PUSKESMAS PULE
TAHUN 2018
0
STOK AWAL
APR MAY JUN JUL AUG SEP OCT NOV DEC
4 5 6 7 8 9 10 11 12
7 8 9 10 11 12 13 14 15
PENERIMAAN
FEB MAR APR MAY JUN JUL AUG SEP OCT NOV
2 3 4 5 6 7 8 9 10 11
17 18 19 20 21 22 23 24 25 26
10
250
-
-
-
-
-
-
-
-
-
300
-
-
-
-
-
-
3,600
1,500
1,200
-
-
-
-
-
-
36
1,000
-
20
-
-
-
-
-
-
-
-
3,100
-
-
500
-
-
-
-
-
-
-
-
-
-
18
12
-
10
12
-
-
-
-
-
-
-
-
-
-
-
-
500
28
-
-
-
10
300
-
-
500
-
-
-
-
-
-
-
-
-
-
-
-
-
-
500
-
10
200
-
-
-
-
-
10
-
-
-
-
-
-
-
-
-
-
-
-
-
-
200
-
-
-
-
-
250
-
-
-
-
15
5
500
200
700
-
-
-
-
-
-
-
-
-
-
-
-
500
-
-
-
-
-
-
70
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3,500
-
-
-
-
-
30
-
-
-
-
-
-
1,000
11
20
-
-
1,500
-
-
-
-
-
-
-
270
-
-
30
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
10
20
-
500
-
-
-
-
-
-
-
500
-
-
-
-
-
-
-
-
-
-
-
-
-
1,000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
45
-
-
-
-
-
-
-
-
500
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
500
-
5
-
-
-
-
20
-
-
-
-
-
5,000
220
-
-
-
-
-
1,000
-
-
-
-
1,200
-
-
-
-
-
1,000
-
-
-
-
-
1,000
-
-
-
-
-
-
-
-
10
-
DEC
12
27
PETUNJUK PENGISIAN
ISILAH DATA YANG DIPERLUKAN PADA SHEET "DATA" DAN "DATA OBAT"
1 Isi semua data pada Sheet "DATA"
2 Ganti nama Puskesmas sesuai Pos masing2, mis Pustu Ngares
3 Isi kode bulan pada kolom "BLN ke" (kode terlampir)
4 Isi kode minggu pada kolom "MGG ke" (kode terlampir)
5 Isi kode tanggal pada kolom "TGL ke" (kode terlampir)
Khusus untuk tgl 21 des - 31 des (di akhir tahun), kode tanggal ditulis 32 - 42
karena laporan ditutup sampai mendekati akhir tahun
Jika tgl 21 des dst dimasukkan untuk awal tahun, maka kode bulannya adalah "1"
dan kode tanggalnya tetap "21"
Kode "BLN ke", "MGG ke", dan "TGL ke" ditulis setelah mengisi data pada hari tersebut
agar komputer tidak memproses lama sehingga menjadi lemot
6 Isi kode unit pada cell di pojok kanan atas (diatas kolom "AGE")
7 kolom diisi
NO no urut
TANGGAL tanggal kunj pasien
UNIT YG DITUJU otomatis akan muncul
NAMA PENDERITA nama pasien
INDEKS no indeks family folder (map) pasien
NAMA KK nama kepala keluarga dalam family folder
ALAMAT nama desa/ kelurahan pasien
RT RT tempat tinggal pasien
l/p jenis kelamin pasien
UMUR umur pasien, dibedakan dalam kolom umur, thn, hari
KUNJ : sts kunj status (list) pasien, diisi b (baru), atau l (lama)
KUNJ : jns kunj jenis pasien (terlampir)
KK kunj family folder, diisi b (baru), atau l (lama)
DG/LG diisi hanya untuk kunj luar gedung
KET keterangan karcis (khusus untuk loket induk, mis kir, cm)
ANAMNESA keluhan pasien
OBYEKTIF hasil pemeriksaan fisik
DIAGNOSA diagnosa penyakit pasien, masing2 kolom untuk 1 diagnosa
KUNJ KASUS kunj kasus pasien, masing2 kolom untuk 1 kunj kasus
PENGOBATAN obat yang diberikan, terdiri dari nama obat dan jumlah (kode terlampir)
TINDAKAN tindakan yang diberikan untuk pasien (kode terlampir)
NO ASURANSI no anggota asuransi, mis jamkesmas, askes (bila ada)
11 Untuk file "obat" otomatis kode bulan akan sama pada file "1 DATA DAN LOKET"
di sheet "SHP"
12 Jika ada obat baru, mohon konfirmasi ke pembuat program sebelum melakukan perubahan
agar perubahan tersebut dapat disosialisasikan ke pengguna program yang lain
sehingga bisa seragam
13 penerimaan dan stok awal obat, isikan pada sheet "DATA OBAT"
sesuai dengan masing2 bulan pada kolom "penerimaan"
dan kolom "stok awal"
14 Untuk mencetak data per bulan, klik autofilter pada kolom "BLN ke",
pilih kode bulan yang diinginkan, kemudian ketik nama bulan pada cel F4
15 Untuk sheet "karcis harian", gantilah tanggal sesuai dengan tanggal berlaku
dengan syarat, untuk bulan februari tanggalnya tetap harus sampai tanggal 29 Februari
16 Untuk file "BP" dan file "OBAT", bukalah hanya ketika membutuhkan untuk melihat data
File "BP" berisi : Sensus Harian Penyakit, Rekap Penyakit per desa, 10 Kunj Kasus Terbanyak
Grafik Kasus Mingguan, Grafik kasus mingguan dengan dilengkapi kunj kasus
Grafik Kunjungan Kasus Mingguan
File "OBAT" berisi : Rekap Harian Obat, LPLPO
SELAMAT BERKARYA
Kode bulan Kode Status dan Kunj KK
1 JANUARI b
2 FEBRUARI l
3 MARET
4 APRIL Kode Jenis Kunj
5 MEI b
6 JUNI a
7 JULI p
8 AGUSTUS ja
9 SEPTEMBER jp
10 OKTOBER jd
11 NOPEMBER g
12 DESEMBER
1401
1402
1403
1499
1500
1601
1602
1603
1701
1702
1703
1799
1801
1802
1803
1804
1805
1806
1901
1902
1903
1904
1905
1906
1907
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2099
2101
2102
2103
2104
2105
2109
2199
2201
2202
2203
2204
2205
2206
2207
2208
2209
2210
2299
2301
2302
2303
2304
2305
2399
2402
2403
2404
2406
2407
2408
2409
2499
2500
2601
2602
2603
2604
2605
2606
2607
2608
2609
2610
2611
2612
2613
2614
2699
2701
2702
2703
2704
2705
2706
2707
2708
2709
2710
2798
2801
2802
2803
2804
2805
2806
2807
2808
2809
2810
2811
2812
2813
2814
2815
2816
2817
2818
2819
2820
2899
2901
2902
2903
2904
2905
2906
2907
2908
2909
2910
2911
2999
3001
3002
3003
3004
3005
3006
3007
3008
3009
3010
3011
3012
3013
3014
3015
3016
3017
3018
3019
3020
3021
3022
3099
3101
3201
3202
3203
3204
3205
3206
3207
3208
3299
3301
3302
3303
3304
3305
3306
3307
3308
3309
3310
3312
3399
3401
3402
3403
3404
3405
3406
3407
3499
3501
3502
3503
3504
3505
3506
3507
3508
3509
3510
3511
3512
3513
3514
3515
3601
3602
3603
3604
3605
3606
3607
3608
3609
3610
3611
3612
3613
3614
3615
3616
3617
3618
3699
3701
3702
3703
3704
3801
3802
3803
3804
3805
3806
3807
3808
3809
3811
3812
3813
3814
3899
3901
3902
3999
4001
4002
4003
4004
4005
4006
4007
4008
4099
4119
4121
4129
4201
4202
4203
4299
4301
4302
4303
4304
4305
4306
4307
4308
4309
4310
4311
4312
4701
4702
4703
4704
4705
4706
4707
4708
4709
4799
4801
4802
4803
4804
4805
4806
4807
4808
4899
4901
4902
4903
4904
4905
4906
4910
4911
4912
4999
5003
5004
5005
5006
5007
5008
5009
5010
5011
5012
5013
5099
Kode Status dan Kunj KK Kode Minggu
kunj pertama kali dalam 1 tahun TAHUN 2012 JANUARI FEBRUARI
kunj kedua dst dalam 1 tahun MINGGU KE 1 2 3 4 5 6 7
minggu 1 8 15 22 29 5 12
Kode Jenis Kunj senin 2 9 16 23 30 6 13
bayar selasa 3 10 17 24 31 7 14
bpjs rabu 4 11 18 25 1 8 15
askes peserta kamis 5 12 19 26 2 9 16
jamkesmas anggota jum'at 6 13 20 27 3 10 17
jamkesmas peserta sabtu 7 14 21 28 4 11 18
jamkesda
sktm, gratis, lain-lain TAHUN 2012 JULI AGUSTUS
MINGGU KE 27 28 29 30 31 32 33
minggu 1 8 15 22 29 5 12
senin 2 9 16 23 30 6 13
Kode Kunj Kasus selasa 3 10 17 24 31 7 14
kunj kasus yang pertama kali rabu 4 11 18 25 1 8 15
kunj kasus untuk yang kedua dlm rentang waktu 1 bln kamis 5 12 19 26 2 9 16
kunj kasus yang sama dalam rentang waktu lebih 1 bln jum'at 6 13 20 27 3 10 17
sabtu 7 14 21 28 4 11 18
Encephalocele
Microcephaly
Congenital Hydrocephalus
Spinabifida
Cleft Palate : Palatum Sumbing
Cleft Lip: Bibir Sumbing
Bibir dan Palatum Sumbing
Cacat pada telapak kaki
Polydactily
Syndactily
Down's Syndrome
Cacat Congenital lain2
Trauma lahir
Asfiksi
Tetanus Neonatorum
Kern Icterus
Icteric Neonatus sebab tidak jelas
lleus Meconium
Kematian Fetus tidak jelas : lahir mati & IUFD
Keadaan lain-2 pada masa perinatal
