DINAS KESEHATAN KABUPATEN TOJO UNA UNA

JL.SULTAN HASANUDDIN NO. 119

SURAT BERITA BARANG KELUAR OBAT / BMHP KE PUSKESMAS MATAKO

SBBK : 197 /XI DAK/ IFK/DINKES TOUNA

SUMBER ANGGARAN DAK
DISTRIBUSI TW IV

NO NAMA OBAT / ALKES SATUAN JUMLAH NO BATCH EXP HARGA TOTAL HARGA

1 2 3 7 15 16 19 20
1 Acyclovir tablet 200 mg Tab 500 0 Rp 607 Rp 303,500
2 Alat suntik sekali pakai 3 ml Piece 500 0 01 February 2025 Rp 939 Rp 469,500
3 Alat suntik sekali pakai 5 ml Piece 300 0 01 June 2022 Rp 993 Rp 297,900
5 Amlodipin Kaplet 10 mg Kap 5000 J12741 01 March 2024 Rp 74 Rp 370,000
6 Amlodipin Tablet 5 mg Tab 33000 F20311BJ JUNI 2027 Rp 55 Rp 1,815,000
7 Amoksisilin Kaplet 500 mg Tab 8000 TAMXB23093 31/03 /2024 Rp 231 Rp 1,848,000
8 Antrain Injeksi (norages) Ampul 30 0 01 May 2024 Rp 1,350 Rp 40,500
9 Asam Askorbat Tablet 50 mg Tab 4000 0 May-25 Rp 46 Rp 184,000
10 Asam Traneksamat 500 mg Tab 1000 0 Feb-23 Rp 2,697 Rp 2,697,000
11 Asam Mefenamat Kaplet 500 Mg Kap 12000 0 01 June 2023 Rp 117 Rp 1,404,000
12 Acetar(ACERING) botol 100 0 Rp 9,592 Rp 959,200
13 Betahistin tab 6 mg Tab 6000 0 Rp 92 Rp 552,000
14 Betametazon slp tube 800 0 juni 2024 Rp 1,520 Rp 1,216,000
15 Becefort Tab Tab 5000 0 Aug-25 Rp 1,485 Rp 7,425,000
16 Biocombin Inj AMPL 200 0 Jul-23 Rp 7,492 Rp 1,498,400
17 Biocombin Tab (BIOMEC-C) Tab 1000 0 Rp 2,172 Rp 2,172,000
18 Caviplex Tab 500 0 Jul-24 Rp - Rp -
19 Cendoxitrol Tetes mata Botol 20 0 Rp 41,208 Rp 824,160
20 Curcuma FCT (Cavicur) Tab 1000 0 Jun-24 Rp 931 Rp 931,000
21 Channafit Syr 100 ml botol 96 360622032 30 JUNI 2024 Rp 77,700 Rp 7,459,200
22 Dimenhidrinat Tablet 50 Mg Tab 2000 B10009N 01 February 2023 Rp 109 Rp 218,000
23 Diphenhidramin Injeksi 10 mg/ml Ampul 30 463420171 Nov-23 Rp 825 Rp 24,750
24 Divalprox Sodium Kap 100 53C0745 mei 2024 Rp 3,200 Rp 320,000
25 Eflin (quantidex) Tab 500 0 Rp 1,873 Rp 936,500
26 Elastis Ferban Rool 20 2207315 19 July 1905 Rp 29,910 Rp 598,200
27 Enbatik salep OINT10 G/TUBE tube 50 0 01 May 2023 Rp 11,286 Rp 564,300
28 Etyl Clorida Spray Botol 5 0 01 May 2023 Rp 337,500 Rp 1,687,500
29 Ergotamine Coffeine Tab 500 0 Rp 675 Rp 337,500
30 Gabapentin Tab 200 0 Rp 11,988 Rp 2,397,600
31 Griseofulvin Tablet 500 mg Tab 1000 0 Rp 1,919 Rp 1,919,000
32 Guagifenesin 100 Mg Tab 10000 0 JULI-24 Rp 121 Rp 1,210,000
33 Herbakof BTL 432 0 Rp - Rp -
34 Handscond No. 7 Steril psg 400 0 MARET-26 Rp 5,900 Rp 2,360,000
35 Handscond No. 7,5 Steril psg 400 0 Apr-26 Rp 5,900 Rp 2,360,000
36 Handscond non steril exam Glove L box 30 0 Rp 75,000 Rp 2,250,000
37 Handscond non steril exam Glove M box 30 0 JUNI-26 Rp 75,000 Rp 2,250,000
38 Hidroklorotiazid Tablet 25 Mg Tab 500 H11164DJ MARET 2027 Rp 148 Rp 74,000
39 Hidrokortison Krim 2,5 % Tube 96 J1293W OKT-25 Rp 2,335 Rp 224,160
40 Ichtyol 10 % Pot 48 0 Rp 7,938 Rp 381,024
41 Infusion Set Dewasa Piece 100 E.50349 OKTOBER 2026 Rp - Rp -
