150 - 150 Rp 1,401,750
15 IV Channula, without wings No. 22 0 pcs Rp - - 0 Rp -
16 IV Channula, without wings No. 24 0 pcs Rp - 0 Rp -
17 Cutgut plan 2/0 plus jarum 1/2 DT 35 mm pcs Rp 16,667 Rp -
0 0
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
18 Cutgut plan 3/0 plus jarum 1/2 DT 35 mm pcs Rp 16,667 - - Rp 400,008
24 24 24 24
19 Cutgut cromic 2/0 plus jarum 1/2 DT 35 pcs Rp 16,667 - Rp 400,008
mm 24 24 24 24
mm 24 24 24 24
21 Etakridin 0 botol Rp 5,200 - 0 0 Rp -
22 Folley Chateter 2 way No 14 16 pcs Rp 10,560 - 16 16 16 Rp 168,960
26 Handscoon panjang steril 0 pcs Rp - - 0 0 Rp -
27 Infuset Anak 150 pcs Rp 2,913 50 100 50 - 150 50 100 Rp 291,300
28 Infuset Dewasa 195 pcs Rp 6,622 95 100 50 50 100 50 50 Rp 331,100
29 Jarum jahit kulit 84 pcs Rp 1,042 - 84 12 72 12 60 Rp 62,520
30 Jarum jahit otot 84 pcs Rp 1,042 - 84 84 - 84 Rp 87,528
31 Kapas pembalut absorben 250 mg 10 roll Rp 15,000 - 10 1 9 2 7 Rp 105,000
32 Kassa pembalut hidrofil 4x10 cm 70 roll Rp 2,524 - 70 - 70 70 0 Rp -
33 Kassa pembalut hidrofil 4x5 cm 100 roll Rp 1,120 40 60 100 60 100 10 90 Rp 100,800
34 Kassa hidrofil 40x80 cm 5 roll Rp 115,000 2 3 3 0 0 Rp -
35 Masker 0 pcs Rp 700 0 0 Rp -
36 Maxter exam glove no powder L pcs Rp 550 - 50 - Rp 27,500
(Handscoon non steril) 0 0 50
37 My Jelly 3 tube Rp 50,380 3 2 1 4 1 3 Rp 151,140
38 One met sunction chateter No. 14 20 pcs Rp 3,200 20 20 20 Rp 64,000
41 Plester 4 roll Rp 20,000 12 3 13 3 10 24 1 33 Rp 660,000
42 Rivanol 24 botol Rp 5,200 - 24 2 22 5 17 Rp 88,400
43 Safeglove surgical steril (Handscoon steril) pcs Rp 25,000 500 300 500 200 600 Rp -
100 300 600 0
44 Silk 2/0 plus jarum 1/2 DT 35 mm 0 pcs Rp 4,556 0 0 Rp -
45 Silk 3/0 plus jarum 1/2 DT 35 mm 0 pcs Rp 4,556 - 0 0 Rp -
46 Urine bag 7 pcs Rp 5,500 - 7 - 7 - 7 Rp 38,500
47 HCL 0 botol Rp - - 0 0 Rp -
48 Sefter Thicker 0 pcs Rp - - 0 Rp -
er 2019 r r
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
49 Lab Kit 0 Paket Rp 901,274 - 0 Rp -
50 Anti HIV 1/2 Cassette 0 Rp 14,490 Rp -
0 Rp 67,201,706
Malinjak, 03 Januari 2020

Mengetahui
Kepala Puskesmas Pengelola Obat Puskesmas
Herlina L Dapa Talu,A.Md Keb Dewi Zuliatik,A.Md Farm

NIP:19730928 199312 2 002 NIP:19831107 200904 2 006
- - -
BULAN JANUARI s/d MARET 2019
NO NAMA ITEM OBAT JUMLAH satuan HARGA SATUAN PENERIMAAN PENGELUARAN SISA PENERIMAAN PENGELUR SISA PENERIMA PENGELUAR SISA SISA MARET DALAM
STOK OBAT JANUARI JANUARI JANUARI FEBRUARI AN FEBRUARI AN MARET AN MARET MARET (Rp)
DESEMBER FEBRUARI
2018
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Albendasol 1652 tablet Rp 527 1,652 - 1,652 3,570 - 5,222 2,751,994
2 Allopurinol 100 mg 1000 tablet Rp 127 300 700 1,000 300 1,400 2,000 700 2,700 342,900
3 Ambroksol sirup 100 botol Rp 4,000 - 100 - 15 85 35 50 200,000
4 Ambroksol tablet 600 tablet Rp 150 4,000 3,700 900 4,000 2,800 2,100 3,000 5,100 - -
5 Aminophilin injeksi 24 mg / ml 0 ampul Rp 3,349 - - - -
6 Aminophilin tablet 200 mg 500 tablet Rp 180 - 500 - 500 - 500 90,000
7 Amitripilin tablet 25 mg 500 tablet Rp 220 500 - 500 - 500 110,000
8 Amlodipin 10 mg 1310 tablet Rp 110 - 1,310 - 1,310 - 1,310 144,100
9 Amoksisilin 500 mg 1200 tablet Rp 245 8,000 6,700 2,500 6,000 5,900 2,600 6,000 6,500 2,100 514,500
10 Amoksisilin sirup kering 125 mg/5 ml 70 botol Rp 4,183 60 20 110 50 115 45 60 105 - -
11 Antalgin Injeksi 0 ampul Rp 520 30 30 30 30 30 - 30 15,600
12 Antalgin Tablet 800 tablet Rp 145 2,000 1,100 1,700 10,000 1,300 10,400 1,700 8,700 1,261,500
13 Antasida DOEN I tablet 1700 tablet Rp 74 2,500 3,100 1,100 4,000 1,900 3,200 2,000 5,200 - -
14 Antasida DOEN II suspensi 0 botol Rp 2,500 100 29 71 50 62 59 50 60 49 122,500
15 Antihemoroid 70 suppo Rp 3,806 10 60 10 50 - 50 190,300
16 Asam Ascorbat 50 mg 2200 tablet Rp 130 2,500 4,100 600 5,000 5,600 - 8,000 5,800 2,200 286,000
17 Asam Ascorbat 250 mg 1500 tablet Rp 139 500 1,000 2,000 1,000 2,000 2,000 2,000 2,000 278,000
18 Asam Folat 1 mg 700 tablet Rp 57 200 500 - 500 500 100 900 51,300
19 Asam Mefenamat 500 mg 3700 tablet Rp 139 2,000 3,700 2,000 6,000 4,000 4,000 3,000 5,500 1,500 208,500
20 Asam Traneksamat Injeksi 0 ampul Rp - - - - -
21 Asiklovir Salep 38 tube Rp 5,000 - 38 12 26 4 22 110,000
22 Asiklovir 200 mg 1300 tablet Rp 287 200 1,100 - 1,100 200 900 258,300
23 Atapulgit (Akita) 500 tablet Rp 120 - 500 100 400 - 400 48,000
24 Aqua Pro injeksi 21 vial Rp 2,400 2 19 6 13 10 5 18 43,200
25 Bedak salicyl serbuk 2 % 10 pot Rp 1,450 18 10 18 5 13 20 3 30 43,500
26 Betametason krim 75 tube Rp 3,500 50 25 100 25 75 30 45 157,500
27 Besi (II) sukfat 200 mg + asam folat 5550 tablet Rp 49 2,550 3,000 3,000 3,000 3,000 3,000 3,330 2,670 130,830
28 Captopril 25 mg 2300 tablet Rp 457 700 1,600 1,000 200 2,400 600 1,800 822,600
29 Clor Etil 2 botol Rp 12,000 - 2 - 2 - 2 24,000
30 Deksametason injeksi 0 ampul Rp 200 100 - 100 - 100 - 100 20,000
31 Deksametason tablet 0,5 mg 1100 tablet Rp 75 5,000 4,700 1,400 5,000 5,000 1,400 3,000 4,400 - -
32 Diazepam injeksi 5 mg / ml 10 ampul Rp 3,038 - 10 5 5 - 5 15,190
33 Diazepam tablet 5 mg 85 tablet Rp 3,038 - 85 20 65 - 65 197,470
DESEMBER FEBRUARI
2018
34 Difenhidramin injeksi 10 mg/ml 0 ampul Rp 1,260 - - - -

35 Domperidon suspensi 5 mg / 5 ml 45 botol Rp 16,400 45 15 30 20 10 164,000
36 Domperidon tablet 10 mg 850 tablet Rp 190 450 400 400 - 1,000 300 700 133,000
37 Epinefrin (adrenalin) injeksi 30 ampul Rp 5,387 - 30 - 30 - 30 161,610
38 Eritromicin 500 mg 700 tablet Rp 128 200 500 - 500 300 200 25,600
39 Fenitoin Na kapsul 10 mg 0 kapsul Rp 545 - - - -
40 Fenobarbital 30 mg 160 tablet Rp 170 200 60 300 70 230 60 170 28,900
41 Ferro fumarat kapsul lunak 250 mg 0 kapsul Rp 350 - - - -
42 Ferro Glukonat 250 mg (Etabion) 0 tablet Rp 580 - - - -
43 Fitomenadion injeksi 2 ml/mg 30 ampul Rp 4,100 30 - 30 - 30 - 30 123,000
44 Fitomenadion tablet 10 mg 100 tablet Rp 866 - 100 100 200 100 200 173,200
45 Furosemid tablet 40 mg 100 tablet Rp 102 300 100 300 100 200 200 100 300 30,600
46 Gentamicin injeksi 40 mg / ml 20 ampul Rp 3,854 - 20 - 20 - 20 77,080
47 Gentamicin salep kulit 0 tube Rp 3,000 - - 100 30 70 210,000
48 Gentamicin tetes mata 0,3% 24 botol Rp 3,832 24 - - - -
49 Glibenklamid 5 mg 400 tablet Rp 93 - 400 - 400 - 400 37,200
50 Gliseril Guaiakolat (GG) 1800 tablet Rp 450 3,000 3,100 1,700 4,000 5,700 - 7,000 7,000 - -
51 Griseovulvin 125 mg 500 tablet Rp 374 500 100 900 1,000 500 1,400 1,000 200 2,200 822,800
52 H2O2 1 vial Rp 55,000 - 1 1 - 2 - 2 110,000
53 Haloperdiol 0,5 mg 0 tablet Rp - - - - -
54 Hidrokortison krim 24 tube Rp 3,047 96 - 120 - 120 - 120 365,640
55 Ibuproven 200 mg 600 tablet Rp 117 - 600 200 400 400 - -
56 Ibuproven 400 mg 2000 tablet Rp 143 3,500 3,400 2,100 4,000 4,100 2,000 4,500 6,200 300 42,900
57 Kalsium Laktat 500 mg 1120 tablet Rp 83 160 960 80 880 1,000 80 1,800 149,400
58 Karbamazepin 200 mg 0 tablet Rp 1,936 - - - -
59 Ketokenasol 200 mg 190 tablet Rp 205 500 200 490 - 490 240 250 51,250
60 Ketokenasol krim 0 tube Rp 2,930 - 50 25 25 25 - 50 146,500
61 Ketorolac Injeksi 12 ampul Rp 1,450 - 12 12 - 12 12 - -
62 Klindamisin 300 mg 500 tablet Rp 678 - 500 500 - 1,000 - 1,000 678,000
63 Kloramfenikol kapsul 250 mg 400 kapsul Rp 715 - 400 300 100 100 - -
64 Kloramfenikol salep kulit 0 tube Rp 7,433 150 24 126 24 102 24 78 579,774
65 Kloramfenikol tetes mata 0 botol Rp 10,780 25 - 25 - 25 25 - -
66 Kloramfenikol tetes telinga 3% 0 botol Rp 3,000 25 - 25 - 25 25 - -
67 Kloramfeniramina Maleat 4 mg (CTM) 1600 tablet Rp 43 6,000 5,200 2,400 5,000 6,800 600 10,000 9,400 1,200 51,600
68 Kotrimoksasol tablet 480 mg 1200 tablet Rp 273 1,500 900 1,800 2,000 500 3,300 900 2,400 655,200
DESEMBER FEBRUARI
2018
69 Kotrimoksasol suspensi 240 mg 19 botol Rp 5,500 50 9 60 50 - 110 10 100 550,000