Anemia: Deff Fe
Anemia :Deff B12
Anemia: Asam Folat
Anemia lain
Impetigo
Abses, Furuncle, Carbuncle
Cellulitis
Lymphadenitis Akuta
Peny kulit infeksi lain
Atopic Dermatitis
Seborrhoic Dermatitis
Penyakit Kontak Alergi
Pruritus
Psoriasis
Urticaria
Acne Vulgaris
Decubitus
Peny kulit lain2
Kejang Demam
Pembesaran Kelenjar Limpa
Vertigo
Kematian Kehamilan
Kematian Persalinan
Kematian Pasca Persalinan
Penyeb+C568ab Mortalitas Ibu lain-2
Tetanus Neonatorum
Infeksi lain
Neoplasma
Malnutrisi
Infeksi Pernafasan
Infeksi Gastrointestinal
Trauma lahir
Asfiksia
Cacat Kongenital
Penyakit lain-2 pada bayi
Kecelakaan pada bayi
BBLR
Sunat / Sirkumsisi
Tindakan
Jahit Luka
Follow up tindakan operasi misal buka jahitan, buka pembalut dsb
Donor Darah
Oxygen
Infus
Doppler
Tindakan lain-2
Posyandu Balita
Posyandu Lansia
UKS- TK
UKS- SD
UKS- SMP
UKS- SMA
UKS- Pesantren
Pemeriksaan Kelompok Petani
Pemeriksaan Kelompok Kerja
Pemeriksaan Kelompok Lain-2
Pemeriksaan Rumah dengan Jentik Malaria
Pemeriksaan PCD
Pemeriksaan ACD
Pemeriksaan Epidemilogi Hepatitis
Pemeriksaan Epidemilogi DBD
Pemeriksaan Epidemilogi Diare
Pemeriksaan HIV / AIDS
Pemeriksaan Epidemilogi Malaria
Pemeriksaan Epidemilogi Folio
Pemeriksaan Epidemiologi Flu Burung
Pemeriksaan Epidmiologi SARS
Pemeriksaan Epidemilogi lain
FEBRUARI MARET APRIL MEI JUNI
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
19 26 4 11 18 25 1 8 15 22 29 6 13 20 27 3 10 17 24
20 27 5 12 19 26 2 9 16 23 30 7 14 21 28 4 11 18 25
21 28 6 13 20 27 3 10 17 24 1 8 15 22 29 5 12 19 26
22 29 7 14 21 28 4 11 18 25 2 9 16 23 30 6 13 20 27
23 1 8 15 22 29 5 12 19 26 3 10 17 24 31 7 14 21 28
24 2 9 16 23 30 6 13 20 27 4 11 18 25 1 8 15 22 29
25 3 10 17 24 31 7 14 21 28 5 12 19 26 2 9 16 23 30
mg/ml-10ml
Salut 25 mg
ng 125 mg/5ml
ah No.2/0-3/0
i 5mg/ml-1ml
nfus 6% steril
p 10 mg/5ml
at tablet 100 mg
jeksi 10mg/ml-1ml
arutan 0,1 %
ksi 50 mg/ml
0 mg/ml-2ml
a tablet 250 mg
a tablet 500 mg
Injeksi 10mg/ml-1ml
Tablet salut gula 10mg
( scabisid cream )
s 10 % Steril
s 40 % Steril
5 mg, micronized
T ) tablet 25 mg
Sublingual 5 mg
tablet 500 mg
(CTM) tablet 4 mg
eksi 5mg/ml-2ml
eksi 25mg/ml-1ml
salut 100 mg
Injeksi 25 % - 2ml
alisilat 20 %
Kombinasi:
resol tersabun 50 %
at Inj 0,200 mg-1ml
at (Metilergometrin)
al 100.000 IU/g
Kategori I( FDC)
Kategori 2
Kategori 3
njk.im.50mg/ml-10ml
ol ( Pengganti TKF )
mer Cemen (GC IX)
droksida Pasta
sasi Metakresol
psul 100.000 IU
psul 200.000 IU
Polivalen Injeksi
Injeksi 1.500IU/ampul
B12) Injeksi
Sutera ) No. 3/0
kombinasi : Besi II
scin Butylbromida
num 250 mg (Dormi compositum)
lidokain
litrol
lope
lora
lorazepam
masker
metfor
mp
metil
metil inj
metoklo inj
metoklo
metro inf
metros
metro250
metro500
mgso420
mgso440
miko
mineral mix
pz
nadik
neurobion inj
neurodek
nefi2
nife
nistatin susp
nistatin vag
oam
oa anak
oa kat2
oakat3
fgc
oa sisipan
obh
JUMLAH OBAT
4
oksi sm
oksitosin inj
omepraz inj
ome
pamol drop
pamols
pamol1
pamol
pehacain inj
burnazin sk
permet
pira inj
pira
pirantel
b6
pirok
plester
polifix
povidon300
povidon60
pred
primakuin
pbp inj
propanolol
radin inj
radin
vita100
vita200
rl
risper
ventolin
salbu
salep24
talk
sabu
JUMLAH OBAT
4
ads
ats
b12
sikzoinj
silk
simvas10
simvas20
spirolakton
hyosin
fe
telmi
teop
molasma
tetra2
tetra5
tiamex
b1
b1 inj
tramadol inj
tramadol
thd
truvit drop
upad
ultafix
baby
urine bag
bcomp
wing
zdv100
zdv300
zdv60
zinks
zink
JUMLAH OBAT
4
REKAP PEMAKAIAN OBAT HARIAN
PUSKESMAS PULE
1 2 3+G10:G18 p 9 1"" 11 13 14
12 1 3 1 3-Dec-19 KIA induk mia p 21 g 012 fe Total fe 227 30 vitc Total fe 14 30
12 2 3 2 3-Dec-19 BP induk bejan aziz l 41 g 011 ibus Total ibus 23 1 fenol Total ibus 19 1
12 3 3 3 3-Dec-19 BP induk musni p 70 g 011 simvas20 Total simvas20 12 5 nadik Total simvas20 9 10 bcomp 10
12 4 3 4 3-Dec-19 BP induk ali djamiya l 71 g 011 nadik Total nadik 45 10 simvas20 Total nadik 31 5 kalk 10
12 5 3 5 3-Dec-19 KIA induk parmi p 36 b 012 fe Total cefad 38 30 vitc Total cefad 0 30
12 6 3 6 3-Dec-19 KIA induk afriska p 22 b 012 fe Total bcomp 5 30 vitc Total bcomp 43 30
12 7 3 7 3-Dec-19 KIA induk sunarti p 32 b 012 fe Total alop1 11 15 kalk Total alop1 5 15
12 8 3 8 3-Dec-19 KIA induk fitri p 17 b 012 fe Total acysk 2 20 kalk Total acysk 0 20
12 9 3 9 3-Dec-19 KIA induk sulfi p 19 b 012 fe Total acy4 4 30 vitc Total acy4 0 30
12 10 3 10 3-Dec-19 Gigi induk marji l 42 b 013 cefad Total alop3 0 6 asmet Total alop3 0 10 mp 10
12 11 3 11 3-Dec-19 BP induk puji lestari p 34 b 011 bcomp Total ambroks 0 10 nadik 10
12 12 3 12 3-Dec-19 BP induk marrtiyah p 33 b 011 sid Total ambrok 36 10 pamol Total ambrok 33 10 cimet 10
12 13 3 13 3-Dec-19 BP induk saikem p 64 g 011 betahis Total amino 0 10 pamol Total amino 2 10 sid 10
12 14 3 14 3-Dec-19 BP induk yayuk s p 45 g 011 alop1 Total amitrip 1 10 ketopro Total amitrip 0 10 nadik 10
12 15 3 15 3-Dec-19 KIA induk siti juariyah p 19 g 012 fe Total amlo10 40 10 vitc Total amlo10 7 10 b1 10
12 16 3 16 3-Dec-19 BP induk torikus l 13 g 011 permet Total amlo5 18 1 ery500 Total amlo5 11 10 deksa 10
12 17 3 17 3-Dec-19 KIA induk lili p 27 g 012 fe Total amok5 47 30 vitc Total amok5 7 30
12 18 3 18 3-Dec-19 KIA induk ika sariana p 20 g 012 fe Total amoks 11 30 vitc Total amoks 2 30
12 19 3 19 3-Dec-19 KIA induk anisa p 17 b 012 fe Total sids 4 15 kalk Total sids 0 15
12 20 3 20 3-Dec-19 BP induk suminto l 52 b 011 doksi Total sid 75 10 ctm Total sid 73 10
12 21 3 21 3-Dec-19 BP induk moh fathan l 9 g 011 gg Total asetil 0 5 pamol 5 ctm 5
12 22 3 22 3-Dec-19 BP induk sarmi p 45 g 011 ketopro Total asmet 28 10 bcomp Total asmet 54 5 sid 10
12 23 3 23 3-Dec-19 BP induk sulasmi p 51 b 011 pred Total vic 10 15 bcomp Total vic 113 10
12 24 3 24 3-Dec-19 KIA induk sulastri p 27 g 012 metil Total pulgit 3 10 fe Total pulgit 1 30
12 25 3 25 3-Dec-19 BP induk zaenaf p 69 g 011 betahis Total betahis 22 10 pamol Total betahis 8 10 sid 10
12 26 3 26 3-Dec-19 Gigi induk sugiarto l 68 g 013 asmet Total beta 2 5 Total beta 2
12 27 3 27 3-Dec-19 BP induk tutik p 24 g 011 asmet Total biolis 6 10 bcomp Total biolis 5 10
12 28 3 28 3-Dec-19 BP induk samsudin l 69 b 011 sid Total dulco 1 10 pamol Total dulco 0 10 pulgit 10
12 29 3 29 3-Dec-19 BP induk fria abdi f l 13 g 011 kloram Total dulcoan 0 20 pamol 10 sid 10
12 30 3 30 3-Dec-19 KIA ngares safrina p 5 g 16 pamols Total biso 0 1 klorams Total biso 1 1 ambrok 5
12 31 3 31 3-Dec-19 KIA ngares tumini p 65 b 16 kloram Total bromhex 0 20 pamol Total bromhex 0 10 sid 10
12 32 3 32 3-Dec-19 KIA ngares bainem p 67 g 16 nadik Total cap 1 10 b1 Total cap 3 10 simvas20 10
12 33 3 33 3-Dec-19 KIA ngares thiya p 6 g 16 pamols Total cap25 0 1 Total cap25 1
12 34 3 34 3-Dec-19 Gigi induk candra k l 23 b 013 cefad Total cefad 38 6 asmet Total cefad 0 10 mp 10
12 35 3 35 3-Dec-19 KIA ngares reza s l 2.5 g 16 pamols Total cefads 12 1 klorams Total cefads 0 1
12 36 3 36 3-Dec-19 BP induk karmijem p 70 b 011 glime Total ceti 0 30 bcomp Total ceti 0 10
