PEMERINTAHAN KABUPATEN MAHAKAM ULU

PUSAT KESEHATAN MASYARAKAT LONG HUBUNG

KECAMATAN LONG HUBUNG
Kode Pos 75566

PUSKESMAS LONG HUBUNG

PUSTU : Lutan PELAPORAN BULAN/PERIODE : OKTOBER-DESEMBER
KECAMATAN : LONG HUBUNG PERMINTAAN BULAN/PERIODE : JANUARI-MARET
KABUPATEN : MAHAKAM ULU
PROVINSI : KALIMANTAN TIMUR

STOK STOK STOK

NO NAMA OBAT SATUAN
AWAL
PENERIMAAN PERSEDIAAN PEMAKAIAN ED
AKHIR OPTIMAL
PERMINTAAN PEMBERIAN KET
/RUSAK

OBAT
1 Acylovir Krim 5% Tube 0 0
2 Acyclovir Tablet 200mg Tablet 0 0
3 Acylovir Tablet 400mg Tablet 100 100 100 300
4 Albendazole Suspensi Botol 0 0
5 Albendazole Tablet 400mg Tablet 0 0
6 Allopurinol Tablet 100mg Tablet 0 0
7 Ambroxol HCL Syr Botol 5 5 5
8 Ambroxol HCL 30mg Tablet 12 200 212 200 12 200
9 Aminopillin Inj 24mg/ml Ampul 5 5 0 5
10 Aminopillin Tablet 200mg Tablet 0 0
11 Amitriptilin Tablet 0 0
12 Amlodipine 10mg Tablet Tablet 120 300 420 410 10 150
13 Amlodipine 5 mg Tablet 356 300 656 636 20
14 Amoxcicillin Kapsul 250mg Kapsul 0 200 200 192 8
15 Amoxcicillin Tablet 500mg Tablet 5 400 405 375 30 200
16 Amoxcicillin Syrup kering 125mg/5ml Botol 0 15 15 15 10
17 Amoxoxicillin syrup 100 mg/dl botol 5 5 2 3
18 Amoxicillin Syrup Forte Botol 0 0 10
19 Anabion Syrup botol 5 5 5 5
20 Anaton Tablet 0 0
21 Anaton Syr Botol 0 0
22 Antasida Doen Tablet Kunyah Tablet 400 400 400 300
23 Antasida Syr Botol 30 30 30 20
24 Antifungi Doen salep Kombinasi Pot 0 0
25 Antihemaroid Supp 0 0
26 Asam Folat Tablet 0 0
27 Asam Mefenamat 250mg Kapsul 0 0
28 Asam Mefenamat 500mg Tablet 0 0 300
29 Asam Tranexamat 500mg Tablet 0 0
30 Asam Transeknamat Injeksi Ampul 0 0
31 Asetosal 100mg Tablet 0 0
32 Atrovin Injeksi Ampul 0 0
33 Bacitracin Polymixcin B Tube 0 0
34 Bedak Salisil Kotak 0 0
35 Betahistin Tablet 270 270 250 20 300
36 Bethametasone Krim 0.1% Tube 5 5 5 5
37 Bethametasone Cr (Skizone) Tube 0 0 5
38 Bisoprolol Fumarate 5mg Tablet 0 0
39 Bufacetine (Chlorampenicol Salep Kulit ) Tube 5 5 5 1
40 Burnasin Cream Tube 0 0
41 Carbamazepine 200mg Tablet 0 0
42 Catopril 12,5 mg Tablet 100 100 100 100
43 Catopril 25 mg Tablet 0 0
44 Captopril 50mg Tablet 0 0
45 Caviplek ( Multivitamin ) Tablet 0 0
46 Cefadroxil 500mg Kapsul 0 0
47 Cefadroxil Syr Botol 1 10 11 6 5 10
48 Cefadroxil syr Forte Botol 0 0
49 Cefixime 100mg Kapsul 0 0
50 Cefixime Syr Botol 0 0
51 Cefotaxime Injeksi 1,0 g Ampul 0 0
52 Cetirizin syr Botol 0 -1 1
53 Chlorampenicol 250 mg Kapsul 0 0
54 Chlorampenicol Salep mata Pcs 0 0
55 Chlorampenicol syr Botol 3 3 0 3
56 Cimetidin 15mg Tablet 0 0
57 Ciprofloxacin 500mg Tablet 0 0
58 Citikolin injeksi Ampul 0 0
59 Clindamicin 150mg Kapsul 0 0 150
60 Clipodogrel Tablet 0 0
61 Clonidine Tablet 0 0
62 Clorpheniramine Maleat (CTM) Tablet 186 400 586 536 50
63 Clozapine 25mg Tablet 0 0
64 Codein 10mg Tablet 0 0
65 Combivent Fls 0 0
66 Cotrimokzasole 480 mg Tablet 205 200 405 335 70 200
67 Cotrimokzasole Pediatrik Tablet 0 0
68 Cotrimokzasole syr Botol 2 15 17 15 2 20
69 CPZ 100 mg Tablet 0 0
70 CPZ 25 mg Tablet 0 0
71 Decacetine Tetes Mata Botol 0 0
72 Dexametasone Injeksi Ampul 7 5 12 4 8
73 Dexametasone Tablet 0,5mg Tablet 0 0
74 Diazepam Injeksi Ampul 0 0
75 Diazepam Tablet Tablet 0 0
76 Digoxin Tablet Tablet 0 0
77 Dimenhydrinate Tablet 50mg Tablet 15 15 -5 20 100
78 Dipenhydramine Injeksi Ampul 0 0
79 Diklofenak sodium 50mg Tablet 0 0
80 Diklofenak sodium 25mg Tablet 400 400 400 100
81 Domperidone Syrup Botol 15 15 12 3 5
82 Domperidone Tablet 10mg Tablet 270 200 470 170 300
83 Doxyciclin Tablet Tablet 0 0
84 Ducolax (bisakodil) Supp Supp 0 0
85 Epinefrine Injeksi 0,1% Ampul 0 0
86 Ergotamine-Cafein Tablet Tablet 0 0
87 Erythromycin Syrup Kering Botol 1 1 1
88 Erytromicin 250mg Kapsul 100 100 0 100 100
89 Erytromisin 500mg Kapsul 0 0
90 Fenobarbital Injeksi Ampul 0 0
91 Fenobarbital 30 mg Kapsul 0 0
92 Ferrous Sulfate Tablet 0 0
93 Furosemide Injeksi Ampul 0 0
94 Furosemide Tablet 40mg Tablet 100 100 0 100
95 Folid Acid Tablet 200 200 400 300 100
96 Garam Oralit Serbuk sachet 26 26 0 26
97 Gavistal Drop Botol 5 5 2 3
98 Gentamicin 40mg Injeksi Ampul 0 0
99 Gentamicin Salep Kulit 0,1% Tube 0 0
100 Gentamisin Tetes Mata Botol 4 4 0 4
101 Gentamisin Salep mata Tube 5 5 5
102 Gentian Violet Larutan Botol 0 0
103 Glibenclamida Tablet 5mg Tablet 340 100 440 390 50 100
