PEMAKAIAN OBAT DINKES PUSKESMAS KRONJO

TAHUN 2017

PEMAKAIAN HARIAN PUSKESMAS

STOK PENERIM PERSEDI RATA-RATA
NO NAMA OBAT SATUAN APRIL 2017 MEI 2017 TOTAL JUMLAH HARI PEMAKAIAN
AWAL AAN AAN
26 27 28 29 30 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 PEMAKAIAN
1 Persediaan Bahan Pakai Habis
Persediaan Peralatan Kesehatan
1 Abbocath jarum infus 18 pieces
2 Abbocath jarum infus 20 pieces
3 Abbocath jarum infus 22 pieces
4 Abbocath jarum infus 24 pieces
5 Abbocath jarum infus 26 pieces
6 Alat Puyer Set
7 Alat suntik 0.05 cc pieces
8 Alat suntik 0.5 cc pieces
9 Alat suntik 1 cc pieces
10 Alat suntik 3 cc pieces
11 Alat suntik 5 cc pieces
12 Alat suntik 10 cc pieces
13 Alat suntik 20 cc pieces
14 Bisturi pieces
15 Blood Set Set
16 Catgut benang bedah no 2/0-3/0 pieces
17 Catgut benang bedah no 3/0 Roll
18 foley Catheter pieces
19 Hand Scond pieces
20 Infus set anak pieces
21 Infus set dewasa pieces
22 Jarum Hecting Kulit pieces
23 Jarum Hecting Otot pieces
24 Kaca Sediaan pieces
25 Kapas pembalut 250 mg Bungkus
26 Kasa Hidrofil 36 m x 80 cm Roll
27 Kasa Hidrofil Steril Kotak
28 Kasa Pembalut Hidrofil 4 x 10 cm Roll
29 KasaPembalut Hidrofil 4 x 5 Roll
30 Kertas Puyer pieces
31 Masker pieces
32 Nelaton catheter pieces
33 Pembalut gips Roll
34 Plester 5 yard x 2 inch Roll
35 Plester kertas / MICROPORE pieces
36 Pot Sputum pot
37 Safety Box pieces
38 Sarung Tangan Panjang Steril pieces
39 Silk ( Benang sutera ) no 3/0 pieces
40 Underpad pieces
41 Urine Bag ( Non Seteril ) pieces
42 Wing needle pieces
43 Lidi button pieces
44 Masker N95 8210 pieces
45 Masker nebulizer Anak pieces
46 Masker nebulizer dewasa pieces
47 NGT pieces
48 Oxigen nasal canule anak dan dewasa pieces
49 Plastik klip 7 x 10 pieces
50 Plastik klip 8 x 13 pieces
51 Pot Urine pot
52 Pot Fesses pot
53 Disposible Lancet pieces
54 Pen Lancet pieces
 55 Catgut Chromic SMI 2/D DS 24 mm pieces
56 Catgut Chromic SMI 3/D DS 26 mm pieces
57 Catgut Plain SMI 2/D DS 24 mm pieces
58 Catgut Plain SMI 3/D DS 24 mm pieces
0
2 Persediaan Bahan/Material
Bahan Obat-obatan 0

OBAT PKD 0
A ANTIBIOTIKA 0
1 Amoksilin kapsul 250 mg Kapsul
2 Amoksilin tab 500 mg Tablet
3 Amoksisilin s kering 125 mg / 5 cc 60 Ml Botol
4 Amoksisilin s kering 250 mg / 5 cc 60 Ml Botol
5 Asiklovir tab 200 gr Tablet
6 Asiklovir tab 400mg Tablet
7 Azitromisin 500 mg Tablet
8 Benzatin Benzil penisilin Vial
9 Cefixim 100 mg kapsul kapsul
10 Cefixime DS 100 mg/ 5ml Botol
11 Doksisiklin kapsul 100 mg Kapsul
12 Erytromisin sirup 60 Ml 200mg/5ml Botol
13 Erytromycin 250 mg Tablet
14 Erytromycin 500 mg Tablet
15 Fenoksimetil Penisilin tablet 250 mg Tablet
16 Fenoksimetil Penisilin tablet 500 mg Tablet
17 Flukonazol kapsul 150 mg Kapsul
18 Griseofulvin tablet 125 mg micronized Tablet
19 Ketokonazol tablet 200 mg Tablet
20 Klindamisin Kapsul 150 mg Kapsul
21 Klindamisin Kapsul 300 mg Kapsul
22 Kloramfenikol kapsul 250 mg Kapsul
23 Kloramfenikol sirup 60 Ml Botol
24 Kotrimoksazol Suspensi 60 Ml 40mg/5ml Botol
25 Kotrimoksazol Tablet Dewasa Tablet
26 Kotrimoksazol Tablet paed Tablet
27 Lincomysin 500 mg Kapsul
28 Metronidazol tablet 500 mg Tablet
29 Nistatin drop / Mycostatin, candistin, Nymiko Botol
30 Nistatin tablet salut gula 500.000 IU/g Tablet
31 Nistatin tablet vagina 100.000 IU/g Tablet
32 Sefadoksil 500 mg Tablet
33 Sefadoksil syrup 125ml/5ml Botol
34 Sefadoksil syrup 250ml/5ml Botol
35 Seftriaxsone 1 gr inj Vial
36 Siproploksasin tab 500 mg Tablet
37 Streptomycin inj 1 gram Vial
38 Tetrasiklin Kapsul 250 mg Kapsul
39 Tetrasiklin Kapsul 500 mg Tablet
40 Tiamfenikol kap 500 mg Tablet
B ANALGETIKA-ANTIPIRETIK-ANTIINFLAMASI 0
1 Alopurinol tablet 100 mg Tablet
2 Alopurinol tablet 300 mg Tablet
3 Antalgin ( Metampiron ) inj 250 mg/ 5 cc Ampul
4 Asam Mefenamat 250 Kapsul
5 Asam Mefenamat 500 Tablet
6 Asetosal Tablet 80 mg (Aspilet) Tablet
7 Ibuprofen Supp Supp
8 Ibuprofen Suspensi 200mg/5ml Botol
9 Ibuprofen tablet 200 mg Tablet
10 Ibuprofen tablet 400 mg Tablet
11 Kalium Diclofenak 50 mg Tablet
12 Ketoprofen Inj Ampul
13 Meloksixam tablet 15 mg Tablet
 14 Natrium Diclofenac tab 50 mg Tablet
15 Parasetamol 100 mg Tablet
16 Parasetamol Drop 15 ml Botol
17 Parasetamol sirup 120 mg / 5ml (60 Ml) Botol
18 Parasetamol tablet 500 mg Tablet
19 Tramadol tablet 50 mg Tablet
C DIGESTIVA 0
1 Antasida DOEN komb Tablet
2 Antasida sirup 60 Ml Botol
3 Lacto B Sachet
4 Mesoprostol 200 mg Tablet
5 Natrium Bikarbonat tablet 500 mg Tablet
6 Omeprazole 20 mg Kapsul
7 Ranitidin inj 25 mg/2ml Ampul
8 Ranitidin tablet 150 mg Tablet
9 Sucraflat sirup Botol
10 Vitazym tab Tablet
D ANTISPASMODIK 0
1 Chlordiazepoxide (Braxidin) Tablet
2 Ekstrak Belladon tablet 10 mg Tablet
3 Hyoscine-N-Butilbromida/Buscopan tablet Tablet
4 Buscopan Inj Ampul
5 Papaverin tablet Tablet
6 Spasminal Tablet
E LAKSATIVA 0
1 Bisacodil Tablet 5 mg Tablet
2 Bisacodil Tablet 5 mg Suppositoria Suppos
3 Laktulosa Syr 3,335g/5ml / Laktulak syrup Botol
F ANTIDIARE & ELEKTROLIT 0
1 Anti Diare Anak Tablet
2 Anti Diare Dewasa Tablet
3 Garam Oralit 200 ml air Sachet
4 Norit Tablet
G ANTIEMESIS 0
1 Dimenhidrinat tab 50 mg Tablet
2 Domperidon 10 mg tablet Tablet
3 Domperidon suspensi 5 mg/ml Botol
4 Metoclopramid Inj Ampul
