FORMULIR PELAPORAN INDIKATOR PERESEPAN ANTIBIOTIK PADA DIARE NON SPESIFIK

Puskesmas : Jebus Bulan : Desember

Kabupaten : Bangka Barat Tahun : 2020
Provinsi : Kep. Bangka Belitung

Jumlah Antibiotik Lama Sesuai Pedoman

Tgl No Nama Umur Item Nama Obat Dosis Pemakaian
Ya / Tidak Ya / Tidak
Obat ( hari )
3-Dec-20 1 Muslim 38 th 4 Tidak R/Zinc 20 2x1 tab x pc habiskan 5 hari
R/Loperamid 2 3x1 tab x pc 3 hari
R/Oralit 3x1 bks x pc Jika BAB 3 hari
R/Ranitidine 150 2x1 tab x pc 3 hari

7-Dec-20 2 May Ketesyen 25 th 4 Ya R/Loperamid 2 3x2 tab x pc 2 hari

R/Paracetamol 500 3x1 tab x pc sprn 3 hari
R/Omeprazol 20 1x1 caps x pc 5 hari
R/Kotrimoksazol forte 480 2x1 tab x pc dihabiskan 5 hari

16-Dec-20 3 Juliyanda 9 th 4 Tidak R/Zinc 20 2x1 tab x pc habiskan 5 hari

R/Paracetamol 500 3x½ tab x pc sprn 3 hari
R/Domperidone 5mg/5ml 3x2 cth fls I ac 3 hari
R/Loperamid 2 3x1 tab x pc Jika BAB 3 hari

28-Dec-20 4 Pahrudin 38 th 2 Tidak R/Loperamid 2 2x1 tab x pc Jika BAB 3 hari

R/Paracetamol 500 3x1 tab xv pc sprn 5 hari

29-Dec-20 5 Aeria 4 th 10 bln 3 Tidak R/Oralit 2x1 bks v pc Jika BAB 3 hari
R/Vitamin C 1x1 tab v pc 5 hari
R/Paracetamol 120mg/5ml 3x1½ cth fls I pc sprn 3 hari

Total item obat A = 17 B=1

N=5 Rerata item obat/

Lembar Resep 3,4
Persentase
Antibiotik 20%

Jebus, 30 Desember 2020

Mengetahui Pengelola Obat
Kepala Puskesmas Jebus Puskesmas Jebus
dr. Era Nurakhmi Marlita Oktaria, S.Farm. Apt
NIP 19880424 201409 2 001 NIP 19911024 201902 2 004
 LAPORAN INDIKATOR PERESEPAN
DI PUSKESMAS JEBUS

Nama Puskesmas : Jebus

Jenis Puskesmas : Perawatan
Jumlah Apoteker : 1 (satu)
Jumlah Asisten Apoteker : 2 (dua)
Jumlah Dokter : 4 (empat)
Kabupaten : Bangka Barat
Provinsi : Kep. Bangka Belitung

Rerata Item Obat/lembar Resep

% Penggunaan Antibiotik pada
% Penggunaan Antibiotik pada ISPA dan Batuk-
ISPA Atas dan Batuk-pilek Diare Non-
Diare Non-Spesifik pilek (common Rata-rata
(common cold) Spesifik
cold)
1 2 3 4 5

10% 20% 3,35 3,4 3,37

Jebus, 30 Desember 2020

Mengetahui Pengelola Obat
Kepala Puskesmas Jebus Puskesmas Jebus

dr. Era Nurakhmi Marlita Oktaria, S.Farm., Apt

NIP 19880424 201409 2 001 NIP 19911024 201902 2 004
 PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN INDIKATOR DI PUSKESMAS (OBAT INDIKATOR)

Nama Puskesmas : Jebus

Alamat : Jl. Kampak No. 188 Jebus Kecamatan Jebus
Kab/Kota : Bangka Barat / Muntok
Provinsi : Bangka Belitung
Penanggungjawab IGD : Marlita Oktaria, S.Farm., Apt
No. Hp/Email : 081367178112/myrzone@mail.com
Periode Pelaporan : Bulan Februari 2021
STOK
NO OBAT INDIKATOR SATUAN PEMASUKAN PENGELUARAN SISA KET.
AWAL
1 Albendazol /Pirantel Pamoat Tablet 150/0 0/0 0/0 150/0
2 Alopurinol 100 mg Tablet 4100 0 1000 3100
3 Amlodipin 5 mg/Kaptopril 25 mg Tablet 2400/300 1800/0 0/300 4200/0
4 Amoksisilin 500 mg Tablet 2600 1000 300 3300
5 Amoksisilin sirup 125 mg/5 ml Botol 85 0 85 0
6 Antasida tablet kunyah/ antasida suspensi Tablet/Botol 8300/100 0/100 300/50 8000/150
7 Asam Askorbat (Vitamin C) Tablet 1300 5000 2500 3800
8 Asiklovir 200 mg Tablet 200 0 0 200
9 Betametason salep Tube 0 0 0 0
Tablet/
10 Deksametason tablet/deksametason injeksi 1000/200 3000/0 0/0 4000/200
Vial/Ampul
11 Diazepam injeksi 5 mg/ml Ampul 5 0 0 5
12 Diazepam 5 mg Tablet 153 100 48 205
Dihidroartemsin+piperakuin (DHP) dan
13 Tablet 0 0 0 0
primaquin
14 Difenhidramin Inj. 10 mg/ml Ampul 30 0 0 30

15 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) Ampul 31 50 31 50

ED= Des 2020
16 Fitominadion (Vitamin K) injeksi 2mg/ml Ampul 81 0 6 75
17 Furosemid 40 mg/Hidroklorotiazid (HCT) Tablet 200/100 0/0 200/0 0/100
18 Garam Oralit serbuk Kantong 400 200 0 600
19 Glibenklamid/Metformin Tablet 0/5800 0/5000 0/3000 0/7800
20 Hidrokortison krim/salep Tube 72 0 24 48
Kotrimoksazol (dewasa) kombinasi
21 Tablet/Botol 200/78 0/0 100/0 100/78
tablet/Kotrimoksazol suspensi
22 Lidokain inj + Epinefrin Vial 60 0 60 0
23 Magnesium Sulfat injeksi 40% Vial 18 0 0 18
24 Metilergometrin Maleat injeksi 0,200 mg-1 ml Ampul 0 0 0 0
25 Natrium Diklofenak 25 mg Tablet 1000 2000 0 3000
26 OAT FDC Kat 1 Paket 3 2 4 1
27 Oksitosin injeksi Ampul 100 0 0 100
28 Parasetamol sirup 120 mg / 5 ml Botol 284 0 100 184
29 Parasetamol 500 mg Tablet 4800 5000 2300 7500
30 Prednison 5 mg Tablet 96 0 60 36 stok apotek
31 Ranitidin 150 mg Tablet 5000 3000 1000 7000
32 Retinol 100.000/200.000 IU Kapsul 47/40 0/0 0/13 47/27 stok apotek
33 Salbutamol 2 mg Tablet 2000 1000 0 3000
34 Oksitetrasiklin Salep Mata Tube 24 0 1 23 stok apotek
 FORM PEMANTAUAN PUSKESMAS DENGAN KETERSEDIAAN VAKSIN IMUNISASI DASAR LENGKAP (IDL)

Nama Puskesmas : Puskesmas Jebus

Alamat : Jl. Kampak No. 188 Jebus Kecamatan Jebus
Kab/Kota : Bangka Barat / Muntok
Provinsi : Bangka Belitung
Penanggungjawab Farmasi : Marlita Oktaria, S.Farm., Apt
No. Hp/Email : 081224494401/oktariamarlita@yahoo.co.id
Periode Pelaporan : Bulan Desember 2020
STOK
NO OBAT INDIKATOR SATUAN PEMASUKAN PENGELUARAN SISA KET
AWAL
1 Vaksin Hepatitis B Vial 56 0 5 51
2 Vaksin BCG Ampul 41 20 18 43
3 Vaksin DPT-HB-HIB Vial 51 30 36 45
4 Vaksin Polio Vial 45 30 24 51
5 Vaksin Campak/Vaksin Rubella Vial/Ampul 57 10 19 48

Jebus, 30 Desember 2020

Mengetahui Pengelola Obat
Kepala Puskesmas Jebus Puskesmas Jebus

dr. Era Nurakhmi Marlita Oktaria, S.Farm., Apt

NIP 19880424 201409 2 001 NIP 19911024 201902 2 004
 MONITORING PENGGUNAAN OBAT GENERIK
TAHUN 2020

BULAN / TAHUN : DESEMBER

NAMA PUSKESMAS : JEBUS
ALAMAT : JL. KAMPAK NO. 188
STATUS PASIEN : BPJS

ITEM OBAT DALAM RESEP

NAMA OBAT
NO. TOTAL ITEM JUMLAH
% OBAT GENERIK NON
RESEP OBAT DALAM ITEM OBAT
= 3/4 X 100% GENERIK
RESEP GENERIK
1 2 3 4 5
1 4 4 100%
2 3 3 100%
3 3 3 100%
4 5 5 100%
5 4 4 100%
6 3 3 100%
7 3 3 100%
8 5 5 100%
9 2 2 100%
10 3 3 100%
11 3 3 100%
12 1 1 100%
13 3 3 100%
14 4 4 100%
15 3 3 100%
16 4 4 100%
17 5 5 100%
18 3 3 100%
19 5 5 100%
20 4 4 100%
21 3 3 100%
22 3 3 100%
23 4 4 100%
24 4 4 100%
25 3 3 100%
26 4 4 100%
27 3 3 100%
28 4 4 100%
29 5 5 100%
30 5 5 100%
31 3 3 100%
32 2 2 100%
33 4 4 100%
34 5 5 100%
35 3 3 100%
36 2 2 100%
37 4 4 100%
38 3 3 100%
39 3 3 100%
40 4 4 100%
41 3 3 100%
42 5 5 100%
43 5 5 100%
44 2 2 100%
45 4 4 100%
46 4 4 100%
47 5 5 100%
48 6 6 100%
49 5 5 100%
50 5 5 100%
TOTAL 185 185