104 Glicab Tablet 0 0
105 Glimepirid 1 mg Tablet 0 0
106 Gliseril guaikolat 100mg(GG) Tablet 10 100 110 110
107 Gradiab (Metformin 500mg) Tablet 0 0
108 Griseofulvin 125mg Tablet Tablet 260 260 110 150
109 Guanistreep syr Botol 0 0
110 Haloperidol 5mg Tablet 0 0
111 Hidroclortiazid 25mg Tablet 0 0
112 Hidrocortisone Krim 2,5% Tube 0 0
113 Hustab (Bromheksin) Tablet 0 0
114 Ibuprofen Suspensi ( Salfenal ) Botol 3 11 14 11 3 6
115 Ibuprofen Tablet 200mg Tablet 200 200 200 200
116 Ibuprofen Tablet 400mg Tablet 20 20 0 20
117 Illiadin Botol 0 0
118 ISDN Tablet 0 0
119 Kalsium Laktat 500mg Tablet 300 300 300
120 Ketokonazole Krim Tube 5 5 5
121 Ketokonazole Tablet Tablet 280 280 120 160 200
122 Ketorolac Injeksi Ampul 0 0
123 Levopar Tablet Tablet 0 0
124 Lidocain HCL Compositum Inj Ampul 4 15 19 10 9 30
125 Lisinopril Dihydrate Tablet 100 100 0 100
126 Lodecon Batuk Flu Tablet 0 0
127 Loperamide HCI 2 mg Tablet 0 0
128 Loratadine Tablet 10mg Tablet 220 220 20 200 50
129 Mebendazole Syrup Botol 0 0
130 Metformin Tablet Tablet 0 0
131 Methilergometrine Maleat Injeksi Ampul 0 0
132 Methilergometrine Tablet Tablet 0 0
133 Methilprednisolone Tablet 0 0
134 Methocloperamide 10mg Tablet 0 0
135 Metochloperamide 5mg Tablet 0 0
136 Metronidazole Tablet 250 mg Tablet 0 0 100
137 Metronidazole Tablet 500mg Tablet 215 200 415 333 82
138 Metronidazole Syr Botol 0 0
139 Metronidazole Infus Botol 0 0
140 Miconazole Krim Tube 5 5 5 5
141 Myorin Serbuk Btl 0 0 1
142 N. Acetylsistein Kapsul 60 60 60 720
143 Natrium Diklofenak 50mg Tablet Tablet 0 0
144 New Antides (Attapulgit) Tablet 0 0
145 Neo Kaominal Syr Botol 5 5 5
146 Nifedipine Tablet 10mg Tablet 180 180 160 20
147 Nistatin Tablet Salut 500.000 IU Tablet 52 52 2 50
148 Nistatin Tablet Vaginal 100.000 IU/g Supp 10 10 10
149 Novimag Tablet 0 0
150 Novagesic Tablet 0 0
151 Novadiar Syr Botol 1 1 1
152 OBH botol 5 30 35 30 5 10
153 Ofloxacime 400mg Tablet 0 0
154 Omeprazole Kapsul 20mg Kapsul 300 300 290 10
155 Ondansentron 4mg Tablet 0 0
156 Ondansentron Injeksi Ampul 0 0
157 Oxytetraciline Salep Kulit 3% Tube 0 0
158 Oxytetraciline Salep Mata 1% Tube 5 25 30 15 15 25
159 Oxytosine Injeksi Ampul 9 9 6 3
160 Paracetamol Drops Botol 0 0
161 Paracetamol Syrup (Novagesic) Botol 10 10 10
162 Paracetamol Tablet 500mg Tablet 400 400 400 300
163 Paracetamol Infus Botol 0 0
164 Pehavral ( Multivitamin ) Tablet 0 0
165 Phenitoin 100mg Tablet 0 0
166 Phenitoin inj Ampul 0 0
167 Phenol Glyserol tts telingga 10% Botol 5 5 5
168 Phytomenadion inj Ampul 5 5 5 10
169 Phytomenadion tab Tablet 190 190 40 150
170 Piracetam 1200mg Tablet 0 0
171 Piracetam Injeksi Ampul 0 0
172 Piridoksin Hcl inj Ampul 0 0
173 Prednisone Tablet 5mg Tablet 0 0
174 Primaquine Tablet Tablet 0 0
175 Propilitualiasil Tablet 0 0
176 Pularex Tablet Tablet 3 150 153 133 20 250
177 Pyrantel Suspensi Botol 0 0
178 Pyrantel Score Tablet 125mg Tablet 40 40 40
179 Pyrazinamide Tablet 0 0
180 Ranitidine Injeksi 25mg/2ml Ampul 9 15 24 20 4
181 Ranitidine Tablet 150mg Tablet 0 0
182 Risperidon 2mg Tablet 0 0
183 Salbutamol 2 mg Tablet 40 40 40 0
184 Salbutamol 4 mg Tablet 10 200 210 185 25 100
185 Salbutamol syr Botol 0 0
186 Salep 2-4 kombinasi pot 0 0
187 Scabimide Cream Tube 0 0
188 Simvastatin Tablet 20mg Tablet 0 0
189 Simvastatin Tablet 10 mg Tablet 4 300 304 254 50 180
190 Skizonoate Injeksi Ampul 0 0
191 Solafluz syr ( Obat Batuk Pilek ) Botol 0 0
192 Solvitral Tablet 20 20 20
193 Stesolite supp(Diazepam) Supp 0 0
194 Sulfadoxime Primetamine Tablet 0 0
195 Tablet Tambah darah Tablet 60 300 360 310 50 150
196 Thiampenicol 500mg Kapsul 0 0
197 Ticomag Tablet Tablet 0 0
198 Tramadol inj Ampul 0 0
199 Trihexipenedil Tablet 0 0
200 Truvit syr ( Multivitamin ) Botol 0 0
201 Vermox ( Mebendazole ) Tablet 0 0
202 Ventolin Inhaler salbutamol Pcs 0 0
203 Vitamin B Complex Tablet Tablet 500 500 500 100
204 Vitamin B1 (Thiamin) Tablet 55 500 555 375 180 500
205 Vitamin B12 Tablet Tablet 205 300 505 325 180 300
206 Vitamin B12 Inj (Cianocobalamin) Ampul 0 0
207 Vitamin B6 (Piridoxsin) Tablet 65 65 65 400
Vitamin C Tablet 0 0 0 300
208 Vitamin C 500 Tablet 0 0 0 200
209 Zink Tablet 200mg Tablet 260 200 460 330 130 200
210 Zink Kids Syr/Zirkum Kids Syr Botol 2 4 6 6 5

