Bry Lplpo Agt 22

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)
KODE PUSKESMAS : 17010407

PUSKESMAS : BERUNTUNG RAYA
KECAMATAN : BANJARMASIN SELATAN
KAB/KODYA : BANJARMASIN
SATU HARGA STOK PENERI PERSE PEMAKAIAN RUSAK / E.D/REALOKASI

KODE NAMA OBAT
AN PER SATUAN AWAL MAAN DIAAN JUMLAH Rp JUMLAH
1 2 3 4 5 6 7=(5+6) 8 9 10
I. OBAT
A OBAT CAIR
Air untuk irigasi lar infus 1000 ml covid botol Rp 12,100.00 0 0 - 0 -
Albendazol suspensi 200mg/5 ml botol Rp 4,146.45 192 0 192 192 796,118
Ambroxol sirup botol Rp 4,860.90 0 0 - 0 -
Aminofilin injeksi 24 mg/ml-10 ml ampul Rp 3,071.00 0 0 - 0 -
Amoksisilin 250mg syrup botol Rp 3,846.00 0 0 - 0 -
Amoksisilin Sirup kering 125 mg/5 ml botol Rp 3,665.20 104 0 104 61 223,577
Ampisilin serbuk injeksi i.m.i.v 1000 mg/ml vial Rp 8,237.00 3 0 3 0 -
Antasida sirup botol Rp 1,756.00 7 100 107 21 36,876
Antrain inj ampul Rp 12,000.00 0 0 - 0 -
Apialis Drops botol Rp 21,175.00 0 0 - 0 -
Apialys sirup botol Rp 33,000.00 0 0 - 0 -
Aqua proinjeksi steril,bebas pirogen vial Rp 2,860.00 21 0 21 4 11,440
Asam Traneksamat injeksi 5 % 250 mg/ 5 ml ampul Rp 1,820.00 0 0 - 0 -
Asetilsistein infus vial Rp 183,876.00 0 0 - 0 -
Atropin Sulfat injeksi 0,25 mg/ml-1 ml ampul Rp 1,859.00 0 0 - 0 -
Baby Cough sirup botol Rp 4,851.00 67 0 67 67 325,017
Benzatin Benzil Penisilin inj 1,2 juta iu/vial vial Rp 10,780.00 0 0 - 0 -
Benzatin Benzil Penisilin inj 1,4 juta iu/vial vial Rp 14,740.00 0 0 - 0 -
Betadine cold defence nasal spray botol Rp 137,021.50 13 0 13 0 -
Betadine kumur 100 ml botol Rp 14,996.00 0 0 - 0 -
Betadine kumur 190 ml botol Rp 29,639.50 0 0 - 0 -
Cendo Augentonic tetes mata botol Rp 29,792.40 0 0 - 0 -
Cendo Catarlent tetes mata botol Rp 31,329.38 0 0 - 0 -
Cendo Edta tetes mata botol Rp 37,500.00 0 0 - 0 -
Cendo Floxa tetes mata botol Rp 30,800.00 0 0 - 0 -
Cendo fungicide tetes mata botol Rp 18,500.00 0 0 - 0 -
Cendo Homatrol tetes mata botol Rp 36,316.00 0 0 - 0 -
Cendo Lyteers tetes mata botol Rp 23,017.50 0 0 - 0 -
Cendo Mydriatil tetes mata botol Rp 34,100.00 0 0 - 0 -
Cendo Tobroson tetes mata botol Rp 52,800.00 0 0 - 0 -
Cendo Tropin tetes mata botol Rp 13,200.00 0 0 - 0 -
Cendo Xytrol tetes mata botol Rp 27,876.00 67 50 117 16 446,016
Deksametason inj 5 mg/ml-1 ml ampul Rp 968.00 18 0 18 0 -
Dekstran 70 larutan infus 6 % steril botol Rp 35,526.00 0 0 - 0 -
Depakene sirup / sodium valproate 250 mg/5 ml botol Rp 12,752.00 1 0 1 0 -
Dextamin sirup botol Rp 30,200.00 0 0 - 0 -
Dextrofen sirup botol Rp 12,450.90 45 0 45 9 112,058
Diazepam inj 5 mg/ml-2 ml ampul Rp 1,545.00 3 0 3 0 -
Difenhidramin Hcl inj 10 mg/ml-1 ml ampul Rp 825.00 6 0 6 0 - 6
Domperidon Suspensi 5 mg/5 ml botol Rp 4,312.00 61 0 61 15 64,680

Epinefrin Hcl/Bitartrat(adrenalin)inj 0,1 %-1 ml ampul Rp 1,518.00 0 0 - 0 -
Erytromisin sirup (trovilon) botol Rp 13,175.80 0 0 - 0 -
Etakridin ( Rivanol ) larutan 0,1 % botol Rp 14,999.60 0 0 - 0 -
Fenitoin natrium inj 50 mg / ml ampul Rp 11,855.58 0 0 - 0 -
Fenobarbital inj 50 mg / ml - 2 ml ampul Rp 2,135.00 0 0 - 0 -
Fenol gliserol tetes telinga 10 % botol Rp 2,764.00 24 48 72 13 35,932
Fitomenadion ( vit k 1 ) inj 10 mg / ml - 1 ml ampul Rp 4,236.00 30 0 30 4 16,944
Fungasol 2 % solution botol Rp 24,200.00 0 0 - 0 -
Furosemid Cairan Injeksi 10 mg/ml ampul Rp 1,555.00 0 0 - 0 -
Gentamisin inj 40 mg/2 ml ampul Rp 3,509.00 0 0 - 0 -
Gentamisin inj 80 mg/2 ml ampul Rp 2,750.00 0 0 - 0 -
Page 1
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Gentamisin Tetes mata botol Rp 4,885.00 27 24 51 18 87,930
Glukosa larutan infus 10 % steril botol Rp 8,003.00 0 0 - 0 -
Glukosa larutan infus 40 % steril botol Rp 10,789.90 0 0 - 0 -
Glukosa larutan infus 5 % steril botol Rp 7,363.00 40 0 40 40 294,520
HEXADOL (Larutan Hexetidine) botol Rp 14,300.00 3 0 3 3 42,900
Ibuprofen syr 100 mg/5ml botol Rp 4,522.10 36 20 56 36 162,796
Iliadin spray botol Rp 39,468.00 0 0 - 0 -
Kalsium Gluconas inj ampul Rp 10,351.00 0 0 - 0 -
Kandistatin drops (nistatin 100.000IU) botol Rp 11,750.00 19 0 19 2 23,500
Kloramfenikol sirup botol Rp 5,319.00 0 0 - 0 -
Kloramfenikol tetes telinga 3 % (reco) botol Rp 8,250.00 27 25 52 9 74,250
Klorpromazin Hcl inj 5 mg / ml - 2 ml ampul Rp 376.00 0 0 - 0 -
Kompolax emulsi botol Rp 5,550.00 1 10 11 3 16,650
Kotrimoksazol suspensi botol Rp 2,190.00 21 0 21 17 37,230
Laxadine emulsi @ 30 ml botol Rp 27,456.00 0 0 - 0 -
Lexapram sirup botol Rp 2,900.00 0 0 - 0 -
Lidocain injeksi 2 % ampul Rp 1,408.00 159 0 159 4 5,632
Lidokain kompositum injeksi ampul Rp 847.00 39 0 39 14 11,858
Lisol botol Rp 45,100.00 0 0 - 0 -
Magnesium sulfat inj ( 1V ) 20 % - 25 ml vial Rp 4,120.00 6 10 16 0 -
Magnesium sulfat inj ( 1V ) 40 % - 25 ml vial Rp 3,796.00 4 0 4 4 15,184
Metilergometrin maleat inj 0,200 mg - 1 ml ampul Rp 3,399.00 3 2 5 0 -
Metoklorpropamid sirup / norvom syr botol Rp 6,877.20 0 0 - 0 -
Metronidazol infus 500 mg/100 ml botol Rp 8,250.00 0 0 - 0 -
Metronidazol sirup botol Rp 3,950.00 0 0 - 0 -
Metronidazol suspension 125 mg/ml (Fragsol syr) botol Rp 7,150.00 11 0 11 0 -
Mycamine/micafungin 50 mg inj ampul Rp 320,610.00 0 0 - 0 -
Natrium klorida larutan infus 0,9 % steril botol Rp 6,840.00 38 0 38 1 6,840
Novastan sirup botol Rp 8,800.00 0 0 - 0 -
Obat Batuk Hitam ( OBH ) cairan botol Rp 4,733.30 95 0 95 28 132,532
Obat Gigi : Achatit/Fuji II kotak Rp 459,910.00 0 0 - 0 -
Obat Gigi : Air raksa dental use botol Rp 437,500.00 0 0 - 0 -
Obat Gigi : Bond strenght kotak Rp 319,000.00 0 0 - 0 -
Obat Gigi : Cresofen / endoseptone / endoseal pack Rp 440,000.00 0 0 - 0 -
Obat Gigi : Cresotin liquid box Rp 1,025,915.00 0 0 - 0 -
Obat gigi : Dentin conditioning kotak Rp 366,465.00 0 0 - 0 -
Obat Gigi : Eugenol cairan botol Rp 136,400.00 0 0 - 0 -
Obat Gigi : Flour sediaan topical ampul Rp 165,000.00 0 0 - 0 -
Obat Gigi : Formokresol botol Rp 239,580.00 0 0 - 0 -
Obat Gigi : G aenial bond kotak Rp 875,578.00 0 0 - 0 -
Obat Gigi : Glass Ionomer cemen ( GC IX ) kotak Rp 957,000.00 0 0 - 0 -
Obat Gigi : Glass Ionomer Light cured Universal restorative kotak Rp 440,000.00 0 0 - 0 -
Obat Gigi : Marbalet/neocones botol Rp 750,000.00 0 0 - 0 -
Obat Gigi : Minyak handpiece 500 ml botol Rp 561,000.00 0 0 - 0 -
Obat Gigi : Monoklorkamfer mentol cairan (CHKM) kotak Rp 77,000.00 0 0 - 0 -
Obat Gigi : Mummifying pasta kotak Rp 385,000.00 0 0 - 0 -
Obat Gigi : Oco Tooth Clensing botol Rp 221,000.00 0 0 - 0 -
Obat Gigi : Orablock carpule Rp 15,400.00 0 0 - 0 -
Obat Gigi : Rockless kotak Rp 1,135,200.00 0 0 - 0 -
Obat Gigi : Scandonest kotak Rp 881,100.00 0 0 - 0 -
Obat Gigi : Semen seng fosfat serbuk dan cairan kotak Rp 220,000.00 0 0 - 0 -
-
Obat Gigi : Silver amalgam serbuk 65 - 75 % kotak Rp 937,500.00 0 0 0 -
Obat Gigi : Temporary stopping fletcher serbuk dan cairan set Rp 62,150.00 0 0 - 0 -
Obat Gigi :Trikesol Formalin ( TKF ) cairan botol Rp 99,000.00 0 0 - 0 -
Oksimetazolin tts hidung 0,025% (Iliadin drops) botol Rp 60,229.00 0 0 - 0 -
Oksitosin injeksi 10 iu / ml ampul Rp 1,232.00 80 100 180 10 12,320
Omeprazol inj 40 mg/10 ml ampul Rp 5,346.00 10 0 10 0 -
Ondansetron inj 4 mg/2ml ampul Rp 963.00 10 0 10 2 1,926
Pantocain 0,5 % TM botol Rp 17,500.00 0 0 - 0 -
Parasetamol Drop 100 mg/ml botol Rp 5,204.00 0 0 - 0 -
Page 2
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Parasetamol sirup 120 mg / 5 ml botol Rp 3,817.00 224 0 224 74 282,458 150
Pedialyte botol Rp 34,100.00 18 0 18 2 68,200

Pehacain injeksi ampul Rp 3,381.40 0 0 - 0 -
Pim-Tra-Kol sirup botol Rp 9,975.00 2 0 2 2 19,950
Pirantel suspensi 5 mg/ml botol Rp 9,100.00 0 0 - 0 -
Povidon Iodida larutan 10 % 30 ml botol Rp 5,500.00 0 0 - 0 -
Povidon Iodida larutan 10 % 300 ml botol Rp 14,350.00 0 0 - 0 -
Povidon Iodida Larutan 1000 ml botol Rp 42,000.00 0 0 - 0 -
Povidon Iodida Larutan 60 ml botol Rp 6,281.00 3 0 3 0 -
Prokain benzil penisilin 3 juta iu / vial injeksi vial Rp 7,910.00 0 0 - 0 -
Pulmicort respules ampul Rp 9,725.00 0 0 - 0 -
Ranitidin inj 25mg/2ml ampul Rp 858.00 0 0 - 0 -
Ringer laktat larutan infus steril botol Rp 7,703.00 40 40 80 15 115,545
Sangobion kids drop botol Rp 35,000.00 0 0 - 0 -
Sangobion Kids Sirup botol Rp 29,645.00 0 0 - 0 -
Sefadroxil syp kering 125 ml / 5 ml botol Rp 4,360.00 41 50 91 47 204,920
Sefiksim syr kering 100mg/5ml botol Rp 32,576.50 4 0 4 4 130,306
Serum anti bisa ular polivalen inj 5 ml ( ABU I ) vial Rp 512,204.00 0 0 - 0 -
Serum anti defteri inj 1000 mg / vial vial Rp 2,200,000.00 0 0 - 0 -
Serum anti tetanus inj 20.000 IU / ampul ( ATS ) ampul Rp 604,670.00 0 0 - 0 -
Setirizin sirup 5 mg/ml botol Rp 3,061.00 86 0 86 86 263,246
Sianokobalamin ( Vit.B.12 ) inj 500 mcg / ml ampul Rp 1,067.00 0 0 - 0 -
Stimuno Sirup botol Rp 25,548.00 8 0 8 8 204,384
Sucralfate 500 mg/5 ml suspensi botol Rp 6,130.00 132 50 182 29 177,770
Sulfasetamid natrium tetes mata 15 % botol Rp 8,500.00 0 0 - 0 -
Tetagam ampul Rp 188,663.00 0 0 - 0 -
Thiamin Hcl ( Vit B1 ) inj.100 mg / ml - 1 ml ampul Rp 730.00 0 0 - 0 -
Timolol tetes mata 0,5% botol Rp 10,286.00 0 0 - 0 -
Tramadol inj 50 mg/ml ampul Rp 1,882.00 0 0 - 0 -
Truvit drops botol Rp 35,200.00 0 0 - 0 -
Truvit sirup botol Rp 15,400.00 0 0 - 0 -
Tuberkulin Injeksi vial Rp 625,900.00 1 0 1 1 625,900
Urea krim (Soft U derm) botol Rp 7,040.00 0 0 - 0 -
Vaksin BCG vial Rp 88,891.00 26 10 36 8 711,128
Vaksin CAMPAK 10 Dosis vial Rp 28,204.00 0 0 - 0 -
Vaksin HBIG ampul Rp 1,325,000.00 0 0 - 0 -
Vaksin HEPATITIS B 0,5 ml ADS vial Rp 23,490.00 21 30 51 13 305,370
Vaksin IPV (Poliomyelitis Vaccine inj (ShanIPV) vial Rp 158,994.00 17 0 17 6 953,964
Vaksin Jerap D T vial Rp 17,450.00 9 0 9 0 -
Vaksin Meningitis ampul Rp 135,000.00 0 0 - 0 -
Vaksin MR vial Rp 152,600.00 30 20 50 23 3,509,800
Vaksin Pentabio DTP-HB-HIB inj vial Rp 77,366.00 41 10 51 13 1,005,758
Vaksin POLIO 10 Dosis vial Rp 19,540.00 13 20 33 9 175,860
Vaksin Td vial Rp 18,128.00 12 10 22 5 90,640
VAR ( Verorab) vial Rp 165,000.00 0 0 - 0 -
Ventolin Nebulizer ampul Rp 11,190.85 12 0 12 1 11,191
Zincpro drops botol Rp 29,700.00 0 0 - 0 -
Zincum Kid sirup botol Rp 2,489.00 5 0 5 3 7,467
Zoloral SS (ketokonazol scalp sol 2 %) botol Rp 60,225.00 10 0 10 0 -
Serum anti tetanus inj 1.500 IU / ampul ( ATS ) ampul Rp 130,999.00 0 0 - 0 -
Fitomenadion ( vit k 1 ) inj 2 mg / ml - 1 ml ampul Rp 4,236.00 0 0 - 0 -
Metoklorpropamid drops (Gavistal) relok RS SS botol Rp 3,995.00 2 0 2 2 7,990
11,866,573.55
Page 3
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Page 4
OBAT
BULAN 0 8 LB2
TAHUN 2 0 2 2
RUSAK / E.D/REALOKASI SISA STOK STOK PERMIN PEMBERIAN
Rp JUMLAH Rp OPT TAAN APBD PROG KET
11 12=(7-8-10) 13 14 15 16 17 18
- - - - POPM
- - - 461
- - - - 200
- - - -
- - - - 60
- 43 157,603.60 103 100
- 3 24,711.00 (3)
- 86 151,016.00 (36) 100
- - - -
- - - -
- - - -
- 17 48,620.00 (7)
- - - -
- - - -
- - - -
- - - 161 72
- - - -
- - - -
- 13 1,781,279.50 (13)
- - - -
- - - - 10
- - - -
- - - - 20
- - - -
- - - - 2
- - - -
- - - -
- - - - 100
- - - -
- - - -
- - - - 10
- 101 2,815,476.00 (63)
- 18 17,424.00 (18)
- - - -
- 1 12,752.00 (1)
- - - -
- 36 448,232.40 (14)
- 3 4,635.00 (3)
4,950 - - -
- 46 198,352.00 (10)
- - - -
- - - - 3 ed terbaru
- - - - 3
- - - -
- - - -
- 59 163,076.00 (28) 24 ed terbaru
- 26 110,136.00 (16) 30
- - - - 10
- - - -
- - - -
- - - -
Page 5
11 12=(7-8-10) 13 14 15 16 17 18
- 33 161,205.00 10 24
- - - -
- - - -
- - - 96 20
- - - 7 10
- 20 90,442.00 66 50
- - - -
- - - - 5
- 17 199,750.00 (12)
- - - - 5
- 43 354,750.00 (21) 25
- - - -
- 8 44,400.00 (1)
- 4 8,760.00 37 20
- - - - 5
- - - -
- 155 218,240.00 (145)
- 25 21,175.00 9 30
- - - -
- 16 65,920.00 (16)
- - - 10 10
- 5 16,995.00 (5)
- - - -
- - - -
- - - -
- 11 78,650.00 (11)
- - - -
- 37 253,080.00 (35)
- - - - 2
- 67 317,131.10 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 2
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
-
- - -
- - - -
- - - -
- - - -
- 170 209,440.00 (146)
- 10 53,460.00 (10)
- 8 7,704.00 (3)
- - - - 5
- - - - 100
Page 6
11 12=(7-8-10) 13 14 15 16 17 18
572,550 - - 178 200 ed terbaru
- 16 545,600.00 (11)
- - - -
- - - 5 72
- - - -
- - - - 5
- - - -
- - - -
- 3 18,843.00 (3)
- - - -
- - - -
- - - -
- 65 500,695.00 (29) 20
- - - - 10
- - - - 15
- 44 191,840.00 69 50 ed terbaru
- - - 10 20
- - - -
- - - -
- - - - 2
- - - 206 150 ed terbaru
- - - -
- - - 19 36
- 153 937,890.00 (83)
- - - -
- - - - 2
- - - -
- - - -
- - - -
- - - - 50
- - - - 50
- - - 2 1
- - - - 2
- 28 2,488,948.00 (9)
- - - -
- - - -
- 38 892,620.00 (7) 30
- 11 1,748,934.00 3
- 9 157,050.00 (9) 19
- - - -
- 27 4,120,200.00 28 30
- 38 2,939,908.00 (7)
- 24 468,960.00 (2)
- 17 308,176.00 (5) 48
- - - -
- 11 123,099.35 (9) 5
- - - - 20
- 2 4,978.00 5 100
- 10 602,250.00 (10)
- - - - 2
- - - - 30
- - - -
577,500 OBAT CAIR 24,089,248.55
Page 7
11 12=(7-8-10) 13 14 15 16 17 18
Page 8
PEMAKAIAN S
PUSKESM
PEMAKAIAN
PERSEDIAAN
NO NAMA OBAT SATUAN POSYA P.LANSIA/
GUDANG PP LAB
NDU PUSLING
I. OBAT
A OBAT CAIR
Air untuk irigasi lar infus 1000 ml covid botol -
Albendazol suspensi 200mg/5 ml botol 192
Ambroxol sirup botol -
Aminofilin injeksi 24 mg/ml-10 ml ampul -
Amoksisilin 250mg syrup botol -
Amoksisilin Sirup kering 125 mg/5 ml botol 104 2
Ampisilin serbuk injeksi i.m.i.v 1000 mg/ml vial 3

Antasida sirup botol 107
Antrain inj ampul -
Apialis Drops botol -
Apialys sirup botol -
Aqua proinjeksi steril,bebas pirogen vial 21
Asam Traneksamat injeksi 5 % 250 mg/ 5 ml ampul -
Asetilsistein infus vial -
Atropin Sulfat injeksi 0,25 mg/ml-1 ml ampul -
Baby Cough sirup botol 67 1
Benzatin Benzil Penisilin inj 1,2 juta iu/vial vial -

Benzatin Benzil Penisilin inj 1,4 juta iu/vial vial -
Betadine cold defence nasal spray botol 13
Betadine kumur 100 ml botol -
Betadine kumur 190 ml botol -
Cendo Augentonic tetes mata botol -
Cendo Catarlent tetes mata botol -
Cendo Edta tetes mata botol -
Cendo Floxa tetes mata botol -
Cendo fungicide tetes mata botol -
Cendo Homatrol tetes mata botol -
Cendo Lyteers tetes mata botol -

Cendo Mydriatil tetes mata botol -
Cendo Tobroson tetes mata botol -
Cendo Tropin tetes mata botol -
Cendo Xytrol tetes mata botol 117 3
Deksametason inj 5 mg/ml-1 ml ampul 18

