Format Lap Akhir Tahun PKM Dan LPLPO

Laporan Perhitungan Stock Persediaan
per 30 Desember Tahun 2017

UPT Puskesmas : Panghegar
Saldo Awal (31/12/2016) Penambahan ( Jan-Des 2017)
No Jenis Barang Satuan

Harga Satuan Jumlah Harga Jumlah Harga Satuan
Jumlah Barang
Barang
Rp Rp Rp
1 2 3 4 5 6 7 8
LIFE SAVING
1 Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml Ampul 9 1,999.80 17,998.20 0 1,999.80
2 Diazepam Lar Rektal 10 mg/ml Tube 0 16,748.00 - 15 16,748.00
3 Epinefrin HCL Inj Ampul 14 8,100.00 113,400.00 18 8,100.00
4 Kalsium Glukonat inj 100 mg / ml Ampul 0 9,955.00 - 0 9,955.00
5 Mg Sulfat Inj 40 % - IV/10 vial Ampul 0 3,650.00 - 0 3,650.00
6 Oksitosin Inj 10 lU/ml 1 ml Ampul 5 2,200.00 11,000.00 0 2,200.00
ANTIINFEKSI
7 ACT ( arthesunat ) Tablet 0 1,333.29 - 0 1,333.29
8 Acyclovir tab 400 mg Tablet 130 345.00 44,850.00 4,300 345.00
9 Albendazol 400 mg Tablet 0 1,356.00 - 7,800 1,356.00
10 Albendazol susp 200 mg/5 ml Botol 0 - - 0 -
11 Amoksilin Kap. 250 mg Kapsul 12114 136.00 1,647,504.00 24,500 136.00
12 Amoksilin Kap.500 mg Tablet 0 232.00 - 26,000 232.00
13 Amoksilin syr kering 125 mg/ ml Botol 186 2,445 454,770.00 760 2,445.00
14 Amoksilin syr kering 250 mg/ ml Botol 12 4,045.00 48,540.00 400 4,045.00
15 Amoksisilin Drops 100 mg/ml Botol 0 20,350.00 - 108 20,350.00
16 Azitromisin 500 mg Kaplet 0 1,900.00 - 0 1,900.00
17 Benzatin Benzil P 2,4 Vial 0 13,400.00 - 0 13,400.00
18 Cefixim tab 100 mg Tablet 0 859.00 - 0 859.00
19 Ciprofloxacin 500 mg Tablet 0 346.50 - 1,500 346.50
20 Dietilkarbamazin Tablet 0 3,566.77 - 0 3,566.77
21 Doxyciclin 100 mg Tablet 0 249.70 - 0 249.70
22 Erytromicin 250 mg Tablet 0 497.00 - 0 497.00
23 Ethambutol 250 mg Tablet 0 314.00 - 0 314.00
24 Flukonazol kaps 50 mg Capsul 0 22,000.00 - 0 22,000.00
25 Gentamisin 40 mg / 2ml inj Ampul 0 5,900.00 - 0 5,900.00
26 Griseofulvin125 mg Tablet 0 219.00 - 0 219.00
27 Isoniazide 100 mg Tablet 0 138.00 - 0 138.00
28 Isoniazide 300 mg Tablet 0 110.00 - 0 110.00
29 Ketoconazole 200 mg Tablet 396 300.00 118,800.00 1,050 300.00
30 Klindamisin 150 mg Capsul 300 382.00 114,600.00 1,350 382.00
31 Klindamisin 300 mg Capsul 590 527.00 310,930.00 2,800 527.00
32 Kloramfenikol 250 mg capsul Capsul 300 349.80 104,940.00 600 349.80
33 Kloramfenikol 500 mg capsul Capsul 0 1,007.00 - 2,500 1,007.00
34 Kloramfenikol susp 125 mg / 5 ml Botol 50 3,955.00 197,750.00 250 3,955.00
35 Kombipak IMS Kotak 0 330.00 - 0 330.00
36 Kotrimoksazol Adult 480 mg Tablet 448 135.00 60,480.00 2,200 135.00
37 Kotrimoksazol Suspensi 240 mg/5 ml Botol 52 2,145.00 111,540.00 100 2,145.00
38 Metronidazol 250 mg Tablet 0 110.00 - 1,400 110.00
39 Metronidazol 500 mg Tablet 0 160.00 - 2,700 160.00
40 Natrium Tiroksin Tablet 0 1,550.00 - 0 1,550.00
41 Nistatin 100.000 IU/g tablet vagina Tablet 92 480.00 44,160.00 500 480.00
42 Nistatin susp 100.000 UI / ml Botol 0 31,350.00 - 0 31,350.00
43 Obat Anti TBC Anak FDC Paket 2 214,985.00 429,970.00 1 214,985.00
44 Obat Anti TBC Kat I FDC Paket 2 359,900.00 719,800.00 25 359,900.00
45 Obat Anti TBC Kat II FDC Paket 0 1,199,900.00 - 1 1,199,900.00
46 Obat Anti TBC Kombipak Paket 0 59,400.00 - 0 59,400.00
47 Pyrantel Pamoat 125 mg Tablet 120 311.00 37,320.00 0 311.00
48 Pyrazinamide 500 mg Tablet 0 198.00 - 0 198.00
49 Pyrimethamine 25 mg Tablet 0 1,315.00 - 0 1,315.00
50 Rifampicin 300 mg Tablet 0 410.78 - 0 410.78
53 Sefadroxil kapsul 500 mg Capsul 0 520.00 - 0 520.00
54 Sefadroxil syr kering 125 mg/ml Botol 0 5,200.00 - 0 5,200.00
55 Streptomicin Inj. Ampul 0 3,650.00 - 0 3,650.00
56 Tetracyclin 250 mg Tablet 770 148.00 113,960.00 0 148.00
-
SALURAN PERNAPASAN
57 Ambroxol Syrup 15 mg Botol 150 104.50 15,675.00 2,700 104.50
58 Ambroxol tab 30 mg Tablet 409 2,530.00 1,034,770.00 9,100 2,530.00
59 Aminopilina 200 mg Tablet 160 90.00 14,400.00 500 90.00
60 Gliseril Guayakolat 100 mg Tablet 1030 39.60 40,788.00 13,000 39.60
Komb : Ipatropium Br 0.5 mg, salbutamol 2,5
61 Vial 20 5,990.00 119,800.00 5,990.00
mg nebules 0
62 N-asetil sistein kaps 200 mg Kapsul 480 426.00 204,480.00 17,400 426.00
63 Obat Batuk Anak Syrup Botol 160 6,600.00 1,056,000.00 550 6,600.00
64 Salbutamol 2 mg Tablet 20 4,000.00 80,000.00 4,200 4,000.00
65 Salbutamol 2.5 mg nebules Vial 200 59.00 11,800.00 0 59.00
ANALGETIK,ANTIPIRETIK,ANTIINFLAMASI,AINS
66 Antimigren Tablet 0 113.00 - 0 113.00
67 Asam Mefenamat 500 mg Tablet 0 112.00 - 0 112.00
68 Betahistine mysilat 6 mg Tablet 55 385.00 21,175.00 300 385.00
69 Etil Klorida Semprot 100 ml Botol 3 94,270.00 282,810.00 10 94,270.00
70 Ibuprofen 400 mg Tablet 180 127.00 22,860.00 5,000 127.00
71 Ibuprofen sirup 200 mg/ 5 ml Botol 0 2,475.00 - 200 2,475.00
72 Ibupropen 200 mg Tablet 0 110.00 - 0 110.00
73 Lidokain inj 2 % (infltr/p.v) Ampul 0 839.00 - 100 839.00
74 Na.Diklofenak 50 mg Tablet 1080 200.00 216,000.00 18,000 200.00
75 Parasetamol 500 mg Tablet 13793 89.00 1,227,577.00 180,000 89.00
76 Parasetamol syr 120 mg/5 ml 60 ml Botol 441 1,438.00 634,158.00 4,702 1,438.00
77 Parasetamol tts 60 mg / 0.6 ml Botol 20 6,450.00 129,000.00 320 6,450.00
78 Piroksikam 10 mg Tablet 110 88.00 9,680.00 4,300 88.00
SISTEM PENCERNAAN
79 Antasida DOEN Tablet 6057 62.00 375,534.00 49,400 62.00
80 Antasida DOEN susp Botol 63 2,100.00 132,300.00 1,300 2,100.00
81 Antihemoroid suppositoria Supp 80 3,045.00 243,600.00 290 3,045.00
82 Atapulgit tab 600 mg Tablet 0 190.00 - 8,500 190.00
83 Bisakodil 5 mg Tablet 0 5,670.00 - 0 5,670.00
84 Bisakodil sup 5 mg Supp 216 249.70 53,935.20 0 249.70
85 Dimenhidrinat tab 50 mg Tablet 30 95.00 2,850.00 2,000 95.00
86 Domperidon 10 mg Tablet 450 167.00 75,150.00 900 167.00
87 Domperidon sirup 5 mg/5 ml Botol 0 3,000.00 - 0 3,000.00
88 Garam Oralit 200 ml Sase 914 292.00 266,888.00 9,100 292.00
89 Hiosina Butilbromida 10 mg Tablet 500 999.90 499,950.00 1,850 999.90
90 Karbo Adsorben 250 mg Tablet 3420 300.30 1,027,026.00 0 300.30
91 Komb Kaolin 550 mg + pektin 20 mg Tablet 29 2,600.00 75,400.00 0 2,600.00
92 Metoklopramide sirup 5 mg/ml Botol 810 12.10 9,801.00 110 12.10
93 Natrium Bicarbonat 500 mg Tablet 0 220.00 - 1,000 220.00
94 Omeprazol 20 mg Capsul 180 211.00 37,980.00 2,190 211.00
95 Omeprazol inj 40 mg / 10 ml Ampul 0 36,000.00 - 0 36,000.00
96 Ranitidin tab 150 mg Tablet 1040 120.00 124,800.00 14,900 120.00
97 Zinc dispersibel Tablet 200 514.00 102,800.00 3,200 514.00
JANTUNG DAN PEMBULUH DARAH

98 Amlodipine 5 mg Tablet 245 187.00 45,815.00 8,400 187.00
99 Amlodipin 10 mg Tablet 1060 330.00 349,800.00 22,800 330.00
100 Atenolol 50 mg Tablet 0 440.00 - 0 440.00
101 Captopril 12,5 mg Tablet 459 62.00 28,458.00 1,900 62.00
102 Captopril 25 mg Tablet 550 80.00 44,000.00 5,400 80.00
103 Digoksin 0,25 mg Tablet 40 97.00 3,880.00 200 97.00
104 Diltiazem 30 mg Tablet 0 139.99 - 0 139.99
105 Furosemid 40 mg Tablet 412 80.30 33,083.60 2,800 80.30
106 Hidrokortiazid HCT tab 25 mg Tablet 0 17.00 - 0 17.00
107 Isosorbid Dinitrat 5 mg tablet Tablet 90 88.00 7,920.00 300 88.00
108 Metyldopa tab 250 mg Tablet 0 869.00 - 0 869.00
109 Nifedipin tab 10 mg Tablet 273 100.00 27,300.00 500 100.00
110 Reserpin 0,25 mg Tablet 0 103.00 - 0 103.00
111 Spironolakton 25 mg Tablet 0 315.00 - 0 315.00
OBAT MATA
112 Klorampenicol S.M 1 % Tube 63 1,760.00 110,880.00 864 1,760.00
113 Koramfenikol TM 1 % Botol 60 5,500.00 330,000.00 100 5,500.00
OBAT KULIT
114 Anti Bacteri DOEN SK Tube 45 2,516.00 113,220.00 350 2,516.00
115 Acyclovir cream 5 % Tube 42 4,158.00 174,636.00 200 4,158.00
116 Antifungi SK Pot 101 2,750.00 277,750.00 121 2,750.00
117 Bedak Salisil serbuk 2 % Dus 49 1,520.00 74,480.00 1,150 1,520.00
118 Betametason Crem 0,1 % Tube 10 1,250.00 12,500.00 675 1,250.00
119 Hidrokortison Crem 2,5 % Tube 47 2,798.00 131,506.00 1,152 2,798.00
120 Ichtyol Sk Pot 0 4,840.00 - 30 4,840.00
121 Ketokonazol krim 2% Tube 0 2,545.00 - 435 2,545.00
122 Kloramfenikol SK 2% Tube 109 3,091.00 336,919.00 960 3,091.00
123 Mikonazol krim 2% Tube 11 22,999.90 252,998.90 432 22,999.90
124 Perak Sulfadiazin krim 1% Tube 48 3,000.00 144,000.00 22 3,000.00
125 Permetrin Krim 5 % Tube 0 11,475.00 - 1,800 11,475.00
126 Salep 2-4 Pot 91 2,000.00 182,000.00 336 2,000.00
VITAMIN DAN MINERAL

127 Asam Askorbat (Vit C) tab 250 mg Tablet 0 39.00 - 12,700 39.00
128 Asam Askorbat (Vit C) tab 50 mg Tablet 470 159.00 74,730.00 7,800 159.00
129 Asam Folat 1 mg Tablet 0 48.00 - 0 48.00
130 Kalsium laktat (kalk) tab 500 mg Tablet 0 31.90 - 0 31.90
131 Mineral Mix Sase 300 660.00 198,000.00 0 660.00
132 Multivitamin dan Mineral Tablet 0 2,450.00 - 6,700 2,450.00
133 Piridoksin HCL 10 mg tablet Tablet 3285 19.80 65,043.00 13,000 19.80
134 Retinol (Vit. A) 100,000 IU Kap Lunak Capsul 0 255.00 - 600 255.00
135 Retinol (Vit. A) 200,000 IU Kap Lunak Capsul 0 417.26 - 5,900 417.26
136 Sianokobalamin (Vitamin B12) tab 50 mcg Tablet 3370 19.80 66,726.00 10,000 19.80
137 Tablet Tambah Darah/FE Tablet 3870 44.00 170,280.00 11,790 44.00
138 Thiamin HCL 50 mg Tablet 0 35.20 - 27,000 35.20
139 Vit. B. Complex Tablet 1800 115.00 207,000.00 50,100 115.00
140 Vit. Syrup Anak 60 ml Botol 10 9,900.00 99,000.00 264 9,900.00
DARAH,AS URAT,KOLESTEROL
141 Alopurinol 100 mg Tablet 515 90.00 46,350.00 3,130 90.00
142 Fitomenadion /Vit K 10 mg Tablet 300 634.00 190,200.00 2,400 634.00
143 Fitomenadion /Vit K Inj 2 mg/ml Ampul 6 3,417.00 20,502.00 600 3,417.00
144 Gemfibrozil 300 mg Tablet 0 289.00 - 30 289.00
145 Metilergometrin Maleat 0,125 mg Tablet 185 154.00 28,490.00 0 154.00
146 Metilergometrin Maleat 0,200 mg 1ml inj Ampul 2 1,366.67 2,733.34 100 1,366.67
147 Simvastatin 10 mg Tablet 0 169.00 - 0 169.00
MULUT,THT
148 Borax Glicerin Botol 54 2,640.00 142,560.00 236 2,640.00
149 Fenol Glicerol Tetes Telinga 10 % Botol 25 2,042.00 51,050.00 96 2,042.00
150 Gentian Violet Lart 1 % 10 ml Botol 27 4,400.00 118,800.00 120 4,400.00
151 Kloramfenikol tetes Telinga 3 % 10 ml Botol 12 2,310.00 27,720.00 0 2,310.00
152 Oksimetazolin tts hidung 0,025% Botol 4 31,000.00 124,000.00 20 31,000.00
ALERGI,KORTIKOSTEROID
153 Deksametason 0,5 mg tablet Tablet 702 44.00 30,888.00 38,000 44.00
154 Deksametason inj 5 mg / ml (i.v / i.m) Ampul 0 1,500.00 - 3 1,500.00
155 Difenhidramin inj 10 mg / ml (i.v / i.m) Ampul 0 1,054.00 - 30 1,054.00
156 Klorfeniramin Maleat/CTM 4 mg Tablet 4814 51.00 245,514.00 56,500 51.00
157 Loratadine Tab 10 mg Tablet 0 154.00 - 4,600 154.00
158 Prednison 5 mg Tablet 0 110.00 - 0 110.00
159 Setirizin sir 5 mg / 5 ml Botol 40 2,850.00 114,000.00 330 2,850.00
HORMON
160 Glibenklamid 5 mg tablet Tablet 275 56.00 15,400.00 16,300 56.00
161 Metformin tab 500 mg Tablet 1165 112.50 131,062.50 14,400 112.50
162 Propiltiourasil tab 100 mg (PTU) Tablet 0 319.00 - 1,900 319.00
ANTISEPTIK,DISINFEKTAN
163 Alkohol Swab Buah 200 196.80 39,360.00 100 196.80
164 Chlorin 10 % Liter 3 14,300.00 42,900.00 8 14,300.00
165 Etakridin 0,1 % Rivanol 300 ml Botol 9 2,550.00 22,950.00 32 2,550.00
166 Etanol 70 % 100 ml Botol 19 2,500.00 47,500.00 162 2,500.00
167 Framisetin sulfat tulle 1% Lembar 0 17,600.00 - 10 17,600.00
168 Hand Rub Liter 5 116,000.00 580,000.00 15 116,000.00
169 Kalium Permanganat (PK) 5 gram Botol 4 312.35 1,249.40 20 312.35
171 Kaporit 60% Kg 0 28,000.50 - 0 28,000.50
172 Lisol 50 % 1000 ml Botol 11 41,000.00 451,000.00 24 41,000.00
173 Polikresulen 10 ml Botol 4 30,250.00 121,000.00 7 30,250.00
174 Povidon Iodin lar 10 mg/ml Botol 30 ml 9 2,163.00 19,467.00 15 2,163.00
175 Povidon Iodin lar 10 mg/ml Botol 300 ml 1 14,203.00 14,203.00 2 14,203.00
INFUS,LAR STERIL
176 Aqua Bidestilata Liter 10 6,000.50 60,005.00 0 6,000.50
177 Aqua pro inj steril 20 ml Vial 2 5,200.00 10,400.00 30 5,200.00
178 Glukosa Lar infus 5 % steril 500 ml Labu 3 4,700.00 14,100.00 0 4,700.00
179 Natrium Klorida Larutan Infus 0,9 % Labu 5 5,200.00 26,000.00 21 5,200.00
180 Ringer Laktat Larutan Infus Steril Labu 0 962.50 - 24 962.50
NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA

181 Amitriptilin tab sal 25 mg Tablet 0 112.00 - 0 112.00
182 Diazepam 2 mg tablet Tablet 145 45.00 6,525.00 100 45.00
183 Fenobarbital tab 30 mg Tablet 0 71.00 - 0 71.00
184 Haloperidol tab 1.5 mg Tablet 0 69.00 - 0 69.00
185 Karbamazepin tab 200 mg Tablet 0 270.00 - 0 270.00
186 Klorpromazin tab sal 25 mg Sallet 0 148.00 - 0 148.00
187 Kodein HCL 10 mg Tablet 0 500.00 - 0 500.00
188 Risperidon tab 2 mg Sallet 0 495.00 - 0 495.00
REAGENT HIV
189 Kontrol CD 4 kitt 0 937,200.00 - 0 937,200.00
190 Open CD 4 Test 0 189,310.00 - 0 189,310.00
191 Rapid Test HIV ( Oncoprobe ) Test 0 22,385.00 - 0 22,385.00
192 Rapid Test HIV ( Biomeriux ) Test 24 19,500.00 468,000.00 0 19,500.00
193 Rapid Test HIV ( Intec ) Test 56 34,870.00 1,952,720.00 0 34,870.00
194 SD HIV Test 176 14,344.00 2,524,544.00 0 14,344.00
REAGENT IMS
195 Pewarnaan gram Kit 0 255,200.00 - 0 255,200.00
196 RPR Antigen/ Trust Test 0 22,385.00 - 0 22,385.00
197 TPHA Sypillis (Hexagon) Test 0 6,930.00 - 0 6,930.00
198 TPHA Sypillis (SD) Test 0 27,710.00 - 0 27,710.00
REAGEN TB
199 Oli Imersi Botol - - - 0 -
200 PPD / Test Mantoux Vial 0 770,000.00 - 0 770,000.00
201 Reagent ZN Kit 3 276,500.00 829,500.00 2 276,500.00
ALAT & BAHAN GIGI
202 Air Raksa Fls 6 328,900.00 1,973,400.00 0 328,900.00
203 Alvogil Fls 0 408,183.60 - 0 408,183.60
204 Amalgam Fls 26 797,500.00 20,735,000.00 2 797,500.00
205 Arkansas Stone Fls 0 11,020.00 - 0 11,020.00
Articulating paper (kertas warna penanda
206 Lembar 0.5 153,010.00 76,505.00 153,010.00
oklusi) 12
Bahan tumpatan sementara (Temporary
207 Pot 7 40,700.00 284,900.00 40,700.00
Fletcher) 1
208 Boor jet Fressure Buah 11 26,180.00 287,980.00 0 26,180.00
209 Boor jet inverted Buah 7 26,180.00 183,260.00 3 26,180.00
210 Boor jet round Buah 7 26,180.00 183,260.00 0 26,180.00
211 Boor low fressure Buah 5 27,500.00 137,500.00 0 27,500.00
212 Boor low inverted Buah 5 27,500.00 137,500.00 5 27,500.00
213 Boor low round Buah 5 27,500.00 137,500.00 0 27,500.00
214 Boor Stone Buah 3 13,750.00 41,250.00 0 13,750.00
215 CaOH with Iodoform 1 syringe 2,2 g Botol 10 129,470.00 1,294,700.00 0 129,470.00
216 Celluloid Strip Lembar 60 2,016.66 120,999.60 0 2,016.66
217 Cement Zn Phospat Powder & Liquid Set 158 635.58 100,421.64 0 635.58
218 Devitalisasi Pasta (arsenik) Fls 3 411,950.00 1,235,850.00 4 411,950.00
219 Devitalisasi Pasta (Non arsen) 3 217,745.00 653,235.00 2 217,745.00
220 Disclossing Tablet 9 16,667.00 150,003.00 0 16,667.00
221 Eugenol Fls 1 64,735.00 64,735.00 8 64,735.00
222 Formokresol Btl 5 591,089.40 2,955,447.00 0 591,089.40
Glass Ionomer ART (Atraumatic Restorative
223 Buah 6 591,059.40 3,546,356.40 591,059.40
Treatment) Anterior/Fuji II 0
Glass Ionomer ART (Atraumatic Restorative
224 Buah 0 55,000.00 - 55,000.00
Treatment) Posterior/Fuji IX 4
225 H2O2 Botol 4 170,665.00 682,660.00 0 170,665.00
226 Kalsium Hidroksida Pasta (CaOH) Tube 4 41,800.00 167,200.00 0 41,800.00
227 Klorfenol Kamfer Mentol (CHKM) Fls 4 410,302.20 1,641,208.80 0 410,302.20
Komb : Artikaine HCl 4% + Epinefrin 1 :
228 cartridge kaca 1 1,475,958.00 1,475,958.00 1,475,958.00
100.000 0
Komb : Deksametason asetat 0,1%, Thymol
229 5%,Paraklorphenol 30%, campor 64% Fls 170 1,845.00 313,650.00 1,845.00
(Chresophene) 0
Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000
230 Ampul 0 - - -
inj 2 ml 590
Komb : Mepivakaine HCl 2 % + Epinefrin
231 cartridge kaca 10 11,000.00 110,000.00 11,000.00
1:100.000 0
232 Komposit Resin Fls 1 39,490.00 39,490.00 0 39,490.00
233 Matrix Band Roll 3 588,500.00 1,765,500.00 0 588,500.00
234 Panasray Buah 0 134,223.10 - 6 134,223.10
235 Pasta Gigi Buah 1 418,000.00 418,000.00 0 418,000.00
236 Pasta Pengisi Saluran Akar Fls 96 4,588.10 440,457.60 1 4,588.10
237 Pembersih noda gigi (TSR/OCO) Buah 2 601,152.20 1,202,304.40 0 601,152.20
238 Rockel Fls 40 9,308.20 372,328.00 0 9,308.20
239 Savlon Liter 17 58,850.00 1,000,450.00 0 58,850.00
240 Slaber Buah 4 759,000.00 3,036,000.00 0 759,000.00
241 Spongostan Buah 0 33.00 - 0 33.00
242 Tissue gulung Buah - 5,500.00 - 170 5,500.00
243 Vaseline Pot 15gr - 58,850.00 - 2 58,850.00
ALKES HABIS PAKAI

244 Abbocat No. 18 Buah 0 12,100.00 - 0 12,100.00
245 Abbocat No. 20 Buah 0 12,100.00 - 10 12,100.00
246 Abbocat No. 22 Buah 10 7,334.00 73,340.00 0 7,334.00
247 Abbocat No. 24 Buah 0 8,910.00 - 0 8,910.00
248 Abbocat No. 26 Buah 10 16,346.00 163,460.00 0 16,346.00
249 ADS 0,5 ml - - - 0 -
250 Alat Suntik 1 ml Buah 83 1,540.00 127,820.00 600 1,540.00
251 Alat Suntik 10 ml Buah 0 932.16 - 0 932.16
252 Alat Suntik 20 ml Buah 0 1,502.58 - 0 1,502.58
253 Alat Suntik 3 ml Buah 120 652.51 78,301.20 1,100 652.51
254 Alat Suntik 5 ml Buah 190 1,485.00 282,150.00 100 1,485.00
255 Bisturi Buah 20 3,000.00 60,000.00 11 3,000.00
256 Blood Lancet Buah 0 145.66 - 0 145.66
257 Cat Gut Chromic/Benang Bedah No. 3.2 Buah 9 22,500.00 202,500.00 31 22,500.00
258 Cat Gut Plain/Benang Bedah No. 3.2 Buah 0 7,395.80 - 0 7,395.80
259 Endotrakeal No 3 Buah 0 24,200.00 - 0 24,200.00
260 Endotrakeal No 3.5 Buah 0 24,200.00 - 0 24,200.00
261 Endotrakeal No 4 Buah 0 24,200.00 - 0 24,200.00
262 Foley Kateter No 18 Buah 0 13,090.00 - 0 13,090.00
263 Foley Kateter No 20 Buah 0 13,090.00 - 0 13,090.00
264 Hecting Nald Buah 0 16,500.00 - 0 16,500.00
265 Infuset anak Buah 0 5,100.00 - 0 5,100.00
266 Infuset dewasa Buah 15 7,590.00 113,850.00 0 7,590.00
267 Iodina Test Botol 0 - - 0 -
268 Jarum Cytojek Buah 0 1,210.00 - 300 1,210.00
269 Jarum vacutainer Buah 400 2,010.60 804,240.00 80 2,010.60
270 Kaca Mulut Buah 3 38,500.00 115,500.00 0 38,500.00
271 Kaca Penutup / Dek glass Kotak 100 0 14,460.50 - 0 14,460.50
272 Kantong Jenazah Buah 0 - - 0 -
273 Kapas Pembalut Absorben 250 g Bks 0 13,400.00 - 20 13,400.00
274 Kassa Kompres 40 x 40 steril Bks 15 1,618.00 24,270.00 30 1,618.00
275 Kassa Pembalut 2 m x 80 cm Bks 9 7,700.00 69,300.00 80 7,700.00
276 Kassa pembalut Hidrofil 4 cm x 15 cm Roll 24 2,100.00 50,400.00 60 2,100.00
277 Kassa pembalut Hidrofil 4 cm x 3 cm Roll 18 590.00 10,620.00 190 590.00
278 Kateter penghisap lendir No 10 Buah 0 3,520.00 - 0 3,520.00
279 Kateter penghisap lendir No 8 Buah 0 3,520.00 - 0 3,520.00
280 Kertas Perkamen Bks 0 20,900.00 - 4 20,900.00
281 Kondom Buah 0 - - 0 -
282 Masker Lembar 100 438.90 43,890.00 2,370 438.90
283 Masker N.95 Buah 0 4,307.00 - 0 4,307.00
284 Masker Oksigen Anak Buah 0 19,800.00 - 0 19,800.00
285 Masker Oksigen dewasa Buah 0 19,800.00 - 0 19,800.00
286 Oksigen can Buah 2 33,000.00 66,000.00 4 33,000.00
287 Peneng Bayi Buah 0 1,078.00 - 0 1,078.00
288 Perban elastis Roll 0 - - 0 -
289 Plastic Bandages Kotak 0 594.00 - 0 594.00
290 Plester Roll 0 14,300.00 - 28 14,300.00
291 Plester kertas Roll 2 4,875.00 9,750.00 7 4,875.00
292 Pot Sputum Buah 100 2,950.00 295,000.00 425 2,950.00
293 Rotator Unit 5 19,700.00 98,500.00 0 19,700.00
294 RTD Malaria Box 0 27,500.00 - 0 27,500.00
295 Sarung Tangan Karet Tebal Buah 0 10,000.00 - 15 10,000.00
296 Sarung Tangan Non Steril Psng 38 11,550.00 438,900.00 200 11,550.00
297 Sarung Tangan Panjang ginekolog Psng 7 7,150.00 50,050.00 105 7,150.00
298 Sarung tangan Steril Psng 300 730.00 219,000.00 1,100 730.00
299 Selang oksigen Anak Buah 0 10,000.00 - 0 10,000.00
300 Selang oksigen dewasa Buah 400 660.00 264,000.00 0 660.00
301 Sendok Obat Buah 0 15,000.00 - 0 15,000.00
302 Silk Buah 0 42,460.00 - 0 42,460.00
303 Slide Box 81 3,650.00 295,650.00 0 3,650.00
304 Spalk 30 cm pasang 0 14,025.00 - 0 14,025.00
305 Three way stop cock Buah 0 2,750.00 - 0 2,750.00
306 Tip pipet kuning Pak 0 175,700.00 - 1 175,700.00
307 Tongue Spatel Kayu Buah 0 184.80 - 0 184.80
308 Ultrasound gel 250 cc Botol 3 182,701.00 548,103.00 8 182,701.00
309 Umbilical Cord Clam Biru Buah 0 1,000.00 - 0 1,000.00
310 Urine Bag Buah 0 3,245.00 - 0 3,245.00
311 Vacutainer/Tabung spesimen darah + tutup Buah 199 2,268.00 451,332.00 80 2,268.00
312 Wing Needle no.27 G Buah 0 1,400.00 - 50 1,400.00
CETAKAN DAN EMBALAGE

313 Buku Resep Buku 355 3,465.00 1,230,075.00 100 3,465.00
314 Berita Acara Serah Terima Barang Buku - - 0 -
315 Buku Harian Buku 0 53,350.00 - 0 53,350.00
316 Etiket Obat putih Lembar 567512 5.72 3,246,168.64 0 5.72
317 Kartu Persediaan Barang (Gudang) Lembar - - - 0 -
318 Kartu stok Barang ( Gudang) Lembar 0 700.00 - 0 700.00
319 LPLPO Buku 0 132.00 - 0 132.00
EMBALAGE
320 K.Obat Plastik 8 x 13 x 05 Kg 0 33,550.00 - 44 33,550.00
321 Kantong kresek Putih Pak 0 8,580.00 - 2 8,580.00
322 Kantong Obat Plastik 20 x 15 x 0.5 Kg 2 36,575.00 73,150.00 4 36,575.00
323 Kantong Obat Plastik 20 x 30 x 0.5 Kg 0 27,533.00 - 3 27,533.00
Obat-obatan Program HIV AIDS

324 Abacavir 300 mg (ABC) Botol 60 tablet - - - 0 -
325 Efavirenz 600 mg (EFV) Botol 30 tablet - - - 0 -
326 Lamivudine 150 mg (3TC) Botol 60 tablet - - - 0 -
327 Neviraphine 200 mg (NVP) Botol 60 tablet - - - 0 -
Tenovir 300 mg (TDF) + Lamivudine 300 mg
328 Botol 30 tablet - - - 0 -
(3TC) + Efavirenz 600 mg (EFV)
329 Tenovofir 300 mg (TDF) Botol 30 tablet - - - 0 -
Tenovir 300 mg (TDF) + Emtricitabine 200 mg
330 Botol 30 tablet - - - 0 -
(FTC)
Zidovudine 60 mg (ZDV)+ Lamivudine 30 mg
331 (3TC)+ Neviraphine 50 mg (NVP) Ped Triple Botol 60 tablet - - - 0 -
FDC
Zidovudine 300 mg (ZDV)+ Lamivudine 150
332 Botol 60 tablet - - - 0 -
mg (3TC)
333 Lovinapir 200 mg + Ronavir 50 mg Botol 120 tablet - - - 0 -
334 DBS Collection Kit Test - - - 0 -
335 Zidovudine 50 mg/ ml Botol - - - 0 -
Obat - Obatan Program Hepatitis 0 -

334 Ribavirin 200 mg (Rebetol) Kapsul - - - 0 -
335 Simeprevir 150 mg (Olysio) Kapsul - - - 0 -
336 Sofosbufir 400 mg (Myhep) Kapsul - - - 0 -
337 HCV Viral Load Test - - - 0 -
338 RDD Anti HCV Test - - - 0 -
339 Reagent Rapid Test HBSAG Test - - - 0 -
340 Hepatitis B Immunoglobulin Syringe - - - 0 -
341 Daclastavir 60 mg Botol - - - 0 -
342 Daclastavir 30 mg Botol - - - 0 -
343 Dehidroartemisin + Piperaquine (DHP) Tablet - - - 0 -
344 RDT Malaria Test - - - 0 -
345 Primakuin 15 mg Tablet - - - 0 -
346 Artesunat inj. 60 mg Ampul - - - 0 -
Logistik DBD
347 Insektisida Liter 0 0 0 0 -
348 BTI Botol 30 ml 0 0 0 0 -
349 Jumantik Paket 0 0 0 0 -
350 NS1 Tes 0 0 0 0 -
351 RDT IGM Tes 0 0 0 0 -
352 RDT Combo Tes 0 0 0 0 -
353 APD Buah 0 0 0 0 -
354 Mesin Foging Swan Fog SF 88 Unit 0 0 0 0 -
355 Larvasida Abate Kg 0 0 0 0 -
Jumlah 81,404,247.42
Mengetahui,
PlT. Kepala UPT Puskesmas Panghegar
dr. Hj. Nina Manarosana, R., M. Kes.
NIP. 19660319 199703 2 001
aporan Perhitungan Stock Persediaan
per 30 Desember Tahun 2017
ahan ( Jan-Des 2017) Penggunaan (Jan -Des 2017) Saldo Akhir Kartu Persediaan(30/12/2017)
Jumlah Harga Jumlah Harga Satuan Jumlah Harga Jumlah Harga Satuan Jumlah Harga
Barang Barang
Rp Rp Rp Rp Rp
9 10 11 12 13 14 15
- 21 1,999.80 41,995.80 9 2,000 17,998.20

