PEMERINTAH KABUPATEN WONOGIRI

DINAS KESEHATAN
PUSKESMAS GIRITONTRO
Jl. Raya Giritontro - Baturetno, Kode Pos. 57676

DAFTAR PENAMBAHAN / PENGURANGAN OBAT-OBATAN

PERIODE 1 JANUARI 2013 S/D 31 DESEMBER 2013

UNIT KERJA : UPT. PUSKESMAS GIRITONTRO

KECAMATAN : GIRITONTRO
KABUPATEN : WONOGIRI

NO NAMA O BAT SATUAN Sisa Penerimaan Pemakaian

awal Nominal 2012 2013 Total Nominal 2012 2013 Total
I. TABLET KAPSUL :
1 ACT-(dehidro artemisin +piperaquin 0 0.00 0 0 0 0.00 0 0 0
2 ACT-Artes Diaquine 0 0.00 0 0 0 0.00 0 0 0
3 ACYCLOVIR TAB 200 MG TAB 0 0.00 0 0 0 0.00 0 0 0
4 ACYCLOVIR TAB 400 MG TAB 314 198,284.72 0 0 0 0.00 196 0 196
5 ADROME TABLET TABLET 0 0.00 0 0 0 0.00 0 0 0
6 ALOPURINOL TABLET 183 24,201.75 1,000 0 1,000 132,250.00 946 0 946
7 ALPRAZOLAM 0,5 MG TAB 0 0.00 0 0 0 0.00 0 0 0
8 AMBROXOL 30 MG KAPSUL 110 13,777.50 1,000 0 1,000 125,250.00 547 0 547
9 AMILORID 5 MG TAB TABLET 0 0.00 0 0 0 0.00 0 0 0
10 AMINOFILINA 200 MG TABLET 2,074 235,419.74 7,000 0 7,000 794,570.00 9074 0 9074
11 AMITRIPTILIN 25 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
12 AMOKSILIN 500 MG TABLET 1,882 693,686.38 29,000 7000 36,000 12,373,940.00 30882 2999 33881
13 AMOKSILINA 250 MG KAPSUL 376 108,773.04 5,000 1200 6,200 1,687,134.00 5376 414 5790
14 AMPISILIN 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
15 ANTALGIN 500 MG TABLET 10,954 1,635,213.12 28,800 0 28,800 4,299,264.00 31728 0 31728
16 ANTASIDA DOEN TABLET 11,870 1,926,501.00 20,000 0 20,000 3,246,000.00 25080 0 25080
17 ANTITUBERKOLUSA ANAK TABLET 0 0.00 0 0 0 0.00 0 0 0
18 ANTITUBERKOLUSA ANAK (FDC) TABLET 0 0.00 0 0 0 0.00 0 0 0
19 ASAM ASKORBAT (VIT C) 50 MG TABLET 10,332 192,588.48 23,000 0 23,000 428,720.00 27442 0 27442
20 ASAM ASKORBAT 250 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
21 ASAM MEFENAMAT 250 MG KAPSUL 0 0.00 16,800 0 16,800 1,276,800.00 10374 0 10374
22 ASAM MEFENAMAT 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
23 ASETOSAL 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
24 ATROPINA SULFAT 0,5 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
25 BESI II SULFAT TABLET 8,054 219,874.20 0 0 0 0.00 8054 0 8054
26 BETAHISTIN MESILAT 6 MG TABLET 38 35,112.00 0 150 150 138,999.00 38 120 158
27 BICARBON TABLET 0 0.00 0 0 0 0.00 0 0 0
28 BROMHEKSIN 8 MG TABLET 0 0.00 200 0 200 7,716.00 30 0 30
29 BUSCOPAN/ SPASHI TABLET 0 0.00 0 0 0 0.00 0 0 0
30 CAPTOPRIL 12,50 MG TABLET 1,323 119,281.68 2,000 0 2,000 180,320.00 1066 0 1066
31 CAPTOPRIL 25 MG TABLET 588 81,144.00 6,000 0 6,000 828,000.00 5842 0 5842
32 CARBAZOKROM NATRIUM SULFONAT 10 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
33 CEFADROXIL 500 MG TABLET 0 0.00 1,500 0 1,500 1,262,370.00 224 0 224
34 CEPHALEXIN 250 MG TAB KAPSUL 0 0.00 0 0 0 0.00 0 0 0
35 CEPHALEXIN 500 MG TAB TABLET 0 0.00 0 0 0 0.00 0 0 0
36 CETIRIZIN 10 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
37 CIMETIDIN 200 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
38 CIPROFLOKSASIN 500 MG TABLET 56 16,003.68 2,000 0 2,000 571,560.00 1008 0 1008
39 CLOBAZAM TABLET 0 0.00 0 0 0 0.00 0 0 0
40 CO AMOXICLAVE 625 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
41 DAPSON 100 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
42 DEKSAMETAZON TAB 0,5 MG TAB 5,491 478,595.56 37,000 0 37,000 3,224,920.00 42491 0 42491
43 DEKSTROMETORFAN HBR 15 MG TABLET 3,897 138,889.08 3,000 0 3,000 106,920.00 4770 0 4770
44 DEXTAMIN TABLET 0 0.00 0 0 0 0.00 0 0 0
45 DIAZEPAM 2 MG TABLET 428 8,474.40 0 1000 1,000 35,100.00 428 0 428
46 DIETILKARBAMASIN TABLET 0 0.00 0 0 0 0.00 0 0 0
47 DIGOKSIN 25 MG TABLET 143 20,487.61 0 0 0 0.00 143 0 143
48 DIMENHIDRINATUM TABLET 475 45,685.50 1,000 500 1,500 143,815.00 1475 108 1583
49 DOKSISIKLIN KAP TABLET 0 0.00 0 0 0 0.00 0 0 0
50 DOMPERIDON 10 MG TABLET 0 0.00 200 0 200 35,302.00 40 0 40
51 EFEDRINA HCL 25 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
52 EKSTRAK BELLADON 10 MG KAPSUL 0 0.00 0 0 0 0.00 0 0 0
53 ERGOTAMIN+KOFFEIN 0 0.00 0 0 0 0.00 0 0 0
54 ERITHROMISIN 250 MG TABLET 496 248,466.24 2,400 0 2,400 1,202,256.00 1560 0 1560
55 ERITHROMISIN 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
56 ERPHATRIM TABLET 0 0.00 0 0 0 0.00 0 0 0
57 ETAMBUTOL HCL 250 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
58 FAMOTIDIN 20 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
59 FAMOTIDIN 40 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
60 FENOBARBITAL 30 MG TABLET 539 16,709.00 0 0 0 0.00 29 0 29
61 FENOKSIMETIL PENISILIN 250 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
62 FENOKSIMETIL PENISILIN 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
63 FITOMENADION (VIT K) 10 MG TABLET 54 36,822.06 100 0 100 68,189.00 104 0 104
64 FUROSEMIDA 40 MG TABLET 255 14,269.80 3,000 0 3,000 167,880.00 1349 0 1349
65 GEMFIBROZIL 300 MG TAB TABLET 0 0.00 0 0 0 0.00 0 0 0
66 GLIBENKLAMIDA 5 MG TABLET 719 51,868.66 1,500 1000 2,500 162,370.00 1970 0 1970
67 GLISERILGUAYAKOLAT 100 MG TABLET 3,339 93,325.05 50,000 0 50,000 1,397,500.00 38965 0 38965
68 GRISIOVULVIN 125 MG TABLET 922 221,694.90 0 0 0 0.00 517 0 517
69 HALOPERIDOL 0,5 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
70 HALOPERIDOL 1,5 MG KAPSUL 820 67,846.80 500 0 500 41,370.00 720 0 720
71 HALOPERIDOL 5 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
72 HECOBAC TABLET 0 0.00 0 0 0 0.00 0 0 0
73 HIDROKLOROTIASIDA 25 MG TABLET 1,382 34,052.48 3,000 0 3,000 73,920.00 4382 0 4382
74 IBUPROVEN 200 MG TABLET 2,623 303,533.56 3,000 0 3,000 347,160.00 1466 0 1466
75 IBUPROVEN 400 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
76 IODIOL TABLET 0 0.00 0 0 0 0.00 0 0 0
77 ISONIASIDA 100 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
78 ISONIASIDA 300 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
79 ISOSORBIT DINITRAT 5 MG TABLET 0 0.00 100 0 100 9,753.00 0 0 0
80 KALIUM DIKLOFENAK 25 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
81 KALIUM DIKLOFENAK 50 MG TABLET 98 69,514.34 350 0 350 248,265.50 160 0 160
82 KALSIUM LAKTAT 500 MG TABLET 0 0.00 35,000 0 35,000 1,823,500.00 24325 0 24325
83 KARBAMEZEPIN 200 MG TAB 0 0.00 0 0 0 0.00 0 0 0
84 KETOKONAZOL 200 MG TABLET 180 66,960.00 500 0 500 186,000.00 287 0 287
85 KININA SULFAT 222 MG KAPSUL 0 0.00 0 0 0 0.00 0 0 0
86 KLOFAZIMIN 100 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
87 KLONIDIN 0,15 MG KAPSUL 0 0.00 0 0 0 0.00 0 0 0
88 KLORAMFENIKOL 250 MG TABLET 121 28,003.03 2,000 0 2,000 462,860.00 1480 0 1480
89 KLORFENIRAMIN MALEAT (CTM) 4 MG TABLET 4,281 102,958.05 85,000 0 85,000 2,044,250.00 76618 0 76618
90 KLOROKINA FOSFAT 250 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
91 KLORPROMAZIN 100 MG TABLET 1,024 81,346.56 0 1000 1,000 133,380.00 900 0 900
92 KLORPROMAZINA HCL 25 MG TABLET 0 0.00 1,000 0 1,000 38,070.00 0 0 0
93 KLORPROPAMID TABLET 0 0.00 0 0 0 0.00 0 0 0
94 KODEINA HCL 10 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
95 KOTRIMOKSAZOL 120 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
96 KOTRIMOKSAZOL 480 MG KAPSUL 0 0.00 3,000 0 3,000 495,930.00 3000 0 3000
97 LINCOMISIN TABLET 0 0.00 0 0 0 0.00 0 0 0
98 LOPERAMID 2 MG TABLET 44 4,035.24 200 0 200 18,342.00 62 0 62
99 LORATADIN 10 MG TABLET 162 53,958.96 200 0 200 66,616.00 177 0 177
100 MDT COMBI MB ADULT TABLET 0 0.00 18 0 18 0.00 18 0 18
101 MDT COMBI MB CHILD KAPSUL 0 0.00 0 0 0 0.00 0 0 0
102 MDT COMBI PB ADULT KAPSUL 0 0.00 5 0 5 0.00 5 0 5
103 MEBENDAZOL 100 MG KAPLET 0 0.00 3,312 0 3,312 1,354,243.68 3312 0 3312
104 MEBHIDROLIN NAPADISILAT TABLET 0 0.00 0 0 0 0.00 0 0 0
105 MELOXICAM 15 MG TABLET 206 247,457.50 0 500 500 174,500.00 206 32 238
106 METFORMIN HCL 500 ML TABLET 390 58,110.00 0 0 0 0.00 366 0 366
107 METILERGOMETRINA MALEAT 0,125 MG TABLET 79 8,686.84 200 0 200 21,992.00 82 0 82
108 METILPREDNISOLON 4 MG TABLET 0 0.00 500 0 500 220,690.00 352 0 352
109 METOKLOPROPAMID TABLET 361 26,414.37 0 0 0 0.00 107 0 107
110 METRONIDAZOL 250 MG KAPSUL 250 35,817.50 1,500 500 2,000 276,480.00 1642 0 1642
111 METRONIDAZOL 500 MG TABLET 1,073 236,499.93 700 0 700 154,287.00 1273 0 1273
112 MULTIVITAMIN TABLET 0 0.00 8,000 0 8,000 5,055,680.00 4387 0 4387
113 NA. DIKLOFENAK 25 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
114 NA. DIKLOFENAK 50 MG TABLET 63 13,738.41 0 0 0 0.00 63 0 63
115 NALTREXON KAPS 0 0.00 0 0 0 0.00 0 0 0
116 NATRIUM BIKARBONAT 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
117 NATRIUM FENITOINA 100 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
118 NATRIUM FENITOINA 30 MG TAB 0 0.00 0 0 0 0.00 0 0 0
119 NATUR E KAP TABLET 0 0.00 0 0 0 0.00 0 0 0
120 NEO DIAFORM PAKET 998 62,834.08 6,000 0 6,000 377,760.00 3183 0 3183
121 NEUROTROPIC PAKET 0 0.00 0 0 0 0.00 0 0 0