Jebus, 30 Desember 2020

Mengetahui Pengelola Obat
Kepala Puskesmas Jebus Puskesmas Jebus

dr. Era Nurakhmi Marlita Oktaria, S.Farm., Apt

NIP 19880424 201409 2 001 NIP 19911024 201902 2 004
 REKAPITULASI LAPORAN NARKOTIKA DAN PSIKOTROPIKA PUSKESMAS JEBUS

Puskesmas : JEBUS
Kecamatan : JEBUS
Kabupaten / Kota : BANGKA BARAT Bulan : DESEMBER
Provinsi : KEPULAUAN BANGKA BELITUNG Tahun : 2020

Pemasukan Pemakaian
No. Nama Obat Satuan Saldo Awal Saldo Akhir Ket.
Dari Jumlah Untuk Jumlah
A NARKOTIKA
1 Codein Tablet

B PSIKOTROPIKA
1 Alprazolam 1 mg tablet Tablet 194 Pasien 5 189
2 Alprazolam 0.5 mg tablet Tablet 136 IFK 100 Pasien 65 171
3 Clobazam tablet 10mg Tablet 100 IFK 100 Pasien 110 90
4 Diazepam injeksi 5mg/ ml-2 Ampul 5 5
5 Diazepam Lart rektal 5mg/2.5ml Tube 6 Pasien 2 4
6 Diazepam Lart rektal 10mg/2.5ml Tube
7 Diazepam 2mg tablet Tablet
8 Diazepam 5mg tablet Tablet 153 IFK 100 Pasien 48 205
9 Fenobarbital 30mg Tablet 120 IFK 100 Pasien 60 160
10 Haloperidol 0,5mg Tablet
11 Haloperidol 1,5mg Tablet
12 Haloperidol 5mg Tablet 2610 Pasien 124 2486
13 Klorpromazin HCL inj 25mg/ml Ampul 30 30
14 Klorpromazin 100mg Tablet 130 IFK Pasien 130 0
15 Klorpromazin 25mg Tablet
16 Triheksifinidil Hidroklorida 2mg Tablet
17 Risperidon 2mg Tablet 1788 IFK 1000 Pasien 1113 1675
18 Amitriptilin HCL 25 mg Tablet 98 98
19 Haloperidol inj 50mg/ml Ampul 5 5
20 Carbamazepin 200 tablet Tablet 230 IFK 100 Pasien 110 220
21 Clozapine 25mg Tablet 1855 IFK 1000 Pasien 580 2275
22 Clozapine 100mg Tablet 1375 Pasien 105 1270
23 Flufenazin inj Ampul 5 IFK 5
24 Fenitoin Tablet

Jebus, 30 Desember 2020

Mengetahui Pengelola obat
Kepala Puskesmas Jebus Puskesmas Jebus

dr. Era Nurakhmi Marlita Oktaria, S.Farm., Apt

NIP 19880424 201409 2 001 NIP 19911024 201902 2 004
 PELAYANAN KEFARMASIAN

Nama Puskesmas : Jebus PERAWATAN

Kabupaten/Kota : Bangka Barat
Provinsi : Kep. Bangka Belitung
Laporan Bulan/tahun : Desember 2020

JENIS PELAYANAN RESEP PELAYANAN

NO TANGGAL KONSELING INFORMASI
Rawat Jalan Rawat Inap
OBAT (PIO)
1 2 3 4 7 8
1 01-Dec-20 24 2 26
2 02-Dec-20 23 7 30
3 03-Dec-20 27 3 30
4 04-Dec-20 37 5 42
5 05-Dec-20 29 8 37
6 07-Dec-20 32 4 36
7 08-Dec-20 29 1 30
8 10-Dec-20 25 3 28
9 11-Dec-20 23 4 27
10 12-Dec-20 40 1 41
11 14-Dec-20 38 4 42
12 15-Dec-20 30 2 32
13 16-Dec-20 34 6 40
14 17-Dec-20 11 0 11
15 18-Dec-20 28 3 31
16 19-Dec-20 25 0 25
17 21-Dec-20 51 3 54
18 22-Dec-20 34 1 35
19 23-Dec-20 26 2 28
20 28-Dec-20 30 0 30
21 29-Dec-20 42 4 46
22 30-Dec-20 30 3 33
TOTAL 668 66 734

Jebus, 30 Desember 2020

Mengetahui Pengelola Obat
Kepala Puskesmas Jebus Puskesmas Jebus

dr. Era Nurakhmi Marlita Oktaria, S.Farm., Apt

NIP 19880424 201409 2 001 NIP 19911024 201902 2 004
 PEMERIN
PUSKESMA
Jl. Kampak No.
Telp (0715) 73

