Au 31 Maret 2017

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DATAR OBAT YANG STOKNYA HABIS

Halaman : 1

NO NAMA OBAT SAT KETERANGAN

1 Adalat Oros Box


2 Alinamin F Tab Box
3 Alinamin injeksi Box
4 Alpamol Drops Fls
5 Alphamol Syr Fls
6 Alprazolam Tab 0.5 mg Box
7 Amitripilin Tab 25 mg 100's Box
8 Amoxan Drops Fls
9 Anti Hemaroid Supp Supp
10 Asabium Tab Box
11 Avodart Tab Box
12 Bersol Cream Tube
13 Bevalex Cream Tube
14 Cefadroxil 500 mg Cap 100's Box
15 Cefixim Syr Fls
16 Cendo Fenicol 0.25% 0,6 ml@ 5's minidose Strip
17 Cendo Genta SM Tube
18 Cendo LFX 0,6 ml @ 5's minidose Strip
19 Cendo Lubricent 0,6 ml@ 5's minidose Strip
20 Cendo Pantocain 2% 0,6 ml@ 5's minidose Strip
21 Cendo Ulcori 0,6 ml @ 5's minidose Strip
22 Citicolin Tab 500 mg 30's Box
23 Citicolon Inj 250 mg 10's Box
24 Co Amoxiclav Box
25 Dexamethason Inj Tin
26 Dextrose 10% Infus Fls
27 Dextrose 5% Infus Fls
28 Diamicron MR Box
29 Digoxin 0,25 mg Tab 100's Box
30 Diovan 160 mg 27's Box
31 Diovan 80 mg 27's Box
32 Domperidon Syr Fls
33 Domperidon Tab 100's Box
34 Dopamin Inj Amp
35 Easy Touch Cholesterol 10's Box
36 Easy Touch Glucose 25's Box
37 Ethambutol Tab 500 mg Box
38 Flutias Inhaler 125 mcg Fls
39 Furosemid 10 mg injeksi 25's Box
40 Harnal ocas 30's Box
41 Illiadin 0,025 % Fls
Dipindahkan
Halaman : 2

NO NAMA OBAT SAT KETERANGAN

Pemindahan
42 Illiadin 0,5 % Fls
43 Infantrim Syr Fls
44 INH 100 mg Tab 1000's Tin
45 INH 300 mg Tin
46 Interhistin Tab Box
47 ISDN 5 mg Tab 100's Box
48 Kalium Diklofenak Box
49 Kandistatin Drops Fls
50 Kapas 100 gr Roll
51 Kapas 250 gr Roll
52 Ketorolac Inj 30 mg Amp
53 Ketricin Orabase Tube
54 klorferson Cream Tube
55 Laminaria Box
56 Laxadine Syr Fls
57 Lexacrol Syr Fls
58 Lexicam 10 mg Tab 100's Box
59 Lexicam 20 mg Tab 100's Box
60 Mebo krim 20 gr Tube
61 Meloxicam 15 mg Box
62 Methylprednisolon Inj Vial
63 Methylprednisolon Tab 4 mg Box
64 Metronidazol Infus Fls
65 Miloz 5 mg/ 5 ml injeksi 10's Box
66 Moladerm Cream Tube
67 Molafate Susp Fls
68 Mucosta Tab 100's Box
69 Myotonic Inj Box
70 Norages Inj Box
71 Omeprazol Cap 30's Box
72 Omeprazol Inj Vial
73 Omeyus Cap 20 mg 30's Box
74 Opineuron Tab 100's Box
75 Pantoprazol Inj Vial
76 Paracetamol Syrup Fls
77 Pehacain Inj 10's Box
78 Piracetam 400 mg Tab Box
79 Piralen Inj Box
80 Pitogin injeksi 10's Box
81 Procain penicillin injeksi Vial
82 Promuba Syr Fls
83 Proten Susu Coklat Box
84 Proxime Tab Box
85 Psidii Syr Fls
Dipindahkan

Halaman : 3

NO NAMA OBAT SAT KETERANGAN

Pemindahan
86 Pyderma Cream Tube
87 Ranitidin Inj Amp
88 Rifampicin 450 Tab 100's Box
89 Ringer Lactat Fls
90 Stesolid Rectal Box
91 Stesolid Syr Fls
92 Stesolid Tab 2 mg Box
93 Sulfas ferosus Tin
94 Suprafenid supp 10's Box
95 Tramadol 50 mg Cap 100's Box
96 Tranfusi Set Box
97 Trifedrin Tab Box
98 Trileptal 600 mg Box
99 Trizedon MR Box
100 Trolip Cap 300 mg Box
101 Valeptic Syr Fls
102 Valsartan 160 mg Tab Box
103 Valsartan 80 mg Tab Box
104 Vectrim Syr Fls
105 Ventolin nebule Box
box
PT Kimia Farma Trade Megatrading
1 Box 20 spironolacton 25 mg tablet
2 Box 5 Aciclovir 400 mg tab
3 Fls 10 Aminofluid infus
4 Box 2 Aminopilin Tab
5 Fls 10 Aminovel Infus
6 Box 2 Amitriptilin tablet 25 mg
7 Box 20 Amlodipin 5 mg
8 Fls 200 Amoxilin Syr 125 mg / 5 ml
9 Fls 600 Antasida Doen Syr 200
10 Fls 400 Aqua Pro injeksi 25 ml 100
11 Box 10 Arixtra Inj
12 Box 10 Asam Traneksamat 500 mg Tab
13 Fls 400 Ashering Infus 200
14 Box 1 Aspar K tab
15 Box 60 Betahistin Tab 6 mg 20
16 Box 20 Bisoprolol Tab 5 mg 50
17 Pot 2 Burnazim Cream 500 gr
18 Vial 5,000 Cefotaxim Inj
19 Box 30 Ceterizin tablet
20 Box 2 Cilostazol Tab
21 Box 100 Clopidogrel 75 mg Tab 30's
22 Box 50 Co Amoxiclav 625 mg 30's 3
23 Box 5 Co Diovan 80 / 12.5 mg
24 Fls 20 Dextrose 40%
25 Fls 100 Dextrose 5% Infus 100
26 Box 5 Digoxin Tab
27 Vial 20 Dobutamin injeksi 250 mg
28 Box 5 Fenofibrate 300 mg
29 Box 5 Flixotide Nebule
30 Box 40 Furosemid Tab 20
31 Box 3 Galvusmet 80 / 850
32 Box 45 Glimepirid 2 mg
33 Box 5 Haloperidol 0.5 mg Tab
34 Box 3 Inhitril Tab 10 mg
35 Fls 30 Kandistatin Drops 5
36 Fls 10 KCL
37 Vial 15 KTM Inj
38 Box 20 Levofloxacin tablet 500 mg
39 Box 1 Manitol infus
40 Box 30 Metformin 500 mg 20
41 Box 20 Metoclopramid Inj 10 mg / 2 ml
42 Fls 200 metronidazol infus 50
43 Box 20 Metronidazol Tab 500 mg 9
44 Box 10 Mucosta Tab 100's 10
45 Fls 60 Nacl 1000 ml
46 Fls 200 NaCL 500 ml
47 Box 3 Neulin PS Tab
48 Box 30 Ofloxacin 200 mg 50's
49 Box 40 Paracetamol 500 mg Tab 50
50 Box 30 Pedab Tab 10
51 Tin 1 Phenobarbital Tab 30 mg
52 Box 5 Pyrazinamid Tab 500 mg 5
53 Box 20 Ramipril 2.5 mg
54 Box 30 Ramipril 5 mg
55 Box 2 Rifampicin 600 mg
56 Fls 3,000 Ringer Lactate 3,000
57 Fls 10 Seretide Discus Inhaler 250 mcg
58 Box 50 Simvastatin 20 mg Tab 100's 18
59 Box 10 Spironolacton 100 mg
60 Box 1 Sulfa Atropin
61 Box 5 Sulfasalazin Tab 500 mg
62 Box 5 Ventolin nebule 5
63 Pot 10 Vitamin B Complex 100's
PT Antar Mitra Sembada
1 Fls 3 Ataroc syrup
2 Box 2 Casodex tablet 50 mg
3 Tube 50 Cloderma Cream 5 gr
4 Box 30 Cotrimoxazol Tab 480 mg
5 Tube 10 Desolex Cream
6 Box 1 Kutoin injeksi 100 mg
7 Box 10 Meloxicam Supp 5's
8 Box 1 Microlax supp
9 Box 2 recofol injeksi
10 Vial 5 Sabu injeksi
11 Box 5 Takelin 1000 mg tablet
12 Box 5 Truvas tablet 20 mg
13 Tube 10 Zelface Cream

PT Buetna Hareukat
1 Fls 10 Albhotyl 5
2 Box 5 Aspilet Tab
3 Box 10 Avodart Tab
4 Set 1 Bahan Tambal Gigi
5 Tube 100 Betamethason Cream 0.1% 5 gr
6 Pcs 50 Botol Tetes Plastik 12 ml
7 Box 30 Candesartan 16 mg Tab 30's
8 Box 50 Candesartan 8 mg Tab 30's
9 Vial 30 Chloramex Inj
10 Fls 6 Chloro Ethyl
11 Box 30 Clindamicin 150 mg 50's
12 Box 50 Clindamicin 300 mg 50's
13 Box 2 Clobazam Tab
14 Fls 30 Colme tetes telinga
15 Vial 10 Cortison Inj
16 Ktk 4 Cotton Roll
17 Box 2 Depokate Tab
18 Box 10 Diamicron MR
19 Box 10 Dulcolax Supp Dewasa
20 Fls 30 Flutias Inhaler 125 mcg 10
21 Tin 1 Formalin Tab
22 Box 20 Gabapentin 300 mg capsul
23 Box 2 Glucophage 850
24 Box 50 Glucosamin Tab 60's
25 Box 15 Harnal ocas 30's
26 Tin 1 HCT Tab 25 mg
27 Vial 30 Hemapo Inj 3000 IU 20
28 Box 1 Hystolan Tab 50's
29 Box 20 Ibuprofen Tab 400 mg 6
30 Pot 50 Ichtiyol salep
31 Fls 20 Illiadin 0,025 %
32 Fls 40 Illiadin 0,5 %
33 Tin 1 INH 100 mg Tab 1000's
34 Tin 2 INH 300 mg
35 Box 3 Itraconazol tablet
36 Box 2 KA EN 3B
37 Box 10 Kalxetin 10 mg
38 Pack 3 Kertas Perkamen
39 Tube 50 Ketoconazole cream 10 gr
40 Tube 50 Ketricin Orabase
41 Box 2 KSR Tab 600 mg
42 Box 5 Levemir Flexpen
43 Box 10 Lipitor 10 mg
44 Box 10 Lipitor 20 mg
45 Box 3 Ludiomil 25 mg
46 Box 5 Lyrica 75 mg
47 Tube 3 Mebo krim 20 gr
48 Box 4 Nald novotwist 100's
49 Ktk 1 Nald u/ Cabut Gigi
50 Tube 10 Nebacetin Zalf
51 Box 10 Neo K 2 mg/ml injeksi
52 Box 3 Norvask 10 mg
53 Box 15 Novorapid flexpen
54 Box 30 Otopain TT
55 Box 2 Pampers Dewasa uk/ L
56 Box 2 Pampers Dewasa uk/ M
57 Box 2 Pampers Dewasa uk/ XL
58 Box 5 Plavix Tab 75 mg
59 Box 3 Pletaal tablet 100 mg
60 pot 50 Pot obat 20 mg
61 Pot 50 Pot obat 40 mg
62 Vial 50 Procain Penicillin Inj 50
63 Box 5 Prostigimin Inj
64 Box 5 Regumen Tab 30's 5
65 Box 5 Risperidon Tab
66 Pot 30 Salicyl Talk
67 Ktk 1 Septocain
68 Box 10 Sistenol Tab
69 Bks 1 Solare X A3
70 Ktk 1 Spongostan
71 Fls 1 Stac 5 ml (Bonding)
72 Box 60 Tramadol Inj 100 mg / 2 ml 5's
73 Box 2 Tramuz Inj
74 Box 5 Trileptal tablet 600 mg
75 Box 20 Trizedon MR
76 Box 2 Urdahex Tab 250 mg
77 Tin 2 Vit K Tab
78 Vial 30 Xylamidon Inj
79 Pcs 2 Xylocain Jell
80 Pcs 2 Xylonor Spray
81 Box 3 Ziloric 300 mg

PT Mensa Bina Sukses


1 Box 30 Alpentin 100 mg 30
2 Fls 10 Alphamol drop 20
3 Fls 200 Alphamol syrup
4 tube 50 Bevalex cream
5 Box 50 Dicloflam 25 mg Tab 100's
6 Box 30 Infantrim Tab 480 mg
7 Box 40 Lexadium Tab 20
8 Box 130 Molaneuron Tab 100's 10
9 Box 50 Piralen Inj
10 Box 50 Pritamox Tab 50
11 Box 50 Pritavit Tab 100's
12 Box 30 Stesolid injeksi 5 mg
13 Box 3 stesolid rectal 5mg
14 Fls 5 Stesolid syrup
15 Box 20 Trifedrin Tab 100
16 Fls 10 Valeptic Syr
17 Fls 300 Vical Syr

PT Mesarinda Abadi
1 Lsn 1 Nald 6030 G/T 7
2 Pcs 12 Assucryl 0 Ref 4346 N
3 Lsn 1 Assucryl 1 Ref 43427 H
4 Lsn 1 Assucryl 1 Ref 43437 H
5 Pcs 1 Assucryl 1 Ref 43977 H
6 Lsn 1 Assucryl 2/0 Ref 4575
7 Lsn 1 Assucryl 3/0 Ref 4254
8 Lsn 1 Assucryl 3/0 Ref 4564
9 Roll 1 Cat Gut Chromic 1
10 Lsn 1 Cat Gut Chromic 1 Ref 2447 H
11 Roll 1 Cat Gut Plain 0
12 Pcs 1 Corset Lumbal uk/ L Pria
13 Pcs 1 Corset Lumbal uk/ M Wanita
14 Box 30 Easy Touch Glucose 20
15 Pak 1 Electroda
16 Pcs 5 Extention Tubing 5
17 Pcs 2 Folley Cateter No 12
18 Pcs 2 Folley cateter No10 2
19 Pcs 2 Folley Catheter No 6 4
20 Pcs 50 Folley Catheter No.18
21 Pcs 2 Folley Catheter No.8
22 Box 10 Hand Scun No.7
23 Box 20 Hand Scun No.7.5
24 Box 5 Hand Scun No.8
25 Ltr 5 Hybiscrub
26 Roll 20 Hypafix 15 x 5 10
27 Roll 30 Hypafix 5 x 5 20
28 Box 10 Infuset Dewasa 4
29 Box 2 Infuset Ped 1
30 Box 5 Iv cateter 20 4
31 Box 15 IV Catheter 22 1
32 Ktk 50 Kasa Hydrofil Kotak 80
33 Roll 3 Kassa Lucky
34 Tube 10 K-Y Jelly
35 Jrg 1 KY Jelly Jerigen
36 Roll 12 Leucocrep 3 inci BSN 12
37 Roll 12 Leucocrep 4 inci BSN
38 Roll 24 Leucocrep 6 inci BSN 12
39 Roll 12 Leucodur 4"
40 Roll 6 Leucodur 6" 6
41 Roll 40 Leucoplast 1623 BSN 20
42 Roll 30 Leucoplast 1624 BSN 5 X 4.5 20
43 Roll 30 Leucoplast 7.5 x 4.5
44 Lsn 1 Nald 6030 G/T 10
45 Lsn 1 Nald 6030 G/T 12
46 Lsn 1 Nald 6030 G/T 14
47 Lsn 1 Nald 6120 E000
48 Pcs 50 Nasal Canula Dewasa 20
49 Pcs 2 NGT 14
50 pcs 5 NGT 16
51 Pcs 15 NGT 18
52 Lsn 1 Polypropylene 3/0 Ref 9574
53 Lsn 1 Polypropylene 4/0 Ref 9553
54 Lsn 1 Polypropylene 5/0 Ref 9532
55 Box 1 Postofix 10x10
56 Box 1 Postofix 10x15
57 Box 1 Postofix 10x25
58 Roll 1 SiLk Black 0
59 Roll 1 Silk Black 2/0
60 Roll 12 Sofband 6"
61 Box 3 Spinocain 2
62 Box 3 Spuit 1 cc
63 Box 1 Spuit 100 cc Lubang Tengah
64 Box 2 Spuit 10cc
65 Box 1 Spuit 50cc Lubang Tengah
66 Box 1 Spuit 50cc Lubang Tepi
67 Pcs 1 Stamper dan mortir
68 Pcs 2 Suction Catheter No.16
69 Box 2 Threway
70 Box 1 Tranfusi Set
71 Box 1 Umbilical cord clamp
72 Pcs 100 Urine Bag
73 Roll 50 Verban 15cm 110
PT Parit Padang
1 Box 5 Anesfar injeksi 5mg
2 Box 30 Calcit (Calcatriol)
3 Tube 5 Decubal Cream
4 Box 1 Efedrin Inj
5 Box 2 Etirox 100 mg
6 Box 3 Farmasal 100 mg Tab 100's
7 Box 30 Farsix 40 mg Tab 100's
8 Vial 10 Farsorbid Inj
9 Box 30 Fasorbid 5 mg tablet
10 Fls 20 Interhistin Syr
11 Box 20 Interhistin Tab
12 Box 2 Ketese Tab 25 mg
13 Vial 2,000 Liaxon Inj
14 Vial 4,000 Litaxim Inj
15 Box 2 Nuzyp Tab 10 mg
16 Box 3 Remital 10 mg tablet
17 Fls 30 Tarivid tetes telinga
18 Tube 20 Trombopop gel 20 gr

PT Sawah Besar
1 Box 100 Clidorel tablet 50
2 Box 10 Ketocid tablet 3
3 Box 5 Levazide tablet
4 Fls 30 Otozambon Tetes Telinga
5 Box 5 Raos tablet 50 mg
6 Box 2 Sandepril Tab 50 mg

PT PENTA VALENT
1 Box 5 Cal -95
2 Strip 20 Cendo Catarlen 0,6 ml @ 5's minidose
3 Strip 20 Cendo Genta 0,6 ml@ 5's minidose
4 Strip 10 Cendo Glaopent 0,6 ml@ 5's minidose
5 Strip 20 Cendo LFX 0,6 ml @ 5's minidose
6 Strip 10 Cendo Lubricent 0,6 ml@ 5's minidose 3
7 Strip 20 Cendo Lyteers 0,6 ml@ 5's minidose 50
8 Strip 20 Cendo polidex 0,6ml@5's minidose
9 Strip 5 Cendo Tonor 0,6ml@5'S minidose
10 Strip 60 Cendo Ulcori 0,6 ml @ 5's minidose
11 Strip 25 Cendo Xitrol 0,6 ml@ 5's minidose
12 Box 20 Diuvar Inj 40
13 Fls 20 Forasma Syr
14 Jrg 3 Handscrub
15 Box 5 L - Bio Sachet 5
16 Fls 50 Lagesil Syrup
17 Box 3 Lapibal Inj
18 Fls 50 L-Zink Syr 20
19 Box 5 Myotonic Tab 1
20 Box 50 Suprafenid Supp

PT United Dico Citas


1 Box 3 Alinamin f injeksi
2 Box 5 Alinamin f Tablet 3

PT PROTEUSSABA NUSANTARA
1 Btl 2 Albumin
2 Gal 1 Alfa Diluent
3 Gal 1 Alfa Lyse
4 Jrg 3 Aquabidest
5 Btl 2 Billirubin Direct
6 Btl 2 Billirubin Total
7 Box 5 Blood Call Red
8 Box 10 Blood Call Ungu
9 Box 3 Blood Lancet
10 Btl 2 Creatinine
11 Btl 2 GGT
12 Btl 2 Glucose
13 Vial 2 Gol Darah A
14 Vial 2 Gol Darah B
15 Kit 2 Hbs Ag
16 Kit 1 HCV
17 Kit 2 HDL Cholesterol
18 Btl 2 Protein Total
19 Kit 1 RF Test
20 Btl 1 SGPT
21 KIt 1 Tubex TF
22 Btl 2 Verify
Kit 1 Widal Test
Inventaris
1 Set 1 Abortus Tang
2 Pcs 1 Alat Potong Gips
3 Pcs 1 Baskom Stenless + Standar
4 Pcs 1 Gunting Benang
5 Pcs 1 Gunting Jaringan
6 Pcs 1 Gunting Kain
7 Pcs 1 Gunting Verban Bengkok
8 Set 1 Irigator
9 Pcs 2 Nierbeken Besar
10 Pcs 2 Pispot Pria
11 Pcs 1 Pispot Wanita
12 Unit 1 Regulator Oksigen
13 Pcs 1 Senter
14 Unit 6 Standar Infus
15 Set 1 Tena Kulum
16 Unit 1 Tensi Kompas
17 Pcs 2 Tensimeter Air Raksa
18 Unit 2 Tensimeter Digital
19 Unit 2 Timbangan Badan
20 Pcs 2 Tongue Spatel Anak Stenless
21 Unit 1 Troly
22 Unit 1 Troly Emergency
23 Pcs 3 Washkom (Washen)

Untuk Kamar Bedah


Surgeri Set Mayor :
1 Pcs 2 - Canula Section (Steinless Stell)
2 Pcs 2 - Gunting Benang Lurus
3 Pcs 3 - Gunting Resesi Ujung Runcing 7"
4 Pcs 3 - Gunting Resesi Ujung Tumpul 7"
5 Pcs 12 - Hemostatic Forcef 6"-7"
6 Pcs 6 - Hemostatic Forcef Kocher 6"
7 Pcs 6 - Intestinal Tissue Forcef Bengkok
8 Pcs 6 - Intestinal Tissue Forcef Lurus
9 Pcs 4 - Kom Steinless Stell
10 Pcs 4 - Nearbeken (Bengkok)
11 Pcs 6 - Needle Holder (Nald Furder) 7"
12 Pcs 6 - Pinset Anatomis 7"
13 Pcs 6 - Pinset Cirugis 7"
14 Pcs 2 - Retractor Mekanic (Hak Otomatis)
15 Pcs 3 - Scalpel
16 Pcs 2 - Selang Suction Silikon
17 Pcs 6 - Sponge Holding Forcef
18 Pcs 1 - Suction Mesin

Surgeri Set Minor :


19 Pcs 2 - Gunting Benang Lurus 5"
20 Pcs 2 - Gunting Verban 5"
21 Pcs 12 - Hemostatic Forcef 5"-6"
22 Pcs 12 - Hernia Klem 5"
23 Pcs 4 - Needle Holder (Nald Furder) 5"
24 Pcs 6 - Pinset Anatomis 5"
25 Pcs 6 - Pinset Cirugis 5"
26 Pcs 3 - Scalpel
box
PT Kimia Farma Trade Megatrading
1 Tube 100 Acyclovir Cream
2 Box 30 Allupurinol 300 mg Tab
3 Fls 400 Ambroxol Syr
4 Fls 10 Aminofluid
5 Box 2 Amitriptilin 25 mg
6 Box 20 Amlodipin 5 mg
7 Fls 600 Amoxilin Syr 125 mg / 5 ml
8 Box 60 Amoxilin Tab 500 mg
9 Box 6 Angioten Tab
10 Fls 600 Antasida Doen Syr
11 Fls 600 Aqua Pro injeksi 25 ml
12 Box 80 Asam Mefenamat Tab
13 Fls 400 Ashering Infus
14 Box 1 Aspar K tab
15 Box 10 ATS 1500 IU
16 Fls 50 Azitromycin Syr
17 Box 50 Bisoprolol Tab 5 mg
18 Pot 2 Burnazim Cream 500 gr
19 Box 20 Captopril 12.5mg
20 Box 2 Carbamazepin Tab
21 Box 50 Cefadroxil 500 mg Cap 100's
22 Fls 300 Cefadroxil Syr
23 Box 30 Cefixim Cap 100's
24 Vial 3,000 Cefotaxim Inj
25 Vial 10 Ceftazidim Inj
26 Box 1,000 Ceftriaxon Inj 10's
27 Box 50 Ceterizin Tab 10 mg 30's
28 Box 60 Ciprofloxacin 500 mg Tab
29 Fls 10 Ciprofloxacin Infus
30 Box 30 Citicolon Inj 250 mg 10's
31 Box 30 Clopidogrel 75 mg Tab 30's
32 Box 20 Co Amoxiclav 625 mg 30's
33 Fls 200 Curcuma Syr
34 Box 5 Dextrose 10% Infus
35 Fls 20 Dextrose 40%
36 Fls 100 Dextrose 5% Infus
37 Vial 5 Dobutamin Inj
38 Fls 20 Domperidon Drops
39 Fls 200 Domperidon Syr
40 Box 2 Efedrin Inj
41 Box 15 Ethambutol Tab 500 mg
42 Box 2 Exjade 500 mg Tab
43 Box 5 Fenofibrate 300 mg
44 Box 5 Flixotide Nebule
45 Box 35 Furosemid 10 mg injeksi 25's
46 Box 30 Gabapentin 300mg
47 Tube 200 Gentamycin SK
48 Box 40 Glimepirid 1 mg Tab 100
49 Box 45 Glimepirid 2 mg
50 Box 50 Glimepirid 3 mg
51 Box 50 Glimepirid 4 mg
52 Box 5 Haloperidol 0.5 mg Tab
53 Fls 50 Ibuprofen Syr
54 Box 80 ISDN Tab
55 Fls 30 Kandistatin Drops
56 Box 30 Ketorolac 10 mg Tab
57 Vial 3 KTM Inj
58 Box 400 Lansoprazol 30 mg Cap
59 Box 4 Lidocain HCl 2 % injeksi 100's
60 Box 150 Meloxicam 15 mg 100's
61 Vial 100 Meropenem Inj 1 gr
62 Box 80 Metformin 500 mg
63 Box 10 Metformin 850 mg
64 Vial 60 Methylprednisolon Inj 125 mg
65 Box 5 Metoclopramid Inj 10 mg / 2 ml
66 Fls 400 Metronidazol Infus
67 Box 10 Mucosta Tab 100's
68 Fls 60 Nacl 1000 ml
69 Fls 400 NaCL 500 ml
70 Box 30 Natrium Diklofenac 50 mg Tab
71 Box 2 Neulin PS Tab
72 Box 30 Ofloxacin 200 mg 50's
73 Box 30 Ofloxacin 400 mg
74 Box 300 Omeprazol Cap
75 Box 30 Ondancentron 4mg Tab
76 Box 100 Paracetamol 500mg Tab
77 Fls 200 Paracetamol Infus
78 Fls 400 Paracetamol Syr
79 Box 20 Pedab Tab
80 Tin 1 Phenobarbital Tab 30 mg
81 Box 10 Piracetam 400 mg Tab
82 Box 20 Prednison Tab
83 Box 5 Pyracetam 800 mg
84 Box 5 Pyrazinamid Tab 500 mg
85 Box 10 Ramipril 2.5 mg
86 Box 10 Ramipril 5 mg
87 Box 100 Ranitidin Tab
88 Box 5 Recofol Inj
89 Box 10 Rifampicin 450 Tab 100's
90 Box 1 Rifampicin 600 mg
91 Fls 4,000 Ringer Lactate
92 Box 20 Salbutamol 2 mg Tab
93 Fls 10 Seretide Discus Inhaler 250 mcg
94 Box 50 Simvastatain 10 mg Tab
95 Box 50 Simvastatin 20 mg Tab 100's
96 Box 20 Spironolacton 25 mg
97 Box 4 Stesolid Rectal
98 Box 7 Stesolid Tab 2 mg
99 Box 1 Sulfa Atropin
100 Box 5 Sulfasalazin Tab 500 mg
101 Box 65 Tramadol 50 mg Cap 100's
102 Box 2 Tramus Inj
103 Fls 20 Ventolin Inhaler
104 Box 15 Ventolin nebule
105 Box 15 Widahest Infus

