DETASEMEN KESEHATAN WILAYAH SINGARAJA

POLIKLINIK MEDIKA WIRASATYA 023201103

DAFTAR PESANAN OBAT BULAN JANUARI 2022

NO NAMA BARANG SATUAN JUMLAH KETERANGAN

1 Amoxicilin Box 10
2 Allopurrinol Box 2
3 Asam Folat Box 1
4 Asam Mafenamat Box 10
5 Anadex Box 3
6 Dexametason 0,5 mg Box 8
7 Ambroxol tab Box 8
8 Amlodipin 5 mg Box 10
9 Amlodipin 10 mg Box 10
10 Tremenza Box 2
11 Ciprofloxacin Box 4
12 Cetirizine Box 5
13 Becom C Box 3
14 Clindamycin Box 1
15 Domperidone tab Box 5
16 Dexteem Box 2
17 Fitbon Box 1
18 Kalnex Box 1
19 Neo Asma Box 1
20 Natrium Diclofenax generik Box 7
21 Methoclopramid Box 3
22 Methyl Prednisolon Box 5
23 Cefixime Box 5
24 Ondansentron Box 1
25 Vit B Box 2
26 Livron Box 10
27 New Diatabs Box 2
28 Paracetamol Box 10
29 Ibu Profen Box 10
30 Caviplex Box 10
31 Vit C 100 mg Box 5
32 Zinc Box 3
33 Ketoconazole tab Box 2
34 Dulcolac Box 1
35 Enervon C Box 5
36 Ester C Box 3
37 Demacolin Box 10
38 Tuzalos Box 1
39 antasida doen Box 7
40 Cefadroxyl Box 7
41 Captopril 12,5 mg Box 4
42 Captopril 25 mg Box 2
43 Acyclovir tab Box 2
44 Ranitidin Box 7
45 Rivanol Liquid Botol 5
46 Salbutamol Box 1
47 Serumen Ekstraktor Set 1
48 Otopain Botol 5
49 Ambeven Box 1
50 Meloxicam 7,5 mg Box 2
51 Meloxicam 15 mg Box 2
52 Metformin Box 2
53 Hufagrip Syr Botol 25
54 Amoxicilin Syr Botol 25
55 Caviplex Syr Botol 25
56 Curcuma Syr Botol 25
57 Cefadroxyl Syr Botol 10
58 Ambroxol Syr Botol 10
59 Sanadryl Syr Botol 24
60 Coldrexine Syr Botol 30
61 Cetirizine Syr Botol 10
62 L-Zinc Syr Botol 5
63 Paracetamol Syr Botol 30
64 Guanistrep Syr Botol 10
65 Cotrimoxazole Syr Botol 10
66 Domperidone Syr Botol 10
67 Oralit Sachet 100
68 OB Herbal 60 ml Botol 20
69 OB Herbal Junior 60 ml Botol 20
70 OBH Combi Jahe Botol 25
71 Dexa Inj Ampul 6
72 Vit B12 Inj Ampul 6
73 Hot in Dcl Tube 5
74 Betason Tube 10
75 Erlamycetin TT Drops 10
76 Cendo Lyters TM Drops 10
77 Eye Fresh TM Strip 6
78 Anti Hemoroid Supp/Facto Supp box 1
79 Hypafic Box 2
80 NaCl Flash 3
81 Plaster Roll Pcs 4
82 Masker Bedah Onemed Box 4
83 SarungTangan M Box 6
84 SarungTangan S Box 2
85 Kapas Pembalut Rol 3
86 Kasa Steril Box 10
87 Safety Box Box 3
88 Mess Pisau Bedah Box 1
89 Daryantule Box 2
90 Elastis Banded Pcs 4
91 Alkohol 70% Box 5
92 Jarum Lancet Box 2