Dekstran 70 larutan infus 6 % steril botol -
Depakene sirup / sodium valproate 250 mg/5 ml botol 1
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Dextamin sirup botol -

Dextrofen sirup botol 45
Diazepam inj 5 mg/ml-2 ml ampul 3
Difenhidramin Hcl inj 10 mg/ml-1 ml ampul 6
Domperidon Suspensi 5 mg/5 ml botol 61 3
Epinefrin Hcl/Bitartrat(adrenalin)inj 0,1 %-1 ml ampul -

Erytromisin sirup (trovilon) botol -
Etakridin ( Rivanol ) larutan 0,1 % botol -
Fenitoin natrium inj 50 mg / ml ampul -
Fenobarbital inj 50 mg / ml - 2 ml ampul -
Fenol gliserol tetes telinga 10 % botol 72
Fitomenadion ( vit k 1 ) inj 10 mg / ml - 1 ml ampul 30
Fungasol 2 % solution botol -
Furosemid Cairan Injeksi 10 mg/ml ampul -
Gentamisin inj 40 mg/2 ml ampul -
Gentamisin inj 80 mg/2 ml ampul -
Gentamisin Tetes mata botol 51 3
Glukosa larutan infus 10 % steril botol -

Glukosa larutan infus 40 % steril botol -
Glukosa larutan infus 5 % steril botol 40
HEXADOL (Larutan Hexetidine) botol 3
Ibuprofen syr 100 mg/5ml botol 56
Iliadin spray botol -
Kalsium Gluconas inj ampul -
Kandistatin drops (nistatin 100.000IU) botol 19
Kloramfenikol sirup botol -
Kloramfenikol tetes telinga 3 % (reco) botol 52
Klorpromazin Hcl inj 5 mg / ml - 2 ml ampul -
Kompolax emulsi botol 11
Kotrimoksazol suspensi botol 21
Laxadine emulsi @ 30 ml botol -
Lexapram sirup botol -
Lidocain injeksi 2 % ampul 159
Lidokain kompositum injeksi ampul 39
Lisol botol -
Magnesium sulfat inj ( 1V ) 20 % - 25 ml vial 16
Magnesium sulfat inj ( 1V ) 40 % - 25 ml vial 4
Metilergometrin maleat inj 0,200 mg - 1 ml ampul 5
Metoklorpropamid sirup / norvom syr botol -
Metronidazol infus 500 mg/100 ml botol -
Metronidazol sirup botol -
Metronidazol suspension 125 mg/ml (Fragsol syr) botol 11
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Mycamine/micafungin 50 mg inj ampul -

Natrium klorida larutan infus 0,9 % steril botol 38
Novastan sirup botol -
Obat Batuk Hitam ( OBH ) cairan botol 95
Obat Gigi : Achatit/Fuji II kotak -
Obat Gigi : Air raksa dental use botol -
Obat Gigi : Bond strenght kotak -
Obat Gigi : Cresofen / endoseptone / endoseal pack -
Obat Gigi : Cresotin liquid box -
Obat gigi : Dentin conditioning kotak -
Obat Gigi : Eugenol cairan botol -
Obat Gigi : Flour sediaan topical ampul -
Obat Gigi : Formokresol botol -
Obat Gigi : G aenial bond kotak -
Obat Gigi : Glass Ionomer cemen ( GC IX ) kotak -
Obat Gigi : Glass Ionomer Light cured Universal restorative kotak -
Obat Gigi : Marbalet/neocones botol -
Obat Gigi : Minyak handpiece 500 ml botol -
Obat Gigi : Monoklorkamfer mentol cairan (CHKM) kotak -
Obat Gigi : Mummifying pasta kotak -
Obat Gigi : Oco Tooth Clensing botol -
Obat Gigi : Orablock carpule -
Obat Gigi : Rockless kotak -
Obat Gigi : Scandonest kotak -
Obat Gigi : Semen seng fosfat serbuk dan cairan kotak -
Obat Gigi : Silver amalgam serbuk 65 - 75 % kotak -
Obat Gigi : Temporary stopping fletcher serbuk dan cairan set -
Obat Gigi :Trikesol Formalin ( TKF ) cairan botol -
Oksimetazolin tts hidung 0,025% (Iliadin drops) botol -
Oksitosin injeksi 10 iu / ml ampul 180
Omeprazol inj 40 mg/10 ml ampul 10
Ondansetron inj 4 mg/2ml ampul 10
Pantocain 0,5 % TM botol -
Parasetamol Drop 100 mg/ml botol -
Parasetamol sirup 120 mg / 5 ml botol 224 3
Pedialyte botol 18
Pehacain injeksi ampul -
Pim-Tra-Kol sirup botol 2 2
Pirantel suspensi 5 mg/ml botol -

Povidon Iodida larutan 10 % 30 ml botol -
Povidon Iodida larutan 10 % 300 ml botol -
Povidon Iodida Larutan 1000 ml botol -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Povidon Iodida Larutan 60 ml botol 3

Prokain benzil penisilin 3 juta iu / vial injeksi vial -
Pulmicort respules ampul -
Ranitidin inj 25mg/2ml ampul -
Ringer laktat larutan infus steril botol 80
Sangobion kids drop botol -
Sangobion Kids Sirup botol -
Sefadroxil syp kering 125 ml / 5 ml botol 91
Sefiksim syr kering 100mg/5ml botol 4
Serum anti bisa ular polivalen inj 5 ml ( ABU I ) vial -
Serum anti defteri inj 1000 mg / vial vial -
Serum anti tetanus inj 20.000 IU / ampul ( ATS ) ampul -
Setirizin sirup 5 mg/ml botol 86
Sianokobalamin ( Vit.B.12 ) inj 500 mcg / ml ampul -
Stimuno Sirup botol 8
Sucralfate 500 mg/5 ml suspensi botol 182
Sulfasetamid natrium tetes mata 15 % botol -
Tetagam ampul -
Thiamin Hcl ( Vit B1 ) inj.100 mg / ml - 1 ml ampul -
Timolol tetes mata 0,5% botol -
Tramadol inj 50 mg/ml ampul -
Truvit drops botol -
Truvit sirup botol -
Tuberkulin Injeksi vial 1
Urea krim (Soft U derm) botol -
Vaksin BCG vial 36
Vaksin CAMPAK 10 Dosis vial -
Vaksin HBIG ampul -
Vaksin HEPATITIS B 0,5 ml ADS vial 51
Vaksin IPV (Poliomyelitis Vaccine inj (ShanIPV) vial 17
Vaksin Jerap D T vial 9
Vaksin Meningitis ampul -
Vaksin MR vial 50
Vaksin Pentabio DTP-HB-HIB inj vial 51
Vaksin POLIO 10 Dosis vial 33
Vaksin Td vial 22
VAR ( Verorab) vial -
Ventolin Nebulizer ampul 12
Zincpro drops botol -
Zincum Kid sirup botol 5 3
Zoloral SS (ketokonazol scalp sol 2 %) botol 10
Serum anti tetanus inj 1.500 IU / ampul ( ATS ) ampul -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Fitomenadion ( vit k 1 ) inj 2 mg / ml - 1 ml ampul -

Metoklorpropamid drops (Gavistal) relok RS SS botol 2
PEMAKAIAN SUB UNIT & APOTEK OBAT CAIR
PUSKESMAS BERUNTUNG RAYA 2022
APBD BULAN
TAHUN
PEMAKAIAN STOK AKHIR

DALUARS
STOK OF KUMULATIF
POSKES A/ POSY P.LANSIA/ POSKES PEMAKAIAN
PONED APOTEK PP LAB PONED APOTEK NAME
DES RELOKAS ANDU PUSLING DES
GUDANG
I
0
192 192
0
0
0
5 54 4 6 33 61
3 0
21 2 84 21
0
0
0
4 17 4
0
0
0
66 67
0
0
13 0
0
0
0
0
0
0
0
0
0
0
0
0
13 7 94 16
18 0
0
1 0
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
3 6 2 34 9
3 0
0
12 2 6 38 15
0
0
0
0
0
13 9 50 13
4 26 4
0
0
0
0
2 13 5 4 24 18
0
0
20 20 40
3 3
36 1 19 36
0
0
2 17 2
0
9 2 1 40 9
0
3 8 3
17 1 3 17
0
0
4 155 4
10 4 25 14
0
16 0
4 0 4
5 0
0
0
0
11 0
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
1 37 1
0
28 2 4 61 28
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 30 140 10
10 0
2 8 2
0
0
9 62 74
2 16 2
0
2
0
0
0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
3 0
0
0
0
15 25 40 15
0
0
47 5 39 47
4 4
0
0
0
86 86
0
8 8
29 2 151 29
0
0
0
0
0
0
0
1 1
0
8 28 8
0
0
13 38 13
6 11 6
9 0
0
23 27 23
13 38 13
9 24 9
5 17 5
0
1 11 1
0
2 3
10 0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
2 2
0 8
2 0 2 2
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
FISIK (SF) (SR - SF)
(SR)
- 0 - Program POPM
- 0 -
- 0 -
- 0 -
- 0 -
43 43 -
3 3 -
86 86 -
- 0 -
- 0 -
- 0 -
17 17 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
13 13 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
101 101 -
18 18 -
- 0 -
1 1 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
36 36 -
3 3 -
6 0 6
46 46 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
59 59 -
26 26 -
- 0 -
- 0 -
- 0 -
- 0 -
33 33 -
- 0 -
- 0 -
- 0 -
- 0 -
20 20 -
- 0 -
- 0 -
17 17 -
- 0 -
43 43 -
- 0 -
8 8 -
4 4 -
- 0 -
- 0 -
155 155 -
25 25 -
- 0 -
16 16 -
- 0 -
5 5 -
- 0 -
- 0 -
- 0 -
11 11 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
37 37 -
- 0 -
67 67 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
170 170 -
10 10 -
8 8 -
- 0 -
- 0 -
150 0 150 ED
16 16 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
3 3 -
- 0 -
- 0 -
- 0 -
65 65 -
- 0 -
- 0 -
44 44 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
153 153 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
28 28 -
- 0 -
- 0 -
38 38 -
11 11 -
9 9 -
- 0 -
27 27 -
38 38 -
24 24 -
17 17 -
- 0 -
11 11 -
- 0 -
2 2 -
10 10 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
- 0 -
(LPLPO)

SATU HARGA STOK PENERI PERSE PEMAKAIAN RUSAK / E.D/REALOK

KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
I. OBAT
B OBAT PADAT
Akarbose tablet 100 mg tablet Rp 920.00 180 0 180 0 -
Albendazol tablet 400 mg tablet Rp 380.00 200 0 200 82 31,160
Allopurinol tablet 100 mg tablet Rp 89.00 1071 0 1,071 172 15,308
Alprazolam 0,5 mg tablet Rp 94.00 0 0 - 0 -
Alprazolam 1 mg tablet Rp 120.00 0 0 - 0 -
Ambroxol tablet tablet Rp 150.44 1430 0 1,430 1430 215,123
Aminofilin tablet 200 mg tablet Rp 101.00 0 0 - 0 -
Amitriptilin Hcl tablet salut 25 mg tablet Rp 237.16 100 0 100 0 -
Amlodipin 10 mg tablet Rp 74.00 730 210 940 460 34,040
Amlodipin 5 mg tablet Rp 81.00 0 0 - 0 -
Amoksisilin 250 mg tablet Rp 377.30 0 0 - 0 -
Amoksisilin 500 mg kaplet tablet Rp 265.00 782 500 1,282 680 180,200
Antasida doen tablet kombinasi tablet Rp 60.00 3375 0 3,375 1185 71,100
Antimigrain doen kombinasi tablet Rp 149.00 0 0 - 0 -
Antiparkinson doen tablet kombinasi tablet Rp 1,035.00 0 0 - 0 -
Arkavit tablet Rp 237.50 0 0 - 0 -
Asam Asetilsalisilat tablet 100 mg (Asetosal) tablet Rp 194.35 0 0 - 0 -
Asam Asetilsalisilat tablet 500 mg (Asetosal) tablet Rp 100.00 0 0 - 0 -
Asam askorbat(vit C) tablet 250 mg tablet Rp 164.04 0 500 500 57 9,350
Asam Askorbat(vit C) tablet 50 mg tablet Rp 120.00 135 0 135 105 12,600
Asam Folat 1 mg tablet tablet Rp 61.00 760 0 760 235 14,335
Asam Folat 5 mg tablet tablet Rp 64.00 0 0 - 0 -
Asam mefenamat 500 mg kaplet tablet Rp 103.00 40 1500 1,540 260 26,780
Asam Traneksamat 500 mg kapsul (nexitra) kapsul Rp 715.72 304 0 304 0 -
Asetilsistein 200mg kaps kapsul Rp 317.00 0 0 - 0 -
Asiklovir 200 mg tablet tablet Rp 705.55 440 0 440 360 253,998
Asiklovir 400 mg tablet tablet Rp 453.74 0 0 - 0 -
Azitromisin 1000 mg + cefixime 400 mg paket Rp 30,030.00 0 0 - 0 -
Azitromisin 500 mg tablet tablet Rp 1,400.30 97 0 97 12 16,804
Betahistin mesilat tablet 6 mg tablet Rp 92.00 900 0 900 50 4,600
Bisoprolol tablet 5 mg tablet Rp 143.00 410 0 410 45 6,435
Buscopan tablet tablet Rp 4,346.10 0 0 - 0 -
Cetop-zink kaplet tablet Rp 4,840.00 0 0 - 0 -
Citoneuron tablet tablet Rp 451.25 0 0 - 0 -
Clindamisin kapsul 300 mg kapsul Rp 1,017.00 0 0 - 0 -
Clopidogrel 75 mg tablet tablet Rp 575.00 690 300 990 230 132,250
Curcuma FCT tablet tablet Rp 973.50 556 600 1,156 196 190,806
Deksametason tablet 0,5 mg tablet Rp 100.39 149 0 149 149 14,958
Demacolin tablet tablet Rp 440.00 0 0 - 0 -
Depakote tablet tablet Rp 1,200.00 0 0 - 0 -
Dextamine tablet tablet Rp 1,956.57 109 0 109 0 -
DHP / Darplex / D-Artepp (Dehidro artemisin Piperaquin) tab tablet Rp 2,134.00 0 0 - 0 -
Diazepam tablet 2 mg tablet Rp 70.00 57 0 57 12 840
Diazepam tablet 5 mg tablet Rp 114.00 0 0 - 0 -
Dietilkarbamazin sitrat tablet 100 mg tablet Rp 180.00 0 0 - 0 -
Digoksin tablet 0,25 mg tablet Rp 104.00 0 0 - 0 -
Diltiazem tablet tablet Rp 143.00 0 0 - 0 -
Dimenhidrinate tablet tablet Rp 129.00 380 0 380 0 -
Doksisiklin 100 mg kapsul kapsul Rp 440.00 100 0 100 0 -
Domperidon 10 mg tablet Rp 522.12 1200 0 1,200 130 67,875
Dopamet (metildopa) tablet Rp 1,014.00 3 100 103 3 3,042
Page 24
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Dulcolax 5 mg tablet tablet Rp 1,660.80 0 0 - 0 -
Efaviren 200 mg tablet Rp 3,202.24 0 0 - 0 -
Efaviren 600 mg tablet Rp 9,625.00 0 0 - 0 -
Efedrin Hcl tablet 25 mg tablet Rp 198.00 0 0 - 0 -
Enfavit tablet tablet Rp 2,420.00 0 0 - 0 -
Erytromisin 250 mg kapsul kapsul Rp 636.00 0 0 - 0 -
Erytromisin 500 mg kaplet tablet Rp 730.00 0 0 - 0 -
Etambutol 500 mg tablet tablet Rp 4,661.00 0 0 - 0 -
Etambutol Hcl tablet 250 mg tablet Rp 186.00 0 0 - 0 -
Famotidin 40 mg tablet tablet Rp 192.00 0 0 - 0 -
Favipiravir 200 mg tablet tablet Rp 10,399.40 0 0 - 0 -
Fenitoin natrium kapsul 100 mg kapsul Rp 158.00 0 0 - 0 -
Fenobarbital tablet 100 mg tablet Rp 127.00 0 0 - 0 -
Fenobarbital tablet 30 mg tablet Rp 197.00 164 0 164 0 -
Fenofibrat kaps 100 mg tablet Rp 473.00 0 0 - 0 -
Ferro folat tab sal selaput 200 mg + 0,4 mg (Tablet tambah darah komb.) tablet Rp 409.00 7285 2000 9,285 2915 1,192,235
Fitomenadion ( vit k 1 ) tablet salut 10 mg tablet Rp 781.00 170 0 170 0 -
Furosemid tablet 40 mg tablet Rp 84.00 0 0 - 0 -
Gemfibrozil 300 mg tablet tablet Rp 484.00 222 0 222 12 5,808
Glibenklamid tablet 5 mg tablet Rp 87.00 400 0 400 100 8,700
Glimepirid tab 1 mg tablet Rp 174.00 400 500 900 250 43,500
Glimepirid tab 2 mg tablet Rp 207.00 380 500 880 245 50,715
Gliseril guayakolat tablet 100 mg tablet Rp 166.54 905 0 905 905 150,719
Glukosamin 250 mg tablet (osmin) tablet Rp 948.64 0 0 - 0 -
Gradilex tablet Rp 157.30 175 100 275 75 11,798
Griseofulvin tablet 125 mg micronized tablet Rp 210.00 145 0 145 145 30,450
Haloperidol tablet 0,5 mg tablet Rp 55.00 0 0 - 0 -
Haloperidol tablet 1,5 mg tablet Rp 59.00 115 0 115 90 5,310
Haloperidol tablet 5 mg tablet Rp 54.00 103 0 103 0 -
Hemafort tablet tablet Rp 854.70 0 0 - 0 -
Hepatin tablet tablet Rp 4,125.00 0 0 - 0 -
Hidroklortiazid ( Hct ) tablet 25 mg tablet Rp 148.00 200 0 200 0 -
Hydroxychloroquine sulfate 200 mg tablet tablet Rp 9,133.00 0 0 - 0 -
Hyorex 10 mg tablet tablet Rp 405.00 0 0 - 0 -
Hyoscine N Butilbromida 10 mg tablet tablet Rp 1,626.00 0 0 - 0 -
Ibuprofen tablet 200 mg tablet Rp 237.16 365 500 865 455 107,908
Ibuprofen tablet 400 mg tablet Rp 344.96 260 0 260 260 89,690
Interhistin tablet tablet Rp 990.00 208 100 308 100 99,000
Isoniazid tablet 100 mg tablet Rp 142.56 175 0 175 0 -
Isoniazid tablet 300 mg tablet Rp 164.00 0 0 - 0 -
Isosorbit dinitrat tablet sublingual 5 mg tablet Rp 99.00 422 0 422 0 -
Kalsium laktat ( Kalk ) tablet 500 mg tablet Rp 60.00 0 3000 3,000 0 -
Kandesartan 16 mg tablet tablet Rp 319.00 0 0 - 0 -
Kandesartan 8 mg tablet tablet Rp 212.00 0 0 - 0 -
Kaptopril 12,5 mg tablet tablet Rp 124.99 1835 0 1,835 90 11,249
Kaptopril 25 mg tablet tablet Rp 92.62 2165 0 2,165 160 14,819
Karbamazepin tablet 200 mg tablet Rp 250.00 1937 0 1,937 0 -
Ketokenazol 200 mg tablet tablet Rp 260.00 0 0 - 0 -
Ketoprofen 100 mg tablet tablet Rp 1,366.00 0 0 - 0 -
Klindamisin 150 mg tablet tablet Rp 803.00 8 0 8 8 6,424
Klobazam 10 mg tablet tablet Rp 916.00 0 0 - 0 -
Klonidin 0,15 mg tablet tablet Rp 224.00 0 0 - 0 -
Kloramfenikol kapsul 250 mg kapsul Rp 711.48 100 0 100 20 14,230
Klorfeniramin maleat ( CTM ) tablet 4 mg tablet Rp 24.00 4563 0 4,563 2183 52,392
Klorokuin 150 mg tablet tablet Rp 1,505.74 60 0 60 0 -
Klorpromazin Hcl tablet salut 100 mg tablet Rp 181.00 0 0 - 0 -
Klorpromazin Hcl tablet salut 25 mg tablet Rp 252.27 0 100 100 90 22,705
Klozapin 25 mg tablet tablet Rp 473.00 0 0 - 0 -
Kodein tablet 10 mg tablet Rp 605.00 253 0 253 25 15,125
Kotrimoksazol DOEN I (dewasa) tablet tablet Rp 133.00 0 0 - 0 -
kuinina (kina) 222 mg tablet Rp 801.00 0 0 - 0 -
Page 25
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Kuinine tablet salut selaput 200 mg tablet Rp 311.00 0 0 - 0 -
Lanzoprazol tablet Rp 278.00 455 600 1,055 470 130,660
Levofloksasin tab 500 mg tablet tablet Rp 373.00 0 0 - 0 -
levofloxacin 750 mg tablet tablet Rp 3,267.00 0 0 - 0 -
Lincomisin 500 mg tablet tablet Rp 1,600.83 0 0 - 0 -
Lisinopril 10 mg tablet tablet Rp 341.00 0 0 - 0 -
Lisinopril 5 mg tablet tablet Rp 250.00 0 0 - 0 -
Longatin 25 mg tablet Rp 3,320.24 0 100 100 8 26,562
Loperamida tablet tablet Rp 85.00 0 0 - 0 -
Loratadin tablet tablet Rp 136.00 608 500 1,108 335 45,560
Lorazepam (Merlopam) 2 mg tablet tablet Rp 995.00 0 0 - 0 -
Lorazepam 1 mg tablet tablet Rp 715.00 0 0 - 0 -
L-Vit D 1000 IU tablet tablet Rp 2,750.00 0 0 - 0 -
Mebendazol tablet 100 mg (vermox) tablet Rp 9,150.00 0 0 - 0 -
Mecovit tablet tablet Rp 819.50 0 0 - 0 -
Megazing tablet tablet Rp 1,090.94 0 0 - 0 -
Meloxikam 15 mg tablet tablet Rp 1,067.00 845 0 845 285 304,095
Meloxikam 7,5 mg tablet tablet Rp 682.00 920 0 920 155 105,710
Metformin tab 500 mg tablet Rp 77.00 270 0 270 120 9,240
Metformin tab 850 mg tablet Rp 159.00 0 0 - 0 -
Metilergometrin maleat tablet salut 0,125 mg tablet Rp 270.60 0 0 - 0 -
Metilprednisolon 4 mg tablet tablet Rp 148.00 1700 0 1,700 100 14,800
Metoklorpropamid tablet tablet Rp 66.00 100 200 300 60 3,960
Metronidazol tablet 250 mg tablet Rp 94.00 0 0 - 0 -
Metronidazol tablet 500 mg tablet Rp 379.50 214 0 214 25 9,488
Miniaspi 80 mg tablet Rp 89.00 9 0 9 9 801
Misoprostol 200 mg (gastrul) tablet Rp 13,043.80 0 0 - 0 -
Multivitamin Sivit Zinc tablet Rp 585.00 0 300 300 87 50,895
Natrium Diklofenak tablet 25 mg tablet Rp 115.00 677 0 677 270 31,050
Natrium Diklofenak tablet 50 mg tablet Rp 145.00 840 0 840 405 58,725
Natrium Tiroksin (Levotiroksin) tablet 100 mg (Euthyrox) tablet Rp 1,072.00 0 0 - 0 -
Neo Diaform tablet Rp 272.73 700 0 700 0 -
Neurodex tablet tablet Rp 495.00 0 0 - 0 -
New Diatabs tablet Rp 557.15 0 0 - 0 -
Nipedipin 10 mg tablet tablet Rp 193.49 410 0 410 130 25,154
Nistatin 100.000 iu /g tablet vagina tablet Rp 688.00 40 100 140 14 9,632
Nistatin 500.000 iu /g tablet salut tablet Rp 910.00 0 0 - 0 -
Nopres 20 mg tablet / Fluoxetine 20 mg tablet Rp 387.00 0 0 - 0 -
novadium tablet Rp 200.00 0 0 - 0 -
Noza tablet tablet Rp 797.50 1487 0 1,487 755 602,113
Obat anti TBC FDC Kategori harian paket Rp 467,656.00 0 1 1 1 467,656
Obat antituberkolusis katagori 1 (KOMBIPAK) paket Rp 317,018.00 0 0 - 0 -
Obat antituberkolusis katagori 2 paket Rp 1,379,984.00 0 0 - 0 -
Obat antituberkulosis anak paket Rp 287,387.00 1 0 1 0 -
Obat FDC Kategori 1 paket Rp 477,791.00 3 0 3 0 -
obat FDC KATEGORI 2 paket Rp 1,592,276.00 0 0 - 0 -
Ofloksasin tab 400 mg tablet Rp 700.00 0 0 - 0 -
Omeprazole 20 mg capsul kapsul Rp 129.00 1906 0 1,906 374 48,246
Ondansetron tab 4 mg tablet Rp 275.00 480 0 480 26 7,150
Oseltamivir 75 mg tablet Rp 14,300.00 270 0 270 0 -
OSTEOTIN tablet Rp 3,283.00 0 0 - 0 -
Paket fase awal 2 RHZE (RIPE) tablet Rp 449.00 0 0 - 0 -
Paket fase intensif 2 RHZE (RIPE) tablet Rp 449.00 0 0 - 0 -
Paket fase lanjutan 4 RHZ (RI) tablet Rp 899.00 0 0 - 0 -
Papaverin 40 mg tablet tablet Rp 528.00 0 0 - 0 -
Parasetamol tablet 500 mg tablet Rp 145.45 5441 3000 8,441 3105 451,622
Pirantel pamoat 125 mg tablet tablet Rp 353.00 100 0 100 0 -
Piridoksin Hcl tablet 10 mg tablet Rp 150.00 0 0 - 0 -
Piridoksin Hcl tablet 25 mg tablet Rp 222.00 0 0 - 0 -
Piroksikam 10 mg tablet tablet Rp 244.39 255 0 255 0 -
Piroksikam 20 mg tablet tablet Rp 316.29 290 0 290 0 -
Page 26
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
PP Isoniazide 100 mg tablet Rp 282.00 0 0 - 0 -
Prednison tablet 5 mg tablet Rp 73.00 297 0 297 10 730
Prenatin DF tablet tablet Rp 3,300.00 0 0 - 0 -
Primakuin tablet 15 mg tablet Rp 242.00 0 0 - 0 -
Primolut N tablet tablet Rp 2,618.00 0 0 - 0 -
Primunox tablet tablet Rp 2,501.00 20 0 20 10 25,010
Propanolol Hcl tablet 40 mg tablet Rp 88.00 100 0 100 0 -
Propiltiourasil tablet 100 mg tablet Rp 440.00 100 0 100 0 -
Prove D3 1000 tablet Rp 2,750.00 0 0 - 0 -
Provital tablet tablet Rp 3,459.50 0 0 - 0 -
Pularex tablet tablet Rp 187.00 480 0 480 46 8,602
Purvit D3 tablet tablet Rp 2,420.00 0 0 - 0 -
Ramvit C 500 mg tablet tablet Rp 0.01 0 0 - 0 -
Ranitidin tablet tablet Rp 228.85 267 0 267 267 61,103
Retinol ( Vit A ) 100.000 IU kapsul kapsul Rp 356.00 47 50 97 51 18,156
Retinol ( Vit A ) 200.000 IU kapsul kapsul Rp 637.00 136 450 586 257 163,709
Rifampisin kaplet 600 mg tablet Rp 1,209.00 0 0 - 0 -
Rifampisin kapsul 300 mg tablet Rp 670.00 0 0 - 0 -
Rifampisin kapsul 450 mg tablet Rp 868.00 0 0 - 0 -
Risperidon 2 mg tab tablet Rp 287.00 0 0 - 0 -
Salbutamol tablet 2 mg tablet Rp 122.11 440 0 440 229 27,963
Salbutamol tablet 4 mg tablet Rp 127.99 367 0 367 25 3,200
Sanbe-C 500 mg tablet tablet Rp 660.00 0 0 - 0 -
Sandepril 50 mg tablet tablet Rp 8,250.00 0 0 - 0 -
Scopma tablet tablet Rp 880.72 160 200 360 125 110,090
Sefadroxil kapsul 500 mg tablet Rp 808.50 1240 200 1,440 650 525,525
Sefiksim kapsul 100 mg kapsul Rp 2,465.18 3 0 3 3 7,396
Selevit Plus tablet tablet Rp 2,915.00 0 0 - 0 -
Seretide Inhaler 50 mcg kotak Rp 58,000.00 0 0 - 0 -
Setirizine tablet 10 mg tablet Rp 104.00 0 2000 2,000 156 16,224
Simetidin tablet (Tidifar) tablet Rp 330.11 590 0 590 140 46,215
Simpastatin 10 mg tablet tablet Rp 663.60 1913 0 1,913 720 477,792
Simpastatin 20 mg tablet tablet Rp 150.00 40 0 40 40 6,000
Siprofloksasin 500 mg tablet tablet Rp 305.83 490 200 690 75 22,937
Sohobion tablet tablet Rp 1,760.00 110 0 110 110 193,600
Spironolakton tab 25 mg tablet Rp 220.00 320 0 320 60 13,200
Stimuno Forte tablet tablet Rp 1,763.00 120 510 630 100 176,300
Tanapress 5 mg (imidapril ) tablet Rp 2,530.00 35 0 35 0 -
Tenofovir 300 mg/lamivudin 300 mg/dolutegravir 50 mg tablet Rp 1.00 0 0 - 0 -
Tenofovir 300 mg/lamivudin 300 mg/efaviren 600 mg tablet Rp 6,935.00 0 0 - 0 -
Tensigard tablet tablet Rp 2,292.55 0 0 - 0 -
Terra Flu tablet tablet Rp 505.31 0 0 - 0 -
Thiamfenicol 500 mg kapsul kapsul Rp 2,600.00 0 0 - 0 -
Thiamin Hcl monohidrat ( Vit B1 ) 50 mg tablet Rp 88.00 2327 0 2,327 2267 199,496
Tramadol 50 mg kapsul kapsul Rp 580.00 5 0 5 5 2,900
Triflouperazin 5mg tablet tablet Rp 330.00 0 0 - 0 -
Triheksilfenidil hidroklorida tablet 2 mg tablet Rp 63.00 118 0 118 60 3,780
Urotractin (asam pipemidat) 400 mg tablet Rp 3,865.69 0 0 - 0 -
valisanbe 2 mg tablet tablet Rp 236.00 0 0 - 0 -
Vitamin B 12 tablet tablet Rp 52.00 607 3000 3,607 1595 82,940
Vitamin B komplek tablet tablet Rp 135.00 310 0 310 310 41,850
Vitamin C 500 mg tablet Rp 660.00 0 0 - 0 -
Zeviton tablet tablet Rp 2,849.00 0 0 - 0 -
Zink 20 mg tablet (generik) tablet Rp 253.00 500 0 500 200 50,600
Asam Traneksamat 500 mg tablet Rp 1,559.00 224 0 224 124 193,316
Tanapress 5 mg (imidapril ) relokasi RS SS tablet Rp 2,333.00 100 0 100 0 -
Vitamin C 500 mg mersi tablet Rp 198.00 0 0 - 0 -
Lactasin relokasi RS SS kapsul Rp 3,850.00 0 0 - 0 -
SKA-VIT C 500 MG kapsul Rp 825.00 0 0 - 0 -
Caviplex D3 tablet Rp 1,195.00 0 0 - 0 -
Favimol 200 mg tablet Rp 4,333.00 840 0 840 200 866,600
Page 27
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Camivit D3 kapsul Rp 634.00 180 0 180 130 82,420
Rifapentin 300 mg paket (isi 36) 0 2 2 2 -
Guaiafenesin 100 mg tablet 0 1000 1000 495 -
9,065,152.06 -
Page 28
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Page 29
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
7,922,816.06
UMUM
JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TDK BYR JKN
251 384 446 1081
Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor

