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PUSKESMAS : SAMBUNGMACAN 1

KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


gini suciati warsidi uki aditiya agus sumarti

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol 1 1 1
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul 1
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 9
19 Antasida Doen tab Tablet 6
20 Antasida sirup Botol 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube 1 1 1
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6 2 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul 6
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6 6 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet 6
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol 1 1
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube 1 1
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 8 8 8 8
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul 6 6
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 6
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul 1 1 1
Sianokobalamin tab ( Vit. B12 )
191 Tablet 6
tab
192 Simetidin tab Tablet 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet 2
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet 4
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
oksigen
8 9 10 11 12 13 14 15 16 17 18 19 20
nova retno tri frida dika ahmad sumini lagiyanto nova wagiyem KO

10

6 6 6 6

10

1
1
6

14

4
6 6

6 10
1

8 8 8 6 12 10

6 12 6

6 6

3 3

1 1 7 6
1

8
1
150
25

2
40

1 1 1 1

3 2 3
1 2

30
1

30

1
2

60
1
41
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
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3
16
1
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0
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36
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19
6
2
0
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0
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0
4
0
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0
1
32
0
0
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0
0
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14
0
4
0
0
6
0
0
0
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0
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18
0
0

0
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0
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0
0
0
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0

6
0
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46
0
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0
0
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0
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0
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0
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6
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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3
0
2
0
0
2
0
0
1
0
84
0
0
0
30
24
0
0
0
0
6
0
0
0
0
0
0
0
6
0
0
0
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15
0
0
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4
6
14
0
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0
150
25
0
0
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2
40
0
4

0
8
3
0
30
1
0
0
30
0
1
2
0
0
0
60

0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
0
0
0
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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
41
0
0
0
0
0
0
0
0
0
0
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


tarno rismita yuliana risma ayu sri ima

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 9
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 9
19 Antasida Doen tab Tablet 6
20 Antasida sirup Botol 1 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6 6 6 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 2
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 8 8 8 4 8
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 6
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet 4 4 4
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet 4
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
riskita dwi aulia reva suryanto sri muklis ika fitri eko sonto kasinem firdani

6 12

3 9 9 14

9
6 6 8
1 1 1
6

3 6 2

6 8

6
3 2

10 13

2
1 1

8
2

1 1

6 2 6 6 9

11

6 6

1 1

2 4 6 4 2
6
1 1
6
6 6

1
6

4 4 4 4
1
1 1 1 1 1

2 3 2 3
1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
suwarti

18

1
6
12
12

4
1

4
1

2
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
24
0
4
0
0
0
0
62
0
1
0
0
18
26
7
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
29
0
0
0
14
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
17
0
0

0
0
0
0
2
0
0
0
0
0
0
0

6
23
0
0
0
0
0
0
0
0
38
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
2
0
77
0
11
0
30
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
22
6
0
0
0
0
0
0
0
3
6
16
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
6
1
6
0
0
0
0
32
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
4
0
1
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
6

0
12
1
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


nafa mila purwanti parinem nurul handayaniheri

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 9 9
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 9
19 Antasida Doen tab Tablet 6 6 6
20 Antasida sirup Botol 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul 6
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube 1 1
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6 6 6 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube 1 1
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 8 8 8 8 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul 6 6 6
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul 1 1 1
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 4 4
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6 6 6 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet 6 6
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 6 6 6 6
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
sanem vino sesya ramadani ranti

4
6 6
4 6 6

4 6
6 4 6 6

1
2
1

2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
6
0
0
0
6
0
0
27
0
1
0
0
9
22
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
28
0
0

0
0
0
0
0
2
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
46
0
0
0
2
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
60
0
0
0
0
18
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
3
0
8
0
0
0
0
0
0
0
0
0
0
0
24
0
12
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
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
1

0
2
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


ratno sunarsi alvin surya alpin ahmad meisa

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 4 9 9
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 9
19 Antasida Doen tab Tablet 6
20 Antasida sirup Botol 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6 4 3
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 4 6 6 3
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1 1 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 8 8 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul 6 6
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet 4 3
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol 1
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
painem sri dina puji karto semi vino suginem joyo kiki sati satiyem sukarno

9 9 9 9 10 9

6 19
6 6 12 10 6 12
1 1 1 1 1 1 1 1
1
6 6 6 6

6 10
6 18

6 6 10 8
12

4
8

1 1

8 8 6 6 6 8 16 14

6 6

1 3 4

9 3 1 1 3 3 6 6 5
6 12 6

4 10

6 6 6 6 6 6

6 6 6 6
1 1
6
8 4
1

1 1 1 1 1 1 1 1

2 2 3 2 1 2 2 3
1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
joyo

6
1

5
13
1

1
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
0
0
6
0
4
0
1
77
0
0
1
0
34
64
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
36
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
37
0
0

0
0
0
0
0
1
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
55
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
4
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
8
0
0
5
0
94
0
8
0
12
18
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
42
13
0
0
0
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
14
0
36
0
7
0
0
0
24
2
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
16
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
1
9

0
18
1
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


putri mawar parti aminah trimo santan sukidi

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 9 2 10
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul 1
38 Deksametason tab 0,5 mg Tablet 6 2
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 10
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube 1 1
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6 6 6 6
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6 6 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 8 8 8 14
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet 6 6
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
fauzan efan ardan ika novita ratno andika indri asnur meisya parmi saliyo

9 9 9 9

1
3

6
6 6 6 6
1
6

6 2 6 7 6 6

6
6 6 6 6

6 6 6 6

6 12 6 10
10
2

6 2 6 6 6 14 12 12

11 3 5
8 12 14

6 6 6 6

10
1 1 1

2 1 1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
8
0
12
0
0
0
0
0
0
57
0
1
3
0
6
24
1
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
1
41
0
0
0
6
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24
0
0

0
0
0
0
0
2
0
0
0
0
0
0

48
0
0
0
0
0
0
0
0
0
64
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
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
2
0
0
2
0
102
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
0
0
0
0
12
34
0
0
0
0
0
0
0
0
0
7
0
36
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
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
3
0

0
4
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


ilham siyem seno marsuti mariyem ratmi risma

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6 6 6 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6 9
19 Antasida Doen tab Tablet
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul 1
38 Deksametason tab 0,5 mg Tablet 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet 6
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet 6 6 6
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet 4
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6 6 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6 6 6 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet 4
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
darmo salma

6 6

1
6

6
6 6
4

3
6

6
1

2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
18
0
0
0
6
0
0
30
0
0
0
0
23
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
12
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
12
0
0

0
0
0
0
0
0
0
0
18
0
0
0

0
4
0
0
0
0
0
0
0
0
30
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
4
0
0
0
0
36
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
6
0
30
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
8
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
1
0

0
0
2
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


ika robi farida sri harti sutar sunarsih

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol 1
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet 6 6 6 6
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 6
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul 6
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet 6
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 3 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 4
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 8 8 8 8 8
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 6
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 3
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
antena jarwanto aisyah wakinah samiyem pawiro

1
14

8
6 6 6
9

1
6 6 6 6

9
2

6 2
1 1

8
1

6 15

5 2 4
6
6
6

4
1 1 1

2 1 1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
2
14
0
6
0
0
0
0
8
0
1
0
0
8
42
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
1
48
0
0
0
9
0
0
7
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
2
0
0

0
0
0
0
0
0
6
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
29
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
8
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
4
0
0
2
0
61
0
0
0
6
0
0
0
0
0
6
0
0
0
0
0
0
0
4
0
0
0
0
11
6
0
0
0
0
0
0
0
0
6
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
4
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
3

0
4
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


harjo virga dwi sri jasmanto satinah luppy

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol 1
6 Ambroxol tab Tablet 12
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 9
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial 3
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 12 6
19 Antasida Doen tab Tablet 6 6
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol 1
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 4
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet 6
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet 6 6 6
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6 6 6
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul 2
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul 2
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 4 6
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 8 4 8 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 4
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 6 4
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6 4 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol 1
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 3
18 IV Cateter No. 24 ( Anak ) Biji 2
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
marambu umi sumarni arif kaniman

9 6 8

6 6 6 6

1 1 1

4
6
4
1

6
6
4 4
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
1
12
0
0
0
0
0
0
32
0
1
3
0
42
12
3
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0

0
0
0
0
0
0
6
0
18
0
0
0

18
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
1
0
32
0
0
0
12
0
0
0
0
0
6
0
0
0
0
0
0
0
4
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
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
2

0
3
2
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


umi sati julva supriyadi suwanti sofiyan supriyadi

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial 1
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet 6 6
20 Antasida sirup Botol 1 1 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 6 6
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol 1
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul 6
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 10
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet 6 6 6
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 10 6 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul 1 2 1
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet 6 8 4
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 4
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 10 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 10
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 4 4
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 3 6 4 5
182 Salbutamol tab 2 mg Tablet 6
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul 6
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet 6
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 2
18 IV Cateter No. 24 ( Anak ) Biji 2 3 3
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
julva saminem siti slamet aida rebi suradi refa stria alifia anisa poni ardan

4 6 6 2 6 6 3 4 6 6

1 1

6 4
4 6 2 6 3 2 4 6

6
2 3 2 6 6

4 6 3 4 6
1
1 1 1

4 3 3 6 6

6
6
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
lia
6
4
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
12
0
0
0
0
0
0
55
0
2
1
0
6
16
4
0
0
0
0
0
10
0
0
0
0
0
0
0
12
0
0
0
51
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
35
0
0

0
0
0
0
0
0
0
0
24
0
0
0

6
6
0
0
0
0
0
0
0
0
51
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
4
0
18
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
4
0
0
4
0
44
0
0
0
6
0
0
0
0
0
16
0
0
0
0
0
0
0
8
0
0
0
0
18
10
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
6
0
6
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
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
3

0
2
8
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


madi amini sajinem kasto jarwanto irgi asih

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 12
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet 6
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 10 12
19 Antasida Doen tab Tablet 6
20 Antasida sirup Botol 1 1 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 12 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 7 6
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 10 4
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 10 12
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 2
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 4 2 4 4
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 12 12 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet 12
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 3
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 3 2 2 2
18 IV Cateter No. 24 ( Anak ) Biji 1
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
riski muqit sutiyem satinah rizal alviatus ika

1 1

4 6

6
6 4
4

4 6
6
6 6 6 1 4

6
6
4 6 6
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
12
0
0
0
6
0
0
6
0
3
0
0
22
16
4
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
28
0
0
0
0
0
0
0
0
0
0
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
0
6
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
1
0
45
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
14
0
0
0
0
0
0
0
0
0
6
46
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
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
4

0
9
1
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


darmi suparmi manto harso aji evita nurdi

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet 10
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 12
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 8 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial 2
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet 6 1 4
20 Antasida sirup Botol 1 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6 6 4 4
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 8
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 10
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 12
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol 12
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 10
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 5
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 12 6 4 4
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 14
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 4
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 4 2 3 2 4
182 Salbutamol tab 2 mg Tablet 10
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6 10 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul 6
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul 6 7
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul 1
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 2 2 2 3
18 IV Cateter No. 24 ( Anak ) Biji 1 1 1 2
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
wahyuni catur suparni sri melani pawiro adila harti

6 8

6 6
6

6 4

1
4 6

10

6 6 6
6
1

6 6 4 6
6

6
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
10
0
12
0
0
0
6
0
0
22
0
2
2
0
14
23
3
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
42
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0

0
0
0
0
0
0
0
0
10
0
0
0

10
0
0
0
0
0
0
0
0
0
36
0
0
0
0
0
12
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
2
0
48
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
15
10
0
0
0
0
0
0
0
0
6
22
0
0
0
0
0
0
0
0
0
6
0
6
0
0
0
0
0
0
0
0
0
13
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
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
5

0
9
5
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


endro loso fikri alviatus samiyem sumi pariyem

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 10
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial 3
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6 15
19 Antasida Doen tab Tablet 1 1
20 Antasida sirup Botol 1 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 1
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet 6
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 6 4 1
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 8 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet 1
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 4 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 8
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6 12
163 Piroksikam tab 10 mg Kapsul 4
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 4
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 4
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 2 2 1 4 4 4 1
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol 1 1
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 6
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol 1
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji 1 1 1 1 1
14 Infus Set dewasa Biji 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 2 1 1 2 1
18 IV Cateter No. 24 ( Anak ) Biji 1 1 2 2 1 1
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
paidi

10

11
9

8
6
16

6
9
1

2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
20
0
0
0
0
0
0
0
0
0
6
0
21
13
3
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
24
0
0
0
0
0
0
6
0
0
0
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
0

0
0
0
0
0
0
1
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
22
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
8
0
0
0
0
40
0
0
0
18
4
0
0
0
0
4
0
0
0
0
0
0
0
4
0
0
0
0
24
0
0
2
0
0
0
0
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
1
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
5
3

0
10
8
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


hindun jiko sutiyem tri evan najwa ayu

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 8 8
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet
20 Antasida sirup Botol 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 10
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet 4 2
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 6
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6 2 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol 1
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet 10
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 4
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 10 10 6 2 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 6
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 2
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 2 3 4
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul 6
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 2
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 6
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet 4
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 6
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 1 1
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
aurania joyo suparti karni bintang retno sugino tri warsono suci

10 6

6 6 6

6
6

4
6 6 6 6

6
6

6 6 6 6 6
8

6
1

6 8 6 6 8 6 6

10
6 6

6 6

4
1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
22
0
0
0
0
0
0
34
0
0
0
0
6
6
2
0
0
0
0
0
0
0
0
0
4
0
0
0
10
0
0
0
24
0
0
0
6
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
0
0

0
0
0
0
0
0
0
0
6
0
0
0

0
0
0
0
0
0
0
0
0
0
42
0
0
0
0
0
0
0
0
0
0
0
1
0
8
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0

0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
4
0
0
0
0
80
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
2
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
6
0
14
0
0
0
0
0
18
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
1
6
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
3

