LAPORAN GUDANG OBAT

KODE PUSKESMAS :
PUSKESMAS : SEI PANCUR
KECAMATAN : SEI BEDUK
KOTA : KOTA BATAM
PROVINSI : KEP RIAU
STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
I OBAT GENERIK
1 Albendazol tablet 400 mg tablet 30 - 30 -
2 Alprozolam tab 0,25 mg tablet - - - -
3 Alprozolam tab 0,5 mg tablet - - - -
4 Acyclovir 200 mg tablet ( OGB ) tablet 400 - 400 -
5 Acyclovir 400 mg tablet ( OGB ) tablet 500 - 500 -
6 Acyclovir cream ( OGB ) tube 100 - 100 -
7 ACT(Atesunat 50 mg+Amodiaquin anhydrida200 mg)tab paket 10 - 10 -
8 Arterakine tablet paket - - - -
9 Arterakine (DARPLEX) paket 5 - 5 -
10 Allopurinol tablet 100 mg tablet 500 - 500 -
11 Allopurinol tablet 300 mg tablet 90 - 90 -
12 Ambroxol syrup ( OGB ) botol 100 - 100 -
13 Ambroxol 30mg tab (OGB ) tablet 200 - 200 -
14 Aminofilin tablet 200 mg tablet - - - -
15 Aminofilina injeksi 24 mg/ml - 10ml ampul - - - -
16 Amitriptilin HCL tablet salut 25 mg tablet - - - -
17 Amlodipine tablet 5 mg tablet 900 - 900 -
18 Amoksisilin sirup kering 125 mg/5 ml botol 50 - 50 -
19 Amoksisilin kapsul 250 mg kapsul - - - -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

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20 Amoksisilin kaplet 500 mg kaplet 18,900 - 18,900 -
21 Ampicillin inj 1 gr ( OGB ) vial - - - -
22 Antalgin (metampiron) tablet 500 mg tablet - - - -
23 Antalgin injeksi 250 mg/ml - 2ml ampul 30 - 30 -
24 Antasida DOEN I tablet kunyah tablet 7,100 - 7,100 -
25 Antasida DOEN II suspensi botol - - - -
26 Anti bakteri DOEN salep komb:Bacitracin+Polimiksin tube 25 - 25 -
27 Anti hemoroid DOEN kombinasi suup 140 - 140 -
28 Antifungi DOEN kombinasi :As Benzoat+As Salisilat pot - - - -
29 Antimigren tartrat 1 mg + kofein 50 mg tablet - - - -
30 Aqua pro injeksi steril, bebas pirogen 20 ml vial 10 - 10 -
31 Aquades steril 1000 ml botol 6 - 6 -
32 Artem (artemether 80 mg ) inj ampul - - - -
33 Artesunate inj 60 mg/ml vial - - - -
34 Asam Mefenamat tablet salut 250 mg kapsul - - - -
35 Asam Mefenamat tablet salut 500 mg kaplet 2,100 - 2,100 -
36 Asetosal tablet 100 mg tablet - - - -
37 Asetosal tablet 500 mg tablet - - - -
38 Atenolol tablet 50 mg tablet 100 - 100 -
39 Atropin sulfat inj 0,25 mg/ml-1 ml ampul - - - -
40 Atropin sulfat tablet 0,5 mg tablet - - - -
41 Atropin sulfat tetes mata 0,5 mg botol - - - -
42 Besi sirup botol - - - -
43 Betametason krim 0,1% tube 150 - 150 -
44 Betahistin Mesilat 6 MG tablet 180 - 180 -
45 Bisoprolol 5 mg tablet 150 - 150 -
46 Bromheksin tab 8 mg tablet - - - -
47 Calcium gluconat injeksi vial 120 - 120 -
48 Calcium Lactate 500 mg tablet 3,000 - 3,000 -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
49 Catopril 12,5 mg tablet 1,000 - 1,000 -
50 Catopril 25 mg tablet 1,000 - 1,000 -
51 Cefadroxil syrup 125 mg/5ml botol 55 - 55 -
52 Cefadroxil kapsul 500 mg kapsul 200 - 200 -
53 Cefixim syrup 100 mg/5 ml botol 50 - 50 -
54 Cefixim 100 mg kapsul kapsul 300 - 300 -
55 Cefotaxim injeksi 1 gram vial - - - -
56 Ceftriazone injeksi vial - - - -
57 Cetirizene syrup 5 mg/ 5 ml botol 20 - 20 -
58 Cetirizene 10 mg tablet 390 - 390 -
59 Chloramphenicol suspensi 60 ml botol 5 - 5 -
60 Chloramphenicol kapsul 250 mg kapsul 250 - 250 -
61 Chloramphenicol tetes Mata 0,5 % botol 72 - 72 -
62 Chloramphenicol salep mata 1 % tube 96 - 96 -
63 Chloramphenicol tetes telinga 3 % botol 48 - 48 -
64 Chlorfeniramin Maleat (CTM) tab 4 mg tablet 100 - 100 -
65 Chlorpromazine HCL 100 mg tablet salut tablet - - - -
66 Chlorpromazine HCL 25 mg tablet salut tablet - - - -
67 Chlorpromazine HCL inj 25 mg / ml - 1 ml ampul - - - -
68 Chlorpromazine HCL inj 5 mg / ml - 2 ml ampul - - - -
69 Cimetidin 200 mg tab (OGB ) tablet 600 - 600 -
70 Clindamisin 150 mg kapsul 150 - 150 -
71 Clindamisin 300 mg kapsul 450 - 450 -
72 Co- Amoxiclav 625 mg tab tablet 300 - 300 -
73 Cotrimoksazole suspensi 60 ml botol 50 - 50 -
74 Cotrimoksazole tablet pediatrik 120 mg tablet - - - -
75 Cotrimoksazole tablet Dewasa 480 mg tablet 500 - 500 -
76 Cyprofloxacin tab 500 mg ( OGB ) tablet 1,000 - 1,000 -
77 Deksametason injeksi 5 mg / ml -1ml ampul - - - -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
78 Deksametason tablet 0,5mg tablet 5,800 - 5,800 -
79 Dekstrometorfan sirup 10 mg/5 ml botol 50 - 50 -
80 Dekstrometorfan tablet 15 mg tablet 1,000 - 1,000 -
81 Dekstran 70 - larutan infus 6 % steril botol - - - -
82 Diazepam tablet 2 mg tablet 1,000 - 1,000 -
83 Diazepam tablet 5 mg tablet - - - -
84 Diazepam injeksi 5 mg/ml ampul 3 - 3 -
85 Diethylcarbamazine tablet 100 mg tablet - - - -
86 Difenhidramin HCL inj 10 mg/ml-1 ml ampul - - - -
87 Digoksin tablet 0,25 mg tablet - - - -
88 Doksisiklin kapsul 100 mg kapsul 200 - 200 -
89 Domperidon syrup botol 48 - 48 -
90 Domperidon 10 mg tab tablet 500 - 500 -
91 Efedrin HCl tablet 25 mg tablet 1,000 - 1,000 -
92 Epinefrina HCL/Bitartrat (Adrenalin ) inj 0,1 %-1 ml ampul 30 - 30 -
93 Ekstrak belladon tablet 10 mg tablet - - - -
94 Erythromycin kapsul 500 mg ( OGB ) kapsul 500 - 500 -
95 Erythromycin syrup 200 mg/5 ml botol 84 - 84 -
96 Fenitoin natrium kapsul 100 mg kapsul - - - -
97 Fenitoin natrium kapsul 30 mg kapsul - - - -
98 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 30 - 30 -
99 Fenobarbital tablet 30 mg tablet - - - -
100 Fenobarbital tablet 100 mg tablet - - - -
101 Fenol Gliserol tetes telinga 10 % botol 50 - 50 -
102 Folic Acid tablet 1 mg tablet 2,000 - 2,000 -
103 Furosemid injeksi ampul - - - -
104 Furosemid tablet 40 mg tablet 100 - 100 -
105 Gameksan emulsi 1% botol - - - -
106 Garam oralit untuk 200 ml air sachet 900 - 900 -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
107 Gentamycin salap kulit 0,1 % - 5 gr (OGB) tube 150 - 150 -
108 Gentamisin tetes mata botol 50 - 50 -
109 Gentamicyn inj 80 mg/ml vial - - - -
110 Gentian violet larutan 1% botol 216 - 216 -
111 Glibenklamid tablet 5 mg tablet 300 - 300 -
112 Gliseril guayakolat tablet 100 mg tablet 7,000 - 7,000 -
113 Gliserin botol - - - -
114 Glukosa larutan infus 5% steril botol 22 - 22 -
115 Glukosa larutan infus 10 % steril botol - - - -
116 Glukosa larutan infus 40 % steril botol - - - -
117 Griseofulvin tablet 125 mg tablet - - - -
118 Haloperidol tablet 0,5 mg tablet - - - -
119 Haloperidol tablet 1,5 mg tablet - - - -
120 Hidroklorotiazid (HCT) tablet 25 mg tablet - - - -
121 Hidrokortison krim 1% pot - - - -
122 Hidrokortison krim 2,5 % tube 120 - 120 -
123 Insulin reguler inj 40IU/ml-10 ml (human) ampul - - - -
124 Ibuprofen suspensi 100 mg/5ml botol 100 - 100 -
125 Ibuprofen tablet 200 mg botol 1,000 - 1,000 -
126 Ibuprofen tablet 400 mg tablet 1,000 - 1,000 -
127 Isosorbid dinitrat tablet sublingual 5 mg tablet 300 - 300 -
128 Kalium Diclofenak 25 mg tablet - - - -
129 Kalium Permangat serbuk 5 gram pot 24 - 24 -
130 Karbamazepin tablet 200 mg tablet - - - -
131 Ketokenazol cream 2 % tube 239 - 239 -
132 Ketokonazol 200 mg tab tablet 300 - 300 -
133 Klonidin tablet 0,15 mg tablet - - - -
134 Klorokuin tablet 150 mg tablet - - - -
135 Klorpropamid tablet 100 mg tablet - - - -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
136 Kodein fosfat tablet 10 mg tablet - - - -
137 Kuinin (kina) tablet 200 mg tablet - - - -
138 Kuinin dihidroklorida inj 25 %-2 ml ampul - - - -
139 Lanzoprazol kapsul 30 mg kapsul - - - -
140 Lidokain komp.injeksi 2 ml ampul 90 - 90 -
141 Loperamid tablet tablet - - - -
142 Loratadin tablet 10 mg tablet 950 - 950 -
143 Lyncomicin 500 mg cap kapsul 120 - 120 -
144 Magnesium Sulfat Inj (IV) 20%-25 ml ampul - - - -
145 Magnesium Sulfat Inj (IV) 40%-25 ml ampul 50 - 50 -
146 Mebendazol sirup 100 mg/5 ml botol - - - -
147 Mebendazol tablet 100 mg tablet - - - -
148 Methochlorpamid syr 5 mg/ml botol - - - -
149 Metilergometrin maleat inj 0,200 mg-1 ml ampul - - - -
150 Metilergometrin maleat tab salut 1,125 mg tablet 100 - 100 -
151 Meloksikam suppositoria supp 80 - 80 -
152 Meloksikam 7,5 mg tablet 500 - 500 -
153 Metformin tab 500 mg tablet 1,000 - 1,000 -
154 Metformin tab 850 mg tablet 200 - 200 -
155 Metilprednisolon 4 mg tablet - - - -
156 Metilprednisolon 8 mg tablet 100 - 100 -
157 Metoclorpramid injeksi 5 mg/ml ampul - - - -
158 Metoclorpramid tab 10 mg tablet 500 - 500 -
159 Metronidazol tablet 250 mg tablet - - - -
160 Metronidazol tablet 500 mg tablet 200 - 200 -
161 Metronidazol 500 mg infus botol - - - -
162 Miconazol 2 % cream (OGB ) tube 96 - 96 -
163 Mineral Mix sachet 160 - 160 -
164 Natrium bikarbonat tablet 500 mg tablet 4,000 - 4,000 -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
165 Natrium Diklofenak tab 50 mg tablet 1,000 - 1,000 -
166 Natrium Tiroksin tablet - - - -
167 Natrium klorida larutan infus 0,9% steril botol 20 - 20 -
168 Nifedipin tab 10 mg tablet - - - -
169 Nistatin tablet salut 100.000 IU tablet - - - -
170 Nistatin tablet salut 500.000 IU tablet - - - -
171 OAT FDC Kategori Anak paket 3 - 3 -
172 OAT Kombipak Kategori Anak paket 11 - 11 -
173 OAT FDC Kategori I Dewasa paket 7 - 7 -
174 OAT Kombipak Kategori I Dewasa paket 2 - 2 -
175 OAT FDC Kategori II Dewasa paket 2 - 2 -
176 OAT FDC Sisipan Dewasa paket 4 - 4 -
177 Obat batuk hitam (OBH) cairan botol 252 - 252 -
178 Oksitetrasiklin HCl injeksi I.m.50mg/ml-10ml vial - - - -
179 Oksitetrasiklin HCl salep mata 1% tube 50 - 50 -
180 Oksitetrasiklin HCl salep 3% tube 250 - 250 -
181 Oksitosin injeksi 10 IU/ml-1 ml ampul - - - -
182 Omeprazol kapsul 20 mg kapsul - - - -
183 Oseltamivir 75 mg (ut flu burung) tablet - - - -
184 Papaverin tablet 40 mg ( OGB ) tablet - - - -
185 Paraformaldehid tablet 1 gram tablet - - - -
186 Parasetamol drop botol 89 - 89 -
187 Parasetamol sirup 120 mg/5 ml botol 150 - 150 -
188 Parasetamol tablet 100 mg tablet - - - -
189 Parasetamol tablet 500 mg tablet 8,800 - 8,800 -
190 Phytomenadion (Vit K1) injeksi 10 mg/ml-1 ml ampul - - - -
191 Phytomenadion (Vit.K1) tablet salut gula 10 mg tablet 300 - 300 -
192 Piracetam 800 mg tablet 100 - 100 -
193 Piracetam 1200 mg tablet - - - -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
194 Pirantel sirup 125 mg/5 ml botol - - - -
195 Pirantel tablet 125 mg tablet 100 - 100 -
196 Piroxicam 10 mg ( OGB ) tablet - - - -
197 Piroxicam 20 mg ( OGB ) tablet 400 - 400 -
198 Prednison tablet 5 mg tablet - - - -
199 Primakuin tablet 15 mg tablet - - - -
200 Propiltiourasil tablet 100 mg tablet 300 - 300 -
201 Propranolol HCl tablet 10 mg tablet - - - -
202 Propranolol HCl tablet 40 mg tablet - - - -
203 Prokain Penisilin inj,3 juta IU vial 118 - 118 -
204 Rabies immuni globulin (himan ) 150 IU/ml ampul - - - -
205 Ranitidin tab tablet 1,400 - 1,400 -
206 Ranitidin injeksi ampul - - - -
207 Reserpin tablet 0,10 mg tablet - - - -
208 Reserpin tablet 0,25 mg tablet - - - -
209 Ringer laktat larutan infus steril botol 21 - 21 -
210 Salbutamol tablet 2 mg tablet 1,100 - 1,100 -
211 Salbutamol tablet 4 mg tablet 200 - 200 -
212 Salep 2-4, komb : As.Salisilat + belerang endap pot 24 - 24 -
213 Salisil bedak 2% kotak 590 - 590 -
214 Serum anti bisa ular polivalen inj 5 ml (ABU I ) ampul - - - -
215 Serum anti difteri inj 20.000 IU/vial (A D S ) ampul - - - -
216 Serum anti tetanus injeksi 1.500 IU/ampul ( A T S ) ampul - - - -
217 Serum anti tetanus injeksi 20.00 IU/ampul ( A T S ) ampul - - - -
218 Simvastatin tab 10 mg tablet - - - -
219 Sulfadoxin 500+Pirimetamin 25 mg tablet tablet - - - -
220 Sulfasetamida Natrium tetes mata 15 % botol - - - -
221 Tambah Darah tablet ( Ferollat ) sachet 1,200 - 1,200 -
222 Tetrakain HCL tetes mata 0,5% botol 5 - 5 -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
223 Tetrasiklin HCL kapsul 250 mg kapsul - - - -
224 Tetrasiklin HCL kapsul 500 mg kapsul 200 - 200 -
225 Thiamphenicol kapsul 500 mg tablet 300 - 300 -
226 Tramadol injeksi ampul - - - -
227 Tramadol 50 mg tablet 150 - 150 -
228 Triheksifenidil Hidroklorida tablet 2 mg tablet 200 - 200 -
229 Vaksin rabies vero ampul - - - -
230 Vitamin A (Retinol) 100.000 IU kapsul lunak kapsul 65 - 65 -
231 Vitamin A (Retinol) 200.000 IU kapsul lunak kapsul 1,000 - 1,000 -
232 Vitamin B1 (Thiamin HCl) injeksi 100 mg/ml-1ml ampul - - - -
233 Vitamin B1 (Thiamin HCl) tablet 50 mg tablet 6,000 - 6,000 -
234 Vitamin B6 (Piridoksin HCl) tablet 10 mg tablet - - - -
235 Vitamin B12 (Cyanocobalamin) injeksi 500 mcg/ml-1ml ampul - - - -
236 Vitamin B12 (Cyanocobalamin) tablet tablet - - - -
237 Vitamin B Complex tablet tablet 11,000 - 11,000 -
238 Vitamin C (Asam Ascorbat ) tablet 50 mg tablet - - - -
239 Vitamin C (Asam Ascorbat ) tablet 250 mg tablet - - - -
240 Zink 20 mg tablet Dispersibel tablet 1,000 - 1,000 -

