Laporan Khusus Penggunaan Morphin, Pethidin, Dan Derivatnya

LAPORAN KHUSUS PENGGUNAAN MORPHIN, PETHIDIN, DAN DERIVATNYA
Nama Sarana : Puskesmas Pelabuhan Dagang

Alamat : Pelabuhan Dagang, Tungkal Ulu
Bulan/Tahun : November 2021
Resep Pasien Dokter

Persediaan Nomor/ Tanggal Sisa
No Nama Bahan Satuan Awal Bulan Tanggal Penyerahan Jumlah Nama Alamat Nama Alamat Persediaan
1 2 3 4 5 6 7 8 9 10 11 12
1 Morphin Tablet 0 Nihil 0
2 Pethidin Tablet 0 Nihil 0
3
4
5
Mengetahui, Tungkal Ulu, Desember 2021

Kepala Puskesmas Pembuat Laporan
dr. Cerli Scorpio Rita Marlia,S.Farm,Apt

NIP.19861110 201505 2001 NIP 19840825 201001 2 001
LAPORAN PENGGUNAAN OBAT OBAT TERTENTU (OOT

Penerimaan
No Nama sediaan Satuan Persediaan Total
Tanggal Dari Jumlah
Awal Bulan Persediaan
1 2 3 4 5 6 7 8=(4+7)
1 Amitriptilin 25 mg Tablet 1310 1310
2 Clozapin 25 mg Tablet 0 0
0 0
3 Clobazam Tablet 200 200
3 Flufenazine Decanoate Inj (Sikzonoate) Ampl 0 0
4 Haloperidol 0,5 mg Tablet 1500 1500
5 Haloperidol 1,5 mg Tablet 1670 1670
0 0
0 0
6 Haloperidol 5 mg Tablet 572 572
0 0
0 0
7 Karbamazepin 200 mg Tablet 820 820
0 0
8 Klorpromazin 100 mg Tablet 768 768
0 0
0 0
9 Klorpromazin 25 mg Tablet 0 0
10 Olanzapine Tablet 30 26-Nov-21 IFK 180 210
11 Risperidon 1 mg Tablet 0 0
0 0
0 0
15 Tramadol 50 mg Tablet 0 0
16 Triheksifenidil 2 mg Tablet 735 735
Mengetahui,
Kepala Puskesmas
dr. Cerli Scorpio
NIP.19861110 201505 2001
T OBAT TERTENTU (OOT) / OBAT KESWA
Pengeluaran
Nama Pasien/ Persediaan No. Batch Ket.
Jumlah
Alamat Akhir Bulan & ED
9 10 11=(8-10) 12 13
1310
0
200 0 49H0409/JUL 21
0
1500
Lamsuri 9/11 (60) 120 1550
Ahmad. S 22/11(60)
Kurnia 3/11 (60), Dina F 24/11 (60) 210 362

A.musa 9/11 (60)
Nurmala 6/11(30)
Ali anfari 18/11 (30),Dina F 24/11 (60) 180 640
Riani 24/11(30), Abdul. S 24/11 (60)
Kurnia 3/11 (60) 143 625
Mustafa R. 13/11 (10)
M.Hasbi 10/11 (13)
A.Musa 9/11 (30),Lamsuri 9/11 (15),Ahmad s. 22/11(15) 0
Nurmala 6/11(30) 30 180
0
Zairowi 3/11(60) 90 520
M.Hasbi 10/11 (30)
0
0
Kurnia 3/11 (30),Ahmad s. 22/11(30) 240 495
Zairowi 3/11(30)
Nurmala 6/11(30)
A.Musa 9/11(30)
Lamsuri 9/11 (30), Dina F 24/11 (60)
Tungkal Ulu, November 2021

Pembuat Laporan
Rita Marlia,S.Farm,Apt
NIP. 19840825 201001 2 017
LAPORAN PENGGUNAAN PSIKOTROPIKA

Bulan/Tahun : Oktober 2021
Penerimaan
Persediaan Tanggal Nomor
No Nama sediaan Satuan Awal Bulan Faktur Faktur Sumber Jumlah
1 2 3 4 5 6 7 8
1 Alprazolam 0,25 mg Tablet 184
2 Alprazolam 0,5 mg Tablet 0
3 Diazepam/ Valisanbe 2 mg Tablet 60
0
0
4 Diazepam/ Valisanbe 5 mg Tablet 0
0
5 Diazepam/ Valisanbe Inj 10 mg/mL Ampl 0
6 Diazepam/ Valisanbe Inj 5 mg/mL Ampl 19
7 Stesolid Rectal 5mg/2,5mL (Diaze Tube 5
8 Stesolid Rectal 10mg/2,5mL (Diaz Tube 18
9 Phenytoin 30 mg Kapsul 300
10 Phenytoin 100 mg Kapsul 1370 28-Nov IFK 400
0
11 Phenobarbital 30 mg Tablet 100
12 Phenobarbital 100 mg Tablet 0
13 Phenobarbital Inj 50mg/mL Ampl 30
Mengetahui,
Kepala Puskesmas
dr. Cerli Scorpio

NIP.19861110 201505 2001
AN PSIKOTROPIKA
Pengeluaran
Total Tanggal/ Nama Pasien/ Persediaan No. Batch Ket.
Persediaan No. Resep Alamat Jumlah Akhir Bulan & ED
9=(4+8) 10 11 12 13=(9-12) 14
184 184 0 5010812/JUL 21
0 0
60 A.Musa (10) 9/11 10 50
0 0
0 0
19 19
5 DINKES 5 0
18 18 0 V23091707/11-21
300 300 0 9064014/20-20-21
1770 Elviarita 18/11 (60) 150 1620
Ardiansyah 9/11(30), Dina F 24/11 (60)
100 100
0 0
30 30
Tungkal Ulu, November 2021

Pembuat Laporan
NIP. 19840825 201001 2 017
FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN INDIKATOR
DI PUSKESMAS
PERIODE PELAPORAN : BULAN November 2021
NAMA PUSKESMAS : Pelabuhan Dagang

ALAMAT : Jl. Kesehatan
Kab/ Kota : Tanjung Jabung Barat
Provinsi : JAMBI
Penanggung jawab Farmasi : Rita Marlia,S.Farm,Apt.
Email : ritamarlia1984@gmail.com
No Hp : 082279642242
Bentuk Ketersediaan
No. Nama Obat
Sediaan Ada/ Tidak
(1) (2) (3) (4)
1 Albendazol /Pirantel Pamoat Tablet 1

2 Alopurinol Tablet 1
3 Amlodipin/Kaptopril Tablet 1
4 Amoksisilin 500 mg Tablet 1
5 Amoksisilin sirup Botol 1
Antasida tablet kunyah/ antasida
6 Tablet/Botol 1
suspensi
7 Asam Askorbat (Vitamin C) Tablet 1
8 Asiklovir Tablet 1
9 Betametason salep Tube 1
Deksametason tablet/deksametason
10 Tablet/Vial/Ampul 1
injeksi
11 Diazepam injeksi 5 mg/ml Ampul 1
12 Diazepam Tablet 1
Dihidroartemsin+piperakuin (DHP) dan
13 Tablet 0
primaquin
14 Difenhidramin Inj. 10 mg/ml Ampul 1
Epinefrin (Adrenalin) injeksi 0,1 %
15 Ampul 1
(sebagai HCl)
16 Fitomenadion (Vitamin K) injeksi Ampul 1
Furosemid 40 mg/Hidroklorotiazid
17 Tablet 1
(HCT)
18 Garam Oralit serbuk Kantong 1
19 Glibenklamid/Metformin Tablet 1
20 Hidrokortison krim/salep Tube 1
Kotrimoksazol (dewasa) kombinasi
21 Tablet/Botol 1
tablet/Kotrimoksazol suspensi
22 Lidokain inj Vial 1
23 Magnesium Sulfat injeksi Vial 1
Metilergometrin Maleat injeksi 0,200
24 Ampul 1
mg-1 ml
25 Natrium Diklofenak Tablet 1
26 OAT FDC Kat 1 Paket 1
27 Oksitosin injeksi Ampul 1
28 Parasetamol sirup 120 mg / 5 ml Botol 1
29 Parasetamol 500 mg Tablet 1
30 Prednison 5 mg Tablet 1
31 Ranitidin 150 mg Tablet 1
32 Retinol 100.000/200.000 IU Kapsul 1
33 Salbutamol Tablet 1
34 Salep Mata/Tetes Mata Antibiotik Tube 1
35 Simvastatin Tablet 1
36 Siprofloksasin Tablet 1
37 Tablet Tambah Darah Tablet 1
38 Triheksifenidil Tablet 1
39 Vitamin B6 (Piridoksin) Tablet 1
40 Zinc 20 mg Tablet 1
41 Vaksin Hepatitis B Vial 1
42 Vaksin BCG Ampul 1
43 Vaksin DPT-HB-HIB Vial 1
44 Vaksin Polio Vial 1
45 Vaksin Campak/Vaksin Rubella Vial/Ampul 1
• KolomKetersediaan (Ada/Tidak) (4) :

- diisi dengan angka 1 jika obat tersebut tersedia untuk pelayanan.
- diisi dengan angka 0 jika obat tersebut tidak tersedia untuk pelayanan.
Keterangan
LAPORAN PENGGUNAAN NARKOTIKA

Penerimaan
Persediaan Tanggal Nomor Total
No Nama sediaan Satuan Awal Bulan Faktur Faktur Sumber Jumlah Persediaan
1 2 3 4 5 6 7 8 9=(4+8)
1 Codein 10 mg Tablet 0 0
2 Codein 20 mg Tablet 0 0
3 Pethidin HCl Inj Ampul 0 0
Mengetahui,
Kepala Puskesmas
dr. Cerli Scorpio

NIP.19861110 201505 2001
KOTIKA
Pengeluaran
Tanggal/ Nama Pasien/ Persediaan No. Batch
No. Resep Alamat Jumlah Akhir Bulan & ED
10 11 12 13=(9-12) 14
Nihil Nihil 0 0
Nihil Nihil 0 0
Nihil Nihil 0 0
Tungkal Ulu, Desember 2021

Pembuat Laporan
NIP. 19840825 201001 2 017
LAPORAN PEMAKAIAN DAN PERMINTAAN OBAT (LPPO)
PUSKESMAS PERAWATAN PELABUHAN DAGANG
TAHUN 2021
BULAN : NOVEMBER 2021
SATUAN KESESUAIAN DGN
NO NAMA SEDIAAN Stok Awal Penerimaan Persediaan
KEMASAN FORNAS
1 ACT (Artesunat 50 mg + Amodiaquin 200 mg) Tablet Tablet TIDAK 0 0 0

