TAHUN 2016

UPT PUSKESMAS : UPT PUSKESMAS ABIANSEMAL IV

PUSKESMAS PEMBANTU YANG ADA :4
PROVINSI : Bali
PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
1 Acyclovir tablet 400 mg Tablet 750 800 600,000 1,800 1,350,000 2,000
2 Acyclovir cream 5 % Tube 2,999.964 230 689,992 150 449,995 255
3 Air Raksa Botol 103,536
4 Akarbos 50 mg Tablet 1,976.282
5 Alopurinol tablet 100 mg Tablet 120 600 72,000 4,500 540,000 4,300
6 Ambroxol syrup Botol 3,300 200 660,000 170
7 Ambroxol tablet 30 mg Tablet 125.070 11,400 1,425,798 19,600 2,451,372 28,000
8 Aminofilin tablet 200 mg Tablet 104.500 100 10,450 200 20,900 300
9 Amlodipine 5 mg T ablet 1,090 1,170 1,275,300 4,800 5,232,000 5,970
10 Amoksisilin kapletl 500 mg Kaplet 370 6,300 2,331,000 20,500 7,585,000 24,600
11 Amoksisilin kapsul 250 mg Kapsul 216
12 Amoksisilin sirup kering 125 mg/5ml Botol 3,699.300 570 2,108,601 240 887,832 700
13 Ampisilin kaplet 500 mg Kapsul 336
14 Antalgin (Metampiron) tablet 500 mg Tablet 47 1,000 47,000 1,000
15 Antasida DOEN kombinasi Tablet 134.992 7,200 971,942 14,400 1,943,885 19,800
16 Antasida DOEN suspensi Botol 2,643 115 303,945 200 528,600 215
17 Anti Hemoroid DOEN Kombinasi Sup 1,470
18 Aqua pro Injeksi steril, bebas pirogen Fles 1,500 10 15,000 2
19 As. Benzoat 3% + As. Salisilat 6% (W-F) salep Pot 1,154
20 As.Salicylsat 2% + Belerang 4 % (2-4) salep Pot 825
21 Asam Askorbat (Vit C) tablet 50 mg Tablet 19 5,400 102,600 9,000 171,000 10,000
22 Asam Folat Tablet 62 500 31,000 11,000 682,000 11,300
23 Asam mefenamat tab 500 mg Tablet 176.000 5,600 985,600 13,000 2,288,000 18,600
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
24 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2,517 2,700 6,795,900 150 377,550 2,825
25 Besi II Sulfat tablet kombinasi Tablet 27 570 15,390 6,000 162,000 6,060
26 Betahistin mesilat 6 mg Tablet 924 270 249,480 4,960 4,583,040 3,910
27 Betametason krim 0.1% Tube 1,865.6 120 223,872 580 1,082,048 675
28 Captopril 12,5 mg Tablet 71 200 14,200 3,500 248,500 3,000
29 Captopril 25 mg Tablet 138 2,000 276,000 6,000 828,000 7,400
30 Cetirizine 10 mg Tablet 330 1,080 356,400
31 Counterpain Tube 18,700
32 Deksametason injeksi 5 mg/ml - 1 ml Ampul 641 25 16,025 25
33 Deksametason tablet 0,5 mg Tablet 24 5,400 129,600 34,900 837,600 36,900
34 Dekstrometorfan sirup 10 mg/5 ml Botol 2,400
35 Dekstrometorfan tablet 15 mg Tablet 36
36 Demacolin tablet kombinasi Tablet 185
37 Devitalisasi Pasta (Non Arsen) Botol 388,994 1 388,994 1
38 Diasepam Inj 5 mg/ml Ampul 873
39 Diasepam Rectal 5 mg/2,5 ml Tube 28,380 20 567,600 20
40 Diazepam tablet 2 mg Tablet 13 1,000 13,000 1,000 13,000 900
41 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 960 90 86,400 90
42 Digoksin tablet 0,25 mg Tablet 83 400 33,200 700 58,100 800
43 Doksisiklin Tablet 229.999 400 92,000 400
44 Efedrin HCl tablet 25 mg Tablet 35
45 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 432 10 4,320 10
46 Erytromicin 500 mg Tablet 535 1,000 535,000 300
47 Erytromicin syrup Botol 6,523 120 782,760 120
48 Etakridina ( rivanol ) larutan 0.1% Botol 1,799.600 19 34,192 44 79,182 50
49 Etanol (alkohol) 70 % 1000 ml Botol 26,488 7.0 185,416 7
50 Etil Klorida spray Botol 81,392 18 1,465,056 20 1,627,840 36
51 Eugenol cairan Botol 3,178 2 6,356 2
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
52 Famotidin tablet 20 mg Tablet 113
53 Fenilbutason tablet Tablet 72
54 Fenobarbital Inj Ampul 670
55 Fenobarbital tablet 30 mg Tablet 32 600 19,200
56 Fenol Gliserol tetes telinga 10% Botol 1,008 80 80,640 80
57 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul 978 430 420,540 12
58 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 681 200 136,200 200 136,200 300
59 Fitomethadion Inj 2 mg/ml Ampul 13,200
60 Frisium (clobazam) 40 mg Tube 950
61 Furosemid tablet 40 mg Tablet 72 600 43,200 1,900 136,800 2,400
62 Garam Oralit untuk 200 ml air Sak 440 800 352,000 4,800 2,112,000 4,300
63 Gentamicin salep kulit Tube 1,650
64 Gentamicin Sulfat TM 0,3% Botol 3,000 110 330,000 208 624,000 318
65 Gentian Violet larutan 1 % Botol 450 50 22,500 50
66 Glibenklamid tablet 5 mg Tablet 72 400 28,800 7,000 504,000 6,100
67 Glikasid 80 mg Tablet 1,914.000
68 Gliseril Guayakolat tablet 100 mg Tablet 23
69 Glukosa larutan infus 10 % steril (Produk lokal) Fles 4,100
70 Glukosa larutan infus 5 % steril (Produk lokal) Fles 3,821 7 26,747 - 7
71 Griseofulvin tablet 125 mg, micronized Tablet 225 600 135,000 400 90,000 1,000
72 Haloperidol 0.5 mg Tablet 60.236
73 Haloperidol tablet 1,5 mg Tablet 123
74 Haloperidol tablet 5 mg Tablet 60
75 Hidroklorotiazid (HCT) tablet 25 mg Tablet 36 1,000 36,000 400
76 Hidrokortison krim 2,5 % Tube 2,999.700 70 209,979 506 1,517,848 456
77 Ibuprofen tablet 200 mg Tablet 104.995 - - -
78 Ibuprofen tablet 400 mg Tablet 148 2,100 310,800 2,000 296,000 4,100
79 Isoniasid (INH) 100 Mg Tablet 38
80 Isosorbid Di Nitrat Tablet 65 200 13,000
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
81 Kalsium Hidroksida Pasta Kotak 102,363 1 102,363 1
82 Kalsium Laktat (Kalk) tablet 500 mg Tablet 52
83 Karbamazepin tablet 200 mg Tablet 246.455
84 Ketokonazole cream 2 % 15 gram Tube 4,666 67 312,622 - 43
85 Ketokonazole tablet 200 mg Tablet 372 - 500 186,000 250
86 Ketorolac Inj 30 mg Ampul 13,365.000 - - -
87 Klindamycin 300 mg Tablet 685 500 342,500 - 400
88 Kloramfenikol kapsul 250 mg Kapsul 153 - - -
89 Kloramfenikol tetes telinga 3 % Botol 1,000 52 52,000 192 192,000 196
90 Kloramphenikol salep mata 1 % Tube 1,563 408 637,704 216
91 Kloramphenikol Tetes Mata Botol 2,499.200 100 249,920 85
92 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 23.9998 22,800 547,195 15,600
93 Klorfenol Kamfer Menthol (CHKM) Botol 55,000
94 Klorpromazin HCl tablet salut 100 mg Tablet 104
95 Klorpromazin HCl tablet salut 25 mg Tablet 31 1,000 31,000 1,000
96 Kotrimoksazol Suspensi Botol 3,500.20 265 927,553 155
97 Kotrimoksazol tablet 480 mg kombinasi Tablet 165 700 115,500 1,700 280,500 2,100
98 Kotrimoksazol tablet pediatrik 120 mg Tablet 50
99 Levertran salep (salep minyak ikan) Pot 1,350
100 Lidokain injeksi Ampul 1,009.998 275 277,749 100 101,000 285
101 Lidokain Kompositum Ampul 1,033.303 145 149,829 145
102 Lisol Botol 49,862 6 299,172 6
103 Loperamid tablet 2 mg Tablet 96 600 57,600 200 19,200 800
104 Loratadin tablet 10 mg Tablet 333 750 249,750 200 66,600 950
105 Meloksikam 15 mg Tablet 1,199
106 Meloksikam 7,5 mg Tablet 692
107 Metformin 500 mg Tablet 182 600 109,200 8,000 1,456,000 8,100
108 Methyl Prednisolon 4 mg Tablet 509 2,000 1,018,000 1,000
109 Metilergometrin Maleat 0,125 mg Tablet 110
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
110 Metilergometrin Maleat inj 0,200 mg-1 ml Ampul 1,490 180 268,200 10 14,900 190
111 Metoklopramid syrup Botol 1,914 - - 120 229,680 40
112 Metoklopramid tablet 5 mg Tablet 73 300 21,900 800 58,400 800
113 Metronidazol tablet 500 mg Tablet 200 700 140,000 1,200 240,000 1,900
114 Mummifying Pasta Botol 527,000
115 Natrium Diklofenac tablet 25 mg Botol 167.662 14,000 2,347,268 12,500
116 Natrium Diklofenac tablet 50 mg Tablet 217.668 300 65,300 8,400 1,828,411 8,700
117 Natrium Klorida larutan infus 0.9% steril Fles 4,899.400 52 254,769 40 195,976 91
118 New Diatabs ( Pularek ) Tablet 1,700.000 900 1,530,000 800 1,360,000 1,650
119 Nifedipin Tablet 108 - - - -
120 Nistatin tablet vaginal 100.000 IU/g Tablet 289 60 17,340 300 86,700 280
121 Obat Batuk Hitam ( O.B.H. ) cairan Botol 2,500
122 Okitetrasiklin Salep Kulit 3 % Tube 1,675 165 276,375 165
123 Oksitetrasiklin HCl salep mata 1 % Tube 1,919.984 170 326,397 170
124 Oksitosin inj 10iu/ml-1ml Ampul 1,785 10 17,850 10
125 Omeprazol 20 mg Tablet 408 300 122,400 6,000 2,448,000 4,590
126 Papaverin Tab 40 mg Tablet 57 700 39,900 600
127 Paraformaldehid tablet Tablet 60
128 Parasetamol Rektal 125 mg/2.5 ml Tube 12,672.000 75 950,400 125 1,584,000 185
129 Parasetamol sirup 120 mg/5 ml Botol 1,725 336 579,600 1,176 2,028,600 1,374
130 Parasetamol tablet 500 mg Tablet 45 11,000 495,000 40,000 1,800,000 43,600
131 Perak Sulfadiazin 1% (Burnazin) Tube 33,000 10 330,000 7
132 Perhidrol ( H2O2) 3 % Botol 10,800
133 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 14.300 2,000 28,600 2,000 28,600 4,000
134 Piroxicam tab 10 mg Tablet 74.998
135 Piroxicam tab 20 mg Tablet 104.995 500 52,498 6,000 629,970 6,500
136 Prednison tablet 5 mg Tablet 38 - - 1,000 38,000 400
137 Ranitidin Tablet 200 7,400 1,480,000 5,000 1,000,000 11,700
138 Ranitidin Inj 25 mg/2 ml Ampul 2,336
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
139 Retinol (vit.A) 100,000 IU tablet salut Tablet 317 550 174,350 550
140 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 462 3,250 1,501,500 3,250
141 Ringer Laktat larutan infus steril (Produk lokal) botol 5,199.700 25 129,993 40 207,988 60
142 Risperidon 2 mg Tablet 2,375.000 300 712,500 300
143 Salbutamol Nebuliser Ampul 10,532.500 55 579,288 140 1,474,550 160
144 Salbutamol tablet 2 mg Tablet 88 - - 1,000 88,000 200
145 Salbutamol tablet 4 mg Tablet 97.482 800 77,986 7,000 682,374 7,800
146 Salicyl spiritus Botol 2,750 - - - -
147 Salisil Bedak 2 % Botol 1,025 175 179,375 144 147,600 289
148 Sefadroxil Syrup Botol 7,227 60 433,620 150 1,084,050 210
149 Sefadroxil tablet 500 mg Capsul 700 100 70,000 5,000 3,500,000 5,000
150 Semen Seng Fosfat serbuk dan cairan Botol 80,659
151 Serum Anti Bisa Ular Polivalen injeksi 50 ml Ampul 273,999
152 Serum Anti Tetanus Injeksi 1.500 IU/ampul Ampul 61,817.800 6 370,907 55 3,399,979 61
153 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 473
154 Silver Amalgam Botol 261,395 1 261,395 1
155 Simetidin tablet 200 mg Tablet 72 200 14,400 200
156 Sinvastatin tablet 10 mg Tablet 513 270 138,510 4,080 2,093,040 1,860
157 Siprofloxacin Tab 500 mg Tablet 240 7,900 1,896,000 6,900
158 Sohobion 5000 mg Tablet 1,100
159 Spironolakton 25 mg Tablet 346.368
160 Sulfasetamida Natrium tetes mata 15 % Botol 3,445 91 313,495 144 496,080 235
161 Supra Livron ( Multivitamin ) Tablet 372.977
162 Supratul bok 11,300 19 214,700 24 271,200 38
163 Tetracain TM 0,5% Botol 3,088
164 Tetrasiklin HCl kapsul 250 mg Kapsul 66
165 Tetrasiklin HCl kapsul 500 mg Kapsul 257 300 77,100 300
166 Thiamin HCl (Vit.B1) injeksi 100mg/ml-1ml Ampul 467
167 Thiamin HCl Mononitrat (Vit.B1) tablet 50mg Tablet 37.739
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
168 Tramadol Inj 5m mg/ml Ampul 6,402.000
169 Triflouperazin 5 mg Tablet 380
170 Triheksifenidil Hidroklorida tablet 2 mg Tablet 41
171 Trikresol Formalin Botol 97,750
172 Vitamin B Kompleks tablet Tablet 22 5,500 121,000 13,600 299,200 16,900
173 Yodium povidon larutan 10% 300ml Botol 14,500 21 304,500 - 13
174 Yodium povidon larutan 10% 30ml Botol 2,000 30 60,000 30
175 Zinc tablet 20 mg Tablet 472.494 1,800 850,489 2,500 1,181,235 3,900
176 Alletrol Tetes Mata botol 11590.7
177 Antalgin Injeksi Ampul 3302.216
178 Asetosal 100 mg Tablet 95.997
179 Astaxanthin 2 mg Tablet 2379.667
180 Bisacodyl 5 mg (Dulcolax) Tablet 2079 200 415,800 200 415,800 400
181 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1040.16 200 208,032 500 520,080 600
182 Hyoscine-N-Butilbromide Inj 20 mg/ml (Buscopan Injek Ampul 2467.498 30 74,025 30
183 Magnesium Sulfat Inj 40% 25 ml Ampul 1947.88 30 58,436 6
184 Miconazol Tube 1718.75 50 85,938 88 151,250 50
185 NB Salep Tube 20,301.6 48 974,477 34
186 Ondancetron 8 mg Tablet 2596 120 311,520
187 Ondansetron 8 mg inj Ampul 10384 20 207,680 15
188 Parasetamol Drop Botol 4799.3 98 470,331 93
189 Pilokarpin tetes mata 2% Botol 5214 50 260,700 50
190 Prenatin Plus Tablet 763.4
191 Sohobion Injeksi Ampul 6490
192 Sucralfate 500 mg Tablet 1090.32
193 Tiamfenikol 500 mg Tablet 616
194 Xanvit Plus 60 ml Botol 16,874
195 Ibuprofen Sirup Botol 8250 220 1,815,000 50 412,500 220
196 Domperidon Sirup Botol 3624 250 906,000 200 724,800 370
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
197 Scabisid Salep Tube 21499.5 103 2,214,449 103
198 Kalium Diklofenak Tablet 708.004 550 389,402 300 212,401 850
199 Albotyl (polikresol) Botol 21801 10 218,010 10 218,010 13
200 Salbutamol Inhaler Botol 63,750 60 3,825,000 60
201 Azitromysin 500 Tablet 200 200
202 Anti TBC Anak Paket 2 2 4
203 Anti TBC Katagori I Paket 6 5
204 Anti TBC Katagori II Paket 2
205 Anti TBC Katagori sisipan Paket 2 2
206 Alkohol Swab biji 900 2,500 3,400
207 Alat suntik 10 ml biji 100 70
208 Alat suntik 2,5 ml biji 1,000 700
209 Alat suntik 5 ml biji 100 85
210 Blood Lanset bok 5 5
211 Cefixim Tablet 150 150
212 Charmbone Botol 1 1
213 Cresophene Botol 1 1
214 Domperidon drop Botol 115 92
215 Deksosimetason Tube 78 81 118
216 Dulcolak ( stolax Supp) Supp 240 156
217 Erlaplu sirup Botol 432 432
218 Erfakaf sirup Botol 576 576
219 Etanol (alkohol) 70 % 300 ml Botol 16 16
220 Etanol ( alkohol ) 70 % 100 ml Botol 200 200
221 Ergotamin cafeein Tablet 200 600 800
222 Endometason N Botol 1 1
223 Glucostik nesco ktk 7 7
224 Glimeperid 1 mg Tablet 3,000
225 Glimeperid 2 mg Tablet 3,000
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
226 Hand scund M Biji 1,300 2,000 3,300
227 Hand scund L Biji 1,300 1,300
228 Inoclar vivadent ( Etsa ) Botol 1 1
229 Infuset anak set 7 6
230 Infuset dewasa set 4 3
231 IV cateter No 18 G Biji 7 10 14
232 IV cateter No 20 G Biji 5 6 7
233 IV cateter No 22 G Biji 7 3 6
234 Jarum Heacting no 14 Biji 12 12
235 Kalium Gluconat Ampul 432 8
236 Kapas Pembalut 250 gram Biji 53 34
237 Kasa Pembalut 2m x 80 cm Rol 145 360 365
238 Kasa Pembalut Hidrofil 4 x 15 cm Rol 130 600 290
239 Kasa Pembalut Hidrofil 4 x 3 cm Rol 200 675 525
240 Kasa gulung besar Rol 8 8
241 Kertas perkamen pak 78 78
242 Klip besar 15 x 10cm Biji 32,000
243 Klip sedang 13 x 10cm biji 82,000 60,000 27,000
244 Klip Kecil 10 x 7 cm biji 34,000 68,000 29,000
245 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 60 3
246 Masker biji 1,750 2,000 2,050
247 Medicin packet bok 2 1
248 Metronidazol vagina ( flagyl ) Supp 290 240
249 Molexflu Tablet 24,000 24,000
250 Mata bur gigi ( Longseng bur ) biji
251 Mata bur gigi ( Fissure bur ) biji
252 Mata bur gigi ( Round bur ) biji
253 Mata bur gigi ( Inverted bur ) biji
254 Nutifar Tablet 4,000 12,000 16,000
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
255 Nurse cup biji 2,000
256 Pirantel suspensi Botol 50 45
257 Plester 5 yard x 2 inchi rol 18 60 43
258 Plester ultrafik 10 cm x 1 m Rol 220 195
259 Pot dahak biji 342 342
260 Pehacain injeksi Ampul 100
261 PP test biji 105 100 205
262 Pisau bedah no 11 biji 100 32
263 Procurma sirup Botol 295 100 305
264 Paracetamol Rectal 250 mg /2,5 ml Tube 25 25
265 Ramipril Tablet 4,500 4,500
266 Rokle 'S Botol 1 1
267 Sucralfate sirup Botol 21 100 121
268 Sohobion Injeksi Ampul 10 10
269 Siobion Tablet 19,000 13,600
270 Tempory stopping fletcher Botol 1 1
271 Tumpatan Permanen Botol 1 1
272 Tumpatan sementara Botol 10 1 11
273 Tumpatan art Botol 1 1
274 Tranfusi set set 5
275 Under ped biji 10 2
276 Urin Bag biji 37 10 26
277 Ultra sound tranmisi gel botol 5 5
278 Wing needle biji 25 15
279 Zinc sirup Botol 125 75 180
280 Zinc drop Botol 25 45 55
TOTAL