II OBAT GIGI
241 Air Raksa botol - - - -
242 Alkahner/Cavit/Dentorit buah 2 - 2 -
243 Devitalisasi pasta (non arsen) kotak 1 - 1 -
244 Etil klorida semprot botol 4 - 4 -
245 Eugenol Cairan botol 5 - 5 -
246 Flour tablet 0,5 mg tablet - - - -
247 Formokresol (pengganti TKF) botol 2 - 2 -
248 Glass ionomer cement (GC IX) set 1 - 1 -
249 Kalsium hidroksida pasta set 5 - 5 -

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 STOK PENE PERSE PERMINTAAN
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250 Klorfenol kamfer menthol (CHKM) botol 3 - 3 -
251 Mummifying pasta botol 3 - 3 -
252 Semen seng fosfat serbuk dan cairan set 2 - 2 -
253 Silver amalgam serbuk 65 - 75% botol - - - -
254 Spons gelatin cubides 1 x 1 x 1 cm dental - - - -
255 Temporary stopping fletcher (Fletcher) serbuk & cairan set 2 - 2 -

III OBAT TAMBAHAN

256 Alphamol Drop / Otopan Drop botol - - - -
257 Amoxan/ Amobiotik drop botol - - - -
258 Armovit tablet - - - -
259 Bioplacenton Jelly tube - - - -
260 Borax gliserin botol - - - -
261 Chloramfecort H cream/Colipred cream tube - - - -
262 Combantrin syr botol - - - -
263 Daryantul kotak - - - -
264 Dettol lig 750ml botol - - - -
265 Dextamin tab tablet - - - -
266 Diafrom tab tablet - - - -
267 Dialac 1 gr zak - - - -
268 Dulcolax tab tablet - - - -
269 Evion 200 soft tab kapsul - - - -
270 FG troches tab isap tablet - - - -
271 Flutamol tab kapsul - - - -
272 Folamil tab tablet - - - -
273 folavit tab 1 mg tablet - - - -
274 Guanestrip syr / Kanina syrup botol - - - -
275 H 2 O 2 3 % 1000 ml botol 7 - 7 -
276 Histolan tab tablet - - - -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
277 Ictiol salep pot 24 - 24 -
278 Kanamycin inj 1 grm vial - - - -
279 Kanamycin inj 2 grm vial - - - -
280 Kandistatin Drop botol - - - -
281 Livron B Plex tablet - - - -
282 Molakrim tube - - - -
283 Multi vitamin syr (calsidol+DHA+Lysin) botol - - - -
284 Novatusin syrup (PCT 120 mg,Efedrin HCl 5mg, CTM 2 mg,GG 50mg) botol - - - -
285 Polikresulen / Albotil concetrate 10 ml botol - - - -
286 Pregnollin tablet tablet - - - -
287 Primpran inj amp - - - -
288 Primulut- N tablet tablet - - - -
289 Rhinofed tablet tablet - - - -
290 Stesolit rectal 5 mg tube - - - -
291 Stesolit rectal 10 mg tube - - - -
292 Streptomisin serbuk inj I.V 1000 mg/ml vial - - - -
293 Transamin tab 250 mg tablet - - - -
294 Trombopop gel tube - - - -
295 Urispas tab tablet - - - -
296 Zistic tablet - - - -

IV OBAT TRADISIONAL/JAMU/HERBAL/FITOFARMAKA
297 Curcuma plus Fruit Veggie syrup botol 200 - 200 -
298 Diapet tablet tablet 300 - 300 -
299 Entrostop anak sachet 144 - 144 -
300 Hemorogard kapsul - - - -
301 Hepagard kapsul - - - -
302 I-flex kapsul kapsul 720 - 720 -
303 Lancar Asi kapsul 570 - 570 -

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 STOK PENE PERSE PERMINTAAN
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304 Maximus dietary herbal kapsul 600 - 600 -
305 Ocugard kapsul 60 - 60 -
306 Prolipid kapsul 240 - 240 -
307 Prouric kapsul - - - -
308 Stimuno syrup botol 160 - 160 -
309 Stimuno kapsul kapsul - - - -
310 Tensigard kapsul 810 - 810 -

V BAHAN HABIS PAKAI

311 Abbocate No. 18 set - - - -
312 Abbocate No. 20 set 21 - 21 -
313 Abbocate No. 22 set 19 - 19 -
314 Abbocate No. 24 set 10 - 10 -
315 Alat suntik sekali pakai 1 ml set - - - -
316 Alat suntik sekali pakai 3 ml/ 2,5 ml set - - - -
317 Alat suntik sekali pakai 5 ml set 800 - 800 -
318 Alat suntik sekali pakai 10 ml set - - - -
319 Alat suntik bias 0,5 ml set 11,500 - 11,500 -
320 Alat suntik bias 0,05 ml set - - - -
321 Alat suntik bias 5 ml set 350 - 350 -
322 Alkohol Swap buah 300 - 300 -
323 Catgut Cromic 2/0 dengan jarum lusin - - - -
324 Catgut Cromic 3/0 dengan jarum lusin - - - -
325 Catgut plain 2/0 dengan jarum lusin - - - -
326 Catgut plain 3/0 dengan jarum lusin - - - -
327 Cotton Aplication steril kotak - - - -
328 Cover glass buah - - - -
329 Etakridin (rivanol) larutan 0,1% btl 300 ml botol 98 - 98 -
330 Etakridin (rivanol) larutan 0,1% btl 100 ml botol - - - -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

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331 Etanol 70% 1000 ml botol 11 - 11 -
332 Foley catheter No. 18 buah 12 - 12 -
333 Hand Scund (Steril) No. 7 psng 450 - 450 -
334 Hand Scund (Steril) No. 7,5 psng 300 - 300 -
335 Hand Scund Size S psng - - - -
336 Hand Scund Size M psng 650 - 650 -
337 Hand Scund Size L psng 250 - 250 -
338 Infusion set Dewasa set 10 - 10 -
339 Infusion set anak set 4 - 4 -
340 Kapas Berlemak 500 gram bungkus - - - -
341 Kapas Pembalut/Absorben 250 gram bungkus 5 - 5 -
342 Kasa Kompres 40/40 steril rol - - - -
343 Kasa Pembalut 2 m x 80 cm rol - - - -
344 Kasa Pembalut Hidrofil 4 m x 15 cm rol - - - -
345 Kasa Pembalut Hidrofil 4 m x 3 cm rol - - - -
346 Kasa Pembalut Hidrofil 40 m x 80 cm Gulung - - - -
347 Kasa Pembalut Hidrifil 36 m x 80 cm rol 10 - 10 -
348 Kasa Hidrofil Steril uk. 16 x 16 (isi 16 lembar) Kotak - - - -
349 Kasa Hidrofil Steril uk. 18 x 22 cm (isi 12 lembar) Kotak 86 - 86 -
350 Kasa Pembalut Hidrofil 4 m x 5 cm elastic Rol 322 - 322 -
351 Kasa Pembalut Hidrofil 4 m x 10 cm elastic Rol 269 - 269 -
352 Kertas Perkamen 75 x 100 cm lembar 1,500 - 1,500 -
353 Klep tali pusat pcs - - - -
354 Lens paper buah - - - -
355 Lisol, mengandung kresol tersabun 50 % botol - - - -
356 Masker kotak 47 - 47 -
357 Medicine paket paket - - - -
358 Nedle 25 g ( Terumo / Setara ) kotak - - - -
359 Nedle Heacting G 3/4 lusin - - - -