251,220.00 3 16,748.00 50,244.00 Err:509 16,748 Err:509
145,800.00 32 8,100.00 259,200.00 Err:509 8,100 Err:509
- 0 9,955.00 - 0 9,955 -
- 0 3,650.00 - 0 3,650 -
- 8 2,200.00 17,600.00 5 2,200 11,000.00
- 0 1,333.29 - 0 1,333.29 -
1,483,500.00 Err:509 345.00 Err:509 Err:509 345.00 Err:509
10,576,800.00 7,800 1,356.00 10,576,800.00 0 1,356.00 -
- Err:509 - Err:509 Err:509 - Err:509
3,332,000.00 36,614 136.00 4,979,504.00 0 136.00 -
6,032,000.00 Err:509 232.00 Err:509 Err:509 232.00 Err:509
1,858,200.00 946 2,445.00 2,312,970.00 0 2,445.00 -
1,618,000.00 412 4,045.00 1,666,540.00 0 4,045.00 -
2,197,800.00 98 20,350.00 1,994,300.00 10 20,350.00 203,500.00
- 0 1,900.00 - 0 1,900.00 -
- 0 13,400.00 - 0 13,400.00 -
- 0 859.00 - 0 859.00 -
519,750.00 1,500 346.50 519,750.00 0 346.50 -
- 0 3,566.77 - 0 3,566.77 -
- Err:509 249.70 Err:509 Err:509 249.70 Err:509
- 0 497.00 - 0 497.00 -
- Err:509 314.00 Err:509 Err:509 314.00 Err:509
- 0 22,000.00 - 0 22,000.00 -
- 0 5,900.00 - 0 5,900.00 -
- 0 219.00 - 0 219.00 -
- 0 138.00 - 0 138.00 -
- 0 110.00 - 0 110.00 -
315,000.00 986 300.00 295,800.00 460 300.00 138,000.00
515,700.00 1,344 382.00 513,408.00 306 382.00 116,892.00
1,475,600.00 2,364 527.00 1,245,828.00 1026 527.00 540,702.00
209,880.00 900 349.80 314,820.00 0 349.80 -
2,517,500.00 620 1,007.00 624,340.00 1880 1,007.00 1,893,160.00
988,750.00 300 3,955.00 1,186,500.00 0 3,955.00 -
- 0 330.00 873,840.00 0 330.00 -
297,000.00 2,648 135.00 20,115.00 0 135.00 -
214,500.00 149 2,145.00 2,786,355.00 3 2,145.00 6,435.00
154,000.00 1,299 110.00 297,000.00 101 110.00 11,110.00
432,000.00 2,700 160.00 52,800.00 0 160.00 -
- 0 1,550.00 - 0 1,550.00 -
240,000.00 330 480.00 1,440.00 262 480.00 125,760.00
- 0 31,350.00 846,450.00 0 31,350.00 -
214,985.00 3 214,985.00 214,985.00 0 214,985.00 -
8,997,500.00 27 359,900.00 - 0 359,900.00 -
1,199,900.00 1 1,199,900.00 71,994,000.00 0 1,199,900.00 -
- 0 59,400.00 - 0 59,400.00 -
- 60 311.00 - 60 311.00 18,660.00
- 0 198.00 - 0 198.00 -
- 0 1,315.00 - 0 1,315.00 -
- 0 410.78 - 0 410.78 -
- 0 594.00 - 0 594.00 -
- 0 830.00 - 0 830.00 -
- 0 520.00 - 0 520.00 -
- 0 5,200.00 4,004,000.00 0 5,200.00 -
- 0 3,650.00 - 0 3,650.00 -
- 770 148.00 - 0 148.00 -
-
282,150.00 2,584 104.50 270,028.00 266 104.50 27,797.00

23,023,000.00 9,509 2,530.00 24,057,770.00 0 2,530.00 -
45,000.00 660 90.00 59,400.00 0 90.00 -
514,800.00 14,030 39.60 555,588.00 0 39.60 -
- 20 5,990.00 119,800.00 0 5,990.00 -
7,412,400.00 15,634 426.00 6,660,084.00 2246 426.00 956,796.00

3,630,000.00 710 6,600.00 4,686,000.00 0 6,600.00 -
16,800,000.00 3,172 4,000.00 12,688,000.00 1048 4,000.00 4,192,000.00
- 200 59.00 11,800.00 0 59.00 -
- 0 113.00 - 0 113.00 -
- 0 112.00 - 0 112.00 -
115,500.00 55 385.00 21,175.00 300 385.00 115,500.00
942,700.00 13 94,270.00 1,225,510.00 0 94,270.00 -
635,000.00 5,180 127.00 657,860.00 0 127.00 -
495,000.00 104 2,475.00 257,400.00 96 2,475.00 237,600.00
- 0 110.00 - 0 110.00 -
83,900.00 53 839.00 44,467.00 47 839.00 39,433.00
3,600,000.00 19,080 200.00 3,816,000.00 0 200.00 -
16,020,000.00 160,275 89.00 14,264,475.00 33518 89.00 2,983,102.00
6,761,476.00 4,155 1,438.00 5,974,890.00 988 1,438.00 1,420,744.00
2,064,000.00 340 6,450.00 2,193,000.00 0 6,450.00 -
378,400.00 4,410 88.00 388,080.00 0 88.00 -
3,062,800.00 45,493 62.00 2,820,566.00 9964 62.00 617,768.00

2,730,000.00 1,184 2,100.00 2,486,400.00 179 2,100.00 375,900.00
883,050.00 215 3,045.00 654,675.00 155 3,045.00 471,975.00
1,615,000.00 6,580 190.00 1,250,200.00 1920 190.00 364,800.00
- -95 5,670.00 (538,650.00) 95 5,670.00 538,650.00
- 216 249.70 53,935.20 0 249.70 -
190,000.00 2,030 95.00 192,850.00 0 95.00 -
150,300.00 1,350 167.00 225,450.00 0 167.00 -
- 0 3,000.00 - 0 3,000.00 -
2,657,200.00 8,264 292.00 2,413,088.00 1750 292.00 511,000.00
1,849,815.00 1,814 999.90 1,813,818.60 536 999.90 535,946.40
- 3,420 300.30 1,027,026.00 0 300.30 -
- 29 2,600.00 75,400.00 0 2,600.00 -
1,331.00 920 12.10 11,132.00 0 12.10 -
220,000.00 460 220.00 101,200.00 540 220.00 118,800.00
462,090.00 2,370 211.00 500,070.00 0 211.00 -
- 0 36,000.00 - 0 36,000.00 -
1,788,000.00 13,097 120.00 1,571,640.00 2843 120.00 341,160.00
1,644,800.00 2,950 514.00 1,516,300.00 450 514.00 231,300.00
1,570,800.00 6,313 187.00 1,180,531.00 2332 187.00 436,084.00

7,524,000.00 23,467 330.00 7,744,110.00 393 330.00 129,690.00
- 0 440.00 - 0 440.00 -
117,800.00 2,112 62.00 130,944.00 247 62.00 15,314.00
432,000.00 3,494 80.00 279,520.00 2456 80.00 196,480.00
19,400.00 95 97.00 9,215.00 145 97.00 14,065.00
- 0 139.99 - 0 139.99 -
224,840.00 2,072 80.30 166,381.60 1140 80.30 91,542.00
- 0 17.00 - 0 17.00 -
26,400.00 270 88.00 23,760.00 120 88.00 10,560.00
- 0 869.00 - 0 869.00 -
50,000.00 560 100.00 56,000.00 213 100.00 21,300.00
- 0 103.00 - 0 103.00 -
- 0 315.00 - 0 315.00 -
1,520,640.00 798 1,760.00 1,404,480.00 129 1,760.00 227,040.00

550,000.00 0 5,500.00 - 0 5,500.00 -
880,600.00 300 2,516.00 754,800.00 95 2,516.00 239,020.00

831,600.00 242 4,158.00 1,006,236.00 0 4,158.00 -
332,750.00 222 2,750.00 610,500.00 0 2,750.00 -
1,748,000.00 934 1,520.00 1,419,680.00 265 1,520.00 402,800.00
843,750.00 500 1,250.00 625,000.00 185 1,250.00 231,250.00
3,223,296.00 1,030 2,798.00 2,881,940.00 169 2,798.00 472,862.00
145,200.00 21 4,840.00 101,640.00 9 4,840.00 43,560.00
1,107,075.00 265 2,545.00 674,425.00 170 2,545.00 432,650.00
2,967,360.00 938 3,091.00 2,899,358.00 131 3,091.00 404,921.00
9,935,956.80 356 22,999.90 8,187,964.40 87 22,999.90 2,000,991.30
66,000.00 0 3,000.00 - 13 3,000.00 39,000.00
20,655,000.00 420 11,475.00 4,819,500.00 1380 11,475.00 15,835,500.00
672,000.00 381 2,000.00 762,000.00 46 2,000.00 92,000.00
495,300.00 10,118 39.00 394,602.00 2582 39.00 100,698.00

1,240,200.00 8,270 159.00 1,314,930.00 0 159.00 -
- 0 48.00 - 0 48.00 -
- 0 31.90 - 0 31.90 -
- 300 660.00 198,000.00 0 660.00 -
16,415,000.00 6,700 2,450.00 16,415,000.00 0 2,450.00 -
257,400.00 12,109 19.80 239,758.20 4176 19.80 82,684.80
153,000.00 550 255.00 140,250.00 50 255.00 12,750.00
2,461,834.00 4,050 417.26 1,689,903.00 1850 417.26 771,931.00
198,000.00 13,370 19.80 264,726.00 0 19.80 -
518,760.00 15,625 44.00 687,500.00 35 44.00 1,540.00
950,400.00 22,606 35.20 795,731.20 4394 35.20 154,668.80
5,761,500.00 45,033 115.00 5,178,795.00 6867 115.00 789,705.00
2,613,600.00 274 9,900.00 2,712,600.00 0 9,900.00 -
281,700.00 3,016 90.00 271,440.00 629 90.00 56,610.00

1,521,600.00 2,566 634.00 1,626,844.00 134 634.00 84,956.00
2,050,200.00 575 3,417.00 1,964,775.00 31 3,417.00 105,927.00
8,670.00 30 289.00 8,670.00 0 289.00 -
- 135 154.00 20,790.00 50 154.00 7,700.00
136,667.00 102 1,366.67 139,400.34 0 1,366.67 -
- 0 169.00 - 0 169.00 -
623,040.00 290 2,640.00 765,600.00 0 2,640.00 -

196,032.00 121 2,042.00 247,082.00 0 2,042.00 -
528,000.00 147 4,400.00 646,800.00 0 4,400.00 -
- 12 2,310.00 27,720.00 0 2,310.00 -
620,000.00 18 31,000.00 558,000.00 6 31,000.00 186,000.00
1,672,000.00 31,031 44.00 1,365,364.00 7671 44.00 337,524.00
4,500.00 3 1,500.00 4,500.00 0 1,500.00 -
31,620.00 30 1,054.00 31,620.00 0 1,054.00 -
2,881,500.00 55,208 51.00 2,815,608.00 6106 51.00 311,406.00
708,400.00 3,057 154.00 470,778.00 1543 154.00 237,622.00
- 0 110.00 - 0 110.00 -
940,500.00 370 2,850.00 1,054,500.00 0 2,850.00 -
912,800.00 15,735 56.00 881,160.00 840 56.00 47,040.00

1,620,000.00 11,535 112.50 1,297,687.50 4030 112.50 453,375.00
606,100.00 1,900 319.00 606,100.00 0 319.00 -
19,680.00 259 196.80 50,971.20 41 196.80 8,068.80

114,400.00 11 14,300.00 157,300.00 0 14,300.00 -
81,600.00 34 2,550.00 86,700.00 7 2,550.00 17,850.00
405,000.00 118 2,500.00 295,000.00 63 2,500.00 157,500.00
176,000.00 10 17,600.00 176,000.00 0 17,600.00 -
1,740,000.00 15 116,000.00 1,740,000.00 5 116,000.00 580,000.00
6,247.00 -3 312.35 (937.05) 27 312.35 8,433.45
- 0 28,000.50 - 0 28,000.50 -
984,000.00 1 41,000.00 41,000.00 34 41,000.00 1,394,000.00
211,750.00 9 30,250.00 272,250.00 2 30,250.00 60,500.00
32,445.00 24 2,163.00 51,912.00 0 2,163.00 -
28,406.00 3 14,203.00 42,609.00 0 14,203.00 -
- 10 6,000.50 60,005.00 0 6,000.50 -

156,000.00 17 5,200.00 88,400.00 15 5,200.00 78,000.00
- 3 4,700.00 14,100.00 0 4,700.00 -
109,200.00 21 5,200.00 109,200.00 5 5,200.00 26,000.00
23,100.00 10 962.50 9,625.00 14 962.50 13,475.00
- 0 45.00 - 0 45.00 -
4,500.00 140 71.00 9,940.00 77 71.00 5,467.00 EXP. 28 TAB
- 0 69.00 - 0 69.00 -
- 0 270.00 - 0 270.00 -
- 0 148.00 - 0 148.00 -
- 0 500.00 - 0 500.00 -
- 0 495.00 - 0 495.00 -
- 0 - - 0 - -
- 0 937,200.00 - 0 937,200.00 -
- 0 189,310.00 - 0 189,310.00 -
- 0 22,385.00 - 0 22,385.00 -
- 24 19,500.00 468,000.00 24 19,500.00 468,000.00
- 56 34,870.00 1,952,720.00 1 34,870.00 34,870.00
- 164 14,344.00 2,352,416.00 12 14,344.00 172,128.00
- 0 255,200.00 - 0 255,200.00 -
- 0 22,385.00 - 0 22,385.00 -
- 0 6,930.00 - 0 6,930.00 -
- 0 27,710.00 - 0 27,710.00 -
- 0 - - 0 - -
- 0 770,000.00 - 0 770,000.00 -
553,000.00 5 276,500.00 1,382,500.00 1 276,500.00 276,500.00
- 0 328,900.00 - 31 328,900.00 10,195,900.00
- 0 408,183.60 - 0 408,183.60 -
1,595,000.00 38 797,500.00 30,305,000.00 27 797,500.00 21,532,500.00
- 0 11,020.00 - 0 11,020.00 -
1,836,120.00 0 153,010.00 - 0 153,010.00 -
40,700.00 24 40,700.00 976,800.00 32 40,700.00 1,302,400.00
- 11 26,180.00 287,980.00 1 26,180.00 26,180.00

78,540.00 10 26,180.00 261,800.00 7 26,180.00 183,260.00
- 7 26,180.00 183,260.00 6 26,180.00 157,080.00
- 14 27,500.00 385,000.00 6 27,500.00 165,000.00
137,500.00 6 27,500.00 165,000.00 6 27,500.00 165,000.00
- 5 27,500.00 137,500.00 6 27,500.00 165,000.00
- 3 13,750.00 41,250.00 3 13,750.00 41,250.00
- 0 129,470.00 - 0 129,470.00 -
- 158 2,016.66 318,632.28 0 2,016.66 -
- 10 635.58 6,355.80 0 635.58 -
1,647,800.00 12 411,950.00 4,943,400.00 0 411,950.00 -
435,490.00 9 217,745.00 1,959,705.00 0 217,745.00 -
- 59 16,667.00 983,353.00 0 16,667.00 -
517,880.00 14 64,735.00 906,290.00 4 64,735.00 258,940.00
- 6 591,089.40 3,546,536.40 0 591,089.40 -
- 9 591,059.40 5,319,534.60 1 591,059.40 591,059.40
220,000.00 14 55,000.00 770,000.00 2 55,000.00 110,000.00
- 0 170,665.00 - 0 170,665.00 -
- 3 41,800.00 125,400.00 0 41,800.00 -
- 6 410,302.20 2,461,813.20 2 410,302.20 820,604.40
- 10 1,475,958.00 14,759,580.00 0 1,475,958.00 -
- 6 1,845.00 11,070.00 1 1,845.00 1,845.00
- 636 - - 242 - -
- 0 11,000.00 - 0 11,000.00 -
- 1 39,490.00 39,490.00 0 39,490.00 -

- 1 588,500.00 588,500.00 0 588,500.00 -
805,338.60 8 134,223.10 1,073,784.80 0 134,223.10 -
- 196 418,000.00 81,928,000.00 13 418,000.00 5,434,000.00
4,588.10 5 4,588.10 22,940.50 0 4,588.10 -
- 0 601,152.20 - 0 601,152.20 -
- 5 9,308.20 46,541.00 1 9,308.20 9,308.20
- 4 58,850.00 235,400.00 0 58,850.00 -
- 0 759,000.00 - 0 759,000.00 -
- 40 33.00 1,320.00 24 33.00 792.00
935,000.00 198 5,500.00 1,089,000.00 0 5,500.00 -
117,700.00 1 58,850.00 58,850.00 1 58,850.00 58,850.00
- 0 12,100.00 - 2 12,100.00 24,200.00

