Laporan Juni 2023

REKAPITULASI PEMAKAIAN OBAT BULANAN
Puskesmas : koncara
Bulan : JUNI 2023
STOK PENERI- JUMLAH

SISA STOK
PERSE- TOTAL PENGELUARAN SESUAI TANGGAL TOTAL
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 PER BLN BLN
OBAT
1 Albendazol Tablet 400 mg Tablet 0 0 - -
2 Acethylcystein Tablet 35 600 635 30 46 30 10 30 30 20 10 30 66 30 10 80 50 10 60 40 582 53
3 Alopurinol Tablet 100 mg Tablet 180 400 580 5 10 15 10 10 7 19 10 5 5 96 484
4 Alopurinol Tablet 300 mg Tablet 0 0 - -
5 Alprazolam 1 mg Tablet 0 0 - -
6 Ambroksol tablet 30 mg Tablet 0 0 - -
Ambroksol sirup 15 mg/ml 1
Botol 0
7 krt=50 btl 0 - -
8 Bisakodil supp Ampul 0 0 - - maks 200/pkm
9 Aminofilin Tablet 200 mg Tablet 0 0 - -
Amitriptilin HCl Tablet Salut 25 mg Tablet 957

10 957 5 30 35 922
11 Amlodipin tablet 10 mg Tablet 190 800 990 60 50 10 40 40 60 20 40 40 50 40 10 10 60 10 30 50 60 20 20 30 750 240
12 Amlodipin tablet 5 mg Tablet 21 900 921 20 60 40 40 30 50 30 80 73 30 10 40 30 20 100 10 10 70 10 70 40 863 58
Amoksisilin + As. Klavulanat 625
Tablet 0
13 mg 0 - -
14 Amoksisilin 500 mg kaplet 402 1400 1,802 65 140 25 60 25 70 20 50 56 70 95 94 55 205 40 60 48 58 20 125 105 1,486 316
15 Amoksisilin 250 mg kapsul 0 0 - -
Amoksisilin Sirup Kering Forte 250
Botol 86
16 mg/5 ml 26 60 2 6 2 1 4 5 3 2 3 5 1 7 3 6 1 3 2 56 30
Amoksisilin Sirup Kering 125 mg/5
Botol 103
17 ml 3 100 2 2 2 1 2 2 1 2 1 2 3 2 2 1 1 2 2 30 73
18 Asetilsestein caps capsul 0 0 - -
Antasida DOEN Tablet Kombinasi Tablet 1,151

19 251 900 40 46 16 20 30 50 20 20 30 20 20 50 50 26 20 20 40 518 633
20 Antasida DOEN Suspensi Botol 54 54 1 2 2 4 4 3 1 1 2 5 2 3 2 2 1 1 1 3 40 14
Anti Bakteri DOEN Salep

Kombinasi : Basitrasin + Polimiksin Tube 0
21 1 ktk = 25 tube 0 - -
22 Antifungi DOEN Kombinasi Pot 0 0 - -
Antimigren DOEN Kombinasi :
Tablet 0
23 Ergotamin Tartrat + Kofein 0 - -
Anti Hemorhoid DOEN ktk 10
Supp 43
24 supp. 43 - 43
25 Antidiare Syrup Botol 0 0 - -
26 Antidiare Tablet Tablet 52 300 352 10 42 8 10 10 20 20 10 10 10 20 20 10 200 152
Aqua Proinjeksi Steril,Bebas
Ampul 30
27 Pirogen 20 ml 30 - 30
Asam asetilsalisilat/Asetosal 100
Tablet 0
28 mg tab 0 - -
Asam Askorbat (Vit. C) Tablet 50
Tablet 600
29 mg 0 600 10 10 10 16 35 10 10 35 8 38 8 11 20 45 10 276 324
Asam Askorbat (Vit. C) Tablet 250
Tablet 0
30 mg 0 - -
Asam Mefenamat 500 mg Tablet Tablet 333

31 133 200 10 10 20 10 20 45 18 10 10 153 180
32 Asiklovir Cream 5% - 5 g Tube 10 20 30 1 1 1 1 1 5 25
33 Asikclovir Tablet 200 mg Tablet 0 0 - -
34 Asiklovir tablet 400 mg Tablet 66 100 166 25 16 25 43 109 57
Atropin injeksi l.m/lv/s.k. 0,25
Ampul 0
35 mg/mL - 1 mL (sulfat) 0 - -
Besi (II) Sulfat + Asam Folat

Tablet
(Tablet Tambah Darah Kombinas)
36 10 240 60 30 60 10 60 240 90 180
37 Betahistin mesilat 6 mg tab Tablet 42 150 192 30 6 16 6 6 20 10 6 6 6 20 132 60
38 Betametason Krim 0,1%-5g Tube 33 20 53 6 3 2 1 2 1 1 2 1 1 1 1 2 24 29
39 Bioplacenton Gel Tube 7 7 - 7
40 Borax Gliserin Botol 23 23 1 2 3 1 1 2 2 1 13 10
41 Bromhexin 8 mg tab Tablet 0 0 - -
42 Bromhexin Syrup Botol 0 0 - -
43 Cetirizin sirup 5 mg/5ml Botol 45 45 - 45
44 Cetirizin 10 mg Kapsul 0 1000 1,000 37 35 16 66 36 54 6 41 33 59 54 12 18 21 36 44 47 615 385
45 VITALEX Tablet 0 0 - -
46 Cendo Xitrol TM Botol 0 0 - -
47 Cendo Lyters TM Botol 0 0 - -
48 Clozapin 25 mg (KTK 50 TAB) Tablet 125 125 - 125
Deksametason Injeksi 5 mg/ml-1 ml Ampul 0

49 0 - -
50 Deksametason Tablet 0,5 mg Tablet 0 0 - -
Dekstran 70- larutan infus 6% steril btl 500 ml 0

51 0 - -
52 Diazepam Rectal Supp 7 7 - 7
53 Diazepam Injeksi 5 mg/ml-2 ml Ampul 2 2 - 2
54 Diazepam Tablet 2 mg Tablet 357 357 - 357
Dietilkarbamazin sitrat (DEC) tab
Tablet 0
55 100 mg 0 - -
Difenhidramin HCl Inj 10 mg/ml-1
Ampul 10
56 ml 10 - 10
57 Dimenhydrinate 50 mg Tablet 62 62 6 6 56
58 Digoksin Tablet 0,25 mg Tablet 0 0 - -
59 Doksisiklin 100 mg kapsul 0 0 - -
60 Domperidon Tablet 10 mg Tablet 246 200 446 16 10 12 6 14 20 20 17 14 6 27 15 22 11 16 226 220
Domperidon suspensi 5 mg/5ml mg Botol 0

61 0 - -
62 Efinephrin 1mg/ml inj ampul 0 0 - -
63 Etambutol tablet 500 mg Tablet 0 0 - -
64 Eritromisin 250 mg Kapsul Tablet 0 0 - -
65 Eritromisin 500 mg Kapsul Kaplet 0 0 - -
66 Eritromisin Sirop 200 mg /5ml Btl 60 ml 0 0 - -
Etakridin (Rrivanol) Larutan 0,1%-
Botol 0
67 300 ml 0 - -
Fenobarbital Injeksi 50 mg/ml -2 ml Ampul 4

68 4 - 4
69 Fenobarbital tablet 30 mg Tablet 0 0 - -
70 Fluconazole 150 mg Tablet 0 0 - -
Tablet 0
71 Fenoksimetil penisilinTablet 500 mg 0 - -
Fenol Gliserol Tetes Telinga 10% - Botol 25

72 5 ml 1 24 1 1 1 2 1 6 19
Fitomenadion (Vit. K1) tablet 10 mg Tablet 0

73 0 - -
Fitomenadion (Vit. K1) Injeksi 10
Ampul 0
74 mg/ml-1 ml 0 - -
Fluoksetin (Prestin) 20 mg KTK 50
Kapsul 0
75 TAB 0 - -
76 Furosemid Tablet 40 mg Tablet 175 100 275 10 10 3 13 36 239
77 Furosemid inj 10 mg/mL Ampul 0 0 - -
78 Garam Oralit 200 ml air kantong 45 200 245 21 12 24 3 11 18 6 6 5 18 12 16 12 5 18 187 58
79 Gentamisin 0,3% TM fls 23 23 1 1 1 1 1 5 18
80 Gentamisin inj 40 mg/ 2 mL Ampul 0 0 - -
Gentamisin Salep Kulit 0,1% - 5 g Tube 91

81 19 72 6 5 3 1 1 1 3 5 2 5 2 6 1 8 6 3 1 2 2 5 8 76 15
82 Gentamisin Salep Mata 0,3 % Tube 0 0 - -
Botol 0
83 Gentian Violet Larutan 1% - 10 ml 0 - -
84 Glimepirid 1 mg Tablet 2 2 - 2
85 Glibenklamid Tablet 5 mg Tablet 223 223 50 20 10 10 25 10 7 132 91
86 Glimepiride 2 mg Tablet 223 200 423 5 5 10 20 5 5 10 20 10 35 125 298
botol 1,109
87 Gliseril Guaikolat Tablet 100 mg 109 1000 14 51 26 12 28 19 37 14 18 16 21 13 10 73 38 46 23 83 23 32 76 673 436
Gliseril Guaikolat 25mg/5ml syrup Btl 100 ml 0

88 0 - -
89 Gliserin Ampul 0 0 - -
Glukosa Larutan Infus 40% Steril
Botol 0
90 25 mL 0 - -
Botol 0
91 500 ml 0 - -
Tablet 0
92 500 ml 0 - -
Griseofulvin Tablet 125 mg,
Ampul 0
93 Micronized 0 - -
94 Haloperidol injeksi 5 mg Ampul 0 0 - -
Haloperidol Dekanoat Injeksi 50
Botol 15
95 mg/ml 15 - 15
96 Haloperidol drops 2 mg/ml Tablet 0 0 - -
97 Haloperidol 0,5 mg Tablet Tablet 0 0 - -
98 Haloperidol 1,5 mg Tablet Tablet 473 473 30 30 60 413
99 Haloperidol 2 mg Tablet Tablet 0 0 - -
Haloperidol tablet 5 mg ktk Tablet 1,962
100 102 1962 56 30 6 92 1,870
Hidroklorotiazid (HCT) Tablet 25
Tube 401
101 mg 101 300 20 20 20 10 6 10 6 10 10 112 289
102 Hidrokortison Krim 2,5% Tablet 3 24 27 2 1 1 5 1 1 1 1 2 15 12
Hyoscine-N-butilbromide tablet
botol 0
103 10mg 0 - -
Ibuprofen suspensi 200 mg/5 ml Tablet 0

104 0 - -
105 Ibuprofen Tablet 200 mg Tablet 0 0 - -
106 Ibuprofen Tablet 400 mg Pot 0 1000 1,000 60 30 20 20 20 66 92 16 46 20 56 30 20 26 45 16 60 62 30 735 265
107 Ichtyol Salep Tablet 0 0 - -
108 Isoniazid tablet 100mg Tablet 0 0 - -
109 Isoniazid tablet 300mg Tablet 0 0 - -
Isosorbid Dinitrat sublingual tab 5
Pot 150
110 mg 150 - 150
Kalium Permanganat Serbuk - 5 g Ampul 0
111 0 - -
Kalsium Glukonas Inj. 100 mg/ml Tablet 0

112 0 - -
Kalsium Laktat (Kalk) Tablet 500
Tablet 1,005
113 mg 205 800 10 110 15 35 60 55 50 30 65 10 40 90 20 10 40 75 715 290
114 Kaptopril Tablet 12,5 mg Tablet 0 0 - -
Kaptopril tablet 25 mg ktk 100 tab Tablet 0

115 0 - -
116 Kaptopril Tablet 50 mg Tablet 0 0 - -
117 Karbamazepin Tablet 200 mg Tube 0 0 - -
118 Ketokonazol cream Tablet 0 0 - -
Ketokonazol tab 200 mg (ktk 50 Tablet 260

119 tab) 260 13 3 4 7 5 7 12 5 56 204
120 Ketoprofen 100 mg Ampul 0 0 - -
121 Ketoprofen Inj 100 mg Ampul 2ml 0 0 - -
122 Ketoprofen Inj 50 mg/ml Ampul 0 0 - -
123 Ketorolac inj. 30 mg Kapsul 0 0 - -
124 Klindamisin kapsul 300mg Tab 0 0 - -
Klobazam 10 mg (kotak 100 tab) Tablet 0

125 0 - -
Klopidogrel tab 75 mg (KOTAK 30 Kapsul 0

126 TAB) 0 - -
127 Kloramfenikol Kapsul 250 mg Tube 0 0 - -
128 Kloramfenikol Salep Kulit 1% Tube 0 0 - -
Kloramfenikol Salep Mata 1% - 3,5 Botol 0
129 g 0 - -
Kloramfenikol Tetes Telinga 3% Tablet 10

130 10 1 1 1 1 4 6
Klorfeniramin Maleat (CTM) Tablet
Tablet 925
131 4 mg 325 600 73 86 70 35 26 40 26 17 13 25 11 51 23 68 40 31 5 20 17 15 46 738 187
Klorpromazin tablet salut 100 mg
Tablet 0
132 btl 1000 tab 0 - -
133 Kodein tablet 10mg btl 250 tab Tablet 0 0 - -
134 Botol 0 0 - -
Kotrimoksazol Suspensi Kombinasi Tablet 99

135 99 - 99
Kotrimoksazol Tablet
Kapsul 604
136 Kombinasi/Dewasa: 104 500 20 10 30 26 36 18 26 20 6 30 222 382
137 Lansoprazole kapsul 30 mg Pot 0 0 - -
138 Lisinopril 5 mg Ampul 190 200 390 20 40 10 10 20 10 20 130 260
139 Lidokain Injeksi Tablet 0 0 - -
140 Loratadin Tablet 0 0 - -
141 Loperamid (HCl) 2 mg vial 0 0 - -
Magnesium Sulfas Inj. 40%-25ml supp 0

142 0 - -
Magnesium Sulfas Inj. 20%-25ml Tablet 0

143 0 - -
144 Meloksikam tablet 15 mg Ampul 127 127 6 6 6 18 109
Metampiron Injeksi 250 mg/ml-2 ml Tablet 0

145 0 - -
146 Metampiron Tablet 500 mg Tablet 0 0 - -
147 Metformin HCl 500 mg tab Tablet 251 600 851 30 30 45 10 50 10 40 50 10 50 10 15 90 20 40 20 40 50 610 241
148 Metformin HCl 850 mg tab Tablet 0 0 - -
149 Metildopa Tablet 250 mg Tablet 116 116 - 116
Metilergometrin Tablet Salut 0,125 Ampul 65

150 g 65 - 65
Metilergometrin Maleat Injeksi
Tablet 0
151 0,200 mg/ml 0 - -
152 Metilprednison tablet 4 mg Tablet 0 0 - -
153 MDT PB Ampul 0 0 - -
154 MDT MB Tablet 0 0 - -
155 Metoklopramide tablet 10 mg Tablet 0 0 - -
156 MDT KUSTA ANAK Tablet 0 0 - -
157 Metronidazol Tablet 250 mg Tablet 0 0 - - bln 4/2012 hrs sdh habis
158 Metronidazol Tablet 500 mg Botol 0 0 - -
Metronidazol Infus 500 mg/100 Tube 0
159 ml 0 - -
160 Miconazol cream 2% sch 0 0 - -
161 Mineral Mix Tablet 0 0 - -
162 Multi vitamin kaplet Botol 0 800 800 50 40 45 35 40 51 20 105 30 5 35 5 15 40 30 546 254
163 Multi vitamin syrup Tablet 16 48 64 1 1 4 2 5 1 1 4 2 4 3 3 5 2 1 4 4 4 4 55 9
Natrium Bikarbonat Tablet 500 mg Btl 500ml 0

164 0 - -
Natrium Clorida Lrt. Infus 0,9%
Tablet 0
165 Steril 0 - -
Natrium Diklofenak 25 mg (ktk 50 Ampul 0

166 tab) 0 - -
Natrium Diklofenak 50 mg (ktk 50
Ampul 762
167 tab) 262 500 6 36 30 12 34 35 38 60 52 18 22 40 24 30 44 12 12 38 18 16 12 589 173
168 Norit tab Tablet 40 40 - 40
169 Nifedipin tablet 10 mg Tablet 71 71 - 71
Nistatin 500.000 IU/gram Tablet Tablet 0
170 Vaginal 0 - -
Nistatin 100.000 IU/gram Tablet Tablet 50
171 Vaginal 50 6 5 5 5 21 29
172 Norit Paket 40 40 - 40
Obat Anti tuberkulosis FDC
Paket 0
173 kategori I 0 - -
Paket 0
174 kategori II 0 - -
Obat Anti tuberkulosis FDC Sisipan Paket 0

175 0 - -
Obat Anti tuberkulosis kategori
Tablet 0
176 anak 0 - -
177 Obat batuk kombinasi tablet/molexfl Botol 515 300 815 40 71 44 80 30 25 70 40 63 6 46 20 40 22 45 46 688 127
178 Obat batuk kombinasi syrup Botol 12 12 - 12
Obat Batuk Hitam (OBH) Cairan- Sch 0

179 100 ml 0 - -
Obat Saluran Pencernaan (Synbio) Tablet 0

180 0 - -
181 Ofloxacin tablet 400mg Tube 0 0 - -
Oksitetrasiklin HCl Salep Kulit 3% -
Tube 0
182 5 g 0 - -
Oksitetrasiklin HCl Salep Mata 1% -
vial 0
183 3,5 g 0 - -
Oksitetrasiklin inj 50 mg/mL-10 mL Ampul 0

184 0 - -
Oksitosin Injeksi 10 IU/ml-1 ml Kapsul 0

185 0 - -
186 Omeprazol Kaps 20 mg Ampul 27 27 5 5 17 27 -
187 Ondansentron 4 mg/2 ml inj. Botol 0 0 - -
188 Parasetamol drops Tablet 0 0 - -
189 Parasetamol Tablet 500 mg Botol 105 4200 4,305 152 303 180 213 121 144 183 159 183 223 165 202 94 376 184 103 116 82 132 197 162 3,674 631
Parasetamol Sirup 120 mg/5 ml -
Botol 0
190 60 ml 0 - -
191 Peroksida (H2O2) 3% Tablet 0 0 - -
192 Permetrim cr tablet 13 13 1 1 1 1 4 9
193 Pirantel Pamoat Tablet 365 Tablet 0 0 - -
194 Piridoksin HCl. Tablet Tablet 79 600 679 27 18 34 28 15 6 23 97 20 8 22 6 6 20 6 8 13 10 35 402 277
195 Piroksikam 20 mg Tablet 320 320 12 16 10 18 16 72 248
196 Piroksikam 10 mg Botol 0 0 - -
197 Polikresulen Botol 0 0 - -
198 Povidon lodida 10%-30 ml Botol 0 0 - -
201 Povidon lodida 10%-1000 ml Tablet 0 0 - -
202 Prednison Tablet 5 mg Vial 0 0 - -
203 Procain PP Tablet 0 0 - -
204 Propranolol HCI Tablet 40 mg Tablet 0 0 - -
205 Propiltiourasil tablet 50 mg Tablet 0 0 - -
206 Pyrazinamide tablet 500 mg Ampul 0 0 - -
207 Ranitidin inj. 50 mg/2ml Tablet 0 0 - -
208 Ranitidin tablet 150 mg Tablet 100 800 900 66 24 10 40 12 42 46 52 24 72 30 58 30 60 54 36 22 36 18 36 18 786 114
209 Reserpin tablet 0,25 mg Kapsul 0 0 - -
Retinol (Vit.A) 100.000 IU Kapsul
Kapsul 0
210 (biru) 0 - -
Tablet 0
211 (merah) 0 - -
212 Rifampicin tablet salut 450 mg Kapsul 0 0 - -
213 Rifampisin Kapsul 600 mg Botol 0 0 - -
214 Ringer Laktat Larutan Infus Steril-50 Botol 0 0 - -
Ringer Asetat Larutan Infus Tablet 0
215 Steril-500 ml 0 - -
216 Risperidon 1 mg Tablet 0 0 - -
217 Risperidon 2 mg Tablet 3524 3,524 60 60 60 60 60 300 3,224
218 Salbutamol 4 mg Tablet 0 0 - -
219 Salbutamol tablet 2 mg Botol 58 200 258 10 10 20 8 11 11 6 10 10 20 10 16 142 116
220 Salbutamol syrup Ampul 0 0 - -
Salbutamol 2.5 mg/2.5 mL NaCl
pot 0
221 sol.for inhalation 0 - -
222 Salep 2-4, Kombinasi Kotak 4 10 14 1 1 1 1 1 1 3 2 1 1 1 14 -
223 Salisil Bedak 2%-50 gram Tablet 0 0 - -
224 Sefadroksil Tablet 500 mg botol 252 500 752 30 10 56 40 18 36 36 38 66 32 36 10 48 46 16 24 24 26 16 36 644 108
vial 46
225 Sefadroksil sirup kering 125mg/5ml 46 4 1 2 1 1 1 1 3 2 1 2 1 20 26
226 Sefotaksim inj 1 g vial 0 0 - -
227 Seftriakson inj 1 g vial 0 0 - -
Serum Anti Bisa Ular Inj.5 ml (ABU
vial 0
228 I) 0 - -
229 Serum Anti Tetanus injeksi set 0 0 - -
Serum Anti Rabies Vero 4"s Vial 10 ml 0

230 0 - -
231 Serum Antidifteri BP 10.000IU Ampul 0 0 - -
Sianokobalamin (Vit.B12) Injeksi
Tablet 0
232 500 mcg/ml-1ml 0 - -
Sianokobalamin (Vit.B12) Tablet Tablet 841
233 41 800 41 10 20 20 30 25 55 10 24 10 16 8 18 16 16 20 20 20 20 399 442
234 Simetidin tablet 200 mg Tablet 0 0 - -
235 Simvastatin Tablet 10 mg Tablet 307 307 10 40 20 20 35 10 10 10 10 10 10 10 10 20 10 20 255 52
236 Simvastatin Tablet 20 mg Tablet 0 0 - -
237 Siprofloksasin 500 mg Botol 0 0 - -
238 Stimuno syr Botol 13 13 3 2 2 2 4 13 -
239 Stimuno forte tab Kapsul 135 150 285 30 29 20 20 6 105 180
240 Tetrasiklin HCI kapsul 250 mg Kapsul 0 0 - -
241 Tetrasiklin HCI kapsul 500 mg Kapsul 0 0 - -
242 Tiamfenikol kapsul 500 mg Tablet 0 0 - -
Tiamin HCI/Mononitrat (Vit.B1)
Ampul 812
243 Tablet 50 mg 212 600 22 58 44 30 34 8 10 10 20 8 40 16 26 8 32 26 48 440 372
244 Tiamin (Vit B1) inj 100 mg/ mL Ampul 0 0 - -
245 Tramadol inj 50 mg/ mL Tablet 0 0 - -
246 Triheksifenidil Tablet PCS 3247 3,247 60 30 120 60 60 60 6 60 30 486 2,761
Kapsul 0
247 Vitamin Pencernaan (Hidrovit) 0 - -
248 Vitamin Neurotropik Tablet 0 0 - -
249 Vitamin B Komplek Tablet Tablet 206 206 30 60 61 35 20 206 -
250 Zink dispersible tab 20 mg Tablet 255 700 955 60 20 50 40 20 10 20 10 40 10 20 20 30 30 50 20 10 30 490 465
OBAT GIGI 0 - -
Bahan Tumpatan Sementara

Set/btl 0
Temporary Stoping Fletcher Serbuk
1 - -
2 CHKM Botol 0 - -
Desinfeksi saluran akar gigi
mengandung o,1 dexametason, 5

btl 13 ml 0
thymol,30g paraklorofenol, 64,9 g
3 champor/ CRESOPHENE - -
mengandung dexametason asetat
0.138 g, fenol 45.285 g, guayakol btl 0
6.790 g, gliserol 22.770 g dan amil