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360 Nedle Heacting G 7 - 13, 12 (segi tiga) lusin - - - -
361 Object Glass buah - - - -
362 PH paper buah - - - -
363 Plaster 5 yards x 2 inch rol - - - -
364 Plastik Kantong Etiket Obat 8,5x13,5 cm (Besar) ball - - - -
365 Plastik Kantong Etiket Obat 6,5x8,05 cm (Kecil) ball - - - -
366 Plastik (kresek) Ukuran 15 x 33 cm (putih) ball - - - -
367 Plastik (kresek) Ukuran 35 x 55 cm (merah) ball - - - -
368 Pot Salep 10 gram pcs - - - -
369 Pot Salep 5 gram pcs 50 - 50 -
370 Pot Sputum/Pot Dahak pcs 593 - 593 -
371 Povidon Iodida 10% 30 ml botol 84 - 84 -
372 Povidon Iodida 10% 300 ml botol 11 - 11 -
373 Povidon Iodida 10% 1000 ml botol - - - -
374 Rapid Test untuk siphilis test - - - -
375 Rol Paper rol - - - -
376 Silk (benang bedah sutera)No. 3/0 dgn jarum bedah (PKD) lusin 9 - 9 -
377 Safety box pcs 100 - 100 -
378 Transfusion set set - - - -
379 Urine bag pcs 3 - 3 -
380 Vaselin botol - - - -
381 Venflon No.18 set - - - -
382 Wing Nedle No.23 set - - - -
383 Wing Nedle No.25 G set 2 - 2 -

VI REAGENSIA & BAHAN LABORATORIUM

384 Blood Lancet pcs 200 - 200 -
385 Imersi Oil Mikroskop 100 ml botol - - - -
386 Kartu golongan darah lembar 300 - 300 -

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 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

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387 Larutan Asam Klorida 0,1 N botol 2 - 2 -
388 Larutan Asam sulfosalisilat 20 % botol - - - -
389 Larutan Benedict 100 ml botol - - - -
390 Larutan Eosin 2 % 100 ml botol - - - -
391 Larutan Etanol Asam 100 ml botol - - - -
392 Larutan Giemsa Stain 100 ml botol 2 - 2 -
393 Larutan Hyem 100 ml botol - - - -
394 Larutan Karbol Fuksin 100 ml botol - - - -
395 Larutan Metilen Biru botol - - - -
396 Larutan Natrium Sitrat botol - - - -
397 Larutan Turk 100 ml botol - - - -
398 Latex/ Tes kehamilan test - - - -
399 Lugol botol - - - -
400 Metanol 100 ml botol - - - -
401 Ose buah - - - -
402 Reagen Zeil Nelsen BTA (Alkohol asam,methyl blue,carbol fuchsin) paket 4 - 4 -
403 Reagen Ig G/Ig M/Dengue Ig G/Ig M (Stick) tes - - - -
404 Reagen Pemeriksaan Trombocit 500 ml set - - - -
405 Reagen Hematologi (mindray):deluent 20 l, Rinse 20 l, EZ set - - - -
406 Reagen Hematologi (sweelab):deluent 20 l, lyse 20 l set - - - -
407 Serum Gol Darah anti A & anti B set 4 - 4 -
408 Stik Glukosa gula Darah (gluco DR) test - - - -
409 Test Widal set - - - -
410 Urine Reagen Strip 3 parameter (PH) kotak - - - -
411 Urine Reagen Strip 10 parameter (PH) kotak 3 - 3 -
412 Urine Gluco Protein Test test - - - -
413 Yodium 1 % 100 ml botol - - - -
414 K O H 1% botol - - - -
415 Xilol / Xilene botol - - - -

Page 15
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
416 USG Ultrasonic gel botol - - - -
417 Ventolin Nebulizer kotak - - - -
418 Voucher oxygen tabung 10 liter lembar - - - -
419 Voucher oxygen tabung 40 liter lembar - - - -

VII OBAT KB
420 Kontrasepsi injeksi Progesteron depot( 3 bln) vial - - - -
421 Kontrasepsi pil kombinasi (Microdiol) strip - - - -
422 Implant KB 3 tahunan buah - - - -

Penanggungjawab Gudang Obat

UPT Puskesmas Sei Pancur
Kota Batam

Yanti Alfina
NIP. 19721209 200604 2 017

Page 16
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
423 Medicine packet SI-20 box - 1 1
424 Reagen hematologi labnovation (Diluent set - 1 1
425 Plester hansaplast rol (1,25 cm x 5 m) rol - 10 10

Page 17
BULAN : JANUARI
TAHUN : 2014

SISA
STOK EXP.DATE

10 11

30 1214
-
-
400 817
500 615
100 916
10 514;914
-
5 515
500 917
90 718
100 916
200 817
-
-
-
900 715
50 915
-

Page 18
SISA
STOK EXP.DATE

10 11
18,900 915;415
-
-
30 314
7,100 1116
-
25 916
140 1114;717
-
-
10 117
6 717
-
-
-
2,100 1017;618
-
-
100 914
-
-
-
-
150 915
180 615
150 915
-
120 615
3,000 715

Page 19
SISA
STOK EXP.DATE

10 11
1,000 916
1,000 917
55 915
200 916
50 714
300 715
-
-
20 914
390 915
5 1214
250 917
72 1014
96 1114
48 115
100 1015
-
-
-
-
600 616
150 1216
450 916
300 614
50 1115
-
500 116
1,000 916
- 1215

Page 20
SISA
STOK EXP.DATE

10 11
5,800 915
50 714
1,000 1114
-
1,000 915
-
3 617
-
-
-
200 915
48 1014
500 517
1,000
30 615
-
500 618
84 915
-
-
30 914
-
-
50 214
2,000 616
-
100 616
-
900 916

Page 21
SISA
STOK EXP.DATE

10 11
150 915
50 915
-
216 914
300 1215
7,000 1114;118
-
22 815;417
-
-
- 1014
-
-
-
-
120 916
-
100 614
1,000 117
1,000 416
300 517
-
24 715
-
239 1014
300 716
-
-
-

Page 22
SISA
STOK EXP.DATE

10 11
-
-
-
-
90 915
-
950 616
120 915
-
50 1015;916
-
-
-
-
100 817
80 1014
500 917
1,000 816
200 315
-
100 816
-
500 614
-
200 817
-
96 1114;917
160 914
4,000 1215

Page 23
SISA
STOK EXP.DATE

10 11
1,000 816
-
20 318
- 615
- 417
-
3 714;1214
11 1214
7 614
2 1214;915
2 816
4 714;615
252 1017
-
50 114;315
250 315
-
- 1215
-
-
-
89 1214
150 1015
- 617
8,800 1017
-
300 1016
100 715
-

Page 24
SISA
STOK EXP.DATE

10 11
-
100 1217
- 915
400 117
-
-
300 1215
-
-
118 815
-
1,400 515
-
-
-
21 514;914
1,100 915;1215
200 415
24 817
590 516
-
-
-
-
-
-
-
1,200 1115
5 1115

Page 25
SISA
STOK EXP.DATE

10 11
-
200 714
300 616
-
150 815;717
200 1215
-
65 615
1,000 515
-
6,000 1014
-
-
-
11,000 717
- 515
- 615
1,000 915

-
2 614
1 514
4 615
5 -
-
2 -
1 615
5 1114

Page 26
SISA
STOK EXP.DATE

10 11
3 1114
3 414
2 -
-
-
2 1114

-
-
-
-
-
-
-
- 1216
-
-
-
-
-
-
-
-
-
-
-
7
-

Page 27
SISA
STOK EXP.DATE

10 11
24 1017
-
-
-
-
-
-
-
-
-
-
-
-
- 814
- 614
-
-
-
-
-

200 914
300 816
144 214
-
-
720 214
570 1016

Page 28
SISA
STOK EXP.DATE

10 11
600 714
60 1014
240 615
-
160 714;815
- 714
810 1016

-
21 1015;517
19 215
10 616
-
- 515
800 617
- 1114
11,500 714
-
350 416
300 116
-
-
-
-
-
-
98 1014
-

Page 29
SISA
STOK EXP.DATE

10 11
11 1015
12 1114
450 1116
300 1116
- 215
650 815
250
10 417
4 715
-
5 1017
-
-
-
-
-
10 914
-
86 1114
322
269
1,500
-
-
-
47
-
-
-

Page 30
SISA
STOK EXP.DATE

10 11
-
-
-
-
-
-
-
-
-
50
593
84 1015
11 515
-
-
-
9 716
100
-
3 817
-
-
-
2 1014

200 217
- 815
300

Page 31
SISA
STOK EXP.DATE

10 11
2
-
-
-
-
2 615
-
-
-
-
-
-
-
-
-
4 1214;314
-
-
-
-
4 515
-
-
-
3 914
-
-
-
-

Page 32
SISA
STOK EXP.DATE

10 11
-
-
-
-

-
-
-

Page 33
SISA
STOK EXP.DATE

10 11
1
1
10

Page 34
-

Page 35
-

Page 36
-

Page 37
 LAPORAN GUDANG OBAT

KODE PUSKESMAS :
PUSKESMAS : SEI PANCUR
KECAMATAN : SEI BEDUK
KOTA : KOTA BATAM
PROVINSI : KEP RIAU
STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
I OBAT GENERIK
1 Albendazol tablet 400 mg tablet 30 - 30 -
2 Alprozolam tab 0,25 mg tablet - - - -
3 Alprozolam tab 0,5 mg tablet - - - -
4 Acyclovir 200 mg tablet ( OGB ) tablet 400 - 400 -
5 Acyclovir 400 mg tablet ( OGB ) tablet 500 - 500 -
6 Acyclovir cream ( OGB ) tube 100 - 100 -
7 ACT(Atesunat 50 mg+Amodiaquin anhydrida200 mg)tab paket 10 - 10 -
8 Arterakine tablet paket - - - -
9 Arterakine (DARPLEX) paket 5 - 5 -
10 Allopurinol tablet 100 mg tablet 500 - 500 -
11 Allopurinol tablet 300 mg tablet 90 - 90 -
12 Ambroxol syrup ( OGB ) botol 100 - 100 -
13 Ambroxol 30mg tab (OGB ) tablet 200 - 200 -
14 Aminofilin tablet 200 mg tablet - - - -
15 Aminofilina injeksi 24 mg/ml - 10ml ampul - - - -
16 Amitriptilin HCL tablet salut 25 mg tablet - - - -
17 Amlodipine tablet 5 mg tablet 900 - 900 -
18 Amoksisilin sirup kering 125 mg/5 ml botol 50 - 50 -
19 Amoksisilin kapsul 250 mg kapsul - - - -

Page 38
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
20 Amoksisilin kaplet 500 mg kaplet 18,900 - 18,900 -
21 Ampicillin inj 1 gr ( OGB ) vial - - - -
22 Antalgin (metampiron) tablet 500 mg tablet - - - -
23 Antalgin injeksi 250 mg/ml - 2ml ampul 30 - 30 -
24 Antasida DOEN I tablet kunyah tablet 7,100 - 7,100 -
25 Antasida DOEN II suspensi botol - - - -
26 Anti bakteri DOEN salep komb:Bacitracin+Polimiksin tube 25 - 25 -
27 Anti hemoroid DOEN kombinasi suup 140 - 140 -
28 Antifungi DOEN kombinasi :As Benzoat+As Salisilat pot - - - -
29 Antimigren tartrat 1 mg + kofein 50 mg tablet - - - -
30 Aqua pro injeksi steril, bebas pirogen 20 ml vial 10 - 10 -
31 Aquades steril 1000 ml botol 6 - 6 -
32 Artem (artemether 80 mg ) inj ampul - - - -
33 Artesunate inj 60 mg/ml vial - - - -
34 Asam Mefenamat tablet salut 250 mg kapsul - - - -
35 Asam Mefenamat tablet salut 500 mg kaplet 2,100 - 2,100 -
36 Asetosal tablet 100 mg tablet - - - -
37 Asetosal tablet 500 mg tablet - - - -
38 Atenolol tablet 50 mg tablet 100 - 100 -
39 Atropin sulfat inj 0,25 mg/ml-1 ml ampul - - - -
40 Atropin sulfat tablet 0,5 mg tablet - - - -
41 Atropin sulfat tetes mata 0,5 mg botol - - - -
42 Besi sirup botol - - - -
43 Betametason krim 0,1% tube 150 - 150 -
44 Betahistin Mesilat 6 MG tablet 180 - 180 -
45 Bisoprolol 5 mg tablet 150 - 150 -
46 Bromheksin tab 8 mg tablet - - - -
47 Calcium gluconat injeksi vial 120 - 120 -
48 Calcium Lactate 500 mg tablet 3,000 - 3,000 -

