KELAS STOK PENERI-

KODE NAMA OBAT SATUAN HARGA JENIS

TERAPI AWAL MAAN
1 2 3 4 5 6 7
SEDIAAN PADAT
O10601 Acyclovir 200 mg 6.6.1 Tablet Obat 150
O10602 Acyclovir 400 mg 6.6.1 Tablet Obat 250
O10603 Albendazol 400 mg 6.1.1 Tablet Obat 1284
O10101 Allopurinol 100 mg 1.3 Tablet Obat 700
O10112 Allopurinol 300 mg 1.3 Tablet Obat 0
Ambeven Tablet Obat 0
Ambroxol 30 mg Tablet Obat 3700
O11701 Amlodipin 10 mg 17.3 Tablet Obat 4680
O11702 Amlodipin 5 mg 17.3 Tablet Obat 4440
O10604 Amoksisilin 250 mg Tablet Obat 2700
O10605 Amoksisilin 500 mg tablet/kapsul 6.2.1 Tablet Obat 5000
O10102 Antalgin (Metampiron) 500 mg 1.2 Tablet Obat 0
O12501 Antasida doen I tablet kunyah 25.1 Tabet Obat 4200
Antiparkinson kombinasi Benserazid 25
mg + Levodopa 100 mg
Tablet 0