2 Albendazol tablet 400 mg (ktk 5 x 6 tab) Tablet YA 0 0 0
3 Albendazole Suspensi 200 mg/ 5 ml botol YA 0 0 0
4 Allopurinol 100mg Tablet Tablet YA 300 0 300
5 Allopurinol 300mg Tablet Tablet 100 0 100
6 Alprazolam 0,25 mg Tablet 184 0 184
7 Alprazolam 0,5 mg Tablet YA 0 0 0
8 Ambroxol Sirup 15mg / 5ml Botol TIDAK 144 50 194
9 Ambroxol 30mg Tab Tablet TIDAK 300 2000 2300
10 Aminofilina 150mg Tablet (DECAFIL) 1000 0 1000
11 Aminofilina 200mg Tablet Tablet YA 500 0 500
12 Aminofilina Injeksi 24mg / ml - 10ml Ampul YA 0 0 0
13 Amitrifilin 25mg Tablet Tablet YA 1310 0 1310
14 Amlodipin 5 mg (ktk 30 tablet) Tablet YA 650 3000 3650
15 Amlodipin 10 mg (ktk 50 tablet) Tablet YA 0 2000 2000
16 Amoksisilin sirup kering 125 mg / 5ml Botol YA 30 0 30
17 Amoksisilin sirup kering 100 / 5ml drop Botol 109 0 109
18 Amoksisilin sirup kering 250 mg / 5ml - Forte Botol YA 50 0 50
19 Amoksisilin 250mg Capsul Kapsul YA 0 0 0
20 Amoxicillin 500mg Tab Tablet YA 1900 4000 5900
21 Ampicillin serbuk 1000mg inj Vial TIDAK 20 0 20
22 Ampicillin 500mg Tablet Tablet TIDAK 0 0 0
23 Ampicillin sirup kering 125 mg / ml Botol TIDAK 0 0 0
24 Antalgin ( Metamizol ) 500mg Tablet TIDAK 0 0 0
25 Antalgin Injeksi 250 mg / ml - 2 ml (METAMIZOL Inj Ampul TIDAK 0 0 0
26 Antasida DOEN tablet 200 mg Mersifarma Tablet YA 0 2000 2000
27 Antasida DOEN Syrup / 60 ml Lucas Botol YA 0 0 0
28 Antasida DOEN Syrup / 60 ml (Itramag Susp) Botol 0 0 0
29 Antibakteri DOEN Salap Kombinasi(BACITRACIN) Tube YA 125 0 125
30 Anti Hemoroid DOEN kombinasi Supp YA 134 0 134
31 Antifungi DOEN Kombinasi Pot YA 255 0 255
32 Antimigrain DOEN komb. (Ergotamin + Kofein) Tablet YA 1200 0 1200
33 Antiparkinson DOEN kombinasi (Levopar Benserazid Tablet YA 300 200 500
34 Aqua proinjeksi steril, bebas pirogen (25 ml) Vial YA 90 30 120
35 Aqua proinjeksi steril, bebas pirogen (25 ml) BDB Vial 0 0 0
36 Aquadest steril Botol 0 0 0
37 Arthemeter 1 mL : 80 mcg Injeksi (ktk 6 amp) ktk 6 amp/1ml YA 0 0 0
38 Asam asetil Salisilat 80 mg (Asetosal), Miniaspi Tablet YA 0 500 500
39 Asam asetil Salisilat 100 mg (Asetosal) Tablet 0 0 0
40 Asam asetil Salisilat 500 mg (Asetosal) Tablet TIDAK 0 0 0
41 Asam askorbat ( Vit. C ) 250mg Tablet Tablet 0 0 0
42 Asam askorbat ( Vit. C ) 50mg Tablet Tablet YA 0 0 0
43 Asam Folat 0,4 mg Tablet (Apolat) Tablet 0 0 0
44 Asam Folat 1 mg Tablet (Folic Acid) Tablet YA 0 0 0
45 Asam Folat 5 mg Tablet Tablet 0 0 0
46 Asam Mefenamat 500mg Tab (Mersifarma) Tablet YA 0 300 300
47 Asam Mefenamat 500mg Tab (Bernofarm) Tablet 0 0 0
48 Asam Tranexamat Injeksi (Transamin Injeksi 250 mg Ampul 0 0 0
49 Asam Tranexamat Injeksi (Transamin Injeksi 500 mg Ampul YA 0 30 30
50 Asam Tranexamat 500 mg Tablet YA 1800 0 1800
51 Asiklovir 5% Cream Tube YA 150 0 150
52 Asiklovir 200mg Tab Tablet YA 0 0 0
53 Asiklovir 400mg Tab Tablet YA 350 0 350
54 Atapulgit tablet 630 mg (Pularex) Tablet YA 4100 2000 6100
55 Atenolol 50 mg (Betablok 50) tablet 0 0 0
56 Atropine Sulfat injeksi 0,25mg / ml ( ktk 30a, ktk 100 Ampul YA 0 0 0
57 Atropine Sulfat 0,5mg Tab Tablet YA 0 0 0
58 Atropine Sulfat Tetes mata 0,5 % (Cendo Tropin) Botol YA 0 0 0
59 Azitromicin 500 mg tablet (ktk 30 tab) Tablet YA 10 0 10
60 Benzatin Benzil Penisilin inj 1,2 juta IU/vial vial TIDAK 0 0 0
61 Benzatin Benzil Penisilin inj 2,4 juta IU/vial vial 0 0 0
62 Benzatin Benzil Penisilin inj 2,4 juta IU/vial vial YA 0 0 0
63 Betahistin Mesilat 6 mg Tube YA 500 0 500
64 Betametasone Cream Tube 90 70 160
65 Betasone N Cream Tube 0 0
66 Bisakodil Tablet 5 mg (ktk 30 tab) Tablet 0 0 0
67 Bisakodil suppositoria 5 mg (Dulcolax Infant) ktk isi supp YA 4 0 4
68 Bisakodil suppositoria 10 mg (Dulcolax Adult) ktk is supp 84 0 84
69 Bismecon/ Bioplacenton jelly Tube TIDAK 0 0 0
70 Bisoprolol 2,5 mg tablet Tablet YA 850 0 850
71 Bisoprolol 5 mg tablet tablet YA 60 0 60
72 Bromhexin HCl 8 mg (Hustab P Tab) @ 30 Tablet TIDAK 9900 3000 12900
73 Bromhexin HCl Syrup (Hustab Sirup) botol TIDAK 50 0 50
74 Cefadroxil 50 mg Tablet 0 0 0
75 Cefadroxil 250 mg kapsul 0 0 0
76 Cefadroxil 500 mg kapsul YA 0 0 0
77 Cefadroxil 125 mg/ 5 ml Dry Syrup botol YA 54 0 54
78 Cefadroxil 150 mg/ 5 ml Dry Syrup kapsul 0 0 0
79 Cefadroxil 250 mg/ 5 ml Dry Syrup botol 0 0 0
80 Cefixime kapsul 100 mg (ktk 30 tablet) Kapsul YA 0 0 0
81 Cefixime kapsul 200 mg (ktk 30 tablet) Kapsul 0 0 0
82 Cefixime Sirup Kering 100 mg/ 5 mL Tablet 0 0 0
83 Cefotaksim serb inj 500 mg/vial vial 0 0 0
84 Cefotaksim injeksi 1 g (dus 2 vial) vial TIDAK 0 0 0
85 Ceftriakson serbuk injeksi 1 g/vial vial YA 0 0 0
86 Cetirizin 10 mg Tablet YA 100 700 800
87 Cetirizin sirup 5 mg/ 5ml Botol 62 50 112
88 Clobazam 10mg Tablet 200 0 200
89 Clozapin Botol 0 0 0
90 Clyndamicin 150 kaps (ktk 50 kaps) kapsul YA 300 0 300
91 Clyndamicin 300 mg kapsul kapsul 0 0 0
92 Ciprofloxacin 500mg Tab (ktk 50 tab) Tablet YA 550 1000 1550
93 Co Amoxiclav (Amoxicillin + As. Clavulanat )625 mg Tablet 0 0 0
94 Deksametasone inj 5mg / ml - 1ml Ampul YA 55 50 105
95 Deksametasone 0,5mg Tab Tablet YA 0 1800 1800
96 Dekstromethorphane Hbr 10mg / 5ml Botol TIDAK 0 0 0
97 Dekstromethorphane Hbr 15mg Tab Tablet TIDAK 0 0 0
98 Dekstran 70 Larutan Infus 6 % botol YA 0 0 0
99 Dermazine 50gr/ Burnazine 35 g Tube 0 0 0
100 Dermazine 250gr Cream Tube 0 0 0
101 Diazepam inj 5mg / ml - 2ml (Valisanbe Inj) Ampul YA 19 0 19
102 Diazepam 2mg Tab (Valisanbe 2) Tablet YA 60 0 60
103 Diazepam 5mg Tab (Valisanbe 5) Tablet YA 0 0 0
104 Diazepam lar Rectal 5 mg/ 2,5 ml (Stesolid 5) tube YA 5 0 5
105 Diazepam lar Rectal 10 mg/ 2,5 ml (Stresolid 10) tube 18 0 18
106 Dietilkarbamazin tab 100 mg Tablet 0 0 0
107 Difenhidramine HCL inj 10mg /ml - ml Ampul YA 183 150 333
108 Digoksin inj 0,25 mg Ampul 0 0 0
109 Digoksin 0,0625 mg tab. Tablet 200 0 200
110 Digoxin 0,25mg Tab Tablet YA 0 0 0
111 Diltiazem 30mg Tab Tablet 500 0 500
112 Dimenhydrinat 50mg Tab Tablet YA 2600 2000 4600
113 Doksisiklin 100mg Tab Tablet YA 200 200 400
114 Domperidon 10 mg Tablet YA 0 600 600
115 Domperidon Maleat Drops 5 mg/ml Tablet 20 0 20
116 Domperidon susp 5 mg/ml Botol YA 0 0 0
117 Efedrine HCL 25mg Tab Tablet TIDAK 0 0 0
118 Ekstrabelladone 100mg Tab Tablet TIDAK 0 0 0
119 Epinefrine HCL / bitartrato inj 0,1% - 1ml (ktk 30 am Ampul YA 38 0 38
120 Eritromicin 250mg Capsul (ktk 10 x 10) Capsul YA 700 0 700
121 Eritromicin 500mg Capsul (Dothrocyn) Capsul YA 0 0 0
122 Eritromicin 200mg Dry Sirup/ 5% Botol YA 0 0 0
123 Etakridine ( Rivanol ) larutan 0,1 Botol TIDAK 0 0 0
124 Etakridine ( Rivanol ) larutan 0,1 Onemed Botol TIDAK 28 0 28
125 Etambutol 250mg Tab Tablet 800 0 800
126 Etambutol 500 mg Tab (Santibi 500 ) Tablet 400 0 400
127 Etanol 70 % 100 ml Botol YA 0 0 0
128 Etanol 70 % 1000 ml Botol YA 2 5 7
129 Famotidine 40mg Tab Tablet TIDAK 0 0 0
130 Fenilbutazon 200 mg tablet TIDAK 0 0 0
131 Fenitoin Natrium inj 50mg / ml (ktk 10 amp) Ampul TIDAK 0 0 0
132 Fenitoin Natrium 100mg Capsul kapsul YA 1370 400 1770
133 Fenitoin Natrium 30mg Capsul kapsul YA 300 0 300
134 Fenobarbital inj 50 mg/ml-2ml Ampul YA 30 0 30
135 Fenobarbital 30mg tab Tablet YA 100 0 100
136 Fenobarbital 100mg Tab Tablet YA 0 0 0
137 Fenoksimetil penisilin (penisilin V) tab 500 mg Tablet TIDAK 0 0 0
138 Fenoksimetil penisilin (penisilin V) tab 250 mg Tablet TIDAK 0 0 0
139 Fenol Gliserol Tetes Telinga 10 % (Fenol 100 mg/ 1 Botol YA 42 90 132
140 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) Ampul YA 8 90 98
141 Fitomenadion (vitamin K 1) tab sal 10 mg Tablet YA 1700 0 1700
142 Flukonazole 150 mg kapsul (ktk 10 tab) Tablet YA 10 0 10
143 Fludexin Tablet 0 0 0
144 Flucort N Cream Tube 0 0 0
