BERITA ACARA STOCK OBAT DAN BMHP

PUSKESMAS BANDAR KHALIPAH KECAMATAN

KABUPATEN DELI SERDANG
TAHUN 2023

NOMOR : 295.7 / PUSK-BK / XII / 2023

Pada hari ini sabtu tanggal tiga puluh bulan Desember tahun dua ribu dua puluh tiga, kami yang
bertanda tangan dibawah ini, telah melakukan Stock Opname Obat dan Perbekalan Kesehatan pada
Puskesmas Bandar Khalipah Kecamatan Percut Sei Tuan Kabupaten Deli Serdang ( daftar terlampir).

Demikian berita acara ini diperbuat dengan sebenarnya untuk dapat dipergunakan sebagaimana
mestinya.

YANG MELAKUKAN STOCK OPNAME OBAT DAN BAHAN MEDIS HABIS PAKAI
PADA PUSKESMAS BANDAR KHALIPAH KECAMATAN PERCUT SEI TUAN KABUPATEN
DELI SERDANG

1. Indah Suci Kesuma Lubis, S. Farm., Apt

NIP : 19950125 201903 2 015 ………………………………

2. Asnawaty Lingga, Amd

NIP : 19690405 199403 2 002 …………………………………..

Diketahui / disetujui oleh :

Kepala Puskesmas Puskesmas Bandar Khalipah
Kecamatan Percut Sei Tuan Kab. Deli Serdang,

dr. Henny Andrianie, MKM

NIP : 19780316 201001 2 007
 STOK OPNAME OBAT DAN BAHAN MEDIS HABIS PAKAI PUSKESMAS BANDAR KHALIPAH
KECAMATAN PERCUT SEI TUAN KABUPATEN DELI SERDANG