Nomor : 440/5931/1.2.1.1.5/2020
Sifat : Biasa
Hal : Permintaan / LPLPO (Obat, B

Sehubungan dengan kebutuhan Kegiatan Pelayanan Kesehatan di Puskesmas Jebus deng

No. Uraian Persedian Harga Satuan

1 2 3
SUMBER INSTALASI FARMASI KABUPATEN
OBAT
1 Abate Rp 4,000.00
2 Anti Bisa Ular (ABU) Rp 512,204.00
3 Asiklovir tablet 200 mg Rp 245.00
4 Asiklovir tablet 400 mg Rp 399.00
5 Asiklovir cream Rp 2,972.00
6 Asam traneksamat injeksi 50 mg/ml Rp 1,813.00
7 Asam Folat Rp 66.00
8 Asam asetilsalisilat (asetosal) tablet 80 mg Rp 105.00
9 Albendazol tablet 400 mg Rp 424.00
10 Alopurinol tablet 100mg Rp 105.00
11 Alprazolam tab 0,5 mg Rp 94.00
12 Alprazolam tab 1 mg Rp 128.00
13 Ambroksol sirup 15 mg/ml Rp 4,500.00
14 Ambroksol tablet 30 mg Rp 128.70
15 Aminofilin 200mg Rp 96.00
16 Aminofilin inj 24mg/ml-10ml Rp 2,976.00
17 Amitriptilin HCL tablet salut 25mg Rp 168.00
18 Amlodipin tablet 5 mg Rp 81.00
19 Amlodipin tablet 10 mg Rp 160.00
20 Amoxicillin 500mg Rp 261.00
21 Amoxicillin sirup kering 125mg/5ml Rp 2,050.00
22 Amoxicillin sirup kering 250mg/5ml Rp 3,400.00
23 Antasida DOEN suspensi Rp 2,189.00
24 Antasida DOEN tablet komb (dws) Rp 60.00
25 Antalgin 500mg Rp 220.00
26 Attapulgite tablet 600 mg Rp 155.00
27 Anti bakteri DOEN salep kombinasi/Bacitracin Rp 3,187.00
28 Anti hemoroid DOEN kombinasi Rp 3,325.00
29 Aqua pro injeksi Rp 2,860.00
30 Asam ascorbat vit. C tab. 50mg Rp 110.00
31 Asam mefenamat kaplet 500 mg Rp 314.60
32 Atropin Sulfat injeksi 0,25mg/ml-1ml Rp 1,540.00
33 Artesunat inj Rp 57,585.00
34 Azitromicyne tablet 500mg Rp 1,888.00
35 Besi II sulfat 200 mg + asam folat 0,25 mg Rp 372.00
Besi II sulfat 200 mg + asam folat 0,25 mg Rp 354.00
Besi II sulfat 200 mg + asam folat 0,25 mg Rp 372.00
36 Betahistin 6mg Rp 110.00
37 Betametason krim 0,1 % Rp 1,465.00
38 Bisakodil suppositoria 5mg Rp 6,000.00
39 Bisakodil tab 5mg Rp 327.00
40 Captopril 12,5mg Rp 62.00
41 Captopril 25mg Rp 89.00
42 Ceftriaxone sodium inj 1 gr Rp 4,997.99
43 Cetirizin tablet 10 mg Rp 101.00
44 Cetirizin sirup 5mg/5ml Rp 3,200.00
45 Ciprofloxacin tablet 500mg Rp 379.00
46 Clobazam 10 Rp 3,325.00
47 Clopidogrel 75 mg Rp 1,404.00
48 Deksametason injeksi 5 mg/ml - 1ml Rp 1,152.00
49 Deksametason tablet 0,5mg Rp 99.00
50 Diazepam tablet 2mg Rp 50.00
51 Diazepam tablet 5mg Rp 114.00
52 Diazepam inj 5 mg/2ml Rp 1,822.00
53 Diazepam rektal 5mg/2,5ml Rp 13,202.00
54 Diazepam rektal 10mg/2,5ml Rp 19,193.00
55 Diethylcarbamazine (DEC) Rp 164.00
56 Difenhidramin HCL inj 10mg/ml-1ml Rp 1,152.00
57 Digoksin tablet 0,25mg Rp 104.00
58 Domperidon suspensi 5mg/5ml Rp 2,781.00
59 Domperidon tablet 10 mg Rp 86.00
60 Domperidon tetes 5 mg/mL Rp 16,379.00
61 Epinefrin ( Adrenalin ) injeksi 0.1% ( sebagai HCL ) Rp 1,408.00
62 Etakridin (rivanol) larutan 0,1% Rp 3,432.00
63 Etanol (alkohol) 70 % 1000ml Rp 24,225.00
64 Etanol (alkohol) 70 % 100ml Rp 5,600.00
65 Erytromisin 500mg Rp 765.00
66 Erytromisin sirup kering 200mg/5ml Rp 6,867.00
67 Fenitoin 100mg Rp 158.00
68 Fenobarbital 30mg Rp 180.00
69 Fenofibrat 100 mg kapsul Rp 1,191.00
70 Fenofibrat 300 mg kapsul Rp 1,446.00
71 Fenol Gliserol Tts. Telinga 10% Rp 2,764.00
72 Fitominadion (vit. K1)inj 2mg/ml-1ml Rp 3,867.00
73 Fitominadion (vit. K1)inj 10mg/ml-1ml Rp 4,167.00
74 Fitominadion (vit. K1)tab salut 10mg Rp 797.00
75 Furosemide tablet 40mg Rp 84.00
76 Furosemid injeksi i.v./i.m. 10 mg/ml Rp 1,333.00
77 Flufenazin inj 25mg Rp 63,986.00
78 Garam Oralit untuk 200ml air Rp 263.00
79 Gentamicin inj 40mg/ml Rp 3,685.00
80 Gentamicin tetes mata 0,3% Rp 4,200.00
81 Gemfibrozil 300 mg kapsul Rp 389.00
82 Glibenklamid Tab 5 mg Rp 183.70
83 Glimepiride tablet 2mg Rp 207.00
84 Glimepiride tablet 4mg Rp 295.00
85 Gliseril Guayakolat tablet 100mg Rp 107.80
86 Glukosa Larutan Infus 5% steril Rp 7,363.40
87 Haloperidol tablet 1,5mg Rp 63.00
88 Haloperidol tablet 5mg Rp 60.00
89 Haloperidol inj 50 mg/mL Rp 101,300.00
90 Hidroklortiazid (HCT) tab 25 mg Rp 156.00
91 Heparin sodium Rp 47,025.00
92 Hydrokortison krim 2,5% Rp 2,533.00
93 Human tetanus Imunoglobulinn inj 250ui Rp 188,663.00
94 Ibupropen tablet 400mg Rp 194.00
95 Ibupropen susp 100mg/5ml Rp 2,420.00
96 Isoniazid (INH) tablet 100 mg Rp 228.00
97 Isosorbid Dinitrat tablet 5mg Rp 93.00
98 Kalsium Laktat(kalk) tablet 500mg Rp 63.00
99 Calporosis Rp 430.00
100 Kalsium Glukonat inj i.v 10% (100mg/ml) Rp 9,955.00
101 Karbamazepin tablet Rp 247.00
102 Ketokonazol krim 2 % Rp 2,577.00
103 Ketokonazol tab 200 mg Rp 288.00
104 Ketorolac inj 30mg/ml Rp 1,089.00
105 Ketoprofen supp 100mg Rp 2,380.00
106 Kloramfenikol kapsul 250mg Rp 320.00
107 Kloramfenikol kapsul 500mg Rp 1,222.00
108 Kloramfenikol salep mata 1% Rp 1,925.00
109 Klorfeniramin Maleat (CTM) tab.4mg Rp 25.00
110 Klorpromazin tablet 100 mg Rp 157.00
111 Klorpromazin tablet 25 mg Rp 71.00
112 Klorpromazin 25 mg inj Rp 1,310.00
113 Klozapin 25 mg Rp 1,121.00
114 Klozapin 100 mg Rp 3,622.00
115 Kodein tablet 10 mg Rp 525.00
Kombinasi tetes mata 2,5 mg/mL: Natrium klorida 8,664 mg; Kalium
116 Rp 15,750.00
klorida 1,32 mg
117 Kotrimoksazol Suspensi Rp 2,190.00
118 Kotrimoksazol 480 mg tablet dewasa Rp 133.00
119 Kotrimoksazol 960 forte kombinasi Rp 323.00
120 Kuinin 222mg Rp 704.00
121 Klindamycin 150 Rp 770.00
122 Lidokain (Xylocaine) gell 2% Rp 44,391.00
123 Lidokain inj 2%(HCL) + Epinefrin Rp 2,037.00
124 Lidokain inj 2%(HCL) Rp 870.00
125 Lisol Rp 45,100.00
126 Larutan Desinfektan (Bayclin) Rp 13,750.00
127 Loperamid tab 2 mg Rp 82.00
128 Magnesium Sulfat Injeksi 20 % Rp 3,328.00
129 Magnesium Sulfat Injeksi 40 % Rp 3,796.00
130 Metilegometrin Maleat inj 0,200 mg-1 ml Rp 3,102.00
131 Metilegometrin Maleat tab 0,125 mg Rp 221.00
132 Metilprednisolon tablet 4 mg Rp 146.00
133 Metoklopramide tablet 5 mg Rp 111.00
134 Metronidazol tablet 500mg Rp 285.00
135 Metformin HCL tab 500 mg Rp 106.00
136 Mikonazol krim salep 2 % Rp 3,585.00
137 Mineral mix Rp 2,920.00
138 Natrium Diklofenak tablet 25mg Rp 141.00
139 Natrium Diklofenak tablet 50mg Rp 127.00
140 Natrium Klorida larutan infus 0,9% Rp 6,840.00
141 Nifedipin tab 20 mg Rp 3,350.00
142 Nistatin 100.000 iu/g tablet vaginal Rp 830.00
143 Nistatin 500.000 tablet salut Rp 803.00
144 OAT - FDC kategori anak Rp 260,526.00
145 OAT - FDC kategori II Rp 1,362,789.00
146 OAT - FDC kategori I Rp 436,243.00
147 Obat Anti Malaria Dihidroartemsin+piperakuin (DHP) Rp 4,149.00
148 OBH sirup Rp 2,290.00
149 Oksimetazolin tetes hidung 0,025% Rp 32,900.00
150 Oksitosin inj Rp 1,199.00
151 Oksitetrasiklin HCL salep mata Rp 2,600.00
152 Omeprazol kapsul 20 mg Rp 144.00
153 Omeprazol 40 mg/2 ml injeksi Rp 10,670.00
154 Ondansetron 4 mg/2 ml injeksi Rp 1,153.00
155 Ofloksasin tetes telinga 3% Rp 36,900.00
156 Parasetamol Sirup 120mg/5ml Rp 1,181.00
157 Parasetamol drop 100mg/ml Rp 5,460.00
158 Parasetamol tablet 500mg Rp 177.10
159 Parasetamol suppositoria 125mg Rp 12,300.20
160 Perak sulfadiazin 35 mg Rp 20,700.00
161 Permethrin (Scabimite) krim 5% Rp 11,825.00
162 Piridoksin (vitamin B6) 10mg Rp 138.00
163 Povidon Iodida lar 10% 300 ml Rp 20,700.00
164 Povidon Iodida larutan 10% 60 ml Rp 4,070.00
165 Primakuin tablet 15mg Rp 253.00
166 Piracetam 800mg Rp 900.90
167 Piracetam 1200mg Rp 1,291.40
168 Pirantel Pamoat 125 mg Rp 328.00
169 Pirantel Pamoat Susp 125 mg / 5 ml Rp 10,778.00
170 Prednison 5mg Rp 77.00
171 Propanolol HCl tablet 10 mg Rp 61.00
172 Ranitidin inj 25 mg/2 ml Rp 1,188.00
173 Ranitidin tab 150 mg Rp 169.40
174 Retinol (Vitamin A) 100.000 IU kapsul lunak Rp 323.00
175 Retinol (Vitamin A) 200.000 IU kapsul lunak Rp 579.00
176 Ringer laktat larutan infus steril Rp 7,630.00
177 Risperidone 2 mg Rp 287.00
178 Salbutamol Tab 2mg Rp 84.00
179 Salbutamol Tab 4mg Rp 102.00
180 Combivent Nebu Rp 4,550.00
181 Salisil bedak 2% Rp 7,700.00
182 Salep 2-4 komb Asam Salisilat 2% + Belerang endap 4% Rp 2,654.00
183 Sefadroksil kapsul 500 mg Rp 451.00
184 Sefadroksil sir kering 125mg/5ml Rp 4,339.00
185 Sefixime kapsul 100mg Rp 2,554.86
186 Sefixime Sirup kering 100 mg/5 ml Rp 16,507.26