PT Antar Mitra Sembada


1 Box 30 Atorvastatin 20 mg
2 Tube 50 Cloderma Cream 5 gr
3 Box 30 Cotrimoxazol Tab 480 mg
4 Box 10 Meloxicam Supp 5's
5 Box 5 Miloz 5 mg/ 5 ml injeksi 10's
6 Box 15 Natrium Diklofenak 50 mg Tab 100's
7 Tube 10 Zelface Cream
PT Buetna Hareukat
1 Set 1 Acchatit (Tambalan Gigi Anterior)
2 Box 5 Adalat Oros
3 Fls 10 Albhotyl
4 Bks 2 Alginate
5 Jrg 4 Alkohol 96 %
6 Box 3 Amaryl M
7 Box 2 Amoxan 500 mg Tab
8 Box 5 Aspilet Tab
9 Box 10 Avodart Tab
10 Set 1 Bahan Tambal Gigi
11 Pot 50 Bedak Salicyl
12 Tube 5 Bepanten Cream
13 Fls 10 Berotec Inhaler
14 Tube 100 Betamethason Cream 0.1% 5 gr
15 Tube 30 Bioplacenton Cream
16 Box 2 Biosanbe Tab
17 Pcs 50 Botol Tetes Plastik 12 ml
18 Box 30 Candesartan 16 mg Tab 30's
19 Box 50 Candesartan 8 mg Tab 30's
20 Box 2 Celebrex 100 mg
21 Bks 1 Cement Powder + Cemen Liquid
22 Vial 30 Chloramex Inj
23 Fls 6 Chloro Ethyl
24 Box 10 Clindamicin 150 mg 50's
25 Box 10 Clindamicin 300 mg 50's
26 Box 2 Clobazam Tab
27 Vial 10 Cortison Inj
28 Bks 2 Cotton Roll
29 Box 35 Curcuma Tab
30 Box 2 Depokate Tab
31 Tin 5 Dexamethason Inj
32 Box 20 Dexamethason Tab
33 Box 10 Diamicron MR
34 Box 25 Diovan 160 mg 27's
35 Box 25 Diovan 80 mg 27's
36 Box 3 Dulcolax Supp Anak
37 Box 10 Dulcolax Supp Dewasa
38 Box 1 Epolite
39 Box 5 Erytromicin Cap 250 mg
40 Box 10 Farmasal Tab
41 Fls 10 Flutias Inhaler 125 mcg
42 Box Formalin Tab
43 Bks 2 Gips Putih
44 Bks 2 Gips Stone
45 Box 10 Glibenclamide 5mg
46 Box 2 Glucophage 850
47 Box 3 Glucophage XR
48 Box 50 Glucosamin Tab 60's
49 Box 15 Harnal ocas 30's
50 Tin 1 HCT Tab 25 mg
51 Vial 40 Hemapo Inj 3000 IU
52 Box 1 Hystolan Tab 50's
53 Pot 50 Ichtiyol salep
54 Fls 20 Illiadin 0,025 %
55 Fls 40 Illiadin 0,5 %
56 Tin 1 INH 100 mg Tab 1000's
57 Tin 2 INH 300 mg
58 Box 1 KA EN 3B
59 Box 3 Kalxetin 10 mg
60 Bks 1 Kapsul Kosong No.1
61 Bks 2 Kapsul Kosong No.2
62 Bks 1 Kapsul Kosong No.3
63 Box 10 Ketoconazol Tab 50's
64 Tube 50 Ketricin Orabase
65 Box 3 Lipitor 10 mg
66 Box 3 Lipitor 20 mg
67 Box 30 Loratadin Tab
68 Box 3 Ludiomil 25 mg
69 Box 3 Lyrica 75 mg
70 Tube 3 Mebo krim 20 gr
71 Box 4 Nald novotwist 100's
72 Ktk 1 Nald u/ Cabut Gigi
73 Tin 3 Natrium Bicarbonat Tab
74 Tube 10 Nebacetin Zalf
75 Box 10 Neo K 2 mg/ml injeksi
76 Box 3 Norvask 10 mg
77 Box 15 Novorapid flexpen
78 Tin 1 Occo
79 Box 1 Oralit
80 Box 30 Otopain TT
81 Box 2 Pampers Dewasa uk/ L
82 Box 2 Pampers Dewasa uk/ M
83 Box 2 Pampers Dewasa uk/ XL
84 Pot 1 Parafin 500
85 Box 20 Pehacain inj
86 Box 3 Plavix Tab 75 mg
87 Vial 100 Procain Penicillin Inj
88 Box 5 Prostigimin Inj
89 Box 3 Proten Susu
90 Fls 5 Psidii Syr
91 Box 5 Recolfar Tab
92 Box 10 Regumen Tab 30's
93 Box 3 Renalof Cap
94 Box 2 Renax Cap
95 Box 2 Rinofer Inj
96 Box 2 Rinofr Tab
97 Vial 3 Serum Anti Bisa Ular (SABU) Inj
98 Box 5 Simarc 2mg Tab
99 Box 10 Sistenol Tab
100 Box 5 Spiriva Refile
101 Strip 1 Spongostam
102 Tin 3 Sulfas ferosus
103 Tin 1 Tetraciclin Cap
104 Box 5 THF Tab 100's
105 Box 30 Tramadol Inj 100 mg / 2 ml 5's
106 Box 3 Trileptal 600 mg
107 Box 20 Trizedon MR
108 Box 5 Trolip Cap 300 mg
109 Box 2 Urdahex Tab 250 mg
110 Tin 2 Vit K Tab
111 Vial 30 Xylamidon Inj
112 Pcs 2 Xylocain Jell
113 Pcs 2 Xylonor Spray
PT Mensa Bina Sukses
1 Fls 100 Alpara Syr
2 Box 50 Alpentin 100 mg
3 Fls 400 Alphamol Syr
4 Box 1 Asabium Tab
5 Tube 150 Bevalex Cream
6 Fls 400 Dextral Syr
7 Box 20 Dextral Tab 100's
8 Box 50 Dicloflam 25 mg Tab 100's
9 Box 50 Dicloflam 50 mg Tab 100's
10 Box 10 Folac Tab
11 Tube 100 Gentalex Cream
12 Fls 200 Infantrim Syr
13 Box 30 Infantrim Tab 480 mg
14 Box 20 Irbesartan 150 mg
15 Box 80 Lexacort Tab
16 Fls 600 Lexacrol Syr
17 Box 30 Lexacrol Tab
18 Box 40 Lexadium Tab
19 Box 10 Lexagin Tab 500 mg 100's
20 Box 60 Lexapram Tab
21 Box 50 Lexavit Tab 100's
22 Fls 300 Lexavon Syr
23 Box 20 Lexavon Tab
24 Box 40 Lexicam 10 mg Tab 100's
25 Box 40 Lexicam 20 mg Tab 100's
26 Box 30 Molacort Tab
27 Tube 50 Moladerm Cream
28 Fls 400 Molafate Susp
29 Box 30 Molagit Tab
30 Box 130 Molaneuron Tab 100's
31 Fls 300 Molapect Syr
32 Box 30 Molapect Tab
33 Box 70 Molasic 500 mg Tab
34 Fls 400 Molexdryl Syr
35 Box 50 Molexflu Tab
36 Fls 10 Mucera Drop
37 Box 20 Piralen Inj
38 Fls 300 Pritamox Syr
39 Box 50 Pritamox Tab
40 Box 30 Pritasma Tab
41 Box 50 Pritavit Tab 100's
42 Tube 100 Renvol Cream
43 Box 30 Thiamfilex Cap 500 mg
44 Fls 15 Valeptic Syr
45 Fls 400 Vical Syr
PT Mesarinda Abadi
1 Pcs 3 Balon Tensi
2 Pcs 5 Circuit anaestesi
3 Pcs 1 Corset Lumbal uk/ L Pria
4 Pcs 1 Corset Lumbal uk/ M Wanita
5 Box 20 Easy Touch Cholesterol 10's
6 Box 20 Easy Touch Glucose 25's
7 Pcs 1 ETT No.6.5 Non King2
8 Pcs 2 ETT No.7 Non King2
9 Pcs 2 ETT No.7.5 Non King2
10 Pcs 10 Extention Tubing
11 Pcs 2 Folley Catheter No.16
12 Pcs 50 Folley Catheter No.18
13 Pcs 5 Guidel Hijau
14 Box 5 Hand Scun No.7
15 Box 10 Hand Scun No.7.5
16 Box 30 Hand Scun Non Steril
17 Roll 20 Hypafix 15 x 5
18 Roll 30 Hypafix 5 x 5
19 Box 5 Infuset Dewasa
20 Box 2 Infuset Ped
21 Pcs 50 Iodine Povidon 60 ml
22 Box 15 IV Catheter 22
23 Roll 40 Kapas 100 gr
24 Ktk 100 Kasa Hydrofil Kotak
25 Roll 7 Kassa Lucky
26 Pack 2 Kertas Print USG
27 Tube 10 K-Y Jelly
28 Jrg 1 KY Jelly Jerigen
29 Box 2 Laminaria
30 Roll 12 Leucocrep 3 inci BSN
31 Roll 12 Leucocrep 4 inci BSN
32 Roll 24 Leucocrep 6 inci BSN
33 Roll 12 Leucodur 4"
34 Roll 6 Leucodur 6"
35 Roll 60 Leucoplast 1623 BSN
36 Roll 30 Leucoplast 1624 BSN 5 X 4.5
37 Roll 30 Leucoplast 7.5 x 4.5
38 Box 20 Lomatul
39 Pcs 3 Manset Omron Latex Free
40 Pcs 3 Manset Tensi
41 Box 30 Masker Tali
42 Box 5 Nald 23
43 Lsn 1 Nald G/T 6030 - 12
44 Lsn 1 Nald G/T 6036 - 12
45 Lsn 1 Nald G/T 6036 - 8
46 Pcs 50 Nasal Canula Dewasa
47 Pcs 10 NGT 18
48 Box 1 Pisau Bisturi No.24
49 Box 1 Postofix 10x10
50 Box 1 Postofix 10x15
51 Box 1 Postofix 10x25
52 Pcs 50 Pot Obat 20 gr
53 Roll 6 Sofband 3"
54 Roll 12 Sofband 6"
55 Box 1 Spinocain
56 Box 1 Spuit 1 cc
57 Box 1 Spuit 100 cc
58 Box 2 Spuit 10cc
59 Box 50 Spuit 3 cc
60 Box 50 Spuit 5 cc
61 Box 3 Three Way
62 Box 2 Topi Operasi
63 Pcs 2 Torax Dray No.20
64 Box 1 Tranfusi Set
65 Pcs 1 Truelene Mesh 6 x 11 cm
66 Pcs 100 Urine Bag
67 Roll 300 Verban 15cm
PT Sapta Sari Tama
1 Fls 10 Belamox Syr
2 Box 10 Calcimega Tab
3 Tube 5 Decubal Cream
4 Box 2 Etirox 100 mg
5 Fls 50 Laxadin Syr
6 Vial 2,000 Liaxon Inj
7 Vial 4,000 Litaxim Inj
8 Box 2 Renalof Cap
9 Box 20 Sohobion Tab
10 Fls 30 Vectrim Syr

PT Sawah Besar
1 Box 10 Epsonal Tab
2 Vial 10 Farsorbid Inj
3 Box 10 Ketocid Tab
4 Box 2 Kutoin Cap
5 Box 2 Levazide Tab
6 Fls 30 Otozambon Tetes Telinga
7 Box 2 Sandepril Tab 50 mg
8 Box 1 Suldox Tab
9 Fls 20 Tarivid Otic TT

PT PENTA VALENT
1 Strip 10 Cendo Asthenof 0,6 ml@ 5's minidose
2 Strip 20 Cendo Augentonic 0,6 ml@ 5's minidose
3 Strip 20 Cendo Catarlen 0,6 ml @ 5's minidose
4 Strip 10 Cendo Cenfresh 0,6 ml@ 5's minidose
5 Strip 10 Cendo Eyefresh 0,6ml@5's minidose
6 Strip 5 Cendo Fenicol 0.25% 0,6 ml@ 5's minidose
7 Strip 5 Cendo Floxa 0,6 ml@ 5's minidose
8 Tube 30 Cendo Genta SM
9 Strip 10 Cendo Glaopent 0,6 ml@ 5's minidose
10 Strip 10 Cendo LFX 0,6 ml @ 5's minidose
11 Strip 10 Cendo Lubricent 0,6 ml@ 5's minidose
12 Strip 50 Cendo Lyteers 0,6 ml@ 5's minidose
13 Strip 5 Cendo Pantocain 2% 0,6 ml@ 5's minidose
14 Strip 20 Cendo Polydex 0,6 ml@ 5's minidose
15 Strip 5 Cendo Tonor 0,6 ml @ 5's minidose
16 Strip 60 Cendo Ulcori 0,6 ml @ 5's minidose
17 Strip 10 Cendo Vitrolenta 0,6 ml@ 5's minidose
18 Strip 25 Cendo Xitrol 0,6 ml@ 5's minidose
19 Box 400 Diufar Inj 5's
20 Fls 20 Forasma Syr
21 Jrg 3 Handscrub
22 Box 5 L - Bio Sachet
23 Box 7 L - Cisien Tab 30's
24 Box 3 Lapibal Inj
25 Fls 50 Lasal Syr
26 Fls 30 L-Zink Syr
27 Box 10 Mecola Tab
28 Box 30 Norages Inj

PT United Dico Citas


1 Box 7 Alinamin injeksi
2 Tube 50 Bersol Cream
3 Box 10 Ciflon Tab
4 Box 2 Esilgan Tab 2 mg
5 Box 2 Imboost Tab
6 Tube 100 Motaderm Cream

PT PROTEUSSABA NUSANTARA
1 Gal 1 Alfa Diluent
2 Gal 1 Alfa Lyse
3 Jrg 1 Aquadest
4 Box 6 Blood Call Ungu
5 Pcs 2 Bola Lampu Halogen A-25
6 Pcs 1 Bola Lampu Halogen Microscope
7 Vial 1 Calibrator
8 Btl 2 Cholesterol
9 Vial 1 Control Serum Level I (CSL I)
10 Vial 1 Control Serum Level II (CSL II)
11 Set 2 Createnine
12 Btl 2 Glucose
13 Kit 1 HDL Cholesterol
14 Pcs 2 Sensi Gloves
15 Btl 2 SGOT
16 Btl 2 SGPT
17 Btl 2 Trigliceride
18 Btl 2 Urea
19 Btl 2 Uric Acid

Inventaris
1 Unit 1 Alat Cek KGD
2 Pcs 1 Alat Potong Gips
3 Pcs 1 Baskom Stenless + Standar
4 Pcs 1 Gunting Benang
5 Pcs 1 Gunting Jaringan
6 Pcs 1 Gunting Kain
7 Pcs 1 Gunting Verban Bengkok
8 Pcs 2 Nierbeken Besar
9 Unit 2 Rustur
10 Pcs 2 Sendok Curretage Doble
11 Pcs 2 Sendok Curretage No.2
12 Pcs 1 Senter
13 Unit 6 Standar Infus
14 Unit 1 Tensi Kompas
15 Unit 1 Tensimeter Digital
16 Pcs 1 Tensimeter Manua
17 Unit 2 Thermometer Air Raksa
18 Pcs 3 Thermometer Manual
19 Unit 1 Timbangan Badan
20 Pcs 2 Tongue Spatel Anak Stenless
21 Pcs 2 Tourniquet
22 Unit 1 Troly
23 Unit 1 Troly Emergency
PT CUT MEUTIA MEDIKA NUSANTARA
RUMAH SAKIT CUT MEUTIA
REKAP AU-31
PERIODE BULAN MEI 2014

NO DISTRIBUTOR NO. AU-31 JUMLAH KETERANGAN

1 PT ANUGRAH ARGON MEDICA RSCM/AU-31/067/2014 279,969,668

2 PT ANTAR MITRA SEMBADA RSCM/AU-31/068/2014 48,152,340

3 PT BUETNA HAREUKAT RSCM/AU-31/069/2014 130,486,795

4 PT ENCEVALL PUTRA MEGATRADING RSCM/AU-31/070/2014 29,632,510

5 PT RAJAWALI NUSINDO RSCM/AU-31/071/2014 118,514,076

6 PT UNITED DICO CITAS RSCM/AU-31/072/2014 75,876,466

7 PT PENTA VALENT RSCM/AU-31/073/2014 164,142,043

8 PT MESARINDA ABADI RSCM/AU-31/074/2014 87,818,730

9 PT TIRTA MEDICAL INDONESIA RSCM/AU-31/075/2014 12,320,802

10 PT HEXALAB SUMATERA RSCM/AU-31/076/2013 10,322,548

11 PT HEXALAB SUMATERA RSCM/AU-31/011/2014 10,242,151

12 PT. SAPTA SARI TAMA RSCM/AU-31/012/2014 27,146,565

13 PT DOS NI ROHA RSCM/AU-31/013/2014 31,942,219

14 PT SAWAH BESAR FARMA RSCM/AU-31/014/2014 33,557,777

15 KOPKAR MON MADU RSCM/AU-31/015/2014 11,434,500

JUMLAH SELURUHNYA 1,071,559,189

Diminta oleh : RSCM


Plh. Kepala

dr. Cut Diah AK


Assur. Operasional & Pelayanan
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Anugrah Argon Medica 1
No. U R A I A N Banyaknya Keterangan
Prod. Actavis
1 Alpentin 300 mg Cap 50's 15 Box
2 Cloramex Inj 10's 5 Box
3 Stesolid Inj 5's SP OKT 2 Box
4 Stesolid 2mg Tab 100's SP OKT 2 Box
5 Stesolid Syr SP OKT 6 Fls

Prod. BSN
6 Leukoplast 4.5 X 2.5 BSN 22 Roll
7 Leukoplast 4.5 X 5 BSN 20 Roll
8 Leukoplast 4.5 X 7.5 BSN 20 Roll
9 Hypafix 5 x 15 20 Roll
10 Leucocrep 3 Inc 6 Roll
11 Leucocrep 4 Inc 12 Roll
12 Masker Tali 50's 15 Box

Prod. Dexa Medica


13 Anvomer B6 Tab 60's 2 Box
14 Azomax 500 mg Tab 10's 15 Box
15 Canderin 8 mg Tab 30's 5 Box
16 Recofol Inj 5's 4 Box
17 Rhinos SR 50's 5 Box
18 Sistenol Tab 60's 5 Box
19 Trolip 300 mg Kaps 30's 2 Box
20 Vectrin Syr 17 Fls
21 Tramus Injeksi 10 Amp

Prod. Ferron
22 Ketricin Orabase 15 Tube

Prod. Merck
23 Concor 2,5 mg Tab 100's 5 Box
24 Concor 5 mg Tab 100's 5 Box
25 Glucopage 500 mg Tab 100's 10 Box

Prod. Novo Nordisk


25 Levemir Flexpen 5's 5 Box
26 Novomix Flexpen 5 's 5 Box
27 Novorapid Flexpen 5's 15 Box

Prod. OGB Dexa Medica


28 Acyclovir 400 mg Tab 50's 5 Box
29 Alprazolam 0.5 mg Tab 100SP OKT 60 Box
30 Amlodipin 5 mg Tab 50's 40 Box
31 Amoxicillin 500 mg Tab 100's 10 Box
32 Asam Mefenamat 500 mg Tab 100's 50 Box
33 Bisoprolol 5 mg Tab100's 25 Box
34 Cefadroxil 500 mg Kaps 50's 25 Box
35 Ceftriaxon Inj 10's 15 Box
36 Clindamicin 300 mg Kaps 50's 10 Box
37 Clopidogrel 75 mg Tab 30's 50 Box
38 Cefotaxim Inj 500 Vial
Dipindahkan
Kepada : PT Anugrah Argon Medica 2
No. U R A I A N Banyaknya Keterangan
Pemindahan
39 Dexametason Inj 100's 2 Box
40 Domperidon 10 mg Tab 100's 40 Box
41 Domperidon Syr 50 Fls
42 Gliquidon 30 mg Tab 100's 1 Box
43 Glucodex Tab 25 Box
44 Ketokonazole Cream 2% 10 gr 24's 4 Box
45 Levofloxacin 500 mg Tab 30's 15 Box
46 Levofloxacin Infus 100 ml 10 Fls
47 Meloxicam 15 mg Tab 30's 70 Box
48 Meropenem Inj 1's 100 Box
49 Mertigo Tab 100's 10 Box
50 Methylprednisolon 125 mg Inj 30 Vial
51 Methylprednisolon 4 mg Tab 100's 40 Box
52 Omeprazol Inj 1's 100 Box
53 Propanolol 10mg Tab 100's 5 Box
54 PTU tab 100's 5 Box
55 Ranitidin Inj 25's 84 Box
56 Rifampicin 450 mg Tab 100's 5 Box
57 Risperidon 2 mg 30's Tab 2 Box
58 Simvastatin 10 mg Tab 30's 100 Box
59 Valsartan 80 mg Tab 28's 10 Box

Prod. Pfizer
60 Caduet 10/20 mg Tab 30's 7 Box
61 Caduet 5/20 mg Tab 30's 7 Box
62 Celebrex Tab 100 mg 30's 110 Box
63 Lipitor 10 mg Tab / 30's 80 Box
64 Lipitor 20 mg Tab/ 30's 120 Box
65 Lyrica 75mg Tab 14's 30 Box

Prod. GSK
66 Avodart Tab 30's 7 Box
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Antar Mitra Sembada
No. U R A I A N Banyaknya Keterangan

Prod. Novell OGB.


1 Cefadroxil Syr 70 Fls
2 Cefixim 100 mg 50's 10 Box
3 Cefixim 200 mg 50's 10 Box
4 Cefixim Syr 30 ml 100 Fls
5 Lansoprazol Cap 20's 150 Box
6 Omeprazol Cap 30's 150 Box
7 Ondancentron 4 mg 12's 30 Box

Prod. Pharos
8 Albothyl Conc 5 Btl

Prod. Pyridam
9 Epsonal 50 mg 100's 3 Box
10 Fuson Cream 5 gr 20 Tube
11 Neotibi 500 mg Tab 100's 10 Box
12 Osteor Cream 30 gr 30 Tube
13 Osteor Tab 30's 70 Box
14 Pantoz Inj 1's 35 Vial
15 Pyderma Cream 10 gr 15 Tube
16 Siberid 5 mg Tab 30's 5 Box
17 Takana Sirup 60 ml 200 Fls
18 Taxfor Inj 40 Vial

Prod. Galenium
19 Laxadin Syr 60 ml 15 Fls

Prod. Novell
20 Ceterizine Tab 50's 30 Box
21 Miloz Injeksi 10's 2 Box
22 Ranivell Syr 60 ml 5 Fls
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Buetna Hareukat 1
No. U R A I A N Banyaknya Keterangan
Alkes
1 Alkohol 96 % 4 Jrg
2 Thrombopob Gel 20 gr 20 Tube

Prod. Bio Farma


3 ATS 1500 IU Inj 5 Box

Prod. Combi
4 OBH Combi Syr 330 Btl

Generik
5 Allupurinol 300 mg Tab 100's 45 Box
6 Alupurinol 100 mg Tab 100's 10 Box
7 Amytriptilin 25 mg Tab 100's 1 Box
8 Asam Traneksamat 500 mg Inj 10's 5 Box
9 Atropin Hcl Inj 100's 1 Box
10 Batugin Elixir 300ml 20 Fls
11 Buscopan Inj 10's 1 Box
12 Calcium Lactat 1 Tin
13 Captropil 12.5mg Tab 100's 40 Box
14 Captropil 25mg Tab 100's 10 Box
15 Chloramfenicol 250 mg Kaps 1000's 3 Tin
16 Chloroquin Tab 1000's 1 Tin
17 Cortison Inj 10's 2 Box
18 Dexametason Inj 100's 3 Box
19 Digoxin 0,25 mg Tab 100's 2 Box
20 Enkapirin Tab 250's 1 Btl
21 Epinefrin Inj 100's 1 Box
22 Erythromycin 250 mg Kaps 100's 10 Box
23 Erythromycin 500 mg Kaps 100's 15 Box
24 Erytromycin Syrup 80 Fls
25 Ethyl Chlorid Spray 2 Fls
26 Furosemide 10 mg Inj 25's 10 Box
27 Furosemide 40 mg Tab 100's 30 Box
28 GG Tab 1 Tin
29 Glibenklamide 5mg Tab 2 Box
30 Glimepiride 4mg Tab 5 Box
31 Haemocain Ointment 8 Tube
32 Ichtiol Salep 15 Pot
33 INH 100 mg Tab 1 Tin
34 INH 300 mg Tab 100's 1 Box
35 Insto TM 22 Fls
36 Itraconazol Tab 20's 2 Box
37 Kejibling Cap 6 Box
38 Mebo Cream 20 gr 3 Tube
39 Moloco B 12 100's 2 Box
40 Natrium Bicarbonat 3 Tin
41 Obimin AF Tab 30's 2 Box
42 Oralit 1 Box
43 Pempers Ukuran L 3 Pak
44 Pempers Ukuran M 3 Pak
45 Pempers Ukuran XL 3 Pak
Dipindahkan
Kepada : PT Buetna Hareukat 2
No. U R A I A N Banyaknya Keterangan
Pemindahan
46 Piroxicam 20mg Tab 100's 10 Box
47 PK 30 Pot
48 Pyrantel 125 mg Tab 100's 2 Box
49 Rifampicin 300 mg Tab 100's 2 Box
50 Sulfas Ferosus Tab 1000's 1 Tin
51 Tramadol Injeksi 10 Box
52 Trihexyphenidil 2 mg Tab 100's 2 Box
53 Vitamin B Complex Tab 1000's 2 Tin
54 Vitamin B1 Tab 3 Tin
55 Vitamin C Tab 1000's 4 Tin
56 Vitamin K Inj 100's 1 Box

