PE

LAPORAN PEM

PUSKESMAS : BOBONG
KECAMATAN : TALIABU BARAT
KABUPATEN : PULAU TALIABU
PROPINSI : MALUKU UTARA
No Nama Obat Satuan

1 2 3
1 Air untuk injeksi ampul/vial/botol 10 mL
2 Air untuk injeksi Botol 100 ml
3 Air untuk injeksi Botol 250 ml
4 Air untuk injeksi amp 20 ml ampul/vial/botol
5 Air untuk injeksi amp 25 ml ampul/vial/botol 25 mL
6 Acetylcistein tablet/kapsul/kaplet
7 Albendazol susp 200 mg/5 ml Botol
8 Albendazol tab 400 mg tablet/kapsul/kaplet
9 Alopurinol tab 100 mg Tab
10 Alopurinol tab 300 mg tablet/kapsul/kaplet
11 Aminofilin inj 24 mg/ml ampul/vial 10 ml
12 Aminofilin tab 150 mg tablet/kapsul/kaplet
13 Aminofilin Tab 200 mg tablet/kapsul/kaplet
14 Amitriptilin tab sal 25 mg tablet/kapsul/kaplet
15 Amlodipin tab 10 mg tablet/kapsul/kaplet
16 Amlodipin tab 5 mg tablet/kapsul/kaplet
17 Amoksisilin drops 100 mg/ml Botol @15 ml
Amoksisilin drops 100 mg/ml Botol @10 ml

18
Amoksisilin drops 100 mg/ml Botol @20 ml

19
Amoksisilin sir forte 250 mg/5 ml botol 60 ml

20
Amoksisilin sir kering 125 mg/5 ml Botol

21
 Amoksisilin tab 250 mg tablet/kapsul/kaplet

22
Amoksisilin tab 500 mg tablet/kapsul/kaplet

23
Ampisilin serb inj 1000 mg/vial ampul/vial

24
Ampisilin serb inj 250 mg/vial Vial

25
Anestetik lokal gigi kombinasi : lidokain hcl 2% + ampul/vial
epinefrin 1 : 80.000 inj 2 ml

26
Antasida, kombinasi : aluminium hidroksida 200 tablet/kapsul/kaplet
mg + magnesium hidroksida 200 mg

27
 Antasida, kombinasi : aluminium hidroksida 200 botol 60 ml
mg + magnesium hidroksida 200 mg

28
Antibakteri kombinasi : Basitrasin 500 UI/g + Tube
Polimiksin B 10.000 UI/g

29
Antifungi salep, kombinasi : asam benzoat 6%+ pot 30 g
asam salisilat 3%

30
 Antihemoroid, kombinasi: bismut subgalat 150 mg Suppositoria
+ heksaklorofen 2,5 mg + lidokain lidokain 10 mg+
seng oksida 120 mg + sup ad 2 g