187 Sefotaxim inj 0,5gr Rp 6,322.00
188 Sefotaxim inj 1 gr Rp 9,459.00
189 Sianokobalamin(vit B12) tab 50 mcg Rp 47.00
190 Sianokobalamin(vit B12) inj.500mcg/ml Rp 1,136.00
191 Simvastatin 20 mg Rp 226.00
192 Simvastatin 10 mg Rp 117.00
193 Tiamin HCL mono. (vit B1) tab.50mg Rp 84.00
194 Triheksifinidil Hidroklorida tablet 2mg Rp 93.00
195 Vitamin B Komplek tablet Rp 131.00
196 Zinc 20mg Rp 555.00
197 Zinc sirup 20 mg/5 ml Rp 3,322.00
198 Vaksin Rabies Rp 78,500.00
199 Vaksin HBIG Rp 1,325,000.00
Reagent
200 Amonium Oxalat 1% Rp 22,000.00
201 Anti-A Monoclonal Gol Darah Rp 77,325.00
202 AMA Anti-A,B Monoclonal Antibodies Rp 50,000.00
203 Anti-B Monoclonal Gol Darah Rp 77,325.00
204 AMA Anti-D IgM Monoclonal Antibodies Rp 105,000.00
205 Benecheck Plus Glucose Test Rp 165,500.00
206 Benecheck Plus Total Cholesterol Test Rp 253,650.00
207 Benecheck Plus Uric Test Rp 153,500.00
208 Diagnostar DS HIV 1/2 one step Rp 13,472.00
209 Elektronika Lab Strips U11 Plus Urine Tes Strips Rp 320,125.00
210 Fokus HbSAg strip Rp 5,641.99
211 Fokus New HIV 1/2 3 Line Rp 14,335.00
212 Hematology reagent Rp 11,748,000.00
213 Rapid Shipilis Trepocheck Rp 9,300.00
214 Indoreagen KOH 10% 500 ml Rp 93,650.00
215 Jayamas Onemed Ultra One Test Hamil Rp 2,132.90
216 KHB Diagnostic Kit For HIV antibody Rp 12,500.00
217 Larutan Benedic Rp 150,000.00
218 Larutan Eosin 2% Rp 350,000.00
219 Larutan Giemsa Rp 362,494.00
220 Larutan H2O2 3% Rp 20,000.00
221 Larutan HCl 0,1 N Rp 73,440.00
222 Larutan Turk Rp 29,994.00
223 Malaria Test Rp 451,000.00
224 Metanol 250 cc Rp 43,470.00
225 Oil Immersion 100ml Rp 206,394.79
226 Reagensia Ziehn Neelsen Rp 277,000.00
227 Dialab Salmonella Paratypi AH Rp 75,900.00
228 Salmonela Paratypi AO
229 Dialab Salmonella Paratypi BH Rp 75,900.00
230 Dialab Salmonella Paratypi BO Rp 75,900.00
231 Dialab Salmonella Paratypi CH Rp 75,900.00
232 Dialab Salmonella Paratypi CO Rp 75,900.00
233 Dialab Salmonella Typi H Rp 75,900.00
234 Dialab Salmonella Typi O Rp 75,900.00
235 SD Dengue NS1Ag Rp 61,000.00
236 SD HBsAg Rp 15,500.00
237 SD HBsAg Rp 9,878.00
238 SD HBsAg (Virocheck HBsAg) Rp 8,260.00
239 SD HIV Rp 11,975.00
240 SD Biosensor Syphilis (Ab test) Rp 20,400.00
241 Serenity Pregnancy test Rp 84,902.33
242 Serenity Malaria PF & PV Antigen Test Rp 463,067.37
243 Strip Triglycerides Test Rp 1,017,645.00
244 Sysmex Cell Clean (CI-50)
245 Sysmex Cellpack (PK-30L) Rp 1,591,920.00
246 Sysmex Control Eight Check 3WP-(H,N,L)
247 Sysmex Stromatolyser -WH (SWH-200A) Rp 1,054,350.00
248 Theramal Paper Rp 38,500.00
249 TPG Kit Rp 5,250.00
250 VIKIA Rp 19,840.00
251 Lituo VTM Kit Rp 54,545.45
Obat Gigi
252 BIODINAMICA Paramono Clorofenol (CHKM) Rp 69,000.00
253 Biodinamica Tricresolformalina (TFK) Rp 76,000.00
254 BUR Carbide HighSpeed Round Rp 203,000.00
255 Caviton White Rp 117,714.00
256 Cotton Ball Mini 500gram Rp 75,040.00
257 Dental cotton roll Rp 36,700.00
258 Dental Sponge Rp 435,600.00
259 Etil Klorida Spray Rp 130,900.00
260 Eugenol Rp 19,765.00
261 Glass Ionomer Cement (GIC)/DENPRO Cement Qick Set Rp 67,076.92
262 Pasta Devitalisasi Pulpa Rp 258,500.00
263 Securafill LC Glass Ionomer Filling Cement Rp 473,500.00
Alat Kesehatan
264 Aesculap blades/carbon steel scalpel blad # 21 Rp 3,150.00
265 Aesculap blades/carbon steel scalpel blad # 22 Rp 3,150.00
266 JAYAMAS Onemed Kapas Pembalut 250 gram Rp 13,739.00
267 Alat suntik sekali pakai 20ml + Jarum 10ml Rp 3,080.00
268 Aquagel sterile jely 82 gr Rp 37,152.00
269 Assut-Switzerland Silk 5/0 TS-15, 75cm Rp 35,077.00
270 Assut-Switzerland Silk 6/0 TS-15, 75cm Rp 35,077.00
271 Aximed Examination Gloves Size L Rp 508.20
272 Aximed Examination Gloves Size M Rp 532.40
273 Aximed Examination Gloves Size S Rp 532.40
274 Gloves S Super Gard OB, Free Powder Rp 110,000.00
275 Aximed Face Mask Ties On Rp 26,400.00
276 Masker Tie On Rp 35,420.00
277 Aximed Infuset Rp 5,605.60
278 Aximed IV Cath No. 18 Rp 6,900.00
279 Aximed IV Cath No. 20 Rp 6,904.70
280 Aximed IV Cath No. 22 Rp 7,353.50
281 Aximed IV Cath No. 24 Rp 6,900.00
282 Aximed Paper tape/1.25 cm x 9.14 m Rp 5,635.00
283 Aximed Pedriatic Set Rp 5,865.00
284 ALCOHOL SWABS Rp 360.45
285 Aximed Urine Bag Rp 6,325.00
286 Betadine Sabun Cair Antiseptik 100ml Rp 23,545.85
287 Aximed Blood Lancet Rp 11,132.00
288 Catgut Benang Bedah no. 2/0 plain Rp 6,141.67
289 Catgut Benang Bedah no. 3/0 plain Rp 147,389.00
290 Catgut Benang Bedah no.2/0 cromic Rp 6,141.67
291 Catgut Benang Bedah no.3/0 cromic Rp 147,389.00
292 Cosmomed Med Apron (IP) 75x130/02 Rp 2,235.23
293 E- CARE Antiseptik Hand Rub 10btl @ 500ml (1650B) Rp 63,900.00
294 Acticare Antiseptik Handrub 500 ml Rp 88,000.00
295 Medikacare 0.5% TPCL Antiseptik Rp 34,787.50
296 Foley Chateter no 14 Rp 10,160.00
297 Cosmomed 2 Way Foley Catheter CH no 16 Rp 15,318.00
298 Idealcare 2 way foley catheter silicone coated-16 Rp 19,950.00
299 Handscoon Obgyn REMEDI Glove Sterile Gynecolog-7 Rp 18,792.00
300 Handscoon steril no 7 Rp 5,091.67
301 Gloves surgical no 7 steril Rp 550,000.00
302 Hypafix 15cm x 5m (Aximed Nonwoven fixation) Rp 107,087.20
303 IV Catheter No. 26 G Rp 8,860.50
304 Jayamas Besmed Masker Nebulizer Set Anak Rp 24,200.00
305 Jayamas Besmed Masker Nebulizer Set Dewasa Rp 24,200.00
306 Jayamas Masker N95 Rp 7,163.20
307 Masker N 95 (Mask 3M 8210) Rp 151,800.00
308 Jayamas Onemed Papsmear Kit L Rp 21,296.00
309 Jayamas Onemed Papsmear Kit M Rp 21,296.00
310 Jayamas Onemed Safety Box 5 L Rp 17,286.50
311 Kaca slide Rp 19,700.00
312 Kapas berlemak 500mg Rp 13,800.00
313 DRC Kasa Hidrofil Steril uk. 16x16 Rp 7,897.26
314 Kasa Hidrofil uk 36 m x 80 cm Rp 137,290.14
315 Kasa Kompres DRC 40cmx40cm Rp 1,419.00
316 Kasa pembalut hidrofil 4m x 10cm Rp 600.00
317 Kasa pembalut hidrofil 4m x 5cm Rp 300.00
318 KATOKATZ Rp 4,860,900.00
319 Leukoplast Hospital 7,5 m x 4,5 m Rp 37,371.00
320 REMEDI Oxygen Mask Elongated-Child Rp 12,650.00
321 Masker Ear Loop Ogan Rp 133,890.00
322 Nasal Canula oksigen size L Rp 7,623.00
323 Nasal Canula oksigen size M Rp 7,590.00
324 Nasal Canula oksigen size S Rp 7,920.00
325 Nasal Canula oksigen size XS Rp 7,590.00
326 Nipro Blood Transfusion Set Rp 16,640.80
327 REMEDI Blood Transfusion Set Rp 5,390.00
328 Aximed Syringe 10cc Rp 1,492.70
329 Serenity Syringe 10 ml Rp 179,742.55
330 Nipro Syringe 50ml Luer Slip Without Needle Rp 6,970.04
331 Jayamas stera syringe 5 cc Rp 825.00
332 Nipro syringe 5 cc Rp 825.00
333 Parafilm 4 In x 125 FT M Rp 636,000.00
334 Policrepe Pembalut Elastis 7.5cmx4.5m Rp 30,110.00
335 Ekomed Pot Dahak Sample Container Steril (kuning) Rp 2,702.70
336 Pot Dahak Putih Rp 2,860.00
337 Pot Urine sample container Rp 2,320.00
338 Aximed Syringe 1 cc Rp 968.40
339 Serenity syringe 1 cc Rp 119,011.81
340 Jayamas Stera Syringe 1cc Rp 715.00
341 Remidi Disposible syringe+Needle 3cc Rp 920.00
342 Jayamas Stera Syringe 3cc Rp 715.00
343 Aximed Syringe 3 cc Rp 976.56
344 Cosmomed 2 Way Foley Catheter CH no 18 Rp 15,318.00
345 Idealcare 2 way foley catheter silicone coated-18 Rp 19,950.00
346 Remidi Oxygen Mask Elongated Adult Rp 12,650.00
347 Gloves surgical no 6.5 steril Rp 550,000.00
348 REMEDI Surgical Glove Sterile Powder 6,5 Rp 5,035.71
349 Serenity Mucus Extractor 25 ml Rp 8,300.00
350 SMI SILK BLACK 2/0 HR 20 MM Rp 21,086.43
351 SMI SILK BLACK 3/0 DS 30 MM Rp 23,777.00
352 Sterintech Flat Sterilization Packaging reels siz 200mmx100m Rp 1,080,772.00
353 Sterintech Flat Sterilization Packaging reels siz 75mmx200m Rp 459,800.00
354 Stomach Tube 12 fr (125 cm) Rp 10,010.00
355 Stomach Tube 14 fr (125 cm) Rp 8,518.40
356 Stomach Tube 16 fr (125 cm) Rp 10,010.00
357 NGT No.16 Terumo Rp 36,850.00
358 Sungkup Bayi Rp 285,000.00
359 Tabung EDTA 0,5 ml Rp 182,600.00
360 Tabung EDTA 3 ml Rp 112,324.32
361 Jayamas Onemed Softpad (Underpad) 60x90cm Rp 4,578.64
362 Tianchang Kanghui UNDERPAD 60x90 cm Rp 4,247.00
363 Gell USG Rp 198,000.00
364 Umbilical Cord Clamp Blue OGS Rp 2,000.00
365 Umbilical Cord Clamp White OGS (JAYAMAS) Rp 71,500.00