Prod. Kimia Farma


57 Bedak Salicil 74 Sach
58 Enkasari Syr 120 ml 10 Btl
59 Scabicid Cream 5 gr 46 Tube

Prod. Mahakam
60 Betadin Ointment 5 gr 5 Tube

Prod. Meiji
61 FG Troches Tab 300's 3 Box
62 Meiact Tab 20's 5 Box
63 Fosmicin 1gr Inj 10's 10 Box
64 Fosmicin 2gr Inj 10's 10 Box
65 Procain Penicillin Inj 100 Vial

Prod. Merck
66 Neurobion 5000 mg Inj 10's 9 Box
67 Sangobion Kaps 250's 2 Box

Prod. Pharos
68 Nebacetin Oint 10 gr 10 Tube
69 Nebacetin powder 5 Btl

Prod. Darya Varya


70 Burnazin Cream 30 gr 5 Tube
71 Burnazin Cream 500 gr 2 Pot

Prod. Sanbe
72 Amoxan 500 mg kapsul 100's 1 Box
73 Biosanbe Cap 100's 5 Box
74 Proxime Tab 30's 10 Box
75 Sanmol 500 mg Tab 100's 2 Box
76 Tricodazol 500 mg Tab 100's 1 Box
78 Sanmol Infus 10 Fls
Prod. Prafa
79 Paradryl Inj 10's 4 Box
80 Paramidon Inj 10's 3 Box

Prod. Merck
81 Illiadin 0.025% 10 Fls
82 Illiadin 0.05% 5 Fls

Dipindahkan
Kepada : PT Buetna Hareukat 3
No. U R A I A N Banyaknya Keterangan
Pemindahan

Prod. Boehringer
83 Dulcolax Supp 10's 1 Box

Prod. Widatra OGB


84 Glucose 10% Infus 500 ml 40 Fls
85 Glucose 5% Infus 500 ml 100 Fls
86 Kaen 3B 100 Fls
87 Kidmin Infus 3 Fls
88 NaCl 0.9% Infus 500 ml 400 Fls
89 RL Infus 500 ml 2,900 Fls
90 Wida Hest Infus 50 Fls

Prod. GSK
91 Ventolin Inhaler 20 Fls
92 Ventolin Nebule 20's 23 Box

Prod. Transfarma
93 Prostigmin Inj 5's 10 Box

Prod. Otsuka
94 Aqua 1 Ltr 100 Fls
95 Ashering 500 ml Infus 400 Box
96 Mucosta 100 mg 100's 15 Box
97 Otsu NaCl 0,9%100 ml 100 Fls
94 Otsu water injeksi 25ml 400 Fls
95 Pletaal 100 mg 100's 5 Box
96 Proten Susu 10's 3 Box
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Encevall Putra Megatrading
No. U R A I A N Banyaknya Keterangan
Prod. Kalbe Farma
1 Angioten 50 mg 30's 7 Box
2 Bioplacenton Jelly 60 Tube
3 Car - Q 30'S 7 Box
4 Irvask 150 mg Tab 30's 15 Box
5 Lancid 30 mg Cap 20's 20 Box
6 Serlof Tab 30's 5 Box
7 Truvaz 20 mg Tab 30's 10 Box
8 Urdahex Kaps 30's 7 Box
9 Vitazym Tab 100's 22 Box
10 Zofredal 2 mg Tab 30's 4 Box
11 Pranza Injeksi 20 Vial
12 Kalxetin 10mg Tab 30's 3 Box
13 Vomitas Tab 30's 5 Box
14 Zypraz 0.5mg Tab 2 Box

Prod. Hexapram Jaya


15 Glucosamin Tab 30's 10 Box
16 Meloxicam Supp 10's 5 Box
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Mensa Bina Sukses 1
No. U R A I A N Banyaknya Keterangan
Prod. Actavis
1 Alpentin 100 mg 50's 7 Box
2 Golmun Syr 60 ml 30 Fls

Prod. Interbat
3 Colme TT 50 Fls
4 Interhistin 50 mg Tab 100's 20 Box
5 Pamol Drops 5 Btl
6 Urinter Tab 100's 2 Box

Prod. Landson
7 Irbesartan 150 mg Tab 30's 50 Box
8 Isosorbid Dinitrat 100's 10 Box

Prod. Molex Ayus


9 Alpara Syr 100 Fls
10 Alphamol 600 mg 150's 20 Box
11 Alphamol Syr 60 ml 600 Fls
12 Bevalex Cream 5 gr 212 Tube
13 Dextral Syr 60 ml 220 Fls
14 Dextral Tab 150's 12 Box
15 Dicloflam 25mg Tab 60 Box
16 Dicloflam 50/ 50's 50 Box
17 Gentalex Cream 5 gr 150 Tube
18 Infantrim Forte Tab 10 Box
19 Infatrim 480 mg Tab 35 Box
20 Infatrim Syr 60 ml 200 Btl
21 Klorfeson Cream 5 gr 30 Tube
22 Lexacorton Cream 5 gr 50 Tube
23 Lexacrol Syr 190 ml 410 Fls
24 Lexacrol Tab 150's 15 Box
25 Lexadium Tab 60's 25 Box
26 Lexagin 500 mg Tab 100's 5 Box
27 Lexapram Syrup 20 Fls
28 Lexapram Tab 10 mg 100's 10 Box
29 Lexavit Tab 100's 15 box
30 Lexavon Syrup 230 Fls
31 Lexavon Tab 100's 12 Box
32 Mofulex Cream 5 gr 60 Tube
33 Molacort 0.5mg Tab 100's 30 Box
34 Moladerm Cream 10 gr 236 Tube
35 Molagit Tab 100's 20 Box
36 Molakrim 30 gr 600 Tube
37 Molaneuron Tab 50's 45 Box
38 Molapect Syrup 60 ml 15 mg / 5 ml 520 Fls
39 Molapect Tab 100's 15 Box
40 Molasic Tab 100's 40 Box
41 Molazol Tab 100's 20 Box
42 Molexdryl Syr 60 ml 450 Fls
43 Molexflu Syrup 50 Fls
44 Molexflu Tab 150's 34 Box
45 Neokaominal Syr 60 ml 70 Fls
Dipindahkan
Kepada : PT Mensa Bina Sukses 2
No. U R A I A N Banyaknya Keterangan
Pemindahan
46 Pritacort Tab 150's 25 Box
47 Pritamox 500 mg 100's 25 Box
48 Pritamox Syr 60 ml 150 Btl
49 Pritanol 100 mg 100's 20 Box
50 Pritasma 4mg Tab 100's 20 Box
51 Pritavit Tab 100's 20 Box
52 Thiamfilex Syr 60 ml 80 Fls
53 Thiamfilex Tab 100's 30 Box
54 Vical Syr 60 ml 200 Fls
55 Vitalex Tab 100's 10 Box

Prod. Otto
56 Asabium 10 mg Tab 100's 1 Box
57 Calcidin Tab 100's 5 Box
58 Cebex Tab 100's 30 Box
59 Folac Tab 100's 5 Box
60 Gerdilium Syr 60 ml 150 Fls
61 Hexadol mint Gargle 30 Btl
62 Letonal 100mg Tab 100's 5 Box
63 Letonal 25 mg Tab 100's 7 Box
64 Lexacort Tab 100's 20 Box
65 Opineuron 500 mg Tab 100SP OKT 10 Box
66 Opizolam 0.5 mg 50's SP OKT 4 Box
67 Ostarin 400 mg Tab 100's 30 Box
68 Ostarin Syr 60 ml 150 Fls
69 Piralen Inj 5's 15 Box
70 Renvoll Emulgel 20 gr 200 Tube
71 Rihest Syr 60 ml 15 Fls
72 Rihest Tab 100's 15 Box
73 Trifedrin Syr 60 ml 70 Fls
74 Trifedrin Tab 30's 85 Box
75 Vical Syrup 200 Fls
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Rajawali Nusindo 1
No. U R A I A N Banyaknya Keterangan
Prod. Combiphar
1 Neo K Inj 5's 10 Box

Prod. Ethica
1 Efedrin HCL Inj 10's 1 Box
2 Neuropil 5000 Inj 10's 10 Box
2 Pitogin Inj 10's 10 Box
3 Vulamox Syr 50 Btl

Prod. Futamed
4 Afamed 30's 10 Box
5 Fudanton 4 mg Tab 30's 10 Box
6 Fudo 10 mg Tab 30's 10 Box
7 Fulopin 10 mg Tab 30's 10 Box
8 Fulopin 5 mg Tab 30's 10 Box
9 Fumethyl 4 mg Tab 30's 10 Box
10 Futalin Tab 20's 15 Box
11 Futamel 15 mg Tab 30's 10 Box
12 Rybest 10 mg Tab 20's 15 Box

Prod Fresenius Kabi


13 Ketosteril Tab 100's 5 Box

Prod. GSK
14 Zyloric 300 mg Kaps 30's 20 Box

Prod. GMP
15 Reco Eye Drops 20 Fls

Prod. Jansen
16 Ultracet 30's 7 Box

Prod. Soho
17 Atsma Soho 1000's 1 Tin
18 Belamox 500 mg 15's 40 Box
19 Curcuma Blister 100's 40 Box

Prod. Phapros
20 Antasida Doen Syr 220 Fls
21 Antasida Doen Tab 2 Tin
22 Betametason Cream 24 Tube
23 Paracetamol Syr 60 ml 400 Btl
24 Thiamfenicol 500 mg 100's 3 Box
25 Paracetamol Tab 100's 65 Box

Prod. UAP
26 Aspilet 80 mg 100's 8 Box

Dipindahkan
Kepada : PT Rajawali Nusindo 2
No. U R A I A N Banyaknya Keterangan
Pemindahan
Prod. Sanofi
27 Amaryl 2 mg Tab 30's 10 Box
28 Amaryl 3 mg Tab 30's 8 Box
29 Amaryl M2 Tab 30's 12 Box
30 Aprovel Tab 150 mg 30's 7 Box
31 Aprovel Tab 300 mg 30's 7 Box
32 Cardace 2.5 mg Tab 60's 5 Box
33 Nasacort Spray 10 Fls
34 Plavix 75 mg Tab 28's 15 Box
35 Triatec 10 mg Tab 30's 15 Box

Prod. MSD
35 Arcoxia Tab 60 mg 30's 10 Box

Prod. Novartis
36 Co Diovan 160/12.5 Tab 30's 7 Box
37 Tegretol Syrup 120ml 5 Fls

Prod. Servier
38 Diamicron MR Tab 60 mg 30's 50 Box
39 Trizedon MR Tab 60's 20 Box

Prod. Fahrenheit
40 Farmasal Tab 100's 2 Box
41 Recolfar Tab 30's 5 Box
42 Renagas Tab 50's 5 Box

Prod. Astelass
42 Harnal Ocas Tab 30's 10 Box

Prod. Sandoz
43 Olandoz 10 mg Tab 30's 4 Box

Prod. MLM
44 Diamelon Tab 60's 3 Btl
Prod. Merk
45 KSR 600mg Tab 1 Box
46 Xylocain Gell 2 Pcs

Prod. Darya Varia


47 Ozid Injeksi 70 Box
48 Salofalk 500mg Tab 100's 2 Box

Prod. Yarindo
49 Atorvastatin 20mg Tab 30 Box
50 Yariflam 50mg Tab 10 Box

DAFTAR PESANAN OBAT - OBATAN


PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT United Dico Citas
No. U R A I A N Banyaknya Keterangan
Prod. Bernofarm
1 Anafen Syrup 200 Fls
2 Bersol 15 gr Cream 50 Tube
3 Berthyco 500 mg Kaps 100's 20 Box
4 Bralin 500 mg Tab 30's 20 Box
5 Bucain Inj 5's 5 Box
6 Glucoryl 2 mg Tab 30's 15 Box
7 Glucoryl 3 mg Tab 30's 30 Box
8 Glucoryl 4 mg Tab 30's 30 Box
9 Kliran 4 mg Inj 5's 100 Box
10 Lovask 10 mg Tab 30's 30 Box
11 Lovask 5 mg Tab 30's 50 Box
12 Macef Inj 30 Fls
13 Motaderm Cream 20 Tube
14 Paramol Infus 100 Fls
15 Tocef Tab 10's 15 Box
16 Trolac 30 mg Inj 5's 100 Box
17 Trolac Tab 10's 20 Box

Prod. Takeda
18 Alinamin F injeksi 5's 8 Box
19 Alinamin F Tab 100's 3 Box
20 Boraginol N Salep 10 Tube
21 Boraginol N Supp 10's 6 Box
22 Nonflamin Tab 60's 15 Box
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Penta Valent
No. U R A I A N Banyaknya Keterangan
Prod. Cendo
1 Cendo Asthenof 0,6 ml @5's minidose 5 Strip
2 Cendo Berry Tab 30's 5 Box
3 Cendo Cenfresh 0,6 ml @ 5's minidose 10 Strip
4 Cendo Conver 0,6 ml @ 5's minidose 10 Strip
5 Cendo Eyefreesh mild 0,6 ml @ 5's minidose 15 Strip
6 Cendo Fenicol 0,25 % 6 ml @ 5's minidose 15 Strip
7 Cendo Fenicol eye ointment 3,5 gr 50 Tube
8 Cendo Genta 0,3 % 6 ml @ 5's minidose 65 Strip
9 Cendo Genta0,3 % 3,5 gr ointment 30 Tube
10 Cendo Glaopen 0,6 ml @5's minidose 10 Strip
11 Cendo Lentikular 0,6 ml @ 5's minidose 5 Strip
12 Cendo LFX 0,6 ml @ 5's minidose 10 Strip
13 Cendo Lubricent 0,6 ml @ 5's minidose 5 Strip
14 Cendo Lyteers 0,6 ml @ 5's minidose 65 Strip
15 Cendo Pantocain 0,6 ml @ 5's minidose 15 Strip
16 Cendo Polydex 0,6 ml @ 5's minidose 20 Strip
17 Cendo Possop 0,6 ml @ 5's minidose 30 Strip
18 Cendo Protogenta 0,6 ml @ 5's minidose 10 Strip
19 Cendo Tonor 0,25 % 0,6 ml @ 5's minidose 10 Strip
20 Cendo Ulcori 0,6 ml @ 5'S minidose 5 Strip
21 Cendo Vital Tab 30's 5 Box
22 Cendo Xitrol 0,6 ml @ 5's minidose 35 Strip

Prod. Gracia
23 Bevita Syr 120 ml 164 Fls
24 Diuvar Inj 5's 35 Box
25 Estin Drops 10 ml 5 Btl
26 Granem Injeksi 100 Vial
27 Propepsa Syr 190 ml 400 Btl
28 Tranec 250 mg Inj 10's 10 Box
29 Tranec 500 mg Tab 50's 7 Box
30 Voxin 500 mg 20's 10 Box

Prod. Guardian
31 Evothyl 300mg Cap 10 Box
32 Forasma Syrup 10 Fls

Prod. Lapi
33 Cal 95 Tab 100's 5 Box
34 Ciflon Tabb 30's 25 Box
35 Cravox Tab 10's 10 Box
36 Hepatin Tab 30's 50 Box
37 Lapixim 1gr Injeksi 15 Vial
38 Lasal Exp Syr 100 Btl
39 Lasal Syr 50 Btl
40 L-Bio Sachet 30's 50 Box
41 L-Zink 100 ml Syr 30 Fls
42 Topazol Injeksi 10 Fls

Dipindahkan
Kepada : PT Penta Valent
No. U R A I A N Banyaknya Keterangan
Pemindahan

Prod. Mepro
43 Myotonic Inj 10's 10 Box
44 Myotonic Tab 100's 3 Box
45 Norages Inj 5's 62 Box
46 Proceles Syr 60 ml 50 Fls
47 Biocombion 5000mg Injeksi 10 Box
48 Suprafenid Supp 10's 6 Box
49 Proneuron Kaplet 200's SP OKT 5 Box

Prod. Promed Raharjo


50 Minosil Handrub 5 Ltr 2 Gal
DAFTAR PESANAN ALAT KESEHATAN
PT CUT MEUTIA MEDIKA NUSANTARA
Periode Mei 2014
Kepada : PT Mesarinda Abadi
No. U R A I A N Banyaknya Keterangan
Alkes
1 Folly Chateter No. 16 Cab 2 5 Pcs
2 Folly Chateter No. 18 Cab 2 70 Pcs
3 Folly Chateter No. 20 Cab 3 2 Pcs
4 Folly Chateter No. 24 Cab 3 5 Pcs
5 Gunting Operasi 1 Bh
6 I.V. Catheter 18 TRM 5 Box
7 I.V. Catheter 20 TRM 10 Box
8 I.V. Catheter 22 TRM 15 Box
9 I.V. Catheter 24 TRM 1 Box
10 Infuset Dewasa 10 Box
11 Infuset Paed 3 Box
12 Kapas 250 gr 2 Roll
13 Kasa Steril 16 x 16 Swallow 100 Pcs
14 Kassa Lucky 3 Roll
15 Manset Tensi 1 Bh
16 Nald 23 100's 500 Pcs
17 Nald Hecting 6036 G/R 10 12 Pcs
18 Nald Hecting 6036 G/R 11 12 Pcs
19 Nald Hecting 6036 G/R 12 12 Pcs
20 Nasal Canula Anak 10 Pcs
21 Nasal Canula Dewasa 15 Pcs
22 Postofix 10 X 25 1 Box
23 Regulator Oxygen 5 Pcs
24 Spuit 1 cc TRM 2 Box
25 Spuit 100 cc Onemed 10 Pcs
26 Spuit 10cc 10 Box
27 Spuit 3 cc TRM 30 Box
28 Spuit 5 cc TRM 15 Box
29 Transfusi Set Terumo 2 Box
30 Verban Gulung 15 cm 165 Roll

Prod. Easy Touch


31 Easy Touch Cholesterol 60 Btl
32 Easy Touch Glucose 64 Btl
33 Easy Touch Uric Acid 44 Btl

DAFTAR PESANAN ALAT KESEHATAN


PT CUT MEUTIA MEDIKA NUSANTARA
Periode Mei 2014
Kepada : PT Tirta Medical Indonesia
No. U R A I A N Banyaknya Keterangan
Alkes
1 Elektroda Cream 1 Tube
2 Iodin Povidon 60ml 50 Btl
3 K Y Jelly 10 Tube
4 Kapas 100gr 10 Roll
5 Lomatule Lbr 10's 5 Box
6 NGT 12 2 Pcs
7 NGT 14 5 Pcs
8 NGT 16 5 Pcs
9 NGT 18 20 Pcs
10 NGT 5 5 Pcs
11 Pensil Couter 1 Bh
12 Postofix 10 x 25 2 Box
13 Surgipro Steril Gloves No.6 2 Box
14 Surgipro Steril Gloves No.6.5 7 Box
15 Surgipro Steril Gloves No.7 15 Box
16 Surgipro Steril Gloves No.7,5 10 Box
17 Tegaderm PM 1623 1 Box
18 Tegaderm PM 1624 1 Box
19 Termometer Ruangan 2 Bh
20 Umbilical Cord Calm 1 Box
21 Urine Bag 50 Pcs

DAFTAR PESANAN ALAT KESEHATAN


PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Hexalab Sumatera
No. U R A I A N Banyaknya Keterangan
Alkes
1 Assucryl 1 REF 43437 12 Pcs
2 Assucryl 1 REF 43957 12 Pcs
3 Assucryl 1 REF 43977 12 Pcs
4 Assucryl 3/0 REF 4564 12 Pcs
5 Assucryl 4/0 REF 4233 12 Pcs
6 Cut Gut Plain 2/0 1 Roll
7 Cut Gut Plain 3/0 1 Roll
8 Polypropelene 3/0 REF 9244 1 Lsn
DAFTAR PESANAN OBAT - OBATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Rajawali Nusindo 1
No. U R A I A N Banyaknya Keterangan

Prod. Futamed
1 Afamed 30's 10 Box
2 Fudanton 4 mg Tab 30's 10 Box
3 Fudo 10 mg Tab 30's 10 Box
4 Fulopin 10 mg Tab 30's 10 Box
5 Fulopin 5 mg Tab 30's 10 Box
6 Fumethyl 4 mg Tab 30's 10 Box
7 Futalin Tab 20's 15 Box
8 Futamel 15 mg Tab 30's 10 Box
9 Rybest 10 mg Tab 20's 15 Box
DAFTAR PESANAN ALAT KESEHATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Dos Ni Roha 1
No. U R A I A N Banyaknya Keterangan

Prod. Bernofarm
1 Amoxicillin 125 mg Syr 60ml 300 Fls
2 Amoxicillin 500 mg Tab 100's 10 Box
3 Ciprofloxacin 500mg Tab .100's 50 Box
4 Imipenem Inj 100 Vial
5 Metformin 500mg Tab 100's 30 Box
6 Metronidazol Infus 150 Box
7 Ranitidin 150mg Tab 100's 40 Box
8 Rifampicin 450 mg Tab 100's 5 Box
DAFTAR PESANAN ALAT KESEHATAN
PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014


Kepada : PT Sapta Sari Tama SP Tambahan
No. U R A I A N Banyaknya Keterangan
Prod. Galenium
1 Haemocain ointment 15 gr 8 Tube

Prod. Mahakam
2 Betadine Gargle 100 cc 45 Btl

Prod. Novartis
3 Voltaren Gel 20 gr 70 Tube
Prod. PT Holi Pharma
4 Allopurinol 100 mg Tab 100's 23 Box
5 Chloramphenicol 250 mg Kaps 1000's 3 Tin
6 Cotrimoksazole 480 kaplet 100's 35 Box
7 Cotrimoksazole suspensi 60 ml 50 Fls
8 Ibuprofen 400 mg Tablet 100's 30 Box

Prod. PT Aditama Raya


9 Adidryl injeksi 40 Vial
10 Adimidon injeksi 30 Vial
11 Antalgin Tablet 100's 5 Box
12 Vitamin B komplex 1000's 1 Tin

Prod. Tropica
13 OBH Tropica menthol (Btl Gelas) 100 ml 150 Fls

DAFTAR PESANAN ALAT KESEHATAN


PT CUT MEUTIA MEDIKA NUSANTARA

Periode Mei 2014

Kepada : PT Sawah Besar Farma SP Tambahan

No. U R A I A N Banyaknya Keterangan


Prod. Actavis
1 Chloramex Injeksi 10's 3 Box

Prod. Indofarma OGB


2 Hydrocortison Krim 60 Tube
3 Amytriptilin 25mg Tab 100's 1 Box

Prod. Pyridam
4 Siberid 5mg Tab 30's 5 Box
5 Zarom 250mg 30's 25 Box

Prod. Zambon
6 Flumucyl Syr 5 Fls

Langsa, Mei 2014


Disetujui Oleh, Diminta Oleh,
PT Cut Meutia Medika Nusantara Apoteker,

Hj. Lidya Bidasari S, SE. Sri Wahyuningsih, S.Farm, Apt.