PELAPORAN : 30 DESEMBER 2023

No NAMA OBAT SATUAN JUMLAH HARGA TOTAL

1 Acyclovir Krim tube 521 9,000 4,689,000
2 Allopurinol 100 mg tablet 4,569 110 502,590
Amoksisilin Sirup kering 125
3 btl 60 ml 342 2,050 701,100
mg/5ml
Antasida DOEN I Kombinasi tablet 5,000 70 350,000
4
Antasida DOEN I Kombinasi tablet 5,000 100 500,000
5 Asam Askorbat (vit C) 50mg tablet 9,682 70 677,740
6 Asam Mefenamat 500 mg Tablet 1,481 145 214,745
7 Bisoprolol 2,5 mg tablet 3,855 650 2,505,750
tube 179 4,000 716,000
8 Betametason Crem
tube 100 2,050 205,000
9 Becefort Syrup Botol 152 17,524 2,663,648
10 Cetrizin tablet tablet 3,900 82 319,800
11 Cetrizin syrup botol 176 4,200 739,200
12 Codein 10 mg tablet 910 600 546,000
13 Dextrofen Syrup botol 248 12,500 3,100,000
14 Diazepam 2 mg tablet 309 85 26,265
Deksametason inj 5mg /ml-
15 ampul 180 968 174,240
1ml
16 Dexametasone Tab 0,5 mg tablet 5,084 68 345,712
17 Digoksin tablet 0,25 mg tablet 4,490 200 898,000
18 Eritromicin Syrup Botol 68 7,500 510,000
19 Fito Menadione tablet 10 mg tablet 476 750 357,000
20 Furosemid tablet 40 mg tablet 397 77 30,569
21 Glibenclamide 5 mg tablet 3,985 174 693,390
22 Glukosa 5 % Larutan Infus botol 320 8,100 2,592,000
23 Griseofulvin 125 mg Tablet tablet 5,145 210 1,080,450
24 Garam Oralit Sachet 2,966 300 889,800
25 Gentamycin Salep Kulit tube 199 5,000 995,000
26 Hustab P Syrup Botol 101 11,655 1,177,155
27 Haloperidol 0,5 mg tab tablet 480 70 33,600
28 Haloperidol 1,5 mg tab tablet 190 53 10,070
29 Hidrokortison Cream 2.5 % tube 255 2,475 631,125
30 Hidrokloratiazid 25 mg tablet 4,562 190 866,780
31 Isosorbit Dinitrat tablet tablet 10,260 91 933,660
 sublingual 5 mg
32 Kaptopril 12,5 mg tablet 1,426 68 96,968
Kotrimoksazol 480 mg komb
33 Tablet 14,818 155 2,296,790
(DW)
34 Kotrimoxsazole Syrup Botol 646 2,600 1,679,600
Kloramfeniramin Maleat
35 tablet 10,000 40 400,000
(CTM) 4 mg
36 Loratadin 10 mg Tablet 4,597 145 666,565
37 Loperamid 2 mg tablet 2,400 135 324,000
Metil Ergometrin Maleat
38 tablet 621 214 132,894
0,125 mg
39 Metoclorpramid Hcl Tablet tablet 8,119 117 949,923
Metronidazole Benzoat
40 Botol 180 4,700 846,000
Suspensi 125 mg
41 Metronidazole 500 mg tablet 3,250 175 568,750
42 Natrium Klorida 0,9 % Botol 40 7,100 284,000
43 Paracetamol 500 mg tablet 770 157 120,890
44 Paracetamol sirup 120 mg/5ml botol 463 1,400 648,200
45 Prednison 5 mg Tablet tablet 7,909 105 830,445
46 Propanolol HCL 10 mg tablet 2,636 60 158,160
Propylthiouracil 100 mg @
47 tablet 1,000 405 405,000
100
48 Pirantel Paneoat tablet 2,250 485 1,091,250
Pyridoksin HCI (Vit B6)
49 tablet 5,987 77 460,999
Tablet
50 Ranitidin Injeksi Vial 25 1,500 37,500
51 Ranitidin 150 Tablet tablet 2,804 194 543,976
52 Ringer Laktat 500 ml Botol 280 8,000 2,240,000
53 Salap 2-5 Tube 180 3,850 693,000
54 Salbutamol tablet 2 mg tablet 3,797 70 265,790
Sianokobalamin (Vit B12)
55 ampul 20 1,033 20,660
injeksi
56 Simvastatin tablet 10 mg tablet 5,179 95 492,005
57 Tetrasiklin 500 mg kapsul 1,938 949 1,839,162
Tiamin Hcl ( Vitamin B 1 50
58 tablet 2,049 89 182,361
mg )
59 Vitamin B Kompleks tablet 1,754 124 217,496
60 Hemafort tablet 1,080 863 932,040
61 Tablet Tambah Darah tablet 212,156 367 77,861,252
62 Zink Tablet tablet 6,284 253 1,589,852
 ampul 330 1,199 395,670
63 Oksitoksin Injeksi 10 iv/ml
ampul 190 3,000 570,000
64 Metil Ergometrin Injeksi ampul 55 3,102 170,610
Botol 20 4,290 85,800
65 MgSO 4 40 %
Botol 18 5,600 100,800
66 MgSO 4 20 % Botol 14 3,760 52,640
ampul 404 3,867 1,562,268
67 Fitomenadion Inj 2 mg / ml
ampul 351 2,997 1,051,947
68 Oksitetrasiklin salep mata 1 % tube 231 2,600 600,600
69 Ampicilin inj 1 gr @ 10 ml ampul 310 8,469 2,625,390
70 Gentamicin Inj 40 mg / ml ampul 350 3,685 1,289,750
71 Gentamicin inj ampul 115 2,698 310,270
72 Garam Oralit sachet 300 280 84,000