O12901 Asam askorbat (vit c) tablet 250 mg 29 Tablet Obat 3400

O12902 Asam askorbat (vit c) tablet 50 mg 29 Tablet Obat 4700
O11001 Asam folat 1 mg tablet/profolat tab 10.1 Tablet Obat 1800
O10103 Asam mefenamat 500 mg 1.2 Tablet Obat 4500
O11703 Asetosal 100 mg 17.4 Tablet Obat 0
O12503 Attapulgite 25.5 Tablet Obat 2900
Atorvastatin Tablet Obat 2000
Azitromisin Tablet Obat 100
Bedak salicyl 2% Pcs Obat 16
O10701 Betahistin maleat 7.2 Tablet Obat 300
Bisacodil 5 mg Tablet Obat 390
Bisoprolol (concor) Tablet Obat 1500
Calsium Laktat (kalk) tab 500 mg Tablet Obat 3200
Candesartan tab 16 mg Tablet Obat 1500
Captopril 12,5 mg 17.3 Tablet Obat 0
O11706 Captopril 25 mg 17.3 Tablet Obat 3900
O11713 Captopril 50 mg 17.3 Tablet Obat 0
Caviplex tab Tablet Obat 0
Cefixime tab 200 mg Tablet Obat 630
O10301 Cetirizin 10 mg 3 Tablet Obat 0
Clopidogrel 75 mg Tablet Obat 270
Chloroquin Tablet Obat 200
O10606 Ciprofloxacin 500 mg tablet 6.2.2.6 Tablet Obat 4500
Clindamycin 150 mg Tablet Obat 3500
Combipain Kaplet Obat 2160
O10607 Cotrimoxazole Doen I dewasa 480 mg 6.2.2.3 Tablet Obat 1500
O10623 Cotrimoxazole Forte dewasa 960 mg 6.2.2.3 Tablet Obat 900
CTM 4 mg Tablet Obat 2650
Depakote tab Tablet Obat 0
Demacollin tab Tablet Obat 0
O11601 Deksametason tablet 0,5 mg 16.5 Tablet Obat 1600
Diltiazem 30 mg Tablet Obat 1000
O11707 Digoksin 0,25 mg 17.2 Tablet Obat 800
O12504 Dimenhidrinat 50 mg 25.2 Tablet Obat 300
O10609 Doksisiklin 100 mg 6.2.2.1 Kapsul Obat 4200
O12505 Domperidon 10 mg 25.2 Tablet Obat 2800
O10610 Erythromycin 500 mg 6.2.2.4 Tablet Obat 800
Farnormin 50 mg Tablet Obat 300
O11002 Fitomenadion (vit K) tablet salut 10 mg 10.2 Tablet Obat 3300
O11501 Furosemid 40 mg 15.1 Tablet Obat 1150
O12002 Garam oralit untuk 200 ml air 20.1 Pcs Obat 1100
Glibenklamide 5 mg Tablet Obat 0
O11603 Glimepiride 1 mg tablet 16.2.1 Tablet Obat 1200
O11604 Glimepiride 2 mg tablet 16.2.1 Tablet Obat 1100
O11605 Glimepiride 3 mg tablet 16.2.1 Tablet Obat 0
O11606 Glipizid 5 mg tablet (Glucotrol) 16.2.1 Tablet Obat 0
Gliseril gauaykolat 100mg Tablet Obat 0
O10612 Griseofulvin 125 mg micronized 6.4.1 Tablet Obat 0
Guaifenisin 100 mg Tablet Obat 450
O11502 Hidroklortiazid (HCT) 25 mg tablet 15.1 Tablet Obat 1300
Hemafort Tablet Obat 2200
Hyosina Butilbromida (Scopma) Tablet Obat 1100
O10104 Ibuprofen tablet 200 mg 1.2 Tablet Obat 30
O10105 Ibuprofen tablet 400 mg 1.2 Tablet Obat 0
Imunaga Tablet Obat 0
Interhistin Tablet Obat 0
O11708 ISDN sublingual 5 mg 17.1 Tablet Obat 1900
Karbamazepin 200 mg Tablet Obat 0
O10107 Ketoprofen 100 mg 1.2 Tablet Obat 0
 Ketoconazole 200 mg Tablet Obat 2700
Klindamisin 150 mg Tablet Obat 900
O10616 Klindamisin 300 mg 6.2.2.4 Kapsul Obat 0
Klorpromazin 100 mg Tablet Obat 200
O10617 Kloramfenikol 250 mg 6.2.2.2 Tablet Obat 700
O10702 Kombinasi Ergotamin+kafein tablet 7.1.2 Tablet Obat 0
Levotiroksin 100 mg Tablet Obat 0
Levopar Tablet Obat 100
Lodia Tablet Obat 0
O12506 Loperamid 2 mg 25.5 Tablet Obat 1100
O10303 Loratadin 10 mg 3 Tablet Obat 2350
O11607 Metformin 500 mg 16.2.1 Tablet Obat 2800
O12201 Metil ergometrin maleat tablet salut 0,125 22 Tablet Obat 2000
O12603 Metilprednisolon 4 mg 26.1 Tablet Obat 1700
Metoclorperamid 5 mg Tablet Obat 2000
O10619 Metronidazol 250 mg 6.2.2.7 Tablet Obat 0
O10620 Metronidazol 500 mg 6.2.2.7 Tablet Obat 300
Miniaspi (Asam Asetilasetat) 80 mg Tablet Obat 2200
Mycosptop 250mg (Griseofulvin) Tablet Obat 1000
O12604 N-Asetil sistein 200 mg kapsul 26.3 Tablet Obat 0
O10109 Natrium diklofenak 25 mg tablet 1.2 Tablet Obat 5155
O10110 Natrium diklofenak 50 mg tablet 1.2 Tablet Obat 6160
O11709 Nifedipin 10 mg 17.3 Tablet Obat 700
Nitral Gliseril trinitrat tab sublingual 0,5 mg Tablet Obat 90
O51816 Nistatin 100.000 iu / g tablet vaginal 18.3 Tablet Obat 200
O11801 Nistatin 500.000 iu tablet salut 18.3 Tablet Obat 200
O12507 Omeprazol 20 mg 25.1 Kapsul Obat 4050
O10111 Parasetamol tablet 500 mg 1.2 Kaplet Obat 2700
Pehavral Tablet Obat 3600
O10621 Pirantel pamoat 125 mg 6.1.1 Tablet Obat 100
O12904 Piridoksin HCl 10 mg 29 Tablet Obat 2500
Piroxicam tab Tablet Obat 0
Pripilturasil ( PTU) Tablet Obat 0
O11608 Prednison 5 mg 16.5 Tablet Obat 3400
O11710 Propranolol HCl 10 mg 17.2 Tablet Obat 2000
Rafa Kamsah Tablet Obat 1400
Recurma Tablet Obat 60
O12508 Ranitidin 150 mg 25.1 Tablet Obat 8500
O12605 Salbutamol 2 mg tablet 26.1 Tablet Obat 2400
O12606 Salbutamol 4 mg tablet 26.1 Tablet Obat 0
O12905 Sianokobalamin (vit B12) 500 mg tablet 29 Tablet Obat 800
O11711 Simvastatin 10 mg tablet 17.8 Tablet Obat 620
Simvastatin 20 mg tablet 17.8 Tablet Obat 3500
O11504 Spironolakton 25 mg tablet 15.1 Tablet Obat 0
Tetracyclin kap 500mg Tablet Obat 2300
O12906 Tiamin HCl mononitrar (vit B 1) tablet 50 29 Tablet Obat 3100
O12909 Vitamin A 100.000 IU tablet 29 Tablet Obat 78
O12910 Vitamin A 200.000 IU tablet 29 Tablet Obat 450
O12907 Vitamin B kompleks tablet 29 Tablet Obat 1000
O12003 Zinc 20 mg tablet 20.1 Tablet Obat 1000

