LAPORAN PENERIMAAN

RUMAH
Bulan : Februari
Tahun : 2018
FA

NO NAMA OBAT STOK AWAL

STOK AWAL
SATUAN HARGA (Rp.) DEPO
GUDANG
FARMASI
1 Acetosal 100 mg tab Tablet Rp 200.00 1300 622
2 Acetylsistein 200mg tab Tablet Rp 1,600.00 0 444
3 Acyclovir 200 mg tab Tablet Rp 300.00 4100 1260
4 Acyclovir 400 mg tab Tablet Rp 500.00 0 0
5 Acyclovir 5% cream 5 gram Tube Rp 3,800.00 975 17
6 Adper single bond 2 Botol Rp 730,935.00 2 0
7 Albendazole 400 mg tab Tablet Rp 500.00 180 50
8 Albothyl concentrate 10 mL suspensi Botol Rp 50,800.00 5 11
9 Allopurinol 100 mg tab Tablet Rp 110.00 39600 497
10 Allopurinol 300 mg tab Tablet Rp 210.00 5000 0
11 Alprazolam 0,25 mg tab Tablet Rp 400.00 200 243
12 Alprazolam 0,5 mg tab Tablet Rp 200.00 200 268
13 Ambroxol HCl 15 mg/5 mL suspensi 60 mL Botol Rp 2,500.00 800 17
14 Ambroxol HCl 30 mg tab Tablet Rp 100.00 100400 819
15 Aminophylline 200 mg tab Tablet Rp 200.00 22800 200
16 Aminophylline 24 mg/mL Injeksi Ampul Rp 3,600.00 93 30
17 Amoxicillin 125 mg/5mL sirup kering Botol Rp 2,300.00 1476 49
18 Amoxicillin 250 mg tab Tablet Rp 300.00 5700 540
19 Amoxicillin 500 mg tab Tablet Rp 400.00 66900 669
20 Amoxicillin Forte DS 250 mg sirup kering Tablet Rp 4,300.00 1450 16
21 Antalgin 500 mg tab Kolf Rp 200.00 3100 500
22 Antasida doen suspensi 60 mL Kolf Rp 2,400.00 1200 54
23 Antasida doen tab Tablet Rp 100.00 35500 709
24 Antihemoroid Doen supp Suppositoria Rp 4,500.00 1150 239
25 Aqua pro injeksi 500 mL Botol Rp 20,700.00 10 0
26 Asam Folat 1 mg tab Tablet Rp 100.00 148800 521
27 Asam mefenamat 500 mg kaplet Kaplet Rp 200.00 87500 758
28 Asam Tranexamat 100 mg/5 ml Injeksi Ampul Rp 2,600.00 0 2
29 Asam Tranexamat 250 mg/5 ml Injeksi Ampul Rp 2,700.00 0 29
30 Asam tranexamat 500 mg/5 ml injeksi Ampul Rp 4,500.00 0 30
31 Asering Infus 500 mL Kolf Rp 11,200.00 1195 17
32 Atropin sulfat 0,25 mg/mL Injeksi Ampul Rp 2,600.00 20 20
33 Azythromycin 200 mg/5 mL dry syrup Botol Rp 35,900.00 496 4
34 Azythromycin 500 mg tab Tablet Rp 2,300.00 3520 340
35 Bacitracin 500 IU Polymyxin B 10000 IU salep 5 gram Tube Rp 2,900.00 150 36
36 Bedak Salicycl 2% Pcs Rp 1,300.00 51 6
37 Berotec 100 mcg (Fenoterol hydrobromide) pcs Rp 96,000.00 6 4
38 Berythyco 500 mcg (Mekobalamin) kapsul Kapsul Rp 800.00 100 125
39 Betahistine mesylate 6 mg tab Tablet Rp 200.00 5220 381
40 Bisolvon (bromhexince HCl) 2 mg/mL 50 mL Botol Rp 87,230.00 15 3
41 Bisoprolol 5 mg tab Tablet Rp 300.00 2250 583
42 Calcium lactate 500 mg tab Tablet Rp 100.00 198800 831
43 Calsium Glukonas 100 mg/mL injeksi Ampul Rp 9,400.00 840 21
44 Candesartan 8 mg tab Tablet Rp 3,800.00 5160 605
45 Canesten SD (Klotrimazol 0,5 gram) tablet vaginal Tablet vagina Rp 77,100.00 80 10
46 Captopril 12,5 mg tab Tablet Rp 100.00 60500 935
