Senin 1 Feb 2015 Rapat Persediaan Obat 2015

LAPORAN PERSEDIAAN OBAT PUSKESMAS ……………………..
31 DESEMBER 2015
SISA STOK 31 DES.

NO. NAMA OBAT SATUAN HARGA 2015 JUMLAH HARGA
1 2 3 4 5 6 (4x5)
ACT (Artesunate 50mg+ Amodiaquin
1 tab. 1,049.00 -
200mg)
2 Air Raksa dental use 100 gram 250,000.00 -
3 Albendazol tab. 400 mg. tab. 230.98 -
4 Alopurinol tablet 100 mg tab. 90.00 -
5 Ambroxol sirup 15 mg/ml btl 60 ml 2,665.00 -
6 Ambroxol tablet 30 mg tab. 89.31 -
7 Aminofilin injeksi 24mg/ml - 10 ml amp 4,204.00 -
8 Aminofilin tablet 200 mg tab. 86.00 -
9 Amitriptilin HCl tablet salut 25 mg tab. 123.00 -
10 Amlodipin 10 mg tab. 352.00 -
11 Amoksisilin kaplet 500 mg kapl 279.00 -
12 Amoksisilin sirup kering 125mg/5ml btl 60 ml 2,560.00 -
13 Amoksisillin sirup kering 250 mg/5 ml. btl 60 ml. 4,730.00 -
14 Ampisillin serbuk Inj. i.m/i.v 1000 vial 5,181.00 -

mg/ml.
15 Antalgin (Metampiron) tablet 500 mg tab. 132.99 -
16 Antasida DOEN sirup btl 60 ml 2,300.00 -
17 Antasida DOEN tablet tab. 78.00 -
18 Anti Bakteri DOEN kombinasi tub 2,767.00 -
19 Antifungi DOEN kombinasi 3 - 6 pot 2,096.00 -
20 Antihemoroid DOEN kombinasi supp. 3,350.00 -
21
Antimigren DOEN kombinasi (Ergotamin) tab. 149.00 -
22 Artemeter inj. amp 24,384.00 -
23 Arterakine tab. - -
24 Asam Ascorbat (vit. C) tablet 50 mg tab. 105.00 -
25 Asam Mefenamat tablet 500 mg tab. 127.00 -
26 Asiklovir krim 5% tube 5 gr 2,367.00 -
27 Asiklovir tablet 200 mg. tab. 245.00 -
29 Attapulgit (Pularex tab.) tab. 220.00 -
30 Betametason krim 0,1% tub 1,558.00 -
31 Bisakodil supp. 10 mg. (Stolax) supp. 6,045.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
32 Cetirizin tab. 190.00 -
33 Deksametason injeksi 5 mg/ml - 1 ml amp 1,738.00 -
34 Deksametason tablet 0,5 mg tab. 68.00 -
35 Devitalisasi pasta (non Arsen) botol - -
36 Diaform tab. - -
37 Diazepam injeksi 5 mg/ml - 2 ml amp 2,604.90 -
38 Diazepam tablet 2 mg tab. 46.00 -
40 Dietil Karbamazin sitrat tablet 100 mg tab. 232.70 -
41 Difenhidramin HCl injeksi 10mg/ml amp 1,160.00 -
42 Digoksin tablet 0,25 mg tab. 103.00 -
43 Domperidon tablet 10 mg tab. 174.00 -
44 Efedrin HCl tablet 25 mg tab. - -
45 Ekstrak Belladon tablet 10 mg tab. 42.00 -
46 Epinefrin injeksi 0,1% amp - -
47 Eritromisin kapsul 500 mg kaps 1,023.00 -
48 Eritromisin sirup 200mg/5 ml btl 60 ml 8,090.00 -
49 Etakridin larutan 0,1% btl 300 ml 2,354.22 -
50 Etanol 70% 1000 ml 30,000.00 -
51 Etanol 70% btl 100 ml. 2,625.00 -
52 Etil Klorida semprot btl 100 ml. 120,000.00 -
53 Eugenol cairan btl 10 ml 18,333.00 -
54 Fenitoin kapsul 100 mg btl 100 kapsul 146.00 -
55 Fenobarbital tablet 30 mg tab. 70.00 -
56 Fenobarbital Inj. i.m. 50 mg/ml - 2 ml. ampul 1,980.00 -
57 Fenol Gliserol tetes telinga 10% btl 1,108.80 -

58 Fitomenadion (vit K) inj 10 mg/ml amp 3,754.00 -
59 Fitomenadion (vit K1) tablet salut gula
10 mg tab. 698.00 -
60 Furosemid inj. 10 mg/ml amp 2,012.00 -
61 Furosemid tablet 40 mg tab. 84.00 -
62 Garam Oralit sase 317.00 -
63 Gentamisin Inj. 40 mg/ml (sulfat) - 2 ml. amp 3,782.00 -
64 Gentamisin salep kulit 0.1% tube 5 gr. 1,469.00 -

65 Gentamisin Sulfat tetes mata 0.3% btl 5 ml 3,513.00 -
66 Gentian Violet larutan 1% btl 10 ml 985.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
67 Glass Ionomer cement (GC IX) set - -
68 Glibenklamida tablet 5 mg tab. 61.00 -
69 Glimepiride tab. 2 mg. tab. 447.00 -
70 Gliseril Guaiakolat tablet 100 mg btl 1000 tab 30.69 -
71 Glucosa 10% Btl 500 ml. 6,270.00 -
72 Glukosa larutan infus 40% steril amp 25 ml - -
73 Glukosa larutan infus 5% btl 500 ml 5,720.00 -
74 Griseofulvin tablet 125 mg, micronized tab. 241.00 -
75 Haloperidol tablet 0.5 mg tab. 62.00 -

77 Haloperidol tablet 5 mg tab. 105.00 -
78 Hidroklorotiazida tablet 25 mg tab. 39.93 -
79 Hidrokortison krim 2,5% tub 2,868.00 -
80 Ibuprofen Susp. 60 ml. btl 60 ml. 3,849.00 -
81 Ibuprofen tablet 200 mg tab. 121.00 -
83 Iodiol kapsul lunak kaps 1,023.00 -
84 Isosorbit Dinitrat tablet sublingual 5 mg tab. 98.00 -
85 Kalsium Glukonat 10% amp - -

86 Kalsium hidroksida pasta set - -
87 Kalsium laktat (Kalk) tablet 500 mg tab. 76.00 -
88 Kaptopril 12,5 mg tab. 69.00 -
89 Kaptopril 25 mg tab. 97.00 -
90 Karbamazepin tablet 200 mg. tab. 269.00 -
91 Ketokonazol krim 2% tube 15 gr 2,633.00 -
92 Ketokonazol tablet 200 mg tab. 320.00 -
93 Ketorolac Inj. 10 mg/ml. amp. - -
94 Kloramfenikol kapsul 250 mg kaps 264.00 -
95 Kloramfenikol salap mata 1% tube 5 gr 1,760.00 -
96 Kloramfenikol susp. 125mg/5 ml btl 60 ml 5,500.00 -
97 kloramfenikol tetes telinga 3% Btl 5 ml 1,759.00 -
98 Kloramfenikol tts mata 1% btl 5 ml. - -
99 Klorfeniramina Maleat (CTM) tabet 4 mg tab. 54.00 -
100 Klorfenol kamfer mentol (CHKM) btl - -

101 Klorokuin tablet 150 mg tab. 110.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
102 Klorpromazin HCl inj.25 mg/ml amp 1,210.00 -
103 Klorpromazin HCl tablet salut 100 mg tab. 162.00 -
105 Kodein tablet 10 mg. tab. 550.00 -
106
Kontrasepsi inj. Depo progestin (3 bln) vial 5,968.00 -
107 Kotrimoksazol susp 60 ml 2,298.00 -
108 Kotrimoksazol tablet 480 mg tab. 152.00 -
109
Kotrimoksazol tablet pediatrik 120 mg tab. 79.00 -
110 Kuinin (kina) tablet 200 mg tab. 737.00 -
111 Lansoprazol kapsul 30 mg kaps 521.00 -
112 Larutan Benedik 100 ml - -
113 Larutan Eosin 100 ml - -
114 Larutan Etanol Asam 100 ml - -
115 Larutan Giemsa 100 ml - -
116 larutan Karbol Fuchin 100 ml - -
117 Larutan Metilen Blue 100 ml - -
118 Larutan Turk 100 ml - -
119 Lidokain injeksi 2% amp 2 ml 1,499.00 -
120 Loperamide / Bidium tab. 97.00 -
121 Loratadin tablet 10 mg tab. 170.00 -
122 Magnesium Sulfat inj. 20% (iv) ampul 1,693.00 -
123 MDT MB Adult blister 25,742.00 -
124 MDT MB Child blister 18,300.00 -
125 MDT PB Adult blister 8,052.00 -
126 MDT PB Child blister 8,052.00 -
127 Mebendazol tablet 100 mg tab. 248.00 -
128 Meloksikam tab. 15 mg. tab. 348.00 -
129 Metformin 500 mg tab. 124.50 -
130 Metilergometrin maleat inj 0.200 mg-1 amp 2,750.00 -
ml
131 Metilergometrin maleat tab. Salut 0.125 tab. 169.00 -