145 Flusinolon asetonid krim 0,025% (Synarcus krim) Tube YA 20 50 70
146 Flusinolon asetonid krim 0,025% ( Dermasolon krim Tube 0 0 0
147 Furosemide inj 10mg / ml Ampul YA 25 0 25
148 Furosemide inj 10mg / ml/ LASIX INJ/ DIUVAR inj Ampul 0 0 0
149 Furosemide 40mg Tab Tablet YA 600 0 600
150 Gameksan Emulsi 1 % (scabicide) Botol TIDAK 0 0 0
151 Garam Oralit untuk 200ml Air sase YA 501 0 501
152 Gentamisin sulfat salap kulit 0,1% Tube YA 0 0 0
153 Gentamicin Salep mata 0,3 % (Genoint Salep Mata) Botol YA 72 0 72
154 Gentamicin Tetes Mata 0,3 % 90 0 90
155 Gentamisin Injeksi 80 mg/2ml Ampul YA 0 0 0
156 Gentian Violet Larutan 1 % Botol TIDAK 0 0 0
157 Glibenclamide 5mg Tab Tablet YA 100 3000 3100
158 Glimepirid 1 mg tablet (ktk 50 tab) Tablet YA 200 2000 2200
159 Glimepirid 2 mg tablet (ktk 50 tab) Tablet YA 300 2000 2300
160 Gliseril Gualacolas 100mg Tab Tablet TIDAK 0 0 0
161 Gliserin tetes 100 mg/ml (Lar 50 %) Botol YA 0 0 0
162 Glukosa Larutan infus 10 % 500ml Botol YA 20 0 20
165 Griseofulfin 125mg Tab Tablet YA 400 1000 1400
166 Haloperidol injeksi 5 mg/ ml (ktk 12 ampul) Ampul 0 0 0
167 Halopuridol 0,5mg Tab Tablet YA 1500 0 1500
168 Halopuridol 1,5mg Tab Tablet YA 1670 0 1670
169 Halopuridol 2 mg Tab (Lodomer 2) Tablet YA 0 0 0
170 Halopuridol 5 mg Tab Tablet YA 572 0 572
171 Heparin Sodium (Thromboflash gel) Tablet 0 0 0
172 Hidrocortiazide 25mg Tab Tablet YA 100 0 100
173 Hidrocortisone 1 % cream Marin Liza Tube 0 0 0
174 Hidrocortisone 1 % cream Kalbe Farma 48 54 102
175 Hidrocortisone 2,5% cream Tube YA 66 144 210
176 Hidrogen Peroksida Cair 3% Botol 10 0 10
177 Hyocine N Butil Bromida 10 mg Tablet 0 0 0
178 Hyoscine buthilbromide injeksi 20 mg/ml (isi 5 ampu Ampul YA 0 0 0
179 Ibuprofen 200mg Tab Tablet YA 100 900 1000
180 Ibuprofen 400mg Tab Tablet YA 0 0 0
181 Ibuprofen sirup 100 mg/ml Botol 195 100 295
182 Ibuprofen sirup 200 mg/ml FORTE Botol YA 36 0 36
183 Ipratropium bromida ih 20mcg/puff (Atrovent AFH ) Botol 0 0 0
184 Ipratropium bromida nebulizer 0,025%(Atrovent Solut Botol 0 0 0
185 Isoniazid ( INH ) 100 Tablet 600 0 600
188 Isosorbide Dinitrat 5mg Tab Tablet YA 0 300 300
189 Isosorbide Dinitrat 10 mg Tab Tablet 0 0 0
190 Kandesartan 8 mg Tablet 0 0 0
191 Kalium Permanganat serbuk Botol 0 0 0
192 Kalsium Glukonat Injeksi i.v 10 % (100 mg/ ml) Ampul 20 0 20
193 Kalsium Laktat ( Kalk ) 500mg Tab Tablet YA 0 2500 2500
194 Kandistatin drop 100.000 ui Botol TIDAK 0 0 0
195 Kaptopril tab 12,5 mg Tablet YA 3000 10000 13000
196 Kaptopril tab 25 mg Tablet YA 1300 3000 4300
197 Karbamazepine 200mg Tab Tablet YA 820 0 820
198 Karbogliserin Tetes Telinga 10 % botol 0 0 0
199 Karbon Aktif serbuk kantong 40 0 40
200 Ketoprofen 100 mg Tablet YA 0 0 0
201 Ketoprofen Suppositoria (Fetik Supp) 100 mg supp 0 0 0
202 Ketokonazol 2% krim Tube YA 100 0 100
203 Ketokonazol 200 mg (ktk 50 tab) Tablet TIDAK 0 0 0
204 Ketokonazol scalp sol 2% (zoloral ss/ Interzol SS) Tube 0 0 0
205 Ketamin inj. 10 mg/ mL Vial 0 0 0
206 Ketamin inj. 50 mg/ mL Vial 0 0 0
207 Klofazimin micronize 100 mg kaps. Kapsul 0 0 0
208 Kloramfenikol 250mg kapsul Kapsul YA 0 0 0
209 Kloramfenikol 500mg kapsul-CHLORAMEX Kapsul 0 0 0
210 Kloramfenikol Salap Kulit (Bufacetin) Tube YA 0 0 0
211 Kloramfenikol Salap Mata1 % Tube 110 0 110
212 Kloramfenikol Suspensi 125 mg / 5mg botol YA 0 0 0
213 kloramphenikol Tetes Mata 0,5% (Decacetin Tetes Botol YA 0 0 0
214 Kloramfenikol tetes Telinga 3 % Botol YA 120 0 120
215 Klorfeniramine Maleat ( CTM ) 4mg Tablet YA 400 2000 2400
216 klorformazine HCL inj 5mg / ml - 1ml (30 amp) Ampul YA 0 0 0
217 klorformazine HCL inj 25mg / ml - 1ml (30 amp) Ampul YA 0 0 0
218 klorformazine HCL 100mg Tab Tablet YA 768 0 768
219 klorformazine HCL 25mg Tab Tablet YA 0 0 0
220 Klorheksidin spray PERIO KLIN Botol 0 0 0
221 Klorpropamid 100mg Tab Tablet 0 0 0
222 Klorokuin fosfat 250mg Tab Tablet TIDAK 0 0 0
223 Kodein 10 mg Tab Tablet YA 0 0 0
224 Kodein 20 mg Tab Tablet YA 0 0 0
225 Kombinasi: Ferro Fumarat 60 mg + As. Folat 0,4 m Tablet 0 0 0
226 Kombinasi: parafin + gliserin + fenolftalein Susp. ( Botol 37 15 52
227 Komb. DMP + CTM + Efedrin HCl (PONCOLIN D) si Botol 0 0 0
228 Komb. Kalamin + Zn Oksid + Difenhidramin (CALA Botol 0 0 0
229 Komb. Primetamin 25mg + Sulfadoksin Tablet YA 0 0 0
230 Kotrimoksazole 240 mg/ 5 ml Suspensi Botol YA 176 100 276
231 Kotrimoksazole Pediatrik Tab Tablet TIDAK 0 0 0
232 Kotrimoksazole 480mg Tab dewasa Tablet YA 900 3800 4700
233 Kotrimoksazole 840 mg Tab Forte dewasa Tablet 3600 800 4400
234 Kuinin dihidroklorida 25% - 2ml (ktk 100 ampul) Ampul YA 0 0 0
235 Kuinin Sulfat 222mg (222 MG sebagai garam) Tab (kt Tablet YA 0 0 0
236 Kuinin (Kina) tablet 200 mg ( stip 12 tablet) Tablet 0 0 0
237 Lactulose Sir 3,335 g/ml Botol 0 0 0
238 Lansoprazol 30 mg (ktk 2 x 10) Tablet YA 350 2500 2850
239 Levofloxacin 500 mg Tablet 300 0 300
240 Larutan mengandung Karbohidrat + Elektrolit (WID Botol YA 0 0 0
241 Lidocain Kompositum injeksi (Anestetik lokal gigi kom Ampul 50 0 50
242 Lidocain Kompositum injeksi (Pehacain inj) Ampul 0 0 0
243 Lidocain Jeli 2 % (XYLOCAIN GEL) Tube YA 0 0 0
244 Lidocain Spray (Xylocain Spray) Botol 0 0 0
245 Lidocain injeksi 2% Ampul YA 100 100 200
246 Loperamid 2 mg Tablet 400 0 400
247 Loratadine tablet 10 mg (ktk 50) Hexapharm Tablet YA 0 1500 1500
248 Loratadine tablet 10 mg (ktk 50) Promedrahardjo Fa Tablet 0 0 0
249 Lorazepam 2 mg Tablet 0 0 0
250 Magnesium sulfat serbuk 30gram Bungkus YA 0 0 0
251 Mebendazole 100mg / 5ml Sirup Botol YA 0 0 0
252 Mebendazole 100mg Tab Tablet YA 0 0 0
253 Mecobalamin 500 Ug Tablet 0 0 0
254 Meloxicam 7,5 mg Tablet TIDAK 0 500 500
255 Metformin HCl 500 mg Tablet YA 300 1400 1700
256 Metformin HCl 850 mg Tablet 100 0 100
257 Metilergometrine maleat 0,125mg Tablet YA 0 0 0
258 Metilergometrine maleat inj 0.200mg - 1ml Ampul YA 0 0 0
259 Metilprednisolon 4 mg Tab Tablet YA 600 0 600
260 Metilprednisolon 8 mg Tab Tablet 0 0 0
261 Methisoprinol Sirup Botol TIDAK 0 0 0
262 Methisoprinol Tablet Tablet TIDAK 0 0 0
263 Metoklopramide HCl 5 mg/ml Inj (PRIMPERAN Inj) Ampul YA 0 0 0
264 Metoklopramide 5 mg tablet (primperan tab) Tablet YA 400 0 400
265 Metoklopramide 10 mg Tab Tablet YA 700 0 700
266 Metoklopramida sirup 5mg/ ml botol YA 0 0 0
267 Metoklopramida sirup 5mg/ ml/ PIRALEN SIRUP/ botol 13 0 13
268 Metoklopramid drop 2 mg/ml (Mepramid) botol 0 0 0
269 Metoklopramid drop 2 mg/ml (GEVISTAL) botol 17 30 47
270 Metronidazol infus 5 mg/ ml botol YA 0 0 0
271 Metronidazole 500mg Tab Tablet YA 0 0 0
272 Metronidazole 250mg Tab Tablet YA 0 0 0
273 Metronidazol sirup 125 mg/5 Ml (Farizol suspensi) Botol TIDAK 75 0 75
274 Mg. sulfat Injeksi ( IV ) 20% - 25ml Vial YA 120 120 240
275 Mg. sulfat Injeksi ( IV ) 40% - 25ml Vial YA 125 120 245
276 Mikonazole 2% Cream Tube YA 32 72 104
277 Mikonazol serb 2% (Mycorine Powder) Tube 0 0 0
278 Mineral Mix. Kombinasi (Multivitamin) sacchet 0 0 0
279 Multivitamin Tablet (PEHAVRAL tab) Tablet 2600 1500 4100
280 Multivitamin Sirup (BECEFORT Sirup) Botol 56 0 56
281 Multivitamin Sirup (TRUVIT Sirup) Botol 28 0 28
282 Multivitamin dan mineral Tablet lansia (GERIAVITA Botol/ 30 tab TIDAK 7 0 7
283 Natrium Bicarbonat 500mg Tab Tablet YA 200 0 200
284 Natrium Diklofenat 25mg Tab Tablet YA 750 2000 2750
285 Natrium Diklofenat 50mg Tab Tablet YA 0 0 0
286 Natrium Klorida Larutan Infus 3 % Botol 0 0 0
287 Natrium Klorida Larutan Infus 0,9% Botol YA 264 64 328
288 Natrium Tiosulfat Injeksi 25% - 10ml Botol 0 0 0
289 N-asetil sistein kaps 200 mg ktk 60 tab Tablet 0 0 0
290 Nifedipine 10mg Tab Tablet YA 0 0 0