121,000.00 2 12,100.00 24,200.00 8 12,100.00 96,800.00
- 8 7,334.00 58,672.00 2 7,334.00 14,668.00
- 0 8,910.00 - 0 8,910.00 -
- 6 16,346.00 98,076.00 4 16,346.00 65,384.00
- 0 - - 0 - -
924,000.00 391 1,540.00 602,140.00 292 1,540.00 449,680.00
- 0 932.16 - 0 932.16 -
- 0 1,502.58 - 0 1,502.58 -
717,761.00 1,047 652.51 683,177.97 173 652.51 112,884.23
148,500.00 206 1,485.00 305,910.00 84 1,485.00 124,740.00
33,000.00 31 3,000.00 93,000.00 0 3,000.00 -
- 0 145.66 - 0 145.66 -
697,500.00 19 22,500.00 427,500.00 21 22,500.00 472,500.00
- 0 7,395.80 - 0 7,395.80 -
- -4,032 24,200.00 (97,574,400.00) 4032 24,200.00 97,574,400.00
- 0 24,200.00 - 0 24,200.00 -
- 0 24,200.00 - 0 24,200.00 -
- 0 13,090.00 - 0 13,090.00 -
- 0 13,090.00 - 0 13,090.00 -
- 0 16,500.00 - 0 16,500.00 -
- 0 5,100.00 - 0 5,100.00 -
- 15 7,590.00 113,850.00 0 7,590.00 -
- -8 - - 8 - -
363,000.00 296 1,210.00 358,160.00 4 1,210.00 4,840.00
160,848.00 392 2,010.60 788,155.20 88 2,010.60 176,932.80
- -72 38,500.00 (2,772,000.00) 75 38,500.00 2,887,500.00
- 0 14,460.50 - 0 14,460.50 -
- 0 - - 0 - -
268,000.00 20 13,400.00 268,000.00 0 13,400.00 -
48,540.00 35 1,618.00 56,630.00 10 1,618.00 16,180.00
616,000.00 76 7,700.00 585,200.00 13 7,700.00 100,100.00
126,000.00 75 2,100.00 157,500.00 9 2,100.00 18,900.00
112,100.00 189 590.00 111,510.00 19 590.00 11,210.00
- -71 3,520.00 (249,920.00) 71 3,520.00 249,920.00
- 0 3,520.00 - 0 3,520.00 -
83,600.00 4 20,900.00 83,600.00 0 20,900.00 -
- -3 - - 3 - -
1,040,193.00 2,470 438.90 1,084,083.00 0 438.90 -
- 0 4,307.00 - 0 4,307.00 -
- 0 19,800.00 - 0 19,800.00 -
- 0 19,800.00 - 0 19,800.00 -
132,000.00 6 33,000.00 198,000.00 0 33,000.00 -
- 0 1,078.00 - 0 1,078.00 -
- 0 - - 0 - -
- 0 594.00 - 0 594.00 -
400,400.00 19 14,300.00 271,700.00 9 14,300.00 128,700.00
34,125.00 8 4,875.00 39,000.00 1 4,875.00 4,875.00
1,253,750.00 445 2,950.00 1,312,750.00 80 2,950.00 236,000.00
- 5 19,700.00 98,500.00 0 19,700.00 -
- 0 27,500.00 - 0 27,500.00 -
150,000.00 9 10,000.00 90,000.00 6 10,000.00 60,000.00
2,310,000.00 238 11,550.00 2,748,900.00 0 11,550.00 -
750,750.00 60 7,150.00 429,000.00 52 7,150.00 371,800.00
803,000.00 1,059 730.00 773,070.00 341 730.00 248,930.00
- 0 10,000.00 - 0 10,000.00 -
- 400 660.00 264,000.00 0 660.00 -
- 0 15,000.00 - 0 15,000.00 -
- -8 42,460.00 (339,680.00) 8 42,460.00 339,680.00
- 81 3,650.00 295,650.00 0 3,650.00 -
- 0 14,025.00 - 0 14,025.00 -
- 0 2,750.00 - 0 2,750.00 -
175,700.00 1 175,700.00 175,700.00 0 175,700.00 -
- 0 184.80 - 0 184.80 -
1,461,608.00 8 182,701.00 1,461,608.00 3 182,701.00 548,103.00
- 0 1,000.00 - 0 1,000.00 -
- 0 3,245.00 - 0 3,245.00 -
181,440.00 201 2,268.00 455,868.00 78 2,268.00 176,904.00
70,000.00 35 1,400.00 49,000.00 15 1,400.00 21,000.00
346,500.00 350 3,465.00 1,212,750.00 0 3,465.00 -

- 0 - - 0 - -
- 0 53,350.00 - 0 53,350.00 -
- 113,859 5.72 651,273.48 0 5.72 -
- 0 - - 0 - -
- 0 700.00 - 0 700.00 -
- 0 132.00 - 0 132.00 -
1,476,200.00 32 33,550.00 1,073,600.00 0 33,550.00 -

17,160.00 2 8,580.00 17,160.00 0 8,580.00 -
146,300.00 12 36,575.00 438,900.00 0 36,575.00 -
82,599.00 2 27,533.00 55,066.00 0 27,533.00 -
- - 0 - -
- - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
0 - - 0 - -
0 - - 0 - -
0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
- 0 - - 0 - -
275,966,446.50 Err:509 Err:509
Bandung, 30 Desember 2017
Pengelola Obat Puskesmas

Pratiwi Oktaviana S.Farm.,Apt.
NIPK. 2017.05.09.012
Puskesmas
NO Nama Obat Satuan
Panghegar
LIFE SAVING
1 Atropin Inj i.m/iv/sk. 0,25 mg/ml (sulfat) Ampul 14
2 Epinefrin HCl Inj. Ampul 0
3 Mg Sulfat inj 20 % - IV/10 vial Ampul 0
4 Mg Sulfat inj 40 % - IV/10 vial Ampul 0
5 Oxytocin Inj Ampul 12
6 Diazepam Lar rectal 10 mg/ml Tube 2,5 ml 8
ANTIINFEKSI
7 ACT ( arthesunat ) Tablet 0
8 Acyclovir tab 400 mg Tablet 320
9 Albendazol 400 mg Tablet 65
10 Albendazol susp 200 mg/5 ml Botol 0
11 Amoksilin Kap. 250 mg Kapsul 0
12 Amoksilin Kap.500 mg Tablet 1736
13 Amoksilin syr kering 125 mg/ ml Botol 51
14 Amoksilin syr kering 250 mg/ ml Botol 0
15 Amoksisilin Drops 100 mg/ml Botol 11
16 Azitromisin 500 mg Kaplet 0
17 Benzatin Benzil P 2,4 Vial 0
18 Cefixim tab 100 mg Tablet 0
19 Ciprofloxacin 500 mg Tablet 0
20 Dietilkarbamazin Tablet 0
21 Doxyciclin 100 mg Tablet 0
22 Erytromicin 250 mg Tablet 0
23 Ethambutol 250 mg Tablet 0
24 Flukonazol kaps 50 mg Capsul 0
25 Gentamisin 80 mg / 2ml inj Ampul 0
26 Griseofulvin125 mg Tablet 0
27 Isoniazide 100 mg Tablet 0
28 Isoniazide 300 mg Tablet 0
29 Ketoconazole 200 mg Tablet 416
30 Klindamisin 150 mg Capsul 463
31 Klindamisin 300 mg Capsul 718
32 Kloramfenikol 250 mg capsul Capsul 0
33 Kloramfenikol 500 mg capsul Capsul 1440
34 Kloramfenikol susp 125 mg / 5 ml Botol @ 60 ml 0
35 Kombipak IMS Kotak 0
36 Kotrimoksazol Adult 480 mg Tablet 0
37 Kotrimoksazol Suspensi 240 mg/5 ml Botol 101
38 Metronidazol 250 mg Tablet 102
39 Metronidazol 500 mg Tablet 0
40 Natrium Tiroksin Tablet 0
41 Nistatin 100.000 IU/g tablet vagina Tablet 267
42 Nistatin susp 100.000 UI / ml Botol 0
43 Obat Anti TBC Anak FDC Paket 2
44 Obat Anti TBC Kat I FDC Paket 2
45 Obat Anti TBC Kat II FDC Paket 1
46 Obat Anti TBC Sisipan Paket 0
47 Pyrantel Pamoat 125 mg Tablet 73
48 Pyrazinamide 500 mg Tablet 0
49 Pyrimethamine 25 mg Tablet 0
50 Rifampicin 300 mg Tablet 0
53 Sefadroxil kapsul 500 mg Capsul 0
54 Sefadroxil syr kering 125 mg/ml Botol 0
55 Streptomicin Inj. Ampul 0
56 Tetracyclin 250 mg Tablet 0
SALURAN PERNAFASAN
57 Ambroxol tab 30 mg Tablet 0
58 Ambroxol Syrup 15 mg Botol 255
59 Aminopilina 200 mg Tablet 0
60 Gliseril Guayakolat 100 mg Tablet 0
61 Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 mg nebules Vial 0
62 N-asetil sistein kaps 200 mg Kapsul 3348
63 Obat Batuk Anak Syrup Botol 0
64 Salbutamol 2.5 mg nebules Vial 0
65 Salbutamol 2 mg Tablet 813
ANALGESIK, ANTIPIRETIK, ANTIINFLAMASI

66 Antimigren Tablet 0
67 Asam Mefenamat 500 mg Tablet 0
68 Betahistine mysilat 6 mg Tablet 180
69 Etil Klorida Semprot 100 ml Botol 0
70 Ibupropen 200 mg Tablet 0
71 Ibuprofen 400 mg Tablet 0
72 Ibuprofen sirup 200 mg/ 5 ml Botol 81
73 Lidokain inj 2 % (infltr/p.v) Ampul 19
74 Na.Diklofenak 50 mg Tablet 228
75 Parasetamol tts 60 mg / 0.6 ml Botol Tts 0
76 Parasetamol 500 mg Tablet 22071
77 Parasetamol syr 120 mg/5 ml 60 ml Botol 784
78 Piroksikam 10 mg Tablet 0
SISTEM PENCERNAAN
79 Antasida DOEN Tablet 8347
80 Antasida DOEN susp Botol @ 60 ml 129

81 Antihemoroid suppositoria Supp 111
82 Atapulgit tab 600 mg Tablet 1552
83 Bisakodil sup 5 mg Supp 0
84 Bisakodil 5 mg Tablet 79
85 Dimenhidrinat tab 50 mg Tablet 0
86 Domperidon 10 mg Tablet 0
87 Domperidon sirup 5 mg/5 ml Btl 60 ml 0
88 Garam Oralit 200 ml Sase 1337
89 Hiosina Butilbromida 10 mg Tablet 343
90 Karbo Adsorben 250 mg Tablet 0
91 Metoklopramide sirup 5 mg/ml Btl 60 ml 2
92 Natrium Bicarbonat 500 mg Tablet 505
93 Komb Kaolin 550 mg + pektin 20 mg Tablet 0
94 Omeprazol 20 mg Capsul 0
95 Omeprazol inj 40 mg / 10 ml Ampul 0
96 Ranitidin tab 150 mg Tablet 2205
97 Zinc dispersibel Tablet 360

98 Amlodipine 5 mg Tablet 1800
99 Amlodipin 10 mg Tablet 386
100 Atenolol 50 mg Tablet 0
101 Captopril 12,5 mg Tablet 242
102 Captopril 25 mg Tablet 1818
103 Digoksin 0,25 mg Tablet 40
104 Diltiazem 30 mg Tablet 0
105 Furosemid 40 mg Tablet 1079
106 Hidrokortiazid HCT tab 25 mg Tablet 0
107 Isosorbid Dinitrat 5 mg tablet Tablet 50
108 Metyldopa tab 250 mg Tablet 0
109 Nifedipin tab 10 mg Tablet 213
110 Reserpin 0,25 mg Tablet 0
111 Spironolakton 25 mg Tablet 0
OBAT MATA
112 Klorampenicol S.M 1 % Tube 107
113 Koramfenikol TM 1 % Botol Tts 0
110
OBAT KULIT
114 Anti Bacteri DOEN SK/Bacitracin Tube 112
115 Antifungi SK Pot 6
116 Acyclovir cream 5 % Tube 0
117 Betametason Crem 0,1 % Tube 181
118 Bedak Salisil serbuk 2 % Dus 246
119 Hidrokortison Crem 2,5 % Tube 121
120 Ichtyol Sk Pot 9
121 Ketokonazol krim 2% Tube 10 gr 151
122 Kloramfenikol SK 2% Tube 127
123 Perak Sulfadiazin krim 1% Tube 11
124 Mikonazol krim 2% Tube 77
125 Permetrin Krim 5 % Tube 1371
126 Salep 2-4 Pot 45
VITAMIN DAN MINERAL

127 Asam Askorbat (Vit C) tab 50 mg Tablet 0
128 Asam Askorbat (Vit C) tab 250 mg Tablet 2247
129 Asam Folat 1 mg Tablet 0
130 Kalsium laktat (kalk) tab 500 mg Tablet 0
131 Multivitamin dan Mineral Tablet 0
132 Mineral Mix Sase 0
133 Piridoksin HCL 10 mg tablet Tablet 3891
134 Retinol (Vit. A) 100,000 IU Kap Lunak Capsul 100
135 Retinol (Vit. A) 200,000 IU Kap Lunak Capsul 1869
136 Sianokobalamin (Vitamin B12) tab 50 mcg Tablet 0
137 Tablet Tambah Darah/FE Tablet 9
138 Thiamin HCL 50 mg Tablet 3437
139 Vit. B. Complex Tablet 4683
140 Vit. Syrup Anak 60 ml Botol 0
141 Alopurinol 100 mg Tablet 561
142 Fitomenadion /Vit K 10 mg Tablet 243
143 Fitomenadion /Vit K Inj 2 mg/ml Ampul 23
144 Gemfibrozil 300 mg Tablet 0
145 Metilergometrin Maleat 0,125 mg Tablet 54
146 Metilergometrin Maleat 0,200 mg 1ml inj Ampul 0
147 Simvastatin 10 mg Tablet 0
MULUT,THT
148 Borax Glicerin Botol 0
149 Fenol Glicerol Tetes Telinga 10 % Botol 0
150 Gentian Violet Lart 1 % 10 ml Botol 0
151 Kloramfenikol tetes Telinga 3 % 10 ml Botol 0
152 Oksimetazolin tts hidung 0,025% Botol 14
153 Deksametason 0,5 mg tablet Tablet 5500
154 Deksametason inj 5 mg / ml (i.v / i.m) Ampul 0
155 Difenhidramin inj 10 mg / ml (i.v / i.m) Ampul 0
156 Klorfeniramin Maleat/CTM 4 mg Tablet 5409
157 Loratadine Tab 10 mg Tablet 593
158 Prednison 5 mg Tablet 0
159 Setirizin sir 5 mg / 5 ml Botol @ 60 ml 0
HORMON
160 Glibenklamid 5 mg tablet Tablet 678
161 Propiltiourasil tab 100 mg (PTU) Tablet 0
162 Metformin tab 500 mg Tablet 3054
163 Alkohol Swab Buah 41
164 Chlorin 10 % Liter 0
165 Etakridin 0,1 % Rivanol 300 ml Botol 5
166 Etanol 70 % 100 ml Botol 71
167 Framisetin sulfat tulle 1% Lembar 0
168 Hand Rub Liter 10
169 Kaporit 60% Kg 0
170 Kaporit 60% Tablet 0
171 Kalium Permanganat (PK) 5 gram Botol 18
172 Lisol 50 % 1000 ml Botol 19
173 Polikresulen 10 ml Botol 2
174 Povidon Iodin lar 10 mg/ml Botol 30 ml 0
175 Povidon Iodin lar 10 mg/ml Botol 300 ml 1
INFUS,LAR STERIL
176 Aqua pro inj steril 20 ml Vial 18
177 Glukosa Lar infus 5 % steril 500 ml Labu 1
178 Natrium Klorida Larutan Infus 0,9 % Labu 10
179 Ringer Laktat Larutan Infus Steril Labu 12
180 Aqua Bidestilata Liter 0

181 Amitriptilin tab sal 25 mg Tablet salut 0
182 Diazepam 2 mg tablet Tablet 72
183 Fenobarbital tab 30 mg Tablet 0
184 Haloperidol tab 1.5 mg Tablet 0
185 Karbamazepin tab 200 mg Tablet 0
186 Klorpromazin tab sal 25 mg Sallet 0
187 Kodein HCL 10 mg Tablet 0
188 Risperidon tab 2 mg Sallet 0
REAGENT HIV
189 Rapid Test HIV ( Oncoprobe ) Test 0
190 Rapid Test HIV ( Intec ) Test 20
191 Rapid Test HIV ( Biomeriux ) Test 24
192 SD HIV Test 12
193 Open CD 4 Test 0
194 Kontrol CD 4 kitt 0
REAGENT IMS
195 TPHA Sypillis (INTEC) Test 0
196 TPHA Sypillis (SD) Test 0
197 RPR Antigen/ Trust Test 0
198 Pewarnaan gram Kit 0
REAGEN TB
199 Reagent ZN Kit 2
200 PPD / Test Mantoux Vial 0
ALAT & BAHAN GIGI