70 Larutan Glukosa 5% 100 botol Rp 6,900 - 100 - 100 - 100 690,000
71 Larutan Glukosa Infus 40% 0 botol Rp - - - - -
72 Larutan NaCL 115 botol Rp 7,000 - 115 115 25 90 630,000
73 Larutan Ringer Laktat 140 botol Rp 7,000 200 240 100 200 220 80 200 240 40 280,000
74 Lidokain Injeksi 50 ampul Rp 1,026 30 20 20 20 20,520
75 Loperamid 2 mg 300 tablet Rp 95 - 300 300 200 100 9,500
76 Loratadin 10 mg 0 tablet Rp 167 - - 2,000 700 1,300 217,100
77 Magnesium Sulfat 20% (MgSO 20%) 0 vial Rp - - - - -
78 Magnesium Sulfat 40% (MgSO 40%) 0 vial Rp 7,920 - 10 - 10 - 10 79,200
79 Metilergometrin Injeksi 100 ampul Rp 4,895 - 100 - 100 - 100 489,500
80 Metilergometrin Tablet 100 tablet Rp 352 - 100 - 100 100 - -
81 Metilprednisolon 4 mg 0 tablet Rp 441 - - 1,000 300 700 308,700
82 Metformin HCL 500 mg 1100 tablet Rp 113 - 1,100 - 1,100 - 1,100 124,300
83 Metoklopramide 10 mg 600 tablet Rp - - 600 600 600 -
84 Metronidasol 250 mg 0 tablet Rp - - - - -
85 Metronidasol 500 mg 1200 tablet Rp 151 200 1,000 1,000 500 1,500 1,000 100 2,400 362,400
86 Mikonasol krim 48 tube Rp 4,060 - 48 - 48 48 - -
87 Natrium diklofenak 50 mg 0 tablet Rp 162 - - 2,000 - 2,000 324,000
88 Nifedipin 10 mg 400 tablet Rp 200 - 400 - 400 - 400 80,000
89 Nistatin tablet 100.000 IU/g 400 tablet Rp 444 - 400 - 400 - 400 177,600
90 Nistatin tablet 500.000 IU/g 200 tablet Rp 720 - 200 - 200 100 100 72,000
91 OBH 90 botol Rp 2,500 - 90 10 80 65 15 37,500
92 Oksitetrasiklin HCL injeksi 0 ampul Rp - - - - -
93 Oksitetrasiklin Salep Mata 0 tube Rp 4,400 100 - 100 25 75 - 75 330,000
94 Oksitocyn injeksi 100 ampul Rp 1,900 - 100 100 20 80 152,000
95 Omeprasol 20 mg 0 kapsul Rp 161 - 990 180 810 900 80 1,630 262,430
96 Ondansetron Injeksi 0 ampul Rp 1,925 - - - -
97 Ondansetron Tablet 252 tablet Rp 590 24 228 60 168 - 168 99,120
98 Oralit 300 sac Rp 460 140 160 300 60 400 20 380 174,800
99 OTSU KCL injeksi 0 botol Rp 7,920 - - - -
100 Parasetamol drop 0 botol Rp 8,900 48 4 44 48 35 57 48 35 70 623,000
101 Parasetamol sirup 120 mg 120 botol Rp 3,520 45 75 150 225 - 200 200 - -
102 Parasetamol tablet 100 mg 900 tablet Rp 96 - 900 - 100 800 800 - -
103 Parasetamol tablet 500 mg 2200 tablet Rp 135 7,000 6,800 2,400 6,000 7,800 600 10,000 8,100 2,500 337,500
104 Phenitoin 100 mg 95 tablet Rp 545 20 75 10 65 - 65 35,425
105 Pirantel Pamoat 125 mg 500 tablet Rp 655 - 500 100 400 - 400 262,000
DESEMBER FEBRUARI
2018
106 Piroksicam 0 tablet Rp 183 2,000 700 1,300 1,000 1,100 1,200 1,000 1,500 700 128,100
107 Piridoksin 10 mg (Vitamin B6) 800 tablet Rp 67 - 800 400 400 1,000 500 900 60,300
108 Povidon Iodida 30 ml 0 botol Rp - - - - -
109 Povidon Iodida 60 ml 40 botol Rp 7,532 - 40 - 40 1 39 293,748
110 Povidon Iodida 300 ml 12 botol Rp 22,600 2 10 - 10 - 10 226,000
111 Propanolol 10 mg 300 tablet Rp 130 100 200 - 200 200 400 52,000
112 Propiltiaurasil 100 mg 300 tablet Rp 675 - 300 100 200 200 100 300 202,500
113 Ranitidin Injeksi 0 ampul Rp 3,099 100 - 100 60 40 20 20 61,980
114 Ranitidin 150 mg 800 tablet Rp 343 2,000 300 2,500 500 2,000 1,400 600 205,800
115 Retinol 100.000 (Vitamin A Biru) 340 kapsul Rp 355 340 168 172 172 - -
116 Retinol 200.000 (Vitamin A Merah) 135 kapsul Rp 636 800 - 935 900 35 35 - -
117 Salbutamol tablet 2 mg 1300 tablet Rp 108 1,100 200 500 200 500 1,000 600 900 97,200
118 Salbutamol tablet 4 mg 1500 tablet Rp 108 300 1,200 400 800 1,000 500 1,300 140,400
119 Salep 24 48 pot Rp 3,040 24 24 - 24 - 24 72,960
120 Sefadroksil 700 tablet Rp 616 200 500 1,000 - 1,500 1,100 400 246,400
121 Seftriakson injeksi 10 ampul Rp 5,688 4 6 4 2 2 11,376
122 Sianokobalamin tablet (Vitamin B12) 200 tablet Rp 69 5,000 2,000 3,200 5,000 4,200 4,000 3,000 4,000 3,000 207,000
123 Sianokobalamin injeksi (Vitamin B12) 0 ampul Rp 1,100 100 10 90 - 90 20 70 77,000
124 Simetidin 300 tablet Rp 220 100 200 100 100 - 100 22,000
125 Simvastatin 20 mg 350 tablet Rp 250 - 350 - 350 150 200 50,000
126 Siprofloksasin tablet score 500 mg 600 tablet Rp 276 1,300 1,900 100 1,800 1,000 600 2,200 607,200
127 Tiamin injeksi 0 ampul Rp 3,800 - 30 - 30 - 30 114,000
128 Tiamin tablet 50 mg (Vitamin B1) 2000 tablet Rp 40 - 2,000 600 1,400 2,000 400 3,000 120,000
129 Vitamin B Kompleks 2200 botol Rp 54 4,000 3,700 2,500 4,000 3,000 3,500 3,000 6,500 - -
130 Zink sirup 20 mg / 5 ml 0 tablet Rp 17,976 - - - -
131 Zink tablet 20 mg 1300 tablet Rp 644 1,000 1,500 800 2,000 1,100 1,700 2,000 900 2,800 1,803,200
132 Ventolin 0 ampul Rp 4,400 60 - 60 40 20 40 40 20 88,000
133 Neurodex 0 tablet - - - - -
134 Lodecon Forte 0 tablet Rp 48,840 1,000 1,000 - 2,000 2,000 - 2,000 2,000 - -
135 Solvitron 0 tablet Rp 176 1,000 1,000 - 1,000 1,000 - - -
136 Truvit sirup 0 botol Rp 14,245 60 5 55 60 9 106 51 55 783,475
-
OBAT PROGRAM, VAKSIN DAN -
1 Air Sound Timer 0 buah Rp 48,840 - - - -
2 Azithromycin 0 tablet Rp 176 - - - -
3 Batrai Air Sound Timer 0 buah Rp - - - - -
DESEMBER FEBRUARI
2018
4 Calcii Glukonas 5 vial Rp 7,964 5 5 - 5 39,820

5 Dietil Karbamezapin 1631 tablet Rp 119 1,631 1,631 - 1,631 194,089
6 Gimza 1 botol Rp 1,451,000 - 1 - 1 - 1 1,451,000
7 Lancet 4400 pcs Rp 176 4,400 4,400 - 4,400 774,400
8 Lysol 100 % 0 botol Rp - - - - - -
9 Malaria HRP2 (RDT) 0 kotak Rp 5,271 - 45 26 19 1 18 94,878
10 Obat Anti Malaria 540 tablet Rp 864 450 630 360 1,368 1,008 720 450 675 495 427,680
11 Paket Kategori I 6 paket Rp 409,075 2 4 1 3 3 3 3 1,227,225
12 Paket Kategori II 0 paket Rp - - - - -
13 Paket Stop TB OAT Anak 0 paket Rp 203,259 - - - -
14 Pot Dahak 200 pot Rp 5,000 - 200 200 400 200 200 1,000,000
15 Primaquin 0 tablet Rp 280 1,500 1,300 200 700 900 - - -
16 Rapit Test 0 paket Rp 20,216 - - - -
17 Reagen Golongan Darah 0 paket Rp - - - - -
18 Smart Diagnostic (Reagen HIV) 0 paket Rp - - - - -
19 Ziehl Neelsen 1 paket Rp 276,500 - 1 - 1 - 1 276,500
20 HB o 40 Bungkus Rp 20,900 50 90 67 23 100 2 121 2,528,900
21 BCG 1 ml/pelarut 0 Vial Rp 54,500 30 30 20 26 24 30 4 50 2,725,000
25 Polio 0 Vial Rp 19,954 50 50 20 33 37 20 17 40 798,160
27 DPT/Pentabion 2 Vial Rp 70,232 50 52 30 58 24 30 - 54 3,792,528
28 Campak/pelarut/MR 30 Vial Rp 25,640 30 20 25 25 50 24 51 1,307,640
30 Dt 0 Vial Rp 15,550 - - - -
31 Td/Tt 20 Vial Rp 15,000 20 5 15 20 2 33 495,000
32 IPV 8 Vial Rp 137,610 20 28 20 23 25 20 - 45 6,192,450
33 Spuit 0,05 150 Dos Rp 1,995 150 300 450 - 300 300 598,500
34 Supit 0,5 300 Dos Rp 1,448 300 600 400 1,000 - 300 300 434,400
35 Saftey Box 5 pak Rp 1,448 5 25 30 30 43,440
36 Hexagon syphilis 0 Rp 26,889 - - - -
37 Spirtus 1 Rp 68,000 1 1 1 68,000
38 susu 10 Rp 135,000 5 2 13 13 3 - 16 2,160,000
39 Slide 3600 Rp 1,111 3,600 3,600 3,600 3,999,600
40 Box Slide 0 Rp - - - - -
41 Oil Emersian 0 Rp - - - - -
42 Tamblet Tambah Darah Program (Ferro Fu 7400 Rp 444 400 7,000 7,000 - 11,200 5,600 5,600 2,486,400
43 Alat Deteksi Resiko kehamilan 1 Paket Rp 422,980 1 1 - - -
- -
DESEMBER FEBRUARI
2018
- -
PERBEKALAN KESEHATAN - - -
1 Alat suntik sekali pakai 0,5 ml 0 pcs Rp 1,448 - - - -
2 Alat suntik sekali pakai 0,05 ml 0 pcs Rp - - - - -
3 Alat suntik sekali pakai 1 ml 200 pcs Rp 1,000 - 200 - 200 - 200 200,000
4 Alat suntik sekali pakai 2,5 ml 0 pcs Rp - - - - -
5 Alat suntik sekali pakai 3 ml 400 pcs Rp 900 115 285 185 100 300 120 280 252,000
6 Alat suntik sekali pakai 5 ml 400 pcs Rp 2,049 100 300 100 200 200 - 200 409,800
7 Alat test kehamilan 0 pcs Rp 975 - - 100 - 100 50 - 150 146,250
8 Alkohol 70% 0 botol Rp 43,000 5 2 3 3 2 4 4 3 5 215,000
9 Benang kulit 0 pcs Rp 13,860 - - - - -
10 Benang otot 0 pcs Rp 13,860 - - - - -
11 Bisturi No. 10 G 100 pcs Rp 1,450 100 200 - 300 - 300 - 300 435,000
12 IV Chateter No. 20 Gx11/4 0 pcs Rp 15,000 50 50 50 50 50 50 750,000
13 IV Chateter No. 22 Gx11/4 100 pcs Rp 9,345 100 - 150 100 50 100 100 50 467,250
14 IV Chateter No. 24 Gx11/4 115 pcs Rp 9,345 115 150 - 265 52 213 1,990,485
15 IV Channula, without wings No. 22 0 pcs Rp - - - - -
16 IV Channula, without wings No. 24 0 pcs Rp - - - - -
17 Cutgut plan 2/0 plus jarum 1/2 DT 35 mm pcs Rp 16,667 - - - -
0
18 Cutgut plan 3/0 plus jarum 1/2 DT 35 mm pcs Rp 16,667 - 24 - 24 - 24 400,008
0
19 Cutgut cromic 2/0 plus jarum 1/2 DT 35 pcs Rp 16,667 - 24 - 24 - 24 400,008
mm 0
20 Cutgut cromic 3/0 plus jarum 1/2 DT 35 pcs Rp 16,667 - 24 - 24 24 400,008
mm 0
21 Etakridin 16 botol Rp 5,200 - 16 16 - 16 83,200
22 Folley Chateter 2 way No 14 10 pcs Rp - 10 10 10 -
24 Folley Chateter 2 way No 18 10 pcs Rp 9,829 10 10 10 98,290
26 Handscoon panjang steril 50 pcs Rp - - 50 - 50 - 50 -
27 Infuset Anak 69 pcs Rp 2,913 - 69 100 - 169 100 38 231 672,903
28 Infuset Dewasa 50 pcs Rp 6,622 100 50 100 100 100 100 100 100 100 662,200
29 Jarum jahit kulit 96 pcs Rp 1,042 12 84 - 84 - 84 87,528
DESEMBER FEBRUARI
2018
30 Jarum jahit otot 96 pcs Rp 1,042 12 84 - 84 - 84 87,528

31 Kapas pembalut absorben 250 mg 8 roll Rp 15,000 1 7 - 7 1 6 90,000
32 Kassa pembalut hidrofil 4x10 cm 180 roll Rp 2,524 40 140 140 10 130 328,120
33 Kassa pembalut hidrofil 4x5 cm 100 roll Rp 1,120 100 100 100 112,000
34 Kassa hidrofil 40x80 cm 0 roll Rp 115,000 5 2 3 3 5 1 5 2 4 460,000
35 Masker 150 pcs Rp 700 50 50 150 50 100 100 100 150 50 35,000
36 Maxter exam glove no powder L pcs Rp 550 1,000 700 500 500 1,000 - 1,000 500 500 275,000
(Handscoon non steril) 200
37 My Jelly 0 tube Rp 50,380 - - 2 - 2 100,760
38 One met sunction chateter No. 14 20 pcs Rp - 20 20 - 20 -
39 One met sunction chateter No. 16 20 pcs Rp - 20 20 - 20 -
40 One met sunction chateter No. 18 10 pcs Rp - - 10 - - 10 - - 10 -
41 Plester 7 roll Rp 20,000 5 2 24 6 20 - 2 18 360,000
42 Rivanol 0 botol Rp 5,200 - - - - -
43 Safeglove surgical steril (Handscoon pcs Rp 25,000 - 250 50 200 - 100 100 2,500,000
steril) 250
44 Silk 2/0 plus jarum 1/2 DT 35 mm 36 pcs Rp 4,556 36 36 - - - -
45 Silk 3/0 plus jarum 1/2 DT 35 mm 36 pcs 36 36 - - - -
46 Urine bag 10 pcs Rp 5,500 - 10 10 - - 10 55,000
47 HCL 0,1 botol Rp - - - - - - -
48 Sefter Thicker 0 pcs Rp - - - - - - -
49 Lab Kit 1 Paket Rp 901,274 1 - - - - - -
50 Anti HIV 1/2 Cassette 100 pcs Rp 14,490 100 - 100 - - - 58
TOTAL Rp 70,843,278
Malinjak, 30 Maret 2019