BMHP GUDANG OBAT PKM

1 Abocath 18 Pcs 0 0
2 Abocath 20 Pcs 0 0
3 Abocath 22 Pcs 9 10 19 17 2
4 Abocath 24 Pcs 4 5 9 3 6 10
5 Abocath 26 Pcs 0 0
6 Alkohol Swab Pcs 20 20 20
7 Alkohol 1000ml Botol 1 2 3 2 1
Alkohol 300ml Botol 0 0 3
8 Alkohol 100ml Botol 0 0
9 Apron pcs 40 40 40
10 AquaPro Injeksi Steril Flabot 0 0
11 Aseptan Liquid Botol 0 0 2
12 Bisturi no.12 Pcs 10 10 0 10
13 Bisturi no.15 Pcs 12 12 0 12
14 Bracket Handwash Pcs 0 0
15 Catgut Chromic 3/0 100m Pcs 0 0
16 Catgut Chromic 2/0 (3.5 Metric) Pcs 2 12 14 10 4 12
17 Catgut Chromic 3/0 HR-37 Pcs 4 4 -1 5
18 Catgut Chromic 3/0 (3 Metric) Pcs 5 5 5
19 Cervical Colar Pcs 0 0
20 Catgut Plain 2/0 (3.5M) Pcs 0 0
21 Chateter No.18 Pcs 0 0
22 Chateter no. 14 Pcs 0 0
23 Chateter no. 16 Pcs 0 0
24 Dermafix 10 x 25 Pcs 0 0
25 Fixomull 10 x 5 Pcs 1 1 0 1
26 Fixomull 5 x 5 Pcs 2 3 5 4 1 1
27 Glukosa Larutan Infus 10% Fls 0 0
28 Glukosa Larutan Infus 5% Fls 0 0
29 Handscoon Steril No 7 Pasang 5 5 10 8 2
30 Handscon Sterill No. 7 1/2 Pasang 5 5 10 9 1
31 Handscon Steril Obgyn Pasang 2 2 4 4 2
32 Handscoon L Pcs 200 200 200 200
33 Handscoon M Pcs 20 200 220 170 50 200
34 Handscoon S Pcs 50 200 250 200 50 200
35 HerbalVit 19 botol 0 0 14
36 H2O2 Botol 1 1 2 2
37 Hidrogen Peroksida Pcs 5 5 3 2
38 Infuset Anak Pcs 3 3 0 3
39 Infuset Dewasa roll 3 3 3
40 Isopalster Pcs 0 0
41 Jarum Kulit No 12 Pcs 0 0
42 Jarum Kulit No 13 Gulung 0 -1 1
43 Kapas 1000g Gulung 1 1 1
44 Kapas 250 gram roll 2 2 2 2
45 Kapas 500 gram pcs/kotak 1 1 0 1
46 Kasa Kotak steril 16 x 16 pcs/kotak 4 5 9 9
47 Kasa Kotak steril 18 x 22 pcs 0 -2 2 5
48 Kasa 4m x 5cm roll 0 -4 4
49 Kasa 4m x 10cm roll 10 10 10
50 Kasa 4m x 15cm roll 4 4 4
51 Kasa Hidrofil 2m x 80 cm roll 0 0
52 Kasa Hidrofil 40yard x 80 cm lembar 1 1 2 2 1
53 Kasa Kompres 40cmx 40cm lembar 0 0
54 Kertas Puyer Pcs 150 150 150
55 Klip Obat 13 x 8.7 Pcs 0 0
56 Klip Obat 10cmx7cm Pcs 100 100 100
57 Klip Obat 8cm x 5cm roll 0 0
58 Leukoplast 2.5 x 4.5 roll 2 2 1 1 2
59 Leukoplast 7.5 x 4.5 roll 0 -1 1
60 Lisol 1 L Fls 0 0
61 Magnesium Sulfate Inj 20% Fls 0 0
62 Magnesium Sulfate Inj 40% Pcs 0 0
63 Masker Karet Pcs 0 0
64 Masker Tali Pcs 0 0 0
65 Masker Oksigen Dws Pcs 3 3 3
66 Masker Oksigen anak Pcs 0 0
67 Masker Oksigen Neonatus (Bayi) Pcs 0 0
68 Medical regulator Pcs 0 0
69 Mucus Extractor Fls 1 1 0 1
70 Natrium Klorida Larutan Infus 0,9% Pcs 3 3 1 2
71 Needle 23 pcs 5 10 15 15 10
72 Needle 24 Pcs 15 15 10 5
73 Needle 25 Pcs 14 14 14
74 NGT 14 Pcs 0 0
75 NGT 16 Pcs 0 0
76 NGT 18 Pcs 0 -1 1
77 Nurse Cap Pcs 6 35 41 23 18 100
78 NGT 20 Pcs 0 0
79 Oxyflow Dewasa Pcs 3 3 3
80 Oxyflow Anak bh 0 0
81 Pencetan Antiseptik Pcs 2 2 2
82 Plesterin bulat Botol 0 0
83 Policlean Pcs 0 0
84 Polifix 5cm x 1m Botol 0 -1 1 1
85 Povidone Lodida 300ml Larutan Botol 2 2 2 1
86 Povidone Lodida 30ml Larutan Pcs 0 0
87 PP tes Flabot 0 0
88 Ringer Lactat Larutan Infus Botol 8 8 4 4 5
89 Rivanol 300ml Pcs 1 1 2 2
90 Signa gel Pcs 0 -1 1 1
91 Silk Braided 2/0 H-R 37mm/2/0( 3M ) pcs 7 5 12 12
92 Silk Braided 3/0 H-R 30mm/3/0( 2 M ) pcs 5 5 5
 93 Spuit 0,5 cc pcs 24 24 24
94 Spuit 1 cc pcs 1 1 -4 5
95 Spuit 2,5cc pcs 2 2 0 2
96 Spuit 3cc Pcs 13 20 33 29 4 20
97 Spuit 5cc pcs 3 10 13 10 3 20
98 Spuit 10cc pcs 8 8 4 4 20
99 surgical blade Pcs 20 20 20
100 Spalak Pcs 0 0 2
101 Spuit 50cc Pcs 0 0
102 Threeway Infus tabung 0 0
103 Tabung Oksigen Besar tabung 0 0
104 Tabung Oksigen Sedang tabung 0 0
105 Tabung Oksigen Kecil Pcs 0 0
106 Ultra Fix pcs 1 1 0 1
107 UnderPad pcs 11 5 16 16 10
108 Urine Bag Fls 0 0
109 Wida DS 5% roll 0 0
110 Wing Needle 21 roll 0 0
111 Wing Needle 23 roll 0 0
112 Wing Needle 25 roll 0 0
113 Wing Needle 27 btl 0 0
114 Viorex Liquid Soap Botol 1 1 0 1
115 Viorex Desinfektan Pcs 1 1 0 1
116 Yurisol Pcs 2
117 Zink Oxide Tipe

Yang Menyerahkan, Mengetahui : Yang Menerima,

dang/Apoteker Penanggung Jawab Kepala Puskesmas Long Hubung Petugas Pustu

…………………………………… Kristianus Yulianto Madang, SKM ………………………………….

NIP 19840710 201505 1 001
 PEMERINTAHAN KABUPATEN MAHAKAM ULU
PUSAT KESEHATAN MASYARAKAT LONG HUBUNG
KECAMATAN LONG HUBUNG
Kode Pos 75566

PUSKESMAS LONG HUBUNG

PUSTU : Lutan PELAPORAN BULAN/PERIODE : JANUARI-MARET
KECAMATAN : LONG HUBUNG PERMINTAAN BULAN/PERIODE : APRIL - JUNI
KABUPATEN : MAHAKAM ULU
PROVINSI : KALIMANTAN TIMUR