Ka. Bag. Administrasi 19820915/SIPA_11.74/2013/2003
Kepada : PT Anugrah Argon Medica -
Box 5 Acyclovir 400 mg / ktk 100 62,784 313,918
Box 5 Albapure 20% 100 ml 1's 1,540,000 7,700,000
Box 5 Albuminar 25% 100 ml 1's 2,035,000 10,175,000
Box 5 Alpentin 300 mg Cap 50's 346,500 1,732,500
Box 60 Alprazolam 0.5 mg Tab 100's 73,810 4,428,600
Box 40 Amlodipin 5 mg Tab 50's 52,800 2,111,982
Box 10 Amoxycillin 500 mg 44,400 444,004
Box 50 Asam Mefenamat 500mg Tab 100's 23,958 1,197,900
Box 10 Avodart Tab 30's 270,001 2,700,005
Box 15 Azomax 500 mg Tab 10's 313,500 4,702,500
Box 35 Bisoprolol Fumarate 5 mg 100's 76,615 2,681,525
Box 7 Caduet 5/20 mg Tab 30's 481,261 3,368,827
Box 7 Canderin 8 mg Tab 30's 165,000 1,155,000
Box 30 Cefadroxil 500 mg 100's 92,400 2,772,013
Box 70 Cefotaxime Injeksi 10's 83,160 5,821,200
Box 15 Ceftriaxone Injeksi 10's 103,131 1,546,958
Box 110 Celebrex Tab 100 mg 30's 227,391 25,012,999
Box 60 Clopidogrel Tab 75 mg 30's 326,700 19,602,000
Box 5 Concor 2,5 mg Tab 100's 540,100 2,700,500
Box 5 Concor 5 mg Tab 100's 782,100 3,910,500
Box 2 Dexamethason 5 mg / ml Inj 100's 240,240 480,480
Box 50 Domperidon 10 mg Tab 100's 44,398 2,219,910
Btl 50 Domperidone 5 mg / 5 ml Susp 15,180 759,000
Box 5 Glucobay 100 mg 50's 220,000 1,100,000
Box 5 Glucopage 500 mg Tab 100's 112,035 560,175
Box 4 Ketokonazole Cream 2% 10 gr 12's 92,400 369,600
Tube 15 Ketricin Orabase 0,1 % @5 gr 40,700 610,500
Roll 6 Leukokrepe 3" 61,470 368,821
Roll 12 Leukokrepe 4" 72,842 874,104
Roll 6 Leukokrepe 6" 93,654 561,924
Roll 22 Leukoplast 4.5 X 2.5 BSN 14,781 325,175
Roll 20 Leukoplast 4.5 X 5 BSN 28,380 567,600
Roll 20 Leukoplast 4.5 X 7.5 BSN 41,388 827,750
Box 5 Levemir Flexpen 5's 859,528 4,297,640
Box 15 Levofloxacin FC 500 mg 20's 25,381 380,721
Fls Levofloxacin Infus 100 ml 96,800 -
Box 60 Lipitor 10 mg Tab / 30's 505,353 30,321,192
Box 100 Lipitor 20 mg Tab/ 30's 505,353 50,535,320
Box 30 Lyrica 75 mg Cap 14's 167,603 5,028,078
Box 70 Meloxicam 15 mg Tab 30's 65,945 4,616,150
Box 10 Mertigo Tab 6 mg 100's 304,700 3,047,000
Box 50 Methylprednisolon 125 mg Inj 1's 39,023 1,951,125
Box 40 Methylprednisolon 4 mg Tab 100's 52,866 2,114,640
Box 5 Neulin PS Tab 30's 346,500 1,732,500
Box 5 Novomix Flexpen 5 's 800,415 4,002,075
Box 15 Novorapid Flexpen 5's 800,415 12,006,225
Box 150 Omeprazol 40 mg Inj 1's 82,280 12,342,000
Box 5 Propanolol 10mg Tab 100's 8,470 42,350
Box 5 PTU tab 100's 32,953 164,764
Box 40 Ranitidin 50 mg/2 ml Inj 25's 70,675 2,827,000
Box 2 Resperidone 2 mg 130,625 261,250
Box 5 Rhnos SR 50's 211,750 1,058,750
Box 50 Simvastatin 10 mg Tab 30's 16,929 846,450
Box 15 Stardec 3 Ply Surgical Mask Tie On 44,000 660,000
Box 5 Tramus 1% 5 ml 5's 390,500 1,952,500
Box 30 Vaclo Tab 30's 412,500 12,375,000
Box 10 Valsartan 80 mg Tab 28's 122,984 1,229,840
Btl 20 Vectrine Dry Syr 37,400 748,000
-
Kepada : PT Antar Mitra Sembada -
Btl 5 Albothyl 10ml 30,800 154,000
Btl 70 Cefadroxil DS 250 mg/5 ml 60 ml 16,500 1,155,000
Box 10 Cefixim 100 mg 50's 119,730 1,197,295
Box 30 Ceterizine Tab 50's 15,675 470,250
Tube 10 Ecolon 10 gr 31,000 310,000
Box 150 Lansoprazol 30 mg 20's 27,027 4,054,050
Fls 15 Laxadin Syr 60ml 31,900 478,500
Box 20 Loratadine 10 mg 16,654 333,080
Box 10 Neotibi 500 mg Tab 100's 132,000 1,320,000
Box 20 Neuraxon 5000 mg Tab 100's 209,000 4,180,000
Tube 10 Niacef 15% 25,000 250,000
Box 30 Ondancentron 4 mg 12's 18,480 554,400
Tube 30 Osteor Cream 30 gr 107,800 3,234,000
Box 15 Osteor Tab 30's 181,500 2,722,500
Vial 35 Pantoz Inj 1's 121,000 4,235,000
Tube 15 Pyderma Cream 10 gr 22,000 330,000
Btl 5 Ranivel Syr 60 ml 46,750 233,750
Box 10 Taxfor 1g inj 126,500 1,265,000
Tube 10 Vitacid 0.5% 27,000 270,000
-
Kepada : PT Buetna Hareukat -
Box 45 Allupurinol 300 mg Tab 100's 28,175 1,267,875
Box 1 Amoxan 500 mg kapsul 100's 373,736 373,736
Box 5 Asam Traneksamat 500 mg Inj 10's 86,620 433,100
Box 1 Atropin Hcl Inj 100's 28,800 28,800
Fls 20 Batugin Elixir 300ml 27,500 550,000
Sach 100 Bedak Salicil 4,859 485,900
Tube 5 Betadin Ointment 5 gr 13,310 66,550
Box 2 Biosanbe Cap 100's 109,581 219,162
Pcs 50 Botol Tetes 12 ml 318 15,900
Box 1 Buscopan Inj 10's 287,530 287,530
Btl 70 Caladine Powder 60 gr 9,306 651,420
Tin 1 Calcium Lactat 65,000 65,000
Box 40 Captropil 12.5mg Tab 100's 11,600 464,000
Box 10 Captropil 25mg Tab 100's 22,000 220,000
Tin 3 Chloramfenicol 250 mg Kaps 1000's 198,000 594,000
Box 10 Citicolin Amp 165,000 1,650,000
Box 2 Cortison Inj 10's 238,820 477,640
Box 2 Digoxin 0,25 mg Tab 100's 15,715 31,430
Box 5 Dulcolax 10 mg 593,560 2,967,800
Box 1 Dulcolax Supp 10's 141,170 141,170
Box 2 Efedrin HCL Inj 10's 302,500 605,000
Btl 1 Enkapirin Tab 250's 25,000 25,000
Btl 10 Enkasari Syr 120 ml 14,578 145,780
Fls 80 Erytromycin Syrup 10,886 870,880
Box 10 Ethambutol 500 mg 100's 68,833 688,325
Box 10 Fosmicin 1gr Inj 10's 1,108,976 11,089,760
Box 5 Fosmicin 2gr Inj 10's 1,844,730 9,223,650
Box 10 Furosemide 10 mg Inj 25's 57,882 578,820
Box 30 Furosemide 40 mg Tab 100's 10,709 321,270
Tin 1 GG Tab 32,000 32,000
Box 2 Glibenklamide 5mg Tab 9,800 19,600
Box 5 Glimepiride 4mg Tab 117,270 586,350
Fls 100 Glucose 5% Infus 500 ml 6,948 694,760
Pot 15 Ichtiol Salep 5,933 88,995
Fls 10 Illiadin 0.025% 33,880 338,800
Fls 5 Illiadin 0.05% 39,926 199,630
Box 1 INH 300 mg Tab 100's 132,000 132,000
Fls 22 Insto TM 8,858 194,876
Fls 40 Kaen 3B 15,000 600,000
Box 6 Kejibling Cap 62,600 375,600
Fls 3 Kidmin Infus 78,000 234,000
Vial 2 KTM Inj 10 ml 193,600 387,200
Box 2 Lidocain 2% Inj 100's 121,199 242,398
Tube 3 Mebo Cream 20 gr 87,450 262,350
Box 15 Mucosta 100 mg 100's 547,200 8,208,000
Fls 200 NaCl 0.9% Infus 500 ml 7,900 1,580,000
Btl 200 OBH Combi Syr 12,936 2,587,200
Box 2 Obimin AF Tab 30's 38,400 76,800
Box 1 Oralit 47,400 47,400
Fls 100 Otsu NaCl 0,9%100 ml 13,487 1,348,700
Fls 400 Otsu water injeksi 25ml 2,640 1,056,000
Box 12 Piroxicam 10 mg / ktk 120 13,846 166,148
Box 10 Piroxicam 20mg Tab 100's 144,000 1,440,000
Pot 30 PK 5,390 161,700
Box 10 Pletaal 100 mg 100's 480,060 4,800,600
Vial 100 Procain Penicillin Inj 13,478 1,347,800
Box 3 Proten Susu 10's 43,000 129,000
Box 10 Proxime Tab 30's 39,180 391,800
Box 2 Pyrantel 125 mg Tab 100's 36,400 72,800
Box 2 Regumen tab 30's 114,265 228,529
Box 2 Rifampicin 300 mg Tab 100's 60,000 120,000
Fls 2,000 RL Infus 500 ml 6,006 12,012,000
Box 2 Sanmol 500 mg Tab 100's 30,200 60,400
Tube 46 Scabicid Cream 5 gr 8,417 387,182
Tin 1 Sulfas Ferosus Tab 1000's 23,000 23,000
Tube 20 Thrombopob Gel 20 gr 51,413 1,028,260
Box 10 Tramadol 50 mg 50's 17,710 177,100
Box 10 Tramadol Injeksi 96,000 960,000
Box 1 Tricodazol 500 mg Tab 100's 192,100 192,100
Box 2 Trihexyphenidil 2 mg Tab 100's 9,700 19,400
Fls 20 Ventolin Inhaler 158,813 3,176,250
Tin 4 Vitamin C Tab 1000's 22,000 88,000
Box 1 Vitamin K Inj 100's 195,400 195,400
Fls 50 Wida Hest Infus 157,500 7,875,000
-
Kepada : PT Encevall Putra Megatrading -
Box 7 Angioten 50mg Tab 30's 319,000 2,233,000
Tube 60 Bioplacenton Jelly 13,915 834,900
Box 3 Blopress 16 mg Tab. 14's 219,736 659,208
Box 3 Cedocard 5 mg Tab 60's 89,034 267,102
Box 15 Irvask 150mg Tab 30's 280,500 4,207,500
Box 3 Kalxetin 10mg Tab 30's 108,900 326,700
Box 5 Meloxicam Supp 10's 72,600 363,000
Box 7 Urdahex Kaps 30's 269,500 1,886,500
Box 2 Zofredal 2 mg Tab 30's 225,500 451,000
-
Kepada : PT Mensa Bina Sukses -
Fls 150 Alpara Syr 60 ml 9,350 1,402,500
Box 7 Alpentin 100 mg 187,000 1,309,000
Box 20 Alphamol 600 mg 150's 41,800 836,000
Btl 600 Alphamol Liquid 60 ml 7,040 4,224,000
Box 2 Asabium Tab 100's 154,000 308,000
Tube 212 Bevalex Cream 5 gr 8,525 1,807,300
Btl 50 Colme Ear Drops 20,900 1,045,000
Fls 150 Dextral Syr 60 ml 7,150 1,072,500
Box 12 Dextral tab 150's 50,600 607,200
Box 50 Diclofam 50 mg 24,200 1,210,000
Box 60 Dicloflam 25 mg 13,200 792,000
Box 5 Folac Tab 66,000 330,000
Tube 150 Gentalex Cream 5 gr 2,475 371,250
Btl 30 Hexadol Solution 120 ml 17,600 528,000
Box 5 Interhistin 50 mg Tab 100's 62,040 310,200
Box 20 Isosorbide Dinitrat 5 mg 100's 11,184 223,674
tube 30 Klorfeson cream 10 gr 7,150 214,500
Box 10 Letonal 25 mg 132,000 1,320,000
Box 20 Lexacort Tab 21,560 431,200
Btl 410 Lexacrol Forte Susp 190 ml 26,950 11,049,500
Box 15 Lexacrol Tab 150's 61,600 924,000
Box 25 Lexadium Tab 60's 33,000 825,000
Box 10 Lexagin 500 mg Tab 100's 19,800 198,000
btl 20 Lexapram syr 7,260 145,200
Box 10 Lexapram Tab 40,150 401,500
Box 15 Lexavit Tab 100's 52,800 792,000
Fls 60 Lexavon Syr 60 ml 6,050 363,000
Box 12 Lexavon Tab 100's 12,100 145,200
Tube 30 Mofulex Cream 5 gr 22,000 660,000
Box 30 Molacort 0,5 mg tab 100's 14,850 445,500
Tube 236 Moladerm Cream 10 mg 6,050 1,427,800
Box 20 Molagit 55,000 1,100,000
Tube 400 Molakrim 30 gr 10,450 4,180,000
Fls 520 Molapect Syrup 60 ml 15 mg / 5 ml 7,700 4,004,000
Box 15 Molapect Tab 100's 52,800 792,000
Box 50 Molasic Tab 100's 39,600 1,980,000
Box 20 Molazol 500mg Tab. Box 100's 34,100 682,000
Fls 450 Molexdryl Syr 60 ml 4,840 2,178,000
Box 34 Molexflu tab 150's 43,450 1,477,300
Btl 5 Pamol Oral Drops 15 ml 21,945 109,725
Box 15 Piralen inj 30,250 453,750
Box 25 Pritacort tab 150's 62,700 1,567,500
Box 25 Pritamox 500 mg 100's 121,000 3,025,000
Btl 150 Pritamox DS 125 mg / 5 ml 8,470 1,270,500
Box 20 Pritanol 100 mg 14,300 286,000
Box 20 Pritasma 4 mg 13,200 264,000
Box 20 Pritavit Tab 100's 110,000 2,200,000
Tube 200 Renvol Emulgel 20 gr 19,800 3,960,000
Box 15 Rihest kaplet 10 mg 385,000 5,775,000
Box 30 Thiamfilex 500 mg 121,000 3,630,000
Btl 80 Thiamfilex Syr 60 ml 7,150 572,000
Btl 200 Vical Susp 60 ml 6,380 1,276,000
Box 10 Vitalex Cap 100's 44,000 440,000
-
Kepada : PT Rajawali Nusindo -
Box 12 Amaryl 2 mg 50's 254,576 3,054,916
Box 5 Amaryl 3 mg 50's 335,910 1,679,552
Box 12 Amaryl M 2/500 mg 30's 335,910 4,030,924
Fls 220 Antasida Doen Syr 4,235 931,700
Box 2 Antasida Doen Tab 17,820 35,640
Box 7 Aprovel 150 mg Tab 339,826 2,378,784
Box 10 Arcoxia Tab 60 mg 30's 249,730 2,497,297
Box 2 Aspilet Tab 58,721 117,443
Fls 15 Berotec Inhaler 123,860 1,857,900
Box 24 Betametason Krim 0.1% / 25 51,315 1,231,560
Box 5 Cardace Tab 2.5 mg 60's 300,156 1,500,780
Box 10 Co Aprovel 600 mg 660,000 6,600,000
Box 7 Co Diovan 160 / 12.5 449,479 3,146,354
Box 20 Curcuma Blister 100's 72,600 1,452,000
Box 1 Ephedrin HCL Inj 302,500 302,500
Box 5 Farmasal Tab 100's 72,600 363,000
Box 15 Harnal Ocas Tab 30's 398,518 5,977,769
Box 5 Ketosteril Tab 100's 726,000 3,630,000
Btl 10 Nasaqort AQ 214,802 2,148,023
Box 10 Neo K 2 mg / ml 71,148 711,480
Box 4 Olandoz 964,310 3,857,238
Box 5 Pantozol 20mg cap 114,400 572,000
Box 65 Paracetamol 500mg Tab 100's 16,500 1,072,500
Box 400 Paracetamol Syr 60 ml 2,530 1,012,000
Box 10 Pitogin S Inj 72,188 721,875
Box 10 Plavix Tab 28's 761,606 7,616,059
Btl 20 Reco Ear Drop 6,050 121,000
Box 5 Recolfar Tab 145,200 726,000
Box 5 Renagas Tab 50's 38,000 190,000
Box 40 Sohobion Tab 110,000 4,400,000
Box 3 Thiamfenicol 500 mg 100's 69,900 209,700
Btl 50 Tribost Syr 41,580 2,079,000
Box 2 Trileptal Ect 600 mg 50's 839,344 1,678,688
Box 20 Zyloric Tab 300 mg 30's 152,714 3,054,282
-
Kepada : PT United Dico Citas -
Box 8 Alinamin injeksi 5's 74,863 598,902
Box 200 Anafen Syr 100 mg/5 ml 60 ml 16,500 3,300,000
Box 40 Benovit C Tab Salut Gula 100's 165,000 6,600,000
Tube 50 Bersol Cream 15g 44,000 2,200,000
Box 20 Berthyco Cap 500 mg 100's 198,000 3,960,000
Tube 10 Boraginol N Oint 15 gr 46,666 466,664
Box 10 Boraginol N Supp 10's 84,502 845,020
Box 20 Bralin 500 mg Tab 30's 346,500 6,930,000
Box 5 Bucain Injeksi 5's 302,500 1,512,500
Box 15 Glucoryl Tab 2 mg 30's 99,000 1,485,000
Box 30 Glucoryl Tab 3 mg 30's 115,500 3,465,000
Box 30 Glucoryl Tab 4 mg 30's 148,500 4,455,000
Box 20 Klinset Tab 30's 132,000 2,640,000
Box 100 Kliran 4mg Inj 5's 145,750 14,575,000
Box 15 Lovask 10mg Tab 30's 280,500 4,207,500
Fls 15 Macef Inj 275,000 4,125,000
Box 20 Motaderm Krim 10 gr 63,250 1,265,000
Btl 100 Nomesis Susp 5 mg/5 ml 60 ml 34,100 3,410,000
Btl 50 Paramol Infus 1 gr 100 ml 1's 57,750 2,887,500
Box 15 Tocef Tab 10's 264,000 3,960,000
Box 15 Trolac 30mg Inj 5's 165,000 2,475,000
Box 165,000 -

Kepada : PT Penta Valent -


Fls 164 Bevita Syrup 120ml 33,000 5,412,000
Box 10 Biocombin 5000 Inj 10's 55,000 550,000
Box 5 Cal-95 Kapl Salut Selaput 30's 105,600 528,000
Box 5 Cendo Berry Tab 30's 103,950 519,750
Fls 20 Cendo Catharlen 0,6 ml @ 5's minidose 22,000 440,000
Strip 10 Cendo Conver 2% 0.6ml minidose 17,738 177,375
Strip 15 Cendo Eyefresh 0.6ml mds 33,688 505,313
Strip 15 Cendo Fenicol 0,25 % 6 ml @ 5's minidos 18,425 276,375
tube 50 Cendo Fenicol Eye Oinment 3,5 gr 24,063 1,203,125
Strip 65 Cendo Genta 0,3 % 6 ml @ 5's minidose 17,463 1,135,063
Tube 30 Cendo Genta Eye Oinment 3.5g 40,013 1,200,375
Strip 5 Cendo Lentikular 0,6 ml @ 5's minidose 33,138 165,688
Strip 10 Cendo LFX 0,6 ml @ 5's minidose 63,250 632,500
Strip 5 Cendo Lubricent 0,6 ml @ 5's minidose 44,550 222,750
Strip 45 Cendo Lyteers 0,6 ml @ 5's minidose 21,175 952,875
Strip 5 Cendo Polydex 0,6 ml @ 5's minidose 29,150 145,750
Box 5 Cendo Vital Tab 30's 99,000 495,000
Box 10 Ciflon Kapl 30's 165,000 1,650,000
Btl 5 Estin Drops 10 ml 44,000 220,000
Box 5 Estin Tab 20's 66,000 330,000
Fls 50 Ezygard Syrup 48,500 2,425,000
Box 50 Ezygard Tab 30's 156,000 7,800,000
Fls 150 Fenatic Syrup 15,000 2,250,000
Box 10 Fenatic Tab 100's 250,000 2,500,000
Btl 300 Gastrinal Susp 120 ml 24,200 7,260,000
Box 10 Gratamin Tab 30's 60,500 605,000
Box 30 Lagas Cap 30's 225,000 6,750,000
Btl 100 Lagesil Susp 170 ml 30,250 3,025,000
Box 2 Lapibal Injeksi 250mg 99,000 198,000
Box 35 L-Bio Sachet 30's 128,700 4,504,500
Box 20 Loremide 2mg 100's 99,000 1,980,000
Tube 20 Lusanoc Cream 10 gr 16,500 330,000
Btl 30 L-Zink Syr 100 ml 30,250 907,500
Box 5 Myotonic Inj 10's 82,500 412,500
Box 62 Norages Injeksi 5's 42,350 2,625,700
Fls 150 Profat Syrup 48,500 7,275,000
Box 5 Proneuron CapTab 20's 209,000 1,045,000
Btl 70 Propepsa Susp 100 ml 50,050 3,503,500
Box 2 Renapar Tab 100's 187,000 374,000
Box 6 Suprafenid Supp 10's 104,500 627,000
Kepada : PT Mesarinda Abadi -
Btl 50 Easy Touch Cholesterol 10's 198,550 9,927,500
Btl 20 Easy Touch Glucose 25's 107,250 2,145,000
Btl 30 Easy Touch Uric Acid 25's 107,250 3,217,500
Pcs 10 Extentiontube Terumo 150 cm 152 52,877 528,770
pcs 2 Folley Catheter 20 Fr WRP Cab 3 83,600 167,200
Pcs 2 Folley Catheter No. 16 Cab 2 22,550 45,100
Pcs 70 Folley Catheter No. 18 Cab 2 22,550 1,578,500
Box 10 Infuset Dewasa 522,500 5,225,000
Box 5 IV.Catheter No.18 1,086,250 5,431,250
Box 10 IV.Catheter No.20 1,086,250 10,862,500
Box 15 IV.Catheter No.22 1,086,250 16,293,750
Box 1 IV.Catheter No.24 1,086,250 1,086,250
Roll 5 Kassa 80 x 100 yds lucky 302,500 1,512,500
Roll 2 Kapas 250 gr 23,100 46,200
Ktk 300 Kasa Swallow 4,400 1,320,000
Box 5 Nald 23 100's 44,000 220,000
Box 3 Nald Novotwist 100's 231,000 693,000
Lsn 1 Nald Uterus 6120 E 000 223,300 223,300
Pcs 10 Spuit 10 cc 412,500 4,125,000
Box 15 Spuit 3 cc TRM 276,650 4,149,750
Box 15 Spuit 5 cc TRM 330,000 4,950,000
Roll 165 Verban Gulung 15cm 2,365 390,225
Roll 14 Leucodur 4" 41,437 580,118
Roll 14 Leucodur 6" 41,437 580,118
Kepada : PT Tirta Medical Indonesia -
Roll 10 Kapas 100gr 8,250 82,500
Pcs 2 NGT 12 Terumo 22,110 44,220
Pcs 5 NGT 14 Terumo 22,110 110,550
Pcs 5 NGT 16 Terumo 22,110 110,550
Pcs 20 NGT 18 Terumo 22,110 442,200
Box 15 Surgipro Steril Gloves No.7 357,500 5,362,500
Box 10 Surgipro Steril Gloves No.7,5 357,500 3,575,000
Pcs 50 Urine Bag Steril Onemed 5,500 275,000
-
Kepada : PT Hexalab Sumatera -
Roll 1 Cat Gut B Broun Chromic 1 1,789,700 1,789,700
Roll 1 Cat Gut B Broun Chromic 2 1,789,700 1,789,700
Roll 1 Cut Gut Plain 1 1,787,500 1,787,500
-
Kepada : PT Dos Ni Roha -
Fls 300 Amoxicillin 125 mg Syr 60ml 5,886 1,765,800
Box 30 Amoxicillin 500 mg Tab 100's 33,600 1,008,000
Box 50 Ciprofloxacin 500mg Tab .100's 32,500 1,625,000
Box 25 Metformin 500mg Tab 100's 27,200 680,000
Box 170 Metronidazol Infus 35,400 6,018,000
Box 60 Ranitidin 150mg Tab 100's 27,500 1,650,000

Kepada : PT Sapta Sari Tama -


Vial 40 Adidryl injeksi 3,630 145,200
Vial 30 Adimidon injeksi 4,506 135,168
Box 40 Afamed Cap 30's 198,000 7,920,000
Box 23 Allopurinol 100 mg Tab 100's 13,200 303,600
Box 5 Antalgin Tablet 100's 21,405 107,025
Btl 45 Betadine Gargle 100 cc 8,140 366,300
Tin 3 Chloramphenicol 250 mg Kaps 1000's 231,000 693,000
Box 35 Cotrimoksazole 480 kaplet 100's 15,895 556,325
Fls 50 Cotrimoksazole suspensi 60 ml 2,839 141,955
Tube 70 Counterpain Cream 30gr 35,000 2,450,000
Box 30 Flamoxi Tab 100's 393,000 11,790,000
Box 30 Ibuprofen 400 mg Tablet 100's 18,000 540,012
Box 40 Qinox 500mg Tab 100's 300,300 12,012,000
Fls 13 Reco Eye Drops TM 8,422 109,486
Box 15 Rybest 10mg 20's 61,600 924,000
Box 20 Solaneuron Tab 100's 114,600 2,292,000
-
Kepada : PT Sawah Besar Farma -
Box 1 Amytriptilin 25mg Tab 100's 15,800 15,800
Box 3 Chloramex Injeksi 10's 112,500 337,500
Fls 5 Flumucyl Syr 75,000 375,000
Tube 60 Hydrocortison Krim 3,890 233,400
Tube 5 Medicasol Cream 105,217 526,085
Btl 10 Otozambon Ear Drops 8 ml 1's 47,300 473,000
Box 3 Siberid 5mg Tab 30's 123,000 369,000