31
Aquadest cairan 500 ml Botol 500 ml

32
Articulating paper kertas warna penanda oklusi Kertas warna penanda oklusi

33
Asam asetat tetes telinga 2% Botol

34
Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kaplet

35
Asam askorbat (vitamin C) tab 250 mg Tab

36
 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kaplet

37
Asam folat tab 0,4 mg tablet/kapsul/kaplet

38
Asam folat tab 1 mg tablet/kapsul/kaplet

39
Asam folat tab 5 mg Tab

40
Asam mefenamat kaps 250 mg tablet/kapsul/kaplet

41
Asam mefenamat kaps 500 mg tablet/kapsul/kaplet/kaptab

42
Asam retinoat krim 0,05% Tube/pot

43
Asam salisilat salep 10% Tube

44
Asam salisilat salep 2% Tube

45
Asam salisilat salep 5% Tube

46
Asetazolamid tab 250 mg tablet/kapsul/kaplet

47
Asiklovir tab 200 mg tablet/kapsul/kaplet

48
Asiklovir tab 400 mg tablet/kapsul/kaplet

49
 Atapulgit 600 mg tablet/kapsul/kaplet
50
Atapulgit tab 630 mg tablet/kapsul/kaplet

51
Atapulgit tablet 650 mg tablet/kapsul/kaplet

52
Atapulgit tablet 750 mg Tab

53
Atenolol tab 100 mg tablet/kapsul/kaplet

54
Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul

55
Atropin tab 0,5 mg Tab

56
Bahan tumpatan sementara lar, serb Botol

57
Bedak salisil serb 2% Dus/Sachet/Plastik

58
Benzatin benzilpenisilin inj 1,2 juta UI/ml (i.m.) Vial

59
Benzatin benzilpenisilin inj 2,4 juta UI/ml (i.m.) Vial

60
 Betahistin tab 6 mg tablet/kapsul/kaplet

61
Betametason krim 0,1% tube 5 gram

62
Betametason krim 0,5 mg/g Tube

63
Bisakodil sup 10 mg Suppositoria

64
Bisakodil sup 5 mg Suppositoria
65
Bisakodil tab sal 5 mg tablet/kapsul/kaplet

66
Bisoprolol tab 2,5 mg tablet/kapsul/kaplet

67
Budesonid cairan ih 0,25mg/ml Botol @ 4 ml

68
Budesonid cairan ih 0,25mg/ml, respoules 2 ml respoules

69
Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml

70
Budesonid cairan ih 0,5 mg/ml, respoules 2 ml respoules

71
 Budesonid serb ih 200 mcg/dosis 100 dosis

72
Budesonid serb ih 200 mcg/dosis 200 dosis

73
Dapson tab 100 mg Tab

74
Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial

75
Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL

76
Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL

77
Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial

78
Diazepam tab 2 mg tablet/kapsul/kaplet

79
Diazepam tab 5 mg tablet/kapsul/kaplet

80
Dietilkarbamazin tab 100 mg tablet/kapsul/kaplet

81
 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial

82
Dimenhidrinat tab 50 mg tablet/kapsul/kaplet

83
Doksisiklin kaps 100 mg tablet/kapsul/kaplet

84
Domperidon susp 5 mg/5 ml botol @60 ml

85
Domperidon tab 10 mg tablet/kapsul/kaplet

86
Ekstrak Herba meniran (Phyllanthi niruri herba) Kapsul

87
Ekstrak Herba meniran (Phyllanthi niruri herba) Botol

88
Epinefrin (adrenalin) inj 1 mg/ml Ampul

89
Ergotamin tab 1 mg Tablet/kapsul/kaplet

90
Eritromisin kaps 250 mg tablet/kapsul/kaplet

91
Eritromisin sir 200 mg/5 ml Botol @ 60 ml

92
 Eritromisin tab 500 mg tablet/kapsul/kaplet

93
Etambutol tab 400 mg tablet/kapsul/kaplet

94
Etanol 70% cairan 70% Botol

95
Etil klorida semprot 100 ml Botol

96
Etonogestrel implan 68 mg Set

97
98 Eugenol Botol
Fenitoin Na inj 50 mg/ml (100 mg/ 2 mL) ampul @ 2 ml

99
Fenitoin Na kaps 100 mg Kaps

100
Fenitoin Na kaps 30 mg Kaps

101
Fenobarbital inj 50 mg/ml Ampul

102
Fenobarbital tab 100 mg Tab

103
Fenobarbital tab 30 mg tablet/kapsul/kaplet

104
 Fenoksimetil penisilin (penisilin V) tab 250 mg Tab

105
Fenoksimetil penisilin (penisilin V) tab 500 mg Tab

106
Ferrakrilum cairan 1% Botol

107
Ferro Sulfat sir 150 mg/5 ml botol

108
Ferro Sulfat tab sal selaput 300 mg tablet salut selaput

109
Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial

110
Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal

111
Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) tablet salut gula/kaplet salut gula

112
 Flufenazin Dekanoat inj 25 mg/ml (i.m) Vial

113
Fluoksetin kaps 10 mg tablet/kapsul/kaplet

114
Fluoksetin kaps 20 mg tablet/kapsul/kaplet

115
Fluor kapl 1 mg Kaplet

116
Fluor sediaan topikal Tube

117
Flutikason propionat cairan ih 0,5 mg/dosis Botol

118
Formokresol Botol
119
Fraksi dari ekstrak campuran Daun bungur Kapsul
(Lagerstroemiae speciosae folium) dan Kulit kayu
manis (Cinnamomi burmannii cortex)

120
 Fraksi dari ekstrak Kulit kayu manis (Cinnamomi Kaplet
burmannii cortex)

121
Framisetin Sulfat Tulle 1% Patch

122
Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial

123
Furosemid tab 40 mg tablet/kapsul/kaplet

124
Galactose microparticle 200-400 mg micropart/ml Vial

125
Garam oralit kombinasi : natrium klorida 0,52 g + sachet
kalium klorida 0,30 g + trinatrium sitrat 0,58 g +
glukosa anhidrat 2,7 g