122 NIFEDIPIN 10 MG TAB PAKET 0 0.00 0 0 0 0.00 0 0 0
123 OBAT ANTI TUBERKULOSIS KATEG I PAKET 0 0.00 7 0 7 1,652,000.00 7 0 7
124 OBAT ANTI TUBERKULOSIS KATEG II KAPSUL 0 0.00 0 0 0 0.00 0 0 0
125 OBAT ANTI TUBERKULOSIS KATEG III TABLET 0 0.00 0 0 0 0.00 0 0 0
126 OBAT ANTI TUBERKULOSIS SISIPAN TABLET 0 0.00 0 0 0 0.00 0 0 0
127 OBAT KOMBIPAK KATEG I TABLET 0 0.00 1 0 1 0.00 1 0 1
128 OMEPRAZOL 20 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
129 PAPAVERIN TABLET 2,115 133,245.00 2,000 0 2,000 126,000.00 2715 0 2715
130 PARASETAMOL 100 MG TABLET 1,976 82,952.48 0 0 0 0.00 618 0 618
131 PARASETAMOL 500 MG TABLET 4,119 430,888.59 97,200 0 97,200 10,168,092.00 88263 0 88263
132 PEHAVRAL TABLET 0 0.00 0 0 0 0.00 0 0 0
133 PENIL BUTASON 200 MG TABLET 3,270 236,666.25 3,000 0 3,000 217,125.00 2726 0 2726
134 PHERPHENAZIN 4 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
135 PIPERAZINA 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
136 PIRACETAM 400 MG TABLET 169 84,770.40 0 0 0 0.00 118 0 118
137 PIRANTEL PAMOAT 365 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
138 PIRAZINAMID TAB 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
139 PIRIDOKSIN HCL (VIT B6) 10 MG TABLET 773 13,473.39 23,000 0 23,000 400,890.00 23773 0 23773
140 PIRITAMIN + SULFADOKSIN TABLET 0 0.00 0 0 0 0.00 0 0 0
141 PIROKSIKAM 10 MG TABLET 2,133 159,975.00 0 0 0 0.00 2133 0 2133
142 PIROKSIKAM 20 MG TABLET 0 0.00 10,800 0 10,800 1,136,052.00 10004 0 10004
143 PRAZIQUANTEL 600 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
144 PREDNISON 5 MG TABLET 3,735 149,400.00 20,000 0 20,000 800,000.00 17233 0 17233
145 PRIMAKINA 15 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
146 PROPANOLOL HCL TABLET 0 0.00 100 0 100 7,714.00 0 0 0
147 PROPILTIOURASIL 100 MG KAPLET 145 43,465.20 200 0 200 59,952.00 165 0 165
148 RANITIDIN 150 MG TAB TABLET 909 200,352.69 500 0 500 110,205.00 996 0 996
149 RESERPINA 0,10 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
150 RESERPINA 0,25 MG KAPSUL 937 51,535.00 0 0 0 0.00 430 0 430
151 RETAPHYL SR KAPSUL 0 0.00 0 0 0 0.00 0 0 0
152 RETINOL 100.000 IU KAPSUL 0 0.00 350 0 350 100,289.00 350 0 350
153 RETINOL 200.000 IU TABLET 0 0.00 650 450 1,100 412,761.00 650 450 1100
154 RIFAMPISINA 450 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
155 RIFAMPISINA 600 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
156 RISPERIDON 2 MG KAPSUL 0 0.00 0 0 0 0.00 0 0 0
157 SALBUTAMOL 2 MG KAPSUL 80 6,735.20 100 2000 2,100 150,819.00 180 736 916
158 SIMVASTATIN 10 MG KAPSUL 36 18,468.00 900 0 900 461,700.00 350 0 350
159 SULFADIMIDIN 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
160 TAMIFLU/OSELTAMIVIR TABLET 0 0.00 0 0 0 0.00 0 0 0
161 TENSIGARD TABLET 0 0.00 0 0 0 0.00 0 0 0
162 TETRASIKLIN 500 MG TABLET 0 0.00 0 0 0 0.00 0 0 0
163 TETRASIKLIN KAP 250 MG TABLET 2,462 411,301.72 3,000 0 3,000 501,180.00 3516 0 3516
164 THIAMINA HCL (VIT B1) 50 MG TABLET 0 0.00 30,000 0 30,000 716,400.00 30000 0 30000
165 THIAMPENIKOL TABLET 0 0.00 500 0 500 308,580.00 72 0 72
166 TRAMADOL 50 MG TABLET 78 27,752.40 50 0 50 17,790.00 64 0 64
167 TRIFLUOPERASIN TABLET 0 0.00 0 0 0 0.00 0 0 0
168 TRIHEKSIPENIDIL HCL 2 MG TABLET 734 30,336.22 1,000 0 1,000 41,330.00 730 0 730
169 URISPAS TABLET 0 0.00 0 0 0 0.00 0 0 0
170 VIT. B12 TABLET 3,306 43,407.78 30,000 0 30,000 393,900.00 29599 0 29599
171 VITAMIN B COMPLEK TABLET 1,195 26,576.80 4,000 0 4,000 88,960.00 3331 0 3331
172 VITAZYM TABLET 0 0.00 0 0 0 0.00 0 0 0
173 Zinc Tab 20 MG ZAK 404 191,924.24 1,700 0 1,700 807,602.00 2104 0 2104
II. INJEKSI 0 0.00 0 0 0 0.00 0 0 0
1 ADONA AC 17 INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
 2 AMINOFILINA 24MG/ML-10 ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
3 AMOKSISILIN SERBUK INJ. BOTOL 0 0.00 0 0 0 0.00 0 0 0
4 AMPICILLIN INJ SET 0 0.00 0 0 0 0.00 0 0 0
5 ANTALGIN 250 MG/ML-2ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
6 AQUA PRO INJ STERIL VIAL 0 0.00 0 0 0 0.00 0 0 0
7 AQUADEST STERIL 500ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
8 ARTE METER INJ 40 Mg AMPUL 0 0.00 0 0 0 0.00 0 0 0
9 ARTE METER INJ 80 Mg AMPUL 0 0.00 0 0 0 0.00 0 0 0
10 ARTE SUNATE INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
11 ASAM TRANEKSAMAT INJ 250MG / 5ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
12 ATROPIN SULFAT AMPUL 0 0.00 0 0 0 0.00 0 0 0
13 BENZATIN BENZIL PENISILLIN AMPUL 0 0.00 0 0 0 0.00 0 0 0
14 BUSCOPAN/ SPASHI INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
15 CARBAZOKROM NATRIUM SULFONAT INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
16 CHININ ANTIPIRIN INJ AMP 0 0.00 0 0 0 0.00 0 0 0
17 DEKSAMETASON AMPUL 22 19,970.94 0 0 0 0.00 22 0 22
18 DIAZEPAM AMP 15 35,521.50 30 0 30 71,043.00 36 0 36
19 DIFENHIDRAMIN HCL 10 MG/ML - 2ML VIAL 0 0.00 0 0 0 0.00 0 0 0
20 DIHIDRO EMETIN FLACON 0 0.00 0 0 0 0.00 0 0 0
21 EPINEFRINA HCL 0,1% - 1 ML VIAL 0 0.00 0 0 0 0.00 0 0 0
22 FENOBARBITAL 50 MG/ML - 2ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
23 FITOMENADION (VITK) 10 MG/ML - 1 ML AMPUL 79 137,715.17 300 0 300 522,969.00 379 0 379
24 FUROSEMID INJ 10 MG / ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
25 GLUKOSA LAR INFUS 40% STERIL AMPUL 0 0.00 0 0 0 0.00 0 0 0
26 HYPOBHAC INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
27 INSULIN REGULER AMPUL 0 0.00 0 0 0 0.00 0 0 0
28 KEMICETIN INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
29 KETAMIN INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
30 KETOROLAC INJEKSI 10 MG AMPL 0 0.00 0 0 0 0.00 0 0 0
31 KININA DIHIDROKLORIDA INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
32 KLORPROMASINA HCL INJ 25MG/ML-1ML AMPUL 18 7,530.00 0 0 0 0.00 18 0 18
33 KLORPROMASINA HCL INJ 5MG/ML-2ML VIAL 0 0.00 0 0 0 0.00 0 0 0
34 LIDOKAINA COMP INJ AMPUL 129 146,905.20 120 300 420 526,272.00 123 0 123
35 MAGNESIUM SULFAT INJ 20%-25ML TABLET 0 0.00 0 0 0 0.00 0 0 0
36 MAGNESIUM SULFAT INJ 40%-25ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
37 METIL ERGOMETRIN MALEAT AMPUL 0 0.00 15 0 15 22,392.00 15 0 15
38 MYOMERGIN VIAL 0 0.00 0 0 0 0.00 0 0 0
39 NATRIUM THIOPENTAL AMPUL 0 0.00 0 0 0 0.00 0 0 0
40 NATRIUM TIOSULFAT INJ 25%-10ML VIAL 0 0.00 0 0 0 0.00 0 0 0
41 OKSITETRASIKLIN KAPSUL 0 0.00 0 0 0 0.00 0 0 0
42 OKSITOSIN AMPL 0 0.00 0 0 0 0.00 0 0 0
43 ONDANSETRON 4MG / 2ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
44 PEHACAIN INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
45 PETIDINA HCL INJ 50MG/ML-2ML VIAL 0 0.00 0 0 0 0.00 0 0 0
46 PIRACETAM 3GR/15 ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
47 PIRIDOKSIN INJ AMPUL 0 0.00 0 0 0 0.00 0 0 0
48 RANITIDIN INJ VIAL 0 0.00 0 0 0 0.00 0 0 0
49 SEFOTAKSIM 1 GRAM VIAL 0 0.00 0 0 0 0.00 0 0 0
50 SIANOKOBALAMIN(B12) INJ VIAL 101 52,520.00 0 0 0 0.00 11 0 11
51 STREPTOMISINA SULFAT INJ 1GR/VL VIAL 0 0.00 0 0 0 0.00 0 0 0
52 SUSPENSI SENG INSULIN VIAL 0 0.00 0 0 0 0.00 0 0 0
53 THIAMINA HCL (B1) INJ 100MG/ML-1ML AMPUL 0 0.00 0 0 0 0.00 0 0 0
54 TRAMADOL INJ VIAL 0 0.00 0 0 0 0.00 0 0 0
55 ULCUMET INJ. VIAL 0 0.00 0 0 0 0.00 0 0 0
III. VAKSIN/SERRA : 0 0.00 0 0 0 0.00 0 0 0
1 SERUM ANTI BISA ULAR I BOTOL 0 0.00 0 0 0 0.00 0 0 0
2 SERUM ANTI BISA ULAR II BOTOL 0 0.00 0 0 0 0.00 0 0 0
3 SERUM ANTI DIFTERI 20.000 IU BOTOL 0 0.00 0 0 0 0.00 0 0 0
4 SERUM ANTI TETANUS 1500 IU BOTOL 0 0.00 0 0 0 0.00 0 0 0
5 SERUM ANTI TETANUS 20.000 IU BOTOL 0 0.00 0 0 0 0.00 0 0 0
6 VAKSIN RABIES KERING BOTOL 0 0.00 0 0 0 0.00 0 0 0
7 VAKSIN RABIES VERO BOTOL 0 0.00 0 0 0 0.00 0 0 0
IV. SIRUP : 0 0.00 0 0 0 0.00 0 0 0
1 AMBROXOL SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
 2 AMOKSILINA SIR 125MG/5ML BOTOL 200 741,188.00 700 0 700 2,594,158.00 800 0 800
3 AMPISILINA SIR 125MG/5ML BOTOL 0 0.00 0 0 0 0.00 0 0 0
4 ANTASIDA SIRUP BOTOL 124 478,296.52 50 0 50 192,861.50 131 0 131
5 BESI II SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
6 COREDRYL SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
7 DEKSTROMETORFAN HBR SIR 10MG/5ML BOTOL 17 48,779.46 250 0 250 717,345.00 158 0 158
8 ERYTROMISIN SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
9 KLORAMFENIKOL SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
10 KOTRIMOKSAZOL SUSPENSI BOTOL 43 170,599.49 200 0 200 793,486.00 213 0 213
11 OBAT BATUK HITAM ( OBH ) BOTOL 54 77,364.72 480 0 480 687,686.40 486 0 486
12 OBAT DIARE SIR BOTOL 0 0.00 0 0 0 0.00 0 0 0
13 OBP BOTOL 0 0.00 0 0 0 0.00 0 0 0
14 PARASETAMOL SIR 120 MG/5ML BOTOL 100 230,332.00 684 0 684 1,575,470.88 616 0 616
15 PIPERASIN SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
16 RECOMINT SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
17 RECOVIT DROP BOTOL 0 0.00 0 0 0 0.00 0 0 0