837,756,991
- 2
- 2
- 2
5 3
- 20
10 17
- 3
- 17
1 4
- 5
- 12
- 2
- 2
2 11
- 23
20 12
30 47
- 20
- 2
1 2
1 1
- 17
- 17
2
20 8
2 2
5 7
- 2
- 4
- 2
- 7
- 7
- 7
1 2
9 8
- -
40 33
20 40
14 15
8 26
- 3
- 17
5 15
- 2
5 3
- 5
- 50
- 2
- 2
50 30
- 1
1 2
50 33
2 6
- 2
- 10
- 3
10 10
- -
- -
- 2
- 23
- 3
5 12
- 3
- 50
- 5
- 7
- 3
- 7
- 3
- 10
- 10
5 4
- 12
- 5
- 2
30 13
- 3
- -
- -
- 15
1 1
1 2
- 1
- 7
- 33
- 2
1 2
- 17
3 1
- 23
1 1
- 22
5 3
1 1
- 3
- 1
- 1
- 2
- 1
- 1
- 1
- 3
20 27
- 3
- 3
1 2
- 3
10 10
- 1
5 1
3 2
20 33
- 5
1 3
2 2
10 1
1 7
- 13
- 2
- 1
1 1
- 1
1 1
- 5
200 67
100 67
- 1
- 1
25 33
45 133
50 4
1 3
1 10
- 3
5 33
- 1
2 3
50 1
1 1
5 1
1,000 1,000
1 1
5 15
1 1
5 7
1 3
- 3
2 1
- 1
5 7
- 1
1 1
- 17
- -
- -
- 2
- 20
- 1
- 1
- 5
- 1
- 2
- 2
- 1
- -
- -
- 50
- 2
10 10
- 200
- 1
100 104
- 17
- 50
30 14
- 17
- 20
- 2
100 83
- 10
14 6
30 17
- 10
5 5
20 13
- 137
- 5
- 8
- 3
- 7
- 3
20 12
167 76
10 7
40 23
20 17
- 79
30 17
200 200
- 173
- 5
- 17
- 7
210 220
15 16
2 2
- 5
20 15
10 12
- 50
14 11
- 7
15 12
- 67
- 5
20 17
- 27
132 111
25 12
- -
- -
- 4
- 2
- 4
- 73
- 1
- 2
- 3
2 1
5 6
10 8
- 2
- 3
1 2
2 7
- 1
- 2
- 5
5 2
- 3
- 3
- 1
- 2
- 22
- 133
- 3
- 3
- 7
- 2
- 2
- 13
- 1
- 17
- 1
- 7
- -
- -
1 3
100 100
- 13
- 17
5 8
- 3
- 3
10 10
- 2
- 5
10 13
10 13
- 7
- 33
- 5
30 15
- 7
100 67
- 17
- 5
30 15
- -
- -
- -
- 55
- 3
- 2
- 2
- 7
- 3
15 10
- 5
- 17
- 22
- 10
- 2
- 3
- 2
30 25
15 7
- 2
25 12
- 2
- 2
- 17
- 17
- 50
- 3
- 100
- 3
- 10
- 33
- 1
15 17
- 7
- 7
- 10
3 3
- 21
- 50
3 3
- 23
- 1
4 3
- -
- -
15 22
40 20
25 18
- 3
- 1
2 1
- 23
- 3
- 2
- 3
- 5
- 1
- 1
- 1
- 100
- 2
- 1
- 1
4 5
15 10
15 10
- 55
- 2
- 2
- -
- 3
- 1
- 2
- 2
- 7
- 5
- 3
50 33
- -
- -
- 1
- 1
- 1
- -
- -
- 100
- 10
10 20
25 17
- 57
- 20
- -
- -
- 13
- 10
30 23
- 8
- 2
- 15
- 1
- 12
- 17
- 23
5 12
- 10
- 13
- 4
- 5
10 10
- -
- -
- 1
- 1
- 2
- 20
- 2
- 3
- 1
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . .
DAFTAR PERMINTAAN Tanggal : Nomor :
Diterima di Bahg. . . . . . . . . . Tgl. . . .
09 RSCM/AU-31/
BARANG2 DAN BAHAN Maret 2017 032/2017
Diterima di Bahg. . . . . . . . . . Tgl. . . .
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.19 Ambroxol syrup Fls 500 50 - - -
2 300.19 Aminopilin Tab Box 2 - - 300,000 600,000
3 300.19 Amitriptilin tablet 25 mg Box 5 - - 128,000 640,000
4 300.19 Amoxilin 500mg Tab Box 50 50 - 14,000 700,000
5 300.19 Antasida syrup Fls 500 200 - 7,000 3,500,000
6 300.19 Aqua 1000 ml Fls 20 - - 820,000 16,400,000
7 300.19 Aqua Injeksi 25ml Fls 500 400 - 140,000 70,000,000
8 300.19 Arixtra Inj Box 20 - - 10,500 210,000
9 300.19 Aspilet tablet Box 10 4 - 427,000 4,270,000
10 300.19 ATS injeksi 1500 ui Box 5 - - 17,000 85,000
11 300.19 Azytromicin Tab 500mg Box 50 - - 198,500 9,925,000
12 300.19 Bamgetol 200mg Tab Box 10 - - 228,000 2,280,000
13 300.19 Berotec Inheler Fls 20 - - 650,000 13,000,000
14 300.19 Betahistin Tab 6mg Box 60 - - 7,200 432,000
15 300.19 Bisoprolol tablet 5 mg Box 50 20 - 8,500 425,000
16 300.19 Candesartan 16mg Tab Box 50 - - 16,000 800,000
17 300.19 Captropil 12.5mg Tab Box 40 - - 250,500 10,020,000
18 300.19 Captropil 25mg Tab Box 20 - - 202,500 4,050,000
19 300.19 Cefadroxil Capsul 500 mg Box 120 - - 220,000 26,400,000
20 300.19 Cefixim 100mg Tab Box 20 - - 550,000 11,000,000
21 300.19 Cefixim 200mg Tab Box 50 - - 10,000 500,000
22 300.19 Chloramfenicol Syrup Fls 15 - - 206,500 3,097,500
23 300.19 Ciprofloxacin Infus Fls 20 - - 40,000 800,000
24 300.19 Ciprofloxacin tablet 500 mg Box 60 40 -
25 300.19 Clindamicin 300mg Cap Box 20 - -
26 300.19 Co Amoxiclav 625 Box 10 7 -
27 300.19 Curcuma tablet Box 20 8 - 20,000 400,000
Dipindahkan 179,534,500
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 032/2017
No. Kode Permintaan Persediaan Taksasi Harga Permintaan Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan 179,534,500
28 300.19 Depacen Syr Fls 5 - - 227,500 1,137,500
29 300.19 Dex 40% Fls 100 - - 65,000 6,500,000
30 300.19 Dexametason injeksi Tin 10 - - 31,500 315,000
31 300.19 Dextrose 5% Infus Fls 100 50 - 22,000 2,200,000
32 300.19 Domperidon Tab Box 30 40 - 7,000 210,000
33 300.19 Eritromicin cap 500 mg Box 10 - - 270,000 2,700,000
34 300.19 Ethambutol 500mg Tab Box 5 - - 225,000 1,125,000
35 300.19 Flixotide Nebule Box 10 - - 75,000 750,000
36 300.19 Furosemid tablet 40mg Box 100 - - 44,000 4,400,000
37 300.19 Glimepirid 1mg Tab Box 20 - - 73,000 1,460,000
38 300.19 Glimepirid 2mg Tab Box 30 - - 130,000 3,900,000
39 300.19 Glucodex Tab Box 30 - - 203,000 6,090,000
40 300.19 Ketorolac Tab Box 3 3 - 50,000 150,000
41 300.19 Levofloxacin 500mg Tab Box 50 2 - 40,500 2,025,000
42 300.19 Lidocain HCL injeksi Box 5 - - 483,000 2,415,000
43 300.19 Lisinopril 10mg Tab Box 10 - - 119,000 1,190,000
44 300.19 Lisinopril 5mg Tab Box 5 - - 119,001 595,005
45 300.19 Loratadin Tab Box 20 - - 119,002 2,380,040
46 300.19 Manitol Infus Box 3 - - 119,003 357,009
47 300.19 Mecobalamin 500 mg capsul Box 50 - - 119,004 5,950,200
48 300.19 Meloxicam 15 mg Box 70 46 - 119,005 8,330,350
49 300.19 Metronidazol tablet 500 mg Box 60 - - 119,006 7,140,360
50 300.19 Metyl prednisolon tablet 4 mg Box 70 20 - 119,007 8,330,490
51 300.19 Na Diclofenac 50 mg Box 100 - - 119,008 11,900,800
52 300.19 NaCL 500 ml Fls 1000 175 -
53 300.19 Ofloxacin tablet 200mg Box 40 - -
Dipindahkan 73,914,254
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 032/2017
No. Kode Permintaan Persediaan Taksasi Harga Permintaan Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan 73,914,254
54 300.19 Ofloxacin tablet 400 mg Box 40 - - 227,501 9,100,040
55 300.19 Omeprazole Cap Box 600 - - 227,502 136,501,200
56 300.19 Oralit Sachet Box 3 - - 227,503 682,509
57 300.19 Paracetamol Syrup Fls 400 - - 227,504 91,001,600
58 300.19 Paracetamol Tablet 500 mg Box 100 1 - 227,505 22,750,500
59 300.19 Phenobarbital Tab 30 mg Tin 3 - - 227,506 682,518
60 300.19 Plasbumin 25 % 100ml Fls 5 - - 227,507 1,137,535
61 300.19 Plasbumin 25% 50ml Fls 5 - - 227,508
62 300.19 Pyrazinamid tablet 500 mg Box 10 - - 227,509
63 300.19 Ranitidin Injeksi Box 100's Tin 20 6 - 227,510
64 300.19 Ranitidin Tablet Box 100 20 - 227,511
65 300.19 Salbutamol Syrup Fls 100 - - 227,512
66 300.19 Scabicid Cream Tube 10 - - 227,513
67 300.19 Sedakter Syrup Fls 50 - - 227,514
68 300.19 Thrombopop Gel Tube 10 - - 227,515
69 300.19 Tramadol capsul Box 50 - - 227,516
70 300.19 Ventolin inhaler Fls 30 - - 227,517
71 300.19 Ventolin Nebule Box 20 2 -
72 300.19 Widahes 130 infus Box 10 - - 227,518
Jumlah 252,755,862

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan
dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN 09 RSCM/AU-31/
Diterima di Bahg. . . . . . . . . . Tgl. . . .
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 033/2017
No. Kode Permintaan Persediaan Taksasi Harga Permintaan Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.19 Atarox Syrup Fls 3 - - 45,000 135,000
2 300.19 Dipsamol Inheler Fls 30 - - 45,001 1,350,030
3 300.19 Eperison HCL Tab Box 30 - - 45,002 1,350,060
4 300.19 Esilgan 2mg Tab Box 3 - - 45,003 135,009
5 300.19 Glicuidon Tablet 30 mg Box 3 - - 45,004 135,012
6 300.19 Glufor tablet 500 mg Box 80 - - 45,005 3,600,400
7 300.19 Hytrin 2mg Box 1 - - 45,006 45,006
8 300.19 Irvask tablet 150 mg Box 5 - - 45,007 225,035
9 300.19 Lansoprazol capsul Box 1,000 - - 45,008 45,008,000
10 300.19 Meloxicam Supp 5's Box 10 2 - 45,009 450,090
11 300.19 Miloz Injeksi 5mg/5ml Box 10 - - 45,010 450,100
12 300.19 PTU tab 100 mg Box 3 - - 45,011 135,033
13 300.19 Ramipril 2,5 mg tablet Box 30 - - 45,012 1,350,360
14 300.19 Ranivel syrup Fls 5 - -
15 300.19 Recofol Injeksi Box 10 - -
16 300.19 Zelface Cream Tube 10 - -

Jumlah 54,369,135

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan
dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 034/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.19 Amlodipin 10md Tab Box 100 - - 42,500 4,250,000
2 300.19 Amlodipin 5mg Tab Box 100 - - 42,501 4,250,100
3 300.19 Arcalion tablet Box 2 - - 42,502 85,004
4 300.19 Avamys Nasal Spray Fls 10 - - 42,503 425,030
5 300.19 Avodart Tab Box 5 4 - 42,504 212,520
6 300.19 Bahan Tambalan Gigi (Liquid Spowder Set 1 - - 42,505 42,505
7 300.19 Bioplacenton cream Tube 30 - - 42,506 1,275,180
8 300.19 Biosanbe tablet Box 3 - - 42,507 127,521
9 300.19 Calsium lactat tablet Tin 5 - - 42,508 212,540
10 300.19 Cavit Bh 1 - - 42,509 42,509
11 300.19 Celebrex 100mg Cap Box 5 - - 42,510 212,550
12 300.19 Chloramex Inj Vial 100 - - 42,511 4,251,100
13 300.19 Clinimix infus Fls 15 - - 42,512 637,680
14 300.19 Clobazam Tab Box 5 - - 42,513 212,565
15 300.19 Cloramfenicol tablet 250 mg Tin 1 - - 42,514 42,514
16 300.19 Colme tetes telinga Fls 30 - - 42,515 1,275,450
17 300.19 Counterpan Cream Tube 30 - - 42,516 1,275,480
18 300.19 Depokate ER 250mg Tab Box 5 - - 42,517 212,585
19 300.19 Depokate ER 500mg Tab Box 8 - - 42,518 340,144
20 300.19 Epineprin Injeksi Box 5 - - 42,519 212,595
21 300.19 Eritromicyn syrup 250mg/ml Fls 20 - - 42,520 850,400
22 300.19 FG Troces Tab Box 1 - - 42,521 42,521
23 300.19 Flutias Inhaler 125 mcg Fls 60 - - 42,522 2,551,320
24 300.19 Furosemid Injeksi Box 120 80 - 42,523 5,102,760
25 300.19 Gentamicin Cream 5gr SK Tube 50 - -
26 300.19 Gentamicyn injeksi 80mg Box 100 - -
27 300.19 Gentian Violet Fls 20 - -
Dipindahkan 28,142,573
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 034/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan 28,142,573
28 300.19 Glimeperid 4mg Tab Box 30 - - 3,750 112,500
29 300.19 Glucophage 850 Box 2 - - 3,751 7,502
30 300.19 Harnal ocas 30's Box 15 - - 3,752 56,280
31 300.19 Hystolan Tab 50's Box 1 - - 3,753 3,753
32 300.19 Ichtiyol salep Pot 50 - - 3,754 187,700
33 300.19 Illiadin 0,025 % Fls 10 10 - 3,755 37,550
34 300.19 Illiadin 0,5 % Fls 10 20 - 3,756 37,560
35 300.19 INH 100 mg Tab 1000's Tin 10 - - 3,757 37,570
36 300.19 INH 300 mg Tin 10 - - 3,758 37,580
37 300.19 Insto tetes mata Fls 50 - - 3,759 187,950
38 300.19 Irvask 150mg Tab Box 5 - - 3,760 18,800
39 300.19 ISDN 5 mg tablet Box 100 - - 3,761 376,100
40 300.19 KA EN 3B Box 2 - - 3,762 7,524
41 300.19 Kalxetin 10 mg Box 15 2 - 3,763 56,445
42 300.19 Kalxetin 20 mg Tab 30's Box 15 1 - 3,764 56,460
43 300.19 Ketricin Orabase Tube 50 - - 3,765 188,250
44 300.19 Levemir Flexpen Box 10 - - 3,766 37,660
45 300.19 Lipitor 10 mg Tab Box 10 - - 3,767 37,670
46 300.19 Lipitor 20 mg Tab Box 10 - - 3,768 37,680
47 300.19 Lipitor 40mg Tab Box 10 - - 3,769 37,690
48 300.19 Lyrica 75 mg Tab Box 5 - - 3,770 18,850
49 300.19 Mebo krim 20 gr Tube 3 - - 3,771 11,313
50 300.19 Metformin 500mg Tab Box 15 9 - 3,772 56,580
51 300.19 Nald novotwist 100's Box 4 - - 3,773 15,092
52 300.19 Nebacetin Powder Pot 20 - -
53 300.19 Nebacetin Zalf Tube 10 - -
Dipindahkan 29,804,632
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 034/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan 29,804,632
54 300.19 Neo K 2 mg/ml injeksi Box 10 - - 3,750 37,500
55 300.19 Norvask 10 mg Box 3 - - 3,751 11,253
56 300.19 Novomix flexpen Box 20 - - 3,752 75,040
57 300.19 Novorapid flexpen Box 30 - - 3,753 112,590
58 300.19 Otopain TT Box 30 - - 3,754 112,620
59 300.19 Piracetam 800mg Tab Box 5 - - 3,755 18,775
60 300.19 Plavix Tab 75 mg Box 5 - - 3,756 18,780
61 300.19 Ringer lactat infus Fls 2,000 3,500 - 3,757 7,514,000
62 300.19 Sabu injeksi Vial 3 - - 3,758 11,274
63 300.19 Septocain Ktk 1 - - 3,759 3,759
64 300.19 Sifrol 0.375mg Tab Box 1 - - 3,760 3,760
65 300.19 Spongostan Ktk 1 - - 3,761 3,761
66 300.19 Tetagam injeksi 250 iu Pcs 2 - - 3,762 7,524
67 300.19 Vit K injeksi Box 3 - - 3,763 11,289
68 300.19 Vit K Tab Tin 2 - - 3,764 7,528
69 300.19 Xylamidon Inj Vial 30 - - 3,765 112,950
70 300.19 Xylocain Jell Pcs 2 - - 3,766 7,532
71 300.19 Xylonor Spray Pcs 2 - -
72 300.19 Ziloric 300 mg Box 3 - - 3,767 11,301
Jumlah 48,753

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 035/2016
No. Kode Permintaan Persediaan Taksasi Harga Permintaan Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.19 Alpara Syrup Fls 100 - -
2 300.19 Alphamol drop Fls 10 - -
3 300.19 Alphamol syrup Fls 400 - -
4 300.19 Alprazolam 0,5 mg Box 90 - -
5 300.19 Alprazolam 1 mg Box 20 - -
6 300.19 Asabium tablet Box 10 - -
7 300.19 Bevalex cream Tube 100 - -
8 300.19 Dextral capsul Box 50 - -
9 300.19 Dextral Syrup Fls 300 - -
10 300.19 Diclofalm 25 mg Box 100 - -
11 300.19 Dicloflam 50 mg Box 100 - -
12 300.19 Gentalex Cream Tube 200 50 -
13 300.19 Lexacrol Syr Pcs 400 15 -
14 300.19 Lexavit Tab Box 80 - -
15 300.19 Lexavon capsul Box 30 - -
16 300.19 Lexavon Syrup Fls 300 - -
17 300.19 Lexicam tablet 10 mg Box 30 - -
18 300.19 Lexicam tablet 20 mg Box 30 - -
19 300.19 Molacort tablet Box 30 - -
20 300.19 Molacream Tube 250 - - 81,269 20,317,250
21 300.19 Moladerm cream Tube 100 - -
22 300.19 Molafate syrup Fls 400 150 -
23 300.19 Molaneuron tablet 1000 mg Box 100 - -
24 300.19 Molapec syrup Box 300 - -
25 300.19 Molapec tablet Box 50 - -
26 300.19 Molasic 500mg Tab Box 80 - -
27 300.19 Molazol Tab 500mg Box 60 - -
28 300.19 Molexdryl Syrup Fls 300 - -
Dipindahkan 20,317,250
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 035/2016
No. Kode Permintaan Persediaan Taksasi Harga Permintaan Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan 20,317,250
29 300.19 Molexflu syrup Fls 150 - - 3,750 562,500
30 300.19 Molexflu tablet Box 80 - - 3,751 300,080
31 300.19 OBH Molex Syrup Fls 200 - - 3,752 750,400
32 300.19 Omeyus Cap Box 200 - - 3,753 750,600
33 300.19 Opilax Syrup Fls 50 - - 3,754 187,700
34 300.19 Pedab tablet Box 40 - - 3,755 150,200
35 300.19 Piralen Inj Box 40 13 - 3,756 150,240
36 300.19 Pritacort tablet Box 60 - - 3,757 225,420
37 300.19 Pritamox 125 mg syrup Fls 150 60 - 3,758 563,700
38 300.19 Pritavit Tab Box 80 - - 3,759 300,720
39 300.19 Renvol Cream Tube 250 - - 3,760 940,000
40 300.19 Spironolacton 25 mg Box 20 - - 3,761 75,220
41 300.19 Stesolid rectal 5mg Box 5 - - 3,762 18,810
42 300.19 Stesolid syrup Fls 5 - - 3,763 18,815
43 300.19 Stesolid tablet 2mg Box 10 - - 3,764 37,640
44 300.19 Thiamfilex syrup Fls 50 - - 3,765 188,250
45 300.19 Trifedrin Syrup Fls 30 - - 3,766 112,980
46 300.19 Trifedrin Tab Box 20 - - 3,767 75,340
47 300.19 Valeptic Syrup Fls 15 10 - 3,768 56,520
48 300.19 Vical syrup Fls 350 - -
49 300.19 Vitalex Cap Box 80 - - 3,769 301,520
Jumlah 1,088,500

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 036/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.19 Alat Cek HB Pcs 1 - - 110,254 110,254
2 300.19 Alat GCU Pcs 1 - - 110,255 110,255
3 300.19 Assucryl 0 Ref 4346 N Pcs 12 - - 110,256 1,323,072
4 300.19 Assucryl 1 Ref 43437 H Lsn 1 - - 110,257 110,257
5 300.19 Assucryl 1 Ref 43977 H Lsn 1 - - 110,258 110,258
6 300.19 Assucryl 8/0 Box 1 - - 110,259 110,259
7 300.19 Blood lancet Box 3 - - 110,260 330,780
8 300.19 Bola Lampu Halogen kecil 500/250 wa Pcs 2 - - 110,261 220,522
9 300.19 Caesar Kit Pcs 24 - - 110,262 2,646,288
10 300.19 Cat Gut Plain 1 B'braun Roll 1 - - 110,263 110,263
11 300.19 Cat Gut Plan 2/0 Roll 1 - - 110,264 110,264
12 300.19 Corset Lumbal uk/ L Pria Pcs 1 - - 110,265 110,265
13 300.19 Corset Lumbal uk/ M Wanita Pcs 2 - - 110,266 220,532
14 300.19 Cut Gut Cromic 2 Roll 2 - - 110,267 220,534
15 300.19 Easy Toch Uric Acid Box 20 - - 110,268 2,205,360
16 300.19 Easy Touch Colesterol Box 20 - - 110,269 2,205,380
17 300.19 Easy Touch Glucose Box 40 20 - 110,270 4,410,800
18 300.19 Electroda Pak 3 - - 110,271 330,813
19 300.19 Extention Tubing Pcs 30 - - 110,272 3,308,160
20 300.19 Folley cateter No10 Pcs 2 - - 110,273 220,546
21 300.19 Folley Catheter No 6 Pcs 2 - -
22 300.19 Folley Catheter No.18 Pcs 100 110 -
23 300.19 Handscun no 7 Box 15 - -
24 300.19 Handscun no 7,5 Box 7 15 -
25 300.19 Hernia Mesh Box 1 - -
26 300.19 Hukmah / Irigator Set 2 - -
27 300.19 Hyfapix 15x5 Roll 40 - -
Dipindahkan 18,524,862
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 036/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan 18,524,862
28 300.19 Hyfapix 5 x5 Roll 40 - - 262,500 10,500,000
29 300.19 Infused Dewasa Box 30 3 - 262,501 7,875,030
30 300.19 Infused Ped Box 5 - - 262,502 1,312,510
31 300.19 IV Catheter No.22 Box 5 30 - 262,503 1,312,515
32 300.19 Kapas 1000gr Roll 10 - - 262,504 2,625,040
33 300.19 Kapas 100gr Roll 60 - - 262,505 15,750,300
34 300.19 Kapas 25gr Roll 30 - - 262,506 7,875,180
35 300.19 Kapas 500gr Roll 30 - - 262,507 7,875,210
36 300.19 Kassa Kotak steril Box 200 - - 262,508 52,501,600
37 300.19 Kassa Lucky Roll 5 5 - 262,509 1,312,545
38 300.19 Kertas Ekg Rool Roll 30 10 - 262,510 7,875,300
39 300.19 Kertas Usg Roll 10 2 - 262,511 2,625,110
40 300.19 KY Jelly Jerigen Jrg 1 - - 262,512 262,512
41 300.19 Leucocrep 3 Inci Roll 12 - - 262,513 3,150,156
42 300.19 Leucocrep 4 inci BSN Roll 24 - - 262,514 6,300,336
43 300.19 Leucocrep 6" Roll 24 - - 262,515 6,300,360
44 300.19 Leucodur 3' Roll 24 - - 262,516 6,300,384
45 300.19 Leucodur 4" Roll 24 - - 262,517 6,300,408
46 300.19 Leucodur 6" Roll 24 - - 262,518 6,300,432
47 300.19 Leucolast 1624 BSN Roll 100 - - 262,519 26,251,900
48 300.19 Leucoplast 1622 BSN Roll 100 - - 262,520 26,252,000
49 300.19 Leucoplast 1623 BSN Roll 100 - - 262,521 26,252,100
50 300.19 Masker Box 30 20 - 262,522 7,875,660
51 300.19 Masker M95 Lsn 1 - -
52 300.19 Nald 23 Box 5 - -
53 300.19 Nald 6030 G/T 10 Lsn 1 - -
Dipindahkan 251,635,790
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 036/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan
54 300.19 Nald 6030 G/T 12 Lsn 1 - -
55 300.19 NGT 10 Pcs 10 - -
56 300.19 NGT 12 Pcs 10 - -
57 300.19 NGT 14 Pcs 10 - -
58 300.19 NGT 16 pcs 10 - -
59 300.19 NGT 18 Pcs 50 - -
60 300.19 Pencil cauter Pcs 3 - -
61 300.19 Perban gulung 15 cm Roll 300 - -
62 300.19 Pisau Bisturi no 15 Box 1 - -
63 300.19 Pisau Bisturi no 24 Box 5 - -
64 300.19 Polypropylene 5/0 Ref 9532 Lsn 1 - -
65 300.19 Postofix 10x10 Box 1 - -
66 300.19 Postofix 10x15 Box 1 - -
67 300.19 Primacef Jrgn 2 - -
68 300.19 Spinocain Box 5 - -
69 300.19 Spuit 10cc Box 5 - -
70 300.19 Spuit 1cc Box 5 - -
71 300.19 Spuit 3cc Box 20 50 -
72 300.19 Spuit 5cc Box 20 40 -
73 300.19 Stamper dan mortir Pcs 1 - -
74 300.19 Tensi Meter Air Raksa Pcs 3 - -
75 300.19 Tensi Meter anak unit 2 - -
76 300.19 Threway Box 3 2 -
77 300.19 Timbangan dewasa Unit 2 - -
78 300.19 Topi operasi pria Box 3 - -
79 300.19 Topi operasi wanita Box 3 - -
Dipindahkan -
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 036/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Pemindahan -
80 300.19 Torniquet Pcs 5 - - 145,600 728,000
81 300.19 Tranfusi Set Box 1 1 - 145,601 145,601
82 300.19 Umbilical cord clamp Box 1 1 - 145,602 145,602
83 300.19 Urine Bag Pcs 100 70 - 145,603 14,560,300
84 300.19 Verban 15cm Roll 300 - - 145,604 43,681,200
85 300.19 Wascom mandi Pcs 2 - - -
86 300.19 Washen Pcs 4 - - -
87 300.19 Waslap Pcs 3 - - -

-
-
-
-
Jumlah

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 037/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 300.19 Decubal Cream Tube 5 - -


2 300.19 Farsix Injeksi Box 120 60 -
3 300.19 Fasodrin Injeksi Box 10 2 -
4 300.19 Ketese Tab 25 mg Box 2 - -
5 300.19 Recolfar Tab Box 20 - -
6 300.19 Remital 10 mg tablet Box 3 - -
7 300.19 Renapar Tab Box 30 - -

Jumlah -

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 038/2017
No. Kode Permintaan Persediaan Taksasi Harga Permintaan Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.19 Arkine tablet Box 30 - - 27,500 825,000
2 300.19 Asetyl sistein syrup Fls 100 - - 27,501 2,750,100
3 300.19 Bamgetol tablet 200 mg Box 20 - - 27,502 550,040
4 300.19 Calcimega tablet Box 20 5 - 27,503 550,060
5 300.19 Diuvar injeksi Box 200 - - 27,504 5,500,800
6 300.19 Endostein syrup Fls 100 - - 27,505 2,750,500
7 300.19 Epsonal tablet Box 50 3 - 27,506 1,375,300
8 300.19 Flumucyl syrup Fls 70 - - 27,507 1,925,490
9 300.19 Flumucyl tablet Box 10 - - 27,508 275,080
10 300.19 Hexymer Tablet 2 mg Box 15 - - 27,509 412,635
11 300.19 Ketocid tablet Box 5 5 - 27,510 137,550
12 300.19 Kutoin capsul Box 10 - - 27,511 275,110
13 300.19 Laxadin syrup Fls 100 - - 27,512 2,751,200
14 300.19 Levazide Tab Box 6 - - 27,513 165,078
15 300.19 Neuraxon Cap Box 80 - - 27,514 2,201,120
16 300.19 Novaldo Injeksi Box 100 260 - 27,516
17 300.19 Osteor cream Tube 100 - -
18 300.19 Otozambon Tetes Telinga Fls 30 - -
19 300.19 Pyderma Cream Tube 50 50 -
Jumlah 3,850,200

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 039/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 300.19 Biocombin tablet Box 80 11 - 390,000 31,200,000


2 300.19 Cal 95 tablet Box 10 - - 390,001 3,900,010
3 300.19 Cendo Astenof 0,6ml@5' minidose Strip 20 - - 390,002 7,800,040
4 300.19 Cendo Catarlen 0,6 ml @ 5's minidose Strip 50 - - 390,003 19,500,150
5 300.19 Cendo Cenfres 0,6 ml@5's minidose Strip 50 - - 390,004 19,500,200
6 300.19 Cendo Eyefres 0,6 ml@ 5's minidose Strip 30 - - 390,005 11,700,150
7 300.19 Cendo Fenicol 0,25% 0,6ml@5;s minid Strip 10 - - 390,006 3,900,060
8 300.19 Cendo Fenicol Sm Tube 30 - - -
9 300.19 Cendo Floxa 0,6ml@5' minidose Strip 10 - -
10 300.19 Cendo Genta SM Tube 50 - -
11 300.19 Cendo Genta tetes mata 0,6ml@5's min Strip 30 3 -
12 300.19 Cendo Glaucor Tab Box 2 - -
13 300.19 Cendo LFX tetes mata 0,6ml@5's mini Strip 40 - -
14 300.19 Cendo Lyters 0,6 ml@ 5's minidose Strip 50 - -
15 300.19 Cendo Pantocain 0,6ml@5' minidose Strip 5 - -
16 300.19 Cendo polidex 0,6ml@5's minidose Strip 50 - -
17 300.19 Cendo posop 0,6ml@5' minidose Strip 20 - -
18 300.19 Cendo Tonor 0,6ml@5'S minidose Strip 5 - -
19 300.19 Cendo Ulcori 0,6 ml @ 5's minidose Strip 40 40 -
20 300.19 Cendo Xitrol 0,6 ml@ 5's minidose Strip 50 - -
21 300.19 Ciflon Tab Box 10 - -
22 300.19 Forasma Syr Fls 50 - -
23 300.19 Gatrinal Syrup Fls 200 100 -
24 300.19 L Bio Sacset Box 5 - -
25 300.19 L zink syrup Fls 200 - -
26 300.19 Lagesyl syrup Fls 100 - -
Dipindahkan 97,500,610
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 039/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang Pembelian dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Pemindahan -
27 300.19 Lasal syrup Fls 50 - - 145,603 7,280,150
28 300.19 L-cisin tablet 30's Box 30 - - 145,604 4,368,120
29 300.19 Norages injeksi Box 100 - - 145,605 14,560,500
30 300.19 Promuba syrup Fls 50 - - 145,606 7,280,300
-

-
-

7,100,015 -
7,100,016
Jumlah

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 040/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
145,602 -
1 300.19 Bersol cream Tube 200 - - 145,603 29,120,600
2 300.19 Nonflamin capsul Box 10 - - 145,604 1,456,040
145,605 -
-
-
-
-

-
-
-
-
-

Jumlah #REF!