Kepala Dinas Kesehatan Kab/Kota Kepala UPTD Instalasi Farmasi Kepala Puskesmas
Page 30
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Dr. Machli Riyadi, S.H., M.H Yohana Rusnayuda,S.Si.,Apt. dr. Hj. Santi Indri Yani Achmadiyah
NIP.19701124 199101 1 004 NIP. 19790311 200501 2 015 NIP. 19821117 201101 2 005
Page 31
AT
BULAN 0 8 LB2
TAHUN 2 0 2 2
11 12=(7-8-10) 13 14 15 16 17 18
- 180 165,600.00 (180) POPM

- 118 44,840.00 79
- 899 80,011.00 (486)
- - - -
- - - -
- - - 3,432 2000
- - - -
- 100 23,716.00 (100)
- 480 35,520.00 624 3000
- - - - 3000
- - - - 200
- 602 159,530.00 1,030 1000 ed terbaru
- 2,190 131,400.00 654 1000
- - - - 100
- - - -
- - - - 3000
- - - -
- - - -
- 443 72,671.05 (306) 1000
- 30 3,600.00 222 2500
- 525 32,025.00 39
- - - -
- 1,280 131,840.00 (656) 2000
- 304 217,578.88 (304)
- - - -
- 80 56,444.08 784 1000
- - - - 500 ED TERBARU
- - - -
- 85 119,025.50 (56)
- 850 78,200.00 (730)
- 365 52,195.00 (257)
- - - -
- - - - 500
- - - - 2500
- - - - 200
- 760 437,000.00 (208)
- 960 934,560.00 (490)
- - - 358 1500
- - - - 2000
- - - -
- 109 213,266.13 (109) 200
- - - -
- 45 3,150.00 (16)
- - - -
- - - -
- - - -
- - - -
- 380 49,020.00 (380)
- 100 44,000.00 (100)
- 1,070 558,663.05 (758)
- 100 101,400.00 (93) 100
Page 32
11 12=(7-8-10) 13 14 15 16 17 18
- - - - 30
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 164 32,308.00 (164)
- - - -
- 6,370 2,605,330.00 626 2000
- 170 132,770.00 (170)
- - - -
- 210 101,640.00 (181)
- 300 26,100.00 (60) ED TERBARU
- 650 113,100.00 (50) 500
- 635 131,445.00 (47) 500
- - - 2,172 2000 ed terbaru
- - - - 500
- 200 31,460.00 (20)
- - - 348 200
- - - -
- 25 1,475.00 191 100
- 103 5,562.00 (103)
- - - -
- - - -
- 200 29,600.00 (200)
- - - -
- - - -
- - - -
- 410 97,235.60 682 1000
- - - 624 1000
- 208 205,920.00 32 100
- 175 24,948.00 (175)
- - - -
- 422 41,778.00 (422)
- 3,000 180,000.00 (3,000) 3000
- - - - 1200
- - - - 1200
- 1,745 218,112.79 (1,529)
- 2,005 185,703.10 (1,621)
- 1,937 484,250.00 (1,937)
- - - -
- - - -
- - - 19 100
- - - -
- - - -
- 80 56,918.40 (32)
- 2,380 57,120.00 2,859 2000
- 60 90,344.40 (60)
- - - - 200
- 10 2,522.74 206 200 relok dari KTM
- - - -
- 228 137,940.00 (168) 100
- - - - 200
- - - -
Page 33
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- 585 162,630.00 543 600
- - - -
- - - -
- - - -
- - - - 30
- - - - 100
- 92 305,462.08 (73) 100
- - - -
- 773 105,128.00 31 500
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 560 597,520.00 124 300
- 765 521,730.00 (393)
- 150 11,550.00 138 5000
- - - - 500
- - - - 100
- 1,600 236,800.00 (1,360)
- 240 15,840.00 (96)
- - - -
- 189 71,725.50 (129)
- - - 22 200
- - - - 60
- 213 124,605.00 (4)
- 407 46,805.00 241 500
- 435 63,075.00 537
- - - -
- 700 190,913.80 (700)
- - - - 2000
- - - - 200 ED TERBARU
- 280 54,177.20 32
- 126 86,688.00 (92)
- - - -
- - - -
- - - -
- 732 583,770.00 1,080 300
- - - 2 1
- - - -
- - - -
- 1 287,387.00 (1)
- 3 1,433,373.00 (3)
- - - -
- - - -
- 1,532 197,628.00 (634)
- 454 124,850.00 (392)
- 270 3,861,000.00 (270)
- - - - 500
- - - -
- - - -
- - - -
- - - -
- 5,336 776,121.20 2,116 3000
- 100 35,300.00 (100)
- - - - 2000
- - - -
- 255 62,318.69 (255)
- 290 91,725.26 (290)
Page 34
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- 287 20,951.00 (263)
- - - -
- - - -
- - - -
- 10 25,010.00 14
- 100 8,800.00 (100)
- 100 44,000.00 (100)
- - - -
- - - -
- 434 81,158.00 (324)
- - - -
- - - - 300
- - - 641 700
- 46 16,376.00 76 100
- 329 209,573.00 288 100
- - - - 100
- - - -
- - - -
- - - -
- 211 25,765.42 339 300
- 342 43,770.87 (282)
- - - -
- - - -
- 235 206,969.20 65 100
- 790 638,715.00 770 1000
- - - 7 400
- - - -
- - - -
- 1,844 191,776.00 (1,470)
- 450 148,549.50 (114)
- 1,193 791,674.80 535
- - - 96 600
- 615 188,087.30 (435)
- - - 264 1000
- 260 57,200.00 (116)
- 530 934,390.00 (290)
- 35 88,550.00 (35)
- - - -
- - - -
- - - -
- - - - 1000
- - - - 100
- 60 5,280.00 5,381 3000
- - - 12 50 ED TERBARU
- - - -
- 58 3,654.00 86 200
- - - - 100
- - - -
- 2,012 104,624.00 1,816 3000
- - - 744 3000 ED TERBARU
- - - - 1000
- - - -
- 300 75,900.00 180 200
- 100 155,900.00 (100)
- 100 233,300.00 (100)
- - - -
- - - -
- - - - 300
- - - -
- 640 2,773,120.00 (640)
Page 35
11 12=(7-8-10) 13 14 15 16 17 18
- 50 31,700.00 (50)
- - - -
- 505 - (505) 1000
- OBAT PADAT 25,891,755.53
Page 36
11 12=(7-8-10) 13 14 15 16 17 18
Page 37
11 12=(7-8-10) 13 14 15 16 17 18
REAGEN #REF!
- #REF!
Yang Menerima
Petugas Puskesmas
Page 38
11 12=(7-8-10) 13 14 15 16 17 18
Achmadiyah Aulia Rahmah, S.Farm., Apt.

2 005 NIP. 19940728 201903 2 021
Page 39
PEMAKAIAN SU
PUSKESM
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
I. OBAT
B OBAT PADAT
Akarbose tablet 100 mg tablet 180
Albendazol tablet 400 mg tablet 200
Allopurinol tablet 100 mg tablet 1,071 30
Alprazolam 0,5 mg tablet -

Alprazolam 1 mg tablet -
Ambroxol tablet tablet 1,430 200
Aminofilin tablet 200 mg tablet -

Amitriptilin Hcl tablet salut 25 mg tablet 100
Amlodipin 10 mg tablet 940 460
Amlodipin 5 mg tablet -
Amoksisilin 250 mg tablet -
Amoksisilin 500 mg kaplet tablet 1,282 70 10
Antasida doen tablet kombinasi tablet 3,375 120 40 320
Antimigrain doen kombinasi tablet -

Antiparkinson doen tablet kombinasi tablet -
Arkavit tablet -
Asam Asetilsalisilat tablet 100 mg (Asetosal) tablet -
Asam Asetilsalisilat tablet 500 mg (Asetosal) tablet -
Asam askorbat(vit C) tablet 250 mg tablet 500
Asam Askorbat(vit C) tablet 50 mg tablet 135 105
Asam Folat 1 mg tablet tablet 760 170
Asam Folat 5 mg tablet tablet -

Asam mefenamat 500 mg kaplet tablet 1,540 40
Asam Traneksamat 500 mg kapsul (nexitra) kapsul 304

Asetilsistein 200mg kaps kapsul -
Asiklovir 200 mg tablet tablet 440 100
Asiklovir 400 mg tablet tablet -

Azitromisin 1000 mg + cefixime 400 mg paket -
Azitromisin 500 mg tablet tablet 97
Betahistin mesilat tablet 6 mg tablet 900
Bisoprolol tablet 5 mg tablet 410 10
Buscopan tablet tablet -

Cetop-zink kaplet tablet -
Citoneuron tablet tablet -
Clindamisin kapsul 300 mg kapsul -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Clopidogrel 75 mg tablet tablet 990

Curcuma FCT tablet tablet 1,156
Deksametason tablet 0,5 mg tablet 149
Demacolin tablet tablet -
Depakote tablet tablet -
Dextamine tablet tablet 109
DHP / Darplex / D-Artepp (Dehidro artemisin Piperaquin) tab tablet -
Diazepam tablet 2 mg tablet 57
Diazepam tablet 5 mg tablet -
Dietilkarbamazin sitrat tablet 100 mg tablet -
Digoksin tablet 0,25 mg tablet -
Diltiazem tablet tablet -
Dimenhidrinate tablet tablet 380
Doksisiklin 100 mg kapsul kapsul 100
Domperidon 10 mg tablet 1,200
Dopamet (metildopa) tablet 103
Dulcolax 5 mg tablet tablet -
Efaviren 200 mg tablet -
Efaviren 600 mg tablet -
Efedrin Hcl tablet 25 mg tablet -
Enfavit tablet tablet -
Erytromisin 250 mg kapsul kapsul -
Erytromisin 500 mg kaplet tablet -
Etambutol 500 mg tablet tablet -
Etambutol Hcl tablet 250 mg tablet -
Famotidin 40 mg tablet tablet -
Favipiravir 200 mg tablet tablet -
Fenitoin natrium kapsul 100 mg kapsul -
Fenobarbital tablet 100 mg tablet -
Fenobarbital tablet 30 mg tablet 164
Fenofibrat kaps 100 mg tablet -
Ferro folat tab sal selaput 200 mg + 0,4 mg (Tablet tambah dara tablet 9,285 640
Fitomenadion ( vit k 1 ) tablet salut 10 mg tablet 170
Furosemid tablet 40 mg tablet -
Gemfibrozil 300 mg tablet tablet 222
Glibenklamid tablet 5 mg tablet 400 100
Glimepirid tab 1 mg tablet 900

Glimepirid tab 2 mg tablet 880
Gliseril guayakolat tablet 100 mg tablet 905 165 140
Glukosamin 250 mg tablet (osmin) tablet -

Gradilex tablet 275
Griseofulvin tablet 125 mg micronized tablet 145
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Haloperidol tablet 0,5 mg tablet -

Haloperidol tablet 1,5 mg tablet 115
Haloperidol tablet 5 mg tablet 103
Hemafort tablet tablet -
Hepatin tablet tablet -
Hidroklortiazid ( Hct ) tablet 25 mg tablet 200
Hydroxychloroquine sulfate 200 mg tablet tablet -
Hyorex 10 mg tablet tablet -
Hyoscine N Butilbromida 10 mg tablet tablet -
Ibuprofen tablet 200 mg tablet 865
Ibuprofen tablet 400 mg tablet 260
Interhistin tablet tablet 308
Isoniazid tablet 100 mg tablet 175
Isoniazid tablet 300 mg tablet -
Isosorbit dinitrat tablet sublingual 5 mg tablet 422
Kalsium laktat ( Kalk ) tablet 500 mg tablet 3,000
Kandesartan 16 mg tablet tablet -
Kandesartan 8 mg tablet tablet -
Kaptopril 12,5 mg tablet tablet 1,835 30
Kaptopril 25 mg tablet tablet 2,165

Karbamazepin tablet 200 mg tablet 1,937
Ketokenazol 200 mg tablet tablet -
Ketoprofen 100 mg tablet tablet -
Klindamisin 150 mg tablet tablet 8