SEDIAAN SIRUP DAN DROPS

Apialys syr Botol Obat 0
Actifed syr Botol Obat 0
Ambroxol syr Botol Obat 107
O20625 Amoksisilin 250 mg/ mL sirup kering 6.2.1 Botol Obat 170
O22509 Antasida doen II suspensi 25.1 Botol Obat 42
Baby cough sirup Botol Obat 0
O20304 Cetirizin 5 mg/5 mL sirup 3 Botol Obat 0 50
O20626 Cotrimoxazole suspensi 240 mg/ml 6.2.2.3 Botol Obat 148
O22510 Domperidon 5 mg/5 mL sirup 25.2 Botol Obat 118
O20627 Erythromycin 200 mg/ 5 mL sirup 6.2.2.4 Botol Obat 0
Ibu profen syr 100 mg/5ml Botol Obat 202 50
Ibu profen syr 200 mg/5ml Botol Obat 66
Metronidazol suspensi 125 mg/5 ml Botol 0
OBH sirup dewasa Botol Obat 0
OBH sirup anak Botol Obat 0
O20112 Parasetamol 100 mg/mL drop 1.2 Botol Obat 55
O20113 Parasetamol 120 mg / 5 ml sirup 1.2 Botol Obat 111
O20631 Pirantel pamoat suspensi 6.1.1 Botol Obat 0
Salbutamol Sirup 2mg/5ml Botol Obat 0
Seven seas syr Botol Obat 0
Sucralfate syr Botol Obat 73
Valproat syr Botol Obat 9
Zinc drop Botol Obat 18
O22005 Zinc 20 mg/5 mL sirup 20.1 Botol Obat 53

SEDIAAN SALEP
O30002 Acyclovir cream tube NN Tube Obat 0
Antifungi doen kombinasi (Salep 2-4) Pot Obat 28
O31804 Antifungi doen kombinasi (Salep 3-6) 18 Pot Obat 50
O31805 Betametason krim 0,1 % 18.4 Tube Obat 104
O62103 Gentamycin salep mata 5 g 21.2 Tube Obat 0
O31806 Hidrokortison 2,5 % krim 18.4 Tube Obat 36
O62105 Kloramfenikol 1% salep mata 21.2 Tube Obat 8
O31807 Kloramfenikol 2% salep kulit (Bufacetin) 18.2 Tube Obat 30
O31809 Miconazole 2% krim 18.3 Tube Obat 12
O31810 Perak sulfadiazin 1% krim 18.2 Tube Obat 7
O31811 Permetrin 5% krim (scabimed cream) 18.5 Tube Obat 20