Singaraja, Januari 2022

Ka Klinik Medika Wirasatya

dr. L. Pt. S. Kusumawati

Pembina-IV/A NIP.196606031997032001
 DETASEMEN KESEHATAN WILAYAH SINGARAJA
POLIKLINIK MEDIKA WIRASATYA 023201103

DAFTAR PESANAN OBAT BULAN FEBRUARI 2022

NO NAMA BARANG SATUAN JUMLAH KETERANGAN

1 Amoxicilin Box 12
2 Allopurrinol Box 2
3 Asam Folat Box 1
4 Asam Mafenamat Box 10
5 Antiza Box 7
6 Alpara Box 5
7 Anadex Box 5
8 Dexametason 0,5 mg Box 10
9 Ambroxol tab Box 10
10 Amlodipin 5 mg Box 7
11 Amlodipin 10 mg Box 7
12 Cefadroxyl Box 10
13 Caviplex tablet Box 8
14 Cetirizine Box 5
15 Bio Plasenton Tube 10
16 Becom C Box 8
17 Combiven Box 3
18 Clindamycin Box 2
19 Captopril 12,5 mg Box 5
20 Domperidone tab Box 2
21 Decolgen Box 7
22 Dexteem Plus Box 4
23 Kertas Lakmus Merah Box 2
24 Kertas Lakmus Biru Box 2
25 Glucosamine Box 6
26 Kalnex Box 1
27 Neo Asma Box 3
28 Natrium Diclofenax generik Box 3
29 Methoclopramid Box 5
30 Methyl Prednisolon Box 5
31 Cefixime Box 2
32 Glibenclamid Box 5
33 L-Bio Sch Box 1
34 Livron B Plex Box 8
35 New Diatabs Box 2
36 Paracetamol Box 10
37 Ibu Profen Box 10
38 Caviplex Box 7
39 Vit C 100 mg Box 6
40 Oxytetracycline Tab Box 1
41 Oxytetracycline Salep Tube 5
42 Dulcolax Box 5
43 Enervon C Box 7
44 Ester C Box 8
45 Demacolin Box 8
46 Omeprazole Box 10
47 Flamar Cr Box 15
48 Tuzalos Box 7
49 Antasida doen Box 7
50 Pisau Bedah (Mess) Box 1
51 Captopril 12,5 mg Box 2
52 Captopril 25 mg Box 2
53 Acyclovir tab Box 5
54 Vitamin B Complex Box 8
55 Burnazin Cr Tube 8
56 Salbutamol Box 2
57 Serumen Ekstraktor Set 1
58 Oxitocyn injeksi Ampul 5
59 Ventolin ampul Ampul 10
60 Methergin injeksi Ampul 5
61 Meloxicam 7,5 mg Box 7
62 Meloxicam 15 mg Box 5
63 Metformin Box 7
64 Hufagrip Syr Botol 20
65 Hufabethamin Syr Botol 10
66 Ambroxol Syr Botol 20
67 Antasida Syr Botol 25
68 Amoxicilin Syr Botol 25
69 Caviplex Syr Botol 25
70 Curcuma Syr Botol 15
71 Cefadroxyl Syr Botol 35
72 Elastis Banded Pcs 5
73 Sanadryl Syr Botol 30
74 Coldrexine Syr Botol 10
75 Cetirizine Syr Botol 10
76 L-Zinc Syr Botol 20
77 Paracetamol Syr Botol 15
78 Guanistrep Syr Botol 15
79 Cotrimoxazole Syr Botol 5
80 Domperidone Syr Botol 15
81 Oralit Box 1
82 OB Herbal 60 ml Botol 24
83 OB Herbal Junior 60 ml Botol 24
84 OBH Combi Menthol Botol 20
85 OBH Combi Jahe Botol 20
86 Dexa Inj Ampul 5
87 Epinefrine injeksi Ampul 5
88 H2O2 1 L Botol 2
89 Ketorolac Inj Ampul 5
90 Hot in Dcl Tube 10
 91 Betason Tube 10
92 Erlamycetin TM Drops 10
93 Cendo Lyters TM Drops 6
94 Alkohol 95% Botol 1
95 Jarum Lancet Box 3
96 Hypafic Box 3
97 Nurse Cap Box 5
98 NaCl Flash 2
99 Plaster Roll Box 4
100 Masker Bedah Onemed Box 6
101 SarungTangan M Box 2
102 SarungTangan S Box 2
103 Spuit 3 cc Box 1
104 Ranitidin Injeksi Ampul 10
105 Kasa Steril Pcs 3