STOK STOK STOK

NO NAMA OBAT SATUAN
AWAL
PENERIMAAN PERSEDIAAN PEMAKAIAN ED
AKHIR OPTIMAL
PERMINTAAN PEMBERIAN KET
/RUSAK

OBAT
1 Acylovir Krim 5% Tube 0 0 0
2 Acyclovir Tablet 200mg Tablet 0 0 0
3 Acylovir Tablet 400mg Tablet 0 300 300 300 300 300
4 Albendazole Suspensi Botol 0 0 0
5 Albendazole Tablet 400mg Tablet 0 0 0
6 Allopurinol Tablet 100mg Tablet 0 0 0
7 Ambroxol HCL Syr Botol 0 0 0
8 Ambroxol HCL 30mg Tablet 12 200 212 212 0 200 200
9 Aminopillin Inj 24mg/ml Ampul 5 5 5
10 Aminopillin Tablet 200mg Tablet 0 0 0
11 Amitriptilin Tablet 0 0 0
12 Amlodipine 10mg Tablet Tablet 10 150 160 150 10 150 150
13 Amlodipine 5 mg Tablet 20 20 5 15
14 Amoxcicillin Kapsul 250mg Kapsul 8 8 8 0
15 Amoxcicillin Tablet 500mg Tablet 30 200 230 200 30 200 200
16 Amoxcicillin Syrup kering 125mg/5ml Botol 0 10 10 8 2 10 10
17 Amoxoxicillin syrup 100 mg/dl botol 3 3 3
18 Amoxicillin Syrup Forte Botol 0 10 10 5 5 10 10
19 Anabion Syrup botol 0 5 5 5 0 5 5
20 Anaton Tablet 0 0 0
21 Anaton Syr Botol 0 0 0
22 Antasida Doen Tablet Kunyah Tablet 0 300 300 240 60 300 300
23 Antasida Syr Botol 0 20 20 17 3 20 20
24 Antifungi Doen salep Kombinasi Pot 0 5 5 5
25 Antihemaroid Supp 0 0 0
26 Asam Folat Tablet 0 0 0
27 Asam Mefenamat 250mg Kapsul 0 0 0
28 Asam Mefenamat 500mg Tablet 0 300 300 200 100 300 300
29 Asam Tranexamat 500mg Tablet 0 0 0
30 Asam Transeknamat Injeksi Ampul 0 0 0
31 Asetosal 100mg Tablet 0 0 0
32 Atrovin Injeksi Ampul 0 0 0
33 Bacitracin Polymixcin B Tube 0 0 0
34 Bedak Salisil Kotak 0 0 0
35 Betahistin Tablet 20 300 320 200 120 300 300
36 Bethametasone Krim 0.1% Tube 0 5 5 5 5 5
37 Bethametasone Cr (Skizone) Tube 0 5 5 5 5 5
38 Bisoprolol Fumarate 5mg Tablet 0 0 0
39 Bufacetine (Chlorampenicol Salep Kulit ) Tube 0 1 1 1 1 1
40 Burnasin Cream Tube 0 0 0
41 Carbamazepine 200mg Tablet 0 0 0
42 Catopril 12,5 mg Tablet 0 100 100 100 100 100
43 Catopril 25 mg Tablet 0 0 0
44 Captopril 50mg Tablet 0 0 0
45 Caviplek ( Multivitamin ) Tablet 0 0 0
46 Cefadroxil 500mg Kapsul 0 0 0
47 Cefadroxil Syr Botol 5 10 15 5 10 10 10
48 Cefadroxil syr Forte Botol 0 0 0
49 Cefixime 100mg Kapsul 0 0 0
50 Cefixime Syr Botol 0 0 0
51 Cefotaxime Injeksi 1,0 g Ampul 0 0 0
52 Cetirizin syr Botol 1 1 1 0
53 Chlorampenicol 250 mg Kapsul 0 0 0
54 Chlorampenicol Salep mata Pcs 0 0 0
55 Chlorampenicol syr Botol 3 3 3
56 Cimetidin 15mg Tablet 0 0 0
57 Ciprofloxacin 500mg Tablet 0 0 0
58 Citikolin injeksi Ampul 0 0 0
59 Clindamicin 150mg Kapsul 0 150 150 150 150 150
60 Clipodogrel Tablet 0 0 0
61 Clonidine Tablet 0 0 0
62 Clorpheniramine Maleat (CTM) Tablet 50 50 50 0
63 Clozapine 25mg Tablet 0 0 0
64 Codein 10mg Tablet 0 0 0
65 Combivent Fls 0 0 0
66 Cotrimokzasole 480 mg Tablet 70 200 270 195 75 200 200
67 Cotrimokzasole Pediatrik Tablet 0 0 0
68 Cotrimokzasole syr Botol 2 20 22 15 7 20 20
69 CPZ 100 mg Tablet 0 0 0
70 CPZ 25 mg Tablet 0 0 0
71 Decacetine Tetes Mata Botol 0 0 0
72 Dexametasone Injeksi Ampul 8 8 4 4
73 Dexametasone Tablet 0,5mg Tablet 0 0 0
74 Diazepam Injeksi Ampul 0 0 0
75 Diazepam Tablet Tablet 0 0 0
76 Digoxin Tablet Tablet 0 0 0
77 Dimenhydrinate Tablet 50mg Tablet 20 100 120 10 110 100 100
78 Dipenhydramine Injeksi Ampul 0 0 0
79 Diklofenak sodium 50mg Tablet 0 0 0
80 Diklofenak sodium 25mg Tablet 0 100 100 100 100 100
81 Domperidone Syrup Botol 3 5 8 6 2 5 5
82 Domperidone Tablet 10mg Tablet 300 300 60 240
83 Doxyciclin Tablet Tablet 0 0 0
84 Ducolax (bisakodil) Supp Supp 0 0 0
85 Epinefrine Injeksi 0,1% Ampul 0 0 0
86 Ergotamine-Cafein Tablet Tablet 0 0 0
87 Erythromycin Syrup Kering Botol 0 0 0
88 Erytromicin 250mg Kapsul 100 100 200 200 100 100
89 Erytromisin 500mg Kapsul 0 0 0
90 Fenobarbital Injeksi Ampul 0 0 0
91 Fenobarbital 30 mg Kapsul 0 0 0
92 Ferrous Sulfate Tablet 0 0 0
93 Furosemide Injeksi Ampul 0 0 0
94 Furosemide Tablet 40mg Tablet 100 100 0 100
95 Folid Acid Tablet 100 100 50 50
96 Garam Oralit Serbuk sachet 26 26 10 16
97 Gavistal Drop Botol 3 3 3
98 Gentamicin 40mg Injeksi Ampul 0 0 0
99 Gentamicin Salep Kulit 0,1% Tube 0 0 0
100 Gentamisin Tetes Mata Botol 4 4 4
101 Gentamisin Salep mata Tube 0 0 0
102 Gentian Violet Larutan Botol 0 0 0
103 Glibenclamida Tablet 5mg Tablet 50 100 150 100 50 100 100
104 Glicab Tablet 0 0 0
105 Glimepirid 1 mg Tablet 0 0 0
106 Gliseril guaikolat 100mg(GG) Tablet 0 0 0
107 Gradiab (Metformin 500mg) Tablet 0 0 0