4 asetat 2.400 g ROCKLE ' S - -
5 Devitalisasi Pasta (Non Arsen) Botol 0 - -
6 Etil Klorida Semprot- 100 ml Botol 0 - -
7 Eugenol Cairan - 10 ml Botol 0 - -
Glass Ionomer Cemen ART Fuji Set/btl 0
8 IX mini pack + 4 ml Liquid - -
Glass Ionomer Restoractive
Cement ART, GC IX HS EXTRA Box 0
9 POSTERIOR - -
10 Kalsium Hidroksida Pasta Botol 0 - -
11 Komposit resin pcs 0 - -
12 Mummifying Pasta Botol 0 - -
13 Pasta Pengisi Saluran Akar botol 0 - -
Semen Seng Fosfat Serbuk dan
Botol 0
14 Cairan - -
15 Silver Amalgam Serbuk 65-75% botol 0 - -
16 Spoon Gelatin Box 0 - -
17 Temporary Filling Material Set 0 - -
18 Trikresol Formalin (TKF) Botol 0 - -
19 antiseptik liquid 0 - -
ALKES HABIS PAKAI 0 - -
1 Alat suntik sekali pakai 0,5 cc pcs 0 - -
2 Alat suntik sekali pakai 1 cc pcs 0 - -
3 Alat Suntik Sekali Pakai 3 ml pcs 0 - -
4 Alat suntik sekali pakai 5 cc pcs 0 - -
Blood lancet 26 G 1 box = 100
pcs 0
5 Pcs - -
6 Bistruri Kotak 0 - -
Catgut chromic no. 2/0 1
pcs 0
7 ktk=12pcs - -
pcs 0
8 ktk=12pcs - -
8 Cover glass 20 mm x 20 mm Box 0 - -
9 Duk Lubang Bulat pcs 0 - -
Folley Catheter No. 18 (for single
use only, steril, natural rubber latex, Pcs 0
2 way silicone)
10 - -
11 Folley Catheter No.16 Pcs 0 - -
12 Infusion plester 76 x 40 mm set/sachet 0 - -
13 Infuset Anak set 0 - -
14 Infuset Dewasa set 0 - -
15 IV catheter no. 18 G x 1" pcs 0 - -
16 IV Chateter No-20G x 1 1/4" pcs 0 - -
17 IV Catheter no. 22 G x 1" pcs 0 - -
18 IV Chateter No-24G pcs 0 - -
19 Jelly USG 250 ml Botol 0 - -
20 Kapas berlemak 500g Bungkus 0 - -
Bungkus 0
21 Kapas Pembalut/Absorben 250 g - -
22 Kasa 16/16 pcs 0 - -
23 Kasa Kompres 40/40 steril Bungkus 0 - -
Kassa Pembalut Hidrofil 4 m x 3 cm Roll 0

24 - -
Kassa Pembalut Hidrofil 4 m x 5 cm Roll 0

25 - -
Kasa Pembalut 2 m x 80 cm
26 Roll 0 - -
Kasa Pembalut Elastis 3 inchi
(elastic bandage, standar ISO
9002, certificate TUV ukuran 3") Roll 0
27 - -
Kasa Pembalut Elastis 4 inchi
(elastic bandage, standar ISO
9002, certificate TUV ukuran 4") Roll 0
28 - -
Kasa Pembalut Hidrofil 4 m x 15 cm Roll 0

29 - -
30 Kertas lensa buku/ 0 - -
31 Kertas puyer pak 0 - -
32 Masker Tali pcs 0 - -
33 Masker N95 Pcs 0 - -
34 Needle 27 0 - -
35 nasal kanul dewasa box 0 - -
36 Pembalut Gips 3 inch Roll 0 - -
39 Penjepit Tabung Kayu Set 0 - -
40 Pisau elektrocutter set 0 - -
41 Plastik obat dgn label dinas pcs 0 - -
42 Plester 5 yards x 2 inch Rol 0 - -
43 Plester bulat transparant sachet 0 - -
44 Plester bulat ukuran kecil Roll 0 - -
45 Plester Micropore Roll 0 - -
46 Pot Dahak pot 0 - -
47 Rak tabung acrylik pcs 0 - -
Sarung Tangan non steril (S) (box
psg/set 0
48 isi 100 pair) - -
49 Sarung Tangan non steril M psg/set 0 - -
50 Sarung tangan non steril uk. L psg/set 0 - -
51 Sendok obat 5 ml pcs 0 - -
Silk (Benang Bedah Sutra)No.3/0 pcs 0

52 - -
53 Tisu Gulung Rol 0 - -
54 Under Pad pcs 0 - -
55 HBSG pcs 0 - -
56 ALAT ACUCHEK pcs 0 - -
57 ACHUCEK STIK pcs 0 - -
58 Wing needle no. 25 G pcs 0 - -
59 Wing needle no. 27 G pcs 0 - -
0 - -
REAGENSIA 0 - -
1 Alkohol swab pcs 0 - -
Antiserum Golongan Darah ABO
set 0
2 10 mL - -
3 Aquabidestilata 500ml btl 0 - -
4 Asam Asetat 6%-100 mL Botol 0 - -
5 Asam Asetat 6%-250 mL 0 - -
Benedict 250 ml (No.Cat.17074) Botol 0

6 - -
7 Di-Ammonium Oxalat GR Botol 0 - -
8 Di-Ethil eter GR Botol 0 - -
Drabskin 500 ml (No.Cat.17080) Botol 0

9 - -
10 EDTA 10% Cair-100 mL Botol 0 - -
11 EDTA 10% Cair-250 mL Botol 0 - -
Tube EDTA pak 100"s 0

12 - -
13 Ethanol 70 % 100 ml Botol 0 - -
14 Ethanol 70 % Botol 1 l 0 - -
15 Giemsa Stok 500 ml Botol 0 - -
HCL 0,1 N 100 ml (No.Cat.17107) Botol 0

16 - -
17 Immersi Oil 100 ml Botol 0 - -
18 Iodine Test Solution-10 ml Botol 0 - -
Kartu Golongan Darah 100
set/pak 0
19 lembar/set/ktk - -
Larutan Antiseptik Clorine 5.25% -
Botol 0
20 500 cc - -
21 Larutan Cat Gram Set- 100 ml Botol 0 - -
Methanol GR for analysis
ACS,ISO-500 ml(No.Cat. Botol 0
22 106009.1000) - -
23 Methanol 100 ml Botol 0 - -
24 Methil alkohol 0 - -
25 Natrium Sitrat 3,8% Botol 0 - -
26 PH Indikator 0-14 pak 0 - -
27 Reagen Test Kehamilan Strip Box 0 - -
28 Spiritus 1 L box 0 - -
29 Stick Urine 10 Parameter Tube 0 - -
30 Stick Asam Urat Tube 0 - -
31 Stick Gula Darah Tube 0 - -
32 Stick Kolesterol Tube 0 - -
33 Turk 100 ml (No.Cat.17126) Botol 0 - -
34 Xylol 100 mL Botol 0 - -
35 Xylol 250 mL 0 - -
Zeil Nelson (ZN set) 100 ml)
Kotak 0
36 No.Cat. 17134) - -
37 Hepatitis c c 0 - -
38 Rapid Test HIV 1/2 SD pcs 0 - -
39 Rapid Test HIV 1/2 Intect pcs 0 - -
40 Rapid Test HIV 1/2 Onco pcs 0 - -
41 Rapid Test Syphilis pcs 0 - -
42 Reagen 1 HIV Test Kit piece 0 - -
45 jJumantik 0 - -
46 Beative 0 - -
47 Filariasis kit 0 - -
maks 200/pkm
bln 4/2012 hrs sdh habis
PUSKESMAS KONCARA
BULAN: JUNI 2023
STOK PENERI- JUMLAH

PERSE-
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN
1 2
OBAT
Albendazol Tablet 400 mg Tablet 0 0

1
2 Acethylcystein Tablet 600 600
Alopurinol Tablet 100 mg Tablet 0 400 400

3
Tablet 0 0
4 Alopurinol Tablet 300 mg
5 Alprazolam 1 mg Tablet 0 0
6 Ambroksol tablet 30 mg Tablet 0 0
Ambroksol sirup 15 mg/ml
Botol 0 0
7 1 krt=50 btl
8 Bisakodil supp supp 0 0
Aminofilin Tablet 200 mg Tablet 0 0

9
Amitriptilin HCl Tablet Salut
Tablet 0 0
10 25 mg
11 Amlodipin tablet 10 mg Tablet 0 1,800 1,800
12 Amlodipin tablet 5 mg Tablet 0 1,200 1,200
Amoksisilin + As.
Tablet 0 0
13 Klavulanat 625 mg
14 Amoksisilin 500 mg kaplet 900 2,000 2,900
15 Amoksisilin 250 mg kapsul 0 0
Amoksisilin Sirup Kering
Botol 60 60 120
16 Forte 250 mg/5 ml
Amoksisilin Sirup Kering
Botol 100 100
17 125 mg/5 ml
18 Asetilsestein caps capsul 0 0
Antasida DOEN Tablet
Tablet 1000 1,000 2,000
19 Kombinasi
Botol 0 60 60
20 Antasida DOEN Suspensi
Anti Bakteri DOEN Salep

Kombinasi : Basitrasin +
Tube 0 0
Polimiksin 1 ktk = 25
tube
21
Antifungi DOEN Kombinasi Pot 0 0
22
Antimigren DOEN
Kombinasi : Ergotamin Tablet 0 0
23 Tartrat + Kofein
Anti Hemorhoid DOEN

Supp 0 0
24 ktk 10 supp.
25 Antidiare Syrup Botol 0 0
26 Antidiare Tablet Tablet 0 300 300
Aqua Proinjeksi
Ampul 0 0
Steril,Bebas Pirogen 20 ml
27
Asam
asetilsalisilat/Asetosal 100 Tablet 0 0
28 mg tab
Asam Askorbat (Vit. C)

Tablet 400 600 1,000
29 Tablet 50 mg
Asam Askorbat (Vit. C)
Tablet 0 0
30 Tablet 250 mg
Asam Mefenamat 500 mg
Tablet 1100 1,100
31 Tablet
32 Asiklovir Cream 5% - 5 g Tube 40 40
33 Asikclovir Tablet 200 mg Tablet 0 0
34 Asiklovir tablet 400 mg Tablet 400 400 800
Atropin injeksi l.m/lv/s.k.

Ampul 0 0
0,25 mg/mL - 1 mL (sulfat)
35
Besi (II) Sulfat + Asam

Folat (Tablet Tambah Tablet 0 0
36 Darah Kombinas)
Betahistin mesilat 6 mg tab Tablet 600 600

37
Betametason Krim 0,1%-5g Tube 20 30 50

38
39 Bioplacenton Gel Tube 20 20
40 Borax Gliserin Botol 0 0
41 Bromhexin 8 mg tab Tablet 0 0
42 Bromhexin Syrup Botol 0 0
43 Cetirizin sirup 5 mg/5ml Botol 50 50
44 Cetirizin 10 mg Kapsul 0 1,000 1,000
45 VITALEX Tablet 0 0
46 Cendo Xitrol TM Botol 0 0
47 Cendo Lyters TM Botol 0 0
48 Clozapin 25 mg (KTK 50 TA Tablet 0 0
Deksametason Injeksi 5
Ampul 0 0
49 mg/ml-1 ml
Deksametason Tablet 0,5
Tablet 0 0
50 mg
Dekstran 70- larutan infus
btl 500 ml 0 0
51 6% steril
52 Diazepam Rectal Supp 0 0
Diazepam Injeksi 5 mg/ml-2 Ampul 0 0

53 ml
54 Diazepam Tablet 2 mg Tablet 0 0
Dietilkarbamazin sitrat
Tablet 100 100
55 (DEC) tab 100 mg
Difenhidramin HCl Inj 10
Ampul 0 0
56 mg/ml-1 ml
57 Dimenhydrinate 50 mg Tablet 0 0
58 Digoksin Tablet 0,25 mg Tablet 0 0
59 Doksisiklin 100 mg kapsul 0 0
Domperidon Tablet 10 mg Tablet 0 500 500

60
Domperidon suspensi 5
Botol 0 0
61 mg/5ml mg
62 Efinephrin 1mg/ml inj ampul 0 0
63 Etambutol tablet 500 mg Tablet 0 0
Eritromisin 250 mg Kapsul Tablet 0 0

64
Eritromisin 500 mg Kapsul Kaplet 0 0

65
Eritromisin Sirop 200 mg
Btl 60 ml 0 0
66 /5ml
Etakridin (Rrivanol) Larutan
Botol 0 0
67 0,1%-300 ml
Fenobarbital Injeksi 50
Ampul 4 4
68 mg/ml -2 ml
Fenobarbital tablet 30 mg Tablet 0 0

69
70 Fluconazole 150 mg Tablet 0 0
Fenoksimetil penisilinTablet Tablet 0 0

71 500 mg
Fenol Gliserol Tetes Botol 24 24
72 Telinga 10% - 5 ml
Fitomenadion (Vit. K1)
Tablet 0 0
73 tablet 10 mg
Fitomenadion (Vit. K1)
Ampul 0 0
74 Injeksi 10 mg/ml-1 ml
Fluoksetin (Prestin) 20 mg
Kapsul 0 0
75 KTK 50 TAB
76 Furosemid Tablet 40 mg Tablet 0 100 100
77 Furosemid inj 10 mg/mL Ampul 0 0
78 Garam Oralit 200 ml air kantong 100 1,000 1,100
79 Gentamisin 0,3% TM fls 0 0
Gentamisin inj 40 mg/ 2 mL Ampul 4 4

80
Gentamisin Salep Kulit
Tube 24 120 144
81 0,1% - 5 g
Gentamisin Salep Mata 0,3 Tube 0 0

82 %
Gentian Violet Larutan 1% - botol 0 0
10 ml
83 Glimepirid 1 mg tablet 0 0
Glibenklamid Tablet 5 mg Tablet 0 0

84
85 Glimepiride 2 mg Tablet 0 200 200
Gliseril Guaikolat Tablet
Tablet 600 1,000 1,600
86 100 mg
Gliseril Guaikolat 25mg/5ml
botol 0 0
87 syrup
88 Gliserin Btl 100 ml 0 0
Glukosa Larutan Infus 40%
Ampul 0 0
89 Steril 25 mL
Glukosa Larutan Infus 10% Botol 0 0

90 Steril 500 ml
Glukosa Larutan Infus 5%
Botol 0 0
91 Steril 500 ml
Tablet 0 0
92 Micronized
93 Haloperidol injeksi 5 mg Ampul 0 0
Haloperidol Dekanoat
Ampul 0 0
94 Injeksi 50 mg/ml
Haloperidol drops 2 mg/ml Botol 0 0

95
Haloperidol 0,5 mg Tablet Tablet 0 0

96
Haloperidol 1,5 mg Tablet Tablet 0 0

97
98 Haloperidol 2 mg Tablet Tablet 0 0
Haloperidol tablet 5 mg
Tablet 0 0
99 ktk 102
Hidroklorotiazid (HCT)
Tablet 300 300
100 Tablet 25 mg
101 Hidrokortison Krim 2,5% Tube 48 48
Hyoscine-N-butilbromide
Tablet 0 0
102 tablet 10mg
Ibuprofen suspensi 200
botol 0 0
103 mg/5 ml
104 Ibuprofen Tablet 200 mg Tablet 0 0
105 Ibuprofen Tablet 400 mg Tablet 500 2,000 2,500
106 Ichtyol Salep Pot 0 0
107 Isoniazid tablet 100mg Tablet 0 0
108 Isoniazid tablet 300mg Tablet 0 0
Isosorbid Dinitrat sublingual
Tablet 0 0
109 tab 5 mg
Kalium Permanganat
Pot 0 0
110 Serbuk - 5 g
Kalsium Glukonas Inj. 100
Ampul 0 0
111 mg/ml
Kalsium Laktat (Kalk)
Tablet 1000 1,000 2,000
112 Tablet 500 mg
113 Kaptopril Tablet 12,5 mg Tablet 0 0
Kaptopril tablet 25 mg ktk
Tablet 0 0
114 100 tab
115 Kaptopril Tablet 50 mg Tablet 0 0
Karbamazepin Tablet 200
Tablet 0 0
116 mg
117 Ketokonazol cream Tube 0 0
Ketokonazol tab 200 mg
Tablet 0 0
118 (ktk 50 tab)
119 Ketoprofen 100 mg Tablet 0 0
120 Ketoprofen Inj 100 mg Ampul 0 0
121 Ketoprofen Inj 50 mg/ml Ampul 2ml 0 0
122 Ketorolac inj. 30 mg Ampul 0 0
Klindamisin kapsul 300mg Kapsul 0 0

123
Klobazam 10 mg (kotak
Tab 0 0
124 100 tab)
Klopidogrel tab 75 mg
Tablet 0 0
125 (KOTAK 30 TAB)
Kloramfenikol Kapsul 250
Kapsul 0 0
126 mg
Kloramfenikol Salep Kulit Tube 0 0

127 1%
Kloramfenikol Salep Mata Tube 0 0
128 1% - 3,5 g
Kloramfenikol Tetes Telinga
Botol 25 25
129 3%
Klorfeniramin Maleat (CTM) Tablet 100 1,000 1,100

130 Tablet 4 mg
Klorpromazin tablet salut
Tablet 0 0
131 100 mg btl 1000 tab
Kodein tablet 10mg btl 250
Tablet 0 0
132 tab
Tablet,
Tablet 0 0
133
Kotrimoksazol Suspensi
Botol 0 0
134 Kombinasi
Kombinasi/Dewasa: Tablet 0 500 500
135
Lansoprazole kapsul 30 mg Kapsul 0 0

136
137 Lisinipril 5 mg tablet 200 200
138 Lidokain Injeksi Ampul 30 30
139 Loratadin Tablet 0 0
140 Loperamid (HCl) 2 mg Tablet 0 0
Magnesium Sulfas Inj. vial 10 10

141 40%-25ml
Magnesium Sulfas Inj. vial 0 0
142 20%-25ml
Meloksikam tablet 15 mg Tablet 500 500

143
Metampiron Injeksi 250
Ampul 0 0
144 mg/ml-2 ml
Tablet 0 0
145 Metampiron Tablet 500 mg
Metformin HCl 500 mg tab Tablet 0 1,000 1,000

146
Metformin HCl 850 mg tab Tablet 0 0

147
Tablet 0 0
148 Metildopa Tablet 250 mg
Metilergometrin Tablet Tablet 0 0
149 Salut 0,125 g
Metilergometrin Maleat
Ampul 10 10
150 Injeksi 0,200 mg/ml
Tablet 0 0
151 Metilprednison tablet 4 mg
152 MDT PB Tablet 0 0
153 MDT MB Ampul 0 0
Metoklopramide tablet 10
Tablet 0 0
154 mg
155 MDT KUSTA ANAK Tablet 0 0
Metronidazol Tablet 250 mg Tablet 0 0

156
Tablet 0 0
157 Metronidazol Tablet 500 mg
Metronidazol Infus 500
Botol 0 0
158 mg/100 ml
159 Miconazol cream 2% Tube 0 0
160 Mineral Mix sch 0 0
161 Multi vitamin kaplet Tablet 0 1,000 1,000
162 Multi vitamin syrup Botol 48 96 144
Natrium Bikarbonat Tablet
Tablet 100 100
163 500 mg
Natrium Clorida Lrt. Infus
Btl 500ml 0 20 20
164 0,9% Steril
Natrium Diklofenak 25 mg
Tablet 0 0
165 (ktk 50 tab)
Natrium Diklofenak 50 mg
Ampul 200 300 500
166 (ktk 50 tab)
167 Norit tab Ampul 0 0
168 Nifedipin tablet 10 mg Tablet 0 0
Nistatin 500.000 IU/gram Tablet 0 0

169 Tablet Vaginal
Nistatin 100.000 IU/gram
Tablet 0 0
170 Tablet Vaginal
171 Norit Tablet 0 0
Obat Anti tuberkulosis FDC Paket 0 0

172 kategori I
Paket 0 5 5
173 kategori II
Paket 0 0
174 Harian
Obat Anti tuberkulosis
Paket 0 5 5
175 kategori anak
Obat batuk kombinasi
Tablet 0 2,100 2,100
176 tablet /molexflu
Obat batuk kombinasi syrup Botol 60 60

177
178 Obat Batuk Hitam (OBH) Cai Botol 0 0
Obat Saluran Pencernaan
Sch 0 0
179 (Synbio)
180 Ofloxacin tablet 400mg Tablet 0 0
Oksitetrasiklin HCl Salep
Tube 0 0
181 Kulit 3% - 5 g
Oksitetrasiklin HCl Salep
Tube 0 0
182 Mata 1% - 3,5 g
Oksitetrasiklin inj 50
vial 0 0
183 mg/mL-10 mL
Oksitosin Injeksi 10 IU/ml-1
Ampul 321 321
184 ml
185 Omeprazol Kaps 20 mg Kapsul 0 0
Ondansentron 4 mg/2
Ampul 0 0
186 ml inj.
187 Parasetamol drops Botol 0 0
Parasetamol Tablet 500 mg
Tablet 3100 6,000 9,100
188
Parasetamol Sirup 120
Botol 0 0
189 mg/5 ml - 60 ml
190 Peroksida (H2O2) 3% Botol 0 0
191 Permetrim cr tube 30 30
Pirantel Pamoat Tablet 365 tablet 0 0

192
193 Piridoksin HCl. Tablet Tablet 300 1,000 1,300
194 Piroksikam 20 mg Tablet 0 0
196 Polikresulen Botol 0 0
Povidon lodida 10%-30 ml Botol 0 0

197

198

199
Povidon lodida 10%-1000
Botol 0 0
200 ml
201 Prednison Tablet 5 mg Tablet 500 500
202 Procain PP Vial 0 0
Propranolol HCI Tablet 40
Tablet 0 0
203 mg
Propiltiourasil tablet 50 mg Tablet 0 0

204
Tablet 0 0
205 Pyrazinamide tablet 500 mg
206 Ranitidin inj. 50 mg/2ml Ampul 0 0
207 Ranitidin tablet 150 mg Tablet 0 1,500 1,500
208 Reserpin tablet 0,25 mg Tablet 0 0
Retinol (Vit.A) 100.000 IU
Kapsul 0 0
209 Kapsul (biru)
Retinol (Vit.A) 200.000 IU
Kapsul 0 0
210 Kapsul (merah)
Rifampicin tablet salut 450
Tablet 0 0
211 mg
Rifampisin Kapsul 600 mg Kapsul 0 0

212
Ringer Laktat Larutan Infus Botol 20 20

213 Steril-500 ml
Ringer Asetat Larutan Infus
Botol 0 0
214 Steril-500 ml
215 Risperidon 1 mg Tablet 0 0
217 Salbutamol 4 mg Tablet 0 0
218 Salbutamol tablet 2 mg Tablet 200 200 400
219 Salbutamol syrup Botol 0 0
Salbutamol 2.5 mg/2.5 mL

Ampul 10 10
NaCl sol.for inhalation
220
221 Salep 2-4, Kombinasi pot 10 10
Salisil Bedak 2%-50 gram Kotak 0 0

222
Sefadroksil Tablet 500 mg Tablet 0 700 700

223
Sefadroksil sirup kering
botol 0 50 50
224 125mg/5ml
225 Sefotaksim inj 1 g vial 0 0
226 Seftriakson inj 1 g vial 0 0
Serum Anti Bisa Ular Inj.5
vial 0 0
227 ml (ABU I)
Serum Anti Tetanus injeksi vial 0 0

228
Serum Anti Rabies Vero
set 0 0
229 4"s
Serum Antidifteri BP
Vial 10 ml 0 0
230 10.000IU
Sianokobalamin (Vit.B12)
Ampul 0 0
Injeksi 500 mcg/ml-1ml
231
Sianokobalamin (Vit.B12)
Tablet 900 500 1,400
232 Tablet
233 Simetidin tablet 200 mg Tablet 0 0
Simvastatin Tablet 10 mg Tablet 0 0