47 Captopril 25 mg tab Tablet Rp 200.00 0 963
48 Cathejell W/ Lidokain PCS Rp 41,600.00 2 0
49 Cavit G RF 28G Botol Rp 139,400.00 7 0
50 Cefadroxil 125 mg sirup kering Botol Rp 4,000.00 944 33
51 Cefadroxil 500 mg kaps Kapsul Rp 500.00 4900 216
52 Cefixime 100 mg kapsul Kapsul Rp 800.00 8400 356
53 Cefotaxime Inj 1g Vial Rp 5,600.00 1570 59
54 Cetadop 200 mg/5 ml injeksi Ampul Rp 7,500.00 0 3
55 Cendo lyteers ed 15 mL Botol Rp 21,600.00 68 9
56 Cendo Mycos (hidrokortison 0,5%, Kloramfenikol 0,2%) sal Tube Rp 33,700.00 80 8
57 Cendo Pantocaine 0,5% 5 mL Botol Rp 18,500.00 90 10
58 Cetrizine 10 mg tablet Tablet Rp 200.00 4450 788
59 Ciprofloxacin 500 mg tab Tabet Rp 300.00 48500 784
60 Clindamysin 300 mg Kapsul Kapsul Rp 400.00 19700 261
61 Clobazam 10 mg tab Tablet Rp 1,200.00 700 300
62 Clonidine 0.15 mg tab Tablet Rp 300.00 9800 199
63 Clopidogrel Bisulfate 75 mg tab Tablet Rp 2,000.00 90 148
64 Clozapine 100 mg tab Tablet Rp 5,800.00 300 200
65 Clozapine 25 mg tab Tablet Rp 1,800.00 200 299
66 Combivent UDV (ipratropium broide, salbutamol sulphate) 2,vial Rp 6,900.00 820 103
67 Cortimoxazole 240 mg/5 mL sirup kering Botol Rp 5,000.00 744 47
68 cotrimoxazole 480 mg tab Tablet Rp 200.00 29000 856
69 Cresophene & apos (cresotin liquid no. 2) BOX Rp 321,750.00 4 0
70 CTM (Chlorpheniramine maleate) tab 4 mg Tablet Rp 100.00 247000 1205
71 Devital non aresnic paste 5 gram PCS Rp 270,000.00 11 0
72 Dexamethasone 5 mg/mL Injeksi Ampul Rp 1,900.00 150 59
73 Diamicron (Gliclazide) tab Tablet Rp 3,600.00 4650 330
74 Diltiazem 30 mg tab Tablet Rp 200.00 300 200
75 Dimenhydrinate 50 mg tab Tablet Rp 200.00 9500 448
76 Diovan (Valsartan) 160 mg tab Tablet Rp 4,500.00 150 150
77 Diovan (Valsartan) 80 mg tablet Tablet Rp 3,300.00 240 67
78 Diphenhydramine HCl 10 mg/mL inj Ampul Rp 1,300.00 450 19
79 Dobutamin Ampul Rp 16,500.00 0 1
80 Domperidone 5 mg/ml sirup 60 ml Botol Rp 3,200.00 0 15
81 Domperidone 10 mg tab Tablet Rp 200.00 1400 604
82 Doxycicline 100 mg kapsul Kapsul Rp 400.00 25800 200
 83 Epinefrin 1 mg Injeksi 1 mL Ampul Rp 12,600.00 5 6
84 Ergotamin Tartrat 1 Mg + Kofein 50 Mg tab Tablet Rp 300.00 700 288
85 Erythromycin 200 mg/5 mL sirup kering 60 mL Botol Rp 10,500.00 86 24
86 Erythromycin 250 mg kapsul Kapsul Rp 700.00 600 432
87 Etambutol HCl 500 mg tab Tab Rp 600.00 9700 300
88 Etching liquid & apos fuji IX P 15 (Etchant) TUBE Rp 189,400.00 5 0
89 Eugenol 15 mL Botol Rp 24,000.00 5 0
90 Fanormin (atenolol) 50 mg tab Tablet Rp 500.00 14200 198
91 Fluconazole 150 mg tab Kapsul Rp 21,600.00 1110 87
92 FUJI MINIPACK 15 GR / 10 GR (GLASS IONOMER) PCS Rp 347,300.00 1 0
93 Furosemide 10 mg/mL Injeksi Ampul Rp 3,100.00 100 11
94 Furosemide 40mg tab Tablet Rp 100.00 132
