INSTALASI FARMASI

RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN NOPEMBER 2019

SISA
JMLH
NO NAMA BARANG SATUAN STOCK JMLH KEBUTUHAN + 20 %
PEMAKAIAN
AKHIR
Alkes
1 BISTURI 11 Buah 1 1
2 BISTURI 15 Buah 1 1
3 CAPSUL KOSONG 0 Buah 352 1000
4 CAPSUL KOSONG 00 Buah 717 1000
5 CAPSUL KOSONG 1 Buah 40 0
6 CAPSUL KOSONG 2 Buah 160 0
7 CAPSUL KOSONG 3 Buah 39 0
8 COLOSTOMY BAG Buah 1 1
9 DISPOSIBLE 1 CC STERA Buah 1 1
10 DISPOSIBLE 10 CC JMI Buah 1 1
11 DISPOSIBLE 20 CC TERUMO Buah 2 2
12 DISPOSIBLE 3 CC JMI Buah 3 4
13 DISPOSIBLE 5 CC JMI Buah 3 4
14 DISPOSIBLE 50 CC TERUMO Buah 3 4
15 FIXOMUL 5X5 CM Rol 1 1
16 KASSA STERIL 16X16 CM Pak 3 4
17 FOLLEY CATHETER 16 CHROMA Buah 0 0
18 MONOSOF 6-0 SN-667 Buah 2 2
19 NEEDLE G 19 TERUMO Buah 1 1
20 NOVOPEN NEEDLE 32 G Buah 0 0
21 OPSITE 15,5 X 8,5 Lembar 2 2
22 OPSITE 9,5 X 8,5 Lembar 1 0
23 OPSITE 6,5X5 Lembar 2 0
24 OPTIME 4/0 TAPER Buah 2 0
25 POLYSORB 4-0 TAPER UL - 203 Buah 2 2
26 POT PLASTIK 100 GR Buah 3 0
27 POT PLASTIK 30 GR Buah 1 0
28 SOFT SILK 2-0 GS-453 ( CV 24 ) Buah 1 0
29 SOFT BAND 4 INC Buah 1 1
30 TENSOCREPE 4 INC / 10 CM Rol 1 1
31 TRANSOFIX Buah 0 0
32 URINE BAG TROGE Buah 3 0
33 WING NEEDLE 21 JMS Buah 1 0

Obat
1 ACARBOSE TAB 100 MG (F) Tabl 501 0
2 ACARBOSE TAB 50 MG (F) Tabl 395 90 0
3 ACETYLCYSTEIN 200 MG Caps 60
4 ALOPURINOL TAB 100 MG OGB (F) Tabl 400 240 0
5 ALOPURINOL TAB 300 MG OGB (F) Tabl 294 100 0
6 ALPENTIN CAP 100 MG (F2) Caps 127 164 100
7 AMBROXOL TAB 30 MG OGB (F) Tabl 234 63 0
8 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 377 228 0
9 AMLODIPIN TAB 10 MG OGB (F) Tabl 221 619 500
10 AMLODIPIN TAB 5 MG OGB (F) Tabl 2 300
11 AMOXYCILLIN 500 MG Tabl 15 100
12 AMOXSAN CAPS 500 MG Caps 16 0
13 ANALSIK TAB Tabl 445 215 0
14 ANEMOLAT TAB 1 MG Tabl 305 600
15 ANGINTRIZ MR Tabl 120
16 ANTACIDA DOEN Fles 2 2
17 APISATE Tabl 240
18 ATORVASTATIN TAB 20 MG (F) Tabl 194 205 150
19 AZITHROMYCIN TAB 500 MG (F) Tabl 85 15 0
20 AKILEN TT FLES 2
21 ALPRAZOLAM 0,5 MG Tabl 131 69 100
22 ARDIUM Tabl 60
23 ARTOFLAM Tabl 30
24 ASAM FOLAT 1 MG Tabl 500
25 ASAM TRANEKSAMAT 500 MG Tabl 1 100
26 ASTHIN FORCE Tabl 60
27 AZOMAX 500 MG Tabl 57 3 0
28 BAMGETOL 200 MG Tabl 103 200
29 BETAHISTINE TAB 6 MG OGB (F) Tabl 286 279 0
30 BETASERC 24 MG Tabl 60
31 BISOPROLOL TAB 5 MG OGB (F) Tabl 105 0
32 BRAIN ACT ODIS Tabl 120
33 BRAINACT TAB 500 MG Tabl 14 45 60
34 BRAXIDIN TAB Tabl 171 0
35 CALOREASE Tabl 200
36 CALOS TAB Tabl 70 120
37 CAMELOC TAB 15 MG (F2) Capl 235 135 100
38 CANDOTENS 8 MG Tabl 120
39 CANDESARTAN TAB 16 MG (F) Tabl 275 700 600
40 CANDESARTAN TAB 8 MG (F) Tabl 101 510 500
41 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl 300
42 CARTYLO Tabl 255 45 0
43 CAR-Q CAPS Caps 30
44 CATAFLAM 50 MG Tabl 100
45 CATAFLAM FASH SACHET 50
46 CEFADROXYL CAPS 500 MG OGB (F) Caps 89 8 0
47 CEFIXIME CAPS 100 MG (F) Tabl 262 272 100
48 CEFIXIME SYR 100 MG/5 ML 30 ML OGB (F) Fls 3 4
49 CEFSPAN 100 MG Caps 10 70 100
50 CEFSPAN TAB 200 MG Tabl 50 100
51 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 278 102 0
52 CHANNA Tabl 150 0
53 CHLORPENIRAMIN MALEAT TAB 4 MG OGB (F) Tabl 88 5 0
54 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 366 285 0
55 CITICOLIN TAB 1000 MG Tabl 70 15 0
56 CITICOLIN TAB 500 MG Tabl 84 290 300
57 CLANEKSI FORTE SYR FLES 1 1
58 CLINDAMYCIN CAPS 150 MG OGB (F) Caps 110 0
59 CLINDAMYCIN CAPS 300 MG (F) Caps 70 140 100
60 CLOBAZAM TAB 10 MG OGB (F) Tabl 161 289 200
61 CLOPIDOGREL TAB 75 MG (F) Tabl 158 210 300
62 CLOZAPINE 100 MG TAB (F) Tabl 75 0
63 CLOZAPINE 25 MG TAB (F) Tabl 269 90 0
64 CO AMOXICLAVE 625 MG Tabl 65 120
65 CODEIN TAB 10 MG OGB ( F ) Tabl 264 24 0
66 CODEIN TAB 20 MG OGB ( F ) Tabl 215 333 200
67 CODIPRONT Caps 13 100
68 CODIPRONT CUM EXP CAPS Caps 15 40 30
69 CODITAM TAB 30 MG Tabl 256 115 0
70 CONCOR TAB 2,5 MG Tabl 126 535 500
71 COXIRON FC TABLET 60 MG Tabl 6 35 90
72 COXIRON FC TABLET 90 MG Tabl 90
73 CPG TAB 75 MG Tabl 42 185 300
74 CRAVIT TAB 500 MG Tabl 12 0
75 CURCUMA TAB Tabl 145 55 0
76 DARYANTULLE (F2) Lembar 1 10
77 DEPAKOTE ER TAB 500 MG (F2) Tabl 81 101 100
78 DEPAKOTE TAB 250 MG (F2) Tabl 199 225 100
79 DEPAKOTE ER 250 MG Tabl 30 100
80 DESOXIMETASONE 0,25 CREAM 15 GR (F) Tube 4 1 0
81 DIAZEPAM TAB 2 MG OGB (F) Tabl 16 394 500
82 DIAZEPAM TAB 5 MG OGB (F) Tabl 100
83 DIAMICRON MR 60 MG Tabl 37 60
84 DIGOXIN TAB 0,25 MG OGB (F) Tabl 491 28 0
85 DOGESIC 500 MG TAB (F) Tabl 556 505 100
86 DOMPERIDON TAB 10 MG OGB (F) Tabl 124 195 100
87 DOGMATIL Tabl 100
88 DOPEPSA SYR 100 ML (F2) Botol 27 29 20
89 ECLID 100 MG Tabl 100
90 ELIZAC 20 MG Caps 60
91 ENYSTIN DROP Fles 2 2
92 EPERISONE TAB Tabl 24 61 100
93 ETORICOXIB 60 MG Tabl 2 100
 94 ETORICOXIB 90 MG Tabl 100
95 ETHAMBUTOL TAB 500 MG OGB (F) Tabl 228 72 0
96 EYEFRESH PLUS MD PAK 6 9 5
97 EYEFRESH MD PAK 20
98 EXAFLAM TAB 50 MG (F) Tabl 50
99 FARGOXIN TAB Tabl 75 0
100 FENOFIBRATE 100 MG Tabl 20 30
101 FLOXA MD 0,6 ML TM Strip 18 50
102 FLOXA TM 5 ML Fls 1 15
103 FLUNARIZINE TAB 5 MG (F) Tabl 166 379 500
104 FORNEURO TAB (F) Tabl 41 73 60
105 FREGO 10MG TAB Tabl 1 100
106 FUROSEMIDA TAB @200 Tabl 259 553 400
107 GABAPENTIN CAPS 300 MG (F) Caps 354 279 0
108 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube 1 2 2
109 GLIMEPIRIDE TAB 1 MG OGB (F) Tabl 30 100
110 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl 113 0
111 GLIQUIDONE TAB 30 MG OGB (F) Tabl 130 350 300
112 GLUCOPHAGE TAB 500 MG Tabl 20 100
113 GLUCOSAMIN CAPS 250 MG Caps 410 150 0
114 GLUTROP CAPS Caps 10 180
115 HALOPERIDOL 1,5 MG Tabl 60 100
116 HALOPERIDOL 5 MG Tabl 60 100
117 HARNAL OCAS CAPS 0,4 MG (F) Caps 150 44 0
118 HEPABALANCE CAPS Caps 120
119 HEXYMER 2 MG Tabl 500
120 IBUPROFEN SIRUP Botol 1
121 IBUPROFEN TAB 400 MG OGB ( F ) Tabl 197 239 100
122 INBUMIN Caps 138 150 600
123 IOPAMIRO 370 / 50 ML Botol 1 1
124 ISONIAZID TAB 300 MG OGB (F) Tabl 154 140 0
125 ISOSORBID DINITRAT TAB 5 MG OGB (F) Tabl 219 195 0
126 ITRACONAZOLE CAPS 100 MG (F) Caps 66 50
127 KALTROFEN TAB 50 MG Tabl 88 0
128 KALXETIN CAPS 20 MG Caps 60
129 KENALOG IN ORABASE Tube 1 1
130 KETOKONAZOLE CREAM 2% 10 GR OGB (F) Tube 5 0
131 KETOPROFEN TAB 100 MG OGB (F) Tabl 50 35 0
132 KETOROLAC TAB 10 MG OGB Tabl 90 16 0
133 KLODERMA CREAM 10 GR Tube 4 9 6
134 KSR ALUFOIL CAPS 600 MG (F) Caps 20 30 100
135 LFX 5 ML TM FLES 8 11 4
136 LAKTULOSA SYR 60 ML (F) Botol 3 3 0
137 LANCID CAPS 30 MG Caps 22 80 200
138 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 463 409 0
139 LEVEMIR FLEXPEN Ampul 4 0
140 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 35 5 0
141 LIDOCAIN COMPOSITUM INJ (F) Ampul 5 8 0
142 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 3 1 0
143 LYTEERS TM 15 ML Fls 5 1 0
144 LUVOX Tabl 100
145 MELOXICAM TAB 7,5 MG (F) Tabl 139 119 0
146 METFORMIN TAB 500 MG OGB (F) Tabl 722 374 0
147 METHYLPREDNISOLON TAB 16 MG (F) Tabl 21 200
148 METHYLPREDNISOLON TAB 4 MG OGB (F) Tabl 56 400 500
149 METHYLPREDNISOLON TAB 8 MG OGB (F) Tabl 0 100
150 METRONIDAZOL TAB 500 MG OGB (F) Tabl 140 120 0
151 MICARDIS TAB 40 MG (F) Tabl 98 10 0
152 MINIASPI 80MG TAB (F) Tabl 61 259 300
153 MOFACORT CREM Tube 2
154 MST CONTINOUS 10 MG Tabl 43 100
155 MUCOSTA TAB 100 MG Tabl 154 60 0
156 MYCOS SM 3,5 GR Tube 7 10
157 MYCETIN ZM Tube 3 0
158 MYORES TAB ( F ) Tabl 93 300
159 NACL 0,9% OGB INF 500 ML Botol 5 2 0
160 NATRIUM BICARBONAT TAB 500 MG OGB (F) Tabl 590 655 100
161 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl 113 40 0
162 NEULIN PS Tabl 20 0
163 NEURODEX TAB Tabl 190 110 200
164 NEVOX XR 500MG Tabl 10 100
165 NEW DIATAB TAB (F2) Tabl 137 16 0
166 NEXURIN Tabl 13 100
167 NITROKAF RETARD TAB (F) Tabl 110 120 100
168 NONCORT MD (F2) Strip 20 2 0
169 NOROID LOTION Botol 3 3 0
170 NOTISIL 2 MG TAB Tabl 85 30 0
171 NOVORAPID FLEX PEN Buah 1 0
172 NUDEP TAB 50 MG Tabl 30 30 100
173 NUTRIFLAM CAPS Caps 101 143 180
174 NYSTATIN DROP Fls 2
175 OBH 100 ML Fls 1 1
176 OFLOXACIN TAB 200 MG OGB (F) Tabl 34 0
177 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 266 714 600
178 ONDANCETRON TAB 4 MG (F) Tabl 183 66 0
179 ORINOX TABLET 120 MG Tabl 0
180 P PRED MD 10 MG/0.6 ML (F2) Strip 15 31 50
181 PANTOPRAZOLE 20 MG Tabl 28 17 0
182 PARACETAMOL SYR 120 MG/5 ML 60 ML OGB (F Fls 2 1 0
183 PARACETAMOL TAB 500 MG (F) Tabl 262 226 0
184 PHENYTOIN CAPS (F) Caps 351 305 0
185 PIROTOP CREAM 5 GRAM Tube 6 7 0
186 PIRACETAM 400 MG Caps 100
187 PIRACETAM 800 MG Caps 100
188 PIROXICAM CAPS 20 MG OGB Caps 235 32 0
189 POLYDEX MDS 0,6 ML TM @5 s Fls 1 2
190 POLYDEX TM 5 ML Fls 2 2
191 POSAFIT Tabl 100
192 PRAXILLENE 200 MG TAB Tabl 72 0
193 PREGABALIN 75 MG Caps 251 258 600
194 PROFOLAT 0,4 MCG Tabl 270 500
195 PROPANOLOL TAB 10 MG OGB (F) Tabl 60 100
196 PRORENAL Tabl 500
197 PROSTAM SR TAB Tabl 6 100
198 PROVELYN 75 MG TAB Tabl 82 600
199 PYRAZINAMID TAB 500 MG OGB (F) Tabl 424 12 0
200 RAMIPRIL TAB 2,5 MG (F) Tabl 182 90 0
201 RAMIPRIL TAB 5 MG (F) Tabl 203 90 0
202 RANITIDIN TAB 150 MG OGB (F) Tabl 345 170 0
203 REDACID Tabl 100
204 RENALOF TAB Tabl 4 75 100
205 RETAPHYL SR CAPL Capl 118 5 0
206 RIFAMPICIN TAB 450 MG OGB (F) Tabl 237 134 0
207 RIFAMPICIN TAB 600 MG OGB (F) Tabl 0
208 RINCOBAL 500MCG Tabl 851 678 0
209 RISPERIDONE TAB 2 MG OGB (F) Tabl 534 110 0
210 SALBUTAMOL TAB 2 MG OGB Tabl 81 38 0
211 SANMOL DROP Fls 2
212 SANTA E Tabl 100
213 SEROQUEL XR TAB 200 (F) Tabl 10 30
214 SEROQUEL XR TAB 300 (F) Tabl 30 60
215 SILEX SYRUP FLES 1 0
216 SIBITAL TAB 50 MG (F2) Tabl 91 30 0
217 SIFROL ER TAB 0,375 MG (F2) Tabl 60
218 SIFROL ER TAB 0,75 MG (F2) Tabl 60
219 SOPAVEL 10 MG Tabl 15 100
220 SIMARC 2 MG Tabl 100 150 100
221 SIMVASTATIN 10 MG Tabl 100
222 SIMVASTATIN 20 MG Tabl 100
223 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 2 2
224 SODIUM VALPROAT Fls 1 0
225 SPIROLA TAB 100 MG Tabl 178 0
226 SPIROLA TAB 25 MG Tabl 25 10 0
227 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 125 98 0
228 STALEVO TAB 100 MG (F) Tabl 68 140 300
229 STARFER CAPS Caps 45 0
230 STELOSI TAB 5 MG (F2) Tabl 28 60 100
231 STOBLED CAPS (F) Caps 23 0
232 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls 2 0
233 THYROZOL TAB 5 MG (F) Tabl 50 30 0
234 TOPAMAX TAB 25 MG Tabl 60 60
235 TORASIC TAB Tabl 30 100
236 TRAJENTA Tabl 60
237 TRACETATE TABLET 160 MG Capl 20
238 TREMENZA TAB Tabl 4 60
239 TRIFACALC TAB 500 MG Tabl 100 105 100
240 TRIHEXYPHENIDIL 2 MG Tabl 240 300
241 TRINOLON TAB 4 MG Tabl 15 0
242 UROTRACTIN TAB 400 MG Tabl 28 100
243 URSODEOXYCHOLIC ACID 250 MG (F) Caps 105 200
244 V BLOC TAB 6,25 MG (F) Tabl 45 90
245 V BLOC TAB 25 MG (F) Tabl 55 30 0
246 VITAMIN B COMPLEX TAB OGB Tabl 191 250 100
247 VITAMIN B6 TAB 10 MG OGB Tabl 100
248 VITAMIN C TAB 50 MG OGB Tabl 237 30 0
249 VITAMIN K TAB /PHYTOMENADION TAB 10MG Tabl 80 105 100

PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON, 4 NOPEMBER 2019

KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI

SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH

NIP 19710717 199203 2 005 NIP 19671230 198803 2 003
INSTALASI FARMASI
RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN MEI 2020