234
Simvastatin Tablet 20 mg Tablet 0 0

235
236 Siprofloksasin 500 mg Tablet 0 0
237 Stimuno syr Botol 0 0
238 Stimuno forte tab tablet 300 300
Tetrasiklin HCI kapsul 250 Kapsul 0 0

239 mg
Tetrasiklin HCI kapsul 500
Kapsul 0 0
240 mg
Tiamfenikol kapsul 500 mg Kapsul 0 0

241
Tiamin HCI/Mononitrat
Tablet 400 600 1,000
242 (Vit.B1) Tablet 50 mg
Tiamin (Vit B1) inj 100 mg/
Ampul 0 0
243 mL
244 Tramadol inj 50 mg/ mL Ampul 0 0
245 Triheksifenidil Tablet Tablet 0 0
Vitamin Pencernaan
PCS 0 0
246 (Hidrovit)
247 Vitamin Neurotropik Kapsul 0 0
Vitamin B Komplek Tablet 0 0
248 Tablet
Zink dispersible tab 20 mg Tablet 600 1,000 1,600

249
OBAT GIGI 0
Bahan Tumpatan
Sementara Temporary Set/btl 0 0
1 Stoping Fletcher Serbuk
2 CHKM Botol 0 0
mengandung o,1
dexametason, 5 thymol,30g btl 13 ml 0 0
paraklorofenol, 64,9 g
3 champor/ CRESOPHENE
mengandung dexametason
asetat 0.138 g, fenol 45.285
g, guayakol 6.790 g, btl 0 0
gliserol 22.770 g dan amil
asetat 2.400 g ROCKLE
4 'S
5 Devitalisasi Pasta (Non Arse Botol 0 0
6 Etil Klorida Semprot- 100 ml Botol 0 0
7 Eugenol Cairan - 10 ml Botol 0 0
Glass Ionomer Cemen

ART Fuji IX mini pack + 4 Set/btl 0 0
8 ml Liquid
Glass Ionomer
Restoractive Cement
Box 0 0
ART, GC IX HS EXTRA
POSTERIOR
9
10 Kalsium Hidroksida Pasta Botol 0 0
11 Komposit resin pcs 0 0
12 Mummifying Pasta Botol 0 0
13 Pasta Pengisi Saluran Akar botol 0 0
Semen Seng Fosfat Serbuk
Botol 0 0
14 dan Cairan
Silver Amalgam Serbuk 65-
botol 0 0
15 75%
16 Spoon Gelatin Box 0 0
17 Temporary Filling Material Set 0 0
18 Trikresol Formalin (TKF) Botol 0 0
19 antiseptik liquid 0 0
0 0
1 ALKES HABIS PAKAI pcs 0 0
2 Alat suntik sekali pakai 5 ml pcs 300 300
Alat suntik sekali pakai 1 cc pcs 0 0

3
Alat Suntik Sekali Pakai 3
pcs 400 400
4 ml
Alat suntik sekali pakai 10
pcs 100 100
5 ml
Blood lancet 26 G 1 box
Kotak 0 0
6 = 100 Pcs
7 Bistruri pcs 0 0
pcs 0 0
8 ktk=12pcs
Catgut chromic no. 3/0 1 Box 0 0
8 ktk=12pcs
9 Cover glass 20 mm x 20 pcs 0 0
10 Duk Lubang Bulat Pcs 0 0
Folley Catheter No. 18 (for
single use only, steril,
natural rubber latex, 2 way Pcs 0 0
silicone)
11
12 Folley Catheter No.16 set/sachet 0 0
Infusion plester 76 x 40 mm set 0 0

13
14 Infuset Anak set 0 0
15 Infuset Dewasa pcs 0 0
16 IV catheter no. 18 G x 1" pcs 0 0
IV Chateter No-20G x 1
pcs 0 0
17 1/4"
18 IV Catheter no. 22 G x 1" pcs 0 0
19 IV Chateter No-24G Botol 2 2
20 Jelly USG 250 ml Bungkus 0 0
21 Kapas berlemak 500g Bungkus 0 0
Kapas Pembalut/Absorben pcs 0 0

22 250 g
23 Kasa 16/16 Bungkus 0 0
Roll 0 0
24 Kasa Kompres 40/40 steril
Kassa Pembalut Hidrofil 4
Roll 0 0
25 m x 3 cm
Kassa Pembalut Hidrofil 4
Roll 50 50
26 m x 5 cm
Kasa Pembalut 2 m x 80
Roll 13 13
27 cm
Kasa Pembalut Elastis 3
inchi (elastic bandage,
standar ISO 9002,
certificate TUV ukuran 3") Roll 0 0
28
Kasa Pembalut Elastis 4
inchi (elastic bandage,
standar ISO 9002,
certificate TUV ukuran 4") Roll 0 0
29
Kasa Pembalut Hidrofil 4 m
buku/ 20 20
30 x 15 cm
31 Kertas lensa pak 0 0
Kertas puyer
32 pcs 0 0
33 Masker Tali Pcs 450 450
34 Masker N95 0 0
35 Needle 27 box 0 0
Masker Nebulizer Dewasa Roll 0 0

36
37 Masker Nebulizer Anak Roll 10 10
38 Masker Oksigen Anak Roll 0 0
39 Masker o2 Dewasa Set 2 2
Nasal Oksigen canul set 2 2

40 dewasa
pcs 2 2
41 Nasal oksigen canul anak
Plastik obat dgn label dinas
Rol 0 0
42
43 Plester 5 yards x 2 inch sachet 0 0
44 Plester bulat transparant Roll 0 0
45 Sarung Tangan No 7 Roll 0 0
46 Sarung Tangan No 7,5 pot 0 0
47 Pot Dahak pcs 0 0
48 Rak tabung acrylik psg/set 0 0
Sarung Tangan non steril

psg/set 0 0
(S) (box isi 100 pair)
49
Sarung Tangan non steril M psg/set 0 300 300

50
Sarung tangan non steril pcs 150 150

51 uk. L
52 Sendok obat 5 ml pcs 0 0
Silk (Benang Bedah
Rol 6 6
53 Sutra)No.3/0
54 umbilical cord pcs 50 50
55 Under Pad pcs 0 0
56 HBSG pcs 0 0
57 ALAT ACUCHEK pcs 0 0
58 ACHUCEK STIK pcs 0 0
59 Wing needle no. 25 G pcs 0 0
Wing needle no. 27 G pcs 0 0
0 0
1 REAGENSIA pcs 0 0
2 Alkohol swab set 0 0
Antiserum Golongan Darah
btl 0 0
3 ABO 10 mL
4 HRSAG Botol 0 0
5 Asam Asetat 6%-100 mL 0 0
6 Asam Asetat 6%-250 mL Botol 0 0
7 TUBERCULIN Botol 0 0
Di-Ammonium Oxalat GR Botol 0 0

8
9 Di-Ethil eter GR Botol 0 0
Drabskin 500 ml
Botol 0 0
10 (No.Cat.17080)
11 RDT COMBO Botol 0 0
12 EDTA 10% Cair-250 mL pak 100"s 0 0
13 Tube EDTA Botol 0 0
14 Ethanol 70 % 100 ml Botol 1 l 0 0
15 Ethanol 70 % Botol 0 0
16 Giemsa Stok 500 ml Botol 0 0
HCL 0,1 N 100 ml
Botol 0 0
17 (No.Cat.17107)
18 Immersi Oil 100 ml Botol 0 0
Iodine Test Solution-10 ml set/pak 0 0

19
Botol 0 0
20 lembar/set/ktk
Larutan Antiseptik Clorine
Botol 0 0
21 5.25% - 500 cc
Larutan Cat Gram Set- 100
Botol 0 0
22 ml
Methanol GR for analysis

ACS,ISO-500 ml(No.Cat. Botol 0 0
106009.1000)
23
24 Methanol 100 ml 0 0
25 Methil alkohol Botol 0 0
26 Natrium Sitrat 3,8% pak 0 0
27 PH Indikator 0-14 Box 0 0
Reagen Test Kehamilan
box 0 0
28 Strip
29 Spiritus 1 L Tube 0 0
Stick Urine 10 Parameter Tube 0 0

30
31 Stick Asam Urat Tube 0 0
32 Stick Gula Darah Tube 0 0
33 Stick Kolesterol Botol 0 0
Turk 100 ml (No.Cat.17126) Botol 0 0

34
35 Xylol 100 mL 0 0
36 Xylol 250 mL Kotak 0 0
Zeil Nelson (ZN set) 100
c 0 0
37 ml) No.Cat. 17134)
38 Hepatitis c pcs 0 0
39 Rapid Test HIV 1/2 SD pcs 0 0
40 Rapid Test HIV 1/2 Intect pcs 0 0
41 Rapid Test HIV 1/2 Vikia (rap pcs 0 0
42 Rapid Test Syphilis piece 0 0
43 Reagen 1 HIV Test Kit piece 0 0
45 Reagen 3 HIV Test Kit Botol 200 200
46 Stericid 5 l Botol 2 2
47 Stericid 500 ml Botol 0 0
48 Softanol 500 ml botol 0 0
48 nurse cap (covid) pcs 0 0
48 sarung tangan (covid) box 0 0
49 handsanitizer 5L (covid) botol 0 0
REKAPITULASI PEMAKA
3 4 5 6 7 8 9 10 11
600
500
100
500
300
20
150
20
24
100
24
600
24
200 300
500
200
10
1000
300
200 300
200
10
400
200
300
200
REKAPITULASI PEMAKAIAN OBAT GUDANG
TOTAL PENGELUARAN SESUAI TANGGAL
12 13 14 15 16 17 18 19 20
400
300 500
600 300
400
60
400
300
300
500 500
100
100
48
200
300
500
600
200 400
500
200 400
400 400
48
300
1000 1200
300
300
200 300
400
150
400
100
1
3
21 22 23 24 25 26 27 28 29
500
200
100
200
400
10
200
300
1200
400
SISA STOK
TOTAL
AKHIR
30 PER BLN BLN
- -
600 -
400 -
- -
- -
- -
- -
- -
- -
- -
800 1,000
900 300
- -
1,400 1,500
- -
60 60
100 -
- -
900 1,100
- 60
- -
- -
- -
- -
- -
300 -
- -
- -
600 400
- -
200 900
20 20
- -
100 700
- -
- -
150 450
20 30
- 20
- -
- -
- -
- 50
1,000 -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 100
- -
- -
- -
- -
200 300
- -
- -
- -
- -
- -
- -
- -
- 4
- -
- -
- -
24 -
- -
- -
- -
100 -
- -
200 900
- -
- 4
72 72
- -
- -
- -
- -
200 -
1,000 600
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
300 -
24 24
- -
- -
- -
1,000 1,500
- -
- -
- -
- -
- -
- -
1,100 900
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 25
600 500
- -
- -
- -
- -
500 -
- -
200 -
20 10
- -
- -
- 10
- 500
- -
- -
600 400
- -
- -
- -
- 10
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
800 200
48 96
- 100
- 20
- -
500 -
- -
- -
- -
- -
- -
- -
- 5
- -
- 5
300 1,800
- 60
- -
- -
- -
- -
- -
- -
- 321
- -
- -
- -
4,400 4,700
- -
- -
- 30
- -
600 700
- -
- -
- -
- -
- -
- -
- -
- 500
- -
- -
- -
- -
- -
800 700
- -
- -
- -
- -
- -
- 20
- -
- -
- -
- -
200 200
- -
- 10
10 -
- -
500 200
- 50
- -
- -
- -
- -
- -
- -
- -
800 600
- -
- -
- -
- -
- -
150 150
- -
- -
- -
600 400
- -
- -
- -
- -
- -
- -
700 900
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 300
- -
100 300
- 100
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 2
- -
- -
- -
- -
- -
- -
- 50
1 12
- -
- -
- 20
- -
- -
200 250
- -
- -
- -
- 10
- -
- 2
- 2
- 2
- -
- -
- -
- -
- -
- -
- -
- -
- 300
- 150
- -
3 3
- 50
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- 200
- 2
- -
- -
- -
- -
- -
LAPORAN PEMASUKAN PENGELUARAN OBAT DAN BAHAN HABIS PA
NAMA OBAT AWAL STOK PEMASUKAN

OBAT APRIL MEI
1 Albendazol Tablet 400 mg Tablet 0
2 Acethylcystein Tablet 0 1800
3 Alopurinol Tablet 100 mg Tablet 24 500
4 Alopurinol Tablet 300 mg Tablet 0
5 Alprazolam 1 mg Tablet 0
6 Ambroksol tablet 30 mg Tablet 0
7 Ambroksol sirup 15 mg/ml 1 krt=50 btl Botol 0
8 Bisakodil supp supp 6
9 Aminofilin Tablet 200 mg Tablet 0
10 Amitriptilin HCl Tablet Salut 25 mg Tablet 1069
11 Amlodipin tablet 10 mg Tablet 1138 500 300
12 Amlodipin tablet 5 mg Tablet 748 600 300
13 Amoksisilin + As. Klavulanat 625 mg Tablet 0
14 Amoksisilin 500 mg kaplet 1460 2000 1400
15 Amoksisilin 250 mg kapsul 0
16 Amoksisilin Sirup Kering Forte 250 mg/5 ml Botol 128 60
17 Amoksisilin Sirup Kering 125 mg/5 ml Botol 154
18 Asetilsestein caps capsul 0
19 Antasida DOEN Tablet Kombinasi Tablet 1096 2000
20 Antasida DOEN Suspensi Botol 96 60
21 Anti Bakteri DOEN Salep Kombinasi : Basitrasin +Tube 0
22 Antifungi DOEN Kombinasi Pot 0
23 Antimigren DOEN Kombinasi : Ergotamin TartratTablet 0
24 Anti Hemorhoid DOEN ktk 10 supp. Supp 65
25 Antidiare Syrup Botol 0
26 Antidiare Tablet Tablet 300 150
27 Aqua Proinjeksi Steril,Bebas Pirogen 20 ml Ampul 30
28 Asam asetilsalisilat/Asetosal 100 mg tab Tablet 0
29 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 423 600
30 Asam Askorbat (Vit. C) Tablet 250 mg Tablet 0
31 Asam Mefenamat 500 mg Tablet Tablet 1050 500 500
32 Asiklovir Cream 5% - 5 g Tube 36 20
33 Asikclovir Tablet 200 mg Tablet 0
34 Asiklovir tablet 400 mg Tablet 691
35 Atropin injeksi l.m/lv/s.k. 0,25 mg/mL - 1 mL (sulAmpul 0
36 Besi (II) Sulfat + Asam Folat (Tablet Tambah Da Tablet 0
37 Betahistin mesilat 6 mg tab Tablet 811
38 Betametason Krim 0,1%-5g Tube 50 50
39 Bioplacenton Gel Tube 31
40 Borax Gliserin Botol 39
41 Bromhexin 8 mg tab Tablet 0
42 Bromhexin Syrup Botol 0
43 Cetirizin sirup 5 mg/5ml Botol 95
44 Cetirizin 10 mg Kapsul 611
45 VITALEX Tablet 0
46 Cendo Xitrol TM Botol 0
47 Cendo Lyters TM Botol 0
48 Clozapin 25 mg (KTK 50 TAB) Tablet 170
49 Deksametason Injeksi 5 mg/ml-1 ml Ampul 0
50 Deksametason Tablet 0,5 mg Tablet 312
51 Dekstran 70- larutan infus 6% steril btl 500 ml 0
52 Diazepam Rectal Supp 7
53 Diazepam Injeksi 5 mg/ml-2 ml Ampul 2
54 Diazepam Tablet 2 mg Tablet 377
55 Dietilkarbamazin sitrat (DEC) tab 100 mg Tablet
56 Difenhidramin HCl Inj 10 mg/ml-1 ml Ampul 10
57 Dimenhydrinate 50 mg Tablet 156
58 Digoksin Tablet 0,25 mg Tablet 0
59 Doksisiklin 100 mg kapsul 0
60 Domperidon Tablet 10 mg Tablet 200 500
61 Domperidon suspensi 5 mg/5ml mg Botol 0
62 Efinephrin 1mg/ml inj ampul 0
63 Etambutol tablet 500 mg Tablet 0
64 Eritromisin 250 mg Kapsul Tablet 0
65 Eritromisin 500 mg Kapsul Kaplet 0
66 Eritromisin Sirop 200 mg /5ml Btl 60 ml 8
67 Etakridin (Rrivanol) Larutan 0,1%-300 ml Botol 0
68 Fenobarbital Injeksi 50 mg/ml -2 ml Ampul 0
69 Fenobarbital tablet 30 mg Tablet 0
70 Fluconazole 150 mg Tablet 0
71 Fenoksimetil penisilinTablet 500 mg Tablet 0
72 Fenol Gliserol Tetes Telinga 10% - 5 ml Botol 38
73 Fitomenadion (Vit. K1) tablet 10 mg Tablet 8
74 Fitomenadion (Vit. K1) Injeksi 10 mg/ml-1 ml Ampul 0
75 Fluoksetin (Prestin) 20 mg KTK 50 TAB Kapsul 0
76 Furosemid Tablet 40 mg Tablet 138 200
77 Furosemid inj 10 mg/mL Ampul 0
78 Garam Oralit 200 ml air kantong 557
79 Gentamisin 0,3% TM fls 31
80 Gentamisin inj 40 mg/ 2 mL Ampul 4
81 Gentamisin Salep Kulit 0,1% - 5 g Tube 11 120 60
82 Gentamisin Salep Mata 0,3 % Tube 17
83 Gentian Violet Larutan 1% - 10 ml botol 0
84 Glimepirid 1 mg tablet 2
85 Glibenklamid Tablet 5 mg Tablet 433
86 Glimepiride 2 mg Tablet 183 200
87 Gliseril Guaikolat Tablet 100 mg Tablet 335 1700
88 Gliseril Guaikolat 25mg/5ml syrup botol 0
89 Gliserin Btl 100 ml 0
90 Glukosa Larutan Infus 40% Steril 25 mL Ampul 0
91 Glukosa Larutan Infus 10% Steril 500 ml Botol 0
92 Glukosa Larutan Infus 5% Steril 500 ml Botol 0
93 Griseofulvin Tablet 125 mg, Micronized Tablet 0
94 Haloperidol injeksi 5 mg Ampul 0
95 Haloperidol Dekanoat Injeksi 50 mg/ml Ampul 15
96 Haloperidol drops 2 mg/ml Botol 0
97 Haloperidol 0,5 mg Tablet Tablet 0
98 Haloperidol 1,5 mg Tablet Tablet 473
99 Haloperidol 2 mg Tablet Tablet 0
100 Haloperidol tablet 5 mg ktk 102 Tablet 2206
101 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 88 500
103 Hyoscine-N-butilbromide tablet 10mg Tablet 0
104 Ibuprofen suspensi 200 mg/5 ml botol 0
105 Ibuprofen Tablet 200 mg Tablet 0
106 Ibuprofen Tablet 400 mg Tablet 635 1500 300
107 Ichtyol Salep Pot 0
108 Isoniazid tablet 100mg Tablet 0
110 Isosorbid Dinitrat sublingual tab 5 mg Tablet 150
111 Kalium Permanganat Serbuk - 5 g Pot 0
112 Kalsium Glukonas Inj. 100 mg/ml Ampul 0
113 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 680 1500 300
114 Kaptopril Tablet 12,5 mg Tablet 0
115 Kaptopril tablet 25 mg ktk 100 tab Tablet 0
116 Kaptopril Tablet 50 mg Tablet 0
117 Karbamazepin Tablet 200 mg Tablet 0
118 Ketokonazol cream Tube 0
119 Ketokonazol tab 200 mg (ktk 50 tab) Tablet 167 200
120 Ketoprofen 100 mg Tablet 0
121 Ketoprofen Inj 100 mg Ampul 0
122 Ketoprofen Inj 50 mg/ml Ampul 2ml 0
123 Ketorolac inj. 30 mg Ampul 0
124 Klindamisin kapsul 300mg Kapsul 0
125 Klobazam 10 mg (kotak 100 tab) Tab 0
126 Klopidogrel tab 75 mg (KOTAK 30 TAB) Tablet 0
127 Kloramfenikol Kapsul 250 mg Kapsul 0
128 Kloramfenikol Salep Kulit 1% Tube 0
129 Kloramfenikol Salep Mata 1% - 3,5 g Tube 0
130 Kloramfenikol Tetes Telinga 3% Botol 15 25
131 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 300 800 300
132 Klorpromazin tablet salut 100 mg btl 1000 ta Tablet 0
133 Kodein tablet 10mg btl 250 tab Tablet 0
134 Kotrimoksazol Pediatrik Tablet, Tablet 0
135 Kotrimoksazol Suspensi Kombinasi Botol 99
136 Kotrimoksazol Tablet Kombinasi/Dewasa: Tablet 302 300
137 Lansoprazole kapsul 30 mg Kapsul 0
138 Lisinipril 5 mg tablet 280 200
140 Loratadin Tablet 633 400 100
141 Loperamid (HCl) 2 mg Tablet 0
142 Magnesium Sulfas Inj. 40%-25ml vial 10
143 Magnesium Sulfas Inj. 20%-25ml supp 8
144 Meloksikam tablet 15 mg Tablet 659
145 Metampiron Injeksi 250 mg/ml-2 ml Ampul 0
146 Metampiron Tablet 500 mg Tablet 0
147 Metformin HCl 500 mg tab Tablet 866 400
148 Metformin HCl 850 mg tab Tablet 0
149 Metildopa Tablet 250 mg Tablet
150 Metilergometrin Tablet Salut 0,125 g Tablet 75
151 Metilergometrin Maleat Injeksi 0,200 mg/ml Ampul 10
152 Metilprednison tablet 4 mg Tablet 560
153 MDT PB Tablet 0
154 MDT MB Ampul 0
155 Metoklopramide tablet 10 mg Tablet 0
156 MDT KUSTA ANAK Tablet 0
157 Metronidazol Tablet 250 mg Tablet 0
159 Metronidazol Infus 500 mg/100 ml Botol 0
160 Miconazol cream 2% Tube 0
161 Mineral Mix sch 0
162 Multi vitamin kaplet Tablet 0
163 Multi vitamin syrup Botol 0 144
164 Natrium Bikarbonat Tablet 500 mg Tablet 100
165 Natrium Clorida Lrt. Infus 0,9% Steril Btl 500ml 10
166 Natrium Diklofenak 25 mg (ktk 50 tab) Tablet 0
167 Natrium Diklofenak 50 mg (ktk 50 tab) Ampul 542 700 500
168 Norit tab Ampul 40
169 Nifedipin tablet 10 mg Tablet 90
170 Nistatin 500.000 IU/gram Tablet Vaginal Tablet 0
171 Nistatin 100.000 IU/gram Tablet Vaginal Tablet 57
172 Norit Tablet 40
173 Obat Anti tuberkulosis FDC kategori I Paket 0
174 Obat Anti tuberkulosis FDC kategori II Paket 0
175 Obat Anti tuberkulosis FDC Harian Paket 0
176 Obat Anti tuberkulosis kategori anak Paket 0
177 Obat batuk kombinasi tablet Tablet 383 1800 900
178 Obat batuk kombinasi syrup Botol 72
179 Obat Batuk Hitam (OBH) Cairan- 100 ml Botol 0
180 Obat Saluran Pencernaan (Synbio) Sch 0
181 Ofloxacin tablet 400mg Tablet 0
182 Oksitetrasiklin HCl Salep Kulit 3% - 5 g Tube 0
183 Oksitetrasiklin HCl Salep Mata 1% - 3,5 g Tube 0
184 Oksitetrasiklin inj 50 mg/mL-10 mL vial 0
185 Oksitosin Injeksi 10 IU/ml-1 ml Ampul 321
186 Omeprazol Kaps 20 mg Kapsul 445
187 Ondansentron 4 mg/2 ml inj. Ampul 0
188 Parasetamol drops Botol 0
189 Parasetamol Tablet 500 mg Tablet 1490 7000 3000
190 Parasetamol Sirup 120 mg/5 ml - 60 ml Botol 0
191 Peroksida (H2O2) 3% Botol 0
192 Permetrim cr tube 68
193 Pirantel Pamoat Tablet 365 tablet 0
194 Piridoksin HCl. Tablet Tablet 1070 500 300
196 Piroksikam 10 mg Tablet 0
197 Polikresulen Botol 0
198 Povidon lodida 10%-30 ml Botol 0
202 Prednison Tablet 5 mg Tablet 617
203 Procain PP Vial 0
204 Propranolol HCI Tablet 40 mg Tablet 0
205 Propiltiourasil tablet 50 mg Tablet 0
206 Pyrazinamide tablet 500 mg Tablet 0
207 Ranitidin inj. 50 mg/2ml Ampul 0
208 Ranitidin tablet 150 mg Tablet 592 1000 500
209 Reserpin tablet 0,25 mg Tablet 0
210 Retinol (Vit.A) 100.000 IU Kapsul (biru) Kapsul 0
211 Retinol (Vit.A) 200.000 IU Kapsul (merah) Kapsul 0
212 Rifampicin tablet salut 450 mg Tablet 0
213 Rifampisin Kapsul 600 mg Kapsul 0
214 Ringer Laktat Larutan Infus Steril-500 ml Botol 0
215 Ringer Asetat Larutan Infus Steril-500 ml Botol 0
216 Risperidon 1 mg Tablet 0
217 Risperidon 2 mg Tablet 4126
218 Salbutamol 4 mg Tablet 0
219 Salbutamol tablet 2 mg Tablet 416 200
220 Salbutamol syrup Botol 0
221 Salbutamol 2.5 mg/2.5 mL NaCl sol.for inhalatio Ampul 10
222 Salep 2-4, Kombinasi pot 24 20
223 Salisil Bedak 2%-50 gram Kotak 0
224 Sefadroksil Tablet 500 mg Tablet 444 1000 300
225 Sefadroksil sirup kering 125mg/5ml botol 66
226 Sefotaksim inj 1 g vial 0
227 Seftriakson inj 1 g vial 0
228 Serum Anti Bisa Ular Inj.5 ml (ABU I) vial 0
229 Serum Anti Tetanus injeksi vial 0
230 Serum Anti Rabies Vero 4"s set 0
231 Serum Antidifteri BP 10.000IU Vial 10 ml 0
232 Sianokobalamin (Vit.B12) Injeksi 500 mcg/ml-1mAmpul 0
233 Sianokobalamin (Vit.B12) Tablet Tablet 987 500
234 Simetidin tablet 200 mg Tablet 0
235 Simvastatin Tablet 10 mg Tablet 287 500
236 Simvastatin Tablet 20 mg Tablet 0
237 Siprofloksasin 500 mg Tablet 0
238 Stimuno syr Botol 55
239 Stimuno forte tab tablet 877 1200 300
240 Tetrasiklin HCI kapsul 250 mg Kapsul 0
242 Tiamfenikol kapsul 500 mg Kapsul 0
243 Tiamin HCI/Mononitrat (Vit.B1) Tablet 50 mg Tablet 735 600
244 Tiamin (Vit B1) inj 100 mg/ mL Ampul 0
245 Tramadol inj 50 mg/ mL Ampul 0
246 Triheksifenidil Tablet Tablet 4018
247 Vitamin Pencernaan (Hidrovit) PCS 0
248 Vitamin Neurotropik Kapsul 0
249 Vitamin B Komplek Tablet Tablet 1234 700
250 Zink dispersible tab 20 mg Tablet 153 700 1000
OBAT GIGI 0
Bahan Tumpatan Sementara Temporary Stoping Fletcher S 0
CHKM Set/btl 0
1 Desinfeksi saluran akar gigi mengandung o,1 d Botol 0
2 Desinfeksi saluran akar gigi mengandung dexametabtl 13 ml 0
3 Devitalisasi Pasta (Non Arsen) btl 0
4 Etil Klorida Semprot- 100 ml Botol 0
5 Eugenol Cairan - 10 ml Botol 0
6 Glass Ionomer Cemen ART Fuji IX mini pack + 4 mBotol 0
7 Glass Ionomer Restoractive Cement ART, GC IX Set/btl 0
8 Kalsium Hidroksida Pasta Box 0
9 Komposit resin Botol 0
10 Mummifying Pasta pcs 0
11 Pasta Pengisi Saluran Akar Botol 0
12 Semen Seng Fosfat Serbuk dan Cairan botol 0
13 Silver Amalgam Serbuk 65-75% Botol 0
14 Spoon Gelatin botol 0
15 Temporary Filling Material Box 0
16 Trikresol Formalin (TKF) Set 0
17 antiseptik liquid Botol 0
18 0
19 ALKES HABIS PAKAI 0
Alat suntik sekali pakai 5 ml pcs 300
1 Alat suntik sekali pakai 1 cc pcs 0
2 Alat Suntik Sekali Pakai 3 ml pcs 300 200
3 Alat suntik sekali pakai 10 ml pcs 100
4 Blood lancet 26 G 1 box = 100 Pcs pcs 0
5 Bistruri Kotak 0
6 Catgut chromic no. 2/0 1 ktk=12pcs pcs 0
7 Catgut chromic no. 3/0 1 ktk=12pcs pcs 0
8 Cover glass 20 mm x 20 mm Box 0
8 Duk Lubang Bulat pcs 0
9 Folley Catheter No. 18 (for single use only, steril Pcs 0
10 Folley Catheter No.16 Pcs 0
11 Infusion plester 76 x 40 mm set/sachet 0
12 Infuset Anak set 0
13 Infuset Dewasa set 2
14 IV catheter no. 18 G x 1" pcs 0
15 IV Chateter No-20G x 1 1/4" pcs 0
16 IV Catheter no. 22 G x 1" pcs 0
17 IV Chateter No-24G pcs 2
18 Jelly USG 250 ml Botol 0
19 Kapas berlemak 500g Bungkus 0
20 Kapas Pembalut/Absorben 250 g Bungkus 0
21 Kasa 16/16 pcs 0
22 Kasa Kompres 40/40 steril Bungkus 0
23 Kassa Pembalut Hidrofil 4 m x 3 cm Roll 0
25 Kasa Pembalut 2 m x 80 cm Roll 13
26 Kasa Pembalut Elastis 3 inchi (elastic bandage, Roll 0
27 Kasa Pembalut Elastis 4 inchi (elastic bandage, Roll 0
28 Kasa Pembalut Hidrofil 4 m x 15 cm Roll 20
29 Kertas lensa buku/ 0
30 Kertas puyer pak 0
31 Masker Tali pcs 650
32 Masker N95 Pcs 0
33 Needle 27 Pcs 0
34 Masker Nebulizer Dewasa Pcs 0
35 Masker Nebulizer Anak Pcs 10
36 Masker Oksigen Anak Pcs 0
37 Masker o2 Dewasa Pcs 2
38 Nasal Oksigen canul dewasa Pcs 2
39 Nasal oksigen canul anak Pcs 2
40 Plastik obat dgn label dinas pcs 0
41 Plester 5 yards x 2 inch Rol 0
42 Plester bulat transparant sachet 0
43 Sarung Tangan No 7 Roll 0
44 Sarung Tangan No 7,5 Roll 0
45 Pot Dahak pcs 0
46 Rak tabung acrylik pcs 0
47 Sarung Tangan non steril (S) (box isi 100 pair) psg/set 0
48 Sarung Tangan non steril M psg/set 50 300
49 Sarung tangan non steril uk. L psg/set 200
50 Sendok obat 5 ml pcs 0
51 Silk (Benang Bedah Sutra)No.3/0 pcs 11
52 umbilical cord pcs 50
53 Under Pad pcs 0
54 HBSG pcs 0
55 ALAT ACUCHEK pcs 0
56 ACHUCEK STIK pcs 0
57 Wing needle no. 25 G pcs 0
58 Wing needle no. 27 G pcs 0
59 0
REAGENSIA 0
Alkohol swab pcs 0
1 Antiserum Golongan Darah ABO 10 mL set 0
2 HRSAG btl 0
3 Asam Asetat 6%-100 mL Botol 0
4 Asam Asetat 6%-250 mL 0
5 TUBERCULIN Botol 0
6 Di-Ammonium Oxalat GR Botol 0
7 Di-Ethil eter GR Botol 0
8 Drabskin 500 ml (No.Cat.17080) Botol 0
9 RDT COMBO Botol 0
10 EDTA 10% Cair-250 mL Botol 0
11 Tube EDTA pak 100"s 0
12 Ethanol 70 % 100 ml Botol 0
13 Ethanol 70 % Botol 1 l 0
14 Giemsa Stok 500 ml Botol 0
15 HCL 0,1 N 100 ml (No.Cat.17107) Botol 0
16 Immersi Oil 100 ml Botol 0
17 Iodine Test Solution-10 ml Botol 0
18 Kartu Golongan Darah 100 lembar/set/ktk set/pak 0
19 Larutan Antiseptik Clorine 5.25% - 500 cc Botol 0
20 Larutan Cat Gram Set- 100 ml Botol 0
21 Methanol GR for analysis ACS,ISO-500 ml(No.Ca Botol 0
22 Methanol 100 ml Botol 0
23 Methil alkohol 0
24 Natrium Sitrat 3,8% Botol 0
25 PH Indikator 0-14 pak 0
26 Reagen Test Kehamilan Strip Box 0
27 Spiritus 1 L box 0
28 Stick Urine 10 Parameter Tube 0
29 Stick Asam Urat Tube 0
30 Stick Gula Darah Tube 0
31 Stick Kolesterol Tube 0
32 Turk 100 ml (No.Cat.17126) Botol 0
33 Xylol 100 mL Botol 0
34 Xylol 250 mL 0
35 Zeil Nelson (ZN set) 100 ml) No.Cat. 17134) Kotak 0
36 Hepatitis c c 0
37 Rapid Test HIV 1/2 SD pcs 0
38 Rapid Test HIV 1/2 Intect pcs 0
39 Rapid Test HIV 1/2 Vikia (rapid 3) pcs 0
40 Rapid Test Syphilis pcs 0
41 Reagen 1 HIV Test Kit piece 0
44 Stericid 5 l Botol 200
45 Stericid 500 ml Botol 2
46 Softanol 500 ml botol 0
47 nurse cap (covid) pcs 0
48 sarung tangan (covid) 0
48 handsanitizer 5L (covid) 0
48 Tuberkulin test 0
OBAT DAN BAHAN HABIS PAKAI TRIWULAN 2
PEMASUKAN PENGELUARAN AKHIR