0
3
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


kinasih budi sunaryo somo harni arum semi

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol 1
6 Ambroxol tab Tablet 12 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 4 7 10
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet
20 Antasida sirup Botol 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet 6
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 6
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 9
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul 1
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet 12 7 7
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 6
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol 1
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 4
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 12 15 10 15
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 4
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 2 1 1 1
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 4 6 4 5 3 6 2
182 Salbutamol tab 2 mg Tablet 2
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 12 6 10
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul 6
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol 1 1
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul 1
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji 1
14 Infus Set dewasa Biji 1 1 1 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 2 2 1 2 1 1
18 IV Cateter No. 24 ( Anak ) Biji 1 1 1
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
rama sinah tri giyem paimin jarot sri mardinem huda marinem ika sifa aga

6 6

6 6 2 6

6 6

6 6 6 6 2 6 2 6
1

6
4
6 2

6 2 6 6
1 1 1

6 6

6
1

4 6 6 6 6 6

6 2 6
4

3 2
4
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
1
30
0
0
0
0
0
0
41
0
0
0
0
12
40
3
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
30
0
0
0
6
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
6
0
0
0
0
0
0
0
0
35
0
0
0
0
0
0
0
0
0
0
0
3
0
12
0
6
0
0
1
0
32
0
0
0
0
0
0
0
0
0

0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
4
0
0
1
0
86
0
0
0
14
0
0
0
0
0
4
0
0
0
0
0
0
0
5
0
0
0
0
30
2
0
0
0
0
0
0
0
0
0
32
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
2
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
1
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
1
6

0
9
3
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


sutini jarot waginem deni sugino manuel mardinem

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6 4 12
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet 8
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 10 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6
19 Antasida Doen tab Tablet 12 6
20 Antasida sirup Botol 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul 3
38 Deksametason tab 0,5 mg Tablet 6 6 6 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet 6
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet 8
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet 8
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet 6
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul 1 1
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet 6
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 2
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6 12 16 6 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 2 2 3
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 4 2 6 6 3 3 3
182 Salbutamol tab 2 mg Tablet 6 2
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 9 16 6 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol 1 1
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol 1
21 Multivitamin tab ( Dewasa ) Tablet 4 8
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul 1
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji 1
14 Infus Set dewasa Biji 1 1 1 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 2 2 2
18 IV Cateter No. 24 ( Anak ) Biji 2 1 2 1 2 1
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
subardi desi yusuf sukartini setu marsudi jumadi anase aqila siti suwoyo semiyati ati

3 6 6 6 2 6

6 6 6 6 6

3 6

6
6 6 6 6 6

10
2 2 6

6 6

2 2 2 6
10

2
1

6 6 3 2 10 6

2 1
6

10

6
4 4

1
1 1

3 2
1 1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
mada
3
3
1
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
22
0
8
0
0
0
0
45
0
1
0
0
36
27
2
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
3
69
0
0
0
6
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
8
10
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
18
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
0
4
0
6
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
4
0
91
0
6
0
12
0
0
0
0
0
2
0
0
0
0
0
0
0
7
0
0
0
0
30
8
0
0
0
0
0
0
0
0
6
37
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
10
2
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
20
0
0
0
0
0
2
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
1
8

0
12
11
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


sukadi rono marinem sastro jamin katmni zahra

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6 6 14
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet 6
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 10
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 12 12
19 Antasida Doen tab Tablet 6 20 6
20 Antasida sirup Botol 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 6
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6 6 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet 4
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet 4
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet 6
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul 1
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 6
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 4
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 6 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 4 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 3
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 1
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 2 1 7 5 6
182 Salbutamol tab 2 mg Tablet 8
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6 6 15
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul 6
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6 3
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet 4 4
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul 10
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 1 1 1
18 IV Cateter No. 24 ( Anak ) Biji 1
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
ika okta eca prasetyo suprapti jarwo juminem mardi hadi endang

6 6 6 6 6 6

6 6 6

6 6 6
6 4 6 6 6 6 6 6 6

1
4 6 6

6 4 6
6

6 4 6 6 6 6

6
6

4
4 4 4
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
26
0
6
0
0
0
0
46
0
1
0
0
42
50
1
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
94
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
16
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
1
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
13
0
50
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
21
8
0
0
0
0
0
0
0
0
0
33
0
0
0
0
0
0
0
0
0
6
0
15
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
10
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
5

0
4
1
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


rendiyant saji nur ari heni aditya suwarno

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet 3
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial 6
13 Amoksisilin kab 500 mg Tablet 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1 1
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 10
19 Antasida Doen tab Tablet 7
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 20 6 6 6 2
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 4 6 2 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6 6
91 Kaptopril tab 25 mg Tablet 6
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6 6 2
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet 6
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 4
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 10 6 6 6 2 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 1
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 11 3 5
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 6 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 1
18 IV Cateter No. 24 ( Anak ) Biji 2
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
rifai

6
9
1
1
6

16
6 6

10
16
1

1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
0
0
0
0
3
0
6
12
0
2
0
0
16
16
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
40
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
24
0
0

0
0
0
0
0
0
16
0
0
0
0
0

12
6
0
0
0
0
0
0
0
0
20
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
48
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
29
0
0
0
0
0
0
0
0
0
0
16
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
10
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
4

0
3
2
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


sutarmi kofifah jiyem yudit puji aisyah parno

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6 2 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6
19 Antasida Doen tab Tablet 6 4 6
20 Antasida sirup Botol 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 6
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet 6
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 6
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul 6
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6 2
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 2
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet 4
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol 1
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 4 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6 2
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 2
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 2 2 3
182 Salbutamol tab 2 mg Tablet 6
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul 1
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 4
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet 4
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 1
18 IV Cateter No. 24 ( Anak ) Biji 1 2 1
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
parinem afda setu alvini asih parti sofyan alimusa sutarni retno nur tri

6 6

6 3 6

6 6 6
6 6 6 6 3
6 4 6 6 6 3 3 6

6 3
6 6 3 3 3

6 4 3 6
1 1

4 6 6 6 3 6 6 6 6
6
4
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
24
0
0
0
0
0
0
29
0
0
0
0
24
43
1
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
40
0
0
0
6
0
0
0
0
0
0
10
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
29
0
0

0
0
0
0
0
0
0
0
6
0
0
0

0
0
0
0
0
0
0
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
4
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
1
0
0
0
0
0
0
0
3
0
65
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
7
6
0
0
0
0
0
0
0
1
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
4
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
3

0
2
4
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


parti sinyo weny titik suparni

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet 10
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet 6
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet 4
20 Antasida sirup Botol 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 10
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 10
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 10
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 10 12 8 8 8
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul 4
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 1
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 5 5 4
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet 6
tab
192 Simetidin tab Tablet 6 10
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 8
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 1 1
18 IV Cateter No. 24 ( Anak ) Biji 2 2 2
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
10
0
0
0
0
0
6
0
0
6
0
0
0
0
0
4
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
0
0
0
0
0
0
0
0
0
0
10
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
10
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
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
46
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
14
0
0
0
0
0
0
0
0
0
6
16
0
0
0
0
0
0
0
0
0
0
0
6
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
8
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
3

0
3
6
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


elisabet fandi febire septiana sukiyem suparno satiyem

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol 1
6 Ambroxol tab Tablet 4 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 2 4 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 4 6
19 Antasida Doen tab Tablet 4 6
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 6
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 2
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol 1
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul 1
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 4 4 8 8
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 2
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 1
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 8 2
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol 1
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 5 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul 6
27 Vitamin neurotropik inj Ampul 1
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 2 2
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
rizal bilal yanti kana sainah jumiyem puji kaniman joko fatma rama abel amanah

6 6 6 6 4

6
6 6 6 6 6 6 6 4 2
6 6 6 4 2 6

6
1

8 6 6 6 6 4 6

6 6
6

6 6

6
1
4 4
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
sukadi surtini sukiman samiyem keila suwarni aditya ratna warsini

1
6 6

6 6

20
6 6
1 2
6

6 6 4
2

2 3
1
1

8 8 6 3 6

10

7
1

6 20

4
4
1

1
1
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
3
22
0
0
0
0
0
0
52
0
0
0
0
36
22
3
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
69
0
0
0
5
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
34
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
4
0
0
0
0
0
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
1
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
1
0
0
0
0
0
0
2
0
103
0
0
0
16
12
0
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
17
0
0
0
0
0
0
0
0
1
6
44
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
6
0
0
1
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
1
21
0
0
0
0
6
1
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
3

0
5
1
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


sumiyem samino parno fauzi warsini suyanto mariyem

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet 12 6 12
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6 6 3
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 3
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet 6
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 3 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet 12 8
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet 8
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet 8
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 8 6
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet 6
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 10 8 9 3 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 5 3 3
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul 1
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6 11 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 6 6
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1 1 1
18 IV Cateter No. 24 ( Anak ) Biji 2 2 2
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
marsudi tawanto kolis novi

14
6
6

6
6

12
6 6

8
6

10

4
1

1
2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
6
0
0
0
0
0
0
12
0
1
0
0
0
44
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
27
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
3
0
0

0
0
0
0
0
0
6
0
0
0
0
0

6
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
20
0
8
0
0
0
0
14
0
0
0
0
0
0
0
0
0

0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
54
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
0
0
0
1
0
29
0
0
0
0
0
0
0
0
0
10
0
6
0
0
0
0
0
18
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
4
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
4

0
4
8
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


nur ridau satria sunarsih ratmi satria sutarno

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 10 6 4
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6 6
19 Antasida Doen tab Tablet 9 12 3 6 4 6
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 3 4
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 4 6
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 4
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 9 12 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet 10
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 9 12 2 4
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 4 4 3
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji 1 1 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji 1 1 1
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
suwarno rebi aska dari sutinem ismanto gimin

6 6 6

6
6

6
6

6
6

6 6 3 6
4

6 6 3 12

4 5
6

3 6
4

6
1 1

1 1
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
0
0
0
0
0
0
0
38
0
0
0
0
18
46
0
0
0
0
0
0
6
0
0
0
0
0
0
0
6
0
0
0
13
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
54
0
0
0
0
0
0
0
0
0
0
0
0
0
10
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
4
0
0
0
0
54
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
6
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
6
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
2
3

0
2
3
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


yanto sugimin huda sutimin alvin nurjanah dwi

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 4
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6
19 Antasida Doen tab Tablet 14
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet 4
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 4
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 12
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet 3
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul 4
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 10 4
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 10
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 6
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul 2
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot 11 1
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 16
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 5
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube 1
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet 4
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji 1
14 Infus Set dewasa Biji 1
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji 1
18 IV Cateter No. 24 ( Anak ) Biji 4
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
jesika

6
6
6
6
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
0
0
0
0
0
0
0
10
0
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0
6
14
0
0
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0
4
0
0
0
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6
0
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0
0
0
0
12
0
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0
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0
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6
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0
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3
0
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0
0
0
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0

0
0
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0
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0
0
0
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0
0
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0
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26
0
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10
0
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0
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6
0
0
0
0
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0
2
0
0
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0
12
0
0
0
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0
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16
0
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0
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1

0
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4
0
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0
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0
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0

0
0
0
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0
0
0
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0
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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
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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
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0
0
0
0
0
0
0
0
0
0
0
0
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0
0
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0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


tri winarni tri teresa rebo dimas dewi wiji

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6 6
19 Antasida Doen tab Tablet 6
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet 6
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet 4
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 6
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet 4
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
reni karti jarwanto nuraini feri ramadani aji karno wasimin diana umri ari lien

1
18 10

4 6

6
15 6
6

2 6 6

6 5 6

1
6 6

2 6 6
6
1

6
1

6 6 4 6 6 12 6

2 1

13 7
1 1
3
16 8

6 10

6 6

6 6
1 1

1
2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
sri sani saka sudarto kanaya umprik

6 6 12
6 6
4
6

6
4

12
6 6 6 12

5
12

1
2
1

1
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
1
34
0
0
0
0
0
0
28
0
0
1
0
18
51
0
0
0
0
0
0
6
0
0
0
0
0
0
0
6
0
0
0
38
0
0
0
0
0
0
0
0
0
0
17
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
18
0
0

0
0
0
0
0
0
0
0
0
0
0
0

12
0
0
0
0
0
0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
0
0
0
10
1
0
0
0
1
0
5
0
0
0
0
0
0
0
0
0

0
0
0
0
22
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
4
0
0
0
0
94
0
0
0
18
0
0
0
0
0
12
0
0
0
0
0
0
0
3
0
0
0
0
25
0
0
0
0
0
0
0
0
2
3
24
0
0
0
0
0
0
0
0
0
28
0
12
0
12
0
0
0
12
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
4
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
1
2

0
2
2
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


aziz anna giyanti sudarno sanusi dwi suryanto

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet 6 2 6
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet 2
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 6
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol 1
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6 3
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet 6
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6 6 3
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 6
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 6 6 6 6 6
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet 6
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet 6
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet 4
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
sulastri nyami warsini wagimin arsya ngatini alviah sugito sayem broto imam afi dewi

1
6

6 6 6

6 6
6 6

6 6
6 2 6 6 6

6
6 6 6 6 6

6 2 6

1
6
6 2 6 6 6 6 6

6
1
6

4
6
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
1
12
0
4
0
0
0
0
24
0
2
0
0
12
26
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
6
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
39
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
1
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
6
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
1
0
59
0
0
0
6
6
0
0
0
0
36
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
6
6
0
0
0
0
0
0
0
0
0
0
0
6
0
6
0
0
0
0
0
6
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
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
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
0
0
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


marsudi sukaryadi esti erista eko aji nurul

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet
20 Antasida sirup Botol 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet 6
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol 1
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 2 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 2 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet 2
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet 6 6 6 6 6
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet 6
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
handayanieris virga fadli rebo maridi

12

6 6 10

6 10

12 10

6
3

1
6 6

10

6
6
6 6 6 10

4 2
6
4
1 1

1
2 2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
18
0
0
0
0
0
0
34
0
0
0
0
16
22
2
0
0
0
0
0
6
0
0
0
6
0
0
0
3
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
0
0

0
0
0
0
0
0
10
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
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
1
0
42
0
0
0
2
0
0
0
0
0
30
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
6
6
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
8
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
2