108 Griseofulvin 125mg Tablet Tablet 150 150 60 90
109 Guanistreep syr Botol 0 0 0
110 Haloperidol 5mg Tablet 0 0 0
111 Hidroclortiazid 25mg Tablet 0 0 0
112 Hidrocortisone Krim 2,5% Tube 0 0 0
113 Hustab (Bromheksin) Tablet 0 0 0
114 Ibuprofen Suspensi ( Salfenal ) Botol 3 6 9 7 2 6 6
115 Ibuprofen Tablet 200mg Tablet 0 200 200 200 0 200 200
116 Ibuprofen Tablet 400mg Tablet 20 20 10 10
117 Illiadin Botol 0 0 0
118 ISDN Tablet 0 0 0
119 Kalsium Laktat 500mg Tablet 0 0 0
120 Ketokonazole Krim Tube 0 0 0
121 Ketokonazole Tablet Tablet 160 200 360 40 320 200 200
122 Ketorolac Injeksi Ampul 0 0 0
123 Levopar Tablet Tablet 0 0 0
124 Lidocain HCL Compositum Inj Ampul 9 30 39 5 34 30 30
125 Lisinopril Dihydrate Tablet 100 100 100
126 Lodecon Batuk Flu Tablet 0 0 0
127 Loperamide HCI 2 mg Tablet 0 0 0
128 Loratadine Tablet 10mg Tablet 200 50 250 50 200 50 50
129 Mebendazole Syrup Botol 0 0 0
130 Metformin Tablet Tablet 0 0 0
131 Methilergometrine Maleat Injeksi Ampul 0 0 0
132 Methilergometrine Tablet Tablet 0 0 0
133 Methilprednisolone Tablet 0 0 0
134 Methocloperamide 10mg Tablet 0 0 0
135 Metochloperamide 5mg Tablet 0 0 0
136 Metronidazole Tablet 250 mg Tablet 0 100 100 100 100 100
137 Metronidazole Tablet 500mg Tablet 82 82 67 15
138 Metronidazole Syr Botol 0 0 0
139 Metronidazole Infus Botol 0 0 0
140 Miconazole Krim Tube 0 5 5 3 2 5 5
141 Myorin Serbuk Btl 0 1 1 1 1 1
142 N. Acetylsistein Kapsul 0 720 720 720 720 720
143 Natrium Diklofenak 50mg Tablet Tablet 0 0 0
144 New Antides (Attapulgit) Tablet 0 0 0
145 Neo Kaominal Syr Botol 0 0 0
146 Nifedipine Tablet 10mg Tablet 20 20 20
147 Nistatin Tablet Salut 500.000 IU Tablet 50 50 15 35
148 Nistatin Tablet Vaginal 100.000 IU/g Supp 0
149 Novimag Tablet 0 0 0
150 Novagesic Tablet 0 0 0
151 Novadiar Syr Botol 0 0 0
152 OBH botol 5 10 15 7 8 10 10
153 Ofloxacime 400mg Tablet 0 0 0
154 Omeprazole Kapsul 20mg Kapsul 10 10 10 0
155 Ondansentron 4mg Tablet 0 0 0
156 Ondansentron Injeksi Ampul 0 0 0
157 Oxytetraciline Salep Kulit 3% Tube 0 0 0
158 Oxytetraciline Salep Mata 1% Tube 15 25 40 3 37 25 25
159 Oxytosine Injeksi Ampul 3 3 3
160 Paracetamol Drops Botol 0 0 0
161 Paracetamol Syrup (Novagesic) Botol 0 0 0
162 Paracetamol Tablet 500mg Tablet 0 300 300 300 300 300
163 Paracetamol Infus Botol 0 0 0
164 Pehavral ( Multivitamin ) Tablet 0 0 0
165 Phenitoin 100mg Tablet 0 0 0
166 Phenitoin inj Ampul 0 0 0
167 Phenol Glyserol tts telingga 10% Botol 0 0 0
168 Phytomenadion inj Ampul 0 10 10 10 10 10
169 Phytomenadion tab Tablet 150 150 150
170 Piracetam 1200mg Tablet 0 0 0
171 Piracetam Injeksi Ampul 0 0 0
172 Piridoksin Hcl inj Ampul 0 0 0
173 Prednisone Tablet 5mg Tablet 0 0 0
174 Primaquine Tablet Tablet 0 0 0
175 Propilitualiasil Tablet 0 0 0
176 Pularex Tablet Tablet 20 250 270 180 90 250 250
177 Pyrantel Suspensi Botol 0 0 0
178 Pyrantel Score Tablet 125mg Tablet 0 0 0
179 Pyrazinamide Tablet 0 0 0
180 Ranitidine Injeksi 25mg/2ml Ampul 4 4 4 0
181 Ranitidine Tablet 150mg Tablet 0 0 0
182 Risperidon 2mg Tablet 0 0 0
183 Salbutamol 2 mg Tablet 0 0 20 -20
184 Salbutamol 4 mg Tablet 25 100 125 10 115 100 100
185 Salbutamol syr Botol 0 0 0
186 Salep 2-4 kombinasi pot 0 0 0
187 Scabimide Cream Tube 0 0 0
188 Simvastatin Tablet 20mg Tablet 0 0 0
189 Simvastatin Tablet 10 mg Tablet 50 180 230 150 80 180 180
190 Skizonoate Injeksi Ampul 0 0 0
191 Solafluz syr ( Obat Batuk Pilek ) Botol 0 0 0
192 Solvitral Tablet 0 0 0
193 Stesolite supp(Diazepam) Supp 0 0 0
194 Sulfadoxime Primetamine Tablet 0 0 0
195 Tablet Tambah darah Tablet 50 150 200 150 50 150 150
196 Thiampenicol 500mg Kapsul 0 0 0
197 Ticomag Tablet Tablet 0 0 0
198 Tramadol inj Ampul 0 0 0
199 Trihexipenedil Tablet 0 0 0
200 Truvit syr ( Multivitamin ) Botol 0 0 0
201 Vermox ( Mebendazole ) Tablet 0 0 0
202 Ventolin Inhaler salbutamol Pcs 0 0 0
203 Vitamin B Complex Tablet Tablet 0 100 100 100 0 100 100
204 Vitamin B1 (Thiamin) Tablet 180 500 680 500 180 500 500
205 Vitamin B12 Tablet Tablet 180 300 480 360 120 300 300
206 Vitamin B12 Inj (Cianocobalamin) Ampul 0 0 0
207 Vitamin B6 (Piridoxsin) Tablet 0 400 400 200 200 400 400
Vitamin C 250 Tablet 0 300 300 300 0 300 300
208 Vitamin C 500 Tablet 0 200 200 100 100 200 200
209 Zink Tablet 200mg Tablet 130 200 330 180 150 200 200
210 Zink Kids Syr/Zirkum Kids Syr Botol 0 5 5 4 1 5 5