18 RECOVIT SIRUP BOTOL 0 0.00 180 0 180 1,056,346.20 180 0 180
19 THIAMPENIKOL 125 MG/ 5ML SIRUP BOTOL 0 0.00 0 0 0 0.00 0 0 0
V. OBAT GIGI : 0 0.00 0 0 0 0.00 0 0 0
1 AIR RAKSA DENTAL USE SET 0 0.00 0 0 0 0.00 0 0 0
2 ARSEN PASTA BOTOL 0 0.00 0 0 0 0.00 0 0 0
3 CELLOLOID BOTOL 0 0.00 0 0 0 0.00 0 0 0
4 DEVITALISASI PASTA BOTOL 0 0.00 2 0 2 895,477.64 2 0 2
5 EUGENOL CAIRAN SET 0 0.00 1 0 1 3,177.50 1 0 1
6 FLUOR BOTOL 0 0.00 0 0 0 0.00 0 0 0
7 GLAS IONOMER CEMEN BOTOL 0 0.00 2 0 2 791,480.98 2 0 2
8 GUTTA PERCHA POINT SET 0 0.00 0 0 0 0.00 0 0 0
9 KALSIUM HIDROKSIDA PASTA BOTOL 0 0.00 2 0 2 409,452.00 2 0 2
10 METAKRESOL SULFON & MET SET 0 0.00 4 0 4 74,360.00 4 0 4
11 MONOKLORKAMFER MENTOL CAIRAN BOTOL 0 0.00 2 0 2 97,524.00 2 0 2
12 MUMIFYING PASTA BOTOL 0 0.00 3 0 3 413,559.00 3 0 3
13 SEMEN SENG POSPAT SERBUK & CAIR BOTOL 0 0.00 0 0 0 0.00 0 0 0
14 SILVER AMALGAM SERBUK 65-75% BOTOL 0 0.00 0 0 0 0.00 0 0 0
15 SINTETIK FELING MAT LAR & SERBUK BOTOL 0 0.00 0 0 0 0.00 0 0 0
16 SPON GELATIN CUBICLUS 1M3 BOTOL 0 0.00 2 0 2 527,948.00 2 0 2
17 SULFA CONUS BOTOL 0 0.00 0 0 0 0.00 0 0 0
18 TEMPORARY STOPING FLETCHER BOTOL 0 0.00 1 0 1 34,063.82 1 0 1
19 TRIKRESOL FORMALIN (TKF) CAIRAN BOTOL 0 0.00 1 0 1 164,275.08 1 0 1
VI. REAGENSIA : 0 0.00 0 0 0 0.00 0 0 0
1 ASAM KLORIDA 0,1 N BOTOL 0 0.00 0 0 0 0.00 0 0 0
2 ASAM SULFOSALISILAT 20 % BOTOL 0 0.00 0 0 0 0.00 0 0 0
3 LARUTAN BENEDICT BOTOL 0 0.00 0 0 0 0.00 0 0 0
4 LARUTAN CARBOL FUKSIN BOTOL 0 0.00 0 0 0 0.00 0 0 0
5 LARUTAN EOSIN 2 % BOTOL 0 0.00 0 0 0 0.00 0 0 0
6 LARUTAN GABBETT BOTOL 0 0.00 0 0 0 0.00 0 0 0
7 LARUTAN GIEMSA STAIN BOTOL 0 0.00 0 0 0 0.00 0 0 0
8 LARUTAN KINYOUN BOTOL 0 0.00 0 0 0 0.00 0 0 0
9 LARUTAN METANOL BOTOL 0 0.00 0 0 0 0.00 0 0 0
10 LARUTAN TURK BOTOL 0 0.00 0 0 0 0.00 0 0 0
VII. INFUS : 0 0.00 0 0 0 0.00 0 0 0
1 DEKSTRAN 70-LAR INFUS 6% STERIL BOTOL 0 0.00 0 0 0 0.00 0 0 0
2 GLUKOSA LAR INFUS 10 % BOTOL 0 0.00 0 0 0 0.00 0 0 0
3 GLUKOSA LAR INFUS 5 % BOTOL 0 0.00 0 0 0 0.00 0 0 0
4 NATRIUM KLORIDA LAR INFUS 0,9% BOTOL 0 0.00 0 0 0 0.00 0 0 0
5 POLIPEPTIDA KOMB DOEN INFUS BOTOL 0 0.00 0 0 0 0.00 0 0 0
6 RINGER LAKTAT LAR INFUS BOTOL 0 0.00 20 0 20 104,195.20 10 0 10
VIII. LAIN - LAIN : 0 0.00 0 0 0 0.00 0 0 0
1 ACYCLOVIR CREAM TUBE 72 227,153.52 50 0 50 157,745.50 54 0 54
2 ANTI BAKTERI DOEN TUBE 103 177,160.00 0 0 0 0.00 24 0 24
3 ANTIHEMOROIDA TABLET 8 16,000.00 12 0 12 24,000.00 20 0 20
4 AQUATAB BOTOL 0 0.00 0 0 0 0.00 0 0 0
5 AS.BENZOAT+AS.SALISILAT ZK TUBE 1 1,154.17 72 0 72 83,100.00 47 0 47
6 AS.SALISIL+BELERANG ZK ( 2-4 SALEP ) TUBE 43 52,953.21 24 0 24 29,555.28 44 0 44
7 ATROPIN SULFAT TM BOTOL 0 0.00 0 0 0 0.00 0 0 0
 8 BETAMETASON KRIM 0,1 % TUBE 0 0.00 350 120 470 837,249.40 350 62 412
9 BETAMETASON N KRIM 0,1 % TUBE 0 0.00 0 0 0 0.00 0 0 0
10 BIOPLACENTON SALEP TUBE 0 0.00 0 0 0 0.00 0 0 0
11 BISACODYL SUPP 10 MG TUBE 0 0.00 10 0 10 0.00 10 -7 3
12 BISACODYL SUPP 5 MG TUBE 0 0.00 0 0 0 0.00 0 0 0
13 CALADIN BEDAK ZAK 0 0.00 0 0 0 0.00 0 0 0
14 CHLORAMFECORT H CREAM TUBE 0 0.00 0 0 0 0.00 0 0 0
15 ETAKRIDINA SERBUK ZAK 0 0.00 0 0 0 0.00 0 0 0
16 ETAKRIDINA(RIVANOL)LAR 0,1 % ZAK 11 19,837.18 10 0 10 18,033.80 12 0 12
17 ETANOL 70% BOTOL 3 46,505.76 10 0 10 155,019.20 9 0 9
18 ETANOL 95% BOTOL 0 0.00 0 0 0 0.00 0 0 0
19 ETER ANESTESI BOTOL 0 0.00 0 0 0 0.00 0 0 0
20 ETIL KLORIDA SEMPROT BOTOL 1 105,196.10 20 0 20 2,103,922.00 9 0 9
21 FENOL GLISEROL TT TUBE 0 0.00 0 0 0 0.00 0 0 0
22 GAMEKSAN BOTOL 0 0.00 0 0 0 0.00 0 0 0
23 GARAM ORALIT 1000 ML ZAK 0 0.00 0 0 0 0.00 0 0 0
24 GARAM ORALIT 200 ML ZAK 0 0.00 100 0 100 30,456.00 50 0 50
25 GENTAMISIN TETES MATA BOTOL 0 0.00 10 0 10 33,061.90 10 0 10
26 GENTAMISIN SK TUBE 0 0.00 25 0 25 46,011.25 4 0 4
27 GENTIAN VIOLET LAR 1 % BOTOL 7 3,155.88 24 0 24 10,820.16 21 0 21
28 GLISEROL BOTOL 0 0.00 0 0 0 0.00 0 0 0
29 HIDROKORTISON KRIM 2,5 % SK TUBE 108 322,354.08 480 0 480 1,432,684.80 360 0 360
30 HYPAFIK 5M x 2M ROL 0 0.00 0 0 0 0.00 0 0 0
31 IKHTIOL SALEP KULIT ROL 0 0.00 20 0 20 71,470.00 20 0 20
32 ISODIN GARGLE ROL 0 0.00 0 0 0 0.00 0 0 0
33 ISODIN OINTMENT TUBE 0 0.00 0 0 0 0.00 0 0 0
34 KALIUM PERMANGANAT SERBUK TUBE 0 0.00 45 0 45 141,691.50 45 0 45
35 KAPAS 250 GRAM ROL 1 11,401.00 10 0 10 114,010.00 5 0 5
36 KAPAS BERLEMAK 500 GRAM ROL 0 0.00 0 0 0 0.00 0 0 0
37 KASA HIDROFIL 40M X 80CM ROL 0 0.00 0 0 0 0.00 0 0 0
38 KASA HIDROFIL STERIL UK 16 X 16 ISI ROL 275 2,364,078.75 0 0 0 0.00 55 0 55
39 KASA HIDROFIL STERIL UK 18 X 22 ISI ROL 20 96,080.20 25 0 25 120,100.25 7 0 7
40 KASA KOMPRES 40/40 STERIL ROL 0 0.00 10 0 10 12,582.70 3 0 3
41 KASA PEMBALUT 2M X 80 CM ROL 0 0.00 25 0 25 226,489.25 12 0 12
42 KASA PEMBALUT ELASTIC 3 INCHI ROL 15 106,194.00 0 0 0 0.00 15 0 15
43 KASA PEMBALUT ELASTIC 4 INCHI ROL 0 0.00 0 0 0 0.00 0 0 0
44 KASA PEMBALUT HIDROFIL 4 X 15 CM ROL 0 0.00 0 0 0 0.00 0 0 0
45 KASA PEMBALUT HIDROFIL 4 X 3 CM ROL 0 0.00 0 0 0 0.00 0 0 0
46 KASA PEMBALUT HIDROFIL 4M X 10CM ROL 0 0.00 50 0 50 30,644.50 50 0 50
47 KASA PEMBALUT HIDROFIL 4M X 5CM ROL 0 0.00 50 0 50 15,347.50 50 0 50
48 KETOKONAZOL KRIM 2% TUBE 11 77,133.54 0 0 0 0.00 11 0 11
49 KLORAMFENIKOL SM 1 % BOTOL 54 84,506.22 24 0 24 37,558.32 58 0 58
50 KLORAMFENIKOL TES MATA BOTOL 31 77,614.39 150 0 150 375,553.50 181 0 181
51 KLORAMFENIKOL TT 3 % BOTOL 22 35,244.00 144 48 192 307,660.80 155 0 155
52 LEVERTRAN SALEP KULIT POT 9 20,610.54 20 0 20 45,801.20 25 0 25
53 LISOL BOTOL 0 0.00 0 0 0 0.00 0 0 0
54 MAGNESIUM SULFAT BOTOL 0 0.00 0 0 0 0.00 0 0 0
55 MIKONAZOL 2 % BOTOL 0 0.00 24 0 24 72,135.12 20 0 20
56 MIKROSKOP SLIDE FROSTED BOTOL 0 0.00 0 0 0 0.00 0 0 0
57 MINERAL MIX ZAK 0 0.00 0 0 0 0.00 0 0 0
58 NATRIUM FLUORESIN TM LEMBAR 0 0.00 0 0 0 0.00 0 0 0
59 NISTATIN TAB VAG 100.000 IU/G TABLET 0 0.00 0 0 0 0.00 0 0 0
60 OKSIGEN GAS DALAM TABUNG BOTOL 0 0.00 0 0 0 0.00 0 0 0
61 OKSITETRASIKLIN 1 % SM TUBE 0 0.00 220 0 220 272,562.40 220 0 220
62 OKSITETRASIKLIN 3 % SK TUBE 64 106,439.68 400 0 400 665,248.00 212 0 212
63 PAC TUBE 0 0.00 0 0 0 0.00 0 0 0
64 PARAFORMALDEHIA TUBE 0 0.00 0 0 0 0.00 0 0 0
65 PEMBALUT GIPS 3 INCHI ROL 0 0.00 0 0 0 0.00 0 0 0
66 PEMBALUT GIPS 4 INCHI ROL 0 0.00 0 0 0 0.00 0 0 0
67 PERHIDROL SET 0 0.00 0 0 0 0.00 0 0 0
68 PILOKARPIN TM SET 0 0.00 0 0 0 0.00 0 0 0
69 PLESTER 5 YARD X 2 INC SET 4 28,744.00 10 0 10 71,860.00 9 0 9
70 POT SPUTUM SET 0 0.00 0 0 0 0.00 0 0 0
71 POVIDON IODIDA 30 ML BOTOL 0 0.00 20 0 20 48,070.00 20 0 20
72 POVIDON IODIDA 300 ML BOTOL 2 29,050.44 0 0 0 0.00 0 0 0
73 SAFETY BOX 2,5L SET 0 0.00 0 0 0 0.00 0 0 0
74 SAFETY BOX 5L SET 0 0.00 0 0 0 0.00 0 0 0
75 SALBUTAMOL NEBULISER 2,5 ML TABLET 0 0.00 0 0 0 0.00 0 0 0
76 SALISIL BEDAK 2 % ZAK 0 0.00 528 0 528 756,455.04 434 0 434
77 SALISIL SPIRITUS BOTOL 0 0.00 0 0 0 0.00 0 0 0
78 SCABICID SET 0 0.00 0 0 0 0.00 0 0 0
79 SOFRATUL SET 0 0.00 5 0 5 62,284.50 5 0 5
80 STESOLID RECTAL 10MG SET 0 0.00 0 0 0 0.00 0 0 0
81 STESOLID RECTAL 5MG SET 0 0.00 0 0 0 0.00 0 0 0
82 SULFASETAMIDA TM 15 % SET 137 472,885.64 240 144 384 1,294,291.68 298 0 298
83 TETRAKAIN TM SET 0 0.00 0 0 0 0.00 0 0 0
84 TROMBHOPOP BIJI 0 0.00 0 0 0 0.00 0 0 0
85 VIRULES BIJI 0 0.00 0 0 0 0.00 0 0 0
86 ZOLAGEL CREM DOSIN 0 0.00 0 0 0 0.00 0 0 0
IX ALAT KESEHATAN 0 0.00 0 0 0 0.00 0 0 0
1 ABOCATH NO 20 SET 0 0.00 0 0 0 0.00 0 0 0
2 ABOCATH NO 22 SET 0 0.00 0 0 0 0.00 0 0 0
3 ABOCATH NO 24 SET 0 0.00 0 0 0 0.00 0 0 0
4 ABOCATH NO 26 SET 0 0.00 0 0 0 0.00 0 0 0
5 ALAT SUNTIK 0,5 MG BIJI 0 0.00 0 0 0 0.00 0 0 0
6 ALAT SUNTIK SEKALI PAKAI 1 ML BIJI 0 0.00 0 0 0 0.00 0 0 0
7 ALAT SUNTIK SEKALI PAKAI 2,5 ML BIJI 274 284,370.90 1,100 0 1,100 1,141,635.00 1005 0 1005
8 ALAT SUNTIK SEKALI PAKAI 5 ML BIJI 165 171,245.25 0 0 0 0.00 0 0 0
9 #REF! BIJI 0 0.00 0 0 0 0.00 0 0 0
10 #REF! BIJI 0 0.00 0 0 0 0.00 0 0 0
11 #REF! BIJI 0 0.00 0 0 0 0.00 0 0 0
12 CATGUT 2/0 dengan jarum SET 1 26,665.83 24 0 24 639,980.00 5 0 5
13 CATGUT 3/0 dengan jarum SET 0 0.00 24 0 24 589,930.00 10 0 10
14 HANDSKUN 7 BIJI 200 849,992.00 0 0 0 0.00 100 0 100
15 HANDSKUN 8 BIJI 200 849,992.00 0 0 0 0.00 100 0 100
16 INFUSION SET ANAK SET 0 0.00 0 0 0 0.00 0 0 0
17 INFUSION SET DEWASA SET 0 0.00 0 0 0 0.00 0 0 0
18 IV Catether 22 G SET 0 0.00 0 0 0 0.00 0 0 0
19 IV Catether 24 G SET 0 0.00 0 0 0 0.00 0 0 0
20 JARUM JAHIT BEDAH SET 0 0.00 0 0 0 0.00 0 0 0
21 MASKER BIJI 1,000 1,113,200.00 0 0 0 0.00 500 0 500
22 NEDLE 25 Gx 5/8 BIJI 0 0.00 0 0 0 0.00 0 0 0
23 NEDLE 26 Gx 1/2 BIJI 0 0.00 0 0 0 0.00 0 0 0
24 POLI CATETER NO 16 BIJI 0 0.00 0 0 0 0.00 0 0 0
25 POLI CATETER NO 18 BIJI 0 0.00 0 0 0 0.00 0 0 0
26 SCALP VEIN NEDLE 23 G BIJI 0 0.00 0 0 0 0.00 0 0 0
27 SILK BIJI 5 28,719.31 36 0 36 206,779.00 12 0 12
28 URINE BAG ( STERIL) BIJI 0 0.00 0 0 0 0.00 0 0 0
17,162,291 632,093 15,912 648,005 90,758,878 608,333 4,914 613,247