Mengetahiu Taman, 14 Januari 2016

Kepala UPT Puskesmas Abiansemal IV Petugas Gudang Farmasi Puskesmas

Luh Gede Krisna Listikawati

dr Agus Wawan
NIP 197802042010012009
NIP 19740392006041002
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
Mengetahiu JUMLAH RUPIAH JUMLAH RUPIAH Taman, 14 Januari 2016
JUMLAH
Kepala UPT Puskesmas Abiansemal IV Petugas Gudang Farmasi Puskesmas

Luh Gede Krisna Listikawati

dr Agus Wawan
NIP 197802042010012009
NIP 19740392006041002
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
 PENERIMAAN TAHUN
HARGA SISA STOK TAHUN 2014 PEMAKAIAN TAHUN 2015
NO NAMA OBAT SATUAN 2015
SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH JUMLAH
 :

SISA STOK AKHIR TAHUN

PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
1,500,000 600 450,000
764,991 125 374,996

516,000 800 96,000

561,000 30 99,000
3,501,960 3,000 375,210
31,350
6,507,300
9,102,000 2,200 814,000

2,589,510 110 406,923

47,000
2,672,842 1,800 242,986
568,245 100 264,300

3,000 8 12,000

190,000 4,400 83,600

700,600 200 12,400
3,273,600
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
7,110,525 25 62,925
163,620 510 13,770
3,612,840 1,320 1,219,680
1,259,280 25 46,640
213,000 700 49,700
1,021,200 600 82,800
1,080 356,400

16,025
885,600 3,400 81,600

388,994

567,600
11,700 1,100 14,300
86,400
66,400 300 24,900
92,000

4,320
160,500 700 374,500
782,760
89,980 13 23,395
185,416
2,930,112 2 162,784
6,356
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH

600 19,200
80,640
11,736 418 408,804
204,300 100 68,100

172,800 100 7,200

1,892,000 1,300 572,000

954,000
22,500
439,200 1,300 93,600

26,747
225,000

14,400 600 21,600

1,367,863 120 359,964
-
606,800

200 13,000
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
102,363

200,638 24 111,984
93,000 250 93,000
- -
274,000 100 68,500
- -
196,000 48 48,000
337,608 192 300,096
212,432 15 37,488
374,397 7,200 172,799

31,000
542,531 110 385,022
346,500 300 49,500

287,849 90 90,900
149,829
299,172
76,800
316,350

1,474,200 500 91,000

509,000 1,000 509,000
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
283,100
76,560 80 153,120
58,400 300 21,900
380,000

2,095,775 1,500 251,493

1,893,712
445,845 1 4,899
2,805,000 50 85,000
- -
80,920 80 23,120

276,375
326,397
17,850
1,872,720 1,710 697,680
34,200 100 5,700

2,344,320 15 190,080
2,370,150 138 238,050
1,962,000 7,400 333,000
231,000 3 99,000

57,200

682,468
15,200 600 22,800
2,340,000 700 140,000
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
174,350
1,501,500
311,982 5 25,999
712,500
1,685,200 35 368,638
17,600 800 70,400
760,360 -
- -
296,225 30 30,750
1,517,670 -
3,500,000 100 70,000

3,770,886

261,395
14,400
954,180 2,490 1,277,370
1,656,000 1,000 240,000

809,575

429,400 5 56,500

77,100
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH

371,800 2,200 48,400

188,500 8 116,000
60,000
1,842,727 400 188,998

831,600
624,096 100 104,016
74,025
11,687 24 46,749
85,938 88 151,250
690,254 14 284,222
120.0 311,520
155,760 5.0 51,920
446,335 5.0 23,997
260,700

1,815,000 50.0 412,500

1,340,880 80.0 289,920
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
2,214,449
601,803
283,413 7 152,607
3,825,000 -

1
2

30
300
15

23
41
84

###
###
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH

1
1
3
4
4

424
19
140
440
350

###
115,000
73,000
57
1,700
1
50
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
###
5
35
25

###

68
90

5,400

###
8
21

10
20
15
15,853,161

Taman, 14 Januari 2016

Petugas Gudang Farmasi Puskesmas

Luh Gede Krisna Listikawati

NIP 197802042010012009
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
Taman, 14 Januari 2016
RUPIAH JUMLAH RUPIAH
Petugas Gudang Farmasi Puskesmas

Luh Gede Krisna Listikawati

NIP 197802042010012009
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
 SISA STOK AKHIR TAHUN
PEMAKAIAN TAHUN 2015
2015
RUPIAH JUMLAH RUPIAH
 LAPORAN PENERIMAAN GUDANG
TAHUN 2016