mg
132 Metoklopramide tablet 10 mg tab. 108.00 -
133 Metronidazol tablet 250 mg tab. 116.00 -
134 MgSo4 40% inj. Vial 2,142.00 -
135 Mikonazol krim/salap 2% nitrat tube 10 gr 3,075.00 -
136 Mummifying pasta botol - -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
137 Natrium Bikarbonat tablet 500 mg tab. 20.00 -
138 Natrium Diklofenak tablet 50 mg tab. 216.00 -
139 Natrium Klorida larutan infus 0,9% btl 500 ml 5,170.00 -
140 Natrium Tiroksin 100 mcg. (Euthyrax) tab. 1,870.00 -
141 Nifedipin tab. 110.00 -
142 Nistatin tablet salut 500.000 IU tab. 704.00 -
143 Nistatin vagina tablet 100.000 IU tab. 528.00 -
144 OAT FDC Katagori 1 paket 359,990.00 -
145 OAT FDC Katagori 2 paket 1,320,000.00 -
146 OAT Katagori Anak paket 214,990.00 -
147 Obat batuk Hitam (OBH) cairan btl 100 ml 3,060.00 -
148 OBP (Obat Batuk Putih) btl 100 ml - -
149 Oksitetrasiklin HCl inj. 50 mg/ml-10 ml vial 3,410.00 -
150 Oksitetrasiklin HCl salap mata 1% tube 3,5 gr 1,640.00 -

151 Oksitetrasiklin salap kulit 3% tube 5 gr 1,646.00 -
152 Oksitosin inj. 10 IU/ml - 1 ml amp 2,420.00 -
153 Omeprazol kapsul 20 mg kaps 221.00 -
154 Parasetamol sirup 120 mg/5 ml 60 ml 1,535.00 -
155 Parasetamol tablet 100 mg tab. 34.51 -
157 Pewarna Ziel Neelsen (BTA) btl 150,000.00 -
158 Pirantel tablet 125 mg tab. 318.00 -
159 Piridoksin (vitamin B6) tablet 10 mg tab. 121.00 -
160 Piroksikam kap 20 mg kaps 99.99 -
161 Povidon Iodida larutan 10% btl 30 ml 2,344.00 -
162 Prednison tablet 5 mg tab. 125.00 -
163 Primakuin tablet 15 mg tab. 205.00 -
164 Prokain Benzil Penisillin G. inj. 3 jt - 15 vial 6,141.67 -
ml.
165 Propanolol HCl tablet 40 mg tab. 114.00 -
166 Propiltiourasil tablet 100 mg (PTU) tab. 351.00 -
167 Ranitidin Inj. 25 mg/ml. amp 1,340.00 -
168 Ranitidin tablet 150 mg tab. 132.00 -
169 Retinol (vitamin A) 100.000 IU kapsul kaps 286.00 -
lunak

lunak
171 Ringer Laktat larutan infus btl 500 ml 5,720.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
172 Salap 2 - 4 pot 2,200.00 -
173 Salbutamol tablet 2 mg tab. 65.00 -
174 Salisil Bedak 2% 50 gram 1,350.00 -
175 Sefadroksil kapsul 500 mg kaps 548.00 -
176 Semen Seng Fosfat serbuk dan cairan set - -
177 Serum Anti Bisa Ular (ABU) inj. vial 567,600.00 -
178 Serum Anti Tetanus inj 1500 IU (ATS) amp. 151,800.00 -
179 Serum Anti Tetanus inj 20.000 IU (ATS) Vial 868,000.00 -
180 Sianokobalamin (vit B12) inj. 500 mcg amp. 1,050.00 -

181 Silk (benang bedah) no. 3 spcs 13,616.00 -
182 Silver Amalgam 1 oz - -
183 Simetidin tablet 200 mg tab. 105.97 -
184 Simvastatin tablet 10 mg tab. 177.00 -
185 Siprofloksasin tablet 500 mg tab. 400.00 -
186 Sulfasetamid natrium tetes mata 15% btl 3,549.00 -
187 Tablet Tambah Darah besi II sulfat tab. 45.00 -
188 Temporary Stopping Fletcher set - -
189 Tetrasiklin kapsul 250 mg kaps 162.00 -
191 Tiamfenikol kapsul 500 mg kaps 440.00 -
192 Tiamin (Vit B1) inj. 100 mg/ml amp 750.00 -
193 Tiamin tablet 50 mg tab. 136.00 -
194 Tramadol kapsul 50 mg kaps 196.35 -
195 Triheksifenidil tablet 2 mg tab. 44.00 -
196 Trikresol Formalin (TKF) botol - -
197 Vaksin BCG 2 ds/vial 59,950.00 -
198 Vaksin Campak 10 ds/vial 28,204.00 -
199 Vaksin DPT/HB 10 ds/vial - -
200 Vaksin DT 10 ds/vial 70,863.00 -
201 Vaksin HB - Uniject 1 ds/vial 20,900.00 -
202 Vaksin Pentabio 1 ds/vial 76,285.00 -
203 Vaksin Polio 10 ds/vial 19,954.00 -
204 Vaksin Td 10 ds/vial 16,500.00 -
205 Vaksin TT 10 ds/vial 14,498.00 -
206 Vitamin B Komplek tablet tab. 112.00 -
207 Zink 20 mg. tab. tab. 521.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
208 Zink sirup (Zircum Kid) btl 60 ml. 8,140.00 -
209 Dihidropiperaquin tab. 4,216.00 -
210 Risperidon 2 mg. tab. 1,781.00 -
JUMLAH -
Mengetahui, 04 Januari 2016

Kepala Puskesmas Pengelola Obat puskesmas
……………………………………….. ………………………………………………
NIP. NIP.
KET
7
KET
7
KET
7
KET
7
KET
7
KET
7
KET
uskesmas
………………………….
LAPORAN PERSEDIAAN BMHP PUSKESMAS ……………………..
31 DESEMBER 2015
SISA STOK 31 DES

1 2 3 4 5 6 (4x5)
1 Abbocath No 20 pcs 7,824.00 -

4 ADS/Spuit 0,05 ml. pcs - -
6 ADS/Spuit 5 ml. pcs 1,348.00 -
7 Alat suntik sekali pakai 1 ml 100 pcs 1,540.00 -
8 Alat suntik sekali pakai 2.5 ml 100 pcs 650.00 -
9 Alat suntik sekali pakai 3 ml 100 pcs 957.00 -
11 Cat Gut/benang bedah No. 2/0 - 3/0 pcs 24,671.00 -
12 Folley Catheter No 18 pcs 8,495.00 -
13 Hand Scun pasang 6,325.00 -
14 Infusion set anak set 4,567.50 -
15 Infusion set dewasa set 4,176.00 -
16 Kasa 4 x 10 cm rol 2,534.24 -
17 Kasa pembalut hidrofil 16 x 16 cm pad 549.27 -
18 Masker ktk 440.00 -
19 Plester rol 33,000.00 -
20 Pot Sputum bh 2,790.00 -
21 Safety Box 0,25 L pcs - -
22 Urine bag pcs 4,000.00 -
JUMLAH -

Kepala Puskesmas Pengelola BMHP puskesmas
……………………………………….. ………………………………………………
NIP. NIP.
KET
puskesmas
………………………….
LAPORAN PERSEDIAAN OBAT PUSTU ……………………..
PUSKESMAS ……………………..
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

1 200mg) pcs 1,049.00 -
2 Air Raksa dental use pcs 250,000.00 -
3 Albendazol tab. 400 mg. pcs 230.98 -
5 Ambroxol sirup 15 mg/ml pcs 2,665.00 -

6 Ambroxol tablet 30 mg pcs 89.31 -
7 Aminofilin injeksi 24mg/ml - 10 ml pcs 4,204.00 -
8 Aminofilin tablet 200 mg 100 gram 86.00 -
9 Amitriptilin HCl tablet salut 25 mg 100 pcs 123.00 -
10 Amlodipin 10 mg 100 pcs 352.00 -
11 Amoksisilin kaplet 500 mg 100 pcs 279.00 -
12 Amoksisilin sirup kering 125mg/5ml 100 pcs 2,560.00 -
13 Amoksisillin sirup kering 250 mg/5 ml. tab. 4,730.00 -

Ampisillin serbuk Inj. i.m/i.v 1000
14 mg/ml. tab. 5,181.00 -
15 Antalgin (Metampiron) tablet 500 mg btl 60 ml 132.99 -
16 Antasida DOEN sirup tab. 2,300.00 -
17 Antasida DOEN tablet amp 78.00 -
18 Anti Bakteri DOEN kombinasi tab. 2,767.00 -
19 Antifungi DOEN kombinasi 3 - 6 tab. 2,096.00 -
20 Antihemoroid DOEN kombinasi tab. 3,350.00 -
21 Antimigren DOEN kombinasi (Ergotamin) kapl 149.00 -

22 Artemeter inj. btl 60 ml 24,384.00 -
23 Arterakine btl 60 ml. - -
24 Asam Ascorbat (vit. C) tablet 50 mg vial 105.00 -