291 Nistatin 100.000 Iu /g Tablet Vaginal ovula YA 300 700 1000
292 Nistatin 500.000 IU/G Tablet Salut Tablet YA 0 0 0
293 Nitrofurantoin 100 mg tab. tablet 0 0 0
294 Obat Batuk Hitam ( OBH ) 100ml Syr Botol TIDAK 134 60 194
295 Ofloxacin 200 mg Tablet 0 0 0
296 Oksigen gas dalam Tabung Tabung 0 0 0
297 Oksimetazolin tetes hidung 0,025 mg (Iliadin 0,025) Botol YA 0 0 0
298 Oksimetazolin tetes hidung 0,050mg (Iliadin 0,05) Botol 0 0 0
299 Oksitetrasiklin HCL inj. I.M.50mg/ml-10ml Vial YA 0 0 0
300 Oksitetrasiklin HCL 3% Salap Kulit Tube 0 0 0
301 Oksitetrasiklin HCL Salap Mata (Terracortil SM) Tube TIDAK 50 250 300
302 Oksitosin inj 10iu / ml -ml Ampul YA 18 0 18
303 Olanzapin Tablet 30 180 210
304 Olopatadin tts mata 0,1% (Patanol ) Botol 0 0 0
305 Omeprazole Injeksi 40 mg/ ml Vial 0 0 0
306 Omeprazol kapsul 20 mg (ktk 3 x 10) kapsul YA 0 0 0
307 Ondansetron Injeksi 4mg/ 2 ml Ampul 0 0 0
308 Ondansetron tab 4 mg (3 x 10 tab) Tablet YA 540 0 540
309 Ondansetron tab 8 mg (2 x 6 tab) Tablet TIDAK 288 0 288
310 Parasetamol Drop 100 mg/ml @ 15 ml (60mg/0,6m Tube YA 5 0 5
311 Parasetamol sirup 120mg / 5ml Tablet YA 249 200 449
312 Parasetamol 100mg Tab Tablet YA 0 0 0
313 Parasetamol 500mg Tab Ampul TIDAK 5800 1000 6800
314 Parasetamol Infus Botol 1 1
315 Perak Sulfadiazin Krim 1 % Tube 12 10 22
316 Permetrin 1 % Lotion (PEDITOX Lotion) Botol 4 0 4
317 Permetrin krim 5 % (Scabimite Cream 10) Tube YA 36 30 66
318 Pethidine HCL inj.50mg / ml - 2ml Ampul TIDAK 0 0 0
319 Pilokarpin Tetes Mata 2 % (HCl/ Nitrat) Botol 0 0 0
320 Pilokarpin Tetes Mata 4 % (HCl/ Nitrat) Botol 0 0 0
321 Pirantel Pamoat 125 mg/ mL Sirup botol YA 0 0 0
322 Pirantel Pamoat 125mg Tab (25 x 4) Tablet YA 1600 0 1600
323 Pirazinamid tab 500 mg Tablet 0 0 0
324 Piridoksine HCL 10mg Tab Tablet YA 5100 2000 7100
325 Piridoksine HCL 10mg Tab Tablet 0 0 0
326 Piridoksine HCL 10mg Tab BDB Tablet 0 0 0
327 Piridoksine HCL 25 mg Tab Tablet 0 0 0
328 Piroxicam 10mg Tab Tablet TIDAK 200 0 200
329 Piroxicam 20mg Tab Tablet TIDAK 0 0 0
330 Povidon Iodida 10 % Larutan 30 mL (Neodin 30 ml) Botol YA 0 0 0
331 Povidon Iodida 10 % Larutan 60 mL Botol YA 0 0 0
334 Polikresulen ( Albothyl ) Botol YA 0 0 0
335 Prednisone 5mg Tab Tablet YA 100 1000 1100
336 Primakuin 15mg Tab Tablet YA 0 0 0
337 Probenesid tab 500 mg (Probenid) Tablet 0 0 0
338 Prokain Benzilpenisillin G 3 jt IU Vial YA 0 0 0
339 Propanolol tablet 10 mg (HCl) Tablet YA 400 500 900
340 Propanolol tablet 40 mg (HCl) Tablet YA 500 500 1000
341 Propiltiorasil 100mg Tab Tablet YA 100 0 100
342 Ranitidine 150mg Tab Tablet YA 0 1000 1000
343 Ranitidine 25 mg/ mL inj (dtng 2500 amp) ktk 10 a Ampul YA 0 0 0
344 Retinol ( Vit.A ) Kapsul 100.000 iu Biru Botol YA 0 0 0
345 Retinol ( Vit.A ) Kapsul 200.000 iu Tablet YA 9 0 9
346 Rifampicin 300mg Tab Tablet 500 0 500
349 Ringer Laktat larutan Infus Steril Botol YA 200 10 210
350 Risperidon 1 mg tablet (ktk 50 tab) Tablet YA 0 0 0
351 Risperidon 2 mg tablet (ktk 50 tab) Tablet YA 610 0 610
352 Risperidon 3 mg tablet (ktk 50 tab) Tablet 0 0 0
353 Salbutamol 2,5 mg cairan ih 0,1 % (dus, 4x5 - botol Ampul TIDAK 10 20 30
354 Salbutamol 2 mg Tab Tablet YA 1100 2000 3100
355 Salbutamol 4 mg Tab Tablet YA 400 0 400
356 Salbutamol 2 mg/ 5 ml Sirup Botol YA 105 0 105
357 Salap 2 - 4 Kombinasi Pot YA 264 48 312
358 Salisil Bedak 2% Kotak 53 0 53
359 Sianokobalamin ( Vit.B12 ) inj 500mcg / ml (Neurobio Ampul YA 1 100 101
360 Sianokobalamin ( Vit.B12 ) 50 mcg Tablet YA 0 600 600
361 Simetidine 200mg Tab Tablet 0 0 0
362 Simvastatin score 10 mg Tab. (ktk 30 tablet) Tablet YA 0 0 0
363 Simvastatin score 20 mg Tab. (ktk 100 tablet) Tablet YA 1100 0 1100
364 Spironolakton tablet 25 mg Tablet YA 0 0 0
365 Sukralfat Suspensi 500 mg/ 5 ml Botol YA 0 0 0
366 Sukralfat tab 500 mg (ULSIDEX 500) Tablet YA 0 0 0
367 Silver Sulfadiazin cream Cream 0 0 0
368 Sulfadimidine 500mg Tab Tablet 0 0 0
369 Stesolid Rectal 5 mg/ml tube 0 0 0
370 Streptomicin serbuk inj. 1000 mg/ mL vial YA 0 0 0
371 Sulfasetamide Na TM 15% Botol 0 0 0
372 Tablet Tambah darah (Kimia Farma) Tablet TIDAK 2400 0 2400
373 Tablet Tambah darah (Sangobion) Tablet 0 0 0
374 Tensigard Capsul Capsul 0 0 0
375 Teofilin Tablet 150 mg BRONSOLVAN tab Tablet 1400 0 1400
376 Teofilin Tablet 300mg tab Tablet 0 0 0
377 Tetrakain 250 mg tab. Tablet 0 0 0
378 Tetrakain 500 mg tab. Tablet 0 0 0
379 Tetrakain Tetes Mata 0,5 % (Pantocain) Botol YA 0 0 0
380 Tetrasiklin HCL 250mg Capsul Capsul YA 200 0 200
381 Tetrasiklin HCL 500mg Capsul Capsul YA 300 0 300
382 Tiamine HCL ( Vit. B1 ) inj 100/ ml - 1ml Ampul 0 0 0
383 Tiamine HCL ( Vit. B1 ) 50mg Tablet Tablet YA 100 200 300
384 Trepental Na. serbuk inj 1000mg / Amp Ampul 0 0 0
385 Tramadol 50mg Tab Tablet YA 0 0 0
386 Tramadol injeksi 50 mg/ml Ampul YA 0 0 0
387 Transamin 500 mg Tablet 0 0 0
388 Transamin inj ampul TIDAK 0 0 0
389 Triheksifenidile 2mg Tab Tablet YA 735 0 735
390 Triheksifenidile 2mg Tab mersifarma Tablet 0 0 0
391 Trimetropin Scored 200 mg Tablet 0 0 0
392 Trikresol Formalin ( TKF ) Cairan Botol 0 0 0
393 Urea Krim 10 % (Soft U Derm) tube YA 36 30 66
394 Valsartan 80 mg Tablet (ktk 30 tab) Tablet YA 0 0 0
395 Verapamide 30mg Tab Tablet 0 0 0
396 Verapamil 80 mg tablet Tablet YA 0 0 0
397 Vitamin B. Complex ab Tablet YA 0 0 0
398 Vitamin B. Complex BDB Tablet 0 0 0
399 Zinc Dispersal 20 mg Tablet Tablet YA 800 200 1000
400 Zinc Dispersal 20 mg Tablet Tablet YA 0 0 0
401 Zinc drop 10 mg/ ml (Zinc Pro/ INTERZINC SIRUP)- Botol YA 18 30 48
402 Zinc sirup 20 mg/ 5 ml (Zircum Kid, Meprofarm) botol YA 66 0 66
403 Pedi Tox Botol 0 0 0
GIGI DAN MULUT 0 0 0
404 Air Raksa Dental Use Botol 0 0 0
405 Camphenol Botol 0 0 0
406 COLTENE Brilliant NG Enamel A3/D3 (Tambalan P pcs YA 0 0 0
407 COLTENE Brilliant Flow A2/ B2 (Tambalan Sewarna pcs YA 0 0 0
408 COLTENE Coltosol F Temporary Filling Material ( pcs YA 0 0 0
409 COLTENE Ethcans Gel S pcs YA 0 0 0
410 COLTENE One Coat Bond SL pcs YA 0 0 0
411 COLTENE Brilliant Everglow A3,5/B3 pcs YA 0 0 0
412 Devitalisasi pasta ( Non arsen ) DENTAL FLOSS Botol YA 1 0 1
413 Etil Kloride Semprot Botol TIDAK 0 5 5
414 Eugenol Cairan Botol TIDAK 0 0 0
415 Glass Ionomer cement ( gc ix ) Set YA 0 0 0
416 Glass Ionomer Cement ART GC Fuji IX Glass Ionom Set 0 0 0
417 Kalsium Hidroksida pasta Tube 0 0 0
418 Monoklorkamfer mentol cairan (CHKM) Botol 0 0 0
419 Mummifying Pasta Botol 0 0 0
420 Semen Seng fosfat serbuk dan cairan Set 0 0 0
421 Temporary Stoping fletser dan cairan Set 0 0 0
422 Semen Seng fosfat serbuk dan cairan (Elite Cement Set 0 0 0
423 Temporary filling Hydraulic Restorative (Caviton 30 Set 0 0 0
424 G-Bond (Bonding One Component Self-Etching Ligh Set 0 0 0
425 Solare 3 gr syringe (Light-Cured Composit Restorativ Set 0 0 0
426 ROEKO Endo - Frost botol 0 0 0
427 Solare X (Light-Cured Composit Restorative) Set 0 0 0
0 0 0
PERBEKALAN KESEHATAN 0 0 0
428 Aceptan 500 cc + dispenser botol 0 0 0
429 Alat suntik sekali pakai 0,5 ml 23 G 1 Set 0 0 0
430 Alat suntik sekali pakai 0,05 ml 26 G 3/8 Set 0 0 0
431 Alat suntik sekali pakai 1 ml COSMOMED Set 400 0 400
434 Alkohol Swab 2 fly Aximed ktk 200 0 200
435 Apron lembar 0 0 0
436 Basic Dressing Set (BMHP K3 Kit) set 0 0 0
437 Blood Transfusion (Transfusi Darah set) pcs 0 0 0
438 Cover glass 18 x 18 cm box/10 pak 0 0 0
439 Cutgut Chromic SMI 2/0 HR 26 MM (ktk/ 12 set) pcs 12 0 12
440 Cutgut Chromic SMI 2/0 DS 24 MM (ktk/ 12 set) Set 0 0 0
441 Cutgut Chromic SMI 3/0 HR 26 MM (ktk 12 set) pcs 21 0 21
442 Cutgut Plain SMI 2/0 DS 24 MM (ktk 12 set) pcs 16 0 16
