PUSKESMAS GANDUSARI KABUPATEN BLITAR LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO

PUSKESMAS GANDUSARI KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

NAMA SUB UNIT : APOTIK/KAMAR OBAT PELAPORAN BULAN :
PERMINTAAN BULAN :
STOK PENERIM PERSEDIA PEMAKAI SISA PERMINT PEMBERI

NO NAMA OBAT SATUAN KET
AWAL AAN AN AN STOK AAN AN
1 2 3 4 5 6 7 8 9 10 11
1 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE
2 ALABETIK TABLET TABLET
3 ALLOPURINOL TABLET 100 MG TABLET
4 ALPRAZOLAM 1 MG TABLET TABLET
5 AMBROXOL SIRUP 5MG/ML BOTOL
6 AMBROXOL TABLET 30 MG TABLET
7 AMINOPHYLLINE TABLET 200 MG TABLET
8 AMITRIPTYLLINE HCL TABLET 25 MG TABLET
9 AMLODIPINE TABLET 10 MG TABLET
11 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL
12 AMOKSISILIN TABLET 500 MG KAPLET
13 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET
14 ANTASIDA DOEN TABLET KOMBINASI TABLET
15 ANTASIDA SUSPENSI 60 ML BOTOL
16 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT
17 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT
18 ANTI HAEMOROID DOEN KOMBINASI SUPP.
19 ANTI INFLUENZA (EMFLU) KOMBINASI TAB TABLET

ANTI INFLUENZA (SOLAFLUZ) KOMBINASI
20 BOTOL
SYRUP
21 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET
22 ANTI SPASMODIK TABLET (DORMICOMP) TABLET
23 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET
25 ASAM FOLAT 1MG TABLET TABLET
26 ASAM MEFENAMAT TABLET 500 MG TABLET
27 ASAM TRANEKSAMAT 500 MG TABLET TABLET

ASAM VALPROAT 250 MG TABLET / DEPAKOTE
28 TABLET
ER
29 ASEPTAN 500CC + PUMP BOTOL
30 ASEPTIC GEL 500CC + DISPENSER BOTOL
31 ASERING (ASETAT RINGER) SOFT BAG BOTOL
32 ASETOSAL TABLET 100 (80) MG TABLET
33 ASIKLOVIR KREAM 5 % 5 GR TUBE
34 ASIKLOVIR TABLET 400 MG TABLET
35 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET TABLET
36 BETAHISTINMESILAT 6 MG TABLET TABLET
37 BETAMETHASONE CREAM 0,1 % 5 GR TUBE
38 BISAKODIL ( BICOLAX ) TABLET 5 MG TABLET
39 BISAKODIL SUPPOSITORIA 10 MG SUPP.
41 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET
42 BISOPROLOL 5 MG TABLET TABLET
43 BROMHEXINE SIRUP (HUSTAB) BOTOL
44 DEKSAMETHASONE TABLET 0,5 MG TABLET
45 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-
46 TUBE
STESOLID
47 DIAZEPAM TABLET 2 MG TABLET

1 2 3 4 5 6 7 8 9 10 11
49 DIGOXIN TABLET 0,25 MG TABLET
50 DIMENHYDRINATE TABLET 50 MG TABLET
51 DOKSISIKLIN TABLET 100 MG KAPSUL
52 DOMPERIDON SUSPENSI 5MG/ML BOTOL
53 DOMPERIDON TABLET 10 MG TABLET

EKSTRACT PLASENTA + NEOMYSIN SALEP 15
54 TUBE
GR
55 ERITROMISIN KAPSUL 250 MG KAPSUL
56 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL
57 ERITROMISIN TABLET 500 MG KAPSUL
58 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL
59 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL
60 FENITOIN NATRIUM TABLET 100 MG KAPSUL
61 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL
62 FENOBARBITAL TABLET 30 MG TABLET
63 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL
64 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG TABLET
65 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML AMPUL
66 FUROSEMID TABLET 40 MG TABLET

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10
67 TUBE
GR
68 GEMFIBROZIL 300 MG KAPSUL KAPSUL
69 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE
70 GENTAMISIN SALEP MATA 0,3% TUBE
71 GENTAMISIN TETES MATA 0,3% BOTOL
72 GLIBENCLAMIDE TABLET 5 MG TABLET
73 GLICERIL GUAIACOLAT TABLET 100 MG TABLET
74 GLIMEPIRIDE 2 MG TABLET TABLET
75 GRISEOFULVIN TABLET 125 MG TABLET
76 HALOPERIDOL DEKANOAT INJ 50 MG VIAL
77 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL
78 HALOPERIDOL TABLET 1,5 MG TABLET
79 HALOPERIDOL 2 MG TABLET
80 HALOPERIDOL TABLET 5 MG TABLET
81 HEPARIN SODIUM 200 UI (THROMBOFLASH) TUBE

HES-HYDROXYETHYL STARCH 6 %/VOLUVEN
82 BOTOL
INFUS 500 ML
83 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE
84 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL
85 IBUPROFEN TABLET 400 MG TABLET
86 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET
87 KAEN 3B BOTOL
88 KALIUM DIKLOFENAK 50 MG TABLET TABLET
89 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET
90 KAOLIN PEKTIN (NOVADIAR) SUSPENSI BOTOL
91 KAPAS PEMBALUT/ABSORBEN 250 GR BKS
92 KAPTOPRIL TABLET 25 MG TABLET
93 KARBAMAZEPIN TABLET 200 MG TABLET
94 KETOKONAZOLE TABLET 200 MG TABLET
95 KETOPROFEN 100 MG SUPPOSITORIA SUPP.
96 KLINDAMISIN KAPSUL 150 MG TABLET
97 KLINDAMISIN KAPSUL 300 MG KAPSUL
98 KLOBAZAM 10 MG TABLET TABLET
99 KLORAMFENIKOL KAPSUL 500 MG KAPSUL
100 KLORAMFENIKOL SALEP KULIT 2 % TUBE
101 KLORAMFENIKOL SALEP MATA 1 % TUBE

1 2 3 4 5 6 7 8 9 10 11
102 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL
103 KLORAMFENIKOL TETES TELINGA 3 % BOTOL
104 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG TABLET
105 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL
106 KLORPROMAZIN HCL TABLET 100 MG TABLET
107 KLOZAPIN 100 MG TABLET TABLET
109 KODEIN HCL TABLET 10 MG TABLET
110 KOTRIMOKSAZOL DEWASA TABLET TABLET
111 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL
112 LEVOFLOXACIN TABLET 500 MG TABLET
113 LOPERAMIDE TABLET 2 MG TABLET
114 LORATADIN TABLET 10 MG TABLET
115 MASKER KERTAS 3 PLY EAR LOOP PCS
116 MASKER KERTAS 3 PLY TIE ON PCS
117 MELOKSIKAM TABLET 7,5 MG TABLET
118 METFORMIN TABLET 500 MG TABLET
119 METILERGOMETRIN MALEAT TABLET 0,125 MG TABLET
120 METILPREDNISOLON TABLET 4 MG TABLET
121 METOKLOPRAMIDE 10 MG TABLET TABLET
123 METOKLOPROMIDE SIRUP BOTOL

METRONIDAZOL + NYSTATIN VAG. (PROVAGIN)
124 VIAL
INJEKSI
125 METRONIDAZOL TABLET 250 MG TABLET
127 MIKONAZOL KREAM 10 GR TUBE
128 MINERAL MIX SACHET
129 MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML BOTOL

MULTIVITAMIN (MALTIRON PLUS) KOMBINASI
130 TABLET
TABLET
131 NATRIUM DIKLOFENAK TABLET 25 MG TABLET
133 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL

NEUROTROPIK KOMBINASI (IKANEURON)
134 TABLET
TABLET
135 NIFEDIPINE TABLET 10 MG TABLET
136 NISTATIN TABLET 500.000 UI TABLET
137 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB
138 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL
139 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE
140 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE
141 OMEPRAZOLE TABLET 20 MG KAPSUL
142 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL
143 PARACETAMOL TABLET 500 MG TABLET
144 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL
145 PEHAVRAL TABLET TABLET
146 PERAK SULFADIAZIN KRIM 1 % TUBE
147 PIRACETAM TABLET 800 MG TABLET
148 PIRANTEL PAMOAT TABLET TABLET
149 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET
150 PIROKSIKAM KAPSUL 10 MG KAPSUL
151 PREDNISON TABLET 5 MG TABLET
152 PROPANOLOL HCL TABLET 40 MG TABLET
153 PROPILTHIOURACIL TABLET 100 MG TABLET
154 RESPERIDON 2 MG TABLET TABLET

1 2 3 4 5 6 7 8 9 10 11
155 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL
156 SALBUTAMOL TABLET 2 MG TABLET
158 SALEP 2-4 KOMBINASI 30 GR POT
159 SALICYL BEDAK 2 % KOTAK
160 SARUNG TANGAM NON STERIL L PCS
161 SARUNG TANGAN NON STERIL M PCS
162 SARUNG TANGAN NON STERIL S PCS
163 SEFADROKSIL KAPSUL 500 MG KAPSUL
164 SEFIKSIM KAPSUL 100 MG KAPSUL

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML
165 VIAL
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
166 VIAL
(ATS)
167 SETIRIZINE TABLET 10 MG TABLET
168 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET
169 SIMETIDINE TABLET 200 MG TABLET
170 SIMVASTATIN TABLET 10 MG TABLET
171 SIPROFLOXACIN INFUS 2% BOTOL
172 SIPROFLOXACIN TABLET 500 MG TABLET
173 SIPROHEPTADINE 4 MG TABLET (PRONICY) TABLET
174 SULFADOKSIN TABLET TABLET

SULFASETAMID NATRIUM TETES MATA 15 % 5
175 BOTOL
ML
176 STIMUNO TAB (100) TABLET
177 STIMUNO TAB (30) BOTOL
178 STIMUNO SYR BOTOL
179 TABLET TAMBAH DARAH (DAK) TABLET
180 TETRAKAIN HCL TETES MATA 5 ML BOTOL
181 TETRASIKLIN HCL TABLET 500 MG KAPSUL

THIAMIN HCL MONONITRAT (VIT B1) TABLET 100
182 TABLET
MG
183 TABLET
MG
TRIAMSINOLON ACETONIDE (BUFACOMB)
184 TUBE
1MG/GR SALEP
185 TRIFLOUPERASIN TABLET 5 MG TABLET
186 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG TABLET
187 VITAMIN B COMPLEX TABLET TABLET
188 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL
189 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL
190 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET
191 ZINK 20 MG TABLET TABLET
192 ZINK SYRUP BOTOL
JUMLAH OBAT PKD

STOK PENERIM PERSEDIA PEMAKAIA SISA PERMINT PEMBERI
NO SATUAN KET
AWAL AAN AN N STOK AAN AN
DAFTAR OBAT PROGRAM / HIBAH
1 ALBENDAZOL TABLET 400 MG KTK30'S
2 DIAZEPAM CAIRAN INJEKSI 5 MG\/2ML (KESGA) VIAL
3 GARAM ORALIT UNTUK 200 ML AIR KTK 100'S
4 ISONIAZID TABLET 100 MG TABLET

