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LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA

KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 45 15480 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 0
14 Aminofilin tablet 200 mg 50 4000 0 50
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 0 0 200 52200 200
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 0 0 0
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 160 11520 200 14400 200
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 0 0 0
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 0 0
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 1 1904 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 20 640 0 20
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 0 0 200 22400 200
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 3 9450 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 5 39185 10 78370
67 Cetirizine tablet 10 mg 0 0 0
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 0 0 0
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 0 0 30 31500 20
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 0
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 9 8100 0
123 Glibenklamida tablet 5 mg 80 4480 0
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 0 0 0
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 2 5549.46 0 2
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 0
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 180 14580 0 80
158 Kaptopril tablet 12,5 mg 10 620 0 10
159 Kaptopril tablet 25 mg 0 0 0
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 5 7810 0 1
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 0 0 0
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 10 21670 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 6 5100 0 2
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 11 14993 0 5
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 200 44000
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 50 5500 0 40
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 20 2660 0 20
249 Natrium Diklofenak tablet 50 mg 0 0 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 41 213200 0 25
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 0
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 1 31174 1 31174
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 980 148960 0 200
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 120 14400 100 12000 120
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 0 0 0
326 Salisil Bedak 2 % 3 3750 0
327 Salisil Bedak 2 % 0 0 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 0 0 10 52000
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 0 0 0
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 20 1620 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 750 25575 0 300
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 90 42660 200 94800
J U M LAH 2774 675680 1151 432844
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 81 88209 50 54450 50
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 2 25000 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 15 22500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 173083.7 50 54450 50
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 0 0
2 Handscoon 0 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000
J U M LAH 0 0 0 25000 0
JUMLAH A+B+C+D 2894 848764 1201 512294 50

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : Januari

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 45 15480 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 0 0 tablet 95
4000 0 0 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
52200 0 0 tablet 261
0 0 0 vial 7,396
0 0 0 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000
14400 160 11520 tablet 72

0 0 0 botol 2,160

0 0 0 tube 2,516
0 1 1904 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
640 0 0 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
22400 0 0 tablet 112
0 0 0 tablet 112
0 3 9450 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
0 15 117555 botol 7,837
0 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
0 0 0 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
21000 10 10500 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
0 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 9 8100 botol 900
0 80 4480 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
0 0 0 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
5549.46 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
0 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
6480 100 8100 tablet 81
620 0 0 tablet 62
0 0 0 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
1562 4 6248 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
0 0 0 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 10 21670 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
1700 4 3400 ampul 850
0 0 0 ampul 850
6815 6 8178 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 200 44000 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
4400 10 1100 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
2660 0 0 tablet 133
0 0 0 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
0 0 0 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
130000 16 83200 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
0 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 2 62348 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
30400 780 118560 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
14400 100 12000 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
0 0 0 pot 1,800
0 3 3750 kotak 1,250
0 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 10 52000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
0 0 0 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 20 1620 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
10230 450 15345 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
0 290 137460 tablet 474
329456 2430 779068

0 20 13000 pcs 650


0 0 0 pcs 1,038
54450 81 88209 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 2 25000 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 15 22500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
54450 120 173083.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 btl 25,000
0 0 0
383906 2550 952151.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN PUS
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
3 Albendazol tablet 400 mg 45 15480 0 0
Antasida DOEN I tablet kunyah, kombinasi :
27 Aluminium Hidroksida 200 mg Magnesium 160 11520 100 7200 100 7200
Hidroksida 200 mg
47 Asiklovir krim 5% 3 9450 0 0
66 Cetirizin sirup 5 mg/5 ml 15 117555 10 78370 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 10 10500 30 31500 23 24150
88 Domperidon tablet 10 mg (EXP) 100 16700 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 100 8100 0 50 4050
159 Kaptopril tablet 25 mg 0 0 300 25200 220 18480
179 Klorfeniramina Maleat (CTM) tablet 4 mg 0 0 200 18200 50 4550
Kotrimoksazol Suspensi komb: Sulfametoksazol 200
190 10 21670 0 0
mg + Trimetoprim 40 mg / 5 ml
203 Lidokain injeksi 2% 4 3400 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 6 8178 0 0
224 Metampiron tablet 500 mg 200 44000 200 44000 320 70400
236 Metoklopramide tablet 10 mg 10 1100 0 0
249 Natrium Diklofenak tablet 50 mg 0 0 100 17600 50 8800
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0 0
275 Parasetamol drops 16 83200 0 6 31200
294 Povidon Iodida larutan 10% 2 62348 0 0
299 Prednison tablet 5 mg 780 118560 0 0
309 Ranitidin tablet 150 mg 100 12000 100 12000 100 12000
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 20 1620 0 0
385 Vitamin B Kompleks tablet 450 15345 0 230 7843
389 Zinc tablet 20 mg 290 137460 0 0
J U M LAH 2430 779068 1545 342580 321665
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0 0
3 Alat suntik sekali pakai 3 ml 81 88209 50 54450 67 72963
4 Alat suntik sekali pakai 5 ml 1 750 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 15 22500 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0 0
J U M LAH 120 173083.7 50 54450 69 97963
C OBAT GIGI
D OBAT TAMBAHAN
1 Masker 0 1 40000 0
2 Handscoon 0 2 425000 0
8 Etanol 70% cairan ( 1000 ml ) 0 0 0
J U M LAH 0 0 3 465000 0 0
JUMLAH A+B+C+D 2550 952151.7 1598 862030 69 419628

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
KALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : februari

SALDO
JUMLAH SATUAN HARGA SATUAN
AKHIR

45 15480 tablet 344

160 11520 tablet 72

3 9450 tube 3,150


25 195925 botol 7,837
17 17850 ampul 1,050
100 16700 tablet 167
50 4050 tablet 81
80 6720 tablet 84
150 13650 tablet 91
10 21670 botol 2,167
4 3400 ampul 850
6 8178 ampul 1,363
80 17600 tablet 220
10 1100 tablet 110
50 8800 tablet 176
2 4400 ampul 2,200
10 52000 botol 5,200
2 62348 botol 31,174
780 118560 tablet 152
100 12000 tablet 120
10 52000 botol 5,200
20 1620 tablet 81
220 7502 tablet 34
290 137460 tablet 474
2224 799983

20 13000 pcs 650


64 69696 pcs 1,089
1 750 pcs 750
15 22500 roll 1,500
1 23624.7 pcs 23,625
101 129570.7

1 40000 kotak 40,000


2 425000 kotak 212,500
btl 25,000
3 465000
2328 1394553.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1 2
98 1 5
98 3 4
73
303 5 11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 45 15480 0 10
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 0
14 Aminofilin tablet 200 mg 0 0 100 8000
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 0 0 300 78300 270
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 0 0 10 24450 5
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 160 11520 100 7200 170
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 0 0 0
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 0 0
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 0 0 300 9600 200
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 0 0 200 22400 200
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 3 9450 0 1
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 25 195925 0
67 Cetirizine tablet 10 mg 0 0 0
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 0 0 100 6200 30
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 17 17850 30 31500 30
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 0
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 0 0 2 1800
123 Glibenklamida tablet 5 mg 0 0 0
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 0 0 0
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 50 4050 0 50
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 80 6720 300 25200 220
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 0 0 10 15620 3
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 150 13650 100 9100 160
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 10 21670 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 4 3400 0 4
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 6 8178 0 3
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 80 17600 300 66000 280
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 10 1100 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 50 8800 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 10 52000 0 5
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 0
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 2 62348 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 780 118560 0 150
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 100 12000 100 12000 100
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 0 0 0
326 Salisil Bedak 2 % 0 0 0
327 Salisil Bedak 2 % 0 0 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 0 0 20 21560 10
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 20 1620 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 220 7502 0 150
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 290 137460 200 94800
J U M LAH 2224 799983 2372 463730
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 64 69696 50 54450 68
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 15 22500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 129570.7 50 54450 68
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 0
J U M LAH 0 3 0 0 0
JUMLAH A+B+C+D 2344 929556.7 2422 518180 68

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : maret

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
3440 35 12040 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 0 0 tablet 95
0 100 8000 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
70470 30 7830 tablet 261
0 0 0 vial 7,396
12225 5 12225 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000
12240 90 6480 tablet 72

0 0 0 botol 2,160

0 0 0 tube 2,516
0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
6400 100 3200 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
22400 0 0 tablet 112
0 0 0 tablet 112
3150 2 6300 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
0 25 195925 botol 7,837
0 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
1860 70 4340 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
31500 17 17850 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
0 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 2 1800 botol 900
0 0 0 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
0 0 0 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
4050 0 0 tablet 81
0 0 0 tablet 62
18480 160 13440 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
4686 7 10934 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
14560 90 8190 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 10 21670 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
3400 0 0 ampul 850
0 0 0 ampul 850
4089 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
61600 100 22000 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 10 1100 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
0 50 8800 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
0 0 0 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
26000 5 26000 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
0 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 2 62348 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
22800 630 95760 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
12000 100 12000 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
0 0 0 pot 1,800
0 0 0 kotak 1,250
0 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 10 52000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
10780 10 10780 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 20 1620 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
5115 70 2387 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
0 490 232260 tablet 474
381245 2345 882468

0 20 13000 pcs 650


0 0 0 pcs 1,038
74052 46 50094 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 15 22500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
74052 83 109968.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 btl 25,000
0 0 0
455297 2428 992436.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 35 12040 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 0
14 Aminofilin tablet 200 mg 100 8000 0
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 30 7830 300 78300 260
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 5 12225 0
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 90 6480 200 14400 270
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 0 0 0
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 0 0
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 100 3200 0 100
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 0 0 300 33600 300
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 2 6300 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 25 195925 0
67 Cetirizine tablet 10 mg 0 0 0
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 70 4340 100 6200 40
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 17 17850 30 31500 27
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 0
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 2 1800 0
123 Glibenklamida tablet 5 mg 0 0 0
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 0 0 0
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 200 30000 200
149 Ibuprofen tablet 400 mg 0 0 0
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 160 13440 300 25200 300
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 7 10934 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 90 8190 100 9100 50
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 10 21670 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 100 22000 0 100
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 10 1100 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 50 8800 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 5 26000 0 5
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 0
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 2 62348 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 630 95760 0 100
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 100 12000 100 12000 20
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 0 0 0
326 Salisil Bedak 2 % 0 0 0
327 Salisil Bedak 2 % 0 0 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 10 10780 20 21560 19
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 20 1620 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 70 2387 0
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 490 232260 0 30
J U M LAH 2345 882468 1650 261860
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 46 50094 50 54450 31
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 15 22500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 109968.7 50 54450 31
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 0
J U M LAH 0 3 0 0 0
JUMLAH A+B+C+D 2465 992439.7 1700 316310 31

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : april

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 35 12040 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 0 0 tablet 95
0 100 8000 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
67860 70 18270 tablet 261
0 0 0 vial 7,396
0 5 12225 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000
19440 20 1440 tablet 72

0 0 0 botol 2,160

0 0 0 tube 2,516
0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
3200 0 0 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
33600 0 0 tablet 112
0 0 0 tablet 112
0 2 6300 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
0 25 195925 botol 7,837
0 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
2480 130 8060 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
28350 20 21000 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
0 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 2 1800 botol 900
0 0 0 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
0 0 0 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
30000 0 0 tablet 150
0 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
25200 160 13440 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
0 7 10934 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
4550 140 12740 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 10 21670 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
22000 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 10 1100 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
0 50 8800 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
0 0 0 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
26000 0 0 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
0 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 2 62348 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
15200 530 80560 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
2400 180 21600 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
0 0 0 pot 1,800
0 0 0 kotak 1,250
0 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 10 52000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
20482 11 11858 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 20 1620 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
0 70 2387 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
14220 460 218040 tablet 474
314982 2174 829346