42 IV Catheter Pen Type Size 20 G ( JELCO 2 Piece 200 4043826 01 September 2025 Rp 6,962 Rp 1,392,400
43 IV Catheter Pen Type Size 22 G (Abocath) Piece 50 4054755 01 September 2025 Rp 6,962 Rp 348,100
44 IV Catheter Pen Type Size 16 G(Abocath) Piece 50 77102H30H AGUST-26 Rp 7,920 Rp 396,000
48 Kasa Hidrofil DRC 36 M X 80 Cm Roll 1 0 25/07/27 Rp 121,330 Rp 121,330
49 Kloramphenicol tetes telinga (RECOEAR Botol 100 0 Rp 11,583 Rp 1,158,300
50 Kloramphenicol tetes Mata (RECO EYE Botol 100 0 Rp 23,076 Rp 2,307,600
51 Kodein tablet 10 mg Tab 100 G12171J JULI-25 Rp 605 Rp 60,500
52 Larutan PK Botol 24 0 Rp 2,430 Rp 58,320
53 Lidocain 2 % Injeksi Ampul 1000 563620391 MEI 2026 Rp 891 Rp 891,000
55 Loratadin tab 500 TLRTB10610 31 MARET 2026 Rp 117 Rp 58,500
56 Metilprednisolon 4 mg TAB 1000 HTMS022349 Apr-24 Rp 102 Rp 102,000
57 Metocloparamide syr Botol 100 0 Rp 24,300 Rp 2,430,000
58 Mikonazole Salep 2% Tube 240 0 01 May 2025 Rp 1,900 Rp 456,000
59 Natrium Diklofenak Tablet 25 Mg Tab 5500 D13236J MARET 2027 Rp 114 Rp 627,000
60 Nebulizer Mask anak pcs 10 0 Rp 10,372 Rp 103,720
61 Nifedipin 10 Mg Tab 500 0 Rp 233 Rp 116,500
62 Novadiar Syrup Botol 120 0 Rp 5,154 Rp 618,488
63 Novadryl syr 60 ml (OBH) botol 120 0 01 July 2025 Rp 4,522 Rp 542,640
64 Oxyvit Kaplet 1800 0 maret 2024 Rp 2,035 Rp 3,663,000
65 Oksitetrasiklin salep kulit 3% Tube 200 0 01 June 2023 Rp 3,746 Rp 749,200
66 Omeprazol Kapsul 20 mg Kapsul 4000 KOPZB20710 MEI 2024 Rp 129 Rp 516,000
67 Ondansetron Injeksi 4 Mg Ampul 100 0 Rp 963 Rp 96,300
68 Pacdin cough botol 96 0 Rp - Rp -
69 Papaverin tab 500 0 Rp 405 Rp 202,500
70 Piracetam 400 mg Tab 500 0 Rp 737 Rp 368,500
71 Piroxicam 10 mg Tab 5000 0 01 July 2023 Rp 135 Rp 675,000
72 Ranitidin Tablet 150 mg Tab 1600 52K4183 Oct-23 Rp 85 Rp 136,000
73 Ryles(mag slang) pcs 10 0 Rp 4,716 Rp 47,160
74 Salep whitfield's @ 30 gram( salisilk acid,b Pot 200 G17201(956)K37108(44) 07 2025/11 2024 Rp 12,150 Rp 2,430,000
75 Striatamin Tab 1980 340422006 30 JUNI 2024 Rp - Rp -
76 Scopamin Inj 20 Mg / Ml Ampul 100 0 Rp 614 Rp 61,400
77 Selkom C Kap 5000 0 Rp 614 Rp 3,070,000
78 Siticolin 500 mg Tab 480 0 Rp 9,990 Rp 4,795,200
79 Simvastatin 10 mg Tab 2000 HTSUND22554 01 April 2024 Rp 73 Rp 146,000
80 Simvastatin 20 mg Tab 5000 E202926/E20292B 4/1/2024-JUNI 2024 Rp 150 Rp 750,000
81 Siprofloksasin Tablet 500 mg Tab 5000 0 Rp 260 Rp 1,300,000
82 Stimuno syrup 60 ml Botol 500 0 01 October 2023 Rp 28,374 Rp 14,187,000
83 Sodium Valproate Botol 20 0 Rp 12,752 Rp 255,040
84 Truvit Syrup Botol 120 0 Rp 23,760 Rp 2,851,200
85 Ventolin Nebulizer Ampul 40 FV0709 Nov-23 Rp 12,825 Rp 513,000
139448 Rp 101,179,792

Yang Menerima Ampana, 18 November 2022

AN. Penanggung Jawab
Gudang Farmasi Dinas Kesehatan
Kabupaten Tojo Una Una

Lutfi Lami,A.Md Far

Nip. 19831007 200902 1 001

Mengetahui
Kepala Bidang SDMK
Kabupaten Tojo Una Una

Ancerudin, SKM
Nip. 19730515 199402 1003