UPT PUSKESMAS : UPT PUSKESMAS ABIANSEMAL IV

PUSKESMAS PEMBANTU YANG ADA :4
PROVINSI : Bali
HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA
NO NAMA OBAT SATUAN JAN FEB MEI JUNI JULI AGUST SEPT OKT
1 2 3 MAR 4 APRIL 5 6 7 8 9 10 11
1 Acyclovir tablet 400 mg Tablet 336.000 500 336.000 1,000 336.000 500 -
2 Acyclovir cream 5 % Tube 2999.964 50 3,938.000 200 3,938.000 100 3,938.000 100
3 Air Raksa Botol
4 Akarbos 50 mg Tablet
5 Alopurinol tablet 100 mg Tablet 86.000 500 86.000 2,000 86.000
6 Ambroxol syrup Botol 4120.000 200 4,120.000 200 4,120.000 200 4,120.000 200 4,120.000 200 4,120.000 200 4,120.000 500 4,120.000 300
7 Ambroxol tablet 30 mg Tablet 412.000 3,000 412.000 3,000 412.000 1,300
8 Aminofilin tablet 200 mg Tablet
9 Amlodipine 5 mg T ablet 187.000 1,020 187.000 1,500 105.000 1,770 105.000
10 Amoksisilin kapletl 500 mg Kaplet 220.000 4,200 220.000 4,200 220.000 4,200 220.000 4,200 220.000 4,200 220.000 4,200 220.000 4,200 261.000
11 Amoksisilin kapsul 250 mg Kapsul
12 Amoksisilin sirup kering 125 mg/5ml Botol 2445.000 120 2,445.000 120 2,445.000 120 2,445.000 120 2,445.000 120 2,445.000
13 Ampisilin kaplet 500 mg Kapsul
14 Antalgin (Metampiron) tablet 500 mg Tablet
15 Antasida DOEN kombinasi Tablet 72.000 1,000 72.000 3,000 72.000 7,200 72.000 7,200 72.000
16 Antasida DOEN suspensi Botol 2112.000 200 2,025.000 100 2,025.000
17 Anti Hemoroid DOEN Kombinasi Sup
18 Aqua pro Injeksi steril, bebas pirogen Fles 5,500.000 10 5,500.000 10 5,500.000 10 2,750.000 10
19 As. Benzoat 3% + As. Salisilat 6% (W-F) salep Pot
20 As.Salicylsat 2% + Belerang 4 % (2-4) salep Pot
21 Asam Askorbat (Vit C) tablet 50 mg Tablet 95.000 7,000 95.000 7,000
22 Asam Folat Tablet 48.000 500 48.000 500 48.000 500
23 Asam mefenamat tab 500 mg Tablet 112.000 3,000 112.000 3,000 112.000 4,500 112.000 4,500 112.000 4,500
Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2516.000
2,516.000 100 2,516.000 150 2,516.000 100
24 100
25 Besi II Sulfat tablet kombinasi Tablet 3,000 3,000 42.000 3,000 42.000
26 Betahistin mesilat 6 mg Tablet 1,150.000 1,800 1,150.000 1,800 1,150.000 1,800 149.000 1,500 149.000
27 Betametason krim 0.1% Tube 1520.000 100 1,520.000 100 1,520.000 150 1,520.000 100 1,520.000 100
28 Captopril 12,5 mg Tablet 63.000 500 63.000 500 63.000 500 63.000 500
29 Captopril 25 mg Tablet 88.000 1,000 88.000 3,000 88.000 2,000 88.000 3,000 88.000 2,000 88.000 2,000 88.000 1,000 88.000
30 Cetirizine 10 mg Tablet
31 Counterpain Tube
32 Deksametason injeksi 5 mg/ml - 1 ml Ampul
33 Deksametason tablet 0,5 mg Tablet 62.000 3,000 62.000 4,000 62.000 4,000 62.000 4,000 62.000 4,000 62.000 4,000 62.000 4,000 62.000 3,000 62.000
34 Dekstrometorfan sirup 10 mg/5 ml Botol
35 Dekstrometorfan tablet 15 mg Tablet
36 Demacolin tablet kombinasi Tablet
37 Devitalisasi Pasta (Non Arsen) Botol 669,493.000 1
38 Diasepam Inj 5 mg/ml Ampul
39 Diasepam Rectal 5 mg/2,5 ml Tube
40 Diazepam tablet 2 mg Tablet
41 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 1050.000 90
42 Digoksin tablet 0,25 mg Tablet 97.000 200 97.000 100 97.000 100
43 Doksisiklin Tablet 229.999 100 220.000 200 229.999 200
44 Efedrin HCl tablet 25 mg Tablet
45 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 2,204.000 10
46 Erytromicin 500 mg Tablet 930.000 500 930.000 1,000 930.000 500 930.000 500
47 Erytromicin syrup Botol 7700.000 120 7,700.000 80 7,700.000 120
48 Etakridina ( rivanol ) larutan 0.1% Botol
49 Etanol (alkohol) 70 % 1000 ml Botol
50 Etil Klorida spray Botol 111980.000 10 111,980.000 10 111,980.000 10 111,980.000 10
51 Eugenol cairan Botol 16667.000 1 16,667.000 1 16,667.000 1
52 Famotidin tablet 20 mg Tablet
53 Fenilbutason tablet Tablet
54 Fenobarbital Inj Ampul
55 Fenobarbital tablet 30 mg Tablet
56 Fenol Gliserol tetes telinga 10% Botol
57 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul
58 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 579.000 100
59 Fitomethadion Inj 2 mg/ml Ampul
60 Frisium (clobazam) 40 mg Tube
61 Furosemid tablet 40 mg Tablet 75.000 500 75.000 1,000 75.000 300 75.000 300 75.000 500 75.000
62 Garam Oralit untuk 200 ml air Sak 380.000 1,800 288.000 1,200
63 Gentamicin salep kulit Tube
64 Gentamicin Sulfat TM 0,3% Botol 3194.000 96 3,194.000 96 4,000.000 120 4,000.000
65 Gentian Violet larutan 1 % Botol
66 Glibenklamid tablet 5 mg Tablet 56.000 2,000
67 Glikasid 80 mg Tablet
68 Gliseril Guayakolat tablet 100 mg Tablet
69 Glukosa larutan infus 10 % steril (Produk lokal) Fles
70 Glukosa larutan infus 5 % steril (Produk lokal) Fles
71 Griseofulvin tablet 125 mg, micronized Tablet 224.994 200 224.994 200 224.994 200
72 Haloperidol 0.5 mg Tablet
73 Haloperidol tablet 1,5 mg Tablet
74 Haloperidol tablet 5 mg Tablet
75 Hidroklorotiazid (HCT) tablet 25 mg Tablet
76 Hidrokortison krim 2,5 % Tube 2,798.000 96 2,798.000 192 2,798.000 120
77 Ibuprofen tablet 200 mg Tablet
78 Ibuprofen tablet 400 mg Tablet 150.000 1,000 150.000 1,000 150.000 1,000 150.000 2,000 150.000 2,000 150.000
79 Isoniasid (INH) 100 Mg Tablet
80 Isosorbid Di Nitrat Tablet
 81 Kalsium Hidroksida Pasta Kotak 303600.000 1 303,600.000 1 303,600.000 1
82 Kalsium Laktat (Kalk) tablet 500 mg Tablet
83 Karbamazepin tablet 200 mg Tablet
84 Ketokonazole cream 2 % 15 gram Tube 4700.000 24 4,700.000 48 4,700.000 96
85 Ketokonazole tablet 200 mg Tablet 300.000 450
86 Ketorolac Inj 30 mg Ampul
87 Klindamycin 300 mg Tablet 553.000 100 553.000 100 553.000 100 553.000 100
88 Kloramfenikol kapsul 250 mg Kapsul
89 Kloramfenikol tetes telinga 3 % Botol 5770.000 48 5,770.000 96
90 Kloramphenikol salep mata 1 % Tube 1,600.000 48 1,600.000 48
91 Kloramphenikol Tetes Mata Botol 13150.000 50 13,150.000 100 13,150.000 200
92 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 80.850 2,000 80.850 2,000 80.850 3,000 80.850 3,000 80.850 2,000 80.850 3,000 80.850
93 Klorfenol Kamfer Menthol (CHKM) Botol 152980.000 1 152,980.000 1
94 Klorpromazin HCl tablet salut 100 mg Tablet
95 Klorpromazin HCl tablet salut 25 mg Tablet
96 Kotrimoksazol Suspensi Botol 2,167.000 50
97 Kotrimoksazol tablet 480 mg kombinasi Tablet 138.000 500 138.000 500 138.000 500 138.000 500 138.000 500
98 Kotrimoksazol tablet pediatrik 120 mg Tablet
99
Levertran salep (salep minyak ikan) Pot
100 Lidokain injeksi Ampul 839.000 100 839.000 100 839.000 100
101 Lidokain Kompositum Ampul
102 Lisol Botol 37300.000 10
103 Loperamid tablet 2 mg Tablet 89.000 200 89.000 300 89.000 300 89.000 300 89.000 300
104 Loratadin tablet 10 mg Tablet 154.000 500 154.000 100 154.000 100
105 Meloksikam 15 mg Tablet
106 Meloksikam 7,5 mg Tablet
107 Metformin 500 mg Tablet 112.500 1,000 112.500 1,500 112.500 2,000 112.500 3,000 112.500 3,000 112.500 4,000 112.500 4,000
108 Methyl Prednisolon 4 mg Tablet 205.000 1,000 205.000 1,000 205.000 1,000 205.000 1,000 205.000 1,000 205.000 2,000
109 Metilergometrin Maleat 0,125 mg Tablet 154.000 200
110 Metilergometrin Maleat inj 0,200 mg-1 ml Ampul
111 Metoklopramid syrup Botol 2,600.000 60
112 Metoklopramid tablet 5 mg Tablet 108.000 500 108.000 1,000 108.000 500
113 Metronidazol tablet 500 mg Tablet 154.000 500 154.000 1,000 154.000 500 154.000 500 154.000 500
114 Mummifying Pasta Botol 890494.000 1 890,494.000 1
115 Natrium Diklofenac tablet 25 mg Botol 133.000 2,800
116 Natrium Diklofenac tablet 50 mg Tablet 176.000 2,800 176.000 2,800 176.000 2,800 176.000 2,800 176.000 2,800 176.000 2,800 159.000
117 Natrium Klorida larutan infus 0.9% steril Fles 4900.000 20 4,900.000 20 4,900.000 20 4,900.000 20 4,900.000 20 4,700.000 20
118 New Diatabs ( Pularek ) Tablet 190.000 200 190.000 500 190.000 500
119 Nifedipin Tablet
120 Nistatin tablet vaginal 100.000 IU/g Tablet 407.000 100
121 Obat Batuk Hitam ( O.B.H. ) cairan Botol
122 Okitetrasiklin Salep Kulit 3 % Tube
123 Oksitetrasiklin HCl salep mata 1 % Tube
124 Oksitosin inj 10iu/ml-1ml Ampul
125 Omeprazol 20 mg Tablet 211.000 1,020 211.000 1,020
126 Papaverin Tab 40 mg Tablet
127 Paraformaldehid tablet Tablet
128 Parasetamol Rektal 125 mg/2.5 ml Tube 21370.800 25
129 Parasetamol sirup 120 mg/5 ml Botol 1438.000 168 1,438.000 252 1,438.000 252 1,438.000 252 1,438.000 252 1,438.000 252 1,438.000 252
130 Parasetamol tablet 500 mg Tablet 79.000 10,000 79.000 10,000 79.000 10,000 79.000 10,000 79.000 10,000 79.000
131 Perak Sulfadiazin 1% (Burnazin) Tube 55,000.000 3 55,000.000 2 55,000.000 2
132 Perhidrol ( H2O2) 3 % Botol
133 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 110.000 1,000 110.000 3,000 110.000 3,000 110.000 3,000
134 Piroxicam tab 10 mg Tablet
135 Piroxicam tab 20 mg Tablet
136 Prednison tablet 5 mg Tablet 114.000 500 114.000 1,000 114.000 1,000 114.000 1,000
137 Ranitidin Tablet 120.000 1,000 120.000 1,000 120.000 2,000 120.000 2,000 105.000 1,000
138 Ranitidin Inj 25 mg/2 ml Ampul
139 Retinol (vit.A) 100,000 IU tablet salut Tablet 260.000 1,000
140 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 459.000 4,000
141 Ringer Laktat larutan infus steril (Produk lokal) botol 5200.000 20 5,200.000 20 5,200.000 20 7,150.000 20
142 Risperidon 2 mg Tablet
143 Salbutamol Nebuliser Ampul 11,440.000 100 11,946.000 100 11,946.000 40 11,946.000
144 Salbutamol tablet 2 mg Tablet 59.000 2,000 59.000 2,000 59.000 1,000 59.000 2,000 59.000 2,000 59.000 1,000
145 Salbutamol tablet 4 mg Tablet
146 Salicyl spiritus Botol
147 Salisil Bedak 2 % Botol 1120.000 100 1,120.000 100 1,250.000 100
148 Sefadroxil Syrup Botol
149 Sefadroxil tablet 500 mg Capsul
150 Semen Seng Fosfat serbuk dan cairan Botol
151 Serum Anti Bisa Ular Polivalen injeksi 50 ml Ampul
152 Serum Anti Tetanus Injeksi 1.500 IU/ampul Ampul 263620.000 10 263,620.000 10 263,620.000 10 263,620.000 10 263,620.000 10 263,620.000 10 263,620.000 10 263,620.000 10 263,620.000
153 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul
154 Silver Amalgam Botol 699996.000 1 699,996.000 1 669,996.000 1
155 Simetidin tablet 200 mg Tablet
156 Sinvastatin tablet 10 mg Tablet
157 Siprofloxacin Tab 500 mg Tablet 255.000 1,000 255.000 1,000 255.000 1,000 255.000 1,000 255.000 1,000
158 Sohobion 5000 mg Tablet
159 Spironolakton 25 mg Tablet
160 Sulfasetamida Natrium tetes mata 15 % Botol
161 Supra Livron ( Multivitamin ) Tablet
162 Supratul bok 206030.000 10 206,030.000 10 206,030.000 10 206,030.000 5
163 Tetracain TM 0,5% Botol
164 Tetrasiklin HCl kapsul 250 mg Kapsul
165 Tetrasiklin HCl kapsul 500 mg Kapsul
166 Thiamin HCl (Vit.B1) injeksi 100mg/ml-1ml Ampul
167 Thiamin HCl Mononitrat (Vit.B1) tablet 50mg Tablet
168 Tramadol Inj 5m mg/ml Ampul
169 Triflouperazin 5 mg Tablet
170 Triheksifenidil Hidroklorida tablet 2 mg Tablet
171 Trikresol Formalin Botol
172 Vitamin B Kompleks tablet Tablet 107.000 6,800 107.000 6,800 107.000 6,800 107.000 6,800 107.000
173 Yodium povidon larutan 10% 300ml Botol 14203.000 10 14,203.000 10 14,203.000 20 14,203.000 20
174 Yodium povidon larutan 10% 30ml Botol
175 Zinc tablet 20 mg Tablet 473.000 1,000 473.000 1,000 473.000 500 473.000 1,500 473.000 500
176 Alletrol Tetes Mata botol
177 Antalgin Injeksi Ampul
178 Asetosal 100 mg Tablet
179 Astaxanthin 2 mg Tablet
180 Bisacodyl 5 mg (Dulcolax) Tablet
181 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1,680.000 500 1,680.000 200 1,680.000 200 1,680.000 200
182 Hyoscine-N-Butilbromide Inj 20 mg/ml (Buscopan Injeksi) Ampul
183 Magnesium Sulfat Inj 40% 25 ml Ampul
184 Miconazol Tube 3,000.000 96 3,000.000 96 3,000.000 96 3,000.000 96
185 NB Salep Tube
186 Ondancetron 8 mg Tablet
187 Ondansetron 8 mg inj Ampul
188 Parasetamol Drop Botol 5200.000 56 5,200.000 56 5,200.000 112 5,200.000 56 5,200.000 112 5,200.000 112 5,200.000 112 5,200.000
189 Pilokarpin tetes mata 2% Botol
190 Prenatin Plus Tablet
191 Sohobion Injeksi Ampul
192 Sucralfate 500 mg Tablet
193 Tiamfenikol 500 mg Tablet
194 Xanvit Plus 60 ml Botol
195 Ibuprofen Sirup Botol 3499.000 50 3,499.000 50
196 Domperidon Sirup Botol 3,333.000 50 3,333.000 50 3,333.000 200
197 Scabisid Salep Tube
198 Kalium Diklofenak Tablet
199 Albotyl (polikresol) Botol 17,393.000 10 17,393.000 10
200 Salbutamol Inhaler Botol
201 Azitromysin 500 Tablet 4500.000 20 4,500.000 20 4,500.000 20
202 Anti TBC Anak Paket 214,990.000 2
203 Anti TBC Katagori I Paket 359,990.000 2 359,990.000 2 358,200.000 2 359,990.000 3 359,990.000 2
204 Anti TBC Katagori II Paket
205 Anti TBC Katagori sisipan Paket
206 Alat suntik 10 ml biji 2750.000 100 2,750.000 100
207 Alat suntik 2,5 ml biji 590.900 1,200
208 Alat suntik 5 ml biji 2640.000 200
209 Blood Lanset bok 19800.000 10
210 Charmbone Botol 349998.000 2 349,998.000 2 349,998.000 2
211 Cresophene Botol 811998.000 1 811,998.000 1 811,998.000 1
212 Domperidon drop Botol 15,600.000 25
213 Deksosimetason Tube 9983.000 81
214 Dulcolak ( stolax Supp) Supp
215 Erfakaf sirup Botol 12980.000 144 12,980.000 144 12,980.000 288 12,980.000 288
216 Etanol ( alkohol ) 70 % 100 ml Botol 2500.000 100 2,500.000 100
217 Euginol Botol
218 Endometason N Botol 797995.000 1 797,995.000 1 797,995.000 1
219 Glucostik nesco ktk
220 Glimeperid 1 mg Tablet
221 Glimeperid 2 mg Tablet
222 Hand scund M Biji 360.000 1,000 441.000 2,000
223 Hand scund S Biji 360.000 1,000 441.000 2,000
224 Inoclar vivadent ( Etsa ) Botol 216997.000 1 216,997.000 1 216,997.000 1
225 Infuset anak set 3185.000 10
226 Infuset dewasa set 2910.000 10
227 IV cateter No 18 G Biji
228 IV cateter No 20 G Biji 5,148.000 50
229 IV cateter No 22 G Biji 5,148.000 50
230 Jarum Heacting no 14 Biji 15840.000 1
231 Kalium Gluconat Ampul 7,800.000 24
232 Kapas Pembalut 250 gram Biji 11,396.000 10 11,396.000 10
233 Kasa Pembalut 2m x 80 cm Rol 21,120.000 250
234 Kasa Pembalut Hidrofil 4 x 15 cm Rol 11,687.500 500
235 Kasa Pembalut Hidrofil 4 x 3 cm Rol 1,584.000 500
236 Kasa hidropyl 40 x 80 cm Rol 95000.000 2 108,150.000 15
237 Kasa Hydropil 16 cm x 16 cm Kotak 5230.000 100
238 Kasa Kompres DRC 40 cm x 40 cm Pcs 1640.000 100
239 Klip besar 15 x 10cm Biji
240 Klip sedang 13 x 10cm biji 99.000 40,000
241 Klip Kecil 10 x 7 cm biji 79.200 36,000
242 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul
243 Masker biji 21,780.000 40 21,780.000
244 Medicin packet bok
245 Metronidazol vagina ( flagyl ) Supp 3,220.000 50
246 Molexflu Tablet
247 Nurse cup Kotak 49,500.000 35
248 Pirantel suspensi Botol
249 Plester 5 yard x 2 inchi rol
250 Plester ultrafik 10 cm x 1 m Rol 8470.000 25 8,470.000 50 8,470.000 100 8,470.000 50
251 PP Tes strip
252 Pehacain injeksi Ampul 1,363.000 100 1,363.000 100
253 Pisau bedah no 11 biji
254 Procurma sirup Botol 14850.000 100 14,850.000 200 14,850.000 100 14,850.000 100 14,850.000 100
255 Paracetamol Rectal 250 mg /2,5 ml Tube 32258.600 5 32,258.600 25 32,258.600 30 32,258.600 100
256 Siobion Tablet
257 Tranfusi set set 6600.000 5 15,015.000 5
258 Under ped biji 52800.000 10
259 Urin Bag biji 8,800.000 10
260 Wing needle biji
261 Zinc sirup Botol
262 Zinc drop Botol 12840.000 24 12,840.000 25 12,840.000 153
263 Micropipet adjustable 5 - 50 ul Biji 1933800.000 1
264 Micropipet adjustable 20- 200 ul Biji 1933800.000 1
265 Micropipet adjustable 200- 1000 ul Biji 1933800.000 1
266 Delelene 2 0 75 C 26 M RB Bok 725560.000 5
267 EDTA set 137500.000 3
268 Intec HIV Test 22250.000 80
269 Oncoprobe Test 22100.100 50
270 Vikia Test 41500.000 25
271 Tabung reaksi 3 ml disposible Bag 657800.000 1 2,585.000 1,500
272 Temporary set 94,897.000 3 94,897.000 1
273 Alat suntik 3 cc Pcs 787.500 200
274 Chirurgic gloves size 8.0 Pcs 7,980.000 50
275 Elastic Bandage uk 7,5 x 4,5 cm roll 81,400.000 35
276 Fissure Bur Pcs 33,000.000 25
277 Foley Cateter biji 8,494.200 10
278 Inverted Bur Pcs 33,000.000 25
279 Long seng bur biji 58,300.000 25
280 Round Bur Pcs 33,000.000 20
281 Rak Micropipetacrilic 8 lubang Pcs 1,061,500.000 7
282 Tabung serum ( tutup merah ) set 350,900.000 7
283 Tabung serum dengan gel ( Kuning ) set 491,700.000 7
284 Tabung Glucosa ( abu abu ) set 456,500.000 7
285 Tabung Sentrifuge Pcs 4,950.000 200
286 Ultrasound Transmisien gel Botol 24,200.000 5 24,200.000
287 Widal test set 2,189,000.000 3
288 Strip urin 11 set 914,100.000 7
289 Vaksin BCG vial 54400.000 20 20 30 ### 30
290 Vaksin Polio vial 19954.000 10 30 20 20 30 30 ###
291 Vaksin campak vial 25640.000 20 20 30 ### 70
292 Vaksin DPT-HB/Pentabio vial 69350.000 40 35 10 30 30 50
293 Vaksin Uniject vial 19000.000 10 27
294 Vaksin TT vial 13180.000 10 10
295 Vaksin DT vial 16180.000 50
296 Vaksin Td Vial 15000.000 90
297 Vaksin IPV vial 272250.000 3
quinina Tablet
JUMLAH

