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Obat Bulanan

This document is a report on the usage and request form for medicines (LPLPO) and disposable medical supplies for a community health center in Karimun, Riau Province, Indonesia for the month of January 2019. It lists 86 different medicines and medical supplies with details on initial stock, receipts, usage, damaged stock, remaining stock, optimal stock levels, requests, and notes. The goal is to track inventory and plan for appropriate stock levels and resupply needs.

Uploaded by

Ghaziah Hafiza
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
47 views136 pages

Obat Bulanan

This document is a report on the usage and request form for medicines (LPLPO) and disposable medical supplies for a community health center in Karimun, Riau Province, Indonesia for the month of January 2019. It lists 86 different medicines and medical supplies with details on initial stock, receipts, usage, damaged stock, remaining stock, optimal stock levels, requests, and notes. The goal is to track inventory and plan for appropriate stock levels and resupply needs.

Uploaded by

Ghaziah Hafiza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS :
KAB / KOTA : KARIMUN BULAN : JANUARI
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 5 5 0 5 0 -5
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 200 200 0 200 0 -200
5 Albendazol tablet TABLET 35 35 0 35 0 -35
6 Allopurinol tablet 100 mg TABLET 460 460 0 460 0 -460
7 Alopurinol tablet 300 mg TABLET 0 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 0 0 0 0 0
9 Ambroxol tablet 30 mg TABLET 0 0 0 0 0
10 Aminophillin injeksi AMPUL 0 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 120 120 0 120 0 -120
14 Amlodipin tablet 5 mg TABLET 0 0 0 0 0
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 10 10 1 9 1 -8
20 Amoxycillin tablet 500 mg TABLET 34 34 34 0 44 44
21 Ampicillin injeksi AMPUL 0 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0 0
26 Antalgin tablet 500 mg TABLET 90 90 40 50 52 2
27 Antasida DOEN Suspensi BOTOL 13 13 3 10 4 -6
28 Antasida DOEN tablet kunyah kombinasi TABLET 329 329 120 209 155 -54
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 2 2 0 2 0 -2
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 1 1
36 Artem Injeksi AMPUL 0 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 0 0 0 0 0
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 177 177 77 100 100 0
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0 0
42 Asam Folat 1 mg TABLET 0 0 0 0 0
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 109 109 109 0 141 141
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 1 1 0 1 0 -1
48 Asam traneksamat tablet 500 mg TABLET 20 20 0 20 0 -20
49 Asetosal tablet 100 mg TABLET 0 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 20 20 0 20 0 -20
61 Betametasone cream 0.1 % TUBE 2 2 1 1 0 1 1
62 Bisoprolol 5 mg TABLET 0 0 0 0 0
63 Bufacetin TUBE 0 0 0 0 0
64 Calsium Glukonas injeksi 10 % AMPUL 3 3 0 3 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 0 0 0 0 0
67 Captopril tablet 25 mg TABLET 320 320 110 210 142 -68
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 60 60 0 60 0 -60
70 Cefadroxil syrup BOTOL 1 1 0 1 0 -1
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0 0
78 Cetirizine syrup BOTOL 5 5 0 5 0 -5
79 Cetirizine tablet 10 mg TABLET 40 40 10 30 13 -17
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 100 100 50 50 65 15
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 50 50 10 40 13 -27
85 Combivent UDV inhalasi VIAL 0 0 0 0 0
86 Coparcetin tablet TABLET 200 200 160 40 207 167
87 Cyloserin 250 mg TABLET 0 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 4 4 0 4 0 -4
90 Deksamethasone tablet 0.5 mg TABLET 321 321 140 181 181 0
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 2 2 0 2 0 -2
96 Digoxin 0.25 mg TABLET 0 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 1 1 1 0 1 1
100 Domperidon tablet 10 mg TABLET 0 0 0 0 0
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 2 2 0 2 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 100 100 0 100 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 0 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 0 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 2 2 0 1 1 0 -1
112 Ethambutol 400 mg TABLET 0 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 76 76 16 60 21 -39
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 0 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 2 2 2 0 3 3
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0 0
126 Garam Oralit SASE 16 16 10 6 13 7
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 1 1 1 0 1 1
129 Gentamisin tetes mata 0.3% BOTOL 6 6 0 6 0 -6
130 Gentian violet larutan 1% BOTOL 9 9 0 9 0 -9
131 Glibenclamide tablet 5 mg TABLET 20 20 0 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 4 4 0 1 3 0 -3
137 GOM Tetes Oral BOTOL 0 0 0 0 0
138 Griseofulvin 500 mg TABLET 0 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 12 12 2 10 3 -7
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 2 2 0 2 0 -2
148 Ibu profen tablet 200 mg TABLET 0 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 0 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 160 160 120 40 155 115
156 Kanamicin injeksi VIAL 0 0 0 0 0
157 Ketokonazole cream 2 % TUBE 5 5 0 5 0 -5
158 Ketokonazole tablet 200 mg TABLET 250 250 0 250 0 -250
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 0 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 3 3 3 0 4 4
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 10 10 0 10 0 -10
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 0 0 0 0 0
166 Klorokuin 150 mg TABLET 0 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 5 5 0 5 0 -5
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 0 0 0 0 0
176 Lamprene tablet 100mg TABLET 0 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 6 6 4 2 5 3
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0 0
181 Loperamide 2 mg TABLET 0 0 0 0 0
182 Loratadine tablet TABLET 0 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 5 5 0 5 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0 0
191 Metil ergometrin injeksi AMPUL 3 3 0 3 0 -3
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 10 90 13 -77
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 3 3 1 2 1 -1
196 Metoclopramide sirup 5mg / 5ml BOTOL 2 2 2 0 3 3
197 Metoclopramide tablet 10 mg TABLET 100 100 20 80 26 -54
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 170 170 0 170 0 -170
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0 0
204 Miconazole cream salap 2% TUBE 2 2 0 2 0 -2
205 Mineral mix SASE 0 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0 0
207 Molexflu syrup BOTOL 3 3 3 0 4 4
208 Molexflu Tablet TABLET 0 0 0 0 0
209 Moxifloxacin TABLET 0 0 0 0 0
210 Multivitamin syrup BOTOL 7 7 2 5 3 -2
211 Multivitamin Tablet TABLET 0 0 0 0 0
212 Natrium Bicarbonat TABLET 0 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 160 160 100 60 129 69
214 Natrium diklofenak tablet 50 mg TABLET 90 90 65 25 84 59
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 3 3 0 3 0 -3
218 Neo entrostop TABLET 0 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 15 15 2 13 3 -10
234 Omeprazole capsul 20 mg CAPSUL 20 20 0 20 0 -20
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0 0
242 Paracetamol drop BOTOL 0 0 0 0 0
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 11 11 2 9 3 -6
245 Paracetamol tablet 100 mg TABLET 0 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 80 80 80 0 103 103
247 Pas-Na 5.52g SACHET 0 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 70 70 0 70 0 -70
254 Piroxicam tablet 20 mg TABLET 90 90 0 90 0 -90
255 Prednison tablet 5 mg TABLET 220 220 0 220 0 -220
256 Primakuin tablet TABLET 0 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 3 3 2 1 3 2
265 Ranitidin tablet 150 mg TABLET 180 180 40 140 52 -88
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 59 59 4 55 5 -50
268 Rifampicin tablet 300 mg TABLET 0 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 16 16 2 1 13 3 -10
272 Risperidon tablet TABLET 0 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 20 20 20 0 26 26
276 Salbutamoltablet 4 mg TABLET 318 318 50 268 65 -203
277 Salep 2 - 4 kombinasi POT 2 2 0 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0 0
279 Scabisid TUBE 0 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 3 3 2 1 3 2
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0 0
286 Sianokobalamin Tablet TABLET 100 100 20 80 26 -54
287 Simvastatin 10 mg TABLET 0 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 100 100 0 100 0 -100
289 Tablet tambah Darah TABLET 395 395 300 95 388 293
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 100 100 60 40 78 38
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 418 418 170 248 220 -28
299 Xylocain Jelly 2% TUBE 0 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0 0
301 Zink syrup BOTOL 6 6 1 5 1 -4
302 Zink tablet TABLET 210 210 0 210 0 -210
BAHAN MEDIS HABIS PAKAI 0
303 Abate 25 kg KOLI 0 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0 0
311 Alat suntik 3 ml SET 0 0 0 0 0
312 Alat suntik 5 ml SET 7 7 7 0 9 9
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0 0
314 Alkohol swap 2 % PCS 197 197 20 177 26 -151
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0 0
324 Blood lancet BOX 0 0 0 0 0
325 Body protective KANTONG 0 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 1 1 1 0 1 1
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 1 1 0 1 0 -1
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0 0
340 Cresotin Paste POT 0 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 0 1 0 -1
353 Etil klorida BOTOL 0 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0 0
357 Folley catheter 18 G PCS 2 2 1 1 1 0
358 Folley catheter 20 G PCS 0 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0 0
364 Infuset anak SET 2 2 0 2 0 -2
365 Infuset dewasa SET 2 2 2 0 3 3
366 IV catheter 18 G PCS 8 8 2 5 1 3 2
367 IV catheter 20 G PCS 12 12 1 3 8 1 -7
368 IV catheter 22 G PCS 13 13 0 1 12 0 -12
369 IV catheter 24 G PCS 0 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 4 4 2 2 3 1
376 Kassa pembalut 2 m x 80 cm ROL 4 4 2 2 3 1
377 Kassa pembalut hidrofil 4 m x 10 m ROL 10 10 0 10 0 -10
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 2 2 1 1 1 0
381 Kertas EKG ROL 0 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0 0
385 Lens paper PCS 0 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0 0
390 Lisol BOTOL 0 0 0 0 0
391 Mantoux test VIAL 0 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0 0
393 Masker N 95 PCS 54 54 2 52 3 -49
394 Masker Tie On KOTAK 0 0 0 0 0
395 Metanol BOTOL 0 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0 0
400 Mikroskop SET 0 0 0 0 0
401 Mitella BUAH 0 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0 0
403 NGT 12 PCS 0 0 0 0 0
404 NGT 14 PCS 0 0 0 0 0
405 NGT 16 PCS 0 0 0 0 0
406 NGT 8 PCS 0 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0 0

409 Objek glass KOTAK 0 0 0 0 0


410 Oncoprobe TEST 0 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 0 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 0 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 0 1 0 -1
416 Pembalut gips ROL 0 0 0 0 0
417 Pemutih BOTOL 0 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0 0
429 Pot sputum POT 0 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0 0
438 Safety Box DUS 0 0 0 0 0
439 Salisyl bedak KOTAK 15 15 0 12 3 0 -3
440 Sarung tangan gynaekologi PCS 4 4 0 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0 0
443 Sarung Tangan S KOTAK 0 0 0 0 0
444 Sarung tangan steril 6 PASANG 0 0 0 0 0
445 Sarung tangan steril 6.5 PCS 6 6 3 3 4 1
446 Sarung tangan steril 7 PCS 5 5 2 3 3 0
447 Sarung tangan steril 7.5 PASANG 0 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0 0
449 SD Sifilis TEST 0 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0 0
452 Silk 2/0 PCS 0 0 0 0 0
453 Silk 3/0 PCS 0 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0 0
456 Slide box BOX 0 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0 0
470 Test gula darah BOX 0 0 0 0 0
471 Test kolesterol PCS 0 0 0 0 0
472 Test kolesterol BOX 0 0 0 0 0
473 Tissu gulung ROL 0 0 0 0 0
474 Triline HIV TEST 0 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0 0

477 Urine bag SET 3 3 0 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 0 0 0 0 0
482 Yodium povidone 30 ml BOTOL 0 0 0 0 0
483 Yodium povidone 300 ml BOTOL 1 1 1 0 1 1
OBAT TAMBAHAN

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

75 0 53 75
Mengetahui, Mengetahui, Januari 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA)