95 Gemfibrozil 300 mg kapsul Kapsul Rp 500.00 11160 744
96 Gentamicin Sulfate 40mg/ml inj Ampul Rp 4,100.00 450 46
97 GIC Fuji IX PCS Rp 808,400.00 11 0
98 Glibenclamide 5 mg tab Tablet Rp 100.00 32500 273
99 Glimepiride 1 mg tab Tablet Rp 300.00 9250 421
100 Glimepiride 2 mg tab Tablet Rp 400.00 8300 258
101 Glimepiride 3 mg tab Tablet Rp 400.00 19500 485
102 Gliquidone 30mg tab Tablet Rp 1,300.00 9800 190
103 Glukosa 10% 500 mL infus Kolf Rp 9,000.00 480 11
104 Glukosa 5% 500 mL infus Kolf Rp 8,300.00 2354 21
105 Gored (Gliclazide) 80 mg tab Tab Rp 300.00 4700 300
106 Griseofulvin 125mg tab Tablet Rp 300.00 800 188
107 Haloperidol 5 mg tab Tablet Rp 100.00 9400 600
108 Hidroklortiazid (HCT) 25 mg tab Tablet Rp 200.00 21700 688
109 Holimicetin (kloramfenikol) 125 mg/5 mL Botol Rp 4,700.00 194 6
110 Hyoscine N-Butylbromide 20 mg/mL Injeksi Ampul Rp 10,700.00 175 18
111 Ibu profen 100 mg/5 mL suspensi 60 mL Botol Rp 4,100.00 495 47
112 Ibu profen 200 mg/5 mL suspensi 60 mL Botol Rp 5,700.00 1050 40
113 Ibu profen 200 tablet Tabet Rp 200.00 58100 269
114 Interzol (ketokonazole) Scalp Solution 2% 80 mL Botol Rp 33,400.00 477 21
115 Irbesartan 300 mg tab Tablet Rp 300.00 2610 90
116 Isosorbite Dinitrate (ISDN) 5 mg tab Tablet Rp 200.00 700 502
117 Ka EN 1B 500 mL Kolf Rp 10,700.00 0 20
118 Ka EN 3A 500 mL Kolf Rp 21,300.00 383 16
119 Ka EN 3B 500 mL Kolf Rp 11,900.00 0 7
120 Kendaron 200 mg tab Tablet Rp 1,500.00 5400 80
121 Ketokonazole 2% cream Tube Rp 4,700.00 200 35
122 ketokonazole 200 mg tablet Tablet Rp 400.00 1100 300
123 Kloramfenikol 250 mg Kapsul Kapsul Rp 600.00 500 290
124 KSR (potassium Chloride) 600 mg tab Tablet Rp 2,100.00 4900 64
125 Lacto B 1 gram Sachet Sachet Rp 6,700.00 320 54
126 Lansoprazole 30 mg kapsul Kapsul Rp 1,900.00 9000 357
127 Levofloksasin 500 mg tablet Kaplet Rp 800.00 1150 321
128 Levofloxacin 5mg/ml Infus 100 mL Vial Rp 26,800.00 80 5
129 Levopar (Levodopa, Benserazide) tab Tablet Rp 1,800.00 2700 70
130 Lexapram (Metoklopramide) 5 mg/5 mL sirup Botol Rp 3,200.00 499 6
131 Lexatrans (asam traneksamat) 500 mg kaplet Kaplet Rp 1,600.00 0 325
132 lidocaine compesitum 2% inj Ampul Rp 2,300.00 3310 58
133 Lidocaine Hcl 2% injeksi Ampul Rp 1,000.00 0 59
134 Lisinopril 10 mg tab Tablet Rp 600.00 3100 806
135 Loperamid 2 mg tab Tablet Rp 100.00 100 723
136 Loratadine 10 mg tab Tablet Rp 200.00 21950 519
137 Meloxicam 15 mg tab Tablet Rp 1,500.00 4850 537
138 Meropenem 1 gram injeksi Tab Rp 44,900.00 40 10
139 Metformin 500 mg Tablet Tablet Rp 200.00 75000 746
140 Metformin 850 mg tab Tablet Rp 200.00 8100 210
141 Metil Prednisolone 4 mg Tablet Tablet Rp 200.00 197200 1214
142 Metil Prednisolone 8 mg tab Tab Rp 400.00 500 341
143 Metil prednisolone sodium succinate 125 mg injeksi Vial Rp 14,600.00 40 5