5 Metoclopramid Syrup Botol
6 Metoclopramid 10 mg Tab Tablet
7 Ondansetron injeksi Ampul
8 Ondansetron tablet 4 mg Tablet
H OBAT METABOLISME (VITAMIN&MINERAL) 0
1 Asam Askorbat (VIT C) Tablet 50 mg Tablet
2 Asam folat 1 mg Tablet
3 Kalsium laktat (Kalk) tablet 500 mg Tablet
4 Multivitamin anak 60 Ml Botol
5 Multivitamin dewasa Tablet
6 Neurobion 5000 injeksi Ampul
7 Phitonadione pead injeksi Ampul
8 Piracetam 800 mg Tablet
9 Piridoksin HCl (Vit B6) tablet 10 mg Tablet
10 Sianokobalamin inj 500 mcg/ml-1ml Ampul
11 Sianokobalamin tab b12 Tablet
12 Tiamin HCL (Vit B1) inj 100 mg/ml-1ml Ampul
13 Tiamin HCL (Vit B1) tablet 50 mg Tablet
14 Vitamin B komplek Inj Ampul
15 Vitamin B komplek tab Tablet
I ANTI ASMA 0
1 Aminofilin inj 24 mg / cc Ampul
2 Aminofilin tab 200 mg Tablet
3 Bisolvon drop Botol
4 Bricasma Inj Ampul
 5 Efedrin HCl tablet 25 mg Tablet
6 Salbutamol tablet 4 mg Tablet
7 Salbutamol inhalasi ( Ventolin ) Nebule
J ANTITUSIVE & EKSPEKTORAN 0
1 Ambroksol sirup 60 ml Botol
2 Ambroksol tablet Tablet
3 Bromhexin tablet 8 mg Tablet
4 Dektrometorfan Tablet Tablet
5 Dektrometorfan sirup 10 mg/5 ml-60 Ml Botol
6 Gliseril Guayakolat tablet 100 mg Tablet
7 Kodein fosfat tablet 10 mg Tablet
8 Obat batuk anak 60 Ml / bromhexin sirup Botol
9 Obat batuk Hitam (OBH) Cairan -100 ml Botol
K ANTI ANEMIA 0
1 Tambah darah komb : Besi + as folat Tablet
L HEMOSTATIK 0
1 Asam Traneksamat 250mg/5ml Ampul
2 Asam Traneksamat 250 MG Tablet
3 Fitomenadion (Vit K1) inj 10 mg / ml-1ml Ampul
4 Fitomenadion (Vit K1) tablet gula 10 mg Tablet
M ANTIALERGI/IMUNOLOGIKUM 0
1 Anti Histamin/Loratadin Tablet
2 Cetirizin sirup 5 mg/5ml 60 ml Botol
3 Deksametason inj 5 mg/ml 1 ml Ampul
4 Deksametason Tablet 0,5 mg Tablet
5 Difenhidramin inj 10 mg/5 ml-1 ml Ampul
6 Klorfeniramin maleat (CTM) tablet 4 mg Tablet
7 Methylprednisolon 4 mg tablet Tablet
8 Prednison tab 5 mg Tablet
N ANTIKONVULSI/ANTIPARKINSON 0
1 Alprazolam tablet 0,5 mg Tablet
2 Amitriptilin HCl tab 25 mg Tablet
3 Fenitoin Na inj 50 mg/ml-2ml Ampul
4 Fenitoin Natrium kapsul 100 mg Kapsul
5 Flufenazin inj Ampul
6 Karbamazepin tablet 200 mg Tablet
7 Triheksifenidil Tablet 2 mg Tablet
O ANTIDEPRESAN 0
1 Diazepam inj 5 mg/ml - 2 ml Ampul
2 Diazepam tablet 2 mg Tablet
3 Fenobarbital inj 50 mg/ml-2ml Ampul
4 Fenobarbital tablet 30 mg Tablet
5 Haloperidol injeksi Ampul
6 Haloperidol 5 mg Tab Tablet
7 Klorpromazin HCl inj 5 mg/2cc Ampul
8 Klorpromazin HCl 100 mg Tablet
9 Risperidone 2 mg Tablet
10 Stesolid Rectal Supp
P ANTIMIGREN 0
1 Antimigren DOEN tab Tablet
2 Betahistin Mesilat tab 6 mg Tablet
Q ANTIDIABETIKUM 0
1 Glibenklamid tablet 5 mg Tablet
2 Glimepirida 1 mg Tablet
3 Metformin Tablet
R OBAT KULIT & OBAT LUAR 0
1 Asiklovir krim 5 % 5 gr Tube
2 Antibakteri DOEN salep komb Tube
3 Antifungi DOEN kombinasi salep Pot
4 Betametason krim 0,1 % Tube
5 Burnazin cream Tube
6 Chloramfecort Krim Tube
7 Gentamisin salep kulit Tube
 8 Gentian violet lar 1 % Botol
9 GOM Botol
10 Hidrokortison krim 2,5 % Tube
11 Kassa Penutup luka/lomatule Pieces
12 Ketokonazol (cream)10 gr Tube
13 Mikonazol krim Tube
14 Obat Luka Bakar Tube
15 Oksitetrasiklin 3% salep kulit Tube
16 Polikresulen ( Albothyl ) Botol
17 Salep 2-4 Pot
18 Salisil bedak 2 % Kotak
19 Scabiecid cream Tube
20 Trombophop salep Tube
S OBAT TELINGA 0
1 Fenol Glicerol Cair Botol
2 Kloramfenikol tetes telinga 3 % Botol
T OBAT MATA 0
1 Atropin sulfat tetes mata 0,5 % Botol
2 Cendoxitrol Tetes Mata Botol
3 Gentamisin tetes mata Botol
4 Kloramfenikol salep mata 1 % Tube
5 Obat edema kornea tetes mata/Optalgon Botol
6 Oksitetrasiklin salep mata Tube
7 Sulfasetamida Na tetes mata Botol
8 Tetracain Hcl 0,5 % Tetes Mata Botol
9 Timolol 0,5 % Tetes mata Botol
U ANTIHAEMORRHOID 0
1 Anti Hemoroid DOEN supp Supp
2 Anti Hemoroid kapsul Kapsul
V KARDIOVASKULUS/ ANTIHIPERTENSI 0
1 Amlodipin 5 mg Tablet
2 Aspar K Tablet
3 Bisoprolol 5 mg Tablet
4 Digoksin tablet 0,25 mg Tablet
5 Isorbid dinitrat tablet sublingual 5 mg Tablet
6 Kaptopril 25 mg Tablet
7 Kaptopril 12.5mg Tablet
8 Metildopa/dopamet Tablet
9 Nifedipin 10 mg tab Tablet
10 Nifedipin 20 mg tab Tablet
11 Propanolol HCl tablet 10 mg Tablet
12 Reserpin tab 0,25 mg Tablet
13 Tensi Gard Tablet
W DIURETIKUM 0
1 Furosemid tablet 40 mg Tablet
2 Hidroklortiazid (HCT) tablet 25 mg Tablet
3 Nefrolit kapsul Kapsul
X OKSITOSIKUM 0
1 Metilergometrin maleat inj 0,200 mg - 1 ml ampul
2 Metilergometrin maleat tab salut 0,125 mg Tablet
3 Oksitoksin inj 10 IU/ml - 1 ml ampul
4 Syntocinon ampul
Y ANTILIPIDEMIKUM 0
1 Simvastatin Tablet 10 mg Tablet
Z HORMON 0
1 Propiltiourasil tablet 100 mg Tablet
AA SYOK ANAFILAKTIK 0
1 Epinefrin / adrenalin inj 0,1 % - 1ml ampul
AB ANTELMINTIK 0
1 Pirantel tablet 125 Tablet
AC PELARUT & INFUS 0
1 Aqua pro inj steril @ 20 cc Botol
2 Cairan infus pengganti plasma/gelofusin Botol
 3 Dekstran 70 lar infus 6 % Botol
4 Glukosa lar infus 10 % Botol
5 Glukosa lar infus 40 % Botol
6 Glukosa lar infus 5 % Botol
7 KN - 3B SOL/KK Botol
8 Magnesium sulfat inj 25 ml -20 % Ampul
9 Magnesium sulfat inj 25 ml -40 % ampul
10 Manitol 20 % Botol
11 Metronidazole infus 500 mg/100ml Botol
12 Natrium Klorida Lar.infus 0,9 % steril Botol
13 Parasetamol Infus Botol
14 Ringer Laktat Larutan Infus Steril Botol