KOMBIPAK AZITHROMYCIN - CEFIXIME
6 PAKET
KOMBINASI
7 KOTRIMOKSASOL 480 TABLET KOMBINASI TABLET

LEVOTHYROXINE ACTAVIS TABLET 100 MCG
9 TABLET
(KESGA)
10 MDT COMBI - MB ADULT (RED) PAKET
11 MDT COMBI - MB CHILD (ORANGE) PAKET

1 2 3 4 5 6 7 8 9 10 11
12 MDT COMBI - PB ADULT (GREEN) PAKET
13 OBAT ANTI TUBERKULOSIS ANAK PAKET
14 OBAT ANTI TUBERKULOSIS KATAGORI 1 PAKET

OBAT ANTI TUBERKULOSIS KOMBIPAK
16 PAKET
KATEGORI I
17 OBAT HIV EFAVIRENZ 200 MG TABLET BTL90'S
19 OBAT HIV LAMIVUDIN 150 MG TABLET BTL60'S
20 OBAT HIV NEVIRAPINE (NVP) 200 MG TABLET BTL60'S
21 OBAT HIV TENOFOVIR 300 MG (TDF) BTL30'S

OBAT HIV TRIPLE FDC ANAK ZDV+3TC+NVP
22 BTL60'S
(60+30+50)
OBAT HIV TRIPLE FDC DEWASA TDC+3TC+EFV
23 BTL30'S
(300/300/600)
24 OBAT HIV ZIDOVUDINE 100 MG TABLET BTL
OBAT HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150
25 BTL60'S
MG
26 OKSITETRASIKLIN SALEP MATA 1% (KESGA) TUBE
27 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET
28 RETINOL ( VIT A ) KAPSUL 100.000 IU BOTOL 100'S
30 TABLET TAMBAH DARAH (PROGRAM) TABLET
31 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET
JUMLAH OBAT DARI BOK STOK PENERIM PERSEDIA PEMAKAIA SISA PERMINT PEMBERI
NO SATUAN KET
1 MASKER N95 PCS
2 SARUNG TANGAN S MAXTER PCS
JUMLAH OBAT DARI DINKES STOK PENERIM PERSEDIA PEMAKAIA SISA PERMINT PEMBERI
NO SATUAN KET
1 HAND SANITIZER 500 ML BOTOL

4 MASKER KN95 PCS
5 MASKER N95 PCS
6 MASKER N95 RESPIRATOR PCS
7 NURSE CAP PCS
8 SARUNG TANGAN L PCS
9 SARUNG TANGAN M PCS
10 SARUNG TANGAN S PCS
11 SARUNG TANGAN STERIL M GYNAEC PCS
12 SARUNG TANGAN STERIL NO.6,5 PCS
13 SARUNG TANGAN STERIL NO.7 PCS
JUMLAH OBAT DARI BLUD STOK PENERIM PERSEDIA PEMAKAIA SISA PERMINT PEMBERI
NO SATUAN KET

3 ANABION PLUS DHA SIRUP BOTOL

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20
4 BOTOL
ML
7 ASPILETS TABLET TABLET
8 BENEURON TABLET TABLET
9 BIOPLACENTON KRIM TUBE

10 BORAX GLISERIN BOTOL
11 CAVIPLEX TABLET TABLET
12 CEFADROKSIL KAPSUL KAPSUL
1 2 3 4 5 6 7 8 9 10 11
13 CEFADROKSIL SIRUP 125 MG/5 ML BOTOL

14 CETERIZINE TAB TABLET
15 CHLORETYL SPRAY BOTOL

16 COPARSETINE SIRUP BOTOL
17 DANASON TABLET TABLET
18 DOMPERIDON TABLET TABLET

19 EPINEFRIN INJEKSI AMPUL
20 ERLAMYCETIN PLUS TETES MATA TABLET
21 ERLAMYCETIN TETES TELINGA BOTOL
22 ERYTRA FORTE TABLET TABLET

23 FARIZOL SIRUP BOTOL
24 FARSIFEN SIRUP BOTOL
25 FASIDOL DROPS 15 ML BOTOL

26 FENOL GLISEROL TETES TELINGA BOTOL
27 FITOMENADION ( VIT K1 ) INJEKSI AMPUL
28 FOLAMIL GENIO KAPSUL

30 GENTIAN VIOLET BOTOL

31 GRAFAZOL TABLET TABLET
32 HELIXIM KAPSUL KAPSUL

33 HISTIGO TABLET TABLET
35 ITRAMOL SIRUP BOTOL
36 JARUM 25 PCS
37 KAPTOPRIL 25 MG TABLET TABLET
38 LAXANA TABLET TABLET
39 LERZIN DROP BOTOL

40 LOVIRES 400 MG TABLET TABLET
41 MASKER BEDAH PCS
42 MASKER N95 PCS
43 MESS NO 11 BIJI
44 METORMIN 500 MG TAB TABLET
46 NACL INFUS BOTOL
47 NIFEDIPIN TABLET TABLET
48 NISAGON KRIM TUBE

49 NORAGES INJEKSI AMPUL
50 OMEPRAZOLE KAPSUL KAPSUL
51 ONDANSENTRON INJEKSI AMPUL
52 ORSADERM SALEP TUBE

53 PARACETAMOL TABLET 500 MG IFI TABLET
54 PARACETAMOL TABLET 500 MG FM TABLET
55 PHENZACOL TABLET TABLET

56 PLESTER BUAH
57 RANITIDIN INJEKSI AMPUL
60 SAMCOFENAC TABLET TABLET

61 SEFOTAXIM INJEKSI VIAL
62 SETRIAXONE INJEKSI VIAL
63 SELTIFORT SIRUP BOTOL
64 SIMETIDIN TABLET TABLET
65 SIMVASTATIN TABLET TABLET
67 SOLFENOX SIRUP BOTOL

68 SYNBIO KAPSUL KAPSUL
69 TIDIFAR 200 MG TABLET TABLET
70 TRIATA SIRUP BOTOL
71 VICCILINE INJEKSI VIAL
72 VITAMIN B6 TABLET TABLET
1 2 3 4 5 6 7 8 9 10 11
JENIS KUNJUNGAN BPJS UMUM LUAR KABUPATEN JUMLAH

JUMLAH KUNJUNGAN
GANDUSARI,........................................
PENANGGUNG JAWAB PENGELOLA OBAT MENGETAHUI

SUB UNIT PUSKESMAS KEPALA PUSKESMAS GANDUSARI
____________________________ NENIN RIKA SUSANTI drg.FITHRIA RACHMAWATI

NIP. NIP.19860526 201903 2 004 NIP.19841219 201101 2 013
NAMA SUB UNIT : PONED/KIA PELAPORAN BULAN :
PERMINTAAN BULAN :
SATUA STOK PENERI PERSEDI PEMAKA SISA PERMIN PEMBER

NO NAMA OBAT KET
N AWAL MAAN AAN IAN STOK TAAN IAN
1 2 3 4 5 6 7 8 9 10 11
1 2 WAY FOLEY CATHETER NO.16 PCS
4 ALAT SUNTIK SEKALI PAKAI 1 ML PCS

AQUA PRO INJEKSI STERIL BEBAS
9 FLES
PIROGEN 20 ML
13 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL
14 CAT GUT NO.2/0 CHROMIC PCS
15 CAT GUT NO.2/0-3/0 PLAIN PCS
16 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL

DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1
17 AMPUL
ML
EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1
18 AMPUL
ML
FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML
20 AMPUL
1 ML
21 FITOMENADION INFANT INJ. 2MG/ML AMPUL
GLUKOSA 40% DEXTROSE INJECTION U.S.P
22 VIAL
CAIRAN INJEKSI
I.V CATHETER NO.20 WITH INJECTION
23 PCS
PORT
24 PCS
PORT
25 PCS
PORT
26 PCS
PORT
27 INFUSION SET DEWASA PCS
KALSIUM GLUCONAS INJEKSI 100 MG/ML 10
28 AMPUL
ML
29 KANTONG URINE DEWASA PCS
31 KASA KOMPRES 40/40 STERIL BKS

KASA PEMBALUT HIDROFIL 16 X 16 CM
32 ROL
STRIL
33 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL

KASA STERIL (DARYAN TOLLE)YG
36 PCS
DIRESAPI FRAMISETIN
37 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL
MAGNESIUM SULFAT INJEKSI (IV) 40 % 25
38 AMPUL
ML

METILERGOMETRIN MALEAT INJEKSI 0,200
41 AMPUL
MG 1 ML
METILERGOMETRIN MALEAT TABLET 0,125
42 TABLET
MG
NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11
44 NOREPINEPHRINE CAIRAN INJEKSI AMPUL
45 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL
47 PLESTER 5 YARD X 2 INCI (LEUKOPLAST) ROL
52 SARUNG TANGAN STERIL NO 6 PSG
53 SARUNG TANGAN STERIL NO. 7,5 PSG
54 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS

THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1
56 AMPUL
ML
59
60
JUMLAH OBAT PKD

NO
1 AMPICILLIN SERBUK INJEKSI 1 G (KESGA) VIAL
2 CA GLUCONAS INJEKSI 10 Ml (KESGA) VIAL

FITOMENADION INJECTION 2 MG\/ ML
3 VIAL
(KESGA)
GENTAMICIN CAIRAN INJEKSI 40 MG/ML
4 (KESGA) VIAL
LEVOTHYROXINE ACTAVIS TABLET 100

5 TABLET
MCG (KESGA)
METILERGOMETRIN MALEAT INJECTION
6 VIAL
0,200 MG (KESGA)
OKSITETRASIKLIN SALEP MATA 1%
7 TUBE
(KESGA)
JUMLAH OBAT DARI BOK

NO
1 MASKER N95 PCS
JUMLAH OBAT DARI DINKES

NO
1 APRON LENGAN PANJANG PCS
4 MASKER KN95 PCS
5 MASKER N95 PCS
7 NURSE CAP PCS

NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11
11 SARUNG TANGAN STERIL M GYNAECOLOGI PCS
JUMLAH OBAT DARI BLUD

NO

1 PIROGEN 20 ML BOTOL
5 JARUM 25 PCS
6 MASKER BEDAH PCS
7 MASKER N95 PCS
8 NACL INFUS BOTOL
10 PLESTER BUAH
11
GANDUSARI,........................................