0
1
4
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


oki nur sumarsih puji siti atrio misrawati

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet 6
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol 1
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 10
19 Antasida Doen tab Tablet 6
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 4
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 4 6 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 4 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet 6 6
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet 6
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet 6
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
ramadani warinem suliyem anisa arjo jumiati arum paimin kasidi sarila sunarno

6 6

1 1

6 6 6
1 1 1 1
4 4

6 6
4 6 6 3 6 6 4

3 6 4
6
1

4 6 6 3 6 6

6 6 6 6 6 6

2 3 1 2 2 1 5
6 6
10 6 6

10

6 4

2
4
1 1 1 1 1 1 1

1 1 1 1
1 1 3 2 2 2 2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
1
6
0
4
0
0
0
0
18
0
3
0
0
10
24
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
51
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
29
0
0
0
0
0
0
0
0
0
0
0
0
0
18
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
1
0
49
0
0
0
6
0
0
0
0
0
36
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
12
22
0
0
0
0
0
0
0
0
0
10
0
6
0
10
0
0
0
6
0
6
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
4
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
7

0
4
13
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


riski dwi wiwik erina sukaryadi tri wiji tri m

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6 6 6
19 Antasida Doen tab Tablet
20 Antasida sirup Botol 1 1
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet 6
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet 6
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet 4
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet 6
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol 1
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet 6
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet 6
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet 4 4
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
yolanda ranem erlangga rebi suparyo yuni kimtan fajar rebi jami senen misrawati rina

6 6 6

6 6

6
6 12

1 1 1 1 1 1 1
4

2 6

6
6 12 12

2 6 6
8 5 6

15
4

6 6 2 6 12 12 12 6

12

2 5 3 6 3
6 6
6 6 6 8 6

6 6 4

6
1
1 1 1 1 1

1 1
2 1 2 1 3
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
18
0
0
0
0
0
0
24
0
1
3
0
24
18
9
0
0
0
0
0
6
0
0
0
0
0
0
0
10
0
0
0
14
0
0
0
4
0
0
0
0
0
0
7
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
0
0

0
0
0
0
0
0
0
0
0
0
0
0

6
0
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
15
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
74
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
19
0
0
0
0
0
0
0
0
0
18
32
0
0
0
0
0
0
0
0
0
6
0
22
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
1
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
5

0
2
9
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
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
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7


endang anton suradi anwar nuryanto suyantow aji

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet 6 6 6 6 6 6
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet 6
19 Antasida Doen tab Tablet
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet 6 6
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet 6
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet 6 6 6
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet 6 6
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet 6 6 6 6 6 6
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet 6
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
imam wagiman mulyani wiryo riminto novi rumanto

6 8

11

6 6

6
4

1
6 4

6 8

6
6
6 6 6 10 12

1 3

3 2 2 4 5

8
1
6
4 6

12

6 4

1
1

1
1 1 1 1 1

1 1 1 1

2 2 3 2 2
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
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16
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24
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8
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12
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5

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11
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0
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0
0
0
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
0
0
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0
0
0
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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

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
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
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
0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN

NO NAMA OBAT SAT 1 2 3 4 5 6 7

A Obat Generik
1 Acetosal 500 mg tab Tablet
Kotak 24
2 ACT tab
tab
3 Albendasol Tablet
4 Allopurinol 100 mg tab Tablet
5 Ambroxol sirup Botol
6 Ambroxol tab Tablet
7 Aminofilin inj. Ampul
8 Aminofilin tab 200 mg Tablet
9 Amitriptilin tab 25 mg Tablet
10 Amlodipin 5mg Tablet
Amoksisilin + As. Klavunalat 625
11 Tablet
mg
12 Amoksisilin injeksi Vial
13 Amoksisilin kab 500 mg Tablet
14 Amoksisilin kap 250 mg Kapsul
15 Amoksisilin Sirup 125 mg Botol
16 Ampisilin injeksi 1 gram Vial
17 Antalgin injeksi Ampul
18 Antalgin tab 500 mg Tablet
19 Antasida Doen tab Tablet
20 Antasida sirup Botol
21 Anti Bacteri Doen salep kulit Tube
22 Anti Hemoroid suppo Suppo
23 Antifungi Kombinasi salep kulit Pot
24 Artemeter inj 80 mg Ktk 6 amp
25 Artesunate Inj ktk 8 amp
26 Asam Askorbat tab 50 mg tab Tablet
27 Asam Mefenamat kap 500 mg Kaplet
28 Asam traneksamat inj 250 mg Ampul
29 Asiklovir salep kulit Tube
30 Asiklovir tab 200 mg Tablet
31 Atropin Sulfas inj Ampul
Benzatin Benzyl Penisilin Inj 2,4jt
32 Flacon
UI
33 Besi II Sulfat Tablet + asam folat Tablet
34 Betahistin mesilat tab Tablet
35 Betamethason salep kulit Tube
36 Bisakodil tab Tablet
37 Deksametason inj Ampul
38 Deksametason tab 0,5 mg Tablet
39 Dekstromethorpan sirup Botol
40 Dekstromethorpan tab Tablet
41 Diazepam inj. 5mg/2ml Ampul
42 Diazepam tab 2 mg Tablet
43 Diazepam tab 5 mg Tablet
44 Difenhydramin HCl inj Ampul
45 Digoxin tab 0,25 mg Tablet
46 Dimenhydrinat tab Tablet
47 Doksisiklin 100 Tablet
48 Domperidon suspensi Botol
49 Domperidon tab 10 mg Tablet
50 Efedrin tab 25 mg Tablet
51 Efinefrin ( Adrenalin inj ) Ampul
52 Ekstrak Belladon tab 10 mg Tablet
53 Erytromicin kap 250 mg Kapsul
54 Erytromicin kap 500 mg Kapsul
55 Erytromicin sirup Botol
56 Etakridin Lakt. ( Rivanol ) Botol
57 Ethambutol tab 250 mg Tablet
58 Fenitoin Na. kap 100 mg Kapsul
59 Fenobarbital inj 50mg/ml Ampul
60 Fenobarbital tab30 mg Tablet
61 Fenol Gliserol Botol
62 Fitomenadion inj Ampul
63 Fitomenadion tab 10 mg Tablet
64 Furosemide tab 40 mg Tablet
65 Furosemide injeksi Ampul
66 Gameksan salep kulit Tube
67 Garam Oralit 200ml Sak
68 Gentamicin tetes mata 0,3 % Botol
69 Gentamicin injeksi Ampul
70 Gentamisin salep kulit Tube
71 Gentian Violet Botol
72 Glibenklamide tab 5 mg Tablet
73 Gliseril guaiakolat tab Tablet
74 Glukonas kalsikus Ampul
75 Glukose 40 % larutan infus Ampul
76 Glukose 10 % larutan infus Ampul
77 Glukose 5 % larutan infus Flabot
78 Griseofulvin tab 125 mg Tablet
79 Haloperidol tab 0,5 mg Tablet
80 Haloperidol tab 1,5 mg Tablet
Hidrokhlorotiazide (HCT) tab 25
81 Tablet
mg
82 Hidrokortison salep kulit Tube
Hiosine-N- butilbromide tablet 10
83 Tablet
mg
84 Ibuprofen tab 200 mg Tablet
85 Ibuprofen tab 400 mg Tablet
86 Isoniazide tab ( INH ) Tablet
87 Isosorbid Dinitrat Tablet
88 Kalium Diklofenak 25 mg Tablet
89 Kalium Diklofenak 50 mg Tablet
90 Kalsium Laktat tab 500 mg Tablet
91 Kaptopril tab 25 mg Tablet
92 Karbamazepin tab 200 mg Tablet
93 Ketokonazole 200 mg Tablet
94 Ketokonazole krim tube
95 Ketoprofen inj Ampul
96 Kinina Dihydroklorid inj Ampul
97 Kinina HCl. Tab Tablet
98 Klobazam tab Tablet
99 Klonidin tab Tablet
100 Klorafeniramin ( CTM ) tab Tablet
101 Kloramfenikol inj Vial
102 Kloramfenikol salep mata 1 % Tube
103 Kloramfenikol sirup Botol
104 Kloramfenikol tetes mata 0,5 % Tube
105 Kloramfenikol tetes telinga Kapsul
106 Kloramfenikol kap 250 mg Botol
107 Klorokuin tab 150 mg Tablet
108 Klorpromasin injeksi Ampul
109 Klorpromasin tab 25 mg Tablet
110 Kontrasepsi implant set
111 Kontrasepsi inj depo prog 3 bln vial
112 Kotrimoksazol suspensi Botol
113 Kotrimoksazol tab 120 mg Tablet
114 Kotrimoksazol tab 480 mg Tablet
115 Lidokain comp injeksi Ampul
116 Loperamid Tablet
117 Mebendazol tab100 mg Tablet
118 Metformin 500 Tablet
119 Methoklopramide injeksi Ampul
120 Methoklopramide sirup Botol
121 Methoklopramide tab10 mg Tablet
122 Metilergomet injeksi 0,2 mg Ampul
123 Metilergomet tab 0,125 mg Tablet
124 Metilprednisolon 4 Tablet
125 Metronidazol inf Ampul
126 Metronidazol tab 250 mg Tablet
127 Metronidazol tab 500 mg Tablet
128 MgSO4 20 % Vial
129 MgSO4 40 % Vial
130 Mineral mix Sak
131 Misoprostol Tablet
132 Myconazol salep kulit Tube
133 Na tiroksin Tablet
134 Na. Bic. Tab 500 mg Tablet
135 Na. Cl. Infus Flabot
136 Natrium Dikofenak 50 Tablet
137 Natrium Tiosulfas inj Ampul
138 Nifedipin Tablet
139 O A T Anak Paket
140 O A T - FDC anak Paket
141 O A T - FDC kat 1 & 3 Paket
142 O A T - FDC kat 2 Paket
143 O A T - FDC sisipan Paket
144 O A T Katagori - 1 Paket
145 O A T Katagori - 2 Paket
146 O A T Katagori - 3 Paket
147 O A T Sisipan Paket
148 Obat Batuk Hitam sirup Botol
149 Oksitetrasiklin salep kulit 3 % Tube
150 Oksitetrasiklin salep mata Tube
151 Oksitetrasiklin 50mg/ml inj Flacon
152 Oksitocin 10mg/ml inj Ampul
153 Omeprazol kaps Kapsul
154 Papaverin inj Ampul
155 Papaverin tab 40 mg Tablet
156 Parasetamol sirup Botol
157 Parasetamol tab 100 mg Tablet
158 Parasetamol tab 500 mg Tablet
159 Perhidrol 2 % Botol
160 Piracetam 400 Kapsul
161 Pirazinamid tab 500 mg Tablet
162 Piridoksin tab 10 mg Tablet
163 Piroksikam tab 10 mg Kapsul
164 Piroksikam tab 20 mg Kapsul
165 Polykrusulen ( Albothyl ) Botol
166 Povidon Iodium 10% 30 ml Botol
167 Povidon Iodium 10% 300 ml Botol
168 Prednison tab 5 mg Tablet
169 Primakuin tab 15 mg Tablet
170 Proc. Pen. 3 juta inj Vial
171 Prokain Benzil Penisilin Vial
172 Propanolol tab 40 mg Tablet
Propylthioracil ( PTU ) tab 100
173 Tablet
mg
174 Pyrantel tab 125 mg Tablet
175 Ranitidine 150 mg Tablet
176 Ranitidine inj ampul
177 Reserpin tab 0,25 mg Tablet
178 Retinol 100.000 iu Kab Btl @50
179 Retinol 200.000 iu Kab Btl @50
180 Rifampisin kap 300 mg Kapsul
181 Ringer Laktat Infus Flabot
182 Salbutamol tab 2 mg Tablet
183 Salep 2 - 4 kombinasi Pot
184 Salysil bedak 2 % Botol
185 Sefadroksil 500 cps Kapsul
186 Sefotaxim 1g inj Vial
187 Seftriaxon inj Vial
188 Serum ABU 5 ml inj. Flacon
189 Serum ATS 1.500 iu inj Ampul
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul
Sianokobalamin tab ( Vit. B12 )
191 Tablet
tab
192 Simetidin tab Tablet
193 Simvastatin 10 Tablet
194 Siprofloxacin tab 500 mg Tablet
195 Streptomicin 1.500 mg inj Vial
196 Sulfacetamid tetes mata Botol
197 Sulfadimidin 500 mg tab Tablet
198 Sulfadoksin + Piritamin tab Tablet
199 Tetracyklin kap 250 mg Kapsul
200 Tetracyklin kap 500 mg Kapsul
201 Thiamin HCl / B1 tab 100 mg Tablet
202 Tiamfenikol kap 500 mg Kapsul
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul
204 Tiamin HCl / B1 Tab 50 mg Tablet
205 Triheksifenidil tab 2 mg Tablet
206 Vitamin B Komplek tab Tablet
207 Zink Tablet

B Obat Non Generik


1 Antasida + Simetikon Tablet
2 Antasida + simetikon sirup Botol
3 Anti Diare kombinasi ( Dewasa ) Tablet
Anti Diare kombinasi sirup ( Anak
4 Botol
)
5 Anti hemorhoid kapsul Kapsul
6 Anti radang topikal mengandung Tube
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul
8 Asam Askorbat tab 500 + Vitamin Tablet
9 Asering infus Flabot
10 Asifit Kapsul
11 Batugin eliksir Botol
Betamethason + Antibiotik salep
12 Tube
kulit
13 Bioprost Kapsul
14 D 1/2NS Flabot
15 Diazepam rectal Tube
16 Flunarizin 5 mg Tablet
17 Mecobalamin 500 Kapsul
18 Minyak kayu putih Botol
19 Minyak telon Botol
20 Multivitamin sirup ( Anak ) Botol
21 Multivitamin tab ( Dewasa ) Tablet
22 Neprolit Kapsul
23 Salep Luka Bakar Tube
24 Simetidin inj Ampul
25 Tablet Tambah Darah + Vitamin Tablet
26 Tensigard Kapsul
27 Vitamin neurotropik inj Ampul
28 Xylomidon inj Vial