15 Siproploksasin infus Botol
AD ANTISEPTIKA & DESINFEKTAN 0
1 Bayclin Botol
2 Etakridin ( rivanol ) lar 0,1 % 300 cc Botol
3 Etanol 70 %1000 ml Botol
4 Etanol 70 %100 ml Botol
5 Lisol 5 % Botol
6 Povidon Iodine 10 % 60 ml Botol
7 Povidon Iodine 10 % 300 ml Botol
AE KB 0
1 Depo progestin/suntik KB Botol
AF ANTI INFLUENZA 0
1 Obat batuk pilek anak 60 ml (Paracetamol, Botol
AG Fenileprin
SERUM Hidroklorida, CTM, Kalium 0
1 sulfoguaiakolat)
Serum anti tetanus inj 1.500 IU/amp Vial
2 Serum anti tetanus inj 20.000 IU/vial Vial
3 Serum antibisa ular Polivalen inj 5 ml Vial
AH LAIN-LAIN 0
1 Atropin sulfat inj 0,25 mg / ml-1ml ampul
2 Atropin Sulfat Tablet 0,5 mg Tablet
3 Calsium gluconas inj ampul
4 Lidokain Jelly Tube
5 Jelly USG Botol
6 Natrium tiosulfat inj ampul
7 Nalokson Inj 0,4 mg/ml Botol
8 Oxycan Botol
OBAT PROGRAM 0
AI ANTI MALARIA 0
1 Artemeter injeksi ampul
2 Arterakine tablet Tablet
3 Artesunate injeksi ampul
4 Kuinin Dihidroklorida injeksi 25%-2 ml ampul
AJ GIZI 0
1 Zinc suspensi 60 ml Botol
2 Mineral Mix Sachet
3 Pan entral Sachet
4 Retinol ( vit A ) kapsul 100.000 unit Kapsul
5 Retinol ( vit A ) kapsul 200.000 unit Kapsul
6 Taburia Sachet
AK FILARIASIS 0
1 Anti Filaria Tablet ( Dietyl Karbamazepin ) Tablet
2 Albendazol tab 400 mg Tablet
AL ANTI LEPRA 0
1 MB Dewasa Blister
2 MB Anak Blister
3 PB Dewasa Blister
4 PB Anak Blister
AM OBAT TBC 0
1 INH 100 mg Tablet
2 Obat Anti Tuberkulosis FDC Kat 1 & 3 Paket
3 Obat Anti Tuberkulosis FDC Kat 2 Paket
 4 Obat Anti Tuberkulosis Kategori Anak Paket
5 Obat Anti Tuberkulosis Sisipan Paket
AN HEPATITIS 0
1 Vaksin HBIg / Hyperhep B Vial
AO VAKSIN 0
1 Vaksin BCG Vial
2 Vaksin Campak Vial
3 Vaksin DT Vial
4 Vaksin HB COM DPT Vial
5 Vaksin HB UNIJECT Syringe
6 Vaksin Polio Vial
7 Vaksin TT Vial
8 Vaksin TD Vial
9 Vaksin DPT HB HIB Vial
10 Polio IVP Vial
AP DENTAL 0
1 Air Raksa Dental Use Botol
2 Bonding Set
3 Carpul pieces
4 Celluloid strip pieces
5 Composite Set
6 Dentorit Botol
7 Descotan Forte (gigi) Botol
8 Devitalisasi Pasta (Non arsen) Botol
9 Etil klorida semprot 100 cc Botol
10 Etching/Extra gel Set
11 Eugenol Cairan Botol
12 Glass Ionomer Cement (GC IX) Botol
13 Jarum Citoject pieces
14 Kalsium Hidroksida pasta pieces
15 Lidokain inj komb ampul
16 Lining Cement pieces
17 Mata Bor pieces
18 Monoklorkamfer mentol cairan Botol
19 Mummifying Pasta Botol
20 Poles pieces
21 Semen seng fosfat serbuk cairan/Glas pieces
22 lonomer lineng semen
Serat pembeku darah pot
23 Silver amalgam serbuk 65-75 % Set
24 Spray pelumas handpiece Botol
25 Sulfa Stopping Fletcher(Fletcher) Set
26 Tissu steril pembersih alat gigi Botol
27 Topikal anestesi Botol
28 Trikresol formalin Botol
AQ Bahan Kimia 0
1 Hidrogen Peroksida (H2O2) Botol
2 Oil Imersi Botol
3 Oil Imersi Botol
4 Reagen Ziehl Neelsen Paket
5 Alkohol Swab pieces
6 PPD 2 TU Vial
7 Test Pack pieces
8 Stik Kolesterol pieces
9 Stik Asam Urat pieces
10 Stik Glukosa pieces
11 VIKIA HIV pieces
12 DI Anti HIV 1/2 pieces
13 Intec HIV III pieces
14 SD Bioline HIV Kit.1 Tes
15 Oncoprobe HIV.3 Tes
16 SD Bioline Shypilis Tes
17 RPR Shypilis (plasmatec) + RPR Component Tes
18 SD HbsAg Tes
AR Obat Tambahan
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PEMAKAIAN OBAT DINKES PUSKESMAS KRONJO
TAHUN 2017

PEMAKAIAN HARIAN PUSKESMAS

STOK PENERIM PERSEDI RATA-RATA
NO NAMA OBAT SATUAN APRIL 2017 MEI 2017 TOTAL JUMLAH HARI
AWAL AAN AAN PEMAKAIAN
26 27 28 29 30 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 PEMAKAIAN
1 Persediaan Bahan Pakai Habis
Persediaan Peralatan Kesehatan
1 Abbocath jarum infus 18 pieces
2 Abbocath jarum infus 20 pieces
3 Abbocath jarum infus 22 pieces
4 Abbocath jarum infus 24 pieces
5 Abbocath jarum infus 26 pieces
6 Alat Puyer Set
7 Alat suntik 0.05 cc pieces
8 Alat suntik 0.5 cc pieces
9 Alat suntik 1 cc pieces
10 Alat suntik 3 cc pieces
11 Alat suntik 5 cc pieces
12 Alat suntik 10 cc pieces
13 Alat suntik 20 cc pieces
14 Bisturi pieces
15 Blood Set Set
16 Catgut benang bedah no 2/0-3/0 pieces
17 Catgut benang bedah no 3/0 Roll
18 foley Catheter pieces
19 Hand Scond pieces
20 Infus set anak pieces
21 Infus set dewasa pieces
22 Jarum Hecting Kulit pieces
23 Jarum Hecting Otot pieces
24 Kaca Sediaan pieces
25 Kapas pembalut 250 mg Bungkus
26 Kasa Hidrofil 36 m x 80 cm Roll
27 Kasa Hidrofil Steril Kotak
28 Kasa Pembalut Hidrofil 4 x 10 cm Roll
29 KasaPembalut Hidrofil 4 x 5 Roll
30 Kertas Puyer pieces
31 Masker pieces
32 Nelaton catheter pieces
33 Pembalut gips Roll
34 Plester 5 yard x 2 inch Roll
35 Plester kertas / MICROPORE pieces
36 Pot Sputum pot
37 Safety Box pieces
38 Sarung Tangan Panjang Steril pieces
39 Silk ( Benang sutera ) no 3/0 pieces
40 Underpad pieces
41 Urine Bag ( Non Seteril ) pieces
42 Wing needle pieces
43 Lidi button pieces
44 Masker N95 8210 pieces
45 Masker nebulizer Anak pieces
46 Masker nebulizer dewasa pieces
47 NGT pieces
48 Oxigen nasal canule anak dan dewasa pieces
49 Plastik klip 7 x 10 pieces
50 Plastik klip 8 x 13 pieces
51 Pot Urine pot
52 Pot Fesses pot
53 Disposible Lancet pieces
54 Pen Lancet pieces
 55 Catgut Chromic SMI 2/D DS 24 mm pieces
56 Catgut Chromic SMI 3/D DS 26 mm pieces
57 Catgut Plain SMI 2/D DS 24 mm pieces