126
 Gentamisin salep mata 0,3% Tube

127
Gentamisin tts mata 0,3% Botol

128
Glibenklamid tab 2,5 mg tablet/kapsul/kaplet

129
Glibenklamid tab 5 mg tablet/kapsul/kaplet

130
Glimepirid tab 1 mg tablet/kapsul/kaplet

131
Glimepirid tab 2 mg tablet/kapsul/kaplet

132
Glimepirid tab 3 mg tablet/kapsul/kaplet

133
Glimepirid tab 4 mg tablet/kapsul/kaplet

134
Glipizid tab 10 mg tablet/kapsul/kaplet

135
Glipizid tab 5 mg tablet/kapsul/kaplet
136
Gliseril trinitrat tab 0,5 mg tablet/kapsul/kaplet

137
Gliserol obat luar 100 ml Botol

138
Glukosa Larutan Infus 10% steril 100 ml Botol

139
 Glukosa Larutan Infus 10% steril 250 ml Botol

140
Glukosa Larutan Infus 10% steril 500 ml Botol

141
Glukosa Larutan Infus 40% Ampul @25 ml

142
Glukosa Larutan Infus 5% steril 100 ml Botol

143
Glukosa Larutan Infus 5% steril 250 ml Botol

144
Glukosa Larutan Infus 5% steril 500 ml Botol

145
Griseofulvin (micronized) tab 125 mg tablet/kapsul/kaplet

146
Griseofulvin (micronized) tab scored 250 mg tablet/kapsul/kaplet

147
Griseofulvin tab 500 mg Tablet/kapsul/kaplet

148
 Haloperidol Dekanoat inj 50 mg/ml Vial

149
Haloperidol inj 5 mg/ml (i.m.) Vial

150
Haloperidol tab 0,5 mg tablet/kapsul/kaplet

151
Haloperidol tab 1,5 mg tablet/kapsul/kaplet

152
Haloperidol tab 2 mg tablet/kapsul/kaplet

153
Haloperidol tab 5 mg tablet/kapsul/kaplet

154
Haloperidol tts 2 mg/ml botol

155
Hepatitis B imunoglobulin (human) inj 110 IU Ampul

156
Hepatitis B imunoglobulin (human) inj 200 IU Ampul

157
Hepatitis B imunoglobulin (human) Inj 220 IU Ampul

158
 Hidrogen peroksida cairan 3% Botol

159
Hidroklorotiazid tab 25 mg tablet/kapsul/kaplet

160
Hidrokortison krim 1% tube @ 5 g

161
Hidrokortison krim 2,5% tube @ 5 g

162
Hidrokortison serb inj 100 mg Vial

163
Hiosina butilbromida tab 10 mg tablet/kapsul/kaplet

164
Human tetanus imunoglobulin inj 250 UI (i.m.) Ampul

165
Human tetanus imunoglobulin inj 500 UI (i.m.) Ampul

166
Ibuprofen sir 100 mg/5 ml botol @ 60 ml

167
Ibuprofen sir 200 mg/5 ml botol @ 60 ml

168
Ibuprofen tab 200 mg tablet/kapsul/kaplet

169
 Ibuprofen tab 400 mg tablet/kapsul/kaplet

170
Ipratropium bromida aerosol 20 mcg/semprot Botol

171
Ipratropium bromida cairan ih 0,025% Botol

172
Isoniazid tab 100 mg Tablet/kapsul/kaplet

173
Isoniazid tab 300 mg Tablet/kapsul/kaplet

174
Isosorbid dinitrat tab 5 mg tablet/kapsul/kaplet

175
176 Kalamin Tube
Kalium Klorida tab lepas lambat 600 mg tab

177
Kalsium glukonat inj 100 mg/ml ampul/vial

178
Kalsium hidroksida bubuk, pasta Tube

179
Kalsium hipoklorit serb Sachet

180
 Kalsium karbonat tab 500 mg tablet/kapsul/kaplet

181
Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kaplet

182
Kaptopril tab 12,5 mg tablet/kaplet

183
Kaptopril tab 25 mg tablet/kaplet

184
Karbamazepin sir 100 mg/5 ml Botol

185
Karbamazepin Tab 200 mg Tablet/kapsul/kaplet

186
Karbogliserin tts telinga 10 % Botol

187
Ketokonazol krim 2% Tube 10 g

188
Ketokonazol scalp sol 2% botol

189
Ketokonazol tab 200 mg tablet/kapsul/kaplet

190
Klindamisin kaps 150 mg Tablet/kapsul/kaplet

191
Klindamisin kaps 300 mg tablet/kapsul/kaplet

192
 Klofazimin, micronized kaps 50 mg Kapsul

193
Klofazimin, micronizedkaps 100 mg kapsul

194
Kloramfenikol kaps 250 mg tablet/kapsul/kaplet

195
Kloramfenikol salep mata 1% tube @ 5 gram

196
Kloramfenikol serb inj 1.000 mg/ml vial/ampul

197
Kloramfenikol susp 125 mg/5 ml botol 60 ml

198
Kloramfenikol tetes telinga 3% Botol

199
Kloramfenikol tts mata 0,5% botol

200
Kloramfenikol tts mata 1% Botol

201
Klorfeniramin tab 4 mg tablet/kapsul/kaplet

202
 Klorfenol kamfer mentol (CHKM) Botol

203
Klorheksidin lar 0,2% Botol

204
Klorheksidin lar 15% Botol

205
Klorpromazin inj 25 mg/ml (i.m.) ampul/vial

206
Klorpromazin inj 5 mg/ml (i.m.) ampul/vial

207
Klorpromazin tab sal 100 mg tablet salut selaput/kaplet salut selaput

208
Klorpromazin tab sal 25 mg Tab sal

209
Kodein tab 10 mg tablet/kapsul/kaplet

210
Kodein tab 15 mg tablet/kapsul/kaplet

211
Kodein tab 20 mg tablet/kapsul/kaplet

212
Kolkisin tab 500 mcg Tablet/kapsul/kaplet

213
 Komb: Deksametason 0,1% Thymol 5% Botol
Paraklorphenol 30

214
Kombinasi (DHP) : dihidroartemisin 20 mg + tablet dispersible
Piperakuin 160 mg tab dispersible

215
Kombinasi : artemether 20 mg + lumefantrin 120 tablet/kapsul/kaplet
mg

216
Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kaplet

217
Kombinasi : levonorgestrel 150 mcg + tab salut gula
etinilestradiol 30 mcg

218
 Kombinasi : triamsinolon asetonoid + dimetil- Pasta tube
klortetrasiklin pasta

219
Kombinasi ekstrak Herba seledri (Apii graveolentis Kapsul
herba) dan ekstrak Daun kumis kucing
(Orthosiphonis staminei folium)