NIP. 19760523 200604 2 026
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS : PUSTU SANGLAR
KAB / KOTA : KARIMUN BULAN : FEBRUARI
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 5 5 5 0 -5
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 200 200 200 0 -200
5 Albendazol tablet TABLET 35 35 35 0 -35
6 Allopurinol tablet 100 mg TABLET 460 460 20 440 26 -414
7 Alopurinol tablet 300 mg TABLET 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 0 0 0 0
9 Ambroxol tablet 30 mg TABLET 0 0 0 0
10 Aminophillin injeksi AMPUL 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 120 120 120 0 -120
14 Amlodipin tablet 5 mg TABLET 0 0 0 0
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 10 10 1 9 1 -8
20 Amoxycillin tablet 500 mg TABLET 34 100 134 134 0 173 173
21 Ampicillin injeksi AMPUL 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0
26 Antalgin tablet 500 mg TABLET 90 90 90 0 -90
27 Antasida DOEN Suspensi BOTOL 13 2 15 15 0 -15
28 Antasida DOEN tablet kunyah kombinasi TABLET 329 200 529 140 389 181 -208
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 2 2 2 0 -2
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 -1
36 Artem Injeksi AMPUL 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 0 0 0 0
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 177 100 277 90 187 116 -71
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0
42 Asam Folat 1 mg TABLET 0 0 0 0
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 109 100 209 209 0 -209
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 1 1 1 0 -1
48 Asam traneksamat tablet 500 mg TABLET 20 20 20 0 -20
49 Asetosal tablet 100 mg TABLET 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 20 20 20 0 -20
61 Betametasone cream 0.1 % TUBE 2 2 4 1 3 0 -3
62 Bisoprolol 5 mg TABLET 0 0 0 0
63 Bufacetin TUBE 0 0 0 0
64 Calsium Glukonas injeksi 10 % AMPUL 3 3 3 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 0 0 0 0
67 Captopril tablet 25 mg TABLET 320 150 470 30 440 39 -401
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 60 60 60 0 -60
70 Cefadroxil syrup BOTOL 1 1 1 0 -1
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0
78 Cetirizine syrup BOTOL 5 5 5 0 -5
79 Cetirizine tablet 10 mg TABLET 40 40 40 0 -40
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 100 20 120 10 110 13 -97
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 50 50 50 0 -50
85 Combivent UDV inhalasi VIAL 0 0 0 0
86 Coparcetin tablet TABLET 100 100 60 40 78 38
87 Cyloserin 250 mg TABLET 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 4 4 4 0 -4
90 Deksamethasone tablet 0.5 mg TABLET 321 321 70 251 90 -161
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 2 2 2 0 -2
96 Digoxin 0.25 mg TABLET 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 1 1 1 0 -1
100 Domperidon tablet 10 mg TABLET 0 0 0 0
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 2 2 2 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 100 100 100 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 2 2 1 1 0 -1
112 Ethambutol 400 mg TABLET 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 76 76 76 0 -76
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 2 2 1 1 1 0
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0
126 Garam Oralit SASE 16 16 16 0 21 21
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 1 2 3 3 0 -3
129 Gentamisin tetes mata 0.3% BOTOL 6 6 1 5 1 -4
130 Gentian violet larutan 1% BOTOL 9 9 9 0 -9
131 Glibenclamide tablet 5 mg TABLET 20 20 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 4 4 1 3 0 -3
137 GOM Tetes Oral BOTOL 0 0 0 0
138 Griseofulvin 500 mg TABLET 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 12 12 12 0 -12
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 2 2 2 0 -2
148 Ibu profen tablet 200 mg TABLET 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 160 100 260 70 190 90 -100
156 Kanamicin injeksi VIAL 0 0 0 0
157 Ketokonazole cream 2 % TUBE 5 5 3 2 4 2
158 Ketokonazole tablet 200 mg TABLET 250 250 20 230 26 -204
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 3 3 1 2 1 -1
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 10 10 2 8 3 -5
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 0 0 0 0
166 Klorokuin 150 mg TABLET 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 5 5 5 0 -5
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 0 0 0 0
176 Lamprene tablet 100mg TABLET 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 6 3 9 9 0 -9
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0
181 Loperamide 2 mg TABLET 0 0 0 0
182 Loratadine tablet TABLET 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 5 5 5 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0
191 Metil ergometrin injeksi AMPUL 3 3 3 0 -3
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 100 0 -100
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 3 2 5 5 0 -5
196 Metoclopramide sirup 5mg / 5ml BOTOL 2 2 2 0 -2
197 Metoclopramide tablet 10 mg TABLET 100 100 10 90 13 -77
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 170 170 20 150 26 -124
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0
204 Miconazole cream salap 2% TUBE 2 2 2 0 -2
205 Mineral mix SASE 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0
207 Molexflu syrup BOTOL 3 3 3 0 -3
208 Molexflu Tablet TABLET 0 0 0 0
209 Moxifloxacin TABLET 0 0 0 0
210 Multivitamin syrup BOTOL 7 7 7 0 -7
211 Multivitamin Tablet TABLET 0 0 0 0
212 Natrium Bicarbonat TABLET 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 160 50 210 60 150 78 -72
214 Natrium diklofenak tablet 50 mg TABLET 90 100 190 190 0 -190
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 3 3 3 0 -3
218 Neo entrostop TABLET 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 15 15 1 14 1 -13
234 Omeprazole capsul 20 mg CAPSUL 20 20 20 0 -20
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0
242 Paracetamol drop BOTOL 3 3 3 0 -3
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 11 11 1 10 1 -9
245 Paracetamol tablet 100 mg TABLET 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 80 150 230 120 110 155 45
247 Pas-Na 5.52g SACHET 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 70 70 70 0 -70
254 Piroxicam tablet 20 mg TABLET 90 90 10 80 13 -67
255 Prednison tablet 5 mg TABLET 220 220 220 0 -220
256 Primakuin tablet TABLET 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 3 3 3 0 -3
265 Ranitidin tablet 150 mg TABLET 180 180 50 130 65 -65
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 59 59 2 57 3 -54
268 Rifampicin tablet 300 mg TABLET 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 16 16 1 1 14 1 -13
272 Risperidon tablet TABLET 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 20 100 120 10 110 13 -97
276 Salbutamoltablet 4 mg TABLET 318 318 90 228 116 -112
277 Salep 2 - 4 kombinasi POT 2 2 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0
279 Scabisid TUBE 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 3 2 5 5 0 -5
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0
286 Sianokobalamin Tablet TABLET 100 100 100 0 -100
287 Simvastatin 10 mg TABLET 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 100 100 100 0 -100
289 Tablet tambah Darah TABLET 395 300 695 240 455 310 -145
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 100 50 150 10 140 13 -127
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 418 418 100 318 129 -189
299 Xylocain Jelly 2% TUBE 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0
301 Zink syrup BOTOL 6 6 1 5 1 -4
302 Zink tablet TABLET 210 210 70 140 90 -50
BAHAN MEDIS HABIS PAKAI
303 Abate 25 kg KOLI 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0
311 Alat suntik 3 ml SET 0 0 0 0
312 Alat suntik 5 ml SET 7 10 17 5 12 6 -6
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0
314 Alkohol swap 2 % PCS 197 197 25 172 32 -140
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0
324 Blood lancet BOX 0 0 0 0
325 Body protective KANTONG 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 1 1 2 2 0 -2
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 1 1 1 0 -1
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0
340 Cresotin Paste POT 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 1 0 -1
353 Etil klorida BOTOL 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0
357 Folley catheter 18 G PCS 2 2 2 0 -2
358 Folley catheter 20 G PCS 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0
364 Infuset anak SET 2 2 2 0 -2
365 Infuset dewasa SET 2 2 1 1 1 0
366 IV catheter 18 G PCS 8 8 5 3 0 -3
367 IV catheter 20 G PCS 12 12 1 3 8 1 -7
368 IV catheter 22 G PCS 13 13 1 1 11 1 -10
369 IV catheter 24 G PCS 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 4 1 5 1 4 1 -3
376 Kassa pembalut 2 m x 80 cm ROL 4 1 5 5 0 -5
377 Kassa pembalut hidrofil 4 m x 10 m ROL 10 10 10 0 -10
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 2 2 2 0 -2
381 Kertas EKG ROL 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0
385 Lens paper PCS 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0
390 Lisol BOTOL 0 0 0 0
391 Mantoux test VIAL 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0
393 Masker N 95 PCS 54 54 54 0 -54
394 Masker Tie On KOTAK 0 0 0 0
395 Metanol BOTOL 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0
400 Mikroskop SET 0 0 0 0
401 Mitella BUAH 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0
403 NGT 12 PCS 0 0 0 0
404 NGT 14 PCS 0 0 0 0
405 NGT 16 PCS 0 0 0 0
406 NGT 8 PCS 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0

409 Objek glass KOTAK 0 0 0 0


410 Oncoprobe TEST 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 1 0 -1
416 Pembalut gips ROL 0 0 0 0
417 Pemutih BOTOL 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0
429 Pot sputum POT 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0
438 Safety Box DUS 0 0 0 0
439 Salisyl bedak KOTAK 15 15 12 3 0 -3
440 Sarung tangan gynaekologi PCS 4 4 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0
443 Sarung Tangan S KOTAK 0 0 0 0
444 Sarung tangan steril 6 PASANG 0 0 0 0
445 Sarung tangan steril 6.5 PCS 6 6 2 4 3 -1
446 Sarung tangan steril 7 PCS 5 5 5 0 -5
447 Sarung tangan steril 7.5 PASANG 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0
449 SD Sifilis TEST 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0
452 Silk 2/0 PCS 0 0 0 0
453 Silk 3/0 PCS 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0
456 Slide box BOX 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0
470 Test gula darah BOX 0 0 0 0
471 Test kolesterol PCS 0 0 0 0
472 Test kolesterol BOX 0 0 0 0
473 Tissu gulung ROL 0 0 0 0
474 Triline HIV TEST 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0

477 Urine bag SET 3 3 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 0 0 0 0
482 Yodium povidone 30 ml BOTOL 0 0 0 0
483 Yodium povidone 300 ml BOTOL 1 1 1 0 -1
OBAT TAMBAHAN

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

47 0 32 47
Mengetahui, Mengetahui, Februari 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA)


NIP. 19760523 200604 2 026
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS : PUSTU SANGLAR
KAB / KOTA : KARIMUN BULAN : MARET
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 5 5 5 0 -5
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 200 200 200 0 -200
5 Albendazol tablet TABLET 35 35 35 0 -35
6 Allopurinol tablet 100 mg TABLET 440 440 10 440 13 -427
7 Alopurinol tablet 300 mg TABLET 0 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 0 5 5 5 0 -5
9 Ambroxol tablet 30 mg TABLET 0 100 100 60 40 78 38
10 Aminophillin injeksi AMPUL 0 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 120 30 150 20 130 26 -104
14 Amlodipin tablet 5 mg TABLET 0 30 30 30 0 -30
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 9 9 9 0 -9
20 Amoxycillin tablet 500 mg TABLET 0 0 0 34 34
21 Ampicillin injeksi AMPUL 0 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0 0
26 Antalgin tablet 500 mg TABLET 90 100 190 20 170 26 -144
27 Antasida DOEN Suspensi BOTOL 15 15 15 0 -15
28 Antasida DOEN tablet kunyah kombinasi TABLET 389 100 489 30 459 39 -420
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 2 2 2 0 -2
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 -1
36 Artem Injeksi AMPUL 0 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 0 100 100 100 0 -100
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 187 100 287 20 267 26 -241
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0 0
42 Asam Folat 1 mg TABLET 0 100 100 100 0 -100
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 209 100 309 110 199 142 -57
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 1 1 1 0 -1
48 Asam traneksamat tablet 500 mg TABLET 20 20 20 0 -20
49 Asetosal tablet 100 mg TABLET 0 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 20 20 20 0 -20
61 Betametasone cream 0.1 % TUBE 3 3 1 2 0 -2
62 Bisoprolol 5 mg TABLET 0 0 0 0 0
63 Bufacetin TUBE 0 0 0 0 0
64 Calsium Glukonas injeksi 10 % AMPUL 0 0 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 0 100 100 100 0 -100
67 Captopril tablet 25 mg TABLET 440 440 80 360 103 -257
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 60 60 60 0 -60
70 Cefadroxil syrup BOTOL 1 1 1 0 -1
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0 0
78 Cetirizine syrup BOTOL 5 5 5 0 -5
79 Cetirizine tablet 10 mg TABLET 40 40 40 0 -40
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 110 110 110 0 -110
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 50 50 50 0 -50
85 Combivent UDV inhalasi VIAL 0 0 0 0 0
86 Coparcetin tablet TABLET 40 50 90 40 50 52 2
87 Cyloserin 250 mg TABLET 0 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 4 4 4 0 -4
90 Deksamethasone tablet 0.5 mg TABLET 251 100 351 140 211 181 -30
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 2 2 2 0 -2
96 Digoxin 0.25 mg TABLET 0 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 1 1 1 0 -1
100 Domperidon tablet 10 mg TABLET 0 0 0 0 0
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 0 0 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 0 0 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 1 1 1 0 0 0
112 Ethambutol 400 mg TABLET 0 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 76 76 76 0 -76
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 0 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 1 1 1 0 -1
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0 0
126 Garam Oralit SASE 0 0 0 0 0
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 3 3 3 0 -3
129 Gentamisin tetes mata 0.3% BOTOL 5 5 5 0 -5
130 Gentian violet larutan 1% BOTOL 9 9 1 8 1 -7
131 Glibenclamide tablet 5 mg TABLET 20 20 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 3 3 1 2 0 -2
137 GOM Tetes Oral BOTOL 0 3 3 3 0 -3
138 Griseofulvin 500 mg TABLET 0 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 12 12 12 0 -12
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 2 2 2 0 -2
148 Ibu profen tablet 200 mg TABLET 0 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 190 190 70 120 90 -30
156 Kanamicin injeksi VIAL 0 0 0 0 0
157 Ketokonazole cream 2 % TUBE 2 2 2 0 -2
158 Ketokonazole tablet 200 mg TABLET 230 230 230 0 -230
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 2 2 2 0 -2
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 8 8 2 6 3 -3
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 0 100 100 100 0 -100
166 Klorokuin 150 mg TABLET 0 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 5 5 5 0 -5
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 0 0 0 0 0
176 Lamprene tablet 100mg TABLET 0 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 9 9 9 0 -9
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0 0
181 Loperamide 2 mg TABLET 0 0 0 0 0
182 Loratadine tablet TABLET 0 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 0 0 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0 0
191 Metil ergometrin injeksi AMPUL 3 3 3 0 -3
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 100 0 -100
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 5 5 5 0 -5
196 Metoclopramide sirup 5mg / 5ml BOTOL 2 2 1 1 1 0
197 Metoclopramide tablet 10 mg TABLET 90 90 90 0 -90
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 150 150 20 130 26 -104
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0 0
204 Miconazole cream salap 2% TUBE 2 2 2 0 -2
205 Mineral mix SASE 0 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0 0
207 Molexflu syrup BOTOL 3 3 1 2 1 -1
208 Molexflu Tablet TABLET 0 150 150 10 140 13 -127
209 Moxifloxacin TABLET 0 0 0 0 0
210 Multivitamin syrup BOTOL 7 7 2 5 3 -2
211 Multivitamin Tablet TABLET 0 0 0 0 0
212 Natrium Bicarbonat TABLET 0 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 150 200 350 10 340 13 -327
214 Natrium diklofenak tablet 50 mg TABLET 190 100 290 10 280 13 -267
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 3 3 3 0 -3
218 Neo entrostop TABLET 0 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 14 14 1 13 1 -12
234 Omeprazole capsul 20 mg CAPSUL 20 20 20 0 -20
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0 0
242 Paracetamol drop BOTOL 3 3 1 2 1 -1
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 10 3 13 1 12 1 -11
245 Paracetamol tablet 100 mg TABLET 0 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 110 100 210 100 110 129 19
247 Pas-Na 5.52g SACHET 0 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 70 70 10 60 13 -47
254 Piroxicam tablet 20 mg TABLET 80 80 30 50 39 -11
255 Prednison tablet 5 mg TABLET 220 220 220 0 -220
256 Primakuin tablet TABLET 0 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 3 3 3 0 -3
265 Ranitidin tablet 150 mg TABLET 130 130 130 0 -130
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 57 2 59 59 0 -59
268 Rifampicin tablet 300 mg TABLET 0 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 14 14 1 1 12 1 -11
272 Risperidon tablet TABLET 0 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 110 110 10 100 13 -87
276 Salbutamoltablet 4 mg TABLET 228 228 90 138 116 -22
277 Salep 2 - 4 kombinasi POT 2 2 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0 0
279 Scabisid TUBE 0 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 5 5 5 0 -5
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0 0
286 Sianokobalamin Tablet TABLET 100 100 10 90 13 -77
287 Simvastatin 10 mg TABLET 0 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 100 100 100 0 -100
289 Tablet tambah Darah TABLET 455 120 575 300 275 388 113
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 140 140 50 90 65 -25
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 318 100 418 136 282 176 -106
299 Xylocain Jelly 2% TUBE 0 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0 0
301 Zink syrup BOTOL 5 5 10 2 8 3 -5
302 Zink tablet TABLET 140 100 240 40 200 52 -148
BAHAN MEDIS HABIS PAKAI 0
303 Abate 25 kg KOLI 0 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0 0
311 Alat suntik 3 ml SET 0 20 20 1 19 1 -18
312 Alat suntik 5 ml SET 12 12 1 11 1 -10
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0 0
314 Alkohol swap 2 % PCS 172 172 172 0 -172
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0 0
324 Blood lancet BOX 0 0 0 0 0
325 Body protective KANTONG 0 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 2 2 2 0 -2
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 1 1 1 0 -1
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0 0
340 Cresotin Paste POT 0 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 1 0 -1
353 Etil klorida BOTOL 0 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0 0
357 Folley catheter 18 G PCS 2 2 2 0 -2
358 Folley catheter 20 G PCS 0 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0 0
364 Infuset anak SET 2 2 2 0 -2
365 Infuset dewasa SET 1 1 1 0 1 1
366 IV catheter 18 G PCS 3 3 3 0 0 0
367 IV catheter 20 G PCS 8 8 1 3 4 1 -3
368 IV catheter 22 G PCS 11 11 1 10 0 -10
369 IV catheter 24 G PCS 0 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 4 4 1 3 1 -2
376 Kassa pembalut 2 m x 80 cm ROL 5 5 5 0 -5
377 Kassa pembalut hidrofil 4 m x 10 m ROL 10 10 10 0 -10
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 2 2 2 0 -2
381 Kertas EKG ROL 0 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0 0
385 Lens paper PCS 0 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0 0
390 Lisol BOTOL 0 0 0 0 0
391 Mantoux test VIAL 0 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0 0
393 Masker N 95 PCS 54 54 54 0 -54
394 Masker Tie On KOTAK 0 0 0 0 0
395 Metanol BOTOL 0 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0 0
400 Mikroskop SET 0 0 0 0 0
401 Mitella BUAH 0 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0 0
403 NGT 12 PCS 0 0 0 0 0
404 NGT 14 PCS 0 0 0 0 0
405 NGT 16 PCS 0 0 0 0 0
406 NGT 8 PCS 0 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0 0