KETERANGAN
1 TOTAL PERSEDIAAN OBAT-OBATAN 31 - 12 -2013 Rp 27,453,132
2 JUMLAH KUNJUNGAN RESEP 20476
3 JUMLAH PEMAKAIAN OBAT Rp 80,468,037
4 HARGA SATU LEMBAR RESEP Rp 3,930
Wonogiri, 8 Januari 2014

Mengetahui Pengelola Obat

Kepala UPT Puskesmas Giritontro

dr.Zaenal Arifin Hari Purnomo Joko Dwi Haryadi

19640421 200701 1 009 19770113 200903 1 001
BUPATEN WONOGIRI
ESEHATAN
S GIRITONTRO
aturetno, Kode Pos. 57676

ENGURANGAN OBAT-OBATAN
13 S/D 31 DESEMBER 2013

Pemakaian Sisa
Nominal 2012
Nominal
2013 Total Nominal

0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
123,770.08 118
### 0 118 74,514.64
0.00 ###
0 0 0 0.00
125,108.50 237
### 0 237 31,343.25
0.00 ###
0 0 0 0.00
68,511.75 563
### 0 563 70,515.75
0.00 ###
0 0 0 0.00
1,029,989.74 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
12,104,625.69 ###
0 4001 4,001 963,000.69
1,638,259.02 ###
0 786 786 157,648.02
0.00 ###
0 0 0 0.00
4,736,355.84 8,026
### 0 8,026 1,198,121.28
4,070,484.00 6,790
### 0 6,790 1,102,017.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
511,518.88 5,890
### 0 5,890 109,789.60
0.00 ###
0 0 0 0.00
788,424.00 6,426
### 0 6,426 488,376.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
219,874.20 ###
0 0 0 0.00
146,311.20 ###
0 30 30 27,799.80
0.00 ###
0 0 0 0.00
1,157.40 170
### 0 170 6,558.60
0.00 ###
0 0 0 0.00
96,110.56 2,257
### 0 2,257 203,491.12
806,196.00 746
### 0 746 102,948.00
0.00 ###
0 0 0 0.00
188,513.92 1,276
### 0 1,276 1,073,856.08
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
288,066.24 1,048
### 0 1,048 299,497.44
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
3,703,515.56 ###
0 0 0 0.00
170,002.80 2,127
### 0 2,127 75,806.28
0.00 ###
0 0 0 0.00
8,474.40 ###
0 1000 1,000 35,100.00
0.00 ###
0 0 0 0.00
20,487.61 ###
0 0 0 0.00
 152,154.66 ###
0 392 392 37,345.84
0.00 ###
0 0 0 0.00
7,060.40 160
### 0 160 28,241.60
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
781,466.40 1,336
### 0 1,336 669,255.84
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
899.00 510
### 0 510 15,810.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
70,916.56 ###
50 0 50 34,094.50
75,490.04 1,906
### 0 1,906 106,659.76
0.00 ###
0 0 0 0.00
142,115.80 249
### 1000 1,249 72,122.86
1,089,071.75 14,374
### 0 14,374 401,753.30
124,312.65 405
### 0 405 97,382.25
0.00 ###
0 0 0 0.00
59,572.80 600
### 0 600 49,644.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
107,972.48 ###
0 0 0 0.00
169,645.52 4,157
### 0 4,157 481,048.04
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 100
### 0 100 9,753.00
 0.00 ###
0 0 0 0.00
113,492.80 288
### 0 288 204,287.04
1,267,332.50 10,675
### 0 10,675 556,167.50
0.00 ###
0 0 0 0.00
106,764.00 393
### 0 393 146,196.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
342,516.40 641
### 0 641 148,346.63
1,842,662.90 12,663
### 0 12,663 304,545.15
0.00 ###
0 0 0 0.00
71,496.00 124
### 1000 1,124 143,230.56
0.00 1,000
### 0 1,000 38,070.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
495,930.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
5,686.02 182
### 0 182 16,691.22
58,955.16 185
### 0 185 61,619.80
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
1,354,243.68 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
258,625.50 ###
0 468 468 163,332.00
54,534.00 ###
24 0 24 3,576.00
9,016.72 197
### 0 197 21,662.12
155,365.76 148
### 0 148 65,324.24
7,829.19 254
### 0 254 18,585.18
235,249.34 108
### 500 608 77,048.16
280,581.93 500
### 0 500 110,205.00
2,772,408.52 3,613
### 0 3,613 2,283,271.48
0.00 ###
0 0 0 0.00
13,738.41 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
200,401.68 3,815
### 0 3,815 240,192.40
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
1,652,000.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
171,045.00 1,400
### 0 1,400 88,200.00
25,943.64 1,358
### 0 1,358 57,008.84
9,233,192.43 13,056
### 0 13,056 1,365,788.16
0.00 ###
0 0 0 0.00
197,294.25 3,544
### 0 3,544 256,497.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
59,188.80 ###
51 0 51 25,581.60
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
414,363.39 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
159,975.00 ###
0 0 0 0.00
1,052,320.76 796
### 0 796 83,731.24
0.00 ###
0 0 0 0.00
689,320.00 6,502
### 0 6,502 260,080.00
0.00 ###
0 0 0 0.00
0.00 100
### 0 100 7,714.00
49,460.40 180
### 0 180 53,956.80
219,528.36 413
### 0 413 91,029.33
0.00 ###
0 0 0 0.00
23,650.00 507
### 0 507 27,885.00
0.00 ###
0 0 0 0.00
100,289.00 ###
0 0 0 0.00
412,761.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
67,557.40 ###
0 1264 1,264 89,996.80
179,550.00 586
### 0 586 300,618.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
587,382.96 1,946
### 0 1,946 325,098.76
716,400.00 ###
0 0 0 0.00
44,435.52 428
### 0 428 264,144.48
22,771.20 ###
64 0 64 22,771.20
0.00 ###
0 0 0 0.00
30,170.90 1,004
### 0 1,004 41,495.32
0.00 ###
0 0 0 0.00
388,634.87 3,707
### 0 3,707 48,672.91
74,081.44 ###
0 1864 1,864 41,846.80
0.00 ###
0 0 0 0.00
999,526.24 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
 0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
19,970.94 ###
0 0 0 0.00
85,251.60 ###
9 0 9 21,312.90
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
660,684.17 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
7,530.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
140,072.40 126
### 300 426 533,104.80
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
22,392.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
5,720.00 ###
90 0 90 46,800.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
2,964,752.00 100
### 0 100 370,594.00
0.00 ###
0 0 0 0.00
505,297.13 ###
43 0 43 165,860.89
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
453,362.04 109
### 0 109 312,762.42
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
845,062.59 ###
30 0 30 119,022.90
696,282.48 ###
0 48 48 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
1,418,845.12 168
### 0 168 386,957.76
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
1,056,346.20 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
895,477.64 ###
0 0 0 0.00
3,177.50 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
791,480.98 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
409,452.00 ###
0 0 0 0.00
74,360.00 ###
0 0 0 0.00
97,524.00 ###
0 0 0 0.00
413,559.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
 0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
527,948.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
34,063.82 ###
0 0 0 0.00
164,275.08 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
52,097.60 ###
10 0 10 52,097.60
0.00 ###
0 0 0 0.00
170,365.14 ###
68 0 68 214,533.88
41,280.00 ###
79 0 79 135,880.00
40,000.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
54,245.83 ###
26 0 26 30,008.33
54,184.68 ###
23 0 23 28,323.81
0.00 ###
0 0 0 0.00
 748,835.94 ###
0 58 58 88,413.46
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
7 0 7 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
21,640.56 ###
9 0 9 16,230.42
139,517.28 ###
4 0 4 62,007.68
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
946,764.90 ###
0 12 12 1,274,327.16
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
15,228.00 ###
50 0 50 15,228.00
33,061.90 ###
0 0 0 0.00
7,361.80 ###
21 0 21 38,649.45
9,467.64 ###
10 0 10 4,508.40
0.00 ###
0 0 0 0.00
1,074,513.60 228
### 0 228 680,525.28
0.00 ###
0 0 0 0.00
71,470.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
141,691.50 ###
0 0 0 0.00
57,005.00 ###
6 0 6 68,406.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
472,815.75 220
### 0 220 1,891,263.00
33,628.07 ###
38 0 38 182,552.38
 3,774.81 ###
7 0 7 8,807.89
108,714.84 ###
13 0 13 117,774.41
106,194.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
30,644.50 ###
0 0 0 0.00
15,347.50 ###
0 0 0 0.00
77,133.54 ###
0 0 0 0.00
90,765.94 ###
20 0 20 31,298.60
453,167.89 ###
0 0 0 0.00
248,310.00 ###
11 48 59 94,594.80
57,251.50 ###
4 0 4 9,160.24
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
60,112.60 ###
4 0 4 12,022.52
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
272,562.40 ###
0 0 0 0.00
352,581.44 252
### 0 252 419,106.24
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
64,674.00 ###
5 0 5 35,930.00
0.00 ###
0 0 0 0.00
48,070.00 ###
0 0 0 0.00
 0.00 ###
2 0 2 29,050.44
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
621,783.12 ###
94 0 94 134,671.92
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
62,284.50 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
1,028,612.56 ###
79 144 223 738,564.76
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
1,043,039.25 369
### 0 369 382,966.65
0.00 165
### 0 165 171,245.25
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
133,329.17 ###
20 0 20 533,316.67
245,804.17 ###
14 0 14 344,125.83
424,996.00 100
### 0 100 424,996.00
424,996.00 100
### 0 100 424,996.00
0.00 ###
0 0 0 0.00
 0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
556,600.00 500
### 0 500 556,600.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
0.00 ###
0 0 0 0.00
68,926.33 ###
29 0 29 166,571.97
0.00 ###
0 0 0 0.00
80,468,037 133,235
### 12,915 146,150 27,453,132

Wonogiri, 8 Januari 2014

Pengelola Obat

Joko Dwi Haryadi

19770113 200903 1 001
 PEMERINTAH KABUPATEN WONOGIRI
DINAS KESEHATAN
PUSKESMAS GIRITONTRO
Jl. Raya Giritontro - Baturetno, Kode Pos. 57676

BERITA ACARA
PEMERIKSAAN FISIK OBAT

Pada Hari ini Kamis Tanggal 6 Januari 2014 Jam 10.00 WB

Nama : JOKO DWI HARYADI
Jabatan : Pengelola obat
Kegiatan : Stok Opname Obat
Tahun Anggaran : 2013
Lokasi : Puskesmas Giritontro

Adapun hasil dari pemeriksaan ini adalah sebagai berikut :

NO N A M A O B A T SATUAN Stok Awal Penerimaan Sisa Akhir

I. TABLET KAPSUL :
1 ACYCLOVIR TAB 400 MG TAB 314 0 118
2 ALOPURINOL TABLET 183 1000 237
3 AMBROXOL 30 MG KAPSUL 110 1000 563
4 AMINOFILINA 200 MG TABLET 2074 7000 0
5 AMOKSILIN 500 MG TABLET 1882 36000 4001
6 AMOKSILINA 250 MG KAPSUL 376 6200 786
7 ANTALGIN 500 MG TABLET 10954 28800 8026
8 ANTASIDA DOEN TABLET 11870 20000 6790
9 ASAM ASKORBAT (VIT C) 50 MG TABLET 10332 23000 5890
10 ASAM MEFENAMAT 250 MG KAPSUL 0 16800 6426
11 BESI II SULFAT TABLET 8054 0 0
12 BETAHISTIN MESILAT 6 MG TABLET 38 150 30
13 BROMHEKSIN 8 MG TABLET 0 200 170
14 CAPTOPRIL 12,50 MG TABLET 1323 2000 2257
15 CAPTOPRIL 25 MG TABLET 588 6000 746
16 CEFADROXIL 500 MG TABLET 0 1500 1276
17 CIPROFLOKSASIN 500 MG TABLET 56 2000 1048
18 DEKSAMETAZON TAB 0,5 MG TAB 5491 37000 0
19 DEKSTROMETORFAN HBR 15 MG TABLET 3897 3000 2127
20 DIAZEPAM 2 MG TABLET 428 1000 1000
21 DIGOKSIN 25 MG TABLET 143 0 0
22 DIMENHIDRINATUM TABLET 475 1500 392
23 DOMPERIDON 10 MG TABLET 0 200 160
24 ERITHROMISIN 250 MG TABLET 496 2400 1336
25 FENOBARBITAL 30 MG TABLET 539 0 510
26 FITOMENADION (VIT K) 10 MG TABLET 54 100 50
27 FUROSEMIDA 40 MG TABLET 255 3000 1906
28 GLIBENKLAMIDA 5 MG TABLET 719 2500 1249
29 GLISERILGUAYAKOLAT 100 MG TABLET 3339 50000 14374
30 GRISIOVULVIN 125 MG TABLET 922 0 405
31 HALOPERIDOL 1,5 MG KAPSUL 820 500 600
32 HIDROKLOROTIASIDA 25 MG TABLET 1382 3000 0
33 IBUPROVEN 200 MG TABLET 2623 3000 4157
34 ISOSORBIT DINITRAT 5 MG TABLET 0 100 100
35 KALIUM DIKLOFENAK 50 MG TABLET 98 350 288
36 KALSIUM LAKTAT 500 MG TABLET 0 35000 10675
37 KETOKONAZOL 200 MG TABLET 180 500 393
38 KLORAMFENIKOL 250 MG TABLET 121 2000 641
39 KLORFENIRAMIN MALEAT (CTM) 4 MG TABLET 4281 85000 12663
40 KLORPROMAZIN 100 MG TABLET 1024 1000 1124
41 KLORPROMAZINA HCL 25 MG TABLET 0 1000 1000
42 KOTRIMOKSAZOL 480 MG KAPSUL 0 3000 0
43 LOPERAMID 2 MG TABLET 44 200 182
44 LORATADIN 10 MG TABLET 162 200 185
45 MDT COMBI MB ADULT TABLET 0 18 0
46 MDT COMBI PB ADULT KAPSUL 0 5 0
47 MEBENDAZOL 100 MG KAPLET 0 3312 0
48 MELOXICAM 15 MG TABLET 206 500 468
49 METFORMIN HCL 500 ML TABLET 390 0 24
50 METILERGOMETRINA MALEAT 0,125 MG TABLET 79 200 197
51 METILPREDNISOLON 4 MG TABLET 0 500 148
52 METOKLOPROPAMID TABLET 361 0 254
53 METRONIDAZOL 250 MG KAPSUL 250 2000 608
54 METRONIDAZOL 500 MG TABLET 1073 700 500
55 MULTIVITAMIN TABLET 0 8000 3613
56 NA. DIKLOFENAK 50 MG TABLET 63 0 0
57 NEO DIAFORM PAKET 998 6000 3815
58 OBAT ANTI TUBERKULOSIS KATEG I PAKET 0 7 0
59 OBAT KOMBIPAK KATEG I TABLET 0 1 0
60 PAPAVERIN TABLET 2115 2000 1400
61 PARASETAMOL 100 MG TABLET 1976 0 1358
62 PARASETAMOL 500 MG TABLET 4119 97200 13056
63 PENIL BUTASON 200 MG TABLET 3270 3000 3544
64 PIRACETAM 400 MG TABLET 169 0 51
65 PIRIDOKSIN HCL (VIT B6) 10 MG TABLET 773 23000 0
66 PIROKSIKAM 10 MG TABLET 2133 0 0
67 PIROKSIKAM 20 MG TABLET 0 10800 796
68 PREDNISON 5 MG TABLET 3735 20000 6502
69 PROPANOLOL HCL TABLET 0 100 100
70 PROPILTIOURASIL 100 MG KAPLET 145 200 180
71 RANITIDIN 150 MG TAB TABLET 909 500 413
72 RESERPINA 0,25 MG KAPSUL 937 0 507
73 RETINOL 100.000 IU KAPSUL 0 350 0
74 RETINOL 200.000 IU TABLET 0 1100 0
75 SALBUTAMOL 2 MG KAPSUL 80 2100 1264
76 SIMVASTATIN 10 MG KAPSUL 36 900 586
77 TETRASIKLIN KAP 250 MG TABLET 2462 3000 1946
78 THIAMINA HCL (VIT B1) 50 MG TABLET 0 30000 0
79 THIAMPENIKOL TABLET 0 500 428
80 TRAMADOL 50 MG TABLET 78 50 64
81 TRIHEKSIPENIDIL HCL 2 MG TABLET 734 1000 1004
82 VIT. B12 TABLET 3306 30000 3707
83 VITAMIN B COMPLEK TABLET 1195 4000 1864
84 Zinc Tab 20 MG ZAK 404 1700 0
II. INJEKSI
1 DEKSAMETASON AMPUL 22 0 0
2 DIAZEPAM AMP 15 30 9
3 FITOMENADION (VITK) 10 MG/ML - 1 ML AMPUL 79 300 0
4 KLORPROMASINA HCL INJ 25MG/ML-1ML AMPUL 18 0 0
5 LIDOKAINA COMP INJ AMPUL 129 420 426
6 METIL ERGOMETRIN MALEAT AMPUL 0 15 0
7 SIANOKOBALAMIN(B12) INJ VIAL 101 0 90
III. VAKSIN/SERRA :
IV. SIRUP : 0 0 0
1 AMOKSILINA SIR 125MG/5ML BOTOL 200 700 100
2 ANTASIDA SIRUP BOTOL 124 50 43
3 DEKSTROMETORFAN HBR SIR 10MG/5ML BOTOL 17 250 109
4 KOTRIMOKSAZOL SUSPENSI BOTOL 43 200 30
5 OBAT BATUK HITAM ( OBH ) BOTOL 54 480 48
6 PARASETAMOL SIR 120 MG/5ML BOTOL 100 684 168
7 RECOVIT SIRUP BOTOL 0 180 0
V. OBAT GIGI :
1 DEVITALISASI PASTA BOTOL 0 2 0
2 EUGENOL CAIRAN SET 0 1 0
3 GLAS IONOMER CEMEN BOTOL 0 2 0
4 KALSIUM HIDROKSIDA PASTA BOTOL 0 2 0
5 METAKRESOL SULFON & MET SET 0 4 0
6 MONOKLORKAMFER MENTOL CAIRAN BOTOL 0 2 0
7 MUMIFYING PASTA BOTOL 0 3 0
8 SPON GELATIN CUBICLUS 1M3 BOTOL 0 2 0
9 TEMPORARY STOPING FLETCHER BOTOL 0 1 0
10 TRIKRESOL FORMALIN (TKF) CAIRAN BOTOL 0 1 0
VI. REAGENSIA :
VII. INFUS :
1 RINGER LAKTAT LAR INFUS BOTOL 0 20 10
VIII. LAIN - LAIN : 0 0 0
1 ACYCLOVIR CREAM TUBE 72 50 68
2 ANTI BAKTERI DOEN TUBE 103 0 79
3 ANTIHEMOROIDA TABLET 8 12 0
4 AS.BENZOAT+AS.SALISILAT ZK TUBE 1 72 26
5 AS.SALISIL+BELERANG ZK ( 2-4 SALEP ) TUBE 43 24 23
6 BETAMETASON KRIM 0,1 % TUBE 0 470 0
7 BETAMETASON N KRIM 0,1 % TUBE 0 0 58
8 BISACODYL SUPP 10 MG TUBE 0 10 7
9 ETAKRIDINA(RIVANOL)LAR 0,1 % ZAK 11 10 9
10 ETANOL 70% BOTOL 3 10 4
11 ETIL KLORIDA SEMPROT BOTOL 1 20 12
12 GARAM ORALIT 200 ML ZAK 0 100 50
13 GENTAMISIN TETES MATA BOTOL 0 10 0
14 GENTAMISIN SK TUBE 0 25 21
15 GENTIAN VIOLET LAR 1 % BOTOL 7 24 10
16 HIDROKORTISON KRIM 2,5 % SK TUBE 108 480 228
17 IKHTIOL SALEP KULIT ROL 0 20 0
18 KALIUM PERMANGANAT SERBUK TUBE 0 45 0
19 KAPAS 250 GRAM ROL 1 10 6
20 KASA HIDROFIL STERIL UK 16 X 16 ISI ROL 275 0 220
21 KASA HIDROFIL STERIL UK 18 X 22 ISI ROL 20 25 38
22 KASA KOMPRES 40/40 STERIL ROL 0 10 7
23 KASA PEMBALUT 2M X 80 CM ROL 0 25 13
24 KASA PEMBALUT ELASTIC 3 INCHI ROL 15 0 0
25 KASA PEMBALUT HIDROFIL 4M X 10CM ROL 0 50 0
26 KASA PEMBALUT HIDROFIL 4M X 5CM ROL 0 50 0
27 KETOKONAZOL KRIM 2% TUBE 11 0 0
28 KLORAMFENIKOL SM 1 % BOTOL 54 24 20
29 KLORAMFENIKOL TES MATA BOTOL 31 150 0
30 KLORAMFENIKOL TT 3 % BOTOL 22 192 59
31 LEVERTRAN SALEP KULIT POT 9 20 4
32 MIKONAZOL 2 % BOTOL 0 24 4
33 OKSITETRASIKLIN 1 % SM TUBE 0 220 0
34 OKSITETRASIKLIN 3 % SK TUBE 64 400 252
35 PLESTER 5 YARD X 2 INC SET 4 10 5
36 POVIDON IODIDA 30 ML BOTOL 0 20 0
37 POVIDON IODIDA 300 ML BOTOL 2 0 2
38 SALISIL BEDAK 2 % ZAK 0 528 94
39 SOFRATUL SET 0 5 0
40 SULFASETAMIDA TM 15 % SET 137 384 223
IX ALAT KESEHATAN
1 ALAT SUNTIK SEKALI PAKAI 2,5 ML BIJI 274 1100 369
2 ALAT SUNTIK SEKALI PAKAI 5 ML BIJI 165 0 165
3 CATGUT 2/0 dengan jarum SET 1 24 20
4 CATGUT 3/0 dengan jarum SET 0 24 14
5 HANDSKUN 7 BIJI 200 0 100
6 HANDSKUN 8 BIJI 200 0 100
7 MASKER BIJI 1000 0 500
8 SILK BIJI 5 36 29