______________________________
NENIN RIKA SUSANTI drg.FITHRIA RACHMAWATI
NIP. NIP.19860526 201903 2 004 NIP.19841219 201101 2 013
NAMA SUB UNIT : UGD PELAPORAN BULAN :
PERMINTAAN BULAN :

NO NAMA OBAT N AWAL MAAN AAN IAN STOK TAAN IAN
KET
1 2 3 4 5 6 7 8 9 10 11
10 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL

AMPICILLIN SERBUK INJEKSI 1.000 MG
13 VIAL
MG/VIAL
16 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL
19 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL

ATTAPULGIT + PECTIN ( NEO DIASTOP )
24 TABLET
TABLET
28 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL

32 TUBE
STESOLID
33 AMPUL
ML
EKSTRACT PLASENTA + NEOMYSIN SALEP
35 TUBE
15 GR
KET
1 2 3 4 5 6 7 8 9 10 11
36 AMPUL
ML
ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300
37 BOTOL
ML
39 ETIL KLORIDA SEMPROT 100 ML BOTOL

FITOMENADION ( VIT K1 ) INJEKSI 10
41 AMPUL
MG/ML 1 ML
FLUPHENASINE DEKANOAT INJEKSI 25 MG
43 AMPUL
1 ML
44 FUROSEMID INJEKSI VIAL

GLUKOSA 40% DEXTROSE INJECTION
46 VIAL
U.S.P CAIRAN INJEKSI
47 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL

HEPARIN SODIUM 200 UI
52 TUBE
(THROMBOFLASH)
53 PCS
PORT
54 PCS
PORT
55 PCS
PORT
56 PCS
PORT
57 PCS
PORT
58 INFUSION SET ANAK PCS
60 KAEN 3B BOTOL
KALSIUM GLUCONAS INJEKSI 100 MG/ML
61 AMPUL
10 ML
KARBAZOKHROME SODIUM SULFONATE
63 AMPUL
INJEKSI 5 MG/ML 10 ML (SALDONA)
65 ROL
STRIL

69 PCS
DIRESAPI FRAMISETIN
KLORFENIRAMINE MALEAT (CTM) TABLET
70 TABLET
4 MG
KLORPROMAZIN HCL INJEKSI 25 MG/ML 1
71 AMPUL
ML
73 AMPUL
ML
KET
1 2 3 4 5 6 7 8 9 10 11
METAMIZOL (NORAGES) INJEKSI 500
75 AMPUL
MG/2ML
METOKLOPROMIDE (SOTATIC) INJEKSI 5
77 AMPUL
MG/ML 2 ML
METRONIDAZOL + NYSTATIN VAG.
78 VIAL
(PROVAGIN) INJEKSI
79 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL
81 NEUROTROPIK (IKANEURON) INJEKSI AMPUL
83 OKSIGEN NASAL CANNULA ADULT PCS
84 OKSIGEN NASAL CANNULA INFANT PCS
85 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL
88 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL
90 RANITIDIN INJEKSI 25 MG/ ML AMPUL

SERUM ANTI BISA ULAR POLIVALEN INJ.5
97 VIAL
ML (ABU I)
SERUM ANTI TETANUS INJEKSI 1.500
98 VIAL
IU/AMP (ATS)
SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500
100 AMPUL
MCG/ML 1 ML

103 AMPUL
ML
104 TRAMADOL INJEKSI 50 MG/ML AMPUL
JUMLAH OBAT PKD SATUA STOK PENERI PERSEDI PEMAKA SISA PERMIN PEMBER
NO KET
DAFTAR OBAT PROGRAM / HIBAH N AWAL MAAN AAN IAN STOK TAAN IAN

KET
1 2 3 4 5 6 7 8 9 10 11
DIAZEPAM CAIRAN INJEKSI 5 MG\/2ML
2 VIAL
(KESGA)
3 VIAL
(KESGA)
GENTAMICIN CAIRAN INJEKSI 40 MG/ML
4 (KESGA) VIAL
LODOMER CAIRAN INJEKSI 5 MG/ML

5 VIAL
(HALOPERIDOL)
JUMLAH OBAT DARI BOK SATUA STOK PENERI PERSEDI PEMAKA SISA PERMIN PEMBER
NO N AWAL MAAN AAN IAN STOK TAAN IAN
KET
1 MASKER N95 PCS
JUMLAH OBAT DARI DINKES SATUA STOK PENERI PERSEDI PEMAKA SISA PERMIN PEMBER
NO KET
3 MASKER KN95 PCS
4 MASKER N95 PCS
6 NURSE CAP PCS
JUMLAH OBAT DARI BLUD SATUA STOK PENERI PERSEDI PEMAKA SISA PERMIN PEMBER
NO KET

BOTOL
1 PIROGEN 20 ML

5 CHLORETYL SPRAY BOTOL


10 JARUM 25 PCS
11 MASKER BEDAH PCS

KET
1 2 3 4 5 6 7 8 9 10 11
12 MASKER N95 PCS

13 MESS NO 11 BIJI
14 NACL INFUS BOTOL
15 NORAGES INJEKSI AMPUL

16 ONDANSENTRON INJEKSI AMPUL
18 PLESTER BUAH
19 RANITIDIN INJEKSI AMPUL
20 SEFOTAXIM INJEKSI VIAL

21 SETRIAXONE INJEKSI VIAL
22 VICCILINE INJEKSI VIAL
23
24
25
26
GANDUSARI,........................................


NIP. NIP.19860526 201903 2 004 NIP.19841219 201101 2 013
NAMA SUB UNIT : PELAPORAN BULAN :
PERMINTAAN BULAN :

NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11

AMOKSISILIN DRY SYRUP 125 MG/5 ML 60
12 BOTOL
ML

ANTI BAKTERI DOEN SALEP KOMBINASI 5
17 POT
GR

21 BOTOL
SYRUP
23 BOTOL
PIROGEN 20 ML

NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11
35 TABLET
TABLET

48 AMPUL
ML

EKSTRACT PLASENTA + NEOMYSIN SALEP
54 TUBE
15 GR
55 AMPUL
ML

ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300
59 BOTOL
ML

FENOL GLISEROL TETES TELINGA 10 % 5
62 BOTOL
ML
FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML
63 AMPUL
1 ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
64 TABLET
MG

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1
67 TUBE
% 10 GR

NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11

82 AMPUL
ML

88 ROL
STRIL

92 PCS
DIRESAPI FRAMISETIN

KLORFENIRAMINE MALEAT (CTM) TABLET 4
101 TABLET
MG
105 LIDOCAIN 2% INJ AMPUL
107 LISOL CONCENTRATE 1000 ML BOTOL

110 AMPUL
ML
NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11

METILERGOMETRIN MALEAT INJEKSI 0,200
115 AMPUL
MG 1 ML
METILERGOMETRIN MALEAT TABLET 0,125
116 TABLET
MG

121 SUPP.
(PROVAGIN) SUPP

MULTIVITAMIN (MALTIRON PLUS)
127 TABLET
KOMBINASI TABLET

131 TABLET
TABLET

NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11
162 SARUNG TANGAN STERILE NO.6,5 PSG
163 SARUNG TANGAN STERILE NO.7 PSG

167 AMPUL
MCG/ML 1 ML
SIANOKOBALAMIN ( VIT B12 ) TABLET 50
168 TABLET
MCG

SULFASETAMID NATRIUM TETES MATA 15
174 BOTOL
% 5 ML

181 AMPUL
ML
THIAMIN HCL MONONITRAT (VIT B1)
182 TABLET
TABLET 100 MG
THIAMIN HCL MONONITRAT (VIT B1)
183 TABLET
TABLET 50 MG
184 TUBE
1MG/GR SALEP

NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11

ZENTRA (TRIPROLIDINE|
188 TABLET
PSEUDOEPHEDRINE)

CAPSU
191 ACETYLCYSTEINE CAPSULE 200 MG
LE
JUMLAH OBAT PKD

NO
2 VIAL
(KESGA)
METILERGOMETRIN MALEAT INJECTION
4 VIAL
0,200 MG (KESGA)
OKSITETRASIKLIN SALEP MATA 1%
5 TUBE
(KESGA)

ZINK TABLET DISPERSIBLE 20 MG
8 TABLET
(PROGRAM)

NO
1 MASKER N95 PCS

NO

3 MASKER KN95 PCS
4 MASKER N95 PCS

NO NAMA OBAT KET
1 2 3 4 5 6 7 8 9 10 11
JENIS KUNJUNGAN BPJS UMUM LUAR KABUPATEN JUMLAH
JUMLAH KUNJUNGAN
GANDUSARI,........................................


NIP. NIP.19860526 201903 2 004 NIP.19841219 201101 2 013
BUKU PENGELUARAN GUDANG OBAT PUSKESMAS GANDUSARI THN 2021
Bulan :MEI 2021
SATUA GONDA BINTAN GADUG SBAGUN IMUNISA SURVEIL
NO NAMA OBAT N
APOTIK SKRENO SKSEWU
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
PONED IGD GIZI LAB GILUT PPI
SI
P3K LOKET
ANS
RPU ED
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
4 ACETYLCYSTEINE CAPSULE 200 MG CAPS
22 AMOKSISILIN SERBUK INJEKSI VIAL
23 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL VIAL
31 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP BOTOL
Page 23
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED
35 BOTOL
ML

42 TABLET
ER
50 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET TABLET
62 COMBIVENT UDV INHALASI VIAL
65 DEVITALISASI PASTA ( NON ARSEN ) POT

67 TUBE
STESOLID
70 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL
Page 24
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED
76 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR TUBE
77 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL
81 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML BOTOL
84 EUGENOL CAIRAN 10 ML BOTOL
90 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML AMPUL
91 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG TABLET
93 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML AMPUL

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10
96 TUBE
GR
101 GLASS IONOMER CEMENT ( GC IX ) BOTOL

105 VIAL
CAIRAN INJEKSI
Page 25
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED

115 BOTOL
INFUS 500 ML
117 I.V CATHETER NO.16 WITH INJECTION PORT PCS
128 KAEN 3B BOTOL
130 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML AMPUL

KARBAZOKHROME SODIUM SULFONATE INJEKSI
137 AMPUL
5 MG/ML 10 ML (SALDONA)
139 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL
Page 26
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED
KASA STERIL (DARYAN TOLLE)YG DIRESAPI
143 PCS
FRAMISETIN
154 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG TABLET
168 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL
172 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL

METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1
174 AMPUL
ML
Page 27
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED
METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2
179 AMPUL
ML
181 VIAL
INJEKSI

188 TABLET
TABLET
193 NEUROTROPIK KOMBINASI (IKANEURON) TABLET TABLET
Page 28
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED

236 VIAL
(ABU I)
237 VIAL
(ATS)
239 AMPUL
MCG/ML 1 ML
247 SPONS GELATIN CUBICLES 1x1x1 CM PCS
249 SULFASETAMID NATRIUM TETES MATA 15 % 5 ML BOTOL
Page 29
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED

TEMPORARY CAVITY SEALER [TUMPATAN
254 PCS
SEMENTARA] (CAVIT G)
257 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL

258 TABLET
MG
259 TABLET
MG
261 TRANFUSION SET ADULT WITH Y INJECTION PCS

262 TUBE
1MG/GR SALEP
264 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG TABLET
JUMLAH OBAT PKD

NO
1 ALAT SUNTIK 0,05 ML (PROGRAM) KTK100'S
3 ALAT SUNTIK 5 ML (PROGRAM) KTK100'S
7 DIAZEPAM CAIRAN INJEKSI 5 MG\/2ML (KESGA) VIAL
8 FITOMENADION INJECTION 2 MG\/ ML (KESGA) VIAL
10 GENTAMICIN CAIRAN INJEKSI 40 MG/ML (KESGA) VIAL
11 IODINE TES SET-6 BTL
Page 30
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED

14 PAKET
KOMBINASI

17 TABLET
(KESGA)
18 VIAL
(HALOPERIDOL)

METILERGOMETRIN MALEAT INJECTION 0,200
22 VIAL
MG (KESGA)