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 09 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 041/2017
No. Kode Permintaan Persediaan Taksasi Harga Permintaan Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.19 Alfa Diluent Swelab Gal 1 - - 145,602 145,602
2 300.19 Alfa Lyse Swelab Gal 1 - - 145,603
3 300.19 ALP Kit 1 - - 145,604
4 300.19 Blood Lancet Box 3 - - 145,605
5 300.19 Control Level 1 Btl 1 - - 145,606
6 300.19 Control Level 2 Btl 1 - - 145,607
7 300.19 Control Level 3 Btl 1 - - 145,608
8 300.19 Electrode Conditioning Sol 100ml Btl 1 - - 145,609
9 300.19 GGT Btl 1 - - 145,610
10 300.19 Hamil Test Kit 1 - - 145,611
11 300.19 HBS AG Kit 1 - - 145,612
12 300.19 HCG Latex Btl 1 - - 145,613
13 300.19 HDL Cholesterol Kit 2 - - 145,614
14 300.19 Ise Cleaning Sol Btl 1 - - 145,615
15 300.19 Plaster Bulat Ktk 2 - - 145,616
16 300.19 Termal Piper 5cm Roll 1 - -
17 300.19 Triglyseride Kit 2 - -
18 300.19 Urea Btl 1 - -
19 300.19 Uric Acid Btl 2 - -
20 300.19 Washing Solution 50ml Btl 1 - -
Jumlah #REF!

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
PT. CUT MEUTIA MEDIKA NUSANTARA Diterima di Bahg. . . . . . . . . . Tgl. . . . Tanggal : Nomor :
DAFTAR PERMINTAAN Diterima di Bahg. . . . . . . . . . Tgl. . . . 30 RSCM/AU-31/
BARANG2 DAN BAHAN Diterima di Bahg. . . . . . . . . . Tgl. . . . Maret 2017 042/2017
Permintaan Persediaan Taksasi Harga Permintaan
No. Kode Ket. Bon Permintaan
No. Permintaan No. Order
Persediaan URAIAN Di Harga Jumlah Sisa setelah Tentang dan Pengeluaran
Urut Sat Jumlah Minimum Jumlah s/d Yl Pembelian
Barang kebun Satuan Setahun Permintaan Persediaan Barang No.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 300.20 AC Merk Panasonic 1.5 PK Unit 1 - - 145,602 145,602
145,603
145,604
145,605
145,606
145,607
145,610
145,611
145,612
145,613
145,614
145,615
145,616

Jumlah #REF!

Untuk diselesaikan Gudang Pusat Kebutuhan & Pengeluaran Disetujui oleh : Pembelian disetujui oleh : Dilaksanakan oleh :
Diminta oleh : RSCM Bagian Administrasi & Operasional PT Cut Meutia Medika Nusantara Bagian Pengadaan

dr. Hj. Cut Diah AK Ikhwanul Hidayat Edi Purnomo Sri Wahyuningsih, S.Farm, Apt.
Kepala Kaur. Administrasi & Operasional Direktur Asst. Pengadaan Barang & Jasa
AU - 31
box
PT Kimia Farma Trade Megatrading
1 Fls 500 Ambroxol syrup 50
2 Box 2 Aminopilin Tab
3 Box 5 Amitriptilin tablet 25 mg
4 Box 50 Amoxilin 500mg Tab 50
5 Fls 500 Antasida syrup 200
6 Fls 20 Aqua 1000 ml
7 Fls 500 Aqua Injeksi 25ml 400
8 Box 20 Arixtra Inj
9 Box 10 Aspilet tablet 4
10 Box 5 ATS injeksi 1500 ui
11 Box 50 Azytromicin Tab 500mg
12 Box 10 Bamgetol 200mg Tab
13 Fls 20 Berotec Inheler
14 Box 60 Betahistin Tab 6mg
15 Box 50 Bisoprolol tablet 5 mg 20
16 Box 50 Candesartan 16mg Tab
17 Box 40 Captropil 12.5mg Tab
18 Box 20 Captropil 25mg Tab
19 Box 120 Cefadroxil Capsul 500 mg
20 Box 20 Cefixim 100mg Tab
21 Box 50 Cefixim 200mg Tab
22 Fls 15 Chloramfenicol Syrup
23 Fls 20 Ciprofloxacin Infus
24 Box 60 Ciprofloxacin tablet 500 mg 40
25 Box 20 Clindamicin 300mg Cap
26 Box 10 Co Amoxiclav 625 7
27 Box 20 Curcuma tablet 8
28 Fls 5 Depacen Syr
29 Fls 100 Dex 40%
30 Tin 10 Dexametason injeksi
31 Fls 100 Dextrose 5% Infus 50
32 Box 30 Domperidon Tab 40
33 Box 10 Eritromicin cap 500 mg
34 Box 5 Ethambutol 500mg Tab
35 Box 10 Flixotide Nebule
36 Box 100 Furosemid tablet 40mg
37 Box 20 Glimepirid 1mg Tab
38 Box 30 Glimepirid 2mg Tab
39 Box 30 Glucodex Tab
40 Box 3 Ketorolac Tab 3
41 Box 50 Levofloxacin 500mg Tab 2
42 Box 5 Lidocain HCL injeksi
43 Box 10 Lisinopril 10mg Tab
44 Box 5 Lisinopril 5mg Tab
45 Box 20 Loratadin Tab
46 Box 3 Manitol Infus
47 Box 50 Mecobalamin 500 mg capsul
48 Box 70 Meloxicam 15 mg 46
49 Box 60 Metronidazol tablet 500 mg
50 Box 70 Metyl prednisolon tablet 4 mg 20
51 Box 100 Na Diclofenac 50 mg
52 Fls 1,000 NaCL 500 ml 175
53 Box 40 Ofloxacin tablet 200mg
54 Box 40 Ofloxacin tablet 400 mg
55 Box 600 Omeprazole Cap
56 Box 3 Oralit Sachet
57 Fls 400 Paracetamol Syrup
58 Box 100 Paracetamol Tablet 500 mg 1
59 Tin 3 Phenobarbital Tab 30 mg
60 Fls 5 Plasbumin 25 % 100ml
61 Fls 5 Plasbumin 25% 50ml
62 Box 10 Pyrazinamid tablet 500 mg
63 Tin 20 Ranitidin Injeksi Box 100's 6
64 Box 100 Ranitidin Tablet 20
65 Fls 100 Salbutamol Syrup
66 Tube 10 Scabicid Cream
67 Fls 50 Sedakter Syrup
68 Tube 10 Thrombopop Gel
70 Box 50 Tramadol capsul
71 Fls 30 Ventolin inhaler
72 Box 20 Ventolin Nebule 2
73 Box 10 Widahes 130 infus
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89

PT Antar Mitra Sembada


1 Fls 3 Atarox Syrup
2 Fls 30 Dipsamol Inheler
3 Box 30 Eperison HCL Tab
4 Box 3 Esilgan 2mg Tab
5 Box 3 Glicuidon Tablet 30 mg
6 Box 80 Glufor tablet 500 mg
7 Box 1 Hytrin 2mg
8 Box 5 Irvask tablet 150 mg
9 Box 1,000 Lansoprazol capsul
10 Box 10 Meloxicam Supp 5's 2
11 Box 10 Miloz Injeksi 5mg/5ml
12 Box 3 PTU tab 100 mg
13 Box 30 Ramipril 2,5 mg tablet
14 Fls 5 Ranivel syrup
15 Box 10 Recofol Injeksi
16 Tube 10 Zelface Cream
17
18
19
20 7
21

PT Buetna Hareukat
1 Box 100 Amlodipin 10md Tab
2 Box 100 Amlodipin 5mg Tab
3 Box 2 Arcalion tablet
4 Fls 10 Avamys Nasal Spray
5 Box 5 Avodart Tab 4
6 Set 1 Bahan Tambalan Gigi (Liquid Spowder)
7 Tube 30 Bioplacenton cream
8 Box 3 Biosanbe tablet
9 Tin 5 Calsium lactat tablet
10 Bh 1 Cavit
11 Box 5 Celebrex 100mg Cap
12 Vial 100 Chloramex Inj
13 Fls 15 Clinimix infus
14 Box 5 Clobazam Tab
15 Tin 1 Cloramfenicol tablet 250 mg
16 Fls 30 Colme tetes telinga
17 Tube 30 Counterpan Cream
18 Box 5 Depokate ER 250mg Tab
19 Box 8 Depokate ER 500mg Tab
20 Box 5 Epineprin Injeksi
21 Fls 20 Eritromicyn syrup 250mg/ml
22 Box 1 FG Troces Tab
23 Fls 60 Flutias Inhaler 125 mcg
24 Box 120 Furosemid Injeksi 80
25 Tube 50 Gentamicin Cream 5gr SK
26 Box 100 Gentamicyn injeksi 80mg
27 Fls 20 Gentian Violet
28 Box 30 Glimeperid 4mg Tab
29 Box 2 Glucophage 850
30 Box 15 Harnal ocas 30's
31 Box 1 Hystolan Tab 50's
32 Pot 50 Ichtiyol salep
33 Fls 10 Illiadin 0,025 % 10
34 Fls 10 Illiadin 0,5 % 20
35 Tin 10 INH 100 mg Tab 1000's
36 Tin 10 INH 300 mg
37 Fls 50 Insto tetes mata
38 Box 5 Irvask 150mg Tab
39 Box 100 ISDN 5 mg tablet
40 Box 2 KA EN 3B
41 Box 15 Kalxetin 10 mg 2
42 Box 15 Kalxetin 20 mg Tab 30's 1
43 Tube 50 Ketricin Orabase
44 Box 10 Levemir Flexpen
45 Box 10 Lipitor 10 mg Tab
46 Box 10 Lipitor 20 mg Tab
47 Box 10 Lipitor 40mg Tab
48 Box 5 Lyrica 75 mg Tab
49 Tube 3 Mebo krim 20 gr
50 Box 15 Metformin 500mg Tab 9
51 Box 4 Nald novotwist 100's
52 Pot 20 Nebacetin Powder
53 Tube 10 Nebacetin Zalf
54 Box 10 Neo K 2 mg/ml injeksi
55 Box 3 Norvask 10 mg
56 Box 20 Novomix flexpen
57 Box 30 Novorapid flexpen
58 Box 30 Otopain TT
59 Box 5 Piracetam 800mg Tab
60 Box 5 Plavix Tab 75 mg
61 Fls 2,000 Ringer lactat infus 3,500
62 Vial 3 Sabu injeksi
63 Ktk 1 Septocain
64 Box 1 Sifrol 0.375mg Tab
65 Ktk 1 Spongostan
66 Pcs 2 Tetagam injeksi 250 iu
67 Box 3 Vit K injeksi
68 Tin 2 Vit K Tab
69 Vial 30 Xylamidon Inj
70 Pcs 2 Xylocain Jell
71 Pcs 2 Xylonor Spray
72 Box 3 Ziloric 300 mg
73
74
75
76
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100

PT Mensa Bina Sukses


1 Fls 100 Alpara Syrup
2 Fls 10 Alphamol drop
3 Fls 400 Alphamol syrup
4 Box 90 Alprazolam 0,5 mg
5 Box 20 Alprazolam 1 mg
6 Box 10 Asabium tablet
7 Tube 100 Bevalex cream
8 Box 50 Dextral capsul
9 Fls 300 Dextral Syrup
10 Box 100 Diclofalm 25 mg
11 Box 100 Dicloflam 50 mg
12 Tube 200 Gentalex Cream 50
13 Pcs 400 Lexacrol Syr 15
14 Box 80 Lexavit Tab
15 Box 30 Lexavon capsul
16 Fls 300 Lexavon Syrup
17 Box 30 Lexicam tablet 10 mg
18 Box 30 Lexicam tablet 20 mg
19 Box 30 Molacort tablet
20 Tube 250 Molacream
21 Tube 100 Moladerm cream
22 Fls 400 Molafate syrup 150
23 Box 100 Molaneuron tablet 1000 mg
24 Box 300 Molapec syrup
25 Box 50 Molapec tablet
26 Box 80 Molasic 500mg Tab
27 Box 60 Molazol Tab 500mg
28 Fls 300 Molexdryl Syrup
29 Fls 150 Molexflu syrup
30 Box 80 Molexflu tablet
31 Fls 200 OBH Molex Syrup
32 Box 200 Omeyus Cap
33 Fls 50 Opilax Syrup
34 Box 40 Pedab tablet
35 Box 40 Piralen Inj 13
36 Box 60 Pritacort tablet
37 Fls 150 Pritamox 125 mg syrup 60
38 Box 80 Pritavit Tab
39 Tube 250 Renvol Cream
40 Box 20 Spironolacton 25 mg
41 Box 5 Stesolid rectal 5mg
42 Fls 5 Stesolid syrup
43 Box 10 Stesolid tablet 2mg
44 Fls 50 Thiamfilex syrup
45 Fls 30 Trifedrin Syrup
46 Box 20 Trifedrin Tab
47 Fls 15 Valeptic Syrup 10
48 Fls 350 Vical syrup
49 Box 80 Vitalex Cap
50
51
52
53
54
55
56
57

PT Mesarinda Abadi
1 Pcs 1 Alat Cek HB
2 Pcs 1 Alat GCU
3 Pcs 12 Assucryl 0 Ref 4346 N
4 Lsn 1 Assucryl 1 Ref 43437 H
5 Lsn 1 Assucryl 1 Ref 43977 H
6 Box 1 Assucryl 8/0
7 Box 3 Blood lancet
8 Pcs 2 Bola Lampu Halogen kecil 500/250 wat
9 Pcs 24 Caesar Kit
10 Roll 1 Cat Gut Plain 1 B'braun
11 Roll 1 Cat Gut Plan 2/0
12 Pcs 1 Corset Lumbal uk/ L Pria
13 Pcs 2 Corset Lumbal uk/ M Wanita
14 Roll 2 Cut Gut Cromic 2
15 Box 20 Easy Toch Uric Acid
16 Box 20 Easy Touch Colesterol
17 Box 40 Easy Touch Glucose 20
18 Pak 3 Electroda
19 Pcs 30 Extention Tubing
20 Pcs 2 Folley cateter No10
21 Pcs 2 Folley Catheter No 6
22 Pcs 100 Folley Catheter No.18 110
23 Box 15 Handscun no 7
24 Box 7 Handscun no 7,5 15
25 Box 1 Hernia Mesh
26 Set 2 Hukmah / Irigator
27 Roll 40 Hyfapix 15x5
28 Roll 40 Hyfapix 5 x5
29 Box 30 Infused Dewasa 3
30 Box 5 Infused Ped
31 Box 5 IV Catheter No.22 30
32 Roll 10 Kapas 1000gr
33 Roll 60 Kapas 100gr
34 Roll 30 Kapas 25gr
35 Roll 30 Kapas 500gr
36 Box 200 Kassa Kotak steril
37 Roll 5 Kassa Lucky 5
38 Roll 30 Kertas Ekg Rool 10
39 Roll 10 Kertas Usg 2
40 Jrg 1 KY Jelly Jerigen
41 Roll 12 Leucocrep 3 Inci
42 Roll 24 Leucocrep 4 inci BSN
43 Roll 24 Leucocrep 6"
44 Roll 24 Leucodur 3'
45 Roll 24 Leucodur 4"
46 Roll 24 Leucodur 6"
47 Roll 100 Leucolast 1624 BSN
48 Roll 100 Leucoplast 1622 BSN
49 Roll 100 Leucoplast 1623 BSN
50 Box 30 Masker 20
51 Lsn 1 Masker M95
52 Box 5 Nald 23
53 Lsn 1 Nald 6030 G/T 10
54 Lsn 1 Nald 6030 G/T 12
55 Pcs 10 NGT 10
56 Pcs 10 NGT 12
57 Pcs 10 NGT 14
58 pcs 10 NGT 16
59 Pcs 50 NGT 18
60 Pcs 3 Pencil cauter
61 Roll 300 Perban gulung 15 cm
62 Box 1 Pisau Bisturi no 15
63 Box 5 Pisau Bisturi no 24
64 Lsn 1 Polypropylene 5/0 Ref 9532
65 Box 1 Postofix 10x10
66 Box 1 Postofix 10x15
67 Jrgn 2 Primacef
68 Box 5 Spinocain
69 Box 5 Spuit 10cc
70 Box 5 Spuit 1cc
71 Box 20 Spuit 3cc 50
72 Box 20 Spuit 5cc 40
73 Pcs 1 Stamper dan mortir
74 Pcs 3 Tensi Meter Air Raksa
75 unit 2 Tensi Meter anak
76 Box 3 Threway 2
77 Unit 2 Timbangan dewasa
78 Box 3 Topi operasi pria
79 Box 3 Topi operasi wanita
80 Pcs 5 Torniquet
81 Box 1 Tranfusi Set 1
82 Box 1 Umbilical cord clamp 1
83 Pcs 100 Urine Bag 70
84 Roll 300 Verban 15cm
85 Pcs 2 Wascom mandi
86 Pcs 4 Washen
87 Pcs 3 Waslap
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106

PT Parit Padang

1 Tube 5 Decubal Cream


2 Box 120 Farsix Injeksi 60
3 Box 10 Fasodrin Injeksi 2
4 Box 2 Ketese Tab 25 mg
5 Box 20 Recolfar Tab
6 Box 3 Remital 10 mg tablet
7 Box 30 Renapar Tab
8
9
10
11
12

PT Sawah Besar
1 Box 30 Arkine tablet
2 Fls 100 Asetyl sistein syrup
3 Box 20 Bamgetol tablet 200 mg
4 Box 20 Calcimega tablet 5
5 Box 200 Diuvar injeksi
6 Fls 100 Endostein syrup
7 Box 50 Epsonal tablet 3
8 Fls 70 Flumucyl syrup
9 Box 10 Flumucyl tablet
10 Box 15 Hexymer Tablet 2 mg
11 Box 5 Ketocid tablet 5
12 Box 10 Kutoin capsul
13 Fls 100 Laxadin syrup
14 Box 6 Levazide Tab
15 Box 80 Neuraxon Cap
16 Box 100 Novaldo Injeksi 260
17 Tube 100 Osteor cream
18 Fls 30 Otozambon Tetes Telinga
19 Tube 50 Pyderma Cream 50
20
21
22
23
24

PT.UDC
1 Tube 200 Bersol cream
2 Box 10 Nonflamin capsul
3

PT PENTA VALENT
1 Box 80 Biocombin tablet 11
2 Box 10 Cal 95 tablet
3 Strip 20 Cendo Astenof 0,6ml@5' minidose
4 Strip 50 Cendo Catarlen 0,6 ml @ 5's minidose
5 Strip 50 Cendo Cenfres 0,6 ml@5's minidose
6 Strip 30 Cendo Eyefres 0,6 ml@ 5's minidose
7 Strip 10 Cendo Fenicol 0,25% 0,6ml@5;s minidose
8 Tube 30 Cendo Fenicol Sm
9 Strip 10 Cendo Floxa 0,6ml@5' minidose
10 Tube 50 Cendo Genta SM
11 Strip 30 Cendo Genta tetes mata 0,6ml@5's minidose 3
12 Box 2 Cendo Glaucor Tab
13 Strip 40 Cendo LFX tetes mata 0,6ml@5's minidose
14 Strip 50 Cendo Lyters 0,6 ml@ 5's minidose
15 Strip 5 Cendo Pantocain 0,6ml@5' minidose
16 Strip 50 Cendo polidex 0,6ml@5's minidose
17 Strip 20 Cendo posop 0,6ml@5' minidose
18 Strip 5 Cendo Tonor 0,6ml@5'S minidose
19 Strip 40 Cendo Ulcori 0,6 ml @ 5's minidose 40
20 Strip 50 Cendo Xitrol 0,6 ml@ 5's minidose
21 Box 10 Ciflon Tab
22 Fls 50 Forasma Syr
23 Fls 200 Gatrinal Syrup 100
24 Box 5 L Bio Sacset
25 Fls 200 L zink syrup
26 Fls 100 Lagesyl syrup
27 Fls 50 Lasal syrup
28 Box 30 L-cisin tablet 30's
29 Box 100 Norages injeksi
30 Fls 50 Promuba syrup
31
32
33
34
35
36
37
38

PT PROTEUSSABA NUSANTARA
1 Gal 1 Alfa Diluent Swelab
2 Gal 1 Alfa Lyse Swelab
3 Kit 1 ALP
4 Box 3 Blood Lancet
5 Btl 1 Control Level 1
6 Btl 1 Control Level 2
7 Btl 1 Control Level 3
8 Btl 1 Electrode Conditioning Sol 100ml
9 Btl 1 GGT
10 Kit 1 Hamil Test
11 Kit 1 HBS AG
12 Btl 1 HCG Latex
13 Kit 2 HDL Cholesterol
14 Btl 1 Ise Cleaning Sol
15 Ktk 2 Plaster Bulat
16 Roll 1 Termal Piper 5cm
17 Kit 2 Triglyseride
18 Btl 1 Urea
19 Btl 2 Uric Acid
20 Btl 1 Washing Solution 50ml
21

Inventaris
1 Unit 2 Abortus Tang
2 Pcs 3 Ateri Clem
3 Pcs 2 Busi
4 Pcs 1 Gunting Episiotomi
5 Pcs 2 Gunting Tali Pusat
6 Pcs 1 I/2 Khoctier
7 Unit 3 Incubator
8 Pcs 1 Nald Pouder
9 Pcs 2 Oval Clem
10 Pcs 2 Pingset
11 Pcs 2 Sendok Curretage Doble
12 Unit 3 Spekulum ( Cocor Bebek )
13 Pcs 2 Spekulum ( Stan )
14 Unit 1 Stetoscop
15 Pcs 1 Stetoscop Bayi
16 Pcs 1 Suction
17 Unit 2 Tenaculum
18 Unit 1 Tensi

1 Box 40 Afamed Tab 30's


2 Box 2 Anadex Dragee 100's
3 Box 5 Bactiprox Cap 20's
4 Box 3 Bartolium 10mg Tab 50's
5 Box 5 Candepres 16mg Tab
6 Tube 20 Cinogenta Cream
1 PT ANUGRAH ARGON MEDICA
2 PT ANTAR MITRA SEMBADA
3 PT BUETNA HAREUKAT
4 PT ENCEVALL PUTRA MEGATRADING
5 PT PROTEUSSABA NUSANTARA
6 PT RAJAWALI NUSINDO
7 PT UNITED DICO CITAS
8 PT PENTA VALENT
9 PT TIRTA MEDICAL INDONESIA
10 PT MESARINDA ABADI
11 PT HEXALAB SUMATERA
12 PT. SAPTA SARI TAMA
13 PT DOS NI ROHA
14 PT SAWAH BESAR FARMA
15 KOPKAR MON MADU
Oxygen
RSCM/AU-31/001/2014 280,616,031
RSCM/AU-31/002/2014 61,911,562
RSCM/AU-31/003/2014 104,681,704
RSCM/AU-31/004/2014 29,735,640
RSCM/AU-31/005/2014 172,321,380
RSCM/AU-31/006/2014 155,071,632
RSCM/AU-31/007/2014 85,079,106
RSCM/AU-31/008/2014 124,551,693
RSCM/AU-31/009/2014 55,010,831
RSCM/AU-31/010/2014 143,137,050
RSCM/AU-31/011/2014 10,242,151
RSCM/AU-31/012/2014 27,146,565
RSCM/AU-31/013/2014 31,942,219
RSCM/AU-31/014/2014 33,557,777
RSCM/AU-31/015/2014 11,434,500
1,326,439,840
box
PT Kimia Farma Trade Megatrading
1 Fls 500 Ambroxol syrup 50
2 Box 2 Aminopilin Tab
3 Box 5 Amitriptilin tablet 25 mg
4 Box 50 Amoxilin 500mg Tab 50
5 Fls 500 Antasida syrup 200
6 Fls 20 Aqua 1000 ml
7 Fls 500 Aqua Injeksi 25ml 400
8 Box 20 Arixtra Inj
9 Box 10 Aspilet tablet 4
10 Box 5 ATS injeksi 1500 ui
11 Box 50 Azytromicin Tab 500mg
12 Box 10 Bamgetol 200mg Tab
13 Fls 20 Berotec Inheler
14 Box 60 Betahistin Tab 6mg
15 Box 50 Bisoprolol tablet 5 mg 20
16 Box 50 Candesartan 16mg Tab
17 Box 40 Captropil 12.5mg Tab
18 Box 20 Captropil 25mg Tab
19 Box 120 Cefadroxil Capsul 500 mg
20 Box 20 Cefixim 100mg Tab
21 Box 50 Cefixim 200mg Tab
22 Fls 15 Chloramfenicol Syrup
23 Fls 20 Ciprofloxacin Infus
24 Box 60 Ciprofloxacin tablet 500 mg 40
25 Box 20 Clindamicin 300mg Cap
26 Box 10 Co Amoxiclav 625 7
27 Box 20 Curcuma tablet 8
28 Fls 5 Depacen Syr
29 Fls 100 Dex 40%
30 Tin 10 Dexametason injeksi
31 Fls 100 Dextrose 5% Infus 50
32 Box 30 Domperidon Tab 40
33 Box 10 Eritromicin cap 500 mg
34 Box 5 Ethambutol 500mg Tab
35 Box 10 Flixotide Nebule
36 Box 100 Furosemid tablet 40mg
37 Box 20 Glimepirid 1mg Tab
38 Box 30 Glimepirid 2mg Tab
39 Box 30 Glucodex Tab
40 Box 3 Ketorolac Tab 3
41 Box 50 Levofloxacin 500mg Tab 2
42 Box 5 Lidocain HCL injeksi
43 Box 10 Lisinopril 10mg Tab
44 Box 5 Lisinopril 5mg Tab
45 Box 20 Loratadin Tab
46 Box 3 Manitol Infus
47 Box 50 Mecobalamin 500 mg capsul
48 Box 70 Meloxicam 15 mg 46
49 Box 60 Metronidazol tablet 500 mg
50 Box 70 Metyl prednisolon tablet 4 mg 20
51 Box 100 Na Diclofenac 50 mg
52 Fls 1,000 NaCL 500 ml 175
53 Box 40 Ofloxacin tablet 200mg
54 Box 40 Ofloxacin tablet 400 mg
55 Box 600 Omeprazole Cap
56 Box 3 Oralit Sachet
57 Fls 400 Paracetamol Syrup
58 Box 100 Paracetamol Tablet 500 mg 1
59 Tin 3 Phenobarbital Tab 30 mg
60 Fls 5 Plasbumin 25 % 100ml
61 Fls 5 Plasbumin 25% 50ml
62 Box 10 Pyrazinamid tablet 500 mg
63 Tin 20 Ranitidin Injeksi Box 100's 6
64 Box 100 Ranitidin Tablet 20
65 Fls 100 Salbutamol Syrup
66 Tube 10 Scabicid Cream
67 Fls 50 Sedakter Syrup
68 Tube 10 Thrombopop Gel
70 Box 50 Tramadol capsul
71 Fls 30 Ventolin inhaler
72 Box 20 Ventolin Nebule 2
73 Box 10 Widahes 130 infus
74
75
76