Demikian berita acara pemeriksaan ini dibuat rangkap 2 (dua)

Mengetahui
Kepala UPT Puskesmas Giritontro Pemeriksa

dr. ZAENAL ARIFIN HARI PURNOMO JOKO DWI HARYADI

NIP. 19640421 200701 1 009 NIP. 19770113 200903 1 001
NO NAMA O BAT SATUAN HARGA
2011 2012 2013
I. TABLET KAPSUL :
1 ACT-(dehidro artemisin +piperaquin
2 ACT-Artes Diaquine
3 ACYCLOVIR TAB 200 MG TAB 388.18 534.50 226.73
4 ACYCLOVIR TAB 400 MG TAB 727.5 631.48 351.01
5 ADROME TABLET TABLET 0
6 ALOPURINOL TABLET 132 132.25 104.3
7 ALPRAZOLAM 0,5 MG TAB
8 AMBROXOL 30 MG KAPSUL 113.27 125.25 95.27
9 AMILORID 5 MG TAB TABLET 0
10 AMINOFILINA 200 MG TABLET 104.5 113.51
11 AMITRIPTILIN 25 MG TABLET 92.1 120.24 102.29
12 AMOKSILIN 500 MG TABLET 370 368.59 240.69
13 AMOKSILINA 250 MG KAPSUL 238 289.29 200.57
14 AMPISILIN 500 MG TABLET 238
15 ANTALGIN 500 MG TABLET 67 149.28 145.42
16 ANTASIDA DOEN TABLET 30.53 162.30 81.23
17 ANTITUBERKOLUSA ANAK TABLET 127200
18 ANTITUBERKOLUSA ANAK (FDC) TABLET
19 ASAM ASKORBAT (VIT C) 50 MG TABLET 18.64
20 ASAM ASKORBAT 250 MG TABLET 74
21 ASAM MEFENAMAT 250 MG KAPSUL 76
22 ASAM MEFENAMAT 500 MG TABLET 131.95 176.33 95.27
23 ASETOSAL 500 MG TABLET 99.62
24 ATROPINA SULFAT 0,5 MG TABLET 26.2
25 BESI II SULFAT TABLET 27.3
26 BETAHISTIN MESILAT 6 MG TABLET 924 926.66
27 BICARBON TABLET 50
28 BROMHEKSIN 8 MG TABLET 38.58 50.85
29 BUSCOPAN/ SPASHI TABLET 0 396.14
30 CAPTOPRIL 12,50 MG TABLET 70.9 90.16 72.21
31 CAPTOPRIL 25 MG TABLET 137.75 138.00 88.25
32 CARBAZOKROM NATRIUM SULFONAT 10 TABLET
33 CEFADROXIL 500 MG TABLET 700 841.58 521.49
34 CEPHALEXIN 250 MG TAB KAPSUL 649.7
35 CEPHALEXIN 500 MG TAB TABLET 1315
36 CETIRIZIN 10 MG TABLET 225.65
37 CIMETIDIN 200 MG TABLET 72.26 108.31
38 CIPROFLOKSASIN 500 MG TABLET 265 285.78 250.72
39 CLOBAZAM TABLET 950 951.74
40 CO AMOXICLAVE 625 MG TABLET 0
41 DAPSON 100 MG TABLET 31.5
42 DEKSAMETAZON TAB 0,5 MG TAB 38.544 87.16
43 DEKSTROMETORFAN HBR 15 MG TABLET 35.64
44 DEXTAMIN TABLET 0
45 DIAZEPAM 2 MG TABLET 19.8 35.1
46 DIETILKARBAMASIN TABLET 73.64
47 DIGOKSIN 25 MG TABLET 83.21 143.27
48 DIMENHIDRINATUM TABLET 84.5 96.18 95.27
49 DOKSISIKLIN KAP TABLET 209.04
50 DOMPERIDON 10 MG TABLET 176.51
51 EFEDRINA HCL 25 MG TABLET 20.742 51.36
52 EKSTRAK BELLADON 10 MG KAPSUL 17.89
53 ERGOTAMIN+KOFFEIN 102.8
54 ERITHROMISIN 250 MG TABLET 337.82 500.94
55 ERITHROMISIN 500 MG TABLET 534.99
56 ERPHATRIM TABLET 0
57 ETAMBUTOL HCL 250 MG TABLET 30.867
58 FAMOTIDIN 20 MG TABLET 113.1
59 FAMOTIDIN 40 MG TABLET 177 175.5
60 FENOBARBITAL 30 MG TABLET 31
61 FENOKSIMETIL PENISILIN 250 MG TABLET 210.92
62 FENOKSIMETIL PENISILIN 500 MG TABLET 370.63
63 FITOMENADION (VIT K) 10 MG TABLET 680.62 681.89 580.66
64 FUROSEMIDA 40 MG TABLET 55.96
65 GEMFIBROZIL 300 MG TAB TABLET 475.66
66 GLIBENKLAMIDA 5 MG TABLET 60 72.14 54.16
67 GLISERILGUAYAKOLAT 100 MG TABLET 23.24 27.95 28.22
68 GRISIOVULVIN 125 MG TABLET 110.97 240.45 228.66
69 HALOPERIDOL 0,5 MG TABLET 60.24
70 HALOPERIDOL 1,5 MG KAPSUL 82.58 82.74
71 HALOPERIDOL 5 MG TABLET 122.29 122.52
72 HECOBAC TABLET 0
73 HIDROKLOROTIASIDA 25 MG TABLET 24.64
74 IBUPROVEN 200 MG TABLET 73.36 115.72
75 IBUPROVEN 400 MG TABLET 147.51
76 IODIOL TABLET 930
77 ISONIASIDA 100 MG TABLET 25
 78 ISONIASIDA 300 MG TABLET 66.14
79 ISOSORBIT DINITRAT 5 MG TABLET 65.24 97.53 92.26
80 KALIUM DIKLOFENAK 25 MG TABLET 390.84 394.45
81 KALIUM DIKLOFENAK 50 MG TABLET 708.02 709.33 426.22
82 KALSIUM LAKTAT 500 MG TABLET 39.33 52.10
83 KARBAMEZEPIN 200 MG TAB 246.45 246.90 243.7
84 KETOKONAZOL 200 MG TABLET 372
85 KININA SULFAT 222 MG KAPSUL 310.65
86 KLOFAZIMIN 100 MG TABLET 2194.28
87 KLONIDIN 0,15 MG KAPSUL 205
88 KLORAMFENIKOL 250 MG TABLET 153.1 231.43
89 KLORFENIRAMIN MALEAT (CTM) 4 MG TABLET 17.165 24.05 26.07
90 KLOROKINA FOSFAT 250 MG TABLET 68.198
91 KLORPROMAZIN 100 MG TABLET 79.44 133.38
92 KLORPROMAZINA HCL 25 MG TABLET 24.45 38.07
93 KLORPROPAMID TABLET 0
94 KODEINA HCL 10 MG TABLET 307.11
95 KOTRIMOKSAZOL 120 MG TABLET 49.88 76.04
96 KOTRIMOKSAZOL 480 MG KAPSUL 100 165.31 140.4
97 LINCOMISIN TABLET 650
98 LOPERAMID 2 MG TABLET 91.55 91.71
99 LORATADIN 10 MG TABLET 333.08
100 MDT COMBI MB ADULT TABLET
101 MDT COMBI MB CHILD KAPSUL
102 MDT COMBI PB ADULT KAPSUL
103 MEBENDAZOL 100 MG KAPLET 141.0333 366.05
104 MEBHIDROLIN NAPADISILAT TABLET 455.12
105 MELOXICAM 15 MG TABLET 1410.76 1,201.25 349
106 METFORMIN HCL 500 ML TABLET 149 105.3
107 METILERGOMETRINA MALEAT 0,125 MG TABLET 109.96
108 METILPREDNISOLON 4 MG TABLET 509.25 441.38 296.68
109 METOKLOPROPAMID TABLET 73.17 89.26
110 METRONIDAZOL 250 MG KAPSUL 105 143.27 123.15
111 METRONIDAZOL 500 MG TABLET 135 220.41 171.49
112 MULTIVITAMIN TABLET 484 631.96 389.38
113 NA. DIKLOFENAK 25 MG TABLET 167.68 167.97 134.39
114 NA. DIKLOFENAK 50 MG TABLET 217.68 218.07 174.5
115 NALTREXON KAPS 0
116 NATRIUM BIKARBONAT 500 MG TABLET 9.75
117 NATRIUM FENITOINA 100 MG TABLET 79.536 80.06
118 NATRIUM FENITOINA 30 MG TAB 58.044
119 NATUR E KAP TABLET 0
120 NEO DIAFORM PAKET 77.55 62.96
121 NEUROTROPIC PAKET 0
122 NIFEDIPIN 10 MG TAB PAKET 107.85 129.24
123 OBAT ANTI TUBERKULOSIS KATEG I PAKET 236000
124 OBAT ANTI TUBERKULOSIS KATEG II KAPSUL 376500
125 OBAT ANTI TUBERKULOSIS KATEG III TABLET 154000
126 OBAT ANTI TUBERKULOSIS SISIPAN TABLET 66000
127 OBAT KOMBIPAK KATEG I TABLET
128 OMEPRAZOL 20 MG TABLET 265.76
129 PAPAVERIN TABLET 63 119.34
130 PARASETAMOL 100 MG TABLET 25.69 41.98 32.32
131 PARASETAMOL 500 MG TABLET 45.5 104.61 81.59
132 PEHAVRAL TABLET 0
133 PENIL BUTASON 200 MG TABLET 72.375
134 PHERPHENAZIN 4 MG TABLET 42.41
135 PIPERAZINA 500 MG TABLET 0
136 PIRACETAM 400 MG TABLET 501.6
137 PIRANTEL PAMOAT 365 MG TABLET 149.8667
138 PIRAZINAMID TAB 500 MG TABLET 220
139 PIRIDOKSIN HCL (VIT B6) 10 MG TABLET 10 17.43 17.6
140 PIRITAMIN + SULFADOKSIN TABLET 473
141 PIROKSIKAM 10 MG TABLET 75
142 PIROKSIKAM 20 MG TABLET 105 105.19 92.22
143 PRAZIQUANTEL 600 MG TABLET 1600
144 PREDNISON 5 MG TABLET 40
145 PRIMAKINA 15 MG TABLET 68.317
146 PROPANOLOL HCL TABLET 57.9 77.14
147 PROPILTIOURASIL 100 MG KAPLET 299.57 299.76 264.76
148 RANITIDIN 150 MG TAB TABLET 200 220.41 105.3
149 RESERPINA 0,10 MG TABLET 32
150 RESERPINA 0,25 MG KAPSUL 55
151 RETAPHYL SR KAPSUL 0
152 RETINOL 100.000 IU KAPSUL 255 286.54 242.7
153 RETINOL 200.000 IU TABLET 335.4 432.78
154 RIFAMPISINA 450 MG TABLET 450
155 RIFAMPISINA 600 MG TABLET 703.15
156 RISPERIDON 2 MG KAPSUL 2,390.72
157 SALBUTAMOL 2 MG KAPSUL 84.03 84.19 71.2
158 SIMVASTATIN 10 MG KAPSUL 513
159 SULFADIMIDIN 500 MG TABLET 0
160 TAMIFLU/OSELTAMIVIR TABLET
161 TENSIGARD TABLET 0
162 TETRASIKLIN 500 MG TABLET 185.94
163 TETRASIKLIN KAP 250 MG TABLET 73 167.06
164 THIAMINA HCL (VIT B1) 50 MG TABLET 23.88
165 THIAMPENIKOL TABLET 409.44 617.16
166 TRAMADOL 50 MG TABLET 355.8
167 TRIFLUOPERASIN TABLET 380 380.21
168 TRIHEKSIPENIDIL HCL 2 MG TABLET 40.77 41.33 40.11
169 URISPAS TABLET 0
170 VIT. B12 TABLET 12.36 13.13
171 VITAMIN B COMPLEK TABLET 22.2 22.24 22.45
172 VITAZYM TABLET 0
173 Zinc Tab 20 MG ZAK
II. INJEKSI 0
1 ADONA AC 17 INJ AMPUL 0
2 AMINOFILINA 24MG/ML-10 ML AMPUL 1865.333 3,005.63
3 AMOKSISILIN SERBUK INJ. BOTOL 4630.7
4 AMPICILLIN INJ SET 3176 4011.5
5 ANTALGIN 250 MG/ML-2ML AMPUL 407.8 1,335.80 1203.45
6 AQUA PRO INJ STERIL VIAL 1500 5,510.32 5014.37
7 AQUADEST STERIL 500ML AMPUL 0
8 ARTE METER INJ 40 Mg AMPUL
9 ARTE METER INJ 80 Mg AMPUL
10 ARTE SUNATE INJ AMPUL
11 ASAM TRANEKSAMAT INJ 250MG / 5ML AMPUL 5830.05
12 ATROPIN SULFAT AMPUL 849.8667
13 BENZATIN BENZIL PENISILLIN AMPUL 5400
14 BUSCOPAN/ SPASHI INJ AMPUL 638
15 CARBAZOKROM NATRIUM SULFONAT IN AMPUL
16 CHININ ANTIPIRIN INJ AMP 0
17 DEKSAMETASON AMPUL 907.77
18 DIAZEPAM AMP 2368.1
19 DIFENHIDRAMIN HCL 10 MG/ML - 2ML VIAL 689.3667 961.77
20 DIHIDRO EMETIN FLACON 0
21 EPINEFRINA HCL 0,1% - 1 ML VIAL 691.4 1,248.21
22 FENOBARBITAL 50 MG/ML - 2ML AMPUL 670
23 FITOMENADION (VITK) 10 MG/ML - 1 ML AMPUL 977.6667 1,743.23