SEDIAAN TETES DAN SPRAY

O62102 Betametason 1 mg/mL tetes mata (Betam- 21.3 Botol Obat 8
Ethyl Chlorida Botol Obat 9
O62104 Kloramfenikol 0,5% tetes mata (Decacetin 21.2 Botol Obat 0
O62106 Kloramfenikol 1% tetes mata 21.2 Botol Obat 0
O62801 Kloramfenikol tetes telinga (Erlamycetin) 28 Botol Obat 0
O62802 Oksimetazolin 0,025% tetes hidung (Illiad 28 Botol Obat 0
O62803
Oksimetazolin 0,05% semprot hidung
28 Botol Obat 0
(Illiadin spray)
Perio kin spray Botol Obat 0
Phenol Gliserol Botol Obat 20
Pulmicort 20x2ml Botol Obat 0
O72612 Salbutamol aerosol 100 mcg/dosis (SAL 26.1 MDI Obat 16
Vasosma Botol Obat 15
Ventolin 2,5 mg nebul Botol Obat 0
Xilocain lidocain spray Botol Obat 0

SEDIAAN INJEKSI, SUPPOSITORIA DAN OVULA

Ampicillin serbuk injeksi 1000 mg Ampul Obat 15
Aminophyllin inj Ampul Obat 25
Antihemoroid doen kombinasi (Superhoid) Supp Obat 23
Anti tetanus serum Ampul Obat 30
O42001 Aqua pro injeksi 20.3 Ampul Obat 102
Asam tranexamat inj Ampul Obat 80
Atropin inj i.m/i.v/s.k 0,25 mg/ml Sulfat Ampul Obat 95
Bisacodil 10 mg supositoria (Dulcolax) Supp Obat 93
Bisacodil 5 mg supositoria (Dulcolax) Supp Obat 0
Ceftriaxon inj Ampul Obat 0
Cefotaxime inj Ampul Obat 0
O41610 Deksametason inj 5 mg/ml - 1 ml 16.5 Ampul Obat 264
O40305 Difenhidramin HCL inj 10 mg / ml - 1 ml 3 Ampul Obat 80
O40306 Epinefrin HCL/bitartrat (adrenalin) inj 3 Ampul Obat 92
0,1 % - 1 ml 50 mg/ml inj (Luminal)
Fenobarbital Ampul Obat 0
Fitomenadion (vit K1) inj 10 mg/mL - 1 m Ampul Obat 0
Fitomenadion (vit K1) inj 2 mg/mL - 1 ml Ampul Obat 110
O41505 Furosemid 10 mg/mL injeksi 15.1 Ampul Obat 80
O40628 Gentamycin 40 mg/mL injeksi 6.2.2.5 Ampul Obat 0
O40404 Kalsium glukonat 10% inj 4.1 Ampul Obat 125
O40202 Lidokain 2% injeksi 2.1 Ampul Obat 175
O40203 Lidokain kompositum injeksi 2.1 Ampul Obat 90 25
O40508 Magnesium sulfat injeksi (iv) 20 % - 25 m 5 Botol Obat 0
O40509 Magnesium sulfat injeksi (iv) 40 % - 25 m 5 Botol Obat 0
O40629 Metronidazol 500 mg/100 mL injeksi 6.2.2.7 Botol Obat 0
O50632 Metronidazol 500 mg ovula 6.2.2.7 Ovula Obat 0
O42203 Oksitosin injeksi 10 iu / ml - 1 ml 22 Ampul Obat 75
O42512 Omeprazol 40 mg serbuk injeksi 25.1 Vial Obat 260
O42908 Sianokobalamin (vit B 12) inj 500 mcg / m 29 Ampul Obat 1100

SEDIAAN INJEKSI (SUHU 2 - 8°C)