443 Cutgut Plain SMI 3/0 DS 24 MM (ktk 12 set) pcs 31 0 31
444 Elastis Bandage Rol 0 0 0
445 Folley Catheter 2 way Fr. 14 pcs 2 5 7
449 Fresh Air Mask Ear Loop - Surgical mask Tie On (is ktk/50 950 1500 2450
450 Gelang Pasien - ID Bracelet Insert Card, Dewasa-Bi box/100 0 0 0
451 Gelang Pasien - ID Bracelet Insert Card, Dewasa-Pi box/100 0 0 0
452 Gelang Pasien - ID Bracelet Insert Card, Anak-Pink box/100 0 0 0
453 Hand Rub 500 mL (Policlean) Botol 14 0 14
454 Infuset Anak (PKD-2) Set 401 0 401
455 Infuset Dewasa (PKD-1) bks/25 set/ Intravascular ad Set 325 0 325
456 Kain penyangga tangan (Sling Arm uk S) Onemed pcs 2 0 2
457 Kain penyangga tangan (Sling Arm uk M) Onemed pcs 2 0 2
458 Kain penyangga tangan (Sling Arm uk L) Onemed pcs 0 0 0
459 Kapas Pembalut 25 g (Hospak) 12 10 22
460 Kapas Pembalut 100 g (Hospak) 22 10 32
461 Kapas Pembalut /Absorben 250mg Surya Husada Bungkus 0 15 15
462 Kapas Berlemak 500 gram Bungkus 0 0 0
463 Kasa Hidrofil Steril 16 x 16 cm (16 lbr) Surya Husad ktk/ 16 lbr 158 0 158
464 Kasa Hidrofil Steril 18 x 22 cm Onemed bks/ 12 lbr 0 0 0
465 Kasa Hidrofil 36 x 80 cm Rol 0 0 0
466 Kasa Kompres 40 cm x 40 cm Steril Surya husada Bungkus 85 0 85
467 Kapas Pembalut Hydrofile 40 yard x 80 cm Medice Rol 2 4 6
468 Kapas Pembalut 2m x 80cm Surya Husada Bungkus 216 0 216
469 Kasa pembalut hidrofil 3 yard x 5 cm Rol 22 40 62
470 Kasa pembalut hidrofil 4 m x 3 cm (3 inc) Onemed Bungkus 0 0 0
471 Kasa Pembalut Hidrofil 4 m x 5 cm ( bks isi 100 p pcs 0 0 0
472 Kasa Pembalut Hidrofil 4 m x 10 cm (bks isi 50 pcs pcs 0 0 0
473 Kasa Pembalut hidrofil 4 m x 15 cm (4 inc)Surya H Bungkus 0 0 0
474 Kapsul Kosong Ukuran 00 pcs 0 0 0
475 Kapsul Kosong Ukuran 0 bks 0 0 0
478 Kertas Perkamen (Obat) lembar 5 0 5
479 Jarum Jahit ( Bedah ) No. 9 s/d 14 Sak 0 0 0
480 Lisol 50 % (protector) Onemed Botol 0 0 0
481 Medicine Pocket pack 0 0 0
482 Mucus Extractor 25 ml (Serenity) Set 1 0 1
483 Nasal Oxygen O2 cannula size xs Aximed pcs 42 0 42
484 Nasal Oxygen O2 cannula size s Aximed pcs 1 0 1
485 Nasal Oxygen O2 cannula size M Aximed pcs 0 0 0
486 Nasal Oxygen O2 cannula size L Aximed pcs 0 0 0
487 NGT-Feeding tube Aximed No. 6 pcs 0 0 0
490 NGT- Stomach Tube 85 cm, no 14 Aximed pcs 0 0 0
491 NGT- Stomach Tube 85 cm, no 18 Aximed pcs 0 0 0
492 Paper Tape 1.25 cm x 9.14 m Aximed Rol 223 24 247
493 Paper Tape 2.5 cm x 9.14 m Aximed Rol 288 24 312
494 Pembalut Gips 3" Rol 0 0 0
497 Penutup Kepala (Nurse Cap) box/100 69 0 69
498 Plastik Obat uk 6 x 10 bungkus 0 0 0
499 Plastik Obat uk 7 x 10 (kecil) bks/100 6 0 6
500 Plastik Obat uk 8,3 x 13 (sedang) bks/100 0 0 0
501 Pharmaplast SA Egypt Pharmafix (Plesterku) Rol 24 0 24
502 Plester 5 Yard x 2inci Rol 0 0 0
503 Poligyp 5 cm x 2.7 m Rol 0 0 0
504 Poligyp 10 cm x 2.7 m Rol 0 0 0
505 Poliban 5 cm x 2.7 m Rol 10 0 10
506 Poliban 10 cm x 2.7 m Rol 20 0 20
507 Pro Crepe Pembalut Elastis Uk. 7,5 cm x 4,55 m (te Rol 0 0 0
508 Pro Crepe Pembalut Elastis Uk. 10 cm x 4,55 m (ter Rol 0 0 0
509 Pro Crepe Pembalut Elastis Uk. 15 cm x 4,55 m (ter Rol 0 0 0
510 Scalpvein 23G X Onionex pcs 0 0 0
511 Scalpvein 27G X Onionex pcs 0 0 0
512 Silk Black 2/0 DS 24 MM (ktk @ 12 set) Set 30 0 30
513 Silk Black 3/0 DS 24 MM (ktk @ 12 set) Set 24 0 24
514 Spons gelatin cubicles 1x 1cm Tabung 0 0 0
515 Stera 1 cc Tuberculin 27 G x 1/2" Set 0 0 0
518 Steril prosedure Glove No. S (6) Set 0 0 0
519 Steril prosedure Glove No. S (6,5) Pasang 0 0 0
520 Steril prosedure Glove No. S ( 7 ) (ktk isi 50 pasang Pasang 0 50 50
521 Steril prosedure Glove No. S ( 7,5 ) Pasang 0 0 0
522 Steril prosedure Glove No. S ( 8 ) ktk/ 50 0 0 0
523 Surgical Glove Non Steril No. XS, S, M, L (Cosmom ktk 700 800 1500
524 Umbilical Cord Nylon box/50 23 0 23
525 Under PAD Onemed pcs 0 0 0
526 Under PAD 60 x 90 cosmomed pcs 0 0 0
527 Urine Bag Steril Standar 2 L (Cosmomed) pcs 0 0 0
528 USG Gel 250 ml Onemed Botol 0 0 0
529 Venican IV Cath G.18 Aximed Set 80 0 80
530 Venican IV Cath G. 20 Set 43 0 43
533 Tabung Darah, Collection Tube EDTA 3 ml (Ungu) bks/100 100 0 100
534 Tabung Darah, Collection Tube PLAIN 4 ml (Merah) bks/100 0 0 0
0 0 0
VAKSIN 0 0 0
535 Serum Anti Bisa Ular (ABU) I vial 3 0 3
536 Serum Anti Difteri (ADS) Inj. 20000 IU vial 0 0 0
537 Serum Antirabies inj. 100 IU/ mL (Verorab) set 5 18 23
538 Serum Anti Tetanus (ATS) 1500, 10000, 20000 IU Ampul 0 0 0
539 Serum Anti Tetanus TETAGAM Ampul 0 0 0
540 Vaksin campak vial 0 0 0
541 Vaksin Hepatitis B Rek inj. 20 mcg/ mL vial 0 0 0
542 Vaksin Jerap Difteri Tetanus (td) vaksin bumil vial 0 0 0
543 Vaksin Jerap Difteri Tetanus Pertusis (DTP) vial 0 0 0
544 Vaksin Polio Trivalen(IPV) vial 0 0 0
545 Vaksin polio 0 0 0
REAGENSIA UJI 0 0 0
545 Abate botol 0 0 0
546 Alkapharm. Alkazyme Sachet 25 gram sase 35 0 35
547 Alkapharm. Alkacide 1 L High Level Desinfectan Liter 0 0 0
548 Aqua bidestillata botol 0 0 0
549 Cynopff (Insektisida) Liter 0 0 0
550 Gluco Protein pcs 10 0 10
551 Pemeriksaan Arsenic kit 0 0 0
552 Pemeriksaan Bakteri E Coli kit 0 0 0
553 Pemeriksaan Boraks kit 0 0 0
554 Pemeriksaan Merkuri kit 0 0 0
555 Pemeriksaan Methanyl Yellow kit 0 0 0
556 Pemeriksaan Rhodamin B kit 0 0 0
557 Reagen Amonium Oksalat 0 0 0
558 Reagen Asam Sulfosalisilat 20 % botol 0 0 0
559 Reagen Barium Klorida botol 0 0 0
560 Reagen Benedict botol 0 0 0
561 Reagen EDTA botol 0 0 0
562 Reagen Eosin 2 % 0 0 0
563 Reagen Fouchet botol 0 0 0
564 Reagen Fuchsin Stain/ Gram 2 0 0 0
565 Reagen Giemsa botol 0 1 1
566 Reagen HCl 0,1 N 0 0 0
567 Reagen Hayem botol 0 0 0
568 Reagen Emertion Oil botol 0 1 1
569 Reagen Etanol Asam 250 mL botol 0 0 0
570 Reagen Na. Sitrat 3,13 % botol 0 1 1
571 Reagen Methanol 250 mL botol 0 0 0
572 Reagen Rees Ecker botol 0 2 2
573 Reagen Turk botol 0 0 0
574 Reagen asam Urat UA-30 botol 0 0 0
575 Reagen SGOT ASAT botol 0 0 0
576 Reagen SGPT ALAT-30 botol 0 0 0
577 Reagen Cholesterol botol 0 0 0
578 Reagen HDL Cholesterol botol 0 0 0
579 Reagen Creatinin botol 0 0 0
580 Reagen Glukosa GLUKOSA-30 botol 0 0 0
581 Reagen Triglyserida TG-30 botol 0 0 0
582 Reagen Ureum UREA-30 botol 0 0 0
583 Sodium Thiosulfat (Grain) 98 % pack 0 0 0
584 Urinalisis Verify/ URIT Reagen 11 G botol 0 0 0
585 Stik Glukosa ACCU CHECK ktk 0 0 0
586 Stik Kolesterol Auto Check ktk 0 0 0
587 Stik Glucosa Auto Check ktk 0 0 0
588 Stik Asam Urat Auto Check ktk 0 0 0
589 Stik Asam Urat BENECHECK ktk 0 0 0
590 Stik Kolesterol Total BENECHECK ktk 0 0 0
591 Stik Asam Urat Easy Touch ktk 0 0 0
592 Stik Glucosa Easy Touch ktk 0 0 0
593 Stik Kolesterol Easy Touch ktk 2 0 2
594 Stik Hemoglobin Easy Touch ktk 0 0 0
595 Stik Glukosa GLUCO DR Auto 25 ktk 0 0 0
596 Tabung Hematokrit tube 0 0 0
597 Tes golongan Darah (A, B, AB, O) set 0 0 0
598 Tes Kehamilan Ultra One Test pcs 0 0 0
599 Kartu Golongan Darah pak/100 lbr 0 0 0
600 Yellow Tip bks/1000 0 0 0
601 Blue Tip bks/1000 0 0 0
602 Blood Lancet (Serenity) ktk 300 0 300
601 Vaksin BCG Vial Ya 0 0 0
602 Vaksin DT Vial Ya 0 0 0
603 Primperan Tablet Tablet Tidak 0 0 0
604 Paket Oat Kategori I Paket Ya 4 0 4
605 Paket OAT kategori Anak Paket Ya 0 0 0
606 Daryantul Pcs Tidak 0 0 0
607 Multivitamin (Folamil) tablet Tidak 0 0 0
607 Hevit C tablet Tidak 1200 1000 2200
607 Bio ATP tablet Tidak 200 0 200
607 Meloxicam 15 mg tablet Tidak 0 0 0
607 Penutup Kepala+face shield tablet Tidak 10 0 10
613 Griseofulfin 500mg Tab tab Tidak 300 0 300
614 Multivitamin anak sirup(ETACURVITA) tab Tidak 124 0 124
615 Azytromiycin injeksi vial Tidak 0 6 6
616 OPTIME PETERS OPTIME TYPE 3/0 USP2 MET 1 vial Tidak 0 0 0
MENGETAHUI
Ka UPTD PUSKESMAS PEL DAGANG
dr. CERLI SCORPIO