24 FUROSEMID INJ 10 MG / ML AMPUL 1035.04 1756.03
25 GLUKOSA LAR INFUS 40% STERIL AMPUL 988
26 HYPOBHAC INJ AMPUL 0
27 INSULIN REGULER AMPUL 0
28 KEMICETIN INJ AMPUL 0
29 KETAMIN INJ AMPUL 11020
30 KETOROLAC INJEKSI 10 MG AMPL 7,514.08 1620.65
31 KININA DIHIDROKLORIDA INJ AMPUL 2616.133
32 KLORPROMASINA HCL INJ 25MG/ML-1M AMPUL 418.3333 38432.09
33 KLORPROMASINA HCL INJ 5MG/ML-2ML VIAL 375.9667
34 LIDOKAINA COMP INJ AMPUL 821.3333 1,138.80 1298.72
35 MAGNESIUM SULFAT INJ 20%-25ML TABLET 1539.8
36 MAGNESIUM SULFAT INJ 40%-25ML AMPUL 1947.9 1,951.56
37 METIL ERGOMETRIN MALEAT AMPUL 1291.533 1,492.80
38 MYOMERGIN VIAL 0
39 NATRIUM THIOPENTAL AMPUL 0
40 NATRIUM TIOSULFAT INJ 25%-10ML VIAL 1476.8
41 OKSITETRASIKLIN KAPSUL 2061.1
42 OKSITOSIN AMPL 1785
43 ONDANSETRON 4MG / 2ML AMPUL 6118.79
44 PEHACAIN INJ AMPUL 0
45 PETIDINA HCL INJ 50MG/ML-2ML VIAL 0
46 PIRACETAM 3GR/15 ML AMPUL 17,137.11 3810.92
47 PIRIDOKSIN INJ AMPUL 0
48 RANITIDIN INJ VIAL 2570 1933.54
49 SEFOTAKSIM 1 GRAM VIAL 8678.5 6,943.01 6819.55
50 SIANOKOBALAMIN(B12) INJ VIAL 520
51 STREPTOMISINA SULFAT INJ 1GR/VL VIAL 0
52 SUSPENSI SENG INSULIN VIAL 0
53 THIAMINA HCL (B1) INJ 100MG/ML-1ML AMPUL 456.7333
54 TRAMADOL INJ VIAL 6707.4
55 ULCUMET INJ. VIAL 0
III. VAKSIN/SERRA : 0
1 SERUM ANTI BISA ULAR I BOTOL 229000 240,900.37 424775.72
2 SERUM ANTI BISA ULAR II BOTOL 41800000
3 SERUM ANTI DIFTERI 20.000 IU BOTOL 450000
4 SERUM ANTI TETANUS 1500 IU BOTOL 50000 52,598.55 92034.74
5 SERUM ANTI TETANUS 20.000 IU BOTOL 340000
6 VAKSIN RABIES KERING BOTOL 0
7 VAKSIN RABIES VERO BOTOL 0
IV. SIRUP : 0
1 AMBROXOL SIRUP BOTOL
2 AMOKSILINA SIR 125MG/5ML BOTOL 3400 3,705.94 2306.61
3 AMPISILINA SIR 125MG/5ML BOTOL 3400
4 ANTASIDA SIRUP BOTOL 2643 3,857.23
5 BESI II SIRUP BOTOL 0
6 COREDRYL SIRUP BOTOL 0
7 DEKSTROMETORFAN HBR SIR 10MG/5ML BOTOL 2400 2,869.38
8 ERYTROMISIN SIRUP BOTOL 0
9 KLORAMFENIKOL SIRUP BOTOL 0
10 KOTRIMOKSAZOL SUSPENSI BOTOL 2839 3,967.43 1980.68
11 OBAT BATUK HITAM ( OBH ) BOTOL 1250 1,432.68
12 OBAT DIARE SIR BOTOL
13 OBP BOTOL 0
14 PARASETAMOL SIR 120 MG/5ML BOTOL 1725 2,303.32 1322.69
15 PIPERASIN SIRUP BOTOL 0
16 RECOMINT SIRUP BOTOL 0
17 RECOVIT DROP BOTOL 5060
18 RECOVIT SIRUP BOTOL 5060 5,868.59 6068.22
19 THIAMPENIKOL 125 MG/ 5ML SIRUP BOTOL
V. OBAT GIGI : .
1 AIR RAKSA DENTAL USE SET 0
2 ARSEN PASTA BOTOL 0
3 CELLOLOID BOTOL 0
4 DEVITALISASI PASTA BOTOL 388994 447,738.82
5 EUGENOL CAIRAN SET 3177.5 46354.49
6 FLUOR BOTOL 0
7 GLAS IONOMER CEMEN BOTOL 400000 395,740.49 399491.45
8 GUTTA PERCHA POINT SET 0
9 KALSIUM HIDROKSIDA PASTA BOTOL 204726 244741.61
10 METAKRESOL SULFON & MET SET 18590
11 MONOKLORKAMFER MENTOL CAIRAN BOTOL 48762 55625.39
12 MUMIFYING PASTA BOTOL 137853
13 SEMEN SENG POSPAT SERBUK & CAIR BOTOL 80659 172,101.54 94563.17
14 SILVER AMALGAM SERBUK 65-75% BOTOL 360000
15 SINTETIK FELING MAT LAR & SERBUK BOTOL 0
16 SPON GELATIN CUBICLUS 1M3 BOTOL 263974
17 SULFA CONUS BOTOL 0
18 TEMPORARY STOPING FLETCHER BOTOL 6862 34,063.82 34386.61
19 TRIKRESOL FORMALIN (TKF) CAIRAN BOTOL 0 164,275.08 77875.55
VI. REAGENSIA : 0
1 ASAM KLORIDA 0,1 N BOTOL 0
2 ASAM SULFOSALISILAT 20 % BOTOL 0
3 LARUTAN BENEDICT BOTOL 0
4 LARUTAN CARBOL FUKSIN BOTOL 0
5 LARUTAN EOSIN 2 % BOTOL 0
6 LARUTAN GABBETT BOTOL 0
7 LARUTAN GIEMSA STAIN BOTOL 0
8 LARUTAN KINYOUN BOTOL 0
9 LARUTAN METANOL BOTOL 0
10 LARUTAN TURK BOTOL 0
VII. INFUS : 0
1 DEKSTRAN 70-LAR INFUS 6% STERIL BOTOL 35526
2 GLUKOSA LAR INFUS 10 % BOTOL 3895
3 GLUKOSA LAR INFUS 5 % BOTOL 3630 5328.27
4 NATRIUM KLORIDA LAR INFUS 0,9% BOTOL 4132 4,908.20 4914.09
5 POLIPEPTIDA KOMB DOEN INFUS BOTOL 0
6 RINGER LAKTAT LAR INFUS BOTOL 4579 5,209.76 5214.95
VIII. LAIN - LAIN : 0
1 ACYCLOVIR CREAM TUBE 3000 3,154.91 2158.19
2 ANTI BAKTERI DOEN TUBE 1720
3 ANTIHEMOROIDA TABLET 2000 20227.42
4 AQUATAB BOTOL 0
5 AS.BENZOAT+AS.SALISILAT ZK TUBE 1154.167
6 AS.SALISIL+BELERANG ZK ( 2-4 SALEP ) TUBE 824.9167 1,231.47
7 ATROPIN SULFAT TM BOTOL 2800.667
8 BETAMETASON KRIM 0,1 % TUBE 1800 1,869.50 1524.37
9 BETAMETASON N KRIM 0,1 % TUBE 0
10 BIOPLACENTON SALEP TUBE 0
11 BISACODYL SUPP 10 MG TUBE
12 BISACODYL SUPP 5 MG TUBE
13 CALADIN BEDAK ZAK 0
14 CHLORAMFECORT H CREAM TUBE 0
15 ETAKRIDINA SERBUK ZAK 0
16 ETAKRIDINA(RIVANOL)LAR 0,1 % ZAK 1254 1,803.38
17 ETANOL 70% BOTOL 18698 15,501.92 40454.83
18 ETANOL 95% BOTOL 18698
19 ETER ANESTESI BOTOL 0
20 ETIL KLORIDA SEMPROT BOTOL 81392 105,196.10 106193.93
21 FENOL GLISEROL TT TUBE 770.8333
22 GAMEKSAN BOTOL 2200
23 GARAM ORALIT 1000 ML ZAK 0
24 GARAM ORALIT 200 ML ZAK 304.56
25 GENTAMISIN TETES MATA BOTOL 2973 3,306.19 2912.35
26 GENTAMISIN SK TUBE 1650 1,840.45 1473.22
27 GENTIAN VIOLET LAR 1 % BOTOL 450 450.84 897.57
28 GLISEROL BOTOL 4180
29 HIDROKORTISON KRIM 2,5 % SK TUBE 2484.5 2,984.76 2405.9
30 HYPAFIK 5M x 2M ROL 0
31 IKHTIOL SALEP KULIT ROL 2960 3,573.50 3843.21
32 ISODIN GARGLE ROL 0
33 ISODIN OINTMENT TUBE 0
34 KALIUM PERMANGANAT SERBUK TUBE 3115 3,148.70 3640.93
35 KAPAS 250 GRAM ROL 11401 7585.28
36 KAPAS BERLEMAK 500 GRAM ROL 13800
37 KASA HIDROFIL 40M X 80CM ROL
38 KASA HIDROFIL STERIL UK 16 X 16 ISI ROL 8596.65
39 KASA HIDROFIL STERIL UK 18 X 22 ISI ROL 4804.01
40 KASA KOMPRES 40/40 STERIL ROL 1393 1,258.27 2022.74
41 KASA PEMBALUT 2M X 80 CM ROL 8799 9,059.57 12136.45
42 KASA PEMBALUT ELASTIC 3 INCHI ROL 7079.6
43 KASA PEMBALUT ELASTIC 4 INCHI ROL 10113.71
44 KASA PEMBALUT HIDROFIL 4 X 15 CM ROL 3373
45 KASA PEMBALUT HIDROFIL 4 X 3 CM ROL 733
46 KASA PEMBALUT HIDROFIL 4M X 10CM ROL 612.89
47 KASA PEMBALUT HIDROFIL 4M X 5CM ROL 306.95
48 KETOKONAZOL KRIM 2% TUBE 7000 7,012.14 6669.12
49 KLORAMFENIKOL SM 1 % BOTOL 1563 1,564.93 1454.17
50 KLORAMFENIKOL TES MATA BOTOL 2500 2,503.69 5056.85
51 KLORAMFENIKOL TT 3 % BOTOL 1000 1,602.00 1603.6
52 LEVERTRAN SALEP KULIT POT 1665 2,290.06 2528.43
53 LISOL BOTOL 49862 18,119.13 15170.56
54 MAGNESIUM SULFAT BOTOL 0
55 MIKONAZOL 2 % BOTOL 3000 3,005.63 3008.62
56 MIKROSKOP SLIDE FROSTED BOTOL
57 MINERAL MIX ZAK
58 NATRIUM FLUORESIN TM LEMBAR 3925.667
59 NISTATIN TAB VAG 100.000 IU/G TABLET 288.91 370.65 408.17
60 OKSIGEN GAS DALAM TABUNG BOTOL 0
61 OKSITETRASIKLIN 1 % SM TUBE 1238.92
62 OKSITETRASIKLIN 3 % SK TUBE 1675 1,663.12 1533.4
63 PAC TUBE 0
64 PARAFORMALDEHIA TUBE 0
65 PEMBALUT GIPS 3 INCHI ROL
66 PEMBALUT GIPS 4 INCHI ROL 0
67 PERHIDROL SET 0
68 PILOKARPIN TM SET 0
69 PLESTER 5 YARD X 2 INC SET 7186 23893.63
70 POT SPUTUM SET
71 POVIDON IODIDA 30 ML BOTOL 2000 2,403.50 2005.75
72 POVIDON IODIDA 300 ML BOTOL 14500 14,525.22 14040.24
73 SAFETY BOX 2,5L SET
74 SAFETY BOX 5L SET
75 SALBUTAMOL NEBULISER 2,5 ML TABLET 8,556.26 8798.93
76 SALISIL BEDAK 2 % ZAK 1025 1,432.68 1123.22
77 SALISIL SPIRITUS BOTOL 0
78 SCABICID SET 0
79 SOFRATUL SET 0 12,456.90
80 STESOLID RECTAL 10MG SET 0
81 STESOLID RECTAL 5MG SET 0
82 SULFASETAMIDA TM 15 % SET 3445.25 3,451.72 3235.27
83 TETRAKAIN TM SET 0
84 TROMBHOPOP BIJI 0
85 VIRULES BIJI 0
86 ZOLAGEL CREM DOSIN 0
IX ALAT KESEHATAN 0
1 ABOCATH NO 20 SET 0 7,792.96
2 ABOCATH NO 22 SET 0 7,792.96
3 ABOCATH NO 24 SET 0 7,792.96
4 ABOCATH NO 26 SET 0
5 ALAT SUNTIK 0,5 MG BIJI 0
6 ALAT SUNTIK SEKALI PAKAI 1 ML BIJI 1092.5
7 ALAT SUNTIK SEKALI PAKAI 2,5 ML BIJI 1037.85
8 ALAT SUNTIK SEKALI PAKAI 5 ML BIJI 1037.85
9 AUTO DISIBLE SYRINGE 0,05 ML BIJI 1,599.49
10 AUTO DISIBLE SYRINGE 0,5 MG BIJI 3,374.48
11 AUTO DISIBLE SYRINGE 5 ML BIJI 1,025.88
12 CATGUT 2/0 dengan jarum SET 26665.83
13 CATGUT 3/0 dengan jarum SET 24580.42
14 HANDSKUN 7 BIJI 0 4249.96
15 HANDSKUN 8 BIJI 0 4249.96
16 INFUSION SET ANAK SET 3993
17 INFUSION SET DEWASA SET 3498 3,504.57 2932.98
18 IV Catether 22 G SET 7786.9 7,792.98 7876.05
19 IV Catether 24 G SET 7786.9 7,792.98
20 JARUM JAHIT BEDAH SET 0
21 MASKER BIJI 1113.2
22 NEDLE 25 Gx 5/8 BIJI 0
23 NEDLE 26 Gx 1/2 BIJI 0
24 POLI CATETER NO 16 BIJI 0
25 POLI CATETER NO 18 BIJI 0
26 SCALP VEIN NEDLE 23 G BIJI 2145
27 SILK BIJI 5743.861
28 URINE BAG ( STERIL) BIJI