Klobazam 10 mg tablet tablet -
Klonidin 0,15 mg tablet tablet -
Kloramfenikol kapsul 250 mg kapsul 100
Klorfeniramin maleat ( CTM ) tablet 4 mg tablet 4,563 113 155
Klorokuin 150 mg tablet tablet 60

Klorpromazin Hcl tablet salut 100 mg tablet -
Klorpromazin Hcl tablet salut 25 mg tablet 100
Klozapin 25 mg tablet tablet -
Kodein tablet 10 mg tablet 253
Kotrimoksazol DOEN I (dewasa) tablet tablet -
kuinina (kina) 222 mg tablet -
Kuinine tablet salut selaput 200 mg tablet -
Lanzoprazol tablet 1,055 20
Levofloksasin tab 500 mg tablet tablet -

levofloxacin 750 mg tablet tablet -
Lincomisin 500 mg tablet tablet -
Lisinopril 10 mg tablet tablet -
Lisinopril 5 mg tablet tablet -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Longatin 25 mg tablet 100

Loperamida tablet tablet -
Loratadin tablet tablet 1,108 46
Lorazepam (Merlopam) 2 mg tablet tablet -

Lorazepam 1 mg tablet tablet -
L-Vit D 1000 IU tablet tablet -
Mebendazol tablet 100 mg (vermox) tablet -
Mecovit tablet tablet -
Megazing tablet tablet -
Meloxikam 15 mg tablet tablet 845 70
Meloxikam 7,5 mg tablet tablet 920 55

Metformin tab 500 mg tablet 270
Metformin tab 850 mg tablet -
Metilergometrin maleat tablet salut 0,125 mg tablet -
Metilprednisolon 4 mg tablet tablet 1,700
Metoklorpropamid tablet tablet 300
Metronidazol tablet 250 mg tablet -
Metronidazol tablet 500 mg (Farizol) tablet 214
Miniaspi 80 mg tablet 9
Misoprostol 200 mg (gastrul) tablet -
Multivitamin Sivit Zinc tablet 300
Natrium Diklofenak tablet 25 mg tablet 677 50 10
Natrium Diklofenak tablet 50 mg tablet 840 10 10
Natrium Tiroksin (Levotiroksin) tablet 100 mg (Euthyrox) tablet -

Neo Diaform tablet 700
Neurodex tablet tablet -
New Diatabs tablet -
Nipedipin 10 mg tablet tablet 410
Nistatin 100.000 iu /g tablet vagina tablet 140 8
Nistatin 500.000 iu /g tablet salut tablet -

Nopres 20 mg tablet / Fluoxetine 20 mg tablet -
novadium tablet -
Noza tablet tablet 1,487 8
Obat anti TBC FDC Kategori harian paket 1

Obat antituberkolusis katagori 1 (KOMBIPAK) paket -
Obat antituberkolusis katagori 2 paket -
Obat antituberkulosis anak paket 1
Obat FDC Kategori 1 paket 3
obat FDC KATEGORI 2 paket -
Ofloksasin tab 400 mg tablet -
Omeprazole 20 mg capsul kapsul 1,906 84 10
Ondansetron tab 4 mg tablet 480

PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Oseltamivir 75 mg tablet 270

OSTEOTIN tablet -
Paket fase awal 2 RHZE (RIPE) tablet -
Paket fase intensif 2 RHZE (RIPE) tablet -
Paket fase lanjutan 4 RHZ (RI) tablet -
Papaverin 40 mg tablet tablet -

Parasetamol tablet 500 mg tablet 8,441 250 30 560
Pirantel pamoat 125 mg tablet tablet 100

Piridoksin Hcl tablet 10 mg tablet -
Piridoksin Hcl tablet 25 mg tablet -
Piroksikam 10 mg tablet tablet 255
Piroksikam 20 mg tablet tablet 290
PP Isoniazide 100 mg tablet -
Prednison tablet 5 mg tablet 297
Prenatin DF tablet tablet -
Primakuin tablet 15 mg tablet -
Primolut N tablet tablet -
Primunox tablet tablet 20
Propanolol Hcl tablet 40 mg tablet 100
Propiltiourasil tablet 100 mg tablet 100
Prove D3 1000 tablet -
Provital tablet tablet -
Pularex tablet tablet 480
Purvit D3 tablet tablet -
Ramvit C 500 mg tablet tablet -
Ranitidin tablet tablet 267 50
Retinol ( Vit A ) 100.000 IU kapsul kapsul 97

Retinol ( Vit A ) 200.000 IU kapsul kapsul 586
Rifampisin kaplet 600 mg tablet -
Rifampisin kapsul 300 mg tablet -
Rifampisin kapsul 450 mg tablet -
Risperidon 2 mg tab tablet -
Salbutamol tablet 2 mg tablet 440 100
Salbutamol tablet 4 mg tablet 367

Sanbe-C 500 mg tablet tablet -
Sandepril 50 mg tablet tablet -
Scopma tablet tablet 360
Sefadroxil kapsul 500 mg tablet 1,440
Sefiksim kapsul 100 mg kapsul 3
Selevit Plus tablet tablet -
Seretide Inhaler 50 mcg kotak -
Setirizine tablet 10 mg tablet 2,000
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Simetidin tablet (Tidifar) tablet 590 70
Simpastatin 10 mg tablet tablet 1,913 10 40
Simpastatin 20 mg tablet tablet 40

Siprofloksasin 500 mg tablet tablet 690
Sohobion tablet tablet 110
Spironolakton tab 25 mg tablet 320
Stimuno Forte tablet tablet 630
Tanapress 5 mg (imidapril ) tablet 35
Tenofovir 300 mg/lamivudin 300 mg/dolutegravir 50 mg tablet -
Tenofovir 300 mg/lamivudin 300 mg/efaviren 600 mg tablet -
Tensigard tablet tablet -
Terra Flu tablet tablet -
Thiamfenicol 500 mg kapsul kapsul -
Thiamin Hcl monohidrat ( Vit B1 ) 50 mg tablet 2,327 440
Tramadol 50 mg kapsul kapsul 5

Triflouperazin 5mg tablet tablet -
Triheksilfenidil hidroklorida tablet 2 mg tablet 118
Urotractin (asam pipemidat) 400 mg tablet -
valisanbe 2 mg tablet tablet -
Vitamin B 12 tablet tablet 3,607 110 120
Vitamin B komplek tablet tablet 310

Vitamin C 500 mg tablet -
Zeviton tablet tablet -
Zink 20 mg tablet (generik) tablet 500
Asam Traneksamat 500 mg tablet 224
Tanapress 5 mg (imidapril ) relokasi RS SS tablet 100
Vitamin C 500 mg mersi tablet -
Lactasin relokasi RS SS kapsul -
SKA-VIT C 500 MG kapsul -
Caviplex D3 tablet -
Favimol 200 mg tablet 840
Camivit D3 kapsul 180
Rifapentin 300 mg paket ISI 36 2
Guaiafenesin 100 mg tablet 1,000
PEMAKAIAN SUB UNIT & APOTEK OBAT PADAT
APBD BULAN
TAHUN

DALUARS
STOK OF KUMULATIF
GUDANG
I
180 0
82 118 82
142 70 229 600 172
0
0
1230 1430
0
100 0
480 460
0
0
20 100 480 120 55 200 127 100 680
50 655 70 110 340 70 1600 1185
0
0
0
0
0
57 43 400 57
30 105
65 80 45 400 235
0
220 180 1100 260
304 0
0
260 80 360
0
0
12 85 12
50 80 70 700 50
35 5 360 45
0
0
0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
230 60 70 630 230
196 120 840 196
20 129 149
0
0
9 100 0
0
12 45 12
0
0
0
0
100 80 200 0
100 0
40 90 100 70 900 130
3 100 3
0
0
0
0
0
0
0
0
0
0
0
0
0
164 0
0
100 2175 40 230 6100 2915
70 100 0
0
12 210 12
10 100 190 0 100
250 50 600 250
245 35 600 245
300 300 905
0
75 200 75
145 145
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
90 25 90
103 0
0
0
200 0
0
0
0
455 10 400 455
260 260
100 8 200 100
175 0
0
4 418 0
200 100 2700 0
0
0
60 170 310 165 1100 90
140 20 160 405 40 1400 160
1937 0
0
0
8 8
0
0
20 80 20
10 119 1786 30 300 250 1800 2183
60 0
0
90 10 90
0
25 228 25
0
0
0
450 85 500 470
0
0
0
0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
8 92 8
0
289 54 119 600 335
0
0
0
0
0
0
215 95 65 400 285
100 130 110 75 450 155
120 100 50 120
0
0
100 1600 100
60 40 200 60
0
25 80 20 89 0 25
9 9
0
87 3 210 87
210 50 135 22 200 270
385 40 160 235 0 405
0
10 690 0
0
0
20 110 80 200 130
6 126 14
0
0
0
747 44 88 600 755
1 1
0
0
1 0
3 0
0
0
280 140 192 1200 374
26 30 34 390 26
DALUARS
STOK OF KUMULATIF
GUDANG
I
270 0
0
0
0
0
0
100 200 1965 261 105 130 240 4600 3105
100 0
0
0
255 0
290 0
0
10 287 10
0
0
0
10 10 10
100 0
100 0
0
0
46 30 104 300 46
0
0
217 267
51 46 0 51
50 207 100 79 150 257
0
0
0
0
50 79 11 200 229
25 42 300 25
0
0
125 35 200 125
0 650 100 90 600 650
3 3
0
0
156 44 1800 156
DALUARS
STOK OF KUMULATIF
GUDANG
I
70 50 400 140
670 90 60 43 1000 720
40 40
75 115 500 75
110 110
60 30 230 60
100 20 510 100
35 0
0
0
0
0
0
210 1617 60 0 2267
5 5
0
60 58 60
0
0
1365 5 207 1800 1595
80 230 310
0
0
200 300 200
124 100 124
100 0
0
0
0
0
200 640 200
130 20 30 130
2 2
495 105 400 495
0 8
2 0 2 2
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
180 180 - Program POPM

118 118 -
899 899 -
- 0 -
- 0 -
- 0 -
- 0 -
100 100 -
480 480 -
- 0 -
- 0 -
602 602 -
2,190 2190 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
443 443 -
30 30 -
525 525 -
- 0 -
1,280 1280 -
304 304 -
- 0 -
80 80 -
- 0 -
- 0 -
85 85 -
850 850 -
365 365 -
- 0 -
- 0 -
- 0 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
760 760 -
960 960 -
- 0 -
- 0 -
- 0 -
109 109 -
- 0 -
45 45 -
- 0 -
- 0 -
- 0 -
- 0 -
380 380 -
100 100 -
1,070 1070 -
100 100 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
164 164 -
- 0 -
6,370 6370 -
170 170 -
- 0 -
210 210 -
300 300 -
650 650 -
635 635 -
- 0 -
- 0 -
200 200 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
25 25 -
103 103 -
- 0 -
- 0 -
200 200 -
- 0 -
- 0 -
- 0 -
410 410 -
- 0 -
208 208 -
175 175 -
- 0 -
422 422 -
3,000 3000 -
- 0 -
- 0 -
1,745 1745 -
2,005 2005 -
1,937 1937 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
80 80 -
2,380 2380 -
60 60 -
- 0 -
10 10 -
- 0 -
228 228 -
- 0 -
- 0 -
- 0 -
585 585 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
92 92 -
- 0 -
773 773 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
560 560 -
765 765 -
150 150 -
- 0 -
- 0 -
1,600 1600 -
240 240 -
- 0 -
189 189 -
- 0 -
- 0 -
213 213 -
407 407 -
435 435 -
- 0 -
700 700 -
- 0 -
- 0 -
280 280 -
126 126 -
- 0 -
- 0 -
- 0 -
732 732 -
- 0 -
- 0 -
- 0 -
1 1 -
3 3 -
- 0 -
- 0 -
1,532 1532 -
454 454 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
270 270 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
5,336 5336 -
100 100 -
- 0 -
- 0 -
255 255 -
290 290 -
- 0 -
287 287 -
- 0 -
- 0 -
- 0 -
10 10 -
100 100 -
100 100 -
- 0 -
- 0 -
434 434 -
- 0 -
- 0 -
- 0 -
46 46 -
329 329 -
- 0 -
- 0 -
- 0 -
- 0 -
211 211 -
342 342 -
- 0 -
- 0 -
235 235 -
790 790 -
- 0 -
- 0 -
- 0 -
1,844 1844 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
450 450 -
1,193 1193 -
- 0 -
615 615 -
- 0 -
260 260 -
530 530 -
35 35 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
60 60 -
- 0 -
- 0 -
58 58 -
- 0 -
- 0 -
2,012 2012 -
- 0 -
- 0 -
- 0 -
300 300 -
100 100 -
100 100 -
- 0 -
- 0 -
- 0 -
- 0 -
640 640 -
50 50 -
- 0 -
505 505 -
(LPLPO)


KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
I. OBAT
C OBAT GAS
Atrovent HFA kotak Rp 83,500.00 0 0 - 0 -
Berotec 0,1 mg MDI kotak Rp 83,190.00 0 0 - 0 -
Obat Gigi : Ethyl klorida semprot botol Rp 192,500.00 4 0 4 1 192,500
Ventolin inhaler kotak Rp 59,999.50 0 0 - 0 -
Xylocain spray kotak Rp 189,107.00 0 0 - 0 -
Salbulin inhaler relokasi RS SS kotak Rp 33,294.00 15 0 15 0 -
D OBAT SERBUK / TEPUNG

Garam oralit untuk 200 ml air sachet Rp 263.00 495 0 495 154 40,502
lacbon sachet Rp 3,391.39 0 0 - 0 -
L-Bio sachet sachet Rp 6,930.00 0 0 - 0 -
Mineral mix serbuk 8 gr sachet Rp 2,920.00 0 0 - 0 -
Neo Mune sachet Rp 32,960.00 0 0 - 0 -
Pulmicort turbuhaler kotak Rp 101,000.00 0 0 - 0 -
Rubysta sachet Rp 23,751.29 0 0 - 0 -
Salisil bedak 2 % kotak Rp 6,926.70 52 24 76 22 152,387
Symbicort turbuhaler 160/4.5 mg kotak Rp 134,284.00 0 0 - 0 -
Symbicort turbuhaler 80/4.5 mg kotak Rp 121,000.00 0 0 - 0 -
Taburia sachet Rp 887.50 0 0 - 0 -
385,389.40 -
Page 58
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Page 59
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
770,778.80
UMUM
JUMLAH
251 384 446 1081

NIP.19701124 199101 1 004 NIP. 19790311 200501 2 015 NIP. 19821117 201101 2 005
Page 60
AN OBAT
BULAN 0 8 LB2
TAHUN 2 0 2 2
11 12=(7-8-10) 13 14 15 16 17 18
- - - - POPM
- - - -
- 3 577,500.00 (1) 2
- - - -
- - - -
- 15 499,410.00 (15)
- 341 89,683.00 29
- - - - 150
- - - - 210
- - - -
- - - -
- - - -
- - - -
- 54 374,041.80 (1) 24
- - - -
- - - -
- - - -
- GAS, SERBUK 1,540,634.80
Page 61
11 12=(7-8-10) 13 14 15 16 17 18
Page 62
11 12=(7-8-10) 13 14 15 16 17 18
REAGEN
#REF!
- #REF!
Yang Menerima
Petugas Puskesmas
ni Achmadiyah Aulia Rahmah, S.Farm., Apt.

1 2 005 NIP. 19940728 201903 2 021
Page 63
PEMAKAIAN SU
PUSKESM
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
I. OBAT
C OBAT GAS
Atrovent HFA kotak -
Berotec 0,1 mg MDI kotak -
Obat Gigi : Ethyl klorida semprot botol 4
Ventolin inhaler kotak -
Xylocain spray kotak -
Salbulin inhaler relokasi RS SS kotak 15
D OBAT SERBUK / TEPUNG

Garam oralit untuk 200 ml air sachet 495
lacbon sachet -
L-Bio sachet sachet -
Mineral mix serbuk 8 gr sachet -
Neo Mune sachet -
Pulmicort turbuhaler kotak -
Rubysta sachet -
Salisil bedak 2 % kotak 76 3
Symbicort turbuhaler 160/4.5 mg kotak -

Symbicort turbuhaler 80/4.5 mg kotak -
Taburia sachet -
PEMAKAIAN SUB UNIT & APOTEK GAS SERBUK
APBD BULAN
TAHUN

DALUARS KUMULATIF
STOK OF
GUDANG
I
0
0
1 3 1
0
0
15 0
2 152 10 15 16 300 154

0
0
0
0
0
0
19 5 1 48 22
0
0
0
0 8
2 0 2 2
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 - Program POPM
- 0 -
3 3 -
- 0 -
- 0 -
15 15 -
341 341 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
54 54 -
- 0 -
- 0 -
- 0 -
(LPLPO)


KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
I. OBAT
E OBAT GEL / SALEP
Acdat salep tube Rp 6,241.00 0 0 - 0 -
Anti bakteri doen salep kombinasi tube Rp 5,454.68 50 0 50 20 109,094
Antifungi doen kombinasi tube Rp 5,517.00 0 0 - 0 -
Antihemaroid doen kombinasi supp Rp 3,642.00 38 10 48 10 36,420
Asiklovir salep kulit tube Rp 3,773.00 61 0 61 9 33,957
Betametason krim 0,1 % tube Rp 1,465.00 0 75 75 4 5,860
Bioplacenton Cream tube 15 gr Rp 21,780.00 25 0 25 3 65,340
Bufacetine 2 % salep 15 gr tube Rp 3,585.00 0 0 - 0 -
Desoksimetason 0,25 mg (Denomix) tube Rp 8,998.00 9 0 9 6 53,988
Dulcolax 10 mg supp supp Rp 5,900.00 28 0 28 1 5,900
Dysclosing agent / Disclosing gel (GC tri plaque ID Gel) tube Rp 361,570.00 0 0 - 0 -
Fucilex ointment (natrium fusidat) tube Rp 4,889.00 9 0 9 6 29,334
Fuson ointment tube Rp 7,500.00 0 0 - 0 -
Gentamisin salep kulit (genoint SK) tube Rp 5,445.00 0 0 - 0 -
Gentamisin salep mata tube Rp 3,075.00 32 0 32 23 70,725
Gentian violet larutan 1 % pot Rp 2,750.00 39 0 39 4 11,000
Hidrokortison krim 1% tube Rp 10,723.90 57 50 107 7 75,067
Hidrokortison krim 2,5 % tube Rp 2,325.00 23 0 23 0 -
Ichtyol salep tube Rp 5,653.00 9 0 9 0 -
Jelly (Aquagel) botol Rp 32,500.00 0 0 - 0 -
Ketokonazol Krim tube Rp 2,518.00 0 0 - 0 -
Kloramfenikol salep 2 % tube Rp 1.00 0 0 - 0 -
Kloramfenikol salep mata 1 % (erlamycetin) tube Rp 10,197.00 20 0 20 0 -
Lapalos Cream tube Rp 14,304.40 0 0 - 0 -
Lidocain jeli 2 % (Xylocaine Jelly 2%) syringe Rp 40,000.00 0 0 - 0 -
Livertran salep tube Rp 4,600.00 0 0 - 0 -
Metronidazol supp 500 mg (Flagyl supp) supp Rp 3,655.00 0 0 - 0 -
Miconazol krim tube Rp 1,900.00 0 0 - 0 -
Mometason furoat krim 0,1 % tube Rp 6,025.00 30 25 55 13 78,325
Obat Gigi : acid etching kotak Rp 231,000.00 0 0 - 0 -
Obat Gigi : Alveogyl kotak Rp 951,049.00 0 0 - 0 -
Obat Gigi : Arsenic Pasta 10 gr/pot Rp 942,040.00 0 0 - 0 -
Obat Gigi : Caviton kotak Rp 202,125.00 1 0 1 0 -
Obat Gigi : Devitalisasi pasta (non arsen) / Devitec / devital kotak Rp 797,500.00 1 0 1 0 -
Obat Gigi : Kalsium hidroksida pasta / hydcal kotak Rp 220,000.00 0 0 - 0 -
Obat Gigi : Pasta pengisi saluran akar kotak Rp 577,500.00 0 0 - 0 -
Obat Gigi : Tambalan sinar solare A2 kotak Rp 302,500.00 0 0 - 0 -
Obat Gigi : Tambalan sinar solare A3 kotak Rp 302,500.00 0 0 - 0 -
Obat Gigi : Varnish box Rp 165,440.00 0 0 - 0 -
Obat Gigi :Citodur (Bahan tambalan sementara) kotak Rp 200,200.00 0 0 - 0 -
Obat Gigi :Surgical ginggival pack (Coe Pak) kotak Rp 669,350.00 0 0 - 0 -
Obat Gigi :Tambalan sinar solare A3,5 kotak Rp 302,500.00 0 0 - 0 -
Obat Gigi :Topical anastesi pasta / lolite kotak Rp 269,522.00 0 0 - 0 -
Oksitetrasiklin Hcl salep kulit 3 % tube Rp 3,960.00 0 0 - 0 -
Oksitetrasiklin Hcl salep mata 1 % tube Rp 2,600.00 0 0 - 0 -
Pamol supp supp Rp 15,178.17 0 0 - 0 -
permetrin krim 5 % tube Rp 7,238.00 25 30 55 20 144,760
Salep 2 - 4 kombinasi tube Rp 2,797.00 8 0 8 7 19,579
Scabicid cream 10 gram tube Rp 11,475.00 0 0 - 0 -
Page 67
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Scabimite cream 10 gram tube Rp 50,396.50 0 0 - 0 -
Stesolid rectal 5 mg supp Rp 14,459.00 4 0 4 1 14,459
Synarcus krim tube Rp 2,534.00 0 0 - 0 -
Thrombophob gel tube Rp 54,450.00 7 0 7 2 108,900
Vagizol ovula (metronidazol ovula) ovula Rp 3,820.00 0 0 - 0 -
862,707.90
F ALAT / OBAT KONTRASEPSI KELUARGA BERENCANA

IUD set Rp 11,800.00 0 0 - 0 -
Obat suntik KB I (3 bulan) ampul Rp 7,175.00 0 0 - 0 -
Obat suntik KB II (1 bulan) ampul Rp 8,800.00 61 0 61 47 413,600
Pil KB I tablet Rp 1,350.00 0 0 - 0 -
Pil KB II / Laktasi tablet Rp 11,062.43 30 0 30 10 110,624
Susuk KB II set Rp 213,937.00 0 0 - 0 -
524,224.30
Page 68
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Page 69
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
2,773,864.40
UMUM
JUMLAH
251 384 446 1081

NIP.19701124 199101 1 004 NIP. 19790311 200501 2 015 NIP. 19821117 201101 2 005
Page 70
AN OBAT
BULAN 0 8 LB2
TAHUN 2 0 2 2
11 12=(7-8-10) 13 14 15 16 17 18
- - - - POPM
- 30 163,640.40 18 50
- - - -
- 38 138,396.00 (14)
- 52 196,196.00 (30)
- 71 104,015.00 (61)
- 22 479,160.00 (15)
- - - -
- 3 26,994.00 11
- 27 159,300.00 (25)
- - - -
- 3 14,667.00 11 10
- - - -
- - - - 150
- 9 27,675.00 46 25
- 35 96,250.00 (25)
- 100 1,072,390.00 (83)
- 23 53,475.00 (23) 48
- 9 50,877.00 (9)
- - - - 5
- - - - 48
- - - -
- 20 203,940.00 (20)
- - - - 36
- - - -
- - - - 5
- - - - 5
- - - - 48
- 42 253,050.00 (11) 24
- - - -
- - - -
- - - -
- 1 202,125.00 (1)
- 1 797,500.00 (1)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 48
- - - - 24
- - - - 6
- 35 253,330.00 13 60
- 1 2,797.00 16 48
- - - -
Page 71
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- 3 43,377.00 (1)
- - - -
- 5 272,250.00 (0)
- - - - 5
- GEL SALEP 4,611,404.40
- - - -
- - - -
- 14 123,200.00 99 40 ed terbaru
- - - -
- 20 221,248.60 4
- - - -
BKKBN 344,448.60
Page 72
11 12=(7-8-10) 13 14 15 16 17 18
Page 73
11 12=(7-8-10) 13 14 15 16 17 18
REAGEN #REF!
- #REF!
Yang Menerima
Petugas Puskesmas
ani Achmadiyah Aulia Rahmah, S.Farm., Apt.