409 Objek glass KOTAK 0 0 0 0 0


410 Oncoprobe TEST 0 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 1 0 -1
416 Pembalut gips ROL 0 0 0 0 0
417 Pemutih BOTOL 0 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0 0
429 Pot sputum POT 0 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0 0
438 Safety Box DUS 0 0 0 0 0
439 Salisyl bedak KOTAK 3 3 3 0 0 0
440 Sarung tangan gynaekologi PCS 4 4 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0 0
443 Sarung Tangan S KOTAK 0 0 0 0 0
444 Sarung tangan steril 6 PASANG 0 0 0 0 0
445 Sarung tangan steril 6.5 PCS 4 4 4 0 -4
446 Sarung tangan steril 7 PCS 5 5 5 0 -5
447 Sarung tangan steril 7.5 PASANG 0 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0 0
449 SD Sifilis TEST 0 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0 0
452 Silk 2/0 PCS 0 0 0 0 0
453 Silk 3/0 PCS 0 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0 0
456 Slide box BOX 0 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0 0
470 Test gula darah BOX 0 0 0 0 0
471 Test kolesterol PCS 0 0 0 0 0
472 Test kolesterol BOX 0 0 0 0 0
473 Tissu gulung ROL 0 0 0 0 0
474 Triline HIV TEST 0 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0 0

477 Urine bag SET 3 3 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 0 0 0 0 0
482 Yodium povidone 30 ml BOTOL 0 0 0 0 0
483 Yodium povidone 300 ml BOTOL 1 1 1 0 -1
OBAT TAMBAHAN

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

56 0 34 56
Mengetahui, Mengetahui, Maret 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA.A.Md.Keb)


NIP. 19760523 200604 2 026
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS : PUSTU SANGLAR
KAB / KOTA : KARIMUN BULAN : APRIL
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 5 5 5 0 -5
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 200 200 200 0 -200
5 Albendazol tablet TABLET 35 35 10 25 13 -12
6 Allopurinol tablet 100 mg TABLET 440 440 10 430 13 -417
7 Alopurinol tablet 300 mg TABLET 0 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 5 3 8 2 6 3 -3 5
9 Ambroxol tablet 30 mg TABLET 40 100 140 80 60 103 43 200
10 Aminophillin injeksi AMPUL 0 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 130 130 30 100 39 -61
14 Amlodipin tablet 5 mg TABLET 30 30 30 0 -30
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 9 5 14 4 10 5 -5
20 Amoxycillin tablet 500 mg TABLET 0 100 100 100 0 34 34 300
21 Ampicillin injeksi AMPUL 0 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0 0
26 Antalgin tablet 500 mg TABLET 170 100 270 80 190 103 -87
27 Antasida DOEN Suspensi BOTOL 15 15 2 13 3 -10
28 Antasida DOEN tablet kunyah kombinasi TABLET 459 100 559 100 459 129 -330
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 2 4 6 6 0 -6
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 -1
36 Artem Injeksi AMPUL 0 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 100 100 100 0 -100
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 267 267 100 167 129 -38 200
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0 0
42 Asam Folat 1 mg TABLET 100 100 100 0 -100
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 199 100 299 110 189 142 -47 200
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 1 1 1 0 -1
48 Asam traneksamat tablet 500 mg TABLET 20 20 20 0 -20
49 Asetosal tablet 100 mg TABLET 0 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 20 100 120 120 0 -120
61 Betametasone cream 0.1 % TUBE 2 3 5 5 0 -5
62 Bisoprolol 5 mg TABLET 0 0 0 0 0
63 Bufacetin TUBE 0 0 0 0 0 5
64 Calsium Glukonas injeksi 10 % AMPUL 0 0 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 100 100 200 10 190 13 -177
67 Captopril tablet 25 mg TABLET 360 360 50 310 65 -245
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 60 60 60 0 -60
70 Cefadroxil syrup BOTOL 1 1 1 0 -1
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0 0
78 Cetirizine syrup BOTOL 5 2 7 7 0 -7
79 Cetirizine tablet 10 mg TABLET 40 40 10 30 13 -17
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 110 110 10 100 13 -87
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 50 50 50 0 -50
85 Combivent UDV inhalasi VIAL 0 0 0 0 0
86 Coparcetin tablet TABLET 50 50 40 10 52 42 200
87 Cyloserin 250 mg TABLET 0 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 4 4 4 0 -4
90 Deksamethasone tablet 0.5 mg TABLET 211 100 311 80 231 103 -128
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 2 2 2 0 -2
96 Digoxin 0.25 mg TABLET 0 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 1 2 3 3 0 -3
100 Domperidon tablet 10 mg TABLET 0 100 100 100 0 -100
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 0 0 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 0 0 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 0 0 0 0 0
112 Ethambutol 400 mg TABLET 0 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 76 50 126 10 116 13 -103
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 0 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 1 1 1 0 1 1
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0 0
126 Garam Oralit SASE 0 10 10 10 0 13 13
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 3 2 5 5 0 -5
129 Gentamisin tetes mata 0.3% BOTOL 5 5 5 0 -5
130 Gentian violet larutan 1% BOTOL 8 2 10 10 0 -10
131 Glibenclamide tablet 5 mg TABLET 20 20 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 2 2 2 0 -2
137 GOM Tetes Oral BOTOL 3 3 3 0 -3
138 Griseofulvin 500 mg TABLET 0 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 12 5 17 2 15 3 -12
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 2 2 2 0 -2
148 Ibu profen tablet 200 mg TABLET 0 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 120 120 120 0 -120
156 Kanamicin injeksi VIAL 0 0 0 0 0
157 Ketokonazole cream 2 % TUBE 2 2 2 0 -2
158 Ketokonazole tablet 200 mg TABLET 230 230 230 0 0 0
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 2 3 5 5 0 -5
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 6 3 9 9 0 -9
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 100 100 200 60 140 78 -62
166 Klorokuin 150 mg TABLET 0 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 5 5 1 4 1 -3
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 0 2 2 2 0 -2
176 Lamprene tablet 100mg TABLET 0 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 9 9 3 6 4 -2
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0 0
181 Loperamide 2 mg TABLET 0 100 100 30 70 39 -31
182 Loratadine tablet TABLET 0 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 0 0 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0 0
191 Metil ergometrin injeksi AMPUL 3 3 3 0 -3
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 100 0 -100
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 5 5 5 0 -5
196 Metoclopramide sirup 5mg / 5ml BOTOL 1 1 1 0 -1
197 Metoclopramide tablet 10 mg TABLET 90 100 190 190 0 -190
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 130 130 130 0 -130
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0 0
204 Miconazole cream salap 2% TUBE 2 2 4 4 0 -4
205 Mineral mix SASE 0 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0 0
207 Molexflu syrup BOTOL 2 2 2 0 -2
208 Molexflu Tablet TABLET 140 140 140 0 -140
209 Moxifloxacin TABLET 0 0 0 0 0
210 Multivitamin syrup BOTOL 5 3 8 8 0 -8
211 Multivitamin Tablet TABLET 0 0 0 0 0
212 Natrium Bicarbonat TABLET 0 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 340 100 440 10 430 13 -417
214 Natrium diklofenak tablet 50 mg TABLET 280 280 40 240 52 -188
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 3 3 3 0 -3
218 Neo entrostop TABLET 0 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 13 13 2 11 3 -8
234 Omeprazole capsul 20 mg CAPSUL 20 60 80 80 0 -80
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0 0
242 Paracetamol drop BOTOL 2 2 2 0 -2
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 12 3 15 4 11 5 -6
245 Paracetamol tablet 100 mg TABLET 0 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 110 150 260 90 170 116 -54
247 Pas-Na 5.52g SACHET 0 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 60 60 60 0 -60
254 Piroxicam tablet 20 mg TABLET 50 50 20 30 26 -4
255 Prednison tablet 5 mg TABLET 220 220 220 0 -220
256 Primakuin tablet TABLET 0 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 3 3 3 0 -3
265 Ranitidin tablet 150 mg TABLET 130 130 20 110 26 -84
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 59 59 4 55 5 -50
268 Rifampicin tablet 300 mg TABLET 0 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 12 12 2 10 3 -7
272 Risperidon tablet TABLET 0 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 100 100 200 50 150 65 -85
276 Salbutamoltablet 4 mg TABLET 138 138 70 68 90 22
277 Salep 2 - 4 kombinasi POT 2 2 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0 0
279 Scabisid TUBE 0 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 5 5 5 0 -5
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0 0
286 Sianokobalamin Tablet TABLET 90 50 140 10 130 13 -117
287 Simvastatin 10 mg TABLET 0 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 100 100 100 0 -100
289 Tablet tambah Darah TABLET 275 160 435 240 195 310 115
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 90 150 240 90 150 116 -34
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 282 100 382 130 252 168 -84
299 Xylocain Jelly 2% TUBE 0 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0 0
301 Zink syrup BOTOL 8 8 1 7 1 -6
302 Zink tablet TABLET 200 100 300 30 270 39 -231
BAHAN MEDIS HABIS PAKAI
303 Abate 25 kg KOLI 0 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0 0
311 Alat suntik 3 ml SET 19 15 34 6 28 8 -20
312 Alat suntik 5 ml SET 11 15 26 26 0 -26
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0 0
314 Alkohol swap 2 % PCS 172 172 34 138 44 -94
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0 0
324 Blood lancet BOX 0 0 0 0 0
325 Body protective KANTONG 0 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 2 2 2 0 3 3
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 1 1 1 0 -1
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0 0
340 Cresotin Paste POT 0 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 1 0 -1
353 Etil klorida BOTOL 0 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0 0
357 Folley catheter 18 G PCS 2 2 2 0 -2
358 Folley catheter 20 G PCS 0 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0 0
364 Infuset anak SET 2 2 2 0 -2
365 Infuset dewasa SET 0 0 0 0 0
366 IV catheter 18 G PCS 0 0 0 0 0
367 IV catheter 20 G PCS 4 4 2 2 3 1
368 IV catheter 22 G PCS 10 10 10 0 -10
369 IV catheter 24 G PCS 0 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 3 3 2 1 3 2
376 Kassa pembalut 2 m x 80 cm ROL 5 5 2 3 3 0
377 Kassa pembalut hidrofil 4 m x 10 m ROL 10 10 10 0 -10
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 2 2 2 0 -2
381 Kertas EKG ROL 0 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0 0
385 Lens paper PCS 0 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0 0
390 Lisol BOTOL 0 0 0 0 0
391 Mantoux test VIAL 0 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0 0
393 Masker N 95 PCS 54 54 54 0 -54
394 Masker Tie On KOTAK 0 0 0 0 0
395 Metanol BOTOL 0 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0 0
400 Mikroskop SET 0 0 0 0 0
401 Mitella BUAH 0 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0 0
403 NGT 12 PCS 0 0 0 0 0
404 NGT 14 PCS 0 0 0 0 0
405 NGT 16 PCS 0 0 0 0 0
406 NGT 8 PCS 0 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0 0

409 Objek glass KOTAK 0 0 0 0 0


410 Oncoprobe TEST 0 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 1 0 -1
416 Pembalut gips ROL 0 0 0 0 0
417 Pemutih BOTOL 0 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0 0
429 Pot sputum POT 0 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0 0
438 Safety Box DUS 0 0 0 0 0
439 Salisyl bedak KOTAK 0 2 2 2 0 -2
440 Sarung tangan gynaekologi PCS 4 4 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0 0
443 Sarung Tangan S KOTAK 0 100 100 100 0 -100
444 Sarung tangan steril 6 PASANG 0 0 0 0 0
445 Sarung tangan steril 6.5 PCS 4 4 4 0 5 5
446 Sarung tangan steril 7 PCS 5 5 5 0 -5
447 Sarung tangan steril 7.5 PASANG 0 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0 0
449 SD Sifilis TEST 0 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0 0
452 Silk 2/0 PCS 0 0 0 0 0
453 Silk 3/0 PCS 0 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0 0
456 Slide box BOX 0 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0 0
470 Test gula darah BOX 0 0 0 0 0
471 Test kolesterol PCS 0 0 0 0 0
472 Test kolesterol BOX 0 0 0 0 0
473 Tissu gulung ROL 0 0 0 0 0
474 Triline HIV TEST 0 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0 0