220
 Kombinasi ekstrak Ikan gabus (Ophiocephali Sachet
striati), ekstrak Buah jeruk (Citri sinensidis
fructus), dan ekstrak Rimpang kunyit (Curcumae
longae rhizoma)

221
Kombinasi: Ipratropium bromida 0,5 mg + Ampul/vial
Salbutamol 2,5 mg, cairan ih

222
Kombinasi: kaolin 550 mg + pektin 20 mg Tab

223
 Kombinasi: lidokain + medisinal creosote phenol + Botol
eugenol + benzil alkohol, cairan

224
Komposit resin Set
225
Kotrimoksazol (dewasa) kombinasi : tab/kaptab
sulfametoksazol 400 mg+ trimetoprim 80 mg

226
Kotrimoksazol (dewasa) kombinasi : tab/kaptab
sulfametoksazol 800 mg+ trimetoprim 160 mg

227
 Kotrimoksazol kombinasi tiap 5 ml suspensi : botol 60 mL
sulfametoksazol 200 mg + trimetoprim 40 mg

228
Kuinin tab 200 mg tablet/kapsul/kaplet

229
Laktulosa sir 3,335 g/5 ml botol @ 60 mL

230
Larutan mengandung elektrolit (CaCl2H2O 0,165 Botol plastik @500 ml
gr, KCl 0,15 gr, NaCl 4,3 gr)

231
Larutan mengandung Elektrolit (Kalium Klorida) Botol

232
 Larutan mengandung Elektrolit (KCl 0,15%, NaCL Botol
0,9%) (KN1)

233
Larutan mengandung Elektrolit (KCl 0,3%,NaCl Botol
0,9%) (KN2)

234
Larutan mengandung Elektrolit (Na 130 mEq, K 4 Softbag @ 500 ml
mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)
Ringer Asetat

235
Larutan mengandung Elektrolit (Na 130 mEq, K 4 Botol plastik @ 500 ml
mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)
Ringer Asetat

236
 Larutan mengandung Elektrolit (Sodium Lactate Botol
sol (50%) 113 gr/L, Potassium Chloride 0.3 gr/L,
Calcium Chloride 0.2 gr/L, elektrolit)

237
Larutan mengandung Elektrolit (Tiap 1000 ml Botol
mengandung electrolit: Sodium 145 mmol/l,
Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
Magnesium 1.0 mmol/l, Chloride 118 mmol/l,
Acetate 24 mmol/l, Malate 5.0 mmol/l)

238
 Larutan mengandung Karbohidrat (Fructose 120 Botol
g, glucose 66 g, Xylitol 60 g/ L)

239
Larutan mengandung Karbohidrat (Fructose 15 softbag
mg, glucose monohydrate 30 mg, xylitol 15 mg)

240
Larutan mengandung Karbohidrat (Fructose 200 Botol
g, glucose 110 g, Xylitol 100 g/ L)

241
 Larutan mengandung Karbohidrat (Fructose 60 g, Botol
glucose 33 g, Xylitol 30 g/ L)

242
Larutan mengandung Karbohidrat (Maltose 10%) Botol

243
Larutan mengandung Karbohidrat + Elektrolit Botol plastik @500 ml
(25.00g dextrose anhidrat, 3.00 g sodium chloride,
0.15 g potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)

244
 Larutan mengandung Karbohidrat + Elektrolit Botol plastik @500 ml
(25.00g maltose, 3.00 g sodium chloride, 0.15 g
potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)

245
Larutan mengandung Karbohidrat + Elektrolit Botol
(Acetate, Na, K, Cl, Ca, Mg, Sorbitol 50 gr/L)

246
 Larutan mengandung Karbohidrat + Elektrolit Botol
(Dextrose 5%, NaCL 0,45%, KCl) (HSD)

247
Larutan mengandung Karbohidrat + Elektrolit Botol
(Fructose 120 g, glucose 66 g, Xylitol 60 g/ L +
elektrolit)

248
Larutan mengandung Karbohidrat + Elektrolit Botol
(Glukosa 25 g, NaCl 2,0 g, KCl 1,3 g, Natrium
Laktat 3,1 g, air untuk injeksi ad 1000 ml)

249
 Larutan mengandung Karbohidrat + Elektrolit Botol
(Glukosa 55 g ; Natrium Chloride 9 g, air untuk
injeksi ad 1000 ml) (D5-NS)

250
Larutan mengandung Karbohidrat + Elektrolit botol/softbag
(Glukosa: 110.0 g; NaCl: 1.80 g) (D10-1/5NS)

251
Larutan mengandung Karbohidrat + Elektrolit Botol
(Glukosa: 25,0 g; NaCl: 4,5 g)

252
 Larutan mengandung Karbohidrat + Elektrolit botol/softbag @ 500 mL
(Glukosa: 55.0 g; NaCl: 2.25 g) (D5-1/4NS)

253
Larutan mengandung Karbohidrat + Elektrolit botol/softbag @ 100 mL
(Glukosa: 55.0 g; NaCl: 2.25 g) (D5-1/4NS)

254
Larutan mengandung Karbohidrat + Elektrolit Botol
(Glukosa: 55.0 g; NaCl: 4.5 g) (D5-1/2NS)

255
 Larutan mengandung Karbohidrat + Elektrolit Botol
(Larutan nutrisi kombinasi infus per L: Na.
100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl
90mEQ, Asetat 38mEQ, Sorbitol 50g)