01 2 005 NIP. 19940728 201903 2 021
Page 74
PEMAKAIAN
PUSKESM
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
I. OBAT
E OBAT GEL / SALEP
Acdat salep tube -
Anti bakteri doen salep kombinasi tube 50
Antifungi doen kombinasi tube -
Antihemaroid doen kombinasi supp 48
Asiklovir salep kulit tube 61
Betametason krim 0,1 % tube 75
Bioplacenton Cream tube 15 gr 25
Bufacetine 2 % salep 15 gr tube -
Desoksimetason 0,25 mg (Denomix) tube 9
Dulcolax 10 mg supp supp 28
Dysclosing agent / Disclosing gel (GC tri plaque ID Gel) tube -
Fucilex ointment (natrium fusidat) tube 9
Fuson ointment tube -
Gentamisin salep kulit (genoint SK) tube -
Gentamisin salep mata tube 32
Gentian violet larutan 1 % pot 39
Hidrokortison krim 1% tube 107
Hidrokortison krim 2,5 % tube 23
Ichtyol salep tube 9
Jelly (Aquagel) botol -
Ketokonazol Krim tube -
Kloramfenikol salep 2 % tube -
Kloramfenikol salep mata 1 % (erlamycetin) tube 20
Lapalos Cream tube -
Lidocain jeli 2 % (Xylocaine Jelly 2%) syringe -
Livertran salep tube -
Metronidazol supp 500 mg (Flagyl supp) supp -
Miconazol krim tube -
Mometason furoat krim 0,1 % tube 55 4 2
Obat Gigi : acid etching kotak -

Obat Gigi : Alveogyl kotak -
Obat Gigi : Arsenic Pasta 10 gr/pot -

Obat Gigi : Caviton kotak 1
Obat Gigi : Devitalisasi pasta (non arsen) / Devitec / devital kotak 1
Obat Gigi : Kalsium hidroksida pasta / hydcal kotak -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Obat Gigi : Pasta pengisi saluran akar kotak -

Obat Gigi : Tambalan sinar solare A2 kotak -
Obat Gigi : Tambalan sinar solare A3 kotak -
Obat Gigi : Varnish box -
Obat Gigi :Citodur (Bahan tambalan sementara) kotak -
Obat Gigi :Surgical ginggival pack (Coe Pak) kotak -
Obat Gigi :Tambalan sinar solare A3,5 kotak -
Obat Gigi :Topical anastesi pasta / lolite kotak -
Oksitetrasiklin Hcl salep kulit 3 % tube -
Oksitetrasiklin Hcl salep mata 1 % tube -
Pamol supp supp -
permetrin krim 5 % tube 55
Salep 2 - 4 kombinasi tube 8 7
Scabicid cream 10 gram tube -

Scabimite cream 10 gram tube -
Stesolid rectal 5 mg supp 4
Synarcus krim tube -
Thrombophob gel tube 7
Vagizol ovula (metronidazol ovula) ovula -
F ALAT / OBAT KONTRASEPSI KELUARGA BERANCANA

IUD set -
Obat suntik KB I (3 bulan) ampul -
Obat suntik KB II (1 bulan) ampul 61 5
Pil KB I tablet -
Pil KB II / Laktasi tablet 30 10
Susuk KB II set -
PEMAKAIAN SUB UNIT & APOTEK GEL SALEP
APBD BULAN
TAHUN

DALUARS
STOK OF KUMULATIF
GUDANG
I
0
3 17 3 10 17 0 20
0
10 38 10
3 6 2 50 9
4 21 50 4
3 22 3
0
6 3 6
1 27 1
0
6 3 6
0
0
5 18 5 4 0 23
4 2 3 30 4
7 100 7
7 16 0 0
9 0
0
0
0
20 0
0
0
0
0
0
7 1 3 38 13
0
0
0
1 0
1 0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
0
0
0
0
0
0
0
0
0
0
20 35 20
1 7
0
0
1 3 1
0
2 1 4 2
0
0
0
11 31 2 12 47
0
20 10
0
0 8
2 0 2 2
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 - Program POPM
30 30 -
- 0 -
38 38 -
52 52 -
71 71 -
22 22 -
- 0 -
3 3 -
27 27 -
- 0 -
3 3 -
- 0 -
- 0 -
9 9 -
35 35 -
100 100 -
23 23 -
9 9 -
- 0 -
- 0 -
- 0 -
20 20 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
42 42 -
- 0 -
- 0 -
- 0 -
1 1 -
1 1 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
35 35 -
1 1 -
- 0 -
- 0 -
3 3 -
- 0 -
5 5 -
- 0 -
- 0 -
- 0 -
14 14 -
- 0 -
20 20 -
- 0 -
(LPLPO)


KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
I. OBAT
G OBAT LAINNYA
Alat suntik sekali pakai 1 ml pcs Rp 776.00 0 0 - 0 -
Alat suntik sekali pakai 10 ml pcs Rp 1,287.00 67 0 67 0 -
Alat suntik sekali pakai 2,5 ml pcs Rp 605.00 0 0 - 0 -
Alat suntik sekali pakai 3 ml pcs Rp 920.00 665 0 665 115 105,800
Alat suntik sekali pakai 5 ml pcs Rp 1,503.00 300 100 400 31 46,593
Alkohol Swab lembar Rp 105.00 2000 0 2,000 100 10,500
APD COVERALL pcs Rp 1.00 0 0 - 0 -
APD Full Set set Rp 1.00 0 0 - 0 -
APD LENGKAP paket Rp 3,500,000.00 0 0 - 0 -
APD SET DISPOSIBLE set Rp 2,800,000.00 0 0 - 0 -
Baju APD Merek sablonku (warna merah dan putih) pcs Rp 120,000.00 0 0 - 0 -
Baju hazmat coverall (KIMCARE MICROPORUS) pcs Rp 86,000.00 8 0 8 0 -
Baju plastik / jas hujan pcs Rp 13,000.00 0 0 - 0 -
Balmed 3 ply earloop face mask pcs Rp 1,540.00 0 0 - 0 -
Bioplacenton tulle pcs Rp 10,920.00 0 0 - 0 -
Bistruri/scalpel balde No 10 pcs Rp 1,137.40 45 0 45 0 -
Bistruri/scalpel balde No 11 pcs Rp 1,137.40 50 0 50 13 14,786
Bisturi/scalpel balde No 15 pcs Rp 2,790.00 57 0 57 0 -
Blood Lancet no 26 om pcs Rp 145.20 0 0 - 0 -
Blood transfusion set pcs Rp 3,780.00 18 0 18 0 -
Blue Tip pack Rp 45,687.59 0 0 - 0 -
botol spray sorax 100 ml botol Rp 15,000.00 0 0 - 0 -
Box Obyek glass* biasa (one lab) pack Rp 100,000.00 3 0 3 0 -
Catgut/benang bedah no 2/0 chronic pcs Rp 3,896.00 21 0 21 0 -
Catgut/benang bedah no 2/0 plain pcs Rp 3,896.00 68 0 68 9 35,064
Catgut/benang bedah no 3/0 chronic pcs Rp 3,625.00 14 0 14 0 -
Catgut/benang bedah no 3/0 plain pcs Rp 5,250.00 57 0 57 14 73,500
cover shoes pcs Rp 1,500.00 250 0 250 0 -
Coverplast transparan 100 (24 mm) pcs Rp 825.00 0 0 - 0 -
Deck gelas / objek glass 24 x 24 mm pack Rp 48,000.00 3 0 3 3 144,000
Deck glass / objek glass 20 x 20 mm pack Rp 48,000.00 0 0 - 0 -
Deck glass / objek glass 22 x 22 mm pack Rp 52,300.00 0 0 - 0 -
Disposibel vagina speculum pcs Rp 7,500.00 0 0 - 0 -
disposible swab nasal pcs Rp 12,000.00 0 0 - 0 -
ECG 112 mm x 30 mm x 16 mm roll Rp 141,400.00 0 0 - 0 -
ECG 58 mm x 25 mm x 16 mm roll Rp 55,325.00 0 0 - 0 -
Face Shield pcs Rp 16,500.00 0 0 - 0 -
Film Rontgen 24 x 30 cm lembar Rp 19,415.00 0 0 - 0 -
Fixomull pcs Rp 42,800.00 0 0 - 0 -
Foley cateter no 16 / Ballon catheter 2 way Fr 16 pcs Rp 11,890.00 26 0 26 0 -
Foley cateter no 18 / Ballon catheter 2 way Fr 18 pcs Rp 12,520.00 26 0 26 0 -
Fukuda M.E.ECG Paper pcs Rp 56,566.70 0 0 - 0 -
Gene Xpert MTB/RIF buah Rp 253,994.20 0 0 - 0 -
Glove non steril nitrile (Pupick Med) Uk. L pcs Rp 1,815.00 0 0 - 0 -
Glove non steril nitrile (pupick Med) Uk. M pcs Rp 1,815.00 0 0 - 0 -
Glove non steril nitrile (pupick Med) Uk. S pcs Rp 1,815.00 0 0 - 0 -
Page 81
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
handiplast pcs Rp 385.00 0 0 - 0 -
Hazmat (program ISPA) pcs Rp 150,000.00 0 0 - 0 -
Holder tube vacutainer pcs Rp 6,940.00 0 0 - 0 -
Hypafix uk. Kecil 5 cm x 5 m pcs Rp 98,900.00 0 0 - 0 -
Infusiun set anak pcs Rp 2,970.00 32 0 32 0 -
Infusiun set dewasa pcs Rp 10,378.00 49 50 99 10 103,780
IV Catheter no 18 G pcs Rp 3,990.00 49 0 49 0 -
IV Catheter no 20 G pcs Rp 3,990.00 52 0 52 0 -
IV Catheter no 22 G (polywin) pcs Rp 10,710.00 30 0 30 0 -
IV Catheter no 24 G pcs Rp 3,990.00 0 0 - 0 -
Jarum (Needle) no 23 pcs Rp 254.00 0 0 - 0 -
Jarum (Needle) no 25 pcs Rp 825.00 0 0 - 0 -
Jarum Jahit kulit no 10 GT pack Rp 38,000.00 12 0 12 12 456,000
Jarum Jahit Kulit No 11 GT pack Rp 32,500.00 9 0 9 9 292,500
Jarum Jahit kulit no 12 GT pack Rp 38,000.00 0 0 - 0 -
Jarum Jahit Kulit No 13 GT pack Rp 32,500.00 0 0 - 0 -
Jarum Jahit Kulit No 14 GT pack Rp 38,000.00 12 0 12 12 456,000
jarum K-File no 15-40 kotak Rp 173,176.50 0 0 - 0 -
Kacamata Google pcs Rp 65,000.00 0 0 - 0 -
Kantong Kertas pak @100 lmbr Rp 16,500.00 0 0 - 0 -
Kantong plastik biohard pak Rp 99,000.00 0 0 - 0 -
kantongan plastik pack @ 100lbr Rp 3,100.00 0 0 - 0 -
Kapas berlemak 500 mg roll Rp 21,532.50 0 0 - 0 -
Kapas pembalut / absorben 250 mg roll Rp 13,000.00 4 0 4 1 13,000
Kasa kompres 40 / 40 steril pcs Rp 1,650.00 0 0 - 0 -
Kasa pembalut 2 m x80 cm pcs Rp 10,915.00 28 10 38 0 -
Kasa pembalut hidrofil 4m x 15 cm pcs Rp 2,767.00 40 0 40 5 13,835
Kasa pembalut hidrofil 4m x 3 cm pcs Rp 619.50 0 0 - 0 -
Kasa steril 16 cm x 16 cm box Rp 6,300.00 72 20 92 17 107,100
kelambu insektisida bungkus Rp 39,245.00 0 0 - 0 -
Kertas EKG (uk 80 x 90 x 280) lembar Rp 106,250.00 0 0 - 0 -
Kertas Puyer lembar Rp 90.00 17500 0 17,500 100 9,000
Kertas thermal mindray 50mm roll Rp 76,500.00 0 0 - 0 -
Kertas thermal mindray 50mm x 57 mm roll Rp 18,200.00 0 0 - 0 -
Kertas thermal mindray 80 x 50 roll Rp 24,250.00 0 0 - 0 -
Kertas thermal mindray 80 x 80 roll Rp 27,550.00 0 0 - 0 -
Kondom pcs Rp 860.48 0 0 - 0 -
kondom sutra pcs Rp 358.00 0 0 - 0 -
Lidi Kapas/cotton swab pcs Rp 1,090.00 100 0 100 0 -
lubrikan sutra pcs Rp 486.00 0 0 - 0 -
Markerpen pcs Rp 1.00 1 0 1 1 1
Masker 3 ply earloop/ karet/ (Altamed) pcs Rp 2,800.00 0 0 - 0 -
Masker 3 ply earloop/ karet/ (solida) pcs Rp 1,400.00 0 0 - 0 -
Masker 3 ply earloop/ karet/ (supamed) pcs Rp 2,890.00 0 0 - 0 -
masker anak program pcs Rp 0.02 0 0 - 0 -
Masker Headloop Altamed pcs Rp 599.50 0 0 - 0 -
Masker kain pcs Rp 1.00 0 0 - 0 -
Masker KN 95 Merk SPC pcs Rp 27,500.00 0 0 - 0 -
Masker KN95 9501V pcs Rp 134,999.70 0 0 - 0 -
Masker N 95 3M 1860 pcs Rp 27,500.00 0 0 - 0 -
Masker N 95 3M 1860S pcs Rp 19,500.00 0 0 - 0 -
Masker N 95 3M 1870 pcs Rp 23,000.00 58 0 58 0 -
-
Masker N 95 8210 pcs Rp 165,000.00 0 0 0 -
Masker n 95 BTL / respirator masker n95 FFP2 pcs Rp 66,000.00 0 0 - 0 -
Masker N 95 garuda safe type 1945 pcs Rp 26,000.00 80 0 80 0 -
Page 82
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Masker n 95 onemed pcs Rp 65,000.00 0 0 - 0 -
masker N 95 Vfex 9105 pcs Rp 121,000.00 0 0 - 0 -
masker nebule dewasa (besmed) pcs Rp 20,428.58 0 0 - 0 -
masker oksigen anak pcs Rp 19,800.00 0 0 - 0 -
masker oksigen dewasa pcs Rp 19,800.00 0 0 - 0 -
Mata Bor high speed pack Rp 154,000.00 0 0 - 0 -
Microtube 1,5 cc pack Rp 245,000.00 0 0 - 0 -
Needle flashback (vacutainer needle BD 22G x 1 pcs Rp 2,783.00 0 0 - 0 -
nitril examination glove uk S pcs Rp 1,350.00 0 0 - 0 -
nitril examination glove uk M Pcs Rp 1,350.00 0 0 - 0 -
Nurse cap (MAS) pcs Rp 242.00 0 0 - 0 -
Obat Gigi : Aplicator kotak Rp 95,000.00 0 0 - 0 -
Obat Gigi : Articulating paper kotak Rp 263,538.00 1 0 1 0 -
Obat Gigi : Cotton pelet pack Rp 38,500.00 2 0 2 0 -
Obat Gigi : Cotton roll pack Rp 82,500.00 5 0 5 0 -
Obat Gigi : Gutta perchha point 15-40 mm kotak Rp 51,700.00 0 0 - 0 -
Obat Gigi : Gutta perchha point 45-80 mm kotak Rp 50,000.00 1 0 1 0 -
Obat Gigi : Jarum Dental cytoject pcs Rp 2,640.00 0 0 - 0 -
Obat Gigi : Paper point 15-40 mm kotak Rp 47,300.00 0 0 - 0 -
Obat Gigi : Paper point 45-80 mm kotak Rp 47,300.00 0 0 - 0 -
Obat Gigi : selang saliva eyector pack Rp 157,300.00 0 0 - 0 -
Obat Gigi : Tampon pack Rp 300,000.00 0 2 2 0 -
Obat Gigi :Dental floss kotak Rp 82,500.00 1 0 1 0 -
Obyek glass* biasa pack Rp 15,000.00 0 0 - 0 -
Open akses bur pcs Rp 135,300.00 0 0 - 0 -
parafilm (Laboratorium film parafilm) kotak Rp 1,000,000.00 0 0 - 0 -
parafilm size 410 x 125 ft roll Rp 880,000.00 0 0 - 0 -
Penjepit tali pusat pcs Rp 1,840.00 85 0 85 0 -
Pharmafix pcs Rp 27,000.00 0 0 - 0 -
pipet ESR citotes pcs Rp 6,600.00 0 0 - 0 -
Plastik Klip bks @ 100 Lmbr) Rp 9,350.00 0 0 - 0 -
Plastik klip sedang pack/100s Rp 5,000.00 0 0 - 0 -
Plastik Obat kecil (uk. 8 cm x 5 cm) pack Rp 17,000.00 0 0 - 0 -
Plastik Obat pembungkus puyer (uk. Besar) pack/100s Rp 7,100.00 0 0 - 0 -
plester (hansaplast 2,5 cm x 4,5 m) roll Rp 12,700.00 0 0 - 0 -
Plester (hansaplast 5 cm x 4,5 m) pcs Rp 12,000.00 0 0 - 0 -
Plesterin pcs Rp 183.75 0 100 100 100 18,375
Pot Sputum pcs Rp 23,790.00 0 0 - 0 -
Pulse oximeter unit Rp 517,000.00 0 0 - 0 -
safety box* (baymed) pcs Rp 12,049.40 2 0 2 2 24,099
Sepatu boot pasang Rp 100,000.00 0 0 - 0 -
Serum gel tes tube 5 ml / tabung gel & cloat activator pcs Rp 2,150.00 0 0 - 0 -
silk no 2/0 pcs Rp 3,208.33 22 0 22 1 3,208
Silk no 3/0 pcs Rp 2,750.00 28 0 28 4 11,000
Simedik Gown Set set Rp 194,700.00 0 0 - 0 -
sound timer unit Rp 650,000.00 0 0 - 0 -
Spuit 0,05 ml pcs Rp 1,650.00 300 0 300 100 165,000
Spuit 0,5 ml (BD syringe soloshot) pcs Rp 2,246.75 100 0 100 100 224,675
stardex nitril examination glove uk L pcs Rp 627.00 0 0 - 0 -
stardex nitril examination glove uk M pcs Rp 627.00 0 0 - 0 -
stardex nitril examination glove uk S pcs Rp 627.00 0 0 - 0 -
Steril Pouch 9 x 26 cm kotak Rp 87,000.00 100 0 100 0 -
Surflo No 18 pcs Rp 6,100.00 65 0 65 1 6,100
Surflo No 20 pcs Rp 6,100.00 109 0 109 0 -
Surflo No 22 pcs Rp 6,100.00 0 0 - 0 -
Surflo No 24 pcs Rp 6,100.00 38 0 38 1 6,100
surgical cap pcs Rp 11,000.00 0 0 - 0 -
Surgical Glove No 6,5 (MAS) pasang Rp 6,160.00 15 50 65 1 6,160
Page 83
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Surgical Glove No 8 pcs Rp 6,449.00 0 0 - 0 -
Surgical glove non steril uk M merek amicare pcs Rp 1,257.30 0 0 - 0 -
Surgical glove non steril uk S merek amicare pcs Rp 1,257.30 0 0 - 0 -
Surgical Glove obsgyn / gynecolog No 6,5 / 56 cm pasang Rp 19,500.00 0 0 - 0 -
Surgical Glove obsgyn / gynecolog No 7 pcs Rp 20,010.00 5 0 5 5 100,050
Surgical Gloves non steril uk L pcs Rp 924.00 0 0 - 0 -
Surgical Gloves non steril uk L (golden gloves) pcs Rp 1,320.00 0 0 - 0 -
Surgical Gloves non steril uk L (MAXTER) pcs Rp 1,372.00 0 0 - 0 -
Surgical Gloves non steril uk L (Protos) pcs Rp 1,305.00 0 0 - 0 -
Surgical Gloves non steril uk L (serenity) pcs Rp 1,870.00 0 0 - 0 -
Surgical Gloves non steril uk M (MAS) pcs Rp 1,320.00 0 0 - 0 -
Surgical Gloves non steril uk M (protos) pcs Rp 1,305.00 3500 0 3,500 100 130,500
Surgical Gloves non steril uk M (safe glove) pcs Rp 1,870.00 0 0 - 0 -
Surgical Gloves non steril uk M (serenity) pcs Rp 1,870.00 0 0 - 0 -
Surgical Gloves non steril uk S (golden G) pcs Rp 880.00 0 0 - 0 -
Surgical Gloves non steril uk S (MAS LATEX) pcs Rp 759.00 0 0 - 0 -
Surgical Gloves non steril uk S (Mas) pcs Rp 1,320.00 0 0 - 0 -
Surgical Gloves non steril uk S (protos) pcs Rp 1,305.00 1300 0 1,300 0 -
Surgical Gloves non steril uk S (safe glove) pcs Rp 1,870.00 0 0 - 0 -
Surgical gown PCS Rp 143,000.00 0 0 - 0 -
Surgical mask 3 ply tie on pcs Rp 550.64 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (altamed) pcs Rp 2,897.96 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (ecogreen) pcs Rp 5,060.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (EVOMED) pcs Rp 6,050.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (Genio) pcs Rp 1,540.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (Gidcare) pcs Rp 5,000.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (Gidcare) pcs Rp 4,070.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (Imaske) pcs Rp 1,680.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (Jilbab) pcs Rp 462.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (MAS) pcs Rp 1,210.00 550 0 550 550 665,500
Surgical mask-plus 3 ply plus earloop (Neo) pcs Rp 6,160.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (ONEMED) pcs Rp 6,600.00 0 0 - 0 -
Surgical mask-plus 3 ply plus earloop (TP surgical mask) pcs Rp 330.00 0 50 50 0 -
Surgical mask-plus 3 ply plus earloop (Zulhan) pcs Rp 4,400.00 0 0 - 0 -
Surgikal Gloves No 7 pcs Rp 6,449.00 20 100 120 10 64,490
Surgikal Gloves No 7.5 pcs Rp 6,449.00 54 0 54 0 -
Tabung EDTA K-3 pcs Rp 682.00 0 0 - 0 -
Tabung EdtA K-3 micro 0,5 cc pcs Rp 1,085.00 0 0 - 0 -
Tabung hematokrit pack Rp 180,500.00 0 0 - 0 -
Tabung reaksi / Test tube 75 x 100 dia 1 cm pcs Rp 5,500.00 0 0 - 0 -
tabung reaksi kaca uk 15 x 105 mm botol Rp 10,560.00 0 0 - 0 -
Tabung reaksi kaca uk.12 x 75 mm pcs Rp 8,745.00 0 0 - 0 -
Thermometer Gun pcs Rp 2,000,000.00 0 0 - 0 -
Tip ukuran 60 pack Rp 179,200.00 0 0 - 0 -
Tip ukuran 61 pack Rp 230,600.00 0 0 - 0 -
Tranport Swab pcs Rp 1.00 0 0 - 0 -
Underpad pcs Rp 4,640.00 105 0 105 15 69,600
Urine bag pcs Rp 3,150.00 23 0 23 9 28,350
USG paper 110 HG (110 mm x 18m_SONY) roll Rp 268,500.00 1 0 1 0 -
Virus Transfor media + transfer media (program) pcs Rp 85,000.00 0 0 - 0 -
Wing needle no 21 pcs Rp 2,450.00 0 0 - 0 -
Wing needle no 23 pcs Rp 1,470.00 50 0 50 0 -
Wing needle no 25 pcs Rp 1,470.00 50 0 50 0 -
Wing needle no 27 pcs Rp 1,470.00 0 0 - 0 -
Yellow Tip pack Rp 36,110.00 0 0 - 0 -
Masker N95 Aero Pro (kotak/30 pcs) pcs Rp 20,000.00 150 0 150 0 -
APD Hazmat Hijau pcs Rp 55,000.00 0 0 - 0 -
Nurse Cap Biru pcs Rp 11,000.00 0 0 - 0 -
Page 84
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
BD Venflon 18 GA relok RS SS pcs Rp 5,601.00 27 0 27 0 -
Spuit 0,5 mL oneject pcs Rp 1,185.00 0 800 800 400 474,000
Nebulizer Mask Dewasa relok RS SS pcs Rp 10,000.00 24 0 24 0 -
Nebulizer Mask Anak relok RS SS pcs Rp 10,000.00 20 0 20 1 10,000
Nasal Canula Neonate relok RS SS pcs Rp 6,608.00 20 0 20 0 -
Nasal Canula Adult relok RS SS pcs Rp 8,350.00 9 0 9 0 -
Nasal Canula Pediatric relok RS SS pcs Rp 6,721.00 10 0 10 0 -
Oksigen Mask Adult relok RS SS pcs Rp 20,175.00 10 0 10 0 -
Oxygen mask pediatric relok RS SS pcs Rp 20,175.00 20 0 20 1 20,175
Universal Surgical Kit relok RS SS pcs Rp 300,300.00 10 0 10 0 -
Spuit 0,5 mL BIAN pcs Rp 1,518.00 0 0 - 0 -
Safety box* BIAN pcs Rp 14,000.00 0 0 - 0 -
Surgical gloves General Care S pcs 1200 0 1,200 600 -
Surgical gloves General Care M pcs 1400 0 1,400 300 -
Surgical gloves Meddis S pcs 0 500 500 0 -
Surgical gloves Meddis M pcs 0 500 500 0 -
3,908,841.33 -
Page 85
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Page 86
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
3,404,666.33
UMUM
JUMLAH
251 384 446 1081