26 Asiklovir krim 5% btl 60 ml 2,367.00 -
28 Asiklovir tablet 400 mg. tub 354.00 -
29 Attapulgit (Pularex tab.) pot 220.00 -
30 Betametason krim 0,1% supp. 1,558.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
31 Bisakodil supp. 10 mg. (Stolax) tab. 6,045.00 -

32 Cetirizin amp 190.00 -
33 Deksametason injeksi 5 mg/ml - 1 ml tab. 1,738.00 -
35 Devitalisasi pasta (non Arsen) tab. - -
36 Diaform tube 5 gr - -
37 Diazepam injeksi 5 mg/ml - 2 ml tab. 2,604.90 -
40 Dietil Karbamazin sitrat tablet 100 mg tub 232.70 -
41 Difenhidramin HCl injeksi 10mg/ml supp. 1,160.00 -
42 Digoksin tablet 0,25 mg pcs 103.00 -
44 Efedrin HCl tablet 25 mg amp - -
46 Epinefrin injeksi 0,1% botol - -
47 Eritromisin kapsul 500 mg tab. 1,023.00 -
48 Eritromisin sirup 200mg/5 ml amp 8,090.00 -
49 Etakridin larutan 0,1% tab. 2,354.22 -
50 Etanol 70% tab. 30,000.00 -
51 Etanol 70% tab. 2,625.00 -
52 Etil Klorida semprot amp 120,000.00 -
53 Eugenol cairan tab. 18,333.00 -
54 Fenitoin kapsul 100 mg tab. 146.00 -
56 Fenobarbital Inj. i.m. 50 mg/ml - 2 ml. tab. 1,980.00 -

57 Fenol Gliserol tetes telinga 10% amp 1,108.80 -
58 Fitomenadion (vit K) inj 10 mg/ml kaps 3,754.00 -
Fitomenadion (vit K1) tablet salut gula
59 10 mg btl 60 ml 698.00 -
60 Furosemid inj. 10 mg/ml btl 300 ml 2,012.00 -
61 Furosemid tablet 40 mg 1000 ml 84.00 -
62 Garam Oralit btl 100 ml. 317.00 -
63 Gentamisin Inj. 40 mg/ml (sulfat) - 2 ml. btl 100 ml. 3,782.00 -

64 Gentamisin salep kulit 0.1% btl 10 ml 1,469.00 -
65 Gentamisin Sulfat tetes mata 0.3% btl 100 kapsul 3,513.00 -
66 Gentian Violet larutan 1% tab. 985.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
67 Glass Ionomer cement (GC IX) ampul - -

68 Glibenklamida tablet 5 mg btl 61.00 -
69 Glimepiride tab. 2 mg. amp 447.00 -
70 Gliseril Guaiakolat tablet 100 mg tab. 30.69 -
71 Glucosa 10% pcs 6,270.00 -
72 Glukosa larutan infus 40% steril amp - -
73 Glukosa larutan infus 5% tab. 5,720.00 -
74 Griseofulvin tablet 125 mg, micronized sase 241.00 -

75 Haloperidol tablet 0.5 mg amp 62.00 -
76 Haloperidol tablet 1.5 mg tube 5 gr. 76.00 -

77 Haloperidol tablet 5 mg btl 5 ml 105.00 -
78 Hidroklorotiazida tablet 25 mg btl 10 ml 39.93 -
79 Hidrokortison krim 2,5% set 2,868.00 -
80 Ibuprofen Susp. 60 ml. tab. 3,849.00 -
82 Ibuprofen tablet 400 mg btl 1000 tab 157.00 -
83 Iodiol kapsul lunak Btl 500 ml. 1,023.00 -
84 Isosorbit Dinitrat tablet sublingual 5 mg amp 25 ml 98.00 -

85 Kalsium Glukonat 10% btl 500 ml - -
86 Kalsium hidroksida pasta tab. - -

90 Karbamazepin tablet 200 mg. pasang 269.00 -
91 Ketokonazol krim 2% tab. 2,633.00 -
92 Ketokonazol tablet 200 mg tub 320.00 -
93 Ketorolac Inj. 10 mg/ml. btl 60 ml. - -
94 Kloramfenikol kapsul 250 mg tab. 264.00 -
95 Kloramfenikol salap mata 1% tab. 1,760.00 -
96 Kloramfenikol susp. 125mg/5 ml set 5,500.00 -
97 kloramfenikol tetes telinga 3% set 1,759.00 -
98 Kloramfenikol tts mata 1% kaps - -
tab. -
99 Klorfeniramina Maleat (CTM) tabet 4 mg 54.00
100 Klorfenol kamfer mentol (CHKM) amp - -
101 Klorokuin tablet 150 mg set 110.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
102 Klorpromazin HCl inj.25 mg/ml tab. 1,210.00 -

103 Klorpromazin HCl tablet salut 100 mg bungkus 162.00 -
106 Kontrasepsi inj. Depo progestin (3 bln) tab. 5,968.00 -

107 Kotrimoksazol susp rol 2,298.00 -
108 Kotrimoksazol tablet 480 mg pad 152.00 -
109 Kotrimoksazol tablet pediatrik 120 mg tube 15 gr 79.00 -

111 Lansoprazol kapsul 30 mg amp. 521.00 -
112 Larutan Benedik kaps - -
113 Larutan Eosin tube 5 gr - -
114 Larutan Etanol Asam btl 60 ml - -
115 Larutan Giemsa Btl 5 ml - -
116 larutan Karbol Fuchin btl 5 ml. - -
117 Larutan Metilen Blue tab. - -
118 Larutan Turk btl - -
119 Lidokain injeksi 2% tab. 1,499.00 -
120 Loperamide / Bidium amp 97.00 -
122 Magnesium Sulfat inj. 20% (iv) tab. 1,693.00 -
123 MDT MB Adult tab. 25,742.00 -
124 MDT MB Child vial 18,300.00 -
125 MDT PB Adult 60 ml 8,052.00 -
126 MDT PB Child tab. 8,052.00 -
129 Metformin 500 mg kaps 124.50 -
Metilergometrin maleat inj 0.200 mg-1
130 ml 100 ml 2,750.00 -
Metilergometrin maleat tab. Salut 0.125
131 mg 100 ml 169.00 -
132 Metoklopramide tablet 10 mg 100 ml 108.00 -
133 Metronidazol tablet 250 mg 100 ml 116.00 -
134 MgSo4 40% inj. 100 ml 2,142.00 -
135 Mikonazol krim/salap 2% nitrat 100 ml 3,075.00 -
136 Mummifying pasta 100 ml - -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
137 Natrium Bikarbonat tablet 500 mg amp 2 ml 20.00 -

139 Natrium Klorida larutan infus 0,9% tab. 5,170.00 -
140 Natrium Tiroksin 100 mcg. (Euthyrax) ampul 1,870.00 -
141 Nifedipin ktk 110.00 -
142 Nistatin tablet salut 500.000 IU blister 704.00 -
143 Nistatin vagina tablet 100.000 IU blister 528.00 -
144 OAT FDC Katagori 1 blister 359,990.00 -
145 OAT FDC Katagori 2 blister 1,320,000.00 -
146 OAT Katagori Anak tab. 214,990.00 -
147 Obat batuk Hitam (OBH) cairan tab. 3,060.00 -
148 OBP (Obat Batuk Putih) tab. - -
149 Oksitetrasiklin HCl inj. 50 mg/ml-10 ml amp 3,410.00 -
150 Oksitetrasiklin HCl salap mata 1% tab. 1,640.00 -
151 Oksitetrasiklin salap kulit 3% tab. 1,646.00 -

152 Oksitosin inj. 10 IU/ml - 1 ml tab. 2,420.00 -
153 Omeprazol kapsul 20 mg Vial 221.00 -
154 Parasetamol sirup 120 mg/5 ml tube 10 gr 1,535.00 -
155 Parasetamol tablet 100 mg botol 34.51 -
157 Pewarna Ziel Neelsen (BTA) tab. 150,000.00 -
158 Pirantel tablet 125 mg btl 500 ml 318.00 -
160 Piroksikam kap 20 mg tab. 99.99 -
161 Povidon Iodida larutan 10% tab. 2,344.00 -
163 Primakuin tablet 15 mg paket 205.00 -
Prokain Benzil Penisillin G. inj. 3 jt - 15
164 ml. paket 6,141.67 -
165 Propanolol HCl tablet 40 mg paket 114.00 -
166 Propiltiourasil tablet 100 mg (PTU) btl 100 ml 351.00 -
167 Ranitidin Inj. 25 mg/ml. btl 100 ml 1,340.00 -
vial -
168 Ranitidin tablet 150 mg 132.00
Retinol (vitamin A) 100.000 IU kapsul
169 lunak tube 3,5 gr 286.00 -
170 lunak tube 5 gr 505.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
171 Ringer Laktat larutan infus amp 5,720.00 -