26 PAKET
KATEGORI I

32 BTL60'S
(60+30+50)
33 BTL30'S
(300/300/600)
OBAT HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150
35 BTL60'S
MG
38 REAGEN HIV (FOKUS) PCS
39 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS
40 REAGEN HIV (VIKIA) PCS

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP
41 PCS
RAPID TEST
REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2)
42 PCS
ANTIBODY (COLLOIDAL GOLD)
43 REAGEN SYPHILIS (TREPOCHECK) PCS
44 REAGEN SYPHILIS RDT (FOKUS) PCS
47 SAFETY BOX PCS
48 SERUM ANTI DIFTERI CAIRAN INJEKSI 125 MG/ML VIAL
Page 31
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED

NO
1 Sarung Tangan steril no.7 PCS

2 Sarung Tangan steril no.7,5 PCS
3 Sarung Tangan M PCS
4 Sarung Tangan S NITRILE PCS
5 Masker N95 PCS
6 Sarung Tangan S MAXTER PCS

NO

2 HAND SANITIZER 500 ML BTL
5 MASKER KN95 PCS
6 MASKER N95 PCS
8 NURSE CAP PCS
12 SARUNG TANGAN STERIL M GYNAECOLOGICAL PCS
15 SPUIT 3ML PCS

NO
1 AMBROXOL TABLET 30 MG
Page 32
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED
2 AMLODIPINE TABLET 10 MG
3 ANABION PLUS DHA SIRUP

4
ML
5 ASAM MEFENAMAT TABLET 500 MG
7 ASPILETS TABLET
8 BENEURON TABLET
9 BIOPLACENTON KRIM
10 BORAX GLISERIN
11 CAVIPLEX TABLET
12 CEFADROKSIL KAPSUL
13 CEFADROKSIL SIRUP 125 MG/5 ML
14 CETERIZINE TAB
15 CHLORETYL SPRAY
16 COPARSETINE SIRUP
17 DANASON TABLET
18 DOMPERIDON TABLET
19 EPINEFRIN INJEKSI
20 ERLAMYCETIN PLUS TETES MATA
21 ERLAMYCETIN TETES TELINGA
22 ERYTRA FORTE TABLET
23 FARIZOL SIRUP
24 FARSIFEN SIRUP
25 FASIDOL DROPS 15 ML
26 FENOL GLISEROL TETES TELINGA
27 FITOMENADION ( VIT K1 ) INJEKSI
28 FOLAMIL GENIO
29 GEMFIBROZIL 300 MG KAPSUL
30 GENTIAN VIOLET
31 GRAFAZOL TABLET
32 HELIXIM KAPSUL
33 HISTIGO TABLET
34 IBUPROFEN TABLET 400 MG
35 ITRAMOL SIRUP
36 JARUM 25
37 KAPTOPRIL 25 MG TABLET
38 LAXANA TABLET
Page 33
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED
39 LERZIN DROP
40 LOVIRES 400 MG TABLET
41 MASKER BEDAH
42 MASKER N95
43 MESS NO 11
44 METORMIN 500 MG TAB
45 METRONIDAZOL TABLET 500 MG
46 NACL INFUS
47 NIFEDIPIN TABLET
48 NISAGON KRIM
49 NORAGES INJEKSI
50 OMEPRAZOLE KAPSUL
51 ONDANSENTRON INJEKSI
52 ORSADERM SALEP
53 PARACETAMOL TABLET 500 MG IFI
54 PARACETAMOL TABLET 500 MG FM
55 PHENZACOL TABLET
56 PLESTER
57 RANITIDIN INJEKSI
58 SALBUTAMOL TABLET 4 MG
60 SAMCOFENAC TABLET
61 SEFOTAXIM INJEKSI
62 SETRIAXONE INJEKSI
63 SELTIFORT SIRUP
64 SIMETIDIN TABLET
65 SIMVASTATIN TABLET
66 SIPROFLOXACIN TABLET 500 MG
67 SOLFENOX SIRUP
68 SYNBIO KAPSUL
69 TIDIFAR 200 MG TABLET
70 TRIATA SIRUP
71 VICCILINE INJEKSI
72 VITAMIN B6 TABLET
73 NURSE CAP PCS

Page 34
Bulan :MEI 2021
NO NAMA OBAT N
NG
KOTES TAMBKN BUTUN
G
NGARGN
N G
SI
P3K LOKET
ANS
RPU ED
Page 35
REKAP SISA OBAT DI KAMAR OBAT TAHUN 2021
NO NAMA OBAT SATUAN JANUARI PEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER OKTOBER NOPEMBER DESEMBER KET
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 ACETYLCYSTEINE CAPSULE 200 MG
2 ALABETIK TABLET
3 ALLOPURINOL TABLET 100 MG
4 ALPRAZOLAM 1 MG TABLET
5 AMBROXOL SIRUP 5MG/ML
7 AMINOPHYLLINE TABLET 200 MG
8 AMITRIPTYLLINE HCL TABLET 25 MG
11 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML
12 AMOKSISILIN TABLET 500 MG
13 ANTALGIN 500 MG TABLET (METAMIZOL)
14 ANTASIDA DOEN TABLET KOMBINASI
15 ANTASIDA SUSPENSI 60 ML
16 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR
17 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR
18 ANTI HAEMOROID DOEN KOMBINASI
19 ANTI INFLUENZA (EMFLU) KOMBINASI TAB
20 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP
21 ANTI MIGRAIN DOEN TABLET KOMBINASI
22 ANTI SPASMODIK TABLET (DORMICOMP)
23 ASAM ASKORBAT ( VIT C ) TABLET 250 MG
24 ASAM ASKORBAT ( VIT C ) TABLET 50 MG
25 ASAM FOLAT 1MG TABLET
27 ASAM TRANEKSAMAT 500 MG TABLET
28 ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER
29 ASEPTAN 500CC + PUMP

30 ASEPTIC GEL 500CC + DISPENSER
31 ASERING (ASETAT RINGER) SOFT BAG
32 ASETOSAL TABLET 100 (80) MG
33 ASIKLOVIR KREAM 5 % 5 GR
34 ASIKLOVIR TABLET 400 MG
Page 36
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
35 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET
36 BETAHISTINMESILAT 6 MG TABLET
37 BETAMETHASONE CREAM 0,1 % 5 GR
38 BISAKODIL ( BICOLAX ) TABLET 5 MG
39 BISAKODIL SUPPOSITORIA 10 MG
40 BISAKODIL SUPPOSITORIA 5 MG
41 BISOPROLOL 2,5 MG TABLET (CONCOR)
42 BISOPROLOL 5 MG TABLET
43 BROMHEXINE SIRUP (HUSTAB)
44 DEKSAMETHASONE TABLET 0,5 MG
45 DIAZEPAM INJEKSI 5 MG/ML 2 ML
46 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID
47 DIAZEPAM TABLET 2 MG
48 DIAZEPAM TABLET 5 MG
49 DIGOXIN TABLET 0,25 MG
50 DIMENHYDRINATE TABLET 50 MG
51 DOKSISIKLIN TABLET 100 MG
52 DOMPERIDON SUSPENSI 5MG/ML
53 DOMPERIDON TABLET 10 MG
54 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR
55 ERITROMISIN KAPSUL 250 MG
56 ERITROMISIN SIRUP KERING 200 MG/5ML
57 ERITROMISIN TABLET 500 MG
58 ETANOL [ ALKOHOL ] 70 % 1000 ML
59 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML
60 FENITOIN NATRIUM TABLET 100 MG
61 FENOBARBITAL INJEKSI 50 MG/ML 2 ML
62 FENOBARBITAL TABLET 30 MG
63 FENOL GLISEROL TETES TELINGA 10 % 5 ML
64 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG
65 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML
66 FUROSEMID TABLET 40 MG
67 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR

69 GENTAMISIN SALEP KULIT 0,1 % 5 GR
70 GENTAMISIN SALEP MATA 0,3%
Page 37
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
71 GENTAMISIN TETES MATA 0,3%
72 GLIBENCLAMIDE TABLET 5 MG
73 GLICERIL GUAIACOLAT TABLET 100 MG
74 GLIMEPIRIDE 2 MG TABLET
75 GRISEOFULVIN TABLET 125 MG
76 HALOPERIDOL DEKANOAT INJ 50 MG
77 HALOPERIDOL INJ. 5 MG/ML (LODOMER)
78 HALOPERIDOL TABLET 1,5 MG
79 HALOPERIDOL 2 MG
80 HALOPERIDOL TABLET 5 MG
81 HEPARIN SODIUM 200 UI (THROMBOFLASH)
HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS
82
500 ML
83 HIDROCORTISONE CREAM 2,5 % 5 GR
84 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML
86 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG
87 KAEN 3B
88 KALIUM DIKLOFENAK 50 MG TABLET
89 KALSIUM LAKTAT (KALK) TABLET 500 MG
90 KAOLIN PEKTIN (NOVADIAR) SUSPENSI
91 KAPAS PEMBALUT/ABSORBEN 250 GR
92 KAPTOPRIL TABLET 25 MG
93 KARBAMAZEPIN TABLET 200 MG
94 KETOKONAZOLE TABLET 200 MG
95 KETOPROFEN 100 MG SUPPOSITORIA
96 KLINDAMISIN KAPSUL 150 MG
97 KLINDAMISIN KAPSUL 300 MG
98 KLOBAZAM 10 MG TABLET
99 KLORAMFENIKOL KAPSUL 500 MG
100 KLORAMFENIKOL SALEP KULIT 2 %
101 KLORAMFENIKOL SALEP MATA 1 %
102 KLORAMFENIKOL SUSPENSI 125 MG/5 ML
103 KLORAMFENIKOL TETES TELINGA 3 %
104 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG
105 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML
106 KLORPROMAZIN HCL TABLET 100 MG
Page 38
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
107 KLOZAPIN 100 MG TABLET
108 KLOZAPIN 25 MG TABLET
109 KODEIN HCL TABLET 10 MG
110 KOTRIMOKSAZOL DEWASA TABLET
111 KOTRIMOKSAZOL SUSPENSI 60 ML
112 LEVOFLOXACIN TABLET 500 MG
113 LOPERAMIDE TABLET 2 MG
114 LORATADIN TABLET 10 MG
115 MASKER KERTAS 3 PLY EAR LOOP
116 MASKER KERTAS 3 PLY TIE ON
117 MELOKSIKAM TABLET 7,5 MG
118 METFORMIN TABLET 500 MG
119 METILERGOMETRIN MALEAT TABLET 0,125 MG
120 METILPREDNISOLON TABLET 4 MG
121 METOKLOPRAMIDE 10 MG TABLET
122 METOKLOPRAMIDE 5 MG TABLET
123 METOKLOPROMIDE SIRUP
124
INJEKSI
127 MIKONAZOL KREAM 10 GR
128 MINERAL MIX
129 MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML
130
TABLET
131 NATRIUM DIKLOFENAK TABLET 25 MG
132 NATRIUM DIKLOFENAK TABLET 50 MG
133 NATRIUM KLORIDA INFUS 0,9 % STERIL
134 NEUROTROPIK KOMBINASI (IKANEURON) TABLET
135 NIFEDIPINE TABLET 10 MG
136 NISTATIN TABLET 500.000 UI
137 NISTATIN VAGINAL TABLET 100.000 UI
138 OBAT BATUK HITAM (OBH) CAIRAN 100 ML
139 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR
140 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR
141 OMEPRAZOLE TABLET 20 MG
142 PARACETAMOL SYRUP 120 MG/5 ML 60 ML
Page 39
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
143 PARACETAMOL TABLET 500 MG
144 PARACETAMOL TETES 100 MG/ML 15 ML
145 PEHAVRAL TABLET
146 PERAK SULFADIAZIN KRIM 1 %
147 PIRACETAM TABLET 800 MG
148 PIRANTEL PAMOAT TABLET
149 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG
150 PIROKSIKAM KAPSUL 10 MG
151 PREDNISON TABLET 5 MG
152 PROPANOLOL HCL TABLET 40 MG
153 PROPILTHIOURACIL TABLET 100 MG
154 RESPERIDON 2 MG TABLET
155 RINGER LAKTATE LARUTAN INFUS STERIL
158 SALEP 2-4 KOMBINASI 30 GR
159 SALICYL BEDAK 2 %
160 SARUNG TANGAM NON STERIL L
161 SARUNG TANGAN NON STERIL M
162 SARUNG TANGAN NON STERIL S
163 SEFADROKSIL KAPSUL 500 MG
164 SEFIKSIM KAPSUL 100 MG
165 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I)
166 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS)
167 SETIRIZINE TABLET 10 MG