KETERANGAN
1 TOTAL PERSEDIAAN OBAT-OBATAN 31 - 12 -2012
2 JUMLAH KUNJUNGAN RESEP
3 JUMLAH PEMAKAIAN OBAT
4 HARGA SATU LEMBAR RESEP
 0
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#DIV/0!
 0
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KODE

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1905
4101

0409
2003

1203

0105

2102

4002
0406

1601
1602
1603
1804
1805
1806
3601
2007
0806

4009
1801
4115
4113
1301
1302
2006
3805
3808
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2005
1802
1902
3809
4114
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4001

1803

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 PEMERINTAH KABUPATEN WONOGIRI
DINAS KESEHATAN
PUSKESMAS GIRITONTRO

PERENCANAAN KEBUTUHAN OBAT TAHUN 2014

Pemakaian Kebutuhan
NO NAMA O BAT SATUAN rat-rata 1 Th
I. TABLET KAPSUL :
1 ACT-(dehidro artemisin +piperaquin 0 0
2 ACT-Artes Diaquine 0 0
3 ACYCLOVIR TAB 200 MG TAB 0 0
4 ACYCLOVIR TAB 400 MG TAB 16 294
5 ADROME TABLET TABLET 0 0
6 ALOPURINOL TABLET 79 1419
7 ALPRAZOLAM 0,5 MG TAB 0 0
8 AMBROXOL 30 MG KAPSUL 46 821
9 AMILORID 5 MG TAB TABLET 0 0
10 AMINOFILINA 200 MG TABLET 756 13611
11 AMITRIPTILIN 25 MG TABLET 0 0
12 AMOKSILIN 500 MG TABLET 2823 50822
13 AMOKSILINA 250 MG KAPSUL 483 8685
14 AMPISILIN 500 MG TABLET 0 0
15 ANTALGIN 500 MG TABLET 2644 47592
16 ANTASIDA DOEN TABLET 2090 37620
17 ANTITUBERKOLUSA ANAK TABLET 0 0
18 ANTITUBERKOLUSA ANAK (FDC) TABLET 0 0
19 ASAM ASKORBAT (VIT C) 50 MG TABLET 2287 41163
20 ASAM ASKORBAT 250 MG TABLET 0 0
21 ASAM MEFENAMAT 250 MG KAPSUL 865 15561
22 ASAM MEFENAMAT 500 MG TABLET 0 0
23 ASETOSAL 500 MG TABLET 0 0
24 ATROPINA SULFAT 0,5 MG TABLET 0 0
25 BESI II SULFAT TABLET 671 12081
26 BETAHISTIN MESILAT 6 MG TABLET 13 237
27 BICARBON TABLET 0 0
28 BROMHEKSIN 8 MG TABLET 3 45
29 BUSCOPAN/ SPASHI TABLET 0 0
30 CAPTOPRIL 12,50 MG TABLET 89 1599
31 CAPTOPRIL 25 MG TABLET 487 8763
32 CARBAZOKROM NATRIUM SULFONAT 10 MG TABLET 0 0
33 CEFADROXIL 500 MG TABLET 19 336
34 CEPHALEXIN 250 MG TAB KAPSUL 0 0
35 CEPHALEXIN 500 MG TAB TABLET 0 0
36 CETIRIZIN 10 MG TABLET 0 0
37 CIMETIDIN 200 MG TABLET 0 0
38 CIPROFLOKSASIN 500 MG TABLET 84 1512
39 CLOBAZAM TABLET 0 0
40 CO AMOXICLAVE 625 MG TABLET 0 0
41 DAPSON 100 MG TABLET 0 0
42 DEKSAMETAZON TAB 0,5 MG TAB 3541 63737
43 DEKSTROMETORFAN HBR 15 MG TABLET 398 7155
44 DEXTAMIN TABLET 0 0
45 DIAZEPAM 2 MG TABLET 36 642
46 DIETILKARBAMASIN TABLET 0 0
47 DIGOKSIN 25 MG TABLET 12 215
48 DIMENHIDRINATUM TABLET 132 2375
49 DOKSISIKLIN KAP TABLET 0 0
50 DOMPERIDON 10 MG TABLET 3 60
51 EFEDRINA HCL 25 MG TABLET 0 0
52 EKSTRAK BELLADON 10 MG KAPSUL 0 0
53 ERGOTAMIN+KOFFEIN TABLET 0 0
54 ERITHROMISIN 250 MG TABLET 130 2340
55 ERITHROMISIN 500 MG TABLET 0 0
56 ERPHATRIM TABLET 0 0
57 ETAMBUTOL HCL 250 MG TABLET 0 0
58 FAMOTIDIN 20 MG TABLET 0 0
59 FAMOTIDIN 40 MG TABLET 0 0
60 FENOBARBITAL 30 MG TABLET 2 44
61 FENOKSIMETIL PENISILIN 250 MG TABLET 0 0
62 FENOKSIMETIL PENISILIN 500 MG TABLET 0 0
63 FITOMENADION (VIT K) 10 MG TABLET 9 156
64 FUROSEMIDA 40 MG TABLET 112 2024
65 GEMFIBROZIL 300 MG TAB TABLET 0 0
66 GLIBENKLAMIDA 5 MG TABLET 164 2955
67 GLISERILGUAYAKOLAT 100 MG TABLET 3247 58448
68 GRISIOVULVIN 125 MG TABLET 43 776
69 HALOPERIDOL 0,5 MG TABLET 0 0
70 HALOPERIDOL 1,5 MG KAPSUL 60 1080
71 HALOPERIDOL 5 MG TABLET 0 0
72 HECOBAC TABLET 0 0
73 HIDROKLOROTIASIDA 25 MG TABLET 365 6573
74 IBUPROVEN 200 MG TABLET 122 2199
75 IBUPROVEN 400 MG TABLET 0 0
76 IODIOL TABLET 0 0
77 ISONIASIDA 100 MG TABLET 0 0
78 ISONIASIDA 300 MG TABLET 0 0
79 ISOSORBIT DINITRAT 5 MG TABLET 0 0
80 KALIUM DIKLOFENAK 25 MG TABLET 0 0
81 KALIUM DIKLOFENAK 50 MG TABLET 13 240
82 KALSIUM LAKTAT 500 MG TABLET 2027 36488
83 KARBAMEZEPIN 200 MG TAB 0 0
 84 KETOKONAZOL 200 MG TABLET 24 431
85 KININA SULFAT 222 MG KAPSUL 0 0
86 KLOFAZIMIN 100 MG TABLET 0 0
87 KLONIDIN 0,15 MG KAPSUL 0 0
88 KLORAMFENIKOL 250 MG TABLET 123 2220
89 KLORFENIRAMIN MALEAT (CTM) 4 MG TABLET 6385 114927
90 KLOROKINA FOSFAT 250 MG TABLET 0 0
91 KLORPROMAZIN 100 MG TABLET 75 1350
92 KLORPROMAZINA HCL 25 MG TABLET 0 0
93 KLORPROPAMID TABLET 0 0
94 KODEINA HCL 10 MG TABLET 0 0
95 KOTRIMOKSAZOL 120 MG TABLET 0 0
96 KOTRIMOKSAZOL 480 MG KAPSUL 250 4500
97 LINCOMISIN TABLET 0 0
98 LOPERAMID 2 MG TABLET 5 93
99 LORATADIN 10 MG TABLET 15 266
100 MDT COMBI MB ADULT TABLET 2 27
101 MDT COMBI MB CHILD KAPSUL 0 0
102 MDT COMBI PB ADULT KAPSUL 0 8
103 MEBENDAZOL 100 MG KAPLET 276 4968
104 MEBHIDROLIN NAPADISILAT TABLET 0 0
105 MELOXICAM 15 MG TABLET 20 357
106 METFORMIN HCL 500 ML TABLET 31 549
107 METILERGOMETRINA MALEAT 0,125 MG TABLET 7 123
108 METILPREDNISOLON 4 MG TABLET 29 528
109 METOKLOPROPAMID TABLET 9 161
110 METRONIDAZOL 250 MG KAPSUL 137 2463
111 METRONIDAZOL 500 MG TABLET 106 1910
112 MULTIVITAMIN TABLET 366 6581
113 NA. DIKLOFENAK 25 MG TABLET 0 0
114 NA. DIKLOFENAK 50 MG TABLET 5 95
115 NALTREXON KAPS 0 0
116 NATRIUM BIKARBONAT 500 MG TABLET 0 0
117 NATRIUM FENITOINA 100 MG TABLET 0 0
118 NATRIUM FENITOINA 30 MG TAB 0 0
119 NATUR E KAP TABLET 0 0
120 NEO DIAFORM PAKET 265 4775
121 NEUROTROPIC PAKET 0 0
122 NIFEDIPIN 10 MG TAB PAKET 0 0
123 OBAT ANTI TUBERKULOSIS KATEG I PAKET 1 11
124 OBAT ANTI TUBERKULOSIS KATEG II KAPSUL 0 0
125 OBAT ANTI TUBERKULOSIS KATEG III TABLET 0 0
126 OBAT ANTI TUBERKULOSIS SISIPAN TABLET 0 0
127 OBAT KOMBIPAK KATEG I TABLET 0 2
128 OMEPRAZOL 20 MG TABLET 0 0
129 PAPAVERIN TABLET 226 4073
130 PARASETAMOL 100 MG TABLET 52 927
131 PARASETAMOL 500 MG TABLET 7355 132395
132 PEHAVRAL TABLET 0 0
133 PENIL BUTASON 200 MG TABLET 227 4089
134 PHERPHENAZIN 4 MG TABLET 0 0
135 PIPERAZINA 500 MG TABLET 0 0
136 PIRACETAM 400 MG TABLET 10 177
137 PIRANTEL PAMOAT 365 MG TABLET 0 0
138 PIRAZINAMID TAB 500 MG TABLET 0 0
139 PIRIDOKSIN HCL (VIT B6) 10 MG TABLET 1981 35660
140 PIRITAMIN + SULFADOKSIN TABLET 0 0
141 PIROKSIKAM 10 MG TABLET 178 3200
142 PIROKSIKAM 20 MG TABLET 834 15006
143 PRAZIQUANTEL 600 MG TABLET 0 0
144 PREDNISON 5 MG TABLET 1436 25850
145 PRIMAKINA 15 MG TABLET 0 0
146 PROPANOLOL HCL TABLET 0 0
147 PROPILTIOURASIL 100 MG KAPLET 14 248
148 RANITIDIN 150 MG TAB TABLET 83 1494
149 RESERPINA 0,10 MG TABLET 0 0
150 RESERPINA 0,25 MG KAPSUL 36 645
151 RETAPHYL SR KAPSUL 0 0
152 RETINOL 100.000 IU KAPSUL 29 525
153 RETINOL 200.000 IU TABLET 92 1650
154 RIFAMPISINA 450 MG TABLET 0 0
155 RIFAMPISINA 600 MG TABLET 0 0
156 RISPERIDON 2 MG KAPSUL 0 0
157 SALBUTAMOL 2 MG KAPSUL 76 1374
158 SIMVASTATIN 10 MG KAPSUL 29 525
159 SULFADIMIDIN 500 MG TABLET 0 0
160 TAMIFLU/OSELTAMIVIR TABLET 0 0
161 TENSIGARD TABLET 0 0
162 TETRASIKLIN 500 MG TABLET 0 0
163 TETRASIKLIN KAP 250 MG TABLET 293 5274
164 THIAMINA HCL (VIT B1) 50 MG TABLET 2500 45000
165 THIAMPENIKOL TABLET 6 108
166 TRAMADOL 50 MG TABLET 5 96
167 TRIFLUOPERASIN TABLET 0 0
168 TRIHEKSIPENIDIL HCL 2 MG TABLET 61 1095
169 URISPAS TABLET 0 0
170 VIT. B12 TABLET 2467 44399
171 VITAMIN B COMPLEK TABLET 278 4997
172 VITAZYM TABLET 0 0
173 Zinc Tab 20 MG ZAK 175 3156
II. INJEKSI 0 0
1 ADONA AC 17 INJ AMPUL 0 0
2 AMINOFILINA 24MG/ML-10 ML AMPUL 0 0
3 AMOKSISILIN SERBUK INJ. BOTOL 0 0
4 AMPICILLIN INJ SET 0 0
5 ANTALGIN 250 MG/ML-2ML AMPUL 0 0
6 AQUA PRO INJ STERIL VIAL 0 0
7 AQUADEST STERIL 500ML AMPUL 0 0
8 ARTE METER INJ 40 Mg AMPUL 0 0
9 ARTE METER INJ 80 Mg AMPUL 0 0
10 ARTE SUNATE INJ AMPUL 0 0
11 ASAM TRANEKSAMAT INJ 250MG / 5ML AMPUL 0 0
12 ATROPIN SULFAT AMPUL 0 0
13 BENZATIN BENZIL PENISILLIN AMPUL 0 0
14 BUSCOPAN/ SPASHI INJ AMPUL 0 0
15 CARBAZOKROM NATRIUM SULFONAT INJ AMPUL 0 0
16 CHININ ANTIPIRIN INJ AMP 0 0
17 DEKSAMETASON AMPUL 2 33
18 DIAZEPAM AMP 3 54
19 DIFENHIDRAMIN HCL 10 MG/ML - 2ML VIAL 0 0
20 DIHIDRO EMETIN FLACON 0 0
21 EPINEFRINA HCL 0,1% - 1 ML VIAL 0 0
22 FENOBARBITAL 50 MG/ML - 2ML AMPUL 0 0
23 FITOMENADION (VITK) 10 MG/ML - 1 ML AMPUL 32 569
24 FUROSEMID INJ 10 MG / ML AMPUL 0 0
25 GLUKOSA LAR INFUS 40% STERIL AMPUL 0 0
26 HYPOBHAC INJ AMPUL 0 0
27 INSULIN REGULER AMPUL 0 0
28 KEMICETIN INJ AMPUL 0 0
29 KETAMIN INJ AMPUL 0 0
30 KETOROLAC INJEKSI 10 MG AMPL 0 0
31 KININA DIHIDROKLORIDA INJ AMPUL 0 0
32 KLORPROMASINA HCL INJ 25MG/ML-1ML AMPUL 2 27
33 KLORPROMASINA HCL INJ 5MG/ML-2ML VIAL 0 0
34 LIDOKAINA COMP INJ AMPUL 10 185
35 MAGNESIUM SULFAT INJ 20%-25ML TABLET 0 0
36 MAGNESIUM SULFAT INJ 40%-25ML AMPUL 0 0
37 METIL ERGOMETRIN MALEAT AMPUL 1 23
38 MYOMERGIN VIAL 0 0
39 NATRIUM THIOPENTAL AMPUL 0 0
40 NATRIUM TIOSULFAT INJ 25%-10ML VIAL 0 0
41 OKSITETRASIKLIN KAPSUL 0 0
42 OKSITOSIN AMPL 0 0
43 ONDANSETRON 4MG / 2ML AMPUL 0 0
44 PEHACAIN INJ AMPUL 0 0
45 PETIDINA HCL INJ 50MG/ML-2ML VIAL 0 0
46 PIRACETAM 3GR/15 ML AMPUL 0 0
47 PIRIDOKSIN INJ AMPUL 0 0
48 RANITIDIN INJ VIAL 0 0
49 SEFOTAKSIM 1 GRAM VIAL 0 0
50 SIANOKOBALAMIN(B12) INJ VIAL 1 17
51 STREPTOMISINA SULFAT INJ 1GR/VL VIAL 0 0
52 SUSPENSI SENG INSULIN VIAL 0 0
53 THIAMINA HCL (B1) INJ 100MG/ML-1ML AMPUL 0 0
54 TRAMADOL INJ VIAL 0 0
55 ULCUMET INJ. VIAL 0 0
III. VAKSIN/SERRA : 0 0
1 SERUM ANTI BISA ULAR I BOTOL 0 0