144 Metronidazole 500 mg/100 mL infus Infus Rp 10,300.00 35 17
145 Metronidazole sirup 125 mg/5 mg sirup kering Botol Rp 4,600.00 492 6
146 MgSO4 25 mL Flacon Rp 3,650 30 2
147 Misoprostol 200 mcg tab Tablet Rp 5,400 0 74
148 Molasma 2,5 mg tab Tablet Rp 100.00 6600 100
149 Mometason Furoate Cr 0,1% Tube Rp 15,600.00 216 19
150 Myomergin (methylergometrine maleate) 200 mcg/ml injeksi Ampul Rp 15,200 0 10
151 NaCl 0,9% Infus 100 mL Kolf Rp 18,300.00 80 45
152 NaCl 0,9% Infus 500 ml Kolf Rp 7,700.00 2764 66
153 Natrium diklofenak 50 mg tab Tablet Rp 300.00 8100 536
Neo Diaform Tablet 0
154 Nifedipine 10 mg tab Tablet Rp 200.00 6400 307
155 Nitrokaf Retard Forte 5 mg tab Kapsul Rp 2,800.00 4800 200
156 Novorapid flexpen PCS Rp 100,100.00 550 48
157 Nystatin 100000 iu Vaginal Rp 700.00 1900 184
158 Paket Stop TB 4
OAT Anak
159 Tahap Intensif : R = 75 mg, H = 50 mg, Z = 150 mg Paket Rp 203,259.00 1 1
Tahap lanjutan = R = 75 mg, H = 50 mg
OAT Kategori I
Tahap intensif : R = 150 mg, Isoniazid = 75 mg, P = 400 mg
160 Paket Rp 359,999.00 16 1
E = 275 mg
Tahap lanjutan : R = 150 mg, I = 150 mg
161 Obat Suntik KB I (Medroxyprogesterone acetate 150 mg/3 mVial Rp 7,100.00 80 0
162 Obat Suntik KB II (Medroxyprogesterone Acetate, Estradiol Vial Rp 6,200.00 60 39
Omeprazole 20mg kapsul kapsul 0
163 Omeprazole Inj 40 mg Vial Rp 14,300.00 270 55
164 Ondansentron 4 mg tablet tablet Rp 600.00 5256 341
165 Ondansentron HCl Dihydrate Injeksi 4mg Ampul Rp 6,900.00 2200 58
166 Oralit sachet Sachet Rp 400.00 500 184
167 Papaverin HCl 4 mg tab Tablet Rp 200.00 2100 215
168 Paracetamol 1 g/100 ml infus 100 mL Kolf Rp 23,700.00 30 41
169 Paracetamol 120 mg/5 ml sirup Botol Rp 5,200.00 1000 19
170 Paracetamol 500 mg tablet Tablet Rp 200.00 390000 6999
171 Pehacain injeksi Ampul Rp - 0 0
172 Phenobarbital 50 mg/mL injeksi Ampul Rp 1,900.00 30 30
173 Phenol Glyserol 10% 5ml tetes telinga Botol Rp 3,000.00 173 25
174 Phenytoin sodium 100 mg kapsul Kapsul Rp 200.00 900 100
175 Phytomenadione (VIT K) 10 mg/mL injeksi Ampul Rp 4,167.00 2820 30
176 Phytomenadione (VIT K) 2 mg/mL injeksi Ampul Rp 2,200.00 0 1
177 PIL KB I Kombinasi (Levonor gestrel 0,15 mg, Ethinyl ETablet 200 0
178 Piroxicam 10 mg tab Tablet Rp 200.00 13800 1038
179 Piroxicam 20 mg tab Tablet Rp 200.00 4800 900
180 Primolut-N (Norethisterone) 5 mg tab Tablet Rp 7,400.00 300 170
181 Propanolol 10 mg tab Tablet Rp 100.00 400 590
182 Propiretic 160 mg (Paracetamol) suppos Suppositoria Rp 7,800.00 96 22
183 Propiretic 240 mg (Paracetamol) suppos Suppositoria Rp 7,735.00 0 45
184 Prosogan (Lansoprazole 30 mg) injeksi Vial Rp 106,200.00 262 9
185 Pyrantel 125mg/ 5 mL sirup Botol Rp 10,100.00 65 5
186 Pyrantel palmoat 125 mg tab Tablet Rp 400.00 2100 100