Page 39
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
49 Catopril 12,5 mg tablet 1,000 - 1,000 -
50 Catopril 25 mg tablet 1,000 - 1,000 -
51 Cefadroxil syrup 125 mg/5ml botol 55 - 55 -
52 Cefadroxil kapsul 500 mg kapsul 200 - 200 -
53 Cefixim syrup 100 mg/5 ml botol 50 - 50 -
54 Cefixim 100 mg kapsul kapsul 300 - 300 -
55 Cefotaxim injeksi 1 gram vial - - - -
56 Ceftriazone injeksi vial - - - -
57 Cetirizene syrup 5 mg/ 5 ml botol 20 - 20 -
58 Cetirizene 10 mg tablet 390 - 390 -
59 Chloramphenicol suspensi 60 ml botol 5 - 5 -
60 Chloramphenicol kapsul 250 mg kapsul 250 - 250 -
61 Chloramphenicol tetes Mata 0,5 % botol 72 - 72 -
62 Chloramphenicol salep mata 1 % tube 96 - 96 -
63 Chloramphenicol tetes telinga 3 % botol 48 - 48 -
64 Chlorfeniramin Maleat (CTM) tab 4 mg tablet 100 - 100 -
65 Chlorpromazine HCL 100 mg tablet salut tablet - - - -
66 Chlorpromazine HCL 25 mg tablet salut tablet - - - -
67 Chlorpromazine HCL inj 25 mg / ml - 1 ml ampul - - - -
68 Chlorpromazine HCL inj 5 mg / ml - 2 ml ampul - - - -
69 Cimetidin 200 mg tab (OGB ) tablet 600 - 600 -
70 Clindamisin 150 mg kapsul 150 - 150 -
71 Clindamisin 300 mg kapsul 450 - 450 -
72 Co- Amoxiclav 625 mg tab tablet 300 - 300 -
73 Cotrimoksazole suspensi 60 ml botol 50 - 50 -
74 Cotrimoksazole tablet pediatrik 120 mg tablet - - - -
75 Cotrimoksazole tablet Dewasa 480 mg tablet 500 - 500 -
76 Cyprofloxacin tab 500 mg ( OGB ) tablet 1,000 - 1,000 -
77 Deksametason injeksi 5 mg / ml -1ml ampul - - - -

Page 40
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
78 Deksametason tablet 0,5mg tablet 5,800 - 5,800 -
79 Dekstrometorfan sirup 10 mg/5 ml botol 50 - 50 -
80 Dekstrometorfan tablet 15 mg tablet 1,000 - 1,000 -
81 Dekstran 70 - larutan infus 6 % steril botol - - - -
82 Diazepam tablet 2 mg tablet 1,000 - 1,000 -
83 Diazepam tablet 5 mg tablet - - - -
84 Diazepam injeksi 5 mg/ml ampul 3 - 3 -
85 Diethylcarbamazine tablet 100 mg tablet - - - -
86 Difenhidramin HCL inj 10 mg/ml-1 ml ampul - - - -
87 Digoksin tablet 0,25 mg tablet - - - -
88 Doksisiklin kapsul 100 mg kapsul 200 - 200 -
89 Domperidon syrup botol 48 - 48 -
90 Domperidon 10 mg tab tablet 500 - 500 -
91 Efedrin HCl tablet 25 mg tablet 1,000 - 1,000 -
92 Epinefrina HCL/Bitartrat (Adrenalin ) inj 0,1 %-1 ml ampul 30 - 30 -
93 Ekstrak belladon tablet 10 mg tablet - - - -
94 Erythromycin kapsul 500 mg ( OGB ) kapsul 500 - 500 -
95 Erythromycin syrup 200 mg/5 ml botol 84 - 84 -
96 Fenitoin natrium kapsul 100 mg kapsul - - - -
97 Fenitoin natrium kapsul 30 mg kapsul - - - -
98 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 30 - 30 -
99 Fenobarbital tablet 30 mg tablet - - - -
100 Fenobarbital tablet 100 mg tablet - - - -
101 Fenol Gliserol tetes telinga 10 % botol 50 - 50 -
102 Folic Acid tablet 1 mg tablet 2,000 - 2,000 -
103 Furosemid injeksi ampul - - - -
104 Furosemid tablet 40 mg tablet 100 - 100 -
105 Gameksan emulsi 1% botol - - - -
106 Garam oralit untuk 200 ml air sachet 900 - 900 -

Page 41
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
107 Gentamycin salap kulit 0,1 % - 5 gr (OGB) tube 150 - 150 -
108 Gentamisin tetes mata botol 50 - 50 -
109 Gentamicyn inj 80 mg/ml vial - - - -
110 Gentian violet larutan 1% botol 216 - 216 -
111 Glibenklamid tablet 5 mg tablet 300 - 300 -
112 Gliseril guayakolat tablet 100 mg tablet 7,000 - 7,000 -
113 Gliserin botol - - - -
114 Glukosa larutan infus 5% steril botol 22 - 22 -
115 Glukosa larutan infus 10 % steril botol - - - -
116 Glukosa larutan infus 40 % steril botol - - - -
117 Griseofulvin tablet 125 mg tablet - - - -
118 Haloperidol tablet 0,5 mg tablet - - - -
119 Haloperidol tablet 1,5 mg tablet - - - -
120 Hidroklorotiazid (HCT) tablet 25 mg tablet - - - -
121 Hidrokortison krim 1% pot - - - -
122 Hidrokortison krim 2,5 % tube 120 - 120 -
123 Insulin reguler inj 40IU/ml-10 ml (human) ampul - - - -
124 Ibuprofen suspensi 100 mg/5ml botol 100 - 100 -
125 Ibuprofen tablet 200 mg botol 1,000 - 1,000 -
126 Ibuprofen tablet 400 mg tablet 1,000 - 1,000 -
127 Isosorbid dinitrat tablet sublingual 5 mg tablet 300 - 300 -
128 Kalium Diclofenak 25 mg tablet - - - -
129 Kalium Permangat serbuk 5 gram pot 24 - 24 -
130 Karbamazepin tablet 200 mg tablet - - - -
131 Ketokenazol cream 2 % tube 239 - 239 -
132 Ketokonazol 200 mg tab tablet 300 - 300 -
133 Klonidin tablet 0,15 mg tablet - - - -
134 Klorokuin tablet 150 mg tablet - - - -
135 Klorpropamid tablet 100 mg tablet - - - -

Page 42
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
136 Kodein fosfat tablet 10 mg tablet - - - -
137 Kuinin (kina) tablet 200 mg tablet - - - -
138 Kuinin dihidroklorida inj 25 %-2 ml ampul - - - -
139 Lanzoprazol kapsul 30 mg kapsul - - - -
140 Lidokain komp.injeksi 2 ml ampul 90 - 90 -
141 Loperamid tablet tablet - - - -
142 Loratadin tablet 10 mg tablet 950 - 950 -
143 Lyncomicin 500 mg cap kapsul 120 - 120 -
144 Magnesium Sulfat Inj (IV) 20%-25 ml ampul - - - -
145 Magnesium Sulfat Inj (IV) 40%-25 ml ampul 50 - 50 -
146 Mebendazol sirup 100 mg/5 ml botol - - - -
147 Mebendazol tablet 100 mg tablet - - - -
148 Methochlorpamid syr 5 mg/ml botol - - - -
149 Metilergometrin maleat inj 0,200 mg-1 ml ampul - - - -
150 Metilergometrin maleat tab salut 1,125 mg tablet 100 - 100 -
151 Meloksikam suppositoria supp 80 - 80 -
152 Meloksikam 7,5 mg tablet 500 - 500 -
153 Metformin tab 500 mg tablet 1,000 - 1,000 -
154 Metformin tab 850 mg tablet 200 - 200 -
155 Metilprednisolon 4 mg tablet - - - -
156 Metilprednisolon 8 mg tablet 100 - 100 -
157 Metoclorpramid injeksi 5 mg/ml ampul - - - -
158 Metoclorpramid tab 10 mg tablet 500 - 500 -
159 Metronidazol tablet 250 mg tablet - - - -
160 Metronidazol tablet 500 mg tablet 200 - 200 -
161 Metronidazol 500 mg infus botol - - - -
162 Miconazol 2 % cream (OGB ) tube 96 - 96 -
163 Mineral Mix sachet 160 - 160 -
164 Natrium bikarbonat tablet 500 mg tablet 4,000 - 4,000 -

Page 43
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
165 Natrium Diklofenak tab 50 mg tablet 1,000 - 1,000 -
166 Natrium Tiroksin tablet - - - -
167 Natrium klorida larutan infus 0,9% steril botol 20 - 20 -
168 Nifedipin tab 10 mg tablet - - - -
169 Nistatin tablet salut 100.000 IU tablet - - - -
170 Nistatin tablet salut 500.000 IU tablet - - - -
171 OAT FDC Kategori Anak paket 3 - 3 -
172 OAT Kombipak Kategori Anak paket 11 - 11 -
173 OAT FDC Kategori I Dewasa paket 7 - 7 -
174 OAT Kombipak Kategori I Dewasa paket 2 - 2 -
175 OAT FDC Kategori II Dewasa paket 2 - 2 -
176 OAT FDC Sisipan Dewasa paket 4 - 4 -
177 Obat batuk hitam (OBH) cairan botol 252 - 252 -
178 Oksitetrasiklin HCl injeksi I.m.50mg/ml-10ml vial - - - -
179 Oksitetrasiklin HCl salep mata 1% tube 50 - 50 -
180 Oksitetrasiklin HCl salep 3% tube 250 - 250 -
181 Oksitosin injeksi 10 IU/ml-1 ml ampul - - - -
182 Omeprazol kapsul 20 mg kapsul - - - -
183 Oseltamivir 75 mg (ut flu burung) tablet - - - -
184 Papaverin tablet 40 mg ( OGB ) tablet - - - -
185 Paraformaldehid tablet 1 gram tablet - - - -
186 Parasetamol drop botol 89 - 89 -
187 Parasetamol sirup 120 mg/5 ml botol 150 - 150 -
188 Parasetamol tablet 100 mg tablet - - - -
189 Parasetamol tablet 500 mg tablet 8,800 - 8,800 -
190 Phytomenadion (Vit K1) injeksi 10 mg/ml-1 ml ampul - - - -
191 Phytomenadion (Vit.K1) tablet salut gula 10 mg tablet 300 - 300 -
192 Piracetam 800 mg tablet 100 - 100 -
193 Piracetam 1200 mg tablet - - - -

Page 44
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
194 Pirantel sirup 125 mg/5 ml botol - - - -
195 Pirantel tablet 125 mg tablet 100 - 100 -
196 Piroxicam 10 mg ( OGB ) tablet - - - -
197 Piroxicam 20 mg ( OGB ) tablet 400 - 400 -
198 Prednison tablet 5 mg tablet - - - -
199 Primakuin tablet 15 mg tablet - - - -
200 Propiltiourasil tablet 100 mg tablet 300 - 300 -
201 Propranolol HCl tablet 10 mg tablet - - - -
202 Propranolol HCl tablet 40 mg tablet - - - -
203 Prokain Penisilin inj,3 juta IU vial 118 - 118 -
204 Rabies immuni globulin (himan ) 150 IU/ml ampul - - - -
205 Ranitidin tab tablet 1,400 - 1,400 -
206 Ranitidin injeksi ampul - - - -
207 Reserpin tablet 0,10 mg tablet - - - -
208 Reserpin tablet 0,25 mg tablet - - - -
209 Ringer laktat larutan infus steril botol 21 - 21 -
210 Salbutamol tablet 2 mg tablet 1,100 - 1,100 -
211 Salbutamol tablet 4 mg tablet 200 - 200 -
212 Salep 2-4, komb : As.Salisilat + belerang endap pot 24 - 24 -
213 Salisil bedak 2% kotak 590 - 590 -
214 Serum anti bisa ular polivalen inj 5 ml (ABU I ) ampul - - - -
215 Serum anti difteri inj 20.000 IU/vial (A D S ) ampul - - - -
216 Serum anti tetanus injeksi 1.500 IU/ampul ( A T S ) ampul - - - -
217 Serum anti tetanus injeksi 20.00 IU/ampul ( A T S ) ampul - - - -
218 Simvastatin tab 10 mg tablet - - - -
219 Sulfadoxin 500+Pirimetamin 25 mg tablet tablet - - - -
220 Sulfasetamida Natrium tetes mata 15 % botol - - - -
221 Tambah Darah tablet ( Ferollat ) sachet 1,200 - 1,200 -
222 Tetrakain HCL tetes mata 0,5% botol 5 - 5 -

Page 45
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
223 Tetrasiklin HCL kapsul 250 mg kapsul - - - -
224 Tetrasiklin HCL kapsul 500 mg kapsul 200 - 200 -
225 Thiamphenicol kapsul 500 mg tablet 300 - 300 -
226 Tramadol injeksi ampul - - - -
227 Tramadol 50 mg tablet 150 - 150 -
228 Triheksifenidil Hidroklorida tablet 2 mg tablet 200 - 200 -
229 Vaksin rabies vero ampul - - - -
230 Vitamin A (Retinol) 100.000 IU kapsul lunak kapsul 65 - 65 -
231 Vitamin A (Retinol) 200.000 IU kapsul lunak kapsul 1,000 - 1,000 -
232 Vitamin B1 (Thiamin HCl) injeksi 100 mg/ml-1ml ampul - - - -
233 Vitamin B1 (Thiamin HCl) tablet 50 mg tablet 6,000 - 6,000 -
234 Vitamin B6 (Piridoksin HCl) tablet 10 mg tablet - - - -
235 Vitamin B12 (Cyanocobalamin) injeksi 500 mcg/ml-1ml ampul - - - -
236 Vitamin B12 (Cyanocobalamin) tablet tablet - - - -
237 Vitamin B Complex tablet tablet 11,000 - 11,000 -
238 Vitamin C (Asam Ascorbat ) tablet 50 mg tablet - - - -
239 Vitamin C (Asam Ascorbat ) tablet 250 mg tablet - - - -
240 Zink 20 mg tablet Dispersibel tablet 1,000 - 1,000 -