2 SERUM ANTI BISA ULAR II BOTOL 0 0
3 SERUM ANTI DIFTERI 20.000 IU BOTOL 0 0
4 SERUM ANTI TETANUS 1500 IU BOTOL 0 0
5 SERUM ANTI TETANUS 20.000 IU BOTOL 0 0
6 VAKSIN RABIES KERING BOTOL 0 0
7 VAKSIN RABIES VERO BOTOL 0 0
IV. SIRUP : 0 0
1 AMBROXOL SIRUP BOTOL 0 0
2 AMOKSILINA SIR 125MG/5ML BOTOL 67 1200
3 AMPISILINA SIR 125MG/5ML BOTOL 0 0
4 ANTASIDA SIRUP BOTOL 11 197
5 BESI II SIRUP BOTOL 0 0
6 COREDRYL SIRUP BOTOL 0 0
7 DEKSTROMETORFAN HBR SIR 10MG/5ML BOTOL 13 237
8 ERYTROMISIN SIRUP BOTOL 0 0
9 KLORAMFENIKOL SIRUP BOTOL 0 0
10 KOTRIMOKSAZOL SUSPENSI BOTOL 18 320
11 OBAT BATUK HITAM ( OBH ) BOTOL 41 729
12 OBAT DIARE SIR BOTOL 0 0
13 OBP BOTOL 0 0
14 PARASETAMOL SIR 120 MG/5ML BOTOL 51 924
15 PIPERASIN SIRUP BOTOL 0 0
16 RECOMINT SIRUP BOTOL 0 0
17 RECOVIT DROP BOTOL 0 0
18 RECOVIT SIRUP BOTOL 15 270
19 THIAMPENIKOL 125 MG/ 5ML SIRUP BOTOL 0 0
V. OBAT GIGI : 0 0
1 AIR RAKSA DENTAL USE SET 0 0
2 ARSEN PASTA BOTOL 0 0
3 CELLOLOID BOTOL 0 0
4 DEVITALISASI PASTA BOTOL 0 3
5 EUGENOL CAIRAN SET 0 2
6 FLUOR BOTOL 0 0
7 GLAS IONOMER CEMEN BOTOL 0 3
8 GUTTA PERCHA POINT SET 0 0
9 KALSIUM HIDROKSIDA PASTA BOTOL 0 3
10 METAKRESOL SULFON & MET SET 0 6
11 MONOKLORKAMFER MENTOL CAIRAN BOTOL 0 3
12 MUMIFYING PASTA BOTOL 0 5
13 SEMEN SENG POSPAT SERBUK & CAIR BOTOL 0 0
14 SILVER AMALGAM SERBUK 65-75% BOTOL 0 0
15 SINTETIK FELING MAT LAR & SERBUK BOTOL 0 0
16 SPON GELATIN CUBICLUS 1M3 BOTOL 0 3
17 SULFA CONUS BOTOL 0 0
18 TEMPORARY STOPING FLETCHER BOTOL 0 2
19 TRIKRESOL FORMALIN (TKF) CAIRAN BOTOL 0 2
VI. REAGENSIA : 0 0
1 ASAM KLORIDA 0,1 N BOTOL 0 0
2 ASAM SULFOSALISILAT 20 % BOTOL 0 0
3 LARUTAN BENEDICT BOTOL 0 0
4 LARUTAN CARBOL FUKSIN BOTOL 0 0
5 LARUTAN EOSIN 2 % BOTOL 0 0
6 LARUTAN GABBETT BOTOL 0 0
7 LARUTAN GIEMSA STAIN BOTOL 0 0
8 LARUTAN KINYOUN BOTOL 0 0
9 LARUTAN METANOL BOTOL 0 0
10 LARUTAN TURK BOTOL 0 0
VII. INFUS : 0 0
1 DEKSTRAN 70-LAR INFUS 6% STERIL BOTOL 0 0
2 GLUKOSA LAR INFUS 10 % BOTOL 0 0
3 GLUKOSA LAR INFUS 5 % BOTOL 0 0
4 NATRIUM KLORIDA LAR INFUS 0,9% BOTOL 0 0
5 POLIPEPTIDA KOMB DOEN INFUS BOTOL 0 0
6 RINGER LAKTAT LAR INFUS BOTOL 1 15
VIII. LAIN - LAIN : 0 0
1 ACYCLOVIR CREAM TUBE 5 81
2 ANTI BAKTERI DOEN TUBE 2 36
3 ANTIHEMOROIDA TABLET 2 30
4 AQUATAB BOTOL 0 0
5 AS.BENZOAT+AS.SALISILAT ZK TUBE 4 71
6 AS.SALISIL+BELERANG ZK ( 2-4 SALEP ) TUBE 4 66
7 ATROPIN SULFAT TM BOTOL 0 0
8 BETAMETASON KRIM 0,1 % TUBE 34 618
9 BETAMETASON N KRIM 0,1 % TUBE 0 0
10 BIOPLACENTON SALEP TUBE 0 0
11 BISACODYL SUPP 10 MG TUBE 0 5
12 BISACODYL SUPP 5 MG TUBE 0 0
13 CALADIN BEDAK ZAK 0 0
14 CHLORAMFECORT H CREAM TUBE 0 0
15 ETAKRIDINA SERBUK ZAK 0 0
16 ETAKRIDINA(RIVANOL)LAR 0,1 % ZAK 1 18
17 ETANOL 70% BOTOL 1 14
18 ETANOL 95% BOTOL 0 0
19 ETER ANESTESI BOTOL 0 0
20 ETIL KLORIDA SEMPROT BOTOL 1 14
21 FENOL GLISEROL TT TUBE 0 0
22 GAMEKSAN BOTOL 0 0
23 GARAM ORALIT 1000 ML ZAK 0 0
24 GARAM ORALIT 200 ML ZAK 4 75
25 GENTAMISIN TETES MATA BOTOL 1 15
26 GENTAMISIN SK TUBE 0 6
27 GENTIAN VIOLET LAR 1 % BOTOL 2 32
28 GLISEROL BOTOL 0 0
29 HIDROKORTISON KRIM 2,5 % SK TUBE 30 540
30 HYPAFIK 5M x 2M ROL 0 0
31 IKHTIOL SALEP KULIT ROL 2 30
32 ISODIN GARGLE ROL 0 0
33 ISODIN OINTMENT TUBE 0 0
34 KALIUM PERMANGANAT SERBUK TUBE 4 68
35 KAPAS 250 GRAM ROL 0 8
36 KAPAS BERLEMAK 500 GRAM ROL 0 0
37 KASA HIDROFIL 40M X 80CM ROL 0 0
38 KASA HIDROFIL STERIL UK 16 X 16 ISI ROL 5 83
39 KASA HIDROFIL STERIL UK 18 X 22 ISI ROL 1 11
40 KASA KOMPRES 40/40 STERIL ROL 0 5
41 KASA PEMBALUT 2M X 80 CM ROL 1 18
42 KASA PEMBALUT ELASTIC 3 INCHI ROL 1 23
43 KASA PEMBALUT ELASTIC 4 INCHI ROL 0 0
44 KASA PEMBALUT HIDROFIL 4 X 15 CM ROL 0 0
45 KASA PEMBALUT HIDROFIL 4 X 3 CM ROL 0 0
46 KASA PEMBALUT HIDROFIL 4M X 10CM ROL 4 75
47 KASA PEMBALUT HIDROFIL 4M X 5CM ROL 4 75
48 KETOKONAZOL KRIM 2% TUBE 1 17
49 KLORAMFENIKOL SM 1 % BOTOL 5 87
50 KLORAMFENIKOL TES MATA BOTOL 15 272
51 KLORAMFENIKOL TT 3 % BOTOL 13 233
52 LEVERTRAN SALEP KULIT POT 2 38
53 LISOL BOTOL 0 0
54 MAGNESIUM SULFAT BOTOL 0 0
55 MIKONAZOL 2 % BOTOL 2 30
56 MIKROSKOP SLIDE FROSTED BOTOL 0 0
57 MINERAL MIX ZAK 0 0
58 NATRIUM FLUORESIN TM LEMBAR 0 0
59 NISTATIN TAB VAG 100.000 IU/G TABLET 0 0
60 OKSIGEN GAS DALAM TABUNG BOTOL 0 0
61 OKSITETRASIKLIN 1 % SM TUBE 18 330
62 OKSITETRASIKLIN 3 % SK TUBE 18 318
63 PAC TUBE 0 0
64 PARAFORMALDEHIA TUBE 0 0
65 PEMBALUT GIPS 3 INCHI ROL 0 0
66 PEMBALUT GIPS 4 INCHI ROL 0 0
67 PERHIDROL SET 0 0
68 PILOKARPIN TM SET 0 0
69 PLESTER 5 YARD X 2 INC SET 1 14
70 POT SPUTUM SET 0 0
71 POVIDON IODIDA 30 ML BOTOL 2 30
72 POVIDON IODIDA 300 ML BOTOL 0 0
73 SAFETY BOX 2,5L SET 0 0
74 SAFETY BOX 5L SET 0 0
75 SALBUTAMOL NEBULISER 2,5 ML TABLET 0 0
76 SALISIL BEDAK 2 % ZAK 36 651
77 SALISIL SPIRITUS BOTOL 0 0
78 SCABICID SET 0 0
79 SOFRATUL SET 0 8
80 STESOLID RECTAL 10MG SET 0 0
81 STESOLID RECTAL 5MG SET 0 0
82 SULFASETAMIDA TM 15 % SET 25 447
83 TETRAKAIN TM SET 0 0
84 TROMBHOPOP BIJI 0 0
85 VIRULES BIJI 0 0
86 ZOLAGEL CREM DOSIN 0 0
IX ALAT KESEHATAN 0 0
1 ABOCATH NO 20 SET 0 0
2 ABOCATH NO 22 SET 0 0
3 ABOCATH NO 24 SET 0 0
4 ABOCATH NO 26 SET 0 0
5 ALAT SUNTIK 0,5 MG BIJI 0 0
6 ALAT SUNTIK SEKALI PAKAI 1 ML BIJI 0 0
7 ALAT SUNTIK SEKALI PAKAI 2,5 ML BIJI 84 1508
8 ALAT SUNTIK SEKALI PAKAI 5 ML BIJI 0 0
9 #REF! BIJI 0 0
10 #REF! BIJI 0 0
11 #REF! BIJI 0 0
12 CATGUT 2/0 dengan jarum SET 0 8
13 CATGUT 3/0 dengan jarum SET 1 15
14 HANDSKUN 7 BIJI 8 150
15 HANDSKUN 8 BIJI 8 150
16 INFUSION SET ANAK SET 0 0
17 INFUSION SET DEWASA SET 0 0
18 IV Catether 22 G SET 0 0
19 IV Catether 24 G SET 0 0
20 JARUM JAHIT BEDAH SET 0 0
21 MASKER BIJI 42 750
22 NEDLE 25 Gx 5/8 BIJI 0 0
23 NEDLE 26 Gx 1/2 BIJI 0 0
24 POLI CATETER NO 16 BIJI 0 0
25 POLI CATETER NO 18 BIJI 0 0
26 SCALP VEIN NEDLE 23 G BIJI 0 0
27 SILK BIJI 1 18
28 URINE BAG ( STERIL) BIJI 0 0
51104 919871

Giritontro, 8 Januari 2014

Mengetahui Pengelola Obat

Kepala UPT Puskesmas Giritontro
dr. Zaenal Arifin Hari Purnomo Joko Dwi Haryadi
19640421 200701 1 009 19770113 200903 1 001
AH KABUPATEN WONOGIRI
DINAS KESEHATAN
KESMAS GIRITONTRO

AN KEBUTUHAN OBAT TAHUN 2014

Stok Kebutuhan
Sisa Stok
Cadangan yang dibeli

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0 0 0
29 118 205
0 0 0
142 237 1,324
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82 563 340
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1361 0 14,972
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5082 4,001 51,903
869 786 8,768
0 0 0
4759 8,026 44,325
3762 6,790 34,592
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0 0 0
4116 5,890 39,389
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1556 6,426 10,691
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1208 0 13,289
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876 746 8,893
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 0 0 0
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151 1,048 615
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6374 0 70,110
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237 392 2,220
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234 1,336 1,238
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202 1,906 320
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296 1,249 2,002
5845 14,374 49,918
78 405 448
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108 600 588
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657 0 7,230
220 4,157 0
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3649 10,675 29,461
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 43 393 81
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222 641 1,801
11493 12,663 113,757
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135 1,124 361
0 1,000 0
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450 0 4,950
0 0 0
9 182 0
27 185 107
3 0 30
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1 0 8
497 0 5,465
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36 468 0
55 24 580
12 197 (62)
53 148 433
16 254 0
246 608 2,101
191 500 1,600
658 3,613 3,626
0 0 0
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407 1,400 3,080
93 1,358 0
13239 13,056 132,578
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165 0 1,815
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53 586 0
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527 1,946 3,855
4500 0 49,500
11 428 (309)
10 64 42
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110 1,004 201
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4440 3,707 45,131
500 1,864 3,632
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 0 0 0
54 228 366
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1 6 2
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1 38 0
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8 0 83
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4 4 37
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91987 146,150 865,708

Giritontro, 8 Januari 2014

Pengelola Obat
 Joko Dwi Haryadi
19770113 200903 1 001