58 Catgut Plain SMI 3/D DS 24 mm pieces
0
2 Persediaan Bahan/Material
Bahan Obat-obatan 0

OBAT PKD 0
A ANTIBIOTIKA 0
1 Amoksilin kapsul 250 mg Kapsul
2 Amoksilin tab 500 mg Tablet
3 Amoksisilin s kering 125 mg / 5 cc 60 Ml Botol
4 Amoksisilin s kering 250 mg / 5 cc 60 Ml Botol
5 Asiklovir tab 200 gr Tablet
6 Asiklovir tab 400mg Tablet
7 Azitromisin 500 mg Tablet
8 Benzatin Benzil penisilin Vial
9 Cefixim 100 mg kapsul kapsul
10 Cefixime DS 100 mg/ 5ml Botol
11 Doksisiklin kapsul 100 mg Kapsul
12 Erytromisin sirup 60 Ml 200mg/5ml Botol
13 Erytromycin 250 mg Tablet
14 Erytromycin 500 mg Tablet
15 Fenoksimetil Penisilin tablet 250 mg Tablet
16 Fenoksimetil Penisilin tablet 500 mg Tablet
17 Flukonazol kapsul 150 mg Kapsul
18 Griseofulvin tablet 125 mg micronized Tablet
19 Ketokonazol tablet 200 mg Tablet
20 Klindamisin Kapsul 150 mg Kapsul
21 Klindamisin Kapsul 300 mg Kapsul
22 Kloramfenikol kapsul 250 mg Kapsul
23 Kloramfenikol sirup 60 Ml Botol
24 Kotrimoksazol Suspensi 60 Ml 40mg/5ml Botol
25 Kotrimoksazol Tablet Dewasa Tablet
26 Kotrimoksazol Tablet paed Tablet
27 Lincomysin 500 mg Kapsul
28 Metronidazol tablet 500 mg Tablet
29 Nistatin drop / Mycostatin, candistin, Nymiko Botol
30 Nistatin tablet salut gula 500.000 IU/g Tablet
31 Nistatin tablet vagina 100.000 IU/g Tablet
32 Sefadoksil 500 mg Tablet
33 Sefadoksil syrup 125ml/5ml Botol
34 Sefadoksil syrup 250ml/5ml Botol
35 Seftriaxsone 1 gr inj Vial
36 Siproploksasin tab 500 mg Tablet
37 Streptomycin inj 1 gram Vial
38 Tetrasiklin Kapsul 250 mg Kapsul
39 Tetrasiklin Kapsul 500 mg Tablet
40 Tiamfenikol kap 500 mg Tablet
B ANALGETIKA-ANTIPIRETIK-ANTIINFLAMASI 0
1 Alopurinol tablet 100 mg Tablet
2 Alopurinol tablet 300 mg Tablet
3 Antalgin ( Metampiron ) inj 250 mg/ 5 cc Ampul
4 Asam Mefenamat 250 Kapsul
5 Asam Mefenamat 500 Tablet
6 Asetosal Tablet 80 mg (Aspilet) Tablet
7 Ibuprofen Supp Supp
8 Ibuprofen Suspensi 200mg/5ml Botol
9 Ibuprofen tablet 200 mg Tablet
10 Ibuprofen tablet 400 mg Tablet
11 Kalium Diclofenak 50 mg Tablet
12 Ketoprofen Inj Ampul
13 Meloksixam tablet 15 mg Tablet
 14 Natrium Diclofenac tab 50 mg Tablet
15 Parasetamol 100 mg Tablet
16 Parasetamol Drop 15 ml Botol
17 Parasetamol sirup 120 mg / 5ml (60 Ml) Botol
18 Parasetamol tablet 500 mg Tablet
19 Tramadol tablet 50 mg Tablet
C DIGESTIVA 0
1 Antasida DOEN komb Tablet
2 Antasida sirup 60 Ml Botol
3 Lacto B Sachet
4 Mesoprostol 200 mg Tablet
5 Natrium Bikarbonat tablet 500 mg Tablet
6 Omeprazole 20 mg Kapsul
7 Ranitidin inj 25 mg/2ml Ampul
8 Ranitidin tablet 150 mg Tablet
9 Sucraflat sirup Botol
10 Vitazym tab Tablet
D ANTISPASMODIK 0
1 Chlordiazepoxide (Braxidin) Tablet
2 Ekstrak Belladon tablet 10 mg Tablet
3 Hyoscine-N-Butilbromida/Buscopan tablet Tablet
4 Buscopan Inj Ampul
5 Papaverin tablet Tablet
6 Spasminal Tablet
E LAKSATIVA 0
1 Bisacodil Tablet 5 mg Tablet
2 Bisacodil Tablet 5 mg Suppositoria Suppos
3 Laktulosa Syr 3,335g/5ml / Laktulak syrup Botol
F ANTIDIARE & ELEKTROLIT 0
1 Anti Diare Anak Tablet
2 Anti Diare Dewasa Tablet
3 Garam Oralit 200 ml air Sachet
4 Norit Tablet
G ANTIEMESIS 0
1 Dimenhidrinat tab 50 mg Tablet
2 Domperidon 10 mg tablet Tablet
3 Domperidon suspensi 5 mg/ml Botol
4 Metoclopramid Inj Ampul
5 Metoclopramid Syrup Botol
6 Metoclopramid 10 mg Tab Tablet
7 Ondansetron injeksi Ampul
8 Ondansetron tablet 4 mg Tablet
H OBAT METABOLISME (VITAMIN&MINERAL) 0
1 Asam Askorbat (VIT C) Tablet 50 mg Tablet
2 Asam folat 1 mg Tablet
3 Kalsium laktat (Kalk) tablet 500 mg Tablet
4 Multivitamin anak 60 Ml Botol
5 Multivitamin dewasa Tablet
6 Neurobion 5000 injeksi Ampul
7 Phitonadione pead injeksi Ampul
8 Piracetam 800 mg Tablet
9 Piridoksin HCl (Vit B6) tablet 10 mg Tablet
10 Sianokobalamin inj 500 mcg/ml-1ml Ampul
11 Sianokobalamin tab b12 Tablet
12 Tiamin HCL (Vit B1) inj 100 mg/ml-1ml Ampul
13 Tiamin HCL (Vit B1) tablet 50 mg Tablet
14 Vitamin B komplek Inj Ampul
15 Vitamin B komplek tab Tablet
I ANTI ASMA 0
1 Aminofilin inj 24 mg / cc Ampul
2 Aminofilin tab 200 mg Tablet
3 Bisolvon drop Botol
4 Bricasma Inj Ampul
 5 Efedrin HCl tablet 25 mg Tablet
6 Salbutamol tablet 4 mg Tablet
7 Salbutamol inhalasi ( Ventolin ) Nebule
J ANTITUSIVE & EKSPEKTORAN 0
1 Ambroksol sirup 60 ml Botol
2 Ambroksol tablet Tablet
3 Bromhexin tablet 8 mg Tablet
4 Dektrometorfan Tablet Tablet
5 Dektrometorfan sirup 10 mg/5 ml-60 Ml Botol
6 Gliseril Guayakolat tablet 100 mg Tablet
7 Kodein fosfat tablet 10 mg Tablet
8 Obat batuk anak 60 Ml / bromhexin sirup Botol
9 Obat batuk Hitam (OBH) Cairan -100 ml Botol
K ANTI ANEMIA 0
1 Tambah darah komb : Besi + as folat Tablet
L HEMOSTATIK 0
1 Asam Traneksamat 250mg/5ml Ampul
2 Asam Traneksamat 250 MG Tablet
3 Fitomenadion (Vit K1) inj 10 mg / ml-1ml Ampul
4 Fitomenadion (Vit K1) tablet gula 10 mg Tablet
M ANTIALERGI/IMUNOLOGIKUM 0
1 Anti Histamin/Loratadin Tablet
2 Cetirizin sirup 5 mg/5ml 60 ml Botol
3 Deksametason inj 5 mg/ml 1 ml Ampul
4 Deksametason Tablet 0,5 mg Tablet
5 Difenhidramin inj 10 mg/5 ml-1 ml Ampul
6 Klorfeniramin maleat (CTM) tablet 4 mg Tablet
7 Methylprednisolon 4 mg tablet Tablet
8 Prednison tab 5 mg Tablet
N ANTIKONVULSI/ANTIPARKINSON 0
1 Alprazolam tablet 0,5 mg Tablet
2 Amitriptilin HCl tab 25 mg Tablet