JUNI total APRIL MEI JUNI total STOK
0 0 0 0 0 0 0 0
1800 245 920 582 1747 1800 53 0
400 900 95 249 96 440 924 484 24
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 6 0 6 6 0 6
0 0 0 0 0 0 0 0
0 80 32 35 147 1069 922 1069
1800 2600 571 1177 750 2498 3738 1240 238
1200 2100 497 1130 863 2490 2848 358 148
0 0 0 0 0 0 0 0
2000 5400 1360 2198 1486 5044 6860 1816 460
0 0 0 0 0 0 0 0
60 120 48 54 56 158 248 90 8
0 18 33 30 81 154 73 54
0 0 0 0 0 0 0 0
1000 3000 739 1106 518 2363 4096 1733 396
60 120 32 70 40 142 216 74 36
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 9 13 0 22 65 43 65
0 0 0 0 0 0 0 0
300 450 77 321 200 598 750 152 0
0 0 0 0 0 30 30 30
0 0 0 0 0 0 0 0
600 1200 186 437 276 899 1623 724 223
0 0 0 0 0 0 0 0
1000 392 425 153 970 2050 1080 450
20 0 6 5 11 56 45 16
0 0 0 0 0 0 0 0
400 400 0 225 109 334 1091 757 191
0 0 0 0 0 0 0 0
0 1090 1090 0 -1090
0 32 137 132 301 811 510 211
30 80 24 23 24 71 130 59 20
0 3 1 0 4 31 27 11
0 8 8 13 29 39 10 15
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 95 95 45
1000 1000 611 0 615 1226 1611 385 211
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 15 30 0 45 170 125 170
0 0 0 0 0 0 0 0
0 312 0 0 312 312 0 312
0 0 0 0 0 0 0 0
0 0 0 0 0 7 7 7
0 0 0 0 0 2 2 2
0 18 2 0 20 377 357 377
0 0 0 0 0 0 0 0
0 0 0 0 0 10 10 10
0 64 30 6 100 156 56 156
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
500 1000 184 270 226 680 1200 520 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 4 4 0 8 8 0 8
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 8 5 6 19 38 19 14
0 8 0 0 8 8 0 8
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
100 300 88 75 36 199 438 239 138
0 0 0 0 0 0 0 0
1000 1000 93 319 187 599 1557 958 57
0 4 4 5 13 31 18 31
0 0 0 0 0 4 4 0
120 300 46 102 76 224 311 87 11
0 6 11 0 17 17 0 17
0 0 0 0 0 0 0 0
0 0 0 0 0 2 2 2
0 100 110 132 342 433 91 33
200 400 70 90 125 285 583 298 183
1000 2700 617 709 673 1999 3035 1036 335
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 15 15 15
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 60 60 473 413 473
0 0 0 0 0 0 0 0
0 120 124 92 336 2206 1870 2206
500 78 109 112 299 588 289 88
24 4 21 15 40 76 36 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
2000 3800 711 1224 735 2670 4435 1765 235
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 150 150 150
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1000 2800 292 983 1015 2290 3480 1190 180
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
200 20 87 56 163 367 204 167
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
25 4 1 4 9 40 31 0
1000 2100 291 684 738 1713 2400 687 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 99 99 99
500 800 168 330 222 720 1102 382 302
0 0 0 0 0 0 0 0
200 50 40 130 220 480 260 280
60 0 10 40 50 60 10 0
500 273 860 0 1133 1133 0 133
0 0 0 0 0 0 0 0
0 0 0 0 0 10 10 0
0 0 0 0 0 8 8 0
0 16 16 18 50 659 609 159
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1000 1400 340 675 610 1625 2266 641 266
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 116
0 10 0 0 10 75 65 75
0 0 0 0 0 10 10 0
0 175 385 0 560 560 0 560
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1000 1000 0 0 546 546 1000 454 0
96 240 12 68 55 135 240 105 0
0 0 0 0 0 100 100 0
20 20 10 0 0 10 30 20 0
0 0 0 0 0 0 0 0
300 1500 414 866 589 1869 2042 173 142
0 0 0 0 0 40 40 40
0 5 13 1 19 90 71 90
0 0 0 0 0 0 0 0
0 0 7 21 28 57 29 57
0 0 0 0 0 40 40 40
0 0 0 0 0 0 0 0
5 5 0 0 5 5 5 0 0
0 0 0 0 0 0 0 0
5 5 0 0 5 5 5 0 0
2100 4800 1269 1299 688 3256 5183 1927 383
0 0 0 0 0 72 72 12
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 321 321 0
0 143 275 27 445 445 0 45
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
6000 16000 3190 5095 3874 12159 17490 5331 290
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 6 19 4 29 68 39 8
0 0 0 0 0 0 0 0
1000 1800 510 981 402 1893 2870 977 170
200 22 46 72 140 388 248 188
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 117 0 0 117 617 500 117
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1500 3000 826 1166 786 2778 3592 814 192
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 390 212 300 902 4126 3224 4126
0 0 0 0 0 0 0 0
200 400 116 242 142 500 816 316 116
0 0 0 0 0 0 0 0
0 0 0 0 0 10 10 0
20 11 19 14 44 44 0 4
0 0 0 0 0 0 0 0
700 2000 642 850 644 2136 2444 308 144
50 50 5 15 20 40 116 76 6
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
500 1000 219 327 399 945 1987 1042 187
0 0 0 0 0 0 0 0
500 160 320 255 735 787 52 287
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 17 25 13 55 55 0 7
1500 218 344 105 667 2377 1710 97
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
600 1200 332 391 440 1163 1935 772 135
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 465 306 486 1257 4018 2761 4018
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
700 616 1112 206 1934 1934 0 234
1000 2700 155 843 490 1488 2853 1365 153
0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 300 300
0 0 0 0 0 0
200 0 300 300 500 200
0 0 0 0 100 100
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 1 1 2 2 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 2 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 9 10 19 69 50
0 0 0 0 13 13
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 20 20
0 0 0 0 0 0
0 0 0 0 0 0
0 150 50 200 650 450
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 10 10
0 0 0 0 0 0
0 0 0 0 2 2
0 0 0 0 2 2
0 0 0 0 2 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
300 600 200 300 500 650 150
0 50 0 50 200 150
0 0 0 0 0 0
0 0 5 5 11 6
0 0 0 0 50 50
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 200 200
0 0 0 0 2 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0
0
0
0
0
0
0
0
0
0
0
900
600
0
1000
0
120
100
0
700
60
0
0
0
0
0
300
0
0
200
0
600
20
0
500
0
0
600
30
20
24
0
0
50
400
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
200
0
0
0
0
0
0
0
4
0
0
0
24
0
0
0
0
0
500
0
4
0
0
0
400
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
48
0
0
0
400
0
0
0
0
0
0
500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
300
0
0
0
0
0
0
0
0
500
0
10
8
500
0
0
600
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
100
10
0
400
0
0
0
0
0
0
0
0
0
0
60
0
0
0
0
0
0
321
400
0
0
1200
0
0
60
0
900
0
0
0
0
0
0
0
500
0
0
0
0
0
400
0
0
0
0
0
0
0
0
0
0
300
0
10
20
0
300
60
0
0
0
0
0
0
0
800
0
0
0
0
48
780
0
0
0
600
0
0
0
0
0
1000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
300
0
300
100
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
69
13
0
0
20
0
0
650
0
0
0
10
0
2
2
2
0
0
0
0
0
0
0
0
50
200
0
11
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
2
0
0
0
0
LEMBAR BANTU LAPORAN
B
SATUAN SISA TOTAL PENERIMAAN

NO NAMA OBAT
GDG SISA Lain 2 DAK APBD II ASK
1 2 3 5 6 7 8 9 10
1 Albendazol Tablet 400 mg Tablet 0

4 Ambroksol tablet 30 mg Tablet 0
Ambroksol sirup 15 mg/ml 1 krt=50
Botol 0
5 btl
6 Aminofilin Injeksi 24 mg/ml-10ml Ampul 0
7 Amok Forte Syr Botol 0
8 Amitriptilin HCl Tablet Salut 25 mg Tablet 0
9 Amlodipin tablet 10 mg Tablet 0
10 Amlodipin tablet 5 mg Tablet 0
11 Amoksisilin 500 mg kaplet 0
12 Amoksisilin 250 mg kapsul 0
Amoksisilin Sirup Kering 125 mg/5 ml Botol 0
13
14 Ampicillin serbuk inj. 1000mg/ml Vial 0
15 Antasida DOEN Tablet Kombinasi Tablet 0
16 Antasida DOEN Suspensi Botol 0
Anti Bakteri DOEN Salep Kombinasi :
Basitrasin + Polimiksin 1 ktk = 25 Tube 0
17 tube
18 Antifungi DOEN Kombinasi Pot 0
Antimigren DOEN Kombinasi :
19 Tablet 0
Ergotamin Tartrat + Kofein
Anti Hemorhoid DOEN ktk 10
Supp 0
20 supp.
21 Antidiare Syrup Botol 0
22 Antidiare Tablet Tablet 0
Aqua Proinjeksi Steril,Bebas Pirogen
23 Ampul 0
20 ml
24 Asam Askorbat (Vit. C) Tablet 250 mg Tablet 0
Asam Askorbat (Vit. C) Tablet 50 mg Tablet 0

25
26 Asam Mefenamat 500 mg Tablet Tablet 0
27 Asiklovir Cream 5% - 5 g Tube 0
28 Asikclovir Tablet 200 mg Tablet 0
29 Asiklovir tablet 400 mg Tablet 0
Atropin injeksi l.m/lv/s.k. 0,25 mg/mL -
Ampul 0
30 1 mL (sulfat) ktk 30 amp
Besi (II) Sulfat 200 mg + Asam Folat
0,25 mg (Tablet Tambah Darah Tablet 0
31 Kombinasi)
32 Betahistin mesilat 6 mg tab Tablet 0
33 Betametason Krim 0,1%-5g Tube 0
34 Bioplacenton Gel Tube 0
35 Borax Gliserin Botol 0
36 Bromhexin 8 mg tab Tablet 0
37 Bromhexin Syrup Botol 0
38 Cetirizin sirup 5 mg/5ml Botol 0
39 Cetirizin tablet 10 mg Tablet 0
40 Cendo Catarlen TM Botol 0
41 Cendo Xitrol TM Botol 0
42 Cendo Lyters TM Botol 0
43 Deksametason Injeksi 5 mg/ml-1 ml Ampul 0
44 Deksametason Tablet 0,5 mg Tablet 0
45 Dekstran 70- larutan infus 6% steril btl 500 ml 0
46 Diazepam Rectal Supp 0
47 Diazepam Injeksi 5 mg/ml-2 ml Ampul 0
48 Diazepam Tablet 2 mg Tablet 0
Dietilkarbamazin sitrat (DEC) tab 100
Tablet 0
49 mg
50 Difenhidramin HCl Inj 10 mg/ml-1 ml Ampul 0
51 Dimenhydrinate 50 mg tab 0
52 Digoksin Tablet 0,25 mg Tablet 0
53 Doksisiklin 100 mg kapsul 0
54 Domperidon Tablet 10 mg Tablet 0
55 Domperidon suspensi 5 mg/5ml mg Botol 0
56 Efinephrin 1mg/ml inj ampul 0
57 Etambutol tablet 500 mg Tablet 0
58 Eritromisin 250 mg Kapsul Tablet 0
59 Eritromisin 500 mg Kapsul Kaplet 0
60 Eritromisin Sirop 200 mg /5ml Btl 60 ml 0
Etakridin (Rrivanol) Larutan 0,1%-300
61 Botol 0
ml
62 Fenobarbital Injeksi 50 mg/ml -2 ml Ampul 0
63 Fenobarbital tablet 30 mg Tablet 0
Fenol Gliserol Tetes Telinga 10% - 5
Botol 0
66 ml
67 Fitomenadion (Vit. K1) tablet 10 mg Tablet 0
Fitomenadion (Vit. K1) Injeksi 10
68 Ampul 0
mg/ml-1 ml
69 Furosemid Tablet 40 mg Tablet 0
70 Furosemid inj 10 mg/mL Ampul 0
71 Garam Oralit 200 ml air kantong 0
72 Gentamisin 0,3% TM fls 0
73 Gentamisin inj 40 mg/ 2 mL Ampul 0
74 Gentamisin Salep Kulit 0,1% - 5 g Tube 0
75 Gentamisin Salep Mata 0,3 % Tube 0
76 Gentian Violet Larutan 1% - 10 ml Botol 0
77 Glibenklamid Tablet 5 mg Tablet 0
78 Gliseril Guaikolat Tablet 100 mg Tablet 0
79 Gliseril Guaikolat 25mg/5ml syrup botol 0
80 Gliserin Btl 100 ml 0
Glukosa Larutan Infus 40% Steril 25
Ampul 0
81 mL
82 Botol 0 0
ml
Botol 0 0
83 ml
84 Tablet 0
Micronized
85 Haloperidol 1,5 mg Tablet Tablet 0 0
Haloperidol tablet 5 mg ktk
86 Tablet 0 0
102
Tablet 0
87 Hidroklorotiazid (HCT) Tablet 25 mg 0
88 Hidrokortison Krim 2,5% Tube 0
89 Hyoscine-N-butilbromide tablet 10mg Tablet 0 0