PENANGANAN COVID-19
1 Multivitamin (Imboost Force) Rp 6,130.67
2 Vitamin (Oranamin C) Rp 5,000.00
3 Baju Azmat (APD) Rp 220,000.00
Baju Azmat (APD) Rp 363,000.00
4 Wondfo SARS-COV-2 Antibody test
Rapid Test (VIVA DIAG) Rp 220,000.00
Rapid Test (Vazyme)
Rapid Test (Egens)
5 Cairan Desinfektan (Wipol) Rp 32,000.00
6 Sepatu Boot
7 Semprotan untuk Desinfektan
8 Face shield
9 Acticare Antiseptik Handrub 500 ml (warna biru)
Acticare Antiseptik Handrub 500 ml (warna merah) Rp 753,000.00

VAKSIN
1 Hepatitis B Rp 25,597.00
2 BCG+Pelarut Rp 66,154.00
3 DPT/HB-Hib Rp 84,282.00
4 POLIO Rp 21,285.00
5 CAMPAK Rp 28,204.00
6 CAMPAK MR Rp 166,265.00
7 TD/TT Caten Rp 16,995.00
8 IPV Rp 158,994.00
9 PCV Rp 249,337.00
10 TD BIAS Rp 16,995.00
11 DT BIAS Rp 19,195.00
12 ADS 0.05 ml Rp 1,650.00
13 ADS 0.5 ml Rp 1,240.00
14 ADS 5 ml Rp 1,705.00
15 Safety box 2,5 L Rp 14,093.72
16 Safety box 5 L Rp 16,500.75

SUMBER LAIN (JKN)

1 Acyclovir 5% krim Rp 3,487.00
2 Ambroksol sirup 15 mg/5ml Rp 4,762.00
3 Ambroksol tablet 30 mg Rp 179.00
4 Amlodipin tablet 10 mg Rp 596.00
5 Amoxicillin sirup kering 125mg/5ml Rp 5,500.00
6 Asam ascorbat vit. C tab. 25mg Rp 84.00
7 Asam mefenamat kaplet 500 mg Rp 303.00
8 Betametason krim 0,1 % Rp 55,993.00
9 Boraks Gliserin (GOM) Rp 3,325.00
10 Cathejell (Xylocaine gel) 12,5g Rp 43,000.00
11 Cefixime 100 mg Rp 1,073.00
12 Cetrizine HCL 10mg Rp 266.00
13 Clozapin tab 25 mg Rp 1,121.00
14 Combivent Nebu Rp 24,750.00
15 Curvit sirup Rp 25,000.00
16 Deksametason tablet 0,5mg Rp 132.00
17 Deksametason injeksi 5 mg/ml - 1ml Rp 1,142.00
18 Diazepam inj Rp 1,900.00
19 Disposable Surgical Drape Rp 390,000.00
20 Dulcolax (Bisacodyl) 5 mg Rp 16,266.00
21 Deck glass Rp 60,500.00
22 Elva Latex Powdered (Handscoon) Size L Rp 50,200.00
23 Elva Latex Powdered (Handscoon) Size M Rp 50,200.00
24 Elva Latex Powdered (Handscoon) Size S Rp 50,200.00
25 Farsix (Furosemid) inj Rp 6,930.00
26 Fasidol (Paracetamol) Drop Rp 9,086.00
27 Gelang ID Bend Anak Rp 90,000.00
28 Gelang ID Bend Dewasa Rp 95,000.00
29 Gelang ID Bend Dewasa (Warna Kuning) Rp 120,000.00
30 Gentamicin salep kulit Rp 3,651.00
31 Glimepiride 2mg Rp 704.00
32 Glukosa Larutan Infus 5% steril Rp 6,680.00
33 Haloperidol tab 5 mg Rp 60.00
34 Imboost Force Rp 6,776.00
35 Kacamata Google Karet Rp 83,000.00
36 Kertas EKG Rp 318,500.00
37 Ketorolac inj 30mg/ml Rp 24,000.00
38 Lakmus Merah Rp 29,334.00
39 Lakmus Biru Rp 33,000.00
40 Masker Nebulizer Dewasa Rp 30,000.00
41 Metformin HCL tab 500 mg Rp 17,500.00
42 Methylen blue 100 ml Rp 110,000.00
43 Nistatin drop 12ml Rp 24,000.00
44 Oksitosin injeksi Rp 2,750.00
45 Omeprazol injeksi Rp 33,000.00
46 Otsu D40 Rp 10,000.00
47 Paracetamol infus 10 mg/ml Rp 11,923.00
48 Parasetamol suppositoria 125mg Rp 14,080.00
49 Parasetamol suppositoria 250mg Rp 20,900.00
50 Parasetamol tablet 500mg Rp 5,400.00
51 Pot Salep 20 cc Rp 500.00
52 Primodiar (Loperamid) 2 mg Rp 275.00
53 Ranitidin inj 25 mg/2 ml Rp 2,327.00
54 Reagent Boraks Rp 1,650,000.00
55 Reagent Formalin Rp 3,850,000.00
56 Reagent Rodamin Rp 1,925,000.00
57 Reco Ear (Chlorampenicol) Drop 10 ml Rp 8,210.00
58 Reco Eye (Chlorampenicol) Drop 10 ml Rp 8,210.00
59 Reoko Endo Frost (Etil Klorida) Spray 200ml Rp 415,000.00
60 Salisil bedak 2% Rp 6,427.00
61 Sefadroksil sir kering 125mg/5ml Rp 4,339.00
62 Sefotaxim inj 1gr Rp 4,500.00
63 Speculum Sim CCB Plastic Ukuran L Rp 7,080.00
64 Spiritus Rp 71,500.00
65 Sysmex Cell Clean (CI-50) Rp 1,258,400.00
66 Sysmex Cellpack (PK-20L) Rp 1,910,700.00
67 Sysmex Control Eight Check 3WP-H,L,N Rp 995,500.00
68 Sysmex Stromatolyser -WH (SWH-200A) Rp 1,265,000.00
69 Theramal Paper Rp 38,500.00
70 Ventolin Nebules 2,5mg/20 Rp 192,000.00
71 Suction cateter no 8 Rp 11,000.00
72 Suction cateter no 6 Rp 11,000.00

TOTAL ASET

Demikian disampaikan, atas perhatiannya diucapkan terima kasih.

Mengetahui
Kepala Puskesmas Jebus

dr. Era Nurakhmi

NIP 19880424 201409 2 001
 PEMERINTAH KABUPATEN BANGKA BARAT
PUSKESMAS JEBUS KABUPATEN BANGKA BARAT
l. Kampak No. 188 Jebus Kecamatan Jebus Kodepos 33362
Telp (0715) 7322064 Email: pkmjebus.babar@gmail.com

1/1.2.1.1.5/2020

an / LPLPO (Obat, BMHP, Vaksin, Reagen)

kesmas Jebus dengan ini mohon disalurkan barang dengan rincian barang sebagai berikut :