Mengetahui

NIP:19730928 199312 2 002 NIP:19831107 200904 2 006
BULAN Oktober s/d Desember 2019
NO NAMA ITEM OBAT JUMLAH SATUAN HARGA PENERIM PENGELU SISA PENERIMA PENGELU SISA PENERIMA PENGELUA SISA SISA Desember
STOK SATUAN AAN ARAN Oktober AN ARAN Nofember AN RAN Desembe DALAM (Rp)
Septemb OBAT Oktober Oktober Nofember Nofember Desember Desember r
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Albendasol 15,470 tablet Rp 527 13,151 2319 - 1,423 860 - 860 Rp 453,220
2 Allopurinol 100 mg 300 tablet Rp 127 2,000 1,100 1200 1,000 900 1300 1,000 1,300 1000 Rp 127,000
3 Ambroksol sirup 100 botol Rp 4,000 100 0 - - 0 100 - 100 Rp 400,000
4 Ambroksol tablet 200 tablet Rp 150 5,500 2,500 3200 2,000 3,700 1500 3,000 2,900 1600 Rp 240,000
6 Aminophilin tablet 200 mg 0 tablet Rp 180 - 100 - 100 - 100 Rp 18,000
7 Amitripilin tablet 25 mg 500 tablet Rp 220 - 500 - - 500 - 500 Rp 110,000
8 Amlodipin 10 mg 90 tablet Rp 110 1,000 590 500 2,000 1,300 1200 1,000 - 2200 Rp 242,000
11 Antalgin Injeksi 25 ampul Rp 520 - 0 0 - 0 Rp -
12 Antalgin Tablet 500 tablet Rp 145 2,000 1,400 1100 2,000 700 2400 900 1500 Rp 217,500
14 Antasida DOEN II suspensi 0 botol Rp 2,500 0 0 - 0 Rp -
15 Antihemoroid 25 suppo Rp 3,806 10 15 50 - 65 65 Rp 247,390
17 Asam Ascorbat 250 mg 0 tablet Rp 139 0 0 0 Rp -
18 Asam Folat 1 mg 900 tablet Rp 57 100 800 500 600 700 1,000 200 1500 Rp 85,500
20 Asam Traneksamat Injeksi 0 ampul Rp - 0 0 - 0 Rp -
21 Asiklovir Salep 25 tube Rp 5,000 15 10 48 10 48 - 48 Rp 240,000
22 Asiklovir 200 mg 400 tablet Rp 287 1,000 - 1400 300 1100 - 1100 Rp 315,700
23 Atapulgit (Akita) 400 tablet Rp 120 100 0 0 0 Rp -
24 Aqua Pro injeksi 10 vial Rp 2,400 - 10 5 5 - 5 Rp 12,000
25 Bedak salicyl serbuk 2 % 38 pot Rp 1,450 5 33 24 - 57 - 57 Rp 82,650
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
26 Betametason krim 25 tube Rp 3,500 50 - 75 50 100 25 100 25 100 Rp 350,000
27 Besi (II) sukfat 200 mg + asam folat 2700 tablet Rp 49 - 0 0 0 Rp -
28 Captopril 25 mg 1800 tablet Rp 457 2,000 300 3500 300 3200 1,300 1900 Rp 868,300
29 Clor Etil 2 botol Rp 12,000 2 - 2 1 1 Rp 12,000
30 Deksametason injeksi 0 ampul Rp 200 0 0 - 0 Rp -
32 Diazepam injeksi 5 mg / ml 0 ampul Rp 3,038 0 - 0 - 0 Rp -
33 Diazepam tablet 5 mg 35 tablet Rp 3,038 - 35 35 - 35 Rp 106,330
34 Difenhidramin injeksi 10 mg/ml 0 ampul Rp 1,260 0 0 - Rp -
35 Domperidon suspensi 5 mg / 5 ml 0 botol Rp 16,400 0 0 Rp -
36 Domperidon tablet 10 mg 400 tablet Rp 190 200 200 500 - 700 600 100 Rp 19,000
38 Eritromicin 500 mg 400 tablet Rp 128 200 200 1,000 200 1000 - 1000 Rp 128,000
39 Fenitoin Na kapsul 10 mg 0 kapsul Rp 545 0 0 Rp -
40 Fenobarbital 30 mg 390 tablet Rp 170 200 190 500 690 140 550 Rp 93,500
41 Ferro fumarat kapsul lunak 250 mg 0 kapsul Rp 350 0 2,000 500 1500 1,500 Rp -
42 Ferro Glukonat 250 mg (Etabion) 0 tablet Rp 580 0 0 Rp -
43 Fitomenadion injeksi 2 ml/mg 0 ampul Rp 4,100 0 0 Rp -
44 Fitomenadion tablet 10 mg 0 tablet Rp 866 0 0 Rp -
45 Furosemid tablet 40 mg 100 tablet Rp 102 100 - 200 - 200 100 100 Rp 10,200
46 Gentamicin injeksi 40 mg / ml 0 ampul Rp 3,854 0 0 Rp -
47 Gentamicin salep kulit 70 tube Rp 3,000 - 70 40 30 50 10 70 Rp 210,000
48 Gentamicin tetes mata 0,3% 0 botol Rp 3,832 - 0 0 Rp -
51 Griseovulvin 125 mg 500 tablet Rp 374 - 500 500 200 300 Rp 112,200
52 H2O2 1 vial Rp 55,000 - 1 2 1 2 1 1 Rp 55,000
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
53 Haloperdiol 0,5 mg 0 tablet Rp - 0 0 Rp -
54 Hidrokortison krim 24 tube Rp 3,047 48 24 48 24 24 24 Rp -
55 Ibuproven 200 mg 0 tablet Rp 117 0 0 Rp -
58 Karbamazepin 200 mg 0 tablet Rp 1,936 500 - 500 - 500 - 500 Rp 968,000
59 Ketokenasol 200 mg 300 tablet Rp 205 - 300 300 0 Rp -
60 Ketokenasol krim 45 tube Rp 2,930 - 45 20 25 25 25 25 Rp 73,250
61 Ketorolac Injeksi 0 ampul Rp 1,450 12 - 12 12 0 12 12 Rp 17,400
62 Klindamisin 300 mg 1000 tablet Rp 678 - 0 0 Rp -
63 Kloramfenikol kapsul 250 mg 0 kapsul Rp 715 - 0 0 Rp -
65 Kloramfenikol tetes mata 0 botol Rp 10,780 - 0 0 Rp -
66 Kloramfenikol tetes telinga 3% 0 botol Rp 3,000 25 - 25 25 0 25 25 Rp -
68 Kotrimoksasol tablet 480 mg 1000 tablet Rp 273 2,000 1,000 2000 900 1100 1,000 1,200 900 Rp 245,700
69 Kotrimoksasol suspensi 240 mg 50 botol Rp 5,500 - 50 240 30 260 60 Rp -
70 Larutan Glukosa 5% 117 botol Rp 6,900 20 80 40 40 40 40 40 Rp 276,000
71 Larutan Glukosa Infus 40% 0 botol Rp - 0 0 Rp -
72 Larutan NaCL 76 botol Rp 7,000 100 116 60 100 40 120 40 85 75 Rp 525,000
73 Larutan Ringer Laktat 0 botol Rp 7,000 100 40 60 40 80 20 240 106 154 Rp 1,078,000
74 Lidokain Injeksi 0 ampul Rp 1,026 - 0 0 Rp -
75 Loperamid 2 mg 100 tablet Rp 95 - 100 100 500 600 Rp -
76 Loratadin 10 mg 1550 tablet Rp 167 200 850 500 350 350 Rp 58,450
77 Magnesium Sulfat 20% (MgSO 20%) 0 vial Rp - 0 0 Rp -
78 Magnesium Sulfat 40% (MgSO 40%) 10 vial Rp 7,920 - 10 10 4 6 Rp 47,520
79 Metilergometrin Injeksi 0 ampul Rp 4,895 100 - 100 - 100 - 100 Rp 489,500
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
80 Metilergometrin Tablet 0 tablet Rp 352 - - 0 0 Rp -
81 Metilprednisolon 4 mg 400 tablet Rp 441 200 200 200 0 Rp -
82 Metformin HCL 500 mg 900 tablet Rp 113 - 900 200 700 - 700 Rp 79,100
83 Metoklopramide 10 mg 600 tablet Rp - - 600 600 600 Rp -
84 Metronidasol 250 mg 0 tablet Rp - 0 0 Rp -
85 Metronidasol 500 mg 600 tablet Rp 151 2,000 900 1700 1,000 300 2400 1,000 1400 Rp 211,400
86 Mikonasol krim 19 tube Rp 4,060 24 - 43 0 19 24 Rp 97,440
87 Natrium diklofenak 50 mg 1000 tablet Rp 162 500 500 500 0 2,000 1,000 1000 Rp 162,000
88 Nifedipin 10 mg 300 tablet Rp 200 100 200 - 200 - 200 Rp 40,000
89 Nistatin tablet 100.000 IU/g 0 tablet Rp 444 0 0 Rp -
90 Nistatin tablet 500.000 IU/g 0 tablet Rp 720 0 0 Rp -
91 OBH 90 botol Rp 2,500 - 90 26 64 - 64 Rp 160,000
92 Oksitetrasiklin HCL injeksi 0 ampul Rp - 0 0 Rp -
93 Oksitetrasiklin Salep Mata 0 tube Rp 4,400 0 50 25 25 25 Rp -
94 Oksitocyn injeksi 0 ampul Rp 1,900 100 10 90 13 77 16 61 Rp 115,900
95 Omeprasol 20 mg 300 kapsul Rp 161 960 640 620 960 1,280 300 1,500 870 930 Rp 149,730
96 Ondansetron Injeksi 0 ampul Rp 1,925 0 0 Rp -
97 Ondansetron Tablet 0 tablet Rp 590 0 0 Rp -
98 Oralit 140 sac Rp 460 40 0 0 500 200 300 Rp 138,000
99 OTSU KCL injeksi 0 botol Rp 7,920 0 0 Rp -
100 Parasetamol drop 18 botol Rp 8,900 18 0 0 Rp -
101 Parasetamol sirup 120 mg 0 botol Rp 3,520 0 0 Rp -
102 Parasetamol tablet 100 mg 0 tablet Rp 96 0 0 Rp -
103 Parasetamol tablet 500 mg 2500 tablet Rp 135 7,000 4,300 5200 6,000 4,200 7000 2,000 3,000 6000 Rp 810,000
104 Phenitoin 100 mg 0 tablet Rp 545 200 - 200 200 100 Rp 54,500
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
106 Piroxicam 1500 tablet Rp 183 2,000 500 3000 800 2200 700 1500 Rp 274,500
107 Piridoksin 10 mg (Vitamin B6) 500 tablet Rp 67 500 300 700 700 0 1,000 700 300 Rp 20,100
108 Povidon Iodida 30 ml 92 botol Rp 6,400 - 92 - 0 Rp -
109 Povidon Iodida 60 ml 0 botol Rp 7,532 0 0 Rp -
110 Povidon Iodida 300 ml 16 botol Rp 22,600 3 13 3 0 Rp -
111 Propanolol 10 mg 500 tablet Rp 130 0 500 500 0 500 Rp 65,000
112 Propiltiaurasil 100 mg 600 tablet Rp 675 300 300 300 300 Rp -
113 Ranitidin Injeksi 15 ampul Rp 3,099 0 0 0 15 15 Rp -
114 Ranitidin 150 mg 700 tablet Rp 343 2,000 0 0 2,700 700 2000 Rp 686,000
115 Retinol 100.000 (Vitamin A Biru) 50 kapsul Rp 355 0 50 50 0 50 Rp 17,750
116 Retinol 200.000 (Vitamin A Merah) 50 kapsul Rp 636 0 50 50 50 Rp -
117 Salbutamol tablet 2 mg 0 tablet Rp 108 0 0 Rp -
119 Salep 24 24 pot Rp 3,040 0 24 0 24 0 24 Rp 72,960
120 Sefadroksil 0 tablet Rp 616 1,000 900 100 1,000 800 300 1,000 400 900 Rp 554,400
121 Seftriakson injeksi 0 ampul Rp 5,688 0 0 Rp -
123 Sianokobalamin injeksi (Vitamin B12) 25 ampul Rp 1,100 5 20 20 20 Rp -
124 Simetidin 100 tablet Rp 220 0 0 0 Rp -
125 Simvastatin 20 mg 450 tablet Rp 250 0 450 450 0 450 Rp 112,500
126 Siprofloksasin tablet score 500 mg 600 tablet Rp 276 2,000 800 1800 500 1300 1,000 500 1800 Rp 496,800
127 Tiamin injeksi 30 ampul Rp 3,800 0 30 0 30 30 Rp -
130 Zink sirup 20 mg / 5 ml 0 tablet Rp 17,976 0 0 Rp -
131 Zink tablet 20 mg 900 tablet Rp 644 1,000 500 1400 800 600 2,000 1,100 1500 Rp 966,000
132 Ventolin 0 ampul Rp 4,400 - 0 0 Rp -
133 Neurodex 0 tablet 0 0 Rp -
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
134 Lodecon Forte 0 tablet Rp 48,840 2,000 2,000 0 5,000 3,100 1900 2,000 2,400 1500 Rp 73,260,000
135 Solvitron 0 tablet Rp 176 0 0 Rp -
136 Truvit sirup 30 botol Rp 14,245 60 50 40 60 60 40 120 40 120 Rp 1,709,400
137 Cetrizine 10 mg 400 tablet Rp 438 - 400 200 200 200 Rp -