172 Salap 2 - 4 kaps 2,200.00 -
173 Salbutamol tablet 2 mg 60 ml 65.00 -
174 Salisil Bedak 2% tab. 1,350.00 -
175 Sefadroksil kapsul 500 mg tab. 548.00 -
176 Semen Seng Fosfat serbuk dan cairan btl - -
177 Serum Anti Bisa Ular (ABU) inj. tab. 567,600.00 -
178 Serum Anti Tetanus inj 1500 IU (ATS) tab. 151,800.00 -
179 Serum Anti Tetanus inj 20.000 IU (ATS) kaps 868,000.00 -

180 Sianokobalamin (vit B12) inj. 500 mcg rol 1,050.00 -
181 Silk (benang bedah) no. 3 bh 13,616.00 -
182 Silver Amalgam btl 30 ml - -
185 Siprofloksasin tablet 500 mg vial 400.00 -
186 Sulfasetamid natrium tetes mata 15% tab. 3,549.00 -

188 Temporary Stopping Fletcher amp - -
189 Tetrasiklin kapsul 250 mg tab. 162.00 -
192 Tiamin (Vit B1) inj. 100 mg/ml btl 500 ml 750.00 -
193 Tiamin tablet 50 mg pcs 136.00 -
194 Tramadol kapsul 50 mg pot 196.35 -
196 Trikresol Formalin (TKF) 50 gram - -
197 Vaksin BCG kaps 59,950.00 -
198 Vaksin Campak set 28,204.00 -
199 Vaksin DPT/HB vial - -
200 Vaksin DT amp. 70,863.00 -
201 Vaksin HB - Uniject Vial 20,900.00 -
202 Vaksin Pentabio amp. 76,285.00 -

203 Vaksin Polio spcs 19,954.00 -
204 Vaksin Td 1 oz 16,500.00 -
205 Vaksin TT tab. 14,498.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

207 Zink 20 mg. tab. tab. 521.00 -
208 Zink sirup (Zircum Kid) btl 8,140.00 -
210 Risperidon 2 mg. set 1,781.00 -
JUMLAH -

Kepala Pustu Pengelola Obat pustu
……………………………………….. ………………………………………………
NIP. NIP.
KET
7
KET
7
KET
7
KET
7
KET
7
KET
7
KET
ustu
………………………….
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

1 200mg) pcs 1,049.00 -


14 mg/ml. tab. 5,181.00 -


SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

50 Etanol 70% tab. 30,000.00 -
51 Etanol 70% tab. 2,625.00 -

59 10 mg btl 60 ml 698.00 -

SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

71 Glucosa 10% pcs 6,270.00 -




tab. -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)



123 MDT MB Adult tab. 25,742.00 -
125 MDT PB Adult 60 ml 8,052.00 -
130 ml 100 ml 2,750.00 -
131 mg 100 ml 169.00 -
134 MgSo4 40% inj. 100 ml 2,142.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)


164 ml. paket 6,141.67 -
vial -
169 lunak tube 3,5 gr 286.00 -
170 lunak tube 5 gr 505.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

172 Salap 2 - 4 kaps 2,200.00 -


200 Vaksin DT amp. 70,863.00 -

204 Vaksin Td 1 oz 16,500.00 -
205 Vaksin TT tab. 14,498.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

207 Zink 20 mg. tab. tab. 521.00 -
JUMLAH -

……………………………………….. ………………………………………………
NIP. NIP.
KET
7
KET
7
KET
7
KET
7
KET
7
KET
7
KET
ustu
………………………….
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

1 200mg) pcs 1,049.00 -


14 mg/ml. tab. 5,181.00 -


SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

50 Etanol 70% tab. 30,000.00 -
51 Etanol 70% tab. 2,625.00 -

59 10 mg btl 60 ml 698.00 -

SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

71 Glucosa 10% pcs 6,270.00 -




tab. -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)



123 MDT MB Adult tab. 25,742.00 -
125 MDT PB Adult 60 ml 8,052.00 -
130 ml 100 ml 2,750.00 -
131 mg 100 ml 169.00 -
134 MgSo4 40% inj. 100 ml 2,142.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)


164 ml. paket 6,141.67 -
vial -
169 lunak tube 3,5 gr 286.00 -
170 lunak tube 5 gr 505.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

172 Salap 2 - 4 kaps 2,200.00 -


200 Vaksin DT amp. 70,863.00 -

204 Vaksin Td 1 oz 16,500.00 -
205 Vaksin TT tab. 14,498.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

207 Zink 20 mg. tab. tab. 521.00 -
JUMLAH -

……………………………………….. ………………………………………………
NIP. NIP.
KET
7
KET
7
KET
7
KET
7
KET
7
KET
7
KET
ustu
………………………….
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

1 200mg) pcs 1,049.00 -


14 mg/ml. tab. 5,181.00 -


SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

50 Etanol 70% tab. 30,000.00 -
51 Etanol 70% tab. 2,625.00 -

59 10 mg btl 60 ml 698.00 -

SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

71 Glucosa 10% pcs 6,270.00 -




tab. -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)



123 MDT MB Adult tab. 25,742.00 -
125 MDT PB Adult 60 ml 8,052.00 -
130 ml 100 ml 2,750.00 -
131 mg 100 ml 169.00 -
134 MgSo4 40% inj. 100 ml 2,142.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)


164 ml. paket 6,141.67 -
vial -
169 lunak tube 3,5 gr 286.00 -
170 lunak tube 5 gr 505.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