187 Pyrazinamide 500 mg tab Kaplet Rp 300.00 11800 200
188 Ramipril 5 mg tablet Tablet Rp 400.00 4700 240
189 Ranitidine 150 mg tab Tablet Rp 200.00 109600 674
190 Ranitidine 25 mg/2ml injeksi Ampul Rp 2,500.00 0 121
191 Reco salep mata(Cholamfenikol 10 mg) tube Rp 5,500.00 490 10
192 Retaphyl (Theophylline 300 mg) kaplet Kaplet Rp 1,300.00 800 100
193 Rifampisin 300 mg kapsul Kapsul Rp 1,000.00 600 400
194 Rifampisin 450 mg tab tablet Rp 1,100.00 10300 200
195 Ringer Laktat 500 mL infus Kolf Rp 8,600.00 5145 68
196 RISPERIDONE 2 mg Tablet Rp 500.00 24880 114
197 Salbutamol 2 mg tab Tablet Rp 100.00 18700 1141
198 Salbutamol 4 mg tab Tablet Rp 200.00 4000 806
199 Salep 2-4 Pot Rp 3,100.00 600 16
200 Sianokobalamin injeksi 500mcg/mL injeksi Ampul Rp 1,100.00 800 100
201 Simvastatin 10 mg tab Tablet Rp 200.00 41400 513
202 Simvastatin 20 mg tab Tablet Rp 900.00 30000 356
203 Spironolactone 100 mg tab Tab Rp 900.00 700 300
204 Spironolactone 25 mg tab Tablet Rp 300.00 2500 341
205 Stesolid RT 10 mg/2,5 mg rektal Tube Rp 21,100.00 180 8
206 Stesolid RT 5 mg/2,5 mg rektal Tube Rp 14,600.00 175 11
207 Sukralfat 500 mg/5mL suspensi Botol Rp 10,100.00 275 16
208 Sulfadiazine silver 10 mg tube 35 gram Tube Rp 23,900.00 468 11
209 Set
Susuk KB II Tiga tahunan (Levonorgestrel 75 mg/implant 10 39
210 Symbicort 80 (budosenid formoterol) turbuhaler Tube Rp 121,000.00 38 8
211 Syntocinon (Oxytocine 10 iu/ui) injeksi Ampul Rp 17,100 0 1
212 Tanapres 5 mg tab Tablet Rp 2,600.00 8940 60
213 Tramadol 50 mg tab Tablet Rp 300.00 1750 250
214 TRILAC (triamsinolon inj) 10 mg/ml vial Rp 52,800.00 96 0
215 ULSIDEX 500 MG tab Tablet Rp 400.00 9000 748
216 VAGIZOL (Metronidazole 500 mg) Ovula Ovula Rp 5,000.00 360 103
217 Ampul
Vaksin Bio Td single dose 0,5 mL (Toksoid tetanus murni Rp 36,300 1768 0
218 vaksin Dtp-Hb-Hib pentabio 2,5 mL Vial 20 0
219 Vaksin hepatitis Bo 0,5 mL (Bayi) pcs 5 0
220 Vaksin jerap DT multidose 5 mL Vial 20 0
221 Vaksin Jerap Td Multi Dose 5 mL Vial Rp 16,500.00 20 0
222 Valporic acid 250 mg/5 mL 100 mL Botol Rp 26,500.00 90 10
223 Vesperum (Domperidone) 5 mg Drops 15 mL Botol Rp 11,900.00 40 8
224 Vesperum (Domperidone) 5 mg/5 mL suspensi 60 mL botol Rp 5,100.00 442 58
Vitamin A 100.000 IU tab Tablet 0
225 Vitamin A 200.000 IU tab Kapsul Rp 700.00 2400 95
226 Vitamin b 6 (Piridoksin HCl) 10 mg tab Tablet Rp 200.00 300 1237
227 Vitamin B Kompleks tab Tablet Rp 200.00 192100 1174
228 Vitamin B12 50 mcg tab Tablet Rp 100.00 18000 690
229 Vitamin C 50 mg tab Tablet Rp 200.00 145500 623
230 Water for Injection 25ml pcs Rp 3,200.00 220 54
231 Xylocain gel 2% Tube Rp 48,000.00 70 8
232 Zink Dispersibel 20 mg tab Tablet Rp 513.00 2300 176
233 Zinkid 10 mg/5mL sirup Botol Rp 18,000.00 0 0