II OBAT GIGI
241 Air Raksa botol - - - -
242 Alkahner/Cavit/Dentorit buah 2 - 2 -
243 Devitalisasi pasta (non arsen) kotak 1 - 1 -
244 Etil klorida semprot botol 4 - 4 -
245 Eugenol Cairan botol 5 - 5 -
246 Flour tablet 0,5 mg tablet - - - -
247 Formokresol (pengganti TKF) botol 2 - 2 -
248 Glass ionomer cement (GC IX) set 1 - 1 -
249 Kalsium hidroksida pasta set 5 - 5 -

Page 46
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
250 Klorfenol kamfer menthol (CHKM) botol 3 - 3 -
251 Mummifying pasta botol 3 - 3 -
252 Semen seng fosfat serbuk dan cairan set 2 - 2 -
253 Silver amalgam serbuk 65 - 75% botol - - - -
254 Spons gelatin cubides 1 x 1 x 1 cm dental - - - -
255 Temporary stopping fletcher (Fletcher) serbuk & cairan set 2 - 2 -

III OBAT TAMBAHAN

256 Alphamol Drop / Otopan Drop botol - - - -
257 Amoxan/ Amobiotik drop botol - - - -
258 Armovit tablet - - - -
259 Bioplacenton Jelly tube - - - -
260 Borax gliserin botol - - - -
261 Chloramfecort H cream/Colipred cream tube - - - -
262 Combantrin syr botol - - - -
263 Daryantul kotak - - - -
264 Dettol lig 750ml botol - - - -
265 Dextamin tab tablet - - - -
266 Diafrom tab tablet - - - -
267 Dialac 1 gr zak - - - -
268 Dulcolax tab tablet - - - -
269 Evion 200 soft tab kapsul - - - -
270 FG troches tab isap tablet - - - -
271 Flutamol tab kapsul - - - -
272 Folamil tab tablet - - - -
273 folavit tab 1 mg tablet - - - -
274 Guanestrip syr / Kanina syrup botol - - - -
275 H 2 O 2 3 % 1000 ml botol 7 - 7 -
276 Histolan tab tablet - - - -

Page 47
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
277 Ictiol salep pot 24 - 24 -
278 Kanamycin inj 1 grm vial - - - -
279 Kanamycin inj 2 grm vial - - - -
280 Kandistatin Drop botol - - - -
281 Livron B Plex tablet - - - -
282 Molakrim tube - - - -
283 Multi vitamin syr (calsidol+DHA+Lysin) botol - - - -
284 Novatusin syrup (PCT 120 mg,Efedrin HCl 5mg, CTM 2 mg,GG 50mg) botol - - - -
285 Polikresulen / Albotil concetrate 10 ml botol - - - -
286 Pregnollin tablet tablet - - - -
287 Primpran inj amp - - - -
288 Primulut- N tablet tablet - - - -
289 Rhinofed tablet tablet - - - -
290 Stesolit rectal 5 mg tube - - - -
291 Stesolit rectal 10 mg tube - - - -
292 Streptomisin serbuk inj I.V 1000 mg/ml vial - - - -
293 Transamin tab 250 mg tablet - - - -
294 Trombopop gel tube - - - -
295 Urispas tab tablet - - - -
296 Zistic tablet - - - -

IV OBAT TRADISIONAL/JAMU/HERBAL/FITOFARMAKA
297 Curcuma plus Fruit Veggie syrup botol 200 - 200 -
298 Diapet tablet tablet 300 - 300 -
299 Entrostop anak sachet 144 - 144 -
300 Hemorogard kapsul - - - -
301 Hepagard kapsul - - - -
302 I-flex kapsul kapsul 720 - 720 -
303 Lancar Asi kapsul 570 - 570 -

Page 48
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
304 Maximus dietary herbal kapsul 600 - 600 -
305 Ocugard kapsul 60 - 60 -
306 Prolipid kapsul 240 - 240 -
307 Prouric kapsul - - - -
308 Stimuno syrup botol 160 - 160 -
309 Stimuno kapsul kapsul - - - -
310 Tensigard kapsul 810 - 810 -

V BAHAN HABIS PAKAI

311 Abbocate No. 18 set - - - -
312 Abbocate No. 20 set 21 - 21 -
313 Abbocate No. 22 set 19 - 19 -
314 Abbocate No. 24 set 10 - 10 -
315 Alat suntik sekali pakai 1 ml set - - - -
316 Alat suntik sekali pakai 3 ml/ 2,5 ml set - - - -
317 Alat suntik sekali pakai 5 ml set 800 - 800 -
318 Alat suntik sekali pakai 10 ml set - - - -
319 Alat suntik bias 0,5 ml set 11,500 - 11,500 -
320 Alat suntik bias 0,05 ml set - - - -
321 Alat suntik bias 5 ml set 350 - 350 -
322 Alkohol Swap buah 300 - 300 -
323 Catgut Cromic 2/0 dengan jarum lusin - - - -
324 Catgut Cromic 3/0 dengan jarum lusin - - - -
325 Catgut plain 2/0 dengan jarum lusin - - - -
326 Catgut plain 3/0 dengan jarum lusin - - - -
327 Cotton Aplication steril kotak - - - -
328 Cover glass buah - - - -
329 Etakridin (rivanol) larutan 0,1% btl 300 ml botol 98 - 98 -
330 Etakridin (rivanol) larutan 0,1% btl 100 ml botol - - - -

Page 49
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
331 Etanol 70% 1000 ml botol 11 - 11 -
332 Foley catheter No. 18 buah 12 - 12 -
333 Hand Scund (Steril) No. 7 psng 450 - 450 -
334 Hand Scund (Steril) No. 7,5 psng 300 - 300 -
335 Hand Scund Size S psng - - - -
336 Hand Scund Size M psng 650 - 650 -
337 Hand Scund Size L psng 250 - 250 -
338 Infusion set Dewasa set 10 - 10 -
339 Infusion set anak set 4 - 4 -
340 Kapas Berlemak 500 gram bungkus - - - -
341 Kapas Pembalut/Absorben 250 gram bungkus 5 - 5 -
342 Kasa Kompres 40/40 steril rol - - - -
343 Kasa Pembalut 2 m x 80 cm rol - - - -
344 Kasa Pembalut Hidrofil 4 m x 15 cm rol - - - -
345 Kasa Pembalut Hidrofil 4 m x 3 cm rol - - - -
346 Kasa Pembalut Hidrofil 40 m x 80 cm Gulung - - - -
347 Kasa Pembalut Hidrifil 36 m x 80 cm rol 10 - 10 -
348 Kasa Hidrofil Steril uk. 16 x 16 (isi 16 lembar) Kotak - - - -
349 Kasa Hidrofil Steril uk. 18 x 22 cm (isi 12 lembar) Kotak 86 - 86 -
350 Kasa Pembalut Hidrofil 4 m x 5 cm elastic Rol 322 - 322 -
351 Kasa Pembalut Hidrofil 4 m x 10 cm elastic Rol 269 - 269 -
352 Kertas Perkamen 75 x 100 cm lembar 1,500 - 1,500 -
353 Klep tali pusat pcs - - - -
354 Lens paper buah - - - -
355 Lisol, mengandung kresol tersabun 50 % botol - - - -
356 Masker kotak 47 - 47 -
357 Medicine paket paket - - - -
358 Nedle 25 g ( Terumo / Setara ) kotak - - - -
359 Nedle Heacting G 3/4 lusin - - - -

Page 50
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
360 Nedle Heacting G 7 - 13, 12 (segi tiga) lusin - - - -
361 Object Glass buah - - - -
362 PH paper buah - - - -
363 Plaster 5 yards x 2 inch rol - - - -
364 Plastik Kantong Etiket Obat 8,5x13,5 cm (Besar) ball - - - -
365 Plastik Kantong Etiket Obat 6,5x8,05 cm (Kecil) ball - - - -
366 Plastik (kresek) Ukuran 15 x 33 cm (putih) ball - - - -
367 Plastik (kresek) Ukuran 35 x 55 cm (merah) ball - - - -
368 Pot Salep 10 gram pcs - - - -
369 Pot Salep 5 gram pcs 50 - 50 -
370 Pot Sputum/Pot Dahak pcs 593 - 593 -
371 Povidon Iodida 10% 30 ml botol 84 - 84 -
372 Povidon Iodida 10% 300 ml botol 11 - 11 -
373 Povidon Iodida 10% 1000 ml botol - - - -
374 Rapid Test untuk siphilis test - - - -
375 Rol Paper rol - - - -
376 Silk (benang bedah sutera)No. 3/0 dgn jarum bedah (PKD) lusin 9 - 9 -
377 Safety box pcs 100 - 100 -
378 Transfusion set set - - - -
379 Urine bag pcs 3 - 3 -
380 Vaselin botol - - - -
381 Venflon No.18 set - - - -
382 Wing Nedle No.23 set - - - -
383 Wing Nedle No.25 G set 2 - 2 -

VI REAGENSIA & BAHAN LABORATORIUM

384 Blood Lancet pcs 200 - 200 -
385 Imersi Oil Mikroskop 100 ml botol - - - -
386 Kartu golongan darah lembar 300 - 300 -

Page 51
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
387 Larutan Asam Klorida 0,1 N botol 2 - 2 -
388 Larutan Asam sulfosalisilat 20 % botol - - - -
389 Larutan Benedict 100 ml botol - - - -
390 Larutan Eosin 2 % 100 ml botol - - - -
391 Larutan Etanol Asam 100 ml botol - - - -
392 Larutan Giemsa Stain 100 ml botol 2 - 2 -
393 Larutan Hyem 100 ml botol - - - -
394 Larutan Karbol Fuksin 100 ml botol - - - -
395 Larutan Metilen Biru botol - - - -
396 Larutan Natrium Sitrat botol - - - -
397 Larutan Turk 100 ml botol - - - -
398 Latex/ Tes kehamilan test - - - -
399 Lugol botol - - - -
400 Metanol 100 ml botol - - - -
401 Ose buah - - - -
402 Reagen Zeil Nelsen BTA (Alkohol asam,methyl blue,carbol fuchsin) paket 4 - 4 -
403 Reagen Ig G/Ig M/Dengue Ig G/Ig M (Stick) tes - - - -
404 Reagen Pemeriksaan Trombocit 500 ml set - - - -
405 Reagen Hematologi (mindray):deluent 20 l, Rinse 20 l, EZ set - - - -
406 Reagen Hematologi (sweelab):deluent 20 l, lyse 20 l set - - - -
407 Serum Gol Darah anti A & anti B set 4 - 4 -
408 Stik Glukosa gula Darah (gluco DR) test - - - -
409 Test Widal set - - - -
410 Urine Reagen Strip 3 parameter (PH) kotak - - - -
411 Urine Reagen Strip 10 parameter (PH) kotak 3 - 3 -
412 Urine Gluco Protein Test test - - - -
413 Yodium 1 % 100 ml botol - - - -
414 K O H 1% botol - - - -
415 Xilol / Xilene botol - - - -

Page 52
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
416 USG Ultrasonic gel botol - - - -
417 Ventolin Nebulizer kotak - - - -
418 Voucher oxygen tabung 10 liter lembar - - - -
419 Voucher oxygen tabung 40 liter lembar - - - -

VII OBAT KB
420 Kontrasepsi injeksi Progesteron depot( 3 bln) vial - - - -
421 Kontrasepsi pil kombinasi (Microdiol) strip - - - -
422 Implant KB 3 tahunan buah - - - -

Penanggungjawab Gudang Obat

UPT Puskesmas Sei Pancur
Kota Batam

Yanti Alfina
NIP. 19721209 200604 2 017

Page 53
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
423 Medicine packet SI-20 box - 1 1
424 Reagen hematologi labnovation (Diluent set - 1 1
425 Plester hansaplast rol (1,25 cm x 5 m) rol - 10 10

Page 54
BULAN : FEBRUARI
TAHUN : 2014

SISA
STOK EXP.DATE

10 11

30 1214
-
-
400 817
500 615
100 916
10 514;914
-
5 515
500 917
90 718
100 916
200 817
-
-
-
900 715
50 915
-