12 37 3 37 3-Dec-19 BP induk partini p 50 b 011 nadik Total cetis 6 10 ibus Total cetis 3 1 bcomp 10
12 38 3 38 3-Dec-19 KIA ngares nardatu firdaus p 8 g 13 pamol Total cimet 0 2 Total cimet 6
12 39 3 39 3-Dec-19 BP induk partiyah p 50 g 011 sid Total cypro 27 10 pamol Total cypro 3 10 nadik 10
12 40 3 40 3-Dec-19 KIA ngares suyati p 49 g 16 pamol Total dexa 5 10 sid Total dexa 14 10
12 41 3 41 3-Dec-19 BP induk kintan amelda p 7 g 011 gg Total dema 1 5 pamol Total dema 0 5 ctm 5
12 42 3 42 3-Dec-19 BP induk sarmun l 50 g 011 cypro Total dias2 4 6 kodein Total dias2 1 10 mp 10
12 43 3 43 3-Dec-19 BP induk mujiyem p 38 g 011 amlo5 Total dimen 3 30 ambrok Total dimen 0 10 pamol 10
12 44 3 44 3-Dec-19 BP induk nur ayu f p 2 g 011 nadik Total dom 0 10 ibus Total dom 3 1 alintab 10
12 45 3 45 3-Dec-19 BP induk sri wahyuni p 37 g 011 halo5 Total doms 1 30 thd Total doms 0 30 cpz 30
12 46 3 46 3-Dec-19 BP induk yatinem p 60 g 011 sid Total ery500 9 10 pamol Total ery500 1 10 cimet 10
12 47 3 47 3-Dec-19 KIA ngares erika p 7 g 16 pamols Total erys 5 1 kotrims Total erys 0 1 obh 1
BUKU LIDI PEMAKAIAN OBAT
PUSKESMAS PULE
TAHUN : 2019
TANGGAL : 01 Desember 2019
UNIT NAMA
UNIT YANG NAMA UMUR KUNJ
BLN no TGL NO TANGGAL l/p JUMLAH DALAM 1 JUMLAH DALAM 1
DITUJU PENDERITA KODE NAMA OBAT NAMA OBAT 1 TOTAL NAMA OBAT NAMA OBAT 2 TOTAL NAMA OBAT TOTAL
ke urut ke thn bln hr jns BULAN BULAN
b1 10
Total biso 0 Total biso 0
Total bromhex 0 Total bromhex 0
Total cap 0 Total cap 0
Total cap25 0 Total cap25 0
Total cefad 0 Total cefad 0
Total cefads 0 Total cefads 0
Total ceti 0 Total ceti 0
Total cetis 0 Total cetis 0
Total cimet 0 Total cimet 0
Total cypro 0 Total cypro 0
Total dexa 0 Total dexa 0
Total dema 0 Total dema 0
Total dias2 0 Total dias2 0
Total dimen 0 ctm 10 Total dimen 0
Total dom 0 Total dom 0
Total doms 0 Total doms 0
Total ery500 0 Total ery500 0
Total erys 0 Total erys 0
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
Total fenol 0 Total fenol 0
Total furo 0 Total furo 0
Total oralit 0 Total oralit 0
Total geebio 0 Total geebio 0
Total gliben 0 Total gliben 0
Total glime1 0 Total glime1 0
Total glime 0 Total glime 0
Total kloram 0 Total kloram 0
Total klorams 0 Total klorams 0
Total kotrims 0 Total kotrims 0
Total kotrim 0 Total kotrim 0
Total kodein 0 Total kodein 0
Total lope 0 Total lope 0
Total lora 0 Total lora 0
Total metfor 0 Total metfor 0
Total metoklo 0 Total metoklo 0
Total Metro250 0
Total Metro500 0 Total Metro500 0
total nadik 0 total nadik 0
total nife 0 total nife 0
total pamols 0 ctm 10 total pamols 0
total pamol 1 total pamol 0
total b6 0 total b6 0
total simvas10 0 total simvas10 0
total simvas20 0 spuit 1 total simvas20 0 amok5 10 asmet 10 kasa4x3 1
total b1 0 total b1 0
total bcomp 0 total bcomp 0
total zink 0 total zink 0
total tiamex 0 total tiamex 0
kotrim 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
amlo5 30
deksa 10
sid 10 simvas20 5
pamol 10
amok5 10 asmet 10
deksa 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
beta 1
kloramsm 1
ibus 1
betahis 10
zink 10
metoklo 15
sid 10
pamol 10
deksa 10
pamol 10
deksa 5
lora 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
thd 30
ctm 10
betahis 10
pamol 10
biolis 1
bcomp 10
pamol 10
metro500 10
gg 10
salbu 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
cypro 6
sid 10
b1 10
sids 1
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
ambrok 10
ctm 3
thd 30
ibus 1
cpz 30
nadik 10
vitk 5
sid 10
hidro 1
b1 10
beta 1
amlo5 10
ambrok 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
simvas20 5
ctm 3
amlo5 10
ambrok 10
deksa 10
b1 10 asetil 10
sid 10
gg 10
bcomp 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
asmet 10
dom 10
amok5 10
cimet 10
bcomp 10
antihem 2
ambrok 10
b1 10
sid 10
ctm 10
nadik 10
beta 1
nadik 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
kloram 20
ctm 10
vitk 10
bcomp 10 betahis 10
cypro 6
deksa 10
sid 10
glime 10
amino 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
bcomp 10
deksa 10
deksa 10
ctm 5
asmet 10 metil 10
amok5 10
sid 10 betahis 10
ctm 3 kotrims 1
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
bcomp 10
ambrok 10
bcomp 10
ctm 3 vitc 3
pamol 10
simvas20 5
sid 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
ctm 10
amlo5 30 acysk 1
sikzoinj 1
vitc 3
gv 1
vitc 10
deksa 10
amlo5 10
nadik 10
pamol 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
ctm 10
nadik 10
ctm 3 deksa 3
mes 1 kasa4x3 1 amok5 10 asmet 10
gv 1
metfor 30
bcomp 10
nife 10
deksa 10
cetis 1
deksa 10
bcomp 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
amitrip 3
lora 10
gentask 1
nadik 10
zink 10
ctm 10
cpz 30
amoks 1
pamol 10
telmi 15
glime 30
amok5 10 asmet 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
amlo5 10 simvas20 5
alop1 10
bcomp 10
sid 10
salbu 10
sid 10
simvas20 5
alop1 10 lora 10
sid 10
cefad 6
alop1 10 simvas20 5
pamol 10
bcomp 10
ctm 10
gv 1
ctm 10
gv 1
pamol 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
pamol 10
acysk 1
simvas20 5
dema 10
ambrok 10 ctm 10
bcomp 10
mp 10
deksa 10
bcomp 10
litrol 1
betahis 10
kalk 10
pamol 4
vitc 10
deksa 10
amlo5 10
nadik 10
pamol 10
ctm 10
nadik 10
ctm 3 deksa 3
mes 1 kasa4x3 1 amok5 10 asmet 10
pamol 4
kloram 10
10
telmi 15
obh 1
deksa 10
salbu 10 ctm 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
gv 1
metfor 30
bcomp 10
nife 10
deksa 10
pamol 3 vitc 3
b1 10
simvas20 5
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
spuit 1 amok5 10 asmet 10
lora 10 pamol 10
sid 10
sid 10 amitrip 3
deksa 3
pamol 10
thd 30
nistatin vag 3
b1 10 10
ctm 3 deksa 3
ctm 10
ambrok 10
cypro 6
sid 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
ctm 5
simvas20 5
bcomp 10
pamol 10
pamol 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
cefads 1
ctm 3 vitc 4
kalk 10
sid 10
mp 10
pamol 10
lora 10
beta 1
ctm 10
gv 1
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
kloram 20
nife 15
b1 10
mp 3 ctm 3
pamol 10
vitc 10
mp 10
nadik 10
ctm 5 vitc 5
,
bcomp 10
sid 10
bcomp 10
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
###
, ###
###
011
NAMA OBAT
JUMLAH DALAM NAMA JUMLAH DALAM 1 NAMA
NAMA OBAT 3 TOTAL NAMA OBAT 4 NAMA OBAT TOTAL NAMA OBAT TOTAL TOTAL
1 BULAN OBAT BULAN OBAT
###
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
KAMAR OBAT INDUK
NOMOR TANGGAL
KODE PUSKESMAS : : …………………………
: …………………………
PUSKESMAS PULE : …………………………
: …………………………
KECAMATAN PULE PELAPORAN BULAN/ PE###
KABUPATEN TRENGGALEK PERMINTAAN BULAN/ P ###
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 Acyclovir SK 5 % tube 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
2 Acyclovir tab. 400 mg tab 0 0 0 0 10 0 30 0 0 0 0 0 0 0 0 0 0 50 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140