0 20 13000 pcs 650


0 0 0 pcs 1,038
33759 65 70785 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 15 22500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
33759 102 130659.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 btl 25,000
0 0 0
348741 2276 960005.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN PUSKE
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0 0
3 Albendazol tablet 400 mg 35 12040 0 0
4 Alopurinol tablet 100 mg 0 0 0 0
5 Alopurinol tablet 300 mg 0 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0 0
8 Alprazolam tablet 1 mg 0 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0 0
11 Ambroxol tablet 30 mg 0 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0 0
13 Aminofilin tablet 150 mg 0 0 0 0
14 Aminofilin tablet 200 mg 100 8000 0 0
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0 0
16 Amlodipin tablet 10 mg 0 0 0 0
17 Amlodipin tablet 5 mg 0 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0 0
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 5 12225 0 2 4890
23 Amoxsan tab 500 mg 0 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0 0
25 Ampisilin syr 0 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0 0
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida
28 0 0 5 10800 0
200 mg/5 ml Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g +
29 0 0 5 12580 0
Polimiksin 10.000 IU/g
Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam
30 0 0 0 0
Salisilat 3%
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg
32 0 0 0 0
Sulfadoksin tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0 0
34 Antrain inj 0 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 0 0 200 6400 120 3840
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0 0
43 Asam Folat tablet 1 mg 0 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 0 0 300 33600 300 33600
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0 0
47 Asiklovir krim 5% 2 6300 0 0
48 Asiklovir tablet 200 mg 0 0 0 0
49 Asiklovir tablet 400 mg 0 0 0 0
50 Asiklovir tablet 400 mg 0 0 0 0
51 Atapulgit tablet 600 mg 0 0 0 0
52 Atenolol tablet 100 mg 0 0 0 0
53 Atenolol tablet 50 mg 0 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet 0 0 0 0
58
tambah darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0 0
61 Bioplacenton 0 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0 0
64 Bromheksin tablet 8 mg 0 0 0 0
65 Buscopan inj 0 0 0 0
66 Cetirizin sirup 5 mg/5 ml 25 195925 0 0
67 Cetirizine tablet 10 mg 0 0 0 0
68 Clobazam tablet 10 mg 0 0 0 0
69 Clobetasol krim 0,05% 0 0 0 0
70 Dapson tablet 100 mg 0 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0 0
73 Deksametason tablet 0,5 mg 130 8060 100 6200 0
74 Dekstran 70 - larutan infus 6% steril 0 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0 0
79 Diazepam tablet 2 mg 0 0 0 0
80 Diazepam tablet 5 mg 0 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0
83 Digoksin tablet 0,25 mg 0 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0 0
89 Efedrin tablet 25 mg (HCl) 0 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0 0
95 Etakridin larutan 0,1% 0 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0 0
99 Famotidine tablet 20 mg 0 0 0 0
100 Famotidine tablet 40 mg 0 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0 0
113 Flukonazol tablet 150 mg 0 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0 0
115 Furosemid tablet 40 mg 0 0 0 0
116 Garam Oralit I serbuk 0 0 20 5760 20 5760
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0 0
122 Gentian Violet larutan 1 % 2 1800 0 0
123 Glibenklamida tablet 5 mg 0 0 0 0
124 Glimepiride tablet 1 mg 0 0 0 0
125 Glimepiride tablet 2 mg 0 0 0 0
126 Glimepiride tablet 2 mg 0 0 0 0
127 Glimepiride tablet 3 mg 0 0 0 0
128 Glimepiride tablet 4 mg 0 0 0 0
129 Gliquidon tablet 30 mg 0 0 0 0
131 Gliserin 0 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0 0
139 Haloperidol tablet 5 mg 0 0 0 0
140 HCT 25 mg 0 0 0 0
141 Hidrokortison krim 1% 0 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200 30000
150 Iodiol kapsul lunak 0 0 0 0
151 Isoniazid tablet 100 mg 0 0 0 0
152 Isoniazid tablet 300 mg 0 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0 0
160 Kaptopril tablet 50 mg 0 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0 0
162 Ketokonazol krim 2% 0 0 5 12845 0
163 Ketokonazol tablet 200 mg 0 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0 0
170 Klomifen tablet 50 mg 0 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0 0
174 Kloramfenikol salep mata 1 % 7 10934 0 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0 0
180 Klorokuin tablet 250 mg 0 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0 0
185 Kodein tablet 10 mg 0 0 0 0
186 Kodein tablet 15 mg 0 0 0 0
187 Kodein tablet 20 mg 0 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi :
188 0 0 0 0
Sulfametoksazol 400 mg , Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi :
189 0 0 0 0
Sulfametoksazol 100 mg Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg +
190 10 21670 0 0
Trimetoprim 40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0 0
194 Lacto B 0 0 0 0
195 Lamivudine tablet 150 mg 0 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq,
196 0 0 0 0
Ca 3 mEq, Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa
197 0 0 0 0
18.75 gr) (KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr,
198 KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B) 0 0 0 0

Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr,


199 Na Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A) 0 0 0 0

200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0 0


201 Levofloksasin tablet 500 mg 0 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0 0
203 Lidokain injeksi 2% 0 0 0 0
204 Lidokain injeksi 2% 0 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0 0
206 Lidokain jeli 2% 0 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0 0
208 Lisinopril tablet 10 mg 0 0 0 0
209 Lisinopril tablet 5 mg 0 0 0 0
210 Loperamid tablet 2 mg 0 0 0 0
211 Loratadin tablet 10 mg 0 0 0 0
212 Lorazepam tablet 2 mg 0 0 0 0
213 Lytacur 0 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0 0
217 Mebendazol tablet 100 mg 0 0 0 0
218 Meloksikam suppositoria 0 0 0 0
219 Meloksikam tablet 15 mg 0 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0 0
222 Metampiron injeksi 250 mg 0 0 0 0
223 Metampiron injeksi 250 mg 0 0 0 0
224 Metampiron tablet 500 mg 0 0 0 0
225 Metampiron tablet 500 mg 0 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0 0
236 Metoklopramide tablet 10 mg 10 1100 0 0
237 Metoklopramide tablet 5 mg 0 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0 0
239 Metronidazol tablet 250 mg 0 0 0 0
240 Metronidazol tablet 500 mg 0 0 0 0
241 Metronidazol tablet 500 mg 0 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0 0
243 Mineral Mix, kombinasi 0 0 0 0
244 Momethason krim 0,1 % 0 0 0 0
245 Momethason krim 0,1 % 0 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0 0
247 Morfin tablet 10 mg 0 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0 0
249 Natrium Diklofenak tablet 50 mg 50 8800 0 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0 0
251 Neurobion 5000 injeksi 0 0 0 0
252 Nevirapin tablet 200 mg 0 0 0 0
253 Nifedipin tablet 10 mg 0 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0 0
256 Norages inj 0 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 0 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0 0
274 Papaverin tablet 40 mg 0 0 0 0
276 Parasetamol sirup 120 mg / 5 ml 0 0 0 0
277 Parasetamol tablet 100 mg 0 0 0 0
278 Parasetamol tablet 500 mg 0 0 0 0
279 Perfenazin tablet 4 mg (HCl) 0 0 0 0
280 Permetrin krim 5% 0 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0 0
285 Piracetam tablet 1200 mg 0 0 0 0
286 Piracetam tablet 400 mg 0 0 0 0
287 Piracetam tablet 800 mg 0 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0 0
294 Povidon Iodida larutan 10% 2 62348 0 0
295 Povidon Iodida larutan 10% 30mL 0 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0 0
297 Povidon Iodida larutan 10% 0 0 0 0
298 Pravastatin tablet 20 mg 0 0 0 0
299 Prednison tablet 5 mg 530 80560 0 0
300 Primakuin tablet 15 mg 0 0 0 0
301 Primperan inj 0 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0 0
307 Ramipril tablet 5 mg 0 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0 0
310 Ranitidin tablet 150 mg 0 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0 0
318 Ringer Laktat larutan infus 0 0 0 0
319 Risperidon tablet 1 mg 0 0 0 0
320 Risperidon tablet 2 mg 0 0 0 0
321 Risperidon tablet 3 mg 0 0 0 0
322 SABU I 0 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 0 0 5 9000 0
326 Salisil Bedak 2 % 0 0 0 0
327 Salisil Bedak 2 % 0 0 5 6250 2 2500
328 Sanmol syr 0 0 0 0
329 Sanmol tab 0 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0 0
336 Sefazolin injeksi 1 g 0 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0 0
342 Seftazidim injeksi 1 g 0 0 0 0
343 Seftriakson injeksi 1 g 0 0 0 0
344 Seftriakson injeksi 1 g 0 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0 0
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0 0
348 Simetidin tablet 200 mg 0 0 0 0
349 Simvastatin tablet 10 mg 0 0 0 0
350 Simvastatin tablet 20 mg 0 0 0 0
351 Simvastatin tablet 5 mg 0 0 0 0
352 Siprofloksasin infus 2% 0 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0 0
355 Spasminal tab 0 0 0 0
356 Spiramisin tablet 500 mg 0 0 0 0
357 Spironolakton tablet 100 mg 0 0 0 0
358 Spironolakton tablet 25 mg 0 0 0 0
359 Stavudin tablet 30 mg 0 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0 0
363 Syntosinon inj 0 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 20 1620 0 20 1620
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0 0
377 Transamin tab 0 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0 0
380 Ulsikur inj 0 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0 0
382 Valdimex tablet 5 mg 0 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0 0
384 Vicillin 1gr inj 0 0 0 0
385 Vitamin B Kompleks tablet 70 2387 0 0
386 Zidovudin tablet 100 mg 0 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0 0
388 Zinc drop 10 mg/mL 0 0 0 0
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0 0
4 Alat suntik sekali pakai 5 ml 1 750 0 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0 0
7 Infusion set anak 0 0 0 0
8 Infusion set dewasa 0 0 0 0
9 IV Catheter No. 20 G 0 0 0 0
10 IV Catheter No. 22 G 0 0 0 0
11 IV Catheter No. 24 G 0 0 0 0
12 Kapas Berlemak 500 gram 0 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 15 22500 10 15000 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0 0
23 Pembalut Gips 3 ichi 0 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0 0
26 Ultrafix 5x5 0 0 0 0
27 Urine Bag 0 0 0 0
28 Foley Catheter 0 0 0 0
29 Handscoon 0 0 0 0
30 Masker 0 0 0 0
C OBAT GIGI
1 Etil Klorida spray 0 0 0
2 Eugenol cairan 0 0 0
3 Formokresol cairan 0 0 0
4 Glass Ionomer Cement ART 0 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0 0
7 Kalsium Hidroksida Pasta 0 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0 0
9 Komposit resin 0 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0 0
11 Mummifying Pasta 0 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0 0
J U M LAH 0 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0 0
2 Handscoon 2 0 0
3 Spuit insulin 1 cc 0 0 0
4 Spuit 3 cc 0 0 0
5 Foley Catheter 0 0 0
6 Larutan mengandung Elektrolit 0 0 0
7 Zink syr 0 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000 0
J U M LAH 0 3 0 25000 0 0

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
N KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : mei

SALDO SATU HARGA


JUMLAH
AKHIR AN SATUAN

0 0 vial 3,509
0 0 botol 3,849
35 12040 tablet 344
0 0 tablet 86
0 0 tablet 200
0 0 tablet 435
0 0 tablet 460
0 0 tablet 233
0 0 botol 2,400
0 0 botol 2,400
0 0 tablet 127
0 0 ampul 3,822
0 0 tablet 95
100 8000 tablet 80
0 0 tablet 112
0 0 tablet 330
0 0 tablet 240
0 0 tablet 4,550
0 0 tablet 190
0 0 vial 7,396
3 7335 botol 2,445
0 0 tablet 3,161
0 0 vial 5,100
0 0 botol 5,100
0 0 vial 3,000
5 10800 botol 2,160