73 Ca. Glukonat Injeksi 10 % ampul 15 10,405 156,075
74 Diazepam Inj 5 mg / ml ampul 22 1,545 33,990
75 atropin injeksi ampul 30 1,718 51,540
76 Dextrose 10% botol 40 8,500 340,000
OBAT JKN/BLUD - -
77 Asam Mefenamat 500 mg tablet 5,000 400 2,000,000
78 CTM tablet 10,000 100 1,000,000
79 Ceftriaxone 1 gr vial 25 14,500 362,500
80 Domperidone 10 mg tablet 2,498 270 674,460
81 Ketorolac Injeksi ampul 6 3,200 19,200
82 Kloramfenikol 250 mg tablet 980 980 960,400
83 Norages injeksi ampul 30 10,500 315,000
84 Ondansetron Injeksi ampul 20 5,500 110,000
85 Guaiafenesin tablet 4,692 220 1,032,240
86 Asam Tranexamat injeksi ampul 25 12,500 312,500
87 Ventolin Nebules flc 39 14,500 565,500
88 Antasida Doen tablet 1,937 320 619,840
89 Amoxicillin 500 mg tablet 2,269 770 1,747,130
90 Loperamide 2 mg tablet 1,197 240 287,280
91 Captopril 12,5 mg tablet 2,500 198 495,000
92 Metformin 500 mg tablet 2,859 295 843,405
93 Kalsium Lactas tablet 769 195 149,955
94 Pehacain injeksi 2 ml ampul 180 4,800 864,000
BAHAN MEDIS HABIS PAKAI -
95 Abbocath No.20 G buah 300 4,180 1,254,000
96 Abbocath No.22 G buah 100 4,180 418,000
97 Abbocath No.24 G buah 250 4,180 1,045,000
98 Alat suntik 3 ml 24 G X1 buah 700 880 616,000
99 Aseptan 500 cc Botol 4 36,080 144,320
100 Alkohol 70 % 1 L Botol 10 49,550 495,500
Blod Strip Test ( Kt Benzatin
101 Kit 107 795,776 85,148,032
Test )
Cat Gut /benang bedah Plain
102 buah 48 34,004 1,632,192
no .3/0
Cat Gut /benang bedah
103 buah 47 33,538 1,576,286
CHROMIC no . 2/0
104 Cotton Swab Steril Jumbo Box 160 118,800 19,008,000
HB Cheke Test Strip Box/25
105 Box 171 115,474 19,746,054
Pcs
106 Infusion Set Dewasa Pcs 88 7,500 660,000
107 Kapas Pembalut 500 g buah 20 30,008 600,160
108 Kasa 16 x 16 Pcs 20 5,000 100,000
109 Kasa Pembalut Hidrofil 4 x 5 roll 200 5,500 1,100,000
110 Kasa Pembalut Hidrofil 4 x 10 roll 250 2,500 625,000
111 Kasa Pembalut Hidrofil 4 x 15 roll 200 2,800 560,000
112 Kasa Pembalut Hidrofil 2 x 80 roll 19 2,800 53,200
Latex Surgical Gloves Powder
113 Pcs 1,000 9,500 9,500,000
Free 7,5
114 Masker Headloop (Hijab) Pcs 1,900 1,800 3,420,000
115 Medika Povidone 10 % 300 ml botol 10 17,200 172,000
116 Metanol 250 ml botol 25 -
117 Plasterin Non Woven 5 x 5 roll 3 27,000 81,000
118 Plasterin Non Woven 10 x 5 roll 12 47,000 564,000
119 Plasterin Non Woven 15 x 5 roll 8 85,000 680,000
Qilan Nitrile Examination
120 Box 998 90,000 89,820,000
Gloves Powder Fre (M)
121 Rivanol 300 botol 35 6,000 210,000
122 Silk 2/0 Pcs 40 25,000 1,000,000
123 Silk 3/0 Pcs 58 25,000 1,450,000
Yuni-sol Cairan Desinfektan,
124 Botol 5 32,000 160,000
Aroma Carbolic
125 Asam Asetat botol 17 1,140,000 19,380,000
126 Aqua Destilata (Aquadest) botol/liter 4 14,500 58,000
127 Infusion Set Anak set 18 3,850 69,300
128 Lancet Darah 286 Serenity pcs 400 194 77,760
129 PULP-X dus 3 217,000 651,000
130 Nald 1 cc Terumo pcs 700 3,500 2,450,000
131 USG Gel botol 8 30,000 240,000
132 Spuit 3 cc pcs 50 1,400 70,000
133 Autocheck Kolesterol box 50 272,300 13,615,000
134 Masker Oksigen Dewasa 11 15,000 165,000
135 Masker Oksigen Anak 4 15,000 60,000
OBAT GIGI - -
136 Articulating Pcs 9 181,500 1,633,500
137 Calcetin Caleium Hidroxide Box 3 102,000 306,000
138 Guta Percha Point #15-40 Pcs 32 42,000 1,344,000
139 Guta Percha Point #45-80 Pcs 3 42,000 126,000
140 Calplus Denpro Box 4 86,000 344,000
141 Champenol Denpro Box 4 54,576 218,304
TOTAL 426,169 4,102,915 434,037,285

YANG MELAKUKAN STOK OPNAME OBAT DAN BMHP

PADA PUSKESMAS BANDAR KHALIPAH KEC. PERCUT SEI TUAN KAB. DELI SERDANG

1. Indah Suci Kesuma Lubis, S. Farm., Apt

NIP : 19950125 201903 2 015 ………………………………

2. Asnawaty Lingga, Amd

NIP : 19690405 199403 2 020 …………………………………..

Diketahui / disetujui oleh :

Kepala Puskesmas Bandar Khalipah
Kec. Percut Sei Tuan Kab. Deli Serdang

dr. Henny Andrianie, MKM

NIP : 19780316 201001 2 007