90 Ibuprofen suspensi 200 mg/5 ml botol 0
91 Ibuprofen Tablet 400 mg Tablet 0
94 Isosorbid Dinitrat sublingual tab 5 mg Tablet 0 0

95 Kalium Permanganat Serbuk - 5 g Pot 0
96 Kalsium Glukonas Inj Ampul 0 0
97 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 0
98 Kaptopril Tablet 12,5 mg Tablet 0
99 Kaptopril tablet 25 mg ktk 100 tab Tablet 0
100 Karbamazepin Tablet 200 mg Tablet 0 0
101 Ketokonazol cream Tube 0
102 Ketokonazol tab 200 mg (ktk 50 tab) Tablet 0 0
103 Ketoprofen 100 mg Tablet 0 0
104 Ketoprofen Inj 100 mg Ampul 0 0
105 Ketorolac inj. 30 mg Ampul 0 0
106 Klindamisin kapsul 300mg Kapsul 0
107 Kloramfenikol Kapsul 250 mg Kapsul 0 0
108 Kloramfenikol Salep Kulit 1% Tube 0 0
Tube 0 0
109 Kloramfenikol Salep Mata 1% - 3,5 g
110 Kloramfenikol Tetes Telinga 3% Botol 0 0
Klorfeniramin Maleat (CTM) Tablet 4
111 mg Tablet 0
Klorpromazin tablet salut 100 mg
Tablet 0 0
112 btl 1000 tab
113 Kodein tablet 10mg btl 250 tab Tablet 0 0
114 Tablet 0 0
115 Kotrimoksazol Suspensi Kombinasi Botol 0 0
116 Kombinasi/Dewasa: Tablet 0 0
117 Lansoprazole kapsul 30 mg Kapsul 0
118 Levertan Salep Pot 0 0
Lisol, (Kresol tersabun 50 % - 1000
Botol 0 0
120 ml)
121 Loperamid (HCl) 2 mg Tablet 0 0
122 Magnesium Sulfas Inj. 40%-25ml vial 0 0
123 Meloksikam suppositoria supp 0 0
124 Meloksikam tablet 7,5 mg Tablet 0
125 Metampiron Injeksi 250 mg/ml-2 ml Ampul 0 0
126 Metampiron Tablet 500 mg Tablet 0
127 Metformin HCl 500 mg tab Tablet 0
128 Metformin Tablet 850 mg Tablet 0
129 Metilergometrin Tablet Salut 0,125 g Tablet 0 0
Metilergometrin Maleat Injeksi 0,200
130 mg-1 ml Ampul 0 0
131 Metilprednison tablet 4 mg/16 mg Tablet 0 0
132 Metoklopramide inj. 5mg/ml Ampul 0 0
133 Metoklopramide tablet 10 mg Tablet 0 0
134 Metoklopramide tablet 5 mg Tablet 0 0
135 Metronidazol Tablet 250 mg Tablet 0 0
137 Metronidazol Infus 500 mg/100 ml Botol 0 0
138 Mineral Mix sch 0 0
139 Multi vitamin kaplet Tablet 0
140 Multi vitamin syrup Botol 0 0
141 Natrium Bikarbonat Tablet 500 mg Tablet 0 0
142 Natrium Clorida Lrt. Infus 0,9% Steril Btl 500ml 0
Natrium Diklofenak 50 mg (ktk 50 tab) Tablet 0

143
144 Natrium Thiosulfat inj. 2% Ampul 0 0
145 Natrium Tiroksin Ampul 0 0
146 Nifedipin tablet 10 mg Tablet 0
Nistatin 500.000 IU/gram Tablet
147 Vaginal Tablet 0 0
Tablet 0
148 Vaginal 0
150 Obat Anti tuberkulosis FDC kategori I Paket 0 0
Obat Anti tuberkulosis FDC kategori II Paket 0 0

151
152 Obat Anti tuberkulosis FDC Sisipan Paket 0 0
153 Obat Anti tuberkulosis kategori anak Paket 0 0
154 Obat batuk kombinasi tablet Tablet 0 0
155 Obat batuk kombinasi syrup Botol 0 0
Obat Batuk Hitam (OBH) Cairan- 100
156 Botol 0
ml
157 Obat Saluran Pencernaan (Synbio) Sch 0 0
158 Ofloxacin tablet 400mg Tablet 0 0
Oksitetrasiklin HCl Salep Kulit 3% - 5
Tube 0 0
159 g
Oksitetrasiklin HCl Salep Mata 1% -
160 Tube 0 0
3,5 g
161 Oksitetrasiklin inj 50 mg/mL-10 mL vial 0 0
162 Oksitosin Injeksi 10 IU/ml-1 ml Ampul 0 0
163 Omeprazol Kaps 20 mg Kapsul 0 0
164 Ondansentron 4 mg/2 ml inj. Ampul 0 0
165 Parasetamol drops Botol 0 0
166 Parasetamol Tablet 500 mg Tablet 0
Parasetamol Sirup 120 mg/5 ml - 60
Botol 0
167 ml
169 Piracetam tablet 800 mg Tablet 0 0
170 Pirantel Pamoat Tablet 365 tablet 0 0
171 Piridoksin HCl. Tablet Tablet 0
174 Polikresulen Botol 0 0
177 Povidon lodida 10%-1000 ml Botol 0 0
178 Prednison Tablet 5 mg Tablet 0
179 Procain PP Vial 0 0
180 Propranolol HCI Tablet 40 mg Tablet 0 0
181 Propiltiourasil tablet 50 mg Tablet 0 0
182 Pyrazinamide tablet 500 mg Tablet 0 0
183 Ranitidin inj. 50 mg/2ml Ampul 0 0
184 Ranitidin tablet 150 mg Tablet 0
185 Reserpin tablet 0,25 mg Tablet 0 0
Kapsul 0 0
186 (biru)
Kapsul 0 0
187 (merah)
188 Rifampicin tablet salut 450 mg Tablet 0 0
189 Rifampisin Kapsul 600 mg Kapsul 0
Ringer Laktat Larutan Infus Steril-500
190 Botol 0
ml
191 Ringer Asetat Larutan Infus Steril-500 Botol 0 0
193 Salbutamol 4 mg Tablet 0 0
Salbutamol 2.5 mg/2.5 mL NaCl Ampul 0 0
195 sol.for inhalation
196 Salep 2-4, Kombinasi pot 0
197 Salisil Bedak 2%-50 gram Kotak 0 0
198 Sefadroksil Tablet 500 mg Tablet 0
199 Sefadroksil sirup kering 125mg/5ml botol 0 0
200 Salbutamol Syr Botol 0 0
201 Seftriakson inj 1 g vial 0 0
202 Serum Anti Bisa Ular Inj.5 ml (ABU I) vial 0 0

203 Serum Anti Tetanus injeksi vial 0 0
Serum Anti Rabies Vero 4"s set 0 0
Sianokobalamin (Vit.B12) Injeksi 500
Ampul 0 0
mcg/ml-1ml
1 Sianokobalamin (Vit.B12) Tablet Tablet 0
2 Simetidin tablet 200 mg Tablet 0 0
3 Simvastatin Tablet 10 mg Tablet 0
4 Siprofloksasin 500 mg Tablet 0
5 Sukralfat Syrup Botol 0 0
Sulfasetamida Natrium Tetes Mata
6 15%-ml Botol 0 0
7 Tetrasiklin HCI kapsul 250 mg Kapsul 0 0
9 Tiamfenikol kapsul 500 mg Kapsul 0
Tiamin HCI/Mononitrat (Vit.B1) Tablet
Tablet 0 0
10 50 mg
11 Tiamin (Vit B1) inj 100 mg/ mL Ampul 0 0
12 Tramadol inj 50 mg/ mL Ampul 0 0
13 Triheksifenidil Tablet Tablet 0 0
14 Vitamin Pencernaan (Hidrovit) PCS 0 0
15 Vitamin Neurotropik Kapsul 0 0
16 Vitamin B Komplek Tablet Tablet 0
Zink dispersible tab 20 mg Tablet
0 0
1 OBAT GIGI 0 0
2 Set/btl 0 0
Temporary Stoping Fletcher Serbuk
3 CHKM Botol 0 0
btl 13 ml 0
4 champor/ CRESOPHENE 0
mengandung dexametason asetat
0.138 g, fenol 45.285 g, guayakol btl 0 0
6.790 g, gliserol 22.770 g dan amil
5 asetat 2.400 g ROCKLE ' S
6 Devitalisasi Pasta (Non Arsen) Botol 0 0
Glass Ionomer Cemen ART Fuji IX
9 mini pack + 4 ml Liquid Set/btl 0 0
Glass Ionomer Restoractive Cement

Box 0 0
ART, GC IX HS EXTRA POSTERIOR
10
12 Komposit resin pcs 0 0
Semen Seng Fosfat Serbuk dan
Botol 0 0
15 Cairan
16 Silver Amalgam Serbuk 65-75% botol 0 0
17 Spoon Gelatin Box 0 0
18 Temporary Filling Material Set 0 0
19 Trikresol Formalin (TKF) Botol 0 0
20 0 0
21 ALKES HABIS PAKAI 0 0
22 Alat suntik sekali pakai 1 cc Set 0
23 Alat Suntik Sekali Pakai 2,5 ml Set 0 0
24 Alat suntik sekali pakai 5 cc Set 0 0
Blood lancet 26 G 1 box = 100
Set 0 0
25 Pcs
26 Bistruri Kotak 0 0
27 Catgut chromic no. 2/0 1 ktk=12pcs Sachet 0
28 Catgut chromic no. 3/0 1 ktk=12pcs Sachet 0
29 Cover glass 20 mm x 20 mm Box 0 0
30 Duk Lubang Bulat pcs 0 0
Folley Catheter No. 18 (for single use
only, steril, natural rubber latex, 2 Pcs 0 0
31 way silicone)
32 Folley Catheter No.16 Pcs 0 0
33 Infusion plester 76 x 40 mm set/sachet 0 0
34 Infuset Anak set 0
35 Infuset Dewasa set 0
36 IV catheter no. 18 G x 1" pcs 0
37 IV Chateter No-20G x 1 1/4" pcs 0
38 IV Catheter no. 22 G x 1" pcs 0
39 IV Chateter No-24G pcs 0
Jelly USG 250 ml Botol 0 0
Kapas berlemak 500g Bungkus 0 0
Kapas Pembalut/Absorben 250 g Bungkus 0
1 Kasa 16/16 pcs 0 0
2 Kasa Kompres 40/40 steril Bungkus 0 0
5 Kasa Pembalut 2 m x 80 cm
Roll 0
Kasa Pembalut Elastis 3 inchi (elastic
bandage, standar ISO 9002, Roll 0 0
6 certificate TUV ukuran 3")
Kasa Pembalut Elastis 4 inchi (elastic
bandage, standar ISO 9002, Roll 0 0
7 certificate TUV ukuran 4")
8 Kasa Pembalut Hidrofil 4 m x 15 cm Roll 0
9 Kertas lensa buku/ 0 0
10 Kertas puyer pak 0 0
11 Masker Tali pcs 0 0
12 Masker N95 Pcs 0 0
13 Needle 27 Pcs 0 0
14 Object glass frosted isi 72 / slide box 0 0
15 Pembalut Gips 3 inch Roll 0 0
18 Penjepit Tabung Kayu Set 0 0
19 Pisau elektrocutter set 0 0
20 Plastik obat dgn label dinas Pcs 0 0
21 Plester 5 yards x 2 inch Rol 6 6
22 Plester bulat transparant sachet 0 0
23 Plester bulat ukuran kecil Roll 0 0
24 Plester Micropore Roll 0 0
25 Pot Dahak pot 0 0
26 Rak tabung acrylik pcs 0 0
Sarung Tangan non steril (S) (box isi
27 psg/set 0 0
100 pair)
28 Sarung Tangan non steril M psg/set 0
29 Sarung tangan non steril uk. L psg/set 0
30 Sendok obat 5 ml pcs 0 0
31 Silk (Benang Bedah Sutra)No.3/0 Sachet 0
32 Tisu Gulung Rol 0 0
33 Masker N95 pcs 0 0
34 Urine Bag (disterilisasi oleh EO) pcs 0 0
0 0
REAGENSIA 0 0
Antiserum Golongan Darah ABO 10
1 set 0 0
mL
2 Aquabidestilata 500ml btl 0 0
5 Benedict 250 ml (No.Cat.17074) Botol 0 0
6 Di-Ammonium Oxalat GR Botol 0 0
7 Di-Ethil eter GR Botol 0 0
8 Drabskin 500 ml (No.Cat.17080) Botol 0 0
9 EDTA 10% Cair-100 mL Botol 0 0
10 EDTA 10% Cair-250 mL Botol 0 0
11 Tube EDTA pak 100"s 0 0
12 Ethanol 70 % 100 ml Botol 0
13 Ethanol 70 % Botol 1 l 0 0
15 HCL 0,1 N 100 ml (No.Cat.17107) Botol 0 0
17 Iodine Test Solution-10 ml Botol 0 0
set/pak 0
18 lembar/set/ktk 0
Larutan Antiseptik Clorine 5.25% -
Botol 0
19 500 cc 0
20 Larutan Cat Gram Set- 100 ml Botol 0 0
Methanol GR for analysis ACS,ISO-
Botol 0
21 500 ml(No.Cat. 106009.1000) 0
22 Methanol 100 ml Botol 0 0
23 Methil alkohol Botol 0 0
24 Natrium Sitrat 3,8% Botol 0 0
25 PH Indikator 0-14 pak 0 0
26 Reagen Test Kehamilan Strip Box 0 0
27 Spiritus 1 L box 0 0
28 Stick Urine 10 Parameter Tube 0 0
29 Stick Asam Urat Tube 0 0
30 Stick Gula Darah Tube 0 0
31 Stick Kolesterol Tube 0 0
32 Turk 100 ml (No.Cat.17126) Botol 0 0
33 Xylol 100 mL Botol 0 0
34 Xylol 250 mL Botol 0 0
Zeil Nelson (ZN set) 100 ml) No.Cat.
35 Kotak 0 0
17134)
36 HIV TEST pak 100"s 0 0
LEMBAR BANTU LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
Bulan : JANUARI 2018
AAN JML JML PENGELUARAN

JPS TERIMA GUDANG LOKET LANSIA POSYANDU BP GIGI GIZI UKS Program TB
11 12 13 14 15 16 17 18 19 20 21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
JML P SISA
KIA LAB
22 23 24 25
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 -3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 6
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
STOK OPTIMUM BULAN …………………………
PEMAKAIAN RATA-RATA
NO NAMA OBAT SATUAN JUMLAH
PERBULAN
1 Acyclovir Cream Tube 0 0
2 Acyclovir Tablet 200 mg Tablet 0 0
3 Acyclovir Tablet 400 mg Tablet 0 0
4 Albendazol Tablet 400 mg Tablet 0 0
7 Ambroksol Sirup 15 mg/ml Botol 0 0
8 Ambroksol tablet Tablet 0 0
9 Aminofilin Injeksi 24 mg/ml-10ml Ampul 0 0
10 Amitriptilin HCl Tablet Salut 25 mg Tablet 0 0
11 Amoksisilin Kaplet 500 mg Kaplet 0 0
12 Amoksisilin Kapsul 250 mg Kapsul 0 0
13 Amoksisilin Sirup Kering 125 mg/5 ml Botol 0 0
14 Antalgin (Metampiron) Tablet 500 mg Tablet 0 0
15 Antalgin Injeksi 250 mg/ml-2 ml Ampul 0 0
16 Asam Asetilsalisilat Tablet 100 mg (Aset Tablet 0 0
17 Antasida DOEN Suspensi Botol 0 0
18 Antasida DOEN Tablet Kombinasi Tablet 0 0
Anti Bakteri DOEN Salep Kkombinasi :
19 Basitrasin + Polimiksin Tube 0 0
Anti Haemorroid DOEN Kombinasi
Bismut Subgallat 150 mg + supp
20 Heksaklorofen 250 mg 0 0
21 Antifungi DOEN Kombinasi Pot 0 0
22 Aqua Proinjeksi Steril,Bebas Pirogen 20 Ampul 0 0
23 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 0 0
24 Asam Mefenamat 500 mg Tablet Tablet 0 0
25 Atropin injeksi i.m./iv/sk. 0.25 mg/ml-1 ml ampul 0 0
26 Aminophyllin 200 mg tablet 0 0
27 Antimigrain/ Ergot caffein tablet 0 0
28 Amlodipin tablet 0 0
29 Asam Mefenamat 250 mg Tablet Tablet 0 0
30 Betametason Krim 0,1%-5g Tube 0 0
31 Betahistin Mesilat 6 mg Tablet Tablet 0 0
32 Bromhexin 8 mg tab Tablet 0 0
33 Captopril Tablet 12,5 mg Tablet 0 0
34 Captopril Tablet 25 mg Tablet 0 0
35 Cutgut chromic 2/0; plain 2/0 sachet 0 0
36 Catgut chromic 3/0 sachet 0 0
37 Ciprofloxacin Tablet 500 mg Tablet 0 0
38 Cetirizin tablet 0 0
39 Cetirizin syr botol 0 0
40 Deksametason Injeksi 5 mg/ml-1 ml Ampul 0 0
41 Deksametason Tablet 0,5 mg Tablet 0 0
42 Dekstran 70 larutan infus 6% steril Botol 0 0
43 Dekstrometorfan HBr Sirup 10 mg/5 ml-6 Botol 0 0
44 Dekstrometorfan HBr Tablet 15 mg Tablet 0 0
45 Diazepam Injeksi 5 mg/ml-2 ml Ampul 0 0
46 Diazepam Tablet 2 mg Tablet 0 0
47 Dietilkarbamazin sitrat (DEC) tab 100 mg Tablet 0 0
48 Difenhidramin HCl Inj 10 mg/ml-1 ml Ampul 0 0
50 Dimenhidrinat Tablet Ktk 0 0
51 Doksisiklin Kapsul 100 mg Kapsul 0 0
52 Domperidon suspensi Botol 0 0
53 Domperidon Tablet 10 mg Tablet 0 0
54 Efedrin HCl Tablet 25 mg Tablet 0 0
55 Ekstrak Belladon Tablet 10 mg Tablet 0 0
56 Epinefrina HCl/Bitartrat (Adrenalina) Ampul 0 0
57 Eritromisin 250 mg Kapsul Kapsul 0 0
58 Eritromisin 500 mg Kapsul Kaplet 0 0
59 Eritromisin Sirup Botol 0 0
60 Etakridin (Rrivanol) Larutan 0,1%-300 ml Botol 0 0
61 Fenobarbital Injeksi 50 mg/ml -2 ml Ampul 0 0
62 Fenobarbital tablet 30 mg Tablet 0 0
63 Fenoksimetil penisilinTablet 250 mg Tablet 0 0
65 Fenol Gliserol Tetes Telinga 10% - 5 ml Botol 0 0
66 Fitomenadion (Vit. K1) Injeksi 10 mg/ml- Ampul 0 0
67 Fitomenadion (Vit. K1) Tablet Salut 10 m Botol 0 0
68 Furosemid Tablet 40 mg Tablet 0 0
69 Furosemid Injeksi iv/im 10 mg/ml Tablet 0 0
70 Garam Oralit 200 ml air kantong 0 0
71 Gentamisin Salep Kulit 0,1% - 5 g Tube 0 0
72 Gentamisin Injeksi 80 mg/2ml Tube 0 0
73 Gentian Violet Larutan 1% - 10 ml Botol 0 0
74 Glibenklamid Tablet 5 mg Tablet 0 0
75 Gliseril Guaikolat Tablet 100 mg Tablet 0 0
77 Glukosa Larutan Infus 40% Steril 500 ml ampul 0 0
78 Glukosa Larutan Infus 10% Steril 500 ml Botol 0 0
80 Griseofulvin Tablet 125 mg, Micronized Tablet 0 0
81 Haloperidol 1,5 mg Tablet Tablet 0 0
82 Haloperidol 5 mg Tablet Tablet 0 0
87 Ibuprofen syr botol 0 0
89 Isoniazida (INH) Tablet 300 mg Tablet 0 0
90 Isosorbid Dinitrat sublingual tab 5 mg Tablet 0 0
91 Kalium Permanganat Serbuk - 5 g Botol 0 0
92 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 0 0
93 Karbamazepin Tablet 200 mg Tablet 0 0
94 Ketamin inj. 10 mg/ml vial 20 ml 0 0
95 Ketokonazol cream Tube 0 0
96 Ketokonazol Tablet 200 mg Tablet 0 0
97 Kloramfenikol Kapsul 250 mg Kapsul 0 0
98 Kloramfenikol Salep Mata 1% - 3,5 g Tube 0 0
Kloramfenikol Tetes Telinga 3% - 5 ml
99 Botol 0 0
100 mg Tablet 0 0
101 Klorpromazin tablet salut 100 mg (HCl) Tablet 0 0
102 Kodein Tablet 10
Kotrimoksazol mg Tablet,
Pediatrik Tablet 0 0
103 Tablet 0 0
104 Kotrimoksazol Suspensi Kombinasi Botol 0 0
106 Klindamisin tablet 0 0
107 Levertran Salep Pot 0 0
108 Lidokain Komp. Injeksi Kombinasi Ampul 0 0
109 Lisol, (Kresol tersabun 50 % - 1000 ml) Botol 0 0
110 Lansoprazol tablet 0 0
111 Magnesium Sulfas Inj. 40%-25ml vial 0 0
112 Metilergometrin Tablet Salut 0,125 g Tablet 0 0
113 Metilergometrin Maleat Injeksi 0.200 mg Iampul 0 0
114 Metformin HCl 500 mg Tablet 0 0
115 Metoklopramid tab 10 mg Tablet 0 0
116 Metronidazol Tablet 250 mg Tablet 0 0
117 Multivitamin Syrup (Solvita) Btl 0 0
118 Mineral mix sach 0 0
119 Multivitamin tablet 0 0
120 Multivitamin syr botol 0 0
121 Meloksikam supp supp 0 0
122 Methylprednisolon tablet 0 0
123 Meloksikam tab tablet 0 0
124 Natrium Bikarbonat Tablet 500 mg Tablet 0 0
125 Natrium Clorida Larutan Infus 0,9% Steri Botol 0 0
126 Natrium Diklofenak 50 mg Tablet 0 0
127 Natrium Thiosulfat Injeksi i.v.25% Ampul 0 0
128 Nifedipin Tablet 10 mg Tablet 0 0
Nistatin 100.000 IU/gram Tablet Vaginal