3 Adona Ac 17 injeksi 5 ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Alat Suntik Sekali Pakai 1 ml pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Alat Suntik Sekali Pakai 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Alat suntik sekali pakai 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik Sekali Pakai 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik Sekali Pakai 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Albendazol tablet 400 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Alinamin F inj. amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Alinamin F tab. tab 0 0 10 50 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65
12 Alopurinol tablet 100 mg tab 0 0 10 0 40 0 0 0 0 0 0 0 0 10 0 0 20 10 10 20 10 0 30 0 0 0 30 40 0 10 20 0 0 260
13 Alopurinol tablet 300 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ambroxol sirup 15mg/60ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Ambroxol tablet tab 0 0 25 23 25 30 40 0 36 35 3 0 0 30 0 61 33 20 30 60 50 0 50 0 0 60 30 30 0 75 30 0 0 776
16 Aminofilina Injeksi 24mg/ml-10ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Aminofilina tablet 200 mg tab 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 20 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32
18 Amitriptilin HCl.Tablet Salut 25 mg tab 0 0 20 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 3 10 0 0 0 0 3 0 0 0 0 0 0 46
19 Amlodipin tab. 10 mg tab 0 0 0 0 85 15 50 0 10 60 30 0 0 45 0 70 45 0 70 140 95 0 205 0 0 60 90 60 0 105 25 0 0 1260
20 Amlodipin tab. 5 mg tab 0 0 30 40 20 0 10 0 90 40 70 0 0 20 0 90 101 30 70 80 30 0 100 0 0 60 45 10 0 30 0 0 0 966
21 Amoksisilin kaplet 500 mg tab 0 0 0 30 52 20 20 0 60 63 30 0 0 40 0 20 50 20 35 120 20 0 80 0 0 50 30 20 0 15 25 0 0 800
22 Amoksisilin kapsul 250 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Amoksisilin sir forte 250 mg/5 ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Amoksisilin Sirup Kering 125 mg/5ml btl 0 0 1 0 0 0 0 0 1 0 0 0 0 2 0 0 3 1 1 0 1 0 1 0 0 1 1 1 0 0 2 0 0 16
25 Ampisillin inj. 1 gr vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Antalgin (Metampiron) Injeksi 250 mg/ml-2m amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Antalgin (Metampiron) Tablet 500 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Antasida DOEN susp, Kombinasi : btl 0 0 0 1 0 0 0 0 1 1 2 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 9
29 Antasida DOEN Tablet, Kombinasi : tab.kunyah 0 0 120 65 70 130 130 0 115 135 90 0 0 60 0 40 70 90 70 200 75 0 160 0 0 110 50 120 0 140 140 0 0 2180
30 Anti Bakteri DOEN Salep Kombinasi : pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Anti Hemoroid DOEN Kombinasi supp 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
32 Antimigren DOEN kombinasi: Tablet tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Antrain inj./ Norages inj. amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Aqua pro Injeksi, bebas pirogen btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Aquadest Steril btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 Artemeter inj. amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Artesunat inj. vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Asam asetilsalisilat (asetosal) tab 80 mg tab 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
39 Asam Askorbat tablet 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Asam Askorbat tablet 50 mg tab 0 0 220 70 120 0 120 0 160 123 148 0 0 92 0 135 133 166 215 280 173 0 260 0 0 130 153 50 0 130 139 0 0 3017
41 Asam Benzoat 6%+Asam Salisilat 3% pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Asam Folat tab. 1 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
43 Asam Mefenamat tablet 500 mg tab 0 0 45 80 60 41 40 0 90 70 30 0 0 40 0 30 10 40 90 120 60 0 65 0 0 35 36 20 0 20 20 0 0 1042
44 Asam Traneksamat inj. 50mg/ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Asetosal tablet 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Asetosal tablet 500 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Aspar K tablet tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Atapulgit tablet 600 mg tab 0 0 20 0 20 10 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55
49 Atropin Sulfat Injeksi 0,25 mg/ml-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Bebat Fracture pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Benzatin Benzil Penisilin Ij. 1,2 juta IU/vial vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Benzatin Benzil Penisilin Ij. 2,4 juta IU/vial vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Betahistin Mesilat tab 6 mg tab 0 0 40 0 10 10 10 0 10 20 20 0 0 30 0 20 20 10 20 20 20 0 40 0 0 10 0 40 0 20 30 0 0 400
54 Betametason krim 0,1 % tube 0 0 1 0 1 0 1 0 0 2 3 0 0 0 0 0 0 1 2 0 0 0 1 0 0 1 0 0 0 1 0 0 0 14
55 Lisin,multivitamin,multimineral sirup 60 ml btl 0 0 0 0 0 2 1 0 1 0 0 0 0 1 0 2 0 0 0 2 1 0 2 0 0 0 0 0 0 1 0 0 0 13
56 Bioplacenton jell tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Bisakodil supp. 10mg (Dulcolax supp) dewasa supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 12
58 Bisakodil supp. 5 mg (Dulcolax supp) anak supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 Bisoprolol tab. 5 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30
60 Bloodset pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Bromheksin tab. 8 mg ( Hexon tab.) tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Buscotika inj.( Spasi inj .) amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Calsium Gluconas injeksi amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
64 Canula Oksigin anak pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Canula Oksigin dewasa pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Captopril 12,5 mg tab. tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 10 0 0 0 0 50 0 0 90
67 Captopril tab. 25 mg tab 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
68 Cartridge GeneXpert biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Catgut / Benang Bedah No.2/0-3/0 pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Multivitamin drop 10 ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
71 Cefadroksil caps 500mg kapsul 0 0 12 12 6 12 6 0 30 6 6 0 0 18 0 12 0 12 18 24 18 0 12 0 0 0 0 6 0 30 12 0 0 252
72 Cefadroksil syr kering 125 mg btl 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 2 1 1 1 2 0 0 0 0 0 0 2 2 0 1 0 0 0 14
73 Cefotaxim inj. vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Ceftriakson inj. vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Cetirizin HCl tab 10 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 Cetirizin sirup 5mg / 5 ml botol 0 0 1 0 0 0 1 0 0 2 2 0 0 1 0 0 1 0 1 0 1 0 0 0 0 1 0 0 0 1 1 0 0 13
77 Cimetidine tab. tab 0 0 20 10 0 10 10 0 10 40 10 0 0 0 0 0 0 10 0 20 0 0 0 0 0 0 0 0 0 30 0 0 0 170
78 Clobazam tab. 10 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Clozapin tab. 25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 30
80 Cyprofloxasin 500 mg tab 0 0 12 6 6 18 0 0 12 28 6 0 0 18 0 0 0 0 6 0 6 0 18 0 0 24 6 18 0 18 6 0 0 208
81 Deksametason injeksi 5mg/ml-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