NIP.19701124 199101 1 004 NIP. 19790311 200501 2 015 NIP. 19821117 201101 2 005
Page 87
N OBAT
BULAN 0 8 LB2
TAHUN 2 0 2 2
11 12=(7-8-10) 13 14 15 16 17 18
- - - - 500 POPM
- 67 86,229.00 (67)
- - - -
- 550 506,000.00 (274)
- 369 554,607.00 (295)
- 1,900 199,500.00 (1,660)
- - - -
- - - -
- - - -
- - - -
- - - -
- 8 688,000.00 (8)
- - - -
- - - -
- - - - 10
- 45 51,183.00 (45)
- 37 42,083.80 (6)
- 57 159,030.00 (57)
- - - - 600
- 18 68,040.00 (18)
- - - -
- - - -
- 3 300,000.00 (3)
- 21 81,816.00 (21)
- 59 229,864.00 (37)
- 14 50,750.00 (14)
- 43 225,750.00 (9)
- 250 375,000.00 (250)
- - - -
- - - 7
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 10
- 26 309,140.00 (26)
- 26 325,520.00 (26)
- - - -
- - - -
- - - -
- - - -
- - - -
Page 88
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- - - -
- - - -
- - - - 10
- 32 95,040.00 (32)
- 89 923,642.00 (65)
- 49 195,510.00 (49)
- 52 207,480.00 (52)
- 30 321,300.00 (30)
- - - -
- - - -
- - - - 200
- - - 29
- - - 22
- - - -
- - - -
- - - 29
- - - -
- - - -
- - - -
- - - -
- - - - 20
- - - -
- - - - 20
- - - -
- 3 39,000.00 (1)
- - - -
- 38 414,770.00 (38)
- 35 96,845.00 (23)
- - - -
- 75 472,500.00 (34)
- - - -
- - - -
- 17,400 1,566,000.00 (17,160)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 100 109,000.00 (100)
- - - -
- - - 2
- - - - 2000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 58 1,334,000.00 (58)
-
- - -
- - - -
- 80 2,080,000.00 (80)
Page 89
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 50
- - - -
- 1 263,538.00 (1)
- 2 77,000.00 (2)
- 5 412,500.00 (5)
- - - -
- 1 50,000.00 (1)
- - - -
- - - -
- - - -
- - - -
- 2 600,000.00 (2)
- 1 82,500.00 (1)
- - - -
- - - -
- - - - 1
- - - -
- 85 156,400.00 (85)
- - - -
- - - -
- - - - 20
- - - - 20
- - - -
- - - - 20
- - - -
- - - - 2
- - - 240 100
- - - - 200
- - - -
- - - 5 10
- - - -
- - - -
- 21 67,374.93 (19)
- 24 66,000.00 (14)
- - - -
- - - -
- 200 330,000.00 40
- - - 240 300
- - - -
- - - -
- - - -
- 100 8,700,000.00 (100)
- 64 390,400.00 (62)
- 109 664,900.00 (109)
- - - - 100
- 37 225,700.00 (35)
- - - -
- 64 394,240.00 (62)
Page 90
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- - - -
- - - -
- - - -
- - - 12
- - - -
- - - -
- - - - 200
- - - -
- - - -
- - - -
- 3,400 4,437,000.00 (3,160)
- - - - 2000
- - - -
- - - -
- - - -
- - - -
- 1,300 1,696,500.00 (1,300) 2000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 1,320 1000
- - - -
- - - -
- 50 16,500.00 (50)
- - - -
- 110 709,390.00 (86)
- 54 348,246.00 (54)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 90 417,600.00 (54)
- 14 44,100.00 8
- 1 268,500.00 (1)
- - - -
- - - -
- 50 73,500.00 (50)
- 50 73,500.00 (50)
- - - -
- - - -
- 150 3,000,000.00 (150)
- - - -
- - - -
Page 91
11 12=(7-8-10) 13 14 15 16 17 18
- 27 151,227.00 (27)
- 113 599,352.00 (113)
- 85 442,850.00 (85)
- 400 474,000.00 (400)
- 24 240,000.00 (24)
- 19 190,000.00 (19)
- 20 132,160.00 (20)
- 9 75,150.00 (9)
- 10 67,210.00 (10)
- 10 201,750.00 (10)
- 19 383,325.00 (19)
- 10 3,003,000.00 (10)
- - - -
- - - -
- 600 - (600)
- 1,100 - (1,100)
- 500 - (500) 1000
- 500 - (500) 1000
- LAINNYA 41,633,012.73
Page 92
11 12=(7-8-10) 13 14 15 16 17 18
Page 93
11 12=(7-8-10) 13 14 15 16 17 18
REAGEN
#REF!
- #REF!
Yang Menerima
Petugas Puskesmas
i Achmadiyah Aulia Rahmah, S.Farm., Apt.

1 2 005 NIP. 19940728 201903 2 021
Page 94
PEMAKAIAN
PUSKESM
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
I. OBAT
G OBAT LAINNYA
Alat suntik sekali pakai 1 ml pcs -
Alat suntik sekali pakai 10 ml pcs 67
Alat suntik sekali pakai 2,5 ml pcs -
Alkohol Swab lembar 2,000
APD COVERALL pcs -
APD Full Set set -
APD LENGKAP paket -
APD SET DISPOSIBLE set -
Baju APD Merek sablonku (warna merah dan putih) pcs -
Baju hazmat coverall (KIMCARE MICROPORUS) pcs 8
Baju plastik / jas hujan pcs -
Balmed 3 ply earloop face mask pcs -
Bioplacenton tulle pcs -
Bistruri/scalpel balde No 10 pcs 45
Bistruri/scalpel balde No 11 pcs 50
Bisturi/scalpel balde No 15 pcs 57
Blood Lancet no 26 om pcs -
Blood transfusion set pcs 18
Blue Tip pack -
botol spray sorax 100 ml botol -
Box Obyek glass* biasa (one lab) pack 3
Catgut/benang bedah no 2/0 chronic pcs 21
Catgut/benang bedah no 2/0 plain pcs 68
Catgut/benang bedah no 3/0 chronic pcs 14
Catgut/benang bedah no 3/0 plain pcs 57
cover shoes pcs 250
Coverplast transparan 100 (24 mm) pcs -
Deck gelas / objek glass 24 x 24 mm pack 3 3
Deck glass / objek glass 20 x 20 mm pack -

Deck glass / objek glass 22 x 22 mm pack -
Disposibel vagina speculum pcs -
disposible swab nasal pcs -
ECG 112 mm x 30 mm x 16 mm roll -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
ECG 58 mm x 25 mm x 16 mm roll -
Face Shield pcs -
Film Rontgen 24 x 30 cm lembar -
Fixomull pcs -
Foley cateter no 16 / Ballon catheter 2 way Fr 16 pcs 26
Foley cateter no 18 / Ballon catheter 2 way Fr 18 pcs 26
Fukuda M.E.ECG Paper pcs -
Gene Xpert MTB/RIF buah -
Glove non steril nitrile (Pupick Med) Uk. L pcs -
Glove non steril nitrile (pupick Med) Uk. M pcs -
Glove non steril nitrile (pupick Med) Uk. S pcs -
handiplast pcs -
Hazmat (program ISPA) pcs -
Holder tube vacutainer pcs -
Hypafix uk. Kecil 5 cm x 5 m pcs -
Infusiun set anak pcs 32
Infusiun set dewasa pcs 99
IV Catheter no 18 G pcs 49
IV Catheter no 20 G pcs 52
IV Catheter no 22 G (polywin) pcs 30
IV Catheter no 24 G pcs -
Jarum (Needle) no 23 pcs -
Jarum (Needle) no 25 pcs -
Jarum Jahit kulit no 10 GT pack 12
Jarum Jahit Kulit No 11 GT pack 9
Jarum Jahit kulit no 12 GT pack -
Jarum Jahit Kulit No 13 GT pack -
Jarum Jahit Kulit No 14 GT pack 12
jarum K-File no 15-40 kotak -
Kacamata Google pcs -
Kantong Kertas pak @100 lmbr -
Kantong plastik biohard pak -
kantongan plastik pack @ 100lbr -
Kapas berlemak 500 mg roll -
Kapas pembalut / absorben 250 mg roll 4
Kasa kompres 40 / 40 steril pcs -
Kasa pembalut 2 m x80 cm pcs 38
Kasa pembalut hidrofil 4m x 15 cm pcs 40
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Kasa pembalut hidrofil 4m x 3 cm pcs -

Kasa steril 16 cm x 16 cm box 92
kelambu insektisida bungkus -
Kertas EKG (uk 80 x 90 x 280) lembar -
Kertas Puyer lembar 17,500
Kertas thermal mindray 50mm roll -
Kertas thermal mindray 50mm x 57 mm roll -
Kertas thermal mindray 80 x 50 roll -
Kertas thermal mindray 80 x 80 roll -
Kondom pcs -
kondom sutra pcs -
Lidi Kapas/cotton swab pcs 100
lubrikan sutra pcs -
Markerpen pcs 1
Masker 3 ply earloop/ karet/ (Altamed) pcs -
Masker 3 ply earloop/ karet/ (solida) pcs -
Masker 3 ply earloop/ karet/ (supamed) pcs -
masker anak program pcs -
Masker Headloop Altamed pcs -
Masker kain pcs -
Masker KN 95 Merk SPC pcs -
Masker KN95 9501V pcs -
Masker N 95 3M 1860 pcs -
Masker N 95 3M 1860S pcs -
Masker N 95 3M 1870 pcs 58
Masker N 95 8210 pcs -
Masker n 95 BTL / respirator masker n95 FFP2 pcs -
Masker N 95 garuda safe type 1945 pcs 80
Masker n 95 onemed pcs -
masker N 95 Vfex 9105 pcs -
masker nebule dewasa (besmed) pcs -
masker oksigen anak pcs -
masker oksigen dewasa pcs -
Mata Bor high speed pack -
Microtube 1,5 cc pack -
Needle flashback (vacutainer needle BD 22G x 1 pcs -
nitril examination glove uk S pcs -
nitril examination glove uk M Pcs -
Nurse cap (MAS) pcs -
Obat Gigi : Aplicator kotak -
Obat Gigi : Articulating paper kotak 1
Obat Gigi : Cotton pelet pack 2
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Obat Gigi : Cotton roll pack 5

Obat Gigi : Gutta perchha point 15-40 mm kotak -
Obat Gigi : Gutta perchha point 45-80 mm kotak 1
Obat Gigi : Jarum Dental cytoject pcs -
Obat Gigi : Paper point 15-40 mm kotak -
Obat Gigi : Paper point 45-80 mm kotak -
Obat Gigi : selang saliva eyector pack -
Obat Gigi : Tampon pack 2
Obat Gigi :Dental floss kotak 1
Obyek glass* biasa pack -
Open akses bur pcs -
parafilm (Laboratorium film parafilm) kotak -
parafilm size 410 x 125 ft roll -
Penjepit tali pusat pcs 85
Pharmafix pcs -
pipet ESR citotes pcs -
Plastik Klip bks @ 100 Lmbr) -
Plastik klip sedang pack/100s -
Plastik Obat kecil (uk. 8 cm x 5 cm) pack -
Plastik Obat pembungkus puyer (uk. Besar) pack/100s -
plester (hansaplast 2,5 cm x 4,5 m) roll -
Plester (hansaplast 5 cm x 4,5 m) pcs -
Plesterin pcs 100
Pot Sputum pcs -
Pulse oximeter unit -
safety box* (baymed) pcs 2
Sepatu boot pasang -
Serum gel tes tube 5 ml / tabung gel & cloat activator pcs -
silk no 2/0 pcs 22
Silk no 3/0 pcs 28
Simedik Gown Set set -
sound timer unit -
Spuit 0,05 ml pcs 300
Spuit 0,5 ml (BD syringe soloshot) pcs 100
stardex nitril examination glove uk L pcs -
stardex nitril examination glove uk M pcs -
stardex nitril examination glove uk S pcs -
Steril Pouch 9 x 26 cm kotak 100
Surflo No 18 pcs 65
Surflo No 20 pcs 109
Surflo No 22 pcs -
Surflo No 24 pcs 38
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
surgical cap pcs -

Surgical Glove No 6,5 (MAS) pasang 65
Surgical Glove No 8 pcs -
Surgical glove non steril uk M merek amicare pcs -
Surgical glove non steril uk S merek amicare pcs -
Surgical Glove obsgyn / gynecolog No 6,5 / 56 cm pasang -
Surgical Glove obsgyn / gynecolog No 7 pcs 5
Surgical Gloves non steril uk L pcs -
Surgical Gloves non steril uk L (golden gloves) pcs -
Surgical Gloves non steril uk L (MAXTER) pcs -
Surgical Gloves non steril uk L (Protos) pcs -
Surgical Gloves non steril uk L (serenity) pcs -
Surgical Gloves non steril uk M (MAS) pcs -
Surgical Gloves non steril uk M (protos) pcs 3,500
Surgical Gloves non steril uk M (safe glove) pcs -
Surgical Gloves non steril uk M (serenity) pcs -
Surgical Gloves non steril uk S (golden G) pcs -
Surgical Gloves non steril uk S (MAS LATEX) pcs -
Surgical Gloves non steril uk S (Mas) pcs -
Surgical Gloves non steril uk S (protos) pcs 1,300
Surgical Gloves non steril uk S (safe glove) pcs -
Surgical gown PCS -
Surgical mask 3 ply tie on pcs -
Surgical mask-plus 3 ply plus earloop (altamed) pcs -
Surgical mask-plus 3 ply plus earloop (ecogreen) pcs -
Surgical mask-plus 3 ply plus earloop (EVOMED) pcs -
Surgical mask-plus 3 ply plus earloop (Genio) pcs -
Surgical mask-plus 3 ply plus earloop (Gidcare) pcs -
Surgical mask-plus 3 ply plus earloop (Gidcare) pcs -
Surgical mask-plus 3 ply plus earloop (Imaske) pcs -
Surgical mask-plus 3 ply plus earloop (Jilbab) pcs -
Surgical mask-plus 3 ply plus earloop (MAS) pcs 550
Surgical mask-plus 3 ply plus earloop (Neo) pcs -
Surgical mask-plus 3 ply plus earloop (ONEMED) pcs -
Surgical mask-plus 3 ply plus earloop (TP surgical mask) pcs 50
Surgical mask-plus 3 ply plus earloop (Zulhan) pcs -
Surgikal Gloves No 7 pcs 120
Surgikal Gloves No 7.5 pcs 54
Tabung EDTA K-3 pcs -
Tabung EdtA K-3 micro 0,5 cc pcs -
Tabung hematokrit pack -
Tabung reaksi / Test tube 75 x 100 dia 1 cm pcs -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
tabung reaksi kaca uk 15 x 105 mm botol -

Tabung reaksi kaca uk.12 x 75 mm pcs -
Thermometer Gun pcs -
Tip ukuran 60 pack -
Tip ukuran 61 pack -
Tranport Swab pcs -
Underpad pcs 105
Urine bag pcs 23
USG paper 110 HG (110 mm x 18m_SONY) roll 1
Virus Transfor media + transfer media (program) pcs -
Wing needle no 21 pcs -
Wing needle no 23 pcs 50
Wing needle no 25 pcs 50
Wing needle no 27 pcs -
Yellow Tip pack -
Masker N95 Aero Pro (kotak/30 pcs) pcs 150
APD Hazmat Hijau pcs -
Nurse Cap Biru pcs -
BD Venflon 18 GA relok RS SS pcs 27
Spuit 0,5 mL pcs 800
Nebulizer Mask Dewasa pcs 24
Nebulizer Mask Anak pcs 20
Nasal Canula Neonate pcs 20
Nasal Canula Adult pcs 9
Nasal Canula Pediatric pcs 10
Oksigen Mask Adult pcs 10
Oxygen mask pediatric pcs 20
Universal Surgical Kit pcs 10
spuit 0,5 Ml BIAN pcs -
safety box* BIAN pcs -
Surgical gloves General Care S pcs 1,200
Surgical gloves General Care M pcs 1,400
PEMAKAIAN SUB UNIT & APOTEK LAINNYA
APBD BULAN
TAHUN