Page 55
SISA
STOK EXP.DATE

10 11
18,900 915;415
-
-
30 314
7,100 1116
-
25 916
140 1114;717
-
-
10 117
6 717
-
-
-
2,100 1017;618
-
-
100 914
-
-
-
-
150 915
180 615
150 915
-
120 615
3,000 715

Page 56
SISA
STOK EXP.DATE

10 11
1,000 916
1,000 917
55 915
200 916
50 714
300 715
-
-
20 914
390 915
5 1214
250 917
72 1014
96 1114
48 115
100 1015
-
-
-
-
600 616
150 1216
450 916
300 614
50 1115
-
500 116
1,000 916
- 1215

Page 57
SISA
STOK EXP.DATE

10 11
5,800 915
50 714
1,000 1114
-
1,000 915
-
3 617
-
-
-
200 915
48 1014
500 517
1,000
30 615
-
500 618
84 915
-
-
30 914
-
-
50 214
2,000 616
-
100 616
-
900 916

Page 58
SISA
STOK EXP.DATE

10 11
150 915
50 915
-
216 914
300 1215
7,000 1114;118
-
22 815;417
-
-
- 1014
-
-
-
-
120 916
-
100 614
1,000 117
1,000 416
300 517
-
24 715
-
239 1014
300 716
-
-
-

Page 59
SISA
STOK EXP.DATE

10 11
-
-
-
-
90 915
-
950 616
120 915
-
50 1015;916
-
-
-
-
100 817
80 1014
500 917
1,000 816
200 315
-
100 816
-
500 614
-
200 817
-
96 1114;917
160 914
4,000 1215

Page 60
SISA
STOK EXP.DATE

10 11
1,000 816
-
20 318
- 615
- 417
-
3 714;1214
11 1214
7 614
2 1214;915
2 816
4 714;615
252 1017
-
50 114;315
250 315
-
- 1215
-
-
-
89 1214
150 1015
- 617
8,800 1017
-
300 1016
100 715
-

Page 61
SISA
STOK EXP.DATE

10 11
-
100 1217
- 915
400 117
-
-
300 1215
-
-
118 815
-
1,400 515
-
-
-
21 514;914
1,100 915;1215
200 415
24 817
590 516
-
-
-
-
-
-
-
1,200 1115
5 1115

Page 62
SISA
STOK EXP.DATE

10 11
-
200 714
300 616
-
150 815;717
200 1215
-
65 615
1,000 515
-
6,000 1014
-
-
-
11,000 717
- 515
- 615
1,000 915

-
2 614
1 514
4 615
5 -
-
2 -
1 615
5 1114

Page 63
SISA
STOK EXP.DATE

10 11
3 1114
3 414
2 -
-
-
2 1114

-
-
-
-
-
-
-
- 1216
-
-
-
-
-
-
-
-
-
-
-
7
-

Page 64
SISA
STOK EXP.DATE

10 11
24 1017
-
-
-
-
-
-
-
-
-
-
-
-
- 814
- 614
-
-
-
-
-

200 914
300 816
144 214
-
-
720 214
570 1016

Page 65
SISA
STOK EXP.DATE

10 11
600 714
60 1014
240 615
-
160 714;815
- 714
810 1016

-
21 1015;517
19 215
10 616
-
- 515
800 617
- 1114
11,500 714
-
350 416
300 116
-
-
-
-
-
-
98 1014
-

Page 66
SISA
STOK EXP.DATE

10 11
11 1015
12 1114
450 1116
300 1116
- 215
650 815
250
10 417
4 715
-
5 1017
-
-
-
-
-
10 914
-
86 1114
322
269
1,500
-
-
-
47
-
-
-

Page 67
SISA
STOK EXP.DATE

10 11
-
-
-
-
-
-
-
-
-
50
593
84 1015
11 515
-
-
-
9 716
100
-
3 817
-
-
-
2 1014

200 217
- 815
300

Page 68
SISA
STOK EXP.DATE

10 11
2
-
-
-
-
2 615
-
-
-
-
-
-
-
-
-
4 1214;314
-
-
-
-
4 515
-
-
-
3 914
-
-
-
-

Page 69
SISA
STOK EXP.DATE

10 11
-
-
-
-

-
-
-

Page 70
SISA
STOK EXP.DATE

10 11
1
1
10

Page 71
-

Page 72
-

Page 73
-

Page 74
 LAPORAN GUDANG OBAT

KODE PUSKESMAS :
PUSKESMAS : SEI PANCUR
KECAMATAN : SEI BEDUK
KOTA : KOTA BATAM
PROVINSI : KEP RIAU
STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
I OBAT GENERIK
1 Albendazol tablet 400 mg tablet 30 - 30 -
2 Alprozolam tab 0,25 mg tablet - - - -
3 Alprozolam tab 0,5 mg tablet - - - -
4 Acyclovir 200 mg tablet ( OGB ) tablet 400 - 400 -
5 Acyclovir 400 mg tablet ( OGB ) tablet 500 - 500 -
6 Acyclovir cream ( OGB ) tube 100 - 100 -
7 ACT(Atesunat 50 mg+Amodiaquin anhydrida200 mg)tab paket 10 - 10 -
8 Arterakine tablet paket - - - -
9 Arterakine (DARPLEX) paket 5 - 5 -
10 Allopurinol tablet 100 mg tablet 500 - 500 -
11 Allopurinol tablet 300 mg tablet 90 - 90 -
12 Ambroxol syrup ( OGB ) botol 100 - 100 -
13 Ambroxol 30mg tab (OGB ) tablet 200 - 200 -
14 Aminofilin tablet 200 mg tablet - - - -
15 Aminofilina injeksi 24 mg/ml - 10ml ampul - - - -
16 Amitriptilin HCL tablet salut 25 mg tablet - - - -
17 Amlodipine tablet 5 mg tablet 900 - 900 -
18 Amoksisilin sirup kering 125 mg/5 ml botol 50 - 50 -
19 Amoksisilin kapsul 250 mg kapsul - - - -

Page 75
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
20 Amoksisilin kaplet 500 mg kaplet 18,900 - 18,900 -
21 Ampicillin inj 1 gr ( OGB ) vial - - - -
22 Antalgin (metampiron) tablet 500 mg tablet - - - -
23 Antalgin injeksi 250 mg/ml - 2ml ampul 30 - 30 -
24 Antasida DOEN I tablet kunyah tablet 7,100 - 7,100 -
25 Antasida DOEN II suspensi botol - - - -
26 Anti bakteri DOEN salep komb:Bacitracin+Polimiksin tube 25 - 25 -
27 Anti hemoroid DOEN kombinasi suup 140 - 140 -
28 Antifungi DOEN kombinasi :As Benzoat+As Salisilat pot - - - -
29 Antimigren tartrat 1 mg + kofein 50 mg tablet - - - -
30 Aqua pro injeksi steril, bebas pirogen 20 ml vial 10 - 10 -
31 Aquades steril 1000 ml botol 6 - 6 -
32 Artem (artemether 80 mg ) inj ampul - - - -
33 Artesunate inj 60 mg/ml vial - - - -
34 Asam Mefenamat tablet salut 250 mg kapsul - - - -
35 Asam Mefenamat tablet salut 500 mg kaplet 2,100 - 2,100 -
36 Asetosal tablet 100 mg tablet - - - -
37 Asetosal tablet 500 mg tablet - - - -
38 Atenolol tablet 50 mg tablet 100 - 100 -
39 Atropin sulfat inj 0,25 mg/ml-1 ml ampul - - - -
40 Atropin sulfat tablet 0,5 mg tablet - - - -
41 Atropin sulfat tetes mata 0,5 mg botol - - - -
42 Besi sirup botol - - - -
43 Betametason krim 0,1% tube 150 - 150 -
44 Betahistin Mesilat 6 MG tablet 180 - 180 -
45 Bisoprolol 5 mg tablet 150 - 150 -
46 Bromheksin tab 8 mg tablet - - - -
47 Calcium gluconat injeksi vial 120 - 120 -
48 Calcium Lactate 500 mg tablet 3,000 - 3,000 -

Page 76
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
49 Catopril 12,5 mg tablet 1,000 - 1,000 -
50 Catopril 25 mg tablet 1,000 - 1,000 -
51 Cefadroxil syrup 125 mg/5ml botol 55 - 55 -
52 Cefadroxil kapsul 500 mg kapsul 200 - 200 -
53 Cefixim syrup 100 mg/5 ml botol 50 - 50 -
54 Cefixim 100 mg kapsul kapsul 300 - 300 -
55 Cefotaxim injeksi 1 gram vial - - - -
56 Ceftriazone injeksi vial - - - -
57 Cetirizene syrup 5 mg/ 5 ml botol 20 - 20 -
58 Cetirizene 10 mg tablet 390 - 390 -
59 Chloramphenicol suspensi 60 ml botol 5 - 5 -
60 Chloramphenicol kapsul 250 mg kapsul 250 - 250 -
61 Chloramphenicol tetes Mata 0,5 % botol 72 - 72 -
62 Chloramphenicol salep mata 1 % tube 96 - 96 -
63 Chloramphenicol tetes telinga 3 % botol 48 - 48 -
64 Chlorfeniramin Maleat (CTM) tab 4 mg tablet 100 - 100 -
65 Chlorpromazine HCL 100 mg tablet salut tablet - - - -
66 Chlorpromazine HCL 25 mg tablet salut tablet - - - -
67 Chlorpromazine HCL inj 25 mg / ml - 1 ml ampul - - - -
68 Chlorpromazine HCL inj 5 mg / ml - 2 ml ampul - - - -
69 Cimetidin 200 mg tab (OGB ) tablet 600 - 600 -
70 Clindamisin 150 mg kapsul 150 - 150 -
71 Clindamisin 300 mg kapsul 450 - 450 -
72 Co- Amoxiclav 625 mg tab tablet 300 - 300 -
73 Cotrimoksazole suspensi 60 ml botol 50 - 50 -
74 Cotrimoksazole tablet pediatrik 120 mg tablet - - - -
75 Cotrimoksazole tablet Dewasa 480 mg tablet 500 - 500 -
76 Cyprofloxacin tab 500 mg ( OGB ) tablet 1,000 - 1,000 -
77 Deksametason injeksi 5 mg / ml -1ml ampul - - - -

Page 77
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
78 Deksametason tablet 0,5mg tablet 5,800 - 5,800 -
79 Dekstrometorfan sirup 10 mg/5 ml botol 50 - 50 -
80 Dekstrometorfan tablet 15 mg tablet 1,000 - 1,000 -
81 Dekstran 70 - larutan infus 6 % steril botol - - - -
82 Diazepam tablet 2 mg tablet 1,000 - 1,000 -
83 Diazepam tablet 5 mg tablet - - - -
84 Diazepam injeksi 5 mg/ml ampul 3 - 3 -
85 Diethylcarbamazine tablet 100 mg tablet - - - -
86 Difenhidramin HCL inj 10 mg/ml-1 ml ampul - - - -
87 Digoksin tablet 0,25 mg tablet - - - -
88 Doksisiklin kapsul 100 mg kapsul 200 - 200 -
89 Domperidon syrup botol 48 - 48 -
90 Domperidon 10 mg tab tablet 500 - 500 -
91 Efedrin HCl tablet 25 mg tablet 1,000 - 1,000 -
92 Epinefrina HCL/Bitartrat (Adrenalin ) inj 0,1 %-1 ml ampul 30 - 30 -
93 Ekstrak belladon tablet 10 mg tablet - - - -
94 Erythromycin kapsul 500 mg ( OGB ) kapsul 500 - 500 -
95 Erythromycin syrup 200 mg/5 ml botol 84 - 84 -
96 Fenitoin natrium kapsul 100 mg kapsul - - - -
97 Fenitoin natrium kapsul 30 mg kapsul - - - -
98 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 30 - 30 -
99 Fenobarbital tablet 30 mg tablet - - - -
100 Fenobarbital tablet 100 mg tablet - - - -
101 Fenol Gliserol tetes telinga 10 % botol 50 - 50 -
102 Folic Acid tablet 1 mg tablet 2,000 - 2,000 -
103 Furosemid injeksi ampul - - - -
104 Furosemid tablet 40 mg tablet 100 - 100 -
105 Gameksan emulsi 1% botol - - - -
106 Garam oralit untuk 200 ml air sachet 900 - 900 -