NIP.19861110201505 2001
PO)
Pemberian
Pemakaian Sisa Stok Stok opt
Askes APBD Lain
0 0 0 - Rp -
0 0 600 422.00 Rp -
0 0 0 4,200.00 Rp -
200 100 1090 105.00 Rp 10,500
0 100 300 680.46 Rp 68,046
184 0 74 316.00 Rp -
0 0 0 790.00 Rp -
164 30 66 5,199.70 Rp 155,991
1,000 1300 400 220.00 Rp 286,000
0 1000 0 142.00 Rp 142,000
0 500 77 96.00 Rp 48,000
0 0 675 2,976.00 Rp -
0 1310 3396 168.00 Rp 220,080
1,550 2100 675 75.00 Rp 157,500
700 1300 310 95.00 Rp 123,500
3 27 73 13,500.00 Rp 364,500
9 100 224 4,268.00 Rp 426,800
8 42 6463 12,958.00 Rp 544,236
0 0 2402 203.00 Rp -
1,300 4600 630 245.00 Rp 1,127,000
0 20 0 8,649.00 Rp 172,980
0 0 330 337.00 Rp -
0 0 153 4,268.00 Rp -
0 0 5720 200.20 Rp -
0 0 3106 3,675.00 Rp -
800 1200 395 60.00 Rp 72,000
0 0 2 2,189.00 Rp -
0 0 45 2,189.00 Rp -
25 100 40 10,092.38 Rp 1,009,238
134 0 219 3,325.00 Rp -
0 255 334 5,038.00 Rp 1,284,690
0 1200 0 194.00 Rp 232,800
0 500 0 1,033.00 Rp 516,500
20 100 8 2,860.00 Rp 286,000
0 0 0 2,860.00 Rp -
0 0 0 2,860.00 Rp -
0 0 900 - Rp -
100 400 450 105.00 Rp 42,000
0 0 1320 135.00 Rp -
0 0 110 235.00 Rp -
0 0 9330 138.00 Rp -
0 0 0 110.00 Rp -
0 0 1540 58.00 Rp -
0 0 0 79.00 Rp -
0 0 3001 78.00 Rp -
0 300 0 461.73 Rp 138,518
0 0 28 461.73 Rp -
0 0 235 2,122.00 Rp -
0 30 110 2,122.00 Rp 63,660
0 1800 405 1,684.00 Rp 3,031,200
5 145 152 3,999.60 Rp 579,942
0 0 300 236.00 Rp -
100 250 190 399.00 Rp 99,750
300 5800 120 171.00 Rp 991,800
0 0 0 297.00 Rp -
0 0 132 1,650.00 Rp -
0 0 0 342.00 Rp -
0 0 0 38,000.00 Rp -
0 10 335 1,700.00 Rp 17,000
0 0 0 1,029.00 Rp -
0 0 0 2,417.80 Rp -
0 0 82 - Rp -
500 0 200 110.00 Rp -
15 145 27 3,388.00 Rp 491,260
0 0 6,800.00 Rp -
0 0 30 222.00 Rp -
0 4 15 6,000.00 Rp 24,000
10 74 9 5,900.00 Rp 436,600
0 0 0 20,499.60 Rp -
150 700 60 597.00 Rp 417,900
0 60 329 237.00 Rp 14,220
1,200 11700 606 303.00 Rp 3,545,084
43 7 617 13,420.00 Rp 93,940
0 0 48 285.00 Rp -
0 0 740 385.00 Rp -
0 0 6 1,520.20 Rp -
2 52 1 4,339.00 Rp 225,628
0 0 0 - Rp -
0 0 15 6,149.00 Rp -
0 0 110 750.00 Rp -
0 0 1500 2,400.00 Rp -
0 0 60 6,150.00 Rp -
0 0 880 4,900.00 Rp -
0 0 0 4,571.00 Rp -
0 0 0 4,998.00 Rp -
600 200 240 101.00 Rp 20,200
21 91 308 2,973.00 Rp 270,543
200 0 80 739.00 Rp -
0 0 6 1,121.00 Rp -
150 150 2527 729.00 Rp 109,350
0 0 0 570.00 Rp -
400 1150 160 669.90 Rp 770,385
0 0 0 - Rp -
15 90 21 1,152.00 Rp 103,680
600 1200 240 115.34 Rp 138,402
0 0 2 8,800.00 Rp -
0 0 23 58.00 Rp -
0 0 105 6,900.00 Rp -
0 0 0 20,700.00 Rp -
0 0 220 20,700.00 Rp -
0 19 0 1,822.00 Rp 34,618
10 50 834 86.00 Rp 4,300
0 0 61 1,513.00 Rp -
5 0 2 13,202.00 Rp -
18 0 307 19,193.00 Rp -
0 0 359 107.10 Rp -
3 330 1201 1,152.00 Rp 380,160
0 0 1200 1,125.00 Rp -
100 100 946 98.00 Rp 9,800
0 0 84 104.00 Rp -
0 500 0 142.00 Rp 71,000
100 4500 40 117.00 Rp 526,500
100 300 100 264.00 Rp 79,200
300 300 123 86.00 Rp 25,800
2 18 301 24,948.00 Rp 449,064
0 0 30 14,498.00 Rp -
0 0 30 77.00 Rp -
0 0 0 100.10 Rp -
0 38 0 1,408.00 Rp 53,504
100 600 106 615.00 Rp 369,000
0 0 0 785.00 Rp -
0 0 6 28,902.50 Rp -
0 0 0 3,450.00 Rp -
3 25 1 3,450.00 Rp 86,250
0 800 220 314.00 Rp 251,200
0 400 45 455.00 Rp 182,000
0 0 8 4,176.00 Rp -
2 5 58 27,097.37 Rp 135,487
0 0 110 186.00 Rp -
0 0 0 56.00 Rp -
0 0 0 3,924.00 Rp -
150 1620 60 158.00 Rp 255,960
300 0 120 97.00 Rp -
0 30 0 1,950.00 Rp 58,500
0 100 0 180.00 Rp 18,000
0 0 1010 216.00 Rp -
0 0 0 660.00 Rp -
0 0 110 442.00 Rp -
0 132 0 2,764.00 Rp 364,848
6 92 17 7,587.80 Rp 698,078
200 1500 80 747.00 Rp 1,120,500
0 10 30 19,656.00 Rp 196,560
0 0 0 - Rp -
0 0 300 10,100.00 Rp -
0 70 55 2,570.00 Rp 179,900
0 0 300 2,570.00 Rp -
0 25 0 1,333.00 Rp 33,325
0 0 60 1,333.00 Rp -
200 400 80 82.00 Rp 32,800
0 0 33 11,825.00 Rp -
101 400 40 274.00 Rp 109,600
0 0 2 3,220.00 Rp -
0 72 1800 12,200.00 Rp 878,400
0 90 900 10,449.00 Rp 940,410
0 0 33 3,569.00 Rp -
0 0 132 5,100.00 Rp -
1,300 1800 520 119.90 Rp 215,820
600 1600 240 174.00 Rp 278,400
700 1600 314 207.00 Rp 331,200
0 0 0 149.60 Rp -
0 0 0 6,720.00 Rp -
0 20 3 8,003.00 Rp 160,060
0 0 725 5,200.00 Rp -
7 100 1433 7,363.00 Rp 736,300
200 1200 589 232.00 Rp 278,400
0 0 0 6,563.00 Rp -
0 1500 144 55.00 Rp 82,500
120 1550 264 59.00 Rp 91,450
0 0 0 130.00 Rp -
210 362 84 60.00 Rp 21,720
0 0 0 30,200.50 Rp -
0 100 2100 163.00 Rp 16,300
0 0 1800 3,059.00 Rp -
0 102 735 2,867.00 Rp 292,434
5 205 17 2,475.00 Rp 507,375
0 10 677 6,800.20 Rp 68,002
0 0 440 - Rp -
0 0 176 4,725.00 Rp -
700 300 280 231.88 Rp 69,564
0 0 0 273.79 Rp -
15 280 6 2,776.00 Rp 777,280
12 24 33 4,750.00 Rp 114,000
0 0 495 86,600.00 Rp -
0 0 0 108,000.00 Rp -
0 600 2520 94.00 Rp 56,400
0 700 0 204.00 Rp 142,800
0 0 3000 - Rp -
100 200 1540 93.00 Rp 18,600
0 0 560 - Rp -
0 0 8 545.00 Rp -
0 0 0 - Rp -
2 18 16 10,351.00 Rp 186,318
500 2000 209 63.00 Rp 126,000
0 0 60 - Rp -
2,200 10800 0 68.00 Rp 734,400
1,800 2500 750 258.49 Rp 646,236
180 640 72 5,306.00 Rp 3,395,840
0 0 66 5,200.00 Rp -
0 40 0 1,458.33 Rp 58,333
0 0 500 - Rp -
0 0 0 2,380.00 Rp -
25 75 10 2,518.00 Rp 188,850
0 0 33 297.00 Rp -
0 0 0 29,400.00 Rp -
0 0 34 - Rp -
0 0 0 - Rp -
0 0 2265 - Rp -
0 0 110 213.00 Rp -
0 0 550 1,145.00 Rp -
0 0 608 3,384.00 Rp -
0 110 0 2,007.00 Rp 220,770
0 0 765 14,828.00 Rp -
0 0 0 2,625.00 Rp -
20 100 426 8,499.70 Rp 849,970
600 1800 240 25.00 Rp 45,000
0 0 0 1,585.00 Rp -
0 0 42 1,310.00 Rp -
143 625 57 330.00 Rp 206,250
0 0 0 - Rp -
0 0 0 124,355.00 Rp -
0 0 0 - Rp -
0 0 0 1,505.74 Rp -
0 0 0 600.00 Rp -
0 0 1200 1,364.00 Rp -
0 0 0 372.00 Rp -
5 47 2 5,555.00 Rp 261,085
0 0 440 - Rp -
0 0 710 15,400.00 Rp -
0 0 220 690.00 Rp -
0 276 33 2,190.00 Rp 604,440
0 0 330 96.00 Rp -
0 4700 60 133.00 Rp 625,100
200 4200 80 319.00 Rp 1,339,800
0 0 0 - Rp -
0 0 200 732.00 Rp -
0 0 600 732.00 Rp -
0 0 1500 15,060.00 Rp -
950 1900 380 323.00 Rp 613,700 1600
300 0 120 434.00 Rp -
0 0 220 8,763.00 Rp -
20 30 39 1,205.00 Rp 36,150
0 0 0 1,205.00 Rp -
0 0 0 41,600.00 Rp -
0 0 19 177,216.00 Rp -
100 100 44 1,289.00 Rp 128,900
0 400 0 984.50 Rp 393,800
50 1450 1070 125.00 Rp 181,250
0 0 65 125.00 Rp -
0 0 8 908.00 Rp -
0 0 0 - Rp -
0 0 220 - Rp -
0 0 165 - Rp -
0 0 0 325.00 Rp -
100 400 92 975.70 Rp 390,280
700 1000 280 99.00 Rp 99,000
100 0 40 166.00 Rp -
0 0 1940 236.00 Rp -
0 0 167 3,102.00 Rp -
300 300 150 146.00 Rp 43,800
0 0 0 375.00 Rp -
0 0 50 - Rp -
0 0 216 - Rp -
0 0 0 4,158.00 Rp -
0 400 2 121.00 Rp 48,400
100 600 790 80.00 Rp 48,000
0 0 12 80.00 Rp -
0 13 16 2,600.00 Rp 33,800
0 0 0 3,990.00 Rp -
2 45 1834 3,990.00 Rp 179,550
0 0 3000 8,250.00 Rp -
0 0 0 945.78 Rp -
0 0 588 110.00 Rp -
5 70 68 3,950.00 Rp 276,500
0 240 0 3,328.00 Rp 798,720
0 245 300 3,796.00 Rp 930,020
5 99 267 3,585.00 Rp 354,915
0 0 126 26,950.00 Rp -
0 0 0 3,116.00 Rp -
1,300 2800 3710 1,156.10 Rp 3,237,080
5 51 3 20,850.50 Rp 1,063,376
2 26 1 15,372.50 Rp 399,685
1 6 0 70,500.10 Rp 423,001
0 200 0 180.40 Rp 36,080
1,400 1350 560 132.00 Rp 178,200
0 0 6 127.00 Rp -
0 0 110 6,840.00 Rp -
5 323 32 6,840.00 Rp 2,209,320
0 0 550 - Rp -
0 0 0 1,533.00 Rp -
0 0 930 110.00 Rp -
0 1000 440 590.00 Rp 590,000
0 0 90 830.00 Rp -
0 0 0 - Rp -
37 157 135 4,099.70 Rp 643,653
0 0 59 669.90 Rp -
0 0 3600 67,078.00 Rp -
0 0 0 34,177.00 Rp -
0 0 0 36,036.00 Rp -
0 0 2310 - Rp -
0 0 0 2,774.00 Rp -
0 300 0 2,774.00 Rp 832,200