1 Air Sound Timer 0 buah Rp 48,840 0 0 Rp -
2 Azithromycin 0 tablet Rp 176 0 Rp -
3 Batrai Air Sound Timer 0 buah Rp - 0 Rp -
4 Calcii Glukonas 5 vial Rp 7,964 - 5 5 5 Rp 39,820
5 Dietil Karbamezapin 43231 tablet Rp 119 34,699 8532 1,423 7109 7109 Rp 845,971
6 Gimza 1 botol Rp 1,451,000 1 1 1 Rp 1,451,000
7 Lancet 0 pcs Rp 176 0 5,800 5800 Rp 1,020,800
8 Lysol 100 % 0 botol Rp - 0 Rp -
11 Paket Kategori I 1 paket Rp 409,075 10 3 8 2 6 4 4 6 Rp 2,454,450
12 Paket Kategori II 0 paket Rp - 0 Rp -
13 Paket Stop TB OAT Anak 0 paket Rp 203,259 0 Rp -
14 Pot Dahak 400 pot Rp 5,000 - 400 - 400 400 Rp 2,000,000
16 Rapit Test 0 paket Rp 20,216 100 20 80 100 180 180 Rp -
17 Reagen Golongan Darah 0 paket Rp - 0 Rp -
18 Smart Diagnostic (Reagen HIV) 0 paket Rp - 0 Rp -
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
19 Ziehl Neelsen 0 paket Rp 276,500 2 2 Rp
2 553,000
20 HB o 64 Bungkus Rp 20,900 20 21 63 13 50 Rp
50 1,045,000
21 BCG 1 ml/pelarut 23 Vial Rp 54,500 17 6 50 14 42 Rp
42 2,289,000
25 Polio 4 Vial Rp 19,954 4 50 16 34 20 Rp
54 1,077,516
27 DPT/Pentabion 12 Vial Rp 70,232 20 24 8 50 21 37 20 Rp
57 4,003,224
28 Campak/pelarut/MR 17 Vial Rp 25,640 20 21 16 50 16 50 Rp
50 1,282,000
30 Dt 0 Vial Rp 15,550 30 25 5 Rp
5 77,750
31 Td/Tt 33 Vial Rp 15,000 3 100 55 45 Rp
45 675,000
32 IPV 5 Vial Rp 137,610 20 2 23 2 21 10 Rp
31 4,265,910
33 Spuit 0,05 225 Dos Rp 1,995 25 200 27 173 300 Rp
473 943,635
34 Supit 0,5 130 Dos Rp 1,448 500 330 300 1,000 1,000 300 300 Rp
600 868,800
35 Saftey Box 48 pak Rp 1,448 16 32 32 Rp
32 46,336
36 Hexagon syphilis 0 Rp 26,889 0 Rp
1 26,889
37 Spirtus 2 Rp 68,000 2 1 1 Rp
1 68,000
38 susu 0 Rp 135,000 0 Rp -
39 Slide 0 Rp 1,111 0 3,744 3744 Rp 4,159,584
40 Box Slide 0 Rp - 0 Rp -
41 Oil Emersian 0 Rp - 0 Rp -
42 Tamblet Tambah Darah Program (Ferro Fum 28800 Rp 444 660 28140 4,710 23430 2,510 20510 Rp 9,106,440
43 Alat Deteksi Resiko kehamilan 0 Paket Rp 422,980 1 1 1 0 Rp -
44 Anti HIV 1/2 Cassette 0 Pcs 0 Rp -
45 RDT Hepatitis 0 Pcs 0 Rp -
46 Klonazepam 0 Tablet 0 Rp -
47 Resperidon 0 Tablet 0 Rp -
48 Clorpromazine(CPZ) 0 Tablet 0 Rp -
49 Fluoxentin 0 Tablet 0 Rp -
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
50 Isosorbid Dinitrit Tablet Rp 172 500 500 500 500 Rp 86,000
PERBEKALAN KESEHATAN Rp -
1 Alat suntik sekali pakai 0,5 ml 200 pcs Rp 1,448 200 200 Rp -
2 Alat suntik sekali pakai 0,05 ml 0 pcs Rp - 0 Rp -
3 Alat suntik sekali pakai 1 ml 100 pcs Rp 1,000 100 100 100 Rp -
4 Alat suntik sekali pakai 2,5 ml 0 pcs Rp - 0 300 200 200 Rp -
5 Alat suntik sekali pakai 3 ml 300 pcs Rp 900 200 100 300 300 100 Rp -
7 Alat test kehamilan 50 pcs Rp 975 100 100 50 200 50 200 - 200 Rp 195,000
8 Alkohol 70% 27 botol Rp 43,000 4 23 12 11 9 2 Rp 86,000
9 Benang kulit 1 pcs Rp 13,860 - 12 3 9 9 Rp -
10 Benang otot 1 pcs Rp 13,860 - 12 2 10 - 10 Rp 138,600
11 Bisturi No. 10 G 200 pcs Rp 1,450 - 200 100 100 100 100 100 Rp 145,000
12 IV Chateter No. 20 Gx11/4 0 pcs Rp 15,000 - 0 - Rp -
13 IV Chateter No. 22 Gx11/4 55 pcs Rp 9,345 55 200 100 100 50 50 Rp 467,250
14 IV Chateter No. 24 Gx11/4 100 pcs Rp 9,345 50 50 100 150 - 150 Rp 1,401,750
15 IV Channula, without wings No. 22 0 pcs Rp - - Rp -
16 IV Channula, without wings No. 24 0 pcs Rp - Rp -
17 Cutgut plan 2/0 plus jarum 1/2 DT 35 mm pcs Rp 16,667 Rp -
0
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
24 24 24 24
mm 24 24 24 24
mm 24 24 24 24
21 Etakridin 0 botol Rp 5,200 - 0 Rp -
22 Folley Chateter 2 way No 14 16 pcs Rp - - 16 16 16 Rp -
26 Handscoon panjang steril 0 pcs Rp - - 0 Rp -
27 Infuset Anak 150 pcs Rp 2,913 50 100 50 - 150 50 100 Rp 291,300
28 Infuset Dewasa 195 pcs Rp 6,622 95 100 50 50 100 50 50 Rp 331,100
29 Jarum jahit kulit 84 pcs Rp 1,042 - 84 12 72 12 60 Rp 62,520
30 Jarum jahit otot 84 pcs Rp 1,042 - 84 84 - 84 Rp 87,528
31 Kapas pembalut absorben 250 mg 10 roll Rp 15,000 - 10 1 9 2 7 Rp 105,000
32 Kassa pembalut hidrofil 4x10 cm 70 roll Rp 2,524 - 70 - 70 70 Rp -
34 Kassa hidrofil 40x80 cm 5 roll Rp 115,000 2 3 3 0 Rp -
35 Masker 0 pcs Rp 700 0 Rp -
36 Maxter exam glove no powder L pcs Rp 550 - 50 - Rp 27,500
(Handscoon non steril) 0 0 50
37 My Jelly 3 tube Rp 50,380 3 2 1 4 1 3 Rp 151,140
38 One met sunction chateter No. 14 20 pcs Rp - 20 20 20 Rp -
41 Plester 4 roll Rp 20,000 12 3 13 3 10 24 1 33 Rp 660,000
42 Rivanol 24 botol Rp 5,200 - 24 2 22 5 17 Rp 88,400
43 Safeglove surgical steril (Handscoon steril) pcs Rp 25,000 500 300 500 200 600 Rp -
100 300 600
44 Silk 2/0 plus jarum 1/2 DT 35 mm 0 pcs Rp 4,556 0 Rp -
45 Silk 3/0 plus jarum 1/2 DT 35 mm 0 pcs - 0 Rp -
47 HCL 0 botol Rp - - 0 Rp -
48 Sefter Thicker 0 pcs Rp - - Rp -
49 Lab Kit 0 Paket Rp 901,274 -
er 2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
50 Anti HIV 1/2 Cassette 0 Rp 14,490 Rp -
Rp 138,191,767
Malinjak, 03 Januari 2020

Mengetahui

NIP:19730928 199312 2 002 NIP:19831107 200904 2 006
- - -
BULAN APRIL s/d JUNI 2019
NO NAMA ITEM OBAT JUMLAH SATUAN HARGA PENERIM PENGELU SISA PENERIM PENGELU SISA MEI PENERIM PENGELU SISA SISA JUNI
STOK SATUAN OBAT AAN ARAN APRIL AAN MEI ARAN AAN ARAN JUNI DALAM (Rp)
MARET APRIL APRIL MEI JUNI JUNI
2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Albendasol 5222 tablet Rp 527 5,222 0 - - 350 - 350 Rp 184,450
2 Allopurinol 100 mg 2700 tablet Rp 127 1,200 1500 1,500 0 2,500 300 2200 Rp 279,400
3 Ambroksol sirup 50 botol Rp 4,000 120 60 110 30 80 - 0 Rp -
4 Ambroksol tablet 0 tablet Rp 150 8,000 4,600 3400 5,000 3,000 5400 3,000 1,700 6700 Rp 1,005,000
6 Aminophilin tablet 200 mg 500 tablet Rp 180 300 - 300 - 0 Rp -
7 Amitripilin tablet 25 mg 500 tablet Rp 220 - 500 - 500 - 500 Rp 110,000
8 Amlodipin 10 mg 1310 tablet Rp 110 150 1160 210 950 260 690 Rp 75,900
10 Amoksisilin sirup kering 125 mg/5 ml 0 botol Rp 4,183 180 90 90 100 90 100 100 70 130 Rp 543,790
11 Antalgin Injeksi 30 ampul Rp 520 - 30 - 30 5 25 Rp 13,000
12 Antalgin Tablet 8700 tablet Rp 145 1,800 6900 4,000 2900 100 0 Rp -
13 Antasida DOEN I tablet 0 tablet Rp 74 8,000 2,200 5800 1,200 4600 2,300 2300 Rp 170,200
14 Antasida DOEN II suspensi 49 botol Rp 2,500 100 59 90 90 0 70 35 35 Rp 87,500
15 Antihemoroid 50 suppo Rp 3,806 - 50 - 50 7 43 Rp 163,658
17 Asam Ascorbat 250 mg 2000 tablet Rp 139 - 2000 300 1700 2,000 700 3000 Rp 417,000
18 Asam Folat 1 mg 900 tablet Rp 57 - 900 100 400 500 - 900 Rp 51,300
20 Asam Traneksamat Injeksi 0 ampul Rp - - 0 - 0 0 Rp -
21 Asiklovir Salep 20 tube Rp 5,000 - 20 - 20 10 10 Rp 50,000
22 Asiklovir 200 mg 900 tablet Rp 287 200 700 - 700 500 200 Rp 57,400
23 Atapulgit (Akita) 400 tablet Rp 120 - 400 - 400 - 400 Rp 48,000
24 Aqua Pro injeksi 18 vial Rp 2,400 6 12 - 12 - 12 Rp 28,800
25 Bedak salicyl serbuk 2 % 30 pot Rp 1,450 10 20 20 - 40 5 35 Rp 50,750
26 Betametason krim 45 tube Rp 3,500 50 25 70 50 20 100 100 0 Rp -
27 Besi (II) sukfat 200 mg + asam folat 2670 tablet Rp 49 3,000 2,670 3000 3,000 3,000 3000 3,000 3,150 2850 Rp 139,650
28 Captopril 25 mg 1800 tablet Rp 457 1,300 500 2,000 1,300 1300 1,000 400 1900 Rp 868,300
29 Clor Etil 2 botol Rp 12,000 1 1 2 - 3 - 3 Rp 36,000
30 Deksametason injeksi 100 ampul Rp 200 - 100 10 90 - 0 Rp -
2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
32 Diazepam injeksi 5 mg / ml 5 ampul Rp 3,038 - 5 - 5 - 5 Rp 15,190
33 Diazepam tablet 5 mg 65 tablet Rp 3,038 - 65 - 65 - 65 Rp 197,470
34 Difenhidramin injeksi 10 mg/ml 0 ampul Rp 1,260 - 0 - 0 0 Rp -
35 Domperidon suspensi 5 mg / 5 ml 10 botol Rp 16,400 10 0 - 0 0 Rp -
36 Domperidon tablet 10 mg 700 tablet Rp 190 1,200 300 1400 200 1200 100 1100 Rp 209,000
38 Eritromicin 500 mg 200 tablet Rp 128 1,000 - 1100 700 400 500 400 500 Rp 64,000
39 Fenitoin Na kapsul 10 mg 0 kapsul Rp 545 - 0 - 0 0 Rp -
40 Fenobarbital 30 mg 170 tablet Rp 170 70 100 300 40 360 130 230 Rp 39,100
41 Ferro fumarat kapsul lunak 250 mg 0 kapsul Rp 350 - 0 - 0 0 Rp -
42 Ferro Glukonat 250 mg (Etabion) 0 tablet Rp 580 - 0 - 0 0 Rp -
43 Fitomenadion injeksi 2 ml/mg 30 ampul Rp 4,100 - 30 - 0 0 Rp -
44 Fitomenadion tablet 10 mg 200 tablet Rp 866 - 200 - 0 - 0 Rp -
45 Furosemid tablet 40 mg 300 tablet Rp 102 - 300 - 300 100 200 Rp 20,400
46 Gentamicin injeksi 40 mg / ml 20 ampul Rp 3,854 - 20 5 15 - 0 Rp -
47 Gentamicin salep kulit 70 tube Rp 3,000 40 30 50 50 30 100 10 120 Rp 360,000
48 Gentamicin tetes mata 0,3% 0 botol Rp 3,832 - 0 - 0 0 Rp -
51 Griseovulvin 125 mg 2200 tablet Rp 374 200 200 - 2000 100 1900 Rp 710,600
52 H2O2 2 vial Rp 55,000 - 2 - 2 - 0 Rp -
53 Haloperdiol 0,5 mg 0 tablet Rp - - 0 - 0 0 Rp -
54 Hidrokortison krim 120 tube Rp 3,047 72 48 24 48 24 48 - 72 Rp 219,384
55 Ibuproven 200 mg 0 tablet Rp 117 - 0 - 0 0 Rp -
58 Karbamazepin 200 mg 0 tablet Rp 1,936 - 0 - 0 0 Rp -
59 Ketokenasol 200 mg 250 tablet Rp 205 1,000 550 700 500 200 1000 100 900 Rp 184,500
60 Ketokenasol krim 50 tube Rp 2,930 - 50 50 - 100 25 75 Rp 219,750
61 Ketorolac Injeksi 12 ampul Rp 1,450 - 12 12 0 12 - 12 Rp 17,400
62 Klindamisin 300 mg 1000 tablet Rp 678 - 1000 - 1000 - 1000 Rp 678,000
63 Kloramfenikol kapsul 250 mg 0 kapsul Rp 715 - 0 - 0 0 Rp -
64 Kloramfenikol salep kulit 78 tube Rp 7,433 78 0 100 48 52 50 102 Rp 758,166
65 Kloramfenikol tetes mata 0 botol Rp 10,780 25 25 0 50 25 25 25 25 25 Rp 269,500
2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
66 Kloramfenikol tetes telinga 3% 0 botol Rp 3,000 25 25 0 50 - 50 25 - 75 Rp 225,000
68 Kotrimoksasol tablet 480 mg 2400 tablet Rp 273 500 1900 800 1100 1,000 - 2100 Rp 573,300
69 Kotrimoksasol suspensi 240 mg 100 botol Rp 5,500 - 100 - 100 40 60 Rp 330,000
70 Larutan Glukosa 5% 100 botol Rp 6,900 - 100 20 0 40 3 37 Rp 255,300
71 Larutan Glukosa Infus 40% 0 botol Rp - - 0 - 0 0 Rp -
72 Larutan NaCL 90 botol Rp 7,000 70 20 40 - 0 40 3 37 Rp 259,000
73 Larutan Ringer Laktat 40 botol Rp 7,000 100 80 60 100 100 60 100 63 97 Rp 679,000
74 Lidokain Injeksi 0 ampul Rp 1,026 - 0 - 0 0 Rp -
75 Loperamid 2 mg 100 tablet Rp 95 - 100 - 100 - 100 Rp 9,500
76 Loratadin 10 mg 1300 tablet Rp 167 950 300 1950 - 1950 - 1950 Rp 325,650
77 Magnesium Sulfat 20% (MgSO 20%) 0 vial Rp - - 0 - 0 0 Rp -
78 Magnesium Sulfat 40% (MgSO 40%) 10 vial Rp 7,920 - 10 - 10 - 10 Rp 79,200
79 Metilergometrin Injeksi 100 ampul Rp 4,895 - 100 - 100 - 100 Rp 489,500
80 Metilergometrin Tablet 0 tablet Rp 352 - 0 - 0 0 Rp -
81 Metilprednisolon 4 mg 700 tablet Rp 441 1,000 100 1600 1,000 800 1800 500 1300 Rp 573,300
82 Metformin HCL 500 mg 1100 tablet Rp 113 - 1100 - 1100 - 1100 Rp 124,300
83 Metoklopramide 10 mg 600 tablet Rp - - 600 - 600 600 Rp -
84 Metronidasol 250 mg 0 tablet Rp - - 0 - 0 0 Rp -
85 Metronidasol 500 mg 2400 tablet Rp 151 600 1800 300 1500 400 1100 Rp 166,100
86 Mikonasol krim 0 tube Rp 4,060 48 - 48 - 48 - 48 Rp 194,880
87 Natrium diklofenak 50 mg 2000 tablet Rp 162 - 2000 200 1800 - 1800 Rp 291,600
88 Nifedipin 10 mg 400 tablet Rp 200 - 400 - 400 100 300 Rp 60,000
89 Nistatin tablet 100.000 IU/g 400 tablet Rp 444 - 400 100 300 - 300 Rp 133,200
90 Nistatin tablet 500.000 IU/g 100 tablet Rp 720 100 0 200 - 200 - 200 Rp 144,000
91 OBH 15 botol Rp 2,500 100 35 80 20 60 64 10 114 Rp 285,000
92 Oksitetrasiklin HCL injeksi 0 ampul Rp - - 0 - 0 0 Rp -
93 Oksitetrasiklin Salep Mata 75 tube Rp 4,400 25 50 25 25 50 - 75 Rp 330,000
94 Oksitocyn injeksi 80 ampul Rp 1,900 - 80 25 55 20 35 Rp 66,500
95 Omeprasol 20 mg 1630 kapsul Rp 161 640 990 60 930 300 630 Rp 101,430
96 Ondansetron Injeksi 0 ampul Rp 1,925 - 0 - 0 0 Rp -
97 Ondansetron Tablet 168 tablet Rp 590 - 168 - 168 - 0 Rp -
98 Oralit 380 sac Rp 460 120 260 300 160 400 20 380 Rp 174,800
99 OTSU KCL injeksi 0 botol Rp 7,920 - 0 - 0 0 Rp -
100 Parasetamol drop 70 botol Rp 8,900 42 28 48 28 48 48 41 55 Rp 489,500
2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
101 Parasetamol sirup 120 mg 0 botol Rp 3,520 300 150 150 100 150 100 50 88 62 Rp 218,240
102 Parasetamol tablet 100 mg 0 tablet Rp 96 - 0 - 0 0 Rp -
103 Parasetamol tablet 500 mg 2500 tablet Rp 135 15,000 4,900 12600 3,700 8900 2,500 6400 Rp 864,000
104 Phenitoin 100 mg 65 tablet Rp 545 30 35 35 0 200 20 180 Rp 98,100
106 Piroxicam 700 tablet Rp 183 2,000 1,100 1600 1,000 1,400 1200 1,000 500 1700 Rp 311,100
107 Piridoksin 10 mg (Vitamin B6) 900 tablet Rp 67 1,000 800 1100 500 600 500 500 600 Rp 40,200
108 Povidon Iodida 30 ml 0 botol Rp 6,400 - 0 96 - 96 - 0 Rp -
109 Povidon Iodida 60 ml 39 botol Rp 7,532 1 0 - 0 0 Rp -
110 Povidon Iodida 300 ml 10 botol Rp 22,600 8 2 30 12 20 20 Rp 452,000
111 Propanolol 10 mg 400 tablet Rp 130 200 100 500 100 500 0 500 Rp 65,000
112 Propiltiaurasil 100 mg 300 tablet Rp 675 200 100 1,000 200 900 100 800 Rp 540,000
113 Ranitidin Injeksi 20 ampul Rp 3,099 20 0 0 0 0 0 Rp -
114 Ranitidin 150 mg 600 tablet Rp 343 2,000 1500 1100 1,000 1500 600 1,000 800 800 Rp 274,400
115 Retinol 100.000 (Vitamin A Biru) 0 kapsul Rp 355 50 0 50 0 50 0 50 Rp 17,750
116 Retinol 200.000 (Vitamin A Merah) 0 kapsul Rp 636 0 0 100 50 50 0 50 Rp 31,800
117 Salbutamol tablet 2 mg 900 tablet Rp 108 0 900 500 1200 200 1,000 200 600 Rp 64,800
118 Salbutamol tablet 4 mg 1100 tablet Rp 108 800 300 1,000 800 500 1,000 500 400 Rp 43,200
119 Salep 24 24 pot Rp 3,040 0 24 0 24 0 24 Rp 72,960
120 Sefadroksil 400 tablet Rp 616 2,000 1200 1200 1,000 500 1700 1000 700 Rp 431,200
121 Seftriakson injeksi 0 ampul Rp 5,688 0 0 0 0 0 Rp -
123 Sianokobalamin injeksi (Vitamin B12) 70 ampul Rp 1,100 12 58 100 58 100 55 0 Rp -
124 Simetidin 100 tablet Rp 220 100 0 500 400 100 0 100 Rp 22,000
125 Simvastatin 20 mg 200 tablet Rp 250 1,000 400 800 0 800 90 710 Rp 177,500
126 Siprofloksasin tablet score 500 mg 2000 tablet Rp 276 1000 1000 1,000 500 1500 600 300 1800 Rp 496,800
127 Tiamin injeksi 30 ampul Rp 3,800 0 30 0 30 0 30 Rp 114,000
128 Tiamin tablet 50 mg (Vitamin B1) 3000 tablet Rp 40 900 2100 400 1700 1,000 0 2700 Rp 108,000
129 Vitamin B Kompleks 0 botol Rp 54 15,000 4500 10500 2900 7600 3700 3900 Rp 210,600
130 Zink sirup 20 mg / 5 ml 0 tablet Rp 17,976 0 - 0 0 Rp -
131 Zink tablet 20 mg 2800 tablet Rp 644 1,300 1500 400 1100 400 700 Rp 450,800
132 Ventolin 20 ampul Rp 4,400 120 40 100 60 40 120 100 60 0 Rp -
133 Neurodex 0 tablet - 0 - 0 0 Rp -
134 Lodecon Forte 0 tablet Rp 48,840 5,000 1,500 3500 2,000 1,200 4300 4300 Rp 210,012,000
135 Solvitron 0 tablet Rp 176 - 0 - 0 0 Rp -
136 Truvit sirup 55 botol Rp 14,245 60 15 100 50 50 36 14 Rp 199,430
137 Cetrizine 10 mg tablet Rp 438 400 - 400 Rp 175,200