3 Fenitoin Na inj 50 mg/ml-2ml Ampul
4 Fenitoin Natrium kapsul 100 mg Kapsul
5 Flufenazin inj Ampul
6 Karbamazepin tablet 200 mg Tablet
7 Triheksifenidil Tablet 2 mg Tablet
O ANTIDEPRESAN 0
1 Diazepam inj 5 mg/ml - 2 ml Ampul
2 Diazepam tablet 2 mg Tablet
3 Fenobarbital inj 50 mg/ml-2ml Ampul
4 Fenobarbital tablet 30 mg Tablet
5 Haloperidol injeksi Ampul
6 Haloperidol 5 mg Tab Tablet
7 Klorpromazin HCl inj 5 mg/2cc Ampul
8 Klorpromazin HCl 100 mg Tablet
9 Risperidone 2 mg Tablet
10 Stesolid Rectal Supp
P ANTIMIGREN 0
1 Antimigren DOEN tab Tablet
2 Betahistin Mesilat tab 6 mg Tablet
Q ANTIDIABETIKUM 0
1 Glibenklamid tablet 5 mg Tablet
2 Glimepirida 1 mg Tablet
3 Metformin Tablet
R OBAT KULIT & OBAT LUAR 0
1 Asiklovir krim 5 % 5 gr Tube
2 Antibakteri DOEN salep komb Tube
3 Antifungi DOEN kombinasi salep Pot
4 Betametason krim 0,1 % Tube
5 Burnazin cream Tube
6 Chloramfecort Krim Tube
7 Gentamisin salep kulit Tube
 8 Gentian violet lar 1 % Botol
9 GOM Botol
10 Hidrokortison krim 2,5 % Tube
11 Kassa Penutup luka/lomatule Pieces
12 Ketokonazol (cream)10 gr Tube
13 Mikonazol krim Tube
14 Obat Luka Bakar Tube
15 Oksitetrasiklin 3% salep kulit Tube
16 Polikresulen ( Albothyl ) Botol
17 Salep 2-4 Pot
18 Salisil bedak 2 % Kotak
19 Scabiecid cream Tube
20 Trombophop salep Tube
S OBAT TELINGA 0
1 Fenol Glicerol Cair Botol
2 Kloramfenikol tetes telinga 3 % Botol
T OBAT MATA 0
1 Atropin sulfat tetes mata 0,5 % Botol
2 Cendoxitrol Tetes Mata Botol
3 Gentamisin tetes mata Botol
4 Kloramfenikol salep mata 1 % Tube
5 Obat edema kornea tetes mata/Optalgon Botol
6 Oksitetrasiklin salep mata Tube
7 Sulfasetamida Na tetes mata Botol
8 Tetracain Hcl 0,5 % Tetes Mata Botol
9 Timolol 0,5 % Tetes mata Botol
U ANTIHAEMORRHOID 0
1 Anti Hemoroid DOEN supp Supp
2 Anti Hemoroid kapsul Kapsul
V KARDIOVASKULUS/ ANTIHIPERTENSI 0
1 Amlodipin 5 mg Tablet
2 Aspar K Tablet
3 Bisoprolol 5 mg Tablet
4 Digoksin tablet 0,25 mg Tablet
5 Isorbid dinitrat tablet sublingual 5 mg Tablet
6 Kaptopril 25 mg Tablet
7 Kaptopril 12.5mg Tablet
8 Metildopa/dopamet Tablet
9 Nifedipin 10 mg tab Tablet
10 Nifedipin 20 mg tab Tablet
11 Propanolol HCl tablet 10 mg Tablet
12 Reserpin tab 0,25 mg Tablet
13 Tensi Gard Tablet
W DIURETIKUM 0
1 Furosemid tablet 40 mg Tablet
2 Hidroklortiazid (HCT) tablet 25 mg Tablet
3 Nefrolit kapsul Kapsul
X OKSITOSIKUM 0
1 Metilergometrin maleat inj 0,200 mg - 1 ml ampul
2 Metilergometrin maleat tab salut 0,125 mg Tablet
3 Oksitoksin inj 10 IU/ml - 1 ml ampul
4 Syntocinon ampul
Y ANTILIPIDEMIKUM 0
1 Simvastatin Tablet 10 mg Tablet
Z HORMON 0
1 Propiltiourasil tablet 100 mg Tablet
AA SYOK ANAFILAKTIK 0
1 Epinefrin / adrenalin inj 0,1 % - 1ml ampul
AB ANTELMINTIK 0
1 Pirantel tablet 125 Tablet
AC PELARUT & INFUS 0
1 Aqua pro inj steril @ 20 cc Botol
2 Cairan infus pengganti plasma/gelofusin Botol
 3 Dekstran 70 lar infus 6 % Botol
4 Glukosa lar infus 10 % Botol
5 Glukosa lar infus 40 % Botol
6 Glukosa lar infus 5 % Botol
7 KN - 3B SOL/KK Botol
8 Magnesium sulfat inj 25 ml -20 % Ampul
9 Magnesium sulfat inj 25 ml -40 % ampul
10 Manitol 20 % Botol
11 Metronidazole infus 500 mg/100ml Botol
12 Natrium Klorida Lar.infus 0,9 % steril Botol
13 Parasetamol Infus Botol
14 Ringer Laktat Larutan Infus Steril Botol
15 Siproploksasin infus Botol
AD ANTISEPTIKA & DESINFEKTAN 0
1 Bayclin Botol
2 Etakridin ( rivanol ) lar 0,1 % 300 cc Botol
3 Etanol 70 %1000 ml Botol
4 Etanol 70 %100 ml Botol
5 Lisol 5 % Botol
6 Povidon Iodine 10 % 60 ml Botol
7 Povidon Iodine 10 % 300 ml Botol
AE KB 0
1 Depo progestin/suntik KB Botol
AF ANTI INFLUENZA 0
1 Obat batuk pilek anak 60 ml (Paracetamol, Botol
AG Fenileprin
SERUM Hidroklorida, CTM, Kalium 0
1 sulfoguaiakolat)
Serum anti tetanus inj 1.500 IU/amp Vial
2 Serum anti tetanus inj 20.000 IU/vial Vial
3 Serum antibisa ular Polivalen inj 5 ml Vial
AH LAIN-LAIN 0
1 Atropin sulfat inj 0,25 mg / ml-1ml ampul
2 Atropin Sulfat Tablet 0,5 mg Tablet
3 Calsium gluconas inj ampul
4 Lidokain Jelly Tube
5 Jelly USG Botol
6 Natrium tiosulfat inj ampul
7 Nalokson Inj 0,4 mg/ml Botol
8 Oxycan Botol
OBAT PROGRAM 0
AI ANTI MALARIA 0
1 Artemeter injeksi ampul
2 Arterakine tablet Tablet
3 Artesunate injeksi ampul
4 Kuinin Dihidroklorida injeksi 25%-2 ml ampul
AJ GIZI 0
1 Zinc suspensi 60 ml Botol
2 Mineral Mix Sachet
3 Pan entral Sachet
4 Retinol ( vit A ) kapsul 100.000 unit Kapsul
5 Retinol ( vit A ) kapsul 200.000 unit Kapsul
6 Taburia Sachet
AK FILARIASIS 0
1 Anti Filaria Tablet ( Dietyl Karbamazepin ) Tablet
2 Albendazol tab 400 mg Tablet
AL ANTI LEPRA 0
1 MB Dewasa Blister
2 MB Anak Blister
3 PB Dewasa Blister
4 PB Anak Blister
AM OBAT TBC 0
1 INH 100 mg Tablet
2 Obat Anti Tuberkulosis FDC Kat 1 & 3 Paket
3 Obat Anti Tuberkulosis FDC Kat 2 Paket
 4 Obat Anti Tuberkulosis Kategori Anak Paket
5 Obat Anti Tuberkulosis Sisipan Paket
AN HEPATITIS 0
1 Vaksin HBIg / Hyperhep B Vial
AO VAKSIN 0
1 Vaksin BCG Vial
2 Vaksin Campak Vial
3 Vaksin DT Vial
4 Vaksin HB COM DPT Vial
5 Vaksin HB UNIJECT Syringe
6 Vaksin Polio Vial
7 Vaksin TT Vial
8 Vaksin TD Vial
9 Vaksin DPT HB HIB Vial
10 Polio IVP Vial
AP DENTAL 0
1 Air Raksa Dental Use Botol
2 Bonding Set
3 Carpul pieces
4 Celluloid strip pieces
5 Composite Set
6 Dentorit Botol