477 Urine bag SET 3 3 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 0 2 2 2 0 -2
482 Yodium povidone 30 ml BOTOL 0 0 0 0 0
483 Yodium povidone 300 ml BOTOL 1 1 1 0 -1
OBAT TAMBAHAN
ERLAFLU BOTOL 0 2 2 2 0 -2

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

56 0 31 56
Mengetahui, Mengetahui, April 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA.A.Md.Keb)


NIP. 19760523 200604 2 026
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS : PUSTU SANGLAR
KAB / KOTA : KARIMUN BULAN : MEI
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 5 5 5 0 -5
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 200 200 200 0 -200
5 Albendazol tablet TABLET 25 25 10 15 0 -15
6 Allopurinol tablet 100 mg TABLET 430 430 430 0 0 0
7 Alopurinol tablet 300 mg TABLET 0 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 6 6 6 0 -6
9 Ambroxol tablet 30 mg TABLET 60 60 20 40 26 -14
10 Aminophillin injeksi AMPUL 0 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 100 100 100 0 -100
14 Amlodipin tablet 5 mg TABLET 30 30 30 0 -30
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 10 10 2 8 3 -5
20 Amoxycillin tablet 500 mg TABLET 0 0 0 34 34
21 Ampicillin injeksi AMPUL 0 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0 0
26 Antalgin tablet 500 mg TABLET 190 190 20 170 26 -144
27 Antasida DOEN Suspensi BOTOL 13 13 13 0 -13
28 Antasida DOEN tablet kunyah kombinasi TABLET 459 459 100 359 129 -230
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 6 6 6 0 -6
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 -1
36 Artem Injeksi AMPUL 0 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 100 100 100 0 -100
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 167 167 167 0 -167
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0 0
42 Asam Folat 1 mg TABLET 100 100 100 0 -100
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 189 189 30 159 39 -120
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 1 1 1 0 -1
48 Asam traneksamat tablet 500 mg TABLET 20 20 20 0 -20
49 Asetosal tablet 100 mg TABLET 0 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 120 120 120 0 -120
61 Betametasone cream 0.1 % TUBE 5 5 1 4 1 -3
62 Bisoprolol 5 mg TABLET 0 0 0 0 0
63 Bufacetin TUBE 0 0 0 0 0
64 Calsium Glukonas injeksi 10 % AMPUL 0 0 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 190 190 190 0 -190
67 Captopril tablet 25 mg TABLET 310 310 10 300 13 -287
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 60 60 10 50 13 -37
70 Cefadroxil syrup BOTOL 1 1 1 0 -1
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0 0
78 Cetirizine syrup BOTOL 7 7 7 0 -7
79 Cetirizine tablet 10 mg TABLET 30 30 30 0 -30
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 100 100 10 90 13 -77
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 50 50 50 0 0 0
85 Combivent UDV inhalasi VIAL 0 0 0 0 0
86 Coparcetin tablet TABLET 10 10 10 0 -10
87 Cyloserin 250 mg TABLET 0 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 4 4 4 0 -4
90 Deksamethasone tablet 0.5 mg TABLET 231 231 50 181 65 -116
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 2 2 2 0 0 0
96 Digoxin 0.25 mg TABLET 0 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 3 3 3 0 -3
100 Domperidon tablet 10 mg TABLET 100 100 100 0 -100
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 0 0 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 0 0 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 0 0 0 0 0
112 Ethambutol 400 mg TABLET 0 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 116 116 116 0 -116
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 0 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 0 0 0 0 0
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0 0
126 Garam Oralit SASE 0 0 0 0 0
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 5 5 5 0 -5
129 Gentamisin tetes mata 0.3% BOTOL 5 5 5 0 -5
130 Gentian violet larutan 1% BOTOL 10 10 2 8 3 -5
131 Glibenclamide tablet 5 mg TABLET 20 20 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 2 2 2 0 -2
137 GOM Tetes Oral BOTOL 3 3 3 0 -3
138 Griseofulvin 500 mg TABLET 0 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 15 15 15 0 -15
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 2 2 2 0 -2
148 Ibu profen tablet 200 mg TABLET 0 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 120 120 80 40 103 63
156 Kanamicin injeksi VIAL 0 0 0 0 0
157 Ketokonazole cream 2 % TUBE 2 2 2 0 -2
158 Ketokonazole tablet 200 mg TABLET 0 0 0 0 0
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 5 5 5 0 -5
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 9 9 2 7 3 -4
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 140 140 30 110 39 -71
166 Klorokuin 150 mg TABLET 0 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 4 4 4 0 -4
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 2 2 2 0 -2
176 Lamprene tablet 100mg TABLET 0 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 6 6 6 0 -6
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0 0
181 Loperamide 2 mg TABLET 70 70 20 50 26 -24
182 Loratadine tablet TABLET 0 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 0 0 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0 0
191 Metil ergometrin injeksi AMPUL 3 3 3 0 -3
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 100 0 -100
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 5 5 5 0 -5
196 Metoclopramide sirup 5mg / 5ml BOTOL 1 1 1 0 -1
197 Metoclopramide tablet 10 mg TABLET 190 190 190 0 -190
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 130 130 130 0 -130
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0 0
204 Miconazole cream salap 2% TUBE 4 4 4 0 -4
205 Mineral mix SASE 0 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0 0
207 Molexflu syrup BOTOL 2 2 2 0 -2
208 Molexflu Tablet TABLET 140 140 10 130 13 -117
209 Moxifloxacin TABLET 0 0 0 0 0
210 Multivitamin syrup BOTOL 8 8 8 0 -8
211 Multivitamin Tablet TABLET 0 0 0 0 0
212 Natrium Bicarbonat TABLET 0 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 430 430 10 420 13 -407
214 Natrium diklofenak tablet 50 mg TABLET 240 240 20 220 26 -194
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 3 3 3 0 -3
218 Neo entrostop TABLET 0 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 11 11 11 0 -11
234 Omeprazole capsul 20 mg CAPSUL 80 80 20 60 26 -34
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0 0
242 Paracetamol drop BOTOL 2 2 2 0 -2
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 11 11 11 0 -11
245 Paracetamol tablet 100 mg TABLET 0 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 170 170 70 100 90 -10
247 Pas-Na 5.52g SACHET 0 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 60 60 60 0 -60
254 Piroxicam tablet 20 mg TABLET 30 30 30 0 -30
255 Prednison tablet 5 mg TABLET 220 220 220 0 -220
256 Primakuin tablet TABLET 0 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 3 3 3 0 -3
265 Ranitidin tablet 150 mg TABLET 110 110 20 90 26 -64
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 55 55 55 0 -55
268 Rifampicin tablet 300 mg TABLET 0 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 10 10 10 0 -10
272 Risperidon tablet TABLET 0 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 150 150 10 140 13 -127
276 Salbutamoltablet 4 mg TABLET 68 68 20 48 26 -22
277 Salep 2 - 4 kombinasi POT 2 2 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0 0
279 Scabisid TUBE 0 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 5 5 5 0 -5
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0 0
286 Sianokobalamin Tablet TABLET 130 130 130 0 -130
287 Simvastatin 10 mg TABLET 0 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 100 100 100 0 0 0
289 Tablet tambah Darah TABLET 195 195 195 0 252 252
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 150 150 10 140 13 -127
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 252 252 30 222 39 -183
299 Xylocain Jelly 2% TUBE 0 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0 0
301 Zink syrup BOTOL 7 7 7 0 -7
302 Zink tablet TABLET 270 270 10 260 0 13 13
BAHAN MEDIS HABIS PAKAI 0
303 Abate 25 kg KOLI 0 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0 0
311 Alat suntik 3 ml SET 28 28 28 0 -28
312 Alat suntik 5 ml SET 26 26 26 0 -26
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0 0
314 Alkohol swap 2 % PCS 138 138 30 108 39 -69
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0 0
324 Blood lancet BOX 0 0 0 0 0
325 Body protective KANTONG 0 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 1 1 1 0 -1
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0 0
340 Cresotin Paste POT 0 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 1 0 -1
353 Etil klorida BOTOL 0 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0 0
357 Folley catheter 18 G PCS 2 2 2 0 -2
358 Folley catheter 20 G PCS 0 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0 0
364 Infuset anak SET 2 2 2 0 -2
365 Infuset dewasa SET 0 0 0 0 0
366 IV catheter 18 G PCS 0 0 0 0 0
367 IV catheter 20 G PCS 2 2 2 0 -2
368 IV catheter 22 G PCS 10 10 10 0 -10
369 IV catheter 24 G PCS 0 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 1 1 1 0 -1
376 Kassa pembalut 2 m x 80 cm ROL 3 3 3 0 -3
377 Kassa pembalut hidrofil 4 m x 10 m ROL 10 10 10 0 -10
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 2 2 2 0 -2
381 Kertas EKG ROL 0 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0 0
385 Lens paper PCS 0 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0 0
390 Lisol BOTOL 0 0 0 0 0
391 Mantoux test VIAL 0 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0 0
393 Masker N 95 PCS 54 54 54 0 -54
394 Masker Tie On KOTAK 0 0 0 0 0
395 Metanol BOTOL 0 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0 0
400 Mikroskop SET 0 0 0 0 0
401 Mitella BUAH 0 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0 0
403 NGT 12 PCS 0 0 0 0 0
404 NGT 14 PCS 0 0 0 0 0
405 NGT 16 PCS 0 0 0 0 0
406 NGT 8 PCS 0 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0 0

409 Objek glass KOTAK 0 0 0 0 0


410 Oncoprobe TEST 0 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 1 0 -1
416 Pembalut gips ROL 0 0 0 0 0
417 Pemutih BOTOL 0 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0 0
429 Pot sputum POT 0 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0 0
438 Safety Box DUS 0 0 0 0 0
439 Salisyl bedak KOTAK 2 2 2 0 -2
440 Sarung tangan gynaekologi PCS 4 4 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0 0
443 Sarung Tangan S KOTAK 100 100 10 90 13 -77
444 Sarung tangan steril 6 PASANG 0 0 0 0 0
445 Sarung tangan steril 6.5 PCS 0 0 0 0 0
446 Sarung tangan steril 7 PCS 5 5 5 0 -5
447 Sarung tangan steril 7.5 PASANG 0 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0 0
449 SD Sifilis TEST 0 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0 0
452 Silk 2/0 PCS 0 0 0 0 0
453 Silk 3/0 PCS 0 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0 0
456 Slide box BOX 0 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0 0
470 Test gula darah BOX 0 0 0 0 0
471 Test kolesterol PCS 0 0 0 0 0
472 Test kolesterol BOX 0 0 0 0 0
473 Tissu gulung ROL 0 0 0 0 0
474 Triline HIV TEST 0 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0 0

477 Urine bag SET 3 3 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 2 2 2 0 -2
482 Yodium povidone 30 ml BOTOL 0 0 0 0 0
483 Yodium povidone 300 ml BOTOL 1 1 1 0 -1
OBAT TAMBAHAN 0
ERLAFLU BOTOL 2 2 2 0 3
ALPARA TABLET 0 20 20 0 26

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

23 1 12 23
Mengetahui, Mengetahui, MEI 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA.A.Md.Keb)