2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Air Sound Timer 0 buah Rp 48,840 0 2 2 0 0 Rp -
2 Azithromycin 0 tablet Rp 176 0 0 0 Rp -
3 Batrai Air Sound Timer 0 buah Rp - 0 0 Rp -
4 Calcii Glukonas 5 vial Rp 7,964 5 - 5 5 Rp 39,820
5 Dietil Karbamezapin 1631 tablet Rp 119 1631 - 1631 1631 Rp 194,089
6 Gimza 1 botol Rp 1,451,000 1 1 2 0 0 Rp -
7 Lancet 4400 pcs Rp 176 4400 8,000 12,400 0 0 Rp -
8 Lysol 100 % 0 botol Rp - 0 0 0 Rp -
9 Malaria HRP2 (RDT) 18 kotak Rp 5,271 18 18 0 0 Rp -
10 Obat Anti Malaria 495 tablet Rp 864 369 126 900 - 900 - 900 Rp 777,600
11 Paket Kategori I 3 paket Rp 409,075 5 7 1 10 6 3 3 Rp 1,227,225
12 Paket Kategori II 0 paket Rp - 0 0 0 Rp -
13 Paket Stop TB OAT Anak 0 paket Rp 203,259 0 0 0 Rp -
14 Pot Dahak 200 pot Rp 5,000 200 200 - 400 - 400 Rp 2,000,000
15 Primaquin 0 tablet Rp 280 500 300 - 300 Rp 84,000
16 Rapit Test 0 paket Rp 20,216 0 0 0 Rp -
17 Reagen Golongan Darah 0 paket Rp - 0 0 0 Rp -
18 Smart Diagnostic (Reagen HIV) 0 paket Rp - 0 0 0 Rp -
19 Ziehl Neelsen 1 paket Rp 276,500 1 1 0 0 Rp -
20 HB o 121 Bungkus Rp 20,900 27 94 7 87 0 87 Rp 1,818,300
21 BCG 1 ml/pelarut 50 Vial Rp 54,500 18 32 20 11 41 - 0 41 Rp 2,234,500
25 Polio 40 Vial Rp 19,954 10 33 17 50 19 48 20 19 49 Rp 977,746
27 DPT/Pentabion 54 Vial Rp 70,232 20 30 44 20 27 40 20 27 33 Rp 2,317,656
28 Campak/pelarut/MR 51 Vial Rp 25,640 21 20 20 14 36 20 14 42 Rp 1,076,880
30 Dt 0 Vial Rp 15,550 - 0 0 0 Rp -
31 Td/Tt 33 Vial Rp 15,000 11 22 10 3 39 - 39 Rp 585,000
32 IPV 45 Vial Rp 137,610 10 35 6 28 - 28 Rp 3,853,080
33 Spuit 0,05 300 Dos Rp 1,995 65 235 35 340 - 340 Rp 678,300
34 Supit 0,5 300 Dos Rp 1,448 - 300 200 200 500 200 200 500 Rp 724,000
35 Saftey Box 30 pak Rp 1,448 5 25 25 5 40 - 40 Rp 57,920
36 Hexagon syphilis 0 Rp 26,889 0 46 46 46 Rp 1,236,894
37 Spirtus 1 Rp 68,000 1 - 1 - 1 Rp 68,000
38 susu 16 Rp 135,000 5 2 19 10 12 17 17 Rp 2,295,000
2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
39 Slide 3600 Rp 1,111 3600 5,040 8,640 0 0 Rp -
40 Box Slide 0 Rp - 0 2 2 0 0 Rp -
41 Oil Emersian 0 Rp - 0 - 0 0 Rp -
42 Tamblet Tambah Darah Program (Ferro F 5600 Rp 444 - 5600 - 5600 - 0 Rp -
43 Alat Deteksi Resiko kehamilan Paket Rp 422,980 - 0 0 Rp -
44 Anti HIV 1/2 Cassette Pcs Rp 14,490 100 100 100 Rp 1,449,000
45 RDT Hepatitis Pcs Rp -
46 Klonazepam Tablet Rp -
47 Resperidon Tablet Rp -
48 Clorpromazine(CPZ) Tablet Rp -
49 Fluoxentin Tablet Rp -
50 Isosorbid Dinitrit Tablet Rp 172 Rp -
1 Alat suntik sekali pakai 0,5 ml 0 pcs Rp 1,448 0 200 200 200 Rp 289,600
2 Alat suntik sekali pakai 0,05 ml 0 pcs Rp - 0 0 0 Rp -
4 Alat suntik sekali pakai 2,5 ml 0 pcs Rp - - 0 0 0 Rp -
5 Alat suntik sekali pakai 3 ml 280 pcs Rp 900 280 0 400 - 400 300 100 Rp 90,000
6 Alat suntik sekali pakai 5 ml 200 pcs Rp 2,049 100 100 100 - 200 - 200 Rp 409,800
7 Alat test kehamilan 150 pcs Rp 975 50 100 100 50 150 50 100 Rp 97,500
8 Alkohol 70% 5 botol Rp 43,000 - 5 2 3 12 1 12 Rp 516,000
9 Benang kulit 0 pcs Rp 13,860 - 0 0 0 Rp -
10 Benang otot 0 pcs Rp 13,860 - 0 0 0 Rp -
11 Bisturi No. 10 G 300 pcs Rp 1,450 - 300 100 200 100 100 Rp 145,000
12 IV Chateter No. 20 Gx11/4 50 pcs Rp 15,000 50 0 - 0 50 5 45 Rp 675,000
13 IV Chateter No. 22 Gx11/4 50 pcs Rp 9,345 50 50 50 100 - 150 55 95 Rp 887,775
14 IV Chateter No. 24 Gx11/4 213 pcs Rp 9,345 - 213 - 213 55 158 Rp 1,476,510
2019
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
15 IV Channula, without wings No. 22 0 pcs Rp - - 0 0 0 Rp -
16 IV Channula, without wings No. 24 0 pcs Rp - - 0 0 0 Rp -
17 Cutgut plan 2/0 plus jarum 1/2 DT 35 pcs Rp 16,667 - Rp -
mm 0 0 0 0
18 Cutgut plan 3/0 plus jarum 1/2 DT 35 pcs Rp 16,667 - - Rp 400,008
mm 24 24 24 24
19 Cutgut cromic 2/0 plus jarum 1/2 DT 35 pcs Rp 16,667 - - - Rp 400,008
mm 24 24 24 24
20 Cutgut cromic 3/0 plus jarum 1/2 DT 35 pcs Rp 16,667 - - Rp 400,008
mm 24 24 24 24
21 Etakridin 0 botol Rp 5,200 0 0 0 Rp -
26 Handscoon panjang steril 50 pcs Rp - - 50 - 50 50 Rp -
27 Infuset Anak 231 pcs Rp 2,913 - 231 - 231 81 150 Rp 436,950
28 Infuset Dewasa 100 pcs Rp 6,622 50 75 75 100 - 175 80 95 Rp 629,090
29 Jarum jahit kulit 84 pcs Rp 1,042 - 84 - 84 - 84 Rp 87,528
30 Jarum jahit otot 84 pcs Rp 1,042 - 84 - 84 - 84 Rp 87,528
31 Kapas pembalut absorben 250 mg 6 roll Rp 15,000 3 3 5 1 7 - 7 Rp 105,000
32 Kassa pembalut hidrofil 4x10 cm 130 roll Rp 2,524 30 100 100 200 70 130 Rp 328,120
33 Kassa pembalut hidrofil 4x5 cm 100 roll Rp 1,120 100 0 200 50 150 100 80 170 Rp 190,400
34 Kassa hidrofil 40x80 cm 4 roll Rp 115,000 3 3 4 3 1 6 4 2 Rp 230,000
35 Masker 50 pcs Rp 700 100 100 50 200 100 150 100 50 200 Rp 140,000
36 Maxter exam glove no powder L pcs Rp 550 500 1,000 700 1,000 500 Rp 330,000
(Handscoon non steril) 500 0 100 600
37 My Jelly 2 tube Rp 50,380 2 0 3 - 3 - 3 Rp 151,140
38 One met sunction chateter No. 14 20 pcs Rp - - 20 820 820 Rp -
41 Plester 18 roll Rp 20,000 7 11 4 7 12 4 15 Rp 300,000
42 Rivanol 0 botol Rp 5,200 - 0 0 0 Rp -
43 Safeglove surgical steril (Handscoon pcs Rp 25,000 50 - 50 Rp -
steril) 100 50 50 0
44 Silk 2/0 plus jarum 1/2 DT 35 mm 0 pcs Rp 4,556 - 0 0 0 Rp -
48 Sefter Thicker 0 pcs Rp - - 0 0 0 Rp -
49 Lab Kit 0 Paket Rp 901,274 - 0 0 0 Rp -
50 Anti HIV 1/2 Cassette 0 Rp 14,490 - 0 - 0 0 Rp -
Rp 269,677,463
Malinjak, 28 Juni 2019
Mengetahui

