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FORM KEBUTUHAN OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)

RUMAH SAKIT DAERAH KOTA TIDORE KEPULAUAN

V F K W P A P A I N K O R U U L
I I 3 A R N E N C H E K O T G A
P S N I A R A U C B D D B I
I A K B K U I P
SATUAN

L
NO NAMA BMHP S

TA
KEMASAN O E
R

TO
T D
E S
R
A
1 Alkohol 70% 1 Liter Botol P 1
I
2 48 48 90 36 225
2 Aqua Steril 1 Liter Botol 4032 108 1440 5580
3 Aseptic Gell 500 ml Botol 24 240 384 60 1080 1788
BABY OIL BOTOL 4
Benang catgut chromic rol 4 4
Benang Catgut Cromic 2/0 sachet 810 810
Benang Catgut Cromic 3/0 sachet 810 810
Benang Catgut Cromic 4/0 sachet 405 405
Benang silk 2/0 sachet 1620 1620
Benang silk 3/0 sachet 1620 1620
Benang silk 4/0 sachet 810 810
4 Benang silk 5/0 sachet 810 810
5 Bisturi No. 10 Pieces 0
6 Bisturi No. 11 Pieces 540 540
7 Bisturi No. 13 Pieces 540 540
8 Bisturi No. 15 Pieces 0
9 Bisturi No. 22 Pieces 0
10 Bisturi No. 23 Pieces 0
11 Bisturi No. 24 Pieces 6 150 156
12 Blood bag Pieces 0
13 Dispo 1 cc Pieces 4032 204 2400 6636
14 Dispo 10 cc Pieces 4032 120 4152
15 Dispo 20 cc Pieces 4032 4032
16 Dispo 3 cc Pieces 6720 2400 6000 15120
17 Dispo 5 cc Pieces 4032 204 600 4836
18 Dispo 50 cc Pieces 4032 4032
19 Dispo 50 cc TIP Pieces 0
Elektroda bayi 12 18

Elektroda anak 18

Elektroda dewasa Pak 96 54 150


ETT NON CAF NO. 2,5 Pieces 150

20 ETT NON CAF NO. 2,5 Pieces 150

21 Film 11 x 14 inci PIECES 0


22 Film 14 x 17 inci PIECES 0
23 film gigi (dental) PIECES 0
24 Gelang Bayi Biru Box 0
25 Gelang Bayi Pink Box 0
26 Gelang Dewasa Biru Box 0
27 Gelang Dewasa Pink Box 0
28 GELANG HIJAU LEMBAR 0
29 GELANG KUNING LEMBAR 0
30 GELANG UNGU LEMBAR 0
31 HANDWASH 500 ML BOTOL 48 48
32 Hansaplast PLESTER Pieces 3600 3600
33 Hc ON (L) Box 6 96 24 500 626
34 Hc ON (M) Box 6 96 48 40 328 24 542
35 Hc ON (S) Box 96 110 48 254
36 HC Steril No. 6.5 Pasang 3600 3600
37 HC Steril No. 7 Pasang 120 2400 696 1000 1800 6016
38 HC Steril No. 7,5 Pasang 120 2064 620 2804
39 HC Steril No. 8 Pasang 0
40 HC Steril Obgyn Pasang 730 730
41 Iodin Povidon 1 liter Botol 5 6 11
42 IODIN POVIDON 300 ML BOTOL 18 18
Kapas 500 gram Rol
1 7 30 24 18 24 104
43 Kasa Rol Besar Rol 4 20 60 216 300
44 KASA STERIL 16 X 16 BOX 24 24
kertas EKG 21,5cmx25cm
45 Rol 72
ONEMED
46 kertas USG Sony Pasang 0
KINESIO TAPPING 5 CMX5M
46 ROL 2
( MEREK LEUKOTAPE K)
47 Masker LEMBAR 9600 4032 1596 25200 4200 44628
48 MASKER N95 LEMBAR 800 100 2880 720 4500
49 MINYAK ZAITUN 150 ML BOTOL 12
50 My Gelly 80 gram LEMBAR 12 24 36
51 NACL 0,9% 500 ML BOTOL 720 720
52 Nall Kulit No. 10 Pieces 90 90
53 Nall Kulit No. 11 Pieces 90 90
54 Nall Kulit No. 12 Pieces 90 90
55 Nall Kulit No. 13 Pieces 0
56 Nall Kulit No. 14 Pasang 0
57 Nall Kulit No. 15 Pasang 0
58 Nall Kulit No. 6 Pasang 0
59 Nall Kulit No. 7 Pasang 0
60 Nall Kulit No. 9 Pieces 10 10
61 Nall Kulit No. 9 Pasang 0
62 Nall Otot No. 10 Botol 90 90
Nall Otot No. 11 Rol 90 90
Nall Otot No. 12 Rol 90 90
Nall Otot No. 13 Rol 0
Nall Otot No. 14 Box 0
Nall Otot No. 15 Pieces 0
Nall Otot No. 7 Tube 0
63 Nall Otot No. 9 Set 0
64 NGT NO. 2,5 Pieces 150
65 NGT NO. 3 Pieces 150
66 NGT NO. 3,5 Pieces 150
67 NGT NO. 5 Pieces 150
68 NGT NO. 6 Pieces 150
69 NGT NO. 8 Pieces 150
70 OKSIGEN TABUNG 2520 2520
71 Onescrub 500 ml Set 24 60 36 84 204
OXYFLOW DEWASA Pieces 24 24
Plester Roll 7,5 cm Set 2 24 60 360 446
REGULATOR OKSIGEN UNIT 60 60
Safety Box Set 48 180 180 408
Scalpel Handie 3 Set 0
SUCTION CATETER NO. 10 PIECES 150
SUCTION CATETER NO. 12 PIECES 150
SUCTION CATETER NO. 14 PIECES 150
SUCTION CATETER NO. 6 PIECES 150
SUCTION CATETER NO. 8 PIECES 150
Termometer Digital Set 2 4 84 36 126
Termometer kulkas Set 4 2 3 9
UDERPAD PIECES 60
ULTRASONIC GEL Botol 5

VOLTAREN GEL 50 GR TUBE


15
WATER FOR IN 25 ML FLACON 1440 1440

NHCU
FORM KEBUTUHAN OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
RUMAH SAKIT DAERAH KOTA TIDORE KEPULAUAN

(ISI KEBUTUHAN SESUAI YANG DIANFRAK BUKAN YANG DIRESEPKAN)

RUANGAN : KEPALA RUANGAN/TTD :


TANDA TANGAN :

SATUAN JUMLAH SATUAN JUMLAH


NO NAMA OBAT/BMHP KETERANGAN NO NAMA OBAT/BMHP KETERANGAN
KEMASAN KEBUTUHAN KEMASAN KEBUTUHAN
1 36
2 37
3 38
4 39
5 40
6 41
7 42
8 43
9 44
10 45
11 46
12 47
13 48
14 49
15 50
16 51
17 52
18 53
19 54
20 55
21 56
22 57
23 58
24 59
25 60
26 61
27 62
28 63
29 64
30 65
31 66
32 67
33 68
34 69 Set
35 70 Set

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