ALAT KES
1 Abocath 18G/32mm PCS Rp 14,000.00 1150 78
2 Abocath 20G/32mm PCS 0 46
3 Abocath 24G/19mm PCS Rp 14,100.00 455 31
4 Alkohol swab PCS Rp 300.00 36461 167
5 Bisturi 11 PCS 0 16
6 Alkohol 70% 200 ml Botol Rp 3,400.00 0 1
7 Blood set PCS Rp 11,400.00 280 11
8 Cement spatel / 675.1 Medesy PCS Rp 227,800.00 7 0
9 Chromic cutgut 3/0 Pcs Rp 9,700.00 456 23
10 Cuticell 10 cm x 40 cm PCS Rp 17,700.00 28 15
11 Cutimed gel 15 g (Sofratullo) pcs 4 3
12 Daryant Tulle Pcs 0 7
13 ELEKTRODA DEFRIBILATOR PCS Rp 6,600.00 420 57
14 Endotracheal Tube Regular (ETT) 3.0 PCS Rp 25,900.00 2 2
15 Endotracheal Tube Regular (ETT) 3.5 PCS 2 2
16 Endotracheal Tube Regular (ETT) 4.0 PCS Rp 25,900.00 2 2
17 Endotracheal Tube Regular (ETT) 4.5 PCS Rp 25,900.00 3 1
18 Endotracheal Tube Regular (ETT) 5.0 PCS Rp 25,900.00 2 2
19 Endotracheal Tube Regular (ETT) 5.5 PCS Rp 25,900.00 2 2
20 Endotracheal Tube Regular (ETT) 6 PCS 3 0
21 Endotracheal Tube Regular (ETT) 6,5 PCS 3 1
22 Endotracheal Tube Regular (ETT) 7 PCS 3 0
23 Endotracheal Tube Regular (ETT) 7,5 pcs 5 0
24 Endotracheal Tube Regular (ETT) 8 PCS 3 0
25 Excavators Alpard 1670 PCS Rp 88,600.00 1 0
26 Excavators Alpard 1677 PCS Rp 88,600.00 1 0
27 Extention tubing 75 cm pcs Dec-99 4
28 Feeding tube (NGT) no 12 PCS 19 6
29 Feeding tube (NGT) no 14 PCS 25 9
30 Feeding tube (NGT) no 5 PCS 6 5
31 Foley Cath no. 10 PCS Rp 12,000.00 1 5
32 Foley Cath no. 12 PCS Rp 15,100.00 1 5
33 Foley Cath no. 14 Pcs Rp 15,100.00 0 0
34 Foley Cath no. 18 PCS Rp 15,100.00 461 31
35 Foley Cath no. 20 PCS Rp 15,100.00 2 4
36 Foley Cath no. 22 PCS Rp 15,100.00 2 4
37 Foley Cath no. 24 PCS Rp 15,100.00 2 4
38 Foley Cath no. 6 PCS Rp 12,000.00 1 0
39 Foley Cath no. 8 PCS Rp 12,000.00 1 0
40 Gelang Anak (Blue) PCS Rp 1,300.00 100 0
41 Gelang Anak (Pink) PCS Rp 1,300.00 200 0
42 Gelang Dewasa (Pink) PCS Rp 1,300.00 100 0
43 Handscoon Non steril size L powder BOX Rp 48,300.00 41 1
44 Handscoon Non steril size M powder BOX Rp 48,300.00 95 3
45 Handscoon Non steril size S powder BOX Rp 48,300.00 66 2
46 Handscoon Steril no.7 PCS Rp 5,863.00 200 53
47 handscoon sterile no. 7,5 PCS Rp 5,863.00 0 6
48 Infus set (Makro) PCS Rp 10,500.00 330 9
49 Infus set (mikro) PCS Rp 3,200.00 1120 26
50 IuD Choper T BOX 2 0
51 Kapas kosmetik 250 gram PCS Rp 10,400.00 63 2
52 Kasa hidrofil/kasa gulung 40 yard x 80 cm ROLL Rp 150,000.00 4 0
53 Kertas EKG (Cardioline) 210 mm ROLL 0 0
54 Kondom box Rp 96,000.00 8 138
55 Kontrasepsi IUD Cooper BOX Rp 11,800.00 1 0
56 Masker tali BOX 75 3
57 Masker tali pcs 0 0
58 Micropore 1 inch PCS Rp 28,800.00 101 6
59 Micropore 1/2 inch PCS Rp 12,600.00 185 5
60 Nasal cannula anak PCS Rp 7,200.00 50 23
61 Nasal cannula dewasa PCS Rp 7,200.00 30 2
62 Nasal Canula bayi pcs Rp 7,200.00 45 5
63 Nelation catheter CH 18 PCS Rp 4,800.00 18 10
64 NRM Anak pcs Rp 18,100.00 0 8
 65 NRM Dewasa pcs Rp 18,100.00 0 5
66 Particular Resp Mask PCS Rp 7,500.00 260 19
67 Povidone iodine 10% 30 ml Botol 1 0
68 Povidone iodine 300 Ml (betadine) Botol 12 1
69 Povidone iodine 300 Ml (betadine) Botol 0 0
70 Povidone iodine 5L (betadine) botol 5 0
71 RM Anak pcs Rp 15,600.00 5 7
72 RM dewasa pcs Rp 15,600.00 5 5
73 Ryles Nasogastric CH 10 PCS 15 0
74 Ryles Nasogastric CH 12 PCS 10 0
75 Silk 3-0 PCS Rp 3,600.00 756 22
76 Sonde SE / 554.2 Medesy PCS Rp 113,900.00 10 0
77 Spalk panjang PCS Rp 26,600.00 1 3
78 spuit 0,5 cc pcs 364 59
79 Spuit 1 cc PCS Rp 800.00 6800 14
80 Spuit 10 cc PCS Rp 1,300.00 200 49
81 Spuit 2,5 cc PCS 100 42
82 Spuit 20 cc PCS 130 18
83 Spuit 3 cc PCS Rp 800.00 13579 95
84 Spuit 5 cc PCS Rp 1,500.00 4972 102
85 Spuit 50 cc PCS 85 0
86 Suction catheter no 10 PCS Rp 3,700.00 50 5
87 Suction catheter no 12 PCS Rp 3,700.00 90 5
88 Suction catheter no 14 PCS Rp 4,100.00 45 0
89 Suction catheter no 16 PCS Rp 4,100.00 49 1
90 Suction catheter no 18 PCS Rp 4,100.00 40 0
91 Suction catheter no 6 PCS Rp 5,000.00 70 5
92 Suction catheter no 8 PCS Rp 5,000.00 50 0
93 Suction Deele disposible pcs 5 69
94 Three way (Discofix) PCS Rp 22,200.00 895 91
95 Three way buntut (Discofix) PCS Rp 37,000.00 430 0
96 Three way stopcock PCS Rp 22,200.00 150 0
97 Underpad PCS Rp 5,400.00 740 17
98 Urine Bag PCS Rp 8,000.00 10 14
99 Wing needle 25 G PCS Rp 1,700.00 36 25
100 Wing needle 27 G PCS Rp 1,700.00 65 12