BMHP GUDANG OBAT PKM

1 Abocath 18 Pcs 0 0 0
2 Abocath 20 Pcs 0 0 0
3 Abocath 22 Pcs 2 2 2 0
4 Abocath 24 Pcs 6 10 16 8 8 10 10
5 Abocath 26 Pcs 0 0 0
6 Alkohol Swab Pcs 0 0 0
7 Alkohol 1000ml Botol 1 1 1 0
Alkohol 300ml Botol 0 3 3 3 3 3
8 Alkohol 100ml Botol 0 0 0
9 Apron pcs 0 0 0
10 AquaPro Injeksi Steril Flabot 0 0 0
11 Aseptan Liquid Botol 0 2 2 2 2 2
12 Bisturi no.12 Pcs 10 10 10
13 Bisturi no.15 Pcs 12 12 12
14 Bracket Handwash Pcs 0 0 0
15 Catgut Chromic 3/0 100m Pcs 0 0 0
16 Catgut Chromic 2/0 (3.5 Metric) Pcs 4 12 16 2 14 12 12
17 Catgut Chromic 3/0 HR-37 Pcs 5 5 1 4
18 Catgut Chromic 3/0 (3 Metric) Pcs 0 0 0
19 Cervical Colar Pcs 0 0 0
20 Catgut Plain 2/0 (3.5M) Pcs 0 0 0
21 Chateter No.18 Pcs 0 0 0
22 Chateter no. 14 Pcs 0 0 0
23 Chateter no. 16 Pcs 0 0 0
24 Dermafix 10 x 25 Pcs 0 0 0
25 Fixomull 10 x 5 Pcs 1 1 1
26 Fixomull 5 x 5 Pcs 1 1 2 1 1 1 1
27 Glukosa Larutan Infus 10% Fls 0 0 0
28 Glukosa Larutan Infus 5% Fls 0 0 0
29 Handscoon Steril No 7 Pasang 2 2 2
30 Handscon Sterill No. 7 1/2 Pasang 1 1 1 0
31 Handscon Steril Obgyn Pasang 0 2 2 2 2 2
32 Handscoon L Pcs 0 200 200 200 200 200
33 Handscoon M Pcs 50 200 250 30 220 200 200
34 Handscoon S Pcs 50 200 250 100 150 200 200
35 HerbalVit 19 botol 0 14 14 14 14 14
36 H2O2 Botol 0 0 0
37 Hidrogen Peroksida Pcs 2 2 2
38 Infuset Anak Pcs 3 3 3
39 Infuset Dewasa roll 0 0 0
40 Isopalster Pcs 0 0 0
41 Jarum Kulit No 12 Pcs 0 0 0
42 Jarum Kulit No 13 Gulung 1 1 1
43 Kapas 1000g Gulung 0 0 0
44 Kapas 250 gram roll 0 2 2 2 2 2
45 Kapas 500 gram pcs/kotak 1 1 1
46 Kasa Kotak steril 16 x 16 pcs/kotak 0 0 0
47 Kasa Kotak steril 18 x 22 pcs 2 5 7 7 5 5
48 Kasa 4m x 5cm roll 4 4 4
49 Kasa 4m x 10cm roll 0 0 0
50 Kasa 4m x 15cm roll 0 0 0
51 Kasa Hidrofil 2m x 80 cm roll 0 0 0
52 Kasa Hidrofil 40yard x 80 cm lembar 0 1 1 1 1 1
53 Kasa Kompres 40cmx 40cm lembar 0 0 0
54 Kertas Puyer Pcs 0 0 0
55 Klip Obat 13 x 8.7 Pcs 0 0 0
56 Klip Obat 10cmx7cm Pcs 0 0 0
57 Klip Obat 8cm x 5cm roll 0 0 0
58 Leukoplast 2.5 x 4.5 roll 1 2 3 3 2 2
59 Leukoplast 7.5 x 4.5 roll 1 1 1
60 Lisol 1 L Fls 0 0 0
61 Magnesium Sulfate Inj 20% Fls 0 0 0
62 Magnesium Sulfate Inj 40% Pcs 0 0 0
63 Masker Karet Pcs 0 0 0
64 Masker Tali Pcs 0 0 0
65 Masker Oksigen Dws Pcs 0 0 0
66 Masker Oksigen anak Pcs 0 0 0
67 Masker Oksigen Neonatus (Bayi) Pcs 0 0 0
68 Medical regulator Pcs 0 0 0
69 Mucus Extractor Fls 1 1 1
70 Natrium Klorida Larutan Infus 0,9% Pcs 2 2 2
71 Needle 23 pcs 0 10 10 10 10 10
72 Needle 24 Pcs 5 5 5
73 Needle 25 Pcs 0 0 0
74 NGT 14 Pcs 0 0 0
75 NGT 16 Pcs 0 0 0
76 NGT 18 Pcs 1 1 1
77 Nurse Cap Pcs 18 100 118 118 100 100
78 NGT 20 Pcs 0 0 0 0
79 Oxyflow Dewasa Pcs 0 0 0
80 Oxyflow Anak bh 0 0 0
81 Pencetan Antiseptik Pcs 0 0 0
82 Plesterin bulat Botol 0 0 0
83 Policlean Pcs 0 0 0
84 Polifix 5cm x 1m Botol 1 1 2 2 1 1
85 Povidone Lodida 300ml Larutan Botol 0 1 1 1 1 1
86 Povidone Lodida 30ml Larutan Pcs 0 0 0
87 PP tes Flabot 0 0 0
88 Ringer Lactat Larutan Infus Botol 4 5 9 1 8 5 5
89 Rivanol 300ml Pcs 0 0 0
90 Signa gel Pcs 1 1 2 0 2 1 1
91 Silk Braided 2/0 H-R 37mm/2/0( 3M ) pcs 0 0 0
92 Silk Braided 3/0 H-R 30mm/3/0( 2 M ) pcs 0 0 0
 93 Spuit 0,5 cc pcs 0 0 0
94 Spuit 1 cc pcs 5 5 5 0
95 Spuit 2,5cc pcs 2 2 2 0
96 Spuit 3cc Pcs 4 20 24 11 13 20 20
97 Spuit 5cc pcs 3 20 23 5 18 20 20
98 Spuit 10cc pcs 4 20 24 1 23 20 20
99 surgical blade Pcs 0 0 0
100 Spalak Pcs 0 2 2 2 2 2
101 Spuit 50cc Pcs 0 0 0
102 Threeway Infus tabung 0 0 0
103 Tabung Oksigen Besar tabung 0 0 0
104 Tabung Oksigen Sedang tabung 0 0 0
105 Tabung Oksigen Kecil Pcs 0 0 0
106 Ultra Fix pcs 1 1 1
107 UnderPad pcs 0 10 10 10 10 10
108 Urine Bag Fls 0 0 0
109 Wida DS 5% roll 0 0 0
110 Wing Needle 21 roll 0 0 0
111 Wing Needle 23 roll 0 0 0
112 Wing Needle 25 roll 0 0 0
113 Wing Needle 27 btl 0 0 0
114 Viorex Liquid Soap Botol 1 1 1
115 Viorex Desinfektan Pcs 1 1 1
116 Yurisol Pcs 0 2 2 2 2 2
117 Zink Oxide Tipe 0 0 0

Yang Menyerahkan, Mengetahui : Yang Menerima,

dang/Apoteker Penanggung Jawab Kepala Puskesmas Long Hubung Petugas Pustu

…………………………………… Kristianus Yulianto Madang, SKM ………………………………….

NIP 19840710 201505 1 001
 PEMERINTAHAN KABUPATEN MAHAKAM ULU
PUSAT KESEHATAN MASYARAKAT LONG HUBUNG
KECAMATAN LONG HUBUNG
Kode Pos 75566

PUSKESMAS LONG HUBUNG

PUSTU : Lutan PELAPORAN BULAN/PERIODE :APRIL-JUNI
KECAMATAN : LONG HUBUNG PERMINTAAN BULAN/PERIODE : JULI-SEP
KABUPATEN : MAHAKAM ULU
PROVINSI : KALIMANTAN TIMUR