201 Air Raksa Fls 31
202 Alvogil Fls 0
203 Amalgam Fls 27
204 Articulating paper (kertas warna penanda oklusi) Lembar 0
205 Devitalisasi Pasta (arsenik) Fls 2
206 Devitalisasi Pasta (Non arsen) 2
207 Arkansas Stone Fls 0
208 Bahan tumpatan sementara (Temporary Fletcher) Pot 32
209 Boor low fressure Buah 6
210 Boor low inverted Buah 6
211 Boor low round Buah 6
212 Boor Stone Buah 0
213 Boor jet Fressure Buah 1
214 Boor jet inverted Buah 5
215 Boor jet round Buah 6
216 CaOH with Iodoform 1 syringe 2,2 g Botol 0
217 Cement Zn Phospat Powder & Liquid Set 0
218 Celluloid Strip Lembar 100
219 Disclossing Sol. Fls 0
220 Eugenol Fls 3
221 Formokresol (TKF ) Btl 0
Glass Ionomer ART (Atraumatic Restorative Treatment)
Buah 2
222 Anterior/Fuji II
Buah 4
223 Posterior/Fuji IX
224 H2O2 Botol 0
225 Kalsium Hidroksida Pasta (CaOH) Tube 3
226 Klorfenol Kamfer Mentol (CHKM) Fls 4
Fls 1
227 5%,Paraklorphenol 30%, campor 64% (Chresophene)
228 Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000 inj 2 ml Ampul 244
Komb : Mepivakaine HCl 2 % + Epinefrin 1:100.000 cartridge kaca 0
229 (Septocain)
Komb : Artikaine HCl 4% + Epinefrin 1 : 100.000 cartridge kaca 0
230
231 Komposit Resin Fls 0
232 Matrix Band Roll 0
233 Pasta Pengisi Saluran Akar (Cresophate) Fls 0
234 Pasta Gigi Buah 13
Panasray Buah 2
235
Pembersih noda gigi (TSR/OCO) Buah 0

236
Rockel Fls 1
237
238 Spongostan Buah 24
239 Slaber Buah 0
240 Savlon Liter 0
241 Tissue gulung Buah 0
242 Vaseline Pot 15gr 1
ALKES HABIS PAKAI

243 Abbocat No. 18 Buah 1
248 Alat Suntik 1 ml Buah 302
253 Bisturi Buah 0
254 Blood Lancet Buah 0
255 Cat Gut Chromic/Benang Bedah No. 3.2 Buah 38
256 Cat Gut Plain/Benang Bedah No. 3.2 Buah 0
257 Endotrakeal No 3 Buah 0
258 Endotrakeal No 3.5 Buah 0
259 Endotrakeal No 4 Buah 0
260 Foley Kateter No 18 Buah 0
261 Foley Kateter No 20 Buah 0
262 Hecting Nald Buah 0
263 Infuset anak Buah 0
264 Infuset dewasa Buah 13
265 Iodina Test Botol 4
266 Jarum Cytojek Buah 102
267 Jarum vacutainer Buah 75
268 Kateter penghisap lendir No 8 Buah 0
269 Kateter penghisap lendir No 10 Buah 0
270 Kaca Mulut Buah 0
271 Kaca Penutup / Dek glass Kotak 100 0
272 Kantong Jenazah Buah 0
273 Kapas Pembalut Absorben 250 g Bks 6
274 Kassa Kompres 40 x 40 steril Bks 10
275 Kassa Pembalut 2 m x 80 cm Bks 7
276 Kassa pembalut Hidrofil 4 cm x 15 cm Roll 19
277 Kassa pembalut Hidrofil 4 cm x 3 cm Roll 70
278 Kertas Perkamen Bks 3
279 Masker Lembar 0
280 Masker N.95 Buah 0
281 Masker Oksigen dewasa Buah 0
282 Masker Oksigen Anak Buah 0
283 Oksigen can Buah 0
284 Plastic Bandages Kotak 100
285 Plester 5 yard x 2 inch Roll 9
286 Plester kertas Roll 1
287 Peneng Bayi Buah 0
288 Perban elastis Roll 0
289 Pot Sputum Buah 66
290 RTD Malaria Box 40 0
291 Rotator Unit 0
292 Slide Box 0
293 Sarung tangan Steril Psng 660
294 Sarung Tangan Non Steril Psng 100
295 Sarung Tangan Panjang ginekolog Psng 57
296 Sarung Tangan Karet Tebal Buah 4
297 Selang oksigen Anak Buah 0
298 Selang oksigen dewasa Buah 0
299 Sendok Obat Buah 0
300 Silk Buah 7
301 Spalk 30 cm pasang 0
302 Three way stop cock Buah 0
303 Tip pipet kuning Pak 0
304 Tongue Spatel Kayu Buah 0
305 Urine Bag Buah 0
306 Ultrasound gel 250 cc Botol 5
307 Umbilical Cord Clam Biru Buah 0
308 Vacutainer/Tabung spesimen darah + tutup Buah 78
309 Wing Needle no.27 G Buah 15
310 Condom Buah 1032

314 Buku Resep Buku 102
315 Etiket Obat Biru Lembar 0
316 Etiket Obat putih Lembar 0
317 Buku Harian Buku 0
318 Kartu stok Lembar 0
319 LPLPO Lembar 0
320 K.Obat Plastik 8 x 13 x 05 Kg 0
321 Kantong Obat Plastik 20 x 15 x 0.5 Kg 1
324 Kantong kresek Putih Pak 0
Mengetahui, Bandung, 2 Desember 2017

Ka. Sub. Bag. TU UPT Puskesmas Panghegar Apoteker UPT. Puskesmas Panghegar
SUKARTI PRATIWI OKTAVIANA S.Farm., Apt.

NIP. 19610517 198403 2009 NIPK. 2017.05.09.012
Puskesmas
Jumlah
Panyileukan
3 17
0 0
0 0
0 0
3 15
7 15
0 0
5 325
0 65
0 0
0 0
764 2500
0 51
0 0
21 32
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
175 591
0 463
530 1248
0 0
885 2325
3 3
0 0
0 0
0 101
85 187
0 0
0 0
151 418
0 0
0 2
0 2
0 1
0 0
30 103
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
180 435
0 0
0 0
0 0
0 3348
0 0
0 0
423 1236
0 0
0 0
120 300
0 0
0 0
0 0
15 96
28 47
0 228
0 0
11447 33518
204 988
0 0
1617 9964
64 193
65 176
398 1950
0 0
85 164
0 0
0 0
0 0
615 1952
310 653
0 0
0 2
220 725
0 0
0 0
0 0
638 2843
240 600
532 2332
7 393
0 0
5 247
925 2743
145 185
0 0
168 1247
0 0
81 131
0 0
0 213
0 0
0 0
28 135
0
0 112
0 6
0 0
35 216
67 313
48 169
0 9
24 175
4 131
3 14
10 87
283 1654
52 97
0 0
857 3104
0 0
0 0
0 0
0 0
1300 5191
51 151
98 1967
0 0
540 549
1160 4597
2184 6867
0 0
68 629
114 357
13 36
0 0
20 74
0 0
0 0
16 16
3 3
0 0
0 0
7 21
2171 7671
0 0
0 0
697 6106
950 1543
0 0
0 0
290 968
0 0
1830 4884
0 41
2 2
4 9
15 86
0 0
1 11
0 0
0 0
9 27
25 44
0 2
0 0
0 1
0 18
0 1
1 11
6 18
10 10
0 0
0 72
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 20
0 24
0 12
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 31
0 0
0 27
0 0
1 3
0 2
0 0
0 32
0 6
0 6
0 6
0 0
0 1
0 5
0 6
0 0
0 0
0 100
0 0
1 4
0 0
0
2
0
4
0 0
0 3
0 4
0
1
82 326
0
0
0
0
0 0
0 0
0 0
0 13
1
3
0
0
1
2
0 24
0 0
0 0
0 0
0 1
2 3
6 14
0 2
0 0
0 4
52 354
0 151
0 96
0 0
0 0
0 0
0 0
5 43
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 13
5 9
0 102
0 75
0 0
0 0
0 0
0 0
0 0
4 10
4 14
2 9
0 19
31 101
0 3
400 400
0 0
0 0
0 0
0 0
0 100
0 9
0 1
0 0
0 0
0 66
0 0
0 0
0 0
50 710
34 134
6 63
2 6
0 0
0 0
350 350
3 10
0 0
0 0
0 0
0 0
0 0
3 8
0 0
0 78
0 15
0 1032
0 102
0 0
0 0
0 0
0 0
0 0
0 0
0 1
0 0
0 0
0 0
ung, 2 Desember 2017

eker UPT. Puskesmas Panghegar
TIWI OKTAVIANA S.Farm., Apt.

K. 2017.05.09.012
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSKESMAS : UPT PANGHEGAR PELAPORAN BULAN : DESEMBER 2017

KECAMATAN : PANYILEUKAN
WILAYAH : UJUNG BERUNG PERMINTAAN BULAN : JANUARI 2018
KOTA : BANDUNG
SISA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK OPTIMUM
AKHIR
1 2 3 4 5 6 7 8 9
LIFE SAVING
1 Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml Ampul 14 0 14 5 9 14
2 Epinefrin HCL Inj Ampul 2 0 2 2 0 5
3 Kalsium Glukonat inj 100 mg / ml Ampul 0 0 0 0 0 0
4 Mg Sulfat Inj 40 % - IV/10 vial Ampul 0 0 0 0 0 0
5 Oksitosin Inj 10 lU/ml 1 ml Ampul 12 0 12 7 5 20
6 Diazepam Lar Rektal 10 mg/ml Tube 12 0 12 0 12 0
ANTIINFEKSI
7 Acyclovir tab 400 mg Tablet 260 0 260 0 260 0
8 ACT ( arthesunat ) Tablet 0 0 0 0 0 0
9 Albendazol susp 200 mg/5 ml Botol 0 0 0 0 0 0
10 Albendazol 400 mg Tablet 0 0 0 0 0 0
11 Amoksilin Kap.500 mg Tablet 0 3000 3000 500 2500 1850
12 Amoksilin Kap. 250 mg Kapsul 0 0 0 0 0 0
13 Amoksilin syr kering 125 mg/ ml Botol 43 0 43 43 0 159
14 Amoksilin syr kering 250 mg/ ml Botol 0 0 0 0 0 0
15 Amoksisilin Drops 100 mg/ml Botol 10 0 10 0 10 0
16 Azitromisin 500 mg Kaplet 0 0 0 0 0 0
17 Benzatin Benzil P 2,4 Vial 0 0 0 0 0 0
18 Cefixim tab 100 mg Tablet 0 0 0 0 0 0
19 Ciprofloxacin 500 mg Tablet 0 0 0 0 0 0
20 Doxyciclin 100 mg Tablet 0 0 0 0 0 0
20 Dietilkarbamazin Tablet 0 0 0 0 0 0
22 Ethambutol 250 mg Tablet 0 0 0 0 0 0
23 Erytromicin 250 mg Tablet 0 0 0 0 0 0
24 Flukonazol kaps 50 mg Capsul 0 0 0 0 0 0
25 Griseofulvin125 mg Tablet 0 0 0 0 0 0
25 Gentamisin 80 mg / 2ml inj Ampul 0 0 0 0 0 0
26 Griseofulvin125 mg Tablet 0 0 0 0 0 0
27 Isoniazide 100 mg Tablet 0 0 0 0 0 0
28 Isoniazide 300 mg Tablet 0 0 0 0 0 0
29 Ketoconazole 200 mg Tablet 460 0 460 0 460 0
30 Klindamisin 150 mg Capsul 306 0 306 0 306 0
31 Klindamisin 300 mg Capsul 334 800 1134 108 1026 400
32 Kloramfenikol 250 mg capsul Capsul 0 0 0 0 0 0
33 Kloramfenikol 500 mg capsul Capsul 1880 0 1880 0 1880 0
34 Kloramfenikol susp 125 mg / 5 ml Botol @ 60 ml 0 0 0 0 0 0
35 Kombipak IMS Kotak 0 0 0 0 0 0
36 Kotrimoksazol Adult 480 mg Tablet 0 0 0 0 0 0
37 Kotrimoksazol Suspensi 240 mg/5 ml Botol 91 0 91 88 3 326
38 Metronidazol 250 mg Tablet 104 0 104 3 101 11
39 Metronidazol 500 mg Tablet 0 0 0 0 0 0
40 Natrium Tiroksin Tablet 0 0 0 0 0 0
41 Nistatin 100.000 IU/g tablet vagina Tablet 262 0 262 0 262 0
42 Nistatin susp 100.000 UI / ml Botol 0 0 0 0 0 0
43 Obat Anti TBC Anak FDC Paket 0 0 0 0 0 0
44 Obat Anti TBC Kat I FDC Paket 0 0 0 0 0 0
45 Obat Anti TBC Kat II FDC Paket 0 0 0 0 0 0
46 Obat Anti TBC Sisipan Paket 0 0 0 0 0 0
47 Pyrantel Pamoat 125 mg Tablet 60 0 60 0 60 0
48 Pyrazinamide 500 mg Tablet 0 0 0 0 0 0
49 Pyrimethamine 25 mg Tablet 0 0 0 0 0 0
50 Rifampicin 300 mg Tablet 0 0 0 0 0 0
53 Sefadroxil kapsul 500 mg Capsul 0 0 0 0 0 0
54 Sefadroxil syr kering 125 mg/ml Botol 0 0 0 0 0 0
55 Streptomicin Inj. Ampul 0 0 0 0 0 0
56 Tetracyclin 250 mg Tablet 0 0 0 0 0 0
SALURAN PERNAPASAN
57 Ambroxol Syrup 15 mg Botol 0 300 300 34 266 99
58 Ambroxol tab 30 mg Tablet 0 0 0 0 0 0
59 Aminopilina 200 mg Tablet 0 0 0 0 0 0
60 Gliseril Guayakolat 100 mg Tablet 0 0 0 0 0 0
61 Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 mg nebules Vial 0 0 0 0 0 0
62 N-asetil sistein kaps 200 mg Kapsul 1206 3600 4806 2560 2246 7424
63 Obat Batuk Anak Syrup Botol 0 0 0 0 0 0
64 Salbutamol 2 mg Tablet 800 600 1400 352 1048 1021
65 Salbutamol 2.5 mg nebules Vial 0 0 0 0 0 0
66 Antimigren Tablet 0 0 0 0 0 0
67 Asam Mefenamat 500 mg Tablet 0 0 0 0 0 0
68 Betahistine mysilat 6 mg Tablet 0 300 300 0 300 0
69 Etil Klorida Semprot 100 ml Botol 0 0 0 0 0 0
70 Ibuprofen 400 mg Tablet 0 0 0 0 0 0
71 Ibuprofen sirup 200 mg/ 5 ml Botol 103 0 103 7 96 20
72 Ibupropen 200 mg Tablet 0 0 0 0 0 0
73 Lidokain inj 2 % (infltr/p.v) Ampul 57 0 57 10 47 29
74 Na.Diklofenak 50 mg Tablet 41 0 41 41 0 119
75 Parasetamol 500 mg Tablet 30802 3000 33802 284 33518 824
76 Parasetamol syr 120 mg/5 ml 60 ml Botol 526 500 1026 264 988 766
77 Parasetamol tts 60 mg / 0.6 ml Botol Tts 0 0 0 0 0 0
78 Piroksikam 10 mg Tablet 0 0 0 0 0 0
SISTEM PENCERNAAN
79 Antasida DOEN Tablet 6407 6500 12907 2943 9964 8535
Botol @
80 Antasida DOEN susp 60 ml 29 150 179 0 179 0
81 Antihemoroid suppositoria Supp 55 100 155 0 155 0
82 Atapulgit tab 600 mg Tablet 1720 200 1920 0 1920 0
83 Bisakodil 5 mg Tablet 95 0 95 0 95 0
84 Bisakodil sup 5 mg Supp 0 0 0 0 0 0
85 Dimenhidrinat tab 50 mg Tablet 0 0 0 0 0 0
86 Domperidon 10 mg Tablet 0 0 0 0 0 0
87 Domperidon sirup 5 mg/5 ml Btl 60 ml 0 0 0 0 0 0
88 Garam Oralit 200 ml Sase 1450 300 1750 0 1750 0
89 Hiosina Butilbromida 10 mg Tablet 536 0 536 0 536 0
90 Karbo Adsorben 250 mg Tablet 0 0 0 0 0 0
91 Komb Kaolin 550 mg + pektin 20 mg Tablet 0 0 0 0 0 0
92 Metoklopramide sirup 5 mg/ml Btl 60 ml 0 0 0 0 0 0
93 Natrium Bicarbonat 500 mg Tablet 540 0 540 0 540 0
94 Omeprazol 20 mg Capsul 0 0 0 0 0 0
95 Omeprazol inj 40 mg / 10 ml Ampul 0 0 0 0 0 0
96 Ranitidin tab 150 mg Tablet 3384 0 3384 541 2843 1569
97 Zinc dispersibel Tablet 450 0 450 0 450 0