129 Tablet 0 0
Nistatin 500.000 IU/gram Tablet Vaginal

130 Tablet 0 0
132 Obat Anti tuberkulosis kategori I (Kombi paket 0 0
Obat Anti tuberkulosis kategori II
133 (Kombipak) paket 0 0
Obat Antituberkulosis kategori Sisipan
134 (kombipak) paket 0 0
135 Obat Anti tuberkulosis (FDC) kategori I paket 0 0
136 Obat Anti tuberkulosis (FDC) kategori II paket 0 0
137 Obat Anti tuberkulosis (kombipak) katego paket 0 0
138 Obat Antituberkulosis (FDC) kategori Sis paket 0 0
139 Obat Batuk Hitam (OBH) Cairan- 100 ml Botol 0 0
140 Obat batuk syrup 0 0
141 Obat batuk komb tab tablet 0 0
142 Obat diare syr botol 0 0
Oksitetrasiklin HCl Injeksi i.m 50 mg/ml
143 - 10 ml vial 0 0
144 Oksitetrasiklin HCl Salep Kulit 3% - 5 g Tube 0 0
145 Oksitetrasiklin HCl Salep Mata 1% - 3,5 Tube 0 0
146 Oksitosin Injeksi 10 IU/ml-1 ml Ampul 0 0
147 Ofloxacin tablet 0 0
148 Paracetamol drop botol 0 0
149 Paracetamol Tablet 100 mg Tablet 0 0
151 Parasetamol Sirup 120 mg/5 ml - 60 ml Botol 0 0
153 Pirantel Tablet Score (base) 125 mg Tablet 0 0
154 Piridoksin HCl. (Vitamin B6) Tablet Botol 0 0
155 Piroxicam Kapsul 20 mg Tablet 0 0
156 Piroxicam Tablet 10 mg Kapsul 0 0
159 Povidon lodila 10%-1000 ml Botol 0 0
160 Prednison Tablet 5 mg Tablet 0 0
161 Propranolol HCI Tablet 40 mg Tablet 0 0
162 Plester 5 Yardx2inchi Roll 0 0
163 Polikresulen (kondensasi Metakresol Sul Botol 0 0
164 Ranitidin tab 150 mg Tablet 0 0
165 Ranitidin Injeksi 25 mg/2ml Ampul 0 0
166 Reserpin Tablet 0,25 mg Tablet 0 0
167 Retinol (Vit.A) 100.000 IU Kapsul (biru) Kapsul 0 0
168 Retinol (Vit.A) 200.000 IU Kapsul (merah Kapsul 0 0
169 Rifampisin Kapsul 300 mg Kapsul 0 0
172 Reserpin 0,1 tablet 0 0
173 Ringer Laktat Larutan Infus Steril-500 ml Botol 0 0
175 Salbutamol 4 mg tablet 0 0
176 Salbutamol 2.5 mg dalam 2.5 mL NaCl sol Ampul 0 0
177 Salep 2-4, Kombinasi Tube 0 0
178 Salisil Bedak 2%-50 gram Kotak 0 0
179 Salisil Spiritus 10%-25 ml Botol 0 0
180 Sefadroksil Tablet 500 mg Tablet 0 0
181 Sefotaksim injeksi 0.5 g vial 0 0
182 Seftriakson injeksi vial 0 0
Serum Anti Bisa Ular Polivalen Inj.5 ml
vial
183 (ABU I) 0 0
184 Serum Anti Rabies/Vaksin Rabiesvero Kuur/set 0 0
Serum Anti Tetanus (kuda) injeksi
185 20.000 IU/vial (ATS) vial 0 0
Ampul
186 mcg/ml-1ml 0 0
187 Sianokobalamin (Vit.B12) Tablet Tablet 0 0
188 Silk (Benang Bedah Sutra)No.3/0 Sachet 0 0
189 Simetidin Tablet 200 mg Tablet 0 0
190 Simvastatin Tablet 10 mg Tablet 0 0
191 Sulfasetamida Natrium Tetes Mata 15%- Botol 0 0
192 Tablet Tambah Darah Kombinasi/Besi II Tablet 0 0
193 Scopma tablet 0 0
194 Sefadroxyl syr botol 0 0
197 Tiamfenicol Kapsul 500 mg Kapsul 0 0
198 Tiamin HCI (vit.B1) Injeksi 100 mg/ml-1 Ampul 0 0
199 Tiamin HCI/Mononitrat (Vit.B1) Tablet 5 Tablet 0 0
200 Tramadol Injeksi 50 mg/ml Ampul 0 0
201 Triheksifenidil Tablet 2 mg Tablet 0 0
202 Vitamin B Komplek Tablet Tablet 0 0
203 Zink dispersible tab 20 mg Tablet 0 0
0 0
OBAT GIGI 0 0
1 Air Raksa Dental Use Botol 0 0
2 Bahan Tumpatan Sementara Temporary S Set 0 0
3 Chlorfenol Kamfer Menthol (CHKM) Botol 0 0
4 Desinfeksi saluran akar gigi mengandu btl 13 ml 0 0
5 Desinfeksi saluran akar gigi mengandung botol 0 0
9 Glass Ionomer Cement ART Set/btl 0 0
11 Komposit Resin set/4pcs 0 0
14 Semen Seng Fosfat Serbuk dan Cairan Botol 0 0
15 Silver Amalgam Serbuk 65-75% Botol 0 0
16 Temporary filling material botol 0 0
0 0
ALAT KESEHATAN HABIS PAKAI 0 0
1 Alat Suntik Sekali Pakai 1 ml Set 0 0
2 Alat Suntik Sekali Pakai 2,5 ml Set 0 0
3 Alat Suntik Sekali Pakai 5 ml Set 0 0
4 Abbocath no 20 buah 0 0
5 Blood Lancet 26 G set 0 0
6 Folley Catheter 2 Way No. 18 set 0 0
7 Infusion Plester set 0 0
8 Infusion Set Anak set 0 0
9 Infusion Set Dewasa set 0 0
10 IV Chateter No-20G pcs 0 0
13 Kapas Berlemak 500 g Bungkus 0 0
14 Kapas Pembalut/Absorben 250 g Bungkus 0 0
16 Kasa Pembalut Hidrofil 4 m x 5 cm Rol 0 0
18 Kasa Pembalut 2 m x 80 cm Rol 0 0
20 Kasa Hydrophyl 18 x 22 lembar 0 0
21 Kasa 16 x 16 buah 0 0
22 Kasa Pembalut Elastis 3 inchi roll 0 0
24 Kertas Lensa buku 0 0
25 Kertas Puyer pak 0 0
26 Masker Tali pcs 0 0
27 Objek Glass box 0 0
28 Pembalut Gips Roll 0 0
29 plastik obat Kg 0 0
30 Plester Bulat sachet 0 0
31 Pot Dahak buah 0 0
32 Sarung Tangan non steril (L) pasang 0 0
33 Sarung Tangan non steril (M) pasang 0 0
34 Sarung Tangan non steril (s) pasang 0 0
35 Sendok Obat buah 0 0
36 Spoon Gelatin butir 0 0
37 Urine Bag pcs 0 0
38 Wing Needle No.23 G buah 0 0
0 0
0 0
REAGENSIA LAB. PUSKESMAS 0 0
1 Antiserum Golongan Darah ABO set 0 0
2 Aqua bidestilata 500 ml Botol 0 0
3 Asam Asetat 6%- Botol 0 0
4 Benedict 250 ml Botol 0 0
5 Di-Ammmonium Oxalat GR - 250 g Botol 0 0
6 Di-Ethil Eter GR for analysis ACS,ISO - 5 Botol 0 0
7 Drabskin 500 ml Botol 0 0
8 EDTA 10% Cair- Botol 0 0
9 Ethanol 70 % 1000 ML Botol 0 0
11 HCL 0,1 N 100 ml Botol 0 0
13 Iodine Test Solution-10 ml botol 0 0
14 Kartu Golongan Darah 100 lembar set 0 0
15 Larutan Antiseptik Clorine 5.25% - 500 c botol 0 0
16 Larutan Cat Gram Set- 100 ml botol 0 0
17 Methanol GR for analysis ACS,ISO-500 m Botol 0 0
18 Natrium Sitrat 3,8 %-100 ml Botol 0 0
19 PH Indikatot 0-14 pak 0 0
20 Reagen Test Kehamilan Strip bok 0 0
21 Spiritus 1 L Botol 0 0
22 Stik Urine 10 Parameter tube 0 0
23 Turk 100 ml Botol 0 0
24 Xylol 250 ml Botol 0 0
25 Zeil Nelson (ZN set) 100 ml) kotak 0 0
26 Stik gula kotak 0 0
27 Amoksisilin + As Klavulanat tablet 0 0
28 Kloramphenikol sk tube 0 0
29 Molagit tablet 0 0
30 Slide buah 0 0
31 Stik asam urat buah 0 0
32 Stik kolesterol buah 0 0
33 Diazepam rectal buah 0 0
RATA-RATA WK WT STOK
PERHARI HARI JML HARI JML OPTIMUM
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBA
PUSKESMAS
PUSKESMAS :
KECAMATAN :
KAB / KOTA : PELAPORAN BULAN / PERIODE
PROPINSI : PERMINTAAN BULAN / PERIODE
STOK PENERI- PERSE- PEMA- STOK

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN AKHIR
1 2 3 4 5 6 7 8
1 Acyclovir Cream Tube 0 0 0
2 Acyclovir Tablet 200 mg Tablet 0 0 0
4 Albendazol Tablet 400 mg Tablet 0 0 0
5 Alopurinol Tablet 100 mg Tablet 0 0 0
7 Ambroksol Sirup 15 mg/ml Botol 0 0 0
8 Ambroksol tablet Tablet 0 0 0
9 Aminofilin Injeksi 24 mg/ml-10ml Ampul 0 0 0
10 Amitriptilin HCl Tablet Salut 25 mg Tablet 0 0 0
11 Amoksisilin Kaplet 500 mg Kaplet 0 0 0
12 Amoksisilin Kapsul 250 mg Kapsul 0 0 0
13 Amoksisilin Sirup Kering 125 mg/5 ml Botol 0 0 0
14 Antalgin (Metampiron) Tablet 500 mg Tablet 0 0 0
15 Antalgin Injeksi 250 mg/ml-2 ml Ampul 0 0 0
16 Asam Asetilsalisilat Tablet 100 mg (Aset Tablet 0 0 0
17 Antasida DOEN Suspensi Botol 0 0 0
18 Antasida DOEN Tablet Kombinasi Tablet 0 0 0
0
19 Basitrasin + Polimiksin Tube 0 0
Bismut Subgallat 150 mg + supp 0
20 Heksaklorofen 250 mg 0 0
21 Antifungi DOEN Kombinasi Pot 0 0 0
22 Aqua Proinjeksi Steril,Bebas Pirogen 20 Ampul 0 0 0
23 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 0 0 0
25 Atropin injeksi i.m./iv/sk. 0.25 mg/ml-1 ml ampul 0 0 0
26 Aminophyllin 200 mg tablet 0 0 0
27 Antimigrain/ Ergot caffein tablet 0 0 0
28 Amlodipin tablet 0 0 0
30 Betametason Krim 0,1%-5g Tube 0 0 0
31 Betahistin Mesilat 6 mg Tablet Tablet 0 0 0
32 Bromhexin 8 mg tab Tablet 0 0 0
33 Captopril Tablet 12,5 mg Tablet 0 0 0
34 Captopril Tablet 25 mg Tablet 0 0 0
35 Cutgut chromic 2/0; plain 2/0 sachet 0 0 0
36 Catgut chromic 3/0 sachet 0 0 0
37 Ciprofloxacin Tablet 500 mg Tablet 0 0 0
38 Cetirizin tablet 0 0 0
39 Cetirizin syr botol 0 0 0
40 Deksametason Injeksi 5 mg/ml-1 ml Ampul 0 0 0
41 Deksametason Tablet 0,5 mg Tablet 0 0 0
42 Dekstran 70 larutan infus 6% steril Botol 0 0 0
43 Dekstrometorfan HBr Sirup 10 mg/5 ml- Botol 0 0 0
44 Dekstrometorfan HBr Tablet 15 mg Tablet 0 0 0
45 Diazepam Injeksi 5 mg/ml-2 ml Ampul 0 0 0
46 Diazepam Tablet 2 mg Tablet 0 0 0
47 Dietilkarbamazin sitrat (DEC) tab 100 m Tablet 0 0 0
48 Difenhidramin HCl Inj 10 mg/ml-1 ml Ampul 0 0 0
49 Digoksin Tablet 0,25 mg Tablet 0 0 0
50 Dimenhidrinat Tablet Ktk 0 0 0
51 Doksisiklin Kapsul 100 mg Kapsul 0 0 0
52 Domperidon suspensi Botol 0 0 0
53 Domperidon Tablet 10 mg Tablet 0 0 0
54 Efedrin HCl Tablet 25 mg Tablet 0 0 0
55 Ekstrak Belladon Tablet 10 mg Tablet 0 0 0
56 Epinefrina HCl/Bitartrat (Adrenalina) Ampul 0 0 0
57 Eritromisin 250 mg Kapsul Kapsul 0 0 0
58 Eritromisin 500 mg Kapsul Kaplet 0 0 0
59 Eritromisin Sirup Botol 0 0 0
60 Etakridin (Rrivanol) Larutan 0,1%-300 m Botol 0 0 0
61 Fenobarbital Injeksi 50 mg/ml -2 ml Ampul 0 0 0
62 Fenobarbital tablet 30 mg Tablet 0 0 0
63 Fenoksimetil penisilinTablet 250 mg Tablet 0 0 0
64 Fenoksimetil penisilinTablet 500 mg Tablet 0 0 0
65 Fenol Gliserol Tetes Telinga 10% - 5 ml Botol 0 0 0
66 Fitomenadion (Vit. K1) Injeksi 10 mg/ml- Ampul 0 0 0
67 Fitomenadion (Vit. K1) Tablet Salut 10 Botol 0 0 0
68 Furosemid Tablet 40 mg Tablet 0 0 0
69 Furosemid Injeksi iv/im 10 mg/ml Tablet 0 0 0
70 Garam Oralit 200 ml air kantong 0 0 0
71 Gentamisin Salep Kulit 0,1% - 5 g Tube 0 0 0
72 Gentamisin Injeksi 80 mg/2ml Tube 0 0 0
73 Gentian Violet Larutan 1% - 10 ml Botol 0 0 0
74 Glibenklamid Tablet 5 mg Tablet 0 0 0
75 Gliseril Guaikolat Tablet 100 mg Tablet 0 0 0
76 Gliserin Btl 100 ml 0 0 0
77 Glukosa Larutan Infus 40% Steril 500 ml ampul 0 0 0
78 Glukosa Larutan Infus 10% Steril 500 ml Botol 0 0 0
79 Glukosa Larutan Infus 5% Steril 500 ml Botol 0 0 0
80 Griseofulvin Tablet 125 mg, Micronized Tablet 0 0 0
81 Haloperidol 1,5 mg Tablet Tablet 0 0 0
82 Haloperidol 5 mg Tablet Tablet 0 0 0
83 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 0 0 0
84 Hidrokortison Krim 2,5% Tube 0 0 0
87 Ibuprofen syr botol 0 0 0
88 Ichtyol Salep Pot 0 0 0
89 Isoniazida (INH) Tablet 300 mg Tablet 0 0 0
90 Isosorbid Dinitrat sublingual tab 5 mg Tablet 0 0 0
91 Kalium Permanganat Serbuk - 5 g Botol 0 0 0
92 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 0 0 0
93 Karbamazepin Tablet 200 mg Tablet 0 0 0
94 Ketamin inj. 10 mg/ml vial 20 ml 0 0 0
95 Ketokonazol cream Tube 0 0 0
96 Ketokonazol Tablet 200 mg Tablet 0 0 0
97 Kloramfenikol Kapsul 250 mg Kapsul 0 0 0
98 Kloramfenikol Salep Mata 1% - 3,5 g Tube 0 0 0
Kloramfenikol Tetes Telinga 3% - 5 ml 0

99 Botol 0 0
0
100 mg Tablet 0 0
101 Klorpromazin tablet salut 100 mg (HCl) Tablet 0 0 0
Pediatrik Tablet 0 0 0
103 Tablet 0 0 0
104 Kotrimoksazol Suspensi Kombinasi Botol 0 0 0
0
106 Klindamisin tablet 0 0 0
107 Levertran Salep Pot 0 0 0
108 Lidokain Komp. Injeksi Kombinasi Ampul 0 0 0
109 Lisol, (Kresol tersabun 50 % - 1000 ml) Botol 0 0 0
110 Lansoprazol tablet 0 0 0
111 Magnesium Sulfas Inj. 40%-25ml vial 0 0 0
112 Metilergometrin Tablet Salut 0,125 g Tablet 0 0 0
113 Metilergometrin Maleat Injeksi 0.200 mg Iampul 0 0 0
114 Metformin HCl 500 mg Tablet 0 0 0
115 Metoklopramid tab 10 mg Tablet 0 0 0
116 Metronidazol Tablet 250 mg Tablet 0 0 0
117 Multivitamin Syrup (Solvita) Btl 0 0 0
118 Mineral mix sach 0 0 0
119 Multivitamin tablet 0 0 0
120 Multivitamin syr botol 0 0 0
121 Meloksikam supp supp 0 0 0
122 Methylprednisolon tablet 0 0 0
123 Meloksikam tab tablet 0 0 0
124 Natrium Bikarbonat Tablet 500 mg Tablet 0 0 0
125 Natrium Clorida Larutan Infus 0,9% Steri Botol 0 0 0
126 Natrium Diklofenak 50 mg Tablet 0 0 0
127 Natrium Thiosulfat Injeksi i.v.25% Ampul 0 0 0
128 Nifedipin Tablet 10 mg Tablet 0 0 0
0
0
131 Norit Tablet 0 0 0
132 Obat Anti tuberkulosis kategori I (Kombi paket 0 0 0
Obat Anti tuberkulosis kategori II
0
133 (Kombipak) paket 0 0
Obat Antituberkulosis kategori Sisipan
0
134 (kombipak) paket 0 0
135 Obat Anti tuberkulosis (FDC) kategori I paket 0 0 0
136 Obat Anti tuberkulosis (FDC) kategori II paket 0 0 0
137 Obat Anti tuberkulosis (kombipak) kateg paket 0 0 0
138 Obat Antituberkulosis (FDC) kategori Si paket 0 0 0
139 Obat Batuk Hitam (OBH) Cairan- 100 ml Botol 0 0 0
140 Obat batuk syrup 0 0 0
141 Obat batuk komb tab tablet 0 0 0
142 Obat diare syr botol 0 0 0
Oksitetrasiklin HCl Injeksi i.m 50 mg/ml
0
143 - 10 ml vial 0 0
144 Oksitetrasiklin HCl Salep Kulit 3% - 5 g Tube 0 0 0
145 Oksitetrasiklin HCl Salep Mata 1% - 3,5 Tube 0 0 0
146 Oksitosin Injeksi 10 IU/ml-1 ml Ampul 0 0 0
147 Ofloxacin tablet 0 0 0
148 Paracetamol drop botol 0 0 0
149 Paracetamol Tablet 100 mg Tablet 0 0 0
150 Paracetamol Tablet 500 mg Tablet 0 0 0
151 Parasetamol Sirup 120 mg/5 ml - 60 ml Botol 0 0 0
152 Peroksida (H2O2) 3% Botol 0 0 0
153 Pirantel Tablet Score (base) 125 mg Tablet 0 0 0
154 Piridoksin HCl. (Vitamin B6) Tablet Botol 0 0 0
155 Piroxicam Kapsul 20 mg Tablet 0 0 0
156 Piroxicam Tablet 10 mg Kapsul 0 0 0
157 Povidon lodida 10%-30 ml Botol 0 0 0
159 Povidon lodila 10%-1000 ml Botol 0 0 0
160 Prednison Tablet 5 mg Tablet 0 0 0
161 Propranolol HCI Tablet 40 mg Tablet 0 0 0
162 Plester 5 Yardx2inchi Roll 0 0 0
163 Polikresulen (kondensasi Metakresol Sul Botol 0 0 0
164 Ranitidin tab 150 mg Tablet 0 0 0
165 Ranitidin Injeksi 25 mg/2ml Ampul 0 0 0
166 Reserpin Tablet 0,25 mg Tablet 0 0 0
167 Retinol (Vit.A) 100.000 IU Kapsul (biru) Kapsul 0 0 0
168 Retinol (Vit.A) 200.000 IU Kapsul (mera Kapsul 0 0 0
169 Rifampisin Kapsul 300 mg Kapsul 0 0 0
172 Reserpin 0,1 tablet 0 0 0
173 Ringer Laktat Larutan Infus Steril-500 ml Botol 0 0 0
174 Salbutamol tablet 2 mg Tablet 0 0 0
175 Salbutamol 4 mg tablet 0 0 0
176 Salbutamol 2.5 mg dalam 2.5 mL NaCl solAmpul 0 0 0
177 Salep 2-4, Kombinasi Tube 0 0 0
178 Salisil Bedak 2%-50 gram Kotak 0 0 0
179 Salisil Spiritus 10%-25 ml Botol 0 0 0
180 Sefadroksil Tablet 500 mg Tablet 0 0 0
181 Sefotaksim injeksi 0.5 g vial 0 0 0
182 Seftriakson injeksi vial 0 0 0
Serum Anti Bisa Ular Polivalen Inj.5 ml
vial 0
183 (ABU I) 0 0
184 Serum Anti Rabies/Vaksin Rabiesvero Kuur/set 0 0 0
Serum Anti Tetanus (kuda) injeksi 20.000
185 IU/vial (ATS) vial
0 0 0
186 mcg/ml-1ml
Ampul 0 0 0
187 Sianokobalamin (Vit.B12) Tablet Tablet 0 0 0
188 Silk (Benang Bedah Sutra)No.3/0 Sachet 0 0 0
189 Simetidin Tablet 200 mg Tablet 0 0 0
190 Simvastatin Tablet 10 mg Tablet 0 0 0
191 Sulfasetamida Natrium Tetes Mata 15% Botol 0 0 0
192 Tablet Tambah Darah Kombinasi/Besi II Tablet 0 0 0
193 Scopma tablet 0 0 0
194 Sefadroxyl syr botol 0 0 0
195 Tetrasiklin HCI kapsul 250 mg Kapsul 0 0 0
196 Tetrasiklin HCI kapsul 500 mg Kapsul 0 0 0
197 Tiamfenicol Kapsul 500 mg Kapsul 0 0 0
198 Tiamin HCI (vit.B1) Injeksi 100 mg/ml-1 Ampul 0 0 0
199 Tiamin HCI/Mononitrat (Vit.B1) Tablet 5 Tablet 0 0 0
200 Tramadol Injeksi 50 mg/ml Ampul 0 0 0
201 Triheksifenidil Tablet 2 mg Tablet 0 0 0
202 Vitamin B Komplek Tablet Tablet 0 0 0
203 Zink dispersible tab 20 mg Tablet 0 0 0
0 0 0
OBAT GIGI 0 0 0
1 Air Raksa Dental Use Botol 0 0 0
2 Bahan Tumpatan Sementara Temporary S Set 0 0 0
3 Chlorfenol Kamfer Menthol (CHKM) Botol 0 0 0
4 Desinfeksi saluran akar gigi mengandu btl 13 ml 0 0 0
5 Desinfeksi saluran akar gigi mengandun botol 0 0 0
6 Devitalisasi Pasta (Non Arsen) Botol 0 0 0
7 Etil Klorida Semprot- 100 ml Botol 0 0 0
8 Eugenol Cairan - 10 ml Botol 0 0 0
9 Glass Ionomer Cement ART Set/btl 0 0 0
10 Kalsium Hidroksida Pasta Botol 0 0 0
11 Komposit Resin set/4pcs 0 0 0
12 Mummifying Pasta Botol 0 0 0
13 Pasta Pengisi Saluran Akar botol 0 0 0
14 Semen Seng Fosfat Serbuk dan Cairan Botol 0 0 0
15 Silver Amalgam Serbuk 65-75% Botol 0 0 0
16 Temporary filling material botol 0 0 0
0 0 0
ALAT KESEHATAN HABIS PAKAI 0 0 0
1 Alat Suntik Sekali Pakai 1 ml Set 0 0 0
2 Alat Suntik Sekali Pakai 2,5 ml Set 0 0 0
4 Abbocath no 20 buah 0 0 0
5 Blood Lancet 26 G set 0 0 0
6 Folley Catheter 2 Way No. 18 set 0 0 0
7 Infusion Plester set 0 0 0
8 Infusion Set Anak set 0 0 0
9 Infusion Set Dewasa set 0 0 0
10 IV Chateter No-20G pcs 0 0 0
13 Kapas Berlemak 500 g Bungkus 0 0 0
14 Kapas Pembalut/Absorben 250 g Bungkus 0 0 0
15 Kasa Kompres 40/40 steril Bungkus 0 0 0
16 Kasa Pembalut Hidrofil 4 m x 5 cm Rol 0 0 0
18 Kasa Pembalut 2 m x 80 cm Rol 0 0 0
20 Kasa Hydrophyl 18 x 22 lembar 0 0 0
21 Kasa 16 x 16 buah 0 0 0
22 Kasa Pembalut Elastis 3 inchi roll 0 0 0
23 Kasa Pembalut Elastis 4 inchi roll 0 0 0
24 Kertas Lensa buku 0 0 0
25 Kertas Puyer pak 0 0 0
26 Masker Tali pcs 0 0 0
27 Objek Glass box 0 0 0
28 Pembalut Gips Roll 0 0 0
29 plastik obat Kg 0 0 0
30 Plester Bulat sachet 0 0 0
31 Pot Dahak buah 0 0 0
32 Sarung Tangan non steril (L) pasang 0 0 0
33 Sarung Tangan non steril (M) pasang 0 0 0
34 Sarung Tangan non steril (s) pasang 0 0 0
35 Sendok Obat buah 0 0 0
36 Spoon Gelatin butir 0 0 0
37 Urine Bag pcs 0 0 0
38 Wing Needle No.23 G buah 0 0 0
39 Wing Needle No.25 G buah 0 0 0
0 0 0
0 0 0
REAGENSIA LAB. PUSKESMAS 0 0 0
1 Antiserum Golongan Darah ABO set 0 0 0
2 Aqua bidestilata 500 ml Botol 0 0 0
3 Asam Asetat 6%- Botol 0 0 0
4 Benedict 250 ml Botol 0 0 0
5 Di-Ammmonium Oxalat GR - 250 g Botol 0 0 0
6 Di-Ethil Eter GR for analysis ACS,ISO - Botol 0 0 0
7 Drabskin 500 ml Botol 0 0 0
8 EDTA 10% Cair- Botol 0 0 0
9 Ethanol 70 % 1000 ML Botol 0 0 0
10 Giemsa Stok 500 ml Botol 0 0 0
11 HCL 0,1 N 100 ml Botol 0 0 0
12 Immersi Oil 100 ml Botol 0 0 0
13 Iodine Test Solution-10 ml botol 0 0 0
14 Kartu Golongan Darah 100 lembar set 0 0 0
15 Larutan Antiseptik Clorine 5.25% - 500 c botol 0 0 0
16 Larutan Cat Gram Set- 100 ml botol 0 0 0
17 Methanol GR for analysis ACS,ISO-500 Botol 0 0 0
18 Natrium Sitrat 3,8 %-100 ml Botol 0 0 0
19 PH Indikatot 0-14 pak 0 0 0
20 Reagen Test Kehamilan Strip bok 0 0 0
21 Spiritus 1 L Botol 6 6 6
22 Stik Urine 10 Parameter tube 0 0 0
23 Turk 100 ml Botol 0 0 0
24 Xylol 250 ml Botol 0 0 0
25 Zeil Nelson (ZN set) 100 ml) kotak 0 0 0
26 Stik gula kotak 0 0 0
27 Amoksisilin + As Klavulanat tablet 0 0 0
28 Kloramphenikol sk tube 0 0 0
29 Molagit tablet 0 0 0
30 Slide buah 0 0 0
31 Stik asam urat buah 0 0
32 Stik kolesterol buah 0 0
33 Diazepam rectal buah 0 0
UMUM
TIDAK ASKES JUMLAH
BAYAR
JUMLAH KUNJUNGAN RESEP BAYAR
Mengetahui/Menyetujui : Yang Menyerahkan