DALUARS
STOK OF KUMULATIF
GUDANG
I
0
15 52 0
0
15 100 550 115
1 30 9 360 31
100 1900 100
0
0
0
0
0
8 0
0
0
0
45 0
13 37 13
57 0
0
18 0
0
0
3 0
21 0
8 1 59 9
14 0
10 4 43 14
250 0
0
3
0
0
0
0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
0
0
0
0
0
26 0
6 20 0
0
0
0
0
0
0
0
0
0
32 0
10 89 10
49 0
52 0
30 0
0
0
0
12 0 12
9 9
0 0
0
12 0 12
0
0
0
0
0
0
0
0
1 3 1
0
3 35 0
5 35 5
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
17 2 73 17
0
0
100 17400 100
0
0
0
0
0
0
100 0
0
1 1
0
0
0
0
0
0
0
0
0
0
58 0
0
0
80 0
0
0
0
0
0
0
0
0
0
0
0
0
1 0
2 0
DALUARS
STOK OF KUMULATIF
GUDANG
I
5 0
0
1 0
0
0
0
0
2 0
1 0
0
0
0
0
35 50 0
0
0
0
0
0
0
0
0
100 0 100
0
0
2 2
0
0
1 21 1
4 24 4
0
0
100 200 100
100 100
0
0
0
100 0
1 64 1
10 99 0
0
1 37 1
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
1 64 1
0
0
0
0
5 5
0
0
0
0
0
0
100 3400 100
0
0
0
0
0
1300 0
0
0
0
0
0
0
0
0
0
0
0
550 0 550
0
0
0
0
10 10 100 10
54 0
0
0
0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
0
0
0
0
0
15 30 60 15
8 1 14 9
1 0
0
0
50 0
50 0
0
0
150 0
0
0
27 0
113 0
85 0
400 400 400
24 0
1 19 1
20 0
9 0
10 0
10 0
1 19 1
10 0
0
0
600 600 600
300 1100 300
0 8
2 0 2 2
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 - Program POPM
67 67 -
- 0 -
550 550 -
369 369 -
1,900 1900 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
8 8 -
- 0 -
- 0 -
- 0 -
45 45 -
37 37 -
57 57 -
- 0 -
18 18 -
- 0 -
- 0 -
3 3 -
21 21 -
59 59 -
14 14 -
43 43 -
250 250 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
26 26 -
26 26 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
32 32 -
89 89 -
49 49 -
52 52 -
30 30 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
3 3 -
- 0 -
38 38 -
35 35 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
75 75 -
- 0 -
- 0 -
17,400 17400 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
100 100 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
58 58 -
- 0 -
- 0 -
80 80 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
1 1 -
2 2 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
5 5 -
- 0 -
1 1 -
- 0 -
- 0 -
- 0 -
- 0 -
2 2 -
1 1 -
- 0 -
- 0 -
- 0 -
- 0 -
85 85 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
21 21 -
24 24 -
- 0 -
- 0 -
200 200 -
- 0 -
- 0 -
- 0 -
- 0 -
100 100 -
64 64 -
109 109 -
- 0 -
37 37 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
64 64 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
3,400 3400 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
1,300 1300 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
110 110 -
54 54 -
- 0 -
- 0 -
- 0 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
90 90 -
14 14 -
1 1 -
- 0 -
- 0 -
50 50 -
50 50 -
- 0 -
- 0 -
150 150 -
- 0 -
- 0 -
27 27 -
113 113 -
85 85 -
400 400 -
24 24 -
19 19 -
20 20 -
9 9 -
10 10 -
10 10 -
19 19 -
10 10 -
- 0 -
- 0 -
600 600 -
1,100 1100 -
(LPLPO)


KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
I. OBAT
A BAHAN KIMIA PADAT
Abate/temephos botol Rp 2,197,800.00 0 0 - 0 -
BIO VTM pcs Rp 47,500.00 0 0 - 0 -
Dengue IgG / IgM test Device pcs Rp 49,808.00 100 0 100 0 -
Edta kering botol Rp 100,100.00 0 0 - 0 -
INAVTM swab naso & oro set Rp 46,500.00 269 0 269 19 883,500
Lipid Panel cardiocheck PA pcs Rp 109,306.33 0 0 - 0 -
Lipid Pro pcs Rp 836,000.00 0 0 - 0 -
PTS Panel Cholesterol pcs Rp 41,924.80 0 0 - 0 -
PTS PANEL GLUCOSA stik Rp 12,463.20 0 0 - 0 -
Rapid 1 SD HIV 1/2 3.0 stik Rp 11,975.00 0 0 - 0 -
Rapid 2 Intec HIV stik Rp 15,380.00 0 0 - 0 -
Rapid 3 oncoprobe stik Rp 49,456.00 0 0 - 0 -
Rapid 4 right sign HIV stik Rp 35,120.00 0 0 - 0 -
Rapid 5 CTK Bioteck HIV stik Rp 30,250.00 0 0 - 0 -
Rapid 6 HIV Vikia stik Rp 51,436.00 0 0 - 0 -
Rapid 7 HIV Card Vcare stik Rp 30,250.00 0 0 - 0 -
Rapid 8 Fokus HIV stik Rp 13,595.00 0 0 - 0 -
Rapid HIV Diagnostar test Rp 15,017.00 100 0 100 0 -
Rapid tes acro 2019-ncov IgG/IgM pcs Rp 198,000.00 0 0 - 0 -
Rapid tes Acro covid 19 antigen test Rp 140,000.00 0 0 - 0 -
Rapid tes Anti HCV test test Rp 13,252.00 0 0 - 0 -
Rapid tes antibodi covid 19 Healgen pcs Rp 121,100.00 0 0 - 0 -
Rapid tes antigen (program) panbio test Rp 1.00 0 0 - 0 -
Rapid tes covid 19 / antibodi indec pcs Rp 108,683.00 0 0 - 0 -
Rapid tes covid 19 antigen (SD Biosensor) test Rp 97,000.00 0 25 25 21 2,037,000
Rapid tes covid 19 antigen / healgen test Rp 140,000.00 0 0 - 0 -
Rapid tes covid 19 antigen juschek pcs Rp 65,000.00 0 0 - 0 -
Rapidan tester anti sifilis test WB/S/P pcs Rp 4,505.38 0 0 - 0 -
Rapidan tester HBSAg test WB/S/P pcs Rp 4,735.38 0 0 - 0 -
Sard-cov-2 IGM rapid tes / one step rapid tes pcs Rp 134,999.99 0 0 - 0 -
star D plus covid 19 IgG/IgM rapid tes pcs Rp 202,750.00 0 0 - 0 -
Stik asam urat easy touch stik Rp 5,280.00 0 0 - 0 -
Stik asam urat Nesco stik Rp 5,720.00 0 0 - 0 -
Stik Cholesterol easy touch stik Rp 22,990.00 0 0 - 0 -
Stik Cholesterol Nesco stik Rp 25,300.00 0 0 - 0 -
Stik gula darah ( gluco dr autosensor) stik Rp 6,798.00 0 0 - 0 -
Stik Gula Darah (Gluko DR supersensor) stik Rp 1,804.66 0 6350 6,350 50 90,233
Stik Gula Darah Accu cek stik Rp 7,590.00 0 0 - 0 -
Stik HB BeneCheck stik Rp 7,955.00 0 0 - 0 -
Stik HB Easy touch stik Rp 7,260.00 0 0 - 0 -
Stik HBSAb merek Intec stik Rp 27,478.00 0 0 - 0 -
Stik HbsAg merek Indec-virocheck pcs Rp 8,100.00 214 0 214 51 413,100
Stik HBSAg merek Intec stik Rp 5,060.00 0 0 - 0 -
Stik HBSAg merek SD Bioline HBSAg stik Rp 8,233.00 0 0 - 0 -
Stik HIV Indec stik Rp 8,445.00 62 0 62 33 278,685
Stik Kehamilan stik Rp 2,156.00 0 0 - 0 -
Stik sifilis merek trepocheck - indec stik Rp 8,870.00 0 0 - 0 -
Stik syphilis 'SD' stik Rp 35,429.00 0 0 - 0 -
Page 113
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Stik urinalisa 10 parameter (Dirui) stik Rp 3,599.75 0 0 - 0 -
Stik urinalisa 10 parameter (Lab U 11) stik Rp 2,079.33 0 0 - 0 -
stik urinalisa 10 prm glory pcs Rp 3,595.00 0 0 - 0 -
Stik urinalisa 3 parameter stik Rp 5,720.00 0 0 - 0 -
VTM Mantacc pcs Rp 19,712.00 23 0 23 4 78,848
3,781,365.89 -
Page 114
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Page 115
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
3,702,517.89
UMUM
JUMLAH
251 384 446 1081
Page 116
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10

NIP.19701124 199101 1 004 NIP. 19790311 200501 2 015 NIP. 19821117 201101 2 005
Page 117
N OBAT
BULAN 0 8 LB2
TAHUN 2 0 2 2
11 12=(7-8-10) 13 14 15 16 17 18
- - - - POPM
- - - -
- 100 4,980,800.00 (100)
- - - -
- 250 11,625,000.00 (204)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 100 1,501,700.00 (100)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 4 388,000.00 46 25
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 200
- - - - 200
- - - - 200
- - - - 200
- - - -
- 6,300 11,369,344.14 (6,180) program
- - - - 200
- - - -
- - - - 200
- - - -
- 163 1,320,300.00 (41)
- - - -
- - - -
- 29 244,905.00 50 50
- - - - 100
- - - - 100
- - - - 200
Page 118
11 12=(7-8-10) 13 14 15 16 17 18
- - - - 300
- - - - 300
- - - -
- - - -
- 19 374,528.00 (19)
- REAGEN PADAT 31,804,577.14
Page 119
11 12=(7-8-10) 13 14 15 16 17 18
Page 120
11 12=(7-8-10) 13 14 15 16 17 18
REAGEN
#REF!
- #REF!
Page 121
11 12=(7-8-10) 13 14 15 16 17 18
Yang Menerima
Petugas Puskesmas

1 2 005 NIP. 19940728 201903 2 021
Page 122
PEMAKAIAN SU
PUSKESMA
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
I. OBAT
A BAHAN KIMIA PADAT
Abate/temephos botol -
BIO VTM pcs -
Dengue IgG / IgM test Device pcs 100
Edta kering botol -
INAVTM swab naso & oro set 269 19
Lipid Panel cardiocheck PA pcs -

Lipid Pro pcs -
PTS Panel Cholesterol pcs -
PTS PANEL GLUCOSA stik -
Rapid 1 SD HIV 1/2 3.0 stik -
Rapid 2 Intec HIV stik -
Rapid 3 oncoprobe stik -
Rapid 4 right sign HIV stik -
Rapid 5 CTK Bioteck HIV stik -
Rapid 6 HIV Vikia stik -
Rapid 7 HIV Card Vcare stik -
Rapid 8 Fokus HIV stik -
Rapid HIV Diagnostar test 100
Rapid tes acro 2019-ncov IgG/IgM pcs -
Rapid tes Acro covid 19 antigen test -
Rapid tes Anti HCV test test -
Rapid tes antibodi covid 19 Healgen pcs -
Rapid tes antigen (program) panbio test -
Rapid tes covid 19 / antibodi indec pcs -
Rapid tes covid 19 antigen (SD Biosensor) test 25 12
Rapid tes covid 19 antigen / healgen test -

Rapid tes covid 19 antigen juschek pcs -
Rapidan tester anti sifilis test WB/S/P pcs -
Rapidan tester HBSAg test WB/S/P pcs -
Sard-cov-2 IGM rapid tes / one step rapid tes pcs -
star D plus covid 19 IgG/IgM rapid tes pcs -
Stik asam urat easy touch stik -
Stik asam urat Nesco stik -
Stik Cholesterol easy touch stik -
Stik Cholesterol Nesco stik -
PEMAKAIAN
PERSEDIAAN
GUDANG PP LAB
NDU PUSLING
Stik gula darah ( gluco dr autosensor) stik -

Stik Gula Darah (Gluko DR supersensor) stik 6,350 50
Stik Gula Darah Accu cek stik -

Stik HB BeneCheck stik -
Stik HB Easy touch stik -
Stik HBSAb merek Intec stik -
Stik HbsAg merek Indec-virocheck pcs 214 51
Stik HBSAg merek Intec stik -

Stik HBSAg merek SD Bioline HBSAg stik -
Stik HIV Indec stik 62 33
Stik Kehamilan stik -

Stik sifilis merek trepocheck - indec stik -
Stik syphilis 'SD' stik -
Stik urinalisa 10 parameter (Dirui) stik -
Stik urinalisa 10 parameter (Lab U 11) stik -
stik urinalisa 10 prm glory pcs -
Stik urinalisa 3 parameter stik -
VTM Mantacc pcs 23 4
PEMAKAIAN SUB UNIT & APOTEK OBAT PADAT
APBD BULAN
TAHUN

DALUARS
STOK OF KUMULATIF
GUDANG
I
0
0
100 0
0
19
0
0
0
0
0
0
0
0
0
0
0
0
100 0
0
0
0
0
0
0
9 4 21
0
0
0
0
0
0
0
0
0
0
DALUARS
STOK OF KUMULATIF
GUDANG
I
0
6300 50
0
0
0
0
13 150 51
0
0
4 25 33
0
0
0
0
0
0
0
19 4
0 8
2 0 2 2
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 - Program POPM
- 0 -
100 100 -
- 0 -
250 0 250
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
100 100 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
4 4 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
STOK AKHIR
STOK AKHIR SELISIH
REGISTER KET
(SR)
- 0 -
6,300 6300 -
- 0 -
- 0 -
- 0 -
- 0 -
163 163 -
- 0 -
- 0 -
29 29 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
19 19 -
(LPLPO)

SATU HARGA STOK PENERI PERSE PEMAKAIAN RUSAK / E.D/REALOKAS

KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
I. OBAT
A BAHAN KIMIA CAIR
ABX M Noclair Horiba botol Rp 1,391,500.00 0 0 - 0 -
ABX Mni Clean Horiba botol Rp 2,655,400.00 0 0 - 0 -
ABX Mni Lyse LMG Horiba botol Rp 7,969,500.00 0 0 - 0 -
ABX Mni Oil LMG Horiba botol Rp 3,718,000.00 0 0 - 0 -
ACS level I (control serum) botol Rp 4,950,000.00 0 0 - 0 -
Aquadest steril botol 500 ml Rp 55,000.00 0 0 - 0 -
B30 Control Hematology Analyzer Mindray botol Rp 2,378,000.00 0 0 - 0 -
Biolarvasida untuk pengendalian jentik nyamuk botol 30 ml Rp 68,200.00 0 0 - 0 -
Blood Analisir Clianac Detergen (Nihon kohden) botol Rp 8,050,000.00 0 0 - 0 -
Blood Analisir Clianac Detergen (norma clean NK) botol Rp 2,112,000.00 0 0 - 0 -
Blood Analisir Hemolinac 3N Lysing (nihon kohden) botol Rp 3,850,000.00 0 0 - 0 -
Blood Analisir Hemolinac 3N Lysing (norma lyse NK) botol Rp 5,240,000.00 0 0 - 0 -
Blood Analisir Isotonac 3 Diluent (nihon kohden) botol Rp 4,290,000.00 0 0 - 0 -
Blood Analisir Isotonac 3 Diluent (norma diluent NK) botol Rp 3,696,000.00 0 0 - 0 -
Carbol gentian violet botol Rp 73,700.00 0 0 - 0 -
Cetride 5 Liter galon Rp 774,972.00 0 0 - 0 -
Chlodine 0,5 % handrub btl 5 L Rp 395,010.00 4 0 4 4 1,580,040
Clorheksidin 2,5 % botol Rp 618,750.00 0 0 - 0 -
Control hematologi (norma) set Rp 2,752,200.00 0 0 - 0 -
Cynoff 25 UL galon Rp 1,320,000.00 0 0 - 0 -
Etanol 70 % 1 Liter botol Rp 107,800.00 2 0 2 0 -
Etanol 70 % 100 ml botol Rp 11,000.00 0 0 - 0 -
Gliserol 98% jerigen/5 L Rp 2,695,000.00 0 0 - 0 -
Klorin botol Rp 15,970.00 0 0 - 0 -
Kontrol darah agappe botol Rp 1,358,500.00 0 0 - 0 -
kontrol norma high botol Rp 596,000.00 0 0 - 0 -
Kontrol norma low botol Rp 596,000.00 0 0 - 0 -
Kontrol norma normal botol Rp 596,000.00 0 0 - 0 -
Larutan Alkohol 95 % botol Rp 335,000.00 0 0 - 0 -
Larutan Alkohol 96 % jerigen/20 L Rp 8,910,000.00 0 0 - 0 -
Larutan Alkohol 96 % botol Rp 48,500.00 0 0 - 0 -
Larutan alkohol aseton botol Rp 31,000.00 0 0 - 0 -
Larutan amonium oksalat botol Rp 56,100.00 0 0 - 0 -
Larutan Anisol botol Rp 418,000.00 0 0 - 0 -
Larutan antiseptik (Aseptan) botol Rp 40,230.00 0 0 - 0 -
Larutan Asam asetat 5% botol Rp 19,500.00 0 0 - 0 -
Larutan Asam klorida 0,1 N botol Rp 154,000.00 1 0 1 0 -
Larutan Asam sulfosalisilat 20 % botol Rp 531,000.00 1 0 1 0 -
Larutan Barium Klorida botol Rp 49,500.00 0 0 - 0 -
Larutan Benedict botol Rp 309,100.00 0 0 - 0 -
Larutan Buffer Fosfat botol Rp 52,800.00 0 0 - 0 -
Larutan Developer botol Rp 1,320,000.00 0 0 - 0 -
Larutan Edta 10% botol Rp 62,700.00 0 0 - 0 -
Larutan Eosin 2 % botol Rp 429,000.00 0 0 - 0 -
Larutan Etanol Asam botol Rp 62,700.00 0 0 - 0 -
Larutan Eter alkohol botol Rp 68,200.00 0 0 - 0 -
Page 129
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Larutan Fixer botol Rp 801,900.00 0 0 - 0 -
Larutan Foucet botol Rp 253,000.00 0 0 - 0 -
Larutan Giemsa Sain botol Rp 378,125.00 0 0 - 0 -
Larutan hayem botol Rp 137,500.00 1 0 1 0 -
Larutan Hidrogen Peroksida botol Rp 66,000.00 0 0 - 0 -
Larutan Iodium 1 % botol Rp 27,500.00 2 0 2 0 -
Larutan Karbol Fuksin botol Rp 165,000.00 0 0 - 0 -
Larutan KOH 10 % botol Rp 36,300.00 0 0 - 0 -
Larutan KOH 20 % botol Rp 40,700.00 0 0 - 0 -
Larutan Lugol 1 % botol Rp 193,600.00 0 0 - 0 -
Larutan Metilen Biru botol Rp 93,170.00 1 0 1 0 -
Larutan Natrium Citrat 3,8 % botol Rp 71,500.00 0 0 - 0 -
larutan safranin botol Rp 68,200.00 0 0 - 0 -
Larutan sodium hipoklorid 1 L botol Rp 132,000.00 0 0 - 0 -
Larutan sodium hipoklorid 100 ML botol Rp 18,634.00 0 0 - 0 -
Larutan Turk botol Rp 44,000.00 0 0 - 0 -
Larutan Xylol botol Rp 100,100.00 0 0 - 0 -
M Notrol 16 Twin-2M Merek Horiba pack Rp 1,683,000.00 0 0 - 0 -
M-30 CFL LYSE 500 ML Mindray botol Rp 2,332,000.00 0 0 - 0 -
M-30 DILUENT Mindray botol Rp 2,200,000.00 0 0 - 0 -
M-30 E-Z Cleanser Mindray botol Rp 1,650,000.00 0 0 - 0 -
M-30 PROBE CLEANSER Mindray botol Rp 165,000.00 0 0 - 0 -
M-30 RINSE Mindray botol Rp 2,200,000.00 0 0 - 0 -
Medicare 0,5% TPCL antiseptik botol 500 ml Rp 41,306.60 0 0 - 0 -
Medonic Diluent 20 L botol Rp 6,116,000.00 0 0 - 0 -
Medonic Lyse 5 L botol Rp 8,305,000.00 0 0 - 0 -
Metanol botol Rp 24,645.00 1 0 1 0 -
NaOcl 2,5 % untuk sal irigasi botol Rp 123,200.00 0 0 - 0 -
Norma cleaner / solution 3 diff botol Rp 2,398,000.00 0 0 - 0 -
Norma diluent diff / norma dil-3-diff botol Rp 2,235,200.00 0 0 - 0 -
Norma lyse diff / norma lyse-3-diff botol Rp 2,992,000.00 0 0 - 0 -
Oil Imersi botol Rp 991,100.00 0 0 - 0 -
One clean 1 Liter OM botol Rp 12,100.00 0 0 - 0 -
Pewarnaan Gram 1 % botol Rp 518,100.00 0 0 - 0 -
Reagen albumin agappe / mindray kit Rp 1,400,000.00 0 0 - 0 -
Reagen Albumin biosystem kit Rp 800,000.00 0 0 - 0 -
Reagen Albumin BT Diagnostik / Albumin Bromcresol Green, kit Rp 770,000.00 0 0 - 0 -
Reagen Albumin randox kit Rp 962,500.00 0 0 - 0 -
Reagen Asam Urat agappe / mindray kit Rp 1,386,000.00 0 0 - 0 -
Reagen Asam Urat biolabo kit Rp 1,363,000.00 0 0 - 0 -
Reagen Asam Urat biosystem kit (1X50ml) Rp 1,100,000.00 0 0 - 0 -
Reagen asam urat BT Diagnostik kit Rp 2,200,000.00 0 0 - 0 -
Reagen Asam Urat randox kit Rp 1,699,500.00 0 0 - 0 -
Reagen Bilirubin Direct agappe / mindray kit Rp 877,800.00 0 0 - 0 -
Reagen Bilirubin Direct biosystem kit Rp 2,090,000.00 0 0 - 0 -
Reagen Bilirubin Direct randox kit Rp 970,000.00 0 0 - 0 -
Reagen Bilirubin Total agappe / mindray kit Rp 877,800.00 0 0 - 0 -
Reagen Bilirubin Total biosystem kit Rp 2,090,000.00 0 0 - 0 -
Reagen Bilirubin Total randox kit Rp 897,000.00 0 0 - 0 -
Reagen Cholesterol agappe / mindray kit Rp 2,189,000.00 1 0 1 0 -
Reagen Cholesterol Biolabo kit Rp 1,132,000.00 0 0 - 0 -
Reagen Cholesterol biosystem kit Rp 935,000.00 0 0 - 0 -
Reagen Cholesterol BT Diagnostik kit Rp 1,760,000.00 0 0 - 0 -
Reagen Cholesterol HDL agappe / mindray kit Rp 8,690,000.00 0 0 - 0 -
Reagen Cholesterol HDL Biolabo kit Rp 5,549,628.00 0 0 - 0 -
Reagen Cholesterol HDL biosystem kit Rp 2,475,000.00 0 0 - 0 -
Page 130
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Reagen Cholesterol HDL BT Diagnostik kit Rp 8,250,000.00 0 0 - 0 -
Reagen Cholesterol HDL randox kit Rp 1,991,000.00 0 0 - 0 -
Reagen Cholesterol randox kit Rp 2,227,500.00 0 0 - 0 -
Reagen Creatinin agappe / mindray kit Rp 930,600.00 0 0 - 0 -
Reagen Creatinin biosystem kit Rp 1,210,000.00 0 0 - 0 -
Reagen Creatinin BT Diagnostik kit Rp 1,100,000.00 0 0 - 0 -
Reagen Creatinin randox kit Rp 937,750.00 0 0 - 0 -
Reagen Creatinine biolabo kit Rp 899,619.00 0 0 - 0 -
Reagen Elitrol 1 Normal 1 x 5 ml (elitech) kit Rp 5,940,000.00 0 0 - 0 -
Reagen Glucose agappe / mindray kit Rp 1,331,000.00 0 0 - 0 -
Reagen Glucose biosystem kit Rp 605,000.00 0 0 - 0 -
Reagen Glucose PAP randox kit Rp 529,290.00 0 0 - 0 -
Reagen Glukosa biolabo kit Rp 866,000.00 0 0 - 0 -
Reagen Glukosa BT Diagnostik kit Rp 660,000.00 0 0 - 0 -
Reagen golongan darah set-2 Rp 128,000.00 0 0 - 0 -
Reagen golongan darah set-4 Rp 142,650.00 0 0 - 0 -
Reagen HB Cyanida botol Rp 275,000.00 0 0 - 0 -
Reagen HB konsentrat biosystem kit Rp 308,000.00 0 0 - 0 -
Reagen HB konsentrat randox kit Rp 533,660.00 0 0 - 0 -
Reagen Protein Total agappe / mindray kit Rp 770,000.00 0 0 - 0 -
Reagen Protein Total biosystem kit Rp 545,000.00 0 0 - 0 -
Reagen Protein Total randox kit Rp 880,000.00 0 0 - 0 -
Reagen SGOT / AST Biolabo kit Rp 1,824,887.00 0 0 - 0 -
Reagen SGOT / AST biosystem kit Rp 825,000.00 0 0 - 0 -
Reagen SGOT / AST Mindray kit Rp 1,265,000.00 0 0 - 0 -
Reagen SGOT / AST randox kit Rp 514,110.00 0 0 - 0 -
Reagen SGOT BT Diagnostik kit Rp 1,650,000.00 0 0 - 0 -
Reagen SGPT / ALT biolabo kit Rp 1,824,887.00 0 0 - 0 -
Reagen SGPT / ALT biosystem kit Rp 825,000.00 0 0 - 0 -
Reagen SGPT / ALT mindray kit Rp 1,265,000.00 0 0 - 0 -
Reagen SGPT / ALT randox kit Rp 509,946.00 0 0 - 0 -
Reagen SGPT BT Diagnostik Kit Rp 1,650,000.00 0 0 - 0 -
Reagen Trigliseride biolabo kit Rp 1,097,000.00 0 0 - 0 -
Reagen Trigliseride biosystem kit Rp 1,430,000.00 0 0 - 0 -
Reagen Trigliseride BT Diagnostik kit Rp 2,750,000.00 0 0 - 0 -
Reagen Trigliseride mindray kit Rp 1,804,000.00 0 0 - 0 -
Reagen Trigliseride randox kit Rp 2,629,000.00 0 0 - 0 -
Reagen Urea Mindray kit Rp 1,072,500.00 0 0 - 0 -
Reagen Ureum Biolabo kit Rp 1,905,773.00 0 0 - 0 -
Reagen Ureum biosystem kit Rp 1,870,000.00 0 0 - 0 -
Reagen Ureum BT Diagnostik kit Rp 2,200,000.00 0 0 - 0 -
Reagen Ureum randox kit Rp 1,430,000.00 0 0 - 0 -
Reagen Wright Stain botol Rp 308,000.00 0 0 - 0 -
reagent cholesterol pap sl (microlab/elitech) kit Rp 3,088,800.00 0 0 - 0 -
reagent cholesterol pap sl (microlab/elitech) + std kit Rp 3,300,000.00 0 0 - 0 -
reagent cholesterol standar 200 mg/dl (microlab/elitech) kit Rp 633,600.00 0 0 - 0 -
reagent glucose pap sl (microlab/elitech) +std kit Rp 1,795,000.00 0 0 - 0 -
reagent glucose standar 100 mg/dl (microlab/elitech) kit Rp 448,800.00 0 0 - 0 -
reagent trigliserid mono sl (microlab/elitech) kit Rp 4,752,000.00 0 0 - 0 -
reagent trigliserid mono sl (microlab/elitech) + std kit Rp 5,000,000.00 0 0 - 0 -
reagent trigliserid standar 200 mg/dl (microlab/elitech) kit Rp 475,200.00 0 0 - 0 -
reagent uric acid mono sl (microlab/elitech) kit Rp 3,350,000.00 0 0 - 0 -
reagent uric acid standar (microlab/elitech) kit Rp 580,800.00 0 0 - 0 -
Res eker botol Rp 154,000.00 0 0 - 0 -
RPR syfilis Fokus Diagnostik kotak Rp 427,000.00 0 0 - 0 -
RPR syfilis randox botol Rp 1,555,920.00 0 0 - 0 -
Page 131
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Serum kontrol mindray (Qualichek normal mindray) botol Rp 968,000.00 0 0 - 0 -
Spiritus 1 L botol Rp 170,500.00 0 0 - 0 -
Swelab alfa diluent 20 L botol Rp 6,573,600.00 0 0 - 0 -
Swelab alfa lyse 5 L botol Rp 8,550,000.00 0 0 - 0 -
Viorex liquid 4 % 5 L galon Rp 682,489.50 0 0 - 0 -
Widal tes 6 set 6 set Rp 279,140.00 0 0 - 0 -
Widal tes 4 set (AO,BO,O,H) 4 set Rp 256,000.00 0 0 - 0 -
Ziehl Nielseen Stain paket Rp 203,046.00 1 0 1 0 -
1,580,040
UMUM
JUMLAH
407 105 619 1131