168 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG
169 SIMETIDINE TABLET 200 MG
170 SIMVASTATIN TABLET 10 MG
171 SIPROFLOXACIN INFUS 2%
173 SIPROHEPTADINE 4 MG TABLET (PRONICY)
174 SULFADOKSIN TABLET
175 SULFASETAMID NATRIUM TETES MATA 15 % 5 ML
176 STIMUNO TAB (100)
177 STIMUNO TAB (30)
178 STIMUNO SYR
Page 40
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
179 TABLET TAMBAH DARAH (DAK)
180 TETRAKAIN HCL TETES MATA 5 ML
181 TETRASIKLIN HCL TABLET 500 MG
182 THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 MG
183 THIAMIN HCL MONONITRAT (VIT B1) TABLET 50 MG
TRIAMSINOLON ACETONIDE (BUFACOMB) 1MG/GR

184
SALEP
185 TRIFLOUPERASIN TABLET 5 MG
186 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG
187 VITAMIN B COMPLEX TABLET
188 YODIUM POVIDON LARUTAN 10 % 30 ML
189 YODIUM POVIDON LARUTAN 10% 60 ML
190 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE)
191 ZINK 20 MG TABLET
192 ZINK SYRUP
JUMLAH OBAT PKD

NO
1 ALBENDAZOL TABLET 400 MG
2 DIAZEPAM CAIRAN INJEKSI 5 MG\/2ML (KESGA)
3 GARAM ORALIT UNTUK 200 ML AIR
4 ISONIAZID TABLET 100 MG
5 ISONIAZID TABLET 300 MG
6 KOMBIPAK AZITHROMYCIN - CEFIXIME KOMBINASI
7 KOTRIMOKSASOL 480 TABLET KOMBINASI
8 KOTRIMOKSASOL 960 TABLET KOMBINASI
9
(KESGA)
10 MDT COMBI - MB ADULT (RED)
11 MDT COMBI - MB CHILD (ORANGE)
12 MDT COMBI - PB ADULT (GREEN)
13 OBAT ANTI TUBERKULOSIS ANAK
14 OBAT ANTI TUBERKULOSIS KATAGORI 1
15 OBAT ANTI TUBERKULOSIS KATAGORI 2
16 OBAT ANTI TUBERKULOSIS KOMBIPAK KATEGORI I
Page 41
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 OBAT HIV EFAVIRENZ 200 MG TABLET
18 OBAT HIV EFAVIRENZ 600 MG TABLET
19 OBAT HIV LAMIVUDIN 150 MG TABLET
20 OBAT HIV NEVIRAPINE (NVP) 200 MG TABLET
21 OBAT HIV TENOFOVIR 300 MG (TDF)
22
(60+30+50)
23
(300/300/600)
24 OBAT HIV ZIDOVUDINE 100 MG TABLET
25 OBAT HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG
26 OKSITETRASIKLIN SALEP MATA 1% (KESGA)

27 PIRIDOKSIN 25 MG TABLET (VIT B6)
28 RETINOL ( VIT A ) KAPSUL 100.000 IU
29 RETINOL ( VIT A ) KAPSUL 200.000 IU
30 TABLET TAMBAH DARAH (PROGRAM)
31 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM)

NO
1 MASKER N95
2 SARUNG TANGAN S MAXTER

NO
1 HAND SANITIZER 500 ML

2 HAND SANITIZER 5000 ML
3 MASKER KERTAS 3 PLY EAR LOOP
4 MASKER KN95
5 MASKER N95
6 MASKER N95 RESPIRATOR
7 NURSE CAP
8 SARUNG TANGAN L
9 SARUNG TANGAN M
10 SARUNG TANGAN S
Page 42
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
11 SARUNG TANGAN STERIL M GYNAEC

12 SARUNG TANGAN STERIL NO.6,5
13 SARUNG TANGAN STERIL NO.7

NO

4 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML
7 ASPILETS TABLET
8 BENEURON TABLET
9 BIOPLACENTON KRIM
10 BORAX GLISERIN
11 CAVIPLEX TABLET
14 CETERIZINE TAB
15 CHLORETYL SPRAY
17 DANASON TABLET
23 FARIZOL SIRUP
24 FARSIFEN SIRUP
28 FOLAMIL GENIO
30 GENTIAN VIOLET
Page 43
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
31 GRAFAZOL TABLET
32 HELIXIM KAPSUL
33 HISTIGO TABLET
35 ITRAMOL SIRUP
36 JARUM 25
38 LAXANA TABLET
39 LERZIN DROP
41 MASKER BEDAH
42 MASKER N95
43 MESS NO 11
46 NACL INFUS
47 NIFEDIPIN TABLET
48 NISAGON KRIM
49 NORAGES INJEKSI
52 ORSADERM SALEP
55 PHENZACOL TABLET
56 PLESTER
63 SELTIFORT SIRUP
64 SIMETIDIN TABLET
67 SOLFENOX SIRUP
Page 44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
68 SYNBIO KAPSUL
70 TRIATA SIRUP
Page 45
REKAP SISA OBAT DI GUDANG OBAT TAHUN 2021
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

23 VIAL
MG/VIAL
31 BOTOL
SYRUP
Page 46
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

AQUA PRO INJEKSI STERIL BEBAS PIROGEN
35 BOTOL
20 ML
42 TABLET
ER
50 TABLET
TABLET
67 TUBE
STESOLID
Page 47
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

76 TUBE
GR
FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1
90 AMPUL
ML
91 TABLET
MG
FLUPHENASINE DEKANOAT INJEKSI 25 MG 1
93 AMPUL
ML
GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %
96 TUBE
10 GR
105 VIAL
CAIRAN INJEKSI
Page 48
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

115 BOTOL
INFUS 500 ML
128 KAEN 3B BOTOL
130 AMPUL
ML
137 AMPUL
Page 49
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

143 PCS
FRAMISETIN
154 TABLET
MG
METILERGOMETRIN MALEAT INJEKSI 0,200 MG
174 AMPUL
1 ML
Page 50
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

179 AMPUL
MG/ML 2 ML
181 VIAL
(PROVAGIN) INJEKSI
188 TABLET
TABLET
193 TABLET
TABLET
Page 51
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

236 VIAL
(ABU I)
237 VIAL
(ATS)
239 AMPUL
MCG/ML 1 ML
249 BOTOL
ML
Page 52
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

254 PCS
THIAMIN HCL MONONITRAT (VIT B1) TABLET
258 TABLET
100 MG
259 TABLET
50 MG
262 TUBE
1MG/GR SALEP
TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2
264 TABLET
MG
JUMLAH OBAT PKD

NO
7 VIAL
(KESGA)
10 GENTAMICIN CAIRAN INJEKSI 40 MG/ML VIAL
(KESGA)
Page 53
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

14 PAKET
KOMBINASI
17 TABLET
(KESGA)
18 VIAL
(HALOPERIDOL)
22 VIAL
MG (KESGA)
26 PAKET
KATEGORI I
32 BTL60'S
(60+30+50)
33 BTL30'S
(300/300/600)
OBAT HIV ZIDOVUDINE 300 MG + LAMIVUDIN
35 BTL60'S
150 MG
41 PCS
RAPID TEST
42 PCS
47 SAFETY BOX PCS
Page 54
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
SERUM ANTI DIFTERI CAIRAN INJEKSI 125
48 VIAL
MG/ML

NO

5 Masker N95 PCS

NO

5 MASKER KN95 PCS
6 MASKER N95 PCS
8 NURSE CAP PCS
12 SARUNG TANGAN STERIL M GYNAECOLOGICALPCS
15 SPUIT 3ML PCS

NO
Page 55
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
4
20 ML
7 ASPILETS TABLET
8 BENEURON TABLET
9 BIOPLACENTON KRIM
10 BORAX GLISERIN
11 CAVIPLEX TABLET
14 CETERIZINE TAB
15 CHLORETYL SPRAY
17 DANASON TABLET
23 FARIZOL SIRUP
24 FARSIFEN SIRUP
28 FOLAMIL GENIO
30 GENTIAN VIOLET
31 GRAFAZOL TABLET
32 HELIXIM KAPSUL
33 HISTIGO TABLET
35 ITRAMOL SIRUP
36 JARUM 25
Page 56
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
38 LAXANA TABLET
39 LERZIN DROP
41 MASKER BEDAH
42 MASKER N95
43 MESS NO 11
46 NACL INFUS
47 NIFEDIPIN TABLET
48 NISAGON KRIM
49 NORAGES INJEKSI
52 ORSADERM SALEP
55 PHENZACOL TABLET
56 PLESTER
63 SELTIFORT SIRUP
64 SIMETIDIN TABLET
67 SOLFENOX SIRUP
68 SYNBIO KAPSUL
70 TRIATA SIRUP
Page 57
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Page 58
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Page 59
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) BLUD
NAMA SUB UNIT : PELAPORAN BULAN :
PERMINTAAN BULAN :
STOK PENERI PERSEDI PEMAKA SISA PERMIN PEMBER