Mengetahui Taman, 31 dESEMBER 20

Kepala UPT Puskesmas Abiansemal IV Petugas Gudang Farmasi UPT Puskesm

dr.Agus Wawan Luh Gede Krisna Listikaw

NIP 197403192006041002 NIP 19780204201001200
 HARGA 1
NOV DES JUMLAH
12
#VALUE! 2,000
450
-
-
500 3,000
2,000
7,300
-
3,600 105.000 3,600 11,490
9,600 39,000
-
60 2,445.000 120 780
-
-
7,200 25,600
100 2,025.000 100 500
-
2,750.000 10 50
-
-
14,000
1,500
19,500

450
3,000 42.000 3,000 15,000
2,010 8,910
1,520.000 100 650
2,000
3,000 17,000
-
-
1,580.000 10 10
5,000 62.000 3,000 38,000
-
-
-
1
2,344.000 5 5
-
-
90
400
500
-
10
2,500
6,700.000 120 440
-
-
111,980.000 10 50
3
-
-
-
-
-
-
691.000 100 200
-
-
500 75.000 500 3,600
288.000 1,200 4,200
-
48 360
-
2,000
-
-
-
-
600
-
-
-
149.000 100 100
2,650.000 96 504
-
4,000 150.000 2,000 13,000
-
88.000 100 100
 3
-
-
168
300.000 450 900
-
400
-
144
1,600.000 48 144
350
5,000 80.850 3,000 23,000
2
-
-
2,167.000 50 100
138.000 300 2,800
-
-
300
-
10
89.000 300 1,700
154.000 100 800
-
-
18,500
205.000 1,000 8,000
200
-
60
2,000
3,000
2
2,800
3,600 159.000 2,800 23,200
4,700.000 20 140
1,200
-
407.000 100 200
-
-
-
-
2,040
-
-
25
1,438.000 252 1,932
20,000 70,000
55,000.000 2 9
-
10,000
-
-
114.000 500 4,000
105.000 1,000 8,000
-
1,000
4,000
7,150.000 20 100
-
40 11,946.000 40 320
59.000 2,000 12,000
-
-
1,250.000 144 444
-
516.000 500 500
-
-
10 263,620.000 10 100
-
3
-
-
255.000 500 5,500
-
-
-
-
206,030.000 5 40
-
-
-
-
-
-
-
 -
-
6,800 34,000
60
-
470.000 1,000 5,500
-
-
-
-
-
1,100
-
5,500.000 5 5
384
23,210.000 24 24
-
-
112 5,200.000 112 840
-
-
-
-
-
-
100
300
-
-
20
-
4,500.000 20 80
2
11
-
-
200
1,200
200
10
6
3
25
81
5,800.000 50 50
864
200
-
3
-
-
-
3,000
3,000
3
5,355.000 5 15
10
-
50
50
1
24
11,300.000 10 30
7,000.000 250 500
11,687.500 200 700
1,584.000 200 700
17
100
100
-
40,000
36,000
-
40 80
-
50
-
35
8,360.000 50 50
31,999.000 30 30
16,500.000 25 250
-
1,363.000 40 240
-
600
160
-
15,015.000 5 15
10
 10
-
14,980.000 48 48
202
1
1
1
5
3
80
50
25
1,501
4
200
50
35
25
10
25
25
20
7
7
7
7
200
5
3
7
130
45 215
20 190
30 225
37
20
50
90
10 13
-
670.000 60 60