JMLH JMLH
SISA JMLH
TAMBA KEBUTU KEBUTU
NO NAMA BARANG SATUAN STOCK PEMAKA
H 20 % HAN + HAN +
AKHIR IAN 20 % 20 %
Alkes
1 BISTURI 11 Buah 0 0 0 0
2 BISTURI 15 Buah 0 0 0 0
3 CAPSUL KOSONG 0 Buah 569 -569 -114 -683 0
4 CAPSUL KOSONG 00 Buah 0 0 0 0
5 CAPSUL KOSONG 1 Buah 102 -102 -20 -122 0
6 CAPSUL KOSONG 2 Buah 30 -30 -6 -36 0
7 CAPSUL KOSONG 3 Buah 230 -230 -46 -276 0
8 COLOSTOMY BAG Buah 1 -1 0 -1 0
9 DISPOSIBLE 1 CC STERA Buah 0 0 0 1
10 DISPOSIBLE 10 CC JMI Buah 0 0 0 1
11 DISPOSIBLE 20 CC TERUMO Buah 0 0 0 0
12 DISPOSIBLE 3 CC JMI Buah 5 -5 -1 -6 1
13 DISPOSIBLE 5 CC JMI Buah 0 0 0 0
14 DISPOSIBLE 50 CC TERUMO Buah 0 0 0 0
15 FIXOMUL 5X5 CM Rol 0 0 0 1
16 KASSA STERIL 16X16 CM Pak 2 -2 0 -2 5
17 FOLLEY CATHETER 16 CHROMA Buah 0 0 0 1
18 MONOSOF 6-0 SN-667 Buah 0 0 0 0
19 NEEDLE G 19 TERUMO Buah 0 0 0 0
20 NOVOPEN NEEDLE 32 G Buah 5 -5 -1 -6 0
21 OPSITE 15,5 X 8,5 Lembar 0 0 0 0
22 OPSITE 9,5 X 8,5 Lembar 0 0 0 0
23 OPSITE 6,5X5 Lembar 0 0 0 0
24 OPTIME 4/0 TAPER Buah 0 0 0 0
25 POLYSORB 4-0 TAPER UL - 203 Buah 0 0 0 0
26 POT PLASTIK 100 GR Buah 0 0 0 1
27 POT PLASTIK 30 GR Buah 0 0 0 1
28 SOFT SILK 2-0 GS-453 ( CV 24 ) Buah 0 0 0 0
29 SOFT BAND 4 INC Buah 0 0 0 0
30 TENSOCREPE 4 INC / 10 CM Rol 0 0 0 0
31 TRANSOFIX Buah 1 -1 0 -1 4
32 URINE BAG TROGE Buah 0 0 0 1
33 WING NEEDLE 21 JMS Buah 0 0 0 0
0 0 0
Obat 0 0 0
1 ABILIFY DISCMELT 10 MG Tabl 14 -14 -3 -17 50
 2 ACARBOSE TAB 100 MG (F) Tabl 109 109 22 131 0
3 ACARBOSE TAB 50 MG (F) Tabl 0 0 0 200
4 ACETYLCYSTEIN 200 MG Caps 0 0 0 100
5 ALOPURINOL TAB 100 MG OGB (F) Tabl 16 -16 -3 -19 200
6 ALOPURINOL TAB 300 MG OGB (F) Tabl 185 15 170 34 204 0
7 ALPENTIN CAP 100 MG (F2) Caps 39 205 -166 -33 -199 150
8 ALPRAZOLAM 0,5 MG Tabl 0 0 0 0
9 AMBROXOL SYR 15MG/5ML 0 0 0 1
10 AMBROXOL TAB 30 MG OGB (F) Tabl 231 10 221 44 265 0
11 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 22 -22 -4 -26 0
12 AMLODIPIN TAB 10 MG OGB (F) Tabl 19 45 -26 -5 -31 500
13 AMLODIPIN TAB 5 MG OGB (F) Tabl 6 490 -484 -97 -581 500
14 AMOXYCILLIN 500 MG Tabl 55 55 11 66 0
15 AMOXSAN CAPS 500 MG Caps 0 0 0 0
16 ANALSIK TAB Tabl 138 30 108 22 130 0
17 ANEMOLAT TAB 1 MG Tabl 88 625 -537 -107 -644 0
18 ANGINTRIZ MR Tabl 0 0 0 0
19 ANTACIDA DOEN Fles 0 0 0 0
20 APISATE Tabl 0 0 0 240
21 ATORVASTATIN TAB 10 MG (F) Tabl 0 0 0 150
22 ATORVASTATIN TAB 20 MG (F) Tabl 113 90 23 5 28 150
23 AZITHROMYCIN TAB 500 MG (F) Tabl 100 100 20 120 0
24 AKILEN TT FLES 0 0 0 2
25 ARDIUM Tabl 0 0 0 60
26 ARTOFLAM Tabl 0 0 0 30
27 ASAM FOLAT 1 MG Tabl 0 0 0 500
28 ASAM TRANEKSAMAT 500 MG Tabl 0 0 0 0
ASAM MEFENAMAT 500 MG Tabl 299 10
29 ASTHIN FORCE Tabl 0 0 0 60
30 AZOMAX 500 MG Tabl 0 0 0 0
31 BNS ( BRESTHY NSL SPRAY ) 30 ML Fls 0 0 0 1
32 BAQUINOR 500 MG Tabl 0 0 0 0
33 BAMGETOL 200 MG Tabl 0 0 0 200
34 BETAHISTINE TAB 6 MG OGB (F) Tabl 40 274 -234 -47 -281 0
35 BETASERC 24 MG Tabl 0 0 0 60
36 BETMIGA Tabl 0 0 0 60
37 BISOPROLOL TAB 5 MG OGB (F) Tabl 0 0 0 100
38 BRAIN ACT ODIS Tabl 18 18 4 22 120
39 BRAINACT TAB 500 MG Tabl 98 98 20 118 60
40 BRAXIDIN TAB Tabl 20 -20 -4 -24 0
41 BRILINTA 90 MG Tabl 0 0 0 60
42 CALCIUM LACTAT 500 MG Tabl 262 30 232 46 278 0
43 CALOREASE Tabl 0 0 0 200
44 CALOS TAB Tabl 0 0 0 120
45 CAMELOC TAB 15 MG (F2) Capl 39 15 24 5 29 0
46 CANDOTENS 8 MG Tabl 23 23 5 28 0
47 CANDOTENS 16 MG Tabl 120 120 24 144 0
48 CANDESARTAN TAB 16 MG (F) Tabl 365 420 -55 -11 -66 600
49 CANDESARTAN TAB 8 MG (F) Tabl 391 150 241 48 289 0
50 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl 0 0 0 300
51 CAPTOPRIL 25 MG Tabl 70 15 55 11 66 0
52 CARTYLO Tabl 545 140 405 81 486 100
53 CARDIOMIN Tabl 0 0 0 100
54 CAR-Q CAPS Caps 0 0 0 30
55 CATAFLAM 50 MG Tabl 0 0 0 100
56 CATAFLAM FASH SACHET 0 0 0 50
57 CEFADROXYL CAPS 500 MG OGB (F) Caps 125 125 25 150 0
58 CEFIXIME CAPS 100 MG (F) Tabl 327 152 175 35 210 0
59 CEFIXIME SYR 100 MG/5 ML 30 ML OGB Fls 0 0 0 4
60 CEFSPAN 100 MG Caps 120 120 24 144
61 CEFSPAN TAB 200 MG Tabl 65 65 13 78
CEFTRIAXON 1 G Vial 60
62 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 180 30 150 30 180 0
63 CHANNA Tabl 25 25 5 30 0
64 CHLORPENIRAMIN MALEAT TAB 4 MG O Tabl 90 90 18 108 0
65 CILOSTAZOL 100 MG Tabl 0 0 0 0
66 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 0 0 0 0
67 CITICOLIN TAB 1000 MG Tabl 55 55 11 66 0
68 CITICOLIN TAB 500 MG Tabl 207 180 27 5 32 300
69 CLANEKSI FORTE SYR FLES 0 0 0 1
70 CLINDAMYCIN CAPS 150 MG OGB (F) Caps 50 50 10 60 0
71 CLINDAMYCIN CAPS 300 MG (F) Caps 0 0 0 0
72 CLOBAZAM TAB 10 MG OGB (F) Tabl 25 195 -170 -34 -204 0
73 CLOPIDOGREL TAB 75 MG (F) Tabl 210 258 -48 -10 -58 300
74 CLOZAPINE 100 MG TAB (F) Tabl 57 90 -33 -7 -40 0
75 CLOZAPINE 25 MG TAB (F) Tabl 138 231 -93 -19 -112 0
76 CO AMOXICLAVE 625 MG Tabl 0 0 0 120
77 CODEIN TAB 10 MG OGB ( F ) Tabl 248 -248 -50 -298 0
78 CODEIN TAB 20 MG OGB ( F ) Tabl 455 45 410 82 492 0
79 CODIPRONT Caps 61 61 12 73 0
80 CODIPRONT SYR Fls 0 0 0 1
81 CODIPRONT CUM EXP CAPS Caps 0 0 0 30
CODIPRONT CUM EXP Fles 1 -1 0 -1 30
82 CODITAM TAB 30 MG Tabl 1 75 -74 -15 -89 0
83 CONCOR TAB 2,5 MG Tabl 138 440 -302 -60 -362 500
84 COXIRON FC TABLET 60 MG Tabl 0 0 0 90
85 COXIRON FC TABLET 90 MG Tabl 0 0 0 0
86 CPG TAB 75 MG Tabl 0 0 0 300
87 CRAVIT TAB 500 MG Tabl 0 0 0 0
88 CURCUMA TAB Tabl 334 50 284 57 341 500
89 DARYANTULLE (F2) Lembar 0 0 0 10
90 DEPAKOTE ER TAB 500 MG (F2) Tabl 77 150 -73 -15 -88 0
 91 DEPAKOTE TAB 250 MG (F2) Tabl 0 0 0 400
92 DEPAKOTE ER 250 MG Tabl 38 60 -22 -4 -26 0
93 DESOXIMETASONE 0,25 CREAM 15 GR ( Tube 12 1 11 2 13 0
94 DEPAKENE SIRUP Tabl 0 0 0 1
95 DEXAMETHASONE Tabl 0 0 0 0
96 DIAZEPAM TAB 2 MG OGB (F) Tabl 8 8 0 0 0 200
97 DIAZEPAM TAB 5 MG OGB (F) Tabl 380 69 311 62 373 0
98 DIAMICRON MR 60 MG Tabl 0 0 0 0
99 DIGOXIN TAB 0,25 MG OGB (F) Tabl 356 30 326 65 391 0
100 DOGESIC 500 MG TAB (F) Tabl 0 0 0 100
101 DOMPERIDON TAB 10 MG OGB (F) Tabl 295 10 285 57 342 100
102 DOGMATIL Tabl 0 0 0 100
103 DOPEPSA SYR 100 ML (F2) Botol 0 0 0 20
104 DULCOLAX 5 MG Tabl 0 0 0 100
105 DULCOLAX SUPP BJ 0 0 0 10
106 ECLID 100 MG Tabl 0 0 0 100
107 EFLIN SYR Fles 0 0 0 0
108 ELIZAC 20 MG Caps 0 0 0 60
109 ELOX CREAM 10 GR Tube 0 0 0 1
110 ENYSTIN DROP Fles 0 0 0 0
111 EPERISONE TAB Tabl 96 32 64 13 77 0
EPISAN Fles 8
112 ETORICOXIB 60 MG Tabl 0 0 0 120
113 ETORICOXIB 90 MG Tabl 0 0 0 120
114 ETHAMBUTOL TAB 500 MG OGB (F) Tabl 0 0 0 100
115 EYEFRESH PLUS MD PAK 16 16 3 19 0
116 EYEFRESH MD PAK 0 0 0 20
117 EXAFLAM TAB 50 MG (F) Tabl 0 0 0 50
118 FARGOXIN TAB Tabl 0 0 0 0
119 FENOFIBRATE 100 MG Tabl 0 0 0 30
120 FENOFIBRATE 300 MG Tabl 0 0 0 30
121 FLOXA MD 0,6 ML TM Strip 42 42 8 50 50
122 FLOXA TM 5 ML Fls 0 0 0 15
123 FLUNARIZINE TAB 5 MG (F) Tabl 500 65 435 87 522 500
124 FORNEURO TAB (F) Tabl 0 0 0 60
125 FRAMYCETIN SULFATE Lembar 3 3 1 4 10
126 FREGO 10MG TAB Tabl 457 55 402 80 482 100
127 FUROSEMIDA TAB @200 Tabl 460 105 355 71 426 400
128 GABAPENTIN CAPS 300 MG (F) Caps 254 210 44 9 53 100
GEMFIBROZIL Caps 88 10 78 16 94 0
129 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube 0 0 0 0
130 GENTAMICIN SK 0,1 % 5 GR OGB Tube 0 0 0 0
131 GLIMEPIRIDE TAB 1 MG OGB (F) Tabl 0 0 0 0
132 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl 0 0 0 100
133 GLIQUIDONE TAB 30 MG OGB (F) Tabl 210 -210 -42 -252 0
134 GLUCOPHAGE TAB 500 MG Tabl 0 0 0 100
135 GLUCOSAMIN CAPS 250 MG Caps 33 15 18 4 22 0
136 GLUTROP CAPS Caps 0 0 0 180
137 HALOPERIDOL 1,5 MG Tabl 0 0 0 100
138 HALOPERIDOL 5 MG Tabl 140 174 -34 -7 -41 0
139 HARNAL OCAS CAPS 0,4 MG (F) Caps 0 0 0 180
140 HEPABALANCE CAPS Caps 0 0 0 120
141 HEXYMER 2 MG Tabl 0 0 0 500
142 HISTRIN Tabl 0 0 0 100
143 IBUPROFEN SIRUP Botol 0 0 0 1
144 IBUPROFEN TAB 200 MG OGB ( F ) Tabl 0 0 0 0
145 IBUPROFEN TAB 400 MG OGB ( F ) Tabl 78 10 68 14 82 300
146 IMUNOS Tabl 0 0 0 100
147 INBUMIN Caps 203 203 41 244 0
148 IOPAMIRO 370 / 50 ML Botol 0 0 0 1
149 ISONIAZID TAB 300 MG OGB (F) Tabl 100 40 60 12 72 0
150 ISOSORBID DINITRAT TAB 5 MG OGB ( Tabl 158 220 -62 -12 -74 100
151 ITRACONAZOLE CAPS 100 MG (F) Caps 36 36 7 43 0
152 KALMECO 500 MG Tabl 0 0 0 100
153 KALTROFEN TAB 50 MG Tabl 41 41 8 49 0
154 KALXETIN CAPS 20 MG Caps 69 32 37 7 44 60
155 KENALOG IN ORABASE Tube 0 0 0 1
156 KETOKONAZOLE CREAM 2% 10 GR OGB ( Tube 5 5 1 6 0
157 KETOPROFEN TAB 100 MG OGB (F) Tabl 88 10 78 16 94 0
158 KETOROLAC TAB 10 MG OGB Tabl 158 158 32 190 0
159 KLODERMA CREAM 10 GR Tube 0 0 0 6
160 KSR ALUFOIL CAPS 600 MG (F) Caps 100 100 20 120 100
161 LFX 5 ML TM FLES 0 0 0 30
162 LAKTULOSA SYR 60 ML (F) Botol 1 2 -1 0 -1 4
163 LANCID CAPS 30 MG Caps 277 59 218 44 262 200
164 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 352 -352 -70 -422 200
165 LAXADIN SYR Fls 0 0 0 0
166 LORATADIN Tabl 0 0 0 0
167 LEVEMIR FLEXPEN Ampul 0 0 0 0
168 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 46 29 17 3 20 30
169 LIDOCAIN COMPOSITUM INJ (F) Ampul 0 0 0 0
170 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 0 0 0 0
171 LIPANTHYL PENTA Tabl 0 0 0 0
172 LYTEERS TM 15 ML Fls 1 1 0 1 0
173 LUVOX Tabl 0 0 0 100
MEGABAL Caps 656 403 253 51 304 100
174 MEIACT Tabl 0 0 0 30
175 MELOXICAM TAB 7,5 MG (F) Tabl 121 30 91 18 109 60
MERLOPAM 2 MG Tabl 10 -10 -2 -12 60
176 METFORMIN TAB 500 MG OGB (F) Tabl 264 90 174 35 209 100
177 METHYLPREDNISOLON TAB 16 MG (F) Tabl 236 37 199 40 239 200
178 METHYLPREDNISOLON TAB 4 MG OGB ( Tabl 21 98 -77 -15 -92 500
179 METHYLPREDNISOLON TAB 8 MG OGB ( Tabl 208 208 42 250 100
180 METRONIDAZOL TAB 500 MG OGB (F) Tabl 30 -30 -6 -36 0
181 MICARDIS TAB 40 MG (F) Tabl 16 30 -14 -3 -17 0
182 MINIASPI 80MG TAB (F) Tabl 0 0 0 300
183 MOFACORT CREM Tube 0 0 0 2
184 MOMETHASONE CREAM 5 GR Tube 0 0 0 1
185 MST CONTINOUS 10 MG Tabl 57 30 27 5 32 0
186 MUCOSTA TAB 100 MG Tabl 0 0 0 0
187 MYCOS SM 3,5 GR Tube 0 0 0 0
188 MYCETIN ZM Tube 2 2 0 2 0
189 MYORES TAB ( F ) Tabl 375 100 275 55 330 300
190 NACL 0,9% OGB INF 500 ML Botol 4 2 2 0 2 0
191 NATRIUM BICARBONAT TAB 500 MG OG Tabl 50 500 -450 -90 -540 800
192 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl 25 36 -11 -2 -13 0
193 NEULIN PS Tabl 0 0 0 0
194 NEURODEX TAB Tabl 0 0 0 200
195 NEVOX XR 500MG Tabl 0 0 0 100
196 NEW DIATAB TAB (F2) Tabl 111 111 22 133 0
197 NEXURIN Tabl 0 0 0 100
198 NITROKAF RETARD TAB (F) Tabl 100 90 10 2 12 0
199 NONCORT MD (F2) Strip 30 30 6 36 0
200 NOROID LOTION Botol 0 0 0 0
201 NOTISIL 2 MG TAB Tabl 200 200 40 240 0
202 NOVORAPID FLEX PEN Buah 5 5 1 6 0
203 NUDEP TAB 50 MG Tabl 75 15 60 12 72 100
204 NUTRIFLAM CAPS Caps 0 0 0 180
205 NYSTATIN DROP Fls 0 0 0 2
206 OBH 100 ML Fls 0 0 0 1
207 OFLOXACIN TAB 200 MG OGB (F) Tabl 123 30 93 19 112 0
208 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 238 62 176 35 211 700
209 ONDANCETRON TAB 4 MG (F) Tabl 75 14 61 12 73 20
210 ORINOX TABLET 90 MG Tabl 0 0 0 0
211 ORINOX TABLET 120 MG Tabl 0 0 0 0
212 OSFIT Tabl 170 170 34 204 0
213 OTILON TT 8 ML Fls 5 1 4 1 5 0
214 P PRED MD 10 MG/0.6 ML (F2) Strip 33 33 7 40 50
215 PANTOPRAZOLE 20 MG Tabl 0 0 0 0
216 PARACETAMOL SYR 120 MG/5 ML 60 ML Fls 0 0 0 0
217 PARACETAMOL TAB 500 MG (F) Tabl 300 374 -74 -15 -89 100
218 PARIET 10 MG Tabl 0 0 0 100
219 PHENOBARBITAL 30 MG Tabl 75 60 15 3 18 100
220 PHENYTOIN CAPS (F) Caps 100 60 40 8 48 0
221 PIROTOP CREAM 5 GRAM Tube 6 6 1 7 0
222 PIRACETAM 400 MG Caps 0 0 0 100
223 PIRACETAM 800 MG Caps 0 0 0 100
224 PIROXICAM CAPS 20 MG OGB Caps 221 10 211 42 253 0
225 POLYDEX MDS 0,6 ML TM @5 s Fls 3 3 1 4 6
226 POLYDEX TM 5 ML Fls 0 0 0 6
227 POSAFIT Tabl 0 0 0 100
228 PRAXILLENE 200 MG TAB Tabl 142 142 28 170 0
229 PREGABALIN 75 MG Caps 0 0 0 600
230 PROFOLAT 0,4 MCG Tabl 0 0 0 700
231 PROPANOLOL TAB 10 MG OGB (F) Tabl 185 185 37 222 0
232 PRORENAL Tabl 0 0 0 300
233 PROSTAM SR TAB Tabl 0 0 0 0
234 PROVELYN 75 MG TAB Tabl 326 159 167 33 200 600
235 PYRAZINAMID TAB 500 MG OGB (F) Tabl 0 0 0 0
236 Q TEN 100 Tabl 0 0 0 0
237 RAMIPRIL TAB 2,5 MG (F) Tabl 583 360 223 45 268 0
238 RAMIPRIL TAB 5 MG (F) Tabl 210 90 120 24 144 0
239 RANITIDIN TAB 150 MG OGB (F) Tabl 120 139 -19 -4 -23 0
240 REDACID Tabl 0 0 0 100
241 RENALOF TAB Tabl 0 0 0 100
242 RETAPHYL SR CAPL Capl 52 5 47 9 56 0
243 RIFAMPICIN TAB 450 MG OGB (F) Tabl 60 58 2 0 2 100
244 RIFAMPICIN TAB 600 MG OGB (F) Tabl 0 0 0 0
245 RINCOBAL 500MCG Tabl 0 0 0 200
246 RISPERIDONE TAB 2 MG OGB (F) Tabl 564 480 84 17 101 0
SAGESTAM 80 MG Ampul 2 1 1 0 1
247 SALBUTAMOL TAB 2 MG OGB Tabl 178 8 170 34 204 0
248 SANMOL DROP Fls 0 0 0 2
249 SANDEPRIL 50 MG Tabl 14 -14 -3 -17 0
250 SANTA E Tabl 0 0 0 100
251 SEROQUEL XR TAB 200 (F) Tabl 22 -22 -4 -26 30
252 SEROQUEL XR TAB 300 (F) Tabl 60 -60 -12 -72 60
253 SEROQUEL XR TAB 400 (F) Tabl 30 30 6 36 60
254 SILOXAN TM Fls 0 0 0 4
255 SILEX SYRUP FLES 0 0 0 1
256 SIBITAL TAB 50 MG (F2) Tabl 0 0 0 0
257 SIFROL ER TAB 0,375 MG (F2) Tabl 215 215 43 258 0
258 SIFROL ER TAB 0,75 MG (F2) Tabl 186 186 37 223 0
259 SODIUM VALPROAT SYR Fls 0 0 0 0
260 SOPAVEL 10 MG Tabl 1 30 -29 -6 -35 0
261 SILOXAN TM Fls 0 0 0 0
262 SIMARC 2 MG Tabl 0 0 0 100
263 SIMVASTATIN 10 MG Tabl 150 150 30 180 100
264 SIMVASTATIN 20 MG Tabl 0 0 0 0
265 SINKRONIK Tabl 0 0 0 0
266 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 4 4 0 0 0 2
267 SODIUM VALPROAT Fls 0 0 0 0
268 SPIROLA TAB 100 MG Tabl 161 161 32 193 0
269 SPIROLA TAB 25 MG Tabl 0 0 0 60
270 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 360 180 180 36 216 0
SPIRONOLACTONE TAB 100 MG OGB (F) Tabl 346 15 331 66 397 0
271 STALEVO TAB 100 MG (F) Tabl 153 153 31 184 300
272 STARFER CAPS Caps 0 0 0 100
273 STELOSI TAB 5 MG (F2) Tabl 0 0 0 0
274 STOBLED CAPS (F) Caps 12 12 2 14 0
275 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls 0 0 0 0
TEGRETOL 200 MG Tabl 86 60 26 5 31 0
276 THYROZOL TAB 5 MG (F) Tabl 70 120 -50 -10 -60 0
277 THYROZOL TAB 10 MG (F) Tabl 0 0 0 0
278 THROMBO ASPILET Tabl 0 0 0 0
279 TIMOL 0,5 %TM 5 ML Fls 0 0 0 1
280 TOBROSON MD Strip 0 0 0 0
281 TOPAMAX TAB 25 MG Tabl 140 140 28 168 0
282 TORASIC TAB Tabl 84 16 68 14 82 100
283 TORREX Tabl 0 0 0 100
284 TRAJENTA Tabl 0 0 0 60
285 TRACETATE TABLET 160 MG Capl 0 0 0 20
TRAMADOL 50 MG Caps 79 85 -6 -1 -7 0
286 TRAMPARA Tabl 0 0 0 0
287 TREMENZA TAB Tabl 0 0 0 60
288 TRIFACALC TAB 500 MG Tabl 0 0 0 100
289 TRIFED Tabl 0 0 0 0
290 TRIHEXYPHENIDIL 2 MG Tabl 0 0 0 300
291 TRINOLON TAB 4 MG Tabl 0 0 0 0
292 ULTRACET Tabl 0 0 0 0
293 UROTRACTIN TAB 400 MG Tabl 96 96 19 115 0
294 URSODEOXYCHOLIC ACID 250 MG (F) Caps 129 129 26 155 0
295 VESICARE 5 MG Tabl 0 0 0 0
296 V BLOC TAB 6,25 MG (F) Tabl 260 180 80 16 96 0
297 V BLOC TAB 25 MG (F) Tabl 25 30 -5 -1 -6 0
298 VIP ALBUMIN Caps 0 0 0 0
299 VITAMIN B COMPLEX TAB OGB Tabl 28 28 6 34 0
300 VITAMIN B6 TAB 10 MG OGB Tabl 115 30 85 17 102 0
301 VITAMIN C TAB 50 MG OGB Tabl 152 152 30 182 0
302 VITAMIN K TAB /PHYTOMENADION 10 Tabl 190 190 38 228 100
303 XANDA SIRUP Tabl 0 0 0 100
304 XEPAZYM Tabl 0 0 0 0
305 ZITANID 2 MG Tabl 0 0 0 0
perencanaan obat dan alkes 2019

PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON, 8 MEI 2020

KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI
SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH
NIP 19710717 199203 2 005 NIP 19671230 198803 2 003
 JMLH
KEBUTU
HAN +
20 %

0
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1000
1000
1000
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200
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100
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150
100
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100
200
500
500
0
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200
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240
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0
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120
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0
 0
600
400
400
0
300
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0
0
0
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0
0
100
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100
100
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0
0
0
50
50
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0
0
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100
400
100
0
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100
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100
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2
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0
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 20
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700
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100
100
100
100
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100
100
0
100
0
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100

0
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0
100
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100
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40
0
0
20
100
100
100
100
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100
0
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100
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100
500
0
100
60
100
60
100
0
150
0
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100
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100
0
INSTALASI FARMASI
RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN NOPEMBER 2020

SISA STOCK JMLH

NO NAMA BARANG SATUAN AKHIR OKTOBER PEMAKAIAN
20 OKTOBER 20

Alkes
1 BISTURI 11 Buah
2 BISTURI 15 Buah
3 CAPSUL KOSONG 0 Buah
4 CAPSUL KOSONG 00 Buah
5 CAPSUL KOSONG 1 Buah
6 CAPSUL KOSONG 2 Buah
7 CAPSUL KOSONG 3 Buah
8 COLOSTOMY BAG Buah
9 DISPOSIBLE 1 CC STERA Buah
10 DISPOSIBLE 10 CC JMI Buah
11 DISPOSIBLE 20 CC TERUMO Buah
12 DISPOSIBLE 3 CC JMI Buah
13 DISPOSIBLE 5 CC JMI Buah
14 DISPOSIBLE 50 CC TERUMO Buah
15 FIXOMUL 5X5 CM Rol
16 KASSA STERIL 16X16 CM Pak
17 FOLLEY CATHETER 16 CHROMA Buah
18 MONOSOF 6-0 SN-667 Buah
19 NEEDLE G 19 TERUMO Buah
20 NOVOPEN NEEDLE 32 G Buah
21 OPSITE 15,5 X 8,5 Lembar
22 OPSITE 9,5 X 8,5 Lembar
23 OPSITE 6,5X5 Lembar
24 OPTIME 4/0 TAPER Buah
25 POLYSORB 4-0 TAPER UL - 203 Buah
26 POT PLASTIK 100 GR Buah
27 POT PLASTIK 30 GR Buah
28 SOFT SILK 2-0 GS-453 ( CV 24 ) Buah
29 SOFT BAND 4 INC Buah
30 TENSOCREPE 4 INC / 10 CM Rol
31 TRANSOFIX Buah
32 URINE BAG TROGE Buah
33 WING NEEDLE 21 JMS Buah

Obat
1 ABILIFY DISCMELT 10 MG Tabl 26 30
2 ACARBOSE TAB 100 MG (F) Tabl 201
3 ACARBOSE TAB 50 MG (F) Tabl 210
4 ACETYLCYSTEIN 200 MG Caps 45 15
5 ALOPURINOL TAB 100 MG OGB (F) Tabl 255 135
6 ALOPURINOL TAB 300 MG OGB (F) Tabl 145
7 ALPENTIN CAP 100 MG (F2) Caps 133 61
8 ALPRAZOLAM 0, 25 MG Tabl
9 ALPRAZOLAM 0,5 MG Tabl
10 AMBROXOL SYR 15MG/5ML Fles
11 AMBROXOL TAB 30 MG OGB (F) Tabl 104 20
12 AMINEFRON Tabl 276 30
13 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 4
14 AMLODIPIN TAB 10 MG OGB (F) Tabl 347 118
15 AMLODIPIN TAB 5 MG OGB (F) Tabl 352 30
16 AMOXYCILLIN 500 MG Fles 20 20
17 AMOXSAN CAPS 500 MG Caps
18 ANALSIK TAB Tabl 50
19 ANEMOLAT TAB 1 MG Tabl 500
20 ANGINTRIZ MR Tabl 185 35
21 ANTACIDA DOEN Fles
22 APISATE Tabl
23 ATORVASTATIN TAB 10 MG (F) Tabl
24 ATORVASTATIN TAB 20 MG (F) Tabl 120 120
25 AZITHROMYCIN TAB 500 MG (F) Tabl 45 5
26 AKILEN TT Fles
27 ARDIUM Tabl
28 ARTOFLAM Tabl
29 ASAM FOLAT 1 MG Tabl 487 600
30 ASAM TRANEKSAMAT 500 MG Tabl
31 ASAM MEFENAMAT 500 MG Tabl 211 15
32 ASTHIN FORCE Tabl
33 AZOMAX 500 MG Tabl 44
34 BNS ( BRESTHY NSL SPRAY ) 30 ML Fls
35 BAQUINOR 500 MG Tabl
36 BAMGETOL 200 MG Tabl
37 BETAHISTINE TAB 6 MG OGB (F) Tabl 345 120
38 BETASERC 24 MG Tabl 60
39 BETMIGA Tabl
40 BISOPROLOL TAB 5 MG OGB (F) Tabl
41 BRAIN ACT ODIS Tabl 56
42 BRAINACT TAB 500 MG Tabl 130
43 BRAXIDIN TAB Tabl 30 40
44 BRILINTA 90 MG Tabl
45 CALCIUM LACTAT 500 MG Tabl 277 55
46 CALOREASE Tabl
47 CALOS TAB Tabl 80 10
48 CAMELOC TAB 15 MG (F2) Capl 53 20
49 CANDOTENS 8 MG Tabl 78 75
50 CANDOTENS 16 MG Tabl 75
51 CANDESARTAN TAB 16 MG (F) Tabl 251 331
52 CANDESARTAN TAB 8 MG (F) Tabl 126 204
53 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl
54 CAPTOPRIL 25 MG Tabl 14
 55 CARTYLO Tabl 295 30
56 CARDIOMIN Tabl
57 CAR-Q CAPS Caps 120
58 CATAFLAM 50 MG Tabl
59 CATAFLAM FASH SACHET
60 CEFADROXYL CAPS 500 MG OGB (F) Caps 65 10
61 CEFIXIME CAPS 100 MG (F) Tabl 140 96
62 CEFIXIME SYR 100 MG/5 ML 30 ML OGB (F) Fls
63 CEFSPAN 100 MG Caps 128
64 CEFSPAN TAB 200 MG Tabl 70
65 CEFTRIAXON 1 G Vial
66 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 141 45
67 CHANNA Tabl 25
68 CHLORPENIRAMIN MALEAT TAB 4 MG OGB (F) Tabl 88
69 CILOSTAZOL 100 MG Tabl
70 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 290 70
71 CITICOLIN TAB 1000 MG Tabl 6
72 CITICOLIN TAB 500 MG Tabl 243 250
73 CLANEKSI FORTE SYR FLES
74 CLINDAMYCIN CAPS 150 MG OGB (F) Caps
75 CLINDAMYCIN CAPS 300 MG (F) Caps 5
76 CLOBAZAM TAB 10 MG OGB (F) Tabl 266 177
77 CLOPIDOGREL TAB 75 MG (F) Tabl 179 165
78 CLOZAPINE 100 MG TAB (F) Tabl 74 60
79 CLOZAPINE 25 MG TAB (F) Tabl 111 15
80 CO AMOXICLAVE 625 MG Tabl 40 25
81 CODEIN TAB 10 MG OGB ( F ) Tabl 231 28
82 CODEIN TAB 20 MG OGB ( F ) Tabl 235 81
83 CODIPRONT Caps 61
84 CODIPRONT SYR Fls
85 CODIPRONT CUM EXP CAPS Caps 10 40
86 CODIPRONT CUM EXP Fles
87 CODITAM TAB 30 MG Tabl 123
88 CONCOR TAB 2,5 MG Tabl 305 472
89 COXIRON FC TABLET 60 MG Tabl
90 COXIRON FC TABLET 90 MG Tabl
91 CPG TAB 75 MG Tabl 415 105
92 CRAVIT TAB 500 MG Tabl
93 CURCUMA TAB Tabl 378 45
94 DARYANTULLE (F2) Lembar 9 1
95 DEPAKOTE ER TAB 500 MG (F2) Tabl 116 150
96 DEPAKOTE TAB 250 MG (F2) Tabl 220 290
97 DEPAKOTE ER 250 MG Tabl
98 DESOXIMETASONE 0,25 CREAM 15 GR (F) Tube 5
99 DEPAKENE SIRUP Tabl
100 DEXAMETHASONE Tabl 90
101 DIAZEPAM TAB 2 MG OGB (F) Tabl 124 129
102 DIAZEPAM TAB 5 MG OGB (F) Tabl 141 70
103 DIAMICRON MR 60 MG Tabl
104 DIGOXIN TAB 0,25 MG OGB (F) Tabl 230 12
105 DISOLF Tabl
106 DOGESIC 500 MG TAB (F) Tabl
107 DOMPERIDON TAB 10 MG OGB (F) Tabl 49
108 DOGMATIL Tabl
109 DOPEPSA SYR 100 ML (F2) Botol
110 DULCOLAX 5 MG Tabl
111 DULCOLAX SUPP BJ
112 ECLID 100 MG Tabl
113 EFLIN SYR Fles
114 ELIZAC 20 MG Caps
115 ELOX CREAM 10 GR Tube
116 ENYSTIN DROP Fles
117 EPERISONE TAB Tabl
118 EPISAN Fles 27 12
119 ETORICOXIB 60 MG Tabl
120 ETORICOXIB 90 MG Tabl
121 ETHAMBUTOL TAB 500 MG OGB (F) Tabl
122 EYEFRESH PLUS MD PAK 8 3
123 EYEFRESH MD PAK 3
124 EXAFLAM TAB 50 MG (F) Tabl
125 FARGOXIN TAB Tabl
126 FENOFIBRATE 100 MG Tabl
127 FENOFIBRATE 300 MG Tabl
128 FLOXA MD 0,6 ML TM Strip 46 28
129 FLOXA TM 5 ML Fls
130 FLUNARIZINE TAB 5 MG (F) Tabl 952 224
131 FORNEURO TAB (F) Tabl 130 25
132 FRAMYCETIN SULFATE Lembar
133 FREGO 10MG TAB Tabl
134 FUROSEMIDA TAB @200 Tabl 112 127
135 GABAPENTIN CAPS 300 MG (F) Caps 83 80
136 GEMFIBROZIL Caps
137 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube
138 GENTAMICIN SK 0,1 % 5 GR OGB Tube
139 GLIMEPIRIDE TAB 1 MG OGB (F) Tabl
140 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl
141 GLIQUIDONE TAB 30 MG OGB (F) Tabl 474 75
142 GLUCOPHAGE TAB 500 MG Tabl
143 GLUCOSAMIN CAPS 250 MG Caps 40 140
144 GLUTROP CAPS Caps 100 10
145 HALOPERIDOL 1,5 MG Tabl 231 50
146 HALOPERIDOL 5 MG Tabl
147 HARNAL OCAS CAPS 0,4 MG (F) Caps 57 105
148 HEPABALANCE CAPS Caps 120
149 HEXYMER 2 MG Tabl
150 HISTRIN Tabl
151 IBUPROFEN SIRUP Botol
152 IBUPROFEN TAB 200 MG OGB ( F ) Tabl 65 135
153 IBUPROFEN TAB 400 MG OGB ( F ) Tabl
154 IMUNOS Tabl
155 INBUMIN Caps 163
156 IOPAMIRO 370 / 50 ML Botol
157 ISONIAZID TAB 300 MG OGB (F) Tabl
158 ISOSORBID DINITRAT TAB 5 MG OGB (F) Tabl 105 215
159 ITRACONAZOLE CAPS 100 MG (F) Caps 36
160 KALMECO 500 MG Tabl
161 KALNEX 500 MG Tabl 54 45
162 KALTROFEN TAB 50 MG Tabl 122
163 KALXETIN CAPS 20 MG Caps 37 15
164 KENALOG IN ORABASE Tube
165 KETOKONAZOLE CREAM 2% 10 GR OGB (F) Tube 3
166 KETOPROFEN TAB 100 MG OGB (F) Tabl
167 KETOROLAC TAB 10 MG OGB Tabl 89 20
168 KLODERMA CREAM 10 GR Tube 5
169 KSR ALUFOIL CAPS 600 MG (F) Caps 145 20
170 LFX 5 ML TM FLES 28
171 LAKTULOSA SYR 60 ML (F) Botol
172 LANCID CAPS 30 MG Caps
173 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 36
174 LAXADIN SYR Fls
175 LORATADIN Tabl
176 LEVEMIR FLEXPEN Ampul
177 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 50
178 LIDOCAIN COMPOSITUM INJ (F) Ampul 5
179 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 1
180 LIPANTHYL PENTA Tabl
181 LYTEERS TM 15 ML Fls 3 2
182 LUVOX Tabl
0.18 MEGABAL Caps 710 472
184 MEIACT Tabl
185 MELOXICAM TAB 7,5 MG (F) Tabl 212 90
186 MERLOPAM 2 MG Tabl
187 METFORMIN TAB 500 MG OGB (F) Tabl 353 105
188 METHYLPREDNISOLON TAB 16 MG (F) Tabl 111
189 METHYLPREDNISOLON TAB 4 MG OGB (F) Tabl 65 70
190 METHYLPREDNISOLON TAB 8 MG OGB (F) Tabl 116 10
191 METRONIDAZOL TAB 500 MG OGB (F) Tabl 100
192 MICARDIS TAB 80 MG (F) Tabl 60
193 MINIASPI 80MG TAB (F) Tabl 147 60
194 MOFACORT CREM Tube
195 MOMETHASONE CREAM 5 GR Tube 2
196 MST CONTINOUS 10 MG Tabl 47
197 MUCOSTA TAB 100 MG Tabl 224 76
198 MYCOS SM 3,5 GR Tube 1
199 MYCETIN ZM Tube 2
200 MYORES TAB ( F ) Tabl 162
201 NACL 0,9% OGB INF 500 ML Botol 4 1
202 NATRIUM BICARBONAT TAB 500 MG OGB (F) Tabl 124 381
203 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl
204 NEULIN PS Tabl
205 NEURODEX TAB Tabl 138 70
206 NEVOX XR 500MG Tabl 90
207 NEW DIATAB TAB (F2) Tabl
208 NEXURIN Tabl 41 53
209 NITROKAF RETARD TAB (F) Tabl 160
210 NONCORT MD (F2) Strip 5 5
211 NOROID LOTION Botol
212 NOTISIL 2 MG TAB Tabl 43 60
213 NOVORAPID FLEX PEN Buah 5
214 NUDEP TAB 50 MG Tabl 76 15
215 NUTRIFLAM CAPS Caps 162 50
216 NYSTATIN DROP Fls
217 OBH 100 ML Fls
218 OFLOXACIN TAB 200 MG OGB (F) Tabl 120
219 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 300
220 ONDANCETRON TAB 4 MG (F) Tabl 6
221 ORINOX TABLET 60 MG Tabl 81 90
222 ORINOX TABLET 90 MG Tabl 191 94
223 ORINOX TABLET 120 MG Tabl
224 OSFIT Tabl 163
225 OTILON TT 8 ML Fls 2
226 P PRED MD 10 MG/0.6 ML (F2) Strip 38 27
227 PANTOPRAZOLE 20 MG Tabl
228 PARACETAMOL SYR 120 MG/5 ML 60 ML OGB (F) Fls 2 1
229 PARACETAMOL TAB 500 MG (F) Tabl 258 107
230 PARIET 10 MG Tabl
231 PHENOBARBITAL 30 MG Tabl 220
232 PHENYTOIN CAPS (F) Caps 250 120
233 PIROTOP CREAM 5 GRAM Tube 3
234 PIRACETAM 400 MG Caps
235 PIRACETAM 800 MG Caps
236 PIROXICAM CAPS 20 MG OGB Caps 158 36
237 POLYDEX MDS 0,6 ML TM @5 s Fls 3
238 POLYDEX TM 5 ML Fls
239 POSAFIT Tabl 30
240 PRAXILLENE 200 MG TAB Tabl 100
241 PREGABALIN 75 MG Caps
242 PROFOLAT 0,4 MCG Tabl
243 PROPANOLOL TAB 10 MG OGB (F) Tabl 89 50
244 PRORENAL Tabl 280 120
245 PROSTAM SR TAB Tabl 151 29
246 PROVELYN 75 MG TAB Tabl 339 110
247 PYRAZINAMID TAB 500 MG OGB (F) Tabl
248 Q TEN 100 Tabl
249 RAMIPRIL TAB 2,5 MG (F) Tabl 413 55
250 RAMIPRIL TAB 5 MG (F) Tabl 400
251 RANITIDIN TAB 150 MG OGB (F) Tabl 190 10
252 REDACID Tabl 63 10
253 RENALOF TAB Tabl
254 RETAPHYL SR CAPL Capl 40 60
255 RIFAMPICIN TAB 450 MG OGB (F) Tabl
256 RIFAMPICIN TAB 600 MG OGB (F) Tabl
257 RINCOBAL 500MCG Tabl
258 RISPERIDONE TAB 2 MG OGB (F) Tabl 552 300
259 SAGESTAM 80 MG Ampul 4 1
260 SALBUTAMOL TAB 2 MG OGB Tabl 73
261 SANMOL DROP Fls
262 SANDEPRIL 50 MG Tabl 77
263 SANTA E Tabl
264 SEROQUEL XR TAB 200 (F) Tabl
265 SEROQUEL XR TAB 300 (F) Tabl
266 SEROQUEL XR TAB 400 (F) Tabl 30
267 SILOXAN TM Fls
268 SILEX SYRUP FLES
269 SIBITAL TAB 50 MG (F2) Tabl
270 SIFROL ER TAB 0,375 MG (F2) Tabl 90
271 SIFROL ER TAB 0,75 MG (F2) Tabl
272 SODIUM VALPROAT SYR Fls
273 SOPAVEL 10 MG Tabl
274 SIMARC 2 MG Tabl 80
275 SIMVASTATIN 10 MG Tabl 150
276 SIMVASTATIN 20 MG Tabl 330 30
277 SINKRONIK Tabl 189 79
278 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 4
279 SPIROLA TAB 100 MG Tabl 18
280 SPIROLA TAB 25 MG Tabl
281 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 507 7
282 SPIRONOLACTONE TAB 100 MG OGB (F) Tabl 232 40
283 STALEVO TAB 100 MG (F) Tabl 120
284 STARFER CAPS Caps
285 STELOSI TAB 5 MG (F2) Tabl 90 72
286 STOBLED CAPS (F) Caps
287 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls
288 TEGRETOL 200 MG Tabl 200
289 THYROZOL TAB 5 MG (F) Tabl 70
290 THYROZOL TAB 10 MG (F) Tabl 110 30
291 THROMBO ASPILET Tabl
292 TIMOL 0,5 %TM 5 ML Fls
293 TOBROSON MD Strip 4
294 TOPAMAX TAB 25 MG Tabl 72
295 TORASIC TAB Tabl 84
296 TORREX Tabl
297 TRAJENTA Tabl
298 TRACETATE TABLET 160 MG Capl
299 TRAMADOL 50 MG Caps
300 TRAMPARA Tabl
301 TREMENZA TAB Tabl
302 TRIFACALC TAB 500 MG Tabl
303 TRIFED Tabl
304 TRIHEXYPHENIDIL 2 MG Tabl 639 545
305 TRINOLON TAB 4 MG Tabl
306 TRIZEDON MR Tabl
307 ULTRACET Tabl
308 UROTRACTIN TAB 400 MG Tabl 96
309 URSODEOXYCHOLIC ACID 250 MG (F) Caps 119
310 VESICARE 5 MG Tabl
311 V BLOC TAB 6,25 MG (F) Tabl 345 15
312 V BLOC TAB 25 MG (F) Tabl 40
313 VIP ALBUMIN Caps 30
314 VITAMIN B COMPLEX TAB OGB Tabl 200 30
315 VITAMIN B6 TAB 10 MG OGB Tabl 55
316 VITAMIN C TAB 50 MG OGB Tabl 240 60
317 VITAMIN K TAB /PHYTOMENADION 10MG Tabl 74
318 VOMETA FT Tabl 10
319 XANDA SIRUP Tabl
320 XEPAZYM Tabl
321 ZITANID 2 MG Tabl 76 50
perencanaan 2020

PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON 3 NOPEMBER 2020

KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI

SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH, S.FARM, APT

NIP 19710717 199203 2 005 NIP 19671230 198803 2 003
AKUNGWATI

JMLH
KEBUTUHAN

0
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100
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100
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100
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60
0
100
100
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 0
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 0
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 0
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5
100
0

OPEMBER 2020
KUTIF PAKUNGWATI

S.FARM, APT
INSTALASI FARMASI
RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN OKTOBER 2020

JMLH
SISA STOCK
PEMAKAIAN JMLH
NO NAMA BARANG SATUAN AKHIR
SEPTEMBER KEBUTUHAN
SEPTEMBER20
20
Alkes
1 BISTURI 11 Buah 0
2 BISTURI 15 Buah 0
3 CAPSUL KOSONG 0 Buah 670 1000
4 CAPSUL KOSONG 00 Buah 146 1000
5 CAPSUL KOSONG 1 Buah 202 1000
6 CAPSUL KOSONG 2 Buah 92 0
7 CAPSUL KOSONG 3 Buah 90 0
8 COLOSTOMY BAG Buah 0
9 DISPOSIBLE 1 CC STERA Buah 1 0
10 DISPOSIBLE 10 CC JMI Buah 1 0
11 DISPOSIBLE 20 CC TERUMO Buah 0
12 DISPOSIBLE 3 CC JMI Buah 3 0
13 DISPOSIBLE 5 CC JMI Buah 0
14 DISPOSIBLE 50 CC TERUMO Buah 0
15 FIXOMUL 5X5 CM Rol 0
16 KASSA STERIL 16X16 CM Pak 0
17 FOLLEY CATHETER 16 CHROMA Buah 0
18 MONOSOF 6-0 SN-667 Buah 0
19 NEEDLE G 19 TERUMO Buah 0
20 NOVOPEN NEEDLE 32 G Buah 0
21 OPSITE 15,5 X 8,5 Lembar 0
22 OPSITE 9,5 X 8,5 Lembar 0
23 OPSITE 6,5X5 Lembar 0
24 OPTIME 4/0 TAPER Buah 0
25 POLYSORB 4-0 TAPER UL - 203 Buah 0
26 POT PLASTIK 100 GR Buah 0
27 POT PLASTIK 30 GR Buah 0
28 SOFT SILK 2-0 GS-453 ( CV 24 ) Buah 0
29 SOFT BAND 4 INC Buah 0
30 TENSOCREPE 4 INC / 10 CM Rol 0
31 TRANSOFIX Buah 0
32 URINE BAG TROGE Buah 0
33 WING NEEDLE 21 JMS Buah 0

Obat
1 ABILIFY DISCMELT 10 MG Tabl 56 4 0
 2 ACARBOSE TAB 100 MG (F) Tabl 201 0
3 ACARBOSE TAB 50 MG (F) Tabl 210 165 45
4 ACETYLCYSTEIN 200 MG Caps 30 60
5 ALOPURINOL TAB 100 MG OGB (F) Tabl 90 180 100
6 ALOPURINOL TAB 300 MG OGB (F) Tabl 145 0
7 ALPENTIN CAP 100 MG (F2) Caps 194 62 0
8 ALPRAZOLAM 0, 25 MG Tabl 114 200
9 ALPRAZOLAM 0,5 MG Tabl 100
10 AMBROXOL SYR 15MG/5ML 2
11 AMBROXOL TAB 30 MG OGB (F) Tabl 124 40 0
12 AMINEFRON Tabl 306 294 0
13 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 2 246 500
14 AMLODIPIN TAB 10 MG OGB (F) Tabl 165 307 200
15 AMLODIPIN TAB 5 MG OGB (F) Tabl 382 30 0
16 AMOXYCILLIN 500 MG Fles 40 45 100
17 AMOXSAN CAPS 500 MG Caps 0
18 ANALSIK TAB Tabl 50 30 100
19 ANEMOLAT TAB 1 MG Tabl 500 0
20 ANGINTRIZ MR Tabl 40 140 120
21 ANTACIDA DOEN Fles 0
22 APISATE Tabl 0
23 ATORVASTATIN TAB 10 MG (F) Tabl 0
24 ATORVASTATIN TAB 20 MG (F) Tabl 60 53 90
25 AZITHROMYCIN TAB 500 MG (F) Tabl 60
26 AKILEN TT Fles 2
27 ARDIUM Tabl 60
28 ARTOFLAM Tabl 30
29 ASAM FOLAT 1 MG Tabl 87 208 500
30 ASAM TRANEKSAMAT 500 MG Tabl 0
31 ASAM MEFENAMAT 500 MG Tabl 227 100 0
32 ASTHIN FORCE Tabl 60
33 AZOMAX 500 MG Tabl 44 0
34 BNS ( BRESTHY NSL SPRAY ) 30 ML Fls 0
35 BAQUINOR 500 MG Tabl 30
36 BAMGETOL 200 MG Tabl 200
37 BETAHISTINE TAB 6 MG OGB (F) Tabl 265 190 0
38 BETASERC 24 MG Tabl 60 30 0
39 BETMIGA Tabl 30
40 BISOPROLOL TAB 5 MG OGB (F) Tabl 0
41 BRAIN ACT ODIS Tabl 56 4 0
42 BRAINACT TAB 500 MG Tabl 120 0
43 BRAXIDIN TAB Tabl 70 20 0
44 BRILINTA 90 MG Tabl 60
45 CALCIUM LACTAT 500 MG Tabl 132 55 0
46 CALOREASE Tabl 0
47 CALOS TAB Tabl 90 30 0
48 CAMELOC TAB 15 MG (F2) Capl 23 34 100
49 CANDOTENS 8 MG Tabl 113 37 0
50 CANDOTENS 16 MG Tabl 75 15 0
51 CANDESARTAN TAB 16 MG (F) Tabl 132 480 600
52 CANDESARTAN TAB 8 MG (F) Tabl 330 170 0
53 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl 200
54 CAPTOPRIL 25 MG Tabl 33 7 0
55 CARTYLO Tabl 125 75 0
56 CARDIOMIN Tabl 100
57 CAR-Q CAPS Caps 60
58 CATAFLAM 50 MG Tabl 60
59 CATAFLAM FASH SACHET 50
60 CEFADROXYL CAPS 500 MG OGB (F) Caps 75 10 0
61 CEFIXIME CAPS 100 MG (F) Tabl 241 207 0
62 CEFIXIME SYR 100 MG/5 ML 30 ML OGB Fls 2
63 CEFSPAN 100 MG Caps 128 0
64 CEFSPAN TAB 200 MG Tabl 70 0
65 CEFTRIAXON 1 G Vial 0
66 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 86 62 0
67 CHANNA Tabl 25 0
68 CHLORPENIRAMIN MALEAT TAB 4 MG O Tabl 88 0
69 CILOSTAZOL 100 MG Tabl 100
70 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 160 40 0
71 CITICOLIN TAB 1000 MG Tabl 6 15 30
72 CITICOLIN TAB 500 MG Tabl 253 74 0
73 CLANEKSI FORTE SYR FLES 0
74 CLINDAMYCIN CAPS 150 MG OGB (F) Caps 30
75 CLINDAMYCIN CAPS 300 MG (F) Caps 5 30 100
76 CLOBAZAM TAB 10 MG OGB (F) Tabl 43 92 100
77 CLOPIDOGREL TAB 75 MG (F) Tabl 44 226 300
78 CLOZAPINE 100 MG TAB (F) Tabl 84 30 0
79 CLOZAPINE 25 MG TAB (F) Tabl 126 51 0
80 CO AMOXICLAVE 625 MG Tabl 5 25 30
81 CODEIN TAB 10 MG OGB ( F ) Tabl 259 241 0
82 CODEIN TAB 20 MG OGB ( F ) Tabl 16 151 200
83 CODIPRONT Caps 61 0
84 CODIPRONT SYR Fls 0
85 CODIPRONT CUM EXP CAPS Caps 50 20 0
86 CODIPRONT CUM EXP Fles 0
87 CODITAM TAB 30 MG Tabl 123 7 0
88 CONCOR TAB 2,5 MG Tabl 477 550 100
89 COXIRON FC TABLET 60 MG Tabl 0
90 COXIRON FC TABLET 90 MG Tabl 0
91 CPG TAB 75 MG Tabl 220 123 0
92 CRAVIT TAB 500 MG Tabl 30
93 CURCUMA TAB Tabl 423 125 0
94 DARYANTULLE (F2) Lembar 2
95 DEPAKOTE ER TAB 500 MG (F2) Tabl 66 0
96 DEPAKOTE TAB 250 MG (F2) Tabl 310 180 0
97 DEPAKOTE ER 250 MG Tabl 198 30 0
98 DESOXIMETASONE 0,25 CREAM 15 GR Tube 5 0
99 DEPAKENE SIRUP Tabl 1
100 DEXAMETHASONE Tabl 100 0
101 DIAZEPAM TAB 2 MG OGB (F) Tabl 253 193 0
102 DIAZEPAM TAB 5 MG OGB (F) Tabl 211 64 0
103 DIAMICRON MR 60 MG Tabl 30
104 DIGOXIN TAB 0,25 MG OGB (F) Tabl 242 52 0
105 DOGESIC 500 MG TAB (F) Tabl 0
106 DOMPERIDON TAB 10 MG OGB (F) Tabl 49 35 0
107 DOGMATIL Tabl 30
108 DOPEPSA SYR 100 ML (F2) Botol 24
109 DULCOLAX 5 MG Tabl 0
110 DULCOLAX SUPP BJ 5
111 ECLID 100 MG Tabl 100
112 EFLIN SYR Fles 0
113 ELIZAC 20 MG Caps 0
114 ELOX CREAM 10 GR Tube 2
115 ENYSTIN DROP Fles 2
116 EPERISONE TAB Tabl 36 0
117 EPISAN Fles 15 9 0
118 ETORICOXIB 60 MG Tabl 0
119 ETORICOXIB 90 MG Tabl 0
120 ETHAMBUTOL TAB 500 MG OGB (F) Tabl 0
121 EYEFRESH PLUS MD PAK 1 10 10
122 EYEFRESH MD PAK 3 2 5
123 EXAFLAM TAB 50 MG (F) Tabl 100
124 FARGOXIN TAB Tabl 0
125 FENOFIBRATE 100 MG Tabl 30
126 FENOFIBRATE 300 MG Tabl 30
127 FLOXA MD 0,6 ML TM Strip 35 40 20
128 FLOXA TM 5 ML Fls 0
129 FLUNARIZINE TAB 5 MG (F) Tabl 176 479 400
130 FORNEURO TAB (F) Tabl 95 40 0
131 FRAMYCETIN SULFATE Lembar 2
132 FREGO 10MG TAB Tabl 0
133 FUROSEMIDA TAB @200 Tabl 39 148 200
134 GABAPENTIN CAPS 300 MG (F) Caps 163 41 0
135 GEMFIBROZIL Caps 0
136 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube 2
137 GENTAMICIN SK 0,1 % 5 GR OGB Tube 2
138 GLIMEPIRIDE TAB 1 MG OGB (F) Tabl 0
139 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl 0
140 GLIQUIDONE TAB 30 MG OGB (F) Tabl 549 40 0
141 GLUCOPHAGE TAB 500 MG Tabl 0
142 GLUCOSAMIN CAPS 250 MG Caps 200
143 GLUTROP CAPS Caps 0
144 HALOPERIDOL 1,5 MG Tabl 181 19 0
145 HALOPERIDOL 5 MG Tabl 10 100
146 HARNAL OCAS CAPS 0,4 MG (F) Caps 72 49 0
147 HEPABALANCE CAPS Caps 120 0
148 HEXYMER 2 MG Tabl 500
149 HISTRIN Tabl 100
150 IBUPROFEN SIRUP Botol 0
151 IBUPROFEN TAB 200 MG OGB ( F ) Tabl 0
152 IBUPROFEN TAB 400 MG OGB ( F ) Tabl 10 100
153 IMUNOS Tabl 60
154 INBUMIN Caps 120 20 0
155 IOPAMIRO 370 / 50 ML Botol 0
156 ISONIAZID TAB 300 MG OGB (F) Tabl 0
157 ISOSORBID DINITRAT TAB 5 MG OGB Tabl 320 80 0
158 ITRACONAZOLE CAPS 100 MG (F) Caps 36 0
159 KALMECO 500 MG Tabl 100
160 KALNEX 500 MG Tabl 4 126 200
161 KALTROFEN TAB 50 MG Tabl 0
162 KALXETIN CAPS 20 MG Caps 52 0
163 KENALOG IN ORABASE Tube 0
164 KETOKONAZOLE CREAM 2% 10 GR OGB Tube 3 0
165 KETOPROFEN TAB 100 MG OGB (F) Tabl 100
166 KETOROLAC TAB 10 MG OGB Tabl 109 0
167 KLODERMA CREAM 10 GR Tube 3
168 KSR ALUFOIL CAPS 600 MG (F) Caps 65 55 0
169 LFX 5 ML TM FLES 8 1 0
170 LAKTULOSA SYR 60 ML (F) Botol 2
171 LANCID CAPS 30 MG Caps 58 59 0
172 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 500
173 LAXADIN SYR Fls 2
174 LORATADIN Tabl 100
175 LEVEMIR FLEXPEN Ampul 0
176 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 50 12 0
177 LIDOCAIN COMPOSITUM INJ (F) Ampul 5 0
178 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 1 1 2
179 LIPANTHYL PENTA Tabl 30
180 LYTEERS TM 15 ML Fls 6 3 0
181 LUVOX Tabl 30
182 MEGABAL Caps 182 626 500
183 MEIACT Tabl 0
184 MELOXICAM TAB 7,5 MG (F) Tabl 302 97 0
185 MERLOPAM 2 MG Tabl 100
186 METFORMIN TAB 500 MG OGB (F) Tabl 458 150 0
187 METHYLPREDNISOLON TAB 16 MG (F) Tabl 111 13 0
188 METHYLPREDNISOLON TAB 4 MG OGB ( Tabl 135 50 0
189 METHYLPREDNISOLON TAB 8 MG OGB ( Tabl 126 64 0
190 METRONIDAZOL TAB 500 MG OGB (F) Tabl 100 0
191 MICARDIS TAB 80 MG (F) Tabl 20 30 20
192 MINIASPI 80MG TAB (F) Tabl 207 33 0
193 MOFACORT CREM Tube 2
194 MOMETHASONE CREAM 5 GR Tube 2 0
195 MST CONTINOUS 10 MG Tabl 47 0
196 MUCOSTA TAB 100 MG Tabl 100
197 MYCOS SM 3,5 GR Tube 1 2 0
198 MYCETIN ZM Tube 2 0
199 MYORES TAB ( F ) Tabl 162 33 0
200 NACL 0,9% OGB INF 500 ML Botol 5 1 0
201 NATRIUM BICARBONAT TAB 500 MG OG Tabl 95 485 500
202 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl 100
203 NEULIN PS Tabl 30
204 NEURODEX TAB Tabl 208 109 0
205 NEVOX XR 500MG Tabl 0
206 NEW DIATAB TAB (F2) Tabl 100
207 NEXURIN Tabl 100
208 NITROKAF RETARD TAB (F) Tabl 160 0
209 NONCORT MD (F2) Strip 13 20
210 NOROID LOTION Botol 2
211 NOTISIL 2 MG TAB Tabl 103 0
212 NOVORAPID FLEX PEN Buah 5 0
213 NUDEP TAB 50 MG Tabl 31 7 0
214 NUTRIFLAM CAPS Caps 90 60 0
215 NYSTATIN DROP Fls 0
216 OBH 100 ML Fls 0
217 OFLOXACIN TAB 200 MG OGB (F) Tabl 120 0
218 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 0
219 ONDANCETRON TAB 4 MG (F) Tabl 6 30
220 ORINOX TABLET 60 MG Tabl 111 90 0
221 ORINOX TABLET 90 MG Tabl 135 114 0
222 ORINOX TABLET 120 MG Tabl 0
223 OSFIT Tabl 163 0
224 OTILON TT 8 ML Fls 2 0
225 P PRED MD 10 MG/0.6 ML (F2) Strip 27 40 20
226 PANTOPRAZOLE 20 MG Tabl 100
227 PARACETAMOL SYR 120 MG/5 ML 60 ML Fls 1 0
228 PARACETAMOL TAB 500 MG (F) Tabl 365 278 0
229 PARIET 10 MG Tabl 100
230 PHENOBARBITAL 30 MG Tabl 20 200 200
231 PHENYTOIN CAPS (F) Caps 370 150 0
232 PIROTOP CREAM 5 GRAM Tube 4 0
233 PIRACETAM 400 MG Caps 100
234 PIRACETAM 800 MG Caps 0
235 PIROXICAM CAPS 20 MG OGB Caps 194 12 0
236 POLYDEX MDS 0,6 ML TM @5 s Fls 3 0
237 POLYDEX TM 5 ML Fls 0
238 POSAFIT Tabl 100
239 PRAXILLENE 200 MG TAB Tabl 3 100
240 PREGABALIN 75 MG Caps 0
241 PROFOLAT 0,4 MCG Tabl 0
242 PROPANOLOL TAB 10 MG OGB (F) Tabl 139 60 0
243 PRORENAL Tabl 200 200
244 PROSTAM SR TAB Tabl 100
245 PROVELYN 75 MG TAB Tabl 168 390 300
246 PYRAZINAMID TAB 500 MG OGB (F) Tabl 0
247 Q TEN 100 Tabl 100
248 RAMIPRIL TAB 2,5 MG (F) Tabl 468 30 0
249 RAMIPRIL TAB 5 MG (F) Tabl 200 120 0
250 RANITIDIN TAB 150 MG OGB (F) Tabl 500
251 REDACID Tabl 73 10 0
252 RENALOF TAB Tabl 100
253 RETAPHYL SR CAPL Capl 100
254 RIFAMPICIN TAB 450 MG OGB (F) Tabl 0
255 RIFAMPICIN TAB 600 MG OGB (F) Tabl 0
256 RINCOBAL 500MCG Tabl 0
257 RISPERIDONE TAB 2 MG OGB (F) Tabl 352 360 100
258 SAGESTAM 80 MG Ampul 5 1 0
259 SALBUTAMOL TAB 2 MG OGB Tabl 73 20 0
260 SANMOL DROP Fls 0
261 SANDEPRIL 50 MG Tabl 77 0
262 SANTA E Tabl 100
263 SEROQUEL XR TAB 200 (F) Tabl 0
264 SEROQUEL XR TAB 300 (F) Tabl 0
265 SEROQUEL XR TAB 400 (F) Tabl 30 30
266 SILOXAN TM Fls 10
267 SILEX SYRUP FLES 0
268 SIBITAL TAB 50 MG (F2) Tabl 100
269 SIFROL ER TAB 0,375 MG (F2) Tabl 0
270 SIFROL ER TAB 0,75 MG (F2) Tabl 0
271 SODIUM VALPROAT SYR Fls 0
272 SOPAVEL 10 MG Tabl 30 0
273 SIMARC 2 MG Tabl 80 60 0
274 SIMVASTATIN 10 MG Tabl 150 0
275 SIMVASTATIN 20 MG Tabl 360 40 0
276 SINKRONIK Tabl 100
277 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 2 1 0
278 SPIROLA TAB 100 MG Tabl 18 7 0
279 SPIROLA TAB 25 MG Tabl 0
280 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 514 39 0
281 SPIRONOLACTONE TAB 100 MG OGB (F Tabl 272 30 0
282 STALEVO TAB 100 MG (F) Tabl 0
283 STARFER CAPS Caps 100
284 STELOSI TAB 5 MG (F2) Tabl 100
285 STOBLED CAPS (F) Caps 0
286 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls 0
287 TEGRETOL 200 MG Tabl 200 0
288 THYROZOL TAB 5 MG (F) Tabl 70 0
289 THYROZOL TAB 10 MG (F) Tabl 140 0
290 THROMBO ASPILET Tabl 100
291 TIMOL 0,5 %TM 5 ML Fls 2
292 TOBROSON MD Strip 4 1 0
293 TOPAMAX TAB 25 MG Tabl 72 0
294 TORASIC TAB Tabl 84 0
295 TORREX Tabl O
296 TRAJENTA Tabl 100
297 TRACETATE TABLET 160 MG Capl 100
298 TRAMADOL 50 MG Caps 75 100
299 TRAMPARA Tabl 0
300 TREMENZA TAB Tabl 0
301 TRIFACALC TAB 500 MG Tabl 0
302 TRIFED Tabl 0
303 TRIHEXYPHENIDIL 2 MG Tabl 164 327 200
304 TRINOLON TAB 4 MG Tabl 0
305 TRIZEDON MR Tabl 100
306 ULTRACET Tabl 100
307 UROTRACTIN TAB 400 MG Tabl 96 0
308 URSODEOXYCHOLIC ACID 250 MG (F) Caps 119 10 0
309 VESICARE 5 MG Tabl 0
310 V BLOC TAB 6,25 MG (F) Tabl 60 245 210
311 V BLOC TAB 25 MG (F) Tabl 40 0
312 VIP ALBUMIN Caps 150
313 VITAMIN B COMPLEX TAB OGB Tabl 230 0
314 VITAMIN B6 TAB 10 MG OGB Tabl 195 60 0
315 VITAMIN C TAB 50 MG OGB Tabl 300 0
316 VITAMIN K TAB /PHYTOMENADION 1 Tabl 74 86 100
317 XANDA SIRUP Tabl 2
318 XEPAZYM Tabl 100
319 ZITANID 2 MG Tabl 126 24 0
perencanaan 2020
PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON, 3 OKTOBER 2020
KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI

SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH, S.FARM, APT

NIP 19710717 199203 2 005 NIP 19671230 198803 2 003
INSTALASI FARMASI
RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN JULI 2020

SISA STOCK JMLH

NO NAMA BARANG SATUAN AKHIR JUNI PEMAKAIAN JMLH KEBUTUHAN
20 JUNI 20
Alkes
1 BISTURI 11 Buah 0
2 BISTURI 15 Buah 0
3 CAPSUL KOSONG 0 Buah 152 1000
4 CAPSUL KOSONG 00 Buah 295 1000
5 CAPSUL KOSONG 1 Buah 238 1000
6 CAPSUL KOSONG 2 Buah 80 1000
7 CAPSUL KOSONG 3 Buah 150 1000
8 COLOSTOMY BAG Buah 0
9 DISPOSIBLE 1 CC STERA Buah 1 0
10 DISPOSIBLE 10 CC JMI Buah 3 0
11 DISPOSIBLE 20 CC TERUMO Buah 2 0
12 DISPOSIBLE 3 CC JMI Buah 3 0
13 DISPOSIBLE 5 CC JMI Buah 0
14 DISPOSIBLE 50 CC TERUMO Buah 0
15 FIXOMUL 5X5 CM Rol 0
16 KASSA STERIL 16X16 CM Pak 0
17 FOLLEY CATHETER 16 CHROMA Buah 0
18 MONOSOF 6-0 SN-667 Buah 0
19 NEEDLE G 19 TERUMO Buah 1 0
20 NOVOPEN NEEDLE 32 G Buah 32 0
21 OPSITE 15,5 X 8,5 Lembar 0
22 OPSITE 9,5 X 8,5 Lembar 0
23 OPSITE 6,5X5 Lembar 0
24 OPTIME 4/0 TAPER Buah 0
25 POLYSORB 4-0 TAPER UL - 203 Buah 0
26 POT PLASTIK 100 GR Buah 0
27 POT PLASTIK 30 GR Buah 0
28 SOFT SILK 2-0 GS-453 ( CV 24 ) Buah 0
29 SOFT BAND 4 INC Buah 0
30 TENSOCREPE 4 INC / 10 CM Rol 0
31 TRANSOFIX Buah 0
32 URINE BAG TROGE Buah 0
33 WING NEEDLE 21 JMS Buah 1 0

Obat
1 ABILIFY DISCMELT 10 MG Tabl 30 60 60
2 ACARBOSE TAB 100 MG (F) Tabl 136 15 200
3 ACARBOSE TAB 50 MG (F) Tabl 0
4 ACETYLCYSTEIN 200 MG Caps 30 15 100
5 ALOPURINOL TAB 100 MG OGB (F) Tabl 200
6 ALOPURINOL TAB 300 MG OGB (F) Tabl 170 0
 7 ALPENTIN CAP 100 MG (F2) Caps 114 110 100
8 ALPRAZOLAM 0,5 MG Tabl 100
9 AMBROXOL SYR 15MG/5ML 3
10 AMBROXOL TAB 30 MG OGB (F) Tabl 206 15 0
11 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 200
12 AMLODIPIN TAB 10 MG OGB (F) Tabl 270 30 0
13 AMLODIPIN TAB 5 MG OGB (F) Tabl 300 55 0
14 AMOXYCILLIN 500 MG Fles 43 12 0
15 AMOXSAN CAPS 500 MG Caps 0
16 ANALSIK TAB Tabl 12 85 100
17 ANEMOLAT TAB 1 MG Tabl 500
18 ANGINTRIZ MR Tabl 100
19 ANTACIDA DOEN Fles 0
20 APISATE Tabl 100
21 ATORVASTATIN TAB 10 MG (F) Tabl 100
22 ATORVASTATIN TAB 20 MG (F) Tabl 188 75 0
23 AZITHROMYCIN TAB 500 MG (F) Tabl 40 0
24 AKILEN TT Fles 3
25 ARDIUM Tabl 60
26 ARTOFLAM Tabl 100
27 ASAM FOLAT 1 MG Tabl 500
28 ASAM TRANEKSAMAT 500 MG Tabl 100
29 ASAM MEFENAMAT 500 MG Tabl 52 52 100
30 ASTHIN FORCE Tabl 100
31 AZOMAX 500 MG Tabl 44 0
32 BNS ( BRESTHY NSL SPRAY ) 30 ML Fls 0
33 BAQUINOR 500 MG Tabl 0
34 BAMGETOL 200 MG Tabl 500
35 BETAHISTINE TAB 6 MG OGB (F) Tabl 253 47 0
36 BETASERC 24 MG Tabl 100
37 BETMIGA Tabl 0
38 BISOPROLOL TAB 5 MG OGB (F) Tabl 100
39 BRAIN ACT ODIS Tabl 18 60
40 BRAINACT TAB 500 MG Tabl 70 20 0
41 BRAXIDIN TAB Tabl 100
42 BRILINTA 90 MG Tabl 120
43 CALCIUM LACTAT 500 MG Tabl 240 15 0
44 CALOREASE Tabl 120
45 CALOS TAB Tabl 120
46 CAMELOC TAB 15 MG (F2) Capl 7 58 100
47 CANDOTENS 8 MG Tabl 23 0
48 CANDOTENS 16 MG Tabl 105 15 0
49 CANDESARTAN TAB 16 MG (F) Tabl 369 457 120
50 CANDESARTAN TAB 8 MG (F) Tabl 165 196 60
51 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl 500
52 CAPTOPRIL 25 MG Tabl 70 0
53 CARTYLO Tabl 155 90 200
54 CARDIOMIN Tabl 100
55 CAR-Q CAPS Caps 90
56 CATAFLAM 50 MG Tabl 100
57 CATAFLAM FASH SACHET 50
58 CEFADROXYL CAPS 500 MG OGB (F) Caps 85 10 0
59 CEFIXIME CAPS 100 MG (F) Tabl 183 104 0
60 CEFIXIME SYR 100 MG/5 ML 30 ML OGB (F) Fls 3
61 CEFSPAN 100 MG Caps 110 10 0
62 CEFSPAN TAB 200 MG Tabl 61 4 0
63 CEFTRIAXON 1 G Vial 0
64 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 101 75 0
65 CHANNA Tabl 25 0
66 CHLORPENIRAMIN MALEAT TAB 4 MG OGB (F) Tabl 90 0
67 CILOSTAZOL 100 MG Tabl 0
68 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 10 100
69 CITICOLIN TAB 1000 MG Tabl 40 15 0
70 CITICOLIN TAB 500 MG Tabl 247 230 0
71 CLANEKSI FORTE SYR FLES 0
72 CLINDAMYCIN CAPS 150 MG OGB (F) Caps 30 100
73 CLINDAMYCIN CAPS 300 MG (F) Caps 100
74 CLOBAZAM TAB 10 MG OGB (F) Tabl 155 110 0
75 CLOPIDOGREL TAB 75 MG (F) Tabl 176 364 210
76 CLOZAPINE 100 MG TAB (F) Tabl 154 0
77 CLOZAPINE 25 MG TAB (F) Tabl 73 78 100
78 CO AMOXICLAVE 625 MG Tabl 100
79 CODEIN TAB 10 MG OGB ( F ) Tabl 100
80 CODEIN TAB 20 MG OGB ( F ) Tabl 31 76 500
81 CODIPRONT Caps 61 0
82 CODIPRONT SYR Fls 0
83 CODIPRONT CUM EXP CAPS Caps 10 50
84 CODIPRONT CUM EXP Fles 2
85 CODITAM TAB 30 MG Tabl 1 100
86 CONCOR TAB 2,5 MG Tabl 292 666 500
87 COXIRON FC TABLET 60 MG Tabl 0
88 COXIRON FC TABLET 90 MG Tabl 0
89 CPG TAB 75 MG Tabl 90 300
90 CRAVIT TAB 500 MG Tabl 0
91 CURCUMA TAB Tabl 624 10 0
92 DARYANTULLE (F2) Lembar 10
93 DEPAKOTE ER TAB 500 MG (F2) Tabl 106 60 0
94 DEPAKOTE TAB 250 MG (F2) Tabl 200 220 500
95 DEPAKOTE ER 250 MG Tabl 258 90 0
96 DESOXIMETASONE 0,25 CREAM 15 GR (F) Tube 9 1 0
97 DEPAKENE SIRUP Tabl 0
98 DEXAMETHASONE Tabl 100
99 DIAZEPAM TAB 2 MG OGB (F) Tabl 100
100 DIAZEPAM TAB 5 MG OGB (F) Tabl 81 233 200
101 DIAMICRON MR 60 MG Tabl 60
102 DIGOXIN TAB 0,25 MG OGB (F) Tabl 324 22 0
103 DOGESIC 500 MG TAB (F) Tabl 0
104 DOMPERIDON TAB 10 MG OGB (F) Tabl 235 25 0
105 DOGMATIL Tabl 0
106 DOPEPSA SYR 100 ML (F2) Botol 0
107 DULCOLAX 5 MG Tabl 100
108 DULCOLAX SUPP BJ 0
109 ECLID 100 MG Tabl 0
110 EFLIN SYR Fles 0
111 ELIZAC 20 MG Caps 0
112 ELOX CREAM 10 GR Tube 0
113 ENYSTIN DROP Fles 3
114 EPERISONE TAB Tabl 80 12 0
115 EPISAN Fles 10 5 25
116 ETORICOXIB 60 MG Tabl 0
117 ETORICOXIB 90 MG Tabl 0
118 ETHAMBUTOL TAB 500 MG OGB (F) Tabl 0
119 EYEFRESH PLUS MD PAK 10 6 0
120 EYEFRESH MD PAK 20
121 EXAFLAM TAB 50 MG (F) Tabl 0
122 FARGOXIN TAB Tabl 0
123 FENOFIBRATE 100 MG Tabl 0
124 FENOFIBRATE 300 MG Tabl 0
125 FLOXA MD 0,6 ML TM Strip 34 8 0
126 FLOXA TM 5 ML Fls 0
127 FLUNARIZINE TAB 5 MG (F) Tabl 358 122 0
128 FORNEURO TAB (F) Tabl 100
129 FRAMYCETIN SULFATE Lembar 2 1 0
130 FREGO 10MG TAB Tabl 274 144 0
131 FUROSEMIDA TAB @200 Tabl 221 195 0
132 GABAPENTIN CAPS 300 MG (F) Caps 307 30 0
133 GEMFIBROZIL Caps 0
134 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube 3
135 GENTAMICIN SK 0,1 % 5 GR OGB Tube 3
136 GLIMEPIRIDE TAB 1 MG OGB (F) Tabl 0
137 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl 0
138 GLIQUIDONE TAB 30 MG OGB (F) Tabl 404 142 0
139 GLUCOPHAGE TAB 500 MG Tabl 0
140 GLUCOSAMIN CAPS 250 MG Caps 3 200
141 GLUTROP CAPS Caps 0
142 HALOPERIDOL 1,5 MG Tabl 100
143 HALOPERIDOL 5 MG Tabl 100 80 0
144 HARNAL OCAS CAPS 0,4 MG (F) Caps 90 0
145 HEPABALANCE CAPS Caps 100
146 HEXYMER 2 MG Tabl 500
147 HISTRIN Tabl 100
148 IBUPROFEN SIRUP Botol 5
149 IBUPROFEN TAB 200 MG OGB ( F ) Tabl 0
150 IBUPROFEN TAB 400 MG OGB ( F ) Tabl 129 33 0
151 IMUNOS Tabl 100
152 INBUMIN Caps 183 0
153 IOPAMIRO 370 / 50 ML Botol 0
154 ISONIAZID TAB 300 MG OGB (F) Tabl 0
155 ISOSORBID DINITRAT TAB 5 MG OGB (F) Tabl 20 200
156 ITRACONAZOLE CAPS 100 MG (F) Caps 36 0
157 KALMECO 500 MG Tabl 100
158 KALTROFEN TAB 50 MG Tabl 139 0
159 KALXETIN CAPS 20 MG Caps 68 100
160 KENALOG IN ORABASE Tube 0
161 KETOKONAZOLE CREAM 2% 10 GR OGB (F) Tube 4 0
162 KETOPROFEN TAB 100 MG OGB (F) Tabl 0
163 KETOROLAC TAB 10 MG OGB Tabl 123 35 0
164 KLODERMA CREAM 10 GR Tube 10
165 KSR ALUFOIL CAPS 600 MG (F) Caps 90 10 0
166 LFX 5 ML TM FLES 5
167 LAKTULOSA SYR 60 ML (F) Botol 1 1
168 LANCID CAPS 30 MG Caps 154 115 0
169 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 500
170 LAXADIN SYR Fls 2
171 LORATADIN Tabl 100
172 LEVEMIR FLEXPEN Ampul 1 5
173 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 69 19 0
174 LIDOCAIN COMPOSITUM INJ (F) Ampul 5 4 0
175 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 6 5 0
176 LIPANTHYL PENTA Tabl 100
177 LYTEERS TM 15 ML Fls 5
178 LUVOX Tabl 100
179 MEGABAL Caps 537 461 0
180 MEIACT Tabl 0
181 MELOXICAM TAB 7,5 MG (F) Tabl 498 108 0
182 MERLOPAM 2 MG Tabl 100
183 METFORMIN TAB 500 MG OGB (F) Tabl 453 311 0
184 METHYLPREDNISOLON TAB 16 MG (F) Tabl 195 38 0
185 METHYLPREDNISOLON TAB 4 MG OGB (F) Tabl 14 100
186 METHYLPREDNISOLON TAB 8 MG OGB (F) Tabl 96 52 0
187 METRONIDAZOL TAB 500 MG OGB (F) Tabl 100
188 MICARDIS TAB 40 MG (F) Tabl 16 0
189 MINIASPI 80MG TAB (F) Tabl 16 60 60
190 MOFACORT CREM Tube 3
191 MOMETHASONE CREAM 5 GR Tube 3
192 MST CONTINOUS 10 MG Tabl 57 0
193 MUCOSTA TAB 100 MG Tabl 100
194 MYCOS SM 3,5 GR Tube 5
195 MYCETIN ZM Tube 5
196 MYORES TAB ( F ) Tabl 332 37 0
197 NACL 0,9% OGB INF 500 ML Botol 2 5 3
198 NATRIUM BICARBONAT TAB 500 MG OGB (F) Tabl 390 510 500
199 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl 100
200 NEULIN PS Tabl 100
201 NEURODEX TAB Tabl 200
202 NEVOX XR 500MG Tabl 200
203 NEW DIATAB TAB (F2) Tabl 100
204 NEXURIN Tabl 0
205 NITROKAF RETARD TAB (F) Tabl 80 100
206 NONCORT MD (F2) Strip 23 1 0
207 NOROID LOTION Botol 5
208 NOTISIL 2 MG TAB Tabl 33 37 100
209 NOVORAPID FLEX PEN Buah 5 3 0
210 NUDEP TAB 50 MG Tabl 68 7 0
211 NUTRIFLAM CAPS Caps 0
212 NYSTATIN DROP Fls 2
213 OBH 100 ML Fls 0
214 OFLOXACIN TAB 200 MG OGB (F) Tabl 120 0
215 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 34 500
216 ONDANCETRON TAB 4 MG (F) Tabl 15 30
217 ORINOX TABLET 60 MG Tabl 52 90
218 ORINOX TABLET 90 MG Tabl 90
219 ORINOX TABLET 120 MG Tabl 90
220 OSFIT Tabl 0
221 OTILON TT 8 ML Fls 4 1 0
222 P PRED MD 10 MG/0.6 ML (F2) Strip 20
223 PANTOPRAZOLE 20 MG Tabl 100
224 PARACETAMOL SYR 120 MG/5 ML 60 ML OGB (F) Fls 5
225 PARACETAMOL TAB 500 MG (F) Tabl 295 160 0
226 PARIET 10 MG Tabl 0
227 PHENOBARBITAL 30 MG Tabl 100
228 PHENYTOIN CAPS (F) Caps 500
229 PIROTOP CREAM 5 GRAM Tube 5 1 0
230 PIRACETAM 400 MG Caps 100
231 PIRACETAM 800 MG Caps 100
232 PIROXICAM CAPS 20 MG OGB Caps 221 0
233 POLYDEX MDS 0,6 ML TM @5 s Fls 3 0
234 POLYDEX TM 5 ML Fls 0
235 POSAFIT Tabl 100
236 PRAXILLENE 200 MG TAB Tabl 106 36 0
237 PREGABALIN 75 MG Caps 120
238 PROFOLAT 0,4 MCG Tabl 100
239 PROPANOLOL TAB 10 MG OGB (F) Tabl 49 136 100
240 PRORENAL Tabl 500
241 PROSTAM SR TAB Tabl 0
242 PROVELYN 75 MG TAB Tabl 274 107 0
243 PYRAZINAMID TAB 500 MG OGB (F) Tabl 0
244 Q TEN 100 Tabl 100
245 RAMIPRIL TAB 2,5 MG (F) Tabl 583 0
246 RAMIPRIL TAB 5 MG (F) Tabl 230 90 0
247 RANITIDIN TAB 150 MG OGB (F) Tabl 25 200
248 REDACID Tabl 100
249 RENALOF TAB Tabl 0
250 RETAPHYL SR CAPL Capl 100
251 RIFAMPICIN TAB 450 MG OGB (F) Tabl 0
252 RIFAMPICIN TAB 600 MG OGB (F) Tabl 0
253 RINCOBAL 500MCG Tabl 0
254 RISPERIDONE TAB 2 MG OGB (F) Tabl 483 180 0
255 SAGESTAM 80 MG Ampul 2 0
256 SALBUTAMOL TAB 2 MG OGB Tabl 163 15 0
257 SANMOL DROP Fls 0
258 SANDEPRIL 50 MG Tabl 19 60
259 SANTA E Tabl 100
260 SEROQUEL XR TAB 200 (F) Tabl 0
261 SEROQUEL XR TAB 300 (F) Tabl 0
262 SEROQUEL XR TAB 400 (F) Tabl 30 30
263 SILOXAN TM Fls 20
264 SILEX SYRUP FLES 0
265 SIBITAL TAB 50 MG (F2) Tabl 0
266 SIFROL ER TAB 0,375 MG (F2) Tabl 215 0
267 SIFROL ER TAB 0,75 MG (F2) Tabl 186 0
268 SODIUM VALPROAT SYR Fls 1
269 SOPAVEL 10 MG Tabl 100
270 SILOXAN TM Fls 20
271 SIMARC 2 MG Tabl 200
272 SIMVASTATIN 10 MG Tabl 30 100
273 SIMVASTATIN 20 MG Tabl 300
274 SINKRONIK Tabl 100
275 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 2 2
276 SPIROLA TAB 100 MG Tabl 85 76 0
277 SPIROLA TAB 25 MG Tabl 0
278 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 233 97 0
279 SPIRONOLACTONE TAB 100 MG OGB (F) Tabl 302 30 0
280 STALEVO TAB 100 MG (F) Tabl 0
281 STARFER CAPS Caps 0
282 STELOSI TAB 5 MG (F2) Tabl 228 72 0
283 STOBLED CAPS (F) Caps 0
284 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls 2
285 TEGRETOL 200 MG Tabl 86 200
286 THYROZOL TAB 5 MG (F) Tabl 25 30 100
287 THYROZOL TAB 10 MG (F) Tabl 70 30 0
288 THROMBO ASPILET Tabl 500
289 TIMOL 0,5 %TM 5 ML Fls 0
290 TOBROSON MD Strip 20
291 TOPAMAX TAB 25 MG Tabl 95 15 0
292 TORASIC TAB Tabl 84 0
293 TORREX Tabl 0
294 TRAJENTA Tabl 100
295 TRACETATE TABLET 160 MG Capl 100
296 TRAMADOL 50 MG Caps 23 20 0
297 TRAMPARA Tabl 100
298 TREMENZA TAB Tabl 100
299 TRIFACALC TAB 500 MG Tabl 0
300 TRIFED Tabl 0
301 TRIHEXYPHENIDIL 2 MG Tabl 210 660 500
302 TRINOLON TAB 4 MG Tabl 0
303 ULTRACET Tabl 0
304 UROTRACTIN TAB 400 MG Tabl 96 0
305 URSODEOXYCHOLIC ACID 250 MG (F) Caps 129 0
306 VESICARE 5 MG Tabl 0
307 V BLOC TAB 6,25 MG (F) Tabl 200 0
308 V BLOC TAB 25 MG (F) Tabl 25 0
309 VIP ALBUMIN Caps 500
310 VITAMIN B COMPLEX TAB OGB Tabl 158 50 0
311 VITAMIN B6 TAB 10 MG OGB Tabl 210 300
312 VITAMIN C TAB 50 MG OGB Tabl 30 100
313 VITAMIN K TAB /PHYTOMENADION 10MG Tabl 160 30 0
314 XANDA SIRUP Tabl 2
315 XEPAZYM Tabl 100
316 ZITANID 2 MG Tabl
perencanaan 2020

PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON,4 JULI 2020

KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI

SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH, S.FARM, APT

NIP 19710717 199203 2 005 NIP 19671230 198803 2 003
INSTALASI FARMASI
RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN JANUARI 2020

SISA JMLH JMLH

NO NAMA BARANG SATUAN STOCK PEMAKAIA KEBUTUHAN +
AKHIR N 20 %

Alkes
1 BISTURI 11 Buah 0
2 BISTURI 15 Buah 1 0
3 CAPSUL KOSONG 0 Buah 1482 559 1000
4 CAPSUL KOSONG 00 Buah 1299 483 1000
5 CAPSUL KOSONG 1 Buah 833 127 1000
6 CAPSUL KOSONG 2 Buah 744 32 1000
7 CAPSUL KOSONG 3 Buah 732 52 1000
8 COLOSTOMY BAG Buah 0
9 DISPOSIBLE 1 CC STERA Buah 1 0
10 DISPOSIBLE 10 CC JMI Buah 1 0
11 DISPOSIBLE 20 CC TERUMO Buah 0
12 DISPOSIBLE 3 CC JMI Buah 1 0
13 DISPOSIBLE 5 CC JMI Buah 0
14 DISPOSIBLE 50 CC TERUMO Buah 0
15 FIXOMUL 5X5 CM Rol 0
16 KASSA STERIL 16X16 CM Pak 4 10
17 FOLLEY CATHETER 16 CHROMA Buah 1 0
18 MONOSOF 6-0 SN-667 Buah 0
19 NEEDLE G 19 TERUMO Buah 0
20 NOVOPEN NEEDLE 32 G Buah 0
21 OPSITE 15,5 X 8,5 Lembar 5
22 OPSITE 9,5 X 8,5 Lembar 5
23 OPSITE 6,5X5 Lembar 5
24 OPTIME 4/0 TAPER Buah 0
25 POLYSORB 4-0 TAPER UL - 203 Buah 0
26 POT PLASTIK 100 GR Buah 1 0
27 POT PLASTIK 30 GR Buah 1 0
28 SOFT SILK 2-0 GS-453 ( CV 24 ) Buah 0
29 SOFT BAND 4 INC Buah 0
30 TENSOCREPE 4 INC / 10 CM Rol 0
31 TRANSOFIX Buah 3 10
32 URINE BAG TROGE Buah 1 0
33 WING NEEDLE 21 JMS Buah 0

Obat
1 ABILIFY DISCMELT 10 MG Tabl 5 45 50
 2 ACARBOSE TAB 100 MG (F) Tabl 381 120 200
3 ACARBOSE TAB 50 MG (F) Tabl 125 270 300
4 ACETYLCYSTEIN 200 MG Caps 100
5 ALOPURINOL TAB 100 MG OGB (F) Tabl 100 210 300
6 ALOPURINOL TAB 300 MG OGB (F) Tabl 414 80 100
7 ALPENTIN CAP 100 MG (F2) Caps 55 172 150
8 ALPRAZOLAM 0,5 MG Tabl 76 55 100
9 AMBROXOL SYR 15MG/5ML 1 2 2
10 AMBROXOL TAB 30 MG OGB (F) Tabl 204 30 100
AMINEFRONE Tabl 204 294 100
11 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 404 310 200
12 AMLODIPIN TAB 10 MG OGB (F) Tabl 154 364 500
13 AMLODIPIN TAB 5 MG OGB (F) Tabl 9 291 500
14 AMOXYCILLIN 500 MG Tabl 100 30 0
15 AMOXSAN CAPS 500 MG Caps 16 0
16 ANALSIK TAB Tabl 308 127 200
17 ANEMOLAT TAB 1 MG Tabl 520 480 500
18 ANGINTRIZ MR Tabl 90 120
19 ANTACIDA DOEN Fles 2 0
20 APISATE Tabl 240
21 ATORVASTATIN TAB 10 MG (F) Tabl 209 285 150
22 ATORVASTATIN TAB 20 MG (F) Tabl 209 285 300
23 AZITHROMYCIN TAB 500 MG (F) Tabl 52 33 50
24 AKILEN TT FLES 3
25 ARDIUM Tabl 60
26 ARTOFLAM Tabl 30
27 ASAM FOLAT 1 MG Tabl 500
28 ASAM TRANEKSAMAT 500 MG Tabl 100 0
29 ASTHIN FORCE Tabl 60
30 AZOMAX 500 MG Tabl 57 0
31 BNS ( BRESTHY NSL SPRAY ) 30 ML Fls 1 1
32 BAQUINOR 500 MG Tabl 60
33 BAMGETOL 200 MG Tabl 8 102 200
34 BETAHISTINE TAB 6 MG OGB (F) Tabl 317 247 300
35 BETASERC 24 MG Tabl 60
36 BETMIGA Tabl 60
37 BISOPROLOL TAB 5 MG OGB (F) Tabl 15 100
38 BRAIN ACT ODIS Tabl 60
39 BRAINACT TAB 500 MG Tabl 14 60
40 BRAXIDIN TAB Tabl 161 10 0
41 BRILINTA 90 MG Tabl 52 60 60
42 CALCIUM LACTAT 500 MG Tabl 447 153 300
43 CALOREASE Tabl 200
44 CALOS TAB Tabl 120
45 CAMELOC TAB 15 MG (F2) Capl 218 17 300
46 CANDOTENS 8 MG Tabl 150 0
47 CANDOTENS 16 MG Tabl 150 0
48 CANDESARTAN TAB 16 MG (F) Tabl 183 692 600
49 CANDESARTAN TAB 8 MG (F) Tabl 468 383 400
50 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl 400
51 CAPTOPRIL 25 MG Tabl 80 20 0
52 CARTYLO Tabl 200 255 300
53 CARDIOMIN Tabl 255 300
54 CAR-Q CAPS Caps 0
55 CATAFLAM 50 MG Tabl 100
56 CATAFLAM FASH SACHET 50
57 CEFADROXYL CAPS 500 MG OGB (F) Caps 164 25 100
58 CEFIXIME CAPS 100 MG (F) Tabl 336 126 300
59 CEFIXIME SYR 100 MG/5 ML 30 ML OGB (F) Fls 4
60 CEFSPAN 100 MG Caps 10 100
61 CEFSPAN TAB 200 MG Tabl 100
62 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 230 48 100
63 CHANNA Tabl 85 65 90
64 CHLORPENIRAMIN MALEAT TAB 4 MG OGB (F) Tabl 78 10 0
65 CILOSTAZOL 100 MG Tabl 101 70 100
66 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 540 326 500
67 CITICOLIN TAB 1000 MG Tabl 70 0
68 CITICOLIN TAB 500 MG Tabl 59 175 300
69 CLANEKSI FORTE SYR FLES 1 2
70 CLINDAMYCIN CAPS 150 MG OGB (F) Caps 110 0
71 CLINDAMYCIN CAPS 300 MG (F) Caps 170 0
72 CLOBAZAM TAB 10 MG OGB (F) Tabl 291 170 200
73 CLOPIDOGREL TAB 75 MG (F) Tabl 281 327 400
74 CLOZAPINE 100 MG TAB (F) Tabl 45 30 0
75 CLOZAPINE 25 MG TAB (F) Tabl 194 52 0
76 CO AMOXICLAVE 625 MG Tabl 43 25 120
77 CODEIN TAB 10 MG OGB ( F ) Tabl 247 17 100
78 CODEIN TAB 20 MG OGB ( F ) Tabl 208 207 200
79 CODIPRONT Caps 1 0
80 CODIPRONT SYR Fls 1 0
81 CODIPRONT CUM EXP CAPS Caps 55 60 50
82 CODITAM TAB 30 MG Tabl 141 30 100
83 CONCOR TAB 2,5 MG Tabl 326 500
84 COXIRON FC TABLET 60 MG Tabl 6 90
85 COXIRON FC TABLET 90 MG Tabl 297 7 90
86 CPG TAB 75 MG Tabl 42 600
87 CRAVIT TAB 500 MG Tabl 12 0
88 CURCUMA TAB Tabl 95 500
89 DARYANTULLE (F2) Lembar 10
90 DEPAKOTE ER TAB 500 MG (F2) Tabl 146 135 100
91 DEPAKOTE TAB 250 MG (F2) Tabl 243 556 400
92 DEPAKOTE ER 250 MG Tabl 100 30 0
93 DESOXIMETASONE 0,25 CREAM 15 GR (F) Tube 4 5
94 DEPAKENE SIRUP Tabl 500
95 DEXAMETHASONE Tabl 183 50 0
96 DIAZEPAM TAB 2 MG OGB (F) Tabl 213 303 200
97 DIAZEPAM TAB 5 MG OGB (F) Tabl 288 12 100
98 DIAMICRON MR 60 MG Tabl 38 0
99 DIGOXIN TAB 0,25 MG OGB (F) Tabl 421 70 100
100 DOGESIC 500 MG TAB (F) Tabl 345 211 0
101 DOMPERIDON TAB 10 MG OGB (F) Tabl 64 60 100
102 DOGMATIL Tabl 100
103 DOPEPSA SYR 100 ML (F2) Botol 10 27 24
104 DULCOLAX 5 MG Tabl 3 100
105 DULCOLAX SUPP BJ 3 10
106 ECLID 100 MG Tabl 100
107 EFLIN SYR Fles 1 0
108 ELIZAC 20 MG Caps 100
109 ELOX CREAM 10 GR Tube 1 2
110 ENYSTIN DROP Fles 1 1 0
111 EPERISONE TAB Tabl 258 66 100
112 ETORICOXIB 60 MG Tabl 2 120
113 ETORICOXIB 90 MG Tabl 120
114 ETHAMBUTOL TAB 500 MG OGB (F) Tabl 60 100
115 EYEFRESH PLUS MD PAK 11 4 0
116 EYEFRESH MD PAK 20
117 EXAFLAM TAB 50 MG (F) Tabl 50
118 FARGOXIN TAB Tabl 75 0
119 FENOFIBRATE 100 MG Tabl 10 60
120 FENOFIBRATE 300 MG Tabl 30 60
121 FLOXA MD 0,6 ML TM Strip 50
122 FLOXA TM 5 ML Fls 51 9 20
123 FLUNARIZINE TAB 5 MG (F) Tabl 9 389 500
124 FORNEURO TAB (F) Tabl 45 60
125 FRAMYCETIN SULFATE Lembar 2 10
126 FREGO 10MG TAB Tabl 100
127 FUROSEMIDA TAB @200 Tabl 298 361 400
128 GABAPENTIN CAPS 300 MG (F) Caps 146 208 300
129 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube 3 2
130 GENTAMICIN SK 0,1 % 5 GR OGB Tube 3 3 3
131 GLIMEPIRIDE TAB 1 MG OGB (F) Tabl 68 0
132 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl 43 70 100
133 GLIQUIDONE TAB 30 MG OGB (F) Tabl 841 190 0
134 GLUCOPHAGE TAB 500 MG Tabl 100
135 GLUCOSAMIN CAPS 250 MG Caps 320 90 100
136 GLUTROP CAPS Caps 100
137 HALOPERIDOL 1,5 MG Tabl 48 92 100
138 HALOPERIDOL 5 MG Tabl 140 0
139 HARNAL OCAS CAPS 0,4 MG (F) Caps 150 210
140 HEPABALANCE CAPS Caps 120
141 HEXYMER 2 MG Tabl 500
142 HISTRIN Tabl 10 100
143 IBUPROFEN SIRUP Botol 1
144 IBUPROFEN TAB 200 MG OGB ( F ) Tabl 145 139 200
145 IBUPROFEN TAB 400 MG OGB ( F ) Tabl 197 300
146 IMUNOS Tabl 197 300
147 INBUMIN Caps 648 90 300
148 IOPAMIRO 370 / 50 ML Botol 0
149 ISONIAZID TAB 300 MG OGB (F) Tabl 321 133 100
150 ISOSORBID DINITRAT TAB 5 MG OGB (F) Tabl 234 285 100
151 ITRACONAZOLE CAPS 100 MG (F) Caps 66 0
152 KALMECO 500 MG Tabl 7 100
153 KALTROFEN TAB 50 MG Tabl 139 0
154 KALXETIN CAPS 20 MG Caps 0
155 KENALOG IN ORABASE Tube 1
156 KETOKONAZOLE CREAM 2% 10 GR OGB (F) Tube 3 1 2
157 KETOPROFEN TAB 100 MG OGB (F) Tabl 110 40 0
158 KETOROLAC TAB 10 MG OGB Tabl 151 59 100
159 KLODERMA CREAM 10 GR Tube 1 3 6
160 KSR ALUFOIL CAPS 600 MG (F) Caps 13 7 100
161 LFX 5 ML TM FLES 1 26 30
162 LAKTULOSA SYR 60 ML (F) Botol 3 4
163 LANCID CAPS 30 MG Caps 22 200
164 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 379 481 200
165 LAXADIN SYR Fls 3 0
166 LORATADIN Tabl 2 59 100
167 LEVEMIR FLEXPEN Ampul 4 0
168 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 31 54 30
169 LIDOCAIN COMPOSITUM INJ (F) Ampul 5 0
170 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 0
171 LIPANTHYL PENTA Tabl 59 100
172 LYTEERS TM 15 ML Fls 3 7 5
173 LUVOX Tabl 100
174 MEIACT Tabl 14 30
175 MELOXICAM TAB 7,5 MG (F) Tabl 50 100
176 METFORMIN TAB 500 MG OGB (F) Tabl 347 375 400
177 METHYLPREDNISOLON TAB 16 MG (F) Tabl 200
178 METHYLPREDNISOLON TAB 4 MG OGB (F) Tabl 219 337 500
179 METHYLPREDNISOLON TAB 8 MG OGB (F) Tabl 100
180 METRONIDAZOL TAB 500 MG OGB (F) Tabl 115 25 100
181 MICARDIS TAB 40 MG (F) Tabl 68 30 40
182 MINIASPI 80MG TAB (F) Tabl 300
183 MOFACORT CREM Tube 2
184 MOMETHASONE CREAM 5 GR Tube 1 2
185 MST CONTINOUS 10 MG Tabl 132 30 100
186 MUCOSTA TAB 100 MG Tabl 319 135 100
187 MYCOS SM 3,5 GR Tube 22 12 10
188 MYCETIN ZM Tube 3 3
189 MYORES TAB ( F ) Tabl 23 500
190 NACL 0,9% OGB INF 500 ML Botol 4 4 0
191 NATRIUM BICARBONAT TAB 500 MG OGB (F) Tabl 545 1000
192 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl 103 10 0
193 NEULIN PS Tabl 10 0
194 NEURODEX TAB Tabl 80 110 200
195 NEVOX XR 500MG Tabl 100
196 NEW DIATAB TAB (F2) Tabl 137 0
197 NEXURIN Tabl 57 45 100
198 NITROKAF RETARD TAB (F) Tabl 190 120 100
199 NONCORT MD (F2) Strip 15 4 0
200 NOROID LOTION Botol 3 0
201 NOTISIL 2 MG TAB Tabl 85 0
202 NOVORAPID FLEX PEN Buah 4 1 0
203 NUDEP TAB 50 MG Tabl 30 100
204 NUTRIFLAM CAPS Caps 29 57 180
205 NYSTATIN DROP Fls 2
206 OBH 100 ML Fls 0
207 OFLOXACIN TAB 200 MG OGB (F) Tabl 34 0
208 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 13 564 700
209 ONDANCETRON TAB 4 MG (F) Tabl 83 100 0
210 ORINOX TABLET 90 MG Tabl 120 0
211 ORINOX TABLET 120 MG Tabl 0
212 OSFIT Tabl 170 15 0
213 OTILON TT 8 ML Fls 2 1 2
214 P PRED MD 10 MG/0.6 ML (F2) Strip 5 34 50
215 PANTOPRAZOLE 20 MG Tabl 28 0
216 PARACETAMOL SYR 120 MG/5 ML 60 ML OGB (F) Fls 1 1 5
217 PARACETAMOL TAB 500 MG (F) Tabl 353 413 100
218 PARIET 10 MG Tabl 413 100
219 PHENOBARBITAL 30 MG Tabl 105 180 200
220 PHENYTOIN CAPS (F) Caps 386 465 100
221 PIROTOP CREAM 5 GRAM Tube 10 6 5
222 PIRACETAM 400 MG Caps 100
223 PIRACETAM 800 MG Caps 100
224 PIROXICAM CAPS 20 MG OGB Caps 235 0
225 POLYDEX MDS 0,6 ML TM @5 s Fls 5 20
226 POLYDEX TM 5 ML Fls 5 0
227 POSAFIT Tabl 100
228 PRAXILLENE 200 MG TAB Tabl 172 0
229 PREGABALIN 75 MG Caps 352 600
230 PROFOLAT 0,4 MCG Tabl 570 700
231 PROPANOLOL TAB 10 MG OGB (F) Tabl 200 0
232 PRORENAL Tabl 240 300
233 PROSTAM SR TAB Tabl 210 7 0
234 PROVELYN 75 MG TAB Tabl 18 600
235 PYRAZINAMID TAB 500 MG OGB (F) Tabl 394 30 100
236 Q TEN 100 Tabl 0 30 100
237 RAMIPRIL TAB 2,5 MG (F) Tabl 227 55 100
238 RAMIPRIL TAB 5 MG (F) Tabl 103 100 100
239 RANITIDIN TAB 150 MG OGB (F) Tabl 315 20 0
240 REDACID Tabl 100
241 RENALOF TAB Tabl 4 100
242 RETAPHYL SR CAPL Capl 90 28 0
243 RIFAMPICIN TAB 450 MG OGB (F) Tabl 109 128 100
244 RIFAMPICIN TAB 600 MG OGB (F) Tabl 0
245 RINCOBAL 500MCG Tabl 502 641 300
246 RISPERIDONE TAB 2 MG OGB (F) Tabl 294 240 100
247 SALBUTAMOL TAB 2 MG OGB Tabl 159 22 0
248 SANMOL DROP Fls 2
249 SANDEPRIL 50 MG Tabl 44 7 0
250 SANTA E Tabl 100
251 SEROQUEL XR TAB 200 (F) Tabl 30
252 SEROQUEL XR TAB 300 (F) Tabl 30 60
253 SEROQUEL XR TAB 400 (F) Tabl 30 60
254 SILOXAN TM Fls 3 20
255 SILEX SYRUP FLES 1 0
256 SIBITAL TAB 50 MG (F2) Tabl 91 100
257 SIFROL ER TAB 0,375 MG (F2) Tabl 105 45 40
258 SIFROL ER TAB 0,75 MG (F2) Tabl 98 52 40
259 SODIUM VALPROAT SYR Fls 1 0
260 SOPAVEL 10 MG Tabl 38 0
261 SILOXAN TM Fls 20 20
262 SIMARC 2 MG Tabl 85 15 100
263 SIMVASTATIN 10 MG Tabl 100
264 SIMVASTATIN 20 MG Tabl 422 78 100
265 SINKRONIK Tabl 0 78 100
266 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 1 0
267 SODIUM VALPROAT Fls 0
268 SPIROLA TAB 100 MG Tabl 178 0
269 SPIROLA TAB 25 MG Tabl 25 100
270 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 300 25 100
271 STALEVO TAB 100 MG (F) Tabl 93 275 300
272 STARFER CAPS Caps 45 100
273 STELOSI TAB 5 MG (F2) Tabl 104 24 0
274 STOBLED CAPS (F) Caps 17 6 0
275 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls 1 1 2
276 THYROZOL TAB 5 MG (F) Tabl 120 30 100
277 THYROZOL TAB 10 MG (F) Tabl 110 60 100
278 THROMBO ASPILET Tabl 60 300
279 TIMOL 0,5 %TM 5 ML Fls 1 1
280 TOBROSON MD Strip 12 1 0
281 TOPAMAX TAB 25 MG Tabl 60 60 0
282 TORASIC TAB Tabl 100
283 TORREX Tabl 100
284 TRAJENTA Tabl 60
285 TRACETATE TABLET 160 MG Capl 40
286 TRAMPARA Tabl 285 15 0
287 TREMENZA TAB Tabl 100
288 TRIFACALC TAB 500 MG Tabl 9 65 0
289 TRIFED Tabl 4 100
290 TRIHEXYPHENIDIL 2 MG Tabl 374 398 500
291 TRINOLON TAB 4 MG Tabl 12 0
292 ULTRACET Tabl 12 100
293 UROTRACTIN TAB 400 MG Tabl 92 40 60
294 URSODEOXYCHOLIC ACID 250 MG (F) Caps 123 20 100
295 VESICARE 5 MG Tabl 40 60
296 V BLOC TAB 6,25 MG (F) Tabl 144 100
297 V BLOC TAB 25 MG (F) Tabl 115 30 0
298 VIP ALBUMIN Caps 20 150
299 VITAMIN B COMPLEX TAB OGB Tabl 406 85 0
300 VITAMIN B6 TAB 10 MG OGB Tabl 100 0
301 VITAMIN C TAB 50 MG OGB Tabl 200 37 100
302 VITAMIN K TAB /PHYTOMENADION 10MG Tabl 20 100
303 XANDA SIRUP Tabl 5
304 XEPAZYM Tabl 5 100
305 ZITANID 2 MG Tabl 528 72 0
perencanaan obat dan alkes 2019

PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON, 20 DESEMBER 2019

KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI

SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH

NIP 19710717 199203 2 005 NIP 19671230 198803 2 003
INSTALASI FARMASI
RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN DESEMBER 2019

SISA JMLH
JMLH
NO NAMA BARANG SATUAN STOCK KEBUTUHAN
PEMAKAIAN
AKHIR + 20 %

Alkes
1 BISTURI 11 Buah 0
2 BISTURI 15 Buah 1 0
3 CAPSUL KOSONG 0 Buah 1482 559 0
4 CAPSUL KOSONG 00 Buah 1299 483 0
5 CAPSUL KOSONG 1 Buah 833 127 0
6 CAPSUL KOSONG 2 Buah 744 32 0
7 CAPSUL KOSONG 3 Buah 732 52 0
8 COLOSTOMY BAG Buah 0
9 DISPOSIBLE 1 CC STERA Buah 1 1
10 DISPOSIBLE 10 CC JMI Buah 1 1
11 DISPOSIBLE 20 CC TERUMO Buah 0
12 DISPOSIBLE 3 CC JMI Buah 1 1
13 DISPOSIBLE 5 CC JMI Buah 0
14 DISPOSIBLE 50 CC TERUMO Buah 0
15 FIXOMUL 5X5 CM Rol 1
16 KASSA STERIL 16X16 CM Pak 4 5
17 FOLLEY CATHETER 16 CHROMA Buah 1 1
18 MONOSOF 6-0 SN-667 Buah 0
19 NEEDLE G 19 TERUMO Buah 0
20 NOVOPEN NEEDLE 32 G Buah 0
21 OPSITE 15,5 X 8,5 Lembar 0
22 OPSITE 9,5 X 8,5 Lembar 0
23 OPSITE 6,5X5 Lembar 0
24 OPTIME 4/0 TAPER Buah 0
25 POLYSORB 4-0 TAPER UL - 203 Buah 0
26 POT PLASTIK 100 GR Buah 1 1
27 POT PLASTIK 30 GR Buah 1 1
28 SOFT SILK 2-0 GS-453 ( CV 24 ) Buah 0
29 SOFT BAND 4 INC Buah 0
30 TENSOCREPE 4 INC / 10 CM Rol 0
31 TRANSOFIX Buah 3 4
32 URINE BAG TROGE Buah 1 1
33 WING NEEDLE 21 JMS Buah 0

Obat
1 ABILIFY DISCMELT 10 MG Tabl 5 45 50
2 ACARBOSE TAB 100 MG (F) Tabl 381 120 0
3 ACARBOSE TAB 50 MG (F) Tabl 125 270 200
4 ACETYLCYSTEIN 200 MG Caps 100
5 ALOPURINOL TAB 100 MG OGB (F) Tabl 100 210 200
6 ALOPURINOL TAB 300 MG OGB (F) Tabl 414 80 0
7 ALPENTIN CAP 100 MG (F2) Caps 55 172 150
8 ALPRAZOLAM 0,5 MG Tabl 76 55 0
9 AMBROXOL SYR 15MG/5ML 1 2 1
10 AMBROXOL TAB 30 MG OGB (F) Tabl 204 30 0
11 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 404 310 0
12 AMLODIPIN TAB 10 MG OGB (F) Tabl 154 364 500
13 AMLODIPIN TAB 5 MG OGB (F) Tabl 9 291 500
14 AMOXYCILLIN 500 MG Tabl 100 30 0
15 AMOXSAN CAPS 500 MG Caps 16 0
16 ANALSIK TAB Tabl 308 127 0
17 ANEMOLAT TAB 1 MG Tabl 520 480 0
18 ANGINTRIZ MR Tabl 90 0
19 ANTACIDA DOEN Fles 2 0
20 APISATE Tabl 240
21 ATORVASTATIN TAB 20 MG (F) Tabl 209 285 150
22 AZITHROMYCIN TAB 500 MG (F) Tabl 52 33 0
23 AKILEN TT FLES 2
24 ARDIUM Tabl 60
25 ARTOFLAM Tabl 30
26 ASAM FOLAT 1 MG Tabl 500
27 ASAM TRANEKSAMAT 500 MG Tabl 100 0
28 ASTHIN FORCE Tabl 60
29 AZOMAX 500 MG Tabl 57 0
30 BNS ( BRESTHY NSL SPRAY ) 30 ML Fls 1 1
31 BAMGETOL 200 MG Tabl 8 102 200
32 BETAHISTINE TAB 6 MG OGB (F) Tabl 317 247 0
33 BETASERC 24 MG Tabl 60
34 BISOPROLOL TAB 5 MG OGB (F) Tabl 15 100
35 BRAIN ACT ODIS Tabl 120
36 BRAINACT TAB 500 MG Tabl 14 60
37 BRAXIDIN TAB Tabl 161 10 0
38 BRILINTA 90 MG Tabl 52 60 60
39 CALCIUM LACTAT 500 MG Tabl 447 153 0
40 CALOREASE Tabl 200
41 CALOS TAB Tabl 120
42 CAMELOC TAB 15 MG (F2) Capl 218 17 0
43 CANDOTENS 8 MG Tabl 150 0
44 CANDOTENS 16 MG Tabl 150 0
45 CANDESARTAN TAB 16 MG (F) Tabl 183 692 600
46 CANDESARTAN TAB 8 MG (F) Tabl 468 383 0
47 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl 300
48 CAPTOPRIL 25 MG Tabl 80 20 0
49 CARTYLO Tabl 200 255 100
50 CAR-Q CAPS Caps 30
51 CATAFLAM 50 MG Tabl 100
52 CATAFLAM FASH SACHET 50
53 CEFADROXYL CAPS 500 MG OGB (F) Caps 164 25 0
54 CEFIXIME CAPS 100 MG (F) Tabl 336 126 0
55 CEFIXIME SYR 100 MG/5 ML 30 ML OGB (F) Fls 4
56 CEFSPAN 100 MG Caps 10 100
57 CEFSPAN TAB 200 MG Tabl 100
58 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 230 48 0
59 CHANNA Tabl 85 65 0
60 CHLORPENIRAMIN MALEAT TAB 4 MG OGB (F) Tabl 78 10 0
61 CILOSTAZOL 100 MG Tabl 101 70 0
62 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 540 326 0
63 CITICOLIN TAB 1000 MG Tabl 70 0
64 CITICOLIN TAB 500 MG Tabl 59 175 300
65 CLANEKSI FORTE SYR FLES 1 1
66 CLINDAMYCIN CAPS 150 MG OGB (F) Caps 110 0
67 CLINDAMYCIN CAPS 300 MG (F) Caps 170 0
68 CLOBAZAM TAB 10 MG OGB (F) Tabl 291 170 0
69 CLOPIDOGREL TAB 75 MG (F) Tabl 281 327 300
70 CLOZAPINE 100 MG TAB (F) Tabl 45 30 0
71 CLOZAPINE 25 MG TAB (F) Tabl 194 52 0
72 CO AMOXICLAVE 625 MG Tabl 43 25 120
73 CODEIN TAB 10 MG OGB ( F ) Tabl 247 17 0
74 CODEIN TAB 20 MG OGB ( F ) Tabl 208 207 0
75 CODIPRONT Caps 1 0
76 CODIPRONT SYR Fls 1 1
77 CODIPRONT CUM EXP CAPS Caps 55 60 30
78 CODITAM TAB 30 MG Tabl 141 30 0
79 CONCOR TAB 2,5 MG Tabl 326 500
80 COXIRON FC TABLET 60 MG Tabl 6 90
81 COXIRON FC TABLET 90 MG Tabl 297 7 0
82 CPG TAB 75 MG Tabl 42 300
83 CRAVIT TAB 500 MG Tabl 12 0
84 CURCUMA TAB Tabl 95 500
85 DARYANTULLE (F2) Lembar 10
86 DEPAKOTE ER TAB 500 MG (F2) Tabl 146 135 0
87 DEPAKOTE TAB 250 MG (F2) Tabl 243 556 400
88 DEPAKOTE ER 250 MG Tabl 100 30 0
89 DESOXIMETASONE 0,25 CREAM 15 GR (F) Tube 4 0
90 DEXAMETHASONE Tabl 183 50 0
91 DIAZEPAM TAB 2 MG OGB (F) Tabl 213 303 200
92 DIAZEPAM TAB 5 MG OGB (F) Tabl 288 12 0
93 DIAMICRON MR 60 MG Tabl 38 0
 94 DIGOXIN TAB 0,25 MG OGB (F) Tabl 421 70 0
95 DOGESIC 500 MG TAB (F) Tabl 345 211 100
96 DOMPERIDON TAB 10 MG OGB (F) Tabl 64 60 100
97 DOGMATIL Tabl 100
98 DOPEPSA SYR 100 ML (F2) Botol 10 27 20
99 DULCOLAX 5 MG Tabl 3 100
100 ECLID 100 MG Tabl 100
101 EFLIN SYR Fles 1 0
102 ELIZAC 20 MG Caps 60
103 ELOX CREAM 10 GR Tube 1 1
104 ENYSTIN DROP Fles 1 1 0
105 EPERISONE TAB Tabl 258 66 0
106 ETORICOXIB 60 MG Tabl 2 120
107 ETORICOXIB 90 MG Tabl 120
108 ETHAMBUTOL TAB 500 MG OGB (F) Tabl 60 100
109 EYEFRESH PLUS MD PAK 11 4 0
110 EYEFRESH MD PAK 20
111 EXAFLAM TAB 50 MG (F) Tabl 50
112 FARGOXIN TAB Tabl 75 0
113 FENOFIBRATE 100 MG Tabl 10 30
114 FENOFIBRATE 300 MG Tabl 30 30
115 FLOXA MD 0,6 ML TM Strip 50
116 FLOXA TM 5 ML Fls 51 9 15
117 FLUNARIZINE TAB 5 MG (F) Tabl 9 389 500
118 FORNEURO TAB (F) Tabl 45 60
119 FRAMYCETIN SULFATE Lembar 2 10
120 FREGO 10MG TAB Tabl 100
121 FUROSEMIDA TAB @200 Tabl 298 361 400
122 GABAPENTIN CAPS 300 MG (F) Caps 146 208 100
123 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube 3 0
124 GENTAMICIN SK 0,1 % 5 GR OGB Tube 3 3 0
125 GLIMEPIRIDE TAB 1 MG OGB (F) Tabl 68 0
126 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl 43 70 100
127 GLIQUIDONE TAB 30 MG OGB (F) Tabl 841 190 0
128 GLUCOPHAGE TAB 500 MG Tabl 100
129 GLUCOSAMIN CAPS 250 MG Caps 320 90 0
130 GLUTROP CAPS Caps 180
131 HALOPERIDOL 1,5 MG Tabl 48 92 100
132 HALOPERIDOL 5 MG Tabl 140 0
133 HARNAL OCAS CAPS 0,4 MG (F) Caps 150 180
134 HEPABALANCE CAPS Caps 120
135 HEXYMER 2 MG Tabl 500
136 HISTRIN Tabl 10 100
137 IBUPROFEN SIRUP Botol 1
138 IBUPROFEN TAB 200 MG OGB ( F ) Tabl 145 139 0
139 IBUPROFEN TAB 400 MG OGB ( F ) Tabl 197 300
140 INBUMIN Caps 648 90 0
141 IOPAMIRO 370 / 50 ML Botol 1
142 ISONIAZID TAB 300 MG OGB (F) Tabl 321 133 0
143 ISOSORBID DINITRAT TAB 5 MG OGB (F) Tabl 234 285 100
144 ITRACONAZOLE CAPS 100 MG (F) Caps 66 0
145 KALMECO 500 MG Tabl 7 100
146 KALTROFEN TAB 50 MG Tabl 139 0
147 KALXETIN CAPS 20 MG Caps 60
148 KENALOG IN ORABASE Tube 1
149 KETOKONAZOLE CREAM 2% 10 GR OGB (F) Tube 3 1 0
150 KETOPROFEN TAB 100 MG OGB (F) Tabl 110 40 0
151 KETOROLAC TAB 10 MG OGB Tabl 151 59 0
152 KLODERMA CREAM 10 GR Tube 1 3 6
153 KSR ALUFOIL CAPS 600 MG (F) Caps 13 7 100
154 LFX 5 ML TM FLES 1 26 30
155 LAKTULOSA SYR 60 ML (F) Botol 3 4
156 LANCID CAPS 30 MG Caps 22 200
157 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 379 481 200
158 LAXADIN SYR Fls 3 0
159 LEVEMIR FLEXPEN Ampul 4 0
160 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 31 54 30
161 LIDOCAIN COMPOSITUM INJ (F) Ampul 5 0
162 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 0
163 LYTEERS TM 15 ML Fls 3 7 0
164 LUVOX Tabl 100
165 MEIACT Tabl 14 30
166 MELOXICAM TAB 7,5 MG (F) Tabl 50 60
167 METFORMIN TAB 500 MG OGB (F) Tabl 347 375 100
168 METHYLPREDNISOLON TAB 16 MG (F) Tabl 200
169 METHYLPREDNISOLON TAB 4 MG OGB (F) Tabl 219 337 500
170 METHYLPREDNISOLON TAB 8 MG OGB (F) Tabl 100
171 METRONIDAZOL TAB 500 MG OGB (F) Tabl 115 25 0
172 MICARDIS TAB 40 MG (F) Tabl 68 30 0
173 MINIASPI 80MG TAB (F) Tabl 300
174 MOFACORT CREM Tube 2
175 MOMETHASONE CREAM 5 GR Tube 1 1
176 MST CONTINOUS 10 MG Tabl 132 30 0
177 MUCOSTA TAB 100 MG Tabl 319 135 0
178 MYCOS SM 3,5 GR Tube 22 12 0
179 MYCETIN ZM Tube 3 0
180 MYORES TAB ( F ) Tabl 23 300
181 NACL 0,9% OGB INF 500 ML Botol 4 4 0
182 NATRIUM BICARBONAT TAB 500 MG OGB (F) Tabl 545 800
183 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl 103 10 0
184 NEULIN PS Tabl 10 0
185 NEURODEX TAB Tabl 80 110 200
186 NEVOX XR 500MG Tabl 100
187 NEW DIATAB TAB (F2) Tabl 137 0
188 NEXURIN Tabl 57 45 100
189 NITROKAF RETARD TAB (F) Tabl 190 120 0
190 NONCORT MD (F2) Strip 15 4 0
191 NOROID LOTION Botol 3 0
192 NOTISIL 2 MG TAB Tabl 85 0
193 NOVORAPID FLEX PEN Buah 4 1 0
194 NUDEP TAB 50 MG Tabl 30 100
195 NUTRIFLAM CAPS Caps 29 57 180
196 NYSTATIN DROP Fls 2
197 OBH 100 ML Fls 1
198 OFLOXACIN TAB 200 MG OGB (F) Tabl 34 0
199 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 13 564 700
200 ONDANCETRON TAB 4 MG (F) Tabl 83 100 20
201 ORINOX TABLET 120 MG Tabl 0
202 OSFIT Tabl 170 15 0
203 OTILON TT 8 ML Fls 2 1 0
204 P PRED MD 10 MG/0.6 ML (F2) Strip 5 34 50
205 PANTOPRAZOLE 20 MG Tabl 28 0
206 PARACETAMOL SYR 120 MG/5 ML 60 ML OGB (F) Fls 1 1 0
207 PARACETAMOL TAB 500 MG (F) Tabl 353 413 100
208 PHENOBARBITAL 30 MG Tabl 105 180 100
209 PHENYTOIN CAPS (F) Caps 386 465 0
210 PIROTOP CREAM 5 GRAM Tube 10 6 0
211 PIRACETAM 400 MG Caps 100
212 PIRACETAM 800 MG Caps 100
213 PIROXICAM CAPS 20 MG OGB Caps 235 0
214 POLYDEX MDS 0,6 ML TM @5 s Fls 5 6
215 POLYDEX TM 5 ML Fls 5 6
216 POSAFIT Tabl 100
217 PRAXILLENE 200 MG TAB Tabl 172 0
218 PREGABALIN 75 MG Caps 352 600
219 PROFOLAT 0,4 MCG Tabl 570 700
220 PROPANOLOL TAB 10 MG OGB (F) Tabl 200 0
221 PRORENAL Tabl 240 300
222 PROSTAM SR TAB Tabl 210 7 0
223 PROVELYN 75 MG TAB Tabl 18 600
224 PYRAZINAMID TAB 500 MG OGB (F) Tabl 394 30 0
225 RAMIPRIL TAB 2,5 MG (F) Tabl 227 55 0
226 RAMIPRIL TAB 5 MG (F) Tabl 103 100 0
227 RANITIDIN TAB 150 MG OGB (F) Tabl 315 20 0
228 REDACID Tabl 100
229 RENALOF TAB Tabl 4 100
230 RETAPHYL SR CAPL Capl 90 28 0
231 RIFAMPICIN TAB 450 MG OGB (F) Tabl 109 128 100
232 RIFAMPICIN TAB 600 MG OGB (F) Tabl 0
233 RINCOBAL 500MCG Tabl 502 641 200
234 RISPERIDONE TAB 2 MG OGB (F) Tabl 294 240 0
235 SALBUTAMOL TAB 2 MG OGB Tabl 159 22 0
236 SANMOL DROP Fls 2
237 SANDEPRIL 50 MG Tabl 44 7 0
238 SANTA E Tabl 100
239 SEROQUEL XR TAB 200 (F) Tabl 30
240 SEROQUEL XR TAB 300 (F) Tabl 30 60
241 SEROQUEL XR TAB 400 (F) Tabl 30 60
242 SILOXAN TM Fls 3 4
243 SILEX SYRUP FLES 1 1
244 SIBITAL TAB 50 MG (F2) Tabl 91 0
245 SIFROL ER TAB 0,375 MG (F2) Tabl 105 45 0
246 SIFROL ER TAB 0,75 MG (F2) Tabl 98 52 0
247 SODIUM VALPROAT SYR Fls 1 0
248 SOPAVEL 10 MG Tabl 38 0
249 SIMARC 2 MG Tabl 85 15 100
250 SIMVASTATIN 10 MG Tabl 100
251 SIMVASTATIN 20 MG Tabl 422 78 0
252 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 1 2
253 SODIUM VALPROAT Fls 0
254 SPIROLA TAB 100 MG Tabl 178 0
255 SPIROLA TAB 25 MG Tabl 25 60
256 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 300 25 0
257 STALEVO TAB 100 MG (F) Tabl 93 275 300
258 STARFER CAPS Caps 45 100
259 STELOSI TAB 5 MG (F2) Tabl 104 24 0
260 STOBLED CAPS (F) Caps 17 6 0
261 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls 1 1 0
262 THYROZOL TAB 5 MG (F) Tabl 120 30 0
263 THYROZOL TAB 10 MG (F) Tabl 110 60 0
264 TIMOL 0,5 %TM 5 ML Fls 1 1
265 TOBROSON MD Strip 12 1 0
266 TOPAMAX TAB 25 MG Tabl 60 60 0
267 TORASIC TAB Tabl 100
268 TRAJENTA Tabl 60
269 TRACETATE TABLET 160 MG Capl 20
270 TRAMPARA Tabl 285 15 0
271 TREMENZA TAB Tabl 60
272 TRIFACALC TAB 500 MG Tabl 9 65 100
273 TRIFED Tabl 4 0
274 TRIHEXYPHENIDIL 2 MG Tabl 374 398 300
275 TRINOLON TAB 4 MG Tabl 12 0
276 UROTRACTIN TAB 400 MG Tabl 92 40 0
277 URSODEOXYCHOLIC ACID 250 MG (F) Caps 123 20 0
278 V BLOC TAB 6,25 MG (F) Tabl 144 0
279 V BLOC TAB 25 MG (F) Tabl 115 30 0
280 VITAMIN B COMPLEX TAB OGB Tabl 406 85 0
281 VITAMIN B6 TAB 10 MG OGB Tabl 100 0
282 VITAMIN C TAB 50 MG OGB Tabl 200 37 0
283 VITAMIN K TAB /PHYTOMENADION 10MG Tabl 20 100
284 XEPAZYM Tabl 5 0
285 ZITANID 2 MG Tabl 528 72 0

PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON, 3 DESEMBER 2019

KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI

SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH

NIP 19710717 199203 2 005 NIP 19671230 198803 2 003
INSTALASI FARMASI
RSD GUNUNG JATI CIREBON

PERENCANAAN OBAT DAN ALKES POLIKLINIK EKSEKUTIF PAKUNGWATI

BULAN OKT0BER 2019

SISA JMLH JMLH

NO NAMA BARANG SATUAN STOCK PEMAKAI KEBUTUHA
AKHIR AN N + 20 %
Alkes
1 BISTURI 11 Buah 2 2
2 BISTURI 15 Buah 2 2
3 CAPSUL KOSONG 0 Buah 1194 2000
4 CAPSUL KOSONG 00 Buah 508 700
5 CAPSUL KOSONG 1 Buah 55 1000
6 CAPSUL KOSONG 2 Buah 232 1000
7 CAPSUL KOSONG 3 Buah 110 1000
8 DISPOSIBLE 1 CC STERA Buah 2 2
9 DISPOSIBLE 10 CC JMI Buah 5 6
10 DISPOSIBLE 20 CC TERUMO Buah 2 2
11 DISPOSIBLE 3 CC JMI Buah 3 4
12 DISPOSIBLE 5 CC JMI Buah 1 1
13 FOLLEY CATHETER 16 CHROMA Buah 1 1
14 MONOSOF 6-0 SN-667 Buah 1 1
15 NEEDLE G 19 TERUMO Buah 1 1
16 NOVOPEN NEEDLE 32 G Buah 14 17
17 OPSITE 15,5 X 8,5 Lembar 1 1
18 OPSITE 9,5 X 8,5 Lembar 5 6
19 POT PLASTIK 100 GR Buah 1 1
20 POT PLASTIK 30 GR Buah 3 4
21 SOFT BAND 4 INC Buah 1 1
22 TENSOCREPE 4 INC / 10 CM Rol 1 1
23 TRANSOFIX Buah 1 1
24 URINE BAG TROGE Buah 3 4
25 WING NEEDLE 21 JMS Buah 1 1

Obat
1 ACARBOSE TAB 100 MG (F) Tabl 301 66 0
2 ACARBOSE TAB 50 MG (F) Tabl 285 90 0
3 ALOPURINOL TAB 100 MG OGB (F) Tabl 240 120 0
4 ALOPURINOL TAB 300 MG OGB (F) Tabl 94 80 0
5 ALPENTIN CAP 100 MG (F2) Caps 91 136 100
6 AMBROXOL TAB 30 MG OGB (F) Tabl 97 94 100
 7 AMITRIPTYLINE TAB 25 MG OGB (F) Tabl 102 621 700
8 AMLODIPIN TAB 10 MG OGB (F) Tabl 243 313 100
9 AMLODIPIN TAB 5 MG OGB (F) Tabl 9 180 300
10 AMOXSAN CAPS 500 MG Caps 16 15 100
11 ANALSIK TAB Tabl 260 50 0
12 ANEMOLAT TAB 1 MG Tabl 0 45 600
13 ANGINTRIZ MR Tabl 120
14 APISATE Tabl 240
15 ATORVASTATIN TAB 20 MG (F) Tabl 99 90 0
16 AZITHROMYCIN TAB 500 MG (F) Tabl 100 3 0
17 AKILEN TT FLES 2
18 ALPRAZOLAM 0,5 MG Tabl 100
19 ARDIUM Tabl 60
20 ARTOFLAM Tabl 30
21 ASAM FOLAT 1 MG Tabl 500
22 ASTHIN FORCE Tabl 60
23 BETAHISTINE TAB 6 MG OGB (F) Tabl 566 225 0
24 BETASERC 24 MG Tabl 60
25 BISOPROLOL TAB 5 MG OGB (F) Tabl 105 30 0
26 BRAIN ACT ODIS Tabl 33 120
27 BRAINACT TAB 500 MG Tabl 59 65 60
28 BRAXIDIN TAB Tabl 171 35 0
CALOREASE Tabl 120 200
29 CALOS TAB Tabl 85 120 120
30 CAMELOC TAB 15 MG (F2) Capl 95 99 100
31 CANDOTENS 8 MG Tabl 120
32 CANDESARTAN TAB 16 MG (F) Tabl 265 470 300
33 CANDESARTAN TAB 8 MG (F) Tabl 251 532 400
34 CARBAMAZEPINE TAB 200 MG OGB (F) Tabl 190 300
35 CAR-Q CAPS Caps 13 30
36 CEFADROXYL CAPS 500 MG OGB (F) Caps 97 10 0
37 CEFIXIME CAPS 100 MG (F) Tabl 334 143 0
38 CEFIXIME SYR 100 MG/5 ML 30 ML OGB (F) Fls 2 3 2
39 CEFSPAN TAB 200 MG Tabl 60 40 50
40 CETIRIZINE TAB 10 MG (FUTAMED) Tabl 118 190 100
41 CHANNA Tabl 100
42 CHLORPENIRAMIN MALEAT TAB 4 MG OGB (F) Tabl 92 14 0
43 CIPROFLOXACIN TAB 500 MG OGB (F) Tabl 162 275 200
44 CITICOLIN TAB 1000 MG Tabl 85 65 0
45 CITICOLIN TAB 500 MG Tabl 74 76 0
46 CLINDAMYCIN CAPS 150 MG OGB (F) Caps 60 25 0
47 CLINDAMYCIN CAPS 300 MG (F) Caps 110 40 0
48 CLOBAZAM TAB 10 MG OGB (F) Tabl 150 320 300
49 CLOPIDOGREL TAB 75 MG (F) Tabl 68 242 300
50 CLOZAPINE 100 MG TAB (F) Tabl 75 30 0
51 CLOZAPINE 25 MG TAB (F) Tabl 159 51 200
52 CODEIN TAB 10 MG OGB ( F ) Tabl 288 11 0
53 CODEIN TAB 20 MG OGB ( F ) Tabl 548 348 0
54 CODIPRONT CUM EXP CAPS Caps 25 30 30
55 CODITAM TAB 30 MG Tabl 171 20 0
56 CONCOR TAB 2,5 MG Tabl 361 359 0
57 COXIRON FC TABLET 60 MG Tabl 0 50 90
58 COXIRON FC TABLET 90 MG Tabl 0 50 90
59 CPG TAB 75 MG Tabl 197 200 300
60 CRAVIT TAB 500 MG Tabl 12 10 0
61 CURCUMA TAB Tabl 400 259 0
62 DARYANTULLE (F2) Lembar 3 2 10
63 DEPAKOTE ER TAB 500 MG (F2) Tabl 81 120 100
64 DEPAKOTE TAB 250 MG (F2) Tabl 424 367 0
65 DESOXIMETASONE 0,25 CREAM 15 GR (F) Tube 5 4 0
66 DIAZEPAM TAB 2 MG OGB (F) Tabl 410 453 100
67 DIAZEPAM TAB 5 MG OGB (F) Tabl 32 100
68 DIGOXIN TAB 0,25 MG OGB (F) Tabl 200 75 0
69 DOGESIC 500 MG TAB (F) Tabl 551 332 0
70 DOMPERIDON TAB 10 MG OGB (F) Tabl 119 137 100
DOGMATIL Tabl 50 100
71 DOPEPSA SYR 100 ML (F2) Botol 9 17 20
72 ECLID 100 MG Tabl 0 0 100
73 ELIZAC 20 MG Caps 0 0 60
74 EPERISONE TAB Tabl 75 69 100
75 ETORICOXIB 60 MG Tabl 0 0 100
76 ETORICOXIB 90 MG Tabl 0 0 100
77 ETHAMBUTOL TAB 500 MG OGB (F) Tabl 351 185 100
78 EYEFRESH MD PAK 20
79 EXAFLAM TAB 50 MG (F) Tabl 10 20 50
80 FARGOXIN TAB Tabl 75 15 0
81 FLOXA MD 0,6 ML TM Strip 10 50
82 FLOXA TM 5 ML Fls 10 15
83 FLUNARIZINE TAB 5 MG (F) Tabl 121 497 500
84 FORNEURO TAB (F) Tabl 73 95 60
85 FREGO 10MG TAB Tabl 6 100
86 FUROSEMIDA TAB @200 Tabl 412 144 0
87 GABAPENTIN CAPS 300 MG (F) Caps 230 124 0
88 GENTAMICIN SM 0,3% 3,5 GR OGB (F) Tube 1 2
89 GLIMEPIRIDE TAB 2 MG OGB (F) Tabl 113 45 0
90 GLIQUIDONE TAB 30 MG OGB (F) Tabl 281 282 0
91 GLUCOPHAGE TAB 500 MG Tabl 20 20 100
92 GLUCOSAMIN CAPS 250 MG Caps 560 120 0
93 GLUTROP CAPS Caps 10 128 180
94 HARNAL OCAS CAPS 0,4 MG (F) Caps 136 169 120
95 HEPABALANCE CAPS Caps 100 120
96 HEXYMER 2 MG Tabl 0 0 500
97 IBUPROFEN SIRUP Botol 1 1
98 IBUPROFEN TAB 400 MG OGB ( F ) Tabl 136 90 0
99 INBUMIN Caps 0 0 600
100 IOPAMIRO 370 / 50 ML Botol 1 1
101 ISONIAZID TAB 300 MG OGB (F) Tabl 294 197 0
102 ISOSORBID DINITRAT TAB 5 MG OGB (F) Tabl 414 20 0
103 ITRACONAZOLE CAPS 100 MG (F) Caps 36 54 50
104 KALTROFEN TAB 50 MG Tabl 159 20 0
105 KALXETIN CAPS 20 MG Caps 28 60
106 KETOKONAZOLE CREAM 2% 10 GR OGB (F) Tube 5 3 0
107 KETOPROFEN TAB 100 MG OGB (F) Tabl 105 15 0
108 KETOROLAC TAB 10 MG OGB Tabl 106 29 0
109 KLODERMA CREAM 10 GR Tube 13 6 0
110 KSR ALUFOIL CAPS 600 MG (F) Caps 50 50 100
111 LAKTULOSA SYR 60 ML (F) Botol 2 2 2
112 LANCID CAPS 30 MG Caps 122 88 200
113 LANSOPRAZOLE CAPS 30 MG OGB (F) Caps 475 451 0
114 LEVEMIR FLEXPEN Ampul 4 1 0
115 LEVOFLOXACIN TAB 500 MG OGB (F) Tabl 40 12 0
116 LIDOCAIN COMPOSITUM INJ (F) Ampul 5 4 0
117 LIDOCAIN INJ 2% 2 ML OGB (F) Ampul 2 1 0
118 LYTEERS TM 15 ML Fls 1 2 2
119 LUVOX Tabl 100
120 MELOXICAM TAB 7,5 MG (F) Tabl 248 134 0
121 METFORMIN TAB 500 MG OGB (F) Tabl 296 284 0
122 METHYLPREDNISOLON TAB 16 MG (F) Tabl 21 26 200
123 METHYLPREDNISOLON TAB 4 MG OGB (F) Tabl 465 288 0
124 METHYLPREDNISOLON TAB 8 MG OGB (F) Tabl 14 100
125 METRONIDAZOL TAB 500 MG OGB (F) Tabl 60 30 100
126 MICARDIS TAB 40 MG (F) Tabl 48 30 0
127 MINIASPI 80MG TAB (F) Tabl 259 207 200
128 MOFACORT CREM Tube 2 2
129 MUCOSTA TAB 100 MG Tabl 214 35 0
130 MYCOS SM 3,5 GR Tube 4 10
131 MYCETIN ZM Tube 2 2
132 MYORES TAB ( F ) Tabl 186 300
133 NACL 0,9% OGB INF 500 ML Botol 2 2 0
134 NATRIUM BICARBONAT TAB 500 MG OGB (F) Tabl 245 315 100
135 NATRIUM DIKLOFENAK TAB 50 MG (F) Tabl 154 85 0
136 NEURODEX TAB Tabl 300 125 200
137 NEVOX XR 500MG Tabl 24 100
138 NEW DIATAB TAB (F2) Tabl 53 40 100
139 NEXURIN Tabl 13 56 100
140 NITROKAF RETARD TAB (F) Tabl 230 20 100
141 NONCORT MD (F2) Strip 22 1 0
142 NOROID LOTION Botol 3 1 0
143 NOTISIL 2 MG TAB Tabl 115 30 100
144 NOVORAPID FLEX PEN Buah 1 1 0
145 NUDEP TAB 50 MG Tabl 28 100
146 NUTRIFLAM CAPS Caps 114 228 180
147 NYSTATIN DROP Fls 1 2
148 OFLOXACIN TAB 200 MG OGB (F) Tabl 35 29 0
149 OMEPRAZOLE CAPS 20 MG OGB (F) Caps 381 472 150
150 ONDANCETRON TAB 4 MG (F) Tabl 99 56 0
151 ORINOX TABLET 120 MG Tabl 22 0
152 P PRED MD 10 MG/0.6 ML (F2) Strip 25 50
153 PARACETAMOL SYR 120 MG/5 ML 60 ML OGB (F) Fls 1 2
154 PARACETAMOL TAB 500 MG (F) Tabl 236 300
155 PHENYTOIN CAPS (F) Caps 556 339 200
156 PIROTOP CREAM 5 GRAM Tube 6 3 10
157 PIRACETAM 400 MG Caps 0 0 100
158 PIRACETAM 800 MG Caps 0 0 100
159 PIROXICAM CAPS 20 MG OGB Caps 167 56 0
160 POLYDEX MDS 0,6 ML TM @5 s Fls 1 2
161 POSAFIT Tabl 0 0 100
162 PRAXILLENE 200 MG TAB Tabl 72 15 0
163 PROPANOLOL TAB 10 MG OGB (F) Tabl 60 134 100
164 PROSTAM SR TAB Tabl 26 74 100
165 PROVELYN 75 MG TAB Tabl 549 600
166 PYRAZINAMID TAB 500 MG OGB (F) Tabl 236 35 0
167 RAMIPRIL TAB 2,5 MG (F) Tabl 274 30 0
168 RAMIPRIL TAB 5 MG (F) Tabl 293 32 0
169 RANITIDIN TAB 150 MG OGB (F) Tabl 626 301 0
170 REDACID Tabl 0 0 100
171 RENALOF TAB Tabl 70 43 0
172 RETAPHYL SR CAPL Capl 123 47 0
173 RIFAMPICIN TAB 450 MG OGB (F) Tabl 171 143 0
174 RIFAMPICIN TAB 600 MG OGB (F) Tabl 113 10 0
175 RINCOBAL 500MCG Tabl 729 738 100
176 RISPERIDONE TAB 2 MG OGB (F) Tabl 404 585 300
177 SALBUTAMOL TAB 2 MG OGB Tabl 129 85 0
178 SANMOL DROP Fls 1 2
179 SANTA E Tabl 30 60
180 SEROQUEL XR TAB 300 (F) Tabl 30 60
181 SIBITAL TAB 50 MG (F2) Tabl 121 30 0
182 SIFROL ER TAB 0,375 MG (F2) Tabl 21 60
183 SIFROL ER TAB 0,75 MG (F2) Tabl 18 60
184 SIMARC 2 MG Tabl 0 100
185 SIMVASTATIN 10 MG Tabl 0 100
186 SIMVASTATIN 20 MG Tabl 0 100
187 SIKZONOATE INJ 25 MG/ML 1 ML Ampul 2 2
188 SODIUM VALPROAT Fls 1 2
189 SPIROLA TAB 100 MG Tabl 178 7 0
190 SPIROLA TAB 25 MG Tabl 35 45 60
191 SPIRONOLACTONE TAB 25 MG OGB (F) Tabl 225 98 0
192 STALEVO TAB 100 MG (F) Tabl 58 186 180
193 STARFER CAPS Caps 45 15 0
194 STELOSI TAB 5 MG (F2) Tabl 88 72 0
195 STOBLED CAPS (F) Caps 23 12 0
196 TARIVID OTIC 3 MG/ML 5 ML EAR (TT) Fls 2 1 0
197 THYROZOL TAB 5 MG (F) Tabl 80 30 0
198 TOPAMAX TAB 25 MG Tabl 30 30 0
199 TORASIC TAB Tabl 70 20 0
200 TRAJENTA Tabl 6 60
201 TRACETATE TABLET 160 MG Capl 8 20
202 TREMENZA TAB Tabl 6 60
203 TRIFACALC TAB 500 MG Tabl 75 100
204 TRINOLON TAB 4 MG Tabl 19 0
205 UROTRACTIN TAB 400 MG Tabl 20 100
206 URSODEOXYCHOLIC ACID 250 MG (F) Caps 248 60 0
207 V BLOC TAB 25 MG (F) Tabl 25 45 60
208 VITAMIN B COMPLEX TAB OGB Tabl 241 130 0
209 VITAMIN B6 TAB 10 MG OGB Tabl 30 100
210 VITAMIN C TAB 50 MG OGB Tabl 267 7 0
211 VITAMIN K TAB /PHYTOMENADION TAB 10MG Tabl 215 10 0

PENANGGUNG JAWAB PERBEKALAN FARMASI CIREBON, 4 NOPEMBER 2019

KEPALA DEPO POLIKLINIK EKSEKUTIF PAKUNGWATI

SUPENTIN, S. FARM, APT. ADE ENDANG ARLINAH

NIP 19710717 199203 2 005 NIP 19671230 198803 2 003