7 Descotan Forte (gigi) Botol
8 Devitalisasi Pasta (Non arsen) Botol
9 Etil klorida semprot 100 cc Botol
10 Etching/Extra gel Set
11 Eugenol Cairan Botol
12 Glass Ionomer Cement (GC IX) Botol
13 Jarum Citoject pieces
14 Kalsium Hidroksida pasta pieces
15 Lidokain inj komb ampul
16 Lining Cement pieces
17 Mata Bor pieces
18 Monoklorkamfer mentol cairan Botol
19 Mummifying Pasta Botol
20 Poles pieces
21 Semen seng fosfat serbuk cairan/Glas pieces
22 lonomer lineng semen
Serat pembeku darah pot
23 Silver amalgam serbuk 65-75 % Set
24 Spray pelumas handpiece Botol
25 Sulfa Stopping Fletcher(Fletcher) Set
26 Tissu steril pembersih alat gigi Botol
27 Topikal anestesi Botol
28 Trikresol formalin Botol
AQ Bahan Kimia 0
1 Hidrogen Peroksida (H2O2) Botol
2 Oil Imersi Botol
3 Oil Imersi Botol
4 Reagen Ziehl Neelsen Paket
5 Alkohol Swab pieces
6 PPD 2 TU Vial
7 Test Pack pieces
8 Stik Kolesterol pieces
9 Stik Asam Urat pieces
10 Stik Glukosa pieces
11 VIKIA HIV pieces
12 DI Anti HIV 1/2 pieces
13 Intec HIV III pieces
14 SD Bioline HIV Kit.1 Tes
15 Oncoprobe HIV.3 Tes
16 SD Bioline Shypilis Tes
17 RPR Shypilis (plasmatec) + RPR Component Tes
18 SD HbsAg Tes
AR Obat Tambahan
1
2
3
4
5
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS

INSTANSI : DINAS KESEHATAN

NO. DOK TANGGAL DOKUMEN
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN/TAHUN : PKM
KABUPATEN : PERMINTAAN BULAN/TAHUN : IFK

Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
1 Persediaan Bahan Pakai Habis
Persediaan Peralatan Kesehatan
1 Abbocath jarum infus 18 pieces
2 Abbocath jarum infus 20 pieces
3 Abbocath jarum infus 22 pieces
4 Abbocath jarum infus 24 pieces
5 Abbocath jarum infus 26 pieces
6 Alat Puyer Set
7 Alat suntik 0.05 cc pieces
8 Alat suntik 0.5 cc pieces
9 Alat suntik 1 cc pieces
10 Alat suntik 3 cc pieces
11 Alat suntik 5 cc pieces
12 Alat suntik 10 cc pieces
13 Alat suntik 20 cc pieces
14 Bisturi pieces
15 Blood Set Set
16 Catgut benang bedah no 2/0-3/0 pieces
17 Catgut benang bedah no 3/0 Roll
18 foley Catheter pieces
19 Hand Scond pieces
20 Infus set anak pieces
21 Infus set dewasa pieces
22 Jarum Hecting Kulit pieces
23 Jarum Hecting Otot pieces
24 Kaca Sediaan pieces
25 Kapas pembalut 250 mg Bungkus
26 Kasa Hidrofil 36 m x 80 cm Roll
27 Kasa Hidrofil Steril Kotak
28 Kasa Pembalut Hidrofil 4 x 10 cm Roll
29 KasaPembalut Hidrofil 4 x 5 Roll
30 Kertas Puyer pieces
31 Masker pieces
32 Nelaton catheter pieces
33 Pembalut gips Roll
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
34 Plester 5 yard x 2 inch Roll
35 Plester kertas / MICROPORE pieces
36 Pot Sputum pot
37 Safety Box pieces
38 Sarung Tangan Panjang Steril pieces
39 Silk ( Benang sutera ) no 3/0 pieces
40 Underpad pieces
41 Urine Bag ( Non Seteril ) pieces
42 Wing needle pieces
43 Lidi button pieces
44 Masker N95 8210 pieces
45 Masker nebulizer Anak pieces
46 Masker nebulizer dewasa pieces
47 NGT pieces
48 Oxigen nasal canule anak dan dewasa pieces
49 Plastik klip 7 x 10 pieces
50 Plastik klip 8 x 13 pieces
51 Pot Urine pot
52 Pot Fesses pot
53 Disposible Lancet pieces
54 Pen Lancet pieces
55 Catgut Chromic SMI 2/D DS 24 mm pieces
56 Catgut Chromic SMI 3/D DS 26 mm pieces
57 Catgut Plain SMI 2/D DS 24 mm pieces
58 Catgut Plain SMI 3/D DS 24 mm pieces
2 Persediaan Bahan/Material 0
0 Bahan Obat-obatan 0
0 OBAT PKD 0
A ANTIBIOTIKA 0
1 Amoksilin kapsul 250 mg Kapsul
2 Amoksilin tab 500 mg Tablet
3 Amoksisilin s kering 125 mg / 5 cc 60 Ml Botol
4 Amoksisilin s kering 250 mg / 5 cc 60 Ml Botol
5 Asiklovir tab 200 gr Tablet
6 Asiklovir tab 400mg Tablet
7 Azitromisin 500 mg Tablet
8 Benzatin Benzil penisilin Vial
9 Cefixim 100 mg kapsul kapsul
10 Cefixime DS 100 mg/ 5ml Botol
11 Doksisiklin kapsul 100 mg Kapsul
12 Erytromisin sirup 60 Ml 200mg/5ml Botol
13 Erytromycin 250 mg Tablet
14 Erytromycin 500 mg Tablet
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
15 Fenoksimetil Penisilin tablet 250 mg Tablet
16 Fenoksimetil Penisilin tablet 500 mg Tablet
17 Flukonazol kapsul 150 mg Kapsul
18 Griseofulvin tablet 125 mg micronized Tablet
19 Ketokonazol tablet 200 mg Tablet
20 Klindamisin Kapsul 150 mg Kapsul
21 Klindamisin Kapsul 300 mg Kapsul
22 Kloramfenikol kapsul 250 mg Kapsul
23 Kloramfenikol sirup 60 Ml Botol
24 Kotrimoksazol Suspensi 60 Ml 40mg/5ml Botol
25 Kotrimoksazol Tablet Dewasa Tablet
26 Kotrimoksazol Tablet paed Tablet
27 Lincomysin 500 mg Kapsul
28 Metronidazol tablet 500 mg Tablet
29 Nistatin drop / Mycostatin, candistin, Nymiko Botol
30 Nistatin tablet salut gula 500.000 IU/g Tablet
31 Nistatin tablet vagina 100.000 IU/g Tablet
32 Sefadoksil 500 mg Tablet
33 Sefadoksil syrup 125ml/5ml Botol
34 Sefadoksil syrup 250ml/5ml Botol
35 Seftriaxsone 1 gr inj Vial
36 Siproploksasin tab 500 mg Tablet
37 Streptomycin inj 1 gram Vial
38 Tetrasiklin Kapsul 250 mg Kapsul
39 Tetrasiklin Kapsul 500 mg Tablet
40 Tiamfenikol kap 500 mg Tablet
B ANALGETIKA-ANTIPIRETIK-ANTIINFLAMASI 0
1 Alopurinol tablet 100 mg Tablet
2 Alopurinol tablet 300 mg Tablet
3 Antalgin ( Metampiron ) inj 250 mg/ 5 cc Ampul
4 Asam Mefenamat 250 Kapsul
5 Asam Mefenamat 500 Tablet
6 Asetosal Tablet 80 mg (Aspilet) Tablet
7 Ibuprofen Supp Supp
8 Ibuprofen Suspensi 200mg/5ml Botol