C Obat Gigi
1 Air raksa dental use Botol
2 Bahan bonding botol
3 Bahan Etsa botol
4 Devitalisasi Pasta Botol
5 Etil Klorida semprot Botol
6 Eugenol sol Pot
7 Flour tablet Tablet
8 Glass Ionomer Cement Pot
9 Kalsium hydroksi pasta dos
Monokror Kamfer Menthol
10 Pot
( CHKM )
11 Mumiying Pasta Biji
12 Semen Seng Fosfat p+liq Botol
13 Silver Amalgam Botol
14 Solare Tube
15 Spons Gelatin Cubices Dos
16 Temp+Stopp Fletc p+liq Set
17 Trikresol Formalin ( TKF ) Botol
18 Yodium Gliserin Cc
D Alkes Pakai Habis
1 ADS 0,05 ml Biji
2 ADS 0,5 ml Biji
3 ADS 5 ml Biji
4 Alat suntik 1 ml Biji
5 Alat suntik 2,5 ml / 3ml Biji
6 Alat Suntik 5 ml Biji
7 Antiseptik/Bayclin Botol
8 Aqua Pro injeksi Flacon
9 Aquadest steril 500ml Botol
10 Cat Gut Biji
11 Etanol 70 % Botol
12 Hand Scoen Biji
13 Infus Set anak Biji
14 Infus Set dewasa Biji
15 IV Cateter No. 18 Biji
16 IV Cateter No. 20 ( Dewasa ) Biji
17 IV Cateter No. 22 ( Dewasa ) Biji
18 IV Cateter No. 24 ( Anak ) Biji
19 Jarum Bengkok / Jahit Biji
20 Jarum Suntik Biji
21 Kapas Adsorben 250 gr Roll
22 Kasa panjang 40 cmx80 yard Roll
23 Kasa Pemb 4 m x 10 cm Roll
24 Kasa Pemb Hydro 4 m x 15 cm Roll
25 Kasa Pemb Hydro 4 x 80 cm Biji
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos
Kasa steril mengand:Framasetin
27 Biji
10%
28 Kasa uk 36 m x 80 cm Roll
29 Kertas Puyer Pak
30 Lisol Botol
31 Masker Biji
32 Masker N95 Biji
33 Mess Biji
34 Penjernih Air Cepat ( PAC ) Set
35 Plastik obat pak
36 Plester 5 yardx2inch Roll
37 Poly Cateter No. 14 Biji
38 Poly Cateter No. 16 Biji
39 Poly Cateter No. 18 Biji
40 Selang oksigen anak Biji
41 Selang Oksigen dws Biji
42 Silk Biji
43 Tranfusi set Biji
44 Urine Bag Biji
45 Wing Needle No 23 Biji
46 Wing Needle No 25 Biji
47 Pot dahak Biji

E Laboratorium Dan Reagen


1 Alkohol swab 100pcs/box
2 Amphetamin dos 50 test dus 50
3 Asam urat Kit 4 x 30 ml
4 Benzodiazepin dos 50 test dus 50
5 Blue tips set @100
6 BOD Nutrient Mixture Botol
7 BOD Standart Botol
Briliant green 2% Bile Broth
8 Btl dlm dus
(BGLB)
9 Cannabinoides dos 50 test dus 50
10 Cell clean Btl 50 ml
11 Cellpack (PK-30 ) box 20 lt
12 Cholinesterase botol
13 Cocain dos 50 test dus 50
14 COD cell test Botol
15 COD sol A Refil Botol
16 Combur test kit 100test Kit 100 test
17 Deck glass box 100 biji
18 EDTA 10 % btl 250 ml
serial
19 Eight check ( L,N,H )
3x1.5ml
Botol 5 x
20 Glukosa
100 ml
21 HbsAg test Dus 50 pcs
22 Iodida Test Botol
23 Kertas ECG lembar
Botol 5 x
24 Kolesterol
100 ml
Botol 2 x
25 Kreatinin
125 ml
26 Lactosa Broth Botol
27 Larutan Asam Klorida 1 % Botol
28 Larutan Asam Sulfosalisilat Botol
29 Larutan Benedick Botol
30 Larutan Eosin Botol
31 Larutan Etanol Asam Botol
32 Larutan Gabbet Botol
33 Larutan Giemsa Botol
34 Larutan Hayem Botol
35 Larutan Karbol Fuksin Botol
36 Larutan Kinyoun Botol
37 Larutan Metanol Botol
38 Larutan Metilen Biru Botol
39 Larutan Turk Botol
40 Larutan Drabkin Botol 500 ml
41 Larutan Rees Ecker Botol 100 ml
42 LDL kit
43 Minyak emersi botol
44 Morphines dos 50 test dus 50
45 Needle boorner dus 100
46 Obyek glass set
47 Oksigen m3
48 Poch-D box 5 lt
49 Poch-L box 500ml
50 Reagen A/B ( GOLDA ) Set
51 Reagen amonium Botol
52 Reagen Cu Btl dlm dus
53 Reagen Fe ( Iron ) Btl dlm dus
54 Reagen Mn Btl dlm dus
55 Reagen Nitrat Btl dlm dus
56 Reagen Nitrit Btl dlm dus
57 Reagen Phospat Botol
58 Reagen Zn Botol
59 Reagen Cyanmet kit/500ml Kit 500ml
60 Serum Widal AO Vial 5 ml
61 Serum Widal H Vial 5 ml
62 Serum Widal O Vial 5 ml
Serum widal S thypi H parathyphi
63 AH vial 5 ml
Botol 2 x
64 SGOT
62,5 ml
Botol 2 x
65 SGPT
62,5 ml
66 Stromatolyser-WH Btl 500 ml
67 Tabung EDTA 3 ml dus 100
68 Tabung EDTA 5 ml dus 100
69 Test Gula Darah Biji
Tube 100
70 Test hematokrit/asisten
biji
71 Thermal roll paper roll
72 Tissue lensa biji
Botol 6 x 50
73 Trigliserida
ml
74 Ultrasonic gel set
Kit 2 x 100
75 Ureum
ml
76 Urine Test Biji
77 Vacum tainer dus 100
78 Yellow tips set @1000

F Obat Tambahan
8 9 10 11 12 13 14 15 16 17 18 19 20
LAPORA

21 22 23 24 25 26 27 28 29 30 31 32 33
LAPORAN PEMAKAIAN KAMAR OBAT BULAN JUNI 2014

Nama
34 35 36 37 38 39 40 41 42 43 44 45 46
47 48 49 50 51 52 53 54 55 56 57 58 59
60 61 62 63 64 65 66 67 68 69 70 71 72
Jumlah
73 74 75 76 77 78 79 80 81
Akhir

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
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0

0
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0
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0
0
0
0
0

0
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0
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0
0
0
0
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0
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0
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0
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0
0

0
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0
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0
0
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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
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
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
PUSKESMAS
MARET 2016
PUSKESMAS : SAMBUNGMACAN 1
KECAMATAN : SAMBUNGMACAN
KABUPATEN : SRAGEN
TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
A Obat Generik
1 Acetosal 500 mg tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kotak 24
2 ACT tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tab
3 Albendasol Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 Allopurinol 100 mg tab Tablet 150 150 0 0 0 0 8 0 0 0 0 0 10 0 0 0 0 0 0 0 10

5 Ambroxol sirup Botol 6 15 21 3 0 0 0 0 0 2 1 0 0 0 0 0 1 0 0 0 0 0

6 Ambroxol tab Tablet 31 400 431 16 24 6 0 12 18 14 12 12 12 12 20 22 30 22 26 0 24 0

7 Aminofilin inj. Ampul 24 24 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Aminofilin tab 200 mg Tablet 63 63 0 4 0 6 0 0 6 0 0 0 0 0 0 0 8 6 0 0 0

9 Amitriptilin tab 25 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 Amlodipin 5mg Tablet 67 30 97 0 0 6 4 0 6 0 0 0 6 6 0 0 0 0 0 3 0 6


Amoksisilin + As. Klavunalat
11 Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
625 mg
12 Amoksisilin injeksi Vial 68 68 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0

13 Amoksisilin kab 500 mg Tablet 437 700 1,137 36 62 27 77 57 30 8 32 55 6 22 0 34 41 45 46 12 29 6

14 Amoksisilin kap 250 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

15 Amoksisilin Sirup 125 mg Botol 4 35 39 0 1 1 0 1 0 1 1 2 3 2 0 0 0 1 1 2 0 0

16 Ampisilin injeksi 1 gram Vial 57 57 3 0 0 1 3 0 0 3 1 0 2 6 0 0 0 0 0 0 0

17 Antalgin injeksi Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

18 Antalgin tab 500 mg Tablet 169 500 669 19 18 9 34 6 23 8 42 6 22 14 21 6 12 36 42 16 24 0

19 Antasida Doen tab Tablet 23 800 823 6 26 22 64 24 0 42 12 16 16 23 13 6 40 27 50 16 43 4

20 Antasida sirup Botol 34 50 84 2 7 2 10 1 1 0 3 4 4 3 3 2 3 2 1 1 1 2

21 Anti Bacteri Doen salep kulit Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
22 Anti Hemoroid suppo Suppo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

23 Antifungi Kombinasi salep kulit Pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

24 Artemeter inj 80 mg Ktk 6 amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

25 Artesunate Inj ktk 8 amp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26 Asam Askorbat tab 50 mg tab Tablet 97 97 0 0 0 0 0 0 0 4 10 6 0 0 0 6 6 0 0 0 0

27 Asam Mefenamat kap 500 mg Kaplet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

28 Asam traneksamat inj 250 mg Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

29 Asiklovir salep kulit Tube 1 5 6 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

30 Asiklovir tab 200 mg Tablet 75 75 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0

31 Atropin Sulfas inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Benzatin Benzyl Penisilin Inj
32 Flacon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2,4jt UI
Besi II Sulfat Tablet + asam
33 Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
folat
34 Betahistin mesilat tab Tablet 68 120 188 0 6 0 0 6 0 15 0 12 0 6 10 10 0 0 6 0 6 0

35 Betamethason salep kulit Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

36 Bisakodil tab Tablet 16 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

37 Deksametason inj Ampul 27 27 1 0 0 1 1 1 1 0 0 0 0 0 0 0 3 0 1 0 0

38 Deksametason tab 0,5 mg Tablet 1,218 1,218 32 29 12 36 41 12 48 6 51 28 42 24 24 30 69 94 40 40 30

39 Dekstromethorpan sirup Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

40 Dekstromethorpan tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

41 Diazepam inj. 5mg/2ml Ampul 26 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

42 Diazepam tab 2 mg Tablet 0 100 100 0 14 0 0 6 0 9 0 0 0 0 0 6 6 6 4 0 6 0

43 Diazepam tab 5 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

44 Difenhydramin HCl inj Ampul 21 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

45 Digoxin tab 0,25 mg Tablet 75 75 0 0 0 0 0 0 7 0 0 0 0 6 0 0 0 0 0 0 0

46 Dimenhydrinat tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

47 Doksisiklin 100 Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

48 Domperidon suspensi Botol 10 6 16 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0

49 Domperidon tab 10 mg Tablet 41 300 341 14 8 12 16 10 6 0 0 0 13 8 19 12 10 10 0 0 10 10


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
50 Efedrin tab 25 mg Tablet 77 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

51 Efinefrin ( Adrenalin inj ) Ampul 4 4 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

52 Ekstrak Belladon tab 10 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

53 Erytromicin kap 250 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

54 Erytromicin kap 500 mg Kapsul 60 100 160 6 0 6 0 0 0 6 0 12 0 0 0 0 0 0 0 0 15 0

55 Erytromicin sirup Botol 24 24 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 0

56 Etakridin Lakt. ( Rivanol ) Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

57 Ethambutol tab 250 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

58 Fenitoin Na. kap 100 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59 Fenobarbital inj 50mg/ml Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

60 Fenobarbital tab30 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

61 Fenol Gliserol Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

62 Fitomenadion inj Ampul 42 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

63 Fitomenadion tab 10 mg Tablet 88 88 0 0 0 0 0 6 0 0 0 0 0 0 0 0 8 0 0 0 0

64 Furosemide tab 40 mg Tablet 132 132 0 6 0 0 0 0 9 0 0 0 0 0 0 0 0 4 0 0 0

65 Furosemide injeksi Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

66 Gameksan salep kulit Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

67 Garam Oralit 200ml Sak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

68 Gentamicin tetes mata 0,3 % Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

69 Gentamicin injeksi Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

70 Gentamisin salep kulit Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

71 Gentian Violet Botol 4 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

72 Glibenklamide tab 5 mg Tablet 78 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0

73 Gliseril guaiakolat tab Tablet 134 1,000 1,134 18 17 28 37 24 12 2 4 35 4 10 14 20 14 10 16 24 29 0

74 Glukonas kalsikus Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

75 Glukose 40 % larutan infus Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

76 Glukose 10 % larutan infus Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

77 Glukose 5 % larutan infus Flabot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
78 Griseofulvin tab 125 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

79 Haloperidol tab 0,5 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

80 Haloperidol tab 1,5 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Hidrokhlorotiazide (HCT) tab 25
81 Tablet 70 70 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
mg
82 Hidrokortison salep kulit Tube 4 4 8 0 0 2 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Hiosine-N- butilbromide tablet
83 Tablet 75 75 0 0 0 0 0 0 6 6 0 0 0 1 0 0 0 0 16 0 0
10 mg
84 Ibuprofen tab 200 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