82 Deksametason tablet 0,5 mg tab 0 0 10 28 30 41 23 0 46 31 13 0 0 66 0 50 30 9 0 0 0 0 3 0 0 380
83 Dekstran 70-larutan infus 6% steril btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Demacolin syr. btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Demacolin tab. tab 0 0 0 0 0 0 0 0 0 0 1 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
86 Dexanta tablet tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
87 Diazepam Injeksi 5 mg/ml-2ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Diazepam rectal tube tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Diazepam tablet 2 mg tab 0 0 0 0 0 0 0 0 10 0 0 0 0 10 0 0 20 0 10 0 5 0 0 0 0 0 0 0 0 0 0 0 0 55
90 Diazepam tablet 5 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Dietilkarbamazin Sitrat tablet 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
92 Difenhidramin HCl. Injeksi 10mg/ml-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Digoxin tablet 0,25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Diltiazem hcl tab 30 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Dimenhidrinat tab . 50 mg tab 0 0 0 0 0 0 0 0 20 0 0 10 0 0 0 0 10 0 0 10 0 0 0 0 0 0 10 0 0 0 0 0 0 60
96 Doksisiklin tab. 100 mg tab 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
97 Domperidom susp. 5 mg / ml btl 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
98 Domperidom tab. tab 0 0 0 0 0 0 0 0 10 25 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45
99 Efavirenz (EFV) 200 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Efavirenz (EFV) 600 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
101 Epinefrina HCl/Bitatrat Injeksi amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
102 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
103 Erytromisin kaps.500 mg kapsul 0 0 10 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 35 10 0 0 105
104 Erytromisin sirup. btl 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 1 0 0 0 5
105 Etakridin ( Rivanol ) larutan 0,1 % btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Etanol 70 % btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
107 Etanol 70% 100 ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
108 Etil Klorida Semprot btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
109 Eugenol cairan btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 Fenitoin Natrium Injeksi 50 mg/ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
111 Fenitoin Natrium Kapsul 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
112 Fenitoin Natrium Kapsul 30 mg kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
113 Fenobarbital Injeksi 50 mg/ml-2ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
114 Fenobarbital tablet 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
115 Fenobarbital tablet 30 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
116 Fenoksimetil Penisilina tablet 250 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
117 Fenoksimetil Penisilina tablet 500 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % btl 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 3
119 Fitomenadion (Vit.K1) Tablet salut gula 10mgtab salut 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Fitomenadion (Vit.K1)Injeksi 10mg/ml-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Fluoksetin kap. 10 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Fluoksetin kap. 20 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
123 Folley Catheter No.16 pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
124 Folley Catheter No.18 pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 Furosemid tablet 40 mg tab 0 0 0 0 0 30 0 0 0 0 30 0 0 30 0 60 0 15 0 0 0 0 0 0 0 0 15 0 0 40 0 0 0 220
126 Furosemida inj. Iv/im 10 mg/ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
127 Garam Oralit 200 ml air sacc 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
128 Geebio sacc 0 0 0 0 0 0 0 0 0 0 4 0 0 4 0 0 0 0 5 10 0 0 0 0 0 0 0 0 0 0 0 0 0 23
129 Gentamisin inj. 40 mg / ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Gentamycin Salep Kulit tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 2 0 0 0 0 0 0 0 0 1 0 0 0 6
131 Gentian Violet Larutan 1 % btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 2 0 0 0 0 0 0 0 0 0 0 0 5
132 Glibenclamid tablet 5 mg tab 0 0 0 0 75 0 30 0 30 60 50 0 0 30 0 60 30 0 30 20 0 0 80 0 0 45 0 60 0 15 0 0 0 615
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
133 Glimepirid tab 1 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 40 0 90 0 0 0 160
134 Glimepirid tab 2 mg tab 0 0 40 60 135 40 30 0 90 10 30 0 0 60 0 20 10 30 0 195 40 0 140 0 0 50 60 0 0 30 25 0 0 1095
135 Gliserilguaiacolat tablet 100 mg tab 20 0 10 30 0 5 18 0 40 10 10 0 0 12 0 5 3 11 10 12 10 0 0 0 0 0 6 19 0 4 8 0 0 243
136 Glukosa Larutan Infus 10 % Steril btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
137 Glukosa Larutan Infus 40 % Steril btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
138 Glukosa Larutan Infus 5 % Steril btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Griseofulvin tablet 125 mg, micronized tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
140 H2O2 ( Hydrogen Peroxide ) 3% btl / 100 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
141 H2O2 ( Hydrogen Peroxide ) 3% btl / 800 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
142 Halloperidol drops 2 mg / ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
143 Haloperidol Decanoas 50 mg/ml inj. amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Haloperidol inj.5 mg/ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Haloperidol tablet 0,5 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Haloperidol tablet 1,5 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
147 Haloperidol tablet 5 mg tab 0 0 30 30 30 60 30 0 30 60 30 0 0 30 0 0 30 60 30 30 30 0 120 0 0 60 0 60 0 0 0 0 0 750
148 Handsaplas jumbo pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Handscoen obgyn psg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Hansdcoen pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
151 Hansdcoen steril psg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
152 Hidroklorotiazid ( HCT ) tablet 25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
153 Hidrokortison Krim 2,5 % tube 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
154 Ibuprifen susp. 100 mg / 5 ml ( novaxipen ) btl 0 0 3 3 5 0 0 0 4 3 3 0 0 3 0 2 1 2 1 4 1 0 3 0 0 4 10 4 0 6 4 0 0 66
155 Ibuprofen tablet 200 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
156 Ibuprofen tablet 400 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
157 Imipramide tab. 25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
158 Infusion Set Anak pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Infusion Set Dewasa pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