172 Salap 2 - 4 kaps 2,200.00 -


200 Vaksin DT amp. 70,863.00 -

204 Vaksin Td 1 oz 16,500.00 -
205 Vaksin TT tab. 14,498.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)

207 Zink 20 mg. tab. tab. 521.00 -
JUMLAH -

……………………………………….. ………………………………………………
NIP. NIP.
KET
7
KET
7
KET
7
KET
7
KET
7
KET
7
KET
ustu
………………………….
REKAPITULASI PUSTU ……………….
PUSKESMAS …………….
31 desember 2015
NO. NAMA OBAT SATUAN HARGA SISA STOK 31 DES. 15
A B C …..
1 ACT (Artesunate 50mg+ Amodiaquin 200mg) tab. 1,049.00 0 0 0 0
2 Air Raksa dental use 100 gram 250,000.00 0 0 0 0
3 Albendazol tab. 400 mg. tab. 230.98 0 0 0 0
4 Alopurinol tablet 100 mg tab. 90.00 0 0 0 0
5 Ambroxol sirup 15 mg/ml btl 60 ml 2,665.00 0 0 0 0
6 Ambroxol tablet 30 mg tab. 89.31 0 0 0 0
7 Aminofilin injeksi 24mg/ml - 10 ml amp 4,204.00 0 0 0 0
8 Aminofilin tablet 200 mg tab. 86.00 0 0 0 0
9 Amitriptilin HCl tablet salut 25 mg tab. 123.00 0 0 0 0
10 Amlodipin 10 mg tab. 352.00 0 0 0 0
11 Amoksisilin kaplet 500 mg kapl 279.00 0 0 0 0
12 Amoksisilin sirup kering 125mg/5ml btl 60 ml 2,560.00 0 0 0 0
13 Amoksisillin sirup kering 250 mg/5 ml. btl 60 ml. 4,730.00 0 0 0 0
14 Ampisillin serbuk Inj. i.m/i.v 1000 mg/ml. vial 5,181.00 0 0 0 0
15 Antalgin (Metampiron) tablet 500 mg tab. 132.99 0 0 0 0
16 Antasida DOEN sirup btl 60 ml 2,300.00 0 0 0 0
17 Antasida DOEN tablet tab. 78.00 0 0 0 0
18 Anti Bakteri DOEN kombinasi tub 2,767.00 0 0 0 0
19 Antifungi DOEN kombinasi 3 - 6 pot 2,096.00 0 0 0 0
20 Antihemoroid DOEN kombinasi supp. 3,350.00 0 0 0 0
21 Antimigren DOEN kombinasi (Ergotamin) tab. 149.00 0 0 0 0
A B C …..
22 Artemeter inj. amp 24,384.00 0 0 0 0
23 Arterakine tab. - 0 0 0 0
24 Asam Ascorbat (vit. C) tablet 50 mg tab. 105.00 0 0 0 0
25 Asam Mefenamat tablet 500 mg tab. 127.00 0 0 0 0
26 Asiklovir krim 5% tube 5 gr 2,367.00 0 0 0 0
27 Asiklovir tablet 200 mg. tab. 245.00 0 0 0 0
28 Asiklovir tablet 400 mg. tab. 354.00 0 0 0 0
29 Attapulgit (Pularex tab.) tab. 220.00 0 0 0 0
30 Betametason krim 0,1% tub 1,558.00 0 0 0 0
31 Bisakodil supp. 10 mg. (Stolax) supp. 6,045.00 0 0 0 0
32 Cetirizin tab. 190.00 0 0 0 0
33 Deksametason injeksi 5 mg/ml - 1 ml amp 1,738.00 0 0 0 0
34 Deksametason tablet 0,5 mg tab. 68.00 0 0 0 0
35 Devitalisasi pasta (non Arsen) botol - 0 0 0 0
36 Diaform tab. - 0 0 0 0
37 Diazepam injeksi 5 mg/ml - 2 ml amp 2,604.90 0 0 0 0
38 Diazepam tablet 2 mg tab. 46.00 0 0 0 0
39 Diazepam tablet 5 mg tab. 52.80 0 0 0 0
40 Dietil Karbamazin sitrat tablet 100 mg tab. 232.70 0 0 0 0
41 Difenhidramin HCl injeksi 10mg/ml amp 1,160.00 0 0 0 0
42 Digoksin tablet 0,25 mg tab. 103.00 0 0 0 0
43 Domperidon tablet 10 mg tab. 174.00 0 0 0 0
44 Efedrin HCl tablet 25 mg tab. - 0 0 0 0
45 Ekstrak Belladon tablet 10 mg tab. 42.00 0 0 0 0
46 Epinefrin injeksi 0,1% amp - 0 0 0 0
A B C …..
47 Eritromisin kapsul 500 mg kaps 1,023.00 0 0 0 0
48 Eritromisin sirup 200mg/5 ml btl 60 ml 8,090.00 0 0 0 0
49 Etakridin larutan 0,1% btl 300 ml 2,354.22 0 0 0 0
50 Etanol 70% 1000 ml 30,000.00 0 0 0 0
51 Etanol 70% btl 100 ml. 2,625.00 0 0 0 0
52 Etil Klorida semprot btl 100 ml. 120,000.00 0 0 0 0
53 Eugenol cairan btl 10 ml 18,333.00 0 0 0 0
54 Fenitoin kapsul 100 mg btl 100 kapsul 146.00 0 0 0 0
55 Fenobarbital tablet 30 mg tab. 70.00 0 0 0 0
56 Fenobarbital Inj. i.m. 50 mg/ml - 2 ml. ampul 1,980.00 0 0 0 0
57 Fenol Gliserol tetes telinga 10% btl 1,108.80 0 0 0 0
58 Fitomenadion (vit K) inj 10 mg/ml amp 3,754.00 0 0 0 0
59 Fitomenadion (vit K1) tablet salut gula 10 mg tab. 698.00 0 0 0 0
60 Furosemid inj. 10 mg/ml amp 2,012.00 0 0 0 0
61 Furosemid tablet 40 mg tab. 84.00 0 0 0 0
62 Garam Oralit sase 317.00 0 0 0 0
63 Gentamisin Inj. 40 mg/ml (sulfat) - 2 ml. amp 3,782.00 0 0 0 0
64 Gentamisin salep kulit 0.1% tube 5 gr. 1,469.00 0 0 0 0
65 Gentamisin Sulfat tetes mata 0.3% btl 5 ml 3,513.00 0 0 0 0
66 Gentian Violet larutan 1% btl 10 ml 985.00 0 0 0 0
67 Glass Ionomer cement (GC IX) set - 0 0 0 0
68 Glibenklamida tablet 5 mg tab. 61.00 0 0 0 0
69 Glimepiride tab. 2 mg. tab. 447.00 0 0 0 0
70 Gliseril Guaiakolat tablet 100 mg btl 1000 tab 30.69 0 0 0 0
71 Glucosa 10% Btl 500 ml. 6,270.00 0 0 0 0
A B C …..
72 Glukosa larutan infus 40% steril amp 25 ml - 0 0 0 0
73 Glukosa larutan infus 5% btl 500 ml 5,720.00 0 0 0 0
74 Griseofulvin tablet 125 mg, micronized tab. 241.00 0 0 0 0
75 Haloperidol tablet 0.5 mg tab. 62.00 0 0 0 0
76 Haloperidol tablet 1.5 mg tab. 76.00 0 0 0 0
77 Haloperidol tablet 5 mg tab. 105.00 0 0 0 0
78 Hidroklorotiazida tablet 25 mg tab. 39.93 0 0 0 0
79 Hidrokortison krim 2,5% tub 2,868.00 0 0 0 0
80 Ibuprofen Susp. 60 ml. btl 60 ml. 3,849.00 0 0 0 0
81 Ibuprofen tablet 200 mg tab. 121.00 0 0 0 0
82 Ibuprofen tablet 400 mg tab. 157.00 0 0 0 0
83 Iodiol kapsul lunak kaps 1,023.00 0 0 0 0
84 Isosorbit Dinitrat tablet sublingual 5 mg tab. 98.00 0 0 0 0
85 Kalsium Glukonat 10% amp - 0 0 0 0
86 Kalsium hidroksida pasta set - 0 0 0 0
87 Kalsium laktat (Kalk) tablet 500 mg tab. 76.00 0 0 0 0
88 Kaptopril 12,5 mg tab. 69.00 0 0 0 0
89 Kaptopril 25 mg tab. 97.00 0 0 0 0
90 Karbamazepin tablet 200 mg. tab. 269.00 0 0 0 0
91 Ketokonazol krim 2% tube 15 gr 2,633.00 0 0 0 0
92 Ketokonazol tablet 200 mg tab. 320.00 0 0 0 0
93 Ketorolac Inj. 10 mg/ml. amp. - 0 0 0 0
94 Kloramfenikol kapsul 250 mg kaps 264.00 0 0 0 0
95 Kloramfenikol salap mata 1% tube 5 gr 1,760.00 0 0 0 0
96 Kloramfenikol susp. 125mg/5 ml btl 60 ml 5,500.00 0 0 0 0
A B C …..
97 kloramfenikol tetes telinga 3% Btl 5 ml 1,759.00 0 0 0 0
98 Kloramfenikol tts mata 1% btl 5 ml. - 0 0 0 0
99 Klorfeniramina Maleat (CTM) tabet 4 mg tab. 54.00 0 0 0 0
100 Klorfenol kamfer mentol (CHKM) btl - 0 0 0 0
101 Klorokuin tablet 150 mg tab. 110.00 0 0 0 0
102 Klorpromazin HCl inj.25 mg/ml amp 1,210.00 0 0 0 0
103 Klorpromazin HCl tablet salut 100 mg tab. 162.00 0 0 0 0
104 Klorpromazin HCl tablet salut 25 mg tab. 75.00 0 0 0 0
105 Kodein tablet 10 mg. tab. 550.00 0 0 0 0
106 Kontrasepsi inj. Depo progestin (3 bln) vial 5,968.00 0 0 0 0
107 Kotrimoksazol susp 60 ml 2,298.00 0 0 0 0
108 Kotrimoksazol tablet 480 mg tab. 152.00 0 0 0 0
109 Kotrimoksazol tablet pediatrik 120 mg tab. 79.00 0 0 0 0
110 Kuinin (kina) tablet 200 mg tab. 737.00 0 0 0 0
111 Lansoprazol kapsul 30 mg kaps 521.00 0 0 0 0
112 Larutan Benedik 100 ml - 0 0 0 0
113 Larutan Eosin 100 ml - 0 0 0 0
114 Larutan Etanol Asam 100 ml - 0 0 0 0
115 Larutan Giemsa 100 ml - 0 0 0 0
116 larutan Karbol Fuchin 100 ml - 0 0 0 0
117 Larutan Metilen Blue 100 ml - 0 0 0 0
118 Larutan Turk 100 ml - 0 0 0 0
119 Lidokain injeksi 2% amp 2 ml 1,499.00 0 0 0 0
120 Loperamide / Bidium tab. 97.00 0 0 0 0
121 Loratadin tablet 10 mg tab. 170.00 0 0 0 0
A B C …..
122 Magnesium Sulfat inj. 20% (iv) ampul 1,693.00 0 0 0 0
123 MDT MB Adult blister 25,742.00 0 0 0 0
124 MDT MB Child blister 18,300.00 0 0 0 0
125 MDT PB Adult blister 8,052.00 0 0 0 0
126 MDT PB Child blister 8,052.00 0 0 0 0
127 Mebendazol tablet 100 mg tab. 248.00 0 0 0 0
128 Meloksikam tab. 15 mg. tab. 348.00 0 0 0 0
129 Metformin 500 mg tab. 124.50 0 0 0 0
130 Metilergometrin maleat inj 0.200 mg-1 ml amp 2,750.00 0 0 0 0
131 Metilergometrin maleat tab. Salut 0.125 mg tab. 169.00 0 0 0 0
132 Metoklopramide tablet 10 mg tab. 108.00 0 0 0 0
133 Metronidazol tablet 250 mg tab. 116.00 0 0 0 0
134 MgSo4 40% inj. Vial 2,142.00 0 0 0 0
135 Mikonazol krim/salap 2% nitrat tube 10 gr 3,075.00 0 0 0 0
136 Mummifying pasta botol - 0 0 0 0
137 Natrium Bikarbonat tablet 500 mg tab. 20.00 0 0 0 0
138 Natrium Diklofenak tablet 50 mg tab. 216.00 0 0 0 0
139 Natrium Klorida larutan infus 0,9% btl 500 ml 5,170.00 0 0 0 0
140 Natrium Tiroksin 100 mcg. (Euthyrax) tab. 1,870.00 0 0 0 0
141 Nifedipin tab. 110.00 0 0 0 0
142 Nistatin tablet salut 500.000 IU tab. 704.00 0 0 0 0
143 Nistatin vagina tablet 100.000 IU tab. 528.00 0 0 0 0
144 OAT FDC Katagori 1 paket 359,990.00 0 0 0 0
145 OAT FDC Katagori 2 paket 1,320,000.00 0 0 0 0
146 OAT Katagori Anak paket 214,990.00 0 0 0 0
A B C …..
147 Obat batuk Hitam (OBH) cairan btl 100 ml 3,060.00 0 0 0 0
148 OBP (Obat Batuk Putih) btl 100 ml - 0 0 0 0
149 Oksitetrasiklin HCl inj. 50 mg/ml-10 ml vial 3,410.00 0 0 0 0
150 Oksitetrasiklin HCl salap mata 1% tube 3,5 gr 1,640.00 0 0 0 0
151 Oksitetrasiklin salap kulit 3% tube 5 gr 1,646.00 0 0 0 0
152 Oksitosin inj. 10 IU/ml - 1 ml amp 2,420.00 0 0 0 0
153 Omeprazol kapsul 20 mg kaps 221.00 0 0 0 0
154 Parasetamol sirup 120 mg/5 ml 60 ml 1,535.00 0 0 0 0
155 Parasetamol tablet 100 mg tab. 34.51 0 0 0 0
156 Parasetamol tablet 500 mg tab. 88.00 0 0 0 0
157 Pewarna Ziel Neelsen (BTA) btl 150,000.00 0 0 0 0
158 Pirantel tablet 125 mg tab. 318.00 0 0 0 0
159 Piridoksin (vitamin B6) tablet 10 mg tab. 121.00 0 0 0 0
160 Piroksikam kap 20 mg kaps 99.99 0 0 0 0
161 Povidon Iodida larutan 10% btl 30 ml 2,344.00 0 0 0 0
162 Prednison tablet 5 mg tab. 125.00 0 0 0 0
163 Primakuin tablet 15 mg tab. 205.00 0 0 0 0
164 Prokain Benzil Penisillin G. inj. 3 jt - 15 ml. vial 6,141.67 0 0 0 0
165 Propanolol HCl tablet 40 mg tab. 114.00 0 0 0 0
166 Propiltiourasil tablet 100 mg (PTU) tab. 351.00 0 0 0 0
167 Ranitidin Inj. 25 mg/ml. amp 1,340.00 0 0 0 0
168 Ranitidin tablet 150 mg tab. 132.00 0 0 0 0
169 Retinol (vitamin A) 100.000 IU kapsul lunak kaps 286.00 0 0 0 0
170 Retinol (vitamin A) 200.000 IU kapsul lunak kaps 505.00 0 0 0 0
171 Ringer Laktat larutan infus btl 500 ml 5,720.00 0 0 0 0
A B C …..
172 Salap 2 - 4 pot 2,200.00 0 0 0 0
173 Salbutamol tablet 2 mg tab. 65.00 0 0 0 0
174 Salisil Bedak 2% 50 gram 1,350.00 0 0 0 0
175 Sefadroksil kapsul 500 mg kaps 548.00 0 0 0 0
176 Semen Seng Fosfat serbuk dan cairan set - 0 0 0 0
177 Serum Anti Bisa Ular (ABU) inj. vial 567,600.00 0 0 0 0
178 Serum Anti Tetanus inj 1500 IU (ATS) amp. 151,800.00 0 0 0 0
179 Serum Anti Tetanus inj 20.000 IU (ATS) Vial 868,000.00 0 0 0 0
180 Sianokobalamin (vit B12) inj. 500 mcg amp. 1,050.00 0 0 0 0
181 Silk (benang bedah) no. 3 spcs 13,616.00 0 0 0 0
182 Silver Amalgam 1 oz - 0 0 0 0
183 Simetidin tablet 200 mg tab. 105.97 0 0 0 0
184 Simvastatin tablet 10 mg tab. 177.00 0 0 0 0
185 Siprofloksasin tablet 500 mg tab. 400.00 0 0 0 0
186 Sulfasetamid natrium tetes mata 15% btl 3,549.00 0 0 0 0
187 Tablet Tambah Darah besi II sulfat tab. 45.00 0 0 0 0
188 Temporary Stopping Fletcher set - 0 0 0 0
189 Tetrasiklin kapsul 250 mg kaps 162.00 0 0 0 0
190 Tetrasiklin kapsul 500 mg kaps 325.00 0 0 0 0
191 Tiamfenikol kapsul 500 mg kaps 440.00 0 0 0 0
192 Tiamin (Vit B1) inj. 100 mg/ml amp 750.00 0 0 0 0
193 Tiamin tablet 50 mg tab. 136.00 0 0 0 0
194 Tramadol kapsul 50 mg kaps 196.35 0 0 0 0
195 Triheksifenidil tablet 2 mg tab. 44.00 0 0 0 0
196 Trikresol Formalin (TKF) botol - 0 0 0 0
A B C …..
197 Vaksin BCG 2 ds/vial 59,950.00 0 0 0 0
198 Vaksin Campak 10 ds/vial 28,204.00 0 0 0 0
199 Vaksin DPT/HB 10 ds/vial - 0 0 0 0
200 Vaksin DT 10 ds/vial 70,863.00 0 0 0 0
201 Vaksin HB - Uniject 1 ds/vial 20,900.00 0 0 0 0
202 Vaksin Pentabio 1 ds/vial 76,285.00 0 0 0 0
203 Vaksin Polio 10 ds/vial 19,954.00 0 0 0 0
204 Vaksin Td 10 ds/vial 16,500.00 0 0 0 0
205 Vaksin TT 10 ds/vial 14,498.00 0 0 0 0
206 Vitamin B Komplek tablet tab. 112.00 0 0 0 0
207 Zink 20 mg. tab. tab. 521.00 0 0 0 0
208 Zink sirup (Zircum Kid) btl 60 ml. 8,140.00 0 0 0 0
209 Dihidropiperaquin tab. 4,216.00 0 0 0 0
210 Risperidon 2 mg. tab. 1,781.00 0 0 0 0
JUMLAH
Mengetahui,
Kepala Puskesmas ………
…………………………………………
NIP.
TOTAL JUMLAH HARGA KET
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
PERSEDIAAN
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
esmas …………
……………………..
LAPORAN PERSEDIAAN BMHP PUSTU ……………………..
PUSKESMAS …………………………..
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