STOK STOK
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN ED
AKHIR OPTIMAL
PERMINTAAN PEMBERIAN KET
/RUSAK

OBAT
1 Acylovir Krim 5% Tube 0 0
2 Acyclovir Tablet 200mg Tablet 0 0
3 Acylovir Tablet 400mg Tablet 300 300 600
4 Albendazole Suspensi Botol 0 0
5 Albendazole Tablet 400mg Tablet 0 0
6 Allopurinol Tablet 100mg Tablet 0 0
7 Ambroxol HCL Syr Botol 0 0
8 Ambroxol HCL 30mg Tablet 0 200 200
9 Aminopillin Inj 24mg/ml Ampul 5 5
10 Aminopillin Tablet 200mg Tablet 0 0
11 Amitriptilin Tablet 0 0
12 Amlodipine 10mg Tablet Tablet 10 150 160
13 Amlodipine 5 mg Tablet 15 15
14 Amoxcicillin Kapsul 250mg Kapsul 0 0
15 Amoxcicillin Tablet 500mg Tablet 30 200 230
16 Amoxcicillin Syrup kering 125mg/5ml Botol 2 10 12
17 Amoxoxicillin syrup 100 mg/dl botol 3 3
18 Amoxicillin Syrup Forte Botol 5 10 15
19 Anabion Syrup botol 0 5 5
20 Anaton Tablet 0 0
21 Anaton Syr Botol 0 0
22 Antasida Doen Tablet Kunyah Tablet 60 300 360
23 Antasida Syr Botol 3 20 23
24 Antifungi Doen salep Kombinasi Pot 5 5
25 Antihemaroid Supp 0 0
26 Asam Folat Tablet 0 0
27 Asam Mefenamat 250mg Kapsul 0 0
28 Asam Mefenamat 500mg Tablet 100 300 400
29 Asam Tranexamat 500mg Tablet 0 0
30 Asam Transeknamat Injeksi Ampul 0 0
31 Asetosal 100mg Tablet 0 0
32 Atrovin Injeksi Ampul 0 0
33 Bacitracin Polymixcin B Tube 0 0
34 Bedak Salisil Kotak 0 0
35 Betahistin Tablet 120 300 420
36 Bethametasone Krim 0.1% Tube 5 5 10
37 Bethametasone Cr (Skizone) Tube 5 5 10
38 Bisoprolol Fumarate 5mg Tablet 0 0
39 Bufacetine (Chlorampenicol Salep Kulit ) Tube 1 1 2
40 Burnasin Cream Tube 0 0
41 Carbamazepine 200mg Tablet 0 0
42 Catopril 12,5 mg Tablet 100 100 200
43 Catopril 25 mg Tablet 0 0
44 Captopril 50mg Tablet 0 0
45 Caviplek ( Multivitamin ) Tablet 0 0
46 Cefadroxil 500mg Kapsul 0 0
47 Cefadroxil Syr Botol 10 10 20
48 Cefadroxil syr Forte Botol 0 0
49 Cefixime 100mg Kapsul 0 0
50 Cefixime Syr Botol 0 0
51 Cefotaxime Injeksi 1,0 g Ampul 0 0
52 Cetirizin syr Botol 0 0
53 Chlorampenicol 250 mg Kapsul 0 0
54 Chlorampenicol Salep mata Pcs 0 0
55 Chlorampenicol syr Botol 3 3
56 Cimetidin 15mg Tablet 0 0
57 Ciprofloxacin 500mg Tablet 0 0
58 Citikolin injeksi Ampul 0 0
59 Clindamicin 150mg Kapsul 150 150 300
60 Clipodogrel Tablet 0 0
61 Clonidine Tablet 0 0
62 Clorpheniramine Maleat (CTM) Tablet 0 0
63 Clozapine 25mg Tablet 0 0
64 Codein 10mg Tablet 0 0
65 Combivent Fls 0 0
66 Cotrimokzasole 480 mg Tablet 75 200 275
67 Cotrimokzasole Pediatrik Tablet 0 0
68 Cotrimokzasole syr Botol 7 20 27
69 CPZ 100 mg Tablet 0 0
70 CPZ 25 mg Tablet 0 0
71 Decacetine Tetes Mata Botol 0 0
72 Dexametasone Injeksi Ampul 4 4
73 Dexametasone Tablet 0,5mg Tablet 0 0
74 Diazepam Injeksi Ampul 0 0
75 Diazepam Tablet Tablet 0 0
76 Digoxin Tablet Tablet 0 0
77 Dimenhydrinate Tablet 50mg Tablet 110 100 210
78 Dipenhydramine Injeksi Ampul 0 0
79 Diklofenak sodium 50mg Tablet 0 0
80 Diklofenak sodium 25mg Tablet 100 100 200
81 Domperidone Syrup Botol 2 5 7
82 Domperidone Tablet 10mg Tablet 240 240
83 Doxyciclin Tablet Tablet 0 0
84 Ducolax (bisakodil) Supp Supp 0 0
85 Epinefrine Injeksi 0,1% Ampul 0 0
86 Ergotamine-Cafein Tablet Tablet 0 0
87 Erythromycin Syrup Kering Botol 0 0
88 Erytromicin 250mg Kapsul 200 100 300
89 Erytromisin 500mg Kapsul 0 0
90 Fenobarbital Injeksi Ampul 0 0
91 Fenobarbital 30 mg Kapsul 0 0
92 Ferrous Sulfate Tablet 0 0
93 Furosemide Injeksi Ampul 0 0
94 Furosemide Tablet 40mg Tablet 100 100
95 Folid Acid Tablet 50 50
96 Garam Oralit Serbuk sachet 16 16
97 Gavistal Drop Botol 3 3
98 Gentamicin 40mg Injeksi Ampul 0 0
99 Gentamicin Salep Kulit 0,1% Tube 0 0
100 Gentamisin Tetes Mata Botol 4 4
101 Gentamisin Salep mata Tube 0 0
102 Gentian Violet Larutan Botol 0 0
103 Glibenclamida Tablet 5mg Tablet 50 100 150
104 Glicab Tablet 0 0
105 Glimepirid 1 mg Tablet 0 0
106 Gliseril guaikolat 100mg(GG) Tablet 0 0
107 Gradiab (Metformin 500mg) Tablet 0 0
108 Griseofulvin 125mg Tablet Tablet 90 90
109 Guanistreep syr Botol 0 0
110 Haloperidol 5mg Tablet 0 0
111 Hidroclortiazid 25mg Tablet 0 0
112 Hidrocortisone Krim 2,5% Tube 0 0
113 Hustab (Bromheksin) Tablet 0 0
114 Ibuprofen Suspensi ( Salfenal ) Botol 2 6 8
115 Ibuprofen Tablet 200mg Tablet 0 200 200
116 Ibuprofen Tablet 400mg Tablet 10 10
117 Illiadin Botol 0 0
118 ISDN Tablet 0 0
119 Kalsium Laktat 500mg Tablet 0 0
120 Ketokonazole Krim Tube 0 0
121 Ketokonazole Tablet Tablet 320 200 520
122 Ketorolac Injeksi Ampul 0 0
123 Levopar Tablet Tablet 0 0
124 Lidocain HCL Compositum Inj Ampul 34 30 64
125 Lisinopril Dihydrate Tablet 100 100
126 Lodecon Batuk Flu Tablet 0 0
127 Loperamide HCI 2 mg Tablet 0 0
128 Loratadine Tablet 10mg Tablet 200 50 250
129 Mebendazole Syrup Botol 0 0
130 Metformin Tablet Tablet 0 0
131 Methilergometrine Maleat Injeksi Ampul 0 0
132 Methilergometrine Tablet Tablet 0 0
133 Methilprednisolone Tablet 0 0
134 Methocloperamide 10mg Tablet 0 0
135 Metochloperamide 5mg Tablet 0 0
136 Metronidazole Tablet 250 mg Tablet 100 100 200
137 Metronidazole Tablet 500mg Tablet 15 15
138 Metronidazole Syr Botol 0 0
139 Metronidazole Infus Botol 0 0
140 Miconazole Krim Tube 2 5 7
141 Myorin Serbuk Btl 1 1 2
142 N. Acetylsistein Kapsul 720 720 1440
143 Natrium Diklofenak 50mg Tablet Tablet 0 0
144 New Antides (Attapulgit) Tablet 0 0
145 Neo Kaominal Syr Botol 0 0
146 Nifedipine Tablet 10mg Tablet 20 20
147 Nistatin Tablet Salut 500.000 IU Tablet 35 35
148 Nistatin Tablet Vaginal 100.000 IU/g Supp 0
149 Novimag Tablet 0 0
150 Novagesic Tablet 0 0
151 Novadiar Syr Botol 0 0
152 OBH botol 8 10 18
153 Ofloxacime 400mg Tablet 0 0
154 Omeprazole Kapsul 20mg Kapsul 0 0
155 Ondansentron 4mg Tablet 0 0
156 Ondansentron Injeksi Ampul 0 0
157 Oxytetraciline Salep Kulit 3% Tube 0 0
158 Oxytetraciline Salep Mata 1% Tube 37 25 62
159 Oxytosine Injeksi Ampul 3 3
160 Paracetamol Drops Botol 0 0
161 Paracetamol Syrup (Novagesic) Botol 0 0
162 Paracetamol Tablet 500mg Tablet 300 300 600
163 Paracetamol Infus Botol 0 0
164 Pehavral ( Multivitamin ) Tablet 0 0
165 Phenitoin 100mg Tablet 0 0
166 Phenitoin inj Ampul 0 0
167 Phenol Glyserol tts telingga 10% Botol 0 0
168 Phytomenadion inj Ampul 10 10 20
169 Phytomenadion tab Tablet 150 150
170 Piracetam 1200mg Tablet 0 0
171 Piracetam Injeksi Ampul 0 0
172 Piridoksin Hcl inj Ampul 0 0
173 Prednisone Tablet 5mg Tablet 0 0
174 Primaquine Tablet Tablet 0 0
175 Propilitualiasil Tablet 0 0
176 Pularex Tablet Tablet 90 250 340
177 Pyrantel Suspensi Botol 0 0
178 Pyrantel Score Tablet 125mg Tablet 0 0
179 Pyrazinamide Tablet 0 0
180 Ranitidine Injeksi 25mg/2ml Ampul 0 0
181 Ranitidine Tablet 150mg Tablet 0 0
182 Risperidon 2mg Tablet 0 0
183 Salbutamol 2 mg Tablet -20 -20
184 Salbutamol 4 mg Tablet 115 100 215
185 Salbutamol syr Botol 0 0
186 Salep 2-4 kombinasi pot 0 0
187 Scabimide Cream Tube 0 0
188 Simvastatin Tablet 20mg Tablet 0 0
189 Simvastatin Tablet 10 mg Tablet 80 180 260
190 Skizonoate Injeksi Ampul 0 0
191 Solafluz syr ( Obat Batuk Pilek ) Botol 0 0
192 Solvitral Tablet 0 0
193 Stesolite supp(Diazepam) Supp 0 0
194 Sulfadoxime Primetamine Tablet 0 0
195 Tablet Tambah darah Tablet 50 150 200
196 Thiampenicol 500mg Kapsul 0 0
197 Ticomag Tablet Tablet 0 0
198 Tramadol inj Ampul 0 0
199 Trihexipenedil Tablet 0 0
200 Truvit syr ( Multivitamin ) Botol 0 0
201 Vermox ( Mebendazole ) Tablet 0 0
202 Ventolin Inhaler salbutamol Pcs 0 0
203 Vitamin B Complex Tablet Tablet 0 100 100
204 Vitamin B1 (Thiamin) Tablet 180 500 680
205 Vitamin B12 Tablet Tablet 120 300 420
206 Vitamin B12 Inj (Cianocobalamin) Ampul 0 0
207 Vitamin B6 (Piridoxsin) Tablet 200 400 600
Vitamin C 250 Tablet 0 300 300
208 Vitamin C 500 Tablet 100 200 300
209 Zink Tablet 200mg Tablet 150 200 350
210 Zink Kids Syr/Zirkum Kids Syr Botol 1 5 6