Dr. M. Ramadhan, S.E.,M.E.,Ak.,CA. Yohana Rusnayuda,S.Si.,Apt. Hj. Arfiah, S.Si.T

NIP.19691208 199803 1 003 NIP. 19790311 200501 2 015 NIP. 19680424 198803 2 012
Page 132
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
Page 133
KODE NAMA OBAT
1 2 3 4 5 6 7=(5+6) 8 9 10
1,580,040.00
UMUM
JUMLAH
251 384 446 1081

NIP.19701124 199101 1 004 NIP. 19790311 200501 2 015 NIP. 19821117 201101 2 005
Page 134
N OBAT
BULAN 0 8 LB2
TAHUN 2 0 2 2
11 12=(7-8-10) 13 14 15 16 17 18
- - - - POPM
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 10
- - - -
- - - -
- - - -
- 2 215,600.00 (2) 2
- - - - 10
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 5
- - - -
- 1 154,000.00 (1)
- 1 531,000.00 (1)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
Page 135
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- - - -
- - - -
- 1 137,500.00 (1)
- - - -
- 2 55,000.00 (2)
- - - -
- - - -
- - - -
- - - -
- 1 93,170.00 (1)
- - - -
- - - -
- - - - 5
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 10
- - - -
- - - -
- 1 24,645.00 (1)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- 1 2,189,000.00 (1) 1
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
Page 136
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - 2
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
Page 137
11 12=(7-8-10) 13 14 15 16 17 18
- - - -
- - - - 1
- - - -
- - - -
- - - -
- - - -
- - - -
- 1 203,046.00 (1)
REAGEN CAIR 3,602,961.00
Total sisa stock 133,518,043
Yang Menerima
Petugas Puskesmas
Aulia Rahmah, S.Farm., Apt.

3 2 012 NIP. 19940728 201903 2 021
Page 138
11 12=(7-8-10) 13 14 15 16 17 18
Page 139
11 12=(7-8-10) 13 14 15 16 17 18
REAGEN
#REF!
- #REF!
Yang Menerima
Petugas Puskesmas

1 2 005 NIP. 19940728 201903 2 021
Page 140
PEMAKAIAN SUB
PUSKESMAS
PEMAKAIAN
PERSEDIA
NO NAMA OBAT SATUAN AN POSYA P.LANSIA/
GUDANG NDU PP LAB PONED
PUSLING
I. OBAT
A BAHAN KIMIA CAIR
ABX M Noclair Horiba botol -
ABX Mni Clean Horiba botol -
ABX Mni Lyse LMG Horiba botol -
ABX Mni Oil LMG Horiba botol -
ACS level I (control serum) botol -
Aquadest steril botol 500 ml -
B30 Control Hematology Analyzer Mindray botol -
Biolarvasida untuk pengendalian jentik nyamuk botol 30 ml -
Blood Analisir Clianac Detergen (Nihon kohden) botol -
Blood Analisir Clianac Detergen (norma clean NK) botol -
Blood Analisir Hemolinac 3N Lysing (nihon kohden) botol -
Blood Analisir Hemolinac 3N Lysing (norma lyse NK) botol -
Blood Analisir Isotonac 3 Diluent (nihon kohden) botol -
Blood Analisir Isotonac 3 Diluent (norma diluent NK) botol -
Carbol gentian violet botol -
Cetride 5 Liter galon -
Chlodine 0,5 % handrub btl 5 L 4
Clorheksidin 2,5 % botol -
Control hematologi (norma) set -
Cynoff 25 UL galon -
Etanol 70 % 1 Liter botol 2
Etanol 70 % 100 ml botol -
Gliserol 98% jerigen/5 L -
Klorin botol -
Kontrol darah agappe botol -
kontrol norma high botol -
Kontrol norma low botol -
Kontrol norma normal botol -
Larutan Alkohol 95 % botol -
Larutan Alkohol 96 % jerigen/20 L -
Larutan Alkohol 96 % botol -
Larutan alkohol aseton botol -
Larutan amonium oksalat botol -
Larutan Anisol botol -
Larutan antiseptik (Aseptan) botol -
PEMAKAIAN
PERSEDIA
PUSLING
Larutan Asam asetat 5% botol -

Larutan Asam klorida 0,1 N botol 1
Larutan Asam sulfosalisilat 20 % botol 1
Larutan Barium Klorida botol -
Larutan Benedict botol -
Larutan Buffer Fosfat botol -
Larutan Developer botol -
Larutan Edta 10% botol -
Larutan Eosin 2 % botol -
Larutan Etanol Asam botol -
Larutan Eter alkohol botol -
Larutan Fixer botol -
Larutan Foucet botol -
Larutan Giemsa Sain botol -
Larutan hayem botol 1
Larutan Hidrogen Peroksida botol -
Larutan Iodium 1 % botol 2
Larutan Karbol Fuksin botol -
Larutan KOH 10 % botol -
Larutan KOH 20 % botol -
Larutan Lugol 1 % botol -
Larutan Metilen Biru botol 1
Larutan Natrium Citrat 3,8 % botol -
larutan safranin botol -
Larutan sodium hipoklorid 1 L botol -
Larutan sodium hipoklorid 100 ML botol -
Larutan Turk botol -
Larutan Xylol botol -
M Notrol 16 Twin-2M Merek Horiba pack -
M-30 CFL LYSE 500 ML Mindray botol -
M-30 DILUENT Mindray botol -
M-30 E-Z Cleanser Mindray botol -
M-30 PROBE CLEANSER Mindray botol -
M-30 RINSE Mindray botol -
Medicare 0,5% TPCL antiseptik botol 500 ml -
Medonic Diluent 20 L botol -
Medonic Lyse 5 L botol -
Metanol botol 1
NaOcl 2,5 % untuk sal irigasi botol -
Norma cleaner / solution 3 diff botol -
Norma diluent diff / norma dil-3-diff botol -
Norma lyse diff / norma lyse-3-diff botol -
PEMAKAIAN
PERSEDIA
PUSLING
Oil Imersi botol -

One clean 1 Liter OM botol -
Pewarnaan Gram 1 % botol -
Reagen albumin agappe / mindray kit -
Reagen Albumin biosystem kit -
Reagen Albumin BT Diagnostik / Albumin Bromcresol Green,e kit -
Reagen Albumin randox kit -
Reagen Asam Urat agappe / mindray kit -
Reagen Asam Urat biolabo kit -
Reagen Asam Urat biosystem kit (1X50ml) -
Reagen asam urat BT Diagnostik kit -
Reagen Asam Urat randox kit -
Reagen Bilirubin Direct agappe / mindray kit -
Reagen Bilirubin Direct biosystem kit -
Reagen Bilirubin Direct randox kit -
Reagen Bilirubin Total agappe / mindray kit -
Reagen Bilirubin Total biosystem kit -
Reagen Bilirubin Total randox kit -
Reagen Cholesterol agappe / mindray kit 1
Reagen Cholesterol Biolabo kit -
Reagen Cholesterol biosystem kit -
Reagen Cholesterol BT Diagnostik kit -
Reagen Cholesterol HDL agappe / mindray kit -
Reagen Cholesterol HDL Biolabo kit -
Reagen Cholesterol HDL biosystem kit -
Reagen Cholesterol HDL BT Diagnostik kit -
Reagen Cholesterol HDL randox kit -
Reagen Cholesterol randox kit -
Reagen Creatinin agappe / mindray kit -
Reagen Creatinin biosystem kit -
Reagen Creatinin BT Diagnostik kit -
Reagen Creatinin randox kit -
Reagen Creatinine biolabo kit -
Reagen Elitrol 1 Normal 1 x 5 ml (elitech) kit -
Reagen Glucose agappe / mindray kit -
Reagen Glucose biosystem kit -
Reagen Glucose PAP randox kit -
Reagen Glukosa biolabo kit -
Reagen Glukosa BT Diagnostik kit -
Reagen golongan darah set-2 -
Reagen golongan darah set-4 -
Reagen HB Cyanida botol -
PEMAKAIAN
PERSEDIA
PUSLING
Reagen HB konsentrat biosystem kit -

Reagen HB konsentrat randox kit -
Reagen Protein Total agappe / mindray kit -
Reagen Protein Total biosystem kit -
Reagen Protein Total randox kit -
Reagen SGOT / AST Biolabo kit -
Reagen SGOT / AST biosystem kit -
Reagen SGOT / AST Mindray kit -
Reagen SGOT / AST randox kit -
Reagen SGOT BT Diagnostik kit -
Reagen SGPT / ALT biolabo kit -
Reagen SGPT / ALT biosystem kit -
Reagen SGPT / ALT mindray kit -
Reagen SGPT / ALT randox kit -
Reagen SGPT BT Diagnostik Kit -
Reagen Trigliseride biolabo kit -
Reagen Trigliseride biosystem kit -
Reagen Trigliseride BT Diagnostik kit -
Reagen Trigliseride mindray kit -
Reagen Trigliseride randox kit -
Reagen Urea Mindray kit -
Reagen Ureum Biolabo kit -
Reagen Ureum biosystem kit -
Reagen Ureum BT Diagnostik kit -
Reagen Ureum randox kit -
Reagen Wright Stain botol -
reagent cholesterol pap sl (microlab/elitech) kit -
reagent cholesterol pap sl (microlab/elitech) + std kit -
reagent cholesterol standar 200 mg/dl (microlab/elitech) kit -
reagent glucose pap sl (microlab/elitech) +std kit -
reagent glucose standar 100 mg/dl (microlab/elitech) kit -
reagent trigliserid mono sl (microlab/elitech) kit -
reagent trigliserid mono sl (microlab/elitech) + std kit -
reagent trigliserid standar 200 mg/dl (microlab/elitech) kit -
reagent uric acid mono sl (microlab/elitech) kit -
reagent uric acid standar (microlab/elitech) kit -
Res eker botol -
RPR syfilis Fokus Diagnostik kotak -
RPR syfilis randox botol -
Serum kontrol mindray (Qualichek normal mindray) botol -
Spiritus 1 L botol -
Swelab alfa diluent 20 L botol -
PEMAKAIAN
PERSEDIA
PUSLING
Swelab alfa lyse 5 L botol -

Viorex liquid 4 % 5 L galon -
Widal tes 6 set 6 set -
Widal tes 4 set (AO,BO,O,H) 4 set -
Ziehl Nielseen Stain paket 1
PEMAKAIAN SUB UNIT & APOTEK REAGEN CAIR
APBD BULAN 0
TAHUN 2

DALUARS STOK AKHIR
STOK OF KUMULATIF REGISTER
APOTEK PP LAB PONED APOTEK NAME (SR)
GUDANG
I
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
4 0 4 -
0 -
0 -
0 -
2 0 2
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
DALUARS STOK AKHIR
GUDANG
I
0 -
1 0 1
1 0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 0 1
0 -
2 0 2
0 -
0 -
0 -
0 -
1 0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 0 1
0 -
0 -
0 -
0 -
DALUARS STOK AKHIR
GUDANG
I
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 0 1
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
DALUARS STOK AKHIR
GUDANG
I
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
DALUARS STOK AKHIR
GUDANG
I
0 -
0 -
0 -
0 -
1 0 1
8
0 2 2
STOK AKHIR SELISIH

KET
0 - Program POPM
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
2 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
STOK AKHIR SELISIH
KET
0 -
1 -
1 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 -
0 -
2 -
0 -
0 -
0 -
0 -
1 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 -
0 -
0 -
0 -
0 -
STOK AKHIR SELISIH
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
STOK AKHIR SELISIH
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
STOK AKHIR SELISIH
KET
0 -
0 -
0 -
0 -
1 -

Bry Lplpo Agt 22

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Bry Lplpo Agt 22

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

KODE PUSKESMAS : 17010407

SATU HARGA STOK PENERI PERSE PEMAKAIAN RUSAK / E.D/REALOKASI

Domperidon Suspensi 5 mg/5 ml botol Rp 4,312.00 61 0 61 15 64,680

Pedialyte botol Rp 34,100.00 18 0 18 2 68,200

RUSAK / E.D/REALOKASI SISA STOK STOK PERMIN PEMBERIAN

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Rp JUMLAH Rp OPT TAAN APBD PROG KET

577,500 OBAT CAIR 24,089,248.55

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Ampisilin serbuk injeksi i.m.i.v 1000 mg/ml vial 3

Benzatin Benzil Penisilin inj 1,2 juta iu/vial vial -

Cendo Lyteers tetes mata botol -

Deksametason inj 5 mg/ml-1 ml ampul 18

Dextamin sirup botol -

Epinefrin Hcl/Bitartrat(adrenalin)inj 0,1 %-1 ml ampul -

Glukosa larutan infus 10 % steril botol -

Mycamine/micafungin 50 mg inj ampul -

Pirantel suspensi 5 mg/ml botol -

Povidon Iodida Larutan 60 ml botol 3

Fitomenadion ( vit k 1 ) inj 2 mg / ml - 1 ml ampul -

PEMAKAIAN STOK AKHIR

KODE PUSKESMAS : 17010407

SATU HARGA STOK PENERI PERSE PEMAKAIAN RUSAK / E.D/REALOK

Mengetahui/Menyetujui Yang Menyerahkan Yang Menerima/Melapor

RUSAK / E.D/REALOKASI SISA STOK STOK PERMIN PEMBERIAN

Rp JUMLAH Rp OPT TAAN APBD PROG KET

- 180 165,600.00 (180) POPM

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Rp JUMLAH Rp OPT TAAN APBD PROG KET

- OBAT PADAT 25,891,755.53

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Rp JUMLAH Rp OPT TAAN APBD PROG KET

Achmadiyah Aulia Rahmah, S.Farm., Apt.

Alprazolam 0,5 mg tablet -

Aminofilin tablet 200 mg tablet -

Antasida doen tablet kombinasi tablet 3,375 120 40 320

Antimigrain doen kombinasi tablet -

Asam Folat 1 mg tablet tablet 760 170

Asam Folat 5 mg tablet tablet -

Asam Traneksamat 500 mg kapsul (nexitra) kapsul 304

Asiklovir 400 mg tablet tablet -

Buscopan tablet tablet -

Clopidogrel 75 mg tablet tablet 990

Glimepirid tab 1 mg tablet 900

Glukosamin 250 mg tablet (osmin) tablet -

Haloperidol tablet 0,5 mg tablet -

Kaptopril 25 mg tablet tablet 2,165

Klindamisin 150 mg tablet tablet 8

Klorokuin 150 mg tablet tablet 60

Levofloksasin tab 500 mg tablet tablet -

Longatin 25 mg tablet 100

Lorazepam (Merlopam) 2 mg tablet tablet -

Meloxikam 7,5 mg tablet tablet 920 55

Natrium Diklofenak tablet 50 mg tablet 840 10 10

Natrium Tiroksin (Levotiroksin) tablet 100 mg (Euthyrox) tablet -

Nistatin 500.000 iu /g tablet salut tablet -

Obat anti TBC FDC Kategori harian paket 1

Ondansetron tab 4 mg tablet 480