5 12580 tube 2,516

0 0 pot 1,904

0 0 suppo 2,450
0 0 tablet 478
0 0 tablet 123
0 0 ampul 9,240
0 0 vial 5,000
0 0 ampul 22,167
0 0 ampul 25,063
0 0 tablet 100
0 0 tablet 162
80 2560 tablet 32
0 0 tablet 51
0 0 tablet 135
0 0 tablet 48
0 0 tablet 121
0 0 tablet 112
0 0 tablet 112
2 6300 tube 3,150
0 0 tablet 237
0 0 tablet 336
0 0 tablet 336
0 0 tablet 190
0 0 tablet 654
0 0 tablet 346
0 0 ampul 1,230
0 0 tablet 74
0 0 ampul 8,935
0 0 ampul 12,185
0 0 tablet 44
0 0 tablet 924
0 0 tube 1,520
0 0 tube 12,650
0 0 suppo 6,045
0 0 tablet 511
0 0 tablet 51
0 0 ampul 21,758
25 195925 botol 7,837
0 0 tablet 181
0 0 tablet 760
0 0 tube 4,000
0 0 tablet 44
0 0 ampul 1,580
0 0 ampul 1,580
230 14260 tablet 62
0 0 botol 39,079
0 0 botol 1,379
0 0 tablet 90
0 0 tablet 90
0 0 ampul 2,344
0 0 tablet 35
0 0 tablet 56
0 0 tablet 93
0 0 tablet 97
0 0 tablet 123
0 0 tablet 104
0 0 tablet 220
0 0 botol 3,624
100 16700 tablet 167
0 0 tablet 51
0 0 tablet 38
0 0 ampul 8,100
0 0 tablet 497
0 0 tablet 864
0 0 botol 7,700
0 0 botol 3,223
0 0 tablet 305
0 0 tablet 410
0 0 botol 2,500
0 0 tablet 113
0 0 tablet 173
0 0 tablet 97
0 0 tablet 133
0 0 ampul 20,250
0 0 tablet 93
0 0 ampul 1,716
0 0 tablet 144
0 0 tablet 165
0 0 tablet 272
0 0 tablet 465
0 0 botol 1,008
0 0 tablet 630
0 0 ampul 3,417
0 0 tablet 22,000
0 0 ampul 1,829
0 0 tablet 85
0 0 sachet 288
0 0 tablet 289
0 0 tablet 680
0 0 ampul 3,104
0 0 tube 1,350
0 0 botol 2,904
2 1800 botol 900
0 0 tablet 56
0 0 tablet 266
0 0 tablet 490
0 0 tablet 490
0 0 tablet 1,000
0 0 tablet 912
0 0 tablet 645
0 0 botol 4,158
0 0 botol 5,727
0 0 botol 1,960
0 0 botol 5,200
0 0 tablet 209
0 0 ampul 83,333
0 0 tablet 59
0 0 tablet 73
0 0 tablet 96
0 0 tablet 36
0 0 tube 2,775
0 0 tube 2,798
0 0 tablet 395
0 0 botol 3,499
0 0 botol 4,455
0 0 tablet 110
0 0 tablet 110
0 0 tablet 150
0 0 tablet 150
0 0 kapsul 980
0 0 tablet 44
0 0 tablet 85
0 0 tablet 88
0 0 tablet 1,300
0 0 tablet 332
0 0 tablet 425
0 0 tablet 81
0 0 tablet 62
0 0 tablet 134
0 0 tablet 245
5 12845 tube 2,569
0 0 tablet 300
0 0 ampul 2,542
0 0 tablet 608
0 0 ampul 1,616
0 0 ampul 7,800
0 0 tablet 361
0 0 tablet 553
0 0 tablet 1,400
0 0 tablet 184
0 0 tablet 188
0 0 tablet 356
7 10934 tube 1,562
0 0 botol 3,700
0 0 botol 3,700
0 0 botol 4,950
0 0 botol 2,343
0 0 tablet 107
0 0 ampul 1,050
0 0 ampul 1,100
0 0 tablet 245
0 0 tablet 168
0 0 tablet 470
0 0 tablet 800
0 0 tablet 1,045
0 0 tablet 138

0 0 tablet 72

10 21670 botol 2,167


0 0 tablet 610
0 0 ampul 4,227
0 0 ampul 5,706
0 0 sachet 3,850
0 0 tablet 1,267
0 0 botol 9,000

0 0 botol 9,000

0 0 botol 10,000

0 0 botol 10,000

0 0 tablet 473
0 0 tablet 528
0 0 tablet 528
0 0 ampul 850
0 0 ampul 850
3 4089 ampul 1,363
0 0 syringe 40,000
0 0 tablet 520
0 0 tablet 550
0 0 tablet 320
0 0 tablet 89
0 0 tablet 154
0 0 tablet 1,341
0 0 botol 11,000
0 0 ampul 6,600
0 0 ampul 6,600
0 0 botol 3,534
0 0 tablet 225
0 0 suppo 6,600
0 0 tablet 506
0 0 tablet 234
0 0 ampul 1,250
0 0 ampul 1,200
0 0 ampul 1,200
0 0 tablet 220
0 0 tablet 145
0 0 tablet 113
0 0 tablet 220
0 0 ampul 3,499
0 0 tablet 140
0 0 ampul 59,000
0 0 tablet 635
0 0 tablet 296
0 0 tablet 370
0 0 ampul 5,500
0 0 botol 2,830
10 1100 tablet 110
0 0 tablet 100
0 0 botol 9,950
0 0 tablet 110
0 0 tablet 160
0 0 tablet 160
0 0 tube 3,000
0 0 sachet 2,450
0 0 tube 17,500
0 0 tube 3,955
0 0 ampul 10,499
0 0 tablet 1,206
0 0 tablet 133
50 8800 tablet 176
0 0 botol 4,700
0 0 ampul 6,006
0 0 tablet 2,613
0 0 tablet 110
0 0 tablet 640
0 0 ovula 407
0 0 ampul 8,030
0 0 paket 359,950
0 0 paket 1,198,000
0 0 paket 214,900
0 0 paket 159,898
0 0 paket 288,100
0 0 paket 171,900
0 0 botol 1,259
0 0 botol 5,940
0 0 tablet 413
0 0 tablet 650
0 0 ampul 8,800
0 0 tube 2,772
0 0 tube 2,010
2 4400 ampul 2,200
0 0 tablet 211
0 0 tablet 13,000
0 0 ampul 1,150
0 0 tablet 119
0 0 botol 1,438
0 0 tablet 32
0 0 tablet 79
0 0 tablet 34
0 0 tube 11,475
0 0 ampul 13,191
0 0 ampul 1,925
0 0 ampul 3,800
0 0 ampul 3,800
0 0 tablet 776
0 0 tablet 194
0 0 tablet 400
0 0 botol 8,360
0 0 tablet 298
0 0 tablet 198
0 0 tablet 17
0 0 tablet 70
0 0 tablet 100
2 62348 botol 31,174
0 0 botol 2,163
0 0 botol 14,203
0 0 botol 2,400
0 0 tablet 2,400
530 80560 tablet 152
0 0 tablet 144
0 0 ampul 9,900
0 0 ampul 6,100
0 0 tablet 65
0 0 tablet 108
0 0 tablet 284
0 0 tablet 300
0 0 tablet 530
0 0 ampul 1,140
0 0 tablet 120
0 0 tablet 81
0 0 tablet 103
0 0 kapsul 242
0 0 kapsul 432
0 0 tablet 376
0 0 tablet 830
0 0 tablet 594
0 0 botol 5,200
0 0 tablet 1,400
0 0 tablet 1,008
0 0 tablet 2,500
0 0 vial 398,420
0 0 tablet 59
0 0 tablet 97
5 9000 pot 1,800
0 0 kotak 1,250
3 3750 kotak 1,250
0 0 botol 10,384
0 0 tablet 242
0 0 tablet 468
0 0 tablet 509
0 0 tablet 510
10 52000 botol 5,200
0 0 tablet 365
0 0 tablet 972
0 0 vial 18,585
0 0 paket 33,000
0 0 tablet 859
0 0 botol 10,558
0 0 vial 3,500
0 0 vial 2,950
0 0 ampul 27,086
0 0 vial 3,300
0 0 vial 3,300
0 0 ampul 137,500
0 0 tablet 14
0 0 tablet 111
0 0 tablet 169
0 0 tablet 391
0 0 tablet 230
0 0 botol 45,000
0 0 tablet 237
0 0 tablet 255
0 0 tablet 517
0 0 tablet 1,386
0 0 tablet 950
0 0 tablet 311
0 0 tablet 843
0 0 vial 3,650
0 0 tablet 415
0 0 botol 3,226
0 0 ampul 12,045
0 0 tablet 1,700
0 0 botol 11,500
0 0 tablet 149
0 0 tablet 300
0 0 tablet 319
0 0 tablet 431
0 0 tablet 38
0 0 tablet 81
0 0 ampul 680
0 0 ampul 680
0 0 ampul 5,200
0 0 tablet 189
0 0 tablet 189
0 0 tablet 1,518
0 0 tablet 405
0 0 tablet 40
0 0 ampul 7,480
0 0 ampul 12,100
0 0 tablet 1,210
0 0 tablet 215
0 0 vial 10,560
70 2387 tablet 34
0 0 tablet 949
0 0 tablet 3,117
0 0 botol 12,840

20 13000 pcs 650


0 0 pcs 1,038
1 750 pcs 750
0 0 pcs 5,583
0 0 pcs 5,583
0 0 pcs 3,500
0 0 pcs 3,509
0 0 pcs 9,185
0 0 pcs 9,185
0 0 pcs 9,185
0 0 roll 16,500
0 0 roll 12,500
0 0 kotak 5,800
0 0 roll 159,500
0 0 roll 105,000
0 0 roll 750
25 37500 roll 1,500
0 0 roll 6,985
0 0 roll 9,955
0 0 roll 33,000
0 0 roll 41,800
0 0 roll 23,485
1 23624.7 pcs 23,625
0 0 kotak 110,000
0 0 roll 23,625
0 0 pcs 3,000
0 0 pcs 8,000
0 0 pasang 4,250
0 0 kotak 22,000

0 0 botol 189,750
0 0 kotak 550,000
0 0 botol 53,130
0 0 set 822,250
0 0 set 41,745
0 0 set 41,745
0 0 kotak 158,125
0 0 botol 58,300
0 0 buah 360,415
0 0 kotak 170,775
0 0 kotak 232,100
0 0 set 93,500
0 0 set 33,990
0 0

0 0 kotak 40,000
0 0 kotak 212,500
0 0 pcs 3,500
0 0 pcs 1,500
0 0 pcs 27,000
0 0 btl 9,000
0 0 btl 7,400
btl 25,000
0 0

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1 2
98 1 5
98 3 4
73
303 5 11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 35 12040 100 34400 30
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 0
14 Aminofilin tablet 200 mg 100 8000 0
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 90 23490 300 78300 270
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 3 7335 0
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 30 2160 200 14400 150
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 5 10800 0
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 5 12580 0 4
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 80 2560 200 6400 200
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 0 0 300 33600 300
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 2 6300 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 25 195925 0
67 Cetirizine tablet 10 mg 0 0 0
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 230 14260 0
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 30 31500 0 23
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 30 8640 12
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 2 1800 5 4500 4
123 Glibenklamida tablet 5 mg 0 0 0
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 30 1303.5 200 8690 220
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 290 24360 200 16800 220
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 5 12845 0 5
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 7 10934 0 7
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 80 7280 0 80
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 10 21670 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 0
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 10 1100 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 50 8800 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 26 135200 0 22
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 0
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 2 62348 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 530 80560 0
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 90 10800 0
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 5 9000 0
326 Salisil Bedak 2 % 0 0 0
327 Salisil Bedak 2 % 3 3750 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 19 20482 0 9
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 0 0 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 70 2387 0
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 620 293880 200 94800 20
J U M LAH 2599 1112639 1935 330530
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 52 56628 50 54450 53
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 25 37500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 131502.7 50 54450 53
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 0
J U M LAH 0 3 0 0 0
JUMLAH A+B+C+D 2719 1244144 1985 384980 53

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : JUNI

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
10320 105 36120 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 0 0 tablet 95
0 100 8000 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
70470 120 31320 tablet 261
0 0 0 vial 7,396
0 3 7335 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000
10800 80 5760 tablet 72