Tanggal Stok Kadaluarsa/

Satuan No Batch Penerimaan Persediaan
Kadaluarsa Awal Rusak
4 5 6 7 8 9=(7+8) 10

Sase 2001070007 Jun-22 0 1000 1000

Vial 4700419 Nov-21 4 4
Tablet 06303018 Jun-21 200 200
Tablet 16304020 May-22 400 400
Tube 26305004 Jul-22 0 0
Ampul 4300397 Feb-23 0 20 20
Tablet T3102AF Aug-21 2500 2500
Tablet A92162 Aug-21 0 100 100
Tablet 1804027 Apr-21 150 150
Tablet A01017 Apr-23 4100 4100
Tablet A92345 Dec-22 136 100 236
Tablet A00409 Feb-23 194 194
Botol 1909-01-184 Sep-21 250 50 300
Tablet A20035 Jan-22 2500 2000 4500
Tablet 18CD003 Apr-21 100 100
Ampul 1916017B Jul-21
Tablet A1420JV Oct-22 98 98
Tablet 92969 Sep-21 2400 1800 4200
Tablet T08162AJ Aug-21 2000 2000
Tablet CAMXA91124 Jun-21 2600 1000 3600
Botol B00129 Mar-23 85 85
Botol
Botol 19SF235 Jun-21 100 100 200
Tablet A00627 Feb-23 8300 8300
Tablet
Tablet HG0321 Jul-22 0 0
Tube 1806007 Jun-22 50 50
Suppos 18SF090 Sep-21 10 10 20
Vial 80C49B Mar-22 36 36 72
Tablet E00132BJ Apr-23 1300 5000 6300
Tablet T8071AJ Aug-22 900 5000 5900
Ampul 97LE0087 May-21 0 0
Vial LA181007 Jun-21 20 20
Tablet C00168B Apr-22 0 0
Tablet E90136BB May-21 7100 7100
Tablet H91994B Jul-21 33600 33600
Tablet E00025BB Mei-22 56000 56000
Tablet 51D0597 Mar-22 0 0
Tube H91278T Aug-21
Suppos 19030457 Mar-23
Tablet EDE174 May-22 0 0
Tablet 95323011 Nov-23 4000 3000 7000
Tablet T10025AJ Oct-21 300 300
Vial I07028AJ Jul-21 0 100 100
Tablet T05114AJ May-21
Botol
Tablet 190819108 Aug-21 0 0
Tablet 51C0282 Feb-23 100 100 200
Tablet 50L0360 Nov-21 0 0
Ampul F0H672 Aug-22 200 200
Tablet D80C5010 Jun-25 1000 3000 4000
Tablet
Tablet A92743 Feb-24 153 100 253
Ampul F8K568 Oct-21 5 5
Suppos W23681710 Apr-22 6 6
Suppos
Tablet G81428B Jun-20
Ampul 06342014-1 Sep-21 30 30
Tablet A86211W Sep-21 0 0
Botol 1910-28-186 Oct-21 190 50 240
Tablet 49A0795 Dec-21 500 1000 1500 500
Botol
Ampul 97MC0054 Mar-21 31 50 81 31
Botol 07081788 Jul-20
Botol J38715 Oct-20 0 0
Botol E58804 Jun-21 14 12 26
Kapsul
Botol
Tablet
Tablet H81563B Mar-24 120 100 220
Kapsul KKFNBA01170 Feb-22 90 90 180
Kapsul KKFNBB02251 Jan-22 90 90 180
Botol 20LE020 Mei-22 0 10 10
Ampul 36478018 Apr-22 60 60
Ampul 063820102 Aug-20
Tablet 16381010 May-21 0 0
Tablet C90551B Feb-21 200 200
Ampul 4300402 Feb-22 0 50 50
Ampul 9EA04250 Aug-22 5 5
Sase D80757B Mar-23 400 200 600
Ampul BF18I069 Oct-20
Botol
Kapsul
Tablet C70304J Mar-22
Tablet 50E0213 Apr-22 0 0
Tablet
Tablet 171373T Sep-22 2600 2600
Kolf 200907 Aug-23 0 40 40
Tablet 1706228 Jun-20
Tablet A00542 Feb-23 2610 2610
Ampul KDB3C01 Mar-23 5 5
Tablet E160426B May-21 100 100
Tube 295D16 May-20
Tube F90891T Jun-23 72 72
Vial P100029725 Dec-21 3 3
Tablet T09135AJ Sep-21
Botol GF2271 Jun-20
Tablet A904237 Jun-22 0 0
Tablet A2326EU Jun-21 0 0
Tablet A01493 Aug-23 1500 4000 5500
Tablet
Vial 97LH0002 Jan-22 0 10 10
Tablet A01030 Apr-23 230 100 330
Tube E90622T Sep-23 25 25
Tablet 170913103 Sep-21 100 100
Ampul 9619B0054A Dec-20 100 100 100
Suppos G8C189 Mar-21 30 30
Kapsul 180109251 Jan-22 500 500
Kapsul 1023881106 Jan-22 300 300
Tube D81081W Apr-21 22 22
Tablet 190820152 Aug-21 6400 6400
Tablet A91612 Jul-22 130 130
Tablet
Ampul 63290011 Feb-21 30 30
Tablet 51D0030 Mar-22 1855 1000 2855
Tablet 5160086 May-21 1375 1375
Tablet

Botol

Botol A80927 Jul-22 78 78

Tablet A91840 Jul-22 200 200
Tablet TPH5546 Jul-22 400 400
Tablet
Kapsul ECD083 Apr-21 750 750
Tube UK2908 Sep-20 0 0
Ampul 171C046 Mar-21 60 60
Ampul 06362027-2 Jun-21
Botol 29031988 Feb-22 22 22
Botol
Tablet 70307 Jul-20
Vial 92E49C May-21 5 5
Vial 87F49D Jun-21 18 18
Ampul 9618L0239A Nov-20 0 0
Tablet DE1082 Jul-22
Tablet M02BY030 May-22 6000 1000 7000
Tablet D70319B Apr-22 0 0
Tablet 190818129 Aug-23 2700 2700
Tablet HTMFNA03093 May-22 5800 5000 10800
Tube 972846W Oct-21 24 24
Sase 1811149 Nov-20 0 0
Tablet 16364020 May-23 1000 2000 3000
Tablet 16365029 May-21 1450 1450
Kolf 390415 Mar-24 0 40 40
Tablet CM63884 May-21 0 90 90
Ovula 16372005 Feb-22 0 100 100
Tablet 16371003 Apr-21
Paket 26493014 May-22 2 2
Paket 16471013 Apr-21 0 0
Paket L94304J Sep-22 3 2 5
Tablet 190326 Mar-21 0 0
Botol
Botol
Ampul 9619G02334 Jul-21 100 100
Tube J82869W Oct-21 0 0
Kapsul 17091053 Sep-21 2310 1200 3510
Ampul 22090 Oct-22 30 30 60
Ampul 4200254 Feb-22 150 200 350
Botol
Botol A101022 Apr-23 284 284
Botol
Tablet 200964117 Sep-22 4800 5000 9800
Suppos
Tube 0689RB May-21 1 1 2
Tube C20003 Jun-22 0 20 20
Tablet E90085B Apr-22 0 300 300
Botol 09061888 Mar-21 3 3
Botol 24041988 Mar-22 4 5 9
Tablet 16386002 May-21 0
Tablet CPMA00112 Jul-22 0 200 200
Tablet
Tablet 1906079 Jun-21
Botol 2908014 Aug-21
Tablet 1901142 Jan-21
Tablet 1004043 Jul-21 0 0
Ampul 9618L0277A Dec-20 0 0
Tablet HTRNTB05432 Sep-23 5000 3000 8000
Kapsul H82359W Aug-21 0 0
Kapsul A00149U Jan-23 800 800
Kolf 490407 Mar-24 200 300 500
Tablet 51E0556 May-23 1788 1000 2788
Tablet F91602B May-23 2000 1000 3000
Tablet 192345B Aug-23 300 300
Vial 8984011 Nov-20 0 0
Pot HU03B2 Aug-25 0 24 24
Tube 17SE020B May-21
Kapsul HH038175 Aug-21 1500 500 2000
Botol 6908006 Aug-22 150 150
Kapsul KCFMB90735 Jun-21 0 0
Botol DCFMA90428 Jul-21 0 0
Vial 68070058B Jul-20
Vial I07009AJ Jul-21 200 100 300
Tablet 18TE042 May-23 0 1000 1000
Ampul 2001F003A Jun-22 300 300
Tablet 32290 Mar-22 3500 1000 4500
Tablet A8796KW Nov-21 900 1500 2400
Tablet 170656158 Jun-21 0 100 100
Tablet A922248 Aug-22 0 0
Tablet 19TC014 Feb-22 4900 2000 6900
Tablet 26496016 Mar-22 200 300 500
Botol 081839 Jul-21 0 36 36
Vial RIE741MA Jun-21 5 5
Vial H2MAC00093 Aug-21 2 2
 Paket
Vial 600143B2 Jun-21 0 0
Vial AB1900802 Aug-21 0 0
Vial 740169B3 Jul-21 0 0
Vial D190908 Sep-21 0 0
Box G19165057 May-21 30 30
Box C19169080 Dec-20 0 0
Box U19079062 Feb-21 57 57
Test 1907100 Jul-21 0 0
Box 05418396 Jan-21 1 1
Test 2021141 Oct-22 0 50 50
Strip 1922159 Dec-21 0 50 50
Strip
Test H19044 Aug-21 0 50 50
Botol 690619KO Aug-21
Strip 05061788 May-20
Test 401190911 Mar-21
Botol
Botol
Botol 920820-GM Oct-22 0 0
Botol 03041788 Mar-20
Botol 730619HC Aug-21 0 0
Botol 840720-TR Sep-22 0 0
Box MR18D01 Sep-20
Botol 28061988 May-22
Botol S4019-IM Mar-21 0 0
Kit 010/2019 Jun-21 0 2 2
Botol 3402/030129A Jan-22 0 0
Botol
Botol 2785/7140032 Aug-21 0 0
Botol 2785/7140031 Jan-22 0 0
Botol 3536/7062536 Feb-21 0 0
Botol 2785/7140035 Feb-22 0 0
Botol 2785/7140034 Feb-22 0 0
Botol 3402/046039C Feb-22 0 0
Test 11BDE005A Apr-21 25 25
Test/30 01ADD008C Dec-20
Test/100 01EMD016A Aug-20
Test/25 C20008 Mar-22 0 0
Test 03ADE008A Jun-21 0 0
Test QSY1018033 Nov-20 0 0
Pack/10 20190619 May-22 5 5
Box@25 20190603 May-21 0 2 2
Box E906 Jan-21 0 0
Botol
 Box/20L AM9062 Feb-21
Series
Botol/500mL AM9015 Jun-20
Pcs
Strip
Strip
Kit Jun-21 16 16

Box 562/18 Jul-21 0 0

Box 767/18 Sep-21 0 0
Box 0 0
Pot 44130 Apr-22 0 0
Box 3 3
Pcs 2 2
Box
Botol
Botol May-21 1 1
Box 1541905 Apr-22 1 1
Pot
Pcs 0 0