Taman, 31 dESEMBER 2016

Petugas Gudang Farmasi UPT Puskesmas Abiansemal IV

Luh Gede Krisna Listikawati

NIP 197802042010012009
 LAPORAN KETERSEDIAAN OBAT PUSKESMAS
TAHUN 2016

UPT PUSKESMAS : UPT PUSKESMAS ABIANSEMAL IV

PUSKESMAS PEMBANTU YANG ADA : 4
PROVINSI : Bali
UNIT : GUDANG PUSKESMAS

SISA STOK TAHUN 2015 PENERIMAAN TAHUN 2016

NO NAMA OBAT SATUAN HARGA SATUAN
JUMLAH RUPIAH JUMLAH RUPIAH
A. OBAT
1 Acyclovir tablet 400 mg Tablet 750.000 600 450,000.000 -
Acyclovir tablet 400 mg Tablet 336.000 - 2,000 672,000.000
2 Acyclovir cream 5 % Tube 3,000.000 125 375,000.000 -
Acyclovir cream 5 % Tube 2,999.964 - 50 149,998.200
Acyclovir cream 5 % Tube 3,938.000 - 400 1,575,200.000
3 Alopurinol tablet 100 mg Tablet 120.000 800 96,000.000 -
Alopurinol tablet 100 mg Tablet 86.000 - 3,000 258,000.000
4 Ambroxol syrup Botol 3,300.000 30 99,000.000 -
Ambroxol syrup Botol 4,120.000 - 2,000 8,240,000.000
5 Ambroxol tablet 30 mg Tablet 125.070 3,000 375,210.000 -
Ambroxol tablet 30 mg Tablet 412.000 - 7,300 3,007,600.000
6 Amlodipine 5 mg T ablet 1,090.000 - -
Amlodipine 5 mg T ablet 187.000 - 2,520 471,240.000
Amlodipine 5 mg T ablet 105.000 - 8,970 941,850.000
7 Amoksisilin kapletl 500 mg Kaplet 370.000 2,200 814,000.000 -
Amoksisilin kapletl 500 mg Kaplet 220.000 - 35,400 7,788,000.000
Amoksisilin kapletl 500 mg Kaplet 261.000 - 3,600 939,600.000
8 Amoksisilin sirup kering 125 mg/5ml Botol 3,699.300 110 406,923.000 -
Amoksisilin sirup kering 125 mg/5ml Botol 2,445.000 - 780 1,907,100.000
9 Antasida DOEN kombinasi Tablet 134.992 1,800 242,985.600 -
Antasida DOEN kombinasi Tablet 72.000 - 25,600 1,843,200.000
10 Antasida DOEN suspensi Botol 2,643.000 100 264,300.000 -
Antasida DOEN suspensi Botol 2,112.000 - 200 422,400.000
Antasida DOEN suspensi Botol 2,025.000 - 300 607,500.000
11 Anti Hemoroid DOEN Kombinasi Sup 1,470.000 - -
12 Asam Askorbat (Vit C) tablet 50 mg Tablet 19.000 4,400 83,600.000 -
Asam Askorbat (Vit C) tablet 50 mg Tablet 95.000 - 14,000 1,330,000.000
13 Asam Folat Tablet 62.000 200 12,400.000 -
Asam Folat Tablet 48.000 - 15,000 720,000.000
14 Asam mefenamat tab 500 mg Tablet 176.000 - -
Asam mefenamat tab 500 mg Tablet 112.000 - 19,500 2,184,000.000
15 Albotyl (polikresol) Botol 21,801.000 7 152,607.000 -
Albotyl (polikresol) Botol 17,393.000 - 20 347,860.000
16 Azitromysin 500 Tablet 4,500.000 - 80 360,000.000
17 Anti TBC Anak Paket 214,990.000 - 2 429,980.000
18 Anti TBC Katagori I Paket 359,990.000 1 359,990.000 9 3,239,910.000
Anti TBC Katagori I Paket 358,200.000 - 2 716,400.000
19 Anti TBC Katagori II Paket 1,199,900.000 2 2,399,800.000 -
20 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2,517.000 25 62,925.000 -
Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2,516.000 - 450 1,132,200.000
21 Besi II Sulfat tablet kombinasi Tablet 27.000 510 13,770.000 -
Besi II Sulfat tablet kombinasi Tablet - 6,000 -
Besi II Sulfat tablet kombinasi Tablet 42.000 - 9,000 378,000.000
22 Betahistin mesilat 6 mg Tablet 924.000 1,320 1,219,680.000 -
Betahistin mesilat 6 mg Tablet 1,150.000 - 5,400 6,210,000.000
Betahistin mesilat 6 mg Tablet 149.000 - 3,510 522,990.000
23 Betametason krim 0.1% Tube 1,865.600 25 46,640.000 -
Betametason krim 0.1% Tube 1,520.000 - 650 988,000.000
24 Captopril 12,5 mg Tablet 71.000 700 49,700.000 -
Captopril 12,5 mg Tablet 63.000 - 2,000 126,000.000
25 Captopril 25 mg Tablet 138.000 600 82,800.000 -
Captopril 25 mg Tablet 88.000 - 17,000 1,496,000.000
26 Cetirizine 10 mg Tablet 330.000 1,080 356,400.000 -
27 Deksametason injeksi 5 mg/ml - 1 ml Ampul 1,580.000 - 10 15,800.000
28 Deksametason tablet 0,5 mg Tablet 24.000 3,400 81,600.000 -
Deksametason tablet 0,5 mg Tablet 62.000 - 38,000 2,356,000.000
Diasepam Inj 5 mg/ml Ampul 2,344.000 - 5 11,720.000
28 Diazepam tablet 2 mg Tablet 13.000 1,100 14,300.000 -
30 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 1,050.000 - 90 94,500.000
31 Digoksin tablet 0,25 mg Tablet 83.000 300 24,900.000 -
Digoksin tablet 0,25 mg Tablet 97.000 - 400 38,800.000
32 Doksisiklin Tablet 229.999 - 500 114,999.500
33 Domperidon Sirup Botol 3,624.000 80 289,920.000 -
Domperidon Sirup Botol 3,333.000 - 300 999,900.000
34 Domperidon drop Botol 15,600.000 23 358,800.000 25 390,000.000
35 Deksosimetason Tube 9,983.000 41 409,303.000 81 808,623.000
36 Dulcolak ( stolax Supp) Supp 6,045.000 84 507,780.000 50 302,250.000
37 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 2,204.000 - 10 22,040.000
38 Erytromicin 500 mg Tablet 535.000 700 374,500.000 -
Erytromicin 500 mg Tablet 930.000 - 2,500 2,325,000.000
39 Erytromicin syrup Botol 7,700.000 - 320 2,464,000.000
Erytromicin syrup Botol 6,700.000 - 120 804,000.000
40 Erfakaf sirup Botol 12,980.000 - 864 11,214,720.000
Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul 978.000 418 408,804.000 -
41 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 681.000 100 68,100.000 -
Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 579.000 - 100 57,900.000
42 Furosemid tablet 40 mg Tablet 72.000 100 7,200.000 -
Furosemid tablet 40 mg Tablet 75.000 - 3,600 270,000.000
43 Garam Oralit untuk 200 ml air Sak 440.000 1,300 572,000.000 -
Garam Oralit untuk 200 ml air Sak 380.000 - 1,800 684,000.000
Garam Oralit untuk 200 ml air Sak 288.000 - 2,400 691,200.000
44 Gentamicin Sulfat TM 0,3% Botol 3,194.000 - 72 229,968.000
Gentamicin Sulfat TM 0,3% Botol 4,000.000 - 288 1,152,000.000
45 Glibenklamid tablet 5 mg Tablet 72.000 1,300 93,600.000 -
Glibenklamid tablet 5 mg Tablet 56.000 - 2,000 112,000.000
46 Glimeperid 1 mg Tablet 265.000 3,000 795,000.000 -
47 Glimeperid 2 mg Tablet 436.000 3,000 1,308,000.000 -
48 Hidroklorotiazid (HCT) tablet 25 mg Tablet 36.000 600 21,600.000 -
Hidroklorotiazid (HCT) tablet 25 mg Tablet 149.000 - 100 14,900.000
49 Hidrokortison krim 2,5 % Tube 2,999.700 120 359,964.000 -
Hidrokortison krim 2,5 % Tube 2,798.000 - 120 335,760.000
Hidrokortison krim 2,5 % Tube 2,650.000 - 96 254,400.000
50 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1,040.160 100 104,016.000 -
Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1,680.000 - 1,100 1,848,000.000
51 Ibuprofen tablet 400 mg Tablet 150.000 - 13,000 1,950,000.000
52 Isosorbid Di Nitrat Tablet 65.000 200 13,000.000 -
Isosorbid Di Nitrat Tablet 88.000 - 100 8,800.000
53 Ibuprofen Sirup Botol 8,250.000 50 412,500.000 -
Ibuprofen Sirup Botol 3,499.000 - 100 349,900.000
54 Ketokonazole cream 2 % 15 gram Tube 4,666.000 24 111,984.000 -
Ketokonazole cream 2 % 15 gram Tube 4,700.000 - 168 789,600.000
55 Ketokonazole tablet 200 mg Tablet 372.000 250 93,000.000 -
Ketokonazole tablet 200 mg Tablet 300.000 - 900 270,000.000
56 Klindamycin 300 mg Tablet 685.000 100 68,500.000 -
Klindamycin 300 mg Tablet 553.000 - 400 221,200.000
57 Kloramfenikol tetes telinga 3 % Botol 1,000.000 48 48,000.000 -
Kloramfenikol tetes telinga 3 % Botol 5,770.000 - 144 830,880.000
58 Kloramphenikol salep mata 1 % Tube 1,563.000 192 300,096.000 -
Kloramphenikol salep mata 1 % Tube 1,600.000 - 144 230,400.000
59 Kloramphenikol Tetes Mata Botol 2,499.200 15 37,488.000 -
Kloramphenikol Tetes Mata Botol 13,150.000 - 350 4,602,500.000
60 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 24.000 7,200 172,798.560 -
Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 80.850 - 23,000 1,859,550.000
61 Kotrimoksazol Suspensi Botol 3,500.200 110 385,022.000 -
Kotrimoksazol Suspensi Botol 2,167.000 - 100 216,700.000
62 Kotrimoksazol tablet 480 mg kombinasi Tablet 165.000 300 49,500.000 -
Kotrimoksazol tablet 480 mg kombinasi Tablet 138.000 - 2,800 386,400.000
62 Kalium Gluconat Ampul 7,800.000 424 3,307,200.000 -
Kalium Gluconat Ampul 7,800.000 - 24 187,200.000
64 Lidokain injeksi Ampul 1,009.998 90 90,899.820 -
 Lidokain injeksi Ampul 839.000 - 300 251,700.000
65 Loperamid tablet 2 mg Tablet 89.000 - 1,700 151,300.000
66 Loratadin tablet 10 mg Tablet 154.000 - 800 123,200.000
67 Metformin 500 mg Tablet 182.000 500 91,000.000 -
Metformin 500 mg Tablet 112.500 - 18,500 2,081,250.000
68 Methyl Prednisolon 4 mg Tablet 509.000 1,000 509,000.000 -
Methyl Prednisolon 4 mg Tablet 205.000 - 8,000 1,640,000.000
69 Metilergometrin Maleat 0,125 mg Tablet 154.000 - 200 30,800.000
70 Metoklopramid syrup Botol 1,914.000 80 153,120.000 -
Metoklopramid syrup Botol 2,600.000 - 60 156,000.000
71 Metoklopramid tablet 5 mg Tablet 73.000 300 21,900.000 -
Metoklopramid tablet 5 mg Tablet 108.000 - 2,000 216,000.000
72 Metronidazol tablet 500 mg Tablet 154.000 - 3,000 462,000.000
73 Magnesium Sulfat Inj 40% 25 ml Ampul 1,947.880 24 46,749.120 -
Magnesium Sulfat Inj 20% 25 ml Ampul 5,500.000 - 5 27,500.000
74 Miconazol Tube 1,718.750 88 151,250.000 -
Miconazol Tube 3,000.000 - 384 1,152,000.000
75 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 7,425.000 57 423,225.000 -
76 Metronidazol vagina ( flagyl ) Supp 154.000 50 7,700.000 -
Metronidazol vagina ( flagyl ) Supp 3,220.000 - 50 161,000.000
77 Natrium Diklofenac tablet 25 mg Botol 167.662 1,500 251,493.000 -
78 Natrium Diklofenac tablet 50 mg Tablet 217.668 - -
Natrium Diklofenac tablet 50 mg Tablet 176.000 - 16,800 2,956,800.000
Natrium Diklofenac tablet 50 mg Tablet 159.000 - 6,400 1,017,600.000
79 Natrium Klorida larutan infus 0.9% steril Fles 4,899.400 1 4,899.400 -
Natrium Klorida larutan infus 0.9% steril Fles 4,900.000 - 100 490,000.000
Natrium Klorida larutan infus 0.9% steril Fles 4,700.000 - 40 188,000.000
80 New Diatabs ( Pularek ) Tablet 1,700.000 50 85,000.000 -
New Diatabs ( Pularek ) Tablet 190.000 - 1,200 228,000.000
81 Nistatin tablet vaginal 100.000 IU/g Tablet 289.000 80 23,120.000 -
Nistatin tablet vaginal 100.000 IU/g Tablet 407.000 - 200 81,400.000
82 NB Salep Tube 20,301.600 14 284,222.400 -
NB Salep Tube 23,210.000 - 24 557,040.000
83 Omeprazol 20 mg Tablet 408.000 1,710 697,680.000 -
Omeprazol 20 mg Tablet 211.000 - 2,040 430,440.000
84 Ondancetron 8 mg Tablet 2,596.000 120 311,520.000 -
85 Ondansetron 8 mg inj Ampul 10,384.000 5 51,920.000 -
86 Papaverin Tab 40 mg Tablet 57.000 100 5,700.000 -
87 Parasetamol Rektal 125 mg/2.5 ml Tube 12,672.000 15 190,080.000 -
Parasetamol Rektal 125 mg/2.5 ml Tube 21,370.800 - 25 534,270.000
88 Parasetamol sirup 120 mg/5 ml Botol 1,725.000 138 238,050.000 -
Parasetamol sirup 120 mg/5 ml Botol 1,438.000 - 1,932 2,778,216.000
89 Parasetamol tablet 500 mg Tablet 45.000 7,400 333,000.000 -
Parasetamol tablet 500 mg Tablet 79.000 - 70,000 5,530,000.000
90 Perak Sulfadiazin 1% (Burnazin) Tube 33,000.000 3 99,000.000 -
Perak Sulfadiazin 1% (Burnazin) Tube 55,000.000 - 9 495,000.000
91 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 14.300 - -
Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 110.000 - 10,000 1,100,000.000
92 Prednison tablet 5 mg Tablet 38.000 600 22,800.000 -
Prednison tablet 5 mg Tablet 114.000 - 4,000 456,000.000
93 Parasetamol Drop Botol 4,799.300 5 23,996.500 -
Parasetamol Drop Botol 5,200.000 - 840 4,368,000.000
94 Pirantel suspensi Botol 8,360.000 5 41,800.000 50 418,000.000
95 Pehacain injeksi Ampul 1,363.000 100 136,300.000 240 327,120.000
95 Procurma sirup Botol 14,850.000 90 1,336,500.000 600 8,910,000.000
97 Paracetamol Rectal 250 mg /2,5 ml Tube 32,258.600 - 160 5,161,376.000
98 quinina Tablet 670.000 - 60 40,200.000
99 Ranitidin Tablet 200.000 700 140,000.000 -
Ranitidin Tablet 120.000 - 6,000 720,000.000
Ranitidin Tablet 105.000 - 2,000 210,000.000
100 Retinol (vit.A) 100,000 IU tablet salut Tablet 260.000 - 1,000 260,000.000
101 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 459.000 - 4,000 1,836,000.000
102 Ringer Laktat larutan infus steril (Produk lokal) botol 5,199.700 5 25,998.500 -
Ringer Laktat larutan infus steril (Produk lokal) botol 5,200.000 - 60 312,000.000
Ringer Laktat larutan infus steril (Produk lokal) botol 7,150.000 - 40 286,000.000
103 Salbutamol Nebuliser Ampul 10,532.500 35 368,637.500 -
 Salbutamol Nebuliser Ampul 11,440.000 - 100 1,144,000.000
Salbutamol Nebuliser Ampul 11,946.000 - 220 2,628,120.000
104 Salbutamol tablet 2 mg Tablet 88.000 800 70,400.000 -
Salbutamol tablet 2 mg Tablet 59.000 - 12,000 708,000.000
105 Salisil Bedak 2 % Botol 1,025.000 30 30,750.000 -
Salisil Bedak 2 % Botol 1,120.000 - 200 224,000.000
Salisil Bedak 2 % Botol 1,250.000 - 244 305,000.000
106 Sefadroxil tablet 500 mg Capsul 700.000 100 70,000.000 -
Sefadroxil tablet 500 mg Capsul 516.000 - 500 258,000.000
107 Sinvastatin tablet 10 mg Tablet 513.000 2,490 1,277,370.000 -
108 Siprofloxacin Tab 500 mg Tablet 240.000 1,000 240,000.000 -
Siprofloxacin Tab 500 mg Tablet 255.000 - 5,500 1,402,500.000
109 Siobion Tablet 1,193.500 5,400 6,444,900.000 -
110 Vitamin B Kompleks tablet Tablet 22.000 2,200 48,400.000 -
Vitamin B Kompleks tablet Tablet 107.000 - 34,000 3,638,000.000
111 Zinc tablet 20 mg Tablet 472.494 400 188,997.600 -
Zinc tablet 20 mg Tablet 473.000 - 4,500 2,128,500.000
Zinc tablet 20 mg Tablet 470.000 - 1,000 470,000.000
112 Zinc sirup Botol 12,840.000 20 256,800.000 -
Zinc sirup Botol 14,980.000 - 48 719,040.000
113 Zinc drop Botol 12,840.000 15 192,600.000 202 2,593,680.000
TOTAL 33,748,985.000 150,883,690.700