85 Ibuprofen tab 400 mg Tablet 179 179 0 0 0 0 0 18 0 18 24 0 10 0 6 0 0 0 0 6 0

86 Isoniazide tab ( INH ) Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

87 Isosorbid Dinitrat Tablet 37 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

88 Kalium Diklofenak 25 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

89 Kalium Diklofenak 50 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

90 Kalsium Laktat tab 500 mg Tablet 175 100 275 6 6 0 0 48 0 0 18 6 0 10 0 0 0 0 0 12 0 0

91 Kaptopril tab 25 mg Tablet 112 100 212 0 23 0 0 0 4 0 0 6 0 0 0 0 6 18 0 6 0 0

92 Karbamazepin tab 200 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

93 Ketokonazole 200 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

94 Ketokonazole krim tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

95 Ketoprofen inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

96 Kinina Dihydroklorid inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

97 Kinina HCl. Tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

98 Klobazam tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

99 Klonidin tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

100 Klorafeniramin ( CTM ) tab Tablet 1,765 1,765 46 38 46 55 64 30 29 0 51 24 36 22 42 35 15 16 20 21 10

101 Kloramfenikol inj Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

102 Kloramfenikol salep mata 1 % Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

103 Kloramfenikol sirup Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

104 Kloramfenikol tetes mata 0,5 % Tube 5 5 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

105 Kloramfenikol tetes telinga Kapsul 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
106 Kloramfenikol kap 250 mg Botol 55 55 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0

107 Klorokuin tab 150 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

108 Klorpromasin injeksi Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

109 Klorpromasin tab 25 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

110 Kontrasepsi implant set 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

111 Kontrasepsi inj depo prog 3 bln vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

112 Kotrimoksazol suspensi Botol 24 24 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 0 0 0 0

113 Kotrimoksazol tab 120 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

114 Kotrimoksazol tab 480 mg Tablet 128 100 228 0 0 0 12 0 0 0 0 0 6 6 0 8 12 10 0 6 4 0

115 Lidokain comp injeksi Ampul 26 20 46 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0 0 0 0 0

116 Loperamid Tablet 78 78 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 6 0 0 0

117 Mebendazol tab100 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

118 Metformin 500 Tablet 198 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

119 Methoklopramide injeksi Ampul 41 30 71 0 2 0 0 0 0 2 2 4 0 0 0 0 1 4 1 0 0 0

120 Methoklopramide sirup Botol 9 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

121 Methoklopramide tab10 mg Tablet 171 171 6 0 0 4 10 0 8 0 18 0 0 0 10 32 6 0 0 0 0

122 Metilergomet injeksi 0,2 mg Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

123 Metilergomet tab 0,125 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

124 Metilprednisolon 4 Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

125 Metronidazol inf Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

126 Metronidazol tab 250 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

127 Metronidazol tab 500 mg Tablet 62 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

128 MgSO4 20 % Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

129 MgSO4 40 % Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

130 Mineral mix Sak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

131 Misoprostol Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

132 Myconazol salep kulit Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

133 Na tiroksin Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
134 Na. Bic. Tab 500 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

135 Na. Cl. Infus Flabot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

136 Natrium Dikofenak 50 Tablet 88 200 288 0 8 0 0 0 0 0 4 0 0 10 0 10 6 0 6 4 0 10

137 Natrium Tiosulfas inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

138 Nifedipin Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

139 O A T Anak Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

140 O A T - FDC anak Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

141 O A T - FDC kat 1 & 3 Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

142 O A T - FDC kat 2 Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

143 O A T - FDC sisipan Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

144 O A T Katagori - 1 Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

145 O A T Katagori - 2 Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

146 O A T Katagori - 3 Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

147 O A T Sisipan Paket 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

148 Obat Batuk Hitam sirup Botol 15 15 3 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 1 0

149 Oksitetrasiklin salep kulit 3 % Tube 6 6 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

150 Oksitetrasiklin salep mata Tube 9 9 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

151 Oksitetrasiklin 50mg/ml inj Flacon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

152 Oksitocin 10mg/ml inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

153 Omeprazol kaps Kapsul 110 60 170 2 4 0 8 2 4 4 10 4 0 5 8 4 4 0 4 0 0 0

154 Papaverin inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

155 Papaverin tab 40 mg Tablet 66 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

156 Parasetamol sirup Botol 13 35 48 1 2 0 5 2 0 2 1 4 1 2 0 0 1 4 13 0 3 0

157 Parasetamol tab 100 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

158 Parasetamol tab 500 mg Tablet 153 2,000 2,153 84 77 60 94 102 36 61 32 44 45 48 40 80 86 91 50 48 65 46

159 Perhidrol 2 % Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

160 Piracetam 400 Kapsul 84 100 184 0 11 0 8 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0

161 Pirazinamid tab 500 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
162 Piridoksin tab 10 mg Tablet 0 500 500 30 30 0 12 2 6 6 12 6 12 14 18 0 14 12 9 0 8 0

163 Piroksikam tab 10 mg Kapsul 128 128 24 0 18 18 0 0 0 0 0 0 0 4 0 0 0 0 0 0 4

164 Piroksikam tab 20 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

165 Polykrusulen ( Albothyl ) Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

166 Povidon Iodium 10% 30 ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

167 Povidon Iodium 10% 300 ml Botol 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

168 Prednison tab 5 mg Tablet 134 200 334 6 0 0 0 0 0 6 6 16 0 0 4 16 4 2 0 0 0 0

169 Primakuin tab 15 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

170 Proc. Pen. 3 juta inj Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

171 Prokain Benzil Penisilin Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

172 Propanolol tab 40 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Propylthioracil ( PTU ) tab 100
173 Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
mg
174 Pyrantel tab 125 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

175 Ranitidine 150 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

176 Ranitidine inj ampul 32 110 142 6 4 0 9 0 4 4 4 8 2 4 4 2 5 7 1 2 2 1

177 Reserpin tab 0,25 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

178 Retinol 100.000 iu Kab Btl @50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

179 Retinol 200.000 iu Kab Btl @50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

180 Rifampisin kap 300 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

181 Ringer Laktat Infus Flabot 462 100 562 15 22 1 42 19 3 11 10 18 14 15 24 9 30 30 21 29 7 14

182 Salbutamol tab 2 mg Tablet 112 112 0 6 0 13 0 0 6 0 10 0 10 0 0 2 8 8 0 6 0

183 Salep 2 - 4 kombinasi Pot 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

184 Salysil bedak 2 % Botol 4 4 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0

185 Sefadroksil 500 cps Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

186 Sefotaxim 1g inj Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

187 Seftriaxon inj Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

188 Serum ABU 5 ml inj. Flacon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

189 Serum ATS 1.500 iu inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
Sianokobalamin inj ( Vit. B12 )
190 Ampul 25 29 54 4 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
inj
Sianokobalamin tab ( Vit. B12 )
191 Tablet 633 633 6 6 0 0 12 0 6 0 0 6 6 0 0 0 6 0 0 0 6
tab
192 Simetidin tab Tablet 59 600 659 14 16 8 24 34 6 12 12 12 46 22 21 6 32 37 33 16 4 16

193 Simvastatin 10 Tablet 166 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

194 Siprofloxacin tab 500 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

195 Streptomicin 1.500 mg inj Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

196 Sulfacetamid tetes mata Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

197 Sulfadimidin 500 mg tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

198 Sulfadoksin + Piritamin tab Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

199 Tetracyklin kap 250 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

200 Tetracyklin kap 500 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

201 Thiamin HCl / B1 tab 100 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

202 Tiamfenikol kap 500 mg Kapsul 29 200 229 0 0 0 14 7 6 0 0 6 0 6 0 6 6 0 6 0 0 0


Tiamin HCl / B1 injeksi
203 Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100mg /ml
204 Tiamin HCl / B1 Tab 50 mg Tablet 309 309 6 6 24 36 36 30 0 16 6 0 6 0 14 0 12 15 0 0 6

205 Triheksifenidil tab 2 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

206 Vitamin B Komplek tab Tablet 916 916 2 0 12 7 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0

207 Zink Tablet 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

B Obat Non Generik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 Antasida + Simetikon Tablet 44 100 144 0 6 24 24 0 0 3 0 0 0 0 6 18 0 10 0 0 0 0

2 Antasida + simetikon sirup Botol 1 8 9 0 1 0 2 0 0 0 1 0 0 0 0 0 2 2 0 0 0 0


Anti Diare kombinasi ( Dewasa
3 Tablet 63 63 0 6 0 6 10 0 0 0 6 0 0 0 0 5 6 0 0 6 0
)
Anti Diare kombinasi sirup
4 Botol 4 4 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
( Anak )
5 Anti hemorhoid kapsul Kapsul 24 24 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0

6 Anti radang topikal mengandung Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Asam Askorbat tab 500 +
8 Tablet 120 100 220 4 32 0 0 0 4 4 0 0 0 6 0 8 0 0 12 0 0 0
Vitamin
TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
9 Asering infus Flabot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 Asifit Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Batugin eliksir Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Betamethason + Antibiotik salep
12 Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
kulit
13 Bioprost Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

14 D 1/2NS Flabot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

15 Diazepam rectal Tube 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 Flunarizin 5 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 Mecobalamin 500 Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

18 Minyak kayu putih Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

19 Minyak telon Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

20 Multivitamin sirup ( Anak ) Botol 5 15 20 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0

21 Multivitamin tab ( Dewasa ) Tablet 0 200 200 0 4 10 16 4 8 0 12 4 3 0 0 6 12 20 16 10 8 8

22 Neprolit Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

23 Salep Luka Bakar Tube 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

24 Simetidin inj Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Tablet Tambah Darah +
25 Tablet 108 108 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0
Vitamin
26 Tensigard Kapsul 120 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0

27 Vitamin neurotropik inj Ampul 24 20 44 0 1 0 0 0 0 0 0 0 0 1 0 0 1 2 0 0 0 0

28 Xylomidon inj Vial 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

C Obat Gigi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 Air raksa dental use Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Bahan bonding botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Bahan Etsa botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 Devitalisasi Pasta Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 Etil Klorida semprot Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 Eugenol sol Pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
7 Flour tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Glass Ionomer Cement Pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 Kalsium hydroksi pasta dos 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Monokror Kamfer Menthol
10 Pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
( CHKM )
11 Mumiying Pasta Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 Semen Seng Fosfat p+liq Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Silver Amalgam Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

14 Solare Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

15 Spons Gelatin Cubices Dos 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 Temp+Stopp Fletc p+liq Set 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 Trikresol Formalin ( TKF ) Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

18 Yodium Gliserin Cc 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

D Alkes Pakai Habis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 ADS 0,05 ml Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 ADS 0,5 ml Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 ADS 5 ml Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 Alat suntik 1 ml Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 Alat suntik 2,5 ml / 3ml Biji 80 100 180 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 Alat Suntik 5 ml Biji 25 25 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 Antiseptik/Bayclin Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Aqua Pro injeksi Flacon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 Aquadest steril 500ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 Cat Gut Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Etanol 70 % Botol 0 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 Hand Scoen Biji 0 40 40 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Infus Set anak Biji 20 20 0 0 0 1 3 1 0 0 0 0 0 5 0 1 1 0 0 0 0

14 Infus Set dewasa Biji 4 100 104 4 6 1 9 0 0 3 2 3 4 5 3 3 6 8 5 4 3 3


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
15 IV Cateter No. 18 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 IV Cateter No. 20 ( Dewasa ) Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 IV Cateter No. 22 ( Dewasa ) Biji 32 150 182 8 12 2 18 4 0 4 3 2 9 9 10 3 9 12 4 3 2 3

18 IV Cateter No. 24 ( Anak ) Biji 12 150 162 3 1 0 1 0 2 0 2 8 1 5 8 0 3 11 1 2 4 6

19 Jarum Bengkok / Jahit Biji 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

20 Jarum Suntik Biji 10 20 30 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

21 Kapas Adsorben 250 gr Roll 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

22 Kasa panjang 40 cmx80 yard Roll 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

23 Kasa Pemb 4 m x 10 cm Roll 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

24 Kasa Pemb Hydro 4 m x 15 cm Roll 0 75 75 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

25 Kasa Pemb Hydro 4 x 80 cm Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26 Kasa Steril 16 x 16 ( 16 lmb ) Dos 1 1 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Kasa steril mengand:Framasetin
27 Biji 0 4 4 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10%
28 Kasa uk 36 m x 80 cm Roll 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

29 Kertas Puyer Pak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

30 Lisol Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

31 Masker Biji 50 25 75 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

32 Masker N95 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

33 Mess Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

34 Penjernih Air Cepat ( PAC ) Set 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

35 Plastik obat pak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

36 Plester 5 yardx2inch Roll 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

37 Poly Cateter No. 14 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

38 Poly Cateter No. 16 Biji 0 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

39 Poly Cateter No. 18 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

40 Selang oksigen anak Biji 6 6 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

41 Selang Oksigen dws Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

42 Silk Biji 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
43 Tranfusi set Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

44 Urine Bag Biji 7 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

45 Wing Needle No 23 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

46 Wing Needle No 25 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

47 Pot dahak Biji 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

E Laboratorium Dan Reagen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 Alkohol swab 100pcs/box 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Amphetamin dos 50 test dus 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Kit 4 x 30
3 Asam urat 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ml
4 Benzodiazepin dos 50 test dus 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 Blue tips set @100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 BOD Nutrient Mixture Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 BOD Standart Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Briliant green 2% Bile Broth
8 Btl dlm dus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(BGLB)
9 Cannabinoides dos 50 test dus 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 Cell clean Btl 50 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Cellpack (PK-30 ) box 20 lt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 Cholinesterase botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Cocain dos 50 test dus 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

14 COD cell test Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

15 COD sol A Refil Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Kit 100
16 Combur test kit 100test 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
test
17 Deck glass box 100 biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

18 EDTA 10 % btl 250 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


serial
19 Eight check ( L,N,H ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3x1.5ml
Botol 5 x
20 Glukosa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 ml
21 HbsAg test Dus 50 pcs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
22 Iodida Test Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

23 Kertas ECG lembar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Botol 5 x
24 Kolesterol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 ml
Botol 2 x
25 Kreatinin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 ml
26 Lactosa Broth Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

27 Larutan Asam Klorida 1 % Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

28 Larutan Asam Sulfosalisilat Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

29 Larutan Benedick Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

30 Larutan Eosin Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

31 Larutan Etanol Asam Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

32 Larutan Gabbet Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

33 Larutan Giemsa Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

34 Larutan Hayem Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

35 Larutan Karbol Fuksin Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

36 Larutan Kinyoun Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

37 Larutan Metanol Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

38 Larutan Metilen Biru Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

39 Larutan Turk Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Botol 500
40 Larutan Drabkin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ml
Botol 100
41 Larutan Rees Ecker 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ml
42 LDL kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

43 Minyak emersi botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

44 Morphines dos 50 test dus 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

45 Needle boorner dus 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

46 Obyek glass set 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

47 Oksigen m3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

48 Poch-D box 5 lt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

49 Poch-L box 500ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
50 Reagen A/B ( GOLDA ) Set 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