NIP:19730928 199312 2 002 NIP:19831107 200904 2 006
BULAN JULI s/d SEPTEMBER 2019
NO NAMA ITEM OBAT JUMLAH SATUAN HARGA PENERIM PENGELU SISA JULI PENERIMA PENGELU SISA PENERIM PENGELU SISA SISA SEPT
STOK SATUAN AAN JULI ARAN AN ARAN AGUSTUS AAN ARAN SEPTEM DALAM (Rp)
JUNI OBAT JULI AGUSTUS AGUSTUS SEPTEM SEPTEM BER
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Albendasol 350 tablet Rp 527 350 - 350 15,120 - 15,470 Rp 8,152,690
2 Allopurinol 100 mg 2200 tablet Rp 127 1,200 1000 400 600 1,000 1,300 300 Rp 38,100
3 Ambroksol sirup 0 botol Rp 4,000 100 - 100 100 10 190 - 40 100 Rp 400,000
4 Ambroksol tablet 6700 tablet Rp 150 2,600 4100 2,000 3,600 2500 3,000 5,300 200 Rp 30,000
5 Aminophilin injeksi 24 mg / ml 0 ampul Rp 3,349 - 0 - 0 - - 0 Rp -
6 Aminophilin tablet 200 mg 0 tablet Rp 180 - 0 - 0 - - 0 Rp -
7 Amitripilin tablet 25 mg 500 tablet Rp 220 200 - 700 100 500 - - 500 Rp 110,000
8 Amlodipin 10 mg 690 tablet Rp 110 240 450 600 600 450 - 360 90 Rp 9,900
11 Antalgin Injeksi 25 ampul Rp 520 - 25 - 25 - - 25 Rp 13,000
12 Antalgin Tablet 0 tablet Rp 145 2,000 900 1100 1,100 5 2,000 1,500 500 Rp 72,500
14 Antasida DOEN II suspensi 35 botol Rp 2,500 50 85 0 50 50 0 - - 0 Rp -
15 Antihemoroid 43 suppo Rp 3,806 6 37 - 10 27 - 2 25 Rp 95,150
16 Asam Ascorbat 50 mg 4300 tablet Rp 130 1,400 2900 3,000 4,800 1100 4,000 5,100 0 Rp -
17 Asam Ascorbat 250 mg 3000 tablet Rp 139 2,000 3,000 2000 2,000 0 - - 0 Rp -
18 Asam Folat 1 mg 900 tablet Rp 57 600 500 500 300 700 500 300 900 Rp 51,300
20 Asam Traneksamat Injeksi 0 ampul Rp - - 0 - 0 - 0 Rp -
21 Asiklovir Salep 10 tube Rp 5,000 10 0 50 10 40 15 25 Rp 125,000
22 Asiklovir 200 mg 200 tablet Rp 287 - 200 1,000 - 1200 800 400 Rp 114,800
23 Atapulgit (Akita) 400 tablet Rp 120 - 400 - 400 - 400 Rp 48,000
24 Aqua Pro injeksi 12 vial Rp 2,400 - 12 - 12 2 10 Rp 24,000
25 Bedak salicyl serbuk 2 % 35 pot Rp 1,450 5 30 20 10 40 2 38 Rp 55,100
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
26 Betametason krim 0 tube Rp 3,500 100 75 25 100 100 100 75 25 Rp 87,500
27 Besi (II) sukfat 200 mg + asam folat 2850 tablet Rp 49 3,000 2,850 3000 3,000 3,000 3000 3,000 3,300 2700 Rp 132,300
28 Captopril 25 mg 1900 tablet Rp 457 1,000 700 2200 700 1500 2,000 1,700 1800 Rp 822,600
29 Clor Etil 3 botol Rp 12,000 - 3 - 3 1 2 Rp 24,000
30 Deksametason injeksi 0 ampul Rp 200 - 0 - 0 - - 0 Rp -
32 Diazepam injeksi 5 mg / ml 5 ampul Rp 3,038 - 5 - 5 - 0 Rp -
33 Diazepam tablet 5 mg 65 tablet Rp 3,038 30 35 - 35 - 35 Rp 106,330
34 Difenhidramin injeksi 10 mg/ml 0 ampul Rp 1,260 0 - 0 - 0 Rp -
35 Domperidon suspensi 5 mg / 5 ml 0 botol Rp 16,400 - 0 - 0 - 0 Rp -
36 Domperidon tablet 10 mg 1100 tablet Rp 190 300 800 200 600 200 400 Rp 76,000
38 Eritromicin 500 mg 500 tablet Rp 128 100 400 - 400 - 400 Rp 51,200
39 Fenitoin Na kapsul 10 mg 0 kapsul Rp 545 0 80 100 100 0 Rp -
40 Fenobarbital 30 mg 230 tablet Rp 170 80 150 300 60 390 - 390 Rp 66,300
41 Ferro fumarat kapsul lunak 250 mg 0 kapsul Rp 350 0 - 0 - 0 Rp -
42 Ferro Glukonat 250 mg (Etabion) 0 tablet Rp 580 0 - 0 - 0 Rp -
43 Fitomenadion injeksi 2 ml/mg 0 ampul Rp 4,100 0 - 0 - 0 Rp -
44 Fitomenadion tablet 10 mg 0 tablet Rp 866 - - 0 - 0 - 0 Rp -
45 Furosemid tablet 40 mg 200 tablet Rp 102 200 - 200 100 100 Rp 10,200
46 Gentamicin injeksi 40 mg / ml 0 ampul Rp 3,854 - 0 - 0 - 0 Rp -
47 Gentamicin salep kulit 120 tube Rp 3,000 120 50 70 - 70 Rp 210,000
48 Gentamicin tetes mata 0,3% 0 botol Rp 3,832 0 - 0 - 0 Rp -
50 Gliseril Guaiakolat (GG) 9600 tablet Rp 450 1,800 7800 4,800 3000 5,000 4,800 3200 Rp 1,440,000
51 Griseovulvin 125 mg 1900 tablet Rp 374 400 1500 300 1200 700 500 Rp 187,000
52 H2O2 0 vial Rp 55,000 1 - 1 1 0 1 - 1 Rp 55,000
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
53 Haloperdiol 0,5 mg 0 tablet Rp - 0 - 0 - 0 Rp -
54 Hidrokortison krim 72 tube Rp 3,047 - 72 24 48 24 24 Rp 73,128
55 Ibuproven 200 mg 0 tablet Rp 117 0 - 0 0 Rp -
56 Ibuproven 400 mg 3300 tablet Rp 143 2,000 3,800 1500 4,000 4,700 800 5,000 5,800 0 Rp -
57 Kalsium Laktat 500 mg 1880 tablet Rp 83 540 1340 - 1340 180 1160 Rp 96,280
58 Karbamazepin 200 mg 0 tablet Rp 1,936 0 - 0 - 0 Rp -
59 Ketokenasol 200 mg 900 tablet Rp 205 200 700 100 600 300 300 Rp 61,500
60 Ketokenasol krim 75 tube Rp 2,930 - 75 25 50 5 45 Rp 131,850
61 Ketorolac Injeksi 12 ampul Rp 1,450 - 12 - 12 12 0 Rp -
62 Klindamisin 300 mg 1000 tablet Rp 678 - 1000 - 1000 - 1000 Rp 678,000
63 Kloramfenikol kapsul 250 mg 0 kapsul Rp 715 0 - 0 - 0 Rp -
65 Kloramfenikol tetes mata 25 botol Rp 10,780 25 0 25 - 25 25 0 Rp -
66 Kloramfenikol tetes telinga 3% 75 botol Rp 3,000 30 45 - 45 45 0 Rp -
68 Kotrimoksasol tablet 480 mg 2100 tablet Rp 273 700 1400 1,000 600 1800 800 1000 Rp 273,000
69 Kotrimoksasol suspensi 240 mg 60 botol Rp 5,500 50 10 100 30 70 20 50 Rp 275,000
70 Larutan Glukosa 5% 37 botol Rp 6,900 20 17 100 - 117 - 117 Rp 807,300
71 Larutan Glukosa Infus 40% 0 botol Rp - 0 - 0 - 0 Rp -
72 Larutan NaCL 37 botol Rp 7,000 40 1 76 60 16 80 20 76 Rp 532,000
73 Larutan Ringer Laktat 97 botol Rp 7,000 60 37 37 0 - 0 Rp -
74 Lidokain Injeksi 0 ampul Rp 1,026 - 0 - 0 - 0 Rp -
75 Loperamid 2 mg 100 tablet Rp 95 - 100 - 100 - 100 Rp 9,500
76 Loratadin 10 mg 1950 tablet Rp 167 - 1950 400 1550 - 1550 Rp 258,850
77 Magnesium Sulfat 20% (MgSO 20%) 0 vial Rp - 0 - 0 - 0 Rp -
78 Magnesium Sulfat 40% (MgSO 40%) 10 vial Rp 7,920 - 10 - 10 - 10 Rp 79,200
79 Metilergometrin Injeksi 100 ampul Rp 4,895 100 - 100 - 0 Rp -
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
80 Metilergometrin Tablet 0 tablet Rp 352 0 - 0 0 Rp -
81 Metilprednisolon 4 mg 1300 tablet Rp 441 300 1000 - 1000 600 400 Rp 176,400
82 Metformin HCL 500 mg 1100 tablet Rp 113 - 1100 100 1000 100 900 Rp 101,700
83 Metoklopramide 10 mg 600 tablet Rp - 600 - 600 - 600 Rp -
84 Metronidasol 250 mg 0 tablet Rp - 0 - 0 - 0 Rp -
85 Metronidasol 500 mg 1100 tablet Rp 151 700 400 500 600 300 1,000 700 600 Rp 90,600
86 Mikonasol krim 48 tube Rp 4,060 - 48 48 29 19 Rp 77,140
87 Natrium diklofenak 50 mg 1800 tablet Rp 162 300 1500 500 1000 - 1000 Rp 162,000
88 Nifedipin 10 mg 300 tablet Rp 200 - 300 - 300 - 300 Rp 60,000
89 Nistatin tablet 100.000 IU/g 300 tablet Rp 444 - 300 - 0 - 0 Rp -
90 Nistatin tablet 500.000 IU/g 200 tablet Rp 720 - 200 - 200 - 0 Rp -
91 OBH 114 botol Rp 2,500 - 114 14 100 10 90 Rp 225,000
92 Oksitetrasiklin HCL injeksi 0 ampul Rp - 0 0 0 Rp -
93 Oksitetrasiklin Salep Mata 75 tube Rp 4,400 5 70 70 70 0 Rp -
94 Oksitocyn injeksi 35 ampul Rp 1,900 - 119 19 100 25 0 Rp -
95 Omeprasol 20 mg 630 kapsul Rp 161 90 540 330 210 600 510 300 Rp 48,300
96 Ondansetron Injeksi 0 ampul Rp 1,925 0 0 - 0 Rp -
97 Ondansetron Tablet 0 tablet Rp 590 0 0 - 0 Rp -
98 Oralit 380 sac Rp 460 80 300 100 200 60 140 Rp 64,400
99 OTSU KCL injeksi 0 botol Rp 7,920 0 0 0 Rp -
100 Parasetamol drop 55 botol Rp 8,900 23 32 48 56 24 48 54 18 Rp 160,200
101 Parasetamol sirup 120 mg 62 botol Rp 3,520 62 0 - 0 - 0 Rp -
102 Parasetamol tablet 100 mg 0 tablet Rp 96 - 0 0 - 0 Rp -
103 Parasetamol tablet 500 mg 6400 tablet Rp 135 3,400 3000 2,000 4,600 400 8,000 5,900 2500 Rp 337,500
104 Phenitoin 100 mg 180 tablet Rp 545 15 165 165 165 0 Rp -
106 Piroxicam 1700 tablet Rp 183 300 1400 600 800 2,000 1,300 1500 Rp 274,500
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
107 Piridoksin 10 mg (Vitamin B6) 600 tablet Rp 67 - 600 300 300 500 300 500 Rp 33,500
108 Povidon Iodida 30 ml 0 botol Rp 6,400 96 - 96 1 95 3 92 Rp 588,800
109 Povidon Iodida 60 ml 0 botol Rp 7,532 0 0 0 Rp -
110 Povidon Iodida 300 ml 20 botol Rp 22,600 0 20 4 16 0 16 Rp 361,600
111 Propanolol 10 mg 500 tablet Rp 130 0 500 0 500 0 500 Rp 65,000
112 Propiltiaurasil 100 mg 800 tablet Rp 675 0 800 100 700 100 600 Rp 405,000
113 Ranitidin Injeksi 0 ampul Rp 3,099 0 0 0 15 0 15 Rp 46,485
114 Ranitidin 150 mg 800 tablet Rp 343 2,000 600 2200 1100 1100 1,000 1400 700 Rp 240,100
115 Retinol 100.000 (Vitamin A Biru) 50 kapsul Rp 355 0 50 200 200 50 0 50 Rp 17,750
116 Retinol 200.000 (Vitamin A Merah) 50 kapsul Rp 636 0 0 1,050 1050 0 100 50 50 Rp 31,800
117 Salbutamol tablet 2 mg 600 tablet Rp 108 600 0 0 0 0 0 Rp -
119 Salep 24 24 pot Rp 3,040 0 24 0 24 0 24 Rp 72,960
120 Sefadroksil 700 tablet Rp 616 1,000 0 1700 900 800 800 0 Rp -
121 Seftriakson injeksi 0 ampul Rp 5,688 0 0 0 0 Rp -
122 Sianokobalamin tablet (Vitamin B12) 4100 tablet Rp 69 2,000 6100 3200 0 5,000 3000 2000 Rp 138,000
123 Sianokobalamin injeksi (Vitamin B12) 0 ampul Rp 1,100 30 3 27 20 7 30 12 25 Rp 27,500
124 Simetidin 100 tablet Rp 220 0 100 0 100 0 100 Rp 22,000
125 Simvastatin 20 mg 710 tablet Rp 250 0 710 60 650 200 450 Rp 112,500
126 Siprofloksasin tablet score 500 mg 1800 tablet Rp 276 0 1800 0 1800 1200 600 Rp 165,600
127 Tiamin injeksi 30 ampul Rp 3,800 0 30 0 30 0 30 Rp 114,000
130 Zink sirup 20 mg / 5 ml 0 tablet Rp 17,976 0 0 - 0 Rp -
131 Zink tablet 20 mg 700 tablet Rp 644 1,000 800 900 2,000 600 2300 1,400 900 Rp 579,600
132 Ventolin 0 ampul Rp 4,400 50 30 20 40 60 0 - 0 Rp -
133 Neurodex 0 tablet 0 0 0 Rp -
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
134 Lodecon Forte 4300 tablet Rp 48,840 4,300 0 2,000 2,000 0 2,000 2,000 0 Rp -
135 Solvitron 0 tablet Rp 176 0 0 - 0 Rp -
136 Truvit sirup 14 botol Rp 14,245 60 56 18 60 54 24 60 54 30 Rp 427,350
137 Cetrizine 10 mg 400 tablet Rp 438 - 400 400 - 400 Rp 175,200