Singaraja, Februari 2022

Ka Klinik Medika Wirasatya Singaraja

dr. L. Pt. S. Kusumawati

Pembina-IV/A NIP.196606031997032001
 DETASEMEN KESEHATAN WILAYAH SINGARAJA
POLIKLINIK MEDIKA WIRASATYA 023201103

DAFTAR PESANAN OBAT BULAN MARET 2022

NO NAMA BARANG SATUAN JUMLAH KETERANGAN

1 Amoxicilin Box 10
2 Folamil Box 5
3 Asam Mafenamat Box 10
4 Sangobion Box 1
5 Alleron Box 4
6 Antiza Box 2
7 Dexametason 0,5 mg Box 10
8 Ambroxol tab Box 8
9 Amlodipin 5 mg Box 6
10 Amlodipin 10 mg Box 5
11 Cefadroxyl Box 10
12 Caviplex tablet Box 8
13 Cetirizine Box 5
14 Bio Plasenton Tube 10
15 Becom C Box 8
16 Glimepirid Box 5
17 Captopril 12,5 mg Box 5
18 Domperidone tab Box 2
19 Vitamin B6 Box 1
20 Dexteem Plus Box 4
21 Kertas Lakmus Merah Box 2
22 Kertas Lakmus Biru Box 2
23 Glucosamine Box 2
24 Neo Asma Box 3
25 Natrium Diclofenax generik Box 3
26 Methoclopramid Box 5
27 Cefixime Box 2
28 Glibenclamid Box 5
29 Bedak Salycil Pcs 5
30 Livron B Plex Box 8
31 New Diatabs Box 2
32 Paracetamol Box 10
33 Ibu Profen Box 10
34 Caviplex Box 7
35 Vitamin C 100 mg Box 6
36 Oxytetracycline Tab Box 1
37 Oxytetracycline Salep Tube 5
38 Dulcolax Box 5
39 Enervon C Box 7
40 Ester C Box 8
41 Demacolin Box 8
42 Omeprazole Box 10
43 Flamar Cr Box 15
44 Etyl Clorida Botol 4
45 Antasida doen Box 7
46 Hidrokrotisone Cr Box 8
47 Captopril 12,5 mg Box 1
48 Captopril 25 mg Box 3
49 Vitamin B Complex Box 8
50 Betadine 15 ml Botol 5
51 Betadine 1 L Botol 1
52 Elastis Banded Box 1
53 Serumen Ekstraktor Set 1
54 Oxitocyn injeksi Ampul 2
55 Chloramfecort Box 10
56 Methergin injeksi Ampul 5
57 Meloxicam 7,5 mg Box 7
58 Meloxicam 15 mg Box 5
59 Metformin Box 7
60 Hufagrip Syr Botol 5
61 Elastis Banded Pcs 3
62 Ambroxol Syr Botol 20
63 Antasida Syr Botol 10
64 Amoxicilin Syr Botol 25
65 Caviplex Syr Botol 15
66 Curcuma Syr Botol 10
67 Cefadroxyl Syr Botol 25
68 Elastis Banded Pcs 5
69 Sanadryl Syr Botol 30
70 Coldrexine Syr Botol 10
71 Cetirizine Syr Botol 10
72 L-Zinc Syr Botol 5
73 Gentamycin Cr Tube 15
74 Cotrimoxazole Syr Botol 5
75 Domperidone Syr Botol 5
76 Lidocain Injeksi 10
77 OB Herbal 60 ml Botol 15
78 OB Herbal Junior 60 ml Botol 15
79 OBH Combi Menthol Botol 15
80 OBH Combi Jahe Botol 15
81 Ketokonazole Cr Tube 10
82 H2O2 1 L Botol 2
83 Ketorolac Inj Ampul 5
84 Testpack (Sensitif) Pcs 5
85 Hot in Dcl Tube 10
86 Betason Tube 10
87 Calsium Lactate Box 3
88 Cendo Xitrol TM Drops 6
89 Nurse Cap Box 2
90 Plaster Roll Box 4
91 Masker Bedah Onemed Box 6
92 SarungTangan M Box 3
93 SarungTangan S Box 2