256
Larutan mengandung Karbohidrat + Elektrolit Botol
(Larutan Ringer & Glukosa 5%)

257
 Larutan mengandung Karbohidrat + Elektrolit Botol
(NaCl 1.125 gr, Dekstrosa 18.75 gr) (KA EN 1B)

258
Larutan mengandung Karbohidrat + Elektrolit Botol
(NaCl 1.75 g, KCL 1.5g, Glukosa 100 gr)

259
Larutan mengandung Karbohidrat + Elektrolit Botol
(NaCl 1.75 g, KCL 1.5g, Na Lactate 2.24 g, Glukosa
100 gr)

260
 Larutan mengandung Karbohidrat + Elektrolit Botol
(Nacl 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr,
Dekstrosa 27 gr) (KA EN 3B)

261
Larutan mengandung Karbohidrat + Elektrolit Botol
(Nacl 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr
Dekstrosa 27 gr) (KA EN 3A)

262
Levonorgestrel implan 2 rods, 75 mg (3-4 tahun) pack/ sachet/ set

263
Lidokain gel 2% syringe/syringe plastik
264
Lidokain inj 2% (infiltr/p.v.) ampul/vial

265
 Lidokain salep 5% Tube
266
Lidokain spray topikal 10% botol

267
Linestrenol tab 0,5 mg tablet/kapsul/kaplet

268
Liquor carbonis detergens lar 5% Botol

269
Lisinopril tab 10 mg tablet/kapsul/kaplet

270
Lisinopril tab 5 mg tablet/kapsul/kaplet
271
Loratadin tab 10 mg tablet/kapsul/kaplet

272
Lorazepam tab 0,5 mg tablet/kapsul/kaplet

273
Lorazepam tab 1 mg tablet/kapsul/kaplet

274
Lorazepam tab sal 2 mg Tab sal

275
Magnesium sulfat inj 20% ampul/vial

276
Magnesium sulfat inj 20% ampul/vial @25 ml

277
Magnesium sulfat inj 40% ampul/vial

278
 Magnesium sulfat inj 40% ampul/vial @25 ml

279
Magnesium sulfat serb, ktg 30 g Sachet

280
Manitol lar infus 20% Botol @ 500 ml

281
Manitol lar infus 20% Botol @ 100 ml

282
Manitol lar infus 20% Botol @ 250 ml

283
Mebendazol sir 100 mg/5 ml Botol

284
Mebendazol tab 100 mg Tablet/kapsul/kaplet

285
Mebendazol tab 500 mg tablet/kapsul/kaplet

286
Medroksi progesteron asetat inj 150 mg/ml ampul/vial

287
Metadon sir 50 mg/5 ml Botol 1000 ml

288
 Metenamin mandelat (heksamin mandelat) tab Tab salut
salut enterik 500 mg

289
Metformin tab 500 mg tablet/kapsul/kaplet

290
Metformin tab 850 mg tablet/kapsul/kaplet

291
Metildopa tab 250 mg tablet/kapsul/kaplet

292
Metilergometrin inj 0,2 mg/ml ampul/vial

293
Metilergometrin tab salut 0,125 mg tablet/kaplet salut selaput

294
Metilprednisolon inj 125 mg ampul/vial

295
Metoklopramid inj 5 mg/ml ampul/vial

296
Metoklopramid tab 10 mg tablet/kapsul/kaplet

297
Metoklopramid tab 5 mg tablet/kapsul/kaplet

298
 Metronidazol susp 125 mg/5 ml Botol @ 60 ml

299
Metronidazol susp 125 mg/5 ml Botol @ 100 ml

300
Metronidazol tab 250 mg tablet/kapsul/kaplet

301
Metronidazol tab 500 mg tablet/kapsul/kaplet

302
Mikonazol krim 2% tube

303
Mikonazol serb 2% botol / sachet

304
Mometason furoat krim 0,1% Tube 5 gram

305
Mometason furoat krim 0,1% tube 10 gram

306
N-asetil sistein kaps 200 mg tablet/kapsul/kaplet

307
N-asetil Sistein sir 100 mg/5ml botol

308
NaCl 0,9% Larutan Botol @1.000 mL

309
NaCl 0,9% Larutan Botol @500 ml

310
 NaCl 0,9% Larutan Botol @250 ml

311
NaCl 0,9% Larutan Botol @25 ml

312
NaCl 0,9% Larutan Ampul/botol @ 10 mL

313
NaCl 0,9% Larutan Botol @100 ml

314
NaCl 3% Larutan Botol plastik @500 ml
315
Natrium bikarbonat tab 500 mg tablet/kapsul/kaplet

316
Natrium diklofenak tab 25 mg tablet salut enterik/kaplet salut enterik

317
Natrium diklofenak tab 50 mg tablet salut enterik/kaplet salut enterik

318
Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL

319
Natrium fluoresein tetes mata 2% Botol

320
Natrium hipoklorit cairan konsentrat 5% Botol

321
Natrium tiosulfat inj 25% (i.v.) Ampul

322
 Nistatin susp 100.000 UI/ml botol/vial

323
Nistatin tab salut 500.000 UI tablet salut gula/kaplet salut gula

324
Nistatin tab vaginal 100.000 UI tablet/kaplet

325
Oksigen ih, gas dlm tabung Botol

326
Oksimetazolin tts hidung 0,025% botol @ 10 mL

327
Oksimetazolin tts hidung 0,050% botol @ 10 mL

328
Oksitetrasiklin 1% Salep Mata tube

329
Oksitosin inj 10 UI/ml ampul/vial

330
Olopatadin tts mata 0,1% Botol

331
Omeprazol inj 40 mg ampul/vial

332
Omeprazol kaps 20 mg tablet/kapsul/kaplet

333
 Parasetamol sir 120 mg/5 ml botol @ 60 mL

334
Parasetamol tab 500 mg tablet/kapsul/kaplet

335
Parasetamol tts 60 mg/0,6 ml botol @ 15 mL

336
Pasta devitalisasi (non arsen) Tube

337
Pasta pengisi saluran akar (pasta) Tube

338
Perak sulfadiazin krim 1% Tube

339
Permetrin krim 5 % Tube 30 g

340
Permetrin krim 5 % Tube 15 g

341
Permetrin krim 5 % Tube 10 g

342
Pilokarpin tetes mata 2% Catchcover, botol 0,6 ml

343
Pilokarpin tetes mata 2% Botol 5 ml

344
Pirantel pamoat susp 125 mg/5 ml Botol

345
 Pirantel pamoat tab scored 125 mg tablet/kapsul/kaplet

346
Pirantel pamoat tab scored 250 mg Tab

347
Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl

348
Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kaplet

349
Povidon iodin lar 100 mg/ml botol 30 mL

350
Povidon iodin lar 100 mg/ml botol @ 60 mL

351
Povidon iodin lar 100 mg/ml Botol 300 ml

352
Povidon iodin lar 100 mg/ml botol @ 1.000 mL

353
Povidon iodin lar obat kumur 1% Botol

354
Povidon iodin tts mata 2,5% botol/strip

355
 Prazikuantel tab scored 600 mg Tab

356
Prednison tab 5 mg tablet/kapsul/kaplet

357
Probenesid tab 500 mg tablet/kapsul/kaplet

358
Prokain benzilpenisilin serb inj 3 juta UI/vial (i.m.) ampul/vial

359
Propranolol tab 10 mg tablet/kapsul/kaplet

360
Ranitidin tab 150 mg tablet/kapsul/kaplet

361
Rifampisin kaps 300 mg tablet/kapsul/kaplet

362
Ringer Laktat Larutan Botol

363
Risperidon tab sal 2 mg tablet/kapsul/kaplet

364
Salbutamol cairan ih 1 mg/mL ampul/vial/botol

365
Salbutamol tab 2 mg tablet/kapsul/kaplet

366
 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang pot 30 gram
endap 4 %