0 5 10800 botol 2,160

10064 1 2516 tube 2,516


0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
6400 80 2560 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
33600 0 0 tablet 112
0 0 0 tablet 112
0 2 6300 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
0 25 195925 botol 7,837
0 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
0 230 14260 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
24150 7 7350 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
3456 18 5184 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
3600 3 2700 botol 900
0 0 0 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
9559 10 434.5 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
18480 270 22680 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
12845 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
10934 0 0 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
7280 0 0 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 10 21670 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 10 1100 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
0 50 8800 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
0 0 0 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
114400 4 20800 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
0 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 2 62348 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
0 530 80560 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
0 90 10800 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
0 5 9000 pot 1,800
0 0 0 kotak 1,250
0 3 3750 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 10 52000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
9702 10 10780 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 0 0 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
0 70 2387 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
9480 800 379200 tablet 474
395540 2758 1047628.5

0 20 13000 pcs 650


0 0 0 pcs 1,038
57717 49 53361 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 25 37500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
57717 96 128235.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 btl 25,000
0 0 0
453257 2854 1175864.2

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 105 36120 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 50 23000
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 40 3800
14 Aminofilin tablet 200 mg 100 8000 0
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 6 1440
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 120 31320 400 104400 340
21 Amoksisilin serbuk injeksi 1000 mg 0 0 2 14792
22 Amoksisilin sirup kering 125 mg/ 5 ml 3 7335 0 3
23 Amoxsan tab 500 mg 0 0 230 727030
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 80 5760 2005 144360 180
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 5 10800 13 28080 4
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 1 2516 5 12580
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 19 9082
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 80 2560 200 6400 200
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 0 0 400 44800 400
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 2 6300 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 25 195925 10 78370 17
67 Cetirizine tablet 10 mg 0 0 0
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 230 14260 100 6200 200
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 7 7350 17 17850 7
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 18 5184 0 18
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 3 2700 0
123 Glibenklamida tablet 5 mg 0 0 0
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 10 434.5 530 23028.5 320
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 270 22680 300 25200 230
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 5 12845
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 0 0 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 0 0 0
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 10 21670 0 8
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 0
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 10 1100 0 10
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 50 8800 50 8800 30
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 4 20800 20 104000 4
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 0
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 2 62348 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 530 80560 0
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 90 10800 0 50
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 5 9000 4 7200 3
326 Salisil Bedak 2 % 0 0 0
327 Salisil Bedak 2 % 3 3750 3 3750 2
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 10 10780 20 21560 17
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 20 64520
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 0 0 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 70 2387 0 70
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 800 379200 0 40
J U M LAH 2758 1047629 4649 1523088
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 49 53361 50 54450 67
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 25 37500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 128235.7 50 54450 67
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000
J U M LAH 0 3 0 25000 0
JUMLAH A+B+C+D 2878 1175867 4699 1602538 67

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : JULI

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 105 36120 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 50 23000 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 40 3800 tablet 95
0 100 8000 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 6 1440 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
88740 180 46980 tablet 261
0 2 14792 vial 7,396
7335 0 0 botol 2,445
0 230 727030 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000

12960 1905 137160 tablet 72

8640 14 30240 botol 2,160

0 6 15096 tube 2,516


0 0 0 pot 1,904
0 0 0 suppo 2,450

0 19 9082 tablet 478


0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
6400 80 2560 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
44800 0 0 tablet 112
0 0 0 tablet 112
0 2 6300 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
133229 18 141066 botol 7,837
0 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
12400 130 8060 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
7350 17 17850 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
5184 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 3 2700 botol 900
0 0 0 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
13904 220 9559 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
19320 340 28560 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 5 12845 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
0 0 0 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
0 0 0 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

17336 2 4334 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
1100 0 0 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
5280 70 12320 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
0 0 0 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
20800 20 104000 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
0 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 2 62348 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
0 530 80560 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
6000 40 4800 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
5400 6 10800 pot 1,800
0 0 0 kotak 1,250
2500 4 5000 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 10 52000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
18326 13 14014 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 20 64520 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 0 0 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
2387 0 0 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
18960 760 360240 tablet 474
488351 5054 2082365

0 20 13000 pcs 650


0 0 0 pcs 1,038
72963 32 34848 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 25 37500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
72963 79 109722.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 btl 25,000
0 0 0
561314 5133 2192087.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 105 36120 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 0
14 Aminofilin tablet 200 mg 100 8000 0 30
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 180 46980 300 78300 240
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 0 0 0
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 100 7200 0 100
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 1 2160 10 21600 2
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 1 2516 0 1
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 80 2560 0 50
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 0 0 400 44800 380
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 2 6300 0 1
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 8 62696 0
67 Cetirizine tablet 10 mg 0 0 100 18100
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 30 1860 100 6200 70
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 0 0 0
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 0
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 3 2700 5 4500 3
123 Glibenklamida tablet 5 mg 0 0 100 5600 10
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 190 8255.5 0 160
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 340 28560 200 16800 110
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 0 0 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 0 0 300 27300 240
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 2 4334 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 0
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 0 0 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 20 3520 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 5 13860 3
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 0 0 0
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 300 23700 240
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 2 62348 0 1
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 530 80560 0 70
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 40 4800 0 40
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 2 3600 0 1
326 Salisil Bedak 2 % 0 0 0
327 Salisil Bedak 2 % 1 1250 0 1
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 13 14014 20 21560 12
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 0 0 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 0 0 0
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 760 360240 0 30
J U M LAH 2625 827762.5 2040 312320
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 32 34848 50 54450 43
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 25 37500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 109722.7 50 54450 43
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000
J U M LAH 0 3 0 25000 0
JUMLAH A+B+C+D 2745 937488.2 2090 391770 43

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : agustus

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 105 36120 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 0 0 tablet 95
2400 70 5600 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
62640 240 62640 tablet 261
0 0 0 vial 7,396
0 0 0 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000

7200 0 0 tablet 72

4320 9 19440 botol 2,160

2516 0 0 tube 2,516


0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
1600 30 960 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
42560 20 2240 tablet 112
0 0 0 tablet 112
3150 1 3150 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
0 8 62696 botol 7,837
0 100 18100 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
4340 60 3720 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
0 0 0 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
0 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
2700 5 4500 botol 900
560 90 5040 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
6952 30 1303.5 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
9240 430 36120 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
0 0 0 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
21840 60 5460 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 2 4334 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 0 0 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
0 20 3520 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
8316 2 5544 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
0 0 0 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
18960 60 4740 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
31174 1 31174 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
10640 460 69920 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
4800 0 0 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
1800 1 1800 pot 1,800
0 0 0 kotak 1,250
1250 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 10 52000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
12936 21 22638 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 0 0 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
0 0 0 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
14220 730 346020 tablet 474
306114 2670 833968.5

0 20 13000 pcs 650


0 0 0 pcs 1,038
46827 39 42471 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 25 37500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
46827 86 117345.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 1 25000 btl 25,000
0 0 0
352941 2756 951314.2

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 105 36120 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 0
14 Aminofilin tablet 200 mg 70 5600 0 70
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 240 62640 200 52200 220
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 0 0 0
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 0 0 0
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 9 19440 0 9
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 0 0
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 30 960 100 3200 80
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 20 2240 400 44800 340
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 1 3150 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 8 62696 0 6
67 Cetirizine tablet 10 mg 100 18100 0 60
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 60 3720 0
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 0 0 0
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 0
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 5 4500 0
123 Glibenklamida tablet 5 mg 90 5040 0 40
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 30 1303.5 0 30
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 430 36120 200 16800 300
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 0 0 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 60 5460 500 45500
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 2 4334 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 0
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 0 0 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 20 3520 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 2 5544 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 0 0 0
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 60 4740 0 60
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 1 31174 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 460 69920 0
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 0 0 0
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 1 1800 0
326 Salisil Bedak 2 % 0 0 0
327 Salisil Bedak 2 % 0 0 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 10 52000 0 5
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 21 22638 20 21560 15
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 0 0 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 0 0 0
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 730 346020 0
J U M LAH 2670 833968.5 1620 214060
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 20 13000 0 5
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 39 42471 50 54450 23
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 25 37500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 117345.7 50 54450 28
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000
J U M LAH 0 3 0 25000 0
JUMLAH A+B+C+D 2790 951317.2 1670 293510 28

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : September

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 105 36120 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 0 0 tablet 95
5600 0 0 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
57420 220 57420 tablet 261
0 0 0 vial 7,396
0 0 0 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000

0 0 0 tablet 72

19440 0 0 botol 2,160

0 0 0 tube 2,516
0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
2560 50 1600 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
38080 80 8960 tablet 112
0 0 0 tablet 112
0 1 3150 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
47022 2 15674 botol 7,837
10860 40 7240 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
0 60 3720 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
0 0 0 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
0 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 5 4500 botol 900
2240 50 2800 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
1303.5 0 0 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
25200 330 27720 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
0 0 0 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
0 560 50960 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 2 4334 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 0 0 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
0 20 3520 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
0 2 5544 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
0 0 0 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
4740 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 1 31174 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
0 460 69920 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
0 0 0 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
0 1 1800 pot 1,800
0 0 0 kotak 1,250
0 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
26000 5 26000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
16170 26 28028 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 0 0 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
0 0 0 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
0 730 346020 tablet 474
286636 2855 761393

3250 15 9750 pcs 650


0 0 0 pcs 1,038
25047 66 71874 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 25 37500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
28297 108 143498.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 1 25000 btl 25,000
0 0 0
314933 2963 904891.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 105 36120 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 0 0 100 9500
14 Aminofilin tablet 200 mg 0 0 0
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 220 57420 300 78300 320
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 0 0 0
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 0 0 0
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 0 0 20 43200 4
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 0 0
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 50 1600 200 6400 200
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 80 8960 300 33600 230
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 1 3150 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 2 15674 0 2
67 Cetirizine tablet 10 mg 40 7240 0 40
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 60 3720 0 60
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 0 0 0
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 0
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 5 4500 0
123 Glibenklamida tablet 5 mg 50 2800 100 5600 40
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 0 0 0
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 330 27720 200 16800 300
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 0 0 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 560 50960 300 27300 340
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 2 4334 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 0
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 0 0 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 20 3520 0 20
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 2 5544 0 2
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 0 0 0
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 200 15800 200
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 1 31174 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 460 69920 0
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 0 0 0
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 1 1800 10 18000 5
326 Salisil Bedak 2 % 0 0 10 12500 8
327 Salisil Bedak 2 % 0 0 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 5 26000 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 26 28028 0 14
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 0 0 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 0 0 0
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 730 346020 0
J U M LAH 2855 761393 1940 297000
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 15 9750 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 66 71874 50 54450 64
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 25 37500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 143498.7 50 54450 64
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000
J U M LAH 0 3 0 25000 0
JUMLAH A+B+C+D 2975 904894.7 1990 376450 64

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : oktober

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 105 36120 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 100 9500 tablet 95
0 0 0 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
83520 200 52200 tablet 261
0 0 0 vial 7,396
0 0 0 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000

0 0 0 tablet 72

8640 16 34560 botol 2,160

0 0 0 tube 2,516
0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
6400 50 1600 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
25760 150 16800 tablet 112
0 0 0 tablet 112
0 1 3150 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
15674 0 0 botol 7,837
7240 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
3720 0 0 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
0 0 0 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
0 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 5 4500 botol 900
2240 110 6160 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
0 0 0 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
25200 230 19320 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
0 0 0 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
30940 520 47320 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 2 4334 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 0 0 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
3520 0 0 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
5544 0 0 tube 2,772
0 0 0 tube 2,010
0 2 4400 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
0 0 0 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
15800 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 1 31174 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
0 460 69920 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
0 0 0 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
9000 6 10800 pot 1,800
10000 2 2500 kotak 1,250
0 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 5 26000 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
15092 12 12936 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 0 0 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
0 0 0 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
0 730 346020 tablet 474
298290 2810 760103