1 Air Sound Timer 0 buah Rp 48,840 0 0 0 Rp -
2 Azithromycin 0 tablet Rp 176 0 0 0 Rp -
3 Batrai Air Sound Timer 0 buah Rp - 0 0 0 Rp -
4 Calcii Glukonas 5 vial Rp 7,964 5 5 5 Rp 39,820
5 Dietil Karbamezapin 1631 tablet Rp 119 1631 1631 41,600 - 43231 Rp 5,144,489
6 Gimza 0 botol Rp 1,451,000 - 0 0 1 1 Rp 1,451,000
7 Lancet 0 pcs Rp 176 0 0 0 Rp -
8 Lysol 100 % 0 botol Rp - 0 0 0 Rp -
11 Paket Kategori I 3 paket Rp 409,075 3 0 10 3 7 6 1 Rp 409,075
12 Paket Kategori II 0 paket Rp - 0 0 0 Rp -
13 Paket Stop TB OAT Anak 0 paket Rp 203,259 0 0 0 Rp -
14 Pot Dahak 400 pot Rp 5,000 - 400 - 400 300 300 400 Rp 2,000,000
16 Rapit Test 0 paket Rp 20,216 0 0 - 0 Rp -
17 Reagen Golongan Darah 0 paket Rp - 0 0 0 Rp -
18 Smart Diagnostic (Reagen HIV) 0 paket Rp - 0 0 0 Rp -
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
19 Ziehl Neelsen 0 paket Rp 276,500 0 0 1 1 0 Rp -
20 HB o 87 Bungkus Rp 20,900 - 25 0 20 0 100 36 64 Rp 1,337,600
21 BCG 1 ml/pelarut 41 Vial Rp 54,500 20 28 33 10 15 28 10 15 23 Rp 1,253,500
25 Polio 49 Vial Rp 19,954 20 33 34 10 14 30 26 4 Rp 79,816
27 DPT/Pentabion 33 Vial Rp 70,232 20 21 39 10 23 26 10 24 12 Rp 842,784
28 Campak/pelarut/MR 42 Vial Rp 25,640 20 11 0 20 48 17 20 20 17 Rp 435,880
30 Dt 0 Vial Rp 15,550 - - 0 0 0 Rp -
31 Td/Tt 39 Vial Rp 15,000 - 8 29 10 3 36 3 33 Rp 495,000
32 IPV 28 Vial Rp 137,610 - 9 11 10 5 16 11 5 Rp 688,050
33 Spuit 0,05 340 Dos Rp 1,995 - 35 265 25 250 25 225 Rp 448,875
34 Supit 0,5 500 Dos Rp 1,448 - 250 250 500 400 350 100 200 130 Rp 188,240
35 Saftey Box 40 pak Rp 1,448 - 5 30 25 5 50 3 5 48 Rp 69,504
36 Hexagon syphilis 46 Rp 26,889 46 46 46 0 Rp -
37 Spirtus 1 Rp 68,000 - 1 1 1 - 2 Rp 136,000
38 susu 17 Rp 135,000 17 0 2 3 3 0 Rp -
39 Slide 0 Rp 1,111 0 0 0 Rp -
40 Box Slide 0 Rp - 0 0 0 Rp -
41 Oil Emersian 0 Rp - 0 0 0 Rp -
42 Tamblet Tambah Darah Program (Ferro Fum 0 Rp 444 - 0 34,020 360 33660 4,860 28800 Rp 12,787,200
43 Alat Deteksi Resiko kehamilan 0 Paket Rp 422,980 0 0 0 Rp -
44 Anti HIV 1/2 Cassette 100 Pcs Rp 14,490 100 100 0 Rp -
45 RDT Hepatitis Pcs 0 Rp -
46 Klonazepam Tablet 0 Rp -
47 Resperidon Tablet 0 Rp -
48 Clorpromazine(CPZ) Tablet 0 Rp -
49 Fluoxentin Tablet 0 Rp -
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
50 Isosorbid Dinitrit Tablet Rp 172 Rp -
1 Alat suntik sekali pakai 0,5 ml 200 pcs Rp 1,448 200 200 200 Rp 289,600
2 Alat suntik sekali pakai 0,05 ml 0 pcs Rp 5,000 0 0 0 Rp -
3 Alat suntik sekali pakai 1 ml 100 pcs Rp 1,000 - 100 - 100 - 100 Rp 100,000
4 Alat suntik sekali pakai 2,5 ml 0 pcs Rp - 0 0 0 Rp -
5 Alat suntik sekali pakai 3 ml 100 pcs Rp 900 300 100 300 100 200 200 100 300 Rp 270,000
6 Alat suntik sekali pakai 5 ml 200 pcs Rp 2,049 100 100 100 200 100 100 Rp 204,900
7 Alat test kehamilan 100 pcs Rp 975 100 50 150 50 100 50 50 Rp 48,750
8 Alkohol 70% 12 botol Rp 43,000 24 6 30 15 15 24 12 27 Rp 1,161,000
9 Benang kulit 0 pcs Rp 13,860 - 0 0 1 - 1 Rp 13,860
10 Benang otot 0 pcs Rp 13,860 - 0 1 - 1 Rp 13,860
11 Bisturi No. 10 G 100 pcs Rp 1,450 - 100 100 100 100 100 - 200 Rp 290,000
12 IV Chateter No. 20 Gx11/4 45 pcs Rp 15,000 - 45 - 45 45 0 Rp -
13 IV Chateter No. 22 Gx11/4 95 pcs Rp 9,345 - 95 - 95 40 55 Rp 513,975
14 IV Chateter No. 24 Gx11/4 158 pcs Rp 9,345 - 158 158 58 100 Rp 934,500
15 IV Channula, without wings No. 22 0 pcs Rp - - 0 - 0 Rp -
16 IV Channula, without wings No. 24 0 pcs Rp - - 0 - 0 Rp -
17 Cutgut plan 2/0 plus jarum 1/2 DT 35 mm pcs Rp 16,667 - - Rp -
0 0 0
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
24 24 24 24
mm 24 24 24 24
mm 24 24 24 24
21 Etakridin 0 botol Rp 5,200 - 0 0 - 0 Rp -
22 Folley Chateter 2 way No 14 16 pcs Rp - - 16 16 - 16 Rp -
23 Folley Chateter 2 way No 16 8 pcs Rp - - 8 8 - 8 Rp -
24 Folley Chateter 2 way No 18 10 pcs Rp 9,829 - 10 10 - 10 Rp 98,290
25 Folley Chateter 2 way No 20 10 pcs Rp - 10 10 - 10 Rp -
26 Handscoon panjang steril 50 pcs Rp - 50 0 - 0 - 0 Rp -
27 Infuset Anak 150 pcs Rp 2,913 - 150 - 150 - 150 Rp 436,950
28 Infuset Dewasa 95 pcs Rp 6,622 - 95 100 - 195 - 195 Rp 1,291,290
29 Jarum jahit kulit 84 pcs Rp 1,042 84 - 84 - 84 Rp 87,528
30 Jarum jahit otot 84 pcs Rp 1,042 84 - 84 - 84 Rp 87,528
31 Kapas pembalut absorben 250 mg 7 roll Rp 15,000 5 2 10 - 10 - 10 Rp 150,000
32 Kassa pembalut hidrofil 4x10 cm 130 roll Rp 2,524 - 130 10 120 50 70 Rp 176,680
34 Kassa hidrofil 40x80 cm 2 roll Rp 115,000 4 1 5 2 3 4 3 2 5 Rp 575,000
35 Masker 200 pcs Rp 700 100 150 150 50 100 100 0 Rp -
36 Maxter exam glove no powder L pcs Rp 550 500 1,000 500 600 400 400 Rp -
(Handscoon non steril) 600 100 0 0
37 My Jelly 3 tube Rp 50,380 2 1 2 1 0 3 - 3 Rp 151,140
38 One met sunction chateter No. 14 820 pcs Rp - 20 20 - 20 Rp -
41 Plester 15 roll Rp 20,000 4 11 3 8 4 4 Rp 80,000
42 Rivanol 0 botol Rp 5,200 0 8 24 - 24 Rp 124,800
43 Safeglove surgical steril (Handscoon steril) pcs Rp 25,000 100 50 100 50 Rp 2,500,000
0 50 50 100
44 Silk 2/0 plus jarum 1/2 DT 35 mm 0 pcs Rp 4,556 0 0 - 0 Rp -
45 Silk 3/0 plus jarum 1/2 DT 35 mm 0 pcs 0 0 Rp -
47 HCL 0 botol Rp - 0 0 Rp -
48 Sefter Thicker 0 pcs Rp - 0 - 0 Rp -
49 Lab Kit 0 Paket Rp 901,274 0 - 0 Rp -
50 Anti HIV 1/2 Cassette 0 Rp 14,490 0 0 Rp -
TOTAL Rp 55,187,893
Malinjak, 30 September 2019
Mengetahui