51 Reagen amonium Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

52 Reagen Cu Btl dlm dus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

53 Reagen Fe ( Iron ) Btl dlm dus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

54 Reagen Mn Btl dlm dus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

55 Reagen Nitrat Btl dlm dus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

56 Reagen Nitrit Btl dlm dus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

57 Reagen Phospat Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

58 Reagen Zn Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59 Reagen Cyanmet kit/500ml Kit 500ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

60 Serum Widal AO Vial 5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

61 Serum Widal H Vial 5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

62 Serum Widal O Vial 5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Serum widal S thypi H
63 parathyphi AH vial 5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Botol 2 x
64 SGOT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62,5 ml
Botol 2 x
65 SGPT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62,5 ml
66 Stromatolyser-WH Btl 500 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

67 Tabung EDTA 3 ml dus 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

68 Tabung EDTA 5 ml dus 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

69 Test Gula Darah Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Tube 100
70 Test hematokrit/asisten 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
biji
71 Thermal roll paper roll 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

72 Tissue lensa biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Botol 6 x
73 Trigliserida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 ml
74 Ultrasonic gel set 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kit 2 x 100
75 Ureum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ml
76 Urine Test Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

77 Vacum tainer dus 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


TANGGAL
NO NAMA OBAT SAT Stok terima jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Awal
78 Yellow tips set @1000 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

F Obat Tambahan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Oksigen 0 41 41 41 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 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 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
AN LEMBAR PERMINTAAN OBAT
USKESMAS
ARET 2016

TANGGAL Harga Jumlah


Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )

0 0 0 0 0 0 0 0 0 0 0 0 0 T6 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 28 122 0.00
3 0 0 0 1 1 0 1 0 0 0 0 13 8 0.00
22 6 0 0 34 12 18 6 18 14 0 0 412 19 0.00
0 0 0 0 0 0 0 0 0 0 0 0 1 23 0.00
0 0 0 0 0 4 0 4 0 11 0 0 49 14 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 37 60 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 7 61 0.00
52 12 38 10 28 24 34 18 24 48 0 0 913 224 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 1 0 0 0 2 0 3 1 0 0 0 23 16 0.00
0 0 0 0 1 0 0 0 3 6 0 0 29 28 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
36 0 18 6 18 12 16 10 24 6 0 0 504 165 0.00
22 44 46 14 51 26 22 24 18 6 0 0 723 100 0.00
3 0 0 0 0 0 2 4 9 0 0 0 70 14 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 6 4 6 14 6 0 6 12 0 0 86 11 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 4 2 0.00
0 0 0 0 0 0 6 0 0 0 0 0 10 65 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
12 0 6 4 6 0 3 0 10 4 0 0 122 66 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 16 0.00
0 0 0 0 0 0 1 0 0 1 0 0 11 16 0.00
69 27 13 6 38 26 0 12 14 16 0 0 909 309 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 26 0.00
5 0 0 0 0 0 0 0 4 4 0 0 70 30 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 21 0.00
0 0 0 0 0 0 0 0 0 0 0 0 13 62 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 1 15 0.00
16 0 16 12 17 12 0 12 7 14 0 0 264 77 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 77 0.00
0 0 0 0 0 0 0 0 0 0 0 0 4 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 6 0 0 6 0 0 0 57 103 0.00
0 0 0 0 1 1 1 0 0 0 0 0 6 18 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 42 0.00
0 0 0 6 0 0 0 0 0 0 0 0 20 68 0.00
0 0 0 0 0 0 0 0 0 6 0 0 25 107 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 4 0.00
0 0 0 0 4 0 0 0 0 0 0 0 12 66 0.00
34 3 10 6 18 39 20 51 30 24 0 0 553 581 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 2 68 0.00
0 0 0 0 0 0 0 0 0 0 0 0 5 3 0.00
0 6 0 0 0 0 10 0 0 0 0 0 45 30 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 82 97 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 37 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 6 0 6 12 0 0 0 6 0 0 0 136 139 0.00
4 0 0 0 0 0 0 0 0 0 0 0 67 145 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
11 15 54 6 26 14 24 29 14 12 0 0 805 960 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 2 3 0.00
0 0 0 0 0 1 0 0 0 0 0 0 1 4 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 12 43 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
2 0 0 0 0 0 0 0 0 0 0 0 6 18 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 20 10 0 10 6 0 18 0 0 0 0 128 100 0.00
0 0 0 0 1 0 0 0 0 0 0 0 4 42 0.00
0 8 0 3 0 0 0 0 0 0 0 0 23 55 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 198 0.00
1 0 0 0 1 0 0 0 0 0 0 0 18 53 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 9 0.00
0 14 0 0 5 0 6 0 19 0 0 0 138 33 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 6 0 0 15 0 0 0 21 41 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 26 0 0 22 0 0 0 0 0 0 0 106 182 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 1 0 0 0 0 0 0 0 7 8 0.00
1 0 0 0 0 0 0 0 0 0 0 0 2 4 0.00
0 0 0 0 0 0 0 0 0 0 0 0 2 7 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 4 4 4 0 0 0 4 0 0 0 79 91 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 6 0 0 0 0 0 0 0 0 0 0 6 60 0.00
2 0 0 1 0 1 1 1 1 0 0 0 48 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
103 54 54 26 94 59 42 49 74 76 0 0 1,820 333 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 25 159 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
16 6 0 10 18 6 2 6 12 0 0 0 267 233 0.00
12 0 0 0 0 6 0 0 0 0 0 0 86 42 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0.00
2 0 3 6 12 36 30 36 0 0 0 0 185 149 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
2 0 0 2 3 0 0 0 3 4 0 0 83 59 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
17 19 20 12 25 0 6 16 19 16 0 0 484 78 0.00
0 0 0 0 0 0 0 0 0 8 0 0 77 35 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0.00
0 0 0 0 0 0 0 0 0 0 0 0 2 2 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
1 1 0 0 2 1 0 0 0 1 0 0 17 37 0.00
6 0 0 0 3 6 6 12 18 12 0 0 117 516 0.00
44 29 0 16 24 6 6 22 32 10 0 0 560 99 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 166 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 10 6 0 28 0 0 10 6 12 0 0 129 100 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
12 6 6 0 12 6 0 6 22 10 0 0 293 16 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 9 0 12 6 0 10 0 0 0 0 70 846 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
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
6 18 0 5 12 0 0 6 0 6 0 0 144 0 0.00
0 0 0 0 0 0 0 0 0 1 0 0 9 0 0.00
0 0 0 0 0 6 0 6 6 0 0 0 63 0 0.00
1 0 0 0 1 0 0 1 0 0 0 0 4 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 13 11 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
4 4 0 0 0 8 0 2 0 0 0 0 88 132 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 1 0 0 0 0 0 0 0 0 1 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
1 0 0 0 0 0 0 0 0 1 0 0 5 15 0.00
21 4 4 0 10 0 8 4 8 0 0 0 200 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 6 4 4 6 0 0 0 0 0 0 28 80 0.00
6 0 0 0 0 0 0 0 0 0 0 0 16 104 0.00
1 0 0 0 0 0 0 0 1 1 0 0 8 36 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
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 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
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 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 150 30 0.00
0 0 0 0 0 0 0 0 0 0 0 0 25 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 2 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 40 0 0.00
0 0 2 1 1 0 0 0 0 0 0 0 16 4 0.00
3 4 3 1 2 0 2 7 5 5 0 0 104 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
5 4 2 1 2 0 1 4 2 4 0 0 142 40 0.00
1 8 3 4 2 0 4 13 9 11 0 0 113 49 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 6 0.00
0 0 0 0 0 0 0 0 0 0 0 0 30 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 30 45 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 1 1 0.00
0 0 0 0 0 0 0 0 0 0 0 0 2 2 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 60 15 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 5 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 1 5 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 7 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
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 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
TANGGAL Harga Jumlah
Jumlah
20 21 22 23 24 25 26 27 28 29 30 31 Stok Satuan Harga
Akhir Akhir ( Rp ) ( Rp )
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
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 41 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( UGD )
PUSKESMAS
PUSKESMAS : SAMBUNGMACAN I
KECAMATAN : SAMBUNGMACAN PELAPORAN BULAN / PERIODE : MARET 2016
KABUPATEN : SRAGEN PERMINTAAN BULAN / PERIODE :

STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga


NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
A Obat Generik
1 Acetosal 500 mg tab Tablet 0 0 0 0 0
2 ACT tab Kotak 24 tab 0 0 0 0 0
3 Albendasol Tablet 0 0 0 0 0 344.00
4 Allopurinol 100 mg tab Tablet 150 0 150 28 122 86.00
5 Ambroxol sirup Botol 6 15 21 13 8 3,297.00
6 Ambroxol tab Tablet 31 400 431 412 19 125.00
7 Aminofilin inj. Ampul 24 0 24 1 23 3,823.00
8 Aminofilin tab 200 mg Tablet 63 0 63 49 14 90.00
9 Amitriptilin tab 25 mg Tablet 0 0 0 0 0 112.00
10 Amlodipin 5mg Tablet 67 30 97 37 60 187.00
11 Amoksisilin + As. Klavunalat 625 mg Tablet 0 0 0 0 0
12 Amoksisilin injeksi Vial 68 0 68 7 61 7,492.00
13 Amoksisilin kab 500 mg Tablet 437 700 1,137 913 224 272.00
14 Amoksisilin kap 250 mg Kapsul 0 0 0 0 0
15 Amoksisilin Sirup 125 mg Botol 4 35 39 23 16 2,445.00
16 Ampisilin injeksi 1 gram Vial 57 0 57 29 28 5,100.00
17 Antalgin injeksi Ampul 0 0 0 0 0 1,200.00
18 Antalgin tab 500 mg Tablet 169 500 669 504 165 149.00
19 Antasida Doen tab Tablet 23 800 823 723 100 75.00
20 Antasida sirup Botol 34 50 84 70 14 2,160.00
21 Anti Bacteri Doen salep kulit Tube 0 0 0 0 0 2,516.00
22 Anti Hemoroid suppo Suppo 0 0 0 0 0
23 Antifungi Kombinasi salep kulit Pot 0 0 0 0 0 1,904.39
24 Artemeter inj 80 mg Ktk 6 amp 0 0 0 0 0 22,000.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
25 Artesunate Inj ktk 8 amp 0 0 0 0 0
26 Asam Askorbat tab 50 mg tab Tablet 97 0 97 86 11 95.00
27 Asam Mefenamat kap 500 mg Kaplet 0 0 0 0 0 112.00
28 Asam traneksamat inj 250 mg Ampul 0 0 0 0 0 2,950.00
29 Asiklovir salep kulit Tube 1 5 6 4 2 2,997.00
30 Asiklovir tab 200 mg Tablet 75 0 75 10 65 237.00
31 Atropin Sulfas inj Ampul 0 0 0 0 0 1,230.00
32 Benzatin Benzyl Penisilin Inj 2,4jt UI Flacon 0 0 0 0 0 13,400.00
33 Besi II Sulfat Tablet + asam folat Tablet 0 0 0 0 0 42.00
34 Betahistin mesilat tab Tablet 68 120 188 122 66 923.00
35 Betamethason salep kulit Tube 0 0 0 0 0 1,520.00
36 Bisakodil tab Tablet 16 0 16 0 16 594.00
37 Deksametason inj Ampul 27 0 27 11 16 1,580.00
38 Deksametason tab 0,5 mg Tablet 1,218 0 1,218 909 309 86.00
39 Dekstromethorpan sirup Botol 0 0 0 0 0
40 Dekstromethorpan tab Tablet 0 0 0 0 0
41 Diazepam inj. 5mg/2ml Ampul 26 0 26 0 26 2,344.00
42 Diazepam tab 2 mg Tablet 0 100 100 70 30 37.00
43 Diazepam tab 5 mg Tablet 0 0 0 0 0
44 Difenhydramin HCl inj Ampul 21 0 21 0 21 1,050.00
45 Digoxin tab 0,25 mg Tablet 75 0 75 13 62 97.00
46 Dimenhydrinat tab Tablet 0 0 0 0 0 105.00
47 Doksisiklin 100 Tablet 0 0 0 0 0
48 Domperidon suspensi Botol 10 6 16 1 15 3,333.00
49 Domperidon tab 10 mg Tablet 41 300 341 264 77 167.00
50 Efedrin tab 25 mg Tablet 77 0 77 0 77 20.74
51 Efinefrin ( Adrenalin inj ) Ampul 4 0 4 4 0 8,100.00
52 Ekstrak Belladon tab 10 mg Tablet 0 0 0 0 0 38.00
53 Erytromicin kap 250 mg Kapsul 0 0 0 0 0
54 Erytromicin kap 500 mg Kapsul 60 100 160 57 103 930.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
55 Erytromicin sirup Botol 24 0 24 6 18 7,700.00
56 Etakridin Lakt. ( Rivanol ) Botol 0 0 0 0 0 2,550.00
57 Ethambutol tab 250 mg Tablet 0 0 0 0 0
58 Fenitoin Na. kap 100 mg Kapsul 0 0 0 0 0 133.00
59 Fenobarbital inj 50mg/ml Ampul 0 0 0 0 0 1,800.00
60 Fenobarbital tab30 mg Tablet 0 0 0 0 0
61 Fenol Gliserol Botol 0 0 0 0 0
62 Fitomenadion inj Ampul 42 0 42 0 42 3,417.00
63 Fitomenadion tab 10 mg Tablet 88 0 88 20 68 630.00
64 Furosemide tab 40 mg Tablet 132 0 132 25 107 85.00
65 Furosemide injeksi Ampul 0 0 0 0 0 1,829.00
66 Gameksan salep kulit Tube 0 0 0 0 0
67 Garam Oralit 200ml Sak 0 0 0 0 0 288.00
68 Gentamicin tetes mata 0,3 % Botol 0 0 0 0 0 3,194.00
69 Gentamicin injeksi Ampul 0 0 0 0 0
70 Gentamisin salep kulit Tube 0 0 0 0 0 1,972.00
71 Gentian Violet Botol 4 0 4 0 4 895.00
72 Glibenklamide tab 5 mg Tablet 78 0 78 12 66 56.00
73 Gliseril guaiakolat tab Tablet 134 1,000 1,134 553 581 28.00
74 Glukonas kalsikus Ampul 0 0 0 0 0 8,522.00
75 Glukose 40 % larutan infus Ampul 0 0 0 0 0
76 Glukose 10 % larutan infus Flabot 0 0 0 0 0 5,720.00
77 Glukose 5 % larutan infus Flabot 0 0 0 0 0 5,200.00
78 Griseofulvin tab 125 mg Tablet 0 0 0 0 0 219.00
79 Haloperidol tab 0,5 mg Tablet 0 0 0 0 0 59.00
80 Haloperidol tab 1,5 mg Tablet 0 0 0 0 0
81 Hidrokhlorotiazide (HCT) tab 25 mg Tablet 70 0 70 2 68 36.30
82 Hidrokortison salep kulit Tube 4 4 8 5 3 2,798.00
83 Hiosine-N- butilbromide tablet 10 mg Tablet 75 0 75 45 30 395.00
84 Ibuprofen tab 200 mg Tablet 0 0 0 0 0 110.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
85 Ibuprofen tab 400 mg Tablet 179 0 179 82 97 150.00
86 Isoniazide tab ( INH ) Tablet 0 0 0 0 0 65.00
87 Isosorbid Dinitrat Tablet 37 0 37 0 37 88.00
88 Kalium Diklofenak 25 mg Tablet 0 0 0 0 0
89 Kalium Diklofenak 50 mg Tablet 0 0 0 0 0 707.00
90 Kalsium Laktat tab 500 mg Tablet 175 100 275 136 139 70.00
91 Kaptopril tab 25 mg Tablet 112 100 212 67 145 84.00
92 Karbamazepin tab 200 mg Tablet 0 0 0 0 0 245.00
93 Ketokonazole 200 mg Tablet 0 0 0 0 0 300.00
94 Ketokonazole krim tube 0 0 0 0 0 4,700.00
95 Ketoprofen inj Ampul 0 0 0 0 0 2,542.00
96 Kinina Dihydroklorid inj Ampul 0 0 0 0 0
97 Kinina HCl. Tab Tablet 0 0 0 0 0
98 Klobazam tab Tablet 0 0 0 0 0 900.00
99 Klonidin tab Tablet 0 0 0 0 0 184.00
100 Klorafeniramin ( CTM ) tab Tablet 1,765 0 1,765 805 960 23.00
101 Kloramfenikol inj Vial 0 0 0 0 0 9,350.00
102 Kloramfenikol salep mata 1 % Tube 0 0 0 0 0 1,600.00
103 Kloramfenikol sirup Botol 0 0 0 0 0 3,680.00
104 Kloramfenikol tetes mata 0,5 % Tube 5 0 5 2 3 4,950.00
105 Kloramfenikol tetes telinga Kapsul 5 0 5 1 4 1,850.00
106 Kloramfenikol kap 250 mg Botol 55 0 55 12 43 240.00
107 Klorokuin tab 150 mg Tablet 0 0 0 0 0 107.00
108 Klorpromasin injeksi Ampul 0 0 0 0 0
109 Klorpromasin tab 25 mg Tablet 0 0 0 0 0 45.00
110 Kontrasepsi implant set 0 0 0 0 0
111 Kontrasepsi inj depo prog 3 bln vial 0 0 0 0 0
112 Kotrimoksazol suspensi Botol 24 0 24 6 18 2,350.00
113 Kotrimoksazol tab 120 mg Tablet 0 0 0 0 0
114 Kotrimoksazol tab 480 mg Tablet 128 100 228 128 100 152.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
115 Lidokain comp injeksi Ampul 26 20 46 4 42 1,363.00
116 Loperamid Tablet 78 0 78 23 55 89.00
117 Mebendazol tab100 mg Tablet 0 0 0 0 0
118 Metformin 500 Tablet 198 0 198 0 198 112.50
119 Methoklopramide injeksi Ampul 41 30 71 18 53 4,400.00
120 Methoklopramide sirup Botol 9 0 9 0 9 2,600.00
121 Methoklopramide tab10 mg Tablet 171 0 171 138 33 85.00
122 Metilergomet injeksi 0,2 mg Ampul 0 0 0 0 0 1,489.77
123 Metilergomet tab 0,125 mg Tablet 0 0 0 0 0 154.00
124 Metilprednisolon 4 Tablet 0 0 0 0 0 205.00
125 Metronidazol inf Ampul 0 0 0 0 0
126 Metronidazol tab 250 mg Tablet 0 0 0 0 0 110.00
127 Metronidazol tab 500 mg Tablet 62 0 62 21 41 160.00
128 MgSO4 20 % Vial 0 0 0 0 0 1,539.80
129 MgSO4 40 % Vial 0 0 0 0 0 2,434.90
130 Mineral mix Sak 0 0 0 0 0
131 Misoprostol Tablet 0 0 0 0 0 13,526.00
132 Myconazol salep kulit Tube 0 0 0 0 0 3,000.00
133 Na tiroksin Tablet 0 0 0 0 0 217.58
134 Na. Bic. Tab 500 mg Tablet 0 0 0 0 0
135 Na. Cl. Infus Flabot 0 0 0 0 0 4,700.00
136 Natrium Dikofenak 50 Tablet 88 200 288 106 182 200.00
137 Natrium Tiosulfas inj Ampul 0 0 0 0 0
138 Nifedipin Tablet 0 0 0 0 0 112.00
139 O A T Anak Paket 0 0 0 0 0
140 O A T - FDC anak Paket 0 0 0 0 0 214,990.00
141 O A T - FDC kat 1 & 3 Paket 0 0 0 0 0 359,900.00
142 O A T - FDC kat 2 Paket 0 0 0 0 0 1,199,990.00
143 O A T - FDC sisipan Paket 0 0 0 0 0
144 O A T Katagori - 1 Paket 0 0 0 0 0 288,199.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
145 O A T Katagori - 2 Paket 0 0 0 0 0
146 O A T Katagori - 3 Paket 0 0 0 0 0
147 O A T Sisipan Paket 0 0 0 0 0
148 Obat Batuk Hitam sirup Botol 15 0 15 7 8 2,200.00
149 Oksitetrasiklin salep kulit 3 % Tube 6 0 6 2 4 1,910.00
150 Oksitetrasiklin salep mata Tube 9 0 9 2 7 1,600.00
151 Oksitetrasiklin 50mg/ml inj Flacon 0 0 0 0 0
152 Oksitocin 10mg/ml inj Ampul 0 0 0 0 0 2,750.00
153 Omeprazol kaps Kapsul 110 60 170 79 91 211.00
154 Papaverin inj Ampul 0 0 0 0 0 1,150.00
155 Papaverin tab 40 mg Tablet 66 0 66 6 60 115.00
156 Parasetamol sirup Botol 13 35 48 48 0 1,438.00
157 Parasetamol tab 100 mg Tablet 0 0 0 0 0
158 Parasetamol tab 500 mg Tablet 153 2,000 2,153 1,820 333 89.00
159 Perhidrol 2 % Botol 0 0 0 0 0
160 Piracetam 400 Kapsul 84 100 184 25 159 194.00
161 Pirazinamid tab 500 mg Tablet 0 0 0 0 0
162 Piridoksin tab 10 mg Tablet 0 500 500 267 233 20.00
163 Piroksikam tab 10 mg Kapsul 128 0 128 86 42 79.00
164 Piroksikam tab 20 mg Kapsul 0 0 0 0 0
165 Polykrusulen ( Albothyl ) Botol 0 0 0 0 0 17,393.00
166 Povidon Iodium 10% 30 ml Botol 0 0 0 0 0 2,900.00
167 Povidon Iodium 10% 300 ml Botol 1 0 1 0 1 18,000.00
168 Prednison tab 5 mg Tablet 134 200 334 185 149 88.00
169 Primakuin tab 15 mg Tablet 0 0 0 0 0 114.00
170 Proc. Pen. 3 juta inj Vial 0 0 0 0 0
171 Prokain Benzil Penisilin Vial 0 0 0 0 0 7,190.00
172 Propanolol tab 40 mg Tablet 0 0 0 0 0
173 Propylthioracil ( PTU ) tab 100 mg Tablet 0 0 0 0 0 319.00
174 Pyrantel tab 125 mg Tablet 0 0 0 0 0 298.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
175 Ranitidine 150 mg Tablet 0 0 0 0 0 120.00
176 Ranitidine inj ampul 32 110 142 83 59 1,140.00
177 Reserpin tab 0,25 mg Tablet 0 0 0 0 0
178 Retinol 100.000 iu Kab Btl @50 0 0 0 0 0 13,000.00
179 Retinol 200.000 iu Kab Btl @50 0 0 0 0 0 22,950.00
180 Rifampisin kap 300 mg Kapsul 0 0 0 0 0
181 Ringer Laktat Infus Flabot 462 100 562 484 78 5,200.00
182 Salbutamol tab 2 mg Tablet 112 0 112 77 35 59.00
183 Salep 2 - 4 kombinasi Pot 2 0 2 0 2 2,000.00
184 Salysil bedak 2 % Botol 4 0 4 2 2 1,250.00
185 Sefadroksil 500 cps Kapsul 0 0 0 0 0 509.00
186 Sefotaxim 1g inj Vial 0 0 0 0 0
187 Seftriaxon inj Vial 0 0 0 0 0 3,300.00
188 Serum ABU 5 ml inj. Flacon 0 0 0 0 0 497,400.00
189 Serum ATS 1.500 iu inj Ampul 0 0 0 0 0 135,000.00
190 Sianokobalamin inj ( Vit. B12 ) inj Ampul 25 29 54 17 37 1,077.00
191 Sianokobalamin tab ( Vit. B12 ) tab Tablet 633 0 633 117 516 15.00
192 Simetidin tab Tablet 59 600 659 560 99 129.00
193 Simvastatin 10 Tablet 166 0 166 0 166 180.00
194 Siprofloxacin tab 500 mg Tablet 0 0 0 0 0 255.00
195 Streptomicin 1.500 mg inj Vial 0 0 0 0 0
196 Sulfacetamid tetes mata Botol 0 0 0 0 0 3,790.00
197 Sulfadimidin 500 mg tab Tablet 0 0 0 0 0
198 Sulfadoksin + Piritamin tab Tablet 0 0 0 0 0
199 Tetracyklin kap 250 mg Kapsul 0 0 0 0 0
200 Tetracyklin kap 500 mg Kapsul 0 0 0 0 0 300.00
201 Thiamin HCl / B1 tab 100 mg Tablet 0 0 0 0 0
202 Tiamfenikol kap 500 mg Kapsul 29 200 229 129 100 504.00
203 Tiamin HCl / B1 injeksi 100mg /ml Ampul 0 0 0 0 0 680.00
204 Tiamin HCl / B1 Tab 50 mg Tablet 309 0 309 293 16 38.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
205 Triheksifenidil tab 2 mg Tablet 0 0 0 0 0 37.79
206 Vitamin B Komplek tab Tablet 916 0 916 70 846 40.00
207 Zink Tablet 0 0 0 0 0 473.00
JUMLAH
B Obat Non Generik
1 Antasida + Simetikon Tablet 44 100 144 144 0 360.00
2 Antasida + simetikon sirup Botol 1 8 9 9 0 29,380.00
3 Anti Diare kombinasi ( Dewasa ) Tablet 63 0 63 63 0 190.00
4 Anti Diare kombinasi sirup ( Anak ) Botol 4 0 4 4 0 7,733.00
5 Anti hemorhoid kapsul Kapsul 24 0 24 13 11 1,550.00
6 Anti radang topikal mengandung Tube 0 0 0 0 0 11,000.00
triamsinolon acetonide 1 mg
7 Anti spasmodik inj / spasi inj Ampul 0 0 0 0 0 4,500.00
8 Asam Askorbat tab 500 + Vitamin Tablet 120 100 220 88 132 1,540.00
9 Asering infus Flabot 0 0 0 0 0 9,000.00
10 Asifit Kapsul 0 0 0 0 0
11 Batugin eliksir Botol 0 0 0 0 0 15,176.70
12 Betamethason + Antibiotik salep kulit Tube 0 0 0 0 0 9,200.00
13 Bioprost Kapsul 0 0 0 0 0 2,658.33
14 D 1/2NS Flabot 0 0 0 0 0 7,700.00
15 Diazepam rectal Tube 1 0 1 1 0 23,760.00
16 Flunarizin 5 mg Tablet 0 0 0 0 0 594.00
17 Mecobalamin 500 Kapsul 0 0 0 0 0 799.99
18 Minyak kayu putih Botol 0 0 0 0 0 13,700.00
19 Minyak telon Botol 0 0 0 0 0 15,100.00
20 Multivitamin sirup ( Anak ) Botol 5 15 20 5 15 6,050.00
21 Multivitamin tab ( Dewasa ) Tablet 0 200 200 200 0 605.00
22 Neprolit Kapsul 0 0 0 0 0 643.50
23 Salep Luka Bakar Tube 1 0 1 1 0 12,265.00
24 Simetidin inj Ampul 0 0 0 0 0
25 Tablet Tambah Darah + Vitamin Tablet 108 0 108 28 80 720.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
26 Tensigard Kapsul 120 0 120 16 104 2,173.31
27 Vitamin neurotropik inj Ampul 24 20 44 8 36 5,500.00
28 Xylomidon inj Vial 0 0 0 0 0 4,158.00
JUMLAH
C Obat Gigi
1 Air raksa dental use Botol 0 0 0 0 0 302,500.00
2 Bahan bonding botol 0 0 0 0 0
3 Bahan Etsa botol 0 0 0 0 0
4 Devitalisasi Pasta Botol 0 0 0 0 0 583,000.00
5 Etil Klorida semprot Botol 0 0 0 0 0 115,500.00
6 Eugenol sol Pot 0 0 0 0 0
7 Flour tablet Tablet 0 0 0 0 0
8 Glass Ionomer Cement Pot 0 0 0 0 0 467,500.00
9 Kalsium hydroksi pasta dos 0 0 0 0 0 242,000.00
10 Monokror Kamfer Menthol ( CHKM ) Pot 0 0 0 0 0 71,999.40
11 Mumiying Pasta Biji 0 0 0 0 0 231,000.00
12 Semen Seng Fosfat p+liq Botol 0 0 0 0 0 121,749.10
13 Silver Amalgam Botol 0 0 0 0 0 522,000.00
14 Solare Tube 0 0 0 0 0 313,500.00
15 Spons Gelatin Cubices Dos 0 0 0 0 0 308,200.00
16 Temp+Stopp Fletc p+liq Set 0 0 0 0 0 41,999.10
17 Trikresol Formalin ( TKF ) Botol 0 0 0 0 0 83,999.30
18 Yodium Gliserin Cc 0 0 0 0 0
JUMLAH
D Alkes Pakai Habis
1 ADS 0,05 ml Biji 0 0 0 0 0 3,058.00
2 ADS 0,5 ml Biji 0 0 0 0 0 3,058.00
3 ADS 5 ml Biji 0 0 0 0 0 3,740.00
4 Alat suntik 1 ml Biji 0 0 0 0 0 650.00
5 Alat suntik 2,5 ml / 3ml Biji 80 100 180 150 30 650.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
6 Alat Suntik 5 ml Biji 25 0 25 25 0 750.00
7 Antiseptik/Bayclin Botol 0 0 0 0 0 6,999.30
8 Aqua Pro injeksi Flacon 0 0 0 0 0 5,500.00
9 Aquadest steril 500ml Botol 0 0 0 0 0
10 Cat Gut Biji 0 0 0 0 0 5,583.33
11 Etanol 70 % Botol 0 2 2 2 0 21,500.00
12 Hand Scoen Biji 0 40 40 40 0 325.00
13 Infus Set anak Biji 20 0 20 16 4 3,500.00
14 Infus Set dewasa Biji 4 100 104 104 0 3,200.00
15 IV Cateter No. 18 Biji 0 0 0 0 0 3,800.00
16 IV Cateter No. 20 ( Dewasa ) Biji 0 0 0 0 0 3,800.00
17 IV Cateter No. 22 ( Dewasa ) Biji 32 150 182 142 40 3,800.00
18 IV Cateter No. 24 ( Anak ) Biji 12 150 162 113 49 3,800.00
19 Jarum Bengkok / Jahit Biji 6 0 6 0 6 2,291.67
20 Jarum Suntik Biji 10 20 30 30 0 780.00
21 Kapas Adsorben 250 gr Roll 0 1 1 1 0 24,000.00
22 Kasa panjang 40 cmx80 yard Roll 0 0 0 0 0 105,000.00
23 Kasa Pemb 4 m x 10 cm Roll 0 0 0 0 0
24 Kasa Pemb Hydro 4 m x 15 cm Roll 0 75 75 30 45 2,100.00
25 Kasa Pemb Hydro 4 x 80 cm Biji 0 0 0 0 0
26 Kasa Steril 16 x 16 ( 16 lmb ) Dos 1 1 2 1 1 7,900.00
27 Kasa steril mengand:Framasetin 10% Biji 0 4 4 2 2 15,000.00
28 Kasa uk 36 m x 80 cm Roll 0 0 0 0 0
29 Kertas Puyer Pak 0 0 0 0 0
30 Lisol Botol 0 0 0 0 0 6,000.00
31 Masker Biji 50 25 75 60 15 330.00
32 Masker N 95 Biji 0 0 0 0 0 300,000.00
33 Mess Biji 0 0 0 0 0 1,500.00
34 Penjernih Air Cepat ( PAC ) Set 0 0 0 0 0
35 Plastik obat pak 0 0 0 0 0
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
36 Plester 5 yardx2inch Roll 0 0 0 0 0 24,865.50
37 Poly Cateter No. 14 Biji 0 0 0 0 0 8,000.00
38 Poly Cateter No. 16 Biji 0 5 5 0 5 8,000.00
39 Poly Cateter No. 18 Biji 0 0 0 0 0 8,000.00
40 Selang oksigen anak Biji 6 0 6 1 5 6,999.30
41 Selang Oksigen dws Biji 0 0 0 0 0 6,999.30
42 Silk Biji 1 0 1 0 1 3,055.55
43 Tranfusi set Biji 0 0 0 0 0
44 Urine Bag Biji 7 0 7 0 7 3,000.00
45 Wing Needle No 23 Biji 0 0 0 0 0
46 Wing Needle No 25 Biji 0 0 0 0 0
47 Pot dahak Biji 0 0 0 0 0
JUMLAH
E Laboratorium Dan Reagen
1 Alkohol swab 100pcs/box 0 0 0 0 0
2 Amphetamin dos 50 test dus 50 0 0 0 0 0
3 Asam urat Kit 4 x 30 ml 0 0 0 0 0
4 Benzodiazepin dos 50 test dus 50 0 0 0 0 0
5 Blue tips set @100 0 0 0 0 0
6 BOD Nutrient Mixture Botol 0 0 0 0 0
7 BOD Standart Botol 0 0 0 0 0
8 Briliant green 2% Bile Broth (BGLB) Btl dlm dus 0 0 0 0 0
9 Cannabinoides dos 50 test dus 50 0 0 0 0 0
10 Cell clean Btl 50 ml 0 0 0 0 0
11 Cellpack (PK-30 ) box 20 lt 0 0 0 0 0
12 Cholinesterase botol 0 0 0 0 0
13 Cocain dos 50 test dus 50 0 0 0 0 0
14 COD cell test Botol 0 0 0 0 0
15 COD sol A Refil Botol 0 0 0 0 0
16 Combur test kit 100test Kit 100 test 0 0 0 0 0
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
17 Deck glass box 100 biji 0 0 0 0 0
18 EDTA 10 % btl 250 ml 0 0 0 0 0
19 Eight check ( L,N,H ) serial 3x1.5ml 0 0 0 0 0
Botol 5 x 100
20 Glukosa 0 0 0 0 0
ml
21 HbsAg test Dus 50 pcs 0 0 0 0 0
22 Iodida Test Botol 0 0 0 0 0
23 Kertas ECG lembar 0 0 0 0 0
Botol 5 x 100
24 Kolesterol 0 0 0 0 0
ml
Botol 2 x 125
25 Kreatinin 0 0 0 0 0
ml
26 Lactosa Broth Botol 0 0 0 0 0
27 Larutan Asam Klorida 1 % Botol 0 0 0 0 0 19,800.00
28 Larutan Asam Sulfosalisilat Botol 0 0 0 0 0
29 Larutan Benedick Botol 0 0 0 0 0
30 Larutan Eosin Botol 0 0 0 0 0
31 Larutan Etanol Asam Botol 0 0 0 0 0
32 Larutan Gabbet Botol 0 0 0 0 0
33 Larutan Giemsa Botol 0 0 0 0 0
34 Larutan Hayem Botol 0 0 0 0 0
35 Larutan Karbol Fuksin Botol 0 0 0 0 0
36 Larutan Kinyoun Botol 0 0 0 0 0
37 Larutan Metanol Botol 0 0 0 0 0
38 Larutan Metilen Biru Botol 0 0 0 0 0
39 Larutan Turk Botol 0 0 0 0 0
40 Larutan Drabkin Botol 500 ml 0 0 0 0 0
41 Larutan Rees Ecker Botol 100 ml 0 0 0 0 0
42 LDL kit 0 0 0 0 0
43 Minyak emersi botol 0 0 0 0 0
44 Morphines dos 50 test dus 50 0 0 0 0 0
45 Needle boorner dus 100 0 0 0 0 0
46 Obyek glass set 0 0 0 0 0 20,000.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
47 Oksigen m3 0 0 0 0 0 35,000.00
48 Poch-D box 5 lt 0 0 0 0 0
49 Poch-L box 500ml 0 0 0 0 0
50 Reagen A/B ( GOLDA ) Set 0 0 0 0 0 520,000.00
51 Reagen amonium Botol 0 0 0 0 0
52 Reagen Cu Btl dlm dus 0 0 0 0 0
53 Reagen Fe ( Iron ) Btl dlm dus 0 0 0 0 0
54 Reagen Mn Btl dlm dus 0 0 0 0 0
55 Reagen Nitrat Btl dlm dus 0 0 0 0 0
56 Reagen Nitrit Btl dlm dus 0 0 0 0 0
57 Reagen Phospat Botol 0 0 0 0 0
58 Reagen Zn Botol 0 0 0 0 0
59 Reagen Cyanmet kit/500ml Kit 500ml 0 0 0 0 0
60 Serum Widal AO Vial 5 ml 0 0 0 0 0
61 Serum Widal H Vial 5 ml 0 0 0 0 0
62 Serum Widal O Vial 5 ml 0 0 0 0 0
63 Serum widal S thypi H parathyphi AH vial 5 ml 0 0 0 0 0
Botol 2 x 62,5
64 SGOT 0 0 0 0 0
ml
Botol 2 x 62,5
65 SGPT 0 0 0 0 0
ml
66 Stromatolyser-WH Btl 500 ml 0 0 0 0 0
67 Tabung EDTA 3 ml dus 100 0 0 0 0 0 187,000.00
68 Tabung EDTA 5 ml dus 100 0 0 0 0 0
69 Test Gula Darah Biji 0 0 0 0 0
70 Test hematokrit/asisten Tube 100 biji 0 0 0 0 0
71 Thermal roll paper roll 0 0 0 0 0
72 Tissue lensa biji 0 0 0 0 0
Botol 6 x 50
73 Trigliserida 0 0 0 0 0
ml
74 Ultrasonic gel set 0 0 0 0 0
75 Ureum Kit 2 x 100 ml 0 0 0 0 0
76 Urine Test Biji 0 0 0 0 0 3,575.00
STOK PENERI PERSE PEMA SISA PERMIN PEMBERIAN Harga
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK TAAN DAU JKN DAK Lain2 Jumlah Satuan(Rp)
77 Vacum tainer dus 100 0 0 0 0 0
78 Yellow tips set @1000 0 0 0 0 0
JUMLAH
F Obat Tambahan