NO JUMLAH OBAT DARI BLUD SATUAN
AWAL MAAN AAN IAN STOK TAAN IAN
KET
1 2 3 4 5 6 7 8 9 10 11

3 ANABION PKUS DHA SIRUP BOTOL

BOTOL
4 PIROGEN 20 ML
6 ASPILETS TABLET TABLET
7 BENEURON TABLET TABLET

9 BORAX GLISERIN BOTOL
10 CAVIPLEX TABLET TABLET
12 COPARSETINE SIRUP BOTOL


16 ERLAMYCETIN PLUS TETES MATA TABLET
17 ERLAMYCETIN TETES TELINGA BOTOL
18 ERYTRA FORTE TABLET TABLET

19 FARIZOL SIRUP BOTOL
20 FARSIFEN SIRUP BOTOL
21 FASIDOL DROPS 15 ML BOTOL

22 FENOL GLISEROL TETES TELINGA BOTOL
24 FOLAMIL GENIO KAPSUL

26 GENTIAN VIOLET BOTOL

27 GRAFAZOL TABLET TABLET
28 HELIXIM KAPSUL KAPSUL

29 HISTIGO TABLET TABLET
31 ITRAMOL SIRUP BOTOL
32 KAPTOPRIL 25 MG TABLET TABLET
33 LAXANA TABLET TABLET
34 LERZIN DROP BOTOL

35 LOVIRES 400 MG TABLET TABLET
36 MASKER BEDAH PCS
37 MASKER N95 PCS
38 METORMIN 500 MG TAB TABLET
40 NIFEDIPIN TABLET TABLET
41 NISAGON KRIM TUBE
Page 60
STOK PENERI PERSEDI PEMAKA SISA PERMIN PEMBER
NO JUMLAH OBAT DARI BLUD SATUAN
AWAL MAAN AAN IAN STOK TAAN IAN
KET
1 2 3 4 5 6 7 8 9 10 11
42 OMEPRAZOLE KAPSUL KAPSUL