Pcs 4507259895 Nov-20 0 0

Pcs
Pcs 01091688 Oct-21 5 5
Pcs
Tube
Pcs 30122014 May-20
Pcs 711063 Nov-22 12 12
Pcs
Pcs 190222 Jan-24 5100 3000 8100
Pcs 1832011 Nov-23 0 0
Box 10 10
Box 6644146 Apr-23 117 117
Box 001.001.001 Jun-22
Pcs 20180930 Aug-23 200 200
Pcs 20170915 Aug-22 50 100 150
Pcs 20170328 Feb-22 50 100 150
Pcs 20181028 Sep-23 50 100 150
Pcs 20170328 Feb-22 99 99
Pcs 20170601 May-22 8 8
Pcs 20160605 May-21 150 150
Pcs 0041713 Jan-25 1600 1600
Pcs 20170320 Mar-22 30 30
Btl DB18094 Apr-21 11 12 23
Box 17545 Aug-22 19 19
 Pcs 1603061 Mar-21 24 24
Box 1605091 May-21 0 1 1
Pcs 30112015 Apr-21 72 72
Box 1605091 May-21 1 1 2
Pcs 201709 500 500
Botol 190618E Jun-22
Botol 223658 Mar-22
Botol 500ml Mar-25 18 18
Pcs
Pcs 20180801 Apr-25 20 20 40
Pcs 8271118 Mar-24 0 0
Pcs 0218 Jun-22 75 75
Pcs 3017870 Mar-22 0 0
Box 50 pair 5 5
Roll 20181201 Sep-23 2 2
Pcs 20181015 Sep-23 200 200
Pcs 4011688 8 8
Pcs 4011688
Pcs 100 100
Pcs 160 160
Set 03101888 Sep-23 60 60
Set 03101888 Sep-23 60 60
Pcs 0 0
Kotak
Bungkus 22 22
Box 030918 Sep-22 30 30 60
Roll 960518 May-22 4 2 6
Pcs 19031888 Feb-23 0 100 100
Roll 280 280
Roll 300 300
Kit 20190614 Jun-21 0 0
Roll 90130209 Dec-22 8 10 18
Pcs 1611021814 Oct-21 4 10 14
Box 1 50 51
Pcs 190320 Mar-24 0 50 50
Pcs 170225 Feb-22 20 20
Pcs 160120 Feb-22 10 10
Pcs 170225 Feb-22 20 20
Pcs 10042015 Apr-20
Pcs MD16153701 Feb-22 140 140
Pcs 20190405 Mar-24 0 100 100
Box/100 1 1
Pcs 16C0802 Feb-21 99 99
Pcs 05061888 May-23
Pcs 17C1306J Feb-22 500 300 800
 Roll 0 0
Pcs 1601028 Jan-21 2 2
Pot 6190503 May-24
Pcs
Pot 6190401 Apr-24
Pcs 20181028 Sep-23 500 500
Box/100 5 5
Pcs 01091688 Aug-21 0 0
Pcs
Pcs 04061888 May-23
Pcs 20181028 Sep-23 511 1000 1511
Pcs 20200430 Apr-25 5 10 15
Pcs 2911117 Aug-22 0 0
Pcs 1611021814 Oct-21 25 25
Box 50 pair 2 2
Pcs 3017865 Mar-22 200 200
Pcs MDI4937501 Feb-21 15 15
Pcs 180685 May-23 36 36
Pcs 181205 Nov-24 36 36
Roll 12171 Jan-23 2 2
Roll 12155 Mar-23 2 2
Pcs
Pcs 15051788 Apr-22 6 6
Pcs 161029B Sep-21 4 4
Pcs 200709B Jun-25 0 5 5
Pcs 0
Pack/100 20190310 Mar-21 0 5 5
Pack 190618 Sep-21
Pcs 0 100 100
Pcs 20170508 0 0
Galon 5L 1 1
Pcs
Box 24081788 Jul-22 1 1

Kaplet 20C0104B Apr-23 0 0

Botol D3000 Apr-21 0 0
Pcs 0 0
Pcs 159 159
Test W19500324 Mar-21
Test
Test
Test
Kantong (1,6L) 456 456
Pasang 13 13
 Pcs 1 1
Pcs
Galon 5 L
Galon 5 L 2 3 5

Syringe 3653019 Oct-21 56 56

Vial 0379G181 Jun-22 41 20 61
Vial 5010519 Oct-21 51 30 81
Vial 2054819 Aug-21 45 30 75
Vial
Vial 0129N264 May-22 57 10 67
Vial 04114618 Aug-21 4 4
Vial 2100718 Dec-21 38 20 58
Dosis X32853 Aug-20
Vial 0415318 Jul-21 19 19
Vial 0400919 Feb-23 2 2
Pcs 17002 Feb-22 300 300
Pcs 18501 Jan-23 700 300 1000
Pcs 17127 Jul-22 0 0
Pcs 0 25 25
Pcs 0 25 25

Tube G9222IJ Jul-21 25 25

Botol E90015BJ Apr-22
Tablet 09620C0040 Mar-22 0 0
Tablet 17619K0060 Sep-21 2010 2010
Botol SKN53848 Dec-22
Tablet 1405015 Mei-22 0 0
Tablet HTMECA02175 Mar-22
Box G81348T Jul-21
Botol 24 24
Pcs
Kapsul KCFMB00888 Mar-22 3500 3500
Tablet HTCTRC04016 Jul-22 4000 4000
Tablet 50C0337 Feb-21
Vial 9984210 Jun-21 0 0
Botol 20B0104 Apr-22 10 10
Tablet 00719L0020 Des-23 0 0
Ampul 26337072-2 Des-22 100 100
Box F8C311 Mar-20
Pcs 7 7
Suppos 20050489 Mei-24
 Box
Box 18-10-110-05-8 Sep-23 1 1
Box
Box
Ampul LA0383 Jan-22 0 0
Botol 00124 Mei-22
Box 2 2
Box 8 8
Box 1 1
Tube B00013T Feb-24 270 270
Tablet HTGMPK03044 Mei-24 4500 4500
Botol I01195J Sep-23 0 0
Tablet A92015 Aug-22
Kaplet 20C0057A Apr-23 0 0
Pcs
Pak 2 2
Box
Pcs
Pcs
Pcs 40 40
Box
Botol 0 0
Botol
Ampul 22F434 Jul-23 15 15
Ampul C10467006 Mar-23 0 0
Vial
Flash 36802002BF Mar-22 20 20
Suppos R001J007 Feb-22 0 0
Suppos R002J005 Mar-22 0 0
Box
Pcs
Tablet HK1801 Nov-23 0 0
Ampul IRNTB90291 Sep-22 0 0
Paket Dec-21 1 1
Paket Dec-21 1 1
Paket Dec-21 1 1
Botol 0101219010 Dec-22
Botol 0091219021 Jun-21
Botol 185375 Des-22 1 1
Pcs F01247S Jun-25 18 18
Botol 6909004 Sep-22
Kotak
Pcs Sep-22 0 0
Botol/1L
Botol A0007 Mar-21 0 0
Botol AM0019 Sep-21
Paket 0312 Feb-21 0 0
Botol AM0005 Feb-21 0 0
Roll
Box/20
Pcs 20190322 Mar-24 20 20
Pcs 20180406 Apr-23 34 34
 Jebus, 30 Desember 2020
Kepada Yth.
Kepala Dinas Kesehatan
Kabupaten Bangka Barat
Di
Muntok

Pemakaian Keluar Sisa Stok Nilai Permintaan

11 12=(10+11) 13=(9-12) 14=(13X3)

0 0 1000 Rp 4,000,000.00
3 3 1 Rp 512,204.00 5
0 0 200 Rp 49,000.00
0 0 400 Rp 159,600.00
0 0 0 Rp -
20 20 0 Rp -
2000 2000 500 Rp 33,000.00 3000
100 100 0 Rp -
0 0 150 Rp 63,600.00
1000 1000 3100 Rp 325,500.00
65 65 171 Rp 16,074.00
5 5 189 Rp 24,192.00
50 50 250 Rp 1,125,000.00
0 0 4500 Rp 579,150.00
0 0 100 Rp 9,600.00

0 0 98 Rp 16,464.00
0 0 4200 Rp 340,200.00
0 0 2000 Rp 320,000.00
300 300 3300 Rp 861,300.00
85 85 0 Rp - 100

50 50 150 Rp 328,350.00
300 300 8000 Rp 480,000.00

0 0 0 Rp -
25 25 25 Rp 79,675.00
0 0 20 Rp 66,500.00
0 0 72 Rp 205,920.00
2500 2500 3800 Rp 418,000.00 5000
900 900 5000 Rp 1,573,000.00 3000
0 0 0 Rp -
0 0 20 Rp 1,151,700.00
0 0 0 Rp -
3500 3500 3600 Rp 1,339,200.00
0 0 33600 Rp 11,894,400.00
0 0 56000 Rp 20,832,000.00
0 0 0 Rp -
100

0 0 0 Rp -
3000 3000 4000 Rp 248,000.00 3000
300 300 0 Rp - 5000
100 100 0 Rp - 200

0 0 0 Rp - 3000
110 110 90 Rp 299,250.00 100
0 0 0 Rp - 120
0 0 200 Rp 230,400.00
0 0 4000 Rp 396,000.00 3000

48 48 205 Rp 23,370.00
0 0 5 Rp 9,110.00
2 2 4 Rp 52,808.00

0 0 30 Rp 34,560.00
0 0 0 Rp -
3 3 237 Rp 659,097.00
1000 1500 0 Rp - 1000 yg baru

0 31 50 Rp 70,400.00
2 yg baru
0 0 0 Rp - 5 yg baru
11 11 15 Rp 84,000.00 12
 100
60 60 160 Rp 28,800.00 100
0 0 180 Rp 214,380.00
60 60 120 Rp 173,520.00
10 10 0 Rp -
0 0 60 Rp 232,020.00

0 0 0 Rp -
200 200 0 Rp - 200
0 0 50 Rp 66,650.00
0 0 5 Rp 319,930.00
0 0 600 Rp 157,800.00

100 yg baru

0 0 0 Rp - 3000

0 0 2600 Rp 280,280.00
0 0 40 Rp 294,536.00

124 124 2486 Rp 149,160.00

0 0 5 Rp 506,500.00
0 0 100 Rp 15,600.00
2 yg baru
24 24 48 Rp 121,584.00
1 1 2 Rp 377,326.00 2