-
4 ADS/Spuit 0,05 ml. pcs -
16 Kasa 4 x 10 cm rol 2,534.24 -
19 Plester rol 33,000.00 -
JUMLAH -

Kepala Pustu Pengelola bmhp Pustu
……………………………………….. ………………………………………………
NIP. NIP.
KET
Pustu
………………………….
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

-
16 Kasa 4 x 10 cm rol 2,534.24 -
19 Plester rol 33,000.00 -
JUMLAH -

……………………………………….. ………………………………………………
NIP. NIP.
KET
Pustu
………………………….
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

-
16 Kasa 4 x 10 cm rol 2,534.24 -
19 Plester rol 33,000.00 -
JUMLAH -

……………………………………….. ………………………………………………
NIP. NIP.
KET
Pustu
………………………….
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)

-
16 Kasa 4 x 10 cm rol 2,534.24 -
19 Plester rol 33,000.00 -
JUMLAH -

……………………………………….. ………………………………………………
NIP. NIP.
KET
Pustu
………………………….
REKAPITULASI PUSTU ……………….
PUSKESMAS …………….
31 DESEMBER 2015
TOTAL
NO. NAMA OBAT SATUAN HARGA SISA STOK 31 DES. 15 PERSEDIAAN JUMLAH HARGA
A B C …..
1 Abbocath No 20 pcs 7,824.00 0 0 0 0 0 -
2 Abbocath No 22 pcs 7,824.00 0 0 0 0 0 -
3 Abbocath No 24 pcs 7,824.00 0 0 0 0 0 -
4 ADS/Spuit 0,05 ml. pcs - 0 0 0 0 0 -
5 ADS/Spuit 0,5 ml. pcs - 0 0 0 0 0 -
6 ADS/Spuit 5 ml. pcs 1,348.00 0 0 0 0 0 -
7 Alat suntik sekali pakai 1 ml 100 pcs 1,540.00 0 0 0 0 0 -
8 Alat suntik sekali pakai 2.5 ml 100 pcs 650.00 0 0 0 0 0 -
9 Alat suntik sekali pakai 3 ml 100 pcs 957.00 0 0 0 0 0 -
10 Alat suntik sekali pakai 5 ml 100 pcs 1,348.00 0 0 0 0 0 -
11 Cat Gut/benang bedah No. 2/0 - 3/0 pcs 24,671.00 0 0 0 0 0 -
12 Folley Catheter No 18 pcs 8,495.00 0 0 0 0 0 -
13 Hand Scun pasang 6,325.00 0 0 0 0 0 -
14 Infusion set anak set 4,567.50 0 0 0 0 0 -
15 Infusion set dewasa set 4,176.00 0 0 0 0 0 -
16 Kasa 4 x 10 cm rol 2,534.24 0 0 0 0 0 -
17 Kasa pembalut hidrofil 16 x 16 cm pad 549.27 0 0 0 0 0 -
18 Masker ktk 440.00 0 0 0 0 0 -
19 Plester rol 33,000.00 0 0 0 0 0 -
20 Pot Sputum bh 2,790.00 0 0 0 0 0 -
21 Safety Box 0,25 L pcs - 0 0 0 0 0 -
TOTAL
NO. NAMA OBAT SATUAN HARGA SISA STOK 31 DES. 15 PERSEDIAAN JUMLAH HARGA
A B C …..
22 Urine bag pcs 4,000.00 0 0 0 0 0 -
JUMLAH -
Mengetahui,
Kepala Puskesmas …………
…………………………………………..
NIP.
KET
KET
LAPORAN PERSEDIAAN OBAT PUSKESMAS ……………………..
31 DESEMBER 2015
SISA STOK 31 DES.