NIP. 19760523 200604 2 026
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS : PUSTU SANGLAR
KAB / KOTA : KARIMUN BULAN : JUNI
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 5 5 1 4 1 -3
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 200 200 10 190 13 -177
5 Albendazol tablet TABLET 15 15 15 0 0 0
6 Allopurinol tablet 100 mg TABLET 0 0 0 0 0
7 Alopurinol tablet 300 mg TABLET 0 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 6 6 1 5 1 -4
9 Ambroxol tablet 30 mg TABLET 40 40 40 0 -40
10 Aminophillin injeksi AMPUL 0 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 100 100 100 0 -100
14 Amlodipin tablet 5 mg TABLET 30 30 30 0 -30
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 8 8 8 0 0 0
20 Amoxycillin tablet 500 mg TABLET 0 0 0 34 34
21 Ampicillin injeksi AMPUL 0 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0 0
26 Antalgin tablet 500 mg TABLET 170 170 110 60 142 82
27 Antasida DOEN Suspensi BOTOL 13 13 4 9 5 -4
28 Antasida DOEN tablet kunyah kombinasi TABLET 359 359 155 204 200 -4
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 6 6 6 0 -6
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 -1
36 Artem Injeksi AMPUL 0 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 100 100 100 0 -100
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 167 167 80 87 103 16
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0 0
42 Asam Folat 1 mg TABLET 100 100 100 0 -100
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 159 159 159 0 205 205
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 1 1 1 0 0 0
48 Asam traneksamat tablet 500 mg TABLET 20 20 20 0 -20
49 Asetosal tablet 100 mg TABLET 0 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 120 120 120 0 -120
61 Betametasone cream 0.1 % TUBE 4 4 1 3 1 -2
62 Bisoprolol 5 mg TABLET 0 0 0 0 0
63 Bufacetin TUBE 0 0 0 0 0
64 Calsium Glukonas injeksi 10 % AMPUL 0 0 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 190 190 40 150 52 -98
67 Captopril tablet 25 mg TABLET 300 300 70 230 90 -140
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 50 50 30 20 39 19
70 Cefadroxil syrup BOTOL 1 1 1 0 -1
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0 0
78 Cetirizine syrup BOTOL 7 7 7 0 -7
79 Cetirizine tablet 10 mg TABLET 30 30 30 0 0 0
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 90 90 90 0 116 116
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 0 0 0 0 0
85 Combivent UDV inhalasi VIAL 0 0 0 0 0
86 Coparcetin tablet TABLET 10 10 10 0 13 13
87 Cyloserin 250 mg TABLET 0 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 4 4 4 0 0 0
90 Deksamethasone tablet 0.5 mg TABLET 181 181 120 61 155 94
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 0 0 0 0 0
96 Digoxin 0.25 mg TABLET 0 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 3 3 1 2 1 -1
100 Domperidon tablet 10 mg TABLET 100 100 100 0 -100
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 0 0 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 0 0 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 0 0 0 0 0
112 Ethambutol 400 mg TABLET 0 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 116 116 116 0 -116
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 0 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 0 0 0 0 0
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0 0
126 Garam Oralit SASE 0 0 0 0 0
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 5 5 2 3 3 0
129 Gentamisin tetes mata 0.3% BOTOL 5 5 1 4 1 -3
130 Gentian violet larutan 1% BOTOL 8 8 8 0 -8
131 Glibenclamide tablet 5 mg TABLET 20 20 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 2 2 2 0 -2
137 GOM Tetes Oral BOTOL 3 3 3 0 -3
138 Griseofulvin 500 mg TABLET 0 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 15 15 2 13 3 -10
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 2 2 2 0 0 0
148 Ibu profen tablet 200 mg TABLET 0 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 40 40 40 0 -40
156 Kanamicin injeksi VIAL 0 0 0 0 0
157 Ketokonazole cream 2 % TUBE 2 2 2 0 3 3
158 Ketokonazole tablet 200 mg TABLET 0 0 0 0 0
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 5 5 2 3 3 0
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 7 7 7 0 -7
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 110 110 100 10 129 119
166 Klorokuin 150 mg TABLET 0 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 4 4 4 0 -4
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 2 2 2 0 -2
176 Lamprene tablet 100mg TABLET 0 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 6 6 6 0 8 8
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0 0
181 Loperamide 2 mg TABLET 50 50 50 0 0 0
182 Loratadine tablet TABLET 0 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 0 0 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0 0
191 Metil ergometrin injeksi AMPUL 3 3 3 0 -3
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 100 0 -100
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 5 5 5 0 -5
196 Metoclopramide sirup 5mg / 5ml BOTOL 1 1 1 0 -1
197 Metoclopramide tablet 10 mg TABLET 190 190 50 140 65 -75
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 130 130 50 80 65 -15
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0 0
204 Miconazole cream salap 2% TUBE 4 4 1 3 1 -2
205 Mineral mix SASE 0 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0 0
207 Molexflu syrup BOTOL 2 2 1 1 1 0
208 Molexflu Tablet TABLET 130 130 40 90 52 -38
209 Moxifloxacin TABLET 0 0 0 0 0
210 Multivitamin syrup BOTOL 8 8 3 5 4 -1
211 Multivitamin Tablet TABLET 0 0 0 0 0
212 Natrium Bicarbonat TABLET 0 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 420 420 80 340 103 -237
214 Natrium diklofenak tablet 50 mg TABLET 220 220 40 180 52 -128
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 3 3 3 0 -3
218 Neo entrostop TABLET 0 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 11 11 1 10 1 -9
234 Omeprazole capsul 20 mg CAPSUL 60 60 60 0 -60
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0 0
242 Paracetamol drop BOTOL 2 2 2 0 -2
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 11 11 3 8 4 -4
245 Paracetamol tablet 100 mg TABLET 0 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 100 100 100 0 129 129
247 Pas-Na 5.52g SACHET 0 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 60 60 60 0 -60
254 Piroxicam tablet 20 mg TABLET 30 30 30 0 -30
255 Prednison tablet 5 mg TABLET 220 220 10 210 13 -197
256 Primakuin tablet TABLET 0 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 3 3 3 0 0 0
265 Ranitidin tablet 150 mg TABLET 90 90 30 60 39 -21
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 55 55 4 51 5 -46
268 Rifampicin tablet 300 mg TABLET 0 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 10 10 4 6 5 -1
272 Risperidon tablet TABLET 0 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 140 140 30 110 39 -71
276 Salbutamoltablet 4 mg TABLET 48 48 20 28 26 -2
277 Salep 2 - 4 kombinasi POT 2 2 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0 0
279 Scabisid TUBE 0 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 5 5 5 0 -5
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0 0
286 Sianokobalamin Tablet TABLET 130 130 20 110 26 -84
287 Simvastatin 10 mg TABLET 0 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 0 0 0 0 0
289 Tablet tambah Darah TABLET 0 0 0 0 0
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 140 140 140 0 -140
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 222 222 103 119 133 14
299 Xylocain Jelly 2% TUBE 0 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0 0
301 Zink syrup BOTOL 7 7 1 6 1 -5
302 Zink tablet TABLET 0 0 0 0 0
BAHAN MEDIS HABIS PAKAI 0
303 Abate 25 kg KOLI 0 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0 0
311 Alat suntik 3 ml SET 28 28 4 24 5 -19
312 Alat suntik 5 ml SET 26 26 6 20 8 -12
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0 0
314 Alkohol swap 2 % PCS 108 108 30 78 39 -39
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0 0
324 Blood lancet BOX 0 0 0 0 0
325 Body protective KANTONG 0 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 1 1 1 0 1 1
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0 0
340 Cresotin Paste POT 0 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 1 0 -1
353 Etil klorida BOTOL 0 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0 0
357 Folley catheter 18 G PCS 2 2 2 0 -2
358 Folley catheter 20 G PCS 0 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0 0
364 Infuset anak SET 2 2 2 0 -2
365 Infuset dewasa SET 0 0 0 0 0
366 IV catheter 18 G PCS 0 0 0 0 0
367 IV catheter 20 G PCS 2 2 2 0 3 3
368 IV catheter 22 G PCS 10 10 1 9 1 -8
369 IV catheter 24 G PCS 0 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 1 1 1 0 1 1
376 Kassa pembalut 2 m x 80 cm ROL 3 3 3 0 -3
377 Kassa pembalut hidrofil 4 m x 10 m ROL 10 10 10 0 -10
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 2 2 1 1 1 0
381 Kertas EKG ROL 0 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0 0
385 Lens paper PCS 0 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0 0
390 Lisol BOTOL 0 0 0 0 0
391 Mantoux test VIAL 0 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0 0
393 Masker N 95 PCS 54 54 5 49 6 -43
394 Masker Tie On KOTAK 0 0 0 0 0
395 Metanol BOTOL 0 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0 0
400 Mikroskop SET 0 0 0 0 0
401 Mitella BUAH 0 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0 0
403 NGT 12 PCS 0 0 0 0 0
404 NGT 14 PCS 0 0 0 0 0
405 NGT 16 PCS 0 0 0 0 0
406 NGT 8 PCS 0 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0 0

409 Objek glass KOTAK 0 0 0 0 0


410 Oncoprobe TEST 0 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 1 0 -1
416 Pembalut gips ROL 0 0 0 0 0
417 Pemutih BOTOL 0 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0 0
429 Pot sputum POT 0 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0 0
438 Safety Box DUS 0 0 0 0 0
439 Salisyl bedak KOTAK 2 2 2 0 -2
440 Sarung tangan gynaekologi PCS 4 4 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0 0
443 Sarung Tangan S KOTAK 90 90 20 70 26 -44
444 Sarung tangan steril 6 PASANG 0 0 0 0 0
445 Sarung tangan steril 6.5 PCS 0 0 0 0 0
446 Sarung tangan steril 7 PCS 5 5 2 3 3 0
447 Sarung tangan steril 7.5 PASANG 0 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0 0
449 SD Sifilis TEST 0 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0 0
452 Silk 2/0 PCS 0 0 0 0 0
453 Silk 3/0 PCS 0 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0 0
456 Slide box BOX 0 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0 0
470 Test gula darah BOX 0 0 0 0 0
471 Test kolesterol PCS 0 0 0 0 0
472 Test kolesterol BOX 0 0 0 0 0
473 Tissu gulung ROL 0 0 0 0 0
474 Triline HIV TEST 0 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0 0

477 Urine bag SET 3 3 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 2 2 2 0 -2
482 Yodium povidone 30 ml BOTOL 0 0 0 0 0
483 Yodium povidone 300 ml BOTOL 1 1 1 0 1 1
OBAT TAMBAHAN 0 0
ERLAFLU BOTOL 0 0 0 0
ALPARA TABLET 0 0 0 0

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

60 2 34 60
Mengetahui, Mengetahui, JUNI 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA.A.Md.Keb)


NIP. 19760523 200604 2 026
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS : PUSTU SANGLAR
KAB / KOTA : KARIMUN BULAN : JULI
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 4 4 1 3 1 -2
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 190 190 30 160 39 -121
5 Albendazol tablet TABLET 0 0 0 0 0
6 Allopurinol tablet 100 mg TABLET 0 0 0 0 0
7 Alopurinol tablet 300 mg TABLET 0 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 5 5 10 10 0 -10
9 Ambroxol tablet 30 mg TABLET 40 100 140 70 70 90 20
10 Aminophillin injeksi AMPUL 0 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 100 100 40 60 52 -8
14 Amlodipin tablet 5 mg TABLET 30 30 30 0 -30
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 0 0 0 0 0
20 Amoxycillin tablet 500 mg TABLET 0 100 100 50 50 34 -16
21 Ampicillin injeksi AMPUL 0 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0 0
26 Antalgin tablet 500 mg TABLET 60 50 110 100 10 129 119
27 Antasida DOEN Suspensi BOTOL 9 5 14 3 11 4 -7
28 Antasida DOEN tablet kunyah kombinasi TABLET 204 100 304 210 94 271 177
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 6 6 6 0 -6
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 -1
36 Artem Injeksi AMPUL 0 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 100 100 100 0 -100
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 87 100 187 50 37 100 65 -35
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0 0
42 Asam Folat 1 mg TABLET 100 100 100 0 -100
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 0 300 300 70 230 90 -140
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 0 0 0 0 0
48 Asam traneksamat tablet 500 mg TABLET 20 20 20 0 0 0
49 Asetosal tablet 100 mg TABLET 0 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 120 120 120 0 -120
61 Betametasone cream 0.1 % TUBE 3 3 2 1 3 2
62 Bisoprolol 5 mg TABLET 0 0 0 0 0
63 Bufacetin TUBE 0 0 0 0 0
64 Calsium Glukonas injeksi 10 % AMPUL 0 0 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 150 150 10 140 13 -127
67 Captopril tablet 25 mg TABLET 230 230 70 160 90 -70
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 20 20 20 0 26 26
70 Cefadroxil syrup BOTOL 1 1 1 0 1 1
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0 0
78 Cetirizine syrup BOTOL 7 7 7 0 0 0
79 Cetirizine tablet 10 mg TABLET 0 0 0 0 0
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 0 0 0 0 0
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 0 0 0 0 0
85 Combivent UDV inhalasi VIAL 0 0 0 0 0
86 Coparcetin tablet TABLET 0 0 0 0 0
87 Cyloserin 250 mg TABLET 0 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 0 5 5 5 0 -5
90 Deksamethasone tablet 0.5 mg TABLET 61 100 161 70 91 90 -1
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 0 3 3 3 0 -3
96 Digoxin 0.25 mg TABLET 0 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 2 2 2 0 -2
100 Domperidon tablet 10 mg TABLET 100 100 100 0 -100
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 0 0 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 0 0 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 0 0 0 0 0
112 Ethambutol 400 mg TABLET 0 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 116 100 216 216 0 -216
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 5 5 5 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 0 0 0 0 0
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0 0
126 Garam Oralit SASE 0 15 15 11 4 14 10
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 3 3 1 2 1 -1
129 Gentamisin tetes mata 0.3% BOTOL 4 4 4 0 -4
130 Gentian violet larutan 1% BOTOL 8 2 10 10 0 -10
131 Glibenclamide tablet 5 mg TABLET 20 20 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 2 2 1 1 0 -1
137 GOM Tetes Oral BOTOL 3 3 1 2 1 -1
138 Griseofulvin 500 mg TABLET 0 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 13 13 1 12 1 -11
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 0 0 0 0 0
148 Ibu profen tablet 200 mg TABLET 0 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 40 40 40 0 52 52
156 Kanamicin injeksi VIAL 0 0 0 0 0
157 Ketokonazole cream 2 % TUBE 0 2 2 2 0 0 0
158 Ketokonazole tablet 200 mg TABLET 0 0 0 0 0
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 3 3 3 0 -3
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 7 2 9 9 0 -9
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 10 10 10 0 13 13
166 Klorokuin 150 mg TABLET 0 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 4 4 4 0 0 0
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 2 2 2 0 -2
176 Lamprene tablet 100mg TABLET 0 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 0 5 5 3 2 4 2
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0 0
181 Loperamide 2 mg TABLET 0 0 0 0 0
182 Loratadine tablet TABLET 0 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 0 0 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0 0
191 Metil ergometrin injeksi AMPUL 3 3 3 0 0 0
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 100 0 -100
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 5 5 3 2 0 -2
196 Metoclopramide sirup 5mg / 5ml BOTOL 1 1 1 0 -1
197 Metoclopramide tablet 10 mg TABLET 140 140 140 0 -140
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 80 80 50 30 65 35
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0 0
204 Miconazole cream salap 2% TUBE 3 3 2 1 3 2
205 Mineral mix SASE 0 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0 0
207 Molexflu syrup BOTOL 1 1 1 0 1 1
208 Molexflu Tablet TABLET 90 90 20 70 26 -44
209 Moxifloxacin TABLET 0 0 0 0 0
210 Multivitamin syrup BOTOL 5 5 2 3 3 0
211 Multivitamin Tablet TABLET 0 50 50 10 40 13 -27
212 Natrium Bicarbonat TABLET 0 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 340 50 390 90 15 285 116 -169
214 Natrium diklofenak tablet 50 mg TABLET 180 100 280 50 230 65 -165
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 3 3 1 2 1 -1
218 Neo entrostop TABLET 0 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 10 2 12 12 0 -12
234 Omeprazole capsul 20 mg CAPSUL 60 60 120 120 0 -120
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0 0
242 Paracetamol drop BOTOL 2 2 2 0 -2
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 8 5 13 3 10 4 -6
245 Paracetamol tablet 100 mg TABLET 0 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 0 100 100 100 0 129 129
247 Pas-Na 5.52g SACHET 0 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 60 50 110 10 100 13 -87
254 Piroxicam tablet 20 mg TABLET 30 100 130 130 0 -130
255 Prednison tablet 5 mg TABLET 210 210 30 180 39 -141
256 Primakuin tablet TABLET 0 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 0 5 5 5 0 -5
265 Ranitidin tablet 150 mg TABLET 60 60 40 20 52 32
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 51 51 4 47 5 -42
268 Rifampicin tablet 300 mg TABLET 0 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 6 8 14 14 0 -14
272 Risperidon tablet TABLET 0 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 110 50 160 50 110 0 65 65
276 Salbutamoltablet 4 mg TABLET 28 100 128 10 118 0 13 13
277 Salep 2 - 4 kombinasi POT 2 2 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0 0
279 Scabisid TUBE 0 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 5 5 5 0 -5
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0 0
286 Sianokobalamin Tablet TABLET 110 110 20 90 26 -64
287 Simvastatin 10 mg TABLET 0 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 0 0 0 0 0
289 Tablet tambah Darah TABLET 0 90 90 90 0 116 116
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 140 140 80 60 103 43
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 119 100 219 190 29 246 217
299 Xylocain Jelly 2% TUBE 0 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0 0
301 Zink syrup BOTOL 6 6 1 5 1 -4
302 Zink tablet TABLET 0 50 50 30 20 39 19
BAHAN MEDIS HABIS PAKAI 0
303 Abate 25 kg KOLI 0 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0 0
311 Alat suntik 3 ml SET 24 10 34 1 33 1 -32
312 Alat suntik 5 ml SET 20 20 20 0 -20
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0 0
314 Alkohol swap 2 % PCS 78 100 178 20 158 26 -132
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0 0
324 Blood lancet BOX 0 0 0 0 0
325 Body protective KANTONG 0 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0 0
340 Cresotin Paste POT 0 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 1 0 -1
353 Etil klorida BOTOL 0 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0 0
357 Folley catheter 18 G PCS 2 2 2 0 -2
358 Folley catheter 20 G PCS 0 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0 0
364 Infuset anak SET 2 2 2 0 -2
365 Infuset dewasa SET 0 5 5 5 0 -5
366 IV catheter 18 G PCS 0 3 3 3 0 -3
367 IV catheter 20 G PCS 0 0 0 0 0
368 IV catheter 22 G PCS 9 9 9 0 -9
369 IV catheter 24 G PCS 0 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 0 2 2 2 0 3 3
376 Kassa pembalut 2 m x 80 cm ROL 3 2 5 4 1 5 4
377 Kassa pembalut hidrofil 4 m x 10 m ROL 10 10 9 1 12 11
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 1 1 1 0 1 1
381 Kertas EKG ROL 0 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0 0
385 Lens paper PCS 0 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0 0
390 Lisol BOTOL 0 0 0 0 0
391 Mantoux test VIAL 0 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0 0
393 Masker N 95 PCS 49 49 49 0 -49
394 Masker Tie On KOTAK 0 0 0 0 0
395 Metanol BOTOL 0 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0 0
400 Mikroskop SET 0 0 0 0 0
401 Mitella BUAH 0 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0 0
403 NGT 12 PCS 0 0 0 0 0
404 NGT 14 PCS 0 0 0 0 0
405 NGT 16 PCS 0 0 0 0 0
406 NGT 8 PCS 0 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0 0