160 INH tab 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 INH tab 300 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Isorbid Dinitrat tablet Sublingual 5 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
163 IV. Cateter No.18 G pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
164 IV. Cateter No.20 G pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 IV. Cateter No.22 G pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 IV. Cateter No.24 G pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 IV. Cateter No.26 G pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
168 Kalamin Lotio btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Kalsium Laktat (Kalk) tablet 500 mg tab 0 0 90 165 75 90 30 0 45 140 15 0 0 0 0 225 190 90 130 160 100 0 250 0 0 155 165 130 0 345 110 0 0 2700
170 Kaltrofen tab tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
171 Kaolin Pektin syr btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
172 Kapas Pembalut/Adsorben 250 gram rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
173 Karbamazepin tablet 200 mg tab 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30
174 Kasa Pembalut Hidrofil 4 m X 15 cm rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
175 Kasa Pembalut Hidrofil 4 m X 3 cm rol 0 0 0 2 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 6 0 0 3 0 0 1 1 0 0 0 0 0 0 16
176 Kasa steril 16x16 rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
177 Ketokonazol tab 200 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
178 Ketoprofen inj amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
179 Ketoprofen supp supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
180 Ketoprofen tab. 100 mg tab 0 0 20 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 33
181 Kloramfenikol injeksi vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 Kloramfenikol Kapsul 250 mg kapsul 0 0 60 50 20 130 80 0 10 50 30 0 0 70 0 0 80 30 20 40 40 0 40 0 0 80 80 60 0 35 100 0 0 1105
183 Kloramfenikol Salep mata 1% tube 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 5
184 Kloramfenikol syr. btl 0 0 2 0 0 0 1 0 2 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 10
185 Kloramfenikol tetes mata ( Reco ) btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
186 Kloramfenikol Tetes telinga 3% btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Klorfeniramin Maleat (CTM) tablet 4 mg tab 0 0 30 18 25 20 33 0 21 13 3 0 0 32 0 25 16 36 35 60 13 0 0 0 0 40 23 28 0 43 8 0 0 522
188 Klorokuin tablet 150 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
189 Klorpromazin HCl.Injeksi 25mg/ml-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
190 Klorpromazin HCl.Injeksi 5mg/ml-2ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
191 Klorpromazin Tablet salut 100 mg tab 10 0 30 30 10 60 30 15 30 60 30 0 0 30 0 0 30 90 30 60 30 0 120 0 0 60 0 60 0 0 0 0 0 815
192 Klorpromazin Tablet salut 25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Kodein Fosfat tablet 10 mg tab 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 30
194 Kombinasi : Ipratropium bromida inhalasi 0, tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
195 Kombinasi: kaolin 550 mg + pektin 20 mg btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 10 20 0 0 10 0 0 0 0 10 0 0 0 0 0 70
196 Kombipak Kategori 1 paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
197 Kotrimoksazol 480 mg tablet tab 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20
198 Kotrimoksazol Suspensi btl 0 0 1 0 0 10 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 27
199 Kuinin ( Kina ) tablet 200 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 Kuinin Dihidroklorida Injeksi 25 % - 2ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
201 Ky jelly / My Jelly tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Laborat Blood Lancet biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Laborat Cover Glass biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
204 Laborat Dempul / malam putih biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
205 Laborat Gluco stik biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
206 Laborat Golongan darah test. biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
207 Laborat Obyek Glass biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
208 Laborat Obyek Glass Frosted biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Laborat Pot dahak biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
210 Lamifudin tab 150 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
211 Laborat Tabung Centrifuge biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
212 Larutan Zn. btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
213 Lidokain gel 2% tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 Lidokain komp.Injeksi Kombinasi: amp 0 0 0 2 0 0 1 0 1 0 1 0 0 0 0 0 1 1 2 0 1 0 0 0 0 0 0 0 10
215 Litrol tetes mata btl 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 0 0 0 5
216 Loperamida tab. tab 0 0 0 0 10 10 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30
217 Loratadin tab.10 mg tab 0 0 10 20 10 10 10 0 0 10 10 0 0 0 0 20 0 10 30 80 30 0 60 0 0 10 10 20 0 30 0 0 0 380
218 Lorazepam ( Merlopam ) tab. 2 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
219 Masker pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
220 MDT-MB Adult kusta blister 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
221 MDT-MB Child kusta blister 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
222 MDT-PB Adult kusta blister 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
223 MDT-PB Child kusta blister 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 Metformin HCl.tab. 500 mg tab 0 0 160 120 140 160 90 0 90 60 210 0 0 60 0 40 0 0 80 60 120 0 60 0 0 120 240 90 0 90 198 0 0 2188
225 Methylprednisolon tab. 4 mg 125 0 0 40 30 30 40 10 0 25 20 10 0 0 50 0 0 0 15 15 40 30 0 40 0 0 35 25 25 0 73 48 0 0 601
226 Metilergometrin Maleat (Metilergometrin) tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
227 Metilergometrin Maleat Inj 0,200 mg-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228 Metoklopramida inj. 10mg/ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Metoklopramida tab. 10 mg tab 0 0 0 0 10 35 0 0 0 0 10 0 0 0 0 0 0 0 10 0 0 0 0 0 0 10 0 0 0 0 10 0 0 85
230 Metronidazol infus btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 Metronidazol sir 125 mg/5 Ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
232 Metronidazol tablet 250 tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Metronidazol tablet 500 mg tab 0 0 0 20 20 10 10 0 10 0 10 0 0 30 0 30 0 0 10 20 20 0 0 0 0 0 20 0 0 0 0 0 0 210
234 MgSO4 20% 25 ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 MgSO4 40% 25 ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