B.GIGI
114 Charmbone Botol 349,998.000 - 6 2,099,988.000
115 Cresophene Botol 811,998.000 - 3 2,435,994.000
116 Endometason N Botol 797,995.000 - 3 2,393,985.000
117 Etil Klorida spray Botol 81,392.000 2 162,784.000 -
Etil Klorida spray Botol 111,980.000 - 50 5,599,000.000
118 Eugenol cairan Botol 16,667.000 - 3 50,001.000
119 Fissure Bur Pcs 33,000.000 - 25 825,000.000
120 Inoclar vivadent ( Etsa ) Botol 216,997.000 - 3 650,991.000
121 Inverted Bur Pcs 33,000.000 - 25 825,000.000
122 Klorfenol Kamfer Menthol (CHKM) Botol 152,980.000 - 2 305,960.000
123 Long seng bur biji 58,300.000 - 25 1,457,500.000
124 Mummifying Pasta Botol 890,494.000 - 2 1,780,988.000
125 Round Bur Pcs 33,000.000 - 20 660,000.000
126 Temporary set 94,897.000 - 4 379,588.000
TOTAL 162,784.000 19,463,995.000

C.VAKSIN
289 Vaksin BCG vial 54,400.000 17 924,800.000 130 7,072,000.000
290 Vaksin Polio vial 19,954.000 10 199,540.000 215 4,290,110.000
291 Vaksin campak vial 25,640.000 38 974,320.000 190 4,871,600.000
292 Vaksin DPT-HB/Pentabio vial 69,350.000 15 1,040,250.000 225 15,603,750.000
293 Vaksin Uniject vial 19,000.000 8 152,000.000 37 703,000.000
294 Vaksin TT vial 13,180.000 12 158,160.000 20 263,600.000
295 Vaksin DT vial 16,180.000 - 50 809,000.000
296 Vaksin Td Vial 15,000.000 - 90 1,350,000.000
297 Vaksin IPV vial 272,250.000 - 13 3,539,250.000
TOTAL 3,449,070.000 38,502,310.000

D.BHP
298 Aqua pro Injeksi steril, bebas pirogen Fles 1,500.000 8 12,000.000 -
Aqua pro Injeksi steril, bebas pirogen Fles 5,500.000 - 30 165,000.000
Aqua pro Injeksi steril, bebas pirogen Fles 2,750.000 - 20 55,000.000
299 Alat suntik 10 ml biji 2,750.000 30 82,500.000 200 550,000.000
300 Alat suntik 2,5 ml biji 590.900 300 177,270.000 1,200 709,080.000
301 Alat suntik 5 ml biji 2,640.000 15 39,600.000 200 528,000.000
302 Alat suntik 3 cc Pcs 787.500 - 200 157,500.000
303 Blood Lanset bok 19,800.000 - 10 198,000.000
304 Chirurgic gloves size 8.0 Pcs 7,980.000 - 50 399,000.000
305 Etanol ( alkohol ) 70 % 100 ml Botol 2,500.000 - 200 500,000.000
306 Etakridina ( rivanol ) larutan 0.1% Botol 1,799.600 13 23,394.800 -
307 Elastic Bandage uk 7,5 x 4,5 cm roll 81,400.000 - 35 2,849,000.000
308 Foley Cateter biji 8,494.200 - 10 84,942.000
309 Hand scund M Biji 360.000 - 1,000 360,000.000
Hand scund M Biji 441.000 - 2,000 882,000.000
310 Hand scund S Biji 360.000 - 1,000 360,000.000
Hand scund S Biji 441.000 - 2,000 882,000.000
311 Infuset anak set 3,185.000 1 3,185.000 10 31,850.000
312 Infuset dewasa set 2,910.000 1 2,910.000 10 29,100.000
313 IV cateter No 18 G Biji 5,148.000 3 15,444.000 -
314 IV cateter No 20 G Biji 5,148.000 4 20,592.000 50 257,400.000
315 IV cateter No 22 G Biji 5,148.000 4 20,592.000 50 257,400.000
316 Jarum Heacting no 14 Biji 15,840.000 - 1 15,840.000
317 Kapas Pembalut 250 gram Biji 11,396.000 19 216,524.000 20 227,920.000
Kapas Pembalut 250 gram Biji 11,300.000 - 10 113,000.000
318 Kasa Pembalut 2m x 80 cm Rol 21,120.000 140 2,956,800.000 250 5,280,000.000
Kasa Pembalut 2m x 80 cm Rol 7,000.000 - 250 1,750,000.000
319 Kasa Pembalut Hidrofil 4 x 15 cm Rol 11,687.500 440 5,142,500.000 700 8,181,250.000
320 Kasa Pembalut Hidrofil 4 x 3 cm Rol 1,584.000 350 554,400.000 700 1,108,800.000
321 Kasa hidropyl 40 x 80 cm Rol 95,000.000 - 2 190,000.000
Kasa hidropyl 40 x 80 cm Rol 108,150.000 - 15 1,622,250.000
322 Kasa Hydropil 16 cm x 16 cm Kotak 5,230.000 - 100 523,000.000
323 Kasa Kompres DRC 40 cm x 40 cm Pcs 1,640.000 - 100 164,000.000
324 Klip besar 15 x 10cm Biji 137.500 32,000 4,400,000.000 -
325 Klip sedang 13 x 10cm biji 99.000 115,000 11,385,000.000 40,000 3,960,000.000
326 Klip Kecil 10 x 7 cm biji 79.200 73,000 5,781,600.000 36,000 2,851,200.000
327 Lisol Botol 37,300.000 - 10 373,000.000
328 Masker biji 435.600 1,700 740,520.000 -
Masker bok 21,780.000 - 80 1,742,400.000
329 Medicin packet bok 2,310,000.000 1 2,310,000.000 -
330 Nurse cup Kotak 649.000 2,000 1,298,000.000 -
Nurse cup Kotak 49,500.000 - 35 1,732,500.000
331 Plester 5 yard x 2 inchi rol 31,999.000 35 1,119,965.000 30 959,970.000
332 Plester ultrafik 10 cm x 1 m Rol 8,470.000 25 211,750.000 225 1,905,750.000
Plester ultrafik 10 cm x 1 m Rol 16,500.000 - 25 412,500.000
333 Pisau bedah no 11 biji 660.000 68 44,880.000 -
334 Supratul bok 11,300.000 5 56,500.000 -
Supratul bok 206,030.000 - 40 8,241,200.000
335 Tranfusi set set 6,600.000 5 33,000.000 5 33,000.000
Tranfusi set set 15,015.000 - 5 75,075.000
336 Under ped biji 52,800.000 8 422,400.000 10 528,000.000
337 Urin Bag biji 8,800.000 21 184,800.000 10 88,000.000
338 Wing needle biji 7,400.000 10 74,000.000 -
339 Yodium povidon larutan 10% 300ml Botol 14,500.000 8 116,000.000 -
Yodium povidon larutan 10% 300ml Botol 14,203.000 - 60 852,180.000
TOTAL 37,446,126.800 52,186,107.000

E.LABORATORIUM
340 Micropipet adjustable 5 - 50 ul Biji 1,933,800.000 - 1 1,933,800.000
341 Micropipet adjustable 20- 200 ul Biji 1,933,800.000 - 1 1,933,800.000
342 Micropipet adjustable 200- 1000 ul Biji 1,933,800.000 - 1 1,933,800.000
343 Delelene 2 0 75 C 26 M RB Bok 725,560.000 - 5 3,627,800.000
344 EDTA set 137,500.000 - 3 412,500.000
345 Intec HIV Test 22,250.000 - 80 1,780,000.000
346 Oncoprobe Test 22,100.100 - 50 1,105,005.000
347 Rak Micropipetacrilic 8 lubang Pcs 1,061,500.000 - 7 7,430,500.000
348 Strip urin 11 set 914,100.000 - 7 6,398,700.000
349 Tabung reaksi 3 ml disposible Bag 657,800.000 - 1 657,800.000
Tabung reaksi 3 ml disposible biji 2,585.000 - 1,500 3,877,500.000
350 Tabung serum ( tutup merah ) set 350,900.000 - 7 2,456,300.000
351 Tabung serum dengan gel ( Kuning ) set 491,700.000 - 7 3,441,900.000
352 Tabung Glucosa ( abu abu ) set 456,500.000 - 7 3,195,500.000
353 Tabung Sentrifuge Pcs 4,950.000 - 200 990,000.000
354 Ultrasound Transmisien gel Botol 24,200.000 - 5 121,000.000
355 Vikia Test 41,500.000 - 25 1,037,500.000
356 Widal test set 2,189,000.000 - 3 6,567,000.000
TOTAL 48,900,405.000