367
Salep 2-4, kombinasi : asam salisilat 2 %+ belerang pot 15 gram
endap 4 %

368
Sefadroksil drops 150 mg/ml botol

369
Sefadroksil kaps 250 mg tablet/kapsul/kaplet

370
Sefadroksil kaps/tab 500 mg tablet/kapsul/kaplet

371
Sefadroksil sir kering 125 mg/5 ml botol @ 60 mL

372
Sefadroksil sir kering 250 mg/5 ml botol @ 60 mL

373
 Serum anti bisa ular : A.B.U. I (khusus ular dari Vial
luar Papua) inj (i.m./i.v.)

374
Serum anti bisa ular :A.B.U.II (khusus ular dari Vial
Papua) inj (i.m./i.v.)

375
Serum antirabies inj 100 UI/ml Vial

376
Serum antirabies inj 200 UI/ml Vial

377
Serum antitetanus (A.T.S) (i.m.) Inj 10.000 UI/vial Vial
(i.m /i.v.)

378
Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul

379
 Serum antitetanus (A.T.S) inj 20.000 UI/vial (i.m Vial
/i.v.)

380
Serum antitetanus (A.T.S) inj 5.000 IU/mL (i.m) Ampul/vial

381
Setirizin sir 5 mg/5 ml. botol @ 60 mL

382
Setirizin tab 10 mg tablet/kapsul/kaplet

383
Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial

384
Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kaplet

385
Simvastatin tab sal 10 mg tablet/kapsul/kaplet/tablet salut selaput/kaplet
salut selaput

386
 Simvastatin tab sal 20 mg tablet/kapsul/kaplet/tablet salut selaput/kaplet
salut selaput

387
Simvastatin tab sal selaput 40 mg Tab salut selaput

388
Siprofloksasin tab scored 500 mg tablet salut selaput/kaplet salut selaput

389
Spironolakton tab 25 mg tablet/kapsul/kaplet

390
Streptomisin serb inj 1.000 mg/vial ampul/vial

391
Surgical ginggival pack Tube

392
Terbutalin cairan ih 2,5 mg/ml Botol

393
Terbutalin inj 0,5 mg/ml ampul/vial

394
Tetanus toxoid inj Ampul

395
Tetrakain tts mata 0,5% Botol

396
 Tetrasiklin kaps 250 mg tablet/kapsul/kaplet

397
Tetrasiklin kaps 500 mg tablet/kapsul/kaplet

398
Tiamin (vitamin B1) tab 50 mg tablet/kapsul/kaplet

399
Timolol tts mata 0,25% botol @ 5 mL

400
Timolol tts mata 0,5% botol @ 5 mL

401
Triheksifenidil tab 2 mg tablet/kapsul/kaplet

402
Tropikamid tts mata 0,5% Botol @ 5 ml

403
Tropikamid tts mata 0,5% Catchcover, botol 0,6 ml

404
Tropikamid tts mata 1% Botol @ 5 ml

405
Tropikamid tts mata 1% Botol @ 0,6 ml

406
Urea krim 10 % Tube/pot

407
Urea krim 20 % Tube/pot

408
Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial

409
 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial

410
Valproat sir 250 mg/5 ml botol @ 120 ml

411
Valproat tab lepas lambat 250 mg tabet lepas lambat/kaplet lepas lambat

412
Valproat tab lepas lambat 500 mg tabet lepas lambat/kaplet lepas lambat

413
Valproat tab sal enterik 250 mg tablet salut enterik/ kaplet salut enterik

414
Vitamin B kompleks tablet

415
Zinc drops 10 mg/ml Botol

416
Zinc sir 20 mg/5 ml botol

417
Zinc tab disp 20 mg tablet dispersible

418
NAMA BMHP SATUAN

1 Abocath 18 Pieces
2 Abocath 20 Pieces
3 Abocath 20 Pieces
4 Abocath 22 Pieces
5 Abocath 24 Pieces
6 Abocath 26 Pieces
8 Alkahol 95% Botol @ 1000ml
9 Alkohol 70% Botol @ 1000ml
10 Alkohol Swab Pieces
11 Bisturi 12 Pieces
12 Bisturi 21 Pieces
13 Bisturi 22 Pieces
14 Bisturi 23 Pieces
15 Bisturi 24 Pieces
16 Blood Lancet Pieces
17 Cat gut plain 0 Pieces
18 Cat gut Plain 2/0 Pieces
19 Cat gut plain 3/0 Pieces
20 Catqut Cromic 2/0 Pieces
21 Catqut Cromic 3/0 Pieces
22 Dermafix s IV Pieces
23 Desinfektan cairan Clorin Botol
24 Disenfektan lantai 10 L Botol @ 10 L
25 Disposible Syringe Stera 0.5 ml Pieces
26 Disposible Syringe Stera 0.3 ml Pieces