Singaraja, Maret 2022

Ka Klinik Medika Wirasatya Singaraja

dr. L. Pt. S. Kusumawati

Pembina-IV/A NIP.196606031997032001
DETASEMEN KESEHATAN WILAYAH SINGARAJA
POLIKLINIK MEDIKA WIRASATYA 023201103

DAFTAR PESANAN OBAT BULAN APRIL 2022

NO NAMA BARANG SATUAN JUMLAH KETERANGAN

1 Amoxicilin Box 12
2 Folamil biasa Box 8
3 Asam Mafenamat Box 10
4 Plesterin Bulat Box 1
5 Alleron Box 4
6 Medika Alkohol 70% Botol 4
7 Dexametason 0,5 mg Box 10
8 Ambroxol tab Box 8
9 Amlodipin 5 mg Box 6
10 Amlodipin 10 mg Box 5
11 Cefadroxyl Box 10
12 Caviplex tablet Box 8
13 Cetirizine Box 5
14 Bio Plasenton Tube 10
15 Becom C Box 8
16 Glimepirid Box 5
17 Captopril 12,5 mg Box 1
18 Domperidone tab Box 2
19 Vitamin B6 Box 1
20 Dexteem Plus Box 4
21 Kertas Lakmus Merah Box 1
22 Kertas Lakmus Biru Box 1
23 Glucosamine Box 2
24 Neo Asma Box 3
25 Natrium Diclofenax generik Box 3
26 Methoclopramid Box 5
27 Cefixime Box 2
28 Glibenclamid Box 5
29 Caladin Lotion Pcs 5
30 Livron B Plex Box 8
31 New Diatabs Box 2
32 Paracetamol Box 10
33 Ibu Profen Box 10
34 Caviplex Box 7
35 Vitamin C 100 mg Box 6
36 Amox drop Drops 5
37 Sanmol drop Drops 5
38 Enervon C Box 7
39 Sangobion Box 1
40 Ester C Box 8
41 Demacolin Box 8
42 Omeprazole Box 10
43 Flamar Cr Box 15
44 Etyl Clorida Botol 4
45 Antasida doen Box 7
46 Hidrokrotisone Cr Tube 10
47 Captopril 25 mg Box 3
48 Vitamin B Complex Box 8
49 Betadine 15 ml Botol 5
50 Serumen Ekstraktor Set 1
51 Oxitocyn injeksi Ampul 1
52 Chloramfecort Box 10
53 Methergin injeksi Ampul 1
54 Meloxicam 7,5 mg Box 7
55 Meloxicam 15 mg Box 5
56 Metformin Box 7
57 Hufagrip Syr Botol 10
58 Ambroxol Syr Botol 20
59 Antasida Syr Botol 15
60 Amoxicilin Syr Botol 30
61 Caviplex Syr Botol 10
62 Curcuma Syr Botol 10
63 Cefadroxyl Syr Botol 25
64 Sanadryl Syr Botol 20
65 Coldrexine Syr Botol 10
66 Hufabethamin syr Botol 10
67 L-Zinc Syr Botol 5
68 Gentamycin Cr Tube 15
69 Cotrimoxazole Syr Botol 5
70 Domperidone Syr Botol 5
71 OB Herbal 60 ml Botol 15
72 OB Herbal Junior 60 ml Botol 15
73 OBH Combi Menthol Botol 15
74 OBH Combi Jahe Botol 15
75 Miconazole Cr Tube 10
76 Ketokonazole Cr Tube 10
77 Easy Touch Strip Gula Darah Box 2
78 Kertas puyer Bungkus 3
79 Hot in Dcl Tube 10
80 Betason Tube 10
81 Calsium Lactate Box 6
82 Erla Salep Mata Tube 2
83 Nurse Cap Box 4
84 Plaster Roll Box 6
85 Masker Bedah Onemed Box 5
86 SarungTangan M Box 3
87 SarungTangan S Box 2
88 Betason-N Cr Tube 10
89 Candesarten Box 2
 Singaraja, April 2022
Ka Klinik Medika Wirasatya Singaraja