Kepala Dinas Kesehatan Kab/Kota Kepala GFK
……………………………………. ……………………………………
NIP. NIP.
MBAR PERMINTAAN OBAT (LPLPO)
ESMAS
DOKUMEN NOMOR TANGGAL

DINKES KAB/KOTA
: GFK KAB/KOTA
: PUSKESMAS
STOK PERMIN PEMBERIAN

JUMLAH
OPT. TAAN DAK APBD GAKIN ASKES PROGRAM LAIN-LAIN
9 10 11 12 13 14 15 16 17
50
1
26
24
12
2
18
54
36
1
1
120
1
28
12
28
52
24
Yang Meminta Yang Menerima
Kepala Puskesmas Petugas Puskesmas
…………………………………… ………………………………………
NIP. NIP.
PUSKESMAS MULYAMEKAR
KECAMATAN BABAKAN CIKAO
SURAT BUKTI BARANG KELUAR

(SBBK)
Nomor :
Diberikan Kepada :
Pada Tanggal :
NO NAMA OBAT BANYAKNYA KETERANGAN

1 Acyclovir Cream
2 Acyclovir Tablet 200 mg
3 Acyclovir Tablet 400 mg
4 Albendazol Tablet 400 mg
7 Ambroksol Sirup 15 mg/ml
8 Ambroksol tablet
9 Aminofilin Injeksi 24 mg/ml-10ml
10 Amitriptilin HCl Tablet Salut 25 mg
11 Amoksisilin Kaplet 500 mg
12 Amoksisilin Kapsul 250 mg
13 Amoksisilin Sirup Kering 125 mg/5 ml
14 Antalgin (Metampiron) Tablet 500 mg
15 Antalgin Injeksi 250 mg/ml-2 ml
16 Asam Asetilsalisilat Tablet 100 mg (Asetosal)
17 Antasida DOEN Suspensi
18 Antasida DOEN Tablet Kombinasi
Anti Bakteri DOEN Salep Kkombinasi : Basitrasin +
19 Polimiksin
Anti Haemorroid DOEN Kombinasi Bismut Subgallat 150
20 mg + Heksaklorofen 250 mg
21 Antifungi DOEN Kombinasi
22 Aqua Proinjeksi Steril,Bebas Pirogen 20 ml
23 Asam Askorbat (Vit. C) Tablet 50 mg
24 Asam Mefenamat 500 mg Tablet
25 Atropin injeksi i.m./iv/sk. 0.25 mg/ml-1 ml (sulfat)
26 Aminophyllin 200 mg
27 Antimigrain/ Ergot caffein
28 Amlodipin
29 Asam Mefenamat 250 mg Tablet
30 Betametason Krim 0,1%-5g
31 Betahistin Mesilat 6 mg Tablet
32 Bromhexin 8 mg tab
33 Captopril Tablet 12,5 mg
34 Captopril Tablet 25 mg
35 Cutgut chromic 2/0; plain 2/0
36 Catgut chromic 3/0
37 Ciprofloxacin Tablet 500 mg
38 Cetirizin
39 Cetirizin syr
40 Deksametason Injeksi 5 mg/ml-1 ml
41 Deksametason Tablet 0,5 mg
42 Dekstran 70 larutan infus 6% steril
43 Dekstrometorfan HBr Sirup 10 mg/5 ml-60 ml
44 Dekstrometorfan HBr Tablet 15 mg
45 Diazepam Injeksi 5 mg/ml-2 ml
46 Diazepam Tablet 2 mg
47 Dietilkarbamazin sitrat (DEC) tab 100 mg
48 Difenhidramin HCl Inj 10 mg/ml-1 ml
49 Digoksin Tablet 0,25 mg
50 Dimenhidrinat Tablet
51 Doksisiklin Kapsul 100 mg
52 Domperidon suspensi
53 Domperidon Tablet 10 mg
54 Efedrin HCl Tablet 25 mg
55 Ekstrak Belladon Tablet 10 mg
56 Epinefrina HCl/Bitartrat (Adrenalina)
57 Eritromisin 250 mg Kapsul
58 Eritromisin 500 mg Kapsul
59 Eritromisin Sirup
60 Etakridin (Rrivanol) Larutan 0,1%-300 ml
61 Fenobarbital Injeksi 50 mg/ml -2 ml
62 Fenobarbital tablet 30 mg
63 Fenoksimetil penisilinTablet 250 mg
64 Fenoksimetil penisilinTablet 500 mg
65 Fenol Gliserol Tetes Telinga 10% - 5 ml
66 Fitomenadion (Vit. K1) Injeksi 10 mg/ml-1 ml
67 Fitomenadion (Vit. K1) Tablet Salut 10 mg
68 Furosemid Tablet 40 mg
69 Furosemid Injeksi iv/im 10 mg/ml
70 Garam Oralit 200 ml air
71 Gentamisin Salep Kulit 0,1% - 5 g
72 Gentamisin Injeksi 80 mg/2ml
73 Gentian Violet Larutan 1% - 10 ml
74 Glibenklamid Tablet 5 mg
75 Gliseril Guaikolat Tablet 100 mg
76 Gliserin
77 Glukosa Larutan Infus 40% Steril 500 ml
80 Griseofulvin Tablet 125 mg, Micronized
81 Haloperidol 1,5 mg Tablet
82 Haloperidol 5 mg Tablet
83 Hidroklorotiazid (HCT) Tablet 25 mg
84 Hidrokortison Krim 2,5%
85 Ibuprofen Tablet 200 mg
86 Ibuprofen Tablet 400 mg
87 Ibuprofen syr
88 Ichtyol Salep
89 Isoniazida (INH) Tablet 300 mg
90 Isosorbid Dinitrat sublingual tab 5 mg
91 Kalium Permanganat Serbuk - 5 g
92 Kalsium Laktat (Kalk) Tablet 500 mg
93 Karbamazepin Tablet 200 mg
94 Ketamin inj. 10 mg/ml
95 Ketokonazol cream
96 Ketokonazol Tablet 200 mg
97 Kloramfenikol Kapsul 250 mg
98 Kloramfenikol Salep Mata 1% - 3,5 g
99 Kloramfenikol Tetes Telinga 3% - 5 ml
100 Klorfeniramin Maleat (CTM) Tablet 4 mg
101 Klorpromazin tablet salut 100 mg (HCl)
102 Kodein Tablet 10 mg
Kotrimoksazol Pediatrik Tablet,
103
104 Kotrimoksazol Suspensi Kombinasi
105 Kotrimoksazol Tablet Kombinasi/Dewasa:
106 Klindamisin
107 Levertran Salep
108 Lidokain Komp. Injeksi Kombinasi
109 Lisol, (Kresol tersabun 50 % - 1000 ml)
110 Lansoprazol
111 Magnesium Sulfas Inj. 40%-25ml
112 Metilergometrin Tablet Salut 0,125 g
113 Metilergometrin Maleat Injeksi 0.200 mg-1ml
114 Metformin HCl 500 mg
115 Metoklopramid tab 10 mg
116 Metronidazol Tablet 250 mg
117 Multivitamin Syrup (Solvita)
118 Mineral mix
119 Multivitamin
120 Multivitamin syr
121 Meloksikam supp
122 Methylprednisolon
123 Meloksikam tab
124 Natrium Bikarbonat Tablet 500 mg
125 Natrium Clorida Larutan Infus 0,9% Steril -500 ml
126 Natrium Diklofenak 50 mg
127 Natrium Thiosulfat Injeksi i.v.25%
128 Nifedipin Tablet 10 mg
129 Nistatin 100.000 IU/gram Tablet Vaginal
130 Nistatin 500.000 IU/gram Tablet Vaginal
131 Norit
132 Obat Anti tuberkulosis kategori I (Kombipak)
133 Obat Anti tuberkulosis kategori II (Kombipak)
134 Obat Antituberkulosis kategori Sisipan (kombipak)
135 Obat Anti tuberkulosis (FDC) kategori I
136 Obat Anti tuberkulosis (FDC) kategori II
137 Obat Anti tuberkulosis (kombipak) kategori Anak
138 Obat Antituberkulosis (FDC) kategori Sisipan
139 Obat Batuk Hitam (OBH) Cairan- 100 ml
140 Obat batuk
141 Obat batuk komb tab
142 Obat diare syr
143 Oksitetrasiklin HCl Injeksi i.m 50 mg/ml - 10 ml
144 Oksitetrasiklin HCl Salep Kulit 3% - 5 g 24tub
145 Oksitetrasiklin HCl Salep Mata 1% - 3,5 g
146 Oksitosin Injeksi 10 IU/ml-1 ml
147 Ofloxacin
148 Paracetamol drop
149 Paracetamol Tablet 100 mg
150 Paracetamol Tablet 500 mg
151 Parasetamol Sirup 120 mg/5 ml - 60 ml
152 Peroksida (H2O2) 3%
153 Pirantel Tablet Score (base) 125 mg
154 Piridoksin HCl. (Vitamin B6) Tablet
155 Piroxicam Kapsul 20 mg
156 Piroxicam Tablet 10 mg
157 Povidon lodida 10%-30 ml
158 Povidon lodida 10%-300 ml
159 Povidon lodila 10%-1000 ml
160 Prednison Tablet 5 mg
161 Propranolol HCI Tablet 40 mg
162 Plester 5 Yardx2inchi
Polikresulen (kondensasi Metakresol Sulfonat dan
163 Metanol) 5 ml
164 Ranitidin tab 150 mg
165 Ranitidin Injeksi 25 mg/2ml
166 Reserpin Tablet 0,25 mg
167 Retinol (Vit.A) 100.000 IU Kapsul (biru)
168 Retinol (Vit.A) 200.000 IU Kapsul (merah)
169 Rifampisin Kapsul 300 mg
172 Reserpin 0,1
173 Ringer Laktat Larutan Infus Steril-500 ml
174 Salbutamol tablet 2 mg
175 Salbutamol 4 mg
176 Salbutamol 2.5 mg dalam 2.5 mL NaCl solution for inhalation
177 Salep 2-4, Kombinasi
178 Salisil Bedak 2%-50 gram
179 Salisil Spiritus 10%-25 ml
180 Sefadroksil Tablet 500 mg
181 Sefotaksim injeksi 0.5 g
182 Seftriakson injeksi
183 Serum Anti Bisa Ular Polivalen Inj.5 ml (ABU I)
184 Serum Anti Rabies/Vaksin Rabiesvero
185 Serum Anti Tetanus (kuda) injeksi 20.000 IU/vial (ATS)
186 Sianokobalamin (Vit.B12) Injeksi 500 mcg/ml-1ml
187 Sianokobalamin (Vit.B12) Tablet
188 Silk (Benang Bedah Sutra)No.3/0
189 Simetidin Tablet 200 mg
190 Simvastatin Tablet 10 mg
191 Sulfasetamida Natrium Tetes Mata 15%-ml
Tablet Tambah Darah Kombinasi/Besi II Sulfat 200 mg+
192 Asam Folat 0.25 mg
193 Scopma
194 Sefadroxyl syr
195 Tetrasiklin HCI kapsul 250 mg
196 Tetrasiklin HCI kapsul 500 mg
197 Tiamfenicol Kapsul 500 mg
198 Tiamin HCI (vit.B1) Injeksi 100 mg/ml-1 ml
199 Tiamin HCI/Mononitrat (Vit.B1) Tablet 50 mg
200 Tramadol Injeksi 50 mg/ml
201 Triheksifenidil Tablet 2 mg
202 Vitamin B Komplek Tablet
203 Zink dispersible tab 20 mg
OBAT GIGI
1 Air Raksa Dental Use
Bahan Tumpatan Sementara Temporary Stopping
2 Fletcher Serbuk dan Cairan
3 Chlorfenol Kamfer Menthol (CHKM)
Desinfeksi saluran akar gigi mengandung o,1
dexametason, 5 thymol,30g paraklorofenol, 64,9 g
4 champor/ CRESOPHENE
Desinfeksi saluran akar gigi mengandung Deksametason
Asetat 0,138 g; Fenol 45,285 g; Guayakol 6,790 g, Gliserol
22,770 g dan Amil asetat 2,400 g.
5
6 Devitalisasi Pasta (Non Arsen)
7 Etil Klorida Semprot- 100 ml
8 Eugenol Cairan - 10 ml
9 Glass Ionomer Cement ART
10 Kalsium Hidroksida Pasta
11 Komposit Resin
12 Mummifying Pasta
13 Pasta Pengisi Saluran Akar
14 Semen Seng Fosfat Serbuk dan Cairan
15 Silver Amalgam Serbuk 65-75%
16 Temporary filling material
ALAT KESEHATAN HABIS PAKAI

1 Alat Suntik Sekali Pakai 1 ml
2 Alat Suntik Sekali Pakai 2,5 ml
3 Alat Suntik Sekali Pakai 5 ml
4 Abbocath no 20
5 Blood Lancet 26 G
6 Folley Catheter 2 Way No. 18
7 Infusion Plester
8 Infusion Set Anak
9 Infusion Set Dewasa
10 IV Chateter No-20G
13 Kapas Berlemak 500 g
14 Kapas Pembalut/Absorben 250 g
15 Kasa Kompres 40/40 steril
16 Kasa Pembalut Hidrofil 4 m x 5 cm
18 Kasa Pembalut 2 m x 80 cm
20 Kasa Hydrophyl 18 x 22
21 Kasa 16 x 16
22 Kasa Pembalut Elastis 3 inchi
23 Kasa Pembalut Elastis 4 inchi
24 Kertas Lensa
25 Kertas Puyer
26 Masker Tali
27 Objek Glass
28 Pembalut Gips
29 plastik obat
30 Plester Bulat
31 Pot Dahak
32 Sarung Tangan non steril (L)
33 Sarung Tangan non steril (M)
34 Sarung Tangan non steril (s)
35 Sendok Obat
36 Spoon Gelatin
37 Urine Bag
38 Wing Needle No.23 G
39 Wing Needle No.25 G
REAGENSIA LAB. PUSKESMAS

1 Antiserum Golongan Darah ABO
2 Aqua bidestilata 500 ml
3 Asam Asetat 6%-
4 Benedict 250 ml
5 Di-Ammmonium Oxalat GR - 250 g
6 Di-Ethil Eter GR for analysis ACS,ISO - 5 L
7 Drabskin 500 ml
8 EDTA 10% Cair-
9 Ethanol 70 % 1000 ML
10 Giemsa Stok 500 ml
11 HCL 0,1 N 100 ml
12 Immersi Oil 100 ml
13 Iodine Test Solution-10 ml
14 Kartu Golongan Darah 100 lembar
15 Larutan Antiseptik Clorine 5.25% - 500 cc
16 Larutan Cat Gram Set- 100 ml
17 Methanol GR for analysis ACS,ISO-500 ml
18 Natrium Sitrat 3,8 %-100 ml
19 PH Indikatot 0-14
20 Reagen Test Kehamilan Strip
21 Spiritus 1 L
22 Stik Urine 10 Parameter
23 Turk 100 ml
24 Xylol 250 ml
25 Zeil Nelson (ZN set) 100 ml)
26 Stik gula
27 Amoksisilin + As Klavulanat
28 Kloramphenikol sk
29 Molagit
30 Slide
31 Stik asam urat
32 Stik kolesterol
33 Diazepam rectal
34 Sinbio
Yang Menerima Yang Mengeluarkan
…………………….. Lily Hodijah

Mengetahui
Kepala Puskesmas Mulyamekar
Drg Suzie Deciana

NIP.19661224 199403 2 001
PUSKESMAS KONCARA
SURAT BUKTI BARANG KELUAR

(SBBK)
Nomor :
Diserahkan kepada :
Pada Tanggal :
Nama Unit/ Program :
NO NAMA OBAT BANYAKNYA KETERANGAN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Yang Menerima Yang Menyerahkan
(....................................................) (Wulan Puspitasari.S.farm.,Apt)
Mengetahui,
Kepala Puskesmas koncara
Hj. IIP NURHIDAYAH. SKM
NIP 19681031 198911 2 001
REKAPITULASI PEMAKAIAN O
Puskesmas koncara
Bulan :FEBRUARI 2016
STOK PENERI- JUMLAH