1 2 3 4 5 6 (4x5)
1 tab. 1,049.00 -
200mg)
2 Air Raksa dental use 100 gram 250,000.00 -
3 Albendazol tab. 400 mg. tab. 230.98 -
5 Ambroxol sirup 15 mg/ml btl 60 ml 2,665.00 -
6 Ambroxol tablet 30 mg tab. 89.31 -
7 Aminofilin injeksi 24mg/ml - 10 ml amp 4,204.00 -
8 Aminofilin tablet 200 mg tab. 86.00 -
9 Amitriptilin HCl tablet salut 25 mg tab. 123.00 -
10 Amlodipin 10 mg tab. 352.00 -
11 Amoksisilin kaplet 500 mg kapl 279.00 -
12 Amoksisilin sirup kering 125mg/5ml btl 60 ml 2,560.00 -
13 Amoksisillin sirup kering 250 mg/5 ml. btl 60 ml. 4,730.00 -
14 Ampisillin serbuk Inj. i.m/i.v 1000 vial 5,181.00 -

mg/ml.
15 Antalgin (Metampiron) tablet 500 mg tab. 132.99 -
16 Antasida DOEN sirup btl 60 ml 2,300.00 -
17 Antasida DOEN tablet tab. 78.00 -
18 Anti Bakteri DOEN kombinasi tub 2,767.00 -
19 Antifungi DOEN kombinasi 3 - 6 pot 2,096.00 -
20 Antihemoroid DOEN kombinasi supp. 3,350.00 -
21 Antimigren DOEN kombinasi (Ergotamin) tab. 149.00
-
22 Artemeter inj. amp 24,384.00 -
23 Arterakine tab. - -
24 Asam Ascorbat (vit. C) tablet 50 mg tab. 105.00 -
26 Asiklovir krim 5% tube 5 gr 2,367.00 -
29 Attapulgit (Pularex tab.) tab. 220.00 -
30 Betametason krim 0,1% tub 1,558.00 -
31 Bisakodil supp. 10 mg. (Stolax) supp. 6,045.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
32 Cetirizin tab. 190.00 -
33 Deksametason injeksi 5 mg/ml - 1 ml amp 1,738.00 -
35 Devitalisasi pasta (non Arsen) botol - -
36 Diaform tab. - -
37 Diazepam injeksi 5 mg/ml - 2 ml amp 2,604.90 -
40 Dietil Karbamazin sitrat tablet 100 mg tab. 232.70 -
41 Difenhidramin HCl injeksi 10mg/ml amp 1,160.00 -
42 Digoksin tablet 0,25 mg tab. 103.00 -
44 Efedrin HCl tablet 25 mg tab. - -
46 Epinefrin injeksi 0,1% amp - -
47 Eritromisin kapsul 500 mg kaps 1,023.00 -
48 Eritromisin sirup 200mg/5 ml btl 60 ml 8,090.00 -
49 Etakridin larutan 0,1% btl 300 ml 2,354.22 -
50 Etanol 70% 1000 ml 30,000.00 -
51 Etanol 70% btl 100 ml. 2,625.00 -
52 Etil Klorida semprot btl 100 ml. 120,000.00 -
53 Eugenol cairan btl 10 ml 18,333.00 -
54 Fenitoin kapsul 100 mg btl 100 kapsul 146.00 -
56 Fenobarbital Inj. i.m. 50 mg/ml - 2 ml. ampul 1,980.00 -
57 Fenol Gliserol tetes telinga 10% btl 1,108.80 -

58 Fitomenadion (vit K) inj 10 mg/ml amp 3,754.00 -
59 Fitomenadion (vit K1) tablet salut gula tab. 698.00
10 mg -
60 Furosemid inj. 10 mg/ml amp 2,012.00 -
61 Furosemid tablet 40 mg tab. 84.00 -
62 Garam Oralit sase 317.00 -
63 Gentamisin Inj. 40 mg/ml (sulfat) - 2 ml. amp 3,782.00 -
64 Gentamisin salep kulit 0.1% tube 5 gr. 1,469.00 -

65 Gentamisin Sulfat tetes mata 0.3% btl 5 ml 3,513.00 -
66 Gentian Violet larutan 1% btl 10 ml 985.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
67 Glass Ionomer cement (GC IX) set - -
68 Glibenklamida tablet 5 mg tab. 61.00 -
69 Glimepiride tab. 2 mg. tab. 447.00 -
70 Gliseril Guaiakolat tablet 100 mg btl 1000 tab 30.69 -
71 Glucosa 10% Btl 500 ml. 6,270.00 -
72 Glukosa larutan infus 40% steril amp 25 ml - -
73 Glukosa larutan infus 5% btl 500 ml 5,720.00 -
74 Griseofulvin tablet 125 mg, micronized tab. 241.00 -

77 Haloperidol tablet 5 mg tab. 105.00 -
78 Hidroklorotiazida tablet 25 mg tab. 39.93 -
79 Hidrokortison krim 2,5% tub 2,868.00 -
80 Ibuprofen Susp. 60 ml. btl 60 ml. 3,849.00 -
83 Iodiol kapsul lunak kaps 1,023.00 -
84 Isosorbit Dinitrat tablet sublingual 5 mg tab. 98.00 -
85 Kalsium Glukonat 10% amp - -

86 Kalsium hidroksida pasta set - -
90 Karbamazepin tablet 200 mg. tab. 269.00 -
91 Ketokonazol krim 2% tube 15 gr 2,633.00 -
92 Ketokonazol tablet 200 mg tab. 320.00 -
93 Ketorolac Inj. 10 mg/ml. amp. - -
94 Kloramfenikol kapsul 250 mg kaps 264.00 -
95 Kloramfenikol salap mata 1% tube 5 gr 1,760.00 -
96 Kloramfenikol susp. 125mg/5 ml btl 60 ml 5,500.00 -
97 kloramfenikol tetes telinga 3% Btl 5 ml 1,759.00 -
98 Kloramfenikol tts mata 1% btl 5 ml. - -
99 Klorfeniramina Maleat (CTM) tabet 4 mg tab. 54.00 -
100 Klorfenol kamfer mentol (CHKM) btl - -

101 Klorokuin tablet 150 mg tab. 110.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
102 Klorpromazin HCl inj.25 mg/ml amp 1,210.00 -
106 Kontrasepsi inj. Depo progestin (3 bln) vial 5,968.00
-
107 Kotrimoksazol susp 60 ml 2,298.00 -
108 Kotrimoksazol tablet 480 mg tab. 152.00 -
109 Kotrimoksazol tablet pediatrik 120 mg tab. 79.00
-
111 Lansoprazol kapsul 30 mg kaps 521.00 -
112 Larutan Benedik 100 ml - -
113 Larutan Eosin 100 ml - -
114 Larutan Etanol Asam 100 ml - -
115 Larutan Giemsa 100 ml - -
116 larutan Karbol Fuchin 100 ml - -
117 Larutan Metilen Blue 100 ml - -
118 Larutan Turk 100 ml - -
119 Lidokain injeksi 2% amp 2 ml 1,499.00 -
120 Loperamide / Bidium tab. 97.00 -
122 Magnesium Sulfat inj. 20% (iv) ampul 1,693.00 -
123 MDT MB Adult blister 25,742.00 -
124 MDT MB Child blister 18,300.00 -
125 MDT PB Adult blister 8,052.00 -
126 MDT PB Child blister 8,052.00 -
129 Metformin 500 mg tab. 124.50 -
130 Metilergometrin maleat inj 0.200 mg-1 amp 2,750.00 -
ml
131 Metilergometrin maleat tab. Salut 0.125 tab. 169.00 -

mg
132 Metoklopramide tablet 10 mg tab. 108.00 -
133 Metronidazol tablet 250 mg tab. 116.00 -
134 MgSo4 40% inj. Vial 2,142.00 -
135 Mikonazol krim/salap 2% nitrat tube 10 gr 3,075.00 -
136 Mummifying pasta botol - -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
137 Natrium Bikarbonat tablet 500 mg tab. 20.00 -
139 Natrium Klorida larutan infus 0,9% btl 500 ml 5,170.00 -
140 Natrium Tiroksin 100 mcg. (Euthyrax) tab. 1,870.00 -
141 Nifedipin tab. 110.00 -
142 Nistatin tablet salut 500.000 IU tab. 704.00 -
143 Nistatin vagina tablet 100.000 IU tab. 528.00 -
144 OAT FDC Katagori 1 paket 359,990.00 -
145 OAT FDC Katagori 2 paket 1,320,000.00 -
146 OAT Katagori Anak paket 214,990.00 -
147 Obat batuk Hitam (OBH) cairan btl 100 ml 3,060.00 -
148 OBP (Obat Batuk Putih) btl 100 ml - -
149 Oksitetrasiklin HCl inj. 50 mg/ml-10 ml vial 3,410.00 -
150 Oksitetrasiklin HCl salap mata 1% tube 3,5 gr 1,640.00 -