O42202 Metil ergometrin maleat injeksi 0,2 mg - 22 Ampul Obat 85
1 ml

OBAT NARKOTIKA
Codein 10 mg 1.1 Tablet Obat 100

OBAT PSIKOTROPIKA
O12301 Amitriptyllin HCL 25 mg 1.4 Tablet Obat 137
Chlorpromazine HCL 100 mg Tablet Obat 200
O50510 Diazepam 10 mg/2,5 mL enema (Stesolid) 5 Supp Obat 14
O50511 Diazepam 5 mg/2 mL enema (Stesolid) 5 Supp Obat 4
O40505 Diazepam injeksi 5 mg / ml - 2 ml 5 Ampul Obat 0
Diazepam tablet 2 mg Tablet Obat 0
O12302 Diazepam tablet 5 mg 23.1 Tablet Obat 90
Haloperidol 1,5 mg Tablet Obat 300
Phenobarbital 30 mg Tablet 150
Trihexyphenidyl HCL 2 mg Tablet Obat 200

SEDIAAN CAIRAN/LARUTAN, LOTION, GEL

Alcohol 70% 100 mL 13.2 Botol Obat 33
Asering asetat Ringer Kolf Obat 15
Betadine 60 ml Botol Obat 42
Betadine 1000 ml Botol Obat 5
O80009 Etakridin (rivanol) larutan 0,1 % 300 mL NN Botol Obat 12
O81303 Etanol 70% 300 mL 13.2 Botol Obat 0
O30201 Lidokain 2% gel (Xylocain) 2.1 Syringe Obat 0
Lotion kombinasi difenhidramin, Botol Obat
O31808
kalamin, zinc, gliserin (Caladin lotion)
18.8 19
O30011 Lubricant gel (Aquagel) NN Pcs Obat 0
O40006 NaCl 0,9 % steril NN Kolf Obat 90
Otsu -D5 (5% Glucose) Pcs Obat 16
Parasetamol infus 10mg/ml Botol Obat 7
 Reagen ZN Paket Reagen 15
O40007 Ringer laktat larutan infus steril NN Kolf Obat 149
Wida KDN-1 Kolf Obat 15