27 Disposible Syringe Stera 1 ml Pieces
28 Disposible Syringe Stera 1 ml Pieces
29 Disposible Syringe Stera 10 ml Pieces
30 Disposible Syringe Stera 2.5 ml Pieces
31 Disposible Syringe Stera 5 ml Pieces
32 Disposible Syringe Stera 5 ml Pieces
33 Disposiblesyringe stera 3ml Pieces
34 Disposiblesyringe stera 3ml Pieces
35 Easy Touch Urid Acid Pieces
36 Easy Touch Gula Darah Pieces
37 Easy Touch Hb Pieces
38 Easy Touch Kolesterol Pieces
39 Endo Ultrasound gel 250 ml Botol
40 Ethyl Clhorida Botol
41 Feeding Tube 16 fr Pieces
42 Feeding Tube 8Fr Pieces
43 Folley cateter no 16 Pieces
44 Folley cateter no 18 Pieces
45 Handsanitezer 500 ml Botol
46 Handscoon non streril L Pasang
47 Handscoon non streril M Pasang
48 Handscoon non streril M Pasang
49 Handscoon non streril S Pasang
50 Handscoon Steril no. 7 Pasang
51 Handscond Steril no. 7,5 Pasang
52 Handscond Steril no. 7,5 Pasang
53 Handscoon Obgyn Pasang
54 Handscoon Steril no 6,5 Pasang
55 Hydrocortison 2.5% krim 5 gr Tube
57 Infusion Set Anak Pieces
58 Infusion Set Dewasa Pieces
59 Kapas pembalut 250 gr Roll
60 Kapas pembalut 500 gr Roll
61 Kasa hydrofil Steril Pieces
62 Kasa hydrofil steril 16x16 cm Pieces
63 Kassa non steril 40 x 80 cm Roll
64 Kassa non steril 4 m x 15 cm Roll
65 Kassa non steril 4 m x 15 cm Roll
66 Lancet Pieces
67 Leucoplast 10 cm x 5 m Roll
68 Leucoplast 2.5 x 4.5 cm Roll
69 Leucoplast 2.5 x 9.2 cm Roll
70 Leucoplast 5 cm x 2 cm Roll
71 Leucoplast 5 cm x 4.5 cm Roll
72 Leucoplast 5 cm x 5 cm Roll
73 Leucoplast 7.5 cm x 4.5 cm Roll
74 Masker Kain Pieces
75 Masker medis Kotak
76 Masker medis Kotak
77 Maxyflow L Pieces
78 MgSO4 20% 25 ml Ampul
79 MgSO4 40% 25 ml Ampul
80 Nasal canula oxygen Dewasa Pieces
81 Oxyflow Pieces
82 Policlean Handrub 500 ml Botol
83 Policrape 10 cm Roll
84 Policrape 7.5 cm Roll
85 Polifyx 5 cm x 5 m Roll
86 Poliwash 500 ml Botol
87 Povidon Iodida 10% 1000 ml Botol
88 Povidon Iodida 10% 30 ml Botol
89 Povidon Iodida 10% 300 ml Botol
90 Regulator Pieces
91 Ringer Laktat (RL) Botol
92 Rivanol 300 Botol
93 Selang section 18FR Pieces
94 Stand Tabung O2 Pieces
95 Tabung O2 Tabung
96 Test Kehamilan Pieces
97 Under pads Pieces
98 Urin bag Pieces
99 Water For Injection 20 ml Vial
Alat LAB SATUAN
1 BD Vacutainer Pieces
2 Hydrogen Pyroksida 3 % Botol
3 Giemsa 500 ml Botol
4 Tabung EDTA 3 ml Pieces
5 Parafilm Roll
6 Pipet Tetes 1000 ml Pieces
7 Plastik Klip Pieces
8 Plastik Klip 25x16 Pieces
9 Microtiner Tube Pieces
10 Vacutainer Brand Pieces
11 Microttainer 22 G Pieces
12 Methanol Lar Botol
13 Reagen HCl 0.1 % 100 ml Botol
14 Winged Infusion 27G Pieces
15 Yellow Holder Pieces
16 Zeil Nelsen Kit
Program Malaria SATUAN
1 Abate 1 gram Botol
2 Lab. Kit Kit
3 Limitor 1 kg Pieces
4 Malaria DHP Tablet
5 Objek Gelas Malaria Pieces
6 RDT DBD Dengue Combo Pieces
7 RDT Malaria Pieces
Program Kusta SATUAN
1 MB Anak/Kusta Pieces
2 MB dewasa/Kusta Pieces
3 PB Dewasa/Kusta Pieces
Program TB SATUAN
1 OAT KAT anak Paket
2 OAT KAT I Paket
3 OAT KAT II Paket
4 Pot Dahak Pieces
COVID-19 SATUAN
1 APD/Baju Hasmat Pieces
2 Rapid tes covit 19 Pieces
3 Rapit tes antigen covit 19 Pieces
Program HIV SATUAN
1 HBSag Pieces
2 Sypilish Pieces
3 Tes hepatitis Pieces
4 Tes HIV 1/2 1 line Pieces
5 Tes HIV 1/2 2 Line Pieces
6 Tes HIV 1/2 3-Line Pieces
VAKSIN SATUAN
1 Vaksin Rabies Vial
 PEMERINTAH KABUPATEN PULAU TALIABU
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )

Kemasan Batch Number Stok Awal Penerimaan Persediaan Pemakaian Sisa Stok

4 5 6 7 8=6+7 9 10=8-9
0
 50pcs/box
50pcs/box
50pcs/b0x
50pcs/b0x
50pcs/b0x
50 pcs/Box
Botol 1 Lt
Botol 1 lt
100 pcs/doz
 100/kotk
100/ktk
100/ktk
100/ktk
100/ktk
100/box
12/pcs/ktk
12/pcs/ktk
12/pcs/ktk
12/pcs/ktk
12/pcs/ktk
ktk
25 Botol/box
10 Liter
100 pcs/box
100 pcs/box
99 pcs/box
100 pcs/box
100 pcs/box
100 Pcs/box
100 pcs/box
100 Pcs/box
100pcs/box
100pcs/box
1 botol 25 tes
1 botol 25 tes
1 botol 25 tes
1 botol 10 tes
btl
Botol
Pcs
Pcs
10pcs/doz
10pcs/doz
Botol
100 pcs/doz
99 pcs/doz
100 pcs/doz
100 pcs/doz
50 pcs
50 pcs/Dos
50 pcs
50 pcs
50 pcs
24 tube/box
 50pcs/dz
25 pcs/pak
Roll
Roll
Pcs
ktk
Roll
50 roll/pak
50 roll/pak
Pact
Roll
Roll
Roll
Roll
Roll
Roll
Roll
-
49 pcs/doz
50 pcs/doz
pcs
Ampul 25 ml
Ampul 25 ml
Bungkus
pcs
Botol 500 ml
Roll
Roll
Roll
Botol 500 ml
Botol 1 Lt
Botol 30 ml
Botol 300 ml
paket
20 btl/box
botol
pcs
pcs
Tabung
1 ktk 50
10 pcs/ box
10 bks/pak
Vial
 Botol

Paket

Kit
Bungkus
9 tb/doz
Pack
10pcs/box
25pcs/box

paket
paket
paket

paket
paket
paket

20 pcs/doz
25pcs/dz

25 test/ktk
25 test/ktk
50 pcs/dz
25 pcs/dz
25 pcs/dktk
25 pcs/ktk
O)

Tanggal :
Bulan :
Tahun :2 0 2 3
Sumber Dana/Pengadaan
Stok OPT Permintaan Pemberian Expired Ket
Sumber Tahun
11=9+20%+T 12=11-10 13 14 15 16 17