409 Objek glass KOTAK 0 0 0 0 0


410 Oncoprobe TEST 0 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 1 0 -1
416 Pembalut gips ROL 0 0 0 0 0
417 Pemutih BOTOL 0 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0 0
429 Pot sputum POT 0 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0 0
438 Safety Box DUS 0 0 0 0 0
439 Salisyl bedak KOTAK 2 2 2 0 0 0
440 Sarung tangan gynaekologi PCS 4 4 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0 0
443 Sarung Tangan S KOTAK 70 70 20 50 26 -24
444 Sarung tangan steril 6 PASANG 0 5 5 5 0 -5
445 Sarung tangan steril 6.5 PCS 0 0 0 0 0
446 Sarung tangan steril 7 PCS 3 3 3 0 -3
447 Sarung tangan steril 7.5 PASANG 0 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0 0
449 SD Sifilis TEST 0 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0 0
452 Silk 2/0 PCS 0 5 5 5 0 -5
453 Silk 3/0 PCS 0 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0 0
456 Slide box BOX 0 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0 0
470 Test gula darah BOX 0 0 0 0 0
471 Test kolesterol PCS 0 0 0 0 0
472 Test kolesterol BOX 0 0 0 0 0
473 Tissu gulung ROL 0 0 0 0 0
474 Triline HIV TEST 0 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0 0

477 Urine bag SET 3 3 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 2 2 2 0 -2
482 Yodium povidone 30 ml BOTOL 0 0 0 0 0
483 Yodium povidone 300 ml BOTOL 0 1 1 1 0 1 1
OBAT TAMBAHAN 0 0

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

66 0 30 66
Mengetahui, Mengetahui, SANGLAR JULI 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA.A.Md.Keb)


NIP. 19760523 200604 2 026
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DAN BAHAN HABIS PAKAI

KODE PUSKESMAS :
NAMA PUSKESMAS : PUSTU SANGLAR
KAB / KOTA : KARIMUN BULAN : AGUSTUS
PROVINSI : KEPULAUAN RIAU TAHUN : 2019

STOK RUSAK / STOK


NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK OPTIMUM PERMINTAAN PEMBERIAN KET
AWAL ED

1 2 3 4 5 6= (4+5) 7 8 9=(6-7-8) 10 11= (10-9) 12 13

OBAT-OBATAN
1 Acyclovir krim 5 % TUBE 3 3 3 0 -3
2 Anti Rabies (200mg/300mg) VIAL 0 0 0 0 0
3 Acyclovir tablet 200 mg TABLET 0 0 0 0 0
4 Acyclovir tablet 400 mg TABLET 160 160 160 0 -160
5 Albendazol tablet TABLET 0 0 0 0 0
6 Allopurinol tablet 100 mg TABLET 0 0 0 0 0
7 Alopurinol tablet 300 mg TABLET 0 0 0 0 0
8 Ambroxol syrup 15 mg/ml BOTOL 10 10 10 0 -10
9 Ambroxol tablet 30 mg TABLET 70 70 70 0 -70
10 Aminophillin injeksi AMPUL 0 0 0 0 0
11 Aminophillin tablet 200 mg TABLET 0 0 0 0 0
12 Amitriptillin HCl tablet 25 mg TABLET 0 0 0 0 0
13 Amlodipin tablet 10 mg TABLET 60 60 60 0 -60
14 Amlodipin tablet 5 mg TABLET 30 30 30 0 -30
15 Amoxicillin forte syrup 250 mg/5 ml BOTOL 0 0 0 0 0
16 Amoxycilin Oral Drop 20ml BOTOL 0 0 0 0 0
17 Amoxycillin capsul 250 mg CAPSUL 0 0 0 0 0
18 Amoxycillin + As.Klavulanat tablet 625 mg TABLET 0 0 0 0 0
19 Amoxycillin syrup kering 125mg/5ml BOTOL 0 0 0 0 0
20 Amoxycillin tablet 500 mg TABLET 50 50 50 34 -16
21 Ampicillin injeksi AMPUL 0 0 0 0 0
22 Ampicillin kaplet 500 mg KAPLET 0 0 0 0 0
23 Ampicillin syrup BOTOL 0 0 0 0 0
24 Analgetik Gel/Krim TUBE 0 0 0 0 0
25 Antalgin injeksi 250 mg AMPUL 0 0 0 0 0
26 Antalgin tablet 500 mg TABLET 10 10 10 0 -10
27 Antasida DOEN Suspensi BOTOL 11 11 11 0 -11
28 Antasida DOEN tablet kunyah kombinasi TABLET 94 94 94 0 -94
29 Anti Batuk Berdahak + Anti Influenza Syrup BOTOL 0 0 0 0 0
30 Anti fungi DOEN Kombinasi POT 6 6 6 0 -6
31 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
32 Anti Influenza + Anti Batuk Tablet TABLET 0 0 0 0 0
33 Anti Influenza Syrup BOTOL 0 0 0 0 0
34 Anti Influenza Tablet TABLET 0 0 0 0 0
35 Aqua pro injeksi steril bebas pirogen VIAL 1 1 1 0 -1
36 Artem Injeksi AMPUL 0 0 0 0 0
37 Arterakine tab KOTAK 0 0 0 0 0
38 Artesunate Injeksi AMPUL 0 0 0 0 0
39 Asam ascorbat (VIT.C) tablet 250 mg TABLET 100 100 100 0 -100
40 Asam ascorbat (VIT.C) tablet 50 mg TABLET 100 100 100 0 -100
41 Asam Asetil Salisilat Tablet 80mg TABLET 0 0 0 0 0
42 Asam Folat 1 mg TABLET 100 100 100 0 -100
43 Asam Mefenamat tablet 250 mg TABLET 0 0 0 0 0
44 Asam Mefenamat tablet 500 mg TABLET 230 230 230 0 -230
45 Asam Traneksamat Injeksi 100mg/ml AMPUL 0 0 0 0 0
46 Asam traneksamat injeksi 250 mg AMPUL 0 0 0 0 0
47 Asam traneksamat injeksi 50 mg/ml AMPUL 0 0 0 0 0
48 Asam traneksamat tablet 500 mg TABLET 0 0 0 0 0
49 Asetosal tablet 100 mg TABLET 0 0 0 0 0
50 Asetosal tablet 500 mg TABLET 0 0 0 0 0
51 Aspilet tablet TABLET 0 0 0 0 0
52 Atropin injeksi im/i.v/s.k 0.25 mg/ml AMPUL 0 0 0 0 0
53 Atropin sulfat tablet 0.5 mg TABLET 0 0 0 0 0
54 Azithromycin 500 mg TABLET 0 0 0 0 0
55 Baby cough syrup BOTOL 0 0 0 0 0
56 Bacitracin polimixin TUBE 0 0 0 0 0
57 Benzatin benzil penicillin 1.2 jt iu/20 ml VIAL 0 0 0 0 0
58 Benzatin benzil penicillin 2.4 jt iu/vial VIAL 0 0 0 0 0
59 Benzatin benzil penicillin 3 jt iu/15 ml VIAL 0 0 0 0 0
60 Betahistin mesilat 6 mg TABLET 120 120 120 0 -120
61 Betametasone cream 0.1 % TUBE 1 1 1 0 -1
62 Bisoprolol 5 mg TABLET 0 0 0 0 0
63 Bufacetin TUBE 0 0 0 0 0
64 Calsium Glukonas injeksi 10 % AMPUL 0 0 0 0 0
65 Captopril 50 mg TABLET 0 0 0 0 0
66 Captopril tablet 12.5 mg TABLET 140 140 140 0 -140
67 Captopril tablet 25 mg TABLET 160 160 160 0 -160
68 Carbamazepin tablet 200 mg TABLET 0 0 0 0 0
69 Cefadroxil kapsul 500 mg CAPSUL 0 0 0 0 0
70 Cefadroxil syrup BOTOL 0 0 0 0 0
71 Cefixim 400 mg + Azitromicin 1000 mg PAKET 0 0 0 0 0
72 Cefixim capsul 100 mg CAPSUL 0 0 0 0 0
73 Cefixim syrup kering 100 mg/5 ml BOTOL 0 0 0 0 0
74 Cefotaxim injeksi 1 gr VIAL 0 0 0 0 0
75 Ceftriaxone injeksi 1 gr VIAL 0 0 0 0 0
76 Cendo Lyteers 15 ml BOTOL 0 0 0 0 0
77 Cendo Pantocain 0.5% BOTOL 0 0 0 0 0
78 Cetirizine syrup BOTOL 0 0 0 0 0
79 Cetirizine tablet 10 mg TABLET 0 0 0 0 0
80 Chloramex 500 mg (Kloramfenikol) CAPSUL 0 0 0 0 0
81 Cimetidin tablet 200 mg TABLET 0 0 0 0 0
82 Ciprofloxacin tablet 500 mg TABLET 0 0 0 0 0
83 Clindamicin capsul 150 mg CAPSUL 0 0 0 0 0
84 Clindamicin capsul 300 mg CAPSUL 0 0 0 0 0
85 Combivent UDV inhalasi VIAL 0 0 0 0 0
86 Coparcetin tablet TABLET 0 0 0 0 0
87 Cyloserin 250 mg TABLET 0 0 0 0 0
88 Dehydro Artemisin + Piperakuin (DHP) TABLET 0 0 0 0 0
89 Deksamethasone injeksi 5 mg/ml-1 ml AMPUL 5 5 5 0 -5
90 Deksamethasone tablet 0.5 mg TABLET 91 91 91 0 -91
91 Diazepam injeksi 5 mg/ml AMPUL 0 0 0 0 0
92 Diazepam Larutan rektal 5 mg/2.5 ml TUBE 0 0 0 0 0
93 Diazepam tablet 2 mg TABLET 0 0 0 0 0
94 Diazepam tablet 5 mg TABLET 0 0 0 0 0
95 Difenhidramine injeksi i.m 10 mg/ml AMPUL 3 3 3 0 -3
96 Digoxin 0.25 mg TABLET 0 0 0 0 0
97 Digoxin tablet 0.5 mg TABLET 0 0 0 0 0
98 Dimenhidrinat tablet 50 mg TABLET 0 0 0 0 0
99 Domperidon syrup 5 mg/5 ml BOTOL 2 2 2 0 -2
100 Domperidon tablet 10 mg TABLET 100 100 100 0 -100
101 Domperidon tetes 5 mg/ml BOTOL 0 0 0 0 0
102 Doxycillin tablet 100 mg TABLET 0 0 0 0 0
103 Dulcolax supp adult 10 mg TABLET 0 0 0 0 0
104 Dulcolax supp infant 5 mg TABLET 0 0 0 0 0
105 Efedrin tablet 25 mg TABLET 0 0 0 0 0
106 Efinefrin HCL (adrenalin) injeksi 0.1 % AMPUL 0 0 0 0 0
Ergotamin tartrat 1 mg + kofein 50 mg (anti migren) TABLET
107 0 0 0 0 0