9 Ibuprofen tablet 200 mg Tablet
10 Ibuprofen tablet 400 mg Tablet
11 Kalium Diclofenak 50 mg Tablet
12 Ketoprofen Inj Ampul
13 Meloksixam tablet 15 mg Tablet
14 Natrium Diclofenac tab 50 mg Tablet
15 Parasetamol 100 mg Tablet
16 Parasetamol Drop 15 ml Botol
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
17 Parasetamol sirup 120 mg / 5ml (60 Ml) Botol
18 Parasetamol tablet 500 mg Tablet
19 Tramadol tablet 50 mg Tablet
C DIGESTIVA 0
1 Antasida DOEN komb Tablet
2 Antasida sirup 60 Ml Botol
3 Lacto B Sachet
4 Mesoprostol 200 mg Tablet
5 Natrium Bikarbonat tablet 500 mg Tablet
6 Omeprazole 20 mg Kapsul
7 Ranitidin inj 25 mg/2ml Ampul
8 Ranitidin tablet 150 mg Tablet
9 Sucraflat sirup Botol
10 Vitazym tab Tablet
D ANTISPASMODIK 0
1 Chlordiazepoxide (Braxidin) Tablet
2 Ekstrak Belladon tablet 10 mg Tablet
3 Hyoscine-N-Butilbromida/Buscopan tablet Tablet
4 Buscopan Inj Ampul
5 Papaverin tablet Tablet
6 Spasminal Tablet
E LAKSATIVA 0
1 Bisacodil Tablet 5 mg Tablet
2 Bisacodil Tablet 5 mg Suppositoria Suppos
3 Laktulosa Syr 3,335g/5ml / Laktulak syrup Botol
F ANTIDIARE & ELEKTROLIT 0
1 Anti Diare Anak Tablet
2 Anti Diare Dewasa Tablet
3 Garam Oralit 200 ml air Sachet
4 Norit Tablet
G ANTIEMESIS 0
1 Dimenhidrinat tab 50 mg Tablet
2 Domperidon 10 mg tablet Tablet
3 Domperidon suspensi 5 mg/ml Botol
4 Metoclopramid Inj Ampul
5 Metoclopramid Syrup Botol
6 Metoclopramid 10 mg Tab Tablet
7 Ondansetron injeksi Ampul
8 Ondansetron tablet 4 mg Tablet
H OBAT METABOLISME (VITAMIN&MINERAL) 0
1 Asam Askorbat (VIT C) Tablet 50 mg Tablet
2 Asam folat 1 mg Tablet
3 Kalsium laktat (Kalk) tablet 500 mg Tablet
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
4 Multivitamin anak 60 Ml Botol
5 Multivitamin dewasa Tablet
6 Neurobion 5000 injeksi Ampul
7 Phitonadione pead injeksi Ampul
8 Piracetam 800 mg Tablet
9 Piridoksin HCl (Vit B6) tablet 10 mg Tablet
10 Sianokobalamin inj 500 mcg/ml-1ml Ampul
11 Sianokobalamin tab b12 Tablet
12 Tiamin HCL (Vit B1) inj 100 mg/ml-1ml Ampul
13 Tiamin HCL (Vit B1) tablet 50 mg Tablet
14 Vitamin B komplek Inj Ampul
15 Vitamin B komplek tab Tablet
I ANTI ASMA 0
1 Aminofilin inj 24 mg / cc Ampul
2 Aminofilin tab 200 mg Tablet
3 Bisolvon drop Botol
4 Bricasma Inj Ampul
5 Efedrin HCl tablet 25 mg Tablet
6 Salbutamol tablet 4 mg Tablet
7 Salbutamol inhalasi ( Ventolin ) Nebule
J ANTITUSIVE & EKSPEKTORAN 0
1 Ambroksol sirup 60 ml Botol
2 Ambroksol tablet Tablet
3 Bromhexin tablet 8 mg Tablet
4 Dektrometorfan Tablet Tablet
5 Dektrometorfan sirup 10 mg/5 ml-60 Ml Botol
6 Gliseril Guayakolat tablet 100 mg Tablet
7 Kodein fosfat tablet 10 mg Tablet
8 Obat batuk anak 60 Ml / bromhexin sirup Botol
9 Obat batuk Hitam (OBH) Cairan -100 ml Botol
K ANTI ANEMIA 0
1 Tambah darah komb : Besi + as folat Tablet
L HEMOSTATIK 0
1 Asam Traneksamat 250mg/5ml Ampul
2 Asam Traneksamat 250 MG Tablet
3 Fitomenadion (Vit K1) inj 10 mg / ml-1ml Ampul
4 Fitomenadion (Vit K1) tablet gula 10 mg Tablet
M ANTIALERGI/IMUNOLOGIKUM 0
1 Anti Histamin/Loratadin Tablet
2 Cetirizin sirup 5 mg/5ml 60 ml Botol
3 Deksametason inj 5 mg/ml 1 ml Ampul
4 Deksametason Tablet 0,5 mg Tablet
5 Difenhidramin inj 10 mg/5 ml-1 ml Ampul
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
6 Klorfeniramin maleat (CTM) tablet 4 mg Tablet
7 Methylprednisolon 4 mg tablet Tablet
8 Prednison tab 5 mg Tablet
N ANTIKONVULSI/ANTIPARKINSON 0
1 Alprazolam tablet 0,5 mg Tablet
2 Amitriptilin HCl tab 25 mg Tablet
3 Fenitoin Na inj 50 mg/ml-2ml Ampul
4 Fenitoin Natrium kapsul 100 mg Kapsul
5 Flufenazin inj Ampul
6 Karbamazepin tablet 200 mg Tablet
7 Triheksifenidil Tablet 2 mg Tablet
O ANTIDEPRESAN 0
1 Diazepam inj 5 mg/ml - 2 ml Ampul
2 Diazepam tablet 2 mg Tablet
3 Fenobarbital inj 50 mg/ml-2ml Ampul
4 Fenobarbital tablet 30 mg Tablet
5 Haloperidol injeksi Ampul
6 Haloperidol 5 mg Tab Tablet
7 Klorpromazin HCl inj 5 mg/2cc Ampul
8 Klorpromazin HCl 100 mg Tablet
9 Risperidone 2 mg Tablet
10 Stesolid Rectal Supp
P ANTIMIGREN 0
1 Antimigren DOEN tab Tablet
2 Betahistin Mesilat tab 6 mg Tablet
Q ANTIDIABETIKUM 0
1 Glibenklamid tablet 5 mg Tablet
2 Glimepirida 1 mg Tablet
3 Metformin Tablet
R OBAT KULIT & OBAT LUAR 0
1 Asiklovir krim 5 % 5 gr Tube
2 Antibakteri DOEN salep komb Tube
3 Antifungi DOEN kombinasi salep Pot
4 Betametason krim 0,1 % Tube
5 Burnazin cream Tube
6 Chloramfecort Krim Tube
7 Gentamisin salep kulit Tube
8 Gentian violet lar 1 % Botol
9 GOM Botol
10 Hidrokortison krim 2,5 % Tube
11 Kassa Penutup luka/lomatule Pieces
12 Ketokonazol (cream)10 gr Tube
13 Mikonazol krim Tube
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
14 Obat Luka Bakar Tube
15 Oksitetrasiklin 3% salep kulit Tube
16 Polikresulen ( Albothyl ) Botol
17 Salep 2-4 Pot
18 Salisil bedak 2 % Kotak
19 Scabiecid cream Tube
20 Trombophop salep Tube
S OBAT TELINGA 0
1 Fenol Glicerol Cair Botol
2 Kloramfenikol tetes telinga 3 % Botol
T OBAT MATA 0
1 Atropin sulfat tetes mata 0,5 % Botol
2 Cendoxitrol Tetes Mata Botol
3 Gentamisin tetes mata Botol
4 Kloramfenikol salep mata 1 % Tube
5 Obat edema kornea tetes mata/Optalgon Botol
6 Oksitetrasiklin salep mata Tube
7 Sulfasetamida Na tetes mata Botol
8 Tetracain Hcl 0,5 % Tetes Mata Botol