236 Mikonazol salp kulit 2 % tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237 Mineral Mix sacc 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Natrium klorida Larutan Infus 0,9 % Steril btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Natriun Diklofenak tab. 50mg tab 0 0 90 20 80 20 6 0 50 46 60 0 0 40 0 50 40 10 50 120 60 0 90 0 0 30 30 20 0 90 60 0 0 1062
240 Thimine Riblofavinn yanocobalamin injeksi psg.amp. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
241 Vitamin B1 vitamin B6 Vitamin B12. tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
242 Nevirapine (NVP) 200 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
243 Nifedipin tab 10 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 20 0 0 20 0 0 10 0 0 15 0 0 0 15 15 0 0 115
244 Nistatin susp 100.000 UI/ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Nistatin Tablet Vaginal 100.000 IU/g supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 3
246 Obat anti malaria tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Obat Antituberkulosis Anak paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Obat Antituberkulosis Kategori 2 paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
249 Obat Antituberkulosis Kategori 3 paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
250 Obat Antituberkulosis Kategori I( FDC) paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Obat Antituberkulosis Sisipan paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
252 Obat batuk Hitam ( OBH ) btl 0 0 1 1 0 1 1 0 0 0 1 0 0 3 0 12 1 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 24
253 Obat Gigi Air Raksa Dental Use biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
254 Obat Gigi Bonding 5 ml biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
255 Obat Gigi Chlorofenol Kamfer Menthol ( CHK biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
256 Obat Gigi Devitalisasi Pasta biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
257 Obat Gigi Forinokresol ( Pengganti TKF ) biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
258 Obat Gigi Glass Ionomer Cemen (GC IX) biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
259 Obat Gigi Kalsium Hidroksida Pasta biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Obat Gigi Silver Amalgam serbuk 65 - 75 % biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
261 Obat Gigi Temporary Restoratif biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 Obat OAT HIV Fase Awal tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
263 Obat OAT HIV Fase Lanjutan tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
264 Oksimetazolin tts hidung 0,050% btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
265 Oksitetrasiklin HCl. Salep 1 % tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Oksitosin Injeksi 10 IU/ml-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
267 Omeprazol inj 40 mg/10 ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 Omeprazol kaps. 20 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
269 Oxygen spray portable biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
270 Parasetamol drop 100mg/ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
271 Parasetamol Sirup 120 mg / 5ml btl 0 0 4 1 0 1 1 0 1 1 3 0 0 1 0 1 3 2 2 2 2 0 3 0 0 1 1 1 0 0 2 0 0 33
272 Parasetamol tablet 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 Parasetamol tablet 500 mg tab 0 0 132 88 177 159 165 0 160 174 60 0 0 149 0 139 124 95 128 210 105 0 106 0 0 102 118 142 0 174 167 0 0 2874
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
274 Pehacain inj. amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
275 Perak Sulfadiazin ( Burnazim salp ) tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
276 Permetrin krim 5 % ( Scabimite krim ) tube 1 0 1 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6
277 Piracetam inj. 3 gr / 15 ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
278 Piracetam tab. 800 mg tab 0 0 0 0 20 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30
279 Pirantel tablet 125 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
280 Piridoksin HCl. (Vit.B6) tablet 10 mg tab 0 0 0 20 0 25 0 0 30 0 0 0 0 10 0 12 20 30 0 20 30 0 0 0 0 30 0 15 0 55 0 0 0 297
281 Piroxicam tab. 20 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
282 Plester 7,5 x 4,5 ( Isoplast ) rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
283 Polifix 5cm x 1 m rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
284 Povidon Iodida 10 % 300 ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
285 Povidon Iodida 10 % 60 ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
286 Prednison tablet 5 mg tab 0 0 15 0 0 0 0 0 0 0 10 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 65
287 Primakuin tablet 15 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
288 Prokain Benzil Penisillin injeksi 3 juta IU/vial vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
289 Propanolol HCl tablet 40 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
290 Propiltiourasil tablet 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
291 Ranitidin inj. 25 mg / 2 ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
292 Ranitidin tab. 150 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
293 RDT Parascreen ( u/ malaria ) test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
294 Reagen TPHA test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
295 Reagen Hbig test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
296 Reagen HIV Fokus test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
297 Reagen HIV Rigsin test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
298 Reagen HIV SD test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
299 Reagen RDT DBD NSI test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
300 Reagen RDT DBD NSI IgG/Igm test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
301 Reagent HIV Aids 1 onco test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
302 Reagent HIV Aids 2 intek test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
303 Reagent HIV Aids 3 vikia test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
304 Reagent SD HBsAg test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
305 Retinol (Vitamin A) kapsul 100.000 IU kaps.lunak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
306 Retinol (Vitamin A) kapsul 200.000 IU kaps.lunak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
307 Ringer Lactat Larutan infus steril btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
308 Risperidone tab 2 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
309 RpR Syphilis test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
310 Salbutamol cairan ih 0,1% ( Ventolin Nebules tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
311 Salbutamol tablet 2 mg tab 0 0 10 0 0 0 10 0 0 0 10 0 0 20 0 10 10 0 0 0 20 0 10 0 0 20 20 20 0 0 10 0 0 170
312 Salep 2-4 , Kombinasi pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
313 Salisil Bedak 2 % dos 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