108 Erytromicin capsul 250 mg CAPSUL 0 0 0 0 0


109 Erytromicin syrup 200 mg/5ml BOTOL 2 2 2 0 -2
110 Erytromicin tablet 500 mg TABLET 100 100 100 0 -100
111 Etakridin (Rivanol) larutan 0.1 % BOTOL 0 0 0 0 0
112 Ethambutol 400 mg TABLET 0 0 0 0 0
113 Ethambutol tablet 250 mg TABLET 0 0 0 0 0
114 Ethambutol tablet 500 mg TABLET 0 0 0 0 0
115 Ethionamide 250mg TABLET 0 0 0 0 0
116 Fenobarbital injeksi AMPUL 0 0 0 0 0
117 Fenobarbital tablet 30 mg TABLET 0 0 0 0 0
118 Fenol Gliserol tetes telinga 10 % BOTOL 0 0 0 0 0
119 Fitomenadion (Vit.K) 10 mg TABLET 216 216 216 0 -216
120 Fitomenadion (Vit.K) injeksi 10mg/ml AMPUL 0 0 0 0 0
121 Fitomenadion injeksi 2 mg/ml AMPUL 0 0 0 0 0
122 Fluconazol Kapsul 50 mg CAPSUL 0 0 0 0 0
123 Flukonazol tablet 150 mg TABLET 0 0 0 0 0
124 Furosemide injeksi AMPUL 0 0 0 0 0
125 Furosemide tablet 40 mg TABLET 0 0 0 0 0
126 Garam Oralit SASE 4 4 4 0 -4
127 Gentamisin injeksi 80 mg/ml AMPUL 0 0 0 0 0
128 Gentamisin salap kulit 0,1% TUBE 2 2 2 0 -2
129 Gentamisin tetes mata 0.3% BOTOL 4 4 4 0 -4
130 Gentian violet larutan 1% BOTOL 10 10 10 0 -10
131 Glibenclamide tablet 5 mg TABLET 20 20 20 0 -20
132 Gliklazid 80 mg TABLET 0 0 0 0 0
133 Glimepiride 1 mg TABLET 0 0 0 0 0
134 Glukosa larutan infus 10 % steril BOTOL 0 0 0 0 0
135 Glukosa larutan infus 40 % steril BOTOL 0 0 0 0 0
136 Glukosa larutan infus 5 % steril BOTOL 1 1 1 0 -1
137 GOM Tetes Oral BOTOL 2 2 2 0 -2
138 Griseofulvin 500 mg TABLET 0 0 0 0 0
139 Griseofulvin tablet 125 mg TABLET 0 0 0 0 0
140 Haloperidol 2 Mg TABLET 0 0 0 0 0
141 Haloperidol tablet 0.5 mg TABLET 0 0 0 0 0
142 Haloperidol tablet 1.5 mg TABLET 0 0 0 0 0
143 Haloperidol tablet 5 mg TABLET 0 0 0 0 0
144 Hidroklorotiacid tablet 25 mg TABLET 0 0 0 0 0
145 Hidrokortison cream 2.5 % TUBE 12 12 12 0 -12
146 Hiosin butilbromid injeksi 20 mg/ml AMPUL 0 0 0 0 0
147 Ibu profen suspensi 100 mg/5 ml BOTOL 0 0 0 0 0
148 Ibu profen tablet 200 mg TABLET 0 0 0 0 0
149 Ibu profen tablet 400 mg TABLET 0 0 0 0 0
150 Interdoxin 50 mg CAPSUL 0 0 0 0 0
151 Isoniazid tablet 100 mg TABLET 0 0 0 0 0
152 Isoniazid tablet 300 mg TABLET 0 0 0 0 0
153 Isosorbit dintrat tablet 5 mg TABLET 100 100 100 0 -100
154 Kalium diklofenak tablet 50 mg TABLET 0 0 0 0 0
155 Kalsium Laktat tablet 500 mg TABLET 0 0 0 0 0
156 Kanamicin injeksi VIAL 0 0 0 0 0
157 Ketokonazole cream 2 % TUBE 0 0 0 0 0
158 Ketokonazole tablet 200 mg TABLET 0 0 0 0 0
159 Ketorolak Injeksi 30 mg/ml AMPUL 1 1 1 0 -1
160 Kloramfenicol capsul 250 mg CAPSUL 0 0 0 0 0
161 Kloramfenicol salap mata 1% TUBE 3 3 3 0 -3
162 Kloramfenicol suspensi 125 mg/ 5 ml BOTOL 0 0 0 0 0
163 Kloramfenicol tetes mata 10 ml BOTOL 9 9 9 0 -9
164 Kloramfenicol tetes telinga 3 % BOTOL 0 0 0 0 0
165 Klorfeniramin maleat (CTM) tablet 4 mg TABLET 0 0 0 0 0
166 Klorokuin 150 mg TABLET 0 0 0 0 0
167 Klorpromazin injeksi i.m 25 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
168 Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL) AMPUL 0 0 0 0 0
169 Klorpromazin tablet salut 100 mg TABLET 0 0 0 0 0
170 Klorpromazine tablet salut 25 mg TABLET 0 0 0 0 0
171 Kombinasi primetamin Sulfadoksin TABLET 0 0 0 0 0
172 Kotrimoksazole DOEN dewasa kombinasi TABLET 0 0 0 0 0
173 Kotrimoksazole DOEN pediatrik kombinasi TABLET 0 0 0 0 0
174 Kotrimoksazole suspensi kombinasi BOTOL 0 0 0 0 0
175 Laktulosa Syrup 3.333 g/5 ml BOTOL 2 2 2 0 -2
176 Lamprene tablet 100mg TABLET 0 0 0 0 0
177 Lanzoprazole tablet 30 mg TABLET 0 0 0 0 0
178 Levofloxacin 250mg TABLET 0 0 0 0 0
179 Lidocain injeksi 2 % AMPUL 2 2 2 0 -2
180 Lidocain injeksi 2%(HCL) + Efinefrin 1:80.000 AMPUL 0 0 0 0 0
181 Loperamide 2 mg TABLET 0 0 0 0 0
182 Loratadine tablet TABLET 0 0 0 0 0
183 Magnesium sulfat injeksi (IV)20%-25ml AMPUL 0 0 0 0 0
184 Magnesium sulfat injeksi (IV)40%-25ml AMPUL 0 0 0 0 0
185 MDT MB combi anak STRIP 0 0 0 0 0
186 MDT MB combi dewasa STRIP 0 0 0 0 0
187 Meloksikam 15 mg TABLET 0 0 0 0 0
188 Meloksikam 7.5 mg TABLET 0 0 0 0 0
189 Metformin tablet 500 mg TABLET 0 0 0 0 0
190 Metformin Tablet 850mg TABLET 0 0 0 0 0
191 Metil ergometrin injeksi AMPUL 0 0 0 0 0
192 Metil ergometrin tablet salut 0.125 mg TABLET 100 100 100 0 -100
193 Metil prednisollon tablet 16 mg TABLET 0 0 0 0 0
194 Metil prednisollon tablet 4 mg TABLET 0 0 0 0 0
195 Metoclopramide injeksi 5mg/ml AMPUL 2 2 2 0 -2
196 Metoclopramide sirup 5mg / 5ml BOTOL 1 1 1 0 -1
197 Metoclopramide tablet 10 mg TABLET 140 140 140 0 -140
198 Metoklopramide drop 2 mg/ml BOTOL 0 0 0 0 0
199 Metronidazole larutan infus 500 mg BOTOL 0 0 0 0 0
200 Metronidazole syrup 125 mg/ml BOTOL 0 0 0 0 0
201 Metronidazole tablet 250 mg TABLET 0 0 0 0 0
202 Metronidazole tablet 500 mg TABLET 30 30 30 0 -30
203 Meylon 84 (Natrium Bicarbonat Injeksi iv 8.4%) AMPUL 0 0 0 0 0
204 Miconazole cream salap 2% TUBE 1 1 1 0 -1
205 Mineral mix SASE 0 0 0 0 0
206 Miniaspi ( Asetosal ) 80 mg TABLET 0 0 0 0 0
207 Molexflu syrup BOTOL 0 0 0 0 0
208 Molexflu Tablet TABLET 70 70 70 0 -70
209 Moxifloxacin TABLET 0 0 0 0 0
210 Multivitamin syrup BOTOL 3 3 3 0 -3
211 Multivitamin Tablet TABLET 40 40 40 0 -40
212 Natrium Bicarbonat TABLET 0 0 0 0 0
213 Natrium diklofenak tablet 25 mg TABLET 285 285 285 0 -285
214 Natrium diklofenak tablet 50 mg TABLET 230 230 230 0 -230
215 Natrium fenitoin injeksi 50 mg/ml AMPUL 0 0 0 0 0
216 Natrium fenitoin tablet TABLET 0 0 0 0 0
217 Natrium Klorida larutan infus 0.9% steril BOTOL 2 2 2 0 -2
218 Neo entrostop TABLET 0 0 0 0 0
219 Neuroptropik tablet TABLET 0 0 0 0 0
220 Neurotropik injeksi AMPUL 0 0 0 0 0
221 New Antides Atapulgit Tablet 600mg TABLET 0 0 0 0 0
222 Nifedipin tablet 10 mg TABLET 0 0 0 0 0
223 Nistatin tablet salut 100.000 iu/g TABLET 0 0 0 0 0
224 Nistatin tablet salut 500.000 iu/g TABLET 0 0 0 0 0
225 Nystatin Drop BOTOL 0 0 0 0 0
226 OAT anak Kombipak PAKET 0 0 0 0 0
227 OAT FDC anak PAKET 0 0 0 0 0
228 OAT FDC kategori 1 dewasa PAKET 0 0 0 0 0
229 OAT FDC kategori 2 dewasa PAKET 0 0 0 0 0
230 OAT FDC kategori sisipan dewasa PAKET 0 0 0 0 0
231 OAT kategori 1 kombipak PAKET 0 0 0 0 0
232 Obat Batuk Hitam syrup BOTOL 0 0 0 0 0
233 Oksitocin injeksi 10 IU/ml-1ml AMPUL 12 12 12 0 -12
234 Omeprazole capsul 20 mg CAPSUL 120 120 120 0 -120
235 Omeprazole injeksi 40 mg/10ml AMPUL 0 0 0 0 0
236 Ondansentron HCI Dihydrate Injeksi 2 mg/ml AMPUL 0 0 0 0 0
237 Ondansentron Tablet 8 mg TABLET 0 0 0 0 0
238 Oxytetraciklin salap mata 1% TUBE 0 0 0 0 0
239 Oxytetracyclin HCL salap kulit 3% TUBE 0 0 0 0 0
240 Papaverin injeksi 40 mg/ml AMPUL 0 0 0 0 0
241 Papaverin tablet 40 mg TABLET 0 0 0 0 0
242 Paracetamol drop BOTOL 2 2 2 0 -2
243 Paracetamol Rectal 5mg/ml TUBE 0 0 0 0 0
244 Paracetamol syrup 120 mg/5 ml BOTOL 10 10 10 0 -10
245 Paracetamol tablet 100 mg TABLET 0 0 0 0 0
246 Paracetamol tablet 500 mg TABLET 0 0 0 0 0
247 Pas-Na 5.52g SACHET 0 0 0 0 0
248 Perak Sulfadiazin 1 % Krim TUBE 0 0 0 0 0
249 Piracetam injeksi 1g/5ml AMPUL 0 0 0 0 0
250 Piracetam tablet 800 mg TABLET 0 0 0 0 0
251 Piridoksin (Vit.B6) tab 25 mg TABLET 0 0 0 0 0
252 Piridoksin (Vit.B6) tablet 10 mg TABLET 0 0 0 0 0
253 Piroxicam tablet 10 mg TABLET 100 100 100 0 -100
254 Piroxicam tablet 20 mg TABLET 130 130 130 0 -130
255 Prednison tablet 5 mg TABLET 180 180 180 0 -180
256 Primakuin tablet TABLET 0 0 0 0 0
257 Propanolol 10 mg TABLET 0 0 0 0 0
258 Propiltiuracil tablet 100 mg TABLET 0 0 0 0 0
259 Propranolol tablet 40 mg TABLET 0 0 0 0 0
260 Pyrantel syrup 125mg/5 ml BOTOL 0 0 0 0 0
261 Pyrantel tablet (base) 125 mg TABLET 0 0 0 0 0
262 Pyrazinamide tablet 500 mg TABLET 0 0 0 0 0
263 Ranitidin injeksi 25 mg/ml AMPUL 0 0 0 0 0
264 Ranitidin injeksi 25 mg/2ml AMPUL 5 5 5 0 -5
265 Ranitidin tablet 150 mg TABLET 20 20 20 0 -20
266 Retinol (Vit.A) 100.000iu CAPSUL 0 0 0 0 0
267 Retinol (Vit.A) 200.000iu CAPSUL 47 47 47 0 -47
268 Rifampicin tablet 300 mg TABLET 0 0 0 0 0
269 Rifampicin tablet 450 mg TABLET 0 0 0 0 0
270 Rifampicin tablet 600 mg TABLET 0 0 0 0 0
271 Ringer laktat larutan infus steril BOTOL 14 14 14 0 -14
272 Risperidon tablet TABLET 0 0 0 0 0
273 Salbutamol cairan ih 0.1% BOTOL 0 0 0 0 0
274 Salbutamol syrup BOTOL 0 0 0 0 0
275 Salbutamoltablet 2 mg TABLET 0 0 0 0 0
276 Salbutamoltablet 4 mg TABLET 0 0 0 0 0
277 Salep 2 - 4 kombinasi POT 2 2 2 0 -2
278 Scabimite cream 5 % TUBE 0 0 0 0 0
279 Scabisid TUBE 0 0 0 0 0
280 Serum anti bisa ular polivalen injeksi 5 ml VIAL 0 0 0 0 0
281 Serum anti difteri injeksi 20000 iu VIAL 0 0 0 0 0
282 Serum anti tetanus injeksi 1500 iu AMPUL 0 0 0 0 0
283 Serum anti tetanus injeksi 20000 iu BOTOL 0 0 0 0 0
284 Sianokobalamin injeksi 50 mcg/ml AMPUL 5 5 5 0 -5
285 Sianokobalamin injeksi 500 mcg AMPUL 0 0 0 0 0
286 Sianokobalamin Tablet TABLET 90 90 90 0 -90
287 Simvastatin 10 mg TABLET 0 0 0 0 0
288 Simvastatin tablet 20 mg TABLET 0 0 0 0 0
289 Tablet tambah Darah TABLET 0 0 0 0 0
290 Tetes Mata Eyefresh Minidose STRIP 0 0 0 0 0
291 Tetraciklin HCL capsul 250 mg CAPSUL 0 0 0 0 0
292 Tetraciklin HCL capsul 500 mg CAPSUL 0 0 0 0 0
293 Thiamfenicol capsul 500 mg CAPSUL 0 0 0 0 0
294 Thiamfenikol syrup BOTOL 0 0 0 0 0
295 Thiamin HCL (Vit.B1) injeksi 100 mg/ml AMPUL 0 0 0 0 0
296 Thiamin HCL (Vit.B1) tablet 50 mg TABLET 60 60 60 0 -60
297 Triheksiphenidil HCL tablet 2 mg TABLET 0 0 0 0 0
298 Vitamin B. Komplek tablet TABLET 29 29 29 0 -29
299 Xylocain Jelly 2% TUBE 0 0 0 0 0
300 Zink drop 10 mg/ml BOTOL 0 0 0 0 0
301 Zink syrup BOTOL 5 5 5 0 -5
302 Zink tablet TABLET 20 20 20 0 -20
BAHAN MEDIS HABIS PAKAI 0
303 Abate 25 kg KOLI 0 0 0 0 0
304 Aesculap Blade No. 13 PCS 0 0 0 0 0
305 Aesculap Blade No. 18 PCS 0 0 0 0 0
306 Aesculap Blades 15 PCS 0 0 0 0 0
307 Air Raksa Dental Use BOTOL 0 0 0 0 0
308 Alat suntik 1 ml SET 0 0 0 0 0
309 Alat suntik 10 ml SET 0 0 0 0 0
310 Alat suntik 2.5 ml SET 0 0 0 0 0
311 Alat suntik 3 ml SET 33 33 33 0 -33
312 Alat suntik 5 ml SET 20 20 20 0 -20
313 Alkohol Swab CHG + 0.5% ( Empac ) BOX 0 0 0 0 0
314 Alkohol swap 2 % PCS 158 158 158 0 -158
315 Anti-Gen A ( Monoclonal ) VIAL 0 0 0 0 0
316 Anti-Gen A,B ( Monoclonal ) VIAL 0 0 0 0 0
317 Anti-Gen B ( Monoclonal ) VIAL 0 0 0 0 0
318 Anti-Gen D ( Duoclone ) VIAL 0 0 0 0 0
319 Anti-HIV 1/2 Cassette TEST 0 0 0 0 0
320 Antiseptik Liquid No. 2 BOTOL 0 0 0 0 0
321 Beam Srerilization Pediatric Set PCS 0 0 0 0 0
Beam Srerilization
322 NIPRO Syringe 10CC Luer Lock Needle 21Gx1-1/2" PCS 0 0 0 0 0
Elektron
323 Biomerieux (Vikia HIV 1/2) TEST 0 0 0 0 0
324 Blood lancet BOX 0 0 0 0 0
325 Body protective KANTONG 0 0 0 0 0
326 Bracket hand wash plastik BUAH 0 0 0 0 0
327 Cairan anti septik dettol BOTOL 0 0 0 0 0
328 Catgut chromic 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
329 Catgut chromic 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
330 Catgut Chromic 4/0 DS 24 MM PCS 0 0 0 0 0
331 Catgut Chromic 5/0 DS 15 MM PCS 0 0 0 0 0
332 Catgut plain 2/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
333 Catgut plain 3/0 + Jarum 1/2GT 35 mm PCS 0 0 0 0 0
334 Catridge Gene Xpert BOX 0 0 0 0 0
335 CD 4 Pima Catridge TEST 0 0 0 0 0
336 Cervical Collar Universal BUAH 0 0 0 0 0
337 Cotton tipped aplicator sterile PCS 0 0 0 0 0
338 Cover glass 22 x 22 mm PACK 0 0 0 0 0
339 Cresotin Liquid No. 2 BOTOL 0 0 0 0 0
340 Cresotin Paste POT 0 0 0 0 0
341 Cuticell Classic 10 cm x 10 cm PCS 0 0 0 0 0
342 Cutticell Ointment Dressing 7.5 cm x 20 cm PCS 0 0 0 0 0
343 Daryantulle LEMBAR 0 0 0 0 0
344 DBS Collection Kit KOTAK 0 0 0 0 0
345 Dengue rapid test PCS 0 0 0 0 0
346 Dermafix T 10x25 cm PIECE 0 0 0 0 0
347 Desinfektan BOTOL 0 0 0 0 0
348 Devitalisasi pasta BOTOL 0 0 0 0 0
349 Ecolab Aquagel Sterile Jely 82gr TUBE 0 0 0 0 0
350 Emersion oil BOTOL 0 0 0 0 0
351 Etakridin (rivanol) larutan 0,1 % BOTOL 0 0 0 0 0
352 Etanol 70% 1000 ml BOTOL 1 1 1 0 -1
353 Etil klorida BOTOL 0 0 0 0 0
354 Eugenol cairan BOTOL 0 0 0 0 0
355 Female Catheter no. 12 Steril BUAH 0 0 0 0 0
356 Folley catheter 16 G PCS 0 0 0 0 0
357 Folley catheter 18 G PCS 2 2 2 0 -2
358 Folley catheter 20 G PCS 0 0 0 0 0
359 Folley Catheter No 14 PCS 0 0 0 0 0
Hansaplast Plester Rol Kain 1.25cm x 4.5cm (hospital) ROL
360 0 0 0 0 0