0 15 9750 pcs 650


0 0 0 pcs 1,038
69696 52 56628 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 25 37500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
69696 94 128252.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 1 25000 btl 25,000
0 0 0
367986 2904 888355.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 105 36120 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 100 9500 0
14 Aminofilin tablet 200 mg 0 0 0
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 200 52200 300 78300 320
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 0 0 10 24450 4
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 0 0 100 7200 100
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 16 34560 10 21600 5
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 0 0
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 50 1600 100 3200 100
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 150 16800 300 33600 320
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 1 3150 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 0 0 0
67 Cetirizine tablet 10 mg 0 0 0
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 0 0 0
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 0 0 0
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 0
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 30 8640 30
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 5 4500 0
123 Glibenklamida tablet 5 mg 110 6160 100 5600 50
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 0 0 0
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 230 19320 200 16800 200
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 0 0 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 520 47320 300 27300 300
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 2 4334 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 0
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 0 0 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 0 0 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 0
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 2 4400 0 2
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 0 0 20 104000 20
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 200 15800 200
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 1 31174 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 460 69920 0 60
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 0 0 100 12000 100
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 6 10800 0 3
326 Salisil Bedak 2 % 2 2500 5 6250 3
327 Salisil Bedak 2 % 0 0 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 5 26000 0 3
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 12 12936 10 10780 4
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 0 0 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 0 0 100 3410 40
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 730 346020 0
J U M LAH 2810 760103 2085 408930
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 15 9750 0
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 52 56628 50 54450 54
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 0
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 25 37500 0
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 128252.7 50 54450 54
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000
J U M LAH 0 3 0 25000 0
JUMLAH A+B+C+D 2930 888358.7 2135 488380 54

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : november

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 105 36120 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
0 100 9500 tablet 95
0 0 0 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
83520 180 46980 tablet 261
0 0 0 vial 7,396
9780 6 14670 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000

7200 0 0 tablet 72

10800 21 45360 botol 2,160

0 0 0 tube 2,516
0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
3200 50 1600 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
35840 130 14560 tablet 112
0 0 0 tablet 112
0 1 3150 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
0 0 0 botol 7,837
0 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
0 0 0 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
0 0 0 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
0 100 16700 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
0 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
8640 0 0 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 5 4500 botol 900
2800 160 8960 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
0 0 0 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
16800 230 19320 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
0 0 0 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
27300 520 47320 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 2 4334 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 0 0 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
0 0 0 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
0 0 0 tube 2,772
0 0 0 tube 2,010
4400 0 0 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
104000 0 0 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
15800 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 1 31174 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
9120 400 60800 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
12000 0 0 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
5400 3 5400 pot 1,800
3750 4 5000 kotak 1,250
0 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
15600 2 10400 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
4312 18 19404 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 0 0 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
1364 60 2046 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
0 730 346020 tablet 474
411626 2831 757407

0 15 9750 pcs 650


0 0 0 pcs 1,038
58806 48 52272 pcs 1,089
0 1 750 pcs 750
0 0 0 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
0 25 37500 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
58806 90 123896.7

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 1 25000 btl 25,000
0 0 0
470432 2921 881303.7

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESEHATA
KABUPATEN SITUBONDO
TAHUN 2018