9 Timolol 0,5 % Tetes mata Botol
U ANTIHAEMORRHOID 0
1 Anti Hemoroid DOEN supp Supp
2 Anti Hemoroid kapsul Kapsul
V KARDIOVASKULUS/ ANTIHIPERTENSI 0
1 Amlodipin 5 mg Tablet
2 Aspar K Tablet
3 Bisoprolol 5 mg Tablet
4 Digoksin tablet 0,25 mg Tablet
5 Isorbid dinitrat tablet sublingual 5 mg Tablet
6 Kaptopril 25 mg Tablet
7 Kaptopril 12.5mg Tablet
8 Metildopa/dopamet Tablet
9 Nifedipin 10 mg tab Tablet
10 Nifedipin 20 mg tab Tablet
11 Propanolol HCl tablet 10 mg Tablet
12 Reserpin tab 0,25 mg Tablet
13 Tensi Gard Tablet
W DIURETIKUM 0
1 Furosemid tablet 40 mg Tablet
2 Hidroklortiazid (HCT) tablet 25 mg Tablet
3 Nefrolit kapsul Kapsul
X OKSITOSIKUM 0
1 Metilergometrin maleat inj 0,200 mg - 1 ml ampul
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
2 Metilergometrin maleat tab salut 0,125 mg Tablet
3 Oksitoksin inj 10 IU/ml - 1 ml ampul
4 Syntocinon ampul
Y ANTILIPIDEMIKUM 0
1 Simvastatin Tablet 10 mg Tablet
Z HORMON 0
1 Propiltiourasil tablet 100 mg Tablet
AA SYOK ANAFILAKTIK 0
1 Epinefrin / adrenalin inj 0,1 % - 1ml ampul
AB ANTELMINTIK 0
1 Pirantel tablet 125 Tablet
AC PELARUT & INFUS 0
1 Aqua pro inj steril @ 20 cc Botol
2 Cairan infus pengganti plasma/gelofusin Botol
3 Dekstran 70 lar infus 6 % Botol
4 Glukosa lar infus 10 % Botol
5 Glukosa lar infus 40 % Botol
6 Glukosa lar infus 5 % Botol
7 KN - 3B SOL/KK Botol
8 Magnesium sulfat inj 25 ml -20 % Ampul
9 Magnesium sulfat inj 25 ml -40 % ampul
10 Manitol 20 % Botol
11 Metronidazole infus 500 mg/100ml Botol
12 Natrium Klorida Lar.infus 0,9 % steril Botol
13 Parasetamol Infus Botol
14 Ringer Laktat Larutan Infus Steril Botol
15 Siproploksasin infus Botol
AD ANTISEPTIKA & DESINFEKTAN 0
1 Bayclin Botol
2 Etakridin ( rivanol ) lar 0,1 % 300 cc Botol
3 Etanol 70 %1000 ml Botol
4 Etanol 70 %100 ml Botol
5 Lisol 5 % Botol
6 Povidon Iodine 10 % 60 ml Botol
7 Povidon Iodine 10 % 300 ml Botol
AE KB 0
1 Depo progestin/suntik KB Botol
AF ANTI INFLUENZA 0
1 Obat batuk pilek anak 60 ml (Paracetamol, Fenil Botol
AG SERUM 0
1 Serum anti tetanus inj 1.500 IU/amp Vial
2 Serum anti tetanus inj 20.000 IU/vial Vial
3 Serum antibisa ular Polivalen inj 5 ml Vial
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
AH LAIN-LAIN 0
1 Atropin sulfat inj 0,25 mg / ml-1ml ampul
2 Atropin Sulfat Tablet 0,5 mg Tablet
3 Calsium gluconas inj ampul
4 Lidokain Jelly Tube
5 Jelly USG Botol
6 Natrium tiosulfat inj ampul
7 Nalokson Inj 0,4 mg/ml Botol
8 Oxycan Botol
0 OBAT PROGRAM 0
AI ANTI MALARIA 0
1 Artemeter injeksi ampul
2 Arterakine tablet Tablet
3 Artesunate injeksi ampul
4 Kuinin Dihidroklorida injeksi 25%-2 ml ampul
AJ GIZI 0
1 Zinc suspensi 60 ml Botol
2 Mineral Mix Sachet
3 Pan entral Sachet
4 Retinol ( vit A ) kapsul 100.000 unit Kapsul
5 Retinol ( vit A ) kapsul 200.000 unit Kapsul
6 Taburia Sachet
AK FILARIASIS 0
1 Anti Filaria Tablet ( Dietyl Karbamazepin ) Tablet
2 Albendazol tab 400 mg Tablet
AL ANTI LEPRA 0
1 MB Dewasa Blister
2 MB Anak Blister
3 PB Dewasa Blister
4 PB Anak Blister
AM OBAT TBC 0
1 INH 100 mg Tablet
2 Obat Anti Tuberkulosis FDC Kat 1 & 3 Paket
3 Obat Anti Tuberkulosis FDC Kat 2 Paket
4 Obat Anti Tuberkulosis Kategori Anak Paket
5 Obat Anti Tuberkulosis Sisipan Paket
AN HEPATITIS 0
1 Vaksin HBIg / Hyperhep B Vial
AO VAKSIN 0
1 Vaksin BCG Vial
2 Vaksin Campak Vial
3 Vaksin DT Vial
4 Vaksin HB COM DPT Vial
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
5 Vaksin HB UNIJECT Syringe
6 Vaksin Polio Vial
7 Vaksin TT Vial
8 Vaksin TD Vial
9 Vaksin DPT HB HIB Vial
10 Polio IVP Vial
AP DENTAL 0
1 Air Raksa Dental Use Botol
2 Bonding Set
3 Carpul pieces
4 Celluloid strip pieces
5 Composite Set
6 Dentorit Botol
7 Descotan Forte (gigi) Botol
8 Devitalisasi Pasta (Non arsen) Botol
9 Etil klorida semprot 100 cc Botol
10 Etching/Extra gel Set
11 Eugenol Cairan Botol
12 Glass Ionomer Cement (GC IX) Botol
13 Jarum Citoject pieces
14 Kalsium Hidroksida pasta pieces
15 Lidokain inj komb ampul
16 Lining Cement pieces
17 Mata Bor pieces
18 Monoklorkamfer mentol cairan Botol
19 Mummifying Pasta Botol
20 Poles pieces
21 Semen seng fosfat serbuk cairan/Glas lonomer pieces
22 Serat pembeku darah pot
23 Silver amalgam serbuk 65-75 % Set
24 Spray pelumas handpiece Botol
25 Sulfa Stopping Fletcher(Fletcher) Set
26 Tissu steril pembersih alat gigi Botol
27 Topikal anestesi Botol
28 Trikresol formalin Botol
AQ Bahan Kimia 0
1 Hidrogen Peroksida (H2O2) Botol
2 Oil Imersi Botol
3 Oil Imersi Botol
4 Reagen Ziehl Neelsen Paket
5 Alkohol Swab pieces
6 PPD 2 TU Vial
7 Test Pack pieces
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
8 Stik Kolesterol pieces
9 Stik Asam Urat pieces
10 Stik Glukosa pieces
11 VIKIA HIV pieces
12 DI Anti HIV 1/2 pieces
13 Intec HIV III pieces
14 SD Bioline HIV Kit.1 Tes
15 Oncoprobe HIV.3 Tes
16 SD Bioline Shypilis Tes
17 RPR Shypilis (plasmatec) + RPR Component Tes
18 SD HbsAg Tes
AR Obat Tambahan
1
2
3
4
5
 Satuan Stok Awal Penerimaan Persediaan Pemakaian Jumlah Hari Pakai Stok Akhir
NO Nama Obat Stok Opt Permintaan Pemberian
Kemasan DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN DINKES JKN
 JUMLAH KUNJUNGAN
PASIEN PUSKESMAS KRONJO TAHUN 2017

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CATATAN : DIISI SETIAP TANGGAL 26