PERSE-
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN
26 27 28 29 30 31 1 2 3
OBAT
1 Acyclovir Cream Tube 0 36 36 6 3 1
3 Acyclovir Tablet 400 mg Tablet 0 200 200 20 20
4 Albendazol Tablet 400 mg Tablet 10 0 10
7 Ambroksol Sirup 15 mg/ml Botol 23 120 143 1 2 7 3
8 Ambroksol tablet Tablet 900 0 900
9 Aminofilin Injeksi 24 mg/ml-10ml Ampul 0 0
10 Amitriptilin HCl Tablet Salut 25 mg Tablet 428 0 428
11 Amoksisilin Kaplet 500 mg Kaplet 1700 5,000 6,700 60 80 50 90 100 70
12 Amoksisilin Kapsul 250 mg Kapsul 550 1,300 1,850 40 20 10 20 10
13 Amoksisilin Sirup Kering 125 mg/5 ml Botol 166 180 346 9 8 5 9 3 11
14 Antalgin (Metampiron) Tablet 500 mg Tablet 1300 1,000 2,300 30 30 10
15 Antalgin Injeksi 250 mg/ml-2 ml Ampul 0 0
16 Asam Asetilsalisilat Tablet 100 mg (Ase Tablet 0 0
17 Antasida DOEN Suspensi Botol 45 50 95 1 4 4 2 3 3
18 Antasida DOEN Tablet Kombinasi Tablet 2170 3,200 5,370 10 20 10 50 20 20
19 Tube 48 25 73 1
Basitrasin + Polimiksin
Bismut Subgallat 150 mg + supp 6 20 26
20 Heksaklorofen 250 mg
21 Antifungi DOEN Kombinasi Pot 0 0 0 7 2
22 Aqua Proinjeksi Steril,Bebas Pirogen 20 Ampul 0 0 0
23 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 1133 1,000 2,133 33 50 6 40 50 28
24 Asam Mefenamat 500 mg Tablet Tablet 92 1,500 1,592
25 Atropin injeksi i.m./iv/sk. 0.25 mg/ml-1 mlampul 0 0 0
26 Aminophyllin 200 mg tablet 150 0 150
27 Antimigrain/ Ergot caffein tablet 90 0 90
28 Amlodipin tablet 0 330 330 3 12 3 9
29 Asam Mefenamat 500 mg Tablet Tablet 1,500 1,500 50 36 30 50 12
30 Betametason Krim 0,1%-5g Tube 0 75 75 1 1 1 1
31 Betahistin Mesilat 6 mg Tablet Tablet 0 210 210 6
32 Bromhexin 8 mg tab Tablet 200 0 200 10 10
33 Captopril Tablet 12,5 mg Tablet 394 900 1,294 18 18 6 24 24 12
34 Captopril Tablet 25 mg Tablet 1018 200 1,218 12 12
35 Cutgut chromic 2/0; plain 2/0 sachet 0 0 0
36 Catgut chromic 3/0 sachet 0 0
37 Ciprofloxacin Tablet 500 mg Tablet 355 100 455 10
38 Cetirizin tablet 129 300 429 4 50 33 20
39 Cetirizin syr botol 19 50 69 4 1 2 1 1
40 BROMHEXIN SYR Ampul 19 60 79 1
41 Deksametason Tablet 0,5 mg Tablet 577 1,800 2,377 12 42 45 30 42 30
42 BORAK GLISER Botol 0 20 20 1 1
43 Dekstrometorfan HBr Sirup 10 mg/5 ml- Botol 0 0
44 Dekstrometorfan HBr Tablet 15 mg Tablet 0 0
45 Diazepam Injeksi 5 mg/ml-2 ml Ampul 0 0
46 Diazepam Tablet 2 mg Tablet 157 100 257 3
47 Dietilkarbamazin sitrat (DEC) tab 100 m Tablet 0 0
48 Difenhidramin HCl Inj 10 mg/ml-1 ml Ampul 0 0
50 Dimenhidrinat Tablet Ktk 0 0
51 Doksisiklin Kapsul 100 mg Kapsul 200 0 200
52 Domperidon suspensi Botol 12 50 62 2 1 1 2
53 Domperidon Tablet 10 mg Tablet 336 0 336 6 6 6
54 Efedrin HCl Tablet 25 mg Tablet 0 0 0
55 Ekstrak Belladon Tablet 10 mg Tablet 0 0
56 Epinefrina HCl/Bitartrat (Adrenalina) Ampul 20 0 20
Kapsu
57 Eritromisin 250 mg Kapsul 0 0
l
58 Eritromisin 500 mg Kapsul Kaplet 176 200 376 10 10 10 10
59 Eritromisin Sirup Botol 22 0 22 6 3 2 1
60 ethambuthol 500mg tablet 500 0 500
61 Fenobarbital Injeksi 50 mg/ml -2 ml Ampul 30 0 30
62 Fenobarbital tablet 30 mg Tablet 0 0
65 Fenol Gliserol Tetes Telinga 10% - 5 ml Botol 0 0
66 Fitomenadion (Vit. K1) Injeksi 10 mg/ml Ampul 30 0 30
67 Fitomenadion (Vit. K1) Tablet Salut 10 Botol 100 0 100
68 Furosemid Tablet 40 mg Tablet 185 0 185 6 2
69 Furosemid Injeksi iv/im 10 mg/ml Tablet 0 0 0
70 Garam Oralit 200 ml air kantong 500 200 700 6 12 18 16 12
71 Gentamisin Salep Kulit 0,1% - 5 g Tube 0 36 36 1
72 Gentamisin Injeksi 80 mg/2ml Tube 9 0 9
73 Gentian Violet Larutan 1% - 10 ml Botol 0 0 0
74 Glibenklamid Tablet 5 mg Tablet 390 100 490 10 10
75 Gliseril Guaikolat Tablet 100 mg Tablet 1824 3,000 4,824 20 61 35 40 20 26
77 GENTAMISIN SM ampul 0 48 48 1 1 1
78 Glukosa Larutan Infus 10% Steril 500 m Botol 0 0
80 Griseofulvin Tablet 125 mg, Micronized Tablet 145 0 145
81 Haloperidol 1,5 mg Tablet Tablet 340 0 340
82 Haloperidol 5 mg Tablet Tablet 270 200 470
84 Hidrokortison Krim 2,5% Tube 0 72 72 4 7 4 3 5
85 ISONIAZIDA 400MG Tablet 0 0 0
86 Ibuprofen Tablet 400 mg Tablet 0 1,000 1,000
87 Ibuprofen syr botol 0 0
88 Ichtyol Salep Pot 45 0 45
89 Isoniazida (INH) Tablet 300 mg Tablet 0 0 15
90 Isosorbid Dinitrat sublingual tab 5 mg Tablet 80 0 80
91 Kalium Permanganat Serbuk - 5 g Botol 7 24 31 1 2 2
92 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 1282 2,000 3,282 10 20
93 Karbamazepin Tablet 200 mg Tablet 70 0 70
94 ketopropen tube 0 0 0 20
95 Ketokonazol cream Tube 0 75 75 1 1 2 1 1
96 Ketokonazol Tablet 200 mg Tablet 54 200 254 10 10 20
97 Kloramfenikol Kapsul 250 mg Kapsul 162 0 162
98 Kloramfenikol Salep Mata 1% - 3,5 g Tube 22 0 22 1
99 Kloramfenikol Tetes Telinga 3% - 5 ml Botol 0 20 20
100 Klorfeniramin Maleat (CTM) Tablet 4 m Tablet 0 5,000 5,000 12 6 66 124 72
101 Klorpromazin tablet salut 100 mg (HCl) Tablet 90 100 190
Pediatrik Tablet 0 0
103 Tablet 0 0
104 Kotrimoksazol Suspensi Kombinasi Botol 65 50 115 1 1 1
184 500 684
105 Kombinasi/Dewasa: Tablet 12 12 12 12 12
106 Klindamisin tablet 40 50 90 10
107 Levertran Salep Pot 0 0 0
108 Lidokain Komp. Injeksi Kombinasi Ampul 0 0 0
109 loperamid Tablet 200 200 10 20
110 Lansoprazol tablet 80 80 5
111 inoxin Tablet 0 0 0
112 Metilergometrin Tablet Salut 0,125 g Tablet 54 0 54
Metilergometrin Maleat Injeksi 0.200
0 0
113 mg-1ml Iampul
114 Metformin HCl 500 mg Tablet 165 300 465 10 20 10
115 Metoklopramid tab 10 mg Tablet 60 100 160 10
116 Metronidazol Tablet 500 mg Tablet 380 100 480 10
117 Multivitamin Syrup (Solvita) Btl 0 0 7
118 Mineral mix sach 380 0 380
119 Multivitamin tablet 144 100 244 10
120 Multivitamin syr botol 28 60 88 3 12
121 Meloksikam supp supp 144 0 144
122 Methylprednisolon tablet 0 400 400
123 Meloksikam tab tablet 0 150 150 18 18
124 Natrium Bikarbonat Tablet 500 mg Tablet 0 0 0
125 Natrium Clorida Larutan Infus 0,9% Ster Botol 0 10 10
126 Natrium Diklofenak 50 mg Tablet 500 500 10 12 6
127 Natrium Thiosulfat Injeksi i.v.25% Ampul 0 0
128 Nifedipin Tablet 10 mg Tablet 100 0 100
129 Nistatin 100.000 IU/gram Tablet Vaginal Tablet 0 0
130 Nistatin 500.000 IU/gram Tablet Vaginal Tablet 0 0 0
132 Obat Anti tuberkulosis kategori I (Komb paket 0 0
133 Obat Anti tuberkulosis kategori II (Komb paket 5 5 5
134 Obat Antituberkulosis kategori Sisipan paket 0 0
135 Obat Anti tuberkulosis (FDC) kategori I paket 0 0
136 Obat Anti tuberkulosis (FDC) kategori II paket 0 0
137 Obat Anti tuberkulosis (kombipak) kateg paket 0 0
138 Obat Antituberkulosis (FDC) kategori Si paket 3 3 3
139 Obat Batuk Hitam (OBH) Cairan- 100 m Botol 224 0 224 3 4 1 3
140 Obat batuk syrup 50 120 170 2 4 2 1
141 Obat batuk komb tab tablet 0 600 600
142 Obat diare syr botol 5 60 65 1 1
143 Oksitetrasiklin HCl Injeksi i.m 50 mg/ml vial 0 0 0
144 Oksitetrasiklin HCl Salep Kulit 3% - 5 g Tube 0 72 72 2 2
145 Oksitetrasiklin HCl Salep Mata 1% - 3,5 Tube 25 0 25
146 Oksitosin Injeksi 10 IU/ml-1 ml Ampul 0 0 0
147 Ofloxacin tablet 0 0 0
148 Paracetamol drop botol 10 10
150 Paracetamol Tablet 500 mg Tablet 9690 7,000 16,690 155 300 184 196 280 148
151 Parasetamol Sirup 120 mg/5 ml - 60 ml Botol 111 504 615 20 20 6 24 15 15
152 Peroksida (H2O2) 3% Botol 0
153 Pirantel Tablet Score (base) 125 mg Tablet 0
154 Piridoksin HCl. (Vitamin B6) Tablet Botol 1319 1,000 2,319 6 6 10 10
155 Piroxicam Kapsul 20 mg Tablet 0 0 6 12 12
156 Piroxicam Tablet 10 mg Kapsul 1182 0 1,182
159 Povidon lodila 10%-1000 ml Botol 0 0
160 Prednison Tablet 5 mg Tablet 750 0 750 10 10
161 PZA 500 MG Tablet 137 100 237
162 Plester 5 Yardx2inchi Roll 0 0
Polikresulen (kondensasi Metakresol
6 4 10
163 Sulfonat dan Metanol) 5 ml Botol
164 Ranitidin tab 150 mg Tablet 198 1,500 1,698 24 36 60 102 78 48
165 Ranitidin Injeksi 25 mg/2ml Ampul 0 0
166 Reserpin Tablet 0,25 mg Tablet 0 0
167 Retinol (Vit.A) 100.000 IU Kapsul (biru) Kapsul 950 950
168 Retinol (Vit.A) 200.000 IU Kapsul (mera Kapsul 4,150 4,150
172 Reserpin 0,1 tablet 0 0
173 Ringer Laktat Larutan Infus Steril-500 m Botol 15 0 15
174 Salbutamol tablet 2 mg Tablet 300 300 6 8 6
175 Salbutamol 4 mg tablet 0 0
176 Salbutamol 2.5 mg dalam 2.5 mL NaCl soAmpul 0 0
177 Salep 2-4, Kombinasi Tube 9 48 57 1 3 3 1
178 Salisil Bedak 2%-50 gram Kotak 7 30 37 1 1 2
179 sukralfat syrup Botol 2 0 2
180 Sefadroksil Tablet 500 mg Tablet 302 200 502 10 20 20
181 sefadroksil sirup 60 ml 43 0 43
182 Seftriakson injeksi vial 0 0
183 Serum Anti Bisa Ular Polivalen Inj.5 ml vial 0 0
Kuur/
184 Serum Anti Rabies/Vaksin Rabiesvero set 0 0
185 Serum Anti Tetanus (kuda) injeksi 20.00 vial 1 1
186 Sianokobalamin (Vit.B12) Injeksi 500 m Ampul 0 0
187 Sianokobalamin (Vit.B12) Tablet Tablet 276 0 276 17 23 26
188 Silk (Benang Bedah Sutra)No.3/0 Sachet 0 0
189 Simetidin Tablet 200 mg Tablet 610 500 1,110 72 6 6
190 Simvastatin Tablet 10 mg Tablet 60 300 360 10 20 20 10
191 Sulfasetamida Natrium Tetes Mata 15% Botol 22 48 70 3 1
Tablet Tambah Darah Kombinasi/Besi
Tablet 0 0
II Sulfat 200 mg+ Asam Folat 0.25 mg
192
193 Scopma tablet 172 0 172
194 Sefadroxyl syr botol 0 0
196 synbio Kapsul 60 60
197 Tiamfenicol Kapsul 500 mg Kapsul 100 100
198 Tiamin HCI (vit.B1) Injeksi 100 mg/ml-1 Ampul 0 0
199 Tiamin HCI/Mononitrat (Vit.B1) Tablet Tablet 0 0 22 30 50 16
200 Tramadol Injeksi 50 mg/ml Ampul 0 0
201 Triheksifenidil Tablet 2 mg Tablet 100 100
202 Vitamin B Komplek Tablet Tablet 5,000 5,000 32 91 88 72 78 64
203 Zink dispersible tab 20 mg Tablet 900 900 30 50 25 30 30
0 0
OBAT GIGI 0 0
1 Air Raksa Dental Use Botol 0 0
Temporary Stopping Fletcher Serbuk Set 0 0
2 dan Cairan
3 Chlorfenol Kamfer Menthol (CHKM) Botol 1 1
0 0
4 champor/ CRESOPHENE btl 13 ml
mengandung Deksametason Asetat
0,138 g; Fenol 45,285 g; Guayakol botol 0 0
6,790 g, Gliserol 22,770 g dan Amil
5 asetat 2,400 g.
9 Glass Ionomer Cement ART Set/btl 0 0
11 Fuji botol 0 0
14 Semen Seng Fosfat Serbuk dan Cairan Botol 1 1
15 Silver Amalgam Serbuk 65-75% Botol 0 0
16 Temporary filling material botol 0 0
17 Tri Kresol Formalin botol 1 1
ALAT KESEHATAN HABIS PAKAI

2 Alat Suntik Sekali Pakai 2,5 ml Set 335 0 335 25
4 Alat suntik sekali 3 ml buah 0 0
5 Blood Lancet 26 G set 0 200 200
6 Folley Catheter 2 Way No. 18 set 0 0
7 Infusion Plester set 43 0 43
8 Infusion Set Anak set 8 0 8
9 Infusion Set Dewasa set 25 0 25
13 Kapas Berlemak 500 g Bungkus 0 0
14 Kapas Pembalut/Absorben 250 g Bungkus 2 6 8 1
18 Kasa Pembalut 2 m x 80 cm Rol 20 20
20 Kasa Hydrophyl 18 x 22 lembar 0 0
21 Kasa 16 x 16 buah 48 48
24 Kertas Lensa buku 0 0
25 Kertas Puyer pak 10 10
26 Masker Tali pcs 200 200 1 1
27 Objek Glass box 0 0
28 Pembalut Gips Roll 0 0
29 plastik obat Kg 2,000 2,000
30 Plester Bulat sachet 0 0
31 Pot Dahak buah 250 250
32 Sarung Tangan non steril (L) pasang 0 0
33 Sarung Tangan non steril (M) pasang 100 100
34 Sarung Tangan non steril (s) pasang 50 50 50
35 Sendok Obat buah 0 0
36 Spoon Gelatin butir 0 0
37 Urine Bag pcs 0 0
0 0
0 0
REAGENSIA LAB. PUSKESMAS 0 0
1 Antiserum Golongan Darah ABO set 0 1 1
2 Aqua bidestilata 500 ml Botol 0 0
3 Asam Asetat 6%- Botol 0 0
4 Benedict 250 ml Botol 0 0
5 Di-Ammmonium Oxalat GR - 250 g Botol 0 0
6 Di-Ethil Eter GR for analysis ACS,ISO - Botol 0 0
7 Drabskin 500 ml Botol 0 0
8 EDTA 10% Cair- Botol 0 0
9 Ethanol 70 % 1000 ML Botol 15 15
11 HCL 0,1 N 100 ml Botol 0 0
13 Iodine Test Solution-10 ml botol 0 0
14 Kartu Golongan Darah 100 lembar set 1 1
15 Larutan Antiseptik Clorine 5.25% - 500 botol 1 1
16 Larutan Cat Gram Set- 100 ml botol 0 0
17 Methanol GR for analysis ACS,ISO-500 Botol 0 0
18 Natrium Sitrat 3,8 %-100 ml Botol 0 0
19 PH Indikatot 0-14 pak 0 0
20 Reagen Test Kehamilan Strip bok 0 0
21 Spiritus 1 L Botol 0 0
22 Stik Urine 10 Parameter tube 1 1
23 Turk 100 ml Botol 1 1
24 Xylol 250 ml Botol 0 0
25 Zeil Nelson (ZN set) 100 ml) kotak 10 10
26 Stik gula buah 0 0
27 Amoksisilin + As Klavulanat Tablet 0 0
28 Kloramphenikol sk tube 24 24
29 Molagit Tablet 182 300 482 10 10 10
30 Slide buah 0 0
REKAPITULASI PEMAKAIAN OBAT BULANAN
TOTAL PENGELUARAN SESUAI TANGGAL
4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
2 2 1 2 1 1 1 2
10 50 30
1 1 1 1
10 10 10 10 10 10
4 4 1 1 2 3 1 3 7
80 20
100 130 90 110 160 60 80 40 100 90 100 40 170 80 80 100 50 20 90

50 30 20 70 10 10 20 60 10 20 60 30 50 80 50 50 30
4 6 6 3 5 6 4 3 3 1 8 5 4 1 4 2 2 4
10 10 10 20
2 3 1 3 3 1 3 2 3 1 2 4 1 7 2 2 2
20 20 50 30 30 40 70 70 80 40 100 60 120 20 30 30 10 90
1 1 1 1 1
5 2 3
24 10 12 12 28 10 36 40 82 77 29 48 256 96 50 58 40 28 122
54 10 28 12 50
3 3
1 1 1
12
10 10 20 20 10
18 12 28 28 10 32 50 52 20 26 20 16 30 12 36 40
6 24 6 10 6 6 6 10 10 10 26 20 10 6 18 10
1 2 2 1 1
10 20 10 10 30 10 10 10 10 10 20
6 3 5 4 3 5 23 10 5 12
1 1 1 1 1 2 2 2 2 2 1 3 2
1 1
78 54 66 66 54 54 6 24 6 6 36 6 24 6 18 12 24 24
1 2 1 2
7 5 6 6 6 4 10 4
1 1 4 1 1 1 1 1 2
24 6 1 6 6
10
1 2
4 6
6 6 6 60 40 60 40 60 20 35 10 50 30 10 20 15 12
5 3 4 2 3 3 2 1 4 3 4 1
1
10 10 10 10
86 66 106 122 90 120 70 16 70 10 50 88 144 98 20 58 52
1 1 2
60
1 2 1 2 2
1 3 2 1
10 10 30 10
10 1 20 10
1 1
12
15 10 5
1 2 2
1 3 2 10 10 70 10 300 1 10
20 10 10 10 60 10
14 0
1 2 2 1 1
4 4 1 5 20 2 2 1 1 5
40 20 10 10
20 30 20 30 1 1 10 3 1
1
126 108 60 168 80 140 190 36 138 146 70 18 100 124 76 156 58 72 30
30
146 18 124 156 58 72
30 20 20 10 1
1 3
60 10 12 12 12 24 12
1 1 3 1 2
12 24 54
10
10 50 10 10 20
10 20 10 10 10
20 10 10
10
5 3 7 5 2 2 1 6
20
18 2
12 6
1 1 7 5 5 3 7 2 5
1 2 2 2 1 1
2 1 4 7 4 3 3 7 60
1 5 1 1 1 1 1
1 1
212 206 298 312 248 292 354 230 258 238 280 176 536 350 396 206 130 240
9 2 8 9 12 13 4 4 2 8 6 3 3 11 11 5 10
30 10 36 10 10 20
10 10 10 20 20 6
16 20 10 10 20 10
6 16 2 1 16 3 30 10
1
10 10
2
23 90 60 6 42 6 6 56 60 90 36 60 36
900
4100
1
6 7
18 12 12 12 18 18 6 6
6 6 6 2 3 3 1
2 2 1 1 2
2
3 1 2 1 10 10 10 1 2 1 1
6 30 30
10 10 10 6
10 6 36 66 36 90 10
5 10 10 10 11 5 20 10
36 90 2 1 1 60 2
30 40 10 240 30 30 30
14 8 6
0 0 0
10 10 15 15
10 20
10 10 60
24 68 66 140 116 130 222 140 102 176 110 10 190 144 194 200 86 120 90
20 10 10 40 10 10 60 10 50 20 86 50 20 30 20 10
1
1
1
250
200
0
10
48
2000
50
50
15
1
1
1
1
6 6
24 20 10 10 26 10 26 10 16 10
SISA STOK
TOTAL
AKHIR
PER BLN BLN
#VALUE! #VALUE!
12 24
- -
130 70
4 6
60 390
- -
39 104
100 800 maks 200/pkm
- -
- 428
2,140 4,560
750 1,100
116 230
120 2,180
- -
- -
59 36
1,040 4,330
6 67
10 16
12 (12)
- -
1,265 868
154 1,438
- -
- 150
- 90
33 297
178 1,322
7 68
18 192
90 110
532 762
208 1,010
7 (7)
- -
160 295
183 246
30 39
3 76
765 1,612
8 12
- -
- -
- -
51 206
- -
- -
- -
- -
- 200
19 43
61 275
- -
- -
- 20
- -
50 326
15 7
- 500
- 30
- -
- -
- -
- -
- 30
- 100
18 167
- -
544 156
36 -
- 9
1 (1)
60 430
1,468 3,356
- -
7 41
- -
- -
- 145
- 340
60 410
- -
31 41
7 (7)
60 940
41 (41)
2 43
27 (27)
30 50
10 21
447 2,835
120 (50)
34 (34)
13 62
85 169
80 82
117 (95)
1 19
2,176 2,824
30 160
574 (574)
81 (81)
7 108
202 482
18 72
90 (90)
- -
40 160
5 75
- -
5 49
- -
140 325
10 150
70 410
7 (7)
40 340
20 224
46 42
20 124
- 400
42 108
- -
20 (10)
46 454
- -
5 95
- -
- -
- 200
- -
5 -
- -
- -
- -
- -
3 -
47 177
18 152
91 509
13 52
- -
6 66
- 25
1 (1)
- -
- 10
- -
6,225 10,465
220 395
- -
- -
148 2,171
106 (106)
86 1,096 bln 4/2012 hrs sdh habis
84 (53)
- 3
1 (1)
40 710
- 237
- -
2 8
919 779
- -
- -
900 50
4,100 50
- -
1 199
13 287
- -
- 15
122 178
- -
- -
35 22
12 25
2 -
92 410
- 43
66 (66)
- -
- -
1 -
- -
102 174
- -
338 772
141 219
196 (126)
410 (410)
28 144
-
- -
- 60
50 50
- -
148 (148)
- -
80 20
2,753 2,247
621 279
- -
- -
- -
- -
1 -
- -
- -
- -
4 -
- -
- -
- -
- -
1 -
1 -
1 -
- -
- -
- -
- -
- 139
275 60
- 190
- -
200 -
- -
- 43
- 8
- 25
- 7
- 27
- -
- -
1 7
- -
10
- 25
10 10
- -
- -
48 -
- -
- -
- -
- 10
2 198
- -
- -
2,000 -
- -
- 250
- -
50 50
50 -
- -
- -
- -
- -
- -
- -
1 (1)
- -
1 -
- -
- -
- -
- -
- -
- -
15 (15)
- 15
- -
- -
- -
- -
1 -
1 -
- -
- -
- -
- -
- -
- -
1 -
1 -
- -
- 10
- -
- -
12 12
192 290
- -

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REKAPITULASI PEMAKAIAN OBAT BULANAN

STOK PENERI- JUMLAH

Amitriptilin HCl Tablet Salut 25 mg Tablet 957

Antasida DOEN Tablet Kombinasi Tablet 1,151

Anti Bakteri DOEN Salep

Asam Mefenamat 500 mg Tablet Tablet 333

Besi (II) Sulfat + Asam Folat

Deksametason Injeksi 5 mg/ml-1 ml Ampul 0

Dekstran 70- larutan infus 6% steril btl 500 ml 0

Domperidon suspensi 5 mg/5ml mg Botol 0

Fenobarbital Injeksi 50 mg/ml -2 ml Ampul 4

Fenol Gliserol Tetes Telinga 10% - Botol 25

Fitomenadion (Vit. K1) tablet 10 mg Tablet 0

Gentamisin Salep Kulit 0,1% - 5 g Tube 91

Gliseril Guaikolat 25mg/5ml syrup Btl 100 ml 0

Ibuprofen suspensi 200 mg/5 ml Tablet 0

Kalsium Glukonas Inj. 100 mg/ml Tablet 0

Kaptopril tablet 25 mg ktk 100 tab Tablet 0

Ketokonazol tab 200 mg (ktk 50 Tablet 260

Klobazam 10 mg (kotak 100 tab) Tablet 0

Klopidogrel tab 75 mg (KOTAK 30 Kapsul 0

Kloramfenikol Tetes Telinga 3% Tablet 10

Kotrimoksazol Suspensi Kombinasi Tablet 99

Magnesium Sulfas Inj. 40%-25ml supp 0

Magnesium Sulfas Inj. 20%-25ml Tablet 0

Metampiron Injeksi 250 mg/ml-2 ml Tablet 0

Metilergometrin Tablet Salut 0,125 Ampul 65

Natrium Bikarbonat Tablet 500 mg Btl 500ml 0

Natrium Diklofenak 25 mg (ktk 50 Ampul 0

Obat Anti tuberkulosis FDC Sisipan Paket 0

Obat Batuk Hitam (OBH) Cairan- Sch 0

Obat Saluran Pencernaan (Synbio) Tablet 0

Oksitetrasiklin inj 50 mg/mL-10 mL Ampul 0

Oksitosin Injeksi 10 IU/ml-1 ml Kapsul 0

Serum Anti Rabies Vero 4"s Vial 10 ml 0

Bahan Tumpatan Sementara

mengandung o,1 dexametason, 5

6.790 g, gliserol 22.770 g dan amil

Kassa Pembalut Hidrofil 4 m x 3 cm Roll 0

Kassa Pembalut Hidrofil 4 m x 5 cm Roll 0

Kasa Pembalut Hidrofil 4 m x 15 cm Roll 0

Silk (Benang Bedah Sutra)No.3/0 pcs 0

Benedict 250 ml (No.Cat.17074) Botol 0

Drabskin 500 ml (No.Cat.17080) Botol 0

Tube EDTA pak 100"s 0

HCL 0,1 N 100 ml (No.Cat.17107) Botol 0

STOK PENERI- JUMLAH

Albendazol Tablet 400 mg Tablet 0 0

Alopurinol Tablet 100 mg Tablet 0 400 400

Aminofilin Tablet 200 mg Tablet 0 0

Anti Bakteri DOEN Salep

Anti Hemorhoid DOEN

Asam Askorbat (Vit. C)

Atropin injeksi l.m/lv/s.k.

Besi (II) Sulfat + Asam

Betahistin mesilat 6 mg tab Tablet 600 600

Betametason Krim 0,1%-5g Tube 20 30 50

Diazepam Injeksi 5 mg/ml-2 Ampul 0 0