dr. L. Pt. S. Kusumawati

Pembina-IV/A NIP.196606031997032001
DETASEMEN KESEHATAN WILAYAH SINGARAJA
POLIKLINIK MEDIKA WIRASATYA 023201103

DAFTAR PESANAN OBAT BULAN MEI 2022

NO NAMA BARANG SATUAN JUMLAH KETERANGAN

1 Amoxicilin Box 10
2 Folamil biasa Box 6
3 Asam Mafenamat Box 10
4 Betahistin Box 2
5 Alleron Box 4
6 Acyclovir Cream Tube 15
7 Dexametason 0,5 mg Box 10
8 Ambroxol tab Box 6
9 Amlodipin 5 mg Box 8
10 Amlodipin 10 mg Box 3
11 Cefadroxyl Box 10
12 Caviplex tablet Box 8
13 Cetirizine Box 6
14 Bufacort Tube 10
15 Bufacomb Tube 10
16 Becom C Box 5
17 Captopril 12,5 mg Box 1
18 Domperidone tab Box 2
19 Salbutamol Box 2
20 Dexteem Plus Box 4
21 Natrium Diclofenax generik Box 3
22 Methoclopramid Box 5
22 Glibenclamid Box 5
24 Candesarten Box 1
25 Livron B Plex Box 8
26 New Diatabs Box 1
27 Paracetamol Box 6
28 Ibu Profen Box 6
29 Caviplex Box 7
30 Vitamin C 100 mg Box 6
31 Amox drop Drops 5
32 Sanmol drop Drops 5
33 Eperison Hcl Box 5
34 Sangobion Box 1
35 Ester C Box 8
36 Demacolin Box 8
37 Omeprazole Box 10
38 Flamar Cr Box 15
39 Gentamycin Cr Tube 4
40 Antasida doen Box 7
41 Hidrokrotisone Cr Tube 10
42 Captopril 25 mg Box 3
43 Vitamin B Complex Box 5
44 Betadine 15 ml Botol 5
45 Microlax supp Tube 5
46 Buscofan Box 2
47 Chloramfecort Box 10
48 Meloxicam 7,5 mg Box 5
49 Meloxicam 15 mg Box 4
50 Metformin Box 7
51 Hufagrip Syr Botol 10
52 Ambroxol Syr Botol 10
53 Antasida Syr Botol 15
54 Amoxicilin Syr Botol 30
55 Caviplex Syr Botol 10
56 Curcuma Syr Botol 10
57 Cefadroxyl Syr Botol 25
58 Sanadryl Syr Botol 20
59 Alkohol Swab Box 3
60 Hufabethamin syr Botol 10
61 L-Zinc Syr Botol 5
62 Gentamycin Cr Tube 15
63 Cotrimoxazole Syr Botol 5
64 Domperidone Syr Botol 5
65 OB Herbal 60 ml Botol 15
66 OB Herbal Junior 60 ml Botol 15
67 OBH Combi Menthol Botol 10
68 OBH Combi Jahe Botol 15
69 Miconazole Cr Tube 10
70 Ketokonazole Cr Tube 10
71 OBH Herbal Anak Syr Botol 12
72 Kertas puyer Bungkus 3
73 Hot in Dcl Tube 10
74 Kasa Gulung Pcs 2
75 Calsium Lactate Box 6
76 Erla Salep Mata Tube 2
77 Nurse Cap Box 4
78 Plaster Roll Box 5
79 Masker Bedah Onemed Box 2
80 SarungTangan M Box 5
81 SarungTangan S Box 2
82 Betason-N Cr Tube 10
83 Spuit 1 cc Box 1
84 Hypafix Box 1
85 Wings Needle Pcs 2
 Singaraja, Mei 2022
Ka Klinik Medika Wirasatya Singaraja