NAMA PUSTU/POLINDES : PALANGAN


ALAMAT : JANGKAR

SALDO MUTASI MUTASI


NO NAMA BARANG JUMLAH JUMLAH
AWAL MASUK KELUAR

A OBAT - OBATAN
1 Air untuk injeksi ampul 25 ml 0 0 0
2 Albendazol suspensi 200 mg/5 ml 0 0 0
3 Albendazol tablet 400 mg 105 36120 0
4 Alopurinol tablet 100 mg 0 0 0
5 Alopurinol tablet 300 mg 0 0 0
6 Alprazolam tablet 0,25 mg 0 0 0
7 Alprazolam tablet 0,5 mg 0 0 0
8 Alprazolam tablet 1 mg 0 0 0
9 Ambroxol sirup 15 mg/ml 0 0 0
10 Ambroxol sirup 15 mg/ml 0 0 0
11 Ambroxol tablet 30 mg 0 0 0
12 Aminofilin injeksi 24 mg/ml 0 0 0
13 Aminofilin tablet 150 mg 100 9500 0 20
14 Aminofilin tablet 200 mg 0 0 0
15 Amitriptilin tablet salut 25 mg (HCl) 0 0 0
16 Amlodipin tablet 10 mg 0 0 0
17 Amlodipin tablet 5 mg 0 0 0
18 Amoksisilin + As. Klavulanat 625 mg tablet 0 0 0
19 Amoksisilin kapsul/kaplet 250 mg 0 0 0
20 Amoksisilin kapsul/kaplet 500 mg 180 46980 200 52200 320
21 Amoksisilin serbuk injeksi 1000 mg 0 0 0
22 Amoksisilin sirup kering 125 mg/ 5 ml 6 14670 0 3
23 Amoxsan tab 500 mg 0 0 0
24 Ampisilin serbuk injeksi i.m./i.v. 1000 mg/vial 0 0 0
25 Ampisilin syr 0 0 0
26 Ampisilin serbuk injeksi i.m./i.v. 500 mg/vial 0 0 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 0 0 100 7200 100
mg Magnesium Hidroksida 200 mg
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 21 45360 0 12
Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 0 0
10.000 IU/g
30 Antifungi DOEN Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% 0 0 0
Antihemoroid DOEN kombinasi : Bismut subgalat 150 mg
31 0 0 0
Heksaklorofen 2,5 mg
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 0 0
tablet 500 mg
33 Antimigren tablet: Ergotamin Tartrat 1 mg + Kofein 50 mg 0 0 0
34 Antrain inj 0 0 0
35 Aqua pro Injeksi steril, bebas pirogen 0 0 0
36 Artemether injeksi 80 mg/ml 0 0 0
37 Artesunate injeksi, vial 60 mg 0 0 0
38 Asam Asetilsalisilat tablet 100 mg (Asetosal) 0 0 0
39 Asam Asetilsalisilat tablet 500 mg (Asetosal) 0 0 0
40 Asam Askorbat (Vitamin C) tablet 50 mg 50 1600 200 6400 120
41 Asam Askorbat (Vitamin C) tablet 100 mg 0 0 0
42 Asam Askorbat (Vitamin C) tablet 250 mg 0 0 0
43 Asam Folat tablet 1 mg 0 0 0
44 Asam Mefenamat kapsul/kaplet 250 mg 0 0 0
45 Asam Mefenamat kapsul/kaplet 500 mg 130 14560 200 22400 200
46 Asam Mefenamat kapsul/kaplet 500 mg 0 0 0
47 Asiklovir krim 5% 1 3150 0
48 Asiklovir tablet 200 mg 0 0 0
49 Asiklovir tablet 400 mg 0 0 0
50 Asiklovir tablet 400 mg 0 0 0
51 Atapulgit tablet 600 mg 0 0 0
52 Atenolol tablet 100 mg 0 0 0
53 Atenolol tablet 50 mg 0 0 0
54 Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) 0 0 0
55 Atropin Sulfat tablet 0,5 mg 0 0 0
56 Benzatin Benzil Penisilin 1,2 juta IU/ vial 0 0 0
57 Benzatin Benzil Penisilin 2,4 juta IU/vial 0 0 0
Besi (II) Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah 0 0 0
58
darah kombinasi )
59 Betahistin Mesilat tablet 6 mg 0 0 0
60 Betametason krim 0,1 % (sebagai Valerat) 0 0 0
61 Bioplacenton 0 0 0
62 Bisakodil suppositoria 10 mg 0 0 0
63 Bisoprolol tablet 5 mg 0 0 0
64 Bromheksin tablet 8 mg 0 0 0
65 Buscopan inj 0 0 0
66 Cetirizin sirup 5 mg/5 ml 0 0 0
67 Cetirizine tablet 10 mg 0 0 0
68 Clobazam tablet 10 mg 0 0 0
69 Clobetasol krim 0,05% 0 0 0
70 Dapson tablet 100 mg 0 0 0
71 Deksametason injeksi i.v. 5 mg/ml 0 0 0
72 Deksametason injeksi i.v. 5 mg/ml 0 0 0
73 Deksametason tablet 0,5 mg 0 0 0
74 Dekstran 70 - larutan infus 6% steril 0 0 0
75 Dekstrometorfan sirup 10 mg/5 ml (HBr) 0 0 0
76 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
77 Dekstrometorfan tablet 15 mg (HBr) 0 0 0
78 Diazepam injeksi 10 mg/ml 0 0 0
79 Diazepam tablet 2 mg 0 0 0
80 Diazepam tablet 5 mg 0 0 0
81 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 0 0 0
83 Digoksin tablet 0,25 mg 0 0 0
84 Diltiazem HCl tablet 30 mg 0 0 0
85 Dimenhidrinat tablet 50 mg 0 0 0
86 Doksisiklin kapsul/kaplet 100 mg 0 0 0
87 Domperidon suspensi 5 mg/5 ml 0 0 0
88 Domperidon tablet 10 mg (EXP) 100 16700 0 100
89 Efedrin tablet 25 mg (HCl) 0 0 0
90 Ekstraks Belladona tablet 10 mg 0 0 0
91 Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) 0 0 0
92 Eritromisin kapsul/kaplet 250 mg 0 0 0
93 Eritromisin kapsul/kaplet 500 mg 0 0 0
94 Eritromisin sirup 200 mg/ 5 ml 0 0 0
95 Etakridin larutan 0,1% 0 0 0
96 Etambutol tablet 250 mg (HCl) 0 0 0
97 Etambutol tablet salut 500 mg (HCl) 0 0 0
98 Etanol 70% cairan ( 300 ml ) 0 0 0
99 Famotidine tablet 20 mg 0 0 0
100 Famotidine tablet 40 mg 0 0 0
101 Fenilbutason tablet 200 mg 0 0 0
102 Fenitoin kapsul/kaplet 100 mg 0 0 0
103 Fenitoin Natrium injeksi 50 mg/ml 0 0 0
104 Fenitoin Natrium kapsul/kaplet 30 mg 0 0 0
105 Fenobarbital injeksi i.m./i.v. 50 mg/ml 0 0 0
106 Fenobarbital tablet 100 mg 0 0 0
107 Fenobarbital tablet 30 mg 0 0 0
108 Fenoksimetil Penisilin tablet 250 mg 0 0 0
109 Fenoksimetil Penisilin tablet 500 mg 0 0 0
110 Fenol Gliserol tetes telinga 10% 0 0 0
111 Fitomenadion (Vit.K1) tablet salut gula 10 mg 0 0 0
112 Fitomenadion (Vitamin K1) injeksi 10 mg/ml 0 0 2 6834 2
113 Flukonazol tablet 150 mg 0 0 0
114 Furosemid injeksi i.v./i.m. 10 mg/ml 0 0 0
115 Furosemid tablet 40 mg 0 0 0
116 Garam Oralit I serbuk 0 0 50 14400 48
117 Gemfibrozil kapsul/kaplet 300 mg 0 0 0
118 Gemfibrozil tablet 600 mg 0 0 0
119 Gentamisin injeksi 40 mg/ ml 0 0 0
120 Gentamisin salep kulit 0.1% 0 0 0
121 Gentamisin Sulfat tetes mata 0,3 % 0 0 0
122 Gentian Violet larutan 1 % 5 4500 0
123 Glibenklamida tablet 5 mg 160 8960 0
124 Glimepiride tablet 1 mg 0 0 0
125 Glimepiride tablet 2 mg 0 0 0
126 Glimepiride tablet 2 mg 0 0 0
127 Glimepiride tablet 3 mg 0 0 0
128 Glimepiride tablet 4 mg 0 0 0
129 Gliquidon tablet 30 mg 0 0 0
130 Gliseril Gualakolat tablet 100 mg 0 0 0
131 Gliserin 0 0 0
132 Glukosa larutan infus 10 % steril 0 0 0
133 Glukosa larutan infus 40 % steril 0 0 0
134 Glukosa larutan infus 5 % steril 0 0 0
135 Griseofulvin tablet 125 mg 0 0 0
136 Haloperidol inj 50 mg/mL 0 0 0
137 Haloperidol tablet 0,5 mg 0 0 0
138 Haloperidol tablet 1,5 mg 0 0 0
139 Haloperidol tablet 5 mg 0 0 0
140 HCT 25 mg 0 0 0
141 Hidrokortison krim 1% 0 0 0
142 Hidrokortison krim 2,5 % 0 0 0
143 Hyoscine -N-Butilbromide tablet 10 mg 0 0 0
144 Ibuprofen suspensi 100 mg/5 ml 0 0 0
145 Ibuprofen suspensi 200 mg/5 ml 0 0 0
146 Ibuprofen tablet 200 mg 0 0 0
147 Ibuprofen tablet 200 mg 0 0 0
148 Ibuprofen tablet 400 mg 0 0 0
149 Ibuprofen tablet 400 mg 0 0 200 30000 200
150 Iodiol kapsul lunak 0 0 0
151 Isoniazid tablet 100 mg 0 0 0
152 Isoniazid tablet 300 mg 0 0 0
153 Isosorbid Dinitrat tablet sublingual 5 mg 0 0 0
154 Itrakonazol kapsul/kaplet 100 mg 0 0 0
155 Kalium Diklofenak tablet 25 mg 0 0 0
156 Kalium Diklofenak tablet 50 mg 0 0 0
157 Kalsium Laktat (Kalk) tablet 500 mg 0 0 0
158 Kaptopril tablet 12,5 mg 0 0 0
159 Kaptopril tablet 25 mg 230 19320 200 16800 70
160 Kaptopril tablet 50 mg 0 0 0
161 Karbamazepin tablet 200 mg 0 0 0
162 Ketokonazol krim 2% 0 0 0
163 Ketokonazol tablet 200 mg 0 0 0
164 Ketoprofen injeksi 100 mg 0 0 0
165 Ketoprofen tablet 100 mg 0 0 0
166 Ketorolac injeksi 10 mg 0 0 0
167 Ketorolac injeksi 30 mg 0 0 0
168 Klindamisin kapsul/kaplet 150 mg 0 0 0
169 Klindamisin kapsul/kaplet 300 mg 0 0 0
170 Klomifen tablet 50 mg 0 0 0
171 Klonidin tablet 0,15 mg 0 0 0
172 Klonidin tablet 0,15 mg 0 0 0
173 Kloramfenikol kapsul/kaplet 250 mg 0 0 0
174 Kloramfenikol salep mata 1 % 0 0 0
175 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
176 Kloramfenikol suspensi 125 mg/ 5 ml 0 0 0
177 Kloramfenicol tetes mata 0,5% 0 0 0
178 Kloramfenikol tetes telinga 3 % 0 0 0
179 Klorfeniramina Maleat (CTM) tablet 4 mg 520 47320 0 250
180 Klorokuin tablet 250 mg 0 0 0
181 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) 0 0 0
182 Klorpromazin injeksi i.m. 25 mg/ml (HCl) 0 0 0
183 Klorpromazin tablet salut 100 mg (HCl) 0 0 0
184 Klorpromazin tablet salut 25 mg (HCl) 0 0 0
185 Kodein tablet 10 mg 0 0 0
186 Kodein tablet 15 mg 0 0 0
187 Kodein tablet 20 mg 0 0 0
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg ,
188 0 0 0
Trimetoprim 80 mg
Kotrimoksazol DOEN II (pediatrik) kombinasi : Sulfametoksazol 100 mg
189 0 0 0
Trimetoprim 20 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim
190 2 4334 0
40 mg / 5 ml
191 Kuinin (Kina) tablet 200 mg 0 0 0
192 Kuinin Dihidroklorida injeksi 25% - 2 ml 0 0 0
193 Kuinin injeksi i.v. 25% (sebagai 2 HCl) 0 0 0
194 Lacto B 0 0 0
195 Lamivudine tablet 150 mg 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
196 0 0 0
Asetat 28 mEq) (ASERING)
Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
197 0 0 0
(KAEN 1B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr,
198 0 0 0
Na Lactat 2.24 gr, Dekstrosa 27 gr) (KAEN 3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat
199 0 0 0
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KAEN 3A)
200 Lanzoprazol kapsul/kaplet 30 mg 0 0 0
201 Levofloksasin tablet 500 mg 0 0 0
202 Levofloksasin tablet 500 mg 0 0 0
203 Lidokain injeksi 2% 0 0 0
204 Lidokain injeksi 2% 0 0 0
205 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml 3 4089 0
206 Lidokain jeli 2% 0 0 0
207 Linkomisin kapsul/kaplet 500 mg 0 0 0
208 Lisinopril tablet 10 mg 0 0 0
209 Lisinopril tablet 5 mg 0 0 0
210 Loperamid tablet 2 mg 0 0 0
211 Loratadin tablet 10 mg 0 0 0
212 Lorazepam tablet 2 mg 0 0 0
213 Lytacur 0 0 0
214 Magnesium Sulfat inj (IV) 20% - 25 ml 0 0 0
215 Magnesium Sulfat inj (IV) 40% - 25 ml 0 0 0
216 Mebendazol sirup 100 mg / 5 ml 0 0 0
217 Mebendazol tablet 100 mg 0 0 0
218 Meloksikam suppositoria 0 0 0
219 Meloksikam tablet 15 mg 0 0 0
220 Meloksikam tablet 7,5 mg 0 0 0
221 Menadion (Vitamin K3) injeksi 10 mg/ml 0 0 0
222 Metampiron injeksi 250 mg 0 0 0
223 Metampiron injeksi 250 mg 0 0 0
224 Metampiron tablet 500 mg 0 0 0
225 Metampiron tablet 500 mg 0 0 0
226 Metformin HCl tablet 500 mg exp 0 0 0
227 Metformin HCl tablet 850 mg 0 0 0
228 Metilergometrin Maleat injeksi 0,200 mg -1 ml 0 0 0
229 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg 0 0 0
230 Metilprednisolon injeksi 500 mg 0 0 0
231 Metilprednisolon tablet 16 mg 0 0 0
232 Metilprednisolon tablet 4 mg 0 0 0
233 Metilprednisolon tablet 8 mg 0 0 0
234 Metoklopramide injeksi 5 mg/ml 0 0 0
235 Metoklopramide sirup 5 mg/ 5 ml 0 0 0
236 Metoklopramide tablet 10 mg 0 0 0
237 Metoklopramide tablet 5 mg 0 0 0
238 Metronidazol infus 500 mg/100 ml 0 0 0
239 Metronidazol tablet 250 mg 0 0 0
240 Metronidazol tablet 500 mg 0 0 0
241 Metronidazol tablet 500 mg 0 0 0
242 Mikonazol krim/salep 2 % (Nitrat) 0 0 0
243 Mineral Mix, kombinasi 0 0 0
244 Momethason krim 0,1 % 0 0 0
245 Momethason krim 0,1 % 0 0 0
246 Morfin injeksi 10 mg/ml 0 0 0
247 Morfin tablet 10 mg 0 0 0
248 Natrium Diklofenak tablet 25 mg 0 0 0
249 Natrium Diklofenak tablet 50 mg 0 0 0
250 Natrium Klorida larutan infus 0,9 % 0 0 0
251 Neurobion 5000 injeksi 0 0 0
252 Nevirapin tablet 200 mg 0 0 0
253 Nifedipin tablet 10 mg 0 0 0
254 Nistatin tablet salut 500.000 IU/ g 0 0 0
255 Nistatin vaginal tablet 100.000 IU/ g 0 0 0
256 Norages inj 0 0 0
257 Obat Antituberkulosis FDC Kategori 1 0 0 0
258 Obat Antituberkulosis FDC Kategori 2 0 0 0
259 Obat Antituberkulosis FDC Kategori Anak 0 0 0
260 Obat Antituberkulosis FDC Sisipan 0 0 0
261 Obat Antituberkulosis Kategori 1 dewasa 0 0 0
262 Obat Antituberkulosis Kategori anak 0 0 0
263 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
264 Obat Batuk Hitam ( O.B.H. ) cairan 0 0 0
265 Ofloxacin tablet 200 mg 0 0 0
266 Ofloxacin tablet 400 mg 0 0 0
267 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 0 0 0
268 Oksitetrasiklin HCl salep mata 1 % 0 0 5 13860 4
269 Oksitetrasiklin salep kulit 3% /Bacitracin 0 0 0
270 Oksitosin injeksi 10 IU/ml - 1 ml 0 0 4 8800 4
271 Omeprazol kapsul/kaplet 20 mg 0 0 0
272 Oseltamivir kapsul/kaplet 75 mg 0 0 0
273 Papaverin injeksi 40 mg/ml 0 0 0
274 Papaverin tablet 40 mg 0 0 0
275 Parasetamol drops 0 0 0
276 Parasetamol sirup 120 mg / 5 ml 0 0 0
277 Parasetamol tablet 100 mg 0 0 0
278 Parasetamol tablet 500 mg 0 0 200 15800 200
279 Perfenazin tablet 4 mg (HCl) 0 0 0
280 Permetrin krim 5% 0 0 0
281 Petidin injeksi 50 mg/ml 0 0 0
282 Piracetam injeksi 1 g/5 ml 0 0 0
283 Piracetam injeksi 3 g/15 ml 0 0 0
284 Piracetam injeksi 3 g/15 ml 0 0 0
285 Piracetam tablet 1200 mg 0 0 0
286 Piracetam tablet 400 mg 0 0 0
287 Piracetam tablet 800 mg 0 0 0
288 Pirantel sirup 125 mg/5 ml 0 0 0
289 Pirantel tablet score (base) 125 mg 0 0 0
290 Pirazinamid tablet 500 mg 0 0 0
291 Piridoksin (Vitamin B6) tablet 10 mg (HCL) 0 0 0
292 Piroksikam kapsul/kaplet/tablet 10 mg 0 0 0
293 Piroksikam kapsul/kaplet/tablet 20 mg 0 0 0
294 Povidon Iodida larutan 10% 1 31174 0
295 Povidon Iodida larutan 10% 30mL 0 0 0
296 Povidon Iodida larutan 10% 300 mL 0 0 0
297 Povidon Iodida larutan 10% 0 0 0
298 Pravastatin tablet 20 mg 0 0 0
299 Prednison tablet 5 mg 400 60800 0
300 Primakuin tablet 15 mg 0 0 0
301 Primperan inj 0 0 0
302 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial 0 0 0
303 Propanolol tablet 10 mg ( HCl ) 0 0 0
304 Propanolol tablet 40 mg (HCl) 0 0 0
305 Propiltiourasil tablet 100 mg 0 0 0
306 Ramipril tablet 2,5 mg 0 0 0
307 Ramipril tablet 5 mg 0 0 0
308 Ranitidin injeksi 25 mg/2 ml 0 0 0
309 Ranitidin tablet 150 mg 0 0 0
310 Ranitidin tablet 150 mg 0 0 0
311 Reserpin tablet 0,10 mg 0 0 0
312 Reserpin tablet 0,25 mg 0 0 0
313 Retinol (Vitamin A) 100.000 IU kapsul lunak 0 0 0
314 Retinol (Vitamin A) 200.000 IU kapsul lunak 0 0 0
315 Rifampisin kapsul/kaplet 300 mg 0 0 0
316 Rifampisin kapsul/kaplet 600 mg 0 0 0
317 Rifampisin tablet salut 450 mg 0 0 0
318 Ringer Laktat larutan infus 0 0 0
319 Risperidon tablet 1 mg 0 0 0
320 Risperidon tablet 2 mg 0 0 0
321 Risperidon tablet 3 mg 0 0 0
322 SABU I 0 0 0
323 Salbutamol tablet 2 mg (sebagai Sulfat) 0 0 0
324 Salbutamol tablet 4 mg (sebagai Sulfat) 0 0 0
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 3 5400 0 2
326 Salisil Bedak 2 % 4 5000 0 2
327 Salisil Bedak 2 % 0 0 0
328 Sanmol syr 0 0 0
329 Sanmol tab 0 0 0
330 Sefadroksil kapsul/kaplet 250 mg 0 0 0
331 Sefadroksil kapsul/kaplet 500 mg 0 0 0
332 Sefadroksil kapsul/kaplet 500 mg 0 0 0
333 Sefadroksil sirup kering 125 mg/5ml 2 10400 0
334 Sefaleksin kapsul/kaplet 250 mg 0 0 0
335 Sefaleksin kapsul/kaplet 500 mg 0 0 0
336 Sefazolin injeksi 1 g 0 0 0
337 Sefiksim 400 mg + Azitromisin 1000 mg 0 0 0
338 Sefiksim kapsul/kaplet 100 mg 0 0 0
339 Sefiksim sirup kering 100 mg/ 5 ml 0 0 0
340 Sefotaksim injeksi 0,5 g 0 0 0
341 Sefotaksim injeksi 1 g 0 0 0
342 Seftazidim injeksi 1 g 0 0 0
343 Seftriakson injeksi 1 g 0 0 0
344 Seftriakson injeksi 1 g 0 0 0
345 Serum A.T.S injeksi 1.500 UI/amp (i.m.) 0 0 0
346 Sianokobalamin (vitamin B12) injeksi 500 mcg 18 19404 0 6
347 Sianokobalamin (vitamin B12) tablet 50 mcg 0 0 0
348 Simetidin tablet 200 mg 0 0 0
349 Simvastatin tablet 10 mg 0 0 0
350 Simvastatin tablet 20 mg 0 0 0
351 Simvastatin tablet 5 mg 0 0 0
352 Siprofloksasin infus 2% 0 0 0
353 Siprofloksasin tablet 250 mg (sebagai HCl) 0 0 0
354 Siprofloksasin tablet 500 mg (sebagai HCl) 0 0 0
355 Spasminal tab 0 0 0
356 Spiramisin tablet 500 mg 0 0 0
357 Spironolakton tablet 100 mg 0 0 0
358 Spironolakton tablet 25 mg 0 0 0
359 Stavudin tablet 30 mg 0 0 0
360 Streptomisin serbuk injeksi i.v 1000 mg/ml 0 0 0
361 Sulfasalazin tablet 500 mg 0 0 0
362 Sulfasetamida Natrium tetes mata 15 % 0 0 0
363 Syntosinon inj 0 0 0
364 Tamoksifen tablet 20 mg 0 0 0
365 Tetrakain HCl tetes mata 0,5% 0 0 0
366 Tetrasiklin kapsul/kaplet 250 mg 0 0 0
367 Tetrasiklin kapsul/kaplet 500 mg 0 0 0
368 Tiamfenikol kapsul/kaplet 250 mg 0 0 0
369 Tiamfenikol kapsul/kaplet 500 mg 0 0 0
370 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 0 0 0
371 Tiamin (Vitamin B1) 100 mg tablet 0 0 0
372 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
373 Tiamin (Vitamin B1) injeksi 100 mg/ml 0 0 0
374 Tramadol injeksi 50 mg/ml 0 0 0
375 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
376 Tramadol kapsul/kaplet/tablet 50 mg 0 0 0
377 Transamin tab 0 0 0
378 Trifluoperazin tablet 5 mg 0 0 0
379 Triheksifenidil tablet 2 mg 0 0 0
380 Ulsikur inj 0 0 0
381 Valdimex Injeksi 5mg/ml (i.v.) 0 0 0
382 Valdimex tablet 5 mg 0 0 0
383 Verapamil tablet 80 mg (HCl) 0 0 0
384 Vicillin 1gr inj 0 0 0
385 Vitamin B Kompleks tablet 60 2046 100 3410 120
386 Zidovudin tablet 100 mg 0 0 0
387 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg 0 0 0
388 Zinc drop 10 mg/mL 0 0 0
389 Zinc tablet 20 mg 730 346020 0 30
J U M LAH 2831 757407 1461 198104
B PERBEKALAN KESEHATAN
1 Alat suntik sekali pakai 1 ml 15 9750 5 3250
2 Alat suntik sekali pakai 2,5 ml 0 0 0
3 Alat suntik sekali pakai 3 ml 48 52272 50 54450 14
4 Alat suntik sekali pakai 5 ml 1 750 0
5 Catgut/benang bedah no.2/0 dengan jarum bedah 0 0 1 5583.33
6 Catgut/benang bedah no.3/0 dengan jarum bedah 0 0 0
7 Infusion set anak 0 0 0
8 Infusion set dewasa 0 0 0
9 IV Catheter No. 20 G 0 0 0
10 IV Catheter No. 22 G 0 0 0
11 IV Catheter No. 24 G 0 0 0
12 Kapas Berlemak 500 gram 0 0 0
13 Kapas Pembalut / Absorben 250 gram 0 0 0
14 Kasa Hidrofil uk. 16 x 16 (isi 16 lembar) 0 0 0
15 Kasa Hidrofil uk. 36 m x 80 cm 0 0 0
16 Kasa Hidrofil uk. 40 m x 80 cm 0 0 0
17 Kasa Pembalut Hidrofil 4 m x 5 0 0 0
18 Kasa Pembalut Hidrofil 4 m x 10 cm 25 37500 0 3
19 Kasa Pembalut Elastic 3 inchi 0 0 0
20 Kasa Pembalut Elastic 4 inchi 0 0 0
21 Kasa Pembalut Elastic 7,5 cm x 4,5m 0 0 0
22 Kasa Pembalut Elastic 10 cm x 4,5m 0 0 0
23 Pembalut Gips 3 ichi 0 0 0
24 Plester 5 yards x 2 inch 1 23624.7 0
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah 0 0 0
26 Ultrafix 5x5 0 0 0
27 Urine Bag 0 0 0
28 Foley Catheter 0 0 0
29 Handscoon 0 0 0
30 Masker 0 0 0
J U M LAH 120 123896.7 56 63283.3 17
C OBAT GIGI
1 Etil Klorida spray 0 0
2 Eugenol cairan 0 0
3 Formokresol cairan 0 0
4 Glass Ionomer Cement ART 0 0
5 Gutta Percha dan Paper points 15-40 mm 0 0
6 Gutta Percha dan Paper points 45-80 mm 0 0
7 Kalsium Hidroksida Pasta 0 0
8 Klorfenol kamfer Menthol ( CHKM ) 0 0
9 Komposit resin 0 0
10 Devitalisasi Pasta (Non Arsen) 0 0
11 Mummifying Pasta 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 0
13 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan 0 0
J U M LAH 0 0 0 0 0
D OBAT TAMBAHAN
1 Masker 1 0
2 Handscoon 2 0
3 Spuit insulin 1 cc 0 0
4 Spuit 3 cc 0 0
5 Foley Catheter 0 0
6 Larutan mengandung Elektrolit 0 0
7 Zink syr 0 0
8 Etanol 70% cairan ( 1000 ml ) 0 1 25000
J U M LAH 0 3 0 25000 0
JUMLAH A+B+C+D 2951 881306.7 1517 286387 17