O
1 Diazepam 10mg/ml injeksi ampul 0
2 Gentalex Krim (Gentamicin) tube 0
3 Betamethasone krim tube 0
4 Hydrocortisone krim tube 0
5 Cefixime 100mg/5ml sirup botol 0
 6 Neo Diaform tab tablet 0
7 Metronidazol 500mg kaplet tablet 0
8 Gliseril Guaiakolat (GG) tab tablet 0
9 Vitamin A 100.000 IU tablet 0
10 Epineprin injeksi ampul 0
11 Metoklopramid 10mg tablet tablet 0
12 ketorolac 10mg/ml injeksi ampul 0
13 Hyorex (Hyoscine) tablet tablet 0
14 Amlodipine 10mg tablet tablet 0
15 Amlodipine 5mg tablet tablet 0
16 Omeprazole 20mg tablet tablet 0
17 Bufacetin (kloramfenicol) salep tube 0
18 Ibuprofen 400mg tablet tablet 0
19 IUD Copper pcs 0
20 Myomergin (metergin) injeksi ampul 0
21 Sytocinon injeksi ampul 0

1 Amfetamine Check test dvice Box Rp 165,500.00 19 0

2 Benzodiazepine (BZD) Rapid Test Box Rp 165,500.00 19 0
3 bilirubin total ben 3 box 1 0
4 creatine plus ver 2 box 3 0
5 Cybow 10 reagent strip box Rp 135,200.00 5 0
6 Febrilie Antigen H FDI 5 ml vial Rp 23,246.00 10 0
7 Febrilie Antigen HA FDI 5 ml vial Rp 23,246.00 10 0
8 Febrilie Antigen HB FDI 5 ml vial Rp 23,246.00 10 0
9 Febrilie Antigen HC FDI 5 ml vial Rp 23,246.00 10 0
10 Febrilie Antigen O FDI 5 ml vial Rp 23,246.00 10 0
11 Febrilie Antigen OA FDI 5 ml vial Rp 23,246.00 10 0
12 Febrilie Antigen OB FDI 5 ml vial Rp 23,246.00 10 0
13 Febrilie Antigen OC FDI 5 ml vial Rp 23,246.00 10 0
14 HCG (Pregnancy test) Box Rp 151,250.00 40 0
15 HCG strip Box Rp 153,650.00 16 0
16 HDL-cholestrol Box 1 0
17 Kartu Golongan Darah Box 35 0
18 LDL-cholestrol Box 2 0
19 Morphine(opiates) Rapid Test Box Rp 165,500.00 19 0
20 RPR 100 Antigen FDI pcs Rp 737,600.00 1 0
21 VIKIA HBsAg box Rp 488,636.66 10 0
22 vikia HIV 1/2 @25 BOX 5 0
23 pot urine pcs 100 0
24 Reagen Golongan Darah set 1 0
25 tabung Urine PCS 50 0
Penanggung Jawab Instalasi farmasi