BMHP GUDANG OBAT PKM

1 Abocath 18 Pcs 0 0
2 Abocath 20 Pcs 0 0
3 Abocath 22 Pcs 0 0
4 Abocath 24 Pcs 8 10 18
5 Abocath 26 Pcs 0 0
6 Alkohol Swab Pcs 0 0
7 Alkohol 1000ml Botol 0 0
Alkohol 300ml Botol 3 3 6
8 Alkohol 100ml Botol 0 0
9 Apron pcs 0 0
10 AquaPro Injeksi Steril Flabot 0 0
11 Aseptan Liquid Botol 2 2 4
12 Bisturi no.12 Pcs 10 10
13 Bisturi no.15 Pcs 12 12
14 Bracket Handwash Pcs 0 0
15 Catgut Chromic 3/0 100m Pcs 0 0
16 Catgut Chromic 2/0 (3.5 Metric) Pcs 14 12 26
17 Catgut Chromic 3/0 HR-37 Pcs 4 4
18 Catgut Chromic 3/0 (3 Metric) Pcs 0 0
19 Cervical Colar Pcs 0 0
20 Catgut Plain 2/0 (3.5M) Pcs 0 0
21 Chateter No.18 Pcs 0 0
22 Chateter no. 14 Pcs 0 0
23 Chateter no. 16 Pcs 0 0
24 Dermafix 10 x 25 Pcs 0 0
25 Fixomull 10 x 5 Pcs 1 1
26 Fixomull 5 x 5 Pcs 1 1 2
27 Glukosa Larutan Infus 10% Fls 0 0
28 Glukosa Larutan Infus 5% Fls 0 0
29 Handscoon Steril No 7 Pasang 2 2
30 Handscon Sterill No. 7 1/2 Pasang 0 0
31 Handscon Steril Obgyn Pasang 2 2 4
32 Handscoon L Pcs 200 200 400
33 Handscoon M Pcs 220 200 420
34 Handscoon S Pcs 150 200 350
35 HerbalVit 19 botol 14 14 28
36 H2O2 Botol 0 0
37 Hidrogen Peroksida Pcs 2 2
38 Infuset Anak Pcs 3 3
39 Infuset Dewasa roll 0 0
40 Isopalster Pcs 0 0
41 Jarum Kulit No 12 Pcs 0 0
42 Jarum Kulit No 13 Gulung 1 1
43 Kapas 1000g Gulung 0 0
44 Kapas 250 gram roll 2 2 4
45 Kapas 500 gram pcs/kotak 1 1
46 Kasa Kotak steril 16 x 16 pcs/kotak 0 0
47 Kasa Kotak steril 18 x 22 pcs 7 5 12
48 Kasa 4m x 5cm roll 4 4
49 Kasa 4m x 10cm roll 0 0
50 Kasa 4m x 15cm roll 0 0
51 Kasa Hidrofil 2m x 80 cm roll 0 0
52 Kasa Hidrofil 40yard x 80 cm lembar 1 1 2
53 Kasa Kompres 40cmx 40cm lembar 0 0
54 Kertas Puyer Pcs 0 0
55 Klip Obat 13 x 8.7 Pcs 0 0
56 Klip Obat 10cmx7cm Pcs 0 0
57 Klip Obat 8cm x 5cm roll 0 0
58 Leukoplast 2.5 x 4.5 roll 3 2 5
59 Leukoplast 7.5 x 4.5 roll 1 1
60 Lisol 1 L Fls 0 0
61 Magnesium Sulfate Inj 20% Fls 0 0
62 Magnesium Sulfate Inj 40% Pcs 0 0
63 Masker Karet Pcs 0 0
64 Masker Tali Pcs 0 0
65 Masker Oksigen Dws Pcs 0 0
66 Masker Oksigen anak Pcs 0 0
67 Masker Oksigen Neonatus (Bayi) Pcs 0 0
68 Medical regulator Pcs 0 0
69 Mucus Extractor Fls 1 1
70 Natrium Klorida Larutan Infus 0,9% Pcs 2 2
71 Needle 23 pcs 10 10 20
72 Needle 24 Pcs 5 5
73 Needle 25 Pcs 0 0
74 NGT 14 Pcs 0 0
75 NGT 16 Pcs 0 0
76 NGT 18 Pcs 1 1
77 Nurse Cap Pcs 118 100 218
78 NGT 20 Pcs 0 0
79 Oxyflow Dewasa Pcs 0 0
80 Oxyflow Anak bh 0 0
81 Pencetan Antiseptik Pcs 0 0
82 Plesterin bulat Botol 0 0
83 Policlean Pcs 0 0
84 Polifix 5cm x 1m Botol 2 1 3
85 Povidone Lodida 300ml Larutan Botol 1 1 2
86 Povidone Lodida 30ml Larutan Pcs 0 0
87 PP tes Flabot 0 0
88 Ringer Lactat Larutan Infus Botol 8 5 13
89 Rivanol 300ml Pcs 0 0
90 Signa gel Pcs 2 1 3
91 Silk Braided 2/0 H-R 37mm/2/0( 3M ) pcs 0 0
92 Silk Braided 3/0 H-R 30mm/3/0( 2 M ) pcs 0 0
 93 Spuit 0,5 cc pcs 0 0
94 Spuit 1 cc pcs 0 0
95 Spuit 2,5cc pcs 0 0
96 Spuit 3cc Pcs 13 20 33
97 Spuit 5cc pcs 18 20 38
98 Spuit 10cc pcs 23 20 43
99 surgical blade Pcs 0 0
100 Spalak Pcs 2 2 4
101 Spuit 50cc Pcs 0 0
102 Threeway Infus tabung 0 0
103 Tabung Oksigen Besar tabung 0 0
104 Tabung Oksigen Sedang tabung 0 0
105 Tabung Oksigen Kecil Pcs 0 0
106 Ultra Fix pcs 1 1
107 UnderPad pcs 10 10 20
108 Urine Bag Fls 0 0
109 Wida DS 5% roll 0 0
110 Wing Needle 21 roll 0 0
111 Wing Needle 23 roll 0 0
112 Wing Needle 25 roll 0 0
113 Wing Needle 27 btl 0 0
114 Viorex Liquid Soap Botol 1 1
115 Viorex Desinfektan Pcs 1 1
116 Yurisol Pcs 2 2 4
117 Zink Oxide Tipe 0 0

Yang Menyerahkan, Mengetahui : Yang Menerima,

dang/Apoteker Penanggung Jawab Kepala Puskesmas Long Hubung Petugas Pustu

…………………………………… Kristianus Yulianto Madang, SKM ………………………………….

NIP 19840710 201505 1 001