Page 78
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
107 Gentamycin salap kulit 0,1 % - 5 gr (OGB) tube 150 - 150 -
108 Gentamisin tetes mata botol 50 - 50 -
109 Gentamicyn inj 80 mg/ml vial - - - -
110 Gentian violet larutan 1% botol 216 - 216 -
111 Glibenklamid tablet 5 mg tablet 300 - 300 -
112 Gliseril guayakolat tablet 100 mg tablet 7,000 - 7,000 -
113 Gliserin botol - - - -
114 Glukosa larutan infus 5% steril botol 22 - 22 -
115 Glukosa larutan infus 10 % steril botol - - - -
116 Glukosa larutan infus 40 % steril botol - - - -
117 Griseofulvin tablet 125 mg tablet - - - -
118 Haloperidol tablet 0,5 mg tablet - - - -
119 Haloperidol tablet 1,5 mg tablet - - - -
120 Hidroklorotiazid (HCT) tablet 25 mg tablet - - - -
121 Hidrokortison krim 1% pot - - - -
122 Hidrokortison krim 2,5 % tube 120 - 120 -
123 Insulin reguler inj 40IU/ml-10 ml (human) ampul - - - -
124 Ibuprofen suspensi 100 mg/5ml botol 100 - 100 -
125 Ibuprofen tablet 200 mg botol 1,000 - 1,000 -
126 Ibuprofen tablet 400 mg tablet 1,000 - 1,000 -
127 Isosorbid dinitrat tablet sublingual 5 mg tablet 300 - 300 -
128 Kalium Diclofenak 25 mg tablet - - - -
129 Kalium Permangat serbuk 5 gram pot 24 - 24 -
130 Karbamazepin tablet 200 mg tablet - - - -
131 Ketokenazol cream 2 % tube 239 - 239 -
132 Ketokonazol 200 mg tab tablet 300 - 300 -
133 Klonidin tablet 0,15 mg tablet - - - -
134 Klorokuin tablet 150 mg tablet - - - -
135 Klorpropamid tablet 100 mg tablet - - - -

Page 79
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
136 Kodein fosfat tablet 10 mg tablet - - - -
137 Kuinin (kina) tablet 200 mg tablet - - - -
138 Kuinin dihidroklorida inj 25 %-2 ml ampul - - - -
139 Lanzoprazol kapsul 30 mg kapsul - - - -
140 Lidokain komp.injeksi 2 ml ampul 90 - 90 -
141 Loperamid tablet tablet - - - -
142 Loratadin tablet 10 mg tablet 950 - 950 -
143 Lyncomicin 500 mg cap kapsul 120 - 120 -
144 Magnesium Sulfat Inj (IV) 20%-25 ml ampul - - - -
145 Magnesium Sulfat Inj (IV) 40%-25 ml ampul 50 - 50 -
146 Mebendazol sirup 100 mg/5 ml botol - - - -
147 Mebendazol tablet 100 mg tablet - - - -
148 Methochlorpamid syr 5 mg/ml botol - - - -
149 Metilergometrin maleat inj 0,200 mg-1 ml ampul - - - -
150 Metilergometrin maleat tab salut 1,125 mg tablet 100 - 100 -
151 Meloksikam suppositoria supp 80 - 80 -
152 Meloksikam 7,5 mg tablet 500 - 500 -
153 Metformin tab 500 mg tablet 1,000 - 1,000 -
154 Metformin tab 850 mg tablet 200 - 200 -
155 Metilprednisolon 4 mg tablet - - - -
156 Metilprednisolon 8 mg tablet 100 - 100 -
157 Metoclorpramid injeksi 5 mg/ml ampul - - - -
158 Metoclorpramid tab 10 mg tablet 500 - 500 -
159 Metronidazol tablet 250 mg tablet - - - -
160 Metronidazol tablet 500 mg tablet 200 - 200 -
161 Metronidazol 500 mg infus botol - - - -
162 Miconazol 2 % cream (OGB ) tube 96 - 96 -
163 Mineral Mix sachet 160 - 160 -
164 Natrium bikarbonat tablet 500 mg tablet 4,000 - 4,000 -

Page 80
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
165 Natrium Diklofenak tab 50 mg tablet 1,000 - 1,000 -
166 Natrium Tiroksin tablet - - - -
167 Natrium klorida larutan infus 0,9% steril botol 20 - 20 -
168 Nifedipin tab 10 mg tablet - - - -
169 Nistatin tablet salut 100.000 IU tablet - - - -
170 Nistatin tablet salut 500.000 IU tablet - - - -
171 OAT FDC Kategori Anak paket 3 - 3 -
172 OAT Kombipak Kategori Anak paket 11 - 11 -
173 OAT FDC Kategori I Dewasa paket 7 - 7 -
174 OAT Kombipak Kategori I Dewasa paket 2 - 2 -
175 OAT FDC Kategori II Dewasa paket 2 - 2 -
176 OAT FDC Sisipan Dewasa paket 4 - 4 -
177 Obat batuk hitam (OBH) cairan botol 252 - 252 -
178 Oksitetrasiklin HCl injeksi I.m.50mg/ml-10ml vial - - - -
179 Oksitetrasiklin HCl salep mata 1% tube 50 - 50 -
180 Oksitetrasiklin HCl salep 3% tube 250 - 250 -
181 Oksitosin injeksi 10 IU/ml-1 ml ampul - - - -
182 Omeprazol kapsul 20 mg kapsul - - - -
183 Oseltamivir 75 mg (ut flu burung) tablet - - - -
184 Papaverin tablet 40 mg ( OGB ) tablet - - - -
185 Paraformaldehid tablet 1 gram tablet - - - -
186 Parasetamol drop botol 89 - 89 -
187 Parasetamol sirup 120 mg/5 ml botol 150 - 150 -
188 Parasetamol tablet 100 mg tablet - - - -
189 Parasetamol tablet 500 mg tablet 8,800 - 8,800 -
190 Phytomenadion (Vit K1) injeksi 10 mg/ml-1 ml ampul - - - -
191 Phytomenadion (Vit.K1) tablet salut gula 10 mg tablet 300 - 300 -
192 Piracetam 800 mg tablet 100 - 100 -
193 Piracetam 1200 mg tablet - - - -

Page 81
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
194 Pirantel sirup 125 mg/5 ml botol - - - -
195 Pirantel tablet 125 mg tablet 100 - 100 -
196 Piroxicam 10 mg ( OGB ) tablet - - - -
197 Piroxicam 20 mg ( OGB ) tablet 400 - 400 -
198 Prednison tablet 5 mg tablet - - - -
199 Primakuin tablet 15 mg tablet - - - -
200 Propiltiourasil tablet 100 mg tablet 300 - 300 -
201 Propranolol HCl tablet 10 mg tablet - - - -
202 Propranolol HCl tablet 40 mg tablet - - - -
203 Prokain Penisilin inj,3 juta IU vial 118 - 118 -
204 Rabies immuni globulin (himan ) 150 IU/ml ampul - - - -
205 Ranitidin tab tablet 1,400 - 1,400 -
206 Ranitidin injeksi ampul - - - -
207 Reserpin tablet 0,10 mg tablet - - - -
208 Reserpin tablet 0,25 mg tablet - - - -
209 Ringer laktat larutan infus steril botol 21 - 21 -
210 Salbutamol tablet 2 mg tablet 1,100 - 1,100 -
211 Salbutamol tablet 4 mg tablet 200 - 200 -
212 Salep 2-4, komb : As.Salisilat + belerang endap pot 24 - 24 -
213 Salisil bedak 2% kotak 590 - 590 -
214 Serum anti bisa ular polivalen inj 5 ml (ABU I ) ampul - - - -
215 Serum anti difteri inj 20.000 IU/vial (A D S ) ampul - - - -
216 Serum anti tetanus injeksi 1.500 IU/ampul ( A T S ) ampul - - - -
217 Serum anti tetanus injeksi 20.00 IU/ampul ( A T S ) ampul - - - -
218 Simvastatin tab 10 mg tablet - - - -
219 Sulfadoxin 500+Pirimetamin 25 mg tablet tablet - - - -
220 Sulfasetamida Natrium tetes mata 15 % botol - - - -
221 Tambah Darah tablet ( Ferollat ) sachet 1,200 - 1,200 -
222 Tetrakain HCL tetes mata 0,5% botol 5 - 5 -

Page 82
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
223 Tetrasiklin HCL kapsul 250 mg kapsul - - - -
224 Tetrasiklin HCL kapsul 500 mg kapsul 200 - 200 -
225 Thiamphenicol kapsul 500 mg tablet 300 - 300 -
226 Tramadol injeksi ampul - - - -
227 Tramadol 50 mg tablet 150 - 150 -
228 Triheksifenidil Hidroklorida tablet 2 mg tablet 200 - 200 -
229 Vaksin rabies vero ampul - - - -
230 Vitamin A (Retinol) 100.000 IU kapsul lunak kapsul 65 - 65 -
231 Vitamin A (Retinol) 200.000 IU kapsul lunak kapsul 1,000 - 1,000 -
232 Vitamin B1 (Thiamin HCl) injeksi 100 mg/ml-1ml ampul - - - -
233 Vitamin B1 (Thiamin HCl) tablet 50 mg tablet 6,000 - 6,000 -
234 Vitamin B6 (Piridoksin HCl) tablet 10 mg tablet - - - -
235 Vitamin B12 (Cyanocobalamin) injeksi 500 mcg/ml-1ml ampul - - - -
236 Vitamin B12 (Cyanocobalamin) tablet tablet - - - -
237 Vitamin B Complex tablet tablet 11,000 - 11,000 -
238 Vitamin C (Asam Ascorbat ) tablet 50 mg tablet - - - -
239 Vitamin C (Asam Ascorbat ) tablet 250 mg tablet - - - -
240 Zink 20 mg tablet Dispersibel tablet 1,000 - 1,000 -

II OBAT GIGI
241 Air Raksa botol - - - -
242 Alkahner/Cavit/Dentorit buah 2 - 2 -
243 Devitalisasi pasta (non arsen) kotak 1 - 1 -
244 Etil klorida semprot botol 4 - 4 -
245 Eugenol Cairan botol 5 - 5 -
246 Flour tablet 0,5 mg tablet - - - -
247 Formokresol (pengganti TKF) botol 2 - 2 -
248 Glass ionomer cement (GC IX) set 1 - 1 -
249 Kalsium hidroksida pasta set 5 - 5 -

Page 83
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
250 Klorfenol kamfer menthol (CHKM) botol 3 - 3 -
251 Mummifying pasta botol 3 - 3 -
252 Semen seng fosfat serbuk dan cairan set 2 - 2 -
253 Silver amalgam serbuk 65 - 75% botol - - - -
254 Spons gelatin cubides 1 x 1 x 1 cm dental - - - -
255 Temporary stopping fletcher (Fletcher) serbuk & cairan set 2 - 2 -

III OBAT TAMBAHAN

256 Alphamol Drop / Otopan Drop botol - - - -
257 Amoxan/ Amobiotik drop botol - - - -
258 Armovit tablet - - - -
259 Bioplacenton Jelly tube - - - -
260 Borax gliserin botol - - - -
261 Chloramfecort H cream/Colipred cream tube - - - -
262 Combantrin syr botol - - - -
263 Daryantul kotak - - - -
264 Dettol lig 750ml botol - - - -
265 Dextamin tab tablet - - - -
266 Diafrom tab tablet - - - -
267 Dialac 1 gr zak - - - -
268 Dulcolax tab tablet - - - -
269 Evion 200 soft tab kapsul - - - -
270 FG troches tab isap tablet - - - -
271 Flutamol tab kapsul - - - -
272 Folamil tab tablet - - - -
273 folavit tab 1 mg tablet - - - -
274 Guanestrip syr / Kanina syrup botol - - - -
275 H 2 O 2 3 % 1000 ml botol 7 - 7 -
276 Histolan tab tablet - - - -

Page 84
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
277 Ictiol salep pot 24 - 24 -
278 Kanamycin inj 1 grm vial - - - -
279 Kanamycin inj 2 grm vial - - - -
280 Kandistatin Drop botol - - - -
281 Livron B Plex tablet - - - -
282 Molakrim tube - - - -
283 Multi vitamin syr (calsidol+DHA+Lysin) botol - - - -
284 Novatusin syrup (PCT 120 mg,Efedrin HCl 5mg, CTM 2 mg,GG 50mg) botol - - - -
285 Polikresulen / Albotil concetrate 10 ml botol - - - -
286 Pregnollin tablet tablet - - - -
287 Primpran inj amp - - - -
288 Primulut- N tablet tablet - - - -
289 Rhinofed tablet tablet - - - -
290 Stesolit rectal 5 mg tube - - - -
291 Stesolit rectal 10 mg tube - - - -
292 Streptomisin serbuk inj I.V 1000 mg/ml vial - - - -
293 Transamin tab 250 mg tablet - - - -
294 Trombopop gel tube - - - -
295 Urispas tab tablet - - - -
296 Zistic tablet - - - -

IV OBAT TRADISIONAL/JAMU/HERBAL/FITOFARMAKA
297 Curcuma plus Fruit Veggie syrup botol 200 - 200 -
298 Diapet tablet tablet 300 - 300 -
299 Entrostop anak sachet 144 - 144 -
300 Hemorogard kapsul - - - -
301 Hepagard kapsul - - - -
302 I-flex kapsul kapsul 720 - 720 -
303 Lancar Asi kapsul 570 - 570 -