PT Antar Mitra Sembada


1 Fls 3 Atarox Syrup
2 Fls 30 Dipsamol Inheler
3 Box 30 Eperison HCL Tab
4 Box 3 Esilgan 2mg Tab
5 Box 3 Glicuidon Tablet 30 mg
6 Box 80 Glufor tablet 500 mg
7 Box 1 Hytrin 2mg
8 Box 5 Irvask tablet 150 mg
9 Box 1,000 Lansoprazol capsul
10 Box 10 Meloxicam Supp 5's 2
11 Box 10 Miloz Injeksi 5mg/5ml
12 Box 3 PTU tab 100 mg
13 Box 30 Ramipril 2,5 mg tablet
14 Fls 5 Ranivel syrup
15 Box 10 Recofol Injeksi
16 Tube 10 Zelface Cream
17
18

PT Buetna Hareukat
1 Box 100 Amlodipin 10md Tab
2 Box 100 Amlodipin 5mg Tab
3 Box 2 Arcalion tablet
4 Fls 10 Avamys Nasal Spray
5 Box 5 Avodart Tab 4
6 Set 1 Bahan Tambalan Gigi (Liquid Spowder)
7 Tube 30 Bioplacenton cream
8 Box 3 Biosanbe tablet
9 Tin 5 Calsium lactat tablet
10 Bh 1 Cavit
11 Box 5 Celebrex 100mg Cap
12 Vial 100 Chloramex Inj
13 Fls 15 Clinimix infus
14 Box 5 Clobazam Tab
15 Tin 1 Cloramfenicol tablet 250 mg
16 Fls 30 Colme tetes telinga
17 Tube 30 Counterpan Cream
18 Box 5 Depokate ER 250mg Tab
19 Box 8 Depokate ER 500mg Tab
20 Box 5 Epineprin Injeksi
21 Fls 20 Eritromicyn syrup 250mg/ml
22 Box 1 FG Troces Tab
23 Fls 60 Flutias Inhaler 125 mcg
24 Box 120 Furosemid Injeksi 80
25 Tube 50 Gentamicin Cream 5gr SK
26 Box 100 Gentamicyn injeksi 80mg
27 Fls 20 Gentian Violet
28 Box 30 Glimeperid 4mg Tab
29 Box 2 Glucophage 850
30 Box 15 Harnal ocas 30's
31 Box 1 Hystolan Tab 50's
32 Pot 50 Ichtiyol salep
33 Fls 10 Illiadin 0,025 % 10
34 Fls 10 Illiadin 0,5 % 20
35 Tin 10 INH 100 mg Tab 1000's
36 Tin 10 INH 300 mg
37 Fls 50 Insto tetes mata
38 Box 5 Irvask 150mg Tab
39 Box 100 ISDN 5 mg tablet
40 Box 2 KA EN 3B
41 Box 15 Kalxetin 10 mg 2
42 Box 15 Kalxetin 20 mg Tab 30's 1
43 Tube 50 Ketricin Orabase
44 Box 10 Levemir Flexpen
45 Box 10 Lipitor 10 mg Tab
46 Box 10 Lipitor 20 mg Tab
47 Box 10 Lipitor 40mg Tab
48 Box 5 Lyrica 75 mg Tab
49 Tube 3 Mebo krim 20 gr
50 Box 15 Metformin 500mg Tab 9
51 Box 4 Nald novotwist 100's
52 Pot 20 Nebacetin Powder
53 Tube 10 Nebacetin Zalf
54 Box 10 Neo K 2 mg/ml injeksi
55 Box 3 Norvask 10 mg
56 Box 20 Novomix flexpen
57 Box 30 Novorapid flexpen
58 Box 30 Otopain TT
59 Box 5 Piracetam 800mg Tab
60 Box 5 Plavix Tab 75 mg
61 Fls 2,000 Ringer lactat infus 3,500
62 Vial 3 Sabu injeksi
63 Ktk 1 Septocain
64 Box 1 Sifrol 0.375mg Tab
65 Ktk 1 Spongostan
66 Pcs 2 Tetagam injeksi 250 iu
67 Box 3 Vit K injeksi
68 Tin 2 Vit K Tab
69 Vial 30 Xylamidon Inj
70 Pcs 2 Xylocain Jell
71 Pcs 2 Xylonor Spray
72 Box 3 Ziloric 300 mg
73
74

PT Mensa Bina Sukses


1 Fls 100 Alpara Syrup
2 Fls 10 Alphamol drop
3 Fls 400 Alphamol syrup
4 Box 90 Alprazolam 0,5 mg
5 Box 20 Alprazolam 1 mg
6 Box 10 Asabium tablet
7 Tube 100 Bevalex cream
8 Box 50 Dextral capsul
9 Fls 300 Dextral Syrup
10 Box 100 Diclofalm 25 mg
11 Box 100 Dicloflam 50 mg
12 Tube 200 Gentalex Cream 50
13 Pcs 400 Lexacrol Syr 15
14 Box 80 Lexavit Tab
15 Box 30 Lexavon capsul
16 Fls 300 Lexavon Syrup
17 Box 30 Lexicam tablet 10 mg
18 Box 30 Lexicam tablet 20 mg
19 Box 30 Molacort tablet
20 Tube 250 Molacream
21 Tube 100 Moladerm cream
22 Fls 400 Molafate syrup 150
23 Box 100 Molaneuron tablet 1000 mg
24 Box 300 Molapec syrup
25 Box 50 Molapec tablet
26 Box 80 Molasic 500mg Tab
27 Box 60 Molazol Tab 500mg
28 Fls 300 Molexdryl Syrup
29 Fls 150 Molexflu syrup
30 Box 80 Molexflu tablet
31 Fls 200 OBH Molex Syrup
32 Box 200 Omeyus Cap
33 Fls 50 Opilax Syrup
34 Box 40 Pedab tablet
35 Box 40 Piralen Inj 13
36 Box 60 Pritacort tablet
37 Fls 150 Pritamox 125 mg syrup 60
38 Box 80 Pritavit Tab
39 Tube 250 Renvol Cream
40 Box 20 Spironolacton 25 mg
41 Box 5 Stesolid rectal 5mg
42 Fls 5 Stesolid syrup
43 Box 10 Stesolid tablet 2mg
44 Fls 50 Thiamfilex syrup
45 Fls 30 Trifedrin Syrup
46 Box 20 Trifedrin Tab
47 Fls 15 Valeptic Syrup 10
48 Fls 350 Vical syrup
49 Box 80 Vitalex Cap
50
51

PT Mesarinda Abadi
1 Pcs 1 Alat Cek HB
2 Pcs 1 Alat GCU
3 Pcs 12 Assucryl 0 Ref 4346 N
4 Lsn 1 Assucryl 1 Ref 43437 H
5 Lsn 1 Assucryl 1 Ref 43977 H
6 Box 1 Assucryl 8/0
7 Box 3 Blood lancet
8 Pcs 2 Bola Lampu Halogen kecil 500/250 wat
9 Pcs 24 Caesar Kit
10 Roll 1 Cat Gut Plain 1 B'braun
11 Roll 1 Cat Gut Plan 2/0
12 Pcs 1 Corset Lumbal uk/ L Pria
13 Pcs 2 Corset Lumbal uk/ M Wanita
14 Roll 2 Cut Gut Cromic 2
15 Box 20 Easy Toch Uric Acid
16 Box 20 Easy Touch Colesterol
17 Box 40 Easy Touch Glucose 20
18 Pak 3 Electroda
19 Pcs 30 Extention Tubing
20 Pcs 2 Folley cateter No10
21 Pcs 2 Folley Catheter No 6
22 Pcs 100 Folley Catheter No.18 110
23 Box 15 Handscun no 7
24 Box 7 Handscun no 7,5 15
25 Box 1 Hernia Mesh
26 Set 2 Hukmah / Irigator
27 Roll 40 Hyfapix 15x5
28 Roll 40 Hyfapix 5 x5
29 Box 30 Infused Dewasa 3
30 Box 5 Infused Ped
31 Box 5 IV Catheter No.22 30
32 Roll 10 Kapas 1000gr
33 Roll 60 Kapas 100gr
34 Roll 30 Kapas 25gr
35 Roll 30 Kapas 500gr
36 Box 200 Kassa Kotak steril
37 Roll 5 Kassa Lucky 5
38 Roll 30 Kertas Ekg Rool 10
39 Roll 10 Kertas Usg 2
40 Jrg 1 KY Jelly Jerigen
41 Roll 12 Leucocrep 3 Inci
42 Roll 24 Leucocrep 4 inci BSN
43 Roll 24 Leucocrep 6"
44 Roll 24 Leucodur 3'
45 Roll 24 Leucodur 4"
46 Roll 24 Leucodur 6"
47 Roll 100 Leucolast 1624 BSN
48 Roll 100 Leucoplast 1622 BSN
49 Roll 100 Leucoplast 1623 BSN
50 Box 30 Masker 20
51 Lsn 1 Masker M95
52 Box 5 Nald 23
53 Lsn 1 Nald 6030 G/T 10
54 Lsn 1 Nald 6030 G/T 12
55 Pcs 10 NGT 10
56 Pcs 10 NGT 12
57 Pcs 10 NGT 14
58 pcs 10 NGT 16
59 Pcs 50 NGT 18
60 Pcs 3 Pencil cauter
61 Roll 300 Perban gulung 15 cm
62 Box 1 Pisau Bisturi no 15
63 Box 5 Pisau Bisturi no 24
64 Lsn 1 Polypropylene 5/0 Ref 9532
65 Box 1 Postofix 10x10
66 Box 1 Postofix 10x15
67 Jrgn 2 Primacef
68 Box 5 Spinocain
69 Box 5 Spuit 10cc
70 Box 5 Spuit 1cc
71 Box 20 Spuit 3cc 50
72 Box 20 Spuit 5cc 40
73 Pcs 1 Stamper dan mortir
74 Pcs 3 Tensi Meter Air Raksa
75 unit 2 Tensi Meter anak
76 Box 3 Threway 2
77 Unit 2 Timbangan dewasa
78 Box 3 Topi operasi pria
79 Box 3 Topi operasi wanita
80 Pcs 5 Torniquet
81 Box 1 Tranfusi Set 1
82 Box 1 Umbilical cord clamp 1
83 Pcs 100 Urine Bag 70
84 Roll 300 Verban 15cm
85 Pcs 2 Wascom mandi
86 Pcs 4 Washen
87 Pcs 3 Waslap
88
89
90

PT Parit Padang

1 Tube 5 Decubal Cream


2 Box 120 Farsix Injeksi 60
3 Box 10 Fasodrin Injeksi 2
4 Box 2 Ketese Tab 25 mg
5 Box 20 Recolfar Tab
6 Box 3 Remital 10 mg tablet
7 Box 30 Renapar Tab
8
9

PT Sawah Besar
1 Box 30 Arkine tablet
2 Fls 100 Asetyl sistein syrup
3 Box 20 Bamgetol tablet 200 mg
4 Box 20 Calcimega tablet 5
5 Box 200 Diuvar injeksi
6 Fls 100 Endostein syrup
7 Box 50 Epsonal tablet 3
8 Fls 70 Flumucyl syrup
9 Box 10 Flumucyl tablet
10 Box 15 Hexymer Tablet 2 mg
11 Box 5 Ketocid tablet 5
12 Box 10 Kutoin capsul
13 Fls 100 Laxadin syrup
14 Box 6 Levazide Tab
15 Box 80 Neuraxon Cap
16 Box 100 Novaldo Injeksi 260
17 Tube 100 Osteor cream
18 Fls 30 Otozambon Tetes Telinga
19 Tube 50 Pyderma Cream 50
20
21

PT.UDC
1 Tube 200 Bersol cream
2 Box 10 Nonflamin capsul
3

PT PENTA VALENT
1 Box 80 Biocombin tablet 11
2 Box 10 Cal 95 tablet
3 Strip 20 Cendo Astenof 0,6ml@5' minidose
4 Strip 50 Cendo Catarlen 0,6 ml @ 5's minidose
5 Strip 50 Cendo Cenfres 0,6 ml@5's minidose
6 Strip 30 Cendo Eyefres 0,6 ml@ 5's minidose
7 Strip 10 Cendo Fenicol 0,25% 0,6ml@5;s minidose
8 Tube 30 Cendo Fenicol Sm
9 Strip 10 Cendo Floxa 0,6ml@5' minidose
10 Tube 50 Cendo Genta SM
11 Strip 30 Cendo Genta tetes mata 0,6ml@5's minidose 3
12 Box 2 Cendo Glaucor Tab
13 Strip 40 Cendo LFX tetes mata 0,6ml@5's minidose
14 Strip 50 Cendo Lyters 0,6 ml@ 5's minidose
15 Strip 5 Cendo Pantocain 0,6ml@5' minidose
16 Strip 50 Cendo polidex 0,6ml@5's minidose
17 Strip 20 Cendo posop 0,6ml@5' minidose
18 Strip 5 Cendo Tonor 0,6ml@5'S minidose
19 Strip 40 Cendo Ulcori 0,6 ml @ 5's minidose 40
20 Strip 50 Cendo Xitrol 0,6 ml@ 5's minidose
21 Box 10 Ciflon Tab
22 Fls 50 Forasma Syr
23 Fls 200 Gatrinal Syrup 100
24 Box 5 L Bio Sacset
25 Fls 200 L zink syrup
26 Fls 100 Lagesyl syrup
27 Fls 50 Lasal syrup
28 Box 30 L-cisin tablet 30's
29 Box 100 Norages injeksi
30 Fls 50 Promuba syrup
31
32
33

PT PROTEUSSABA NUSANTARA
1 Gal 1 Alfa Diluent Swelab
2 Gal 1 Alfa Lyse Swelab
3 Kit 1 ALP
4 Box 3 Blood Lancet
5 Btl 1 Control Level 1
6 Btl 1 Control Level 2
7 Btl 1 Control Level 3
8 Btl 1 Electrode Conditioning Sol 100ml
9 Btl 1 GGT
10 Kit 1 Hamil Test
11 Kit 1 HBS AG
12 Btl 1 HCG Latex
13 Kit 2 HDL Cholesterol
14 Btl 1 Ise Cleaning Sol
15 Ktk 2 Plaster Bulat
16 Roll 1 Termal Piper 5cm
17 Kit 2 Triglyseride
18 Btl 1 Urea
19 Btl 2 Uric Acid
20 Btl 1 Washing Solution 50ml
box
PT Kimia Farma Trade Megatrading
1 Fls 5 Albumin 20% 100 ml
2 Fls 200 Ambroxol syrup
3 Fls 20 Aminofluid infus 5
4 Box 2 Aminopilin Tab
5 Box 5 Amitriptilin tablet 25 mg
6 Box 40 Amlodipin 10 mg tablet
7 Box 80 Amlodipin tablet 5 mg 20
8 Fls 300 Amoxilin syrup
9 Box 40 Amoxilin tablet 500 mg
10 Fls 400 Antasida syrup
11 Box 10 Arixtra Inj
12 Box 10 Asam Traneksamat 500 mg Tab 1
13 Fls 800 Ashering Infus
14 Box 10 Aspilet tablet 5
15 Box 30 Atorvastatin tablet 20 mg
16 Box 10 Bamgetol 200mg Tab
17 Box 100 Betahistin tablet 6mg
18 Tube 100 Betametason cream 12
19 Box 50 Bisoprolol tablet 5 mg
20 Pot 3 Burnazim Cream 500 gr
21 Box 40 Captopril 12,5 mg
22 Box 30 Captopril 25 mg tablet 8
23 Box 80 Cefadroxil capsul 500 mg 10
24 Box 80 Ceterizin tablet
25 Box 2 Cilostazol Tab 1
26 Box 40 Ciprofloxacin tablet 500 mg 10
27 Box 60 Citicolin 1000 mg tablet
28 Box 100 Citicolin injeksi 5
29 Box 80 Citicolin tablet 500 mg
30 Box 200 Clopidogrel 75 mg Tab 30's
31 Box 30 Co amoxiclav 625 mg tablet 15
32 Box 5 Co Diovan 80 / 12.5 mg
33 Fls 50 Dextrose 40%
34 Fls 100 Dextrose 5% Infus 100
35 Box 10 Digoxin Tab
36 Vial 20 Dobutamin injeksi 250 mg 5
37 Box 10 Doxixiclin 100 mg tablet
38 Box 10 Eritromicin cap 500 mg
39 Box 10 Fenofibrate 300 mg
40 Box 10 Flixotide Nebule
41 Box 60 Furosemid tablet 40mg 10
42 Box 3 Galvusmet 80 / 850
43 Box 10 Haloperidol 0.5 mg Tab
44 Fls 100 Ibuprofen syrup
45 Box 20 Ibuprofen tab 400 mg
46 Box 5 Inhitril Tab 10 mg
47 Box 20 Irbesartan tablet 150 mg
48 Box 10 Itraconazol tablet
49 Box 10 kalium diclofenac 50 mg
50 Fls 50 Kandistatin Drops 5
51 Fls 20 KCL 5
52 Box 200 Keterolac injeksi 30 mg/1ml @12's
53 Tube 100 Ketoconazol cream 10 gr
54 Box 20 Ketoconazol tablet200 mg
55 Vial 25 KTM Inj
56 Box 1,000 Lansoprazole Cap 30mg. Box 20's
57 Box 40 Levofloxacin tablet 500 mg 15
58 Box 3 Lidocain injeksi
59 Box 100 Meloxicam 15 mg 20
60 Box 80 Metformin 500 mg tablet
61 Box 50 Metoclopramid Inj 10 mg / 2 ml
62 Fls 300 Metronidazol infus
63 Box 30 Metronidazol tablet 500 mg 20
64 Box 100 Metyl prednisolon tablet 4 mg 20
65 Fls 10 Mgso4 20%
66 Box 15 Mucosta Tablet 3
67 Box 50 Na diclofenac 50 mg 4
68 Fls 2,000 NaCL 500 ml
69 Box 5 Neulin PS Tab
70 Box 30 Ofloxacin tablet 200 mg 10
71 Box 20 Ofloxacin tablet 400 mg 10
72 Box 200 Ondancentron injeksi 4mg/2ml
73 Fls 400 Paracetamol Syrup
74 Box 60 Paracetamol Tablet 500 mg 30
75 Tin 3 Phenobarbital Tab 30 mg
76 Box 300 Ranitidin Inj. Box 25s
77 Box 30 Ramipril 2.5 mg
78 Box 30 Ramipril 5 mg
79 Box 80 Ranitidin Tablet 20
80 Box 2 Rifampicin 600 mg
81 Fls 20 Seretide Discus Inhaler 250 mcg
82 Box 2 Simarc 2mg
83 Box 50 Simvastatin 10 mg
84 Box 80 Simvastatin 20 mg
85 Box 10 Spironolacton 100 mg
86 Box 20 Spironolacton 25 mg Tablet
87 Box 1 Sulfa Atropin
88 Box 20 Ventolin Nebule 5

PT Antar Mitra Sembada


1 Fls 3 Ataroc Syrup
2 Tube 10 Betadin Oint 10 gr
3 Box 20 Biocombin injeksi
4 Box 50 Buscopan injeksi
5 Box 2 Casodex Tablet 50 mg
6 Box 50 Cotrimoxzasol tab 480 mg
7 Tube 10 Desolex Cream
8 Box 3 Glicuidon Tablet 30 mg
9 Box 15 Heximer tablet 2 mg
10 Box 1 Hytrin 2mg
11 Box 1 Kutoin Injeksi 100 mg
12 Box 10 Meloxicam Supp 5's
13 Box 1 Microlax Supp
14 Box 10 Miloz injeksi 5mg/5ml
15 Box 5 Nonflamin Cap
16 Box 3 PTU tab 100 mg
17 Box 2 Recofol Injeksi
18 Box 5 Sandepril Tablet 50 mg
19 Box 15 Takelin 1000mg Tablet 30s
20 Box 5 Truvas Tablet 20 mg
21 Tube 10 Zelface Cream

PT Buetna Hareukat
1 Box 5 Acilovir tablet 400 mg
2 Bgks 2 Alginate
3 Jrg 5 Alkohol 96 %
4 Box 2 Arcalion tablet
5 Box 10 Avodart Tab
6 Set 1 Bahan Tambal Gigi
7 Fls 20 Berotec inhaler
8 Pcs 50 Botol Tetes Plastik 12 ml
9 Btl 100 Caladin lotion
10 Box 30 Candesartan 16 mg Tab 30's
11 Box 50 Candesartan 8 mg Tab 30's
12 Vial 100 Ceftadzidim injeksi 10
13 Vial 30 Chloramex Inj 10
14 Fls 6 Chloro Ethyl
15 Box 80 Clindamicin 150 mg 50's
16 Box 50 Clindamicin 300 mg 50's
17 Fls 15 Clinimix infus
18 Box 2 Clobazam Tab
19 Fls 30 Colme tetes telinga
20 Vial 10 Cortison Inj
21 Box 6 Depokate Tab
22 Box 10 Diamicron MR
23 Box 5 Ethambutol 500mg Tab
24 Fls 15 Flutias Inhaler 125 mcg 20
25 Tin 1 Formalin Tab
26 Box 100 Furosemid injeksi 25's 20
27 Box 60 Gabapentin 300 mg
28 Box 100 Gentamicyn injeksi 80mg
29 Box 2 Glucophage 850
30 Box 50 Glucosamin Tab 60's
31 Box 15 Harnal ocas 30's
32 Tin 2 HCT Tab 25 mg
33 Vial 30 Hemapo Inj 3000 IU 20
34 Box 1 Hystolan Tab 50's
35 Pot 50 Ichtiyol salep
36 Fls 20 Illiadin 0,025 %
37 Fls 40 Illiadin 0,5 %
38 Tin 5 INH 100 mg Tab 1000's
39 Tin 5 INH 300 mg
40 Box 100 ISDN 5 mg tablet 20
41 Box 2 KA EN 3B
42 Box 10 Kalxetin 10 mg
43 Box 5 Kalxetin 20 mg Tab 30's
44 bgks 1 Kapsul kosong no 0
45 Pack 3 Kertas Perkamen
46 Tube 50 Ketricin Orabase
47 Box 10 KSR Tab 600 mg
48 Box 10 Levemir Flexpen
49 Box 10 Lipitor 10 mg
50 Box 10 Lipitor 20 mg
51 Box 40 Loratadin tablet
52 Box 5 Ludiomil 25 mg
53 Box 5 Lyrica 75 mg
54 Tube 3 Mebo krim 20 gr
55 Box 4 Nald novotwist 100's
56 Ktk 1 Nald u/ Cabut Gigi
57 Tube 10 Nebacetin Zalf
58 Box 10 Neo K 2 mg/ml injeksi
59 Box 3 Norvask 10 mg
60 Box 20 Novorapid flexpen
61 Box 30 Otopain TT
62 Box 2 Pampers Dewasa uk/ L
63 Box 2 Pampers Dewasa uk/ M
64 Box 2 Pampers Dewasa uk/ XL
65 Box 5 Plavix Tab 75 mg
66 Box 3 Pletaal tablet 100 mg
67 pot 50 Pot obat 20 mg
68 Pot 50 Pot obat 40 mg
69 Vial 100 Procain Penicillin Inj 50
70 Box 5 Prostigimin Inj
71 Box 10 Pyrazinamid tablet 500 mg 2
72 Fls 50 Reco tetes telinga
73 Box 10 Regumen tablet
74 Box 10 Rifampicin 450 tablet
75 Fls 8,000 Ringer lactat infus
76 Box 5 Risperidon Tab
77 Btl 50 Rodeca lotion
78 Vial 2 Sabu injeksi
79 Ktk 1 Septocain
80 Box 10 Sistenol Tab
81 Pot 150 Slicyl talk 50
82 Fls 1 Sojorn (cefofluran )
83 Ktk 1 Spongostan
84 Fls 1 Stac 5 ml (Bonding)
85 Box 5 Tensivask 10 mg
86 Box 5 Tensivask 5mg
87 Pcs 1 Tetagam injeksi 250 iu
88 Box 100 Tramadol injeksi 50 mg
89 Box 2 Tramuz Inj
90 Box 5 Trileptal tablet 600 mg
91 Box 20 Trizedon MR
92 Tin 2 Vit K Tab
93 Vial 30 Xylamidon Inj
94 Pcs 2 Xylocain Jell
95 Pcs 2 Xylonor Spray
96 Box 3 Ziloric 300 mg
PT Mensa Bina Sukses
1 Box 50 Alpentin 100 mg cap
2 Box 50 Alpentin 300 mg
3 Box 60 Alphamol 600 mg tablet 40
4 Fls 10 Alphamol drop
5 Fls 400 Alphamol syrup 20
6 Box 90 Alprazolam 0,5 mg
7 Box 20 Alprazolam 1 mg
8 Fls 10 Amobiotic drop
9 Box 2 Asabium tablet
10 Tube 100 Bevalex cream 50
11 Box 40 Diclofalm 25 mg 20
12 Box 50 Dicloflam 50 mg
13 Box 40 Infantrim Tab 480 mg
14 Pcs 300 Lexacrol Syr 50
15 Box 30 Lexapram tablet 20
16 Tube 100 Molacream
17 Tube 100 Moladerm cream
18 Fls 300 Molafate syrup 120
19 Box 40 Molexflu tablet
20 Box 40 Pedab tablet 20
21 Box 50 Piralen Inj
22 Box 30 Stesolid injeksi 5 mg
23 Box 3 Stesolid rectal 5mg
24 Fls 5 Stesolid syrup
25 Box 10 Stesolid tablet 2mg
26 Box 20 Trifedrin Tab
27 Fls 15 Valeptic Syr 15