361 Hexagon Syphilis TEST 0 0 0 0 0


362 Human Humasens Plus UNIT 0 0 0 0 0
363 Human Humasens Plus Test Strips DUS 0 0 0 0 0
364 Infuset anak SET 2 2 2 0 -2
365 Infuset dewasa SET 5 5 5 0 -5
366 IV catheter 18 G PCS 3 3 3 0 -3
367 IV catheter 20 G PCS 0 0 0 0 0
368 IV catheter 22 G PCS 9 9 9 0 -9
369 IV catheter 24 G PCS 0 0 0 0 0
370 Kantong mayat KANTONG 0 0 0 0 0
371 Kapas 500 gram ROL 0 0 0 0 0
372 Kapas berlemak 500 gram ROL 0 0 0 0 0
373 Kapas pembalut/absorben 250 gram ROL 0 0 0 0 0
374 Kassa gulung 40 yardx80 cm ROL 0 0 0 0 0
375 Kassa kotak steril 16 cm x 16 cm KOTAK 0 0 0 0 0
376 Kassa pembalut 2 m x 80 cm ROL 1 1 1 0 -1
377 Kassa pembalut hidrofil 4 m x 10 m ROL 1 1 1 0 -1
378 Kassa pembalut hidrofil 4 m x 15 m ROL 0 0 0 0 0
379 Kassa pembalut hidrofil 4 m x 5 m ROL 0 0 0 0 0
380 Kassa steril 40 cm x 40 cm ROL 0 0 0 0 0
381 Kertas EKG ROL 0 0 0 0 0
382 Larutan HCL 0.1 % BOTOL 0 0 0 0 0
383 Larutan spiritus BOTOL 0 0 0 0 0
384 Lens Cleaning Tissue PCS 0 0 0 0 0
385 Lens paper PCS 0 0 0 0 0
386 Leokoplast 5 X 4.5 inchi ROL 0 0 0 0 0
387 Leukoplast 1.25 cm x 4.5 m ROL 0 0 0 0 0
388 Leukoplast 2.5 cm x 4.5 m ROL 0 0 0 0 0
389 Liquid handsoap BOTOL 0 0 0 0 0
390 Lisol BOTOL 0 0 0 0 0
391 Mantoux test VIAL 0 0 0 0 0
392 Masker Ear Loop KOTAK 0 0 0 0 0
393 Masker N 95 PCS 49 49 49 0 -49
394 Masker Tie On KOTAK 0 0 0 0 0
395 Metanol BOTOL 0 0 0 0 0
396 Methilated spirit lamp SET 0 0 0 0 0
397 Micro sample cube 100 ml POT 0 0 0 0 0
398 Micropipet Tips MT II 1 ml PCS 0 0 0 0 0
399 Micropipet yellow tips PCS 0 0 0 0 0
400 Mikroskop SET 0 0 0 0 0
401 Mitella BUAH 0 0 0 0 0
402 Mucus extractor BUAH 0 0 0 0 0
403 NGT 12 PCS 0 0 0 0 0
404 NGT 14 PCS 0 0 0 0 0
405 NGT 16 PCS 0 0 0 0 0
406 NGT 8 PCS 0 0 0 0 0
NIPRO Syringe 1CC Need 26Gx1/2" Elektron Beam PCS
407 Srerilization 0 0 0 0 0
NIPRO Syringe 5CC Luer Lock Needle 22Gx1-1/2" PCS
408 Elektron 0 0 0 0 0

409 Objek glass KOTAK 0 0 0 0 0


410 Oncoprobe TEST 0 0 0 0 0
411 Onescrub 5 Liter BOTOL 0 0 0 0 0
412 Onescrub 500 cc + Dispenser BOTOL 0 0 0 0 0
413 Oxyflow nasal oxygen anak PIECE 1 1 1 0 -1
414 Oxyflow nasal oxygen bayi PIECE 1 1 1 0 -1
415 Oxyflow nasal oxygen dewasa PIECE 1 1 1 0 -1
416 Pembalut gips ROL 0 0 0 0 0
417 Pemutih BOTOL 0 0 0 0 0
418 Perban elastis 3 inchi ROL 0 0 0 0 0
419 Pewarna ZN PAKET 0 0 0 0 0
420 PH paper 3,8-5,4 LEMBAR 0 0 0 0 0
421 Pharmafix 5 cm x 500 cm PCS 0 0 0 0 0
422 Uniflek 7,5 cm x 4,5 m/120 (Verban Elastic) ROL 0 0 0 0 0
423 Plesterin non woven roll 5cm x 5m ROL 0 0 0 0 0
424 Policrepe pembalut elastis 10 cm x 4.55 m ROL 0 0 0 0 0
425 Polikresulen BOTOL 0 0 0 0 0
426 Polypropylene 2/0 DS 24 MM PCS 0 0 0 0 0
427 Polypropylene 3/0 DS 30 MM PCS 0 0 0 0 0
428 Polypropylene 5/0 DS 12MM SACHET 0 0 0 0 0
429 Pot sputum POT 0 0 0 0 0
Rapid test 1/2 antibodi standart pemeriksaan II PCS
430 0 0 0 0 0
Rapid test HIV 1/2 antibodi dan antingen HIV-1 standart PCS
431 pemeriksaan II 0 0 0 0 0

432 Rapid test HIV 1/2 antibodi standart PCS 0 0 0 0 0


433 Rapid test untuk sphilis PCS 0 0 0 0 0
434 RDT DBD IgG/IgM PCS 0 0 0 0 0
435 RDT DBD NS 1 PCS 0 0 0 0 0
436 RPR Antigen Test Syphilis TEST 0 0 0 0 0
437 RPR Test Kit PCS 0 0 0 0 0
438 Safety Box DUS 0 0 0 0 0
439 Salisyl bedak KOTAK 0 0 0 0 0
440 Sarung tangan gynaekologi PCS 4 4 4 0 -4
441 Sarung Tangan L KOTAK 0 0 0 0 0
442 Sarung Tangan M KOTAK 0 0 0 0 0
443 Sarung Tangan S KOTAK 50 50 50 0 -50
444 Sarung tangan steril 6 PASANG 5 5 5 0 -5
445 Sarung tangan steril 6.5 PCS 0 0 0 0 0
446 Sarung tangan steril 7 PCS 3 3 3 0 -3
447 Sarung tangan steril 7.5 PASANG 0 0 0 0 0
448 Sarung tangan steril 8 PCS 0 0 0 0 0
449 SD Sifilis TEST 0 0 0 0 0
450 SD HIV 1/2 3.0 ( Multi) TEST 0 0 0 0 0
451 Seal (penyumbat tabung hematokrit) PCS 0 0 0 0 0
452 Silk 2/0 PCS 5 5 5 0 -5
453 Silk 3/0 PCS 0 0 0 0 0
454 Silk Black 3/0 DS 19 MM PCS 0 0 0 0 0
455 Silk Black 4/0 DS 16 MM PCS 0 0 0 0 0
456 Slide box BOX 0 0 0 0 0
457 SMI Surgicryl Monofast 2/0 DS 24 MM SACHET 0 0 0 0 0
458 SMI Surgicryl Monofast 3/0 DS 24 MM SACHET 0 0 0 0 0
459 SMI Surgicryl Rapid 2/0 DS 24 MM SACHET 0 0 0 0 0
460 SMI Surgicryl Rapid 3/0 DS 26 MM SACHET 0 0 0 0 0
461 Spalk kayu BUAH 0 0 0 0 0
462 Stomach Tube No. 12 PIECE 0 0 0 0 0
463 Stomach Tube No. 14 PIECE 0 0 0 0 0
464 Surgical Tape 0.5" ( 18350 ) PCS 0 0 0 0 0
465 Surgical Tape 1" ( 18351 ) PCS 0 0 0 0 0
466 Tabung hematokrit KOTAK 0 0 0 0 0
467 Terumo Agani Needle 22G x 38MM PCS 0 0 0 0 0
468 Terumo Agani Needle 23Gx32MM PCS 0 0 0 0 0
469 Terumo Agani Needle 25G x 25MM PCS 0 0 0 0 0
470 Test gula darah BOX 0 0 0 0 0
471 Test kolesterol PCS 0 0 0 0 0
472 Test kolesterol BOX 0 0 0 0 0
473 Tissu gulung ROL 0 0 0 0 0
474 Triline HIV TEST 0 0 0 0 0
Tube EDTA PLH 13 x 75 3.0 BLBE LAV ( Vacutainer with BOX
475 EDTA 0 0 0 0 0
Tube EDTA PLH 13 x 75 4.0 PLBR RD ( Vacutainer tabung BOX
476 Plain ) 0 0 0 0 0

477 Urine bag SET 3 3 3 0 -3


478 Uritest reagent strip U11 Plus TUBE 0 0 0 0 0
479 Vacutainer tabung plain PCS 0 0 0 0 0
480 Vacutainer tube edta 3 ml PCS 0 0 0 0 0
481 Yodium Povidone 10% 60 ml BOTOL 2 2 2 0 -2
482 Yodium povidone 30 ml BOTOL 0 0 0 0 0
483 Yodium povidone 300 ml BOTOL 0 0 0 0 0
OBAT TAMBAHAN

JUMLAH KUNJUNGAN RESEP TIDAK BAYAR LAIN - LAIN JUMLAH

50 0 26 24
Mengetahui, Mengetahui, SANGLAR AGUSTUS 2019
KEPALA UPTD INSTALASI FARMASI KEPALA PUSKESMAS ……… PENGURUS BARANG PENANGGUNG JAWAB OBAT
KABUPATEN KARIMUN KABUPATEN KARIMUN

LELY AELIYA,S.Si. Apt (…………………...…..………) (…………………...…..………) (LINA.A.Md.Keb)


NIP. 19760523 200604 2 026

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