KEPALA PUSKESMAS JANGKAR YANG MELAPORKAN

drg. ABDUL FATAH AHADI MUCH ANDRI MAULIDIN


NIP. 19720729 200604 1 014 _
EKALAN KESEHATAN PUSKESMAS

TAHUN : 2018
BULAN : Desember

SALDO
JUMLAH JUMLAH SATUAN HARGA SATUAN
AKHIR

0 0 0 vial 3,509
0 0 0 botol 3,849
0 105 36120 tablet 344
0 0 0 tablet 86
0 0 0 tablet 200
0 0 0 tablet 435
0 0 0 tablet 460
0 0 0 tablet 233
0 0 0 botol 2,400
0 0 0 botol 2,400
0 0 0 tablet 127
0 0 0 ampul 3,822
1900 80 7600 tablet 95
0 0 0 tablet 80
0 0 0 tablet 112
0 0 0 tablet 330
0 0 0 tablet 240
0 0 0 tablet 4,550
0 0 0 tablet 190
83520 60 15660 tablet 261
0 0 0 vial 7,396
7335 3 7335 botol 2,445
0 0 0 tablet 3,161
0 0 0 vial 5,100
0 0 0 botol 5,100
0 0 0 vial 3,000

7200 0 0 tablet 72

25920 9 19440 botol 2,160

0 0 0 tube 2,516
0 0 0 pot 1,904
0 0 0 suppo 2,450

0 0 0 tablet 478
0 0 0 tablet 123
0 0 0 ampul 9,240
0 0 0 vial 5,000
0 0 0 ampul 22,167
0 0 0 ampul 25,063
0 0 0 tablet 100
0 0 0 tablet 162
3840 130 4160 tablet 32
0 0 0 tablet 51
0 0 0 tablet 135
0 0 0 tablet 48
0 0 0 tablet 121
22400 130 14560 tablet 112
0 0 0 tablet 112
0 1 3150 tube 3,150
0 0 0 tablet 237
0 0 0 tablet 336
0 0 0 tablet 336
0 0 0 tablet 190
0 0 0 tablet 654
0 0 0 tablet 346
0 0 0 ampul 1,230
0 0 0 tablet 74
0 0 0 ampul 8,935
0 0 0 ampul 12,185
0 0 0 tablet 44
0 0 0 tablet 924
0 0 0 tube 1,520
0 0 0 tube 12,650
0 0 0 suppo 6,045
0 0 0 tablet 511
0 0 0 tablet 51
0 0 0 ampul 21,758
0 0 0 botol 7,837
0 0 0 tablet 181
0 0 0 tablet 760
0 0 0 tube 4,000
0 0 0 tablet 44
0 0 0 ampul 1,580
0 0 0 ampul 1,580
0 0 0 tablet 62
0 0 0 botol 39,079
0 0 0 botol 1,379
0 0 0 tablet 90
0 0 0 tablet 90
0 0 0 ampul 2,344
0 0 0 tablet 35
0 0 0 tablet 56
0 0 0 tablet 93
0 0 0 ampul 1,050
0 0 0 tablet 97
0 0 0 tablet 123
0 0 0 tablet 104
0 0 0 tablet 220
0 0 0 botol 3,624
16700 0 0 tablet 167
0 0 0 tablet 51
0 0 0 tablet 38
0 0 0 ampul 8,100
0 0 0 tablet 497
0 0 0 tablet 864
0 0 0 botol 7,700
0 0 0 botol 3,223
0 0 0 tablet 305
0 0 0 tablet 410
0 0 0 botol 2,500
0 0 0 tablet 113
0 0 0 tablet 173
0 0 0 tablet 97
0 0 0 tablet 133
0 0 0 ampul 20,250
0 0 0 tablet 93
0 0 0 ampul 1,716
0 0 0 tablet 144
0 0 0 tablet 165
0 0 0 tablet 272
0 0 0 tablet 465
0 0 0 botol 1,008
0 0 0 tablet 630
6834 0 0 ampul 3,417
0 0 0 tablet 22,000
0 0 0 ampul 1,829
0 0 0 tablet 85
13824 2 576 sachet 288
0 0 0 tablet 289
0 0 0 tablet 680
0 0 0 ampul 3,104
0 0 0 tube 1,350
0 0 0 botol 2,904
0 5 4500 botol 900
0 160 8960 tablet 56
0 0 0 tablet 266
0 0 0 tablet 490
0 0 0 tablet 490
0 0 0 tablet 1,000
0 0 0 tablet 912
0 0 0 tablet 645
0 0 0 tablet 43
0 0 0 botol 4,158
0 0 0 botol 5,727
0 0 0 botol 1,960
0 0 0 botol 5,200
0 0 0 tablet 209
0 0 0 ampul 83,333
0 0 0 tablet 59
0 0 0 tablet 73
0 0 0 tablet 96
0 0 0 tablet 36
0 0 0 tube 2,775
0 0 0 tube 2,798
0 0 0 tablet 395
0 0 0 botol 3,499
0 0 0 botol 4,455
0 0 0 tablet 110
0 0 0 tablet 110
0 0 0 tablet 150
30000 0 0 tablet 150
0 0 0 kapsul 980
0 0 0 tablet 44
0 0 0 tablet 85
0 0 0 tablet 88
0 0 0 tablet 1,300
0 0 0 tablet 332
0 0 0 tablet 425
0 0 0 tablet 81
0 0 0 tablet 62
5880 360 30240 tablet 84
0 0 0 tablet 134
0 0 0 tablet 245
0 0 0 tube 2,569
0 0 0 tablet 300
0 0 0 ampul 2,542
0 0 0 tablet 608
0 0 0 ampul 1,616
0 0 0 ampul 7,800
0 0 0 tablet 361
0 0 0 tablet 553
0 0 0 tablet 1,400
0 0 0 tablet 184
0 0 0 tablet 188
0 0 0 tablet 356
0 0 0 tube 1,562
0 0 0 botol 3,700
0 0 0 botol 3,700
0 0 0 botol 4,950
0 0 0 botol 2,343
22750 270 24570 tablet 91
0 0 0 tablet 107
0 0 0 ampul 1,050
0 0 0 ampul 1,100
0 0 0 tablet 245
0 0 0 tablet 168
0 0 0 tablet 470
0 0 0 tablet 800
0 0 0 tablet 1,045
0 0 0 tablet 138