BAHAN MEDIS HABIS PAKAI

A10001 Alat suntik sekali pakai 1 mL NN Pcs Alkes 178
Alat suntik sekali pakai 3 ml NN Pcs alkes 305
A10002 Alat suntik sekali pakai 5 mL NN Pcs Alkes 0
A10003 Alat suntik sekali pakai 10 ml NN Pcs Alkes 0
A10004 Alat suntik sekali pakai 20 mL NN Pcs Alkes 86
A10005 Alat suntik sekali pakai 50 mL NN Pcs Alkes 41
A30015 Alchohol swab NN Box Alkes 0
Bisturi no 20 NN Pcs Alkes 208
Bisturi no 25 NN Pcs Alkes 72
Bisturi no 11 NN Pcs Alkes 0
Bio plasenton tulle NN Pcs Alkes 14
Chromic Catgut/benang bedah no. 3/0
A60039
dgn jarum bedah
NN Pcs Alkes 56
Chromic Catgut/benang bedah no. 2/0
A60038
dgn jarum bedah
NN Pcs Alkes 33
Composer Nebulizer NN Paket Alkes 0
Fescoplast 5 x 4,5m NN Rol Alkes 32
A20010 Folley catheter 2-w CH no. 16 NN Pcs Alkes 3
A20011 Folley catheter 2-w CH no. 18 NN Pcs Alkes 12
Hand rub 5 L Botol antiseptik 2
Hand rub 500 ml Botol antiseptik 3
A50034 Handscoon non steril uk. L NN Botol Alkes 0
A50027 Handscoon non steril uk. M/7 NN ktk Alkes 0
A50028 Handscoon non steril uk. S NN Pcs Alkes 0
A50029 Handscoon steril no. 6,5 NN Psg Alkes 99
A50030 Handscoon steril no. 7 NN Psg Alkes 3
Handscoon obgyn no 7 NN psg Alkes 44
A30021 High elastic bandage 7,5x 4 NN Pcs Alkes 2
Hopitech Suction yankauer Pcs Alkes 10
Hospitech Mucus extractor CH-10 Pcs Alkes 20
A40025 Hypafix 5 cm X 5 m NN Rol Alkes 0
Hypafix 5 cm X 10 m NN Rol Alkes 14
A20012 Infusion set anak NN Set Alkes 121
A20013 Infusion set dewasa NN Set Alkes 142
Iv catheter no 16g NN Pcs Alkes 30
Iv catheter no 18g 8
A10006 IV catheter no. 20G NN Pcs Alkes 66
A10007 IV catheter no. 22G NN Pcs Alkes 7
A10008 IV catheter no. 24G NN Pcs Alkes 40
A30016 Kapas 250 g NN Bks Alkes 18
A30018 Kasa 30 m X 80 cm NN Pcs Alkes 10
A30019 Kasa hidrofil steril uk. 16x16cm NN Box Alkes 42
Kasa Hidrofil 10cm nn pcs Alkes 49
Kasa Pembalut NN Ktk Alkes 0
Kapas bola NN Pak Alkes 0
A50033 Masker disposal NN Box Alkes 12
Masker- N95 NN PCS Alkes 37
One Clean Was Glove pak Alkes 5
OXY FLOW NN Set Alkes 0
Pita Pasien 0
Plesterin bulat NN ktk Alkes 100
A40026 Plester leukoplas 7,5cm x 4,5 m NN Pcs Alkes 0
Plester leukoplas 5cm x 4,5 m NN Pcs Alkes 29
Plain Catgut/benang bedah no.2/0 dgn
A60035
jarum bedah
NN Pcs Alkes 9
Plain Catgut/benang bedah no.2/0
TANPA jarum bedah
NN Pcs Alkes 2
Plain Catgut/benang bedah no.3/0 dgn
A60036
jarum bedah
NN Pcs Alkes 0
Plain Catgut/benang bedah no.3/0
TANPA jarum bedah
NN Kotak Alkes 2
Remedi Jarum otot no 11 NN Pcs Alkes 0
Remedi Jarum otot no 12 NN Pcs Alkes 0
Remedi Jarum Kulit no 11 NN Pcs Alkes 10
Remedi jarum kulit no 12 NN Pcs Alkes 19
Selang Nasogastrik tube dewasa Pcs Alkes 0
Selang Nasogastrik tube Anak Pcs Alkes 0
Semilas Nasal canula Anak NN Pcs BMHP 22
Semilas Nasal canula Dewasa NN Pcs BMHP 31
Silk (benang bedah sutra) no.3/0 dgn
A60037
jarum bedah (jahit luar)
NN Pcs Alkes 33
Silk tanpa jarum NN Pcs Alkes 3
Ultrasound gel NN Botol 12
Umbilical cord clamp (Penjepit tali pusar bayi)NN Pcs Alkes 0
A20014 Urine bag NN Pcs Alkes 23
Wing needle NN Pcs Alkes 83

Mengetahui/Menyetujui:
Kepala Puskesmas,
 Bambang Sutanto, SKM
NIP: 19810626 201001 1 013
PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN
DIAAN KAIAN STOK OPT. TAAN INPRES ASKES APBD LAIN JML
8=(6+7) 9=(8-10) 10 11 12 13 14 15 16 17

150 0 150
250 0 250
1284 684 600
700 300 400
0 0 0
0 0 0
3700 1000 2700
4680 560 4120
4440 1240 3200
2700 1200 1500
5000 1000 4000
0 0 0
4200 1300 2900
0 0 0
3400 800 2600
4700 300 4400
1800 500 1300
4500 900 3600
0 0 0
2900 1200 1700
2000 0 2000
100 0 100
16 1 15
300 100 200
390 280 110
1500 0 1500
3200 1000 2200
1500 0 1500
0 0 0
3900 600 3300
 0 0 0
0 0 0
630 0 630
0 0 0
270 0 270
200 0 200
4500 200 4300
3500 990 2510
2160 150 2010
1500 200 1300
900 0 900
2650 650 2000
0 0 0
0 0 0
1600 1000 600
1000 0 1000
800 0 800
300 0 300
4200 1840 2360
2800 100 2700
800 0 800
300 0 300
3300 0 3300
1150 850 300
1100 50 1050
0 0 0
1200 300 900
1100 200 900
0 0 0
0 0 0
0 0 0
0 0 0
450 150 300
1300 0 1300
2200 1100 1100
1100 0 1100
30 30 0
0 0 0
0 0 0
0 0 0
1900 0 1900
0 0 0
0 0 0
2700 0 2700
900 0 900
0 0 0
200 200 0
700 0 700
0 0 0
0 0 0
100 0 100
0 0 0
1100 0 1100
2350 150 2200
2800 2100 700
2000 0 2000
1700 800 900
2000 0 2000
0 0 0
300 100 200
2200 0 2200
1000 200 800
0 0 0
5155 1855 3300
6160 1560 4600
700 0 700
90 0 90
200 110 90
200 0 200
4050 1020 3030
2700 300 2400
3600 600 3000
100 25 75
2500 400 2100
0 0 0
0 0 0
3400 400 3000
2000 0 2000
1400 560 840
60 10 50
8500 900 7600
2400 600 1800
0 0 0
800 400 400
620 100 520
3500 210 3290
 0 0 0
2300 200 2100
3100 1100 2000
78 29 49
450 50 400
1000 1000 0
1000 100 900