PT Mesarinda Abadi
1 Pcs 1 Alat GCU
2 Pcs 12 Assucryl 0 Ref 4346 N
3 Lsn 1 Assucryl 1 Ref 43427 H
4 Lsn 1 Assucryl 1 Ref 43437 H
5 Lsn 1 Assucryl 1 Ref 43977 H
6 Lsn 1 Assucryl 2/0 Ref 4575
7 Lsn 1 Assucryl 3/0 Ref 4254
8 Lsn 1 Assucryl 3/0 Ref 4564
9 Box 5 Blood lancet
10 Pcs 24 Caesar Kit
11 Roll 1 Cat Gut Chromic 1
12 Roll 1 Cat Gut Cromic 0
13 Roll 1 Cat Gut Plain 0 B'braun
14 Roll 1 Cat Gut Plan 2/0
15 Pcs 1 Corset Lumbal uk/ L Pria
16 Pcs 2 Corset Lumbal uk/ M Wanita
17 Box 10 Easy toch uric acid 1
18 Box 20 Easy touch Colesterol 12
19 Box 30 Easy Touch Glucose 10
20 Pak 3 Electroda
21 Pcs 15 Extention Tubing
22 Pcs 2 Folley Cateter No 12
23 Pcs 2 Folley cateter No10
24 Pcs 2 Folley Catheter No 6
25 Pcs 100 Folley Catheter No.18 180
26 Box 10 Handscun no 7 7
27 Box 15 Handscun no 7,5 5
28 Box 10 Handsun no. 8
29 Box 30 Handsun Non Steril
30 Set 2 Hukmah / Irigator
31 Roll 15 Hyfapix 5 x5
32 Box 2 Infused Ped 1
33 Box 10 IV cateter no 24 1
34 Box 10 IV Catheter 22 10
35 Roll 50 Kapas 100 gr
36 Box 50 Kasa kotak 150
37 Roll 6 Kassa lucky 3
38 Roll 5 Kertas Usg
39 Tube 15 K-Y Jelly 5
40 Jrg 1 KY Jelly Jerigen
41 Roll 12 Leucocrep 3 Inci 6
42 Roll 12 Leucocrep 4 inci BSN
43 Roll 12 Leucocrep 6"
44 Roll 12 Leucodur 4"
45 Roll 12 Leucodur 6"
46 Roll 40 Leucoplast 1623 BSN
47 Roll 10 Leucoplast 1624
48 Set 2 Minor Set Stainles
49 Box 5 Nald 23
50 Lsn 1 Nald 6030 G/T 10
51 Lsn 1 Nald 6030 G/T 12
52 Lsn 1 Nald 6030 G/T 14
53 Lsn 1 Nald 6030 G/T 7
54 Lsn 1 Nald 6036 G/R 11
55 Lsn 1 Nald 6036 G/R 12
56 Lsn 1 Nald 6036 G/R 8
57 Lsn 1 Nald 6120 E000
58 Pcs 100 Nasal Canula Oksigen 50
59 Pcs 5 NGT 12
60 Pcs 2 NGT 14
61 pcs 5 NGT 16 2
62 Box 1 Pisau Bisturi no 15
63 Box 2 Pisau Bisturi no 24
64 Box 1 Poly Propylenen 3/0 4564
65 Lsn 1 Polypropylene 3/0 Ref 9574
66 Lsn 1 Polypropylene 4/0 Ref 9553
67 Lsn 1 Polypropylene 5/0 Ref 9532
68 Box 1 Postofix 10x10
69 Box 1 Postofix 10x15
70 Box 1 Postofix 10x25
71 jrgn 1 Primacef
72 Pcs 2 Skin Truction Anak
73 Pcs 2 Skin Truction Dewasa
74 Roll 12 Sofband 6"
75 Box 4 Spinocain 2
76 Box 1 Spuit 100 cc Lubang Tengah
77 Box 3 Spuit 1cc 4
78 Box 30 Spuit 3cc 15
79 Box 30 Spuit 5cc
80 Pcs 1 Stamper dan mortir
81 Set 2 Tensimeter Air Raksa
82 Box 3 Topi operasi pria
83 Box 3 Topi operasi wanita
84 Box 1 Tranfusi Set 2
85 Box 2 Umbilical cord clamp 1
86 Roll 200 Verban 15cm
87 Pcs 4 Washen
PT Parit Padang

1 Box 30 Calcit (Calcatriol)


2 Tube 5 Decubal Cream
3 Box 10 Efedrin Inj
4 Box 2 Etirox 100 mg
5 Vial 50 Farsorbid Inj
6 Fls 20 Interhistin Syr
7 Box 20 Interhistin Tab
8 Box 2 Ketese Tab 25 mg
9 Box 5 Kutoin Capsul
10 Box 2 Nuzyp Tab 10 mg
11 Box 50 Regivel injeksi
12 Box 3 Remital 10 mg tablet

PT Sawah Besar
1 Box 100 Clidorel Tablet
2 Box 20 Ketocid tablet
3 Box 15 Levazide Tablet
4 Vial 150 Metyl prednisolon injeksi 10
5 Fls 30 Otozambon Tetes Telinga
6 Box 5 Raos tablet 50 mg

PT PENTA VALENT
1 Tube 50 Bersol Cream
2 Box 10 Cal 95 tablet
3 Strip 50 Cendo Catarlen 0,6 ml @ 5's minidose 5
4 Strip 100 Cendo Cenfresh 0,6ml@5's minidose
5 Strip 50 Cendo eye fresh 0,6ml@5's minidose
6 Strip 30 Cendo floxa 0,6 @ml5' minidose
7 Strip 50 Cendo Genta 0,6 ml@ 5's minidose 10
8 Strip 30 Cendo Glaopent 0,6 ml@ 5's minidose 10
9 Strip 30 Cendo LFX 0,6 ml@ 5's minidose 15
10 Strip 20 Cendo Lubricen 0,6 ml@ 5's minidose 13
11 Strip 40 Cendo Lyters 0,6 ml@ 5's minidose
12 Strip 10 Cendo Pantocain 2% 0,6ml@5's minidose 5
13 Strip 50 Cendo polidex 0,6ml@5's minidose
14 Strip 20 cendo posop 0,6ml@5' minidose
15 Strip 5 Cendo timol 0,6ml@5'minidose
16 Strip 5 Cendo Tonor 0,6ml@5'S minidose
17 Strip 60 Cendo Ulcori 0,6 ml @ 5's minidose 40
18 Strip 50 Cendo vitrolenta 0,6ml@5' minidose
19 Strip 50 Cendo Xitrol 0,6 ml@ 5's minidose 28
20 Box 10 Ciflon Tab
21 Fls 20 Forasma Syr
22 Jrg 3 Handscrub
23 Fls 30 L zink syrup
24 Fls 50 Lagesyl syrup
25 Box 3 Lapibal Inj
26 Box 10 Mecola tab
27 Box 10 Myotonic injeksi 10
28 Box 5 Myotonic Tab
29 Box 250 Norages injeksi 50
30 Fls 50 Promuba syrup
31 Box 30 Suprafenid supp 7

PT PROTEUSSABA NUSANTARA

1 Btl 2 Albumin
2 Set 2 Bilirubin Total
3 Gal 1 Alfa Diluent Swelab
4 Gal 1 Alfa Lyse Swelab
5 Btl 1 Extran
6 Jrg 3 Aquabidest
7 Box 8 Blood Call Red
8 Box 15 Blood Call Ungu
9 Box 5 Blood Lancet
10 Plastik 1 Blue Tip
11 Plastik 1 Yellow Tip
12 Btl 2 Cholesterol
13 Btl 2 Creatinine
14 Plastik 2 Sample Cup
15 Box 10 Slides Frosted
16 Btl 2 SGOT
17 Btl 2 SGPT
18 Btl 2 Triglyceride
19 Btl 2 Urea
20 Btl 2 Uric Acid
21 Btl 1 Verify
22 Kit 2 HBS AG
23 Kit 1 HCV
24 Kit 1 DHF
25 Btl 2 Glucose
26 Kit 1 HDL Cholesterol

PT United Dico Citas


1 Box 3 Alinamin F Injeksi
2 Box 5 Alinamin F Tab
3 Box 30 Tramadol Injeksi
box
PT Kimia Farma Trade Megatrading
1
2 Fls 400 Ambroxol syrup 19
3 Fls 20 Aminofluid infus 3
4 Box 2 Aminopilin Tab
5 Box 5 Amitriptilin tablet 25 mg
6 Box 40 Amlodipin 10 mg tablet 14
7 Box 80 Amlodipin tablet 5 mg 40
8 Fls 300 Amoxilin syrup
9 Box 60 Amoxilin tablet 500 mg
10 Fls 400 Antasida syrup
11 Box 10 Arixtra Inj
12 Box 2 widahes 130 infus 1
13
14 Box 10 Aspilet tablet 4
15
16 Box 10 Bamgetol 200mg Tab
17 Box 40 Betahistin tablet 6mg 40
18 Tube 100 Betametason cream
19 Box 50 Bisoprolol tablet 5 mg 5
20 Pot 3 Burnazim Cream 500 gr
21 Box 20 Captopril 12,5 mg 20
22
23 Box 80 Cefadroxil capsul 500 mg 1
24 Box 50 Ceterizin tablet 40
25
26 Box 40 Ciprofloxacin tablet 500 mg
27 Box 60 Citicolin 1000 mg tablet
28 Box 100 Citicolin injeksi 10
29 Box 80 Citicolin tablet 500 mg 5
30
31
32 Box 5 Co Diovan 80 / 12.5 mg
33
34 Fls 100 Dextrose 5% Infus 60
35 Box 10 Digoxin Tab
36
37 Box 5 Doxixiclin 100 mg tablet 7
38 Box 10 Eritromicin cap 500 mg
39 Box 10 Fenofibrate 300 mg
40 Box 10 Flixotide Nebule
41 Box 60 Furosemid tablet 40mg
42 Box 3 Galvusmet 80 / 850
43 Box 10 Haloperidol 0.5 mg Tab
44 Fls 100 Ibuprofen syrup
45 Box 10 Ibuprofen tab 400 mg 8
46
47
48 Box 10 Itraconazol tablet
49 Box 10 kalium diclofenac 50 mg
50 5
51 5
52 Box 200 Keterolac injeksi 30 mg/1ml @12's
53 Tube 100 Ketoconazol cream 10 gr
54
55 Vial 25 KTM Inj
56
57 Box 40 Levofloxacin tablet 500 mg 4
58 Box 3 Lidocain injeksi
59 Box 100 Meloxicam 15 mg 3
60 Box 80 Metformin 500 mg tablet
61 Box 50 Metoclopramid Inj 10 mg / 2 ml
62 Fls 300 Metronidazol infus 50
63 Box 20 Metronidazol tablet 500 mg 10
64 Box 100 Metyl prednisolon tablet 4 mg 6
65
66 Box 15 Mucosta Tablet 3
67 Box 80 Na diclofenac 50 mg 2
68 Fls 2,000 NaCL 500 ml
69 Box 5 Neulin PS Tab
70 Fls 50 Batugin elixir
71 Box 20 Ofloxacin tablet 400 mg 10
72 Box 200 Ondancentron injeksi 4mg/2ml 80
73 Fls 300 Paracetamol Syrup 250
74 Box 60 Paracetamol Tablet 500 mg 30
75 Tin 3 Phenobarbital Tab 30 mg
76 Box 300 Ranitidin Inj. Box 25s
77 Vial 50 Recodryl injeksi
78 Box 20 Tramadol capsul 10
79 Box 80 Ranitidin Tablet 20
80 Box 2 Rifampicin 600 mg
81 Fls 20 Seretide Discus Inhaler 250 mcg
82 10 Cefixim capsul 200 mg
83 Box 50 Simvastatin 10 mg
84 Box 80 Simvastatin 20 mg
85 Fls 20 Aqua 1000 ml
86 Box 30 Cefixim capsul 100 mg 7
87 Box 1 Sulfa Atropin
88 Box 20 Ventolin Nebule 5

PT Antar Mitra Sembada


1
2 Tube 10 Betadin Oint 10 gr
3
4
5 Box 2 Casodex Tablet 50 mg
6 Box 30 Cotrimoxzasol tab 480 mg 24
7
8 Box 3 Glicuidon Tablet 30 mg
9 Box 80 Glufor tablet 500 mg
10 Box 1 Hytrin 2mg
11
12 Box 10 Meloxicam Supp 5's
13 Box 30 Ramipril 2,5 mg tablet
14 Box 30 Ramipril 5 mg tablet
15 Box 40 Gabapentin 300 mg capsul 20
16 Box 3 PTU tab 100 mg
17 Box 2 Recofol Injeksi
18
19
20 Box 5 Truvas Tablet 20 mg
21 Tube 10 Zelface Cream
Box 30 Atorvastatin 20 mg

PT Buetna Hareukat
1
2
3 Jrg 5 Alkohol 96 % 2
4 Box 2 Arcalion tablet
5 Box 10 Avodart Tab
6 Tin 5 Bicnat tablet
7
8 Pcs 50 Botol Tetes Plastik 12 ml
9
10
11
12 Vial 100 Ceftadzidim injeksi
13 Vial 50 Chloramex Inj
14 Fls 6 Chloro Ethyl
15
16
17 Fls 15 Clinimix infus
18 Box 2 Clobazam Tab
19 Fls 30 Colme tetes telinga
20 Vial 10 Cortison Inj
21 Box 6 Depokate Tab
22 Box 10 Diamicron MR
23
24 Fls 15 Flutias Inhaler 125 mcg 20
25 Tin 1 Formalin Tab
26
27
28 Box 100 Gentamicyn injeksi 80mg
29 Box 2 Glucophage 850
30 Box 50 Glucosamin Tab 60's
31 Box 15 Harnal ocas 30's
32 Tin 2 HCT Tab 25 mg
33 Vial 30 Hemapo Inj 3000 IU 20
34 Box 1 Hystolan Tab 50's
35 Pot 50 Ichtiyol salep
36 Fls 20 Illiadin 0,025 %
37 Fls 40 Illiadin 0,5 %
38 Tin 5 INH 100 mg Tab 1000's
39 Tin 5 INH 300 mg
40 Box 100 ISDN 5 mg tablet 20
41 Box 1 KA EN 3B 1
42 Box 10 Kalxetin 10 mg
43 Box 5 Kalxetin 20 mg Tab 30's
44 bgks
45
46 Tube 50 Ketricin Orabase
47 Box 10 KSR Tab 600 mg
48 Box 10 Levemir Flexpen
49 Box 10 Lipitor 10 mg
50 Box 10 Lipitor 20 mg
51
52 Box 5 Ludiomil 25 mg
53 Box 5 Lyrica 75 mg
54 Tube 3 Mebo krim 20 gr
55 Box 4 Nald novotwist 100's
56 Ktk 1 Nald u/ Cabut Gigi
57 Tube 10 Nebacetin Zalf
58 Box 10 Neo K 2 mg/ml injeksi
59 Box 3 Norvask 10 mg
60 Box 20 Novorapid flexpen
61 Box 30 Otopain TT
62 Box 2 Pampers Dewasa uk/ L
63 Box 2 Pampers Dewasa uk/ M
64 Box 2 Pampers Dewasa uk/ XL
65 Box 5 Plavix Tab 75 mg
66
67 pot 50 Pot obat 20 mg
68 Pot 50 Pot obat 40 mg
69 Vial 100 Procain Penicillin Inj 20
70 Box 5 Prostigimin Inj
71 2
72 Fls 50 Reco tetes telinga
73
74 Box 10 Rifampicin 450 tablet
75 Fls 8,000 Ringer lactat infus
76 Box 5 Risperidon Tab
77
78 Vial 2 Sabu injeksi
79 Ktk 1 Septocain
80 Box 10 Sistenol Tab
81 Pot 150 Slicyl talk 30
82 Fls 1 Sojorn (cefofluran )
83 Ktk 1 Spongostan
84
85 Box 5 Tensivask 10 mg
86 Box 5 Tensivask 5mg
87 Pcs 1 Tetagam injeksi 250 iu
88
89 Box 2 Tramuz Inj
90 Box 5 Trileptal tablet 600 mg
91 Box 20 Trizedon MR
92 Tin 2 Vit K Tab
93 Vial 30 Xylamidon Inj
94 Pcs 2 Xylocain Jell
95 Pcs 2 Xylonor Spray
96 Box 3 Ziloric 300 mg
Box 3 Vit K injeksi
PT Mensa Bina Sukses
1 Box 50 Alpentin 100 mg cap
2 Box 50 Alpentin 300 mg
3 Box 60 Alphamol 600 mg tablet 30
4 Fls 10 Alphamol drop
5 Fls 400 Alphamol syrup
6 Box 90 Alprazolam 0,5 mg 20
7 Box 20 Alprazolam 1 mg
8 Fls 10 Amobiotic drop
9 Box 2 Asabium tablet
10 Tube 100 Bevalex cream 10
11 Box 40 Diclofalm 25 mg 20
12 Box 50 Dicloflam 50 mg
13 Box 40 Infantrim Tab 480 mg
14 Pcs 300 Lexacrol Syr 15
15 Box 20 Lexapram tablet 10
16 Tube 100 Molacream
17 Tube 100 Moladerm cream
18 Fls 300 Molafate syrup 120
19 Box 40 Molexflu tablet
20 Box 40 Pedab tablet 15
21 Box 50 Piralen Inj
22
23 Box 2 Stesolid rectal 5mg 1
24 Fls 5 Stesolid syrup
25 Box 10 Stesolid tablet 2mg
26 Box 20 Trifedrin Tab
27 Fls 350 Vical syrup 15
Fls 50 interhistin syrup
Box 30 Interhistin tablet
Box 20 Spironolacton 25 mg
Box 10 Spironolacton 100 mg

PT Mesarinda Abadi
1 Pcs 1 Alat GCU
2 Pcs 12 Assucryl 0 Ref 4346 N
3 Lsn 1 Assucryl 1 Ref 43427 H
4 Lsn 1 Assucryl 1 Ref 43437 H
5 Lsn 1 Assucryl 1 Ref 43977 H
6 Lsn 1 Assucryl 2/0 Ref 4575
7 Lsn 1 Assucryl 3/0 Ref 4254
8 Lsn 1 Assucryl 3/0 Ref 4564
9 Roll 1 Cut Gut Cromic 2
10 Pcs 24 Caesar Kit
11 Roll 1 Cat Gut Chromic 1
12 Roll 1 Cat Gut Cromic 0
13 Roll 1 Cat Gut Plain 0 B'braun
14 Roll 1 Cat Gut Plan 2/0
15 Pcs 1 Corset Lumbal uk/ L Pria
16 Pcs 2 Corset Lumbal uk/ M Wanita
17 Box 20 Easy toch uric acid
18 Box 20 Easy touch Colesterol
19 Box 30 Easy Touch Glucose 10
20 Pak 3 Electroda
21 Pcs 15 Extention Tubing
22 Pcs 2 Folley Cateter No 12
23 Pcs 2 Folley cateter No10
24 Pcs 2 Folley Catheter No 6
25 Pcs 50 Folley Catheter No.18 80
26 Box 10 Handscun no 7 1
27 Box 15 Handscun no 7,5 8
28 Roll 1 Cut Gut Plain 3/0
29 Box 30 Handsun Non Steril
30 Set 2 Hukmah / Irigator
31 Roll 40 Hyfapix 5 x5 2
32 Box 2 Infused Ped 1
33 Box 10 IV cateter no 24 1
34 Box 10 IV Catheter 22 1
35 Roll 1 Cut Gut Cromic 2/0
36 Roll 50 Leucoplast 1622 BSN
37 Roll 20 Hyfapix 15x5 3
38 Roll 10 Kertas Usg
39 Tube 15 K-Y Jelly 5
40 Jrg 1 KY Jelly Jerigen
41 Roll 12 Leucocrep 3 Inci 6
42 Roll 12 Leucocrep 4 inci BSN
43 Roll 12 Leucocrep 6" 12
44 Roll 12 Leucodur 4" 6
45 Roll 12 Leucodur 6"
46 Roll 40 Leucoplast 1623 BSN
47 Roll 10 Leucolast 1624 BSN
48 Set 2 Minor Set Stainles
49 Box 5 Nald 23
50 Lsn 1 Nald 6030 G/T 10
51 Lsn 1 Nald 6030 G/T 12
52 Lsn 1 Nald 6030 G/T 14
53 Lsn 1 Nald 6030 G/T 7
54 Lsn 1 Nald 6036 G/R 11
55 Lsn 1 Nald 6036 G/R 12
56 Lsn 1 Nald 6036 G/R 8
57 Lsn 1 Nald 6120 E000
58 Pcs 50 Nasal Canula Oksigen 50
59 Pcs 5 NGT 12
60 Pcs 2 NGT 14
61 pcs 5 NGT 16
62 Box 1 Pisau Bisturi no 15
63 Box 2 Pisau Bisturi no 24
64 Box 1 Poly Propylenen 3/0 4564
65 Lsn 1 Polypropylene 3/0 Ref 9574
66 Lsn 1 Polypropylene 4/0 Ref 9553
67 Lsn 1 Polypropylene 5/0 Ref 9532
68 Box 1 Postofix 10x10
69 Box 1 Postofix 10x15
70 Box 1 Postofix 10x25
71 jrgn 1 Primacef
72 Pcs 2 Skin Truction Anak
73 Pcs 2 Skin Truction Dewasa
74 Roll 12 Sofband 6"
75 Box 4 Spinocain 2
76 Pcs 5 NGT 10
77
78 Box 30 Spuit 3cc 2
79 Box 50 Spuit 5cc 3
80 Pcs 1 Stamper dan mortir

1 Box 3 Topi operasi pria 1


2 Box 3 Topi operasi wanita
3 Box 1 Tranfusi Set 1
4 Box 2 Umbilical cord clamp 1
5 Roll 200 Verban 15cm
6 Pcs 4 Washen
Roll 2 Zide Silk rool

Roll 200 Perban gulung 15 cm


Box 20 Masker
PT Parit Padang

1 Box 30 Calcit (Calcatriol)


2 Tube 5 Decubal Cream
3
4 Box 2 Etirox 100 mg
5 Vial 50 Farsorbid Inj
6
7
8 Box 2 Ketese Tab 25 mg
9
10 Box 2 Nuzyp Tab 10 mg
11
12 Box 3 Remital 10 mg tablet
Box 1 Atropin Sulfat injeksi
Box 2 Simarck 2 mg

unit 4 Tensi meter Nova


Unit 2 Timbangan dewasa
Pcs 2 Bola Lampu Halogen kecil 500/250 wat
unit 1 Tensi meter anak
Pcs 2 Regulator oksigen
Pcs 3 Waslap
Pcs 2 Wascom mandi
Pcs 2 Minor set stenlies

PT Sawah Besar
1 Box 5 Kutoin capsul
2 Box 10 Bamgetol tablet 200 mg
3 15 Hexymer Tablet 2 mg
4 Vial 150 Metyl prednisolon injeksi 10
5 Fls 30 Otozambon Tetes Telinga
6 Box 5 Sandepril 50 mg
Box 15 Takelin 1000 mg
Box 10 Calcimega tablet
Tube 50 Osteor cream
Box 30 Osteor Tablet
Box 1 Kutoin injeksi

PT PENTA VALENT
1
2 Box 10 Cal 95 tablet
3 Strip 50 Cendo Catarlen 0,6 ml @ 5's minidose 5
4
11 Strip 40 Cendo Lyters 0,6 ml@ 5's minidose
12 5
13 Strip 50 Cendo polidex 0,6ml@5's minidose
14 Strip 20 cendo posop 0,6ml@5' minidose
15 Strip 5 Cendo timol 0,6ml@5'minidose
16 Strip 5 Cendo Tonor 0,6ml@5'S minidose
17 Strip 60 Cendo Ulcori 0,6 ml @ 5's minidose 40
18
19 Strip 50 Cendo Xitrol 0,6 ml@ 5's minidose 28
20 Box 10 Ciflon Tab
21 Fls 20 Forasma Syr
22 Jrg 3 Handscrub
23 Fls 60 L zink syrup
24 Fls 50 Lagesyl syrup
25 Box 3 Lapibal Inj
26 Box 10 Mecola tab 5
27 Box 10 Myotonic injeksi
28 Box 10 Myotonic Tab
29 Box 50

PT PROTEUSSABA NUSANTARA
1 Kit 1 ALP
2 Vial 1 Gol Darah A
3 Btl 2 Bilirubin Total
4 Gal 2 Alfa Diluent Swelab
5 Gal 2 Alfa Lyse Swelab
6 Vial 1 Gol Darah B
7 Jrg 2 Aquabidest
8 Box 10 Blood Call Red
9 Box 15 Blood Call Ungu
10 Box 3 Blood Lancet
11 Box 3 Nald Bilgod
12 Kit 1 Asto Test
13 Btl 2 Cholesterol
14 Btl 2 Creatinine
15 Box 4 Sensiglove ( M )
16 Btl 2 SGOT
17 Btl 2 SGPT
18 Btl 2 Triglyceride
19 Btl 2 Urea
20 Btl 1 Verify
21 Kit 1 HBS AG
22 Kit 1 HCV
23 Kit 1 DHF
24 Btl 2 Glucose
25 Kit 2 HDL Cholesterol
26 Btl 2 Bilirubin Direk
27 Btl 2 Protein Total
28 Kit 1 RF Test

PT United Dico Citas


1 Box 3 Alinamin F Injeksi
2 Box 5 Alinamin F Tab
3 Tube 50 Bersol cream
Box 10 Nonflamin capsul
Box 10 Inhitril 10 mg tablet

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