dr. L. Pt. S. Kusumawati

Pembina-IV/A NIP.196606031997032001
DETASEMEN KESEHATAN WILAYAH SINGARAJA
POLIKLINIK MEDIKA WIRASATYA 023201103

DAFTAR PESANAN OBAT BULAN JUNI 2022

NO NAMA BARANG SATUAN JUMLAH KETERANGAN

1 Amoxicilin Box 10
2 Ciprofloxacin Box 2
3 Asam Mafenamat Box 8
4 Ranitidin Box 2
5 Alleron Box 2
6 Medika Alkohol 70% Botol 3
7 Dexametason 0,5 mg Box 10
8 Ambroxol tab Box 5
9 Amlodipin 5 mg Box 6
10 Amlodipin 10 mg Box 5
11 Cefadroxyl Box 8
12 Caviplex tablet Box 8
13 Cetirizine Box 5
14 Bio Plasenton Tube 10
15 Becom C Box 8
16 Captopril 25 mg Box 1
17 Captopril 12,5 mg Box 1
18 Domperidone tab Box 2
19 Metronidazole Box 1
20 Dexteem Plus Box 4
21 Bufacort Tube 10
22 Bufacomb Tube 10
23 Acyclovir Cr Tube 10
24 Busofan Box 3
25 Natrium Diclofenax generik Box 3
26 Methoclopramid Box 5
27 Cefixime Box 2
28 Glibenclamid Box 5
29 Gentamycin Cr Tube 10
30 Livron B Plex Box 8
31 New Diatabs Box 2
32 Paracetamol Box 8
33 Ibu Profen Box 6
34 Caviplex Box 6
35 Alpara Box 3
36 Enervon C Box 3
37 Sangobion Box 1
38 Ester C Box 2
39 Demacolin Box 8
40 Omeprazole Box 10
41 Flamar Cr Box 15
42 Etyl Clorida Botol 2
43 Antasida doen Box 5
44 Hidrokrotisone Cr Tube 10
45 Chloramfecort Box 10
46 Serumen Ekstraktor Set 1
47 Meloxicam 7,5 mg Box 7
48 Meloxicam 15 mg Box 5
49 Metformin Box 8
50 Hufagrip Syr Botol 10
51 Ambroxol Syr Botol 15
52 Antasida Syr Botol 20
53 Amoxicilin Syr Botol 25
54 Caviplex Syr Botol 10
55 Curcuma Syr Botol 10
56 Cefadroxyl Syr Botol 20
57 Sanadryl Syr Botol 20
58 Coldrexine Syr Botol 10
59 Hufabethamin syr Botol 10
60 L-Zinc Syr Botol 5
61 Gentamycin Cr Tube 15
62 Cotrimoxazole Syr Botol 5
63 Domperidone Syr Botol 5
64 OB Herbal 60 ml Botol 10
65 OB Herbal Junior 60 ml Botol 10
66 OBH Combi Menthol Botol 10
67 OBH Combi Jahe Botol 10
68 Miconazole Cr Tube 10
69 Ketokonazole Cr Tube 10
70 Ibu Profen Syr Botol 20
71 OBH Herbal Anak Syr Botol 10
72 Hot in Dcl Tube 15
73 Betason-N Tube 5
74 Calsium Lactate Box 6
75 Nurse Cap Box 4
76 Masker Bedah Onemed Box 3
77 Metil Prednisolon Box 5
78 Neurovit E Box 5
79 Pehachain Ampul 10
80 SarungTangan M Box 4
80 SarungTangan S Box 1

Singaraja, Juni 2022

Ka Klinik Medika Wirasatya Singaraja

dr. L. Pt. S. Kusumawati

Pembina-IV/A NIP.196606031997032001