98 Amlodipine 5 mg Tablet 0 3000 3000 668 2332 1737
99 Amlodipin 10 mg Tablet 742 0 742 349 393 733
100 Atenolol 50 mg Tablet 0 0 0 0 0 0
101 Captopril 12,5 mg Tablet 400 0 400 153 247 321
102 Captopril 25 mg Tablet 2456 0 2456 0 2456 0
103 Digoksin 0,25 mg Tablet 145 0 145 0 145 0
104 Diltiazem 30 mg Tablet 0 0 0 0 0 0
105 Furosemid 40 mg Tablet 1140 0 1140 0 1140 0
106 Hidrokortiazid HCT tab 25 mg Tablet 0 0 0 0 0 0
107 Isosorbid Dinitrat 5 mg tablet Tablet 120 0 120 0 120 0
108 Metyldopa tab 250 mg Tablet 0 0 0 0 0 0
109 Nifedipin tab 10 mg Tablet 285 0 285 72 213 151
110 Reserpin 0,25 mg Tablet 0 0 0 0 0 0
111 Spironolakton 25 mg Tablet 0 0 0 0 0 0
OBAT MATA
112 Klorampenicol S.M 1 % Tube 129 0 129 0 129 0
113 Koramfenikol TM 1 % Botol Tts 0 0 0 0 0 0
OBAT KULIT
114 Anti Bacteri DOEN SK/Bacitracin Tube 20 75 95 0 95 0
115 Acyclovir cream 5 % Tube 0 0 0 0 0 0
116 Antifungi SK Pot 0 0 0 0 0 0
117 Bedak Salisil serbuk 2 % Dus 165 100 265 0 265 0
118 Betametason Crem 0,1 % Tube 60 125 185 0 185 0
119 Hidrokortison Crem 2,5 % Tube 76 144 220 51 169 148
120 Ichtyol Sk Pot 9 0 9 0 9 0
121 Ketokonazol krim 2% Tube 10 gr 20 150 170 0 170 0
122 Kloramfenikol SK 2% Tube 103 96 199 68 131 197
123 Mikonazol krim 2% Tube 18 72 90 3 87 9
124 Perak Sulfadiazin krim 1% Tube 13 0 13 0 13 0
125 Permetrin Krim 5 % Tube 1380 0 1380 0 1380 0
126 Salep 2-4 Pot 46 0 46 0 46 0
VITAMIN DAN MINERAL

127 Asam Askorbat (Vit C) tab 250 mg Tablet 82 2500 2582 0 2582 0
128 Asam Askorbat (Vit C) tab 50 mg Tablet 0 0 0 0 0 0
129 Asam Folat 1 mg Tablet 0 0 0 0 0 0
130 Kalsium laktat (kalk) tab 500 mg Tablet 0 0 0 0 0 0
131 Mineral Mix Sase 0 0 0 0 0 0
132 Multivitamin dan Mineral Tablet 0 0 0 0 0 0
133 Piridoksin HCL 10 mg tablet Tablet 2176 2000 4176 0 4176 0
134 Retinol (Vit. A) 100,000 IU Kap Lunak Capsul 50 0 50 0 50 0
135 Retinol (Vit. A) 200,000 IU Kap Lunak Capsul 1850 0 1850 0 1850 0
136 Sianokobalamin (Vitamin B12) tab 50 mcg Tablet 0 0 0 0 0 0
137 Tablet Tambah Darah/FE Tablet 35 0 35 0 35 0
138 Thiamin HCL 50 mg Tablet 1394 3000 4394 0 4394 0
139 Vit. B. Complex Tablet 4046 5000 9046 2179 6867 4140
140 Vit. Syrup Anak 60 ml Botol 0 0 0 0 0 0
141 Alopurinol 100 mg Tablet 170 600 770 141 629 409
142 Fitomenadion /Vit K 10 mg Tablet 134 0 134 0 134 0
143 Fitomenadion /Vit K Inj 2 mg/ml Ampul 31 0 31 0 31 0
144 Gemfibrozil 300 mg Tablet 0 0 0 0 0 0
145 Metilergometrin Maleat 0,125 mg Tablet 50 0 50 0 50 0
146 Metilergometrin Maleat 0,200 mg 1ml inj Ampul 0 0 0 0 0 0
147 Simvastatin 10 mg Tablet 0 0 0 0 0 0
MULUT,THT
148 Borax Glicerin Botol 0 0 0 0 0 0
149 Fenol Glicerol Tetes Telinga 10 % Botol 0 0 0 0 0 0
150 Gentian Violet Lart 1 % 10 ml Botol 0 0 0 0 0 0
151 Kloramfenikol tetes Telinga 3 % 10 ml Botol 0 0 0 0 0 0
152 Oksimetazolin tts hidung 0,025% Botol 6 0 6 0 6 0
153 Deksametason 0,5 mg tablet Tablet 2194 8000 10194 2523 7671 7317
154 Deksametason inj 5 mg / ml (i.v / i.m) Ampul 0 0 0 0 0 0
155 Difenhidramin inj 10 mg / ml (i.v / i.m) Ampul 0 0 0 0 0 0
156 Klorfeniramin Maleat/CTM 4 mg Tablet 4379 2000 6379 273 6106 792
157 Loratadine Tab 10 mg Tablet 2051 0 2051 508 1543 1473
158 Prednison 5 mg Tablet 0 0 0 0 0 0
159 Setirizin sir 5 mg / 5 ml Botol @ 60 ml 0 0 0 0 0 0
HORMON
160 Glibenklamid 5 mg tablet Tablet 340 500 840 0 840 0
161 Metformin tab 500 mg Tablet 4030 0 4030 0 4030 0
162 Propiltiourasil tab 100 mg (PTU) Tablet 0 0 0 0 0 0
163 Alkohol Swab Buah 61 0 61 20 41 58
164 Chlorin 10 % Liter 0 0 0 0 0 0
165 Etakridin 0,1 % Rivanol 300 ml Botol 7 0 7 0 7 0
166 Etanol 70 % 100 ml Botol 3 60 63 0 63 0
167 Framisetin sulfat tulle 1% Lembar 0 0 0 0 0 0
168 Hand Rub Liter 0 5 5 0 5 0
169 Kalium Permanganat (PK) 5 gram Botol 27 0 27 0 27 0
170 Kaporit 60% Kg 0 0 0 0 0 0
171 Kaporit 60% Tablet 0 0 0 0 0 0
172 Lisol 50 % 1000 ml Botol 34 0 34 0 34 0
173 Polikresulen 10 ml Botol 2 0 2 0 2 0
174 Povidon Iodin lar 10 mg/ml Botol 30 ml 0 0 0 0 0 0
175 Povidon Iodin lar 10 mg/ml Botol 300 ml 0 0 0 0 0 0
INFUS,LAR STERIL
176 Aqua Bidestilata Liter 0 0 0 0 0 0
177 Aqua pro inj steril 20 ml Vial 15 0 15 0 15 0
178 Glukosa Lar infus 5 % steril 500 ml Labu 0 0 0 0 0 0
179 Natrium Klorida Larutan Infus 0,9 % Labu 5 0 5 0 5 0
180 Ringer Laktat Larutan Infus Steril Labu 14 0 14 0 14 0

181 Amitriptilin tab sal 25 mg Tablet salut 0 0 0 0 0 0
182 Diazepam 2 mg tablet Tablet 111 0 111 6 77 11
183 Fenobarbital tab 30 mg Tablet 0 0 0 0 0 0
184 Haloperidol tab 1.5 mg Tablet 0 0 0 0 0 0
185 Karbamazepin tab 200 mg Tablet 0 0 0 0 0 0
186 Klorpromazin tab sal 25 mg Sallet 0 0 0 0 0 0
187 Kodein HCL 10 mg Tablet 0 0 0 0 0 0
188 Risperidon tab 2 mg Sallet 0 0 0 0 0 0
REAGENT HIV
189 Kontrol CD 4 kitt 0 0 0 0 0 0
190 Open CD 4 Test 0 0 0 0 0 0
191 Rapid Test HIV ( Oncoprobe ) Test 0 0 0 0 0 0
192 Rapid Test HIV ( Biomeriux ) Test 24 0 24 0 24 0
193 Rapid Test HIV ( Intec ) Test 20 0 20 19 1 38
194 SD HIV Test 12 0 12 0 12 0
REAGENT IMS
195 Pewarnaan gram Kit 0 0 0 0 0 0
196 RPR Antigen/ Trust Test 0 0 0 0 0 0
197 TPHA Sypillis (INTEC) Test 0 0 0 0 0 0
198 TPHA Sypillis (SD) Test 0 0 0 0 0 0
REAGEN TB
199 Reagent ZN Kit 2 0 2 1 1 3
200 PPD / Test Mantoux Vial 0 0 0 0 0 0
ALAT & BAHAN GIGI

201 Air Raksa Fls 31 0 31 0 31 0
202 Alvogil Fls 0 0 0 0 0 0
203 Amalgam Fls 27 0 27 0 27 0
204 Arkansas Stone Fls
0 0 0 0 0 0
205 Articulating paper (kertas warna penanda oklusi) Lembar 0 0 0 0 0 0
206 Bahan tumpatan sementara (Temporary Fletcher) Pot 32 0 32 0 32 0
207 Boor jet Fressure Buah 7 0 7 6 1 17
208 Boor jet inverted Buah 7 0 7 2 7 6
209 Boor jet round Buah 7 0 7 1 6 3
210 Boor low fressure Buah 6 0 6 0 6 0
211 Boor low inverted Buah 6 0 6 0 6 0
212 Boor low round Buah 6 0 6 0 6 0
213 Boor Stone Buah 3 0 3 0 3 0
214 CaOH with Iodoform 1 syringe 2,2 g Botol 3 0 3 3 0 9
215 Celluloid Strip Lembar 0 0 0 0 0 0
216 Cement Zn Phospat Powder & Liquid Set 0 0 0 0 0 0
217 Devitalisasi Pasta (arsenik) Fls 0 1 1 0 0 0
218 Devitalisasi Pasta (Non arsen) 0 0 0 0 0 0
219 Disclossing Sol. Fls 0 0 0 0 0 0
220 Eugenol Fls 1 3 4 0 4 0
221 Formokresol (TKF ) Btl 0 0 0 0 0 0
222 Anterior/Fuji II Buah
1 0 1 0 1 0
223 Posterior/Fuji IX Buah
2 0 2 0 2 0
224 H2O2 Botol 0 0 0 0 0 0
225 Kalsium Hidroksida Pasta (CaOH) Tube 0 0 0 0 0 0
226 Klorfenol Kamfer Mentol (CHKM) Fls 2 0 2 0 2 0
cartridge
227 Komb : Artikaine HCl 4% + Epinefrin 1 : 100.000 kaca
0 0 0 0 0 0
228 5%,Paraklorphenol 30%, campor 64% (Chresophene) Fls
1 0 1 0 1 0
229 Ampul
Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000 inj 2 ml 122 120 242 0 242 0
Komb : Mepivakaine HCl 2 % + Epinefrin 1:100.000 cartridge
230 (Septocain) kaca 0 0 0 0 0 0
231 Komposit Resin Fls 0 0 0 0 0 0
232 Matrix Band Roll 0 0 0 0 0 0
233 Panasray Buah 0 3 3 0 0 0
234 Pasta Gigi Buah 18 0 18 5 13 15
235 Pasta Pengisi Saluran Akar (Cresophate) Fls 0 0 0 0 0 0
236 Pembersih noda gigi (TSR/OCO) Buah 0 0 0 0 0 0
237 Rockel Fls 1 0 1 0 1 0
238 Savlon Liter 0 0 0 0 0 0
239 Slaber Buah 0 0 0 0 0 0
240 Spongostan Buah 24 0 24 0 24 0
241 Tissue gulung Buah 0 0 0 0 0 0
242 Vaseline Pot 15gr 1 0 1 0 1 0
ALKES HABIS PAKAI

243 Abbocat No. 18 Buah 2 0 2 0 2 0
244 Abbocat No. 20 Buah 8 0 8 0 8 0
245 Abbocat No. 22 Buah 2 0 2 0 2 0
246 Abbocat No. 24 Buah 0 0 0 0 0 0
247 Abbocat No. 26 Buah 4 0 4 0 4 0
248 Alat Suntik 1 ml Buah 292 0 292 0 292 0
253 Bisturi Buah 0 0 0 0 0 0
254 Blood Lancet Buah 0 0 0 0 0 0
255 Cat Gut Chromic/Benang Bedah No. 3.2 Buah 21 0 21 0 21 0
256 Cat Gut Plain/Benang Bedah No. 3.2 Buah 0 0 0 0 0 0
257 Condom Buah 4032 0 4032 0 4032 0
258 Endotrakeal No 3 Buah 0 0 0 0 0 0
259 Endotrakeal No 3.5 Buah 0 0 0 0 0 0
260 Endotrakeal No 4 Buah 0 0 0 0 0 0
261 Foley Kateter No 18 Buah 0 0 0 0 0 0
262 Foley Kateter No 20 Buah 0 0 0 0 0 0
263 Hecting Nald Buah 0 0 0 0 0 0
264 Infuset anak Buah 0 0 0 0 0 0
265 Infuset dewasa Buah 8 0 8 0 8 0
266 Iodina Test Botol 4 0 4 0 4 0
267 Jarum Cytojek Buah 88 0 88 0 88 0
268 Jarum vacutainer Buah 75 0 75 0 75 0
269 Kaca Mulut Buah 0 0 0 0 0 0
270 Kaca Penutup / Dek glass Kotak 100 0 0 0 0 0 0
271 Kantong Jenazah Buah 0 0 0 0 0 0
272 Kapas Pembalut Absorben 250 g Bks 0 10 10 0 10 0
273 Kassa Kompres 40 x 40 steril Bks 3 10 13 0 13 0
274 Kassa Pembalut 2 m x 80 cm Bks 3 10 13 4 9 8
275 Kassa pembalut Hidrofil 4 cm x 15 cm Roll 23 0 23 4 19 8
276 Kassa pembalut Hidrofil 4 cm x 3 cm Roll 71 0 71 0 71 0
277 Kateter penghisap lendir No 10 Buah 0 0 0 0 0 0
278 Kateter penghisap lendir No 8 Buah 0 0 0 0 0 0
279 Kertas Perkamen Bks 3 0 3 0 3 0
280 Masker Lembar 0 0 0 0 0 0
281 Masker N.95 Buah 0 0 0 0 0 0
282 Masker Oksigen Anak Buah 0 0 0 0 0 0
283 Masker Oksigen dewasa Buah 0 0 0 0 0 0
284 Oksigen can Buah 0 0 0 0 0 0
285 Peneng Bayi Buah 0 0 0 0 0 0
286 Perban elastis Roll 0 0 0 0 0 0
287 Plastic Bandages Kotak 0 0 0 0 0 0
288 Plester 5 yard x 2 inch Roll 1 8 9 0 9 0
289 Plester kertas Roll 1 0 1 0 1 0
290 Pot Sputum Buah 181 0 181 101 80 212
291 Rotator Unit 0 0 0 0 0 0
292 RTD Malaria Box 40 0 0 0 0 0 0
293 Sarung Tangan Karet Tebal Buah 3 5 8 2 6 4
294 Sarung Tangan Non Steril Psng 0 0 0 0 0 0
295 Sarung Tangan Panjang ginekolog Psng 2 50 52 0 52 0
296 Sarung tangan Steril Psng 341 0 341 0 341 0
297 Selang oksigen Anak Buah 0 0 0 0 0 0
298 Selang oksigen dewasa Buah 0 0 0 0 0 0
299 Sendok Obat Buah 0 0 0 0 0 0
300 Silk Buah 8 0 8 0 8 0
301 Slide Box 0 0 0 0 0 0
302 Spalk 30 cm pasang 0 0 0 0 0 0
303 Three way stop cock Buah 0 0 0 0 0 0
304 Tip pipet kuning Pak 0 0 0 0 0 0
305 Tongue Spatel Kayu Buah 0 0 0 0 0 0
306 Ultrasound gel 250 cc Botol 0 3 3 0 3 0
307 Umbilical Cord Clam Biru Buah 0 0 0 0 0 0
308 Urine Bag Buah 0 0 0 0 0 0
309 Vacutainer/Tabung spesimen darah + tutup Buah 78 0 78 0 78 0
400 Wing Needle no.27 G Buah 15 0 15 0 15 0

310 Buku Resep Buku 64 0 64 64 0
311 Etiket Obat Biru Lembar 1500 0 1500 1500 0
312 Etiket Obat putih Lembar 80000 0 80000 80000 0
313 Buku Harian Buku 0 0 0 0 0
314 Kartu stok Lembar 0 0 0 0 0
315 LPLPO Lembar 0 0 0 0 0
316 K.Obat Plastik 8 x 13 x 05 Kg 0 0 0 0 0
317 Kantong Obat Plastik 20 x 15 x 0.5 Kg 0 0 0 0 0
320 Kantong kresek Putih Pak 0 0 0 0 0
KUNJUNGAN JUMLAH R/ GENERIK R/ NON GENERIK
PASIEN UMUM BPJS KUNJUNGAN UMUM BPJS UMUM
BALITA 1060 768 1828 584 172 296
ANAK 2542 1034 3576 342 212 88
DEWASA 7566 1175 8741 3542 3364 139
JUMLAH 11168 2977 14145 4468 3748 523
Mengetahui, Yang menyerahkan, Yang Menerima Yang Melaporkan

Kepala Seksi Farbekes Pemegang Barang Khusus Obat Plt. Kepala UPT. Puskesma
------------------------------------ ---------------------------------- ---------------------------------- dr. Hj. Nina Manarosana, R

NIP NIP NIP NIP 19660319 199703
O)
NO DOKUMEN TANGGAL
TERIMA KEMBALI
RATA RATA PEMAKAIAN #REF!
PEMBERIAN
PERMINTAAN KET
APBD APBD I APBN
10 11 12 13 14
0
0
0
0
0
0
0
0
0
0
0
0
318
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
323
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10356
0
0
0
0
1000
600
10
0
0
0
0
238
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
680
0
0
500
0
0
4000
0
0
0
200
0
0
100
200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
100
100
60
100
20
0
0
0
0
0
0
100
0
0
0
34
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 EXP. 28 tab
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
40
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
145
0
0
0
0
0
0
2
1
0
0
JUMLAH
/ NON GENERIK PENULIS
BPJS ANR/
70 1,122
56 698
218 7,263
344 9,083
Yang Melaporkan,
Plt. Kepala UPT. Puskesmas Panghegar
dr. Hj. Nina Manarosana, R., M. Kes.