Page 85
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
304 Maximus dietary herbal kapsul 600 - 600 -
305 Ocugard kapsul 60 - 60 -
306 Prolipid kapsul 240 - 240 -
307 Prouric kapsul - - - -
308 Stimuno syrup botol 160 - 160 -
309 Stimuno kapsul kapsul - - - -
310 Tensigard kapsul 810 - 810 -

V BAHAN HABIS PAKAI

311 Abbocate No. 18 set - - - -
312 Abbocate No. 20 set 21 - 21 -
313 Abbocate No. 22 set 19 - 19 -
314 Abbocate No. 24 set 10 - 10 -
315 Alat suntik sekali pakai 1 ml set - - - -
316 Alat suntik sekali pakai 3 ml/ 2,5 ml set - - - -
317 Alat suntik sekali pakai 5 ml set 800 - 800 -
318 Alat suntik sekali pakai 10 ml set - - - -
319 Alat suntik bias 0,5 ml set 11,500 - 11,500 -
320 Alat suntik bias 0,05 ml set - - - -
321 Alat suntik bias 5 ml set 350 - 350 -
322 Alkohol Swap buah 300 - 300 -
323 Catgut Cromic 2/0 dengan jarum lusin - - - -
324 Catgut Cromic 3/0 dengan jarum lusin - - - -
325 Catgut plain 2/0 dengan jarum lusin - - - -
326 Catgut plain 3/0 dengan jarum lusin - - - -
327 Cotton Aplication steril kotak - - - -
328 Cover glass buah - - - -
329 Etakridin (rivanol) larutan 0,1% btl 300 ml botol 98 - 98 -
330 Etakridin (rivanol) larutan 0,1% btl 100 ml botol - - - -

Page 86
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
331 Etanol 70% 1000 ml botol 11 - 11 -
332 Foley catheter No. 18 buah 12 - 12 -
333 Hand Scund (Steril) No. 7 psng 450 - 450 -
334 Hand Scund (Steril) No. 7,5 psng 300 - 300 -
335 Hand Scund Size S psng - - - -
336 Hand Scund Size M psng 650 - 650 -
337 Hand Scund Size L psng 250 - 250 -
338 Infusion set Dewasa set 10 - 10 -
339 Infusion set anak set 4 - 4 -
340 Kapas Berlemak 500 gram bungkus - - - -
341 Kapas Pembalut/Absorben 250 gram bungkus 5 - 5 -
342 Kasa Kompres 40/40 steril rol - - - -
343 Kasa Pembalut 2 m x 80 cm rol - - - -
344 Kasa Pembalut Hidrofil 4 m x 15 cm rol - - - -
345 Kasa Pembalut Hidrofil 4 m x 3 cm rol - - - -
346 Kasa Pembalut Hidrofil 40 m x 80 cm Gulung - - - -
347 Kasa Pembalut Hidrifil 36 m x 80 cm rol 10 - 10 -
348 Kasa Hidrofil Steril uk. 16 x 16 (isi 16 lembar) Kotak - - - -
349 Kasa Hidrofil Steril uk. 18 x 22 cm (isi 12 lembar) Kotak 86 - 86 -
350 Kasa Pembalut Hidrofil 4 m x 5 cm elastic Rol 322 - 322 -
351 Kasa Pembalut Hidrofil 4 m x 10 cm elastic Rol 269 - 269 -
352 Kertas Perkamen 75 x 100 cm lembar 1,500 - 1,500 -
353 Klep tali pusat pcs - - - -
354 Lens paper buah - - - -
355 Lisol, mengandung kresol tersabun 50 % botol - - - -
356 Masker kotak 47 - 47 -
357 Medicine paket paket - - - -
358 Nedle 25 g ( Terumo / Setara ) kotak - - - -
359 Nedle Heacting G 3/4 lusin - - - -

Page 87
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
360 Nedle Heacting G 7 - 13, 12 (segi tiga) lusin - - - -
361 Object Glass buah - - - -
362 PH paper buah - - - -
363 Plaster 5 yards x 2 inch rol - - - -
364 Plastik Kantong Etiket Obat 8,5x13,5 cm (Besar) ball - - - -
365 Plastik Kantong Etiket Obat 6,5x8,05 cm (Kecil) ball - - - -
366 Plastik (kresek) Ukuran 15 x 33 cm (putih) ball - - - -
367 Plastik (kresek) Ukuran 35 x 55 cm (merah) ball - - - -
368 Pot Salep 10 gram pcs - - - -
369 Pot Salep 5 gram pcs 50 - 50 -
370 Pot Sputum/Pot Dahak pcs 593 - 593 -
371 Povidon Iodida 10% 30 ml botol 84 - 84 -
372 Povidon Iodida 10% 300 ml botol 11 - 11 -
373 Povidon Iodida 10% 1000 ml botol - - - -
374 Rapid Test untuk siphilis test - - - -
375 Rol Paper rol - - - -
376 Silk (benang bedah sutera)No. 3/0 dgn jarum bedah (PKD) lusin 9 - 9 -
377 Safety box pcs 100 - 100 -
378 Transfusion set set - - - -
379 Urine bag pcs 3 - 3 -
380 Vaselin botol - - - -
381 Venflon No.18 set - - - -
382 Wing Nedle No.23 set - - - -
383 Wing Nedle No.25 G set 2 - 2 -

VI REAGENSIA & BAHAN LABORATORIUM

384 Blood Lancet pcs 200 - 200 -
385 Imersi Oil Mikroskop 100 ml botol - - - -
386 Kartu golongan darah lembar 300 - 300 -

Page 88
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
387 Larutan Asam Klorida 0,1 N botol 2 - 2 -
388 Larutan Asam sulfosalisilat 20 % botol - - - -
389 Larutan Benedict 100 ml botol - - - -
390 Larutan Eosin 2 % 100 ml botol - - - -
391 Larutan Etanol Asam 100 ml botol - - - -
392 Larutan Giemsa Stain 100 ml botol 2 - 2 -
393 Larutan Hyem 100 ml botol - - - -
394 Larutan Karbol Fuksin 100 ml botol - - - -
395 Larutan Metilen Biru botol - - - -
396 Larutan Natrium Sitrat botol - - - -
397 Larutan Turk 100 ml botol - - - -
398 Latex/ Tes kehamilan test - - - -
399 Lugol botol - - - -
400 Metanol 100 ml botol - - - -
401 Ose buah - - - -
402 Reagen Zeil Nelsen BTA (Alkohol asam,methyl blue,carbol fuchsin) paket 4 - 4 -
403 Reagen Ig G/Ig M/Dengue Ig G/Ig M (Stick) tes - - - -
404 Reagen Pemeriksaan Trombocit 500 ml set - - - -
405 Reagen Hematologi (mindray):deluent 20 l, Rinse 20 l, EZ set - - - -
406 Reagen Hematologi (sweelab):deluent 20 l, lyse 20 l set - - - -
407 Serum Gol Darah anti A & anti B set 4 - 4 -
408 Stik Glukosa gula Darah (gluco DR) test - - - -
409 Test Widal set - - - -
410 Urine Reagen Strip 3 parameter (PH) kotak - - - -
411 Urine Reagen Strip 10 parameter (PH) kotak 3 - 3 -
412 Urine Gluco Protein Test test - - - -
413 Yodium 1 % 100 ml botol - - - -
414 K O H 1% botol - - - -
415 Xilol / Xilene botol - - - -

Page 89
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
416 USG Ultrasonic gel botol - - - -
417 Ventolin Nebulizer kotak - - - -
418 Voucher oxygen tabung 10 liter lembar - - - -
419 Voucher oxygen tabung 40 liter lembar - - - -

VII OBAT KB
420 Kontrasepsi injeksi Progesteron depot( 3 bln) vial - - - -
421 Kontrasepsi pil kombinasi (Microdiol) strip - - - -
422 Implant KB 3 tahunan buah - - - -

Penanggungjawab Gudang Obat

UPT Puskesmas Sei Pancur
Kota Batam

Yanti Alfina
NIP. 19721209 200604 2 017

Page 90
 STOK PENE PERSE PERMINTAAN
NO NAMA OBAT SATUAN AWAL RIMAAN DIAAN APOTEK

1 2 4 5 6 7=(5+6) 8
423 Medicine packet SI-20 box - 1 1
424 Reagen hematologi labnovation (Diluent set - 1 1
425 Plester hansaplast rol (1,25 cm x 5 m) rol - 10 10

Page 91
BULAN : MARET
TAHUN : 2014

SISA
STOK EXP.DATE

10 11

30 1214
-
-
400 817
500 615
100 916
10 514;914
-
5 515
500 917
90 718
100 916
200 817
-
-
-
900 715
50 915
-

Page 92
SISA
STOK EXP.DATE

10 11
18,900 915;415
-
-
30 314
7,100 1116
-
25 916
140 1114;717
-
-
10 117
6 717
-
-
-
2,100 1017;618
-
-
100 914
-
-
-
-
150 915
180 615
150 915
-
120 615
3,000 715

Page 93
SISA
STOK EXP.DATE

10 11
1,000 916
1,000 917
55 915
200 916
50 714
300 715
-
-
20 914
390 915
5 1214
250 917
72 1014
96 1114
48 115
100 1015
-
-
-
-
600 616
150 1216
450 916
300 614
50 1115
-
500 116
1,000 916
- 1215

Page 94
SISA
STOK EXP.DATE

10 11
5,800 915
50 714
1,000 1114
-
1,000 915
-
3 617
-
-
-
200 915
48 1014
500 517
1,000
30 615
-
500 618
84 915
-
-
30 914
-
-
50 214
2,000 616
-
100 616
-
900 916

Page 95
SISA
STOK EXP.DATE

10 11
150 915
50 915
-
216 914
300 1215
7,000 1114;118
-
22 815;417
-
-
- 1014
-
-
-
-
120 916
-
100 614
1,000 117
1,000 416
300 517
-
24 715
-
239 1014
300 716
-
-
-

Page 96
SISA
STOK EXP.DATE

10 11
-
-
-
-
90 915
-
950 616
120 915
-
50 1015;916
-
-
-
-
100 817
80 1014
500 917
1,000 816
200 315
-
100 816
-
500 614
-
200 817
-
96 1114;917
160 914
4,000 1215

Page 97
SISA
STOK EXP.DATE

10 11
1,000 816
-
20 318
- 615
- 417
-
3 714;1214
11 1214
7 614
2 1214;915
2 816
4 714;615
252 1017
-
50 114;315
250 315
-
- 1215
-
-
-
89 1214
150 1015
- 617
8,800 1017
-
300 1016
100 715
-

Page 98
SISA
STOK EXP.DATE

10 11
-
100 1217
- 915
400 117
-
-
300 1215
-
-
118 815
-
1,400 515
-
-
-
21 514;914
1,100 915;1215
200 415
24 817
590 516
-
-
-
-
-
-
-
1,200 1115
5 1115

Page 99
SISA
STOK EXP.DATE

10 11
-
200 714
300 616
-
150 815;717
200 1215
-
65 615
1,000 515
-
6,000 1014
-
-
-
11,000 717
- 515
- 615
1,000 915

-
2 614
1 514
4 615
5 -
-
2 -
1 615
5 1114

Page 100
SISA
STOK EXP.DATE

10 11
3 1114
3 414
2 -
-
-
2 1114

-
-
-
-
-
-
-
- 1216
-
-
-
-
-
-
-
-
-
-
-
7
-

Page 101
SISA
STOK EXP.DATE

10 11
24 1017
-
-
-
-
-
-
-
-
-
-
-
-
- 814
- 614
-
-
-
-
-

200 914
300 816
144 214
-
-
720 214
570 1016

Page 102
SISA
STOK EXP.DATE

10 11
600 714
60 1014
240 615
-
160 714;815
- 714
810 1016

-
21 1015;517
19 215
10 616
-
- 515
800 617
- 1114
11,500 714
-
350 416
300 116
-
-
-
-
-
-
98 1014
-

Page 103
SISA
STOK EXP.DATE

10 11
11 1015
12 1114
450 1116
300 1116
- 215
650 815
250
10 417
4 715
-
5 1017
-
-
-
-
-
10 914
-
86 1114
322
269
1,500
-
-
-
47
-
-
-

Page 104
SISA
STOK EXP.DATE

10 11
-
-
-
-
-
-
-
-
-
50
593
84 1015
11 515
-
-
-
9 716
100
-
3 817
-
-
-
2 1014

200 217
- 815
300

Page 105
SISA
STOK EXP.DATE

10 11
2
-
-
-
-
2 615
-
-
-
-
-
-
-
-
-
4 1214;314
-
-
-
-
4 515
-
-
-
3 914
-
-
-
-

Page 106
SISA
STOK EXP.DATE

10 11
-
-
-
-

-
-
-

Page 107
SISA
STOK EXP.DATE

10 11
1
1
10

Page 108
-

Page 109
-

Page 110
-

Page 111