151 Oksitetrasiklin salap kulit 3% tube 5 gr 1,646.00 -
152 Oksitosin inj. 10 IU/ml - 1 ml amp 2,420.00 -
153 Omeprazol kapsul 20 mg kaps 221.00 -
154 Parasetamol sirup 120 mg/5 ml 60 ml 1,535.00 -
157 Pewarna Ziel Neelsen (BTA) btl 150,000.00 -
158 Pirantel tablet 125 mg tab. 318.00 -
160 Piroksikam kap 20 mg kaps 99.99 -
161 Povidon Iodida larutan 10% btl 30 ml 2,344.00 -
163 Primakuin tablet 15 mg tab. 205.00 -
164 Prokain Benzil Penisillin G. inj. 3 jt - 15 vial 6,141.67 -
ml.
165 Propanolol HCl tablet 40 mg tab. 114.00 -
166 Propiltiourasil tablet 100 mg (PTU) tab. 351.00 -
167 Ranitidin Inj. 25 mg/ml. amp 1,340.00 -
168 Ranitidin tablet 150 mg tab. 132.00 -
lunak

lunak
171 Ringer Laktat larutan infus btl 500 ml 5,720.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
172 Salap 2 - 4 pot 2,200.00 -
173 Salbutamol tablet 2 mg tab. 65.00 -
174 Salisil Bedak 2% 50 gram 1,350.00 -
175 Sefadroksil kapsul 500 mg kaps 548.00 -
176 Semen Seng Fosfat serbuk dan cairan set - -
177 Serum Anti Bisa Ular (ABU) inj. vial 567,600.00 -
178 Serum Anti Tetanus inj 1500 IU (ATS) amp. 151,800.00 -
179 Serum Anti Tetanus inj 20.000 IU (ATS) Vial 868,000.00 -
180 Sianokobalamin (vit B12) inj. 500 mcg amp. 1,050.00 -

181 Silk (benang bedah) no. 3 spcs 13,616.00 -
182 Silver Amalgam 1 oz - -
185 Siprofloksasin tablet 500 mg tab. 400.00 -
186 Sulfasetamid natrium tetes mata 15% btl 3,549.00 -
188 Temporary Stopping Fletcher set - -
192 Tiamin (Vit B1) inj. 100 mg/ml amp 750.00 -
193 Tiamin tablet 50 mg tab. 136.00 -
194 Tramadol kapsul 50 mg kaps 196.35 -
196 Trikresol Formalin (TKF) botol - -
197 Vaksin BCG 2 ds/vial 59,950.00 -
198 Vaksin Campak 10 ds/vial 28,204.00 -
199 Vaksin DPT/HB 10 ds/vial - -
200 Vaksin DT 10 ds/vial 70,863.00 -
201 Vaksin HB - Uniject 1 ds/vial 20,900.00 -
202 Vaksin Pentabio 1 ds/vial 76,285.00 -
203 Vaksin Polio 10 ds/vial 19,954.00 -
204 Vaksin Td 10 ds/vial 16,500.00 -
205 Vaksin TT 10 ds/vial 14,498.00 -
207 Zink 20 mg. tab. tab. 521.00 -
SISA STOK 31 DES.
1 2 3 4 5 6 (4x5)
208 Zink sirup (Zircum Kid) btl 60 ml. 8,140.00 -
210 Risperidon 2 mg. tab. 1,781.00 -
JUMLAH -

Kepala Puskesmas Pengelola Obat puskesmas
……………………………………….. ………………………………………………
NIP. NIP.
KET
7
KET
7
KET
7
KET
7
KET
7
KET
7
KET
uskesmas
………………………….
LAPORAN PERSEDIAAN BMHP PUSKESMAS ……………………..
31 DESEMBER 2015
SISA STOK 31 DES

1 2 3 4 5 6 (4x5)

16 Kasa 4 x 10 cm rol 2,534.24 -
19 Plester rol 33,000.00 -
JUMLAH -

Kepala Puskesmas Pengelola BMHP puskesmas
……………………………………….. ………………………………………………
NIP. NIP.
KET
puskesmas
………………………….

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Senin 1 Feb 2015 Rapat Persediaan Obat 2015

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LAPORAN PERSEDIAAN OBAT PUSKESMAS ……………………..

SISA STOK 31 DES.

13 Amoksisillin sirup kering 250 mg/5 ml. btl 60 ml. 4,730.00 -

14 Ampisillin serbuk Inj. i.m/i.v 1000 vial 5,181.00 -

57 Fenol Gliserol tetes telinga 10% btl 1,108.80 -

64 Gentamisin salep kulit 0.1% tube 5 gr. 1,469.00 -

75 Haloperidol tablet 0.5 mg tab. 62.00 -

85 Kalsium Glukonat 10% amp - -

100 Klorfenol kamfer mentol (CHKM) btl - -

131 Metilergometrin maleat tab. Salut 0.125 tab. 169.00 -

150 Oksitetrasiklin HCl salap mata 1% tube 3,5 gr 1,640.00 -

170 Retinol (vitamin A) 200.000 IU kapsul kaps 505.00 -

179 Serum Anti Tetanus inj 20.000 IU (ATS) Vial 868,000.00 -

180 Sianokobalamin (vit B12) inj. 500 mcg amp. 1,050.00 -

Mengetahui, 04 Januari 2016

SISA STOK 31 DES

1 Abbocath No 20 pcs 7,824.00 -

Mengetahui, 04 Januari 2016

SISA STOK 31 DES.

ACT (Artesunate 50mg+ Amodiaquin

4 Alopurinol tablet 100 mg tab. 90.00 -

5 Ambroxol sirup 15 mg/ml pcs 2,665.00 -

13 Amoksisillin sirup kering 250 mg/5 ml. tab. 4,730.00 -

21 Antimigren DOEN kombinasi (Ergotamin) kapl 149.00 -

24 Asam Ascorbat (vit. C) tablet 50 mg vial 105.00 -

25 Asam Mefenamat tablet 500 mg tab. 127.00 -

31 Bisakodil supp. 10 mg. (Stolax) tab. 6,045.00 -

56 Fenobarbital Inj. i.m. 50 mg/ml - 2 ml. tab. 1,980.00 -

63 Gentamisin Inj. 40 mg/ml (sulfat) - 2 ml. btl 100 ml. 3,782.00 -

67 Glass Ionomer cement (GC IX) ampul - -

74 Griseofulvin tablet 125 mg, micronized sase 241.00 -

76 Haloperidol tablet 1.5 mg tube 5 gr. 76.00 -

84 Isosorbit Dinitrat tablet sublingual 5 mg amp 25 ml 98.00 -

87 Kalsium laktat (Kalk) tablet 500 mg tab. 76.00 -

102 Klorpromazin HCl inj.25 mg/ml tab. 1,210.00 -

106 Kontrasepsi inj. Depo progestin (3 bln) tab. 5,968.00 -

109 Kotrimoksazol tablet pediatrik 120 mg tube 15 gr 79.00 -

137 Natrium Bikarbonat tablet 500 mg amp 2 ml 20.00 -

150 Oksitetrasiklin HCl salap mata 1% tab. 1,640.00 -

151 Oksitetrasiklin salap kulit 3% tab. 1,646.00 -

171 Ringer Laktat larutan infus amp 5,720.00 -

179 Serum Anti Tetanus inj 20.000 IU (ATS) kaps 868,000.00 -

186 Sulfasetamid natrium tetes mata 15% tab. 3,549.00 -

191 Tiamfenikol kapsul 500 mg kaps 440.00 -

202 Vaksin Pentabio amp. 76,285.00 -

206 Vitamin B Komplek tablet tab. 112.00 -

Mengetahui, 04 Januari 2016

SISA STOK 31 DES.

ACT (Artesunate 50mg+ Amodiaquin

4 Alopurinol tablet 100 mg tab. 90.00 -

5 Ambroxol sirup 15 mg/ml pcs 2,665.00 -

13 Amoksisillin sirup kering 250 mg/5 ml. tab. 4,730.00 -

21 Antimigren DOEN kombinasi (Ergotamin) kapl 149.00 -

24 Asam Ascorbat (vit. C) tablet 50 mg vial 105.00 -

25 Asam Mefenamat tablet 500 mg tab. 127.00 -

31 Bisakodil supp. 10 mg. (Stolax) tab. 6,045.00 -

56 Fenobarbital Inj. i.m. 50 mg/ml - 2 ml. tab. 1,980.00 -

63 Gentamisin Inj. 40 mg/ml (sulfat) - 2 ml. btl 100 ml. 3,782.00 -