NIP:19730928 199312 2 002 NIP:19831107 200904 2 006

NIP:19730928 199312 2 002 NIP:19831107 200904 2 006
2019 BER BER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
- - -
NO NAMA ITEM OBAT JUMLAH STOK SATUAN HARGA
DESEMBER SATUAN
2018 OBAT
1 2 3 4 5
1 Albendasol 1,652 tablet Rp 527
2 Allopurinol 100 mg 1,000 tablet Rp 127
3 Ambroksol sirup 100 botol Rp 4,000
4 Ambroksol tablet 600 tablet Rp 150
5 Aminophilin injeksi 24 mg / ml 40 ampul Rp 3,349
6 Aminophilin tablet 200 mg 500 tablet Rp 180
7 Amitripilin tablet 25 mg 500 tablet Rp 220
8 Amlodipin 10 mg 1,310 tablet Rp 110
9 Amoksisilin 500 mg 1,200 tablet Rp 245
10 Amoksisilin sirup kering 125 mg/5 ml 70 botol Rp 4,183
12 Antalgin Tablet 800 tablet Rp 145
13 Antasida DOEN I tablet 1,700 tablet Rp 74
15 Antihemoroid 70 suppo Rp 3,806
16 Asam Ascorbat 50 mg 2,200 tablet Rp 130
17 Asam Ascorbat 250 mg 1,500 tablet Rp 139
18 Asam Folat 1 mg 900 tablet Rp 57
19 Asam Mefenamat 500 mg 3,700 tablet Rp 139
21 Asiklovir Salep 38 tube Rp 5,000
22 Asiklovir 200 mg 1,300 tablet Rp 287
23 Atapulgit (Akita) 800 tablet Rp 120
24 Aqua Pro injeksi 66 vial Rp 2,400
25 Bedak salicyl serbuk 2 % 10 pot Rp 1,450
26 Betametason krim 75 tube Rp 3,500
27 Besi (II) sukfat 200 mg + asam folat 5,550 tablet Rp 49
28 Captopril 25 mg 2,300 tablet Rp 457
29 Clor Etil 2 botol Rp 12,000
31 Deksametason tablet 0,5 mg 1,100 tablet Rp 75
32 Diazepam injeksi 5 mg / ml 10 ampul Rp 3,038
33 Diazepam tablet 5 mg 85 tablet Rp 3,038
34 Difenhidramin injeksi 10 mg/ml 30 ampul Rp 1,260
35 Domperidon suspensi 5 mg / 5 ml 45 botol Rp 16,400
36 Domperidon tablet 10 mg 2,550 tablet Rp 190
37 Epinefrin (adrenalin) injeksi 30 ampul Rp 5,387
38 Eritromicin 500 mg 700 tablet Rp 128
39 Fenitoin Na kapsul 10 mg 440 kapsul Rp 545
40 Fenobarbital 30 mg 1,040 tablet Rp 170
43 Fitomenadion injeksi 2 ml/mg 60 ampul Rp 4,100
44 Fitomenadion tablet 10 mg 300 tablet Rp 866
45 Furosemid tablet 40 mg 100 tablet Rp 102
46 Gentamicin injeksi 40 mg / ml 20 ampul Rp 3,854
48 Gentamicin tetes mata 0,3% 24 botol Rp 3,832
49 Glibenklamid 5 mg 400 tablet Rp 93
50 Gliseril Guaiakolat (GG) 1,800 tablet Rp 450
51 Griseovulvin 125 mg 500 tablet Rp 374
52 H2O2 1 vial Rp 55,000
54 Hidrokortison krim 24 tube Rp 3,047
55 Ibuproven 200 mg 600 tablet Rp 117
56 Ibuproven 400 mg 1,500 tablet Rp 143
57 Kalsium Laktat 500 mg 1,260 tablet Rp 83
59 Ketokenasol 200 mg 190 tablet Rp 205
61 Ketorolac Injeksi 12 ampul Rp 1,450
62 Klindamisin 300 mg 700 tablet Rp 678
63 Kloramfenikol kapsul 250 mg 400 kapsul Rp 715
67 Kloramfeniramina Maleat 4 mg (CTM) 2200 tablet Rp 43
68 Kotrimoksasol tablet 480 mg 1200 tablet Rp 273
69 Kotrimoksasol suspensi 240 mg 19 botol Rp 5,500
70 Larutan Glukosa 5% 100 botol Rp 6,900
72 Larutan NaCL 115 botol Rp 7,000
73 Larutan Ringer Laktat 140 botol Rp 7,000
74 Lidokain Injeksi 50 ampul Rp 1,026
75 Loperamid 2 mg 300 tablet Rp 95
78 Magnesium Sulfat 40% (MgSO 40%) 20 vial Rp 7,920
79 Metilergometrin Injeksi 100 ampul Rp 4,895
80 Metilergometrin Tablet 100 tablet Rp 352
82 Metformin HCL 500 mg 1100 tablet Rp 113
85 Metronidasol 500 mg 1200 tablet Rp 151
86 Mikonasol krim 48 tube Rp 4,060
88 Nifedipin 10 mg 400 tablet Rp 200
89 Nistatin tablet 100.000 IU/g 400 tablet Rp 444
90 Nistatin tablet 500.000 IU/g 200 tablet Rp 720
91 OBH 90 botol Rp 2,500
94 Oksitocyn injeksi 100 ampul Rp 1,900
97 Ondansetron Tablet 252 tablet Rp 590
98 Oralit 300 sac Rp 460
99 OTSU KCL injeksi 16 botol Rp 7,920
101 Parasetamol sirup 120 mg 120 botol Rp 3,520
102 Parasetamol tablet 100 mg 49 tablet Rp 96
103 Parasetamol tablet 500 mg 2200 tablet Rp 135
104 Phenitoin 100 mg 50 tablet Rp 545
105 Pirantel Pamoat 125 mg 500 tablet Rp 655
107 Piridoksin 10 mg (Vitamin B6) 800 tablet Rp 67
109 Povidon Iodida 60 ml 40 botol Rp 7,532
110 Povidon Iodida 300 ml 12 botol Rp 22,600
111 Propanolol 10 mg 300 tablet Rp 130
112 Propiltiaurasil 100 mg 300 tablet Rp 675
114 Ranitidin 150 mg 800 tablet Rp 343
115 Retinol 100.000 (Vitamin A Biru) 610 kapsul Rp 355
116 Retinol 200.000 (Vitamin A Merah) 135 kapsul Rp 636
117 Salbutamol tablet 2 mg 1300 tablet Rp 108
118 Salbutamol tablet 4 mg 1500 tablet Rp 108
119 Salep 24 48 pot Rp 3,040
120 Sefadroksil 700 tablet Rp 616
121 Seftriakson injeksi 10 ampul Rp 5,688
122 Sianokobalamin tablet (Vitamin B12) 200 tablet Rp 69
124 Simetidin 300 tablet Rp 220
125 Simvastatin 20 mg 350 tablet Rp 250
126 Siprofloksasin tablet score 500 mg 600 tablet Rp 276
128 Tiamin tablet 50 mg (Vitamin B1) 2000 tablet Rp 40
129 Vitamin B Kompleks 2200 botol Rp 54
131 Zink tablet 20 mg 1300 tablet Rp 644
0
OBAT PROGRAM, VAKSIN DAN PERBEKALAN -
KESEHATAN
4 Calcii Glukonas 5 vial Rp 7,964
5 Dietil Karbamezapin 1,631 tablet Rp 119
6 Gimza 1 botol ###
7 Lancet 4,400 pcs Rp 176
10 Obat Anti Malaria 540 tablet Rp 864
11 Paket Kategori I 6 paket Rp 409,075
14 Pot Dahak 200 pot Rp 5,000
19 Ziehl Neelsen 1 paket Rp 276,500
20 HB o 40 Bungkus Rp 20,900
27 DPT/Pentabion 2 Vial Rp 70,232
28 Campak dan Pelarut 30 Vial Rp 25,640
31 Td/Tt 20 Vial Rp 15,000
32 IPV 8 Vial Rp 137,610
33 Spuit 0,05 150 Dos Rp 1,995
34 Supit 0,5 640 Dos Rp 1,448
35 Saftey Box 5 pak Rp 1,448
36 Hexagon syphilis 400 Rp 26,889
37 Spirtus 1 Rp 68,000
38 susu 10 Rp 135,000
42 Tamblet Tambah Darah Program 7,400 Rp 444
43 Alat Deteksi Resiko kehamilan 1 Paket Rp 422,980
PERBEKALAN KESEHATAN -
3 Alat suntik sekali pakai 1 ml 200 pcs Rp 1,000
5 Alat suntik sekali pakai 3 ml 400 pcs Rp 900
6 Alat suntik sekali pakai 5 ml 400 pcs Rp 2,049
11 Bisturi No. 10 G 100 pcs Rp 1,450
13 IV Chateter No. 22 Gx11/4 100 pcs Rp 9,345
14 IV Chateter No. 24 Gx11/4 115 pcs Rp 9,345
21 Etakridin 16 botol Rp 5,200
24 Folley Chateter 2 way No 18 10 pcs Rp 9,829
27 Infuset Anak 69 pcs Rp 2,913
28 Infuset Dewasa 50 pcs Rp 6,622
29 Jarum jahit kulit 96 pcs Rp 1,042
30 Jarum jahit otot 96 pcs Rp 1,042
31 Kapas pembalut absorben 250 mg 8 roll Rp 15,000
32 Kassa pembalut hidrofil 4x10 cm 180 roll Rp 2,524
33 Kassa pembalut hidrofil 4x5 cm 100 roll Rp 1,120
35 Masker 150 pcs Rp 700
36 Maxter exam glove no powder L (Handscoon non 200 pcs Rp 550
steril)
41 Plester 7 roll Rp 20,000
43 Safeglove surgical steril (Handscoon steril) 250 pcs Rp 25,000
44 Silk 2/0 plus jarum 1/2 DT 35 mm 36 pcs Rp 4,556
46 Urine bag 9 pcs Rp 5,500
49 Lab Kit 1 paket Rp 901,274
50 Anti HIV 1/2 Cassette 100 pcs Rp 14,490
TOTAL
PENERIMAAN Jan-19
JANUARI 2019
Dameka TanamoduTaman Mas Lolukay Tangairi Konda Wailawa RRI
- 100 200
-
n-19 JUMLAH SISA STOK PENERIM
PENGELUA 31 AAN
RAN JANUARI FEBRUAR
I 2019
PKDT SLB KIA LAB APOTEK Lainnya Dameka
- 1,652
300 700 1,000
- 100
- 600
- 40
- 500
- 500
- 1,310
- 1,200
- 70
- 800
- 1,700
- 70
- 2,200
- 1,500
- 900
- 3,700
- 38
- 1,300
- 800
- 66
- 10
- 75
- 5,550
- 2,300
- 2
- 1,100
- 10
- 85
- 30
- 45
- 2,550
- 30
- 700
- 440
- 1,040
- 60
- 300
- 100
- 20
- 24
- 400
- 1,800
- 500
- 1
- 24
- 600
- 1,500
- 1,260
- 190
- 12
- 700
- 400
- 2,200
- 1,200
- 19
- 100
- 115
- 140
- 50
- 300
- 20
- 100
- 100
- 1,100
- 1,200
- 48
- 400
- 400
- 200
- 90
- 100
- 252
- 300
- 16
- 120
- 49
- 2,200
- 50
- 500
- 800
- 40
- 12
- 300
- 300
- 800
- 610
- 135
- 1,300
- 1,500
- 48
- 700
- 10
- 200
- 300
- 350
- 600
- 2,000
- 2,200
- 1,300
- -
- -
- 5
- 1,631
- 1
- 4,400
- 540
- 6
- 200
- 1
- 40
- 2
- 30
- 20
- 8
- 150
- 640
- 5
- 400
- 1
- 10
- 7,400
- 1
- -
- -
- 200
- 400
- 400
- 100
- 100
- 115
- 16
- 10
- 69
- 50
- 96
- 96
- 8
- 180
- 100
- 150
- 200
- 7
- 250
- 36
- 9
- 1
- 100
Feb-19
TanamoduTaman Mas Lolukay Tangairi Konda Wailawa RRI PKDT SLB KIA
100 200
JUMLAH SISA STOK PENERIMA
PENGELU 28 AN MARET
ARAN FEBRUARI
LAB APOTEK Lainnya Dameka TanamoduTaman Mas Lolukay

- 1,652
300 1,400
15 15 85
- 600
- 40
- 500
- 500
- 1,310
- 1,200
- 70
- 800
- 1,700
- 70
- 2,200
- 1,500
- 900
- 3,700
- 38
- 1,300
- 800
- 66
- 10
- 75
- 5,550
- 2,300
- 2
- 1,100
- 10
- 85
- 30
- 45
- 2,550
- 30
- 700
- 440
- 1,040
- 60
- 300
- 100
- 20
- 24
- 400
- 1,800
- 500
- 1
- 24
- 600
- 1,500
- 1,260
- 190
- 12
- 700
- 400
- 2,200
- 1,200
- 19
- 100
- 115
- 140
- 50
- 300
- 20
- 100
- 100
- 1,100
- 1,200
- 48
- 400
- 400
- 200
- 90
- 100
- 252
- 300
- 16
- 120
- 49
- 2,200
- 50
- 500
- 800
- 40
- 12
- 300
- 300
- 800
- 610
- 135
- 1,300
- 1,500
- 48
- 700
- 10
- 200
- 300
- 350
- 600
- 2,000
- 2,200
- 1,300
- -
- -
- 5
- 1,631
- 1
- 4,400
- 540
- 6
- 200
- 1
- 40
- 2
- 30
- 20
- 8
- 150
- 640
- 5
- 400
- 1
- 10
- 7,400
- 1
- -
- -
- 200
- 400
- 400
- 100
- 100
- 115
- 16
- 10
- 69
- 50
- 96
- 96
- 8
- 180
- 100
- 150
- 200
- 7
- 250
- 36
- 9
- 1
- 100
Mar-19
Tangairi Konda Wailawa RRI PKDT SLB KIA LAB APOTEK Lainnya
JUMLAH SISA STOK
PENGELU 28
ARAN FEBRUARI
- 1,652
- 1,400
- 85
- 600
- 40
- 500
- 500
- 1,310
- 1,200
- 70
- 800
- 1,700
- 70
- 2,200
- 1,500
- 900
- 3,700
- 38
- 1,300
- 800
- 66
- 10
- 75
- 5,550
- 2,300
- 2
- 1,100
- 10
- 85
- 30
- 45
- 2,550
- 30
- 700
- 440
- 1,040
- 60
- 300
- 100
- 20
- 24
- 400
- 1,800
- 500
- 1
- 24
- 600
- 1,500
- 1,260
- 190
- 12
- 700
- 400
- 2,200
- 1,200
- 19
- 100
- 115
- 140
- 50
- 300
- 20
- 100
- 100
- 1,100
- 1,200
- 48
- 400
- 400
- 200
- 90
- 100
- 252
- 300
- 16
- 120
- 49
- 2,200
- 50
- 500
- 800
- 40
- 12
- 300
- 300
- 800
- 610
- 135
- 1,300
- 1,500
- 48
- 700
- 10
- 200
- 300
- 350
- 600
- 2,000
- 2,200
- 1,300
- -
- -
- 5
- 1,631
- 1
- 4,400
- 540
- 6
- 200
- 1
- 40
- 2
- 30
- 20
- 8
- 150
- 640
- 5
- 400
- 1
- 10
- 7,400
- 1
- -
- -
- 200
- 400
- 400
- 100
- 100
- 115
- 16
- 10
- 69
- 50
- 96
- 96
- 8
- 180
- 100
- 150
- 200
- 7
- 250
- 36
- 9
- 1
- 100

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LAPORAN STOK OPNAME PUSKESMAS MALINJAK 2019

BULAN Oktober s/d Desember 2019

OBAT PROGRAM, VAKSIN DAN

Malinjak, 03 Januari 2020

Herlina L Dapa Talu,A.Md Keb Dewi Zuliatik,A.Md Farm

34 Difenhidramin injeksi 10 mg/ml 0 ampul Rp 1,260 - - - -

69 Kotrimoksasol suspensi 240 mg 19 botol Rp 5,500 50 9 60 50 - 110 10 100 550,000

4 Calcii Glukonas 5 vial Rp 7,964 5 5 - 5 39,820

30 Jarum jahit otot 96 pcs Rp 1,042 12 84 - 84 - 84 87,528

Malinjak, 30 Maret 2019

Herlina L Dapa Talu,A.Md Keb Dewi Zuliatik,A.Md Farm

OBAT PROGRAM, VAKSIN DAN

Malinjak, 03 Januari 2020

Herlina L Dapa Talu,A.Md Keb Dewi Zuliatik,A.Md Farm

OBAT PROGRAM, VAKSIN DAN

Malinjak, 28 Juni 2019

Herlina L Dapa Talu,A.Md Keb Dewi Zuliatik,A.Md Farm

OBAT PROGRAM, VAKSIN DAN

Malinjak, 30 September 2019

Herlina L Dapa Talu,A.Md Keb Dewi Zuliatik,A.Md Farm

Herlina L Dapa Talu,A.Md Keb Dewi Zuliatik,A.Md Farm

Dameka TanamoduTaman Mas Lolukay Tangairi Konda Wailawa RRI

LAB APOTEK Lainnya Dameka TanamoduTaman Mas Lolukay

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