13 5 5 1,199.00 Rp 5,995
30 180 342 3,150.00 Rp 567,000
0 0 300 - Rp -
0 0 0 9,999.00 Rp -
0 0 6770 501.60 Rp -
0 0 0 6,487.80 Rp -
150 390 60 385.00 Rp 150,150
48 240 19 369.00 Rp 88,560
3 2 1 6,981.00 Rp 13,962
102 347 41 1,184.00 Rp 410,848
0 0 36 312.84 Rp -
2,600 4200 1113 312.84 Rp 1,313,928
1 0 0 45,856.00 Rp -
0 22 310 20,700.00 Rp 455,400
1 3 0 8,580.00 Rp 25,740
11 55 414 11,825.00 Rp 650,375
0 0 440 15,225.00 Rp -
0 0 3 - Rp -
0 0 24 - Rp -
0 0 300 10,778.00 Rp -
0 1600 11 322.00 Rp 515,200
0 0 220 231.00 Rp -
900 6200 2526 138.00 Rp 855,600
0 0 15 138.00 Rp -
0 0 0 - Rp -
0 0 0 138.00 Rp -
100 100 40 110.00 Rp 11,000
0 0 0 130.00 Rp -
0 0 0 2,250.00 Rp -
0 0 0 4,255.00 Rp -
3 3 16 20,700.00 Rp 62,100
0 0 330 62,000.00 Rp -
0 0 825 - Rp -
1,000 100 6120 77.00 Rp 7,700
0 0 600 235.00 Rp -
0 0 1200 1,913.00 Rp -
0 0 0 8,122.50 Rp -
200 700 149 61.00 Rp 42,700
200 800 850 85.00 Rp 68,000
0 100 60 479.60 Rp 47,960
400 600 1667 126.00 Rp 75,600
0 0 2100 1,155.00 Rp -
0 0 2000 322.00 Rp -
0 9 3000 579.00 Rp 5,211
0 500 110 761.00 Rp 380,500
0 0 601 829.00 Rp -
0 900 0 830.00 Rp 747,000
30 180 12 7,630.00 Rp 1,373,400
0 0 539 336.00 Rp -
60 550 24 273.00 Rp 150,150
0 0 0 - Rp -
10 20 6005 4,000.00 Rp 80,000
200 2900 80 67.00 Rp 194,300
0 400 0 74.00 Rp 29,600
2 103 301 4,446.00 Rp 457,938
0 312 6110 2,935.00 Rp 915,720
5 48 3002 6,990.50 Rp 335,544
11 90 224 9,658.00 Rp 869,220
300 300 120 50.00 Rp 15,000
0 0 33 998.80 Rp -
0 0 0 110.00 Rp -
600 500 240 214.00 Rp 107,000
0 0 0 195.00 Rp -
0 0 0 6,989.00 Rp -
0 0 60 466.00 Rp -
0 0 0 - Rp -
0 0 1 - Rp -
0 0 0 13,202.00 Rp -
0 0 1005 5,460.00 Rp -
0 0 0 - Rp -
1,800 600 720 372.00 Rp 223,200
0 0 60 - Rp -
0 0 0 - Rp -
200 1200 80 310.00 Rp 372,000
0 0 0 1,103.00 Rp -
0 0 3000 500.00 Rp -
0 0 0 750.00 Rp -
0 0 900 25,000.00 Rp -
0 200 15 185.00 Rp 37,000
300 0 135 323.00 Rp -
0 0 0 1,549.90 Rp -
100 200 95 92.00 Rp 18,400
0 0 0 - Rp -
0 0 0 192.23 Rp -
0 0 6 1,882.00 Rp -
0 0 6 - Rp -
0 0 6 - Rp -
240 495 102 93.00 Rp 46,035
0 0 0 93.00 Rp -
0 0 0 - Rp -
0 0 7 - Rp -
10 56 4 6,809.00 Rp 381,304
0 0 110 - Rp -
0 0 3 250.00 Rp -
0 0 0 234.00 Rp -
0 0 83 123.00 Rp -
0 0 75 - Rp -
300 700 195 551.00 Rp 385,700
0 0 2 - Rp -
0 48 11 6,281.00 Rp 301,488
0 66 33 3,122.00 Rp 206,052
0 0 1 - Rp -
0 0 3 - Rp -
0 0 11 - Rp -
0 0 0 150,000.00 Rp -
0 0 33 572,700.00 Rp -
0 0 22 245,000.00 Rp -
0 0 0 250,900.00 Rp -
0 0 600 254,000.00 Rp -
0 0 608 509,000.00 Rp -
0 0 600 309,000.00 Rp -
0 1 0 758,700.00 Rp 758,700
2 3 1 237,000.00 Rp 711,000
0 0 0 21,091.00 Rp -
0 0 0 1,282,500.00 Rp -
0 0 3 1,282,500.00 Rp -
0 0 11 472,500.00 Rp -
0 0 0 318,000.00 Rp -
0 0 1 1,647,000.00 Rp -
0 0 7 588,000.00 Rp -
0 0 0 475,200.00 Rp -
0 0 60 588,000.00 Rp -
0 0 9 - Rp -
0 0 0 470,000.00 Rp -
0 0 120 - Rp -
0 0 110 - Rp -
0 0 330 - Rp -
0 0 250 - Rp -
0 0 0 - Rp -
0 0 165 78,200.00 Rp -
0 0 0 778.00 Rp -
0 0 6 650.00 Rp -
0 400 0 977.91 Rp 391,164
200 1100 80 1,001.22 Rp 1,101,342
100 800 40 1,068.93 Rp 855,144
0 200 55 127.64 Rp 25,529
0 0 12 2,520.00 Rp -
0 0 22 16,095.20 Rp -
0 0 90 8,658.00 Rp -
0 0 4 13,831.72 Rp -
0 12 0 8,145.83 Rp 97,750
0 0 15 8,145.83 Rp -
0 21 0 8,145.83 Rp 171,063
0 16 0 17,875.00 Rp 286,000
0 31 2 7,570.83 Rp 234,696
0 0 0 29,000.00 Rp -
0 7 0 7,707.14 Rp 53,950
0 0 0 7,707.14 Rp -
0 0 12 7,707.14 Rp -
0 1 11 7,706.25 Rp 7,706
350 2100 162 488.37 Rp 1,025,582
0 0 11 690.00 Rp -
0 0 39 690.00 Rp -
0 0 40 690.00 Rp -
1 13 0 78,200.00 Rp 1,016,600
0 401 15 5,661.00 Rp 2,270,061
25 300 10 5,445.00 Rp 1,633,500
0 2 0 17,424.00 Rp 34,848
0 2 0 17,424.00 Rp 34,848
0 0 0 17,424.00 Rp -
2 20 1 4,100.00 Rp 82,000
1 31 15 12,400.00 Rp 384,400
1 14 15 23,988.00 Rp 335,832
0 0 0 31,262.00 Rp -
23 135 9 499.13 Rp 67,382
0 0 0 10,640.00 Rp -
0 0 0 120,000.00 Rp -
0 85 3 1,435.50 Rp 122,018
0 6 0 141,450.00 Rp 848,700
10 206 4 100.79 Rp 20,763
12 50 152 100.00 Rp 5,000
0 0 0 4,500.00 Rp -
0 0 0 812.80 Rp -
0 0 150 432.00 Rp -
0 0 300 520.00 Rp -
0 0 0 117.15 Rp -
0 0 0 108,000.00 Rp -
0 0 0 52,000.00 Rp -
0 0 15 48,000.00 Rp -
0 5 0 15,000.00 Rp 75,000
0 0 0 - Rp -
0 0 30 68,000.00 Rp -
0 0 30 190,300.00 Rp -
0 1 15 6,900.00 Rp 6,900
0 42 0 7,623.00 Rp 320,166
0 1 0 7,623.00 Rp 7,623
0 0 0 7,623.00 Rp -
0 0 0 7,623.00 Rp -
0 0 0 8,470.00 Rp -
0 0 0 8,470.00 Rp -
0 0 0 8,470.00 Rp -
0 0 9 4,780.60 Rp -
0 0 0 4,780.60 Rp -
8 239 3 7,556.18 Rp 1,805,926
0 312 0 12,451.73 Rp 3,884,938
0 0 0 15,000.00 Rp -
0 0 0 20,000.00 Rp -
0 0 0 25,000.00 Rp -
19 50 8 367.29 Rp 18,365
0 0 0 79.00 Rp -
3 3 1 89.90 Rp 270
0 0 0 124.25 Rp -
4 20 2 16,500.00 Rp 330,000
0 0 0 3,000.00 Rp -
0 0 0 15,000.00 Rp -
0 0 0 22,100.00 Rp -
0 10 0 9,800.00 Rp 98,000
0 20 0 15,100.00 Rp 302,000
0 0 0 29,000.00 Rp -
0 0 0 34,500.00 Rp -
0 0 0 45,000.00 Rp -
0 0 0 345.00 Rp -
0 0 0 545.00 Rp -
1 29 0 23,800.00 Rp 690,200
0 24 0 22,900.00 Rp 549,600
0 0 0 - Rp -
0 0 0 977.91 Rp -
0 0 0 1,001.22 Rp -
0 0 0 1,068.93 Rp -
0 0 0 6,595.00 Rp -
0 0 0 6,595.00 Rp -
0 50 0 6,595.00 Rp 329,750
0 0 0 6,595.00 Rp -
0 0 0 3,036.13 Rp -
600 900 240 611.61 Rp 550,449
10 13 4 1,430.00 Rp 18,590
0 0 0 8,388.60 Rp -
0 0 0 8,769.00 Rp -
0 0 0 5,328.00 Rp -
0 0 0 14,471.60 Rp -
0 80 0 7,254.10 Rp 580,328
13 30 5 12,631.00 Rp 378,930
3 64 1 12,631.00 Rp 808,384
0 59 0 12,631.00 Rp 745,229
0 100 0 2,079.00 Rp 207,900
0 0 0 1,639.00 Rp -
0 0 0 - Rp -
0 0 0 - Rp -
3 0 1 512,204.00 Rp -
0 0 0 125,000.00 Rp -
5 18 2 293,218.08 Rp 5,277,925
0 0 0 130,999.00 Rp -
0 0 0 128,000.00 Rp -
0 0 0 131,000.00 Rp -
0 0 0 110,000.00 Rp -
0 0 0 125,000.00 Rp -
0 0 0 136,000.00 Rp -
0 0 0 86,000.00 Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 255,080.00 Rp -
0 35 0 32,040.00 Rp 1,121,400
0 0 0 2,702,700.00 Rp -
0 0 0 17,204.00 Rp -
0 0 0 - Rp -
1 9 0 1,149.50 Rp 10,346
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 600,000.00 Rp -
0 0 0 800,000.00 Rp -
0 0 0 600,000.00 Rp -
0 0 0 750,000.00 Rp -
0 0 0 - Rp -
0 0 0 587,620.00 Rp -
0 0 0 415,300.00 Rp -
0 0 0 343,860.00 Rp -
0 0 0 472,093.00 Rp -
0 0 0 523,732.00 Rp -
0 0 0 563,310.00 Rp -
0 0 0 - Rp -
0 1 0 363,950.00 Rp 363,950
0 0 0 19,000.00 Rp -
0 0 0 - Rp -
0 1 0 207,200.00 Rp 207,200
0 0 0 55,786.50 Rp -
0 1 0 27,175.00 Rp 27,175
0 0 0 43,470.00 Rp -
0 2 0 54,250.00 Rp 108,500
0 0 0 415,685.00 Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 121,000.00 Rp -
0 0 0 420,000.00 Rp -
0 0 0 500,000.00 Rp -
0 0 0 480,000.00 Rp -
0 0 0 400,000.00 Rp -
0 0 0 155,575.00 Rp -
0 0 0 254,525.00 Rp -
0 0 0 510,000.00 Rp -
0 0 0 500,000.00 Rp -
0 2 0 675,000.00 Rp 1,350,000
0 0 0 - Rp -
0 0 0 - Rp -
0 0 0 700,000.00 Rp -
0 0 0 726,000.00 Rp -
0 0 0 2,132.90 Rp -
0 0 0 1,800.00 Rp -
0 0 0 37.84 Rp -
0 0 0 47.86 Rp -
0 300 0 138.00 Rp 41,400
0 0 0 131,000.00 Rp -
0 0 0 801,000.00 Rp -
0 0 0 1,063.00 Rp -
0 4 0 360,000.00 Rp 1,440,000
0 0 0 120,000.00 Rp -
0 0 0 26,830.00 Rp -
0 0 0 372 Rp -
1,100 1100 440 601 Rp 661,100
200 0 80 2749 Rp -
0 0 0 669 Rp -
0 10 0 52925 Rp 529,250
0 300 0 952 Rp 285,600
2 122 1 8022 Rp 978,684
0 6 0 95400 Rp 572,400
0 0 0 55000 Rp -
###
TUNGKAL ULU, Desember 2021
PEMBUATAN LAPORAN
Rita Marlia,S.Farm,Apt.
NIP. 19840825 201001 2 017
#REF! 952 - #REF!
#REF! 8022 - #REF!
#REF! 8022 - #REF!
#REF! 8022 - #REF!