43 ORSADERM SALEP TUBE
44 PARACETAMOL TABLET 500 MG IFI TABLET
46 PHENZACOL TABLET TABLET

47 PLESTER BUAH
50 SAMCOFENAC TABLET TABLET

51 SELTIFORT SIRUP BOTOL
52 SIMETIDIN TABLET TABLET
53 SIMVASTATIN TABLET TABLET
55 SOLFENOX SIRUP BOTOL

56 SYNBIO KAPSUL KAPSUL
57 TIDIFAR 200 MG TABLET TABLET
58 TRIATA SIRUP BOTOL
59 VITAMIN B6 TABLET TABLET
Page 61
2 WAY FOLEY CATHETER EKSTRACT PLASENTA + KLORAMFENIKOL SALEP
NO.16 NEOMYSIN SALEP 15 GR MATA 1 %
2 WAY FOLEY CATHETER EPINEFRIN (ADRENALIN) KLORAMFENIKOL SUSPENSI
NO.18 HCL INJ.0,1 % 1 ML 125 MG/5 ML
2 WAY FOLEY CATHETER ERITROMISIN KAPSUL 250 KLORAMFENIKOL TETES
NO.20 MG TELINGA 3 %
ACETYLCYSTEINE CAPSULE ERITROMISIN SIRUP KERING KLORFENIRAMINE MALEAT
200 MG 200 MG/5ML (CTM) TABLET 4 MG
ERITROMISIN TABLET 500 KLORPROMAZIN HCL
ALABETIK TABLET
MG INJEKSI 25 MG/ML 1 ML
ALAT SUNTIK SEKALI PAKAI ETAKRIDIN ( RIVANOL ) KLORPROMAZIN HCL
1 ML LARUTAN 0,1 % 300 ML TABLET 100 MG
ALAT SUNTIK SEKALI PAKAI ETANOL [ ALKOHOL ] 70 %
KLOZAPIN 100 MG TABLET
10 ML 1000 ML
ALAT SUNTIK SEKALI PAKAI ETIL KLORIDA SEMPROT 100
KLOZAPIN 25 MG TABLET
20 ML ML
ALAT SUNTIK SEKALI PAKAI
EUGENOL CAIRAN 10 ML KODEIN HCL TABLET 10 MG
3 ML
ALAT SUNTIK SEKALI PAKAI FENITOIN NATRIUM INJEKSI KOTRIMOKSAZOL DEWASA
5 ML 50 MG/ML 2 ML TABLET
ALLOPURINOL TABLET 100 FENITOIN NATRIUM TABLET KOTRIMOKSAZOL SUSPENSI
MG 100 MG 60 ML
FENOBARBITAL INJEKSI 50 LEVOFLOXACIN TABLET 500
ALPRAZOLAM 1 MG TABLET
MG/ML 2 ML MG
FENOBARBITAL TABLET 30
AMBROXOL SIRUP 5MG/ML LIDOCAIN 2% INJ
MG
FENOL GLISEROL TETES LIDOCAIN COMPOSITUM
AMBROXOL TABLET 30 MG
TELINGA 10 % 5 ML INJEKSI 2 ML
AMINOPHYLLINE INJEKSI 24 FITOMENADION ( VIT K1 ) LISOL CONCENTRATE 1000
MG/ML 10 ML INJEKSI 10 MG/ML 1 ML ML
AMINOPHYLLINE TABLET FITOMENADION ( VIT K1 )
LOPERAMIDE TABLET 2 MG
200 MG TABLET SALUT 10 MG
AMITRIPTYLLINE HCL FITOMENADION INFANT INJ.
LORATADIN TABLET 10 MG
TABLET 25 MG 2MG/ML
FLUPHENASINE DEKANOAT MAGNESIUM SULFAT
AMLODIPINE TABLET 10 MG
INJEKSI 25 MG 1 ML INJEKSI (IV) 40 % 25 ML
MASKER KERTAS 3 PLY EAR
AMLODIPINE TABLET 5 MG FUROSEMID INJEKSI
LOOP
AMOKSISILIN DRY SYRUP MASKER KERTAS 3 PLY TIE
FUROSEMID TABLET 40 MG
125 MG/5 ML 60 ML ON
GAMEKSAN
AMOKSISILIN TABLET 500 MELOKSIKAM TABLET 7,5
(SCABICID)/PERMETRIN
MG MG
KRIM 1 % 10 GR
AMOKSISILIN SERBUK GEMFIBROZIL 300 MG METAMIZOL (NORAGES)
INJEKSI KAPSUL INJEKSI 500 MG/2ML
AMPICILLIN SERBUK INJEKSI GENTAMISIN SALEP KULIT
METFORMIN TABLET 500 MG
1.000 MG MG/VIAL 0,1 % 5 GR
ANTALGIN 500 MG TABLET GENTAMISIN SALEP MATA METILERGOMETRIN MALEAT
(METAMIZOL) 0,3% INJEKSI 0,200 MG 1 ML
ANTASIDA DOEN TABLET GENTAMISIN TETES MATA METILERGOMETRIN MALEAT
KOMBINASI 0,3% TABLET 0,125 MG
GLASS IONOMER CEMENT METILPREDNISOLON
ANTASIDA SUSPENSI 60 ML
( GC IX ) TABLET 4 MG
ANTI BAKTERI DOEN SALEP GLIBENCLAMIDE TABLET 5 METOKLOPRAMIDE 10 MG
KOMBINASI 5 GR MG TABLET
ANTI FUNGI DOEN SALEP GLICERIL GUAIACOLAT METOKLOPRAMIDE 5 MG
KOMBINASI 30 GR TABLET 100 MG TABLET
METOKLOPROMIDE
ANTI HAEMOROID DOEN
GLIMEPIRIDE 2 MG TABLET (SOTATIC) INJEKSI 5 MG/ML
KOMBINASI
GLUKOSA 40% DEXTROSE 2 ML
ANTI INFLUENZA (EMFLU)
INJECTION U.S.P CAIRAN METOKLOPROMIDE SIRUP
KOMBINASI TAB
ANTI INFLUENZA INJEKSI
GLUKOSA LARUTAN INFUS METRONIDAZOL + NYSTATIN
(SOLAFLUZ) KOMBINASI
10 % STERIL VAG. (PROVAGIN) INJEKSI
SYRUP
ANTI MIGRAIN DOEN TABLET GLUKOSA LARUTAN INFUS 5 METRONIDAZOL TABLET 250
KOMBINASI % STERIL MG
ANTI SPASMODIK INJEKSI GRISEOFULVIN TABLET 125 METRONIDAZOL TABLET 500
(SPASHI) MG MG
ANTI SPASMODIK TABLET HALOPERIDOL DEKANOAT METRONIDAZOLE INFUS 5
(DORMICOMP) INJ 50 MG MG/ML 100 ML
AQUA PRO INJEKSI STERIL HALOPERIDOL INJ. 5 MG/ML
MIKONAZOL KREAM 10 GR
BEBAS PIROGEN 20 ML (LODOMER)
ASAM ASKORBAT ( VIT C ) HALOPERIDOL TABLET 1,5
MINERAL MIX
TABLET 250 MG MG
ASAM ASKORBAT ( VIT C ) MULTIVITAMIN (LYSOVIT )
HALOPERIDOL 2 MG
TABLET 50 MG SYRUP 100 ML
MULTIVITAMIN (MALTIRON
ASAM FOLAT 1MG TABLET HALOPERIDOL TABLET 5 MG
PLUS) KOMBINASI TABLET
ASAM MEFENAMAT TABLET HEPARIN SODIUM 200 UI NATRIUM DIKLOFENAK
500 MG (THROMBOFLASH) TABLET 25 MG
HES-HYDROXYETHYL
ASAM TRANEKSAMAT 100 NATRIUM DIKLOFENAK
STARCH 6 %/VOLUVEN
MG/ML INJEKSI TABLET 50 MG
INFUS 500 ML
ASAM TRANEKSAMAT 500 HIDROCORTISONE CREAM NATRIUM KLORIDA INFUS
MG TABLET 2,5 % 5 GR 0,9 % STERIL
ASAM VALPROAT 250 MG I.V CATHETER NO.16 WITH NEUROTROPIK
TABLET / DEPAKOTE ER INJECTION PORT (IKANEURON) INJEKSI
I.V CATHETER NO.18 WITH NEUROTROPIK KOMBINASI
ASEPTAN 500CC + PUMP
INJECTION PORT (IKANEURON) TABLET
ASEPTIC GEL 500CC + I.V CATHETER NO.20 WITH
NIFEDIPINE TABLET 10 MG
DISPENSER INJECTION PORT
ASERING (ASETAT RINGER) I.V CATHETER NO.22 WITH
NISTATIN TABLET 500.000 UI
SOFT BAG INJECTION PORT
ASETOSAL TABLET 100 (80) I.V CATHETER NO.24 WITH NISTATIN VAGINAL TABLET
MG INJECTION PORT 100.000 UI
I.V CATHETER NO.26 WITH NOREPINEPHRINE CAIRAN
ASIKLOVIR KREAM 5 % 5 GR
INJECTION PORT INJEKSI
IBUPROFEN SUSPENSI 100 OBAT BATUK HITAM (OBH)
ASIKLOVIR TABLET 400 MG
MG/5 ML 60 ML CAIRAN 100 ML
ATROPIN SULFAT INJEKSI OKSIGEN NASAL CANNULA
IBUPROFEN TABLET 400 MG
0,25 MG/ML 1 ML ADULT
ATTAPULGIT + PECTIN ( NEO OKSIGEN NASAL CANNULA
INFUSION SET ANAK
DIASTOP ) TABLET INFANT
BETAHISTINMESILAT 6 MG OKSITETRACYCLIN SALEP
INFUSION SET DEWASA
TABLET KULIT 3 % 5 GR
BETAMETHASONE CREAM ISOSORBIDE DINITRATE OKSITETRACYCLIN SALEP
0,1 % 5 GR SUBLINGUAL 5 MG MATA 1 % 3,5 GR
BISAKODIL ( BICOLAX ) OKSITOSIN INJEKSI 10 IU/ML
KAEN 3B
TABLET 5 MG 1 ML
BISAKODIL SUPPOSITORIA KALIUM DIKLOFENAK 50 MG OMEPRAZOLE TABLET 20
10 MG TABLET MG
BISAKODIL SUPPOSITORIA 5 KALSIUM GLUCONAS ONDANSENTRON 4 MG/2 ML
MG INJEKSI 100 MG/ML 10 ML INJEKSI
BISOPROLOL 2,5 MG TABLET KALSIUM LAKTAT (KALK) PARACETAMOL SYRUP 120
(CONCOR) TABLET 500 MG MG/5 ML 60 ML
PARACETAMOL TABLET 500
BISOPROLOL 5 MG TABLET KANTONG URINE DEWASA
MG
BROMHEXINE SIRUP KAOLIN PEKTIN (NOVADIAR) PARACETAMOL TETES 100
(HUSTAB) SUSPENSI MG/ML 15 ML
KAPAS
CAT GUT NO.2/0 CHROMIC PEMBALUT/ABSORBEN 250 PEHAVRAL TABLET
GR
PERAK SULFADIAZIN KRIM 1
CAT GUT NO.2/0-3/0 PLAIN KAPTOPRIL TABLET 25 MG
%
CITICHOLIN 250 MG/ML-2ML KARBAMAZEPIN TABLET 200 PERHYDROL [ H2O2 ] 3 %
INJEKSI MG 800 ML
KARBAZOKHROME SODIUM
COMBIVENT UDV INHALASI SULFONATE INJEKSI 5 PIRACETAM TABLET 800 MG
MG/ML 10 ML (SALDONA)
DEKSAMETHASONE INJEKSI KASA KOMPRES 40/40
PIRANTEL PAMOAT TABLET
5 MG/ML 1 ML STERIL
DEKSAMETHASONE TABLET KASA PEMBALUT HIDROFIL PIRIDOKSIN HCL (VIT B6)
0,5 MG 16 X 16 CM STRIL TABLET 10 MG
DEVITALISASI PASTA ( NON KASA PEMBALUT HIDROFIL
PIROKSIKAM KAPSUL 10 MG
ARSEN ) 2 M X 80 CM
DIAZEPAM INJEKSI 5 MG/ML KASA PEMBALUT HIDROFIL PLESTER 5 YARD X 2 INCI
2 ML 4 M X 10 CM (LEUKOPLAST)
DIAZEPAM LARUTAN
KASA PEMBALUT HIDROFIL
RECTAL 5MG/ 2,5ML- PREDNISON TABLET 5 MG
4 M X 5 CM
STESOLID KASA STERIL (DARYAN
PROPANOLOL HCL TABLET
DIAZEPAM TABLET 2 MG TOLLE)YG DIRESAPI
40 MG
FRAMISETIN
KETOKONAZOLE TABLET PROPILTHIOURACIL TABLET
DIAZEPAM TABLET 5 MG
200 MG 100 MG
DIFENHIDRAMINE HCL KETOPROFEN 100 MG RANITIDIN INJEKSI 25 MG/
INJEKSI 10 MG/ML 1 ML SUPPOSITORIA ML
KLINDAMISIN KAPSUL 150
DIGOXIN TABLET 0,25 MG RESPERIDON 2 MG TABLET
MG
DIMENHYDRINATE TABLET KLINDAMISIN KAPSUL 300 RINGER LAKTATE LARUTAN
50 MG MG INFUS STERIL
DOKSISIKLIN TABLET 100
KLOBAZAM 10 MG TABLET SALBUTAMOL TABLET 2 MG
MG
DOMPERIDON SUSPENSI KLORAMFENIKOL KAPSUL
SALBUTAMOL TABLET 4 MG
5MG/ML 500 MG
DOMPERIDON TABLET 10 KLORAMFENIKOL SALEP
SALEP 2-4 KOMBINASI 30 GR
MG KULIT 2 %
GARAM ORALIT UNTUK 200
SALICYL BEDAK 2 % STIMUNO TAB (30)
ML AIR
SARUNG TANGAM NON GENTAMICIN CAIRAN
STIMUNO SYR
STERIL L INJEKSI 40 MG/ML (KESGA)
SARUNG TANGAN NON TABLET TAMBAH DARAH
ISONIAZID TABLET 100 MG
STERIL M (DAK)
TEMPORARY CAVITY
SARUNG TANGAN NON
SEALER [TUMPATAN ISONIAZID TABLET 300 MG
STERIL S
SARUNG TANGAN STERIL TETRAKAIN HCL TETES
KOMBIPAK AZITHROMYCIN -
NO 6 MATA 5 ML CEFIXIME KOMBINASI
SARUNG TANGAN STERIL TETRASIKLIN HCL TABLET KOTRIMOKSASOL 480
NO. 7,5 500 MG TABLET KOMBINASI
SARUNG TANGAN STERILE THIAMIN HCL (VIT B1) KOTRIMOKSASOL 960
NO.6,5 INJEKSI 100 MG/ML 1 ML TABLET KOMBINASI
SARUNG TANGAN STERILE THIAMIN HCL MONONITRAT LEVOTHYROXINE ACTAVIS
NO.7 (VIT B1) TABLET 100 MG
TABLET 100 MCG (KESGA)
SEFADROKSIL KAPSUL 500 THIAMIN HCL MONONITRAT LODOMER CAIRAN INJEKSI 5
MG (VIT B1) TABLET 50 MGMG/ML (HALOPERIDOL)
TRAMADOL INJEKSI 50 MDT COMBI - MB ADULT
SEFIKSIM KAPSUL 100 MG
MG/ML (RED)
SERUM ANTI BISA ULAR TRANFUSION SET ADULT MDT COMBI - MB CHILD
POLIVALEN INJ.5 ML (ABU I) WITH Y INJECTION (ORANGE)
TRIAMSINOLON ACETONIDE
SERUM ANTI TETANUS MDT COMBI - PB ADULT
(BUFACOMB) 1MG/GR
INJEKSI 1.500 IU/AMP (ATS) (GREEN)
SALEP METILERGOMETRIN MALEAT
TRIFLOUPERASIN TABLET 5
SETIRIZINE TABLET 10 MG INJECTION 0,200 MG
MG
TRIHEKSIFENIDIL (KESGA)
SIANOKOBALAMIN ( VIT B12 ) OBAT ANTI TUBERKULOSIS
HIDROKLORIDA TABLET 2
INJEKSI 500 MCG/ML 1 ML ANAK
MG
SIANOKOBALAMIN ( VIT B12 ) VITAMIN B COMPLEXOBAT ANTI TUBERKULOSIS
TABLET 50 MCG TABLET KATAGORI 1
SILK (BENANG BEDAH YODIUM POVIDON LARUTANOBAT ANTI TUBERKULOSIS
SUTERA) NO.3/0 10 % 30 ML KATAGORI 2
YODIUM POVIDON LARUTANOBAT ANTI TUBERKULOSIS
SIMETIDINE TABLET 200 MG
10% 60 ML KOMBIPAK KATEGORI I
ZENTRA (TRIPROLIDINE|OBAT HIV EFAVIRENZ 200
SIMVASTATIN TABLET 10 MG
PSEUDOEPHEDRINE) MG TABLET
OBAT HIV EFAVIRENZ 600
SIPROFLOXACIN INFUS 2% ZINK 20 MG TABLET
MG TABLET
SIPROFLOXACIN TABLET OBAT HIV LAMIVUDIN 150
ZINK SYRUP
500 MG MG TABLET
SIPROHEPTADINE 4 MG DAFTAR OBAT PROGRAM / OBAT HIV NEVIRAPINE (NVP)
TABLET (PRONICY) HIBAH 200 MG TABLET
SPONS GELATIN CUBICLES ALBENDAZOL TABLET 400 OBAT HIV TENOFOVIR 300
1x1x1 CM MG MG (TDF)
AMPICILLIN SERBUK INJEKSI OBAT HIV TRIPLE FDC ANAK
SULFADOKSIN TABLET
1 G (KESGA) ZDV+3TC+NVP (60+30+50)
OBAT HIV TRIPLE FDC
SULFASETAMID NATRIUM CA GLUCONAS INJEKSI 10
DEWASA TDC+3TC+EFV
TETES MATA 15 % 5 ML Ml (KESGA)
(300/300/600)
FITOMENADION INJECTION 2 OBAT HIV ZIDOVUDINE 100
STIMUNO TAB (100)
MG\/ ML (KESGA) MG TABLET
OBAT HIV ZIDOVUDINE 300 ASAM MEFENAMAT TABLET
GRAFAZOL TABLET
MG + LAMIVUDIN 150 MG 500 MG
OKSITETRASIKLIN SALEP
ASPILETS TABLET HELIXIM KAPSUL
MATA 1% (KESGA)
PIRIDOKSIN 25 MG TABLET
BENEURON TABLET HISTIGO TABLET
(VIT B6)
TABLET TAMBAH DARAH
BIOPLACENTON KRIM IBUPROFEN TABLET 400 MG
(PROGRAM)
ZINK TABLET DISPERSIBLE
BORAX GLISERIN ITRAMOL SIRUP
20 MG (PROGRAM)
JUMLAH OBAT DARI
CAVIPLEX TABLET JARUM 25
DINKES
APRON LENGAN PANJANG CEFADROKSIL KAPSUL KAPTOPRIL 25 MG TABLET
CEFADROKSIL SIRUP 125
HAND SANITIZER 500 ML LAXANA TABLET
MG/5 ML
HAND SANITIZER 5000 ML CETERIZINE TAB LERZIN DROP
MASKER KERTAS 3 PLY EAR
CHLORETYL SPRAY LOVIRES 400 MG TABLET
LOOP
MASKER KN95 COPARSETINE SIRUP MASKER BEDAH
MASKER N95 DANASON TABLET MASKER N95
MASKER N95 RESPIRATOR DOMPERIDON TABLET MESS NO 11
NURSE CAP EPINEFRIN INJEKSI METORMIN 500 MG TAB

ERLAMYCETIN PLUS TETES METRONIDAZOL TABLET 500
SARUNG TANGAN L
MATA MG
ERLAMYCETIN TETES
SARUNG TANGAN M NACL INFUS
TELINGA
SARUNG TANGAN S ERYTRA FORTE TABLET NIFEDIPIN TABLET
SARUNG TANGAN STERIL M
FARIZOL SIRUP NISAGON KRIM
GYNAE
SARUNG TANGAN STERIL
FARSIFEN SIRUP NORAGES INJEKSI
NO.6,5
SARUNG TANGAN STERIL
FASIDOL DROPS 15 ML OMEPRAZOLE KAPSUL
NO.7
FENOL GLISEROL TETES
JUMLAH OBAT DARI BLUD ONDANSENTRON INJEKSI
TELINGA
FITOMENADION ( VIT K1 )
AMBROXOL TABLET 30 MG ORSADERM SALEP
INJEKSI
AMLODIPINE TABLET 10 MG FOLAMIL GENIO VITAMIN B6 TABLET
GEMFIBROZIL 300 MG PARACETAMOL TABLET 500
ANABION PLUS DHA SIRUP
KAPSUL MG FM
AQUA PRO INJEKSI STERIL
GENTIAN VIOLET PHENZACOL TABLET
BEBAS PIROGEN 20 ML
SIPROFLOXACIN TABLET
PLESTER SEFOTAXIM INJEKSI
500 MG
RANITIDIN INJEKSI SETRIAXONE INJEKSI SOLFENOX SIRUP
SALBUTAMOL TABLET 4 MG SELTIFORT SIRUP SYNBIO KAPSUL
SALBUTAMOL TABLET 2 MG SIMETIDIN TABLET TIDIFAR 200 MG TABLET
SAMCOFENAC TABLET SIMVASTATIN TABLET TRIATA SIRUP