NIP 19660319 199703 2 001
NAMA OBAT Grand Total
BLUD
Setirizin sir 5 mg / 5 ml 147
BLUD Total 147
DINAS KESEHATAN KOTA BANDUNG

Deksametason 0,5 mg tablet 22823
Klorfeniramin Maleat/CTM 4 mg 46803
Setirizin sir 5 mg / 5 ml 340
Loratadine Tab 10 mg 2625
DINAS KESEHATAN KOTA BANDUNG Total 72591
ALERGI,KORTIKOSTEROID Total 72738
ALKES HABIS PAKAI

Kassa Kompres 40 x 40 steril 1
Masker 443
ALKES HABIS PAKAI Total 444
BLUD
Ibuprofen 400 mg 2546
Parasetamol tts 60 mg / 0.6 ml 66
Piroksikam 10 mg 538
Pyridol Drops (PCT Drops) 100
Betahistin 6 mg 179
Asam Mefenamat 500 mg 340
BLUD Total 3769

Ibuprofen 400 mg 4690
Ibuprofen sirup 200 mg/ 5 ml 778
Na.Diklofenak 50 mg 16160
Parasetamol 500 mg 124930
Parasetamol syr 120 mg/5 ml 60 ml 3110
Parasetamol tts 60 mg / 0.6 ml 357
Piroksikam 10 mg 4043
Betahistin 6 mg 0
Asam Mefenamat 500 mg 0
Etil Klorida 4
Lidokain Inj. 2% 43
ANALGETIK,ANTIPIRETIK,ANTIINFLAMASI,AINS Total 157884
ANTIINFEKSI
BLUD
Amoksilin Kap.500 mg 9870
Amoksilin syr kering 125 mg/ ml 103
Ciprofloxacin 500 mg 106
BLUD Total 10227

Acyclovir tab 400 mg 3650
Albendazol 400 mg 3029
Amoksilin Kap. 250 mg 36823
Amoksilin Kap.500 mg 17180
Ciprofloxacin 500 mg 1275
Ketoconazole 200 mg 655
Klindamisin 150 mg 877
Klindamisin 300 mg 1785
Kloramfenikol 250 mg capsul 1051
Kloramfenikol 500 mg capsul 150
Kloramfenikol susp 125 mg / 5 ml 39
Kotrimoksazol Adult 480 mg 2261
Kotrimoksazol Suspensi 240 mg/5 ml 213
Metronidazol 250 mg 535
Metronidazol 500 mg 1945
Nistatin 100.000 IU/g tablet vagina 221
Pyrantel Pamoat 125 mg 30
Tetracyclin 250 mg 770
Amoksisilin Drops 100 mg/ml 56
Obat Paket TB Anak 2
Obat Paket TB Dewasa Kat. I 2
ANTIINFEKSI Total 83924
Rivanol 300 mL 2
Polikresulen 10 mL 4
ANTISEPTIK,DISINFEKTAN Total 6
BLUD
Alopurinol 100 mg 125
Simvastatin 10 mg 900
BLUD Total 1025

Alopurinol 100 mg 1716
Fitomenadion /Vit K 10 mg 523
Fitomenadion /Vit K Inj 2 mg/ml 0
Metilergometrin Maleat 0,125 mg 236
Simvastatin 10 mg 0
DARAH,AS URAT,KOLESTEROL Total 3500
HORMON
BKKBN
Pil KB (Ethynilastradiol dan Levonergestron) 1
BKKBN Total 1

Glibenklamid 5 mg tablet 1446
Metformin tab 500 mg 7630
Glimepirid 2 mg 0
PROLANIS
Glimepirid 2 mg 50
PROLANIS Total 50
HORMON Total 9127

BLUD
Amlodipine 5 mg 785
BLUD Total 785

Amlodipin 10 mg 19662
Amlodipine 5 mg 7942
Captopril 12,5 mg 1678
Captopril 25 mg 2433
Digoksin 0,25 mg 30
Furosemid 40 mg 978
Isosorbid Dinitrat 5 mg tablet 165
Nifedipin tab 10 mg 346
PROLANIS
Amlodipine 5 mg 310
PROLANIS Total 310
JANTUNG DAN PEMBULUH DARAH Total 34329
LIFE SAVING
Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml 21
Diazepam Lar Rektal 10 mg/ml 4
Epinefrin HCL Inj 32
Oksitosin Inj 10 lU/ml 1 ml 8
LIFE SAVING Total 65
MULUT,THT
BLUD
Borax Glicerin 43
Fenol Glicerol Tetes Telinga 10 % 11
BLUD Total 54

Borax Glicerin 150
Fenol Glicerol Tetes Telinga 10 % 116
Gentian Violet Lart 1 % 10 ml 11
Kloramfenikol tetes Telinga 3 % 10 ml 12
Oksimetazolin tts hidung 0,025% 6
MULUT,THT Total 349

Diazepam 2 mg tablet 69
NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA Total 69
OBAT KULIT
BLUD
Acyclovir cream 5 % 10
Hidrokortison Crem 2,5 % 38
BLUD Total 48

Acyclovir cream 5 % 254
Anti Bacteri DOEN SK 183
Antifungi SK 64
Bacitracin 28
Bedak Salisil serbuk 2 % 502
Betametason Crem 0,1 % 445
Hidrokortison Crem 2,5 % 800
Ketokonazol krim 2% 169
Kloramfenikol SK 2% 695
Mikonazol krim 2% 269
Perak Sulfadiazin krim 1% 17
Permetrin Krim 5 % 117
Salep 2-4 182
Ichtyol s.k 17
OBAT KULIT Total 3790
OBAT MATA
BLUD
Eye Fresh (HPMC, Dextran) 146
BLUD Total 146

Klorampenicol S.M 1 % 580
Koramfenikol TM 1 % 61
Eye Fresh (HPMC, Dextran) 0
Kloramfenikol TM 1 % 103
OBAT MATA Total 890
SALURAN PERNAPASAN
BLUD
Ambroxol Syrup 15 mg 152
Calortusin (PCT, CTM, DMP, Phenylepherine) 3290
Pramolta (PCT, Guafenesin, CTM) 357
Obat Flu dan Batuk Dewasa (Calortusin/PCT, CTM, 2534
Obat Flu dan Batuk Sirup Anak (Pramolta/PCT, Guaf 211
Obat Batuk Hitam 11
BLUD Total 6555

Ambroxol Syrup 15 mg 2084
Ambroxol tab 30 mg 9305
Aminopilina 200 mg 50
Gliseril Guayakolat 100 mg 11030
Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 mg ne 155
N-asetil sistein kaps 200 mg 9299
Obat Batuk Anak Syrup 0
Salbutamol 2 mg 2387
Salbutamol 2.5 mg nebules 20
Obat Flu dan Batuk Dewasa (Calortusin/PCT, CTM, 0
Obat Flu dan Batuk Sirup Anak (Pramolta/PCT, Guaf 710
Obat Batuk Hitam 0
SALURAN PERNAPASAN Total 41595
SISTEM PENCERNAAN
BLUD
Zinc dispersibel 855
Zinc Syr 20mg/5 mL 3
Ranitidin Inj. 1
BLUD Total 859

Antasida DOEN 36674
Antasida DOEN susp 831
Antihemoroid suppositoria 279
Atapulgit tab 600 mg 5315
Bisakodil 5 mg 119
Bisakodil sup 5 mg 4
Dimenhidrinat tab 50 mg 1650
1193
Garam Oralit 200 ml 5913
Hiosina Butilbromida 10 mg 1632
Karbo Adsorben 250 mg 3420
Metoklopramide sirup 5 mg/ml 112
Natrium Bicarbonat 500 mg 1170
Omeprazol 20 mg 2367
Ranitidin tab 150 mg 11013
Zinc dispersibel 2438
Zinc Syr 20mg/5 mL 0
SISTEM PENCERNAAN Total 74989
VITAMIN DAN MINERAL

BLUD
Kalsium laktat (kalk) tab 500 mg 195
Multivitamin dan Mineral 649
Tablet Tambah Darah/FE 160
Vit. Syrup Anak 60 ml 104
Lyscavit (Multivitamin) 61
Tropifer (Fe, Asam Folat) 1095
Biovitan (Multivitamin) 63
Multivitamin Syr Anak 5
BLUD Total 2332

Asam Askorbat (Vit C) tab 250 mg 7064
Asam Askorbat (Vit C) tab 50 mg 7713
Kalsium laktat (kalk) tab 500 mg 1028
Multivitamin dan Mineral 5897
Piridoksin HCL 10 mg tablet 9095
Retinol (Vit. A) 200,000 IU Kap Lunak 2923
Sianokobalamin (Vitamin B12) tab 50 mcg 11745
Tablet Tambah Darah/FE 54690
Thiamin HCL 50 mg 16758
Vit. B. Complex 35114
Vit. Syrup Anak 60 ml 274
Retinol (Vit. A) 100,000 IU Kap Lunak 300
VITAMIN DAN MINERAL Total 154933
638632
NAMA OBAT, ALKES, BMHP
ALAT & BAHAN GIGI
Air Raksa
Alvogil
Amalgam
Arkansas Stone
Articulating paper (kertas warna penanda oklusi)
Bahan tumpatan sementara (Temporary Fletcher)
Boor jet Fressure
Boor jet inverted
Boor jet round
Boor low fressure
Boor low inverted
Boor low round
Boor Stone
CaOH with Iodoform 1 syringe 2,2 g
Celluloid Strip
Cement Zn Phospat Powder & Liquid
Devitalisasi Pasta (arsenik)
Devitalisasi Pasta (Non arsen)
Disclossing
Eugenol
Formokresol
Glass Ionomer ART (Atraumatic Restorative Treatment) Anterior/Fuji II
Glass Ionomer ART (Atraumatic Restorative Treatment) Posterior/Fuji IX
H2O2
Kalsium Hidroksida Pasta (CaOH)
Klorfenol Kamfer Mentol (CHKM)
Komb : Artikaine HCl 4% + Epinefrin 1 : 100.000
Komb : Deksametason asetat 0,1%, Thymol 5%,Paraklorphenol 30%, campor 64% (Chresophene)
Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000 inj 2 ml
Komb : Mepivakaine HCl 2 % + Epinefrin 1:100.000
Komposit Resin
Matrix Band
Panasray
Pasta Gigi
Pasta Pengisi Saluran Akar
Pembersih noda gigi (TSR/OCO)
Rockel
Savlon
Slaber
Spongostan
Tissue gulung
Vaseline
Deksametason 0,5 mg tablet
Deksametason inj 5 mg / ml (i.v / i.m)
Difenhidramin inj 10 mg / ml (i.v / i.m)
Klorfeniramin Maleat/CTM 4 mg
Loratadine Tab 10 mg
Prednison 5 mg
Setirizin sir 5 mg / 5 ml
ALKES HABIS PAKAI
Abbocat No. 18
Abbocat No. 20
Abbocat No. 22
Abbocat No. 24
Abbocat No. 26
ADS 0,5 ml
Alat Suntik 1 ml
Alat Suntik 10 ml
Alat Suntik 20 ml
Alat Suntik 3 ml
Alat Suntik 5 ml
Bisturi
Blood Lancet
Cat Gut Chromic/Benang Bedah No. 3.2
Cat Gut Plain/Benang Bedah No. 3.2
Endotrakeal No 3
Endotrakeal No 3.5
Endotrakeal No 4
Foley Kateter No 18
Foley Kateter No 20
Hecting Nald
Infuset anak
Infuset dewasa
Iodina Test
Jarum Cytojek
Jarum vacutainer
Kaca Mulut
Kaca Penutup / Dek glass
Kantong Jenazah
Kapas Pembalut Absorben 250 g
Kassa Kompres 40 x 40 steril
Kassa Pembalut 2 m x 80 cm
Kassa pembalut Hidrofil 4 cm x 15 cm
Kassa pembalut Hidrofil 4 cm x 3 cm
Kateter penghisap lendir No 10
Kateter penghisap lendir No 8
Kertas Perkamen
Kondom
Masker
Masker N.95
Masker Oksigen Anak
Masker Oksigen dewasa
Oksigen can
Peneng Bayi
Perban elastis
Plastic Bandages
Plester
Plester kertas
Pot Sputum
Rotator
RTD Malaria
Sarung Tangan Karet Tebal
Sarung Tangan Non Steril
Sarung Tangan Panjang ginekolog
Sarung tangan Steril
Selang oksigen Anak
Selang oksigen dewasa
Sendok Obat
Silk
Slide
Spalk 30 cm
Three way stop cock
Tip pipet kuning
Tongue Spatel Kayu
Ultrasound gel 250 cc
Umbilical Cord Clam Biru
Urine Bag
Vacutainer/Tabung spesimen darah + tutup
Wing Needle no.27 G
Antimigren
Asam Mefenamat 500 mg
Betahistine mysilat 6 mg
Etil Klorida Semprot 100 ml
Ibuprofen 400 mg
Ibuprofen sirup 200 mg/ 5 ml
Ibupropen 200 mg
Lidokain inj 2 % (infltr/p.v)
Na.Diklofenak 50 mg
Parasetamol 500 mg
Parasetamol syr 120 mg/5 ml 60 ml
Parasetamol tts 60 mg / 0.6 ml
Piroksikam 10 mg
ANTIINFEKSI
ACT ( arthesunat )
Acyclovir tab 400 mg
Albendazol 400 mg
Albendazol susp 200 mg/5 ml
Amoksilin Kap. 250 mg
Amoksilin Kap.500 mg
Amoksilin syr kering 125 mg/ ml
Amoksilin syr kering 250 mg/ ml
Amoksisilin Drops 100 mg/ml
Azitromisin 500 mg
Benzatin Benzil P 2,4
Cefixim tab 100 mg
Ciprofloxacin 500 mg
Dietilkarbamazin
Doxyciclin 100 mg
Erytromicin 250 mg
Ethambutol 250 mg
Flukonazol kaps 50 mg
Gentamisin 40 mg / 2ml inj
Griseofulvin125 mg
Isoniazide 100 mg
Isoniazide 300 mg
Ketoconazole 200 mg
Klindamisin 150 mg
Klindamisin 300 mg
Kloramfenikol 250 mg capsul
Kloramfenikol 500 mg capsul
Kloramfenikol susp 125 mg / 5 ml
Kombipak IMS
Kotrimoksazol Adult 480 mg
Kotrimoksazol Suspensi 240 mg/5 ml
Metronidazol 250 mg
Metronidazol 500 mg
Natrium Tiroksin
Nistatin 100.000 IU/g tablet vagina
Nistatin susp 100.000 UI / ml
Obat Anti TBC Anak FDC
Obat Anti TBC Kat I FDC
Obat Anti TBC Kat II FDC
Obat Anti TBC Kombipak
Pyrantel Pamoat 125 mg
Pyrazinamide 500 mg
Pyrimethamine 25 mg
Rifampicin 300 mg
Rifampicin 450 mg
Rifampicin 600 mg
Sefadroxil kapsul 500 mg
Sefadroxil syr kering 125 mg/ml
Streptomicin Inj.
Tetracyclin 250 mg
Alkohol Swab
Chlorin 10 %
Etakridin 0,1 % Rivanol 300 ml
Etanol 70 % 100 ml
Framisetin sulfat tulle 1%
Hand Rub
Kalium Permanganat (PK) 5 gram
Kaporit 60%
Lisol 50 % 1000 ml
Polikresulen 10 ml
Povidon Iodin lar 10 mg/ml (30 mL)
Povidon Iodin lar 10 mg/ml (300 mL)
Berita Acara Serah Terima Barang
Buku Harian
Buku Resep
Etiket Obat putih
K.Obat Plastik 8 x 13 x 05
Kantong kresek Putih
Kantong Obat Plastik 20 x 15 x 0.5
Kantong Obat Plastik 20 x 30 x 0.5
Kartu Persediaan Barang (Gudang)
Kartu stok Barang ( Gudang)
LPLPO
Alopurinol 100 mg
Fitomenadion /Vit K 10 mg
Fitomenadion /Vit K Inj 2 mg/ml
Gemfibrozil 300 mg
Metilergometrin Maleat 0,125 mg
Metilergometrin Maleat 0,200 mg 1ml inj
Simvastatin 10 mg
HORMON
Glibenklamid 5 mg tablet
Metformin tab 500 mg
Propiltiourasil tab 100 mg (PTU)
INFUS,LAR STERIL
Aqua Bidestilata
Aqua pro inj steril 20 ml
Glukosa Lar infus 5 % steril 500 ml
Natrium Klorida Larutan Infus 0,9 %
Ringer Laktat Larutan Infus Steril
Amlodipin 10 mg
Amlodipine 5 mg
Atenolol 50 mg
Captopril 12,5 mg
Captopril 25 mg
Digoksin 0,25 mg
Diltiazem 30 mg
Furosemid 40 mg
Hidrokortiazid HCT tab 25 mg
Isosorbid Dinitrat 5 mg tablet
Metyldopa tab 250 mg
Nifedipin tab 10 mg
Reserpin 0,25 mg
Spironolakton 25 mg
LIFE SAVING
Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml
Diazepam Lar Rektal 10 mg/ml
Epinefrin HCL Inj
Kalsium Glukonat inj 100 mg / ml
Mg Sulfat Inj 40 % - IV/10 vial
Oksitosin Inj 10 lU/ml 1 ml
Logistik DBD
APD
BTI
Insektisida
Jumantik
Larvasida Abate
Mesin Foging Swan Fog SF 88
NS1
RDT Combo
RDT IGM
MULUT,THT
Borax Glicerin
Fenol Glicerol Tetes Telinga 10 %
Gentian Violet Lart 1 % 10 ml
Kloramfenikol tetes Telinga 3 % 10 ml
Oksimetazolin tts hidung 0,025%
Amitriptilin tab sal 25 mg
Diazepam 2 mg tablet
Fenobarbital tab 30 mg
Haloperidol tab 1.5 mg
Karbamazepin tab 200 mg
Klorpromazin tab sal 25 mg
Kodein HCL 10 mg
Risperidon tab 2 mg
Obat - Obatan Program Hepatitis
Artesunat inj. 60 mg
Daclastavir 30 mg
Daclastavir 60 mg
Dehidroartemisin + Piperaquine (DHP)
HCV Viral Load
Hepatitis B Immunoglobulin
Primakuin 15 mg
RDD Anti HCV
RDT Malaria
Reagent Rapid Test HBSAG
Ribavirin 200 mg (Rebetol)
Simeprevir 150 mg (Olysio)
Sofosbufir 400 mg (Myhep)
OBAT KULIT
Acyclovir cream 5 %
Anti Bacteri DOEN SK
Antifungi SK
Bedak Salisil serbuk 2 %
Betametason Crem 0,1 %
Hidrokortison Crem 2,5 %
Ichtyol Sk
Ketokonazol krim 2%
Kloramfenikol SK 2%
Mikonazol krim 2%
Perak Sulfadiazin krim 1%
Permetrin Krim 5 %
Salep 2-4
OBAT MATA
Klorampenicol S.M 1 %
Koramfenikol TM 1 %
REAGEN TB
Oli Imersi
PPD / Test Mantoux
Reagent ZN
REAGENT HIV
Kontrol CD 4
Open CD 4
Rapid Test HIV ( Oncoprobe )
Rapid Test HIV ( Biomeriux )
Rapid Test HIV ( Intec )
SD HIV
REAGENT IMS
Pewarnaan gram
RPR Antigen/ Trust
TPHA Sypillis (Hexagon)
TPHA Sypillis (SD)
SALURAN PERNAPASAN
Ambroxol Syrup 15 mg
Ambroxol tab 30 mg
Aminopilina 200 mg
Gliseril Guayakolat 100 mg
Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 mg nebules
N-asetil sistein kaps 200 mg
Obat Batuk Anak Syrup
Salbutamol 2 mg
Salbutamol 2.5 mg nebules
SISTEM PENCERNAAN
Antasida DOEN
Antasida DOEN susp
Antihemoroid suppositoria
Atapulgit tab 600 mg
Bisakodil 5 mg
Bisakodil sup 5 mg
Dimenhidrinat tab 50 mg
Domperidon 10 mg
Domperidon sirup 5 mg/5 ml
Garam Oralit 200 ml
Hiosina Butilbromida 10 mg
Karbo Adsorben 250 mg
Komb Kaolin 550 mg + pektin 20 mg
Metoklopramide sirup 5 mg/ml
Natrium Bicarbonat 500 mg
Omeprazol 20 mg
Omeprazol inj 40 mg / 10 ml
Ranitidin tab 150 mg
Zinc dispersibel
VITAMIN DAN MINERAL
Asam Askorbat (Vit C) tab 250 mg
Asam Askorbat (Vit C) tab 50 mg
Asam Folat 1 mg
Kalsium laktat (kalk) tab 500 mg
Mineral Mix
Multivitamin dan Mineral
Piridoksin HCL 10 mg tablet
Retinol (Vit. A) 100,000 IU Kap Lunak
Retinol (Vit. A) 200,000 IU Kap Lunak
Sianokobalamin (Vitamin B12) tab 50 mcg
Tablet Tambah Darah/FE
Thiamin HCL 50 mg
Vit. B. Complex
Vit. Syrup Anak 60 ml
Grand Total
Grand Total
810
0
0
2
0
12
1
0
3
0
0
5
0
0
0
0
0
4
2
0
8
0
0
4
0
0
0
0
0
590
0
0
0
6
0
1
0
0
0
0
0
170
2
99463
38000
3
30
56500
4600
0
330
7009
0
10
0
0
0
0
600
0
0
1100
100
11
0
31
0
0
0
0
0
0
0
0
0
0
300
80
0
0
0
20
30
80
60
190
0
0
4
0
2370
0
0
0
4
0
0
0
28
7
425
0
0
15
200
105
1100
0
0
0
0
0
0
0
1
0
8
0
0
80
50
212932
0
0
300
10
5000
200
0
100
18000
180000
4702
320
4300
80845
0
4300
7800
0
24500
26000
760
400
108
0
0
0
1500
0
0
0
0
0
0
0
0
0
1050
1350
2800
600
2500
250
0
2200
100
1400
2700
0
500
0
1
25
1
0
0
0
0
0
0
0
0
0
0
0
395
100
8
32
162
10
15
20
0
24
7
15
2
153
0
0
100
0
44
2
4
3
0
0
0
3130
2400
600
30
0
100
0
0
16300
1900
14400
0
75
0
30
0
21
24
42300
22800
8400
0
1900
5400
200
0
2800
0
300
0
500
0
0
15
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
236
96
120
0
0
20
100
0
100
0
0
0
0
0
0
200
0
0
0
0
0
0
0
0
0
200
0
0
0
7663
200
350
121
1150
675
1152
30
435
960
432
22
1800
336
964
864
100
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
47450
2700
9100
500
13000
0
17400
550
4200
0
94740
49400
1300
290
8500
0
0
2000
900
0
9100
1850
0
0
110
1000
2190
0
14900
3200
145854
12700
7800
0
0
0
6700
13000
600
5900
10000
11790
27000
50100
264
760636
1 Format Obat tidak boleh di ubah
2 Harga di ambil dari bukti penerimaan barang
3 Obat Yang dilaporkan adalah obat yg diterima dari Dinas Kesehatan Kota Bandung
4 Laporan ( soft Copy) Dikirim melalui Email farmasikotabandung@yahoo.com tanggal 30 Desember 2017
5 Laporan ( hard Copy) yang sudah di tanda tangani oleh Ka UPT diterima tgl 2 Januari 2018
6 Kolom Sisa Awal diisi dari sisa akhir laporan thn lalu ( des 2016 )
7 Untuk Obat Paket TB dihitung per paket ( bukan per Tablet)