0 0 0
0 0 0
107 4 103
170 44 126
42 31 11
0 0 0
50 22 28
148 40 108
118 11 107
0 0 0
202 100 102
66 3 63
0 0 0
0 0 0
0 0 0
55 8 47
111 91 20
0 0 0
0 0 0
0 0 0
73 40 33
9 0 9
18 3 15
53 10 43

0 0 0
28 2 26
50 0 50
104 13 91
0 0 0
36 12 24
8 0 8
30 4 26
12 9 3
7 1 6
20 0 20

8 8 0
9 1 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
20 7 13
0 0 0
16 2 14
15 8 7
0 0 0
0 0 0

15 0 15
25 0 25
23 15 8
30 0 30
102 24 78
80 10 70
95 0 95
93 0 93
0 0 0
0 0 0
0 0 0
264 21 243
80 0 80
92 0 92
0 0 0
0 0 0
110 30 80
80 0 80
0 0 0
125 0 125
 175 15 160
115 0 115
0 0 0
0 0 0
0 0 0
0 0 0
75 27 48
260 50 210
1100 1000 100

85 0 85

100 0 100

137 0 137
200 0 200
14 0 14
4 0 4
0 0 0
0 0 0
90 0 90
300 0 300
150 0 150
200 0 200

33 0 33
15 0 15
42 4 38
5 1 4
12 2 10
0 0 0
0 0 0
19 6 13
0 0 0
90 7 83
16 0 16
7 0 7
 15 5 10
149 39 110
15 0 15

178 0 178
305 115 190
0 0 0
0 0 0
86 16 70
41 0 41
0 0 0
208 8 200
72 1 71
0 0 0
14 4 10
56 42 14

33 8 25
0 0 0
32 0 32
3 1 2
12 4 8
2 0 2
3 2 1
0 0 0
0 0 0
0 0 0
99 8 91
3 3 0
44 8 36
2 0 2 Tidak tertera
10 0 10
20 5 15
0 0 0
14 0 14
121 0 121
142 15 127
30 28 2
8 0 8
66 17 49
7 7 0
 40 5 35
18 0 18
10 2 8
42 5 37
49 40 9
0 0 0
0 0 0
12 2 10
37 21 16
5 0 5
0 0 0
0 0 0
100 100 0
0 0 0
29 0 29
9 7 2

2 0 2

0 0 0

2 0 2
0 0 0
0 0 0
10 0 10
19 0 19
0 0 0
0 0 0
22 6 16
31 0 31
33 14 19
3 1 2
12 0 12
0 0 0
23 2 21
83 26 57

Kantewu, 29 Januari 2021

getahui/Menyetujui:
PJ Farmasi,
apt. Nurjanna, S.Farm
NRPK: 19.6.0504410
KET.
18

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Apr-23

Apr-22

Sep-22
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Jul-22
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Jul-24
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Aug-23
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agus-21
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Feb-24
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Oct-22
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Jul-22
juli-21
agust-21
Mei - 2021
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Apr-21
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