Laporan Khusus Penggunaan Morphin, Pethidin, Dan Derivatnya

Uploaded by

Copyright:

Available Formats

You might also like

Laporan Khusus Penggunaan Morphin, Pethidin, Dan Derivatnya

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Laporan Khusus Penggunaan Morphin, Pethidin, Dan Derivatnya

Uploaded by

Copyright:

Available Formats

LAPORAN KHUSUS PENGGUNAAN MORPHIN, PETHIDIN, DAN DERIVATNYA

Nama Sarana : Puskesmas Pelabuhan Dagang

Resep Pasien Dokter

Mengetahui, Tungkal Ulu, Desember 2021

dr. Cerli Scorpio Rita Marlia,S.Farm,Apt

Nama Sarana : Puskesmas Pelabuhan Dagang

Kurnia 3/11 (60), Dina F 24/11 (60) 210 362

Tungkal Ulu, November 2021

Nama Sarana : Puskesmas Pelabuhan Dagang

dr. Cerli Scorpio

Tungkal Ulu, November 2021

PERIODE PELAPORAN : BULAN November 2021

NAMA PUSKESMAS : Pelabuhan Dagang

(1) (2) (3) (4)

1 Albendazol /Pirantel Pamoat Tablet 1

• KolomKetersediaan (Ada/Tidak) (4) :

Nama Sarana : Puskesmas Pelabuhan Dagang

dr. Cerli Scorpio

Tungkal Ulu, Desember 2021

1 ACT (Artesunat 50 mg + Amodiaquin 200 mg) Tablet Tablet TIDAK 0 0 0

dr. CERLI SCORPIO

You might also like