TOTAL KESELURUHAN 74,806,965.80 309,936,507.70

 Mengetahiu
Kepala UPT Puskesmas Abiansemal IV

dr Agus Wawan
NIP 19740392006041002
 :

PEMAKAIAN TAHUN 2016 SISA STOK AKHIR TAHUN 2016

JUMLAH RUPIAH JUMLAH RUPIAH

600 450,000.000 -
1,900 638,400.000 100 33,600.000
125 375,000.000 -
50 149,998.200 -
315 1,240,470.000 85 334,730.000
800 96,000.000 -
3,000 258,000.000 -
30 99,000.000 -
2,000 8,240,000.000 -
3,000 375,210.000 -
7,300 3,007,600.000 -
- - -
2,520 471,240.000 -
3,930 412,650.000 5,040 529,200.000
2,200 814,000.000 -
35,400 7,788,000.000 -
300 78,300.000 3,300 861,300.000
110 406,923.000 -
720 1,760,400.000 60 146,700.000
1,800 242,985.600 -
23,500 1,692,000.000 2,100 151,200.000
 100 264,300.000 -
200 422,400.000 -
160 324,000.000 140 283,500.000
- - -
4,400 83,600.000 -
11,100 1,054,500.000 2,900 275,500.000
200 12,400.000 -
15,000 720,000.000 -
- - -
18,700 2,094,400.000 800 89,600.000
7 152,607.000 -
16 278,288.000 4 69,572.000
60 270,000.000 20 90,000.000
1 214,990.000 1 214,990.000
8 2,879,920.000 2 719,980.000
- - 2 716,400.000
2 2,399,800.000 -
25 62,925.000 -
450 1,132,200.000 -
510 13,770.000 -
6,000 - -
8,070 338,940.000 930 39,060.000
1,320 1,219,680.000 -
5,400 6,210,000.000 -
2,790 415,710.000 720 107,280.000
25 46,640.000 -
570 866,400.000 80 121,600.000
700 49,700.000 -
2,000 126,000.000 -
600 82,800.000 -
15,400 1,355,200.000 1,600 140,800.000
1,080 356,400.000 -
8 12,640.000 2 3,160.000
 3,400 81,600.000 -
33,800 2,095,600.000 4,200 260,400.000
- - 5 11,720.000
800 10,400.000 300 3,900.000
58 60,900.000 32 33,600.000
300 24,900.000 -
300 29,100.000 100 9,700.000
500 114,999.500 -
80 289,920.000 -
220 733,260.000 80.0 266,640.000
48 748,800.000 -
122 1,217,926.000 -
89 538,005.000 45 272,025.000
8 17,632.000 2 4,408.000
700 374,500.000 -
1,800 1,674,000.000 700 651,000.000
305 2,348,500.000 15 115,500.000
- - 120 804,000.000
864 11,214,720.000 -
408 399,024.000 10 9,780.000
100 68,100.000 -
- - 100 57,900.000
100 7,200.000 -
2,900 217,500.000 700 52,500.000
1,300 572,000.000 -
1,800 684,000.000 -
1,100 316,800.000 1,300 374,400.000
72 229,968.000 -
288 1,152,000.000 -
1,300 93,600.000 -
1,700 95,200.000 300 16,800.000
3,000 795,000.000 -
1,500 654,000.000 1,500 654,000.000
 600 21,600.000 -
- - 100 14,900.000
120 359,964.000 -
120 335,760.000 -
13 34,450.000 83 219,950.000
100 104,016.000 -
1,000 1,680,000.000 100 168,000.000
9,400 1,410,000.000 3,600 540,000.000
200 13,000.000 -
100 8,800.000 -
50 412,500.000 -
100 349,900.000 -
24 111,984.000 -
168 789,600.000 -
250 93,000.000 -
600 180,000.000 300 90,000.000
100 68,500.000 -
400 221,200.000 -
48 48,000.000 -
78 450,060.000 66 380,820.000
192 300,096.000 -
116 185,600.000 28 44,800.000
15 37,488.000 -
350 4,602,500.000 -
7,200 172,798.560 -
20,200 1,633,170.000 2,800 226,380.000
110 385,022.000 -
50 108,350.000 50 108,350.000
300 49,500.000 -
2,800 386,400.000 -
424 3,307,200.000 -
- - 24 187,200.000
90 90,899.820 -
 280 234,920.000 20 16,780.000
1,700 151,300.000 -
750 115,500.000 50 7,700.000
500 91,000.000 -
13,700 1,541,250.000 4,800 540,000.000
1,000 509,000.000 -
7,000 1,435,000.000 1,000 205,000.000
100 15,400.000 100 15,400.000
80 153,120.000 -
40 104,000.000 20 52,000.000
300 21,900.000 -
2,000 216,000.000 -
2,800 431,200.000 200 30,800.000
24 46,749.120 -
- - 5 27,500.000
88 151,250.000 -
220 660,000.000 164 492,000.000
57 423,225.000 -
50 7,700.000 -
50 161,000.000 -
1,500 251,493.000 -
- - -
16,800 2,956,800.000 -
4,900 779,100.000 1,500 238,500.000
1 4,899.400 -
100 490,000.000 -
22 103,400.000 18 84,600.000
50 85,000.000 -
1,200 228,000.000 -
80 23,120.000 -
100 40,700.000 100 40,700.000
14 284,222.400 -
- - 24 557,040.000
 1,710 697,680.000 -
2,040 430,440.000 -
120 311,520.000 -
5 51,920.000 -
100 5,700.000 -
15 190,080.000 -
25 534,270.000 -
138 238,050.000 -
1,732 2,490,616.000 200 287,600.000
7,400 333,000.000 -
56,700 4,479,300.000 13,300 1,050,700.000
3 99,000.000 -
7 385,000.000 2 110,000.000
- - -
8,000 880,000.000 2,000.0 220,000.000
600 22,800.000 -
3,800 433,200.000 200 22,800.000
5 23,996.500 -
784 4,076,800.000 56 291,200.000
30 250,800.000 25 209,000.000
300 408,900.000 40 54,520.000
690 10,246,500.000 -
160 5,161,376.000 -
60 40,200.000 -
700 140,000.000 -
6,000 720,000.000 -
1,700 178,500.000 300 31,500.000
1,000 260,000.000 -
4,000 1,836,000.000 -
5 25,998.500 -
60 312,000.000 -
21 150,150.000 19 135,850.000
35 368,637.500 -
 100 1,144,000.000 -
180 2,150,280.000 40 477,840.000
800 70,400.000 -
10,800 637,200.000 1,200 70,800.000
30 30,750.000 -
200 224,000.000 -
130 162,500.000 114 142,500.000
100 70,000.000 -
- - 500 258,000.000
2,490 1,277,370.000 -
1,000 240,000.000 -
5,100 1,300,500.000 400 102,000.000
5,400 6,444,900.000 -
2,200 48,400.000 -
31,700 3,391,900.000 2,300 246,100.000
400 188,997.600 -
4,500 2,128,500.000 -
600 282,000.000 400 188,000.000
20 256,800.000 -
- - 48 719,040.000
170 2,182,800.000 47 603,480.000
166,596,880.700 18,035,795.000 18,035,795.000

-
6 2,099,988.000 -
3 2,435,994.000 -
3 2,393,985.000 -
2 162,784.000 -
36 4,031,280.000 14 1,567,720.000
3 50,001.000 -
25 825,000.000 -
3 650,991.000 -
25 825,000.000 -
 2 305,960.000 -
25 1,457,500.000 -
2 1,780,988.000 -
20 660,000.000 -
4 379,588.000 -
18,059,059.000 1,567,720.000 1,567,720.000
-
-
129 7,017,600.000 18 979,200.000
200 3,990,800.000 25 498,850.000
179 4,589,560.000 49 1,256,360.000
200 13,870,000.000 40 2,774,000.000
20 380,000.000 25 475,000.000
26 342,680.000 6 79,080.000
41 663,380.000 9 145,620.000
80 1,200,000.000 10 150,000.000
5 1,361,250.000 8 2,178,000.000
33,415,270.000 8,536,110.000 8,536,110.000
-
-
8 12,000.000 -
30 165,000.000 -
18 49,500.000 2 5,500.000
230 632,500.000 -
1,500 886,350.000 -
215 567,600.000 -
200 157,500.000 -
10 198,000.000 -
50 399,000.000 -
200 500,000.000 -
13 23,394.800 -
8 651,200.000 27.0 2,197,800.000
6 50,965.200 4.0 33,976.800
 1,000 360,000.000 -
1,500 661,500.000 500 220,500.000
1,000 360,000.000 -
1,400 617,400.000 600 264,600.000
9 28,665.000 2 6,370.000
10 29,100.000 1.0 2,910.000
3 15,444.000 -
17 87,516.000 37 190,476.000
13 66,924.000 41 211,068.000
1 15,840.000 -
36 410,256.000 3 34,188.000
- - 10 113,000.000
390 8,236,800.000 -
10 70,000.000 240 1,680,000.000
835 9,759,062.500 305 3,564,687.500
1,050 1,663,200.000 -
2 190,000.000 -
10 1,081,500.000 5 540,750.000
100 523,000.000 -
100 164,000.000 -
15,000 2,062,500.000 17,000 2,337,500.000
33,000 3,267,000.000 122,000 12,078,000.000
31,000 2,455,200.000 78,000.0 6,177,600.000
10 373,000.000 -
1,673 728,758.800 27 11,761.200
80 1,742,400.000 -
1 2,310,000.000 -
2,000 1,298,000.000 -
29 1,435,500.000 6 297,000.000
38 1,215,962.000 27 863,973.000
245 2,075,150.000 5 42,350.000
- - 25 412,500.000
68 44,880.000 -
 5 56,500.000 -
40 8,241,200.000 -
9 59,400.000 1 6,600.000
- - 5 75,075.000
18 950,400.000 -
21 184,800.000 10 88,000.000
10 74,000.000 -
8 116,000.000 -
41 582,323.000 19 269,857.000
57,906,191.300 31,726,042.500 31,726,042.50

-
1 1,933,800.000 -
1 1,933,800.000 -
1 1,933,800.000 -
5 3,627,800.000 -
3 412,500.000 -
80 1,780,000.000 -
50 1,105,005.000 -
7 7,430,500.000 -
7 6,398,700.000 -
1 657,800.000 -
1,500 3,877,500.000 -
7 2,456,300.000 -
7 3,441,900.000 -
7 3,195,500.000 -
200 990,000.000 -
5 121,000.000 -
25 1,037,500.000 -
3 6,567,000.000 -
48,900,405.000 -

324,877,806.000 59,865,667.500 59,865,667.50

 Taman, 2 Januari 2017
Petugas Gudang Farmasi Puskesmas

Luh Gede Krisna Listikawati

NIP 197802042010012009