0 0 0 Rp - 200
0 0 0 Rp -
1900 1900 3600 Rp 226,800.00 3000

0 0 10 Rp 99,550.00
110 110 220 Rp 54,340.00 100
25 25 0 Rp - 25
0 0 100 Rp 28,800.00
0 100 0 Rp - 100 yg baru
0 0 30 Rp 71,400.00
0 0 500 Rp 160,000.00
0 0 300 Rp 366,600.00
22 22 0 Rp -
1400 1400 5000 Rp 125,000.00
130 130 0 Rp - 1000
 0 0 30 Rp 39,300.00
580 580 2275 Rp 2,550,275.00 500
105 105 1270 Rp 4,599,940.00

0 0 78 Rp 170,820.00
100 100 100 Rp 13,300.00
0 0 400 Rp 129,200.00

0 0 750 Rp 577,500.00
0 0 0 Rp - 5 yg baru
60 60 0 Rp - 60

1 1 21 Rp 947,100.00

1000 yg baru
0 0 5 Rp 16,640.00
0 0 18 Rp 68,328.00
0 0 0 Rp - 10 yg baru

0 0 7000 Rp 1,022,000.00
0 0 0 Rp - 100
300 300 2400 Rp 684,000.00
3000 3000 7800 Rp 826,800.00 5000
0 0 24 Rp 86,040.00
0 0 0 Rp -
0 0 3000 Rp 423,000.00
0 0 1450 Rp 184,150.00
0 0 40 Rp 273,600.00 40
0 0 90 Rp 301,500.00
100 100 0 Rp -

0 0 2 Rp 521,052.00
0 0 0 Rp -
4 4 1 Rp 436,243.00 5
0 0 0 Rp - 36

0 0 100 Rp 119,900.00
0 0 0 Rp -
300 300 3210 Rp 462,240.00 900
20 20 40 Rp 426,800.00 40
200 200 150 Rp 172,950.00 200
100 100 184 Rp 217,304.00

2300 2300 7500 Rp 1,328,250.00 3000

1 1 1 Rp 20,700.00 1
10 10 10 Rp 118,250.00 20
300 300 0 Rp - 300
1 1 2 Rp 41,400.00
2 2 7 Rp 28,490.00
0 0 0 Rp -
200 200 0 Rp -

0 0 0 Rp -
0 0 0 Rp - 100 yg baru
1000 1000 7000 Rp 1,185,800.00
0 0 0 Rp -
0 0 800 Rp 463,200.00
0 0 500 Rp 3,815,000.00
1113 1113 1675 Rp 480,725.00 1000
0 0 3000 Rp 252,000.00 1000
0 0 300 Rp 30,600.00
0 0 0 Rp - 40 yg baru
0 0 24 Rp 184,800.00

300 300 1700 Rp 766,700.00

0 0 150 Rp 650,850.00
0 0 0 Rp -
0 0 0 Rp - 48

50 50 250 Rp 2,364,750.00
0 0 1000 Rp 47,000.00 1000
100 100 200 Rp 227,200.00 100
0 0 4500 Rp 1,017,000.00
450 450 1950 Rp 228,150.00 1500
0 0 100 Rp 8,400.00
0 0 0 Rp - 2000
1400 1400 5500 Rp 720,500.00 1000
0 0 500 Rp 277,500.00
0 0 36 Rp 119,592.00
0 0 5 Rp 392,500.00
1 1 1 Rp 1,325,000.00 3
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
4 4 26 Rp 4,303,000.00
0 0 0 Rp - 20 yg baru
8 8 49 Rp 7,521,500.00
0 0 0 Rp -
1 1 0 Rp - 2 yg baru
50 50 0 Rp - 50
0 0 50 Rp 716,750.00

50 50 0 Rp - 50

0 0 0 Rp - 2

0 0 0 Rp -
0 0 0 Rp -

0 0 0 Rp -
2 2 0 Rp -
0 0 0 Rp -

0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
25 25 0 Rp - 50

0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 5 Rp 424,511.65
2 2 0 Rp - 2
0 0 0 Rp - 2 yg baru
 1
2

6 6 10 Rp 545,454.54

0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 3 Rp 225,120.00
0 0 2 Rp 73,400.00

3
0 0 1 Rp 19,765.00
0 0 1 Rp 67,076.92

0 0 0 Rp -

0 0 0 Rp - 100 yg baru

1 1 4 Rp 54,956.00

12 yg baru
0 0 12 Rp 420,924.00

1700 1700 6400 Rp 3,407,360.00 3000

0 0 0 Rp - 3000
10 10 0 Rp -
37 37 80 Rp 2,112,000.00 40

50 50 150 Rp 840,840.00 100

0 0 150 Rp 1,035,000.00
50 50 100 Rp 690,470.00
0 0 150 Rp 1,103,025.00
0 0 99 Rp 683,100.00
0 0 8 Rp 45,080.00
0 0 150 Rp 879,750.00
300 300 1300 Rp 468,585.00
30 30 0 Rp - 60
6 6 17 Rp 400,279.45 12
0 0 19 Rp 211,508.00
 0 0 24 Rp 147,400.08
0 0 1 Rp 147,389.00
0 0 72 Rp 442,200.24
0 0 2 Rp 294,778.00
100 100 400 Rp 894,092.40

0 0 18 Rp 626,175.00

30 30 10 Rp 153,180.00 20
0 0 0 Rp -
0 0 75 Rp 1,409,400.00
0 0 0 Rp -
2 2 3 Rp 1,650,000.00 2
0 0 2 Rp 214,174.40
0 0 200 Rp 1,772,100.00
8 8 0 Rp - 20
20
0 0 100 Rp 716,320.00
0 0 160 Rp 24,288,000.00
0 0 60 Rp 1,277,760.00
0 0 60 Rp 1,277,760.00
0 0 0 Rp -

0 0 22 Rp 303,600.00
10 10 50 Rp 394,863.00
3 3 3 Rp 411,870.42 2
0 0 100 Rp 141,900.00
0 0 280 Rp 168,000.00
0 0 300 Rp 90,000.00
0 0 0 Rp -
3 3 15 Rp 560,565.00
0 0 14 Rp 177,100.00
13 13 38 Rp 5,087,820.00
0 0 50 Rp 381,150.00
5 5 15 Rp 113,850.00
0 0 10 Rp 79,200.00
5 5 15 Rp 113,850.00

40 40 100 Rp 269,500.00
0 0 100 Rp 149,270.00
0 0 1 Rp 179,742.55
49 49 50 Rp 348,502.00

100 100 700 Rp 577,500.00

 0 0 0 Rp -
0 0 2 Rp 60,220.00

100 100 400 Rp 387,360.00

0 0 5 Rp 595,059.05
0 0 0 Rp 858,000.00

151 151 1360 Rp 1,328,121.60

0 0 15 Rp 229,770.00 20
0 0 0 Rp -
5 5 20 Rp 253,000.00
2 2 0 Rp -
0 0 200 Rp 1,007,142.00
0 0 15 Rp 124,500.00
0 0 36 Rp 759,111.48
24 24 12 Rp 285,324.00 24
0 0 2 Rp 2,161,544.00
0 0 2 Rp 919,600.00

1 1 5 Rp 42,592.00
3 3 1 Rp 10,010.00
0 0 5 Rp 184,250.00
0 0 0 Rp - 1
5 5 0 Rp -

0 0 100 Rp 457,864.00
0 0 0 Rp -
0 0 1 Rp 198,000.00

0 0 1 Rp 71,500.00

0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 159 Rp 57,717,000.00

0 0 456 Rp 14,592,000.00
0 0 13 Rp -
 0 0 1 Rp -

1 1 4 Rp 3,012,000.00

5 5 51 Rp 1,305,447.00
18 18 43 Rp 2,844,622.00 20
36 36 45 Rp 3,792,690.00 30
24 24 51 Rp 1,085,535.00 30

19 19 48 Rp 7,980,720.00 20
2 2 2 Rp 33,990.00
19 19 39 Rp 6,200,766.00 20

0 0 19 Rp 322,905.00
0 0 2 Rp 38,390.00
0 0 300 Rp 495,000.00
400 400 600 Rp 744,000.00
0 0 0 Rp -
0 0 25 Rp 352,343.00
0 0 25 Rp 412,518.75

0 0 25 Rp 87,175.00

0 0 0 Rp -
0 0 2010 Rp 1,197,960.00

0 0 0 Rp -

0 0 24 Rp 79,800.00

0 0 3500 Rp 3,755,500.00
0 0 4000 Rp 1,064,000.00

0 0 0 Rp -
0 0 10 Rp 250,000.00
0 0 0 Rp -
100 100 0 Rp -

0 0 7 Rp 2,730,000.00
 0 0 1 Rp 50,200.00

0 0 0 Rp -

0 0 2 Rp 180,000.00
0 0 8 Rp 760,000.00
0 0 1 Rp 120,000.00
30 30 240 Rp 876,240.00
500 500 4000 Rp 2,816,000.00
0 0 0 Rp -

0 0 0 Rp -

0 0 2 Rp 637,000.00

15 15 25 Rp 750,000.00

0 0 0 Rp -

15 15 0 Rp -
0 0 0 Rp -

10 10 10 Rp 119,230.00
0 0 0 Rp -
0 0 0 Rp -

0 0 0 Rp -
0 0 0 Rp -
0 0 1 Rp 1,650,000.00
0 0 1 Rp 3,850,000.00
0 0 1 Rp 1,925,000.00

0 0 1 Rp 415,000.00
18 18 0 Rp -

0 0 0 Rp -

0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -

0 0 20 Rp 220,000.00
3 3 31 Rp 341,000.00

Rp 290,191,006.53

Pengelola Obat
Puskesmas Jebus

Marlita Oktaria, S.Farm., Apt

NIP 19911024 201902 2 004