FENOL GLISEROL TETES
OBAT LUAR TELINGA
ONDANSENTRON INJEKSI
FITOMENADION ( VIT K1 )
AMBROXOL TABLET 30 MG ORSADERM SALEP
INJEKSI
AMLODIPINE TABLET 10 MG FOLAMIL GENIO VITAMIN B6 TABLET
GEMFIBROZIL 300 MG PARACETAMOL TABLET 500
ANABION PLUS DHA SIRUP
KAPSUL MG FM
AQUA PRO INJEKSI STERIL
GENTIAN VIOLET PHENZACOL TABLET
BEBAS PIROGEN 20 ML
SIPROFLOXACIN TABLET
PLESTER SEFOTAXIM INJEKSI
500 MG
RANITIDIN INJEKSI SETRIAXONE INJEKSI SOLFENOX SIRUP
SALBUTAMOL TABLET 4 MG SELTIFORT SIRUP SYNBIO KAPSUL
SALBUTAMOL TABLET 2 MG SIMETIDIN TABLET TIDIFAR 200 MG TABLET
SAMCOFENAC TABLET SIMVASTATIN TABLET TRIATA SIRUP

ASAM MEFENAMAT TABLET
GRAFAZOL TABLET ERYTRA FORTE TABLET
500 MG
ASPILETS TABLET HELIXIM KAPSUL FARIZOL SIRUP
BENEURON TABLET HISTIGO TABLET FARSIFEN SIRUP
BIOPLACENTON KRIM IBUPROFEN TABLET 400 MG FASIDOL DROPS 15 ML
BORAX GLISERIN ITRAMOL SIRUP NIFEDIPIN TABLET
CAVIPLEX TABLET JARUM 25 NISAGON KRIM
CEFADROKSIL KAPSUL KAPTOPRIL 25 MG TABLET NORAGES INJEKSI

CEFADROKSIL SIRUP 125
LAXANA TABLET OMEPRAZOLE KAPSUL
MG/5 ML
CETERIZINE TAB LERZIN DROP OBAT BLUD
CHLORETYL SPRAY LOVIRES 400 MG TABLET OBAT BLUD
COPARSETINE SIRUP MASKER BEDAH OBAT BLUD
DANASON TABLET MASKER N95 OBAT BLUD
DOMPERIDON TABLET MESS NO 11 OBAT REGULER
EPINEFRIN INJEKSI METORMIN 500 MG TAB OBAT REGULER
ERLAMYCETIN PLUS TETES METRONIDAZOL TABLET 500
MATA MG OBAT REGULER
ERLAMYCETIN TETES
TELINGA
NACL INFUS OBAT REGULER
KETERANGAN/PENANDA OBAT KADALUARSA PUSKESMAS GANDUSARI KAB BLITAR
TAHUN :
SEPTEMB NOPEMB DESEMBE
NO NAMA OBAT SATUAN JANUARI PEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS OKTOBER KET
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

23 VIAL
MG/VIAL
Page 69
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

31 BOTOL
SYRUP

35 BOTOL
20 ML

42 TABLET
ER

50 TABLET
TABLET
Page 70
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

67 TUBE
STESOLID

76 TUBE
GR
Page 71
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1
90 AMPUL
ML
91 TABLET
MG
FLUPHENASINE DEKANOAT INJEKSI 25 MG 1
93 AMPUL
ML

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %
96 TUBE
10 GR

105 VIAL
CAIRAN INJEKSI
Page 72
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

115 BOTOL
INFUS 500 ML
128 KAEN 3B BOTOL

130 AMPUL
ML

137 AMPUL
Page 73
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

143 PCS
FRAMISETIN

154 TABLET
MG
Page 74
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

METILERGOMETRIN MALEAT INJEKSI 0,200 MG
174 AMPUL
1 ML

179 AMPUL
MG/ML 2 ML
181 VIAL
(PROVAGIN) INJEKSI

188 TABLET
TABLET

193 TABLET
TABLET
Page 75
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Page 76
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

236 VIAL
(ABU I)
237 VIAL
(ATS)
239 AMPUL
MCG/ML 1 ML

249 BOTOL
ML
Page 77
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

254 PCS

258 TABLET
100 MG
259 TABLET
50 MG

262 TUBE
1MG/GR SALEP
TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2
264 TABLET
MG
JUMLAH OBAT PKD

NO
Page 78
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

7 VIAL
(KESGA)
10 GENTAMICIN CAIRAN INJEKSI 40 MG/ML VIAL

(KESGA)

14 PAKET
KOMBINASI

17 TABLET
(KESGA)
18 VIAL
(HALOPERIDOL)

22 VIAL
MG (KESGA)

26 PAKET
KATEGORI I

32 BTL60'S
(60+30+50)
Page 79
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
33 BTL30'S
(300/300/600)
OBAT HIV ZIDOVUDINE 300 MG + LAMIVUDIN
35 BTL60'S
150 MG

41 PCS
RAPID TEST
42 PCS
47 SAFETY BOX PCS

SERUM ANTI DIFTERI CAIRAN INJEKSI 125
48 VIAL
MG/ML

NO

5 Masker N95 PCS
Page 80
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

NO

5 MASKER KN95 PCS
6 MASKER N95 PCS
8 NURSE CAP PCS
12 SARUNG TANGAN STERIL M GYNAECOLOGICALPCS

15 SPUIT 3ML PCS

NO

4
20 ML
Page 81
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
7 ASPILETS TABLET
8 BENEURON TABLET
9 BIOPLACENTON KRIM
10 BORAX GLISERIN
11 CAVIPLEX TABLET
14 CETERIZINE TAB
15 CHLORETYL SPRAY
17 DANASON TABLET
23 FARIZOL SIRUP
24 FARSIFEN SIRUP
28 FOLAMIL GENIO
30 GENTIAN VIOLET
31 GRAFAZOL TABLET
32 HELIXIM KAPSUL
33 HISTIGO TABLET
Page 82
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
35 ITRAMOL SIRUP
36 JARUM 25
38 LAXANA TABLET
39 LERZIN DROP
41 MASKER BEDAH
42 MASKER N95
43 MESS NO 11
46 NACL INFUS
47 NIFEDIPIN TABLET
48 NISAGON KRIM
49 NORAGES INJEKSI
52 ORSADERM SALEP
55 PHENZACOL TABLET
56 PLESTER
Page 83
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
63 SELTIFORT SIRUP
64 SIMETIDIN TABLET
67 SOLFENOX SIRUP
68 SYNBIO KAPSUL
70 TRIATA SIRUP
Page 84
ER ER R
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Page 85
APOTEK PUSTU SUKORENO
POLINDES GONDANG POLINDES SUKOSEWU
POLINDES KOTES PONKESDES BUTUN
PONKESDES SUMBER
PONKESDES GADUNGAN
AGUNG
UGD PONED/KIA
PPI GILUT
PUSTU NGARINGAN POLINDES TAMBAKAN
POLINDES BINTANG GIZI
LABORATORIUM IMUNISASI

PUSKESMAS GANDUSARI KABUPATEN BLITAR LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO

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PUSKESMAS GANDUSARI KABUPATEN BLITAR LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO

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PUSKESMAS GANDUSARI KABUPATEN BLITAR

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

STOK PENERIM PERSEDIA PEMAKAI SISA PERMINT PEMBERI

1 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE

2 ALABETIK TABLET TABLET

3 ALLOPURINOL TABLET 100 MG TABLET

4 ALPRAZOLAM 1 MG TABLET TABLET

5 AMBROXOL SIRUP 5MG/ML BOTOL

6 AMBROXOL TABLET 30 MG TABLET

7 AMINOPHYLLINE TABLET 200 MG TABLET

8 AMITRIPTYLLINE HCL TABLET 25 MG TABLET

9 AMLODIPINE TABLET 10 MG TABLET

10 AMLODIPINE TABLET 5 MG TABLET

11 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL

12 AMOKSISILIN TABLET 500 MG KAPLET

13 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET

14 ANTASIDA DOEN TABLET KOMBINASI TABLET

15 ANTASIDA SUSPENSI 60 ML BOTOL

16 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT

17 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT

18 ANTI HAEMOROID DOEN KOMBINASI SUPP.

19 ANTI INFLUENZA (EMFLU) KOMBINASI TAB TABLET

22 ANTI SPASMODIK TABLET (DORMICOMP) TABLET

23 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET

24 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET

25 ASAM FOLAT 1MG TABLET TABLET

26 ASAM MEFENAMAT TABLET 500 MG TABLET

27 ASAM TRANEKSAMAT 500 MG TABLET TABLET

30 ASEPTIC GEL 500CC + DISPENSER BOTOL

31 ASERING (ASETAT RINGER) SOFT BAG BOTOL

32 ASETOSAL TABLET 100 (80) MG TABLET

33 ASIKLOVIR KREAM 5 % 5 GR TUBE

34 ASIKLOVIR TABLET 400 MG TABLET

35 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET TABLET

36 BETAHISTINMESILAT 6 MG TABLET TABLET

37 BETAMETHASONE CREAM 0,1 % 5 GR TUBE

38 BISAKODIL ( BICOLAX ) TABLET 5 MG TABLET

39 BISAKODIL SUPPOSITORIA 10 MG SUPP.

40 BISAKODIL SUPPOSITORIA 5 MG SUPP.

41 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET

42 BISOPROLOL 5 MG TABLET TABLET

43 BROMHEXINE SIRUP (HUSTAB) BOTOL

44 DEKSAMETHASONE TABLET 0,5 MG TABLET

45 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL

48 DIAZEPAM TABLET 5 MG TABLET

49 DIGOXIN TABLET 0,25 MG TABLET

50 DIMENHYDRINATE TABLET 50 MG TABLET

51 DOKSISIKLIN TABLET 100 MG KAPSUL

52 DOMPERIDON SUSPENSI 5MG/ML BOTOL

53 DOMPERIDON TABLET 10 MG TABLET

56 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL

57 ERITROMISIN TABLET 500 MG KAPSUL

58 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL

59 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL

60 FENITOIN NATRIUM TABLET 100 MG KAPSUL

61 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL

62 FENOBARBITAL TABLET 30 MG TABLET

63 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL

64 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG TABLET

65 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML AMPUL

66 FUROSEMID TABLET 40 MG TABLET

69 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE

70 GENTAMISIN SALEP MATA 0,3% TUBE