314 Serum anti Bisa ular Polivalen Injeksi amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
315 Serum Anti Difteri ( ADS ) amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
316 Serum Anti Tentanus Injeksi 1.500IU/ampul amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
317 Sianokobalamina (vit.B12) Injeksi amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
318 Sikzonoate ( Fluphenazine) inj. amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 2
319 Silk (Benang Bedah Sutera ) No. 3/0 pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
320 Sinvastatin tab 10 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
321 Sinvastatin tab 20 mg tab 0 0 30 5 25 0 0 0 5 5 5 0 0 10 0 5 15 10 20 10 15 0 45 0 0 5 5 15 0 0 20 0 0 250
322 Spironolakton tab 25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
323 Tablet Hyoscin Butylbromida tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
324 Tablet tambah Darah kombinasi : Besi II fer tab 0 0 340 225 195 120 140 0 280 195 135 0 0 110 0 350 285 225 325 400 290 0 475 0 0 300 295 155 0 435 200 0 0 5475
325 Telmisartan tab 80 mg tab 0 0 0 0 15 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 15 0 0 0 0 0 0 30 0 30 0 0 0 109
326 Teofilin tab 150 mg (BRONSOLVAN) tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
327 Terbutalin tab.2,5 mg (Molasma tablet) tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
328 Tetrasiklin HCl. Kapsul 250 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
329 Tetrasiklin HCl. Kapsul 500 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
330 Thiamfenikol kapsul 500 mg/Tiammex tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
331 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg tab 0 0 40 35 10 10 0 0 111 110 30 0 0 35 0 0 10 10 25 0 20 0 30 0 0 40 10 10 0 30 30 0 0 596
332 Tiamin HCl. (Vit.B1) Injeksi 100 mg/ml-1ml amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
333 Tramadol inj. amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
334 Tramadol tab. 50 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
335 Trifluoperazine 5mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
336 Triheksifenidil Hidroklorida tablet 2 mg tab 0 0 30 30 30 60 30 0 30 60 30 0 0 30 0 0 30 90 30 60 30 0 120 0 0 90 0 60 0 0 0 0 0 840
337 Multivitamin drop 15 ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
338 U pad pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
339 Ultrafix 5cmx5m rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
340 Unibeby Cough syr btl 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 5
341 Urine Bag pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
342 Vitamin B Komplex tablet tab 0 0 65 20 50 55 40 0 0 10 40 0 0 50 0 120 70 60 50 120 60 0 105 0 0 10 40 45 0 95 100 0 0 1205
343 Wing Nedle pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
344 Zidofudine (ZDV) 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
345 Zidofudine (ZDV) 300 mg+ Lamivudine (3TC) tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
346 Zidofudine 60 mg+ Lamivudine 30 mg+Nevira tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
347 Zinc sir 10 mg/ml btl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
348 Zinc tablet tab 0 0 0 10 10 20 30 0 0 0 20 0 0 0 0 10 0 40 30 100 30 0 20 0 0 0 15 20 0 20 0 0 0 375
349 Vaksin HBIG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
350 SD Biosensor 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
360
361 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
436 mes buah 0 0 0 2 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 6 0 0 4 0 0 1 0 0 0 0 0 0 0 16
437 spuit buah 0 0 0 2 1 0 3 0 1 2 1 0 0 0 0 0 0 1 1 2 0 0 3 0 0 1 3 0 0 0 0 0 0 21
438 Depo vial 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 0 0 1 0 0 0 0 2 0 0 1 2 0 0 0 0 0 0 10
439 Pil KB tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
440 IUD biji 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
441 Implan biji 0 0 0 2 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 6 0 0 2 0 0 1 1 0 0 0 0 0 0 15
NO. SATU
NAMA - OBAT
URUT AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33 ### JUMLAH
442 Kondom biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 12 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 12 0 0 0 0 0 0 0 24
BAYAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
gratis 0 0 57 49 54 43 40 0 58 58 37 0 0 50 0 52 52 51 55 96 45 0 81 0 0 70 45 47 0 75 49 0 0 1164
jamkesda 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
bpjs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
jumlah 0 0 57 49 54 43 40 0 58 58 37 0 0 50 0 52 52 51 55 96 45 0 81 0 0 70 45 47 0 75 49 0 1164
### LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
KAMAR OBAT l
NO. SATU STOK PENE PERSE PEMAKAI EXP SISA STOK PERMIN- PEMBERIAN
NAMA - OBAT KET
URUT AN AWAL RIMAAN DIAAN AN STOK OPT TAAN PKD ASKES PKPS LAIN2 JML
1 2 3 4 5 6 7 8 10 12 14 16
9 11 13 15
NO TANGGAL NAMA ALAMAT UMUR JUMLAH NO TANGGAL NAMA ALAMAT UMUR JUMLAH OBAT
1 1 1-Apr-19 Karni Jombok 62 10
2 9-Apr-19 Kusni Joho 55 10
3 9-Apr-19 Saikem Joho 56 10
4 10-Apr-19 Karsito Sidomulyo 43 10
5 10-Apr-19 Sarli Pule 70 10
6 13-Apr-19 Sujud Tanggaran 37 10
7 15-Apr-19 Satinem Jombok 69 10
8 22-Apr-19 Satinem Jombok 69 10
25-Apr-19 Musdiyanto Pule 85 10
9 25-Apr-19 Sarli Pule 71 10
10 26-Apr-19 Sumarto Karanganyar 59 10
11 27-Apr-19 Danis Puyung 65 10
12
13
14
15
16
17
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
JUMLAH 0 0 0 JUMLAH 120
MENGETAHUI
KEPALA PUSKESMAS PETUGAS APOTEK
Puskesmas : Pule
Kabupaten : Trenggalek Bulan : April
Provinsi : Jawa Timur Tahun : 2019
Sesu
Lama ai
Jumlah Item Antibiotik Dosis Pemak Pedo
Tgl No. Nama Umur Nama Obat
Obat Ya/Tidak Obat aian man
(hari) Ya/Ti
(1) (2) (3) (4) (5) (6) (7) (8) (9) dak
( 10 )
Petugas,
VIDHA ERNAWATI
NIP:19760406 200604 2 012
FORMULIR PELAPORAN INDIKATOR PERESEPAN DIARE NON SPESIFIK
Puskesmas : Pule
Kabupaten : Trenggalek Bulan : April
Propinsi : Jawa Timur Tahun : 2019
Total Item 12 1
Rerata
Item
4 Obat/ 3.00
Lembar
Resep
Persentase AB 25.00
Petugas,
VIDHA ERNAWATI
NIP:19760406 200604 2 012
FORM-2
Sesuai
Pedoman
Ya/Tidak
( 11 )
FORM-3
FORMULIR PELAPORAN INDIKATOR PERESEPAN MYALGIA
Puskesmas : Pule
Kabupaten : Trenggalek Bulan : April
Propinsi : Jawa Timur Tahun : 2019
Lama Sesuai
Jumlah Injeksi
No. Nama Umur Nama Obat Dosis Pemakaia Pedoman
Item Obat Ya/Tidak
n (hari) Ya/Tidak
Petugas,
VIDHA ERNAWATI
NIP:19760406 200604 2 012
LAPORAN INDIKATOR PERESEPAN
DI PUSKESMAS
Petugas,
VIDHA ERNAWATI
NIP:19760406 200604 2 012
REGISTER OBAT GUDANG TAHUN 2019
PUSKESMAS PULE
BULAN / TAHUN :PEBRUARI 2019
NAMA PETUGAS : VIDHA ERNAWATI
300
3,600
1,500
1,200
36
1,000
20
3,100
500
18
12
10
12
500
28
10
300
500
500
10
200
10
200
250
15
5
500
200
700
500
70
3,500
30
1,000
11
20
1,500
270
30
10
20
500
500
1,000
45
500
500
20
5,000
220
1,000
1,200
1,000
1,000
10
10
10
10