0 0 0 tablet 72

0 2 4334 botol 2,167


0 0 0 tablet 610
0 0 0 ampul 4,227
0 0 0 ampul 5,706
0 0 0 sachet 3,850
0 0 0 tablet 1,267
0 0 0 botol 9,000

0 0 0 botol 9,000

0 0 0 botol 10,000

0 0 0 botol 10,000
0 0 0 tablet 473
0 0 0 tablet 528
0 0 0 tablet 528
0 0 0 ampul 850
0 0 0 ampul 850
0 3 4089 ampul 1,363
0 0 0 syringe 40,000
0 0 0 tablet 520
0 0 0 tablet 550
0 0 0 tablet 320
0 0 0 tablet 89
0 0 0 tablet 154
0 0 0 tablet 1,341
0 0 0 botol 11,000
0 0 0 ampul 6,600
0 0 0 ampul 6,600
0 0 0 botol 3,534
0 0 0 tablet 225
0 0 0 suppo 6,600
0 0 0 tablet 506
0 0 0 tablet 234
0 0 0 ampul 1,250
0 0 0 ampul 1,200
0 0 0 ampul 1,200
0 0 0 tablet 220
0 0 0 tablet 145
0 0 0 tablet 113
0 0 0 tablet 220
0 0 0 ampul 3,499
0 0 0 tablet 140
0 0 0 ampul 59,000
0 0 0 tablet 635
0 0 0 tablet 296
0 0 0 tablet 370
0 0 0 ampul 5,500
0 0 0 botol 2,830
0 0 0 tablet 110
0 0 0 tablet 100
0 0 0 botol 9,950
0 0 0 tablet 110
0 0 0 tablet 160
0 0 0 tablet 160
0 0 0 tube 3,000
0 0 0 sachet 2,450
0 0 0 tube 17,500
0 0 0 tube 3,955
0 0 0 ampul 10,499
0 0 0 tablet 1,206
0 0 0 tablet 133
0 0 0 tablet 176
0 0 0 botol 4,700
0 0 0 ampul 6,006
0 0 0 tablet 2,613
0 0 0 tablet 110
0 0 0 tablet 640
0 0 0 ovula 407
0 0 0 ampul 8,030
0 0 0 paket 359,950
0 0 0 paket 1,198,000
0 0 0 paket 214,900
0 0 0 paket 159,898
0 0 0 paket 288,100
0 0 0 paket 171,900
0 0 0 botol 1,259
0 0 0 botol 5,940
0 0 0 tablet 413
0 0 0 tablet 650
0 0 0 ampul 8,800
11088 1 2772 tube 2,772
0 0 0 tube 2,010
8800 0 0 ampul 2,200
0 0 0 tablet 211
0 0 0 tablet 13,000
0 0 0 ampul 1,150
0 0 0 tablet 119
0 0 0 botol 5,200
0 0 0 botol 1,438
0 0 0 tablet 32
15800 0 0 tablet 79
0 0 0 tablet 34
0 0 0 tube 11,475
0 0 0 ampul 13,191
0 0 0 ampul 1,925
0 0 0 ampul 3,800
0 0 0 ampul 3,800
0 0 0 tablet 776
0 0 0 tablet 194
0 0 0 tablet 400
0 0 0 botol 8,360
0 0 0 tablet 298
0 0 0 tablet 198
0 0 0 tablet 17
0 0 0 tablet 70
0 0 0 tablet 100
0 1 31174 botol 31,174
0 0 0 botol 2,163
0 0 0 botol 14,203
0 0 0 botol 2,400
0 0 0 tablet 2,400
0 400 60800 tablet 152
0 0 0 tablet 144
0 0 0 ampul 9,900
0 0 0 ampul 6,100
0 0 0 tablet 65
0 0 0 tablet 108
0 0 0 tablet 284
0 0 0 tablet 300
0 0 0 tablet 530
0 0 0 ampul 1,140
0 0 0 tablet 120
0 0 0 tablet 120
0 0 0 tablet 81
0 0 0 tablet 103
0 0 0 kapsul 242
0 0 0 kapsul 432
0 0 0 tablet 376
0 0 0 tablet 830
0 0 0 tablet 594
0 0 0 botol 5,200
0 0 0 tablet 1,400
0 0 0 tablet 1,008
0 0 0 tablet 2,500
0 0 0 vial 398,420
0 0 0 tablet 59
0 0 0 tablet 97
3600 1 1800 pot 1,800
2500 2 2500 kotak 1,250
0 0 0 kotak 1,250
0 0 0 botol 10,384
0 0 0 tablet 242
0 0 0 tablet 468
0 0 0 tablet 509
0 0 0 tablet 510
0 2 10400 botol 5,200
0 0 0 tablet 365
0 0 0 tablet 972
0 0 0 vial 18,585
0 0 0 paket 33,000
0 0 0 tablet 859
0 0 0 botol 10,558
0 0 0 vial 3,500
0 0 0 vial 2,950
0 0 0 ampul 27,086
0 0 0 vial 3,300
0 0 0 vial 3,300
0 0 0 ampul 137,500
6468 12 12936 ampul 1,078
0 0 0 tablet 14
0 0 0 tablet 111
0 0 0 tablet 169
0 0 0 tablet 391
0 0 0 tablet 230
0 0 0 botol 45,000
0 0 0 tablet 237
0 0 0 tablet 255
0 0 0 tablet 517
0 0 0 tablet 1,386
0 0 0 tablet 950
0 0 0 tablet 311
0 0 0 tablet 843
0 0 0 vial 3,650
0 0 0 tablet 415
0 0 0 botol 3,226
0 0 0 ampul 12,045
0 0 0 tablet 1,700
0 0 0 botol 11,500
0 0 0 tablet 149
0 0 0 tablet 300
0 0 0 tablet 319
0 0 0 tablet 431
0 0 0 tablet 38
0 0 0 tablet 81
0 0 0 ampul 680
0 0 0 ampul 680
0 0 0 ampul 5,200
0 0 0 tablet 189
0 0 0 tablet 189
0 0 0 tablet 1,518
0 0 0 tablet 405
0 0 0 tablet 40
0 0 0 ampul 7,480
0 0 0 ampul 12,100
0 0 0 tablet 1,210
0 0 0 tablet 215
0 0 0 vial 10,560
4092 40 1364 tablet 34
0 0 0 tablet 949
0 0 0 tablet 3,117
0 0 0 botol 12,840
14220 700 331800 tablet 474
314671 2479 640840

0 20 13000 pcs 650


0 0 0 pcs 1,038
15246 84 91476 pcs 1,089
0 1 750 pcs 750
0 1 5583.33 pcs 5,583
0 0 0 pcs 5,583
0 0 0 pcs 3,500
0 0 0 pcs 3,509
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 pcs 9,185
0 0 0 roll 16,500
0 0 0 roll 12,500
0 0 0 kotak 5,800
0 0 0 roll 159,500
0 0 0 roll 105,000
0 0 0 roll 750
4500 22 33000 roll 1,500
0 0 0 roll 6,985
0 0 0 roll 9,955
0 0 0 roll 33,000
0 0 0 roll 41,800
0 0 0 roll 23,485
0 1 23624.7 pcs 23,625
0 0 0 kotak 110,000
0 0 0 roll 23,625
0 0 0 pcs 3,000
0 0 0 pcs 8,000
0 0 0 pasang 4,250
0 0 0 kotak 22,000
19746 129 167434.03

0 0 0 botol 189,750
0 0 0 kotak 550,000
0 0 0 botol 53,130
0 0 0 set 822,250
0 0 0 set 41,745
0 0 0 set 41,745
0 0 0 kotak 158,125
0 0 0 botol 58,300
0 0 0 buah 360,415
0 0 0 kotak 170,775
0 0 0 kotak 232,100
0 0 0 set 93,500
0 0 0 set 33,990
0 0 0

0 0 0 kotak 40,000
0 0 0 kotak 212,500
0 0 0 pcs 3,500
0 0 0 pcs 1,500
0 0 0 pcs 27,000
0 0 0 btl 9,000
0 0 0 btl 7,400
0 1 25000 btl 25,000
0 0 0
334417 2608 808274.03

PENGELOLA OBAT

MARTINA
NIP. 19710817 200701 2 015

34 1
98 1
98 3
73
303 5
2
5
4

11
LAPORAN MUTASI BARANG PERSEDIAAN OBAT DAN PERBEKALAN KESE
7 Alprazolam tablet 0,5 mg 0 0 50 23000 50
13 Aminofilin tablet 150 mg 0 0 340 32300 340
17 Amlodipin tablet 5 mg 0 0 6 1440 6
21 Amoksisilin serbuk injeksi 1000 mg 0 0 2 14792 2
23 Amoxsan tab 500 mg 0 0 230 727030 230
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
27 11520 209520
mg Magnesium Hidroksida 200 mg 160 2910 1270
Antasida DOEN II suspensi, kombi : Aluminium Hidroksida 200 mg/5 ml
28 0 222480
Magnesium Hidroksida 200 mg/5 ml 0 103 103
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g + Polimiksin
29 0 12580
10.000 IU/g 0 5 5
Antimalaria DOEN kombinasi : Pirimetamin tablet 25 mg Sulfadoksin
32 0 32982
tablet 500 mg 0 69 69
66 Cetirizin sirup 5 mg/5 ml 5 39185 20 156740 25
73 Deksametason tablet 0,5 mg 0 0 400 24800 400
82 Difenhidramin injeksi i.m. 10 mg/ml (HCl) 0 0 107 112350 107
130 Gliseril Gualakolat tablet 100 mg 0 0 730 31718.5 730
162 Ketokonazol krim 2% 0 0 5 12845 5
249 Natrium Diklofenak tablet 50 mg 0 0 50 8800 50
275 Parasetamol drops 41 213200 40 208000 81
325 Salep 2-4 , Kombinasi: Asam Salisilat 2% + Belerang endap 4% 0 0 14 25200 14
327 Salisil Bedak 2 % 0 0 3 3750 3
362 Sulfasetamida Natrium tetes mata 15 % 0 0 20 64520 20
ALAN KESEHATAN PUSKESMAS
23000 0 0 tablet 460
32300 0 0 tablet 95
1440 0 0 tablet 240
14792 0 0 vial 7,396
727030 0 0 tablet 3,161
91440 1800 129600 tablet 72

222480 0 0 botol 2,160

12580 0 0 tube 2,516

32982 0 0 tablet 478


195925 0 0 botol 7,837
24800 0 0 tablet 62
112350 0 0 ampul 1,050
31718.5 0 0 tablet 43
12845 0 0 tube 2,569
8800 0 0 tablet 176
421200 0 0 botol 5,200
25200 0 0 pot 1,800
3750 0 0 kotak 1,250
64520 0 0 botol 3,226
18 Kasa Pembalut Hidrofil 4 m x 10 cm roll
19 Kasa Pembalut Elastic 3 inchi roll
20 Kasa Pembalut Elastic 4 inchi roll
21 Kasa Pembalut Elastic 7,5 cm x 4,5m roll
22 Kasa Pembalut Elastic 10 cm x 4,5m roll
23 Pembalut Gips 3 ichi roll
24 Plester 5 yards x 2 inch pcs
25 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah kotak
26 Ultrafix 5x5 roll

27 Urine Bag pcs

28 Foley Catheter pcs


29 Handscoon pasang
30 Masker kotak
D OBAT TAMBAHAN
1 Masker kotak
2 Handscoon kotak
3 Spuit insulin 1 cc pcs
4 Spuit 3 cc pcs
5 Foley Catheter pcs
6 Larutan mengandung Elektrolit btl
7 Zink syr btl
8 Etanol 70% cairan ( 1000 ml ) btl

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