Ivans Panduwiguna
NIP.198411262017090106
Mengetahui,
Ka.Seksi Keperawatan dan Penunjang

Hilda Royarind Skp., M.Kp

NIP.197308202007012016
LAPORAN PENERIMAAN DAN LAPORAN PENGELUARAN OBAT DEPO FARMASI
RUMAH SAKIT UMUM DAERAH JATI PADANG

FARMASI
PEMASUKAN
PEMASUKAN PENGELUARAN PENGELUARAN SISA STOK GUDANG SISA STOK DEPO
DEPO
GUDANG GUDANG DEPO FARMASI FARMASI FARMASI
FARMASI
270
455
969
243
200

584

216

94
215

5463

100

1026
890
105
590

300
200
150
579

200
400
200

114
864
751

473
242
300
299
 60
242

728

200
93
1000
1312
892
974

401

ALAT KESEHATAN DAN BAHAN MEDIS HABIS PAKAI

OBAT DAN ALAT KESEHATAN BARU
2
20
25
24
36
 1000
500
1200
200
20
500
126
500
600
600
600
36
1000
25
50
50

ALAT LABORATORIUM
0 0 0 19 0
0 0 0 19 0
0 0 0 1 0
0 1 0 2 0
0 0 0 5 0
0 1 0 9 0
0 1 0 9 0
0 1 0 9 0
0 1 0 9 0
0 1 0 9 0
0 1 0 9 0
0 1 0 9 0
0 1 0 9 0
0 0 0 40 0
0 0 0 16 0
0 0 0 1 0
0 2 0 33 0
* 0 0 2 #VALUE!
0 0 0 19 0
0 0 0 1 0
0 0 0 10 0
0 0 0 5 0
0 100 0 0 0
0 1 0 0 0
0 50 0 0 0
 Jakarta, 1 Februari 2018

Penanggung Jawab Depo Farmasi

Hanief Mulia Ar rosyid., S.Farm., Apt

NIP.19198810032017090107
ui,

07012016
TOTAL JUMLAH TOTAL HARGA
KETERANGAN
PERSEDIAAN PERSEDIAAN

0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
 0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
455 Rp 136,500.00
969
243 Rp 48,600.00
200 Rp 560,000.00
0 Rp -
0 Rp -
4 Rp -

1 Rp 203,259.00

1 Rp 359,999.00

0 Rp -
0 Rp -
584
0 Rp -
216 Rp 129,600.00
0 Rp -
94 Rp 37,600.00
 215 Rp 43,000.00
0 Rp -
0 Rp -
5463 Rp 1,092,600.00
0 Rp -
0 Rp -
0 Rp -
100 Rp 20,000.00
0 Rp -
0 Rp -
0 Rp -
1026 Rp 205,200.00
890 Rp 178,000.00
105 Rp 777,000.00
590 Rp 59,000.00
0 Rp -
0 Rp -
0 Rp -
0 Rp -
300 Rp 120,000.00
200 Rp 60,000.00
150 Rp 60,000.00
579 Rp 115,800.00
0 Rp -
0 Rp -
200 Rp 260,000.00
400 Rp 400,000.00
200 Rp 220,000.00
0 Rp -
114 Rp 57,000.00
864 Rp 86,400.00
751 Rp 150,200.00
0 Rp -
0 Rp -
473 Rp 94,600.00
242 Rp 217,800.00
300 Rp 270,000.00
299 Rp 89,700.00
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
 60 Rp 156,000.00
242 Rp 72,600.00
0 Rp -
728 Rp 291,200.00
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
200
93 Rp 65,100.00
1000 Rp 200,000.00
1312 Rp 262,400.00
892 Rp 89,200.00
974 Rp 194,800.00
0 Rp -
0 Rp -
401 Rp 205,713.00
0 Rp -

0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
0 Rp -
 19 Rp 3,144,500.00
19 Rp -
1 Rp -
2 Rp -
5 Rp -
9 Rp -
9 Rp -
9 Rp -
9 Rp -
9 Rp -
9 Rp -
9 Rp -
9 Rp -
40 Rp -
16 Rp -
1 Rp -
33 Rp -
#VALUE! #VALUE!
19 Rp -
1 Rp -
10 Rp -
5 Rp -
0 Rp -
0 Rp -
0 Rp -
 karta, 1 Februari 2018

ggung Jawab Depo Farmasi

Mulia Ar rosyid., S.Farm., Apt

19198810032017090107