al 30 Desember 2017
NAMA ALKES BMHP Grand Total
ALAT & BAHAN GIGI 1529
Air Raksa 0
Alvogil 0
Amalgam 38
Arkansas Stone 0
Articulating paper (kertas warna penanda oklusi) 0
Bahan tumpatan sementara (Temporary Fletcher) 24
Boor jet Fressure 11
Boor jet inverted 10
Boor jet round 7
Boor low fressure 14
Boor low inverted 6
Boor low round 5
Boor Stone 3
CaOH with Iodoform 1 syringe 2,2 g 0
Celluloid Strip 158
Cement Zn Phospat Powder & Liquid 10
Devitalisasi Pasta (arsenik) 12
Devitalisasi Pasta (Non arsen) 9
Disclossing Sol. 59
Eugenol 14
Formokresol 6
Glass Ionomer ART (Atraumatic Restorative Treatment) 9
Glass Ionomer ART (Atraumatic Restorative Treatment) 14
H2O2 0
Kalsium Hidroksida Pasta (CaOH) 3
Klorfenol Kamfer Mentol (CHKM) 6
Komb : Artikaine HCl 4% + Epinefrin 1 : 100.000 10
Komb : Deksametason asetat 0,1%, Thymol 5%,Parakl 6
Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000 inj 2 ml 636
Komb : Mepivakaine HCl 2 % + Epinefrin 1:100.000 0
Komposit Resin 1
Matrix Band 1
Panaspray 8
Pasta Gigi 196
Pasta Pengisi Saluran Akar 5
Pembersih noda gigi (TSR/OCO) 0
Rockel 5
Savlon 4
Slaber 0
Spongostan 40
Tissue gulung 198
Vaseline 1
ALKES HABIS PAKAI 13386
Abbocat No. 18 2
Abbocat No. 20 11
Abbocat No. 22 11
Abbocat No. 24 0
Abbocat No. 26 5
ADS 0,5 ml 0
Alat Suntik 1 ml 614
Alat Suntik 10 ml 0
Alat Suntik 20 ml 0
Bisturi 31
Blood Lancet 0
Cat Gut Chromic/Benang Bedah No. 3.2 24
Cat Gut Plain/Benang Bedah No. 3.2 1
Endotrakeal No 3 0
Endotrakeal No 3.5 0
Endotrakeal No 4 0
Foley Kateter No 18 0
Foley Kateter No 20 0
Hecting Nald 0
Infuset anak 0
Infuset dewasa 5
Iodina Test 0
Jarum Cytojek 256
Jarum vacutainer 602
Kaca Mulut 0
Kaca Penutup / Dek glass 0
Kantong Jenazah 0
Kapas Pembalut Absorben 250 g 15
Kassa Kompres 40 x 40 steril 21
Kassa Pembalut 2 m x 80 cm 85
Kassa pembalut Hidrofil 4 cm x 15 cm 60
Kassa pembalut Hidrofil 4 cm x 3 cm 157
Kateter penghisap lendir No 10 0
Kateter penghisap lendir No 8 0
Kertas Perkamen 1
Kondom 4568
Masker 2891
Masker N.95 0
Masker Oksigen Anak 0
Masker Oksigen dewasa 0
Oksigen can 3
Peneng Bayi 0
Perban elastis 0
Plastic Bandages 0
Plester 5 yard x 2 inch 20
Plester kertas 10
Pot Sputum 397
Rotator 0
RTD Malaria 20
Sarung Tangan Karet Tebal 9
Sarung Tangan Non Steril 450
Sarung Tangan Panjang ginekolog 25
Sarung tangan Steril 991
Selang oksigen Anak 0
Selang oksigen dewasa 0
Sendok Obat 400
Silk 41
Slide 5
Spalk 30 cm 0
Three way stop cock 0
Tip pipet kuning 0
Tongue Spatel Kayu 0
Ultrasound gel 250 cc 9
Umbilical Cord Clam Biru 0
Urine Bag 0
Vacutainer/Tabung spesimen darah + tutup 221
Wing Needle no.27 G 47
ANTISEPTIK,DISINFEKTAN 602
Alkohol Swab 339
Chlorin 10 % 10
Etakridin 0,1 % Rivanol 300 ml 41
Etanol 70 % 100 ml 118
Framisetin sulfat tulle 1% 11
Hand Rub 20
Kalium Permanganat (PK) 5 gram 6
Kaporit 60% 0
Lisol 50 % 1000 ml 19
Polikresulen 10 ml 9
Povidon Iodin lar 10 mg/ml (30 mL) 27
Povidon Iodin lar 10 mg/ml (300 mL) 2
CETAKAN DAN EMBALAGE 273033
Berita Acara Serah Terima Barang 0
Buku Harian 0
Buku Resep 350
Etiket Obat Biru 158776
Etiket Obat putih 113859
Kantong kresek Putih 2
Kantong Obat Plastik 20 x 15 x 0.5 12
Kantong Obat Plastik 20 x 30 x 0.5 2
Kantong Obat Plastik 8 x 13 x 05 32
Kartu Persediaan Barang (Gudang) 0
Kartu stok Barang ( Gudang) 0
LPLPO 0
INFUS,LAR STERIL 37
Aqua Bidestilata 5
Aqua pro inj steril 20 ml 0
Glukosa Lar infus 5 % steril 500 ml 2
Natrium Klorida Larutan Infus 0,9 % 19
Ringer Laktat Larutan Infus Steril 11
REAGEN TB 6
Oli Imersi 0
PPD / Test Mantoux 0
Reagent ZN 6
REAGENT HIV 244
Kontrol CD 4 0
Open CD 4 0
Rapid Test HIV ( Oncoprobe ) 0
Rapid Test HIV ( Biomeriux ) 24
Rapid Test HIV ( Intec ) 56
SD HIV 164
REAGENT IMS 0
Pewarnaan gram 0
RPR Antigen/ Trust 0
TPHA Sypillis (Hexagon) 0
TPHA Sypillis (SD) 0
Grand Total 288837

Format Lap Akhir Tahun PKM Dan LPLPO

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Laporan Perhitungan Stock Persediaan

per 30 Desember Tahun 2017

Saldo Awal (31/12/2016) Penambahan ( Jan-Des 2017)

No Jenis Barang Satuan

JANTUNG DAN PEMBULUH DARAH

VITAMIN DAN MINERAL

NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA

ALKES HABIS PAKAI

CETAKAN DAN EMBALAGE

Obat-obatan Program HIV AIDS

Obat - Obatan Program Hepatitis 0 -

- 21 1,999.80 41,995.80 9 2,000 17,998.20

282,150.00 2,584 104.50 270,028.00 266 104.50 27,797.00

- 20 5,990.00 119,800.00 0 5,990.00 -

7,412,400.00 15,634 426.00 6,660,084.00 2246 426.00 956,796.00

3,062,800.00 45,493 62.00 2,820,566.00 9964 62.00 617,768.00

1,570,800.00 6,313 187.00 1,180,531.00 2332 187.00 436,084.00

1,520,640.00 798 1,760.00 1,404,480.00 129 1,760.00 227,040.00

880,600.00 300 2,516.00 754,800.00 95 2,516.00 239,020.00

495,300.00 10,118 39.00 394,602.00 2582 39.00 100,698.00

281,700.00 3,016 90.00 271,440.00 629 90.00 56,610.00

623,040.00 290 2,640.00 765,600.00 0 2,640.00 -

912,800.00 15,735 56.00 881,160.00 840 56.00 47,040.00

19,680.00 259 196.80 50,971.20 41 196.80 8,068.80

- 10 6,000.50 60,005.00 0 6,000.50 -

1,836,120.00 0 153,010.00 - 0 153,010.00 -

40,700.00 24 40,700.00 976,800.00 32 40,700.00 1,302,400.00

- 11 26,180.00 287,980.00 1 26,180.00 26,180.00

- 9 591,059.40 5,319,534.60 1 591,059.40 591,059.40

220,000.00 14 55,000.00 770,000.00 2 55,000.00 110,000.00

- 6 1,845.00 11,070.00 1 1,845.00 1,845.00

- 1 39,490.00 39,490.00 0 39,490.00 -

- 0 12,100.00 - 2 12,100.00 24,200.00

346,500.00 350 3,465.00 1,212,750.00 0 3,465.00 -

1,476,200.00 32 33,550.00 1,073,600.00 0 33,550.00 -

Bandung, 30 Desember 2017

Pengelola Obat Puskesmas

ANALGESIK, ANTIPIRETIK, ANTIINFLAMASI

80 Antasida DOEN susp Botol @ 60 ml 129

JANTUNG DAN PEMBULUH DARAH

VITAMIN DAN MINERAL

NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA

ALAT & BAHAN GIGI

Pembersih noda gigi (TSR/OCO) Buah 0

ALKES HABIS PAKAI

CETAKAN DAN EMBALAGE

Mengetahui, Bandung, 2 Desember 2017

SUKARTI PRATIWI OKTAVIANA S.Farm., Apt.

ung, 2 Desember 2017

TIWI OKTAVIANA S.Farm., Apt.

PUSKESMAS : UPT PANGHEGAR PELAPORAN BULAN : DESEMBER 2017

JANTUNG DAN PEMBULUH DARAH

VITAMIN DAN MINERAL

NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA

ALAT & BAHAN GIGI

ALKES HABIS PAKAI

CETAKAN DAN EMBALAGE

Mengetahui, Yang menyerahkan, Yang Menerima Yang Melaporkan

------------------------------------ ---------------------------------- ---------------------------------- dr. Hj. Nina Manarosana, R

RATA RATA PEMAKAIAN #REF!

dr. Hj. Nina Manarosana, R., M. Kes.

DINAS KESEHATAN KOTA BANDUNG

ALERGI,KORTIKOSTEROID Total 72738