JUMLAH TOTAL

JKN
Jumlah Kunjungan Resep Bayar Gratis Saraswati Jumlah
( Askes & JPS )

Rawat Inap
UGD

Sragen,
Mengetahui
Kepala UPTD Pusk. Sambungmacan I Petugas Farmasi Puskesmas Petugas UGD

dr. N.A. Oka Manuaba, M.Kes Dwi Retno D. W ………………………………..


NIP. 19731222 200312 1 003 NIP.19670815 199303 2 010
DAN LEMBAR PERMINTAAN OBAT ( UGD )
PUSKESMAS

Jumlah
KET
Harga(Rp)

0.00
0.00
0.00
10,492.00
26,376.00
2,375.00
87,929.00
1,260.00
0.00
11,220.00
0.00
457,012.00
60,928.00
0.00
39,120.00
142,800.00
0.00
24,585.00
7,500.00
30,240.00
0.00
0.00
0.00
0.00
Jumlah
KET
Harga(Rp)
0.00
1,045.00
0.00
0.00
5,994.00
15,405.00
0.00
0.00
0.00
60,918.00
0.00
9,504.00
25,280.00
26,574.00
0.00
0.00
60,944.00
1,110.00
0.00
22,050.00
6,014.00
0.00
0.00
49,995.00
12,859.00
1,596.98
0.00
0.00
0.00
95,790.00
Jumlah
KET
Harga(Rp)
138,600.00
0.00
0.00
0.00
0.00
0.00
0.00
143,514.00
42,840.00
9,095.00
0.00
0.00
0.00
0.00
0.00
0.00
3,580.00
3,696.00
16,268.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,468.40
8,394.00
11,850.00
0.00
Jumlah
KET
Harga(Rp)
14,550.00
0.00
3,256.00
0.00
0.00
9,730.00
12,180.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
22,080.00
0.00
0.00
0.00
14,850.00
7,400.00
10,320.00
0.00
0.00
0.00
0.00
0.00
42,300.00
0.00
15,200.00
Jumlah
KET
Harga(Rp)
57,246.00
4,895.00
0.00
22,275.00
233,200.00
23,400.00
2,805.00
0.00
0.00
0.00
0.00
0.00
6,560.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
36,400.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Jumlah
KET
Harga(Rp)
0.00
0.00
0.00
17,600.00
7,640.00
11,200.00
0.00
0.00
19,201.00
0.00
6,900.00
0.00
0.00
29,637.00
0.00
30,846.00
0.00
4,660.00
3,318.00
0.00
0.00
0.00
18,000.00
13,112.00
0.00
0.00
0.00
0.00
0.00
0.00
Jumlah
KET
Harga(Rp)
0.00
67,260.00
0.00
0.00
0.00
0.00
405,600.00
2,065.00
4,000.00
2,500.00
0.00
0.00
0.00
0.00
0.00
39,849.00
7,740.00
12,771.00
29,880.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
50,400.00
0.00
608.00
Jumlah
KET
Harga(Rp)
0.00
33,840.00
0.00
3,034,495.38

0.00
0.00
0.00
0.00
17,050.00
0.00
0.00
203,280.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
90,750.00
0.00
0.00
0.00
0.00
57,600.00
Jumlah
KET
Harga(Rp)
226,024.24
198,000.00
0.00
792,704.24

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

0.00
0.00
0.00
0.00
19,500.00
Jumlah
KET
Harga(Rp)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
14,000.00
0.00
0.00
0.00
152,000.00
186,200.00
13,750.02
0.00
0.00
0.00
0.00
94,500.00
0.00
7,900.00
30,000.00
0.00
0.00
0.00
4,950.00
0.00
0.00
0.00
0.00
Jumlah
KET
Harga(Rp)
0.00
0.00
40,000.00
0.00
34,996.50
0.00
3,055.55
0.00
21,000.00
0.00
0.00
0.00
621,852.07

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Jumlah
KET
Harga(Rp)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Jumlah
KET
Harga(Rp)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Jumlah
KET
Harga(Rp)
0.00
0.00
0.00
0.00

4,449,051.69

………………………………..

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